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Levy D, Maddox J, Folsom S, Kopp W, Sherpa A, Stockmann C, Fassl B. Assessment of perinatal outcomes, health practices and health system
capacity in Solukhumbu, Nepal. Ann Glob Health 2016. [DOI: 10.1016/j.aogh.2016.04.629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Levy D, Stockmann C, Wissenbach J, Poneru S, Bhattarai M, Rimal S, Fassl B. Assessment of the effectiveness of a multi-district pediatric
malnutrition program in Nepal. Ann Glob Health 2016. [DOI: 10.1016/j.aogh.2016.04.630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Stockmann C, Barrett JS, Roberts JK, Sherwin CMT. Use of Modeling and Simulation in the Design and Conduct of Pediatric Clinical Trials and the Optimization of Individualized Dosing Regimens. CPT Pharmacometrics Syst Pharmacol 2015; 4:630-40. [PMID: 26783499 PMCID: PMC4716585 DOI: 10.1002/psp4.12038] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Revised: 09/01/2015] [Accepted: 09/07/2015] [Indexed: 12/11/2022] Open
Abstract
Mathematical models of drug action and disease progression can inform pediatric pharmacotherapy. In this tutorial, we explore the key issues that differentiate pediatric from adult pharmacokinetic (PK) / pharmacodynamic (PD) studies, describe methods to calculate the number of participants to be enrolled and the optimal times at which blood samples should be collected, and therapeutic drug monitoring methods for individualizing pharmacotherapy. The development of pediatric-specific drug dosing dashboards is also highlighted, with an emphasis on clinical-relevance and ease of use.
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Affiliation(s)
- C Stockmann
- Department of PediatricsUniversity of Utah School of MedicineSalt Lake CityUtahUSA
| | | | - JK Roberts
- Department of PediatricsUniversity of Utah School of MedicineSalt Lake CityUtahUSA
| | - CMT Sherwin
- Department of PediatricsUniversity of Utah School of MedicineSalt Lake CityUtahUSA
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Stockmann C, Rogatcheva M, Harrel B, Vaughn M, Crisp R, Poritz M, Thatcher S, Korgenski EK, Barney T, Daly J, Pavia AT. How well does physician selection of microbiologic tests identify Clostridium difficile and other pathogens in paediatric diarrhoea? Insights using multiplex PCR-based detection. Clin Microbiol Infect 2014; 21:179.e9-15. [PMID: 25599941 DOI: 10.1016/j.cmi.2014.07.011] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2014] [Revised: 07/07/2014] [Accepted: 07/14/2014] [Indexed: 12/22/2022]
Abstract
The objective of this study was to compare the aetiologic yield of standard-of-care microbiologic testing ordered by physicians with that of a multiplex PCR platform. Stool specimens obtained from children and young adults with gastrointestinal illness were evaluated by standard laboratory methods and a developmental version of the FilmArray Gastrointestinal (GI) Diagnostic System (FilmArray GI Panel), a rapid multiplex PCR platform that detects 23 bacterial, viral and protozoal agents. Results were classified according to the microbiologic tests requested by the treating physician. A median of three (range 1-10) microbiologic tests were performed by the clinical laboratory during 378 unique diarrhoeal episodes. A potential aetiologic agent was identified in 46% of stool specimens by standard laboratory methods and in 65% of specimens tested using the FilmArray GI Panel (p < 0.001). For those patients who only had Clostridium difficile testing requested, an alternative pathogen was identified in 29% of cases with the FilmArray GI Panel. Notably, 11 (12%) cases of norovirus were identified among children who only had testing for Clostridium difficile ordered. Among those who had C. difficile testing ordered in combination with other tests, an additional pathogen was identified in 57% of stool specimens with the FilmArray GI Panel. For patients who had no C. difficile testing performed, the FilmArray GI Panel identified a pathogen in 63% of cases, including C. difficile in 8%. Physician-specified laboratory testing may miss important diarrhoeal pathogens. Additionally, standard laboratory testing is likely to underestimate co-infections with multiple infectious diarrhoeagenic agents.
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Affiliation(s)
- C Stockmann
- Department of Pediatrics, University of Utah Health Sciences Center, Salt Lake City, UT, USA.
| | - M Rogatcheva
- BioFire Diagnostics Inc., Salt Lake City, UT, USA
| | - B Harrel
- BioFire Diagnostics Inc., Salt Lake City, UT, USA
| | - M Vaughn
- BioFire Diagnostics Inc., Salt Lake City, UT, USA
| | - R Crisp
- BioFire Diagnostics Inc., Salt Lake City, UT, USA
| | - M Poritz
- BioFire Diagnostics Inc., Salt Lake City, UT, USA
| | - S Thatcher
- BioFire Diagnostics Inc., Salt Lake City, UT, USA
| | - E K Korgenski
- Primary Children's Hospital, Intermountain Healthcare, Salt Lake City, UT, USA
| | - T Barney
- Primary Children's Hospital, Intermountain Healthcare, Salt Lake City, UT, USA
| | - J Daly
- Primary Children's Hospital, Intermountain Healthcare, Salt Lake City, UT, USA; Department of Pathology, University of Utah Health Sciences Center, Salt Lake City, UT, USA
| | - A T Pavia
- Department of Pediatrics, University of Utah Health Sciences Center, Salt Lake City, UT, USA
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