Navegando por Palavras-chave "pediatric oncology"
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- ItemSomente MetadadadosClinical aspects and treatment of pain in children and adolescents with cancer(Wiley-Blackwell, 2005-12-01) Caran, EMM; Dias, C. G.; Seber, A.; Petrilli, A. S.; Universidade Federal de São Paulo (UNIFESP)Background. the aim of this study was to characterize the clinical aspects and the treatment of mild to severe pain in Brazilian children and adolescents with cancer. We evaluated the importance of classifying patients according to the phase of cancer treatment (diagnosis, treatment, recurrence, and end-of-life palliative care) and the opioid-related side effects.Methods. An institutional prospective study of 184 episodes of pain in children and adolescents with cancer was conducted. Pain was classified according to its cause, physiopathology and intensity. Treatment was based on the WHO guidelines for cancer pain relief.Results. Pain scales were completed by 77% of the patients. Numerical scales were used by 49% of them. Morphine was given in 111 episodes for 2,758 patient days. Morphine doses had to be escalated when it was given to patients during end-of-life palliative care. Opioids were well tolerated with no severe side effects. Psychological dependence on morphine was found in 2% (2/111) of the cases. Pain control was satisfactory in 97% of the episodes.Conclusions. the WHO guidelines for cancer pain relief were effective in controlling pain in children and adolescents with cancer. Despite their low socioeconomic level, patients were able to quantify their pain using rating scales.
- ItemSomente MetadadadosEssential medicines for pediatric oncology in developing countries(Wiley-Blackwell, 2013-05-01) Mehta, Parth S.; Wiernikowski, John T.; Sergio Petrilli, J. A. [UNIFESP]; Barr, Ronald D.; SIOP; Baylor Coll Med; McMaster Childrens Hosp; Universidade Federal de São Paulo (UNIFESP); McMaster UnivThe burden of cancer in children in low and middle income countries (LMICs) is substantial, comprising at least 80% of incident cases globally, and an even higher proportion of cancer-related deaths. With survival rates exceeding 80% in high income countries, it is imperative to transfer these successes to LMICs. A major challenge is the poor availability of safe, cost-effective chemotherapy. A list of 51 drugschemotherapeutics, infectious disease agents, and supportive care medicationsis proposed as essential to improving the survival of children with cancer in LMICs with an additional 13 drugs identified as being of further value. Pediatr Blood Cancer 2013; 60: 889891. (c) 2013 Wiley Periodicals, Inc.
- ItemSomente MetadadadosA Palliative Prognostic Score for Terminally Ill Children and Adolescents With Cancer(Wiley-Blackwell, 2010-12-01) Kurashima, Andrea Yamaguchi; Dias de Oliveira Latorre, Maria do Rosario; Camargo, Beatriz de; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP)Background. the loss of a child is considered the hardest moment in a parent's life. Studies addressing length of survival under pediatric palliative care are rare. the aim of this study was to improve a survival prediction model for children in palliative care, as accurate information positively impacts parent and child preparation for palliative care. Procedure. Sixty-five children referred to a pediatric palliative care team were followed from August 2003 until December 2006. Variables investigated (also included in previous studies) were: diagnosis, home care provider, presence of anemia, and performance status score given by the home care provider. Clinical variables such as symptom number were also used to test the score's ability to pre-validated using the above variables. the number of symptoms at transition to palliative care does not improve the score's predictive ability. the sum of the single scores gives an overall score for each patient, dividing the population into three groups by probability of 60-day survival: Group A 80.0%, Group B 38.0%, and Group C 28.5% (P < 0.001). Conclusion. A pediatric palliative care score based on easily accessible variables is statistically significant in multivariate analysis. Factors that increase accuracy of life expectancy prediction enable adequate information to be given to patients and families, contributing to therapeutic decision-making issues. Pediatr Blood Cancer. 2010;55:1167-1171. (C) 2010 Wiley-Liss, Inc.
- ItemAcesso aberto (Open Access)Rabdomiosarcoma de cabeça e pescoço na infância(ABORL-CCF Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial, 2003-01-01) Neves, Beatrice Mª J. [UNIFESP]; Pontes, Paulo A. de L. [UNIFESP]; Caran, Eliana Maria Monteiro [UNIFESP]; Figueiredo, Claudia [UNIFESP]; Weckx, Luc Louis Maurice [UNIFESP]; Fujita, Reginaldo Raimundo [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Rhabdomyosarcoma (RMS) is a malignant tumor of immature mesenchymal cells; it can arise from any part of the body. RMS is the most common soft tissue sarcomain the childhood and its most frequent primary site is the head and neck. AIM: The purpose of this study was to review the occurrence of head and neck RMS in childhood and its clinical-histopathologic features. STUDY DESIGN: Clinical retrospective. METHOD: Eighty-two patients with soft tissue sarcoma treated in the Institute of Pediatric Oncology, UNIFESP-EPM, between 1988 and 2002 were included in this study. The medical records of the patients with head and neck soft tissue sarcomas were reviewed. The following parameters were analyzed: incidence of RMS in the childhood and in the head and neck, sex, age, histological classification, primary site, follow-up. RESULTS: In this study, 65% of soft tissue sarcomas were RMS; 33% of RMS were in the head and neck region; 77% of soft tissue sarcoma in this region were RMS. The mean age at diagnosis was 7.62 years, 41% were between 5 and 9 years. In this sample, there were 47% men and 53% women. Embryonic RMS was the predominant histological type (64.6%) and the orbit was the most common primary site (52.8%). One hundred percent, 50% and 33.3% of the parameningeal, nonparameningeal and orbital RMS, respectively, led to death. CONCLUSION: RMS is the most common soft tissue sarcoma in the childhood and the head and neck is the most frequent primary site. Males were more affected by RMS than females. The mean age at diagnosis was 7.62 years and the most frequent age interval was between 5 and 9 years old. The embryonic histological type and the orbit as primary site were predominant. The highest mortality was found for parameningeal RMS and the lowest, for orbital RMS.