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https://www.readbyqxmd.com/read/29683943/pentoxifylline-added-to-steroid-window-treatment-phase-modified-apoptotic-gene-expression-in-pediatric-patients-with-acute-lymphoblastic-leukemia
#1
Jesus Meza-Arroyo, Alejandro Bravo-Cuellar, Luis Felipe Jave-Suárez, Georgina Hernández-Flores, Pablo Ortiz-Lazareno, Adriana Aguilar-Lemarroy, Marlin Padilla-Corona, Fernando Sanchez-Zubieta, Oscar Gonzalez-Ramella
Pentoxifylline is a xanthine that possesses antitumor properties and that can induce higher apoptosis in the leukemic cells of pediatric patients with acute lymphoblastic leukemia (ALL) during treatment with prednisone. We conducted a phase 1 pilot, controlled, randomized trial to evaluate the gene expression modified by pentoxifylline during the steroid window of induction to remission phase in patients newly diagnosed with ALL. Experimental and control treatments induced broad changes in the gene expression profile...
April 20, 2018: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/29683873/eltrombopag-induced-acute-liver-failure-in-a-pediatric-patient-a-pharmacokinetic-and-pharmacogenetic-analysis
#2
M Marano, J Serafinelli, S Cairoli, D Martinelli, M Pisani, G Palumbo, M G Cefalo, C Cecchetti, M Di Nardo, F S Falvella, B M Goffredo
Eltrombopag is an oral thrombopoietin-receptor-agonist (TPO-RA) approved for the treatment of patients with chronic idiopathic thrombocytopenic purpura (ITP), who are more than one year old, and show poor response to first-line therapy. ITP is a hematological disorder characterized by isolated thrombocytopenia in the absence of secondary causes or disorders. Eltrombopag is generally well tolerated in the pediatric population, therefore therapeutic drug monitoring (TDM) is not usually performed in clinical practice...
April 20, 2018: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/29683097/dtcm-glutarimide-delays-growth-and-radiosensitizes-glioblastoma
#3
Gabriela Molinari Roberto, Helder Henrique Paiva, Lucas Eduardo Botelho de Souza, Julia Alejandra Pezuk, Gabriela Maciel Vieira, Harley Francisco de Oliveira, Kazuo Umezawa, Luiz Gonzaga Tone, Maria Sol Brassesco
BACKGROUND AND PURPOSE: Glioblastoma (GBM) is the most aggressive brain tumor. Even with the advent of temozolomide, patient survival remains poor, with expected median survival around 1 year from diagnosis. Consequently, the relentless search for new therapeutic strategies able to increase patient outcome persists. 3-[(dodecylthiocarbonyl) methyl] glutarimide (DTCM-g) is a new anti-inflammatory compound that already showed antitumor effects. MATERIAL AND METHODS: Clonogenic survival, proliferation, apoptosis, cell cycle progression and invasion capacity of pediatric and adult GBM cell lines (U87MG, U251MG, SF188 and KNS-42) were evaluated under treatment with DTCM-g...
April 22, 2018: Anti-cancer Agents in Medicinal Chemistry
https://www.readbyqxmd.com/read/29681490/safety-and-efficacy-of-delayed-release-dimethyl-fumarate-in-pediatric-patients-with-relapsing-multiple-sclerosis-focus
#4
Raed Alroughani, Rajiv Das, Natasha Penner, Joe Pultz, Catherine Taylor, Satish Eraly
BACKGROUND: No therapies have been formally approved by the Food and Drug Administration for use in pediatric multiple sclerosis, a rare disease. OBJECTIVE: We evaluated the safety, efficacy, and pharmacokinetics of dimethyl fumarate in pediatric patients with multiple sclerosis. METHODS: FOCUS, a phase 2, multicenter study of patients aged 10 to 17 years with relapsing-remitting multiple sclerosis, comprised an eight-week baseline and 24-week treatment period; during treatment, patients received dimethyl fumarate (120 mg twice daily on days one to seven; 240 mg twice a day thereafter)...
March 22, 2018: Pediatric Neurology
https://www.readbyqxmd.com/read/29681166/direct-acting-antivirals-to-prevent-vertical-transmission-of-viral-hepatitis-c-when-is-the-optimal-time-to-treat
#5
Leigh Cervino, Lauren M Hynicka
OBJECTIVE: To describe the most current evidence for the use of direct-acting antivirals (DAAs) to treat hepatitis C along the pregnancy-pediatric continuum in the United States. DATA SOURCES: The MEDLINE/PubMed databases were searched (January 1995 to February 2018) for articles in English using the terms: hepatitis C, vertical transmission, pregnancy, pediatrics, ribavirin, interferon, direct acting antivirals, daclatasvir, dasabuvir, elbasvir, glecaprevir, grazoprevir, ledipasvir, ombitasvir, paritaprevir, pibrentasvir, simeprevir, sofosbuvir, and velpatasvir...
April 1, 2018: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/29680919/aggravation-of-seizures-and-status-epilepticus-after-vagal-nerve-stimulation-therapy-the-first-pediatric-case-and-review-of-the-literature
#6
Ebru Arhan, Ayşe Serdaroğlu, Tuğba Hirfanoğlu, Gökhan Kurt
BACKGROUND: We describe the first child with drug-resistant epilepsy in whom vagus nerve stimulation aggravated seizures and emerged status epilepticus after the increase in vagal nerve stimulation current output. OBJECTIVE: A 13-year-old girl presented with refractory secondary generalized focal epilepsy. Vagal nerve stimulator was implanted because of drug-resistant epilepsy. After the increase of vagal nerve stimulator current output to a relatively high level, the patient experienced seizure aggravation and status epilepticus...
April 22, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29680212/impact-of-a-clinical-therapeutic-intervention-on-pain-assessment-management-and-nursing-practices-in-an-intensive-care-unit-a-before-and-after-study
#7
Vincenzo Damico, Flavio Cazzaniga, Liana Murano, Rita Ciceri, Giuseppe Nattino, Alberto Dal Molin
Accurate pain assessment and management constitute a major challenge for medical and nursing staff in intensive care units (ICUs). A distinct recollection of pain is reported by high proportions of ICU patients. A clinical therapeutic intervention directed at improving pain assessment and management in critically ill patients who are unable to communicate was implemented at an Italian ICU. In this before-and-after study, data were collected before (T0 ) and after (T1 ) the adoption of a protocol involving pain assessment with an ad hoc behavioral pain scale and the administration of analgesics, rather than sedatives, to patients with intermediate to high pain scores...
April 18, 2018: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
https://www.readbyqxmd.com/read/29679911/the-effects-of-valproate-and-topiramate-use-on-serum-insulin-leptin-neuropeptide-y-and-ghrelin-levels-in-epileptic-children
#8
Nafiye Polat Çiçek, Tülay Kamaşak, Mine Serin, Aysenur Okten, Ahmet Alver, Ali Cansu
PURPOSE: Although some drugs used in the treatment of epilepsy are known to affect body weight, the hormonal factors responsible have not been sufficiently described. The purpose of this study was to compare insulin, leptin, neuropeptide Y and ghrelin levels in children with epilepsy receiving monotherapy with topiramate (TPM) and valproic acid (VPA), the drugs whose effects on body weight have been most discussed, with those of a control group. METHOD: 48 patients (25 VPA, 23 TPM) aged between 6 and 15...
April 11, 2018: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/29679141/ethical-considerations-of-researchers-conducting-pediatric-clinical-drug-trials-a-qualitative-survey-in-two-belgian-university-children-s-hospitals
#9
Wannes Van Hoof, Kevin Meesters, Lien Dossche, Daphné Christiaens, Pauline De Bruyne, Johan Vande Walle
There is a general consensus about the underlying theoretical ethical principles that ground the practice of pediatric clinical trials: scientific necessity, good risk/benefit ratio, minimized burden, and parental consent/child assent. However, these principles are so broadly construed that it is not always clear how they should be applied in clinical practice. We conducted a qualitative study at Ghent University Hospital and the hospital of the Dutch-speaking university of Brussels on how researchers weigh ethical principles, assess the risk/benefit balance, estimate patient experience, and experience informed consent procedures in pediatric drug studies...
April 21, 2018: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29675639/pharmacokinetic-pharmacodynamic-modeling-in-pediatric-drug-development-and-the-importance-of-standardized-scaling-of-clearance
#10
REVIEW
Eva Germovsek, Charlotte I S Barker, Mike Sharland, Joseph F Standing
Pharmacokinetic/pharmacodynamic (PKPD) modeling is important in the design and conduct of clinical pharmacology research in children. During drug development, PKPD modeling and simulation should underpin rational trial design and facilitate extrapolation to investigate efficacy and safety. The application of PKPD modeling to optimize dosing recommendations and therapeutic drug monitoring is also increasing, and PKPD model-based dose individualization will become a core feature of personalized medicine. Following extensive progress on pediatric PK modeling, a greater emphasis now needs to be placed on PD modeling to understand age-related changes in drug effects...
April 19, 2018: Clinical Pharmacokinetics
https://www.readbyqxmd.com/read/29675067/making-pediatric-neuroanesthesia-safer
#11
REVIEW
Neelakshi Kalita, Amna Goswami, Parthasarathi Goswami
It a challenging task for a Neuroanaesthetist to do the tight rope walking of maintaining the homeostasis of the small baby and at the same time complying with to the demands of the surgery and the surgeon. With the advancement of surgical techniques and availability of safer anaesthetic drugs and equipments it is possible to provide anaesthesia to even premature babies. This article gives a comprehensive review of the anatomical and physiological differences between the adult and the pediatric population and the anaesthetic implications of the various neurosurgical disorders...
October 2017: Journal of Pediatric Neurosciences
https://www.readbyqxmd.com/read/29674338/prevalence-of-hypertension-in-children-with-early-stage-adpkd
#12
Laura Massella, Djalila Mekahli, Dušan Paripović, Larisa Prikhodina, Nathalie Godefroid, Anna Niemirska, Ayşe Ağbaş, Karolina Kalicka, Augustina Jankauskiene, Malgorzata Mizerska-Wasiak, Alberto Caldas Afonso, Rémi Salomon, Georges Deschênes, Gema Ariceta, Z Birsin Özçakar, Ana Teixeira, Ali Duzova, Jérôme Harambat, Tomáš Seeman, Gabriela Hrčková, Adrian Catalin Lungu, Svetlana Papizh, Amira Peco-Antic, Stéphanie De Rechter, Ugo Giordano, Marietta Kirchner, Teresa Lutz, Franz Schaefer, Olivier Devuyst, Elke Wühl, Francesco Emma
BACKGROUND AND OBJECTIVES: Autosomal dominant polycystic kidney disease is the most common inheritable kidney disease, frequently thought to become symptomatic in adulthood. However, patients with autosomal dominant polycystic kidney disease may develop signs or symptoms during childhood, in particular hypertension. Although ambulatory BP monitoring is the preferred method to diagnose hypertension in pediatrics, data in children with autosomal dominant polycystic kidney disease are limited...
April 19, 2018: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29673722/density-spectral-array-of-bis-vista%C3%A2-monitoring-system-in-a-functional-hemispherectomy
#13
C Luis, E Vilà, L Moltó, A Pardo, J L Fernández Candila, S Pacreu
We present the case of an adult patient with drug-resistant epilepsy caused by extensive inflammation in the right cerebral hemisphere. She was scheduled to undergo right functional hemispherectomy, which is common in pediatric surgery, but about which few studies have been published with respect to adult patients. During the intraoperative period, the density spectral array of the bilateral bispectral index (BIS) VISTATM monitoring system was used. We observed a power increase in low frequency (0.1-4Hz) and alpha bands (8-12Hz) in the right hemisphere, where the epileptogenic focus was...
April 16, 2018: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/29671499/poststreptococcal-illness-recognition-and-management
#14
David L Maness, Michael Martin, Gregg Mitchell
Group A beta-hemolytic streptococcus can cause several postinfectious, nonsuppurative immune- mediated diseases including acute rheumatic fever, poststreptococcal reactive arthritis, pediatric autoimmune neuropsychiatric disorders, and poststreptococcal glomerulonephritis. Except for sporadic outbreaks, poststreptococcal autoimmune syndromes occur most commonly in sub-Saharan Africa, India, Australia, and New Zealand. Children younger than three years are rarely affected by group A streptococcus pharyngitis or rheumatic fever, and usually do not require testing...
April 15, 2018: American Family Physician
https://www.readbyqxmd.com/read/29670869/pathogenetic-and-prognostic-factors-for-neonatal-gastric-perforation-personal-experience-and-systematic-review-of-the-literature
#15
Chiara Iacusso, Alessandro Boscarelli, Fabio Fusaro, Pietro Bagolan, Francesco Morini
Introduction: Neonatal gastric perforation (NGP) is a rare entity. Our aim was to report our experience and review the recent literature to characterize NGP, describe associated factors, and define prognostic factors. Materials and methods: Retrospective review of all consecutive patients with NGP treated between June 2009 and December 2017 in a third level pediatric hospital. In addition, a systematic review of Medline and Scopus database was performed using a defined strategy...
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29670217/bacterial-derived-exopolysaccharides-enhance-antifungal-drug-tolerance-in-a-cross-kingdom-oral-biofilm
#16
Dongyeop Kim, Yuan Liu, Raphael I Benhamou, Hiram Sanchez, Áurea Simón-Soro, Yong Li, Geelsu Hwang, Micha Fridman, David R Andes, Hyun Koo
Fungal-bacterial interactions generate unique biofilms that cause many infections in humans. Candida albicans interact with Streptococcus mutans in dental biofilms associated with severe childhood tooth-decay, a prevalent pediatric oral disease. Current modalities are ineffective and primarily based on antimicrobial monotherapies despite the polymicrobial nature of the infection. Here, we show that the combination of clinically used topical antifungal fluconazole with povidone iodine (PI) can completely suppress C...
April 18, 2018: ISME Journal
https://www.readbyqxmd.com/read/29667769/targeting-the-phosphatidylinositol-3-kinase-akt-mechanistic-target-of-rapamycin-signaling-pathway-in-b-lineage-acute-lymphoblastic-leukemia-an-update
#17
REVIEW
Carolina Simioni, Alberto M Martelli, Giorgio Zauli, Marco Vitale, James A McCubrey, Silvano Capitani, Luca M Neri
Despite considerable progress in treatment protocols, B-lineage acute lymphoblastic leukemia (B-ALL) displays a poor prognosis in about 15-20% of pediatric cases and about 60% of adult patients. In addition, life-long irreversible late effects from chemo- and radiation therapy, including secondary malignancies, are a growing problem for leukemia survivors. Targeted therapy holds promising perspectives for cancer treatment as it may be more effective and have fewer side effects than conventional therapies. The phosphatidylinositol 3-phosphate kinase (PI3K)/Akt/mechanistic target of rapamycin (mTOR) signaling pathway is a key regulatory cascade which controls proliferation, survival and drug-resistance of cancer cells, and it is frequently upregulated in the different subtypes of B-ALL, where it plays important roles in the pathophysiology, maintenance and progression of the disease...
April 18, 2018: Journal of Cellular Physiology
https://www.readbyqxmd.com/read/29665951/statistical-considerations-for-pediatric-multidrug-resistant-tuberculosis-efficacy-trials
#18
S Kim, J A Seddon, A J Garcia-Prats, G Montepiedra
The inclusion of newly licensed or repurposed drugs in regimens to treat children for multidrug-resistant tuberculosis (TB) may lead to treatment that is shorter than traditional regimens and composed only of oral medications. As an all-oral regimen may be more acceptable and have a better safety profile than current regimens, demonstrating non-inferiority may be satisfactory. Demonstrating non-inferior efficacy requires setting a non-inferiority margin and safeguarding study assay sensitivity. Multi-arm, multistage designs may currently not be appropriate in pediatric trials because of the lack of sensitive and specific intermediate outcomes...
May 1, 2018: International Journal of Tuberculosis and Lung Disease
https://www.readbyqxmd.com/read/29665948/preclinical-tools-for-the-evaluation-of-tuberculosis-treatment-regimens-for-children
#19
E W Tucker, K E Dooley
Tuberculosis (TB) treatment regimens have been extrapolated from adults to children. However, pediatric disease merits different treatment strategies to avoid under- or over-treatment. While animal models have been pivotal in identifying effective regimens for adult disease, pediatric TB is heterogeneous and cannot be represented by a single preclinical model. Infants and young children most commonly have disseminated disease or tuberculous meningitis (TBM), school-aged children have paucibacillary disease, and adolescents have adult-like cavitary lung disease...
May 1, 2018: International Journal of Tuberculosis and Lung Disease
https://www.readbyqxmd.com/read/29663424/primary-endpoints-in-pediatric-efficacy-trials-submitted-to-the-us-fda
#20
Dionna J Green, Janelle M Burnham, Paul Schuette, Xiaomei I Liu, Brian M Maas, Lynne Yao, Susan K McCune, Joseph Chen, John N van den Anker, Gilbert J Burckart
The selection of appropriate endpoints in pediatric drug development trials is a critical aspect of trial design. Given the high pediatric trial failure rate, selecting optimal trial design elements, such as the primary efficacy endpoint, is essential to ensuring increased potential for trial success. The objectives of this study were to identify the primary efficacy endpoints measured in pediatric drug development trials submitted to the US Food and Drug Administration and to relate endpoint attributes to trial and label outcome...
April 17, 2018: Journal of Clinical Pharmacology
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