Jordanboje4067
Coronavirus disease 2019 (COVID-19) infection may become more severe in those who have undergone kidney transplantation than in the general population. False-negative reverse transcription-polymerase chain reaction (RT-PCR) results have been reported for COVID-19 infection. Patients might carry infection even though RT-PCR results are negative.
A 65-year-old man with a 19-year history of ABO-incompatible kidney transplantation presented with fever and arthralgia. Although the RT-PCR result was negative, a focal slit-glass shadow in the left upper lobe on computed tomography (CT) suggested COVID-19 pneumonia. His symptoms did not improve until after 10 days, and CT showed multiple slit-glass shadows in the bilateral lung fields. However, RT-PCR remained negative. The patient was admitted, and mycophenolate mofetil was discontinued. Anticoagulants were administered on the third day of hospitalization. Because of poor oxygenation, the patient was intubated in the intensive care unit on the fifth day, and sivelestat sodium was administered. The patient was extubated on the 12th day after improvement in oxygenation. There was no exacerbation, and CT showed improvements on day 51.
We report a case of pneumonia with suspected COVID-19 infection 18 years after living donor kidney transplantation. If COVID-19 is suspected, infection control and aggressive therapeutic interventions should be undertaken while considering the possibility of a positive result.
We report a case of pneumonia with suspected COVID-19 infection 18 years after living donor kidney transplantation. If COVID-19 is suspected, infection control and aggressive therapeutic interventions should be undertaken while considering the possibility of a positive result.
When a child needs to be placed in substitute care by child protection services, social workers are encouraged to use kinship care (KC), mainly because of the greater stability associated with it. However, current state of knowledge on reunification and placement stability is essentially based on studies that combined children in KC and children in other types of substitute care setting.
This paper aims to describe longitudinally the placement trajectory of children placed in KC and to identify the factors associated with the type of exit from KC (move to another substitute care setting or reunification).
All children in a Québec child protection services agency who started a KC placement in 2014-15 under the age of 13 are observed for three years (N=172). Data come from the child's casefile and from telephone questionnaires with the caseworker at the beginning and at the end of placement (or at the end of observation if the child has not exited).
Several children remained in the same KC setting during the observation (39%). The others were reunified (34%) or moved to another substitute setting (27%). Multivariate regression analyzes indicated that reunification was mostly determined by higher frequency of parent-child contacts, less registrations in clinical programs and absence of parental mental health problems, while placement move was mostly associated with placement beginning as provisional measure, higher frequency of parent-child contacts and presence of parental mental health problems.
This study highlights determinants of stability and permanency that may be specific to kinship placements.
This study highlights determinants of stability and permanency that may be specific to kinship placements.
In the face of the COVID-19 pandemic, many therapeutic services for children and their parents who had experienced intimate partner violence (IPV) were required to rapidly transition to telehealth.
The current study aims to explore parents' experiences of participating in a parent-child telehealth intervention during the COVID-19 pandemic. The study also aimed at exploring clinicians' experiences of delivering the service, including key strengths and challenges.
Participants were five mothers who took part in Berry Street's Restoring Childhood service during the COVID-19 pandemic in Melbourne, Australia, and 14 Restoring Childhood clinicians, delivering the service across metropolitan and regional sites.
Semi-structured qualitative interviews were conducted, and data were analysed using thematic analysis to determine key themes and sub-themes within the data.
Parents identified several strengths and benefits of Restoring Childhood delivered via telehealth including improvements in parenting skills aeed for rigorous evaluations of telehealth services for children exposed to IPV.
Little is known about the benefits of implementing trauma-informed care (TIC) training programs for child welfare workers serving in out-of-home treatment settings, or about how staff, child and youth characteristics affect adoption of favorable attitudes towards TIC.
This study aimed to understand how attitudes towards TIC changed over time for child welfare workers receiving training and monthly supervision sessions.
Child welfare workers (n=429) serving juveniles mandated to protection or offender units (ages=3-20years), across 11 child protection agencies in Quebec, Canada.
Participants completed the ARTIC-35 at pre-training, 6months post-training, and 1year follow-up. Multilevel mixed effect regression models were fit to examine outcomes for all subscales.
Participants reported small improvements in attitudes towards TIC at post-training and 1year follow-up for subscales related to problematic child/youth behavior (β=0.23-0.32, p's<0.001). Multilevel modeling revealed that age group (adolescent), unit gender (boys) and legal mandate (offender) predicted higher pre-training TIC ratings for staff in management versus frontline positions across three subscales related to problematic child/youth behavior (β=0.77-0.93, p's<0.05) and two subscales related to trauma work and support needs (β=0.66/0.84, p's<0.05).
Results extend previous research demonstrating an association between TIC training and improved attitudes towards TIC over time, and highlight specific contexts in which frontline staff may experience more difficulty applying TIC-based principles than colleagues in management positions.
Results extend previous research demonstrating an association between TIC training and improved attitudes towards TIC over time, and highlight specific contexts in which frontline staff may experience more difficulty applying TIC-based principles than colleagues in management positions.Tremor, the most common movement disorder, may occur in isolation or may co-exist with a variety of other neurologic and movement disorders including parkinsonism, dystonia, and ataxia. When associated with Parkinson's disease, tremor may be present at rest or as an action tremor overlapping in phenomenology with essential tremor. Essential tremor may be associated not only with parkinsonism but other neurological disorders, suggesting the possibility of essential tremor subtypes. Besides Parkinson's disease, tremor can be an important feature of other parkinsonian disorders, such as atypical parkinsonism and drug-induced parkinsonism. In addition, tremor can be a prominent feature in patients with other movement disorders such as fragile X-associated tremor/ataxia syndrome, and Wilson's disease in which parkinsonian features may be present. This article is part of the Special Issue "Parkinsonism across the spectrum of movement disorders and beyond" edited by Joseph Jankovic, Daniel D. Truong and Matteo Bologna.The relationship between cerebrovascular disease and parkinsonism is commonly seen in everyday clinical practice but remains ill-defined and under-recognised with little guidance for the practising neurologist. We attempt to define this association and to illustrate key clinical, radiological and pathological features of the syndrome of Vascular Parkinsonism (VaP). VaP is a major cause of morbidity in the elderly associated with falls, hip fractures and cognitive impairment. Although acute parkinsonism is reported in the context of an acute cerebrovascular event, the vast majority of VaP presents as an insidious syndrome usually in the context of vascular risk factors and radiological evidence of small vessel disease. There may be an anatomic impact on basal ganglia neuronal networks, however the effect of small vessel disease (SVD) on these pathways is not clear. There are now established reporting standards for radiological features of SVD on MRI. White matter hyperintensities and lacunes have been thought to be the representative radiological features of SVD but other features such as the perivascular space are gaining more importance, especially in context of the glymphatic system. It is important to consider VaP in the differential diagnosis of Parkinson disease (PD) and in these situations, neuroimaging may offer diagnostic benefit especially in those patients with atypical presentations or refractoriness to levodopa. Proactive management of vascular risk factors, monitoring of bone density and an exercise program may offer easily attainable therapeutic targets in PD and VaP. Levodopa therapy should be considered in patients with VaP, however the dose and effect may be different from use in PD. This article is part of the Special Issue "Parkinsonism across the spectrum of movement disorders and beyond" edited by Joseph Jankovic, Daniel D. Truong and Matteo Bologna.
Our objective was to assess safety and adverse events associated with intraperitoneal Olvi-Vec virotherapy in patients with platinum-resistant or refractory ovarian cancer (PRROC). Secondary objectives included objective response rate (ORR) per RECIST 1.1 and progression-free survival (PFS).
Olvi-Vec is a modified vaccinia virus that causes oncolysis and immune activation. An open-label phase 1b trial using a 3+3 dose escalation was conducted. Intraperitoneal Olvi-Vec was given as monotherapy in two consecutive daily doses. Translational analyses included anti-virus antibody levels, viral shedding, circulating tumor cells (CTCs) and T cells.
Twelve patients (median age 69years, range 45-77) with median 5 prior therapies (range 2-10) and 2 prior platinum lines (range 1-5) were enrolled. There were three dose level cohorts 3×10
(n=6), 1×10
(n=5), and 2.5×10
(n=1) plaque forming units (PFU)/day on two consecutive days. Treatment-related adverse events (TRAEs) included G1/G2 nausea (n=6), fever (n=6),nting further clinical investigation.During tumor progression, lysosome function is often maladaptively upregulated to match the high energy demand required for cancer cell hyper-proliferation and invasion. Here, we report that mucolipin TRP channel 1 (TRPML1), a lysosomal Ca2+ and Zn2+ release channel that regulates multiple aspects of lysosome function, is dramatically upregulated in metastatic melanoma cells compared with normal cells. TRPML-specific synthetic agonists (ML-SAs) are sufficient to induce rapid (within hours) lysosomal Zn2+-dependent necrotic cell death in metastatic melanoma cells while completely sparing normal cells. ML-SA-caused mitochondria swelling and dysfunction lead to cellular ATP depletion. While pharmacological inhibition or genetic silencing of TRPML1 in metastatic melanoma cells prevents such cell death, overexpression of TRPML1 in normal cells confers ML-SA vulnerability. In the melanoma mouse models, ML-SAs exhibit potent in vivo efficacy of suppressing tumor progression. MS177 datasheet Hence, targeting maladaptively upregulated lysosome machinery can selectively eradicate metastatic tumor cells in vitro and in vivo.