In childhood cancer patients, early diagnosis may have an impact on survival that reduces the potential morbidity. This study aimed to identify the factors associated with delay in diagnosis in children with cancer in southeastern Turkey. The clinical records of 682 patients with childhood cancer were evaluated. Study variables were classified as factors related to the patient, their disease, and the health care system. The median parental delay, physician delay, and total delay were determined as 20, 23, and 60 days, respectively. There was a significant relationship between parental delay, physician delay, and total delay and age at diagnosis (P = .005, P = .008, and P = .004, respectively). Long parental delay was least frequent in children younger than 1 year (P = .001). Parental, physician, and total delay were longer in patients with solid tumors than in patients with leukemias (P = .007, P = .000, and P = .000, respectively). Patients with tumors of the genitalia had longer physician delay and total delay than patients with other solid tumors (P = .001 and P = .000, respectively). Patients with solid tumor and early-stage disease had longer physician delay and total delay (P = .016 and P = .013, respectively). According to the first physician contacted, long physician delay was less frequent among pediatricians (P = .003). Delayed diagnosis was associated with age, type/localization and stage of tumor, the first physician consulted, and area of residence. A sustained effort should be made to raise the level of awareness of childhood cancer among parents and to sensitize all physicians, especially those who treat pediatric patients infrequently, with regard to the warning signs of the disease.
Purpose: e use of complementary and alternative medicine (CAM) in children is becoming increasingly acceptable and popular. e aim of this questionnaire-based study was to determine the prevalence, patterns of use, types, perceived e ectiveness and associated factors of CAM in children.Methods: Parents of children (n= 268) who attended the Pediatric Outpatient Department of the Faculty of Medicine at Gaziantep University in June and July 2008 were asked to complete a questionnaire.Results: e prevalence of CAM use, at least once in the previous year, was 58.6%. e most commonly used CAM modality was herbal preparations (82.7%), which were used to treat cough (42.0%), diarrhea (30.0%) and gas (colic) pains (34.4%). ese products were recommended by the respondents' mother/mother-in-law (52.5%), neighbors (20.0%), friends (14.7%) and doctors (12.8%). Only 31.6% (61) of these parents informed their doctor about their use of CAM to treat their children. irty-eight percent (n=102) of the participants stated that they preferred to use CAM modalities rather than referring to a doctor when their child was sick. While most of the families (57.7 %) stated that the method they used was "slightly" useful, 18.6% of them stated the method to be "fairly" useful. e parental use of CAM and the educational level of the parents were among the factors of a ecting the use of CAM in children. No correlation was found between the use of CAM and the sex, social security status, income level and other sociodemographic properties of the respondents.Conclusion: is study showed that a great majority of parents of children in this population used CAM modalities and that herbal products were preferred. Most parents did not inform their physicians of their use of CAM. In the light of these ndings, pediatricians should be prepared to discuss alternative therapies with parents, since talking about CAM may be helpful in minimizing associated risks.
Giriş ve Amaç: Bu çalışmada, ebeveynlerin çocukluk çağında yüksek ateş konusunda bilgi düzeyleri, ateş karşısındaki tutum ve davranışları ile ateş düşürücü ilaç kullanımı ve bunlarla ilişkili olan faktörlerin ortaya konulması amaçlandı. Gereç ve Yöntemler: Çalışmaya çocuk acil servisine herhangi bir şikayetle başvuran, çocuğunda kronik bir hastalık olmayan ve anket formunu doldurmayı kabul eden 400 aile dahil edildi. Anket verileri SPSS for Windows 13.0 paket programında değerlendirilerek p<0.05 değerleri istatistiksel olarak anlamlı kabul edildi. Bulgular: Çocukların yaş ortalaması 4.98±4.28 yıl dı. Ailelerin çoğunluğu ateşin koltuk altından (n: 318, %79.5) ölçüleceğini, 137'si (%34.3) 38˚C ve üzeri değerlerin ateş olarak kabul edileceğini belirtmekteydi. Katılanların 261'i (%65.3) soğuk algınlığında, 179'u (%44.8) aşılama sonrasında, 160'ı ise (%40.0) ise diş çıkarma döneminde ateşin yüksek olabileceği görüşündeydi. Ailelerin büyük çoğunluğu (n: 386, %96.5) ateşin çocuk için zararlı olabileceğini düşünüyordu. Yüksek ateş tedavisinde en sık tercih edilen yöntem ateş düşürücü ilaç kullanımı (n: 314, %78.50), ilaç ise parasetamol (n: 376, %94.0) olarak saptandı. Sadece 169'u (%42.2) ilacı uygun dozda kullanıyordu. İlaçlar hakkında bilgi kaynağı olarak doktor (n: 368, %92.0), eczacı (n: 62, %15.5) ve hemşireler (n: 54, %13.5) gösterilmekteydi. Sonuç: Ailelerin büyük çoğunluğu yüksek ateş tedavisinde ateş düşürücü ilaçları tercih ediyordu, ancak sadece yarıya yakını ilacı uygun dozda kullanmaktaydı. Ateş düşürücü ilaçlar konusundaki bilgi çoğunlukla sağlık çalışanlarından alınmaktaydı. Bu nedenlerle sağlık çalışanlarının ebeveynlerin ateşle ilgili yaklaşımlarında büyük öneme sahip olduğu, aileye ateşin tanımı, nedenleri, ateşli çocuğa yapılacak ilk müdaheleler gibi konularda eğitim verilmesinin ateşli çocuklarda hatalı uygulamaların önlenmesine katkıda bulunabileceği düşünüldü.
No significant difference was found between genotypes and alleles of DRD2 Taq1A and DRD2 Taq1B polymorphism in patients and controls, while the CNR1 receptor 1359G/A polymorphism and the presence of the A allele may be one risk factor for susceptibility to obesity.
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