Reported adverse drug reactions during the use of inhaled steroids in children with asthma in the Netherlands

Objective: Inhaled corticosteroids (ICS) are widely used in the treatment of asthma. We studied the suspected adverse drug reactions (sADRs) reported during the use of ICS in the Netherlands. Methods: In the Netherlands, health professionals and patients can report suspected ADRs to the Pharmacovigilance Centre Lareb. All reported sADRs on ICS were categorised and assessed as to whether these were likely to be associated with use of the steroid. Age and gender adjusted Reported Odds Ratios (RORs) and Naranjo Scores (NS) were computed for sADRs reported more than 3 times. Results: Since 1984, sADRs of ICS were reported in 89 children (mean age 6 years), 48 (54%) were boys. Suspected drugs were fluticasone in 46 children (52%), budesonide in 21 (24%), and beclomethasone in 22 cases (24%). Psychiatric symptoms were reported in 19 children (21%; ROR 3.8, NS 3.6), growth retardation in 6 children (7%; ROR 47.8, NS 3.0) and rashes in 6 cases (7%; ROR 0.7, NS 2.4). There were 7 reports (8%; ROR 2.1, NS 3.4) concerning abnormalities of the teeth, 4 reports of alopecia (4%; ROR 3.3, NS 3.5), and 3 reports of hirsutism and hypertrichosis (NS 4.0). Non-fatal adrenal insufficiency was reported once. Conclusion: Alteration of behaviour was the most frequently reported sADR. There are more indications that alterations of behaviour could be a real sADR of ICS. Non-fatal adrenal insufficiency was the only reported possible life threatening sADR. The association of hypertrichosis and teeth abnormalities after ICS in children has not been reported in the literature before

Antibiotic usage, dosage and course length in children between 0 and 4 years

Antibiotic drugs are most frequently used by 0- to 4-year-old children. We performed a cross-sectional study in the Netherlands using a pharmacy prescription database to investigate the use, dose and course length of antibiotic drugs in 0- to 4-year-olds. We used a database with pharmacy drug-dispensing data. We investigated all prescriptions of systemic antibiotics prescribed in the years 2002-2006 for children of 0-4 years of age. Prescriptions for children under the age of 3 months were excluded. Children of 9-12 months of age received more antibiotics than children in other age groups. In the 3- to 6-month-olds, amoxicillin was prescribed in 75.2% of the cases. This percentage was 50.4% in the 4-year-olds. The contribution of other broad-spectrum antibiotics increased with age (clarithromycin and amoxicillin/clavulanic acid). Small-spectrum penicillins were prescribed less often than the broad-spectrum antibiotics. From the prescriptions of the five most used drugs, 97.6% were within the recommended dose range. Most course lengths corresponded with the guidelines. Of the prescriptions, 3.9% were unlicensed or off-label. Within the group of 0- to 4-year-old children, most antibiotics were used by 9- to 12-month-olds. The doses and course lengths were mostly correct, but the choice of antibiotics was not according to the guidelines. Young children received unlicensed and off-label prescribed antibiotics

Inadequate folic acid intake around the time of conception, particularly among less highly educated women

Objective. To describe the knowledge and use of folic acid by women in the North of the Netherlands who wish to become pregnant, in relation to their social-economic status. Design. Descriptive. Method. Pregnant women who were attending one of 3 gynaecological and 7 midwifery practices for their first or second pregnancy check-up in October or November 2000 in the provinces Groningen, Friesland and Drenthe were asked to complete a questionnaire about their knowledge, sources of information and use of folic acid. Four hundred and sixty-one of the 473 women were prepared to take part. The highest level of education achieved was used as an indicator of social-economic status. Results. Three hundred and fifty-seven (77%) respondents had heard about folic acid before becoming pregnant, 289 (63%) knew about its protective effect in terms of neural-tube defects, and 151 (33%) knew the full length of the advised period of folic acid intake. Two hundred and sixty-five (61%) respondents had taken folic acid for some part of the advised period and 164 (36%) had taken it for the entire duration of the advised period. More women with a higher education than women with lower levels of education knew about folic acid and had used it. Conclusion. Three quarters of the respondents had heard about folic acid before their pregnancy, and less than half took it during the advised period around the time of conception. Women with a higher education were more likely to follow the advice.</p

Inadequate folic acid intake around the time of conception, particularly among less highly educated women

Objective. To describe the knowledge and use of folic acid by women in the North of the Netherlands who wish to become pregnant, in relation to their social-economic status. Design. Descriptive. Method. Pregnant women who were attending one of 3 gynaecological and 7 midwifery practices for their first or second pregnancy check-up in October or November 2000 in the provinces Groningen, Friesland and Drenthe were asked to complete a questionnaire about their knowledge, sources of information and use of folic acid. Four hundred and sixty-one of the 473 women were prepared to take part. The highest level of education achieved was used as an indicator of social-economic status. Results. Three hundred and fifty-seven (77%) respondents had heard about folic acid before becoming pregnant, 289 (63%) knew about its protective effect in terms of neural-tube defects, and 151 (33%) knew the full length of the advised period of folic acid intake. Two hundred and sixty-five (61%) respondents had taken folic acid for some part of the advised period and 164 (36%) had taken it for the entire duration of the advised period. More women with a higher education than women with lower levels of education knew about folic acid and had used it. Conclusion. Three quarters of the respondents had heard about folic acid before their pregnancy, and less than half took it during the advised period around the time of conception. Women with a higher education were more likely to follow the advice.</p

Inadequate folic acid intake around the time of conception, particularly among less highly educated women

Objective. To describe the knowledge and use of folic acid by women in the North of the Netherlands who wish to become pregnant, in relation to their social-economic status. Design. Descriptive. Method. Pregnant women who were attending one of 3 gynaecological and 7 midwifery practices for their first or second pregnancy check-up in October or November 2000 in the provinces Groningen, Friesland and Drenthe were asked to complete a questionnaire about their knowledge, sources of information and use of folic acid. Four hundred and sixty-one of the 473 women were prepared to take part. The highest level of education achieved was used as an indicator of social-economic status. Results. Three hundred and fifty-seven (77%) respondents had heard about folic acid before becoming pregnant, 289 (63%) knew about its protective effect in terms of neural-tube defects, and 151 (33%) knew the full length of the advised period of folic acid intake. Two hundred and sixty-five (61%) respondents had taken folic acid for some part of the advised period and 164 (36%) had taken it for the entire duration of the advised period. More women with a higher education than women with lower levels of education knew about folic acid and had used it. Conclusion. Three quarters of the respondents had heard about folic acid before their pregnancy, and less than half took it during the advised period around the time of conception. Women with a higher education were more likely to follow the advice.</p

Inadequate folic acid intake around the time of conception, particularly among less highly educated women

Objective. To describe the knowledge and use of folic acid by women in the North of the Netherlands who wish to become pregnant, in relation to their social-economic status. Design. Descriptive. Method. Pregnant women who were attending one of 3 gynaecological and 7 midwifery practices for their first or second pregnancy check-up in October or November 2000 in the provinces Groningen, Friesland and Drenthe were asked to complete a questionnaire about their knowledge, sources of information and use of folic acid. Four hundred and sixty-one of the 473 women were prepared to take part. The highest level of education achieved was used as an indicator of social-economic status. Results. Three hundred and fifty-seven (77%) respondents had heard about folic acid before becoming pregnant, 289 (63%) knew about its protective effect in terms of neural-tube defects, and 151 (33%) knew the full length of the advised period of folic acid intake. Two hundred and sixty-five (61%) respondents had taken folic acid for some part of the advised period and 164 (36%) had taken it for the entire duration of the advised period. More women with a higher education than women with lower levels of education knew about folic acid and had used it. Conclusion. Three quarters of the respondents had heard about folic acid before their pregnancy, and less than half took it during the advised period around the time of conception. Women with a higher education were more likely to follow the advice.</p

Inadequate folic acid intake around the time of conception, particularly among less highly educated women

Objective. To describe the knowledge and use of folic acid by women in the North of the Netherlands who wish to become pregnant, in relation to their social-economic status. Design. Descriptive. Method. Pregnant women who were attending one of 3 gynaecological and 7 midwifery practices for their first or second pregnancy check-up in October or November 2000 in the provinces Groningen, Friesland and Drenthe were asked to complete a questionnaire about their knowledge, sources of information and use of folic acid. Four hundred and sixty-one of the 473 women were prepared to take part. The highest level of education achieved was used as an indicator of social-economic status. Results. Three hundred and fifty-seven (77%) respondents had heard about folic acid before becoming pregnant, 289 (63%) knew about its protective effect in terms of neural-tube defects, and 151 (33%) knew the full length of the advised period of folic acid intake. Two hundred and sixty-five (61%) respondents had taken folic acid for some part of the advised period and 164 (36%) had taken it for the entire duration of the advised period. More women with a higher education than women with lower levels of education knew about folic acid and had used it. Conclusion. Three quarters of the respondents had heard about folic acid before their pregnancy, and less than half took it during the advised period around the time of conception. Women with a higher education were more likely to follow the advice.</p

Towards Realistic String Vacua From Branes At Singularities

We report on progress towards constructing string models incorporating both realistic D-brane matter content and moduli stabilisation with dynamical low-scale supersymmetry breaking. The general framework is that of local D-brane models embedded into the LARGE volume approach to moduli stabilisation. We review quiver theories on del Pezzo $n$ ($dP_n$) singularities including both D3 and D7 branes. We provide supersymmetric examples with three quark/lepton families and the gauge symmetries of the Standard, Left-Right Symmetric, Pati-Salam and Trinification models, without unwanted chiral exotics. We describe how the singularity structure leads to family symmetries governing the Yukawa couplings which may give mass hierarchies among the different generations. We outline how these models can be embedded into compact Calabi-Yau compactifications with LARGE volume moduli stabilisation, and state the minimal conditions for this to be possible. We study the general structure of soft supersymmetry breaking. At the singularity all leading order contributions to the soft terms (both gravity- and anomaly-mediation) vanish. We enumerate subleading contributions and estimate their magnitude. We also describe model-independent physical implications of this scenario. These include the masses of anomalous and non-anomalous U(1)'s and the generic existence of a new hyperweak force under which leptons and/or quarks could be charged. We propose that such a gauge boson could be responsible for the ghost muon anomaly recently found at the Tevatron's CDF detector.Comment: 40 pages, 10 figure