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Pediatric Trauma

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https://www.readbyqxmd.com/read/28445376/defining-temporal-hairline-landmarks
#1
Purushottam A Nagarkar, Jonathan Cheng
Brow dermoids are benign pediatric neoplasms. Endoscopic resection requires incisions placed within the temporal hairline, which is often difficult to reliably locate in infants. The authors studied adult and pediatric patients to define the location of the hairline in relationship to simple facial landmarks. Adult and pediatric patients who were seen in preoperative consultation for facial surgical procedures were identified and included in the study. Patients with a history of facial trauma, surgery, or congenital anomalies were excluded...
May 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28443277/pediatric-hand-surgery-training-in-nicaragua-a-sustainable-model-of-surgical-education-in-a-resource-poor-environment
#2
Mary Claire B Manske, Jairo J Rios Roque, Gabriel Ramos Zelaya, Michelle A James
Recent reports have demonstrated that nearly two-thirds of the world's population do not have access to adequate surgical care, a burden that is borne disproportionately by residents of resource-poor countries. Although the reasons for limited access to surgical care are complex and multi-factorial, among the most substantial barriers is the lack of trained surgical providers. This is particularly true in surgical subspecialties that focus on life-improving, rather than life-saving, treatments, such as pediatric hand and upper extremity surgery, which manages such conditions as congenital malformations, trauma and post-traumatic deformities including burns, and neuromuscular conditions (brachial plexus birth palsy, spinal cord injury, and cerebral palsy)...
2017: Frontiers in Public Health
https://www.readbyqxmd.com/read/28443269/epidemiology-and-risk-assessment-of-pediatric-venous-thromboembolism
#3
REVIEW
Arash Mahajerin, Stacy E Croteau
The incidence of diagnosed venous thromboembolism (VTE) has been increasing concurrent with advances in technology and medical care that enhance our ability to treat pediatric patients with critical illness or complex multiorgan system dysfunction. Although the overall incidence of VTE is estimated at 0.07-0.49 per 10,000 children, higher rates are observed in specific populations including hospitalized children, those with central venous catheters (CVCs) or patients convalescing from a major surgery. While the absolute number of pediatric VTE events may seem trivial compared to adults, the increasing incidence, associated with increased mortality and morbidity, the availability of novel therapies, and the impact on the cost of care have made investigation of VTE risk factors and prevention strategies a high priority...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28441281/incarcerated-medial-epicondyle-fractures-with-elbow-dislocation-risk-factors-associated-with-morbidity
#4
Carley Vuillermin, Kyna S Donohue, Patricia Miller, Andrea S Bauer, Dennis E Kramer, Yi-Meng Yen
BACKGROUND: Incarcerated medial epicondyle fractures in association with elbow trauma are rare and an absolute indication for intervention. Because of the infrequent nature, outcomes following this injury are not well documented. We studied a large cohort of these injuries to determine factors associated with functional outcomes. It was hypothesized that a greater duration between initial presentation and time of surgery would lead to poorer outcomes. METHODS: A total of 32 patients aged 18 and under who underwent surgical treatment for an incarcerated medical epicondyle fracture at a level-1 pediatric trauma center from 2003 to 2015 were identified...
April 24, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28441278/the-utility-of-routine-postoperative-radiographs-after-pinning-of-pediatric-supracondylar-humerus-fractures
#5
Vytas P Karalius, Jacob Stanfield, Philip Ashley, Laura W Lewallen, Casey M DeDeugd, Janet Walker, Annalise N Larson, Todd A Milbrandt
BACKGROUND: The purpose of this study was to determine the frequency with which postoperative radiographs resulted in a change in management following closed reduction and percutaneous pinning of displaced pediatric supracondylar humerus fractures. We hypothesize that only the initial postoperative radiograph will lead to changes in management of operative supracondylar humerus fractures. METHODS: A retrospective review was performed at 2 level I pediatric trauma centers...
April 24, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28441242/identifying-undiagnosed-pediatric-mental-illness-in-the-emergency-department
#6
La Vonne A Downey, Leslie S Zun
BACKGROUND: It is well known that pediatric psychiatric patients frequent emergency department (ED), but the number of patients with undiagnosed psychiatric illness presenting to an ED is not well known. Identification and referral of these patients may provide an opportunity for improved patient care. The primary study objective was to identify a tool that can screen for unsuspected psychiatric illness in pediatric patients who present to the ED with non-psychiatric-related complaints...
April 24, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28441239/traumatic-abdominal-wall-hernia-in-children-by-handlebar-injury-when-to-suspect-scan-and-call-the-surgeon
#7
Victoria Elisa Rinaldi, Mirko Bertozzi, Elisa Magrini, Sara Riccioni, Giuseppe Di Cara, Antonino Appignani
Traumatic abdominal wall hernias (TAWHs) can be defined as a herniation through disrupted musculature and fascia associated with blunt trauma. They are seen in approximately 1% of patients with blunt abdominal trauma. Data on TAWH in the pediatric population are very limited and principally based on case reports and a few case series. Past reports have indicated that the presence of the "handlebar sign" confers an increased risk of internal injury. Concomitant internal injuries are reported with an incidence between 25% and 70%, and occult hernias may also occur and are usually detected only by abdominal computed tomography scan and ultrasonography...
April 24, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28441071/efficacy-and-safety-of-23-gauge-pars-plana-vitrectomy-silicone-oil-tamponade-combination-for-treatment-of-pediatric-post-traumatic-endophthalmitis
#8
Wei Jin, Yaopeng Xu, Wenjun Wang, Yiqiao Xing, Anhuai Yang
PURPOSE: To determine (i) the etiology, epidemiology, mechanism of injury, and risk factors associated with open globe injuries (OGIs) in children and (ii) visual outcomes of pediatric patients with post-traumatic endophthalmitis following 23-gauge pars plana vitrectomy (PPV) combined with silicone oil tamponade (SOT). METHODS: A total of 107 consecutive patients, <15 years of age, who had been diagnosed with post-traumatic endophthalmitis between September 2009 and October 2015, were included in this 6-year retrospective study...
April 25, 2017: Current Eye Research
https://www.readbyqxmd.com/read/28439310/syndesmosis-injuries-in-the-pediatric-and-adolescent-athlete-an-analysis-of-risk-factors-related-to-operative-intervention
#9
D E Kramer, M X Cleary, P E Miller, Y-M Yen, B J Shore
PURPOSE: To review all paediatric ankle syndesmotic injuries occurring at our institution and identify risk factors associated with operative intervention. METHODS: Among 22 873 evaluations for ankle trauma, we found 220 children suffering from syndesmotic injuries (incidence: 0.96%). We recorded demographic data, details of the injury, features on examination and treatment variables. Univariable and multivariable logistic regression modelling was performed to identify risk factors associated with operative intervention...
2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/28433455/peritoneal-fluid-localization-on-fast-examination-in-the-pediatric-trauma-patient
#10
Timothy E Brenkert, Cynthia Adams, Rebecca L Vieira, Rachel G Rempell
OBJECTIVE: To determine the location of intraperitoneal free fluid on FAST exam in pediatric patients undergoing evaluation for trauma. METHODS: Retrospective review of all FAST exams positive for intraperitoneal free fluid performed in patients sustaining trauma between August 2009 and February 2016 in an urban pediatric emergency department. Positive results were categorized into one of nine potential intraperitoneal locations; 4 each in the right and left upper quadrants, and the pelvis...
April 14, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28433205/federal-research-priorities-in-child-abuse-and-neglect-research-a-commentary-on-multi-site-research-networks
#11
Valerie Maholmes
The National Institutes of Health has a long history of supporting investigator initiated child abuse research, including risk-factor studies on prevalence, course and consequences of child abuse and neglect. These studies laid the ground work for prevention research as well as the development and testing of therapeutic interventions. The newly established Pediatric Trauma and Critical Illness Branch at the Eunice Kennedy Shriver National Institute of Child Health and Human Development represents a new opportunity to call attention to the need for greater collaboration among researchers to build on prior work, pursue complex lines of inquiry, address more medically focused research and new clinical questions that will heighten the awareness of the unique needs for treatment and care of abused children...
April 19, 2017: Child Abuse & Neglect
https://www.readbyqxmd.com/read/28433064/resilience
#12
Gail Hornor
Every child is a unique individual. This individuality is evident in children exposed to psychosocial trauma or adverse childhood experiences. There exists wide variation in the way children respond to toxic stressors in their lives. Some children appear to be relatively unaffected, while others develop a variety of psychological, behavioral, and physical consequences. What is the explanation for this phenomenon? Resiliency has been suggested to explain this variation in pathology expressions in trauma-exposed children...
May 2017: Journal of Pediatric Health Care
https://www.readbyqxmd.com/read/28431416/caring-for-critically-injured-children-an-analysis-of-56-pediatric-damage-control-laparotomies
#13
Miguel A Villalobos, Joshua P Hazelton, Rachel L Choron, Lisa Capano-Wehrle, Krystal Hunter, John P Gaughan, Steven E Ross, Mark J Seamon
BACKGROUND: Injury is the leading cause of death in children under 18 years. Damage control principles have been extensively studied in adults but remain relatively unstudied in children. Our primary study objective was to evaluate the use of damage control laparotomy (DCL) in critically injured children. METHODS: An American College of Surgeons-verified Level 1 trauma center review (1996-2013) of pediatric trauma laparotomies was undertaken. Exclusion criteria included: age older than 18 years, laparotomy for abdominal compartment syndrome or delayed longer than 2 hours after admission...
May 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28430759/evaluation-of-guidelines-for-injured-children-at-high-risk-for-venous-thromboembolism-a-prospective-observational-study
#14
Rachel M Landisch, Sheila J Hanson, Laura D Cassidy, Kristin Braun, Rowena C Punzalan, David M Gourlay
BACKGROUND: Pharmacologic prophylaxis for venous thromboembolism (VTE) is a widely accepted practice in adult trauma patients to prevent associated morbidity and mortality. However, VTE prophylaxis has not been standardized in injured pediatric patients. Our institution identified factors potentially associated with a high risk of VTE in critically injured children that led to prospective implementation of VTE prophylaxis guidelines. We hypothesize that the guidelines are accurate in predicting children at risk for VTE...
May 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28430697/abusive-head-trauma-and-mortality-an-analysis-from-an-international-comparative-effectiveness-study-of-children-with-severe-traumatic-brain-injury
#15
Nikki Miller Ferguson, Ajit Sarnaik, Darryl Miles, Nadeem Shafi, Mark J Peters, Edward Truemper, Monica S Vavilala, Michael J Bell, Stephen R Wisniewski, James F Luther, Adam L Hartman, Patrick M Kochanek
OBJECTIVES: Small series have suggested that outcomes after abusive head trauma are less favorable than after other injury mechanisms. We sought to determine the impact of abusive head trauma on mortality and identify factors that differentiate children with abusive head trauma from those with traumatic brain injury from other mechanisms. DESIGN: First 200 subjects from the Approaches and Decisions in Acute Pediatric Traumatic Brain Injury Trial-a comparative effectiveness study using an observational, cohort study design...
April 20, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28429381/the-structural-connectome-of-children-with-traumatic-brain-injury
#16
Marsh Königs, L W Ernest van Heurn, Roel Bakx, R Jeroen Vermeulen, J Carel Goslings, Bwee Tien Poll-The, Marleen van der Wees, Coriene E Catsman-Berrevoets, Jaap Oosterlaan, Petra J W Pouwels
This study aimed to investigate the impact of mild to severe pediatric TBI on the structural connectome. Children aged 8-14 years with trauma control (TC) injury (n = 27) were compared to children with mild TBI and risk factors for complicated TBI (mild(RF+) , n = 20) or moderate/severe TBI (n = 16) at 2.8 years post-injury. Probabilistic tractography on diffusion tensor imaging data was used in combination with graph theory to study structural connectivity. Functional outcome was measured using neurocognitive tests and parent and teacher questionnaires for behavioral functioning...
April 21, 2017: Human Brain Mapping
https://www.readbyqxmd.com/read/28427053/growing-skull-fracture-and-the-orbitocranial-variant-nuances-of-surgical-management
#17
Vikram Singh, Gopalakrishnan M Sasidharan, Dhananjaya Ishwar Bhat, Bhagavatula Indira Devi
AIMS: Growing skull fracture (GSF) is a rare complication resulting from diastatic enlargement of a pediatric skull fracture. Orbitocranial GSF is a distinct variant with more complex management issues due to the displacement of the globe. This study aims to discuss surgical considerations in the management of GSF, with particular reference to orbitocranial variants. METHODS: We conducted a retrospective analysis of 7 children operated for GSFs at our institute from 2008 to 2015...
April 21, 2017: Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28424128/analysis-of-all-terrain-vehicle-trauma-data-implications-for-increased-regulation-and-injury-prevention
#18
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/28423091/an-unusual-abdominal-wall-mass-in-a-child
#19
Amalia Maria do Espirito Santo Souza, Tomas Marzagão Barbuto, Flávia Alessandra Freitas, Nathalia Fernandes Vianna, Carla Maria Costa Zanchetta, Silvana Forsait, Claudio Borba, Alessandra Milani Prandini de Azambuja, Lilian Maria Cristofani, Vicente Odone
Abdominal tumors are one of the most common types of pediatric cancer. Therefore, they should always be included in the differential diagnosis of abdominal masses. Here, we present the case of a child whose initial hypothesis of diagnosis contemplated this possibility. Later, it was demonstrated that the abdominal mass found was secondary to a common parasitosis. A 2-year old, moderately malnourished and pale white boy was referred with a history of a rapidly growing, well-limited, middle abdominal mass. The mass was 10 by 3 cm, hard and poorly movable, apparently involving both abdominal rectus muscles...
April 13, 2017: Revista do Instituto de Medicina Tropical de São Paulo
https://www.readbyqxmd.com/read/28422922/the-spatial-epidemiology-of-pediatric-trauma-a-statewide-assessment
#20
Allison Ertl, Kirsten Beyer, Sergey Tarima, Yuhong Zhou, Jonathan I Groner, Laura D Cassidy
INTRODUCTION: Despite significant advances in the prevention and treatment of pediatric trauma, preventable injuries continue to burden the lives of millions of children. In order to target prevention strategies, it is critical to identify areas with high burdens of pediatric trauma. Therefore, this study analyzed statewide data from the Ohio Trauma Registry (OTR) from 2007-2012 to identify geographical patterns in pediatric injury. METHODS: Data from the first hospital of care for 16,330 pediatric trauma patients under 16 years old were analyzed using the disease mapping method adaptive spatial filtering to estimate a series of maps that display age- and sex-adjusted rates of pediatric trauma, severe trauma, and standardized mortality ratios (SMR) while controlling for population size to create stable estimates throughout the study area...
April 18, 2017: Journal of Trauma and Acute Care Surgery
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