1,107 results match your criteria Neonatal Injuries in Child Abuse


High-risk Pediatric Emergencies.

Emerg Med Clin North Am 2020 May;38(2):383-400

Department of Pediatrics, Division of Pediatric Emergency Medicine, Boston University School of Medicine, 4th floor, 801 Albany Street, Boston, MA, 02119, USA.

More than half of pediatric malpractice cases arise from emergency departments, primarily due to missed or delayed diagnoses. All providers who take care of children in emergency departments should be aware of this risk and the most common diagnoses associated with medicolegal liability. This article focuses on diagnosis and management of high-risk diagnoses in pediatric patients presenting to emergency departments, including meningitis, pneumonia, appendicitis, testicular torsion, and fracture. Read More

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http://dx.doi.org/10.1016/j.emc.2020.01.004DOI Listing

Subgaleal Hemorrhage Secondary to Child Physical Abuse in a 4-Year-Old Boy.

Pediatr Emerg Care 2020 Feb 27. Epub 2020 Feb 27.

Division of Child Advocacy, Dayton Children's Hospital, Dayton, OH.

Subgaleal hemorrhage is commonly described in the neonatal population but is a rare injury in young children and adolescents. Though infrequently seen, it can follow blunt head trauma or hair pulling. This case report details a 4-year-old African American boy with massive subgaleal hemorrhage and bilateral periorbital swelling and ecchymosis as a result of hair pulling in the setting of child physical abuse. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001937DOI Listing
February 2020

[Effectiveness of an educational video on infant crying for prevention of shaken baby syndrome among Japanese caregivers of infants].

Nihon Koshu Eisei Zasshi 2019 ;66(11):702-711

Department of Social Medicine, National Center on Child Health and Development.

Objectives Spreading awareness of shaken baby syndrome is considered to be essential in the prevention of infant deaths resulting from abuse. This study aimed to determine whether an educational video on infant crying, developed by the Ministry of Health, Labour and Welfare, was effective at increasing knowledge of infant crying and shaking among Japanese caregivers of infants aged under 1 year.Methods We targeted caregivers who had infants aged under 1 year for intervention through health checkups and home visits in 29 municipalities across Japan from April 2013 to March 2014. Read More

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http://dx.doi.org/10.11236/jph.66.11_702DOI Listing
February 2020

The true cost of child abuse at a level 1 pediatric trauma center.

J Pediatr Surg 2020 Feb 1;55(2):335-340. Epub 2019 Nov 1.

Division of Pediatric Surgery, Children's Hospital Colorado, Aurora, CO, USA; Department of Surgery, University of Colorado School of Medicine, Aurora, CO, USA.

Background: Child physical abuse (CPA) is a significant cause of morbidity and mortality. Children who sustain CPA consume significant healthcare resources. We hypothesized that the costs to care for children who sustain for children with CPA-type injuries are greater than the costs to care for children who sustain accidental injuries. Read More

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http://dx.doi.org/10.1016/j.jpedsurg.2019.10.024DOI Listing
February 2020

Pediatric Genitourinary Infections and Other Considerations.

Emerg Med Clin North Am 2019 Nov 31;37(4):739-754. Epub 2019 Aug 31.

Department of Pediatrics, University of Rochester, 601 Elmwood Avenue Box 655, Rochester, NY 14642, USA.

Pediatric patients pose a unique host of challenges to the emergency provider across all complaints and ages, but this is particularly notable in the genitourinary (GU) system. The pediatric GU system is different from that of the adult in its etiology of symptoms, complications, and treatments. Based on age, there are variations in the anatomy. Read More

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http://dx.doi.org/10.1016/j.emc.2019.07.010DOI Listing
November 2019
2 Reads

Feasibility and Accuracy of Fast MRI Versus CT for Traumatic Brain Injury in Young Children.

Pediatrics 2019 10;144(4)

School of Medicine, University of Colorado, Denver, Colorado.

Background: Computed tomography (CT) is commonly used for children when there is concern for traumatic brain injury (TBI) and is a significant source of ionizing radiation. Our objective was to determine the feasibility and accuracy of fast MRI (motion-tolerant MRI sequences performed without sedation) in young children.

Methods: In this prospective cohort study, we attempted fast MRI in children <6 years old who had head CT performed and were seen in the emergency department of a single, level 1 pediatric trauma center. Read More

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http://dx.doi.org/10.1542/peds.2019-0419DOI Listing
October 2019
6 Reads
5.473 Impact Factor

Identifying Targets to Improve Coding of Child Physical Abuse at a Pediatric Trauma Center.

J Trauma Nurs 2019 Sep/Oct;26(5):239-242

Trauma Program (Ms Durand and Drs Upperman and Jensen), Division of Pediatric Surgery (Ms Durand and Drs McLaughlin, Upperman, and Jensen), The Audrey Hepburn CARES Center (Dr Imagawa), and Division of General Pediatrics (Dr Imagawa), Children's Hospital Los Angeles, California; and the Keck School of Medicine, University of Southern California, Los Angeles (Drs Imagawa, Upperman, and Jensen).

Child physical abuse is a leading cause of morbidity and mortality in young children. Identification of abused children is challenging, and can affect risk-adjusted benchmarking of trauma center performance. The purpose of this project was to understand diagnosis coding capture rates for child abuse and develop a standardized approach to clinician documentation to improve trauma registry capture. Read More

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http://Insights.ovid.com/crossref?an=00043860-201909000-0000
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http://dx.doi.org/10.1097/JTN.0000000000000461DOI Listing
March 2020
2 Reads

Kinderschutz-Leitlinie AWMF S3(+) (ID-Nr. 20123).

Authors:
M Born

Rofo 2019 Sep 20;191(S 02):S109-S111. Epub 2019 Aug 20.

Radiologische Klinik der Universität Bonn - Kinderradiologie Universitätskinderklinik.

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http://dx.doi.org/10.1055/a-0943-1083DOI Listing
September 2019

The Infant Injury Database: A Tool for the Study of Injury Patterns in Medicolegal Investigations of Child Abuse.

J Forensic Sci 2019 Nov 2;64(6):1622-1632. Epub 2019 Jul 2.

Dallas County Medical Examiner Office, Southwestern Institute of Forensic Sciences, 2355 N Stemmons Fwy, Dallas, TX, 75207.

In 2012, the Harris County Institute of Forensic Sciences began prospectively collecting injury data from pediatric autopsies. These data and associated case information from 635 pediatric cases are archived in the Infant Injury Database (IID). This paper introduces the IID to the forensic community and demonstrates its potential utility for child abuse and infant fatality investigations. Read More

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http://dx.doi.org/10.1111/1556-4029.14120DOI Listing
November 2019
4 Reads

Rachitic change and vitamin D status in young children with fractures.

Skeletal Radiol 2020 Jan 26;49(1):85-91. Epub 2019 Jun 26.

Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.

Objective: To examine the association between rachitic changes and vitamin D levels in children less than 2 years old with fractures.

Methods: Children less than 2 years old who were admitted to a large children's hospital for a fracture and underwent a skeletal survey were included. Two pediatric radiologists blinded to the children's vitamin D levels independently reviewed the skeletal surveys for the following rachitic findings: demineralization, widened sutures, rachitic rosary, Looser zones, and metaphyseal changes. Read More

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http://dx.doi.org/10.1007/s00256-019-03261-6DOI Listing
January 2020
3 Reads

Physical violence against children and adolescents in Recife: a 5-year retrospective study.

J Forensic Odontostomatol 2019 May 1;37(1):20-25. Epub 2019 May 1.

Faculty of Dental Medicine, University of Porto (FMDUP), Porto, Portugal.

The aim of the present study was to analyze the prevalence results of physical violence against children and adolescents in a 5-year period in Recife, Brazil. Inter-personal violence is one of the most recognizable forms of child aggression and has become as an imperative public health issue. All violence related forensic reports performed between 2009 and 2013 in the clinical services of the Institute of Legal Medicine Antônio Percivo Cunha were analyzed. Read More

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6875244PMC
May 2019
4 Reads

Emergent Imaging of Pediatric Cervical Spine Trauma.

Radiographics 2019 Jul-Aug;39(4):1126-1142. Epub 2019 Jun 7.

From the Department of Radiology, Nationwide Children's Hospital, 700 Children's Dr, Columbus, OH 43205, and Department of Radiology, The Ohio State University, Columbus, Ohio (A.S.M.); Department of Radiology and Medical Imaging, Cincinnati Children's Hospital, Cincinnati, Ohio (U.N.); and Department of Radiology and Imaging Sciences, Riley Hospital for Children at Indiana University Health, Indianapolis, Ind (R.R.).

Owing to physiologic and biomechanical differences, the incidence, patterns, distributions, and mechanisms of spinal injury in children differ from those in adults. Furthermore, evaluation of the spine can be complicated by synchondroses, developmental and/or anatomic variants, and interpretative pitfalls that are unique to the developing spine of a child. Although the incidence of spinal injury is lower in children, the sequelae are more severe, with higher morbidity and mortality. Read More

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http://dx.doi.org/10.1148/rg.2019180100DOI Listing
May 2020
6 Reads

Yield of Neuroimaging in Infant Physical Abuse Evaluations: Do Infant Age and Injury Type Matter?

J Emerg Med 2019 Aug 3;57(2):195-202. Epub 2019 Jun 3.

Division of General Pediatrics, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.

Background: Neuroimaging can be an important part of the medical workup for children with suspected physical abuse, but there are not specific guidelines on which children should undergo neuroimaging.

Objective: We sought to evaluate the yield of neuroimaging in children <12 months of age who are undergoing physical abuse evaluations and to determine how the yield varied by age, injuries, and social risk factors.

Methods: This was a retrospective observational study of infants who presented to an urban children's hospital between September 2007 and October 2012, were evaluated by the hospital's child abuse team, and who received skeletal surveys and underwent neuroimaging for suspected physical abuse. Read More

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http://dx.doi.org/10.1016/j.jemermed.2019.03.041DOI Listing
August 2019
6 Reads

Profile of unnatural mortalities in Northern part of Ghana; a forensic-based autopsy study.

J Forensic Leg Med 2019 Jul 22;65:137-142. Epub 2019 May 22.

Department of Pathology, Komfo Anokye Teaching Hospital, Kumasi, Ghana.

Introduction: Bereavement is usually difficult to come to terms with. However, sudden, violent or traumatic death can be particularly hard to accept for any family, group or nation as a whole. A retrospective study of all autopsies on unnatural and traumatic deaths of medico-legal importance was made at the Komfo Anokye Teaching Hospital from 2008 to 2016. Read More

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http://dx.doi.org/10.1016/j.jflm.2019.05.012DOI Listing
July 2019
12 Reads

Every child, every time: hospital-wide child abuse screening increases awareness and state reporting.

Pediatr Surg Int 2019 Jul 21;35(7):773-778. Epub 2019 May 21.

Division of Pediatric Surgical Specialties, Department of Surgery, Lehigh Valley Reilly Children's Hospital, Lehigh Valley Health Network, 1210 S Cedar Crest Blvd, Suite 1100, Allentown, PA, 18103, USA.

Purpose: A review of our child abuse evaluation system demonstrated a lack of standardization leading to low reporting levels. The purpose of this quality improvement initiative was to develop a standard child abuse screening tool; an education program increasing awareness to child abuse; and to measure the impact of the screening tool in reporting.

Methods: A screening tool was developed and implemented for all trauma patients < 15 years of age; staff was educated; and a child protection team (CPT) was established. Read More

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http://dx.doi.org/10.1007/s00383-019-04485-2DOI Listing
July 2019
7 Reads

Altered Mental Status in Children After Traumatic Brain Injury.

Pediatr Ann 2019 May;48(5):e192-e196

Pediatric head injuries are common and may present with varying degrees of altered mental status in children. The approach to evaluation, diagnosis, treatment, and prevention of further injury is important in achieving good health outcomes after a head injury. In this article, we review the pathophysiology, classifications, signs and symptoms, and management of traumatic brain injury. Read More

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https://www.healio.com/doiresolver?doi=10.3928/19382359-2019
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http://dx.doi.org/10.3928/19382359-20190422-03DOI Listing
May 2019
11 Reads

Diseases, Injuries, and Risk Factors in Child and Adolescent Health, 1990 to 2017: Findings From the Global Burden of Diseases, Injuries, and Risk Factors 2017 Study.

Authors:
Robert C Reiner Helen Elizabeth Olsen Chad Thomas Ikeda Michelle M Echko Katherine E Ballestreros Helen Manguerra Ira Martopullo Anoushka Millear Chloe Shields Alison Smith Bryan Strub Molla Abebe Zegeye Abebe Beyene Meressa Adhena Tara Ballav Adhikari Mohammed Akibu Rajaa M Al-Raddadi Nelson Alvis-Guzman Carl Abelardo T Antonio Olatunde Aremu Solomon Weldegebreal Asgedom Netsanet Abera Asseffa Leticia Avila-Burgos Aleksandra Barac Till W Bärnighausen Quique Bassat Isabela M Bensenor Zulfiqar A Bhutta Ali Bijani Nigus Bililign Lucero Cahuana-Hurtado Deborah Carvalho Malta Jung-Chen Chang Fiona J Charlson Samath Dhamminda Dharmaratne David Teye Doku Dumessa Edessa Ziad El-Khatib Holly E Erskine Alize J Ferrari Nancy Fullman Rahul Gupta Hamid Yimam Hassen Simon I Hay Olayinka Stephen Ilesanmi Kathryn H Jacobsen Amaha Kahsay Amir Kasaeian Tesfaye Dessale Kassa Seifu Kebede Yousef Saleh Khader Ejaz Ahmad Khan Mohammed Nuruzzaman Khan Young-Ho Khang Jagdish Khubchandani Yohannes Kinfu Sonali Kochhar Yoshihiro Kokubo Ai Koyanagi Barthelemy Kuate Defo Dharmesh Kumar Lal Fekede Asefa Kumsa Heidi J Larson Janni Leung Abdullah A Mamun Suresh Mehata Mulugeta Melku Walter Mendoza Haftay Berhane Mezgebe Ted R Miller Nurilign Abebe Moges Shafiu Mohammed Ali H Mokdad Lorenzo Monasta Subas Neupane Huong Lan Thi Nguyen Dina Nur Anggraini Ningrum Yirga Legesse Nirayo Vuong Minh Nong Felix Akpojene Ogbo Andrew T Olagunju Bolajoko Olubukunola Olusanya Jacob Olusegun Olusanya George C Patton David M Pereira Farshad Pourmalek Mostafa Qorbani Anwar Rafay Rajesh Kumar Rai Usha Ram Chhabi Lal Ranabhat Andre M N Renzaho Mohammad Sadegh Rezai Luca Ronfani Gregory A Roth Saeid Safiri Benn Sartorius James G Scott Katya Anne Shackelford Karen Sliwa Chandrashekhar Sreeramareddy Mu'awiyyah Bable Sufiyan Abdullah Sulieman Terkawi Roman Topor-Madry Bach Xuan Tran Kingsley Nnanna Ukwaja Olalekan A Uthman Stein Emil Vollset Kidu Gidey Weldegwergs Andrea Werdecker Harvey A Whiteford Tissa Wijeratne Naohiro Yonemoto Marcel Yotebieng Liesl J Zuhlke Hmwe Hmwe Kyu Mohsen Naghavi Theo Vos Christopher J L Murray Nicholas J Kassebaum

JAMA Pediatr 2019 06 3;173(6):e190337. Epub 2019 Jun 3.

Institute for Health Metrics and Evaluation, Seattle, Washington.

Importance: Understanding causes and correlates of health loss among children and adolescents can identify areas of success, stagnation, and emerging threats and thereby facilitate effective improvement strategies.

Objective: To estimate mortality and morbidity in children and adolescents from 1990 to 2017 by age and sex in 195 countries and territories.

Design, Setting, And Participants: This study examined levels, trends, and spatiotemporal patterns of cause-specific mortality and nonfatal health outcomes using standardized approaches to data processing and statistical analysis. Read More

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http://dx.doi.org/10.1001/jamapediatrics.2019.0337DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6547084PMC
June 2019
31 Reads

Radiation doses in diagnostic imaging for suspected physical abuse.

Arch Dis Child 2019 09 17;104(9):863-868. Epub 2019 Apr 17.

Te Puaruruhau (Child Protection Team), Starship Children's Health, Auckland, New Zealand.

Objective: To measure the actual radiation dose delivered by imaging techniques commonly used in the radiography of suspected physical abuse and to make this information available to health professionals and families.

Methods: Data were collected retrospectively on children under 3 years referred for skeletal surveys for suspected physical abuse, non-contrast CT head scan or radionuclide imaging of the bones in Starship Children's Hospital, Auckland, New Zealand from January to December 2015. Patient size-specific conversion coefficients were derived from International Commission on Radiologic Protection tissue weighting factors and used to calculate effective dose. Read More

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http://adc.bmj.com/lookup/doi/10.1136/archdischild-2018-3162
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http://dx.doi.org/10.1136/archdischild-2018-316286DOI Listing
September 2019
15 Reads

Classic Metaphyseal Lesions among Victims of Abuse.

J Pediatr 2019 06 5;209:154-159.e2. Epub 2019 Apr 5.

Pediatrics and Forensic Unit, Hôtel Dieu Hospital, AP-HP Paris, France.

Objective: To use legal statements by perpetrators to gain new insights into the causative mechanism of classic metaphyseal lesion (CML). The CML, so called "corner fracture," is considered a highly specific marker for abuse in infants. However, the precise correlation between CMLs and abusive head trauma is still unknown. Read More

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http://dx.doi.org/10.1016/j.jpeds.2019.02.013DOI Listing
June 2019
6 Reads

Firearm Legislation Stringency and Firearm-Related Fatalities among Children in the US.

J Am Coll Surg 2019 08 28;229(2):150-157. Epub 2019 Mar 28.

Department of Surgery, Division of Pediatric Surgery, Stanford University, Stanford, CA.

Background: Firearm-related injuries are the second leading cause of pediatric deaths in the US. We sought to evaluate the effectiveness of both state child access prevention (CAP) laws and gun regulations on pediatric firearm mortality. We hypothesized that states with more stringent firearm legislation had lower pediatric firearm mortality. Read More

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http://dx.doi.org/10.1016/j.jamcollsurg.2019.02.055DOI Listing
August 2019
12 Reads

Early Involvement of the Child Protection Team in the Care of Injured Infants in a Pediatric Emergency Department.

J Emerg Med 2019 Jun 14;56(6):592-600. Epub 2019 Mar 14.

Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut.

Background: Physical abuse is a significant cause of infant morbidity and mortality. Early detection in the emergency department (ED) is crucial.

Objective: We describe the impact of a clinical pathway focused on early involvement of the child protection team (CPT) and social work (SW) team for infants presenting to a pediatric emergency department with an injury concerning for abuse. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S07364679193003
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http://dx.doi.org/10.1016/j.jemermed.2019.01.030DOI Listing
June 2019
18 Reads

Brain interrupted: Early life traumatic brain injury and addiction vulnerability.

Exp Neurol 2019 07 9;317:191-201. Epub 2019 Mar 9.

Department of Pathology and Laboratory Medicine, The Lewis Katz School of Medicine at Temple University, Philadelphia, PA 19140, USA; Center for Substance Abuse Research, The Lewis Katz School of Medicine at Temple University, Philadelphia, PA 19140, USA; Shriners Hospitals Pediatric Research Center, The Lewis Katz School of Medicine at Temple University, Philadelphia, PA 19140, USA. Electronic address:

Recent reports provide evidence for increased risk of substance use disorders (SUD) among patients with a history of early-life traumatic brain injury (TBI). Preclinical research utilizing animal models of TBI have identified injury-induced inflammation, blood-brain barrier permeability, and changes to synapses and neuronal networks within regions of the brain associated with the perception of reward. Importantly, these reward pathway networks are underdeveloped during childhood and adolescence, and early-life TBI pathology may interrupt ongoing maturation. Read More

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http://dx.doi.org/10.1016/j.expneurol.2019.03.003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6544498PMC
July 2019
1 Read

Fracture incidence in Ehlers-Danlos syndrome - A population-based case-control study.

Child Abuse Negl 2019 05 8;91:95-101. Epub 2019 Mar 8.

Department of Pediatric and Adolescent Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. Electronic address:

Background: The differential diagnosis of non-accidental injury during childhood includes medical conditions that predispose to skeletal fragility. Ehlers-Danlos syndrome (EDS) has been proposed as one such condition despite little objective evidence in the medical literature.

Objective: To investigate if EDS causes increased bone fragility during infancy and childhood. Read More

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http://dx.doi.org/10.1016/j.chiabu.2019.03.008DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7064152PMC
May 2019
2 Reads

Are we looking for retinal haemorrhages?

Med Sci Law 2019 01;59(1):70-71

William Harvey Institute, Queen Mary University of London, UK.

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http://dx.doi.org/10.1177/0025802419828922DOI Listing
January 2019
3 Reads

Factors Associated With Nonaccidental Trauma Evaluation Among Patients Below 36 Months Old Presenting With Femur Fractures at a Level-1 Pediatric Trauma Center.

J Pediatr Orthop 2019 Apr;39(4):175-180

Division of Orthopaedic Surgery and Sports Medicine, Children's National Health System, Washington, DC.

Background: In 2009, the American Academy of Orthopedic Surgeons published clinical practice guidelines (CPGs) on the treatment of pediatric diaphyseal femur fractures, which recommended a nonaccidental trauma (NAT) evaluation for all patients below 36 months of age. A recent study of these guidelines found <50% clinical compliance with this treatment recommendation. We aimed to identify areas for improvement in compliance with this guideline. Read More

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http://dx.doi.org/10.1097/BPO.0000000000000911DOI Listing
April 2019
9 Reads

Do data from child protective services and the police enhance modelling of perinatal risk for paediatric abusive head trauma? A retrospective case-control study.

BMJ Open 2019 03 1;9(3):e024199. Epub 2019 Mar 1.

Paediatrics, University of Auckland, Auckland, New Zealand.

Objectives: First, to investigate whether there is a relationship between a family being known to child protective services or police at the time of birth and the risk of abusive head trauma (AHT, formerly known as shaken baby syndrome). Second, to investigate whether data from child protective services or police improve a predictive risk model derived from health records.

Design: Retrospective case control study of child protective service and police records. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-024199DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6429859PMC
March 2019
4 Reads

Traumatic brain injuries in New Zealand: National Insurance (Accident Compensation Corporation) claims from 2012 to 2016.

J Neurol Sci 2019 Apr 12;399:61-68. Epub 2019 Feb 12.

Australian College of Physical Education, Department of Sport Performance, Sydney Olympic Park NSW, Australia.

Aim: To provide epidemiological data and related costs to the national health insurance scheme for traumatic brain injury (TBI) in New Zealand.

Method: A retrospective analytical review utilising detailed descriptive minor and moderate-to-severe epidemiological TBI data obtained from the Accident Compensation Corporation (ACC) for 2012-2016. Injuries were analysed by three levels of increasing severity: moderate, moderate-to-serious (MSC) and severe claims categories. Read More

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http://dx.doi.org/10.1016/j.jns.2019.01.049DOI Listing
April 2019
1 Read

The pathology and aetiology of subcortical clefts in infants.

Forensic Sci Int 2019 Mar 19;296:115-122. Epub 2019 Jan 19.

Department of Neuropathology and Ocular Pathology, John Radcliffe Hospital, Oxford University Hospital, Oxford, United Kingdom.

In infants, traumatic surface contusions of the brain are rare but subcortical clefts or cysts, variously labelled "contusional tears", "contusional clefts", "cortical tears" or "parenchymal lacerations" have been ascribed to trauma, and are even said to be characteristic of shaking and abuse. We describe the pathology of subcortical clefts or haemorrhages in seven infants. In none were the axonal swellings characteristic of traumatic axonal injury seen in relation to the clefts. Read More

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http://dx.doi.org/10.1016/j.forsciint.2019.01.011DOI Listing
March 2019
6 Reads

Feasibility study of the calm baby gently program: An educational baby book intervention on safe practices related to infant crying.

Child Abuse Negl 2019 03 16;89:135-142. Epub 2019 Jan 16.

Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229, USA; University of Cincinnati College of Medicine, 3230 Eden Avenue, Cincinnati, OH, 45267, USA. Electronic address:

Background: Abusive head trauma (AHT) is a preventable form of child abuse.

Objective: This project used a mixed method design to assess the feasibility of the Calm Baby Gently educational baby book intervention for promoting safe practices related to infant crying in an effort to prevent AHT.

Participants And Setting: Three pediatric practices participated between June 2016 and January 2018, including 1045 caregivers who attended their infant's 2-month well-child visit. Read More

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http://dx.doi.org/10.1016/j.chiabu.2018.12.011DOI Listing
March 2019
13 Reads

Oral injuries in children less than 24 months of age in a pediatric emergency department.

Child Abuse Negl 2019 03;89:70-77

Department of Pediatrics, Section of Emergency Medicine, Yale University School of Medicine, 100 York Street, Suite 1F, New Haven, Connecticut, 06511, USA. Electronic address:

Background: Oral injuries in young children may indicate physical abuse. The prevalence of oral injuries in young children presenting to the emergency department is unknown. These data would assist providers in making decisions about the need for further abuse evaluation. Read More

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http://dx.doi.org/10.1016/j.chiabu.2019.01.006DOI Listing
March 2019
29 Reads

Multicentre study of physical abuse and limb fractures in young children in the East Anglia Region, UK.

Arch Dis Child 2019 10 12;104(10):956-961. Epub 2019 Jan 12.

Department of Orthopaedics, West Suffolk Hospital, Suffolk, UK.

Objective: To determine if the detection of physical abuse in young children with fractures is of uniform high standard in the East Anglia Region of the UK, and whether we can identify areas for improvement in our detection of high-risk groups.

Design: Multicentre retrospective 4-year study.

Setting: 7 hospitals across the East Anglia Region of Britain (East Anglia Paediatric Physical Abuse and Fractures study). Read More

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http://adc.bmj.com/lookup/doi/10.1136/archdischild-2018-3150
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http://dx.doi.org/10.1136/archdischild-2018-315035DOI Listing
October 2019
27 Reads

Classic metaphyseal lesion acquired during physical therapy.

Clin Imaging 2019 Mar - Apr;54:100-102. Epub 2018 Nov 20.

Department of Radiology and Imaging Sciences, Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, IN, USA.

A classic metaphyseal lesion (CML) is highly specific for nonaccidental trauma. Missing CMLs can be devastating to the child as the child can continue to be exposed to inflicted trauma. Yet, there are rare case reports on CMLs that occur due to birth trauma, IV line placement, and treatment for clubfoot. Read More

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http://dx.doi.org/10.1016/j.clinimag.2018.11.007DOI Listing
May 2019
13 Reads

Quality Improvement Initiative to Improve Abuse Screening Among Infants With Extremity Fractures.

Pediatr Emerg Care 2019 Sep;35(9):643-650

Division of General Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA.

Objectives: The aim of this study was to evaluate the effectiveness of clinical pathway implementation and quality improvement (QI) interventions to increase the percentage of infants with extremity fractures undergoing evaluation for suspected physical abuse, including skeletal survey (SS), and consultation with social work, and/or Child Protection Team.

Methods: Charts were retrospectively reviewed to establish percentage of infants less than 12 months old with extremity fractures undergoing an SS and consultation during the prepathway (January 1, 2012 to December 31, 2013) and postpathway (January 1, 2014 to June 30, 2015) periods. Using an Ishikawa framework, key process drivers were identified and additional QI interventions (clinical decision support and provider education) were developed and implemented. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001671DOI Listing
September 2019
29 Reads

Metabolic bone disease risk factors strongly contributing to long bone and rib fractures during early infancy: A population register study.

PLoS One 2018 19;13(12):e0208033. Epub 2018 Dec 19.

Forensic Medicine, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.

Background: The aim of this study was to assess the incidence of fractures in infancy, overall and by type of fracture, its association with accidents, metabolic bone disease risk factors, and abuse diagnosis.

Methods: The design was a population-based register study in Sweden. Participants: Children born 1997-2014, 0-1 years of age diagnosed with fracture-diagnosis according to International Classification of Diseases (ICD10) were retrieved from the National Patient Register and linked to the Swedish Medical Birth Register and the Death Cause Register. Read More

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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0208033PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6300197PMC
June 2019
4 Reads

Patterns of moderate and severe injury in children after the introduction of major trauma networks.

Arch Dis Child 2019 04 23;104(4):366-371. Epub 2018 Nov 23.

Department of Trauma and Orthopaedics, Manchester Foundation Trust, Royal Manchester Children's Hospital, Manchester, UK.

Objective: To describe the demographics, mechanisms, presentation, injury patterns and outcomes for children with traumatic injuries.

Setting: Data collected from the UK's Trauma and Audit Research Network.

Design And Patients: The demographics, mechanisms of injury and outcomes were described for children with moderate and severe injuries admitted to the Major Trauma Network in England between 2012 and 2017. Read More

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http://dx.doi.org/10.1136/archdischild-2018-315636DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6530074PMC
April 2019
31 Reads

Traumatic macular retinoschisis in infants and children.

J AAPOS 2018 12 28;22(6):433-437.e2. Epub 2018 Oct 28.

Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania; Pediatric Ophthalmology and Ocular Genetics, Wills Eye Hospital, Philadelphia, Pennsylvania. Electronic address:

Purpose: To provide detailed description of pediatric traumatic retinoschisis.

Methods: The medical records of children with either abusive head trauma and traumatic macular retinoschisis seen at a single center from 1993 to 2006 were reviewed retrospectively. Clinical details were extracted from the record and photographic documentation. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S10918531183055
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http://dx.doi.org/10.1016/j.jaapos.2018.08.007DOI Listing
December 2018
60 Reads

Skeletal Survey Yield in Young Children with Femur Fractures.

J Emerg Med 2018 Dec 30;55(6):758-763. Epub 2018 Oct 30.

Division of Emergency Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois.

Background: Fractures are common in children, and it can be difficult to distinguish unintentional injuries from child abuse.

Objective: We describe circumstances of injury, prevalence of suspicion for physical abuse, and use of imaging to identify additional occult fractures in young children with femur fractures.

Methods: We reviewed the medical records for children younger than 48 months old with femur fractures treated at a pediatric referral hospital (2011-2013). Read More

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http://dx.doi.org/10.1016/j.jemermed.2018.09.041DOI Listing
December 2018
8 Reads

Epidemiology of subdural haemorrhage during infancy: A population-based register study.

PLoS One 2018 31;13(10):e0206340. Epub 2018 Oct 31.

Department of Clinical Medicine, University of Bergen and Department of Neurosurgery, Haukeland University Hospital, Bergen, Norway.

Objectives: To analyse subdural haemorrhage (SDH) during infancy in Sweden by incidence, SDH category, diagnostic distribution, age, co-morbidity, mortality, and maternal and perinatal risk factors; and its association with accidents and diagnosis of abuse.

Methods: A Swedish population-based register study comprising infants born between 1997 and 2014, 0-1 years of age, diagnosed with SDH-diagnoses according to the (International Classification of Diseases, 10th version (ICD10), retrieved from the National Patient Register and linked to the Medical Birth Register and the Death Cause Register. Outcome measures were: 1) Incidence and distribution, 2) co-morbidity, 3) fall accidents by SDH category, 4) risk factors for all SDHs in the two age groups, 0-6 and 7-365 days, and for ICD10 SDH subgroups: S06. Read More

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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0206340PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6209227PMC
April 2019
17 Reads

Injuries due to caustics ingestion in children: A psychological approach to the suspicion of childish jealousies.

Med Leg J 2019 Mar 31;87(1):21-23. Epub 2018 Oct 31.

2 Forensic Medicine Department, Rasoul Akram Hospital, Iran University of Medical Science, Tehran, Iran.

Most injuries from caustics ingestion occur due to parental negligence, but other causes such as psychological tendency or childish jealousy or behaviour may be the major cause for harming. Here, we describe a case of injury in a neonate who ingested a caustic substance, probably induced by his brother, but not as a consequence of the negligence of his parents. The mother said she had fed the child toilet bleach instead of water and was very concerned about the child's condition. Read More

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http://journals.sagepub.com/doi/10.1177/0025817218796918
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http://dx.doi.org/10.1177/0025817218796918DOI Listing
March 2019
11 Reads

The added value of a second read by pediatric radiologists for outside skeletal surveys.

Pediatr Radiol 2019 02 26;49(2):203-209. Epub 2018 Oct 26.

Department of Pediatrics, Riley Hospital for Children, Section of Child Protection Programs, Indiana University School of Medicine, Indianapolis, IN, USA.

Background: Fractures are the second most common finding in non-accidental trauma after cutaneous signs. Interpreting skeletal surveys could be challenging as some fractures are subtle and due to anatomical variations that can mimic injuries.

Objective: To determine the effect of a second read by a pediatric radiologist of skeletal surveys for suspected non-accidental trauma initially read at referring hospitals by general radiologists. Read More

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http://link.springer.com/10.1007/s00247-018-4276-8
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http://dx.doi.org/10.1007/s00247-018-4276-8DOI Listing
February 2019
35 Reads

Assessment of Maternal Knowledge and Confidence About Abusive Head Trauma and Coping With Infant Crying Before and After Infant Safety Education in the Neonatal Intensive Care Unit.

J Perinat Neonatal Nurs 2018 Oct/Dec;32(4):373-381

Department of Pediatrics, Medical College of Wisconsin, Milwaukee (Drs Rabbitt, Parker, and Yan and Ms Zhang); and Child Advocacy and Protection Services, Children's Hospital of Wisconsin, Milwaukee (Ms Bretl). Dr Parker is now at the Pediatric Residency Training Program at the University of California, Los Angeles.

Infants with a history of perinatal illness are at higher risk for abusive head trauma (AHT). Crying is a common trigger for physical abuse, and education on coping with infant crying is an important component of AHT prevention. This study assesses the effects of education in the neonatal intensive care unit (NICU) on mothers' knowledge about AHT and infant crying, self-efficacy in applying the education to infant cares and providing the education to others, and the quality of AHT and infant crying education after discharge. Read More

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http://Insights.ovid.com/crossref?an=00005237-201810000-0001
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http://dx.doi.org/10.1097/JPN.0000000000000362DOI Listing
February 2019
24 Reads

Do we get the message through? Difficulties in the prevention of abusive head trauma.

Eur J Pediatr 2019 Feb 23;178(2):139-146. Epub 2018 Oct 23.

Department of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Steinhövelstr. 5, 89075, Ulm, Germany.

Many programs aim to prevent abusive head trauma throughout the USA, Europe, and in many other regions of the world. Most of these programs inform mothers shortly after delivery about the dangers of abusive head trauma. Effectiveness of these programs usually is measured by the increase of knowledge on abusive head trauma. Read More

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http://link.springer.com/10.1007/s00431-018-3273-0
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http://dx.doi.org/10.1007/s00431-018-3273-0DOI Listing
February 2019
32 Reads

Emergency Department Visits Owing to Intentional and Unintentional Traumatic Brain Injury among Infants in the United States: A Population-Based Assessment.

J Pediatr 2018 12 25;203:259-265.e1. Epub 2018 Sep 25.

Department of Emergency Medicine; Department of Pediatrics, Alpert Medical School of Brown University; Hassenfeld Child Health Innovation Institute, Brown School of Public Health; Injury Prevention Center, Rhode Island Hospital, Providence, RI.

Objective: To examine national trends of emergency department (ED) visits owing to traumatic brain injury (TBI) among infants (age <12 months), specifically in the context of intentional and unintentional mechanisms.

Study Design: National Electronic Injury Surveillance System-All Injury Program data documenting nonfatal ED visits from 2003 to 2012 were analyzed. TBI was defined as ED visits resulting in a diagnosis of concussion, or fracture, or internal injury of the head. Read More

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http://dx.doi.org/10.1016/j.jpeds.2018.08.023DOI Listing
December 2018
6 Reads

Rib fractures: elusive, but important.

Lancet Child Adolesc Health 2018 11 22;2(11):769-770. Epub 2018 Sep 22.

Children's Protection Program, Seattle Children's Hospital, and Department of Pediatrics, General Pediatric Division, University of Washington School of Medicine Seattle, WA 98105, USA. Electronic address:

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https://linkinghub.elsevier.com/retrieve/pii/S23524642183028
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http://dx.doi.org/10.1016/S2352-4642(18)30282-7DOI Listing
November 2018
5 Reads

Chest radiographs versus CT for the detection of rib fractures in children (DRIFT): a diagnostic accuracy observational study.

Lancet Child Adolesc Health 2018 11 22;2(11):802-811. Epub 2018 Sep 22.

Department of Clinical Radiology, Great Ormond Street Hospital for Children, London, UK; UCL Great Ormond Street Institute of Child Health, London, UK. Electronic address:

Background: Internationally, chest radiography is the standard investigation for identifying rib fractures in suspected physical abuse in infants. Several small observation studies in children have found that chest CT can provide greater accuracy than radiography for fracture detection, potentially aiding medicolegal proceedings in abuse cases; however, to our knowledge, this greater accuracy has not been comprehensively evaluated. We aimed to determine differences in rib fracture detection rates between post-mortem chest radiographs and chest CT images, using forensic autopsy as the reference standard. Read More

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http://dx.doi.org/10.1016/S2352-4642(18)30274-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6350458PMC
November 2018
38 Reads

The detection of significant fractures in suspected infant abuse.

J Forensic Leg Med 2018 Nov 5;60:9-14. Epub 2018 Sep 5.

Manchester Molecular Pathology Innovation Centre, 3rd floor Citylabs, Nelson Street, Manchester, M13 9NQ, United Kingdom. Electronic address:

Objective: Skeletal survey is a commonly used means of detecting fractures in infants, and is used as a screen in suspected cases of physical abuse. It is recognised that in live infants, a repeat survey some days after a suspected episode of injury will detect more fractures than one taken shortly after the suspected injury, indicating that the latter lacks sensitivity. In infants who die soon after a suspected episode of physical abuse, the managing clinicians do not have the option of a second survey; however there is the opportunity for the microscopic examination of bones removed at autopsy. Read More

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http://dx.doi.org/10.1016/j.jflm.2018.09.002DOI Listing
November 2018
12 Reads

Infant skull fracture risk for low height falls.

Int J Legal Med 2019 May 7;133(3):847-862. Epub 2018 Sep 7.

Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, U.A. Whitaker Building, 313 Ferst Drive, Suite 2116, Atlanta, GA, 30332-0535, USA.

Skull fractures are common injuries in young children, typically caused by accidental falls and child abuse. The paucity of detailed biomechanical data from real-world trauma in children has hampered development of biomechanical thresholds for skull fracture in infants. The objectives of this study were to identify biomechanical metrics to predict skull fracture, determine threshold values associated with fracture, and develop skull fracture risk curves for low-height falls in infants. Read More

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http://dx.doi.org/10.1007/s00414-018-1918-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6469693PMC
May 2019
9 Reads

Child Maltreatment Red Flags: Two Cases of Bruising in Premobile Infants.

J Pediatr Health Care 2019 01 3;33(1):92-96. Epub 2018 Sep 3.

Child maltreatment is a serious public health concern in the United States. Young infants and children younger than 3 years are at the highest risk of being abused and can experience both acute injuries and long-term developmental, behavioral, and mental health problems. Health care providers are mandated reporters of suspected abuse but may misdiagnose potentially abusive injuries because of lack of knowledge in recognizing maltreatment. Read More

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http://dx.doi.org/10.1016/j.pedhc.2018.07.003DOI Listing
January 2019
36 Reads

Risk factors for maltreatment-related infant hospitalizations in New York City, 1995-2004.

Ann Epidemiol 2018 09 2;28(9):590-596. Epub 2018 Jun 2.

Department of Epidemiology, Brown University School of Public Health, Providence, RI; Department of Obstetrics and Gynecology, Brown University Alpert Medical School, Providence, RI.

Background: Child maltreatment is a major public health problem, but population-based surveillance and research is hindered by limitations of official child welfare data. The present study used a promising complementary data source, hospital discharge data, to investigate risk factors for infant injuries suggestive of maltreatment.

Methods: Discharge data from all hospital births to New York City residents from 1995 to 2004 were linked to birth certificates and to subsequent infant hospitalizations within 12 months after delivery. Read More

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http://dx.doi.org/10.1016/j.annepidem.2018.05.010DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6117827PMC
September 2018
48 Reads