Hoarseness and vocal cord injuries are clinically relevant complications related to short-term general anesthesia using an endotracheal tube or laryngeal mask. However, more well-designed prospective studies are necessary to generate reliable data as well as to investigate techniques to reduce adverse laryngeal effects. For future research, a proposal to categorize the vocal cord lesions due to general anesthesia is presented. Furthermore, use of a preoperative and postoperative standardized measurement protocol using acoustic analysis and the Voice Handicap Index is advised.

Lichen sclerosus (LS), first described by Breisky (1885) and Hallopeau (1887), is a chronic inflammatory skin disease which predominantly affects the anogenital region. 1,2 LS is relatively common in postmenopausal women, with an estimated prevalence between 1:1000 and 1:60. 3,4 In men, LS seems less common 5 ; the reported ratio between men and women varies from 1:10 to 1:6. 6,7 The disease is well-documented in adults; less is known regarding LS in children. In addition, many publications address LS in either boys or girls, but not both. Therefore, we aim to assess the literature on LS in both boys and girls. LS has been known by various synonyms such as white spot disease, kraurosis vulvae, lichen sclerosus et atrophicus vulvae or, in men, balanitis xerotica obliterans (BXO). For consistency, in this review, we uniformly use the term lichen sclerosus.

The purpose of this study was to compare long-term neurocognitive functioning (working memory, processing speed, and attention) between children who had been treated with either propranolol or atenolol for infantile hemangioma during infancy. All eligible children (n = 158) aged 6 years or older and treated with propranolol or atenolol as infants were invited to participate in this two-center cross-sectional study. The primary outcome was the Wechsler Intelligence Scale for Children-V Cognitive Proficiency Index (CPI), a measure of working memory, processing speed, and attention. Secondary outcomes were general intelligence, auditory, visuospatial, and narrative memory, as well as executive functioning and sleep. A total of 105 children, of whom 36 had been treated with propranolol (age 6.0–11.8 years, follow-up time 1.6–9.7 years, 19% male) and 69 had been treated with atenolol (age 6.9–9.7 years, follow-up time 4.5–8.4 years, 19% male), were analyzed. The CPI and other neurocognitive outcomes did not differ between the propranolol and atenolol groups and were in line with general population test norms. Post hoc analyses revealed lower CPI scores for males, both compared to participating females (10.3 IQ points, medium effect size) and compared to matched test norms (12.4 IQ points, medium effect size).Conclusions: Long-term neurocognitive functioning did not differ between children treated with propranolol and those treated with atenolol for IH. Overall, propranolol and atenolol appear to be safe treatments for IH regarding long-term neurocognitive functioning. The substantially lower CPI scores in males warrant further investigation.Trial registration: Netherlands Trial Register, NL7703 https://www.trialregister.nl/trial/7703 What is Known: • Infants with infantile hemangioma are effectively treated with propranolol or atenolol. • Parents and professionals are concerned about long-term neurocognitive effects. What is New: • No long-term (≥ 6 years) differences in neurocognitive functioning were found between children treated with propranolol or atenolol. • Males treated with beta-blockers had substantially lower IQ scores than treated females and males from the general population, which is a matter of concern and should be considered when evaluating the risk/benefit ratio in less severe forms of infantile hemangioma.

Infantile haemangiomas are common benign tumours of infancy, which can be treated effectively with beta-blockers such as propranolol and atenolol. Different types of beta-blockers may result in different long-term aesthetic outcomes. This study evaluated the difference in long-term aesthetic outcomes between infantile haemangiomas treated with either propranolol or atenolol, including the perspective of physicians, parents, and children. Children, aged ≥6 years, treated with propranolol or atenolol for infantile haemangioma during infancy, participated in this 2-centre cross-sectional study. The primary endpoint was change in appearance of the infantile haemangioma from pre-treatment to follow-up, using a physician-rated visual analogue scale (VAS). Secondary outcomes were the Patient Observer Scar Assessment Scale (physician- and parent-rated) and a VAS (child-rated), assessing the residual lesion. In total, 103 children (35 treated with propranolol, 68 with atenolol) were analysed. No differences were found between children treated with propranolol and children treated with atenolol on physician-rated VAS (p = 0.10) or any secondary outcomes. Physicians indicated a large aesthetic improvement from pre-treatment to follow-up. Physicians, parents and children were positive about the current state of the residual lesion. Minor sequelae were common (86%). These results, in combination with the favourable safety profile of atenolol, should be considered when choosing beta-blocker treatment for infantile haemangioma

We report a case of disseminated cutaneous Mycobacterium chelonae infection in a patient who was treated with chemotherapy for acute myeloid leukemia. We discuss the clinical manifestations, diagnosis, and treatment of this unusual infection in neutropenic patients.