Diagnosis and treatment of febrile neutropenia in pediatric cancer patients Consensus of the Sociedad Latinoamericana de Infectología Pediátrica This document is a consensus guideline on the "Diagnosis and treatment of febrile neutropenia in children with cancer" developed by the Committee for Infectious Diseases in Immunocompromised Children of the Sociedad Latinoamericana de Infectología Pediátrica. This guideline discusses the management of febrile neutropenia focused on Latin American children with cancer. It is based on a thorough review of the literature, with particular attention to experiences reported by centers within the continent in order to provide recommendations applicable to the region. The manuscript includes a description of the regional epidemiology of cancer and infections in children, recommendations for clinical and laboratory studies required for patient management, description of a classifi cation method to identify patients at different risk for invasive bacterial infections, outpatient and inpatient general care strategies and differential treatment strategies adjusted to local epidemiological realities, different algorithms for patient follow-up according to clinical course, a discussion of the rationale for prophylaxis strategies in specifi c situations including general guidelines for antifungal treatment. The Guidelines intend to provide practical, evidence-based recommendations in order to promote the best possible management for children with cancer, fever and neutropenia, throughout oncology centers of Latin America.
The rs13466632 variant in zinc transporter SLC30A8 encodes for an amino acid substitution (Arg>Trp) in a zinc transporter that is mainly expressed in pancreas. This SNP has been associated with risk for type 2 diabetes in Caucasian and Chinese. Zinc is required for production, storage and release of insulin in beta cells. Deficiency of this micronutrient has been associated with glucose metabolism abnormalities. Low zinc levels are frequent among Mexican women. No studies have been conducted on the role of zinc status on the association between variation in SLC30A8 and the risk for type 2 diabetes, and glucose metabolism. A sample of 45 non‐pregnant adult women were included in the study. Fasting glucose, insulin, and zinc levels in plasma and erythrocytes were measured using standard techniques. The rs13466632 variant was genotyped by allelic discrimination. Genotypes followed the HW distribution. Associations between genotype and levels of the analyzed variables was explored using GLM using age, BMI and waist circumference as covariates, and genotype as fix factor. A significant association was found between fasting insulin levels and gentoype (P<0.05), after controlling for BMI and age. This association was not mediated by zinc status, as measured by the mentioned methods. No association was found between genotype and glucose or zinc levels.
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