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Annetta MG, Celentano D, Zumstein L, Attinà G, Ruggiero A, Conti G, Pittiruti M. Catheter-related complications in onco-hematologic children: A retrospective clinical study on 227 central venous access devices. J Vasc Access 2024; 25:512-518. [PMID: 36113076 DOI: 10.1177/11297298221122128] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2023] Open
Abstract
BACKGROUND The use of central venous access devices (CVADs) is of paramount importance to safely deliver antiblastic and support therapies in children with cancer. Though, in pediatric patients, as much as in adults, CVADs are potentially associated with severe complications which may result in unscheduled interruption of therapy, hospitalization, increased morbidity/mortality, and increased cost of care. METHODS We have reviewed retrospectively our experience with CVADs in children with solid tumors and hematologic diseases, with the purpose of verifying if the adoption of well-defined insertion and maintenance bundles might be effective in reducing catheter-related complications, and in particular catheter-related thrombosis. RESULTS A total of 227 CVADs were analyzed: 175 peripherally inserted central catheters (PICCs), 50 centrally inserted central catheters (CICCs), and 2 femorally inserted central catheters. All CVADs were non-valved, non-cuffed power injectable polyurethane catheters; 81% were tunneled. Median dwelling time of CVADs was 172 days, for a total number of 39,044 catheter days. A very low incidence of both symptomatic catheter-related thrombosis (0.9%) and catheter-related blood stream infection (0.56 episodes per 1000 catheter days) was found. Unscheduled removal or guidewire replacement because of mechanic complications occurred in 15.7% of CVADs. There was no difference in terms of complications between PICCs and CICCs or between tunneled and non-tunneled catheters. CONCLUSIONS Our experience with CVADs in oncologic and hematologic children suggests that catheter-related complications may be minimized by the adoption of appropriate insertion and maintenance bundles.
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Affiliation(s)
- Maria Giuseppina Annetta
- Department of Anesthesia and Intensive Care, Catholic University Hospital "A.Gemelli," Rome, Italy
| | - Davide Celentano
- Department of Oncology, Catholic University Hospital "A.Gemelli," Rome, Italy
| | - Lucrezia Zumstein
- Department of Pediatric Oncology, Catholic University Hospital "A.Gemelli," Rome, Italy
| | - Giorgio Attinà
- Department of Pediatric Oncology, Catholic University Hospital "A.Gemelli," Rome, Italy
| | - Antonio Ruggiero
- Department of Pediatric Oncology, Catholic University Hospital "A.Gemelli," Rome, Italy
| | - Giorgio Conti
- Department of Anesthesia and Intensive Care, Catholic University Hospital "A.Gemelli," Rome, Italy
| | - Mauro Pittiruti
- Department of Surgery, Catholic University Hospital "A.Gemelli," Rome, Italy
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2
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Zhou ES, Valenzuela AF, Robbins R, Page JM, Bona K. Gaps in Parental Understanding of Sleep Disturbances During Maintenance Therapy for Pediatric Acute Lymphoblastic Leukemia. J Pediatr Hematol Oncol Nurs 2023; 40:369-378. [PMID: 37455493 DOI: 10.1177/27527530231168587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Abstract
Background: Acute lymphoblastic leukemia (ALL) is the most common cancer in childhood, with survival rates approaching 90%. Sleep disturbance is common among ALL patients, often developing during the initial stages of chemotherapy treatment. While there have been significant efforts to understand and intervene in this issue during survivorship, there is far less research on children who are actively receiving treatment. In the current study, we sought to better understand the parent's experience in the sleep domain during maintenance therapy, including their perceptions of how their child's medical team had managed sleep disturbances, and recommendations for how to improve sleep management. Method: Fifteen parents of pediatric ALL patients (aged 4-12 years) completed semistructured interviews. Interview content was analyzed using a multistage thematic analysis. Results: Parents consistently expressed feeling unprepared to manage the sleep disruptions that arose during treatment, often reporting that they did not recall being told this would be a side effect. They were enthusiastic about learning how to improve their child's sleep, though they did not want pharmacotherapeutic interventions or additional medical/psychosocial appointments to address this. Conclusion: Despite consistent provider communication on sleep, parents report limited knowledge of the issue. This provides an obvious intervention target to improve treatment-related sleep disturbances. Clear messaging may help direct parents' attention and expectations regarding their child's treatment and potential for disturbed sleep, possibly in the form of a behavioral intervention that empowers parents with information about how to support their child's sleep health while they are undergoing treatment for ALL.
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Affiliation(s)
- Eric S Zhou
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA, USA
- Department of Neurology, Boston Children's Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - Ariana F Valenzuela
- Department of Pediatric Oncology and Division of Population Sciences, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Rebecca Robbins
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - Jessica M Page
- Department of Neurology, Boston Children's Hospital, Boston, MA, USA
- Department of Psychiatry, Boston Children's Hospital, Boston, MA, USA
| | - Kira Bona
- Department of Pediatric Oncology and Division of Population Sciences, Dana-Farber Cancer Institute, Boston, MA, USA
- Department of Pediatrics, Division of Hematology/Oncology, Boston Children's Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
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Schenck L, Bäumer C, Ross B, Schäfer G, Stember N, Thomas H, Stieglitz S, Timmermann B. Development of a smartphone virtual reality game to support the radiation therapy of children and adolescents in proton centers. Front Pediatr 2023; 11:1163022. [PMID: 37408981 PMCID: PMC10319066 DOI: 10.3389/fped.2023.1163022] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 06/08/2023] [Indexed: 07/07/2023] Open
Abstract
Introduction For most patients, cancer therapy with radiation is a new experience coming with many unknown challenges. This can be stressful, particularly for children and adolescents. With the aim of reducing this stress and anxiety, a virtual-reality (VR) game, which can be used by patients prior to treatment, was developed and evaluated in a proton therapy center. Methods The specifications were derived from literature and from interviews with medical staff and patients. The gantry including the sound of its moving components and the sound of the interlock and safety system were identified as the main features relevant for preparation of a radiation course. Potential implementation difficulties were identified in a literature study and regarded in the design. Within the VR game, patients could interact with modeled equipment of the treatment room and hear the reportedly stress-inducing sounds in a stress-free environment prior to the treatment. The VR game was evaluated in a second series of interviews with patients. Results and Discussion This exploratory study demonstrated the specification, implementation and safe application of a VR game dedicated to young proton therapy patients. Initial anecdotal evidence suggested that the VR gaming experience was well received and found to be helpful when preparing young patients for radiation therapy.
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Affiliation(s)
- Leonardo Schenck
- West German Proton Therapy Centre Essen (WPE), Essen, Germany
- Department of Computer Science and Applied Cognitive Science, University of Duisburg-Essen, Essen, Germany
| | - Christian Bäumer
- West German Proton Therapy Centre Essen (WPE), Essen, Germany
- West German Cancer Center (WTZ), University Hospital Essen, Essen, Germany
- German Cancer Consortium (DKTK), Essen, Germany
- Department of Physics, TU Dortmund University, Dortmund, Germany
| | - Björn Ross
- Department of Computer Science and Applied Cognitive Science, University of Duisburg-Essen, Essen, Germany
| | - Gabriele Schäfer
- West German Proton Therapy Centre Essen (WPE), Essen, Germany
- West German Cancer Center (WTZ), University Hospital Essen, Essen, Germany
| | - Nicole Stember
- West German Proton Therapy Centre Essen (WPE), Essen, Germany
- West German Cancer Center (WTZ), University Hospital Essen, Essen, Germany
| | - Heike Thomas
- West German Proton Therapy Centre Essen (WPE), Essen, Germany
- West German Cancer Center (WTZ), University Hospital Essen, Essen, Germany
- Department of Particle Therapy, University Hospital Essen, Essen, Germany
| | - Stefan Stieglitz
- Department of Computer Science and Applied Cognitive Science, University of Duisburg-Essen, Essen, Germany
| | - Beate Timmermann
- West German Proton Therapy Centre Essen (WPE), Essen, Germany
- West German Cancer Center (WTZ), University Hospital Essen, Essen, Germany
- German Cancer Consortium (DKTK), Essen, Germany
- Department of Particle Therapy, University Hospital Essen, Essen, Germany
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4
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Simon A, Fahrendorf W, Hitschmann G. Preclinical evaluation of passive disinfection caps with a long-term catheter for the prevention of catheter-related bloodstream infection in pediatric cancer patients. GMS Hyg Infect Control 2021; 16:Doc20. [PMID: 34113538 PMCID: PMC8167456 DOI: 10.3205/dgkh000391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
The use of passive disinfection devices (disinfection caps) may be a beneficial part of a maintenance care bundle, aiming at the prevention of catheter-related bloodstream infections in pediatric cancer patients. This preclinical in vitro investigation tested the visual and mechanical integrity of a Broviac™ catheter hub after simulation testing with 122 3M™ CurosTM Stopper Disinfection Caps for Open Female Luers repeatedly attached and removed over 6 months. We found that these catheter hubs were compatible, fully operational, and airtight with use of 3M Curos stopper caps after 6 months of use with 122 caps per catheter hub.
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Affiliation(s)
- Arne Simon
- Pediatric Oncology and Hematology, Children's Hospital Medical Center, Saarland University Hospital, Homburg/Saar, Germany
| | - Wolfgang Fahrendorf
- 3M Medical Solutions Division, Health Care Business Group, 3M Central Europe Region, 3M Deutschland GmbH, Neuss, Germany
| | - Guido Hitschmann
- Medical Solutions Division Laboratory, Europe, Middle East and Africa, 3M Deutschland GmbH, Neuss, Germany
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5
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Park BK, Kim JY, Rogers VE. Development and Usability Evaluation of a Facebook-Based Intervention Program for Childhood Cancer Patients: Mixed Methods Study. J Med Internet Res 2020; 22:e18779. [PMID: 32720897 PMCID: PMC7420636 DOI: 10.2196/18779] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 05/22/2020] [Accepted: 06/11/2020] [Indexed: 01/23/2023] Open
Abstract
Background Childhood cancers previously considered to be incurable now have 5-year survival rates up to 84%. Nevertheless, these patients remain at risk of morbidity and mortality from therapy-related complications. Thus, patient education and self-management strategies for promoting a healthy lifestyle are of tantamount importance for improving short- and long-term health outcomes. A Facebook-based “Healthy Teens for Soaam” (a Korean term for childhood cancers) program was developed to help improve knowledge and self-management practices of teens with cancer related to their disease and treatment. Objective The two-fold purpose of this usability study was (1) to describe the process of developing an 8-week Facebook-based intervention program for teens with cancer, and (2) to evaluate its usability to refine the program. Methods Multiple phases and methods were employed to develop and evaluate the usability of the program. Study phases included: (1) needs assessment through focus group interviews and qualitative content analysis, (2) development of module content, (3) expert review and feedback on module content, (4) Facebook-based program development, (5) usability evaluation by heuristic evaluation, (6) usability evaluation by targeted end-user testing, and (7) modification and final version of the program. Usability of the final version was confirmed through feedback loops of these phases. Results Based on 6 focus group discussion sessions, it was determined that teens with cancer were interested in seeing stories of successful childhood cancer cases and self-management after discharge, and preferred multimedia content over text. Therefore, each Facebook module was redesigned to include multimedia materials such as relevant video clips tailored for teens. Usability assessed by heuristic evaluation and user testing revealed several critical usability issues, which were then revised. Potential end users tested the final program and perceived it to be usable and useful for teens with cancer. Conclusions To our knowledge, “Healthy Teens for Soaam” is the first Facebook-based intervention program for teens with cancer. We actively worked with current childhood cancer patients and survivors to develop and improve this program, achieved good usability, and met the expressed needs and preferences of target end users. This 8-week Facebook-based educational program for teens with cancer, developed as the first step of an upcoming intervention study, will be useful for improving knowledge and self-management strategies of teens.
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Affiliation(s)
- Bu Kyung Park
- College of Nursing, Research Institute of Nursing Science, Kyungpook National University, Daegu, Republic of Korea
| | - Ji Yoon Kim
- Department of Pediatrics, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Valerie E Rogers
- School of Nursing (retired), University of Maryland Baltimore, Baltimore, MD, United States
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Al Jaouni SK, Hussein A, Alghamdi N, Qari M, El Hossary D, Almuhayawi MS, Olwi D, Al-Raddadi R, Harakeh S, Mousa SA. Effects of Phoenix dactylifera Ajwa on Infection, Hospitalization, and Survival Among Pediatric Cancer Patients in a University Hospital: A Nonrandomized Controlled Trial. Integr Cancer Ther 2019; 18:1534735419828834. [PMID: 30791734 PMCID: PMC7242798 DOI: 10.1177/1534735419828834] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
This nonrandomized controlled trial determined the effects of Phoenix
dactylifera palm date (Ajwa) intake on the number of infections and
hospitalizations associated with fever, neutropenia, and mortality of pediatric
cancer patients admitted between 2008 and 2017 to King Abdulaziz University
Hospital (Jeddah, Saudi Arabia). Patients were eligible to be enrolled if they
fulfilled the inclusion criteria, were not allergic to Ajwa, and were not
enrolled in another study. Of 200 screened patients, 56 were included and 144
were excluded. Of the 56, 26 agreed to take Ajwa, and 30 served as controls.
Both groups were assessed based on infection rates, frequency of hospital
admissions for fever and neutropenia, and mortality rate. Background information
regarding demographics, clinicopathological data, and treatment options was
documented. Supplementation of Ajwa significantly reduced hospital admissions
(for fever-associated neutropenia) and infections (P = .009 and
P < .001, respectively). Off-treatment did not
significantly differ between the Ajwa and control groups. The Ajwa group had a
better survival rate in comparison to the non-Ajwa group (stratified log-rank
P = .005), where the main cause of death of patients in the
non-Ajwa group was disease progression associated with infections (77%). In
summary, Ajwa intake during the standard treatment of pediatric cancer patients
improved their treatment outcome.
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Affiliation(s)
| | | | | | | | - Dalia El Hossary
- 1 King Abdulaziz University, Jeddah, Saudi Arabia.,2 Zagazig University, Zagazig, Egypt
| | | | - Duaa Olwi
- 3 King Abdullah International Medical Research Center, Ministry of National Guard Health Affairs, Jeddah, Saudi Arabia
| | - Rajaa Al-Raddadi
- 1 King Abdulaziz University, Jeddah, Saudi Arabia.,3 King Abdullah International Medical Research Center, Ministry of National Guard Health Affairs, Jeddah, Saudi Arabia
| | | | - Shaker A Mousa
- 4 Albany College of Pharmacy and Health Sciences, Rensselaer, NY, USA
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Vitorino LM, Lopes-Júnior LC, de Oliveira GH, Tenaglia M, Brunheroto A, Cortez PJO, Lucchetti G. Spiritual and religious coping and depression among family caregivers of pediatric cancer patients in Latin America. Psychooncology 2018; 27:1900-1907. [PMID: 29663569 DOI: 10.1002/pon.4739] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 03/21/2018] [Accepted: 04/09/2018] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Several studies have shown that spiritual/religious beliefs are associated with mental health and quality of life. However, so far, no study assessed the relationship between spiritual/religious coping (SRC) and depressive symptoms in family caregivers (FCs) of pediatric cancer patients, particularly in Latin America. This study aimed to investigate whether Positive and Negative SRC strategies are associated with depressive symptoms in FCs of pediatric cancer patients in Brazil. METHODS We conducted a cross-sectional study comprising 77 FCs of pediatric cancer patients from one Brazilian Pediatric Oncology Institute. Spiritual/religious coping was assessed using the Brief SRC scale, and depressive symptoms were evaluated by the Beck Depression Inventory. Multiple regression models were performed to identify factors associated with SRC of FCs and their depressive symptoms. RESULTS In the unadjusted linear regression models, depressive symptoms were positively associated with Negative SRC (B = 0.401; P < .001; Adjusted R2 = 16.1%) but not with Positive SRC (B = 0.111; P = .334). After adjusting for socio-demographics, religious practice/faith, and health, Negative SRC remained associated with depressive symptoms (B = 3.56; P = .01; Adjusted R2 = 37.8%). In the logistic regression models, depressive symptoms were positively associated with Negative SRC (OR = 3.68; 95% CI, 1.46-9.25; P = .006), but not with Positive SRC (OR = 1.49; 95% CI, .69-3.22; P = .309). After adjustments, Negative SRC remained significant (OR = 4.01; 95% CI, 1.21-13.33; P = .023). CONCLUSIONS Negative SRC was associated with depressive symptoms in FCs of pediatric cancer patients. Health professionals must be aware of the use of Negative SRC strategies in oncology care.
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Affiliation(s)
| | - Luís Carlos Lopes-Júnior
- Nursing Department, Center for Biological Sciences and Health of the Federal University of São Carlos-UFSCar, São Carlos, Brazil
| | | | - Mariane Tenaglia
- Pediatric Residency program at Hospital Infantil Cândido Fontoura (HICF), São Paulo, Brazil
| | | | | | - Giancarlo Lucchetti
- School of Medicine, Federal University of Juiz de Fora, Juiz de Fora, Brazil
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Abstract
It is important for the responsive and effective treatment of pediatric cancer patients that functional disability is successfully measured, but no measures of functional disability have been validated for use with Arabic-speaking children and adolescents. The purpose of this study was to examine the psychometric characteristics of the first Arabic translation of the Functional Disability Inventory (FDI). A methodological study limited to the secondary analysis of functional disability data on 62 pediatric patients in Lebanon using the rating scale model and WINSTEPS Rasch analysis software was used. Disordered responses to 4 FDI times suggest that the Arabic translation of the rating scale categories might need revision or supplementation with a visual analogue scale. The dimensionality of the FDI needs further exploration because principal component analyses of residuals suggested the presence of secondary and possibly higher order dimensions. Additional FDI items are needed to improve targeting if low levels of functional disability are demonstrated to be clinically important for patient assessment and pain management. The FDI-A is suitable for clinical assessment and for monitoring the outcomes of pain management in Lebanese pediatric cancer patients. Our findings support the construct validity of the FDI-A and acceptable reliability for the 15-item scale, Cronbach α .93 and .85 for 4 of the item subsets we examined. Rating scale categories and the dimensionality of the FDI-A require further examination. The clinical relevance of distinctions between levels of functional disability in children and adolescents with cancer pain remains to be established.
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Affiliation(s)
- Dina Madi
- American University of Beirut, Beirut, Lebanon
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9
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Götte M, Kesting S, Winter C, Rosenbaum D, Boos J. Experience of barriers and motivations for physical activities and exercise during treatment of pediatric patients with cancer. Pediatr Blood Cancer 2014; 61:1632-7. [PMID: 24753116 DOI: 10.1002/pbc.25071] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2014] [Accepted: 03/25/2014] [Indexed: 11/09/2022]
Abstract
BACKGROUND Due to growing evidence about the value of exercise in pediatric cancer patients, the purpose of this study was to determine factors that influence participation in physical activities and exercise in children and adolescents during treatment. PROCEDURE This cross-sectional qualitative study included 40 pediatric cancer patients during intensive treatment. Patients were recruited at the Department for Pediatric Hematology and Oncology, University Hospital of Muenster where a supervised exercise program has been implemented for hospital stays. The qualitative approach included semi-structured guideline interviews, transcription and coding based on grounded theory. Four major topics were discussed in the interviews: (1) values and beliefs, (2) barriers to exercise, (3) motivations to exercise, and (4) encouragement from parents and physicians. RESULTS Patients reported mainly positive attitudes toward physical activities during treatment and the local exercise program was desired and valued as essential for engaging in exercise during in-patient stays. Identified barriers included physical, psychological, and organizational aspects. Motivational aspects were based on improvements in physical fitness and mental well-being. Parents' behavior related to physical activities of their children differed between being supportive, inhibiting, and inert. Few patients received information about exercise during treatment by their physicians. CONCLUSIONS Interventions that aim at maintaining physical activities during treatment and eliminating exercise barriers are required due to the patients' positive attitudes and multiple motivations toward exercise. These interventions need to be supervised and should include health-counseling programs for patients, parents, and physicians to underline the importance of physical activities in childhood cancer patients.
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Affiliation(s)
- Miriam Götte
- Department of Pediatric Hematology and Oncology, University Hospital of Muenster, Muenster, Germany
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Götte M, Kesting S, Winter C, Rosenbaum D, Boos J. Comparison of self-reported physical activity in children and adolescents before and during cancer treatment. Pediatr Blood Cancer 2014; 61:1023-8. [PMID: 24357259 DOI: 10.1002/pbc.24898] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2013] [Accepted: 11/19/2013] [Indexed: 11/08/2022]
Abstract
BACKGROUND Physical activities are important for the development of children and increasing evidence suggests beneficial effects of physical activity promotion during cancer treatment as well. The present study aimed at evaluating the current need of exercise interventions in pediatric cancer patients undergoing acute treatment and identifying risk factors for inactivity. PROCEDURE Data about self-reported physical activity before and during treatment was collected in a cross-sectional design with the physical activity questionnaire from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) in a modified cancer specific version. RESULTS One hundred thirty pediatric cancer patients with various entities were questioned 3.0 ± 1.6 months since diagnosis. Patients' activity levels before diagnosis mainly matched reference values for healthy children in Germany. Reductions during treatment affected all dimensions of daily physical activities and minutes of exercise per week decreased significantly (P < 0.001). Largest reductions of physical activities during treatment were identified for bone tumor patients and in-patient stays. CONCLUSIONS Due to the well known importance of physical activity during childhood and the identified risk of inactivity during cancer treatment, supervised exercise interventions should be implemented into acute treatment phase to enhance activity levels and ensure a continuously support by qualified exercise professionals.
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Affiliation(s)
- Miriam Götte
- Department of Pediatric Hematology and Oncology, University Hospital of Muenster, Muenster, Germany
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Yee-Guardino S, Gowans K, Yen-Lieberman B, Berk P, Kohn D, Wang FZ, Danziger-Isakov L, Sabella C, Worley S, Pellett PE, Goldfarb J. Beta-herpesviruses in febrile children with cancer. Emerg Infect Dis 2008. [PMID: 18394275 PMCID: PMC2570945 DOI: 10.3201/eid1404.0706512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
We conducted a cross-sectional study of beta-herpesviruses in febrile pediatric oncology patients (n = 30), with a reference group of febrile pediatric solid-organ transplant recipients (n = 9). One (3.3%) of 30 cancer patients and 3 (33%) of 9 organ recipients were PCR positive for cytomegalovirus. Four (13%) of 30 cancer patients and 3 (33%) of 9 transplant recipients had human herpesvirus 6B (HHV-6B) DNAemia, which was more common within 6 months of initiation of immune suppression (4 of 16 vs. 0 of 14 cancer patients; p = 0.050). HHV-6A and HHV-7 were not detected. No other cause was identified in children with HHV-6B or cytomegalovirus DNAemia. One HHV-6B-positive cancer patient had febrile disease with concomitant hepatitis. Other HHV-6B-positive children had mild "viral" illnesses, as did a child with primary cytomegalovirus infection. Cytomegalovirus and HHV-6B should be included in the differential diagnosis of febrile disease in children with cancer.
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Affiliation(s)
| | - Kate Gowans
- Cleveland Clinic Children’s Hospital, Cleveland, Ohio, USA
| | | | | | | | - Fu-Zhang Wang
- Cleveland Clinic, Cleveland, Ohio, USA ,Current affiliation: University of North Carolina, Chapel Hill, North Carolina, USA
| | - Lara Danziger-Isakov
- Cleveland Clinic Children’s Hospital, Cleveland, Ohio, USA,Cleveland Clinic, Cleveland, Ohio, USA
| | - Camille Sabella
- Cleveland Clinic Children’s Hospital, Cleveland, Ohio, USA,Cleveland Clinic, Cleveland, Ohio, USA
| | | | - Philip E. Pellett
- Cleveland Clinic, Cleveland, Ohio, USA ,Current affiliation: Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Johanna Goldfarb
- Cleveland Clinic Children’s Hospital, Cleveland, Ohio, USA,Cleveland Clinic, Cleveland, Ohio, USA
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