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  1. Article ; Online: Procalcitonin in Pediatric Sepsis: What Is It Good for?

    Downes, Kevin J

    Journal of the Pediatric Infectious Diseases Society

    2021  Volume 10, Issue 12, Page(s) 1108–1110

    MeSH term(s) Calcitonin ; Child ; Humans ; Procalcitonin ; Sepsis/diagnosis
    Chemical Substances Procalcitonin ; Calcitonin (9007-12-9)
    Language English
    Publishing date 2021-07-30
    Publishing country England
    Document type Journal Article
    ZDB-ID 2668791-4
    ISSN 2048-7207 ; 2048-7193
    ISSN (online) 2048-7207
    ISSN 2048-7193
    DOI 10.1093/jpids/piab066
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Current and Emerging Antiviral Agents in the Prevention and Treatment of Cytomegalovirus in Pediatric Transplant Recipients.

    Valencia Deray, Kristen G / Danziger-Isakov, Lara A / Downes, Kevin J

    Journal of the Pediatric Infectious Diseases Society

    2024  Volume 13, Issue Supplement_1, Page(s) S14–S21

    Abstract: Despite current prophylaxis regimens, cytomegalovirus (CMV) is common in hematopoietic cell transplantation (HCT) and solid organ transplantation (SOT) and remains a significant cause of morbidity and mortality. Newer antiviral medications are reshaping ... ...

    Abstract Despite current prophylaxis regimens, cytomegalovirus (CMV) is common in hematopoietic cell transplantation (HCT) and solid organ transplantation (SOT) and remains a significant cause of morbidity and mortality. Newer antiviral medications are reshaping the landscape for prevention and treatment of CMV DNAemia, infection, and disease. Letermovir is approved for CMV prevention in adult HCT patients and is attractive due to the absence of marrow suppression seen with ganciclovir/valganciclovir. Letermovir should not be routinely used for CMV treatment due to its low threshold for resistance. Maribavir is approved for the treatment of refractory or resistant CMV disease in HCT and SOT recipients ≥12 years of age, though it has no current role in CMV prevention. More research is needed to fully elucidate the roles, efficacy, and safety of these newer agents in prevention and treatment of CMV in pediatric transplant recipients.
    MeSH term(s) Adult ; Humans ; Child ; Cytomegalovirus ; Antiviral Agents/therapeutic use ; Transplant Recipients ; Cytomegalovirus Infections/drug therapy ; Cytomegalovirus Infections/prevention & control ; Hematopoietic Stem Cell Transplantation/adverse effects ; Acetates ; Quinazolines
    Chemical Substances letermovir (1H09Y5WO1F) ; Antiviral Agents ; Acetates ; Quinazolines
    Language English
    Publishing date 2024-02-28
    Publishing country England
    Document type Journal Article
    ZDB-ID 2668791-4
    ISSN 2048-7207 ; 2048-7193
    ISSN (online) 2048-7207
    ISSN 2048-7193
    DOI 10.1093/jpids/piad059
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Continuous-Infusion Vancomycin-Teaching an Old Dog New Tricks?

    Downes, Kevin J

    Journal of the Pediatric Infectious Diseases Society

    2018  Volume 7, Issue 3, Page(s) e128–e130

    MeSH term(s) Anti-Bacterial Agents/administration & dosage ; Anti-Bacterial Agents/adverse effects ; Child ; Drug Therapy, Combination/adverse effects ; Humans ; Infusions, Intravenous/methods ; Vancomycin/administration & dosage ; Vancomycin/adverse effects
    Chemical Substances Anti-Bacterial Agents ; Vancomycin (6Q205EH1VU)
    Language English
    Publishing date 2018-06-15
    Publishing country England
    Document type Journal Article
    ZDB-ID 2668791-4
    ISSN 2048-7207 ; 2048-7193
    ISSN (online) 2048-7207
    ISSN 2048-7193
    DOI 10.1093/jpids/piy052
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  4. Article ; Online: Too Much of a Good Thing: Defining Antimicrobial Therapeutic Targets to Minimize Toxicity.

    Downes, Kevin J / Goldman, Jennifer L

    Clinical pharmacology and therapeutics

    2021  Volume 109, Issue 4, Page(s) 905–917

    Abstract: Antimicrobials are a common cause of drug toxicity. Understanding the relationship between systemic antimicrobial exposure and toxicity is necessary to enable providers to take a proactive approach to prevent undesired drug effects. When an exposure ... ...

    Abstract Antimicrobials are a common cause of drug toxicity. Understanding the relationship between systemic antimicrobial exposure and toxicity is necessary to enable providers to take a proactive approach to prevent undesired drug effects. When an exposure threshold has been defined that predicts drug toxicity, therapeutic drug monitoring (TDM) can be performed to assure drug exposure does not exceed the defined threshold. Although some antimicrobials have well-defined dose-dependent toxicities, many other exposure-toxicity relationships have either not been well-defined or, in some cases, not been evaluated at all. In this review, we examine the relationship between exposures and toxicities for antibiotic, antifungal, and antiviral agents. Furthermore, we classify these relationships into four categories: known association between drug exposure and toxicity such that clinical implementation of a specific exposure threshold associated with toxicity for TDM is supported (category 1), known association between drug exposure and toxicity but the specific exposure threshold associated with toxicity is undefined (category 2), association between drug exposure and toxicity has been suggested but relationship is poorly defined (category 3), and no known association between drug exposure and toxicity (category 4). Further work to define exposure-toxicity thresholds and integrate effective TDM strategies has the potential to minimize many of the observed antimicrobial toxicities.
    MeSH term(s) Anti-Infective Agents/adverse effects ; Anti-Infective Agents/pharmacokinetics ; Anti-Infective Agents/pharmacology ; Anti-Infective Agents/therapeutic use ; Area Under Curve ; Dose-Response Relationship, Drug ; Drug Monitoring/methods ; Drug Monitoring/standards ; Drug-Related Side Effects and Adverse Reactions/prevention & control ; Humans ; Microbiological Techniques
    Chemical Substances Anti-Infective Agents
    Language English
    Publishing date 2021-02-27
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Systematic Review
    ZDB-ID 123793-7
    ISSN 1532-6535 ; 0009-9236
    ISSN (online) 1532-6535
    ISSN 0009-9236
    DOI 10.1002/cpt.2190
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 20: Show issues Location:
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    Jg. 1995 - 2021: Lesesall (1.OG)
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  5. Article ; Online: Rapid readout of terahertz orbital angular momentum beams using atom-based imaging.

    Downes, Lucy A / Whiting, Daniel J / Adams, C Stuart / Weatherill, Kevin J

    Optics letters

    2023  Volume 47, Issue 22, Page(s) 6001–6004

    Abstract: We demonstrate the rapid readout of terahertz orbital angular momentum (OAM) beams using an atomic-vapor-based imaging technique. OAM modes with both azimuthal and radial indices are created using phase-only transmission plates. The beams undergo ... ...

    Abstract We demonstrate the rapid readout of terahertz orbital angular momentum (OAM) beams using an atomic-vapor-based imaging technique. OAM modes with both azimuthal and radial indices are created using phase-only transmission plates. The beams undergo terahertz-to-optical conversion in an atomic vapor, before being imaged in the far field using an optical CCD camera. In addition to the spatial intensity profile, we also observe the self-interferogram of the beams by imaging through a tilted lens, allowing the sign and magnitude of the azimuthal index to be read out directly. Using this technique, we can reliably read out the OAM mode of low-intensity beams with high fidelity in 10 ms. Such a demonstration is expected to have far-reaching consequences for proposed applications of terahertz OAM beams in communications and microscopy.
    Language English
    Publishing date 2023-05-23
    Publishing country United States
    Document type Journal Article
    ISSN 1539-4794
    ISSN (online) 1539-4794
    DOI 10.1364/OL.476945
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  6. Article: Optimizing Vancomycin Therapy in Critically Ill Children: A Population Pharmacokinetics Study to Inform Vancomycin Area under the Curve Estimation Using Novel Biomarkers.

    Downes, Kevin J / Zuppa, Athena F / Sharova, Anna / Neely, Michael N

    Pharmaceutics

    2023  Volume 15, Issue 5

    Abstract: Area under the curve (AUC)-directed vancomycin therapy is recommended, but Bayesian AUC estimation in critically ill children is difficult due to inadequate methods for estimating kidney function. We prospectively enrolled 50 critically ill children ... ...

    Abstract Area under the curve (AUC)-directed vancomycin therapy is recommended, but Bayesian AUC estimation in critically ill children is difficult due to inadequate methods for estimating kidney function. We prospectively enrolled 50 critically ill children receiving IV vancomycin for suspected infection and divided them into model training (n = 30) and testing (n = 20) groups. We performed nonparametric population PK modeling in the training group using Pmetrics, evaluating novel urinary and plasma kidney biomarkers as covariates on vancomycin clearance. In this group, a two-compartment model best described the data. During covariate testing, cystatin C-based estimated glomerular filtration rate (eGFR) and urinary neutrophil gelatinase-associated lipocalin (NGAL; full model) improved model likelihood when included as covariates on clearance. We then used multiple-model optimization to define the optimal sampling times to estimate AUC
    Language English
    Publishing date 2023-04-25
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2527217-2
    ISSN 1999-4923
    ISSN 1999-4923
    DOI 10.3390/pharmaceutics15051336
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  7. Article ; Online: A practical guide to terahertz imaging using thermal atomic vapour

    Lucy A Downes / Lara Torralbo-Campo / Kevin J Weatherill

    New Journal of Physics, Vol 25, Iss 3, p

    2023  Volume 035002

    Abstract: This tutorial aims to provide details on the underlying principles and methodologies of atom-based terahertz imaging techniques. Terahertz imaging is a growing field of research which can provide complementary information to techniques using other ... ...

    Abstract This tutorial aims to provide details on the underlying principles and methodologies of atom-based terahertz imaging techniques. Terahertz imaging is a growing field of research which can provide complementary information to techniques using other regions of the electromagnetic spectrum. Unlike infrared, visible and ultraviolet radiation, terahertz passes through many everyday materials, such as plastics, cloth and card. Compared with images formed using lower frequencies, terahertz images have superior spatial resolution due to the shorter wavelength, while compared to x-rays and gamma rays, terahertz radiation is non-ionising and safe to use. The tutorial begins with the basic principles of terahertz to optical conversion in alkali atoms before discussing how to construct a model to predict the fluorescent spectra of the atoms, on which the imaging method depends. We discuss the practical aspects of constructing an imaging system, including the subsystem specifications. We then review the typical characteristics of the imaging system including spatial resolution, sensitivity and bandwidth. We conclude with a brief discussion of some potential applications.
    Keywords atomic ; vapour ; terahertz ; imaging ; Rydberg ; Science ; Q ; Physics ; QC1-999
    Subject code 535
    Language English
    Publishing date 2023-01-01T00:00:00Z
    Publisher IOP Publishing
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  8. Article ; Online: Association of delivery risk phenotype with early-onset sepsis in preterm infants.

    Coggins, Sarah A / Mukhopadhyay, Sagori / Triebwasser, Jourdan / Downes, Kevin J / Christie, Jason D / Puopolo, Karen M

    Journal of perinatology : official journal of the California Perinatal Association

    2023  Volume 43, Issue 9, Page(s) 1166–1172

    Abstract: Objective: To determine delivery risk phenotype-specific incidence of early-onset sepsis (EOS) among preterm infants.: Study design: Retrospective cohort study of infants born <35 weeks' gestation at four perinatal centers during 2017-2021. Infants ... ...

    Abstract Objective: To determine delivery risk phenotype-specific incidence of early-onset sepsis (EOS) among preterm infants.
    Study design: Retrospective cohort study of infants born <35 weeks' gestation at four perinatal centers during 2017-2021. Infants were classified into one of six delivery risk phenotypes incorporating delivery mode, presence of labor, and duration of rupture of membranes (ROM). The primary outcome was EOS incidence within the overall cohort and each risk phenotype.
    Results: Among 2937 preterm infants, 21 had EOS (0.7%, or 7.1 cases/1000 preterm infants). The majority of EOS cases (13/21, 62%) occurred in the setting of prolonged ROM ≥ 18 h, with a phenotype incidence of 23.8 cases/1000 preterm infants. There were no EOS cases among infants born by cesarean section without ROM (with or without labor), nor via cesarean section with ROM < 18 h without labor.
    Conclusion: Delivery risk phenotyping may inform EOS risk stratification in preterm infants.
    MeSH term(s) Infant ; Infant, Newborn ; Humans ; Pregnancy ; Female ; Infant, Premature ; Cesarean Section ; Retrospective Studies ; Sepsis/epidemiology ; Gestational Age ; Fetal Membranes, Premature Rupture/epidemiology
    Language English
    Publishing date 2023-08-05
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, N.I.H., Extramural
    ZDB-ID 645021-0
    ISSN 1476-5543 ; 0743-8346
    ISSN (online) 1476-5543
    ISSN 0743-8346
    DOI 10.1038/s41372-023-01743-z
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 2412: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
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  9. Article ; Online: Incidence of Antimicrobial-Associated Acute Kidney Injury in Children: A Structured Review.

    Joerger, Torsten / Hayes, Molly / Stinson, Connor / Mikhail, Ibram / Downes, Kevin J

    Paediatric drugs

    2023  Volume 26, Issue 1, Page(s) 59–70

    Abstract: Acute kidney injury (AKI) is a commonly reported adverse effect of administration of antimicrobials. While AKI can be associated with poorer outcomes, there is little information available to understand rates of AKI in children exposed to various ... ...

    Abstract Acute kidney injury (AKI) is a commonly reported adverse effect of administration of antimicrobials. While AKI can be associated with poorer outcomes, there is little information available to understand rates of AKI in children exposed to various antimicrobials. We performed a structured review using the PubMed and Embase databases. Articles were included if they provided an AKI definition in patients who were < 19 years of age receiving an antimicrobial and reported the frequency of AKI. Author-defined AKI rates were calculated for each study and mean pooled estimates for each antimicrobial were derived from among all study participants. Pooled estimates were also derived for those studies that reported AKI according to pRIFLE (pediatric risk, injury, failure, loss, end stage criteria), AKIN (acute kidney injury network), or KDIGO (kidney disease improving global outcomes) creatinine criteria. A total of 122 studies evaluating 28 antimicrobials met the inclusion criteria. Vancomycin was the most commonly studied drug: 11,514 courses across 44 included studies. Among the 27,285 antimicrobial exposures, the overall AKI rate was 13.2% (range 0-42.1% by drug), but the rate of AKI varied widely across studies (range 0-68.8%). Cidofovir (42.1%) and conventional amphotericin B (37.0%) had the highest pooled rates of author-defined AKI. Eighty-one studies used pRIFLE, AKIN, or KDIGO AKI criteria and the pooled rates of AKI were similar to author-defined AKI rates. In conclusion, antimicrobial-associated AKI is reported to occur frequently in children, but the rates of AKI varies widely across studies and drugs. Most published studies examined hospitalized patients and heterogeneity in study populations and in author definitions of AKI are barriers to a comparison of nephrotoxicity risk among antimicrobials in children.
    MeSH term(s) Child ; Humans ; Incidence ; Retrospective Studies ; Acute Kidney Injury/chemically induced ; Acute Kidney Injury/epidemiology ; Creatinine ; Anti-Infective Agents ; Risk Factors
    Chemical Substances Creatinine (AYI8EX34EU) ; Anti-Infective Agents
    Language English
    Publishing date 2023-12-13
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 1492748-2
    ISSN 1179-2019 ; 1174-5878
    ISSN (online) 1179-2019
    ISSN 1174-5878
    DOI 10.1007/s40272-023-00607-5
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: From Dose to Exposure: Shifting the Paradigm of Pediatric Clinical Pharmacology Research and Education.

    Morales Junior, Ronaldo / Amajor, Victor / Paice, Kelli / Kyler, Kathryn E / Hambrick, H Rhodes / Pavia, Kathryn E / Haynes, Andrew S / Gooden, Felicia / Pais, Gwendolyn M / Downes, Kevin J / Ramsey, Laura B / Wagner, Jonathan / Tang Girdwood, Sonya

    Clinical pharmacology and therapeutics

    2024  

    Language English
    Publishing date 2024-04-30
    Publishing country United States
    Document type Journal Article
    ZDB-ID 123793-7
    ISSN 1532-6535 ; 0009-9236
    ISSN (online) 1532-6535
    ISSN 0009-9236
    DOI 10.1002/cpt.3281
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    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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