Indicações de tomografia de crânio em crianças com trauma cranioencefálico leve

Ghizoni, Enrico; Fraga, Andréa de Melo Alexandre; Baracat, Emílio Carlos Elias; Joaquim, Andrei Fernandes; Fraga, Gustavo Pereira; Rizoli, Sandro; Nascimento, Barto

doi:10.1590/s0100-69912013000600016

Cited by 7 publications

(5 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Several factors may contribute to their perceived rarity in contemporary groups. First, cranial imaging is not typically used in cases of infection (Ghizoni et al, 2013). Radiological investigations of respiratory infection typically focus on the chest (Frieden, Sterling, & Munsiff, 2003).…”

Section: Discussionmentioning

confidence: 99%

Cribra orbitalia and porotic hyperostosis are associated with respiratory infections in a contemporary mortality sample from New Mexico

O’Donnell

Hill

Anderson

et al. 2020

American J Phys Anthropol

View full text Add to dashboard Cite

Objectives: Cribra orbitalia (CO) and porotic hyperostosis (PH) are porous cranial lesions (PCLs) classically associated with iron-deficiency anemia in bioarchaeological contexts. However, recent studies indicate a need to reassess the interpretation of PCLs. This study addresses the potential health correlates of PCLs in a contemporary sample by examining relationships between the known cause of death (COD) and PCL presence/absence. Methods: This study includes a sample of 461 juvenile individuals (6 months to 15 years of age) who underwent examination at the University of New Mexico's Office of the Medical Investigator between 2011 and 2019. The information available for each individual includes their sex, age at death, and their COD and manner of death. Results: Odds ratio of having CO (OR = 3.92, p < .01) or PH (OR = 2.86, p = .02) lesions are increased in individuals with respiratory infections. Individuals with heart conditions have increased odds of having CO (OR = 3.52, p = .03) lesions, but not PH. Conclusion: Individuals with respiratory infection are more likely to have CO and/or PH. CO appears to have a greater range of health correlates than PH does, as indicated by the heart condition results. However, individuals with congenital heart defects are at higher risk for respiratory infections, so bony alterations in cases of heart conditions may be due to respiratory illness. Since respiratory infection remains a leading cause of mortality today, CO and PH in bioarchaeological contexts should be considered as potential indicators of respiratory infections in the past.

show abstract

Section: Discussionmentioning

confidence: 99%

Cribra orbitalia and porotic hyperostosis are associated with respiratory infections in a contemporary mortality sample from New Mexico

O’Donnell

Hill

Anderson

et al. 2020

American J Phys Anthropol

View full text Add to dashboard Cite

show abstract

“…In addition, these examinations also increase costs to the health system. 23 The Brazilian Society of Pediatrics 22 considers clinical observation prior to CT scan to be a more effective approach.…”

Section: Discussionmentioning

confidence: 99%

“…In case of neurological damage, the computed tomography (CT) is the best indication. 23 The Brazilian Society of Pediatrics 22 recommends that CT be used in cases of traumatic brain injury in the following situations: moderate and severe trauma; in mild cases where there is a change in mental state such as restlessness, drowsiness, repetitive questioning, or slow response to verbal communication; when there is a suspected cranial fracture to palpation; prominent subgaleal hematoma in the occipital, temporal, or parietal region; loss of consciousness; when there is a mechanism of severe trauma; falls greater than 0.9 m in children younger than 2 years of age or greater than 1.5 m for children older than 2 years of age; and when the child is not acting normally in the perception of the parents.…”

Section: Discussionmentioning

confidence: 99%

Choosing Wisely in Pediatric Internship

Mendonça

Aguiar

Lins-Kusterer

et al. 2019

Global Pediatric Health

View full text Add to dashboard Cite

Background . The Choosing Wisely (CW) campaign informs physicians and the public about safety and quality in medical practice. Objective . To evaluate a CW campaign in a medical internship in pediatrics. Methods . An interventionist study with teachers of medicine and pediatric internship students in which the Delphi technique was applied using online questionnaires. Specialists identified 3 unnecessary situations that commonly occur in clinical practice. Following the Objective Structured Clinical Examination (OSCE) model evaluation, a group of students who participated in the educational interventions was compared with another group that was not exposed to the campaign. Results . Most students evaluated the CW campaign content as excellent (64%) or very good (31.6%). The level of successes in the OSCE evaluation was higher in the exposed group when compared with the nonexposed group ( P = .001). Conclusions . The CW campaign improved the clinical skills of pediatric internship students.

show abstract

“…14 Many studies have assessed the conformity of clinical practice to guidelines for traumatic brain injury or other conditions, [19][20][21][22][23] but very few have provided a broad overview of medical conditions which are associated with the use of CT in paediatrics, 10,11,13 and none, to our knowledge, was conducted in the UK. Tompane et al 10 described billing records associated with 14,000 CT scans of children and adolescents by US practitioners between 2001 and 2009.…”

Section: Discussionmentioning

confidence: 99%

Medical conditions associated with the use of CT in children and young adults, Great Britain, 1995–2008

Journy¹,

McHugh²,

Harbron³

et al. 2016

BJR

View full text Add to dashboard Cite

Objective: To describe the medical conditions associated with the use of CT in children or young adults with no previous cancer diagnosis. Methods: Radiologist reports for scans performed in 1995-2008 in non-cancer patients less than 22 years of age were collected from the radiology information system in 44 hospitals of Great Britain. By semantic search, an automated procedure identified 185 medical conditions within the radiologist reports. Manual validation of a subsample by a paediatric radiologist showed a satisfactory performance of the automatic coding procedure. Results: Medical information was extracted for 37,807 scans; 19.5% scans were performed in children less than 5 years old; 52.0% scans were performed in 2000 or after. Trauma, diseases of the nervous (mainly hydrocephalus) or the circulatory system were each mentioned in 25-30% of scans. Hydrocephalus was mentioned in 19% of all scans, 59% of scans repeated $5 times in a year, and was the most frequent condition in children less than 5 years of age. Congenital diseases/malformations, disorders of the musculoskeletal system/connective tissues and infectious or respiratory diseases were each mentioned in 5-10% of scans. Suspicionor diagnosis of benign or malignant tumour was identified in 5% of scans. Conclusion: This study describes the medical conditions that likely underlie the use of CT in children in Great Britain. It shows that patients with hydrocephalus may receive high cumulative radiation exposures from CT in early life, i.e. at ages when they are most sensitive to radiation. Advances in knowledge: The majority of scans were unrelated to cancer suspicion. Repeated scans over time were mainly associated with the management of hydrocephalus. INTRODUCTIONThe benefits of CT, in the diagnosis and follow-up of numerous conditions, are undeniable. The justification for CT scanning must be balanced against the potential harmful effects of radiation exposures, particularly in children, who appear to be at a greater risk of radiation-related cancer than adults.1,2 Increased cancer risks in relation to CT exposures at young ages have been reported in several populations. The UK CT cohort study showed a significant dose-response relationship between radiation doses from scans received before the age of 22 years and the risk of cerebral tumours and leukaemia/myelodysplastic syndromes.3 After a first scan before the age of 10 years, 1 excess case of leukaemia and 1 excess case of cerebral tumour per 10,000 head scans were estimated to occur in the subsequent 10 years. Other cohort studies have found comparable results. 4-7The interpretation of these results nevertheless requires an understanding of whether the excess risks of later malignancies observed after CT scans were due to the radiation exposure or to the underlying medical condition. 8,9 It is indeed possible that the increased incidence rates observed after receipt of CT scans were, at least in part, attributable to the indication for CT use, whether it was the first symptoms of a tumour, a fol...

show abstract

Indicações de tomografia de crânio em crianças com trauma cranioencefálico leve

Cited by 7 publications

References 12 publications

Cribra orbitalia and porotic hyperostosis are associated with respiratory infections in a contemporary mortality sample from New Mexico

Cribra orbitalia and porotic hyperostosis are associated with respiratory infections in a contemporary mortality sample from New Mexico

Choosing Wisely in Pediatric Internship

Medical conditions associated with the use of CT in children and young adults, Great Britain, 1995–2008

Contact Info

Product

Resources

About