ABSTRACT
BACKGROUND: Skull fractures are commonly seen after both accidental and nonaccidental head injuries in young children. A history of recent trauma may be lacking in either an accidental or nonaccidental head injury event. Furthermore, skull fractures do not offer an indication of the stage of healing on radiologic studies because they do not heal with callus formation as seen with long bone fractures. Thus, a better understanding on the timing of skull fracture resolution may provide guidance on the medical evaluation for accidental or nonaccidental head injury. OBJECTIVE: The aim of the study was to determine the time required for radiographic skull fracture resolution in children younger than 24 months. METHODS: This was a retrospective observational analysis of children younger than 24 months referred with skull fractures between January 2008 and December 2012. Analysis included children with accidental head injuries with a known time interval since injury and a negative skeletal survey who underwent serial radiographic studies. Complete healing of a skull fracture was defined as resolution of fracture lucency by radiograph. RESULTS: Of the 26 children who met inclusion criteria, 11 (42.3%) demonstrated resolution of skull fracture(s) on follow-up imaging. Fracture resolution on radiologic studies ranged from 2 to 18 weeks. Twelve fractures in 10 children demonstrated fracture resolution at 10 or more weeks after injury. CONCLUSIONS: Healing or resolution of a skull fracture can take months in children younger than 24 months. With the high variability in skull fracture presentation and large window to fracture resolution, unexplained or multiple skull fractures in children younger than 24 months may be the result of a single or multiple events of head trauma.
Subject(s)
Child Abuse , Craniocerebral Trauma , Skull Fractures , Child , Child Abuse/diagnosis , Child, Preschool , Craniocerebral Trauma/diagnostic imaging , Fracture Healing , Humans , Infant , Retrospective Studies , Skull , Skull Fractures/diagnostic imagingABSTRACT
Bronchopulmonary dysplasia (BPD) is a major cause of morbidity and mortality in surviving extremely preterm infants, with long-term morbidity disproportionately affecting children with severe BPD (sBPD). Infants with sBPD experience multiple organ system dysfunction. To best treat these complicated patients, we created a multidisciplinary team in 2011 consisting of multiple pediatric subspecialists with a specific interest in sBPD. In the past six years, 150 patients have been referred to our multidisciplinary team, with 131 of the 150 patients discharged home, 65% on home oxygen. Twelve were transferred to the Pediatric Intensive Care Unit (PICU), 3 to a level 2 nursery and 4 died. The multidisciplinary BPD team has standardized the care of children with sBPD and complex medical problems and improved outpatient referral to subspecialists.
Subject(s)
Bronchopulmonary Dysplasia/therapy , Patient Care Team/organization & administration , Patient Discharge/statistics & numerical data , Adult , Female , Gestational Age , Humans , Infant , Infant, Extremely Premature , Infant, Newborn , Male , Rhode Island , Standard of Care , Young AdultABSTRACT
An 11-year-old-girl and a 13-year-old-boy presented with characteristic findings of Parinaud's oculoglandular syndrome. The girl was initially suspected of having Bartonella henselae infection and the boy was initially diagnosed as Francisella tularensis infection. Both children had laboratory-confirmed infection with Rickettsia typhi.
Subject(s)
Ocular Motility Disorders/microbiology , Rickettsia typhi , Typhus, Endemic Flea-Borne/complications , Typhus, Endemic Flea-Borne/drug therapy , Adolescent , Anti-Bacterial Agents/therapeutic use , Child , Doxycycline/therapeutic use , Female , Humans , MaleABSTRACT
BACKGROUND: In the last few decades, there has been exponential growth in the field of herbal remedies. Pharmacopoeial preparations like avleha or paka (semi-solid), swarasa (expressed juice), kalka (mass), him (cold infusion) and phanta (hot infusion), kwatha (decoction) and churna (powder) form the backbone of Ayurvedic formulations. Newer guidelines for standardization, manufacture, and quality control, and scientifically rigorous research will be necessary for traditional treatments. This traditional knowledge can serve as powerful search engine that will greatly facilitate drug discovery. PURPOSE: The aim of the present study is to standardize Saubhagya Shunthi Paka in churna (powder) form. The powder form makes this traditional drug more stable for long-term storage and hence, easier to preserve. MATERIALS AND METHODS: Saubhagya Shunthi Paka is an ayurvedic formulation containing Shunthi (Zingiber officinalis) as one of its chief ingredients. The basic preparation of this drug is a semisolid. We checked the microbial load and nutrient values (using International Standard IS and Association of Official Analytical chemists AOAC methods) RESULTS: The powdered form of Saubhagya Shunthi Churna yielded a weight loss of approximately 17.64% of the total weight of ingredients. The total energy of Churna (calculated based on nutrient content) was found higher over Paka. CONCLUSION: Saubhagya Shunthi Churna may be a good therapeutic and dietary medicine for Indian women, which may be easily prepared at home.
