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Bibliografía de interés
Cuidados de calidad en adultos jóvenes y adolescentes con cáncer.
Brad Zebrack, Beth Mathews-Bradshaw, and Stuart Siegel. Quality Cancer Care for Adolescents and Young Adults: A Position Statement. JOURNAL OF CLINICAL ONCOLOGY. VOLUME 28; NUMBER 32: NOVEMBER 10 2010:4862-7
Purpose
This consensus-based position statement on behalf of the LIVESTRONG Young Adult Alliance (Alliance) offers recommendations to enhance oncologic care of adolescent and young adult (AYA)
patients with cancer.
Background
In 2005 to 2006, the National Cancer Institute and the Lance Armstrong Foundation jointly sponsored the Adolescent and Young Adult Oncology Progress Review Group (PRG). The PRG report included the directive to develop standards of care for AYA patients with cancer and to disseminate these guidelines to the community. To this end, the Alliance convened a meeting of experts (clinicians, researchers, and advocates) in June 2009 and derived this position statement.
Results Quality care for AYAs depends on four critical elements: timely detection; efficient processes for diagnosis, initiation of treatment, and promotion of adherence; access to health care professionals who possess knowledge specific to the biomedical and psychosocial needs of this population; and research that will ultimately derive objective criteria for the development of AYA oncology care
guidelines. Achieving quality care for AYAs will require assistance with management of disease and treatment effects; cognizance of the unique psychosocial context for AYA growth and development; assessment of and attention to cognitive, psychiatric, and psychosocial issues; facilitated transition to treatment care; and referral to age-appropriate information and support services.
Conclusion
Dissemination of recommendations stated here will raise awareness of the need for AYA-specific care guidelines and assist providers in the delivery of care that is responsive to the distinct needs of AYAs with cancer.
Drogas antiretrovirales para el tratamiento de la mujer embarazada y la prevención de infección por VHI en RN
ANTIRETROVIRAL DRUGS FOR TREATING PREGNANT WOMEN AND PREVENTING HIV INFECTION IN INFANTS Recommendations for a public health approach 2010 version World Health Organization.
Significant progress is being made in the global scale-up of prevention of mother-to-child transmission of HIV (PMTCT), including in high burden and resource-limited settings. For the first time, the elimination of mother-to-child transmission of HIV (MTCT) is now considered a realistic public health goal and an important part of the campaign to achieve the millennium development goals. In the light of the global effort, it is critically important to provide the best evidence-based interventions to reduce the risk of transmission from an HIV-infected mother to her newborn child, while at the same time promoting the health of both the mother and the child. Since WHO issued revised guidelines in 2006, important new evidence has emerged on the use of antiretroviral (ARV) prophylaxis to prevent MTCT, including during breastfeeding, on the optimal time to initiate antiretroviral therapy (ART) in individuals who need treatment, and on safe feeding practices for HIV-exposed infants. This evidence forms the basis for the new recommendations contained in these 2010 revised guidelines and summarized in preliminary form in the 2009 Rapid Advice: Use of antiretroviral drugs for treating pregnant women and preventing HIV infection in infants
(http://www.who.int/hiv/pub/mtct/rapid_advice_mtct.pdf). The Rapid Advice gives a list of the key recommendations whereas the full guidelines document presents in detail the scientific evidence and rationale supporting these recommendations. The detailed guidelines document provides the necessary information for countries to adapt the WHO recommendations to their local settings. The 2010 guidelines are developed to provide international standards, primarily for low- and middleincome
settings, in support of the global scale-up of more effective interventions aimed at preventing MTCT in resource-limited settings. Once implemented, these recommendations could reduce the risk of MTCT to less than 5% (or even lower) in breastfeeding populations from a background risk of 35%, and to less than 2% in non-breastfeeding populations from a background risk of 25%, and will ensure increased maternal and child survival……………………………………………..
Esquema de vacunación recomendado en niños y adolescentes
Policy Statement—Recommended Childhood and Adolescent Immunization Schedules—United States, 2011American Academy of Pediatrics, : PEDIATRICS Volume 127, Number 2, February 2011
http://www.pediatrics.org/cgi/content/full/127/2/387
The 2011 recommended childhood and adolescent immunization schedules have been approved by the American Academy of Pediatrics, the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention, and the American Academy of Family Physicians (schedules have been provided following this article and online as Supplemental Information). These schedules are revised annually to reflect current recommendations for use of vaccines licensed by the US Food and Drug Administration and include the following changes from last year:
Guidance for administration of the hepatitis B vaccine series for children who did not receive the recommended birth dose
Information on the use of the 13-valent pneumococcal conjugate vaccine (PCV13). A PCV series begun with 7-valent PCV (PCV7) should be completed with PCV13. .
Guidance for administration of 1 or 2 doses of influenza vaccine on the basis of the child's history of receipt of monovalent 2009 H1N1 vaccine. unknown should receive 2 doses of 2010 –2011 seasonal influenza vaccine.
Guidance regarding a booster dose of quadrivalent meningococcal conjugate
vaccine (MCV4).
Children 7 through 10 years of age who are not fully immunized against pertussis (including those never vaccinated or with unknown pertussis vaccine status) should
receive a single dose of tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine (Tdap).
Guidance for use of Haemophilus influenzae type b vaccine in people 5 years of age and older at increased risk.
Guidance for the use of human papillomavirus vaccine (HPV). The quadrivalent vaccine (HPV4) and the bivalent vaccine (HPV2) are recommended for prevention of cervical precancers and cancers in females.
Manejo de emergencia en el paciente pediátrico con estado epiléptico
JN Friedman Emergency management of the paediatric patient with generalized convulsive status epilepticus ; Canadian Paediatric Society, Acute Care Committee Paediatr Child Health Vol 11 No 2 February 2011
The present guideline paper addresses the emergency management of generalized convulsive status epilepticus (CSE) in children and infants older than one month of age. It replaces the previous statement from 1996, and includes a new treatment algorithm and table of recommended medications, reflecting new evidence and the evolution of clinical practice over the past 15 years. The document focuses on the acute pharmacological management of CSE, but some issues regarding supportive care, diagnostic approach and treatment of refractory CSE are discussed.
Background and epidemiology
The conventional definition of convulsive status epilepticus (CSE) is continuous generalized tonic-clonic seizure activity with loss of consciousness for longer than 30 min, or two or more discrete seizures without a return to baseline mental status (1). More recently, the terms 'early' or 'impending' status epilepticus have been based on a definition of continuous or intermittent seizures lasting longer than 5 min without full recovery of consciousness between seizures. It has been shown that early treatment is more effective in stopping the seizure, and treatment delay results in increased morbidity and mortality (2).
The annual incidence of CSE in children is reported as 10 to 73 episodes/100,000 children and is highest (135/100,000 to 156/100,000 children) in children younger than two years of age (3). Common etiologies are listed in Table 1 (3). Mortality has been reported to be between 2.7% and 8%, with an overall morbidity
(mainly newly diagnosed neurological disorders) of between 10% and 20% (2).
The present guideline paper addresses CSE in children and infants older than one month of age. It replaces the statement published in 1996 (4).
Guía de diagnóstico, tratamiento y seguimiento del sarcoma óseo.
P. C. W. Hogendoorn Bone sarcomas: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up Annals of Oncology 21 (Supplement 5): v204–v213, 2010
On behalf of the ESMO/EUROBONET Working Group*
clinical practice guidelines doi:10.1093/annonc/mdq223
introduction
Primary bone tumours are rare, accounting for <0.2% of malignant tumours registered at the EUROCARE database.
They have a relatively high incidence in children and adolescents, but are still numerically outnumbered by benign bone tumours, which clinically may have a similar presentation. They are also frequently difficult to recognize as malignant by clinicians, radiologists as well as pathologists and this leads to major diagnostic difficulties in non-specialized
centres. One of the main recommendations of this guideline is that all patients with a suspected primary malignant bone tumour should be referred to a bone sarcoma reference centre or an institution belonging to a specialized bone sarcoma network before biopsy. Primary bone tumours are considerably outnumbered by metastases to the bone in older patients, which in some instances might mimic the presentation of a primary bone
tumour. The presence of non-mechanical pain or night pain around the knee of a person in this or indeed any age group should cause concern and lead to further immediate
investigation. Swelling will only be present if the tumour has progressed through the cortex and distended the periosteum…………….
Quality Cancer Care for Adolescents and Young Adults: A Position Statement
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ANTIRETROVIRAL DRUGS FOR TREATING PREGNANT WOMEN AND PREVENTING HIV INFECTION IN INFANTS
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Recommended Childhood and Adolescent Immunization Schedules United States, 2011
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Emergency management of the paediatric patient with generalized convulsive status epilepticus
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Bone sarcomas: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up
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