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Non accidental trauma

Raquel M Schears, Zainab Farzal, Zehra Farzal, Anne C Fischer
BACKGROUND: The actual baseline of radiation exposure used in evaluating pediatric trauma is not known and has relied on estimates in the literature that may not reflect clinical reality. Our objectives were to determine the baseline amount of radiation delivered in a pediatric trauma evaluation and correlate radiation exposure with trauma activation status to identify the cohort most at risk. METHODS: We retrospectively evaluated trauma patients (N = 1050) at an independent Level I children's hospital for each level of trauma activation (consults, alerts, stats) from June 2010 to January 2011...
March 14, 2018: International Journal of Emergency Medicine
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...
February 10, 2018: Journal of Pediatric Surgery
Raymond Leung, Panos Thomas
Osteochondral defects (OCD) are rare conditions that usually present in young adolescents. The causes include trauma, inflammation, ischaemia, genetics and changes at secondary ossification centres. The case report presents a 27-year-old man with chronic intermittent left knee pain for about 3 years. He typically develops the symptom after prolonged standing or when rising from a prolonged seated position. An initial MRI scan in 2014 did not identify and report an OCD that was present in his left lateral tibial plateau...
March 7, 2018: BMJ Case Reports
Christopher Kevin Huls, Corey Detlefs
Trauma is the leading non-obstetric cause of death during pregnancy and approximately 6-8% of all pregnancies are complicated by injury, both accidental and intentional. The initial evaluation and management of the injured pregnant patient often requires a multidisciplinary, collaborative team to provide the optimal outcome for both mother and fetus. It is important to recognize that even minor mechanisms of injury may result in poor outcomes for both fetus and mother. Injured pregnant patients meeting admission criteria experience a progressive increase in the number of complications as well as the number of patients that require delivery...
February 2018: Seminars in Perinatology
Joshua B Brown, Mark L Gestring, Christine M Leeper, Jason L Sperry, Andrew B Peitzman, Timothy R Billiar, Barbara A Gaines
BACKGROUND: Children suffering non-accidental trauma (NAT) are at high risk of death. It is unclear whether markers of injury severity for trauma center/system benchmarking such as injury severity score (ISS) adequately characterize this. Our objective was to evaluate mortality prediction of ISS in children with NAT compared to accidental trauma (AT). METHODS: Pediatric patients age<16years from the Pennsylvania state trauma registry 2000-2013 were included. Logistic regression predicted mortality from ISS for NAT and AT patients...
February 17, 2018: Journal of Trauma and Acute Care Surgery
M Katherine Henry, Benjamin French, Chris Feudtner, Mark R Zonfrillo, Daniel M Lindberg, James D Anderst, Rachel P Berger, Joanne N Wood
OBJECTIVES: The aim of this study was to evaluate cervical magnetic resonance imaging (MRI) and computed tomography (CT) practices and cervical spine injuries among young children with non-motor vehicle crash (MVC)-associated traumatic brain injury (TBI). METHODS: We performed a retrospective study of a stratified, systematic random sample of 328 children younger than 2 years with non-MVC-associated TBI at 4 urban children's hospitals from 2008 to 2012. We defined TBI etiology as accidental, indeterminate, or abuse...
February 15, 2018: Pediatric Emergency Care
M E M Vester, R A C Bilo, H G T Nijs, R R van Rijn
We present two cases of infants who died under suspicious circumstances. After clinical and legal investigations, non-accidental constrictive asphyxia inflicted by one of the parents was established. The first case presents a to date not yet reported, unique mechanism of trauma. In order to stop his daughter from crying, the father admitted that he sometimes sat on his baby while she was lying on the bed. Occasionally increasing his force by pulling with his hands on the bottom of the bed. In the second case tight swaddling and encircling chest compression was the causative mechanism...
January 10, 2018: Forensic Science International
Marc O'Donnell, William F Lavelle, Mike H Sun
Spondylolysis is frequently seen in adolescents, typically at the L5 vertebral level. While there may be a congenital predisposition for spondylolysis, it has long been suggested that the defect results from a fatigue or stress fracture of the pars interarticularis. Spondylolisthesis may result from a bilateral spondylolytic defect and is frequently asymptomatic. There is a paucity of literature on infant and toddler spondylolysis, as the focus is primarily on school-aged children, typically those over ten years of age...
December 2017: Journal of Spine Surgery (Hong Kong)
Liviana Da Dalt, Niccolo' Parri, Angela Amigoni, Agostino Nocerino, Francesca Selmin, Renzo Manara, Paola Perretta, Maria Paola Vardeu, Silvia Bressan
OBJECTIVE: We aim to formulate evidence-based recommendations to assist physicians decision-making in the assessment and management of children younger than 16 years presenting to the emergency department (ED) following a blunt head trauma with no suspicion of non-accidental injury. METHODS: These guidelines were commissioned by the Italian Society of Pediatric Emergency Medicine and include a systematic review and analysis of the literature published since 2005...
January 15, 2018: Italian Journal of Pediatrics
C Talbot, N Davis, I Majid, M Young, O Bouamra, F E Lecky, S Jones
AIMS: The aim of this study was to describe the epidemiology of closed isolated fractures of the femoral shaft in children, and to compare the treatment and length of stay (LOS) between major trauma centres (MTCs) and trauma units (TUs) in England. PATIENTS AND METHODS: National data were obtained from the Trauma and Audit Research Network for all isolated, closed fractures of the femoral shaft in children from birth to 15 years of age, between 2012 and 2015. Age, gender, the season in which the fracture occurred, non-accidental injury, the mechanism of injury, hospital trauma status, LOS and type of treatment were recorded...
January 2018: Bone & Joint Journal
Frederike J C Haverkamp, Gordon G Giesbrecht, Edward C T H Tan
BACKGROUND: Accidental hypothermia concerns a body core temperature of less than 35°C without a primary defect in the thermoregulatory system. It is a serious threat to prehospital patients and especially injured patients, since it can induce a vicious cycle of the synergistic effects of hypothermia, acidosis and coagulopathy; referred to as the trauma triad of death. To prevent or manage deterioration of a cold patient, treatment of hypothermia should ideally begin prehospital. Little effort has been made to integrate existent literature about prehospital temperature management...
November 4, 2017: Injury
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
Bédis Amri, Emanuela Martino, Francesca Vitulo, Federica Corana, Leila Bettaieb-Ben Kaâb, Marta Rui, Daniela Rossi, Michela Mori, Silvia Rossi, Simona Collina
Several factors contribute in wound generation, e.g., accidental traumas or surgery, and in certain cases, this dermal injury may have a devastating outcome. When skin damage occurs, the human body puts in place a sophisticated choreography, which involves numerous repairing processes to restore physiological conditions. Nevertheless, natural healing mechanisms are ineffective towards chronic or non-healing wounds and thus, therapeutic strategies may represent the only beneficial alternative to counteract these tissue insults...
October 28, 2017: Molecules: a Journal of Synthetic Chemistry and Natural Product Chemistry
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...
October 26, 2017: International Journal of Legal Medicine
Mona Mohamed Abo El-Noor, Naema Mahmoud ElHosary, Hytham Ibrahim Elatrozy, Hussein Mohamed Abou Elgheit, Ahmed Mohamed Elbelkasy, Ahmed Gamal Fath, Ghada Hamed El-Shafy
Head trauma is one of the leading causes of death and disability worldwide. Combined head lesions consist of more than one form of lesions. Biochemical markers of brain injury are used in determining the extent of brain injury and predicting its outcomes. The aim of this study was to investigate the forensic and clinical significance of serum amylase, lipase and gamma glutamyl transferase (GGT) as predictors of the outcome in head injured patients. PATIENTS AND METHODS: Sixty head injured patients were enrolled and subjected to personal history taking, general and local physical examination...
October 4, 2017: Journal of Forensic and Legal Medicine
N Patel, I Khofi-Phiri, R Mathiva, A Grieve, J Loveland, G Nethathe
BACKGROUND: Paediatric trauma is a major cause of morbidity and mortality in low and middle income countries. Data from these regions describing the extent and severity of this problem is scant. Local data is vital to understanding and responding to the problem of childhood injury. METHOD: A retrospective record review of all trauma cases admitted to the PICU at CHBAH from 1 January 2011 to 31 December 2013 was performed. Descriptive statistics were generated using MS Excel...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
V M Meijering, S Edu, P Navsaria, A J Nicol, S Sobnach
BACKGROUND: South Africa has one of the most violent societies worldwide. The national homicide rate is 34 per 100 000; young males form the majority of this cohort. Comprehensive injury surveillance in low and middle-income countries is limited and there is paucity of data describing the epidemiology and outcomes of intentional injuries within the juvenile population. METHOD: Ethical approval was obtained for this study. The Electronic Trauma Health Registry (eTHR) Application of the Trauma Centre at Groote Schuur Hospital in Cape Town was interrogated over an 18-month period (April 2014 - December 2016) for all patients (aged 12-19 years) treated for non-accidental trauma...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
Chester J Donnally, William Hannay, Derek A Rapp, Nikola Lekic, Seth D Dodds
PURPOSE: We intend to describe and analyze the spectrum of upper extremity injuries that arises from both accidental and intentional machete injuries with a focus on associated complications and comorbidities. This review is the first from a United States institution, and the only from a designated level 1 trauma center. METHODS: A retrospective review of machete related upper extremity injuries admitted to a level 1 trauma center from 2008 to 2016. The following data was collected on admitted patients: demographics, mechanism of injury, surgical management, and complications...
December 2017: Archives of Orthopaedic and Trauma Surgery
Neha A Deshpande, Lauren M Kucirka, Randi N Smith, Corrina M Oxford
BACKGROUND: Trauma is the leading nonobstetric cause of death in women of reproductive age, and pregnant women in particular may be at increased risk of violent trauma. Management of trauma in pregnancy is complicated by altered maternal physiology, provider expertise, potential disparate imaging, and distorted anatomy. Little is known about the impact of trauma on maternal mortality. OBJECTIVE: We sought to: (1) characterize nonviolent and violent trauma among pregnant women; (2) determine whether pregnancy is associated with increased mortality following traumatic injury; and (3) identify risk factors for trauma-related death in pregnant women...
November 2017: American Journal of Obstetrics and Gynecology
Hui Wu, Fang Zhang, Wenhong Cheng, Ying Lin, Qian Wang
BACKGROUND: Those injured in accidents commonly have strong emotional reactions to their situation. However, despite the large number of patients who are admitted to general hospitals each year for orthopedic injuries due to an accident, research focusing on psychological disorders due to these injuries is lacking. OBJECTIVE: To investigate the presentation and factors related to depression and acute anxiety among inpatients being treated for injury on a Trauma Orthopedics Unit...
April 25, 2017: Shanghai Archives of Psychiatry
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