Full Text Journal Articles by
Author Karel Allegaert

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Pregnancy related pharmacokinetics and antimicrobial prophylaxis during fetal surgery, cefazolin and clindamycin as examples.

Karel Allegaert, Anouk E Muller, Francesca Russo, Sam Schoenmakers, Jan Deprest, Birgit Cp Koch,

Antimicrobial prophylaxis during surgery aims to prevent post-operative site infections. For fetal surgery, this includes the fetal and amniotic compartments. Both are deep compartments as drug equilibrium with maternal blood is achieved relatively late. Despite prophylaxis, chorio-amnionitis or endometritis following ex utero intrapartum treatment or fetoscopy occur in 4.13 and ... Read more >>

Prenat. Diagn. (Prenatal diagnosis)
[2020, :]

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The oral bioavailability and metabolism of midazolam in stable critically ill children: a pharmacokinetic microtracing study.

Bianca D van Groen, Elke H J Krekels, Miriam G Mooij, Esther van Duijn, Wouter H J Vaes, Albert D Windhorst, Joost van Rosmalen, Stan J F Hartman, N Harry Hendrikse, Birgit C P Koch, Karel Allegaert, Dick Tibboel, Catherijne A J Knibbe, Saskia N de Wildt,

Midazolam is metabolized by the developmentally regulated intestinal and hepatic drug metabolizing enzyme cytochrome P450 (CYP) 3A4/5. It is frequently administered orally to children, yet knowledge is lacking on the oral bioavailability in term neonates up until 1 year of age. Furthermore, the dispositions of the major metabolites 1-OH-midazolam (OHM) ... Read more >>

Clin. Pharmacol. Ther. (Clinical pharmacology and therapeutics)
[2020, :]

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A core outcome set for pre-eclampsia research: An international consensus development study.

James M N Duffy, Alexandra E Cairns, Dan Richards-Doran, Janneke van 't Hooft, Chris Gale, Mark Brown, Lucy C Chappell, William A Grobman, Ray Fitzpatrick, S Ananth Karumanchi, A Khalil, D Nuala Lucas, Laura A Magee, Ben W Mol, Michael Stark, Shakila Thangaratinam, Mathew J Wilson, Peter von Dadelszen, Paula R Williamson, Sue Ziebland, Richard J McManus, ,

OBJECTIVE:To develop a core outcome set for pre-eclampsia. DESIGN:Consensus development study. SETTING:International. POPULATION:Two hundred and eight one healthcare professionals, 41 researchers, and 110 patients, representing 56 countries, participated METHODS: Modified Delphi method and Modified Nominal Group Technique. RESULTS:A longlist of 116 potential core outcomes was developed, by combining the outcomes ... Read more >>

BJOG (BJOG : an international journal of obstetrics and gynaecology)
[2020, :]

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A Physiology-Based Pharmacokinetic Framework to Support Drug Development and Dose Precision During Therapeutic Hypothermia in Neonates.

Anne Smits, Pieter Annaert, Steven Van Cruchten, Karel Allegaert,

Therapeutic hypothermia (TH) is standard treatment for neonates (≥36 weeks) with perinatal asphyxia (PA) and hypoxic-ischemic encephalopathy. TH reduces mortality and neurodevelopmental disability due to reduced metabolic rate and decreased neuronal apoptosis. Since both hypothermia and PA influence physiology, they are expected to alter pharmacokinetics (PK). Tools for personalized dosing ... Read more >>

Front Pharmacol (Frontiers in pharmacology)
[2020, 11:587]

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A Physiology-Based Pharmacokinetic Framework to Support Drug Development and Dose Precision During Therapeutic Hypothermia in Neonates.

Anne Smits, Pieter Annaert, Steven Van Cruchten, Karel Allegaert,

Therapeutic hypothermia (TH) is standard treatment for neonates (≥36 weeks) with perinatal asphyxia (PA) and hypoxic–ischemic encephalopathy. TH reduces mortality and neurodevelopmental disability due to reduced metabolic rate and decreased neuronal apoptosis. Since both hypothermia and PA influence physiology, they are expected to alter pharmacokinetics (PK). Tools for personalized dosing ... Read more >>

Front Pharmacol (Frontiers in pharmacology)
[2020, 11:]

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The Predictive Value of Glomerular Filtration Rate-Based Scaling of Pediatric Clearance and Doses for Drugs Eliminated by Glomerular Filtration with Varying Protein-Binding Properties.

Sinziana Cristea, Elke H J Krekels, Karel Allegaert, Catherijne A J Knibbe,

INTRODUCTION:For drugs eliminated by glomerular filtration (GF), clearance (CL) is determined by GF rate (GFR) and the unbound fraction of the drug. When predicting CL of GF-eliminated drugs in children, instead of physiologically based pharmacokinetic (PBPK) methods that consider changes in both GFR and protein binding, empiric bodyweight-based methods are ... Read more >>

Clin Pharmacokinet (Clinical pharmacokinetics)
[2020, :]

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Characterization of esophageal motility and esophagogastric junction in preterm infants with bronchopulmonary dysplasia.

Maissa Rayyan, Taher Omari, Anne Debeer, Karel Allegaert, Nathalie Rommel,

BACKGROUND:To characterize esophageal motility and function of the esophagogastric junction (EGJ) in preterm infants with bronchopulmonary dysplasia (BPD). METHODS:High-resolution manometry with impedance was used to investigate esophageal motility and EGJ function in 28 tube-fed preterm infants with BPD. Patients with BPD were studied at term age during oral feeding. Thirteen ... Read more >>

Neurogastroenterol. Motil. (Neurogastroenterology and motility : the official journal of the European Gastrointestinal Motility Society)
[2020, :e13849]

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Maternal Fasting or Fluid Abstention Does Not Significantly Affect the Macronutrient Composition of Human Milk: Clinical and Clinical Research Relevance

Karel Allegaert, anne smits,

There are guidelines on lactation following maternal analgo-sedative exposure, but these do not consider the effect of maternal fasting, nor fluid abstention on human milk macronutrient composition. We therefore performed a structured search (PubMed) on ‘human milk composition’ and screened title, abstract and full paper on ‘fasting’ or ‘abstention’ and ... Read more >>

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Enantiomer specific pharmacokinetics of ibuprofen in preterm neonates with patent ductus arteriosus.

Aline G J Engbers, Robert B Flint, Swantje Völler, Johan C A de Klerk, Irwin K M Reiss, Peter Andriessen, Kian D Liem, Pieter L J Degraeuwe, Siska Croubels, Joske Millecam, Karel Allegaert, Sinno H P Simons, Catherijne A J Knibbe,

AIMS:Racemic ibuprofen is widely used for the treatment of preterm neonates with patent ductus arteriosus. Currently used bodyweight-based dosing guidelines are based on total ibuprofen, while only the S-enantiomer of ibuprofen is pharmacologically active. We aimed to optimize ibuprofen dosing for preterm neonates of different ages based on an enantiomer-specific ... Read more >>

Br J Clin Pharmacol (British journal of clinical pharmacology)
[2020, :]

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Maturation of Esophageal Motility and Esophagogastric Junction in Preterm Infants.

Maissa Rayyan, Taher Omari, Gunnar Naulaers, Raf Aerts, Karel Allegaert, Nathalie Rommel,

BACKGROUND:Preterm infants commonly present with oral feeding problems. The role of maturation of esophageal bolus transport mechanisms herein remains unclear. OBJECTIVES:To characterize esophageal motility and function of esophagogastric junction (EGJ) during deglutitive swallowing in healthy preterm infants and to describe maturational changes. METHODS:Four consecutive high-resolution manometry studies with impedance studies ... Read more >>

Neonatology (Neonatology)
[2020, :1-9]

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Glomerular Filtration Rate in Former Extreme Low Birth Weight Infants over the Full Pediatric Age Range: A Pooled Analysis.

Elise Goetschalckx, Djalila Mekahli, Elena Levtchenko, Karel Allegaert,

Various cohort studies document a lower glomerular filtration rate (GFR) in former extremely low birth weight (ELBW, <1000 g) neonates throughout childhood when compared to term controls. The current aim is to pool these studies to describe the GFR pattern over the pediatric age range. To do so, we conducted ... Read more >>

Int J Environ Res Public Health (International journal of environmental research and public health)
[2020, 17(6):]

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A Critical Review on the Relevance of Paracetamol for Procedural Pain Management in Neonates.

Karel Allegaert,

Effective and safe pain relief in neonates matters. This is not only because of ethical constraints or human empathy, but even more because pain treatment is an important and crucial part of contemporary medical, paramedical, and nursing care to improve the outcome in neonatal intensive care graduates. Paracetamol (acetaminophen) is ... Read more >>

Front Pediatr (Frontiers in pediatrics)
[2020, 8:89]

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"How can a drug to treat claudication in adults save preterm newborns?"

Serife Kurul, Karel Allegaert, Robert B Flint, H Rob Taal,

Eur. J. Pediatr. (European journal of pediatrics)
[2020, :]

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Outcome reporting in neonates experiencing withdrawal following opioid exposure in pregnancy: a systematic review.

Flora Shan, Sonya MacVicar, Karel Allegaert, Martin Offringa, Lauren M Jansson, Sarah Simpson, Wendy Moulsdale, Lauren E Kelly,

BACKGROUND:Neonatal withdrawal secondary to in utero opioid exposure is a growing global concern stressing the psychosocial well-being of affected families and scarce hospital resources. In the ongoing search for the most effective treatment, randomized controlled trials are indispensable. Consistent outcome selection and measurement across randomized controlled trials enables synthesis of ... Read more >>

Trials (Trials)
[2020, 21(1):262]

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Acetaminophen Use in Pregnant Women and Their Neonates: Safe or Unsafe till Proven Otherwise?

John N van den Anker, Karel Allegaert,

Neonatology (Neonatology)
[2020, :1-3]

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Preterm birth impairs postnatal lung development in the neonatal rabbit model.

Thomas Salaets, Margo Aertgeerts, André Gie, Janne Vignero, Derek de Winter, Yannick Regin, Julio Jimenez, Greetje Vande Velde, Karel Allegaert, Jan Deprest, Jaan Toelen,

BACKGROUND:Bronchopulmonary dysplasia continues to cause important respiratory morbidity throughout life, and new therapies are needed. The common denominator of all BPD cases is preterm birth, however most preclinical research in this area focusses on the effect of hyperoxia or mechanical ventilation. In this study we investigated if and how prematurity ... Read more >>

Respir. Res. (Respiratory research)
[2020, 21(1):59]

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Integration of Placental Transfer in a Fetal-Maternal Physiologically Based Pharmacokinetic Model to Characterize Acetaminophen Exposure and Metabolic Clearance in the Fetus.

Paola Mian, Karel Allegaert, Sigrid Conings, Pieter Annaert, Dick Tibboel, Marc Pfister, Kristel van Calsteren, John N van den Anker, André Dallmann,

BACKGROUND AND OBJECTIVE:Although acetaminophen is frequently used during pregnancy, little is known about fetal acetaminophen pharmacokinetics. Acetaminophen safety evaluation has typically focused on hepatotoxicity, while other events (fetal ductal closure/constriction) are also relevant. We aimed to develop a fetal-maternal physiologically based pharmacokinetic (PBPK) model (f-m PBPK) to quantitatively predict placental ... Read more >>

Clin Pharmacokinet (Clinical pharmacokinetics)
[2020, :]

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Anatomical and physiological alterations of pregnancy.

Jamil M Kazma, John van den Anker, Karel Allegaert, André Dallmann, Homa K Ahmadzia,

The extensive metabolic demands of pregnancy require specific physiological and anatomical changes. These changes affect almost all organ systems, including the cardiovascular, respiratory, renal, gastrointestinal, and hematologic system. The placenta adds another layer of complexity. These changes make it challenging for clinicians to understand presenting signs and symptoms, or to ... Read more >>

J Pharmacokinet Pharmacodyn (Journal of pharmacokinetics and pharmacodynamics)
[2020, :]

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Effect of esophageal length on high-resolution manometry metrics: Extension to the neonatal population.

Maissa Rayyan, Taher Omari, Rammy Abu-Assi, Karel Allegaert, Nathalie Rommel,

Neurogastroenterol. Motil. (Neurogastroenterology and motility : the official journal of the European Gastrointestinal Motility Society)
[2020, 32(2):e13800]

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Glomerular Filtration Rate in Former Extreme Low Birth Weight Infants over the Full Pediatric Age Range: A Pooled Analysis

Elise Goetschalkx, Djalila Mekahli, Elena Levtchenko, Karel Allegaert,

Different cohort studies documented a lower glomerular filtration rate (GFR) in former extremely low birth weight (ELBW, &lt;1000 g) neonates throughout childhood when compared to term controls. The current aim is to pool these studies to describe the GFR pattern over the pediatric age range. To do so, we conducted ... Read more >>

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Nonlinear Transfer Entropy to Assess the Neurovascular Coupling in Premature Neonates.

Dries Hendrikx, Liesbeth Thewissen, Anne Smits, Gunnar Naulaers, Karel Allegaert, Sabine Van Huffel, Alexander Caicedo,

In the adult brain, it is well known that increases in local neural activity trigger changes in regional blood flow and, thus, changes in cerebral energy metabolism. This regulation mechanism is called neurovascular coupling (NVC). It is not yet clear to what extent this mechanism is present in the premature ... Read more >>

Adv. Exp. Med. Biol. (Advances in experimental medicine and biology)
[2020, 1232:11-17]

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Off-label use of medicines in neonates, infants, children, and adolescents: a joint policy statement by the European Academy of Paediatrics and the European society for Developmental Perinatal and Pediatric Pharmacology.

Lenneke Schrier, Adamos Hadjipanayis, Tom Stiris, Rob I Ross-Russell, Arunas Valiulis, Mark A Turner, Wei Zhao, Pieter De Cock, Saskia N de Wildt, Karel Allegaert, John van den Anker,

Health-care professionals who prescribe medicines have the professional duty to choose medicines that are in the best interest of their individual patient, irrespective if that patient is an adult or a child. However, the availability of medicines with an appropriate label for pediatric use is lagging behind those for adults, ... Read more >>

Eur. J. Pediatr. (European journal of pediatrics)
[2020, 179(5):839-847]

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Growth patterns and body composition in former extremely low birth weight (ELBW) neonates until adulthood: a systematic review.

Caroline Van de Pol, Karel Allegaert,

Preterm infants are obviously born lighter and shorter, with smaller head circumferences than normal birth weight term born neonates. They also have a different body composition. Compromised growth is associated with adverse health outcomes. Both growth retardation and accelerated growth are suggested to cause metabolic, cardiovascular, and renal complications. Reviews ... Read more >>

Eur. J. Pediatr. (European journal of pediatrics)
[2020, 179(5):757-771]

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Physiologically Based Pharmacokinetic Modeling to Characterize Acetaminophen Pharmacokinetics and N-Acetyl-p-Benzoquinone Imine (NAPQI) Formation in Non-Pregnant and Pregnant Women.

Paola Mian, John N van den Anker, Kristel van Calsteren, Pieter Annaert, Dick Tibboel, Marc Pfister, Karel Allegaert, André Dallmann,

BACKGROUND AND OBJECTIVE:Little is known about acetaminophen (paracetamol) pharmacokinetics during pregnancy. The aim of this study was to develop a physiologically based pharmacokinetic (PBPK) model to predict acetaminophen pharmacokinetics throughout pregnancy. METHODS:PBPK models for acetaminophen and its metabolites were developed in non-pregnant and pregnant women. Physiological and enzymatic changes in ... Read more >>

Clin Pharmacokinet (Clinical pharmacokinetics)
[2020, 59(1):97-110]

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Intralesional steroid injections to prevent refractory strictures in patients with oesophageal atresia: study protocol for an international, multicentre randomised controlled trial (STEPS-EA trial).

Chantal A Ten Kate, John Vlot, Hanneke IJsselstijn, Karel Allegaert, Manon C W Spaander, Marten J Poley, Joost van Rosmalen, Erica L T van den Akker, Rene M H Wijnen,

INTRODUCTION:Anastomotic stricture formation is the most common postoperative complication after oesophageal atresia (OA) repair. The standard of care is endoscopic dilatation. A possible adjuvant treatment is intralesional steroid injection, which is thought to inhibit scar tissue formation and thereby to prevent stricture recurrence. We hypothesise that this intervention could prevent ... Read more >>

BMJ Open (BMJ open)
[2019, 9(12):e033030]

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