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1.
Karin Plummer Maria McCarthy Fiona Newall Elizabeth Manias 《Pediatric blood & cancer》2023,70(11):e30614
Background
Children hospitalized following hematopoietic stem cell transplantation (HSCT) experience complex and prolonged pain in response to the intensity of this treatment.Objectives
To describe how pain was managed for children during HSCT therapy and how contextual factors related to the clinical environment influenced healthcare providers' and parents' pain management practices.Methods
A qualitative case study was conducted and involved semi-structured interviews at two time points following transplantation (30 and 90 days) with parents (n = 10) and naturalistic observations of pain-related care provided to children (n = 29) during HSCT therapy by their healthcare providers (n = 10). Semi-structured interviews were also conducted with healthcare providers (n = 14).Results
The effectiveness of pain management interventions was hindered by the multifactorial nature of pain children experienced, a gap in the provision of psychosocial interventions for pain and a lack of evidence-based guidelines for the sustained, and often long-term, administration of opioids and adjuvant medications. Misconceptions were demonstrated by healthcare providers about escalating pain management according to pain severity and differentiating between opioid tolerance and addiction. Parents were active in the management of pain for children, especially the provision of nonpharmacological interventions. Collaboration with external pain services and the impact of caring for children in protective isolation delayed timely management of pain.Conclusions
There is a pressing need to create evidence-based supportive care guidelines for managing pain post transplantation to optimize children's relief from pain. If parents and children are to be involved in managing pain, greater efforts must be directed toward building their capacity to make informed decisions. 相似文献2.
Keri A. Streby Marguerite T. Parisi Barry L. Shulkin Brian LaBarre Rochelle Bagatell Lisa Diller Stephan A. Grupp Katherine K. Matthay Stephan D. Voss Alice L. Yu Wendy B. London Julie R. Park Gregory A. Yanik Arlene Naranjo 《Pediatric blood & cancer》2023,70(8):e30418
Background
Diagnostic mIBG (meta-iodobenzylguanidine) scans are an integral component of response assessment in children with high-risk neuroblastoma. The role of end-of-induction (EOI) Curie scores (CS) was previously described in patients undergoing a single course of high-dose chemotherapy (HDC) and autologous hematopoietic cell transplant (AHCT) as consolidation therapy.Objective
We now examine the prognostic significance of CS in patients randomized to tandem HDC and AHCT on the Children's Oncology Group (COG) trial ANBL0532.Study design
A retrospective analysis of mIBG scans obtained from patients enrolled in COG ANBL0532 was performed. Evaluable patients had mIBG-avid, International Neuroblastoma Staging System (INSS) stage 4 disease, did not progress during induction therapy, consented to consolidation randomization, and received either single or tandem HDC (n = 80). Optimal CS cut points maximized the outcome difference (≤CS vs. >CS cut-off) according to the Youden index.Results
For recipients of tandem HDC, the optimal cut point at diagnosis was CS = 12, with superior event-free survival (EFS) from study enrollment for patients with CS ≤ 12 (3-year EFS 74.2% ± 7.9%) versus CS > 12 (59.2% ± 7.1%) (p = .002). At EOI, the optimal cut point was CS = 0, with superior EOI EFS for patients with CS = 0 (72.9% ± 6.4%) versus CS > 0 (46.5% ± 9.1%) (p = .002).Conclusion
In the setting of tandem transplantation for children with high-risk neuroblastoma, CS at diagnosis and EOI may identify a more favorable patient group. Patients treated with tandem HDC who exhibited a CS ≤ 12 at diagnosis or CS = 0 at EOI had superior EFS compared to those with CS above these cut points. 相似文献3.
Jacques Rigo Jean-Michel Hascoët Jean-Charles Picaud Fabio Mosca Amandine Rubio Elie Saliba Michaël Radkë Umberto Simeoni Bernard Guillois Nicholas P. Hays Mickaël Hartweg Claude Billeaud Johannes Spalinger 《Acta paediatrica (Oslo, Norway : 1992)》2020,109(3):527-533
Aim
This study examined the influence of different human milk fortifiers on biomarkers of gastrointestinal immaturity and inflammation in preterm infants.Methods
We report secondary outcomes from a controlled, double-blind, randomised, parallel group study conducted from 2011 to 2014 in neonatal intensive care units at 11 metropolitan hospitals in France, Belgium, Germany, Switzerland and Italy. Preterm infants born at up to 32 weeks or weighing up to 1500 g were randomised to a new powdered human milk fortifier (n = 77) or a control fortifier (n = 76) for a minimum of 21 days. We analysed faecal markers of gut inflammation, namely alpha-1 antitrypsin and calprotectin, and maturity, namely elastase-1.Results
Faecal alpha-1 antitrypsin was slightly lower in the new than control fortifier group after 21 days of full enteral feeding, with a geometric mean and standard deviation of 1.52 ± 1.32 vs 1.82 ± 1.44 mg/g stools (P = .01). There was no significant difference in faecal calprotectin (median [Q1-Q3] of 296 [136-565] μg/g stools in both groups combined at study day 21). Faecal elastase-1 was lower in the new fortifier than control fortifier group (202.5 ± 1.6 vs 257.7 ± 1.5 μg/g stools, P = .016).Conclusion
Mean values for each parameter were within the ranges in healthy term infants, indicating favourable markers of gastrointestinal status in both groups. In addition, for faecal calprotectin, the relatively high concentration observed in preterm infants fed fortified human milk suggests that the threshold level for detecting necrotising enterocolitis should be revised.4.
Kenji Mine Atsushi Ohashi Shoji Tsuji Jun‐ichi Nakashima Masato Hirabayashi Kazunari Kaneko 《Acta paediatrica (Oslo, Norway : 1992)》2013,102(8):e347-e352
Aim
Haemodynamically significant patent ductus arteriosus (hsPDA) is frequently observed in premature infants. This study was conducted to explore whether the blood BNP can be a valuable biomarker to assess the necessity of treatment for hsPDA in premature infants.Methods
Serial measurements of the blood BNP were performed during the first 5 days of life in premature infants with hsPDA (Group I) and those without hsPDA (Group N). The definition of the hsPDA was the PDA requiring treatment, such as indomethacin administration and/or surgical ligation.Results
Forty‐six subjects were enrolled. Compared with Group N, Group I showed significantly higher level of blood BNP at postnatal 24–96 h and demonstrated the peak value at postnatal 24–48 h. With the ROC curve using the data at postnatal 24–48 h in Group I, we deduced the predictive value of 250 pg/mL of blood BNP for indomethacin treatment. Similarly, with the ROC curve using the maximal value of blood BNP within the first 5 days of life, the predictive value of 2000 pg/mL for surgical ligation was deduced.Conclusions
Blood BNP during early postnatal period can be a useful biomarker to assess the necessity of treatment for hsPDA in premature infants. 相似文献5.
Objective
To show utility of telemedicine to children in Indian subcontinent. 相似文献6.
Nearly half of the adolescents in an Italian school‐based study exceeded the recommended upper limits for daily caffeine consumption
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Barbara Santangelo Rosa Lapolla Irene Rutigliano Massimo Pettoello Mantovani Angelo Campanozzi 《Acta paediatrica (Oslo, Norway : 1992)》2018,107(6):1055-1059
Aim
No data are available on caffeine consumption among Italian adolescents. We investigated caffeine intake from coffee, soft drinks and energy drinks in a sample of Italian adolescents and determined if they exceeded the recommended limits.Methods
The study comprised 1213 adolescents with a mean age of 15.1 years (range 12–19) from four schools in Foggia, southern Italy. Caffeine intake was assessed using an anonymous self‐reported questionnaire during the 2013/2014 school year. We calculated the percentage of daily caffeine consumers, their mean intake of caffeine from beverages and the contribution of each beverage category to the total caffeine intake.Results
Approximately 76% of the sample consumed caffeine every day, amounting to 125.5 ± 69.2 mg/day and 2.1 ± 1.2 mg/kg/day. When we applied the reference values from the Academy of Pediatrics, we found that 46% of the adolescents exceeded the recommended upper limits. Coffee was the most frequently consumed caffeinated drink and the main contributor to daily caffeine intake.Conclusion
More than three quarters (76%) of the Italian adolescents in our study drank coffee on a daily basis and nearly half (46%) exceeded the recommended upper limits. Strategies are needed to reduce caffeine consumption by adolescents. 相似文献7.
Helena Lindgren Malin Carvalho Nejstgaard Martin Salö Pernilla Stenström 《Acta paediatrica (Oslo, Norway : 1992)》2018,107(5):875-885
Aim
We evaluated bowel function in healthy children with regard to gender and age.Methods
The study was carried out in 2016 at a tertiary children's hospital. Healthy children aged 3.5 years to 15 years who were admitted to the hospital, siblings to patients or offspring of staff members were included. Validated self‐report questionnaires and internally developed questions regarding obstructive outlet‐ and gas‐related symptoms were used.Results
A total of 310 participants (50% girls) were included, which corresponded to a 94% answer frequency. Respondents were divided into a younger age group (3.5 years to seven years), consisting of 135 children, and an older age group (eight years to 15 years), consisting of 175 children. Younger children reported more foul odours than older children (50% vs. 29%, p = 0.001) and more obstructive symptoms (21% vs. 10%, p = 0.01). There was no difference between the age groups regarding constipation (19% vs 16%, NS). Overall, 55% of those with constipation had no treatment for the condition, although they reported abdominal pain (51%) and problems with foul odours (57%).Conclusion
Healthy children frequently reported constipation, abdominal pain and gas‐related problems, but treatment was rare. Overall, bowel function seemed to improve during childhood, although constipation remained largely untreated. 相似文献8.
The effect of montelukast on early‐life wheezing: A randomized,double‐blinded placebo‐controlled study
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Background
Cysteinyl‐leukotrienes are increased in the airways of infants with virus‐associated wheezing. We aimed to determine the effects of a cysteinyl‐leukotriene‐1 receptor antagonist on symptoms during an early‐life wheezing illness and to investigate the factors that affect the response to this drug.Method
This placebo‐controlled double‐blinded randomized controlled trial recruited children aged 3‐36 months with wheezing illness and randomized to active drug or placebo for 56 days. A symptom score diary (SSD) was kept by the children's caregivers.Results
One‐hundred patients completed the study, and 62 (30 montelukast and 32 placebo) were analyzed. There were no significant differences in the percent of symptom‐free days, symptom scores, and the need for rescue salbutamol between the two groups. However, the percent of symptom‐free days within the first week was significantly higher for the montelukast than for the placebo group (13.8 ± 4.1% vs. 5.4 ± 3.4%; P = 0.028); wheezing score at 7th day was significantly lower for the montelukast than for the placebo group (0.5 ± 0.1 vs. 1.4 ± 0.2; P = 0.002). In addition, the number of inhaled ß2‐agonist rescue episodes per day during the first week was significantly lower for the montelukast compared with the placebo group (12.7 ± 1.8 vs. 19.2 ± 1.6; P = 0.013).Conclusions
Our results indicate that montelukast may be effective for reducing caregiver‐observed wheezing and the need for salbutamol during the first week of treatment for early‐life wheezing. The impact for caregivers and the optimal duration of treatment will need to be explored in studies of larger size. 相似文献9.
Holly J. Roberts Yujie Wang Jessica L. Spruit Laura Taylor Andrea T. Franson 《Pediatric blood & cancer》2023,70(3):e30115
Background
Palliative care (PC) provides numerous benefits for children with cancer. Pediatric patients with high-grade glioma (HGG) are particularly well suited for early PC involvement given their high symptom burden and poor prognosis. However, studies continue to reveal that children with cancer, including HGG, have delayed PC involvement. We hypothesized that clinical trial enrollment may lead to a lack of or delay in PC involvement in this population.Procedure
For each patient in our cohort of 43 pediatric patients with HGG, demographic, diagnostic, therapeutic, clinical trial enrollment, and PC information were collected. Statistical analysis was performed comparing PC characteristics between patients who did and did not enroll in a clinical trial.Results
Seventy-two percent of patients had at least one visit with a PC provider. Fifty-six percent of patients enrolled in a clinical trial with HGG-directed therapy. Seventy-one percent of patients who enrolled in a clinical trial received specialty PC compared to 74% of non-trial participants (p = 1.000). Patients who enrolled in clinical trials received PC earlier in their disease course measured in days before death (mean = 177 days) compared to those who did not enroll (mean = 113 days, p = .180), though not statistically significant.Conclusions
The prevalence of clinical trial enrollment is high in patients with HGG and will likely increase as the genomic/epigenomic landscape of these tumors is better understood. As such, our data reassuringly suggest that trial participation does not interfere with the receipt of specialty PC in this population. 相似文献10.
Petra Kühr Rodrigo Antunes Lima Anders Grøntved Niels Wedderkopp Heidi Klakk 《Acta paediatrica (Oslo, Norway : 1992)》2020,109(3):595-601
Aim
We evaluated the effect that increasing physical education lessons from 1.5 to 4.5 hours per week for 5 years had on the body mass index (BMI) and waist circumferences of children aged 5-11 years at inclusion.Methods
From 2008 to 2013, six intervention schools in Svendborg, Denmark, delivered 4.5 hours of physical education lessons per week to 750 children. Meanwhile, four matched control schools gave 549 children the standard 1.5 hours of physical education lessons per week. Measurements were taken at baseline and yearly for 5 years. Of the 1299 children, 81 joined the schools after 2008.Results
At baseline, the percentage of overweight children was 12% in the intervention schools and 13% in the control schools, whereas 15% and 19% were abdominal obese, respectively. After 5 years, the respective risks of remaining abdominal obese or overweight were 43% and 51% in the intervention schools and 78% and 84% in the control schools. Mean BMI increased 0.450 kg/m2 more in the control group over the five-year period. The intervention was not effective in decreasing the average waist circumference.Conclusion
Three times as much physical education lessons per week, for 5 years, effectively decreased BMI and the likelihood of remaining overweight or obese.11.
A randomised cross‐over study showed no difference in diaphragm activity during weaning from respiratory support
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Hilde Brenne Kristine Hermansen Grunewaldt Turid Follestad Håkon Bergseng 《Acta paediatrica (Oslo, Norway : 1992)》2018,107(10):1726-1732
Aim
We measured electrical activity of the diaphragm (Edi) to compare the breathing effort in preterm infants during weaning from respiratory support with high‐flow nasal cannulae (HFNC) or nasal continuous positive airway pressure (nCPAP).Methods
This randomised cross‐over study was carried out at St Olav's University Hospital, Trondheim, Norway, from December 2013 to June 2015. We gave 21 preterm infants weighing at least 1000 g HFNC 6 L/minute for four hours and nCPAP 3 cmH2O for four hours with a one‐hour wash‐out period. Measurements included diaphragmatic load, Edi, vital signs and a modified Silverman‐Andersen Retraction Score.Results
We found no differences in HFNC and nCPAP in the median Edi peak (8.0 μV versus 7.8 μV, p = 0.095), median Edi min (1.1 μV versus 1.2 μV in, p = 0.958) or mean heart rate (157 versus 159, p = 0.300) in the 21 infants who took part. The mean respiratory rate was significantly lower during HFNC than nCPAP (47 versus 52, p = 0.012). The modified Silverman‐Andersen Retraction Score showed no significant differences.Conclusion
This study of preterm infants found no difference in the breathing effort measured by Edi between HFNC 6 L/minute and nCPAP 3 cmH2O. HFNC could replace nCPAP when preterm infants are ready for weaning. 相似文献12.
Poor family functioning mediates the link between childhood adversity and adolescent nonsuicidal self‐injury
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Matthew Cassels Anne‐Laura van Harmelen Sharon Neufeld Ian Goodyer Peter B. Jones Paul Wilkinson 《Journal of child psychology and psychiatry, and allied disciplines》2018,59(8):881-887
Background
Non‐suicidal self‐injury (NSSI) is a common harmful behavior during adolescence. Exposure to childhood family adversity (CFA) is associated with subsequent emergence of NSSI during adolescence. However, the pathways through which this early environmental risk may operate are not clear.Aims
We tested four alternative hypotheses to explain the association between CFA and adolescent‐onset NSSI.Methods
A community sample of n = 933 fourteen year olds with no history of NSSI were followed up for 3 years.Results
Poor family functioning at age 14 mediated the association between CFA before age 5 and subsequent onset of NSSI between 14 and 17 years.Conclusions
The findings support the cumulative suboptimal environmental hazards ( proximal family relationships as a mediator) hypothesis. Improving the family environment at age 14 may mitigate the effects of CFA on adolescent onset of NSSI. 相似文献13.
Florent Guérin Hélène Martelli Timothy Rogers Ilaria Zanetti Sheila Terwisscha van Scheltinga Federica De Corti Gabriella Guillen Burrieza Véronique Minard-Colin Daniel Orbach Max M. van Noesel Marie Karanian Raquel Dávila Fajardo Johannes H. M. Merks Andrea Ferrari Gianni Bisogno 《Pediatric blood & cancer》2023,70(7):e30374
Background
To assess the outcomes of pediatric patients with undifferentiated embryonal sarcoma of the liver (UESL) and treatment including at least surgery and systemic chemotherapy.Methods
This study included patients aged up to 21 years with a pathological diagnosis of UESL prospectively enrolled from 1995 to 2016 in three European trials focusing on the effects of surgical margins, preoperative chemotherapy, use of radiotherapy (RT), and chemotherapy.Results
Out of 65 patients with a median age at diagnosis of 8.7 years (0.6–20.8), 15 had T2 tumors, and one had lymph node spread, 14 were Intergroup Rhabdomyosarcoma Study (IRS) I, nine IRS II, 38 IRS III, and four IRS IV. Twenty-eight upfront surgeries resulted in five operative spillages and 11 infiltrated surgical margins, whereas 37 delayed surgeries resulted in no spillages (p = .0119) and three infiltrated margins (p = .0238). All patients received chemotherapy, including anthracyclines in 47. RT was administered in 15 patients. With a median follow-up of 78.6 months, 5-year overall and event-free survivals (EFS) were 90.1% (95% confidence interval [CI]: 79.2–95.5) and 89.1% (95% CI: 78.4–94.6), respectively. Two out four local relapses had previous infiltrated margins and two out of three patients with metastatic relapses received reduced doses of alkylating agents. Infiltrated margins (p = .1607), T2 stage (p = .3870), use of RT (p = .8731), and anthracycline-based chemotherapy (p = .1181) were not correlated with EFS.Conclusions
Multimodal therapy improved the outcome of UESL. Neoadjuvant chemotherapy for pediatric patients increases the probability of complete surgical resection. The role of anthracyclines and RT for localized disease remains unclear. 相似文献14.
Objective
To estimate the prevalence of serum zinc deficiency in children of 6 months to 60 months of age. 相似文献15.
Impact of ovarian transposition before pelvic irradiation on ovarian function among long‐term survivors of childhood Hodgkin lymphoma: A report from the St. Jude Lifetime Cohort Study
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Israel Fernandez‐Pineda Andrew M. Davidoff Lu Lu Bhaskar N. Rao Carmen L. Wilson D. Kumar Srivastava James L. Klosky Monica L. Metzger Matthew J. Krasin Kirsten K. Ness Ching‐Hon Pui Leslie L. Robison Melissa M. Hudson Charles A. Sklar Daniel M. Green Wassim Chemaitilly 《Pediatric blood & cancer》2018,65(9)
1 Background
We reviewed the effect of ovarian transposition (OT) on ovarian function among long‐term survivors of childhood Hodgkin lymphoma (HL) treated with pelvic radiotherapy.2 Procedure
Female participants (age 18+ years) with HL in the St. Jude Lifetime Cohort Study (SJLIFE) were clinically evaluated for premature ovarian insufficiency (POI) 10 or more years after pelvic radiotherapy. Reproductive history including age at menopause and pregnancy/live births was available on all patients.3 Results
Of 127 eligible females with HL, 90 (80%) participated in SJLIFE, including 49 who underwent OT before pelvic radiotherapy. Median age at STLIFE evaluation was 38 years (range 25–60). In a multiple regression adjusted for age at diagnosis, pelvic radiotherapy doses > 1,500 cGy (hazard ratio [HR] = 25.2, 95% confidence interval [CI] = 3.1–207.3; P = 0.0027) and cumulative cyclophosphamide equivalent doses of alkylating agents > 12,000 mg/m2 (HR = 11.2, 95% CI = 3.4–36.8; P < 0.0001) were significantly associated with POI. There was no significant association between OT and occurrence of POI (HR = 0.6, 95% CI = 0.2–1.9; P = 0.41).4 Conclusions
OT did not appear to modify risk of POI in this historic cohort of long‐term survivors of HL treated with gonadotoxic therapy. Modern fertility preservation modalities, such as mature oocyte cryopreservation, should be offered to at‐risk patients whenever feasible. 相似文献16.
Esther Saguil Josefina Almonte Wilma Baltazar Alfredo Acosta Alvin Caballes Antonio Catangui Celine Villegas 《Pediatric surgery international》2009,25(9):775-780
Introduction
We describe our experience with 22 conjoined twins managed from 1974 to 2006. 相似文献17.
Zhengyu Zhou Yubin Wang Huiying Zhou Meng Huang Huiting Liu Chengtai Hsieh Zhimou Xue 《Indian journal of pediatrics》2010,77(8):893-897
Objective
To evaluate the efficacy and safety of defibrillation on children according to AHA 2005 recommendations 相似文献18.
Purpose
This study aimed to develop and provisionally validate a novel scoring index for preoperative cancer-risk prediction in childhood ovarian tumors. 相似文献19.
Aim
To determine the occurrence and risk factors of sudden unexpected postnatal collapse (SUPC) in presumably healthy newborn infants.Methods
All live‐born infants during a 30‐month period, in five major delivery wards in Stockholm, were screened, and possible cases of SUPC thoroughly investigated. Infants were ≥35 weeks of gestation, had an Apgar score >8 at 10 min and collapsed within 24 h after birth. Maternal, infant, event characteristics and outcome data were collected.Results
Twenty‐six cases of SUPC were found among 68 364 live‐born infants, an incidence of 38/100 000 live births. Sixteen of these cases of SUPC required resuscitation with ventilation >1 min, and 14 of these remained unexplained (21/100 000). Fifteen of the 26 children were found in a prone position, during skin‐to‐skin contact, 18 were primipara, and 13 occurred during unsupervised breastfeeding at <2 h of age. Three cases occurred during smart cellular phone use by the mother. Five developed hypoxic–ischaemic encephalopathy (HIE) grade 2, and 4 underwent hypothermia treatment. Twenty‐five infants had a favourable neurological outcome.Conclusion
SUPC in apparent healthy babies is associated with initial, unsupervised breastfeeding, prone position, primiparity and distractions. Guidelines outlining the appropriate monitoring of newborns and safe early skin‐to‐skin contact should be implemented.20.
Determining the prevalence of vestibular screening failures in pediatric cancer patients whose therapies include radiation to the head/neck and platin‐based therapies: A pilot study
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Miranda L. Camet Susan S. Hayashi Belinda C. Sinks Jennifer Henry Katie Gettinger Ashley Hite Juliann Kiefer Caroline Mohrmann Taryn Sandheinrich Feng Gao Robert J. Hayashi 《Pediatric blood & cancer》2018,65(6)