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Janson, Christopher M. "Marriage and Divorce in Survivors of Childhood Cancer: A Report from the Childhood Cancer Survivor Study." Yale University, 2008. http://ymtdl.med.yale.edu/theses/available/etd-08092007-145913/.
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In this report from the Childhood Cancer Survivor Study (CCSS), we described marriage and divorce rates in survivors of childhood cancer, as compared to a sibling control group and the general U.S. population. We also sought to identify patient and treatment characteristics that were associated with survivor marital status. This study included 8,930 five-year survivors of childhood malignancy and 2,855 sibling controls participating in the CCSS. Data on marital status, sociodemographic factors, and current health status were obtained from questionnaires; detailed disease and treatment histories were available from medical records. Marital status of the U.S. population was obtained from the 2002 Current Population Survey of the U.S. Census. We found that survivors were more likely to have never married than both sibling (odds ratio [OR] = 1.79; 95 % CI = 1.65-1.94; p < 0.0001) and population controls (OR = 2.29; 95 % CI = 2.19-2.38; p < 0.0001), with persistence of trends across age and gender strata. Once married, survivors divorced at rates equivalent to controls. In adjusted analysis, we found that several survivor characteristics predicted never-married status, including treatment involving cranial radiation (OR = 2.41; p < 0.0001), CNS tumor diagnosis (OR = 2.05; p < 0.0001), history of growth hormone deficiency (OR = 2.02; p < 0.0001), and unemployment secondary to disability (OR = 1.78; p = 0.0001). Survivor characteristics predictive of divorce included unemployment (OR = 1.91; p < 0.0001, for unemployed or disabled), lower educational achievement (OR = 1.74; p < 0.0001, for non-college graduates), and psychological distress (OR = 1.60; p < 0.0001). This study confirms prior reports of lower marriage rates in survivors of childhood cancer, providing further evidence that this population struggles with psychosocial adjustment to adult life.
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Sköldenberg, Erik. "Angiogenesis in childhood malignancies /." Uppsala : Institutionen för kirurgiska vetenskaper, Uppsala universitet, 2003. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-3481.
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Wilson, Carmen Louise Children's Cancer Institute Australia for Medical Research UNSW. "The late effects of therapy in an Australian cohort of childhood cancer survivors." Awarded By:University of New South Wales. Children's Cancer Institute Australia for Medical Research, 2008. http://handle.unsw.edu.au/1959.4/43794.
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In Australia, up to 80% of individuals diagnosed with childhood cancer are now expected to survive for more than five years after their initial diagnosis. However, survivors of childhood cancer are at risk of developing late sequelae as a consequence of therapies received during childhood. The aim of this study was to determine the incidence of selected late sequelae in a cohort of Australian childhood cancer survivors and identify treatment and genetic factors that may modify the risk of late sequelae in survivors. Our study included 1150 individuals treated for childhood cancer at the Sydney Children??s Hospital between 1962 and 1999, who had remained in remission >3 years and were confirmed to be alive. Rates of mortality and second cancers among survivors were compared against population rates to determine standardised mortality and incidence ratios. Survivors completed a questionnaire on the incidence of adverse health conditions and provided a buccal specimen. Real time PCR was used to detect polymorphisms in genes involved in drug detoxification and transport. Rates of mortality and secondary cancers were found to be 7.5-fold (95%CI 5.4-10.1) and 4.9-fold (95%CI 2.9-8.0) higher among survivors of childhood cancer relative to the general population, respectively, with the highest risks observed for those survivors previously treated for Hodgkin??s disease. Over 60% of survivors reported at least one cardiopulmonary, endocrine or sensory-motor condition following diagnosis of childhood cancer; the most frequently observed conditions included growth hormone deficiency, hypothyroidism, and hypertension. Late sequelae were most frequently reported by females and survivors of brain tumours. Genetic investigations showed that an increased risk of growth hormone deficiency was associated with homozygosity for the GSTM1 null polymorphism, while no gene associations were observed to influence the risk of second cancers among survivors. Our study demonstrates that survivors of childhood cancer are at risk of developing a variety of health conditions as a result of anti-cancer therapies received during childhood. Determining risk factors for late sequelae based on therapy type, lifestyle and genetic predisposition will enable the optimisation of treatment protocols and promote the future well-being of childhood cancer survivors.
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Dunwell, Thomas Lawson. "Epigenetic analysis of childhood leukaemia and the Hippo pathway." Thesis, University of Birmingham, 2010. http://etheses.bham.ac.uk//id/eprint/991/.
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Hypermethylation of CpG islands is one of the many processes that a developing cancer cell may use for the inactivation of tumour suppressor genes. The Sav/Hippo/Warts pathway was originally identified in Drosophila and shown to be responsible for controlling both growth and apoptosis, implying this is a tumour suppressor pathway. This pathway is both evolutionarily and functionally conserved in mammals. Work presented here shows that apart from FAT1 and YAP other pathway members are not epigenetically silenced in common epithelial or haematological cancers. FAT1 and YAP were frequently methylated in childhood acute lymphoblastic leukaemia (ALL) but unmethylated in epithelial cancers. Childhood ALL is a blood cancer with peak prevalence between the ages of 3-5 years. The epigenetics of this cancer were examined with three separate approaches; the first, a candidate gene approach, second a NotI restriction enzyme based array examining the methylation of genes residing on chromosome 3, and thirdly the methylated-CpG island recovery assay (MIRA) combined with CpG island arrays examining methylation on a genome-wide scale. These approaches identified a large number of novel genes which were frequently methylated in ALL. Many of the identified genes were new methylation targets and were shown to be likely targets for methylation in both common epithelial and haematological cancers. A series of these genes was seen to be specifically methylated in different leukaemia sub types, and to cluster T-ALL and B-ALL samples into high and low methylation clusters. When examined in chronic lymphoblastic leukaemia (CLL) methylation of two of the above genes was associated with disease progression and methylation of another gene was associated with response to clinical treatment.
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Dreifaldt, Ann Charlotte. "Epidemiological aspects on malignant diseases in childhood /." Örebro : Örebro University : Universitetsbiblioteket, 2006. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-585.
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Gill, Simrandip Kaur. "Single voxel proton magnetic resonance spectroscopy of childhood brain tumours." Thesis, University of Birmingham, 2014. http://etheses.bham.ac.uk//id/eprint/4899/.
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Conventional magnetic resonance imaging (MRI) is essential for the management of childhood brain tumours. However, it is increasingly being supplemented with functional techniques such as magnetic resonance spectroscopy (MRS). This thesis investigates how pre-treatment single voxel MRS can aid in diagnosis and surveillance of paediatric brain tumours and identify prognostic biomarkers. Data from multiple centres, scanners from three leading manufacturers and field strengths of 1.5 T and 3 T are incorporated. MRS was analysed using TARQUIN software with metabolite peaks fitted using a simulated basis set to provide metabolite concentrations. Univariate and multivariate statistical tests were used to compare variables. Multi-scanner spectroscopy detected significant differences in common and rare paediatric brain tumours. Diagnostic metabolite profiles were able to confirm tumour on follow-up imaging. Elevated creatine and total choline determined good prognosis in medulloblastoma. Myo-inositol and citrate aided in the characterisation of diffuse pontine gliomas (DIPG). While conventional MRI was unable to identify prognostic markers for DIPG, elevated taurine was found to be significantly associated with a better prognosis. The results encourage the use of MRS as an adjunct to conventional MRI in routine clinical practice. For future studies, accurate assignment of biomarkers will be determined in tumour tissue using in vitro high-resolution spectroscopy methods.
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Guha, Joyeeta. "Risks of adverse health and social outcomes among childhood cancer survivors." Thesis, University of Birmingham, 2016. http://etheses.bham.ac.uk//id/eprint/6612/.
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As a result of improvement in survival after childhood cancer, there are now increasing numbers of long-term survivors of childhood cancer living in the United Kingdom and across Europe. Specific groups of these childhood cancer survivors experience substantial excess risks of adverse health and social outcomes. Using the population-based British Childhood Cancer Survivor Study (BCCSS) the following areas were investigated: (I) The proportion of survivors on regular long-term hospital follow-up using risk stratification levels of care developed by the BCCSS in partnership with the National Cancer Survivorship Initiative. (2) The risks of adverse health and social outcomes using record-linkage and a self-reported questionnaire to assess which survivors of central nervous system tumours were at excess risk compared to the general population. (3) The risk of hospitalisation due to cerebrovascular conditions among childhood cancer survivors by electronic record linkage with Hospital Episode Statistics. Using the European PanCareSurFup cohort, the excess risks of genitourinary subsequent primary neoplasms were investigated among five-year survivors of childhood cancer. This thesis quantifies the risks experienced by childhood cancer survivors in four areas and provides an evidence-base for risk stratification by healthcare professionals caring for survivors.
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Wong, Kwok Fai. "Epidemiological analysis of survivorship after childhood cancer." Thesis, University of Birmingham, 2016. http://etheses.bham.ac.uk//id/eprint/6629/.
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This thesis investigates the adverse outcomes amongst survivors of childhood cancer using the British Childhood Cancer Survivor Study (BCCSS) and the Pancare Childhood and Adolescent Cancer Survivor Care and Follow-up studies (PCSF). The specific aims were to investigate (1) adverse outcomes up to 50 years of follow-up in survivors of Wilms’ tumour; (2) risks of hospitalisations due to renal morbidities in childhood cancer survivors; (3) risk of subsequent primary neoplasms arising in the digestive system in survivors of childhood cancer; and (4) adverse outcomes beyond 50 years of follow-up in survivors of heritable retinoblastoma. This thesis demonstrated that survivors of Wilms’ tumour are at substantial risk of premature mortality, particularly for those who have survived 30 years from original diagnosis. This particular group of survivors have the highest risk of hospitalisations due to renal morbidities, such as chronic renal failure, and subsequent primary neoplasms in specific organs in the lower digestive system. Survivors of heritable retinoblastoma who received external beam radiotherapy experienced an increased risk of subsequent primary neoplasms developing above the shoulder, whereas those who received brachytherapy were similar to those who did not receive any radiotherapy and did not experience an increased risk of subsequent primary neoplasms.
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Davis, Emma E. "Neurodevelopmental outcome following cerebellar tumour sustained in early childhood." Thesis, University of Nottingham, 2011. http://eprints.nottingham.ac.uk/12201/.
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Mounting evidence from imaging studies, developmental disorders and typically-developing children suggests that different domains of functioning are more closely related than previously considered. This is reflected in theories of development which are increasingly recognising that developmental progression should be considered as an integrated process, with associations between domains. The extent of the interrelation between cognitive and motor skills remains unclear despite previous investigations. Examination of this relationship in typically-developing children is important to clarify the nature of this link, thereby informing theories of development for both typical and atypical populations. This thesis investigated the underlying nature of the association between cognitive and motor domains to establish the extent of interrelation and whether this link alters across development. As the cerebellum has been hypothesised to be instrumental in this relationship (Diamond, 2000), the role of the cerebellum was investigated by examining cognitive and motor development in children treated for cerebellar tumour in the preschool years (N=15). The impact of cerebellar injury on development of scholastic and attentional skills was also investigated, together with the influence of factors affecting prognosis. The interrelation of cognitive and motor skills in typically-developing children (N=248; 4-11 years) was found to be underpinned by a link between visual processing abilities and fine manual motor skills. Despite fluctuations in correlations between other aspects of cognitive and motor functioning, this core relationship remained constant, furthering evidence that cognitive and motor development are linked from an early age. A similar pattern of correlations was seen for the patient sample, suggesting that development in these domains remains tightly linked despite damage to an underlying component of the anatomical network. This suggests that the patients are demonstrating a developmental delay, rather than deviation; their trajectory does not appear to be qualitatively different from that of typically-developing children, rather development appears to be more constrained than suggested by some hypotheses (e.g. Karmiloff-Smith, 1992). Cerebellar damage was therefore found to impact on the two domains similarly, offering support to a „universal cerebellar transform‟ (Schmahmann, 2000b) conceptualisation of cerebellar functioning. Both cognitive and motor skills were found to be compromised following a cerebellar tumour, although no specific impact of cerebellar damage was reported on scholastic skills, above and beyond general cognitive deficit. Attention was found to be impaired in the patient sample, with sustained attention most closely related to functioning in cognitive, academic and motor skills, suggesting that a deficit in this basic underlying process underlies difficulties in other domains. In addition, sustained attention was implicated in the association between visual processing and fine manual control in the patient sample, suggesting that this core link may be further underpinned by more basic cognitive processes. Effective rehabilitation may therefore target sustained attention, as this appears to be related to functioning in the other domains assessed in this study, as well as recognising that an integrated approach across domains is likely to yield maximum benefits. Of the potential moderating factors investigated, age at diagnosis and tumour type/treatment were found to be the most reliable predictors of outcome. This research highlights the importance of a case-study approach, and the clinical importance of individual investigation of each child‟s needs for rehabilitation.
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Hjalmars, Ulf. "Epidemiological studies including new methods for cluster analysis of acute childhood leukaemia and brain tumours in Sweden /." Stockholm, 1998. http://diss.kib.ki.se/1998/91-628-3264-6/.
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Orphanidou, Eleni. "Advanced magnetic resonance imaging and metabolic studies of low grade gliomas in childhood." Thesis, University of Birmingham, 2012. http://etheses.bham.ac.uk//id/eprint/3434/.
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Introduction: Paediatric low grade brain tumours present diagnostic and prognostic challenges, providing a need for better non-invasive imaging characterization. The value of \(^1\)H Magnetic Resonance Spectroscopy (MRS) performed on 5 scanners in the diagnosis and prognostication of an extensive bi-centre cohort of low-grade gliomas is investigated. Methods: Single voxel MRS was performed routinely in children with brain tumours at the Birmingham Children’s Hospital and Queen’s Medical Centre. Histopathological features were semi-quantified and in vitro \(^1\)H NMR used to study pilocytic astrocytoma cell lines. Magnetic Resonance Spectroscopic Imaging (MRSI) and texture analysis of MR images were performed. Results: MRS detects differences between subgroups of low grade brain tumours in children and between tumours of the same histology. High myo-inositol and glycerophosphocholine and low phosphocholine are markers of good prognosis. Histological correlates for MRS metabolites have been identified and paediatric pilocytic astrocytoma cell lines (‘typical’, metastatic and recurrence) have been discriminated. The value of MRSI in answering clinical questions has been demonstrated. Texture analysis achieved high accuracy in the diagnosis of paediatric posterior fossa tumours. Conclusion: Advanced MR techniques have a significant role in the study of paediatric brain tumours, and promising results from MRS, MRSI and texture analysis are reported here.
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Bright, Chloe Jayne. "Adverse health outcomes among long-term survivors of childhood, teenage and young adult cancer." Thesis, University of Birmingham, 2017. http://etheses.bham.ac.uk//id/eprint/7455/.
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Survivors of childhood, teenage and young adult cancer are at increased risk of developing adverse health outcomes. This thesis aims to address the gaps in knowledge regarding the most severe adverse health outcomes. The Teenage and Young Adult Cancer Survivor Study (TYACSS) provides 200,945 survivors of cancer diagnosed aged 15-39 years. The PanCare Childhood and Adolescent Cancer Survivor Care and Follow-Up Studies (PanCareSurFup) provides 69,460 survivors of cancer diagnosed aged < 20 years. Within the TYACSS cohort 1) cancer survivors had increased risk of developing subsequent primary neoplasms, particularly in previously irradiated sites; 2) cancer survivors who likely received cranial irradiation had increased risk of a cerebrovascular event; and 3) central nervous system tumour survivors experienced premature mortality due to neoplastic and nonneoplastic causes. Within the PanCareSurFup cohort 1) the excess number of subsequent softtissue sarcoma was low, except leiomyosarcoma after retinoblastoma; and 2) the excess number of subsequent breast cancers remained elevated beyond 40 years of age among survivors of Hodgkin lymphoma, Wilms tumour and sarcoma. This thesis focuses on the most severe adverse health outcomes among childhood, teenage and young adult cancer survivors and provides evidence for developing clinical follow-up guidelines aimed at reducing such adverse health outcomes.
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Pai, Jui-sheng. "Family crisis in childhood illness: an investigation of families having a school-age child with a brain tumor /." Thesis, Connect to this title online; UW restricted, 1999. http://hdl.handle.net/1773/7212.
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Larham, Bethany. "Do childhood experiences and insecure attachment style in women with gynaecological cancer affect trust in care?" Thesis, University of Liverpool, 2013. http://livrepository.liverpool.ac.uk/14053/.
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This volume presents the research carried out in partial fulfilment of the Doctorate in Clinical Psychology at the University of Liverpool. It contains three papers, addressing the area of cancer patients‘ trust in care. In times of distress, patients engaged in a course of psychological therapy wish to feel safe, contained and to trust that the clinician is working in their best interests. The same holds true in a medical setting, where being diagnosed with a life-threatening illness such as cancer evokes feelings of vulnerability, helplessness and intense fear. Clinicians can be viewed as attachment figures in this time of stress, being the cancer patient‘s main hope for creating safety in the face of threat. Whilst a relationship with the clinician characterised by trust is beneficial at this time, unfortunately not all patients experience the relationship in this way. Before we can suggest means to improve cancer patients‘ sense of trust in the clinician, we need to understand the factors which prevent patients from developing trust in their clinician. Unlike the field of psychotherapy, where patient factors influencing the relationship with the therapist have been extensively researched, the medical field has focused its efforts on attempting to highlight the contribution of the clinician. This thesis aims to address this current dearth of literature, and focus on patient factors which could impede them from having trust in cancer care. Paper 1: Literature review The review paper provides the backdrop for the research. A specific sub-section of the background literature that informed the development of the research is considered here. A general review of current knowledge relating to all aspects of cancer patients‘ experiences highlighted an area of relative dearth in research. From this, a specific research question was developed: what is the role of patients‘ experiences in trust in cancer care? A focussed literature review was conducted in response to this pre-determined question, investigating whether patient factors of trauma, abuse and attachment style shape patients‘ trust in cancer care. The review adopted a structured approach to interrogating the evidence base, and the search terms and eligibility criteria for inclusion of papers are outlined. This section presents the identified papers, comparing and contrasting aims, design, methodology and findings, and explores the key themes that arose. The collective limitations, inconsistencies and gaps in this literature base are explored, and future directions to address these points are suggested. The review paper presents a picture of the current knowledge in this area, enabling the reader to locate the research study in its broader context. Paper 2: Empirical paper Building upon paper one, the second paper describes the main features of the research study, presented according to author guidelines set out for the journal Psycho-Oncology (Appendix A). Whilst a trusting patient/clinician relationship is repeatedly highlighted as important in healthcare, there is a tendency in the research to neglect the patient‘s contribution to this interaction. Attempts to identify individual patient factors that contribute to the sense of clinical relationship are dwarfed by extensive research focussing upon the clinician‘s competence, skill, communication and interpersonal style. The little research that has been carried out in this area has predominantly sampled women with breast cancer, leaving unexplored questions about the generalisability to other populations. In an attempt to redress balance, this research investigated patient factors which affect trust in the clinician, in a sample of gynaecological cancer survivors. The process of developing and conducting the study took two and a half years, whilst recruitment commenced after ethical approval was sought, and spanned 52 weeks. The key features of the study are outlined in this section. Paper 3: Concluding discussion The third section draws out the main findings of the research, and discusses the wider relevance. Further attention is given to the relative strengths and weaknesses of the study, and the study‘s applicability to clinical practice is considered. A short lay summary is presented, which was written for dissemination of the research to the participants who had requested feedback. This discusses the key contributions of the research to the literature base, and states what will be done with the findings. Finally, a research proposal describing a possible follow up study is outlined, taking into account the limitations of this research and considering how it can be extended. This concludes the thesis.
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Larsson, Lina, and Li Nyman. "När jag också får synas : En litteraturstudie om stödinsatser för syskon till barn med cancer." Thesis, Röda Korsets Högskola, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:rkh:diva-730.
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Bakgrund: Människor som inkluderas i varandras liv har stor påverkan på varandra. Varje gång ett barn insjuknar i cancer drabbas således hela barnets familj. Familjerelationer och vardagen blir turbulent jämfört med den trygghet familjen vanligtvis erbjuder och de friska syskonen hamnar ofta i skymundan. Syskonen drabbas, till följd av situationen, utav såväl somatiska som psykologiska problem och kan behöva hjälp av stödinsatser för att kunna ta sig igenom vardagen. Syfte: Att beskriva resultatet av stödinsatser som finns för syskon till cancersjuka barn. Metod: En litteraturstudie baserad på 10 vetenskapliga artiklar med kvalitativ (2), kvantitativ (6) och mixad (2) ansats. Resultat: Effekter från tre typer av stödinsatser presenteras. Stödgrupper, syskonläger och individuella stödinsatser visar alla en signifikant minskning av ångestsymtom, PTSD, psykisk stress, depressiva symtom, rädsla och isolering. Stödinsatserna resulterade i ökad livskvalitet, självkänsla, självuppfattning och kunskap om sjukdomen. Syskonenen upplevde samhörighet med övriga grupp- och lägerdeltagare samt sin egen familj. Grupptillhörighet visade sig vara betydelsefull. Slutsats: Studien visar att stödinsatser har en positiv effekt på syskon till cancersjuka barn där ökad kunskap, sammanhållning och grupptillhörighet var bidragande faktorer. Resultatet speglar vikten av familjefokuserad omvårdnad. Klinisk betydelse: Sjuksköterskor har en viktig roll i den familjecentrerade vården. Sjuksköterskor bör kunna identifiera syskon som mår dåligt och rekommendera dem till lämpliga stödsatser.Background: People who are included in each other's life, have a great influence on one another. Every time a child is diagnosed with cancer the child's whole family is affected. Family relationships and everyday life becomes turbulent compared to the security the family usually offers and the healthy siblings often end up neglected. Because of this, these siblings face both somatic and psychological problems and may need support to get through everyday life. Aim: To describe the outcome of supporting interventions available for siblings of children with cancer. Methods: A literature review based on 10 scientific articles with a qualitative (2), quantitative (6) and mixed (2) approach. Results: The outcome of three types of support interventions is presented. Support groups, sibling camps and individual support actions all show a significant decrease in anxiety symptoms, PTSD, mental stress, depressive symptoms, fear and isolation. These supportive interventions resulted in increased quality of life, self-esteem, self-perception and knowledge about the disease. Siblings experienced connectedness with the other group and camp participants and also with their own family. Group membership showed to be meaningful. Conclusion: The study shows that support interventions have a positive effect on siblings of children with cancer where knowledge, cohesion and group belonging were contributing factors. The result reflects the importance of family-focused nursing. Clinical Implications: Nurses have an important role in family-centered care. The nurse should identify siblings who feel bad and consequently recommend suitable support interventions.
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Wilson, Shaun Robert. "An investigation into the role of receptor tyrosine kinases in childhood Acute Lymphoblastic Leukaemia." Thesis, University of Birmingham, 2014. http://etheses.bham.ac.uk//id/eprint/4820/.
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Deregulation of tyrosine kinases has been implicated in Philadelphia chromosome negative Acute Lymphoblastic Leukaemia (ALL) with a higher risk of relapse. The studies in this thesis sought to identify potential receptor tyrosine kinase targets and to explore the use of tyrosine kinase inhibitors (TKIs) in childhood ALL. Initial work describes the baseline receptor tyrosine kinase profiles of 18 primary ALLs. Alterations in the phosphorylation signals of Axl, EphA2, EphB2, FGFR2, FLT3, Mer and PDGFRβ were identified and associated with clinical and biological features. Subsequently, 5 ALL cell lines and a panel of 20 primary samples representative of common biological features were screened for sensitivity to a library of TKIs. Significant heterogeneity in sensitivity was observed in the panel of leukaemia cells. No correlation was evident between response to TKIs and current clinical or biological stratification parameters in the primary cell panel. Two candidate inhibitors, dovitinib and foretinib, were taken forward for further preclinical work. Potent nanomolar activity was demonstrated in cell lines and primary ALL. The combination of dovitinib or foretinib with conventional cytotoxics demonstrated significant synergy and sensitised steroid – resistant cell lines to dexamethasone. Objective responses were not identified to single agent TKI therapy in a murine primagraft model.
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Ito, Yoshinori, Jun-ichi Kawada, and Hiroshi Kimura. "EPSTEIN-BARR VIRUS-ASSOCIATED LYMPHOID MALIGNANCIES : THE EXPANDING SPECTRUM OF HEMATOPOIETIC NEOPLASMS." Nagoya University School of Medicine, 2013. http://hdl.handle.net/2237/18466.
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Hölttä, Päivi. "Developmental aberrations of permanent teeth after high-dose anticancer therapy in childhood : a study on stem cell transplant recipients /." Helsinki : Helsinki University Printing House, 2005. http://ethesis.helsinki.fi/julkaisut/laa/hamma/vk/holtta/.
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Thesis (doctoral)--University of Helsinki, 2005.At head of title: Institute of Dentistry, Department of Pediatric and Preventive Dentistry, University of Helsinki, Finland; Hospital for Children and Adolescents, University of Helsinki, Finland. Includes bibliographical references. Also available on World Wide Web.
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Cremin, Bryan J. "Imaging of tumours of the urinary tract in children, with particular reference to Wilms' tumour." Doctoral thesis, University of Cape Town, 1986. http://hdl.handle.net/11427/27214.
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The investigation of an abdominal mass in a child is a common problem in the radiology department of the Red Cross Children's Hospital. The majority of these masses involve the urinary tract. The commonest neoplasm is a Wilms' tumour of the kidney. Against a pathological and clinical background, the investigation of Wilms' tumour by diagnostic imaging is presented. The imaging modalities currently utilised are the intravenous urogram (IVU), ultrasound (US), computed tomography (CT) and magnetic resonance (MR). Using the material available in the last decade, the principles, techniques and imaging characteristics of these modalities are investigated and compared. These results are reflected against those reported in the medical literature. This literature is not yet extensive as the current technology has only been available for the last six to seven years. The IVU has in the past been the main imaging modality and we still use it extensively. Its strengths and weaknesses are discussed. In the last five years US has taken its place as the primary method of diagnostic imaging. We have found that with our increasing experience that this is justified. The use of US and IVU in a practiced hand is a powerful diagnostic combination. CT as a primary investigation is not readily available at our institution. We have used it for comparative purposes in about 20% of our recent cases. CT has not added greatly to our initial diagnostic impression. However, it has been most useful for follow up of metastasis and for assessing the normality of the lungs before ceasing chemotherapy. Our experience with MRI is limited and confined to unusual presentations in the last year. Other modalities such as arteriography and nuclear medicine have special indications which are to be discussed. The remaining tumours of the upper urinary tracts are all rare, but are reported and the literature researched. In the lower urinary tract the main pelvic lesion is a rhabdomyosarcoma. The comparative advantages of the IVU, US, CT and MRI are also noted. In the pelvis, US has also become the primary imaging modality, and is replacing contrast medium cystography. However, examples of the latter are included as it still has a place, particularly in the less sophisticated institutes. CT and MRI, when available, have imaging advantages in the pelvis and are becoming the methods of choice for follow up. The main objective of this document has been to investigate the available imaging techniques, but, against this overall theme, the clinical care of the child is most important. With this in mind the treatment protocols that are used at our hospital are noted in the appendices to the thesis.
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Samuelsson, Carolina, and Amanda Törnqvist. "Föräldrars hopp i upplevelsen av att ha ett barn med diagnosen cancer." Thesis, Högskolan i Halmstad, Akademin för hälsa och välfärd, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:hh:diva-29780.
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Varje år drabbas ca 300 barn av någon form av cancer i Sverige. Att ett barn insjuknar i cancer påverkar inte bara det sjuka barnet utan även föräldrarna. Cancerdiagnosen skapar en krissituation hos hela familjen. I samband med denna krissituation uppkommer även begreppet hopp. Föräldrars hopp i upplevelsen av att ha ett barn med cancer. För att föräldrarna ska kunna ha en chans att klara av den krävande situationen är det av betydelse att belysa de faktorer som kan påverka hoppet hos föräldrarna på ett positivt eller negativt sätt. Vad kan sjukvårdspersonalen göra för att eliminera de faktorer som utgör ett hot mot hoppet samt hur hopp ska upprätthållas. Vilket svarar mot litteraturstudiens syfte. Fem kategorier har identifieras som speglar resultatet för att beskriva faktorer som främjar och hotar hoppet; Kunskap ger hopp, Socialt stöd ger hopp, Familjecentrerad vård ger hopp, Hot mot hoppet och Framtidstro ger hopp. Är föräldrarna väl informerade, får socialt stöd från familj, vänner och andra föräldrar i liknande situation och har framtidstro gör det att föräldrarna har goda möjligheter att bibehålla hoppet. Dock finns det faktorer som kan hota känslan och upplevelsen av hopp.Each year about 300 children gets sick in some sort of cancer in Sweden. That a child becomes ill in cancer do not only affects the sick child even the parents. Cancer diagnosis creates a crisis to the whole family. In connection with this crisis situation arising also the concept of hope. Parents hope in the experience of having a child with cancer. To enable parents to be able to have a chance to cope with the challenging situation it is important to illuminate the factors that can affect the parents hope in a positive or in a negatively way. What can the medical personnel do to eliminate the factors that are a threat to the hope and how hope can be maintained. Which corresponds to the literature study’s purpose. Five categories have been identified to reflect the result to describe the factors that promotes and threats the hope; Knowledge gives hope, Social support gives hope, family-centered care gives hope, Threats to the hope and Belief in the future gives hope. If the parents are well-informed, receive social support from family, friends and other parents in a similar situation and have belief in the future makes the parents to have good opportunities to maintain hope. However, there are factors that can threaten the feelings and experiences of hope.
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Remes, T. (Tiina). "Signs of radiation-induced accelerated ageing in survivors of childhood brain tumors:the incidence of cerebrovascular disease, neurocognitive impairment, secondary neoplasms, and low bone mineral density after 18 years of follow-up." Doctoral thesis, Oulun yliopisto, 2019. http://urn.fi/urn:isbn:9789526224305.
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Abstract Background: Childhood brain tumors (CBTs) are the most common solid tumors in childhood. CBT survivors have a high risk of several late-effects, including cerebrovascular disease (CVD), neurocognitive impairment, secondary neoplasms, and low bone mineral density; however, only a few studies have clinically investigated the late-sequelae in young-adult CBT survivors. Aim: To determine the prevalence of CVD, neurocognitive impairment, secondary neoplasms, and bone mineral density in a national cohort of radiotherapy-treated long-term survivors of CBT. Subjects and Methods: Radiotherapy-treated CBT survivors diagnosed between 1970–2008 were selected based on the following inclusion criteria: follow-up ≥5 years since the cessation of therapy and age of ≥16 years at the time of the study. Survivors were clinically and neuropsychologically examined, and investigated by magnetic resonance imaging (MRI), bone mineral densitometry, and laboratory analysis. Results: We included 74 survivors after a mean follow-up time of 18.9 ± 6.1 years. The mean age at follow-up was 28.4 ± 6.8 years and at diagnosis 8.3 ± 4.3 years. At the 20-year follow-up, the cumulative prevalence of CVD, along with small- and large-vessel disease was 52%, 38%, and 16%, respectively. Ischemic infarcts or transient ischemic attacks were diagnosed in 11% of the survivors, lacunar infarcts in 10%, and cerebral hemorrhage in 3%. White matter lesions (WMLs) were noted in 49% of the survivors. Higher blood pressure was associated with CVD, large-vessel disease, WMLs, and lacunar infarcts. Survivors had lower cognitive performance in all neuropsychological domains than controls. Mean verbal intelligence quotient was 89 ± 14 and mean performance intelligence quotient 87 ± 19. Executive functions (Z-score -5.0 ± 5.3 SD) and processing speed (Z-score -4.3 ± 5.4 SD) were extensively impaired. Executive functions and processing speed were associated with everyday life skills. Cumulative incidence of secondary meningiomas was 10.2% at the 25-year follow-up using the clinical data, and that of secondary neoplasms was 2.4% using the Finnish Cancer Registry data. We observed low bone mineral density in 23.6% of the survivors, which was associated with fractures in long bones. Conclusions: Young adult CBT survivors experienced late-consequences typically associated with ageingTiivistelmä Taustaa: Suomessa sairastuu vuosittain 46-60 lasta aivokasvaimeen, joka on lapsuusiän yleisin, kiinteä kasvain. Selviytyneillä on todettu lisääntynyt hoitojen myöhäisvaikutuksien riski. Kuitenkin nuorten aikuisten haittavaikutuksia on toistaiseksi tutkittu melko vähän. Tutkimuksen tarkoitus: Tarkoituksena oli selvittää sädehoidon jälkihaittoina esiintyvien sairauksien, kuten aivoverisuonisairauksien, älyllisten ongelmien, sekundaaristen kasvainten ja luustonhaurastumisen yleisyyttä ja riskitekijöitä suomalaisessa, kansallisessa kohortissa. Aineisto ja Menetelmät: Tutkimukseen kutsuttiin kaikki Suomessa lapsuusiällä aivokasvaimen sairastaneet aikuiset, jotka oli hoidettu sädehoidolla vuosina 1970-2008. Tutkittavat olivat yli 16-vuotiaita ja hoitojen päättymisestä oli yli 5 vuotta. Osallistuneille tehtiin kliininen ja neuropsykologinen tutkimus, pään magneettikuvaus, luustontiheysmittaus ja laboratoriotutkimuksia. Tulokset: Tutkimukseemme osallistui 74 nuorta aikuista 18,9 ± 6,1 vuotta hoitojen päättymisen jälkeen. Tutkittavat olivat iältään 28,4 ± 6,8 -vuotiaita osallistuessaan, ja 8,3 ± 4,3 -vuotiaita diagnoosihetkellä. Aivoverisuonisairaus todettiin 52% tutkimukseen osallistuneella 20 vuoden seurannan jälkeen, pienten suonten tauti oli 38 %:lla ja suurten suonten tauti 16 %:lla. Aivoinfarktin oli sairastanut 9 % tutkituista, lakuunainfarktin 10 % ja aivoverenvuodon 3 % tutkituista. Valkean aivoaineen muutoksia todettiin 49 %:lla magneettikuvauksessa. Korkea verenpaine lisäsi aivoverisuonisairauden, suurten suonten taudin, valkoisen aivoaineen muutoksien sekä lakuunainfarktien riskiä. Selviytyjien keskimääräinen kielellinen älykkyysosamäärä oli 89 ± 14 ja ei-kielellinen 87 ± 19. Suurimmat vaikeudet todettiin toiminnanohjauksessa (Z-luku -5,0 ± 5,3 SD) ja prosessointinopeudessa (Z-luku -4,3 ± 5,4 SD). Toiminnanohjauksen ja prosessointinopeuden vaikeudet olivat yhteydessä arkielämän haasteisiin. Sekundaaristen aivokalvokasvainten kumulatiivinen esiintyvyys oli 25 vuoden seuranta-aikana 10,2 % kliinisessä tutkimuksessa ja sekundaaristen kasvainten 2,4 % Syöpärekisteriaineistossa. Matala luustontiheys todettiin 23,6%:lla selviytyneistä. Johtopäätökset: Nuorilla aikuisilla, jotka ovat lapsena aivokasvaimen vuoksi saaneet sädehoitoa, esiintyy useita sellaisia jälkihaittoja, jotka yleensä liittyvät ikääntymiseen
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Karlsson, Pia. "Cutaneous melanoma in children and adolescents and aspects of naevus phenotype in melanoma risk assessment." Doctoral thesis, Linköping : Univ, 2006. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-7703.
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Balling, Karla. "Surviving childhood cancer : the impact on transition to emerging adulthood /." 2002. http://www.library.wisc.edu/databases/connect/dissertations.html.
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"The impact of childhood cancer at different stages of the disease on Hong Kong Chinese families." 2000. http://library.cuhk.edu.hk/record=b5890477.
Full textAbstract:
Lin Kwok Yin.Thesis (M.Phil.)--Chinese University of Hong Kong, 2000.
Includes bibliographical references (leaves 116-124).
Abstracts in English and Chinese.
ACKNOWLEDGMENT --- p.i
ABSTRACT --- p.ii
LIST OF CONTENTS --- p.vii
LIST OF APPENDIX --- p.x
LIST OF TABLES --- p.xi
Chapter CHAPTER 1 --- INTRODUCTION --- p.1
Chapter CHAPTER 2 --- LITERATURE REVIEW --- p.3
Introduction --- p.3
Impact of childhood cancer on the family in general --- p.4
Impact of childhood cancer on children with the disease --- p.10
Impact of childhood cancer on the well siblings --- p.16
Impact of childhood cancer on parents --- p.21
Impact on families with terminally ill children --- p.25
Impact of the disease on families who have lost children with cancer --- p.29
Summary of literature review --- p.32
Chapter CHAPTER 3 --- OBJECTIVES AND METHODOLOGY --- p.35
Aim and objectives --- p.35
Methodology and research design --- p.35
Subjects for study --- p.36
Data collection method --- p.38
Data collection procedure --- p.42
Data analysis --- p.45
Validity --- p.47
Reliability --- p.48
Pilot study --- p.50
Ethics --- p.51
Chapter CHAPTER 4 --- FINDINGS AND DISCUSSION --- p.54
Introduction --- p.54
Parents --- p.55
Summary of the findings obtained from parents' data --- p.75
Children with cancer --- p.76
Summary of the findings obtained from children's data --- p.85
Siblings --- p.86
Summary of the findings obtained from siblings' data --- p.98
A comparison of the findings obtained from parents' and children's data --- p.99
Chapter CHAPTER 5 --- CONCLUSION --- p.104
Limitations --- p.104
Implications for nursing practice --- p.107
Recommendations for nursing practice and further research --- p.112
Conclusion --- p.114
REFERENCES --- p.116
APPENDIX --- p.125
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Van, Deuren Heidi J. "Siblings of long-term survivors of childhood cancer their experience and how they are now /." 1994. http://catalog.hathitrust.org/api/volumes/oclc/31383475.html.
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Thesis (M.S.)--University of Wisconsin-Madison, 1994.Typescript. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 42-43).
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Schubert, Jeanne Ellen. "The effects of childhood cancer on healthy siblings their perceptions, experiences, and coping strategies /." 1993. http://catalog.hathitrust.org/api/volumes/oclc/29386069.html.
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Thesis (M.S.)--University of Wisconsin-Madison, 1993.Typescript. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 68-72).
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Penn, Anthony. "The effect of childhood brain tumours on the child and family: a prospective multidisciplinary follow up of children with intracranial tumours." Thesis, 2014.
Find full textAbstract:
Brain tumours are the second most common malignancy in childhood and account
for approximately 20% of all childhood cancers. Children diagnosed with a primary
brain tumour are at risk of significant morbidity. Measurement of quality of life (QOL)
and health status (HS) are important in quantifying morbidity and identifying
strategies to provide relevant support for patients.
We aimed to: (1) Measure QOL and HS, using the PedsQL and HUI3 in children with
brain tumours one, six and twelve months after diagnosis.
(2) Compare QOL and HS with “normal” matched controls, and assess the
relationship between parent- and self-report QOL and HS.
(3) Identify determinants of overall QOL one year after diagnosis.
A total of 45 patients and 43 controls were recruited to the study, with 37 patients
and 42 controls and 27 patients and 31 controls eligible for comparison of QOL using
parent-report and self-report PedsQL respectively. Thirty-five patients were eligible
for analysis of determinants of parent-report and 26 for self-report QOL one year
after diagnosis.
There were 29 patients and 29 controls, and 21 patients and 22 controls eligible for
comparison of HS between patients and controls using the parent-report and selfreport
HUI3 respectively, one year after diagnosis. In addition, 29 and 21 patients
were eligible for analysis of determinants of parent- and self-reported HS one year
after diagnosis.
Children with a primary brain tumour have significantly lower QOL/ HS in the first
year after diagnosis than normal controls. QOL/ HS improved significantly over time,
most notably in the six months after diagnosis.
For patients, agreement between parent- and self-report was variable, with greater
agreement for the more observable (physical), compared with less observable
(psychosocial) domains. Agreement between parent- and self-report was better
using the HUI3 than the PedsQL. Parents of patients rated their children's HRQL
lower than their child did, while for controls this was reversed.
Selective attention one month after diagnosis and infratentorial tumour site are most
important in predicting both parent- and self-report overall QOL at 1 year after
diagnosis.
Larger multi-centre, prospective studies are needed to confirm these findings.
Cognitive remediation and/ or pharmacological intervention, particularly aimed at
children with infratentorial tumours may improve attention and subsequently QOL,
and both merit further investigation.
THE CLIC SARGENT BRAIN TUMOUR STUDY
The study on QOL and its determinants as reported in this thesis was undertaken as
part of a prospective longitudinal multidisciplinary study led by Dr Peta Sharples
(Consultant Paediatric Neurologist) and Dr Stephen Lowis (Consultant Paediatric
Oncologist), with support from Dr Renee McCarter (Consultant Neuropsychologist),
Professor Mike Stevens (Professor of Paediatric Oncology), Dr Andrew Curran
(Senior Registrar in Paediatric Neurology), Dr Linda Hunt (Senior Lecturer in Medical
Statistics) and Mr Robert Shortman (Assistant Psychologist). The overall aim of the
study was to investigate, in detail, the effects of childhood brain tumour on the child
and family. More specifically, it was intended to investigate the effect of primary brain
tumours on cognitive, neurological, behavioural and functional outcome by
comparing children presenting with CNS tumours with matched normal controls. In
addition, the study sought to assess the effect of the diagnosis and treatment on the
primary carer’s emotional status, family functioning and other family variables.
Assessments were to be undertaken at an early stage (within 1 month of diagnosis)
and at 6 and 12 months thereafter with the intention that the findings would define
the early rehabilitation needs and rate of recovery of this patient population.
In collaboration with supervisors, particularly Dr. Sharples, the author of this thesis,
after reviewing the literature on QOS in children diagnosed and treated for a primary
intracranial tumour made the decision to use QOL as the primary outcome measure
and dependent variable. During the study, the importance of assessment of the
relationship between parent- and child-reported QOL using both the PedsQL and
HUI3 became clear, and self- report HUI3, in addition to the PedsQL, was
incorporated into the study and became an important theme of two of the papers
submitted in support of the author’s thesis and the thesis itself.
In addition to the contribution to the direction of the study, as mentioned above, the
PhD applicant’s role in the study were (1) to recruit all patients and controls; (2) to
collect, score and enter data relating to quality of life, behavioural/emotional
functioning, neurological and physical outcome and family structure and function in
patients, controls and their families; (3) to undertake preliminary data analysis for
presentation at local, national and international meetings, and publication of results
in the form of the four papers submitted in support of the PhD, Integrated Format; (4)
to collate the data and divide it for publication in its current form; (5) to write and act
as corresponding author for the four papers submitted in support of the PhD. Details
of collection, handling and statistical analysis of data are covered below.
For the purpose of this manuscript, only data used in the papers submitted in support
of the author’s PhD are referred to, not other data arising from study.
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Long, Zsofia Banhegyi. "Incidence and clinical relevance of abnormal complete blood counts in survivors of childhood cancer." 2005. http://edissertations.library.swmed.edu/pdf/LongZ032105/LongZsofia.pdf.
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Bhat, Samrat V. Carson Arch I. Burau Keith D. "Toxics Release Inventory facilities and childhood cancer : geographic information systems based approach." 2007. http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&res_dat=xri:pqdiss&rft_dat=xri:pqdiss:1445111.
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