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EN
Invasive fungal infection (IFI) in patients with malignant solid tumours is rare, but it highly increases the risk of cancer recurrence because of prolonged discontinuation of cancer treatment. This paper presents a case of IFI induced by Candida glabrata in a 14-year-old girl with advanced Ewing’s sarcoma and metastases to the bone marrow. She was intensively treated with chemotherapy (CWS, CEVAIE, EWING 2008 + VIDE) and radiotherapy. As the treatment was ineffective, the tumour was surgically removed from the sacrum, and VAI chemotherapy was administered. Due to the symptoms of infection, antifungal treatment was initiated with caspofungin, followed by prophylaxis with posaconazole. In terms of anti-cancer treatment, the patient received megatherapy with auto-HSCT. Signs of infection and gastrotoxic complications developed, which is why broad-spectrum antibiotics and amphotericin B lipid complex were administered. Even so, a multisystem IFI appeared, causing the patient’s death. In multidrug chemotherapy with extended periods of agranulocytosis, primary prevention should be considered, similar to the one offered to patients with haematological malignancies.
EN
The lack of registration of ultrasound contrast agents for use in patients below the age of 18 is a signifi cant limitation of their usage. Despite this, examinations with the use of contrast agents are conducted in numerous centers, mainly as part of the diagnostic process of vesicoureteral refl ux. Examinations after an intravenous administration of contrast agents are conducted rarely. The reason for this is not only the lack of registration, but also the lack of studies on their safety profi le in paediatric patients or no guidelines concerning the dosage. It seems that imaging with the use of such agents could help solve certain clinical problems when other diagnostic methods fail. The paper presents selected cases of pediatric patients treated in oncological departments, in whom the examination with the use of ultrasound contrast agents had a considerable infl uence on the diagnostic and therapeutic process.
PL
Istotnym ograniczeniem stosowania ultrasonografi cznych środków kontrastujących w populacji pediatrycznej jest brak ich rejestracji dla osób poniżej 18. roku życia. Mimo to w wielu ośrodkach wykonywane są badania z ich użyciem, głównie w diagnostyce refl uksu pęcherzowo-moczowodowego. Badania po dożylnym podaniu środków kontrastujących przeprowadzane są sporadycznie. Wynika to nie tylko z ograniczeń rejestracyjnych, ale również braku prac oceniających profi l bezpieczeństwa ultrasonografi cznych środków kontrastujących u dzieci czy też braku schematów dawkowania. Wydaje się, że obrazowanie z ich zastosowaniem mogłoby pomóc w rozwiązaniu problemów klinicznych w sytuacjach, gdy zawodzą inne metody diagnostyczne. W pracy zaprezentowano wybrane przypadki kliniczne dzieci leczonych na oddziale onkologii, u których badanie z użyciem ultrasonografi cznych środków kontrastujących istotnie wpłynęło na proces diagnostyczny lub leczniczy.
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