Pediatric blood & cancer
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Pediatric blood & cancer · Jan 2015
Randomized Controlled Trial Clinical TrialTopical analgesia treats pain and decreases propofol use during lumbar punctures in a randomized pediatric leukemia trial.
Lumbar punctures are frequently performed in pediatric leukemia for central nervous system leukemic prophylaxis. The contribution of local anesthetic with deep sedation is unknown. The objective was to evaluate EMLA (eutectic mixture of local anesthetics) cream as a pain reliever in conjunction with propofol in the setting of routine lumbar punctures. ⋯ This study demonstrated that the combination of EMLA cream with propofol is beneficial. Topical analgesics are at the discretion of the oncologist, allowing us to advocate for patients by providing safe and efficacious pain management for lumbar punctures.
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Pediatric blood & cancer · Jan 2015
Multicenter StudyGrief reactions and impact of patient death on pediatric oncologists.
To examine pediatric oncologists' grief reactions to patient death, and the impact patient death has on their personal and professional lives. ⋯ Grief over patient death and the emotional labour involved in these losses are a robust part of the pediatric oncology workplace and have major impacts on pediatric oncologist's personal and professional lives. Interventions that focus on how to help pediatric oncologists deal with these reactions are needed.
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Pediatric blood & cancer · Jan 2015
Comparative StudyCoronary artery dilation and left ventricular hypertrophy do not predict morbidity in children with sickle cell disease.
Little is known about the clinical significance of coronary artery dilation (CAD) and left ventricular hypertrophy (LVH) in patients with sickle cell disease (SCD). ⋯ LVH and CAD are common findings in children with SCD; however, they are not associated with need for subsequent hospital or intensive care unit admission.
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Pediatric blood & cancer · Jan 2015
Dexmedetomidine and hydromorphone: a novel pain management strategy for the oncology ward setting during anti-GD2 immunotherapy for high-risk neuroblastoma in children.
Treatment of neuroblastoma with targeted immunotherapy using chimeric anti-GD2 monoclonal antibodies (ch14.18) is associated with significant pain requiring management with a high-dose opioid infusion. We present a case series of six children, for whom dexmedetomidine and hydromorphone infusions safely and effectively reduced the pain of ch14.18 therapy in the oncology ward setting. ⋯ Dexmedetomidine infusion may be an effective and safe pain management adjunct to opioid therapy for the pain of ch14.18 infusion.
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Pediatric blood & cancer · Jan 2015
Hematopoietic stem cell transplantation for patients with acute lymphoblastic leukemia and Down syndrome.
Hematopoietic stem cell transplantation (HSCT) is one curable option for high-risk acute lymphoblastic leukemia (ALL); however, transplant-related toxicities might be severe in patients with Down syndrome and ALL (DS-ALL). ⋯ Therapy-related mortality accounted for five out of seven deceased patients in this case series. Attempts to reduce toxicities should be considered in HSCT for patients with DS-ALL.