Biomedical subjects

P Schweich

Publications and source records attributed to P Schweich.

3 recordsLinked to original sources

PubMed1987

Afebrile pneumonitis in infants: predictors of outcome.

This study was performed to determine which elements of the history, physical examination, and laboratory data of infants with afebrile pneumonitis predict the need for hospitalization. We used a risk score based on clinical history and a respiratory score based on the respiratory physical examination, to assess 101 infants with afebrile pneumonitis in the emergency department. Admission and length of hospitalization were decided independently of the study. The population was divided into three groups depending on outcome: mild disease--outpatient management or hospitalization for up to 48 hours; moderate disease--three or more days of hospitalization; and severe disease--admission to the intensive care unit. Twenty-four infants were followed as outpatients. Seventy-seven children were hospitalized: 12 for 48 hours, and 61 for a mean of 4.5 days. Four children were admitted to the intensive care unit. Patients in group 2 versus group 1 were significantly younger and sicker on initial examination, as evidenced by a worse average respiratory score, general appearance, and severity of retractions. Other parameters, including risk score, did not predict course of illness as measured by length of hospitalization. Respiratory physical examination, especially general appearance and severity of retractions, and young age are associated with a worse outcome in afebrile pneumonitis.

Blood Gas Analysis↗

PubMed1985

Rib fractures in children.

We reviewed the charts of 21 children admitted to the hospital with rib fractures to determine the cause of trauma, the relationship of the number and location of rib fractures to other injuries, the course of flail chest in children, and the frequency and characteristics of injuries caused by child abuse. Sixteen (76%) of 21 children were injured by accidental causes, most commonly by motor vehicles. However, five (24%) children were victims of child abuse. Nineteen children fractured an average of 3.5 ribs (range 1 to 8), while two other children fractured 22 and 23 ribs. Neither an increased number of fractures, nor first or second rib fractures were associated with more severe intrathoracic injuries. Two children with flail chest required intubation but recovered without further complications. The five children with nonaccidental rib fractures were young, had an unexplained history, and a paucity of multiple trauma. These characteristics should alert the physician to the possibility of child abuse in the patient with rib fractures.

Accidents, Traffic↗

PubMed1985

Human bites in children.

We studied 40 children aged four months to 18 years seen in the Emergency Department (ED) to determine the spectrum of human bites and the incidence of infection in treated and untreated wounds. Initial data concerning time elapsed until a physician examined the bite, site and size of the bite, whether the bite was infected when first seen, and whether antibiotics were prescribed, were obtained from the ED chart. Follow-up by phone or mail was available on 33 of the 40 children. The incidence of human bites was one in 600 visits. The commonest lesion was a superficial abrasion of the face, inflicted by another child. Twenty-nine of the 33 bites were uninfected when first seen; 13 of them received no antibiotics; and 16 received oral antibiotics. There was no significant difference in mean age, sex, site, or type of wound between these two groups. None of 13 untreated and one of 16 treated children developed an infection (P = NS). Four patients had infected wounds when first seen; three received oral antibiotics; and one was admitted for intravenous antibiotics. Of the three on oral antibiotics, two were subsequently admitted to the hospital. Conclusions. We came to the following conclusions at the end of the study. (1) The majority of human bites in children are superficial and do not become infected. (2) Antibiotics do not appear to be useful in prophylaxis for minor bite wounds seen shortly after injury. (3) Follow-up is necessary for all bite wounds, since serious infection may develop, or an established, seemingly minor infection may worsen.

Adolescent↗