Objective(s)
To determine the association of Clostridioides difficile Infection (CDI) with in‐hospital mortality, Length of Stay (LOS), and hospital charges among pediatric Cystic Fibrosis (CF) ...hospitalizations using a large nationally representative pediatric hospital database.
Study design
We identified Cystic Fibrosis‐related hospitalizations during the years 1997 to 2016 in the Kids' Inpatient Database (KID) and compared in‐hospital mortality, LOS, and hospital charges among hospitalizations with and without a coexisting diagnosis of C. difficile using logistic regression models for mortality and general linear models with gamma distribution and logarithmic transformation for LOS and hospital charges. We also evaluated temporal trends in the proportion of CF hospitalizations with concomitant CDI using data published triennially
Results
We analyzed 21,616 pediatric CF hospitalizations between the years 1997 to 2016 and found a total of 240 (1.1%) hospitalizations with concurrent CDI diagnosis. Adjusted analyses demonstrated an association of CDI with increased mortality (OR 5.2, 95% CI 2.5–10.7), longer LOS (46.5% increment, 95% CI 36.0–57.1), and higher charges (65.8% increment, 95% CI 53.5–78.1) for all comparisons. The proportion of CF hospitalizations with CDI increased over time from 0.64% in 1997 to 1.73% in 2016 (p < 0.001).
Conclusion(s)
As CDI is associated with excess mortality, LOS, and cost in children hospitalized for CF, a healthy level of suspicion for CDI may be needed in patients with CF in the appropriate clinical context. Efforts to prevent, diagnose, and treat CDI may improve hospital outcomes among children with CF.
Electronic cigarette or vaping product use-associated lung injury (EVALI) is a disease process that has become prevalent in the United States.
The Centers for Disease Control and Prevention reported ...there have been almost 2700 cases of this condition in the United States as of January 14, 2020, with >50% of these patients aged ≤24.
We present a 13-year-old boy with a history of functional abdominal pain who presented with recurrent episodes of nausea, emesis, periodic fevers, and severe episodic abdominal pain after a 12-month history of significant electronic cigarette use. On admission, he had severe abdominal pain and appeared anxious. A computed tomography scan of the abdomen was unremarkable, but a computed tomography scan of the chest demonstrated both multifocal ground-glass and crazy-paving pulmonary opacities bilaterally, with scattered septal thickening and dependent bibasilar opacities associated with volume loss. Inflammatory markers were significantly elevated, and cell counts were remarkable for leukocytosis and neutrophilia. The patient was ultimately diagnosed with EVALI and treated with intravenous methylprednisolone, resulting in improvement. This is an example of a case of EVALI in an adolescent, in which the presenting symptoms are largely gastrointestinal. It is important to keep EVALI in the differential diagnosis of patients who exhibit gastrointestinal symptoms, have markers of increased systemic inflammation, and endorse a history of vaping or are in the age range of electronic cigarette users. Although obtaining an accurate history of vaping can be challenging in the pediatric population, it is especially critical to do so.
The present study was aimed to assess the effect of gibberellic acids to enhance the growth, biomass, pigment, and exopolysaccharides production in
Tetraselmis suecica
under reciprocal nitrogen ...concentrations. For this study, the seven types of experimental media (N-P, NL-P/2GA3, N0-P/2GA3, NL-P/4GA3, N0-P/4GA3, NL-P/6GA3, and N0-P/6GA3) were prepared with the addition of gibberellic acids under various nitrogen concentrations. The experiment lasted for 15 days and the cell density, biomass, chlorophyll ‘a’, and exopolysaccharides (EPS) concentration of
T. suecica
were estimated for every 3 days. Then the EPS was subjected to the analyses of chemical (carbohydrate, protein, sulfate, and uronic acid), and antioxidant activity. In addition, nutrient removal efficiency was evaluated using different concentration of EPS. The highest DPPH (2,2-diphenyl-1-picrylhydrazyl) (86.7 ± 0.95%) and hydroxyl radical activity (85.7 ± 2.48%) were observed at the EPS concentrations 2.5 and 1.2 mg/mL, respectively. The immobilized magnetic Fe
3
O
4
–EPS (ferric oxide–exopolysaccharides) nanoparticles (5.0 and 10.0 g/L) have efficiently removed the excessive phosphate (89.5 ± 1.65%) and nitrate (73.5 ± 1.72%) from the
Litopenaeus vannamei
cultured wastewater. Thus, the application of gibberellic acids combined with limited nitrogen concentration could produce higher EPS that could exhibit excellent antioxidant activity, and nutrient removal efficacy in the form of Fe
3
O
4
–EPS magnetic nanoparticles.
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