Brain abscess due to Klebsiella pneumoniae in a liver-transplanted child.

Brain abscesses are a rare, severe complication of orthotopic liver transplantation (OLT). They are almost exclusively due to fungi, Nocardia, or Toxoplasma, and usually occur within months of surgery. Here we report the case of an adolescent who developed a brain abscess due to Klebsiella pneumoniae 11.5 years after OLT. Fever was absent and laboratory parameters were not indicative of infectious disease, and therefore the diagnosis of a central nervous system neoplasm was considered. Subsequent magnetic resonance imaging and spectroscopy led to a diagnosis of a brain abscess, and to prompt appropriate antibiotic treatment. This case shows that K. pneumoniae may cause a brain abscess long after liver transplantation. The appearance of neurological symptoms should alert clinicians to consider a brain abscess even in the absence of overt clinical/laboratory signs of inflammation, which may be blunted by chronic immunosuppression

Brain abscess due to Klebsiella pneumoniae in a liver-transplanted child

Brain abscesses are a rare, severe complication of orthotopic liver transplantation (OLT). They are almost exclusively due to fungi, Nocardia, or Toxoplasma, and usually occur within months of surgery. Here we report the case of an adolescent who developed a brain abscess due to Klebsiella pneumoniae 11.5 years after OLT. Fever was absent and laboratory parameters were not indicative of infectious disease, and therefore the diagnosis of a central nervous system neoplasm was considered. Subsequent magnetic resonance imaging and spectroscopy led to a diagnosis of a brain abscess, and to prompt appropriate antibiotic treatment. This case shows that K. pneumoniae may cause a brain abscess long after liver transplantation. The appearance of neurological symptoms should alert clinicians to consider a brain abscess even in the absence of overt clinical/laboratory signs of inflammation, which may be blunted by chronic immunosuppression

New chemical derivatives of the natural compound dictyophlebine inhibiting acetyl- and butyrylcholinesterase

Devkota KP, Choudhary MI, Anjum S, Nawaz SA, Lenta BN, Sewald N. New chemical derivatives of the natural compound dictyophlebine inhibiting acetyl- and butyrylcholinesterase. Zeitschrift für Naturforschung B. 2007;39(3):1324-1328.The acetyl- and butyrylcholinesterase inhibiting natural product dictyophlebine 1 was subjected to different N-alkylation and hydrochlorination reactions by which five new and bioactive chemical derivatives (2-6) with pentyl, pent-4-en-1-yl, hex-5-en-1-yl, 4-chloropentyl and 5-chlorohexyl substituents at the 3-N position were obtained with high yield. The alkylated and chlorinated products 3 - 6 were found to have significantly higher inhibitory potential towards cholinesterase than the parent compound 1

Effects of Lactobacillus rhamnosus strain GG in pediatric obesity-related liver disease.

Various lines of evidence suggest that malfunctioning of the gut-liver axis contributes to hepatic damage of rodents and humans with nonalcoholic fatty liver disease. We evaluated the effects of short-term probiotic treatment in children with obesity-related liver disease who were noncompliant with lifestyle interventions.Twenty obese children (age 10.7 ± 2.1 years) with persisting hypertransaminasemia and ultrasonographic (US) bright liver were enrolled in this double-blind, placebo-controlled pilot study. At baseline, patients underwent clinical and laboratory anthropometric evaluation, measurement of the US hepatorenal ratio, standard liver function tests, oral glucose tolerance test, serum tumor necrosis factor-alpha, the glucose hydrogen breath test, and evaluation of serum antibodies to antipeptidoglycan-polysaccharide polymers. After exclusion of causes of liver disease other than obesity, patients received either probiotic Lactobacillus rhamnosus strain GG (12 billion CFU/day) or placebo for 8 weeks.Multivariate analysis after probiotic treatment revealed a significant decrease in alanine aminotransferase (average variation vs placebo P = 0.03) and in antipeptidoglycan-polysaccharide antibodies (average variation vs placebo P = 0.03) irrespective of changes in BMI z score and visceral fat. Tumor necrosis factor-alpha, and US bright liver parameters remained fairly stable.Probiotic L rhamnosus strain GG warrants consideration as a therapeutic tool to treat hypertransaminasemia in hepatopathic obese children noncompliant with lifestyle interventions

Human intestinal in vitro organ culture response to bacterial exposure in Crohn's disease

Makrides, M., Gibson, R., Marshall, H

Is Covid-19 lockdown related to an increase of accesses for seizures in the emergency department? An observational analysis of a paediatric cohort in the Southern Italy

Background: The World Health Organization (WHO) declared a global pandemic of Covid-19 on 11 March 2020. The lockdown caused a lifestyle changes: an increase in the use of mobile media devices (MMDs), sleep and psychiatric disorders, incorrect habits regarding food and physical activities. We investigate prevalence of admission for seizures at our emergency department (ED), during Italian lockdown, comparing with that of the same period of the previous year (2019), and the relationship with some lifestyle changes. Methods: In this observational study, patients (4\u201314 years) with seizures that accessed at our ED, during Italian lockdown, were eligible. Non-epileptic events and febrile seizures were excluded. We describe two groups: patients with new-onset seizures and not. Moreover, a questionnaire concerning use of MMDs and sleep habits was administered. Results: Fifty-seven patients were included; median age 8.03 years. Considering only paediatric medical emergencies, the prevalence of accesses for seizures was 2.6% (CI 95% 0.020\u20130.034), while the incidence was 0.94% (CI 95% 0.006\u20130.0149). There was a statistically significant difference with prevalence of previous years, \u3c72 102.21 (p = 0.0001). We also reported a difference in daily screen time (DST) (p = 0.001) and total sleep time (TST) (p = 0.045), in all population, between period pre- and during lockdown. A negative correlation between DST and seizures latency (Spearman\u2019s \u3c1 -0.426, p = 0.038) was found. In the two groups, the results were partially overlapping. Conclusions: During lockdown period, we assisted to an increase of accesses for seizures. It is conceivable that a sleep time change and/or higher MMD use could act as triggers for seizures