Pediatric radiology
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Pediatric radiology · Apr 2006
Case ReportsBasal ganglia germinoma in children with associated ipsilateral cerebral and brain stem hemiatrophy.
Germinoma is the most common and least-malignant intracranial germ cell tumor, usually found in the midline. Germinoma that arises in the basal ganglia, called ectopic germinoma, is a rare and well-documented entity representing 5% to 10% of all intracranial germinomas. The association of cerebral and/or brain stem atrophy with basal ganglia germinoma on CT and MRI is found in 33% of the cases. ⋯ The association of a focal lesion in the basal ganglia of children with progressive hemiparesis, neuropsychiatric symptoms and ipsilateral cerebral and/or brain stem hemiatrophy should prompt the diagnosis of ectopic germinoma, avoiding delay in the diagnosis and further irreversible clinical deterioration, in a malignancy with an otherwise favorable prognosis. In these patients, hemiatrophy preceding or accompanying the imaging depiction of a basal ganglia mass lesion is thought to be caused by a paraneoplastic process.
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Pediatric radiology · Apr 2006
CT for suspected appendicitis in children: an analysis of diagnostic errors.
Mistakes have been made by the use of CT in diagnosing children with suspected appendicitis. Although others have reported the frequency of diagnostic errors, we were unable to find any studies that addressed the specific situations in which diagnostic errors occurred in children with suspected appendicitis. ⋯ Isolated CT findings of an appendicolith, an enlarged appendix, or minimal fat stranding are not sufficient signs for the diagnosis of appendicitis. Pathological diagnosis rather than surgical findings should be used as the reference standard of true-positive imaging findings.
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Pediatric radiology · Apr 2006
Development and implementation of a hospital-based patient safety program.
Evidence from numerous studies indicates that large numbers of patients are harmed by medical errors while receiving health-care services in the United States today. The 1999 Institute of Medicine report on medical errors recommended that hospitals and health-care agencies "establish safety programs to act as a catalyst for the development of a culture of safety" [1]. In this article, we describe one approach to successful implementation of a hospital-based patient safety program. ⋯ Key components include the development of safety teams, provision of tools that teams can use to support an environment of safety, and ongoing program modification to meet patient and staff needs and respond to changing priorities. By moving patient safety to the forefront of all that we do as health-care providers, we can continue to improve our delivery of health care to children and adults alike. This improvement is fostered when we enhance the culture of safety, develop a constant awareness of the possibility of human and system errors in the delivery of care, and establish additional safeguards to intercept medical errors in order to prevent harm to patients.
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Pediatric radiology · Mar 2006
Case ReportsIngestion of multiple magnets: hazardous foreign bodies for children.
We report a case of perforation, fistula formation, and small bowel obstruction in a 2-year-old child who had ingested 32 small magnets. Multiple magnets will attract one another through the bowel wall and lead to pressure necrosis with complications. We recommend early surgical intervention before the onset of gastrointestinal complications if ingested multiple magnets have not moved on the follow-up radiograph. Both clinicians and the lay population need to be aware that multiple magnets can be hazardous foreign bodies for children.