Luis Carlos Romero Quezada
Dean of the school of medicine
Associate Editor Mexican Journal of Medical Research
It has been published that about 148,000 cases of cancers occurred during 2008 in children aged 0–14 years in less-developed regions. Childhood cancer is the most important cause of death from illness in children in high income countries. The progress of childhood cancer therapies has led to a considerable rise of survival rates. For example, the overall 5-year survival rate for children diagnosed with cancer has risen from 44% in the 1970s to 81% in the early 2000s in developed countries. In this sense, major reasons for this result include the progress in the early detection, refined multimodality treatment, and enhancements of supportive care, together with prevention and efficient management of infections1-5.
However, there are unresolved problems. For example, a problem in these patients is the impaired physical fitness during and after childhood cancer treatment, causing reduced cardiopulmonary function, decreased muscle strength, fatigue, and altered physical function. Likewise, reduced levels of physical activity can contribute to cardiac deconditioning and skeletal muscle atrophy, ultimately limiting opportunities for participation in recreational activities and life roles that are dependent on adequate physical fitness. Exercise intervention has the potential to improve cardiopulmonary and musculoskeletal function, perhaps preventing long-term deficits in physical fitness if incorporated during or soon after treatment in children with cancer diagnoses6-8.
Another serious problem in children with cancer is the presence of malnutrition. In this sense, there are reports that suggest that up to 46% of children and young adults with cancer experience malnutrition due to numerous tumor- and treatment-related factors. This problem about malnutrition may be a contributing factor for decreased immune function (increasing the infections or sepsis), delayed wound healing, and disturbed drug metabolism influencing prognosis. Therefore, an adequate nutrition plays a decisive role on several clinical outcome measures such as treatment response, quality of life, and cost of care9, 10.
Viruses, fungus and bacterial infections are a severe problem in children with cancer. This problem is due to intrinsic and extrinsic factors. However, the intensive myelosuppressive chemotherapy is the main risk factor. Infection also remains a significant contributor to mortality in these oncologic children. Therefore, empiric therapy for suspected infections and treatment of documented infections are well-established standards of care in almost all the oncology hospitals. Likewise, the routine use of prophylactic strategies must be realized in all the cases1-5, 11. In the present issue of this journal, García-Luna and coworkers explains us in theirs manuscript the profile of antimicrobial resistance in oncologic pediatric patients12.In the same report, authors explain infection with multi-resistant microorganisms is associated with treatment failure, prolonged hospital stay, increased hospital costs and increased mortality, especially in critically ill patients. Authors concluded that multidrug-resistant bacteria in these patients are of a nosocomial origin, without a specific group of germ (gram positive vs. gram negative). In the same issue of cancer in children, Alvarado-Cano and coworkers show a non-experimental, transversal, prospective, descriptive study to determine the depressive symptoms that young patients with cancer present within an infantile Hospital and the strategies used by parents to notice these changes in their children13. Authors found that 6 children had mild depression and 18 children with a normal range of depression. The main coping strategies of parents were distraction, reinforcement, detachment, avoidance, social support and activities. Therefore, the study demonstrated a relatively low prevalence of mild depression in these patients and that the strategies used were very heterogeneous.
On the other hand, Acuña Ávila and coworkers show an interesting review about the level of anxiety of football association players and its management with Biofeedback techniques14. Finally, Sosa Bermúdez and Paz Bautista talk us about an analytical, cross-sectional epidemiological study to determine the association between intimate partner violence and damage to health of pregnant women which were attended in a primary care level in 12 municipalities of Hidalgo Health Services in the period of November 2008 to April 200915. Authors concluded that intimate partner violence in pregnant women was present in the 4 different types (psychological, physical, sexual and economic). The association was mainly present in damage to emotional health but it was also found association with damage to physical health.
We hope that the published manuscripts will be of interest and useful to the academic and scientific community, remembering that the most important for our journal is the valuable participation of authors and readers, therefore, again we invite to the reader to make a critical reading of the material and we invite to the researchers to submit basic or clinical manuscript to be published in our journal.
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12. García-Luna M, Madrid Gómez-Tagle JA, O’Brien JP. Profile of Antimicrobial Resistance in Oncologic Pediatric Patients. Mex J Med Res 2014; 2 (4).Available in http://www.uaeh.edu.mx/scige/revista/icsa/n4/a4.html
13. Alvarado-Cano ND, Del Valle-Del Valle F, Macías-Vargas G, Romo-Hernández G, Escamilla Acosta MA. Child Depression in Patients with Cancer. Mex J Med Res 2014; 2 (4).Available inhttp://www.uaeh.edu.mx/scige/revista/icsa/n4/a3.html
14. Acuña Ávila JM, Murguía Cánovas G, López Fajardo AD. Biofeedback to Decrease Anxiety in Football Association Players. Mex J Med Res 2014; 2 (4).Available inhttp://www.uaeh.edu.mx/scige/revista/icsa/n4/a2.html
15. Sosa Bermúdez NE, Paz Bautista JC. Association of Intimate Partner Violence and Health Damage in Pregnant Women, Hidalgo Mexico. Mex J Med Res 2014; 2 (4). Available in http://www.uaeh.edu.mx/scige/revista/icsa/n4/a1.html