Foreign body (FB) aspiration/ingestion in children represents a major cause of hospital admission and mortality. Evaluating risk factors and identifying trends in specific FB products could improve targeted health literacy and policy changes. A cross-sectional study querying emergency department patients less than 18 years old with a diagnosis of aspirated/ingested FB was conducted using the National Electronic Injury Surveillance System database between 2010 and 2020. Incidence rates per 100 000 people-year were calculated and multivariate analyses were performed to identify risk factors for hospital admission and mortality. There has been a significantly decreasing rate of aspirated (−23.6%; P = .013) but not ingested FB (−9.4%; P = .066) within the study period. Within pediatric aspirated FB, black compared with white patients had decreased odds of same hospital admission (odds ratio [OR]: 0.8), but increased odds of transfer admission (OR: 1.6) and mortality (OR: 9.2) (all, P < .001).
Objectives Understanding the obstacles to adoption of PBE by inner-city patients is essential to provide effective nutrition counseling for management of chronic health conditions that may be improved by this dietary pattern. Methods A telephone survey was conducted in a random convenience sample of patients from FM (18) and CKD (13) clinics. Questionnaires regarding familiarity with PBE and the Multidimensional Health Locus Questionnaire (MHLC) were administered. Diet analysis was performed by 24-hr dietary recall using ASA24 software. Entries reporting <800 kcal were excluded as possibly incomplete. An PBE index (PB-I) was calculated by averaging the difference in grams cholesterol (only in animal products) and grams fiber (only in plant sources) over total kcal. Results Mean age was 63.13 ± 10.4 yrs. 10 were male (32%) and 21 female (68%). 22 were Black (71%), 3 Hispanic (10%), 1 white (3%), 4 other (17%). There was no difference between FM and CKD for nutrition parameters, including kcal (mean 1433.8 ± 444.7), protein (52.9 ± 22.8 g), fat (52.9 ± 22.8 g), and carbohydrates (173.5 ± 64.8 g). There was no significant difference in PB-I between FM and CKD. For both groups, lower PB-I was correlated with lack of information on PBD (r = −0.58, P = 0.002, n = 27). Higher PB-I was correlated with higher score for “Belief In Powerful Others” (r = 0.47, P = 0.14, n = 25) and “Reliance on Doctors” (r = 0.45, P = 0.02, n = 25). For FM, lower PB-I correlated with lack of information (r = −0.54, P = 0.05, n = 14) and someone else preparing their food (r = −0.65, P = 0.01, n = 14). Higher PB-I correlated with higher score for “Powerful Others” (r = 0.06, P = 0.02, n = 13), “Doctors” (r = 0.62, P = 0.02, n = 13), and “Internal” categories (r = 0.66, P = 0.01, n = 13). For CKD, lower PB-I also correlated with lack of information (r = 0.62, P = 0.02, n = 13) but did not correlate with MHLC responses. Conclusions In our population: 1. Pts with a lower PBE-I reported knowing less about PBE and had a lower external locus of control 2. FM patients who had a greater internal locus of control and relied more on doctors had a higher PBE-I and were less likely for to rely on someone else to prepare their food. 3. Understanding the patient's locus of control and improving education about PBE will be important in removing obstacles to adoption in our underserved inner-City population with a high prevalence of CKD and other chronic conditions. Funding Sources None.
Objectives We examined the impact of the COVID19 pandemic on dietary intake in an inner-city population of CKD and KTx patients. Methods Dietary intake was assessed using 24-hour recall in a random sample of patients from CKD and Transplant clinics in 2019 (48) and in 2020 (30). Dietary assessments were conducted in person in 2019 and by phone in 2020. Diets were analyzed using ASA-24 software. Entries with less than 1,100 kcal were excluded from analysis. There was no difference in patterns between the two clinics so they were analyzed together. Statistical analysis was by t-test or Chi-square as appropriate. Results The 2019 cohort and the 2020 cohort were similar for age (55.9 ± 12.5 vs 60.0 ± 11.7, P = 0.148), gender (60.4% vs 43.3% male, P = 0.141), race (81.3% vs 69.2% Black, P = 0.241), and education (75% vs 80.8% with less than a college degree, P = 0.573). The 2020 patients consumed fewer total calories (1513.16 ± 350.82 vs 1731.02 ± 573.07 kcal, P = 0.041) compared to 2019 patients. For macronutrients, the 2020 cohort ate less protein (72.59 ± 24.40 vs 88.44 ± 37.17 g, P = 0.030), with no significant difference in total fat (62.11 ± 19.38 vs 72.59 ± 38.85 g, P = 0.118) and carbohydrate intake (163.08 ± 64.75 vs 185.02 ± 76.46 g, P = 0.179). In relation to protein intake, the 2020 cohort consumed less protein-rich foods such as meat, poultry, seafood, organ meat and cured meat compared to the 2019 cohort (6.74 ± 3.21 vs 8.83 ± 5.53 oz. eq., P = 0.038). Dark green vegetable consumption was also significantly less in the 2020 cohort (0.14 ± 0.29 vs 0.35 ± 0.60 cup eq., P = 0.031). Finally, the 2020 cohort consumed less water (1883.98 ± 1005.99 vs 2694.12 ± 1410.35 g, P = 0.004). Conclusions In our population: 1. CKD and Transplant patients consumed less protein and water during the Covid-19 pandemic than in the previous year. 2. Consumption of dark green vegetables and protein-rich foods decreased significantly during the pandemic. 4. The cause of these findings may be secondary to food insecurity and/or unhealthy behaviors emerging during the COVID19 pandemic and should be explored further as poor nutrition could contribute to worse outcomes in these populations. Funding Sources Unfunded
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