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A total of 28 adolescents aged 12 to 17 years with severe asthma were enrolled in the Phase 3 asthma trials. Of the 19 adolescents who received mepolizumab, 9 received 100 mg and the mean apparent clearance in these subjects was 35% less than that of adults. The safety profile observed in adolescents was generally similar to that of the overall population in the Phase 3 studies [see Adverse Reactions (6. Enrollment criteria were the same as for adolescents in the 32-week exacerbation trial (Trial 2). The safety profile and pharmacodynamic response observed in this trial for children aged 6 to 11 years were similar to that seen in adults and adolescents [see Adverse Reactions (6. The safety and efficacy in pediatric patients aged younger than 6 years with severe asthma have not been established. If overdose occurs, the patient should be treated supportively with appropriate monitoring as necessary. It is supplied in a single-dose, 1-mL, prefilled autoinjector with a fixed 29-gauge, half-inch needle or in a single-dose, 1-mL, prefilled syringe with a fixed 29-gauge, half-inch needle with a needle guard. The prefilled autoinjector and prefilled syringe are not made with natural rubber latex. Subjects received 1 of 4 mepolizumab treatments (administered every 28 days for a total of 3 doses): 12. Compared with baseline levels, blood eosinophils decreased in a dose-dependent manner. A reduction in blood eosinophil levels was observed in all treatment groups by Day 3 (48 hours post-dose). On Day 84 (4 weeks post-last dose), the observed geometric mean reduction from baseline in blood eosinophils was 64%, 78%, 84%, and 90% in the 12. The pharmacodynamic response (blood eosinophil reduction) was also evaluated in children aged 6 to 11 years with severe asthma. The magnitude of reduction in adults, adolescents, and children was observed within 4 weeks of treatment and was maintained throughout the treatment periods. There was a geometric mean reduction of 83% compared with placebo and this magnitude of reduction was observed within 4 weeks of treatment [see Clinical Studies (14. Distribution the population central volume of distribution of mepolizumab in adult subjects with asthma is estimated to be 3. Metabolism Mepolizumab is a humanized IgG1 monoclonal antibody that is degraded by proteolytic enzymes widely distributed in the body and not restricted to hepatic tissue. The population apparent systemic clearance of mepolizumab in adult and adolescent subjects with asthma is estimated to be 0. Specific Populations Racial Groups and Male and Female Patients: Population pharmacokinetics analyses indicated there was no significant effect of race and gender on mepolizumab clearance.

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Dantrolene is a drug that interferes with calcium release from the sarcoplasmic reticulum and will put an end to the metabolic abnormality. Because rhabdomyolysis, which may result in acute renal failure, is very common in this disorder, treatment with hydration, bicarbonate to alkalinize the urine followed by diuresis induced by mannitol is also recommended. When exposed to a triggering anesthetic, susceptible patients have the uncontrolled release of calcium from their sarcoplasmic reticulum. This torrential release of calcium results in a marked increase in skeletal muscle metabolism and heat production. Once the episode has resolved and the patient has recovered, it is suggested that the patient and his first-degree relatives be evaluated for this diagnosis. Abnormal augmentation of muscle contraction following treatment of the biopsy specimen with halothane or caffeine is diagnostic. Ecstasy is a methamphetamine derivative that significantly impacts the physiology of the human nervous system by alterations in serotonin metabolism. Each of these conditions can be associated with multisystem complications, and each can result in death. Additionally, the patient must have at least 3 of the following: mental status changes, agitation, myoclonus, muscle rigidity, hyperreflexia, diaphoresis, shivering or tremor, diarrhea, incoordination, and fever. Blockade of dopamine receptors within the basal ganglia is believed to precipitate symptoms. The most commonly implicated are neuroleptic agents such as haloperidol, the withdrawal of dopamine agonists (eg, Ldopa), other antipsychotic agents such as chlorpromazine and fluphenazine, and the narcotic agonist meperidine. It also may be appropriate to consider the administration of an anti-serotonin medication. Both propranolol and cyproheptadine block serotonin activity at the postsynaptic receptor. It is possible that these drugs may be useful, but their benefit is supported only by case reports. Although all of these syndromes pose a threat to life, the mortality of each should be well under 20% when appropriately treated. The key to successful intervention in life-threatening drug-induced hyperthermia is the prompt recognition and elimination of the drug that might have triggered such a response and careful supportive care. She snores and her mother allows her to sleep with her so she can ?listen to her breathe. She is the youngest of 5 siblings, and none of her other children breathes as this child does.

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Most children had limitations in their activities of daily living and had visited the emergency department. La periostina es un biomarcador de asma grave en adultos, pero su papel en ninos es pobremente conocido. Material y metodos: Estudio observacional en ninos de 5 a 14 anos de edad con asma mal controlada. La mayoria de los ninos tenian limitaciones en las actividades de la vida diaria, visitas a urgencias y el 38% habian necesitado ingreso hospitalario. Asthma is At least 1 of the following more a syndrome than a disease, exhibiting considerable heterogeneity in its presentation and clinical course [1]. The level of asthma control is the extent to which the In recent years, studies on the role of periostin in asthma manifestations of asthma can be observed in the patient or have been published. Periostin is a cell matrix protein that was have been reduced/eliminated by treatment. It is secreted by bronchial fbroblasts and epithelial underlying disease processes, current treatment, environment, cells, acts as an immunomodulator, repairs connective tissue, and psychosocial factors. Periostin binds to integrins management of symptoms and the future risk of adverse present on the surface of fbroblasts and epithelial cells. Asthma severity main function is to maintain tissue structure by binding to is assessed retrospectively based on the level of treatment fbronectin, tenascin C, and collagen V. Serum periostin levels exhibit very low for several months and, if appropriate, step down has been variability and high reproducibility [16]. Asthma severity is not a static feature and may infammation [17] and of the T 2 mechanism underlying H change over months or years. This term encompasses Very few studies have been published in relation to other forms such as difcult-to-control asthma, treatment periostin levels in children, although levels are known to be refractory asthma, and difcult-to-treat asthma. Patients with higher in children than in adults owing to the cell turnover that uncontrolled asthma may be difcult to manage owing to occurs during growth [15]. They may also have refractory asthma, in which asthma of difering severity and to analyze associated factors, the response to treatment of comorbidities is incomplete [9 especially serum periostin. The result of Inclusion criteria Exclusion criteria the skin prick test with aeroallergens and food allergens was considered positive when wheals were larger than 3 mm and Diagnosis of uncontrolled Serious cardiopulmonary specifc IgE was >0. The study population comprised Diagnosis was based on the medical history and the results children aged 5 to 14 years with uncontrolled asthma according of additional tests. Statistical Analysis All parents or legal representatives and all children over 12 years gave their informed consent. The nonparametric Wilcoxon, Mann-Whitney, and Kruskal-Wallis diagnosis was made after the second visit and after proper tests were used for comparison of numerical variables. Results Allergy test results and the comparison between biomarkers are shown in Table 5. Psychological disturbances were recorded in half of age (838 ng/mL for children aged 5-7 years, 961 ng/mL for the families, mainly anxiety and depression in the mother. Most of the children had comorbidities Based on clinical practice guidelines, only 42% of the (96% rhinitis, 62% atopic dermatitis, and 32% food allergy).

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