Lymphoblastic lymphoma of the palate.

Lymphoblastic lymphomas are neoplasms of immature or precursor lymphoid cells with no or limited bone marrow involvement, whose clinical presentation varies according to the immunophenotype. While mediastinal involvement is predominant in T-lymphoblastic lymphomas, B-lymphoblastic lymphomas frequently involve nodal sites. Extranodal presentation of B-lymphoblastic lymphomas is extremely rare.

Fever with Rashes.

Fever with rashes is one of the commonest clinical problems a general practitioner or pediatrician has to face in day-to-day clinical practice. It can be a mild viral illness or a life-threatening illness like meningococcemia or Dengue hemorrhagic fever or it can be one with a lifelong consequence like Kawasaki disease. It is very important to arrive at a clinical diagnosis as early as possible with the minimum investigational facilities.

Hypereosinophilia: A rare presentation of acute lymphoblastic leukaemia.

Acute lymphoblastic leukaemia (ALL) presenting as peripheral blood hypereosinophilia is very rare and the incidence is <1%. The characteristic feature of patients with ALL and hypereosinophilia is the absence of blasts in peripheral blood, and this might lead to misdiagnosis of ALL. It is important for clinicians and pathologists to be aware of this uncommon initial presentation of ALL to avoid delay in diagnosis.

Isolated Intracranial Myeloid Sarcoma Occurring as Relapse in Acute Myeloid Leukemia.

Myeloid sarcoma (MS) or chloroma is a rare extramedullary tumor composed of extramedullary proliferation of blasts of granulocytic, monocytic, erythroid, or megakaryocytic lineage occurring at sites outside the bone marrow. MS occurs in 2%-8% of patients with acute myeloid leukemia (AML), sometimes it occurs as the presenting manifestation of relapse in a patient in remission. We describe the case of a young male with AML in remission for 6 years presenting with central nervous system symptoms.

Mixed phenotypic acute leukemia with leukemia cutis and neuroleukemiosis.

Leukemia cutis and neuroleukemiosis are two rare extramedullary manifestations of acute leukemia. We report a 32-year-old woman with multiple skin lesions and painful peripheral neuropathy. Bone marrow biopsy and skin biopsy confirmed the diagnosis of mixed phenotypic acute leukemia.

Rhabdomyosarcoma of the Vagina in an Adolescent Girl.

Background: Gynecologic neoplasms are rare in children and represent only less than 5% of all childhood tumors. Rhabdomyosarcoma (RMS) of the female genital tract of children accounts for only 3.5% of the cases.

Ewing's Sarcoma of the Cranial Vault.

Primary Ewing's sarcoma (EWS) arising from cranial bones is rare and accounts for only 1%-4% of all EWS. We report the case of a 15-year-old girl with EWS of the frontoparietal region of the skull. She underwent excision following which she received combination chemotherapy with vincristine, doxorubicin, cyclophosphamide alternating with ifosfamide, and VP16 and local radiation of 45 Gy.

Lymphoblastic Lymphoma Presenting as Bilateral Ovarian Mass in an Adolescent Girl.

Background: Lymphomas rarely involve the genital tract and non-Hodgkin lymphoma (NHL) presenting as ovarian tumor is rare. Precursor B-cell lymphoblastic lymphoma arising from the ovary is extremely rare and to our knowledge, only 5 cases have been reported in the literature.

Case: A 15-year-old girl presented with bilateral ovarian masses, which, on biopsy proved to be precursor B-cell lymphoblastic lymphoma.

Mixed Phenotype Acute Leukemia Presenting as Leukemia Cutis.

Leukemia cutis (LC) is defined as infiltration of the skin by leukemic cells resulting in clinically recognizable cutaneous lesions. It is common in congenital leukemia and acute myeloid leukemia. However, LC has rarely been reported with mixed phenotypic acute leukemia (MPAL).

Bilateral synchronous plasmacytoma of the testis.

Extramedullary plasmacytoma (EMP) is usually seen in the head and neck regions and in the upper respiratory, gastrointestinal, and central nervous systems. Testis is a rare site for EMP, and bilateral synchronous testicular plasmacytoma occurring as an isolated event at initial presentation has been reported only once previously. We present herein the second such report in a 70-year-old man who underwent bilateral orchidectomy.

Primitive Neuroectodermal Tumor of the Vulva in an Adolescent Girl.

Extraskeletal primitive neuroectodermal tumor (PNET) is rare and that affecting the female genital tract is extremely rare. We report the case of a 17-year-old girl who presented with swelling of the clitorus. She underwent excision and histopathology was PNET.

Life course outcomes on mental and physical health: the impact of foster care on adulthood.

Objective: We compared the prevalence rates of mental health and physical health problems between adults with histories of childhood foster care and those without.

Methods: We used 2003-2005 California Health Interview Survey data (n = 70,456) to test our hypothesis that adults with childhood histories of foster care will report higher rates of mental and physical health concerns, including those that affect the ability to work, than will those without.

Results: Adults with a history of childhood foster care had more than twice the odds of receiving Social Security Disability Insurance because they were unable to work owing to mental or physical health problems for the past year, even after stratifying by age and adjusting for demographic and socioeconomic characteristics.

The Federal Deficit Reduction Act and its impact on children.

The Deficit Reduction Act of 2005 makes changes in the Medicaid program that may have a significant effect on children's health. Nurses and other health care professionals should be aware of these changes in order to monitor the impact of the legislation, guide families in the process of accessing needed services, and advocating on behalf of children and families.

The impact of insurance lapse among low-income children.

Children living in poverty not only have disproportionately more health problems, but also have disproportionately lower health care service utilization. Change, whether in health care delivery system or in family living situation, may interfere with or jeopardize insurance status and thereby influence access to health care services. We hypothesized that children who have maintained Medicaid insurance compared to those who have not will be more likely to have preventive care visits and less likely to have emergency room visits.

The interplay of national, state, and local policy in financing care for drug-affected women and children in California.

Recent prevalence studies in California indicate that perinatal alcohol and other drug use remains a serious issue for large numbers of women and their children. In response, national, state and local policymakers have taken steps to address the problem, including increasing funding for treatment services. To gauge the impact of policy attention to this problem, the Center for the Vulnerable Child at Children's Hospital, Oakland, California, surveyed state and local administrators of programs that serve drug-affected women and children in California.

Implementing critical health services for children in foster care.

This article reports recommendations that were developed at the California Conference on Health Care for Children in Foster Care, organized to discuss implementation in the state of CWLA's Standards for Health Care Services for Children in Out-of-Home Care. Programs and legislation developed in the state are also discussed.

Local perceptions of federal block grants.

We report the results of a survey of California county medical societies and county health officers on federal health block grants. Survey respondents agreed that the existing network of health services funded through the federal block grants and the current statelocal apparatus for providing these services are sound. Most respondents do not recommend major changes in the service system, and most support a strong state role in administering programs under the block grants.