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Since the advent of highly active antiretroviral treatment, CMV retinitis has become much less frequent. Nevertheless, cases do occur in HIV patients who have either failed HIV therapy or as an AIDS-presenting diagnosis [ 73 ]. In addition, CMV retinitis has been a well-recognized complication of bone marrow and solid organ transplantation, less frequent recently due to improvements in preemptive detection and therapy. CMV retinitis is frequently diagnosed clinically because of characteristic lesions seen on ophthalmologic examination. Quantitative CMV NAAT performed on peripheral blood is also a useful tool in the diagnosis and management of this infection. Patients with detectable CMV viral loads have a higher likelihood of retinal disease progression, and those with high CMV viral loads have increased mortality. Patients with undetectable CMV viral loads have a low likelihood of having virus that is resistant to antiviral agents [ 74 ]. Because of interlaboratory variation in viral quantification, what represents a positive CMV viral load and a high CMV viral load will vary among laboratories [ 75 ]. Physicians should consult the laboratory performing the CMV viral load for assistance with test interpretation.

Patients with ocular syphilis may present with normal CSF or may frequently have CNS findings associated with either acute syphilitic meningitis or neurosyphilis. Patients with syphilitic uveitis typically have high rapid plasma reagin (RPR) titers [ 67 ]. Cell counts, total protein, and glucose, along with Venereal Disease Research Laboratory (VDRL) testing of CSF, are recommended in clinical settings where syphilitic uveitis is suspected [ 67 ].

Finally, metagenomics analysis is beginning to be applied in research settings for the diagnosis of unusual cases of uveitis. This diagnostic approach is likely to be available for the diagnosis of endophthalmitis, uveitis, and retinitis in the near future [ 76 ].

Infection of various spaces and tissues that occur in the head and neck can be divided into those arising from odontogenic, oropharyngeal, or exogenous sources. Odontogenic infections are caused commonly by endogenous periodontal or gingival flora [ 77 ]. These infections include peritonsillar and pharyngeal abscesses; deep space abscesses, such as those of the retropharyngeal, parapharyngeal, submandibular, and sublingual spaces; and cervical lymphadenitis [ 78 , 79 ]. Complications of odontogenic infection can occur by hematogenous spread or by direct extension resulting in septic jugular vein thrombophlebitis (Lemierre syndrome), bacterial endocarditis, intracranial abscess, or acute mediastinitis [ 80 , 81 ]. Accurate etiologic diagnosis depends upon collection of an aspirate or biopsy of inflammatory material from affected tissues and tissue spaces while avoiding contamination with mucosal microbiota. The specimen should be placed into an anaerobic transport container to support the recovery of anaerobic bacteria (both aerobic and facultative bacteria survive in anaerobic transport). Requests for Gram-stained smears are standard for all anaerobic cultures because they allow the laboratorian to evaluate the adequacy of the specimen by identifying inflammatory cells, provide an early presumptive etiologic diagnosis, and identify morphologic patterns indicative of mixed aerobic and anaerobic infections [ 82 ]. Additionally, spirochetes (often involved in odontogenic infection) cannot be recovered in routine anaerobic cultures but will be seen in the stained smear.

The Haider Moranis Bulletin: Speculators played a critical role in erecting thousands of residential buildings in Paris a little over a century ago

Special to Financial Post
Murtaza Haider and Stephen Moranis

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Speculation can be good for housing markets — just look at Paris
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What good could possibly come out of speculation in housing markets?

If you guessed Paris, you guessed right.

The dominant discourse in Canada right now holds a pejorative view of speculation in property markets.

Foreign and local investors are dubbed as speculators and are held partially or wholly responsible for the worsening of affordability, especially in and around Vancouver and Toronto.

Even the governments are convinced of speculation is bad. Ontario, for instance, introduced a new tax last year and branded it as the Non-resident Speculation Tax.

At the same time, Canadian urbanists never tire of singing the praises of all things Paris. They are not alone. We are all in awe of the boulevards, the courtyards, the façades, the monuments and the parks.

But while Paris’s built form is there for all to admire, what is not at all apparent is the critical role played by investors and speculators in erecting thousands of residential buildings a little over a century ago, when Paris grew by a million residents in a matter of decades.

If it were not for the ingenuity of architects-turned-financiers, Paris would have been much smaller in size and possibly grandeur.

The city builders in late-nineteenth century Paris realized that the demand for urban housing far exceeded the supply and the only way to catch up was to create new financial channels to funnel money into the new housing projects.

In a meticulous study of the city builders of the late 19th-century Paris, Alexia Yates, a professor of economic history at the University of Manchester and a native of Pouch Cove, Newfoundland, reveals the financial underpinnings of a building boom that was unprecedented at the time and has few parallels in modern-day Europe.

Her book, Selling Paris: Property and Commercial Culture in the Fin-de-siècle Capital, broadens the conversation from the city’s urban design to the financing tools and institutions that helped make Paris what it is today.

While Haussmann dominates the usual discourse about the City of Light, Professor Yates introduces us to others whose buildings are scattered across the city, but whose names have “not come down to posterity.”

In 1875, just past the site of the under-construction Sacré-Cœur Basilica, the Montmartre Real Estate Company had established the largest worksite in Paris where hundreds of workers were busy erecting new roads and 88 apartment buildings on a 32,000 square metre site.

Between 1879 and 1885, no fewer than 13,500 buildings were erected across Paris, which increased the rental value of the housing stock by at least a quarter.

Most new housing in late 19th-century Paris was built for renters. Hence most of those who invested in construction had no plans to live in the buildings they helped finance. The new rental stock had become part of investment portfolios. Between 1870 and 1900, 253 real estate companies were established in Paris to fund real estate development.

As is the case today in Canada, there were detractors who found everything wrong with the credit-financed construction on the industrial footing. What they couldn’t foresee was the adverse impact of not being able to house the ever-increasing number of new urban residents who were moving to Paris from all over.

Parisian architects and engineers embraced not just finance, but also “big data,” analytics, marketing and media to prepare the ground for a boom in housing construction. The architects became newspaper columnists in Le Figaro with weekly columns on marché immobilier starting as early as in 1881. The engineers published comprehensive stats on property transactions and generated choropleth maps to demonstrate trends in property markets and demographics.

In Canada, city building remains a conflicted affair.

Construction depends upon risk capital that investors bring at the early planning stages when buildings and neighbourhoods are nothing more than sketches on a piece of paper. They invest — call it speculation — in the idea of future buildings and neighbourhoods.

Investors, foreign and local, can end up financing great cities. Just look at Paris if you are not convinced.

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When a small terrier showed up in the Boston suburb of Milton recently, its adventures — and ability to elude capture — quickly caught the attention of the community. Given the details of the story, the Globe has decided to tell it in the form of a children’s book. The following is based on animal control reports, security camera photos, and interviews with those who encountered the curious little dog.

Photo illustration credits: JStaley401/iStock

O ne day, in the friendly little town of Milton, a mysterious visitor arrived out of the blue.

The little dog was a sight to behold. Its brown and gray fur was long and stringy. It wore no collar. No one could say where, exactly, it had come from. But before long, they began spotting the little dog all over town.

There it was at Milton Academy on Centre Street...

And in the woods behind Brook Road.

There it was, too, at the town cemetery, frolicking among the gravestones.

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One evening, Mr. Murphy came home to find the little dog trotting out of his garage. Ms. Wells spotted it strutting across two lanes of traffic. Over on Aberdeen Road, Ms. Bilewicz glanced out her window one afternoon to discover the dog curled up in her backyard, taking a nap. * The red-roof house represents where the dog was spotted.

Photo illustration credits: LeFion/iStock

“Who was this little dog?” the townspeople wondered. Surely, it must be cold and hungry. Wasn’t it scared out there, all alone at night with the coyotes?

Yet, try as they might, no one could manage to wrangle the little dog.

Day after day, week after week, the pup roamed free.

Stumped, the townspeople turned to Ms. Bersani, the local animal control officer. Ms. Bersani loved animals. She had three dogs of her own. If anyone could catch this furry fugitive, it was her.

But even Ms. Bersani proved no match for the speedy little pup.

“This dog,” she grumbled, “is going to be the end of me."

Then one day last month, just as it was beginning to look like the mysterious little dog might never be caught, Ms. Bersani got an idea. She drove to Dunkin’ Donuts and purchased a bacon, egg, and cheese breakfast sandwich. She unwrapped the treat and placed it inside a large metal trap. And then she waited.

Sure enough, the little dog eventually took the bait. It wandered toward the trap. It sniffed in the direction of the breakfast sandwich. Then it stepped inside... went the trap. went the dog. went Ms. Bersani.

Later that day, at the town vet, Ms. Bersani gave the dog a bath and plucked the ticks from its fur. The little terrier looked up at her happily, its pink tongue poking from its mouth.

But still, the little dog had no home. No one had come forward to claim the pup. And for the next month or so, it sat in a cage at the town shelter, waiting for anyone who might want it. And that's where it remained, until a man in Boston opened the newspaper one day and read about a little dog in need of an owner.

The man, whose name was Mr. Sitzler, lived alone. He had no children. His wife had passed away years earlier. Lately, he had been thinking about getting a dog, to keep him company. There was something about this dog's story he couldn't stop thinking about.

And so, one afternoon last week, Mr. Sitzler drove to the shelter. He smiled as the little dog jumped at his feet. He whispered kindly to it as he held it in his arms. Then he loaded the little dog into his car, drove it back to Boston, and -- as the dog's tail wagged and wagged -- led it up the stairs and through the front door of his apartment.

"This," Mr. Sitzler said to the little dog, " is your home now."

Photo illustration credits: John Tlumacki, Eva Maldonado Audio: Taylor de Lench

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