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Aliakbari F, Gilani MAS, Amidi F, Baazm M, Korouji M, Izadyar F, Yazdekhasti H, Abbasi M. Improving the Efficacy of Cryopreservation of Spermatogonia Stem Cells by Antioxidant Supplements. Cell Reprogram 2016; 18:87-95. [DOI: 10.1089/cell.2015.0067] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Affiliation(s)
- Fereshte Aliakbari
- Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran, 1417613151
| | - Mohamad Ali Sedighi Gilani
- Department of Urology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran, 1417613151
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran, 1417613151
| | - Fardin Amidi
- Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran, 1417613151
| | - Maryam Baazm
- Department of Anatomy, School of Medicine, Arak University of Medical Sciences, Arak, Iran, 3133705
| | - Morteza Korouji
- Cellular and Molecular Research Center and Department of Anatomical Sciences, Iran University of Medical Science, Tehran, Iran, 88052965
| | | | - Hosein Yazdekhasti
- Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran, 1417613151
| | - Mehdi Abbasi
- Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran, 1417613151
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Kılıcarslan Toruner E, Altay N, Kisecik Z. Determine the difficulties of home care in children following haematopoietic stem cell transplantation. Eur J Cancer Care (Engl) 2015; 25:661-7. [PMID: 26053129 DOI: 10.1111/ecc.12335] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2015] [Indexed: 11/29/2022]
Abstract
The aim of this study was to determine the difficulties regarding the home care of children following haematopoietic stem cell transplantation (HSCT). The sample of the study includes the families of 73 children in a bone marrow transplant unit between 2010 and 2013, Turkey. Data were collected using a form included descriptive information and questions about the difficulties and complications of home care. Families were telephoned and problems they had encountered were recorded. Mann-Whitney U-test and the logistic regression analysis were used. The average age of the children was 10.65 ± 5.03 years, the average age was 8.89 ± 4.9 when HSCT was performed, and the average year after HSCT was 1.79 ± 0.74. 41.1% of the children underwent transplantation with diagnoses of anaemia. Primary physical problems that were found after discharge from the hospital were fever (43.8%), decreased appetite (37%), rash (34.2%) and pain (26%). Socially, 43.8% of families reported that their children had difficulties with school. Primary difficulties regarding care and follow-up were reported as skin care (34.2%) and catheter care (33.3%). In the post-transplantation period, it is important to provide information about potential problems and care to patients and families in order to increase the quality of life.
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Affiliation(s)
| | - N Altay
- Faculty Nursing Department, Gazi University Health Sciences, Ankara, Turkey
| | - Z Kisecik
- Ankara Child Health and Illness Hematology-Oncology Education Research Hospital, Ankara, Turkey
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3
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Payros D, Secher T, Boury M, Brehin C, Ménard S, Salvador-Cartier C, Cuevas-Ramos G, Watrin C, Marcq I, Nougayrède JP, Dubois D, Bedu A, Garnier F, Clermont O, Denamur E, Plaisancié P, Theodorou V, Fioramonti J, Olier M, Oswald E. Maternally acquired genotoxic Escherichia coli alters offspring's intestinal homeostasis. Gut Microbes 2014; 5:313-25. [PMID: 24971581 PMCID: PMC4153768 DOI: 10.4161/gmic.28932] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
The neonatal gut is rapidly colonized by a newly dominant group of commensal Escherichia coli strains among which a large proportion produces a genotoxin called colibactin. In order to analyze the short- and long-term effects resulting from such evolution, we developed a rat model mimicking the natural transmission of E. coli from mothers to neonates. Genotoxic and non-genotoxic E. coli strains were equally transmitted to the offspring and stably colonized the gut across generations. DNA damage was only detected in neonates colonized with genotoxic E. coli strains. Signs of genotoxic stress such as anaphase bridges, higher occurrence of crypt fission and accelerated renewal of the mature epithelium were detected at adulthood. In addition, we observed alterations of secretory cell populations and gut epithelial barrier. Our findings illustrate how critical is the genotype of E. coli strains acquired at birth for gut homeostasis at adulthood.
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Affiliation(s)
- Delphine Payros
- INRA; USC 1360; Toulouse, France,Inserm; UMR1043; Toulouse, France,CNRS; UMR5282; Toulouse, France,Université de Toulouse; UPS; Toulouse, France,Neuro-gastroenterologie & Nutrition; UMR Toxalim INRA/ENVT 1331; Toulouse, France
| | - Thomas Secher
- INRA; USC 1360; Toulouse, France,Inserm; UMR1043; Toulouse, France,CNRS; UMR5282; Toulouse, France,Université de Toulouse; UPS; Toulouse, France
| | - Michèle Boury
- INRA; USC 1360; Toulouse, France,Inserm; UMR1043; Toulouse, France,CNRS; UMR5282; Toulouse, France,Université de Toulouse; UPS; Toulouse, France
| | - Camille Brehin
- INRA; USC 1360; Toulouse, France,Inserm; UMR1043; Toulouse, France,CNRS; UMR5282; Toulouse, France,Université de Toulouse; UPS; Toulouse, France,CHU Toulouse; Hôpital Purpan; Service de bactériologie-Hygiène; Toulouse, France
| | - Sandrine Ménard
- Neuro-gastroenterologie & Nutrition; UMR Toxalim INRA/ENVT 1331; Toulouse, France
| | | | - Gabriel Cuevas-Ramos
- INRA; USC 1360; Toulouse, France,Inserm; UMR1043; Toulouse, France,CNRS; UMR5282; Toulouse, France,Université de Toulouse; UPS; Toulouse, France
| | - Claude Watrin
- INRA; USC 1360; Toulouse, France,Inserm; UMR1043; Toulouse, France,CNRS; UMR5282; Toulouse, France,Université de Toulouse; UPS; Toulouse, France
| | - Ingrid Marcq
- Université de Picardie Jules Verne; EA 4666 UFR de médecine d’Amiens, France
| | - Jean-Philippe Nougayrède
- INRA; USC 1360; Toulouse, France,Inserm; UMR1043; Toulouse, France,CNRS; UMR5282; Toulouse, France,Université de Toulouse; UPS; Toulouse, France
| | - Damien Dubois
- INRA; USC 1360; Toulouse, France,Inserm; UMR1043; Toulouse, France,CNRS; UMR5282; Toulouse, France,Université de Toulouse; UPS; Toulouse, France,CHU Toulouse; Hôpital Purpan; Service de bactériologie-Hygiène; Toulouse, France
| | - Antoine Bedu
- CHU Limoge; Service de Pédiatrie; Limoges, France
| | - Fabien Garnier
- Université de Limoges UMR-S1092; Limoges, France,Inserm U1092; Limoges, France
| | - Olivier Clermont
- Inserm UMR-S 722; Univ Paris Diderot; PRES Sorbonne Cité; Paris, France
| | - Erick Denamur
- Inserm UMR-S 722; Univ Paris Diderot; PRES Sorbonne Cité; Paris, France
| | | | - Vassilia Theodorou
- Neuro-gastroenterologie & Nutrition; UMR Toxalim INRA/ENVT 1331; Toulouse, France
| | - Jean Fioramonti
- Neuro-gastroenterologie & Nutrition; UMR Toxalim INRA/ENVT 1331; Toulouse, France
| | - Maïwenn Olier
- INRA; USC 1360; Toulouse, France,Inserm; UMR1043; Toulouse, France,CNRS; UMR5282; Toulouse, France,Université de Toulouse; UPS; Toulouse, France,Neuro-gastroenterologie & Nutrition; UMR Toxalim INRA/ENVT 1331; Toulouse, France,Correspondence to: Maïwenn Olier, and Eric Oswald,
| | - Eric Oswald
- INRA; USC 1360; Toulouse, France,Inserm; UMR1043; Toulouse, France,CNRS; UMR5282; Toulouse, France,Université de Toulouse; UPS; Toulouse, France,CHU Toulouse; Hôpital Purpan; Service de bactériologie-Hygiène; Toulouse, France,Correspondence to: Maïwenn Olier, and Eric Oswald,
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Schuitema I, Deprez S, Van Hecke W, Daams M, Uyttebroeck A, Sunaert S, Barkhof F, van Dulmen-den Broeder E, van der Pal HJ, van den Bos C, Veerman AJP, de Sonneville LMJ. Accelerated aging, decreased white matter integrity, and associated neuropsychological dysfunction 25 years after pediatric lymphoid malignancies. J Clin Oncol 2013; 31:3378-88. [PMID: 23960182 DOI: 10.1200/jco.2012.46.7050] [Citation(s) in RCA: 92] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
PURPOSE CNS-directed chemotherapy (CT) and cranial radiotherapy (CRT) for childhood acute lymphoblastic leukemia or lymphoma have various neurotoxic properties. This study aimed to assess their impact on the maturing brain 20 to 30 years after diagnosis, providing a much stronger perspective on long-term quality of life than previous studies. PATIENTS AND METHODS Ninety-three patients treated between 1978 and 1990 at various intensities, with and without CRT, and 49 healthy controls were assessed with magnetic resonance diffusion tensor imaging (DTI) and neuropsychological tests. Differences in fractional anisotropy (FA)-a DTI measure describing white matter (WM) microstructure-were analyzed by using whole brain voxel-based analysis. RESULTS CRT-treated survivors demonstrated significantly decreased FA compared with controls in frontal, parietal, and temporal WM tracts. Trends for lower FA were seen in the CT-treated survivors. Decreases in FA correlated well with neuropsychological dysfunction. In contrast to the CT group and controls, the CRT group showed a steep decline of FA with age at assessment. Younger age at cranial irradiation and higher dosage were associated with worse outcome of WM integrity. CONCLUSION CRT-treated survivors show decreased WM integrity reflected by significantly decreased FA and associated neuropsychological dysfunction 25 years after treatment, although effects of CT alone seem mild. Accelerated aging of the brain and increased risk of early onset dementia are suspected after CRT, but not after CT.
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Affiliation(s)
- Ilse Schuitema
- Ilse Schuitema and Leo M.J. de Sonneville, Leiden University, Leiden; Ilse Schuitema, Marita Daams, Frederik Barkhof, Eline van Dulmen-den Broeder, and Anjo J.P. Veerman, Vrije Universiteit University Medical Center; Helena J. van der Pal and Cor van den Bos, Academic Medical Center, Amsterdam, the Netherlands; Sabine Deprez, Anne Uyttebroeck, and Stefan Sunaert, University Hospitals Leuven; Wim Van Hecke, icoMetrix, Leuven, Belgium
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Betz CL, Redcay G. AN EXPLORATORY STUDY OF FUTURE PLANS AND EXTRACURRICULAR ACTIVITIES OF TRANSITION-AGE YOUTH AND YOUNG ADULTS. ACTA ACUST UNITED AC 2009; 28:33-61. [PMID: 15824028 DOI: 10.1080/01460860590916753] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
A descriptive profile of the health related concerns, school-related and extracurricular activities, employment-related activities, social relationships and future plans of 25 transition-aged youth and young adults (ages 14 to 21 years) were conducted. The findings of this exploratory study provide insight on the impact their chronic condition had upon all aspects of their lives. Sixty percent of respondents indicated they had missed school due to their condition and a third of the respondents had not completed high school. Health care professionals usually were not identified as participatory in youth transition planning. The majority of these transition-aged youth and young adults had positive feelings towards their school experience, although most of the respondents were not involved in school projects or clubs, which suggests their participation in school-related extra-curricular activities was limited. Nearly all of the respondents had some form of employment experience. Most of their work experiences were nonpaying jobs such as serving as a volunteer and participating in school-based employment training. Nearly all of the respondents expressed desires for sustainable employment and fiscal and social independence. Most of the respondents reported having social relationships with just less than half reporting seeing friends outside of school.
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Affiliation(s)
- Cecily L Betz
- USC University Center of Excellence for Developmental Disabilities, Childrens Hospital Los Angeles, California 90033, USA.
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6
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van Casteren NJ, Dohle GR, Romijn JC, de Muinck Keizer-Schrama SMPF, Weber RFA, van den Heuvel-Eibrink MM. Semen cryopreservation in pubertal boys before gonadotoxic treatment and the role of endocrinologic evaluation in predicting sperm yield. Fertil Steril 2008; 90:1119-25. [PMID: 17905241 DOI: 10.1016/j.fertnstert.2007.08.006] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2007] [Revised: 08/02/2007] [Accepted: 08/03/2007] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To evaluate the feasibility of semen cryopreservation in pubertal boys before they receive gonadotoxic therapy and to identify which pretreatment parameters might predict successful cryopreservation. DESIGN Retrospective data analysis. SETTING Tertiary fertility center, academic children's hospital. PATIENT(S) Between 1995 and 2005, 80 boys (median age 16.6 years, range 13.7-18.9 years) consulted the outpatient clinic of andrology for semen cryopreservation before a potentially gonadotoxic treatment. INTERVENTION(S) We assessed the pretreatment semen parameters, hormone levels, and patients' characteristics. MAIN OUTCOME MEASURE(S) Measurement of the number of adolescents able to cryopreserve semen. RESULT(S) Thirteen boys were unable to produce semen by masturbation. In 53 boys semen quality was adequate for cryopreservation. In 14 patients semen analysis did not show motile spermatozoa, and therefore semen cryopreservation could not be performed. Although inhibin B showed a strong correlation with sperm count, no significant difference was found in serum T, inhibin B, LH, and FSH levels in the patients with or without successful sperm yield. Moreover, median age was not different between patients with and without a successful sperm yield. CONCLUSION(S) Semen cryopreservation in boys is a feasible method to preserve spermatozoa before gonadotoxic therapy is started and should be offered to all pubertal boys despite their young age. Serum hormone levels do not predict sperm yield.
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Affiliation(s)
- Niels J van Casteren
- Department of Urology, Andrology Unit, Erasmus MC-University Medical Center, Rotterdam, The Netherlands
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7
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Parkes SE, Jenkinson HC, Griffiths A, Kinch D, Mann JR. Is postal follow-up of childhood cancer survivors worthwhile? Pediatr Blood Cancer 2008; 50:80-4. [PMID: 17514735 DOI: 10.1002/pbc.21196] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Childhood cancer survival has increased over the last 30 years, but long-term effects necessitate continued monitoring of survivors. Since not all of them attend follow-up clinics, this study assesses the efficacy of obtaining information from general practitioners (GPs) through a 5-year rolling postal program. PROCEDURE Survivors were included who had been diagnosed with a malignancy in the West Midlands since 1957 and were not attending central long-term follow-up clinics. RESULTS One thousand twenty-seven patients were followed up between 1993 and 2004. Replies were received on 903 (88% response). There were 44 subsequent malignancies and 42 deaths. No medical problems were reported in 341/935 patients (36.5%); in the other 594 endocrine effects were the most common, with visual effects the biggest single problem. Brain tumor survivors had the largest proportion of problems. CONCLUSIONS The response rate and information quality achieved show that this method of follow-up is feasible, in cases of discharged or defaulting patients. These data will complement those derived from hospital-based follow-up studies, to give a broader understanding of the spectrum of late effects experienced by survivors and may inform the development of specific long-term follow-up protocols.
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Affiliation(s)
- Sheila E Parkes
- Oncology Department, Birmingham Children's Hospital, Steelhouse Lane, Birmingham, United Kingdom.
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8
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Poppelreuter M, Weis J, Mumm A, Orth HB, Bartsch HH. Rehabilitation of therapy-related cognitive deficits in patients after hematopoietic stem cell transplantation. Bone Marrow Transplant 2007; 41:79-90. [DOI: 10.1038/sj.bmt.1705884] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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9
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Aslett H, Levitt G, Richardson A, Gibson F. A review of long-term follow-up for survivors of childhood cancer. Eur J Cancer 2007; 43:1781-90. [PMID: 17543515 DOI: 10.1016/j.ejca.2007.04.009] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2006] [Revised: 04/06/2007] [Accepted: 04/11/2007] [Indexed: 10/23/2022]
Abstract
Though cure from cancer is not guaranteed, children's chances of survival have increased significantly. As a result the paediatric oncology community is focused on providing appropriate follow-up care to an increasing number of young cancer survivors. How this care should be designed and delivered however remains the centre of ongoing discussion and was the focus of this review. The aims of the review were to (1) gain an understanding of current follow-up practices from studies involving health care professionals, (2) identify and evaluate studies presenting views of survivors, (3) examine commentaries on both the current and future design of long-term follow-up services and (4) evaluate existing follow-up guidelines. Empirical research, commentary papers and published guidelines were reviewed. Twenty-eight papers and five guidelines were analysed. Empirical papers were examined in relation to sample, design, findings and limitations. Commentary papers were assessed in relation to key issues about follow-up care. Guidelines were assessed on how far they were evidence-based, peer-reviewed and involved users in their development. Varying models of care were illustrated, and were dependent upon personnel and centre orientation. Variability in the level and degree to which long-term survivors were followed up was also reported. Inconsistencies in practice were noted. Nonetheless requirements for an effective service were highlighted in the majority of publications, these included communication and information. Although young people and professionals had a shared view on many aspects of follow-up care, these preferences were not consistently mirrored in service provision.
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Affiliation(s)
- Helen Aslett
- Department of Psychology, London Metropolitan University, Calcutta House, Old Castle Street, London E1 7NT, United Kingdom.
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10
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Ream E, Gibson F, Edwards J, Seption B, Mulhall A, Richardson A. Experience of fatigue in adolescents living with cancer. Cancer Nurs 2006; 29:317-26. [PMID: 16871100 DOI: 10.1097/00002820-200607000-00011] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This article reports on a small-scale exploratory study conducted with cohorts of adolescents during and after treatment of cancer to explore experiences of fatigue and perceptions of its impact on functioning. A concurrent mixed method design was used to enable detailed understanding of the phenomenon of fatigue in these groups of individuals through convergence of quantitative and qualitative data. Participants completed an investigator-designed Fatigue and Quality of Life Diary for a period of 1 week. Second, they took part in a semistructured interview to explore issues around fatigue and functioning in more detail. Eight adolescents undergoing treatment participated in the study, along with 6 in early remission (1-2 years off treatment) and 8 receiving follow-up (5 or more years off treatment). Data gained from these sources suggested that fatigue can be a considerable problem for adolescents during and after treatment, and that it may not necessarily abate quickly. Some individuals perceived that their quality of life remained compromised many years after treatment, and it seemed that fatigue might play an important part in this. These preliminary findings suggest that research into management of fatigue in this adolescent group is warranted, along with research and development to determine how best to provide supportive care once treatment finishes.
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Affiliation(s)
- Emma Ream
- Florence Nightingale School of Nursing and Midwifery, King's College London, England.
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11
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Felder-Puig R, di Gallo A, Waldenmair M, Norden P, Winter A, Gadner H, Topf R. Health-related quality of life of pediatric patients receiving allogeneic stem cell or bone marrow transplantation: results of a longitudinal, multi-center study. Bone Marrow Transplant 2006; 38:119-26. [PMID: 16820782 DOI: 10.1038/sj.bmt.1705417] [Citation(s) in RCA: 79] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The results of a 5-year longitudinal prospective study about the health-related quality of life (HRQL) of pediatric patients receiving allogeneic bone marrow or stem cell transplantation (BMT) are described. The patients' HRQL was assessed twice before, and five times after BMT, the end point being 1 year after BMT. For the measurement of HRQL, standardized questionnaires were completed by patients, parents and physicians. The final sample consisted of 68 patients aged 4-18 years, of which 19 were lost in the course of the study owing to relapse, transplant rejection and/or death. The worst HRQL was seen shortly after transplant and HRQL thereafter improved steadily, although the improvement was not always linear and not all patients drew benefit from this average positive evolution. Compromised emotional functioning, a high level of worry and reduced communication during the acute phase of treatment had a negative impact on HRQL 1 year after BMT. Nausea and pain during the acute phase of treatment did not have an effect on later HRQL. The interobserver agreement of HRQL reports between parents and their children was moderate to good, and generally better than child-physician and parent-physician agreement.
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12
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Koch SV, Kejs AMT, Engholm G, Møller H, Johansen C, Schmiegelow K. Leaving home after cancer in childhood: a measure of social independence in early adulthood. Pediatr Blood Cancer 2006; 47:61-70. [PMID: 16572415 DOI: 10.1002/pbc.20827] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Previous studies on psychosocial outcomes for childhood and adolescent cancer survivors have found diverse results concerning social independence. As a measure of social independence, we investigated whether cancer survivors displayed the same patterns of leaving home as population-based control group. PROCEDURE We identified 1,597 patients in the Danish Cancer Register, born in 1965-1980, in whom a primary cancer was diagnosed before they reached the age of 20 in the period 1965-1995. The patients were compared with a random sample of the general population (n = 43,905) frequency matched on sex and date of birth. By linking the two cohorts to registers in Statistics Denmark, we obtained socioeconomic data for the period 1980-1997. The relative risk for leaving home was estimated with discrete-time Cox regression models. RESULTS The risk for leaving home of survivors of hematological malignancies and solid tumors did not differ significantly from that of the control cohort. Adjustments for possible socioeconomic confounders did not change this pattern. In contrast, survivors of central nervous system (CNS) tumors had a significantly reduced risk for leaving home, which was most pronounced for men (relative risk, men: 0.66; 95% confidence interval, 0.55-0.80; women: 0.88, 95% confidence interval, 0.80-0.97). CONCLUSION Overall, the psychosocial effects of cancer in childhood or adolescence and its treatment on the survivor and family did not appear to impede social independence in early adulthood, except for survivors of CNS tumors.
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Affiliation(s)
- Susanne Vinkel Koch
- Section of Pediatric Hematology and Oncology, Pediatric Clinic II, Juliane Marie Center, University Hospital, H:S Rigshospitalet, Copenhagen, Denmark
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13
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Skinner R, Wallace WHB, Levitt GA. Long-term follow-up of people who have survived cancer during childhood. Lancet Oncol 2006; 7:489-98. [PMID: 16750499 DOI: 10.1016/s1470-2045(06)70724-0] [Citation(s) in RCA: 118] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Substantial improvements in survival after treatment for malignant disease in childhood are leading to a rapidly increasing number of long-term survivors, many of whom are now adults. However, late chronic adverse effects of treatment are common, and have potentially severe effects on survivors' future physical, cognitive, or psychosocial health. The aim of long-term follow-up is to facilitate timely diagnosis and appropriate management of late adverse effects, thereby reducing the frequency of severe complications. Although the delivery of long-term follow-up care varies substantially--particularly in terms of who provides it, where, and how--recognition of the importance of appropriate multidisciplinary care and cross-speciality care is increasing, especially for adolescent and adult survivors of cancer during childhood. Several models of long-term follow-up care have been developed to address this need. This review discusses the present provision of long-term follow-up, and summarises information that might facilitate design and implementation of future models of long-term follow-up care.
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Affiliation(s)
- Roderick Skinner
- Department of Paediatric and Adolescent Oncology, Royal Victoria Infirmary, Newcastle upon Tyne Hospitals NHS Trust, Newcastle upon Tyne, UK.
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Abstract
Research into depression in paediatric cancer is in its early stages, but nevertheless has presented interesting challenges regarding the recognition and measurement of depression in a medically ill population. In this article we discuss the complex interaction between physical and psychological variables, and the diagnostic difficulties arising from this. We review the epidemiological findings regarding prevalence, evaluating the apparently low prevalence rate in the light of methodological weaknesses. Hypotheses put forward to explain the findings are discussed. We conclude by highlighting areas for future research.
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15
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Maligne Knochentumoren bei jungen Patienten. Monatsschr Kinderheilkd 2006. [DOI: 10.1007/s00112-005-1271-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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16
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Abstract
ISSUES AND PURPOSE This article describes the development and implementation of an innovative advanced practice role, as a transition service coordinator for nurses who work with adolescents with special healthcare needs. Transition services for adolescents with special healthcare needs is an area of growing clinical need requiring that all healthcare professionals, including advanced practice nurses develop new clinical knowledge and skills to practice effectively. CONCLUSION This emerging specialty area will require advanced practice nurses to provide direct services blending both pediatric and adult healthcare needs and to function in advanced practice roles such as case managers who can ensure the coordination of services between these two very different systems of care while promoting the youth's acquisition of goals for adulthood. This nursing role was first created to provide and coordinate transition services to youth seen in a piloted clinic titled Creating Healthy Futures. PRACTICE IMPLICATIONS This article describes the various components of this nursing role that incorporated the advanced practice dimensions of clinical expert, consultant, change agent, leader, researcher, and educator that can be replicated in other clinical settings.
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Affiliation(s)
- Cecily L Betz
- University of Southern California Center for Excellence in Developmental Disabilities, Children's Hospital, Los Angeles, USA
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Demark-Wahnefried W, Werner C, Clipp EC, Guill AB, Bonner M, Jones LW, Rosoff PM. Survivors of childhood cancer and their guardians. Cancer 2005; 103:2171-80. [PMID: 15812823 DOI: 10.1002/cncr.21009] [Citation(s) in RCA: 131] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Survivors of childhood cancer are at increased risk for osteoporosis, cardiovascular disease, and second malignancies-conditions for which modifiable risk factors are recognized and lifestyle interventions have shown benefit. Although some data regarding health behaviors of this population exist, receptivity to health promotion is largely unknown. METHODS A survey was mailed to 380 survivors (age range, 11-33 years) of childhood leukemia, lymphoma, or central nervous system carcinomas (and guardians of survivors < 18 years old) to elicit data on exercise, dietary intake of calcium, fat, and fruits and vegetables, smoking status, readiness to pursue lifestyle change, quality of life, and interest in various health interventions. RESULTS Responses from 209 survivors (a 55% response rate) suggested that most did not meet guidelines for fruit and vegetable consumption (79%), calcium intake (68%), or exercise (52%), 42% were overweight/obese, and 84% consumed > 30% of calories from fat. Older (> 18 years) compared with younger (< 18 years) survivors were more likely to smoke (17% vs. 1%), to be obese (21.6% vs. 14.6%), and to have suboptimal calcium intakes (75.6% vs. 57.6%). No differences in lifestyle behaviors were observed between cancer groups. Compared with interventions aimed at weight control, improving self-esteem, or smoking cessation, the highest levels of interest were found consistently for interventions aimed at getting in shape and eating healthy. Survivors preferred mailed interventions to those delivered in-person, by telephone counselors, or via computers. CONCLUSIONS Survivors of childhood cancer practiced several suboptimal health behaviors. Health promotion interventions aimed at areas of interest and delivered through acceptable channels have the potential to improve long-term health and function of this vulnerable population.
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Affiliation(s)
- Wendy Demark-Wahnefried
- Department of Surgery, Duke University Medical Center, Durham, North Carolina 27710, USA. demar001mc.duke.edu
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Abstract
Inactivation of p53 function is a common event in cancer. Approximately 50% of human tumours express mutant p53 and there is evidence that in others, including many childhood tumours, p53 function is impaired in other ways. These defects in p53 function may be due to the alteration of cellular factors that modulate p53 or to the expression of viral oncoproteins. Radiotherapy and many of the chemotherapeutic drugs currently used in cancer treatment are potent activators of p53. However, most of these therapies have a serious drawback, and that is the long-term consequences of their DNA damaging effects. Here, we review the discoveries in p53 research that are most significant to the development of new therapies based on the induction of the transcriptional activity of p53 in a non-genotoxic way and discuss the situations in which this type of approach may be most beneficial.
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Affiliation(s)
- S Lain
- Department of Surgery and Molecular Oncology, University of Dundee, Ninewells Hospital, Scotland, UK.
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Schulman KA, Seils DM. Outcomes research in oncology: improving patients' experiences with cancer treatment. Clin Ther 2003; 25:665-70. [PMID: 12749520 DOI: 10.1016/s0149-2918(03)80103-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Outcomes research in oncology is a relatively young field, but its potential for expanding our understanding of patients' experiences with cancer gives it increasing relevance to clinical oncology research. We provide a brief overview of the growing prevalence of oncology outcomes research, and we discuss some of the key areas of inquiry currently engaging outcomes researchers. In doing so, we introduce the articles in this supplemental section, which address some of the unique concerns of outcomes researchers and outline the most important challenges confronting this research community.
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Affiliation(s)
- Kevin A Schulman
- Center for Clinical and Genetic Economics, Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina 27715, USA.
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