Meningeal solitary fibrous tumour in a child.

INTRODUCTION: Meningeal solitary fibrous tumour is a relatively recent pathological entity that has rarely been described in children. With radiological techniques, it cannot be distinguished from meningiomas, and the diagnosis has to be confirmed histologically. CASE REPORT: We discuss the possible histogenesis of this tumour and the need for recognizing this lesion as a separate entity. We report the case of a 12-year-old boy who developed a meningeal solitary fibrous tumour; the main clinical symptoms were progressive headaches for a long period and recent transient hemiparesis. CONCLUSION: This child presents an uneventful evolution without additional therapy 3.5 years after surgery

Effects of a species-specific probiotic formulation on multiresistant Escherichia coli isolates from the gut of veal calves

In this study, 254 Escherichia coli isolates from faecal samples of veal calves were evaluated for antimicrobial susceptibility using the disk diffusion method. During the experimental period, six mass antibiotic treatments were administered to the animals (about one treatment per month). The active principles used were oxytetracycline, colistin, tylosin, doxycycline, chlortetracycline, and sulphonamides. An extremely high resistance prevalence (> 70%) towards penicillin, sulphonamide, tetracycline, ampicillin, and spyramicin was detected. Sixty E. coli isolates could be defined as multiresistant, showing resistance to at least 6 antimicrobial classes. Subsequently, we evaluated the inhibitory effect of a species-specific probiotic against multiresistant E. coli, showing its beneficial action with large inhibition halos for 76% of the isolates. This suggests the potentiality of the probiotic, putting in evidence a clear advantage of its use in veal calves nutrition, in particular during the first phases, when the animals are more susceptible to severe enteric infections by E. coli

Ethical Criteria for the Admission and Management of Patients in the ICU Under Conditions of Limited Medical Resources: A Shared International Proposal in View of the COVID-19 Pandemic

Introduction The present pandemic has exposed us to unprecedented challenges that need to be addressed not just for the current state, but also for possible future similar occurrences. It is worth pointing out that discussions on the allocation of medical resources may not necessarily refer to an exception, but, unfortunately, to a regular condition for a large part of humanity (1). The criteria for admission to an Intensive Care Unit (ICU) setting generally take into account multiple factors. There must be a diagnostic and prognostic basis for the decisions made, considering both biological factors and patient values and wishes. Furthermore, the decision-making process should, whenever possible, respect the patient's advance directives as well as the relationship with the patient's family or attorney. Therapeutic neglect should be avoided. Having applied standard clinical evaluation criteria for the appropriate treatment of patients with COVID-19, including consideration of prognosis, if a hospital then finds itself unable to provide optimal treatment (e.g., due to a disproportion between the number of patients and the availability of beds, healthcare providers, ventilators, and drugs in the ICU), it becomes necessary to evaluate, case by case, how to achieve justice and the best possible good for the greatest number of patients. It is therefore mandatory to explore alternative solutions; these include increasing available beds and healthcare providers, implementing alternative, though suboptimal, approaches (where appropriate), transferring patients to other clinical units, etc. Making these decisions properly also involves the recovery of the political role of medicine and science (2). If the imbalance between needs and resources reaches a critical level, an emergency triage protocol, following the operational and ethical indications of “disaster medicine,” should be activated. These have been deployed in major and serious natural (earthquakes or tsunamis for example) and technological (factory explosions, public transport accidents for example) disasters, as well as following terrorist attacks (3, 4). The question of the feasibility of developing a clinical evaluation algorithm to support the decision-making of the triage team remains open, though many such protocols have been written. According to the above, we propose the following five ethical criteria for the triage of patients in conditions of limited resources, such as the COVID pandemic. They are the result of an interdisciplinary and intercultural dialogue between specialists from different disciplines. Several of the authors are working in the main epicenters of the crisis and currently are playing a central role in the bioethical, clinical, social and legal aspects of the management of the COVID-19 pandemic

O conceito de “Dispositivo universal” (Universalapparat) em Günther Anders

Encontra-se em curso, sensivelmente no último meio século, a finalização de um processo de planetarização da Tecnologia, que, na ordem das causas, terá sido mais proximamente determinado pela Globalização político-económica urdida e imposta pelo Neoliberalismo e mais remotamente influenciado por sucessivas revoluções industriais, desde o século XVIII. Ele implicou uma transformação na própria natureza da Tecnologia, fazendo com que deixasse de ser mero meio (utensílio, ferramenta, instrumento) para determinados fins e se tivesse tornado num ambiente vital e existencial. Günther Anders foi um atento e perspicaz observador e crítico desse fenómeno, que, no seu jargão, concebeu como o do advento de um “Dispositivo universal” (Universalapparat). Dedica-se a primeira parte deste artigo à releitura da interpretação que esse filósofo alemão fez da sua suposta génese e evolução. Na segunda parte, analisa-se esse conceito. Explora-se, na terceira parte, duas consequências filosóficas maiores desse fenómeno.More or less in the last half century, a process of planetarization of Technology is underway, which in the order of causes will have been more directly determined by the politicaleconomic Globalization woven and imposed by the so-called Neoliberalism and more remotely influenced by successive industrial revolutions since the 18th century. It implied a transformation in the nature of Technology, ceasing to be a mere means (utensil, tool, instrument) for certain purposes and becoming a vital and existential environment. Günther Anders was an attentive, perceptive and critical observer of this phenomenon that, in his jargon, he conceived as the advent of a “Universal apparatus” (Universalapparat). I dedicate the first part of this article to reread the German philosopher’s interpretation of his supposed genesis and evolution. In the second part, I analyze this concept. In the third part, I explore two main philosophical consequences of this phenomenon

How do parents manage irritability, challenging behavior, non-compliance and anxiety in children with Autism Spectrum Disorders? A meta-synthesis

Although there is increasing research interest in the parenting of children with ASD, at present, little is known about everyday strategies used to manage problem behaviour. We conducted a meta-synthesis to explore what strategies parents use to manage irritability, non-compliance, challenging behaviour and anxiety in their children with ASD. Approaches included: (1) accommodating the child; (2) modifying the environment; (3) providing structure, routine and occupation; (4) supervision and monitoring; (5) managing non-compliance with everyday tasks; (6) responding to problem behaviour; (7) managing distress; (8) maintaining safety and (9) analysing and planning. Results suggest complex parenting demands in children with ASD and problem behaviour. Findings will inform the development of a new measure to quantify parenting strategies relevant to ASD

Chronic Citalopram Administration Causes a Sustained Suppression of Serotonin Synthesis in the Mouse Forebrain

BACKGROUND:Serotonin (5-HT) is a neurotransmitter with important roles in the regulation of neurobehavioral processes, particularly those regulating affect in humans. Drugs that potentiate serotonergic neurotransmission by selectively inhibiting the reuptake of serotonin (SSRIs) are widely used for the treatment of psychiatric disorders. Although the regulation of serotonin synthesis may be an factor in SSRI efficacy, the effect of chronic SSRI administration on 5-HT synthesis is not well understood. Here, we describe effects of chronic administration of the SSRI citalopram (CIT) on 5-HT synthesis and content in the mouse forebrain. METHODOLOGY/PRINCIPAL FINDINGS:Citalopram was administered continuously to adult male C57BL/6J mice via osmotic minipump for 2 days, 14 days or 28 days. Plasma citalopram levels were found to be within the clinical range. 5-HT synthesis was assessed using the decarboxylase inhibition method. Citalopram administration caused a suppression of 5-HT synthesis at all time points. CIT treatment also caused a reduction in forebrain 5-HIAA content. Following chronic CIT treatment, forebrain 5-HT stores were more sensitive to the depleting effects of acute decarboxylase inhibition. CONCLUSIONS/SIGNIFICANCE:Taken together, these results demonstrate that chronic citalopram administration causes a sustained suppression of serotonin synthesis in the mouse forebrain. Furthermore, our results indicate that chronic 5-HT reuptake inhibition renders 5-HT brain stores more sensitive to alterations in serotonin synthesis. These results suggest that the regulation of 5-HT synthesis warrants consideration in efforts to develop novel antidepressant strategies