Background. A violation of nutritional status (obesity) and emotional-behavioral status (depression) is one of the urgent problems of modern health care. Often these two problems are at the same time. Particularly striking manifestations of a decrease in nutritional and emotional statuses are observed in children with oncological diseases of various origins.Objective: to assess the emotional-behavioral status and nutritional status in pediatric cancer and hematological diseases after treatment.Materials and methods. The study included 112 children with acute lymphoblastic leukemia (n = 49) and central nervous system tumors (n = 63) in remission. Age 6–18 years (median 11.5 years). 66 male (58.9 %). The Aachenbаch questionnaire was used to assess the behavioral and individual-personality characteristics. CDI (children depression inventory) questionnaire was used to assess the presence and level of depression. Body mass index (in percentile terms) and body tissue composition by bioimpedance analysis (body fat and lean body mass were evaluated) were used to assess nutritional status.Results. As a result, it was found that a significant proportion of children have delayed effects of treatment in the form of reduced nutritional status and emotional and behavioral difficulties. Children with brain tumors have an increased risk of nutritional and emotional-behavioral disorders compared to children who have survived acute lymphoblastic leukemia. The nutritional and emotional-behavioral statuses of children are related: the presence of excess fat mass increases the risk of emotional-behavioral disorders. According to questionnaires, parents identify detected problems much more often than patients themselves.Conclusion. In children who have experienced antitumor treatment and achieved remission, in case of excess body fat, the risk of emotionalbehavioral disorders increases. Emotional-behavioral disorders can have a negative effect on rehabilitation measures; therefore, before starting rehabilitation measures it is necessary to take into account the nutritional and emotional-behavioral status of patients.
Despite significant achievements in oncopediatrics there is an increasing amount of children with remote consequences of anticancer treatment. Nutritional disorders are one of the key consequences, the main factors of which are taste disorders. Despite the interest in this issue, an increase in the number of studies, the exact genesis and causal relationships of these violations have not yet been established.Objective. To study the characteristics of taste perception in children with hemoblastosis and CNS tumors after treatment. Material and methods. The authors carried out a cross-sectional study, which included 110 children with hematological malignancies (42 patients) and CNS tumors (68 patients) aged from 10 to 17 years. The after – treatment period was 2–5 years. They analyzed the nutritional screening data (body mass index and survey data). A test for the identification of four tastes (sour, bitter, salty, sweet) was carried out with the solutions in a regulated concentration according to the standard GOST ISO 3972-2014.Results. The majority of children had violations of taste: to bitter taste – 64,6%, sweet – 40%, sour – 43,7%, salty – 33,6%. Children with hemoblastosis had more disorders.Parageusia was more common in children with CNS tumors. Obese children have a greater proportion of these disorders compared to children with malnutrition and normal nutritional status. There is no relationship with the frequency of food intake, its regularity andappetite.Conclusion. The authors have confirmed the presence of nutritional disorders and problems with taste perception that persist for a long time after the end of treatment. Apparently, a significant part of them has a peripheral genesis.
The article describes the model of complex rehabilitation of children treated for cancer, developed by specialists of the Research Clinical Rehabilitation Center "Russkoe Pole" Federal Research Clinical Center of Pediatric Hematology, Oncology and Immunology named after D.Rogachev. Two areas of assistance have been proposed: a retrospective based on identifying potential health risks posed by anamnestic events and a prospective one that reflects the identification of relevant factors related to health and social functioning, the impact on these factors and the tracking of future effects. Methods batteries are described that allow studying and influencing different aspects of the health-related quality of life of patients: physical, psychological and social functioning, as well as an algorithm for directed diagnostics of toxic effects.
Background. Juvenile myelomonocytic leukaemia is a malignant disease with clonal impairment of haematopoiesis, characterized by excessive proliferation of monocytic and granulocytic sprout. Currently, the only way to cure it is hematopoietic stem cell transplantation. Vigorous treatment is accompanied by the development of a large number of complications, including nutritional ones. Nutritional support for these patients is fraught with many difficulties due to the treatment characteristics, patient’s condition, and complications of therapy.Description of a Clinical Case. A child diagnosed with juvenile myelomonocytic leukaemia, 1 year and 11 months old, received antineoplastic therapy — chemotherapy and bone marrow transplantation. In the course of treatment and after it, severe complications developed, which required various types of nutritional support, depending on the clinical situation. It is illustrated how important timely nutritional support is and how long and difficult nutritional disorders can proceed in these children even after termination of the main therapy.Conclusion. Preventive nutritional support with infant formulas is advisable for children with oncological diseases prior to treatment even with normal nutritional indicators. With the potential long-term impossibility of adequate alimentation per os, it is advisable to consider the placement of a gastrostomy tube for enteral nutrition since problems with appetite can be very long.
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