Incidence of Hypertension Among Children Treated With Adrenocorticotropic Hormone (ACTH) or Prednisolone for Infantile Spasms.

Children with infantile spasms are often treated with hormonal therapies including adrenocorticotropic hormone (ACTH) and prednisolone. These have numerous systemic side effects including hypertension and, rarely, fatal cardiomyopathy; however, the incidence of these side effects has not been well described. This study aims to quantify the incidence and short-term sequelae of hypertension in this population. A retrospective chart review was performed at a single institution. Children 2 months to 2 years old with newly diagnosed infantile spasms treated from 2013 to 2017 were included. Variables collected included age, sex, etiology and treatment of infantile spasms, documented or missed diagnosis of hypertension, treatment of hypertension, echocardiogram results, referrals for hypertension, and persistence of hypertension 2 to 4 months after treatment. Analyses included descriptive statistics with percentiles, means, and medians. Differences between groups were assessed using Fisher exact tests. Hypertension occurred in 34/77 children (44%) during treatment with ACTH and 4/11 children (36%) during treatment with prednisolone. No child developed hypertension during treatment with nonhormonal therapies. The incidence of hypertension between ACTH and prednisolone groups was not significantly different (P = .75). The incidence of hypertension was significantly higher in the ACTH and prednisolone groups compared to the nonhormonal group (P < .001 for each). Sixteen children received echocardiograms, with no cases of cardiomyopathy. Two children had persistent hypertension at 2 months after discontinuation of hormonal therapy. Hypertension is a very common side effect of hormonal therapy for infantile spasms; however, few developed long-term hypertension and none developed cardiomyopathy. Further study is needed to determine the role of antihypertensive treatment for hormone-related hypertension.

Use and diversion of medical marijuana among adults admitted to inpatient psychiatry.

BACKGROUND: Marijuana use is associated with anxiety, depressive, psychotic, neurocognitive, and substance use disorders. Many US states are legalizing marijuana for medical uses. OBJECTIVE: To determine the prevalence of medical marijuana use and diversion among psychiatric inpatients in Colorado. METHODS: Some 623 participants (54.6% male) responded to an anonymous 15-item discharge survey that assessed age, gender, marijuana use, possession of a medical marijuana card, diversion of medical marijuana, perceived substance use problems, and effects of marijuana use. Univariate statistics were used to characterize participants and their responses. Chi-square tests assessed factors associated with medical marijuana registration. RESULTS: Of the total number of respondents, 282 (47.6%) reported using marijuana in the last 12 months and 60 (15.1%) reported having a marijuana card. In comparison to survey respondents who denied having a medical marijuana card, those respondents with a medical marijuana card were more likely to have initiated use before the age of 25, to be male, to have used marijuana in the last 12 months, and to have used at least 20 days in the past month. 133 (24.1%) respondents reported that someone with a medical marijuana card had shared or sold medical marijuana to them; 24 (41.4%) of respondents with a medical marijuana card reported ever having shared or sold their medical marijuana. CONCLUSION: Medical marijuana use is much more prevalent among adults hospitalized with a psychiatric emergency than in the general population; diversion is common. Further studies which correlate amount, dose, duration, and strain of use with particular psychiatric disorders are needed.

Substrate effects on the wettability of electrospun titania-poly(vinylpyrrolidone) fiber mats.

Titania-poly(vinylpyrrolidone) (PVP) core-shell nano/microfibers are electrospun on substrates of differing hydrophilicity and conductivity in order to investigate the connection between these substrate properties and the apparent water contact angles against the fiber mats. The focus of this study compares current data from silicon- and aluminum foil-supported mats to extant data from ITO and glass-supported fibers to detail the complexities of apparent contact angle dependence on mat structure related to substrate properties. Electrospinning time and collection distance were controlled parameters for producing thicker and denser mats. In all cases, contact angles increased with collection time for a given substrate series. A morphological wettability study of the fiber mat surface was conducted by applying Rhodamine B dye solution droplets. Using fluorescence microscopy, the stained fibers indicate the extent of true wetting contact and the lack of penetration into the fiber layers. Image comparisons with bright-field illumination confirms that even some fibers of the top layers are not wetted.

Wettability of electrospun poly(vinylpyrrolidone)-titania fiber mats on glass and ITO substrates in aqueous media.

Networks of nano/microfibers (fiber mats) have been electrospun from solutions of dispersed poly(vinylpyrrolidone) (PVP) and a titania precursor onto glass and indium-tin oxide (ITO) plates to study their wettability. Collection time and electrode separation are the two key fabrication parameters investigated, along with the flow rate, polymer molecular weight, and drying conditions, to determine the effects on network morphology and the relationship to contact angles. Measurements indicate that the fiber mats on both glass and ITO increase in thickness and contact angle for longer spinning time and shorter distance, resulting in an extreme case of apparent ultrahydrophobicity on ITO of up to 169.9 degrees with water. The fiber mats are shown by optical microscopy to exhibit differences in morphology for insulating glass (straight) and conductive ITO (loopy) substrates responsible for the wide-ranging and well-controlled wettability to within 1-2 degrees. Fiber mats baked at 200 degrees C for 24 h show excellent mechanical stability with wetting even against frequent heavy rinsing, conducive for reusable aqueous applications such as biosensors or cellular scaffolding.