Disseminated and Congenital Toxoplasmosis in a Mother and Child With Activated PI3-Kinase δ Syndrome Type 2 (APDS2): Case Report and a Literature Review of Toxoplasma Infections in Primary Immunodeficiencies

Phosphoinositide 3-kinase (PI3K) plays an integral role in lymphocyte function. Mutations in PIK3CD and PIK3R1, encoding the PI3K p110δ and p85α subunits, respectively, cause increased PI3K activity and result in immunodeficiency with immune dysregulation. We describe here the first cases of disseminated and congenital toxoplasmosis in a mother and child who share a pathogenic mutation in PIK3R1 and review the mechanisms underlying susceptibility to severe Toxoplasma gondii infection in activated PI3Kδ syndrome (APDS) and in other forms of primary immunodeficiency

Lack of privileged access to awareness for rewarding social scenes in Autism Spectrum Disorder

Reduced social motivation is hypothesised to underlie social behavioural symptoms of Autism Spectrum Disorder (ASD). The extent to which rewarding social stimuli are granted privileged access to awareness in ASD is currently unknown. We use continuous flash suppression to investigate whether individuals with and without ASD show privileged access to awareness for social over nonsocial rewarding scenes that are closely matched for stimulus features. Strong evidence for a privileged access to awareness for rewarding social over nonsocial scenes was observed in neurotypical adults. No such privileged access was seen in ASD individuals, and moderate support for the null model was noted. These results suggest that the purported deficits in social motivation in ASD may extend to early processing mechanisms

Using Interprofessional Education as a Means to Enhance Personal and Professional Development

The ACPE 2016 standards have increased emphasis on Interprofessional Education (IPE) and skills in the affective domain such as personal and professional development. The Wegmans School of Pharmacy (WSOP) at St. John Fisher College has prepared for the transition to the new standards by incorporating IPE into the pre-APPE (Advanced Pharmacy Practice Experience) curriculum so that students improve their communication skills, plan for their professional development, and learn to deal effectively with other healthcare providers. WSOP has incorporated TeamSTEPPS® training into its curriculum. TeamSTEPPS® is an evidence-based teamwork system designed to improve communication and teamwork skills among healthcare professionals. Training is comprised of preparatory work, a 4-hour workshop, and learning scenarios in groups. Both nursing and pharmacy faculty co-present modules using the TeamSTEPPS® slides followed by an online post-work assessment and course evaluation surveys. WSOP students also experience several thorough and unique exercises during their Introduction to Pharmacy Practice Experiences (IPPE) III and IV. The IPPE-III course places students in a long-term care facility, each paired with a patient. Students spend over 10 hours on-site interviewing the patient, working up a comprehensive medication plan, and interacting with members of the healthcare team. 15 hours of IPPE-III classroom time supplement this training through lectures offered by different members of the health care team sharing their roles and perspectives. The IPPE-IV class offers additional classroom instruction focused on the skills needed to succeed on advanced rotations. This course requires an additional 30 hours onsite, working closely with the WSOP clinical faculty

Using Interprofessional Education as a Means to Enhance Personal and Professional Development

The ACPE 2016 standards have increased emphasis on Interprofessional Education (IPE) and skills in the affective domain such as personal and professional development. The Wegmans School of Pharmacy (WSOP) at St. John Fisher College has prepared for the transition to the new standards by incorporating IPE into the pre-APPE (Advanced Pharmacy Practice Experience) curriculum so that students improve their communication skills, plan for their professional development, and learn to deal effectively with other healthcare providers. WSOP has incorporated TeamSTEPPS® training into its curriculum. TeamSTEPPS® is an evidence-based teamwork system designed to improve communication and teamwork skills among healthcare professionals. Training is comprised of preparatory work, a 4-hour workshop, and learning scenarios in groups. Both nursing and pharmacy faculty co-present modules using the TeamSTEPPS® slides followed by an online post-work assessment and course evaluation surveys. WSOP students also experience several thorough and unique exercises during their Introduction to Pharmacy Practice Experiences (IPPE) III and IV. The IPPE-III course places students in a long-term care facility, each paired with a patient. Students spend over 10 hours on-site interviewing the patient, working up a comprehensive medication plan, and interacting with members of the healthcare team. 15 hours of IPPE-III classroom time supplement this training through lectures offered by different members of the health care team sharing their roles and perspectives. The IPPE-IV class offers additional classroom instruction focused on the skills needed to succeed on advanced rotations. This course requires an additional 30 hours onsite, working closely with the WSOP clinical faculty

Conserved T cell and natural killer cell function in treatment-experienced adults receiving tenofovir plus didanosine as nucleoside reverse transcription inhibitor backbone

Anti-retroviral treatment (ART) usually results in efficient control of virus replication and in immune reconstitution. Among potential adverse effects, impairment of immune responses in terms of CD4+ T cell counts has been attributed to some ART regimens, as with didanosine–tenofovir. We studied the functional integrity of adaptive and innate immunity during didanosine–tenofovir-containing ART. Two groups of extensively pretreated patients completing at least 48 weeks of ART containing either lamivudine–didanosine (n = 21) or tenofovir–didanosine (n = 25) were identified. In addition to standard clinical immune and virological parameters, we performed a flow cytometric analysis of natural killer (NK) cells, of memory and naive CD4+ T cells and of T cell receptor αβ+ T cells co-expressing inhibitory NK receptors. Functional analysis consisted in specific and total interferon-γ production by NK cells and of recall antigen proliferation of peripheral blood mononuclear cells. Comparable clinical immunological reconstitution and virological control were confirmed in the two groups of patients in the absence of clinically relevant adverse effects. The proportion of CD4+CD45RA+ T cells and of functionally inhibited killer immunoglobulin-like receptor T cell receptor αβ+ cells, the proliferation to recall antigens as well as NK cell phenotype and function as determined by interferon-γ production in patients treated with tenofovir–didanosine were comparable to those treated with a different regimen. Thus, no differences in functional innate or adaptive immune reconstitution are detected in drug-experienced human immunodeficiency virus-infected patients on tenofovir–didanosine nucleoside reverse transcription inhibitor regimens