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Non accidental trauma

Rebecca D Powell-Doherty, Nora E Raynor, Donna A Goodenow, David G Jacobs, Anthony Stallion
BACKGROUND: Diagnosing NAT (non-accidental trauma) includes a skeletal survey to identify injuries. A follow-up survey is performed for missed injuries. This study examines the necessity of follow-up surveys. METHODS: The trauma database identified cases of suspected NAT in <4 years olds (2013-2014). Data were stratified by survey, age, injury, then analyzed for the prevalence of findings. All analyses (relative risk, prevalence and odds ratios) utilized RealStats Resource Pack (Trento, Italy)...
December 11, 2016: American Journal of Surgery
Bogumił Lewandowski, Robert Brodowski, Paweł Pakla, Aleksander Makara, Wojciech Stopyra, Bartek Startek
INTRODUCTION: Mucoceles are benign lesions associated with the pathology of the oral mucosa of minor salivary glands. Two types of cysts are distinguished depending on their pathogenesis. Most often they occur as a result of mechanical trauma and mucus extravasation into tissues or obstruction of the gland ducts. AIM: The aim of the study was to present our own experiences regarding mucoceles of minor salivary glands in the oral cavity taking into account how frequently the individual types of cysts occur in children...
2016: Developmental Period Medicine
Kentaro Ide, Satoko Uematsu, Kenichi Tetsuhara, Satoshi Yoshimura, Takahiro Kato, Tohru Kobayashi
OBJECTIVES: The Pediatric Emergency Care Applied Research Network (PECARN) head trauma prediction rules are used to assist computed tomography (CT) decision-making for children with minor head trauma. Although the PECARN rules have been validated in North America and Europe, they have not yet been validated in Asia. In Japan, there are no clinical decision rules for children with minor head trauma. The rate of head CT for children with minor head trauma in Japan is high since CT is widely accessible across the country...
November 12, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Cory M Pfeifer, Matthew R Hammer, Kate L Mangona, Timothy N Booth
Non-accidental trauma is a significant source of morbidity and mortality in the pediatric population. Given the vulnerable state of the child, the radiologist can often provide valuable diagnostic information in the setting of suspected abuse. This review focuses on common findings of abusive trauma and serves as a guide to aid in clinical decision-making for providers of emergency medicine and pediatrics. Amid this discussion is an assessment of modern controversies regarding reported mimicking pathologies, recapitulation of the current state of evidence with respect to radiologic findings of abuse, and examination of the contribution that spine imaging may add to the diagnosis of possible abusive head trauma in the acutely injured child...
November 10, 2016: Emergency Radiology
Cameron A Elliott, Vijay Ramaswamy, Francois D Jacob, Tejas Sankar, Vivek Mehta
BACKGROUND: Traumatic brain injury (TBI) is a major cause of infant morbidity and mortality. In these patients, magnetic resonance imaging (MRI) including diffusion-weighted imaging (DWI) is the test of choice to describe the extent of microstructural injury. CASE PRESENTATION AND DISCUSSION: In this case series, we describe novel acute and chronic MRI findings in four infants (6-19 months) with small, unilateral subdural hematomas in whom the etiology of head injury was suspicious for non-accidental trauma (NAT)...
October 20, 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Paige A Culotta, James E Crowe, Quynh-Anh Tran, Jeremy Y Jones, Amy R Mehollin-Ray, H Brandon Tran, Marcella Donaruma-Kwoh, Cristina T Dodge, Elizabeth A Camp, Andrea T Cruz
BACKGROUND: Young children with suspected abusive head trauma often receive skull radiographs to evaluate for fractures as well as computed tomography (CT) of the head to assess for intracranial injury. Using a CT as the primary modality to evaluate both fracture and intracranial injury could reduce exposure to radiation without sacrificing performance. OBJECTIVE: To evaluate the sensitivity of CT head with (3-D) reconstruction compared to skull radiographs to identify skull fractures in children with suspected abusive head trauma...
January 2017: Pediatric Radiology
Cristen N Litz, David J Ciesla, Paul D Danielson, Nicole M Chandler
PURPOSE: The purpose of this study was to examine the outcomes of non-accidental trauma (NAT) patients compared to other trauma (OT) patients across the state of Florida. In addition, NAT and OT patients with a mechanism of injury of assault were further analyzed. METHODS: A statewide database was reviewed from January 2010 to December 2014 for patients aged 0-18years who presented following trauma. Patients were sorted by admitting diagnosis into two groups: rule out NAT and all other diagnoses...
September 2, 2016: Journal of Pediatric Surgery
Nyla Alam Khan, Vincent Lam, Andrew Rickett, Fiona Dickinson
No abstract text is available yet for this article.
June 30, 2016: BMJ Case Reports
Nida P Intarapanich, Emily C McCobb, Robert W Reisman, Elizabeth A Rozanski, Pichai P Intarapanich
Motor vehicle accidents (MVA) are often difficult to distinguish from non-accidental injury (NAI). This retrospective case-control study compared animals with known MVA trauma against those with known NAI. Medical records of 426 dogs and cats treated after MVA and 50 after NAI were evaluated. Injuries significantly associated with MVA were pelvic fractures, pneumothorax, pulmonary contusion, abrasions, and degloving wounds. Injuries associated with NAI were fractures of the skull, teeth, vertebrae, and ribs, scleral hemorrhage, damage to claws, and evidence of older fractures...
July 2016: Journal of Forensic Sciences
Laura A Leaman, William L Hennrikus, James J Bresnahan
PURPOSE: Fractures are the second most common presentation of child abuse following soft-tissue bruising and burns. It is often difficult to determine potential abuse in a child presenting with a non-rib fracture(s) and without soft-tissue injuries. METHODS: One hundred and fifteen consecutive patients aged ≤2 years who presented with a fracture between January 2010 and June 2012 to our emergency department (ED) or pediatric fracture clinic were retrospectively analyzed...
August 2016: Journal of Children's Orthopaedics
Sibi Rajendran, David Nickels, Barbara Pawley
This is the 19 installment of a series that will highlight one case per publication issue from the bank of cases available online as part of the American Society of Emergency Radiology (ASER) educational resources. Our goal is to generate more interest in and use of our online materials. To view more cases online, please visit the ASER Core Curriculum and Recommendations for Study online at: .
June 2016: Emergency Radiology
F W Hirsch, I Sorge, C Roth, J-H Gosemann
The focus of this review article is on child abuse and the radiographic pattern of X‑ray findings. The radiologist should be able to recognize typical injuries resulting from child abuse. In some cases the findings are highly specific for abuse and these include metaphyseal corner fractures of the long bones in children aged up to 24 months. In other cases the fractures are not specific but highly indicative of child abuse: rib fractures, for example can be associated with child abuse in more than 50 % of the cases; however, maltreatment is difficult to diagnose without taking the entire pattern of skeletal findings into consideration so that a radiological screening of the entire skeleton is often necessary...
May 2016: Der Radiologe
Ha Son Nguyen, Saman Shabani, Sean Lew
BACKGROUND: Retroclival hematomas are a rare entity. The pathology can be categorized into epidural hematoma or subdural hematoma based on the anatomy of the tectorial membrane. Frequently, the etiology is related to accidental trauma, though other mechanisms have been observed, including coagulopathy, non-accidental trauma, and pituitary apoplexy. There have been only 2 prior cases where both epidural and subdural hematoma co-present. CASE PRESENTATION: An 8-year-old male was involved in a high-speed motor vehicle accident...
September 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Ashley D Ellis, Gerald McGwin, Gregory G Davis, Daniel W Dye
PURPOSE: Heroin has a half-life of 2-6 min and is metabolized too quickly to be detected in autopsy samples. The presence of 6-acetylmophine (6-AM) in urine, blood, or other samples is convincing evidence of heroin use by a decedent, but 6-AM itself has a half-life of 6-25 min before it is hydrolyzed to morphine, so 6-AM may not be present in sufficient concentration to detect in postmortem samples. Codeine is often present in heroin preparations as an impurity and is not a metabolite of heroin...
September 2016: Forensic Science, Medicine, and Pathology
Misari Oe, Sonja Schumacher, Ulrich Schnyder, Christoph Mueller-Pfeiffer, Frank H Wilhelm, Eveline Kuelen, Chantal Martin-Soelch
Impairments in classical fear conditioning and deficits in discriminative learning are observed in posttraumatic stress disorder (PTSD). However, it is unknown whether similar impairments can be found with types of discriminative learning other than classical conditioning, such as evaluative conditioning (EC), in which the valence of a stimulus can be transferred to other stimuli. In this study, we investigated whether EC is also influenced by traumatic experiences independently of presence of PTSD. We tested 14 accident survivors with remitted PTSD, 14 survivors without PTSD, and 16 non-trauma controls...
30, 2016: Psychiatry Research
Hiroji Miyake
Various types of shunt valves have been developed during the past 50 years, most of which can be classified into the following categories: (1) fixed differential pressure valves; (2) fixed differential pressure (DP) valves with an antisiphon mechanism; (3) programmable DP valves; (4) programmable DP valves with an antisiphon mechanism; and (5) programmable antisiphon valves. When considering the myriad of possible postoperative condition changes, such as the onset of accidental non-related diseases or trauma in adults, and changes in normal physiological development or anticipation of future shunt removal in children, it has become standard to use the programmable valve as a first choice for cerebrospinal fluid shunting...
May 15, 2016: Neurologia Medico-chirurgica
Michael C Dewan, Nishit Mummareddy, John C Wellons, Christopher M Bonfield
BACKGROUND: Traumatic brain injury (TBI) is a common condition affecting children all over the world, and it represents a global public health concern. It is unclear how geopolitical, societal, and ethnic differences may influence the nature of TBI among children. METHODS: A comprehensive literature search was conducted incorporating studies with hospital-, regional-, or country-specific pediatric TBI epidemiology data published between 1995 and 2015. Incidence, age, severity, mechanism of injury, and other relevant injury characteristics were extracted and compared across diverse geographic regions...
July 2016: World Neurosurgery
Shu-Ling Chong, Su Yah Chew, Jasmine Xun Yi Feng, Penny Yun Lin Teo, Sock Teng Chin, Nan Liu, Marcus Eng Hock Ong
OBJECTIVE: To study the causes of head injuries among the paediatric population in Singapore, and the association between causes and mortality, as well as the need for airway or neurosurgical intervention. DESIGN: This is a prospective observational study utilising data from the trauma surveillance system from January 2011 to March 2015. SETTING: Paediatric emergency departments (EDs) of KK Women's and Children's Hospital and the National University Health System...
February 23, 2016: BMJ Open
Oren Tavor, Sirisha Boddu, Abhaya V Kulkarni
PURPOSE: The purpose of this study is to describe the presenting characteristics of a large group of children who required neurosurgical intervention (NSI) following a head injury and to retrospectively assess which of the criteria for imaging from Children's Head Injury Algorithm for the Prediction of Important Clinical Events (CHALICE), Pediatric Emergency Care Applied Research Network (PECARN), and Canadian Assessment of Tomography for Childhood Head Injury (CATCH) clinical decision rules (CDRs) were met by these patients...
May 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Mauricio A Escobar, Bethann M Pflugeisen, Yolanda Duralde, Carolynn J Morris, Dustin Haferbecker, Paul J Amoroso, Hilare Lemley, Elizabeth C Pohlson
PURPOSE: Each year, nearly 1 million children in the USA are victims of non-accidental trauma (NAT). Missed diagnosis or poor case management often leads to repeat/escalation injury. Victims of recurrent NAT are at higher risk for severe morbidity and mortality resulting from abuse. The objective of this review is to describe the evolution and implementation of this tool and evaluate our institutional response to NAT prior to implementation. METHODS: A systematic guideline for the evaluation of pediatric patients in which NAT is suspected or confirmed was developed and implemented at a level II pediatric trauma hospital...
April 2016: Pediatric Surgery International
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