Showing posts with label injury. Show all posts
Showing posts with label injury. Show all posts

Monday, June 15, 2015

Victimization of Children and Weapon Involvement: Some Alarming Statistics

By: Lewis First, MD, MS; Editor-in-Chief  

Texas A&M University-Com
      With so much attention on firearms and firearm safety in the news, the epidemiologic data on the prevalence of weapons involved in youth victimization seems to have been lacking—until now!   
      Mitchell et al. (doi: 10.1542/peds.2014-3966) have shared data on a national survey of children exposed to violence and report an astounding finding—more than 17.5 million children and teens are exposed to violence in which a weapon is involved—meaning they have served as witnesses or victims.  More than 2 million children and teens report they have been directly assaulted in incidents where guns or knives were used.
       Perhaps those on the fence regarding strengthening our gun-safety practices will jump off that fence and recognize the need to do all we can to restrict youth access as well as exposure to firearms so that the mental health repercussions of being victimized by these weapons and the people using them can be reduced as much as possible.   
     There is a lot of important information in this study worth sharing with those who are making decisions regarding gun control in your state or region—so do not hesitate to share this important study wherever it can make a difference.

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Monday, May 26, 2014

Ice Hockey Injuries: How Common Are They?

Pediatrics Editorial Board Member Joann Schulte, DO, MPH, shares her expert perspective on a new article from our June issue. To learn more about Dr. Schulte and her work in general pediatrics and preventive medicine, check out her bio on our Contributors page.

By: Joann Schulte, DO, MPH

Watch the bodies collide on the ice and players go flying. Though the outside ice has melted, the hockey puck is still flying inside during June as the NHL finishes the Stanley Cup playoffs. And just like their professional counterparts, younger, amateur, pediatric hockey players also go flying in this contact sport.

Photo by Battle Creek CVB via Flickr
An article by Stephanie Polites et al. published the June issue of Pediatrics (doi:10.1542/2013-3628) highlights the injuries sustained by youth hockey players aged 18 years and younger in Minnesota. Surgeons at the pediatric trauma center at Mayo Clinic evaluated the injuries of youth hockey players during a 16-year period from July 1997 to July 2013, one of the few longitudinal studies done. They saw 155 children with 168 injuries, and almost 16 percent were in girls. Most injuries were sustained by intentional contact; extremity injuries and traumatic brain injury (TBI) were the most common diagnoses. Upper limb fractures were the most common extremity injury and concussions were the most common form of TBI. Players who were older and male were more likely to experience injuries requiring hospital admission and major medical procedures.

Polites and her co-authors reported that 40 percent of players who suffered TBI had sustained prior concussions and 35 percent of players followed reported symptoms lasting for more than a year. Multiple concussions have well-documented risks, such as the long-term effects now being reported and studied among professional football players.

The authors suggest that young hockey players and their parents need to be educated about the risks of TBI. They recommend that concussion be treated with a return to play only after symptoms have resolved and neurocognitive testing is at the player’s baseline.

Hopefully, many teams will have such measures in place when things freeze up for the next hockey season. And let’s also hope those measures are put in place for girls who play hockey, since as of 2011, 65,000 girls were playing youth hockey, according to USA Hockey.

Pediatricians who want to know more about such measure may want to review the measures recommended by the 4th International Conference on Concussion in Sport, held in Zurich in 2012 or the new AAP policy statement, “Reducing Injury Risk from Body Checking in Boys’ Hockey” (doi: 10.1542/peds.2014-0692).

Related Reading:

Tuesday, May 13, 2014

Heads Up on the Type and Duration of Post-Concussive Symptoms

By: Lewis First, MD, MS

Concurrent with the prominence of concussion as a topic that seems to be garnering more and more attention in the public media have been an array of studies attempting to help us better correctly diagnose and treat this traumatic brain injury. Our journal is no exception to the flurry of solid studies we have recently published on concussion.

Photo by Lindsay Shaver via Flickr
This week, we share a prospective cohort study by Eisenberg et al. (doi: 10.1542/peds. 2014-0158) that uses this longitudinal methodology to track children, teens, and young adults (ages 11-22) seen in an emergency department with acute concussion and then follows them for three months or until symptoms resolved.

The authors track the type of symptom encountered at the time of concussion as well as new symptoms, largely emotional, that develop during the follow-up period. They also chart the time course of symptoms to resolution providing new insight into the natural history and what to expect in the post-concussive time period.

If you want to stay ahead when it comes to knowing about concussion, this study gives you, and in turn the families of your patients, post-concussion information that will allow all of us to better monitor their recovery progress as well as what to expect in the days following the injury. Check out this article and learn more.

Related Reading:

Friday, May 9, 2014

Alcohol Impaired Drivers and Pediatric Passengers: A Far Too Lethal Combination

By: Lewis First, MD, MS

So much has been written on the dangers of drinking and driving, but sadly 1 in 5 child passenger-related US deaths occurs when the driver is alcohol impaired—yet what happens when you look at a statistic like that at a state level or over time? Are some states worse than others?
Photo by J_Palinsad360 via Flickr

Quinlan et al. (doi: 10.1542/peds. 2013-2318) provide us this week with a descriptive analysis of 10 years of child fatalities involving passengers under 15 years of age from data obtained from the Fatality Analysis Reporting System—a national data set.

The results show that more fatal crashes occur when a child is inside the car with a drunk driver than outside the car—although the data suggest both types of fatalities still occur with unfortunate frequency. The good news is that over the past ten years, the death rate of children riding with an alcohol impaired driver has decreased substantively. Sadly of the 37 states submitting data to this data base, several do not shine due to the higher numbers of children killed or the highest annualized rates of death—often due to children not being properly restrained in their seats during the crash. What makes this study even more disturbing is that one third of the drivers responsible for a child death did not have a valid driver’s license.

So what should we do? I turn to you, the reader, to read this study and see where your state stands. No matter whether you are high or low on the list of most child deaths—we need to do more. I hope you will share what you or your community is doing to reduce these statistics even more going forward. Read this study to learn more and share what is being done or what needs to be done where you live to reduce the severity of the statistics contained in this article.

Related Reading:

Thursday, May 1, 2014

Cervical Spine Injuries in Children: What Do We Know?

Cervical spine injuries are not very common in children, so when Leonard et al. (doi: 10.1542 /peds.2013-3505) compiled more than 500 children with these injuries over five years using data obtained from hospitals participating in the Pediatric Emergency Care Applied Research Network, we were interested in sharing it with you.

Photo by Michael Dorausch
This descriptive
study compared characteristics of cervical spine injuries in three age groups: less than 2 years, 2-7 years, and 8-15 years. The three age groups provide a wealth of knowledge as well as interesting differences in mechanism for cervical spine injury, treatments, and outcomes making this an important compendium of information on what you should know about this devastating injury and what can be done about it.

If you have not reviewed cervical spine injuries since you last focused on them in adult medicine as a student, then this article about childhood cervical spine injuries should be a must-read.

Related Reading:

Friday, April 18, 2014

Injury Risk in Children with Epilepsy: New Opportunities for Prevention Strategies

Photo by Amanda Mills via the CDC
Having a seizure disorder is certainly a challenge for our patients, but does having such a disorder further predispose them to accidental fractures, burns, and overdoses of medications?

Prasad et al. (doi: 10.1542/peds. 2013-2554) opted to look into the prevalence of various injuries in
almost 12,000 patients with epilepsy between the ages of 1 to 24 years and compared these patients to a comparison group of more than 46,000 patients without seizures using a large longitudinal data base of primary care records.

Do you counsel your patients with seizures in regard to injury and poison prevention strategies? After reading this study, I suspect you will, based on the results and the discussion of these results by the authors. Check out this early-released study and learn more.

Related Reading:

Monday, April 7, 2014

Does Walking to School Increase Children’s Chances of Being Hit by a Vehicle?

Photo by Amanda Mills via the CDC
Increased physical activity such as walking to school is highly encouraged in study after study published in both our journal and others, but is it true that the higher the numbers of children walking to school means a higher number of possible pedestrian collisions with vehicles?

Rothman et al. (doi: 10.1542/peds. 2013-2317) drive forward to answer this question by comparing a decade’s worth of  police-reported pedestrian collision data for children ages 4-12 with the proportion of uninjured children walking to school. What makes the article even more relevant is that the authors looked at the influence of the environment in which the child was walking (e.g. numbers of traffic lights, presence of school crossing guard, etc.).

You don’t have to take a crash course to absorb all the interesting findings worth reading about in this study.

Likewise—don’t stop there, but cruise on to a commentary by Drs. Gilbert Liu and Jason Mendoza (doi: 10.1542/peds. 2014-0600) who break down this study even further and offer their take on why it’s so important to continue to fund initiatives to keep kids walking to school, and to keep them as safe as possible while doing so.

So buckle up and learn more from this provocative study and commentary, which will hopefully convince you that the benefits of walking to school do outweigh the risks.

Related Reading:

Friday, January 31, 2014

Touchdown! Winning Studies Help You Care for Young Football Players

Photo by Greyerbaby via Pixabay
While America’s tuning in to watch one
of the biggest sporting events of the year, Pediatrics wanted to get in on the fun. And although we won’t be passing the pigskin or serving up snacks here on First Read, we can share some of our favorite articles from our brand new February issue to help you tackle some of the health care issues that may arise for the young football players and athletes you see in your practice.

  • If you think that coaches of student athletes could be more encouraging, you’re not alone. Check out a Pediatrics Perspective piece by Swigonski et al. (doi: 10.1542/ peds.2013-3146 - free through March 1, 2014) that takes a look at coaches’ bullying behaviors and ways pediatricians can identify and intervene.

  • The lasting impact concussions have on players is on many football fans’ minds this season. But even if your patients aren’t yet in the pros, you can help inform your treatment of concussions with this latest study on the effects of cognitive activity level on the duration of post-concussion symptoms by Brown et al. (doi: 10.1542/peds.2013-2125).

  • And, if you feel as though many of your athletic patients get sidelined with shoulder injuries, take a look at this study by Robinson et al. (doi: 10.1542/peds.2013-2279) to learn more about the shoulder injury rates and patterns of high school athletes.

So whether you are rooting for the team in blue and green or the team in blue and orange this weekend, hopefully you’ll get your kicks and touch down to read these articles. Doing so will help you cheer for the health and success of your favorite young athletes as well.

Tuesday, January 14, 2014

6 Years of High School Shoulder Injuries: Some Data That Is Not Out of Joint!

We all encounter athletic patients who come in with a myriad of shoulder injuries following an athletic practice or competitive event. But what do we really know about these injuries?

Photo by Public Domain Pictures via Pixabay
Robinson et al. (doi: 10.1542/peds.2013-2279) opted to categorize the spectrum of shoulder injuries over a six year period in a nationally representative sample of high school athletes engaged in playing at least one of nine sports. The authors describe their findings in terms of differences in gender, type of sports, and type of injury as well as whether the injuries are more or less likely to occur in a practice or actual competition. The number needing surgical repair and the morbidity associated with these injuries are also categorized.

The take-away from this study, given the prevalence of shoulder injuries, is how to better prevent them. Prevention begins by raising your level of concern about these injuries and that is certain to happen only if you don’t give this study the cold shoulder.