Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 27
Filtrar
2.
BMJ Paediatr Open ; 8(1)2024 Apr 16.
Artículo en Inglés | MEDLINE | ID: mdl-38627059

RESUMEN

BACKGROUND: Cancer treatment for children is typically long-term and difficult, and the experience is unique for each child. When designing child-centred care, individuals' values and preferences are considered equally important as the clinical evidence; therefore, understanding children's thoughts and attitudes while they receive long-term treatment could offer valuable insights for better clinical practice. METHODS: We conducted long-term consecutive participatory observations and interviews with seven children, who were hospitalised and receiving cancer treatment for the first time. The daily observational data on those children's discourses, behaviours and interactions with health professionals were systematically collected and thematically examined. The analysis was expanded to explore significant narratives for each child to capture their narrative sequence over time. RESULTS: The initial analysis identified 685 narrative indexes for all observation data, which were categorised into 21 sub-codes. Those sub-codes were assembled into five main themes by thematic analysis: making promises with health professionals, learning about the treatment procedures through participation, taking care of oneself, increasing the range of activities one can perform and living an ordinary life. CONCLUSION: We observed a forward-looking attitude toward understanding cancer, accepting treatment and looking forward to the future among children undergoing in-hospital cancer treatment. In addition, the children developed cognitively, affectively and relationally throughout cancer treatment processes. These findings have implications for better clinical practice in child-centred care, including children's participation in shared decision-making in paediatric oncology.


Asunto(s)
Antropología Cultural , Neoplasias , Humanos , Cognición , Aprendizaje , Neoplasias/terapia , Investigación Cualitativa , Niño
5.
Clin Pediatr (Phila) ; 62(9): 1059-1066, 2023 10.
Artículo en Inglés | MEDLINE | ID: mdl-36680345

RESUMEN

Parental participation in shared decision-making in children's cancer therapy is essential because parents advocate for and support their children's wishes. However, little research has focused on this issue. We conducted a longitudinal observational study of 7 parents whose child had received their first cancer treatment. We recorded parents' behaviors, interactions, and narratives in 1 pediatric ward and 2 outpatient clinics. The recordings were systematically conducted and thematically analyzed using variable-oriented and process-oriented modes to assess the causal relationships among phenomena. We found 4 themes describing the processes by which parents developed and participated in shared decision-making. The first 2 themes reflected the development of reciprocal parental relationships and parent-other child relationships. These 2 types of relationship generated mutual trust and a sense of solidarity among parents (the third theme). This, in turn, became the foundation for parents to share decision-making with health care professionals (the fourth theme).


Asunto(s)
Toma de Decisiones , Neoplasias , Niño , Humanos , Padres , Estudios Longitudinales , Relaciones Padres-Hijo , Investigación Cualitativa , Neoplasias/terapia
6.
Int J Hematol ; 117(1): 128-133, 2023 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-36168084

RESUMEN

The widespread recognition of the concept of sarcopenia, or muscle loss, has impacted the prognosis of patients undergoing high-intensity treatments. We focused on the effect of muscle loss on the prognosis of pediatric patients with hematologic diseases. A total of 65 patients with hematologic malignancies who underwent allogeneic HCT once were investigated. The change in cross-sectional psoas muscle area (PMA) measured on computed tomography (CT) images was expressed as the muscle loss index (MLI), which was calculated by dividing the pre-HCT PMA by the baseline PMA. In this study, patients with MLI values less than 0.85 were classified into the muscle loss group. Muscle loss was observed in 27 patients (41.5%). Patients who experienced muscle loss were older than those who did not. Muscle loss was an independent predictor of higher non-relapse mortality (NRM) (p = 0.012) and inferior overall survival (OS) (p = 0.045) at 5 years. Multivariate analysis showed that muscle loss was an independent risk factor for higher NRM (p = 0.046), and inferior EFS (p = 0.048). Muscle loss observed pre-HCT may be a predictor of increased NRM, poor OS and EFS in pediatric patients with hematologic malignancies undergoing allogeneic HCT.


Asunto(s)
Neoplasias Hematológicas , Trasplante de Células Madre Hematopoyéticas , Humanos , Niño , Estudios Transversales , Trasplante Homólogo , Recurrencia Local de Neoplasia , Neoplasias Hematológicas/patología , Trasplante de Células Madre Hematopoyéticas/métodos , Músculos Psoas , Acondicionamiento Pretrasplante/métodos , Estudios Retrospectivos
8.
Pediatr Int ; 64(1): e14700, 2022 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33740287

RESUMEN

BACKGROUND: The survival rate of children with cancer has increased substantially in recent years. Shared decision making (i.e., the ability of children with cancer to express their will and share it with medical personnel) has become a particularly important issue. The nature and developmental processes of children's decision making in hospital should be understood. There is, however, a lack of research in this area. METHODS: From January 2016 to March 2018, we conducted a longitudinal qualitative observational study, within the context of medical anthropology, in a hospital pediatric ward in Japan. We investigated the nature and development of decision making among seven children aged 5-12 years with hematologic cancers. We recorded their everyday behaviors, interactions, narratives, and events in the ward. The recording was conducted systematically and it was analyzed thematically using both variable-oriented and process-oriented modes to assess causal relationships between phenomena. RESULTS: The thematic analysis identified three thematic scenes in which children developed their will regarding cancer treatment: (1) adjusting to hospital life; (2) forming friendships with other children; and (3) communicating with medical personnel. Sharing information, building trusting relationships, and sharing treatment goals with medical personnel were identified as forms of children's participation in medical decision making. Through cultivated friendships, children's peer groups were sources of resilience and strength in overcoming difficulties in hospital life. CONCLUSIONS: The development of children's decision making in a pediatric oncology ward was based on various rich human relationships. Such relationships should be promoted to improve shared decision making substantially.


Asunto(s)
Toma de Decisiones , Neoplasias , Niño , Humanos , Neoplasias/terapia , Estudios Longitudinales , Personal de Salud , Hospitales
9.
Exp Hematol ; 106: 47-57, 2022 02.
Artículo en Inglés | MEDLINE | ID: mdl-34808257

RESUMEN

Although allogeneic hematopoietic stem cell transplantation (HSCT) is a curative treatment for diverse malignant and nonmalignant diseases, acute graft-versus-host disease (aGVHD) is strongly linked to mortality caused by HSCT. We previously reported that CC chemokine ligand 8 (CCL8) is closely correlated to aGVHD mortality in both humans and mice. To study the role of CCL8 in aGVHD, CCL8 knockout (CCL8-/-) mice were transplanted with fully allogeneic marrow grafts. These mice exhibited a significant reduction in mortality (90.0% vs. 23.4% survival for CCL8-/- vs. wild-type recipients at day 28, p < 0.0001). As a result, apparent prolonged median survival from 9 days in wild-type mice to 45 days in CCL8-/- mice was observed. Acute GVHD pathology and liver dysfunction in CCL8-/- mice were significantly attenuated compared with those in wild-type mice. In association with the reduced mortality, a surge of plasma interleukin (IL)-6 was observed in CCL8-/- recipients with allogeneic marrow, which was significantly increased compared with wild-type mice that received allografts. Donor T-cell expansion and plasma levels of interferon-γ and TNF-α during aGVHD were similar in both types of mice. Collectively, these findings indicate that CCL8 plays a major role in aGVHD pathogenesis with possible involvement of an IL-6 signaling cascade.


Asunto(s)
Quimiocina CCL8/genética , Enfermedad Injerto contra Huésped/genética , Interleucina-6/genética , Animales , Trasplante de Médula Ósea , Femenino , Eliminación de Gen , Enfermedad Injerto contra Huésped/patología , Ratones Endogámicos C57BL , Ratones Noqueados
11.
J Pediatr Hematol Oncol ; 43(8): e1136-e1139, 2021 11 01.
Artículo en Inglés | MEDLINE | ID: mdl-33560083

RESUMEN

Familial Mediterranean fever (FMF) is a hereditary autoinflammatory disorder accompanied by periodic fever and sterile serositis. We report a 5-year-old boy with FMF, who underwent second unrelated cord blood transplantation (CBT) for recurrent familial hemophagocytic lymphohistiocytosis. Periodic attacks of fever and abdominal pain started 6 months after CBT. He was diagnosed with FMF according to the Tel-Hashomer criteria and treated successfully with colchicine. Genetic testing showed heterozygous p.E148Q mutation in the MEFV gene from both donor and recipient cells. Several CBT-related factors including use of an immunosuppressant can potentially be involved in the pathogenesis of FMF in our patient.


Asunto(s)
Trasplante de Células Madre de Sangre del Cordón Umbilical/efectos adversos , Fiebre Mediterránea Familiar/patología , Linfohistiocitosis Hemofagocítica/terapia , Mutación , Pirina/genética , Preescolar , Fiebre Mediterránea Familiar/etiología , Humanos , Linfohistiocitosis Hemofagocítica/genética , Linfohistiocitosis Hemofagocítica/patología , Masculino , Pronóstico
13.
Pediatr Int ; 62(3): 403-405, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32022381
14.
Int J Surg Oncol ; 2019: 6708474, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31915549

RESUMEN

BACKGROUND: Lymph node metastasis (LNM) is a relatively rare event in soft tissue sarcoma. An association between the timing of LNM detection and patient prognosis is presently unknown. PATIENTS AND METHODS: We retrospectively analyzed the clinicopathological features of 33 patients with LNM between 2001 and 2015. Analysis of the timing of LNM diagnosis was grouped according to patients presenting LNM in either <8 months (the median time from primary tumor diagnosis to LNM) or ≥8 months after primary tumor diagnosis. RESULTS: A relationship between the primary tumor size and the timing of the LNM was not significantly found (Rs = 0.0088, p=0.96). Sixteen patients had an LNM detection duration of <8 months, and 17 patients had a duration of ≥8 months. The 5-year survival for patients with an LNM detection duration of <8 months and ≥8 months was 19% and 71%, respectively (p=0.0016). There were 19 patients with pulmonary metastases. Among them, there were 13 patients with a duration of primary tumor diagnosis to LNM of <8 months and 6 with a duration of ≥8 months (p=0.01). CONCLUSION: Early LNM (<8 months) may predict poor prognosis in soft tissue sarcoma.


Asunto(s)
Metástasis Linfática , Sarcoma/mortalidad , Sarcoma/patología , Neoplasias de los Tejidos Blandos/mortalidad , Neoplasias de los Tejidos Blandos/patología , Diagnóstico Tardío , Femenino , Humanos , Neoplasias Pulmonares/secundario , Masculino , Persona de Mediana Edad , Pronóstico , Estudios Retrospectivos , Sarcoma/terapia , Neoplasias de los Tejidos Blandos/terapia , Tasa de Supervivencia
16.
Int J Hematol ; 107(4): 390-391, 2018 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-29181701
17.
J Med Virol ; 89(2): 358-362, 2017 02.
Artículo en Inglés | MEDLINE | ID: mdl-27364410

RESUMEN

Several studies have indicated that viral reactivations following allogeneic hematopoietic stem cell transplantation (allo-HSCT) are frequent, but viral reactivations after autologous HSCT (auto-HSCT) have not been investigated in detail. We performed multiplex polymerase chain reaction (PCR) assay to examine multiple viral reactivations simultaneously in 24 patients undergoing auto-HSCT between September 2010 and December 2012. Weekly whole blood samples were collected from pre- to 42 days post-HSCT, and tested for the following 13 viruses; herpes simplex virus 1 (HSV-1), HSV-2, varicella-zoster virus (VZV), Epstein-Barr virus (EBV), cytomegalovirus (CMV), human herpesvirus 6 (HHV-6), HHV-7, HHV-8, adeno virus (ADV), BK virus (BKV), JC virus (JCV), parvovirus B19 (B19V), and hepatitis B virus (HBV). Fifteen (63%) patients had at least one type of viral reactivation. HHV6 (n = 10; 41.7%) was most frequently detected followed by EBV (n = 7; 29.2%). HHV-6 peaked on day 21 after HSCT and promptly declined. In addition, HBV, CMV, HHV7, and B19V were each detected in one patient. HHV6 reactivation was detected in almost half the auto-HSCT patients, which was similar to the incidence in allo-HSCT patients. The incidence of EBV was unexpectedly high. Viral infections in patients undergoing auto-HSCT were higher than previously reported in other studies. Although there were no particular complications of viral infection, we should pay attention to possible viral reactivations in auto-HSCT patients. J. Med. Virol. 89:358-362, 2017. © 2016 Wiley Periodicals, Inc.


Asunto(s)
Virus ADN/aislamiento & purificación , Trasplante de Células Madre Hematopoyéticas/efectos adversos , Reacción en Cadena de la Polimerasa Multiplex , Trasplante Autólogo/efectos adversos , Activación Viral , Adolescente , Adulto , Anciano , Niño , Preescolar , Virus ADN/clasificación , Femenino , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Estudios Prospectivos , Adulto Joven
18.
J Pediatr Hematol Oncol ; 37(4): e234-7, 2015 May.
Artículo en Inglés | MEDLINE | ID: mdl-25493455

RESUMEN

RARA rearrangement-negative acute promyelocytic leukemia (APL) is uncommon, and its extramedullary relapse is extremely rare. We report a 5-year-old girl with RARA rearrangement-negative APL, which recurred solely at the external auditory canal and mastoid air cells. She was successfully treated with chemotherapy, local radiotherapy, and unrelated cord blood transplantation. She has maintained complete remission for 24 months after transplantation. The clinical features and our therapeutic strategy in this patient will provide valuable information for extramedullary relapse of RARA rearrangement-negative APL.


Asunto(s)
Trasplante de Células Madre de Sangre del Cordón Umbilical , Reordenamiento Génico , Leucemia Promielocítica Aguda/terapia , Receptores de Ácido Retinoico/genética , Aloinjertos , Trióxido de Arsénico , Arsenicales/uso terapéutico , Terapia Combinada , Femenino , Humanos , Lactante , Leucemia Promielocítica Aguda/genética , Óxidos/uso terapéutico , Recurrencia , Receptor alfa de Ácido Retinoico
19.
J Pediatr Hematol Oncol ; 37(3): e170-2, 2015 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-24663070

RESUMEN

In childhood acute myelogenous leukemia, extramedullary tumor is an occasional clinical symptom. However, extramedullary acute megakaryocytic leukemia is extremely rare. Here, we report an extremely rare case of acute megakaryocytic leukemia in a patient who presented with extramedullary tumor of cerebral falx as a first manifestation before the diagnosis of systemic bone marrow leukemia.


Asunto(s)
Neoplasias Encefálicas/complicaciones , Neoplasias Encefálicas/patología , Leucemia Megacarioblástica Aguda/complicaciones , Leucemia Megacarioblástica Aguda/patología , Neoplasias Encefálicas/terapia , Femenino , Humanos , Lactante , Leucemia Megacarioblástica Aguda/terapia , Pronóstico
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA