The purpose of this study was to ( a) determine the frequency of diagnostic errors in pediatric cancer, ( b) categorize errors, and ( c) underscore themes associated with misdiagnosis. This is a retrospective cohort study at a tertiary children's hospital of 265 patients with new oncologic diagnoses. The diagnostic error rate was 28%. Compared with those with no diagnostic error, those in whom there was an error were more likely to have ( a) more visits before diagnosis ( P < .001), ( b) not been seen in an acute care setting ( P = .03), ( c) inappropriate treatment ( P < .001), and ( d) misinterpreted laboratory studies or imaging ( P < .001). Themes in diagnostic errors were lack of appropriate evaluation for persistent symptoms (47%), failure to recognize signs and symptoms suggestive of malignancy (45%), and misinterpretation of tests (8%). Clinicians should consider diagnostic evaluation for multiple visits for the same complaint or a constellation of signs and symptoms suggestive of malignancy.
The indefinite mandatory detention on the mainland and in offshore processing centers of asylum seekers applying for protection in Australia is particularly controversial due to the government's notoriously harsh policy. In response, large-scale public protests have been staged across the country in recent years to register popular dissent and convey concerns to decision-makers. However, dominant media representations of protests have historically been largely negative, often cast as ineffectual at best, and at worst, violent clashes that alienate the broader population from the cause in question. This paper outlines a visual analysis of media representations of protests that took place in February 2016 against the proposed deportation of 267 asylum seekers from the Australian mainland as part of the #LetThemStay campaign. Through the analysis of four photographs from a range of media outlets, we found that depicting peaceful protests methods and community mobilization complicated dominant understandings of protests and protesters. Indeed, #LetThemStay demonstrated the political power of compassionate solidarity between participants afforded the privilege of safe residency and citizenship, and those forcibly absent who are denied such rights. As such, the paper highlights the impact of peaceful protesting, while also recognizing its limitations in changing Australia's punitive asylum seeker policies.
Septic arthritis can be a devastating condition that leads to further morbidity and potential mortality if not identified early in its course. Emergency providers must keep septic arthritis high on their differential of any joint-related pain in the pediatric population. We present a case of an eight-year-old female who initially presented with the chief complaint of chest pain and was subsequently diagnosed with septic arthritis of the left sternoclavicular joint in the emergency department.
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