l outcomes. Therefore, smoking may be used as a predictive indicator for pretreatment evaluation and adjustment of treatment regimen. © 2020 Liu L. et al.Objective To analyze changes in immune functions by detecting lymphocyte subsets in the peripheral blood of residents in the vicinity of radon from hot springs. Methods Two groups were randomly selected; 61 residents in the vicinity of the hot springs were assigned to the radon group, and 51 residents with a similar lifestyle and habits but no contact with hot springs were assigned to the control group. The percentages of lymphocyte subsets (CD3+, CD4+CD8-, CD4-CD8+, CD4+/CD8+, and TCR/CD3) in the 2 groups were evaluated on a FACS Aria flow cytometer. The absolute values of lymphocytes (LYMPH#) and percentages of lymphocytes (LYMPH%) were measured by an automatic blood analyzer. Results In the radon group, the numbers of CD3+ (Z = -0.140, P > .05) and CD4+CD8- (Z = -0.964, P > .05) T cells were higher, as compared with the controls, but this difference was not significant. In addition, the number of CD4-CD8+ (t = -2.141, P .05) showed no significant change. Conclusion Radon-rich hot springs could alter the proportions of lymphocyte subsets and possibly affect immunologic functions. © The Author(s) 2020.This article serves as a Position Statement of the Pediatric Pharmacy Association (PPA), which supports safe and effective medication use in schools. PPA recommends that schools develop comprehensive medication use policies to support safe and appropriate administration of both chronic and emergency medication in schools. These policies must address issues specific to pediatric patients, including off-label and over-the-counter medication use, various pediatric dosage forms, as well as appropriate medication storage, administration, and disposal practices. PPA also advocates for continued staff development and education regarding laws, regulations, and policies surrounding medication use in school to ensure safe and effective care of children and adolescents in the school setting. For permissions, mhelms@pediatricpharmacy.org 2020.Lymphatic malformations in neonates often manifest as a chylothorax, and although rare, morbidity and mortality can be significant. First-line treatment with medium-chain triglyceride-enriched formulas, or enteric rest with total parenteral nutrition, are not always successful. We describe the case of a premature neonate with trisomy 21 who presented with bilateral pleural effusions and a pericardial effusion that worsened with the initiation of enteral nutrition. https://www.selleckchem.com/products/lorundrostat.html Clinical improvement was not seen until the initiation of treatment with oral propranolol at a maximum dosage of 0.5 mg/kg/day divided every 8 hours with extubation 8 days after propranolol initiation. Two case reports have described the use of propranolol in similar patients receiving 2 mg/kg/day; however, our experience is the first to report treatment success at a much lower dose. A review of the literature for alternative medication treatments uncovered numerous case reports and series documenting variable results with incongruent definitions of treatment success in a diverse patient population. The rarity of this disease state makes accrual of patients difficult and more robust treatment data unlikely. Therefore, selection of the optimal adjunctive treatment must be based on individual patient and disease state characteristics as well as safety and efficacy profile of the medication. For permissions, mhelms@pediatricpharmacy.org 2020.Children and adolescents with autism spectrum disorder (ASD) often experience high levels of irritability, which adversely affects their functioning and behaviors. N-acetylcysteine (NAC), an antioxidant precursor to glutathione, has recently been studied for a variety of neuropsychiatric disorders. There is growing evidence to support its use to decrease irritability and self-injurious behaviors in youth with ASD. However, previous studies were limited to outpatient youth with mild symptoms of irritability, maintained on stable medication regimens, who do not meet criteria for higher levels of care. We describe the use of NAC among 4 youths (14-17 years) with ASD who had Aberrant Behavior Checklist-Irritability (ABC-I) scores of ≥ 20 and other psychotropic medication trials prior to treatment with NAC. In all of the cases, NAC appeared to be well tolerated. There was a reduction of symptoms of irritability and/or antipsychotic medication dosages in these cases; despite this, the authors cannot know whether use of NAC or other medication or behavioral strategies were responsible for such changes because this study was not a controlled trial. For permissions, mhelms@pediatricpharmacy.org 2020.BACKGROUND Compared with adults, children may be at greater risk of medication errors and potential adverse effects. The American Academy of Pediatrics recommends developing mechanisms for proactively identifying patients at risk for medication-related adverse events and failed reconciliation. This study's primary purpose was to evaluate pediatric patients admitted to identify risk factors requiring pharmacist intervention during medication reconciliation (MedRec). METHODS This prospective study included pediatric patients admitted during the study time frame until the target population of 500 patient encounters was achieved. During each admission, pharmacy staff completed a medication history, after which a pediatric pharmacist completed a MedRec, as is standard hospital practice. The primary outcome was identification of factors for high-risk transitions of care during pediatric admissions based on the need for pharmacist interventions during the MedRec process. RESULTS In total, 331 interventions were made for 127 patients (median 2; range, 1-12). Of the 331 interventions, 196 (59.2%) were classified as being of moderate or significant severity. Although patients with at least 2 home medications were significantly more likely to require any intervention (p less then 0.0001), patients with 5 or more home medications were more likely to have a significant intervention. CONCLUSION Identifying patients with home medications could allow for focused efforts to intervene. Also, patients admitted to the PICU or those with cardiology- or endocrinology-related diagnoses should be prioritized for MedRec process, because of the likelihood of requiring multiple home medications. This strategy should be tailored to individual pediatric institutions based on internal quality control assessments and available resources. For permissions, mhelms@pediatricpharmacy.org 2020.