Opinions on childhood cancer care and degree of agreement between patient/mother and mother/father pairs

During the past decades in Finland and internationally, numerous improvements have been made to relieve the inconveniencies faced by patients and their parents during childhood cancer treatment. The aim of this study was to find out which issues are rated differently by patients and proxies and also by mothers and fathers. The results may, in the future, guide us in planning the assessments aimed to be used near the time of treatment. In a cross-sectional setting, queries were performed from 3 to 48 months after diagnosis, and a questionnaire with visual analog scales was used. The issues in relation to disease, treatment, and social network were assessed. There were 99 families responding, which was 67% of all eligible families. An analysis of observer agreement of categorical assessments was performed between mother and father in 61 families, and between mother and school-aged patient in 34 families. Changes in appearance, influence of isolation, missing school, and treatment-related procedures such as venous punctures were rated more unpleasant/worrisome by school-aged patients than parents. Thus, these issues cannot be assessed reliably by proxies. Child's social relations, acute side effects of treatment, and perceived support and also adequacy of information from hospital team were quite reliably assessed by proxies. The influences of pain and procedures under anesthesia were, however, overestimated by the proxies. The concerns about acute symptoms, possibilities of recovery, and especially late effects did not seem to be an issue affecting the patients' well-being. However, these items did significantly bother the minds of the parents, especially mothers, and may thus have an indirect influence on the patients' life as well. The minor differences between the ratings of fathers and mothers could mainly be explained by mothers' major role as caregivers and fathers' role as breadwinners of the family. However, as fathers may be less involved in hospital-related issues, they also may miss some information and support provided by the hospital team.     

Panhypopituitarism after traumatic head injury

Introduction  We describe a case report of panhypopituitarism after traumatic head injury. A previously healthy young man suffered a closed head injury and multiple spinal fractures after a motorcycle accident. Methods  His treatment in the intensive care unit was prolonged because of numerous problems with raised intracranial pressure, hemodynamics, and electrolyte balance. Results  Eventually, hypocortisolism and other pituitary hormone deficiencies were diagnosed. Magnetic resonance images showed incoherent pituitary stalk and re-review of the first computed tomography scans of the day of the accident confirmed hemorrhage in the infundibulum. Conclusion  This case and review of the literature suggests that hormone deficiencies are not uncommon after head injuries.     

Association of physical activity to cardiovascular fitness and fatness in 12–13-year-old boys in different weight status

Aim

The aim was to examine the associations between physical activity (PA) and cardiovascular fitness (CVF) and fatness in boys (age 12.04?±?0.77 year) and to assess if weight status influences these associations.

Subjects and methods

Two hundred sixty-five boys participated in the study. PA was measured by accelerometry. Body fatness estimators included body mass index (BMI), body fat%, sum of five skinfolds and waist circumference. CVF was directly measured during stepwise incremental exercise test and expressed in peak oxygen uptake (VO_2peak) and maximal power output (W _max).

Results

All measured PA levels (except vigorous PA in obese boys) were significant predictors of W _max per kilogram of body mass in normal weight and obese boys. Vigorous PA, moderate-to-vigorous PA (MVPA), total PA in normal weight and vigorous PA in obese boys were significant predictors of W _max. Variation in VO_2peak per kilogram of body mass was significantly explained by moderate PA, vigorous PA, MVPA and total PA in normal weight only. For those of normal weight, vigorous PA, MVPA and total PA were negatively associated with body fat% and sum of five skinfolds. In obese boys, moderate PA and MVPA were negatively associated with BMI.

Conclusions

Time spent in vigorous PA and MVPA was associated with fatness parameters in normal weight and obese boys and with CVF parameters only in normal weight boys. Normal weight boys spent more time in vigorous PA and MVPA than overweight and obese boys and had high values in VO_2peak, VO_2peak per kilogram of body mass and W _max per kilogram of body mass.

     

Absence of polysialylated NCAM is an unfavorable prognostic phenotype for advanced stage neuroblastoma

Background  

The expression of a neural crest stem cell marker, polysialic acid (polySia), and its main carrier, neural cell adhesion molecule (NCAM), have been detected in some malignant tumors with high metastatic activity and unfavorable prognosis, but the diagnostic and prognostic value of polySia-NCAM in neuroblastoma is unclear.     

Analysis of swimming performance from physical, physiological, and biomechanical parameters in young swimmers

The purpose of this study was to examine the influence of the energy cost of swimming, body composition, and technical parameters on swimming performance in young swimmers. Twenty-nine swimmers, 15 prepubertal (11.9 +/- 0.3 years; Tanner Stages 1-2) and 14 pubertal (14.3 +/- 1.4 years; Tanner Stages 3-4) boys participated in the study. The energy cost of swimming (Cs) and stroking parameters were assessed over maximal 400-m front-crawl swimming in a 25-m swimming pool. The backward extrapolation technique was used to evaluate peak oxygen consumption (VO2peak). A stroke index (SI; m2 . s(-1) . cycles(-1)) was calculated by multiplying the swimming speed by the stroke length. VO2peak results were compared with VO2peak test in the laboratory (bicycle, 2.86 +/- 0.74 L/min, vs. in water, 2.53 +/- 0.50 L/min; R2 = .713; p = .0001). Stepwise-regression analyses revealed that SI (R2 = .898), in-water VO2peak (R2 = .358), and arm span (R2 = .454) were the best predictors of swimming performance. The backward-extrapolation method could be used to assess VO2peak in young swimmers. SI, arm span, and VO2peak appear to be the major determinants of front-crawl swimming performance in young swimmers.     

Pilot study on obesity in caries prediction

The aim of the present study was to explore the possibility of predicting the incidence of dental caries from obesity. The subjects were 516 children living in Luvia, Finland, born between 1972 and 1981. Obesity alone was not a very good predictor of dental decay. When predicting caries in the permanent first molars using both earlier obesity and earlier caries experience as predicting indicators, 65-70% of the true risk group was identified. This combination was even better for the prediction of caries in permanent second molars.     

Epidemiological risk assessment of mobile phones and cancer: where can we improve?

This paper aims to provide an overview of factors affecting the validity of epidemiological studies on health effects of mobile phone use. A qualitative review of published studies is presented, covering both risk assessment and exposure assessment. Considerable random error is likely to have occurred in studies carried out so far, primarily related to exposure assessment. Self-reported use of mobile phone appears to be imprecise. The relationship between the amount of mobile phone use and the radio-frequency field is unclear. Several factors affect the strength of the radio-frequency field emitted by the phone, and accommodating their effect has the potential to improve exposure assessment. The major opportunity to improve the quality of evidence is, however, through prospective studies. The major limitation of epidemiological studies addressing the health effects of mobile phone use is related to exposure assessment. These limitations are inherent in case-control studies. Quality of evidence can be improved by conducting prospective cohort studies.     

Hydrops fetalis associated with Ureaplasma urealyticum

A hydroptic newborn was born at 32 weeks' gestation and at the age of 14 h died of post-asphyxial syndrome. Immunologic causes of hydrops fetalis were excluded, as were anomalies and chromosomal aberrations. Ureaplasma urealyticum was isolated in bronchial secretions, lung tissue and brain tissue of the newborn. Our findings suggest that U. urealyticum infection should be considered in the differential diagnosis of hydrops fetalis.