Early Treatment
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Timothy R Holmes ◽  
Jenny L Hepschke ◽  
Ian Jacobson ◽  
Anthony Maloof

2021 ◽  
Evdoxia Kyriazopoulou ◽  
Garyfallia Poulakou ◽  
Haralampos Milionis ◽  
Simeon Metallidis ◽  
Georgios Adamis ◽  

Children ◽  
2021 ◽  
Vol 8 (10) ◽  
pp. 880
Yair Sadaka ◽  
Judah Freedman ◽  
Shai Ashkenazi ◽  
Shlomo Vinker ◽  
Avivit Golan-Cohen ◽  

It has recently been shown that children with early shigellosis are at increased risk of attention deficit/hyperactivity disorder (ADHD). This study aimed to evaluate the association between antibiotic treatment of shigellosis with long-term ADHD rates. A retrospective cohort study was conducted that included all the Leumit Health Services (LHS) enrollees aged 5–18 years between 2000–2018 with a documented Shigella-positive gastroenteritis before the age of 3 years. Of the 5176 children who were positive for Shigella gastroenteritis before the age of 3 years, 972 (18.8%) were treated with antibiotics early (<5 days), 250 (4.8%) were treated late (≥5 days), and 3954 children (76.4%) were not prescribed antibiotics. Late antibiotic treatment was associated with significantly increased rates of ADHD (adjusted OR = 1.61; 95% CI, 1.1–2.3). Early treatment with antibiotics was not associated with increased ADHD rates (adjusted OR = 1.02; 95% CI, 0.8–1.3). In conclusion, late antibiotic treatment of early childhood shigellosis was associated with increased rates of ADHD.

2021 ◽  
Vol 14 (10) ◽  
pp. e242619
Kapil L Barbind ◽  
Revanth Boddu ◽  
KP Shijith ◽  
Kundan Mishra

Eosinophilia can occur due to a plethora of allergic, infective, neoplastic and idiopathic conditions. Hypereosinophilic syndrome (HES) is characterised by sustained eosinophilia and multiorgan dysfunction in the absence of an identifiable cause. It may range from a self-limiting condition to a rapidly progressive life-threatening disorder, of which ischaemic stroke is a rare presentation. Such episodes can rarely be the presenting manifestation, and may develop before any other laboratory abnormality or organ involvement. We report a case of HES presented with multiorgan (neurological and renal) involvement, managed successfully with steroids and cytoreductive therapy. High initial absolute eosinophil count can be a clue to the diagnosis and early treatment should be initiated in such patients, to prevent fatal outcomes.

2021 ◽  
Jolana Wagner-Skacel ◽  
David Riedl ◽  
Hanna Kampling ◽  
Astrid Lampe

Abstract Background: Impairment of mentalization may impact coping strategies, regulation of affect and stress. So far, little is known about the influence of impaired mentalization on dissociation in patients with adverse childhood experiences (ACEs). The aim of this study is to assess the relationship between ACEs, mentalizing and dissociation in adult individuals. Methods: Sixty-seven patients with ACEs completed the Mentalization Questionnaire (MZQ), the Essener Trauma Inventory (ETI) and the Brief Symptom Inventory-18 (BSI-18). The SPSS PROCESS macro tool was applied to test if mentalization mediated the relationship of ACEs and dissociation. Results: ACEs were significantly associated with higher dissociation (β=.42, p<.001) and lower mentalization (β=-.49, p<.001). When mentalization was added to the model as a predictor, the association of ACEs with dissociation was no longer significant (β=.11, p=.31) and a statistically significant indirect effect was found (β=.32, 95% CI: .16-.47). The overall explained variance of dissociation notably improved after inclusion of mentalization (17.5% to 49.1%). Thus, the results indicated that the association of ACEs on dissociation was fully mediated by mentalization. Conclusion: Our results suggest that ACEs are associated with lower mentalization and higher dissociation. Lower mentalization was also associated with worse depression, anxiety, somatization and PTSD symptoms. These findings underline the increasing importance of early treatment of individuals affected by ACDs with a focus to foster the development of mentalization.

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Raphael Rosen ◽  
Shelief Robbins-Juarez ◽  
Jacob Stevens

Ethylene glycol is commonly used in antifreeze, and ingestion of even a small amount can result in acute kidney injury, severe metabolic acidosis, and neurological injury. When cases are recognized early, treatment involves administration of alcohol dehydrogenase inhibitors to prevent conversion to toxic metabolites of glycolate, glyoxolate, and oxalate. In later presentations with more severe renal injury, hemodialysis may be required for clearance of toxic metabolites and supportive care for renal failure. We present the first reported case of severe ethylene glycol intoxication requiring support of extracorporeal membrane oxygenation (ECMO) due to refractory cardiopulmonary collapse.

J. O. Imaralu ◽  
A. A. Akadri ◽  
T. O. Solaja ◽  
O. I. Odelola ◽  
C. C. Nwankpa

Aims: To highlight the pathogenesis of endometrial osseus metaplasia, its importance as a rare cause of infertility and the benefit of hysteroscopic evaluation of infertile women with risk factors for osseus metaplasia. Presentation of Case: A diagnosis of endometrial osseus metaplasia was confirmed histologically in three women undergoing diagnostic hysteroscopy as part of infertility evaluation. They all had chronic vaginal discharge and a preceding history of induced second trimester abortion. Two of the patients were referred for evaluation before in-vitro-fertilization (IVF). Hysteroscopy was done with a 30° telescope, initially using a 2-channel diagnostic sheath, which was later replaced with a 4-channel operating sheath for tissue retrieval. Discussion: Endometrial osseus metaplasia is a rare condition characterized by the presence of mature or immature bone in the endometrial cavity. Endometrial retention of embryonic tissue following an abortion is the commonest theory of etio-pathogenesis. It is an important cause of infertility and while other causes of infertility can be easily by-passed in an IVF cycle, endometrial factors may not be addressed by IVF alone, as a defective endometrium is a risk for failure. Although there is no consensus on routine hysteroscopy for women undergoing IVF, it is the mainstay of evaluation and treatment of women with endometrial osseus metaplasia. Conclusion: Only complete removal of metaplastic tissue would restore fertility, in patients with osseus metaplasia. Hysteroscopy done in infertile women with risk factors for endometrial osseus metaplasia may enhance early treatment and ultimately increase successful spontaneous and IVF pregnancy rates.

Hamed Cheraghmakani ◽  
Reza Jafari ◽  
Elahe Karimpour-razkenari ◽  
monireh Ghazaeian

A 20-year-old girl referred with vision loss upon closantel use. Plasma exchange and high-dose corticosteroid pulse therapy were administered. A 2.5-year follow-up showed improved vision and increased layer thickness of the peripheral nerve fiber. Early treatment with plasma exchange and high-dose corticosteroid therapy can be beneficial to reverse closantel toxicity.

Hengliang Dong ◽  
Tongtong Zhu ◽  
Mingran Zhang ◽  
Dapeng Wang ◽  
Xukai Wang ◽  

Osteonecrosis without effective early treatment eventually leads to the collapse of the articular surface and causes arthritis. For the early stages of osteonecrosis, core decompression combined with bone grafting, is a procedure worthy of attention and clinical trial. And the study of bone graft substitutes has become a hot topic in the area of osteonecrosis research. In recent years, polymers have received more attention than other materials due to their excellent performance. However, because of the harsh microenvironment in osteonecrosis, pure polymers may not meet the stringent requirements of osteonecrosis research. The combined application of polymers and various other substances makes up for the shortcomings of polymers, and to meet a broad range of requirements for application in osteonecrosis therapy. This review focuses on various applying polymers in osteonecrosis therapy, then discusses the development of biofunctionalized composite polymers based on the polymers combined with different bioactive substances. At the end, we discuss their prospects for translation to clinical practice.

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