DOCSLIB.ORG

Front Matter (PDF)

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Front Matter (PDF) Lead POlSO#{241}ii iiIT.7J/7/]/ (:1//(/ ‘(i! ;i Pediatrics in Review Vol 13 No 12 December 1992 EDITOR Robert J. Haggerty University of Rochester School of Medicine and Dentistry Rochester, NY Editorial Office: Department of Pediatrics University of Rochester School of Medicine and Dentistry CONTENTS 601 Elmwood Ave. Box 777 Rochester, NY 14642 ASSOCIATE EDITOR ARTICLES Lawrence F. Nazarian Panorama Pediatric Group Rochester, NY 443 Child Sexual Abuse ABSTRACTS EDITOR Carol D. Berkowitz Steven P. Shelov, Bronx, NY MANAGING EDITOR 453 Failure to Thrive/Growth Deficiency Jo Largent, Elk Grove Village, IL L$dhiam G. Bithoney, Howard Dubowitz EDITORIAL CONSULTANT Victor C. Vaughan, III, Stanford, CA Harwood Egan EDITORIAL BOARD Moris A. Mgulo, Mineola, NY 461 Lead Poisoning Russell W. Chesney, Memphis, 7N Michael Weitzman and Deborah Glotzer Catherine DeAngelis, Bakimoxe, MD Peggy C. Ferry, Tucson, AZ Richard B. Goldbloom, Halifax, NS 469 Index of Suspicion John L Green, Rochester, NY Robert L Johnson, Newark, NJ John L Green, David M. Tejeda, Alan M. Lake, Glen Arm, MD Lawrence E. Nazarian Frederick H. Lovejoy, Jr, Boston, MA John T. McBride, Rochester, NY Vincent J. Menna, Doylestown, PA Lawrence C. Pakula. Timonium, MD ABSTRACTS Ronald L Poland, Hershey, PA James E. Rasmussen, Ann Arbor, Ml James S. Seidel, Torrance, CA Richard H. SINs, Newark, NJ 460 Inheritance Patterns in Tourette Syndrome Laurie J. Smith, Washington, DC WIlliam B. Strong, Augusta, GA 471 Changes in Laboratory Values During Adolescence: Jon Thgelstad, Greenville, NC Vernon T. Tolo, Los Angeles, CA Alkaline Phosphatase Robert J. Toulouklan, New Haven, CT Terry Yamauchi, Little Rock, AR 472 Changes in Laboratory Values During Adolescence: Morltz N. Ziegler, Cincinnati, OH Cholesterol EDITORIAL ASSISTANT Sydney Sutherland 472 Cor Pulmonale PUBLISHER 474 Exercise Intolerance American Academy of Pediatrics Errol R. Alden, Director, Department of Education DEPARTMENT OF CORRECTIONS Jean Dow, Director Division of PREP/PEDIATRICS Deborah Kuhlman, Copy Editor PEDIATRICS IN REViEW (ISSN 0191-9801) Is 488 Erratum owned aid controlled by the American Academy of Pediatrics. It Is published monthly by the American Academy of PedIatrics, 141 Northwest INDEXES Point BIvd, P0 Box 927, Elk Grove VIllage, IL 60009-0927. Statements aid opinions arpreseed in PIcs in Review are those of the authors and not 475 CumulatIve Subject Index necessarily those of the American Academy of Pediatrics or Its Committees. Recommendations included in this publication do not indicate an 489 CumulatIve Author Index ac*alve cotaieofPener*or serve aetanderd of medlcat care. Subscription price 1992: MP Fellow $85; AAP Candidate Fellow $65; AllIed Health or Resident $65; Nonmember or Institution $115. Current single price Is $10. Subscription claims COVER wilbehonoreduplo 12morlhsfromthepublIcon date. “The Knitting Lesson” (ca 1860) by Jean Francois Millet (1814-1875). Second-class postage paid at ARLINGTON Renowned for his peasant palntlnp, Millet In this painting illustrates the HEIGHTS, LIJNOIS 60009-0927 aid at aidlilonal cycles of life and the passing on of shills from one generation to another. - moss #{149}AMERICAN ACADEMY OF PEDIATRICS, One of the major tasks of pediatricians Is to teach parents and children 1992. AN rights reserved. Printed in USA No pert skills to promote health. May we do It as gently and lovingly as this may be duplicated or reproduced without mother teaches her daughter knitting. (From the Museum of ne Ails, permission of the Mierlowi Aowismy of Pel Massachusetts) POSTMASTER: Send address changes to PEDIATRICS IN REVIEW, American Academy of PedIatrics, P0 Box 927, Eli Grove Village, IL ANSWER KEY 60009-0927. _ The prkaing and production 1. D 2. B; 3. E 4. D 5. D’, 6. A 7. D 8. D 9. E 10. A 11. B; 12. C; of Pertrics in Review Is U U 13. E 14. E made possible, in pert by R088 an eduradonal ati from PECATRIC Roes Lordes. EDUCATION PSYCHOSOCIAL PROBLEMS Sexual Abuse innocence of the perpetrator will be anatomical dolls among professionals in measurement in prepubescent girls. Am I assessed. sexual abuse evaluation. Child Abase Dis Child 1989;143:1366-1368 NegI. 1988;12:171-180 17. American Academy of Pediatrics. Testifying in court is frequently 9. Summit RC. The child abuse accom- Committee on Child Abuse and Neglect. stressful and anxiety-provoking. To modation syndrome. Child Abase NegI. Guidelines for the evaluation of sexual facilitate the process, the physician 1983;7:177-193 abuse of children. Pediatrics. 1991; should review medical notes with the 10. Reinhart MA. Sexually abused boys. 87:254-260 Child Abase NegI. 1987;11:229-235 18. Jenny C, Kirby P, Fuguay D. Genital attorney who issued the subpoena. It 11. McCann J, Voris J, Simon M, Wells R. lichen sclerosis mistaken for child sexual is also helpful for the physician to re- Comparison of genital examination tech- abuse. Pediatrics. 1981;83:597-599 member that he or she is not the one niques in prepubertal girls. Pediatrics. 19. DeJong AR, Finkel MA. Sexual abuse of on trial; rather, the physician is there 1990;85:182-187 children. Curr Probl Pediatr. 1990;20: to rebate the medical findings in a 12. Woodling BA, Heger A: The use of the 489-567 colposcope in the diagnosis of sexual 20. Hobbs CJ, Wynne JM. Buggery in complex case in which undoubtedly abuse in the pediatric age group. Child childhood-A common syndrome of child there will be other experts. Although Abase NegI. 1986;10:111-114 abuse. Lancet. 1986;2:792-796 the physician usually is assigned the 13. Chadwick DL, Berkowitz CD, Kerns DL, 21. McCann J, Woris J, Simon M, et al. role of child advocate, it is important et al. Color Atlas of Child Sexual Abase Perianal findings in prepubertal children Chicago, IL: Year Book Medical not to get caught up in the legal bat- selected for non-abuse: A descriptive Publishers; 1989 study. Child Abase NegI. 1989;13:211- tle, but to remain neutral and advo- 14. McCann J, Wells R, Simon M, Voris J. 216 cate for the truth. Genital findings in prepubertal girls 22. Gellert GA, Durfee M, Berkowitz CD. selected for non-abuse: A descriptive Developing guidelines for antibody testing study. Pediatrics. 1990;86:428-439 among victims of pediatric sexual abuse. Prognosis 15. Jenny C, Kuhns MLD, Arakawa F. Child Abase Negl. 1990;14:9-17 The prognosis for sexually abused Hymens in newborn female children. 23. Davis AJ, Emans SJ. Human papilloma children varies. Studies on adolescent Pediatrics. 1987;80:399-400 virus infection in the pediatric and 16. Goff CW, Burke KR, Rickenback C, adolescent patient. I Pediatr. 1989;115: suicide, depression, and eating disor- Buebendorf DP: Vaginal opening 1-10 ders show a high prevalence of sex- ual abuse in these populations. The medical problems are addressed read- PIR QUIZ iby by the use of antibiotics when ap- 1. Each of the following statements A. Normal anus. propriate; the psychological trauma is about child sexual abuse is true B. Perianal scarring. except: C. Normal hymen. more enduring. Appropriate referrals A. The perpetrator is usually D. Markedly distorted hymen. for counseling should be initiated in known to the child. E. Imperforate hymen. B. Perpetrators are predominantly all abused children. It is hoped that 4. Assuming you encounter the clini- male. cessation of the abuse and involve- cal situations listed below, for C. Developmentally delayed and which one is sexual abuse the ment with therapy will improve the physically disabled children only acceptable explanation? long-term outlook for these children. are increased risk. at A. A 6-year-old girl with a pos- D. Less than 1% of sexual abuse itive VDRL test and fluores- victims are REFERENCES male. cent treponemal antibody E. Accusations of sexual abuse tests. 1 . Green AH. True and false allegations of arising within custody disputes B. A 12-month-old boy with per- sexual abuse in child custody disputes. I are particularly difficult to meal warts. Am Acad Child Psychiatr. 1986;25:449- resolve. 456 C. A 9-year-old girl with bacte- 2. Paradise JE, Rostain AL, Nathanson M. 2. A 6-year-old girl is brought to rial vaginosis. Substantiation of sexual abuse charges your office after disclosing to her D. A 4-year-old girl with Tricho. when parents dispute custody or visitation. teacher that her mother’s boy- monas vaginitis. Pediatrics. 1988;81:835-839 friend “touches my privates.” To E. An 18-month-old girl with 3. Elvik SL, Berkowitz CD, Nicholas E, obtain the most reliable informa- Chiamydia conjunctivitis. tion from the girl, you would do Lipman JL, Inkelis SH. Sexual abuse in 5. You strongly suspect a 7-year-old except: the developmentally disabled: Dilemmas each of the following boy has been sexually abused. A. Explore the allegations pri- of diagnosis. Child Abase NegL 1990; Each of the following statements 14:497-502 vately with the child. regarding your responsibility for 4. Seidel JS, Elvik SL, Berkowitz CD, Day B. Carefully validate the child’s reporting and testifying about responses in a series of sepa- C. Presentation and evaluation of sexual child sexual abuse is true except: misuse in the emergency department. rate interviews. A. You are legally required to re- C. Use open-ended, nonleading Pediatr Emerg Care. 1986;2:157-164 port your concerns. 5. Berkowitz CD. Sexual abuse of children questions. B. You do not need to be certain and adolescents. Adv Pediatr. 1987; D. Record the child’s responses that sexual abuse actually verbatim. 34:275-312 occurred. E. Suggest that the girl draw her 6. Jones DPH, McQuiston M. Inten’iewing C. Failure to report suspected memory of the event(s). the Sexually Abased ChiI#{128}LDenver, CO: sexual abuse may result in The C.
Load more

Recommended publications
  • Clinical an Urgent Care Approach to Complications and Conditions of Pregnancy Part 2
    Clinical An Urgent Care Approach to Complications and Conditions of Pregnancy Part 2 Urgent message: From pregnancy confirmation to the evaluation of bleeding, urgent care centers are often the initial location for management of obstetric-related issues. Careful use of evidence-based guidelines is the key to successful outcomes. DAVID N. JACKSON, MD, FACOG and PETAR PLANINIC, MD, FACOG Introduction rgent care providers are called upon to manage a Uvariety of complaints in pregnancy. Some conditions can be managed at the urgent care center whereas others require stabilization and transport to a center with expert obstetrical capabilities. In all situations, practitioners should consider that a gestational age of fetal viability (many centers now use 23 to 24 weeks) is best served with referral for continuous fetal monitor- ing if there is bleeding, trauma, significant hypertension, relative hypoxemia (O2 saturation less than 95% for pregnant women), or contractions. Part 2 of this two- part series will discuss: Ⅲ Bleeding in pregnancy Ⅲ Ectopic gestation Ⅲ Trauma and pregnancy Ⅲ Acute abdominal pain in pregnancy Dr. Jackson is Professor of Maternal-Fetal Medicine at the University of Nevada, School of Medicine, Las Vegas, Nevada. Dr. Planinic is Assistant Professor of Obstetrics and Gynecology at the University of Nevada, School of Medicine, Las Vegas, Nevada. © gettyimages.com www.jucm.com JUCM The Journal of Urgent Care Medicine | September 2013 9 AN URGENT CARE APPROACH TO COMPLICATIONS AND CONDITIONS OF PREGNANCY Figure 1. Bleeding endocervical polyp with Evaluation of vaginal bleeding should follow a sys- inflammation tematic process. History of last menses and sexual activ- ity determines the possibility of pregnancy.
    [Show full text]
  • USMLE – What's It
    Purpose of this handout Congratulations on making it to Year 2 of medical school! You are that much closer to having your Doctor of Medicine degree. If you want to PRACTICE medicine, however, you have to be licensed, and in order to be licensed you must first pass all four United States Medical Licensing Exams. This book is intended as a starting point in your preparation for getting past the first hurdle, Step 1. It contains study tips, suggestions, resources, and advice. Please remember, however, that no single approach to studying is right for everyone. USMLE – What is it for? In order to become a licensed physician in the United States, individuals must pass a series of examinations conducted by the National Board of Medical Examiners (NBME). These examinations are the United States Medical Licensing Examinations, or USMLE. Currently there are four separate exams which must be passed in order to be eligible for medical licensure: Step 1, usually taken after the completion of the second year of medical school; Step 2 Clinical Knowledge (CK), this is usually taken by December 31st of Year 4 Step 2 Clinical Skills (CS), this is usually be taken by December 31st of Year 4 Step 3, typically taken during the first (intern) year of post graduate training. Requirements other than passing all of the above mentioned steps for licensure in each state are set by each state’s medical licensing board. For example, each state board determines the maximum number of times that a person may take each Step exam and still remain eligible for licensure.
    [Show full text]
  • HHS Public Access Author Manuscript
    HHS Public Access Author manuscript Author Manuscript Author ManuscriptObstet Gynecol Author Manuscript. Author Author Manuscript manuscript; available in PMC 2016 January 12. Published in final edited form as: Obstet Gynecol. 2013 October ; 122(4): 885–900. doi:10.1097/AOG.0b013e3182a5fdfd. Prophylaxis and Treatment of Anthrax in Pregnant Women: A Systematic Review of Antibiotics Dana Meaney-Delman, MD MPH1, Sonja A. Rasmussen, MD MS1, Richard H. Beigi, MD2, Marianne E. Zotti, DrPH1, Yalonda Hutchings, MD MPH1, William A. Bower, MD1, Tracee A. Treadwell, DVM MPH1, and Denise J. Jamieson, MD MPH1 1Centers for Disease Control and Prevention, Atlanta, Georgia 2Department of Obstetrics, Gynecology and Reproductive Sciences, Division of Reproductive Infectious Diseases and Obstetric Specialties, Magee-Women’s Hospital of the University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania Abstract Objective—To review the safety and pharmacokinetics of antibiotics recommended for anthrax post-exposure prophylaxis and treatment in pregnant women. Data Sources—Articles were identified in the PUBMED database from inception through December 2012 by searching the keywords ([“pregnancy]” and [generic antibiotic name]). Additionally, hand searches of references from REPROTOX, TERIS, review articles and Briggs’ Drugs in Pregnancy and Lactation were performed. Methods of Study Selection—Articles included in the review contain primary data related to the safety and pharmacokinetics among pregnant women of five antibiotics recommended for anthrax post-exposure prophylaxis and treatment (ciprofloxacin, levofloxacin, moxifloxacin, doxycycline, amoxicillin), and of nine additional antibiotics recommended as part of the treatment regimen (penicillin, ampicillin, linezolid, clindamycin, meropenem, doripenem, rifampin, chloramphenicol, or vancomycin). Tabulation, Integration and Results—The PUBMED search identified 3850 articles for review.
    [Show full text]
  • Effect of Synbiotic on the Treatment of Jaundice in Full Term Neonates: a Randomized Clinical Trial
    Pediatr Gastroenterol Hepatol Nutr. 2019 Sep;22(5):453-459 https://doi.org/10.5223/pghn.2019.22.5.453 pISSN 2234-8646·eISSN 2234-8840 Original Article Effect of Synbiotic on the Treatment of Jaundice in Full Term Neonates: A Randomized Clinical Trial Shokoufeh Ahmadipour ,1,2 Parastoo Baharvand ,3 Parisa Rahmani ,4 Amin Hasanvand ,5 and Azam Mohsenzadeh 2 1Razi Herbal Medicine Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran 2Department of Pediatrics, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran 3Department of Social Medicine, School of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran 4Pediatric Gastroenterology and Hepatology Research Center, Tehran University of Medical Sciences, Tehran, Iran 5Department of Pharmacology and Toxicology, Faculty of Pharmacy, Lorestan University of Medical Sciences, Khorramabad, Iran Received: Jun 27, 2018 Revised: Mar 28, 2019 ABSTRACT Accepted: Apr 8, 2019 Purpose: Jaundice accounts for most hospital admissions in the neonatal period. Nowadays, Correspondence to in addition to phototherapy, other auxiliary methods are used to reduce jaundice and the Azam Mohsenzadeh length of hospitalization. This study aimed to investigate the effect of probiotics on the Department of Pediatrics, Faculty of Medicine, Lorestan University of Medical Sciences, treatment of hyper-bilirubinemia in full-term neonates. Anooshirvan Rezaei Square, Khorramabad, Methods: In this randomized clinical trial, 83 full-term neonates, who were admitted to the Lorestan 6813833946, Iran. hospital to receive phototherapy in the first 6 months of 2015, were randomly divided into E-mail: [email protected] two groups: synbiotic (SG, n=40) and control (CG, n=43). Both groups received phototherapy Copyright © 2019 by The Korean Society of but the SG also received 5 drops/day of synbiotics.
    [Show full text]
  • Anti-Infective Drug Development in Neonates September 15, 2016
    Anti-Infective Drug Development in Neonates September 15, 2016 Page 1 1 FOOD AND DRUG ADMINISTRATION (FDA) 2 3 PUBLIC WORKSHOP: 4 FACILITATING ANTI-INFECTIVE DRUG DEVELOPMENT FOR 5 NEONATES AND YOUNG INFANTS 6 7 September 15, 2016 8 9 10 Sheraton Silver Spring 11 8777 Georgia Avenue 12 Silver Spring, Maryland 20910 13 14 15 16 17 18 19 20 21 Reported by: Chaz Bennett 22 Capital Reporting Company www.CapitalReportingCompany.com 202-857-3376 Anti-Infective Drug Development in Neonates September 15, 2016 Page 2 1 P A R T I C I P A N T S 2 3 John Alexander, MD, MPH 4 Deputy Director 5 Division of Pediatric and Maternal Health (DPMH) 6 Office of Drug Evaluation IV (ODEIV), CDER 7 Food and Drug Administration, Silver Spring, Maryland 8 9 Gerri Baer, MD 10 Medical Officer, Office of Pediatric Therapeutics 11 Food and Drug Administration, Silver Spring, Maryland 12 13 Danny Benjamin, MD, PhD, MPH 14 Kiser-Arena Distinguished Professor of Pediatrics 15 Chair, Pediatric Trials Network 16 Faculty Associate Director, Duke Clinical 17 Research Institute 18 Duke University, Durham, North Carolina 19 20 21 22 www.CapitalReportingCompany.com 202-857-3376 Anti-Infective Drug Development in Neonates September 15, 2016 Page 3 1 P A R T I C I P A N T S 2 (Continued) 3 4 John Bradley, MD 5 Professor and Chief of the Division of Infectious 6 Diseases in the Department of Pediatrics 7 University of California, San Diego 8 9 Maria Fernandez Cortizo 10 PDCU 11 12 John Farley, MD, MPH 13 Deputy Director 14 Office of Antimicrobial Products (OAP), CDER 15 Food and Drug Administration, Silver Spring, Maryland 16 17 William Hope, PhD 18 Professor of Therapeutics and Infectious Diseases 19 University of Liverpool, Liverpool, U.K.
    [Show full text]
  • Iatrogenic Complications in the Neonatal Intensive Care Unit
    Journal of Perinatology (2010) 30, S51–S56 r 2010 Nature America, Inc. All rights reserved. 0743-8346/10 www.nature.com/jp REVIEW Iatrogenic complications in the neonatal intensive care unit KC Sekar Department of Pediatrics, Neonatal-Perinatal Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA In neonatal medicine, significant iatrogenic events leading With the introduction of novel technologies and approaches in neonatal to severe morbidity and death have been identified and addressed. care and the lack of appropriately designed and well-executed randomized Low incubator temperature leading to death (1930); irradiation clinical trials to investigate the impact of these interventions, iatrogenic causing thyroid cancer, and excess oxygen exposure causing complications have been increasingly seen in the neonatal intensive care retinopathy of prematurity and blindness (1940); excess unit. In addition, increased awareness and the introduction of more synthetic vitamin K, sulfisoxazole and chloramphenicol causing appropriate quality control measures have resulted in higher levels of kernicterus and gray baby syndrome (1950); intrauterine suspicion about and increased recognition of complications associated with exposure to thalidomide causing limb defects (1960); umbilical delivery of care. The incidence of complications also rises with the increased arterial catheter, tolazoline and total parenteral nutrition (TPN) length of hospital stay and level of immaturity. Approximately half of the causing thrombosis, hypotension and essential fatty acid deficiency, iatrogenic complications are related to medication errors. The other respectively (1970); vitamin E and propylene glycol causing complications are due to nosocomial infections, insertion of invasive organ damage, hyperosmolarity and seizures (1980); and catheters, prolonged mechanical ventilation, administration of parenteral mechanical ventilation and systemic corticosteroid administration nutrition solution, skin damage and environmental complications.
    [Show full text]
  • Learning Objectives: 1. Relation of Drugs and Lactation 2. Factors Modifying Passage of Drugs in Milk 3
    Learning Objectives: 1. Relation of drugs and lactation 2. Factors modifying passage of drugs in milk 3. Effects of drugs on milk production 4. Role of lactation on drugs excretion This lecture was done by: 5. Drug safety during lactation / use of Abdullah Saleh Bawazir safe drugs 6. Drugs contraindicated during lactation And reviewed by: Tuqa Alkaff Lactaon: • Breast feeding is very important because breast milk is the healthiest form of milk for babies. • It provides the baby with immunoglobulins (IgA, IgM) that are essenAal for protecAon against gastroenteriAs. Drugs & Lactaon: . Most drugs administered to breast feeding woman are detectable in milk. The concentraon of drugs achieved in breast milk is usually low (< 1 %). However, even small amounts of some drugs may be of significance for the suckling child. (all the execratory mechanisms are going down in babies) Pediatric populaon are classified into: • Newborn: less than one month old – Preterm neonates: born before 38 weeks of pregnancy (it's the harmful stage) – Full-term neonates: 38-42 weeks of gestaonal age • Infants (babies): 1 month – 12 months of age • Children: 1 -12 years of age – Toddler (young child): 1-5 years – Older child: 6-12 years • Adolescent: 13-18 years 2 Pharmacokine%cs in pediatric: • Higher gastric PH • Higher concentraon of free drug • Higher percenrage of body water • Neonate’s especially premature babies have limited capacity for metabolism and excreAon. • Neonates have very limited rate of metabolism due to immaturity of liver enzymes. • Renal clearance is less efficient: ( decrease Renal blood flow – decrease GFR). • The epithelium of the breast alveolar cells is most permeable to drugs during the 1st week postpartum, so drug transfer to milk may be greater during the 1st week of an infant’s life.
    [Show full text]
  • Is Pediatric Labeling Really Necessary?
    Is Pediatric Labeling Really Necessary? Michael L. Christensen, PharmD; Richard A. Helms, PharmD; and Russell W. Chesney, MD ABBREVIATIONS. FDA, US Food and Drug Administration; For solid dosage forms, parents often must divide FDCA, Food, Drug and Cosmetic Act; GFR, glomerular filtration adult tablets in halves or quarters to get an appro- rate; BSA, body surface area. priate dose for their child. This results in imprecise dosing that can lead to poor therapeutic response. abeling refers to the label on the drug container Practitioners are left to use empiric therapy in and all printed materials, including the pack- treating their pediatric patients because of the inad- age insert, that accompanies the product. La- equate information available for prescribing of L drugs. They often must choose between not treating beling of a drug indicates that there is substantial evidence from adequate and well controlled clinical children with potentially beneficial medications be- trials for the safe and effective use of that drug. cause they are not approved for use in children, or to Labeling provides important information on clinical treat them with these medications based on adult pharmacology, indications and usage, contraindica- studies and limited or anecdotal experience in chil- tions, precautions, adverse effects, dosage, and ad- dren. In either case, children may not be prescribed ministration. Unfortunately for children, most drug optimal therapy. labeling contains the precautionary disclaimer, be- cause safety and efficacy in children have not been FOOD, DRUG AND COSMETIC ACT established. Concern for the risk to public health and safety The availability of safe and effective drugs has with unsanitary food and adulterated drugs, a com- been directly responsible for the improvement in mon problem during that time, lead to passage of health over the past 50 years.
    [Show full text]
  • Abortus, 4 Absolute Neutrophil Count, 146 Absorption
    Index A on respiratory syncytial virus, 158, 160 on sedation management, 112 Abortus, 4 on systemic corticosteroids, 88 Absolute neutrophil count, 146 on vaccinations, 187 Absorption, 17 on Vitamin K IM, 10-11 extravascular, 18 American College of Chest Physicians, 159 gastrointestinal, 18 American College of Emergency Physicians, 159 intramuscular, 18 American College of Obstetrics and Gynecology, 61 percutaneous, 19 American Congress of Obstetricians and rectal, 19 Gynecologists, 145 Academy of Breastfeeding Medicine, 49, 61 American Society for Parenteral and Enteral Acetaminophen, 21, 119, 126 Nutrition, 30, 34 PDA and, 103-104 American Society of Health-System Pharmacists vaccination response and, 191-192 (ASHP), 34 Acid ionization constant, breast milk and, 47 American Thoracic Society, 159 Acid-base balance, 32 Amino acids, 30, 34-35 Activity, 5 Aminoglycoside(s), 19, 134, 172 Acute lung injury, 84-85 Aminophylline, 69 Acyclovir, 46 Aminosyn, 30 parenteral, 147-148 Amoxicillin-sulbactam, 172 Addiction, maternal, 61 Amphotericin B, 137 Adverse drug events, methylxanthine toxicity, 71 Ampicillin, 6, 134, 172 Adverse effects, neonatal abstinence treatment, 60 Ampicillin-sulbactam, 172 Airway patency maintenance, 68 Anaerobic antibiotic therapy, 172 Albuterol, 87, 161 Analgesia Alcohol, 48 common agents for, 127-129 Alginate, 181 pharmacologic agents for, 118-119 Alpha agonists, 115-116 principles of, 116-117 Aluminum toxicity, 36-37 Analgesics, 123 American Academy of Pediatrics, 45 reversal of, 121 acyclovir shortage recommendations,
    [Show full text]
  • Evidence of Drug Safety in Pregnancy
    DRUGS IN PREGNANCY Evidence of drug safety in pregnancy For an area as complex as prescribing in pregnancy, unfortunately, there is very little information in the literature to support practice. Newer antimicrobials are trialled excluding pregnant women for reasons of risk-avoidance and, therefore, prescribers must rely on post-marketing surveillance data. For some medications, this takes the form of a formal registry (for example, the antiretroviral pregnancy registry). Obviously, prospective safety data from Phase I/II clinical trials is preferable, but in the absence of this, registry data provides some reassurance. Older antibiotics, on the other hand, may have many years of practical experience to suggest their safety, but little robust scientific evidence to support their safe use. Evidence of treatment efficacy in pregnancy Large prospective trials of treatment in pregnancy are conspicuously absent from the literature. There have been a number of Cochrane reviews on different topics in the treatment of infections in pregnancy – from asymptomatic bacteriuria to bacterial vaginosis. All of the reviews have in common very heterogeneous primary articles and cautious recommendations based on lack of data. In general, antibiotics are effective at treating the infection in question, but studies are underpowered to provide information on optimum therapy or fetal safety. 1 Done by : Pharm.D –Neda'Rwashdeh Infection and pregnancy Immune tolerance’ in pregnancy is widely discussed and there are some data to suggest that pregnant women are at slightly higher risk of developing disease from some infections (including poliomyelitis, smallpox, hepatitis A and falciparum malaria). Also, the risk of severe disease and death are increased for some infections.
    [Show full text]
  • A Pediatric Perspective on the Unique
    A Pediatric Perspective on the Unique Vulnerability and Resilience of the Embryo and the Child to Environmental Toxicants: The Importance of Rigorous Research Concerning Age and Agent Robert L. Brent, MD, PhD*; Susanne Tanski, MD‡; and Michael Weitzman, MD‡ 1 ABBREVIATIONS. PCB, polychlorinated biphenyl; MPE, maximal cal agents. In fact, the publication edited by Miller permissible exposure; NOAEL, no observable adverse effect level. was primarily devoted to exposures to the embryo and the fetus. Because the embryo and the child are growing and their tissues and organs are differenti- here is realistic concern about the impact of ating, deleterious effects may occur at lower expo- environmental influences on the health of hu- sures to some chemicals, drugs, and physical agents Tman populations. First, exposure to environ- and produce more severe effects than those seen in mental agents continues despite successes in reduc- adults. In fact, some effects may not occur in adults. ing exposures to known toxicants such as lead, Thus, maximal permissible exposures (MPEs) for polychlorinated biphenyls (PCBs) and tobacco some environmental chemicals should be lower for smoke. Second, there has been increasing concern the embryo and the child. about the cause of autism and other neurodevelop- It is important to note that children and adoles- mental problems and hypotheses that environmental cents have better recuperative capacities than adults influences may play a role in the prevalence of these for many toxic agents, and, similarly, appropriate and other such childhood and adult conditions as drug dosages may be lower or higher on a mg/kg or asthma and obesity.
    [Show full text]
  • CHLORAFAST, Eye Drops, Solution, 0.5 %W/V
    NEW ZEALAND DATA SHEET 1. PRODUCT NAME CHLORAFAST, Eye drops, solution, 0.5 %w/v 2. QUALITATIVE AND QUANTITATIVE COMPOSITION Each mL contains 5mg of chloramphenicol equivalent to 0.5%w/v. Excipient with known effect: phenyl mercuric nitrate For the full list of excipients, see section 6.1. 3. PHARMACEUTICAL FORM Eye drops, solution. CHLORAFAST is a colourless to faint yellow aqueous solution. 4. CLINICAL PARTICULARS 4.1 Therapeutic indications For the treatment of bacterial conjunctivitis and other superficial ocular infections caused by chloramphenicol-sensitive organisms. 4.2 Dose and method of administration Adults and children (including the Elderly) Instil 1 or 2 drops in the affected eye(s) every two to six hours for two to three days. The interval between applications may then be increased. Treatment should be continued for at least 48 hours after the eye appears normal. Information for patients In order to minimise systemic absorption of CHLORAFAST eye drops, apply gentle pressure to the tear duct for approximately one minute immediately after application. Care should be taken not to touch the eyelids or surrounding areas with the dropper tip of the bottle. Do not touch dropper tip to any surface, as this may contaminate the solution. 4.3 Contraindications CHLORAFAST is contraindicated in individuals with a history of hypersensitivity to any excipients and/or toxic reaction to the medicine (refer section 6.1). 4.4 Special warnings and precautions for use Bone marrow hypoplasia, including aplastic anaemia and death, has been rarely reported following local application of chloramphenicol. Chloramphenicol should not be used when less potentially dangerous agents would be expected to provide effective treatment.
    [Show full text]