borrelia burgdorferi infection and lyme disease in children

Summary Lyme disease is a multisystem disease that frequently affects children. It is caused by a group of related spirochetes, Borrelia burgdorferi sensu lato, that are transmitted by ticks belonging to species of the genus Ixodes . The clinical characteristics of Lyme disease in pediatrics resemble those observed in adults, although the symptoms may last for a shorter time and the outcome may be better. However, identifying Lyme disease in children can be significantly more difficult because some of its signs and symptoms can be similar to those of other common pediatric clinical manifestations. Finally, the diagnostic and therapeutic approach to childhood Lyme disease is frequently not codified, and guidelines specifically prepared for adults are used for children without having been validated. This review of the currently available data will evaluate what may be the best approach to the diagnosis and treatment of B. burgdorferi infection and disease in the pediatric population

Hyperacusis in children: a preliminary study on the effects of hypersensitivity to sound on speech and language

There is a growing awareness that children may experience hyperacusis, a condition that is often associated with behavioral and developmental disorders. This preliminary study was aimed to investigate the effects of hyperacusis alone on various components of speech and language in children without developmental disorders. This study was conducted on 109 children aged between 4 and 7 years attending kindergarten and primary school. Hyperacusis was assessed through behavioral observation of children and questionnaires for parents. Different components of speech and language were assessed through specific tests. Hyperacusis was diagnosed in fifteen children (13.8%); ten (66.7%) were attending primary school and five (33.3%) kindergarten. A significant difference between children with and without hyperacusis was found for tests evaluating the average number of words in a sentence and phonemic fluency; older children appeared to have more difficulties. Several differences in education profiles were found: parents of children with hyperacusis spent less time with their children compared to parents of children without hyperacusis. Our preliminary results suggest some difficulties in lexical access and the use of shorter sentences by children with hypersensitivity to sound; however, the small size of our sample and the largely unknown interactions between hyperacusis and developmental disorders suggest caution when interpreting these results. Further studies on larger samples are necessary to gain additional knowledge on the effects of hyperacusis on speech and language in children without developmental disorders

BeppoSAX Observations of 1 Jy BL Lacertae Objects. I

We present new BeppoSAX observations of seven BL Lacertae objects selected from the 1 Jy sample plus one additional source. The collected data cover the energy range 0.1 - 10 keV (observer's frame), reaching ~ 50 keV for one source (BL Lac). All sources characterized by a peak in their multifrequency spectra at infrared/optical energies (i.e., of the LBL type) display a relatively flat (alpha_x ~ 0.9) X-ray spectrum, which we interpret as inverse Compton emission. Four objects (2/3 of the LBL) show some evidence for a low-energy steepening which is likely due to the synchrotron tail merging into the inverse Compton component around ~ 1 - 3 keV. If this were generally the case with LBL, it would explain why the 0.1 - 2.4 keV ROSAT spectra of our sources are systematically steeper than the BeppoSAX ones (by ~ 0.5 in alpha_x). The broad-band spectral energy distributions fully confirm this picture and a synchrotron inverse Compton model allows us to derive the physical parameters (intrinsic power, magnetic field, etc.) of our sources. Combining our results with those obtained by BeppoSAX on BL Lacs covering a wide range of synchrotron peak frequencies, we confirm and clarify the dependence of the X-ray spectral index on synchrotron peak frequency originally found in ROSAT data.Comment: 14 pages, 7 figures. Accepted for publication in MNRAS. Postscript file also available at http://icarus.stsci.edu/~padovani/xrayspectra_papers.htm

Treatment of Chronic Hepatitis C in a Patient Affected by Systemic Sclerosis

The currently recommended treatment for patients infected with hepatitis C virus (HCV) is pegilated interferon α (IFN α) plus ribavirin. Despite the numerous benefits of this therapy, there is an increasing concern regarding his tolerance. Among the most common side effects, interferon may trigger the onset or exacerbation of autoimmune diseases. When chronic hepatitis C coexists with an autoimmune disorder, it is not clear whether using interferon is better than avoiding it. We evaluated the disease state of a 55-year old female affected by sistemic sclerosis (SSc), during and after therapy with IFNα pegilated plus ribavirin for chronic HCV infection. We were worried about the potential worsening of the autoimmune disease during the therapy, but we were confident that we would give our patient a short course of peginterferon and ribavirin. A mild, asymptomatic worsening of lung SSc was observed during IFN administration, without life threatening symptoms. After 24 months follow up we observed the maintenance of the virological response and a good control of the rheumatological disease. Thus, in liver disease at high risk of progression and concomitant SSc, the antiviral therapy with IFNα is a feasible approach

A wide field X-ray telescope for astronomical survey purposes: from theory to practice

X-ray mirrors are usually built in the Wolter I (paraboloid-hyperboloid) configuration. This design exhibits no spherical aberration on-axis but suffers from field curvature, coma and astigmatism, therefore the angular resolution degrades rapidly with increasing off-axis angles. Different mirror designs exist in which the primary and secondary mirror profiles are expanded as a power series in order to increase the angular resolution at large off-axis positions, at the expanses of the on-axis performances. Here we present the design and global trade off study of an X-ray mirror systems based on polynomial optics in view of the Wide Field X-ray Telescope (WFXT) mission. WFXT aims at performing an extended cosmological survey in the soft X-ray band with unprecedented flux sensitivity. To achieve these goals the angular resolution required for the mission is very demanding ~5 arcsec mean resolution across a 1-deg field of view. In addition an effective area of 5-9000 cm^2 at 1 keV is needed.Comment: Accepted for publication in the MNRAS (11pages, 3 table, 13 figures

Hepatic abscess caused by trans-gastric migration of a fishbone

Background Stomach or duodenal perforation due to foreign body are usually associated with the development of a walled-off abdominal mass or abscess, and are less prone to cause systemic signs of infection. Methods and Case presentation A 65-year-old man with no comorbidities was admitted for rapid onset of abdominal discomfort, fever, and chills. An abdominal computed tomography (CT) showed an 8 cm abscess in the left lobe of the liver. The lesion was aspirated under ultrasound guidance; cultures from the abscess grew Streptococcus constellatus. Chest CT scan, colonoscopy, esophagogastroduodenoscopy, and blood cultures were negative. The patient’s clinical status rapidly improved with antibiotic therapy, but a follow-up CT scan revealed the presence of a thin, 3 cm-long radiopaque object at the site of the previous abscess. A few months later, due to symptomatic cholelithiasis, the patient underwent elective laparoscopic cholecystectomy and concurrent removal of a 3 cm-long fishbone, which was embedded into the wall of the gastric antrum and the third segment of the liver, the latter which was partially resected. Results The small gastrotomy was reapproximated with a single resorbable stitch. The post-operative course was uneventful and at 6 month follow up, the patient was asymptomatic without evidence of residual abdominal pathology. Conclusions Asymptomatic perforation of the gastric wall by an ingested foreign body can occur and be subsequently complicated by a liver abscess. A contained perforation can be successfully managed conservatively

Incidence of toxoplasmosis in pregnancy in Campania: A population-based study on screening, treatment, and outcome

INTRODUCTION: The aim of this study was to evaluate the incidence of toxoplasmosis infection during pregnancy and to describe the characteristics of the serological status, management, follow-up and treatment. MATERIAL AND METHODS: This is a population-based cohort study of women referred for suspected toxoplasmosis during pregnancy from January, 2001 to December, 2012. Suspected toxoplasmosis was defined as positive IgM antibody during pregnancy. Women with suspected toxoplasmosis during pregnancy were classified into three groups: seroconversion, suspected infection, or no infection in pregnancy. Women in the first and second group were treated according to local protocol, and amniocentesis with toxoplasmosis PCR detection and serial detailed ultrasound scans were offered. Neonates were investigated for congenital toxoplasmosis at birth and were monitored for at least one year after birth. RESULTS: During the study period, there were 738,588 deliveries in Campania. Of them 1159 (0.2%) were referred to our Institution for suspected toxoplasmosis during pregnancy: 183 (15.8%) women were classified as seroconversion, 381 (32.9%) were suspected infection, and 595 (51.3%) were not infected in pregnancy. Neonatal outcome was available for 476 pregnancies, including 479 neonates (3 twins, 473 singletons), out of the 564 pregnancies with seroconversion or suspected infection. 384 (80.2%) babies were not infected at birth and at follow-up, 67 (14.0%) had congenital toxoplasmosis, 10 (2.1%) were voluntary induced termination of pregnancy, 15 (3.1%) were spontaneous miscarriage, and 4 (0.8%) were stillbirth (of which one counted already in the infected cohort). Considering cases of congenital toxoplasmosis, the transmission rate in women with seroconversion was 32.9% (52/158), and in women with suspected infection was 4.7% (15/321). CONCLUSIONS: Toxoplasmosis is uncommon in pregnancy with overall incidence of seroconversion and suspected infection in pregnancy of 0.8 per 1000 live births and incidence of congenital toxoplasmosis 0.1 per 1000 live births when applying a strict protocol of screening, follow-up, and treatment. 51.3% (595/1159) of women referred to our center for suspected infection were actually considered not infected

Fulvestrant and trastuzumab in patients with luminal HER2-positive advanced breast cancer (ABC): an Italian real-world experience (HERMIONE 9)

Purpose The most appropriate therapy for HR+/HER2-positive (HER2+) advanced breast cancer (ABC) is a matter of debate. Co-targeting of both receptors represents an attractive strategy to overcome the cross-talk between them. Methods The HERMIONE 9 is an observational retrospective multicentric study which aimed to describe the clinical outcome of patients with HR+/HER2+ABC who received the combination of Fulvestrant (F) and Trastuzumab (T) as part of their routine treatment at 10 Italian Institutions. Results Eighty-seven patients were included. Median age was 63 (range, 35–87) years. The median number of previous treatments was 3 (range, 0–10) and F and T were administered as≥3rd line in 67 patients. Among the 86 evaluable patients, 6 (6.9%) achieved CR, 18 (20.7%) PR, and 44 (50.6%) had SD ≥24 weeks with an overall CBR of 78.2%. At a median follow-up of 33.6 months, mPFS of the entire cohort was 12.9 months (range, 2.47–128.67). No diference was observed in mPFS between patients treated after progression or as maintenance therapy (mPFS 12.9 and 13.9 months in 64 and 23 patients, respectively), neither considering the number of previous treatment lines (≤3 or<3). Conclusion The combination of F and T was active in this cohort at poor prognosis and deserves further investigations possibly in combination with pertuzumab in patients with high ER expression

The Jet-Disk Connection and Blazar Unification

We discuss the relation between the power carried by relativistic jets and the nuclear power provided by accretion, for a group of blazars including FSRQs and BL Lac objects. They are characterized by good quality broad band X-ray data provided by the Beppo SAX satellite. The jet powers are estimated using physical parameters determined from uniformly modelling their spectral energy distributions (SEDs). Our analysis indicates that for Flat Spectrum Radio Quasars the total jet power is of the same order as the accretion power. We suggest that blazar jets are likely powered by energy extraction from a rapidly spinning black hole through the magnetic field provided by the accretion disk. FSRQs must have large BH masses (10^8 - 10^9 solar masses) and high, near Eddington accretion rates. For BL Lac objects the jet luminosity is larger than the disk luminosity. This can be understood within the same scenario if BL Lac objects have masses similar to FSRQ but accrete at largely subcritical rates, whereby the accretion disk radiates inefficiently. Thus the ``unification'' of the two classes into a single blazar population, previously proposed on the basis of a spectral sequence governed by luminosity, finds a physical basis.Comment: 27 pages, 3 figures, ApJ in pres

Il riallestimento del Museo Astronomico di Brera

Grazie a uno stanziamento della Regione Lombardia ottenuto tramite il bando “Progetti di valorizzazione e promozione di Istituti, Luoghi della cultura, siti UNESCO, itinerari culturali e di catalogazione del patrimonio culturale - ambito museo 2019” tra il maggio e il dicembre 2020 è stato realizzato il nuovo allestimento della galleria del MusAB. Il MusAB ha in questa nuova esposizione l’ambizione di rispondere alla domanda “Cosa fa l’astronoma/o”? “Osservare, scoprire, misurare, rappresentare, sono queste le operazioni che compiono gli astronomi; noi cercheremo di illustrarle con l’aiuto degli antichi strumenti della Specola di Brera.” Così si legge nella rinnovata pannellistica del Museo mentre il telescopio Gualtieri, il Magnetometro, Boscovich e Napoleone ci guidano in prima persona alla scoperta di questa straordinaria disciplina. Van Gogh, Shakespeare, Tomasi di Lampedusa fanno da cornice alla visita e ci conducono fino a Marte dove il ricco patrimonio archivistico dell’INAF – Osservatorio Astronomico di Brera viene illustrato grazie alle riproduzioni digitali