Background: Identifying non-accidental trauma (NAT) in pediatric trauma patients is challenging. We developed a machine learning model that uses demographic characteristics and ICD10 codes to detect the first diagnosis of NAT.
Methods: We analyzed data from the Maryland Health Services Cost Review Commission (2015-2020) for patients aged 0-19 years.
Introduction: Indications for extracorporeal membrane oxygenation (ECMO) in pediatric trauma continue to evolve. This study evaluates trends and practices in ECMO use for injured children and identifies factors associated with mortality using the National Trauma Data Bank (NTDB).
Methods: We conducted a retrospective review of children ≤18 years who underwent ECMO therapy following trauma, recorded in the NTDB from 2007 to 2018.
New drugs for the treatment of protozoal parasite infections such as toxoplasmosis and leishmaniasis are required. Cinnamaldehyde and its derivatives appear to be promising antiparasitic drug candidates. Acyl hydrazones of cinnamaldehyde, 4-dimethylaminocinnamaldehyde, and of the synthetic fragrances silvial and florhydral were prepared and tested for activity against () and () parasites.
View Article and Find Full Text PDFIntroduction: Pediatric firearm injuries are a significant public health concern in the United States. This study examines risk factors for firearm reinjury in Maryland's pediatric population.
Methods: Pediatric patients (age 0-19 y) who presented to any hospital in Maryland with a firearm injury between October 1, 2015, and December 31, 2019, were identified in the Maryland Health Services Cost Review Commission database and were followed for repeat firearm injuries through March 31, 2020.
During the recent COVID-19 pandemic, governments implemented mobile applications for contact tracing as a rapid and effective solution to mitigate the spread of the virus. However, these seemingly straightforward solutions did not achieve their intended objectives. In line with previous research, this paper aims to investigate the factors that influence the acceptance and usage of contact-tracing mobile apps (CTMAs) in the context of disease control.
View Article and Find Full Text PDFObjective: Screening, brief intervention, and referral to treatment (SBIRT) for adolescent alcohol and drug (AOD) use is recommended to occur with adolescents admitted to pediatric trauma centers. Most metrics on SBIRT service delivery only reference medical record documentation. In this analysis we examined changes in adolescents' perception of SBIRT services and concordance of adolescent-report and medical record data, among a sample of adolescents admitted before and after institutional SBIRT implementation.
View Article and Find Full Text PDFIntroduction: Paediatric drowning is an injury associated with significant morbidity and mortality.
Objective: The objective is to describe drowning trends, including associations with inpatient hospitalisation or fatality, in a state-wide paediatric cohort to inform prevention strategies.
Methods: In this retrospective cohort study using the Health Services Cost Review Commission database, we used International Classification of Diseases, Tenth Revision (ICD-10) codes to identify patients aged 0-19 years with an outpatient (including emergency department) or inpatient medical encounter following a non-fatal or fatal drowning event between 2016 and 2019.
Background: Pediatric trauma centers have had challenges meeting the American College of Surgeons criteria for screening and intervening for alcohol with adolescent trauma patients. The study objective was to conduct an implementation trial to evaluate the effectiveness of the Science to Service Laboratory (SSL) implementation strategy in improving alcohol and other drugs (AOD) screening, brief intervention, and referral to treatment (SBIRT) delivery at pediatric trauma centers.
Methods: Using a stepped wedge cross-over cluster randomized design, 10 US pediatric trauma centers received the SSL implementation strategy to deliver SBIRT with admitted adolescent (12-17 years old) trauma patients.
Firearm injuries are a common and major public health problem in Baltimore, Maryland. The city is also one of the first U.S.
View Article and Find Full Text PDFObjective: The PEDSPINE I and PEDSPINE II scores were developed to determine when patients require advanced imaging to rule out cervical spine injury (CSI) in children younger than 3 years of age with blunt trauma. This study aimed to evaluate these scores in an institutional cohort.
Methods: The authors identified patients younger than 3 years with blunt trauma who received cervical spine MRI from their institution's prospective database from 2012 to 2015.
Background: National estimates suggest pediatric trauma recidivism is uncommon but are limited by short follow up and narrow ascertainment. We aimed to quantify the long-term frequency of trauma recidivism in a statewide pediatric population and identify risk factors for re-injury.
Methods: The Maryland Health Services Cost Review Commission Dataset was queried for 0-19-year-old patients with emergency department or inpatient encounters for traumatic injuries between 2013 and 2019.
Introduction: Violent traumatic injury, including firearm violence, can adversely impact individual and community health. Trauma-informed care (TIC) can promote resilience and prevent future violence in patients who have experienced trauma. However, few protocols exist to facilitate implementation of TIC for patients who survive traumatic injury.
View Article and Find Full Text PDFBackground: The exstrophy-epispadias complex is a spectrum of ventral wall malformations including classic bladder exstrophy and cloacal exstrophy (CE). Patients undergo multiple soft-tissue procedures to achieve urinary continence. If unsuccessful bladder neck closure (BNC) is performed, muscle flaps may be used to reinforce BNC or afterward for fistula reconstruction.
View Article and Find Full Text PDFBackground: Chronic spontaneous urticaria (CSU) is unpredictable and can severely impair patients' quality of life. Patients with CSU need a convenient, user-friendly platform to complete patient-reported outcome measures (PROMs) on their mobile devices. CRUSE , the Chronic Urticaria Self Evaluation app, aims to address this unmet need.
View Article and Find Full Text PDFObjective: To assess the utility of 18F-PSMA-1007 PET/MRI in initial staging of intermediate- to high-risk prostate cancer (HRPCa).
Methods: A total of 46 patients with pathologically verified intermediate and/or HRPCa who underwent 18F-PSMA-1007 PET/MRI with dedicated pelvic high-resolution multiparametric MRI (mpMRI) were included.
Results: PET/MRI showed 100% sensitivity (SN), specificity (SP), positive predictive value (PPV), negative predictive value (NPV), and accuracy in detecting seminal vesicle (SV) and rectal invasion, versus 87.
Background: Traumatic brain injury (TBI) leads to acute gastrointestinal dysfunction and mucosal damage, resulting in feeding intolerance. C-C motif chemokine receptor 2 (Ccr2 + ) monocytes are crucial immune cells that regulate the gut's inflammatory response via the brain-gut axis. Using Ccr2 ko mice, we investigated the intricate interplay between these cells to better elucidate the role of systemic inflammation after TBI.
View Article and Find Full Text PDFIntroduction: While intravenous fluid therapy is essential to re-establishing volume status in children who have experienced trauma, aggressive resuscitation can lead to various complications. There remains a lack of consensus on whether pediatric trauma patients will benefit from a liberal or restrictive crystalloid resuscitation approach and how to optimally identify and transition between fluid phases.
Methods: A panel was comprised of physicians with expertise in pediatric trauma, critical care, and emergency medicine.
Background: Expert consensus recommends prescription opioid safety counseling be provided when prescribing an opioid. This may be especially important for youth with preexistent alcohol and other drug (AOD) use who are at higher risk of developing opioid use disorder. This study examined the frequency that adolescent trauma patients prescribed opioids at hospital discharge received counseling and if this differed by adolescents' AOD use.
View Article and Find Full Text PDFObjective: To determine prognostic value of bone marrow retention index (RI-bm) and bone marrow-to-liver ratio (BLR) measured on baseline dual-phase F-FDG PET/CT in a series of newly diagnosed patients with diffuse large B-cell lymphoma (DLBCL) treated homogeneously with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) chemotherapy.
Patients And Methods: This prospective study enrolled 135 patients with newly diagnosed DLBCL. All patients underwent dual-phase F-FDG PET/CT.
Purpose: Staged pelvic osteotomy has been shown in the past to be an effective tool in the closure of the extreme pubic diastasis of cloacal exstrophy. The authors sought to compare orthopedic complications between non-staged pelvic osteotomies and staged pelvic osteotomies in cloacal exstrophy.
Methods: A prospectively maintained exstrophy-epispadias complex database of 1510 patients was reviewed for cloacal exstrophy bladder closure events performed with osteotomy at the authors' institution.
Background: Concern about disease exacerbations and fear of reactions after coronavirus disease 2019 (COVID-19) vaccinations are common in chronic urticaria (CU) patients and may lead to vaccine hesitancy.
Objective: We assessed the frequency and risk factors of CU exacerbation and adverse reactions in CU patients after COVID-19 vaccination.
Methods: COVAC-CU is an international multicenter study of Urticaria Centers of Reference and Excellence (UCAREs) that retrospectively evaluated the effects of COVID-19 vaccination in CU patients aged ≥18 years and vaccinated with ≥1 dose of any COVID-19 vaccine.