Kawasaki disease recurrence in the COVID-19 era: a systematic review of the literature

Kawasaki disease (KD) is a vasculitis of unknown origin of small and medium caliber blood vessels, especially involving coronary arteries and is the leading cause of acquired heart disease in childhood in developed countries. Although rarely, it can recur: most recurrences occur within 2 years of the initial episode. No data are available on incidence of recurrent KD in Europe and multiple recurrences are rarely seen. We reviewed the medical literature on Kawasaki disease recurrence and reported a new case of Kawasaki disease recurrence in a child with SARS-CoV-2 infection. We believe that in our case SARS Cov2 acted as a trigger capable to determine, in a genetically susceptible individual, a second recurrence of the disease. In the Covid-19 era we affirm the importance for Kawasaki disease to be tested for SARS Cov2 infection

Evidence of orbital reconstruction at interfaces in La0.67Sr0.33MnO3 films

Electronic properties of transition metal oxides at interfaces are influenced by strain, electric polarization and oxygen diffusion. Linear dichroism (LD) x-ray absorption, diffraction, transport and magnetization on thin La0.7Sr0.3MnO3 films, allow identification of a peculiar universal interface effect. We report the LD signature of preferential 3d-eg(3z2-r2) occupation at the interface, suppressing the double exchange mechanism. This surface orbital reconstruction is opposite of that favored by residual strain and independent of dipolar fields, chemical nature of the substrate and capping.Comment: 13 pages, 5 figure

Efficacy and safety of dolutegravir and doravirine dual therapy in the context of antiretroviral therapy switch: 48 weeks analysis.

Dual therapy in HIV represents an attractive opportunity for HIV infected people in virologic suppression Dual therapy regimens should achieve and maintain viral suppression and immunologic control while minimizing short and long term AEs, improve adherence and convenience and reduce drug drug interactions and costs To date, there are few clinical data to support a dual regimen with dolutegravir and doravirine 1 The individual efficacy of both doravirine and dolutegravir suggests that concomitant administration of these two molecules as part of an NRTI sparing regimen could be a viable option, although to date there are no studies in the HIV infected population The aim of our study is to investigate whether a dual therapy regimen containing dolutegravir and doravirine is effective and saf

Dissipation in ultra-thin current-carrying superconducting bridges; evidence for quantum tunneling of Pearl vortices

We have made current-voltage (IV) measurements of artificially layered high-$T_c$ thin-film bridges. Scanning SQUID microscopy of these films provides values for the Pearl lengths $\Lambda$ that exceed the bridge width, and shows that the current distributions are uniform across the bridges. At high temperatures and high currents the voltages follow the power law $V \propto I^n$, with $n=\Phi_0^2/8\pi^2\Lambda k_B T+1$, and at high temperatures and low-currents the resistance is exponential in temperature, in good agreement with the predictions for thermally activated vortex motion. At low temperatures, the IV's are better fit by $\ln V$ linear in $I^{-2}$. This is expected if the low temperature dissipation is dominated by quantum tunneling of Pearl vortices.Comment: 5 pages, 7 fig

Cefiderocol Efficacy in a Real-Life Setting: Single-Centre Retrospective Study

The current carbapenem-resistant gram-negative bacteria (CR-GN) treatment guidelines lack strong evidence about cefiderocol (CFD) efficacy against CR-GN, especially CRAB. The study’s purpose is to evaluate the effectiveness of CFD in a real-life setting. We made a single-center retrospective study of 41 patients who received CFD in our hospital for several CR-GN infections. Bloodstream infections (BSI) affected 43.9% (18/41) of patients, while CRAB affected 75.6% (31/41) of isolated CR-GN patients. Thirty-days (30-D) all-causes mortality affected 36.6% (15/41) of patients, while end-of-treatment (EOT) clinical cure affected 56.1% (23/41). Finally, microbiological eradication at EOT affected 56.1% (23/41) of patients. Univariate and multivariate analysis showed that septic shock is an independent factor associated with mortality. Subgroup analyses showed no difference in CFD effectiveness between monotherapy and combination therapy

A case of syphilis associated with immune reconstitution inflammatory syndrome and review of the literature

Background: Immune reconstitution inflammatory syndrome (IRIS) associated with syphilis has rarely been described in HIV-infected patients. Diagnosis can be challenging because it is not always possible to discern it from a recent infection or a worsening of an undiagnosed one. Case presentation: An HIV-positive 42-year-old man with a poor compliance history of antiretroviral therapy presented at our unit and complained of ocular symptoms. Ocular syphilis diagnosis was posed after initial misdiagnosing with cytomegalovirus infection, and antiretroviral therapy compliance improved after switching to a bictegravir-based regimen. Despite intravenous (IV) penicillin, we observed an initial worsening with the appearance of new skin lesions, and IRIS syphilis was suspected. In the literature, 14 cases of IRIS syphilis are described, all regarding male patients. Seven were HIV naïve to therapy, and 7 HIV-experienced with poor therapy compliance. Basal syphilis serology was negative in ten, with subsequent seroconversion after the development of IRIS. IRIS-syphilis development was observed after a median time of 28 days from ART initiation; 10 cases were considered "unmasking-IRIS" and 4 "paradoxical-IRIS". Skin and ocular involvement were the most often reported. In most cases, it was not necessary to use a systemic steroid. A good outcome was reported in 12. Conclusions: Syphilis should be considered in differential diagnosis with other diseases associated with IRIS. A negative syphilis serology before beginning antiretroviral therapy could convey the impression that syphilis has been ruled out. Whereas a high index of suspicion should be maintained when symptoms suggestive of syphilis, such as ocular and skin manifestations, are noticed after therapy has begun

Neurological complications in pediatric patients with SARS-CoV-2 infection: a systematic review of the literature

Objectives: To describe clinical characteristics, laboratory tests, radiological data and outcome of pediatric cases with SARS-CoV-2 infection complicated by neurological involvement. Study design: A computerized search was conducted using PubMed. An article was considered eligible if it reported data on pediatric patient(s) with neurological involvement related to SARS-CoV-2 infection. We also described a case of an acute disseminated encephalomyelitis (ADEM) in a 5-year-old girl with SARS-CoV-2 infection: this case was also included in the systematic review. Results: Forty-four articles reporting 59 cases of neurological manifestations in pediatric patients were included in our review. Most (32/59) cases occurred in the course of a multisystem inflammatory syndrome in children (MIS-C). Neurological disorders secondary to cerebrovascular involvement were reported in 10 cases: 4 children with an ischemic stroke, 3 with intracerebral hemorrhage, 1 with a cerebral sinus venous thrombosis, 1 with a subarachnoid hemorrhage, 1 with multiple diffuse microhemorrhages. Reversible splenial lesions were recognized in 9 cases, benign intracranial hypertension in 4 patients, meningoencephalitis in 4 cases, autoimmune encephalitis in 1 girl, cranial nerves impairment in 2 patients and transverse myelitis in 1 case. Five cases had Guillain-Barré syndrome (GBS) and two, including ours, had ADEM. Radiological investigations were performed in almost all cases (45/60): the most recurrent radiological finding was a signal change in the splenium of the corpus callosum. The presence of SARS-CoV-2 viral nucleic acid in the cerebrospinal fluid was proved only in 2 cases. The outcome was favorable in almost all, except in 5 cases. Conclusions: Our research highlights the large range of neurological manifestations and their presumed pathogenic pathways associated with SARS-CoV-2 infection in children. Nervous system involvement could be isolated, developing during COVID-19 or after its recovery, or arise in the context of a MIS-C. The most reported neurological manifestations are cerebrovascular accidents, reversible splenial lesions, GBS, benign intracranial hypertension, meningoencephalitis; ADEM is also a possible complication, as we observed in our patient. Further studies are required to investigate all the neurological complications of SARS-CoV-2 infection and their underlying pathogenic mechanism

Attrition in a Multi-Component Smoking Cessation Study for Females

Limiting attrition (i.e., participant dropout before the conclusion of a study) is a major challenge faced by researchers when implementing clinical trials. Data from a smoking cessation trial for females (N = 246) were analyzed in order to identify baseline smoking-related, demographic and psychological characteristics affecting likelihood of early (i.e., before the quit attempt) and late (i.e., after the quit attempt) dropout. There were a number of significant demographic predictors of attrition. Participants with at least one child living at home were at increased risk of both early and late dropout. Non-Whites were at increased risk of early dropout, while not having a college degree put one at increased risk of late dropout. Age was found to be a protective factor in that the older a participant was, the less likely she was to drop out in the early stages of the trial. With respect to psychological variables, weight concerns increased risk of attrition, as did the experience of guilt. In terms of smoking-related variables, mean cigarettes per day was not a significant predictor of attrition, although length of longest prior quit attempt was a significant predictor of early dropout when age was removed from the regression

Resistenza di Pseudomonas aeruginosa a ciprofloxacina e levofloxacina : 1998-2002

The aim of this study was to evaluate resistance rates to ciprofloxacin and levofloxacin of Pseudomonas aeruginosa (n=1917 strains) isolated at Laboratory of Microbiology at L. Sacco Teaching Hospital in Milan, Italy in the period between January 1998 and October 2002. Twenty-five percent of tested strains were isolated from sputum, 18% from bronchial lavage, 10% from urine, 9% from ear, 4.5% from blood and 26% from other materials. Ciprofloxacin-resistant strains were 121/ 411 (29%) in 1998, 158/ 526 (30%) in 1999, 136/ 400 (34%) in 2000, 129/390 (33%) in 2001 and 53/ 190 (28%) in 2002. Resistance rates for levofloxacin were 132/472 (28%) in 1999, 104/ 400 (26%) in 2000, 101/ 390 (26 %) in 2001 and 47/ 190 (25%) in 2002. Our data highlight overall stability in resistance to ciprofloxacin and levofloxacin with minor variations for ciprofloxacin. Moreover, in contrast with international worldwide studies, resistance rates to ciprofloxacin remained higher than those related to levofloxacin throughout the period studied

Strain induced phase separation in La0.7Sr0.3MnO3 thin films.

La0.7Sr0.3MnO3 thin films having different thicknesses were grown by pulsed laser deposition with in situ reflection high energy electron diffraction diagnostics on LaAlO3 substrates. The mismatch between film and substrate gives rise to an in-plane compressive biaxial strain, which partially relaxes in films thicker than 30 unit cells. Accordingly, the ratio between the out-of-plane and the in-plane lattice parameter c/a varies between 1.06 fully strained and 1.03 partially relaxed. In-plane compressive strain favors the stabilization of the 3z2−r2 orbitals chain-type antiferromagnetic phase, thus giving rise to a sizeable x-ray absorption linear dichroism signal. The shape of the linear dichroism depends weakly on the c/a ratio, while its intensity strongly increases with c/a. At the same time, the metal-insulator transition temperature shifts from about 360 K towards lower temperatures with decreasing thickness, eventually reaching an insulating state for the 30 unit cells film. Low-temperature nuclear magnetic resonance spectra show a decrease of the MnDE doubleexchange metallic contribution with decreasing the thickness, which becomes negligible in the 30 unit cells thick film. The experimental results demonstrate a strain driven competition between two stable phases: the orbital ordered chain-type insulating antiferromagnetic and the orbital disordered metallic ferromagnetic. For intermediate values of the epitaxial strain the local minimum state of the system lies in a gap region between the two stable phases. Such a region has glassy characteristics with coexisting clusters of the two phases. The strain is used as a driving force to span the glassy region