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Personalised dosing of medicines for children
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Abstract<sec><title>Objectives

Doses for most drugs are determined from population-level information, resulting in a standard ?one-size-fits-all’ dose range for all individuals. This review explores how doses can be personalised through the use of the individuals’ pharmacokinetic (PK)-pharmacodynamic (PD) profile, its particular application in children, and therapy areas where such approaches have made inroads.

Key findings

The Bayesian forecasting approach, based on population PK/PD models that account for variability in exposure and response, is a potent method for personalising drug therapy. Its potential utility is even greater in young children where additional sources of variability are observed such as maturation of eliminating enzymes and organs. The benefits of personalised dosing are most easily demonstrated for drugs with narrow therapeutic ranges such as antibiotics and cytotoxics and limited studies have shown improved outcomes. However, for a variety of reasons the approach has struggled to make more widespread impact at the bedside: complex dosing algorithms, high level of technical skills required, lack of randomised controlled clinical trials and the need for regulatory approval.

Summary

Personalised dosing will be a necessary corollary of the new precision medicine initiative. However, it faces a number of challenges that need to be overcome before such an approach to dosing in children becomes the norm.

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Publication Date
Sat Jun 19 2021
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Serum Chitotriosidase level as a Novel Biomarker for Therapeutic Monitoring of Nephropathic Cystinosis among the Iraqi children
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Background: Cystinosis is a rare autosomal recessive lysosomal storage disease with high morbidity and mortality. It is caused by mutations in the CTNS gene that encodes the cystine transporter, cystinosin, which leads to lysosomal cystine accumulation. It is the major cause of inherited Fanconi syndrome, and should be suspected in young children with failure to thrive and signs of renal proximal tubular damage. The diagnosis can be missed in infants, because not all signs of renal Fanconi syndrome are present during the first months of life. Elevated white blood cell cystine content is the cornerstone of the diagnosis. Since chitotriosidase (CHIT1 or chitinase-1) is mainly produced by activated macrophages both in normal and inflammator

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Publication Date
Thu Nov 08 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Assessment of nurses' knowledge towards signs of gross motor delay for children at Alhawija District in Kirkuk Governorate
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Background: the early identification of developmental disabilities allows intervention at the earliest possible point to
improve the developmental potential.
Objective: Identify the scope of knowledge of nurses toward signs of gross motor delay for children and its relation to
their demographic characteristics.
Methodology: A descriptive study design was conducted at (18) primary health care centers in first of the primary
health care sector of Alhawija District in Kirkuk Governorate. This study started from September 2010 to the end of
January 2011, in order to identify the level of nurses' knowledge toward signs of gross motor delay for children in
primary health care centers. Non probability (purposive) sample of

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Publication Date
Fri Jun 01 2018
Journal Name
Kerbala Journal Of Medicine
Polymerase Chain Reaction Testing in Comparison to Culture of Cerebrospinal Fluid for Diagnosis of Bacterial Meningitis in Children
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Publication Date
Fri Jun 28 2019
Journal Name
Journal Of The College Of Education For Women
The Effectiveness of an Educational Program For Early Intervention depending on Illustrative Pictures to Acquire some concepts For Children with Hearing impairment
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“Child of today is a man of the future" this slogan is one of the most popular logos of international organizations and institutions that dealing with human beings needs in general and children needs in particular, whether these needs are educational, health, social, or economic. Children require special care and extra legal protection, since the child-raising is not the Child’s own issue, but it's the issue of the society in which he/she would integrate.

As the education and language skillsacquisition primarily associated with hearing, because human being receives most of the skills and knowledge through the hearing; that imitate sounds and learn how to speak isacquired only by hearing, so therefore the hearing - impairedchi

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Publication Date
Thu Jan 20 2022
Journal Name
Journal Of Clinical Medicine
Comparison of the Safety and Efficacy of Laser Versus Pneumatic Intracorporeal Lithotripsy for Treatment of Bladder Stones in Children
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This study aimed to compare the safety and efficacy of laser lithotripsy and pneumatic lithotripsy, the two most commonly used transurethral lithotripsy methods for treating bladder stones in children in Iraq. Between January 2013 and December 2016, 64 children with bladder stones were included in this prospective randomized study, after ethical committee approval and written consent from the children’s parents or caregivers were obtained. Patients were assigned randomly by computer software to two groups treated with either pneumatic cystolithotripsy or laser lithotripsy. A 9 Fr. semirigid ureteroscope was used to pass the lithotripter through and fragment the stone. A catheter of 8–12 Fr. was then introduced and kept in place

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Publication Date
Thu Dec 24 2020
Journal Name
Psychology And Education
A Proposed Programme Based On Sensory Integration Theory For Remediating Some Development Learning Disabilities Among Children
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The current research aims to prepare a proposed Programmebased sensory integration theory for remediating some developmental learning disabilities among children, researchers prepared a Programme based on sensory integration through reviewing studies related to the research topic that can be practicedby some active teaching strategies (cooperative learning, peer learning, Role-playing, and educational stories). The Finalformat consists of(39) training sessions.

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Publication Date
Fri Jul 24 2020
Journal Name
Al-kindy College Medical Journal
The Functional Results of Surgical Percutaneous Joystick Reduction Therapy for Isolated Severely Angulated Radial Neck Fracture in Children
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Background: Radial neck fractures in children account for 5 to 10% of all elbow fractures in children. They are extra-articular fractures of the radius proximal to the bicipital tuberosity. The physis is typically involved as a Salter-Harris I or II pattern. Alternatively, the fracture sometimes is extraphyseal, through the metaphysis. In children there is considerable potential for remodeling after these fractures. Up to 30° of radial head tilt and up to 3 mm of transverse displacement are acceptable. Many modalities of treatment are available regarding Surgical &Non-Surgical treatments. Objectives: To evaluate the functional outcome after surgical percutaneous joystick reduction therapy of severely angulated radial neck fracture i

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Publication Date
Sat Mar 21 2020
Journal Name
Electronic Journal Of General Medicine
The Possible Immunological Pathways for the Variable Immunopathogenesis of COVID—19 Infections among Healthy Adults, Elderly and Children
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Publication Date
Thu Jun 20 2030
Journal Name
Al-kindy College Medical Journal
The Functional Results of Surgical Percutaneous Joystick Reduction Therapy for Isolated Severely Angulated Radial Neck Fracture in Children
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Background: Radial neck fractures in children account for 5 to 10% of all elbow fractures in children. They are extra-articular fractures of the radius proximal to the bicipital tuberosity. The physis is typically involved as a Salter-Harris I or II pattern. Alternatively, the fracture sometimes is extraphyseal, through the metaphysis. In children there is considerable potential for remodeling after these fractures. Up to 30° of radial head tilt and up to 3 mm of transverse displacement are acceptable. Many modalities of treatment are available regarding Surgical &Non-Surgical treatments. Objectives: To evaluate the functional outcome after surgical percutaneous joystick reduction therapy of severely angulated radial neck fracture i

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Publication Date
Thu Jun 15 2023
Journal Name
Alustath Journal For Human And Social Sciences
The Effectiveness of a Cognitive-Behavioral Treatment Program to Reduce Nervous Fatigue for Mothers of Children with Cerebral Palsy
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Cognitive-behavioral therapy is one of the most important relatively recent; treatment programs that attempt to modify behavior and control psychological disorders by modifying the individual's thinking style and awareness of himself and his environment, and cognitive reconstruction by replacing negative thoughts with positive ones. The current study aimed to know the effectiveness of a cognitive behavioral treatment program in reducing nervous fatigue among mothers of children with cerebral palsy. The sample on which the nervous fatigue scale was applied consisted of (30) mothers whose son suffers from cerebral palsy, and the results indicated that (24) mothers suffer from nervous fatigue. This sample was divided

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