Search

Abstract Background Listeria monocytogenes is a Gram-positive bacteria transmitted to human by animal stools, contaminated water and food. In children, Listeria monocytogenes typically affects newborns and immunocompromised patients often leading to invasive syndromes including sepsis, brain abscesses, meningitis, meningoencephalitis and rhombencephalitis. In healthy and immunocompetent children, Listeria meningitis is rare, but can progress rapidly and may be associated with severe complications (hydrocephalus, ventriculitis, cranial nerves palsy and cerebrospinal abscesses) and high mortality rate. Case presentation We describe a very uncommon case of meningoencephalitis due to Listeria monocytogenes in a 11-month-old immunocompetent girl. Cerebrospinal fluid (CSF) culture was positive on the second day. Antibiotic therapy was promptly started but the disease was complicated by neurological deterioration and decompensated hydrocephalus. The child required a very demanding pediatric and neurosurgical management and was discharged after 40 days without major sequelae. Conclusion Listeria is difficult to isolate and it is not susceptible to first-line treatment for bacterial meningitis with extended-spectrum cephalosporins. Early recognition is therefore crucial for a positive outcome. Pediatricians have to perform close clinical monitoring of these children and be aware of possible complications. A review of all cases of Listeria meningitis complicated by hydrocephalus in healthy children has been performed, to provide an overview on clinical features, treatment options and outcome.

The role of muscle biopsy in the diagnostic workup of floppy infants is controversial. Muscle sampling is invasive, and often, results are not specific. The rapid expansion of genetic approach has made the muscle histopathology analysis less crucial. This study aims to assess the role and efficacy of muscle histopathology in the diagnostic algorithm of hypotonia in early infancy through a retrospective analysis of 197 infants who underwent muscle biopsy in their first 18 months of life. Data analysis revealed that 92/197 (46.7%) of muscle biopsies were non-specific (80) or normal (12), not allowing a specific diagnosis. In 41/197 (20.8%) cases, biopsy suggested a metabolic or mitochondrial myopathy, while in 23/197 cases (11.7%), we found evidence of muscular dystrophy. In 19/197 cases (9.7%), histopathology characteristics of a congenital myopathy were reported. In 22/197 cases (11.7%), the histopathological study indicated presence of a neurogenic damage. Overall, 46 diagnoses were then achieved by oriented genetic tests. Muscle biopsy results were consistent with genetic results in 90% of cases. Diagnostic algorithms for the diagnosis of a floppy infant are largely missing. Muscle biopsy alone can lead to a diagnosis, help the clinician in the choice of a genetic test, or even modify a diagnosis made previously.

Magnetic resonance-guided laser interstitial thermal therapy (MR-gLiTT) is a novel minimally invasive treatment approach for drug-resistant focal epilepsy and brain tumors. Using thermal ablation induced by a laser diode implanted intracranially in a stereotactic manner, the technique is highly effective and safe, reducing the risk associated with more traditional open surgical approaches that could lead to increased neurological morbidity. Indications for MR-gLiTT in pediatric epilepsy surgery include hypothalamic hamartoma, tuberous sclerosis complex, cavernoma-related epilepsy, SEEG-guided seizure onset zone ablation, corpus callosotomy, periventricular nodular heterotopia, mesial temporal lobe epilepsy, and insular epilepsy. We review the available literature on the topic and present our series of patients with drug-resistant epilepsy treated by MR-gLiTT. Our experience, represented by six cases of hypothalamic hamartomas, one case of tuberous sclerosis, and one case of dysembryoplastic neuroepithelial tumor, helps to confirm that MR-gLiTT is a highly safe and effective procedure for several epilepsy conditions in children.

The aim of the present study was to evaluate the effects of Strawberry tree honey (STH) on oxidative stress, metabolic phenotype, migration, invasion and epithelial-mesenchymal transition in adenocarcinoma (HCT-116) and metastatic (LoVo) colon cancer cells as well as in human dermal fibroblasts (HDF). Significant oxidative stress was observed through the increase of intracellular ROS generation, lipid and protein damage and reduction of antioxidant enzyme activities in colon cancer cells; in HDF these effects were limited or none. The expression of NF-кB, p-IкBα, Nrf2 was suppressed after STH treatment in colon cancer cells. All the parameters of mitochondrial respiration and glycolysis were reduced after STH treatment in cancer cells, while they were unchanged in HDF. Wound-closure percentages and the expression of MMP-2, MMP-9, N-cadherin, β-catenin decreased, while those of E-cadherin increased after STH treatment in colon cancer cells. Thus, STH can be used for its potential in cancer prevention.

The aim of this work was to assess the phytochemical composition and anticancer effects of Strawberry-tree honey (STH) on cellular proliferation, cell cycle and apoptosis in human colon adenocarcinoma (HCT-116) and metastatic (LoVo) cancer cells. Kaempferol and gallic acid were the major phenolic compounds. STH showed higher cytotoxic and anti-colonogenic effects in a time- and dose-dependent manner; it arrested cell cycle in S and G2/M and regulated cell cycle genes, such as cyclin D1, cyclin E, CDK2, CDK4, p21Cip, p27Kip and p-RB. STH treatment promoted apoptosis by modulating key genes (p53, caspase-3, c-PARP) as well as intrinsic (Bax/Bcl2, Cyto C and caspase-9) and extrinsic (Fas L and caspase-8) apoptotic factors. STH also caused endoplasmic reticulum stress by increasing ATF-6 and XBP-1 expressions, suppressed EGFR, HER2 and downstream markers (p-Akt and p-mTOR) and elevated p-p38MAPK and p-ERK1/2. In conclusion, STH have shown a chemo-preventive action on different colon cancer cell models.

The role of MR Arterial-Spin-Labeling Cerebral Blood Flow maps (ASL-CBF) in the assessment of pediatric focal epilepsy is still debated. We aim to compare the Seizure Onset Zone (SOZ) detection rate of three methods of evaluation of ASL-CBF: 1) qualitative visual (qCBF), 2) z-score voxel-based quantitative analysis of index of asymmetry (AI-CBF), and 3) z-score voxel-based cluster analysis of the quantitative difference of patient’s CBF from the normative data of an age-matched healthy population (cCBF). Interictal ASL-CBF were acquired in 65 pediatric patients with focal epilepsy: 26 with focal brain lesions and 39 with a normal MRI. All hypoperfusion areas visible in at least 3 contiguous images of qCBF analysis were identified. In the quantitative evaluations, clusters with a significant z-score AI-CBF ≤ −1.64 and areas with a z-score cCBF ≤ −1.64 were considered potentially related to the SOZ. These areas were compared with the SOZ defined by the anatomo-electro-clinical data. In patients with a positive MRI, SOZ was correctly identified in 27% of patients using qCBF, 73% using AI-CBF, and 77% using cCBF. In negative MRI patients, SOZ was identified in 18% of patients using qCBF, in 46% using AI-CBF, and in 64% using cCBF (p < 0.001). Quantitative analyses of ASL-CBF maps increase the detection rate of SOZ compared to the qualitative method, principally in negative MRI patients.

The aim of this study was to investigate and compare the change in the total content of phenolic compounds, flavonoids, and the antioxidant capacity in Manuka Honey (MH) after gastrointestinal digestion and different purification methods. MH was subjected to an in vitro gastrointestinal simulation process, and various spectrophotometric analyses [total phenolic content, total flavonoid content (TFC), 2,2-diphenyl-1-picrylhydrazyl, ferric ion reducing antioxidant power, and Trolox equivalent antioxidant capacity] were carried out on raw MH and on bioaccessible and eliminated fractions. Our results demonstrated that there was a significant decrease in the quantity of phenolic compounds (between 3.59% and 1.52% of the total amount of phenolic compounds found in undigested honey) and flavonoids in the bioaccessible fraction (between 15% and 19% of the TFC found in undigested honey) after gastrointestinal digestion and that the decrease was lower also for the antioxidant activity of the samples (ranging between 12.39% and 13.67% of the activity of raw honey), suggesting that the phenolic compounds are not only responsible for this activity. Additionally, we demonstrated that the purification method can affect the amount of phenolic compounds and the antioxidant capacity, showing that centrifugation is the most efficient method of purification.