Quetiapine Excretion Into Human Breast Milk.

Background: Risk assessment of the use of quetiapine during breastfeeding is challenging owing to a paucity of data.

Methods: A pharmacokinetic study was conducted in lactating women who were taking quetiapine. The primary endpoint was to determine quetiapine concentration profiles in milk and estimated infant exposure levels.

The Vibrio cholerae Minor Pilin TcpB Initiates Assembly and Retraction of the Toxin-Coregulated Pilus.

Type IV pilus (T4P) systems are complex molecular machines that polymerize major pilin proteins into thin filaments displayed on bacterial surfaces. Pilus functions require rapid extension and depolymerization of the pilus, powered by the assembly and retraction ATPases, respectively. A set of low abundance minor pilins influences pilus dynamics by unknown mechanisms.

Increased serum vitamin A and E levels after lung transplantation.

Background: Adult cystic fibrosis (CF) patients experience significant increases in serum vitamin A and E levels after lung transplantation. It is unclear whether this finding is specific to the CF population or inherent to the lung transplantation process.

Methods: The objectives of this study were to assess pre- and postlung transplantation serum vitamin A and E levels in subjects with end-stage lung disease secondary to all causes.

Pediatric reference intervals for lymphocyte vitamin C (ascorbic acid).

Objective: To establish pediatric reference intervals for lymphocyte vitamin C.

Design And Methods: This was a prospective study of 194 well children aged 0-7 years old of mixed ethnicity who had blood drawn for the purpose of this study. Blood was collected during elective surgery under general anesthesia and lymphocytes isolated and stored as frozen ascorbic acid lymphocyte lysates for later HPLC analysis by previously described methodology.

Alcohol content in declared non-to low alcoholic beverages: implications to pregnancy.

Background: Alcohol consumption in pregnancy may result in serious adverse fetal outcome. Non- or low alcoholic wines and beers may be a risk-reduction strategy to help alcohol-dependent individuals to prevent or limit ethanol consumption. The objective of this study was to quantify ethanol concentrations in Canadian beverages claiming to contain no or low alcohol content.

A pitfall of measuring lithium levels in neonates.

If lithium therapy is required during pregnancy or lactation, serum lithium monitoring may be indicated in the newborns. In the neonatal population, however, blood samples are often obtained with a sampling device containing lithium heparin. Given the infrequent nature of lithium measurement in the neonatal population, a risk of oversight on the use of these lithium-containing devices for lithium measurements exists.

The association between acetaminophen concentrations in the cerebrospinal fluid and temperature decline in febrile infants.

The objective of this study consisting of a prospective cohort of febrile infants was to describe the correlation between cerebrospinal fluid (CSF) acetaminophen (paracetamol) concentrations and changes in body temperature in febrile infants. Infants, one week to one year of age, with rectal temperature >or=38.0 degrees C, treated with acetaminophen were studied if they underwent a lumbar puncture (LP).

Generalized seizures following topical lidocaine administration during circumcision: establishing causation.

We report a case of neonatal seizures after lidocaine administration for circumcision. A 3-month-old male infant received an overdose as evidenced by toxic lidocaine levels and developed generalized seizures shortly after. Back extrapolation of the serum lidocaine concentration to time zero was used to determine the administered dose.

Pharmacokinetic disposition and clinical outcomes in infants and children receiving intravenous busulfan for allogeneic hematopoietic stem cell transplantation.

We conducted a retrospective pharmacokinetic analysis of i.v. busulfan in children undergoing hematopoietic stem cell transplantation (HSCT) and describe its relation to transplantation outcomes.

Breast-feeding during maternal use of azathioprine.

Objective: To report the clinical outcome of infants whose mothers were taking azathioprine while nursing and to quantify the transfer of 6-mercaptopurine (6-MP), its active metabolite, into breast milk.

Case Summary: We report on a series of 4 patients treated with azathioprine while lactating. Breast milk samples were analyzed for 6-MP in 2 of the mothers.

Toxicokinetics of mercury elimination by succimer in twin toddlers.

We describe the toxicokinetics of mercury in two twin toddlers poisoned by an East Indian remedy for teething. Succimer (dimercaprosuccinic acid, DMSA) decreased the plasma elimination half-life of mercury by 3-fold in the patient with high exposure; a more modest effect was observed in the other twin. Succimer is a chelation agent used in the treatment of heavy metal intoxication.

Ontogeny of renal P-glycoprotein expression in mice: correlation with digoxin renal clearance.

Digoxin is eliminated mainly by the kidney through glomerular filtration and P-glycoprotein (P-gp) mediated tubular secretion. Toddlers and young children require higher doses of digoxin per kilogram of bodyweight than adults, although the reasons for this have not been elucidated. We hypothesized there is an age-dependant increase in P-gp expression in young children.

Measurement of intracellular vitamin C levels in human lymphocytes by reverse phase high performance liquid chromatography (HPLC).

Objectives: Vitamin C plays an active role in many important metabolic processes, such as collagen formation and the prevention of bleeding. Although overt scurvy is now rare, there is evidence that subclinical vitamin C deficiency is still quite common. Serum and plasma vitamin C measurements do not correlate well with tissue levels while lymphocyte vitamin C levels provide the most accurate assessment of the true status of vitamin C stores and are not affected acutely by circadian rhythm or dietary changes.

Increased vitamin A and E levels in adult cystic fibrosis patients after lung transplantation.

Most patients with cystic fibrosis (CF) and pancreatic insufficiency require supplementation with fat-soluble vitamins to maintain normal serum levels. Even with supplementation, toxicity is rare. We evaluated serum vitamin A and E levels in 23 adult patients with CF who underwent double lung transplantation.

Analytical performance and workflow evaluation of the Roche E170 modular immunoassay analyzer in a pediatric setting.

Objectives: To evaluate the analytical performance of the Roche E170 modular analytics immunoassay analyzer and assess its impact on workflow efficiency and ability to consolidate workstations in a pediatric setting.

Design And Methods: Analytical performance of eleven common immunoassays was assessed. Total imprecision was determined using Roche PreciControl Universal controls, Bio-Rad Lyphochek Immuno Plus, Anemia controls, and a human serum pool.

Prospective observational study on the incidence of medication errors during simulated resuscitation in a paediatric emergency department.

Objectives: To characterise the incidence and nature of medication errors during paediatric resuscitations.

Design: A prospective observational study of simulated emergencies.

Setting: Emergency department of a tertiary paediatric hospital.

Improved HPLC methodology for monitoring thiopurine metabolites in patients on thiopurine therapy.

Objective: Standardization of thiopurine metabolite testing is currently lacking. This paper presents in-depth methodological analysis and optimization of two currently available HPLC procedures (Lennard-Singleton [J. Chromatogr.

Cyclosporine excretion into breast milk.

Although many female patients of childbearing age who are receiving cyclosporine have successful pregnancies, these women may be advised not to breast-feed. During recent years, cases of uneventful pregnancies and subsequent successful breast-feeding have been reported in the literature. The infant's blood cyclosporine concentration was usually very low.

Analytical evaluation of hemoglobin A(1c) dual kit assay on Bio-Rad Variant II: an automated HPLC hemoglobin analyzer for the management of diabetic patients.

Objectives: To evaluate the analytical performance of the Bio-Rad Variant II HbA(1c) dual kit assay.

Design And Methods: Precision, carryover, linearity and analytical range were investigated. 139 patients' HbA(1c) results analyzed by the Variant II were compared to the Variant I method.