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Related Concept Videos

Pharmacokinetics in Pediatric Patients: Drug Excretion01:26

Pharmacokinetics in Pediatric Patients: Drug Excretion

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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...
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Pharmacokinetics in Pediatric Patients: Drug Distribution01:17

Pharmacokinetics in Pediatric Patients: Drug Distribution

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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,...
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Pharmacokinetics in Pediatric Patients: Drug Metabolism01:24

Pharmacokinetics in Pediatric Patients: Drug Metabolism

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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...
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Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption01:23

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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...
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Mechanical Ventilation II: Invasive Ventilation01:23

Mechanical Ventilation II: Invasive Ventilation

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Ventilators are essential medical equipment used to aid patients with respiratory difficulties. Their primary function is to assist or replace spontaneous breathing by providing mechanical ventilation. There are two general classes of mechanical ventilators: negative-pressure and positive-pressure ventilators.
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Thoracic Aorta01:15

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The thoracic section of the aorta begins at the T5 vertebra and extends to the T12 level at the diaphragm, initially progressing through the mediastinum to the left of the spinal column. Throughout its course in the thoracic segment, the thoracic aorta emits various offshoots known collectively as visceral and parietal branches. The branches that predominantly supply blood to visceral organs are termed visceral branches and include bronchial, pericardial, esophageal, and mediastinal arteries,...
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Author Spotlight: Enhancing Diagnostic Strategies and Biomarker Development for Comprehensive Lung Function Analysis
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Using 4DCT-ventilation to characterize lung function changes for pediatric patients getting thoracic radiotherapy.

Yevgeniy Vinogradskiy1, Austin Faught1, Richard Castillo2

  • 1Department of Radiation Oncology, University of Colorado School of Medicine, Aurora, CO, USA.

Journal of Applied Clinical Medical Physics
|June 27, 2018
PubMed
Summary

Four-dimensional computed tomography ventilation imaging (4DCT-ventilation) showed lung function changes in most pediatric patients after radiotherapy. This technique assesses post-treatment lung function and predicts toxicity without additional cost.

Keywords:
CT ventilationdose--response assessmentlung function imagingpediatric radiotherapy

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Area of Science:

  • Medical Imaging
  • Radiation Oncology
  • Pediatric Pulmonology

Background:

  • Four-dimensional computed tomography (4DCT) is standard for managing breathing motion in radiotherapy.
  • 4DCT-ventilation, a functional imaging technique, offers insights into lung function at no extra cost.
  • This method has not been previously described in pediatric populations.

Purpose of the Study:

  • To perform a preliminary evaluation of 4DCT-ventilation-based lung function changes in pediatric patients undergoing lung radiotherapy.
  • To assess the utility of 4DCT-ventilation in pediatric patients receiving chest radiotherapy.

Main Methods:

  • Utilized pre- and post-radiotherapy 4DCT scans from four pediatric patients.
  • Employed deformable image registration and a density-change algorithm to compute 4DCT-ventilation images.
  • Compared pre- and post-treatment 4DCT-ventilation images for global and intrapatient dose-response.

Main Results:

  • Three of four patients showed a global ventilation decline of 7-37%.
  • One patient exhibited no global functional decline.
  • Dose-response analysis revealed no consistent intrapatient response up to 20 Gy, but one patient showed decline with doses up to 50 Gy.

Conclusions:

  • This is the first study to evaluate spatial lung function changes using 4DCT-ventilation in pediatric patients.
  • Lung function changes were observed in most patients, highlighting the technique's potential.
  • Further longitudinal studies are needed to correlate imaging findings with long-term clinical toxicity.