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Biomedical subjects

J M Mayr

Publications and source records attributed to J M Mayr.

8 recordsLinked to original sources

Bunk beds--a still underestimated risk for accidents in childhood?

UNLABELLED: A retrospective analysis of 218 bunk-bed accidents and a random sample survey with 991 family interviews were performed in order to establish guidelines for bunk-bed accident prevention. Falls from the top bed during sleep (35.1%) or while playing (34.4%) and falling off the ladder (23.2%) are the leading causes of bunk-bed accidents. Of the 218 children, 91 (41.7%) had sustained major injuries, including 3 polytrauma, 7 skull fractures, 44 cerebral concussions, 33 long bone fractures, 2 Lisfranc injuries, and 2 lacerations of the spleen. Of these accidents, 58.3% resulted in minor injuries with 18 fractures in other locations than the long bones or cranial vault, 89 contusions and sprains, 18 skin lacerations and 2 tooth fractures. A total of 23.8% of the accidents occurred in children under 3 years of age. The random sample survey demonstrated that in relation to age groups of children 30.8% (0%-45.8%) of families interviewed had been using bunk beds, with peaks at 3 years (29.8%), 7 years (36.5%) and 11 years (45.8%) of age. Of these bunk beds, 75.3% were equipped with side-rails, 57.3% had placed carpets alongside the bunk bed and 43.0% had used night lights. CONCLUSION: There is only one recommendation: no bunk beds!!!

Accidents↗

Foam party risks.

Explore the source record for details and available documents.

Accidental Falls↗

Reconstruction of part of the distal tibial growth plate with an autologous graft from the iliac crest.

We describe the reconstruction of a defect of the medial malleolus which was the result of an accident in a ten-year-old child. A graft from the iliac crest, with the apophyseal cartilage and perichondrium, was used for reconstruction of the medial malleolus, the growth plate and the adjacent metaphyseal defect, respectively. The soft-tissue defect was covered with a free scapular flap with microvascular anastomosis. Three years after the injury stability of the ankle is excellent with adequate growth of the reconstructed epiphyseal plate.

Bone Transplantation↗

Morbidity and mortality of the short-bowel syndrome.

From 1976 to 1998 we have treated 17 neonates with short-bowel syndrome. Those 8 patients who had an intact ileocecal valve as well as the total colon preserved did significantly better than the 9 children without ileocecal valve and > 50% missing colon. In addition to the length of the intestinal remnants, motility had a major impact on the incidence of complications and final outcome. Four patients died (23.5%). All of them had an intestinal length of less than 30 cm, severe dysmotility, no ileocecal valve and an incomplete colon. The average duration of hospitalization of the children weaned from parenteral nutrition (n = 11) was 8.5 months. The majority of them still need supplementation of vitamins and/or trace elements. Two children suffer from recurrent d-lactic acidemia. Six children have a significant psychomotor developmental delay with three suffering from congenital cerebral abnormalities.

Bacterial Translocation↗

Undescended testicles: an epidemiological review.

In a retrospective study the records of 447 boys (median age 5 y, age range 2 wk to 12 y) undergoing orchidopexy in a university hospital paediatric surgical department over a 2-y period were analysed for epidemiological factors related to disturbed testicular descent by comparison with the notes of an equal number of otherwise healthy male trauma patients matched for age. There were higher rates of peripartal asphyxia and intrauterine growth retardation (reflected by lower birthweights in combination with equal gestational age distribution), more complicated deliveries, an increased incidence of congenital malformations and more frequent occurrence of a number of chronic diseases in the families of affected boys. First- and second-born boys were over-represented in the study group. A cyclical pattern for the month of birth is suggested by the data, but this did not reach statistical significance. Neither was any statistical difference found for premature delivery, the incidence of extra-uterine fertilization, hormonal treatment of the mother while pregnant, twin pregnancies, threatened or imminent abortions or parental age. The literature dealing with this topic was reviewed. Discrepancies between different studies can be explained, at least in part, by considering different forms of undescended testicles as different nosological entities that should be assessed separately in forthcoming research.

Abnormalities, Multiple↗

Highchair accidents.

In order to establish guidelines for highchair accident prevention we investigated causes, mode and complications of highchair accidents by the following methods: The charts of 103 children attending our Accident & Emergency department for highchair related injuries were studied retrospectively. Questionnaires were sent to the parents to obtain detailed information about the mode of accident. They were also asked to suggest preventive measures. In addition, a random sample survey was performed with 163 families inquiring about the rate of highchair use and the incidence of highchair related accidents. Of the 103 infants, 15.5% had sustained a skull fracture, 13.6% a brain concussion, 2.0% limb fractures and 68.9% a simple contusion of the head or lacerations to the scalp or face. The questionnaires were fully completed by 61.2% of parents. Every second family reported that their infant had tried to stand up in the highchair before falling off (only one child had been wearing a restraint). In a further 14.3% of accidents the highchair tipped over. Eighty-seven percent of parents would appreciate a pre-installation of restraints, 54.0% requested more informative instructions for users, and 33.3% asked for products with better stability. The random sample survey revealed a highchair use rate of 92%; 18% of families used highchairs equipped with restraints, and 6% reported highchair accidents sustained by their children. We conclude that most highchair accidents occur when unrestrained infants try to stand up. Pre-installed child restraints, better manuals for users and increased highchair stability should be recommended as promising accident prevention strategies.

Accidental Falls↗