Low-intensity lasers in pediatric oncology

The paper outlines the outcomes of treatment for complications associated with chemo- and radiation therapy in children with malignant neoplasms by using low-intensity laser radiation. The use of this therapy may reduce the duration of treatment of these complications by 1.5-2 times. The use of low-intensity laser radiation in the treatment of other complications that are common in pediatric oncological care is briefly described.     

Sociomedical service in the care system for children with oncological diseases

Children with oncological diseases and their families receive no adequate social and psychological support, which adversely affects the outcomes of treatment and prognosis in patients and in those who have been cured from malignant tumors and deteriorates their and their families' life quality. A concept of sociomedical measures, which has been worked out at the Research Institute of Pediatric Oncology and Hematology, N. Blokhin Russian Cancer Research Center, is built on the principle of interdisciplinary approach to providing care to children with malignant tumors and it implies the rendering the patient and his or her family various social and psychological supports at all stages of specialized care.     

Histopathology of inflammatory skin disease in oncological patients

The spectrum of cutaneous lesions in oncological patients includes entities encountered in the general population, lesions associated with underlying malignant processes (such as paraneoplastic syndromes) and conditions related to the immunosuppressed status of these patients or their antineoplastic treatment. The paraneoplastic syndromes represent a group of skin conditions that may precede or coexist with the diagnosis of malignancy and may also signal tumour recurrences. In general, there is a high prevalence of immunosuppression in oncological patients, related to the alteration of humoral and cellular immunity or their immunosuppressive therapy. Thus, these patients are especially susceptible to certain infections associated with high morbidity and mortality. Correct and early recognition of the cutaneous manifestations in oncological patients provides an important insight into underlying malignant process, possible complications (iatrogenic or not) and prognosis. In this review we offer a practical overview of inflammatory or neoplastic conditions associated with internal malignancies and cutaneous infectious in oncological patients.     

AIDS conference data on children

Studies concerning HIV in children are highlighted, revealing a gap in pediatric research volume compared to research in adults, and indicating differences in how drug effects are measured between pediatric studies and adult studies. Some positive results from pediatric studies are discussed, such as how having a cesarean section may decrease the chance of perinatal infection to less than 1 percent. One study supports the use of large doses of vitamin A supplements to cut the mortality rates of hospitalized HIV-positive children. Another study reveals that HIV-positive children benefit more from three- rather than two-drug regimens. The final study highlighted recommends treating HIV-positive pregnant women with approved or experimental HIV therapies as necessary.     

A Comparison of Specialized and Mainstreamed Preschools from the Perspectives of Parents of Handicapped Children

Mothers of 14 handicapped children placed in specialized preschoolsand 17 handicapped children placed in mainstreamed preschoolswere interviewed regarding factors which influenced their choiceof preschools and their evaluation (benefits and drawbacks)of their child's current preschool. The interview was conductedin two phases including a focused interview in the parents'homes and a telephone-administered questionnaire based on thethemes which emerged during the focused interview. Similaritiesand differences were found in the perspectives of mothers towardmainstreamed and specialized preschools. The major differencesincluded greater emphasis placed by mothers of mainstreamedchildren on exposure to normal peers and the "real world" andgreater emphasis placed by parents of children in specializedsettings on the need for having professionals assume responsibilityfor the education of their child so they can relax and work.     

Comparison between a Pediatric Health Promotion Center and a Pediatric Obesity Clinic in Detecting Metabolic Syndrome and Non-Alcoholic Fatty Liver Disease in Children

This study was done to evaluate the efficacy of health check-ups in children in detecting metabolic syndrome and non-alcoholic fatty liver disease (NAFLD) by comparing the pediatric health promotion center with the pediatric obesity clinic. Children who visited a pediatric health promotion center (n=218) or a pediatric obesity clinic (n=178) were included. Anthropometric data, blood pressure, laboratory tests, and abdominal ultrasonography were evaluated. Two different criteria were applied to diagnose metabolic syndrome. The prevalence of metabolic syndrome in the 2 units was 3.2%-3.7% in a pediatric health promotion center and 23%-33.2% in a pediatric obesity clinic. Significant differences were observed in the prevalence of each component of metabolic syndrome between the 2 units including abdominal adiposity, blood pressure, serum triglycerides, and fasting blood glucose (P<0.05). The prevalence of NAFLD was 8.7% and 71.9% in the 2 units according to liver enzymes and 5.9% and 61.8% according to ultrasonography (P<0.05). The prevalence of metabolic syndrome and NAFLD was higher among patients visiting the obesity clinic targeting obese children than that among patients visiting the health promotion center offering routine check-ups. An obesity-oriented approach is required to prevent obesity-related health problems in children.

Graphical Abstract

相似文献   

Mandatory Nap Times and Group Napping Patterns in Child Care: An Observational Study

Policy provision for naps is typical in child care settings, but there is variability in the practices employed. One practice that might modify children’s early sleep patterns is the allocation of a mandatory nap time in which all children are required to lie on their beds without alternate activity permitted. There is currently limited evidence of the effects of such practices on children’s napping patterns. This study examined the association between duration of mandatory nap times and group-level napping patterns in child care settings. Observations were undertaken in a community sample of 113 preschool rooms with a scheduled nap time (N = 2,114 children). Results showed that 83.5% of child care settings implemented a mandatory nap time (range = 15–145 min) while 14.2% provided alternate activities for children throughout the nap time period. Overall, 31% of children napped during nap times. Compared to rooms with ≤ 30 min of mandatory nap time, rooms with 31–60 min and > 60 min of mandatory nap time had a two-and-a-half and fourfold increase, respectively, in the proportion of children napping. Nap onset latency did not significantly differ across groups. Among preschool children, exposure to longer mandatory nap times in child care may increase incidence of napping.     

Mothers' Supervision and Perception of Young Children's Risk of Unintentional Injury in the Home

Investigated whether control exerted through supervision isbelieved by mothers to reduce risk of unintentional injury totheir children. 150 mothers of 1-, 2-, and 3-year-old childrenrated the risk of their child having an injury and indicatedwhat injuries they anticipated in different rooms of the homeunder four conditions of supervision. A clear effect of supervisionwas observed in that rated risk and the number of anticipatedinjuries decreased depending on whether the mother was in thesame room or not. Furthermore, a decrease was found when themother was in the same room engaged in the same activity asthe child (either playing with or being assisted by the child).The observed effects of supervision were less strong for olderchildren and for rooms perceived as less dangerous.     

Improvement of the organization of oncological aid under conditions of specific technogenic load on the population

Social and economic disbenifits due to mortality from malignant neoplasms were estimated taking into account the losses of man-years of work, mean life expectancy for the sick, losses from temporary disablement and invalidization caused by malignancies, and the cost of oncological aid. The study was based at an area in Uzbekistan subjected to pollution by industrial wastes from an uranium-extracting enterprise. A special purpose-oriented program has been elaborated for the correction of oncological aid currently provided to the workers of the Navoi mining and metallurgical works and the local population. Its implementation resulted in a 13% reduction of standardized mortality from malignant neoplasm in 2004 compared with 1999 and another 24% in 2009. The disbenefit prevented by the reduction of mortality at active ages is estimated at 60,6 mln rubles.     

Criteria for burn severity. Epidemiology. prevention, organization of management

Total body surface area burned and deep of the skin injury are the main determinants of the burn severity. Other factors like age of the patient, pathological conditions, pulmonary injury by smoke inhalation, wound localizations play also a major role. 500,000 cases of burn injuries occurred each year in France. Ten hundred are hospitalized among witch 3,000 are hospitalized in burn units. Burns by flames are the most common in adult severely burned patients. In children, for all type of injuries, and in adult patients suffering of light or medium injuries, hot liquids are the most frequent encountered agents. Obviously, prevention programs should markedly decrease the occurrence of burn injuries. Regulation modifications are probably more potent than information campaigns. There is 25 burn units in France. Unfortunately, these units take care of less than one third of all the burned hospitalized patients. The organization of a national network binding regional burn centers and local specialized units would probably improve the efficiency of burn therapy in our country.     

Evidence-based assessment, intervention and psychosocial care in pediatric oncology: a blueprint for comprehensive services across treatment

OBJECTIVE: This paper describes the translation of psychological research into clinical services in pediatric oncology, based on two decades of research and clinical services in the Division of Oncology at The Children's Hospital of Philadelphia (CHOP). METHOD: Two models helpful in conceptualizing clinical care underlying intervention work at CHOP are summarized: The Pediatric Psychosocial Preventative Health Model (PPPHM; Kazak, 2006) and the Medical Traumatic Stress Model, specific to pediatric illness and injury (Kazak, Kassam-Adams et al., 2006). RESULTS: Integration of these two models offers a "blueprint" for development and evaluation of services to children with cancer and their families relevant for all families across the complete spectrum of disease and treatment. CONCLUSION: The dissemination of evidence-based psychosocial practice in pediatric oncology remains a large and challenging goal. The proposed blueprint may facilitate collaborative work to help assure that children with cancer and their families have access to evidence-based care.     

Schlaflabor

Today, every doctor is required to learn about economic concerns of his specialized area and to take any measures necessary. In the context of the pediatric sleep laboratory, an analysis showed that the number of patients in the sleep laboratory has been at a constant low level since 2003, but the prevalence can expect far more patients. Based on a regional analysis, only 15 of 46 pediatricians in Augsburg and 13 of 21 from the surrounding area refer patients to the pediatric sleep laboratory Josefinum. This indicates that 31 doctors from Augsburg and 8 from the surrounding areas are not aware of the diagnostic possibilities of the sleep laboratory or are not sufficiently informed about sleep-related breathing disorders/sleep disorders in children. These results require the discussion of marketing activities for the SGE (strategische/Gesch?ftseinheit, strategic business unit) ??sleep lab??. Based on target group segmentation, doctors have to be divided depending on their frequency allocation into primary, middle or low allocater, while parents are divided into parents of patients who are infants, infants in nursery school, school children, the early school years, and older children and adolescents. A marketing mix of the various elements offers potential for success in the areas business to business (B2B) and for business to consumer (B2C) sectors. This, however, also includes ethical, moral, and legal risks. Ultimately only institutionalized marketing controlling will be able to ensure that the marketing is established as a management function, forcing the ongoing development of a niche product.     

Psychological practice in a pediatric rehabilitation hospital

Described 127 consecutive referrals to a newly formed psychological consultation service in a pediatric rehabilitation hospital. This setting served children whose needs for comprehensive care and long-term hospitalization could not be met effectively elsewhere in the community. The complex patient population included children with permanent mental and/or physical handicaps who had survived due to advances in medical technology, those with traumatic or congenital brain injury, failure to thrive, feeding problems, apnea, tracheostomy, child abuse, and psychosomatic disorders. A range of psychological services were offered, including specialized assessments and treatment planning for rehabilitation, home and school placement, direct treatment and monitoring of behavioral progress, and consultation with staff. Implications for the practice of pediatric psychology and service delivery to patients in pediatric rehabilitation settings are discussed.     

Neurodevelopmental MRI brain templates for children from 2 weeks to 4 years of age

Spatial normalization and segmentation of pediatric brain magnetic resonance images (MRI) data with adult templates may impose biases and limitations in pediatric neuroimaging work. To remedy this issue, we created a single database made up of a series of pediatric, age-specific MRI average brain templates. These average, age-specific templates were constructed from brain scans of individual children obtained from two sources: (1) the NIH MRI Study of Normal Brain Development and (2) MRIs from University of South Carolina's McCausland Brain Imaging Center. Participants included young children enrolled at ages ranging from 8 days through 4.3 years of age. A total of 13 age group cohorts spanning the developmental progression from birth through 4.3 years of age were used to construct age-specific MRI brain templates (2 weeks, 3, 4.5, 6, 7.5, 9, 12, 15, 18 months, 2, 2.5, 3, 4 years). Widely used processing programs (FSL, SPM, and ANTS) extracted the brain and constructed average templates separately for 1.5T and 3T MRI volumes. The resulting age-specific, average templates showed clear changes in head and brain size across ages and between males and females, as well as changes in regional brain structural characteristics (e.g., myelin development). This average brain template database is available via our website (http://jerlab.psych.sc.edu/neurodevelopmentalmridatabase) for use by other researchers. Use of these age-specific, average pediatric brain templates by the research community will enhance our ability to gain a clearer understanding of the early postnatal development of the human brain in health and in disease.     

The impact of a large-scale population-based asthma management program on pediatric asthma patients and their caregivers.

BACKGROUND: The consequences of pediatric asthma include missed school attendance, limitations in physical activity, and increased health care utilization and costs. Caregivers of asthmatic children are affected through missed work days and decreased job productivity. In response to these issues, a disease management program encompassing asthmatic children and their caregivers was developed as part of the core services offered to members of a large, national health care plan. OBJECTIVE: To determine the impact of the asthma management program on pediatric asthma patients and their caregivers over a 12-month period. METHODS: In this longitudinal study, 401 randomly selected member households with asthmatic children from 17 regional markets completed surveys before and after 12 months of participation in the asthma management program. Program interventions, which were tailored according to risk and need status, included various staggered educational mailings, reminder aids, videos, a peak expiratory flow rate meter, and telephonic case management. The Asthma Quality Assessment System survey, a battery of self-reported quality indicators, was used to solicit information from parents or caregivers of asthmatic children on issues pertaining to quality of life, asthma management skills and knowledge, and lost work/school days related to asthma. RESULTS: Statistically significant postprogram outcomes were observed in various domains, including a reduction in adverse utilization, symptomatology, and restricted activity days for children and lost work days for adult caretakers. CONCLUSIONS: These findings demonstrate that a large-scale population-based intervention program can produce measurable clinical and economic benefits, thereby lessening the burden of asthma on the family unit.     

Antifungal drugs for pediatric use]

There are no specialized formulations of antifungal drugs in Japan which are prepared for children. Modification of the therapeutic doses by age groups or by body weight of the patients from the recommended doses for adults as well as special precautions against side effects are needed for pediatric use. Reports focusing on the side effects of topical and systemic antifungal drugs are reviewed. All the newly introduced systemic drugs, such as fluconazole, itraconazole and terbinafine, have been well tolerated during the treatment of fungal infections of neonates and infants.     

Sentinel node biopsy for melanocytic tumors in children

Sentinel node biopsy is as pivotal for the staging of pediatric melanoma patients as it is for adults. However, pediatric patients frequently present the clinician with pigmented lesions-such as atypical Spitz tumors or Spitzoid melanomas-that are not easy to classify as benign or malignant, and often fall into a diagnostic gray area when assessed with light microscopy alone. For these lesions, the performance of sentinel node biopsy can contribute to an understanding of the lesion's biology. We present a strategy for incorporating sentinel node biopsy into the overall management approach to children with atypical pigmented lesions with features suspicious for melanoma. With the inclusion of additional adjunctive techniques such as comparative genomic hybridization, this algorithm may lend more diagnostic precision to difficult-to-classify lesions.     

Childhood neurofibromatosis: risk factors for malignant disease

Forty-five children with both neurofibromatosis and malignant tumors were compared with a pediatric population with neurofibromatosis without tumors to ascertain if any of the clinical manifestations of this disorder were associated with either tumor development or histology. No such factors emerged except that, in most of the optic glioma patients, the neurofibromatosis mutation was paternally inherited. Concordance of histologic tumor types was seen when malignancies occurred in affected family members, similar to that noted in the literature. Although cancer is independent of the other manifestations of neurofibromatosis and these manifestations may vary among family members, it appears that malignant tumors are often concordant when they occur within a family.