Prolonged Survival Using Outpatient Palliative Chemotherapy in Two Children With Refractory Acute Myelogenous Leukemia.

Background: Therapy options for relapsed/refractory acute myelogenous leukemia (AML) are limited. Palliative chemotherapy options have been explored in adult patients, but little evidence exists in children.

Objectives: Describe the clinical course of 2 pediatric patients with refractory AML who transitioned to outpatient palliative chemotherapy with good disease control and quality of life on these regimens.

A randomized controlled trial to examine the effect of the Pediatric Opioid Analgesia Self-Instruction System (PedOASIS) tool on pediatric hematology/oncology trainee education.

Background: Many children with hematologic and oncologic diagnoses require opioids for management of pain, yet knowledge gaps persist among pediatric hematology/oncology (PHO) fellows.

Objective: Pediatric Opioid Analgesia Self-Instruction System (PedOASIS) is an interactive, case-based education tool designed for independent learning. The goal of this study was to evaluate its efficacy in increasing PHO fellows' knowledge and comfort with using opioids to manage pain.

Development and Validation of Pediatric Opioid Analgesia Self-Instruction System (PedOASIS): An Opioid Knowledge Tool for Pediatric Clinicians.

Background: Acute pain is common in children and young adults with cancer and sickle cell disease. Current training curricula fail to adequately impart skills for pain management. We sought to develop and validate an education and assessment tool to address the safe effective use of opioids for pain management by pediatrics trainees.

Acute Myocardial Dysfunction and Hypereosinophilic Infiltrative Myocarditis Secondary to New-Onset Pediatric Acute Lymphoblastic Leukemia.

Myocardial infiltration by eosinophils leads to myocardial inflammation and fibrosis, resulting in restrictive hemodynamics. We describe an uncommon presentation of eosinophilic predominant acute lymphoblastic leukemia that manifested with hypereosinophilic infiltrative myocarditis. ().

Evaluation of knowledge and comfort with opioid prescribing among pediatric hematology/oncology fellows.

Background: Deficits in knowledge and comfort related to pain management have been demonstrated in adult hematology/oncology fellows. No such evaluation has been undertaken in pediatric hematology/oncology (PHO) trainees.

Procedure: An IRB-approved survey was administered to PHO fellows throughout the United States (US) to assess comfort with opioid dosing, attitudes related to the use of opioids, and knowledge of basic concepts including weight-based dosing, incomplete cross-tolerance, and management of side effects.

Counting Backward by Seven.

I delayed my neurology rotation in medical school because I was trying to ignore the symptoms of dementia developing in my mother. They became painfully apparent when I saw my parents less frequently after I moved away for residency, and finally had to be addressed when I had a child of my own and felt unsafe having her care for him. Through my experiences with her and in my training in palliative care and oncology, I have learned that tools like the Mini Mental State Examination (MMSE) and Functional Assessment Staging Test (FAST) can only tell us so much; the true measure of a patient's decline can be found in the patient's and family's own story.

Cost-effectiveness Analysis of Screening Extremely Low Birth Weight Children for Hepatoblastoma Using Serum Alpha-fetoprotein.

Objectives: To evaluate the cost-effectiveness of screening children born at extremely low birth weight (ELBW) for hepatoblastoma using serial serum alpha-fetoprotein measurements.

Study Design: We created a decision tree to evaluate the cost effectiveness of screening children born at ELBW between 3 and 48 months of age compared with current standard of care (no screening). Our model used discounted lifetime costs and monetary benefits in 2018 US dollars, based on estimates in the published literature.

Mutations within the Activation Loop Domain of FLT3 in Two Pediatric Patients with Refractory Infant Acute Myeloid Leukemia.

Approximately 24% of all pediatric acute myeloid leukemia (AML) cases have mutations in the FMS-like tyrosine kinase 3 () receptor gene. FLT3-TKD point mutations are rare in pediatrics and often occur in younger patients and in combination with 11q23 abnormalities. There is a paucity of data related to their prognostic implications in children.

Not Quite Child's Play: Using Beanbags to Teach Opioid Dosing and Rotation.

Pain management education is lacking in medical education, especially pediatrics. Using beanbags constructed to represent commonly used opioids with areas proportional to the drugs' potencies, this hands-on approach is used in small-group sessions to introduce opioid dosing, potencies, and rotation through case-based exercises. Next steps will include analysis of impact using pre- and post-intervention surveys.