Pediatric hematology and oncology
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Pediatr Hematol Oncol · Sep 2007
Practice of palliative sedation in children with brain tumors and sarcomas at the end of life.
Despite progress in the treatment of pediatric cancer, approximately 25% of these children will die of the disease. The last period of life is characterized by profound physical and psychological suffering, both of the children and their loved ones. Adequate alleviation of this suffering becomes the priority in the management of these patients. ⋯ Twelve of the 18 S patients received PS, as did 13 of the 19 BT patients. Indications for initiation of PS for those with BT were seizures and/or pain, for those with S were pain and/or respiratory insufficiency. It was concluded that PS may be the only efficacious and safe treatment for the alleviation of suffering in these children at the end of life, despite differing indications.
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Pediatr Hematol Oncol · Oct 2006
Intraindividual propofol dosage variability in children undergoing repetitive procedural sedations.
The authors prospectively assessed intraindividual variability in propofol dosage for induction of sedation in repetitive procedures in children with malignancies. A total of 80 procedures were performed in 24 children. ⋯ Twenty-five percent of the patients had a dose range of 0.0-0.5 mg x kg-1; 37.5%, >0.5-1.0 mg x kg-1; and 37.5% >1.0-2.2 mg x kg-1. Due to remarkable intraindividual differences, propofol dosage should be titrated toward the desired level of sedation.
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Pediatr Hematol Oncol · Jul 2006
Case ReportsHemophagocytic syndrome and acute liver failure associated with ethylene glycol ingestion: a case report.
The authors describe a case of accidental ethylene glycol poisoning in an 18-month-old boy who developed hemophagocytic syndrome (HPS). Ethylene glycol is a common substance in various antifreeze preparations. ⋯ The taking of a detailed history, physical examination, and laboratory testing are essential for diagnosis. To the best of the authors' knowledge this is the first case in the literature of a subject who developed HPS after ethylene glycol intoxication.
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Pediatr Hematol Oncol · Jul 2006
Case ReportsCardiac mucormycosis in a child with severe aplastic anemia: a case report.
Mucormycosis is an uncommon, severe, life-threatening fungal infection in the immunocompromised host. Mucormycosis with aplastic anemia is seen rarely. Only a few cases of cardiac mucormycosis with aplastic anemia have been reported in the literature. The authors present a case with severe aplastic anemia that did not respond to classic and immunosuppressive treatment for disease and developing invasive cardiac mucormycosis despite empiric treatment for febrile neutropenia.
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Pediatr Hematol Oncol · Apr 2006
Episodes of fever and neutropenia in children with cancer in a tertiary care medical center in Turkey.
The aim of this study was to determine the clinical features and microbiological spectrum during episodes of fever and neutropenia (FEN) in children with cancer. Demographics, clinical information, treatment approaches, and outcomes of the patients admitted to Akdeniz University Department of Pediatric Hematology and Oncology from October 1996 to June 2004 were evaluated retrospectively. Of the total 621 episodes, 345 (55.5%) were microbiologically documented (MDI) (36.4%) or clinically suspected (CSI) (19.2%) infections. ⋯ The rate of mortality was significantly higher among under 1-year-old patients (p = .039). Hypotension and uncontrolled cancer were the significant determinants of poor prognosis. These results may help to consider a more selective management strategy for children with these problems.