Discomfort relief after paracetamol administration in febrile children admitted to a third level paediatric emergency department

Background

international guidelines recommend treating fever in children not at a predefined body temperature limit but based on the presence of discomfort. However few studies evaluated discomfort relief after administration of antipyretics in children.

Methods

Between 1st January and 30th September 2021 a single-center prospective observational study was performed in febrile children consecutively admitted to a pediatric emergency department and treated with paracetamol orally. For each child, body temperature, presence and severity of discomfort, defined using a previously published semiquantitative likert scale, were evaluated at baseline and 60 min after administration of paracetamol, and differences were analyzed.

Results

172 children (males: 91/172; 52.9%; median age: 41.7 months) were included. Significant reductions in body temperature (median body temperature at T0: 38.9 °C; IQR: 38.3-39.4, median body temperature at T60: 36.9 °C; IQR: 36.4-37.5; P < 0.0001), and in the level of discomfort (proportion of children with severe discomfort at T0: 85% and at T60:14%; P < 0.0001) were observed. Severe discomfort at T60 persisted in a minority of children (24/172; 14%) and it was not related to body temperature values.

Conclusions

paracetamol in febrile children is associated not only with significantly reduction in body temperature but also with discomfort relief.

Degradation of emerging organic pollutants in wastewater effluents by electrochemical photocatalysis on nanostructured TiO2 meshes

An immobilized photoactive TiO₂ coating grown directly on titanium meshes was successfully exploited for the electrochemical photocatalytic degradation of carbamazepine in real secondary wastewater effluent. The catalyst was prepared by Plasma Electrolytic Oxidation and during the photocatalytic water treatment an electrical polarization (bias) was applied to the catalyst. The investigated process was compared with the conventional one employing suspended TiO₂ powder (Degussa P25). Results showed that carbamazepine degradation rate follows the order UV/supported TiO₂+bias ≈ UV/TiO₂ Degussa P25 > UV/supported TiO₂ > UV. The investigation also included the identification of other micropollutants and degradation products. This allowed the detection of 201 compounds present in the secondary wastewater effluent employed for the photocatalysis tests, 51 of them also successfully associated to compounds of emerging concern (CECs), and 194 to transformation products (TPs). The degradation of detected compounds followed first-order kinetics and the mean kinetic constant values of the 51 CECs resulted to be 0.048, 0.035 and 0.043 min^-1 for the TiO₂+Bias + UV, TiO₂+UV and UV, respectively. As for TPs, results showed that the TiO₂+Bias + UV treatment is much more efficient than both TiO₂+UV and UV in minimizing the intensity of the organics in the real wastewater. Such a better performance was more pronounced at higher reaction time reaching 60% reduction of mean peak area of TPs at 90 min of reaction. Among the detected TPs also compounds belonging to known carbamazepine TPs were found. This allowed to propose a degradation pathway of carbamazepine. The supported catalyst was positively tested for 15 cycles demonstrating that it has the potential to be used in real wastewater tertiary steps aimed at removing CECs.