Background: Viral respiratory infections in pediatric patients with hematopoietic stem cell transplantation (HSCT) significantly impact morbidity and mortality. It is necessary to determine the viral agents and their frequency of presentation to understand their impact on transplantation patients' evolution. Methods: From January 2017 to December 2019, we conducted a cross-sectional, descriptive, and observational study of patients who underwent HSCT with a viral respiratory infection. Viral identification was performed using multiplex polymerase chain reaction for nine respiratory viruses. Descriptive statistics were performed with a report of central tendency measures and percentages. Results: Of the 54 pediatric patients who underwent HSCT, 59.2% presented an airway infection; in turn, at least one viral agent was identified in 59.3% of these patients. The most frequent viral agents were influenza (25.9%), human rhinovirus (18.5%), and respiratory syncytial virus (18.5%). Viral co-infections occurred in 36.8% of the cases. The reported complications were supplemental oxygen requirement (73.6%), support with mechanical ventilation (21%), admission to the pediatric intensive care unit (15.7%), and mortality associated with a viral respiratory infection (10.5%). Conclusions: Viral respiratory infections are frequent in pediatric patients with HSCT; influenza A/B virus was the most frequent agent. As morbidity and mortality increase due to these infections in patients with HSCT, strategies are necessary for its prevention and timely treatment after transplantation.
La supervivencia en osteosarcoma (OS) ha mejorado debido a la quimioterapia prequirúrgica y el tratamiento multimodal. La intensidad de dosis es un factor que puede modificar la supervivencia. Objetivo del estudio: Evaluar la adherencia a los protocolos de tratamiento en OS y la intensidad de dosis en niños. Material y métodos: Se revisaron los expedientes de pacientes con OS del año 2009 al 2014. Se calculó la intensidad de dosis relativa (IDR), dividiendo la dosis de cada uno de los fármacos entre el tiempo comprendido entre el inicio del tratamiento y la cirugía (IDC), posteriormente comparando con la intensidad de dosis planeada. Resultados: Treinta y dos pacientes fueron incluidos, 13 recibieron cisplatino (CDDP)/adriamicina (ADR)/metotrexato y 19 CDDP/ADR. La media de IDR fue de 0.65 ± 0.21% y el IDC medio de 19.25 ± 8.54 semanas. El 23.5% de los pacientes rechazaron la cirugía. A 23 se les realizó cirugía de control local, el 34.7% de ellos tuvieron buena necrosis (≥ 90%). Conclusiones: La intensidad de dosis no es adecuada en este grupo de pacientes; la cual se reporta en protocolos internacionales del 85% o más. En nuestros pacientes la cirugía no se practicó en el tiempo recomendado. Algunos factores identificados en nuestra población que evitan la adherencia al tratamiento fueron: rechazo a la cirugía radical, problemas económicos y sistema de salud sobrepoblado.
Introduction: Osteopetrosis is a rare hereditary bone dysplasia characterized by insufficient osteoclast activity that results in increased bone mineral density. Hematopoietic stem cell transplantation (HSCT) can reverse skeletal abnormalities and restore hematopoiesis. Clinical case: We present the case of a 3-year and 2-month-old male patient with the diagnosis of osteopetrosis. The patient underwent allogeneic HSCT (Allo-HSCT) using 100% compatible bone marrow from a related and received a myeloablative conditioning regimen and a CD34 cell dose (4.7 × 10 7 /kg). In the early post-transplant, frequent complications such as pneumonitis, hypercalcemia, and hyperphosphatemia ocurred. With a suitable granulocytic graft and chimerism of 100%, it was considered a successful transplant. However, the patient showed a delayed platelet graft treated with a platelet-stimulating factor for 6 months. The patient is currently disease-free, outpatient follow-up, with no data on graftversus-host disease, and no progressive neurological damage. Conclusion: Osteopetrosis is a childhood disease that requires clinical suspicion and early diagnosis. HSCT is necessary at an early age to prevent disease progression and sensorineural, hematological, and endocrinological functions damage that can lead to death.
Introduction: Oral mucositis (OM) is a common chemo and radiotherapy adverse effect in oncological pediatric patients, oral complications may be observed during chemotherapy and are important side effects that may directly affect the anticancer treatment. Methods: We included 420 children and monitored them for 2 weeks after the initiation of chemotherapy between June 2012 and June 2016. Subjects were asked to use a daily diary to complete the related questions of the OM Daily Questionnaire from the start of chemotherapy to day 14. Results: Overall, 73% (n = 307) of paediatric patients developed OM. Most cases were Grade 2 and 3. Of these, 12% (n = 32) were Grade 1, and 49% (n = 205) Grade 2. The mean time to onset of OM was 4.5
Introduction: Long-term survival rates in osteosarcoma had improved because of neoadjuvant chemotherapy and multimodal therapy. Dose intensity is a factor than can determine outcome in cancer patients. Objective: Evaluate adherence to international osteosarcoma treatment protocols and dose intensity in a pediatric population. Patients and methods: We analyzed 34 medical records of pediatric patients with osteosarcoma between the year 2009 and 2014. The relative dose intensity (RDI) was estimated by dividing each drug dose/the time (days) between day 1 of chemotherapy and the surgery. After that we compared it with the planned dose intensity. Results: Thirty-two patients were included, 13 of them were treated with cisplatin (CDDP)/adriamycin (ADR)/methotrexate and 19 with CDDP/ADR. The RDI average was 0.65 ± 0.21% and the median of time between day 1 of chemotherapy and surgery was 19.25 ± 8.54 weeks. Local control surgery was rejected by 23.5% of patients. Local control surgery was practiced in 23 patients, of which 34.7% reported more than 90% of necrosis. Conclusions: Dose intensity is not suitable in this group of patients, which is reported around 85% in international treatment protocols. About surgery, in our patients, it was not practiced on recommended time. Some identified factors in our population that avoid the treatment adherence were: reject to radical surgery, economical issues and overcrowded healthy system.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.