Identification of N-homocysteinylated apolipoprotein AI in normal human serum

Background: In human serum, a portion of homocysteine (Hcy) exists as an N-linked form to the {varepsilon}-amino group of protein lysine residues. N-homocysteinylated proteins differ structurally and functionally from native proteins. The present study strives to develop detection and potential semi-quantification methods for N-homocysteinylated apolipoprotein AI (N-Hcy-apoAI) in human serum.Methods: Serum treated with or without cysteamine was supplied to isoelectric focusing (IEF) followed by an immunoblot using an anti-apoAI antibody. Cysteamine treatment increased the isoelectric point for N-Hcy-apoAI, but not for unmodified apoAI, due to the presence of -SH group(s) derived from Hcy and the absence of a cysteine residue in the apoAI molecule. N-Hcy-apoAI was semi-quantified from the scanned immunoblot pattern via a computer.Results: After cysteamine treatment, N-Hcy-apoAI in the serum was identified by IEF at the position with a higher pI value compared with intact apoAI. The reproducibility (between assays) of the semi-quantification method was 19.1% CV (coefficient of variation) for an average ratio 5.9% of N-Hcy-apoAI to the whole apoAI in the serum. Approximately 1.0–7.4% of apoAI was N-homocysteinylated in the serum obtained from 27 healthy subjects. Neither the ratio of N-Hcy-apoAI nor its concentration, calculated by total apoAI concentration, indicated correlation with the so-called total (free and S-linked) Hcy concentration.Conclusions: We directly found that a portion of apoAI in the serum undergoes homocysteinylation in an N-linkage manner, and used this to develop a potential semi-quantification method for N-Hcy-apoAI

Pandemic A/H1N1v influenza 2009 in hospitalized children: a multicenter Belgian survey

<p>Abstract</p> <p>Background</p> <p>During the 2009 influenza A/H1N1v pandemic, children were identified as a specific "at risk" group. We conducted a multicentric study to describe pattern of influenza A/H1N1v infection among hospitalized children in Brussels, Belgium.</p> <p>Methods</p> <p>From July 1, 2009, to January 31, 2010, we collected epidemiological and clinical data of all proven (positive H1N1v PCR) and probable (positive influenza A antigen or culture) pediatric cases of influenza A/H1N1v infections, hospitalized in four tertiary centers.</p> <p>Results</p> <p>During the epidemic period, an excess of 18% of pediatric outpatients and emergency department visits was registered. 215 children were hospitalized with proven/probable influenza A/H1N1v infection. Median age was 31 months. 47% had ≥ 1 comorbid conditions. Febrile respiratory illness was the most common presentation. 36% presented with initial gastrointestinal symptoms and 10% with neurological manifestations. 34% had pneumonia. Only 24% of the patients received oseltamivir but 57% received antibiotics. 10% of children were admitted to PICU, seven of whom with ARDS. Case fatality-rate was 5/215 (2%), concerning only children suffering from chronic neurological disorders. Children over 2 years of age showed a higher propensity to be admitted to PICU (16% vs 1%, p = 0.002) and a higher mortality rate (4% vs 0%, p = 0.06). Infants less than 3 months old showed a milder course of infection, with few respiratory and neurological complications.</p> <p>Conclusion</p> <p>Although influenza A/H1N1v infections were generally self-limited, pediatric burden of disease was significant. Compared to other countries experiencing different health care systems, our Belgian cohort was younger and received less frequently antiviral therapy; disease course and mortality were however similar.</p

Sakurajima volcano: a physico-chemical study of the health consequences of long-term exposure to volcanic ash

Regular eruptions from Sakurajima volcano, Japan, repeatedly cover local urban areas with volcanic ash. The frequency of exposure of local populations to the ash led to substantial concerns about possible respiratory health hazards, resulting in many epidemiological and toxicological studies being carried out in the 1980s. However, very few mineralogical data were available for determination of whether the ash was sufficiently fine to present a respiratory hazard. In this study, we review the existing studies and carry out mineralogical, geochemical and toxicological analyses to address whether the ash from Sakurajima has the potential to cause respiratory health problems. The results show that the amount of respirable (<4 μm) material produced by the volcano is highly variable in different eruptions (1.1–18.8 vol.%). The finest samples derive from historical, plinian eruptions but considerable amounts of respirable material were also produced from the most recent vulcanian eruptive phase (since 1955). The amount of cristobalite, a crystalline silica polymorph which has the potential to cause chronic respiratory diseases, is ~3–5 wt.% in the bulk ash. Scanning electron microscope and transmission electron microscope imaging showed no fibrous particles similar to asbestos particles. Surface reactivity tests showed that the ash did not produce significant amounts of highly reactive hydroxyl radicals (0.09–1.35 μmol m−2 at 30 min.) in comparison to other volcanic ash types. A basic toxicology assay to assess the ability of ash to rupture the membrane of red blood cells showed low propensity for haemolysis. The findings suggest that the potential health hazard of the ash is low, but exposure and respiratory conditions should still be monitored given the high frequency and durations of exposure

Characterizing pediatric high frequency users of California emergency departments

ObjectiveEmergency department (ED) utilization has increased for the last several decades. Despite a focus on adult frequent ED users, little research has examined pediatric frequent ED users. The purpose of this study was to assess pediatric ED utilization in California and to describe those identified as frequent ED users.MethodsThis was a retrospective multi-facility study of ED visits by children 1-17 years of age using statewide data from the California Office of Statewide Health Planning and Development. Patients were classified into utilization groups by the number of ED visits in a one-year period prior to their last visit in 2016: occasional (1-5 visits) vs. frequent (&gt;5 visits). Differences in patient characteristics were compared between occasional and frequent users.ResultsThere were 690,130 patients between 1 and 17 years of age with 1,238,262 visits during the study period. Children with ≥6 visits (2.3%) accounted for 9.3% of all visits. 67% of frequent users had no visits to a pediatric ED. Over 40% (41.4%) of frequent users visited 2 or more hospitals, compared to 7.7% of occasional users. In multivariate analysis, the characteristics with the largest associations with frequent ED use were age, payer, and being admitted/transferred.ConclusionsThe majority of pediatric frequent users do not seek care in pediatric EDs. Age, prior admission, and Medicare/Medicaid appear to have the largest associations with pediatric patient frequent ED utilization