A comprehensive pediatric cardio-oncology program: a single institution approach to cardiovascular care for pediatric patients with cancer and childhood cancer survivors.

Cardiovascular complications related to cancer therapies are broad and variable in onset. These complications are the leading cause of non-cancer related morbidity and mortality in childhood cancer survivors and can also impact ongoing cancer treatment. Despite this understanding, dedicated cardio-oncology programs are lacking in pediatric cardiology. In an attempt to respond to these concerns, a risk-stratified, comprehensive cardio-oncology program was established to address the cardiovascular needs including prevention, early diagnosis, and management of patients with and at risk for cardiovascular complications of cancer therapy. This manuscript describes a single institution's experience of building and managing a multidisciplinary pediatric cardio-oncology program with close collaboration among cardiologists, oncologists, advanced cardiology and oncology practice providers, and allied health providers such as a dietitian and psychologist to provide comprehensive cardiovascular care for childhood cancer patients and survivors. In developing this program, emphasis was on the childhood cancer survivor population, as various cardiovascular complications can present many years after cancer treatment.

Changes in Weight Status and the Intestinal Microbiota Among College Freshman, Aged 18 Years.

PURPOSE: The transition to college is a vulnerable period for weight gain and the onset of obesity. Gut microbes differ in obese compared with lean individuals, but gut microbiota in adolescent-aged college freshmen during a known period of weight gain have never been studied. This pre-post observational pilot study assessed associations between intestinal microbiota changes and weight-related outcomes in healthy adolescent college freshmen living in on-campus dormitories at Arizona State University (n = 39). METHODS: We measured anthropometrics (waist circumference [WC], height, weight, and body mass index [BMI]) and collected fecal samples at the beginning and end of the 2015-2016 academic year. Fold changes in species-level microbes across time were measured by quantitative real-time polymerase chain reaction and used in correlation and multivariate regression analyses. RESULTS: A total of 24 female and 15 male adolescents (aged 18.54 ± .67 years) participated in this study. Over the academic year, BMI and WC increased by .97±1.28 kg/m2 and 2.64±4.90 cm, respectively. Correlation analyses indicated a significant negative association between Akkermansia muciniphila and both percentage WC change and percentage BMI change (r = -.66, p < .01; and r = -.33, p = .04, respectively). Multivariate regression analysis controlling for sociodemographics showed a significant association between A. muciniphila and percentage WC change, but not percentage BMI change (R2 = .53, p < .01; and R2 = .24, p = .15, respectively). CONCLUSIONS: As this was the first study in a university-based adolescent population to show a relationship between A. muciniphila and weight-related outcomes, further research is needed to explore these findings.