Search Results (3)

Childhood-onset lupus nephritis (cLN) should no longer be framed as a smaller version of adult lupus nephritis. It is a high-stakes pediatric kidney disease in which immune injury, treatment toxicity, growth, puberty, fertility, adherence, and transition to adult care intersect over decades. Approximately 10–20% of systemic lupus erythematosus begins in childhood, and 40–60% of affected children develop lupus nephritis. Regional cohorts report even higher renal involvement in some populations, including 65–73% among Saudi children with SLE. Contemporary guidance has moved from prolonged high-dose glucocorticoids and cyclophosphamide-dominant treatment toward biopsy-driven, treat-to-target care built around mycophenolic acid analogues, hydroxychloroquine, nephroprotection, rapid steroid tapering, and selected belimumab- or calcineurin-inhibitor-based triple therapy. This Viewpoint argues that the central question in cLN is no longer simply how to induce remission, but how to produce a durable kidney response early enough, with sufficiently low cumulative toxicity, to preserve kidney function and childhood development. Pediatric practice must therefore combine adult trial evidence with child-specific caution, explicit adherence strategies, fertility and growth protection, and structured transition planning. The aim should be efficacy without toxicity: not undertreatment, but intelligent, sustainable, developmentally informed treatment. Full article

Objectives: We aimed to investigate the short-term effects of preoperative postauricular glucocorticoid (GC) injection on electrode impedance in cochlear implant (CI) recipients. Methods: A total of 69 participants were enrolled: 44 children (<18 years) and 25 adults (18–85 years). Using a pre-specified non-randomized alternating assignment strategy, they were respectively assigned to either the treatment group (preoperative postauricular methylprednisolone injection and intraoperative intratympanic betamethasone) or the control group (intraoperative intratympanic betamethasone alone). Electrode impedance was measured intraoperatively and at 1, 3, and 6 months postoperatively. Owing to the use of different implant systems in pediatric and adult patients, the two cohorts were analyzed separately. Longitudinal impedance data across cochlear turns (apex, middle, base) were analyzed using linear mixed-effects models adjusted for baseline values. This study was registered on Chictr.org.cn (ChiCTR2400081024). Results: In the pediatric cohort, a significant interaction between group and time was observed (F = 8.34, p < 0.001); however, post hoc analyses did not demonstrate statistically significant differences between groups at individual postoperative time points (all p > 0.05). In the adult cohort, a significant interaction between group and turn was identified (F = 3.07, p = 0.049); post hoc analysis demonstrated statistically significant differences in impedance in the middle turn between groups (intervention effect = 1.355 kΩ; 95% CI, 0.115 to 2.596; p = 0.033). Conclusions: Preoperative postauricular GC administration, when combined with intraoperative intratympanic steroid therapy, may be associated with differences in postoperative electrode impedance dynamics and the electrode–tissue interface. Full article

Background: Pharmaceutical compounding remains a predominantly manual process with limited innovation, particularly in non-sterile applications. This study explores the implementation of an automated compounding platform based on 3D printing to enhance precision, efficiency, and adaptability in pediatric corticosteroid formulations. Methods: Personalized hydrocortisone dosage forms were prepared in a hospital pharmacy setting using a proprietary excipient base and standardized procedures, including automated dosing and syringe heating when required. Three dosage forms—3.2 mg gel tablets, 2.8 mg water-free troches, and 1.2 mg orodispersible films (ODFs)—were selected to demonstrate the platform’s versatility and to address pediatric needs for varying strengths and dosage types. All products were prepared using a reproducible semi-solid extrusion (SSE)-based workflow with the consistent API-excipient blending and automated deposition. Results: Analytical testing confirmed that all formulations met pharmacopeial criteria for mass and content uniformity. The ODF and troche forms achieved rapid drug release, exceeding 75% within 5 min, while the gel tablet showed a slower release profile, reaching 86% by 60 min. Additionally, in-process homogeneity testing across syringe printing cycles confirmed the consistent API distribution. Conclusions: The results support the feasibility of integrating automated compounding technologies into pharmacy workflows. Such systems can improve accuracy, minimize variability, and streamline the production of customized pediatric medications, particularly for drugs with poor palatability or narrow therapeutic windows. Overall, this study highlights the potential of automation to modernize non-sterile compounding, and to better support individualized therapy. Full article