• Title/Summary/Keyword: children with cancer

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Efficacy and Safety of Neurokinin-1 Receptor Antagonists for Prevention of Chemotherapy-Induced Nausea and Vomiting: Systematic Review and Meta-analysis of Randomized Controlled Trials

  • Yuan, Dong-Mei;Li, Qian;Zhang, Qin;Xiao, Xin-Wu;Yao, Yan-Wen;Zhang, Yan;Lv, Yan-Ling;Liu, Hong-Bin;Lv, Tang-Feng;Song, Yong
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.4
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    • pp.1661-1675
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    • 2016
  • Objectives: Can addition of neurokinin-1 receptor antagonists (NK1-RAs) be considered as an ideal strategy for the prevention of chemotherapy-induced nausea and vomiting (CINV)? Researchers differ on this question. Materials and Methods: Electronic databases were searched for randomized control trials (RCTs) that evaluated the effectiveness and safety of NK1-RAs in preventing CINV. The primary end point was complete response (CR) in the acute, delayed, and overall phases after chemotherapy. Subgroup analyses evaluated the types of NK1-RAs, routines of administration, types of malignancies, regimens used in combination with NK1-RAs, and age of patients included in the studies. The incidences of different types of adverse events were also extracted to estimate the safety of NK1-RAs. Results: A total of 38 RCTs involving 13,923 patients were identified. The CR rate of patients receiving NK-RAs was significantly higher than patients in the control groups during overall phase (70.8% vs 56.0%, P<0.001), acute phase (85.1% vs 79.6%, P<0.001), and delayed phase (71.4% vs 58.2%, P<0.001). There were three studies including patients of children or adolescents, the CR rate was also significantly higher in the treatment group (overall phase: OR=2.807, P<0.001; acute phase: OR=2.863, P =0.012; delayed phase: OR=2.417, P<0.001). For all the other outcomes, patients in the NK1-RAs groups showed improvements compared to the control groups (incidence of nausea: 45.2% vs 45.9%, P<0.001; occurrence of vomiting: 22.6% vs 38.9%, P<0.001; usage of rescue drugs: 23.5% vs 34.1%, P<0.001). The pooled side effects from NK1-RAs did not significantly differ from previous reports and the toxicity rates in patients less than eighteen years old also did not diff between the two groups (P=0.497). However, we found that constipation and insomnia were more common in the patients of control groups, whereas diarrhea and hiccups were more frequently detected in patients receiving NK1-RAs. Conclusions: NK1-RAs improved the CR rate of CINV. They are effective for both adults and children. The use of NK1-RAs might be associated with the appearance of diarrhea and hiccups, while decreasing the possibility of constipation and insomnia.

Neutropenia in children (소아기 호중구 감소증)

  • Yoo, Eun Sun
    • Clinical and Experimental Pediatrics
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    • v.52 no.6
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    • pp.633-642
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    • 2009
  • Neutropenia is defined as an absolute neutrophil count (ANC) of <$1,500/{\mu}L$, and the severity of neutropenia generally can be graded as mild ($1,000-1,500/{\mu}L$), moderate ($500-1,000/{\mu}L$), or severe (<500/$\mu{L}$). This stratification aids in predicting the risk of pyogenic infection because the susceptibility to life-threatening infections is significantly increased in patients with prolonged episodes of severe neutropenia. Especially cancer-related neutropenia carry significant mortality. Neutropenia can develop under various conditions such as decreased bone marrow production, the sequestering of neutrophils, and increased destruction of neutrophils in the peripheral blood. Neutropenia is classified according to the etiology as congenital or acquired, with the latter further defined according to the etiology or pathology. The clinical result is increased risk for infection, which is directly proportional to the severity and duration of the neutropenia. The typical workup of neutropenia starts with a 6-week period in which complete blood counts are measured twice weekly to document the persistence of the neutropenia and whether a cyclic pattern is present. When persistent neutropenia is diagnosed and no spontaneous recovery occurs within 3 months, a more extensive evaluation is advised. Treatment is usually unnecessary for most patients with severe neutropenia, as the majority of patients have a good prognosis. However, for patients who have severe and frequent infections, treatment with filgrastim may prevent infectious complications and improve quality of life.

Poor Treatment Outcome of Neuroblastoma and Other Peripheral Nerve Cell Tumors May be Related to Under Usage of Radiotherapy and Socio-Economic Disparity: A US SEER Data Analysis

  • Cheung, Rex
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.9
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    • pp.4587-4592
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    • 2012
  • Purpose: This study used receiver operating characteristic curve to analyze Surveillance, Epidemiology and End Results (SEER) neuroblastoma (NB) and other peripheral nerve cell tumors (PNCT) outcome data. This study found under usage of radiotherapy in these patients. Materials and methods: This study analyzed socio-economic, staging and treatment factors available in the SEER database for NB and other PNCT. For the risk modeling, each factor was fitted by a generalized linear model to predict the outcome (soft tissue specific death, yes/no). The area under the receiver operating characteristic curve (ROC) was computed. Similar strata were combined to construct the most parsimonious models. A random sampling algorithm was used to estimate the modeling errors. Risk of neuroendocrine (other endocrine including thymus as coded in SEER) death was computed for the predictors. Results: There were 5261 patients diagnosed from 1973 to 2009 were included in this study. The mean follow up time (S.D.) was 83.8 (97.6) months. The mean (SD) age was 18 (25) years. About 30.45% of patients were un-staged. The SEER staging has high ROC (SD) area of 0.58 (0.01) among the factors tested. We simplified the 4-layered risk levels (local, regional, distant, un-staged/others) to a simpler 3-tiered model with comparable ROC area of 0.59 (0.01). Less than 50% of PNCT patients received radiotherapy (RT) including the ones with localized disease. This avoidance of RT use occurred in adults and children. Conclusion: The high under-staging rate may have precented patients from selecting definitive radiotherapy (RT) after surgery. Using RT for, especially, adult PNCT patients is a potential way to improve outcome.

Measurement of Breast Skin Dose According to Shield Thickness During Whole Spine Scanography Using Digital Radiography System (Digital Radiography 시스템을 사용하여 전 척추검사 시 차폐체 두께에 따른 유방피부선량 측정)

  • Nam, Soon-Kwon;Choi, Joon-Ho
    • Journal of radiological science and technology
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    • v.42 no.1
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    • pp.25-30
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    • 2019
  • Whole Spine Scanography (WSS) using the Digital Radiography (DR) system is an examination that requires whole body X-ray exposure, which involves more exposure to radiation for patients than other general radiographies. This can affect the occurrence of breast cancer. This research measured radiation dose when breasts were shield and not shield using the Auto Exposure Control (AEC) mode. The radiation dose without a shield was 1.540 mGy, and that using a collimator was measured 0.506 mGy. Moreover, 0.733 mGy was measured when 1 shield (0.3 mm) was used, and $0.523{\mu}Gy$ when 5 of them (1.5 mm) were used. The results showed that the radiation dose with 5 shields and the radiation dose with a collimator were similar. Moreover, 0.233 mGy was measured when 8 shields (2.4 mm) were used. The standard deviation were 0.081 when using collimator and 0.014 when 5 shields were used. Also, when 8 shields were used, it was found to be 0.002. Most patients who go under a scoliosis test are children or young people who are highly sensitive to radiation. In the research results, the case where the organs sensitive to radiation, women's breasts, were shielded showed more distinct differences compared to without shields. It is considered that using shields can provide more constant shield than using a collimator and lower the risk of breast cancer caused by exposure to radiation.

Development of the Tailored Health Promotion Program for Rural Elderly: Based on the PRECEDE Model (농촌형 노인 건강증진프로그램 개발 연구: PRECEDE 모형을 중심으로)

  • Oh, Yun-Jung;Park, Jeong-Sook
    • Korean Journal of Health Education and Promotion
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    • v.22 no.4
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    • pp.179-202
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    • 2005
  • Purpose: The purpose of this study was to develop the health promotion program for rural elderly through PRECEDE process. Method: The health promotion program was developed based on the preliminary diagnosis. The data collection was performed from March 10th to April 9th, 2003. The subjects were selected at Mari Myun, Geochang Gun, in Korea. The preliminary diagnosis was examined with the 115 elders. Data was analyzed by descriptive statistics and Cronbach's n test with SPSS/Win 10.0 program. Results: The health promotion program was developed based on diagnostic result using PRECEDE model. The developed program was corrected and revised with the advices from 6 experts. The final program included health responsibility(cancer prevention and early detection, hygienic, false teeth management no smoking and moderation in drink, and chronic disease prevention and management), physical activity(6 kinds of exercise), nutrition(low sodium diet calcium intake, and right eating habit), spiritual growth(spiritual demand and death preparation teaching), interpersonal relations(relationship with couple, children, grandchildren, neighborhood), and stress management(sports dance, foot massage, positive thought, and song class). Conclusion: I propose that it is necessary to identity the effect of health promotion program for rural elderly. And strategy development that can spread the health promotion program elderly is needed.

Effects of Endocrine Disruptors on Endocrine Function and Reproductive Function in Wildlife and Humans (내분비교란물질이 야생동물 및 인간의 내분비기능과 생식기능에 미치는 영향)

  • 류병호
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.28 no.5
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    • pp.1180-1186
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    • 1999
  • A wide ranges of chemicals released into the environment have potential to interfere with physiological and development process by disrupting endocrine pathways. Endocrine system embraces a multitude of mechanisms of action, including effect on growth, behavior, reproduction and immune function. These environmental endocrine disruptors are present in environment and pose potential health consequences to human and wildlife. The best known form in endocrine distruptors involves substances which mimic or block the action of natural hormone in the body. Endocrine disruptor have been variously defined as exogenous agents that interfere with the synthesis, secretion, transport, metabolism, binding action or elimination of the natural hormones in the body which are responsible for the maintenance of homeostasis, reproduction developmental and/or behavior. Many compounds polluted into the environment by human activity are capable of disrupting the endocrine system of animals, including fish, wildlife, and humans. Among these chemicals are pesticides, industrial chemicals, and other anthropogenic products. It has been alleged that several adverse effects on human health are linked with exposure to chemicals which are claimed to be endocrine disrupters, that is, increased incidence of testicular, prostate and female breast cancer, time dependent reductions in sperm quality and quantity, increased incidence of cryptorchidism (undescended testicles) and hypospadias(malformation of the penis), altered physical and mental de velopment in children. This observation is currently the only example of chemically mediated endocrine disruption which has resulted in a clear effect at the population level.

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Assessment of Relationship between Wilms' Tumor Gene (WT1) Expression in Peripheral Blood of Acute Leukemia Patients and Serum IL-12 and C3 Levels

  • Rezai, Omran;Khodadadi, Ali;Heike, Yuji;Mostafai, Ali;Gerdabi, Nader Dashti;Rashno, Mohammad;Abdoli, Zahra
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.16
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    • pp.7303-7307
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    • 2015
  • Background: Leukemia is a common cancer among children and adolescents. Wilms' tumor gene (WT1) is highly expressed in patients with acute leukemia. It is found as a tumor associated antigen (TAA) in various types of hematopoietic malignancies and can be employed as a useful marker for targeted immunotherapy and monitoring of minimal residual disease (MRD). In this regard, WT1 is a transcription factor that promotes gene activation or repression depending on cellular and promoter context. The purpose of this study was assessment of WT1 gene expression in patients with acute leukemia, measurement of IL-12 and C3 levels in serum and evaluation of the relationship between them. Materials and Methods: We evaluated the expression of WT1 mRNA using real-time quantitative RT-PCR and serum levels of IL-12 and C3 using ELISA and nephelometry in peripheral blood of 12 newly diagnosed patients with acute leukemia and 12 controls. Results: The results of our study showed that the average wT1 gene expression in patients was 7.7 times higher than in healthy controls (P <0.05). In addition, IL-12 (P = 0.003) and C3 (P <0.0001) were significantly decreased in the test group compared to controls. Conclusions: WT1 expression levels are significantly higher in patients compared with control subjects whereas serum levels of interleukin-12 and C3 are significantly lower in patients. Wt1 expression levels in patients are inversely related with serum levels of IL-12 and C3.

A Survey on the Salt Content of Kindergarten Lunch Meals and Meal Providers' Dietary Attitude to Sodium Intake in Gyeonggi-do Area (경기도지역 어린이집과 유치원 급식의 소금함량 및 유아 식사준비자의 나트륨 섭취관련 식태도 조사)

  • Kim, Jin Nam;Park, Seoyun;Ahn, Sohyun;Kim, Hye-Kyeong
    • Korean Journal of Community Nutrition
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    • v.18 no.5
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    • pp.478-490
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    • 2013
  • Dietary habit of excess sodium consumption is formed mainly by excessive salt intake from the younger age and this may lead to hypertension, stroke, and stomach cancer. This study was performed to estimate the salt content in kindergarten meals and provide basic data on meal providers' dietary attitude to sodium intake for nutrition education. We collected data on161 food items from 16 institutions in Gyeonggi-do and salt content was calculated from salinity and weight of individual food items. The average salt content from lunch meals was 2.2 g, which was about daily adequate intake of sodium for children aged 3 to 5 years old. Greatest contributor to the salt content in a meal was soup and stew (47.8%). The most salty dishes were sauces and kimchi followed by stir-fried food, deep-fried food, braised food, and grilled food. The salt content was higher in soup and stew despite of low salinity, due to the large quantity per serving. The salt contents of soups and kimchi were 40.6% and 14.3%, respectively of the total salt content in dish groups. Staff members and caregivers at home who prepared food for the child showed preference for one-dish rice meal, dried fish and salted mackerel, and broth when eating soup, stew, and noodles. Caregivers showed higher sodium index score and had higher preference for processed food such as Ramen, canned food, and ham compared with staff members (p < 0.05). These results suggested that monitoring salt content of kindergarten meals and nutrition education for those prepare meals for children are needed to lower sodium intake in childhood.

Ginseng berry polysaccharides on inflammation-associated colon cancer: inhibiting T-cell differentiation, promoting apoptosis, and enhancing the effects of 5-fluorouracil

  • Wang, Chong-Zhi;Hou, Lifei;Wan, Jin-Yi;Yao, Haiqiang;Yuan, Jinbin;Zeng, Jinxiang;Park, Chan Woong;Kim, Su Hwan;Seo, Dae Bang;Shin, Kwang-Soon;Zhang, Chun-Feng;Chen, Lina;Zhang, Qi-Hui;Liu, Zhi;Sava-Segal, Clara;Yuan, Chun-Su
    • Journal of Ginseng Research
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    • v.44 no.2
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    • pp.282-290
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    • 2020
  • Background: Ginseng is a commonly used herbal medicine in treating various medical conditions. Chronic gut inflammation is a recognized factor for the development of colorectal cancer (CRC). In this project, Asian ginseng berry polysaccharide preparations were used to assess their effects on CRC and related immune regulation mechanisms. Methods: Ginseng berry polysaccharide extract (GBPE) and purified ginseng berry polysaccharide portion (GBPP) were used to evaluate their activities on human HCT-116 and HT-29 CRC cell proliferation. Interleukin-8 secretion analysis was performed on HT-29 cells. Naive CD4 cell isolation and T-helper cell differentiation were performed and determined using flow cytometry for Th1 and Treg in addition to cell cycle and apoptotic investigation. Results: GBPE and GBPP significantly inhibited interleukin-8 secretion and cancer cell proliferation, inhibited CD4+IFN-γ+ cell (Th1) differentiation, and decreased CD4+FoxP3+ cell (Treg) differentiation. Compared to the GBPE, GBPP showed more potent antiinflammatory activities on the malignant cells. This is consistent with the observation that GBPP can also inhibit Th1-cell differentiation better, suggesting that it has an important role in antiinflammation, whereas Treg cells hinder the body's immune response against malignancies. Supported by cell cycle and apoptosis data, GBPE and GBPP, at various degrees, remarkably enhanced the anticancer activities of 5-fluorouracil. Conclusion: Data from this project suggested that Asian ginseng berry potentially has clinical utility in managing enteric inflammation and suppressing CRC through immunomodulation mechanisms.

The Effect of Eating Behavior on Being Overweight or Obese During Preadolescence

  • Lee, Hye-Ah;Lee, Won-Kyung;Kong, Kyoung-Ae;Chang, Nam-Soo;Ha, Eun-Hee;Hong, Young-Sun;Park, Hye-Sook
    • Journal of Preventive Medicine and Public Health
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    • v.44 no.5
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    • pp.226-233
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    • 2011
  • Objectives: Being overweight or obese is central to metabolic syndrome, and these characteristics constitute dominant risk factors for chronic diseases. Although behavioral factors, including eating habits and sedentary lifestyles, are considered to be determinants of obesity, the specific childhood factors that contribute to this condition have not been clearly defined. Methods: The subjects consisted of 261 children aged 7- 9 years who were recruited from an elementary school during October 2003. Information was obtained from their parents using a questionnaire focused on eating behaviors and lifestyle factors, additional data were also collected via anthropometric measurements and biochemical examinations, including blood tests. Results: A total of 48 (18.4%) of the 261 children were overweight, and 34 (70.8%) had at least one other component of metabolic syndrome. Eating behaviors emerged as significant lifestyle-related risk factors for being overweight or obese. Those who engaged in overeating more than twice per week had three times the risk of being overweight (odds ratio [OR], 3.10, 95% confidence interval [CI], 1.39 to 6.92), and those who ate rapidly had three times the risk of being overweight (OR, 3.28; 95% CI, 1.68 to 6.41). Those who had fewer family meals (fewer than 2?3/month) had a nine times higher risk of being overweight than those who had family meals more frequently (at least 1/day) (OR, 9.51; 95% CI, 1.21 to 74.82). Conclusions: This study showed that being overweight or obese during preadolescence is associated with a higher risk of metabolic syndrome and is related to unhealthy eating behaviors. Thus, weight-control strategies and healthy eating behaviors should be developed early in life to reduce the risk for metabolic syndrome.