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Judith A Wilimas

Publications and source records attributed to Judith A Wilimas.

7 recordsLinked to original sources
PubMed2007

Impact of an education program on late diagnosis of retinoblastoma in Honduras.

BACKGROUND: In developed countries, more than 90% of children with retinoblastoma present with limited-stage disease and are cured; however, in countries with limited resources, like Honduras, most patients present with advanced disease and cure rates are less than 50%. Early diagnosis is necessary to improve the survival of children with retinoblastoma in these countries. PROCEDURE: We describe the preliminary results of a retinoblastoma education program linked to a national vaccination campaign in Honduras. Posters and flyers were designed to be accessible to poorly educated readers, to convey the severity of retinoblastoma, and to provide contact information. Charts and an electronic database were reviewed to determine age at diagnosis, presenting signs and symptoms, date of diagnosis, and outcome. RESULTS: During the eight previous years (July 1995-June 2003), 73% of the 59 diagnosed cases of retinoblastoma were extraocular; in contrast, during the post-campaign period (June 2003-January 2005), only 35% of the 23 diagnosed cases showed extraocular spread (P = 0.002). More than one-third of patients in both time periods either refused therapy or abandoned treatment. CONCLUSION: This inexpensive approach is an effective first step toward improving survival of childhood retinoblastoma. Abandonment and refusal of therapy are continuing obstacles.

Child↗
PubMed2007

Iron deficiency.

Explore the source record for details and available documents.

Anemia, Iron-Deficiency↗
PubMed2004

Significance of pleural effusion at diagnosis of Wilms tumor.

BACKGROUND: Pleural effusion is uncommon at diagnosis of Wilms tumor. Because the clinical significance of this finding has not been reported, a retrospective review of this entity was conducted. PROCEDURE: The radiology reports and medical records of 233 patients with Wilms tumor who were treated at St. Jude Children's Research Hospital between 1985 and 2001 were reviewed. RESULTS: Ten of the 233 patients (4.3%) had pleural effusions detected on pre-nephrectomy imaging studies. Computed tomography (CT) scans were more sensitive than chest X-rays in identifying pleural effusions. All of the patients with pleural effusions had tumors of favorable histology. Two patients had stage II disease, five had stage III disease, two had stage IV disease, and one had stage V (bilateral) disease. All of the effusions occurred on the same side as the primary kidney tumors and six effusions were associated with ascites. The two effusions that were tapped were negative for tumor cells. All 10 patients in our series were alive without recurrence with a median follow-up duration of 68 months, yet only two patients were treated with lung irradiation. CONCLUSION: Pleural effusion at presentation of Wilms tumor is uncommon and not associated with adverse prognosis. We recommend that pleural effusions be tapped whenever feasible if the results will change therapy. Patients with pleural effusions that are small and difficult to tap may be treated according to their local stage without pulmonary irradiation. Further analysis of pleural effusions in a larger group of patients is necessary to confirm our preliminary observations.

Follow-Up Studies↗
PubMed2003

Training subspecialty nurses in developing countries: methods, outcome, and cost.

BACKGROUND: As infections are controlled in developing countries, other pediatric subspeciality programs such as oncology become increasingly important. A major impediment to the development of such programs is a lack of trained nurses. Therefore, education of pediatric subspecialty nurses becomes a priority. PROCEDURE: We describe three models we have used for education of pediatric oncology nurses: a short series of classes or lectures with additional training of key nurses, an expanded 12 week series of classes at centers combining didactic and clinical instruction and a regional residential school offering regular 12 week courses in theory and clinical practice. RESULTS: Cost analysis showed that the cost per nurse trained was, respectively, 3,700; 4,350; and 5,500 US dollars. Early effectiveness indicators show that retention rates are high, home institutions are satisfied, and nurses trained shared their knowledge with other nurses and improved nursing practices. CONCLUSIONS: Programs to teach subspecialty nursing in developing countries are effective and can improve medical care. Such programs should be based on past experience and evaluated as to cost and effectiveness.

Developing Countries↗
PubMed2003

Hematologic findings in children with rotavirus-positive and -negative diarrhea.

The authors studied neutropenia in 101 children hospitalized for gastroenteritis between 1 December 2000 and 30 June 2001 and identified children tested for rotavirus by reviewing their laboratory records. Rotavirus-positive and rotavirus-negative subjects did not differ significantly in their white blood cell counts, absolute neutrophil counts, or frequency of neutropenia (defined as an absolute neutrophil count < 1.0 x 10(9)/L), which accompanied 8.6% of rotavirus-positive cases and 9.3% of rotavirus-negative cases of gastroenteritis. The authors conclude that mild neutropenia accompanying diarrhea does not require further evaluation unless it persists or is associated with other factors such as sepsis.

Black or African American↗
PubMedDate not supplied

Improved survival for patients with recurrent Wilms tumor: the experience at St. Jude Children's Research Hospital.

BACKGROUND: Reported estimates of survival for patients with recurrent Wilms tumor are 24% to 43%. Because published survival data are more than a decade old and do not reflect advances in therapy, the authors reviewed their experience in treating recurrent Wilms tumor to determine whether the probability of survival has increased. PATIENTS AND METHODS: The authors reviewed the cases of 54 patients with recurrent Wilms tumor who were treated on one of six consecutive clinical trials at St. Jude Children's Research Hospital between 1969 and 2000. RESULTS: Five-year overall survival estimates after relapse were 63.6 +/- 15.7% for patients treated during or after 1984 (n = 20) and 20.6 +/- 6.5% for patients treated before 1984 (n = 34) (P = 0.002). When the analysis was restricted to patients with high-risk clinical features, 5-year overall survival estimates were 47.6 +/- 15.7% for those treated in the modern era (n = 16) and 11.1 +/- 5.2% for those treated in the earlier era (n = 25) (P = 0.005). Only three patients received high-dose chemotherapy with autologous stem cell rescue; one survived. No patients with recurrent anaplastic histology disease survived. CONCLUSIONS: Significant progress has been achieved in the treatment of recurrent favorable-histology Wilms tumor using multimodality salvage regimens with conventional doses of chemotherapy. Novel therapeutic strategies will be necessary to cure patients with recurrent anaplastic Wilms tumor.

Adolescent↗