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A 3-year-old girl came to our attention for fever and upper respiratory tract infection associated with thrombocytopenia, non-immune hemolytic anemia, and acute kidney injury (AKI). Complete blood count and renal function slowly normalized, with no need for dialysis. She was always normotensive with valid diuresis; her neurological status also rapidly improved. Nasal swab turned out positive for influenza A H1N1; stool test was negative for Shiga toxin-producing Escherichia coli (STEC). The patient was treated with oseltamivir for 5 days with a favorable outcome. Association between hemolytic uremic syndrome (HUS) and H1N1 influenza is poorly reported in literature [1, 2, 3, 4]. The pathogenic role of the virus in causing HUS is still controversial and debated [1, 2, 3, 4]. In our patient, complement activity markers (serum C3 and C5b-9) alteration suggested a transient, virus-mediated complement activation.

Variations on normality on the vulvar aspect have generated many difficulties among general pediatricians.The great amount of aesthetical perfection has led to an increasing number of adolescents seeking for vulvar correction. Here we describe a common alteration and provide some clues on the eventual surgical managing of the condition. info:eu-repo/semantics/acceptedVersion

Key Clinical Message Subcutaneous fat necrosis (SCFN) is a rare fat tissue inflammation of the newborn. Risk factors include cord prolapse, perinatal asphyxia, therapeutic hypothermia, meconium aspiration, and sepsis. When present, hypercalcemia comes with lethargy, hypotonia, irritability, vomiting, polyuria, polydipsia, constipation, and dehydration. Kidney injury must be avoided. SCFN is often completely autoresolutive.

Key Clinical Message Classic CO (also called Iso–Kikuchi syndrome) represents a benign, isolated condition associated with normal patient outcome. Nevertheless, clinical follow-up and/or further clinically-based tests are needed to exclude other nail diseases associated with multisystem pathology; complete family history is also important to determine sporadic or hereditary transmission of such condition.

Sonographic cardiac evaluation of newborns with suspected aortic coarctation (AoC) should tend to demonstrate a good phasic and pulsatile flow and the absence of pressure gradient along a normally conformed aortic arch from the modified left parasternal and suprasternal echocardiographic views; these findings, however, may not necessarily rule out a more distal coarctation in the descending aorta. For this reason, the sonographic exam of newborns with suspected AoC should always include a Doppler evaluation of abdominal aortic blood flow from the subcostal view. Occasionally, however, a clearly pulsatile Doppler flow trace in abdominal aorta may be difficult to obtain due to the bad insonation angle existing between the probe and the vessel. In such suboptimal ultrasonic alignment situation, the use of Tissue Doppler Imaging instead of classic Doppler flow imaging may reveal a preserved aortic pulsatility by sampling the aortic wall motion induced by normal flow. We propose to take advantage of the TDI pattern as a surrogate of a normal pulsatile Doppler flow trace in abdominal aorta when the latter is difficult to obtain due to malalignment with the insonated vessel.La valutazione ecocardiografica del neonato con sospetta coartazione aortica deve poter dimostrare, dalle proiezioni parasternale sinistra alta e soprasternale, un arco aortico normoconformato con traccia Doppler normale (flusso fasico) in assenza di gradiente transistmico; tali rilievi, tuttavia, non escludono la possibilità di una coartazione aortica più distale, sita in aorta discendente toracica. Per tale motivo, la valutazione ecografica neonatale nel sospetto di coartazione aortica deve sempre includere un’analisi Doppler del flusso in aorta discendente, visualizzata tramite approccio sottocostale. Talvolta, tuttavia, l’angolo che si viene a creare tra il fascio ultrasonoro e il vaso a questo livello può risultare subottimale ai fini di un adeguato campionamento Doppler che dimostri la presenza di flusso fasico e privo di run-off diastolico in aorta addominale. In tale situazione di allineamento non ottimale per l’analisi Doppler classica, la metodica TDI (Tissue Doppler Imaging) può rivelare una preservata pulsatilità aortica tramite l’analisi della motilità di parete del vaso indotta dal normale flusso fasico. Tale metodica di valutazione della pulsatilità di parete aortica potrebbe, se validata attraverso studi di numerosità adeguata sul neonato sano, rappresentare un adeguato surrogato di una traccia Doppler normale in aorta addominale nei casi in cui quest’ultima fosse difficoltosa da ottenere a causa di un malallineamento tra il vaso ed il fascio ultrasonoro esplorante.La valutazione ecocardiografica del neonato con sospetta coartazione aortica deve poter dimostrare, dalle proiezioni parasternale sinistra alta e soprasternale, un arco aortico normoconformato con traccia Doppler normale (flusso fasico) in assenza di gradiente transistmico; tali rilievi, tuttavia, non escludono la possibilità di una coartazione aortica più distale, sita in aorta discendente toracica. Per tale motivo, la valutazione ecografica neonatale nel sospetto di coartazione aortica deve sempre includere un’analisi Doppler del flusso in aorta discendente, visualizzata tramite approccio sottocostale. Talvolta, tuttavia, l’angolo che si viene a creare tra il fascio ultrasonoro e il vaso a questo livello può risultare subottimale ai fini di un adeguato campionamento Doppler che dimostri la presenza di flusso fasico e privo di run-off diastolico in aorta addominale. In tale situazione di allineamento non ottimale per l’analisi Doppler classica, la metodica TDI (Tissue Doppler Imaging) può rivelare una preservata pulsatilità aortica tramite l’analisi della motilità di parete del vaso indotta dal normale flusso fasico. Tale metodica di valutazione della pulsatilità di parete aortica potrebbe, se validata attraverso studi di numerosità adeguata sul neonato sano, rappresentare un adeguato surrogato di una traccia Doppler normale in aorta addominale nei casi in cui quest’ultima fosse difficoltosa da ottenere a causa di un malallineamento tra il vaso ed il fascio ultrasonoro esplorante.

Background Pre-delivery maternal electrolyte derangements may reflect themselves in the newborn, since placental homeostasis determines electrolyte equilibrium between mother and fetus. Case presentation A term newborn, transferred to our Neonatal Intensive Care Unit 1 h after birth for an apnoea episode, presented with initially left-sided, and subsequently generalized tonic-clonic seizures due to severe hyponatremia (119 mmol/L). Seizures rapidly ceased after electrolyte correction plus a phenobarbital bolus. Deep hyponatremia was also detected in the mother (123 mmol/L). Conclusions As placental homeostasis determines electrolytes equilibrium between mother and fetus, obstetrics and neonatologists should be aware that any maternal dyselectrolytemia will reflect itself in the newborn; hence, it is fundamental to detect possible maternal electrolyte imbalances before delivery, in order to be prepared to timely correction of electrolyte derangements in the newborn.

We describe a case of 17-year-old Chinese girl referred to our Pediatric Cardiology Unit for asthenia, reduced exercise tolerance, and dyspnea. Past medical history was relevant for multiple chest pain episodes in childhood and several syncopal episodes, for which the patient had been never evaluated. Clinical examination, electrocardiogram, and echocardiography were compatible with Williams–Beuren syndrome; such condition was later confirmed by genetic analysis. Cardiac magnetic resonance imaging showed transmural fibrosis of the apex with impaired left ventricular ejection fraction (29 %), severe stenosis of aortic sinotubular junction with left and right coronary ostia involvement; more importantly, the whole coronary artery tree beyond ostia was affected by multiple stenosis and aneurysmatic tracts. Ascending aorta proved hypoplastic, with post-stenotic dilation and multiple aneurysms. At the end of the diagnostic process, surgical risk was considered too high to proceed with the correction. The presented case is of educational value since it provides good iconographical illustration of diffuse, multiple-site coronary artery tree involvement, a rather rare co-morbidity in Williams–Beuren syndrome. Electronic supplementary material The online version of this article (doi:10.1186/s40064-015-1231-0) contains supplementary material, which is available to authorized users.

Despite the fact that sheep are a widely used animal model in cardiovascular research, reference values for transthoracic echocardiography in normal growing animals are not available. Eight healthy female lambs underwent two-dimensional, M-mode and pulsed wave Doppler echocardiographic examination at 100 days of age and every three months thereafter over a 12-month period. The study was conducted under sedation with midazolam, butorphanol and constant rate infusion of intravenous propofol. Their growth phase was completed at about one year of age. All the echocardiographic parameters considered were significantly correlated with body weight and age class except for the left ventricular systolic and diastolic diameters. Functional indices were not correlated to body weight or age except for the E-point to septal separation distance (EPSS). Doppler-derived parameters were not influenced by independent variables. Transthoracic echocardiography can be considered an applicable method for cardiovascular research using a growing lamb animal model after appropriate adjustments for age and body size.

Ankyloblepharon filiforme adnatum (AFA) is a rare congenital anomaly consisting of a partial or complete fusion of the eyelid margins. It is usually an isolated and benign malformation but its presence should alert the neonatologist because it can be rarely associated to other important multisystemic disorders. We report a case of a newborn presenting with isolated AFA at birth, treated in the first day of life.

We have obtained deep BVI CCD photometry of Phoenix, a galaxy considered a transition case between dwarf spheroidal and dwarf irregular galaxies. A comparison of our data with the RGBs of Galactic globular clusters gives a mean metal abundance [Fe/H] = -1.81+/-0.10 dex. The presence of an intrinsic color dispersion in the upper red RGB suggests an abundance range of about 0.5 dex, although a range in age may also affect the RGB width. For the first time, a HB has been revealed at V~23.8. The HB is predominantly red yet moderately extended to the blue, which indicates the presence of a significant population with age comparable to that of old halo GGCs. This HB morphology in a metal-poor system indicates a mild "second parameter" effect. From the mean level of the HB we derived a true distance modulus 23.21+/-0.08, in good agreement with the distance modulus 23.04+/-0.07 estimated from the cutoff of the RGB at I~23.1. We find a radial gradient in the HB morphology, and our CMDs show a small number of stars above the RGB tip, that most likely are AGB stars of an intermediate age population. Their number indicates that the fraction of intermediate age population in Phoenix is approximately 30-40%. A young stellar population is definitely present in Phoenix, consistent with a star formation episode started at least 0.6 Gyr ago, up to 1x10^{8} yr ago. Both young stars and AGB stars are centrally concentrated, which indicates that recent star formation preferentially occurred in the inner galaxy regions. In many respects, Phoenix appears not dissimilar from dwarf spheroidal galaxies in the Local Group., 14 pages, 13 figures, accepted for publication in Astronomy and Astrophysics (main journal)

We propose a plausible mechanism for orbital angular momentum loss in black-hole intermediate-mass X-ray binaries, assuming that a small fraction of the transferred mass form a circumbinary disc. The disc can effectively drain orbital angular momentum from the binary, leading to the formation of compact black-hole low-mass X-ray binaries. This scenario also suggests the possible existence of luminous, persistent black hole low-mass X-ray binaries.

We present broadband V,I CCD photometry for ca. 1700 stars towards the Galactic globular cluster Palomar 12, covering a field of 10.7' x 10.7'. From these data, a color-magnitude diagram from the red giant branch tip to ca. 2 mag below the cluster's turn-off is obtained. From a comparison with the color magnitude diagrams of 47 Tuc and M5, and using different theoretical models, we confirm that Pal 12 is younger, finding an age 68% +/- 10% that of both template clusters. Revised structural parameters are also obtained: r(c) = 37.8 +/- 0.6 and c = 1.08 +/- 0.02., 10 pages, 7 figures, to be published in Astronomy & Astrophysics, vol. 339

We are carrying out a survey of 51 poorly studied globular clusters, by means of spectroscopy of ̃20 red giants per cluster. Optical spectra (4600-5800 Å) were obtained with the FORS2@VLT/ESO, at a resolution Delta lambda ̃ 2.5 Å. We are using ETOILE code to derive [Fe/H], T_eff, log g for each star, by finding the best fitting spectrum among a grid of ̃ 2000 stars of the ELODIE library. These parameters represent the initial guess for HALO, which finds [Mg/Fe] values by comparing the observed spectrum to a grid of 4000 synthetic spectra. The main contributions of this work are: to provide a homogeneous scale of [Fe/H], [Mg/Fe], and radial velocities for the 51 clusters -- in particular for the 29 distant and/or highly reddened ones -- to provide a catalogue of confirmed member stars for each cluster, as well as to find interesting cases for follow-up with high resolution (like M 22, and NGC 5824, for which we found a spread in [Fe/H]).