Case of chest-wall rigidity in a preterm infant caused by prenatal fentanyl administration

The inability to appropriately ventilate neonates shortly after their birth could be related in rare cases to chest-wall rigidity caused by the placental transfer of fentanyl. Although this adverse effect is recognized when fentanyl is administered to neonates after their birth, the prenatal phenomenon is less known. Treatment with either naloxone or muscle relaxants reverses the fentanyl effect and may prevent unnecessary excessive ventilatory settings

Wall Crossing and Instantons in Compactified Gauge Theory

We calculate the leading weak-coupling instanton contribution to the moduli-space metric of N=2 supersymmetric Yang-Mills theory with gauge group SU(2) compactified on R^3 x S^1. The results are in precise agreement with the semiclassical expansion of the exact metric recently conjectured by Gaiotto, Moore and Neitzke based on considerations related to wall-crossing in the corresponding four-dimensional theory.Comment: 24 pages, no figure

New AdS solitons and brane worlds with compact extra-dimensions

We construct new static, asymptotically AdS solutions where the conformal infinity is the product of Minkowski spacetime $M_n$ and a sphere $S^m$. Both globally regular, soliton-type solutions and black hole solutions are considered. The black holes can be viewed as natural AdS generalizations of the Schwarzschild black branes in Kaluza-Klein theory. The solitons provide new brane-world models with compact extra-dimensions. Different from the Randall-Sundrum single-brane scenario, a Schwarzschild black hole on the Ricci flat part of these branes does not lead to a naked singularity in the bulk.Comment: 28 pages, 4 figure

Correction to: Pharmacokinetics of Fentanyl and Its Derivatives in Children: A Comprehensive Review

Fentanyl and its derivatives sufentanil, alfentanil, and remifentanil are potent opioids. A comprehensive review of the use of fentanyl and its derivatives in the pediatric population was performed using the National Library of Medicine PubMed. Studies were included if they contained original pharmacokinetic parameters or models using established routes of administration in patients younger than 18 years of age. Of 372 retrieved articles, 44 eligible pharmacokinetic studies contained data of 821 patients younger than 18 years of age, including more than 46 preterm infants, 64 full-term neonates, 115 infants/toddlers, 188 children, and 28 adolescents. Underlying diagnoses included congenital heart and pulmonary disease and abdominal disorders. Routes of drug administration were intravenous, epidural, oral-transmucosal, intranasal, and transdermal. Despite extensive use in daily clinical practice, few studies have been performed. Preterm and term infants have lower clearance and protein binding. Pharmacokinetics was not altered by chronic renal or hepatic disease. Analyses of the pooled individual patients’ data revealed that clearance maturation relating to body weight could be best described by the Hill function for sufentanil (R2 = 0.71, Bmax 876 mL/min, K50 16.3 kg) and alfentanil (R2 = 0.70, Bmax (fixed) 420 mL/min, K50 28 kg). The allometric exponent for estimation of clearance of sufentanil was 0.99 and 0.75 for alfentanil clearance. Maturation of remifentanil clearance was described by linear regression to bodyweight (R2 = 0.69). The allometric exponent for estimation of remifentanil clearance was 0.76. For fentanyl, linear regression showed only a weak correlation between clearance and bodyweight in preterm and term neonates (R2 = 0.22) owing to a lack of data in older age groups. A large heterogeneity regarding study design, clinical setting, drug administration, laboratory assays, and pharmacokinetic estimation was observed between studies introducing bias into the analyses performed in this review. A limitation of this review is that pharmacokinetic data, based on different modes of administration, dosing schemes, and parameter estimation methods, were combined