Browsing by Author "Liu, Tzu-Hsuan"

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Pharmaceutical Poisoning Exposure and Outcome Analysis in Children Admitted to the Pediatric Emergency Department
(2011-02-01)
Lin, Yan-Ren
;
Liu, Tzu-Hsuan
;
Liu, Tzu-An
;
Chang, Yu-Jun
;
Chou, Chu-Chung
Background: Pharmaceuticals involved in childhood poisoning vary, and treatment of poison exposure can be a challenge for primary physicians when children are unconscious or histories are lacking. Knowledge of the clinical manifestations and prognosis of poisoning will help primary physicians perform appropriate clinical assessments. In this study, we aim to report on patient characteristics, outcomes, and clinical features of pediatric poisoning in the emergency department. Methods: We retrospectively evaluated the medical records of 87 children younger than 18 years of age and presented to the emergency department with pharmaceutical poisoning (2001-2008). The detailed categories of pharmaceutical were reported, and their associations with patient outcomes were analyzed. Furthermore, children were divided into two groups, based on the reasons for poison exposure (accidental or intentional poisoning). Clinical features and outcomes between accidental or intentional poisoning were analyzed, and the cut-off age for high risk of intentional poisoning was also calculated. Results: Age groups of adolescents (48.3%) and preschool age (32.2%) children were the major representation. Neurologic system agents (48.3%) and analgesics (18.4%) were the most common causes of poisoning. Among the two major agents above, anxiolytic/hypnotic drugs (lorazepam) and acetaminophen were the most frequent causes. Of all children, 70.1% had duration of major symptoms for <= 1 day, and intentional poisoning caused significantly longer duration of hospital stay than accidental poisoning did (p = 0.008). Moreover, female gender (p < 0.001), older age (p < 0.001), and analgesics (p = 0.008) were more predominantly associated with intentional poisoning in children, and the cut-off age for high risk of intentional poisoning was over 10.5 years. Conclusion: Neurologic system agents and analgesics were responsible for the majority of cases. Intentional poisoning caused longer hospital length of stay than accidental poisoning, and the factors associated with intentional poisoning were older age, female, and neurologic system agents. Copyright (C) 2011, Taiwan Pediatric Association. Published by Elsevier Taiwan LLC. All rights reserved.
Predictive factors of the duration of a first-attack acute urticaria in children
(2011-10-01)
Lin, Yan-Ren
;
Liu, Tzu-Hsuan
;
Wu, Tung-Kung
;
Chang, Yu-Jun
;
Chou, Chu-Chung
Purposes: This study's aim was to determine the predictive factors of the duration of first-attack acute urticaria in children. Basic Procedures: The sample included 1075 children admitted to the emergency department with first-attack acute urticaria. Variables comprising the clinical features and past histories of children with duration of disease of 3 days or less, 4 to 7 days, 8 to 14 days, and 15 days or more were compared to determine the predictors of duration of acute urticaria. Main Findings: Age, various etiologies, clinical presentations, coexistent pyrexia or angioedema, and personal histories of allergic diseases were significant factors (all P < .05). Among allergic diseases, atopic dermatitis was the most significant predictor of duration of acute urticaria, and those with multiple allergic diseases had longer durations of urticaria (both P < .05). Oral plus injection forms of antihistamine or steroid were related to shorter duration of disease (P < .05). Principal Conclusions: Etiologies and personal allergy history may be the most important predictors of the duration of a first attack of acute urticaria. (C) 2011 Elsevier Inc. All rights reserved.
Significant factors associated with severity and outcome of an initial episode of acute urticaria in children
(2010-11-01)
Liu, Tzu-Hsuan
;
Lin, Yan-Ren
;
Yang, Kuo-Chia
;
Tsai, Yi-Giien
;
Fu, Yun-Ching
The aim of this study was to determine the predictive factors of severity and duration of an initial episode of acute urticaria in children. This was a retrospective study of 1120 children of < 18 yr who presented to the emergency department (ED) with an initial episode of acute urticaria during the period January 1, 2001, to December 31, 2007. These patients were followed in the ED or outpatient department (OPD) until their symptoms subsided. Variables comprising mild, moderate, and severe urticaria were compared to determine the predictors of severity. The relationships between duration of urticaria and clinical features, including physician-diagnosed causes and treatment modalities, were also analyzed. Significant predictive factors of severity of an initial episode of acute urticaria in children included age, physician-diagnosed causes of urticaria, clinical presentation, coexistent pyrexia or angioedema, and personal allergic history (all p < 0.001). The duration of urticaria was dependent on the physician-diagnosed causes and treatment. Inhalants and unknown causes were predictive of longer duration, while contact materials were associated with shorter duration of urticaria (p < 0.001). Combination treatment comprising an oral plus injectable form of antihistamine or corticosteroid significantly shortened the duration of urticaria compared to single treatment (p < 0.001), especially in children receiving short-term aggressive treatment in the pediatric observation unit (POU) of the ED.