efforts should be taken to ensure that residents have the tools/confidence to independently publish their research/scholarship.

The lack of randomized controlled trials comparing biologics for the treatment of juvenile idiopathic arthritis (JIA) has led to wide variation in treatment approaches. The objective of this study is to compare the efficacy and safety of abatacept, adalimumab, and etanercept in JIA patients treated at a tertiary pediatric institution.

This was a single-center, retrospective chart review of patients initiated on abatacept, adalimumab, or etanercept from December 1, 2015, to August 31, 2018, at Monroe Carell Jr. Children’s Hospital at Vanderbilt (VCH). The primary outcome was the change in the Physician Global Assessment (PGA) score after 4 to 6 months of biologic therapy. Secondary outcomes included change in laboratory markers of JIA disease activity, change in the number of joints with active disease or limitation of motion, reduction in corticosteroid dose, adverse effects, adherence among patients who have their medications filled at the institution’s specialty pharmacy, and reason for discontinuation of therapy.

A total of 139 patients were included, with a median age of 13 years. Most patients, 80.6%, experienced a reduction in their PGA score after starting biologic therapy. There was not a statistically significant difference among the agents (p = 0.64). Adverse effects were reported in only 26.6% of patients, with the most frequent being injection site reactions or pain (n = 35). Ultimately, 32% of patients discontinued biologic therapy with a lack of efficacy being the most common reason.

Abatacept, adalimumab, and etanercept were not significantly different in efficacy and safety for the treatment of JIA at this single institution.

Abatacept, adalimumab, and etanercept were not significantly different in efficacy and safety for the treatment of JIA at this single institution.

Prevalence of chronic migraine in children can reach 7.7%, causing decreased school performance, difficulty with extracurricular activities (including sports, theater, or music), and changes in sleep and mood. Many studies confirm that botulinum toxin type A injections effectively alleviate chronic migraines in adults; however, the literature regarding children is sparse. This study aims to analyze the safety and effectiveness of botulinum type A injections in a group of pediatric patients diagnosed with chronic migraines in a pediatric pain clinic.

In this retrospective (2013-2018) study, the effects of botulinum toxin type A injections were analyzed using data from 65 pediatric patients diagnosed with chronic migraines. The study group ranged from 11 to 18 years of age. A pediatric pain management physician administered the botulinum using the Phase 3 Research Evaluating Migraine Prophylaxis Therapy program protocol and followed the pain pattern. Dosages, tolerance, and side effects were measured.

In this study, 74% of the patients tried more than 6 medications before the injections. There was a decrease in the visual analog scale score of 5.2 ± 2.2 points upon 6-week follow-up. The mean amount of medication used was 173.2 ± 35 units, and patients received an average of 2.8 ± 1.1 units/kg. Adverse events include one patient who developed dizziness and another who had low-grade fevers with enlarged cervical lymph nodes; both resolved within few minutes.

This study supports the use of botulinum type A for chronic migraines in pediatric patients. Multicentered, randomized studies with larger population are needed to evaluate the long-term safety and efficacy of this therapy.

This study supports the use of botulinum type A for chronic migraines in pediatric patients. Multicentered, randomized studies with larger population are needed to evaluate the long-term safety and efficacy of this therapy.

Neonatal seizures are common complications. Phenobarbital is the agent of choice but leads to adverse neurologic outcomes. There has been increased use of newer agents like levetiracetam. The objective of this study was determining the rate of seizure resolution in neonates treated with phenobarbital or levetiracetam.

This was a retrospective, single-center, cohort study from June 1, 2012-June 1, 2018 evaluating seizure resolution in neonates following first-line treatment with phenobarbital versus levetiracetam. Data were collected via review of the patient’s charts in the electronic medical record. The primary outcome was seizure resolution without addition of a second antiepileptic agent. Logistic regression was used to assess the impact of pertinent variables.

Each group included 73 patients. The mean gestational age was 36.01 and 37.91 weeks for the phenobarbital and levetiracetam groups, respectively (p = 0.011). The phenobarbital group had higher rates of intraventricular hemorrhage at baseline. rther research into the pharmacodynamic interaction with benzodiazepines is necessary.

This study explored adolescents’ perspectives on prescription opioids, opioid safety and misuse, and sources of opioid information.

High school students participated in focus groups that elicited information about adolescent perspectives on prescription opioids and opioid safety. Demographic information was collected. Focus groups consisted of 5 to 8 student participants and 2 moderators. Focus groups were audio-recorded and professionally transcribed. Transcript content was thematically analyzed using NVivo.

A total of 54 high school students (59% female, 44% white, 44% Latino) participated in 8 focus groups. Participants ranged from ages 14 to 18 years and grades 9 to 12. Five major themes emerged 1) perceptions of prescription opioids and misuse; 2) prevalence of prescription opioid misuse; 3) reasons for prescription opioid misuse; 4) consequences of prescription opioid misuse; and 5) sources of medication information. Participants identified examples of misuse and reasons for and consequences of tees. Educational efforts that target adolescents should provide opportunities for addressing misconceptions about safe and responsible use of medications.

Children who undergo hemodialysis (HD) and peritoneal dialysis are at increased risk of infection. Daptomcyin is used to treat resistant infections; however, the pharmacokinetics of daptomycin in pediatric and adolescent dialysis patients remain unknown.

We report the safety and pharmacokinetics of a single intravenous 5 mg/kg dose of daptomycin for 6 individuals age 12 to 17 years old who underwent HD or continuous cycling peritoneal dialysis (CCPD). Daptomycin concentrations from all samples were determined by high-performance liquid chromatography. A non-compartmental analysis was performed to compare the pharmacokinetic parameters among HD and CCPD patients. A population pharmacokinetic model was developed to describe the concentration-time profiles of daptomycin in plasma, urine, and dialysis effluent. Monte Carlo simulations were performed to assess the pharmacodynamic outcomes.

All subjects tolerated the single dose of daptomycin. During HD, significant drug removal was observed, compared with CClation. Our pharmacokinetic model can be further used to optimize dosing regimens of daptomycin in this population.Invasive candidiasis accounts for approximately 10% of nosocomial infections in preterm infants, with an incidence of 1% to 4% among neonatal intensive care unit (NICU) admissions and a mortality as high as 20% to 30%. These outcomes warrant improved treatment and prevention strategies for infants at highest risk. The Infectious Diseases Society of America provides guidelines on antifungal medications for the prophylaxis and treatment of candidiasis in NICUs; however, there are still variations in practice on the use of fluconazole for prophylaxis and treatment of invasive candidiasis. This review provides specific information regarding fluconazole activity, pharmacokinetics, and a literature evaluation of dosing strategies and comparisons to other treatments in the neonatal population.Almond production generates a large number of coproducts, but the farmer’s interest mainly focuses on the nutritional and commercial aspects of the kernel for getting the best return from their harvests. Thus, almond coproducts such as almond shells that represent more than 70% of biomass remain underexplored. In this work, the suitability of almond shell powder (ASP) as a natural low-cost adsorbent was evaluated in the adsorption of brilliant green dye (BG), which is known as a chemical pollutant. Brunauer-Emmett-Teller (BET) method, for the determination of specific surface area, Fourier-transform infrared spectroscopy (FTIR), and scanning electron microscopy (SEM) techniques were performed to characterize the ASP adsorbent. The batch adsorption kinetic study for the removal of BG dye was carried out by varying pH, temperature, initial concentration of the dye, bioadsorbent dose, and contact time. It was found that 98% of BG dye is removed under the following optimal experimental conditions ASP bioadsorbent dose of 1 g/L at T = 25°C, pH = 6.8, and C 0 = 1 g/L, which proves that ASP can be used as an excellent low-cost bioadsorbent for the removal of BG dye from wastewater. The experimental isotherm data were analyzed using Freundlich and Langmuir models. The results show the best correlation with single-layer adsorption, and the adsorption kinetics seems to follow a pseudo-second-order model.Dentists prescribe several types of drugs such as anti-inflammatory medicines in their practice in order to manage pain. An adequate knowledge of anti-inflammatory drugs’ characteristics is mandatory for a reasonable prescription to ensure patients safety. The study aimed to describe dentists’ anti-inflammatory drugs prescription in dental practice. Materials and Methods. This study was conducted on independent practice dentists working in the region of Tunis. A questionnaire was made on „Google forms” and sent to all of them via personal emails. The questionnaire included demographic data and 13 questions about anti-inflammatory medicines indications and contraindications, the side effects, and their prescription in dental practice. Data analysis was performed on SPSS software version 20.0 (trial version), using the χ2 test for statistical analysis. Results. Two hundred dentists participated to the survey. The female gender was predominant (70%). More than half of the responders were recently graduated and working in their own dental offices. The present study showed that 60% of dentists rarely prescribe anti-inflammatory drugs. Ibuprofen was prescribed by 82% of the dentists. Next came dexamethasone acetate (68.2%). The most frequent indication was postoperative pain (65%). Gastric problem was found to be the most mentioned adverse effect (69%). Thus, 72% of the dentists prescribed proton pump inhibitors with AI. Conclusion. According to this study, dentists have a lack of knowledge and awareness about some contraindications, side effects, and drugs interactions. Thus, knowledge updating, practices assessment, and continuous education are always required to avoid drug iatrogenesis.

Basic life support (BLS) is a level of medical care that is used for individuals with life-threatening illnesses or injuries until they can be given full medical care at a hospital. It can be provided by trained medical personnel, including emergency medical technicians and paramedics, and by qualified bystanders. Vital areas of adult BLS include immediate identification of sudden cardiac arrest and activation of the emergency response system, early performance of high-quality cardiopulmonary resuscitation (CPR), and rapid defibrillation, when appropriate.

To assess the awareness of secondary school students regarding BLS in Abha City, Saudi Arabia.

. A descriptive cross-sectional survey was conducted targeting all accessible secondary school students in Abha City during the academic years 2018-2019. After explaining the objectives and importance of the research topic, all students in the three grades were invited to complete the study questionnaire. The questionnaire was developed by the researchers after reviewing the literature for related topics and consulting an expert for any additions or modifications.