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Pediatric Studies (pediatric + studies)

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Medical Sciences	100%

Selected Abstracts

Estimation of the burden of active and life-time epilepsy: A meta-analytic approach

EPILEPSIA, Issue 5 2010
Anthony K. Ngugi
Summary Purpose:, To estimate the burden of lifetime epilepsy (LTE) and active epilepsy (AE) and examine the influence of study characteristics on prevalence estimates. Methods:, We searched online databases and identified articles using prespecified criteria. Random-effects meta-analyses were used to estimate the median prevalence in developed countries and in urban and rural settings in developing countries. The impact of study characteristics on prevalence estimates was determined using meta-regression models. Results:, The median LTE prevalence for developed countries was 5.8 per 1,000 (5th,95th percentile range 2.7,12.4) compared to 15.4 per 1,000 (4.8,49.6) for rural and 10.3 (2.8,37.7) for urban studies in developing countries. The median prevalence of AE was 4.9 per 1,000 (2.3,10.3) for developed countries and 12.7 per 1,000 (3.5,45.5) and 5.9 (3.4,10.2) in rural and urban studies in developing countries. The estimates of burden for LTE and AE in developed countries were 6.8 million (5th,95th percentile range 3.2,14.7) and 5.7 million (2.7,12.2), respectively. In developing countries these were 45 (14,145) million LTE and 17 (10,133) million AE in rural areas and 17 (5,61) million LTE and 10 (5,17) million AE in urban areas. Studies involving all ages or only adults showed higher estimates than pediatric studies. Higher prevalence estimates were also associated with rural location and small study size. Conclusions:, This study estimates the global burden of epilepsy and the proportions with AE, which may benefit from treatment. There are systematic differences in reported prevalence estimates, which are only partially explained by study characteristics. [source]

Evaluation of drugs in pediatrics using K-PD models: perspectives

FUNDAMENTAL & CLINICAL PHARMACOLOGY, Issue 6 2008
M. Tod
Abstract Some pharmacodynamic (PD) models, called K-PD models, have been developed for the description of drug action kinetics in the absence of drug concentration measurements. Because blood samples for drug measurements are not needed, these models may be very useful in pediatric studies, by reducing their invasiveness. In addition, a number of PD measurements are also non-invasive and specific devices exist for measures in children. Therefore, the kinetics of drug action may be characterized with minimal invasiveness. A brief description of the key features of these models is given, and a number of examples of application are presented. K-PD models are expected to be most useful when the drug kinetics is simple (i.e. when the one-compartment model is a reasonable description), or when the response kinetics is slow compared with drug kinetics. K-PD models have already demonstrated their usefulness in animal and adult studies. They are very attractive for pediatric studies and they should facilitate the assessment of drug efficacy and safety. [source]

35 Electrogastrography in healthy participants: comparison of children and adults

NEUROGASTROENTEROLOGY & MOTILITY, Issue 6 2006
CA FRIESEN
The current study examined whether electrogastrogram (EGG) patterns differ between children/adolescents and adults, including whether EGG recordings obtained from healthy children would be considered normal by standards established for adults. Twenty-eight healthy children (54% females; ages 8,17, M = 12.4 years) were evaluated and compared to 15 healthy adults. EGGs were recorded for 30 min in the fasting state and for 1 h following a standard meal. For both pediatric and adult participants, there was a significant increase in both the dominant frequency and the dominant power from the pre- to the post , prandial period (p < 0.001 for each). There was a significant post-prandial increase in the %normal slow waves in pediatric participants only (81.5 vs. 89.0% vs. p < 0.001). Children demonstrated a significantly lower mean fasting %normal slow waves (81.5% vs. 94.2%) and a significantly greater fasting % tachygastria (8.9% vs. 2.3%) than did adults. Other parameters did not differ. Using adult standards, the %normal slow waves were ,70% of recording time in 96% children in the fasting state and in 100% in the postprandial period. A postprandial power increase was seen in 89% of the children. In conclusion, while adults should not be used as controls in pediatric studies of EGG, our data would indicate that American Motility Society (AMS) consensus adult criteria for a normal EGG are appropriate to apply to children and adolescents when utilizing methodology and meal challenge similar to that used to establish the adult norms. [source]

Are Implantable Loop Recorders Useful in Detecting Arrhythmias in Children with Unexplained Syncope?

PACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 11 2009
KHALID N. AL DHAHRI M.B.B.S.
Introduction: Syncope and presyncope are symptoms that occur infrequently in children, are unpredictable, and represent a diagnostic challenge to the physician. Conventional diagnostic investigations are often unable to establish a diagnosis, making it difficult to determine patient risk and direct appropriate therapy. The implantable loop recorder (ILR) is a medical device that was created for prolonged monitoring of heart rate and rhythm and has been used in a limited number of pediatric studies in which the cause of the syncope is unknown. Methods: This is a retrospective review of the clinical, surgical, and follow-up data of patients who had ILR devices implanted after conventional testing failed to identify a cause for their symptoms. Results: The diagnostic yield of the ILR device in unmasking the cause for symptoms in our patient cohort was 64%. In our study, manually activated events accounted for 71% of all documented episodes and 68% of the cases involving hemodynamically important arrhythmias or transient rhythm changes. The ILR device can be safely implanted and explanted in children without significant morbidity, in most cases. None of our patients experienced any long-term adverse events associated with placement of the device and all were alive at last follow-up. Conclusions: The use of the ILR device is a useful tool to help unmask arrhythmias as a cause of unexplained syncope in children. Patient selection for who should and should not have an ILR device implanted will continue to influence its diagnostic utility and generate controversy among stakeholders. [source]