Background: US and EU pediatric laws promote industry-sponsored pediatric studies, based on the therapeutic orphans concept that claims discrimination of children in drug treatment and drug development.
Objective: We investigated the medical validity of international pediatric studies with centers in Slovenia, an EU member state, and challenge their medical utility.
Methods: We analyzed international industry-sponsored pediatric studies with centers in Slovenia, listed in www.ClinicalTrials.gov, for their medical value.
Results: Most pediatric studies triggered by the US Food and Drug Administration and by the European Medicines Agency were/are without medical or scientific value. They were/are formally and regulatorily justified, but lack medical sense and thus were/are unethical. Several even harm children and/or adolescents with serious diseases by exposing them to placebo or substandard treatment.
Conclusions: Pediatric studies triggered by US and EU regulatory demands are a serious abuse of nonneonatal children and adolescents in Slovenia and worldwide. They are medically redundant at best and often deter patients from effective innovative personalized therapy. They also exclude young patients from reasonable studies. Institutional review boards/ethics committees should be alerted, should critically review all ongoing pediatric studies, should suspend those found to be questionable, and should reject newly submitted questionable ones.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6677645 | PMC |
http://dx.doi.org/10.1016/j.curtheres.2019.01.002 | DOI Listing |
Sleep
January 2025
Sleep Research & Treatment Center, Department of Psychiatry & Behavioral Health, Penn State University, College of Medicine, Hershey PA, USA.
Study Objectives: Although heart rate variability (HRV), a marker of cardiac autonomic modulation (CAM), is known to predict cardiovascular morbidity, the circadian timing of sleep (CTS) is also involved in autonomic modulation. We examined whether circadian misalignment is associated with blunted HRV in adolescents as a function of entrainment to school or on-breaks.
Methods: We evaluated 360 subjects from the Penn State Child Cohort (median 16y) who had at least 3-night at-home actigraphy (ACT), in-lab 9-h polysomnography (PSG) and 24-h Holter-monitoring heart rate variability (HRV) data.
Paediatr Drugs
January 2025
Institute of Clinical Pharmacology, Peking University First Hospital, Beijing, China.
Background: This study aimed to provide a comprehensive review of adverse events (AEs) associated with factor Xa (FXa) inhibitors in pediatric patients.
Methods: We searched PubMed, Embase, Cochrane Library, ClinicalTrials.gov, and the European Union Clinical Trials Register for English-language records from the establishment of the database up to October 17, 2023.
Curr Cardiol Rep
January 2025
Section of Pediatric Nephrology, Department of Pediatrics, Yale University School of Medicine, New Haven, USA.
Purpose Of Review: To review the benefits of ambulatory blood pressure monitoring and home blood pressure monitoring in children and to discuss implementation of guideline-recommended ambulatory blood pressure monitoring.
Recent Findings: Compared with office blood pressure, ambulatory blood pressure monitoring and home blood pressure monitoring provide superior accuracy, reproducibility, and stronger associations with target organ damage although future work is needed to determine the utility of home blood pressure monitoring to predict hypertension status on ambulatory blood pressure monitoring. Due to the benefits of out-of-office blood pressure measurement, ambulatory blood pressure monitoring has been recommended to confirm the diagnosis of hypertension in children and adolescents since publication of the 2017 American Academy of Pediatrics clinical practice guidelines on hypertension.
Eur Arch Paediatr Dent
January 2025
Qatar University Health, College of Dental Medicine, Qatar University, Doha, Qatar.
Purpose: To review the current evidence on the association between salivary protein profile and dental caries in children during mixed dentition stage.
Methods: This systematic review followed the PRISMA 2020 guidelines. Searches were run in PubMed, Scopus and Embase along with gray literature.
Indian J Pediatr
January 2025
Department of Pediatrics, All India Institute of Medical Sciences, Jodhpur, India.
Objectives: To evaluate the predictive ability of furosemide stress test (FST), serum and urine cystatin-C in identifying progressive acute kidney injury (AKI) and the need for kidney replacement therapy (KRT).
Methods: Children aged one month to 18 y admitted in the pediatric intensive care unit (PICU) with Kidney Diseases Improving Global Outcomes (KDIGO) stage-1/2 AKI were enrolled. FST and serum and urine cystatin-C levels were performed and analyzed.
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