Peer Reviewed Manuscripts
- Elzagallaai, A. A., Greff, M. J. E., and Rieder, M. J., (2017) Adverse Drug Reactions in Children: The Double Edged Sword of Therapeutics. Clinical Pharmacology & Therapeutics. doi: 10.1002/cpt.677
- Abstract: Adverse drug reactions (ADRs) represent a major health problem worldwide with high morbidity and mortality rates. ADRs are classified into type A (augmented) and type B (bizarre) ADRs with the former group being more common and the later less common but often severe and clinically more problematic due to their unpredictable nature and occurrence at any dose. Pediatric populations are especially vulnerable to ADRs due to the lack of data for this age group from the drug development process and because of the wide use of Off-label and unlicensed use of drugs. Children are more prone to specific types of ADRs because of the level of maturity of body systems involved in absorption, metabolism, transportation and elimination of drugs. This state-of-the-are review provides an overview of definitions, classifications, epidemiology and pathophysiology of ADRs and discusses the available evidence for related risk factors and causes of ADRs in the pediatric population. This article is protected by copyright. All rights reserved.
- MacLeod, S. M., Greff, M. J. E., Knoppert, D. C., Ito, S., and Rieder, M. J., (2017) An international asset map of clinicians, educators and researchers pursuing better medicine use in children: Initial findings. Clinical Pharmacology & Therapeutics, 101: 274–280. doi: 10.1002/cpt.460
- Abstract: The world’s 1.89 billion children (0-14) too frequently receive treatments that have not been validated through clinical pharmacology research, especially in low and middle income countries. Initial findings from an international asset map of professionals and clinician scientists available to address the needs for education, research and treatment support suggest a critical shortage of clinical pharmacologists, clinical pharmacists and other professionals with advanced training in the evaluation of therapies for childhood conditions and illnesses. A total of 497 individuals responded to a survey conducted between May 2015 and February 2016. An alarming signal is apparent showing that, while the overall resource pool is unquestionably limited, 87% of relevant qualified personnel are located in high income countries. The data suggest urgent need for targeted training in pediatric clinical pharmacology with particular focus on the needs in Africa, Latin America and most of Asia. This article is protected by copyright. All rights reserved.
- Faught, L. N., Greff, M. J. E., Rieder, M. J., and Koren, G. (2015) Drug-induced acute kidney injury in children. British Journal of Clinical Pharmacology, 80: 901–909. doi: 10.1111/bcp.12554 .
- Abstract: Acute kidney injury (AKI) is a serious problem occurring in anywhere between 8 and 30% of children in the intensive care unit. Up to 25% of these cases are believed to be the result of pharmacotherapy. In this review we have focused on several relevant drugs and/or drug classes, which are known to cause AKI in children, including cancer chemotherapeutics, non-steroidal anti-inflammatory drugs and antimicrobials. AKI demonstrates a steady association with increased long term risk of poor outcomes including chronic kidney disease and death as determined by the extent of injury. For this reason it is important to understand the causality and implications of these drugs and drug classes. Children occupy a unique patient population, advocating the importance of understanding how they are affected dissimilarly compared with adults. While the kidney itself is likely more susceptible to injury than other organs, the inherent toxicity of these drugs also plays a major role in the resulting AKI. Mechanisms involved in the toxicity of these drugs include oxidative damage, hypersensitivity reactions, altered haemodynamics and tubule obstruction and may affect the glomerulus and/or the tubules. Understanding these mechanisms is critical in determining the most effective strategies for treatment and/or prevention, whether these strategies are less toxic versions of the same drugs or add-on agents to mitigate the toxic effect of the existing therapy.
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Poster Presentations & Conference Papers
- Greff, M.J.E., Hair Cortisol Analysis: Overview, Applications, and Case Study. Presented at: Molecular Medicine Data Club, Robarts Research Institute, Western University; 2017 March 22; London, ON, Canada.
- Le, T., V. Bhushan, and M. Sochat, First Aid for the USMLE Step 1 2014. 24th ed. First Aid. 2014, New York: McGraw-Hill Education. doi: 10.1036/9780071831437
- I reviewed this top selling medical education textbook for content accurarcy. Find my name in the credits on page xiv