This case report highlights details of a case of critical acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) with B1.1.7 variant in a 4-year-old girl who died due to pneumonia and pulmonary hemorrhage. The girl was referred to our University ECMO Center from another University hospital for veno-arterial extracorporeal membrane oxygenation (VA-ECMO). In the clinical course, superinfection with Pseudomonas aeruginosa was detected. Virological evidence of herpes simplex sepsis was also obtained in blood samples on her day of death. Transcription polymerase chain reaction (PCR) confirmed SARS-CoV-2 infection in lung tissue. Postmortem computed tomography showed pulmonary hemorrhage with inhomogeneous density values in both lungs. Lung tissue showed no ventilated areas. Autopsy revealed a massively congested lung with evidence of acute respiratory distress syndrome (ARDS) and pneumonia with multiple abscesses. Histopathology showed a mixture of diffuse alveolar injury with hyaline membranes, massive hemorrhage, and bronchopneumonia with multiple granulocytic abscesses. Cardiac examination revealed pericarditis. Suspicion of myocarditis or myocardial infarction could not be confirmed microscopically. To our knowledge, this is the first autopsy-based case report of the death of a previously healthy child due to the new variant B 1.1.7 in Germany.

The number of pediatric procedural sedations for diagnostic and minor therapeutic procedures performed outside the operating room has increased. Therefore, we established a specialized interdisciplinary team of pediatric anesthesiologists and intensivists (Children’s Analgosedation Team, CAST) at our tertiary-care university hospital and retrospectively analyzed the first year after implementation of the CAST. Within one year, 784 procedural sedations were performed by the CAST; 12.2% of the patients were infants <1 year, 41.9% of the patients were classified as American Society of Anesthesiologists (ASA) grade III or IV. Most children received propofol (79%) and, for painful procedures, additional esketamine (48%). Adverse events occurred in 51 patients (6.5%), with a lack of professional experience (OR 0.60; 95% CI 0.42–0.81) and increased propofol dosage (OR 1.33; 95% CI 1.17–1.55) being significant predictors. Overall, the CAST enabled safe and effective procedural sedation in children outside the operating room.

Critical Coronavirus disease 2019 (COVID-19) developed in a 7-year-old girl with a history of dystrophy, microcephaly, and central hypothyroidism. Starting with gastrointestinal symptoms, the patient developed severe myocarditis followed by progressive multiple organ failure complicated by Pseudomonas aeruginosa bloodstream infection. Intensive care treatment consisting of invasive ventilation, drainage of pleural effusion, and high catecholamine therapy could not prevent the progression of heart failure, leading to the implantation of venoarterial extracorporeal life support (VA-ECLS) and additional left ventricle support catheter (Impella® pump). Continuous venovenous hemofiltration (CVVH) and extracorporeal hemadsorption therapy (CytoSorb®) were initiated. Whole exome sequencing revealed a mutation of unknown significance in DExH-BOX helicase 30 (DHX30), a gene encoding a RNA helicase. COVID-19 specific antiviral and immunomodulatory treatment did not lead to viral clearance or control of hyperinflammation resulting in the patient’s death on extracorporeal life support-(ECLS)-day 20. This fatal case illustrates the potential severity of pediatric COVID-19 and suggests further evaluation of antiviral treatment strategies and vaccination programs for children.

and older. Hence, we are left with the blanket statement that children are spared from severe COVID-19, an argument that is currently being used in many European countries, including the UK and Germany, to not vaccinate adolescents. Although few children become severely ill from SARS-CoV-2 infection compared with adults, the increasing number of delta variant infections will most likely result in preventable morbidity and mortality in this age group. Therefore, we call not only for pediatric clinical trials of antiviral drugs but, more importantly, for universal access to COVID-19 immunization for children and adolescents as safe and effective vaccines become licensed and available. 5

Our project on fatness begins by turning attention to the multiple cultural instances in which fatness has been intrinsically linked with notions such as self-neglect and poor self-management. In Foucauldian terms, we analyse the fat subject as a failed homo economicus, an individual who has failed to be an "entrepreneur of himself, being for himself his own capital, being for himself his own producer, being for himself the source of [his] earnings" (Foucault, 2008, p. 226). From this perspective, we analyse instances of collective hatred towards fat subjects as direct results of the biopolitical triplet of responsibility, rationality, and morality. Morality is our bridge into the field of posthumanism, in which, as we demonstrate, these biopolitical imperatives also apply, reinforced by the field's fascination with prosthetics and enhancement. Where, by biopolitical standards, fat subjects have failed to manage themselves, posthuman subjects find themselves guilty of not responsibly, rationally, and morally manipulating themselves to optimal productivity. Using criticism that disability studies scholars like Sarah S. Jain and Vivian Sobchack have voiced about posthumanism, we demonstrate the ways in which, within posthumanism, all subjects can be found as lacking when compared to their potential, enhanced posthuman version.

ZusammenfassungPlazentare Chorangiome sind als benigne Tumore des Choriongewebes seltene Ursache fetaler und maternaler Morbidität. Wir beschreiben den Fall eines großen plazentaren Chorangioms, das zu einem Polyhydramnion, konsekutiver Frühgeburt und kindlicher High-Output-Herzinsuffizienz führte. Aus einer Literaturrecherche leiten wir zudem Hinweise zur Diagnostik und Empfehlungen zur optimalen Schwangerschaftsbetreuung bei Verdacht auf Chorioangiom ab.

This study presents the results of the response of Sparus aurata to three different musical stimuli, derived from the transmission (4 h per day, 5 days per week) of particular music pieces by Mozart, Romanza and Bach (140 dB(rms) re 1 μPa), compared to the same transmission level of white noise, while the underwater ambient noise in all the experimental tanks was 121 dB(rms) re 1 μPa. Using recirculating sea water facilities, 10 groups, 2 for each treatment, of 20 specimens of 11.2 ± 0.02 g (S.E.), were reared for 94 days, under 150 ± 10 l× 12L-12D, and were fed an artificial diet three times per day. Fish body weight showed significant differences after 55 days, while its maximum level was observed after the 69th day until the end of the experiment, the highest value demonstrated in Mozart (M) groups, followed by those of Romanza (R), Bach (B), control (C) and white noise (WN). SGR (M = B), %WG (M = B) and FCR (all groups fed same % b.w.) were also improved for M group. Brain neurotransmitters results exhibited significant differences in DA-dopamine, (M > B), 5HIAA (C > B), 5HIAA:5HT (WN > R), DOPAC (M > B), DOPAC:DA and (DOPAC + HVA):DA, (C > M), while no significant differences were observed in 5HT, NA, HVA and HVA:DA. No differences were observed in biometric measurements, protease activity, % fatty acids of fillet, visceral fat and liver, while differences were observed regarding carbohydrase activity and the amount (mg/g w.w.) of some fatty acids in liver, fillet and visceral fat. In conclusion, present results confirm those reported for S. aurata, concerning the observed relaxing influence--due to its brain neurotransmitters action--of the transmission of Mozart music (compared to R and B), which resulted in the achievement of maximum growth rate, body weight and improved FCR. This conclusion definitely supports the musical "understanding" and sensitivity of S. aurata to music stimuli as well as suggesting a specific effect of white noise.

Demands in procedural sedation and analgesia in children are growing as the number of diagnostic and minor therapeutic procedures performed on paediatric patients outside the operating room setting has increased. We established a specialized interdisciplinary team of paediatric anaesthesiologists and paediatric intensivists (Children’s Analgosedation Team, CAST) for diagnostic and therapeutic procedures and aimed to analyse the incidence and risk factors of adverse events. A retrospective analysis of data collected in the first year after implementation of the interdisciplinary CAST at our tertiary care university hospital was conducted. Within one year, 784 procedural sedations were performed by the CAST. 7.4% of the patients were infants < 1 year of age. 53% of the patients were classified as American Society of Anesthesiologists (ASA) status III or IV. Most children received propofol (79%) and for painful procedures, additional esketamine (48%). Adverse events occurred in 51 patients (6.5%), most frequently apnoea (1.7%), airway obstruction (1%), and problems with the intravenous access (1%). Cancellation of the procedure occurred in four cases (0.5%). Lack of experience (OR 0.60; 95% CI 0.42-0.81) and increasing propofol dosage of 1mg kg-1 (OR 1.33; 95% CI 1.17-1.55) were identified as predictors for adverse events. ASA classification did not reveal a significant difference in complication rates. Conclusion: Increasing dosage of propofol and lack of experience were associated with adverse events in paediatric analgosedation for brief diagnostic or therapeutic procedures. Trial registration number: NCT04760249 (retrospectively registered on February 7th, 2021)