Endotipsitis as an indication for pediatric liver transplantation.

Endotipsitis is a rare but severe complication of transjugular intrahepatic portosystemic shunt (TIPS), a device widely used to treat portal hypertension in adults, but sparsely used in children. We report a case of endotipsitis in a 3-year-old child affected of biliary atresia. She underwent a Kasai procedure at 3 months of age but, although the bile flow was restored, she presented upper gastrointestinal bleeding due to portal hypertension 1.5 years later. A TIPS was placed in order to control the hemorrhage. A year after TIPS placement, she started presenting repeated episodes of cholangitis. Blood cultures were positive to Enterobacter cloacae. Even with long antibiotic courses, adjusted to blood cultures, infectious signs were observed after antibiotic withdrawal. Device infection was demonstrated through Positron emission tomography-Computed tomography scan. The patient was listed for liver transplantation, and intravenous antibiotic treatment was maintained until stent removal during the liver transplant 8 months later. No infectious complications were demonstrated after the surgery. To the best of our knowledge, this is the first case report of endotipsitis described in a pediatric patient.

Determination of latent fingerprint degradation patterns-a real fieldwork study.

For over a century, law enforcement agencies, forensic laboratories, and penal courts worldwide have used fingerprint impressions as reliable and conclusive evidence to identify perpetrators of criminal activity. Although fingerprint identification has been repeatedly proven as one of the most robust and definite forensic techniques, a measure of the rate at which latent fingerprints degrade over time has not been established effectively. Ideally, criminal investigators should be able not only to place any given individual at a crime scene but also be able to date the moment any latent fingerprints were deposited at the location. The present report aims to determine particular visual patterns of degradation of latent fingerprints exposed to certain monitored laboratory conditions simulating those in the field. Factors considered include temperature, relative humidity, air currents, composition of fingerprint depositions (sebaceous and eccrine), various exposures to daylight (direct, penumbra, and darkness), and type of physical substrate (glass and plastic) over a period of 6 months. The study employs a titanium dioxide-based powder as developer. Our results indicate that, contrary to common belief, certain latent fingerprints exposed to direct sunlight indoors degrade similarly to those in the dark where environmental conditions are more constant. While all sebaceous latent fingerprints on glass are still useful for identification after 6 months, diverse results are obtained with impressions on plastic; these demonstrate a much higher and faster degree of decay, making identification difficult or impossible, especially for eccrine depositions.