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S Renier

Publications and source records attributed to S Renier.

At least 19 recordsLinked to original sources
PubMed2004

[Poisoning in first year of age. A multicentre study].

AIM: The aim of this study is to describe clinical and epidemiological features of toxic exposures in children under 1 year. METHODS: During 2001 a prospective study on poisoning was carried out in the Pediatric Emergency Departments (ED) of 14 hospitals. Information stored concerned epidemiological and clinical features, evaluation of accidental or deliberate manner of exposure as well as of clinical consequences. Data were compared with those registered in 1-4 year-old patients. RESULTS: During 2001 out of 1,026 children registered, 111 (10.8%) were under 1 year. Exposure occurred exclusively at home and by accident. As compared to 1-4 year-old patients, children exposures were more frequently due to parental errors (38.7% of cases vs 7.3%), and involved plant poisons (22.5% vs 7.3%). In 1/3 of these cases the cause was due to non-toxic exposures, in another 1/3 an early treatment avoided clinical consequences. In the other cases, symptoms were of low to moderate severity, only in 1 case they were serious. No deaths occurred. One out of every 3 children was admitted, the others were sent home directly from ED (23.4%) or after a short observation period (44.1%). CONCLUSION: The increase in poisoning in children under 1 year, as compared to previous multicentre studies, is deserving of concern. In spite of the relatively low severity they are completely preventable. The study shows that information on poisons prevention for parents needs to be improved to prevent exposure of children under 1 year to toxic substances at home.

Accidents, Home↗
PubMed1998

Childhood poisoning: a population study in Trieste, Italy, 1975-1994.

We describe the epidemiology of 1918 cases of childhood poisoning referred to the emergency room in Trieste, Italy, from 1975 to 1994. The incidence rate of emergency room referral and subsequent hospitalization was calculated on the basis of the distribution of children resident in Trieste by calendar year. The occurrence of childhood poisoning was described according to time trends, age and gender of the child, route of exposure, symptoms at presentation to the emergency room, role of the child or others, intention, and substance involved in the poisoning. The association between presence of symptoms and characteristics of referral, host factors and substances involved was evaluated by estimating the odds ratio in multivariate models. Possible determinants of the clinical decision to treat certain cases were evaluated using logistic regression. Despite an increasing incidence of referral (from 155 per 100,000 persons per year in 1975-79 to 352 per 100,000 in 1990-94), hospital admission rates showed a two-fold decrease. Younger children (age 0-4 years) were more likely to be asymptomatic and required treatment and hospitalization less often than older children (age > or = 10 years). Trends show a decrease in pharmaceutical poisonings due probably to the introduction of child-resistant containers and an increase in domestic poisons. We also observed a steady increase in carbon monoxide inhalation and alcohol poisonings, mostly among teenagers.

Adolescent↗
PubMed1997

Cervical lymph node metastasis from an unknown primary: is a tonsillectomy necessary?

PURPOSE: The detection of an infraclinical primary by tonsillectomy in case of cervical lymph node of an epidermoid carcinoma with unknown primary after a radical neck dissection, allows avoiding irradiation of the normal larynx. The aim of this study is to quantify the rate of tonsil primary to justify this procedure. METHODS AND MATERIALS: From 1969 to 1992, 87 patients had a tonsillectomy as part of the workup for cervical nodal metastasis of an epidermoid carcinoma with unknown primary. The mean age was 57 years (range: 39-75 years) and the sex ratio was 8.6. Sixty-seven patients had a single cervical adenopathy (17 N1, 30 N2a, 5 N3, 15 Nx), and 20 patients multiple cervical adenopathies (17 N2b, 3 N2c). The treatments included always an irradiation to the node areas (50 Gy), and to the pharyngolarynx in case of normal tonsil (50 Gy), or to the tonsil if it was the primary (50 Gy with a brachytherapy boost of 20-25 Gy). In this last case, the larynx could be protected. RESULTS: Tonsillectomy never induced specific complication. Out of 87 patients, 26% had a tonsil primary. There was not specific histological differentiation in this group. In the 67 patients with a single cervical adenopathy, 31% had a tonsil primary (6 N1, 7 N2, 1 N3, 7 Nx). It was a subdigastric adenopathy in 38%, a submandibular in 28% and a midjugulocarotidian in 23%. Among the 17 patients N2b, none had a tonsil primary. In the three patients N2c, two presented a tonsil carcinoma (two subdigastric nodes). CONCLUSION: Tonsillectomy allows avoiding irradiation of normal larynx in 26% of patients who have a cervical lymph node with unknown primary. It should be performed in case of a single node of the subdigastric, midjugulocarotidian or submandibular area or bilateral subdigastric adenopathies.

Adult↗
PubMed1995

[Evaluation of temporary observation and short hospital stay in a pediatric emergency department].

Temporary observation is a very short stay in Emergency Department, widely carried out in adult patients in our Country. No experience in childhood has been reported. In our emergency department children under 16 with acute diseases are admitted for 24-48 hours. From 1991 we carried out also temporary observation. Its effectiveness has been evaluated by studying our activity in 1992 (14.574 emergency room visits, with 664 admissions to our Department and 274 temporary observation) and 1993 (12820 emergency room visits, 573 admissions, 428 temporary observation). Compared to 1992, in 1993 there was a decrease of both emergency room visits (higher than expected from demographic lowering and in part due to payment for emergency room visits) and hospital admissions, and an increase of temporary observation. The stay in hospital was less than 6 hours in 94.2% of temporary observation patients. 18.2% of them were evaluated on clinical basis, 57% also by diagnostic examinations, 24.8% had some treatment. The 89% of the children were sent home following temporary observation, the others were admitted. Criteria for temporary observation were fairly similar to those for hospital admission, but not far as Central Nervous System and Renal Disease are concerned. Our study confirms the usefulness of temporary observation in childhood to reduce both the number of hospital admissions and the discomfort of the patient and his family. Nevertheless there is a need of criteria of appropriateness. Therefore we have elaborated guide lines for temporary observation and admission to our Department.

Child↗
PubMed1994

The risk associated with poisonings in children.

The risk associated with poisonings in children was assessed on 6175 subjects admitted to the pediatric hospitals of 3 regions of Northern Italy between 1975 and 1990. The frequency of exposures and the severity of sequelae allowed high- and low-risk substances to be identified. Risks were studied separately in the 0-4, 5-9 and 10-13 y age group to determine age-related differences. A decrease in drug-related poisonings and an increase of those caused by household products, particularly in the first 2 y of life, were observed in 1983-90 as against 1975-82 in association with the introduction of safety caps and containers for drugs. Our study points out the need to strengthen active primary prevention through health education and parental and adolescent information, and to improve passive prevention through the extension of safety closures to household products.

Adolescent↗
PubMed1992

[Evaluation of a pediatric emergency room: ten years later].

Utilization of the pediatric Emergency Room has been evaluated during the year 1991, by a questionnaire study on 694 children. By comparison with a previous research in 1981 it was possible to identify a further decrease of urgent and appropriate visits with increase of those inappropriate. Visits were more frequently urgent of appropriate in case of acute health problems, inappropriate if related to recurrent problems. Without considering true emergencies, three main causes for ER consultation have been identified: family custom, inappropriate relationships with the practitioner, dependence on the hospital. In the first group of children most of the visits proved inappropriate. The study points out a further increase of inappropriate utilization of ER, due mainly to inappropriate relationships between the family and the practitioner. This has to be corrected to reduce costs and improve child care.

Adult↗
PubMed1992

Epidemiology of children poisoning: comparison between telephone inquiries and emergency room visits.

We studied 674 telephone inquiries to the Poison Information Centre and 532 Emergency Room (ER) visits due to suspected poisonings in 1018 children below the age of 16 y and living at Trieste. The cases were prospectively recorded during 1985-1989. Age distribution, toxic substances and consequences were different in the 2 groups. Telephone inquiries concerned children below the age of 5 y more frequently, and most of the exposures were assessed as non-toxic. Among children admitted to the hospital ER, 22.2% were more than 10-y old, and of these 79.7% were confirmed poisonings. This study demonstrated the need to take account of both Poison Control Centre and ER data to get reliable information on the occurrence of poisonings in children.

Adolescent↗
PubMed1990

[The sports, the child and accidents. III. Long-term sequelae].

Sports-related injuries in children and adolescents are an emergent health problem in our country, because of their incidence and severity. Nevertheless information is lacking on possible long term sequelae. This topic has been studied in 220 out of 1040 6-15 years old children, prospectively registered during 1985 in our hospital because of acute sports injuries. Selection for the follow-up was based on injuries severity, assessed according to the Abbreviated Injury Scale. Subjective and/or objective sequelae have been observed at a clinical control three years after the accident, in 68 out of the 220 controlled children (30.9%). The prevalence of the sequelae was similar in males and females, but quite different according to the age, being higher in children older than 14, the type of sports activity and the site of the injuries, with higher prevalence of those of the ankle and knee rather than of the wrist. Prevention of sports-related injuries and their possible sequelae is well established in Sports Medicine, but not yet fully applied to children. Pediatricians must sensitize the school and sports clubs to the problem.

Adolescent↗
PubMedDate not supplied

The role of the office assistant or operating room nurse in botulinum injection as an alternative to strabismus surgery.

Botulinum injection of eye muscles as an alternative to strabismus surgery can be performed in young children with low dose ketamine sedation, or reassurance without sedation for older children. The OR nurse or office assistant should provide a calm, restful environment rapport with the patient prior to surgery, a connection with her voice through the procedure and rapid reunion of the child and parent in a restful environment. If a child over 6 years is unable to cooperate with the office procedure, it quickly abandoned and it is done in the operating room under sedation.

Botulinum Toxins↗
PubMedDate not supplied

[Study of the risk of analgesic-antipyretic drugs in children].

Poisonings by analgesic-antipyretic drugs in childhood in our country need specific prevention measures because of their incidence and clinical severity. We analysed the clinical-epidemiologic data of 114 cases of poisonings in children under 16 years of age and the results of a questionnaire answered by 507 adults to identify risks factors. The most of these poisonings happened at home; the esposition was accidental in younger children, even if it often depended from therapeutic mishaps; it was more frequently voluntary at the age of 10. Disinformation on risks and lack of appropriate store in the house are the main factors. The prevention therefore must be based either on the education and the use of safe child resistant containers, besides other passive preventive measures.

Accident Prevention↗