Archives of disease in childhood
-
The 'white-eyed' blowout fracture is an orbital injury in children that is commonly initially misdiagnosed as a head injury because of predominant autonomic features and lack of soft-tissue signs. We present five patients who presented with nausea and vomiting following an apparent mild head or facial injury. None of the five had any external evidence of injury. ⋯ CT examination demonstrated an inferior orbital wall fracture in all cases with entrapment of the inferior rectus muscle. Each patient underwent surgical repair, two within 48 h of their injury, both of whom achieved complete recovery of ocular movements, while three were delayed beyond 48 h, with a resulting residual limitation of upgaze in all. It is, therefore, important for clinicians to be aware of this condition, so that it can be diagnosed early in order for early surgical release to be performed, which is associated with an excellent prognosis.
-
To investigate a reported rise in the emergency hospital admission of children in England for conditions usually managed in the community. ⋯ The continuing increase in very-short-term admission of children with common infections suggests a systematic failure, both in primary care (by general practice, out-of-hours care and National Health Service Direct) and in hospital (by emergency departments and paediatricians), in the assessment of children with acute illness that could be managed in the community. Solving the problem is likely to require restructuring of the way acute paediatric care is delivered.
-
To determine the agreement of fingertip and sternum capillary refill time (CRT) in children. ⋯ Measurements of CRT taken at the fingertip and sternum are not comparable. Fingertip CRT was faster than sternum CRT. Normal CRT is 2-3 s. The current study questions the usefulness of CRT in the assessment of circulation in children.
-
Comparative Study
Trends in body mass index distribution and prevalence of thinness, overweight and obesity in two cohorts of Surinamese South Asian children in The Netherlands.
Asians have a smaller muscle mass and a larger fat mass at the same body mass index (BMI) than most other ethnic groups. Due to a resulting higher cardiometabolic risk, the BMI cut-offs for overweight and obesity were lowered for adults. For Asian children universal criteria apply. The objectives of this study were to determine the normal BMI distribution and assess the BMI class distribution in a reference cohort of affluent South Asian children born before the obesity epidemic and to assess the influence of the obesity epidemic on the distributions. ⋯ The low mean BMI Z-score and high prevalence of thinness are likely expressions of the characteristic body composition of South Asians. Universal BMI cut-offs should be applied carefully in South Asian populations as thinness prevalence is likely to be overestimated and obesity underestimated. The development of ethnic specific cut-offs is recommended.