USE OF CLOPIDOGREL IN PEDIATRIC ARTERIAL ISCHEMIC STROKE: SAFETY AND ADVERSE EFFECTS
Bibliographic record
Abstract
Objectives: Aspirin (ASA) is the main anti-platelet treatment for secondary prevention in children with Arterial Ischemic Stroke (AIS). Clopidogrel is an alternative anti-platelet medication for such children. Our study objective was to determine the tolerability and adverse effects of Clopidogrel in children with AIS. Methods: Consecutive cohort study of children aged 1 to 18 years with AIS and receiving Clopidogrel between January 2000 and June 2004 were included. Compliance, tolerability and side effects were assessed in all study children with review of Stroke clinic charts and hospital health records. Results: 16 children received Clopidogrel therapy: 8 children Clopidogrel alone and 8 in conjunction with ASA. Average length of treatment was 22 months. No children had recurrent stroke during Clopidogrel treatment. No major side effects were reported during Clopidogrel treatment alone. However, significant intracranial hemorrhage was reported in 2 patients (25%) on the ASA and Clopidogrel combination. One patient developed a significant subdural hematoma 6 weeks after revascularization surgery for moyamoya disease while receiving both Clopidogrel and Aspirin. Another patient also developed a subdural hematoma while on Aspirin and Clopidogrel. This patient had cerebral atrophy and hypertention due to Progeria. Both medications were put on hold and the patients recovered. Conclusion: Clopidogrel is a safe and well-tolerated alternative in children when used alone but should be used with caution when used in conjunction with ASA. Combination therapy maybe unsafe in children with stroke, particularly in the setting of diffuse vasculopathy and cerebral atrophy. Additional studies in larger numbers of children are needed to determine the true safety and the effectiveness of Clopidogrel.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".