Search

Immunocompromised patients with hematologic diseases may experience life-threatening infections with rather uncommon manifestations. Laryngitis has been described as a potential infection in such vulnerable patients and may result in major complications, ranging from impending airway obstruction to total laryngeal necrosis. Immediate laryngoscopy is of paramount importance, as it provides quantification of laryngeal edema and evidence of necrosis. Documentation of the causative pathogen is usually feasible through tissue culture. In the literature, 14 cases of necrotizing laryngitis have already been published. Here, we present the case of a 38-year-old male with a recent diagnosis of multiple myeloma, who received the first cycle of therapy a few days before admission. The patient presented with neutropenic fever, diarrhea, and multiple organ dysfunction. His course was complicated with hemophagocytic lymphohistiocytosis and stridor. A diagnosis of necrotizing laryngitis attributed to Acinetobacter baumannii invasion of the larynx was established. This manuscript highlights that the management of patients with hematologic disease and necrotizing laryngitis should be coordinated in highly specialized centers and clinicians should have a high level of clinical suspicion and act promptly. [ABSTRACT FROM AUTHOR]

Neonatal brain injury (NBI) is a critical condition for preterm neonates with potential long-term adverse neurodevelopmental outcomes. This prospective longitudinal case–control study aimed at investigating the levels and prognostic value of serum neuron-specific enolase (NSE) during the first 3 days of life in preterm neonates (<34 weeks) that later developed brain injury in the form of either periventricular leukomalacia (PVL) or intraventricular hemorrhage (IVH) during their hospitalization. Participants were recruited from one neonatal intensive care unit, and on the basis of birth weight and gestational age, we matched each case (n = 29) with a neonate who had a normal head ultrasound scan (n = 29). We report that serum NSE levels during the first three days of life do not differ significantly between control and preterm neonates with NBI. Nevertheless, subgroup analysis revealed that neonates with IVH had significantly higher concentrations of serum NSE in comparison to controls and neonates with PVL on the third day of life (p = 0.014 and p = 0.033, respectively). The same pattern on the levels of NSE on the third day of life was also observed between (a) neonates with IVH and all other neonates (PVL and control; p = 0.003), (b) neonates with II–IV degree IVH and all other neonates (p = 0.003), and (c) between control and the five (n = 5) neonates that died from the case group (p = 0.023). We conclude that NSE could be an effective and useful biomarker on the third day of life for the identification of preterm neonates at high risk of developing severe forms of IVH. [ABSTRACT FROM AUTHOR]

Platonic dialogues are All of poetic references. As well as revealing a vivid interest in, and acquaintance with, previous poetic works, Plato's citations of the poets are also reflective of a widespread--but in Plato's view reprehensible-4th century Athenian practice of treating poetry as a compendium of absolute and undeniable truths and of appropriating it only for self-serving purposes, instead of using it as a springboard for philosophical discussion. In this paper I restrict my attention to the Theaetetus with a view to scrutinizing the intricate and sophisticated ways in which Plato tackles not so much the cited poetic quotations and paraphrases per se, as their reception and handling by his contemporaries. More specifically, I examine three explicit Homeric citations (I52e, 153cd, and 194c). Although in all three cases Socrates embarks upon an allegorical interpretation of Homer, the authority that he allegedly lays upon his proposed readings eventually proves to be merely a masquerade. I suggest that as well as parodying the allegorical method of interpretation, Socrates ' treatment of the Homeric citations is also philosophically significant., Plato's banishment of poetry from his ideal city and his warnings about its potential effects upon the young are a much-discussed issue. (1) Nevertheless, paradoxically, Platonic dialogues are packed with [...]

Background A limited number of studies have evaluated biochemical bone metabolism markers in children with idiopathic hypercalciuria, which in adults has been linked with osteopenia. Our aim was to investigate in children with idiopathic hypercalciuria biochemical markers of bone formation and resorption and the osteoprotegerin (OPG) and soluble receptor activator of nuclear factor kB ligand (sRANKL) system which is involved in the osteoclastogenesis process. Methods A prospective study was conducted on 50 children with idiopathic hypercalciuria and 50 healthy age-, sex-, and Tanner stage-matched control subjects. Following the diagnosis, patients were requested to follow a 3-month dietary recommendation for idiopathic hypercalciuria. In patients, at diagnosis and at 3 months of follow-up, and in controls, bone-related hormones and serum/urine biochemical parameters were studied. The bone formation markers (total ALP and osteocalcin) and the bone resorption markers ([beta]-Crosslaps) and the OPG and sRANKL levels were determined. Results No differences were found in the bone formation markers or OPG and sRANKL between the children with idiopathic hypercalciuria and controls. The [beta]-Crosslaps and the [beta]-Crosslaps/osteocalcin ratio were higher in the patients at diagnosis than in controls (p = 0.019 and p = 0.029, respectively), with a trend to decrease after the 3-month dietary intervention. The initially increased 24-h urinary Ca in the patients decreased after the 3-month dietary intervention (p = 0.002). Conclusions Children with idiopathic hypercalciuria had biochemical markers compatible with normal bone formation but increased bone resorption. After a 3-month dietary intervention, the trend observed towards decrease in the serum [beta]-Crosslaps may reflect a beneficial response., Author(s): Maria Pavlou [sup.1] , Vasileios Giapros [sup.2] , Anna Challa [sup.1] , Nikolaos Chaliasos [sup.1] , Ekaterini Siomou [sup.1] Author Affiliations: (Aff1) 0000 0004 0622 9754, grid.411740.7, Department of [...]

This paper seeks to contribute to the discussion of the political ramifications of Pythian 10 by drawing attention to two less studied features of the ode's mythical narrative: the glossing over of King Polydectes within Perseus' story, and the attribution of the rare appellation λαγέτας to Perseus. Additionally, it is argued that, as well as targeting a Thessalian audience, the ode sends a powerful political message to the other cities of the Delphic Amphictyony, in which Thessaly held a prominent place at the time. [ABSTRACT FROM AUTHOR]

Background Arterial hypertension (AHT) is a common finding in children with Williams-Beuren syndrome (WBS). Although cardiovascular and renal abnormalities can explain the AHT in some patients with WBS, its etiology is not fully understood and most cases are considered idiopathic. Case-diagnosis/treatment The case is reported of a 10-year-old girl with WBS who developed severe AHT during treatment with triptorelin, a long-lasting gonadotropin-releasing hormone (GnRH) analog, administered because of early normal puberty. Comprehensive diagnostic studies ruled out other-known causes of AHT associated with WBS. After discontinuation of triptorelin, the blood pressure remained within the normal range for her age and height with no antihypertensive treatment on long-term follow-up. To the best of the authors' knowledge, this is the first report of AHT associated with triptorelin administration in a child with WBS. Conclusions Clinicians should be aware of the possibility, although rare, of AHT developing during triptorelin administration in childhood, specifically in patients at increased risk of AHT, such as those with WBS. Keywords Williams-Beuren syndrome Arterial hypertension * Triptorelin * Precocious puberty * Gonadotropin-releasing hormone (GnRH) analog, Background Williams-Beuren syndrome (WBS; OMIM # 194050) is a rare multisystem disorder caused by heterozygous deletion of ~1.6 Mb of the chromosome sub-band 7q11.23 [1]. Although population-based data on the [...]

Background Children with a solitary kidney (SK) have an increased long-term risk of hypertension, albuminuria and glomerulosclerosis. In this study, we assessed the early signs of impaired glomerular filtration in children with a SK from birth or from early infancy. Methods Renal growth and function at ages 4-15.5 years were studied in 38 children with SK and 40 matched control subjects in terms of accelerated growth. Results The systolic/diastolic blood pressure Z-scores (p = 0.01/< 0.05) and the resistance index (RI) of the arcuate arteries (p = 0.05) were higher in the children with SK. Creatinine clearance and 24-h protein and albumin urinary excretion showed no difference. All but seven children with SK had 99mTc diethylene-triamine pentaacetic acid glomerular filtration rate values of > 80 ml/min/1.73 [m.sup.2]. An independent positive correlation was found between length of the follow-up time and 24-h albumin urinary excretion (β = 0.54, p < 0.01). Accelerated postnatal growth was positively related with kidney volume (β = 0.35, p < 0.05). Conclusions Among our patient cohort, renal function was well preserved at ages 4-15.5 years in children who were born with a SK. However, both their higher blood pressure and RI and the correlation of 24-h albumin urinary excretion with length of follow-up time underline the need for monitoring to detect early signs of glomerular hyperfiltration and, if necessary, implement timely intervention. SK hypertrophy was found to be correlated with postnatal growth. Keywords Solitary kidney * Unilateral renal agenesis * Uninephrectomy * Glomerulosclerosis * Resistance index * Microalbuminuria, Introduction An apparently normal solitary kidney (SK), resulting from unilateral renal agenesis, unilateral non-functioning kidney or uninephrectomy, is typically associated with increased renal growth in childhood [1-6]. The increased growth [...]

\n Epidemiologic evidence from different countries shows both increasing and decreasing incidence rates of Parkinson's disease over time without clear trends.We aimed to investigate age-specific incidence rates of Parkinson's disease and possible explanations for the observed trends in Germany over a 10-year period.Two different random samples of subjects aged ≥50 years included in 2004–2009 and 2014–2019, each consisting of 250,000 individuals, were drawn from Germany's largest health care insurance company followed up for new Parkinson's disease cases. We compared the age-specific incidence rates of Parkinson's disease for both cohorts and performed Cox regression models to calculate the hazard ratios (HR) of PD in the second period compared with the first period, adjusted for age, sex, and risk factors for Parkinson's disease.For most age groups in men and in women, we found lower age-specific Parkinson's disease incidence rates in the second period. Cox regression analysis showed an overall 18% risk reduction in Parkinson's disease incidence (HR = 0.82, 95% confidence interval [0.76–0.89]). Mean age at diagnosis increased in men (+1.9 years) and women (+0.8 years). After adjustment for risk factors, the HR was 0.78 [0.72–0.85]. Sensitivity analysis considering the competing event of death showed an HR of 0.79 [0.73–0.86]), demonstrating the independence of time trends from changes in death rates.Our data show that the risk of Parkinson's disease has decreased over time and that this decrease is independent of factors such as changes in death rates, age structure, sex, and specific risk factors.Parkinson's disease is the second most prevalent neurodegenerative disorder, showing both increasing and decreasing incidence rates with no clear trend. Our group sought to investigate age-specific incidence rates of Parkinson's disease in Germany over a period of ten years. The data that were used for our analysis, were drawn from Germany's largest health care insurance company. Our study revealed that the risk of Parkinson's disease has decreased in the German population over the investigated time frame. However, we observed that this decrease does not depend on factors such as changes in death rates, age structure, sex, and specific risk factors. [ABSTRACT FROM AUTHOR]