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paediatric drugs

Marco Giardiello, Neill J Liptrott, Tom O McDonald, Darren Moss, Marco Siccardi, Phil Martin, Darren Smith, Rohan Gurjar, Steve P Rannard, Andrew Owen
Considerable scope exists to vary the physical and chemical properties of nanoparticles, with subsequent impact on biological interactions; however, no accelerated process to access large nanoparticle material space is currently available, hampering the development of new nanomedicines. In particular, no clinically available nanotherapies exist for HIV populations and conventional paediatric HIV medicines are poorly available; one current paediatric formulation utilizes high ethanol concentrations to solubilize lopinavir, a poorly soluble antiretroviral...
October 21, 2016: Nature Communications
Lesley J Scott
Intravenous ceftaroline fosamil (Zinforo™), a prodrug that is rapidly converted to its active metabolite ceftaroline, is approved for use in adults and children (from 2 months of age) with complicated skin and soft tissue infections (cSSTIs) or community-acquired pneumonia (CAP). In several multinational trials, ceftaroline fosamil was an effective and generally well tolerated treatment in adult and paediatric patients with cSSTIs or CAP. In the phase 3 CANVAS trials, ceftaroline fosamil treatment was noninferior to vancomycin plus aztreonam in adults with cSSTIs...
October 20, 2016: Drugs
Lai Heng Lee
The group of new oral anticoagulants or NOACs, now termed direct oral anticoagulants or DOACs, with their favourable results from large scale phase III clinical trials, represent a major advancement and expanded armamentarium in antithrombotic therapy. Dabigatran, rivaroxaban, apixaban and edoxaban are now in clinical routine use for prevention and treatment of arterial and venous thrombotic diseases as addressed in their clinical trials. Usage of the DOACs is expected to increase as clinicians gain more experience and reassurance with data from the real world studies which are generally consistent with that from clinical trials...
2016: Thrombosis Journal
Heloise Buys, Rudzani Muloiwa, Colleen Bamford, Brian Eley
BACKGROUND: Klebsiella pneumoniae (KP) is a significant paediatric bloodstream pathogen in children. There is little data from Africa. In this study we describe the epidemiology of multi-drug resistant Klebsiella pneumoniae bloodstream infection (KPBSI) at Red Cross War Memorial Children's Hospital, Cape Town, South Africa. METHODS: We conducted a retrospective cross-sectional study of KPBSI from 1 January 2006 to 31 December 2011 using conventional descriptive and inferential statistical methods...
October 17, 2016: BMC Infectious Diseases
Jeroen R Scheepe, Bertil F M Blok, Lisette A 't Hoen
PURPOSE OF REVIEW: The purpose of this article is to provide an overview about the applicability of botulinum toxin type A (BTX-A) in paediatric neurogenic bladder based on the recently published literature combined with hypothetical notes and future perspectives. RECENT FINDINGS: The indications, clinical outcomes, urodynamic outcome parameters and cost-effectiveness are presented from recent publications. Also, alternative routes of application of BTX-A in the bladder are discussed as well as the influence of BTX-A on conservative and invasive treatment...
September 29, 2016: Current Opinion in Urology
Mapi Fleury, Caroline Fonzo-Christe, Charline Normand, Pascal Bonnabry
A heavily immunosuppressed, 43-kg, 9-year-old patient was recovering from a bone marrow transplant. Primary prophylaxis against invasive fungal infections was liposomal amphotericin B (AmBisome(®), 2.3 mg/kg [100 mg] two times per week). Once home, following a first amphotericin B infusion, he presented with strong diarrhoea and vomiting; this was repeated after the second infusion. The clinical situation worsened rapidly and the patient was rehospitalised. On admission, he presented with acute renal failure...
December 2016: Drug Saf Case Rep
Chandni Sinha, Bindey Kumar, Umesh Kumar Bhadani, Ajeet Kumar, Amarjeet Kumar, Alok Ranjan
BACKGROUND: Caudal block is a reliable regional analgesic technique for pediatric urogenital surgeries. Various adjuvants have been tried to enhance the duration of action of bupivicaine. Though clonidine is extensively used as an adjuvant in caudal anaesthesia, it can have troublesome adverse effects like bradycardia, hypotension and sedation. Lately dexamethasone has become popular as an adjuvant in paediatric caudals due to its safety profile. AIM: The aim of this study was to compare dexamethasone and clonidine coadministered with bupivicaine caudally in paediatric patients undergoing urogenital surgeries in terms of analgesia and adverse effects...
September 2016: Anesthesia, Essays and Researches
Berglind Jonsdottir, Christer Larsson, Annelie Carlsson, Gun Forsander, Sten Anders Ivarsson, Åke Lernmark, Johnny Ludvigsson, Claude Marcus, Ulf Samuelsson, Eva Örtqvist, Helena Elding Larsson
CONTEXT: Screening of autoimmune thyroid disease in children and young adults with Type 1 diabetes is important but vary greatly between clinics. OBJECTIVE: The aim was to determine the predictive value of thyroid autoantibodies, thyroid function, islet autoantibodies, and HLA- DQ at diagnosis of Type 1 diabetes for autoimmune thyroid disease during subsequent follow-up. SETTING: 43 Paediatric Endocrinology units Sweden. Design, patients and main outcome measures: At diagnosis of Type 1 diabetes, samples from 2433 children were analysed for autoantibodies against thyroid peroxidase (TPOAb), thyroglobulin (TGAb), glutamic acid decarboxylase (GADA), insulin (IAA), insulinoma-associated protein-2 (IA-2A), and the three variants of the zinc transporter 8 (ZnT8W/R/QA) as well as HLA-DQA1-B1 genotypes and thyroid function...
October 14, 2016: Journal of Clinical Endocrinology and Metabolism
Liz Jamieson, Ian C K Wong, Finella Craig, Nanna Christiansen, Karen Brombley, Catherine Tuleu, Emily Harrop
OBJECTIVES: This paper seeks to highlight from a UK perspective the current lack of a research evidence base in paediatric palliative care that has resulted in a paucity of available medicines with appropriate formulations (strength and dosage form) to provide symptom management for children with life-limiting illnesses and to raise awareness of this group of 'therapeutic orphans'. Currently, clinicians have limited, often unsuitable medication choices for their paediatric palliative care patients, with little hope of moving away from the status quo...
October 13, 2016: Journal of Pharmacy and Pharmacology
P S Sidhu
In these days of political vagueness, to use a kinder term, although many would describe the situation as turmoil, in Europe, there are success stories to be lauded. Notwithstanding the direction individual countries choose in relation to closer or not so close co-operation in Europe and the direction the political agenda will travel over the next few years, I believe science and in particular medicine has benefited enormously form close co-operation across the European Union and with colleagues outside this political and trading block of nations...
October 2016: Ultraschall in der Medizin
Sophie Desmonde, Tessa Goetghebuer, Claire Thorne, Valériane Leroy
PURPOSE OF REVIEW: The number of HIV-exposed but uninfected (HEU) infants exposed to both HIV and multiple antiretroviral drugs in utero and during prolonged breastfeeding is increasing in low-income countries where HIV prevalence is the highest. We review recent evidence on the effects of perinatal/postnatal exposure to maternal HIV and combined antiretroviral therapy (cART) on health outcomes of HEU children (mitochondrial and metabolic toxicity, adverse pregnancy outcomes, neurodevelopment, growth, infectious morbidity, and mortality)...
September 2016: Current Opinion in HIV and AIDS
Viviane Klingmann
To ensure optimal, reliable treatment, it is necessary to investigate the efficacy, safety and the optimal dose of drug substances and to develop suitable age-specific pharmaceutical formulations for the different paediatric age groups due to a lack of evidence-based therapeutic options for children. While WHO recommends the use of solid dosage forms in general, European Medicines Agency (EMA) requires evidence for the suitability of these dosage forms in the targeted age group. This review aims to summarize and discuss the data obtained in acceptability studies on the suitability of coated and uncoated mini-tablets in children of different ages in comparison to a sweet syrup considered as gold standard...
October 6, 2016: AAPS PharmSciTech
(no author information available yet)
The European Paediatric Regulation 2007 was introduced to improve development of high quality medicines for children. A lack of appropriate medicines for this client group is an extensive and well-documented problem and the use of off-label and unlicensed medication is a widespread practice. Ernest et al ( 2007 ) state that most drugs are not labelled, or are inadequately labelled, for use in child patients. Critical safety and efficacy information is lacking and poses significant risks to this vulnerable population...
September 29, 2011: Nursing Children and Young People
(no author information available yet)
Background The lack of appropriate available medications for children is a well-known problem. Before a medicine is licensed, has to undergo extensive studies to test safety and efficacy in the target population, however, 50-70 per cent of drugs given to children have not been tested for this specific population. Barriers to research on children's drug development include: cost compared with the size of the market, making it financially unrewarding for pharmaceutical companies; difficulties in trial design; time taken to complete studies; long approval processes; complex ethical considerations; and risk-benefit issues...
September 29, 2011: Nursing Children and Young People
Mia Sivén, Satu Kovanen, Outi Siirola, Tuomas Hepojoki, Sari Isokirmo, Niina Laihanen, Tiina Eränen, Jukka Pellinen, Anne M Juppo
OBJECTIVES: The study evaluated the quality of compounded sachets and hard gelatine capsules and their feasibility in paediatric drug administration. METHODS: Commercial tablets were compounded to sachets and capsules in hospital environment, and the uniformity of content and simulated drug dose were determined. KEY FINDINGS: Compounded formulations were successfully obtained for a range of drug substances; dipyridamole, spironolactone, warfarin and sotalol formulations were within acceptable limits for uniformity of content, in most cases...
October 5, 2016: Journal of Pharmacy and Pharmacology
Joana Martir, Talia Flanagan, James Mann, Nikoletta Fotaki
OBJECTIVES: This review focuses on the recommended strategies for the oral administration of paediatric medicines with food in the context of their biopharmaceutical properties. KEY FINDINGS: Acceptability of oral medicines in young patients is more challenging than in adult patients. Mixing oral dosage forms with foods and drinks is sometimes suggested to administer a specific dose and enhance compliance in the paediatric population. In this review, the strategies for the co-administration of paediatric medicines with food and drinks are discussed...
October 5, 2016: Journal of Pharmacy and Pharmacology
Tracy Coelho, Gaia Andreoletti, James J Ashton, Akshay Batra, Nadeem Ahmad Afzal, Yifang Gao, Anthony P Williams, Robert M Beattie, Sarah Ennis
The aim of our study was to assess the utility of next generation sequencing (NGS) for predicting toxicity and clinical response to thiopurine drugs in paediatric patients with inflammatory bowel disease. Exome data for 100 patients were assessed against biochemically measured TPMT enzyme activity, clinical response and adverse effects. The TPMT gene and a panel of 15 other genes implicated in thiopurine toxicity were analysed using a gene based statistical test (SKAT-O test). Nine patients out of 100 (Crohn's disease- 67, ulcerative colitis- 23 and IBDU-10) had known TPMT mutations associated with deficient enzyme activity...
October 5, 2016: Scientific Reports
Sebastian Botzenhardt, Asia N Rashed, Ian C K Wong, Stephen Tomlin, Antje Neubert
AIM: Analgesic and anti-inflammatory drugs are frequently prescribed in paediatrics. Prescribing and dosing patterns in hospitalised children are not well known. This study explores analgesic drug utilisation on five paediatric wards and discusses its findings in comparison with World Health Organization (WHO) guidelines. METHOD: A sub-analysis of a prospective, multicentre, observational cohort study was undertaken. Prescription data of children aged up to ≤18 years were collected between October 2008 and December 2009 on paediatric general medical wards in five hospitals in Australia, Germany, the United Kingdom (UK), Hong Kong (HK) and Malaysia...
September 30, 2016: Paediatric Drugs
Sheetal Gupta, Ghanshyam Singh Sengar, Praveen K Meti, Anil Lahoti, Mukesh Beniwal, Murlidhar Kumawat
OBJECTIVE: To determine incidence, risk factors, and outcome of acute kidney injury (AKI) in Pediatric Intensive Care Unit (PICU). MATERIALS AND METHODS: This is a prospective, observational study conducted in PICU of Department of Paediatrics, S.P. Medical College, Bikaner, from October 2013 to May 2014. In this study, 536 patients of aged 29 days to 16 years were screened for AKI according to the Pediatric Risk, Injury, Failure, Loss, End-stage Renal Disease (pRIFLE) criteria...
September 2016: Indian Journal of Critical Care Medicine
Nadeem Ullah Khan, Uzma Rahim Khan, Asher Feroze, Sajjad Ali Khan, Najia Ali, Kiran Ejaz, Afshan Rahim Khan, Shahnila Nooruddin, Jabeen Fayyaz
OBJECTIVE: To determine the trends of acute poisoning in terms of frequency, nature of poisoning agent, clinical presentation and its outcome. METHODS: The retrospective study was conducted at the Aga Khan University Hospital, Karachi, and comprised data of patients who presented with poisoning between January 1989 and December 2010.The patients were randomly selected , and demographic, chemical information, clinical feature, treatment and outcome were analysed using SPSS 16...
October 2016: JPMA. the Journal of the Pakistan Medical Association
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