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Fever neutropenia pediatric cancer

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https://www.readbyqxmd.com/read/28877157/external-validation-of-six-pediatric-fever-and-neutropenia-clinical-decision-rules
#1
Gabrielle M Haeusler, Karin A Thursky, Monica A Slavin, Francoise Mechinaud, Franz E Babl, Penelope Bryant, Richard De Abreu Lourenco, Robert Phillips
BACKGROUND: Fever and neutropenia (FN) clinical decision rules (CDRs) are recommended to help distinguish children with cancer at high and low risk of severe infection. The aim of this study was to validate existing pediatric FN CDRs, designed to stratify children with cancer at high or low risk of serious infection or medical complication. METHODS: Pediatric CDRs suitable for validation were identified from a literature search. Relevant data were extracted from an existing dataset of 650 retrospective FN episodes in children with cancer...
September 5, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28812473/implementation-of-a-pathway-for-the-treatment-of-fever-and-neutropenia-in-pediatric-patients-with-cancer
#2
Joy Vanderway, Catherine Vincent, Susan M Walsh, Jennifer Obrecht
Fever and neutropenia is an oncologic emergency. Time-to-antibiotics (TTA) refers to the amount of time from initial provider evaluation for fever and neutropenia to intravenous antibiotic administration. Research supports that rapid time-to-antibiotics (RTTA) is associated with improved patient outcomes. This quality improvement project evaluated the success of implementing an RTTA pathway in pediatric oncology patients with fever and neutropenia. The setting was an advanced practice nurse-managed pediatric ambulatory infusion center where patients with fever and neutropenia were often evaluated and treated...
September 2017: Journal of Pediatric Oncology Nursing: Official Journal of the Association of Pediatric Oncology Nurses
https://www.readbyqxmd.com/read/28696047/a-randomized-trial-of-the-effectiveness-of-the-neutropenic-diet-versus-food-safety-guidelines-on-infection-rate-in-pediatric-oncology-patients
#3
Karen M Moody, Rebecca A Baker, Ruth O Santizo, Inan Olmez, Jeanie M Spies, Amanda Buthmann, Linda Granowetter, Robin Y Dulman, Kanyalakshmi Ayyanar, Jonathan B Gill, Aaron E Carroll
BACKGROUND: The neutropenic diet (ND) is prescribed to avoid introduction of bacteria into a host's gastrointestinal tract and reduce infection. Due to a lack of evidence to support the ND, there continues to be debate among pediatric oncologists regarding its usefulness. This prospective randomized controlled trial evaluated the difference in neutropenic infection rates in pediatric oncology patients randomized to Food and Drug Administration approved food safety guidelines (FSGs) versus the ND plus FSGs during one cycle of chemotherapy...
July 11, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28691431/low-dose-computed-tomography-in-assessment-of-pulmonary-abnormalities-in-children-with-febrile-neutropenia-suffering-from-malignant-diseases
#4
Urszula Zaleska-Dorobisz, Cyprian Michal Olchowy, Mateusz Łasecki, Dąbrówka Sokołowska-Dąbek, Aleksander Pawluś, Jowita Frączkiewicz, Ewa Gorczyńska
BACKGROUND: Management of febrile neutropenia in pediatric patients is challenging. Chest X-ray and CT help to identify infective foci; however, exposure to radiation is a risk factor for development of secondary cancer. For this reason, attention is paid to reduce radiation exposure. OBJECTIVES: TTo define the role of LDCT examination in early detection of pulmonary lesions in children during oncology or autoimmune treatment complicated by neutropenia related fever...
June 27, 2017: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
https://www.readbyqxmd.com/read/28459614/guideline-for-the-management-of-fever-and-neutropenia-in-children-with-cancer-and-hematopoietic-stem-cell-transplantation-recipients-2017-update
#5
REVIEW
Thomas Lehrnbecher, Paula Robinson, Brian Fisher, Sarah Alexander, Roland A Ammann, Melissa Beauchemin, Fabianne Carlesse, Andreas H Groll, Gabrielle M Haeusler, Maria Santolaya, William J Steinbach, Elio Castagnola, Bonnie L Davis, L Lee Dupuis, Aditya H Gaur, Wim J E Tissing, Theo Zaoutis, Robert Phillips, Lillian Sung
Purpose To update a clinical practice guideline (CPG) for the empirical management of fever and neutropenia (FN) in children with cancer and hematopoietic stem-cell transplantation recipients. Methods The International Pediatric Fever and Neutropenia Guideline Panel is a multidisciplinary and multinational group of experts in pediatric oncology and infectious diseases that includes a patient advocate. For questions of risk stratification and evaluation, we updated systematic reviews of observational studies...
June 20, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28270852/effects-of-honey-on-oral-mucositis-among-pediatric-cancer-patients-undergoing-chemo-radiotherapy-treatment-at-king-abdulaziz-university-hospital-in-jeddah-kingdom-of-saudi-arabia
#6
Soad K Al Jaouni, Mohammad S Al Muhayawi, Abear Hussein, Iman Elfiki, Rajaa Al-Raddadi, Saad M Al Muhayawi, Saad Almasaudi, Mohammad Amjad Kamal, Steve Harakeh
One of the most common complications of cancer chemotherapy is oral mucositis. This study evaluates the therapeutic effects of honey with the focus on grade III and IV oral mucositis, reduction of bacterial and fungal infections, duration of episodes of oral mucositis, and body weight in pediatric leukemic patients undergoing chemo/radiotherapy. This is an open labeled randomized controlled study conducted at our hospital on 40 pediatric cancer patients undergoing chemo/radiotherapy. All the 40 patients included in this study experienced a sum total of 390 episodes of fever and neutropenia associated with oral mucositis...
2017: Evidence-based Complementary and Alternative Medicine: ECAM
https://www.readbyqxmd.com/read/27567122/galactomannan-%C3%AE-d-glucan-and-polymerase-chain-reaction-based-assays-for-the-diagnosis-of-invasive-fungal-disease-in-pediatric-cancer-and-hematopoietic-stem-cell-transplantation-a-systematic-review-and-meta-analysis
#7
REVIEW
Thomas Lehrnbecher, Paula D Robinson, Brian T Fisher, Elio Castagnola, Andreas H Groll, William J Steinbach, Theoklis E Zaoutis, Zelalem F Negeri, Joseph Beyene, Bob Phillips, Lillian Sung
We systematically reviewed and analyzed the available data for galactomannan (GM), β-D-glucan (BG), and polymerase chain reaction (PCR)-based assays to detect invasive fungal disease (IFD) in patients with pediatric cancer or undergoing hematopoietic stem cell transplantation when used as screening tools during immunosuppression or as diagnostic tests in patients presenting with symptoms such as fever during neutropenia (FN). Of 1532 studies screened, 25 studies reported on GM (n = 19), BG (n = 3), and PCR (n = 11)...
November 15, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/27103976/serum-endocan-levels-in-children-with-febrile-neutropenia
#8
Eylem Kiral, Ener Cagri Dinleyici, Ayse Bozkurt-Turhan, Ozcan Bor, Yurdanur Akgun, Necat Akdeniz Akgun
Endocan is an endotelial cell specific molecule; previous studies have shown that serum endocan levels increased in cancer and sepsis and are also related to the severity of sepsis. There are no clinical study about serum endocan levels in children with febrile neutropenia. The aim of this study was to evaluate serum endocan levels in pediatric leukemia patients with febrile neutropenia (n=33) and compare them with children with leukemia without fever (n=33) and also with healthy children (n=24). The median serum endocan level in the first group (children with febrile neutropenia) was statistically significantly higher compared to the leukemic children without febrile neutropenia and also control group (P<0...
March 17, 2016: Hematology Reports
https://www.readbyqxmd.com/read/27022114/strategies-for-empiric-management-of-pediatric-fever-and-neutropenia-in-patients-with-cancer-and-hematopoietic-stem-cell-transplantation-recipients-a-systematic-review-of-randomized-trials
#9
REVIEW
Paula D Robinson, Thomas Lehrnbecher, Robert Phillips, L Lee Dupuis, Lillian Sung
PURPOSE: To describe treatment failure and mortality rates with different antibiotic regimens and different management strategies for empirical treatment of fever and neutropenia (FN) in pediatric patients with cancer and hematopoietic stem-cell transplantation (HSCT) recipients. METHODS: We conducted a systematic review and performed searches of MEDLINE, Embase, PubMed, and Cochrane Central Register of Controlled Trials. Studies were included if pediatric patients had cancer or were HSCT recipients and the intervention was related to the management of FN...
June 10, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/26900730/fever-and-neutropenia-hospital-discharges-in-children-with-cancer-a-2012-update
#10
MULTICENTER STUDY
Emily L Mueller, James Croop, Aaron E Carroll
Fever and neutropenia (FN) is a common precipitant for hospitalization among children with cancer, but hospital utilization trends are not well described. This study describes national trends for hospital discharges for FN among children with cancer for the year 2012, compared with the authors' previous analysis from 2009. Data were analyzed from the Kids' Inpatient Database (KID), an all-payer US hospital database, for 2012. Pediatric patients with cancer who had a discharge for FN were identified using age ≤19 years, urgent or emergent admit type, nontransferred, and a combination of International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes for fever and neutropenia...
February 2016: Pediatric Hematology and Oncology
https://www.readbyqxmd.com/read/26714675/a-retrospective-analysis-of-treatment-related-hospitalization-costs-of-pediatric-adolescent-and-young-adult-acute-lymphoblastic-leukemia
#11
Sapna Kaul, Ernest Kent Korgenski, Jian Ying, Christi F Ng, Rochelle R Smits-Seemann, Richard E Nelson, Seth Andrews, Elizabeth Raetz, Mark Fluchel, Richard Lemons, Anne C Kirchhoff
This retrospective study examined the longitudinal hospital outcomes (costs adjusted for inflation, hospital days, and admissions) associated with the treatment of pediatric, adolescent, and young adult acute lymphoblastic leukemia (ALL). Patients between one and 26 years of age with newly diagnosed ALL, who were treated at Primary Children's Hospital (PCH) in Salt Lake City, Utah were included. Treatment and hospitalization data were retrieved from system-wide cancer registry and enterprise data warehouse...
February 2016: Cancer Medicine
https://www.readbyqxmd.com/read/26713542/characteristics-of-children-with-cancer-discharged-or-admitted-from-the-emergency-department
#12
MULTICENTER STUDY
Emily L Mueller, Matthew Hall, Samir S Shah, Keith J August, Mohamed A Radhi, Michelle L Macy
BACKGROUND: Emergency department (ED) utilization by children with cancer is poorly understood. Among children with cancer, we explored reasons for ED visits and factors associated with admission within U.S. children's hospitals. METHODS: A retrospective study of the 2011-2013 Pediatric Health Information System (PHIS) was conducted. Eligible ED visits included those within 365 days from the first inpatient encounter with an International Classification of Diseases, Ninth Edition, Clinical Modification (ICD-9-CM) code for cancer...
May 2016: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/26292080/a-prospective-cohort-quality-improvement-study-to-reduce-the-time-to-antibiotics-for-new-fever-in-neutropenic-pediatric-oncology-inpatients
#13
Adam L Green, Joanna Yi, Natalie Bezler, Yana Pikman, Venée N Tubman, Esther A Obeng, Teresa O'Neil, Robert Mersereau, Lisa Morrissey, Amy L Billett
BACKGROUND: Fever and neutropenia (F&N) is a pediatric oncology emergency due to the risk of disseminated infection. Quality improvement (QI) efforts to improve time to antibiotics for F&N in the emergency department have been documented, but the issue has not been studied in the established inpatient setting. PROCEDURE: We undertook a prospective cohort QI study to decrease time to antibiotics for neutropenic pediatric oncology inpatients with new fever to <60 min...
January 2016: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/26086779/variation-in-management-of-fever-and-neutropenia-among-pediatric-patients-with-cancer-a-survey-of-providers-in-michigan
#14
MULTICENTER STUDY
Emily L Mueller, Kelly J Walkovich, Gregory A Yanik, Sarah J Clark
Considerable variation in the management of fever and neutropenia (FN) exists, with factors associated with treatment variation not well described. An online survey of 90 pediatric cancer providers in Michigan was performed in Spring 2014. The survey frame was pediatric patients with cancer receiving treatment, with a Port-a-cath, who were clinically stable. Criteria for "Decreased" and "Increased" risk groups were defined by respondents. Survey questions addressed FN definitions, risk groups conceptualization, routine clinical practice, and management guidelines, in the context of risk groups and distance to treating institution...
2015: Pediatric Hematology and Oncology
https://www.readbyqxmd.com/read/26019777/presepsin-scd14-as-a-marker-of-serious-bacterial-infections-in-chemotherapy-induced-severe-neutropenia
#15
Elham Olad, Iraj Sedighi, Azim Mehrvar, Maryam Tashvighi, Vahid Fallahazad, Amirabbas Hedayatiasl, Hossein Esfahani
OBJECTIVE: Timely detection of serious bacterial infections or prediction of sepsis and death is of paramount importance in neutropenic patients especially in oncology settings. The aim of this study was to determine a rapid and secure predictor of sepsis in severe neutropenic cancer children. METHODS: In addition to blood culture, we have evaluated serum soluble CD14 on this role and measured it in 39 neutropenic episodes in Mahak pediatric oncology center from September 2012 to January 2013...
December 2014: Iranian Journal of Pediatrics
https://www.readbyqxmd.com/read/25957578/hospital-discharges-for-fever-and-neutropenia-in-pediatric-cancer-patients-united-states-2009
#16
Emily L Mueller, Kelly J Walkovich, Rajen Mody, Achamyeleh Gebremariam, Matthew M Davis
BACKGROUND: Fever and neutropenia (FN) is a common complication of pediatric cancer treatment, but hospital utilization patterns for this condition are not well described. METHODS: Data were analyzed from the Kids' Inpatient Database (KID), an all-payer US hospital database, for 2009. Pediatric FN patients were identified using: age ≤19 years, urgent or emergent admit type, non-transferred, and a combination of ICD-9-CM codes for fever and neutropenia. Sampling weights were used to permit national inferences...
May 10, 2015: BMC Cancer
https://www.readbyqxmd.com/read/25929242/the-utility-of-computed-tomography-in-the-management-of-fever-and-neutropenia-in-pediatric-oncology
#17
Avani D Rao, Elizabeth A Sugar, Neil Barrett, Mahadevappa Mahesh, Robert J Arceci
Despite the frequent use and radiation exposure of computed tomography (CT) scans, there is little information on patterns of CT use and their utility in the management of pediatric patients with fever and neutropenia (FN). We examined the contribution of either the commonly employed pan-CT (multiple anatomical locations) or targeted CT (single location) scanning to identify possible infectious etiologies in this challenging clinical scenario. Procedure Pediatric patients with an underlying malignancy admitted for fever (temperature ≥ 38...
October 2015: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/25728418/preventive-antibiotics-in-pediatric-patients-with-acute-myeloid-leukemia-aml
#18
Dawn Nolt, Susan Lindemulder, Jeffrey Meyrowitz, Bill H Chang, Suman Malempati, Gregory Thomas, Linda Stork
BACKGROUND: Treatment of acute myeloid leukemia (AML) comes with a significant risk of life-threatening infection during periods of prolonged severe neutropenia. We studied the impact of preventive intravenous (IV) antibiotic administration at onset of absolute neutropenia on the incidence and outcome of life-threatening infections during treatment of childhood AML. PROCEDURES: This is a retrospective study on pediatric patients (aged 0-18 years) consecutively diagnosed with de novo AML and treated at a single institution from April 2005 through February 2013...
July 2015: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/25671574/the-influence-of-different-fever-definitions-on-the-rate-of-fever-in-neutropenia-diagnosed-in-children-with-cancer
#19
Roland A Ammann, Oliver Teuffel, Philipp Agyeman, Nadine Amport, Kurt Leibundgut
BACKGROUND: The temperature limit defining fever (TLDF) is based on scarce evidence. This study aimed to determine the rate of fever in neutropenia (FN) episodes additionally diagnosed by lower versus standard TLDF. METHODS: In a single center using a high TLDF (39.0°C tympanic temperature, LimitStandard), pediatric patients treated with chemotherapy for cancer were observed prospectively. Results of all temperature measurements and CBCs were recorded. The application of lower TLDFs (LimitLow; range, 37...
2015: PloS One
https://www.readbyqxmd.com/read/25663663/pediatric-patients-who-receive-antibiotics-for-fever-and-neutropenia-in-less-than-60-min-have-decreased-intensive-care-needs
#20
Jennifer L Salstrom, Rebecca L Coughlin, Kathleen Pool, Melissa Bojan, Camille Mediavilla, William Schwent, Michael Rannie, Dawn Law, Michelle Finnerty, Joanne Hilden
BACKGROUND: Antibiotic delivery to patients with fever and neutropenia (F&N) in <60 min is an increasingly important quality measure for oncology centers, but several published reports indicate that a time to antibiotic delivery (TTA) of <60 min is quite difficult to achieve. Here we report a quality improvement (QI) effort that sought to decrease TTA and assess associated clinical outcomes in pediatric patients with cancer and F&N. PROCEDURE: We used Lean-Methodology and a Plan-Do-Study-Act approach to direct QI efforts and prospectively tracked TTA measures and associated clinical outcomes (length of stay, duration of fever, use of imaging studies to search for occult infection, bacteremia, intensive care unit (ICU) consultation or admission, and mortality)...
May 2015: Pediatric Blood & Cancer
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