scholarly journals Acid Suppression Therapy for the Empirical Treatment of Nausea and Vomiting in Hospitalized Pediatric Patients

2021 ◽  
Vol 11 (5-S) ◽  
pp. 13-18
Author(s):  
YOUSIF S ALAKEEL ◽  
Meshary F. Almeshary ◽  
Mohammed A. Alghamdi ◽  
Rawa M. Faden
Keyword(s):  
Proton Pump ◽  
Complete Resolution ◽  
Pediatric Patients ◽  
Rescue Therapy ◽  
Acid Suppression ◽  
Nausea And Vomiting ◽  
Acid Suppression Therapy ◽  
Medical City ◽  
The Mean ◽  
Selection Of

Objective: To investigate and compare the safety and efficacy of the empirical use of Histamine-2-receptor antagonists (H2RAs) and Proton pump inhibitors (PPIs), for the treatment of unspecified nausea and vomiting (NV) in hospitalized children. Methods: The retrospective cohort study was conducted at King Abdulaziz Medical City in Riyadh (KAMC-R) and included pediatric patients ≤14 years who received acid suppression therapy (AST), H2RAs or PPIs, for the treatment of unspecified NV between April 30, 2018, and April 30, 2019. The primary outcome was the complete resolution of NV within three days of AST. The secondary outcomes were the frequency of rescue medication use, the number of vomiting episodes since starting the AST, and the adverse drug reactions (ADRs). Results: Sixty-two patients were included in the study, 25 (40.3%) were in the H2RAs group and 37 (59.7%) in the PPIs group. The mean age was 3.69 ± 4.13 years, with the majority male (64.5%). Overall, 87% (n=54) of the sample had complete resolution of NV within 3 days of the AST therapy with no difference between the H2RAs and PPIs groups (p=0.344). The number of NV episodes from initiating the AST until the complete resolution was similar between the groups. In total, 14 patients (25.9%) required rescue therapy with granisetron, 6 (26.1%) in the H2RAs group compared to 8 (25.8%) in the PPIs group. There was no difference in the number of the required granisetron doses or the incidence of ADRs. Conclusion: Both PPIs and H2RAs were effective and safe for the treatment of unspecified NV in hospitalized pediatric patients. The selection of either agent should be based on other factors. Keywords: Pediatric; Nausea and vomiting; Proton pump inhibitor; Histamine-2-receptor antagonist; Granisetron.

scholarly journals Biologic Use in Pediatric Patients With Hidradenitis Suppurativa: A Systematic Review

2021 ◽  
pp. 120347542110497
Author(s):  
Muskaan Sachdeva ◽  
Patrick Kim ◽  
Asfandyar Mufti ◽  
Khalad Maliyar ◽  
Cathryn Sibbald ◽  
...  
Keyword(s):  
Systematic Review ◽  
Complete Resolution ◽  
Hidradenitis Suppurativa ◽  
Large Scale ◽  
Pediatric Patients ◽  
Biologic Therapy ◽  
Pediatric Population ◽  
Safety Data ◽  
Tnf Alpha ◽  
The Mean

Background: There is currently at least 1 biologic (adalimumab) approved in North America for treatment of Hidradenitis Suppurativa in the pediatric population. However, no reviews or clinical trials have specifically analyzed the effectiveness and safety data of biologic use in this population. The objective of this systematic review is to identify and summarize the outcomes of biologic therapy in pediatric patients with HS. Methods: MEDLINE and EMBASE databases were used to conduct the search on Sept 18, 2020. Results: The 15 included studies consisted of 26 patients, with the mean age of 15 ± 2.3 years. Females accounted for 53.8% ( n = 14/26) of cases. The mean duration of HS prior to biologic initiation was 3.5 ± 2.9 years, with the majority having Hurley Stage II. The 26 patients received 34 biologics in total: 85.3% treated with TNF alpha inhibitors (adalimumab n = 17, infliximab n = 10, etanercept n = 1, unspecified n = 1), 5.9% with IL-12/23 inhibitors (ustekinumab n = 2), 5.9% with IL-1 inhibitors (i.e., anakinra n = 2) and 2.9% received IL-23 inhibitors (i.e., guselkumab n = 1) biologics. Of the 26 patients, 23.1% ( n = 6/26) experienced complete resolution (CR), 73.1% ( n = 19/26) experienced partial resolution (PR), and 3.8% ( n = 1/26) had no resolution outcomes reported. The time to resolution of HS lesions after biologic initiation ranged from 10 days to 11.5 months (mean: 5.1 months). No adverse events were reported in the studies. Conclusion: Although anti-TNF alpha were the most common biologics used for HS in pediatric cases, large-scale trials specific to pediatric patients with HS are needed to confirm these findings.

scholarly journals Impact of Acid Suppression Therapy on Iron Supplementation in the Pediatric Intensive Care Unit

2021 ◽  
Vol 26 (4) ◽  
pp. 366-371
Author(s):  
Emily Hailstone ◽  
Sheryl Falkos ◽  
Rosa Vidal ◽  
K. Ashley Jones ◽  
Philippe R. Gaillard ◽  
...  
Keyword(s):  
Serum Iron ◽  
Iron Supplementation ◽  
Primary Outcome ◽  
Pediatric Intensive Care ◽  
Gastric Ph ◽  
Mean Difference ◽  
Acid Suppression ◽  
Acid Suppression Therapy ◽  
The Mean ◽  
The Impact

OBJECTIVE We assessed the impact of acid suppression therapy (i.e., ranitidine or proton pump inhibitors) on iron supplementation and its ability to maintain or alter laboratory values that are commonly associated with anemia. METHODS This was a prospective, observational trial. The primary outcome was changes in serum iron levels from baseline. Secondary outcomes were changes in hemoglobin (Hgb) and hematocrit (Hct), transfusions, and maintenance of an alkalotic gastric pH. RESULTS Thirty-four patients (mean 24 ± 43 months) met inclusion criteria. The serum iron levels increased to 50.9 ± 24.6 mcg/dL by day 3. The mean difference from baseline was 1.5 mcg/dL (95% CI, 1.14–1.98, p = 0.0056). Gastric pH increased to 4.68 ± 1.49 on day 5. The mean Hgb and Hct increased on day 5 to 10 ± 1.06 g/dL and 29.6% ± 3.27%, respectively. The mean difference of Hgb was 1.15 g/dL (95% CI, 0.51–1.78, p = 0.0009). The mean difference of Hct was 3.04% (95% CI, 1.11–4.97, p = 0.0032). CONCLUSIONS The use of antacids along with oral ferrous sulfate supplementation did not affect the absorption of iron. Serum iron, Hgb, and Hct all showed statistically significant increases despite combined antacid and iron therapy. Thus, despite use of antacids, combination use showed increases in iron absorption.

Evaluation of the Pediatric Patient for Liver Transplantation

PEDIATRICS ◽  
1986 ◽  
Vol 78 (4) ◽  
pp. 559-565
Author(s):  
Basil J. Zitelli ◽  
J. Jeffrey Malatack ◽  
J. Carlton Gartner ◽  
Andrew H. Urbach ◽  
Laurel Williams ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Informed Consent ◽  
Organ Donation ◽  
Pediatric Patient ◽  
Pediatric Patients ◽  
Family Education ◽  
Formal Evaluation ◽  
The Mean ◽  
Psychosocial Stability ◽  
Selection Of

In a 36-month period from 1981 to 1984, 209 pediatric patients were evaluated for liver transplantation. The purpose of the evaluation was to assess the severity and progression of the disease, anatomical suitability for transplantation, and psychosocial stability and to initiate family education. Of the 209 patients evaluated, 85 (41%) underwent transplantations and 64 (75%) survived at least 12 months. Thirty-four (16%) patients were not considered candidates for transplantation. The mean waiting period increased from 80.3 days to 232 days. Of 174 patients considered for transplantation, 41 (24%) died prior to surgery. A formal evaluation for liver transplantation permitted appropriate selection of candidates and provided education for informed consent. We also stress the need for greater participation in pediatric organ donation.

scholarly journals Analysis of effects of acid suppression therapy on renal tissue using experimental animal.

2019 ◽  
Vol 26 (11) ◽  
pp. 1856-1860
Author(s):  
Shoaib Ahmed ◽  
Farwa Naqvi ◽  
Nadeem Yaqoob ◽  
Bilal Habib ◽  
Nadir Ali Rana ◽  
...  
Keyword(s):  
Experimental Animal ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Histological Study ◽  
Renal Tissue ◽  
International Standards ◽  
Acid Suppression ◽  
Control Group ◽  
Acid Suppression Therapy ◽  
Animal House

Objectives: To analyze the effects of acid suppression therapy by proton pump inhibitors on renal tissue by using mice as experimental animal. Study Design: Randomized control trial. Setting: Animal house of University of Sargodha. Period: 6 weeks (From 1st January 2018 to 15th February 2018). Material and Methods: The sample consisted of 60 mice. Simple Random Sampling was the technique which was used for the sampling procedure. The mice were procured from Veterinary University Lahore Punjab. The animals were handled according to the international standards of environmental and ethical conditions. The animals were divided into three groups. One group was labeled as control group for comparison and the other groups served as experimental. The histological study was done to analyze the effects of proton pump inhibitors. Results: Histological analysis of the sections made from the renal tissue revealed that acid suppression therapy given in the form of proton pump inhibitors induced toxic effects on the kidneys. The glomerulus was observed to be congested along with cellular infiltrate in the interstitium.

Long-term outcomes of lumbar microdiscectomy in the pediatric population: a large single-institution case series

2019 ◽  
Vol 24 (5) ◽  
pp. 549-557
Author(s):  
Malia McAvoy ◽  
Heather J. McCrea ◽  
Vamsidhar Chavakula ◽  
Hoon Choi ◽  
Wenya Linda Bi ◽  
...  
Keyword(s):  
Conservative Management ◽  
Functional Outcomes ◽  
Pediatric Patients ◽  
Clinical Presentation ◽  
Case Series ◽  
Csf Leak ◽  
Single Institution ◽  
The Mean

OBJECTIVEFew studies describe long-term functional outcomes of pediatric patients who have undergone lumbar microdiscectomy (LMD) because of the rarity of pediatric disc herniation and the short follow-up periods. The authors analyzed risk factors, clinical presentation, complications, and functional outcomes of a single-institution series of LMD patients over a 19-year period.METHODSA retrospective case series was conducted of pediatric LMD patients at a large pediatric academic hospital from 1998 to 2017. The authors examined premorbid risk factors, clinical presentation, physical examination findings, type and duration of conservative management, indications for surgical intervention, complications, and postoperative outcomes.RESULTSOver the 19-year study period, 199 patients underwent LMD at the authors’ institution. The mean age at presentation was 16.0 years (range 12–18 years), and 55.8% were female. Of these patients, 70.9% participated in competitive sports, and among those who did not play sports, 65.0% had a body mass index greater than 25 kg/m2. Prior to surgery, conservative management had failed in 98.0% of the patients. Only 3 patients (1.5%) presented with cauda equina syndrome requiring emergent microdiscectomy. Complications included 4 cases of postoperative CSF leak (2.0%), 1 case of a noted intraoperative CSF leak, and 3 cases of wound infection (1.5%). At the first postoperative follow-up appointment, minimal or no pain was reported by 93.3% of patients. The mean time to return to sports was 9.8 weeks. During a mean follow-up duration of 8.2 years, 72.9% of patients did not present again after routine postoperative appointments. The total risk of reoperation was a rate of 7.5% (3.5% of patients underwent reoperation for the same level; 4.5% underwent adjacent-level decompression, and one patient [0.5%] ultimately underwent a fusion).CONCLUSIONSMicrodiscectomy is a safe and effective treatment for long-term relief of pain and return to daily activities among pediatric patients with symptomatic lumbar disc disease in whom conservative management has failed.

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