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https://www.readbyqxmd.com/read/30048385/pathology-of-perimacular-folds-due-to-vitreoretinal-traction-in-abusive-head-trauma
#1
Waleed Abed Alnabi, Garland J Tang, Ralph C Eagle, Sam Gulino, Avrey Thau, Alex V Levin
PURPOSE: To demonstrate vitreoretinal traction as a mechanism for perimacular folds in abusive head trauma. METHODS: We performed gross and histopathologic examination of eyes of children with suspected abusive head trauma and identified those with typical perimacular folds. Information was collected regarding the incident that led to the child's death and systemic manifestations noted at autopsy. Eyes were prepared in a fashion that allowed for demonstration of the vitreoretinal interface...
July 25, 2018: Retina
https://www.readbyqxmd.com/read/30037976/the-eye-examination-in-the-evaluation-of-child-abuse
#2
Cindy W Christian, Alex V Levin
Child abuse can cause injury to any part of the eye. The most common manifestations are retinal hemorrhages (RHs) in infants and young children with abusive head trauma (AHT). Although RHs are an important indicator of possible AHT, they are also found in other conditions. Distinguishing the number, type, location, and pattern of RHs is important in evaluating a differential diagnosis. Eye trauma can be seen in cases of physical abuse or AHT and may prompt referral for ophthalmologic assessment. Physicians have a responsibility to consider abuse in the differential diagnosis of pediatric eye trauma...
August 2018: Pediatrics
https://www.readbyqxmd.com/read/29913434/factors-influencing-child-protection-professionals-decision-making-and-multidisciplinary-collaboration-in-suspected-abusive-head-trauma-cases-a-qualitative-study
#3
Laura E Cowley, Sabine Maguire, Daniel M Farewell, Harriet D Quinn-Scoggins, Matthew O Flynn, Alison M Kemp
Clinicians face unique challenges when assessing suspected child abuse cases. The majority of the literature exploring diagnostic decision-making in this field is anecdotal or survey-based and there is a lack of studies exploring decision-making around suspected abusive head trauma (AHT). We aimed to determine factors influencing decision-making and multidisciplinary collaboration in suspected AHT cases, amongst 56 child protection professionals. Semi-structured interviews were conducted with clinicians (25), child protection social workers (10), legal practitioners (9, including 4 judges), police officers (8), and pathologists (4), purposively sampled across southwest United Kingdom...
August 2018: Child Abuse & Neglect
https://www.readbyqxmd.com/read/29903429/simulation-based-research-to-improve-infant-health-outcomes-using-the-infant-simulator-to-prevent-infant-shaking
#4
Kirsten Bechtel, Ambika Bhatnagar, Marc Auerbach
Simulation is a technique that creates a situation or environment to allow persons to experience a representation of a real event for the purpose of practice, learning, evaluation, testing, or to gain understanding of systems or human actions. We will first provide an introduction to simulation in healthcare and describe the two types of simulation-based research (SBR) in the pediatric population. We will then provide an overview of the use of SBR to improve health outcomes for infants in health care settings and to improve parent-child interactions using the infant simulator...
June 11, 2018: Infant Behavior & Development
https://www.readbyqxmd.com/read/29771763/recognizing-diagnosing-and-preventing-child-maltreatment-an-update-for-pediatric-clinicians
#5
Fiona Danaher, Andrea Vandeven, Aine Blanchard, Alice W Newton
PURPOSE OF REVIEW: Despite an increasing understanding of the impact of emotional trauma and physical abuse on children, clinicians and hospitals still sometimes miss the diagnosis of abuse. The literature in 2017 focused on creating standardized approaches to recognition and diagnosis of physical abuse and occult injury, including using the electronic medical record to provide triggers for consultation of the hospital Child Protection Program. The American College of Radiology updated their standardized approach to the evaluation of physical abuse in the child, and other authors gave us screening tools for commercial exploitation, as well as guidance about how to recognize risks for emotional abuse in families...
August 2018: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/29753199/acceptability-of-the-predicting-abusive-head-trauma-predaht-clinical-prediction-tool-a-qualitative-study-with-child-protection-professionals
#6
Laura E Cowley, Sabine Maguire, Daniel M Farewell, Harriet D Quinn-Scoggins, Matthew O Flynn, Alison M Kemp
The validated Predicting Abusive Head Trauma (PredAHT) tool estimates the probability of abusive head trauma (AHT) based on combinations of six clinical features: head/neck bruising; apnea; seizures; rib/long-bone fractures; retinal hemorrhages. We aimed to determine the acceptability of PredAHT to child protection professionals. We conducted qualitative semi-structured interviews with 56 participants: clinicians (25), child protection social workers (10), legal practitioners (9, including 4 judges), police officers (8), and pathologists (4), purposively sampled across southwest United Kingdom...
July 2018: Child Abuse & Neglect
https://www.readbyqxmd.com/read/29622594/clinical-prediction-rules-for-abusive-head-trauma-a-systematic-review
#7
Helena Pfeiffer, Louise Crowe, Alison Mary Kemp, Laura Elizabeth Cowley, Anne S Smith, Franz E Babl
OBJECTIVE: Misdiagnosis of abusive head trauma (AHT) has serious consequences for children and families. This systematic review identifies and compares clinical prediction rules (CPredRs) assisting clinicians in assessing suspected AHT. DESIGN: We searched MEDLINE, Embase, PubMed and Cochrane databases (January 1996 to August 2016). Externally validated CPredRs focusing on the detection of AHT in the clinical setting were included. RESULTS: Of 110 potential articles identified, three studies met the inclusion criteria: the Pediatric Brain Injury Research Network (PediBIRN) 4-Variable AHT CPredR, the Predicting Abusive Head Trauma (PredAHT) tool and the Pittsburgh Infant Brain Injury Score (PIBIS)...
August 2018: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/29523358/injury-patterns-of-child-abuse-experience-of-two-level-1-pediatric-trauma-centers
#8
Yangyang R Yu, Annalyn S DeMello, Christopher S Greeley, Charles S Cox, Bindi J Naik-Mathuria, David E Wesson
PURPOSE: This study examines non-accidental trauma (NAT) fatalities as a percentage of all injury fatalities and identifies injury patterns in NAT admissions to two level 1 pediatric trauma centers. METHODS: We reviewed all children (<5years old) treated for NAT from 2011 to 2015. Patient demographics, injury sites, and survival were obtained from both institutional trauma registries. RESULTS: Of 4623 trauma admissions, 557 (12%) were due to NAT...
May 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29510999/abusive-head-trauma-and-the-triad-a-critique-on-behalf-of-rcpch-of-traumatic-shaking-the-role-of-the-triad-in-medical-investigations-of-suspected-traumatic-shaking
#9
REVIEW
Geoffrey David Debelle, Sabine Maguire, Patrick Watts, Rosa Nieto Hernandez, Alison Mary Kemp
The Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU) has recently published what they purported to be a systematic review of the literature on 'isolated traumatic shaking' in infants, concluding that 'there is limited evidence that the so-called triad (encephalopathy, subdural haemorrhage, retinal haemorrhage) and therefore its components can be associated with traumatic shaking'. This flawed report, from a national body, demands a robust response. The conclusions of the original report have the potential to undermine medico-legal practice...
June 2018: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/29371238/potential-opportunities-for-prevention-or-earlier-diagnosis-of-child-physical-abuse-in-the-inpatient-setting
#10
Henry T Puls, James D Anderst, Jessica L Bettenhausen, Abbey Masonbrink, Jessica L Markham, Laura Plencner, Molly Krager, Matthew B Johnson, Jacqueline M Walker, Christopher S Greeley, Matthew Hall
OBJECTIVES: To compare rates of previous inpatient visits among children hospitalized with child physical abuse (CPA) with controls as well as between individual abuse types. METHODS: In this study, we used the Pediatric Health Information System administrative database of 44 children's hospitals. Children <6 years of age hospitalized with CPA between January 1, 2011, and September 30, 2015, were identified by discharge codes and propensity matched to accidental injury controls...
January 25, 2018: Hospital Pediatrics
https://www.readbyqxmd.com/read/29292621/-seizure-in-a-baby-shaking-the-diagnosis
#11
Ayelet Shles, Rodica Stackievicz, Rama Schwartz
Abusive head trauma(AHT), formally known as "shaken baby syndrome" , is one of the most violent expressions of child abuse, and one of the leading causes of mortality due to trauma among infants. It occurs mainly in children under 1 year of age, and may result in severe consequences, such as physical and mental disabilities. Symptoms and signs of this form of abuse can be easily mistaken for common illnesses in children or accidental head injury. Therefore, the clinician can establish this diagnosis with confidence only if he/she maintains a high index of suspicion regarding the diagnosis...
December 2017: Harefuah
https://www.readbyqxmd.com/read/29160091/probabilistic-description-of-infant-head-kinematics-in-abusive-head-trauma
#12
T O Lintern, M P Nash, P Kelly, F H Bloomfield, A J Taberner, P M F Nielsen
Abusive head trauma (AHT) is a potentially fatal result of child abuse, but the mechanisms by which injury occur are often unclear. To investigate the contention that shaking alone can elicit the injuries observed, effective computational models are necessary. The aim of this study was to develop a probabilistic model describing infant head kinematics in AHT. A deterministic model incorporating an infant's mechanical properties, subjected to different shaking motions, was developed in OpenSim. A Monte Carlo analysis was used to simulate the range of infant kinematics produced as a result of varying both the mechanical properties and the type of shaking motions...
December 2017: Computer Methods in Biomechanics and Biomedical Engineering
https://www.readbyqxmd.com/read/29075919/a-systematic-autopsy-survey-of-human-infant-bridging-veins
#13
Emma C Cheshire, Roger D G Malcomson, Peng Sun, Evgeny M Mirkes, Jasmin M Amoroso, Guy N Rutty
In the first years of life, subdural haemorrhage (SDH) within the cranial cavity can occur through accidental and non-accidental mechanisms as well as from birth-related injury. This type of bleeding is the most common finding in victims of abusive head trauma (AHT). Historically, the most frequent cause of SDHs in infancy is suggested to be traumatic damage to bridging veins traversing from the brain to the dural membrane. However, several alternative hypotheses have been suggested for the cause and origin of subdural bleeding...
March 2018: International Journal of Legal Medicine
https://www.readbyqxmd.com/read/28956988/recognition-and-nursing-management-of-abusive-head-trauma-in-children
#14
Francesca Louise Payne, Daphin Nazareth Fernandez, Lucy Jenner, Siba Prosad Paul
Abusive head trauma (AHT) describes an injury to the head caused by a deliberate impact or shaking by a parent or carer. It can cause significant morbidity and mortality in infants, and is most commonly seen in those aged under 2 years. The initial presentation of AHT can include vague symptoms and the correct diagnosis may be missed by health professionals. Subdural haematoma, brain oedema and retinal haemorrhages are well-known features associated with AHT. However, other conditions such as birth trauma, accidental falls in infants and bleeding disorders can all mimic AHT, thus making its recognition difficult...
September 28, 2017: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/28685210/lifetime-cost-of-abusive-head-trauma-at-ages-0-4-usa
#15
Ted R Miller, Ryan Steinbeigle, Bruce A Lawrence, Cora Peterson, Curtis Florence, Marilyn Barr, Ronald G Barr
This paper aims to estimate lifetime costs resulting from abusive head trauma (AHT) in the USA and the break-even effectiveness for prevention. A mathematical model incorporated data from Vital Statistics, the Healthcare Cost and Utilization Project Kids' Inpatient Database, and previous studies. Unit costs were derived from published sources. From society's perspective, discounted lifetime cost of an AHT averages $5.7 million (95% CI $3.2-9.2 million) for a death. It averages $2.6 million (95% CI $1.0-2.9 million) for a surviving AHT victim including $224,500 for medical care and related direct costs (2010 USD)...
August 2018: Prevention Science: the Official Journal of the Society for Prevention Research
https://www.readbyqxmd.com/read/28665242/changes-in-use-of-cervical-spine-magnetic-resonance-imaging-for-pediatric-patients-with-nonaccidental-trauma
#16
Ahyuda Oh, Michael Sawvel, David Heaner, Amina Bhatia, Andrew Reisner, R Shane Tubbs, Joshua J Chern
OBJECTIVE Past studies have suggested correlations between abusive head trauma and concurrent cervical spine (c-spine) injury. Accordingly, c-spine MRI (cMRI) has been increasingly used in radiographic assessments. This study aimed to determine trends in cMRI use and treatment, and outcomes related to c-spine injury in children with nonaccidental trauma (NAT). METHODS A total of 503 patients with NAT who were treated between 2009 and 2014 at a single pediatric health care system were identified from a prospectively maintained database...
September 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28609181/effect-of-the-earned-income-tax-credit-on-hospital-admissions-for-pediatric-abusive-head-trauma-1995-2013
#17
Joanne Klevens, Brian Schmidt, Feijun Luo, Likang Xu, Katie A Ports, Rosalyn D Lee
OBJECTIVES: Policies that increase household income, such as the earned income tax credit (EITC), have shown reductions on risk factors for child maltreatment (ie, poverty, maternal stress, depression), but evidence is lacking on whether the EITC actually reduces child maltreatment. We examined whether states' EITCs are associated with state rates of hospital admissions for abusive head trauma among children aged <2 years. METHODS: We conducted difference-in-difference analyses (ie, pre- and postdifferences in intervention vs control groups) of annual rates of states' hospital admissions attributed to abusive head trauma among children aged <2 years (ie, using aggregate data)...
July 2017: Public Health Reports
https://www.readbyqxmd.com/read/28605024/a-unique-type-of-birth-trauma-mistaken-for-abuse
#18
Carolyn V Isaac, Jered B Cornelison, Rudolph J Castellani, Joyce L deJong
Pediatric abusive head trauma is a challenging subject across many disciplines. Of particular importance is the identification of mimics of abuse, so cause and manner of death can be properly assigned. We present the case of suspected child abuse involving an infant who presented unresponsive to the hospital with hypoglycemia, hypothermia, and bilateral parietal fractures. An autopsy revealed fractures associated with organizing scalp hemorrhage and gross leptomeningeal congestion and hemorrhage. The fractures were circular with external displacement, rounded margins, and subperiosteal new bone formation indicative of healing...
March 2018: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/28584471/child-maltreatment-cross-sectional-survey-of-general-dentists
#19
Harsimran Kaur, K S Vinod, Harpreet Singh, Lavina Arya, Prateek Verma, Baldeep Singh
BACKGROUND: Child abuse continues to be a social menace causing both physical and emotional trauma to benevolent children. Census has shown that nearly 50-75% of child abuse include trauma to mouth, face, and head. Thus, dental professionals are in a strategic position to identify physical and emotional manifestations of abuse. AIM: A cross-sectional survey was conducted to assess knowledge and attitude of dental professionals on the exigent issue of child abuse...
January 2017: Journal of Forensic Dental Sciences
https://www.readbyqxmd.com/read/28574318/pediatric-abusive-head-trauma-and-stroke
#20
Nickalus R Khan, Brittany D Fraser, Vincent Nguyen, Kenneth Moore, Scott Boop, Brandy N Vaughn, Paul Klimo
OBJECTIVE Despite established risk factors, abusive head trauma (AHT) continues to plague our communities. Cerebrovascular accident (CVA), depicted as areas of hypodensity on CT scans or diffusion restriction on MR images, is a well-known consequence of AHT, but its etiology remains elusive. The authors hypothesize that a CVA, in isolation or in conjunction with other intracranial injuries, compounds the severity of a child's injury, which in turn leads to greater health care utilization, including surgical services, and an increased risk of death...
August 2017: Journal of Neurosurgery. Pediatrics
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