Febrile seizures and mechanisms of epileptogenesis: insights from an animal model.

Temporal lobe epilepsy (TLE) is the most prevalent type of human epilepsy, yet the causes for its development, and the processes involved, are not known. Most individuals with TLE do not have a family history, suggesting that this limbic epilepsy is a consequence of acquired rather than genetic causes. Among suspected etiologies, febrile seizures have frequently been cited. This is due to the fact that retrospective analyses of adults with TLE have demonstrated a high prevalence (20-->60%) of a history of prolonged febrile seizures during early childhood, suggesting an etiological role for these seizures in the development of TLE. Specifically, neuronal damage induced by febrile seizures has been suggested as a mechanism for the development of mesial temporal sclerosis, the pathological hallmark of TLE. However, the statistical correlation between febrile seizures and TLE does not necessarily indicate a causal relationship. For example, preexisting (genetic or acquired) 'causes' that result independently in febrile seizures and in TLE would also result in tight statistical correlation. For obvious reasons, complex febrile seizures cannot be induced in the human, and studies of their mechanisms and of their consequences on brain molecules and circuits are severely limited. Therefore, an animal model was designed to study these seizures. The model reproduces the fundamental key elements of the human condition: the age specificity, the physiological temperatures seen in fevers of children, the length of the seizures and their lack of immediate morbidity. Neuroanatomical, molecular and functional methods have been used in this model to determine the consequences of prolonged febrile seizures on the survival and integrity of neurons, and on hyperexcitability in the hippocampal-limbic network. Experimental prolonged febrile seizures did not lead to death of any of the seizure-vulnerable populations in hippocampus, and the rate of neurogenesis was also unchanged. Neuronal function was altered sufficiently to promote synaptic reorganization of granule cells, and transient and long-term alterations in the expression of specific genes were observed. The contribution of these consequences of febrile seizures to the epileptogenic process is discussed

International Consensus Statement on Rhinology and Allergy: Rhinosinusitis

Background: The 5 years since the publication of the first International Consensus Statement on Allergy and Rhinology: Rhinosinusitis (ICAR‐RS) has witnessed foundational progress in our understanding and treatment of rhinologic disease. These advances are reflected within the more than 40 new topics covered within the ICAR‐RS‐2021 as well as updates to the original 140 topics. This executive summary consolidates the evidence‐based findings of the document. Methods: ICAR‐RS presents over 180 topics in the forms of evidence‐based reviews with recommendations (EBRRs), evidence‐based reviews, and literature reviews. The highest grade structured recommendations of the EBRR sections are summarized in this executive summary. Results: ICAR‐RS‐2021 covers 22 topics regarding the medical management of RS, which are grade A/B and are presented in the executive summary. Additionally, 4 topics regarding the surgical management of RS are grade A/B and are presented in the executive summary. Finally, a comprehensive evidence‐based management algorithm is provided. Conclusion: This ICAR‐RS‐2021 executive summary provides a compilation of the evidence‐based recommendations for medical and surgical treatment of the most common forms of RS

Parent Perceptions of Connectedness in a Full Service Community School Project

Quality partnerships between parents and schools are widely considered necessary components of effective educational approaches for improving student academic performance. Nevertheless, there is a paucity of research that has examined the effect of school-community collaboration on parent–teacher relationships or parent involvement. The Providence Full Service Community Schools (PFSCS) model, created to connect schools, families, and communities, provided comprehensive services, including family literacy, out-of-school time, wraparound case management, health outreach, and a focus on family engagement. To understand how community service integration, the key component of PFSCS, can improve parent involvement as social capital, the Parent–Teacher Involvement Questionnaire was used to measure perceptions of the amount and type of contact that occur between parents and teachers; parent interest and comfort in talking with teachers; parent satisfaction with their children’s school; and the extent of parental involvement in their child’s education. The PTIQ was administered during the fall of each participating school’s first year of PFSCS implementation and then again during each subsequent fall. Descriptive analyses and one-way ANOVAs were conducted for each subscale of the PTIQ and then for each subscale by school. Overall, findings were mixed and, perhaps most notably, three of the four subscales showed an initial score decrease followed by longer term improvements. While some caution in interpretation is warranted due to design limitations, our primary recommendation is for schools to focus on building trusting relationships with parents and also that data collection, such as was used in this study, can facilitate these efforts. Likewise, the importance of documenting school and intervention contexts is reiterated