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Pediatric simulation

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https://www.readbyqxmd.com/read/28931691/vertical-transmission-of-hepatitis-c-virus-variable-transmission-bottleneck-and-evidence-of-mid-gestation-in-utero-infection
#1
Sébastien Fauteux-Daniel, Ariane Larouche, Virginie Calderon, Jonathan Boulais, Chanel Béland, Doris G Ransy, Marc Boucher, Valérie Lamarre, Normand Lapointe, Isabelle Boucoiran, Armelle Le Campion, Hugo Soudeyns
Hepatitis C virus (HCV) can be transmitted from mother to child during pregnancy and childbirth. However, the timing and precise biologic mechanisms that are involved in this process are incompletely understood, as are the determinants that influence transmission of particular HCV variants. Here we report results of a longitudinal assessment of HCV quasispecies diversity and composition in 5 cases of vertical HCV transmission, including 3 women coinfected with HIV-1. The population structure of HCV variant spectra based on E2 envelope gene sequences (nucleotide positions 1491-1787), including hypervariable regions 1 and 2, was characterized using next-generation sequencing and median joining network analysis...
September 20, 2017: Journal of Virology
https://www.readbyqxmd.com/read/28925064/improving-realism-in-clinical-trial-simulations-via-real-world-data
#2
EDITORIAL
Holly Kimko, Kwan Lee
Simulation validity depends on how well sampling distributions used reflect real-patient characteristics, such as drug adherence, disease progression, and pharmacologic handling in the body. We challenge the current use of growth charts from nondisease-specific pediatrics in simulations for drug development. Complementary use of data from clinical trials and the real-world is expected to achieve a more realistic representation of clinical outcomes for decisions in drug development, regulatory approval, and health technology assessment...
September 19, 2017: CPT: Pharmacometrics & Systems Pharmacology
https://www.readbyqxmd.com/read/28910514/pharmacokinetics-of-single-dose-ceftaroline-fosamil-in-children-with-cystic-fibrosis
#3
Jennifer Le, John S Bradley, Sara Hingtgen, Shannon Skochko, Nanette Black, Ronald N Jones, Meerana Lim, Edmund V Capparelli
BACKGROUND: Single-dose pharmacokinetics (PK) and safety of ceftaroline fosamil with population pharmacokinetic/pharmacodynamic (PK/PD) modeling for staphylococcal pneumonia was performed in children with CF. METHODS: Subjects between 6 and 18 years old were evaluated in this phase 1, open-label, single-dose, prospective study using 10 mg/kg (up to 600 mg). Non-compartmental analysis and population-based PK analyses with Monte Carlo simulation (for doses 8-20 mg/kg every 8 h, infused over 1-4 h) were conducted...
September 14, 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/28884437/extrapolation-of-a-brivaracetam-exposure-response-model-from-adults-to-children-with-focal-seizures
#4
Rik Schoemaker, Janet R Wade, Armel Stockis
INTRODUCTION: Prediction of brivaracetam effects in children was obtained by scaling an existing adult pharmacokinetic/pharmacodynamic (PK/PD) model for brivaracetam to children, using an existing population PK model for brivaracetam in children. The scaling was supported by estimating the change from adults to children in the concentration-effect relationship parameters for levetiracetam, a compound interacting with the same target protein (synaptic vesicle protein SV2A). METHODS: The existing adult PK/PD model for brivaracetam was applied to a combined adult-pediatric dataset of levetiracetam...
September 7, 2017: Clinical Pharmacokinetics
https://www.readbyqxmd.com/read/28875617/clinical-considerations-when-applying-vital-signs-in-pediatric-korean-triage-and-acuity-scale
#5
Bongjin Lee, Do Kyun Kim, June Dong Park, Young Ho Kwak
Initial vital signs of children at the emergency department may be abnormal because of anxiety and irritability, resulting in unrealistic triage levels. This study aimed to evaluate the effectiveness of pediatric triage by clinical decision based on the patient's general condition. The Pediatric Korean Triage and Acuity Scale (PedKTAS) has been used nationwide for triage since 2016. The triage level, as assessed by an experienced triage nurse and based on the patient's clinical condition, was defined as the 'real practice (RP)-level,' while the re-calculated triage level, as assessed by the direct application of initial vital signs, was defined as the 'simulation (S)-level...
October 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/28873292/dose-exposure-simulation-for-piperacillin-tazobactam-dosing-strategies-in-infants-and-young-children
#6
Céline Thibault, Nastya Kassir, Yves Théorêt, France Varin, Catherine Litalien, Julie Autmizguine
BACKGROUND: Extended piperacillin-tazobactam (TZP) infusions have been associated with favourable outcomes. There are currently no pediatric dosing recommendations. OBJECTIVES: To determine appropriate TZP dosing strategies in children 2 months - 6 years according to age and different minimal inhibitory concentrations (MICs). METHODS: Age and weight were simulated for 1000 children. Post-hoc pharmacokinetic parameter estimates were generated using published clearance and volume of distribution data...
August 21, 2017: Journal of Population Therapeutics and Clinical Pharmacology
https://www.readbyqxmd.com/read/28865887/flow-characteristics-of-urethral-catheters-of-the-same-caliber-vary-between-manufacturers
#7
Carrie A Stewart, Eiichiro Yamaguchi, Jessica Teixeira Vaz, Donald P Gaver, Joseph Ortenberg
BACKGROUND: Clean intermittent catheterization (CIC) is frequently prescribed for bladder dysfunction, either per urethra or via a continent catheterizable channel. Small catheters may be required for infants or continent channels. Success with CIC is highly dependent upon patient and family compliance. The urinary flow rate through the catheter is an important factor, which can decrease CIC time and improve quality of life. There is little objective information regarding flow rate through urinary catheters to guide catheter recommendation or prescription...
July 28, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28862717/an-original-valveless-artificial-heart-providing-pulsatile-flow-tested-in-mock-circulatory-loops
#8
Piergiorgio Tozzi, Audrey Maertens, Jonathan Emery, Samuel Joseph, Matthias Kirsch, François Avellan
PURPOSE: We present the test bench results of a valveless total artificial heart that is potentially compatible with the pediatric population. METHODS: The RollingHeart is a valveless volumetric pump generating pulsatile flow. It consists of a single spherical cavity divided into 4 chambers by 2 rotating disks. The combined rotations of both disks produce changes in the volumes of the 4 cavities (suction and ejection). The blood enters/exits the spherical cavity through 4 openings that are symmetrical to the fixed rotation axis of the first disk...
August 11, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28860113/physiologically-based-pharmacokinetic-pbpk-model-of-the-cyp2d6-probe-atomoxetine-extrapolation-to-special-populations-and-drug-drug-interactions
#9
Weize Huang, Mariko Nakano, Jennifer E Sager, Isabelle Ragueneau-Majlessi, Nina Isoherranen
Physiologically based pharmacokinetic (PBPK) modeling of drug disposition and drug-drug interactions has become a key component of drug development. PBPK modeling has also been considered as an approach to predict drug disposition in special populations. However, whether models developed and validated in healthy populations can be extrapolated to special populations is not well established. The goal of this study was to determine whether a drug specific PBPK model validated using healthy populations could be used to predict drug disposition in specific populations and in organ impairment...
August 31, 2017: Drug Metabolism and Disposition: the Biological Fate of Chemicals
https://www.readbyqxmd.com/read/28856394/radiation-risk-index-for-pediatric-ct-a-patient-derived-metric
#10
Ehsan Samei, Xiaoyu Tian, W Paul Segars, Donald P Frush
BACKGROUND: There is a benefit in characterizing radiation-induced cancer risk in pediatric chest and abdominopelvic CT: a singular metric that represents the whole-body radiation burden while also accounting for age, gender and organ sensitivity. OBJECTIVE: To compute an index of radiation risk for pediatric chest and abdominopelvic CT. MATERIALS AND METHODS: Using a protocol approved by our institutional review board, 42 pediatric patients (age: 0-16 years, weight: 2-80 kg) were modeled into virtual whole-body anatomical models...
August 30, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28843486/children-with-medical-complexity-a-web-based-multimedia-curriculum-assessing-pediatric-residents-across-north-america
#11
Neha H Shah, Priti Bhansali, Aisha Barber, Keri Toner, Michael Kahn, Meaghan MacLean, Micah Kadden, Jeffrey Sestokas, Dewesh Agrawal
PURPOSE: No standardized curricula exist for training residents in the special needs of children with medical complexity (CMC). We assessed resident satisfaction, knowledge and behavior after implementing a novel online curriculum composed of multimedia modules on care of CMC utilizing virtual simulation. METHODS: We conducted a randomized controlled trial of residents across North America. A web-based curriculum of 6 self-paced, interactive, multimedia modules was developed...
August 23, 2017: Academic Pediatrics
https://www.readbyqxmd.com/read/28843460/safety-threats-during-the-care-of-infants-with-hypoglycemic-seizures-in-the-emergency-department-a-multicenter-simulation-based-prospective-cohort-study
#12
Barbara M Walsh, Sandeep Gangadharan, Travis Whitfill, Marcie Gawel, David Kessler, Robert A Dudas, Jessica Katznelson, Megan Lavoie, Khoon-Yen Tay, Melinda Hamilton, Linda L Brown, Vinay Nadkarni, Marc Auerbach
BACKGROUND: Errors in the timely diagnosis and treatment of infants with hypoglycemic seizures can lead to significant patient harm. It is challenging to precisely measure medical errors that occur during high-stakes/low-frequency events. Simulation can be used to assess risk and identify errors. OBJECTIVE: We hypothesized that general emergency departments (GEDs) would have higher rates of deviations from best practices (errors) compared to pediatric emergency departments (PEDs) when managing an infant with hypoglycemic seizures...
August 23, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28840168/size-based-quality-informed-framework-for-quantitative-optimization-of-pediatric-ct
#13
Ehsan Samei, Xiang Li, Donald P Frush
The purpose of this study was to formulate a systematic, evidence-based method to relate quantitative diagnostic performance to radiation dose, enabling a multidimensional system to optimize computed tomography imaging across pediatric populations. Based on two prior foundational studies, radiation dose was assessed in terms of organ doses, effective dose ([Formula: see text]), and risk index for 30 patients within nine color-coded pediatric age-size groups as a function of imaging parameters. The cases, supplemented with added noise and simulated lesions, were assessed in terms of nodule detection accuracy in an observer receiving operating characteristic study...
July 2017: Journal of Medical Imaging
https://www.readbyqxmd.com/read/28837739/animal-model-for-retinopathy-of-prematurity-laser-surgery-training
#14
W Walker Motley, Dema M Atoum
Peripheral retinal laser ablation for high-risk retinopathy of prematurity (ROP) improves visual outcomes. Some pediatric ophthalmology fellows receive little exposure to this procedure. The authors identified and evaluated an animal teaching model that simulates peripheral retinal laser ablation in human infants with ROP. [J Pediatr Ophthalmol Strabismus. 2017;54:e47-e49.].
August 24, 2017: Journal of Pediatric Ophthalmology and Strabismus
https://www.readbyqxmd.com/read/28830854/a-mobile-device-app-to-reduce-medication-errors-and-time-to-drug-delivery-during-pediatric-cardiopulmonary-resuscitation-study-protocol-of-a-multicenter-randomized-controlled-crossover-trial
#15
Johan N Siebert, Frederic Ehrler, Christian Lovis, Christophe Combescure, Kevin Haddad, Alain Gervaix, Sergio Manzano
BACKGROUND: During pediatric cardiopulmonary resuscitation (CPR), vasoactive drug preparation for continuous infusions is complex and time-consuming. The need for individual specific weight-based drug dose calculation and preparation places children at higher risk than adults for medication errors. Following an evidence-based and ergonomic driven approach, we developed a mobile device app called Pediatric Accurate Medication in Emergency Situations (PedAMINES), intended to guide caregivers step-by-step from preparation to delivery of drugs requiring continuous infusion...
August 22, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28822210/evaluation-of-the-association-between-disaster-training-and-confidence-in-disaster-response-among-graduate-medical-trainees-a-cross-sectional-study
#16
Andrew Grock, Adam R Aluisio, Elizabeth Abram, Patricia Roblin, Bonnie Arquilla
OBJECTIVE: Disasters by definition overwhelm the resources of a hospital and may require a response from a range of practitioners. Disaster training is part of emergency medicine (EM) resident curricula, but less emphasized in other training programs. This study aimed to compare disaster educational training and confidence levels among resident trainees from multiple specialties. DESIGN: A structured questionnaire assessed graduate medical training in disaster education and self-perceived confidence in disaster situations...
January 2017: American Journal of Disaster Medicine
https://www.readbyqxmd.com/read/28815823/ten-years-of-simulation-based-training-in-pediatric-anesthesia-the-inception-evolution-and-dissemination-of-the-managing-emergencies-in-pediatric-anesthesia-mepa-course
#17
Tobias C Everett, Ralph MacKinnon, David de Beer, Matthew Taylor, Matthew Dylan Bould
2016 marked the 10-year anniversary of the inception of the Managing Emergencies in Paediatric Anaesthesia (MEPA) course. This simulation-based program was originally created to allow trainees in pediatric anesthesia to experience operating room emergencies which although infrequent, would be considered key competencies for any practicing anesthetist with responsibility for providing care to children. Since its original manifestation, the course has evolved in content, scope, and worldwide availability, such that it is now available at over 60 locations on five continents...
October 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28814552/larose-g-levy-a-bailey-b-cummins-mcmanus-b-lebel-d-gravel-j-decreasing-prescribing-errors-during-pediatric-emergencies-a-randomized-simulation-trial-pediatrics-2017-139-3-e20163200
#18
https://www.readbyqxmd.com/read/28814318/annexin-a2-could-enhance-multidrug-resistance-by-regulating-nf-%C3%AE%C2%BAb-signaling-pathway-in-pediatric-neuroblastoma
#19
Yi Wang, Kai Chen, Yihong Cai, Yuanxia Cai, Xiaojun Yuan, Lifeng Wang, Zhixiang Wu, Yeming Wu
BACKGROUND: Chemotherapy is one of major therapeutic regimens for neuroblastoma (NB) in children. However, recurrence and metastasis associated with poor prognosis caused by acquired multidrug resistance remains a challenge. There is a great need to achieve new insight into the molecular mechanism of drug resistance in NB. The aim of this study is to identify novel drug sensitivity-related biomarkers as well as new therapeutic targets to overcome chemoresistance. METHODS: We proteome-wide quantitatively compared protein expression of two NB cell lines with different drug sensitivities, isolated from the same patient prior to and following chemotherapy...
August 16, 2017: Journal of Experimental & Clinical Cancer Research: CR
https://www.readbyqxmd.com/read/28806954/-usability-of-data-integration-and-visualization-software-for-multidisciplinary-pediatric-intensive-care-a-human-factors-approach-to-assessing-technology
#20
Ying Ling Lin, Anne-Marie Guerguerian, Jessica Tomasi, Peter Laussen, Patricia Trbovich
BACKGROUND: Intensive care clinicians use several sources of data in order to inform decision-making. We set out to evaluate a new interactive data integration platform called T3™ made available for pediatric intensive care. Three primary functions are supported: tracking of physiologic signals, displaying trajectory, and triggering decisions, by highlighting data or estimating risk of patient instability. We designed a human factors study to identify interface usability issues, to measure ease of use, and to describe interface features that may enable or hinder clinical tasks...
August 14, 2017: BMC Medical Informatics and Decision Making
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