1.Age group characteristics of children who visited the emergency department with acute poisoning by ingestion
Weon Seon RYU ; Jea Yeon CHOI ; Jin Seong CHO ; Yong Su LIM ; Sung Youl HYUN ; Hyuk Jun YANG
Pediatric Emergency Medicine Journal 2018;5(1):5-12
PURPOSE: To investigate the age group characteristics of children who visited the emergency department with acute poisoning by ingestion. METHODS: We reviewed children under 19 years who visited the emergency department for acute poisoning by ingestion from 2012 to 2017. The children were divided into 3 age groups; infants (0-1 years), preschoolers (2-5 years), and schoolers (6-18 years). Clinical characteristics, intentional ingestion, involved substances (drugs, household products, artificial substances, and pesticides), decontamination and antidote therapy, and outcomes of the 3 age groups were compared. We also performed multivariable logistic regression analysis to identify factors associated with hospitalization. RESULTS: A total of 622 children with acute poisoning by ingestion were analyzed. Their annual proportions to overall pediatric emergency patients ranged from 0.3% to 0.4%. Age distribution showed bimodal peaks at 0-2 years and 15-17 years. The infants showed lower frequency of girls, intentional ingestion, ingestion of drugs, performance of decontamination and antidote therapy, and hospitalization than 2 older groups (P < 0.001). Most decontamination, antidote therapy, and hospitalization occurred in the schoolers (P < 0.001). The most frequently reported substances were household cleaning substances in the infants (18.2%), antihistamines in the preschoolers (15.8%), and analgesics in the schoolers (37.5%). The factors associated with hospitalization were intentional ingestion (adjusted odds ratio [aOR], 7.08; 95% confidence interval [CI], 2.85-17.61; P = 0.001) and schoolers (aOR, 2.33; 95% CI, 1.10-7.53; P = 0.031; compared with infants). Only 1 in-hospital mortality was found in a boy aged 2 years who ingested methomyl. CONCLUSION: Infants may experience non-intentional ingestion, ingestion of non-pharmacologic substances (especially household cleaning substances), discharge without decontamination and antidote therapy more frequently than older children. Thus, we need age group-specific, preventive and therapeutic plans for children with acute poisoning.
Adolescent
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Age Distribution
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Analgesics
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Child
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Decontamination
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Eating
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Emergencies
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Emergency Service, Hospital
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Epidemiology
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Family Characteristics
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Female
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Histamine Antagonists
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Hospital Mortality
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Hospitalization
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Household Products
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Humans
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Infant
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Logistic Models
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Male
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Methomyl
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Odds Ratio
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Poisoning
2.Predictors of Outcome in Patients with Primary Achalasia Treated by Pneumatic Dilation.
Sun Jin SYM ; Hwoon Yong JUNG ; Chang Lae JO ; Hyung Suk JI ; Tae Il PARK ; Sa Rah PARK ; Ah Young KIM ; Seung Jae MYUNG ; Jin Sok RYU ; Suk Kyun YANG ; Hyun Kwon HA ; Weon Seon HONG ; Jin Ho KIM ; Young Il MIN
Korean Journal of Gastrointestinal Endoscopy 2002;25(4):187-191
BACKGROUND/AIMS: Pneumatic dilation is the most effective non-surgical treatment option for the patients with achalasia. The aim of this study was to determine the predictors of outcome after pnematic dilation in patients with primary achalasia. METHODS: Thrity-five patients with primary achalasia between May 1996 and April 2001 were included. They were divided into two groups; responder and nonresponder. Esophageal manometry, scintigraphy and barium esophagogram was performed before dilation and 4 weeks after dilation. RESULTS: Seven patients having symptomatic relapse were treated with repeated pneumatic dilation. Remaining 28 patients (83%) had no recurrence during follow-up period (mean duration 16 month, range 6~43 month). Among the factors evaluated in the initial examination, only young age affected outcome (p=0.039). The post treatment retention fraction at 5, 20 minutes were the most valuable factors for predicting the clinical response (p<0.05). CONCLUSIONS: Older patients are more likely to have sustained response. Radionuclide esophageal emptying test remains a useful objective study evaluating esophageal transit before and after pneumatic dilation in the patients with achalasia and may have an important role in the follow-up evaluation of treatment for achalasia.
Barium
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Esophageal Achalasia*
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Follow-Up Studies
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Humans
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Manometry
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Radionuclide Imaging
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Recurrence