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head trauma child abuse

Preethi Murali, Manoj Prabhakar
Child sexual abuse (CSA) is defined as inappropriate adolescent or adult sexual behavior or contact with a child. Sexual abuse may be committed by any person including those under the age of 18 years when that person is either significantly older than the victim or is in a position of power or control over the child. Detecting CSA requires a high incidence of suspicion and familiarity with physical, behavioral, and verbal indications of abuse. Shame and guilt often may have discussion difficult. Studies have shown that approximately 60% of abused children have injuries to head, face, and mouth...
May 2018: Journal of Forensic Dental Sciences
Emily A Eismann, Eve S Pearl, Jack Theuerling, Alonzo T Folger, John S Hutton, Kathi Makoroff
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...
January 15, 2019: Child Abuse & Neglect
Darshini Ayton, Elizabeth Pritchard, Tess Tsindos
Brain injury is often a precursor to, or result of, family violence. Yet there is little research identifying the connection of these two phenomena. The health cost (personal or societal) of brain injury within the family violence context is difficult to ascertain. Family violence can lead to lifelong psychological or physical scars and even death. A systematic review was conducted over three databases using Medical Subject Heading terms to investigate incidence, prevalence, and contributing factors of brain injury within a family violence context...
January 16, 2019: Trauma, Violence & Abuse
En-Pei Lee, Jainn-Jim Lin, Shao-Hsuan Hsia, Oi-Wa Chan, Han-Ping Wu
BACKGROUND: Pneumatosis intestinalis and portomesenteric venous gas are usually caused by necrotizing enterocolitis; however they can occur secondary to abusive abdominal trauma with bone fractures and bruising. It is difficult to recognize initially if there is no bruising on the skin or bone fractures. CASE PRESENTATION: We report a 1-year-old child with no obvious history of trauma who presented with conscious disturbance. Abdominal computed tomography showed acute ischemic bowel complicated with pneumatosis intestinalis and portomesenteric venous gas...
January 15, 2019: BMC Pediatrics
Angell Shi, Abhaya Kulkarni, Kenneth W Feldman, Avery Weiss, Emily A McCourt, Susan Schloff, Michael Partington, Brian Forbes, Brooke E Geddie, Karin Bierbrauer, Paul H Phillips, David L Rogers, Waleed Abed Alnabi, Gil Binenbaum, Alex V Levin
OBJECTIVES: Increased intracranial pressure (ICP) has been suggested in legal settings as an alternative cause of retinal hemorrhages (RHs) in young children who may have sustained abusive head trauma. We assessed the prevalence and characteristics of RHs in children with increased ICP. METHODS: We conducted a prospective, multicenter study of children <4 years old with newly diagnosed increased ICP as determined by using direct measurement and/or clinical criteria...
January 10, 2019: Pediatrics
Caroline L S George, Samuel S N Theesfeld, Qi Wang, Mark J Hudson, Nancy S Harper
OBJECTIVES: Accurately differentiating inflicted from accidental injury in infants and toddlers is critical. Many studies have documented characteristics of inflicted bruises, fractures, and head injuries facilitating the development of clinical tools. There are few studies characterizing inflicted oral injuries, and no clinical tools exist. This study identified characteristics that differentiated inflicted from accidental oral injuries in children younger than 24 months. METHODS: Retrospective review using International Classification of Diseases, Ninth Revision billing codes and an internal clinical database tool identified children younger than 24 months between 2004 and 2014...
December 28, 2018: Pediatric Emergency Care
Kent P Hymel, Ming Wang, Vernon M Chinchilli, Wouter A Karst, Douglas F Willson, Mark S Dias, Bruce E Herman, Christopher L Carroll, Suzanne B Haney, Reena Isaac
BACKGROUND: Evidence-based, patient-specific estimates of abusive head trauma probability can inform physicians' decisions to evaluate, confirm, exclude, and/or report suspected child abuse. OBJECTIVE: To derive a clinical prediction rule for pediatric abusive head trauma that incorporates the (positive or negative) predictive contributions of patients' completed skeletal surveys and retinal exams. PARTICIPANTS AND SETTING: 500 acutely head-injured children under three years of age hospitalized for intensive care at one of 18 sites between 2010 and 2013...
December 11, 2018: Child Abuse & Neglect
Samantha Jones, Sarah Tyson, Michael Young, Matthew Gittins, Naomi Davis
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. RESULTS: Data regarding 9851 children were collected...
November 23, 2018: Archives of Disease in Childhood
Erika Moors Cornell, Elizabeth C Powell
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)...
October 30, 2018: Journal of Emergency Medicine
Laura E Cowley, Daniel M Farewell, Alison M Kemp
BACKGROUND: The validated Predicting Abusive Head Trauma (PredAHT) tool estimates the probability of abusive head trauma (AHT) in children <3 years old with intracranial injury. OBJECTIVE: To explore the impact of PredAHT on clinicians' AHT probability estimates and child protection (CP) actions, and assess inter-rater agreement between their estimates and between their CP actions, before and after PredAHT. PARTICIPANTS AND SETTING: Twenty-nine clinicians from different specialties, at teaching and community hospitals...
October 9, 2018: Child Abuse & Neglect
Marzieh Hajiaghamemar, Ingrid S Lan, Cindy W Christian, Brittany Coats, Susan S Margulies
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. To achieve these objectives, we utilized an integrated approach consisting of case evaluation, anthropomorphic reconstruction, and finite element simulation...
September 7, 2018: International Journal of Legal Medicine
Abigail Kleinschmidt
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. Premobile infants rarely have bruising or intraoral injuries without a reported accident or underlying systemic disease and should raise concern for abuse...
September 3, 2018: Journal of Pediatric Health Care
Anne Laurent-Vannier, Catherine Adamsbaum, Jean-Sébastien Raul, Caroline Rey-Salmon, Caroline Rambaud
No abstract text is available yet for this article.
December 2018: Acta Paediatrica
Linda A Morgan, Samiksha Fouzdar Jain, Austin Svec, Claire Svec, Suzanne B Haney, Sandra Allbery, Robin High, Donny W Suh
Purpose: Child abuse is a leading cause of death in infants, which is often associated with abusive head trauma (AHT). The purpose of this retrospective analysis was to identify ocular and systemic findings in confirmed cases of AHT and compare them to a group of non-abusive head trauma (NAHT) patients. Patients and methods: A retrospective chart review of 165 patients with accidental and non-accidental trauma admitted between 2013 and 2015 to Children's Hospital and Medical Center in Omaha, NE, USA, was performed...
2018: Clinical Ophthalmology
Waleed Abed Alnabi, Garland J Tang, Ralph C Eagle, Sam Gulino, Avrey Thau, Alex V Levin
PURPOSE: To demonstrate vitreoretinal traction as a mechanism for perimacular folds in abusive head trauma. METHODS: We performed gross and histopathologic examination of eyes of children with suspected abusive head trauma and identified those with typical perimacular folds. Information was collected regarding the incident that led to the child's death and systemic manifestations noted at autopsy. Eyes were prepared in a fashion that allowed for demonstration of the vitreoretinal interface...
July 25, 2018: Retina
Cindy W Christian, Alex V Levin
Child abuse can cause injury to any part of the eye. The most common manifestations are retinal hemorrhages (RHs) in infants and young children with abusive head trauma (AHT). Although RHs are an important indicator of possible AHT, they are also found in other conditions. Distinguishing the number, type, location, and pattern of RHs is important in evaluating a differential diagnosis. Eye trauma can be seen in cases of physical abuse or AHT and may prompt referral for ophthalmologic assessment. Physicians have a responsibility to consider abuse in the differential diagnosis of pediatric eye trauma...
August 2018: Pediatrics
Laura E Cowley, Sabine Maguire, Daniel M Farewell, Harriet D Quinn-Scoggins, Matthew O Flynn, Alison M Kemp
Clinicians face unique challenges when assessing suspected child abuse cases. The majority of the literature exploring diagnostic decision-making in this field is anecdotal or survey-based and there is a lack of studies exploring decision-making around suspected abusive head trauma (AHT). We aimed to determine factors influencing decision-making and multidisciplinary collaboration in suspected AHT cases, amongst 56 child protection professionals. Semi-structured interviews were conducted with clinicians (25), child protection social workers (10), legal practitioners (9, including 4 judges), police officers (8), and pathologists (4), purposively sampled across southwest United Kingdom...
August 2018: Child Abuse & Neglect
Kirsten Bechtel, Ambika Bhatnagar, Marc Auerbach
Simulation is a technique that creates a situation or environment to allow persons to experience a representation of a real event for the purpose of practice, learning, evaluation, testing, or to gain understanding of systems or human actions. We will first provide an introduction to simulation in healthcare and describe the two types of simulation-based research (SBR) in the pediatric population. We will then provide an overview of the use of SBR to improve health outcomes for infants in health care settings and to improve parent-child interactions using the infant simulator...
June 11, 2018: Infant Behavior & Development
Fiona Danaher, Andrea Vandeven, Aine Blanchard, Alice W Newton
PURPOSE OF REVIEW: Despite an increasing understanding of the impact of emotional trauma and physical abuse on children, clinicians and hospitals still sometimes miss the diagnosis of abuse. The literature in 2017 focused on creating standardized approaches to recognition and diagnosis of physical abuse and occult injury, including using the electronic medical record to provide triggers for consultation of the hospital Child Protection Program. The American College of Radiology updated their standardized approach to the evaluation of physical abuse in the child, and other authors gave us screening tools for commercial exploitation, as well as guidance about how to recognize risks for emotional abuse in families...
August 2018: Current Opinion in Pediatrics
Laura E Cowley, Sabine Maguire, Daniel M Farewell, Harriet D Quinn-Scoggins, Matthew O Flynn, Alison M Kemp
The validated Predicting Abusive Head Trauma (PredAHT) tool estimates the probability of abusive head trauma (AHT) based on combinations of six clinical features: head/neck bruising; apnea; seizures; rib/long-bone fractures; retinal hemorrhages. We aimed to determine the acceptability of PredAHT to child protection professionals. We conducted qualitative semi-structured interviews with 56 participants: clinicians (25), child protection social workers (10), legal practitioners (9, including 4 judges), police officers (8), and pathologists (4), purposively sampled across southwest United Kingdom...
July 2018: Child Abuse & Neglect
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