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Trauma pediatric

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https://www.readbyqxmd.com/read/29150368/the-utility-of-ercp-in-pediatric-pancreatic-trauma
#1
Eric H Rosenfeld, Adam M Vogel, Denise B Klinkner, Mauricio Escobar, Barbara Gaines, Robert Russell, Brendan Campbell, Hale Wills, Anthony Stallion, David Juang, Rajan K Thakkar, Jeffrey Upperman, Mubeen Jafri, Randall Burd, Bindi J Naik-Mathuria
BACKGROUND/PURPOSE: Endoscopic retrograde cholangiopancreatography (ERCP) is an adjunct for pediatric pancreatic injury management, but its use and utility in pediatric patients are unclear. We set out to evaluate the use of ERCP and its effects on outcomes. METHODS: A retrospective review was performed for children who had pancreatic injuries at 22 pediatric trauma centers between 2010 and 2015. ERCP details and outcomes were collected. Analysis was performed using descriptive statistics and Wilcoxon rank-sum tests...
October 13, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29149395/shaken-baby-syndrome-what-certainty-do-we-have
#2
Matthieu Vinchon
BACKGROUND: Shaken baby syndrome is a common and devastating disease in infants. In spite of its frequency, many controversies persist, regarding the pathophysiology, diagnosis, and management. AIM OF THE STUDY: We reviewed several salient and challenging issues related to SBS, like its pathogenesis, predisposing factors, differential diagnosis, and prevention programs. MATERIAL AND METHODS: We derive arguments from the literature and from our prospective registry of accidental and non-accidental traumas in infants...
October 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29149393/challenges-in-minor-tbi-and-indications-for-head-ct-in-pediatric-tbi-an-update
#3
Navneet Singh, Ash Singhal
INTRODUCTION: Pediatric head trauma is one of the commonest presentations to emergency departments. Over 90% of such head injuries are considered mild, but still present risk acute clinical deterioration and longer term morbidity. Identifying which children are at risk of clinically important brain injuries remains challenging and much of the data on minor head injuries is based on the adult population. CHALLENGES IN PEDIATRICS: Children, however, are different, both anatomically and in terms of mechanism of injury, to adults and, even within the pediatric group, there are differences with age and stage of development...
October 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29148922/feasibility-and-safety-of-using-thoracic-and-lumbar-cortical-bone-trajectory-pedicle-screws-in-spinal-constructs-in-children-technical-note
#4
Jonathan N Sellin, Jeffrey S Raskin, Kristen A Staggers, Alison Brayton, Valentina Briceño, Amee J Moreno, Andrew Jea
Thoracic and lumbar cortical bone trajectory pedicle screws have been described in adult spine surgery. They have likewise been described in pediatric CT-based morphometric studies; however, clinical experience in the pediatric age group is limited. The authors here describe the use of cortical bone trajectory pedicle screws in posterior instrumented spinal fusions from the upper thoracic to the lumbar spine in 12 children. This dedicated study represents the initial use of cortical screws in pediatric spine surgery...
November 17, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29145243/obstructive-internal-hernia-caused-by-mesodiverticular-bands-in-children-two-case-reports-and-a-review-of-the-literature
#5
Mirko Bertozzi, Berardino Melissa, Elisa Magrini, Giuseppe Di Cara, Susanna Esposito, Antonino Apignani
INTRODUCTION: The mesodiverticular band (MDB) is an embryologic remnant of the vitelline circulation, which carries the arterial supply to the Meckel diverticulum. In the event of an error of involution, a patent or nonpatent arterial band persists and extends from the mesentery to the apex of the antimesenteric diverticulum. This creates a snare-like opening through which bowel loops may herniate and become obstructed. This report describes 2 rare cases of small bowel occlusion owing to an internal hernia caused by a MDB...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29142631/mortality-and-epidemiology-in-256-cases-of-pediatric-traumatic-brain-injury-korean-neuro-trauma-data-bank-system-kntdbs-2010-2014
#6
Hee-Won Jeong, Seung-Won Choi, Jin-Young Youm, Jeong-Wook Lim, Hyon-Jo Kwon, Shi-Hun Song
Objective: Among pediatric injury, brain injury is a leading cause of death and disability. To improve outcomes, many developed countries built neurotrauma databank (NTDB) system but there was not established nationwide coverage NTDB until 2009 and there have been few studies on pediatric traumatic head injury (THI) patients in Korea. Therefore, we analyzed epidemiology and outcome from the big data of pediatric THI. Methods: We collected data on pediatric patients from 23 university hospitals including 9 regional trauma centers from 2010 to 2014 and analyzed their clinical factors (sex, age, initial Glasgow coma scale, cause and mechanism of head injury, presence of surgery)...
November 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/29136254/completion-of-multiple-fellowships-by-orthopedic-surgeons-analysis-of-the-american-board-of-orthopaedic-surgery-certification-database
#7
J Mason DePasse, Alan H Daniels, Wesley Durand, Brandon Kingrey, John Prodromo, Mary K Mulcahey
Orthopedic surgeons have become increasingly subspecialized, and recent studies have shown that American Board of Orthopaedic Surgery (ABOS) Step II applicants are performing a higher percentage of their cases within their chosen subspecialties. However, these studies focused exclusively on surgeons who have completed a single fellowship; little data exist on those who pursue a second fellowship. All applicants to the ABOS Part II examination from 2004 to 2016 were classified by their self-reported fellowship training history using the ABOS Part II examination database...
November 11, 2017: Orthopedics
https://www.readbyqxmd.com/read/29133650/epidemiology-clinical-profile-and-factors-predicting-final-visual-outcome-of-pediatric-ocular-trauma-in-a-tertiary-eye-care-center-of-central-india
#8
Satendra Singh, Bhavana Sharma, Kavita Kumar, Aditi Dubey, Kanchan Ahirwar
PURPOSE: Ocular trauma constitutes an important cause of preventable visual morbidity worldwide. This study was done to study the incidence, sociodemographic pattern, and clinical profile of ocular trauma in pediatric age group. Also to evaluate the factors influencing final visual outcome in these patients. METHODS: This was a prospective interventional study concerning ocular trauma in pediatric patients up to 16 years of age of either sex. Various variables having an impact on final visual outcome were studied, and results were analyzed using statistical indices - relative risk, Chi-square test, P value, and linear regression analysis...
November 2017: Indian Journal of Ophthalmology
https://www.readbyqxmd.com/read/29132580/the-kids-are-alright-pediatric-trauma-pearls
#9
REVIEW
Angelo Mikrogianakis, Vincent Grant
Pediatric patients with trauma pose unique challenges, both practical and cognitive, to front-line care providers. The combination of anatomic, physiologic, and metabolic factors leads to unique injury patterns with different approaches and responses to treatment compared with adults. A similar traumatic mechanism can lead to slightly different internal injuries with unique management and treatment strategies between the two groups. This article is intended for community, nonpediatric trauma centers, and emergency physicians who are frequently required to assess, resuscitate, and stabilize injured children before they can be safely transferred to a pediatric trauma center for ongoing definitive care and rehabilitation...
February 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/29131915/visual-and-refractive-outcomes-of-children-after-early-secondary-cataract-extraction-following-wound-repair-for-penetrating-ocular-trauma
#10
Kamaldeep Arora, Priyanka Arora, Suma Ganesh, Shriya Gupta, Rashmi Ranjan Das
PURPOSE: To evaluate the visual and refractive outcomes in children 8 years of age or younger with corneal laceration and cataract following penetrating ocular injuries who underwent primary corneal tear repair followed within 1 to 8 weeks by early secondary cataract extraction. METHODS: This retrospective, non-comparative case series reviewed the admission and operative charts of children 8 years of age or younger (range: 3 to 8 years) who underwent corneal wound repair as the primary surgical procedure followed within 1 to 8 weeks by cataract extraction with intraocular lens implantation, with a minimum follow-up period of 6 months...
November 11, 2017: Journal of Pediatric Ophthalmology and Strabismus
https://www.readbyqxmd.com/read/29131913/unilateral-congenital-cataract-clinical-profile-and-presentation
#11
Sudarshan Khokhar, Cijin P Jose, Ramanjit Sihota, Neha Midha
PURPOSE: To study the clinical profile and presentation of children with unilateral cataract. METHODS: In this hospital-based, observational, cross-sectional study, patients 15 years of age or younger who presented with unilateral cataract were recruited. Cases of cataract secondary to causes such as trauma or uveitis were excluded. Age at detection and presentation, distance from the treatment center, presenting complaints, cataract morphology, and biometry were noted for each case...
November 11, 2017: Journal of Pediatric Ophthalmology and Strabismus
https://www.readbyqxmd.com/read/29129151/false-positive-diagnosis-of-brain-death-following-the-pediatric-guidelines-case-report-and-discussion
#12
D Alan Shewmon
A 2-year-old boy with severe head trauma was diagnosed brain dead according to the 2011 Pediatric Guidelines. Computed tomographic (CT) scan showed massive cerebral edema with herniation. Intracranial pressures were extremely high, with cerebral perfusion pressures around 0 for several hours. An apnea test was initially contraindicated; later, one had to be terminated due to oxygen desaturation when the Pco2 had risen to 57.9 mm Hg. An electroencephalogram (EEG) was probably isoelectric but formally interpreted as equivocal...
December 2017: Journal of Child Neurology
https://www.readbyqxmd.com/read/29126550/trends-in-pediatric-adjusted-shock-index-predict-morbidity-and-mortality-in-children-with-severe-blunt-injuries
#13
Robert J Vandewalle, Julia K Peceny, Scott C Dolejs, Jodi L Raymond, Thomas M Rouse
PURPOSE: The utility of measuring the pediatric adjusted shock index (SIPA) at admission for predicting severity of blunt injury in pediatric patients has been previously reported. However, the utility of following SIPA after admission is not well described. METHODS: The trauma registry from a level-one pediatric trauma center was queried from January 1, 2010 to December 31, 2015. Patients were included if they were between 4 and 16years old at the time of admission, sustained a blunt injury with an Injury Severity Score≥15, and were admitted less than 12h after their injury (n=286)...
October 14, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29125442/long-term-outcomes-after-surgical-treatment-of-pediatric-neurogenic-thoracic-outlet-syndrome
#14
Jennifer Hong, Jared M Pisapia, Zarina S Ali, Austin J Heuer, Erin Alexander, Gregory G Heuer, Eric L Zager
OBJECTIVE Neurogenic thoracic outlet syndrome (nTOS) is an uncommon compression syndrome of the brachial plexus that presents with pain, sensory changes, and motor weakness in the affected limb. The authors reviewed the clinical presentations and outcomes in their series of pediatric patients with surgically treated nTOS over a 6-year period. METHODS Cases of nTOS in patients age 18 years or younger were extracted for analysis from a prospective database of peripheral nerve operations. Baseline patient characteristics, imaging and neurophysiological data, operative findings, and outcomes and complications were assessed...
November 10, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29124036/surgical-repair-of-a-traumatic-tracheobronchial-injury-in-a-pediatric-patient-assisted-with-venoarterial-extracorporeal-membrane-oxygenation
#15
Jee Won Suh, Hong Ju Shin, Chang Young Lee, Seung Hwan Song, Kyoung Sik Narm, Jin Gu Lee
Tracheobronchial rupture due to blunt chest trauma is a rare but life-threatening injury in the pediatric population. Computed tomography (CT) is not always reliable in the management of these patients. An additional concern is that ventilation may be disrupted during surgical repair of these injuries. This report presents the case of a 4 -year-old boy with an injury to the lower trachea and carina due to blunt force trauma that was missed on the initial CT scan. During surgery, he was administered venoarterial extracorporeal membrane oxygenation (ECMO)...
October 2017: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29123900/evaluation-of-factors-associated-with-the-difficulty-in-finding-receiving-hospitals-for-traffic-accident-patients-at-the-scene-treated-by-emergency-medical-services-a-population-based-study-in-osaka-city-japan
#16
Yusuke Katayama, Tetsuhisa Kitamura, Kosuke Kiyohara, Taku Iwami, Takashi Kawamura, Sumito Hayashida, Hiroshi Ogura, Takeshi Shimazu
Aim: Although the prolongation of the time between injury and hospital arrival of traffic accident patients can influence their prognosis, factors associated with the difficulty in hospital acceptance of these patients have not been sufficiently evaluated in Japan. Methods: We retrospectively analyzed the population-based ambulance records of all traffic accident patients for whom the Osaka Municipal Fire Department (Osaka City, Japan) dispatched an ambulance in 2013...
October 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29122642/evaluation-of-the-roche%C3%A2-elecsys-and-the-diasorin%C3%A2-liaison-s100-kits-in-the-management-of-mild-head-injury-in-the-emergency-room
#17
Quentin Delefortrie, François Lejeune, Benjamin Kerzmann, Raphaël Levy, Jean-François Adam, Thierry Sottiaux, Alexandre Grimmelprez, Patrick Vankerkhoven, Said Hachimi-Idrissi
INTRODUCTION: The aim of this single-center prospective study is to compare two commercially available S100ß kits (the Roche® Elecsys and the Diasorin® Liaison S100 kits) in terms of analytical and clinical performances in a population admitted in the emergency room for mild traumatic brain injury (mTBI). MATERIAL AND METHOD: 110 patients were enrolled from September 2014 to May 2015. Blood sample draws were performed within 3h after head trauma and the study population was split into pediatric and adult subpopulations (>18years of age)...
November 7, 2017: Clinical Biochemistry
https://www.readbyqxmd.com/read/29117059/vascular-access-in-critically-ill-pediatric-patients-with-obesity
#18
Elizabeth E Halvorson, Doug Case, Joseph A Skelton, Michael C McCrory
OBJECTIVES: Pediatric obesity is highly prevalent and has been associated with poor outcomes for hospitalized children. Vascular access is essential in critically ill patients. The aim of this study was to evaluate whether critically ill children with obesity are more likely to undergo vascular device insertion (excluding peripheral IV catheters) and develop related complications. DESIGN: Multi-institutional retrospective observational cohort study. SETTING: Ninety-four U...
November 7, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29114160/clinical-characteristics-of-troublesome-pediatric-tinnitus
#19
Annett Szibor, Topi Jutila, Antti Mäkitie, Antti Aarnisalo
Objectives: The frequency of tinnitus in children and adults is practically the same. However, although adults reveal their symptoms and seek for medical aid, the suffering often remains unrecognized in the young. This is due to both the inability of children to properly describe their symptoms and the lack of recognition. Materials and methods: Among 5768 patients entering our department with complaints of tinnitus between 2010 and 2015, there were only 112 children...
2017: Clinical Medicine Insights. Ear, Nose and Throat
https://www.readbyqxmd.com/read/29112540/aeromedical-transport-in-children-a-descriptive-analysis-of-96-cases
#20
Guillaume Mortamet, Karen Harrington, Hervé Raffin, Mehdi Oualha, Sylvain Renolleau
OBJECTIVE: Pediatric aeromedical transport (AT) is highly challenging. We aim to describe a series of 96 cases of children requiring medical transport in terms of the indication, modalities, and related adverse events. METHODS: In this single-center retrospective study, we included air-transported patients less than 18 years old. RESULTS: During the study period, 96 patients, with median age of 120 months (range, 0-204), were air transported...
November 6, 2017: Pediatric Emergency Care
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