Canine spinal meningiomas and nerve sheath tumours in 34 dogs (2008-2016): Distribution and long-term outcome based upon histopathology and treatment modality.

The purpose of this retrospective, multicentre case series was to describe the outcome following surgery and/or radiation of spinal meningiomas and nerve sheath tumours (NSTs) based upon treatment modality, with a specific aim to evaluate the survival times and time to recurrence following treatment for each histopathological diagnosis. Our hypothesis was that the addition of radiation therapy modalities to treatment will yield longer time to recurrence of clinical signs and survival time. Thirty-four dogs met the inclusion criteria of histopathologically diagnosed extramedullary spinal meningioma or NST. Sixteen extramedullary spinal meningiomas and 18 NSTs were diagnosed. A diagnosis of meningioma was associated with a significantly longer survival time compared with NSTs, with median survival times (MST) of 508 days (95% confidence interval [CI]: 66-881) vs 187 days (95% CI: 76-433; P = .02). Dogs (seven) treated with stereotactic radiation therapy (SRT) for recurrence after surgery alone or SRT alone as their initial treatment gained an additional 125 to 346 days survival time.

Mapping resistance to Southern rust in a tropical by temperate maize recombinant inbred topcross population.

Southern rust, caused by Puccinia polysora Underw, is a foliar disease that can severely reduce grain yield in maize (Zea mays L.). Major resistance genes exist, but their effectiveness can be limited in areas where P. polysora is multi-racial. General resistance could be achieved by combining quantitative and race-specific resistances. This would be desirable if the resistance alleles maintained resistance across environments while not increasing plant maturity. Recombinant inbred (RI) lines were derived from a cross between NC300, a temperate-adapted all-tropical line, and B104, an Iowa Stiff Stalk Synthetic line. The RI lines were topcrossed to the tester FR615 x FR697. The 143 topcrosses were scored for Southern rust in four environments. Time to flowering was measured in two environments. The RI lines were genotyped at 113 simple sequence repeat markers and quantitative trait loci (QTL) were mapped for both traits. The entry mean heritability estimate for Southern rust resistance was 0.93. A multiple interval mapping model, including four QTL, accounted for 88% of the variation among average disease ratings. A major QTL located on the short arm of chromosome 10, explained 83% of the phenotypic variation, with the NC300 allele carrying the resistance. Significant (P < 0.001), but relatively minor, topcross-by-environment interaction occurred for Southern rust, and resulted from the interaction of the major QTL with the environment. Maturity and Southern rust rating were slightly correlated, but QTL for the two traits did not co-localize. Resistance was simply inherited in this population and the major QTL is likely a dominant resistant gene that is independent of plant maturity.

Kawasaki syndrome-like illness associated with infection caused by enterotoxin B-secreting Staphylococcus aureus.

Two children had symptoms and clinical signs that were characteristic of the diagnostic criteria for Kawasaki syndrome, temporally associated with Staphylococcus aureus bacteremia. One child initially had focal osteomyelitis that was evident clinically and radiographically, and radiographic evidence of multifocal osteomyelitis was noted at follow-up. The blood-borne S. aureus isolates from these two patients secreted staphylococcal enterotoxin B and were negative for toxic shock syndrome toxin. Staphylococcal and streptococcal superantigens may play a role in the pathogenesis of some cases of Kawasaki syndrome or Kawasaki syndrome-like illness.

HIV infection in women and children. Special concerns in prevention and care.

Unfortunately, HIV infection continues to spread rapidly among women in the United States, and infected women still have a poorer outcome than do infected men. Prevention, early diagnosis, and facilitation of care in women are critical to both their own and their children's health. Fortunately, significant advances continue to be made in prevention of HIV transmission to children. Not only HIV experts but also primary care physicians play an important role in identification and care of HIV-infected women and children. In addition, prevention of HIV infection requires the efforts of professionals throughout the healthcare spectrum.

Levodopa therapy improves motor function in HIV-infected children with extrapyramidal syndromes.

Five children with human immunodeficiency virus type-1 (HIV-1) infection, aged 4 to 13 years, manifested extrapyramidal dysfunction characterized by rigidity/stiffness, ambulation difficulties/shuffling gait, dysarthria/drooling/swallowing dysfunction, hypomimetic/inexpressive facies, and bradykinesia. Levodopa therapy caused an initial improvement in all symptoms, and the effect was sustained in most patients. Levodopa is a useful adjunctive therapy in HIV-1-infected children with extrapyramidal syndromes, by enhancing motor function and improving their quality of life.

HIV infection in women and children.

AIDS is increasing more rapidly among women than men and has become the fourth-leading cause of death for women between the ages of 25 and 44 years in the United States. This changing epidemiological trend accounts for the increase in pediatric cases of HIV infection. This article summarizes features on women and children. We review epidemiology, clinical characteristics, vertical transmission, treatment, and prevention opportunities.

Older children and adolescents living with perinatally acquired human immunodeficiency virus infection.

OBJECTIVE: To describe the clinical, immunologic, and psychosocial characteristics of children living with perinatally-acquired human immunodeficiency virus (HIV) infection beyond the age of 9 years. METHODS: This is a descriptive cohort study of 42 surviving perinatally infected children older than 9 years followed at the Children's Hospital Acquired Immunodeficiency Syndrome (AIDS) Program (part of a university-based inner city medical center) as of June 1993. The study is based on medical record data of clinical, immunologic, and psychosocial parameters. RESULTS: The cohort includes 20 boys and 22 girls with a mean age of 136 months. The mean age at diagnosis of HIV infection was 88 months, and 59.5% were asymptomatic at the time of diagnosis. Currently, after a mean follow-up period of 48 months from diagnosis, 23.8% remain asymptomatic, 19.1% have non-AIDS-defining HIV-related symptoms, and 57.1% have AIDS; 85.7% of the cohort did not develop HIV-related symptoms until after 48 months of age (late-onset prolonged survivors). There was an average annual decline of 71.4 CD4+ cells/microL in the cohort from the ages of 7 to 16 years, and 21.4% have a current CD4+ lymphocyte count of greater than 500 cells/microL, 28.6% between 200 and 500 cells/microL, and 50% less than 200 cells/microL; 76% are orphaned as a result of maternal death, with the majority of the cohort (60%) cared for by extended family members. Disclosure of diagnosis has occurred in 57.1%. The vast majority of the cohort (76%) are attending regular school, with the remainder in special education. CONCLUSIONS: Although close to one quarter of the children and adolescents ages 9 to 16 years living with perinatally acquired HIV infection described in this cohort remain asymptomatic and have a relatively intact immune system, the remainder are living with significant HIV-related symptoms, many of which are chronic in nature and have an impact on daily living. The children in this cohort had both significant immunologic deterioration and symptomatic disease progression during the mean follow-up period of 48 months from the time of diagnosis with HIV infection.

Living beyond the odds: a psychosocial perspective on long-term survivors of pediatric human immunodeficiency virus infection.

Pediatric human immunodeficiency virus (HIV) disease parallels other chronic illnesses in that medical advances are facilitating treatment, and many children infected early in life are living through school age and into adolescence. A medical overview of pediatric HIV, a review of natural history studies, and a recent study of older children provide the basis for a definition of long-term survivors of pediatric HIV infection. The noncategorical approach to examining the common consequences of pediatric chronic illness and a description of unique aspects of HIV disease provide the framework for a discussion of the psychosocial and developmental issues for long-term survivors of pediatric HIV. Clinical case examples from the Children's Hospital AIDS Program are included. This analysis leads to the conclusion that long-term survivors of pediatric HIV, with a few exceptions, are in many ways like their peers with other chronic illness.

Population-based study of measles and measles immunization in human immunodeficiency virus-infected children.

This study reports the course of measles and results of measles immunization in a cohort of human immunodeficiency virus-infected children. Six cases of measles were identified. All had typical clinical manifestations, 5 of 6 developed pneumonia and 3 of 6 died. A measles intervention program consisting of serologic screening and active immunization (measles-mumps-rubella (MMR)) was instituted in 1990. Among 127 children with data available for analysis (mean age, 6.7 years), only 35% had documentation of prior immunization with MMR. Among 80 children who had preimmunization measles serology reported, 56% were measles antibody-negative and 40% were antibody-positive; following intervention 36% remained measles antibody-negative. Six children lost measles antibody over time. MMR nonresponders had lower CD4 lymphocyte counts (303 +/- 394) compared with responders (865 +/- 677; P = 0.0058). Measles is a potentially fatal illness in human immunodeficiency virus-infected children. Prevention strategies are limited by low rates of age-appropriate MMR immunization, poor antibody responses to MMR in older human immunodeficiency virus-infected children and seroreversion.

Varicella does not appear to be a cofactor for human immunodeficiency virus infection in children.

We performed a retrospective analysis of longitudinal clinical and immunologic data obtained from 22 children in the early stages of infection with human immunodeficiency virus (HIV) when they developed varicella. We studied the course of HIV infection to determine whether clinical deterioration occurred after chickenpox. We examined the following indices: growth and development; neurologic status; helper T lymphocyte counts; blood values of core (p24) antigen of HIV; changes in the stage of HIV infection; and need for administration of zidovudine. We studied children for a mean of 2.8 years and for as long as 9.8 years after onset of varicella. There was little evidence that chickenpox affected HIV infection. Three (14%) children developed clinical zoster, 2 of whom (9%) had evidence of chronic infection with varicella-zoster virus. One additional child (5%) had 2 episodes of chickenpox. These observations suggest that children with early HIV infection could be considered for immunization with live attenuated varicella vaccine, which would be predicted to decrease their morbidity from varicella-zoster virus.

Nontuberculous mycobacteria in children with acquired immunodeficiency syndrome.

Among 139 children with acquired immunodeficiency syndrome at Children's Hospital of New Jersey, 20 had positive cultures for non-tuberculous mycobacteria. Eighty-five percent had Mycobacterium avium complex isolated and 70% had definite evidence of disseminated disease. Ninety-three percent had CD4 lymphocyte counts less than 100 cells/mm3 and 95% had met acquired immunodeficiency syndrome criteria before the time of first positive culture. Clinical findings included failure to gain weight, anorexia, fever, abdominal pain/tenderness and anemia. The median age at onset of symptoms was 46 months and the median time between onset of symptoms and positive culture was 9 months. Outcome for patients with positive cultures for nontuberculous mycobacteria was poor, with 75% of the children surviving for less than or equal to 10 months. Nontuberculous mycobacteria are increasingly important causes of morbidity and indirect mortality in human immunodeficiency-infected children. Children with severe immunodeficiency are at particular risk. In addition to M. avium complex, other species of nontuberculous mycobacteria may be involved.