Online extreme challenges putting children at risk: what we know to date.

INTRODUCTION: Extreme online challenges consist in taking part in challenges proposed on web and sharing the results in videos posted on social media. The use of social networks is widespread among the very young, giving easy access to potentially dangerous content with consequences on health. EVIDENCE ACQUISITION: The aim of this literature review was to describe the most common challenges involving children and adolescents over the last 20 years. We focused on participants features (such as age, sex and psychological background) and health implications. The review included research articles and reviews published between 2000 and 2021. We used Pubmed, Scopus and Web of science as search engines. EVIDENCE SYNTHESIS: Many types of online challenges emerged from the analysis of the literature. The most common challenges are those that lead to self-harm, which involve acts at risk of choking and challenges that potentially lead to suicide and ingestion of substances. The extreme challenge phenomenon is a public health issue that affects a vulnerable population, as it is young and susceptible to peer pressure influence. Participants often showed problematic personality traits, making them more likely to get involved in these behaviors. CONCLUSIONS: It is necessary for parents, teachers and health workers to be aware of the spread of the online challenges, to improve prevention interventions in the age groups involved.

Scedosporium apiospermum (Pseudoallescheria boydii) infection in lung transplant recipients.

BACKGROUND: Scedosporium apiospermum, the asexual counterpart of the teleomorph Pseudallescheria boydii, is increasingly recognized as an important opportunistic pathogen in transplant recipients. Infection is associated with a high rate of dissemination and poor outcome overall. METHODS: A retrospective analysis of The Cleveland Clinic lung transplant database identified 5 patients with S. apiospermum isolated from respiratory tract specimens. Demographic data and lung transplant outcomes were obtained by review of medical records. RESULTS: S. apiospermum was isolated from respiratory culture in 5 lung transplant recipients. Disseminated disease developed in 3 patients, whereas 2 appeared only to be colonized. CONCLUSIONS: Our experience and review of the literature highlights the importance of early diagnosis and differentiation from Aspergillus, since Scedosporium is inherently resistant to amphotericin B. Effective therapeutic approaches being explored include combinations of anti-fungals, because even the newer triazoles have a 50% response rate in clinical studies. Surgical débridement and immune recovery are associated with improved prognosis, favoring the use of agents that expedite immune reconstitution in these patients. Close monitoring of clinical improvement and frequent reevaluation of treatment is essential.