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https://www.readbyqxmd.com/read/28105598/clinical-pharmacokinetics-and-pharmacodynamics-of-dexmedetomidine
#1
REVIEW
Maud A S Weerink, Michel M R F Struys, Laura N Hannivoort, Clemens R M Barends, Anthony R Absalom, Pieter Colin
Dexmedetomidine is an α2-adrenoceptor agonist with sedative, anxiolytic, sympatholytic, and analgesic-sparing effects, and minimal depression of respiratory function. It is potent and highly selective for α2-receptors with an α2:α1 ratio of 1620:1. Hemodynamic effects, which include transient hypertension, bradycardia, and hypotension, result from the drug's peripheral vasoconstrictive and sympatholytic properties. Dexmedetomidine exerts its hypnotic action through activation of central pre- and postsynaptic α2-receptors in the locus coeruleus, thereby inducting a state of unconsciousness similar to natural sleep, with the unique aspect that patients remain easily rousable and cooperative...
January 19, 2017: Clinical Pharmacokinetics
https://www.readbyqxmd.com/read/28105511/bone-density-in-the-obese-child-clinical-considerations-and-diagnostic-challenges
#2
Jennifer C Kelley, Nicola Crabtree, Babette S Zemel
The prevalence of obesity in children has reached epidemic proportions. Concern about bone health in obese children, in part, derives from the potentially increased fracture risk associated with obesity. Additional risk factors that affect bone mineral accretion, may also contribute to obesity, such as low physical activity and nutritional factors. Consequences of obesity, such as inflammation, insulin resistance, and non-alcoholic fatty liver disease, may also affect bone mineral acquisition, especially during the adolescent years when rapid increases in bone contribute to attaining peak bone mass...
January 20, 2017: Calcified Tissue International
https://www.readbyqxmd.com/read/28104717/clinical-targeted-exome-based-sequencing-in-combination-with-genome-wide-copy-number-profiling-precision-medicine-analysis-of-203-pediatric-brain-tumors
#3
Shakti H Ramkissoon, Pratiti Bandopadhayay, Jaeho Hwang, Lori A Ramkissoon, Noah F Greenwald, Steven E Schumacher, Ryan O'Rourke, Nathan Pinches, Patricia Ho, Hayley Malkin, Claire Sinai, Mariella Filbin, Ashley Plant, Wenya Linda Bi, Michael S Chang, Edward Yang, Karen D Wright, Peter E Manley, Matthew Ducar, Sanda Alexandrescu, Hart Lidov, Ivana Delalle, Liliana C Goumnerova, Alanna J Church, Katherine A Janeway, Marian H Harris, Laura E MacConaill, Rebecca D Folkerth, Neal I Lindeman, Charles D Stiles, Mark W Kieran, Azra H Ligon, Sandro Santagata, Adrian M Dubuc, Susan N Chi, Rameen Beroukhim, Keith L Ligon
BACKGROUND: Clinical genomics platforms are needed to identify targetable alterations, but implementation of these technologies and best practices in routine clinical pediatric oncology practice are not yet well established. METHODS: Profile is an institution-wide prospective clinical research initiative that uses targeted sequencing to identify targetable alterations in tumors. OncoPanel, a multiplexed targeted exome-sequencing platform that includes 300 cancer-causing genes, was used to assess single nucleotide variants and rearrangements/indels...
January 19, 2017: Neuro-oncology
https://www.readbyqxmd.com/read/28103632/global-health-and-emergency-care-defining-clinical-research-priorities
#4
Bhakti Hansoti, Adam R Aluisio, Meagan A Barry, Kevin Davey, Brian A Lentz, Payal Modi, Jennifer A Newberry, Melissa H Patel, Tricia A Smith, Alexandra M Vinograd, Adam C Levine
OBJECTIVES: Despite recent strides in the development of Global Emergency Medicine (EM), the field continues to lag in applying a scientific approach to identifying critical knowledge gaps and advancing evidence-based solutions to clinical and public health problems seen in emergency departments worldwide. Here, progress on the Global EM research agenda created at the 2013 Academic Emergency Medicine Global Health and Emergency Care Consensus Conference is evaluated and critical areas for future development in emergency care research internationally are identified...
January 19, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28103181/positive-schemas-psychopathology-and-quality-of-life-in-children-with-pediatric-cancer-a-pilot-study
#5
Brae Anne McArthur, Douglas Strother, Fiona Schulte
PURPOSE: Research in the area of pediatric oncology has shown that although some children and youth diagnosed with this disease cope adaptively after their diagnosis, others continue to have long-term psychosocial difficulties. The potential mechanisms that may protect against the experience of psychopathology and poor quality of life within this population are not well known. The purpose of this pilot study was to utilize a new comprehensive measure of positive schemas to better understand the relationship between positive schemas, quality of life, and psychopathology, for children on active treatment for cancer...
January 19, 2017: Journal of Psychosocial Oncology
https://www.readbyqxmd.com/read/28100464/six-month-market-exclusivity-extensions-to-promote-research-offer-substantial-returns-for-many-drug-makers
#6
Aaron S Kesselheim, Benjamin N Rome, Ameet Sarpatwari, Jerry Avorn
To incentivize pharmaceutical manufacturers to invest in areas of unmet medical need, policy makers frequently propose extending the market exclusivity period of desired drugs. Some such proposals are modeled after the pediatric exclusivity patent extension program, which since 1997 has provided six additional months of market exclusivity for drugs studied in children. The most recent proposal would encourage rare disease research by providing six months of extended exclusivity for any existing drug that is granted subsequent FDA approval for a new rare disease indication...
January 18, 2017: Health Affairs
https://www.readbyqxmd.com/read/28099423/high-dose-erythropoietin-population-pharmacokinetics-in-neonates-with-hypoxic-ischemic-encephalopathy-receiving-hypothermia
#7
Adam Frymoyer, Sandra E Juul, An N Massaro, Theo K Bammler, Yvonne W Wu
BACKGROUND: High-dose erythropoietin (Epo) is a promising neuroprotective treatment in neonates with hypoxic ischemic encephalopathy (HIE) receiving hypothermia. We evaluated the pharmacokinetics and dose-exposure relationships of high-dose Epo in this population to inform future dosing strategies. METHODS: We performed a population pharmacokinetic analysis of 47 neonates with HIE treated with hypothermia who received up to 6 doses of Epo in two previous clinical trials...
January 18, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28099323/anesthesia-and-databases-pediatric-cardiac-disease-as-a-role-model
#8
David F Vener, Sara K Pasquali, Emad B Mossad
Large data sets have now become ubiquitous in clinical medicine; they are particularly useful in high-acuity, low-volume conditions such as congenital heart disease where data must be collected from many centers. These data fall into 2 categories: administrative data arising from hospital admissions and charges and clinical data relating to specific diseases or procedures. In congenital cardiac diseases, there are now over a dozen of these data sets or registries focusing on various elements of patient care...
February 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28097382/ventriculoperitoneal-shunt-malfunction-caused-by-fractures-and-disconnections-over-10%C3%A2-years-of-follow-up
#9
Fatih Serhat Erol, Sait Ozturk, Bekir Akgun, Metin Kaplan
PURPOSE: We have discussed the diagnosis and treatment approaches in patients with discontinued (disconnected or fractured) ventriculoperitoneal (VP) shunts that caused mechanical dysfunction. METHODS: Between 2006 and 2016, VP shunt surgery was performed on 1357 pediatric patients in our clinic. In follow-up examinations, we retrospectively reviewed patients who underwent revision surgery. Except for diagnosis of discontinued VP shunt, by excluding revision-surgery patients, only those patients who underwent surgical treatment owing to discontinued (fracture or disconnection) catheter were included in the study...
January 17, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28094121/mealtime-behavior-among-parents-and-their-young-children-with-food-allergy
#10
Linda Jones Herbert, Priya Mehta, Hemant Sharma
BACKGROUND: Food allergies are increasingly prevalent in the pediatric population. Balancing allergen avoidance with the promotion of healthy eating behaviors can be challenging for families. OBJECTIVE: To characterize mealtime behaviors among parents of young children with food allergy. METHODS: Seventy-four parents of young children with food allergies (≤7 years of age) completed measures of mealtime behavior, perceptions of food allergy risk and severity, pediatric parenting stress, and food allergy-related quality of life...
January 13, 2017: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/28093801/from-questions-to-answers-examining-the-role-of-pediatric-surveillance-units-in-eating-disorder-research
#11
Debra K Katzman, Sloane Madden, Dasha Nicholls, Karizma Mawjee, Mark L Norris
Pediatric Surveillance Units (PSUs) provide a unique model for the study of pediatric eating disorders (EDs). Australia, Britain, and Canada have surveillance programs that have generated valuable epidemiological and clinical data on early-onset eating disorders (EOED). The PSUs represent an important collaborative tool that has helped shape our understanding of EOEDs and offers potential to contribute to decisions regarding health resource allocation and public health policy. This paper reviews the role of PSUs as a unique model to study pediatric EDs and its success in translating the knowledge generated by these programs into improving the health of children and adolescents with EDs worldwide...
January 17, 2017: International Journal of Eating Disorders
https://www.readbyqxmd.com/read/28092724/the-pediatric-rome-iv-criteria-what-s-new
#12
Ilan J N Koppen, Samuel Nurko, Miguel Saps, Carlo Di Lorenzo, Marc A Benninga
Functional gastrointestinal disorders (FGIDs) are common in children of all ages and comprise of a wide range of conditions related to the gastrointestinal tract that cannot be attributed to structural or biochemical abnormalities. FGIDs are diagnosed according to the symptom-based Rome criteria. Areas covered: In 2016, the revised pediatric Rome IV criteria were published, these revised criteria are discussed in this review article. For the youngest age group (neonates/toddlers), the criteria for infant colic have undergone the most notable revisions...
January 16, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28092280/challenges-and-opportunities-to-enhance-global-drug-development-in-neonates
#13
Alexandra M Smith, Jonathan M Davis
PURPOSE OF REVIEW: This study reviews the history of neonatal drug development, recent legislative efforts designed to facilitate the study of therapeutic agents in neonates, and future steps necessary to advance drug development. RECENT FINDINGS: Although many federal regulations have been introduced over the past 15 years to encourage pediatric and neonatal drug development, the majority of medications that are used in the Neonatal Intensive Care Unit are not approved by the Food and Drug Administration (FDA) for use in neonates...
January 13, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28091816/pediatric-cerebral-sinovenous-thrombosis-following-cranial-surgery
#14
Dmitriy Petrov, Michael Y Uohara, Rebecca Ichord, Zarina Ali, Laura Jastrzab, Shih-Shan Lang, Lori Billinghurst
PURPOSE: Pediatric cerebral sinovenous thrombosis (CSVT) is an important, though less common subtype of pediatric stroke. It has been linked to several risk factors, including cranial procedures, with few studies highlighting this relationship. The aim of this study was to characterize the diagnosis and treatment of CSVT after cranial surgery. METHODS: An institutional pediatric stroke research database was used to identify all CSVT cases diagnosed within 30 days of cranial surgery from November 2004 to December 2014...
January 14, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28091414/acute-myeloid-leukemia-advancements-in-diagnosis-and-treatment
#15
REVIEW
Meng-Ge Yu, Hu-Yong Zheng
OBJECTIVE: Leukemia is the most common pediatric malignancy and a major cause of morbidity and mortality in children. Among all subtypes, a lack of consensus exists regarding the diagnosis and treatment of acute myeloid leukemia (AML). Patient survival rates have remained modest for the past three decades in AML. Recently, targeted therapy has emerged as a promising treatment. DATA SOURCES: We searched the PubMed database for recently published research papers on diagnostic development, target therapy, and other novel therapies of AML...
2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28090807/neurocognitive-function-in-pediatric-obsessive-compulsive-disorder
#16
Daniel A Geller, Amitai Abramovitch, Andrew Mittelman, Abigail Stark, Kesley Ramsey, Allison Cooperman, Lee Baer, S Evelyn Stewart
OBJECTIVES: The small body of neuropsychological research in pediatric OCD yields inconsistent results. A recent meta-analysis found small effect sizes, concluding that pediatric OCD may not be associated with cognitive impairments, stressing the need for more research. We investigated neuropsychological performance in a large sample of OCD youth, while assessing potential moderators. METHODS: Participants with OCD (n = 102), and matched controls (n = 161) were thoroughly screened and blindly evaluated for comorbidities, and completed a neuropsychological battery assessing processing-speed, visuospatial abilities (VSA), working memory (WM), nonverbal memory (NVM), and executive functions (EF)...
January 16, 2017: World Journal of Biological Psychiatry
https://www.readbyqxmd.com/read/28089294/the-american-academy-of-pediatrics-workforce-survey-for-the-section-on-urology-2015
#17
E Shapiro, Christopher S Cooper, S Greenfield
INTRODUCTION: In 2013, the American Academy of Pediatrics (AAP) Division of Workforce and Medical Education Policy assumed the task of organizing the updated AAP Workforce Survey, which was modeled after the Future of Pediatric Education II study. OBJECTIVE: The objective of the present study was to evaluate changes in practice patterns of all pediatric medical and surgical specialists over time, to facilitate advocacy work by the Academy at federal and state levels...
October 8, 2016: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28089099/clinical-characteristics-and-outcome-of-invasive-fungal-infections-in-pediatric-acute-myeloid-leukemia-patients-in-a-medical-center-in-taiwan
#18
Gu-Lung Lin, Hsiu-Hao Chang, Chun-Yi Lu, Chung-Ming Chen, Meng-Yao Lu, Ping-Ing Lee, Shiann-Tarng Jou, Yung-Li Yang, Li-Min Huang, Luan-Yin Chang
BACKGROUND: Invasive fungal infection (IFI) causes significant morbidity and mortality in patients with hematological malignancies, especially those with acute myeloid leukemia (AML), recurrent acute leukemia, high-risk acute lymphoblastic leukemia, and after allogeneic hematopoietic stem cell transplantation. The study aimed to investigate the clinical characteristics and outcome of IFIs in pediatric AML patients in a medical center in Taiwan. METHODS: We performed retrospective chart reviews...
December 19, 2016: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
https://www.readbyqxmd.com/read/28087540/international-evidence-based-consensus-diagnostic-criteria-for-hhv-8-negative-idiopathic-multicentric-castleman-disease
#19
David C Fajgenbaum, Thomas S Uldrick, Adam Bagg, Dale Frank, David Wu, Gordan Srkalovic, David Simpson, Amy Y Liu, David Menke, Shanmuganathan Chandrakasan, Mary Jo Lechowicz, Raymond S M Wong, Sheila Pierson, Michele Paessler, Jean-François Rossi, Makoto Ide, Jason Ruth, Michael Croglio, Alexander Suarez, Vera Krymskaya, Amy Chadburn, Gisele Colleoni, Sunita Nasta, Raj Jayanthan, Christopher S Nabel, Corey Casper, Angela Dispenzieri, Alexander Fosså, Dermot Kelleher, Razelle Kurzrock, Peter Voorhees, Ahmet Dogan, Kazuyuki Yoshizaki, Frits van Rhee, Eric Oksenhendler, Elaine S Jaffe, Kojo S J Elenitoba-Johnson, Megan S Lim
Human Herpesvirus-8(HHV-8)-negative, idiopathic multicentric Castleman disease (iMCD) is a rare and life-threatening disorder involving systemic inflammatory symptoms, polyclonal lymphoproliferation, cytopenias, and multiple organ system dysfunction due to a cytokine storm often including interleukin-6. iMCD accounts for one-third to one-half of all cases of MCD and can occur in individuals of any age. Accurate diagnosis is challenging, as no standard diagnostic criteria or diagnostic biomarkers currently exist, and there is significant overlap with malignant, autoimmune, and infectious disorders...
January 13, 2017: Blood
https://www.readbyqxmd.com/read/28086969/multicenter-neonatal-databases-trends-in-research-uses
#20
Liza M Creel, Sean Gregory, Catherine J McNeal, Madhava R Beeram, David R Krauss
BACKGROUND: In the US, approximately 12.7% of all live births are preterm, 8.2% of live births were low birth weight (LBW), and 1.5% are very low birth weight (VLBW). Although technological advances have improved mortality rates among preterm and LBW infants, improving overall rates of prematurity and LBW remains a national priority. Monitoring short- and long-term outcomes is critical for advancing medical treatment and minimizing morbidities associated with prematurity or LBW; however, studying these infants can be challenging...
January 13, 2017: BMC Research Notes
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