The effects of virtual reality telemedicine a single pediatric use case patient with PTSD, post COVID-19: Exploratory research method. (Preprint)

UNSTRUCTURED This paper is an exploratory research comparison between using standard tele psych over 2D devices with HMD ( Head Mounted Device) using the Thera VRTM software. The single case example is with the pediatric mental health subject, and was specifically used to treat PTSD and co morbid symptoms related to the impact of COVID-19. The case usage was all delivered as telemedicine, and was conducted in private practice. Interventions used on all devices were Trauma Focused CBT. Results suggested a positive improvement on both patient engagement and outcome in treatment after continuous use of Virtual Reality as telehealth with avatar technology. Written informed consent was obtained from the minor’s legal guardian under the THERA VR™ agreement, for the publication of any potentially identifiable images or data included in this article.

How bilastine is used to treat allergic rhinitis and urticaria in children

Management guidelines for allergic rhinitis and urticaria recommend oral second-generation antihistamines as first-line treatment. The efficacy and safety of bilastine, the newest nonsedating second-generation antihistamine, are well established in adolescents/adults with these allergic conditions. The bilastine development program for pediatric use (2–<12 years) followed EMA-authorized processes. Pharmacokinetic/pharmacodynamic simulation and modeling and a pharmacokinetic study were conducted to identify and confirm the pediatric dose (10 mg/day). A Phase III, multicenter, double-blind, randomized, placebo-controlled, parallel-group study was performed to confirm the safety of bilastine 10 mg/day in children. In this article, evidence is reviewed for use of bilastine in children with allergic rhinoconjunctivitis or urticaria. Several cases are presented which demonstrate its role in routine clinical practice.

Combined Use of Cyclodextrins and Amino Acids for the Development of Cefixime Oral Solutions for Pediatric Use

Cefixime (CEF) is a cephalosporin included in the WHO Model List of Essential Medicines for Children. Liquid formulations are considered the best choice for pediatric use, due to their great ease of administration and dose-adaptability. Owing to its very low aqueous solubility and poor stability, CEF is only available as a powder for oral suspensions, which can lead to reduced compliance by children, due to its unpleasant texture and taste, and possible non-homogeneous dosage. The aim of this work was to develop an oral pediatric CEF solution endowed with good palatability, exploiting the solubilizing and taste-masking properties of cyclodextrins (CDs), joined to the use of amino acids as an auxiliary third component. Solubility studies indicated sulfobutylether-β-cyclodextrin (SBEβCD) and Histidine (His) as the most effective CD and amino acid, respectively, even though no synergistic effect on drug solubility improvement by their combined use was found. Molecular Dynamic and 1H-NMR studies provided insight into the interactions of binary CEF:His and ternary CEF:His:SBEβCD systems used to prepare CEF solutions, which resulted stable and maintained unchanged antimicrobial activity during the two-weeks-use in therapy. The ternary solution was superior in terms of more tolerable pH (5.6 vs. 4.7) and better palatability, being resulted completely odorless by a panel test.

Five-year pediatric use of a digital wearable fitness device: lessons from a pilot case study

Objectives Wearable fitness devices are increasingly being used by the general population, with many new applications being proposed for healthy adults as well as for adults with chronic diseases. Fewer, if any, studies of these devices have been conducted in healthy adolescents and teenagers, especially over a long period of time. The goal of this work was to document the successes and challenges involved in 5 years of a wearable fitness device use in a pediatric case study. Materials and methods Comparison of 5 years of step counts and minutes asleep from a teenaged girl and her father. Results At 60 months, this may be the longest reported pediatric study involving a wearable fitness device, and the first simultaneously involving a parent and a child. We find step counts to be significantly higher for both the adult and teen on school/work days, along with less sleep. The teen walked significantly less towards the end of the 5-year study. Surprisingly, many of the adult’s and teen’s sleeping and step counts were correlated, possibly due to coordinated behaviors. Discussion We end with several recommendations for pediatricians and device manufacturers, including the need for constant adjustments of stride length and calorie counts as teens are growing. Conclusion With periodic adjustments for growth, this pilot study shows these devices can be used for more accurate and consistent measurements in adolescents and teenagers over longer periods of time, to potentially promote healthy behaviors.

A brief analysis of parenteral medicines delivered in community pharmacies for off-label use in pediatric

Objectives. The current paper aims to obtain an overview regarding the use of parenteral medicines recommended for the pediatric sector and delivered in Romanian community pharmacies. Materials and methods. A retrospective observational study was developed, based on a questionnaire which was distributed in community pharmacies in Romania. Results. The parenteral medicines were delivered in 100 community pharmacies which partake in the study, and which are distributed in 22 counties in Romania. The total number of parenteral medicines considered in the study were aimed for pediatric use and they represented approximately 5% of the total number of medicines prescribed for children delivered in the respective pharmacies. Of these, most of them are medicines authorized for adults, delivered for off-label use, by other routes of administration, in their original form or reformulated in the form of other pharmaceutical preparations, during the compounding activity in the pharmacy. Conclusions. The parenteral medications most prescribed for pediatric use and delivered in community pharmacies are injectable solutions and powders for parenteral use. They are used as off-label medication in children, by other routes of administration, both to capitalize the therapeutic action of the active principle, and also as a vehicle for other medications with oral route or external route of administration.

Complementary therapy in pediatric pain

There is increasing pediatric use of complementary therapies, especially for pediatric pain. This chapter reviews the key literature on studies that pertain to the use of complementary therapy in pediatric pain management. Though limited evidence exists for many complementary therapy modalities, initial evidence is promising. Currently, the strongest evidence supports the use of hypnotherapy, which will have its own chapter, and biofeedback for headaches. Acupuncture research is growing, but there are few well-designed studies in children. Most data indicate that complementary therapy use is safe in children when administered by a trained practitioner using good clinical judgment (e.g., avoiding massage in children aversive to touch).