Risk Factors for Typhlitis in Pediatric Patients With Cancer

2009 ◽  
Vol 31 (9) ◽  
pp. 630-634 ◽  
Author(s):  
Hadar Moran ◽  
Isaac Yaniv ◽  
Shai Ashkenazi ◽  
Michael Schwartz ◽  
Salvador Fisher ◽  
...  
2021 ◽  
Vol 10 (Supplement_1) ◽  
pp. S15-S16
Author(s):  
Miguel A Minero ◽  
Asia Castro ◽  
Martha Avilés-Robles

Abstract Background Infectious processes are frequent complications presented in pediatric patients with cancer. Currently, the indiscriminate use of antibiotics induces resistance to available treatments, creating the emergence of multi-drug-resistant organisms (MDROs). Due to the impact in morbidity and mortality secondary to MDRO infection, we aimed to identify risk factors associated with mortality in infections due to MDROs in pediatric patients with cancer. Methods Case–control study nested in a prospective cohort of pediatric oncology patients with febrile neutropenia (FN) at Hospital Infantil de México Federico Gómez (HIMFG) in Mexico City from March 2015 to September 2017. MDRO was defined as acquired non-susceptibility to at least one agent in three or more antimicrobial categories. Patients with FN episodes who died from an infection due to MDROs were defined as cases and patients with FN episodes of an infection due to MDROs who did not die were defined as controls. Mucositis, septic shock, PICU stay, and bacterial prophylaxis (Trimethoprim/Sulfamethoxazole) were compared between groups. Descriptive statistics was performed and Pearson χ 2 or Student’s t-test were used to compare risk factors between groups. Results A total of 929 FN episodes were documented, 44.4% episodes occurred in male patients, mean age was 7.9 years, with the population under 5 years being the most represented (68.2%). The most frequent diagnosis was acute lymphoblastic leukemia in 75% followed by rhabdomyosarcoma in 10.5% and acute myeloid leukemia in 9.6%. Prophylaxis (trimethoprim/sulfamethoxazole) was used in 86%, mucositis was present in 9.2% of episodes. 12.1% had septic shock and 4.7% were admitted to PICU. In 148 FN episodes (15.9%) a microorganism was identified, of these 50 (33.7%) were due to an MDROs. Urinary tract infection was the most frequent site (49%), followed by bloodstream infections (47%). K. pneumoniae was the most frequent MDRO in 22.8%, followed by E. coli in 19.2% and P. aeruginosa in 14%. Septic shock was presented in 26% of MDROs infections. Overall mortality was 1.94% and only 0.86% (8) were secondary to MDROs. Of patients with MDRO isolated mortality was 30% (15/50). Mortality associated with bloodstream infection due to MDROs was 25% compared with other source of MDROs infections (3%) (P = 0.01). Septic shock was present in 40% of patients with death due to MDROs infection (P = 0.001). Conclusions In our population of children with FN episodes who had an isolated microorganism, infection due to MDROs are high (33.7%) and MDROs infection-directed mortality was as high as 30%. Bloodstream infections and septic shock were risk factors associated with mortality due to MDROs.


2021 ◽  
Vol 22 (8) ◽  
pp. 4112
Author(s):  
Silvia Triarico ◽  
Alberto Romano ◽  
Giorgio Attinà ◽  
Michele Antonio Capozza ◽  
Palma Maurizi ◽  
...  

Vincristine-induced peripheral neurotoxicity (VIPN) is a very common side effect of vincristine chemotherapy among pediatric patients with cancer. Neuropathy may be sensory, motor and/or autonomic, with consequent reduction, delay or discontinuation of vincristine-chemotherapy, but also pain, disability, reduced quality of life of patients and an increase in medical costs. Vincristine acts out its antineoplastic function by altering the normal assembly and disassembly of microtubules, with their consequent mitosis block and death. Vincristine leads to VIPN through a complex mechanism of damage, which occurs not only on the microtubules, but also on the endothelium and the mitochondria of nerve cells. Furthermore, both patient-related risk factors (age, race, ethnicity and genetic polymorphisms) and treatment-related risk factors (dose, time of infusion and drug–drug interactions) are involved in the pathogenesis of VIPN. There is a lack of consensus about the prophylaxis and treatment of VIPN among pediatric oncologic patients, despite several molecules (such as gabapentin, pyridoxine and pyridostigmine, glutamic acid and glutamine) having been already investigated in clinical trials. This review describes the molecular mechanisms of VIPN and analyzes the risk factors and the principal drugs adopted for the prophylaxis and treatment of VIPN in pediatric patients with cancer.


Author(s):  
MARINA CURRA ◽  
AMANDA DE FARIAS GABRIEL ◽  
MARCO ANTONIO TREVIZANI MARTINS ◽  
MARIA BEATRIZ CARDOSO FERREIRA ◽  
ANDRé BRUNETTO ◽  
...  

2017 ◽  
Vol 39 (3) ◽  
pp. e167-e172 ◽  
Author(s):  
Atsuro Daida ◽  
Hiroki Yoshihara ◽  
Ikuko Inai ◽  
Daisuke Hasegawa ◽  
Yasushi Ishida ◽  
...  

1970 ◽  
Vol 4 (3) ◽  
pp. 41-47
Author(s):  
Renata Pinto Ribeiro ◽  
Teresa Francisca Moraes Pinto ◽  
Clarissa Santos Carvalho Ribeiro ◽  
Valdinéa Luiz Hertel

Objetivo: O objetivo desse estudo foi de identificar as dificuldades do profissional enfermeiro frente à criança com câncer, verificar se há preparo adequado para atender às necessidades de uma criança com doenças oncológicas; e qual a forma de enfrentamento utilizada pelo profissional diante das dificuldades encontradas, no atendimento a essa criança. Metodologia: Trata-se de uma pesquisa qualitativa, objetivando identificar quais dificuldades o profissional de enfermagem enfrenta no cuidado de criança com câncer e de seus familiares, os mecanismos de enfrentamento dessas dificuldades no atendimento dos mesmos e se há preparo adequado dos mesmos para atender as necessidades dessas crianças. Os sujeitos foram quatro enfermeiras que cuidam ou já cuidaram de crianças com câncer no Hospital Bom Pastor – Varginha/MG. A coleta de dados foi desenvolvida por uma entrevista semiestruturada. Resultados: Constatou-se que as dificuldades são: cuidar de criança em estado grave, seus pais e o envolvimento emocional. Aos meios de enfrentamento referem à oração e a distração. Quanto ao preparo do profissional referem despreparo para atuar nesta área. Conclusão: Conclui-se que há falta de preparo aos profissionais, embora os mesmos cuidem com humanização dessas crianças.  Palavras-chave: Enfermeiro; Crianças; Câncer.   ABSTRACT: Objective: The aim of this study was to identify the difficulties of the professional nurse when taking care of a child with cancer, check the adequate preparation to meet the needs of children with oncological diseases; and what form of coping with the situation the professionals used when taking care of this child. Methodology: This was a qualitative study , aiming to identify the difficulties the professional faces in the care of children with cancer and their families , the coping mechanisms of these difficulties in the care  and if there is adequate preparation thereof to meet the needs of these children. The subjects were four nurses who care or have cared for children with cancer at Good Shepherd Hospital – Varginha/MG. Data collection was carried out by a semi - structured interview. Results: It was found that the difficulties are care of a child in serious condition, his parents and the emotional involvement. Means of coping relate to prayer and distraction. As to their preparation, professionals refer as being unprepared to act in this area. Conclusion: We concluded that there is lack of preparation of professionals, although they take care of these children in a humanistic way  Keywords: Nurse; children; Cancer.


Author(s):  
Alvin J. X. Lee ◽  
Karin Purshouse

AbstractThe SARS-Cov-2 pandemic in 2020 has caused oncology teams around the world to adapt their practice in the aim of protecting patients. Early evidence from China indicated that patients with cancer, and particularly those who had recently received chemotherapy or surgery, were at increased risk of adverse outcomes following SARS-Cov-2 infection. Many registries of cancer patients infected with SARS-Cov-2 emerged during the first wave. We collate the evidence from these national and international studies and focus on the risk factors for patients with solid cancers and the contribution of systemic anti-cancer treatments (SACT—chemotherapy, immunotherapy, targeted and hormone therapy) to outcomes following SARS-Cov-2 infection. Patients with cancer infected with SARS-Cov-2 have a higher probability of death compared with patients without cancer. Common risk factors for mortality following COVID-19 include age, male sex, smoking history, number of comorbidities and poor performance status. Oncological features that may predict for worse outcomes include tumour stage, disease trajectory and lung cancer. Most studies did not identify an association between SACT and adverse outcomes. Recent data suggest that the timing of receipt of SACT may be associated with risk of mortality. Ongoing recruitment to these registries will enable us to provide evidence-based care.


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