Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0027497 (nausea)
 23,468 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We evaluated the responses of 39 children with cancer who, after failure to respond to conventional chemotherapeutic agents, received either or both of two epipodophyllotoxins: 4'-demethylepipodophyllotoxin 9-(4,6-o-2-thenylidene-beta-D-glucopyranoside) (NSC-122819) and 4'-demethylepipodophyllotoxin 9-(4,6-o-ethylidene-beta-D-glucopyranoside) (NSC-141540). Seventeen patients has acute lymphocytic leukemia (ALL). 12 had acute nonlymphocytic leukemia (ANLL), and ten had solid tumors. Initially, the patients in each disease category were randomized to receive 50 mg/m2/dose of NSC-122819 intravenously (iv) twice weekly or 75 mg/m2/dose iv of NSC-141540 twice weekly for 4 weeks. Drug dosages and schedules of administration were adjusted during the course of the study. Although objective responses were not detected in the heterogeneous group of solid tumor patients, definite clinical responses were obtained in nine of the 29 patients with acute leukemia. The responses to the two epipodophyllotoxins were noted in patients with ALL as well as in patients with ANLL. Toxic side-effects included nausea, vomiting, diarrhea, fever, alopecia, leukopenia, and thrombocytopenia. These results, the first reported with both NSC-122819 and NSC-141540 in childhood cancer, indicate that the epipodophyllotoxins are well tolerated and may be effective against acute leukemia.
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PMID:4'-demethylepipodophyllotoxin 9-(4,6-o-2-thenylidene-beta-D-glucopyranoside) (NSC-122819; VM-26) and 4'-demethylepipodophyllotoxin 9-(4.6-0-ethylidene-beta-D-glucopyranoside) (NSC-141540; VP-16-213) in childhood cancer: preliminary observations. 110 Feb 25

Systematic treatment in children suffering from cancer pain is a field of pediatric oncology that was neglected for a long time. Investigations have shown that pain therapy oriented to the special situation of the child's body is urgently necessary. In Germany, an unpublished study by Fengler (Berlin), who reviewed all pediatric cancer centers, revealed serious deficiencies in the therapy of pain in children. In our study, we attempted to develop a new concept of cancer pain management, with the emphasis on cooperation between pediatric oncologist and anesthesiological pain therapists. PATIENTS AND METHODS. A total of 36 children and adolescents suffering from malignant tumors and in whom pain therapy according to WHO stage III was necessary were treated. After being seen by a pediatric oncologist and an anesthetist (pain therapist) each patient received either slow release oral morphine (MST, 0.5-1 mg/kg per dose) two to three times a day or a continuous infusion of morphine (0.05 mg/kg per h). The amount of morphine administered was quickly raised until the young patients were free of pain. Drug actions (pain score) and side effects were registered continuously with a documentation form. The morphine was combined with dipyrone 5-15 mg/kg per dose five times a day. The intravenous dosage of oral dipyrone was 2-5 mg/kg per h. RESULTS. The average age of the patients treated was 12 years (1.5-19 years); 10 were inpatients, and 26 were outpatients. All patients were treated successfully. The doses of morphine required for pain relief varied substantially (1-25 mg/kg per day p.o. and 0.05 mg-1 mg/kg per h i.v.). We did not observe extreme sedation or respiratory depression. In our patients we did not observe opioid-induced nausea such as is frequently seen in adults. All children needed laxatives. In 2 children, intolerable itching was experienced after oral administration of slow-release morphine. In 20 patients cortisone was given as adjuvant therapy, in 5 patients with neuropathic pain, anticonvulsants e.g., carbamazepine. In 6 patients we administered benzodiazepines successfully for sedation and anxiolysis. CONCLUSIONS. Therapy of pain in children with advanced cancer requires interdisciplinary cooperation. In most children therapy of pain can be successfully administered with slow-release morphine in combination with dipyrone, so that the children can remain in their usual social environment.
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PMID:[Cancer pain therapy in children and adolescents using morphine]. 204 10

Fifty-four pediatric cancer patients were studied to determine the relative efficacy of two forms of behavioral intervention for reducing chemotherapy-related distress. Following baseline assessment, subjects were randomly assigned to receive either hypnosis, non-hypnotic distraction/relaxation, or attention placebo (control) during the subsequent identical chemotherapy course. Observational and interview measures of anticipatory and postchemotherapy nausea, vomiting, distress, and functional disruption served as outcome data. Results indicated that treatment condition was the single best predictor of change from baseline to intervention, with children in the hypnosis group reporting the greatest reduction of both anticipatory and postchemotherapy symptoms. The cognitive distraction/relaxation intervention appeared to have a maintenance effect in which symptoms did not get much worse or much better, while children in the control group had symptoms that consistently became worse over time. Emetic potential of the chemotherapy and the prophylactic use of antiemetics each appeared to contribute to the overall severity of symptoms. While the efficacy of hypnosis in the management of chemotherapy distress is supported, the complexities of interacting biologic and psychologic factors are highlighted.
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PMID:A randomized, controlled study of behavioral intervention for chemotherapy distress in children with cancer. 205 71

Ondansetron, a 5HT3 antagonist, was given to 20 children aged 4 to 18 years who were undergoing treatment with the Australian and New Zealand Childhood Cancer Study Group Acute Lymphocytic Leukaemia (ALL) Study V Protocol. The study was open, dose ranging, and noncomparative, and designed to evaluate safety and efficacy of ondansetron in preventing nausea and vomiting caused by cyclophosphamide intravenous (IV) 1,000 mg/m2 day 1, and cytarabine IV subcutaneously (SC) 75 mg/m2 on days 2 to 5. Ten patients were given ondansetron 5 mg/m2 IV (group A) and subsequently another 10 patients were given ondansetron 3 mg/m2 IV (group B). Oral ondansetron was given for 14 doses, at the same dosage for both groups, commencing simultaneously with the IV infusion and continuing at 8 hourly intervals, ie, until day 5. The oral dose was based on surface area with the following schedule: 0.3 to 0.6 m2, 2 mg; 0.6 to 1 m2, 3 mg; and greater than 1 m2, 4 mg. Vomiting on the first day of chemotherapy was reported in group A by one patient and by one patient in group B. Vomiting during days 2 to 5 was reported by two group-A patients and by three group-B patients. Nausea was recorded on day 1 by one patient in group A, and two in group B, and on days 2 to 5 by three patients in group A, and by seven in group B. All patients were alert during treatment with ondansetron and there was no dystonia. There were no changes in renal function or hematology values that could be ascribed to the study drug. Transient elevations in bilirubin and liver enzymes were observed. We conclude that our results indicate that ondansetron is a safe and extremely effective single-agent antiemetic with minimal side effects, when administered both IV and orally.
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PMID:Prevention of cyclophosphamide/cytarabine-induced emesis with ondansetron in children with leukemia. 214 19

Epidemiological evidence for prenatal carcinogenesis includes associations between cancer in young people and intrauterine exposure to X-rays, drugs and hormones and prezygotic events such as specific chromosomal aberrations associated with specific cancers. Recent findings suggest that the hormonal environment during early gestation can result not only in the development of clear-cell adenocarcinoma of the vagina but also in the development of germ cell tumours of the testes and ovary. Hormone-related risk factors for testicular germ cell neoplasms include maternal use of exogenous oestrogens during early gestation and, possibly, maternal nausea, maternal obesity and race as well. Ovarian germ cell tumours also appear to be related to maternal use of hormones and obesity. Several epidemiological studies of cancer in young people have been directed towards suggested associations with parental occupational exposures, parental cigarette smoking and household exposures to electric and magnetic fields (EMF). The findings of the many studies of parental occupational exposures are inconsistent and are often nonspecific with respect to the type of childhood cancer and the job exposure implicated. Parental cigarette smoking has been associated in some studies with an increased risk for cancer among children and young adults, and in other studies with an increased risk among mature adults, but the findings are not consistent across studies. Three studies of all types of childhood cancer found risk to be related to household exposures to EMF; in all three, the risk for central nervous system tumours was increased, and in two of the three leukaemia risk as well. A fourth study showed no association between childhood leukaemia and EMF. A hypothesis is proposed which suggests that prenatal and early childhood exposure to N-nitroso compounds (NOC) may be related to the development of primary tumours of the brain in children. Experimentalists have shown that various NOC are potent nervous system carcinogens, particularly when animals are exposed transplacentally. This experimental model and findings from a Los Angeles case-control study (209 pairs) of brain tumours in young people led to the proposed epidemiological hypothesis. Although this and other epidemiological studies of NOC have major limitations, findings from epidemiological studies of congenital defects and of other childhood cancers lend the hypothesis some support. A large international collaborative case-control study of childhood brain tumours was begun recently. This study has a major advantage over most case-control studies in adults because the exposure period of greatest interest (gestation) is clearly defined.
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PMID:Epidemiological studies of perinatal carcinogenesis. 268 Sep 50

Clinical experience with 25 pediatric cancer patients referred by oncologists for imagery exercises (self-hypnosis) at Minneapolis Children's Health Center suggests that this modality is valuable adjunct therapy for symptom relief, such as reduction of pain and nausea, especially among those patients who begin these exercises at the time of their initial diagnosis. Twenty-one of these patients agreed to use the exercises and 19 demonstrated substantial symptom relief associated with their practice. This experience suggests the need for more research regarding the optimal use of this modality in children with cancer, and for better understanding of how psychological factors contribute, if at all to the development and course of malignancies. A 5-year prospective study of imagery as adjunct therapy in childhood cancer is now in process.
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PMID:Imagery (self-hypnosis) as adjunct therapy in childhood cancer: clinical experience with 25 patients. 728 97

Pain treatment for 17 pediatric cancer patients in our institution was evaluated and disirable cancer pain management for children was discussed. Most of the patients (aged 1-17 years) suffering severe pain for about one month were in the advanced stage of the malignant diseases (e.g. leukemia). The pain etiology was mostly tumor-associated while therapy-related pain accounted for 23.5%. These pains were treated with NSAIDs or pentazocine before the consultation with inadequate relief. Oral morphine sulfate or continuous intravenous morphine chloride was administered to 16 patients with successful pain relief and side effects such as nausea (52.9%) and drowsiness (41.2%). It took 5.5 days on average until adequate pain control methods were determined. It is known that most NSAIDs frequently used for pediatric pain possibly cause adverse effects such as platelet dysfunction or mucous membrane injury with a suppository, which could lead to a fatal disorder in clinically ill pediatric cancer patients. Moreover sufficient doses for the pain relief are not necessarily given to the pediatric patients because of a limit to the dosage of NSAIDs. The period of pediatric cancer pain in which the patient require a methodical treatment and receive benefit from pain relief is relatively short in the advanced stage, not to mention the early stage in which chemotherapy is efficacious against cancer disease itself. Therefore, to obtain effective pain control within a short time, the authors propose the pain management for advanced pediatric cancer patients by the two-step analgesic ladder prescribing weak or strong opioid analgesics first, adapted from the three-step ladder of the WHO Cancer Pain Relief, 1986.
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PMID:[Pain management in advanced pediatric cancer patients--a proposal of the two-step analgesic ladder]. 754 19

Neutropenic pediatric patients with solid tumors and malignant lymphomas were treated with recombinant granulocyte-macrophage colony stimulating factor (rh-GM-CSF). Eleven patients, including seven lympho-reticular malignancies, two Ewing's sarcoma and one patient in each group with the diagnosis of nasopharyngeal rhabdomyosarcoma, malignant mesenchymal tumor, entered the study. Six were females and five were males, the mean age was 10.4 yr, the range was 4 to 21 years. rh-GM-CSF was given at the dose of 5 micrograms/kg s.c. daily, starting either on the day following the last day of cytotoxic chemotherapy or when ANC < 1000/ml was determined. All patients received rh-GM-CSF for a total of seven days. Hematopoietic recovery occurred in all children except one. The response to rh-GM-CSF was achieved in a mean time of 7.4 days. Tolerance to rh-GM-CSF treatment was good. Adverse events were documented as fever, nausea, vomiting, fatigue, chills and itching. Sagittal sinus thrombosis developed in one patient 5 days following the completion of chemotherapy and rh-GM-CSF cycle. In conclusion, rh-GM-CSF can be applied during the intensive chemotherapy schedules of pediatric cancer patients.
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PMID:Granulocyte-macrophage colony stimulating factor (rh-GM-CSF) in the treatment of chemotherapy-induced neutropenia. 859 35

Nausea and/or vomiting are adverse side-effects of cancer chemotherapeutic drugs in adult as well as pediatric cancer patients' complicating treatment and compliance. Nausea and vomiting are not only experienced as posttreatment symptoms after chemotherapy (i.e., posttreatment nausea and/or vomiting). In a subgroup of cancer patients, these symptoms also occur prior to a chemotherapeutic drug infusion, called anticipatory nausea (AN) and anticipatory vomiting (AV). The aim of this paper is to present a model derived from basic psychology to explain anticipatory symptoms as learned responses based on classical conditioning. In addition, food aversions and also immunomodulation are interpreted as conditioned responses. Some data on prevalence of ANV in a pediatric sample and on the correspondence between anticipatory symptoms and predictions from the conditioning model are presented. Finally, therapeutic techniques to prevent AN and/or AV are deduced from the conditioning model.
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PMID:[Anticipatory nausea and anticipatory vomiting, food aversion and anticipatory immunomodulation: classical conditioning in cytostatic drug treatment of pediatric chemotherapy patients]. 978 42

Measurement of pediatric cancer patients' health-related quality of life (HRQL) in phase III randomized, controlled clinical trials is being recognized increasingly as an essential component in evaluating the comprehensive health outcomes of modern anti-neoplastic treatment protocols. Use of a brief core measure of HRQL plus disease-specific symptom modules is a way to assess specific HRQL outcomes with a minimum of subject burden. Demonstrating a measure's feasibility, reliability and validity also represents children's ability to provide reliable and valid responses to HRQL questions. The Pediatric Cancer Quality of Life Inventory (PCQL) Modular Approach consists of a 15-item core measure of HRQL and 2 specific symptom modules: pain and nausea. To validate a patient-report form and a parent-report form, the PCQL was administered to 291 pediatric cancer patients and to their parents. Feasibility and range of measurement, as well as patient-parent concordance, were assessed. Internal consistency reliability was assessed via Cronbach's alpha. Validity was determined by the known-groups approach and by correlating PCQL scores with days missed from school. Patients had minimal missing data, and the range of measurement for the items was good. Patient-parent concordance was large but not perfect. For both patient and parent forms, internal consistency reliability of the PCQL core scale (0.83 and 0. 86, respectively) was strong. The internal consistency reliabilities of the 2 symptom modules for both patient and parent forms were in the acceptable range for group comparisons. Regarding clinical validity, the core scale and the 2 symptom modules distinguished between patients on and off treatment for both patient and parent reports. Further, both patient and parent reports correlated with days of missed school in the past 6 and 12 months. The PCQL Modular Approach has demonstrated acceptable internal consistency reliability and clinical validity for both patient-report and parent-report forms. By implication, children are capable of providing reliable and valid responses to these HRQL questions.
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PMID:The Pediatric Cancer Quality of Life Inventory: a modular approach to measuring health-related quality of life in children with cancer. 1067 74


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