Evaluating glycemic control for patient-aligned care team clinical pharmacy specialists at a large Veterans Affairs medical center.

Background: Management of diabetes mellitus (DM) remains a challenge in the US, as almost half of patients with diabetes are uncontrolled with a hemoglobin A1c (HbA1c) >7%. Over the last decade there has been increasing evidence supporting the integration of Clinical Pharmacy Specialists (CPSs) to multidisciplinary medical teams which have demonstrated improved glycemic control and better clinical outcomes in the primary care setting.

Objectives: The primary objective of this study was to evaluate the change in HbA1c levels in patients with diabetes followed by a CPS.

Characteristics of Bordetella pertussis infection among infantsand children admitted to paediatric intensive care units in Greece: A multicentre, 11-year study.

Aim: To describe children with pertussis who required intensive care.

Methods: This is a retrospective analysis of pertussis admissions to all (six) national intensive care units in Greece from 2003 to 2013.

Results: A total of 31 children were included, 28 of whom were younger than 12 months old.

Subclinical VZV reactivation in immunocompetent children hospitalized in the ICU associated with prolonged fever duration.

A prospective observational study was conducted to examine whether asymptomatic VZV reactivation occurs in immunocompetent children hospitalized in an ICU and its impact on clinical outcome. A secondary aim was to test the hypothesis that vaccinated children have a lower risk of reactivation than naturally infected children. Forty immunocompetent paediatric ICU patients and healthy controls were enrolled.

Ciprofloxacin in critically ill children.

Data regarding the use of fluoroquinolones in critically ill children are scarce. We present our experience regarding the use of ciprofloxacin in this specific patient population. We prospectively identified all paediatric patients who received ciprofloxacin treatment in the intensive care unit of the tertiary care P.

Liposomal amphotericin B in critically ill paediatric patients.

What Is Known And Objective: Literature provides much evidence regarding liposomal amphotericin B treatment for fungal infections in neonates and infants. Relevant data regarding critically ill paediatric patients of older age are scarce. We aimed to present our experience regarding liposomal amphotericin B use in critically ill paediatric patients from a tertiary-care paediatric hospital in Athens, Greece.

Inhaled colistin for the treatment of tracheobronchitis and pneumonia in critically ill children without cystic fibrosis.

Data regarding the role of inhaled colistin in critically ill pediatric patients without cystic fibrosis are scarce. Three children (one female), admitted to the intensive care unit (ICU) of a tertiary-care pediatric hospital in Athens, Greece, during 2004-2009 received inhaled colistin as monotherapy for tracheobronchitis (two children), and as adjunctive therapy for necrotizing pneumonia (one child). Colistin susceptible Acinetobacter baumannii and Pseudomonas aeruginosa were isolated from the cases' bronchial secretions specimens.

Intravenous colistimethate (colistin) use in critically ill children without cystic fibrosis.

Introduction: The increasing frequency of infections caused by multidrug-resistant (MDR) Gram-negative bacteria has led to the reappraisal of colistimethate use.

Methods: We present a case series of critically ill pediatric patients without cystic fibrosis who received intravenous colistimethate treatment. All available relevant medical records were reviewed.

SM16, an orally active TGF-beta type I receptor inhibitor prevents myofibroblast induction and vascular fibrosis in the rat carotid injury model.

Objective: TGF-beta plays a significant role in vascular injury-induced stenosis. This study evaluates the efficacy of a novel, small molecule inhibitor of ALK5/ALK4 kinase, in the rat carotid injury model of vascular fibrosis.

Methods And Results: The small molecule, SM16, was shown to bind with high affinity to ALK5 kinase ATP binding site using a competitive binding assay and biacore analysis.

Adopting a practical statistical approach for evaluating assay agreement in drug discovery.

The authors assess the equivalence of 2 assays and put forward a general approach for assay agreement analysis that can be applied during drug discovery. Data sets generated by different assays are routinely compared to each other during the process of drug discovery. For a given target, the assays used for high-throughput screening and structure-activity relationship studies will most likely differ in their assay reagents, assay conditions, and/or detection technology, which makes the interpretation of data between assays difficult, particularly as most assays are used to measure quantitative changes in compound potency against the target.

Unexpected combination of acute croup and myocarditis: case report.

Background: Lower vaccination coverage among foreign-born children is of concern because they live in households and communities characterized by more intense exposure to infectious diseases. Because of their higher prevalence rates, there is an increasing occurrence of infectious diseases imported into developed countries. This case report emphasizes the emerging necessity for new clinicians and pathologists of having competence with old infectious disease pathology.

Successful shape-based virtual screening: the discovery of a potent inhibitor of the type I TGFbeta receptor kinase (TbetaRI).

We describe the discovery, using shape-based virtual screening, of a potent, ATP site-directed inhibitor of the TbetaRI kinase, an important and novel drug target for fibrosis and cancer. The first detailed report of a TbetaRI kinase small molecule co-complex confirms the predicted binding interactions of our small molecule inhibitor, which stabilizes the inactive kinase conformation. Our results validate shape-based screening as a powerful tool to discover useful leads against a new drug target.

Paraquat poisoning in a family.

A familial occurrence of acute paraquat (PQ) poisoning is reported. The mother administered a PQ solution to their 3 children aged 8 y, 6 y and 15 mo and then ingested an unknown amount of the herbicide herself. In the absence of history or diagnostic signs, the poisoning was initially misdiagnosed as gastroenteritis.

Air leaks from the respiratory tract in mechanically ventilated children with severe respiratory disease.

Our objectives were to evaluate the frequency of air leaks (AL) from the respiratory tract (pneumothorax, pneumomediastinum, pneumoperitoneum, subcutaneous emphysema) in critically ill children on mechanical ventilation (MV) for severe respiratory diseases, and to examine whether AL could be correlated with specific clinical events or ventilator settings. The study constitutes a retrospective cohort of 80 consecutive critically ill children receiving MV for severe respiratory diseases between 1986 and 1993. Patients (mean age 2.

Correlation between serum IL-6 and CRP levels and severity of head injury in children.

Objective: To examine interleukin-6 (IL-6) and C-reactive protein (CRP) release in children with head injury (HI) and investigate if there is a correlation between the levels of these two proteins and the severity of HI.

Design: Prospective clinical investigation.

Setting: Eight-bed paediatric intensive care unit in a university hospital.

Clinical and pharmacokinetic study of a single daily dose of amikacin in paediatric patients with severe gram-negative infections.

The efficacy and safety of a single 20 mg/kg daily dose of amikacin was studied in an open, uncontrolled trial in 56 infants and children. Most of the patients suffered from severe Gram-negative infection which had failed to respond to previous antibacterial therapy. Amikacin was given in combination with a beta-lactam antibiotic in 43 cases, with other antibiotics in five cases and monotherapy in eight cases.

Vincristine overdose: experience with 3 patients.

Vincristine overdose (7.5 mg/m2) was accidentally administered to 3 children with acute lymphoblastic leukemia. Treatment included double-volume exchange transfusion, phenobarbital administered prophylactically, and folinic acid rescue 18 mg every 3 hours for 16 doses.

Hepatotoxicity due to Atractylis gummifera-L.

The authors describe an intoxication by Atractylis gummifera in a 7-year old boy who drunk an extract made from the plant's root as traditional medicine. He was admitted to the Hospital 2 days after ingestion, in coma stage II, with epigastric pain, vomiting and general anxiety. Laboratory findings showed severe hepatocellular damage and acute renal failure.

A review of paediatric admissions to a general intensive therapy unit over a 13-year period.

Paediatric admissions to a general ITU are briefly reviewed. Although it may not be an ideal arrangement it is suggested that children can be safely cared for in such a unit. The problems created by the child with acute upper airway obstruction are discussed to demonstrate the way in which the unit is organized to receive acutely ill children.

Efficacy of phototherapy and/or exchange transfusions in neonatal jaundice.

In a review of treatment of neonatal jaundice, the authors studied the impact of phototherapy on outcome. From comparing exchange transfusion treatment over a 39-month period prior to the availability of phototherapy to a 39-month period incorporating phototherapy in the treatment regimen, the authors conclude that phototherapy (1) acts slowly but constantly to reduce bilirubin levels and (2) is effective even in severe hemolytic jaundice, but its effectiveness is inversely related to the degree of hemolysis. While phototherapy can never totally replace exchange transfusion, it can certainly reduce the number of transfusions needed.

Concentration of antibacterial agents in rat bone. A comparative study of gentamicin, ampicillin and cephaloridine.

The concentrations of Gentamicin, Ampicillin and Cephaloridine in thigh rat bone were studied. Measurements were done after a 24 h administration for 3 different times. Measurable quantities in the bone for the three antibiotics were detected.

Vitamin E serum levels in newborn infants undergoing phototherapy.

The serum vitamin E levels of 11 full-term and 10 premature infants, jaundiced and subjected to phototherapy, were measured and compared wth 9 premature and 10 full-term jaundiced control infants. No differences were observed before or after phototherapy or 1 week after stopping it. The same negative results were noted in the two groups of infants regarding the values of microhematocrit, Hb and reticulocytes.

The content of trace elements (Cu, Zn, Fe, Mg) in fingernails of children.

The concentrations of Cu, Zn, Fe and Mg in fingernails of 212 normal children, 109 males and 103 females, 6--11 years old, were determined by atomic absorption spectroscopy. A wide scatter of results in all trace element determinations in fingernails was found. Nevertheless, it was noted that the petrographical composition of the region influences the trace element concentration in fingernails.