Aprepitant reduces chemotherapy-induced vomiting in children and young adults with brain tumors

Determining the factors affecting chemotherapy-induced nausea and vomiting in children with cancer

PURPOSE

We evaluated the factors affecting chemotherapy-induced nausea and vomiting (CINV) in children with cancer.

DESIGN AND METHODS

This cross-sectional study was conducted with 62 children aged 9 to 18 years old with a solid tumor who received chemotherapy for the first time, and their parents. Data were collected using a data collection form, the State-Trait Anxiety Inventory for Children, the Beck Anxiety Inventory, the Spielberger State-Trait Anxiety Inventory, and the Baxter Retching Faces Scale. Data were analyzed using Spearman's correlation and logistic regression analyses.

RESULTS

Risk factors related to the child, treatment, and parent were examined. Child-related factors were determined as diagnosis (odds ratio [OR] = 5.5), time since diagnosis (OR = 1.9, OR = 4.7), pretreatment anxiety of the child (r = 0.439, r = 0.422), and past experience of nausea and vomiting before treatment (OR = 1.2). Treatment-related factors involved anti-emetic prophylaxis (OR = 4.9, OR = 9.2). Parent-related factors included pretreatment anxiety of the parent (r = 0.271, r = 0.287), accommodation (OR = 5.5), not eating (OR = 1.2, OR = 1.3), and bad smell (OR = 1.2), which were described amongst parents' as factors that trigger CINV.

CONCLUSIONS

The occurrence of CINV is significantly affected by child-, treatment-, and parent-related risk factors.

PRACTICE IMPLICATIONS

Pediatric nurses should create an environment for children and their parents to reduce their anxiety and provide basic knowledge and skills about the management of CINV.

The Effect of Concealing the Hydration Fluid on Anticipatory Nausea-Vomiting in Pediatric Hematology-Oncology Patients Undergoing Chemotherapy Treatment: A Randomized Controlled Study

PURPOSE

The aim of this study was to assess the effectiveness of concealing the hydration fluid bottle in order to reduce the experience of anticipatory nausea and vomiting before chemotherapy treatment in pediatric hematology oncology patients undergoing chemotherapy treatment.

DESIGN AND METHODS

The study was carried out as a randomized controlled clinical trial. The study was conducted sixty-two pediatric oncology patients who underwent chemotherapy in a hospital in Ankara, Turkey. The patients were randomly alloceted to an intervention group (n = 32) or a control group (n = 30). Patients in the intervention group concealing the hydration fluid bottle throughout the duration of hydration; patients in the control group received routine procedure (No concealment intervention) during hydration degree of nausea and vomiting were measured by the Baxter Retching Faces (BARF) scale.

RESULTS

This study found no differences in the characteristics of the patients or in degree of nausea and vomiting between groups at enrollment. After concealing the hydration fluid bottle during the hydration, BARF scores were lower in the intervention group (p < .001).

CONCLUSION

Concealing the hydration fluid had significant effects on degree of nausea and vomiting in pediatric oncology patient who received hydration before chemotherapy.

APPLICATION TO PRACTICE

This approach can be added as routine care as an effective non pharmacological intervention for pediatric oncology patient with receiving chemotherapy.

Postfundoplication retching: Strategies for management

BACKGROUND

Retching is a common symptom in children following antireflux surgery, particularly in those with neurodisability. There is now a strong body of evidence that implicates retching as a major cause of wrap breakdown. Retching is not a symptom of gastroesophageal reflux disease; it is a component of the emetic reflex. In addition to causing wrap breakdown, it is indicative of the presence of nausea. It is a highly aversive experience and warrants treatment in its own right.

METHODS

A framework was constructed for the management of postoperative retching, with strategies targeting different components of the emetic reflex. The impact of differing antireflux procedures upon retching was also considered.

CONCLUSIONS

Once treatable underlying causes have been excluded, the approach includes modifications to feeds and feeding regimens, antiemetics and motility agents. Neuromodulation and other, novel, therapies may prove beneficial in future. Children at risk of postoperative retching may be identified before any antireflux surgery is performed. Fundoplication is inappropriate in these children because it does not treat their symptoms, which are not because of gastroesophageal reflux, and may make them worse. They are also at risk of wrap disruption. Alternative strategies for symptom management should be employed, and fundoplication should be avoided.

LEVEL OF EVIDENCE

II-V.

Validity and Reliability of the Turkish Version of the Adapted Rhodes Index of Nausea and Vomiting for Pediatrics by Child (ARINVc) and by Parent (ARINVp)

The study was conducted methodologically to adapt the Adapted Rhodes Index of Nausea and Vomiting for Pediatrics by Child (ARINVc) and Adapted Rhodes Index of Nausea and Vomiting for Pediatrics by Parent (ARINVp) into Turkish. The scales are administered to children who receive chemotherapy and to their parents, respectively. The study sample consisted of 8- to 18-year-old children who were hospitalized in the pediatric oncology and hematology clinics of a university hospital, met the sampling criteria, and agreed to participate in the research. The study data were collected with the Sociodemographic Attributes Information Form, ARINVc, and ARINVp using the face-to-face interview method. The mean ages of the children and their mothers and fathers who participated in the study were 13.26 ± 2.01, 36.33 ± 5.10, and 40.17 ± 4.94 years, respectively. The mean total scores obtained from the ARINVc and ARINVp were 5.43 ± 4.06 and 5.70 ± 3.77, respectively. While Cronbach's alpha reliability coefficients of the scales were .85 for the ARINVc and .84 for the ARINVp, the item-total correlation coefficients were between 0.60 and 0.89 for the ARINVc and between 0.66 and 0.85 for the ARINVp ( P < .01). The Turkish versions of ARINVc and ARINVp were determined to be valid and reliable scales.

Age Affects the Mitigating Efficacy of Riboflavin Against Cisplatin-Induced Toxicity In Vivo

Cis-diamminedichloroplatinum (CP), a prominent anticancer drug, exerts toxic insults that are functional to various factors that compromise its antineoplastic activity. Riboflavin (RF) is an essential vitamin and photosensitizer that ameliorates CP-induced toxic insults in vivo in a dose-dependent manner. The aim of the present study is to investigate how age can influence the ameliorative effect of RF against CP-induced toxicity. Ninety male mice were divided into three age groups: young, adult, and old for the present investigation under an established treatment strategy with CP, RF, and their combinations under photoillumination for 1 mo. Their kidneys and serum samples were assessed for redox status [superoxide dismutase, catalase, reduced glutathione, malondialdehyde (MDA), carbonyl contents, and glutathione-S-transferase], biochemical analysis (renal function markers-nitric oxide), comet assay, and histopathology. The adult group showed not only the strongest resistance against the CP-induced toxicity but also the better ameliorative effect of RF followed by the young and old groups, respectively, with well-maintained redox status concomitant with the level of renal function markers, MDA, and carbonyl contents near the control values. Furthermore, comet assay and histopathological evaluation confirmed the results in a dose-dependent manner. Hence, age is an important patient-related factor that can influence the final clinical outcome under personalized chemoradiotherapy.