Browsing by Author "Kling, S."

Now showing 1 - 4 of 4
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    Asthma treatment in children : a pragmatic approach
    (Health & Medical Publishing Group, 2018) Masekela, R.; Jeevanathrum, A.; Kling, S.; Gray, T. C.; Morrison, J.; Vanker, A.; Puterman, A. S.; Rhode, D.; Zollner, E. W.; De Waal, P.; Manjra, A.; Levin, M.; Zar, H.; Green, R. J.; Kritzinger, F. E.
    Background. Asthma is a heterogeneous condition characterised by chronic inflammation and variable expiratory airflow limitation, with airway reversibility. Management of chronic inflammation with anti-asthma medication improves asthma control and quality of life. Objectives. To provide an evidence-based approach for chronic asthma management in young children and adolescents and provide guidance on the use of new asthma drugs in children. Methods. The South African Childhood Asthma Working Group (SACAWG) convened in January 2017. The asthma treatment task group reviewed the available scientific literature and international asthma treatment guidelines. The evidence was then graded according to the Grades of Recommendation Assessment, Development and Evaluation (GRADE) system and recommendations were made based on scientific evidence and local context. Asthma management recommendations were made for children ˂6 years of age and older children and adolescents, as well as for stepping up and stepping down of therapy. This review does not include biologics or novel asthma drugs, which are covered in another CME article in this edition of SAMJ. Conclusions. To ensure good response, treatment and adherence, type of medication, device and checking of technique are all critical. Stepping up of therapy should be done only after ensuring good adherence and technique. Once therapeutic response is achieved, medication administration has to be stepped down to improve ease of use and avoid unnecessary side-effects.
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    Ethical considerations in the application of cell and gene therapies in children
    (Health & Medical Publishing Group, 2018) Pepper, M. S.; Pope, A.; Kling, S.; Alessandrini, M.; Van Staden, W.; Green, R. J.
    ENGLISH ABSTRACT: Rapidly evolving fields such as cell and gene therapies that involve state-of-the-art technology hold out possibilities that may be ahead of what ethics, guidelines and the law have considered. This results in a regulatory lag. Furthermore, ethical and legal considerations are often debated in real time as issues pertaining to these technologies that were previously not considered begin to come to the fore. Finding the appropriate balance between facilitating potential therapeutic gains and ensuring the safety interests of recipients of the new treatments requires close attention, especially for minors. This vulnerable population frequently has off-label treatment prescribed on the basis of extrapolation of clinical trial data derived from adults, which is ethically and scientifically questionable. In this article we discuss how best to maintain ethical integrity while introducing innovative cell and gene therapies to minors. We advocate that clinical trials of promising innovative therapies should be designed so that testing in adults is followed as soon as possible by testing in minors, given the impressive gains that have recently been reported.
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    H1N1 influenza (‘swine ‘flu’) in the paediatric ICU in South Africa
    (Health & Medical Publishing Group, 2015-09-18) Kling, S.
    No abstract available.
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    Targeting mothers and selling men what they do not want : a response to "Missed opportunities for circumcision of boys"
    (Health & Medical Publishing Group, 2017) Sidler, D.; Earp, B. D.; Van Niekerk, Anton A.; Moodley, K.; Kling, S.
    No abstract available