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      Accidentes vinculados a la Cirugía Plástica Pediátrica durante el confinamiento voluntario en Uruguay por SARS-CoV-2 Translated title: Accidents related to Pediatric Plastic Surgery during voluntary confinement in Uruguay due to SARS-CoV-2

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          Abstract

          Resumen Introducción y objetivo. Epidemiológicamente se esperaban cambios en los patrones de consulta en emergencia durante la pandemia por SARS-CoV-2. La permanencia dentro del hogar de todos los integrantes de la familia, la suspensión de la actividad deportiva, recreativa y social, sumadas al temor por concurrir a emergencia y contraer COVID-19 podían generar la interrogante en cuanto a la incidencia de accidentes. Material y método. Analizamos las historias clínicas de las consultas en emergencia de 3 instituciones en Uruguay, país en el cual el confinamiento durante la pandemia por COVID-19 fue voluntario desde el 13 de marzo de 2020 al 29 de junio del mismo año. Incluimos todos los motivos de consulta vinculados a Cirugía Plástica Pediátrica en nuestro medio en pacientes menores de 16 años. Resultados. Obtuvimos datos de 166 pacientes. Durante el mismo período del 2019 se recabaron datos de 268 pacientes. Conclusiones. Nuestro trabajo evidencia menos accidentes vinculados a Cirugía Plástica Pediátrica durante el confinamiento. Los pacientes de sexo masculino fueron los más afectados durante el confinamiento y fuera de él. Hubo una disminución de accidentes en pacientes de 6 a 16 años, siendo la franja más afectada la de los pacientes de edad prescolar. Aumentaron las mordeduras de perro, disminuyeron las consultas menos graves junto con los procedimientos más sencillos y no se evidenció aumento en los ingresos hospitalarios ni en las cirugías por accidentes. Nivel de evidencia científica Terapéutico 5c

          Translated abstract

          Abstract Background and objective. Changes in the epidemiology at the emergency department during the SARS-CoV-2 pandemic were expected. Confinement of all family members, the suspension of sports, and social activity, in addition to the fear of attending an emergency and contracting COVID-19 could change the incidence of accidents. Methods. The medical records of the emergency department of 3 institutions in Uruguay, country in which confinement during the COVID-19 pandemic was voluntary from March 13, 2020 to June 29 of the same year. All the consults related to Pediatric Plastic Surgery in patients under 16 years of age were included. Results. Data was obtained from 166 patients during the period of voluntary confinement. During the same period of 2019, data from 268 patients were collected. Conclusions. In our study, fewer accidents related to Pediatric Plastic Surgery were present during confinement. Male patients were the most affected in both periods. A decrease in accidents was evidenced in patients aged 6-16 years, with preschool-age patients being the most affected group. Not severe consultations decreased along with the simplest procedures and there were no increases in hospital admissions or surgeries due to accidents. Level of evidence Therapeutic 5c

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          Injuries in the time of COVID-19

          Research has shown that during the 2003 SARS pandemic, emergency department (ED) visits among the pediatric population decreased. We set out to investigate if this was also true for injury-related ED visits during the COVID-19 pandemic. Using data from the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP), we looked at 28 years of injury-related ED visits at the Montreal Children’s Hospital, a provincially designated Pediatric Trauma Centre. We compared data from a two-month period during the COVID-19 lockdown (16 March to 15 May) to the same period in previous years (1993–2019) to determine whether the 2020 decrease in ED visit numbers was unprecedented (i.e. a similar decrease had never occurred) for different age groups, nature of injuries, mechanisms and severity. The 2020 decrease was unprecedented across all age groups between 1993 and 2019. When compared with the 2015 to 2019 average, the decrease was smallest in children aged 2 to 5 years (a 35% decrease), and greatest in the group aged 12 to 17 years (83%). Motor vehicle collisions and sports-related injuries practically vanished during the COVID-19 lockdown. Surprisingly, more children aged 6 to 17 years presented with less urgent injuries during the COVID-19 lockdown than in previous years. As was the case with SARS in 2003, COVID-19 acted as a deterrent for pediatric ED visits. The lockdown in particular had a profound impact on injury-related visits. The de-confinement period will be monitored to determine the impact in both the short and the long term.
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            Declining Emergency Department Visits and Costs During the Severe Acute Respiratory Syndrome (SARS) Outbreak

            Background The immediate and long-term impact of severe acute respiratory syndrome (SARS) outbreak on emergency department (ED) visits and hospital expenditures for these visits has not been thoroughly investigated. The objectives of this retrospective observational study investigated the impact of SARS outbreak on ED visits and the cost of these visits in a designated SARS medical center. Methods Data related to the total number of ED visits and their costs were collected for the SARS epidemic period in 2003 and the same period in the preceding year in 2002. Data collected included total number of ED visits, services provided, triage categories, and total expenditures for all patients. Data for before and during the outbreak were retrieved and compared. Results At the peak of the SARS epidemic, the reduction in daily ED visits reached 51.6% of pre-epidemic numbers (p < 0.01). In pediatric, trauma and non-trauma patients, the maximum mean decreases in number of visits were 80.0% (p < 0.01), 57.6% (p < 0.01) and 40.8% (p < 0.01), respectively. In triage 1, 2 and 3 patients, the maximum mean decreases were 18.1% (p < 0.01), 55.9% (p < 0.01) and 53.7% (p < 0.01), respectively. The maximum decrease in total costs was 37.7% (p < 0.01). The maximum mean costs per patient increased 35.9% (p < 0.01). The proportions of increases in mean costs for each patient were attributed to laboratory investigations (31.4%), radiography (21.9%) and medications (29.5%). Conclusion The SARS outbreak resulted in a marked reduction in the number of ED visits which persisted for 3 months after the end of the epidemic. Total cost of treating individual patients showed a simultaneous marked increase, while overall operational costs in the ED showed a marked decrease. The increased total cost for each patient was attributed to the increased number of diagnostic procedures to screen for possible SARS in the ED.
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              Lockdown: more domestic accidents than COVID-19 in children

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                Author and article information

                Journal
                cpil
                Cirugía Plástica Ibero-Latinoamericana
                Cir. plást. iberolatinoam.
                Sociedad Española de Cirugía Plástica, Reparadora y Estética (SECPRE) (Madrid, Madrid, Spain )
                0376-7892
                1989-2055
                March 2023
                : 49
                : 1
                : 97-102
                Affiliations
                [2] Montevideo orgnameHospital Central de las Fuerzas Armadas de Uruguay Uruguay
                [4] Montevideo orgnameUniversidad de la República orgdiv1Centro Hospitalario "Pereira Rossell" orgdiv2Departamento de Emergencia Pediátrica Uruguay
                [1] Montevideo orgnameHospital Central de las Fuerzas Armadas de Uruguay Uruguay
                [3] Montevideo orgnameMutualista Asociación Española Uruguay
                Article
                S0376-78922023000100014 S0376-7892(23)04900100014
                10.4321/s0376-78922023000100014
                dc8625dc-a085-474c-a587-c1b1d88ce625

                This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

                History
                : 09 August 2022
                : 23 February 2023
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 14, Pages: 6
                Product

                SciELO Spain

                Categories
                Pediátrica

                Fracturas mano,COVID-19,Accidents,Pediatric Plastic Surgery,Emergency,Unintentional injuries,Hand fractures,Injuries,Dog bites,Accidentes,Cirugía Plástica Pediátrica,Lesiones no intencionales,Heridas,Mordeduras perro

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