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pediatric clinical pharmacology

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https://www.readbyqxmd.com/read/28737198/-tetany-secondary-to-phosphate-enema-toxicity-case-report
#1
María José Núñez Sánchez, Sofía Leighton Swaneck, Franco Díaz
Phosphate enemas are frequently used in the treatment of constipation. Errors in dosage and administration can lead to severe complications. OBJECTIVE: To report a case of severe toxicity of phosphate enemas in a child with no risk factors. CASE: 2 years old female, with functional constipation, was brought to emergency department because abdominal pain. She was diagnosed with fecal impaction and received half a bottle of Fleet Adult® (Laboratorio Synthon, Chile) two times, with no clinical resolution, deciding to start proctoclisis in pediatric ward...
June 2017: Revista Chilena de Pediatría
https://www.readbyqxmd.com/read/28735109/design-and-rationale-for-a-real-world-observational-cohort-of-patients-with-nonalcoholic-fatty-liver-disease-the-target-nash-study
#2
A Sidney Barritt, Norman Gitlin, Samuel Klein, Anna S Lok, Rohit Loomba, Laura Malahias, Margaret Powell, Miriam B Vos, L Michael Weiss, Kenneth Cusi, Brent A Neuschwander-Tetri, Arun Sanyal
Nonalcoholic fatty liver disease (NAFLD) is highly prevalent and can lead to cirrhosis, hepatocellular carcinoma, and end-stage liver disease. NAFLD comprises the spectrum from simple steatosis (nonalcoholic fatty liver, NAFL), to steatosis with inflammation (nonalcoholic steatohepatitis, NASH). Current primary therapy recommended for NAFLD is weight loss induced by lifestyle modification. The difficulty in achieving this has led to robust pharmacological therapy development. While new drugs may show efficacy in selected phase II/III clinical trial populations, their real-world effectiveness is unknown...
July 19, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28696783/course-of-neuropsychiatric-symptoms-after-introduction-and-removal-of-nonsteroidal-anti-inflammatory-drugs-a-pediatric-observational-study
#3
Ellen J Spartz, G Mark Freeman, Kayla Brown, Bahare Farhadian, Margo Thienemann, Jennifer Frankovich
OBJECTIVE: Accumulating evidence suggests that anti-inflammatory interventions can modulate neuropsychiatric symptoms. Pediatric Acute-onset Neuropsychiatric Syndrome (PANS) is characterized by an abrupt and dramatic onset of obsessive-compulsive (OC) symptoms and/or severely restrictive food intake and at least two coinciding, equally debilitating neuropsychiatric symptoms. When associated with group A Streptococcus, the syndrome is labeled Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal infections (PANDAS)...
July 11, 2017: Journal of Child and Adolescent Psychopharmacology
https://www.readbyqxmd.com/read/28678061/pain-in-children-with-cancer-prevalence-characteristics-and-parent-management
#4
Perri R Tutelman, Christine T Chambers, Jennifer N Stinson, Jennifer A Parker, Conrad V Fernandez, Holly O Witteman, Paul C Nathan, Melanie Barwick, Fiona Campbell, Lindsay A Jibb, Karen Irwin
OBJECTIVES: Pain is a common and distressing symptom of pediatric cancer, as reported by both children and their parents. Increasingly, children with cancer are cared for as outpatients, yet little is known about how parents manage their cancer-related pain. The aim of the current study was to examine pain prevalence and characteristics, and the pharmacological, physical and psychological pain management strategies used by parents to manage their child's cancer pain. METHODS: In total, 230 parents and caregivers (89% mothers) of children (mean age=8...
July 3, 2017: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28677996/headache-in-pediatric-and-adolescent-patients-with-chronic-kidney-disease-with-and-without-hemodialysis-a-comparative-cohort-study
#5
Miriam Davidovits, Tal Eidlitz Markus
Background Several studies have reported dialysis-related headache in adults. We investigated headache and its characteristics in pediatric and adolescent patients with chronic kidney disease and patients treated with dialysis, and compared characteristics of patients with and without headache in the entire cohort and separately among dialysis and among chronic kidney disease patients. Methods Patients and their parents who attended a nephrology clinic and hemodialysis unit were interviewed regarding the existence of headache and its characteristics...
January 1, 2017: Cephalalgia: An International Journal of Headache
https://www.readbyqxmd.com/read/28673313/mdm2-x-inhibitors-under-clinical-evaluation-perspectives-for-the-management-of-hematological-malignancies-and-pediatric-cancer
#6
REVIEW
Veronica Tisato, Rebecca Voltan, Arianna Gonelli, Paola Secchiero, Giorgio Zauli
The two murine double minute (MDM) family members MDM2 and MDMX are at the center of an intense clinical assessment as molecular target for the management of cancer. Indeed, the two proteins act as regulators of P53, a well-known key controller of the cell cycle regulation and cell proliferation that, when altered, plays a direct role on cancer development and progression. Several evidence demonstrated that functional aberrations of P53 in tumors are in most cases the consequence of alterations on the MDM2 and MDMX regulatory proteins, in particular in patients with hematological malignancies where TP53 shows a relatively low frequency of mutation while MDM2 and MDMX are frequently found amplified/overexpressed...
July 3, 2017: Journal of Hematology & Oncology
https://www.readbyqxmd.com/read/28669553/expert-consensus-guidelines-for-stocking-of-antidotes-in-hospitals-that-provide-emergency-care
#7
Richard C Dart, Lewis R Goldfrank, Brian L Erstad, David T Huang, Knox H Todd, Jeffrey Weitz, Vikhyat S Bebarta, E Martin Caravati, Fred M Henretig, Theodore R Delbridge, William Banner, Sandra M Schneider, Victoria E Anderson
We provide recommendations for stocking of antidotes used in emergency departments (EDs). An expert panel representing diverse perspectives (clinical pharmacology, medical toxicology, critical care medicine, hematology/oncology, hospital pharmacy, emergency medicine, emergency medical services, pediatric emergency medicine, pediatric critical care medicine, poison centers, hospital administration, and public health) was formed to create recommendations for antidote stocking. Using a standardized summary of the medical literature, the primary reviewer for each antidote proposed guidelines for antidote stocking to the full panel...
June 29, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28660776/gender-affirming-pharmacological-interventions-for-youth-with-gender-dysphoria-when-treatment-guidelines-are-not-enough
#8
Leena Nahata, Gayathri Chelvakumar, Scott Leibowitz
Youth with gender dysphoria, also known as transgender youth, are increasingly presenting to multidisciplinary clinics within academic pediatric centers across the United States. Gender-affirming pharmacological interventions for adolescents with gender dysphoria may be used to promote positive psychological well-being and mental health outcomes. Interventions range from completely reversible to partially irreversible, based on the age and sexual maturity of the adolescent. For each intervention, dilemmas and controversies exist regarding age at treatment initiation, treatment duration, safety, and cost...
June 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28660740/prolonged-first-line-peg-asparaginase-treatment-in-pediatric-acute-lymphoblastic-leukemia-in-the-nopho-all2008-protocol-pharmacokinetics-and-antibody-formation
#9
Louise Tram Henriksen, Sofie Gottschalk Højfeldt, Kjeld Schmiegelow, Thomas Leth Frandsen, Peder Skov Wehner, Henrik Schrøder, Birgitte Klug Albertsen
BACKGROUND: As pegylated asparaginase is becoming the preferred first-line asparaginase preparation in the chemotherapy regimens of childhood acute lymphoblastic leukemia (ALL), there is a need to evaluate this treatment. METHODS: The aim of this study was to evaluate the pharmacokinetics of prolonged upfront biweekly PEG-asparaginase (where PEG is polyethylene glycol) treatment by measuring serum l-asparaginase activity and formation of anti-PEG-asparaginase antibodies...
June 29, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28650778/success-of-dental-treatments-under-behavior-management-sedation-and-general-anesthesia
#10
Sigalit Blumer, Liora Costa, Benjamin Peretz
OBJECTIVE: To present comparative study aims to assist the practitioner to choose between behavior modification (BM) techniques, pharmacologic sedation (N2O-O2 alone or combined with midazolam 0.5 mg/ kg) or routine general anesthesia (GA) for the most successful approach in enabling pediatric dental care. STUDY DESIGN: Dental records of 56 children treated in a university dental clinic between 2006-2016 were reviewed, and data on age, gender, required treatment (amalgam restorations, composite restorations, pulpotomy, and stainless steel crowns [SSC]), treatment approaches and therapeutic success at final follow-up were retrieved...
2017: Journal of Clinical Pediatric Dentistry
https://www.readbyqxmd.com/read/28641548/pediatric-cutaneous-graft-versus-host-disease-a-review
#11
Connie R Shi, Jennifer T Huang, Vinod E Nambudiri
BACKGROUND: Graft versus host disease (GVHD) is a significant complication following hematopoietic stem cell transplantation in the pediatric population. The most common clinical manifestation of GVHD is in the skin. This article will present a review of key concepts related to pediatric cutaneous GVHD, including pathophysiology, clinical epidemiology, diagnosis, and treatment options. GVHD is an immune-mediated process characterized by an inflammatory immune response in acute GVHD and mixed inflammatory and fibrotic states in chronic GVHD...
June 14, 2017: Current Pediatric Reviews
https://www.readbyqxmd.com/read/28632924/metabolomics-as-a-driver-in-advancing-precision-medicine-in-sepsis
#12
Michelle Eckerle, Lilliam Ambroggio, Michael Puskarich, Brent Winston, Alan E Jones, Theodore J Standiford, Kathleen A Stringer
OBJECTIVE: The objective of this review is to explain the science of metabolomics-a science of systems biology that measures and studies endogenous small molecules (metabolites) that are present in a single biological sample-and its application to the diagnosis and treatment of sepsis. In addition, we discuss how discovery through metabolomics can contribute to the development of precision medicine targets for this complex disease state and the potential avenues for those new discoveries to be applied in the clinical environment...
June 20, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28624959/systematic-review-of-diagnostic-criteria-used-in-atopic-dermatitis-randomized-controlled-trials
#13
REVIEW
Paras P Vakharia, Rishi Chopra, Jonathan I Silverberg
BACKGROUND: Numerous diagnostic criteria for atopic dermatitis are used in clinical trials, which may limit comparison of results. OBJECTIVE: We sought to determine the most commonly used atopic dermatitis diagnostic criteria in randomized controlled trials internationally. METHODS: We performed a systematic review of randomized controlled trials with a pharmacological intervention from 2007 to 2016. Cochrane Library, EMBASE, GREAT, LILACS, MEDLINE, and Scopus were searched...
June 17, 2017: American Journal of Clinical Dermatology
https://www.readbyqxmd.com/read/28620868/osteoporosis-in-children-with-chronic-illnesses-diagnosis-monitoring-and-treatment
#14
REVIEW
Monica Grover, Laura K Bachrach
PURPOSE OF REVIEW: Osteoporosis is an under-recognized complication of chronic illness in childhood. This review will summarize recent literature addressing the risk factors, evaluation, and treatment for early bone fragility. RECENT FINDINGS: Criteria for the diagnosis of pediatric osteoporosis include the presence of low trauma vertebral fractures alone or the combination of low bone mineral density and several long bone fractures. Monitoring for bone health may include screening for vertebral fractures that are common but often asymptomatic...
June 15, 2017: Current Osteoporosis Reports
https://www.readbyqxmd.com/read/28612637/treatment-options-for-children-and-adolescents-with-inflammatory-bowel-disease-is-granulomonocytapheresis-an-effective-alternative-to-drug-therapy
#15
Tomotaka Tanaka, Takayuki Yamamoto, Koji Sawada, Rodolfo Sacco
Patients with inflammatory bowel diseases (IBD) require life-long medications, which even if effective have the potential to cause adverse effects as additional morbidity factors. In pediatric patients, drug therapy has more serious limitations, including impaired physical and mental development. A non-drug therapeutic option is believed to be depletion of elevated and activated granulocytes and monocytes known to release inflammatory cytokines, like the CD14+CD16+ monocyte phenotype known to release tumor necrosis factor-α...
June 28, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28612093/clinical-trial-design-in-juvenile-idiopathic-arthritis
#16
Stephen J Balevic, Mara L Becker, Michael Cohen-Wolkowiez, Laura E Schanberg
Randomized clinical trials provide the gold standard evidence base to guide clinical practice. Despite major advances in trial design, pediatric clinical trials are still difficult to perform and pose unique challenges, including the need to consider the impact of developmental changes in trial design. Advances within pediatric rheumatology combined with the need to comply with legislative requirements have driven new approaches to performing pediatric clinical trials such as utilization of large research networks, incorporation of patient and family stakeholders in the planning and implementation of clinical trials, and the development of novel trial designs...
June 13, 2017: Paediatric Drugs
https://www.readbyqxmd.com/read/28597354/pharmacologic-considerations-for-pediatric-sedation-and-anesthesia-outside-the-operating-room-a-review-for-anesthesia-and-non-anesthesia-providers
#17
REVIEW
Narjeet Khurmi, Perene Patel, Molly Kraus, Terrence Trentman
Understanding the pharmacologic options for pediatric sedation outside the operating room will allow practitioners to formulate an ideal anesthetic plan, allaying anxiety and achieving optimal immobilization while ensuring rapid and efficient recovery. The authors identified relevant medical literature by searching PubMed, MEDLINE, Embase, Scopus, Web of Science, and Google Scholar databases for English language publications covering a period from 1984 to 2017. Search terms included pediatric anesthesia, pediatric sedation, non-operating room sedation, sedation safety, and pharmacology...
June 8, 2017: Paediatric Drugs
https://www.readbyqxmd.com/read/28595685/implementing-psychopharmacology-rounds-in-a-nursing-facility-to-improve-antipsychotic-usage
#18
Evan Sasson, Marian James, Berhane Wubshet, Darko Todorov, Henry Cohen
OBJECTIVES: Evaluate whether implementing of pharmacy-led psychopharmacology rounds in a nursing facility will improve the rate of antipsychotic use. DESIGN: Single-center, prospective; medication use evaluation (MUE). SETTING: Rutland Nursing Home, Brooklyn, New York. PARTICIPANTS: Nursing facility residents, excluding the pediatric unit. INTERVENTIONS: Weekly interdisciplinary psychopharmacology rounds that include: clinical pharmacists, nurse managers, medical director, social workers, and administration...
June 1, 2017: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/28567798/management-for-intussusception-in-children
#19
REVIEW
Steven Gluckman, Jonathan Karpelowsky, Angela C Webster, Richard G McGee
BACKGROUND: Intussusception is a common abdominal emergency in children with significant morbidity. Prompt diagnosis and management reduces associated risks and the need for surgical intervention. Despite widespread agreement on the use of contrast enema as opposed to surgery for initial management in most cases, debate persists on the appropriate contrast medium, imaging modality, pharmacological adjuvant, and protocol for delayed repeat enema, and on the best approach for surgical management for intussusception in children...
June 1, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28516235/clinical-imaging-and-genotypical-features-of-three-deceased-and-five-surviving-cases-with-ada2-deficiency
#20
Sezgin Sahin, Amra Adrovic, Kenan Barut, Serdal Ugurlu, Eda Tahir Turanli, Huri Ozdogan, Ozgur Kasapcopur
Deficiency of adenosine deaminase type 2 (DADA2) is a rare form of autoinflammatory disorder with limited reported cases. In this paper, we have presented the clinico-immunological, radiological and genetic characteristics of five surviving and three deceased childhood-onset DADA2 patients. We aimed to compare surviving and deceased patients in terms of clinical features and treatment modalities. Moreover, we have evaluated the causes of death in our DADA2 subjects together with the previously reported cases...
May 17, 2017: Rheumatology International
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