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Biomedical subjects

J van Eys

Publications and source records attributed to J van Eys.

At least 19 recordsLinked to original sources
PubMed1979

Malnutrition in children with cancer: incidence and consequence.

Overt malnutrition in children with cancer is seen with surprising frequency: up to 37.5% in a group of patients with disease metastatic to or from bone, and 17.5% in a group of newly diagnosed patients with abdominal or pelvic tumors. It appears more frequent in some cancers. e.g., Ewing's sarcoma, than in others, e.g., osteosarcoma. Criteria for diagnosis of overt malnutrition are applicable to the child with cancer. Such overt malnutrition can be successfully and safely treated with intravenous hyperalimentation (IVH). Marginal malnutrition is a state that can be inferred from clinical behavior, although it cannot be objectively diagnosed as yet. Early data suggest that deterioration to overt malnutrition can be averted through IVH. Such nutritional intervention may increase chemotherapeutic tolerance and improve immune defenses. Since childhood cancer is beginning to frequently show excellent outcome, the association of malnutrition with progressive disease strongly suggests investigation of the role of nutritional support.

Antineoplastic Agents↗
PubMed1979

Current concepts of bacteremia in children with malignancies.

One hundred fifteen episodes of bacteremia occurred among 2790 children with malignancies hospitalized during a 45-month period. The mean age was 9.3 years with a male predilection (62%). A greater (p less than .025) number of children over 10 years of age died with bacteremia when compared to younger children. The majority of episodes occurred in children with leukemia (56%); however, once bacteremia developed, a significantly (p less than .05) greater number of children with lymphoma died when compared to children with other malignancies. Absolute polymorphonuclear leukocyte counts were greater in survivors (p less than .025) than in children who died. Thirty-seven different microorganisms were isolated with E. coli, S. Aureus, P. aeruginosa, and K. pneumoniae accounting for 50% of the episodes. Anaerobes were isolated from blood of 12 (10%) children. Twelve children had polymicrobial bacteremia and 14 had recurrent bacteremia which occurred during antibiotic therapy. Mortality (78%) in these children was significantly (p less than .001) greater then in children from whom one microorganism was isolated (47%). Interesting aspects include the resurgence of S. aureus, failure of development of meningitis in children with bacteremia, and unchanged antibiotic susceptibility since the last review of bacteremia in this institution. Polymicrobial and recurrent bacteremia necessitate obtaining simultaneous and sequential blood cultures to facilitate administration of appropriate antimicrobial therapy until bone marrow function improves.

Adolescent↗
PubMed1978

Combination chemotherapy with MOPP in children with recurrent brain tumors.

Twenty-three children with CNS tumors were treated with combination chemotherapy including nitrogen mustard, vincristine sulfate, procarbazine, and prednisone (MOPP). All but one had progressive or recurrent tumors following surgery and irradiation. In addition, nine of these patients had prior chemotherapy. Seventeen out of 23 patients (73.4%) responded to MOPP chemotherapy including seven patients who had prior chemotherapy with single or multiple agents such as VCR, nitrosoureas, intrathecal methotrexate, and VM-26. Three comatose patients who were being kept on Decadron without benefit recovered from coma. At the time of this report 8 of the 17 responders are surviving without evidence of recurrence 7--30 months from the start of MOPP chemotherapy. In two of these children chemotherapy has been completely stopped.

Adolescent↗
PubMed1978

Clinical pharmacology of tobramycin in children.

The pharmacokinetics of tobramycin were evaluated in 50 pediatric patients (two to 18 years of age) with malignancies and normal renal function. Patients receiving either 240 or 300 mg/m2 per 24 hr (8 or 10 mg/kg per 24 hr) divided into doses given every 4 hr had peak serum concentrations (mean +/- standard error) of 3.10 +/- 0.23 microgram/ml and 4.23 +/- 0.25 microgram/ml, respectively, at the end of a 1-hr infusion. Serum concentrations at 4 hr were 0.82 +/- 0.15 and 1.05 +/- 0.15 microgram/ml, respectively. The half-life of the drug was 96.6 min and was inversely correlated with age of the patients. The total clearance rate of tobramycin was 164 +/- 15 mg/min per 1.73 m2 and was directly correlated with age. The mean volume of distribution was 0.42 +/- 0.038 liter/kg and was inversely correlated with age. No accumulation of tobramycin was noted, and no side effects occurred. If therapeutic serum concentrations of tobramycin are to be achieved and maintained in children, the currently recommended dose and frequency of administration should be changed to 300 mg/m2 per 24 hr given in divided doses every 4 hr.

Adolescent↗
PubMed1977

Nutritional therapy in children with cancer.

The special biology and behavior of the child make nutrition an even more important adjunct to cancer therapy than is true for the adult. The time has come to add nutritional therapy routinely to our other modes of therapy: surgery, radiotherapy, chemotherapy, and immunotherapy. But it should be done in the same way other modalities are added, i.e., with continued prospective and retrospective review of the data to optimize the approach to the child.

Child↗
PubMed1975

Erythrocyte pyruvate kinase activity in patients with haematological malignancies.

Erythrocyte pyruvate kinase (PK) activity was decreased with acute myelomonoblastic leukaemia (AML) and lymphosarcoma cell leukaemia (LSAL) but increased in patients with chronic myelocytic leukaemia (CML). There was no difference in the enzyme activity between controls and relatives of patients with AML. PK activity in patients with ALL during complete remission was higher than during untreated and relapsed stages. These data provided evidence that the altered enzyme activity is acquired rather than genetic. There was a positive correlation between PK activity and red cell creatine levels. The red cell creatine was low in patients with AML but high in patients with CML. This suggests that the altered enzyme activity in these patients is at least part due to red cell age.

Adolescent↗
PubMedDate not supplied

Platelet use in pediatric oncology: a review of 393 transfusions.

A total of 393 platelet transfusions, administered on the pediatric service at the M. D. Anderson Hospital and Tumor Institute between March, 1973, to December, 1974, were reviewed. Of these 64 were administered on indications of hemorrhage or surgery, while 324 were administered prophylactically. In only 33% was an adequate platelet rise seen, and in only 40% of those bleeding was the bleeding controlled. The primary factor precluding the success was the number of previously administered platelet transfusions. Infection, the use of random or single donors, and ABO matching had no effect on the outcome, but this was not accentuated in the bleeding patients. Surprisingly, transfusions in patients with leukemia resulted in greater success than transfusions in patients with solid tumors. The lower the platelet count prior to transfusion, the less likely the transfusion was to be successful.

Blood Cell Count↗