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2.
Adv Pediatr ; 66: xix-xx, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31230702
3.
Adv Pediatr ; 65(1): xix, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-30053933
4.
N Engl J Med ; 377(4): 399-400, 2017 07 27.
Artigo em Inglês | MEDLINE | ID: mdl-28745983
6.
Pediatr Emerg Care ; 29(10): 1114-5, 2013 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-24084612

RESUMO

A previously healthy toddler presented to the emergency department with nonspecific gastrointestinal complaints. Laboratory studies were consistent with pancreatitis, and imaging studies demonstrated a pancreatic transection. Alopecia felt to be related to traction was also noted. There was no history of any witnessed trauma, and nonaccidental trauma was diagnosed.


Assuntos
Traumatismos Abdominais/diagnóstico , Dor Abdominal/etiologia , Alopecia em Áreas/etiologia , Maus-Tratos Infantis/diagnóstico , Pâncreas/lesões , Pancreatite/etiologia , Vômito/etiologia , Ferimentos não Penetrantes/diagnóstico , Traumatismos Abdominais/etiologia , Amilases/sangue , Biomarcadores , Pré-Escolar , Diagnóstico Diferencial , Emergências , Feminino , Humanos , Intussuscepção/diagnóstico , Lipase/sangue , Pseudocisto Pancreático/etiologia , Pancreatite/diagnóstico , Pancreatite/diagnóstico por imagem , Estresse Mecânico , Tomografia Computadorizada por Raios X , Ferimentos não Penetrantes/etiologia
7.
Pediatr Emerg Care ; 29(2): 222-6, 2013 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-23546430

RESUMO

Subconjunctival hemorrhages in infants and children can be a finding after nonaccidental trauma. We describe 14 children with subconjunctival hemorrhages on physical examination, who were subsequently diagnosed by a child protection team with physical abuse. Although infrequent, subconjunctival hemorrhage may be related to abuse. Nonaccidental trauma should be on the differential diagnosis of subconjunctival hemorrhage in children, and consultation with a child abuse pediatrics specialist should be considered.


Assuntos
Maus-Tratos Infantis/diagnóstico , Doenças da Túnica Conjuntiva/etiologia , Hemorragia Ocular/etiologia , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Exame Físico , Estudos Retrospectivos
9.
J Child Sex Abus ; 20(5): 537-47, 2011 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-21970645

RESUMO

Child sexual abuse as well as accidental trauma may cause acute injuries in the anogenital area. Most data on residual findings following genital trauma come from longitudinal studies of children who have been sexually assaulted, undergone surgical procedures, or experienced accidental trauma. Like injuries in other part parts of the body, such injuries undergo a predictable pattern of healing. Most superficial injuries heal without any residual evidence. Deeper injuries, as well as those that become infected or experience repeated disruption, may produce permanent changes. While the presence of such changes supports allegations of prior anogenital trauma, their absence does not preclude the trauma from having occurred.


Assuntos
Canal Anal/lesões , Abuso Sexual na Infância , Genitália Feminina/lesões , Genitália Masculina/lesões , Cicatrização , Canal Anal/patologia , Criança , Feminino , Medicina Legal/métodos , Genitália Feminina/patologia , Genitália Masculina/patologia , Humanos , Hímen/lesões , Masculino , Anamnese/métodos , Exame Físico/métodos , Relações Profissional-Família , Relações Profissional-Paciente
11.
Acad Pediatr ; 10(5): 360-6, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-20692217

RESUMO

OBJECTIVE: The aim of this study was to examine the importance of family-friendly features in residency program selection, benefits offered to and used by residents, and importance of benefits in future job selection. METHODS: A survey of a random, national sample of 1000 graduating pediatric residents in 2008 was mailed and e-mailed. RESULTS: Survey response rate for graduating resident respondents was 59%. Among the respondents, 76% were women. Thirty-seven percent of men and 32% of women were parents. Residents with children were more likely than residents without children to rate family-friendly characteristics as very important in their residency selection (P < .05). Many residents reported that their programs offered maternity leave (88%), paternity leave (59%), individual flexibility with schedule (63%), and lactation rooms (55%), but fewer reported on-site child care (24%), care for ill children (19%), and part-time residency positions (12%). Among residents reporting availability, 77% of women with children used maternity leave and lactation rooms. Few held part-time residency positions (2%), but many expressed interest (23% of women with children). The majority of residents with and without children reported that flexibility with schedule was important in their future job selection. Most women with children (71%) and many women without children (52%) considered part-time work to be very important in their job selection. CONCLUSIONS: Family-friendly benefits are important to residents, particularly those with children. The data provides a benchmark for the availability and use of family-friendly features at pediatric training programs. The data also shows that many residents are unaware if benefits are offered, which suggests a need to make available benefits more transparent to residents.


Assuntos
Tomada de Decisões , Internato e Residência/organização & administração , Pediatria/educação , Salários e Benefícios , Adulto , Mobilidade Ocupacional , Criança , Cuidado da Criança , Feminino , Humanos , Masculino , Cultura Organizacional , Licença Parental/estatística & dados numéricos , Médicas , Salários e Benefícios/estatística & dados numéricos , Mulheres Trabalhadoras
13.
Pediatr Emerg Care ; 26(3): 206-8, 2010 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-20216282

RESUMO

A 12-year-old girl was brought to the pediatric emergency department by ambulance after her mother found her hanging from her bunk bed. The patient was resuscitated initially but died 5 days later after support was withdrawn. A sexual assault examination was performed, and the finding was negative. The case was investigated as a possible homicide or suicide. Upon questioning relatives, it was disclosed that the deceased had played the choking game. No one knew she had been playing the game alone. The choking game is popular with adolescents and is particularly dangerous when played alone. Emergency physicians should be aware of the characteristic warning signs that include frequent severe headaches, altered mental status after spending time alone, neck markings, and bloodshot eyes and counsel adolescents about the real risks associated with the activity. Accident, suicide, homicide, autoerotic behavior, and the "choking game" should be considered in the differential when an adolescent presents with evidence of strangulation.


Assuntos
Obstrução das Vias Respiratórias , Asfixia , Hipóxia Encefálica/mortalidade , Comportamento Autodestrutivo , Acidentes , Criança , Evolução Fatal , Feminino , Humanos , Recreação , Suicídio
15.
JAMA ; 301(13): 1367-72, 2009 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-19336712

RESUMO

Professional medical associations (PMAs) play an essential role in defining and advancing health care standards. Their conferences, continuing medical education courses, practice guidelines, definitions of ethical norms, and public advocacy positions carry great weight with physicians and the public. Because many PMAs receive extensive funding from pharmaceutical and device companies, it is crucial that their guidelines manage both real and perceived conflict of interests. Any threat to the integrity of PMAs must be thoroughly and effectively resolved. Current PMA policies, however, are not uniform and often lack stringency. To address this situation, the authors first identified and analyzed conflicts of interest that may affect the activities, leadership, and members of PMAs. The authors then went on to formulate guidelines, both short-term and long-term, to prevent the appearance or reality of undue industry influence. The recommendations are rigorous and would require many PMAs to transform their mode of operation and perhaps, to forgo valuable activities. To maintain integrity, sacrifice may be required. Nevertheless, these changes are in the best interest of the PMAs, the profession, their members, and the larger society.


Assuntos
Conflito de Interesses , Ética Institucional , Apoio Financeiro/ética , Indústrias , Política Organizacional , Organizações/normas , Sociedades Médicas/normas , Conflito de Interesses/economia , Congressos como Assunto/economia , Revelação/ética , Revelação/normas , Educação Médica Continuada/economia , Educação Médica Continuada/ética , Educação Médica Continuada/normas , Doações/ética , Guias como Assunto , Indústrias/economia , Comunicação Interdisciplinar , Liderança , Marketing , Afiliação Institucional , Organizações/economia , Organizações/ética , Editoração/economia , Editoração/ética , Editoração/normas , Pesquisa/economia , Sociedades Médicas/economia , Sociedades Médicas/ética
16.
Pediatrics ; 122 Suppl 1: S10-2, 2008 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-18676508

RESUMO

As shown previously in the Child Abuse Recognition Experience Study (CARES), primary care providers reported that they decided not to report a substantial proportion of injuries that they suspected might have resulted from abuse. The most serious cases result in death. This article provides detailed reports of 2 illustrative cases from the author's experience as a member of a multidisciplinary child fatality review team and discusses several alternative legal mechanisms for improving mandated reporting. Regional centers of excellence in child protection may be an effective way of improving child protection; current proposals to establish such centers are reviewed.


Assuntos
Maus-Tratos Infantis/legislação & jurisprudência , Fidelidade a Diretrizes/legislação & jurisprudência , Notificação de Abuso , Autopsia/legislação & jurisprudência , Criança , Maus-Tratos Infantis/diagnóstico , Maus-Tratos Infantis/prevenção & controle , Bem-Estar da Criança/legislação & jurisprudência , Pré-Escolar , Comportamento Cooperativo , Serviço Hospitalar de Emergência , Prova Pericial/legislação & jurisprudência , Feminino , Humanos , Lactente , Comunicação Interdisciplinar , Internet , Traumatismo Múltiplo/diagnóstico , Traumatismo Múltiplo/mortalidade , Traumatismo Múltiplo/patologia , Garantia da Qualidade dos Cuidados de Saúde/legislação & jurisprudência , Encaminhamento e Consulta/legislação & jurisprudência , Estados Unidos , Ferimentos e Lesões/diagnóstico , Ferimentos e Lesões/mortalidade , Ferimentos e Lesões/patologia , Ferimentos e Lesões/prevenção & controle
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