PURPOSE: Increasing visit of children to emergency departments (EDs) necessitates the effort to expand pediatric emergency medicine resources. We conducted this study to understand the epidemiologic characteristics of children who visited a community hospital ED. METHODS: The medical records of 32,031 children aged younger than 18 years were reviewed retrospectively from January 2013 to December 2015. We analyzed the age distribution, season, day, and time of visit, cause of visit, test performed, initial diagnosis, injury mechanisms, and disposition. RESULTS: Mean age of the children was 6.2±5.1 years and boys accounted for 59.1%. Children who had disease (65.5%) and aged 1 to 4 years (41.9%) accounted for the largest population. There was no difference of age distribution through seasons (P = 0.07). The proportions of children with disease and injury were the highest during winter (72.5%) and autumn (38.2%), respectively (P < 0.001). Children tended to visit the ED more frequently during non-business hours. In particular, children who aged 1 to 4 years, had disease or were slight ill visited the ED more frequently during this period (P < 0.001). Plain abdomen radiographs and urinalyses were performed to 29.8% and 16.1% of the children, respectively. Functional gastrointestinal disorder (20.3%) and laceration (30.1%) were the most common initial diagnoses among the children with disease and injury, respectively. The most common injury mechanism was struck injury (29.7%). After the treatment, 94.4% of the children were sent home from the ED. Of the remaining children, 5.5% were admitted, 0.1% were transferred to other hospitals, and 0.04% expired. CONCLUSION: Children who aged 1 to 4 years, had disease or were slight ill visited the ED more frequently during non-business hours than business hours. Pediatric emergency medicine resources should be expanded in consideration of this.
Abdomen ; Age Distribution ; Child* ; Commerce ; Diagnosis ; Emergencies* ; Emergency Medicine ; Emergency Service, Hospital* ; Epidemiology ; Gastrointestinal Diseases ; Hospitals, Community ; Humans ; Lacerations ; Medical Records ; Retrospective Studies ; Seasons ; Urinalysis ; Urinary Tract Infections

Background: High circulating levels of dioxins and dioxin-like chemicals, acting via the aryl hydrocarbon receptor (AhR), have previously been linked to diabetes. We now investigated whether the serum AhR ligands (AhRL) were higher in subjects with metabolic syndrome (MetS) and in subjects who had developed a worsened glucose tolerance over time. Methods: Serum AhRL at baseline was measured by a cell-based AhRL activity assay in 70-year-old subjects (n=911) in the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) study. The main outcome measures were prevalent MetS and worsening of glucose tolerance over 5 years of follow-up. Results: AhRL was significantly elevated in subjects with prevalent MetS as compared to those without MetS, following adjustment for sex, smoking, exercise habits, alcohol intake and educational level (P=0.009). AhRL at baseline was higher in subjects who developed impaired fasting glucose or diabetes at age 75 years than in those who remained normoglycemic (P=0.0081). The odds ratio (OR) of AhRL for worsening glucose tolerance over 5 years was 1.43 (95% confidence interval [CI], 1.13 to 1.81; P=0.003, continuous variables) and 2.81 (95% CI, 1.31 to 6.02; P=0.008, in the highest quartile) adjusted for sex, life style factors, body mass index, and glucose. Conclusion These findings support a large body of epidemiologic evidence that exposure to AhR transactivating substances, such as dioxins and dioxin-like chemicals, might be involved in the pathogenesis of MetS and diabetes development. Measurement of serum AhRL in humans can be a useful tool in predicting the onset of metabolic disorders.

Background: High circulating levels of dioxins and dioxin-like chemicals, acting via the aryl hydrocarbon receptor (AhR), have previously been linked to diabetes. We now investigated whether the serum AhR ligands (AhRL) were higher in subjects with metabolic syndrome (MetS) and in subjects who had developed a worsened glucose tolerance over time. Methods: Serum AhRL at baseline was measured by a cell-based AhRL activity assay in 70-year-old subjects (n=911) in the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) study. The main outcome measures were prevalent MetS and worsening of glucose tolerance over 5 years of follow-up. Results: AhRL was significantly elevated in subjects with prevalent MetS as compared to those without MetS, following adjustment for sex, smoking, exercise habits, alcohol intake and educational level (P=0.009). AhRL at baseline was higher in subjects who developed impaired fasting glucose or diabetes at age 75 years than in those who remained normoglycemic (P=0.0081). The odds ratio (OR) of AhRL for worsening glucose tolerance over 5 years was 1.43 (95% confidence interval [CI], 1.13 to 1.81; P=0.003, continuous variables) and 2.81 (95% CI, 1.31 to 6.02; P=0.008, in the highest quartile) adjusted for sex, life style factors, body mass index, and glucose. Conclusion These findings support a large body of epidemiologic evidence that exposure to AhR transactivating substances, such as dioxins and dioxin-like chemicals, might be involved in the pathogenesis of MetS and diabetes development. Measurement of serum AhRL in humans can be a useful tool in predicting the onset of metabolic disorders.