123 results on '"Postovsky S"'
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2. Immune and hematopoietic reconstitution after transplantation of cord blood progenitor cells: case report and review of the literature
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Elhasid, R, Ben Arush, M Weyl, Pollack, S, Tavor, K, Streichman, S, Postovsky, S, Haddad, N, and Rowe, JM
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- 2000
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3. Positron Emission Tomography/Computed Tomography With 18Fluoro-Deoxyglucose in the Detection of Local Recurrence and Distant Metastases of Pediatric Sarcoma
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Arush, Weyl Ben M., Israel, O., Postovsky, S., Militianu, D., Meller, I., Zaidman, I., Sapir, Even A., and Bar-Shalom, R.
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- 2007
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4. Successful haploidentical bone marrow transplantation in Fanconi anemia
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Elhasid, R, Ben Arush, MWeyl, Katz, T, Gan, Y, Shechter, Y, Sami, I, Postovsky, S, Reisner, Y, and Rowe, JM
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- 2000
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5. Pharmacokinetic analysis of amikacin twice and single daily dosage in immunocompromised pediatric patients
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Krivoy, N., Postovsky, S., Elhasid, R., and Weyl Ben Arush, M.
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- 1998
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6. Pediatric Tumors
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Elhasid, R., Vlodavsky, E., Nachtigal, A., Keidar, Z., Postovsky, S., and Ben Arush, M. Weyl
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- 2001
7. P01.085 Experience with TTFields (Optune®) in pediatric high grade glioma patients in Israel
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Toledano, H, primary, Abebe Campino, G, additional, Dvir, R, additional, Postovsky, S, additional, Yalon, M, additional, and Siegal, T, additional
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- 2018
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8. RARE TUMORS
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Kiyotani, C., primary, Uno, T., additional, Ogiwara, H., additional, Morota, N., additional, Nakazawa, A., additional, Tsutsumi, Y., additional, Masaki, H., additional, Mori, T., additional, Sanz, J. A. S., additional, Guibelalde, M., additional, Tavera, A., additional, Herandez, I., additional, Ibanez, J., additional, Brell, M., additional, Mas, A., additional, Muller, H. L., additional, Gebhardt, U., additional, Warmuth-Metz, M., additional, Pietsch, T., additional, Sorensen, N., additional, Kortmann, R.-D., additional, Stapleton, S., additional, Gonzalez, I., additional, Steinbrueck, S., additional, Rodriguez, L., additional, Tuite, G., additional, Krzyzankova, M., additional, Mertsch, S., additional, Jeibmann, A., additional, Kordes, U., additional, Wolff, J., additional, Paulus, W., additional, Hasselblatt, M., additional, Nonaka, Y., additional, Hara, S., additional, Fukazawa, S., additional, Shimizu, K., additional, Ben-Arush, M., additional, Postovsky, S., additional, Toledano, H., additional, Peretz-Nahum, M., additional, Fujimura, J., additional, Sakaguchi, S., additional, Kondo, A., additional, Saito, Y., additional, Shimoji, K., additional, Ohara, Y., additional, Arakawa, A., additional, Saito, M., additional, Shimizu, T., additional, Benesch, M., additional, von Bueren, A. O., additional, Dantonello, T., additional, von Hoff, K., additional, Leuschner, I., additional, Claviez, A., additional, Bierbach, U., additional, Kropshofer, G., additional, Korinthenberg, R., additional, Graf, N., additional, Suttorp, M., additional, Kortmann, R. D., additional, Friedrich, C., additional, Klingebiel, T., additional, Koscielniak, E., additional, Rutkowski, S., additional, Mesa, M., additional, Sanchez, M., additional, Mejia, J., additional, Pena, G., additional, Dussan, R., additional, Cabeza, M., additional, Storino, A., additional, Dincer, F., additional, Roffidal, T., additional, Powell, M., additional, Berrak, S., additional, Wolff, J. E., additional, Fouyssac, F., additional, Delaunay, C., additional, Vignaud, J.-M., additional, Schmitt, E., additional, Klein, O., additional, Mansuy, L., additional, Chastagner, P., additional, Cruz, O., additional, Guillen, A., additional, Garcia, G., additional, Alamar, M., additional, Candela, S., additional, Roussos, I., additional, Garzon, M., additional, Sunol, M., additional, Muchart, J., additional, Rebollo, M., additional, Mora, J., additional, Diez, B., additional, Muggeri, A., additional, Arakaki, N., additional, Meli, F., additional, Sevlever, G., additional, Tsitouras, V., additional, Pettorini, B., additional, Fellows, G., additional, Blair, J., additional, Didi, M., additional, Daousi, C., additional, Steele, C., additional, Javadpour, M., additional, Sinha, A., additional, Hishii, M., additional, Ishii, H., additional, Miyajima, M., additional, Arai, H., additional, Dvir, R., additional, Sayar, D., additional, Levin, D., additional, Ben-Sirah, L., additional, Constantini, S., additional, Elhasid, R., additional, Gertsch, E., additional, Foreman, N., additional, Valera, E. T., additional, Brassesco, M. S., additional, Machado, H. R., additional, Oliveira, R. S., additional, Santos, A. C., additional, Terra, V. C., additional, Barros, M. V., additional, Scrideli, C. A., additional, Tone, L. G., additional, Merino, D., additional, Pienkowska, M., additional, Shlien, A., additional, Tabori, U., additional, Gilbertson, R., additional, Malkin, D., additional, Jeeva, I., additional, Chang, B., additional, Long, V., additional, Picton, S., additional, Burton, D., additional, Clark, S., additional, Kwok, C., additional, Mokete, B., additional, Rafiq, O., additional, Simmons, I., additional, Shing, M. M. K., additional, Li, C. K., additional, Chan, G. C. F., additional, Ha, S. Y., additional, Yuen, H. L., additional, Luk, C. W., additional, Ling, S. C., additional, Li, R. C. H., additional, Yoon, J. H., additional, Park, H. J., additional, Shin, H. J., additional, Park, B.-K., additional, Kim, J.-Y., additional, Jung, H. L., additional, Ra, Y. S., additional, Ghim, T. T., additional, Hartung, S., additional, Garami, M., additional, Traunecker, H., additional, Thall, P., additional, Mahajan, A., additional, Sumerauer, D., additional, Grillner, P., additional, Orrego, A., additional, Mosskin, M., additional, Gustavsson, B., additional, Holm, S., additional, Peters, N., additional, Rogers, M., additional, Chowdry, S., additional, Selman, W., additional, Mitchell, A., additional, Bangert, B., additional, Ahuja, S., additional, Laschinger, K., additional, Gold, D., additional, Stearns, D., additional, Wright, K., additional, Gupta, K., additional, Klimo, P., additional, Ellison, D., additional, Keating, G., additional, Eckel, L., additional, Giannini, C., additional, Wetjen, N., additional, Patton, A., additional, Zaky, W., additional, McComb, G., additional, Finlay, J., additional, Grimm, J., additional, Wong, K., additional, Dhall, G., additional, Gilles, F., additional, Ormandy, D., additional, Alston, R., additional, Estlin, E., additional, Gattamaneni, R., additional, Birch, J., additional, Kamaly-Asl, I., additional, Hemenway, M., additional, Rush, S., additional, Reginald, Y. A., additional, Nicolin, G., additional, Bartel, U., additional, Buncic, J. R., additional, Aguilera, D., additional, Flamini, R., additional, Mazewski, C., additional, Schniederjan, M., additional, Hayes, L., additional, Boydston, W., additional, MacDonald, T., additional, Fleming, A., additional, Jabado, N., additional, Saint-Martin, C., additional, Albrecht, S., additional, Ramsay, D. A., additional, Farmer, J. P., additional, Bendel, A., additional, Hansen, M., additional, Dugan, S., additional, and Mendelsohn, N., additional
- Published
- 2012
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9. Plasma heparanase as a significant marker of treatment response in pediatric malignancies: Pilot study
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Ben Arush, M. W., primary, Shafat, I., additional, Ben Barak, A., additional, Postovsky, S., additional, Elhasid, R., additional, Vlodavsky, I., additional, and Ilan, N., additional
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- 2007
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10. SERUM VASCULAR ENDOTHELIAL GROWTH FACTOR AS A SIGNIFICANT MARKER OF TREATMENT RESPONSE IN PEDIATRIC MALIGNANCIES
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Ben Arush, M. Weyl, primary, Schenzer, P., additional, Maurice, S., additional, Elhasid, R., additional, Postovsky, S., additional, Barak, A. Ben, additional, Haimi, M., additional, Zeidman, I., additional, Hayari, L., additional, and Livne, E., additional
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- 2005
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11. Central Nervous System Involvement in Children with Sarcoma
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Postovsky, S., primary, Ash, S., additional, Ramu, I.N., additional, Yaniv, Y., additional, Zaizov, R., additional, Futerman, B., additional, Elhasid, R., additional, Ben Barak, A., additional, Halil, A., additional, and Ben Arush, M.W., additional
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- 2003
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12. Policies Designed to Enhance the Quality of Life of Children with Cancer at the End-of-Life
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Tadmor, C. S., primary, Postovsky, S., additional, Elhasid, R., additional, Barak, A. Ben, additional, and Arush, M. Weyl Ben, additional
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- 2003
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13. Prophylactic therapy with enoxaparin during l-asparaginase treatment in children with acute lymphoblastic leukemia
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Elhasid, R., primary, Lanir, N., additional, Sharon, R., additional, Arush, M. Weyl Ben, additional, Levin, C., additional, Postovsky, S., additional, Barak, A. Ben, additional, and Brenner, B., additional
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- 2001
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14. Late Recurrence of Combined Hepatocellular Carcinoma and Hepatoblastoma in a Child: Case Report and Review of the Literature
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Postovsky, S., primary, Elhasid, R., additional, Otte, G. B., additional, Ben Itzhak, O., additional, Gaitini, D., additional, and Weyl Ben Arush, M., additional
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- 2001
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15. Allergic reaction to high-dose methotrexate
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Postovsky, S., primary, Elhasid, R., additional, Ben-Barak, A., additional, Levin, K., additional, and Arush, M. Weyl Ben, additional
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- 2000
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16. Neuroblastoma maturation by [131I] metaiodobenzylguanidine in chemoresistant neuroblastoma
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Arush, M. Weyl Ben, primary, Itzhak, O. Ben, additional, Yossilevski, G., additional, El Hasid, R., additional, Postovsky, S., additional, and Israel, O., additional
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- 1999
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17. CLINICAL AND RADIOGRAPHIC RESPONSE IN THREE CHILDREN WITH RECURRENT MALIGNANT CEREBRAL TUMORS WITH HIGH-DOSE TAMOXIFEN
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Postovsky, S., primary, Goldsher, D., additional, Hasid, R. El, additional, and Constantini, S., additional
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- 1999
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18. 200 PHARMACOKINETIC ANALYSIS ON STEADY STATE OF GENTAMICIN IN PEDIATRIC CANCER PATIENTS. THRICE AND SINGLE DAILY DOSAGE.
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Krivoy, N., primary, Postovsky, S., additional, Kassis, E., additional, Elhasid, R., additional, and Weyl Ben-Arush, M., additional
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- 1997
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19. 203 PHARMACOKINETIC ANALYSIS ON STEADY STATE CONDITIONS OF VANCOMYCIN IN PEDIATRIC CANCER PATIENTS.
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Krivoy, N., primary, Peleg, S., additional, Postovsky, S., additional, and Weyl Ben-Arush., M., additional
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- 1997
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20. Positron emission tomography/computed tomography with 18fluoro-deoxyglucose in the detection of local recurrence and distant metastases of pediatric sarcoma.
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Arush, M. Weyl Ben, Israel, O., Postovsky, S., Militianu, D., Meller, I., Zaidman, I., Sapir, A. Even, and Bar-Shalom, R.
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- 2007
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21. CLINICAL AND RADIOGRAPHIC RESPONSE IN THREE CHILDREN WITH RECURRENT MALIGNANT CEREBRAL TUMORS WITH HIGH-DOSE TAMOXIFEN.
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Arush, M . Weyl Ben, Postovsky, S., Goldsher, D., Hasid, R. El, and Constantini, S.
- Subjects
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CEREBRAL cortex diseases , *TUMORS in children , *TAMOXIFEN , *DRUG efficacy , *TUMOR treatment - Abstract
The purpose of this study was to deliver tamoxifen as antiangiogenic therapy to children with recurrent progressive malignant brain tumors. Tamoxifen was administered orally in very high dosage to one child as monotherapy and to two children in combination with oral etoposide and dexamethasone. One boy was diagnosed with high-grade astrocytoma in the brain stem, one girl with anaplastic ependymoma of the fourth ventricule, and one girl with high-grade astrocytoma in the midbrain. Conventional treatment with multiple surgeries, first- and second-line chemotherapy, and external beam therapy had failed. Tumor reduction was seen in radiographic images together with clinical improvement in 2 children, and clinical and radiographic halting of tumor progression was demonstrated in the patient with anaplastic ependymoma. None of the patients developed complications from the treatment. Follow up of the patients ranged from 15 to 30 months with a mean of 17 months. These encouraging preliminary results suggest a potential for this type of therapy. More studies are needed to start clinical trials and prove that angiostatic activity may contribute to the therapeutic effect of antiestrogens in estrogen receptor-negative tumors. [ABSTRACT FROM AUTHOR]
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- 1999
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22. Nutritional status of children with solid tumors.
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Elhasid, Ronit, Laor, Arie, Lischinsky, Sophie, Postovsky, Sergey, Weyl Ben Arush, Myriam, Elhasid, R, Laor, A, Lischinsky, S, Postovsky, S, and Weyl Ben Arush, M
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- 1999
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23. Ewing's sarcoma of the facial zygomatic area bones in a young child: A case presentation
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Postovsky, S., Daitzchman, M., Elhasid, R., and Weyl Ben Arush, M.
- Abstract
We present the case of a young patient with Ewing's sarcoma of the facial zygomatic area bones. This type of tumor in a very young child is a rare event and poses significant diagnostic and therapeutic challenges for the attending physician. In this case, the diagnosis was made by a computed tomography scan with subsequent histological confirmation. The differential diagnoses and therapeutic options are discussed.
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- 2000
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24. Neuroblastoma maturation by [131I] metaiodobenzylguanidine in chemoresistant neuroblastoma.
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Arush, M. Weyl Ben, Itzhak, O. Ben, Yossilevski, G., El Hasid, R., Postovsky, S., and Israel, O.
- Published
- 1999
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25. Neuroblastoma maturation by [<SUP>131</SUP>I] metaiodobenzylguanidine in chemoresistant neuroblastoma
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Arush, M. Weyl Ben, Itzhak, O. Ben, Yossilevski, G., Hasid, R. El, Postovsky, S., and Israel, O.
- Abstract
No abstract.
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- 1999
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26. Concomitant variants in NF1, LZTR1 and GNAZ genes probably contribute to the aggressiveness of plexiform neurofibroma and warrant treatment with MEK inhibitor.
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Cohen-Barak E, Toledano-Alhadef H, Danial-Farran N, Livneh I, Mwassi B, Hriesh M, Zagairy F, Gafni-Amsalem C, Bashir H, Khayat M, Warrour N, Sher O, Marom D, Postovsky S, Dujovny T, Ziv M, and Shalev SA
- Subjects
- Female, GTP-Binding Protein alpha Subunits genetics, GTP-Binding Protein alpha Subunits metabolism, Heterozygote, Humans, Mitogen-Activated Protein Kinase Kinases, Neurofibromin 1, Protein Kinase Inhibitors pharmacology, Protein Kinase Inhibitors therapeutic use, Transcription Factors genetics, Neurofibroma, Plexiform drug therapy, Neurofibroma, Plexiform genetics, Neurofibroma, Plexiform metabolism, Neurofibromatosis 1 drug therapy, Neurofibromatosis 1 genetics, Neurofibromatosis 1 pathology
- Abstract
Neurofibromatosis 1 (NF1) is caused by germline mutations in the NF1 gene and manifests as proliferation of various tissues, including plexiform neurofibromas. The plexiform neurofibroma phenotype varies from indolent to locally aggressive, suggesting contributions of other modifiers in addition to somatic loss of NF1. In this study, we investigated a life-threatening plexiform neurofibroma in a 9-month-old female infant with NF1. Germline mutations in two RASopathy-associated genes were identified using whole-exome sequencing-a de novo pathogenic variant in the NF1 gene, and a known pathogenic variant in the LZTR1 gene. Somatic analysis of the plexiform neurofibroma revealed NF1 loss of heterozygosity and a variant in GNAZ, a gene encoding a G protein-coupled receptor. Cells expressing mutant GNAZ exhibited increased ERK 1/2 activation compared to those expressing wild-type GNAZ. Taken together, we suggest the variants in NF1, LZRT1 and GNAZ act synergistically in our patient, leading to MAPK pathway activation and contributing to the severity of the patient's plexiform neurofibromatosis. After treatment with the MEK inhibitor, trametinib, a prominent clinical improvement was observed in this patient. This case study contributes to the knowledge of germline and somatic non-NF1 variants affecting the NF1 clinical phenotype and supports use of personalized, targeted therapy., (© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
- Published
- 2022
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27. Ultrasound-guided core biopsy with on-site cytology-immediate diagnosis in pediatric oncology.
- Author
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Sokolovski B, Scolnik M, Malkin L, Postovsky S, Weyl Ben-Arush M, and Ilivitzki A
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- Adolescent, Adult, Child, Child, Preschool, Female, Humans, Image-Guided Biopsy methods, Infant, Infant, Newborn, Male, Retrospective Studies, Young Adult, Biopsy, Large-Core Needle methods, Cytodiagnosis methods, Neoplasms diagnosis, Ultrasonography, Interventional methods
- Abstract
Background: Accurate and swift tissue diagnosis is extremely important for the timely initiation of treatment in pediatric oncology. In our department, ultrasound-guided core needle biopsy (US-guided CNB) is used for tissue diagnosis. In 2016, we added on-site cytology, allowing for an immediate primary diagnosis. We retrospectively reviewed our performance in terms of safety and accuracy for CNBs and on-site cytology., Methods: All pediatric biopsies performed in our hospital between February 2016 and December 2020, were included. Patient clinical, procedural and follow-up data were collected. CNB pathology and cytology results were compared to the final pathologic diagnosis., Results: We included 71 patients for which 72 biopsies with on-site touch imprint (TI) cytology were performed; the average latency time to biopsy was 1 day. Altogether, we had 61 tumors, (58 malignant, 3 benign) and 11 other lesions. On-site cytology diagnosed 58 malignant tumors, 3 benign tumors and 11 non-tumor tissues. The cytologist correctly differentiated tumor from inflammation in all cases, and diagnosed the precise tumor type in 57 cases, with an accuracy of 94% for final diagnosis. We had no complications related to the procedure or sedation., Conclusion: US-guided CNB with on-site TI cytology for suspected malignancy in the pediatric population is highly available, safe, and accurate, with real-time diagnosis in most cases. This accelerated diagnostic route has a huge impact on patient care., (© 2021 Wiley Periodicals LLC.)
- Published
- 2021
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28. Polypharmacy among pediatric cancer patients dying in the hospital.
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Tamir S, Kurnik D, Weyl Ben-Arush M, and Postovsky S
- Subjects
- Child, Critical Pathways statistics & numerical data, Demography, Female, Health Services Research, Hospitalization statistics & numerical data, Humans, Israel epidemiology, Male, Neoplasm Staging, Resuscitation Orders, Antineoplastic Agents therapeutic use, Neoplasms drug therapy, Neoplasms mortality, Neoplasms pathology, Palliative Care methods, Palliative Care statistics & numerical data, Polypharmacy, Steroids therapeutic use, Terminal Care methods, Terminal Care statistics & numerical data
- Abstract
Background: Decisions on medication treatment in children dying from cancer are often complex and may result in polypharmacy and increased medication burden. There is no information on medication burden in pediatric cancer patients at the end of life (EOL)., Objectives: To characterize medication burden during the last hospitalization in children dying from cancer., Methods: We performed a retrospective cohort study based on medical records of 90 children who died from cancer in hospital between 01 January 2010 and 30 December 2018. Demographic and clinical information were collected for the last hospitalization. We compared medication burden (number of medication orders) at hospitalization and at time of death and examined whether changes in medication burden were associated with clinical and demographic parameters., Results: Median medication burden was higher in leukemia/lymphoma patients (6 orders) compared to solid (4 orders) or CNS tumor patients (4 orders, P = 0.006). Overall, the median number of prescriptions per patient did not change until death (P = 0.42), while there was a significant reduction for some medication subgroups (chemotherapy [P = 0.035], steroids [P = 0.010]).Patients dying in the ICU (n=15) had a higher medication burden at death (6 orders) than patients dying on wards (3 orders, P = 0.001). There was a trend for a reduction in medication burden in patients with "Do not resuscitate" (DNR) orders (P = 0.055)., Conclusions: Polypharmacy is ubiquitous among pediatric oncology patients at EOL. Disease type and DNR status may affect medication burden and deprescribing during the last hospitalization.
- Published
- 2021
29. Ultrasound-Guided Core Biopsy for Tissue Diagnosis in Pediatric Oncology: 16-Year Experience With 597 Biopsies.
- Author
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Ilivitzki A, Sokolovski B, Assalia A, Benbarak A, Postovsky S, Glozman L, and Ben-Arush M
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- Child, Female, Humans, Male, Neoplasms diagnosis, Retrospective Studies, Sensitivity and Specificity, Biopsy, Large-Core Needle methods, Image-Guided Biopsy methods, Neoplasms pathology, Ultrasonography, Interventional methods
- Abstract
OBJECTIVE. Percutaneous imaging-guided core needle biopsies (CNBs) for cancer diagnosis in pediatric patients are gaining interest because of their availability, lower rate of complications, and high diagnostic power compared with traditional surgical biopsies. Nevertheless, their precise role in the diagnostic algorithm of pediatric oncology is still unknown. The purpose of this study was to report our accumulated 16-year experience with CNB; discuss the availability, safety, and diagnostic accuracy of the procedure and the adequacy of ancillary testing; and compare our findings with the available literature. MATERIALS AND METHODS. Pediatric ultrasound-guided CNBs performed in our hospital between November 2003 and December 2019 were retrospectively studied. Data collection included demographics, clinical and procedural parameters, complications, and final diagnosis. RESULTS. A total of 597 biopsies were performed in 531 patients (132 performed in known oncologic patients and 465 performed to establish diagnosis). The median time between the biopsy request and the procedure was 1 day. Of 432 biopsies performed in patients with malignancies, 12 (2.8%) had false-negative results. In 165 cases of benign pathologic findings, all had true-negative results. Ancillary testing was adequate in all malignant cases. Overall sensitivity, specificity, and accuracy rates were 97.2%, 100%, and 98.0%, respectively. Five biopsies (0.8%) resulted in complications, including one major bleed and one track seeding. CONCLUSION. Our experience shows that ultrasound-guided CNB for suspected malignancy in pediatric patients has a high safety profile, availability, and accuracy rate compared with surgical biopsy. Our fast-track strategy enables early initiation of designated therapy and has the potential to become the procedure of choice.
- Published
- 2021
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30. Rare haematogenous sarcoma metastasis to the heart in a child - ERRATUM.
- Author
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Gross GJ, Postovsky S, and Khoury A
- Published
- 2019
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31. Correction to: Human Development Index and its association with staff spiritual care provision: a Middle Eastern oncology study.
- Author
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Bar-Sela G, Schultz MJ, Elshamy K, Rassouli M, Ben-Arye E, Doumit M, Gafer N, Albashayreh A, Ghrayeb I, Turker I, Ozalp G, Kav S, Fahmi R, Nestoros S, Ghali H, Mula-Hussain L, Shazar I, Obeidat R, Punjwani R, Khleif M, Can G, Tuncel G, Charalambous H, Faraj S, Keoppi N, Al-Jadiry M, Postovsky S, Al-Omari M, Razzaq S, Ayyash H, Khader K, Kebudi R, Omran S, Rasheed O, Qadire M, Ozet A, and Silbermann M
- Abstract
Incorrect family name of Layth Mula-Hussain.
- Published
- 2019
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32. Human Development Index and its association with staff spiritual care provision: a Middle Eastern oncology study.
- Author
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Bar-Sela G, Schultz MJ, Elshamy K, Rassouli M, Ben-Arye E, Doumit M, Gafer N, Albashayreh A, Ghrayeb I, Turker I, Ozalp G, Kav S, Fahmi R, Nestoros S, Ghali H, Mula-Hussain L, Shazar I, Obeidat R, Punjwani R, Khleif M, Can G, Tuncel G, Charalambous H, Faraj S, Keoppi N, Al-Jadiry M, Postovsky S, Al-Omari M, Razzaq S, Ayyash H, Khader K, Kebudi R, Omran S, Rasheed O, Qadire M, Ozet A, and Silbermann M
- Subjects
- Adult, Attitude, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Neoplasms nursing, Physicians psychology, Surveys and Questionnaires, Medical Oncology methods, Patient-Centered Care methods, Religion, Religion and Psychology, Spirituality
- Abstract
Background: Although staff spiritual care provision plays a key role in patient-centered care, there is insufficient information on international variance in attitudes toward spiritual care and its actual provision., Methods: A cross-sectional survey of the attitudes of Middle Eastern oncology physicians and nurses toward eight examples of staff provision of spiritual care: two questionnaire items concerned prayer, while six items related to applied information gathering, such as spiritual history taking, referrals, and encouraging patients in their spirituality. In addition, respondents reported on spiritual care provision for their last three advanced cancer patients., Results: Seven hundred seventy responses were received from 14 countries (25% from countries with very high Human Development Index (HDI), 41% high, 29% medium, 5% low). Over 63% of respondents positively viewed the six applied information gathering items, while significantly more, over 76%, did so among respondents from very high HDI countries (p value range, p < 0.001 to p = 0.01). Even though only 42-45% overall were positively inclined toward praying with patients, respondents in lower HDI countries expressed more positive views (p < 0.001). In interaction analysis, HDI proved to be the single strongest factor associated with five of eight spiritual care examples (p < 0.001 for all). Significantly, the Middle Eastern respondents in our study actually provided actual spiritual care to 47% of their most recent advanced cancer patients, compared to only 27% in a parallel American study, with the key difference identified being HDI., Conclusions: A country's development level is a key factor influencing attitudes toward spiritual care and its actual provision. Respondents from lower ranking HDI countries proved relatively more likely to provide spiritual care and to have positive attitudes toward praying with patients. In contrast, respondents from countries with higher HDI levels had relatively more positive attitudes toward spiritual care interventions that involved gathering information applicable to patient care.
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- 2019
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33. Medical marijuana use for pediatric oncology patients: single institution experience.
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Ofir R, Bar-Sela G, Weyl Ben-Arush M, and Postovsky S
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- Adolescent, Adult, Child, Child, Preschool, Complementary Therapies, Female, Humans, Male, Nausea pathology, Nausea physiopathology, Neoplasms pathology, Neoplasms physiopathology, Pain pathology, Pain physiopathology, Sleep Wake Disorders pathology, Sleep Wake Disorders physiopathology, Vomiting pathology, Vomiting physiopathology, Medical Marijuana administration & dosage, Nausea drug therapy, Neoplasms drug therapy, Pain drug therapy, Sleep Wake Disorders drug therapy, Vomiting drug therapy
- Abstract
Medical marijuana (MM) is widespread in many medical fields, including oncology, with limited use in pediatric oncology where research is scarce and often shows conflicting results. This research focuses on alleviating side effects of anticancer treatment as an integral part of supportive and palliative care of children with cancer. We report our experience with MM treatment in 50 children, adolescents, and young adults with different types of cancer during 2010-2017. The main indications for prescriptions were nausea and vomiting, decreased mood, disturbed sleep, and pain. The medication was supplied to 30 patients via oil drops (60%) and 11 via smoking (22%), followed by vaporization, capsules, or combinations of various routes. Positive effects were reported by verbal children and parents in 80% of cases. MM was generally well tolerated with few patients reporting toxicity, with the most common adverse reactions being burning in the throat and anxiety attacks in subjects who chose to smoke the product. We conclude that MM may serve as a potentially useful complementary therapy to conventional supportive treatment of children suffering from cancer at the end of life. Further research is needed on the safety and efficacy and the consequences of prolonged use in pediatric populations.
- Published
- 2019
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34. Training for awareness of one's own spirituality: A key factor in overcoming barriers to the provision of spiritual care to advanced cancer patients by doctors and nurses.
- Author
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Bar-Sela G, Schultz MJ, Elshamy K, Rassouli M, Ben-Arye E, Doumit M, Gafer N, Albashayreh A, Ghrayeb I, Turker I, Ozalp G, Kav S, Fahmi R, Nestoros S, Ghali H, Mula-Hussain L, Shazar I, Obeidat R, Punjwani R, Khleif M, Can G, Tuncel G, Charalambous H, Faraj S, Keoppi N, Al-Jadiry M, Postovsky S, Al-Omari M, Razzaq S, Ayyash H, Khader K, Kebudi R, Omran S, Rasheed O, Qadire M, Ozet A, and Silbermann M
- Subjects
- Adult, Attitude of Health Personnel, Chi-Square Distribution, Female, Humans, Male, Middle Aged, Middle East, Neoplasms psychology, Palliative Care methods, Palliative Care psychology, ROC Curve, Surveys and Questionnaires, Health Personnel education, Health Personnel psychology, Neoplasms therapy, Palliative Care standards, Spiritualism psychology
- Abstract
Objective: When patients feel spiritually supported by staff, we find increased use of hospice and reduced use of aggressive treatments at end of life, yet substantial barriers to staff spiritual care provision still exist. We aimed to study these barriers in a new cultural context and analyzed a new subgroup with "unrealized potential" for improved spiritual care provision: those who are positively inclined toward spiritual care yet do not themselves provide it., Method: We distributed the Religion and Spirituality in Cancer Care Study via the Middle East Cancer Consortium to physicians and nurses caring for advanced cancer patients. Survey items included how often spiritual care should be provided, how often respondents themselves provide it, and perceived barriers to spiritual care provision.ResultWe had 770 respondents (40% physicians, 60% nurses) from 14 Middle Eastern countries. The results showed that 82% of respondents think staff should provide spiritual care at least occasionally, but 44% provide spiritual care less often than they think they should. In multivariable analysis of respondents who valued spiritual care yet did not themselves provide it to their most recent patients, predictors included low personal sense of being spiritual (p < 0.001) and not having received training (p = 0.02; only 22% received training). How "developed" a country is negatively predicted spiritual care provision (p < 0.001). Self-perceived barriers were quite similar across cultures.Significance of resultsDespite relatively high levels of spiritual care provision, we see a gap between desirability and actual provision. Seeing oneself as not spiritual or only slightly spiritual is a key factor demonstrably associated with not providing spiritual care. Efforts to increase spiritual care provision should target those in favor of spiritual care provision, promoting training that helps participants consider their own spirituality and the role that it plays in their personal and professional lives.
- Published
- 2019
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35. Factors Influencing Do-Not-Resuscitate Status in Children During Last Month of Life: Single Institution Experience.
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Moaed B, Mordechai O, Weyl Ben-Arush M, Tamir S, Ofir R, and Postovsky S
- Subjects
- Adolescent, Child, Child, Preschool, Female, Humans, Infant, Male, Retrospective Studies, Young Adult, Advance Directives ethnology, Resuscitation Orders
- Abstract
Background: It is currently expected that about 20% of children with cancer will ultimately die. Writing advanced life directives sufficiently long before the actual death of a child ensues allows both parents and medical staff to develop optimal treatment plans in the best interests of the child., Aim of the Study: The aim of the study was to evaluate factors that may influence the process of decision-making regarding Do-Not-Resuscitate (DNR) status., Methods: Retrospective single institution study., Results: Totally, 79 patients died between September 01, 2011 and August 31, 2017. Median age of the children was 10.5 years (range, 1 to 24 y). Forty-five were males. There were 37 Muslims, 27 Jews, 9 Druze, and 6 Christians. Twenty-one patients had sarcomas, 20 had CNS tumors, 10 had neuroblastoma, 17 had leukemias/lymphomas, 11 had carcinomas, and other rare tumors as well as nonmalignant diseases. No statistically significant association between all evaluated factors and DNR order status was found., Conclusions: It is possible that, other than demographic, clinical-associated, or therapy-associated factors play an important role in the process of decision-making regarding DNR. We feel that sincere communication between parents, their child (when appropriate) and medical and psychosocial staff may have a more crucial role when such decisions have to be made.
- Published
- 2019
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36. Medical students' attitudes towards participating in a palliative medicine course: A new specialty in Israel.
- Author
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Bar-Sela G, Mitnik I, Zalman D, Flechter E, Sheinman-Yuffe H, Vulfsons S, Postovsky S, Smolin B, Nave R, and Azzam ZS
- Subjects
- Adult, Attitude of Health Personnel, Curriculum standards, Education, Medical, Undergraduate methods, Education, Medical, Undergraduate standards, Female, Humans, Israel, Male, Palliative Medicine standards, Personal Satisfaction, Specialization trends, Surveys and Questionnaires, Palliative Medicine education, Students, Medical psychology
- Abstract
Background: Palliative medicine is a growing field in Israel, and its training program is still in process. The current study aimed to evaluate students' attitudes regarding a course in palliative care established in a division of oncology., Method: Some 45 medical students in their 5th to 6th years participated in a one-week course on palliative care. At the end of each training week, students were asked to complete a questionnaire, evaluating their attitudes regarding different aspects of the program content, such as its importance and relevance to their training as physicians, as well as the contribution of specific parts of the program to their knowledge regarding palliative care., Results: The overall satisfaction of the 45 students was high. The most contributory parts of the course were the multidisciplinary team and the complementary and alternative medicine. Participating in the staff meetings and accompanying physicians in their daily work were scored as the least contributory parts.Significance of resultsThis preliminary study demonstrated students' overall high satisfaction with the newly established palliative care course and their need for more practical skills. Future studies should investigate and evaluate educational programs in palliative care in order to establish suitable training for medical students.
- Published
- 2018
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37. STAT3 gain-of-function mutations associated with autoimmune lymphoproliferative syndrome like disease deregulate lymphocyte apoptosis and can be targeted by BH3 mimetic compounds.
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Nabhani S, Schipp C, Miskin H, Levin C, Postovsky S, Dujovny T, Koren A, Harlev D, Bis AM, Auer F, Keller B, Warnatz K, Gombert M, Ginzel S, Borkhardt A, Stepensky P, and Fischer U
- Subjects
- Biphenyl Compounds, Butylated Hydroxytoluene analogs & derivatives, Case-Control Studies, Child, Preschool, Enzyme-Linked Immunosorbent Assay, Family, Fas Ligand Protein metabolism, Female, Gene Expression Profiling, Germ-Line Mutation, Humans, Immunoblotting, Immunophenotyping, Leukocytes, Mononuclear, Lymphocytes, Nitrophenols, Piperazines, Proto-Oncogene Proteins c-bcl-2 antagonists & inhibitors, Proto-Oncogene Proteins c-bcl-2 metabolism, Real-Time Polymerase Chain Reaction, Reverse Transcriptase Polymerase Chain Reaction, Sequence Analysis, DNA, Sulfonamides, T-Lymphocytes drug effects, T-Lymphocytes metabolism, fas Receptor metabolism, Apoptosis genetics, Autoimmune Lymphoproliferative Syndrome genetics, STAT3 Transcription Factor genetics
- Abstract
Autoimmune lymphoproliferative syndrome (ALPS) is typically caused by mutations in genes of the extrinsic FAS mediated apoptotic pathway, but for about 30% of ALPS-like patients the genetic diagnosis is lacking. We analyzed 30 children with ALPS-like disease of unknown cause and identified two dominant gain-of-function mutations of the Signal Transducer And Activator Of Transcription 3 (STAT3, p.R278H, p.M394T) leading to increased transcriptional activity. Hyperactivity of STAT3, a known repressor of FAS, was associated with decreased FAS-mediated apoptosis, mimicking ALPS caused by FAS mutations. Expression of BCL2 family proteins, further targets of STAT3 and regulators of the intrinsic apoptotic pathway, was disturbed. Cells with hyperactive STAT3 were consequently more resistant to intrinsic apoptotic stimuli and STAT3 inhibition alleviated this effect. Importantly, STAT3-mutant cells were more sensitive to death induced by the BCL2-inhibitor ABT-737 indicating a dependence on anti-apoptotic BCL2 proteins and potential novel therapeutic options., (Copyright © 2017 Elsevier Inc. All rights reserved.)
- Published
- 2017
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38. An 8-Year-Old Child with Malignant Deciduoid Mesothelioma of the Abdomen: Report of a Case and Review of the Literature.
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Wolff-Bar M, Dujovny T, Vlodavsky E, Postovsky S, Morgenstern S, Braslavsky D, Nissan A, Steinberg R, and Feinmesser M
- Subjects
- Abdominal Pain etiology, Biopsy, Child, Female, Humans, Mesothelioma complications, Mesothelioma therapy, Peritoneal Neoplasms complications, Peritoneal Neoplasms therapy, Treatment Outcome, Mesothelioma pathology, Peritoneal Neoplasms pathology
- Abstract
Malignant mesothelioma is an uncommon tumor that usually arises in the pleural cavity of adults with a history of asbestos exposure. Less frequently, it appears in the peritoneum or other mesothelial surfaces. Deciduoid mesothelioma is a rare subtype that has been found at both sites. Of the 3 reported cases in children, 2 originated in the mesenterium and 1 in the pleura. We describe a 4th case of pediatric, malignant, deciduoid mesothelioma and a third case in the mesenteric cavity. The patient was an 8-year-old girl who presented with abdominal pain and fullness. Workup revealed extensive involvement of the abdomen by a serosa-based tumor. The clinical and pathologic findings are described, and the pertinent literature is reviewed.
- Published
- 2015
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39. Metastatic rhabdoid meningioma with BRAF V600E mutation and good response to personalized therapy: case report and review of the literature.
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Mordechai O, Postovsky S, Vlodavsky E, Eran A, Constantini S, Dotan E, Cagnano E, and Weyl-Ben-Arush M
- Subjects
- Adenomatous Polyposis Coli Protein genetics, Child, Cyclin-Dependent Kinase Inhibitor p15 genetics, Cyclin-Dependent Kinase Inhibitor p16 genetics, Female, Gene Expression Profiling, High-Throughput Nucleotide Sequencing, Humans, Imidazoles therapeutic use, Magnetic Resonance Imaging, Meningeal Neoplasms drug therapy, Meningioma drug therapy, Oximes therapeutic use, Precision Medicine, Proto-Oncogene Proteins B-raf antagonists & inhibitors, Pyridones therapeutic use, Pyrimidinones therapeutic use, Rhabdoid Tumor drug therapy, Antineoplastic Agents therapeutic use, Meningeal Neoplasms genetics, Meningioma genetics, Mutation genetics, Proto-Oncogene Proteins B-raf genetics, Rhabdoid Tumor genetics
- Abstract
Rhabdoid meningioma is an aggressive phenotype of meningioma, associated with a poor prognosis. We present a very rare case of high-grade meningioma with rhabdoid features that eventually expressed in a coma state. Comprehensive genomic profiling using a Next Generation Sequencing (NGS) assay revealed three genomic alterations: activating BRAF mutation (V600E), loss of CDKN2A/2B, and APC I1307K. After treatment with BRAF inhibitor (dabrafenib), the child's clinical condition improved progressively. After seven months, an MEK inhibitor was added (trametinib).
- Published
- 2015
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40. Ultrasound-guided core biopsy as the primary tool for tissue diagnosis in pediatric oncology.
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Ilivitzki A, Abugazala M, Arkovitz M, Benbarak A, Postovsky S, Arad-Cohen N, and Ben-Arush M
- Subjects
- Adolescent, Adult, Biopsy, Needle, Child, Child, Preschool, Female, Follow-Up Studies, Humans, Infant, Male, Neoplasm Recurrence, Local surgery, Neoplasms surgery, Prognosis, Retrospective Studies, Ultrasonography, Young Adult, Image-Guided Biopsy, Neoplasm Recurrence, Local diagnostic imaging, Neoplasm Recurrence, Local pathology, Neoplasms diagnostic imaging, Neoplasms pathology
- Abstract
Introduction: Traditionally in pediatric oncology, biopsies were incisional, with a recent alternative of percutaneous imaging-guided biopsies. In our department, ultrasound (US)-guided core biopsy is the first choice for tissue diagnosis in the pediatric population. We retrospectively reviewed our experience and assessed the accuracy rate, safety, and availability of the procedure., Materials and Methods: Pediatric US-guided biopsies performed in our hospital between November 2003 and November 2011 were studied. Data collection included demographics, clinical and procedural data, and follow-up., Results: A total of 213 biopsies were performed on 191 patients: 40 known oncologic patients and 173 to establish diagnosis. Seventeen biopsies were excluded, as malignancy was not suspected. Sixty-five percent of the patients had a biopsy within a day. A total of 138 biopsies with tumor at the biopsy site were correctly diagnosed and 4 were missed. Fifty-eight patients were negative for tumor. The sensitivity of our ultrasound-guided core biopsy is 97.1%, specificity 100%, and accuracy 97.9%.We found no complication related to sedation, and 2 procedural complications-bleeding from the biopsy site and seeding of tumor cells-were reported., Discussion: We find US-guided core biopsy for suspected malignancy in the pediatric population to be highly available, safe, and very accurate, having a potential to become the procedure of choice.
- Published
- 2014
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41. Association between religious and socio-economic background of parents of children with solid tumors and DNR orders.
- Author
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Hileli I, Weyl Ben Arush M, Hakim F, and Postovsky S
- Subjects
- Adolescent, Adult, Child, Child, Preschool, Education, Female, Follow-Up Studies, Humans, Infant, Male, Medical Records, Prognosis, Retrospective Studies, Socioeconomic Factors, Survival Rate, Young Adult, Decision Making, Neoplasms mortality, Neoplasms psychology, Parents psychology, Religion, Resuscitation Orders psychology
- Abstract
Background: The influence of socio-economic and religious background on decisions made by parents of children with incurable cancer regarding DNR orders is not fully understood., Procedure: A retrospective analysis of medical charts of patients who died between January 2000 and January 2011 was performed. The following data were sought: written evidence of DNR discussion with parents, religious background, educational level, monthly income., Results: There was evidence of a discussion on DNR in 73/90 charts. DNR consent was obtained in 14/17 (82.4%) cases where at least one parent had >15 years of education versus in only 24/45 (53.3%) cases where both parents had ≤15 years education as determined by univariate analysis (P = 0.03). DNR consent was also more likely to be obtained among parents of children with income >10,000 NIS (24/30, 80.0% vs. 20/38, 52.6%, P = 0.013). Parents of Jewish (22/30, 73.3%), Islamic (16/26, 61.5%), and Christian (8/9, 88.9%) background were equally likely to provide DNR consent. However, Druze families were less likely to do so (2/8, 25.0%, P = 0.036)., Conclusions: The process of decision-making to a DNR request was associated with parents' educational level and monthly family income, and not by religious background, with the exception of Druze families., (© 2013 Wiley Periodicals, Inc.)
- Published
- 2014
- Full Text
- View/download PDF
42. Alkaline phosphatase level change in patients with osteosarcoma: its role as a predictive factor of tumor necrosis and clinical outcome.
- Author
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Khoury JF, Ben-Arush MW, Weintraub M, Waldman E, Futerman B, Vlodavsky E, and Postovsky S
- Subjects
- Adolescent, Child, Female, Follow-Up Studies, Humans, Male, Necrosis pathology, Neoplasm Metastasis, Osteosarcoma drug therapy, Prognosis, Retrospective Studies, Sex Factors, Survival Rate, Treatment Outcome, Young Adult, Alkaline Phosphatase metabolism, Antineoplastic Agents therapeutic use, Neoadjuvant Therapy methods, Osteosarcoma pathology
- Abstract
Background: In osteosarcoma the histological response, measured by the percentage of tumor necrosis, constitutes one of the most significant predictive factors, with better survival in patients whose tumor necrosis is > or = 90%., Objectives: To determine if the decrease rate of serum alkaline phosphatase (SAP) levels during the first month of neoadjuvant chemotherapy could serve as a predictive indicator of tumor necrosis and clinical outcome., Methods: We analyzed the medical files of 53 osteosarcoma patients (19 females, 34 males) (median age 16 years, range 8-24); the disease was metastatic in 12 and localized in the other 41., Results: The histological responses were good in 38 patients (71.7%) and poor in 15 (28.3%). At a median follow-up of 50 months, 34 patients (64.2%) had no evidence of disease and 19 (35.8%) had died from the disease. High levels of SAP at diagnosis correlated with worse survival (P = 0.002). There was no difference in overall survival between patients whose SAP decrease rate was > 25% and those with a rate < 25% (P = 0.14). Among female patients, "rapid" SAP responders had better survival than "slow" responders (P= 0.026). In patients with metastases the SAP decrease rate was positively correlated with survival (P = 0.042)., Conclusions: There was no evidence that "rapid" SAP responders had a higher percentage of tumor necrosis than "slow" responders, although female "rapid" SAP responders had a better prognosis than "slow" responders. Patients with metastases at presentation and "rapid" SAP response had better prognoses.
- Published
- 2014
43. Role of 18F-FDG PET/CT in the staging of pediatric peritoneal mesothelioma.
- Author
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Abikhzer G, Gourevich K, Arkovitz M, Postovsky S, and Keidar Z
- Subjects
- Child, Female, Humans, Mesothelioma diagnostic imaging, Multimodal Imaging, Neoplasm Staging, Peritoneal Neoplasms diagnostic imaging, Fluorodeoxyglucose F18, Mesothelioma diagnosis, Mesothelioma pathology, Peritoneal Neoplasms diagnosis, Peritoneal Neoplasms pathology, Positron-Emission Tomography, Tomography, X-Ray Computed
- Abstract
A 7-year-old girl with a 1-month history of diffuse abdominal pain underwent an ultrasound which showed a pelvic mass with multiple peritoneal implants and ascites. An US-guided core biopsy of one of the implants as well as a transrectal biopsy of the pelvic tumor showed pathological findings consistent with epithelioid mesothelioma. We describe the findings on (18)F-FDG PET/CT in pediatric peritoneal mesothelioma.
- Published
- 2013
- Full Text
- View/download PDF
44. Primitive neuroectodermal tumor of the kidney with renal failure.
- Author
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Gefen A, Arush MW, Eisenstein I, Vlodavsky E, Abdah-Bortnyak R, and Postovsky S
- Subjects
- Adolescent, Female, Humans, Kidney Neoplasms pathology, Neuroectodermal Tumors, Primitive pathology, Kidney Neoplasms complications, Neuroectodermal Tumors, Primitive complications, Renal Insufficiency etiology
- Published
- 2012
45. Anaplastic ganglioglioma in the spinal cord: case report and literature review.
- Author
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Kuten J, Kaidar-Person O, Vlodavsky E, Postovsky S, Billan S, Kuten A, and Bortnyak-Abdah R
- Subjects
- Adolescent, Female, Humans, Cervical Vertebrae, Ganglioglioma diagnosis, Ganglioglioma surgery, Spinal Cord Neoplasms diagnosis, Spinal Cord Neoplasms surgery
- Abstract
Anaplastic ganglioglioma (AGG) is a rare tumor. A PubMed database search yielded only a few case reports and fewer case series. An even rarer entity is AGG arising in the spinal cord. We present a case of a pediatric patient with a pathological diagnosis of spinal AGG., (Copyright © 2013 S. Karger AG, Basel.)
- Published
- 2012
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46. Value of routine bone scans in patients with bone sarcomas before local treatment.
- Author
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Bakri D, Bar-Shalom R, Ben Arush MW, and Postovsky S
- Subjects
- Adolescent, Adult, Antineoplastic Agents therapeutic use, Bone Neoplasms drug therapy, Bone Neoplasms pathology, Child, Female, Humans, Male, Neoadjuvant Therapy, Radionuclide Imaging, Retrospective Studies, Sarcoma drug therapy, Sarcoma secondary, Young Adult, Bone Neoplasms diagnostic imaging, Sarcoma diagnostic imaging
- Abstract
During modern treatment of children with bone sarcomas, the children undergo multiple diagnostic imaging procedures, including bone scan (BS) with Tc99m. The aim of the BS is to establish the metastatic status of the skeletal system at the time of initial diagnosis and thereafter. We retrospectively reviewed 85 medical charts of patients with osteosarcoma (n = 40) and Ewing sarcoma (n = 45) who had been treated in our department between 01.01.1995 and 01.11.2009. Every patient underwent routine imaging studies including BS at the time of initial diagnosis and before local treatment. Median age of all patients was 15.5 years (range, 8 to 29). Fifteen patients had metastases at diagnosis. All patients were treated with neoadjuvant chemotherapy. No patient with localized disease developed metastatic disease to the skeletal system before local treatment; those with localized disease who developed metastases did so some time after completion of the treatment plan. As the probability of developing bone metastatic disease while receiving therapy is very low, routine BS in asymptomatic patients before local treatment may safely be omitted.
- Published
- 2011
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47. Undifferentiated sarcoma of the thyroid in a child.
- Author
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Postovsky S, Vlodavsky E, Kuten A, Shendler Y, Doweck I, and Ben Arush MW
- Subjects
- Adolescent, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Combined Modality Therapy, Dactinomycin administration & dosage, Doxorubicin administration & dosage, Female, Humans, Ifosfamide administration & dosage, Immunohistochemistry, Radiotherapy, Thyroidectomy, Vincristine administration & dosage, Sarcoma pathology, Sarcoma therapy, Thyroid Neoplasms pathology, Thyroid Neoplasms therapy
- Abstract
The most common malignant tumor of the thyroid is papillary carcinoma. Sarcoma of the thyroid is encountered very rarely; its therapy is complex and poses significant problems due to the problematic location of the tumor. A 14-year-old female was diagnosed with undifferentiated sarcoma of the thyroid and received combined therapy comprising surgery, chemo- and radiotherapy without significant side effects. This case underlines the fact that undifferentiated thyroid sarcoma may be a diagnostic possibility in children with malignant masses of the neck and may be successfully treated with modern therapeutic strategies., (Copyright 2010 Wiley-Liss, Inc.)
- Published
- 2010
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- View/download PDF
48. Osteogenic sarcoma in a child with familial expansile osteolysis syndrome: an accidental association?
- Author
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Bacri D, Arush MW, Vlodavsky E, Kollander Y, Militianu D, and Postovsky S
- Subjects
- Adolescent, Alkaline Phosphatase blood, Bone Neoplasms blood, Bone Neoplasms drug therapy, Bone Remodeling, Humans, Male, Mutation, Osteosarcoma blood, Osteosarcoma drug therapy, Bone Neoplasms genetics, Osteolysis genetics, Osteosarcoma genetics, Receptor Activator of Nuclear Factor-kappa B genetics
- Abstract
We present the first reported case of a child with familial expansile osteolysis syndrome (FEO) who developed osteogenic sarcoma (OS) of the iliac bone. A 17-year-old adolescent presented with pain and a mass on the left pelvis. He was from a family with several members who had been diagnosed with FEO, from which he also suffered. The median life expectancy of affected members of the family was reported as 25 to 30 years, with death ensuing as a result of various respiratory and cardiac complications of severe skeletal deformations, characteristic of increased bone turnover as seen in FEO. Biopsy of the patient's mass revealed chondroblastic OS. He was treated according to the P9754 protocol for patients with newly diagnosed nonmetastatic OS. Chemotherapy consisted of HD-MTX, ifosfomide, doxorubicin, and cisplatin. Complete resection of the tumor was carried out, but the patient subsequently developed metastatic disease and died (histologic response to neoadjuvant chemotherapy-85%). The patient's alkaline phosphatase level that was highly elevated before the start of chemotherapy, dropped significantly during treatment, with repeated elevation soon after definitive surgery, while he was recuperating and not on treatment. We speculate that chemotherapy affected not only the malignant cells of OS but normal osteoblasts as well, with a decreasing level of alkaline phosphatase even in the absence of any clinical and radiographic signs of OS. We also think that increased bone turnover, characteristic of a condition such as FEO, may facilitate de novo development of OS.
- Published
- 2010
- Full Text
- View/download PDF
49. Unusual leptomeningeal dissemination in a child with extracranial metastatic alveolar rhabdomyosarcoma.
- Author
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Arush MW, Kollender Y, Issakov J, Shalom RB, Arieh YB, Malkin L, and Postovsky S
- Subjects
- Bone Marrow Neoplasms drug therapy, Brain Neoplasms drug therapy, Child, Humans, Lung Neoplasms drug therapy, Magnetic Resonance Imaging, Male, Meningeal Neoplasms drug therapy, Thigh, Bone Marrow Neoplasms secondary, Brain Neoplasms secondary, Lung Neoplasms secondary, Meningeal Neoplasms secondary, Rhabdomyosarcoma, Alveolar secondary, Soft Tissue Neoplasms pathology
- Abstract
The authors describe a 6-year-old boy diagnosed with alveolar rhabdomyosarcoma located in the thigh, with distal metastases to lungs, bones, and bone marrow. A very good partial response to first-line chemotherapy was obtained, but the child developed fatal leptomeningeal dissemination immediately after complete resection of the primary tumor. This case demonstrates the rapidity with which leptomeningeal spread of extracranial metastatic alveolar rhabdomyosarcoma can occur and underscores the importance of diagnostic lumbar puncture and brain radiological investigations at diagnosis, even when the tumors are not in the parameningeal location.
- Published
- 2009
- Full Text
- View/download PDF
50. Does regular follow-up influence the survival of patients with sarcoma after recurrence? The Miri Shitrit pediatric oncology department experience.
- Author
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Postovsky S, Barzilai M, Meller I, Kollander Y, Futerman B, and Ben Arush MW
- Subjects
- Adolescent, Adult, Bone Marrow Examination, Bone Neoplasms diagnosis, Bone Neoplasms secondary, Bone Neoplasms therapy, Child, Child, Preschool, Female, Follow-Up Studies, Humans, Israel, Magnetic Resonance Imaging, Male, Neoplasm Recurrence, Local diagnosis, Neoplasm Recurrence, Local secondary, Neoplasm Recurrence, Local therapy, Positron-Emission Tomography, Predictive Value of Tests, Prognosis, Recurrence, Retrospective Studies, Sarcoma diagnosis, Sarcoma secondary, Sarcoma therapy, Soft Tissue Neoplasms diagnosis, Soft Tissue Neoplasms secondary, Soft Tissue Neoplasms therapy, Survival Analysis, Survival Rate, Time, Tomography, X-Ray Computed, Bone Neoplasms mortality, Neoplasm Recurrence, Local mortality, Oncology Service, Hospital statistics & numerical data, Outcome Assessment, Health Care statistics & numerical data, Sarcoma mortality, Soft Tissue Neoplasms mortality
- Abstract
Despite comprehensive management of pediatric sarcomas, only 60% to 70% of children become long-term survivors. This study was undertaken to evaluate whether regular follow-up improves overall survival of children with recurrent sarcomas. The medical charts of 107 children diagnosed with soft tissue and bone sarcomas were reviewed, of whom 29 relapsed. They were divided into 2 groups according to the way of relapse diagnosis: due to complaints/physical examination (14) or on routine imaging studies (15). All were followed by regular physical examination and imaging studies (chest computed tomography, magnetic resonance imaging, and bone scan/positron emission tomography-computed tomography scan with fluorodeoxyglucose) at regular intervals. Analysis of the results showed that (1) regular imaging studies do not facilitate earlier recognition of relapse in children with sarcomas; (2) regular follow-up with imaging studies does not influence overall survival of children with sarcomas; (3) other diagnostic and treatment approaches are needed to improve the survival of children with recurrent sarcomas.
- Published
- 2008
- Full Text
- View/download PDF
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