Pediatric blood & cancer
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Methadone is frequently used in the treatment of adults with advanced cancer. A criticism of relevant research is the use of single or fixed doses, which does not reflect use in clinical practice. Literature about use of methadone in the treatment of pediatric patients is limited to case reports. The objective of this study is to describe methadone use as primary opioid analgesic for advanced pediatric cancer over a 6.5-year period. ⋯ With close monitoring, methadone therapy can be done safely in pediatric oncology patient populations in both inpatient and outpatient settings. Our experience suggests improvement in analgesia with the use of methadone, with 16 patients remaining on methadone until they died.
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Pediatric blood & cancer · Aug 2008
Peripherally inserted central venous catheters are a good option for prolonged venous access in children with cancer.
A long term venous access device is essential in children with malignancies for the safe administration of medication and to avoid repeated painful venipunctures. The advantage of peripherally inserted central venous catheters (PICC) over conventional central venous catheter (CVC) is easy bedside insertion without need for general anesthesia and theatre time. The purpose of this study was to evaluate our experience with PICCs particularly with regard to catheter life, reason for removal and complications in children suffering from various malignancies. ⋯ We found PICC to be a convenient, cheap, safe, and reliable device for long term intravenous access in children with malignancies. This was possible with the help of dedicated catheter care nurses.
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Pediatric blood & cancer · Aug 2008
Retrospective evaluation of pain assessment and treatment for acute vasoocclusive episodes in children with sickle cell disease.
This study was conducted to assess the care of pediatric patients hospitalized for sickle cell disease-related vasoocclusive episodes (VOE). The aim of this research was to illustrate the course of pain scores and methods of therapeutic intervention during hospitalization. ⋯ Despite opiate dosing within recommended guidelines, mean pain scores remain in the moderate to severe range for several days following hospitalization for VOE. Future research should explore the factors which influence pain scores, as well as improved pain assessment and management techniques.
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Pediatric blood & cancer · Jul 2008
Results in patients with cranial parameningeal sarcoma and metastases (Stage 4) treated on Intergroup Rhabdomyosarcoma Study Group (IRSG) Protocols II-IV, 1978-1997: report from the Children's Oncology Group.
Determine outcome of patients with cranial parameningeal sarcoma and concurrent metastases treated on Intergroup Rhabdomyosarcoma Study Group (IRSG) Protocols II-IV. ⋯ Cure was possible for some patients with metastatic cranial parameningeal sarcoma. Patients with the best outlook had embryonal RMS located in the nasopharynx/nasal cavity, middle ear/mastoid, or parapharyngeal region. Distant metastases were the most frequent type of recurrence, indicating that more effective systemic agents are needed to eliminate residual disease.
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Pediatric blood & cancer · Jul 2008
Treatment of uncomplicated vaso-occlusive crises in children with sickle cell disease in a day hospital.
Day hospital management for patients with sickle cell disease experiencing uncomplicated vaso-occlusive pain crises has been described in adult populations as an alternative care delivery system. The objective of this study was to characterize and descriptively assess the benefits of a day hospital exclusively designed for children. ⋯ We conclude that a dedicated Day Hospital facility has the potential to provide patient-centered, effective, and timely management of vaso-occlusive crises in children as well as adults.