Psychosocial impacts of a camping experience for children with cancer and their siblings

BACKGROUND: We conducted a prospective two-group evaluation of pediatric cancer patients and their siblings regarding experiences and affective changes resulting from a 1-week summer camp experience. METHODS: The patients and siblings were assessed prior to camp (Baseline), at the end of camp (Follow-up 1), and again 4-6 months later (Follow-up 2). Assessments included standardized tests for depressive affects, social competency, and a measure of pleasure and participation in camp activities. RESULTS: Sixty-six children were assessed, including 31 (47%) patients and 35 (53%) siblings. Ages ranged from 7 to 17 years. Of the patient campers 19 (61%) had leukemia or lymphoma and 12 (39%) had solid tumors. Results showed marked changes in affective symptoms for patient campers over time (improvements), not shown by sibling campers. For patient campers these affective changes were not present immediately after camp, but were quite significant when measured 4-6 months later. Both patient and sibling campers reflected the same positive memories and pleasure in camp activities over time. For neither group did memories or pleasure fade over time. The camping experience did not have differential impacts on first time versus returning campers. Twelve campers (18% of sample) indicated suicidal ideation on the measure of depressive affects. They did well at camp and presented no special management issues. CONCLUSION: Expectations appear substantially different for patient versus sibling campers. The camping experience appeared to impact these groups differently, with patient campers impacted in ways not experienced by sibling campers.     

Camper Learning and Friendship at Pediatric Oncology Camps in North America

Children with cancer and their families often attend specialized camps (therapeutic recreation) through their cancer treatment journey, yet little is known about the effects of these camps. A qualitative cohort study was used to assess learning and friendship development by campers attending one of four pediatric oncology summer camps during 2010 in North America. Standardized perceived change questionnaires developed by the American Camp Association were administered following camp attendance. Five-hundred and eighteen campers were enrolled: 120 (age 6–9 years) and 398 (age 10 and older). The largest positive response from the younger campers was observed for the question, “At camp did you learn to look forward to trying new activities?” For the older campers’ survey, the items “Becoming better at enjoying being with my friends,” “Becoming better at helping my friends have a good time when they are with me,” and “Becoming better at getting to know more things about my friends” were perceived to increase the most for the majority of campers compared to other questions. Items for which older campers most often perceived little change were “Becoming better at choosing people who would be good friends to be with” and “Becoming better at understanding friends’ emotions.” Camp helps children learn new activities as well as enjoy good times with friends. Dealing with one's own mistakes and understanding others’ emotions are areas for improvement. Ultimately it is hoped that these skills gained at camp will help build coping and resiliency for children/siblings affected by pediatric cancers.     

A multisite evaluation of summer camps for children with cancer and their siblings

ABSTRACT

Summer camps for pediatric cancer patients and their families are ubiquitous. However, there is relatively little research, particularly studies including more than one camp, documenting outcomes associated with children's participation in summer camp. The current cross-sectional study used a standardized measure to examine the role of demographic, illness, and camp factors in predicting children's oncology camp-related outcomes. In total, 2,114 children at 19 camps participated. Campers were asked to complete the pediatric camp outcome measure, which assesses camp-specific self-esteem, emotional, physical, and social functioning. Campers reported high levels of emotional, physical, social, and self-esteem functioning. There were differences in functioning based on demographic and illness characteristics, including gender, whether campers/siblings were on or off active cancer treatment, age, and number of prior years attending camp. Results indicated that summer camps can be beneficial for pediatric oncology patients and their siblings, regardless of demographic factors (e.g., gender, treatment status) and camp factors (e.g., whether camp sessions included patients only, siblings only, or both). Future work could advance the oncology summer camp literature by examining other outcomes linked to summer camp attendance, using longitudinal designs, and including comparison groups.     

Call for Systematic Population-Based Cervical Cancer Screening: Findings from Community-Based Screening Camps in Tamil Nadu,India

Background: In India, systematic cervical cancer screening under the national programme is yet to cover the entire population and therefore opportunistic or camp based approach is commonly practiced screening mode currently. This study presents the proportion of screen-positive women [positive visual inspection of the cervix with acetic acid (VIA) and/or Papanicolaou (Pap) smear results] and its associated factors from a rural community-based cervical cancer screening conducted in a service setting. Methods: In this cross-sectional study involving record review, data was drawn from free screening camps conducted by a non-governmental organization in two rural districts of Tamil Nadu, India between March 2015 and March 2017. The associations were assessed using adjusted prevalence ratio with 95% confidence interval. Results: A total of 5,207 women were screened from 307 camps. The mean age was 39.5 years (SD: 8.6). At least one symptom was observed among 2,245 women (43.1%). Of 5,207 women, 19.4% (n=1,009, 95% CI: 18.3%, 20.5%) were screen-positive. Screen positivity in women     

Clinical Research of a Modified Midfacial Degloving in a Maxillectomy （with a Report of a Typical Case）

OBJECTIVE To investigate the feasibility of employing a modified midfacial degloving in maxillectomy. METHODS Eight patients with carcinoma of the maxillary sinus underwent a modified midfacial degloving operation.The tumors were classified according to the 2002 AJCC system.The TNM staging of the cases was as follows:1 T4aN0M0,2 T3N0M0 and 5 T2N0M0.Of the 8 cases,1 patient underwent extended maxillectomy;exenteration of the orbit;tumorectomy of the sphenomaxillary and infratemporal fossae.Two patients received a total maxillectomy,and 5 a partial resection of the maxilla. Postoperative pathological report:4 well-di?erentiated squamous carcinoma,2 moderately-differentiated squamous carcinoma,1 mucoepidermoid carcinoma and 1 adenoid cystic carcinoma. RESULTS A modified midfacial degloving operation can sufficiently expose a field of operation,resect the tumor within a safe margin,and leave no facial cicatricles.One patient died of intracranial metastasis 8 months a er operation.We observed no recurrences or metastasis in other patients during the period of follow-up. CONCLUSION The major advantages of employing the modified midfacial degloving in maxillectomy is that a facial incision can be avoided.It has an advantage of minimal invasive surgery.     

Complications of a temozolomide overdose: a case report

Purpose and background This is a report of a 53 year-old man with a glioblastoma multiforme (GBM) treated with an excessive dose of temozolomide (TMZ).Methods This is a single case review of all clinically relevant records. O ⁶-methylguanine-DNA methyltransferase activity was determined by a biochemical assay.Results Following conventional radiotherapy (RT) without concurrent chemotherapy, the patient received 5,500 mg of TMZ over 2 days. At the standard dose of 200 mg/m²/day his total 5-day dose should have been 1,940 mg. Acutely he had nausea, vomiting and diarrhea for 2 days which cleared. The dominant severe toxicity was pancytopenia between one and four weeks after TMZ which was complicated by secondary infections that were successfully managed. Transient transaminitis occurred but there were no significant pulmonary, renal or other systemic toxicities. His progression free survival was 22 months and overall survival 24 months.Conclusion His outcome suggests that TMZ may prove to be a good agent for dose-escalation trials with hematopoietic stem cell rescue.     

Acute appendicitis as a sign of a colorectal carcinoma

The relationship of acute appendicitis occurring previous to cancer in colon and rectum was studied in the consecutive records of 561 patients, of 40 years of age and older, operated upon with an appendectomy because of acute appendicitis. Sixteen (2.9%) of these patients were readmitted within three years because of a carcinoma in colon or rectum. The incidence of carcinoma in the colon and rectum in the population, of the same age, is only 0.1%, according to the Swedish Cancer Registry (1). This difference is statistically significant. Where acute appendicitis and colon carcinoma co-exist, the danger is that the carcinoma may be missed. Therfore, any patient over the age of 40 presenting with acute appendicitis should be carefully checked for carcinoma in the colon.     

术者之行始于扶镜

胸外科手术技术已发生革命性变化,胸腔镜手术（video-assisted thoracic surgery, VATS）已经、正在成为各类胸部手术的主流方式。安全、高质、艺术化的VATS离不开扶镜手与术者默契的团队配合,如果说优秀的开放手术是术者脑、眼、手、体并用并无缝连接的整体配合的结果,那么,VATS的扶镜手则担负着两个人的眼睛,即本人和术者,这比照顾一个人脑、眼、手、体更为精细,更为困难。当然,优秀的扶镜手必将成长为不久将来优秀的术者。     

Pleomorphic xanthoastrocytoma as a component of a temporal lobe cystic ganglioglioma: a case report

We report a case of pleomorphic xanthoastrocytoma (PXA) as a component of a ganglioglioma in a 13-year-old Japanese boy. Magnetic resonance imaging showed a large cystic lesion with an enhanced mural nodule of the left temporal lobe. Microscopic examination of the tumor showed that it was composed of two distinct neoplastic components: dysplastic ganglion cells and a PXA. There were gradual transitions between the two neoplastic components, and the PXA constituted the gliomatous component of the ganglioglioma. The PXA component showed spindle-shaped and pleomorphic large cells with lipidized cytoplasm. The tumor cells were surrounded by numerous reticulin fibers. Immunohistochemically, the ganglion cells were negative for glial fibrillary acidic protein (GFAP), but showed positive staining for a 70-kDa neurofilament protein, synaptophysin, and NeuN. In contrast, PXA cells were positive for GFAP but negative for neuronal markers. Our case is therefore histologically classified as ganglioglioma with PXA as the glial component. These results suggested that PXA and ganglioglioma share a common origin and that the combination of PXA-ganglioglioma would be positioned along the spectrum between PXA and ganglioglioma. Alternatively, these results may support the hypothesis that PXA originates from glioneuronal progenitor cells capable of generating astrocytic and neuronal cell types.     

Leptospirosis: a report on a series of five autochthonous cases in a Greek region

Leptospirosis is a worldwide zoonotic disease difficult to diagnose both to the clinic and the laboratory. Many risk factors have been involved, such as planting, hunting, harvesting and butchering or sports, such as rafting. We reported our experience through a period of 20 months and we tried to investigate prognostic factors predicting clinical outcomes. Five male patients were admitted to our Department with a median age of 40 years. Overall, three out of five patients presented to other hospital and were transferred to ours with a wrong or delayed diagnosis. In terms of clinical signs and symptoms, all presented with fever, myalgia, headache and jaundice, whereas conjunctival suffusion was present in 80% of them. Acute renal injury and liver deficiency were diagnosed in all subjects. Acute renal failure management required dialysis in 3/5 patients, whereas renal recovery was achieved soon after clinical improvement. However, clinical awareness and serology are the most important tools for accurate and quick diagnosis in order to administer the appropriate therapy.     

Endobronquial metastasis of a ductal carcinoma in a male

Breast cancer in male is uncommon and 60% of the cases are presented in advanced stadiums of the disease. Malignant pleural effusion is a frequent form of presentation of breast cancer in women, being uncommon in males. We describe the case of a malignant pleural effusion and metastatic endobronchial of a ductal carcinoma of breast in male. A fifty five years old male, non-smoker, without other pathological recards, consulted our hospital because of a medical profile of 1 month of evolution of dyspnea of effort and dry cough. In the physical examination he only emphasized a hypophonesis in left side of chest and an exofitc injury in the right nipple. The blood analysis detected a mild normocitic anaemia and an ESR of 76 mm/h. The radiology of the chest showed a massive left pleural effusion, that was confirmed subsequently in a thoracic computed tomography scan. A bronchoscopy was practiced finding a tumor in the left principal bronchus which obstructed the light of the lumen. At the same time a mammography was accomplished, showing a nodule in the right breast suggestive of carcinoma whose aspirative puncture was positive for infiltrating ductal carcinoma moderately differentiated. Also, the result of the endobrochial biopsy was compatible with metastatic ductal carcinoma of the breast. No other metastasis were detected. The patient began chemoterapy during 6 cycles, appreciated a symptomatic improvement and a partial response in the thoracic computed tomography scan. After 6 months of follow-up the patient stays stable and without symptoms.     

Identification of multiple copies of a 20q-chromosome in a case of myelodysplastic syndrome: a FISH study

In myelodysplastic syndromes (MDS) karyotypic aberrations identify subgroups of patients with distinct clinical-morphological features and can be relevant in risk assessment of developing leukemia. Often conventional cytogenetic analysis is not sufficiently informative due to the presence of partially or completely unrecognizable chromosome markers. By chromosome microdissection (MD) and fluorescence in situ hybridization (FISH) we investigated the nature of a karyotypic marker occurring in multiple copies in one case of MDS arisen in a patient previously treated for breast cancer. Results showed dicentrics derived from telomeric fusion between interstitially deleted 20q-chromosomes. The abnormal karyotype resulted into polysomy for a deleted chromosome 20q.