Mcneilkromann3801

To assess demographic, clinical, and biomarker features distinguishing patients with multisystem inflammatory syndrome in children (MIS-C); compare MIS-C sub-phenotypes; identify cytokine biosignatures; and characterize viral genome sequences.

We performed a prospective observational cohort study of 124 children hospitalized and treated under the institutional MIS-C Task Force protocol from March to September 2020 at Children's National, a quaternary freestanding children's hospital in Washington, DC. Of this cohort, 63 of the patients had the diagnosis of MIS-C (39 confirmed, 24 probable) and 61 were from the same cohort of admitted patients who subsequently had an alternative diagnosis (controls).

Median age and sex were similar between MIS-C and controls. Black (46%) and Latino (35%) children were over-represented in the MIS-C cohort, with Black children at greatest risk (OR 4.62, 95% CI 1.151-14.10; P=.007). Cardiac complications were more frequent in critically ill patients with MIS-C (55% vs 28%; characterized large cohort of MIS-C evaluated and treated following a standardized protocol and identifies key clinical, biomarker, cytokine, viral load, and sequencing features. Long-term follow-up will provide opportunity for future insights into MIS-C and its sequelae.

This study establishes a well-characterized large cohort of MIS-C evaluated and treated following a standardized protocol and identifies key clinical, biomarker, cytokine, viral load, and sequencing features. Long-term follow-up will provide opportunity for future insights into MIS-C and its sequelae.

To determine the prevalence of and identify factors associated with gastrointestinal (GI) symptoms among patients with channelopathy-associated developmental and epileptic encephalopathy (DEE).

Parents of 168 patients with DEEs linked to SCN1A (N=59), KCNB1 (N=31), or KCNQ2 (N=78) completed online CLIRINX surveys about their children's GI symptoms. Analysis examined prevalence, frequency, and severity of GI symptoms, as well as DEE type, functional mobility, feeding difficulties, ketogenic diet, anti-seizure medication, autism spectrum disorder (ASD), and seizures. Statistical analyses included chi-square tests, Wilcoxon rank-sum analyses, and multiple logistic regression.

Patients (median age of 6.3 years; 92 [55%] females) included 59 (44%) with SCN1A-DEE, 31 (35%) with KCNB1-DEE, and 78 (71%) with KCNQ2-DEE. GI symptoms were reported in 92/168 (55%) patients among whom 63/86 (73%) reported daily or weekly symptoms, 29/92 (32%) had frequent or serious discomfort, and 13/91 (14%) had appetite disturbances as a result. After adjustment for DEE type, current use of ketogenic diet (6% reported), and gastrostomy tube (13% reported) were both associated with GI symptoms in a statistically, but not clinically significant manner (P < .05). Patient age, functional mobility, feeding difficulties, ASD, and seizures were not clearly associated with GI symptoms. Overall, no individual anti-seizure medication was significantly associated with GI symptoms.

GI symptoms are common and frequently severe in DEE patients.

GI symptoms are common and frequently severe in DEE patients.Solar ultraviolet radiation (UV) can have a wide range of negative effects on animal fitness that take place not only during, but also after exposure (carryover effects). UV-induced carryover effects and potential adaptations to avoid or mitigate them are understudied in terrestrial animals, including arthropods and their potentially most vulnerable life stages. The spined soldier bug, Podisus maculiventris, increases the emergence of its eggs that are exposed to UV radiation by coating them in sunscreen-like pigmentation, but consequences of these conditions of embryonic development for nymphs and adults are unknown. We measured stink bug nymph survival, adult size and sex ratio following exposure of differently pigmented eggs across a range of UV intensities. Nymph survival to adulthood decreased with higher intensity of embryonic UV exposure and this carryover effect decreased with higher level of egg pigmentation, similar to previously observed effects on embryonic survival. Nymph development time, adult size and sex ratio were not affected by embryonic exposure to UV radiation nor by photoprotective egg pigmentation. This study is the first to demonstrate the potential for lethal carryover effects of UV radiation in terrestrial insects, highlighting the need for more studies of how this pervasive environmental stressor can affect fitness across life stages.Whilst intraepithelial lymphocytes (IELs) are considered normal within the distal esophageal mucosa, they have an increasingly recognised role in the pathogenesis of reflux esophagitis, and IEL quantification establishes the diagnosis of lymphocytic esophagitis. Knowledge regarding the upper limit of a normal IEL count in health is lacking. We studied 117 non-healthcare seeking adult volunteers from a random community sample (the Kalixanda study) with esophageal biopsies 2 cm above the gastroesophageal junction. Miransertib mouse Subjects were divided into four groups based on the presence or absence of gastro-esophageal reflux symptoms and/or esophagitis on endoscopy. Asymptomatic subjects with no endoscopic esophagitis were selected as controls, and the cell counts in this group were used to define the upper limit of normal of IELs, eosinophils and neutrophils. The entire sample was used to identify independent predictors of increased cellular counts by logistic regression analysis. None of the healthy controls had an IEL count of more than three per five high power fields (HPF), and therefore this was considered as the upper limit of normal; no controls had eosinophils or neutrophils in esophageal biopsies. Independent predictors of an elevated IEL count were spongiosis on histology (OR 11.17, 95% CI 3.32-37.58, P less then 0.01) and current smoking (OR 4.84, 95% CI 1.13-2.71, P = 0.03). A receiver operating characteristics analysis concluded that a threshold of 3 IELs/5HPFs performs best in predicting reflux symptoms when a normal esophageal mucosa is visualized on endoscopy (sensitivity = 100.0%, specificity = 35.2%). The healthy esophageal mucosa does not contain more than three IELs per five HPF in the distal esophagus.