Ultrasound-Assisted Lumbar Puncture in Pediatric Emergency Department

WOS: 000407233100003PubMed ID: 26425932Background: Lumbar puncture (LP) is one of the essential diagnostic tools in pediatric emergency services. Recently, ultrasound-assisted LP was reported to be beneficial in the emergency service by facilitating the procedure and improving the successful procedure rates. In addition, this method may be effective in reducing patient and parent anxiety due to the LP procedure. Objectives: The aim of this study was to investigate the effect of ultrasound-assisted LP on the outcomes of puncture procedures and traumatic LP. Methods: The study included patients younger than 18 years, who were admitted to the pediatric emergency service and underwent LP because of suspected central nervous system infection. The patients requiring LP were randomly divided into 2 groups designated as odd and even. One group received LP using the conventional method, whereas the other group had LP after spinal space measurement by ultrasound. The patients who did and who did not undergo ultrasound-assisted LP were compared for demographics, number of puncture attempts, and traumatic LP. Statistical analysis was performed using the Mann-Whitney U test and the Student t test. The chi(2) test was used when nominal data were compared between the 2 groups. Results: Ultrasound-assisted LP was performed in 56 patients, and LP by using conventional method was performed in 55 patients. There was traumatic LP in 5 (8.9%) of the patients who underwent ultrasoundassisted LP and 9 (16.3%) of the patients who underwent LP using the conventional method (P > 0.05). The number of puncture attempts was 2 or more in 2 (3.5%) of the patients who underwent ultrasoundassisted LP and 5 (9%) of the patients who had LP using the conventional method (P > 0.05). Conclusions: Ultrasound-assisted LP reduced traumatic LP and the number of puncture attempts in pediatric patients; however, the resultswere not statistically significant

Ambient particulate matter source apportionment using receptor modelling in European and Central Asia urban areas

This work presents the results of a PM2.5 source apportionment study conducted in urban background sites from 16 European and Asian countries. For some Eastern Europe and Central Asia cities this was the first time that quantitative information on pollution source contributions to ambient particulate matter (PM) has been performed. More than 2200 filters were sampled and analyzed by X-Ray Fluorescence (XRF), Particle-Induced X-Ray Emission (PIXE), and Inductively Coupled Plasma Mass Spectrometry (ICP-MS) to measure the concentrations of chemical elements in fine particles. Samples were also analyzed for the contents of black carbon, elemental carbon, organic carbon, and water-soluble ions. The Positive Matrix Factorization receptor model (EPA PMF 5.0) was used to characterize similarities and heterogeneities in PM2.5 sources and respective contributions in the cities that the number of collected samples exceeded 75. At the end source apportionment was performed in 11 out of the 16 participating cities. Nine major sources were identified to have contributed to PM2.5: biomass burning, secondary sulfates, traffic, fuel oil combustion, industry, coal combustion, soil, salt and “other sources”. From the averages of sources contributions, considering 11 cities 16% of PM2.5 was attributed to biomass burning, 15% to secondary sulfates, 13% to traffic, 12% to soil, 8.0% to fuel oil combustion, 5.5% to coal combustion, 1.9% to salt, 0.8% to industry emissions, 5.1% to “other sources” and 23% to unaccounted mass. Characteristic seasonal patterns were identified for each PM2.5 source. Biomass burning in all cities, coal combustion in Krakow/POL, and oil combustion in Belgrade/SRB and Banja Luka/BIH increased in Winter due to the impact of domestic heating, whereas in most cities secondary sulfates reached higher levels in Summer as a consequence of the enhanced photochemical activity. During high pollution days the largest sources of fine particles were biomass burning, traffic and secondary sulfates.JRC.C.5-Air and Climat