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https://www.readbyqxmd.com/read/28333284/revisiting-the-mutant-prevention-concentration-to-guide-dosing-in-childhood-tuberculosis
#1
Devan Jaganath, H Simon Schaaf, Peter R Donald
The mutant prevention concentration (MPC) is a well-known concept in the chemotherapy of many bacterial infections, but is seldom considered in relation to tuberculosis (TB) treatment, as the required concentrations are generally viewed as unachievable without undue toxicity. Early studies revealed single mutations conferring high MICs of first- and second-line anti-TB agents; however, the growing application of genomics and quantitative drug susceptibility testing in TB suggests a wide range of MICs often determined by specific mutations and strain type...
March 9, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28331043/world-health-organization-treatment-guidelines-for-drug-resistant-tuberculosis-2016-update
#2
Dennis Falzon, Holger J Schünemann, Elizabeth Harausz, Licé González-Angulo, Christian Lienhardt, Ernesto Jaramillo, Karin Weyer
Antimicrobial resistance is a major global concern. Tuberculosis (TB) strains resistant to rifampicin and other TB medicines challenge patient survival and public health. The World Health Organization (WHO) has published treatment guidelines for drug-resistant TB since 1997 and last updated them in 2016 based on reviews of aggregated and individual patient data from published and unpublished studies. An international expert panel formulated recommendations following the GRADE approach. The new WHO guidelines recommend a standardised 9-12 months shorter treatment regimen as first choice in patients with multidrug- or rifampicin-resistant TB (MDR/RR-TB) strains not resistant to fluoroquinolones or second-line injectable agents; resistance to these two classes of core second-line medicines is rapidly detectable with molecular diagnostics also approved by WHO in 2016...
March 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28329212/clinical-status-of-adolescents-with-perinatal-hiv-at-transfer-to-adult-care-in-the-uk-ireland
#3
Intira Jeannie Collins, Caroline Foster, Anna Tostevin, Pat Tookey, Andrew Riordan, David Dunn, D M Gibb, Ali Judd
Background.: Increasing numbers of children infected perinatally with human immunodeficiency virus (HIV) are surviving to adolescence and transitioning to adult care, yet there are scarce data on their clinical status at transfer. Methods.: We analyzed prospective cohort data from the UK/Ireland national Collaborative HIV Pediatric Study (CHIPS). Clinical status at last pediatric clinic visit prior to transfer was described. Factors associated with higher CD4 cell count and viral load (VL) suppression<400 c/mL among patients on antiretroviral therapy (ART) at transfer were assessed using linear and logistic regression, respectively...
March 9, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28325648/role-of-bromocriptine-in-multi-spectral-manifestations-of-traumatic-brain-injury
#4
Sunil Munakomi, Binod Bhattarai, Bijoy Mohan Kumar
PURPOSE: Despite the prevalence and cost of traumatic brain injury related disabilities, there is paucity in the literature on modern approaches to pharmacotherapy. Medications may promote recovery by enhancing some neurological functions without impacting others. Herein we discussed the role of bromocriptine in neurorehabilitation for patients with traumatic brain injury. METHODS: A cohort comprising of 36 selective nonsurgical cases of traumatic brain injury in minimally conscious state were enrolled in the study...
February 21, 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/28321893/dose-finding-methods-for-phase-i-clinical-trials-using-pharmacokinetics-in-small-populations
#5
Moreno Ursino, Sarah Zohar, Frederike Lentz, Corinne Alberti, Tim Friede, Nigel Stallard, Emmanuelle Comets
The aim of phase I clinical trials is to obtain reliable information on safety, tolerability, pharmacokinetics (PK), and mechanism of action of drugs with the objective of determining the maximum tolerated dose (MTD). In most phase I studies, dose-finding and PK analysis are done separately and no attempt is made to combine them during dose allocation. In cases such as rare diseases, paediatrics, and studies in a biomarker-defined subgroup of a defined population, the available population size will limit the number of possible clinical trials that can be conducted...
March 21, 2017: Biometrical Journal. Biometrische Zeitschrift
https://www.readbyqxmd.com/read/28306345/a-retrospective-study-on-non-drug-related-poisoning-in-the-community-among-children-from-south-india
#6
Debasis Das Adhikari, Saibal Das, Blessed Winston A, Kaysina Vazhudhi, Aniket Kumar, Margaret Shanthi Fx, Indira Agarwal
OBJECTIVES: This retrospective study was performed to determine the incidence, demographic distribution, types and outcomes across various non-drug related poisonings among children attending a tertiary care center in south India. METHODS: All children from 0-16 years who presented to the Paediatric Emergency Department, Christian Medical College, Vellore with non-drug related poisoning from October 2004 to September 2013 were included. RESULTS: Out of the total 997 cases of poisoning, 629 (63...
March 17, 2017: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/28298202/evaluation-of-sublingual-microcirculation-in-a-paediatric-intensive-care-unit-prospective-observational-study-about-its-feasibility-and-utility
#7
Rafael González, Jorge López, Javier Urbano, María José Solana, Sarah Nicole Fernández, María José Santiago, Jesús López-Herce
BACKGROUND: Evaluation of the microcirculation in critically ill patients is usually done by means of indirect parameters. The aim of our study was to evaluate the functional state of the microcirculation by direct visualization of sublingual microcirculation using Sidestream Dark Field Imaging, to determine the correlation between these findings and other parameters that are commonly used in the clinical practice and to assess the applicability of the systematic use of this technique in critically ill children...
March 15, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28288233/-dress-syndrome-in-paediatrics-clinical-case
#8
Marcos Silva-Feistner, Elena Ortiz, María Jesús Rojas-Lechuga, Daniel Muñoz
Drug reaction with eosinophilia and systemic symptoms (DRESS) is a rare, potentially life-threatening, drug-induced hypersensitivity reaction that includes skin eruption, haematological abnormalities, lymphadenopathy, and internal organ involvement. OBJECTIVE: Presenting a rare condition in children, to facilitate a rapid diagnostic suspicion and recognition by doctors. CASE REPORT: An 9 months old infant admitted due to a severe viral pneumonia, managed with non-invasive ventilation and ceftriaxone...
February 2017: Revista Chilena de Pediatría
https://www.readbyqxmd.com/read/28287056/the-total-inotrope-exposure-score-an-extension-of-the-vasoactive-inotrope-score-as-a-predictor-of-adverse-outcomes-after-paediatric-cardiac-surgery
#9
Harish Bangalore, Michael Gaies, Elena C Ocampo, Jeffrey S Heinle, Danielle Guffey, Charles G Minard, Paul Checchia, Lara S Shekerdemian
OBJECTIVE: The aim of the present study was to explore and compare the association between a new vasoactive score - the Total Inotrope Exposure Score - and outcome and the established Vasoactive Inotrope Score in children undergoing cardiac surgery with cardiopulmonary bypass DESIGN: The present study was a single-centre, retrospective study. SETTING: The study was carried out at a 21-bed cardiovascular ICU in a Tertiary Children's Hospital between September, 2010 and May, 2011 METHODS: The Total Inotrope Exposure Score is a new vasoactive score that brings together cumulative vasoactive drug exposure and incorporates dose adjustments over time...
March 13, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28281768/parents-are-aware-of-the-ototoxic-effects-of-chemotherapy-in-paediatrics-undergoing-cancer-treatment-professional-versus-parental-views-a-pilot-study
#10
Nomfundo F Moroe, Kirstie Hughes
BACKGROUND: The primary goal of chemotherapy is to cure cancer and its symptoms. Hence, in recent years, there has been an increase in cancer paediatric survival rate. However, there have also been adverse side effects such as ototoxic hearing loss because of chemotherapy. Therefore, this study aimed at exploring whether the parents of children undergoing chemotherapy are aware of ototoxic effects of chemotherapy. METHODS: A non-experimental quantitative study was conducted to collect data through questionnaires, one for paediatric oncologists and the other for parents...
February 27, 2017: South African Journal of Communication Disorders. die Suid-Afrikaanse Tydskrif Vir Kommunikasieafwykings
https://www.readbyqxmd.com/read/28280887/brivaracetam-population-pharmacokinetics-in-children-with-epilepsy-aged-1%C3%A2-month-to-16%C3%A2-years
#11
Rik Schoemaker, Janet R Wade, Armel Stockis
PURPOSE: The aims of the study were to develop a population pharmacokinetic model of orally administered brivaracetam in paediatric patients and to provide dosing suggestions. METHODS: Analysis included 600 brivaracetam plasma concentrations from a phase 2a study (NCT00422422; N01263) in 96 paediatric patients with epilepsy aged 1 month to 16 years, taking one to three concomitant antiepileptic drugs (AEDs). Pharmacokinetic analysis was performed using non-linear mixed effects modelling, and a stepwise covariate search was used to determine factors influencing brivaracetam clearance...
March 9, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28279691/-use-of-urine-drug-screening-in-the-emergency-department-of-a-paediatric-hospital
#12
Núria Ferrer Bosch, Lidia Martínez Sánchez, Victoria Trenchs Sainz de la Maza, Jesús Velasco Rodríguez, Elsa García González, Carles Luaces Cubells
OBJECTIVE: To describe the situations in which urine drug screening is used in a Paediatric Emergency Department (ED). An analysis is also made on its potential usefulness on whether it changes the patient management, and if the results are confirmed by using specific techniques. METHODOLOGY: A retrospective study was conducted on patients under the age of 18 attended in the ED during 2014 and in whom urine drug screening was requested. Depending on the potential capacity of the screening result to change patient management, two groups were defined (potentially useful and not potentially useful)...
March 6, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/28279690/-early-clinical-trials-in-paediatric-oncology-in-spain-a-nationwide-perspective
#13
Francisco Bautista, Soledad Gallego, Adela Cañete, Jaume Mora, Cristina Díaz de Heredia, Ofelia Cruz, José María Fernández, Susana Rives, Pablo Berlanga, Raquel Hladun, Antonio Juan Ribelles, Luis Madero, Manuel Ramírez, Rafael Fernández Delgado, Antonio Pérez-Martínez, Cristina Mata, Anna Llort, Javier Martín Broto, María Elena Cela, Gema Ramírez, Constantino Sábado, Tomás Acha, Itziar Astigarraga, Ana Sastre, Ascensión Muñoz, Mercedes Guibelalde, Lucas Moreno
INTRODUCTION: Cancer is the leading cause of death between the first year of life and adolescence, and some types of diseases are still a major challenge in terms of cure. There is, therefore, a major need for new drugs. Recent findings in cancer biology open the door to the development of targeted therapies against individual molecular changes, as well as immunotherapy. Promising results in adult anti-cancer drug development have not yet been translated into paediatric clinical practice...
March 6, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/28276281/in-vitro-susceptibility-and-resistance-phenotypes-in-contemporary-citrobacter-isolates-in-a-university-hospital-in-crete-greece
#14
Sofia Maraki, Konstantinos Z Vardakas, Viktoria-Eirini Mavromanolaki, Margarita Kyriakidou, George Spais, Diamantis P Kofteridis, George Samonis, Matthew E Falagas
BACKGROUND: Data on Citrobacter spp. susceptibility are scarce. We sought to study the evolution in the susceptibility of 385 Citrobacter spp. at the University Hospital of Heraklion, Crete, Greece during a six-year period (2010-2015). METHODS: Non-duplicate strains isolated from inpatients (intensive care unit, oncology, surgery, internal medicine, paediatrics) and outpatients were studied using Vitek 2. Phenotypic confirmatory tests were applied for detection of β-lactamases and aminoglycoside modifying enzymes...
March 9, 2017: Infectious Diseases
https://www.readbyqxmd.com/read/28273966/stenotrophomonas-maltophilia-an-emerging-pathogen-in-paediatric-population
#15
Charu Nayyar, Preeti Thakur, Vibhor Tak, Karnika Saigal
INTRODUCTION: Stenotrophomonas maltophilia (formerly Pseudomonas maltophilia/Xanthomonas maltophilia), a Gram- negative, non-fermenting bacillus, is being increasingly recognized as a threatening nosocomial pathogen, associated with significant mortality. AIM: To determine the prevalence of infection, antimicrobial susceptibility pattern and clinical outcome of S. maltophilia in a paediatric population. MATERIALS AND METHODS: This was a retrospective study conducted over a period of eight months, i...
January 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28267299/predicting-the-effect-of-treatment-in-paediatric-osa-by-clinical-examination-and-functional-respiratory-imaging
#16
Monique Slaats, Wim Vos, Cedric Van Holsbeke, Jan De Backer, Dieter Loterman, Wilfried De Backer, An Boudewyns, Stijn Verhulst
OBJECTIVE: The aim of this study was to investigate whether functional respiratory imaging (FRI) or clinical examination could predict treatment outcome for obstructive sleep apnea (OSA) in normal-weight, non-syndromic children. METHODS: Normal weight children diagnosed with OSA by polysomnography were prospectively included. All children got a thorough evaluation and an ultra-low dose computed tomography scan of the upper airway (UA). A 3-D reconstruction was built combined with computational fluid dynamics for FRI...
March 7, 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/28264021/antimicrobial-use-in-paediatric-patients-in-a-teaching-hospital-in-ethiopia
#17
Hafte Kahsay Kebede, Hailay Abrha Gesesew, Tewodros Eyob Woldehaimanot, Kabaye Kumela Goro
BACKGROUND: Antibiotics use in in children are different from adults due to a lack of data on pharmacokinetics, pharmacodynamics, efficacy and safety of drugs, different physiological spectrum, pediatrics populations being vulnerable to the majority of the illnesses, and the adverse effect of their irrational use is more serious. However, antibiotic use is not explored much in a paediatric population. The current study focused on antibiotic use among pediatric population using data from a tertiary hospital in Ethiopia...
2017: PloS One
https://www.readbyqxmd.com/read/28262914/prophylactic-levosimendan-for-the-prevention-of-low-cardiac-output-syndrome-and-mortality-in-paediatric-patients-undergoing-surgery-for-congenital-heart-disease
#18
REVIEW
Johanna Hummel, Gerta Rücker, Brigitte Stiller
BACKGROUND: Low cardiac output syndrome remains a serious complication, and accounts for substantial morbidity and mortality in the postoperative course of paediatric patients undergoing surgery for congenital heart disease. Standard prophylactic and therapeutic strategies for low cardiac output syndrome are based mainly on catecholamines, which are effective drugs, but have considerable side effects. Levosimendan, a calcium sensitiser, enhances the myocardial function by generating more energy-efficient myocardial contractility than achieved via adrenergic stimulation with catecholamines...
March 6, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28262913/pharmacological-interventions-for-recurrent-abdominal-pain-in-childhood
#19
REVIEW
Alice E Martin, Tamsin V Newlove-Delgado, Rebecca A Abbott, Alison Bethel, Joanna Thompson-Coon, Rebecca Whear, Stuart Logan
BACKGROUND: Between 4% and 25% of school-aged children at some stage complain of recurrent abdominal pain (RAP) of sufficient severity to interfere with their daily lives. When no clear organic cause is found, the children are managed with reassurance and simple measures; a large range of pharmacological interventions have been recommended for use in these children. OBJECTIVES: To determine the effectiveness of pharmacological interventions for RAP in children of school age...
March 6, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28258343/efficacy-safety-and-feasibility-of-antifungal-prophylaxis-with-posaconazole-tablet-in-paediatric-patients-after-haematopoietic-stem-cell-transplantation
#20
Michaela Döring, Karin Melanie Cabanillas Stanchi, Manon Queudeville, Judith Feucht, Franziska Blaeschke, Patrick Schlegel, Tobias Feuchtinger, Peter Lang, Ingo Müller, Rupert Handgretinger, Werner J Heinz
PURPOSE: Paediatric recipients of haematopoietic stem cell transplantation (HSCT) have a high risk for invasive fungal infections. Posaconazole oral suspension has proven to be effective in antifungal prophylaxis in adult and paediatric patients. A new posaconazole tablet formulation with absorption independent of the gastric conditions was approved by the FDA in 2013. This is the first report on the use of posaconazole tablets in paediatric patients. METHODS: This single-centre study included 63 paediatric patients with haemato-oncological malignancies who received posaconazole for antifungal prophylaxis after HSCT...
March 3, 2017: Journal of Cancer Research and Clinical Oncology
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