Severe forms of hypophosphatasia due to loss-of-function in the ALPL gene may present with diverse neurological problems including pyridoxine-responsive seizures. We present a short report of pyridoxine-responsive neonatal seizures. Due to severe osteopenia with unmeasurable levels of alkaline phosphatase, targeted genetic screening was performed and two pathogenic variants in the gene for the nonspecific alkaline phosphatase confirmed the diagnosis of hypophosphatasia. We would like to emphasize the importance of considering infantile hypophosphatasia in the differential diagnosis of pyridoxine-responsive seizures with concomitant low alkaline phosphatase level and bone pathology, especially with the new treatments becoming available in the future.Fosfomycin tromethamol (FT) was reintroduced as an option for the treatment of low urinary tract infection (UTI) in children. In this study, we described the antibiotic sensitivity and mechanisms of resistance to fosfomycin in isolates from children older than 6 years with UTI. Urine culture and antibiotic susceptibility study were performed. In fosfomycin resistant strains, PCR for fos, blaCTX-M was performed followed by classification by phylogenetic group and sequencetyping. Escherichia coli was the most frequent etiological agent (89.2%). The susceptibility percentages were fosfomycin 97.9%; amoxicillin-clavulanate 92.7%; cefuroxime and ceftriaxone 99%; nitrofurantoin 94.4%. An E. coli strain (ST69, phylogenetic group D) was resistant to fosfomycin (MIC 256mg/l) and carried the blaCTX-M-14 and fosA3 genes in a 45kb IncN-type plasmid. This is the first report of E. coli ST69 with blaCTX-M-14/fosA3 of human origin.

To study the epidemiological and clinical characteristics of intermittent exotropia and to describe our therapeutic choices as well as their results and prognostic factors.

This was a retrospective study including 57 cases of intermittent exotropia. All patients underwent a complete ophthalmological examination with a sensory-motor assessment. Surgery was performed by the same surgeon, and the vertical component was addressed surgically at the same time as the exotropia. Statistical analysis was performed using SPSS software version 21.0.

Our patients were classified as basic exotropia in 46 cases (80.7%), divergence excess in eight cases (14.1%), and convergence insufficiency in three cases (5.2%). Amblyopia was found in 26% of cases. The preoperative maximum angle of deviation was 36.5DP±9.1DS and a vertical component was found in 16 patients (28%). The most common was V pattern (8 patients). The mean age at the time of surgery was 14.8 years old. After a single surgery, we obtained motor success in 78.9% of the patients. Three patients were re-operated, with an overall motor success of 84.2%.

Motor and sensory success may be achieved in intermittent exotropia. Rigorous, early management is necessary, even if tropic episodes are still rare. The rate of early consultation among children is still low in our country; thus, a national strabismus screening program must be established to obtain the best results.

Motor and sensory success may be achieved in intermittent exotropia. Rigorous, early management is necessary, even if tropic episodes are still rare. The rate of early consultation among children is still low in our country; thus, a national strabismus screening program must be established to obtain the best results.We report our experience in the surgical technique of sutureless intrascleral posterior chamber intraocular lens (PC IOL) fixation in patients with insufficient capsular support using a uniquely designed, foldable, acrylic Carlevale IOL. It is specifically designed for sutureless scleral fixation and is equipped with a small plug attached to each of two haptics to anchor the lens to the sclera with a self-retaining mechanism. This surgery does not require creation of a scleral tunnel or transscleral exposure or excessive manipulation of the haptics. The harpoon-like plugs provide great stability to this implant, which can be injected through a 2.2mm incision. Selleck VPS34 inhibitor 1 The characteristics of this IOL and the relative simplicity of this implantation technique makes it widely applicable in aphakic patients after previous complicated cataract surgery.

Research has explored the impact of various medical cannabis policies on substance use treatment admission in recent years, but we know little about factors related to participants’ treatment engagement and outcome. To fill this gap in the existing literature, this study used national data to examine the influence of cannabis policies (decriminalized, medical, and recreational) and referral sources (criminal justice vs. voluntary) on treatment completion and length of stay.

Data came from the Treatment Episode Data Set-Discharge (2006-2017) on adults 18+ whose primary drug at treatment admission was cannabis. Difference-in-difference analyses using logistic regression examined the effect of cannabis policies on outpatient treatment completion (yes/no; n=2,192,807) and length of stay (more/fewer than 90days; n=1,863,585) in those with a criminal justice or voluntary referral source.

Cannabis policy was not associated with treatment completion in either those with a criminal justice or voluntary referral t 90 days. In this sense, length of stay may be a more useful measure of treatment outcome for research than treatment completion moving forward. Furthermore, our study found that neither medical nor recreational policies affected length of stay or treatment completion, regardless of referral source.

Buprenorphine-naloxone is an evidence-based treatment for opioid use disorder (OUD). Despite its efficacy, nearly half of patients discontinue treatment prematurely. Novel intervention strategies that may be delivered outside of traditional treatment settings are needed to support buprenorphine uptake and maintenance. The goal of this study was to elucidate key elements surrounding the acceptability/feasibility and structure of an interactive computer- and text message-delivered personalized feedback intervention for adults initiating outpatient buprenorphine treatment.

Twenty-four adults engaged in treatment at two outpatient addiction treatment centers completed semistructured interviews exploring preferences around digital health interventions. Trained interviewers conducted interviews, the study audio-recorded them, and a professional agency transcribed them verbatim. The research team iteratively developed a coding structure using thematic and content analysis and entered it into a framework matrix. The team double coded each transcript.