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Pediatrics trauma

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https://www.readbyqxmd.com/read/29026917/-fractures-of-the-lower-extremities-in-childhood-part-2-lower-leg-and-ankle-fractures
#1
M Voth, L Kremer, I Marzi
The treatment of pediatric patients in trauma surgery is a special situation in every aspect. For deciding on the correct treatment of fractures of the lower leg and ankle joint, various parameters, such as residual growth rate, skeletal age and height of the patient are decisive. The differences between fractures in children and adolescents are the open epiphyseal plate and the resulting residual growth. The bones of young children have a higher healing tendency and a greater potential for correction than in adolescents...
October 12, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/29019754/abnormalities-of-the-coronary-arteries-in-children-looking-beyond-the-origins
#2
Lauren J Saling, Demetrios A Raptis, Keyur Parekh, Toby A Rockefeller, Elizabeth F Sheybani, Sanjeev Bhalla
Coronary arterial abnormalities are uncommon findings in children that have profound clinical implications. Although anomalies of the coronary origins are well described, there are many other disease processes that affect the coronary arteries. Immune system-mediated diseases (eg, Kawasaki disease, polyarteritis nodosa, and other vasculiditides) can result in coronary arterial aneurysms, strictures, and abnormal tapering of the vessels. Because findings at imaging are an important component of diagnosis in these diseases, the radiologist's understanding of them is essential...
October 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/29019747/masses-of-the-nose-nasal-cavity-and-nasopharynx-in-children
#3
Diana P Rodriguez, Emily S Orscheln, Bernadette L Koch
A wide range of masses develop in the nose, nasal cavity, and nasopharynx in children. These lesions may arise from the nasal ala or other structures of the nose, including the mucosa covering any surface of the nasal cavity, the cartilaginous or osseous portion of the nasal septum, the nasal turbinates, and the nasal bones. Lesions may also arise from the nasopharynx or adjacent structures and involve the nose by way of direct extension. The causes of nasal masses in children include congenital and developmental disorders such as congenital nasolacrimal duct mucocele, dermoid cyst, cephalocele, and nasal neuroglial heterotopia; inflammatory and infectious processes such as mucocele, polyp, and pyogenic granuloma; benign neoplasms such as infantile hemangioma and juvenile nasopharyngeal angiofibroma; malignant lesions such as rhabdomyosarcoma and nasopharyngeal carcinoma; and masses related to prior trauma such as septal hematoma...
October 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/29019632/racial-and-ethnic-health-disparities-and-trauma-informed-care-for-children-exposed-to-community-violence
#4
Bradley C Stolbach, Seeba Anam
Racial and ethnic disparities in health outcomes and access have been consistently documented for a wide variety of physical and behavioral health conditions. Health inequities are most pronounced in areas with high levels of racial and ethnic segregation, where children and adolescents are also more likely to face economic inequality, which places them at high risk for exposure to neighborhood violence and traumatic loss. Community violence exposure (CVE) has been increasingly recognized as a prominent contributor to negative physical and mental health outcomes...
October 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/29016519/clinical-decision-rule-to-identify-orbital-wall-fracture-among-children-retrospective-derivation-and-validation-study
#5
So Hyun Paek, Jin Hee Jung, Young Ho Kwak, Do Kyun Kim, Jin Hee Lee, Jae Yun Jung, Sohee Oh
OBJECTIVES: Head and face injuries are leading causes of emergency department visits in children. There is yet no clinical decision rule on face CT such as pediatric head CT rules. The goal was to develop and validate a clinical decision rule for identifying orbital wall fractures in children with periorbital trauma in the emergency department. METHODS: This was a retrospective derivation and validation study. Children younger than 18 years who underwent orbit CT after periorbital trauma were included between January 2011 and December 2013 in 3 emergency centers...
October 9, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29016432/is-systemic-inflammatory-response-syndrome-relevant-to-pulmonary-complications-and-mortality-in-multiply-injured-children
#6
Waleed Al-Mahdi, Mazen M Ibrahim, David A Spiegel, Alexandre Arkader, Michael Nance, Keith Baldwin
BACKGROUND: Systemic inflammatory response syndrome (SIRS) is a well-recognized phenomenon in adult trauma populations. The "initial hit" of the traumatic event is often coupled with a systemic immune response characterized by changes in vital signs and laboratory indicators. A "second hit" from surgery during this time frame often results in acute lung injury, along with deterioration of the patient's clinical condition. We hypothesized that children and adolescents would experience SIRS physiology, but would not experience adult respiratory distress syndrome (ARDS) or "second hit" related death to the extent seen in the adult populations...
October 9, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28991830/development-and-validation-of-an-empiric-tool-to-predict-favorable-neurologic-outcomes-among-picu-patients
#7
Punkaj Gupta, Mallikarjuna Rettiganti, Jeffrey M Gossett, Jennifer Daufeldt, Tom B Rice, Randall C Wetzel
OBJECTIVES: To create a novel tool to predict favorable neurologic outcomes during ICU stay among children with critical illness. DESIGN: Logistic regression models using adaptive lasso methodology were used to identify independent factors associated with favorable neurologic outcomes. A mixed effects logistic regression model was used to create the final prediction model including all predictors selected from the lasso model. Model validation was performed using a 10-fold internal cross-validation approach...
October 6, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28988836/parental-perceptions-risks-and-incidence-of-pediatric-unintentional-injuries
#8
Catherine M Hogan, Nancy L Weaver, Claire Cioni, Jessica Fry, Alyssa Hamilton, Samantha Thompson
INTRODUCTION: More than 9,000 children die annually from various causes of unintentional injury. Of all the pediatric unintentional injuries occurring in the United States, 8.7 million are treated in emergency departments, and 225,000 require hospitalization annually. Health education programs are available to address these injuries. The objective of this research was to examine the distribution of self-reported high priority injury risks in an urban Midwestern pediatric level 1 trauma center and investigate the relationship between parental perceptions and injury-prevention behaviors...
October 6, 2017: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/28987312/incidental-findings-on-pediatric-abdominal-computed-tomography-at-a-pediatric-trauma-center
#9
Youanna Daoud, Alexander Philip, Gal Altberg, Hadassa Leader, Jeremy Neuman, Barry Hahn
BACKGROUND: The increasing availability and use of computed tomography (CT) in pediatric abdominal trauma has increased the detection of incidental findings. While some of these findings are benign, others may require further evaluation for possible clinical importance. OBJECTIVES: This study aimed to identify the frequency and type of incidental findings and their need for follow-up on abdominal CT in patients at a pediatric trauma center. METHODS: This was a retrospective, observational study on trauma patients ≤21 years of age who presented to the emergency department between January 1, 2004 and July 31, 2016 and underwent CT scans of the abdomen and pelvis...
October 5, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28985969/modifiable-factors-associated-with-survival-after-out-of-hospital-cardiac-arrest-in-the-pan-asian-resuscitation-outcomes-study
#10
Hideharu Tanaka, Marcus E H Ong, Fahad J Siddiqui, Matthew H M Ma, Hiroshi Kaneko, Kyung Won Lee, Kentaro Kajino, Chih-Hao Lin, Han Nee Gan, Pairoj Khruekarnchana, Omer Alsakaf, Nik H Rahman, Nausheen E Doctor, Pryseley Assam, Sang Do Shin
STUDY OBJECTIVE: The study aims to identify modifiable factors associated with improved out-of-hospital cardiac arrest survival among communities in the Pan-Asian Resuscitation Outcomes Study (PAROS) Clinical Research Network: Japan, Singapore, South Korea, Malaysia, Taiwan, Thailand, and the United Arab Emirates (Dubai). METHODS: This was a prospective, international, multicenter cohort study of out-of-hospital cardiac arrest in the Asia-Pacific. Arrests caused by trauma, patients who were not transported by emergency medical services (EMS), and pediatric out-of-hospital cardiac arrest cases (<18 years) were excluded from the analysis...
October 3, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28985200/cellular-therapy-for-traumatic-neurological-injury
#11
REVIEW
Charles S Cox
Neurological injury is the primary lethal mechanism of injury in children, and the primary etiology of long-term disability after trauma. Laboratories and clinical/translational teams have sought to develop stem/progenitor cell therapies to improve recovery in a clinical setting in which there is no significant reparative option. While none of these treatments are currently standard therapeutics, Phase 2b clinical trials are underway in both adults and children in severe traumatic brain injury and Phase 1/2a trials in spinal cord injury...
October 6, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28984538/lessons-learned-from-administration-of-high-dose-methylprednisolone-sodium-succinate-for-acute-pediatric-spinal-cord-injuries
#12
Michelle C Caruso, Margot C Daugherty, Suzanne M Moody, Richard A Falcone, Karin S Bierbrauer, Gary L Geis
OBJECTIVE Methylprednisolone sodium succinate (MPSS) has been studied as a pharmacological adjunct that may be given to patients with acute spinal cord injury (ASCI) to improve neurological recovery. MPSS treatment became the standard of care in adults despite a lack of evidence supporting clinical benefit. More recently, new guidelines from neurological surgeon groups recommended no longer using MPSS for ASCI, due to questionable clinical benefit and known complications. However, little information exists in the pediatric population regarding MPSS use in the setting of ASCI...
October 6, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28980203/correction-to-common-pediatric-medical-emergencies-in-office-practice
#13
Bharat Mehra, Suresh Gupta
The published online version contains an inadvertent error. On page 8, under the heading "Approach to a Child with Trauma" there is a box with "Primary Survey & Resuscitation".
October 2, 2017: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/28980061/applications-of-contrast-enhanced-ultrasound-in-the-pediatric-abdomen
#14
Aikaterini Ntoulia, Sudha A Anupindi, Kassa Darge, Susan J Back
Contrast-enhanced ultrasound (CEUS) is a radiation-free, safe, and in specific clinical settings, highly sensitive imaging modality. Over the recent decades, there is cumulating experience and a large volume of published safety and efficacy data on pediatric CEUS applications. Many of these applications have been directly translated from adults, while others are unique to the pediatric population. The most frequently reported intravenous abdominal applications of CEUS in children are the characterization of focal liver lesions, monitoring of solid abdominal tumor response to treatment, and the evaluation of intra-abdominal parenchymal injuries in selected cases of blunt abdominal trauma...
October 4, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/28977339/glucocorticoid-induced-bone-disease-mechanisms-and-importance-in-pediatric-practice
#15
Emanuel Sávio Cavalcanti Sarinho, Verônica Maria Pinho Pessoa Melo
OBJECTIVE: To describe mechanisms by which glucocorticoids cause osteoporosis, with fracture risk, combining this learning with a possible professional behavior change. DATA SOURCES: A systematic search on SciELO, PubMed, Scopus, and Medline databases was carried out for consensus, review articles, including systematic reviews and meta-analysis, which were published in English, between 2000 and 2016. Keywords used on the search were the following: glucocorticoids, fractures, osteoporosis, bone health, vitamin D, children, and adolescents...
April 2017: Revista Paulista de Pediatria: Orgão Oficial da Sociedade de Pediatria de São Paulo
https://www.readbyqxmd.com/read/28973391/postoperative-epileptic-seizures-in-children-is-the-brain-incision-a-risk-factor
#16
Luca Massimi, Domenica Battaglia, Federico Bianchi, Simone Peraio, Elisabetta Peppucci, Concezio Di Rocco
BACKGROUND: Postoperative seizures (PSs) after neurosurgical operations are common but little is known about the role of surgical brain incision on their genesis. This topic has not been addressed so far. OBJECTIVE: To verify if the corticotomy affects the risk of PSs and postoperative epilepsy (PE) in children. METHODS: One hundred forty-three consecutive pediatric cases operated on for supratentorial lesions at the same institution in the last 15 yr have been retrospectively reviewed by dividing them into group A, 68 children who required brain corticotomy mainly for hemispheric tumors, and group B, 75 children treated through extracortical approaches mainly for suprasellar and optic tumors...
July 7, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28972667/fracture-incidence-and-characteristics-in-young-adults-aged-18-to-49-years-a-population-based-study
#17
Joshua N Farr, L Joseph Melton, Sara J Achenbach, Elizabeth J Atkinson, Sundeep Khosla, Shreyasee Amin
Although fractures in both the pediatric and, especially, the elderly populations have been extensively investigated, comparatively little attention has been given to the age group in between. Thus, we used the comprehensive (inpatient and outpatient) data resources of the Rochester Epidemiology Project to determine incidence rates for all fractures among young adult (age range, 18 to 49 years) residents of Olmsted County, Minnesota, in 2009 to 2011, and compared the distribution of fracture sites and causes in this young adult cohort with those for older residents aged 50 years or older...
July 29, 2017: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
https://www.readbyqxmd.com/read/28970241/does-the-addition-of-a-black-bone-sequence-to-a-fast-multisequence-trauma-mr-protocol-allow-mri-to-replace-ct-after-traumatic-brain-injury-in-children
#18
M H G Dremmen, M W Wagner, T Bosemani, A Tekes, D Agostino, E Day, B P Soares, T A G M Huisman
BACKGROUND AND PURPOSE: Head CT is the current neuroimaging tool of choice in acute evaluation of pediatric head trauma. The potential cancer risks of CT-related ionizing radiation should limit its use in children. We evaluated the role of MR imaging, including a "black bone" sequence, compared with CT in detecting skull fractures and intracranial hemorrhages in children with acute head trauma. MATERIALS AND METHODS: We performed a retrospective evaluation of 2D head CT and brain MR imaging studies including the black bone sequence of children with head trauma...
September 28, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28965684/universal-health-insurance-and-its-association-with-long-term-outcomes-in-pediatric-trauma-patients
#19
Meesha Sharma, Andrew J Schoenfeld, Wei Jiang, Muhammad A Chaudhary, Anju Ranjit, Cheryl K Zogg, Peter Learn, Tracey Koehlmoos, Adil H Haider
BACKGROUND: Racial disparities in mortality exist among pediatric trauma patients; however, little is known about disparities in outcomes following discharge. METHODS: We conducted a longitudinal cohort study of children admitted for moderate to severe trauma, covered by TRICARE from 2006 to 2014. Patients were followed up to 90days after discharge. All children <18 years with a primary trauma diagnosis, an Injury Severity Score >9 and 90days of follow-up after discharge were included...
September 23, 2017: Injury
https://www.readbyqxmd.com/read/28964315/pediatric-tracheotomy-a-comparison-of-outcomes-and-lengths-of-hospitalization-between-different-indications
#20
Che-Yi Lin, Te-Tien Ting, Tzu-Yu Hsiao, Wei-Chung Hsu
OBJECTIVES: To assess outcomes of pediatric tracheotomy and duration of associated hospital stay according to indications. SUBJECTS AND METHODS: In this retrospective study, subjects were 142 consecutive pediatric patients (<18 years old) who underwent tracheotomy at a tertiary referral medical center, National Taiwan University Hospital, in 1997-2012. Age, sex, indications, pre-operative status (oxygen demand, number of repeated intubations), and post-operative status (duration of weaning, length of hospital stay, mortality) were analyzed...
October 2017: International Journal of Pediatric Otorhinolaryngology
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