Massive transfusion (MT) in pediatric patients remains poorly defined. Using the largest existing registry of transfused trauma patients, we sought a data-driven MT threshold.The Department Defense Trauma Registry was queried from 2001 to 2013 for (<18 years). Burns, drowning, isolated head injury, and missing Injury Severity Score (ISS) were excluded. evaluated as weight-based volume all blood products first 24 hours. Mortality at hours hospital calculated increasing volumes. Sensitivity...

Humanitarian and civilian emergency care accounts for up to one-third of US military combat support hospital (CSH) admissions. Almost half these admissions are children. The purpose this study is describe the features pediatric wartime deployed CSHs in Iraq Afghanistan.A retrospective database review was conducted using Patient Administration Systems Biostatistics Activity. Details 2,060 were analyzed.Nontraumatic diagnoses responsible 25% all Penetrating injuries (76.3%) dominate trauma...

BACKGROUND Throughout history, children have been victims of armed conflict, including the blast injury complex, however, pattern injury, physiologic impact, and treatment needs with this are not well documented. METHODS The Joint Theatre Trauma Registry provides data on all civilians admitted to US military facilities from 2002 2010 injuries an explosive device. were stratified by age analyzed for differences in anatomic patterns, Injury Severity Score (ISS), Revised (RTS), mortality,...

Component balanced resuscitation and avoidance of crystalloids in traumatically injured adults requiring massive transfusion are beneficial. Evidence for children is lacking.After institutional review board approval was obtained, the Department Defense Trauma Database identified 1,311 14 years or younger after an injury admitted to a deployed US military hospital from 2002 2012. Logistic regression determined risk factors high-volume (≥40 mL/kg) (≥70 transfusions. The effects crystalloid...

Abstract Background Early identification of child abuse is critical to prevent death and disability. Studies suggest implicit bias providers may lead overrepresentation minority impoverished children in reporting. At our institution, universal screening for sexual physical all under 18 years age was implemented 2016. A rigorous, objective evaluation protocol focusing on the mechanism injury exam findings improve recognition eliminate 2019. Findings Demographics clinical characteristics...

Acute blast injury requires aggressive operative intervention. This study documents therapeutic procedures required for children with in Afghanistan and Iraq from 2002 to 2010 at US military treatment facilities, understand pediatric resources after explosions.The Joint Theatre Trauma Registry provides data the previously mentioned population. The were stratified by years of age as follows: 0 3, 4 8, 9 14, 15 19, older than 19 years. Therapeutic defined DRG International Classification...

Studies in preterm infants have shown that prolonged treatment with topical iodine (multiple doses, often over multiple days) can transiently suppress thyroid function. However, it is uncertain if exposure for very short periods of time cause significant changes We report two cases transient hypothyroidism after short-term to during surgical preparation, and review their clinical laboratory findings before exposure. conclude premature are at risk developing response a single, iodine, even...

Current Surgical Diagnosis and Treatment , ninth ed Edited by Lawrence W. Way 1991, 1.359 pp $39.95 paperback

Atlas of the Visible Human Male By Victor M. Spitzer, David G. Whitlock 1998, 519 pp $99.95 hardcover

Introduction Computerized tomography (CT) scans are the mainstay of diagnostic imaging in blunt trauma. Particularly pediatric trauma, utilization CT has increased exponentially recent years. Concerns regarding radiation exposure to this vulnerable population have resulted scrutiny practice. What is not known if liberal practices decrease length stay by eliminating need for clinical observation, and impact false-positive rates from use scanning on outcomes. Methods Medical records a...

findings of impaired activity aryl hydrocarbon hydroxylase in the liver and small bowel patients with psoriasis.'The salivary clearances indicate that inducing effect smoking on antipyrine metabolism is similar normal subjects.This contrasts our observations skin: so far we have been unable to show any difference skin between smokers non-smokers, in-vitro induction benzanthracene lesion-free psoriasis only about 50% normal.'Clearly, in-vivo by as measured clearance not analogous 40 0 o30 c O...

Objectives: The military uses “just-in-time” training to refresh deploying medical personnel on skills necessary for and surgical care in the theater of operations. burden pediatric at Role 2 facilities has yet be characterized; predeployment been extremely limited primarily informed by anecdotal experience. goal this analysis was describe enable data-driven development high-fidelity simulation core knowledge concepts specific combat zone. Setting Patients: A retrospective review Database...

F R A N C E S B O K ’ T H I Y M L G U : P X MARY JANE EDWARDS Carleton University in ce its first publication by James Dodsley, the London bookseller, April 1769, Frances Brooke’s The History of Emily Montague has been con­ sidered a variety contexts.1 In English literature it discussed as an epistolary novel tradition Richardson; sensibil­ ity; popular late eighteenth century; pre-romantic novel; and early feminine — feminist novel.2 influence such French writers Riccoboni Rousseau on...