Pediatric valganciclovir dosing recommendations have not been extensively validated for prevention or treatment for CMV infection. As such, we performed a pharmacokinetic study to compare different valganciclovir dosing regimens and the potential benefits of individualized dose adjustments in children following organ transplantation. Ganciclovir AUCs were calculated from four plasma drug levels in pediatric SOT recipients aged six months through three yr receiving valganciclovir suspension by mouth. Of the 28 ganciclovir AUC calculations performed, 11 (39%) were outside the therapeutic target range of 40-60 mcg h/L leading to a valganciclovir dose adjustment. Current manufacturer-recommended dosing based on BSA and CrCl was estimated to result in therapeutic AUCs in fewer patients than the simple weight-based formula used in our institution (4 vs. 13; p = 0.017). An AUC calculation using only the two- and five-h measurements was strongly correlated with the AUC using all four time measurements (R(2) = 0.846; p < 0.001). A simple weight-based dosing approach gives a higher probability for therapeutic AUCs compared to the manufacturer-recommended dosing in pediatric transplant patients aged six months through three yr with normal renal function. An AUC calculated using two sample times might allow for fewer blood draws in the future.

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Advances in immunosuppressive therapy over the past decade have led to dramatic improvements in graft survival. The immunosuppression that is used is center-dependent and is constantly evolving with the development of new medications. The goal remains to find the best combination that will optimize graft survival, while minimizing the adverse effects.

Balogh L., G. Andócs, J. Thuróczy, T. Németh, J. Láng, K. Bodó, G. A. Jánoki: Veterinary Nuclear Medicine. Scintigraphical examinations -a review. Acta Vet. Brno 68, 1999: 231-239. A review is presented of Veterinary Nuclear Medicine focusing on scintigraphical examinations. Most frequently applied clinical examination protocols are described, i.e. bone, thyroid, hepatic, renal, brain, cardiac and pulmonary scintigraphy, as well as oncological and inflammation scintigraphy, and miscellaneous scintigraphical examinations. Emphasis is placed on the types of procedures and the clinical information gained therefrom. No attempt is made to present or justify procedural details concerning instrumentation, radiopharmaceutical preparations, kinetic or radiation safety aspects. Detailed examinations are described following a schematic framework as: radiopharmaceuticals, examination protocol, indications and data evaluation, and illustrations. All the illustrations were taken between 1995 and 1999 from the data archive of the authors. Veterinary nuclear medicine, scintigraphy, companion animalsVeterinary Nuclear Medicine procedures can be subdivided into two main categories: isotope diagnostics (called also scintigraphy) and radiation (isotope) therapy (Hightower 1986), similar to the situation in human medicine. In the present paper the focus is on the first category.In isotope diagnostic procedures substances containing a radioactive label -the radiopharmaceutical are required. The label ideally is a gamma radiation-emitting isotope, has a short physical half-life, its chemical characteristics are suitable for stable labelling of different materials, and is economical as well. According to the above listed requirements the most frequently used isotope has recently been 99m Technetium ( 99m Tc) in both human and veterinary scintigraphical procedures. Radiopharmaceuticals are formulated in various physicochemical forms to deliver the radioactive atoms to particular parts of the living organism. Once localized, the gamma radiation emitted from the radiopharmaceutical will be available for external detection and measurement. Radiopharmaceuticals (there are more than 30 only in the Hungarian market) are applied parenterally or, less frequently, orally.The primary equipment used for detection is the gamma camera (scintillation camera, Anger camera) attached to or built in a personal computer. Whole body and SPECT (single photon emission computer tomography) procedures need the most developed instrumentation, the so called SPECT-camera, where the detector can be moved by the computer to allow imagine three-dimensional distribution of radiopharmaceutical and There are many types of nuclear medicine procedures also in the everyday clinical work. The purpose of the present paper is to present an overview of veterinary scintigraphy to specialists working in the field of nuclear medicine or biomedical research, and to provide information helpful to veterinarians referring animal patients to nuclear medicine laboratories....