Pediatrics
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To estimate the numbers and rates of all-terrain vehicle (ATV)-related nonfatal injuries among riders aged ≤ 15 years treated in hospital emergency departments (EDs) in the United States during 2001-2010. ⋯ The reasons for the decline in ATV-related injuries among young riders are not well understood but might be related to the economic recession of the mid-2000s and decreased sales of new ATVs. Although many states have regulations governing children's use of ATVs, their effectiveness in reducing injuries is unclear. Broader use of known effective safety measures, including prohibiting children aged ≤ 15 years from riding adult-sized ATVs, always wearing a helmet while riding, not riding on paved roads, and not riding as or carrying a passenger could additionally reduce ATV-related injuries among children. Last, more research to better understand ATV crash dynamics might lead to safer designs for ATVs.
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The use of physical punishment is controversial. No studies have comprehensively examined the relationship between physical punishment and several physical health conditions in a nationally representative sample. The current study investigated possible associations between harsh physical punishment (ie, pushing, grabbing, shoving, slapping, and hitting) in the absence of more severe child maltreatment (ie, physical abuse, sexual abuse, emotional abuse, physical neglect, emotional neglect, and exposure to intimate partner violence) and several physical health conditions. ⋯ Harsh physical punishment in the absence of child maltreatment is associated with some physical health conditions in a general population sample. These findings inform the ongoing debate around the use of physical punishment and provide evidence that harsh physical punishment independent of child maltreatment is associated with a higher likelihood of physical health conditions.
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The practice of pediatric/neonatal interfacility transport continues to expand. Transport teams have evolved into mobile ICUs capable of delivering state-of-the-art critical care during pediatric and neonatal transport. The most recent document regarding the practice of pediatric/neonatal transport is more than a decade old. The following article details changes in the practice of interfacility transport over the past decade and expresses the consensus views of leaders in the field of transport medicine, including the American Academy of Pediatrics' Section on Transport Medicine.
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To evaluate the implementation of a neonatal pain and sedation protocol at 2 ICUs. ⋯ Implementation of a neonatal pain and sedation protocol at 2 ICUs resulted in an increase in opiate prescription, pharmacologic interventions, and staff satisfaction without affecting time on mechanical ventilation, length of intensive care stay, and adverse outcomes.
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A 12-year-old girl presented with acute abdominal pain due to an acute ovarian torsion. She required an oophorectomy. Clinical and laboratory assessment confirmed severe primary hypothyroidism. In this report, we review this rare complication of untreated primary hypothyroidism and the physiologic mechanisms proposed to explain this phenomenon.