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J Laver

Publications and source records attributed to J Laver.

61 records · Page 4Linked to original sources

Comparison of serum theophylline levels in asthmatic children receiving sustained-release and rapid-release theophylline tablets.

Serum theophylline levels were compared after the administration of a sustained-release (Theo-Dur, Key Pharmaceuticals, USA) vs. a rapid-release (Glyphyllin, Ikapharm, Israel) theophylline preparation to 24 children suffering from chronic bronchial asthma. They received each of the two drugs for a 5-d period, and serum theophylline levels were determined on the 6th d. Therapeutic serum levels were achieved in 66.6 and 75% of the patients receiving sustained-release and rapid-release theophylline preparations, respectively. The peak-trough difference for the rapid-release drug was higher than that of the sustained-release preparations (5.5 +/- 2.6 micrograms/ml vs. 2.6 +/- 2.3 micrograms/ml). Both drugs caused nearly the same low percentage of side effects (15 and 16.6%). A noncompliance rate of 16.6% was found with the rapid-release drug, and all the parents preferred the sustained-release drug is preferable for chronic treatment of children with bronchial asthma, as it maintains more stable serum theophylline levels and has a higher compliance rate.

Adolescent↗

Growth factor practice patterns among pediatric oncologists: results of a 1998 Pediatric Oncology Group Survey. Economic Evaluation Working Group the Pediatric Oncology Group.

The American Society of Clinical Oncology (ASCO) guidelines on growth factor (GF) use recommend applying adult-derived guidelines in pediatric oncology. An ASCO survey of adult oncology GF use determined the preference for first degree prophylaxis (use of GF when febrile neutropenia [FN] is expected to be high in untreated patients), second-degree prophylaxis (administration of GF after a documented episode of FN on a previous cycle of chemotherapy), and intervention in the treatment of FN. Similar preferences have not been evaluated in pediatrics. The purpose of this study was to (1) characterize GF use in pediatric oncology; (2) correlate use patterns with demographic factors; and (3) compare the Pediatric Oncology Group (POG) and ASCO surveys. The ASCO survey was revised for use within pediatric oncology and was mailed to the physician membership of POG; 341 were returned (86% completion rate). Comparisons were made with the ASCO survey. Most (76%) physicians said GF use was determined by protocol requirements and most (70%) patients were entered on POG protocols. GF use as first-degree prophylaxis was selected 40% of the time, which was significantly greater than in adults; this was most influenced by anticipated duration of neutropenia (> or =7 days). The severity of the initial clinical course (e.g., neutropenia, infection) influenced use in second-degree prophylaxis; dose reduction alone was never selected. For FN, GF use was 45%, with lower preferences in uncomplicated FN (16%-38%) compared with complicated FN (66%). POG respondents endorse greater use of GF for first-and second-degree prophylaxis but less use in uncomplicated FN than do ASCO respondents. These patterns may reflect different strategies, including the role of chemotherapy, value of dose intensity, and perceived toxicity of regimens. Given these differences, adult-based guidelines may not be appropriate for pediatrics.

Age Factors↗

T-cell lymphoma in a child after heart transplantation.

Lymphoproliferative disease remains a small but worrisome problem after organ transplantation. This disorder is often a B-cell proliferation associated with Epstein-Barr virus. This article describes the unusual association of Epstein-Barr virus with a T-cell lymphoma in a child after heart transplantation and ultimately an atypical rejection episode with an increased number of eosinophils.

Child↗