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جستجوی مقالات مرتبط با کلیدواژه « Childhood cancer » در نشریات گروه « پزشکی »

  • زینب حبیب پور، لیلا مختاری، شهریار سخائی*
    زمینه و اهداف

    سرطان، بیماری شایع، ناتوان کننده و یکی از علل اصلی مرگ ومیر در کودکان شناخته شده است. آگاهی از ابتلا فرزند به سرطان، تنش روانی شدیدی را در والدین ایجادکرده و با آسیب رسانی به کیفیت زندگی در زمینه های مختلف فیزیکی، روانی، اجتماعی و محیطی،  نیازمند تاب آوری مناسب و مهارت های سازگارانه است. هدف از این پژوهش، تعیین میزان تاب آوری و ارتباط آن باکیفیت زندگی والدین دارای فرزند مبتلا به سرطان در شهر ارومیه است.

    مواد و روش ها

    این پژوهش، یک مطالعه توصیفی-تحلیلی مقطعی است که در سال 1401 به صورت اتفاقی و در دسترس با حجم نمونه 345 نفر از والدین کودکان مبتلا به سرطان در ارومیه انجام شد. برای جمع آوری داده ها از پرسشنامه تاب آوری کونور و دیویدسون و پرسشنامه کیفیت زندگی (12-SF) استفاده شد. پس از تکمیل پرسشنامه ها، داده ها با استفاده از نرم افزارSPSS  و شاخص های توصیفی و تحلیلی در سطح معنی داری (0/05>p) مورد تجزیه و تحلیل قرار گرفت.

    یافته ها

    نتایج نشان داد که میانگین نمره تاب آوری والدین 65.84 و نمره تاب آوری پدران بیشتر از مادران بود. تاب آوری باکیفیت زندگی رابطه معنی داری مستقیم داشت (0/001>p) و بین تاب آوری والدین و مشخصاتی نظیرسن کودک، طول مدت بیماری فرزند، سن والدین، وضعیت اقتصادی خانواده، شغل و میزان تحصیلات والدین تفاوت معنی دار آماری دیده شد (0/005> P).

    نتیجه گیری

    والدین کودکان مبتلا به سرطان با تقویت میزان تاب آوری می توانند کیفیت زندگی خود را بهبود دهند و در این راستا بهره مندی از منابع مذهبی، اجتماعی، آموزشی  و روانشناختی موثر واقع خواهندشد.

    کلید واژگان: تاب آوری, کیفیت زندگی, والدین, کودکان, سرطان}
    Zeinab Habibpour, Leila Mokhtari, Shahriar Sakhaei*
    Background & Aim

    Childhood cancer is a prevalent and debilitating disease that serves as a major cause of mortality among children. Awareness of a child's cancer diagnosis generates substantial psychological distress in parents, impairing their quality of life (QOL) across physical, psychological, social, and environmental domains. Consequently, parents require adequate resilience and coping skills to navigate this challenging situation. This study aimed to determine the level of resilience and its association with QOL in parents of children with cancer in Urmia, Iran.

    Materials & Methods

    This cross-sectional descriptive-analytical study was conducted in 2022 with a convenience sample of 345 parents of children with cancer in Urmia. Data were collected using the Connor-Davidson Resilience Scale and the SF-12 QOL questionnaire. The collected data were analyzed using SPSS software and descriptive and analytical statistics at a significance level of P < 0.05.

    Results

    The mean resilience score of the parents was 65.84, with fathers exhibiting higher resilience than mothers. A significant positive correlation was observed between resilience and QOL (P < 0.001). Additionally, significant associations were found between parental resilience and characteristics such as age and duration of the child's illness, parental age, family economic status, occupation, and educational level (P < 0.005).

    Conclusion

    Parents of children with cancer can improve their QOL by strengthening their resilience. In this regard, utilizing religious, social, educational, and psychological resources can be highly effective.

    Keywords: Resilience, Quality Of Life, Parents, Childhood Cancer, Urmia}
  • Mojgan Karimi-Zarchi, Soheila Sayad *, Mohammad Vakili, Ahmad Shirinzadeh-Dastgiri, Amirhossein Naseri, Mohammad Hossein Antikchi, Sepideh Azizi, Kazem Aghili, Hossein Neamatzadeh, Elahe Akbarian

    The coronavirus disease 2019 (COVID-19) pandemic is the main challenges to public health systems worldwide now. Cancer patients are considered as a high risk group during the COVID-19 pandemic. Considering the evidence so far, cancer as underlying comorbidities might increase the risk of death in patients with COVID-19. Many cancer patients with increased risk of contracting COVID-19 than the general population regularly visit health facilities for treatment and disease surveillance. Thus, the COVID-19 pandemic has a profound impact on cancer care and treatment. Here, we attempted to summarize the current suggestions for handling of cancer patients during COVID-19 pandemic. We carried out a integrative literature review using several online bibliographies. A total of 113 papers were accessed for the time frame between October 05 2020 and October 10 2020. After screening of titles and full-texts, 10 publications were selected in this study. In this work some recommendations and guidelines that would help for management and treatment of cancer for the purpose of address the challenges during COVID-19 pandemic were collected. We hope that this collection recommendations and guidelines assist health care providers in management of individuals with underlying malignancy during the COVID-19 pandemic.

    Keywords: COVID-19, Recommendations, Gastrointestinal cancer, Gynecological cancer, Lung cancer, Childhood cancer, Breast cancer}
  • Mohammad Faranoush, Narjes Mehrvar, Yasaman Sadeghi, Maryam Tashvighi, Mardawig Alebouyeh, Azim Mehrvar *
    Background

    The childhood cancer registry in Iran is a hospital-based system and there is not any unique and national registry system for pediatric malignancies in Iran. According to the limitations and requirements, this study was designed to clarify the aspect of childhood malignancies in Iran and promote establishing the Iranian national childhood cancer registry system. 

    Materials and Methods

    This cross-sectional longitudinal study was implied on 1500 patients younger than 20-years old diagnosed with any malignancy and admitted at MAHAK Pediatric Cancer Treatment and Research Center (MPCTRC) from 2007 to 2014. Data collection was based on a validated questionnaire with three categories including demographic data, clinical data and type of malignancy, and outcomes. Collected data were analyzed using methods for qualitative and quantitative variables (P-Value < 0.05) by SPSS software version 22. The survival rate was calculated by the Kaplan-Meyer method.     

    Results

    This study was implied on 1500 children with a mean age of 6.1 years old. The most common malignancy was acute leukemia (30.7%) followed by central nervous system tumors (27%). At the onset of starting treatment, the rate of conferring with relapse, metastasis, and secondary malignancies was 29%, 19.5%, and 1% respectively. In addition, 52 patients had bone marrow transplantation of whom, 14 cases died. Totally, 42% of patients died and the 3-years, 5-years, and 10-years overall survival rates were 67.7% ± 0.01, 60.3% ± 0.01, and 53.8% ± 0.01, respectively.

    Conclusion

    Establishing a population-based pediatric cancer registry in Iran is necessary and will be useful for improving the survival rate of mentioned patients.

    Keywords: Cancer registry, Iran, Pediatrics, Childhood cancer}
  • Shahyad Salehi Ardebili, Mohammad Radvar, Behnam Askari *

    Fungal endocarditis is rare and has a mortality rate of over 80%. It must be suspected in all immunocompromised patients with culture-negative sepsis and failure of antibiotic treatment. In such cases, echocardiography can be diagnostic.We herein describe a child with Candida albicans endocarditis presenting with heart failure, severe jaundice, and anasarca. A large obstructive mass of the tricuspid valve was detected by echocardiography, and blood culture confirmed the diagnosis. The patient was successfully treated with the surgical excision of the vegetation and intravenous liposomal amphotericin B for 3 weeks. (Iranian Heart Journal 2022; 23(1): 220-222)

    Keywords: Fungal infection, Childhood cancer, Candida endocarditis}
  • پریسا حاج کرمی، الهه حجازی، فریده موسوی
    زمینه و هدف

     کودکان مبتلا به سرطان در مقایسه با کودکان سالم، سازگاری روانی کمتری دارند. در عین حال، این کودکان حق دارند از درمان موثرتری برخوردار باشند تا بتوانند زودتر به روند طبیعی زندگی خود بازگردند. از این رو شناسایی و ارایه راهکارهای حمایتی والدین، به خصوص مراقب اصلی (مادر)، در طول بیماری کودک در جهت افزایش سازگاری او از اهمیت ویژه‌ای برخوردار است. تحقیق حاضر در راستای شناسایی و معرفی راهکارهای مورد استفاده مادران این کودکان برای سازگاری و مقابله موثر فرزند بیمارشان، انجام شده است.

    مواد و روش‌‌ها:

     این پژوهش از نوع کیفی و با رویکرد پدیدارشناختی و با تاکید بر تجربه زیسته مادران انجام شده است. جهت انجام پژوهش، تعداد 19 مادر دارای فرزند 1 تا 15 سال مبتلا به سرطان و تحت درمان، به روش نمونه‌گیری هدفمند انتخاب شده و با روش مصاحبه عمیق و نیمه‌ساختاریافته مورد مطالعه قرار گرفتند.

    ملاحظات اخلاقی:

     قبل از اجرا، ابتدا در مورد هدف پژوهش و همچنین تضمین محرمانه‌بودن اطلاعات، به مشارکت‌کنندگان توضیح داده شد. با اخذ رضایت‌نامه، ایشان به صورت آگاهانه در تحقیق شرکت کردند.

    یافته‌ ها:

     راهکارهای حمایتی هنگام آگاهی از بیماری شامل سه دسته «پنهان‌کاری»، «دریافت کمک و حمایت از طرف دیگران» و «مواجهه مستقیم» بودند. این راهکار در طول فرایند درمان نیز در 9 دسته اصلی طبقه‌بندی شدند: «تغییر مصلحتی شرایط خود»، «کمک به تخلیه هیجانی کودک»، «تمسک به معنویت و خداوند»، «افزایش امید و رغبت»، «استفاده از فعالیت‌های مشترک»، «روابط خانوادگی و اجتماعی»، «ابراز محبت بیرونی»، «تفریح خانوادگی» و «تغییرات ارتباطی مادر با کودک بیمار».

    نتیجه‌ گیری: 

    مادران این پژوهش با توجه به شرایط خود و فرزندشان، از راهکارهای مختلفی استفاده کردند، اما به نظر می‌رسد می‌توان با سازمان‌دهی و آموزش صحیح راهکارهای مقابله‌ای به آن‌ها، در جهت مدیریت بهتر شرایط بیماری و بالابردن کیفیت زندگی آن‌ها و فرزندشان اقدام نمود و از این طریق، نیل به درمان موثرتر را تسهیل کرد.

    کلید واژگان: مادران, سرطان کودکان, راهکارهای حمایتی, سازگاری و مقابله}
    Parisa Hajkarami, Elaheh Hejazi, Farideh Moussavi
    Background and Aim

     Children, have the right to and should be provided with a more effective treatment to return to the natural path of their lives. Therefore, identifying and offering supportive solutions to the parents especially the primary care (the mother) are essential for balancing the child's condition. This research's goal is to identify and introduce the solutions used by the mothers of children with cancer to improve their consistency and resistance against the disease.

    Materials and Methods

     This is a qualitative with a phenomenological approach and an emphasis on the lived experience of those mothers. For doing the research, 19 mothers of 1 to 15hl year old in-treatment children with cancer were chosen by purposive sampling and studied with in-depth semi-structured interviews.

    Ethical Considerations:

     First, the purpose of the research and also to ensure the confidentiality of the results were explained to the participants. After obtaining the consent, they consciously participated in the research.

    Findings

     The supporting solutions after knowing about the disease included "hiding", "getting help and support from others" and "direct confrontation". The solutions for boosting the kid's morale during the treatment process were categorized into 9 main categories: "the prudent change of the condition", "facilitating the kid's catharsis", "resorting to spirituality and God", "increasing hope and encouragement", "using common activities", "family and social relationships", "expressing kindness", "having fun with family", "communicative changes between the mother and the kid".

    Conclusion

     The mothers studied in this research, according to the conditions of their children and themselves, used different solutions. However, it seems possible to manage their conditions and improve their quality of life by organizing and teaching the right coping solutions to them, thus facilitating a more effective treatment.

    Keywords: Mothers, Childhood Cancer, Supportive Solutions, Consistency, Copping}
  • الهام فیاض، محمدعلی مظاهری تهرانی*، لیلی پناغی، فاطمه باقریان
    زمینه و هدف

    مراقبت از کودکان مبتلا به سرطان، مسیری دشوار و منحصر بفرد است که مراقب را در معرض طیفی از تجارب مختلف قرار می دهد. هدف پژوهش حاضر واکاوی پدیدارشناسانه تجربیات زیسته مراقبین کودکان مبتلا به سرطان در مرحله یا فاز وخامت بود.

    روش کار

    این مطالعه به روش کیفی و با استفاده از سنت پدیدارشناسی توصیفی انجام گردید. از میان تمام مراقبین اصلی کودکان و نوجوانانی که پیش از 18 سالگی تجربه ی تشخیص شایع ترین سرطان های کودکی را داشته اند و طبق نظر پزشکان معالج در فاز وخیم یا بعبارتی فاز انتهایی زندگی بیماری قرار داشتند با استفاده از روش نمونه گیری هدفمند و مبتنی بر اصل اشباع هشت نفر برای مشارکت در فرایند پژوهش انتخاب و مورد مصاحبه قرار گرفتند. همه مصاحبه ها ضبط و سپس خط به خط دست نویس شد و در نهایت با استفاده از روش کلایزی (1987) تحلیل گردید.

    یافته ها

    هشت مصاحبه نیمه ساختاریافته انجام شد و تحلیل داده های حاصل از مصاحبه منجر به شناسایی و طبقه بندی 11 زیر مضمون و دو مضمون اصلی (در محاصره ی ناخوشایندی ها در مواجهه با رخدادهایی ویژه) در زمینه ی تجارب زیسته مراقبین کودکان مبتلا به سرطان در فاز وخامت شد.

    نتیجه گیری

    مراقبین در حوزه ی سرطان کودکی  پیشرفته با تجربه های دشوار هیجانی  و موقعیت هایی منحصربفرد روبرو هستند که می تواند بر سلامت جسم و روان مراقب و روند مراقبت در پایان زندگی بیمار اثرات منفی قابل توجهی بگذارد. شناخت تجربه ی زیسته ی این گروه مهم از مراقبین به تیم های تخصصی درمان سرطان کمک خواهدکرد تا آگاهی مکفی جهت راهنمایی و پشتیبانی مراقبین داشته باشند و بطور مشارکت کننده ای برای شفاف سازی نیازهای بیماران و ارایه خدمات با کیفیت بالاتر مراقبین را همراهی کنند.

    کلید واژگان: کلیدواژه ها: مراقبت, سرطان کودکی, فاز انتهایی زندگی, مطالعه کیفی}
    Elham Fayyaz, MohmmadAli Mazaheri Tehrani*, Leili Panaghi, Fatemeh Bagherian
    Background

    Cancer is one of the leading causes of childhood death worldwide. Cancers under the age of 18 have been epidemiologically called pediatric cancers (1). Childhood cancer is one of the most common and yet deadly diseases among children. Among childhood cancers, leukemia and central nervous system tumours are the most common and have a larger population of patients and caregivers in this category of cancers (2, 3).Diagnosing and treating the disease will involve the whole family in a series of stressors such as frequent medical visits, invasive procedures, severe side effects and changes in family plans, as well as economic issues (4). Parents are more likely to be challenged to balance the physical and emotional effects of a chronic illness imposed on the family, and the distress they face can put all family members at risk of severely declining quality of life (5) Or put other negative consequences incompatibility (6). Caregiving, especially for children with malignant cancers, is an overwhelming task that exposes the caregiver to a variety of different experiences and situations. The purpose of the present study was to understand the lived experience of caregivers in childhood cancer at the end of life of the patient. 

    Methods

    The research method is qualitative in terms of interpretive phenomenology. The population participating in this study included all primary caregivers of children and adolescents who had been diagnosed with childhood cancer before the age of 18 and have faced with the failure of the therapeutic process. The sampling method was purposive sampling in which 8 caregivers were selected to participate in the research and they were interviewed and analyzed. All interviews were recorded and then transcribed manually and finally analyzed using the interpretive analysis method.

    Results

    Eight semi-structured interviews with participants in the study were conducted and the analysis of interview data led to the identification and classification of two main themes: Surrounded by unpleasant emotions and encountering special events consists of 11 sub-themes: Experience of disability, Loneliness, Anger and failure, Exhaustion, Overwhelmed with worries, In the difficulty of waiting and ambiguity, Surrender, Facing recurrence, Facing the need to make decisions, Facing the certainty of death, Interacting with a child in the shadow of death.

    Conclusion

    In the final phase of a childchr(chr('39')39chr('39'))s life, the caregiver will be surrounded by a series of negative and unpleasant emotions; on the one hand, they experience a heavy emotional burden, dealing with the childchr(chr('39')39chr('39'))s physical condition, and on the other hand, in challenging decision-making processes (20). A caregiver, or more specifically a parent/caregiver, in the final phase of a childchr(chr('39')39chr('39'))s life, experiences a variety of negative emotions. the caregiver will experience a strong sense of helplessness and inadequacy(26). Emotions followed by feelings of inability include extreme anger and frustration. As a caring parent, all caregivers strive to maintain hope and improve the childchr(chr('39')39chr('39'))s condition (27). The result of these unsuccessful efforts will be an experience of unpleasant feelings such as constant threat and encountering intense ambiguity, or in other words, uncontrollable and unpredictable stimuli that evoke a high volume of persistent anxiety (28).In the last days of the childchr(chr('39')39chr('39'))s presence in the hospital, the caregiverchr(chr('39')39chr('39'))s fatigue, frustration and feelings of the inability toward the existing condition make the situation extremely exhaustive for the caregiver. The burden of care will be much heavier when the patient is more likely to die. The burnout experience in caregivers can be described by the general adaptation syndrome introduced by Selye (29). Some parts of the surrender that caregivers reported, might be the result of the fatigue caused by constant anxiety.Caregivers pointed to the concept of loneliness in two dimensions; one is feeling lonely and the other is being alone, especially in caregiving tasks. Since the course of treatment in cancer patients will require full-time care, both caregiver and patient are deprived of normal social interactions and experience forced limitations in their relationships. Therefore, Social isolation is one of the consequences of such procedures. The other dimension is related to the deep feelings of loneliness and the lack of being understood by others. For that reason, a distinction must be made between being alone and feeling alone (31). Some researchers have described two components of loneliness, the first of which involves emotional loneliness due to a lack of intimacy or close emotional attachment, and the second is social loneliness (32). In the present study, caregivers complained about the experience of both dimensions of loneliness as well.Another theme that was extracted from the interviews was " encountering special events ". In this context, the sub-themes were about facing new and challenging situations that generally require using more cognitive abilities under the pressure of intensified and unpleasant emotions.caregivers find themselves in the middle of a variety of important and challenging decisions. One of the most difficult decisions to make is whether continuing the treatment or choosing a new type of therapy among the options; A treatment that could be the last hope before the child dies. Due to the ambiguity of the path ahead, one of the needs expressed by caregivers, in this case, is the urgent need for and informing the caregiver of all possible options and their consequences (20).The caregiverchr(chr('39')39chr('39'))s interaction with the child in the final phase is one of the most challenging ones. For the parent/caregiver in this period, communication with the dying child will activate two dimensions: The first is interacting with the child while waiting for the last day, and the second is maintaining the quality of the interaction.   Another sub-theme is the experience of recurrence throughout the treatment process. The parent/caregiver reports feelings of frustration, extreme sadness, inability, and loss of control over the situation. Parents as caregivers consider their responsibility to protect their child and the difference between their desire and the existing reality will lead to feelings of severe failure and guilt (35).Furthermore, owing to the high ambiguity of the situation in this phase, providing sufficient and honest information and helping caregivers to make the right decision in difficult situations, is one of the essential services that health professionals should provide to the caregiver. In conclusion, understanding the lived experience of this important group of caregivers will help specialists in cancer treatment teams to have sufficient knowledge for managing and supporting caregivers and provide higher quality services.

    Keywords: Caregiving, Childhood Cancer, End of life, Qualitative Study}
  • Elham Koohkan, Saeed Yousofian, Gholamreza Rajabi, Firoozeh Zare-Farashbandi
    INTRODUCTION

    Cancer is the second cause of mortality among children. The aim of this study is to identify the health information needs of families in childhood cancer as main source of support and care for these children.

    MATERIALS AND METHODS

    The qualitative content analysis approach was used in this study. The study population comprised parents of childhood cancer patients visiting Omid Hospital among which 35 were selected using purposive sampling until data saturation was achieved. The study tool was semi-structured interview.

    RESULTS

    A
    total of 9 main themes and 24 subthemes were identified. The main themes included: (1) information about cancer, (2) disease management and self-care, (3) communication and information interaction of medical team, (4) consultation services, (5) information sharing and exchange, (6) access to health services, (7) hospital's facilities and equipment, (8) access to social and financial support, and (9) access to health information sources.

    CONCLUSION

    Health information needs of families in Isfahan are consistent in information needs of families identified in other studies. Meeting this information needs through plans of health-care system can help these families in better control and treatment of their children's condition.

    Keywords: Childhood cancer, family, health information needs}
  • Aznida Mohammad Zaki, Muhammad Aklil Abd Rahim, Zuraidah Zaidun, Abdul Rahman Ramdzan*, Zaleha Md Isa
    Background

    A slight increase in the childhood cancer trend has been observed for the past few decades. Non-ionizing radiation is one of the environmental factors linked to childhood cancers. This review is conducted to assess the association between non-ionizing radiation and childhood cancer based on all original studies to date.

    Methods

    A systematic search was conducted on the titles and abstracts pertaining to non-ionizing radiation and childhood cancers using the PubMed, Scopus, SAGE and ScienceDirect databases from inception up to November 2018. Quality of each article was appraised using the Newcastle-Ottawa Scale, meta-analysis was performed with Review Manager, and fixed effects were used to estimate the pooled OR of the selected studies.

    Results

    A total of 15 articles met all the selection criteria. Twelve articles were included in the meta-analysis. Pooled risk estimates of the 12 studies, obtained via fixed effects model, showed that children exposed to 0.2 µT or more of EMF non-ionizing radiation run 1.33 times higher risks of contracting childhood cancer compared to those with less than 0.2 µT exposure (95% CI: 1.10, 1.60). The studies were statistically homogeneous (chi-squared P=0.71, I2=0%), and there was no evidence of publication bias.

    Conclusion

    It cannot be concluded that children exposed to non-ionizing radiation have higher risks of childhood cancer compared to those who were not exposed as claimed by the previous reviews. However, concerns about non-ionizing radiation exposure and childhood cancer should not be neglected.

    Keywords: Non-ionizing radiation, Childhood cancer, Electromagnetic fields, Meta-analysis}
  • وحید پاک پور*، لیلا شیخ نژاد، صدیقه سلیمی، آزاد رحمانی
    پیش زمینه و هدف

    سرطان در کودکان به عنوان یک بیماری تهدیدکننده حیات، پیامدهایی منفی بر بیماران و اعضای خانواده شان دارد. والدین کودکان مبتلا به سرطان، استرس روانی زیادی را تجربه می کنند که می تواند بسیاری از جنبه های سلامتی آنان را تحت تاثیر قرار می دهد. هدف از این مطالعه تعیین میزان افسردگی و خوش بینی در والدین کودکان مبتلا به سرطان و تعیین ارتباط بین این دو متغیر بود.

    مواد و روش کار

    مطالعه حاضر از نوع توصیفی- همبستگی است که با مشارکت 148 نفر از والدین کودکان مبتلا به سرطان مراجعه کننده به بیمارستان کودکان تبریز انجام گردید. نمونه این مطالعه به صورت نمونه در دسترس انتخاب گردید. برای تعیین سطح خوش بینی از "آزمون گرایش زندگی" و جهت تعیین میزان افسردگی آزمودنی ها "مقیاس اضطراب و افسردگی بیمارستان" استفاده شد. داده ها با استفاده از ویرایش 16 نرم افزار آماری SPSS مورد تجزیه وتحلیل و استنباط آماری قرار گرفت.

    یافته ها

    میانه و دامنه بین چارکی امتیاز خوش بینی (4IQR:) 16 و افسردگی (7IQR:) 8 بوده است. همچنین بین خوش بینی و افسردگی والدین کودکان مبتلا به سرطان همبستگی معکوس معنادار مشاهده شد (439/0- =r، 001/0>p).

    نتیجه گیری

    با توجه به میزان افسردگی در والدین کودکان مبتلا به سرطان، توجه بیشتر به عوامل موثر در آن ضروری است. همچنین نظر به ارتباط معنادار بین خوش بینی و افسردگی، آموزش راهکارهای تقویت خوش بینی در برنامه های مراقبتی توصیه می شود.

    کلید واژگان: خوش بینی, افسردگی, سرطان کودکان, والدین}
    Vahid Pakpour*, Leyla Sheikh Nejhad, Sedigheh Salimi, Azad Rahmani
    Background & Aims

    Childhood cancer as a life-threatening illness has negative consequences for both the patients and their family. Parents of children with cancer are experiencing high levels of psychological stress, and it affect many aspects of parents’ health. The aim of this study was to determine the depression and optimism among parents of children with cancer and relationship between these variables.

    Methods & Materials

     This is a descriptive‑correlational study on 148 parents of children with cancer admitted to a pediatric hospital affiliated to Tabriz University of Medical Sciences, Tabriz/Iran. Participants were selected using convenience sampling method.“Life Orientation Test-Revised” and depression section of ‘Hospital Anxiety and Depression Scale” were used to evaluate participants’ levels of optimism and depression. The data were analyzed using SPSS version 16.0.

    Results

    The mean rank for optimism and depression was 16 (IQR: 4) and 8 (IQR: 7) respectively. Also, there was a negative, significant correlation between parents optimism and depression (P<0.001, R=-0.439).

    Conclusion

    Considering the rate of depression in parents of children with cancer, more attention is needed to the factors affecting this. In addition, due to the significant relationship between optimism and depression, incorporating optimism-promoting strategies into caring planes is recommended.

    Keywords: Optimism, Depression, Childhood cancer, Parents}
  • عزیز اقبالی، حسن طاهراحمدی، شهلا ذبیح زاده، مرتضی موسوی حسن زاده*
    زمینه و هدف
    سرطان دومین علت مرگ ومیر کودکان زیر 14 سال محسوب می شود. هدف از این مطالعه بررسی اپیدمیولوژی و عوامل مستعدکننده سرطان های کودکان می باشد.
    مواد و روش ها
     در یک مطالعه ی مشاهده ای-توصیفی 82 کودک مراجعه کننده به بخش انکولوژی بیمارستان امیرکبیر شهر اراک بین سال های 1390 تا 1395 بررسی شدند. اطلاعات مربوط به سن، جنس، نوع بدخیمی و عوامل مستعدکننده به صورت مصاحبه حضوری و یا از پرونده بیماران استخراج و در چک لیست وارد شده و مورد تجزیه و تحلیل آماری قرار گرفت.
    ملاحظات اخلاقی
     این مطالعه با کد اخلاق IR.ARAKMU.REC.2.46.87 به تصویب کمیته اخلاق پژوهشی دانشگاه علوم پزشکی اراک رسیده است.
    یافته ها
     1/56 درصد بیماران در دامنه سنی صفر تا 5 سال، 1/74 درصد ساکن شهر و 2/90 درصد آن ها زنده، 99 درصد تک قلو، 7/92 درصد ترم، 3/46 درصد آنان فرزند اول و 9/87 درصد وزن هنگام تولد بیش از 2500 داشتند. رابطه معنی داری بین روش زایمان و مشکلات زایمانی، جنس بیماران و عوامل محیطی (هم چون مصرف مواد کنسروشده، سوسیس و کالباس، استفاده از حشره کش ها، مصرف دارو هنگام بارداری و میزان ابتلا به بیماری های عفونی) با ابتلا به سرطان وجود نداشت، اما بین افزایش سن پدر و مادر و بالا بودن سطح اقتصادی-اجتماعی با ریسک ابتلا به سرطان ارتباط مستقیم دیده شد.
    نتیجه گیری
     ریسک ابتلا به سرطان های اطفال در استان مرکزی بیشتر در ارتباط با عوامل ژنتیکی می باشد و عوامل محیطی ایجادکننده سرطان های اطفال در این مطالعه کمتر دخیل است.
    کلید واژگان: ریسک فاکتور, سرطان کودکان, محیط}
    Aziz Eghbali, Hasan Taher Ahmadi, Shahla Zabihzadeh, Morteza Mousavi Hasanzadeh*
    Background and Aim
    Cancer is the second cause of death in children under fourteen years old. The aim of this study was to determine the epidemiology and predisposing factors of childhood cancers.
    Materials and Methods
    This observational-descriptive study was performed on 82 children in the oncology department of Amir-kabir Hospital in Arak who were referred between 2011 and 2016. Data on age, sex, type of malignancy and predisposing factors were carried out by person interviews or patient records and were registered in checklist and analyzed.
    Ethical Considerations
     This study with research ethics code IR.ARAKMU.REC.2.46.87 has been approved by research ethics committee at Arak University of Medical Sciences.
    Findings
    The results showed that 56.1 percentage of patients were aged 0-5 years, 74.1 percentage were urban, 90.2 percentage were alive, 99 percentage were singleton, 92.7 percentage full term, 46.3 percentage of them were the first children and 87.9% of them had birth weight over 2500 g. There was no significant relationship between the delivery method and delivery problems, the sex of the patients, the environmental factors (such as consuming canned food, sausages, insecticide use, drug use during pregnancy and the rate of infectious diseases), However, there was a direct relationship between the increased age of parents and the high socioeconomic level with the risk of cancer.
    Conclusion
    The risk of childhood cancers in Markazi province is more related to genetic factors and the environmental factors causing cancers in children are less involved in this study.
    Keywords: Childhood cancer, Environment, Risk factor}
  • Soheil Hassanipour, Mohammad Fathalipour, Hamed Delam, Mohammad Ghorbani, Elham Abdzadeh, Morteza Arab, Zozani, Shirin Riahi, Hamid Salehiniya*
    Background
    Childhood cancer (ChC) is very rare and occurs between birth and 14 years of age. There are several reports about ChC incidence from various regions of Iran, but with conflicting results.  The present study aimed to do a systematic review to estimate the accurate incidence rate of ChC among Iranian people.
    Materials and Methods
    This systematic review was performed based on the preferred reporting items for systematic reviews and meta-analyses (PRISMA) checklist in 2018. A literature search was conducted using international databases (Medline/PubMed, Scopus, ISI/Web of Knowledge, and Google Scholar) for English papers, and national databases (Scientific Information Database, MagIran, IranMedex, and IranDoc) for Persian papers which estimated the incidence rate of ChC in any geographical location in  Iran. The incidence rate of ChC was calculated using random-effect model.
    Results
    Out of 157 papers in the primary searches, 12 studies were included by advanced screening and refinement. The crude incidence rate (CIR) of ChC in 0-14 years was 16.8 per 100,000 (95% CI: 9.04-24.56) for boys and 16.56 per 100,000 (95% CI: 10.51-22.62) for girls.
    Conclusion
    The incidence of ChC in Iran is higher compared to other parts of the world. Considering this issue, holding some interventional programs on tackling potential risk factors, including air pollution, in different regions of Iran is suggested.
    Keywords: Childhood cancer, Incidence, Iran}
  • Gulsan Yavuz, Emel Unal, Nurdan Tacyildiz, S.Kenan Kose, Hafize Gokce, Zulfukar Gordu, Esra Pekpak, Basak Aksoy, Eda Ilarslan, Fatih Gunay, Handan Dincaslan
    Background
    Studies on various adult cancer types showed that there are changes in levels of protein types that are related to iron metabolism. In our study, proteins related to iron metabolism are examined for the first time in childhood malignancies and results are presented.
    Methods
    Between January 2013 and December 2014, 58 patients 17 healthy children were included in the study. Blood samples were taken from patients at diagnosis and in remission and serum ferritin heavy chain (FTH-1), ferritin light chain (FTL), LCN-2, soluble transferrin receptor (sTFR), transferrin receptor-2 (TFR-2), hepcidin and ferroportin levels were examined using ELISA method.
    Results
    Levels of FTH-1 were found higher in all patient groups than in control group (P
    Keywords: Iron Metabolism, Childhood Cancer}
  • Ahmad Mohammadi, Afsoon Hassani Mehraban*, Shahla Ansari Damavandi, Mehdi Alizadeh Zarei, Malek Amini
    Background
    Participation in daily life activities is an essential aspect of health, which can facilitate a child’s development. Children with cancer are at risk of functional limitations and participation restrictions. The present study aims to investigate participation of children with cancer in daily life activities compared to healthy peers.
    Methods
    This was a comparative cross-sectional study. In the first phase, we assessed the test-retest reliability of the Iranian Children Participation Assessment Scale in 30 children (6-12 years of age) diagnosed with cancer and their parents (child and parent versions). The second phase of the study included a comparison of daily life activities as measured by the Iranian Children Participation Assessment Scale between the children with cancer (diagnosed at least 4 months prior and currently receiving active treatment) and their age- and gender-matched healthy peers.
    Results
    The child version had excellent reliability according to Cronbach’s alpha in diversity of activities (0.97), intensity of participation (0.95), with whom they participated (0.95), and enjoyment of daily activities (0.94). The parent version had excellent reliability (Cronbach’s alpha) as follows: 0.99 for diversity, 0.97 for intensity, 0.97 for with whom, 0.98 for enjoyment, and 0.98 for parents’ satisfaction. The coefficients of agreement were 0.77 (total scores of diversity), 0.63 (intensity), 0.60 (with whom), and 0.91 (enjoyment). The child version indicated that children with cancer had significantly lower scores in daily life activities items of diversity (P=0.000), intensity (P=0.000), with whom (P=0.000), and enjoyment (P=0.000) compared to healthy children. Based on the total scores in the parent version, children with cancer showed significantly lower scores in diversity (P=0.001), intensity (P=0.000), with whom (P=0.001), enjoyment (P=0.002), and satisfaction (P=0.000) compared to the healthy group.
    Conclusion
    The findings of the present study show that cancer diagnosis and treatment can restrict children’s participation in daily life activities. Early planning and intervention to facilitate participation in these activities can minimize negative consequences and may mitigate or prevent adverse long-term functional effects of childhood cancer.
    Keywords: Childhood cancer, Participation, Daily life activities, ICPAS}
  • Arya Emami, Zahra Sepehri, Joseph W. Gordon, Saeid Ghavami *
    Rhabdomyosarcoma (RMS) is a muscle-derived tumor and is the most common pediatric soft tissue sarcoma representing 5% of all childhood cancers. Statistically, soft tissue sarcomas account for approximately 10% of all cancers in children, of which more than half of these tumors are RMS. Thus, RMS is a major clinical problem in pediatric oncology. RMS is caused by a disruption in the pathway of primitive mesenchymal stem cells directed towards myogenesis. In most cases of patients diagnosed with RMS there is a genetic or chromosomal alteration involved. In past few years there have been discoveries of more therapeutic approaches that has improved the quality of life in RMS patients and has resulted in a better survival rate in this population from 25% to 60%. However, Additional researches and clinical trials are needed in order to minimize the devastating consequences of the pediatric cancer including RMS. In the current mini review we will briefly discuss current knowledge in RMS focusing on most common biological and clinical aspects of the disease.
    Keywords: Rhabdomyosarcoma, Childhood cancer, Cancer therapy}
  • Salman Khazaei, Erfan Ayubi, Mokhtar Soheylizad, Kamyar Manosri
    Background
    Geographic differences in the incidence of cancers may suggest unique genetic or environmental exposures that impact the risk of acquiring cancer. This research aims to determine the incidence rate and geographical distribution of common cancers among Iranian children.
    Methods
    In this ecological study, we extracted data that pertained to the incidence rate of common cancers among children from reports by the National Registry of Cancer and Disease Control and Prevention in 2008. A map of the cancer incidence rates was designed by using geographic information system.
    Results
    The most common cancer sites among children were the hematology system, brain and central nervous system, and lymph nodes. The central provinces had the lowest cancer incidences.
    Conclusion
    The considerable variation in incidence of childhood cancers in Iran suggests a possible potential environmental risk factor or genetic background related to this increased risk among children.
    Keywords: Childhood cancer, Epidemiology, Incidence}
  • ربابه قرقره چی* باسعلی حسین پورفیضی
    زمینه و اهداف
    تقریبا 50-20 درصد کودکان نجات یافته از بدخیمی حداقل به یک اختلالات اندوکرین در طول زندگی مبتلا خواهند شد. هدف این مطالعه بررسی شیوع عوارض اندوکرین ناشی از خود بیماری یا عوارض درمان در نجات یافتگان از بدخیمی می باشد.
    مواد و روش ها
    در این مطالعه مقطعی تحلیلی 72 بیمار 18-2 ساله نجات یافته از بدخیمی، در درمانگاه فوق تخصصی انکولوژی بیمارستان کودکان تبریز از شهریور ماه سال 80 لغایت اسفند 91 مورد ارزیابی قرار گرفتند. سن، جنس، نوع و محل بدخیمی و داروهای مورد استفاده ثبت شدند. بعد از معاینه بالینی، نمونه خون برای اندازه گیری قند خون ناشتا، کلسیم، فسفر، تست های عملکرد تیروئید و گنادها به آزمایشگاه رفرانس ارسال شد.
    یافته ها
    میانگین سنی بیماران و سن ابتلا به بدخیمی به ترتیب 3/39 ± 11/43و 1/34±3/2 سال بود. 77/8% مذکر و 22/2% مونث بودند. شایع ترین بدخیمی لوکمی لنفوبلاستیک حاد(55/5%) بود. 88/9% مبتلایان وین کریستین دریافت کرده بودند. 27/7 درصد نجات یافته گان از بدخیمی حداقل یک اختلال اندوکرینی را داشتند. گلوکز ناشتای مختل، اختلال عملکرد تیروئید و اختلال گنادی به ترتیب 16/7، 8/3 و 2/7 در صد بود.
    نتیجه گیری
    کودکان نجات یافته از بدخیمی در معرض خطر بالای اختلالات اندوکرین، به خصوص ااختلال متابولیسم گلوکز، عملکرد تیروئید و گنادها هستند. با تشخیص و درمان این اختلالات در افراد آسیب پذیر می توان مرگ و میر را کاهش داده و کیفیت زندگی انها را بهبود بخشید.
    کلید واژگان: بدخیمی کودکان, عوارض اندوکرین, نجات یافته}
    Robabeh Ghergherehchi*, Abasali Hoseinpour Feizi
    Background And Objectives
    Approximately 20-50% of childhood cancer survivors will develop at least one endocrine disorder in their life time. The purpose of this study was to evaluate endocrine disorders caused by the disease or complications of treatment among cancer survivors.
    Material And Methods
    This cross sectional study was conducted on 72 survivors of childhood cancer patients with the age of 2-18 years, who were followed up in Pediatric Oncology Clinic of Tabriz children's hospital from September 2001 to March 2012. Age, gender, type and site of malignancy and prescribed medications were recorded. After clinical examination, Blood samples were taken and sent to the reference laboratory to measure serum levels of fasting blood sugar, calcium, phosphorus, thyroid and gonadal function tests.
    Results
    The mean age of patients at their diagnosis time and after treatment were 11.43±3.39 and 3.2 ± 1.34 years, respectively. 77.8% were male and 22.2% female. Acute lymphoblastic leukemia was the most common malignancy (55.5%). 88.9% of patients had received vincristine. 27.7% of survivors had at least one endocrine complication. Impaired fasting glucose, hypothyroidism, hypogonadism were 16.7%, 8.3% and 2.7%, respectively.
    Conclusion
    Survivors of childhood malignancy are at risk of endocrine complications, especially impaired glucose metabolism, thyroid and gonadal dysfunction. The diagnosis and treatment of these disorders in vulnerable individuals can reduce mortality and improve their quality of life.
    Keywords: Childhood cancer, Survivor, Endocrine Complications}
  • Shahla Ansari, Saeed Yousefian, Ghasem Miri, Aliabad, Tayeb Ramim
    Rhabdomyosarcomas are the most common soft tissue sarcoma in adult and children that accompany with skeletal muscle differentiation. Skin metastasis of rhabdomyosarcomas is unusual and has only been sporadically reported in literature. In this paper we present a case of skin metastasis of rhabdomyosarcoma in an 8-year-old girl that has treated with chemotherapy.
    Keywords: Chemotherapy, Rhabdomyosarcoma, Skin metastasis, Childhood cancer, Diagnosis}
  • حسین قمری کیوی*، افشین فتحی، لاله صنوبر
    هدف
    خشم و پرخاشگری از عوارض بیماری های مزمن، ازجمله سرطان، در کودکان بیمار به شمار می آید. هدف از این مطالعه بررسی اثربخشی تلفیق دو فن تصویرسازی ذهنی و ماساژدرمانی بر میزان خشم کودکان مبتلا به سرطان است.
    روش بررسی
    این مطالعه مداخله ای از نوع کارآزمایی بالینی بود و در کلینیک تخصصی ساختمان ارم وابسته به بیمارستان بوعلی اردبیل انجام شده است. تعداد 30 کودک مبتلا به سرطان خون و لنفوم با استفاده از روش نمونه گیری دردسترس انتخاب شدند و به طور تصادفی، در دو گروه 15نفری آزمایش و کنترل قرار گرفتند. برای گردآوری اطلاعات، از مقیاس ابراز خشم استیل و همکاران در دو مرحله قبل از کاربست تجربی و بعد از آن، استفاده شد. پس از ارائه آموزش های لازم به گروه آزمایش، درمانگر روش درمانی را بر هریک از بیماران گروه آزمایش به مدت سه هفته و در شش جلسه، یعنی هفته ای دو جلسه 20دقیقه ای اعمال کرد. برای تجزیه وتحلیل داده ها، از روش آماری تحلیل پراکنش چندمتغیره استفاده شد.
    یافته ها
    نتایج نشان داد که در گروه آزمایش، ازنظر میزان متغیرهای صفت خشم، ابراز خشم، خشم درونی و کنترل خشم در قبل و بعد از مداخله، تفاوت آماری معناداری دیده می شود (0٫001>P و 0٫05>P)؛ به این معنی که در گروه آزمایش، میزان صفت خشم، ابراز خشم و خشم درونی کاهش و میزان کنترل خشم افزایش یافته بود؛ اما در گروه کنترل، میزان متغیرهای صفت خشم، ابراز خشم، خشم درونی و کنترل خشم در قبل و بعد از مداخله، تفاوت آماری معناداری وجود نداشت.
    نتیجه گیری
    ترکیب دو روش ماساژدرمانی و تصویرسازی ذهنی در جریان درمان کودکان مبتلا به سرطان می تواند موجب کاهش تمایل به پرخاشگری و احساس خشم شود. بنابراین، به منظور کاستن از عوارض روان شناختی سرطان و درمان های مختلف آن، آموزش این دو روش به مسئولان درمان توصیه می شود و استفاده از آن ها می تواند موثر واقع شود.
    کلید واژگان: تصویرسازی ذهنی, خشم, سرطان کودکی, ماساژدرمانی}
    Hosein Ghamarigivi, Afshin Fathi, Laleh Senobar
    Objective
    anger and aggressive are effects of chronic illnesses such as childhood cancer. The aim of the present study is investigation of the efficacy of the combination of mental imagination and massage therapy on anger in children with cancer.
    Materials and Methods
    the research method of the study was clinical trial and was done in Eram clinic of Ardabil’s boali hospital. Thirty children with blood and lymph cancer were selected by accessible method and were plague into two groups as experimental group (15 children) and control group (15 children). For data gathering, Steels anger expression scale were used in pretest and posttest phases. Therapist thought the subjects of the experimental group and used two techniques individually with children, during three weeks (six sessions with two times per week) about 20 minutes in one session. For data analysis was used multiply analysis of variance.
    Results
    Findings showed that there is significant difference in anger trait, anger expression, inner anger and anger control in experimental group in pretest and posttest phases (p<0.001,p<0.05). In experimental group, anger trait, anger expression and inner anger had been decreased and anger control was increased, but there was no significant difference in this variable in control group.
    Conclusion
    the combination of two techniques of massage therapy and mental imagination decreases the aggression and anger emotion during in treatment of children with cancer. Thus education and application of these techniques are effective in reduction of the psychological effects of the cancer and its side effects of treatments.
    Keywords: Mental imagination, Massage therapy, Angry, Childhood cancer}
  • نثا زابلی نژاد، سعادت میرصدرایی، مهران هیرادفر، زهرا بدیعی، امیر مریخی اردبیلی
    زمینه و هدف
    تومورهای کلیه حدود 7درصد از تومورهای بدخیم کودکان را شامل می شود و کاملا از انواع آن در بالغین متفاوت است. هدف این مطالعه بررسی ویژگی های بالینی و آسیب شناسی تومورهای بدخیم کودکان در بیمارستان کودکان دکترشیخ و امام رضا (ع) مشهد طی سال های 85-1370 بود.
    روش بررسی
    در این مطالعه توصیفی 52 کودک شامل 27 پسر و 25 دختر با تشخیص تومور کلیه در مراکز پاتولوژی بیمارستان های کودکان دکتر شیخ و امام رضا (ع) مشهد طی سال های 85-1370 مورد بررسی قرار گرفتند.
    یافته ها
    ابتلا کلیه هر طرف در 24 نفر (3/45درصد) و دوطرفه در 5 مورد (4/9درصد) مشاهده شد. توده شکمی شایع ترین شکایت و نشانه بالینی بود. ناهنجاری های مادرزادی در 6 بیمار (6/14درصد) مشاهده گردید. در بررسی هیستوپاتولوژیک 46 مورد (8/86درصد) تومور ویلمز، 2 مورد (8/3درصد) نفروبلاستوم کیستیک با تمایز نسبی، 2 مورد (8/3درصد) نفروم مزوبلاستیک، 1مورد (9/1درصد) تومور رابدوئید کلیه، 1مورد (9/1درصد) آدنوم متانفریک با کارسینوم توبولوپاپیلری گرید پائین و 1مورد سارکوم با سلول روشن کلیه (9/1درصد) داشتند. در هنگام مراجعه 11 مورد (8/20درصد) در مرحله یک، 16 مورد (2/30درصد) در مرحله دو، 13 مورد (5/24درصد) در مرحله سه، 8 مورد (1/15درصد) در مرحله چهار و 5 مورد (4/9درصد) در مرحله پنج بودند.
    نتیجه گیری
    اگرچه تومور ویلمز شایع ترین تومور کلیه در دوران کودکی است، اما موارد اخیر توصیف شده ای نظیر تومورهای متانفریک و کارسینوم های کلیه کودکان نیز می بایست در بررسی هیستوپاتولوژیک مدنظر قرار گیرند. نقش روش های مولکولی و سیتوژنتیک برای تقسیم بندی و درمان تومورهای کلیه کودکان رو به افزایش می باشد.
    کلید واژگان: تومورهای کلیه کودکان, کلیه, تومورهای کودکان}
    Zabolinejad N., Mirsadraee S., Hiradfar M., Badiee Z., Merikhi Ardabili A.
    Background and Objective
    Pediatric renal tumors represent approximately 7% of all childhood cancers and are completely different from those occurring in adults. The aim of this study was to make an analysis of clinical and pathological characteristics of these tumors.
    Materials and Methods
    In this descriptive study all of the pediatric patients diagnosed as having renal neoplasm in departments of pathology of Dr Sheikh children hospital and Imam Reza hospital from 1991-2006 were evaluated.
    Results
    52 patients including 27 boys and 25 girls with mean age of 40.63 months were studied. Tumors involved each kidney in 24 (45.3%) and were bilateral in 5 (9.4%) patients. Abdominal mass was the commonest clinical symptom and sign. Congenital anomalies were presented in 6 (14.6%) patients. Histopathological examination showed Wilms tumor in 46 (86.8%), cystic partially differentiated nephroblastoma in 2 (3.8%), mesoblastic nephroma in 2 (3.8%) rhabdoid tumor of the kidney in 1 (1.9%), metanephric adenofiroma and low-grade tubulopapillary carcinoma in 1 (1.9%) and clear cell sarcoma of the kidney in 1 (1.9%) patient. 11 (20.8%) cases were in stage I, 16 (30.2%) stage II, 13 (24.5%) stage III, 8 (15.1%) stage IV and 5 (9.4%) stage V.
    Conclusion
    Although Wilms tumor is the commonest renal neoplasm in childhood there are also recently described entities such as metanephirc tumors and juvenile renal carcinoma that must be considered in histopathological evaluation of a pediatric renal neoplasm. Role of molecular and cytogenetic methods is increasing for classification and treatment of childhood renal neoplasms.
    Keywords: Pediatric renal tumors, Kidney, Childhood cancer}
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