scholarly journals Approaches to prevention of antibiotic-associated diarrhea in children

2020 ◽  
Author(s):  
N. L. Pakhomovskaia ◽  
O. F. Tatyanina ◽  
Т. Yu. Lazareva
Keyword(s):  
Randomized Clinical Trials ◽  
Pediatric Population ◽  
Eradication Therapy ◽  
Current Data ◽  
Electrolyte Balance ◽  
Clinical Effects ◽  
Bacterial Strains ◽  
Contributing Factors ◽  
Treatment And Prevention ◽  
Antibiotic Associated Diarrhea

The incidence of antibiotic-associated diarrhea, according to various authors, ranges from 5 to 39% and depends on the patient’s age and other contributing factors. Antibiotic-associated diarrhea can be caused by any antibiotic, regardless of dosage form or route of administration. In the pediatric population, the prevalence of antibiotic-associated diarrhea ranges from 6 to 70%. An urgent problem is the development of this disease against the background of a course of H. pylori eradication therapy, which significantly complicates tolerance and adherence to therapy.This article presents current data on the pathogenesis and risk factors of antibiotic-associated diarrhea in children. The clinical picture ranges from idiopathic enteritis to antibiotic-associated diarrhea caused by Cl. difficile - pseudomembranous colitis.The main principle of antibiotic-associated diarrhea treatment is cancellation of the antibacterial medicine that caused the diarrhea, or reducing its dose (if the course of the disease allows it). In complex treatment sorbents are used, correction of water-electrolyte balance is carried out. The use of probiotics seems quite logical for the treatment and prevention of antibiotic-associated diarrhea in terms of the pathogenesis of this condition. To correct dysbiosis, drugs are used to maintain and restore the quantitative and qualitative composition of the intestinal microbiota.Taking into account modern recommendations the main groups of drugs (probiotics, prebiotics, synbiotics) used for correction of intestinal microbiocenosis are presented. The mechanism of action of probiotics and mechanisms of their effect on intestinal microflora are considered. The basic requirements for bacterial strains that are part of the probiotic drugs are presented.The results of various randomized clinical trials and meta-analyses confirming the necessity of including probiotic complexes in antibiotic-associated diarrhea treatment regimens are presented from an evidence-based medicine perspective. The clinical effects of strains of Lactobacillus spp., Bifidobacterium spp., Streptococcus spp. and Lactococcus spp. on the digestive tract microbiota are considered.The role of a synbiotic containing 9 probiotic strains of 4.5 × 109 CFU in one capsule and the prebiotic component fructooligosaccharides in the prevention of antibiotic-associated diarrhea in children is discussed separately. The results of microbiological studies confirmed the presence of microorganisms of genera Bifidobacterium, Lactobacillus, Streptococcus in the product, and the content of bacteria in one dose of the product was not less than 2 x 1010 CFU.

scholarly journals Allergy and obesity in children: is there any link?

2021 ◽  
pp. 17-26
Author(s):  
Natalia Begievna Migacheva ◽  
Dariia Alekseevna Rakcheeva ◽  
Olga Viktorovna Skvortsova ◽  
Evgeniia Gennadevna Mikhailova
Keyword(s):  
Mutual Influence ◽  
Pediatric Population ◽  
Allergic Diseases ◽  
Current Data ◽  
Steady Increase ◽  
Laboratory Studies ◽  
Prevention Strategies ◽  
Causal Factors ◽  
Treatment And Prevention ◽  
Obesity In Children

The steady increase in the prevalence of non-communicable diseases in the population, including obesity and allergic diseases, dictates the need to study both common causal factors and mechanisms of their development, and to search for new effective treatment and prevention strategies. However the resultsof epidemiologic, clinical and laboratory studies are still inconclusive, especially in pediatric population. In this review we present and discuss current data that may help to understand the possible relationship and mechanisms of mutual influence of allergy and obesity in children.

Phytotherapy and Herbal Medicines for Kidney Stones

2020 ◽  
Vol 22 (1) ◽  
pp. 22-30
Author(s):  
Esteban Emiliani ◽  
Adrian Jara ◽  
Andres Koey Kanashiro
Keyword(s):  
Uric Acid ◽  
Calcium Oxalate ◽  
Kidney Stones ◽  
Animal Studies ◽  
Randomized Clinical Trials ◽  
Herbal Medicines ◽  
Phyllanthus Niruri ◽  
Treatment And Prevention ◽  
Number Of Patients ◽  
Uric Acid Stones

Background: Kidney stones are one of the oldest known and common diseases in the urinary tract with a prevalence that varies from 1% to 20%. Many phytotherapic and herbal medicines for kidney stones have been described for their treatment and prevention. Objective: The objective of this study is to perform a comprehensive review of several phytotherapic and herbal medicines published including clinical and animal studies. Results: Phytotherapy may influence the risk of recurrence in calcium oxalate and uric acid stones. The most solid evidence suggest that Phyllanthus niruri is one of the most studied components that appear to interfere with the calcium oxalate crystallization, reduced hyperoxaluria and hiperuricosuria and increased shock wave lithotripsy efficacy due to reduced crystallization without significant adverse effects, also Theobromine have shown to reduce the crystallization of uric acid in patients and appears to be a promising supplement to treat such stones. Conclusion: Many phytoterapic and herbal agents have been studies to treat and present urolithiasis, most of them only with studies of small number of patients or in animal models. Further randomized clinical trials are needed to evaluate the effect of these agents in kidney stones.

Incidence and Risk Factors of Oral Antibiotic-Associated Diarrhea in an Outpatient Pediatric Population

2003 ◽  
Vol 37 (1) ◽  
pp. 22-26 ◽  
Author(s):  
Dominique Turck ◽  
Jean-Paul Bernet ◽  
Jacques Marx ◽  
Hélène Kempf ◽  
Patrick Giard ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pediatric Population ◽  
Oral Antibiotic ◽  
Antibiotic Associated Diarrhea

Pierwotna małopłytkowość immunologiczna u dzieci

2018 ◽  
Vol 22 (4) ◽  
Author(s):  
Anna Dusza ◽  
Michał Matysiak
Keyword(s):  
Immune Thrombocytopenia ◽  
Clinical Symptoms ◽  
Pediatric Population ◽  
Current Data ◽  
Current Investigation ◽  
Surgical Interventions ◽  
Hematological Disorders ◽  
Primary Immune Thrombocytopenia

In this article we present current investigation on primary immune thrombocytopenia in children. There are described pathomorphology, clinical symptoms, diagnosis and treatment. We also present current data from literature about genetic tests and latest data on treating options in children. Primary immune thrombocytopenia (ITP) is one of the most frequent hematological disorders in pediatric population. Although the majority of children have a self-limited and short duration of the disease. However, approximately 20-30% of those patients can develop chronic ITP, which can cause significant complications and higher mortality and reduced quality of life. Especially regarding to long-term immunosupression or surgical interventions, such like splenectomy and restrictions on daily activities to avoid trauma. Over the past decades a lot of informations has been reported about pathogenic features of ITP. Nowdays, we know that it is not only caused by increased platet destruction and decreased platet production, but also complex, multifactorial immune dysregulation, like loss of immune tolerance and generation of platelet autoantibodies. In this article we present current investigation on ITP including clinical symptoms, diagnosis, pathomorphology and latests options on treatment in children. We also present current data about genetic biomarker, such as Vanin-1 (VNN-1) which has been suggested as one of predictors of chronic disease and potentially can offer early prognosis estimation.

scholarly journals Systematic treatment and prevention of cardiac digoxin toxicity

2021 ◽  
Author(s):  
Omar Rezk Alshaer ◽  
Abdullah Obaid Binobaid ◽  
Abdelelah Hesham Mofti ◽  
Mohannad Mahmood Sadagah ◽  
Khalid Mustafa Olwi ◽  
...  
Keyword(s):  
Therapeutic Index ◽  
Digoxin Toxicity ◽  
Clinical Settings ◽  
Clinical Effects ◽  
Systematic Treatment ◽  
Narrow Therapeutic Index ◽  
Serious Adverse Events ◽  
Treatment And Prevention ◽  
Cost Efficacy ◽  
The Cost

Digoxin has a narrow therapeutic index, such as complicated pharmacokinetics and dynamics.  Many drug interactions may occur when the administration of one drug alters the clinical effects of another. As a result, digoxin toxicity can be a common condition within clinical settings that might lead to the development of many morbidities and even mortality. Many studies were published to investigate the efficacy and safety of different management modalities to enhance the outcomes that follow digoxin administration. The aim of the study was to discuss the approaches to systematically treat and prevent the development of cardiac digoxin toxicity. The findings are based on evidence from previous studies in the literature. To be specific, Fab fragments are the most effective modalities that can be used to treat severe cases within ideal periods. However, evidence regarding their administration for asymptomatic or mild cases is still poor regarding the cost-efficacy and the development of serious adverse events. Physicians should primarily care for a better intervention as it is usually associated with a significantly more enhanced prognosis and clinical outcomes. Nevertheless, adequate monitoring of the patients and evaluation of their personal and medical history are important steps in the process, and further approaches are still needed. Also, detailed information about our intended outcomes is furtherly discussed within the manuscript.

scholarly journals Prednisolone adverse events in the treatment and prevention of leprosy neuropathy in two large double blind randomized clinical trials 

2021 ◽  
Vol 92 (3) ◽  
pp. 236-246
Author(s):  
Erik Post ◽  
Inge Wagenaar ◽  
Wim Brandsma ◽  
Bob Bowers ◽  
Khorshed Alam ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Adverse Events ◽  
Randomized Clinical Trials ◽  
Double Blind ◽  
Treatment And Prevention ◽  
Leprosy Neuropathy

The Role of Carnitine Supplementation during Valproic Acid Therapy

2000 ◽  
Vol 34 (5) ◽  
pp. 630-638 ◽  
Author(s):  
Jackie Y Raskind ◽  
Gladys M El-Chaar
Keyword(s):  
Valproic Acid ◽  
Advisory Committee ◽  
Randomized Clinical Trials ◽  
Pediatric Population ◽  
Carnitine Deficiency ◽  
Carnitine Supplementation ◽  
Acid Therapy ◽  
Pediatric Neurology ◽  
Valproic Acid Therapy

OBJECTIVE: To review the pathophysiology and significance of valproic acid–induced carnitine deficiency; to present and evaluate the literature pertaining to carnitine supplementation in pediatric patients receiving valproic acid; and to present the consensus guidelines for carnitine supplementation during valproic acid therapy. DATA SOURCES: A MEDLINE search (1966–December 1998) restricted to English-language literature, using MeSH headings of carnitine and valproic acid, was conducted to identify clinically relevant articles. Selected articles and references focusing on the pediatric population were included for review. DATA EXTRACTION: Study design, patient population, methods, and clinical outcomes were evaluated. DATA SYNTHESIS: Valproic acid, a widely used antiepileptic agent in the pediatric population, is limited by a 1/800 incidence of fatal hepatotoxicity in children under the age of two years. Carnitine is an essential amino acid necessary in β-oxidation of fatty acids and energy production in cellular mitochondria. It has been hypothesized that valproic acid may induce a carnitine deficiency in children and cause nonspecific symptoms of deficiency, hepatotoxicity, and hyperammonemia. Relevant published case reports and trials studying this relationship are evaluated, and a consensus statement by the Pediatric Neurology Advisory Committee is reviewed. CONCLUSIONS: Despite the lack of prospective, randomized clinical trials documenting efficacy of carnitine supplementation in preventing valproic acid–induced hepatotoxicity, the few limited studies available have shown carnitine supplementation to result in subjective and objective improvements along with increases in carnitine serum concentrations in patients receiving valproic acid. The Pediatric Neurology Advisory Committee in 1996 provided more concrete indications on the role of carnitine in valproic acid therapy, such as valproic acid overdose and valproic acid–induced hepatotoxicity. Carnitine was strongly recommended for children at risk of developing a carnitine deficiency. Although carnitine has been well tolerated, future studies are needed to evaluate the efficacy of prophylactic carnitine supplementation for the prevention of hepatotoxicity.

Prevention of Steroid-Induced Neuropsychiatric Complications With Neuroleptic Drugs: A Review

2021 ◽  
pp. 104990912110347
Author(s):  
Ivy Akid ◽  
Suzanne Nesbit ◽  
Julie Nanavati ◽  
Oscar Joseph Bienvenu ◽  
Thomas J. Smith
Keyword(s):  
Low Dose ◽  
Randomized Clinical Trials ◽  
Neuropsychiatric Symptoms ◽  
Review Literature ◽  
Treatment And Prevention ◽  
Neuropsychiatric Complications ◽  
History Of ◽  
Trial Evidence ◽  
History Of Depression ◽  
Positive Effect

Corticosteroids are used for a multitude of indications in palliative patients. In this narrative review, we aim to review literature on the treatment and prevention of neuropsychiatric complications of steroids. For prevention, only lamotrigine had a positive effect in a small number of studies. For treatment, olanzapine appears to be nearly universally effective at low doses, but randomized trial evidence is lacking. Further randomized clinical trials are necessary to elucidate data-driven guidelines for prevention and treatment of corticosteroid-induced neuropsychiatric symptoms. Until further data are available, it is reasonable to consider low dose olanzapine for any patient taking 40 mg of prednisone or its equivalent, especially those with a history of depression or neuropsychiatric symptoms.

scholarly journals Direct Oral Anticoagulants in Cancer Patients. Time for a Change in Paradigm

Cancers ◽  
2020 ◽  
Vol 12 (5) ◽  
pp. 1144 ◽  
Author(s):  
Marek Z. Wojtukiewicz ◽  
Piotr Skalij ◽  
Piotr Tokajuk ◽  
Barbara Politynska ◽  
Anna M. Wojtukiewicz ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Randomized Clinical Trials ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Anticoagulation Therapy ◽  
Current Evidence ◽  
Low Molecular Weight ◽  
Treatment And Prevention ◽  
Prevention Of Cancer ◽  
Selection Of

Thrombosis is a more common occurrence in cancer patients compared to the general population and is one of the main causes of death in these patients. Low molecular weight heparin (LMWH) has been the recognized standard treatment for more than a decade, both in cancer-related thrombosis and in its prevention. Direct oral anticoagulants (DOACs) are a new option for anticoagulation therapy. Recently published results of large randomized clinical trials have confirmed that DOAC may be a reasonable alternative to LMWH in cancer patients. The following review summarizes the current evidence on the safety and efficacy of DOAC in the treatment and prevention of cancer-related thrombosis. It also draws attention to the limitations of this group of drugs, knowledge of which will facilitate the selection of optimal therapy.

Diabetes mellitus and the central nervous system

2016 ◽  
Vol 88 (10) ◽  
pp. 82-86 ◽  
Author(s):  
E V Surkova
Keyword(s):  
Diabetes Mellitus ◽  
Central Nervous System ◽  
Nervous System ◽  
Blood Glucose Control ◽  
Current Data ◽  
Treatment And Prevention ◽  
Imaging Results ◽  
The Central Nervous System ◽  
Considerable Impact ◽  
Relationship Of

The review considers the current views on the central nervous system (CNS) in diabetes mellitus (DM). It discusses an attitude towards the term «diabetic encephalopathy». The data of investigations of cognitive functions in types 1 and 2 DM and the brain structural imaging results obtained using up-to-date technologies are considered. The results of studies of the factors that induce cerebral changes in DM and their associated cognitive impairments are given. There is evidence that hyperglycemia has a more considerable impact on the above processes than hypoglycemia; other possible factors, apart from blood glucose control, are set out. The current views on the function of insulin in the CNS and the relationship of central insulin resistance to Alzheimer’s disease are outlined. There are current data on intranasal insulin application that is still exploratory, but, as might be judged from the findings, may by a promising method for the treatment and prevention of cognitive decline in both patients with DM and those without this condition.

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