Articles

The Importance of Diagnostic Vigilance Amid Cultural Barriers in Pediatric Oncology: A Case of Atypical B-ALL

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Pediatric cancers have the ability to spread rapidly, however, they also respond well to chemotherapy, and can have incredible success rates when diagnosis and intervention are implemented early. This case report describes an unusual presentation of B-ALL in a patient whose treatment was initially delayed due to barriers of cultural origin. The child initially presented with high fevers and vomiting, with mild abdominal distention and tenderness. With concern for sepsis or the need for surgical intervention, the pediatrician urged the family to proceed to a tertiary care center for further workup. The family felt these processes were unnecessary and felt that he would recover at home with over-the-counter medications. As the boy remained ill, emergency care was sought, and further investigations revealed a diagnosis of B-cell acute lymphoblastic leukemia. With this case report, we examine the importance of diagnostic vigilance amongst physicians to ensure a prompt and accurate diagnosis, while remaining mindful of cultural factors that may complicate clinical assessment and compliance.

Educational Services for Hospitalized Children and Adolescents in Pediatric Oncology: A Cartography of Academic Production in Brazilian Federal Universities

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This study maps the academic production on Educational Services for Hospitalized Children and Adolescents related to pediatric oncology at Brazilian Federal Universities, aiming to understand how different fields of knowledge construct meanings about illness, schooling, and educational continuity for children and adolescents undergoing cancer treatment. The research adopts an exploratory and cartographic approach grounded in Antoine Culioli’s Theory of Predicative and Enunciative Operations (TOPE), analyzing lexical variations, metadata, institutional affiliations, and regional academic productions. Two analytical levels were established: Level II, focused on textual surface and metadata analysis, and Level I, centered on enunciative activity and networks of meaning. The results reveal that the naming of Educational Services for Hospitalized Children and Adolescents is not neutral but constitutes strategic enunciative operations that reflect distinct epistemic territories. Although Hospital Class remains the most stable descriptor nationwide, regional specificities demonstrate differentiated modes of institutionalization and conceptualization. The North region prioritizes continuity of schooling and preservation of pedagogical identity; the Northeast expands the field through ethics, aesthetics, and intersectoral dialogue; the Southeast consolidates institutional and professional dimensions; and the South emphasizes subjective, neurocognitive, and socio-emotional aspects. The study also identifies a progressive displacement from biomedical approaches toward relational and rights-based perspectives, in which the child ceases to be represented exclusively as a patient and becomes re-enunciated as a subject of learning, participation, and continuity. The findings reinforce Educational Services for Hospitalized Children and Adolescents as an ethical, pedagogical, and political practice essential to sustaining educational trajectories during illness.