CONTACT-TYPE DELAYED HYPERSENSITIVITY IN INFANTS AND CHILDREN: INDUCTION OF RHUS SENSITIVITY

PEDIATRICS ◽  
1961 ◽  
Vol 27 (1) ◽  
pp. 51-53
Author(s):  
William L. Epstein
Keyword(s):  
Intermediate Position ◽  
Infants And Children ◽  
Delayed Hypersensitivity ◽  
Older Children ◽  
Contact Sensitization ◽  
Contact Type ◽  
Frequency Of Contact ◽  
In Infants And Children

The frequency of contact sensitization to a Rhus allergen, pentadecyl catechol, was determined in 102 infants and children 1 month to 8 years of age. Children between 3 and 8 years were readily sensitized and showed a depth of sensitivity and intensity of reaction comparable to that seen in adults. Infants below the age of 1 year had a markedly depressed ability to react to Rhus allergens. Children between 1 and 3 years old assumed an intermediate position, being more reactive than infants, but less so than older children. Theoretically these observations suggest that the mechanism of delayed hypersensitivity matures more slowly than other processes of immunity and resistance. Clinically the findings mean that lack of exposure is a more important factor than lack of susceptibility in explaining the diminished incidence of clinical Rhus sensitivity in children below the age of 8 years.

scholarly journals Endoscopic retrograde cholangiopancreatography in infants and children

2021 ◽  
Vol 09 (03) ◽  
pp. E292-E296
Author(s):  
Tone Lise Åvitsland ◽  
Lars Aabakken
Keyword(s):  
Endoscopic Retrograde Cholangiopancreatography ◽  
Medical Records ◽  
Pediatric Patients ◽  
Biliary Stricture ◽  
Infants And Children ◽  
University Hospital ◽  
Older Children ◽  
Endoscopic Retrograde ◽  
Procedure Codes ◽  
In Infants And Children

Abstract Background and study aims Previous reports have suggested that endoscopic retrograde cholangiopancreatography (ERCP) in pediatric patients are safe. However, the total number of cases presented in the literature remains small. We present results regarding safety and outcomes in pediatric patients undergoing ERCP at Oslo University Hospital. Patients and methods Patients < 18 years who underwent ERCP between April 1999 and November 2017 were identified using procedure codes. Medical records were examined for age, gender, diagnosis, indications, type of sedation, findings, interventions, and complications. Results A total of 244 procedures were performed in 158 patients. Fifty-six of these were in 53 infants (age ≤ 1 year). Mean age was 8.8 years. The youngest patient was 8 days old. Mean weight was 5.0 kg in infants, the smallest weighing 2.9 kg. Cannulation failed in 19 (7.8 %). The main indication in infants was suspicion of biliary atresia (n = 38). Six of the procedures (10.7 %) were therapeutic. In children the main indications were biliary stricture (n = 64) and investigation of primary sclerosing cholangitis (PSC) (n = 45). 119 (63.2 %) of these procedures were therapeutic.Complications were uncommon in infants; only two episodes of infection were registered. In children (> 1 year) post-ERCP pancreatitis were seen in 10.4 %. Conclusions Our retrospective series of ERCP procedures includes 56 procedures in infants, which is one of the largest series presented. Complications in infants are rare and post-ERCP pancreatitis was not seen. In older children 10.4 % experienced post-ERCP pancreatitis. In expert hands, ERCP was shown to be acceptably feasible and safe in infants and children.

Pediatric Pain

2019 ◽  
pp. 773-782
Author(s):  
Juliana H. O’Brien ◽  
Maggie C. Root
Keyword(s):  
Pain Management ◽  
Pain Assessment ◽  
Developmental Stages ◽  
Developmentally Appropriate ◽  
Infants And Children ◽  
Psychological Consequences ◽  
Older Children ◽  
Nonverbal Children ◽  
In Infants And Children ◽  
Experience Pain

Children and infants experience pain as a serious complication of disease and injury, but only recently have clinicians come to understand how children experience pain. Exposure to painful injury is associated with psychological consequences in infants and children, including posttraumatic stress symptoms, neurodevelopmental issues, increased anxiety, and cortical dysfunction in childhood. In seriously ill infants, pain may be associated with increased morbidity and mortality; in older children, untreated pain can lead to decreased functioning, social isolation, sleep disorders, and mood changes. Prevention and relief of pain for this vulnerable population is essential. Pain assessment and management in infants and children require that palliative care nurses understand the developmental stages of childhood. This chapter provides a recommended approach to pain assessment and pain management in children. It outlines age-specific and developmentally appropriate pain assessment tools. It describes commonly observed pain behaviors in verbal and nonverbal children. It highlights the management differences between acute pain, neuropathic pain, and chronic pain. It details a combined nonpharmacologic and pharmacologic (including weight-based dosing) approach for pain management.

scholarly journals P117 Dose evaluation of intravenous metamizole (dipyrone) in infants and children: a prospective population pharmacokinetic study

2019 ◽  
Vol 104 (6) ◽  
pp. e66.1-e66
Author(s):  
V Ziesenitz ◽  
F Rodieux ◽  
A Atkinson ◽  
C Borter ◽  
J Bielicki ◽  
...  
Keyword(s):  
Active Metabolite ◽  
Optimal Dose ◽  
Infants And Children ◽  
Population Pharmacokinetic ◽  
Older Children ◽  
Post Dose ◽  
Large Variability ◽  
Age Cohorts ◽  
Population Pharmacokinetic Study ◽  
In Infants And Children

BackgroundThe prodrug metamizole is frequently dosed intravenously (IV) for postoperative pain in children of all ages, despite its off-label use in infants < 1 year. We aimed to investigate the pharmacokinetics (PK) of the main metabolite of metamizole, 4-aminoantipyrine (MAA), in children aged 3–72 months following IV dosing.Methods10 mg/kg metamizole was administered IV for postoperative analgesia. PK samples were drawn at 5 predefined time points. PK of the main active metabolite MAA and three other metabolites was characterized by both non-compartmental (NCA) and population PK analysis (PPK). AUC0-inf of MAA was calculated by NCA for two age cohorts (3–23 months, 2–6 years) and compared to the 80–125% range of adult dose-adjusted reference exposure (AUCref). PPK investigated age and weight dependency of the kinetics, and dosing strategies to achieve equivalent adult exposure in children.ResultsA total of 25 children aged 5 months - 5.8 years (7.8–24.8 kg) with at least one plasma concentration sample were included in PPK, 19 children who had 5 predefined samples up to 10 h post-dose were included in NCA. AUC0-inf of MAA in children of 2–6 years was 29.8 (95%CI 23.3–38.1) mg/L*h, significantly lower than AUCref(80%-125% range: 39.2–61.2 mg/L*h). AUC0-inf of MAA in infants of 3–23 months was 42.5 (95%CI 15.7–115.4) mg/L*h, overlapping with AUCref. The large variability observed in infants could be partially explained by covariates body weight and age.ConclusionsKinetics of the main active metabolite MAA depends on age in infants and children. MAA exposure after a single IV dose of 10 mg/kg metamizole in infants < 1 year of age was higher compared to an equal dose in adults and older children. This suggests that the optimal dose for this age group to achieve equivalent exposure compared to adults is lower than currently recommended.Disclosure(s)Nothing to disclose.

Thrombosis in Infants and Children

Hematology ◽  
2006 ◽  
Vol 2006 (1) ◽  
pp. 86-96 ◽  
Author(s):  
Reinhard Schneppenheim ◽  
Jeanette Greiner
Keyword(s):  
Risk Factors ◽  
Clinical Presentation ◽  
Infants And Children ◽  
Therapeutic Interventions ◽  
Older Children ◽  
Thrombotic Risk ◽  
Therapeutic Decisions ◽  
Prophylactic Anticoagulation ◽  
Clinical Conditions ◽  
In Infants And Children

Abstract During the last decade much progress has been made toward better understanding of the underlying reasons causing thromboembolism in children. A considerable number of acquired and hereditary thrombotic risk factors have been identified which may also have an impact on therapeutic decisions and prognosis concerning outcome and the risk of a second event. However, indications for therapeutic interventions, such as thrombolysis and prophylactic anticoagulation with respect to the different clinical conditions and their combination with other risk factors, are not yet well defined. The following article describes the causes, clinical presentation and management of thrombosis in neonates, infants and older children, focusing on the clinically most relevant conditions.

scholarly journals Clinical pharmacology of teicoplanin in infants and children

2021 ◽  
Vol 3 (6) ◽  
pp. 01-07
Author(s):  
Gian Pacific
Keyword(s):  
Cell Wall ◽  
Maintenance Dose ◽  
Molecular Size ◽  
The Body ◽  
Infants And Children ◽  
Published Data ◽  
Loading Dose ◽  
Older Children ◽  
Once Daily ◽  
In Infants And Children

Teicoplanin is a glycopeptide and is a mixture of related glycopeptides. Teicoplanin inhibits the synthesis of the cell wall in sensitive bacteria by binding with high affinity to the D-alanyl-D-alanine terminus of cell wall precursor units. Because of its large molecular size, teicoplanin is unable to penetrate the outer membrane of gram-negative bacteria. The intravenous dosage of teicoplanin consists in a loading dose of 16 mg/kg followed by a maintenance dose of 8 mg/kg once-daily to infants aged < one month and in older infants the dosage of teicoplanin consists in a loading dose of 12 mg/kg twice-daily followed by a maintenance dose of 10 mg/kg once daily. In children, the oral dose is 100 to 200 mg twice-daily and the intravenous dosage consists in 12 mg/kg twice-daily followed by 12 mg/kg once-daily. Teicoplanin has been found efficacy and safe in infants and children. The elimination half-life of teicoplanin is 73.9 hours in infants and children and teicoplanin is cleared from the body by renal and extra-renal routes. The total body clearance of teicoplanin is 0.09 L/h in children aged < 12 months and 0.29 L/h in older children. The treatment and the prophylaxis with teicoplanin have been described in infants and children. Teicoplanin administered intravenously and/or intraventricularly treats the cerebral infections caused by staphylococci and enterococci. The aim of this study is to review the published data on teicoplanin dosing, efficacy and safety, pharmacokinetics, drug-interactions, treatment, prophylaxis, and penetrates into the cerebrospinal fluid in infants and children.

Nutritional Interventions and the Gut Microbiome in Children

2021 ◽  
Vol 41 (1) ◽  
Author(s):  
Saurabh Mehta ◽  
Samantha L. Huey ◽  
Daniel McDonald ◽  
Rob Knight ◽  
Julia L. Finkelstein
Keyword(s):  
Gut Microbiome ◽  
Public Health Practice ◽  
Infants And Children ◽  
Annual Review ◽  
Publication Date ◽  
Older Children ◽  
Nutritional Interventions ◽  
Integral Role ◽  
Health And Disease ◽  
In Infants And Children

The gut microbiome plays an integral role in health and disease, and diet is a major driver of its composition, diversity, and functional capacity. Given the dynamic development of the gut microbiome in infants and children, it is critical to address two major questions: ( a) Can diet modify the composition, diversity, or function of the gut microbiome, and ( b) will such modification affect functional/clinical outcomes including immune function, cognitive development, and overall health? We synthesize the evidence on the effect of nutritional interventions on the gut microbiome in infants and children across 26 studies. Findings indicate the need to study older children, assess the whole intestinal tract, and harmonize methods and interpretation of findings, which are critical for informing meaningful clinical and public health practice. These findings are relevant for precision health, may help identify windows of opportunity for intervention, and may inform the design and delivery of such interventions. Expected final online publication date for the Annual Review of Nutrition, Volume 41 is September 2021. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

Understanding Limited Use of Amplification in Infants and Children Who Are Hard of Hearing

2015 ◽  
Vol 25 (1) ◽  
pp. 15-23 ◽  
Author(s):  
Ryan W. McCreery ◽  
Elizabeth A. Walker ◽  
Meredith Spratford
Keyword(s):  
Hard Of Hearing ◽  
Hearing Aid ◽  
Management Strategies ◽  
Infants And Children ◽  
Future Research ◽  
Research Needs ◽  
Case Examples ◽  
Hearing Aid Use ◽  
Wide Range ◽  
In Infants And Children

The effectiveness of amplification for infants and children can be mediated by how much the child uses the device. Existing research suggests that establishing hearing aid use can be challenging. A wide range of factors can influence hearing aid use in children, including the child's age, degree of hearing loss, and socioeconomic status. Audiological interventions, including using validated prescriptive approaches and verification, performing on-going training and orientation, and communicating with caregivers about hearing aid use can also increase hearing aid use by infants and children. Case examples are used to highlight the factors that influence hearing aid use. Potential management strategies and future research needs are also discussed.

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