e93 of drugs serum concentrations followed by interpretation and good cooperation with clinicians. Almost every pregnant woman is exposed to some type of medication during pregnancy. It was found a significant correlation between teratogenic effects and maternal or umbilical cord concentrations of some drugs, but not dose. For this reason, TDM in mother during pregnancy is more valuable than the given dose for estimating and possibly obviating the teratogenic risk of these drugs on the fetus. However, the data relating to the transplacental passage for most of drugs remain sparse. It was reported that analytical models should also take into account not only type and dose, but also levels of drugs in the mother and the neonate at birth as a closer surrogate marker for fetal exposure. Measuring the umbilical cord/maternal serum drug level ratio at birth is the method recommended to assess transplacental transfer. The decline in plasma concentrations during pregnancy was also observed with a considerable interindividual variability in the effect of pregnancy on kinetics of some drugs. Therefore, frequent TDM during pregnancy and after delivery is necessary to optimize treatment in women taking these drugs in the period of instable kinetics. The data on the transfer of drugs to the milk and the risk of exposure to the breastfed infants remain also sparse and only a limited number of studies have actually measured the infant blood levels. It was reported that the monitoring of breastfed infant's concentrations appears to be the most relevant method for analysis of drugs exposure in breastfed infants (especially in those with some clinical problems such as sedation, poor suckling, and life-threatening rashes), overriding any other calculation.

Background: Type 1 Diabetes Mellitus is among the most common conditions worldwide, affecting nearly 95 million children worldwide. One of the detrimental effects of this condition can be vision loss. Comprehensive annual ocular screenings can have an important role in early detection and management of vision-threatening complications. Over 2,200 family members and children with diabetes type 1 (www.childrenwithdiabetes.com) from Australia, Asia, Canada, Europe, Latin America and the United States of America attended an annual meeting where participants wishing to undergo a full ocular wellness screening had to pre-register for this weeklong activity. Methods: Sixteen (16) volunteer screeners made up of second year medical students, allied health care specialist, physician optometrist and ophthalmologist participated in this yearly event since 2007. Ocular wellness screening involved several stations where participants went through 8 stations, which included personal/family health history, visual acuity (Snellen visual chart), non-contact auto-tonometry for measurement of intra-ocular pressure, automated-refractor, and optical coherence tomography angiography (OCT and OCTA). The last station was a Canon non-mydriatic retinal camera used to acquire an anterior segment, as well as 45-degree fundus color and mono-chromatic auto fluorescence images (FAF). Results: Two hundred and sixteen (216) participants or 10% of the attendees (average age 21-years-old) underwent this screening event at the Disney Property in Orlando, Florida. Forty-one (41) participants had some retinal hemorrhages findings including microaneurysms, dot hemorrhages, flame hemorrhages and Intraretinal Microvascular Abnormalities (IrMa). Fifty-six (56) cases had varying levels of nuclear sclerosis. Three on-site readers evaluated all collected data and counseled families on findings. Participants with proliferative diabetic retinopathy findings or macular edema seen on OCT were referred to a remote off-site board-certified ophthalmologist through a secure line following Digital Imaging and Communications in Medicine (DICOM) and Health Insurance Portability and Accountability Act (HIPPA) protocols and recommended for further workup or treatment by the participant's eye-care professional. Conclusions: Creating a safe and comprehensive yearly ocular screening for children with type 1 diabetes mellitus along with a positive learning experience for can improve the lives of those living with type 1 diabetes and their families. Early detection, prevention and management of vision threatening diseases (VTDs) insures the affected individual can safeguard their vision.

Background: Type 1 diabetes affects approximately 3 million Americans. Subjects are on average 14-years-old at time of diagnosis. It is a systemic, chronic condition that has retinal complications. Yearly ophthalmic consultation is important to maintaining adequate ocular health. The National Institute of Health (NIH) estimates that about half of individuals affected by diabetes are not aware they have some level of retinopathy.

Citation