Pediatric blood & cancer
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Pediatric blood & cancer · Jun 2005
ReviewPathophysiology of anthracycline- and radiation-associated cardiomyopathies: implications for screening and prevention.
Great progress has been made in treating childhood cancers over the past 40 years. Along with second malignancies, a major complication of anti-cancer therapies is adverse cardiovascular effects, especially cardiomyopathy and coronary artery disease. The pathophysiology and characteristics of cardiomyopathy associated with radiation therapy and anthracycline therapy are distinctive. ⋯ These distinctive cardiomyopathies require different screening tests. Appropriate screening of the entire cardiovascular system should be performed because radiation and chemotherapy affect the entire system. Prevention recommendations focus on cardiomyopathy and coronary artery disease.
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Approximately 70% of all children diagnosed with malignancy become long-term survivors. Anthracycline cardiotoxicity may complicate physical performance and invite a "spectrum of disuse." There is a paucity of information derived from longitudinal, prospective, randomized clinical trials of exercise in cancer survivors, and there are no guidelines concerning the risk of recreational (non-competetive) exercise in adolescent and young adult patients with anthracycline cardiomyopathy. This review will discuss screening procedures that should be performed when assigning exercise regimens to cancer survivors with or without evidence of left ventricular dysfunction. Current recommendations for exercise testing and exercise prescription are also provided.
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Pediatric blood & cancer · Jun 2005
Use of alternative and complementary therapies in children with cancer.
The use of complementary and alternative medicines (CAM) is becoming increasingly popular. Although considered beneficial by users, the potential for interaction or substitution with conventional treatment should not be overlooked by health care professionals. It is therefore important to gain insight into the prevalence and the factors related to the use of CAM. To establish the prevalence of use of CAM among children with cancer treated in a large pediatric hospital, describe the profile of use and factors related with use. As a secondary objective we aimed at measuring quality of life of the children aged 5 or more and compare the scores between users and non-users. ⋯ CAM is likely to be used by a wide variety of people. In our study, we found that about half of the children with cancer has used CAM in the 2 preceding months. No specific profile of CAM users emerged from this study. The high prevalence of CAM warrants further studies to better understand the reasons and consequences of CAM use particularly on quality of life.