Journal of pediatric hematology/oncology
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J. Pediatr. Hematol. Oncol. · May 2003
Positive blood cultures in sickle cell disease: time to positivity and clinical outcome.
To prospectively identify all cases of bacteremia in children with sickle cell disease (SCD), establish time to positivity for various microorganisms, correlate clinical findings with microbiology data, and determine the antibiotic resistance pattern of the pneumococcal isolates. ⋯ The average time to positivity for pathogens can be used in conjunction with other factors to determine the length of observation required for children with SCD who present with febrile illness. Chest radiographs should be obtained on children with SCD who are bacteremic with S. pneumoniae. Bone scans should be obtained on children with SCD who are bacteremic with Salmonella or S. aureus.
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J. Pediatr. Hematol. Oncol. · May 2003
Audiotaping communication of the diagnosis of childhood leukemia: parents' evaluation.
To evaluate how parents viewed the authors' practice of audiotaping the initial communication of the leukemia diagnosis and of the complete program of care, including the prognosis. ⋯ The authors' use of audiotapes was strongly supported by the parents as a supplementary intervention and has become a routine procedure.
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J. Pediatr. Hematol. Oncol. · May 2003
Case ReportsMechanism of transient adrenal insufficiency with megestrol acetate treatment of cachexia in children with cancer.
Megestrol acetate (MA) is used to stimulate appetite in children with cancer, but it can impair adrenal function and cause adrenal insufficiency. Three children with brain tumors were treated with MA to improve weight gain. Standard low-dose ACTH stimulation tests were performed on and off MA. ⋯ The suppression of the adrenal axis was at the level of the hypothalamus/pituitary. Adrenal suppression can occur in patients treated with MA. Awareness of this possibility and the use of glucocorticoid stress coverage are advised.