Detailed assessment and risk factor analysis of corticosteroid-induced psychiatric disorders in pediatric, adolescent, and young adult patients undergoing induction or consolidation therapy for hematologic malignancy

2019 ◽  
Vol 26 (5) ◽  
pp. 1041-1051
Author(s):  
Yukiko Staub ◽  
Yukio Suga ◽  
Yasuhiro Ikawa ◽  
Kiyotaka Tsubouchi ◽  
Mikie Hashimoto ◽  
...  
Keyword(s):  
Risk Factors ◽  
Young Adult ◽  
Psychiatric Disorders ◽  
Treatment Regimen ◽  
Behavioral Problems ◽  
Developmental Process ◽  
Hematologic Malignancy ◽  
Adult Patients ◽  
Adolescent And Young Adult ◽  
Emotional And Behavioral Problems

Background Corticosteroid-induced psychiatric disorders (CIPDs) represent an adverse effect that can cause severe emotional and behavioral problems. The aim of the present study was to assess the incidence and risk factors of CIPDs. Methods A retrospective analysis of 92 pediatric and young adult patients with hematologic malignancies was conducted. Results The incidence of CIPDs in patients receiving a treatment regimen with prednisolone or dexamethasone was 64.9% and 77.5%, respectively, both of which were significantly higher than that in patients not receiving corticosteroids. Independent risk factors and adjusted odds ratios (95% confidence intervals) related to severe CIPD were 2.15 (1.11–4.18) for dexamethasone (using prednisolone as the reference) and 0.81 (0.75–0.87) for age, suggesting that the odds increase with decreasing age. Frequently observed symptoms, respectively in terms of behavioral and emotional problems were defiance, crying, psychomotor excitement, dysphoria, irritability, and depression. To our knowledge, this is the first report to mention the risk factors and characteristics for clinical symptoms of CIPDs during the developmental process. Conclusions Healthcare professionals should predict and prepare for psychiatric adverse events prior to chemotherapy in the clinical settings, especially in patients in younger age and receiving a treatment regimen with dexamethasone.

scholarly journals Vancomycin-Associated Acute Kidney Injury in Critically Ill Adolescent and Young Adult Patients

2019 ◽  
Vol 33 (6) ◽  
pp. 749-753 ◽  
Author(s):  
William B. Hays ◽  
Emma Tillman
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Young Adult ◽  
Critically Ill ◽  
Kidney Injury ◽  
Adult Patients ◽  
Adolescent And Young Adult ◽  
Daily Dose ◽  
Vancomycin Trough ◽  
Trough Levels

Background: Risk factors for the development of vancomycin-associated acute kidney injury (AKI) have been evaluated in both pediatric and adult populations; however, no previous studies exist evaluating this in the critically ill adolescent and young adult patients. Objective: Identify the incidence of AKI and examine risk factors for the development of AKI in critically ill adolescents and young adults on vancomycin. Methods: This retrospective review evaluated the incidence of AKI in patients 15 to 25 years of age who received vancomycin, while admitted to an intensive care unit. Acute kidney injury in this population was defined as an increase in serum creatinine by 0.5 mg/dL or 50% from baseline. Patients who developed AKI were evaluated for specific risk factors compared to those who did not develop AKI. Results: A total of 50 patients (20 developed AKI) were included in the study. There was no difference in vancomycin daily dose or duration of vancomycin therapy. Maximum vancomycin trough (31.15 mg/dL vs 12.5 mg/dL, P = .006), percentage of patients with concurrent nephrotoxic medication (95% vs 60%, P = .012) and concurrent vasopressor (55% vs 23%, P = .029) were higher in those who developed AKI. Percentage of patients who underwent a procedure while on vancomycin (35% vs 6.7%, P = .021) was also higher within the AKI group. Conclusions: Vancomycin-associated AKI occurred in 40% of critically ill adolescent and young adult patients. These patients may be more likely to develop vancomycin-associated AKI if they had undergone a procedure, as well as in the presence of high vancomycin trough levels, concurrent nephrotoxic agents, and concurrent vasopressor therapy.

Psychiatric disorders in adolescent and young adult patients with phenylketonuria

2016 ◽  
Vol 117 (1) ◽  
pp. 12-18 ◽  
Author(s):  
Filippo Manti ◽  
Francesca Nardecchia ◽  
Flavia Chiarotti ◽  
Claudia Carducci ◽  
Carla Carducci ◽  
...  
Keyword(s):  
Young Adult ◽  
Psychiatric Disorders ◽  
Adult Patients ◽  
Adolescent And Young Adult

Risk factors for emotional and behavioral problems

2009 ◽  
Author(s):  
W. Douglas Tynan ◽  
Meredith Dreyer ◽  
Meredith Lutz Stehl
Keyword(s):  
Risk Factors ◽  
Behavioral Problems ◽  
Emotional And Behavioral Problems

Capturing the financial hardship of cancer in military adolescent and young adult patients: A conceptual framework

2021 ◽  
pp. 1-18
Author(s):  
Christabel K. Cheung ◽  
Patricia W. Nishimoto ◽  
Thuli Katerere-Virima ◽  
Laura E. Helbling ◽  
Bria N. Thomas ◽  
...  
Keyword(s):  
Young Adult ◽  
Conceptual Framework ◽  
Adult Patients ◽  
Financial Hardship ◽  
Adolescent And Young Adult

scholarly journals Adolescent and young adult patients as co‐researchers: A scoping review

2021 ◽  
Author(s):  
Kjersti J. Ø. Fløtten ◽  
Ana Isabel Fernandes Guerreiro ◽  
Ilaria Simonelli ◽  
Anne Lee Solevåg ◽  
Isabelle Aujoulat
Keyword(s):  
Young Adult ◽  
Scoping Review ◽  
Adult Patients ◽  
Adolescent And Young Adult

scholarly journals Opioid Overprescription in Adolescents and Young Adults Undergoing Hip Arthroscopy

2021 ◽  
Vol 9 (7_suppl3) ◽  
pp. 2325967121S0005
Author(s):  
Mahad M. Hassan ◽  
Omar F. Rahman ◽  
Zaamin B. Hussain ◽  
Stephane L. Burgess ◽  
Yi-Meng Yen ◽  
...  
Keyword(s):  
Young Adult ◽  
Hip Arthroscopy ◽  
Pain Syndrome ◽  
Adult Patients ◽  
Adolescent And Young Adult ◽  
Bivariate Analysis ◽  
Opioid Use ◽  
Duration Of Surgery ◽  
Opioid Medications ◽  
Arthroscopic Procedures

Background: Previous studies have examined factors related to the increased use of opioids after hip arthroscopy in adults. However, few have focused on the adolescent population. Purpose: The purpose of this study was to compare the opioids prescribed to opioids consumed after hip arthroscopic procedures in adolescent and young adult patients, and to determine patient or surgical factors associated with increased postoperative opioid use. Methods: Adolescent and young adult patients who underwent hip arthroscopy and associated arthroscopic interventions between January 2017 and January 2020 were included. Patients with a diagnosed pain syndrome or history of chronic pain, as determined by the patient taking opioid medications prior to surgery, were excluded. Daily postoperative opioid intake was recorded via pain-control logbooks. The outcome of the study was defined as the average total number of opioid tablets consumed postoperatively. Results: Fifty-eight patients returned completed logbooks, 72% of whom were female patients. The average age was 21.30 years (range, 14.9 – 34.2). Most patients (73%) were prescribed 30 oxycodone tablets. The median amount of tablets consumed was 7 (range, 0-41) over a median duration of 7 days (range, 1-22). The median ratio of tablets consumed to prescribed was 20% and the 95th percentile of opioids consumed was 28 tablets. Bivariate analysis showed that patient age at surgery was positively correlated to the total amount of tablets consumed (r=0.28, p=0.04) and to the ratio of tablets consumed to prescribed (r=0.30, p=0.03). Duration of surgery was negatively correlated to the number of days tablets were consumed (r=-0.31, p=0.03). Multivariate analysis showed that patients who were prescribed more than 30 tablets took on average 7.8 more tablets overall compared to those prescribed 30 or fewer tablets (p=0.003), and that for each additional year of age, the ratio of tablets consumed to prescribed increased by 1% (p=0.02). Conclusion: After undergoing hip arthroscopy and associated arthroscopic procedures, adolescents and young adult patients are commonly overprescribed opioids, consuming on average only one-fifth of the tablets prescribed. This finding mirrors trends in the pediatric knee arthroscopy literature and provides an opportunity to reassess current opioid prescribing behaviors in the adolescent and young adult populations. [Table: see text][Table: see text][Table: see text][Table: see text][Table: see text]

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