Multisystemic Disease in a Child and Successful Recovery With Antiviral Treatment.

Cytomegalovirus (CMV), a member of the Herpesviridae family, typically causes asymptomatic infections or mild mononucleosis-like syndromes in immunocompetent individuals. However, severe manifestations are well-documented in immunocompromised populations. This case report presents a previously healthy seven-year-old girl with a rare and complex presentation of primary CMV infection leading to severe multiorgan involvement, hepatosplenomegaly, cholestasis, bicytopenia, and a prolonged disease course. The patient's condition prompted an exhaustive diagnostic investigation, ruling out other potential causes. The diagnosis was confirmed by positive CMV IgM and IgG antibodies and a significantly elevated CMV DNA viral load. Treatment with intravenous ganciclovir resulted in a remarkable recovery. The case underscores the importance of considering CMV as a potential etiology of hepatitis, even in immunocompetent children, and the challenges of diagnosing complicated CMV infections. While guidelines for treating CMV in immunocompetent individuals are lacking, this report suggests that antiviral therapy may be beneficial in severe cases. Further research is needed to establish clear treatment protocols for such instances. This report contributes to the limited body of literature on severe CMV-induced hepatitis in immunocompetent children, emphasizing the need for heightened clinical awareness and timely interventions to prevent progression to acute liver failure.

Coping and emotions of global higher education students to the Ukraine war worldwide.

Trauma scientists have raised the alarm about the devastating consequences of the Ukraine war on mental health. We examined how higher education students-as indirect victims-coped with this conflict and how they emotionally reacted during 2022. We involved 2314 students from 16 countries through an online survey. A structural equation model indicated significant relations between war-related worry about military and macroeconomics domains and two coping strategies (opposition, support giving), in turn significantly linked with six emotions. The model was strongly invariant across gender, study field, and geographic area. The most frequent emotions were anger and anxiety, followed by two future-centred emotions (hopelessness and hope). Emotions were more frequent for females and students of the countries geographically close to the war region. Our findings call for evidence-based policy recommendations to be implemented by institutions to combat the negative short and long-term psychological sequelae of being witnesses of armed conflicts.

Patient-specific instrumentation in total knee arthroplasty. Should we adopt it? / Instrumentação personalizada na artroplastia total do joelho. Devemos adotá-la?

ABSTRACT Total knee arthroplasty (TKA) is a surgical procedure of paramount relevance that restores a substantial degree of function in arthritic knees. Increased consideration has been given to the influence of limb alignment on longevity after TKA, as errors in component placement can be associated with inferior function and compromised long-term performance. Consequently, numerous studies comparing patient-specific instrumentation (PSI) to standard instruments (SI) have been published. Patient-specific approaches use preoperative imaging to create specific materials for each patient's anatomy and were designed to achieve a higher rate of success in TKA, causing the entire procedure to be more efficient and cost-effective. However, it is not clear to what degree these studies support the potential advantages of PSI. Thus, the present study aimed to review the current evidence comparing PSI to SI, concerning alignment, cost-effectiveness, and postoperative functional evaluation.

RESUMO A artroplastia total do joelho (ATJ) é um procedimento cirúrgico de fundamental relevância que restaura boa parte da função de joelhos artríticos. Maior atenção tem sido dada à influência do alinhamento do membro na longevidade após a ATJ, uma vez que erros no posicionamento dos componentes podem estar associados a uma menor função e comprometimento do desempenho em longo prazo. Consequentemente, vários estudos compararam a instrumentação personalizada para cada paciente (IPP) com a instrumentação padrão (IP). As abordagens personalizadas usam imagens pré-operatórias para criar materiais específicos para a anatomia de cada paciente e foram projetados para atingir uma maior taxa de sucesso na ATJ e tornar todo o processo mais eficiente e rentável. No entanto, não está claro até que ponto tais estudos respaldam as vantagens potenciais da IPP. Assim, o presente estudo teve como objetivo avaliar as evidências atuais e comparar IPP e IP com respeito ao alinhamento, à relação custo-benefício e à avaliação funcional pós-operatória.

Adição de piruvato de sódio e trolox ao diluidor utilizado para congelação de sêmen de garanhões férteis e subférteis / Effect of pyruvate and trolox added to the extender used for freezing fertile and subfertile stallion semen

O objetivo deste trabalho foi avaliar o efeito do piruvato e trolox (forma solúvel da vitamina E) sobre a qualidade espermática pós-descongelamento. Assim, com o intuito de proteger as células espermáticas dos efeitos deletérios da criopreservação,foram considerados os seguintes tratamentos: T1 (Controle)= INRA82-HEPES sem antioxidantes; T2= INRA82-HEPES + 2mM de piruvato e T3= INRA82-HEPES + 120mM de trolox. As amostras de sêmen descongeladas foram avaliadas quanto à motilidade total (MT) e progressiva (MP), a integridades de membrana plasmática e acrossômica, integridade do DNA, à estabilidade de membrana e ao potencial de membrana mitocondrial (Δψm). A adiηγo de piruvato proporcionou resultados superiores (P<0,05) àqueles obtidos com trolox na motilidade espermática total (9,17 e 14,5 por cento, respectivamente). A adição de piruvato incrementa a motilidade espermática (18,92 e 19,0 por cento, respectivamente) em garanhões férteis e subférteis submetidos à congelação.

The objective of this research was to evaluate the effect of pyruvate and trolox on the thawed sperm quality. For freezing, antioxidants were added to INRA 82-HEPES extender to protect sperm from the deleterious effects of oxidative stress, according to the treatments: T1= INRA82-HEPES without antioxidants; T2= INRA82-HEPES + 2mM of pyruvate and T3= INRA82-HEPES + 120 mM de trolox. The thawed semen samples were evaluated according to the total (MT) and progressive (MP) motility, integrity of plasma and acrossomal membrane, DNA integrity, membrane stability and mitochondrial membrane potential (Δψm). It was observed that the addition of pyruvate resulted in a significantly higher total sperm motility (P<0.05) to those obtained with trolox (9.17 and 14.5 percent, respectively). It can be concluded that the addition of pyruvate improves sperm motility (18.92 and 19.0 percent, respectively) in samples from fertile and sub-fertile stallions submitted to freezing.