Vitamin K deficiency mimicking child abuse.
ABSTRACT Supplemental vitamin K is required for normal hemostasis in infancy. Infants born outside the hospital may not receive prophylactic vitamin K. They may suffer from bleeding into various tissues and are likely to present to the emergency department. This report describes an infant born at home who presented with intracranial bleeding and signs and symptoms consistent with child abuse. Further investigations confirmed the diagnosis of Vitamin K deficiency. Although it is important to consider child abuse when the history and examination are consistent with the diagnosis, it is equally important to consider other potential diagnoses including Vitamin K deficiency.
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ABSTRACT: Abusive Head Trauma (AHT) refers to the combination of findings formerly described as shaken baby syndrome. Although these findings can be caused by shaking, it has become clear that in many cases there may have been impact trauma as well. Therefore a less specific term has been adopted by the American Academy of Pediatrics. AHT is a relatively common cause of childhood neurotrauma with an estimated incidence of 14-40 cases per 100,000 children under the age of 1 year. About 15-23% of these children die within hours or days after the incident. Studies among AHT survivors demonstrate that approximately one-third of the children are severely disabled, one-third of them are moderately disabled and one-third have no or only mild symptoms. Other publications suggest that neurological problems can occur after a symptom-free interval and that half of these children have IQs below the 10th percentile. Clinical findings are depending on the definitions used, but AHT should be considered in all children with neurological signs and symptoms especially if no or only mild trauma is described. Subdural haematomas are the most reported finding. The only feature that has been identified discriminating AHT from accidental injury is apnoea. CONCLUSION: AHT should be approached with a structured approach, as in any other (potentially lethal) disease. The clinician can only establish this diagnosis if he/she has knowledge of the signs and symptoms of AHT, risk factors, the differential diagnosis and which additional investigations to perform, the more so since parents seldom will describe the true state of affairs spontaneously.European Journal of Pediatrics 03/2012; 171(3):415-23. · 1.98 Impact Factor
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ABSTRACT: Families represent the most important resources that young people have in their journey through treatment toward recovery. Unfortunately, family members are often seen as part of the problem and not as part of the solution to adolescent alcohol and other drug (AOD) treatment and recovery. This attitude and misperception can be changed through education, outreach, and engagement of family members. Family involvement and creating a parent-professional collaborative partnership is a step toward improving the outcomes for adolescents in need of treatment and recovery. It is crucial that families understand the treatment process, as well as the hope, process, and reality of recovery. Without information families may not understand the importance of a treatment and recovery plan for their adolescent, the potential adverse consequences, and the impact of these AOD problems on other family members. Families need to learn the continuum of services and supports available, and how family participation improves treatment outcomes and strengthens the recovery process. Family involvement should be an essential part of intake, treatment, and recovery planning, as well as the foundation for effective parent-professional partnerships.Children and Youth Services Review 09/2011; 33(Supplement 1):70-70. · 1.27 Impact Factor