Liquid formulation of pentoxifylline is a poorly tolerated treatment for duchenne dystrophy.

INTRODUCTION: In this study we performed an open-label, pilot study of an orally administered liquid formulation of immediate-release pentoxifylline (PTX) on patients with Duchenne muscular dystrophy (DMD). Treatment efficacy, safety, and tolerability were assessed. METHODS: The tolerability and safety of PTX and measures of muscle strength and function were evaluated during 12 months of treatment. RESULTS: Seventeen boys with DMD, between 4 and 8 years of age, were enrolled at one of five Cooperative International Neuromuscular Research Group (CINRG) centers. Only 9 were able to complete the 12-month PTX treatment phase; the primary reason for discontinuation was adverse events. Intolerable gastrointestinal side effects were experienced by 65% of participants. Two participants had severe leukopenia that resolved with medication withdrawal. CONCLUSIONS: Open-label treatment with a liquid formulation of immediate-release PTX resulted in a high incidence of adverse events in boys with DMD. Poor tolerability of this PTX formulation precluded adequate assessment of efficacy.

A systems theory approach to career decision making.

Many career development studies have linked career indecision, an inability to make a decision about the vocation one wishes to pursue, to interpersonal and intrapersonal processes. Systems theory can help to explain the processes behind these concepts in a way that other theories have not been able to explain. Systems Theory Framework, (STF, Patton and McMahon, 1997), incorporates both the contextual system, e.g., parents and peers, and the individual system (i.e., STF's content component). Process, the second component, identifies the presence of recursive interaction processes within the individual and the context, as well as, between the individual and the context. STF brings back the value of interdependence. Specific systemic constructs are useful in career decision-making and can add a practical dimension on to the counseling process.

Advances in postoperative care of pediatric cardiac patients.

PURPOSE OF REVIEW: The past two decades have seen tremendous technological advances in the care of infants and children with congenital and acquired heart disease. Recent advances in postoperative management have made it possible to support smaller and more fragile infants, extended the capabilities of extracorporeal circulation, and have brought new and innovative monitoring capabilities to the intensive care unit. RECENT FINDINGS: We chose to focus our review on four main themes: management of pulmonary hypertension, mechanical support of the myocardium, near infrared spectroscopy, and heparin-induced thrombocytopenia. SUMMARY: As operative and cardiopulmonary bypass techniques have evolved, early complete repair in neonates and repair of more complex lesions is now possible, creating new challenges for postoperative care in the intensive care unit. Additionally, recognition and management of newly appreciated complications is essential.