Macdonaldmcgrath3958
Acute chest syndrome (ACS) is the leading cause of death for children with sickle cell disease (SCD). Recurrent ACS has detrimental effects on pulmonary health and health care costs. Neighborhood characteristics affect the outcomes of many pediatric chronic diseases, but their role in SCD is not well studied. In this study, we investigated the effects of area-level socioeconomic deprivation and racial composition on the recurrence of ACS.
We performed a retrospective cross-sectional analysis of clinical data from a large pediatric SCD center. Patients' residential addresses were geocoded and linked to a composite area deprivation index (ADI) and percent African American population at the level of Census block groups. The association of recurrent ACS with neighborhood characteristics was evaluated using logistic regression analysis.
The sample included 709 children with SCD. Residence in a socioeconomically deprived neighborhood was associated with 27% less risk of recurrent ACS, and residence in a predominantly African American neighborhood was associated with 41% less risk of ACS recurrence. The racial composition explained the protective effect of living in a high-deprivation area after adjusting for sociodemographic and clinical covariates. Demographic and clinical factors associated with recurrent ACS included older age, male gender, asthma, hydroxyurea use, and chronic transfusion therapy.
This is the first study to report a protective effect of residing in a predominantly African American community for ACS recurrence. Further prospective studies are needed to confirm the association and to understand the mechanisms of such relationship.
This is the first study to report a protective effect of residing in a predominantly African American community for ACS recurrence. Further prospective studies are needed to confirm the association and to understand the mechanisms of such relationship.Plasma cells are usually absent in normal bronchoalveolar lavage (BAL) fluids. Frequent plasma cells in BAL are always pathologically significant. They raise a rather narrow differential diagnosis, predominantly extrinsic allergic alveolitis and few other interstitial lung diseases. BAL is a key diagnostic procedure for certain lung diseases. Because plasma cells are uncommon in BAL fluids and usually associated with limited conditions compared to other more common interstitial lung diseases, the focus of cell count differentials in BAL fluids was on other mononuclear and granulocytic inflammatory cells. Recently, cases of IgG4 positive plasma cell-related lung diseases have been reported in tissue specimens. learn more This may raise the importance of cytologically recognizing plasma cells in BAL fluids. We report a case of a 16-year-old boy with clinical and radiologic features of diffuse interstitial lung disease. His BAL cytology showed frequent plasma cells. Endobronchial biopsy showed substantial infiltration by plasma cells confirmed by immunohistochemistry. After excluding other lung diseases, the possibility of IgG4 plasma cell-related disease was raised. Blood tests showed elevated serum levels of IgG4. This case emphasizes the importance of including of IgG4 plasma cell-related lung disease as a possible differential diagnosis. This should prompt proper serologic tests for confirmation and appropriate management. With increasing reports of IgG4-related lung disease, cytopathologists should be aware of this possibility when examining BAL fluids. Measurement of IgG levels in BAL fluids and plasma cell immunophenotyping might be promising tools.
Spontaneous oscillations in the somatosensory cortex, especially of the alpha (8-14Hz) and gamma (60-80Hz) frequencies, affect tactile perception; moreover, these oscillations can be selectively modulated by frequency-matched transcranial alternating current stimulation (tACS) on the basis of ongoing oscillatory brain activity. To examine whether tACS can actually improve tactile perception via alpha and gamma modulation, we measured the effects of 10-Hz and 70-Hz tACS (α- and γ-tACS) on the left somatosensory cortex on right-finger tactile spatial orientation discrimination, and the associations between performance changes and individual alpha and gamma activities.
Fifteen neurologically healthy subjects were recruited into this study. Electroencephalography (EEG) was performed before the first day, to assess the normal alpha- and gamma-activity levels. A grating orientation discrimination task was performed before and during 10-Hz and 70-Hz tACS.
The 10-Hz tACS protocol decreased the grating orientation discrimination threshold, primarily in subjects with low alpha event-related synchronization (ERS). In contrast, the 70-Hz tACS had no effect on the grating orientation discrimination threshold.
This study showed that 10-Hz tACS can improve tactile orientation discrimination in subjects with low alpha activity. Alpha-frequency tACS may help identify the contributions of these oscillations to other neurophysiological and pathological processes.
This study showed that 10-Hz tACS can improve tactile orientation discrimination in subjects with low alpha activity. Alpha-frequency tACS may help identify the contributions of these oscillations to other neurophysiological and pathological processes.The hexapeptide hIAPP22-27 (NFGAIL) is known as a crucial amyloid core sequence of the human islet amyloid polypeptide (hIAPP) whose aggregates can be used to better understand the wild-type hIAPP's toxicity to β-cell death. In amyloid research, the role of hydrophobic and aromatic-aromatic interactions as potential driving forces during the aggregation process is controversially discussed not only in case of NFGAIL, but also for amyloidogenic peptides in general. We have used halogenation of the aromatic residue as a strategy to modulate hydrophobic and aromatic-aromatic interactions and prepared a library of NFGAIL variants containing fluorinated and iodinated phenylalanine analogues. We used thioflavin T staining, transmission electron microscopy (TEM) and small-angle X-ray scattering (SAXS) to study the impact of side-chain halogenation on NFGAIL amyloid formation kinetics. Our data revealed a synergy between aggregation behavior and hydrophobicity of the phenylalanine residue. This study introduces systematic fluorination as a toolbox to further investigate the nature of the amyloid self-assembly process.