The assessment of risk factors for febrile seizures in children

Objective The aim of the paper was to assess the risk factors of febrile seizures in children. Methods The paper presents an analysis of a group of 176 children aged 6 months to 5 years who were admitted to A&E because of febrile seizures. Results The analysed group of 176 children comprised 61.96% boys and 38.07% girls, and the average age equalled 23 months. Family history was significant in 9.66% of patients. A statistically significant difference was noticed between insignificant family history and the incidence of febrile seizures. In all the studied groups of children the factor that determined the incidence of febrile seizures was a sudden increase in the body temperature with an infection of the upper respiratory tract of several day's duration as another cause. Febrile seizure incident was most frequently associated with a sudden increase in the body temperature in 53.40% children. A statistically significant difference was observed between persisting fever and an increase thereof during the day. Yet another factor predisposing for febrile seizures incidence was an infection of the upper respiratory system that could be observed in 32.95% patients. The mean body temperature when the seizures occurred was 38.9°C. Conclusions A sudden increase in the body temperature within the first day of pyrexia predisposes for the incidence of febrile seizures and it was proved that it depends on how long fever persists during the day. The other factor triggering the seizures was an infection of the upper respiratory tract of several days’ duration

The assessment of risk factors for febrile seizures in children

Objective The aim of the paper was to assess the risk factors of febrile seizures in children. Methods The paper presents an analysis of a group of 176 children aged 6 months to 5 years who were admitted to A&E because of febrile seizures. Results The analysed group of 176 children comprised 61.96% boys and 38.07% girls, and the average age equalled 23 months. Family history was significant in 9.66% of patients. A statistically significant difference was noticed between insignificant family history and the incidence of febrile seizures. In all the studied groups of children the factor that determined the incidence of febrile seizures was a sudden increase in the body temperature with an infection of the upper respiratory tract of several day's duration as another cause. Febrile seizure incident was most frequently associated with a sudden increase in the body temperature in 53.40% children. A statistically significant difference was observed between persisting fever and an increase thereof during the day. Yet another factor predisposing for febrile seizures incidence was an infection of the upper respiratory system that could be observed in 32.95% patients. The mean body temperature when the seizures occurred was 38.9°C. Conclusions A sudden increase in the body temperature within the first day of pyrexia predisposes for the incidence of febrile seizures and it was proved that it depends on how long fever persists during the day. The other factor triggering the seizures was an infection of the upper respiratory tract of several days’ duration

Partial detachment of the aorta: a fatal complication of CPR chest compressions

Abstract Background Partial aorta detachment is a rare and fatal complication of mechanical chest compression. Case presentation The paper describes a patient in cardiac arrest who died despite receiving CPR using mechanical chest compression. After death, an autopsy showed the presence of a partial rupture of the aortic wall in the intra-pericardial section. Discussion In the discussion, for this case, we propose to deepen our knowledge of post-resuscitation complications, which may help to understand the need to maintain the recommended parameters of chest compressions, respond more confidently to changes in the patient's condition during CPR, to interpret the results of bedside examinations better, and to understand the autopsy results better. In our opinion, the best method of diagnosing internal injuries, which we provide with Point-of-Care (POCUS) ultrasound, allows for therapeutic interventions that maximize the chances of spontaneous circulation. Education and skill development are also indispensable aspects of CPR. Particular attention should be paid to the same quality of chest compressions performed. Conclusions As conclusions drawn from the analysis of this case, we propose paying particular attention to the difficulty of explaining changes in the patient's condition during CPR, the widespread use of POCUS, and considering the use of compressions performed by staff in situations where it is possible and safe

Selected aspect of the epidemiology of febrile seizures in children

Drgawki gorączkowe u dzieci są najczęstszym stanem napadowym pochodzenia mózgowego, ich częstość wynosi 4–5 na 100 000 na rok w populacji dzieci w wieku przedszkolnym. Celem pracy była ocena epidemiologiczna napadów drgawek gorączkowych u dzieci. Materiał i metody. Do badania włączono grupę 176 dzieci w wieku od 6. miesiąca życia do 5. roku życia, które były hospitalizowane w Specjalistycznym Zespole Opieki Zdrowotnej nad Matką i Dzieckiem w Poznaniu w okresie od 1 stycznia 2008 do 31 grudnia 2009 roku z powodu epizodu napadu drgawek gorączkowych. W analizie retrospektywnej uwzględniono takie czynniki jak: wiek i płeć oraz porę doby i roku, podczas których pojawiły się drgawki gorączkowe. Wyniki. W analizowanej grupie 176 dzieci 61,93% (n = 109) pacjentów stanowili chłopcy, a 38,07% (n = 67) dziewczynki. W badanej populacji zaobserwowano istotne statystycznie różnice pomiędzy płcią dzieci a wystąpieniem drgawek gorączkowych. Najczęściej drgawki gorączkowe występowały u dzieci w wieku poniemowlęcym (1.–3. rok życia) i dotyczyły 67,05% pacjentów, a średnia wieku wyniosła 23 miesiące +/– SD 13 miesięcy. Najwięcej napadów drgawek gorączkowych zanotowano w okresie jesienno-zimowym, ze szczytem występowania w styczniu (17,61%), lutym (12,50%) i grudniu (10,23%). Stwierdzono istotnie statystycznie różnice występowania drgawek gorączkowych w badanych grupach w zależności od miesiąca i pór roku. Najczęściej napad drgawek gorączkowych występował w godzinach popołudniowych i wieczornych pomiędzy godziną 15.00 a 18.00 u 42 dzieci (23,86%). Zaobserwowano istotnie statystycznie różnice wystąpienia drgawek gorączkowych w badanych grupach w zależności od pory dnia. Wnioski. Na wystąpienie drgawek gorączkowych w badanej populacji narażeni są bardziej chłopcy niż dziewczęta oraz dzieci w wieku poniemowlęcym. Najczęściej epizod napadu drgawek gorączkowych obserwowano w okresie jesienno-zimowym ze szczytem występowania w styczniu, lutym i grudniu, a także w godzinach popołudniowych i wieczornych. Wykazano, że pojawienie się napadu drgawek gorączkowych jest zależne od pór roku i miesięcy oraz pory dnia.Febrile convulsions in children is the most common paroxysmal state of cerebral origin, the frequency is 4–5/100 000 per year in the population of preschool children. The aim of the study was to evaluate the epidemiological febrile seizures in children. Material and methods. The study included a group of 176 children aged 6 months to 5 years who were hospitalized in the Specialized Complex of Health Care for Mother and Child in Poznan from 1 January 2008 to 31 December 2009 with an episode of febrile convulsions. In a retrospective analysis were taken into account factors such as age and sex, time of day and year, during which there were febrile seizures. Results. In the analyzed group of 176 children 61.93% (n = 109) were boys and 38.07% (n = 67) girls. In the study population was observed a statistically significant difference between the gender and the occurrence of febrile seizures. The most common febrile seizures occurred in toddlers (1–3 years old) and affected 67.05% of patients, the average age 23 months +/– SD 13 months. Most febrile seizures were recorded in the autumn - winter period, with a peak incidence in January (17.61%), February (12.50%) and December (10.23%). It was found a statistically significant difference of febrile seizures in the studied groups depending on the month and seasons. The most commonly febrile seizures occurred in the afternoon and evening, between 3 pm and 6 pm in 42 children (23.86%). There was a statistically significant difference in febrile seizures in the studied groups depending on the time of day. Conclusions. The study has shown that boys are exposed to more febrile seizures than girls and toddlers. Frequently the episodes of febrile convulsions were observed in the autumn-winter period of peak incidence in January, February and December, as well as in the afternoon and evening. It has been shown that the occurrence of febrile convulsions is dependent on the seasons and months as well as the time of day

Analysis of deaths in children with diseases of the nervous system

Choroby przewlekłe oraz wady rozwojowe wrodzone należą do najczęstszych przyczyn zgonów u dzieci i młodzieży na świecie. Celem poniższej pracy była analiza przyczyn zgonów u dzieci z chorobami układu nerwowego w latach 2003 – 2013 przeprowadzona jednoośrodkowo na terenie miasta Poznania. Materiał i metody: analizie poddano grupę 28 dzieci, u których w latach 2003 – 2013 doszło do zgonu. Wyniki: analizowana grupa dzieci stanowiła 18,18% pacjentów, u których stwierdzono zgon w latach 2003 – 2013. Największą liczbę zgonów ze schorzeniami układu nerwowego odnotowano w latach 2005 i 2010. W analizowanych latach obserwowano trend spadkowy zgonów z chorobami układu nerwowego. W badanej grupie dzieci było 11 chłopców i 17 dziewcząt. Wiek dzieci wahał się od 2 miesiąca życia do 16 lat i 6 miesięcy. Średnia wyniosła 10 lat i 2 miesiące. Najwięcej zgonów zanotowano: w marcu i wrześniu. Najczęstszą wyjściową (pierwotną) przyczyną zgonu u dzieci z chorobami układu nerwowego było: ostra niewydolność oddechowa, którą rozpoznano u 12 dzieci, a następnie zapalenie płuc (n=11), niewydolność serca (n=3), zaburzenia gospodarki wodno – elektrolitowej i zaburzenia rytmu serca (n=1). Do najczęściej występujących chorób układu nerwowego u dzieci, u których doszło do zgonu należały: MPD (n=13), wodogłowie (n=4) oraz padaczka i zapalenie opon mózgowo – rdzeniowych (n=3). Wśród chłopców było to mózgowe porażenie dziecięce (n=4) oraz wodogłowie i zapalenie mózgu (n=2). U dziewcząt oprócz mózgowego porażenia dziecięcego (n=9) najczęściej stwierdzono zapalenie opon mózgowo – rdzeniowych (n=3). Wnioski: Zgony dzieci z chorobami neurologicznymi częściej występowały u dziewcząt niż chłopców. Wykazano, że u płci żeńskiej wraz z wiekiem rosła liczba zgonów. Do najczęściej występujących chorób układu nerwowego należało: mózgowe porażenie dziecięce, wodogłowie, padaczka oraz zapalenie opon mózgowo – rdzeniowych.Chronic diseases and congenital defects are the most common causes of death in children and adolescents in the world. The purpose of this study was to analyze the causes of death in children with diseases of the nervous system in the years 2003 – 2013 conducted in a single center in Poznan. Material and methods: We analyzed a group of 28 children who died in the period 2003-2013. Results: The analyzed group of children accounted for 18.18% of patients who died from 2003 to 2013. The highest numbers of deaths from diseases of the nervous system were recorded in 2005 and 2010. In the analyzed period was observed a downward trend in mortality from diseases of the nervous system. In the group of children were 11 boys and 17 girls. The age of children ranged from 2 months to 16 years and 6 months. The average was 10 years and 2 months. Most deaths were recorded in March and September. The most common initial (primary) causes of death in children with neurological disorders were: acute respiratory distress diagnosed in 12 children, followed by pneumonia (n = 11), heart distress (n = 3), water–electrolyte disorders and cardiac arrhythmias (n = 1). The most common diseases of the nervous system in children who died were: CP (n = 13), hydrocephalus (n = 4), epilepsy and meningitis - spinal (n = 3). Among the boys it was cerebral palsy (n = 4), hydrocephalus and brain inflammation (n = 2). In girls, in addition to cerebral palsy (n = 9), most frequently was found meningitis – spinal (n = 3). Conclusions: Deaths of children with neurological diseases occurred more commonly in girls than boys. It has been shown that for females the number of deaths increased with age. The most common diseases of the nervous system were: cerebral palsy, hydrocephalus, epilepsy and meningitis – core