Verhandelingen - Koninklijke Academie voor Geneeskunde van België
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Verh. K. Acad. Geneeskd. Belg. · Jan 2005
Multicenter StudyClinical pharmacology of non opioid analgesics in neonates.
An integrated approach of neonatal analgesia starts with the systematic evaluation of pain and should be followed by effective interventions, mainly based on the appropriate (i.e. safe and effective) administration of analgesics. In contrast to the more potent opioids, data on the pharmacokinetics and -dynamics of non-opioid analgesics in this specific population are still rare or even lacking. We therefore evaluated various aspects of developmental pharmacology of non-opioid analgesics (paracetamol, ibuprofen, acetylsalicyl acid) in neonates. ⋯ Neonatal renal clearance strongly depends on glomerular filtration rate (GFR) and GFR itself strongly depends on the vaso-dilatative of prostaglandins on the afferent arterioli. We therefore evaluated the impact of the administration of ibuprofen or acetylsalicylic acid on renal clearance in preterm infants and hereby used amikacin clearance as a surrogate marker. We hereby documented the negative effect of ibuprofen on glomerular filtration rate in preterm infants up to 34 weeks and we were able to show that ibuprofen and acetylsalicylic acid had an equal impact on the glomerular filtration rate.
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The first Belgian nuclear emergency plan was drawn up in the aftermath of the Chernobyl accident and was primarily aimed at dealing with the consequences of major accidents happening in large nuclear facilities like nuclear power plants. Both the experience during a decade of nuclear emergency exercises and a changing environment with increased menace of malevolent actions by terrorists urged the modification and extension of the initial plan; The latest "Nuclear and radiological emergency plan for the Belgian territory" was published as the Royal Decree of October 17th, 2003. In contrast to what happened in other emergency situations, nuclear and radiological emergencies are, from the moment they are recognised as such and regardless of their (potential) impact, coordinated at the level of the federal authorities. ⋯ The radiological evaluation is being prepared by introducing "emergency reference levels", for which the Federal Agency for Nuclear Control is responsible. This consists in pre-defining radiation doses which "generally" to "almost invariably" call for the adoption of a given countermeasure. Finally, the nuclear and radiological emergency plan includes stipulations on the required information to the population, on the education and training of (potentially) intervening parties as well as on the minimum requirements for running nuclear emergency exercises.