Chylous effusion presenting in a 37-year-old woman with severe hypothyroidism: a case report

<p>Abstract</p> <p>Introduction</p> <p>We report what is to the best of our knowledge the second adult case of chylothorax clearly associated with severe hypothyroidism in the English-language medical literature. To the best of our knowledge, this is the first case of its kind reported without a prior history of malignancy.</p> <p>Case presentation</p> <p>A 37-year-old Hispanic woman with no reported significant past medical history initially presented with shortness of breath and inability to lose weight. She was found to have a large chylous effusion requiring chest-tube drainage, as well as severe hypothyroidism. After several weeks of thyroid hormone-replacement therapy, the formation of chylous pleural fluid in the patient greatly diminished, and the chest tube was removed. Upon long-term follow-up her minimal residual effusion remains stable on serial chest radiographs.</p> <p>Conclusion</p> <p>Although the exact pathophysiologic relation between low thyroid hormone levels and chyle formation remains to be elucidated, hypothyroidism should be a diagnostic consideration in patients with chylous effusions, especially those refractory to conventional treatments.</p

Historical influences on the current provision of multiple ecosystem services: is there a legacy of past landcover?

Ecosystem service provision varies temporally in response to natural and human-induced factors, yet research in this field is dominated by analyses that ignore the time-lags and feedbacks that occur within socio-ecological systems. The implications of this have been unstudied, but are central to understanding how service delivery will alter due to future land-use/cover change. Urban areas are expanding faster than any other land-use, making cities ideal study systems for examining such legacy effects. We assess the extent to which present-day provision of a suite of eight ecosystem services, quantified using field-gathered data, is explained by current and historical (stretching back 150 years) landcover. Five services (above-ground carbon density, recreational use, bird species richness, bird density, and a metric of recreation experience quality (continuity with the past) were more strongly determined by past landcover. Time-lags ranged from 20 (bird species richness and density) to over 100 years (above-ground carbon density). Historical landcover, therefore, can have a strong influence on current service provision. By ignoring such time-lags, we risk drawing incorrect conclusions regarding how the distribution and quality of some ecosystem services may alter in response to land-use/cover change. Although such a finding adds to the complexity of predicting future scenarios, ecologists may find that they can link the biodiversity conservation agenda to the preservation of cultural heritage, and that certain courses of action provide win-win outcomes across multiple environmental and cultural goods

Major histocompatibility complex class I molecules protect motor neurons from astrocyte-induced toxicity in amyotrophic lateral sclerosis

Astrocytes isolated from individuals with amyotrophic lateral sclerosis (ALS) are toxic to motor neurons (MNs) and play a non–cell autonomous role in disease pathogenesis. The mechanisms underlying the susceptibility of MNs to cell death remain unclear. Here we report that astrocytes derived from either mice bearing mutations in genes associated with ALS or human subjects with ALS reduce the expression of major histocompatibility complex class I (MHCI) molecules on MNs; reduced MHCI expression makes these MNs susceptible to astrocyte-induced cell death. Increasing MHCI expression on MNs increases survival and motor performance in a mouse model of ALS and protects MNs against astrocyte toxicity. Overexpression of a single MHCI molecule, HLA-F, protects human MNs from ALS astrocyte–mediated toxicity, whereas knockdown of its receptor, the killer cell immunoglobulin-like receptor KIR3DL2, on human astrocytes results in enhanced MN death. Thus, our data indicate that, in ALS, loss of MHCI expression on MNs renders them more vulnerable to astrocyte-mediated toxicity

The Plant Pathogen Phytophthora andina Emerged via Hybridization of an Unknown Phytophthora Species and the Irish Potato Famine Pathogen, P. infestans

Emerging plant pathogens have largely been a consequence of the movement of pathogens to new geographic regions. Another documented mechanism for the emergence of plant pathogens is hybridization between individuals of different species or subspecies, which may allow rapid evolution and adaptation to new hosts or environments. Hybrid plant pathogens have traditionally been difficult to detect or confirm, but the increasing ease of cloning and sequencing PCR products now makes the identification of species that consistently have genes or alleles with phylogenetically divergent origins relatively straightforward. We investigated the genetic origin of Phytophthora andina, an increasingly common pathogen of Andean crops Solanum betaceum, S. muricatum, S. quitoense, and several wild Solanum spp. It has been hypothesized that P. andina is a hybrid between the potato late blight pathogen P. infestans and another Phytophthora species. We tested this hypothesis by cloning four nuclear loci to obtain haplotypes and using these loci to infer the phylogenetic relationships of P. andina to P. infestans and other related species. Sequencing of cloned PCR products in every case revealed two distinct haplotypes for each locus in P. andina, such that each isolate had one allele derived from a P. infestans parent and a second divergent allele derived from an unknown species that is closely related but distinct from P. infestans, P. mirabilis, and P. ipomoeae. To the best of our knowledge, the unknown parent has not yet been collected. We also observed sequence polymorphism among P. andina isolates at three of the four loci, many of which segregate between previously described P. andina clonal lineages. These results provide strong support that P. andina emerged via hybridization between P. infestans and another unknown Phytophthora species also belonging to Phytophthora clade 1c

Analysis of shared common genetic risk between amyotrophic lateral sclerosis and epilepsy

Because hyper-excitability has been shown to be a shared pathophysiological mechanism, we used the latest and largest genome-wide studies in amyotrophic lateral sclerosis (n = 36,052) and epilepsy (n = 38,349) to determine genetic overlap between these conditions. First, we showed no significant genetic correlation, also when binned on minor allele frequency. Second, we confirmed the absence of polygenic overlap using genomic risk score analysis. Finally, we did not identify pleiotropic variants in meta-analyses of the 2 diseases. Our findings indicate that amyotrophic lateral sclerosis and epilepsy do not share common genetic risk, showing that hyper-excitability in both disorders has distinct origins

GROWTH on S190425z: Searching Thousands of Square Degrees to Identify an Optical or Infrared Counterpart to a Binary Neutron Star Merger with the Zwicky Transient Facility and Palomar Gattini-IR

The third observing run by LVC has brought the discovery of many compact binary coalescences. Following the detection of the first binary neutron star merger in this run (LIGO/Virgo S190425z), we performed a dedicated follow-up campaign with the Zwicky Transient Facility (ZTF) and Palomar Gattini-IR telescopes. The initial skymap of this single-detector gravitational wave (GW) trigger spanned most of the sky observable from Palomar Observatory. Covering 8000 deg2 of the initial skymap over the next two nights, corresponding to 46% integrated probability, ZTF system achieved a depth of ≈21 m AB in g- and r-bands. Palomar Gattini-IR covered 2200 square degrees in J-band to a depth of 15.5 mag, including 32% integrated probability based on the initial skymap. The revised skymap issued the following day reduced these numbers to 21% for the ZTF and 19% for Palomar Gattini-IR. We narrowed 338,646 ZTF transient "alerts" over the first two nights of observations to 15 candidate counterparts. Two candidates, ZTF19aarykkb and ZTF19aarzaod, were particularly compelling given that their location, distance, and age were consistent with the GW event, and their early optical light curves were photometrically consistent with that of kilonovae. These two candidates were spectroscopically classified as young core-collapse supernovae. The remaining candidates were ruled out as supernovae. Palomar Gattini-IR did not identify any viable candidates with multiple detections only after merger time. We demonstrate that even with single-detector GW events localized to thousands of square degrees, systematic kilonova discovery is feasible

GROWTH on GW190425: Searching thousands of square degrees to identify an optical or infrared counterpart to a binary neutron star merger with the Zwicky Transient Facility and Palomar Gattini IR

The beginning of the third observing run by the network of gravitational-wave detectors has brought the discovery of many compact binary coalescences. Prompted by the detection of the first binary neutron star merger in this run (GW190425 / LIGO/Virgo S190425z), we performed a dedicated follow-up campaign with the Zwicky Transient Facility (ZTF) and Palomar Gattini-IR telescopes. As it was a single gravitational-wave detector discovery, the initial skymap spanned most of the sky observable from Palomar Observatory, the site of both instruments. Covering 8000 deg$^2$ of the inner 99\% of the initial skymap over the next two nights, corresponding to an integrated probability of 46\%, the ZTF system achieved a depth of $\approx$\,21 $m_\textrm{AB}$ in $g$- and $r$-bands. Palomar Gattini-IR covered a total of 2200 square degrees in $J$-band to a depth of 15.5\,mag, including 32\% of the integrated probability based on the initial sky map. However, the revised skymap issued the following day reduced these numbers to 21\% for the Zwicky Transient Facility and 19\% for Palomar Gattini-IR. Out of the 338,646 ZTF transient "alerts" over the first two nights of observations, we narrowed this list to 15 candidate counterparts. Two candidates, ZTF19aarykkb and ZTF19aarzaod were particularly compelling given that their location, distance, and age were consistent with the gravitational-wave event, and their early optical lightcurves were photometrically consistent with that of kilonovae. These two candidates were spectroscopically classified as young core-collapse supernovae. The remaining candidates were photometrically or spectroscopically ruled-out as supernovae. Palomar Gattini-IR identified one fast evolving infrared transient after the merger, PGIR19bn, which was later spectroscopically classified as an M-dwarf flare. [abridged

Patient-Specific Implants for Pelvic Tumor Resections

Introduction Limb salvage surgery for periacetabular malignancies is technically demanding and associated with a considerable likelihood of postoperative complications and surgical revision. Reconstruction using custom-made implants represents the treatment of choice. This study was conducted to analyze treatment outcomes of custom-made implants in a single orthopaedic tumor center. Patients and Methods Twenty patients with a histologically verified periacetabular malignancy and a median follow up time of 5 (1–17) years were included. Results The median number of revision surgeries per patient was 1.5 (0–7). Complications were dislocations in 3 patients, aseptic loosening in 4 patients, deep infections in 9 patients, thromboembolic events in 5 patients and sciatic nerve lesions in 4 patients. Overall survival was 77% after one year, 69% after two years and 46% after five years. Median Harris Hip Score was 81 (37–92) points at last follow up. Conclusion Although internal hemipelvectomy and reconstruction using custom-made implants is linked with a high risk of postoperative complications, good functional outcomes can be regularly achieved. This information may help treating surgeons to find adequate indications, as eligible patients need to be critically selected and integrated into the decision-making process

Using Food to Treat a Complex and Common Condition: Polycystic Ovary Syndrome (PCOS

https://scholarspace.jccc.edu/math_science_gallery/1187/thumbnail.jp

Using Food to Treat a Complex and Common Condition: Polycystic Ovary Syndrome (PCOS)

Polycystic Ovary Syndrome (PCOS) is a complex disorder of the endocrine system and is the primary cause of anovulatory infertility in women. It affects, by some estimates, up to 15% of women of child-bearing age. The cause of PCOS is unknown, but it is believed to be caused by a combination of genetic and environmental factors. There is no cure, but treatments to reduce the symptoms of the disorder include lifestyle changes and prescription medications. Women with PCOS are more likely to have increased levels of biomarkers associated with systemic oxidative stress; they also have imbalances in levels of specific hormones. This project seeks to educate about the condition of PCOS and explore possible methods of symptom remediation through nutrition with a special focus on foods that can serve as antioxidants or can help reduce the effects of hormone imbalances