A case report of pedal monkeypox in a HIV patient: A challenging diagnosis with a misleading history.

Pedal Monkeypox is a disease which can mimic many other pedal conditions. It should always be considered in differential diagnosis. A young male HIV patient who presented with a tender foot lesion and diagnosed with pedal Monkeypox as a result of performed tests is discussed hereby in the case report. We expect that this case report adds to the existing literature on this subject.

Postnatal genetic and neurodevelopmental assessment in infants born at term with severely low birth weight of non-placental origin.

OBJECTIVE: To determine the frequency of genetic syndromes and childhood neurodevelopmental impairment in non-malformed infants born at term with severely low birth weight and no evidence of placental insufficiency. METHODS: This case series was constructed from the data of infants delivered at term between 2013 and 2018 with severely low birth weight, defined as birth weight more than 2.5 SD below the mean, with normal maternal and fetal Doppler (umbilical artery, fetal middle cerebral artery, cerebroplacental ratio and uterine artery) and no maternal hypertensive disorder during pregnancy or fetal structural anomaly on prenatal ultrasound examination. Clinical exome sequencing and copy number variation (CNV) analysis were performed using DNA extracted from the children's saliva. Cognitive and psychomotor development was evaluated using the Bayley Scales of Infant and Toddler Development, 3rd edition or the Wechsler Intelligence Scale for Children, 5th edition tests, according to the child's age at testing. RESULTS: Among the 36 405 infants born within the study period, 274 (0.75%) had a birth weight below -2.5 SD, of whom 98 met the inclusion criteria. Among the 63 families contacted, seven (11%) reported a postnatal diagnosis of a genetic syndrome and a further 18 consented to participate in the study. Median gestational age at delivery was 38.0 (interquartile range (IQR), 37.3-38.5) weeks and median birth weight was 2020 (IQR, 1908-2248) g. All 18 children showed a normal result on clinical exome sequencing and CNV analysis, but six (33%) obtained a low score on neurodevelopmental testing. CONCLUSION: Non-malformed severely small term infants with no clinical or Doppler signs of placental insufficiency present a high rate of genetic syndromes and neurodevelopmental impairment during childhood. © 2023 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.

Helminth community from Azara's grass mouse (Akodon azarae) in three habitats with different land use in farming systems of Argentina.

In the Pampa region of Argentina, farming activities have been performed since the beginning of the 20th century, but in the 1990s, land-use patterns rapidly changed towards intensive agriculture and poultry breeding. This study compares the helminth community of Akodon azarae (Rodentia) among three habitats with different land use in pampean agroecosystems: poultry farms, mono-cultivated fields and abandoned fields (not used for 35 years), under the prediction that there will be greater helminth richness and diversity in mice from abandoned fields compared to those from the other habitats. Nevertheless, the highest abundance of A. azarae occurred on poultry farms, the habitat most disturbed by human activity, while cultivated fields showed the lowest. Helminth richness and diversity were significantly higher on poultry farms than in the other habitats, due to the presence of Trichuris laevitestis, Protospirura numidica criceticola and cysts of Taenia taeniaeformis. We suggest that the helminth fauna of A. azarae can survive on poultry farms despite disturbance from farming activities, because rodents can move and get shelter within farm perimeter fences, where dense and high vegetation grows. This farm area could offer good conditions for geohelminth development, while chicken sheds could attract insects that are intermediate hosts of helminths with indirect life cycles. On the contrary, agrochemicals applied in cultivated fields would negatively influence helminth diversity and composition, by decreasing host populations (arthropods and rodents) and affecting free larval stages of geohelminths.

Diversity of the helminth community of the Pampean grassland mouse (Akodon azarae) on poultry farms in central Argentina.

This paper describes the helminth community of the Pampean grassland mouse (Akodon azarae) inhabiting poultry farms in central Argentina. Winter diversity (season of high rodent abundance) has been compared to spring diversity (season of low rodent abundance). Species richness was seven in both seasons: five nematodes (Syphacia carlitosi, Stilestrongylus spp., Trichuris laevitestis, Pterygodermatites (Paucipectines) azarai and Protospirura numidica criceticola) and two cestodes (adults of Cyclophyllidea and Taenia taeniaeformis hepatic cysts). No difference in richness was detected between host sexes in each season or among host age classes. However, the helminth community showed 67% similarity between winter and spring, with diversity being significantly higher in spring (H = 0.873) than in winter (H = 0.546; P < 0.0005). This could be attributed to different factors, such as host abundance, host diet or environmental factors, that affect the transmission of each species differently. On the other hand, Stilestrongylus spp. and S. carlitosi showed higher dominance and intensity in both seasons compared to their cohabiting species, P. (P.) azarai and T. laevitestis, respectively. The lower values of the latter two species may be related to a crowding effect due to their large body sizes. This is the first report of cestodes in A. azarae. The finding of T. taeniaeformis strobilocerci could be important in the epidemiology of parasitosis in domestic animals of the farms.

Infection pattern of the spirurid nematode Protospirura numidica criceticola in the cricetid rodent Akodon azarae on poultry farms of central Argentina.

The nematode Protospirura numidica criceticola infects the stomach of Neotropical cricetid rodents when they ingest infected arthropods. In North America, prevalence values fluctuated, showing marked peaks in desert habitats, while remaining low in humid environments. The infection pattern has not been studied in South American rodents. In this work, yearly infection by P. n. criceticola was analysed in the South American cricetid Akodon azarae seasonally captured from July 1998 to July 2000 and in March 2001 on poultry farms of a humid region of Argentina. Seasonal occurrence of third- and fourth-stage larvae and adults was recorded. Seasonal population and community parameters of the parasite were calculated. The occurrence of larval stages was confirmed for the four seasons. Prevalence fluctuated between 0 and 36% and did not show a seasonal pattern. It was not related to the abundance of A. azarae (rs = 0.37) or to rainfall. In this humid region of Argentina, where food resources are diverse throughout the year, the omnivorous A. azarae may have a variable diet so that infection can occur in the four seasons. Prevalence values were not very high, in accordance with observations in humid habitats of North America. The infection was also characterized by low intensity, abundance and dominance. Only 3.8% of the rodents were parasitized with three or more specimens of the parasite, and that was only in autumn. It is suggested that rodents can not overwinter successfully with a heavy biomass of stomach parasites.

Success rate and patient satisfaction with the Essure sterilisation in an outpatient setting: a prospective study of 857 women.

After 857 women with Essure system inserted for tubal obstruction as a method of sterilization in an outpatient setting, insertion is achieved in close to 99% of the women. Physician described the procedure as very difficult in 15% of the cases, mainly due to anatomical tubal anomalis or tubal spasm, and women felt highly satisfied in all cases.

Hybrid lethality in interspecific F1 hybrid Nicotiana gossei x N. tabacum involves a MAP-kinases signalling cascade.

A cultured cell line, GTH4 (Nicotiana gossei Domin x N. tabacum L.), which exhibits hybrid lethality, died at 26 degrees C, but not at 37 degrees C. Pharmacological experiments using inhibitors of protein phosphatases and protein kinases indicated the involvement of a protein kinase signalling pathway in the cell death process. Immunoblot analysis revealed that salicylic acid-induced protein kinase (SIPK) was phosphorylated soon after the shift in temperature from 37 degrees C to 26 degrees C. Cultured cells of the hybrid of N. gossei x transgenic N. tabacum harboring a steroid (dexamethasone; DEX)-inducible NtMEK2 (DD) or NtMEK2 (KR), constitutively active and inactive forms of NtMEK2, respectively, were established. Induction of NtMEK2 (DD) by DEX in the hybrid cells induced the activation of SIPK, the generation of hydrogen peroxide (H (2)O (2)), and cell death at 37 degrees C. The activation of SIPK, generation of H (2)O (2), and cell death at 26 degrees C were compromised by DEX treatment in hybrid cells harbouring NtMEK2 (KR). This study provides evidence for the involvement of MAPK signalling in the regulation of cell death in hybrids.

Expression of KIT (CD117) in neoplasms of the head and neck: an ancillary marker for adenoid cystic carcinoma.

Adenoid cystic carcinoma is an indolent salivary gland malignancy that is associated with a poor long-term prognosis. The distinction of adenoid cystic carcinoma from other head and neck neoplasms can occasionally be problematic, particularly in small biopsies. Recent studies suggest that KIT (CD117) might be useful as an ancillary marker for adenoid cystic carcinoma; however, the expression of KIT in other benign and malignant head and neck neoplasms, including those that might mimic adenoid cystic carcinoma, has not been well studied. Here we use two different antibodies against KIT to evaluate its expression in a series of 66 adenoid cystic carcinomas compared with its expression in 98 other neoplasms of the head and neck. Overall, 94% (n = 62) of adenoid cystic carcinomas from various anatomic sites and of various histologic subtypes were positive for at least one of the KIT antibodies, and 77% (n = 50) of adenoid cystic carcinoma cases were positive for both antibodies. This contrasted with only 8% (n = 8) of other head and neck neoplasms that were positive for both KIT antibodies (P <.001). It was of note that certain neoplasms, including pleomorphic adenoma, basal cell adenoma, polymorphous low-grade adenocarcinoma, and basal cell carcinoma, that can show histologic overlap with adenoid cystic carcinoma had significantly less KIT immunoreactivity than did adenoid cystic carcinoma (P <.001). In contrast, KIT expression did not reliably distinguish adenoid cystic carcinoma from basal cell adenocarcinoma and basaloid squamous carcinoma (P >.05). The overall sensitivity of the two KIT antibodies for adenoid cystic carcinoma was 82-89%, and the specificity was 87-88%. The findings in this study support the potential use of KIT immunoexpression for distinguishing adenoid cystic carcinoma from many other benign and malignant head and neck neoplasms.

Thermoinduction of genes encoding the enzymes of gibberellin biosynthesis and a putative negative regulator of gibberellin signal transduction in Eustoma grandiflorum.

Eustoma grandiflorum Shinn requires vernalization for the induction of stem elongation and flowering. To investigate the role of gibberellins (GAs) in vernalization, the expression levels of genes encoding enzymes of GA biosynthesis, copalyl diphosphate synthetase, GA 20-oxidase and GA 3 beta-hydroxylase, were examined using two culitvars that show different responses to vernalization. The three genes were induced in a vernalization- and a cultivar-dependent manner. EgSPY, a putative negative regulator of GA signal transduction, was also induced during the vernalization period. The results suggest that the expression of the genes encoding GAs biosynthesis is regulated by vernalization. We postulate that EgSPY functions as a negative regulator of GA signal transduction during vernalization, inhibiting adventitious shoot elongation during vernalization.

Tratamiento de la taquicardia supraventricular fetal precoz complicada con hidrops / Treatment of early fetal supraventricular tachycardia with hydrops

Describimos un caso de taquicardia supraventricular (TPSV) fetal asociado a hidrops grave y polihidramnios diagnosticado en la semana 23. Tras fracasar el tratamiento instaurado con digoxina v.o., se produjo la cardioversión con flecainida v.o. administrada a la madre y la progresiva resolución del hidrops y el polihidramnios. En la semana 34 nació un varón que, tras 6 meses de seguimiento, se encuentra sano sin tratamiento. Al no poder monitorizar en nuestro laboratorio los valores plasmáticos de flecainida se vigiló la posible aparición de toxicidad con electrocardiogramas seriados. Diversas publicaciones recomiendan la flecainida como fármaco de primera elección en caso de TPSV fetal asociada a hidrops. (AU)

Histopathology of coronary in-stent restenosis following gamma brachytherapy.

The histopathology of in-stent restenosis (ISR) following gamma brachytherapy is described. Such histology has not been reported previously. An 82 year old man presented with recurrent ISR three months after gamma brachytherapy to an area of ISR within a native circumflex vessel. The recurrent ISR was treated with directional coronary atherectomy; the histopathology of this directional coronary atherectomy specimen is discussed. These histopathological examinations showed abundant extracellular matrix material. Surprisingly, there was a relatively small cellular (myofibroblastic) component, with an absence of endothelial cells and little evidence of active proliferation. ISR after gamma brachytherapy may be a pathologically distinct entity.

[An epithelial cyst at the frontal convexity].

We report a rare case of an epithelial cyst at the right frontal convexity. A 60-year-old woman came to our hospital suffering from dysarthria and gait disturbance. Computed tomography (CT) of the brain on admission showed a round low-density area, 6 cm in diameter, at the right frontal convexity. Midline shift and displacement of the lateral ventricle are seen. There is no contrast enhancement effect. Excision of the cyst wall and fenestration into the subarachnoid space was carried out and the patient was discharged with no neurological deficits. After 5 years, regrowth of the cyst was seen. Cyst-peritoneal shunt was performed and she was discharged uneventfully. Light microscopy showed the cyst wall consisted of a monolayer of flat epithelium and loose connective tissue. An electronmicrograph of the cyst wall showed a non-ciliated epithelial layer with microvilli and basement membrane. The epithelial cells connecting with each other through desmosome have numerous endoplasmic reticulum and mitochondria. Interdigitation of the cytoplasmic membrane was not seen. The term "epithelial cyst" seems ambiguous. We discuss the pathogenesis and the nomenclature for intracranial benign cystic lesions based on the previous literature.

[Epidural blood patch for the treatment of intracranial hypotension due to cerebrospinal fluid leakage after thoracic spine surgery].

We report a case of a 44-year-old woman successfully treated by an epidural blood patch for intracranial hypotension due to cerebrospinal fluid (CSF) leakage into the thoracic cavity after thoracic spine surgery. The patient was admitted to our hospital with the complaint of postural headaches. She had received anterior thoracic instrumentation for thoracic disc herniation four months earlier. Lumbar puncture demonstrated low CSF pressure, and Gd-enhanced MR images displayed diffuse dural enhancement. Accordingly, she was diagnosed as having intracranial hypotension. 111In-DTPA cisternography revealed a CSF leakage into the left thoracic cavity, possibly caused by dural laceration during thoracic spine surgery. To avoid the risk of direct surgery, we performed epidural blood patch; 3 ml of autologous blood was injected into the epidural cavity. Postoperatively postural headaches immediately disappeared. MRI taken one year later revealed disappearance of diffuse dural enhancement, and 111In-DTPA cisternography revealed no CSF fluid leaks. Epidural blood patch seems to be a choice of treatment for CSF leak after spinal surgery.

Meconium concentration and amniotic fluid index influence the outcome of amnioinfusion.

BACKGROUND: To determine the usefulness of amnioinfusion as a function of meconium concentration and amniotic fluid index. METHODS: This was a prospective study of 206 pregnant women in whom amniotic fluid was moderately or heavily stained with meconium, according to subjective evaluation. The women were assigned randomly to receive amnioinfusion (n=103) or no amnioinfusion (control group, n=103). The results were compared in women with =/<15 % or >15 % meconium in the amniotic fluid (measured by centrifugation), and in women in whom the amniotic fluid index calculated 60 min after insertion of the amnioinfusion catheter was <10 or =/>10. RESULTS: In women with >15% meconium, amnioinfusion decreased the rate of cesarian sections motivated by fetal distress (2.5% vs 22.2%), and in women with =/<15% meconium, amnioinfusion decreased the presence of meconium below the vocal cords (6.4% vs 25.9%). Greater benefits after amnioinfusion were seen in women with an amniotic fluid index =/>10: the rate of cesarian sections was lower (1.3% vs 13.3%), as was the frequency of meconium below the vocal cords (10.1% vs 33.3%). CONCLUSIONS: Beneficial effects of amnioinfusion were seen in women with high and low concentrations of meconium, and with high and low amniotic fluid indexes. These criteria should therefore not be used to decide whether amnioinfusion is indicated when the amniotic fluid is moderately or heavily stained with meconium.

Free hand aspiration for large periventricular hemorrhage. Case report.

BACKGROUND: At present, there are several therapeutic options, including craniotomy and stereotactic aspiration, for large intracerebral hemorrhage perforating into the lateral ventricle. In the cases with Glasgow Coma Scale (GCS) scores under 6 with anisocoria, external ventricular drainage would be the first choice [2-4]. We have also performed anterior ventricular horn puncture in a standard manner. The target was the foramen of Monro, at a depth of 5.5 cm from the inner table of the skull. The point of insertion was located just anterior to the coronal suture, approximately 10 cm above the nasion, and 3 cm from the midline [1]. However, we noticed that the insertion of a catheter into the periventricular hematoma adjacent to the lateral ventricle was made easier by tilting the catheter 30 degrees laterally as in the first case (Figure 1). METHODS: In our method, inclining the catheter by 30 degrees laterally, we used a silicone tube 3.5 mm in internal diameter (Silascon ventricle drainage tube, Kaneka Medix Corp., Osaka, Japan) and then replaced it with another Silascon tube with a 2.5 mm-internal diameter. From January 1999 through December 2000, eleven patients who all had GCS scores under 6 and anisocoria preoperatively were treated by this method. The series included two patients who were undergoing hemodialysis because of renal failure, two with bleeding tendency because of liver dysfunction, and one with heart failure. RESULTS: The insertion itself caused no complications. Cerebrospinal fluid was drained smoothly after removal of hematoma because the hematoma cavity connecting with the lateral ventricle was opened. Two typical cases using this technique are shown (Figures 1 and 2). All patients recovered favorable consciousness postoperatively compared with the preoperative state but hemiparesis remained. Postsurgical follow up at 3 months revealed the outcomes evaluated by Glasgow Outcome Scale (GOS) were moderate disability in 5 patients and severe disability in 6 patients . CONCLUSION: This direct aspiration and drainage of a large intracerebral hematoma that ruptures into the lateral ventricle is superior to simple ventricular drainage in regard to the removal of the hematoma clot. This technique would be the choice especially in patients with serious complications such as cardiac disease and renal failure.

Environmental factors associated with rodent infestations in Argentine poultry farms.

1. Seasonal variations in rodent infestations were studied at poultry farms in central Argentina as well as the environmental factors associated with rodent infestations at poultry farms. 2. During the summer and winter of 1998 rodent infestation was monitored at 10 poultry farms by means of tracking stations, and 21 environmental variables were selected that a priori could be related with the extent of rodent infestation. 3. There was a higher rodent infestation in winter than in summer. 4. Species detected by rodent sightings at the poultry farms included Akodon azarae, Calomys spp. (C. laucha and possibly C. musculinus) and Mus musculus. 5. In summer, rodent infestation was positively associated with the perimeter of the farm, whereas there was an inverse relationship with the maintenance conditions of the sheds. In winter, rodent infestation was positively associated with the percentage of the borders of the farm covered with vegetation, and with the amount of plant cover, especially the amount of plant cover which was above 20 cm in height. 6. There was no significant relationship between rodent infestation and the time lag since the last application of rodenticide (first-generation anticoagulant) at the farms. 7. These results suggest that strategies for controlling rodents based solely on chemical methods may not be good enough for efficient rodent control. Farms which are properly managed, with a better control of vegetation growth at both the perimeter and within the internal area, in addition to a higher maintenance of sheds have appreciably lower rodent infestations.

Elevated sensitivity to gibberellin by vernalization in the vegetative rosette plants of Eustoma grandiflorum and Arabidopsis thaliana.

Changes in the sensitivity to gibberellin (GA) after vernalization were studied in the vegetative rosette of Eustoma grandiflorum and late flowering Arabidopsis thaliana mutant, fca-1. The sensitivity to GA after vernalization was monitored using the bolting rate of plants that were grown on a medium containing GA(3) or ancymidol. The bolting rates were higher in vernalized plants than non-vernalized plants when the same GA(3) concentration was used. There was a positive relationship between the duration of vernalization and the bolting rate in E. grandiflorum. In contrast, a negative relationship between the duration of treatment and bolting rate was found in the non-vernalized plants. In fca-1, the flowering time of vernalized plants was significantly reduced compared with the non-vernalized plants under various concentrations of GA(3) treatment. To elucidate whether this elevated sensitivity relates to the efficiency of GA signal transduction, we measured the transcript amounts of Expansin (Exp), which is up-regulated by GA, and GA20-oxidase (GA20ox) and GA3 beta-hydroxylase (GA3betahy), which are down-regulated by GA. The transcript amounts were estimated using the Taq-Man PCR system based on combinations of primers and probes that specifically detect the genes, and normalized by the transcript amount of ubiquitin gene measured as an internal standard. For each concentration of GA treatments examined, Expansin of both E. grandiflorum and A. thaliana was induced at a higher rate in the vernalized plants than in the non-vernalized plants. The expression of GA20ox and GA3betahy of E. grandiflorum decreased faster in the vernalized plants than the non-vernalized plants. We conclude that vernalization is a critical environmental cue not only for initiating GA biosyntheses in vegetative rosette, but also for elevating the GA sensitivity of the plants via a GA signal transduction pathway.

Association of glutathione with flowering in Arabidopsis thaliana.

In order to study the relationship between GSH and flowering, wild-type and late-flowering mutant, fca-1, of Arabidopsis thaliana were treated with L-buthionine sulfoximine (BSO), a specific inhibitor of GSH biosynthesis, under long-day conditions. BSO treatment of the fca-1 mutant starting at 17 d after imbibition promoted flowering. However, when the treatment was started at 12 d after imbibition, BSO treatment at 10(-4) M resulted in an inhibition of flowering. This inhibitory effect of BSO on flowering was abolished by GSH treatment at 10(-4) M, although GSH treatment at an increased concentration of 10(-3) M clearly delayed flowering. In contrast, BSO treatment of wild-type plants starting at 12 d after imbibition promoted flowering, whose effect was abolished by GSH application. In the fca-1 mutant, whose endogenous GSH levels were high, chilling treatment lowered the GSH levels and promoted flowering, as was the case in the BSO treatment. An A. thaliana mutant, cad2-1, which has a defect in GSH biosynthesis also exhibited late flowering. The late-flowering phenotype of this mutant tended to be strengthened by BSO and abolished by GSH treatment. These results suggest that flowering is associated with the rate of GSH biosynthesis and/or the levels of GSH in A. thaliana.

Evidence of alpha-adrenoceptor-mediated chronotropic action in children.

We investigated alpha-adrenoceptor-mediated positive chronotropic action in children using a pharmacological autonomic function test. Under cardiac vagal and sympathetic blockade, chronotropic responses to intravenous infusion of an alpha-agonist, phenylephrine, were determined in 129 patients with suspected autonomic dysfunction. Heart rate changes to phenylephrine infusion (0.4 microg/kg/min) for 5 minutes ranged from -2 to 50 beats/min (mean +/- SD, 13.8 +/- 9.7 beats/min). alpha-Adrenoceptor-mediated chronotropic (APC) action more than 5 beats/min was observed in 88 (68%) subjects. APC was negatively correlated with age. Multivariate analysis showed that APC was correlated negatively with beta-sympathetic tone and positively correlated with intrinsic heart rate. These results suggest that the alpha-adrenoceptor-mediated chronotropic action is a developmental phenomenon and may play an important role in controlling heart rate in response to cardiac sympathetic activation.