• Title/Summary/Keyword: Child with cancer

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A prospective study on changes in body composition and fat percentage during the first year of cancer treatment in children

  • Yang, Hye Ran;Choi, Hyoung Soo
    • Nutrition Research and Practice
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    • v.13 no.3
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    • pp.214-221
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    • 2019
  • BACKGROUNDS/OBJECTIVES: Cancer treatment may lead to significant body composition changes and affect growth and disease outcomes in pediatric cancer patients. This prospective study aimed to evaluate short- and long-term body compositions changes focused on body fat during the first year of cancer treatment in children. SUBJECTS/METHODS: A prospective study was conducted in 30 pediatric cancer patients (19 hematologic malignancies and 11 solid tumors) and 30 age- and sex-matched healthy controls. Anthropometric measurements and body composition analysis using whole body dual energy X-ray absorptiometry were performed at baseline and 1, 6, and 12 month(s) of cancer treatment. Kruskal-Wallis tests, Wilcoxon paired t tests, and generalized estimation equation (GEE) were applied for statistical analysis. RESULTS: At baseline, no differences in weight, height, body mass index, abdominal circumferences, body fat, and fat-free mass were observed between 30 controls and 30 pediatric cancer patients. Total fat mass (P < 0.001) and body fat percentage (P = 0.002) increased significantly during the first month, but no changes were observed from 1 to 12 months; however, no changes in the total mass were observed during the first year of cancer treatment. Meanwhile, the total fat-free mass decreased during the first month (P = 0.008) and recovered between 6 and 12 months of follow-up (P < 0.001). According to GEE analysis, there was a significant upward trend in body fat percentage during the first year, especially the first month, of cancer treatment in children with hematologic malignancies, but not in those with solid tumors. CONCLUSIONS: Our results indicate that cancer treatment is related to significant body composition changes and rapid body fat gain, particularly during the first month after initiating cancer treatment, in children with hematologic malignancies. Therefore, individualized dietary strategies to prevent excessive fat gain are needed in pediatric cancer patients for better outcomes.

Breast Feeding and Breast Cancer Risk: A Case-control Study in Korea

  • Do, Min-Hee;Lee, Sang-Sun;Jung, Pa-Jong;M.D.;Lee, Min-Hyuk;M.B.
    • Nutritional Sciences
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    • v.3 no.2
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    • pp.77-82
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    • 2000
  • We carried out a case-control study to investigate protective effect of lactating against breast cancer in Korea. Cases (n=108) were the newly histologically identified breast cancer between December 1997 and August 1999. Hospital-based controls were selected by frequency matching method with age ($\pm$4 age) and menopausal status from the patients at the same hospital in the plastic surgery, general surgery and opthalmology department. Interviews included information on general characteristics of subjects, disease history, family history of breast cancer, vitamin supplementation, alcohol intake, food intake, and reproductive factors as well as lactation history. Odds ratio (OR) and 95% Confidence Intervals (CI) were calculated by using unconditional logistic regression. Age distribution of case control subjects were similar. Late menarche age $\geq$ 17 in premenopausal women was related to the lower risk of breast cancer OR = 0.41, 95% CI = 0.28-0.91. Family history of breast cancer was related to the higher risk of breast cancer only in premenopausal women (OR = 2.07, 95% CI = 1.35-2.71). Higher body mass index mass index (> 30) were associated with higher risk of breast cancer in postmenopausal women. For premenopausal women, women who had lactated $\geq$ 12 months to the first child had a significantly lower risk (OR = 0.53, 95% CI = 0.24-0.97) than the women had no breast feeding experience. However, results from postmenopausal women did not show an association with decreased breast cancer risk. These findings suggest that lactation may be a protective factor of breast cancer in Korean women.

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A Multi-center Survey of HPV Knowledge and Attitudes Toward HPV Vaccination among Women, Government Officials, and Medical Personnel in China

  • Zhao, Fang-Hui;Tiggelaar, Sarah M.;Hu, Shang-Ying;Zhao, Na;Hong, Ying;Niyazi, Mayinuer;Gao, Xiao-Hong;Ju, Li-Rong;Zhang, Li-Qin;Feng, Xiang-Xian;Duan, Xian-Zhi;Song, Xiu-Ling;Wang, Jing;Yang, Yun;Li, Chang-Qin;Liu, Jia-Hua;Liu, Ji-Hong;Lu, Yu-Bo;Li, Li;Zhou, Qi;Liu, Jin-Feng;Xu, Li-Na;Qiao, You-Lin
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.5
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    • pp.2369-2378
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    • 2012
  • Objectives: To assess knowledge of HPV and attitudes towards HPV vaccination among the general female population, government officials, and healthcare providers in China to assist the development of an effective national HPV vaccination program. Methods: A cross-sectional epidemiologic survey was conducted across 21 urban and rural sites in China using a short questionnaire. 763 government officials, 760 healthcare providers, and 11,681 women aged 15-59 years were included in the final analysis. Data were analyzed using standard descriptive statistics and logistic regression. Results: Knowledge of HPV among the general female population was low; only 24% had heard of HPV. Less than 20% of healthcare providers recognized sexually na$\ddot{i}$ve women as the most appropriate population for HPV vaccination. There was high acceptance of the HPV vaccine for all categories of respondents. Only 6% of women were willing to pay more than US $300 for the vaccine. Conclusions: Aggressive education is necessary to increase knowledge of HPV and its vaccine. Further proof of vaccine safety and efficacy and government subsidies combined with increased awareness could facilitate development and implementation of HPV vaccination in China.

Prospective Study on the Survival of HCC Patients Treated with Transcatheter Arterial Lipiodol Chemoembolization

  • Mao, Ying-Min;Luo, Zu-Yan;Li, Bo;Hu, Ting-Yang
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.3
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    • pp.1039-1042
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    • 2012
  • Aim: Tanscatheter arterial embolization irrespective of with or without an anticancer agent and lipiodol has been controversial with regard to survival benefit. Therefore, we conducted a prospective study to analyze the effect of transcatheter arterial lipiodol chemoembolization (TACE) on the survival of HCC. Methods: A prospective study was conducted, and a total of 326 patients with primary liver cancer who were newly diagnosed were collected from January 2004 to January 2005 in Zhejiang Provincial People's Hospital of China. A univariate Cox's regression analysis was used to assess the survival of the HCC cases receiving TACE. Results: The duration of follow-up for the HCC patients treated with TACE ranged from 3 months to 60 months. For the overall patients, survival rate at 5 years was 42%. Both HBV Ag and HCV Ab positive patients showed significantly low survival rate at 5 years. The multivariate analysis revealed The IV TNM stage was related to an heavy increased risk of death of HCC patients, and Child C grade group showed a significant moderate increased risk. Conclusion: Our study showed TACE is associated with a better prognosis of HCC patients, and the HBV infection, TNM stage, Child-Pugh grade and number of TACE may influence the survival probability. Further TACE studies should be assess the quality of life of HCC patients, so as to provide more information for treatment of HCC.

2017 Clinical practice guidelines for dyslipidemia of Korean children and adolescents

  • Lim, Jung Sub;Kim, Eun Young;Kim, Jae Hyun;Yoo, Jae-Ho;Yi, Kyung Hee;Chae, Hyun Wook;Choi, Jin-Ho;Kim, Ji Young;Hwang, Il Tae;Committee of Dyslipidemia of Korean Children and Adolescents on behalf of Korean Society of Pediatric Endocrinology (KSPE),
    • Clinical and Experimental Pediatrics
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    • v.63 no.12
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    • pp.454-462
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    • 2020
  • The Committee on Dyslipidemia of Korean Pediatric and Adolescents of the Korean Society of Pediatric Endocrinology has newly developed evidence-based clinical practice guidelines for dyslipidemia in Korean children and adolescents. These guidelines were formulated with the Grading of Recommendations, which include both the strength of recommendations and the quality of evidence. In the absence of sufficient evidence, conclusions were based on expert opinion. These guidelines are based on the 2011 National Heart, Lung, and Blood Institute Guidelines, which focus on the prevention of cardiovascular disease in children and draw from a comprehensive review of evidence. These guidelines contain the definition of and screening process for dyslipidemia and introduce new dietary methods: the Cardiovascular Health Integrated Lifestyle Diet (CHILD)-1, the CHILD-2-low-density lipoprotein cholesterol, and the CHILD-2-triglyceride. Potential drug therapies for dyslipidemia along with their main effects and doses were also included.

The Experience of the Family Whose Child Has Died of Cancer (암으로 자녀를 잃은 가족의 경험에 대한 질적연구)

  • 이정섭;김수지
    • Journal of Korean Academy of Nursing
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    • v.24 no.3
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    • pp.413-431
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    • 1994
  • The purpose of this study was to build a substantive theory about the experience of the family whose child has died of cancer The qualitative re-search method used was grounded theory. The interviewees were 17 mothers who had cared for a child who had died of cancer Traditionally in Korea, mothers are the care givers in the family and are considered sensitive to the family's thoughts, feelings. The data were collected through in-depth interviews by the investigator over a period of nine months. The data were analyzed simultaniously by a constant comparative method in which new data are continuously coded into categories and properties according to Strauss and Corbin's methodology. The 16 concepts which were found as a result of analyzing the grounded data were, -left over time, the empty place, meaninglessness, inner sadness, situational sadness, heartache, physical pain, guilt, resentment, regret, support / stigmatization, finding meaning in the death, changing attitudes about life and living, changing attitudes about health, changing religious practice and changing family relations. Five categories emerged from the analysis. They were emptiness, consisting of left over time, the empty place and meaninglessness ; sadness, consisting of inner sadness and situational sadness ; pain, consisting of heartache and physical pain ; bitterness, consisting of guilt, resentment, regret, sup-port / stigmatization and finding meaning in the death : and transition, consisiting of changing attitudes about life and living, changing attitudes about health, changing religious practice and changing family relations. These categories were synthesized into the core concept, -the process of filling the empty space. The core phenomenon was emptiness. Emptiness varied with the passing of time, was perceived differently according to support / stigmatization and finding meaning in the death, was followed by sad-ness, pain, and bitterness, and finally resulted in changes in attitudes about life and living and about health, and in changes in religious practice and family relations. The process of filling the empty space proceeded by ① accepting realty, ② searching for the reason for the child's death, ③ controlling the bitter feelings, ④ reconstructing the relationships ameng death, illness and health and ⑤ filling the emptiness by resolving causes of child's death, adopting, having another child or with work. Six hypotheses were derived from the analysis. ① The longer the bereavement, the mere the empty space becomes filled. ② The longer the hospitalization, the more sup-port the family needs. ③ The more the sadness, pain and bitterness are expressed, the mere positive changes emerge. ④ Family support faciliates the process of filling the empty space. ⑤ Higher family cohesiveness faciliates the process of filling the empty space. ⑥ The greater the variety of reasons attributed to the child's death, the greater the variety of patterns of change. Four propositions related to emptiness and bitter-ness were developed. ① When the sense of emptiness is great and bitterness is manifested by severe feelings of guilt and resentment, the longer the process of fill-ing the empty space. ② When the sense of emptiness is great and the family is highly motivated to get rid of the bitterness, the shorter the process of filling the empty space. ③ When the sense of emptiness is less and bitter-ness is manifested by severe feelings of guilt and resentment, the process of filling the empty space is delayed. ④ When the sense of emptiness is less and the family is highly motivated to get rid of the bitterness, the process of filling the empty space goes on to completion. Through this substantive theory, nurses under-stand the importance of emptiness and bitterness in helping the family that has lost a child through cancer fill the empty space. Further research to build substantive theories to explain other losses may con-tribute to a formal theory of how family health is restored after human tragedies are experienced.

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A Case of Primary Jejunal Adenocarcinoma in Children (소아에서 발생한 공장의 선암종 1례)

  • Cho, Myung-Hwan;Min, Yong-Sik;Park, Kyung-Bae;Park, Joon-Soo;Kim, Young-Chang
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.1 no.1
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    • pp.125-132
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    • 1998
  • Primary adenocarcinoma of the jejunum which accounts for only approximately 3% of all gastrointestinal tract malignancies, is distinctly unusual. The rarity and the non-specific symptoms of this cancer, which are the major factors contributing to its poor prognosis, make the diagnosis difficult. As the prognosis of primary adenocarcinoma of the jejunum, once metastasized, is poor, a greater awareness of the possibility of a jejunal cancer must accompany aggressive diagnostic and surgical procedure. We report our experience of a child with primary adenocarcinoma of the jejunum with a brief review of the literature.

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Environmental tobacco smoke and children's health

  • Hwang, Sang-Hyun;Hwang, Jong-Hee;Moon, Jin-Soo;Lee, Do-Hoon
    • Clinical and Experimental Pediatrics
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    • v.55 no.2
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    • pp.35-41
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    • 2012
  • Passive exposure to tobacco smoke significantly contributes to morbidity and mortality in children. Children, in particular, seem to be the most susceptible population to the harmful effects of environmental tobacco smoke (ETS). Paternal smoking inside the home leads to significant maternal and fetal exposure to ETS and may subsequently affect fetal health. ETS has been associated with adverse effects on pediatric health, including preterm birth, intrauterine growth retardation, perinatal mortality, respiratory illness, neurobehavioral problems, and decreased performance in school. A valid estimation of the risks associated with tobacco exposure depends on accurate measurement. Nicotine and its major metabolite, cotinine, are commonly used as smoking biomarkers, and their levels can be determined in various biological specimens such as blood, saliva, and urine. Recently, hair analysis was found to be a convenient, noninvasive technique for detecting the presence of nicotine exposure. Because nicotine/cotinine accumulates in hair during hair growth, it is a unique measure of longterm, cumulative exposure to tobacco smoke. Although smoking ban policies result in considerable reductions in ETS exposure, children are still exposed significantly to tobacco smoke not only in their homes but also in schools, restaurants, child-care settings, cars, buses, and other public places. Therefore, more effective strategies and public policies to protect preschool children from ETS should be consolidated.

Prognostic Significance of the Peripheral Blood Absolute Monocyte Count in Patients with Locally Advanced or Metastatic Hepatocellular Carcinoma Receiving Systemic Chemotherapy

  • Lin, Gui-Nan;Jiang, Xiao-Mei;Peng, Jie-Wen;Xiao, Jian-Jun;Liu, Dong-Ying;Xia, Zhong-Jun
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.15
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    • pp.6387-6390
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    • 2014
  • Background: The prognostic significance of the circulating absolute monocyte count (AMC) in patients with locally advanced hepatocellular carcinoma (HCC) is uncertain. This study was designed to assess the association of circulating AMC with survival outcomes in patients diagnosed with locally advanced or metastatic HCC receiving systemic chemotherapy. Materials and Methods: Between January 1, 2005 and December 30, 2012, locally advanced or metastatic HCC patients who had Child-Pugh stage A or B disease and received systemic chemotherapy were retrospectively enrolled. Patient features including gender, age, extrahepatic metastasis, Child-Pugh stage, serum alpha-fetoprotein(AFP) level and AMC were collected to investigate their prognostic impact on overall survival(OS). Results: A total of 216 patients were eligible for the study. The optimal cut-off value of AMC for OS analysis was $0.38{\times}10^9/L$. Median OS was 5.84 months in low-AMC group (95% confidence interval [CI], 5.23 to 6.45), and 5.21 months in high-AMC group (95% CI, 4.37 to 6.04; p=0.003). In COX multivariate analysis, elevated AMC remained as an independent prognostic factor for worse OS (HR, 1.578; 95% CI, 1.120 to 2.223, p=0.009). Conclusions: Our results indiicate that circulating AMC is confirmed to be an independent prognostic factor for OS in patients with locally advanced or metastatic HCC receiving systemic chemotherapy.

Exploring Communication Difficulties in Pediatric Hematology: Oncology Nurses

  • Citak, Ebru Akgun;Toruner, Ebru Kilicarslan;Gunes, Nebahat Bora
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.9
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    • pp.5477-5482
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    • 2013
  • Background: Communication plays an important role for the well being of patients, families and also health care professionals in cancer care. Conversely, ineffective communication may cause depression, increased anxiety, hopelessness and decreased of quality life for patients, families and also nurses. Objective: This study aimed to explore communication difficulties of pediatric hematology/oncology nurses with patients and their families, as well as their suggestions about communication difficulties. Materials and Methods: It was conducted in a pediatric hematology/oncology hospital in Ankara, Turkey. Qualitative data were collected by focus groups, with 21 pediatric hematology/oncology nursing staff from three groups. Content analysis was used for data analysis. Results: Findings were grouped in three main categories. The first category concerned communication difficulties, assessing problems in responding to questions, ineffective communication and conflicts with the patient's families. The second was about the effects of communication difficulties on nurses and the last main category involved suggestions for empowering nurses with communication difficulties, the theme being related to institutional issues. Conclusions: Nurses experience communication difficulties with children and their families during long hospital stays. Communication difficulties particularly increase during crisis periods, like at the time of first diagnosis, relapse, the terminal stage or on days with special meaning such as holidays. The results obtained indicate that pediatric nurses and the child/family need to be supported, especially during crisis periods. Feeling of empowerment in communication will improve the quality of care by reducing the feelings of exhaustion and incompetence in nurses.