ABSTRACT
This article describes the process for reporting and investigating child sexual abuse cases. Reporting mandates are discussed, as well as several concerns and criticisms about how these are implemented. The article also discusses a number of key issues related to the investigation of claims. The authors recommend greater use of multidisciplinary investigative teams and the development of comprehensive investigative protocols. Specific controversies, such as those concerning the use of video-taping, anatomical dolls, and validation tests, are also addressed.
Subject(s)
Child Abuse, Sexual/legislation & jurisprudence , Child , Child Abuse, Sexual/prevention & control , Child Advocacy/legislation & jurisprudence , Child, Preschool , Female , Humans , Male , United StatesABSTRACT
This report is a 20-year follow-up of 14 patients treated with external beam craniospinal irradiation and intrathecal gold (10-45 mCi) for medulloblastoma. Six of the patients died within 2 years of treatment from persistent disease. No patients are alive without complications. Six of eight surviving patients developed arachnoiditis and cauda equina syndrome within 5 to 10 years of treatment. Seven of eight survivors developed aneurysms and/or cerebrovascular accidents 9 to 20 years after treatment. Four of the cerebrovascular events were fatal. Intrathecal gold pools in the basal cisterns and cauda equina delivering an extremely inhomogeneous dose throughout the neuroaxis. Its use is discouraged.
Subject(s)
Arachnoiditis/etiology , Brachytherapy/adverse effects , Cerebellar Neoplasms/radiotherapy , Gold Radioisotopes/adverse effects , Injections, Spinal/adverse effects , Intracranial Aneurysm/etiology , Medulloblastoma/radiotherapy , Adolescent , Adult , Cerebral Hemorrhage/etiology , Cerebrovascular Disorders/etiology , Child , Child, Preschool , Female , Follow-Up Studies , Gold Radioisotopes/administration & dosage , Humans , Infant , MaleABSTRACT
The efficacy of an emulsion of perfluorochemicals (Fluosol-DA) to sensitize RIF-1 tumors of C3H mice to radiation was studied. An i.v. injection of 12 ml/kg of Fluosol-DA (20%) to tumor-bearing animals and keeping the animals in an atmosphere of a mixture of O2 (95%) and CO2 (5%) (carbogen) for 1 hr before and during irradiation of s.c. tumors in the thigh significantly enhanced the tumoricidal effect of radiation as measured with growth delay of the treated tumors. A lesser but significant enhancement of radiation damage in the tumors was also observed when the animals were kept in carbogen for 1 hr without injection of Fluosol-DA. It was concluded that Fluosol-DA increased the delivery of oxygen to hypoxic areas in the tumors and enhanced the response of hypoxic cells to radiation.
