Similarities between the neuronal degeneration seen in NRHypo and in AD There are important similarities between the overall pattern of NRHypo neurodegeneration and the pattern that has been described in the AD brain by various researchers. The PC/RS

cortex, which is the brain region most vulnerable to NRHypo degeneration, was recently reported to be selectively affected early in the course of AD in a PET study of living patients.146 The PC/RS cortex has also been shown to be markedly atrophic Inhibitors,research,lifescience,medical late in the disease.147 In contrast, neurodegeneration in the anterior cingulate cortex is less severe in both the AD brain148 and the NRHypo animal model. While it is difficult to make precise anatomical comparisons between the rodent and human brain, the transentorhinal area, considered among the earliest and most severely affected regions in the human AD brain,149 is roughly

homologous to the perirhinal cortex Inhibitors,research,lifescience,medical in rat brain, which is second only to the PC/RS cortex in its sensitivity to NRHypo neurodegeneration. Other brain regions preferentially affected in both the AD brain and the NRHypo model include portions of the parietal, temporal, enlorhinal, amygdaloid, subicular, hippocampal, and insular cortices. A Inhibitors,research,lifescience,medical mild but transient microglial and astrocytic response accompanies the neurodegeneration seen with NRHypo. Inhibitors,research,lifescience,medical However, consistent with the known pathology of AD, a robust phagocytic response is conspicuously absent.150 The neurons primarily involved in neurofibrillary tangle (NFT) formation in the AD brain are distributed widely throughout cortical and limbic brain regions, but in each region these neurons tend to be pyramidal or multipolar neurons and in certain cortical

regions they are distributed in a bilaminar pattern. This fits the description of the subpopulation of neurons primarily affected in the NRHypo neurodegenerative syndrome.113 Interneurons in the cerebral cortex are also occasionally involved but, the most, Inhibitors,research,lifescience,medical prominently affected neurons are mediumsized pyramidal or multipolar neurons in each region. The tortuousity of dendritic processes in the NRHypo model Resminostat is accompanied by a parallel pattern of tortuosity of the microtubular cytoskeleton within the distorted dendrite. This JNK assay suggests that, changes in the external configuration of the dendrite are due to cytoskeletal changes within the dendrite. The cytoskeleton of the injured neurons appears to be undergoing both degenerative and regenerative processes, but the repair effort is not, very successful. As described above the mechanism of injury involves simultaneous hyperactivation of the neuron through several excitatory receptors, including a muscarinic (M3) cholinergic receptor and a glutamatergic (non-NMDA) receptor (Figure 1).

Within a formal trauma system a HEMS can provide numerous advantages including access to areas without road infrastructure, timely treatment by a specialist physician and/or PARP inhibitor paramedic and the ability to rapidly transport patients over large distances. During pre-hospital and inter-hospital

transport, HEMS typically bypass smaller hospitals, transporting patients to major trauma centres to comply with the aims of the NSW trauma system [10]. Although this practice Inhibitors,research,lifescience,medical conforms to local transport protocols, the resource implications for major trauma centres have not been previously investigated. Like most pre-hospital ambulance services, HEMS transport a proportion of patients with less severe injuries to major trauma centres, known as over-triage [11]. Although this practice negatively influences HEMS cost-effectiveness [12], it is common in Inhibitors,research,lifescience,medical practice because it

safeguards against under-triage, an outcome that is likely to be medically, politically and societally unacceptable. Given a degree of HEMS over-triage is likely to remain common practice for the foreseeable future, it is important to document its incidence and to assess the relationship between differing levels of over-triage and cost. Further, taking into account the current episode funding model it is important Inhibitors,research,lifescience,medical to examine the financial implications of HEMS over-triage to receiving hospitals such as major trauma centres, Inhibitors,research,lifescience,medical which receive the majority of HEMS transports. Using a state-wide sample of HEMS transports,

the aim of this study was to investigate the financial implications of HEMS over-triage from the perspective of major trauma centres in NSW. In doing so we provide a description of HEMS patients, estimates of over-triage and a comparison of the true cost of treating HEMS patients at major trauma centres in NSW in relation to peer group averages to assess potential funding discrepancies. Methods Inclusion Inhibitors,research,lifescience,medical criteria Patients were included in this study if they were admitted to a NSW major trauma centre via HEMS transport and were captured in the respective trauma databases (see ‘Data capture’) during Ketanserin the 2008/2009 financial year. Patients transported by other transport modes such as ambulance or private vehicle were excluded from the sample (see ‘Variable definition and data analysis’ for further information). Setting The characteristics of the NSW trauma system and HEMS in NSW have been previously described [9,13]. As of the 1st July 2008, the NSW trauma care system incorporated a networked system of 23 designated trauma hospitals, which were classified as either major adult (n=9), major paediatric (n=3), regional (n=2) or rural regional (n=10) according to available resources [13].

8,10 The difference between our findings and those of previous reports might be due to the differences in the animal model as well as the duration of diabetes and/or hypertension. There are various models of experimental hypertension and type 2 diabetes. Each model of such diseases portrays a specific aspect of such diseases in humans, and none of them is a full representation of the diseases. It would be interesting to examine how the simultaneity of other models of hypertension and type 2 diabetes would affect cardiac functions. Whether Inhibitors,research,lifescience,medical or not the findings of the present study can be extended to a combination

of other models and the significance of such findings needs further investigations. Conclusion The findings of the present study indicated that type 2 diabetes impaired cardiac functions, short-term renovascular hypertension improved cardiac functions, and simultaneity

of hypertension with type 2 diabetes attenuated the diabetes-induced cardiac impairment. Acknowledgment This work was supported Inhibitors,research,lifescience,medical Inhibitors,research,lifescience,medical by the Vice Chancellor for Research Affairs, Shiraz University of Medical Sciences. This paper is an extract from Azadeh Khalili’s PhD thesis. The authors declare no conflict of interest, financial or otherwise, with regards to this paper. Conflict of Interest: None declared.
Background: Medicinal plants are considered new resources for producing agents that could act as alternatives to antibiotics in the treatment of antibiotic-resistant bacteria. The aim of this study was to evaluate the antibacterial activity of 28 plant extracts

and oils against four Gram-negative bacterial species. Methods: Experimental, in vitro, evaluation of the activities of 28 plant Inhibitors,research,lifescience,medical extracts and oils Inhibitors,research,lifescience,medical as well as some antibiotics against E. coli O157:H7, Yersinia enterocolitica O9, Proteus spp., and Klebsiella pneumoniae was performed. The activity against 15 isolates of each bacterium was determined by disc diffusion method at a concentration of 5%. Microdilution susceptibility assay was used in order to determine the minimal inhibitory concentrations (MICs) of the plant extracts, oils, and antibiotics. MEK inhibitor review Results: Among the evaluated herbs, only Origanum syriacum L., Thymus syriacus Boiss., Syzygium aromaticum L., Juniperus foetidissima Wild, until Allium sativum L., Myristica fragrans Houtt, and Cinnamomum zeylanicum L. essential oils and Laurus nobilis L. plant extract showed anti-bacterial activity. The MIC50 values of these products against the Gram-negative organisms varied from 1.5 (Proteus spp. and K. pneumoniae( and 6.25 µl/ml (Yersinia enterocolitica O9 ) to 12.5 µl/ml (E. coli O:157). Conclusion: Among the studied essential oils, O. syriacum L., T. syriacus Boiss., C. zeylanicum L., and S. aromaticum L. essential oils were the most effective.

This observation suggests initial hyperfiltration in the smaller kidneys, which could not be sustained after 7 years, likely due to on-going nephron loss, as reflected in more proteinuria, more antihypertensive drug use, a greater degree of glomerulosclerosis, and a 55% increased risk for transplant failure by 2 years in the low DKW/RBW group. The authors conclude that

incompatibility between graft and recipient weight is an independent predictor of long-term graft BI 6727 survival. These data strongly support the contention that nephron “dose”, relative to the recipient’s needs, should be an important consideration Inhibitors,research,lifescience,medical in organ allocation. Strategies for Optimization of Nephron Number Evidence is emerging that clinically feasible interventions, Inhibitors,research,lifescience,medical at a critical period of nephron development, can rescue nephron number and impact later life blood pressure. In rats, adequate postnatal nutrition, achieved by cross-fostering growth-restricted pups onto normal lactating females at birth, was found to restore nephron Inhibitors,research,lifescience,medical number and abrogate development of subsequent

hypertension.73 Similarly, supplementation of maternal low-protein diet with glycine, urea, or alanine during gestation normalized nephron number in all rat offspring, although blood pressure was only normalized in those supplemented with glycine.71 Postnatal hypernutrition in normal rats was found to increase nephron number by 20%, but these rats went on to develop hypertension and glomerulosclerosis with age, likely Inhibitors,research,lifescience,medical as a result of obesity.72 Vitamin A deficiency has been shown to reduce nephron number in a dose-dependent manner, but encouragingly a single dose of retinoic acid, administered during early nephrogenesis,

was enough to restore nephron numbers to levels of control Inhibitors,research,lifescience,medical rats in pups exposed to a low-protein diet in utero.30,161 Interestingly, administration of ouabain was also found to abrogate the effect of serum starvation and low-protein diet on nephron development in vitro and in vivo again in rats.162 Although still preliminary, taken together, these studies suggest possible all mechanisms whereby nephron numbers could be rescued if at-risk fetuses were identified early enough. Likewise, avoidance or judicious use of drugs during pregnancy, that are known to impact kidney development as described above, are another means to optimize fetal nephron number.21–30,32–34,36,163–165 CONCLUSION The idea that low nephron number may have a long-term impact on an individual’s later life risk of hypertension and renal disease has now entered the main stream. Until we learn more about developmental programming in nephrology, LBW should be used as the most useful current clinical surrogate for low nephron number and inborn risk of hypertension and renal disease. It is not surprising that nephron number and LBW are not the whole story, however.

Yet, as described here, the amygdala is but one of the sources of modu lation of visual responses that take into consideration the behavioral and affective significance of sensory stimuli. Future research is needed to establish how these multiple modulatory

sources www.selleckchem.com/products/OSI-906.html influence visual processing in particular, and other sensory modalities more Inhibitors,research,lifescience,medical generally. Executive control and competition How does emotional content impact executive function? Because emotion can either enhance or impair performance of executive functions, answering this question has been challenging. At least part of the answer may be related to the level of threat posed by an emotional item. When threat content is relatively low, processing is biased in favor of the emotional item and although emotional items are prioritized, the impact on behavior may be modest. Importantly, emotional content Inhibitors,research,lifescience,medical enhances task-relevant processing with relatively minor effects on irrelevant stimuli and other executive functions that may be concurrently needed. A more dramatic effect of emotional content on behavior is expected

when the level of threat is high. In this situation, Inhibitors,research,lifescience,medical processing resources are diverted toward the processing of the item at hand and because the mobilization of resources is more extreme, the effects on behavior are considerably more dramatic.113,114 In particular, the impact on behavior may come from the recruitment Inhibitors,research,lifescience,medical of attentional/effortful control that is required to prioritize the processing of high-threat information. Attentional/effortful control involves processing resources that are shared across executive functions and because high threat is expected to recruit some of these resources (see also refs 78,115,116), it will impair other executive functions that are reliant on them (Figure 4). Consistent with this idea, performance during response inhibition was compromised when participants viewed high- vs low-arousing pictures.84 Figure 4. Executive competition

and threat. Inhibitors,research,lifescience,medical Executive functions can be viewed as relying on multiple mechanisms, also referred to as resources (R1 through R4; eg, “shifting,” “updating”), that are partly independent but, critically, … either In the past, the notion of resources has been employed in order to account for the limits of human information processing. A potential approach to understanding resource consumption by threat may be to probe the correspondence of brain sites that are sensitive to specific experimental conditions. It is particularly instructive, for instance, to examine the overlap between manipulations of threat level and those involving attention – given that attentional manipulations are sensitive to changes in the distribution of processing resources.

Table 2. Factors affecting transdermal transport and bioavailability. Psychotropic medication and transdermal

patches Medical specialties such as general practice, palliative care and endocrinology frequently use transdermal formulations for pain relief, smoking cessation and hormone replacement, but the use of psychotropics as transdermal patches is less studied and underinvestigated. Advances in enhancing transdermal drug delivery have led to treatment options for various psychiatric and neuropsychiatric conditions. Conditions such as depression, attention deficit hyperactivity disorder (ADHD), Parkinson’s disease and dementia benefit from long-acting formulations Inhibitors,research,lifescience,medical due to the nature of the symptom relief required and this can be achieved through

constant plasma levels of medication against episodic peaks. TDS may be of particular Inhibitors,research,lifescience,medical use in patients who are unable or unwilling to take oral or intramuscular medicines. Offering patients another formulation also facilitates control and choice over their treatment. An appropriately administered patch which is visible and potentially easy to monitor offers clinicians reassurance in patients who are noncompliant that a medicine is administered without the Inhibitors,research,lifescience,medical need for invasive and often injurious intramuscular injections when given under restraint. Table 3 summarizes Inhibitors,research,lifescience,medical the psychotropics that are currently approved by the US Food and Drug Administration (FDA) and the UK Medicine http://www.selleckchem.com/products/pci-32765.html healthcare Regulatory Authority (MHRA). Table 3. Summary of various psychotropic drugs used as transdermal systems. Dementia Dementia is a chronic condition that has significant impact on an individual’s health and social care [Harada and Vanderplas, 2006]. The cost of dementia care in Inhibitors,research,lifescience,medical the UK is expected to rise to approximately £28 billion by 2018 [All Party Parliamentary

Group on Dementia, 2011]. In a time of increasing financial constraints, the demand to implement a more efficient approach to the delivery of community-based healthcare is increasing. In patients receiving antidementia therapies for longer periods at adequate doses there is a greater chance of slowing or delaying the progression of cognitive decline, leading to fewer admissions to nursing homes and reduced healthcare costs [Harada and Vanderplas, mafosfamide 2006]. However, misunderstanding complex titration schedules can result in people with dementia receiving subtherapeutic doses [Bernabei and Lage, 2008]. Medications featuring less frequent dosing schemes, such as extended-wear transdermal patches, are capturing the interest of providers and healthcare purchasers. Rivastigmine is a cholinesterase inhibitor used for treating Alzheimer’s disease and dementia associated with Parkinson’s disease. It is the only antidementia drug currently available as a transdermal formulation.

Hippocampal volume loss, as well as reduction of other brain

regions, is present in patients with temporal lobe epilepsy and is related to epilepsy chronicity.42 Hippocampal sclerosis may also accompany transactive response DNA binding protein 43 kDa (TDP-43) associated FTD,43 which may account for a hippocampal volume loss.12 Elderly patients with hippocampal sclerosis may be misdiagnosed as having AD, since the clinical features of memory loss may be identical to memory loss in AD.31,44 Memory impairment due to other neurological diseases Impairment of episodic memory and other cognitive functions is a common feature in a range of neurological disorders such as Parkinson’s disease,45 Huntington’s disease,46,47 epilepsy,48 Inhibitors,research,lifescience,medical multiple Inhibitors,research,lifescience,medical sclerosis,49 amyotrophic lateral sclerosis,50 or limbic encephalitis.51 In most of these diseases, clinical investigation

and brain imaging will lead to the correct diagnosis of non-AD memory impairment, and the syndromal overlap with AD is usually smaller than in other neurodegenerative Inhibitors,research,lifescience,medical disorders. Awareness of cognitive symptoms in Parkinson’s disease is growing. Approximately one fourth of nondemented patients with Parkinson’s disease were identified as suffering from MCI, with the majority suffering from the amnestic subtype.45 In a recent MRI study on hippocampal volume and microstructural alterations using diffusion tensor imaging analyses, declarative memory impairment was associated with microstructural alterations,

but not hippocampal total volume in nondemented Parkinson’s disease patients.52 In patients with epilepsy, hippocampal atrophy has been described in patients with transient amnesia53 and hippocampal sclerosis associated Inhibitors,research,lifescience,medical Inhibitors,research,lifescience,medical with epilepsy may also lead to an amnestic syndrome possibly resembling AD in elderly patients.42 Atrophy observed in patients with epilepsy may be partly reversible.54 Limbic encephalitis is a rare but treatable neurological, autoimmune, often paraneoplastic, disorder that mainly presents with memory impairment, temporal lobe seizures, or affective symptoms.51 Damage of the medial temporal lobe is common in limbic encephalitis; typical hyperintensities of the temporal Histamine H2 receptor lobes are seen in the cranial MRI and may cause severe reduction of memory function.55 Memory impairment due to general medical conditions Apart from neurodegenerative or neurological diseases, general medical diseases may also lead to an impairment of memory, eg, diabetes KPT-330 research buy mellitus, obstructive sleep apnea (OSA), pregnancy, or menopause among others (for an overview see ref 6). Brain atrophy, particularly microstructural hippocampal alterations seen using diffusion tensor imaging, has been associated with diabetes, independent of vascular lesions.56 Hypoglycemia due to insulin therapy may also lead to structural brain damage and memory impairments in patients with type 1 diabetes.

06 versus 0.48, respectively). Exposure alone had an effect, size of 0.81, nonsignificantly different, from placebo. Effect sizes tended to improve at follow-ups. CBT effectiveness was confirmed by Gould’s metaanalysis109 in which pharmacotherapy (11 studies) had an effect, size of 0.62 versus placebo, while CBT (16 studies) reached 0.74 Inhibitors,research,lifescience,medical compared with control conditions. In summary, meta-analytic approaches of the research suggest, that CBT is effective and exposure is a crucial component, of CBT, while

the effect, of CT remains in discussion. Medication and CBT in social phobia Main outcome studies Buspirone was less effective than CBT at 6 weeks in reducing performance anxiety in musicians.110 Gel ernter et al111 compared four groups: CBT, phenelzine, alprazolam, and placebo. All four groups received instruction of self-exposure. All groups improved

significantly at 2 months with few differences between them. However, this equal improvement could have resulted from the exposure instructions. BT was superior to atenolol at Inhibitors,research,lifescience,medical 3 and 6 months.112 A positive combination of exposure Inhibitors,research,lifescience,medical with sertraline was found at 24 weeks. Combination was superior to placebo, but. equal to sertraline alone.113 Few differences, but, in favor of clonazepam, were found in a comparison of this BDZ with behavioral group therapy114; patients were only rated at. 4, 8, and 12 weeks. CBGT was found to be superior to pill-Gedatolisib ic50 placebo and educational group therapy, but. slightly inferior to phenelzine on Inhibitors,research,lifescience,medical some measures at the 12 weeks’ evaluation in a randomized trial.115 Follow-up data found that, after withdrawal of the medication, CBGT was better, especially in generalized social phobia.116 Meta-analysis of CBT and medication A meta-analysis117 of psychological and pharmacological treatments for social phobia

was conducted: 108 treatment-outcome trials were entered in this meta-analysis. Eleven treatment, conditions were compared: waiting-list control, pill placebo, BDZ, SSRIs, monoamine oxidase inhibitors, Inhibitors,research,lifescience,medical attention placebo, exposure, cognitive restructuring, and applied relaxation. The most, consistently effective treatments for social phobias were pharmacotherapies. BDZs and SSRIs were equally more effective than control conditions. Dropout rates were similar among all the active treatment conditions. Oxygenase The durability of treatment, gains for pharmacotherapies was not assessed because of an insufficient number of drug studies with follow-up data. The treatment gains of CBT, although moderate, continued during the follow-up period. BDZs and SSRIs seem to be effective treatments for social phobia, at, least in the short, term. The authors recommended assessment, of the long-term outcome and evaluation of the inclusion of a CBT during the drug-tapering period. Psychoanalytic therapies in performance anxiety A randomized study by Paul118 in 1.

This was addressed in a second fitness test: Each participant had to perform a three-minute ramp protocol on a rowing ergometer starting at 25 watts. Strain was increased by 25-watt steps to a minimum of 75

watts and a maximum of 125 watts. Stroke frequency had to be kept constant at between 30-40/min. As the seat of the custom-made rowing machine was not movable, all force had to be recruited from the upper part of the body. Between the cycling and the rowing ergometry tests, all participants were allowed to recover for at least two hours. Full recovery was verified by repeated lactate measurements until two consecutive measurements had returned to the individual’s baseline values. Ergospirometry Ergospirometric measurements Inhibitors,research,lifescience,medical were performed with a mobile breath-by-breath ergospirometry device (Cortex Metamax 3 B™, Cortex Biophysik, Leipzig, Germany), combined with a chest-belt heart rate meter (Polar T 41™, Polar Electro, Inhibitors,research,lifescience,medical Büttelborn, Germany) during the endurance tests.

We recorded respiratory rate, respiratory minute volume, oxygen consumption, carbon dioxide production and HR. All parameters were transmitted to a Windows™ based PC and recorded using MetaSoft 3.3™ software (Cortex Biophysik, Leipzig, Germany). As PWC170 is a validated, standard, cycling-based parameter of physical fitness, we aimed to determine a corresponding fitness parameter evaluated during rowing exercises. Therefore, correlations for ergospirometric parameters measured Inhibitors,research,lifescience,medical during rowing with Inhibitors,research,lifescience,medical the individual PWC170 were calculated. Part II: External chest compression Two days after part I, the participants performed two nine-minute sequences of ECC. We chose nine-minute sequences because this is approximately the average time that a first responder has to give ECC during out-of-hospital resuscitation prior to the arrival of professional healthcare providers at the scene [15,16]. Using a computer-generated randomization list, participants were randomly assigned to Inhibitors,research,lifescience,medical start ECC with a CVR of either 15:2 or 30:2, followed by a CVR of

30:2 or 15:2 in a crossover manner. Between the two ECC sequences, all participants were allowed to recover for at least 90 minutes. Full recovery was verified by repeated lactate measurements until two consecutive measurements had returned to the individual’s baseline values. ECC was performed on a standard ALS ALK inhibitor manikin (ResusciAnne™, Bumetanide Laerdal Medical, Stavanger, Norway) placed on the floor with a linear force-depth relationship (32.5 kg 38 mm, 44 kg 51 mm, see Figure ​Figure1).1). The quality of the ECC, determined by the compression depth and rate was measured and recorded by a PC-based automated skill reporting system (SkillMaster™ Reporting System, Laerdal Medical, Stavanger, Norway). In a brief pre-trial test, all participants were initially reminded to use the correct compression site (centre of the chest), rate (100 min-1) and depth (4-5 cm), but no corrective feedback was given during the course of the trial.

22 A single 8 mg oral Dexamethasone following intravenous Phenothiazine treatment for migraine attack

did not reduce the rate of recurrent headache in an Australian study.23 A placebo-controlled study was conducted by Fiesseler et al.24 on 173 patients with migraine. The authors did not find a statistically significant therapeutic effect of 10 mg IVDEX in patients with acute migraine headache. The distribution of the relapse patterns was not significantly Inhibitors,research,lifescience,medical different between the two therapeutic groups in the present study (P=0.870). A pooled analysis of seven trials, Akt inhibitor involving 742 patients, suggested a modest but significant benefit in preventing headache recurrence when IVDEX was added to standard antimigraine therapy.25 Friedman et al.26 determined the efficacy of 10 mg IVDEX in a placebo-controlled study in 205 migrainous patients. Their study confirmed that a moderate dose of IVDEX should not be administered routinely

in acute migraine, Inhibitors,research,lifescience,medical although it might be useful for patients with migraine status. Adding 3.5 mg of Prochlorperazine to 20 mg of IVDEX significantly shortened the response time for the abortive therapy of migraine status in one study.27 Elsewhere, the administration of IVDEX decreased the incidence of severe recurrent headache following the treatment of migraine attack,14 whereas it had no preventive effect on the recurrence of migraine in another study.28 Inhibitors,research,lifescience,medical The distribution of pain-free response was not significantly different between the IVVP and IVDEX groups of our patients (P=0.704). A meta-analysis of the effects of single-dose IVDEX, by comparison with a placebo, showed that IVDEX and placebo provided similar acute pain reduction; nevertheless, IVDEX was significantly more Inhibitors,research,lifescience,medical effective than the placebo in reducing headache recurrence within 72 hours.29 Another US study included 40 participants with prolonged severe migraine, Inhibitors,research,lifescience,medical who alternatively received either 500 mg IVVP or 10 mg Metoclopramide intramuscularly, followed by one mg Dihydroergotamine. The study reported that IVVP

was similar in effectiveness to Metoclopramide/Dihydroergotamine as abortive therapy for prolonged severe migraine.30 It is deserving of note that although textbooks on headache have mentioned the usefulness of IVVP in the treatment of severe acute migraine,31 further research Tryptophan synthase is required to shed sufficient light on this issue. Conclusion A meticulous review of the literature shows that our study is the only clinical trial to date to compare 16 mg IVDEX with 900 mg IVVP (Orifil) in patients with migraine status. In our study, IVVP (Orifil) was similar to IVDEX as abortive therapy and IVVP (Orifil) appears to offer a safe and well-tolerated abortive treatment. Conflict of Interest: None declared.
Dear Editor, An 8-year-old boy, a known case of T-cell acute lymphoblastic leukemia (ALL), was admitted for an episode of fever and neutropenia.