Oral and maxillofacial cancer in pediatric patients: 30 years experience from a Brazilian reference center.

OBJECTIVE: The aim of this study is to determine the relative frequency, demographic distribution and clinicopathological features of pediatric oral and maxillofacial cancer (POMC). METHODS: Medical records were retrospectively reviewed for all cancer cases diagnosed from 1986 to 2016 affecting patients aged 19 years and younger. Demographic variables, anatomical site, and histopathological diagnoses were collected and analyzed by descriptive statistics. RESULTS: Fifty-five (0.77%) POMCs were found among 7181 pediatric malignancies. Mean age at diagnosis was 8 years and patients aged 5-9 years presented the higher prevalence of malignant tumors (40%). White male patients were more frequently affected (78.18% and 65.45%, respectively). The most common cancer type was lymphomas (52.73%) followed by sarcomas (27.27%) and carcinomas (20%). Burkitt lymphoma (32.73%), rhabdomyosarcoma (14.55%), diffuse large B-cell lymphoma (9.09%), and mucoepidermoid carcinoma (9.09%) were the most common histopathological diagnoses. The main affected anatomical site was the oropharynx (38.18%), followed by salivary glands (30.91%), maxillofacial bone (20%), and oral cavity (10.91%). CONCLUSION: POMC has a low incidence; however, highly aggressive tumors, such as lymphomas and sarcomas, are common in this scenario. A better knowledge about the clinicopathological distribution of POMC may contribute to early diagnosis and improve survival rates.

Intervenção psicológica com familiares enlutados em oncologia pediátrica: revisão da literatura / Psychological intervention for bereaved relatives in pediatric oncology: a literature review / Intervención psicológica con familiares de luto en oncología pediátrica: revisión de literatura

Compreende-se luto como a vivência de pesar diante de alguma perda, que exige a reorganização dos papéis familiares e projetos de vida. A assistência aos familiares enlutados é essencial para a elaboração da perda do ente querido e prevenção de danos à saúde emocional. O objetivo desta revisão integrativa é analisar a produção científica sobre a atenção psicossocial especializada oferecida a familiares enlutados no cenário da oncologia pediátrica. Foram analisados 20 artigos publicados entre 2002 e 2013 e recuperados nas bases BVS, PsycINFO e SciELO, com os descritores: neoplasias, família, luto/pesar e consternação. Os resultados permitiram caracterizar o panorama do cuidado oferecido a familiares enlutados em diferentes contextos. Destacaram-se ações preventivas, serviços de transição e medidas de apoio após a perda. Neste artigo, consideram-se os potenciais riscos para o desenvolvimento dos irmãos enlutados e o possível comprometimento do relacionamento conjugal, e são propostas algumas reflexões visando à ampliação dos modelos de atenção psicossocial.

Grief is defined as the mourning experience after some loss, which requires the reorganization of family roles and of life projects. The assistance to bereaved families is essential for closure when it comes to the loss of beloved ones as well as for the prevention of impairments concerning emotional health. This integrative review aimed to analyze the scientific literature on specialized psychosocial care provided to grieving families in the area of Pediatric Oncology. Twenty papers published from 2002 to 2013, retrieved from three different databases (BVS, PsycINFO and SciELO) and using the keywords: neoplasms, family, grief and bereavement, have been analysed. The results allowed us to characterize the scenario for care delivery to bereaved families in different contexts. Preventive actions, transition services and post-loss support measures were highlighted. Possibilities to expand psychosocial care models are discussed considering the potential developmental risks for bereaved siblings and for marital relationship jeopardy.

El luto es la experiencia de pesar delante de alguna pérdida, lo que requiere la reorganización de los roles familiares y proyectos de vida. Reflexionar sobre el cuidado a las familias en duelo es una estrategia valiosa para hacer frente a la elaboración de la pérdida de un ser querido y para prevención de daños a la salud emocional. Esta revisión integradora tuvo como objetivo analizar la producción científica sobre atención psicosocial especializada a las familias en duelo en el ámbito de la Oncologia Pediátrica. Se analizaron 20 artículos publicados desde 2002 hasta 2013, recuperados en las bases de datos BVS, PsycINFO y SciELO, con las palabras clave: cáncer, familia, luto/pesar y consternación. Los resultados permitieron caracterizar el panorama del cuidado ofrecido a familiares enlutados en diferentes contextos. Se destacaron acciones de prevención, servicios de transición y medidas de apoyo después de la pérdida. Al considerar los riesgos latentes para el desarrollo de los hermanos enlutados y el posible comprometimiento de la relación conyugal, se proponen algunas reflexiones para ampliar los modelos de atención psicosocial.

Oral Mucositis in Pediatric Acute Lymphoblastic Leukemia Patients: Evaluation of Microbiological and Hematological Factors.

OBJECTIVE: to investigate the associations of oral microbiota, leucocytes count, neutrophil count, platelet counts and hemoglobin level, and the severity of oral mucositis in pediatric patients with acute lymphoblastic leukemia (ALL) receiving chemotherapy. MATERIALS AND METHODS: 71 prospective patients were included. Analyses of oral microbiota and blood sample were conducted on days 14 (D14) and 56 (D56) of the Brazilian GBTLI-99 treatment protocol. Herpes simplex virus (HSV) identification was performed by PCR followed by DNA sequencing analysis. Bacteria and fungi identification was obtained by standard microbiological culture tests. RESULTS: 103 episodes of mucositis occurred, being 65 at D14 and 38 at D56. Most cases positive for herpes viral DNA sequences were identified as HSV-1. At D14, we found a significant association between the severity of mucositis and presence of HSV-1 (p = 0.0347), Candida spp. (p = 0.0078), and low platelet count (p = 0.0064). At D56, we found a significant association between the severity of mucositis and the presence of HSV-1 (p = 0.0317), previous HSV-1 presence on D14 (p < 0.0001) and neutrophil count (p = 0.0211). CLINICAL RELEVANCE: the identification of risk factors for mucositis in children and adolescents may contribute to the development of new strategies for prevention and/or treatment, reducing the complications associated with this condition. CONCLUSIONS: the presence of HSV, platelet count, and Candida spp. presence at D14 of ALL induction treatment is associated with increased severity of mucositis in children and adolescents. At D56 of ALL treatment, mucositis severity was associated with neutrophil count, HSV presence, and previous presence of HSV (at D14).