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The Clinical Impact of Methotrexate-Induced Stroke-Like Neurotoxicity in Paediatric Departments: An Italian Multi-Centre Case-Series

Introduction: Stroke-like syndrome (SLS) is a rare subacute neurological complication of intrathecal or high-dose (≥500 mg) Methotrexate (MTX) administration. Its clinical features, evoking acute cerebral ischaemia with fluctuating course symptoms and a possible spontaneous resolution, have elicited interest among the scientific community. However, many issues are still open on the underlying pathogenesis, clinical, and therapeutic management and long-term outcome. Materials and Methods: We retrospectively analyzed clinical, radiological and laboratory records of all patients diagnosed with SLS between 2011 and 2021 at 4 National referral centers for Pediatric Onco-Hematology. Patients with a latency period that was longer than 3 weeks between the last MTX administration of MTX and SLS onset were excluded from the analysis, as were those with unclear etiologies. We assessed symptom severity using a dedicated arbitrary scoring system. Eleven patients were included in the study. Results: The underlying disease was acute lymphoblastic leukemia type B in 10/11 patients, while fibroblastic osteosarcoma was present in a single subject. The median age at diagnosis was 11 years (range 4–34), and 64% of the patients were women. Symptoms occurred after a mean of 9.45 days (± 0.75) since the last MTX administration and lasted between 1 and 96 h. Clinical features included hemiplegia and/or cranial nerves palsy, paraesthesia, movement or speech disorders, and seizure. All patients underwent neuroimaging studies (CT and/or MRI) and EEG. The scoring system revealed an average of 4.9 points (± 2.3), with a median of 5 points (maximum 20 points). We detected a linear correlation between the severity of the disease and age in male patients. Conclusions: SLS is a rare, well-characterized complication of MTX administration. Despite the small sample, we have been able to confirm some of the previous findings in literature. We also identified a linear correlation between age and severity of the disease, which could improve the future clinical management

Consensus on COVID‐19 Vaccination in Pediatric Oncohematological Patients, on Behalf of Infectious Working Group of Italian Association of Pediatric Hematology Oncology

Vaccines represent the best tool to prevent the severity course and fatal consequences of the pandemic by the new Coronavirus 2019 infection (SARS‐CoV‐2). Considering the limited data on vaccination of pediatric oncohematological patients, we developed a Consensus document to support the Italian pediatric hematological oncological (AIEOP) centers in a scientifically correct communication with families and patients and to promote vaccination. The topics of the Consensus were: SARS‐CoV‐2 infection and disease (COVID‐19) in the pediatric subjects; COVID‐19 vaccines (type, schedule); who and when to vaccinate; contraindications and risk of serious adverse events; rare adverse events; third dose and vaccination after COVID‐19; and other general prevention measures. Using the Delphi methodology for Consensus, 21 statements and their corresponding rationale were elaborated and discussed with the representatives of 31 centers, followed by voting. A high grade of Consensus was obtained on topics such as the potential risk of severe COVID‐19 outcome in pediatric oncohematological patients, the need for vaccination as a preventative measure, the type, schedule and booster dose of vaccine, the eligibility of the patients for vaccination, and the timing, definition, and management of contraindications and serious adverse events, and other general prevention measures. All 21 of the statements were approved. This consensus document highlights that children and adolescents affected by hematological and oncological diseases are a fragile category. Vaccination plays an important role to prevent COVID‐ 19, to permit the regular administration of chemotherapy or other treatments, to perform control visits and hospital admissions, and to prevent treatment delays

Actualistic taphonomic study of the rodents digested by the Achala culpeo fox (Lycalopex culpaeus smithersi) in the highlands of central Argentina

We present the first actualistic study of the rodents consumed by the South American foxLycalopex culpaeus smithersi (Achala culpeo fox), a subspecies of the culpeo fox that is endemicto the highlands of central Argentina. We provide a taphonomic characterization of this canidbased on digested micromammal bones, and compare it to other carnivores. We studied over 1000bones derived from 83 scats collected in Quebrada del Condorito National Park, Córdobaprovince, Argentina, corresponding to caviomorph and myomorph rodents. Galea leucoblepharawas the main prey (59.8% MNI, 93.1% biomass). Average relative abundance for the totalassemblage was 26.7. Cranial and, to a lesser extent, proximal limb bones were the most abundantelements. A high degree of breakage was observed in cranial elements and, to a lesser extent, inlimb bones. A high proportion of heavy and extreme digestion was inferred, while some elementsbear light or no digestion traces at all. Overall, the Achala culpeo fox fits best with othermammalian carnivores in the category of extreme modification, and shows types and proportionsof taphonomic attributes similar to other South American mammalian predators. These resultscontribute to the understanding of regional taphonomic processes and of digestivemodifications by Lycalopex foxes generally, and are thus relevant to interpreting the presence of micromammal remains in the archaeological and palaeontological recordsand the impact of these foxes in their formation.Fil: Coll, Daiana Geraldine. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales; ArgentinaFil: Montalvo, Claudia Inés. Universidad Nacional de La Pampa. Facultad de Ciencias Exactas y Naturales; ArgentinaFil: Fernández, Fernando Julián. Universidad de Buenos Aires. Facultad de Ingeniería; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Pia, Monica Valeria. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Ciencias de la Tierra y Ambientales de La Pampa. Universidad Nacional de La Pampa. Facultad de Ciencias Exactas y Naturales. Instituto de Ciencias de la Tierra y Ambientales de La Pampa; ArgentinaFil: Mondini, Nora Mariana. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto de Antropología de Córdoba. Universidad Nacional de Córdoba. Facultad de Filosofía y Humanidades. Instituto de Antropología de Córdoba; Argentin

Reconocimiento de diásporas de Malveae (Malvaceae) en muestras de suelos de zonas serranas (Sierras Chicas, Córdoba, Argentina) afectadas por incendios

En el marco de un estudio de regeneración post-incendio de la vegetación autóctona en campos de sierra ubicados en proximidades de Falda del Carmen (Sierras Chicas, Córdoba, Argentina), se ha analizado el banco de semillas aéreo para facilitar la identificación de las especies presentes en las muestras de suelo. Entre las familias con mayor diversidad y abundancia en la zona evaluada, las Malvaceae se encuentran representadas por 14 especies pertenecientes a los géneros: Abutilon Mill., Gaya Kunth., Krapovickasia Fryxell, Malvastrum A. Gray, Pavonia Cav., Pseudabutilon R. E. Fr., Sida L. y Sphaeralcea A. St.-Hil.. Se presentan dos claves dicotómicas para diferenciar las especies utilizando caracteres morfológicos de las diásporas, mericarpos y semillas respectivamente, acompañadas por las descripciones y las ilustraciones de las estructuras consideradas. Se tienen en cuenta aspectos morfológicos de los mericarpos (forma, tamaño, superficie de las caras dorsal y laterales, dehiscencia, aristas, pubescencia, divisiones internas, número de semillas por mericarpo) y de las semillas (forma, tamaño, superficie, pubescencia, hilo)

Exomorfología y anatomía de órganos vegetativos aéreos en especies de Flourensia DC. (Asteraceae) con importancia fitoquímica

El género Flourensia DC. es americano y comprende 32 especies. Son arbustos resinosos utilizados en medicina popular; poseen un potencial valor económico, por lo que, en algunas especies representantes, se han caracterizado sus compuestos químicos y determinado algunos posibles usos. En el presente trabajo, se estudió la exomorfología y anatomía de órganos vegetativos de F. hirta S. F. Blake, F. leptopoda S. F. Blake, F. niederleinii S. F. Blake y F. tortuosa Griseb., especies endémicas del centro de Argentina. Se observó que todas son similares en cuanto a la anatomía de hoja y tallo. En cuanto al estudio de la epidermis foliar, se concluye que es posible diferenciar las especies teniendo en cuenta la frecuencia estomática y la presencia de tricomas. Finalmente, las diferencias más notables se encontraron en la exomorfología foliar ya que se observó una gran variación en cuanto a la forma de las hojas y tamaño de las láminas y pecíolos. Con respecto a las estructuras secretoras, se encontraron tricomas y conductos secretores esquizógenos en las hojas y los tallos de todas las especies, las cuales serían responsables de la producción y secreción de las resinas.The genus Flourensia DC. is American and comprises 32 species. They are resiniferous shrubs used in folk medicine. As they have potential economic value, its chemical compounds have been characterized and some possible uses identified. In this work, the exomorphology and anatomy of vegetative organs of F. hirta S. F. Blake, F. leptopoda S. F. Blake, F. niederleinii S. F. Blake and F. tortuosa Griseb., endemic species from central Argentina, have been studied. All species are similar in leaf and stem anatomy. Regarding the epidermis, it is possible to differentiate the species according to the stomatal frequency and the presence of trichomes. Finally, the most remarkable differences were found in leaf exomorphology, since there was a large variation in shape and size of blades and petioles. Concerning the secretory structures, trichomes and secretory ducts were found in the leaves and stems of all species, which would be responsible for the production and secretion of the resins