Measles is back

Measles is one of the most deadly vaccine preventable diseases. The incidence of measles, and resultant mortality, had dropped drastically following the introduction of widespread measles immunisation since the 1960s. However, there is currently a worldwide surge in measles cases, with a marked increase over the past 3 years. Measles outbreaks and endemic transmission have been re-established in countries which had previously achieved measles elimination. The rise in measles cases has been mainly attributed to a drop in the recommended two dose vaccination schedule below the 95% uptake threshold necessary for interruption of transmission and sustainment of herd protection. This resurgence of measles is largely a result of the damage done by Andrew Wakefield, who in 1998 incorrectly and maliciously suggested a possible link between the measles, mumps and rubella (MMR) vaccine and autism. Such a possible association has subsequently been disproven by several scientifically robust studies. Still, most cases of measles have occurred in unimmunised individuals, mainly teenagers, who had missed out on vaccination in early childhood, and in infants under one year of age, who are too young to be vaccinated. Measles is highly contagious, with up to 18 people being potentially infected from a single case, so containment measures are important to prevent spread. These include isolation and immediate notification of suspected or confirmed cases, as well as wearing appropriate personal protective equipment when in contact with these patients. Health care professionals have a crucial role in promoting measles immunisation, which is the only rational way of preventing measles.peer-reviewe

Parentage and human rights : the child's point of view

It is tempting to write of child rights and their recognition as human rights within the sphere of parentage. It is similarly inviting to study the shifting parallels between rights and duties and the obligations set out under parental responsibility. The growing concern for children over the past centuries has been steady and unabated, although its real results have yielded divergent products depending on their geographical distribution.peer-reviewe

Solitary confinement in Malta : a call for reform

The issue of Solitary Confinement has long been one of contention within the area of prison management, due to concerns regarding human rights surrounding its implementation and practice. The practice of Solitary Confinement has been shown, through multiple empirical research publications, to be detrimental to prisoners’ wellbeing, resulting in negative effects on their physical, psychological and social health (Shalev, 2008; Brunner et al., 2017), as well as worsening rates of recidivism (Gordon, 2014). Research has shown Solitary Confinement to be ineffective in reducing violent behaviour or rehabilitating the prisoner, in many cases increasing the chances of re-offending, in particular increasing the risk of a prisoner committing violent crimes (Zgoba et al., 2020), thus revealing that it’s use is by nature an admission of failure. The use of Solitary Confinement as a ‘last resort’ indicates that all other methods of resolving a situation have failed. It is therefore pertinent that alternative courses of action are re-evaluated with a view towards the abolishment of Solitary Confinement. This document will present a number of research findings, in order to highlight the urgent need for legislative reform with regard to the use of Solitary Confinement practices in the Maltese context, where this punishment still resides as part of the Criminal Code (Article 9(1), Laws of Malta).peer-reviewe

N′-[5-(4-Nitro­phen­yl)furan-2-yl­methyl­idene]-N,N-diphenyl­hydrazine

The title compound, C23H17N3O3, has an E configuration with respect to the C=N bond. The dihedral angle between the two phenyl rings bonded to the hydrazine group is 86.45 (13)°. The furan ring makes dihedral angles of 3.4 (2) and 7.06 (13)°, respectively, with the methyl­idenehydrazine C=N—N plane and the benzene ring

(E)-1-(3,4-Dimethyl­benzyl­idene)-2,2-diphenyl­hydrazine

The asymmetric unit of the title compound, C21H20N2, contain two mol­ecules, both of them showing an E configuration of the C=N bond. The dihedral angles between the phenyl rings in the phenyl­hydrazone groups are 86.84 (10) and 84.85 (8)° for the two mol­ecules. Inter­molecular C—H⋯π inter­actions are observed in the crystal structure

(E)-1-Benzyl­idene-2,2-diphenyl­hydrazine

The asymmetric unit of the title compound, C19H16N2, contains two independent mol­ecules, both of which show an E configuration with respect to the C=N bond. The dihedral angles between the phenyl rings bonded to the hydrazine group are 81.00 (10) and 88.34 (8)° in the two mol­ecules. Inter­molecular C—H⋯π inter­actions are observed in the crystal structure

Acquired unilateral Brown Syndrome in newly diagnosed Systemic Lupus Erythematosus

Brown Syndrome is a congenital or acquired ocular movement disorder that is known to be a rare complication of Systemic Lupus Erythematosus (SLE). We report a case of acquired Brown Syndrome in an adolescent girl with newly diagnosed SLE which responded well to oral prednisolone.peer-reviewe

Presentations of children to emergency departments across Europe and the COVID-19 pandemic : A multinational observational study

Publisher Copyright: © 2022 Nijman et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.Background During the initial phase of the Coronavirus Disease 2019 (COVID-19) pandemic, reduced numbers of acutely ill or injured children presented to emergency departments (EDs). Concerns were raised about the potential for delayed and more severe presentations and an increase in diagnoses such as diabetic ketoacidosis and mental health issues. This multinational observational study aimed to study the number of children presenting to EDs across Europe during the early COVID-19 pandemic and factors influencing this and to investigate changes in severity of illness and diagnoses. Methods and findings Routine health data were extracted retrospectively from electronic patient records of children aged 18 years and under, presenting to 38 EDs in 16 European countries for the period January 2018 to May 2020, using predefined and standardized data domains. Observed and predicted numbers of ED attendances were calculated for the period February 2020 to May 2020. Poisson models and incidence rate ratios (IRRs), using predicted counts for each site as offset to adjust for case-mix differences, were used to compare age groups, diagnoses, and outcomes. Reductions in pediatric ED attendances, hospital admissions, and high triage urgencies were seen in all participating sites. ED attendances were relatively higher in countries with lower SARS-CoV-2 prevalence (IRR 2.26, 95% CI 1.90 to 2.70, p < 0.001) and in children aged <12 months (12 to <24 months IRR 0.86, 95% CI 0.84 to 0.89; 2 to <5 years IRR 0.80, 95% CI 0.78 to 0.82; 5 to <12 years IRR 0.68, 95% CI 0.67 to 0.70; 12 to 18 years IRR 0.72, 95% CI 0.70 to 0.74; versus age <12 months as reference group, p < 0.001). The lowering of pediatric intensive care admissions was not as great as that of general admissions (IRR 1.30, 95% CI 1.16 to 1.45, p < 0.001). Lower triage urgencies were reduced more than higher triage urgencies (urgent triage IRR 1.10, 95% CI 1.08 to 1.12; emergent and very urgent triage IRR 1.53, 95% CI 1.49 to 1.57; versus nonurgent triage category, p < 0.001). Reductions were highest and sustained throughout the study period for children with communicable infectious diseases. The main limitation was the retrospective nature of the study, using routine clinical data from a wide range of European hospitals and health systems. Conclusions Reductions in ED attendances were seen across Europe during the first COVID-19 lockdown period. More severely ill children continued to attend hospital more frequently compared to those with minor injuries and illnesses, although absolute numbers fell.publishersversionPeer reviewe