Pediatric emergency care
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Pediatric emergency care · Dec 1992
Comparative StudyIron absorption from chewable vitamins with iron versus iron tablets: implications for toxicity.
The medical literature contains few, if any, reports of severe iron (Fe) poisonings from ingestion of chewable multivitamins with iron. One possible explanation for this observation is that iron from multivitamins is more poorly absorbed than iron from iron tablets. To compare iron absorption from multivitamins with iron absorption from ferrous fumarate tablets, male adult volunteers were given 6 mg of elemental Fe/kg body weight as chewable multivitamins with iron or as crushed ferrous fumarate tablets in a crossover study. ⋯ Statistical analyses demonstrated increased and more rapid absorption of Fe from the multivitamin preparation. These results suggest that iron is well absorbed from chewable multivitamins with iron and should theoretically have the potential for producing serious toxicity when taken in overdose. The reasons that such toxicity is not commonly seen clinically are discussed, and a plan for further investigation of this issue is proposed.
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The charts of 370 children under the age of two years who presented to a pediatric emergency department between September 1988 and August 1989 were reviewed. Twenty-seven patients (7% of the total) had injuries associated with child safety seat (CSS) misuse. Thirteen were infants and toddlers injured as motor vehicle occupants when improperly restrained--CSS harness not properly connected (8), use of an improper device (3), and CSS not anchored to the car seat (2). ⋯ Nine patients were hospitalized. Injuries associated with CSS misuse may be more common than previously recognized and can result in significant injury. Educational efforts should focus on correct usage.
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Pediatric emergency care · Dec 1992
Case ReportsTesticular torsion versus epididymitis: a diagnostic challenge.
Unlike the patient who presents with a potentially acute abdomen, the child or adolescent with a potentially acute scrotum cannot simply be observed. If testicular torsion is present, the testicle must be detorted and orchiopexy performed as soon as possible for fertility to be maintained. Torsion of the appendix testis, however, can usually be managed without surgery. ⋯ Any patient with an acute scrotal complaint and a negative scan should receive daily follow-up until the symptoms subside. Although our adolescent patient did well, his acute presentation and findings should have warranted immediate exploration. It is only through this aggressive approach that we can continue to increase testicular salvage rates.