Journal of pediatric hematology/oncology
-
J. Pediatr. Hematol. Oncol. · Nov 2008
Case ReportsDyshemoglobinemias and pulse oximetry: a therapeutic challenge.
Pulse oximetry normally provides a reliable indicator of arterial blood oxygen saturation. Individuals with a variant hemoglobin with low oxygen affinity would exhibit pulse oximetry values consistent with hypoxemia despite maintaining adequate oxygen delivery to tissues. ⋯ These values were significantly lower than physical examination suggested. A possible dyshemoglobinemia should be suspected when discordance exists between pulse oximetry readings and physical examination findings.
-
J. Pediatr. Hematol. Oncol. · Jul 2008
Comparative StudyNoninvasive ventilation in immunocompromised pediatric patients: eight years of experience in a pediatric oncology intensive care unit.
The experience of noninvasive positive pressure ventilation (NPPV) in the pediatric setting is limited. The aim of the present study is to retrospectively evaluate the effectiveness of NPPV in pediatric immunocompromised patient admitted in our PICU (Pediatric Intensive Care Unit) for acute respiratory failure. ⋯ Our results encourage the use of NPPV as a first-line treatment in children with malignancies who develops acute respiratory failure, except in those with severe hemodynamic status.
-
J. Pediatr. Hematol. Oncol. · Jul 2008
Risk factors for death in children and adolescents with cancer and sepsis/septic shock.
To assess risk factors for mortality in children and adolescents with cancer and sepsis/septic shock, admitted to intensive care unit. ⋯ Our data suggest that mortality in Oncological Pediatric Intensive Care Unit is high and the main factors involved in prognosis are number of dysfunctional organs, respiratory infections, and duration of granulocytopenia; the mortality rises 7.4 times for each dysfunctional organ. We believe that prospective and multicenter studies are necessary to better characterize risk factors that are specific for cancer patients to produce a particular score to predict severity of complications and mortality of children with cancer.
-
J. Pediatr. Hematol. Oncol. · Jul 2008
Case ReportsSevere neurotoxicities in a case of Charcot-Marie-Tooth disease type 2 caused by vincristine for acute lymphoblastic leukemia.
We report a 13-year-old male patient with Charcot-Marie-Tooth disease (CMT) type 2 who developed severe neuropathy because of vincristine (VCR) for his acute lymphoblastic leukemia. A clumsy gait, muscle weakness in his fingers, and inverted champagne bottlelike muscle in the lower limbs were noticed after remission induction treatment for acute lymphoblastic leukemia, which included VCR at a total dose of 8 mg/m. ⋯ His symptoms gradually worsened, and even after VCR was discontinued, he could not walk alone for 7 months. VCR has previously been considered to be relatively safe in CMT type 2, however, some patients with CMT type 2 might show severe neurologic toxicities, as seen in patients with CMT type 1.
-
J. Pediatr. Hematol. Oncol. · Jun 2008
Safety and efficacy of acupuncture in children: a review of the evidence.
Acupuncture has been used therapeutically in China for thousands of years and is growing in prominence in Europe and the United States. In a recent review of complementary and alternative medicine use in the US population, an estimated 2.1 million people or 1.1% of the population sought acupuncture care during the past 12 months. Four percent of the US population used acupuncture at any time in their lives. ⋯ Through our review of pediatric adverse events, we found a 1.55 risk of adverse events occurring in 100 treatments of acupuncture that coincides with the low risk detailed in the studies mentioned previously. The actual risk to an individual patient is hard to determine because certain patients, such as an immunosuppressed patient, can be predisposed to an increased risk, acupuncturist's qualifications differ, and practices vary in certain parts of the world. Nevertheless, it seems acupuncture is a safe complementary/alternative medicine modality for pediatric patients on the basis of the data we reviewed.