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  • Author: L. Kovács x
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Off-label drug use among hospitalized children: identifying extent and nature

Objective of the study was to determine the extent and nature of medicinal products used off-label in hospitalized children and to highlight the therapeutic areas with the highest need. Over a 4 week period, data about prescribed drugs to patients under 18 years of age at two paediatric wards in Bratislava (Unit for Infants and Unit for Older Children) were recorded and the drug-licensing status according to valid Summary of Product Characteristics (SPC) was identified. In total, 206 medicinal products containing 70 different generic substances were given to 49 paediatric patients at the Unit for Infants. Of these, 22% were evaluated as off-label. The highest rates were established among the drugs used for diseases of respiratory system and diseases of digestive system. The 68 children had been given at the Unit for Older Children 267 medicinal products resulting in 97 generic substances. In 15.7% of cases medicines were used in off-label manner, mainly due to unapproved paediatric indication and age. This pilot study provided a preliminary survey on drugs administered off-label to paediatric patients in Slovak Republic.

The paper briefly describes the role of Orphanet as an informational and educational source for rare diseases. Most attention is given to the Centres of Expertise and European Reference Networks. The authors suggest an easy procedure how to get the basic data about the readiness of the clinics to be recognised for Centres of Expertise at the national level. EUCERD recommendations on quality criteria for centres of expertise are introduced. The coordinators of the potential Centres of Expertise should be contacted and asked to fill in the questionnaire designed to check whether the centre matches the EUCERD recommendations or not. In order for the process to be transparent, the selection criteria of expert resources are listed on national website (www.orphanet.sk).

The analysis of the questionnaires has to be carried out at the national level, to map the basic data about the current status. One questionnaire per department or clinic shall be filled in order to allow the evaluation. Clinics will be divided in two groups the ones which achieved the threshold and could be recognised as Centres of Expertise at the National level and the ones which need to be further monitored to reach the threshold.

Abstract

The article deals with the research of operational reliability of forest felling machines with the method FMEA (Failure Mode and Effect Analysis) and its implementation for observed machines in the organization. Forwarders 810D by John Deere were chosen for this research. The research was realized in real operational conditions. Application of the FMEA method allows flexibility in case of unexpected situations and optimization of human potential abilities. FMEA tool is a tool preventing outages operational reliability and preventive tool for ensuring the maintenance of facilities. This paper explores and verifies the operational reliability theory in practical real-world conditions, resulting in a reduction in operating (variable) costs, minimization of failures and readiness and increased performance of observed machines.

Abstract

Understanding the quality of intact rock is one of the most important parts of any engineering projects in the field of rock mechanics. The expression of correlations between the engineering properties of intact rock has always been the scope of experimental research, driven by the need to depict the actual behaviour of rock and to calculate most accurately the design parameters. To determine the behaviour of intact rock, the value of important mechanical parameters such as Young’s modulus (E), Poisson’s ratio (ν) and the strength of rock (σcd) was calculated. Recently, for modelling the behaviour of intact rock, the crack initiation stress (σci) is another important parameter, together with the strain (σ). The ratio of Young’s modulus and the strength of rock is the modulus ratio (M R), which can be used for calculations. These parameters are extensively used in rock engineering when the deformation of different structural elements of underground storage, caverns, tunnels or mining opening must be computed. The objective of this paper is to investigate the relationship between these parameters for Hungarian granitic rock samples. To achieve this goal, the modulus ratio (M R = Ec) of 50 granitic rocks collected from Bátaapáti radioactive waste repository was examined. Fifty high-precision uniaxial compressive tests were conducted on strong (σc >100 MPa) rock samples, exhibiting the wide range of elastic modulus (E = 57.425–88.937 GPa), uniaxial compressive strength (σc = 133.34–213.04 MPa) and Poisson’s ratio (ν = 0.18–0.32). The observed value (M R = 326–597) and mean value of M R = 439.4 are compared with the results of similar previous researches. Moreover, the statistical analysis for all studied rocks was performed and the relationshipbetween M R and other mechanical parameters such as maximum axial strain (εa,max)for studied rocks was discussed.

Abstract

We present the case of a 65 years old patient, initially hospitalized at Regional Pneumology Clinic with marked fatigue, severe pulmonary symptoms (suddenly developed severe resting dyspnea, orthopnea, irritating cough), loss of appetite, weight loss and dysphagia. Chest radiography raises the suspicion of giant ascending aortic aneurysm. Echocardiography confirms the presence of the aneurysm, but CT scan with contrast and angiography showed a giant pseudoaneurysm of ascending aorta with severe local compression of the right lung hilum and right main bronchus and in posterior on the esophagus. Coronary angiography also shows significant compression and deformation of the left main coronary artery. Echocardiography reveals marked dilated ascending aorta in the suprabulbar portion without aortic insufficiency. Replacement of the ascending aorta was performed in extracorporeal circulation with a impregnated Dacron prosthesis. Because of technically difficult approach, the ascending aorta ( being the right anterolateral wall of the pseudoaneurysm) was incanculated via right axillary artery, the aortic crossclamp was performed initially transluminal with Foley catheter and later with classical metallic instruments, and myocardial protection was achieved initially by retrograde administration of cardioplegic solution with monitoring of lactic acid, pH and base excess simultaneous from coronary sinus and the coronary ostia during administration of cardioplegic solution. The postoperative evolution was favorable, the weaning from extracorporeal circulation was succeeded without inotropics, with a 48 hours length of stay in ICU, and the patient was discharged after 8 days postoperatively.

Abstract

Neurofibromatosis type 1 (NF1) is one of the most common autosomal dominant disorders with mainly mild cutaneous manifestations. Some patients with NF1, however, develop severe complications such as progressive optic pathway glioma, plexiform neurofibroma or malignant peripheral nerve sheath tumour. Due to potentially progressive and asymptomatic course of the disease, patients with NF1 require a regular multidisciplinary follow-up in coordination with various specialties and early intervention. In this article, we summarise our long-term experience with multidisciplinary follow-up of NF1 patients in the Centre for Neurofibromatosis Type 1 patients at the Children's University Hospital in Bratislava.

Abstract

In this paper authors present the results of identification of emission and capture processes in tandem solar cell structures based on quaternary InGaAsN semiconductor alloys by DLTFS (Deep Level Transient Fourier Spectroscopy) and by ana- lytical evaluation processes. The energies of five trap levels ET1=0.77 eV, ET2=0.47 eV, ET3=0.64 eV, HT1=0.62 eV and HT2=0.53 eV were identified with reliable accuracy. These values were obtained by available analytical procedures, verified by simulations and confirmed by reference structures with basic layer types and compared with possible reference trap data. Native structural defects in GaAs were stated as the origin of these deep energy levels