THE EPIDEMIOLOGY OF PEDIATRIC CANCER IN THE PALLIATIVE CARE UNIT AT DR. SOETOMO GENERAL HOSPITAL, SURABAYA

Background: Children with cancer require special interventions and palliative care to improve their quality of life. The epidemiology of pediatric cancer is needed as a basis for determining health policy. Purpose: This study describes pediatric cancer patients in the palliative outpatient clinic in Dr. Soetomo General Hospital, Surabaya. Methods: This study is an observational descriptive study that uses the medical records of pediatric patients with cancer at the palliative care unit in Dr. Soetomo General Hospital between June 2014 and July 2015. The data included the demographic characteristics of the pediatric cancer patients and was analyzed using descriptive statistics. Results: The number of children in the 1–5 years, 6–10 years, and 11–15 years age groups was similar, while noticeably fewer children fell into the 16–18 years group. The majority of children suffering from cancer were male (68,70%). The most common type of cancer in was blood cancer (leukemia) with a percentage of 51.91%, while the rarest types were retinoblastoma and lymph node cancer (malignant lymphoma) with percentage of 3.05%. Conclusion: The incidence of pediatric cancer patients in the palliative outpatient clinic was quite high. These patients tended to be male, aged 6–10 years, and suffered from leukemia.

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A 2-week prognostic prediction model for terminal cancer patients in a palliative care unit at a Japanese general hospital

Palliative Medicine ◽

10.1177/0269216310383741 ◽

2010 ◽

Vol 25 (2) ◽

pp. 170-176 ◽

Cited By ~ 19

Author(s):

Sachiko Ohde ◽

Akitoshi Hayashi ◽

Osamu Takahasi ◽

Sen Yamakawa ◽

Megumi Nakamura ◽

...

Keyword(s):

Palliative Care ◽

Prediction Model ◽

Cancer Patients ◽

General Hospital ◽

Palliative Care Unit ◽

Terminal Cancer ◽

Terminal Cancer Patients ◽

Prognostic Prediction

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Assessment of acute kidney injury by urinary β2-MG and NAG in pediatric cancer patients prescribed with Cisplatin, Carboplatin, and Ifosfamide as the chemotherapeutic agents

Iranian Journal of Pediatric Hematology & Oncology ◽

10.18502/ijpho.v10i4.4404 ◽

2020 ◽

Author(s):

Alireza Moafi ◽

Hanieh Basirkazeruni ◽

Nahid Reisi ◽

Moein Dehbashi ◽

Leila Ghanbarinia ◽

...

Keyword(s):

Acute Kidney Injury ◽

Cancer Patients ◽

Pediatric Cancer ◽

Age Groups ◽

Kidney Injury ◽

Chemotherapeutic Agents ◽

Pediatric Cancer Patients ◽

The Mean ◽

Beta 2 Microglobulin ◽

Kidney Injury Molecule 1

Background: Acute kidney injury (AKI) is defined as a failure in renal function leading to insufficiency of fluid and electrolyte homeostasis. Thus, sensitive biomarkers of renal tubular injury are needed to detect AKI earlier. In this study, urinary beta 2-microglobulin (β2-MG) and urinary N-acetyl-β-D-glucosaminidase (NAG) were evaluated for AKI prognosis/diagnosis in pediatric patients suffering different cancers prescribed with Ifosfamide, Ifosfamide plus Carboplatin, and Ifosfamide plus Cisplatin. Materials and Methods: In this prospective study done in Isfahan, Iran, urinary β2-MG, urinary NAG, blood urea nitrogen (BUN), and serum and urinary creatinine (Cr) were measured in 40 pediatric cancer patients less than 16 years old in three age groups during 61 courses of chemotherapy on day 0, three and six after the treatment. Results: Using ANOVA and t-test, the mean levels of urinary β2-MG (p= 0.001), urinary β2-MG/Cr (p= 0.003) and urinary NAG/Cr (p= 0.001), before and on day six of the treatment were statistically significant (p< 0.05). Also, the mean levels of BUN (p= 0.01), urinary β2-MG (p= 0.001), β2-MG/Cr (p= 0.001) and NAG/Cr (p= 0.004) based on the gender groups, the mean levels of urinary NAG (p=0.001), NAG/Cr (p= 0.001) and β2-MG/Cr (p= 0.008) based on three age groups, and the mean levels of serum Cr (p= 0.047), urinary β2-MG (p= 0.005), β2-MG/Cr (p= 0.032) and NAG/Cr (p= 0.032) based on the Ifosfamide dosage were statistically significant during the time of the treatment. Conclusion: Urinary β2-MG, urinary β2-MG/Cr, and urinary NAG/Cr are more significant biomarkers than serum Cr in earlier diagnosis and treatment of AKI in cancer patients. However, urinary NAG should be further studied to prove its reliability for AKI prognosis/diagnosis. It is suggested that urinary NAG can be used along with other renal biomarkers such as urinary β2-MG, kidney injury molecule-1(KIM-1), or interleukin-18 (IL-18) for AKI prognosis/diagnosis.

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Transfusion Reactions in Pediatric Cancer Patients

Althea Medical Journal ◽

10.15850/amj.v7n4.1820 ◽

2020 ◽

Vol 7 (4) ◽

Author(s):

Cakra Jati Pranata ◽

Nur Suryawan ◽

Delita Prihatni

Keyword(s):

Cancer Patients ◽

Pediatric Cancer ◽

Pediatric Patients ◽

Tertiary Hospital ◽

Cross Sectional Study ◽

Cross Sectional ◽

Patients With Cancer ◽

Treatment And Prevention ◽

Pediatric Cancer Patients ◽

Transfusion Reactions

Background: Transfusion is an essential component of supportive management for cancer patients with anemia and thrombocytopenia. It is generally safe; however, it has several risks and complications including those caused by transfusion reactions. This study aimed to describe transfusion reactions in pediatric cancer patients in a tertiary hospital in Indonesia. Methods: This was a descriptive cross-sectional study with a total sampling method. A prospective analysis was performed on episodes of blood transfusion in pediatric patients aged younger than 18 years old with cancer and were hospitalized at the Department of Child Health of the hospital from July to August 2019. After the consent of the parents, the patients were interviewed for various transfusion reactions. Data collected were presented using tables and charts. Results: Leukemia was the most frequent cancer in children cancer patients who need transfusion. Out of 42 children included, 155 episodes of transfusion were observed with 22 episodes showed transfusion reactions (14.2%). The most frequent manifestations were pruritus (31.8%), followed by combination of pruritus and erythema (27.4%) and fever (13.6%). These reactions appeared mostly in 1 to 2 hours (27.2%), with most were mild reactions (59.1%). Conclusion: Transfusion reactions mostly occurred among pediatric patients with cancer in the acute phase with clinical manifestation of allergic reactions, predominantly mild. Early identification of these reactions would result in better treatment and prevention for recurrence of transfusion reactions.

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Improving the rate of influenza vaccination in pediatric patients with cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.31_suppl.49 ◽

2013 ◽

Vol 31 (31_suppl) ◽

pp. 49-49

Author(s):

Jason Lawrence Freedman ◽

Anne F. Reilly ◽

L. Charles Bailey

Keyword(s):

Influenza Vaccine ◽

Influenza Vaccination ◽

Cancer Patients ◽

Pediatric Cancer ◽

Pediatric Patients ◽

Provider Education ◽

Clinical Process ◽

Patients With Cancer ◽

Increased Risk ◽

Pediatric Cancer Patients

49 Background: Pediatric patients with cancer are at increased risk of influenza, with high mortality, morbidity, and delay of cancer therapy. CDC guidelines support yearly vaccination in these patients. In prior years at our center, only 53-56% of pediatric cancer patients received at least one dose of the vaccine. Our objective was to increase the rates of influenza vaccination in pediatric cancer patients through a multi-faceted QI initiative. Methods: Five interventions were instituted concomitantly, in eligible patients (>6 months old, >100 days from BMT if applicable, and within 1 year of chemotherapy) over a 6-month period (9/1/12 to 3/31/13). 1) Family education: provision of influenza/vaccine handouts to families in clinic waiting rooms; 2) Health informatics intervention: via electronic health records, generation of daily lists of patients due for doses with automated email lists to triage and nurses; 3) Clinical process interventions: standardization of triage process to identify patients needing vaccination and provision of colored wristbands to such patients alerting providers to order the vaccine, or document refusals, during the encounter; 4) Inpatient orders: influenza vaccine order built into computerized physician admission order set to trigger vaccination upon discharge; and 5) Provider education: printed materials and tutorials for staff at conferences on proper screening of patients, vaccine ordering/dose, and correct documenting of refusals/contraindications. These processes were iteratively refined over the 6-month timeframe. Results: Influenza immunization rates increased by 20% after the changes were implemented; this was seen across all tumor subgroups. Overall, 74% of patients received at least one dose as compared with 52% in the prior year. 61% of patients were fully immunized (vs. 42% in 2011-12). Immunizations were deferred due to allergy/refusal in 8% of patients (vs. 7% in 2011-12). Consequently, only 18% of eligible patients were unimmunized as compared to 41% in the prior year. Conclusions: Technology, education, and clinical process changes led to a successful increase in influenza vaccination rates. Ongoing efforts will target subgroups with lowest overall rates of immunization.

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Correlation of Plasma Kynurenic Acid Level with the Severity of Depression, Pain, And the Need of Opioids for Pain Management in Cancer Patients in Palliative Care Unit in Dr. Soetomo General Hospital Surabaya

International Journal Of Scientific Advances ◽

10.51542/ijscia.v2i5.40 ◽

2021 ◽

Vol 2 (5) ◽

Author(s):

Rizky Iman Kurniawan ◽

Arie Utariani ◽

Dedi Susila

Keyword(s):

Palliative Care ◽

Pain Management ◽

Cancer Patients ◽

General Hospital ◽

Acid Level ◽

Kynurenic Acid ◽

Rating Scale ◽

Palliative Care Unit ◽

Pain Level ◽

Severity Of Depression

Introduction: Most cancer cases in Indonesia are diagnosed at an advanced stage, and the cure rate and life expectancy are not as expected. Depression and pain are the most common problems that arise in cancer patients. Kynurenic acid and quinolinic acid are neuroactive metabolites produced in the kynurenine pathway. Decreased kynurenic acid levels have been reported to be associated with depression, pain, and pathology in cancer. Objective: This study aims to determine the correlation between kynurenic acid levels and the severity of depression, pain level, and opioid need in cancer patients undergoing palliative treatment. Material and Method: This study was an observational analytic study with a retrospective cohort design. The study population was adult patients with malignancy in the palliative care unit of Dr. Soetomo General Hospital Surabaya that received opioid treatment during the study period. The sample of this study was 54 patients. Plasma kynurenic acid levels were measured using the ‘Human Kynurenic acid ELISA kit’ from BT Lab. The severity of depression was measured by the Hamilton Depression Rating Scale (HDRS). Pain level was scored with Pain Numeric Rating Scale (NRS), while the opioid use was collected from the patient’s medical record. Result and Discussion: There was a significant relationship between kynurenic acid levels and the severity of depression (p<0.001), pain level (p<0,001), and opioid need (p=0,007). Simple linear regression analysis showed that the lower the kynurenic acid level, the more severe the depression (p<0.001) and the higher the opioid dose needed (p=0,004). Moderate pain has a lower median kynurenic acid level than mild pain, 12.32 nmol/L, and 16.29 nmol/L, respectively. Patients with a lower level of kynurenic acid require a higher dose of the same type of opioid. Conclusion: The lower level of plasma kynurenic acid is associated with more severe depression, more pain level, and more opioid need for pain management in malignancy patients in the palliative care unit of Dr. Soetomo General Hospital Surabaya.

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