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Head trauma in pediatric patients

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https://www.readbyqxmd.com/read/28424128/analysis-of-all-terrain-vehicle-trauma-data-implications-for-increased-regulation-and-injury-prevention
#1
Cathy V Ho, James R Dunne, Wesley R Stroud, Alvaro H Fonseca, Frank E Davis, William J Bromberg
To determine the incidence and severity of all-terrain vehicle crashes (ATVCs) compared with motorcycle crashes (MCCs) in all critically injured patients. Prospective data were retrospectively reviewed on 1840 patients involved in ATVCs and MCCs admitted to a rural level one trauma center over 16 years. ATVC patients (n = 655) were younger (25 vs 38, P < 0.0001), more likely female (20% vs 11%, P < 0.001), less severely injured (13.5 vs 16, P < 0.0001), had similar Glasgow Coma Score (13.3 vs 13.4, p = NS), less helmet use (6% vs 69%, P < 0...
April 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28419017/the-evaluation-of-trauma-care-the-comparison-of-2-high-level-pediatric-emergency-departments-in-the-united-states-and-turkey
#2
Alkan Bal, Michael Cooper, Amanda Lee, Murat Anil, Halim Hennes
OBJECTIVE: The purpose of the study is to compare the outcomes of pediatric trauma patients with motor vehicle crashes (MVCs) and motor vehicle versus pedestrian crashes (MPCs) at a level 1 pediatric trauma center in the United States and a pediatric trauma center in Turkey. METHODS: The medical records of all pediatric MVC and MPC subjects presenting to the emergency departments (EDs) of a level 3 hospital in Turkey (Izmir Tepecik Training and Research Hospital [ITTRH]) and a level 1 pediatric trauma center in the United States (Children's Medical Center Dallas [CMCD]) over a 1-year period were reviewed...
April 18, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28406438/u-s-trends-of-ed-visits-for-pediatric-traumatic-brain-injuries-implications-for-clinical-trials
#3
Cheng Chen, Junxin Shi, Rachel M Stanley, Eric A Sribnick, Jonathan I Groner, Henry Xiang
Our goal in this paper was to use the 2006-2013 Nationwide Emergency Department Sample (NEDS) database to describe trends of annual patient number, patient demographics and hospital characteristics of pediatric traumatic brain injuries (TBI) treated in U.S. emergency departments (EDs); and to use the same database to estimate the available sample sizes for various clinical trials of pediatric TBI cases. National estimates of patient demographics and hospital characteristics were calculated for pediatric TBI...
April 13, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28397274/does-incidental-mastoid-opacification-on-computerized-tomography-necessitate-referral-to-ent
#4
Sophie L Wilkinson, Raguwinder S Sahota, James D Constable, Frazer Harper, Owen Judd
OBJECTIVE: The prevalence of incidental temporal bone disease on magnetic resonance imaging has been widely reported in the medical literature. Despite this, there currently is little evidence regarding incidental otological disease on computerized tomography (CT). Thus, the study aimed to review the CT prevalence of asymptomatic adult ear disease and evaluate the appropriateness of ear, nose, and throat (ENT) referral following its discovery. STUDY DESIGN: Retrospective observational study of 468 CT scans...
April 11, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28395008/derivation-and-validation-of-a-serum-biomarker-panel-to-identify-infants-with-acute-intracranial-hemorrhage
#5
Rachel Pardes Berger, Brian J Pak, Mariya D Kolesnikova, Janet Fromkin, Richard Saladino, Bruce E Herman, Mary Clyde Pierce, David Englert, Paul T Smith, Patrick M Kochanek
Importance: Abusive head trauma is the leading cause of death from physical abuse. Missing the diagnosis of abusive head trauma, particularly in its mild form, is common and contributes to increased morbidity and mortality. Serum biomarkers may have potential as quantitative point-of-care screening tools to alert physicians to the possibility of intracranial hemorrhage. Objective: To identify and validate a set of biomarkers that could be the basis of a multivariable model to identify intracranial hemorrhage in well-appearing infants using the Ziplex System...
April 10, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28393708/minor-head-trauma-in-the-pediatric-emergency-department-decision-making-nodes
#6
Mario Mastrangelo, Fabio Midulla
BACKGROUND: Minor head trauma is one of the leading cause of access to pediatric emergency departments with only a limited quote of patients resulting in clinically relevant brain injuries. OBJECTIVES: The aim of this review is to guide physicians involved in the management of pediatric head trauma towards a correct clinical approach. METHODS: A Pubmed/Medline search was realized through different entries including "minor head trauma" or "mild head trauma", "minor head injury" or "mild head injury", "acute head trauma"...
April 4, 2017: Current Pediatric Reviews
https://www.readbyqxmd.com/read/28387644/medical-necessity-of-routine-admission-of-children-with-mild-traumatic-brain-injury-to-the-intensive-care-unit
#7
Jared D Ament, Krista N Greenan, Patrick Tertulien, Joseph M Galante, Daniel K Nishijima, Marike Zwienenberg
OBJECTIVE Approximately 475,000 children are treated for traumatic brain injury (TBI) in the US each year; most are classified as mild TBI (Glasgow Coma Scale [GCS] Score 13-15). Patients with positive findings on head CT, defined as either intracranial hemorrhage or skull fracture, regardless of severity, are often transferred to tertiary care centers for intensive care unit (ICU) monitoring. This practice creates a significant burden on the health care system. The purpose of this investigation was to derive a clinical decision rule (CDR) to determine which children can safely avoid ICU care...
April 7, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28341799/use-of-traumatic-brain-injury-prediction-rules-with-clinical-decision-support
#8
Peter S Dayan, Dustin W Ballard, Eric Tham, Jeff M Hoffman, Marguerite Swietlik, Sara J Deakyne, Evaline A Alessandrini, Leah Tzimenatos, Lalit Bajaj, David R Vinson, Dustin G Mark, Steve R Offerman, Uli K Chettipally, Marilyn D Paterno, Molly H Schaeffer, Jun Wang, T Charles Casper, Howard S Goldberg, Robert W Grundmeier, Nathan Kuppermann
OBJECTIVES: We determined whether implementing the Pediatric Emergency Care Applied Research Network (PECARN) traumatic brain injury (TBI) prediction rules and providing risks of clinically important TBIs (ciTBIs) with computerized clinical decision support (CDS) reduces computed tomography (CT) use for children with minor head trauma. METHODS: Nonrandomized trial with concurrent controls at 5 pediatric emergency departments (PEDs) and 8 general EDs (GEDs) between November 2011 and June 2014...
March 24, 2017: Pediatrics
https://www.readbyqxmd.com/read/28328674/the-value-of-the-injury-severity-score-in-pediatric-trauma-time-for-a-new-definition-of-severe-injury
#9
Joshua B Brown, Mark L Gestring, Christine M Leeper, Jason L Sperry, Andrew B Peitzman, Timothy R Billiar, Barbara A Gaines
BACKGROUND: The Injury Severity Score (ISS) is the most commonly used injury scoring system in trauma research and benchmarking. An ISS>15 conventionally defines severe injury; however, no studies evaluate whether ISS performs similarly between adults and children. Our objective was to evaluate ISS and AIS to predict mortality and define optimal thresholds of severe injury in pediatric trauma. METHODS: Patients from the Pennsylvania trauma registry 2000-2013 were included...
March 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28325786/impact-on-hospital-resources-of-systematic-evaluation-and-management-of-suspected-nonaccidental-trauma-in-patients-less-than-4-years-of-age
#10
Bethann M Pflugeisen, Mauricio A Escobar, Dustin Haferbecker, Yolanda Duralde, Elizabeth Pohlson
OBJECTIVE: There has been an increasing movement worldwide to create systematic screening and management procedures for atypical injury patterns in children with the hope of better detecting and evaluating nonaccidental trauma (NAT). A legitimate concern for any hospital considering implementation of a systematic evaluation process is the impact on already burdened hospital resources. We hypothesized that implementation of a guideline that uses red flags related to history, physical, or radiologic findings to trigger a standardized NAT evaluation of patients <4 years would not negatively affect resource utilization at our level II pediatric trauma center...
March 21, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28302282/traumatic-pelvic-fractures-in-children-and-adolescents
#11
Christopher J DeFrancesco, Wudbhav N Sankar
Although traumatic pelvic fractures in children are relatively rare, these injuries are identified in about 5% of children admitted to level 1 trauma centers after blunt trauma.(1-4) Such injuries differ from adult pelvic fractures in important ways and require distinct strategies for management. While the associated mortality rate for children with pelvic fractures is much lower than that for adults, the patient may require urgent surgical intervention for associated life-threatening injuries such as head trauma and abdominal injury...
February 2017: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/28259707/clinical-and-molecular-phenotyping-of-a-child-with-hermansky-pudlak-syndrome-7-an-uncommon-genetic-type-of-hps
#12
Melanie M Bryan, Nathanial J Tolman, Karen L Simon, Marjan Huizing, Robert B Hufnagel, Brian P Brooks, Vladislav Speransky, James C Mullikin, William A Gahl, May Christine V Malicdan, Bernadette R Gochuico
PURPOSE: Hermansky-Pudlak syndrome (HPS) is a rare inherited disorder with ten reported genetic types; each type has defects in subunits of either Adaptor Protein-3 complex or Biogenesis of Lysosome-related Organelles Complex (BLOC)-1, -2, or -3. Very few patients with BLOC-1 deficiency (HPS-7, -8, and -9 types) have been diagnosed. We report results of comprehensive clinical testing and molecular analyses of primary fibroblasts from a new case of HPS-7. RESULTS: A 6-year old Paraguayan male presented with hypopigmentation, ocular albinism, nystagmus, reduced visual acuity, and easy bruising...
April 2017: Molecular Genetics and Metabolism
https://www.readbyqxmd.com/read/28255067/reducing-head-ct-use-for-children-with-head-injuries-in-a-community-emergency-department
#13
Rebecca M Jennings, Jennifer J Burtner, Joseph F Pellicer, Deepthi K Nair, Miranda C Bradford, Michele Shaffer, Neil G Uspal, Joel S Tieder
BACKGROUND AND OBJECTIVE: Clinical decision rules have reduced use of computed tomography (CT) to evaluate minor pediatric head injury in pediatric emergency departments (EDs). CT use remains high in community EDs, where the majority of children seek medical care. We sought to reduce the rate of CT scans used to evaluate pediatric head injury from 29% to 20% in a community ED. METHODS: We evaluated a quality improvement (QI) project in a community ED aimed at decreasing the use of head CT scans in children by implementing a validated head trauma prediction rule for traumatic brain injury...
March 2, 2017: Pediatrics
https://www.readbyqxmd.com/read/28248802/repeat-head-imaging-in-blunt-pediatric-trauma-patients-is-it-necessary
#14
E Patricia Hill, P J Stiles, Jared Reyes, R Joseph Nold, Stephen D Helmer, James M Haan
BACKGROUND: Children with confirmed brain injury usually undergo follow-up computed tomography (CT) scan of the head within 24 hours of admission. To date, no evidence exists to validate the diagnostic or therapeutic value of these repeat CTs. The purpose of this study was to (1) evaluate progression of traumatic brain injuries, (2) determine if routine repeat imaging changes management, and (3) compare the efficacy of recognizing worsening hemorrhage with serial neurological examination versus repeat imaging...
May 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28192567/development-and-internal-validation-of-a-clinical-risk-score-for-treating-children-with-mild-head-trauma-and-intracranial-injury
#15
Jacob K Greenberg, Yan Yan, Christopher R Carpenter, Angela Lumba-Brown, Martin S Keller, Jose A Pineda, Ross C Brownson, David D Limbrick
Importance: The appropriate treatment of children with mild traumatic brain injury (mTBI) and intracranial injury (ICI) on computed tomographic imaging remains unclear. Evidence-based risk assessments may improve patient safety and reduce resource use. Objective: To derive a risk score predicting the need for intensive care unit observation in children with mTBI and ICI. Design, Setting, and Participants: This retrospective analysis of the prospective Pediatric Emergency Care Applied Research Network (PECARN) head injury cohort study included patients enrolled in 25 North American emergency departments from 2004 to 2006...
April 1, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28183837/diagnostic-performance-of-ultrafast-brain-mri-for-evaluation-of-abusive-head-trauma
#16
S F Kralik, M Yasrebi, N Supakul, C Lin, L G Netter, R A Hicks, R A Hibbard, L L Ackerman, M L Harris, C Y Ho
BACKGROUND AND PURPOSE: MR imaging with sedation is commonly used to detect intracranial traumatic pathology in the pediatric population. Our purpose was to compare nonsedated ultrafast MR imaging, noncontrast head CT, and standard MR imaging for the detection of intracranial trauma in patients with potential abusive head trauma. MATERIALS AND METHODS: A prospective study was performed in 24 pediatric patients who were evaluated for potential abusive head trauma...
February 9, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28183726/injury-region-and-risk-of-hospital-acquired-pneumonia-among-pediatric-trauma-patients
#17
Gretchen J Cutler, Anupam B Kharbanda, Jeffrey Nowak, Henry W Ortega
OBJECTIVE: To describe the relationship between injury region and risk of hospital-acquired pneumonia (HAP) in pediatric trauma patients. METHODS: Analyses included patients <19 years of age from the National Trauma Data Bank, during 2009-2011. Multivariable logistic regression was used to examine the association between injury region and odds of developing HAP stratified by age group. RESULTS: A total of 71 377 patients were eligible for analysis, and 1818 patients developed pneumonia...
February 9, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28170143/prevalence-of-brain-injuries-and-recurrence-of-seizures-in-children-with-post-traumatic-seizures
#18
Mohamed K Badawy, Peter S Dayan, Michael G Tunik, Frances M Nadel, Kathleen A Lillis, Michelle Miskin, Dominic A Borgialli, Michael C Bachman, Shireen M Atabaki, John D Hoyle, James F Holmes, Nathan Kuppermann
OBJECTIVES: Computed tomography (CT) is often used in the emergency department (ED) evaluation of children with post-traumatic seizures (PTS); however, the frequency of traumatic brain injuries (TBI) and short-term seizure recurrence is lacking. Our main objective was to evaluate the frequency of TBI on CT and short-term seizure recurrence in children with PTS. We also aimed to determine the associations between the likelihood of TBI on CT with the timing of onset of PTS after the traumatic event and duration of PTS...
February 7, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28169980/epidemiologic-characteristics-of-pediatric-trauma-patients-receiving-prehospital-care-in-kigali-rwanda
#19
Adam R Aluisio, Olivier Félix Umuhire, Gabin Mbanjumucyo, Naomi George, Alexis Kearney, Naz Karim, Jeanne DʼArc Nyinawankusi, Eric Uwitonze, Sam Enumah, John W Scott, Zeta Mutabazi, Georges Ntakiyiruta, Sudha Jayaraman, Robert Riviello, Jean Claude Byiringiro, Adam C Levine
BACKGROUND: Pediatric trauma is a significant public health problem in resource-constrained settings; however, the epidemiology of injuries is poorly defined in Rwanda. This study describes the characteristics of pediatric trauma patients transported to the emergency department (ED) of the Centre Hospitalier Universitaire de Kigali by emergency medical services in Kigali, Rwanda. METHODS: This cohort study was conducted at the Centre Hospitalier Universitaire de Kigali from December 2012 to February 2015...
February 4, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28166167/stepwise-percutaneous-leverage-technique-to-avoid-posterior-interosseous-nerve-injury-in-pediatric-radial-neck-fracture
#20
Wan-Sun Choi, Kyeong-Jin Han, Doo-Hyung Lee, Ga-Eun Lee, Heon-Ju Kweon, Jae-Ho Cho
OBJECTIVES: To introduce a stepwise percutaneous leverage technique to avoid posterior interosseous nerve (PIN) injury in pediatric patients with radial neck fractures and to evaluate the clinical outcome and the predisposing factors affecting the outcome. DESIGN: Retrospective case series study. SETTING: University level 1 trauma center. PATIENTS: Thirty-four children with a radial neck fracture, who were treated using a stepwise percutaneous leverage technique, were included in the study...
May 2017: Journal of Orthopaedic Trauma
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