Reducing Antibiotic Duration for Uncomplicated UTI in the Pediatric Emergency Department.

Background: Short-duration (3-5 days) antibiotic treatment of uncomplicated urinary tract infection (uUTI) in children >24 months of age is equivalent to longer-duration antibiotic treatment, with added benefits of antibiotic stewardship. At our pediatric emergency department (ED), 13% of 5- to 18-year-old patients discharged with uUTI received ≤5 days of antibiotics. We aimed to increase short-duration prescriptions in patients with uUTI from 13% to >50% over 12 months.

Evaluation and validation of a prediction model for extubation success in very preterm infants.

Objective: To perform an external validation of a publicly available model predicting extubation success in very preterm infants.

Study Design: Retrospective study of infants born <1250 g at a single center. Model performance evaluated using the area under the receiver operating characteristic curve (AUROC) and comparing observed and expected probabilities of extubation success, defined as survival ≥5 d without an endotracheal tube.

Valorization of fruit processing waste to produce high value-added bacterial nanocellulose by a novel strain Komagataeibacter xylinus IITR DKH20.

To date, the production of bacterial nanocellulose (BNC) by standard methods has been well known, while the use of low-cost feedstock as an alternative medium still needs to be explored for BNC commercialization. This study explores the prospect for the use of the different aqueous extract of fruit peel wastes (aE-FPW) as a nutrient and carbon source for the production of BNC. Herein, this objective was accomplished by the use of a novel, high- yielding strain, isolated from rotten apple and further identified as Komagataeibacter xylinus IITR DKH20 using 16 s rRNA sequencing analysis.

Caffeine for preterm infants: Fixed standard dose, adjustments for age or high dose?

Caffeine is an effective treatment for apnea of prematurity and has several important benefits, including decreasing respiratory morbidity and motor impairment. In this article, we focus on the dose of caffeine. We review the evidence regarding the efficacy and safety of standard caffeine dosing and alternative dosing approaches, including the use of high dose caffeine and routine dose adjustments for age.

Transfusion-related Gut Injury and Necrotizing Enterocolitis.

Necrotizing enterocolitis (NEC) accounts for 10% of deaths in neonatal intensive care units. Several causal mechanisms are likely to lead to a final common disease phenotype. This article summarizes recent data on NEC following red blood cell (RBC) transfusion, with a focus on the most recent literature and ongoing trials.

Epidemiology of Necrotizing Enterocolitis: New Considerations Regarding the Influence of Red Blood Cell Transfusions and Anemia.

This article summarizes available evidence on the relationship between red blood cell transfusion and anemia, and necrotizing enterocolitis (NEC). We review recent studies that highlight the uncertainty of the effect of red blood cell transfusion on NEC and the potential role of anemia. We also discuss potential pathophysiologic effects of both red blood cell transfusion and anemia and highlight strategies to prevent anemia and red blood cell transfusion.

Optimizing Caffeine Use and Risk of Bronchopulmonary Dysplasia in Preterm Infants: A Systematic Review, Meta-analysis, and Application of Grading of Recommendations Assessment, Development, and Evaluation Methodology.

Caffeine reduces the risk of bronchopulmonary dysplasia (BPD). Optimizing caffeine use could increase therapeutic benefit. We performed a systematic-review and random-effects meta-analysis of studies comparing different timing of initiation and dose of caffeine on the risk of BPD.

Tissue cell stress response to obesity and its interaction with late gestation diet.

Intrauterine growth restriction in late pregnancy can contribute to adverse long-term metabolic health in the offspring. In the present study we used an animal (sheep) model of maternal dietary manipulation in late pregnancy, combined with exposure of the offspring to a low-activity, obesogenic environment after weaning, to characterise the effects on glucose homeostasis. Dizygotic twin-pregnant sheep were either fed to 60% of requirements (nutrient restriction (R)) or fed ad libitum (~140% of requirements (A)) from 110 days gestation until term (~147 days).

Association of novel SNPs in the candidate genes affecting caprine milk fatty acids related to human health.

In the present investigation, 618 milk samples of Sirohi breed of goat were collected, and analyzed for conjugated linoleic acid (CLA, C18:2) and other fatty acids. The CLA in studied goat milk samples was 4.87 mg/g of milk fat and C18:2 cis-9, trans-11 contributes 2.

Sex differences in metabolic and adipose tissue responses to juvenile-onset obesity in sheep.

Sex is a major factor determining adipose tissue distribution and the subsequent adverse effects of obesity-related disease including type 2 diabetes. The role of gender on juvenile obesity and the accompanying metabolic and inflammatory responses is not well established. Using an ovine model of juvenile onset obesity induced by reduced physical activity, we examined the effect of gender on metabolic, circulatory, and related inflammatory and energy-sensing profiles of the major adipose tissue depots.

What is the easier and more reliable dose calculation for iv phenytoin in children at risk of developing convulsive status epilepticus, 18 mg/kg or 20 mg/kg?

Background: With the Convulsive Status Guidelines due for renewal, we wondered if a phenytoin dose of '20 mg/kg' would be easier to calculate correctly and therefore safer than the current '18 mg/kg'. An educational exercise in dose calculation was therefore undertaken to assess ease of calculation.

Method: A standard question paper was prepared, comprising five clinical scenarios with children of varying ages and estimated body weights.

Genetic structuring of nine Indian domestic goat breeds based on SNPs identified in IGF-1 gene.

The caprine Insulin like Growth Factor1 (IGF1) gene was analyzed for identification of single nucleotide polymorphisms (SNPs) and genetic structuring of Indian goat breeds. A panel of 80 samples belonging to nine Indian goat breeds (Capra hircus) including three large sized breeds (Jamunapari, Beetal and Jakhrana); three medium sized breeds (Sirohi, Barbari, and Osmanabadi) and three small sized breeds (Black Bengal, Changthangi, and Gaddi) were screened for SNP identification and diversity analysis. The comparative gene sequence analysis of all the nine goat breeds studied revealed a total of 18 SNPs in IGF1 gene.

Excess nutrient supply in early life and its later metabolic consequences.

Suboptimal nutrition in early life, both in utero and during infancy, is linked to increased risk of adult obesity and its associated adverse metabolic health problems. Excess nutrient supply during early life can lead to metabolic programming in the offspring. Such overnutrition can occur in the offspring of obese mothers, the offspring of mothers who gain excess weight during gestation, infants of diabetic mothers and infants who undergo rapid growth, particularly weight gain, during early infancy.

Femoral pseudoaneurysm in drug addicts: Hunterian ligation still a gold standard.

Pseudoaneurysm formation in the site of Intravenous drug abuser had been reported in literature. The repeated puncture of femoral vessels leads to abscess formation and epithelisation of the wall which leads to pseudoaneurysm formation. A case of lacking pseudoaneurysm presenting as reptured groin abscess in a drug addict is reported, which was managed successfully by Hunterian ligation with salvage of lower limb.

Highly cellular leiomyoma mimics a malignant small round-cell tumor: a diagnostic dilemma on frozen sections.

Objective: Cellular leiomyoma is characterized by significantly increased cellularity and may mimic malignant tumors. Our aim was to differentiate these from other malignant small round-cell tumors.

Case Report: We report a case of cellular leiomyoma that mimicked a malignant small round-cell tumor upon frozen section examination.

Solitary lymphangioleiomyoma of pancreas mimicking pancreatic pseudocyst--a case report.

Introduction: Lymphangioleiomyomatosis (LAM) is a rare disease characterized by proliferation of morphologically distinguishable smooth muscle cells in the lymphatics and lymph nodes of the pulmonary parenchyma in most cases. Extrapulmonary LAM is a rare condition and is found to occur concurrently, before or after pulmonary LAM, and show strong association with tuberous sclerosis.

Discussion: The literature regarding extrapulmonary LAM without associated pulmonary LAM is limited due to the extreme rarity of the cases.