Last data update: May 13, 2024. (Total: 46773 publications since 2009)
Records 1-2 (of 2 Records) |
Query Trace: Sukumar S[original query] |
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Population pharmacokinetics and pharmacodynamics of lumefantrine in young Ugandan children treated with artemether-lumefantrine for uncomplicated malaria
Tchaparian E , Sambol NC , Arinaitwe E , McCormack SA , Bigira V , Wanzira H , Muhindo M , Creek DJ , Sukumar N , Blessborn D , Tappero JW , Kakuru A , Bergqvist Y , Aweeka FT , Parikh S . J Infect Dis 2016 214 (8) 1243-51 BACKGROUND: The pharmacokinetics and pharmacodynamics of lumefantrine, a component of the most widely-used treatment for malaria, artemether-lumefantrine, has not been adequately characterized in young children. METHODS: Capillary whole blood was collected in 105 Ugandan children, ages 6 months to 2 years, treated for 249 episodes of Plasmodium falciparum malaria with artemether-lumefantrine. RESULTS: Population pharmacokinetics for lumefantrine employed a 2-compartment open model with first-order absorption. Age had a significant positive correlation with bioavailability in a model that included allometric scaling. Children not on trimethoprim-sulfamethoxazole with concentrations below 200 ng/mL had a 3-fold higher hazard of 28-day recurrent parasitemia compared to those above 200 ng/mL(p=0.0007). However, for children on trimethoprim-sulfamethoxazole, the risk of recurrent parasitemia did not differ significantly based on this threshold. Day 3 concentrations were a stronger predictor of 28-day recurrence than day 7 concentrations. CONCLUSIONS: We demonstrate that age, in addition to weight, is a determinant of lumefantrine exposure, and in the absence of TS, lumefantrine exposure is a determinant of recurrent parasitemia. Exposure in children 6 months to 2 years was generally lower than those published for older children and adults. Further refinement of artemether-lumefantrine dosing to improve exposure in infants and very young children may be warranted. |
Proceedings from the workshop on estimating the contributions of sodium reduction to preventable death
Schmidt SM , Andrews T , Bibbins-Domingo K , Burt V , Cook NR , Ezzati M , Geleijnse JM , Homer J , Joffres M , Keenan NL , Labarthe DR , Law M , Loria CM , Orenstein D , Schooley MW , Sukumar S , Hong Y . CVD Prev Control 2011 6 (2) 35-40 The primary goal of this workshop was to identify the most appropriate method to estimate the potential effect of reduction in sodium consumption on mortality. Difficulty controlling hypertension at the individual level has motivated international, federal, state, and local efforts to identify and implement population-wide strategies to better control this problem; reduction of sodium intake is one such strategy. Published estimates of the impact of sodium consumption on mortality have used different modeling approaches, effect sizes, and levels of sodium consumption, and thus their estimates of preventable deaths averted vary widely, and are not comparable. In response to this problem, the Centers for Disease Control and Prevention's Division for Heart Disease and Stroke Prevention (DHDSP) convened and facilitated a workshop to examine different methods of estimating the effect of sodium reduction on mortality. The panelists agreed that any of the methodologies presented could provide reasonable estimates, and therefore discussion focused on challenges faced by all methods. The panel concluded that future sodium modeling efforts should generate multiple estimates employing the same scenarios and effect sizes while using different modeling techniques; in addition, future efforts should include outcomes other than mortality (morbidity, costs, and quality of life). Varying reductions in sodium should be modeled at the population level over different time intervals. In an effort to better address some of the uncertainties highlighted by this workshop, the panelists are currently considering developing multiple estimates in a collaborative manner to clarify the potential impact of population-based interventions to reduce sodium consumption. |
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