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Abstract Background Clinical trials with dupilumab in atopic dermatitis (AD) patients showed a trend towards better effectiveness with a weekly or biweekly dosing interval, compared with extended dosing intervals. However, literature about adjusted dose regimens in daily practice is lacking. Objectives To evaluate adjusted dosing intervals of dupilumab for AD in daily practice. Methods An observational, longitudinal cohort study was conducted in AD patients who started dupilumab treatment in daily practice. Dosing intervals were adjusted upon shared decision making between physicians and patients in daily practice, without strict criteria. Disease courses of patients with shortened or extended dosing intervals were illustrated using spaghetti plots. In addition, data of patients who were treated with standard or extended dosing intervals were analysed using linear mixed effect (LME) models to determine the estimated effectiveness of extended dosing regimens. Results In total, 180 AD consecutive patients treated with dupilumab in daily practice were included in our study. Patients with an extended dosing interval (n = 28) had relatively low Eczema Area and Severity Index (EASI) scores at the time of interval adjustment (range: 0−7) and the majority of patients showed continuous effectiveness after adjustment. In patients with a shortened dosing interval (n = 26), the scores at the time of adjustment were more widespread (range: 0−34) and follow‐up showed variable disease courses. Based on the LME model, we found an overall continuous improvement of EASI scores in time, in patients with a regular and extended interval. Conclusions Patients with extended dosing intervals showed sustained effectiveness, similar to patients with standard dosing intervals. The effects of shortened intervals on disease severity could not be adequately analysed due to methodological limitations in this retrospective study.

Abstract Children treated in a pediatric intensive care unit (PICU) are at risk of distress and pain. This study investigated if aromatherapy massage can reduce children's distress and improve comfort. This observational before‐after study was performed in a 22‐bed PICU in Cape Town, South Africa. The aromatherapy massage consisted of soft massaging using the “M‐technique” and a 1% blend of essential oils of Lavender (Lavandula angustifolia), German Chamomile (Matricatia recutita) and Neroli (Citrus aurantium) mixed with a grapeseed carrier oil. All present children were eligible, except those who had recently returned, were asleep or deemed unstable. The primary outcome was distress measured with the COMFORT‐Behavior scale (COMFORT‐B). Secondary outcomes were heart rate, oxygen saturation (SatO2), the Numeric Rating Scale (NRS)‐Anxiety and pain assessed by the NRS‐Pain scale. Outcomes variables were evaluated with Wilcoxon signed‐rank test and multiple regression analysis. The intervention was applied to 111 children, fifty‐one of whom (45.9%) were younger than three years old. The group median COMFORT‐B score before intervention was 15 (IQR 12–19), versus 10 (IQR 6–14) after intervention. Heart rate and NRS‐Anxiety were significantly lower after the intervention (P

Abstract Background The incidence of hemostatic complications in pediatric patients undergoing extracorporeal membrane oxygenation (ECMO) is high. The optimal anticoagulation strategy in children undergoing ECMO is unknown. Objectives To study the association between hemostatic complications, coagulation tests, and clinical parameters in pediatric patients undergoing ECMO and their effect on survival. Methods We performed a retrospective cohort study of pediatric patients undergoing centrifugal pump ECMO. Collected data included patient characteristics, risk factors, and coagulation test results. Statistical analysis was done using logistic regression analysis for repeated measurements. Dependent variables were thrombosis and bleeding, independent variables were rotational thromboelastometry (ROTEM), activated partial thromboplastin time (aPTT) and antifactor‐Xa assay (aXa) results, ECMO duration, age