Posts Tagged ‘child’

Provider, parental assumptions on teen sex yield ‘missed opportunities’ for HPV vaccine

Researchers at Boston University School of Medicine (BUSM) conducted hundreds of interviews to offer new insights into this frequent — and often controversial — clinic room conversation. Their findings and recommendations will appear in the September 2014 issue of Pediatrics.

Specifically researchers found that vaccination rates could be traced to personal biases and communication styles of providers. Providers who believed a child was at low risk for sexual activity — an assessment, they admitted, not always accurate — were more likely to delay administration. Often, this deferred decision was never readdressed. Those with high vaccination rates approached HPV vaccines as a routine part of the age 11 vaccine bundle, unequivocally recommended it to parents, and framed the conversation as one about cancer prevention.

“Emphasis on cancer prevention and concurrent administration with other routine childhood vaccines has the potential to dramatically reduce missed opportunities occurring among well- intentioned providers and parents,” explained lead author Rebecca Perkins, MD, MSc, assistant professor of Obstetrics and Gynecology at BUSM and a gynecologist at Boston Medical Center.

The researchers interviewed 124 parents and 37 health-care providers at four clinics between September 2012 and August 2013. Parents and providers were asked to discuss their reasons why their HPV vaccine eligible girls did or did not ultimately receive the vaccine. Remarkably, the most common parental reason (44 percent) was that their child was never offered the vaccine. Other common reasons included the perception that the vaccination was optional instead of recommended or being told by their provider that it was unnecessary prior to sexual debut. Among those that declined the vaccine, the rationale often involved safety concerns and a belief that their daughters were too young to need it.

source : http://www.sciencedaily.com/releases/2014/08/140818012326.htm

Guidelines can predict early menopause in child cancer survivors, giving hope for fertility

The criteria — developed in Edinburgh — will help to select which girls should be offered the opportunity to freeze some tissue from their ovaries for use in the future.

Doctors are optimistic that the frozen tissue could one day help young cancer survivors to have children of their own.

Some cancer treatments can affect female fertility by bringing on early menopause. Freezing samples of ovary tissue before patients start treatment is the only option to try to preserve their fertility.

At least 30 babies have been born from frozen ovarian tissue taken from adult women but the procedure remains unproven in girls and young women.

Taking the initial samples of ovaries to be frozen involves a surgical technique and is still relatively experimental. It is therefore crucial that doctors can accurately predict which patients are most likely to benefit and when it can be safely performed.

Guidelines were developed almost 20 years ago to select which girls should be offered the procedure, based on their age, type of cancer treatment and their chances of being cured of their cancer. Now that the girls are older, doctors are able to validate their predictions.

Researchers — led by the University of Edinburgh — validated the criteria by looking back at more than 400 girls with cancer who were under 18 years of age when diagnosed. They found that the criteria accurately predicted all but one of the patients who entered early menopause.

The study, funded by the Medical Research Council, is published in the journal Lancet Oncology.

The lead researcher is Professor Hamish Wallace of the University of Edinburgh’s Department of Child Life and Health and Consultant Paediatric Oncologist at the Royal Hospital for Sick Children (RHSC), where the research was carried out. He said: “Advances in lifesaving treatments mean that more and more young people with cancer are surviving the disease. Here we have an opportunity to help young women to have families of their own when they grow up, if they so choose.”

source : http://www.sciencedaily.com/releases/2014/08/140815102235.htm

Childhood cancer treatment takes toll on hearts of survivors

Cancer is the leading cause of disease-related death among U.S. children, but the rate of survival has increased significantly from a 5-year survival rate of 58.1 percent in 1975-77 to 83.1 percent in 2003-09.

"Research has shown childhood cancer survivors face heart and other health problems decades after treatment," said Donald R. Dengel, Ph.D., study lead author and a kinesiology professor at the University of Minnesota in Minneapolis. "But researchers had not — until now — looked at the heart health effects of childhood cancer treatment while survivors are still children."

Dengel and colleagues measured artery stiffness, thickness and function in 319 U.S. boys and girls (ages 9-18) who had survived leukemia or cancerous tumors. Participants had survived 5 years or longer since their initial cancer diagnosis. Comparing the survivors to 208 sibling children not diagnosed with cancer, researchers found:

  • Premature heart disease, as demonstrated by a decline in arterial function, was more likely among the children who survived cancer.
  • Childhood leukemia survivors had a 9 percent decrease in arterial health after completing chemotherapy compared to the non-cancer group.

"Given this increased risk, children who survive cancer should make lifestyle changes to lower their cardiovascular risk," Dengel said. "Healthcare providers who are managing chemotherapy-treated childhood cancer survivors need to monitor cardiovascular risk factors immediately following the completion of their patients’ cancer therapy."

The children in the study were predominately white, so the findings might not apply to other racial and ethnic groups, Dengel said.

"And because of differences in childhood cancer treatment protocols, we are unable to attribute the changes in vascular structure and function to a specific chemotherapy agent," he said.

source : http://www.sciencedaily.com/releases/2013/11/131117155452.htm