Clinical pediatrics
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This case discussion is part of the Integrating Basic Science Into Clinical Teaching Initiative. It examines the presentation of altered mental status and describes the underlying physiology, which explains the basic laboratory findings in an attempt to reach a diagnosis. This article describes a 13-year-old boy who presented to the emergency department with altered mental status after being found unconscious and alone in an abandoned building. ⋯ Subsequent investigation confirms a diagnosis of ethanol toxic effects. An understanding of electrolyte and acid-base physiology allows the clinician to use basic laboratory studies to build a focused differential diagnosis for altered mental status. This case discussion demonstrates how basic science principles of anatomy and physiology can be applied in clinical settings.
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Clinical pediatrics · Mar 2009
Bicycle-related injuries among children and adolescents in the United States.
The objective of this study is to describe the epidemiology of bicycle-related injuries among children and adolescents 18 years and younger on a national level. This is a retrospective analysis of data from the National Electronic Injury Surveillance System of the US Consumer Product Safety Commission for patients 18 years and younger who were seen in emergency departments (EDs) between January 1, 1990, and December 31, 2005, for injuries received while operating a bicycle. ⋯ Children with head injuries were more than 3 (relative risk, 3.63) times as likely to require hospitalization and were almost 6 (relative risk, 5.77) times more likely to have their injuries result in death. The large number of annual bicycle related-injuries is evidence that prevention of these injuries should remain an important area of bicycle safety research and practice.