Is late prevention of cerebral palsy in extremely preterm infants plausible?

Preterm birth continues to be associated with neurodevelopmental problems including cerebral palsy. Cystic white matter injury is still the major neuropathology underlying cerebral palsy, affecting 1-3% of preterm infants. Although rates have gradually fallen over time, the pathogenesis and evolution of cystic white matter injury are still poorly understood. Hypoxia-ischemia (HI) remains an important contributor yet there is no established treatment to prevent injury. Clinically, serial ultrasound and magnetic resonance imaging studies typically show delayed development of cystic lesions 2 to 4 weeks after birth. This raises the important and unresolved question as to whether this represents slow evolution of injury occurring around the time of birth, or repeated injury over many weeks after birth. There is increasing evidence that tertiary injury after HI can contribute to impairment of white and grey matter maturation. In the present review, we discuss preclinical evidence that severe, cystic white matter injury can evolve for many weeks after acute HI and is associated with microglia activity. This suggests the intriguing hypothesis that the tertiary phase of injury is not as subtle as often thought and that there may be a window of therapeutic opportunity for one to two weeks after hypoxic-ischemic injury to prevent delayed cystic lesions and so further reduce the risk of cerebral palsy after preterm birth.

Stroke-Like Migraine after Radiation Treatment Syndrome in Children with Cancer

Stroke-like migraine attacks after radiation therapy (SMART) syndrome is a symptom complex of transient neurological deficits, headache, and abnormal cortical contrast enhancement on brain MRI. Pathophysiology is unclear, but exposure to cranial radiation (RT) is a sine qua non. We report five children with SMART syndrome treated with RT therapy for medulloblastoma (n = 3), atypical teratoid rhabdoid tumor (n = 1), and pleomorphic xanthoastrocytoma (n = 1). Median age at tumor diagnosis was 9.4 years (range 5.1–14.7). Median follow-up from cancer diagnosis was 3.1 years (range 1.4–12.9). All patients had 54 Gy focal RT treatment and medulloblastoma children had additional 36 Gy craniospinal irradiation. Median time from the end of RT to first transient neurological deficit was 1 year (range 0.7–12.1). The median follow-up since first SMART episode was 0.6 years (range 0.3–2.6). Presenting symptoms included the gradual development of unilateral weakness (n = 4), non-fluent dysphasia (n = 1), somnolence (n = 1), and headaches (n = 3). Neurological deficits resolved within 30 minutes to 10 days. Transient cortical enhancement on magnetic resonance imaging (MRI) was confirmed in two children and was absent in the other three. Two children had a single and three had multiple episodes over the next few months. Two children with protracted symptoms responded to 3 days treatment with high dose intravenous methylprednisolone. Symptoms ultimately resolved in all patients. SMART syndrome is a rare disorder characterized by slow evolution of neurological deficits with variable abnormal cortical contrast enhancement. The use of steroids may improve symptoms and speed resolution.

Magnetic Archaeology of Early-type Stellar Dynamos

Early-type stars show a bimodal distribution of magnetic field strengths, with some showing very strong fields (≳1 kG) and others very weak fields (≲10 G). Recently, we proposed that this reflects the processing or lack thereof of fossil fields by subsurface convection zones. Stars with weak fossil fields process these at the surface into even weaker dynamo-generated fields, while in stars with stronger fossil fields magnetism inhibits convection, allowing the fossil field to remain as is. We now expand on this theory and explore the timescales involved in the evolution of near-surface magnetic fields. We find that mass loss strips near-surface regions faster than magnetic fields can diffuse through them. As a result, observations of surface magnetism directly probe the frozen-in remains of the convective dynamo. This explains the slow evolution of magnetism in stars with very weak fields: these dynamo-generated magnetic fields evolve on the timescale of the mass loss, not that of the dynamo.

“Havens of mercy”: health, medical research, and the governance of the movement of dogs in twentieth-century America

This article argues that the movement of dogs from pounds to medical laboratories played a critically important role in debates over the use of animals in science and medicine in the United States in the twentieth century, not least by drawing the scientific community into every greater engagement with bureaucratic political governance. If we are to understand the unique characteristics of the American federal legislation that emerges in the 1960s, we need to understand the long and protracted debate over the use of pound animals at the local municipal and state level between antivivisectionists, humane activists, and scientific and medical researchers. We argue that the Laboratory Animal Care Act of 1966 reflects the slow evolution of a strategy that proved most successful in local conflicts, and which would characterize a “new humanitarianism”: not the regulation of experimental practices but of the care and transportation of the animals being provided to the laboratory. Our analysis is consistent with, and draws upon, scholarship which has established the productive power of public agencies and civil society on the periphery of the American state.

The first late cretaceous mawsoniid coelacanth (Sarcopterygii: Actinistia) from North America: Evidence of a lineage of extinct ‘living fossils’

Today, the only living genus of coelacanth, Latimeria is represented by two species along the eastern coast of Africa and in Indonesia. This sarcopterygian fish is nicknamed a "living fossil", in particular because of its slow evolution. The large geographical distribution of Latimeria may be a reason for the great resilience to extinction of this lineage, but the lack of fossil records for this genus prevents us from testing this hypothesis. Here we describe isolated bones (right angular, incomplete basisphenoid, fragments of parasphenoid and pterygoid) found in the Cenomanian Woodbine Formation in northeast Texas that are referred to the mawsoniid coelacanth Mawsonia sp. In order to assess the impact of this discovery on the alleged characteristic of "living fossils" in general and of coelacanths in particular: 1) we compared the average time duration of genera of ray-finned fish and coelacanth in the fossil record; 2) we compared the biogeographic signal from Mawsonia with the signal from the rest of the vertebrate assemblage of the Woodbine formation; and 3) we compared these life traits with those of Latimeria. The stratigraphical range of Mawsonia is at least 50 million years. Since Mawsonia was a fresh, brackish water fish with probably a low ability to cross large sea barriers and because most of the continental components of the Woodbine Fm vertebrate assemblage exhibit Laurasian affinities, it is proposed that the Mawsonia’s occurrence in North America is more likely the result of a vicariant event linked to the break-up of Pangea rather than the result of a dispersal from Gondwana. The link between a wide geographic distribution and the resilience to extinction demonstrated here for Mawsonia is a clue that a similar situation existed for Latimeria, which allowed this genus to live for tens of millions of years.

HORMONAL MANIFESTATIONS OF THYROID CANCER ASSOCIATED WITH AUTOIMMUNE THYROIDITIS

In medical practice, early diagnosis of CT is difficult because the neoplasm coexists or develops against the background of nodular-inflammatory thyroid pathologies, which have a slow evolution, CT is often associated with thyroiditis. The association of thyroid carcinoma with autoimmune thyroiditis remains debatable. In the literature, this combination is noted in 1% to 75% of cases. In recent years, there has been a steady increase in the number of thyroid cancers developed against the background of autoimmune thyroiditis, this being explained by improved diagnostic methods, living environment and increasing the number of elderly people. The relationship between inflammation and cancer is known to be that patients with autoimmune thyroiditis have a higher risk of developing thyroid cancer. The literature does not fully elucidate the hormonal peculiarities of thyroid cancer associated with autoimmune thyroiditis have not been studied yet in the Repulic Of Moldova

Histopathological Correlation in Different Types of Leprosy in a Tertiary Health Care Centre

Hansen’s disease or Leprosy, is a chronic infectious disease that is contagious and has a slow evolution. It affects mainly skin and schwann cells in the peripheral nerves and causes peripheral neuropathy which contributes to the permanent functional impairments [1]. It is caused by a rod shaped,acid fast staining bacteria known as Mycobacterium Leprae which has parallel sides, round ends and a characteristic bundle of cigar appearance due to the presence of a glial substance which is a surface lipid that makes the bacilli to be arranged side by side in parallel arrays [2]. It has a distinctive empathy towards the peripheral nerves where it establishes originally therefore it is the site where the pathological processes start mainly with the principal target being Schwann cell [3,4]. Amidst the communicable diseases, Leprosy is the most common cause of physical disabilities which is permanent. When the bacterium enters a person with good cell-mediated immunity against it, it gets destroyed. If there is a slight impairment in the cell-mediated immunity against it, some bacilli will multiply and a lesion develops. Depending upon the immune status of a host, it expresses itself in different clinico-histopathological forms [5]. Ridley and Jopling suggested a five-group classification of leprosy known as immunological classification based upon the immunological status of the patient as (a) tuberculoid (TT), (b) borderline tuberculoid (BT), (c) mid-borderline (BB), (d) borderline lepromatous (BL) and (e) lepromatous (LL) [6]. Bacteriological, immunological, clinical and histopathological features exhibit continuous but slow changes from one pole to another pole. The main disadvantage of this classification is that there is no specific position for pure neuritic as well as indeterminate leprosy in the spectrum [7].

Liberal Democracy and Its Discontent

There is unanimous agreement about the growing discontent vis-à-vis liberal democracy. Despite a considerable diversity of its manifestations, the disenchantment with democracy, its institutions as well as its policies is universal. The disease has contaminated every democratic system: those recently set up as well as consolidated democracies such as the UK and USA; rich countries as well as less affluent ones; social-democratic regimes as well as neoliberal ones; federal as well as centralized states. This new trend is well consolidated. Thirty years after the fall of the Soviet regimes, the naïve belief that there was no alternative to liberal democracy has faded away. This chapter argues that the crisis is not a mere effect of the post-2008 financial collapse but rather a consequence of three processes. First is the incremental but deep transformation of what we call democracy over the past 50 years. We have a single word (democracy) to label systems which have gone through a profound transformation and which, at the end, do not fit with democracy’s ideals, hopes, and expectations. The second process is the shaking of the very foundations of the past equilibrium based on a compromise between two conflicting values: the power of the people, on one hand, and the liberal limitations on the people’s capacity to act, decide, and control, on the other. The new equilibrium reached after many years of slow evolution is characterized by a serious imbalance between the popular input and the checks and balances, contributing to the frustration of those who are, in theory, the ‘sovereign’. Third is the increasing discrepancy between democratic systems and institutions that have developed exclusively within the Westphalian nation-state, and policies that are more and more framed by or dependent upon global actors. Finally, the failure of the European Union to tackle the so-called ‘democratic deficit’ has disillusioned those who had dreamed of reconciling democratic processes and policies with supranational institutions, flows, and actors. The populist outburst in both its anarchic and authoritarian versions, while fuelling discontent, might become a mere ‘impasse’. There is, indeed, ‘only a single bed for two dreams’ and some new balance between the contradicting values of democracy and liberalism has to be established for the future.

Child's Craniopharyngiomas About 11 Cases and Review of the Literature

Craniopharyngioma is a benign and rare intracranial tumor. In children, the clinic is characterized by the semiological, neurological, ophthalmological, and endocrine tripod. Medical imaging, represented by computed tomography (CT) and especially magnetic resonance imaging (MRI), has revolutionized the approach to the diagnosis of the latter. It has a slow evolution and likely to recur late. Thus, prolonged clinical-radiological follow-up is important to affirm a cure. The aim of this study is to highlight the epidemiological, clinical, paraclinical, therapeutic and evolutionary characteristics of craniopharyngiomas in children. This work consisted of a retrospective study of 11 pediatric cases of this tumor collected in the Neurosurgery Department of the IBN ROCHD University Hospital in Casablanca between January 2011 and January 2017. In this series, the child's craniopharyngiomas accounted for a rate of 45.8% of all these tumors. The average age of our patients was 9.09 years, with a sex ratio of 0.37. The average time to diagnose was 10 months. The picture was dominated by 100% visual disturbances, signs of intracranial hypertension at 63.63% and endocrine disorders at 36.36%. The lesion was intra and suprasellar seat in 91% of cases and suprasellar seat in 9%. Tumor size was less than 4cm in 54.53% of cases. Hydrocephalus is observed in 27.27% of cases. The fronto-pterrional modus operandi was the most used 72% of cases. Total exeresis was achieved in 9.1% of cases. Overall trends were favorable in 72% of cases without noting mortality. Tumor progressive recovery was observed in 9.1% of cases, but there were no recurrences. Given its location, the treatment of craniopharyngioma can lead to significant consequences in children affecting the long-term quality of life, hence the importance of post-operative follow-up and multidisciplinary management.

Slow Invariant Manifold of Laser with Feedback

Previous studies have demonstrated, experimentally and theoretically, the existence of slow–fast evolutions, i.e., slow chaotic spiking sequences in the dynamics of a semiconductor laser with AC-coupled optoelectronic feedback. In this work, the so-called Flow Curvature Method was used, which provides the slow invariant manifold analytical equation of such a laser model and also highlights its symmetries if any exist. This equation and its graphical representation in the phase space enable, on the one hand, discriminating the slow evolution of the trajectory curves from the fast one and, on the other hand, improving our understanding of this slow–fast regime.