CARBAPENEM ANTIBIOTIC DOSE MODE FOR PEDIATRIC PATIENT AT CAN THO CHILDREN’S HOSPITAL

2021 ◽  
Vol 62 (5) ◽  
Author(s):  
Bui Dang Lan Huong ◽  
Le Thi Kim Ngan ◽  
Doan Thanh Truc ◽  
Bui Tung Hiep
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Dose Regimen ◽  
Dosage Regimen ◽  
Recommended Dose ◽  
Children's Hospital ◽  
Treatment Dose ◽  
Children’S Hospital ◽  
Antibiotic Dose ◽  
Carbapenem Antibiotic

Objective: Analyzing the dose regimen of carbapenem antibiotics used in pediatric patients at Can Tho Children’s Hospital.Objects and methods: retrospective-descriptive study on 140 medical records of patients being treated at departments of Can Tho Children’s Hospital during the period from June 1st, 2020 toDecember 31st, 2020. Results: Regarding the dosage regimen characteristics of meropenem showed that 20.3% and 10.8%of meropenem’s indications for the dose of meropenem for non-central nervous system infections and meningitis treament was appropriate according to the recommendations. Meanwhile, up to63.5% of the dose was higher than the recommended dose and 5.5% of the treatment dose was lower than the recommended dose. Regarding imipenem dosage regimen characteristics from the resultsshowed that 71.2% of the dose of imipenem for the treatment of infections non-central nervous system complied with recommendations according to the literature. However, more than 20% of the recommended dose for patients was lower than recommended dose. Conclusion: The meropenem dose regimen was consistent with the recommendation was low. The imipenem dose regimen was consistent with the relatively high recommendation.

scholarly journals GC-08TREATMENT AND OUTCOME OF PEDIATRIC NON-MIDLINE CENTRAL NERVOUS SYSTEM GERMINOMA: CHILDREN'S HOSPITAL LOS ANGELES EXPERIENCE

2016 ◽  
Vol 18 (suppl 3) ◽  
pp. iii43.4-iii43
Author(s):  
Kee Kiat Yeo ◽  
Hung Tran ◽  
Kenneth Wong ◽  
Nathan Robison ◽  
Ashley Margol ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Los Angeles ◽  
Children's Hospital ◽  
Children’S Hospital

Alterations of the Fundus in Hypernatremia

PEDIATRICS ◽  
1966 ◽  
Vol 37 (5) ◽  
pp. 855-855
Author(s):  
DR. COSTOS APOSTIKIS
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Considerable Influence ◽  
Children's Hospital ◽  
Children’S Hospital ◽  
The Central Nervous System ◽  
Pathological Image ◽  
Hypernatremic Dehydration

Disturbance in electrolyte equilibrium as a result of dehydration, especially hypernatremic dehydration, seems to have a considerable influence on the eye, besides its effect on the central nervous system. In 18 infants suffering from dehydration observed at the children's hospital "Saint Sophia" in Athens, nine presented varying degrees of hypernatremia. Seven of these, with higher values of Na in the serum ranging from 160 mEq to 182 mEq, displayed a pathological image of the fundus, consisting of an edema of the area between disc and macula, undefined disc limits, and, occasionally, small spotted capillary hemorrhages.

Evaluation of a Fixed-Dose Regimen of 4-Factor Prothrombin Complex Concentrate for Warfarin Reversal

2021 ◽  
pp. 106002802199214
Author(s):  
Clare McMahon ◽  
Joe Halfpap ◽  
Qianqian Zhao ◽  
Ana Bienvenida ◽  
Anne E. Rose
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Dose Regimen ◽  
Prothrombin Complex Concentrate ◽  
Primary Outcome ◽  
International Normalized Ratio ◽  
Fixed Dose ◽  
Optimal Dosing ◽  
Warfarin Reversal ◽  
Higher Doses

Background: Fixed-dose (FD) regimens of 4-factor prothrombin complex concentrate (4F-PCC) may be effective for the emergent reversal of warfarin; however, the optimal dosing is unknown. Our institution transitioned to a FD regimen of 1000 or 2000 units of 4F-PCC based on indication. Objective: The purpose of this study is to report our experience with FD 4F-PCC compared with a historical weight-based dosing cohort for warfarin reversal. Methods: A retrospective analysis was conducted for 3 groups: central nervous system (CNS) bleeds regardless of international normalized ratio (INR), non-CNS bleeds with an initial INR ≤6, and non-CNS bleeds with an initial INR ≥6.1. The primary outcome of the study was achievement of the target INR. Results: There were 54 patients with a CNS bleed, 153 with a non-CNS bleed and INR ≤6, and 19 with a non-CNS bleed and INR ≥6.1. In the CNS bleeding group, weight-based and FD achieved target INR 79.4% and 70% ( P = 0.52). In the INR ≥6.1 non-CNS bleeding group, weight-based and FD achieved target INR 100% and 70% ( P = 0.21). In the INR ≤6 non-CNS bleeding group, weight-based and FD achieved target INR 86.4% and 57.5% ( P = 0.0002). Conclusion and Relevance: An FD strategy of 2000 units for warfarin reversal for CNS bleeds or INR ≥6.1 was comparable to weight-based dosing. The FD strategy of 1000 units for INR ≤6 achieved target INR less often than weight-based dosing. Application of findings suggest that higher doses may be needed to achieve target INR.

scholarly journals THE REASONABLENESS OF USING DRUGS TO TREAT PNEUMONIA

2021 ◽  
Vol 62 (4) ◽  
Author(s):  
Nguyen Viet Dang ◽  
Tri Kim Ngoc ◽  
Bui Tung Hiep ◽  
Bui Dang Minh Tri
Keyword(s):  
Treatment Regimen ◽  
Medical Records ◽  
Initial Treatment ◽  
Descriptive Study ◽  
Antibiotic Regimen ◽  
Children's Hospital ◽  
Children’S Hospital ◽  
Antibiotic Dose ◽  
Very High ◽  
Antibiotic Delivery

Objective: To investigate the reasonableness of using drugs to treat pneumonia at Can Tho Children’s Hospital. Subjects and methods: a retrospective-descriptive study on 384 inpatient medical records at Can Tho Children’s Hospital from January 2019 to December 2019 was diagnosed pneumonia. Results: The percentage of the initial treatment regimen that was not reasonable with the recommended antibiotic regimen was relatively high at 84.11%. The proportion of antibiotics with inappropriate dose was only 1.71% of the total number of surveyed cases. The appropriate rate of antibiotic dose was 98.29%. The proportion of adjuvants with high appropriate doses such as Salbutamol, Hydrocortison and Prednisolon accounted for 100%. The rate of taking antibiotics in accordance with recommendations accounted for 94.67%. The rate of adjuvanvt drug delivery was very high, there were only a few cases that did not comply with recommendations such as Ibuprofen with 14 cases, accounting for 37.84%, Acetylcysteine ​​and Hydrocortison accounted for 14.58% with 7 cases, and Prednisolon and Budesonid accounted for the very low percentage. Conclusion: The proportion of the initial treatment regimen that was not compatible with the antibiotic regimen was relatively high. The appropriate rate of antibiotic dose was high. The proportion of adjuvants with suitable doses was high such as Salbutamol, Hydrocortison and Prednisolon. The antibiotic delivery rate was consistent with recommendations. The rate of adjuvant delivery was very high.

Reduction in central nervous system leukemia with a pharmacokinetically derived intrathecal methotrexate dosage regimen.

1983 ◽  
Vol 1 (5) ◽  
pp. 317-325 ◽  
Author(s):  
W A Bleyer ◽  
P F Coccia ◽  
H N Sather ◽  
C Level ◽  
J Lukens ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Life Table ◽  
Dosage Regimen ◽  
Irradiation Dose ◽  
Cranial Irradiation ◽  
Intrathecal Methotrexate ◽  
Marginal Effect ◽  
Average Risk ◽  
Risk Patients

During the period 1976-1981, 3241 children were enrolled on three major studies of acute lymphoblastic leukemia by participating institutions of the Children's Cancer Study Group. Each study included a different method of central nervous system (CNS) prophylaxis: (1) standard therapy with cranial irradiation, 2400 rads, and intrathecal methotrexate at 12 mg/m2 six times during consolidation (CCG-141); (2) a modification of CCG-141 in which the intrathecal methotrexate was initiated during induction (CCG-141A); and (3) a reduced cranial irradiation dose of 1800 rads with intrathecal methotrexate given at the same frequency as a CCG-141A, with or without maintenance intrathecal methotrexate, but with a dosage regimen derived from CNS volume considerations rather than based on body surface area (CCG-160 series). Strategy 3, a change in the intrathecal methotrexate dosage, has resulted in the lowest incidence of CNS leukemia to date (p less than 0.007). The cumulative 3-yr CNS relapse rate has decreased from 8%-10% to 2%-5% in average-risk patients (p less than 0.02; life table estimate) and from 23%-27% to 6% in high-risk patients (p less than 0.0002; life table estimate), despite a reduction in the cranial irradiation dose from 2400 to 1800 rads. Maintenance intrathecal chemotherapy has had a marginal effect among patients randomized to receive this additional therapy (p = 0.06). The overall outcome has been an increase in the continuous complete remission rate (p = 0.04) but not in the estimated 3-yr continuous hematologic remission or survival rates.

DR CHARLES WEST ON THE PROPER APPROACH TO THE ILL CHILD (1850)

PEDIATRICS ◽  
1989 ◽  
Vol 83 (6) ◽  
pp. 1015-1015
Author(s):  
T. E. C.
Keyword(s):  
Nervous System ◽  
Know How ◽  
Children's Hospital ◽  
Children’S Hospital ◽  
The Face ◽  
Medical Historian

Charles West (1816-1898), founder of the Children's Hospital, Great Ormond Street, London, has been described by Fielding H. Garrison, America's leading medical historian, as: "The greatest English pediatrist of his time, and perhaps the most genial practitioner of the art who ever lived." West's pediatric treatise, first published in 1848, opens with this admirable advice on the approach to the ill child. The quiet manner and the gentle voice which all who have been ill know how to value in their attendants, are especially needed when the patient is a child. Your first object must be not to alarm it; if you suceed in avoiding this danger, it will not be long before you acquire its confidence; do not therefore, on entering the room, go at once close up to the child, but, sitting down sufficiently near to watch it, and yet so far off as to attract its attention, put a few questions to its attendant. While doing this, you may, without seeming to notice it, acquire a great deal of important information; you may observe the expression of the face, the character of the respiration, whether slow or frequent, regular or unequal, and if the child utter any sound, you may attend to the character of the cry. All your observations must be made without staring the child in the face, little children, especially if ill, seem always disturbed by this, and would be almost sure to cry. If the child be asleep at the time of your visit, your observations may be more minute; the kind of sleep should be noticed, whether quiet or disturbed, whether the eyes be perfectly closed during it, or partly open as they are in many cases where the nervous system is disordered: you may, too, if the sleep seem sound, venture to count the frequency of the respiration, and the beat of the pulse, but in doing this you should be careful not to arouse the child. It should be awoke gently by the nurse or mother, and a strange face should not be the first to meet its eye on awakening. If it were awake when you entered the room, it will probably in a few minutes have grown accustomed to your presence, and will allow you to touch its hand, and feel its pulse.

Tapentadol and Sleepwalking: A Case Report

2021 ◽  
pp. 089719002199697
Author(s):  
Elena (You Jung) Ko ◽  
Michael W. Tupper
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Case Report ◽  
Laboratory Data ◽  
Package Insert ◽  
Recommended Dose ◽  
Patient History ◽  
Recommended Dosage ◽  
The Central Nervous System ◽  
Norepinephrine Reuptake

Objective: This is a case report of a patient with sleepwalking likely caused by tapentadol ER secondary to higher than the recommended dose for the treatment of pain. Methods: This report presents the relevant patient history, laboratory data and literature review on possible causes of this patient’s sleepwalking. Results: A 39-year-old female reported sleepwalking as the dose of tapentadol increased above the recommended maximum provided in the package insert. The mechanism of action of tapentadol involving norepinephrine reuptake inhibition affecting the central nervous system, higher dosage and drug interactions with other home medications likely contributed to her sleepwalking. Conclusion: This case highlights the importance of adhering to the recommended dosage of a medication and if it is clinically warranted to exceed the maximum recommended dose, the importance of diligent monitoring for any adverse effects.

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