Treatment of patients with anaplastic ependymoma under three years of age

WOS: 000431893600028In pediatric age group, two thirds of the ependymomas are located in posterior fossa and less frequently arise from supratentorial or spinal intramedullar region. Patient age, degree of resection and histopathologic subtype are among the prognostic criteria. Most of the patients with intracranial anaplastic ependymoma are candidate for radiotherapy. The role of chemotherapy remains controversial though benefits have been suggested in some studies. In the present study, 2 patients with anaplastic ependymoma, under the age of 3 years at the time of diagnosis are presented. Treatment was started with chemotherapy and radiotherapy was delivered after 36 months in both patients. Adjuvant chemotherapy and consecutive radiotherapy seem effective in patients with anaplastic ependymoma under the age of 3 years until more effective treatment methods are developed

Body Temperature Measurement Skills and Fever Knowledge of Caregivers with a Child Having Cancer

Purpose: We did not encounter a study dealing with the knowledge of fever and attitudes of caregivers having children with a diagnosis of malignant disease toward fever in English literature. Materials and Methods: Caregivers of 124 pediatric oncology patients and 72 patients without any malignant disease were recruited and interviewed using a 26-item questionnaire about fever and its management in two hospital clinics in Diyarbakir, Turkey. Results: Seventy point one percent of the mothers in oncology group were illiterate and in 75% of the cases, caregiver was the mother of the patient. Most of the caregivers in control group (72.2%) knew at least one harmful effect of high fever (p=0.001). The primary method of measurement however was palpation in both groups. 41.9% of the caregivers in oncology group knew the correct measurement of fever, but only 2.7% in control group (p=0.001). Resources of fever konowledge was mainly doctors and nurses in oncology group (p=0.001). Conclusion: Pediatric health care providers must have more initiative and exploit oppportunities on parental understanding of fever and its management. Educational interventions are needed to correct caregivers’ misconceptions about fever and to promote appropriate management of febrile pediatric oncology patients. [Cukurova Med J 2013; 38(4.000): 706-711

Childhood Cancers and Quality of Life

With the improvement of survival rates in childhood cancer, attempts are made to develop less toxic treatment modalities and priority is given to the studies about this subject. Health related quality of life is defined as a multidimensional concept involving physical, emotional, mental and social well being as well as perception of the effects caused by disease and its treatment. In this review, we evaulated the health related quality of life and the factors affecting it both in patients receiving cancer treatment and childhood cancer survivors. Furthermore, an emphasize was made to the necessity of parent attendance, parent psychopathology and ways of coping evaluation in the assesment of quality of life in children. [Archives Medical Review Journal 2015; 24(3.000): 368-389

Interactions between physicians and drug industry

Ethical issues involving drug industry physician relationship have resulted in an ongoing debate about its appropriateness for many years in medical World. The most familiar marketing strategies of drug companies include individual gifts for physicians and sponsorship for educational and social activities. This interaction begins during medical school years of doctors and types of interactions are modified according to factors such as physician's position, title and number of patients. Although data reveal the opposite, most doctors deny or underestimate the influence of drug companies on their drug prescription. Both sides have common interests such as effective drug usage and observation, conduction of creative scientific studies. However, they have conflict of interests in some aspects. Physicians mostly care about patients' well-being and scientific improvement while drug companies are mostly involved in commercial benefit. Furthermore, some of the marketing strategies may have significant consequences on health of society such as rising drug costs, wrong or excessive usage of drugs. Regulations and guidelines have been designed in order to overcome these issues. However, the most important role in modelling of physician-drug industry interaction belongs to physicians. [Cukurova Med J 2016; 41(4.000): 777-781

The Value of F-18-FDG PET/CT in Detecting Bone Marrow Involvement in Childhood Cancers

WOS: 000479116100015PubMed ID: 31033787Background: The aim of this study was to assess the utility of F-18-fluoro-2-deoxy-d-glucose (F-18-FDG) positron emission tomography/computed tomography (PET/CT) in assessing bone marrow involvement (BMI) compared with bone marrow biopsy (BMB) in the initial staging of pediatric patients with non-Hodgkin lymphoma (NHL), Hodgkin lymphoma (HL), Ewing sarcoma (ES), and neuroblastoma (NB). Procedure: A total of 94 patients (57 boys, 37 girls, median age 7 y, range 1 to 18 y) with newly diagnosed NHL, HL, ES, and NB between July 2014 and December 2017, who underwent BMB and F-18-FDG PET/CT before chemotherapy were included in this study. There were 36 patients with NHL, 27 HL, 16 ES, and 15 NB. F-18-FDG PET/CT and BMB results were reviewed and compared retrospectively. Findings: Retrospective analysis of data from 94 pediatric patients (57 boys, 37 girls, median age 7 y, range 1 to 18 y) was performed. Of the 94 patients, 29 had BMI on F-18-FDG PET/CT. BMB was positive in 14, negative in 13, and insufficient in 2 of these 29 patients. In 65 patients negative on F-18-FDG PET/CT, BMB was also negative in 54 and insufficient in 7. For the whole group, sensitivity, specificity, and positive and negative predictive values of F-18-FDG PET/CT in detecting bone marrow metastasis at the time of diagnosis were 90.6%, 100%, 100%, and 95.4% and those of BMB were 53.1%, 87.1%, 94.4%, and 80.6%, respectively. Conclusion: Our study demonstrates that F-18-FDG PET/CT predicts BMI better than BMB. F-18-FDG PET/CT may be used at initial staging of pediatric patients with NHL, HL, ES, and NB

Carboplatin hypersensitivity in children with glial tumors: a report of two cases

Carboplatin, commonly used chemotherapeutic agent in treatment of pediatric cancers, can cause life-threatening hypersensitivty reactions. Carboplatin hypersensitivity is protocol-specific and associated with repeated doses and prolonged use of the drug. Vincristin and carboplatin combination is used efficiently in treatment of pediatric low-grade gliomas. However, hypersensitivity reactions are frequently observed during usage of this protocol. Desensitization strategies with variable success rates were reported. Failure of these strategies may lead to cessation of carboplatin Here, we report two cases with carboplatin hypersensitivity treated with epinephrine administration, in whom carboplatin was discontinued after hypersensitivity reaction. [Cukurova Med J 2016; 41(4.000): 796-798

Gluteal Congenital Fibrous Hamartoma of Infancy: A Case Report

Fibrous hamartoma of infancy (FHI) is a rare benign subcutaneous tumor which is commonly seen in the first year of life. Patients usually present with a single, painless, rapidly growing mass located mostly on the upper extremities. It can be difficult to distinguish this lesion from the malignant soft tissue sarcomas because of the rapid growth and radiological characteristics. Here we report a 5-month-old boy with a large gluteal mass and cutaneous findings which was initially thought to be an infiltrative malignant tumor and finally diagnosed as FHI. [Cukurova Med J 2013; 38(2.000): 333-337