Lung ultrasound outperforms conventional radiology in the emergency diagnosis of pneumothorax and pleural effusions. In the pediatric age, lung ultrasound has been also successfully applied to the fluid-to-air transition after birth and to rapid pneumonia diagnosis.

Nasal ventilation has dramatically decreased the need for invasive mechanical respiratory support. This study demonstrates that, after a short trial on nasal continuous positive airway pressure, lung ultrasonography reliably predicts the failure of noninvasive ventilation unlike the conventional chest radiogram. (Read the full article)

Although frequent utilizers of emergency departments (EDs) are targeted for quality improvement initiatives across the United States, little is known about the health services these patients receive in the ED.

Eight percent of children account for 24% of ED visits and 31% of all costs. Frequent utilizers of pediatric EDs, especially infants without a chronic condition, are least likely to need medications, testing, and hospital admission during their ED visits. (Read the full article)

Evidence from cohort studies has consistently found that universal bilirubin screening is associated with reductions in rates of severe hyperbilirubinemia but has shown variation in other outcomes such as phototherapy use, length of stay, emergency department visits, and readmission rates.

Universal bilirubin screening may not increase neonatal length of stay or postdischarge hospital use. Preexisting trends in health care utilization have an impact on observed effects of universal bilirubin screening. (Read the full article)

Infants who require positive pressure ventilation at birth are considered to be at risk for subsequent compromise and are recommended to receive postresuscitation care. The supportive evidence and details of this care have not been fully investigated.

We investigate the need for postresuscitation care in infants who require positive pressure ventilation at birth, review the aspects of care needed, and explore the important risk factors most predictive of it. (Read the full article)

Obstructive sleep apnea syndrome (OSAS) is associated with significant comorbidity: behavioral problems, sleepiness, and impaired quality of life. However, the utility of OSAS symptoms versus polysomnography in the prediction of comorbidities or response to treatment is not well known.

Among children with OSAS, the Pediatric Sleep Questionnaire, a well-validated, simple 1-page symptom inventory, predicts key adenotonsillectomy-responsive OSAS comorbidities and their improvement after adenotonsillectomy. In contrast, polysomnographic results do not offer similar predictive value. (Read the full article)

Noninvasive ventilation (NIV) reduced the need of intubation in preterm infants with RDS. However, randomized studies comparing nasal synchronized intermittent positive pressure ventilation and bilevel continuous positive airway pressure are still lacking.

The present study shows no differences in short-term outcomes between 2 different NIV strategies, nasal synchronized intermittent positive pressure ventilation and bilevel continuous positive airway pressure, in preterm infants for the initial treatment of RDS. (Read the full article)

Treatment of idiopathic steroid-resistant nephrotic syndrome is challenging, and therapeutic options are limited. In spite of good initial response with rituximab, responders always remain prone to further relapse, necessitating either repeat course of rituximab or addition of another steroid-sparing immunosuppressant.

Mycophenolate mofetil may be an effective maintenance therapy to consider as an additive immunosuppressant after induction with rituximab in maintaining remission among children with refractory steroid-resistant nephrotic syndrome. (Read the full article)

Children with medical complexity require a disproportionate amount of health services due to a multitude of chronic severe illness, and their impact on the health care system appears to be increasing.

This study provides one of the first comparisons of health care utilization patterns for children with medical complexity between medical centers in a population-based cohort. (Read the full article)

Given the efforts to decrease the use of ionizing radiation in pediatric patients, there is significant variability in head computed tomography (CT) scan use in pediatric emergency departments for minor head trauma.

This study characterized variability in CT scan rates for all body regions in emergency department, observation, and inpatient encounters across 30 tertiary pediatric hospitals. Two-fold variation remained after case-mix adjustment, with higher volume hospitals having lower rates of CT scanning. (Read the full article)

A Fin24 reader nearing retirement wants to know if he can access his retirement annuity now while still employed or only after officially retiring.

There has been a distinct trend of consolidation among private medical schemes in South Africa, according to an actuarial specialist at Alexander Forbes.

A Fin24 reader who bought a property in December 2019 sent his registration papers off just before the lockdown was announced, which was unfortunately too late. A property law expert responds.

Due to markets and festivals closing until the end of June, a Fin24 reader will have no source of income and wants to know if there will be a payment holiday period. A debt expert responds.

Despite three agreements between the rebels and the government, peace is still elusive in eastern Democratic Republic of Congo. The Kivus need regional dialogue and a clear, fair repatriation plan, argues Thierry Vircoulon at the International Crisis Group.

Leishmania major is the causative agent of cutaneous leishmaniasis (CL). No human vaccine is available for CL and current drug regimens present several drawbacks such as emerging resistance, severe toxicity, medium effectiveness, and/or high cost. Thus, the need for better treatment options against CL is a priority. In the present study, we validate the enzyme methionine aminopeptidase-1 (MetAP1), a metalloprotease that catalyzes the removal of N-terminal methionine from peptides and proteins, as a chemotherapeutic target against CL infection. The in vitro antileishmanial activity of eight novel MetAP1 inhibitors (OJT001-OJT008) were investigated. Three compounds OJT006, OJT007, and OJT008 demonstrated potent anti-proliferative effect in macrophages infected with L. major amastigotes and promastigotes at submicromolar concentrations, with no cytotoxicity against host cells. Importantly, the leishmanicidal effect was diminished by almost 10-fold in transgenic L. major promastigotes overexpressing MetAP1_LM in comparison to wild-type promastigotes. Furthermore, the in vivo activity of OJT006, OJT007, and OJT008 were investigated in L. major-infected BALB/c mice. In comparison to the control group, OJT008 significantly decreased footpad parasite load by 86%, and exhibited no toxicity against in treated mice. We propose MetAP1 inhibitor OJT008 as a potential chemotherapeutic candidate against CL infection caused by L. major infection.

Objectives: Carbapenemase-producing Enterobacterales and specifically KPC-producing Klebsiella pneumoniae (KPC-Kp) are rapidly spreading worldwide. The prognosis of ventilator-associated pneumonia (VAP) caused by KPC-producing Klebsiella pneumoniae (KPC-Kp) is not well known. Our study tries to assess whether ventilator-associated pneumonia caused by a KPC-Kp strain is associated with higher all-cause mortality than if caused by carbapenem-susceptible isolates.

Study design and methods: This is a retrospective cohort study of patients with VAP due to K. pneumoniae from a 35-bed polyvalent Intensive Care Unit in a university hospital (> 40,000 annual admissions) between January 2012 and December 2016. Adjusted multivariate analysis was used to study the association of KPC-Kp with 30-day all-cause mortality (Cox regression).

Results. We analyze 69 cases of K. pneumoniae VAP of which 39 were produced by a KPC-Kp strain with high-level resistance to meropenem (MIC > 16 mg/mL). All-cause mortality at 30 days was 41% in the KPC-Kp group (16/39) and 33.3% in the carbapenem-susceptible cases (10/30). KPC-Kp etiology was not associated with higher mortality when controlled for confounders (adjusted hazard ratio [lsqb]HR[rsqb] 1.25; 95% CI: 0.46–3.41). Adequate targeted therapy (HR 0.03; 95% CI: <0.01–0.23) was associated with all-cause mortality.

Conclussion. Assuming the limitations due to the available sample size, the prognosis of VAP caused by KPC-Kp is similar to VAPs caused by carbapenem-susceptible K. pneumoniae when appropriate treatment is used.

OBJECTIVES:

Infantile hemangiomas (IHs) are common; some cases require timely referral and treatment to prevent complications. We developed and validated a reliable instrument for timely and adequate referral of patients with IH to experts by nonexpert primary physicians.

Before inviting everyone over to watch, make sure your TV setup is Super Bowl ready. After all, there's no excuse with sales like these.

So many years after vouchers began, we still can't agree on their benefits.

T. Michael O'Shea
Jul 1, 1999; 104:15-21
ARTICLES

The universe is full of questions waiting to be solved. So why teach science like all the discoveries have already been made? asks Alexander Bell.

Prime Day is over but there are still some great deals available. AirPods, Apple Watch Series 4, Samsung Galaxy S10e, Google Pixel 3 XL are discounted right now.

There’s still an opportunity to take classes this summer with Penn State York. The two six-week summer sessions, offered remotely, give students a chance to get ahead for fall, catch up on classes, or just get started.

The recent breaches of NordVPN and TorGuard demonstrate how trust is an intangible but important feature of security software. If you lose confidence in a security product, such as a VPN, it's probably time to ditch it.

Qualcomm-powered 5G PCs will go on sale early next year, likely at very low prices. Intel 5G laptops won't happen until much later, but they could be worth the wait.

The College of Education presented a number of awards this spring to faculty, staff and students.

Calls to fully fund the nation's main special education law resound on the campaign trail, but a complex array of factors make that an elusive goal.

A 64-core/128-thread CPU. A new challenger in laptop processors. A feisty new fighter in midrange graphics. These three things have three letters in common. Plus: SSDs take on stunning new capacities, speeds, and looks.

Roombas, Echo and Ring Alarm devices, and the Apple Watch Series 5 are all still discounted. There's also a great Nintendo Switch deal that includes $20 in Nintendo eShop credit.

If this was a review, these AirPods would definitely earn a passing grade.

Here are five takeaways on the teaching profession from the newly released 2017-18 National Teacher and Principal Survey.

Although cash should still be seen as a "trashy" asset class, investors do not have many other places to park their money, says an analyst.

There is still no light at the end of the tunnel for small enterprises, according to the SMME Business Confidence Index for 2010.

Hedge funds: Better long-term returns at less risk.

A perceived lack of liquidity can make creditors uneasy.

Lebanon’s Ministry of Telecommunications has been authorized by the Cabinet to temporarily operate the country’s two cellular networks until a new tender is launched, Minister of Telecommunications Talal Hawat said Tuesday.

The Delaware Public Service Commission yesterday approved a petition from the state’s Public Advocate to ensure that consumers will receive the benefits of any savings realized by regulated Delaware utilities under the federal Tax Cuts and Jobs Act of 2017.

Javier Sotomayor talks to Sonam Saini about entering the hinterlands, rising ticket prices, and the threat from OTT players.

Narinder Batra will continue to hold his post as International Hockey Federation's (FIH) annual congress was postponed due to the coronavirus pandemic.

Former Chhattisgarh Chief Minister Ajit Jogi has been admitted to a hospital in Raipurafter he suffered a cardiac arrest at his home this afternoon. His condition is said to be "serious" and is on...

State offices to remain closed until 8 a.m. Tuesday

Closure of state offices extended until 4:30 p.m. Tuesday

American and Delaware flags at state buildings and facilities are to remain lowered to half-staff until Monday, December 8, to recognize Pearl Harbor Remembrance Day.

Delaware farmers, lawn care companies, golf courses and other nutrient handlers should not apply nutrients to the ground during the winter months, the Delaware Department of Agriculture says in a reminder.

Delaware farmers, lawn care companies, golf courses and other nutrient handlers should not apply nutrients to the ground during the winter months, the Delaware Department of Agriculture reminds applicators.

 Settlement and Default Handling Procedures in Multilateral and Deferred Net Settlement Systems under the PSS Act, 2007

 Regarding imposing of anti-dumping duty on all imports of Recordable Digital Versatile Disc [DVD] of all kinds origina