Retrospective case report: evaluation of pain in a child with pervasive developmental disorder.

PURPOSE: To describe how a nurse and a physical therapist in an interprofessional (IP) school-based clinic collaborated to meet the needs of a child with pervasive developmental disorder-not otherwise specified, with atypical classroom behaviors and declining student performance. SUMMARY: The IP team sought answers for atypical classroom behaviors with declining student performance. Student sensory perceptions masked and delayed the ability to recognize infection. OBSERVATIONS: Cumulative observations by the team generated serial referrals until a diagnosis of dental abscess was identified. CONCLUSIONS: An IP team in this school setting generated a positive outcome for a student demonstrating absence of clear indicators of pain or infection, with additional positive outcomes for the clinic. RECOMMENDATIONS FOR CLINICAL PRACTICE: Further studies are needed to recognize illness earlier in the absence of pain or pain perception in children with a form of autism spectrum disorder and to develop reliable and valid metrics for pain identification.

Communicating with physicians, protecting yourself from legal harm.

When a patient's condition changes, you as a physical therapist (PT) must quickly consider when, how, and what to communicate to the physician. As you do, remember that these questions have not only clinical implications, but also legal implications.

Microdose pharmacokinetics of IDX899 and IDX989, candidate HIV-1 non-nucleoside reverse transcriptase inhibitors, following oral and intravenous administration in healthy male subjects.

IDX899 and IDX989 are new non-nucleoside reverse-transcriptase inhibitors (NNRTIs) that exhibit potent inhibition of HIV-1 replication, including NNRTI-resistant mutants. This microdose study investigates the pharmacokinetics and determined oral bioavailability. For each compound, 4 healthy male subjects are randomized to receive via a crossover design a single 100-microg oral and intravenous dose together with 100 nCi of [(14)C]-labeled drug. Plasma and urine samples are obtained over a period of 168 hours postdose and analyzed for total, unchanged drug and major metabolites using an accelerator mass spectrometry method. Based on total radioactivity, oral absorption is near complete. For the parent drug, mean absolute bioavailability is 61% and 65% for IDX899 and IDX989, respectively. Both compounds are extensively metabolized especially after oral dosing. Observed terminal phase half-lives after oral and intravenous doses range from 4 to 10 hours and are comparable for the 2 compounds. Urine excretion of radioactivity for both compounds is less than 10%. These data show for the first time that IDX899 and IDX989 possess favorable pharmacokinetic properties in humans, including high mean absolute bioavailability and long half-life. IDX899 has been selected based on these initial pharmacokinetic assessments and other criteria as the candidate for further clinical development.