Adam S. Levy

Career burnout among pediatric oncologists.

Burnout is a work‐related syndrome consisting of emotional exhaustion, depersonalization, and diminished feelings of personal accomplishment. Physicians who care for patients with life‐threatening illnesses are at high risk for developing burnout. This survey evaluates the prevalence of burnout among pediatric oncologists, and assesses risk factors associated with the development of burnout.

Repeating blood cultures in neutropenic children with persistent fevers when the initial blood culture is negative.

Febrile neutropenia is a common reason for the hospitalization of pediatric oncology patients. The initiation of antibiotics and the overall decline in rates of bacteremia, would predict a low yield of detection of bacteremia in repeated blood cultures. Despite little evidence supporting the utility of serial cultures, repeat culturing with fever persists.

Ambulatory high‐dose methotrexate administration among pediatric osteosarcoma patients in an urban, underserved setting is feasible, safe, and cost‐effective

We describe the safety, feasibility, and provide a cost‐estimate of outpatient high‐dose methotrexate administration (HDMTX) among an urban, underserved population.

Day One Talk: parent preferences when learning that their child has cancer

PurposeThe discussion that occurs between a pediatric oncologist and a family when they first learn about their child’s new diagnosis of cancer is known as the “Day One Talk.” Few studies have addressed parent preferences when learning that their child has been diagnosed with cancer. The objective of this study is to assess what information parents of children with newly diagnosed cancer believe is important to learn during the Day One Talk.MethodsIn this cross-sectional study, a survey tool based on expert opinion was created to assess parents’ views of components of the Day One Talk including its content, length, and setting, as well as whether the child should be present for the initial talk and which staff should be present for the talk.ResultsSixty-two parents of children with newly diagnosed cancer participated. Ninety-seven percent believed that the Day One Talk is extremely important. Ninety percent believed that the word “cancer” should be used during the Day One Talk. Seventy-seven percent believed that the pediatric oncologist should provide specific numbers regarding cure rates for the patient’s diagnosis. Eighty-four percent of parents do not believe that children younger than 14 should be present.ConclusionsThese results suggest that parents of children with cancer have certain preferences regarding the Day One Talk. When conducting the Day One Talk, providers should elicit parent preferences regarding these issues in order to best meet families’ needs.

Mentoring in pediatric oncology: A report from the children's oncology group young investigator committee

A formal Mentorship Program within the Children’s Oncology Group (COG) was established to pair young investigators (mentees) with established COG members (mentors). Despite the American Academy of Pediatrics policy statement promoting mentorship programs, there are no publications describing and evaluating national mentorship programs in pediatric subspecialties. In this study, a series of internal program evaluations were performed using surveys of both mentors and mentees. Responses were deidentified and analyzed to determine the utility of the program by both participant satisfaction and self-reported academic productivity. Results indicated that mentees were generally satisfied with the program. Mentor-mentee pairs that met at least quarterly demonstrated greater academic productivity than pairings that met less frequently. This formal mentorship program appeared to have subjective and objective utility for the development of academic pediatric subspecialists.

Prenatally Diagnosed Aggressive Intracranial Immature Teratoma–Clinicopathological Correlation

ABSTRACT Objective: To describe clinicopathological correlation of congenital intracranial immature teratoma. Methods: A retrospective case analysis from a tertiary medical center. Results: We report a case of an intracranial immature teratoma detected prenatally at 35 weeks of gestation. The tumor showed rapid growth, causing acute hydrocephalus requiring subsequent ventriculoperitoneal shunting. Resective surgery was performed within 2 weeks after birth. The infant died at day of life 29. Histological examination revealed an immature teratoma, with high MIB1/Ki-67 proliferation index. Conclusion/Implications: Intracranial immature teratoma with high MIB1/Ki-67 proliferation index may serve as an independent poor prognostic factor.

Long-term evidence that a pediatric oncology mentorship program for young investigators is feasible and beneficial in the cooperative group setting: A report from the Children's Oncology Group

Mentorship of junior faculty is an integral component of career development. The Childrens Oncology Group (COG) Young Investigator (YI) Committee designed a mentorship program in 2004 whose purpose was to pair YIs (faculty ≤10 years of first academic appointment) with a senior mentor to assist with career development and involvement in COG research activities. This study reports on the committees ability to achieve these goals.

Pilomatrixoma in an infant: diagnostic challenges of fine-needle aspiration.

Fine-needle aspiration biopsy (FNAB) is a well-recognized minimally invasive tool in the diagnosis of neoplasia of various organ systems. Several reports in the literature suggest that FNAB can be an accurate method for the preoperative diagnosis and treatment planning. We describe a case to caution the interpretation from a FNAB that contains suboptimal contents (basaloid cells only) and highlight a clinical–pathologic-based algorithm that can provide the appropriate management for the patient when the cytopathologic diagnosis does not fit the clinical impression.