Rejected

the strict dietary recommendations we impose on patients with advanced chronic kidney disease (ACKD) have negative impact on quality of life.

Monosaccharides, which include the simple sugars such as glucose and fructose, are among the most important carbohydrates in the human diet. Certain chronic diseases, e.g., diabetes mellitus, are associated with anomalous glucose blood levels. Detecting and measuring the levels of monosaccharides in vivo or in aqueous solutions is thus of the utmost importance in life science, health, and point-of-care applications. Noninvasive sensing would avoid problems such as pain and potential infection hazards. Here, with the help of surface enhanced infrared absorption (SEIRA) spectroscopy, we demonstrate the reliable optical detection in the mid-infrared spectral range of pure glucose and fructose solutions as well as mixtures of both in aqueous solution. We utilize a reflection flow cell geometry with physiologically relevant concentrations as small as 10 g/L. As significant improvement over the standard baseline correction employed in SEIRA applications, we utilize principal component analysis (PCA) as machine learning algorithm, which is ideally suited for the extraction of vibrational data. We anticipate our results as important step in biosensing applications that will stimulate efforts to further improve the employed SEIRA substrates, the noise level of the spectroscopic light source, as well as the flow cell environment en route to significantly higher sensitivities and quantitative analysis, even in tear drops.

Facet joint septic arthritis is a rare cause of spinal infection in children with only four cases reported. The transmission pathway is believed to be haematogenous in 72% of cases. The authors present the case of a 13-year-old boy hospitalised for acute lumbosciatalgia, limp and fever, with pain upon palpation of the paravertebral muscles, a positive Laségue signal and elevated serum inflammatory markers. The initial lumbar computerised tomography (TC) scan revealed no abnormalities in the interapophyseal joints. After improving on treatment with analgesics and antibiotics, he was readmitted one month later due to clinical deterioration, and septic arthritis of left facet joint L3-L4 was confirmed by magnetic resonance imaging (MRI). The patient experienced a full recovery after treatment with systemic antibiotics (cefotaxime-cloxacilin) and rehabilitation. A high index of suspicion is necessary to diagnose this localization as a manifestation of lumbosciatalgia and/or limp in children. CT-scan or, preferably, MRI is mandatory to confirm this diagnosis.

Anxiety and depression are highly prevalent neuropsychiatric conditions and are associated with chronic diseases, pain, loss of autonomy, dependence on others to perform routine activities, and loneliness. Depression often has a cause-and-effect relationship with other diseases, such as: acute myocardial infarction (AMI), systemic arterial hypertension (SAH), diabetes mellitus (DM) and peripheral arterial disease (PAD).

We aimed to compare patients' and physicians' safety reporting using data from large acupuncture trials (44,818 patients) and to determine associations between patient characteristics and reporting of adverse reactions.

Postoperative pulmonary complications (PPCs) represent the most frequent complications after esophagectomy. The aim of this study was to identify modifiable risk factors for PPCs and 90-days mortality related to PPCs after esophagectomy in esophageal cancer patients.

The therapeutic effects of B. coagulans Unique IS2 have been well established in children with irritable bowel syndrome (IBS), but its efficacy in adults remain under reported. Thus, in this study the efficacy of B. coagulans Unique IS2 in the management of IBS symptoms in adults was investigated. Patients (n = 153) fulfilling Rome III criteria were provided placebo capsules for a 2 weeks run-in period. Only patients satisfying compliance criteria (n = 136) were randomized (double blind) to receive either B. coagulans Unique IS2 (2 billion CFU) or placebo capsules daily for 8 weeks. Reduction of abdominal discomfort/pain intensity and increase in complete spontaneous bowel movements were analyzed as primary end points. Other clinical symptoms of IBS and serum cytokines were also evaluated. B. coagulans Unique IS2 showed significant improvement in primary and secondary endpoints, as compared to placebo. Haematology of both the arms remained normal. No significant changes in pro- (IL-6, IL-12, TNF-α, INF- γ) and anti-inflammatory cytokine (IL-10) levels were detected at the end of B. coagulans treatment (8 weeks) as compared to placebo. B. coagulans was well tolerated with no severe adverse events to report. Overall, the results demonstrate that B. coagulans Unique IS2 is efficacious in the management of IBS symptoms in adults (18-60 years).

Sézary syndrome (SS) is an aggressive cutaneous T cell lymphoma with pruritic skin inflammation and immune dysfunction, driven by neoplastic, clonal memory T cells in both peripheral blood and skin. To gain insight into abnormal gene expression promoting T cell dysfunction, lymphoproliferation and transformation in SS, we first compared functional transcriptomic profiles of both resting and activated CD4CD45RO T cells from SS patients and normal donors to identified differential expressed genes. Next, a meta-analysis was performed to compare our SS data to public microarray data from a novel benign disease control, lymphocytic-variant hypereosinophilic syndrome (L-HES). L-HES is a rare, clonal lymphoproliferation of abnormal memory T cells that produces similar clinical symptoms as SS, including severe pruritus and eosinophilia. Comparison revealed gene sets specific for either SS (370 genes) or L-HES (519 genes), and a subset of 163 genes that were dysregulated in both SS and L-HES T cells compared to normal donor T cells. Genes confirmed by RT-qPCR included elevated expression of PLS3, and only in SS, while mRNA was increased only in L-HES. was increased in both diseases. In an L-HES patient who progressed to peripheral T cell lymphoma, the malignant transformation identified increases in the expression of , , and , which are highly expressed in SS, suggesting that these genes contribute to neoplastic transformation. In summary, we have identified gene expression biomarkers that implicate a common transformative mechanism and others that are unique to differentiate SS from L-HES.

Approximately 25%-35% of the 1991 Gulf War Veteran population report symptoms consistent with Gulf War Illness (GWI), a chronic, multi-symptom illness characterised by fatigue, pain, irritable bowel syndrome and problems with cognitive function. GWI is a disabling problem for Gulf War Veterans, and there remains a critical need to identify innovative, novel therapies.Gut microbiota perturbation plays a key role in the symptomatology of other chronic multi-symptom illnesses, including myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Given similarities between ME/CFS and GWI and the presence of gastrointestinal disorders in GWI patients, Veterans with GWI may also have gut abnormalities like those seen with ME/CFS. In this longitudinal cohort study, we are comparing the diversity (structure) and the metagenomes (function) of the gut microbiome between Gulf War Veterans with and without GWI. If we find differences in Veterans with GWI, the microbiome could be a target for therapeutic intervention to alleviate GWI symptoms.

BACKGROUND As a result of climate change, we will have to deal more and more often with the consequences of the oak processionary caterpillar. CASE DESCRIPTION In June, we saw a 6-year-old girl with a severely itchy rash all over her body. The rash had developed a day after school and consisted of erythematous papules on an erythematous base. Several other children at the school were suffering from a similar skin rash. The girl also seemed to have a bad cold. We diagnosed 'oak processionary caterpillar dermatitis'. It turned out there was indeed an oak processionary caterpillar nest at her school. The nest was removed. We prescribed cetirizine oral solution, followed by triamcinolone cream, after which the itch and skin rash disappeared. CONCLUSION The oak processionary caterpillar can cause a lot of symptoms in the period from April to July, including skin rash and eye and upper airway symptoms. The symptoms are usually self-limiting and automatically disappear within 2 weeks. In case of severe itching, menthol-based creams, topical corticosteroids and antihistamines may be prescribed.