Combining screening tests significantly increased the number of test positives and led to more child abuse cases detected. Combined screening for child abuse in all children less than 18 years old presenting to an ED is recommended.

Background:In order to create sport-specific preventive measures to enhance healthy sport participation in youth athletes, valid data on incidence, prevalence, and etiology of overuse injuries have to be identified. This systematic review aims to provide an update on incidence, prevalence, and risk factors for overuse injuries of the elbow and shoulder in youth athletes participating in overhead sports. Materials and Methods: MEDLINE and EMBASE were searched from inception until January 19, 2018, for studies that reported incidence, prevalence, or risk factors for overuse injuries or pain of the elbow and shoulder in youth overhead athletes. Results: In total, 36 studies were included. Incidence rates of overuse injuries of the elbow and shoulder were highest in tennis, baseball, and softball. Incidence and prevalence of elbow pain in baseball were 12%-58% and 17%-35%, respectively. Incidence of shoulder pain was 8%-32% for baseball, 47% for basketball, 63% for handball, and 52% for volleyball. Prevalence of shoulder pain was 9%-16% for baseball, 41% for basketball, 32%-49% for handball, and 40% for volleyball. Risk factors for pain were almost exclusively described for youth baseball players and included playing position, throwing technique, and intensity and duration of training. Conclusions: Incidence and prevalence of overuse injuries and pain of the elbow and shoulder are high in youth overhead athletes. Interpretation is challenging as different definitions are used to report overuse injuries and pain. Risk factors in youth baseball are largely covered by preventive pitch-count restrictions; knowledge on risk factors in other overhead sports is currently lacking. K E Y W O R D Sathletic injuries, elbow, overhead sports, overuse injuries, risk factors, shoulder

Abstract. The serum lipid profile in malaria patients has been found to differ from that of healthy controls. We investigated serum lipid profile changes in malaria patients over time compared with patients with other febrile diseases. In total, 217 patients were included in the study (111 malaria patients and 106 symptomatic controls, defined as malaria-negative febrile patients). Serum lipid levels (mmol/L) were significantly lower in malaria patients compared with those with other febrile diseases (total cholesterol . No significant differences were found for apolipoprotein A1, apolipoprotein B, and lipoprotein(a). Cholesterol levels increased toward reference values on day 28 ( TC = 3.26-3.98, P < 0.001; HDL-C = 0.43-0.96, P < 0.001; LDL-C = 2.05-2.60, P < 0.001). TG levels decreased from 1.81 on admission to 1.76 (day 3) and 0.88 (day 28; P = 0.130). Lipid profile changes were not correlated with parasitemia or Plasmodium falciparum histidine-rich protein 2 levels. This study confirms characteristic temporary lipid profile changes in malaria. Lipid profile changes demonstrated a good accuracy to discriminate between malaria and other febrile diseases (area under the curve = 0.80 (95% confidence interval = 0.742-0.863, P < 0.001). Several plausible hypotheses exist regarding the pathophysiology of lipid profile changes in malaria. Further studies to elucidate the precise pathways may lead to improved understanding of the underlying pathophysiology.[