Fronto-Subcortical Circuits for Cognition and Motivation: Dissociated Recovery in a Case of Loss of Psychic Self-Activation

In humans and non-humans primates, extensive evidence supports the existence of subcortico-cortical circuits for cognition and behavior. Lesions studies are critical to understand the clinical significance of these functionally segregated circuits. Mapping these circuits from lesion studies is difficult given the heterogeneous etiology of the lesions, the lack of long-term and systematic testing of cognitive and behavioral disturbances, as well as the scarcity of neuroimaging data for identifying the precise location and extent of subcortical lesions. Here, we report the long-term follow-up study of a patient who developed a loss of psychic self-activation associated to a dysexecutive syndrome following resuscitation from cardiac arrest. Neuroimaging revealed extensive bilateral lesions in the putamen, with a relative spare of the caudate, and exhibiting a dorsoventral gradient that was predominantly rostrally to the anterior commissure and spared most of the ventral striatum. In comprehensive neuropsychological and neuropsychiatric assessments, we observed dissociation between the improvement of the self-activation deficits and the stability of the dysexecutive syndrome. The pattern of recovery after this lesion lends support to current models proposing the existence of two main subcortico-cortical circuits: a dorsal circuit, mostly mediating cognitive processes, and a ventral circuit, implicated in motivation

Risk Factors and Outcomes Related to Pediatric Intensive Care Unit Admission after Hematopoietic Stem Cell Transplantation: A Single-Center Experience

Abstract To describe incidence, causes, and outcomes related to pediatric intensive care unit (PICU) admission for patients undergoing hematopoietic stem cell transplantation (HSCT), we investigated the risk factors predisposing to PICU admission and prognostic factors in terms of patient survival. From October 1998 to April 2015, 496 children and young adults (0 to 23 years) underwent transplantation in the HSCT unit. Among them, 70 (14.1%) were admitted to PICU. The 3-year cumulative incidence of PICU admission was 14.3%. The main causes of PICU admission were respiratory failure (36%), multiple organ failure (16%), and septic shock (13%). The overall 90-day cumulative probability of survival after PICU admission was 34.3% (95% confidence interval, 24.8% to 47.4%). In multivariate analysis, risk factors predisposing to PICU admission were allogeneic HSCT (versus autologous HSCT, P  = .030) and second or third HSCT ( P  = .018). Characteristics significantly associated with mortality were mismatched HSCT ( P  = .011), relapse of underlying disease before PICU admission ( P P  = .012), hepatic failure at admission ( P  = .021), and need for invasive ventilation during PICU course (

Management of Pediatric Urinary Tract Infections: A Delphi Study

Urinary tract infection (UTI) is one of the most common infectious diseases in the pediatric population and represents a major cause of antibiotic consumption and hospitalization in children. Considering the ongoing controversies on the management of pediatric UTI and the challenges due to increasing antimicrobial resistance, the aim of the present study was to evaluate the level of agreement on UTI management in pediatric age in Emilia-Romagna Region, Italy, and to assess on the basis of recent studies whether there is the need to change current recommendations used by primary care pediatricians, hospital pediatricians, and pediatric surgeons in everyday clinical practice to possibly improve outcomes. This consensus provides clear and shared indications on UTI management in pediatric age, based on the most updated literature. This work represents, in our opinion, the most complete and up-to-date collection of statements on procedures to follow for pediatric UTI, in order to guide physicians in the management of the patient, standardize approaches, and avoid abuse and misuse of antibiotics. Undoubtedly, more randomized and controlled trials are needed in the pediatric population to better define the best therapeutic management in cases with antimicrobial resistance and real usefulness of long-term antibiotic prophylaxis

Gourob

Introduction Une quatrième saison a pu être menée sur le terrain à Gourob en décembre 2020 malgré la pandémie, qui nous a toutefois conduits à travailler en équipe plus réduite et pour une durée plus courte. L’ensemble de l’équipe tient à remercier pour leur aide et leurs conseils les membres du comité permanent du MoTA et plus particulièrement : Mostafa Wasiri (secrétaire général), Nashwa Gaber (directeur du Comité permanent et des missions étrangères), Sayed Ashur (Responsable de l’inspecto..

Gourob

Dans le cadre de cette troisième campagne, le travail sur le terrain (pl. 1) a été réparti entre : Des travaux archéologiques dans les zones à l’est, dites du « fort » et de la « jetée », dans le palais, dans la zone des fours, dans les tombes au nord et à l’est du « fort » ainsi qu’à l’est de la zone des fours. Ils ont été complétés par une étude anthropologique sur les ossements provenant des sépultures. Travaux géoarchéologiques pour localiser l’ancien chenal du Nil à l’est du site. Travau..

New Mediterranean Biodiversity Records (December 2019)

This paper is a collection of novel distributional records of 20 species belonging to 8 phyla (Chlorophyta, Rhodophyta, Cnidaria, Ctenophora, Annelida, Mollusca, Arthropoda and Chordata) from 11 Mediterranean countries, namely, Spain: an additional record of the Canary dentex Dentex canariensis is reported from Spain (Valencia), this is the northernmost record of this species in the Mediterranean; Algeria: the first documented record of Caulerpa chemnitzia is reported from the Algerian coast; France: the first record of the Spotted sea hare Aplysia dactylomela is reported from the eastern coast of Corsica; Italy: the first records of the Lessepsian polychaete Dorvillea similis and the alien bivalve Isognomon legumen are reported from Italian waters while additional records of Mnemiopsis leidyi in the south Adriatic are provided;  Libya: the first record of an alien mollusc Crepidula fornicata is reported from Libyan waters; Malta: multiple sightings of gelatinous species Apolemia uvaria, Phacellophora camtschatica and Physophora hydrostatica are reported for the first time from Maltese waters, as well as the first tentative record of the Orange-spotted grouper Epinephelus cfr. coioides; Greece: an occurrence of a rare Bigeye thresher shark Alopias superciliosus is reported from Hellenic Ionian waters, while the first records of the alien Mertens’ prawn-goby Vanderhorstia mertensi, the recently described cyclopoid copepod Oithona davisae and the alien red seaweed Asparagopsis armata are reported from the Aegean Sea. The presence of the micromollusc Euthymella colzumensis is confirmed for Greece; Cyprus: the first record of the red cornetfish Fistularia petimba is reported from Cyprus; Turkey: the first record of the alien jellyfish Marivagia stellata is reported from south-eastern Turkey; Israel: the first records of the sea nettle Chrysaora sp. in the Levant are reported

Practical Recommendations for Optimal Thromboprophylaxis in Patients with COVID-19: A Consensus Statement Based on Available Clinical Trials.

Coronavirus disease 2019 (COVID-19) has been shown to be strongly associated with increased risk for venous thromboembolism events (VTE) mainly in the inpatient but also in the outpatient setting. Pharmacologic thromboprophylaxis has been shown to offer significant benefits in terms of reducing not only VTE events but also mortality, especially in acutely ill patients with COVID-19. Although the main source of evidence is derived from observational studies with several limitations, thromboprophylaxis is currently recommended for all hospitalized patients with acceptable bleeding risk by all national and international guidelines. Recently, high quality data from randomized controlled trials (RCTs) further support the role of thromboprophylaxis and provide insights into the optimal thromboprophylaxis strategy. The aim of this statement is to systematically review all the available evidence derived from RCTs regarding thromboprophylaxis strategies in patients with COVID-19 in different settings (either inpatient or outpatient) and provide evidence-based guidance to practical questions in everyday clinical practice. Clinical questions accompanied by practical recommendations are provided based on data derived from 20 RCTs that were identified and included in the present study. Overall, the main conclusions are: (i) thromboprophylaxis should be administered in all hospitalized patients with COVID-19, (ii) an optimal dose of inpatient thromboprophylaxis is dependent upon the severity of COVID-19, (iii) thromboprophylaxis should be administered on an individualized basis in post-discharge patients with COVID-19 with high thrombotic risk, and (iv) thromboprophylaxis should not be routinely administered in outpatients. Changes regarding the dominant SARS-CoV-2 variants, the wide immunization status (increasing rates of vaccination and reinfections), and the availability of antiviral therapies and monoclonal antibodies might affect the characteristics of patients with COVID-19; thus, future studies will inform us about the thrombotic risk and the optimal therapeutic strategies for these patients