Introduction Cystadenofibromas are rare benign tumors of the fallopian tube with only 15 reported cases worldwide. They are usually asymptomatic and are found incidentally. This case is presented on account of its rarity and to the best of our knowledge, is the first reported case of cystadenofibroma of the fallopian tube discovered during an appendicectomy. Case presentation We report a rare case of cystadenofibroma of the fallopian tube in a year-old Caucasian woman who presented with sudden onset of right iliac fossa pain. A clinical diagnosis of appendicitis was made and she was taken to the operating theater for an appendicectomy.
Intraoperatively, the appendix appeared normal. However, the 8 cm cyst contained within the right ovary and the blood in the pelvis warranted a salpingo-oopherectomy. Our patient made an uneventful recovery and was discharged after four days. Histology revealed a benign cystadenofibroma of the fallopian tube. There was no evidence of recurrence in the follow-up period of 12 months. Conclusion Cystadenofibromas are benign tumors that may macroscopically and ultrasonographically appear malignant.
We recommend that the diagnosis of cystadenofibroma is considered prior to performing radical surgery that may affect the fecundity of these patients. Cystadenofibromas confined to the fallopian tube can be treated curatively with unilateral salpingo-oophorectomy, without the need for any further treatment. However, long-term follow-up of more cases is required to draw more definitive conclusions.
Childhood Acute Bacterial Meningitis: Clinical Spectrum, Bacteriological Profile and Outcome. To determine the disease pattern, etiological agents and outcome of childhood acute bacterial meningitis. Atotal of children between the ages of 1 month and 5 years, admitted with the diagnosis of meningitis on the basis of clinical findings and positive cerebrospinal fluid CSF , were included.
Data was analysed using SPSS version Out of children, F ratio of 1. Mean age was Maximum numbers of children were Acute bacterial meningitis mostly affected children under the age of 1 year. CSF culture revealed both Grampositive and Gram-negative bacteria. The most common pathogen in children who died was streptococcus pneumoniae.
Predicting relapse risk in childhood acute lymphoblastic leukaemia. Intensive multi-agent chemotherapy regimens and the introduction of risk-stratified therapy have substantially improved cure rates for children with acute lymphoblastic leukaemia ALL. Current risk allocation schemas are imperfect, as some children are classified as lower-risk and treated with less intensive therapy relapse, while others deemed higher-risk are probably over-treated.
Most cooperative groups previously used morphological clearance of blasts in blood and marrow during the initial phases of chemotherapy as a primary factor for risk group allocation; however, this has largely been replaced by the detection of minimal residual disease MRD. Other than age and white blood cell count WBC at presentation, many clinical variables previously used for risk group allocation are no longer prognostic, as MRD and the presence of sentinel genetic lesions are more reliable at predicting outcome.
Currently, a number of sentinel genetic lesions are used by most cooperative groups for risk stratification; however, in the near future patients will probably be risk-stratified using genomic signatures and clustering algorithms, rather than individual genetic alterations. This review will describe the clinical, biological, and response-based features known to predict relapse risk in childhood ALL, including those currently used and those likely to be used in the near future to risk-stratify therapy.
Treatment for childhood acute lymphoblastic leukaemia: Research on parental adaptation to a child's chronic illness is still scant, and this is particularly so in relation to the experience of treatment for paediatric Acute Lymphoblastic Leukaemia ALL. The work that does exist on parental reactions tends to conflate maternal responses with paternal responses, as fathers are usually seen as having a secondary role.
Consequently, little is known about how fathers cope with treatment for childhood ALL. The present discussion seeks to make a contribution to this area by presenting findings on the paternal experience of treatment for paediatric ALL from a longitudinal study conducted at Royal Children's Hospital in Brisbane, Queensland.
The findings from this research clearly indicate the emotional pain that fathers face in their struggle to accept the diagnosis of a serious, life-threatening illness such as ALL in their child. The findings challenge the notion of the make stereotype by showing that the shock of diagnosis, the emotional pain of coping with the illness, the expression of pain through tears, the desire to be with the child, the struggle to cope with the medical interventions, and concerns about other family members are not gender specific, but are rather issues common to both parents.
Other myeloid malignancies include transient abnormal myelopoiesis and myelodysplastic syndrome. Get detailed information about the classification, clinical presentation, diagnostic and molecular evaluation, prognosis, and treatment of newly diagnosed and recurrent disease in this summary for clinicians. Patients and Methods We analyzed data on risk factors and outcomes of children with SMNs occurring after treatment for ALL from 18 collaborative study groups between and Five-year survival estimates for AML were DNMT3A mutations were detected in 4 out of 1.
Furthermore, there was 1 intronic mutation c. One patient gave up treatment due to remission induction failure in day Only 1 patient achieved continuous complete remission. The mutation positions were different from the hotspots reported in adult AML. Benign course after acute high dose levothyroxine intoxication in a 3-year-old boy. Acute ingestion of thyroid hormone preparations is a common intoxication, with cases in children acute intoxication with high dose levothyroxine 0.
We describe the proper management of levothyroxine intoxication in children. His vital-signs were normal and the only symptom during admission was a tachycardia the following day. He was treated prophylactically and therapeutically with activated charcoal and propranolol. Despite very high levels, his clinical symptoms were relatively mild. After clinical follow-up for 3 d he was discharged. Aim To explore associations between acute otitis media in early childhood and prenatal and postnatal tobacco smoke exposure. Methods Subjects were 32, children born — in the Norwegian Mother and Child Study with questionnaire data on tobacco smoke exposure and acute otitis media up to 18 months of age.
Multivariate regression models were used to obtain adjusted relative risks for acute otitis media.
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Results Acute otitis media was slightly more common in children exposed to parental smoking. The incidence from 0—6 months was 4. After adjusting for postnatal exposure and covariates, the relative risk for acute otitis media 0—6 months when exposed to maternal smoking in pregnancy was 1. Maternal smoking in pregnancy was associated with acute otitis media up to 12 months of age. Compared to non-exposed children, there was a slightly increased risk of recurrent acute otitis media for children exposed both pre- and postnatally with a relative risk of 1. Conclusion Even in a cohort with relatively low exposure levels of parental smoking, maternal smoking in pregnancy was associated with an increased risk of acute otitis media in early childhood.
Birth weight and risk of childhood acute leukaemia. Studies of risk factors for acute leukaemia are inconclusive. This case-control study was done in West Azerbaijan province, Islamic Republic of Iran, to determine the relationship between birth weight and acute leukaemia in children aged under 15 years. For every patient 2 age- and sex-matched controls were selected from hospital and community populations.
Of cases diagnosed over the period , Significantly more of them were male than female In a multivariate logistic regression model variables significantly associated with acute leukaemia were: The risk of acute leukaemia increased significantly with increasing birth weight in the total group and among girls, but not among boys. Rates of prostate surgery and acute urinary retention for benign prostatic hyperplasia in men treated with dutasteride or finasteride. Previous studies have suggested a greater benefit for various outcomes in men diagnosed with benign prostatic hyperplasia BPH who are treated with dutasteride than for men treated with finasteride.
This study investigates whether the rates of BPH-related prostate surgery and acute urinary retention AUR differ between dutasteride and finasteride users in the Netherlands. The incidence of BPH-related prostate surgery and AUR was determined during dutasteride or finasteride treatment and stratified by type of initial BPH-treatment 5-ARI monotherapy or combination with alpha-blocker and prescriber general practitioner GP or urologist. Comparison of the incidence of BPH-related prostate surgery and AUR between the treatment groups was done by Cox proportional hazard regression.
Most users started treatment in combination with an alpha-blocker. Overall, dutasteride users had a lower risk of BPH-related prostate surgery was lower among dutasteride users than finasteride users HR: This lower risk among dutasteride users was also seen when stratifying by monotherapy or combination therapy HR: However, the association was only present among men treated by urologists. For AUR the rates were low and no statistical significant difference was observed between dutasteride and finasteride users.
The risk of undergoing BPH-related prostate surgery was lower among men using dutasteride compared to men using finasteride. The association was observed for monotherapy as well as combination therapy, however, only among men who received their prescription from a. Uroflowmetric assessment of acute effects of sildenafil on the voiding of men with erectile dysfunction and symptomatic benign prostatic hyperplasia. To evaluate the acute effects of sildenafil 50 mg on the micturation of men with erectile dysfunction ED and concomitant benign prostatic hyperplasia BPH with lower urinary tract symptoms LUTS using uroflowmetric parameters.
A total of 68 male patients randomized into two groups 36 treatment, 32 control groups with International Prostate Symptom Score IPSS greater than 7 and International Index of Erectile Dysfunction-erectile function domain score lower than 26 were enrolled in the study. Patients in the treatment group received a single dose of 50 mg of oral sildenafil. Patients in the control group received no treatment. Prevoiding urine volumes determined ultrasonographically and voided urine volumes were also recorded. Mean ages were similar between treatment and control groups In the treatment group the maximum and average flow rates increased significantly Q max from In this paper we demonstrate applying time series models on medical research.
The Hungarian mortality rates were analysed by autoregressive integrated moving average models and seasonal time series models examined the data of acute childhood lymphoid leukaemia. The mortality data may be analysed by time series methods such as autoregressive integrated moving average ARIMA modelling. This method is demonstrated by two examples: Mathematical expressions are given for the results of analysis.
Calculations of confidence intervals for autoregressive parameters by tree methods: Analysing the confidence intervals of the first order autoregressive parameters we may conclude that the confidence intervals were much smaller than other estimations by applying the continuous time estimation model.
We present a new approach to analysing the occurrence of acute childhood lymphoid leukaemia. We decompose time series into components. The periodicity of acute childhood lymphoid leukaemia in Hungary was examined using seasonal decomposition time series method. The cyclic trend of the dates of diagnosis revealed that a higher percent of the peaks fell within the winter months than in the other seasons.
This proves the seasonal occurrence of the childhood leukaemia in Hungary. Therefore, we aimed to investigate BIRC6 gene expression in childhood acute leukemia in relation to clinicopathological characteristics at presentation, therapeutic response, and prognosis. BIRC6 expression level was assessed in 75 children with acute leukemia; 30 patients with acute myeloblastic leukemia AML and 45 patients with acute lymphoblastic leukemia ALL using real-time quantitative reverse transcriptase-polymerase chain reaction.
BIRC6 gene expression was higher in patients with unfavorable response to therapy at day 14, those who developed relapse or died in both leukemic groups. The best cutoff value of BIRC6 to predict therapeutic response and disease outcome was determined. Our results suggested that BIRC6 gene expression could be considered as an adverse risk factor in childhood acute leukemia and, hence, could be used to guide therapeutic regimens. Acute epidural hematoma is a critical emergency all around the world, and its aggressive diagnosis and treatment are of vital importance.
Emergent surgical evacuation of the hematoma is known as standard management; however, conservative procedures are also used for small ones. Spontaneous rapid resolution of these hematomas has also been reported in eight pediatric cases. Various theories have been proposed to explain the underlying pathophysiology of this resolution. Herein, we are reporting a new pediatric case with spontaneously resolving acute epidural hematoma 12 hours after admission to the emergency room.
Of a series of children suffering from acute purulent meningitis at the Children's Hospital, Winnipeg, in the years , 12 9. Fortyone of the survivors were re-studied 2. Five children exhibited psychiatric evidence of organic brain damage; seven, neurological abnormality; 11, electroencephalographic abnormality. Three had defective intelligence and nine psychological test evidence of organic brain damage. There was a positive correlation between the severity of the acute illness and the presence of neuropsychiatric sequelae; also between neuropsychiatric sequelae, defective intelligence and psychological evidence of brain damage.
No correlation existed between the electroencephalographic abnormality and neuropsychiatric defect. Does childhood misfortune raise the risk of acute myocardial infarction in adulthood? Whereas most research on acute myocardial infarction AMI has focused on more proximal influences, such as adult health behaviors, the present study examines the early origins of AMI. A series of event history analyses modeling age of first AMI investigated the direct effects of accumulated and separate domains of childhood misfortune as well as the mediating effects of adult health lifestyle and psychosocial factors.
Findings reveal that accumulated childhood misfortune and child maltreatment increased AMI risk, net of several adult covariates, including family history of AMI. Smoking fully mediated the effects of both accumulated childhood misfortune and child maltreatment. These findings reveal the importance of the early origins of AMI and health behaviors as mediating factors. Acute leukemia is the most common type of childhood and adolescence cancer, characterized by clonal proliferation of variably differentiated myeloid or lymphoid precursors.
Recent insights into the molecular pathogenesis of leukemia have shown that epigenetic modifications, such as deacetylation of histones and DNA methylation, play crucial roles in leukemogenesis, by transcriptional silencing of critical genes. HDIs promote or enhance several different anticancer mechanisms, such as apoptosis, cell cycle arrest, and cellular differentiation and, therefore, are in evidence as promising treatment for children and adolescents with acute leukemia, in monotherapy or in association with other anticancer drugs.
Here we review the main preclinical and clinical studies regarding the use of HDIs in treating childhood and adolescence leukemia. Treatment of relapsed or refractory acute leukemia in childhood with bisantrene combined with high dose aracytine. Bisantrene is an anthracene derivative which has demonstrated activity in acute myeloblastic leukemia AML and in lymphoma.
Patients who relapsed after bone marrow transplantation were eligible. Twenty-six children were included. Diagnoses were as follows: All patients had been very highly pretreated, especially with anthracyclines, and most of them were of poor prognosis. According to diagnosis, complete remission CR rates are: Four children died, three from infection and one from acute lysis syndrome. No significant cardiac toxicity was noted. Hepatic and renal toxicity was noted. Hepatic and renal toxicity were limited and transient. Bisantrene should be evaluated with a five-day schedule in other pediatric malignancies.
In children with acute leukemia previously treated with high dose aracytine, new combination regimen is warranted. Birth Weight and Acute Childhood Leukemia: A Meta-analysis of Observational Studies. A Meta - analysis of Observational We conducted a meta - analysis of nine case-control studies published between and Based on a meta - analysis of only three case-control studies published between and involving over children with AML and over 1, Parents' help-seeking behaviours during acute childhood illness at home: A contribution to explanatory theory.
Uncertainty and anxiety surround parents' decisions to seek medical help for an acutely ill child. Consultation rates for children are rising, yet little is known about factors that influence parents' help-seeking behaviours. We used focus groups and interviews to examine how 27 parents of children under five years, from a range of socioeconomic groups in the East Midlands of England, use information to make decisions during acute childhood illness at home.
This article reports findings elucidating factors that influence help-seeking behaviours. Parents reported that decision-making during acute childhood illness was influenced by a range of personal, social and health service factors. Principal among these was parents' concern to do the right thing for their child.
Their ability to assess the severity of the illness was influenced by knowledge and experience of childhood illness. When parents were unable to access their general practitioner GP , feared criticism from or had lost trust in their GP, some parents reported using services elsewhere such as Accident and Emergency. These findings contribute to explanatory theory concerning parents' help-seeking behaviours.
Professional and political solutions have not reduced demand; therefore, collaborative approaches involving the public and professionals are now needed to improve parents' access to information. Despite the favourable survival rates of childhood acute lymphoblastic leukaemia ALL , a significant number of patients present resistance to antileukaemic agents and dismal prognosis.
The study included bone marrow specimens obtained on diagnosis and on BFM day 33 from patients and 64 healthy children. Following extraction, RNA was polyadenylated and reverse transcribed. Cytogenetics, immunohistotype and MRD were analysed according to international guidelines. Downregulated miRb levels were detected in childhood ALL patients and correlated with adverse prognosis.
Moreover, multivariate regression models highlighted the independent prognostic value of miRb for childhood ALL. Finally, the combination of miRb with clinically used disease markers clearly enhanced the prediction of patients' resistance to BFM chemotherapy. Pyrethroid pesticide exposure and risk of childhood acute lymphocytic leukemia in Shanghai. Significant amounts of pyrethroid pesticides are used throughout China. Previous studies have suggested that exposure to pesticides may increase the risk of childhood cancer; however, few studies have focused on pyrethroid metabolites.
We investigated five nonspecific metabolites of pyrethroid pesticides found in children's urine and examined the correlation with childhood leukemia. We conducted a hospital-based case-control study of childhood acute lymphocytic leukemia ALL in Shanghai between and The study included children aged years and controls matched for age and sex.
Compared with those in the lowest quartiles of total and individual metabolites, the highest quartiles were associated with an approximate 2-fold increased risk of ALL [total metabolites: Virus detection and cytokine profile in relation to age among acute exacerbations of childhood asthma. Little information is available regarding eosinophil activation and cytokine profiles in relation to age in virus-induced bronchial asthma. Viruses were detected in 71 There was no change in the levels of rhinoviruses and RS viruses between the two age groups, defined as children aged acute asthma cases compared with controls.
Production and hosting by Elsevier B. Such EEG abnormalities in left hemisphere correlated with greater social fear, right hemisphere EEG abnormalities with greater anger. Right hemisphere localization in CPS was also associated with parent-reported problems at home.
Potential of gene expression profiling in the management of childhood acute lymphoblastic leukemia. Childhood acute lymphoblastic leukemia ALL is a heterogeneous disease. Current treatment approaches are tailored according to the clinical features of the host, genotypic features of the leukemic blast, and early response to therapy.
Further insights into the biologic basis of the disease may contribute to novel, rational treatment strategies. Childhood ALL has served as an example for demonstrating the feasibility and potential of high-throughput technologies such as global gene expression or transcript profiling. In the last decade or so, utilization of these techniques has grown exponentially.
As the methodology undergoes refinement and validation, it is plausible that microarrays may be used in the routine management of childhood ALL in the next few years. This article discusses the numerous applications to date of gene expression profiling in childhood ALL. Multiple investigators have made it evident that microarrays can be used as a single platform for the accurate classification of ALL into the various cytogenetic subtypes. Additional promising utilities include prediction of early response to therapy, overall outcome, and adverse effects.
Identification of patients who are predicted to have an unfavorable outcome may allow for early intervention such as intensification of therapy or avoidance of drugs that are associated with specific secondary effects such as therapy-related acute myelogenous leukemia. Knowledge has been gained into pathways contributing to leukemogenesis and chemoresistance. Therapeutic targets have been identified, some of which are entering clinical trials following validation in additional preclinical models. These newer methods of genome analyses complemented by studies involving the proteome as well as host.
Acute lymphoblastic leukemia of childhood monitored by bacteriocin and flowcytometry. Bacteriocin and flowcytometric analysis of blood samples from children with acute lymphoblastic leukemia were correlated with clinical stages of disease. Bacteriocins interacted selectively with malignant, and not with normal, lymphocytes causing cell cycle perturbation which was rapidly and objectively recorded by the flowcytometer.
The patients were grouped as: A newly-diagnosed 15 ; B early induction 11 ; C remission with viral infection 7 ; D remission 64 ; E bone marrow relapsed 5 ; F extramedullary relapsed 3 ; G non-malignant pediatric controls 8. Repeated testing correlated well with the clinical status. Blood from 7 patients in remission and from 3 normal individuals, each with transient viral infection, reacted with bacteriocin.
A quantitative correlation between peripheral blood blasts or surface markers for ALL and bacteriocin reactivity was not established. This test can be recommended for preliminary diagnosis and possibly prognosis of lymphoblastic leukemia and provides means of monitoring progress during chemotherapy. The extent to which genetic susceptibility contributes to the causation of childhood acute myeloid leukaemia AML is not known.
Our results thus do not exclude the possibility that this polymorphic variant contributes to the risk of a small proportion of childhood AML. Background Asparaginase and steroids can cause hypertriglyceridemia in children with acute lymphoblastic leukemia ALL. Patients and Methods Fasting lipid profiles were obtained prospectively at 4 time-points for children consecutively enrolled on a frontline ALL study. Risk factors were evaluated by the exact chi-square test. Details of adverse events and management of hypertriglyceridemia were extracted retrospectively. Severe hypertriglyceridemia was not associated with pancreatitis after adjustment for age and treatment arm or with osteonecrosis after adjustment for age.
However, patients with severe hypertriglyceridemia had a 2. Of the 30 episodes of severe hypertriglyceridemia in 18 patients, 7 were managed conservatively while the others with pharmacotherapy. Seventeen of 18 patients continued to receive asparaginase and steroids. Triglyceride levels normalized after completion of ALL therapy in all 12 patients with available measurements. Conclusion Asparaginase- and steroid-induced transient hypertriglyceridemia can be adequately managed with dietary modifications and close monitoring without altering chemotherapy.
Patients with severe hypertriglyceridemia were not at increased risk of adverse events, with a possible exception of thrombosis. The benefit of pharmacotherapy in decreasing symptoms and potential complications requires further investigation. Severe hypertriglyceridaemia during therapy for childhood acute lymphoblastic leukaemia. Asparaginase and steroids can cause hypertriglyceridaemia in children with acute lymphoblastic leukaemia ALL. Fasting lipid profiles were obtained prospectively at four time-points for children consecutively enrolled on a frontline ALL study.
Details of adverse events and management of hypertriglyceridaemia were extracted retrospectively. Severe hypertriglyceridaemia was not associated with pancreatitis after adjustment for age and treatment arm or with osteonecrosis after adjustment for age. However, patients with severe hypertriglyceridaemia had a 2.
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Of the 30 episodes of severe hypertriglyceridaemia in 18 patients, seven were managed conservatively while the others with pharmacotherapy. Triglyceride levels normalised after completion of ALL therapy in all 12 patients with available measurements. Asparaginase- and steroid-induced transient hypertriglyceridaemia can be adequately managed with dietary modifications and close monitoring without altering chemotherapy.
Patients with severe hypertriglyceridaemia were not at increased risk of adverse events, with a possible exception of thrombosis. Attentional and academic difficulties, particularly in math, are common in survivors of childhood acute lymphoblastic leukemia ALL. Of cognitive deficits experienced by survivors of childhood ALL, attention deficits may be particularly responsive to intervention.
However, it is unknown whether deficits in particular aspects of attention are associated with deficits in math skills. The current study investigated relationships between math calculation skills, performance on an objective measure of sustained attention, and parent- and teacher-reported attention difficulties.
Parent and teacher ratings of inattention and impulsivity were obtained. Visual response control and visual attention accounted for Objective testing of visual response control, rather than parent-rated attentional problems, may have clinical utility in identifying ALL survivors at risk for math difficulties. Published by Oxford University Press. For permissions, please e-mail: Acute glomerulonephritis AGN is an important cause of renal morbidity and mortality in children. The incidence varies across the countries with lower rates in developed countries due to improved environmental hygiene and socio-economic status.
The patients' demographic data, presenting complaints; antecedent history of sore throat or skin infections, clinical findings including blood pressure; investigations, management and outcome were obtained. Data was compared with a previous study done in UPTH 14 years ago and in other countries. A total of 31 patients aged 3 to 16 years had AGN, giving an annual incidence of They comprised 16 There is no significant change in the annual incidence of AGN when compared with the The highest incidence occurred during the dry cold windy harmattan season of October to February in 19 Sore throat was the commonest infection preceeding AGN Hypertensive encephalopathy with seizure occurred in 5 There were 4 Urinary tract infection occurred in 7 All patients received conservative treatment while dialysis was done in 5 patients; one peritoneal dialysis PD and 4 haemodialysis.
The recovery rate was The annual incidence of AGN has remained almost the same in Port Harcourt despite the increased urbanization. Childhood parental separation experiences and depressive symptomatology in acute major depression. The aim of this study was to examine the pathoplastic effects of childhood parental separation experiences on depressive symptoms. Patients with acute major depression were identified in a large center study of affective disorders in Japan. Information regarding the patients' childhood losses was collected using a semistructured interview, and their depressive symptomatology was assessed by the Center for Epidemiologic Studies Depression Scale CES-D.
Patients reported significantly higher CES-D total scores when they had experienced early object loss of the same-sex parent. In terms of the CES-D subscores derived by factor analysis, early object loss significantly aggravated symptoms that people normally could cope with but could no longer cope with when depressed e. Once depression develops, early object loss may act as a pathoplastic factor by making it severer especially by rendering people less able to perform what they normally could do. Efficacy and safety of Saccharomyces boulardii in acute childhood diarrhea: To see the efficacy and safety of mg of Saccharomyces boulardii twice daily for 5 d in acute childhood diarrhea.
Those included randomly were given either a placebo or Saccharomyces boullardi SB in identical packets mixed with puffed rice powder. The time of appearance of first semi formed stool in SB group No statistically significant difference was found in rest of the parameters. There is initial evidence available that SB may have a therapeutic role in the management of acute childhood diarrhea. Evidence for under-diagnosis of childhood acute lymphoblastic leukaemia in poorer communities within Great Britain.
Recorded incidence of childhood acute lymphoblastic leukaemia tends to be lower in poorer communities. A 'preemptive infection hypothesis' proposes that some children with leukaemia die from infection without diagnosis of leukaemia. Various different blood abnormalities can occur in untreated leukaemia. Children combining severe neutropenia risk of serious infection with relatively normal haemoglobin and platelet counts lack of pallor and bleeding were postulated to be at risk of dying from infection without leukaemia being suspected.
A deficit of these children among diagnosed patients from poorer communities was predicted. Under-diagnosis in poorer communities may have contributed to socioeconomic variation in recorded childhood acute lymphoblastic leukaemia incidence within Great Britain, and elsewhere. Implications for clinical practice and epidemiological studies should be considered.
Association between air pollution and acute childhood wheezy episodes: SUBJECTS children attending the accident and emergency department with acute wheezy episodes; children with other conditions as the control group. RESULTS--After seasonal adjustment, day to day variations in daily average concentrations of ozone and sulphur dioxide were found to have significant associations with the incidence of acute wheezy episodes. The strongest association was with ozone, for which a non-linear U shaped relation was seen.
Sulphur dioxide had a weaker log-linear relation with incidence 1. Further adjustment for temperature and wind speed did not significantly alter these associations. A critical ozone concentration seems to exist in the atmosphere above or below which children are more likely to develop symptoms. Air toxics and early childhood acute lymphocytic leukemia in Texas, a population based case control study.
Traffic exhaust, refineries and industrial facilities are major sources of air toxics identified by the U. Environmental Protection Agency U. EPA for their potential risk to human health. In utero and early life exposures to air toxics such as benzene and 1,3-butadiene, which are known leukemogens in adults, may play an etiologic role in childhood leukemia that comprises the majority of pediatric cancers. Texas Cancer Registry cases were linked to birth records and then were frequency matched by birth month and year to 10 population-based controls.
Maternal and infant characteristics from birth certificates were abstracted to obtain information about potential confounders. Modelled estimates of benzene, 1,3-butadiene and POM exposures at the census tract level were assigned by linking geocoded maternal addresses from birth certificates to U. Mixed-effects logistic regression models were applied to evaluate associations between air toxics and childhood leukemia.
In adjusted single pollutant models, odds of childhood leukemia among mothers with the highest ambient air exposures compared to those in the lowest quartile were 1. In co-pollutant models, odds ratios for childhood leukemia remained elevated for 1,3-butadiene but were close to the null value for benzene and POM.
We observed positive associations between 1,3-butadiene and childhood leukemia in single and co-pollutant models whereas effect estimates from single pollutant models were diminished for benzene and POM in co. Young adult survivors of childhood acute lymphoblastic leukemia show evidence of chronic inflammation and cellular aging. Large epidemiologic studies have reported the premature onset of age-related conditions, such as ischemic heart disease and diabetes mellitus, in childhood cancer survivors, decades earlier than in their peers.
The authors investigated whether young adult survivors of childhood acute lymphoblastic leukemia ALL have a biologic phenotype of cellular ageing and chronic inflammation. Plasma inflammatory cytokines were measured using a cytometric bead array in 87 asymptomatic young adult survivors of childhood ALL median age, 25 years; age range, years who attended annual follow-up clinic and compared with healthy, age-matched and sex-matched controls.
Leukocyte telomere length LTL was measured using Southern blot analysis. Compared with published data, LTL in survivors was similar to that in healthy individuals aged 20 years older. Asymptomatic young adult survivors of childhood ALL demonstrate a biologic profile of chronic inflammation and telomere attrition, consistent with an early onset of cellular processes that drive accelerated aging. These processes may explain the premature development of age-related chronic conditions in childhood cancer survivors.
Understanding their molecular basis may facilitate targeted interventions to disrupt the accelerated aging process and its long-term impact on overall health. EEG background activity is abnormal in the temporal and inferior parietal cortex in benign rolandic epilepsy of childhood: Benign rolandic epilepsy of childhood BERS is an epilepsy syndrome with presumably genetic-developmental etiology. The pathological basis of this syndrome is completely unknown.
We postulated that a developmental abnormality presumably results in abnormal EEG background activity findings. Bonferroni-corrected p Consensus definitions of 14 severe acute toxic effects for childhood lymphoblastic leukaemia treatment: Although there are high survival rates for children with acute lymphoblastic leukaemia, their outcome is often counterbalanced by the burden of toxic effects. This is because reported frequencies vary widely across studies, partly because of diverse definitions of toxic effects.
Using the Delphi method, 15 international childhood acute lymphoblastic leukaemia study groups assessed acute lymphoblastic leukaemia protocols to address toxic effects that were to be considered by the Ponte di Legno working group. Our results showed that none of the protocols addressed all 14 toxic effects, that no two protocols shared identical definitions of all toxic effects, and that no toxic effect definition was shared by all protocols.
Using the Delphi method over three face-to-face plenary meetings, consensus definitions were obtained for all 14 toxic effects. In the overall assessment of outcome of acute lymphoblastic leukaemia treatment, these expert opinion-based definitions will allow reliable comparisons of frequencies and severities of acute toxic effects across treatment protocols, and facilitate international research on cause, guidelines for treatment adaptation, preventive strategies, and development of consensus algorithms for reporting on acute lymphoblastic leukaemia treatment.
Integration of childhood TB into guidelines for the management of acute malnutrition in high burden countries. Childhood tuberculosis TB and undernutrition are major global public health challenges. In , although an estimated 1 million children aged acute malnutrition from 17 high TB burden countries were reviewed to gather information on TB symptom screening, exposure history, and treatment.
TB screening is not consistently included in guidelines for acute malnutrition in high TB burden countries. Routine TB risk assessment, especially history of TB exposure, among acutely malnourished children, combined with improved linkages with TB services, would help increase TB case finding and could impact outcomes. Operational research on how best to integrate services at different levels of the health care system is needed. Association of the methylenetetrahydrofolate reductase polymorphism in Korean patients with childhood acute lymphoblastic leukemia. Methylenetetrahydrofolate reductase plays a central role in converting folate to methyl donor for DNA methylation.
Recently, methylenetetrahydrofolate reductase MTHFR CT and AC mutations were discovered to be associated with childhood acute lymphoblastic leukemia ALL , as well as colon cancer, lymphoma, esophageal and stomach cancer. To evaluate the associations between birth order, maternal abortion and mode of delivery and childhood acute leukemia risk.
Multiple electronic databases were searched to identify relevant studies up to March using the search terms " childhood leukemia", " acute lymphoblastic leukemia", " acute myeloid leukemia","birth order", "abortion", "miscarriage", "cesarean", "birth characteristics" and "prenatal risk factor". Data from cohort and case-control studies were analyzed using the Stata software. Twenty-three studies were included in this meta-analysis according to the selection criteria.
However, there was a significant association between maternal abortion and childhood acute leukemia risk spontaneous abortion: This meta-analysis revealed that maternal abortion might contribute to the childhood acute leukemia risk. Diffusion tensor imaging and neurocognition in survivors of childhood acute lymphoblastic leukaemia. Survivors of childhood acute lymphoblastic leukaemia are at risk for neurocognitive impairment, though little information is available on its association with brain integrity, particularly for survivors treated without cranial radiation therapy.
Mean standard deviation age at evaluation was Brain grey and white matter volume and diffusion tensor imaging was compared between survivor groups and to 23 healthy controls with a mean standard deviation age of Survivors treated with chemotherapy alone had higher fractional anisotropy in fibre tracts within the left P acute lymphoblastic leukaemia, regardless of treatment, had a lower ratio of white matter to intracranial volume in frontal and temporal lobes P acute lymphoblastic leukaemia treated with chemotherapy alone performed worse in processing speed P acute lymphoblastic leukaemia treated with chemotherapy alone demonstrated significant long-term differences in.
Using data from a genome-wide association study of individuals with childhood acute lymphoblastic leukemia cases and 2, controls and with validation in samples totaling 2, cases and 2, controls, we have shown that common variation at 9p Case-control study of childhood acute lymphoblastic leukemia and residential radon exposure. Several ecologic analyses have shown significant positive associations between mean indoor radon concentrations and risk of leukemia at all ages acute myeloid leukemia and chronic lymphocytic leukemia and for children all leukemia, acute myeloid leukemia, and acute lymphoblastic leukemia [ALL].
As part of an age-matched, case-control study of childhood ALL in the United States, we investigated the association between the incidence of ALL in children under age 15 years and indoor radon exposure. Radon detectors were placed in current and previous homes of subjects where they resided for 6 months or longer.
Mean radon concentration was lower for case subjects For categories less than 37, , , and or more Bqm -3 of radon exposure, relative risks based on matched case-control pairs were 1. There was no association between ALL and radon exposure within subgroups defined by categories of age, income, birth order, birth weight, sex, type of residence, magnetic field exposure, parental age at the subject's birth, parental occupation, or parental smoking habits. In contrast to prior ecologic studies, the results from this analytic study provide no evidence for an association between indoor radon exposure and childhood ALL.
Background While many studies have evaluated the association between acute childhood leukemia and environmental factors, knowledge is limited. Ambient air pollution has been classified as a Group 1 carcinogen, but studies have not established whether traffic-related air pollution is associated with leukemia. The goal of our study was to determine if children with acute leukemia had higher odds of exposure to traffic-related air pollution at birth compared to controls.
Using a novel satellite-based land-use regression model of nitrogen dioxide NO2 and estimating road density based on the US Census, we evaluated the association between traffic-related air pollution and childhood leukemia using conditional logistic regression. Results The odds of exposure to the fourth quartile of NO2 These estimates were stronger among children with acute myeloid leukemia AML than acute lymphoid leukemia, with a positive association observed among urban children with AML 4th quartile odds ratio: While we observed no significant association with road density, male cases had an elevated odds of exposure to roads at m from the birth residence compared to controls OR: Conclusions Although we observed no association overall between NO2 or road density, this was the first study to observe an elevated odds of exposure to NO2 among children with AML compared to controls suggesting further exploration of traffic-related air pollution and AML is.
Long-term hearing outcomes after recurrent acute otitis media during early childhood. To survey long-term hearing outcomes and middle ear pathology in a year follow-up in individuals with onset of recurrent acute otitis media rAOM before three years of age. Thirteen subjects had suffered from rAOM during early childhood and 15 subjects served as a control group. Recurrent acute otitis media subjects reported hearing problems comparable to those of the controls. Children suffering from rAOM will be at low risk of developing hearing loss and severe middle ear disease.
Contextual factors associated with health care service utilization for children with acute childhood illnesses in Nigeria. To examine the independent contribution of individual, community and state-level factors to health care service utilization for children with acute childhood illnesses in Nigeria. The study was based on secondary analyses of cross-sectional population-based data from the Nigeria Demographic and Health Survey DHS. Multilevel logistic regression models were applied to the data on 6, under-five children who used or did not use health care service when they were sick level 1 , nested within communities level 2 from 37 states level 3.
Our findings highlight that utilization of healthcare service for acute childhood illnesses was influenced by not only maternal factors but also community-level factors, suggesting that public health strategies should recognise this complex web of individual composition and contextual composition factors to guide provision of healthcare services.
Such interventions could include: Living on a farm, contact with farm animals and pets, and childhood acute lymphoblastic leukemia: The associations between childhood acute lymphoblastic leukemia ALL and several factors related to early stimulation of the immune system, that is, farm residence and regular contacts with farm animals livestock, poultry or pets in early childhood , were investigated using data from 13 case-control studies participating in the Childhood Leukemia International Consortium.
In all studies, the data were obtained from case and control parents using standardized questionnaires. There was no evidence of a significant association with farm residence in the first year of life. The findings of these large pooled and meta-analyses add additional evidence to the hypothesis that regular contact with animals in early childhood is inversely associated with childhood ALL occurrence which is consistent with Greaves' delayed infection hypothesis.
Advances in therapy for Philadelphia-positive acute lymphoblastic leukaemia of childhood and adolescence. This treatment approach has been applied in a few clinical trials by paediatric leukaemia study groups. Thus, this subtype of ALL serves as the first model system for truly targeted treatment. The role of haematopoietic stem cell transplantation HSCT is increasingly called into question, at least in a favourable, though not yet clearly defined, subset of patients.
Currently, the choice of the most effective tyrosine kinase inhibitor is not yet settled, in particular, in view of potential reduction of overall treatment intensity. Such alterations result in the acquisition of stem cell-like features, overexpression of adhesion molecules causing aberrant cell-cell and cell-stroma interaction, and decreased sensitivity to tyrosine kinase inhibitors. The majority of variants adversely affected IKZF1 function and drug responsiveness of leukemic cells.
These results identify IKZF1 as a leukemia predisposition gene, and emphasize the importance of germline genetic variation in the development of both familial and sporadic ALL. High interleukin expression characterizes childhood acute lymphoblastic leukemia with involvement of the CNS. Applying current diagnostic methods, overt CNS involvement is a rare event in childhood acute lymphoblastic leukemia ALL.
In contrast, CNS-directed therapy is essential for all patients with ALL because without it, the majority of patients eventually will experience relapse.
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To approach this discrepancy and to explore potential distinct biologic properties of leukemic cells that migrate into the CNS, we compared gene expression profiles of childhood ALL patients with initial CNS involvement with the profiles of CNS-negative patients. We evaluated leukemic gene expression profiles from the bone marrow of 17 CNS-positive patients and 26 CNS-negative patients who were frequency matched for risk factors associated with CNS involvement.
Results were confirmed by real-time quantitative polymerase chain reaction analysis and validated using independent patient samples. Diagnostic likelihood ratios for CNS positivity were 0. Acute lymphoblastic leukemia ALL is a malignant disease of the white blood cells. The etiology of ALL is believed to be multifactorial and likely to involve an interplay of environmental and genetic variables. These associations and another association at 11p The identification of TP63 and PTPRJ as susceptibility genes emphasize the role of the TP53 gene family and the importance of proteins regulating cellular processes in connection with tumorigenesis.
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Exposure to professional pest control treatments and the risk of childhood acute lymphoblastic leukemia. Previous studies suggest that exposure to pesticides increases the risk of childhood acute lymphoblastic leukemia ALL. The aim of this analysis was to investigate whether professional pest treatments in or around the home before birth or during childhood increased the risk of childhood ALL. Data from cases and frequency-matched controls were analyzed using unconditional logistic regression, adjusting for study matching variables and potential confounders, to calculate odds ratios ORs.
A meta-analysis of our findings with the published findings of previous studies was also conducted. The ORs for any professional pest control treatments were 1. If you use a digital signature, your signature must exactly match the First and Last names that you specified earlier in this form. This form does not constitute legal advice and nothing that you read or are provided on this web site should be used as a substitute for the advice of competent legal counsel. If someone believes in good faith that a Lulu Account Holder has infringed their copyright, they can request that we take down the infringing material by filing a DMCA Notice.
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An awful pain resulting from a terrible disease that excavates the body, like a war, without any reason, without any future. The author offers, in these simple, harsh and emotional poems in which we are often left breathless, the experience of a man who's had to come to terms with the meaning of life, the anger mounting inside his soul, the inability to understand, the need to scream and protest against what has been taken away, day after day.
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