An Atypical Cause Of Atypical Hemolytic Uremic Syndrome

Atypical hemolytic syndrome is an extremely rare, life threatening, progressive disease. Approximately one to two cases per million are seen annually in the US (3,4). It is known to be associated with variety of conditions including infections, drugs, autoimmune conditions, vaccination, malignancy, organ transplantation, pregnancy, and metabolic conditions (11,13).We hereby describe a case of atypical hemolytic uremic syndrome associated with CABG surgery. A 58 year old female presented to the emergency department (ED) with three days of worsening shortness of breath and cold like symptoms including nausea, vomiting and rhinorrhea. Twenty six days prior to presentation she had undergone Coronary Artery Bypass Graft (CABG) for three vessel disease. The physical examination was unremarkable. Labs showed anemia, acute renal injury and thrombocytopenia. A peripheral smear demonstrated over 10 per high-power field of schistocytes. She was presumptively diagnosed with Thrombotic Thrombocytopenic Purpura (TTP) and started on plasmapheresis. ADAMSTS-13 was normal and autoimmune workup was negative. After an extensive workup she was diagnosed with Atypical Hemolytic Uremic Syndrome (aHUS). To our knowledge this is the first case of aHUS associated with CABG. In fact, there has been only one other case of aHUS related to cardiac surgery which was found in a child who underwent Tetralogy of Fallot repair (1). Key Words: Atypical hemolytic uremic syndrome, CABG, TTP, Acute renal failure, Thrombocytopeni

Humor Works in Funny Ways: Examining Satirical Tone as a Key Determinant in Political Humor Message Processing

This multi-experiment study builds upon extant political entertainment theory, testing whether satire type (horatian versus juvenalian) cues varying processing mechanisms (message discounting versus resource allocation), and if consequential differences to argument scrutiny levels or message persuasiveness result. Using novel stimuli (e.g., animated cartoons, study one) and real-world late-night political satire (The Daily Show and The Colbert Report, study two), results suggest that satire type was a key antecedent in political humor message processing. Additionally, the varying mechanisms had differential effects on political argument scrutiny levels and message persuasiveness

Veterinary Students’ Knowledge and Perceptions About Antimicrobial Stewardship and Biosecurity—A National Survey

A better understanding of veterinary students’ perceptions, attitudes, and knowledge about antimicrobial stewardship and biosecurity could facilitate more effective education of future veterinarians about these important issues. A multicenter cross-sectional study was performed by administering a questionnaire to veterinary students expected to graduate in 2017 or 2018 in all Australian veterinary schools. Four hundred and seventy-six of 1246 students (38%) completed the survey. Many students were unaware of the high importance of some veterinary drugs to human medicine, specifically enrofloxacin and cefovecin (59% and 47% of responses, respectively). Fewer than 10% of students would use appropriate personal protective equipment in scenarios suggestive of Q fever or psittacosis. Students expected to graduate in 2018 were more likely to select culture and susceptibility testing in companion animal cases (OR 1.89, 95% CI 1.33–2.69, p < 0.001), and were more likely to appropriately avoid antimicrobials in large animal cases (OR 1.75, 95% CI 1.26–2.44, p = 0.001) than those expected to graduate in 2017. However, 2018 graduates were less likely to correctly identify the importance rating of veterinary antimicrobials for human health (OR 0.48, 95% CI 0.34–0.67, p < 0.001) than 2017 graduates. Students reported having a good knowledge of antimicrobial resistance, and combating resistance, but only 34% thought pharmacology teaching was adequate and only 20% said that teaching in lectures matched clinical teaching. Efforts need to be made to harmonize preclinical and clinical teaching, and greater emphasis is needed on appropriate biosecurity and antimicrobial stewardship

The Development of a Novel Interprofessional Education Curriculum for third year medical and pharmacy students

Abstract Introduction: The Liaison Committee on Medical Education and the Accreditation Council for Pharmacy Education, agencies responsible for the accreditation of medical and pharmacy schools respectively, require interprofessional education (IPE) to be integrated into both curricula. Institutions are given the autonomy to design and implement this requirement, however research is equivocal in regards to when and how best to implement IPE. The development of a new IPE curriculum is often met with a number of challenges, such as a lack of faculty support and resources. Methods: This study describes a newly created pilot IPE curriculum developed with minimal existing organizational IPE structure and resources, led by faculty champions from two complementary healthcare professions, Internal Medicine and Pharmacy. The validated 10-item Student Perceptions of Interprofessional Clinical Education- Revised (SPICE-R) instrument was used to assess the medical and pharmacy students’ attitudes towards interprofessional healthcare teams and the team approach to patient care. Results: Overall, students demonstrated a statistically significant increase in their perception of interprofessional healthcare teams and team approach to patient care. Conclusion: Prior to this IPE curriculum no formal IPE curriculum existed in this setting. This IPE curriculum was successfully implemented with minimal existing resources, the use of faculty champions and student’s perception of IPE improved using the validated SPICE-R instrument. IPE curriculum integration at our institution is in various stages of development. As IPE integration moves forward this pilot can serve as one example of how IPE could be implemented

An Atypical Cause Of Atypical Hemolytic Uremic Syndrome

Atypical hemolytic syndrome is an extremely rare, life threatening, progressive disease. Approximately one to two cases per million are seen annually in the US (3,4). It is known to be associated with variety of conditions including infections, drugs, autoimmune conditions, vaccination, malignancy, organ transplantation, pregnancy, and metabolic conditions (11,13).We hereby describe a case of atypical hemolytic uremic syndrome associated with CABG surgery. A 58 year old female presented to the emergency department (ED) with three days of worsening shortness of breath and cold like symptoms including nausea, vomiting and rhinorrhea. Twenty six days prior to presentation she had undergone Coronary Artery Bypass Graft (CABG) for three vessel disease. The physical examination was unremarkable. Labs showed anemia, acute renal injury and thrombocytopenia. A peripheral smear demonstrated over 10 per high-power field of schistocytes. She was presumptively diagnosed with Thrombotic Thrombocytopenic Purpura (TTP) and started on plasmapheresis. ADAMSTS-13 was normal and autoimmune workup was negative. After an extensive workup she was diagnosed with Atypical Hemolytic Uremic Syndrome (aHUS). To our knowledge this is the first case of aHUS associated with CABG. In fact, there has been only one other case of aHUS related to cardiac surgery which was found in a child who underwent Tetralogy of Fallot repair (1)

The N-terminal intrinsically disordered domain of mgm101p is localized to the mitochondrial nucleoid.

The mitochondrial genome maintenance gene, MGM101, is essential for yeasts that depend on mitochondrial DNA replication. Previously, in Saccharomyces cerevisiae, it has been found that the carboxy-terminal two-thirds of Mgm101p has a functional core. Furthermore, there is a high level of amino acid sequence conservation in this region from widely diverse species. By contrast, the amino-terminal region, that is also essential for function, does not have recognizable conservation. Using a bioinformatic approach we find that the functional core from yeast and a corresponding region of Mgm101p from the coral Acropora millepora have an ordered structure, while the N-terminal domains of sequences from yeast and coral are predicted to be disordered. To examine whether ordered and disordered domains of Mgm101p have specific or general functions we made chimeric proteins from yeast and coral by swapping the two regions. We find, by an in vivo assay in S.cerevisiae, that the ordered domain of A.millepora can functionally replace the yeast core region but the disordered domain of the coral protein cannot substitute for its yeast counterpart. Mgm101p is found in the mitochondrial nucleoid along with enzymes and proteins involved in mtDNA replication. By attaching green fluorescent protein to the N-terminal disordered domain of yeast Mgm101p we find that GFP is still directed to the mitochondrial nucleoid where full-length Mgm101p-GFP is targeted