Clinical Pharmacokinetics and Dose Recommendations for Posaconazole in Infants and Children.

OBJECTIVES: The objectives of this study were to investigate the population pharmacokinetics of posaconazole in immunocompromised children, evaluate the influence of patient characteristics on posaconazole exposure and perform simulations to recommend optimal starting doses. METHODS: Posaconazole plasma concentrations from paediatric patients undergoing therapeutic drug monitoring were extracted from a tertiary paediatric hospital database. These were merged with covariates collected from electronic sources and case-note reviews. An allometrically scaled population-pharmacokinetic model was developed to investigate the effect of tablet and suspension relative bioavailability, nonlinear bioavailability of suspension, followed by a step-wise covariate model building exercise to identify other important sources of variability. RESULTS: A total of 338 posaconazole plasma concentrations samples were taken from 117 children aged 5 months to 18 years. A one-compartment model was used, with tablet apparent clearance standardised to a 70-kg individual of 15 L/h. Suspension was found to have decreasing bioavailability with increasing dose; the estimated suspension dose to yield half the tablet bioavailability was 99 mg/m2. Diarrhoea and proton pump inhibitors were also associated with reduced suspension bioavailability. CONCLUSIONS: In the largest population-pharmacokinetic study to date in children, we have found similar covariate effects to those seen in adults, but low bioavailability of suspension in patients with diarrhoea or those taking concurrent proton pump inhibitors, which may in particular limit the use of posaconazole in these patients

WSES guidelines for management of Clostridium difficile infection in surgical patients

In the last two decades there have been dramatic changes in the epidemiology of Clostridium difficile infection (CDI), with increases in incidence and severity of disease in many countries worldwide. The incidence of CDI has also increased in surgical patients. Optimization of management of C difficile, has therefore become increasingly urgent. An international multidisciplinary panel of experts prepared evidenced-based World Society of Emergency Surgery (WSES) guidelines for management of CDI in surgical patients.Peer reviewe

Waterfowl Production at Malheur National Wildlife Refuge, 1942-1980

Malheur National Wildlife Refuge (NWR), Harney County, Oregon, is an important breeding area for Pacific Flyway Waterfowl. Trumpeter swans (Olor buccinator), Canada geese (Branta canadensis), and 14 species of ducks nest at Malheur NWR. The refuge is one of the most important redhead (Aythya americana) nesting areas in the western United States. Malheur NWR was established by President Theodore Roosevelt in 1908, primarily as a nesting area for migratory birds. The refuge also serves as an important migration stop for thousands of waterfowl and other migratory birds. Originally the refuge was called Malheur Lake Reservation and included only Malheur, Mud, and Harney Lakes. The 60,000 acre (24,280 ha) Blitzen River Valley was added in 1935, primarily to help protect the water supply for Malheur Lake. The 22,000 acre (8,900 ha) Double-O Ranch was acquired in 1941 and smaller parcels have been added more recently. Relatively complete records have been kept of annual waterfowl production estimates at the refuge since 1942. The objectives of this paper are to summarize those historical records, describe apparent trends, and discuss some of the factors that may influence waterfowl production at Malheur NWR

SUMMARY OF SANDHILL CRANE HUNTING SEASONS IN NORTH DAKOTA, 1968-94

The migratory Mid-continent Population (MCP), containing 3 subspecies, is the most numerous of all sandhill crane (Grus canadensis) populations. During fall the MCP uses major staging areas in the Canadian prairie provinces and northcentral United States. In North Dakota, sport hunting of the MCP resumed in 1968, after being closed during 1916-67. The resumption and expansion of crane hunting in North Dakota during 1968-94 followed a gradual panern of implementation. Subspecies considerations, the presence of whooping cranes (G. americana), crop depredation complaints. and public reaction influenced the geographic and temporal expansion of seasons. Harvests gradually increased following each expansion and in 1993-94 reached near record levels (6,200-7,000), as seasons utilizing the full federal frameworks were implemented. Spring surveys indicate that the MCP is relatively stable, and current sport harvest levels appear appropriate to maintain current popUlation size. A primary management concern is to maintain subspecies abundance, especially of the less numerous greater sandhill crane (G. c. tabida)

NESTING SUCCESS AND PRODUCTION OF GREATER SANDHILL CRANES DURING EXPERIMENTAL PREDATOR CONTROL AT MALHEUR NATIONAL WILDLIFE REFUGE, OREGON,1982-83

Greater sancfrtill cranes (Grus canadensis tabida) nest commonly on Malheur National Wildlife Refuge, Oregon, but depredations by common ravens (Corvus corax) and coyotes (Canis latrans) contributed substantially to low recruitment during the 1970\u27s. An experimental predator removal study was initiated in 1982 to determine if nesting success and recruitment would increase if predator populations were reduced. We monitored 120 crane nests located in 2 treatment areas (ravens and coyotes removed, and only ravens removed) and 1 control area (40 nests per area). Nesting success between the 2 predator control areas differed significantly during the 2-year study, but not between either predator control area and the area where no predators were removed. Two years of predator removal did not sufficiently reduce the number of predators in the study area to increase nest success to a level that would maintain a stable nesting population

Mice of the genus Peromyscus in Guadalupe Mountains National Park, Texas /

no.74 (1981

Mammals of the Guadalupe Mountains National Park, Texas

Our survey began in late May 1973 and continued through August 1975. The objectives of our study, which was supported by the National Park Service, were to survey the mammals occurring in the Guadalupe Mountains National Park, Texas, and to correlate their distribution with major plant associations. This inventory of the natural resources of the park is preliminary to the development of any serious management program. Therefore, we present the following accounts to serve as baseline data for future mammalian work in the park and development of the master plan for the park

EFFECTS OF AN EARLY SPRING BURN ON GREATER SANDHILL CRANE NESTING SUCCESS AT MALHEUR NATIONAL WILDLIFE REFUGE, OREGON

A 2430 ha prescribed burn was conducted on Malheur National Wildlife Refuge, Harney County, Oregon in March 1985. About 35 days later, 11 greater sandhill crane (Grus canadensis tabida) pairs nested within the burned area; 9 of these hatched. The remaining 2 clutches were destroyed by coyotes (Canis latrans). Crane hatching success was significantly higher (P = 0.01) on the burned area (81.8%) than elsewhere (38.5%). Two factors were likely responsible for the higher success rate in the burn; nests were placed in deeper water and the smaI1 mammal prey base was temporarily reduced or eliminated resulting in reduced predator activity during incubation. Although hatching success was high for the burned area, no young fledged, probably because of increased predator pressure by late May