Pediatric hematology and oncology
-
Pediatr Hematol Oncol · Apr 2006
Randomized Controlled Trial Comparative StudyExperience with cefepime versus meropenem as empiric monotherapy for neutropenia and fever in pediatric patients with solid tumors.
A prospective, open-label, randomized, comparative study in pediatric cancer patients was conducted to evaluate the efficacy and safety of cefepime and meropenem in the empiric therapy of febrile neutropenic patients. Febrile episodes were classified as microbiologically documented infection, clinical documented infection, or fever of unknown origin. Clinical response to therapy was classified as success or failure. ⋯ There was no infection-related death. There were no statistical differences between the cefepime and meropenem groups for duration of fever or neutropenia, response rate, and necessity for modification. Cefepime appears to be as effective and safe as meropenem for empiric treatment of febrile episodes in neutropenic pediatric cancer patients.
-
Pediatr Hematol Oncol · Mar 2005
Randomized Controlled Trial Comparative Study Clinical TrialA prospective randomized trial of the antiemetic efficacy and cost-effectiveness of intravenous and orally disintegrating tablet of ondansetron in children with cancer.
Orally disintegrating tablet (ODT) of ondansetron is a new formulation, which instantaneously disintegrates and disperses in the saliva without need for ingestion of a liquid. This makes the formulation suitable for administration in children. The objective of this study was to compare the relative efficacy and cost of ODT and intravenous (IV) formulation of ondansetron in controlling nausea and vomiting in children receiving chemotherapy regimens without cisplatin. ⋯ In the courses without corticosteroids complete response rates were not also different between the two arms. The mean costs per successfully controlled courses were 121.3 USD for the IV formulation whereas 63.2 USD for the ODT formulation. The results of this study confirmed that ODT formulation of ondansetron is a safe, well-tolerated, and cost-effective antiemetic for children during non-cisplatin-containing moderately and highly emetogenic chemotherapy.
-
Pediatr Hematol Oncol · Jan 2004
Comment Letter Randomized Controlled Trial Comparative Study Clinical TrialMidazolam compared with ketamine for invasive procedures.
The combination of ketamine and topical placebo cream was compared with the combination of midazolam and topical lidocaine-prilocaine cream (EMLA) in 13 children with leukaemia undergoing bone marrow punctures. This double-blind, randomized, crossover study showed that the children prefer midazolam and EMLA as sedation for invasive procedures and that some parents and the nursing staff have doubts because of the anxiety during the procedure and the physical restraint that often is necessary during midazolam and EMLA. Both methods cause several, more or less unpleasant, side effects.
-
Pediatr Hematol Oncol · Jun 2003
Randomized Controlled Trial Clinical TrialEffect of twice weekly versus daily iron treatment in Turkish children with iron deficiency anemia.
This study was designed to propose a more practical, effective, safer, inexpensive, and manageable alternative treatment of iron deficiency anemia (IDA) for the developing countries. The study involves 94 children between the ages of 5 months and 6 years who had been seen in the authors' hospital and diagnosed as having iron deficiency anemia. Ninety-four children with IDA were randomly divided into two groups: 48 children comprised the first group, which was administered conventional treatment, and 46 children comprised the second group, which was administered intermittent treatment involving iron administration 2 days a week. ⋯ With respect to certain parameters, such as red cell distribution, serum iron binding capacity, transferrin saturation, transferrin receptor, and transferrin receptor/log ferritin, however, intermittent treatment was superior to the conventional treatment method (p <.05). In IDA, when a conventional treatment method or an intermittent treatment method is used, there are no differences between the hematological parameters. In fact, the intermittent treatment method has been found to be superior in many parameters.
-
Pediatr Hematol Oncol · Dec 2002
Randomized Controlled Trial Clinical TrialThe efficacy of heparinization in prolonging patency of arterial and central venous catheters in children: a randomized double-blind trial.
This study evaluates the efficacy of heparinization in prolonging patency of arterial and central venous catheters in children. A randomized double-blind trial in a tertiary 10-bed pediatric intensive care unit was used to evaluate 300 children (age older than 4 weeks, younger than 18 years). Trial medication consisted of either NaCl 0.9% infusion or NaCl 0.9% infusion to which 1 IU of heparin per milliliter was added. ⋯ No significant risk increase for nonpatency could be demonstrated for the nonheparinized central venous catheters (RR: 7.63; 95% CI: 0.40-145). The median duration of stay of the patent arterial and central venous catheters was similar for both treatment groups. These results indicate that the use of normal saline in arterial catheters is associated with an increased frequency of catheter nonpatency as compared with heparinized saline.