Pediatric hematology and oncology
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Pediatr Hematol Oncol · Oct 1992
Randomized Controlled Trial Comparative Study Clinical TrialAnalgesia in children with sickle cell crisis: comparison of intermittent opioids vs. continuous intravenous infusion of morphine and placebo-controlled study of oxygen inhalation.
The objectives of the study were to compare the efficacy and safety of a continuous infusion (CIV) of morphine and intermittent parenteral opioids (IPO) in children with sickle cell vaso-occlusive crises (VOCs); to determine whether 50% oxygen administration through a face mask can reduce the duration of severe pain in patients receiving CIV morphine; and to measure morphine concentration at steady state for pharmacokinetic and pharmacodynamic analysis in patients receiving CIV morphine. The study was designed as a prospective, controlled, "before-and-after" evaluation of two different analgesic regimens. For patients receiving CIV morphine, there was a randomized, double-blind, placebo-controlled study of O2 vs. air. ⋯ Total body clearance (TBC) of morphine was greater in children before puberty than after (40.4 +/- 10 vs. 28 +/- 11 mL/kg/min; p < 0.05). In conclusion, in children with severe VOCs, continuous infusion of morphine provides better analgesia than intermittent opioid therapy. Fifty percent oxygen inhalation had no effect on the duration of pain.
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Pediatr Hematol Oncol · Oct 1992
Review Historical ArticleHistory of pediatric hematology and oncology in Finland: a brief review.
The history of Finnish pediatric hematology started in the late 1940s, but this field of pediatrics was not officially acknowledged before 1979. The Children's Hospital, University of Helsinki started hematological services in 1950 but at that time there was no position for a specialist--it was a "spare time" work until 1980 when a hematology/oncology ward was established led by a full time specialist. ⋯ The Blood Transfusion Service of the Finnish Red Cross has also played an important role in Finnish pediatric hematology. The remaining four University Hospitals have now established wards for pediatric Hematology/oncology.
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Pediatr Hematol Oncol · Jul 1992
Case ReportsYersinia infections in patients with homozygous beta-thalassemia associated with iron overload and its treatment.
Patients with homozygous beta-thalassemia are at increased risk of serious infections. Yersinia enterocolitica is an organism with a predilection for these and other iron-overloaded patients. Three young adult patients with beta-thalassemia who were chronically transfused and developed yersiniosis are reported. ⋯ Iron excess both immunologically compromises the host and greatly enhances yersinial growth. Desferrioxamine may make host iron even more bioavailable to Yersinia. Recognition of this association and unusual manifestations in these patients such as an appendicitis-like syndrome may direct clinicians to earlier antiyersinial therapy and temporary cessation of chelation.
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Pediatr Hematol Oncol · Jan 1989
Review Case ReportsNutritional vitamin B12 deficiency in infancy: three case reports and a review of the literature.
Three cases of vitamin B12 deficiency that occurred during infancy are presented. These cases appeared to be the result of pre-existing maternal deficiency. ⋯ In all three cases the hematologic and neurologic abnormalities were corrected with vitamin B12 therapy. The literature is reviewed and discussed with respect to the mechanism of the infants' vitamin B12 deficiency and neurodevelopmental manifestations.