scholarly journals Methadone prolongs cardiac conduction in young patients with cancer-related pain

2016 ◽  
Vol 12 (2) ◽  
pp. 131 ◽  
Author(s):  
Doralina L. Anghelescu, MD ◽  
Rakesh M. Patel, MD ◽  
Daniel P. Mahoney, MD ◽  
Luis Trujillo, MD ◽  
Lane G. Faughnan, BSN ◽  
...  
Keyword(s):  
Methadone Treatment ◽  
Young Patients ◽  
Torsades De Pointes ◽  
Cardiac Conduction ◽  
Qtc Prolongation ◽  
Methadone Dose ◽  
Methadone Dosage ◽  
Duration Of Therapy ◽  
Day Range ◽  
The Mean

Objective: Methadone prolongs cardiac conduction, from mild corrected QT (QTc) prolongation to torsades de pointes and ventricular fibrillation, in adults. However, methadone use for pain and its effects on cardiac conduction have not been investigated in pediatric populations.Methods: A retrospective review of QTc intervals in patients receiving methadone analgesia was conducted. Medical records from a 4-year period (September 2006 to October 2010) at a pediatric oncology institution were reviewed, and correlations were tested between cardiac conduction and methadone dosage and duration of therapy, electrolyte levels, renal and hepatic dysfunction, and concurrent medications.Results: Of the 61 patients who received methadone, 37 met our inclusion criteria and underwent 137 electrocardiograms (ECGs). During methadone treatment, the mean QTc was longer than that at baseline (446.5 vs 437.55 ms). The mean methadone dose was 27.0 ± 24.3 mg/d (range, 5-125 mg/d; median, 20 mg/d) or 0.47 ± 0.45 mg/kg per day (range, 0.05-2.25 mg/kg per day; median, 0.37 mg/kg per day), and the mean duration of therapy was 49 days. The authors identified a correlation between automated and manual ECG readings by two cardiologists (Pearson r = 0.649; p < 0.0001), but the authors found no correlations between methadone dose or duration and concurrent QTc-prolonging medications, sex, age, electrolyte abnormalities, or renal or hepatic dysfunction.Conclusion: At a clinically effective analgesic dose, methadone dosage and duration were not correlated with QTc prolongation, even in the presence of other risk factors, suggesting that methadone use may be safe in pediatric populations. The correlation between automated and manual ECG readings suggests that automated ECG readings are reliable for monitoring cardiac conductivity during the reported methadone-dosage regimens.

Fluconazole Treatment of Neonates and Infants with Severe Fungal Infections

1997 ◽  
Vol 25 (4) ◽  
pp. 214-218 ◽  
Author(s):  
AN Gürpinar ◽  
E Balkan ◽  
N Kiliç ◽  
İ Kiriştioǧlu ◽  
İ Avşar ◽  
...  
Keyword(s):  
Adverse Events ◽  
Fungal Infection ◽  
Clinical Response ◽  
Fungal Infections ◽  
Efficacy And Safety ◽  
Duration Of Therapy ◽  
Day Range ◽  
The Mean ◽  
Neonates And Infants

A total of 24 neonates and infants, aged from 2 days to 10 months, received treatment with intravenous fluconazole for microbiologically documented or presumed fungal infection. The mean fluconazole dosage was 6 mg/kg/day (range 2 –16 mg/kg/day) and the mean duration of therapy was 25 days (range 5–72 days). Efficacy was evaluated in neonates with proven fungal infections, as documented by the presence of pathogen at baseline. A positive clinical response was achieved in 23 of the 24 clinically evaluable patients (96%); eradication of the fungal organism was also achieved in 23 of the 24 evaluable patients (96%). Adverse events occurred in two patients (8%) but therapy was not discontinued in either patient. The present results confirm the efficacy and safety of fluconazole in the treatment of neonates and infants with severe fungal infections.

scholarly journals Outcome of Corneal Collagen Crosslinking for Progressive Keratoconus in Paediatric Patients

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Deepa Viswanathan ◽  
Nikhil L. Kumar ◽  
John J. Males
Keyword(s):  
Young Patients ◽  
Ultraviolet A ◽  
Effective Treatment Option ◽  
Collagen Crosslinking ◽  
Paediatric Patients ◽  
Corneal Grafting ◽  
Minimum Angle ◽  
Corneal Collagen Crosslinking ◽  
The Mean ◽  
Corneal Collagen

Purpose. To evaluate the efficacy of corneal collagen crosslinking for progressive keratoconus in paediatric patients.Methods. This prospective study included 25 eyes of 18 patients (aged 18 years or younger) who underwent collagen crosslinking performed using riboflavin and ultraviolet-A irradiation (370 nm, 3 mW/cm2, 30 min).Results. The mean patient age was 14.3 ± 2.4 years (range 8–17) and mean followup duration was 20.1 ± 14.25 months (range 6–48). Crosslinked eyes demonstrated a significant reduction of keratometry values. The mean baseline simulated keratometry values were 46.34 dioptres (D) in the flattest meridian and 50.06 D in the steepest meridian. At 20 months after crosslinking, the values were 45.67 D (P=0.03) and 49.34 D (P=0.005), respectively. The best spectacle corrected visual acuity (BSCVA) and topometric astigmatism improved after crosslinking. Mean logarithm of the minimum angle of resolution (logMAR) BSCVA decreased from 0.24 to 0.21 (P=0.89) and topometric astigmatism reduced from mean 3.50 D to 3.25 D (P=0.51).Conclusions. Collagen crosslinking using riboflavin and ultraviolet-A is an effective treatment option for progressive keratoconus in paediatric patients. Crosslinking stabilises the condition and, thus, reduces the need for corneal grafting in these young patients.

scholarly journals Ocular manifestations in Herpes Zoster Ophthalmicus

1970 ◽  
Vol 3 (2) ◽  
pp. 165-171 ◽  
Author(s):  
LR Puri ◽  
GB Shrestha ◽  
DN Shah ◽  
M Chaudhary ◽  
A Thakar
Keyword(s):  
Herpes Zoster ◽  
Young Patients ◽  
Ocular Involvement ◽  
Post Herpetic Neuralgia ◽  
Visual Disability ◽  
Herpes Zoster Ophthalmicus ◽  
Cross Sectional ◽  
Ocular Manifestations ◽  
Visual Status ◽  
The Mean

Background: Ocular complications of herpes zoster ophthalmicus (HZO) may lead to substantial visual disability, severe post-herpetic neuralgia and rarely fatal cerebral complications. Aim: To identify the pattern of ocular manifestation in herpes zoster ophthalmicus. Materials and methods: A cross-sectional descriptive study was under taken including the clinically diagnosed cases of HZO. All of them underwent a complete ophthalmological evaluation. Results: Sixty-eight cases of HZO were examined, of which 37 (54.4 %) were male and 31 (45.6%) female. The mean age was 48.7 ± 18.5 years. Most of the patients (64.7 %) were above the age of 40 years. 77.94 % of the patients had some form of ocular involvement. Pain (77.9 %) was the commonest ocular complaint. In young patients less than 35 years, HIV was the most common risk factor (19.3 %).Visual status was good in the majority (73.5 %) of patients at presentation. Lid and adnexal findings (45.8 %) were most common ocular involvement followed by conjunctivitis (41.1 %). Corneal complication was seen in 38.2 % of cases, uveitis in 19.1 % and post-herpetic neuralgia (PHN) and secondary glaucoma each in 5.8 %. Conclusion: Eyelid and ocular adnexal involvement is most commonly found in patients with herpes zoster ophthalmicus followed by corneal complication and uveitis. There needs to be awareness of ocular involvement, which can be sight threatening, among the HZO patients and other medical departments and an increased emphasis on regular ophthalmic examination. Key words: herpes virus, herpes zoster, conjunctivitis, keratitis DOI: http://dx.doi.org/10.3126/nepjoph.v3i2.5271 Nepal J Ophthalmol 2011; 3(2): 165-171

Rapid Maxillary Expansion in Obstructive Sleep Apnea in Young Patients: Cardio-Respiratory Monitoring

2017 ◽  
Vol 41 (4) ◽  
pp. 312-316 ◽  
Author(s):  
Alfio Buccheri ◽  
Fabio Chinè ◽  
Giovanni Fratto ◽  
Licia Manzon
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Young Patients ◽  
Rapid Maxillary Expansion ◽  
Respiratory Monitoring ◽  
Respiratory Disorder ◽  
Maxillary Expansion ◽  
Mean Values ◽  
Obstructive Sleep ◽  
The Mean

Objective(s): Obstructive sleep apnea syndrome (OSAS) is a respiratory disorder which affects from 1 to 3 % of people during development. OSAS treatment may be pharmacological, surgical or based on application of intraoral devices to increase nasal respiratory spaces. The purpose of this study was to determine the efficacy of the Rapid Maxillary Expander in OSAS young patients by measuring cardio-respiratory monitoring parameters (AHI, the average value of complete and incomplete obstructed respiration per hour of sleep, and SAO2, the percentage of oxygen saturation). Study design: The study was conducted on 11 OSAS young subjects (mean age 6.9±1.04 years), all treated with rapid maxillary expansion (RME). Cardio-respiratory monitoring (8-channel Polymesam) was performed at the beginning (diagnostic, T0) and after 12 months of treatment. Results: The mean values of cardio-respiratory parameters at TO were: AHI=6.09±3.47; SAO2=93.09%±1.60. After 12 months of treatment, the mean values of the same polysomnographic parameters were: AHI=2.36 ± 2.24;SAO2=96.81% ±1.60. These changes were associated with an improvement in clinical symptoms, such as reduction of snoring and sleep apnea. Conclusion(s): This study confirms the therapeutic efficacy of RME in OSAS young patients. This orthopedic-orthodontic treatment may represent a good option in young patients affected by this syndrome.

scholarly journals Intercalary reconstruction of femur after tumour resection: is a vascularized fibular autograft plus allograft a long-lasting solution?

2018 ◽  
Vol 100-B (3) ◽  
pp. 378-386 ◽  
Author(s):  
D. A. Campanacci ◽  
F. Totti ◽  
S. Puccini ◽  
G. Beltrami ◽  
G. Scoccianti ◽  
...  
Keyword(s):  
Weight Bearing ◽  
Young Patients ◽  
Bone Tumour ◽  
Full Weight Bearing ◽  
Tumour Resection ◽  
Fibular Graft ◽  
Musculoskeletal Tumor Society ◽  
Long Term Outcome ◽  
The Mean

Aims After intercalary resection of a bone tumour from the femur, reconstruction with a vascularized fibular graft (VFG) and massive allograft is considered a reliable method of treatment. However, little is known about the long-term outcome of this procedure. The aims of this study were to determine whether the morbidity of this procedure was comparable to that of other reconstructive techniques, if it was possible to achieve a satisfactory functional result, and whether biological reconstruction with a VFG and massive allograft could achieve a durable, long-lasting reconstruction. Patients and Methods A total of 23 patients with a mean age of 16 years (five to 40) who had undergone resection of an intercalary bone tumour of the femur and reconstruction with a VFG and allograft were reviewed clinically and radiologically. The mean follow-up was 141 months (24 to 313). The mean length of the fibular graft was 18 cm (12 to 29). Full weight-bearing without a brace was allowed after a mean of 13 months (seven to 26). Results At final follow-up, the mean Musculoskeletal Tumor Society Score of 22 evaluable patients was 94% (73 to 100). Eight major complications, five fractures (21.7%), and three nonunions (13%) were seen in seven patients (30.4%). Revision-free survival was 72.3% at five, ten, and 15 years, with fracture and nonunion needing surgery as failure endpoints. Overall survival, with removal of allograft or amputation as failure endpoints, was 94.4% at five, ten, and 15 years. Discussion There were no complications needing surgical revision after five years had elapsed from surgery, suggesting that the mechanical strength of the implant improves with time, thereby decreasing the risk of complications. In young patients with an intercalary bone tumour of the femur, combining a VFG and massive allograft may result in a reconstruction that lasts a lifetime. Cite this article: Bone Joint J 2018;100-B:378–86.

scholarly journals QTc interval in patients with schizophrenia receiving antipsychotic treatment as monotherapy or polypharmacy

CNS Spectrums ◽  
2017 ◽  
Vol 23 (4) ◽  
pp. 278-283 ◽  
Author(s):  
Anja Elliott ◽  
Thibault Johan Mørk ◽  
Mikkel Højlund ◽  
Thomas Christensen ◽  
Rasmus Jeppesen ◽  
...  
Keyword(s):  
Small Sample Size ◽  
Torsades De Pointes ◽  
Small Sample ◽  
Polymorphic Ventricular Tachycardia ◽  
Antipsychotic Treatment ◽  
Qtc Interval ◽  
Qtc Prolongation ◽  
Worst Case ◽  
Clinical Interviews ◽  
Observational Cohort

ObjectiveAntipsychotics are associated with a polymorphic ventricular tachycardia, torsades de pointes, which, in the worst case, can lead to sudden cardiac death. The QT interval corrected for heart rate (QTc) is used as a clinical proxy for torsades de pointes. The QTc interval can be prolonged by antipsychotic monotherapy, but it is unknown if the QTc interval is prolonged further with antipsychotic polypharmaceutical treatment. Therefore, this study investigated the associations between QTc interval and antipsychotic monotherapy and antipsychotic polypharmaceutical treatment in schizophrenia, and measured the frequency of QTc prolongation among patients.MethodsWe carried out an observational cohort study of unselected patients with schizophrenia visiting outpatient facilities in the region of Central Jutland, Denmark. Patients were enrolled from January of 2013 to June of 2015, with follow-up until June of 2015. Data were collected from clinical interviews and clinical case records.ResultsElectrocardiograms were available for 65 patients, and 6% had QTc prolongation. We observed no difference in average QTc interval for the whole sample of patients receiving no antipsychotics, antipsychotic monotherapy, or antipsychotic polypharmaceutical treatment (p=0.29). However, women presented with a longer QTc interval when receiving polypharmacy than when receiving monotherapy (p=0.01). A limitation of this study was its small sample size.ConclusionsWe recommend an increased focus on monitoring the QTc interval in women with schizophrenia receiving antipsychotics as polypharmacy.

Oestrogen treatment of adolescent tall girls; short term side effects

1986 ◽  
Vol 113 (4_Suppl) ◽  
pp. S170-S173 ◽  
Author(s):  
OLAV TRYGSTAD
Keyword(s):  
Side Effects ◽  
Idiopathic Scoliosis ◽  
Final Height ◽  
Psychosocial Problems ◽  
Short Term ◽  
Oestrogen Treatment ◽  
Duration Of Therapy ◽  
Tall Girls ◽  
The Mean ◽  
Ethinyl Oestradiol

Abstract In 1980-1985 680 preadolescent tall girls were treated with pharmacological doses of oestrogen to reduce final height. Indications for the therapy were predicted final height >+2.5 SD (180.75 cm), idiopathic scoliosis, and psychosocial problems. Until 1976 141 girls were given diethyl stilboestrol 5 mg daily. By advice of Prader this was then replaced by ethinyl oestradiol and a progestin was given on days 5-10 each month. The mean duration of therapy was close to 2 years. The observed short-term unwanted effects were due to the pharmacological actions of the drugs, (11 girls had galactorrhoea at the end of therapy; no pituitary prolactionoma was observed) or events happening by chance.

Kingella kingae septic arthritis

2021 ◽  
Vol 103-B (3) ◽  
pp. 584-588
Author(s):  
Mohammed Khattak ◽  
Sujith Vellathussery Chakkalakumbil ◽  
Robert A. Stevenson ◽  
David J. Bryson ◽  
Michael J. Reidy ◽  
...  
Keyword(s):  
Septic Arthritis ◽  
Young Patients ◽  
Case Series ◽  
Blood Parameters ◽  
Pcr Analysis ◽  
Kingella Kingae ◽  
Patient Demographics ◽  
The Mean ◽  
Polymerase Chain ◽  
Prospective Case Series

Aims The aim of this study was to determine the extent to which patient demographics, clinical presentation, and blood parameters vary in Kingella kingae septic arthritis when compared with those of other organisms, and whether this difference needs to be considered when assessing children in whom a diagnosis of septic arthritis is suspected. Methods A prospective case series was undertaken at a single UK paediatric institution between October 2012 and November 2018 of all patients referred with suspected septic arthritis. We recorded the clinical, biochemical, and microbiological findings in all patients. Results A total of 160 patients underwent arthrotomy for a presumed septic arthritis. Of these, no organism was identified in 61 and only 25 of these were both culture- and polymerase chain reaction (PCR)-negative. A total of 36 patients did not undergo PCR analysis. Of the remaining 99 culture- and PCR-positive patients, K. kingae was the most commonly isolated organism (42%, n = 42). The knee (n = 21), shoulder (n = 9), and hip (n = 5) were the three most commonly affected joints. A total of 28 cases (66%) of K. kingae infection were detected only on PCR. The mean age of K. kingae-positive cases (16.1 months) was significantly lower than that of those whose septic arthitis was due to other organisms (49.4 months; p < 0.001). The mean CRP was significantly lower in the K. kingae group than in the other organism group (p < 0.001). The mean ESR/CRP ratio was significantly higher in K. kingae (2.84) than in other infections (1.55; p < 0.008). The mean ESR and ESR/CRP were not significantly different from those in the 'no organism identified' group. Conclusion K. kingae was the most commonly isolated organism from paediatric culture- and/or PCR-positive confirmed septic arthritis, with only one third of cases detected on routine cultures. It is important to develop and maintain a clinical suspicion for K. kingae infection in young patients presenting atypically. Routine PCR testing is recommended in these patients. Cite this article: Bone Joint J 2021;103-B(3):584–588.

Epidemiological profile of esophageal cancer at the Joliot Curie Institute in Dakar in 2018

2021 ◽  
Vol 1 (1) ◽  
pp. 24-25
Author(s):  
Mohammed Ezzet Charfi ◽  
Abdoul Halim Bagué ◽  
Awaleh Ahmed Awaleh ◽  
Sidy Ka ◽  
Ahmadou Dem
Keyword(s):  
Squamous Cell Carcinoma ◽  
Esophageal Cancer ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Adenosquamous Carcinoma ◽  
Young Patients ◽  
The World ◽  
The Mean ◽  
Epidemiological Profile ◽  
Consultation Time

INTRODUCTION: Esophageal cancer is one of the most common cancers in the world affecting males more often than females and with a poor prognosis. The aim of our work was to describe the epidemiology of patients followed for esophageal cancer at the Joliot-Curie Institute in 2018. MATERIALS AND METHODS: This is a descriptive retrospective study including all patients followed at the institute from January 1, 2018 to December 31, 2018 for esophageal cancer with histological evidence. RESULTS: We collected 93 patients referred to the institute for the management of esophageal cancer, 46 women (49.5%) and 47 men (50.5%). The mean age was 49 years with a median age of 50 and extremes of 22 and 84 years. The notion of smoking was found in 24 patients (25.8%) exclusively men (51%), associated in six cases with a notion of alcoholism. The median consultation time was five months. The main circumstance of discovery remains dysphagia (87.1%), followed by aphagia (4.3%) and odynophagia (4.3%). Squamous cell carcinoma is the most represented histological type with 89 patients (95.7%) distributed as follows: 45 women and 44 men. Adenocarcinoma was found in three cases (two men and one woman) and finally one case of adenosquamous carcinoma. CONCLUSION: Squamous cell carcinoma is the most frequent esophagus cancer. It represents the fifth location in our institute and occurs in young patients without gender predominance.

Sign in / Sign up

Export Citation Format

Share Document