..... on the controversy behind "shaken baby syndrome" .... some of you are either real health professionals or are good at finding data on the topics for your e-lives.... in any case any info would be AWESOME
What controversy? If the baby was shaken there is irrefutable evidence through fundoscopic exam of the eye and neuroimaging of characteristic findings. There is no controversy except to the possible exact mechanism most important in causing the mental retardation. http://www.emedicine.com/neuro/topic238.htm "The mechanism by which brain damage occurs is controversial. Traditionally, shearing forces were believed to cause axonal damage. Geddes et al suggested that hypoxia-ischemia, rather than axonal injury, as the mechanism, as seen in older children and adults with lethal head trauma. They also thought that acceleration and deceleration forces may damage the neuraxis to cause apnea, with consequent ischemia and cerebral edema. " Neuroimaging and fundoscopic exam alone are enough to put people in jail. I've seen little babies with profound mental retardation and recurrent seizures following SBS and the kids parent in this case the dad was put in jail pretty quickly.
http://www.jpands.org/vol10no2/orient.pdf just one example dan i don;t feel like posting others and i doubt the links would work
Smiles, there are many pieces of this article don't sound accurate. For example, the author states "It appears that the tragedy of sudden infant death is being compounded by the destruction of hundreds or thousands of families by unwarranted prosecutions and imprisonment." I find it very hard to believe that there are "hundreds of thousands" in jail for this problem. While I am sure there are people wrongfully prosecuted, I have my doubts that there is some "vast medical conspiracy" to wrongfully convict people. The author of the article thinks there is - "The medical profession is complicit in the travesty of justice by providing expert testimony" Good topic by the way. Makes me think.
I think people who would abuse a baby should be made to lie belly down on a filthy street with their head cocked back teeth biting onto a street curb and then find the stoutest individual in the local area of both size and strength to stomp the back of their skull. Then again it would almost be an equal travesty if someone were wrongly convicted of a crime and punished in anyway. Weather it were permissible in court or not I think people suspected of such a crime should be subject to mandatory lie detector tests. It is a shame but when a science or medical journal says that anything is irrefutable it means nothing to me. I have not read the article yet though.
It seems that there are two factors at play here that you commonly see. this is basically regarding cases where there is a "scientific evidence" factor as well as one where there is a crime that the general public finds to be extremely repulsive. In the case of a heinous crime such as this I believe people have a tendency to be willing to lower the bar of proof leveraging the desire to evoke a system of deterrence against the possibility of such a thing. This distorting their perception of the importance of a fair and blind justice system. The second regarding issues of "scientific evidence" there are two human factors at play one being the health-care worker being similarly effected when providing their opinion regarding forensic evidence. The second is the tendency take statements of evidence by scientific analysis far to seriously. I do not have the confidence of most people in the accuracy of this type of evidence. I would probably be filtered out of the process however during the initial jury selection phase.
I admit I have not read all those articles about how they could be misdiagnosed. I know however that the kid I saw there was no question. He was fine one day and then he is profoundly retarded with recurrent seizures. Now the parent can make up some story about how the kid fell off the 3rd floor of a building without getting any characterstic bruises and such enough to shear off the motor tracts in his brain and making his retinas bleed with subdural hematomas but in that case it was clear cut and the father just admitted it in the face of overwhelming evidence. The kid clearly had an upper motor nueron lesion that you didn't even need imaging to appreciate with "clonus" sustained in both feet upon dorsiflexion. Child abuse is alot more common than most people think. I have seen a bunch of kids where we had to sick child protective services on the parents. Some statistics: Most common cause of serious intracranial injuries in children less than 1 year of age 3rd most common cause of death in children after sudden infant death syndrome and true accidents Prevalence 1.7 million cases reported, 833,000 of which were substantiated in United States in 1990 Results in 2,500-5,000 deaths/year 5-10% of children seen in emergency rooms suffer from child abuse Radiologist has legal obligation to report suspected child abuse, usually to the referring physician Age Usually <2 years In children <2 years of age, a skeletal survey may be best to demonstrate other fractures In children >2 years of age, a bone scan may be best Clinical findings Skin burns Bruises Lacerations Hematomas Skeletal trauma is seen in 50-80% Sites of skeletal trauma Multiple ribs Transverse fracture of sternum Costochondral / costovertebral separation Lateral end of clavicles Scapula Acromion Skull Vertebral bodies Anterior-superior wedging of vertebral bodies Vertebral compression Vertebral fracture dislocation Disk space narrowing Spinous processes Frontal radiograph of the chest demonstrates multiple rib fractures with callous formation, including a fracture of the left 2nd and 6th ribs posteriorly. Posterior rib fractures are highly suggestive of child abuse (from forceful squeezing) Appearances of skeletal trauma Hallmark of the syndrome are multiple, asymmetric fractures in different stages of healing Separation of distal epiphysis Marked irregularity and fragmentation of metaphyses "Corner" fracture (11%) or "Bucket-handle" fracture = avulsion of a metaphyseal fragment overlying the lucent epiphyseal cartilage secondary to a sudden twisting motion of extremity Isolated spiral fracture (15%) of diaphysis secondary to external rotatory force applied to femur / humerus Extensive periosteal reaction from large subperiosteal hematoma Exuberant callus formation at fracture sites Cortical hyperostosis extending to epiphyseal plate Avulsion fracture at site of ligamentous insertion Frequently seen without periosteal reaction Head trauma (13-25%) Most common cause of death and/or physical disability Skull fracture (flexible calvaria + meninges decrease likelihood of skull fractures) Subdural hematoma Brain contusion Cerebral hemorrhage Infarction Generalized edema Shearing injuries with associated subarachnoid hemorrhage Skull film (associated fracture in 1%): Linear fracture > comminuted fracture CT findings in head trauma Subdural hemorrhage (most common) Interhemispheric location most common Subarachnoid hemorrhage Epidural hemorrhage (uncommon) Cerebral edema (focal, multifocal, diffuse) Acute cerebral contusion appears as ovoid collection of intraparenchymal blood with surrounding edema MR findings of head trauma More sensitive in identifying hematomas of differing ages White matter shearing injuries as areas of prolonged T1 + T2 at corticomedullary junction, centrum semiovale, corpus callosum Viscera (3%) Second leading cause of death in child abuse Cause Crushing blow to abdomen (punch, kick) Age Often >2 years Small bowel and/or gastric rupture Hematoma of duodenum and/or jejunum Contusion and/or laceration of lung, pancreas, liver, spleen, kidney Traumatic pancreatic pseudocyst Differential diagnosis of child abuse Normal periostitis of infancy Osteogenesis imperfecta Congenital insensitivity to pain Infantile cortical hyperostosis Menkes kinky hair syndrome Schmid-type chondrometaphyseal dysplasia Scurvy Congenital syphilitic metaphysitis
man, reading that my first instinct is to turn away and ignore it. but of course that behaviour is what allows the patterns to continue. my question is that do the abusers not know the damage they're causing? or are they indeed trying to cause that damage? is it the type of situation that they get caught up in the moment of - but then again this is 2007 - shouldn't we all know better?
that was kind of the point of doing the project... we should know not to physically abuse anyone let alone a child in it's most fragile state of development.... but we SHOULDN'T know better from a medical perspective, we shouldn’t pretend to know anything in general we’re not fully versed in... SBS has been so widely publicized and endorsed by children’s rights activists that the science behind it has taken a back seat to sensationalism... can a child sustain the damage as described by mr. dan through SBS? yes. is every child with such damage a victim of SBS? new evidence points to no, so we should leave things we don't know to the experts and not toy with peoples lives.
The problem with that mr. smiles is i'm a medical student more than 4 years away from being an attending physician. I'm also 4 years ahead of where you are. The sensationalism in this case is actually the people who take one case that might have been falsely dianosed out of more than 5,000 cases. I don't claim to be a radiologist even if I spent 4 more years studying medicine I would not be the one to make the call. The call would be made by someone who does nothing but look at the human anatomy by various MRI and CT exams as well as an opthomologist who does nothing but look at eyes and conduct fundoscopic exams all day long. That together with the outward signs of trauma is a science just as the science of ballistics is a science and can determine the distance a certain caliber weapon is discharged from and the characteristic powder burns and angle and markings placed on the bullet from the specific gun through extensive analyses. So you see your side is actually the sensationist side lacking in science. The loud sirens going off in the medical profession include those who hunger for name recognition and notoriety by picking selected questionable cases and making a big deal out of it. When I here a gallop I think of horses first and not zebras.
Additionally, one of the major tip offs to child abuse is injury that is delayed in reporting or is not explainable by the parents. If the parent shows up with a kid where all the descending motor tracks have been sheared off and he is bleeding from the retinas and has subdural hematomas and states "Duh I don't know what happened he was just sitting in the crib and then he starts crying" with a history of being arrested for child neglect and psychiatric hospitilizations and a criminal record a mile long then that might just be a tip off that something isn't kosher.
It's pretty funny how lawyers and sensationalists can so easily turn the views of the public who love conspiracy theories. All it takes is a "if the glove doesn't fit you must aquit" despite overwhelming scientific evidence and DNA sampling. A large number of the popularion are ignorant drunks, addicts, dyslexics and retards that do nothing but watch day time tv and gain 100's of pounds until they die of eating fried chicken.
dude no need to rant... there are other cases, i've finished my assig. so I don’t feel like bringing them up... I don't even know what you're trying to argue... that there are idiots out there that beat their children? that there are neglectful incompetent parents that shake their babies? we know this! it's funny you should compare it to GSR testing, like you said they do it throughout EXTENSIVE analysis and you don't disregard evidence to the contrary, this was for a forensics class so i'm well versed in the steps undertaken for all kinds of useless shit... and none of the sciences are perfect, none yield 100% matches, with that being said the golden rule is that you don't disregard contradictory evidence especially when it can put someone away for a very long time.... like they say… rather a thousand guilty men go free than one innocent be imprisoned… dude I’m not a med student, nor did I do the assignment from a medical standpoint….. but there is enough information out there done by trained professionals that suggests that doctors can be overzealous to dismiss a case as SBS
As for the person guilty in your example I'd be glad to do the stomping although I would rather be the spectator and watch Barry do it I bet he could exert quite a bit of force stomping on the back of a skull. You make a compelling case Michelle. There would be more uproar against this type of sick behavior if it were not for the after school special movie/documentary/editorial brainwash episodes. I picture the type of individuals that would do this kind of abuse as typical x or y generation, frustrated because they have a responsibility they do not want, feeling sorry for themselves, punks. They are miserable about their standing in life, and all their life have not accepted any responsibility for their own actions, or the result thereof. A baby comes into the picture and here is their target. The victim to blame as the cause for all their misery something they can blame, hate, and retaliate against safely. As for the idea of trust-worthy science. I'm not necessarily buying it. Sorry. The scientific community simply put has spent most all of its integrity capital lately in my view. Your example seems compelling enough however and I would be doubly suspicious of some "glove doesn't fit must acquit" defense lawyer shitbag. So the scales are tipped in your favor none the less.
Smiles, Michelle hey look you are both right. This is my point regarding issues that tend to strike a deep nerve there is an equally passionate reaction taken. The only point is I have to disagree with the “1000 go free to prevent convicting one falsely” idea. I say if there are 100 wrongful convictions per thousand I'm cool with that. I'll write a consolatory letter to the guys in prison something like: "Look if your innocent well ...sorry dude but it is for the better good so suck it up and be a man about it three hots and a cot isn't so bad. But if you’re guilty just remember this life is only the beginning of your horror."
