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Related Concept Videos

Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption01:23

Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption

375
Understanding the physiological differences in the pediatric population is crucial for effective pharmacotherapy. Neonates, infants, and children exhibit significant variations in gastric pH, gastric emptying time, intestinal transit time, and biliary function. These variations profoundly affect oral drug absorption, necessitating a nuanced approach to pediatric dosing.Neonates present with a unique physiological profile, having a gastric pH greater than 4 and faster and more irregular gastric...
375
Pharmacokinetics in Pediatric Patients: Drug Distribution01:17

Pharmacokinetics in Pediatric Patients: Drug Distribution

359
Drug distribution in the pediatric population exhibits unique challenges and considerations due to the physiological differences between children, particularly neonates and infants, and adults. A crucial aspect of pediatric pharmacology is understanding how these differences impact the pharmacokinetics of various drugs, necessitating age-specific dosing strategies to ensure efficacy and safety.Neonates and infants have a higher total body water content, ~75%–90% of their body weight,...
359
Pharmacokinetics in Pediatric Patients: Drug Metabolism01:24

Pharmacokinetics in Pediatric Patients: Drug Metabolism

286
In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses...
286
Pharmacokinetics in Pediatric Patients: Drug Excretion01:26

Pharmacokinetics in Pediatric Patients: Drug Excretion

329
In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
329
Drug Dosing: Infants and Children01:29

Drug Dosing: Infants and Children

388
Pediatric patient dosages diverge from adults due to disparities in body surface area, total body water, and extracellular fluid per kilogram of body weight. The dosing regimen considers the variations in pharmacokinetics and pharmacology across distinct age groups, encompassing preterm newborns, infants, young children, older children, and adolescents. Calculation of pediatric patient doses is predicated on determining body surface area, which exhibits a superior correlation with the child's...
388
Combination Therapies and Personalized Medicine02:50

Combination Therapies and Personalized Medicine

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Combining two or more treatment methods increases the life span of cancer patients while reducing damage to vital organs or tissue from the overuse of a single treatment. Combination therapy also targets different cancer-inducing pathways, thus reducing the chances of developing resistance to treatment.
The combination of the drug acetazolamide and sulforaphane is a good example of combination therapy to treat cancer. The cells in the interior of a large tumor often die due to the hypoxic and...
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Related Experiment Video

Updated: Feb 25, 2026

Proton Therapy Delivery and Its Clinical Application in Select Solid Tumor Malignancies
08:34

Proton Therapy Delivery and Its Clinical Application in Select Solid Tumor Malignancies

Published on: February 6, 2019

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Insurance coverage decisions for pediatric proton therapy.

Eric Ojerholm1,2, Christine E Hill-Kayser1

  • 1Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania.

Pediatric Blood & Cancer
|August 8, 2017
PubMed
Summary

Proton beam therapy (PBT) for children was often initially denied by insurers, but appeals led to approval in over 99% of cases. Streamlining these processes could save time and resources for all parties involved.

Keywords:
insuranceinsurance coveragepediatricproton therapyprotons

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Area of Science:

  • Oncology
  • Radiation Oncology
  • Pediatric Medicine

Background:

  • Proton beam therapy (PBT) shows potential for pediatric cancer treatment.
  • Limited level 1 evidence currently exists for PBT in pediatric patients.

Purpose of the Study:

  • To analyze insurance coverage decisions for pediatric proton beam therapy.
  • To evaluate the real-world approval rates and appeal processes for PBT.

Main Methods:

  • Retrospective review of insurance coverage decisions for pediatric PBT.
  • Analysis of initial denials, appeals, and final approval rates from 2010 to 2015.

Main Results:

  • Initially, 11% of pediatric PBT cases were denied coverage.
  • Over 99% of denied cases were ultimately approved after appeals.
  • The appeals process frequently caused treatment delays exceeding one week.

Conclusions:

  • Despite initial denials and policy language, payers largely approve pediatric PBT.
  • The appeals process is resource-intensive for both patients and providers.
  • Streamlining insurance approvals for PBT could improve patient access and reduce administrative burden.