- Transfusion Medicine Equations Made Internet Accessible. [Review]Transfus Med Rev 2019TM
- Multiple mathematical equations inform the practice of transfusion medicine. These equations apply to a wide range of topics: dosage of blood products, calculation of fluid volumes, and even specific treatment decisions (e.g. corrected count increment for determination of platelet refractoriness). The calculation of these equations can be complicated, prone to error, and time-consuming. A trusted…
Multiple mathematical equations inform the practice of transfusion medicine. These equations apply to a wide range of topics: dosage of blood products, calculation of fluid volumes, and even specific treatment decisions (e.g. corrected count increment for determination of platelet refractoriness). The calculation of these equations can be complicated, prone to error, and time-consuming. A trusted source is needed to accurately perform these calculations 24 hours a day without error and without monetary cost. We sought to build internet-enabled calculators relevant to the practice of transfusion medicine. We partnered with MDCalc, an online host of medical calculators with 1 million monthly users in 196 countries, to design and host the calculators. The calculators guide users in the application of transfusion medicine equations by providing indications for use, inputs for the equations variables, error-checking, warnings for bad inputs, and interpretive guidance of the result. The following calculators were built: blood volume, corrected count increment (CCI), plasma dosage, cryoprecipitated antihemophilic factor dosage, approximate number of units for compatibility testing, maternal-fetal hemorrhage Rh(D) immune globulin dosage, intrauterine RBC transfusion dosage, neonatal polycythemia partial exchange, theoretical removal of a substance by plasmapheresis, sickle cell RBC exchange volume, peripheral blood stem cell collection, and a calculator relevant to donor lymphocyte infusion. Clinicians can now utilize this reputable and highly visible online source to access these common transfusion medicine equations at any time with an internet-enabled device (https://www.mdcalc.com/search?filter=transfusion+medicine).
- Drug Dose Selection in Pediatric Obesity: Available Information for the Most Commonly Prescribed Drugs to Children. [Review]Paediatr Drugs 2019; 21(5):357-369PD
- Obesity rates continue to rise in children, and little guidance exists regarding the need for adjustment away from total body weight-based doses for those prescribing drugs to this population of children. A majority of drugs prescribed to children with obesity result in either sub-therapeutic or supra-therapeutic concentrations, placing these children at risk for treatment failure and drug toxici…
Obesity rates continue to rise in children, and little guidance exists regarding the need for adjustment away from total body weight-based doses for those prescribing drugs to this population of children. A majority of drugs prescribed to children with obesity result in either sub-therapeutic or supra-therapeutic concentrations, placing these children at risk for treatment failure and drug toxicities. In this review, we highlight available obesity-specific pharmacokinetic and dosing information for the most frequently prescribed drugs to children in the inpatient and outpatient clinical settings. We also comment on available dosing recommendations for drugs prescribed to treat common pediatric obesity-related comorbidities. This review highlights that there is no safe or proven 'rule of thumb,' for dosing drugs for children with obesity, and a striking lack of pharmacokinetic data to support the creation of dosing guidelines for children with obesity for the most commonly prescribed drugs. It is important that those prescribing for children with obesity are aware of these gaps in knowledge and of potential drug treatment failure or adverse events related to drug toxicity as a result of these knowledge gaps. Until more data are available, we recommend close monitoring of drug response and adverse events in children with obesity receiving commonly prescribed drugs.
- Bodyweight-adjusted rivaroxaban for children with venous thromboembolism (EINSTEIN-Jr): results from three multicentre, single-arm, phase 2 studies. [Clinical Trial, Phase II]Lancet Haematol 2019; 6(10):e500-e509LH
- CONCLUSIONS: Treatment with bodyweight-adjusted rivaroxaban appears to be safe in children. The treatment regimens that we confirmed in children with bodyweights of at least 20 kg and the revised treatment regimens that we predicted in those with bodyweights less than 20 kg will be evaluated in the EINSTEIN-Jr phase 3 trial in children with acute venous thromboembolism.
- Pediatric Antibiotic Pack Size Compliance With the Dosage Regimen: A Descriptive Study. [Journal Article]Ther Innov Regul Sci 2019; :2168479019853770TI
- CONCLUSIONS: The study concluded that the packaging sizes of antibiotics failed to supply the recommended dosage regimen to pediatrics for common indications. This may contribute to development of antibiotic resistance among pediatric patients. Health policy makers should devise strict rules and regulations to ensure the availability of child-specific antibiotic pack sizes.
- Development and validation of an open source Monte Carlo dosimetry model for wide-beam CT scanners using Fluka. [Journal Article]J Appl Clin Med Phys 2019; 20(4):132-147JA
- CONCLUSIONS: A Fluka-based Monte Carlo simulation model of axial and helical acquisition techniques using a wide-beam collimation CT scanner demonstrated good agreement between measured and simulated results for both fixed current and TCM in complex and simple geometries. Code and dataset will be made available at https://github.com/chezhia/FLUKA_CT.
- Increasing optimal coagulation factor dosing in the paediatric emergency department: A quality improvement study. [Journal Article]Haemophilia 2019; 25(2):258-263H
- CONCLUSIONS: Optimal coagulation factor dosing is important for patient care and resource management. QI interventions promoted increased accuracy of factor dosing for patients with haemophilia seen in the ED.
- Use of dupilimab in pediatric atopic dermatitis: Access, dosing, and implications for managing severe atopic dermatitis. [Journal Article]Pediatr Dermatol 2019; 36(1):172-176PD
- Population pharmacokinetics and dose simulation of oxcarbazepine in Chinese paediatric patients with epilepsy. [Journal Article]J Clin Pharm Ther 2019; 44(2):300-311JC
- CONCLUSIONS: A PPK model of MHD in Chinese paediatric patients was successfully established. A priori dosing guideline was proposed considering WT and MHD plasma concentrations, providing a basis for OXC dosage calculations and adjustments in Chinese epileptic children.
- Measles antibody trough levels after treatment with immunoglobulin products and predicted levels assuming lower measles antibody specifications. [Journal Article]Transfusion 2018; 58 Suppl 3:3072-3077T
- CONCLUSIONS: Lowering the measles antibody level specification to 0.30× Center for Biologics Evaluation and Research Reference 176 in IG products will still provide trough serum antibody levels against measles infection of greater than 0.12 IU/mL when dosed at 400 mg/kg or higher.
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- Suitability of new drugs registered in Brazil from 2003 to 2013 for pediatric age groups. [Journal Article]Einstein (Sao Paulo) 2018; 16(4):eAO4354E
- CONCLUSIONS: Drugs for children aged under 6 years were less often adequate, considering the dosage form and capacity to provide the recommended dose. The availability and proportional suitability of medicines for pediatric use are greater for older age groups, according to age groups the drug is registered for.