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Childhood cancer is the second cause of mortality of the population between 4 and 15 years. More than 20 million new cases of cancer in the world are expected by the year 2025, and 80% of the load will be on countries of low to middle income. In the past two decades, significant changes have been observed in patterns of incidence, prevalence, survival, and childhood cancer mortality in Mexico. An extensive review of all the published studies in Mexico by various health institutions revealed a steady 18-year trend of 150 new cases/million/year. The prevalence showed that acute leukemias constitute a 50% of all childhood cancer cases, followed by lymphoma (Hodkin and non-Hodgkin), and primary malignant brain tumors. A significant survival rate was observed in 8 thousand children with acute lymphoblastic leukemia with an overall 5-year survival rate of 62%, with a range of 45 to 73%. The national mortality rate for all types of cancer was 5.2/100,000/year, which is higher than what is reported in most middle-income countries. In the face of the current results, the need arises to modify how we approach this group of diseases by integrating a socio-educational healthcare of the Mexican children who are currently treated under unfavorable conditions. The current sanitary authorities must be aware of the importance of the transmission and adjustment of the care received by children with these diseases at a national level, to be in line with international standards. [ABSTRACT FROM AUTHOR]

O câncer é uma patologia que tem como característica o crescimento desordenado de células, estas, de forma agressiva, podem acometer qualquer área do corpo, provocando o surgimento e crescimento de tumores. A incidência de câncer entre os seres humanos cresce a cada ano, podendo chegar a 21 milhões de pessoas até o ano de 2030, segundo a Organização Mundial da Saúde (OMS). Os tumores do Sistema Nervoso Central (SNC) são os mais presentes dentro da pediatria, um tipo de tumor cerebral conhecido como Gioblastoma Multiforme, afeta as células da glia que tem como função o suporte e a nutrição dos neurônios. O desequilíbrio homeostático provocado por esses tumores e os locais onde eles residem acabam provocando a ineficiência da terapia, levando a incapacidade dos fármacos de chegar até o local em sua dose recomendada, podendo também atingir regiões do SNC que podem prejudicar a saúde de paciente, não alcançando o real objetivo esperado. Não há validação da origem dessa malignidade, podendo ser genética ou ambiental (química). Os estudos dentro da pediatria são escassos e as terapias como cirurgia, quimioterapia e radioterapia ainda não são eficientes, aumentando a sobrevida do paciente em pouco mais de um ano. O uso da moderna técnica de nanopartículas é recente e raro, porém é um grande passo para se alcançar o propósito que é uma terapia que leve à cura do Gioblastoma Multiforme. Cancer is a pathology characterized by the disorderly growth of cells, which, aggressively, can affect any body's area, causing the appearance and growth of tumors. Cancer's incidence among human grows every year, and could reach 21 million people by the year of 2030, according World Health Organization (WHO). Central Nervous System (CNS) tumors are the most common in pediatrics, a type of brain tumor known as Gioblastoma Multiforme, affects glial cells whose function is to support and to nourish neurons. The homeostatic imbalance caused by these tumors and the places where they reside end up causing the inefficiency of the therapy, leading to the inability of the drugs to reach the site in their recommended dose, and may also reach regions CNS that can harm the patient health, not achieving the expected objective. There is no validation of this malignancy's origin, which may be genetic or environmental (chemical). Studies within pediatrics are scarce and therapies such as surgery, chemotherapy and radiotherapy are still not efficient, increasing patient survival by just over a year. The use of the modern nanoparticle technique is recent and rare, but it is a big step towards achieving the purpose of a therapy that leads to the cure of Gioblastoma Multiforme. [ABSTRACT FROM AUTHOR]

Introduction: the prevalence of undernutrition in the pediatric cancer population can vary considerably, an element that significantly influences the clinical outcome of patients. However, this is a potentially modifiable prognostic factor, which requires timely identification of nutritional risk to guide the nutritional care process. Objectives: to evaluate the operational performance of the Spanish version of the nutritional screening tool for childhood cancer (SCAN) in the context of the validation process of this instrument in a high-complexity hospital in the city of Bogotá, Colombia. Methods: the methodological design for the validation of a diagnostic scale was followed. The final sample consisted of 96 patients between 0 and 17 years with cancer and hospitalized at the Children's Cancer Center of the HOMI Foundation in Bogota. The SCAN-SP was applied to each patient and a complete nutritional assessment (CNA) was performed as a gold standard to determine nutritional status. Results: 82.3 % (n = 79) of patients were classified "at risk of malnutrition" by SCAN-SP and 69.8 % (n = 67) of the total sample had undernutrition. The evaluation of the operative performance of SCAN-SP against CNA showed excellent results: sensitivity of 100 %, specificity of 59 %, PPV of 85 %, NPV of 100 %, positive likelihood ratio of 2.4, and negative likelihood ratio of 0. Conclusion: the SCAN-SP scale performs well as a nutritional screening tool in pediatric cancer patients, so its use in clinical practice is recommended. [ABSTRACT FROM AUTHOR]

Introducción: el cáncer representa una de las principales causas de muerte en niños, niñas y adolescentes a nivel global, el cual es superado escasamente por los accidentes. Las neoplasias más frecuentes son, en primer lugar, las leucemias; segundo, los tumores del Sistema Nervioso Central; y, tercero, los linfomas. Es importante destacar que no existe prevención, sin embargo, hay signos de alarma que si se logran identificar a tiempo pueden verse traducidos en una enfermedad más manejable con una sobrevida más alta y un mejor pronóstico. Objetivo: realizar una actualización académica sobre la importancia de los signos y síntomas de alarma del cáncer infantil. Método: se realizó una investigación documental y se utilizó como buscador de información científica Google Académico. Se evaluaron artículos de investigación y revisión de diferentes bases de datos, como: site de la Organización Mundial de la Salud, site de la Oficina Panamericana de la Salud, Revista de Pediatría Integral, American Cáncer Society y publicaciones periodísticas locales, entre otros. Conclusiones: el cáncer en la infancia y adolescencia no puede prevenirse; sin embargo, si los médicos de los distintos niveles de atención en salud pueden reconocer los signos de alarma ante un probable caso de malignidad, se lograrán referimientos oportunos, diagnósticos tempranos y una mejor tasa de curabilidad y sobrevida en los niños.

Objective: To analyze the predictive role of coping strategies and social support over humor styles in parents who migrate along with children with cancer. Method: A transactional-correlational quantitative design and non-probabilistic convenience sampling were used. It involved 62 parents (11 men and 51 women) between 20 and 61 years. They answered the Humor Styles Questionnaire (HSQ), COPE Inventory (COPE) and the Medical Outcomes Study Social Support Survey (MOS-SSS). Results: Regression models were developed for affiliative (R²=0,19, p<0,001) and aggressive humor (R²=0,25, p<0,001), both considered humor styles towards others. For self-oriented humor styles, two models were built to predict self-enhancing humor. The first model considers global social support (R²=0,25, p<0,001), while the second model, affective support (R²=0,27, p<0,001). Likewise, the first model explaining self-defeating humor considers global social support (R²=0,28, p<0,001) and the second, instrumental support (R²=0,27, p<0,001). Discussion: Coping strategies and social support in relation to humor styles in the context of illness and migration demonstrate the effectiveness of certain strategies and styles considered maladaptive in face of a highly stressful situation. [ABSTRACT FROM AUTHOR]

Objetivo: Este estudio evaluó el efecto de la proximidad a fuentes industriales de contaminación del aire sobre la aparición de conglomerados de casos de cáncer infantil en el Área Metropolitana del Valle de Aburrá, del departamento de Antioquia, durante el período 2000-2015. Metodología: La información de casos de cáncer infantil en menores de 15 años residentes del área metropolitana se obtuvo del Registro Poblacional de Cáncer de Antioquia, de dicho periodo. Se identificaron 32 conglomerados industriales, a partir del inventario de la autoridad ambiental local. Se realizaron pruebas de escaneo circular de Kulldorf locales y focalizadas, para detectar conglomerados de cáncer infantil en los municipios y alrededor de los conglomerados industriales respectivamente. Se usó un modelo de regresión multivariable ajustado por estrato socioeconómico, para evaluar el efecto de las variables espaciales. Resultados: La tasa de incidencia específica en el Valle de Aburrá para el periodo evaluado fue de 117,13 casos por millón de niños menores de 15 años. Las tasas de incidencia más altas se presentaron en los municipios de Medellín y Sabaneta. La prueba de Kulldorf identificó 12 conglomerados espaciales y 8 espaciotemporales con significación estadística en 7 de los municipios, particularmente en Bello y Medellín. Las pruebas focalizadas identificaron conglomerados alrededor de 20 conglomerados industriales. En los modelos multivariables, un conglomerado en Bello evidenció asociación estadísticamente significativa e inversa entre la incidencia y la distancia al conglomerado con direccionalidad sureste. Conclusión: Algunos conglomerados espacio-temporales de cáncer infantil en el Área Metropolitana del Valle de Aburrá entre 2000 y 2015 están relacionados con proximidad a fuentes industriales de contaminación del aire.

Background. Fear of cancer recurrence is one of the most distressing psychological consequences in cancer survivors and their informal primary caregivers (IPC). IPC of childhood cancer survivors (CCS) are often their mothers, which could intensify fear of cancer recurrence (FCR) and its impact on both IPC and CCS. However, the phenomenon has not been widely described in this specific population. Objective. To summarize and analyze current evidence on the evaluation and management of FCR among IPC of CCS. Method. A narrative review of studies included in four databases (PsycInfo, Medline, CINALH, and Web of Science) with no language or year of publication restrictions. Results. Measures specifically developed to assess FCR among IPC of CCS comprising an interview and a questionnaire with initial psychometric evaluations and two short, online intervention programs based on cognitive-behavioral-contextual therapy were identified (ENGAGE and CASCAdE). Both have demonstrated acceptability in parents of CCS in high-income countries; preliminary evidence also exists of the effectivity of CASCAdE in reducing FCR. Discussion and conclusion. Given the limitations of this area of psychological evaluation, the Fear of Cancer Recurrence Inventory, originally developed for adult cancer survivors, constitutes the most suitable tool for evaluating FCR among IPC of CCS. The CASCAdE program seems a promising intervention for IPC of CSS, although cultural adaptations, evaluations of its acceptability in low- and middle-income countries, and controlled studies in large samples are still required. [ABSTRACT FROM AUTHOR]

Introduction: Ototoxicity occurs in different percentages in patients after treatment with platinum-based chemotherapy or cranial radiation therapy. The aim of this study was to present our experience in ototoxicity monitoring. Material and methods: A review was made of the registry of paediatric cancer patients referred to the Children’s Hearing Loss Unit from 1999 to 2019. Results: Of the 46 patients referred to this unit, 41 had received platinum as part of their treatment, 17 patients underwent neurosurgery, and 18 patients received cranial radiation therapy. An anamnesis and otoscopy were performed on all of them, and the monitoring was carried out with tone-verbal audiometry and/or distortion products. Hearing loss was observed in eight patients (21.05% of patients referred for audiological follow-up) as a consequence of the treatment. It was impossible to determine the audiological situation in eight patients at the end of treatment. Hearing aid adaption was necessary in two patients. In coordination with Paediatric Oncology, a change from cisplatin to carboplatin due to bilateral grade two ototoxicity was considered appropriate during treatment in one patient. Conclusion: Adequate coordination with Paediatric Oncology is essential to carry out active surveillance for ototoxicity and to modify, if possible, the dosage or type of chemotherapy in case hearing is affected. In our experience, and following current recommendations, a pre-treatment assessment is usually performed, as well as monitoring during treatment, at the end of treatment, and annually thereafter due to the risk of a later development of hearing loss. Resumen: Introducción: La ototoxicidad se presenta en diversos porcentajes según estudios tras el tratamiento con quimioterapia basada en platino y/o radioterapia craneal. El objetivo es mostrar nuestra experiencia en la monitorización de la ototoxicidad. Material y métodos: Se realizó una revisión del 1999 al 2019 en el registro de pacientes oncológicos pediátricos de nuestro hospital y remitidos a la Unidad de Hipoacusia Infantil. Resultados: 46 pacientes fueron remitidos a nuestra unidad. 41 pacientes recibieron platinos como parte de su tratamiento, 17 pacientes fueron sometidos a una intervención neuroquirúrgica y 18 pacientes recibieron radioterapia craneal. A todos se les realizó una anamnesis y otoscopia, y la monitorización se llevó a cabo con una audiometría tono-verbal y/o productos de distorsión. Se objetivó una hipoacusia como secuela del tratamiento en ocho pacientes (21,05% de los pacientes remitidos para seguimiento audiológico). Fue imposible determinar la situación audiológica al finalizar el tratamiento en ocho pacientes. La adaptación audioprotésica fue necesaria en dos pacientes. En la coordinación con Oncología Pediátrica, se consideró oportuno el cambio de cisplatino por carboplatino por ototoxicidad importante durante el tratamiento en un único paciente. Conclusión: Es imprescindible una adecuada coordinación con Oncología Pediátrica para realizar una vigilancia activa de la ototoxicidad y modificar, si es posible, la dosificación o el tipo de quimioterápico en caso de verse afectada la audición. En nuestra experiencia, y siguiendo las recomendaciones actuales, realizamos una valoración pretratamiento, una monitorización durante el tratamiento, al finalizarlo y después de forma anual por el riesgo de desarrollo diferido de una hipoacusia

Usando o Interacionismo Simbólico objetivamos explorar as dimensões das experiências vivenciadas por enfermeiras de uma instituição hospitalar no cuidado à criança com câncer e à sua família. Essas profissionais consideram o câncer infantil um acontecimento que causa muitas mudanças na vida da criança e seus familiares, que o tratamento é na maioria das vezes de curso longo, trazendo implicações que a criança e a família terão que enfrentar e onde a mãe é vista como a principal fonte de suporte. Referem que as famílias apresentam comportamentos distintos no início do tratamento e no transcorrer dele, modificando também suas necessidades. O cuidado é visto como “grande e complicado”, necessitando ser fornecido por uma equipe multiprofissional, onde a enfermeira separa as necessidades que julga ser de sua competência e as que são de outros profissionais. Inserido no cuidado está a dimensão de “ajuda”, associada à expectativa de aliviar a dor e dar conforto físico e psicológico quando a enfermeira conversa, acaricia, brinca, consola, fala a verdade e respeita a vontade da criança colocando-se no seu lugar. Cuidar da família compreende estar disponível quando necessário, conversar, escutar, encorajar, dedicar-se e “não abandonar” quando não existe mais nada que possa ser feito. As formas de cuidar relatadas corroboram a existência de um “cuidado universal” apresentadas por Leininger e Watson, baseadas em princípios humanísticos. Sugerimos que novos estudos sejam desenvolvidos para descrever os comportamentos, valores e práticas associadas ao cuidar em enfermagem, de maneira que este conhecimento possa ser incorporado na educação e prática profissional, direcionando a um cuidar mais ético, moral e humano.

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Los/as adolescentes curados de cáncer pueden ver alterada su proyección vital por las consecuencias de la enfermedad, pues las secuelas sociales, poco estudiadas, tienen un protagonismo importante en sus trayectorias académicas y relacionales. La nota de investigación trata de contribuir al análisis de contextos educativos y sus efectos en la construcción subjetiva de los adolescentes a través de la experiencia de la diferencia en las distintas dimensiones a las que afecta haber sido diagnosticados y tratados de un cáncer infantil, considerando el ámbito educativo, familiar o de ocio. Especialmente interesa el impacto del diagnóstico y el paréntesis del tratamiento (un año en tumores óseos) en la interacción social y la recuperación de una vida social normalizada.

Objective: This study evaluated the effect of proximity to industrial sources of air pollution on the occurrence of clusters of childhood cancer cases in the Aburrá Valley Metropolitan Area, Department of Antioquia, during the 2000-2015 period. Methodology: The information on childhood cancer cases in children under 15 years of age residing in the metropolitan area was obtained from the Registro Poblacional de Cáncer de Antioquia (Antioquia Cancer Population Registry) for that period. 32 industrial clusters were identified based on the local environmental authority's inventory. Local and targeted Kulldorff's circular scan tests were performed to detect childhood cancer clusters in the municipalities and surrounding the industrial clusters, respectively. We used a multivariate regression model adjusted for socioeconomic strata to assess the effect of spatial variables. Results: The specific incidence rate in the Aburrá Valley for the evaluated period was 117.13 cases per million children under 15 years of age. The highest incidence rates occurred in the municipalities of Medellín and Sabaneta. The Kulldorff test identified 12 spatial clusters and 8 space-time clusters that were statistically significant in 7 municipalities, particularly in Bello and Medellín. The targeted tests identified childhood cancer clusters surrounding 20 industrial clusters. In multivariate models, an industrial cluster in Bello showed a statistically significant inverse association between incidence and distance from the industrial cluster toward the southeast. Conclusion: Some space-time childhood cancer clusters in the Aburrá Valley Metropolitan Area between 2000 and 2015 are related to proximity to industrial sources of air pollution. [ABSTRACT FROM AUTHOR]

Objective. To determine the magnitude of mortality due to acute lymphoblastic leukemia (ALL) nationally and by age group, sex, state of residence and insurance status, as well as to evaluate time trends during the period 1998-2018 Materials and methods. We obtained ALL mortality data and estimated age-standardized national, state-level and health insurance mortality rates. We conducted a joinpoint regression analysis to describe mortality trends across the study period and estimate the average annual percent change (AAPC). Results. In a 20-year period, age-standardized ALL mortality rates increased from 1.6 per 100 000 in 1998 to 1.7 in 2018. Nationally, a constant annual increase in mortality was observed for both sexes (1998-2002 AAPC 0.6 in boys, and 1998-2002 AAPC 0.3 in girls). We observed heterogeneity in childhood ALL at a state level. Conclusion. Our results reflect the social, economic, geographic diversity of the country. Monitoring and surveillance of this disease is crucial to assess quality of care. [ABSTRACT FROM AUTHOR]

Objective: the following study was to determine the association between the history of human breastfeeding for more than 6 months, as a protective factor in the development of cancer in children and adolescents treated at the Pediatric Oncology and Hematology Clinic (Instituto Autónomo Hospital Universitario de Los Andes (IAHULA) in Merida-Venezuela; especially leukemias and lymphomas. Methods: Analytical, observational, case-control study. An interview was conducted with the mothers of children and adolescents aged between 2-15 years diagnosed with malignant neoplasms who attended the IAHULA pediatric oncology and hematology of clinic. The control group was made up of healthy subjects or those with minor medical problems, who attended the Pediatric Emergency Service or were hospitalized in the IAHULA pediatric areas. Results: When comparing the exclusive and supplemented human lactation groups, a significant association with the development of childhood cancer was demonstrated for those patients who did not receive exclusive human lactation (p= 0.018). No protective effect of human lactation for more than 6 months was demonstrated in terms of the occurrence of childhood cancer. Conclusion: The use of exclusive human lactation is associated with a protective effect for the development of childhood cancer; therefore, it could be considered that children fed human milk better cope with carcinogenic insults, modulating the interaction between infectious agents and the development of the infant immune system. [ABSTRACT FROM AUTHOR]

Copyright of Psicooncologia is the property of Universidad Complutense de Madrid and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

El presente trabajo tuvo como propósito proponer lineamientos para la reinserción escolar de niños del Instituto Oncológico del Oriente Boliviano, los cuales deben retomar actividades escolares luego de periodos de internación prolongados, por causa del tratamiento respectivo. La metodología utilizada fue la de Investigación Acción Participativa, se contó con 8 participantes de los cuales 2 fueron entrevistados y 6 conformaron el grupo focal para realizar una indagación sobre los temas de la investigación en perspectiva de producir información colectiva. Se trata, por tanto, de recoger, desde las concepciones y experiencias del grupo, actitudes, creencias y significados sobre el problema. Estos instrumentos, tanto las entrevistas como el grupo focal, permitieron diseñar los lineamientos para la reinserción escolar. Al inicio de la investigación se pretendía elaborar un programa para la reinserción escolar de estos niños, sin embargo, debido a las características de la investigación acción durante el procedimiento se observó que éste podría resultar muy concreto para responder a la problemática en general. Por ello, se llegó a la propuesta de unos lineamientos que en el futuro serán de gran aporte en la elaboración de programas específicos y personalizados para estos niños.

Objetivo: explorar la vivencia emocional de los padres de niños y adolescentes con cáncer de un modo más abierto y no exclusivamente centrado en búsqueda de consecuencias negativas para la familia. Método: Se realizó un estudio mixto (cuantitativo y cualitativo) a través de la realización de una entrevista semiestructurada a 30 padres de niños y adolescentes con cáncer en tratamiento en la Unidad de Hematología y Oncología Pediátrica de HM Montepríncipe. Resultados: Se han obtenido 5 temas principales de las entrevistas realizadas a los padres. Los padres de niños con cáncer durante el tratamiento de la enfermedad de su hijo emplean un afrontamiento activo, centrado en el presente que permite la aceptación. Por otro lado, los padres reflejan los modos de expresión emocional, la presencia de valores y crecimiento personal, la actitud de gratitud y el modelo de ayuda que han recibido en el lugar dónde ha sido atendido su hijo. En el modelo teórico se presenta la importancia y consistencia como predictor del bienestar psicológico (crecimiento personal y propósito vital) y la gratitud en esta población. Discusión/conclusiones: En los padres de niños y adolescentes con cáncer se debe favorecer un afrontamiento activo, permitiendo la importancia y consistencia con los valores y generando actitudes de gratitud y confianza que permitirán el crecimiento personal y el propósito vital de las familias, y por lo tanto una adecuada vivencia emocional en los padres resultará un beneficio directo para los hijos.

O diagnóstico de câncer em crianças causa um forte impacto na população, acompanhado principalmente por pensamentos negativos, apesar dos índices de cura terem aumentado nos últimos anos. Assim sendo, o presente estudo teve por objetivo analisar a percepção acerca do câncer infantil. Participaram 331 adultos, 155 com ou sem filhos e 176 pais de crianças com câncer. Para tanto, foram utilizados dois tipos de questionário: um sóciodemográfico, e outro de percepções sobre o câncer infantil. Os dados foram analisados através da estatística descritiva e uso do qui-quadrado. Os resultados indicaram que as percepções relacionadas ao câncer são predominantemente negativas. Diante disso, conclui-se que o câncer infantil está relacionado a um estigma de morte e sofrimento, o que está em contradição com os índices atuais de cura. Desse modo, o investimento no desenvolvimento de um trabalho de informação e conscientização da população pode ser importante para que o câncer seja visto de uma maneira mais realista.

as neoplasias malignas han ido adquiriendo a lo largo de los últimos años una prevalencia significativa. Esta enfermedad no excluye a la población infantil, aunque se presenta en baja frecuencia, constituye una de las tres causas de muerte en niños. El tratamiento antineoplásico a través de los años ha logrado porcentajes altos de curaciones, sin embargo, los grados de toxicidad que afectan a las células normales han aumentado por la intensidad de los tratamientos, siendo la cavidad oral muy susceptible a los efectos adversos directos e indirectos de la quimioterapia y radioterapia, debido a un alto índice de renovación celular. Dichas manifestaciones orales de carácter aguda o crónicas se ven agravadas por los problemas odontológicos preexistentes (caries, gingivitis y mala higiene). Es importante para el odontólogo conocer dichas alteraciones, identificarlas y así poder asistir adecuadamente a los pacientes para mejorar la calidad de vida. En este artículo se describen las alteraciones que se presentan con más frecuencia así como la experiencia y manejo clínico dentro del servicio de odontopediatría del Instituto Nacional de Enfermedades Neoplásicas.

The epidemiological trend of hemato-oncological problems in the pediatric population in our country is increasing and represents the second cause of death in children under 5 years of age. Chemotherapy or immunosuppressive treatment affect the natural or acquired immune response in general, also in the expected antibody titers when vaccines are applied. In addition to the intrinsic way in cancer patients and especially in acute leukemia, there is an alteration in the number and function of B and T lymphocyte cells. The recovery of these cells occurs at least 6 to 12 months after treatment, provided that when there is complete remission of the oncological disease. Infectious complications in cancer patients continue to represent the greatest challenge to improve survival curves, especially in developing countries like ours, requiring specific protocols with broad-spectrum antibiotic regimens and other specific measures for the prevention of infectious diseases, especially those that can be prevented by vaccination. This review focuses on pointing out the current immunization guidelines in the immunocompromised pediatric patient. [ABSTRACT FROM AUTHOR]

Objective: To describe the cardiovascular effects of childhood cancer treatment in survivors through clinical, electrocardiogram and echocardiographic methods. Material and methods: Prospective, observational case-control study of 34 patients of a Childhood Cancer Survivors Clinic, evaluated clinically, with electrocardiogram, with conventional echocardiography and strain. Average age 13.03 years; cumulative average anthracyclic dose 219.5 mg/m2; seven also with chest radiation. Analysis with student T tests and linear regression. Results: Left ejection fraction in survivors was preserved. Longitudinal left strain in 2, 3 chambers and circumferential was decreased in survivors (p < 0.05). Those undergoing radiotherapy and anthracyclic presented increased heart rate, ejection fraction and left shortening fraction decreased (< 0.05). Right ventricle without significant changes. Discussion and conclusions: There are a large number of childhood cancer survivors treated with cardiotoxics and radiotherapy. They may present changes in ventricular myocardial strain (even with normal ejection fraction) and/or arrhythmias, as evidenced in the group studied, which is consistent with previous international studies. Its complete cardiovascular evaluation is important to predict the risk of heart failure as part of a protocolized follow-up in well-established cardio oncology clinics. [ABSTRACT FROM AUTHOR]

En este artículo se abordan los itinerarios terapéuticos de niños/as con cáncer en Argentina a partir del análisis de narrativas de sus madres, en el contexto de las migraciones producidas desde el noroeste y noreste argentino hacia la Ciudad Autónoma de Buenos Aires con el objeto de acceder a diagnósticos y/o tratamientos médicos no disponibles en sus lugares de origen. La metodología consistió en un trabajo de campo etnográfico desarrollado en un hospital público de pediatría de referencia nacional, así como también, una fundación y un hotel en donde se hospedan algunas de estas familias durante estos períodos. El objetivo del artículo es analizar las diversas acciones desplegadas por los sujetos frente a la enfermedad en términos de tácticas articuladoras del proceso de atención.

Objective: Childhood cancer is a disease that modifies the style and quality of life of children and their families due to the physical, emotional and financial impact it has on them. Pediatric Palliative Care has among its functions the granting of psychological attention to children and their families from the pre-diagnostic stage until terminal stage. We present the case of a pediatric patient diagnosed withSynovial Sarcoma who presents depression and anxious avoidance as a result of her medical condition.Method: The evaluation was carried out through a behavioral interview, direct observation of anxiety anddepression responses in the hospital and Visual Analogue Scale (VAS) for pain. The treatment consistedof seven sessions of intervention with Cognitive-Behavioral Therapy techniques. Results: The obtainedresults include adaptive verbalizations about their condition, possible medical treatments, self-concept, animprovement in emotional expression and management of pain. Conclusion: This case is a sample of theimportance of the work of the psychologist in Pediatric Palliative Care, as well as the impact of workingwith children suffering from oncological diseases and their families. Cognitive-Behavioral Therapy hasbeen shown to be highly effective in this type of patients, even in brief interventions.

Introduction: family resilience is the positive adaptation to adversity, involving the change of its dynamics and its functioning, allowing to resolve any stressor that is found during the life of its members. Objective: to know some aspects related to family resilience in the field of pediatric oncology. Method: through a systematic review, one search is performed on the databases Medline, SCOPUS/Sciencedirect, Academic Search complete, Psychology and Behavioral Sciences Collection, CINAHL and E-Journals, to know the latest impact researches about models, variables, instruments and family resilience interventions, obtaining 13 articles. Results: 84.7% of the investigations are of a quantitative type and present an impact factor. Most studies use the Connor-Davidson Resilience Scale and find that most families of children with cancer are resilient. Two articles present models of family resilience. Conclusion: the family resilience construct is complex and studied from differentperspectives. A model that summarizes all the aspects that influence it, can help the intervention ofthe psychologist with the families of children with cancer.

El presente trabajo tiene como objetivo determinar la frecuencia y distribución de los tumores sólidos malignos en niños de 0-15 años, según tipo histológico, edad y género. Revisión de 17 años (1986-2003), en el servicio de anatomía patológica “Dr. Hans R. Döehnert” del Hospital Central “Antonio María Pineda”. Se realizó un estudio transversal, descriptivo, retrospectivo no experimental., se revisaron 247 biopsias de pacientes con diagnóstico de tumor sólido maligno en el servicio de anatomía patológica “Dr. Hans R. Döehnert” del Hospital Central Universitario “Antonio María Pineda” entre los años 1986 al 2003. Resultados: Los Linfomas ocuparon el primer lugar con 76 casos (30,76%): Linfomas no Hodgkin 46 casos (18.62 %), enfermedad de Hodgkin 30 casos (12,14%), en segundo lugar están los tumores del Sistema Nervioso Central (SNC): 33 casos (13,36 %), luego los Neuroblastomas: 30 casos (12,14%), Nefroblastoma (Tumor de Wilms):22 casos (8,90%); Osteosarcomas 18 casos (7,28%), Rabdomiosarcomas: 17 casos (6.88%); Tumores de células germinales 10 casos (4,84%), Retinoblastoma 9 casos (3,64%), y tumores de células redondas 7 casos (2,83), Sarcoma de Ewing 5 casos(2,02%), Teratomas no gonadales (inmaduros): 4 casos (1,60%), Hepatoblastoma 4 casos (1,60%), Tumores de células del Estroma y Cordones Sexuales 3 casos (1,21%), Carcinoma de Tiroides 2 casos (0.80%), adenocarcinoma de colon 2 casos (0,80%), melanoma 1 caso (0,40%), histiocitosis un caso (0,40%), sarcoma de células clara de riñón un caso (0,40%), hemangiopericitoma un caso (0,40%), Schwannoma maligno un caso (0,40%). En niños de 2 a 6 años fueron más frecuentes los linfomas y los Nefroblastomas y neuroblastoma. En niños de 10 a 12 años fueron los Rabdomiosarcomas y Osteosarcomas, con un predominio en el sexo masculino (59,6%). Los tumores sólidos malignos más frecuentes fueron los linfomas, seguidos de los tumores de SNC, el grupo etario más afectados está entre los 2 y 6 años, con predominio en el sexo masculino.

El presente artículo parte de un estudio de tipo descriptivo con enfoque mixto y diseño no experimental, cuyo objetivo consistió en evaluar las reacciones psicológicas presentes en padres y/o cuidador de paciente oncológico pediátrico en la ciudad de Bucaramanga durante el año 2017; fueron seleccionados 40 participantes de forma no probabilística, por conveniencia, y se les aplico el inventario de Ansiedad estado/rasgo STAI, Inventario de Depresión estado/rasgo IDER y escala de apreciación al estrés EAE. Se encontró que el 42,5% de los participantes puntuaron en niveles de ansiedad media alta para estado y el 42,5% para ansiedad rasgo alta, por otra parte los resultados relacionados con depresión evidencian que el 40% de la muestra presentan depresión tipo estado y un 25% puntuó para depresión tipo rasgo; en cuanto a la escala de apreciación al estrés existe un paralelo entre nivel bajo y nivel alto con un 45% para cada parámetro.

Childhood cancer diagnosis has emotional effects not only on the child with cancer, but also on the family system. This study presents the results of a research project about art therapy with families of children with cancer after discharge from a pediatric ward. Objectives: The main objective of the research project is to understand the family dynamics during the creative process. The aim is to develop a specific methodology to offer a therapeutic support to the families when they return home. Method: Over three years 10 families (36 people) have taken part in the art therapy study. After the therapeutic program finalized, the results were analyzed using a qualitative methodology and relate with the Grounded Theory. Results: This studio showed that the overall effect of the family art therapeutic intervention during this period was helpful allowing family members to explore alternative ways of relating, to adapt their roles to the situation they are living and to use symbolic language to express ideas and emotion when words are not enough. Conclusions: The art therapeutic program on the return home after a pediatric ward admission helps the family to face some problems related to the readaptation process. Broaden the therapeutic approach to the family system helped the family members to share their experiences and personal growth after the impact of the childhood cancer.

This article addresses the therapeutic itineraries of children with cancer in Argentina, based on the analysis of their mothers' narratives, in the context of migrations from the Argentine Northwest and Northeast towards the Autonomous City of Buenos Aires in order to access diagnoses and / or medical care that are unavailable in their places of origin. Ethnographic fieldwork was carried out in a public pediatric hospital of national reference, as well as at a foundation and a hotel where some of these families stayed during these periods. The article aims to analyze the various actions deployed by these mothers against the disease in terms of tactics that articulate the care process. [ABSTRACT FROM AUTHOR]

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Los tumores cerebrales del niño representan la primera causa de tumor sólido en pediatría y, gracias a los progresos efectuados en el tratamiento de las hemopatías malignas, ellos son actualmente la primera causa de mortalidad por cáncer en esta edad. Los problemas que plantean son diversos según la edad de aparición del tumor, su tipo histológico y su sitio. Los objetivos actuales en neuro-oncología pediátrica conciernen no solamente a la mejoría del pronóstico vital sino que igualmente a la disminución de la morbilidad ligada a la enfermedad y a los tratamientos. Los medios para lograrlo implican: • La sofisticación de los métodos de imágenes que permiten una mejor guía del gesto quirúrgico, favoreciendo así una exéresis más completa de las lesiones tumorales con respecto de los tejidos sanos peritumorales. • Una mejor precisión de los criterios de diagnóstico y de pronóstico basándose no solamente en los parámetros histológicos e inmunohistoquímicos sino también, integrando los nuevos marcadores biológicos oncogenéticos. • La adaptación de las modalidades terapéuticas a la edad, a la localización y al tipo histológico de los diferentes tumores así como a la mejor prestación a realizar por los equipos especializados.

El Cáncer en la niñez tiene una incidencia mundial de 11 x 100,000 personas nacidas vivas en menores de 20 años. La sobrevida en los países desarrollados es alrededor del 80% no así en los países en vía de desarrollo en donde la baja prioridad que se le da al Cáncer Infantil en los programas de salud hace que la mortalidad sea alta debido por lo general a lo tardío del diagnóstico. Este retraso es debido especialmente a situaciones socio-económicas, y por ignorancia de los padres y del médico que debido al desconocimiento de los tumores infantiles en la gran mayoría de los casos nunca consideran como posibilidad diagnóstica esta patología. Se realiza una diferencia entre los cánceres del adulto y los infantiles.

O câncer infantil apresenta 70% de chance de cura se diagnosticado precocemente, embora seja uma doença rara, e pode resultar na morte. A associação entre o câncer e a morte passa a ser conhecida pelas crianças, de alguma forma, desde o momento do diagnóstico, esse encontro é constante. Nesta pesquisa buscou-se desvelar se o tema da morte de si mesma ou de outras crianças com câncer são abordados por meio dos desenhos-estórias. A pesquisa foi desenvolvida em uma associação que presta assistência psicossocial, hospedagem, alimentação e transporte às crianças e aos acompanhantes durante o tratamento oncológico. Colaboraram com a pesquisa cinco crianças que estavam em tratamento oncológico e hospedadas na casa, sendo quatro do sexo feminino e uma do sexo masculino. Como instrumento para coleta dos dados foi utilizado entrevista semiestruturada com os responsáveis, objetivando identificar informações gerais a respeito das crianças. Posteriormente, com as crianças, foi executado o procedimento de desenho-estória, por meio de desenhos e associações verbais, introduzido por Walter Trinca, em 1972. Para análise e compreensão dos dados coletados, utilizou-se o modelo de Amedeo Giorgi. Posteriormente foram construídos dois eixos temáticos: as diversas perdas no adoecer e a morte de si e de seus companheiros de enfermaria. Os resultados desvelam que a criança busca compressão do que ocorre consigo e com o ambiente onde se encontra, lidam com a incerteza em relação ao futuro, podendo sentir a proximidade da morte e expressar seus sentimentos e emoções.

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Objective. To redefine family relationships during childhood cancer confrontation through a dialogic encounter with three families of the Alejandra Velez Mejia Foundation. Methodology. Qualitative hermeneutical research carried out through conversational encounters using in-depth interviews with three families from their experience of confrontation of the chronic illnes of their children. Results and conclusion. The results include perceptions of abandonment in the family as a stressor in family relationships, anticipated family mourning for perceived losses and recognition of family-health institution knowledge. The family in a ritual to welcome a new lifestyle: new roles and links and dilemmas that represent childhood cancer. In the processes of crisis intervention, the dialogical capacity of individuals and families is strengthened with an emphasis on listening to children, adolescents and families through reflective criticism, constructive dialogue, conversation and narrative. [ABSTRACT FROM AUTHOR]

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Este estudo é uma discussão dos aspectos psicológicos envolvidos na sobrevivência do câncer infantil, seu objetivo foi analisar as complicações psicossociais de adultos sobreviventes dessa afecção. Justifica-se pela necessidade de informação sobre a temática, explicitando-se a incidência do câncer infantil, as sequelas fisiológicas e as marcas psíquicas deixadas pelo tratamento agressivo utilizado para vencer a enfermidade. Trata-se de uma pesquisa bibliográfica, que inicia-se explicando o câncer infantil na sobrevivência das crianças por ele acometidas. A metodologia explana os recursos e ferramentas utilizados na elaborção do Artigo e os resultados explicitam todos os tipos mais comuns de câncer infantil o desgaste psicológico das famílias ao receber o diagnóstico de câncer, o medo da morte; as sequelas deixadas como amputações, problemas de saúde e o alto risco de uma segunda neoplasia. Traz ainda apontamentos sobre a atuação do psicólogo com pacientes infantis com câncer, o acompanhamentos das famílias para assegurar a manutenção da autoconfiança no tratamento e reinserção dos sobreviventes na sociedade, dados que foram discutidos na sequência. Conclui-se discutindo a impôrtancia do papel do psicólogo no amparo às famílias e aos pacientes desde o diagnóstico, durante o tratamento, na sua reinserção social, apoiando-os no caso de outra neoplasia.

O livro de Jociara Alves Nóbrega é uma versão elaborada de sua dissertação de mestrado, defendida no Programa de Pós-Graduação em Antropologia Social da UFRN e premiada no referido programa como melhor dissertação de mestrado de 2011. A publicação do livro veio como decorrência. O trabalho de Nóbrega foi desenvolvido no Grupo de Apoio à Criança com Câncer (GACC) no Rio Grande do Norte, e seu enfoque permeia os eixos família, doença e instituições de apoio. Na graduação, Nóbrega também desenvolveu sua monografia no GACC, cujo título foi “A experiência social da doença: práticas de humanização e de reciprocidade no tratamento do câncer infantil”. Percebe-se que o interesse da autora pelos temas voltados à área da saúde permeia sua trajetória acadêmica.