RESUMEN
Treatment advances over the last few decades have dramatically increased survival for children with cancer. More than half the children treated for cancer are now cured. Consequently, professionals working with these children are beginning to focus on minimizing the adverse effects of cancer and its treatment as well as helping families cope with a chronic, life-threatening illness. This article presents an overview of the incidence, etiology, diagnosis, and treatment of common childhood cancers. Approaches to care, efforts to prevent acute and late toxic effects, and nursing management of children with malignancies are discussed.
Asunto(s)
Neoplasias/terapia , Niño , Preescolar , Terapia Combinada/efectos adversos , Educación Continua en Enfermería , Femenino , Humanos , Incidencia , Lactante , Masculino , Neoplasias/diagnóstico , Neoplasias/epidemiología , Estados Unidos/epidemiologíaRESUMEN
The role of adjuvant chemotherapy for osteosarcoma has been well defined. Recently, the use of preoperative chemotherapy has been further enhanced by the use of intraarterial cisplatin. The authors describe the use and results of systemic doxorubicin and intraarterial cisplatin as a preoperative regimen for eight pediatric patients with nonmetastatic osteosarcoma of an extremity. The therapy was well tolerated. Six patients achieved satisfactory local tumor control and were able to receive the surgical procedure to permit limb salvage. Two of these six patients subsequently developed metastatic disease. Of the two patients who did not achieve satisfactory local tumor control to permit a limb salvage procedure, both underwent amputation and one later developed metastatic disease. Five patients have remained continuously free of disease for a median of 18 months (range, 12-21 months). This report confirms the observations that intraarterial cisplatin and doxorubicin can be used as a safe and effective regimen preoperatively for pediatric patients with osteosarcoma of an extremity.
Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/administración & dosificación , Neoplasias Óseas/terapia , Osteosarcoma/terapia , Adolescente , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Neoplasias Óseas/patología , Neoplasias Óseas/secundario , Niño , Preescolar , Cisplatino/administración & dosificación , Terapia Combinada , Doxorrubicina/administración & dosificación , Extremidades , Femenino , Pérdida Auditiva de Alta Frecuencia/inducido químicamente , Humanos , Infusiones Intraarteriales , Infusiones Intravenosas , Enfermedades Renales/inducido químicamente , Neoplasias Pulmonares/secundario , Masculino , Osteosarcoma/patología , Osteosarcoma/secundario , Huesos Pélvicos , Periodo Posoperatorio , Cuidados PreoperatoriosRESUMEN
Eighty-two patients, ranging in age from 11 months to 24 years, underwent the percutaneous placement of an implanted catheter in order to have improved venous access. Thirty-five patients (43%) were beginning chemotherapy for cancer, four (5%) had a chronic hematologic disorder, and the remaining 43 (52%) were on chemotherapy for cancer. The mean duration of catheter function was 168 days (range of 7-1,030 days), with a cumulative experience of 18,812 days of catheter use. Complications were minimal. Only four catheters (5%) required removal secondary to infection, infiltration, or tissue breakdown. Substantially reduced complication rates were observed as compared to other studies using implanted central venous catheters. Implanted central venous catheters were proven to be safe in patients with hematologic disorders. These catheters enhance the ability to infuse chemotherapy, hyperalimentation, blood products, anesthesia, and imaging solutions and are safe to use in patients with a hemostatic or host defense deficiency.
Asunto(s)
Catéteres de Permanencia/efectos adversos , Adolescente , Adulto , Cateterismo Venoso Central/efectos adversos , Cateterismo Venoso Central/instrumentación , Niño , Preescolar , Femenino , Humanos , Lactante , Inflamación/etiología , Masculino , Sepsis/etiologíaRESUMEN
We have reported the first case of isolated submucosal hematoma of the true vocal cord in a hemophilic patient. He was managed with factor VIII replacement therapy as an outpatient for five consecutive days, without complication. Similar but more serious cases usually require more aggressive intervention by the pediatrician and the otolaryngologist.
Asunto(s)
Hematoma/etiología , Hemofilia A/complicaciones , Pliegues Vocales , Enfermedad Aguda , Niño , Factor VIII/uso terapéutico , Humanos , Masculino , Pliegues Vocales/lesiones , Heridas no Penetrantes/complicacionesAsunto(s)
Ansiedad/prevención & control , Neoplasias/enfermería , Enfermería Oncológica/métodos , Dolor/prevención & control , Enfermería Pediátrica , Adaptación Psicológica , Adolescente , Niño , Femenino , Humanos , Hipnosis , Masculino , Neoplasias/psicología , Neoplasias/terapia , Terapia por RelajaciónRESUMEN
Hypnosis, as a relaxation technique to reduce anxiety and drug-related nausea and vomiting in children with cancer, is an effective treatment modality. Its benefit as a self-relaxation technique is now being realized.