During the current opioid epidemic, the number of children with illicit toxic ingestions is increasing. Children presenting with altered mental status and neurologic, particularly cerebellar symptoms of unclear etiology, should be considered to undergo brain imaging as well as toxicology screening to not miss the possible complication of acute toxic leukoencephalopathy. We report the case of an eight-year-old child who presented with somnolence and respiratory depression of unclear etiology, responding profoundly to naloxone, quickly raising concern for drug ingestion. The toxicology screen was positive for fentanyl, cocaine metabolites, caffeine, and diphenhydramine, but not available until day 3 of the hospital stay. In the interim, head CT and brain MRI findings revealed concerning bilateral cerebellar hypodensities, suggestive of opioid-induced leukoencephalopathy. This condition has been described as potentially malignant and fatal, but very few cases of this pathology have been described in children so far. Fortunately, all neurological symptoms in our patient, including altered mental status, respiratory depression, atactic gait, blurry vision, and lower extremity pain, completely resolved within five days of presentation and the patient seemingly underwent a full clinical recovery without residual symptoms. Awareness and prompt recognition of acute toxic leukoencephalopathy in children presenting with altered mental status or neurological symptoms of unclear etiology is of utmost importance to prevent deterioration and optimize treatment, especially during times of a worsening opioid epidemic in our country.
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http://dx.doi.org/10.7759/cureus.66573 | DOI Listing |
Commun Biol
January 2025
Department of Medicine, Universite de Montreal, Montreal, QC, Canada.
Severe COVID-19 can trigger a cytokine storm, leading to acute respiratory distress syndrome (ARDS) with similarities to superantigen-induced toxic shock syndrome. An outstanding question is whether SARS-CoV-2 protein sequences can directly induce inflammatory responses. In this study, we identify a region in the SARS-CoV-2 S2 spike protein with sequence homology to bacterial super-antigens (termed P3).
View Article and Find Full Text PDFEnviron Sci Pollut Res Int
January 2025
Department of Civil and Environmental Engineering, Norwegian University of Science and Technology, S. P. Andersens Veg 5, 7031, Trondheim, Norway.
The characterization of tunnel wash water (TWW) from 12 Norwegian tunnels showed very high concentrations of total suspended solids (TSS), metals, and polycyclic aromatic hydrocarbons (PAHs). Iron (Fe), aluminum (Al), and manganese (Mn) were mainly particle-associated. They are efficiently removed by sedimentation, while the dissolved concentrations of toxic metals like Cu, Zn, and As did not change.
View Article and Find Full Text PDFSci Rep
January 2025
School of Chemistry, Institute of Science, Suranaree University of Technology, Nakhon Ratchasima, 30000, Thailand.
In this work, we synthesize a quinoline-based heptamethine cyanine, QuCy7, with sulfonate groups to enhance water solubility. This dye demonstrates exceptional near-infrared absorption beyond 750 nm, accompanied by photothermal properties but low photostability. Encapsulating QyCy7 with polyethylene glycol to form nanopolymer, QuCy7@mPEG NPs, addresses the issue of its photoinstability.
View Article and Find Full Text PDFRadiother Oncol
January 2025
Department of Oncology, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark.
Background And Purpose: Late toxicity is substantial after chemotherapy for anal cancer. This study aimed to investigate the relationship between radiation dose to lower urinary tract sub-structures and the risk of late urinary toxicities, in patients with anal cancer treated with chemoradiotherapy or radiotherapy.
Materials And Methods: From 2015 to 2021, 314 patients with localized anal cancer were included in a national prospective registration study.
Int J Radiat Oncol Biol Phys
January 2025
Department of Radiation Oncology, University of Leipzig Medical Center, Leipzig, Germany; Comprehensive Cancer Center Central Germany, Partner Site Leipzig, Leipzig, Germany; Department of Radiation Oncology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, German Cancer Consortium (DKTK), Partner site DKTK, Freiburg, Germany. Electronic address:
Purpose: The value of stereotactic body radiotherapy (SBRT) in patients with oligometastatic head-and-neck squamous cell carcinoma (HNSCC) remains unclear, as existing evidence is primarily derived from retrospective single-center analyses with small patient cohorts. This study aimed to evaluate the outcomes of pulmonary SBRT in patients with oligometastatic HNSCC and to identify factors associated with survival.
Methods: This trinational multicenter cohort study, including 16 centers from XXX, XXX, and XXX, retrospectively analyzed patients with oligometastatic HNSCC undergoing SBRT for pulmonary metastases between 2010 and 2023.
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