THE CHALLENGES FACED BY SCHOOL COUNSELLORS IN THE REPORTING OF CHILD SEXUAL ABUSE

Identifying and reporting sexually abused children is one of the most important responsibilities of school counsellors. In this study, we aimed to determine the challenges of reporting child sexual abuse. We used a questionnaire form that was prepared by reviewing the literature about reporting sexual abuse. Participants were asked to state their level of knowledge of child sexual abuse, whether they had encountered such cases, whether they faced any challenges when notifying to authorities, and the possible solutions to problems encountered during this process. Of the school counsellors contacted, 40.9% of the participants stated that they encountered a claim of child sexual abuse at least once, but the majority of them (47.4%) could not report it to judicial authorities because of various reasons; such as being unsure whether the event was really happening, anticipating reactions towards them or school management, and fearing the school’s loss of reputation in the case of disclosure.  Article visualizations

A prenatally detected adrenal cyst treated by adrenal-sparing surgery: case report and review of the literature

A neonatal case of left adrenal cyst detected in utero and successfully treated by adrenal-sparing surgery is presented and discussed with review of the literature. Incidentally discovered prenatal adrenal masses present a diagnostic dilemma. Benign and malignant conditions can present as a fetal suprarenal mass. There is a wide spectrum of management modalities ranging from followup by serial sonographic scanning during pregnancy to early primary excision of the mass. We report a neonate with prenatal diagnosis of a cystic mass arising from the left adrenal gland. Postnatal excision of the mass without adrenalectomy was carried out. Frozen sections of the mass and a biopsy of the left adrenal gland confirmed the benign nature of the cyst and normal adrenal tissue. The uniloculated cyst was reported as a pseudocyst. After surgery, the recovery was uneventful, and the patient was discharged 4 days postoperatively in good condition. On the basis of this case and review of the literature, we may conclude that early primary surgical excision is recommended for either diagnosis or treatment if the results of prenatal or postnatal imaging studies are unreliable for the precise diagnosis of suprarenal mass. Adrenal-sparing surgery is recommended if pathological evaluation of frozen sections has confirmed the benign nature of the mass.Keywords: adrenal-sparing surgery, neonates, prenatal diagnosis, suprarenal cys

Surfaces of Revolution with Constant Gaussian Curvature in Four-Space

In this paper, we show that the constant property of the Gaussian curvature of surfaces of revolution in both $\mathbb R^4$ and $\mathbb R_1^4$ depend only on the radius of rotation. We then give necessary and sufficient conditions for the Gaussian curvature of the general rotational surfaces whose meridians lie in two dimensional planes in $\mathbb R^4$ to be constant, and define the parametrization of the meridians when both the Gaussian curvature is constant and the rates of rotation are equal.Comment: 8 paper

Continuous single cell imaging reveals sequential steps of plasmacytoid dendritic cell development from common dendritic cell progenitors

Functionally distinct plasmacytoid and conventional dendritic cells (pDC and cDC) shape innate and adaptive immunity. They are derived from common dendritic cell progenitors (CDPs) in the murine bone marrow, which give rise to CD11c(+) MHCII- precursors with early commitment to DC subpopulations. In this study, we dissect pDC development from CDP into an ordered sequence of differentiation events by monitoring the expression of CD11c, MHC class II, Siglec H and CCR9 in CDP cultures by continuous single cell imaging and tracking. Analysis of CDP genealogies revealed a stepwise differentiation of CDPs into pDCs in a part of the CDP colonies. This developmental pathway involved an early CD11c(+) SiglecH(-) pre-DC stage and a Siglec H+ CCR9(low) precursor stage, which was followed rapidly by upregulation of CCR9 indicating final pDC differentiation. In the majority of the remaining CDP pedigrees however the Siglec H+ CCR9(low) precursor state was maintained for several generations. Thus, although a fraction of CDPs transits through precursor stages rapidly to give rise to a first wave of pDCs, the majority of CDP progeny differentiate more slowly and give rise to longer lived precursor cells which are poised to differentiate on demand

Comparison of iron-reduced and iron-supplemented semisynthetic diets in T cell transfer colitis

Clinical observations in inflammatory bowel disease patients and experimental studies in rodents suggest that iron in the intestinal lumen derived from iron-rich food or oral iron supplementation could exacerbate inflammation and that iron depletion from the diet could be protective. To test the hypothesis that dietary iron reduction is protective against colitis development, the impact of iron reduction in the diet below 10 mg/kg on the course of CD4+ CD62L+ T cell transfer colitis was investigated in adult C57BL/6 mice. Weight loss as well as clinical and histological signs of inflammation were comparable between mice pretreated with semisynthetic diets with either < 10mg/kg iron content or supplemented with 180 mg/kg iron in the form of ferrous sulfate or hemin. Accumulation and activation of Ly6C(high) monocytes, changes in dendritic cell subset composition and induction of proinflammatory Th1/Th17 cells in the inflamed colon were not affected by the iron content of the diets. Thus, dietary iron reduction did not protect adult mice against severe intestinal inflammation in T cell transfer induced colitis

Behçet disease: evaluation of clinical manifestations in Turkish children

PubMe

Fulminant Leptospirosis (Weil's disease) in an urban setting as an overlooked cause of multiorgan failure: a case report

<p>Abstract</p> <p>Introduction</p> <p>Leptospirosis has recently come to international attention as a globally important re-emerging infectious disease. Our case is unusual given the season, location and setting in which leptospirosis occurred. According to the New York City Board of Health, there were only two other cases of leptospirosis in New York City in the year that our patient was diagnosed.</p> <p>Case presentation</p> <p>A 49-year-old healthy Chinese man presented to our hospital with sepsis and multiorgan failure. The patient did not respond to antibiotics and his multiorgan failure worsened. His workup did not show any significant findings except for a positive nasopharyngeal swab result for influenza A. Later the patient developed hemoptysis with evidence of bilateral infiltrates on radiography. His status mildly improved after he was started on steroids. Eventually, a microagglutination test confirmed the presence of antibodies against <it>Leptospira icterohaemorrhagiae. </it>The patient subsequently recovered after a course of intravenous antibiotics.</p> <p>Conclusion</p> <p>The case of fulminant leptospirosis presented here should serve to alert health care providers and the general public to the clinical importance of this severe, sometimes fatal, disease. Leptospirosis should be considered early in the diagnosis of any patient with acute, non-specific febrile illness with multiorgan system involvement or high fever in a returning traveler. In addition, not only should it be considered in tropical and rural areas between late summer to early fall, but also in any location or time if the risk factors are present.</p

Safety of psychotropic medications in people with COVID-19: evidence review and practical recommendations

Background: The novel coronavirus pandemic calls for a rapid adaptation of conventional medical practices to meet the evolving needs of such vulnerable patients. People with coronavirus disease (COVID-19) may frequently require treatment with psychotropic medications, but are at the same time at higher risk for safety issues because of the complex underlying medical condition and the potential interaction with medical treatments. Methods: In order to produce evidence-based practical recommendations on the optimal management of psychotropic medications in people with COVID-19, an international, multi-disciplinary working group was established. The methodology of the WHO Rapid Advice Guidelines in the context of a public health emergency and the principles of the AGREE statement were followed. Available evidence informing on the risk of respiratory, cardiovascular, infective, hemostatic, and consciousness alterations related to the use of psychotropic medications, and drug-drug interactions between psychotropic and medical treatments used in people with COVID-19, was reviewed and discussed by the working group. Results: All classes of psychotropic medications showed potentially relevant safety risks for people with COVID-19. A set of practical recommendations was drawn in order to inform frontline clinicians on the assessment of the anticipated risk of psychotropic-related unfavorable events, and the possible actions to take in order to effectively manage this risk, such as when it is appropriate to avoid, withdraw, switch, or adjust the dose of the medication. Conclusions: The present evidence-based recommendations will improve the quality of psychiatric care in people with COVID-19, allowing an appropriate management of the medical condition without worsening the psychiatric condition and vice versa