COVID-19 mortality,excess mortality,deaths per million and infection fatality ratio,Belgium, 9 March 2020 to 28 June 2020

BackgroundCOVID-19 mortality, excess mortality, deaths per million population (DPM), infection fatality ratio (IFR) and case fatality ratio (CFR) are reported and compared for many countries globally. These measures may appear objective, however, they should be interpreted with caution.AimWe examined reported COVID-19-related mortality in Belgium from 9 March 2020 to 28 June 2020, placing it against the background of excess mortality and compared the DPM and IFR between countries and within subgroups.MethodsThe relation between COVID-19-related mortality and excess mortality was evaluated by comparing COVID-19 mortality and the difference between observed and weekly average predictions of all-cause mortality. DPM were evaluated using demographic data of the Belgian population. The number of infections was estimated by a stochastic compartmental model. The IFR was estimated using a delay distribution between infection and death.ResultsIn the study period, 9,621 COVID-19-related deaths were reported, which is close to the excess mortality estimated using weekly averages (8,985 deaths). This translates to 837 DPM and an IFR of 1.5% in the general population. Both DPM and IFR increase with age and are substantially larger in the nursing home population.DiscussionDuring the first pandemic wave, Belgium had no discrepancy between COVID-19-related mortality and excess mortality. In light of this close agreement, it is useful to consider the DPM and IFR, which are both age, sex, and nursing home population-dependent. Comparison of COVID-19 mortality between countries should rather be based on excess mortality than on COVID-19-related mortality.     

American cutaneous leishmaniasis in infancy and childhood

Infant and young child skin diseases are among the most common features of morbidity throughout the tropics. Because the skin is directly exposed to the environment, it is considerably affected by climatic and local conditions such as vectors and microorganisms, as in the case of leishmaniasis. In America the observed magnitude of cutaneous leishmaniasis in children has led to the study of increased risk of exposure of this group due to the possibility of peri‐ and intradomiciliary transmission. The present review pretends to make a concrete approach all through the broad and main figures of this parasitic disease, including the clinical, physiopathological, epidemiological, diagnostic, and therapeutic aspects, in order to be used as a practical source of reference for pediatricians leading with tropical cutaneous pathology in the region.     

Augmented reality haptic (ARH): an approach of electromagnetic tracking in minimally invasive surgery

Purpose  

Minimally Invasive Surgery (MIS) is a widely used surgical technique that requires a long training process due to its difficulty and complexity. We developed an Augmented Reality Haptic (ARH) System based on electromagnetic tracking devices for use in creation training models (computer-enhanced trainers), in computer-assisted surgery or telemanipulation applications.     

Extent of law compliance and anti-smoking teaching at Spanish schools

OBJECTIVE: Knowing the degree of fulfillment of the anti tobacco legislation in Spanish schools and the influence that this has on the percentage of smoking pupils. MATERIAL AND METHODS: A survey was carried out among 3050 headmasters of Spanish schools, who were asked about different aspects of the fulfillment of the antitobacco laws in their schools and about the main characteristics of tobacco consumption in their centers. RESULTS: A 80.9% of the headmasters claim that the fulfillment of the legislation is demanded in their centers, and only a 64.9% of them have posters in theirs schools that warn people about smoking ban. Anti tobacco teachings are imparted in a 82.2% of the schools where laws is demanded and only in a 64.8% where is not demanded. The percentage of teachers who, smoke in the presence of the pupils is of a 5.9% in the schools where anti tobacco legislation is demanded and a 12.9% where is not demanded. In the schools where anti tobacco teachings are imparted, a 29% of the pupils have tried tobacco, opposite a 31% who have tried in the schools where these teachings are not imparted. CONCLUSIONS: The, headmasters of the schools, as people in charge of watching over the fulfillment of the anti tobacco legislation in theirs schools, must demand the fulfillment of this one, because this measure is effective in order to improve the global functioning of the schools and to reduce the percentages of smoking pupils and teachers.     

Anti-CD20 monoclonal antibody therapy in refractory immune thrombocytopenic purpura

Multiple agents have been tried in patients with refractory immune thrombocytopenic purpura (ITP); however, none of these stands as a clear first choice. We administered rituximab, 375 mg/m2 weekly x 4, to four patients with refractory ITP. With a median follow-up of 7 months, one patient has achieved a complete response, proving the possible efficacy of such a therapeutic modality in this context.     

A noncanonical sequence phosphorylated by casein kinase 1 in beta-catenin may play a role in casein kinase 1 targeting of important signaling proteins

Protein kinase casein kinase 1 (CK1) phosphorylates Ser-45 of beta-catenin, "priming" the subsequent phosphorylation by glycogen synthase-3 of residues 41, 37, and 33. This concerted phosphorylation of beta-catenin signals its degradation and prevents its function in triggering cell division. The sequence around Ser-45 does not conform to the canonical consensus for CK1 substrates, which prescribes either phosphoamino acids or acidic residues in position n-3 from the target serine. However, the beta-catenin sequence downstream from Ser-45 is very similar to a sequence recognized by CK1 in nuclear factor for activated T cells 4. The common features include an SLS motif followed two to five residues downstream by a cluster of acidic residues. Synthetic peptides reproducing residues 38-65 of beta-catenin were assayed with purified rat liver CK1 or recombinant CK1 alpha and CK1 alpha L from zebrafish. The results demonstrate that SLS and acidic cluster motifs are crucial for CK1 recognition. Pro-44 and Pro-52 are also important for efficient phosphorylation. Similar results were obtained with the different isoforms of CK1. Phosphorylation of mutants of full-length recombinant beta-catenin from zebrafish confirmed the importance of the SLS and acidic cluster motifs. A search for proteins with similar motifs yielded, among other proteins, adenomatous polyposis coli, previously found to be phosphorylated by CK1. There is a strong correlation of beta-catenin mutations found in thyroid tumors with the motifs recognized by CK1 in this protein.     

Uncommon locations of abdominal hydatid disease

South Chile is an endemic zoonosis area of hydatid disease, where prevalence rates can be 30 to 40/100 000 habitants. Not only is surgery performed on a great number of liver and lung hydatid cysts every year, but also upon cysts found in uncommon abdominal locations such as spleen, peritoneum and kidney. Information on this subject is scarce. We reviewed PubMed index from 1975 to 2001 and found only five related articles, reporting more than 30 cases.     

Are activation markers (CD25, CD38 and CD103) predictive of sensitivity to purine analogues in patients with T-cell prolymphocytic leukemia and other lymphoproliferative disorders?

T-cell prolymphocytic leukemia (T-PLL) is a rare lymphoproliferative disorder with distinctive clinical and laboratory features. It is often resistant to conventional chemotherapy, but complete or partial responses have been documented with the use of purine analogues. We report on two cases of T-PLL with a slightly different immunophenotype but a remarkably different response to pentostatin. We discuss the possible therapeutic implications of this finding and establish a comparison between immunophenotype and sensitivity to purine analogues in patients with T-PLL and other chronic lymphoproliferative disorders.