Pediatric blood & cancer
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Pediatric blood & cancer · Oct 2013
Clinical TrialRacial and ethnic differences in hospice enrollment among children with cancer.
Hospice is an important provider of end of life care. Adult minorities are less likely to enroll on hospice; little is known regarding the prevalence of pediatric hospice use or the characteristics of its users. Our primary objective was to determine whether race/ethnicity was associated with hospice enrollment in children with cancer. We hypothesized that minority (Latino) race/ethnicity is negatively associated with hospice enrollment in children with cancer. ⋯ These results indicate that race/ethnicity and diagnosis are likely to play a role in hospice enrollment during childhood. A striking number of patients of all race/ethnicities left hospice prior to death. More studies describing the impact of culture on end of life decision-making and the hospice experience in childhood are warranted.
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Pediatric blood & cancer · Oct 2013
Clinical TrialMethylnaltrexone for opioid-induced constipation in pediatric oncology patients.
Pediatric oncology patients can experience opioid-induced constipation, which may not respond to laxative treatment. Methylnaltrexone is an opioid receptor antagonist that can reverse opioid-induced constipation without affecting analgesia. Published literature on the use of methylnaltrexone in children is very limited. This retrospective review describes the effectiveness and safety of methylnaltrexone for opioid-induced constipation in pediatric oncology patients. ⋯ This case series suggests that methylnaltrexone is safe and may be effective when given subcutaneously as a 0.15 mg/kg single dose to pediatric oncology patients with opioid-induced constipation.
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Pediatric blood & cancer · Oct 2013
Multicenter Study Meta Analysis Clinical TrialAssociation between baseline fetal hemoglobin levels and incidence of severe vaso-occlusive pain episodes in children with sickle cell anemia.
The ameliorating effect of high fetal hemoglobin (HbF) levels on the incidence of pain episodes in sickle cell anemia (SCA) is well-known; however, in children this relationship is less clearly established. We hypothesized that higher HbF levels in children with SCA are associated with fewer severe pain episodes. A meta-analysis of data from the Silent Infarct Transfusion Trial (n = 456) and the Cooperative Study of Sickle Cell Disease (n = 764), demonstrated that baseline HbF levels were associated with the incidence of severe pain, commonly defined across studies as an event requiring hospitalization (P-value = 0.02).
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Pediatric blood & cancer · Oct 2013
Clinical TrialClinically meaningful measurement of pain in children with sickle cell disease.
Limited understanding of the interpretability of patient-reported pain scores may impact pain management. The current study assessed the minimal clinically significant improvement in pain and pain scores signifying patient-reported need for medication and treatment satisfaction in patients with sickle cell disease (SCD). ⋯ The minimal clinical significant improvement was defined for the VAS and NRS and both scales were able to discriminate between important clinical findings including pain relief, need for pain medication, and treatment satisfaction. Collectively, this study provides data to improve our understanding of pain ratings of pediatric patients with SCD.