1,139 results match your criteria Neonatal Injuries in Child Abuse


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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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

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

Things must not fall apart: the ripple effects of the COVID-19 pandemic on children in sub-Saharan Africa.

Pediatr Res 2021 04 24;89(5):1078-1086. Epub 2020 Sep 24.

International Research Center of Excellence, Institute of Human Virology Nigeria, Plot 252 Herbert Macaulay Way, Abuja, Nigeria.

Zero to 19 year-old children in sub-Saharan Africa bear a disproportionate proportion of the global burden of communicable and non-communicable diseases. Significant public health gains have been made in the fight against these diseases, however, factors such as underequipped health systems, disease outbreaks, conflict, and political instability continue to challenge prevention and control. The novel coronavirus disease (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) introduces new challenges to public health programs in sub-Saharan Africa. Read More

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Child Protection Team Consultation for Injuries Potentially Due to Child Abuse in Community Emergency Departments.

Acad Emerg Med 2021 01 9;28(1):70-81. Epub 2020 Oct 9.

From the, Department of Pediatrics, Yale University School of Medicine, New Haven, CT, USA.

Objectives: Emergency care for children is provided predominantly in community emergency departments (CEDs), where abusive injuries frequently go unrecognized. Increasing access to regional child abuse experts may improve detection of abuse in CEDs. In three CEDs, we intervened to increase involvement of a regional hospital child protection team (CPT) for injuries associated with abuse in children < 12 months old. Read More

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January 2021

Identifying Abuse and Neglect in Hospitalized Children With Burn Injuries.

J Surg Res 2021 01 27;257:232-238. Epub 2020 Aug 27.

Dewitt Daughtry Family Department of Surgery, University of Miami, Miller School of Medicine, Miami, Florida. Electronic address:

Background: The purpose of this study was to identify the pattern of injuries that relates to abuse and neglect in children with burn injuries.

Methods: The Nationwide Readmissions Database for 2010-2014 was queried for all patients aged less than 18 y admitted with burn injuries. The primary outcome was child maltreatment identified at the index admission. Read More

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January 2021

Femoral shaft fracture following oil massage in neonates: a single-centre experience.

Trop Doct 2020 Oct 14;50(4):387-389. Epub 2020 Jul 14.

Associate Professor, Department of Pediatrics, Uttar Pradesh University of Medical Sciences, Saifai, Uttar Pradesh, India.

Femoral shaft fractures following oil massage in newborns are very rare. We describe our observations at a tertiary centre in northern India. Three such cases encountered during the study period from July 2014 to June 2019 were evaluated. Read More

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October 2020

Asphyxia Homicides in Finland, 1983-2012.

J Forensic Sci 2020 Sep 30;65(5):1548-1556. Epub 2020 Jun 30.

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

Finland has one of the highest homicide rates in Western Europe, and almost every tenth homicide is caused by asphyxiation. Reliable statistics, a strict legislation, and an exceptionally high medico-legal autopsy rate formed a base for a nationwide analysis of asphyxia homicides (n = 383) during 30 years. The cases were identified through multiple records, and all the forensic pathology case files were studied in detail. Read More

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September 2020

Prevalence and distribution of occult fractures on skeletal surveys in children with suspected non-accidental trauma imaged or reviewed in a tertiary Dutch hospital.

Pediatr Surg Int 2020 Sep 26;36(9):1009-1017. Epub 2020 Jun 26.

Amsterdam UMC, Department of Radiology and Nuclear Medicine, Emma Children's Hospital, University of Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, The Netherlands.

Purpose: The purpose of the study was to determine the rate of occult fractures (without clinical symptoms) per presenting clinical injury i.e., children presenting with a fracture, bruise, abusive head trauma and the types of fracture most likely to be found, in a series of infants and young children suspected of being victims of NAT. Read More

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September 2020

Which Mothers Know That All Babies Cry? A Randomized Controlled Trial of a Child Abuse Prevention Program for Low-Income New Mothers.

Clin Pediatr (Phila) 2020 09 20;59(9-10):865-873. Epub 2020 May 20.

Brown University, Providence, RI, USA.

This study evaluated an intervention for low-income new mothers, half from Spanish-speaking homes, that provides education around infant crying and abusive head trauma (AHT). At enrollment, non-US-born mothers were less likely than US-born mothers to have heard of shaken baby syndrome (60% vs 89%, ≤ .0001) or to know shaking babies could lead to brain damage or death (48% vs 80%, < . Read More

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September 2020

A Retrospective Records-Based Cohort of 1,082 Pediatric Forensic Cases Presenting to the Emergency Department.

J Emerg Nurs 2020 May;46(3):373-383

Introduction: This study was conducted to determine the pediatric forensic case type and demographic characteristics of patients presenting to the emergency department.

Methods: This study was a medical record-based cohort design, with a descriptive correlational analysis. Records were retrieved from the emergency department of a university hospital, in the Central Anatolia Region, for visits between 2013 and 2018. Read More

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Proximal femoral physeal fractures in children: a rare abusive injury.

Pediatr Radiol 2020 07 2;50(8):1115-1122. Epub 2020 May 2.

Child and Adolescent Protection Center, Children's National Hospital, Washington, DC, USA.

Background: Proximal femoral physeal fractures are rare in abused children. Recognition may be hampered due to their rarity and lack of an ossified femoral head. Prompt diagnosis and treatment are essential to preventing coxa vara. Read More

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Adherence to PECARN criteria in children transferred to a pediatric trauma center: An opportunity for improvement?

Am J Emerg Med 2020 07 18;38(7):1546.e1-1546.e4. Epub 2020 Apr 18.

St. Christopher's Hospital for Children, Department of Pediatric General, Thoracic, and Minimally Invasive Pediatric Surgery, 160 East Erie Avenue, Philadelphia, PA 19134, USA; Drexel University College of Medicine, 2900 West Queen Lane, Philadelphia, PA 19129, USA.

Background: The Pediatric Emergency Care Applied Research Network (PECARN) criteria identify children at low risk of clinically important traumatic brain injury (ciTBI) in whom CT head (CTH) is unnecessary. We assessed compliance with PECARN at outside hospitals (OSH) among children transferred to our pediatric trauma center.

Methods: Patients <18 years transferred between May 2016 and December 2018 undergoing CTH at an OSH were reviewed. Read More

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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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Differences in Facial Fracture Patterns in Pediatric Nonaccidental Trauma.

J Craniofac Surg 2020 Jun;31(4):956-959

Division of Plastic and Reconstructive Surgery.

Background: The purpose of this study was to characterize differences in facial fracture injury patterns among pediatric patients at highest risk of abusive head trauma/nonaccidental trauma (age ≤ 5 years).

Methods: Using the National Trauma Databank from 2007 to 2015, patients (age ≤ 5 years) suffering facial fractures were included. Demographics and injury characteristics were compared between those sustaining accidental versus nonaccidental trauma (NAT). Read More

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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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February 2020

Estimating the Relevance of Historical Red Flags in the Diagnosis of Abusive Head Trauma.

J Pediatr 2020 03 9;218:178-183.e2. Epub 2020 Jan 9.

Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA.

Objective: To replicate the previously published finding that the absence of a history of trauma in a child with obvious traumatic head injuries demonstrates high specificity and high positive predictive value (PPV) for abusive head trauma.

Study Design: This was a secondary analysis of a deidentified, cross-sectional dataset containing prospective data on 346 young children with acute head injury hospitalized for intensive care across 18 sites between 2010 and 2013, to estimate the diagnostic relevance of a caregiver's specific denial of any trauma, changing history of accidental trauma, or history of accidental trauma inconsistent with the child's gross motor skills. Cases were categorized as definite or not definite abusive head trauma based solely on patients' clinical and radiologic findings. Read More

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Characteristics of rib fractures in young abused children.

Pediatr Radiol 2020 05 10;50(5):726-733. Epub 2020 Jan 10.

Department of Radiology, Norton Children's Hospital, 231 Chestnut St., Louisville, KY, USA.

Background: The presumed mechanism of rib fractures in abuse is violent grasping of the torso causing anterior-posterior chest compression. We hypothesized an asymmetrical distribution of rib fractures in abused infants given the greater incidence of right-hand dominance within the general population.

Objective: The objective of this study was to characterize rib fractures in abused children, particularly sidedness; additionally, we evaluated the sidedness of other abusive skeletal fractures. Read More

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Avoiding skull radiographs in infants with suspected inflicted injury who also undergo head CT: "a no-brainer?"

Eur Radiol 2020 Mar 3;30(3):1480-1487. Epub 2019 Dec 3.

Academic Unit of Child Health, University of Sheffield, Damer Street Building, Sheffield Children's NHS Foundation Trust, Western Bank, Sheffield, S10 2TH, UK.

Objectives: To assess whether head CT with 3D reconstruction can replace skull radiographs (SXR) in the imaging investigation of suspected physical abuse (SPA)/abusive head trauma (AHT).

Methods: PACS was interrogated for antemortem skeletal surveys performed for SPA, patients younger than 2 years, SXR and CT performed within 4 days of each other. Paired SXR and CT were independently reviewed. Read More

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[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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February 2020

The German Evidence-Based Child Protection Guideline - Imaging in Suspected Child Abuse.

Rofo 2020 Apr 20;192(4):343-348. Epub 2019 Nov 20.

Patient Management, University of Bonn, Germany.

Aim:  Development of a fully evidence-based guideline including all aspects of child abuse.

Methods:  In a case-based procedure, 144 primary PICO questions were generated from 476 presented cases of child abuse. Literature research was performed in 5 databases (Pubmed, CINHAL, Embase, PsycInfo, Eric) and in the Cochrane Library. Read More

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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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February 2020

Ophthalmology referral as part of a multidisciplinary approach to suspected abusive head trauma.

Can J Ophthalmol 2020 04 14;55(2):172-178. Epub 2019 Sep 14.

Division of Ophthalmology, McMaster University Department of Surgery, McMaster Children's Hospital, Hamilton, Ont.

Objective: To determine the use of ophthalmology consultation as part of investigation of children with suspected abusive head trauma (AHT).

Methods: Retrospective chart review of children under age 3 years evaluated at McMaster Children's Hospital for suspected AHT from January 2011 to December 2017.

Results: Fifty-seven children were investigated, and 29 (50. Read More

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Non-accidental broom sticks injury as a cause of post-neonatal tetanus.

Pan Afr Med J 2019 13;34:143. Epub 2019 Nov 13.

Department of Paediatrics, University of Calabar Teaching Hospital, Calabar, Nigeria.

Introduction: Non accidental injury sustained following deliberate self-harm or inflicted by parents or caregivers for disciplinary, traditional and therapeutic measures have grave consequences including exposing the incompletely child to post neonatal tetanus. This contributes to the continuing high incidence of post neonatal tetanus in developing countries.

Methods: A 12 year retrospective review of all children admitted into the children's ward of the University of Calabar Teaching Hospital with diagnosis of post neonatal tetanus was carried out. Read More

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Health care utilization pattern prior to maltreatment among children under five years of age in Taiwan.

Child Abuse Negl 2019 12 9;98:104202. Epub 2019 Oct 9.

Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan. Electronic address:

Background: Several studies have hypothesized that the pattern of health care utilization among maltreated children differ from others without the experience. However, the conclusions have not been consistent.

Objective: The study aims to examine whether the pattern of health care utilization among children 0-5 years old with maltreatment different from their counterparts without maltreatment in Taiwan. Read More

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December 2019

Early Pediatric Fractures in a Universally Insured Population within the United States.

BMC Pediatr 2019 10 8;19(1):343. Epub 2019 Oct 8.

Department of Health Services Administration, Department of Preventive Medicine & Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, USA.

Background: Musculoskeletal injury, including fracture, is one of the most common causes of morbidity in pediatric patients. The purpose of this epidemiologic study is to determine the prevalence and risk factors for fracture in a large cohort of pediatric patients under the age of 5.

Results: Of the 233,869 patients included in the study, 13,698 fractures were identified in 10,889 patients. Read More

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October 2019

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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November 2019

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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October 2019