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Premature Cessation (premature + cessation)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

Premature cessation of breastfeeding in infants: development and evaluation of a predictive model in two Argentinian cohorts: the CLACYD study,, 1993,1999

ACTA PAEDIATRICA, Issue 5 2001
S Berra
The objective of this study was to develop a model to predict premature cessation of breastfeeding of newborns, in order to detect at-risk groups that would benefit from special assistance programmes. The model was constructed using 700 children with a birthweight of 2000 g or more, in 2 representative cohorts in 1993 and 1995 (CLACYD I sample) in Córdoba, Argentina. Data were analysed from 632 of the cases. Mothers were selected during hospital admittance for childbirth and interviewed in their homes at 1 mo and 6 mo. To evaluate the model, an additional sample with similar characteristics was drawn during 1998 (CLACYD II sample). A questionnaire was administered to 347 mothers during the first 24,48 h after birth and a follow-up was completed at 6 mo, with weaning information on 291 cases. Premature cessation of breastfeeding was considered when it occurred prior to 6 mo. A logistic regression model was fitted to predict premature end of breastfeeding, and was applied to the CLACYD II sample. The calibration (Hosmer-Lemeshow C statistic) and the discrimination [area under the receiver operating characteristics (ROC) curve] of the model were evaluated. The predictive factors of premature end of breastfeeding were: mother breastfed for less than 6 mo [odds ratio (OR) = 1.84,95% confidence interval (CI) 1.26,2.70], breastfeeding of previous child for less than 6 mo (OR = 4.01, 95% CI 2.58,6.20), the condition of the firstborn child (OR = 2.75, 95% CI 1.79,4.21), the first mother-child contact occurring after 90min of life (OR =1.88; 95% CI 1.22,2.91) and having an unplanned pregnancy (OR = 1.50, 95% CI 1.05,2.15). The calibration of the model was acceptable in the CLACYD I sample (p= 0.54), as well as in the CLACYD II sample (p= 0.18). The areas under the ROC curve were 0.72 and 0.68, respectively. Conclusion: A model has been suggested that provides some insight onto background factors for the premature end of breastfeeding. Although some limitations prevent its general use at a population level, it may be a useful tool in the identification of women with a high probability of early weaning. [source]

Oxford experience with neoadjuvant chemotherapy and surgical resection for esophageal adenocarcinomas and squamous cell tumors

DISEASES OF THE ESOPHAGUS, Issue 3 2008
P. M. Safranek
SUMMARY., The Medical Research Council trial for oesophageal cancer (OEO2) trial demonstrated a clear survival benefit from neoadjuvant chemotherapy in resectable esophageal carcinoma. Since February 2000 it has been our practice to offer this chemotherapy regime to patients with T2 and T3 or T1N1 tumors. We analyzed prospectively collected data of patients who received neoadjuvant chemotherapy prior to esophageal resection under the care of a single surgeon. Complications of treatment and overall outcomes were evaluated. A total of 194 patients had cisplatin and 5-fluorouracil prior to esophageal resection. Six patients (5.7%) had progressive disease and were inoperable (discovered in four at surgery). During chemotherapy one patient died and one perforated (operated immediately). Complications including severe neutropenia, coronary artery spasm, renal impairment and pulmonary edema led to the premature cessation of chemotherapy in 12 patients (6.2%). A total of 182 patients with a median age of 63 (range 30,80), 41 squamous and 141 adenocarcinomas underwent surgery. Operations were 91 left thoracoabdominal (50%), 45 radical transhiatal (25%), 40 Ivor-Lewis (22%) and six stage three (3%), and 78.6% had microscopically complete (R0) resections. Median survival was 28 months with 77.3% surviving for 1 year and 57.7% for 2 year. In hospital mortality was 5.5% and anastomotic leak rate 7.7%. A radical surgical approach to the primary tumor in combination with OEO2 neoadjuvant chemotherapy has led to a high R0 resection rate and good survival with acceptable morbidity and mortality. [source]

Efficacy and safety of linezolid in immunocompromised children with cancer

PEDIATRICS INTERNATIONAL, Issue 5 2010
Maria Moschovi
Abstract Background:, The aim of this study was to determine the safety, tolerance and efficacy of linezolid for the treatment of infections from Gram-positive bacteria in immunocompromised children with cancer. Methods:, This was a prospective non-comparative unblinded study in the Hematology/Oncology Unit over a two-year period, administering linezolid as monotherapy in children with cancer. Results:, Seventeen children received linezolid (30 mg/kgr: 3 i.v. per day). Mean duration of linezolid administration was 12.2 days (range, 6,38 days), while the median age of the evaluable patients was 2.2 years (range, 6 months,11.2 years). Primary diagnosis was acute lymphoblastic leukemia (nine patients), brain tumor (three patients), multi-organ Langerhans cell histiocytosis (two patients), rhabdomyosarcoma, Burkitt's lymphoma and ovarian tumor (one patient each). All patients were in the midst of chemotherapy cycles. Ten out of 17 children had positive blood cultures (methicillin-resistant Staphylococcus aureus, four patients; vancomycin-resistant Enterococcus, three patients; penicillin-resistant Streptococcus pneumoniae, three patients), while seven of the 17 had fever and vancomycin-resistant Enterococcus in stool cultures. All patients were considered clinically cured after the end of the linezolid regimen (100% efficacy). The main adverse events were thrombocytopenia grade 1,3 and anemia grade 2,3 (four and two patients, respectively). Chemotherapy-induced myelotoxicity (six patients) was not worsened during linezolid therapy. No bleeding episodes were presented. Self-limited diarrhea grade 1,2 was presented in four patients (mean duration 2 days). The total adverse event rate was 23.5%; however, there was no premature cessation of linezolid in any patient. Conclusions:, Linezolid may be another effective and safe therapy to treat infections from resistant Gram-positive bacteria in immunocompromised children, even in young ages. [source]