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Kidney anomalies are always a challenge even for the most experienced vascular and urologic surgeons in the reconstruction of the abdominal aortic segment. In the literature, the most common anomalies of the kidney are the horseshoe kidney. BTK inhibitor The case A 77-year-old male headed to the emergency department with complaints of acute abdominal pain and sudden onset of fatigue. The enhanced CT-scan performed and the horseshoe kidney with the ruptured aortic aneurysm seen. The cardiovascular and transplantation surgery team decided to perform explorative surgery. © 2019 Published by Elsevier Inc.Introduction Influential theories maintain that some of Autism Spectrum Disorder (ASD) core symptoms may arise from deficits in executive functions (EF). EF deficits are also considered a neuropsychological marker of early treated individuals with phenylketonuria (PKU). Aims of this study were to verify the occurrence and patterns of specific EF impairments in both clinical groups; to explore the coexistence of EF alterations with adaptive, behavioral and emotional problems in each clinical condition. Material and methods We assessed EF, adaptive, behavioral and emotional profile in 21 participants with ASD, 15 early treated PKU individuals, comparable for age and IQ, and 14 controls, comparable for age to the clinical groups (age range 7-14 years). Results ASD and PKU participants presented two different, but partially overlapping patterns of EF impairment. While ASD participants showed a specific deficit in cognitive flexibility only, PKU individuals showed a more extensive impairment in EF with a weaker performance in two core EF domains (inhibition, cognitive flexibility) as compared to healthy controls. Psychological and adaptive profile was typical in PKU participants, while ASD participants experienced behavioral (externalizing symptoms), emotional (internalizing symptoms) and adaptive disorders (general, practical, social domains). Conclusions Present results support the view of a relative disengagement of adaptive and emotional-behavioral profile with respect to EF skills and suggest that other dysfunctions contribute to the multidimensional phenotype of ASD participants. © 2020 The Authors.Pegvaliase (Palynziq®) was FDA approved in 2018 as an enzyme substitution therapy in patients with Phenylketonuria. However, various drug induced hypersensitivity adverse events (HAEs) have been reported. We present a case of Pegvaliase (Palynziq®) induced anaphylaxis and successful desensitization. A 13-step desensitization protocol was performed using three solution concentrations of Palynziq with premedication of diphenhydramine and prednisone in an outpatient setting. The patient tolerated the desensitization and was able to continue Palynziq.Borrelia burgdorferi is a spirochete that can cause Lyme disease from an infected tick bite causing a myriad of syndromes ranging from erythema migrans to oligoarticular arthritis and/or atrioventricular conduction block in the heart. It can also infect the central nervous system (CNS) and peripheral nervous system (PNS) causing cranial neuropathy, radiculoneuropathy as well as myelopathy. It has rarely been reported to involve the phrenic nerve presenting as dyspnea from diaphragmatic paralysis. Here, we present a case of a patient presenting with orthopnea and dyspnea on exertion who was diagnosed with Lyme disease causing unilateral diaphragmatic paralysis with resolution after treatment. © 2020 The Authors.Sporadic cases of visceral and neural nematode larva migrans have been diagnosed at necropsy in the endangered New Zealand kiwi (Apteryx spp.), but the causative organisms have not yet been definitively identified. From an initial group of five affected kiwi, PCR was performed on DNA extracted from archival formalin-fixed paraffin-embedded tissue sections in which larval nematodes had been histologically identified. Sequencing of positive results from four out of the five kiwi aligned with sequences from Toxocara cati, a nematode parasite whose definitive host is the domestic cat. PCR was then performed on a second group of 12 kiwi that had histologic inflammatory lesions consistent with larva migrans, but variable larval presence. Repeatable positive PCR results were only achieved in one tissue, in which larval organisms were histologically confirmed. This study supports the use of PCR as an alternative or adjunct to the morphological identification of nematode larvae in formalin-fixed histopathological samples, as well as showing that in investigation of larva migrans, PCR has greatest chance of success from sections where nematode larvae are evident histologically. The identification of Toxocara cati from lesions of larva migrans in kiwi reflects an indirect, parasite-mediated effect of an invasive mammalian species on a native species. © 2020 The Author(s).Upper airway obstruction due to foreign body aspiration is rare in adolescents. Diagnosis of the same is difficult, and incorrect, delay of treatment is common in patients with no aspiration history. Herein, we describe the case of a 15-year-old boy who presented with upper airway obstruction because of swallowing chewing gum 4 days before presentation. The patient was initially misdiagnosed and was scheduled for an emergency tracheotomy. However, this unnecessary surgical procedure was narrowly avoided because his symptoms resolved after he expelled the chewing gum from his airway. Despite being questioned several times about aspiration of any foreign bodies, he did not self-report the incident because he did not suspect that his symptoms were due to swallowing of the chewing gum. © 2020 The Authors.Background The aim of present study was to examine early childhood caries' impact on oral health-related quality of life from children's self report and parental perception. Methods 200 healthy children in the age group of 3-5 years and their parents/guardians were enrolled in the study. 100 children diagnosed with early childhood caries (interventional group) and 100 children without caries (control group) along with their parents/guardians participated in face to face interview and responded to Michigan oral health related quality of life scale - child and parent version. Four weeks after full mouth rehabilitation children with ECC and their parents responded to a survey for a follow-up assessment. Data was analyzed and evaluated using Statistical Package for Social Sciences Version 21.0 statistical software and Chi square test. Results In our study we have found that ECC subjects had poorer oral health-related quality of life compared to caries free subjects. Further one month follow up after complete treatment, the oral health-related QoL improved significantly in ECC children.

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