Journal of pediatric hematology/oncology
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J. Pediatr. Hematol. Oncol. · Nov 2002
Prospective study of indwelling central venous catheter-related complications in children with broviac or clampless valved catheters.
To compare two types of central venous catheters (Broviac and valved clampless) for the incidence and severity of catheter-related complications in children. ⋯ There were no major differences in the incidence of mechanical or infectious complications between the two devices. Malfunction was more frequent in Broviac catheters, whereas catheter displacement occurred more frequently in clampless valved catheters. These results show the importance of central venous catheter-related mechanical complications in the management of children with hematologic or oncologic malignancies.
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J. Pediatr. Hematol. Oncol. · Oct 2002
Clinical Trial32P Radiosynoviorthesis in children with hemophilia.
This study was performed to prospectively evaluate the safety, efficacy, and cost of injecting P-colloid into joints of children with hemophilia and synovitis to decrease the rate of joint bleeding. ⋯ Radiosynoviorthesis is effective in limiting the frequency of joint hemorrhage, decreasing pain and improving function in children with hemophilia. However, long-term safety studies are needed.
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J. Pediatr. Hematol. Oncol. · Aug 2002
Invasion of the cardiovascular system in childhood malignant hepatic tumors.
To evaluate the utility of transthoracic echocardiography for the early detection of subclinical cardiac metastasis in childhood malignant hepatic tumors. ⋯ Echocardiography may be useful for the early detection of cardiovascular metastases of malignant hepatic tumors in children; this was the case for 33% of the patients in this series. The frequent occurrence of cardiovascular tumor involvement and the high degree of association between lung metastasis and cardiovascular involvement observed in this small series suggest that transthoracic echocardiography should be studied prospectively in a large series of children with hepatic tumors.
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J. Pediatr. Hematol. Oncol. · May 2002
Modeling administrative outcomes in fever and neutropenia: clinical variables significantly influence length of stay and hospital charges.
Administrative outcomes such as length of stay and charges are used to compare the quality of care across institutions and among individual providers. Clinical variables representing disease severity may explain some of the variability in these outcomes. ⋯ The clinical variables that were significant in this study account, in validation R2 estimates, for more than 25% of the variability in administrative outcomes for encounters of fever and neutropenia. Adjusting length of stay and charges for these clinical variables would allow for a fairer comparison of institutions and individual providers. The electronic case-finding algorithm served as an efficient way to identify absolute monocyte count and tumor type as the major predictors and provided a conservative estimate of R2.
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J. Pediatr. Hematol. Oncol. · May 2002
Value of electronic data for model validation and refinement: bacteremia risk in children with fever and neutropenia.
Validating published risk models in a different time and setting can be a labor-intensive process. Data in electronic format provide the potential to test the validity of risk models without labor-intensive chart reviews and data capture. The authors attempted to use readily available electronic data to find appropriate cases and to validate and refine a previously developed risk model for predicting bacteremia in children with cancer who had fever and neutropenia. ⋯ Existing electronic data provide an efficient means for case-finding and model validation and refinement. The previously developed bacteremia model had good but not optimal predictive performance in the new data set. Admission absolute monocyte count and temperature remain significant risk factors for bacteremia. Redefining the risk categories, including a much lower cutpoint for admission absolute monocyte count, improved the model's discrimination, which suggests that predictive models need periodic updating.