1,146 results match your criteria Neonatal Injuries in Child Abuse

Neonatal Abusive Head Trauma without External Injuries: Suspicion Improves Diagnosis.

Children (Basel) 2022 May 30;9(6). Epub 2022 May 30.

Department of Pediatrics, Inha University Hospital, Incheon 22332, Korea.

The term "shaken baby syndrome" has been replaced by "abusive head trauma (AHT)" based on the mechanism of injury. The reported mortality rate of AHT ranges from 10% to 30%. Up to two-thirds of survivors suffer from serious long-term disabilities. Read More

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Deep learning of birth-related infant clavicle fractures: a potential virtual consultant for fracture dating.

Pediatr Radiol 2022 May 17. Epub 2022 May 17.

Department of Radiology, Boston Children's Hospital, 300 Longwood Ave., Boston, MA, 02115, USA.

Background: In infant abuse investigations, dating of skeletal injuries from radiographs is desirable to reach a clear timeline of traumatic events. Prior studies have used infant birth-related clavicle fractures as a surrogate to develop a framework for dating of abuse-related fractures.

Objective: To develop and train a deep learning algorithm that can accurately date infant birth-related clavicle fractures. Read More

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Homicide in children under ten years old in México: A 20-year study.

Colomb Med (Cali) 2021 Jul-Sep;52(3):e2024492. Epub 2021 Jun 17.

National Institute of Public Health, Cuernavaca, Mexico.

Background: In a society, children are the most vulnerable members of the population. Violence experienced in Mexico during the last decade has also affected children under ten years of age.

Objective: Analyze the trend of homicides in children under ten years from 1998 to 2017. Read More

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Retinal hemorrhage after pediatric neurosurgical procedures.

J AAPOS 2022 04 16;26(2):74.e1-74.e5. Epub 2022 Mar 16.

The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania. Electronic address:

Background: Neurosurgical procedures may occur prior to eye examination in children with suspected abusive head trauma and raise questions by child abuse physicians and ophthalmologists regarding the contribution of neurosurgery to retinal hemorrhage found postoperatively. The purpose of this study was to determine the prevalence and patterns of retinal hemorrhage attributable to neurosurgical intervention in children.

Methods: We conducted a retrospective cohort study of children undergoing neurosurgery who had postoperative ophthalmoscopy. Read More

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Nonaccidental trauma: bilateral corneal abrasions as only initial presentation.

J AAPOS 2022 04 9;26(2):97-98. Epub 2022 Feb 9.

Department of Ophthalmology, Faculty of Medicine, University of Montreal, Montreal, Canada; Centre Hospitalier Universitaire Sainte-Justine, Montreal, Canada. Electronic address:

We report a case of nonaccidental trauma in a child who presented emergently with bilateral corneal abrasions of unclear etiology. It was later discovered that these lesions were actually caused by the newborn's father, who had forcefully pressed his thumbs against the child's orbits. Although uncommon, such types of anterior segment pathology should raise suspicion of nonaccidental trauma. Read More

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Characteristics and age-related injury patterns of maxillofacial fractures in children and adolescents: A multicentric and prospective study.

Dent Traumatol 2022 Jun 11;38(3):213-222. Epub 2022 Feb 11.

Department Oral and Maxillofacial Surgery, Paracelsus Medical University, Salzburg, Austria.

Background/aims: Paediatric maxillofacial trauma accounts for 15% of all maxillofacial trauma but remains a leading cause of mortality. The aim of this prospective, multicentric epidemiological study was to analyse the characteristics of maxillofacial fractures in paediatric patients managed in 14 maxillofacial surgery departments on five continents over a 1-year period.

Methods: The following data were collected: age (preschool [0-6 years], school age [7-12 years], and adolescent [13-18 years]), cause and mechanism of the maxillofacial fracture, alcohol and/or drug abuse at the time of trauma, fracture site, Facial Injury Severity Scale score, associated injuries, day of the maxillofacial trauma, timing and type of treatment, and length of hospitalization. Read More

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The first winter of social distancing improved most of the health indexes in a paediatric emergency department.

Acta Paediatr 2022 May 4;111(5):1027-1033. Epub 2022 Feb 4.

Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy.

Aim: We compared visits to a tertiary level paediatric emergency department (PED) in Italy, during winter 2020-2021, when COVID-19 social distancing measures were in place, with winter 2019-2020.

Methods: This was a retrospective analysis of an electronic database. We obtained the number of visits and the ages, main complaints, triage codes, discharge diagnoses and outcomes of patients who accessed the PED from the 1 October 2020 to 28 February 2021. Read More

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Multi-modality imaging characteristics of costochondral fractures, a highly specific rib fracture for child abuse.

Pediatr Radiol 2022 05 22;52(5):910-923. Epub 2022 Jan 22.

Department of Radiology and Imaging Sciences, Riley Hospital for Children, 705 Riley Hospital Drive, Room 1053, Indianapolis, IN, 46202, USA.

Background: Rib fractures in young children are strongly associated with nonaccidental trauma (NAT). Costochondral junction (CCJ) fractures are unique with most being identified in the healing phase on radiographs. NAT-associated CCJ fractures, therefore, may be underdiagnosed. Read More

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Is bridging vein rupture/thrombosis associated with subdural hematoma at birth?

Pediatr Radiol 2022 05 6;52(5):932-940. Epub 2022 Jan 6.

Pediatric Radiology Department, AP-HP, Bicêtre Hospital, 94270, Le Kremlin Bicêtre, France.

Background: The combination of bridging vein rupture/thrombosis and subdural hematoma in infants has recently gained attention as highly suggestive of abusive head trauma. While subdural hematomas are frequently observed at birth, there are no previous studies of bridging vein rupture/thrombosis prevalence in that context.

Objective: To evaluate the prevalence of bridging vein rupture/thrombosis in newborns with and without subdural hematoma. Read More

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Value of additional lateral radiographs in paediatric skeletal surveys for suspected physical abuse.

Clin Radiol 2022 01 3;77(1):e40-e47. Epub 2021 Nov 3.

Great Ormond Street Hospital for Children NHS Foundation Trust, London, WC1N 3JH, UK; UCL Great Ormond Street Institute of Child Health, London, UK; NIHR Great Ormond Street Hospital Biomedical Research Centre, UK.

Aim: To determine the added value of lateral limb radiographs in suspected physical abuse (SPA), particularly with regard to fracture detection and reporter confidence.

Methods And Materials: A 3-year (October 2017 to November 2020) retrospective study was conducted. Two blinded paediatric radiologists independently reviewed the appendicular radiographs for the presence of fractures, first by reviewing just the frontal projections, then both frontal and lateral radiographs. Read More

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January 2022

Period of Purple Crying Program for the Prevention of Abusive Head Trauma/Shaken Baby Syndrome.

E Power F Sharif

Ir Med J 2021 Aug 19;114(7):415. Epub 2021 Aug 19.

Department of Paediatrics, Mullingar Regional Hospital, Westmeath.

The Period of PURPLE Crying Program is an educational program delivered to parents of newborn children that aims to reduce the incidence of abusive head trauma/shaken baby syndrome1. The program was developed by a research-based, non-profit organisation and has already been implemented in many countries around the world. It educates parents on what to expect during the first few months of their newborn infant's life, allowing parents to become more informed and better prepared to care for their child. Read More

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A systematic review of clinical and laboratory findings of lead poisoning: lessons from case reports.

Toxicol Appl Pharmacol 2021 10 18;429:115681. Epub 2021 Aug 18.

Medical Toxicology and Drug Abuse Research Center (MTDRC), Birjand University of Medical Sciences (BUMS), Birjand, Iran; Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA. Electronic address:

Lead is one of the most toxic heavy metals in the environment. The present review aimed to highlight hazardous pollution sources, management, and review symptoms of lead poisonings in various parts of the world. The present study summarized the information available from case reports and case series studies from 2009 to March 2020 on the lead pollution sources and clinical symptoms. Read More

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October 2021

Child abuse in children living with special guardians, a service evaluation of child protection medical examinations.

BMJ Paediatr Open 2021 2;5(1):e001103. Epub 2021 Jul 2.

College of Medicine and Dentistry, University of Birmingham, Edgbaston, UK.

Objective: To determine difference in frequency of referral for child protection medical examination (CPME) in children subject to special guardianship order (SGO), subject to child protection plan (CPP) or neither.

Design: Service evaluation analysing data from CPME reports.

Setting: Acute and community healthcare providers in Birmingham UK, during 2018. Read More

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February 2022

Increase in Mental Health Diagnoses Among Youth With Nonfatal Firearm Injuries.

Acad Pediatr 2021 Sep-Oct;21(7):1203-1208. Epub 2021 Jun 10.

Department of Pediatrics, College of Medicine, Medical University of South Carolina (AL Andrews), Charleston, SC.

Background And Objectives: Firearm injury is a leading cause of mortality for US youth. For every youth who dies from a firearm injury, at least 4 more survive. Little is known about the mental health consequences of non-fatal firearm injury in youth. Read More

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September 2021

Preventing abusive head trauma: can educating parents reduce the incidence?

Pediatr Radiol 2021 May 17;51(6):1093-1096. Epub 2021 May 17.

Public Health Sciences, Penn State College of Medicine,, Penn State Health Hershey Medical Center, Hershey, PA, USA.

Abusive head trauma (AHT) is the most lethal form of child abuse; preventing AHT should be a national priority, but research into this area is woefully underfunded. Prevention programs have primarily focused on universal parent education during the neonatal period, a time when parents are a captive audience of the health care establishment whose focus is on the needs of their newborn infant, and who will soon be exposed to the frustration and anger of infant crying. Research has suggested a strong causal link between infant crying and AHT, and parents - particularly fathers and father figures - have been identified as the most common perpetrators of AHT. Read More

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Why Programs for Managing Colicky Crying Fail to Prevent Abusive Head Trauma and Suggestions for Improvement.

JAMA Pediatr 2021 07;175(7):671-672

Department of Community Medicine and Rehabilitation, Division of Forensic Medicine, Umeå University, Umeå, Sweden.

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Validation of a Clinical Decision Rule to Predict Abuse in Young Children Based on Bruising Characteristics.

JAMA Netw Open 2021 04 1;4(4):e215832. Epub 2021 Apr 1.

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

Importance: Bruising caused by physical abuse is the most common antecedent injury to be overlooked or misdiagnosed as nonabusive before an abuse-related fatality or near-fatality in a young child. Bruising occurs from both nonabuse and abuse, but differences identified by a clinical decision rule may allow improved and earlier recognition of the abused child.

Objective: To refine and validate a previously derived bruising clinical decision rule (BCDR), the TEN-4 (bruising to torso, ear, or neck or any bruising on an infant <4. Read More

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An Evaluation of Pediatric Secondary Overtriage in the Pennsylvania Trauma System.

J Surg Res 2021 08 10;264:368-374. Epub 2021 Apr 10.

Trauma and Acute Care Surgery, Penn Medicine Lancaster General Health, Lancaster, Pennsylvania.

Background: We sought to determine the secondary overtriage rate of pediatric trauma patients admitted to pediatric trauma centers. We hypothesized that pediatric secondary overtriage (POT) would constitute a large percentage of admissions to PTC.

Materials And Methods: The Pennsylvania Trauma Outcome Study database was retrospectively queried from 2003 to 2017 for pediatric (age ≤ 18 y) trauma patients transferred to accredited pediatric trauma centers in Pennsylvania (n = 6). Read More

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Evaluation of an Emergency Department High-risk Bruising Screening Protocol.

Pediatrics 2021 04 2;147(4). Epub 2021 Mar 2.

Seattle Children's Hospital and.

Objectives: The objective of this study was to describe the outcomes of implementing a high-risk bruise screening pathway in a pediatric emergency department (ED).

Methods: A retrospective observational study was performed of children aged 0 to <48 months who presented to the ED between December 1, 2016, and April 1, 2019, and had bruising that is high-risk for physical abuse on a nurse screening examination. A high-risk bruise was defined as any bruise if aged <6 months or a bruise to the torso, ears, or neck if aged 6 to <48 months. Read More

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Rib fractures in infancy, case-series and register case-control study from Sweden.

J Pediatr Endocrinol Metab 2021 Mar 25;34(3):363-372. Epub 2021 Feb 25.

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

Objectives: To assess cases with rib fractures in infants under observation for or with an abuse diagnosis, and to compare risk factors with that in infants with fractures but no abuse diagnosis.

Methods: Design was case-series and register case-control of infants (aged <1 year) with rib fractures. Data was clinical records for the case-series (n = 26) and from national health registers for the case-controls (n = 28 and n = 31). Read More

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Accidental injury, self-injury, and assault among children of women with schizophrenia: a population-based cohort study.

Acta Psychiatr Scand 2021 05 11;143(5):406-417. Epub 2021 Feb 11.

Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada.

Objective: We aimed to compare the risk for injury overall and by intent (accidental injury, self-injury, and assault) among children born to women with versus without schizophrenia.

Methods: Using health administrative data from Ontario, Canada, children born from 2003 to 2017 to mothers with (n = 3769) and without (n = 1,830,054) schizophrenia diagnosed prior to their birth were compared on their risk for child injury, captured via emergency department, hospitalization, and vital statistics databases up to age 15 years. Cox proportional hazard models generated hazard ratios for time to first injury event (overall and by intent), adjusted for potential confounders (aHR). Read More

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Child physical abuse trauma evaluation and management: A Western Trauma Association and Pediatric Trauma Society critical decisions algorithm.

J Trauma Acute Care Surg 2021 04;90(4):641-651

From the Division of General and Thoracic Surgery, Cincinnati Children's Hospital Medical Center (N.G.R., R.A.F.), Cincinnati, Ohio; Department of Surgery, Mary Bridge Children's Hospital (M.A.E.), Tacoma, Washington; Division of Acute Care Surgery, Dell Medical School (C.V.B.), Austin, Texas; Department of Surgery, University of Colorado School of Medicine (E.E.M.), Denver, Colorado; Division of Trauma, MedStar Hospital Center (J.A.S.), Washington, DC; Department of Surgery, Scripps Mercy (K.P.), San Diego, California; Acute Care Surgery Division, Morsani College of Medicine (D.J.C.), Tampa, Florida; Division of Trauma Surgery, University of Pittsburgh (J.L.S.), Pittsburgh, Pennsylvania; Department of Surgery, Inova Trauma Center (A.G.R.), Falls Church, Virginia; Cedars-Sinai Medical Center (E.J.L.), Los Angeles, California; Division of Trauma, Critical Care, and Acute Care Surgery, Oregon Health/Science University (K.J.B.), Portland, Oregon; Department of Surgery, University of Maryland School of Medicine (R.K.), Baltimore, Maryland; Division of Trauma, Emergency Surgery, and Surgical Critical Care, Keck School of Medicine (K.I.), Los Angeles, California; Department of Pediatrics, Albert Einstein College of Medicine (J.L.H.-R.), Bronx, New York; Division of Pediatric Surgery, Phoenix Children's Hospital (D.M.N., L.W.S., T.N.), Phoenix, Arizona; Department of Surgery, Nemours Children's Specialty Care (R.W.L.), Jacksonville, Florida; Departments of Surgery, UT Health San Antonio and Baylor College of Medicine (I.C.M.), San Antonio, Texas; and the Department of Surgery, Scripps Mercy Hospital (M.J.M.), San Diego, California.

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Evaluation of Pediatric Forensic Cases Admitted to the Emergency Department in Turkey: A Retrospective Analysis.

J Forensic Nurs 2021 Jan-Mar 01;17(1):E1-E8

Ordu University Health Science Faculty, Department of Pediatric Nursing, Ordu, Turkey.

Aim: The aim of this study was to determine retrospectively the demographic characteristics of forensic cases aged 0-18 years who were admitted to the emergency department.

Method: A total of 14,352 pediatric forensic cases aged 0-18 years, who were admitted to the emergency department of a hospital, were analyzed retrospectively in terms of the date of presentation, age, gender, and type of case.

Results: Among the pediatric cases presenting to the emergency department, 56% were due to falling, 19% were due to burns, 8. Read More

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Musculoskeletal Manifestations of Child Abuse: Analysis at a Level 2 Trauma Center in Puerto Rico.

P R Health Sci J 2020 12;39(4):283-287

Department of Orthopaedic Surgery, School of Medicine, University of Puerto Rico Medical Sciences Campus, San Juan, PR.

Objective: To describe the epidemiological manifestations and assess major risk factors in children under the age of three years presenting with non-accidental injury (NAI) fractures in a level two trauma center in Puerto Rico.

Methods: An IRB approved retrospective descriptive study was performed by reviewing case records of 75 patients who presented with a NAI fracture at the Pediatric University Hospital of the Puerto Rico Medical Center. The study time period was from October 1996 to October 2014. Read More

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December 2020

The epidemiology of infant shaft fractures of femur or humerus by incidence, birth, accidents, and other causes.

BMC Musculoskelet Disord 2020 Dec 11;21(1):840. Epub 2020 Dec 11.

Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.

Background: The purpose of this population-based registry study was to analyze both birth-related femur and humerus shaft fractures and diagnosed later in infancy, as regards incidence, perinatal characteristics, other diagnoses, and reported accidents.

Methods: Children born in 1997-2014, diagnosed with a femur or humerus shaft fracture before age 1 year, were identified in the Swedish Health Registries. Rate of birth fractures were estimated by combining femur and humerus shaft fractures coded as birth-related with femur and humerus shaft fractures diagnosed during day 1-7 without registered trauma or abuse. Read More

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December 2020

Epidemiologic Trends in Fatal and Nonfatal Firearm Injuries in the US, 2009-2017.

JAMA Intern Med 2021 02;181(2):237-244

Department of Biostatistics and Epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia.

Importance: Firearm injury research in the US has focused on fatal injuries. The incidence and epidemiologic factors associated with nonfatal firearm injuries are less understood.

Objective: To evaluate estimates of incidence and trends over time of fatal and nonfatal firearm injuries. Read More

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February 2021

Can we increase detection? A nationwide analysis of age-related fractures in child abuse.

J Pediatr Surg 2021 Jan 13;56(1):153-158. Epub 2020 Oct 13.

Division of Pediatric Surgery, Dewitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine; Leonard M. Miller School of Medicine, University of Miami, 1120 NW 14(th) Street, Suite 450K, Miami, FL 33136.. Electronic address:

Purpose: The purpose of this study was to stratify fractures associated with child abuse in relation to the child's age.

Methods: The Kids' Inpatient Database (1997-2012) was queried for all patients (<18 years old) with a diagnosis of fracture and child abuse. The primary outcome was age-related determinants of fracture distribution. Read More

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January 2021

Medical findings and symptoms in infants exposed to witnessed or admitted abusive shaking: A nationwide registry study.

PLoS One 2020 13;15(10):e0240182. Epub 2020 Oct 13.

Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.

Background: Many physicians regard the combination of encephalopathy, subdural haemorrhage (SDH), retinal haemorrhage (RH), rib fractures, and classical metaphyseal lesions (CML) as highly specific for abusive head trauma (AHT). However, without observed abuse or other criteria that are independent of these findings, bias risk is high.

Methods: Infants subjected for examination under the suspicion of maltreatment during the period 1997-2014 were identified in the National Patient Registry, International Classification of Diseases (ICD-10 SE). Read More

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December 2020

Abusive head trauma in court: a multi-center study on criminal proceedings in Germany.

Int J Legal Med 2021 Jan 8;135(1):235-244. Epub 2020 Oct 8.

Institute of Legal Medicine, Jena University Hospital, Friedrich Schiller University, Am Klinikum 1, 07747, Jena, Germany.

The shaken baby syndrome (SBS) is a common variant of abusive head trauma (AHT) in infants and toddlers. Data on the legal outcome of such cases are still sparse. By means of a retrospective multi-center analysis, 72 cases of living children diagnosed with SBS/AHT from three German university institutes of legal medicine were identified. Read More

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January 2021

Pearls and Pitfalls in Imaging of Abusive Head Trauma.

Einat Blumfield

Semin Ultrasound CT MR 2020 Oct 28;41(5):411-420. Epub 2020 May 28.

Department of Radiology, Children's Hospital of Montefiore, Albert Einstein College of Medicine, Bronx, NY. Electronic address:

Abusive head trauma (AHT) is the leading cause of fatal head injuries in infants. The mechanism of injury usually involves vigorous shaking of the infant, impact, or a combination of the 2. There are characteristic imaging findings of which the most common are subdural hemorrhages. Read More

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October 2020