Clopidogrel Use in Children.
Bibliographic record
Abstract
Abstract Background: Children with congenital heart problems have an increased incidence (up to 4%) of thrombotic vascular complications, particularly after interventional catheterization procedures that include device implantation. Clopidogrel, a thienopyridine derivative, is a specific platelet aggregation inhibitor. The preferred anti-thrombotic therapy after percutaneous coronary intervention (PCI) with stent placement in adults has evolved from aspirin and systemic anticoagulation with warfarin to dual antiplatelet therapy with aspirin and clopidogrel. Presently, no published data exists on clopidogrel use in children. Objective: The aim of the present study was to report the first experience with clopidogrel therapy for primary and secondary prevention of thrombotic phenomena in children with complex heart disease after interventional cardiac catheterization, and to suggest a dose regimen for a paediatric population. Methods: A retrospective chart review of all infants and children with complex heart disease treated with clopidogrel in the Hospital for Sick Children, Toronto between January 2001 and April 2004. Clopidogrel dosages, duration of therapy, complications and adverse effects in a paediatric population were explored. Results: Fifteen infants and children with congenital and acquired heart disease were treated with clopidogrel (median age 3.5 years; range 6 weeks- 16 years). In 10 of them endovascular stents were inserted. Dosages ranged from 1 to 6 mg/kg/day, for periods ranging between 1 to 6 months. No thrombotic events were reported in these patients during clopidogrel therapy. One child had a bleeding complication (gastrointestinal) while on triple antithrombotic therapy. Other complications reported in adults, such as rash, were not noted in this paediatric series. Conclusion: Clopidogrel was well tolerated, and there were no thrombotic events during treatment. We suggest a dose of 1mg/kg/day for children to be started.
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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 | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 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".