A Rare Case of Hemophagocytic Lymphohistiocytosis of Unknown Etiology

Hemophagocytic lymphohistiocytosis (HLH) is an uncommon cytokine storm syndrome marked which can cause high mortality. In adults, acquired HLH usually has an underlying infectious, autoimmune or malignant process that triggers the syndrome. In this case report, we present a 64-year old Caucasian male presenting with productive cough, fevers, weight loss and altered mental status who was ultimately found to have HLH of unknown etiology

A color flow tract in ultrasound-guided random renal core biopsy predicts complications

OBJECTIVES: To determine patient and procedural risk factors for major complications in ultrasound (US)-guided random renal core biopsy. METHODS: Random renal biopsies performed by radiologists in the US department at a single institution between 2014 and 2018 were retrospectively reviewed. The patient\u27s age, sex, race, and estimated glomerular filtration rate (eGFR) were recorded. The biopsy approach, needle gauge, length of cores, number of throws, and presence of a color flow tract were recorded. Outcome data included minor and major complications. Associations between variables were tested with χ RESULTS: A total of 231 biopsies (167 native and 64 allografts) were reviewed. There was no significant difference in the sex, age, race, or eGFR between native and allograft groups. The overall rate for any complication was 18.2%, with a 4.3% rate of major complications, which was significantly greater in native compared to allograft biopsies (6% versus 0%; P = .045). A risk analysis in native biopsies only showed that major complications were significantly associated with a low eGFR such that patients with stage 4 or 5 kidney disease had higher odds of complications (odds ratio [95% confidence interval]: stage 4, 9.405 [1.995-44.338]; P = .0393; stage 5, 10.749 [2.218-52.080]; P = .0203) than patients with normal function (eGFR \u3e60 mL/min). The presence of a color flow tract portended a 10.7 times greater risk of having any complication (95% confidence interval, 4.595-24.994; P \u3c .001). Other procedural factors were not significantly associated with complications. CONCLUSIONS: There is an increased risk of major complications in US-guided random native kidney biopsy in patients with a low eGFR (\u3c30 mL/min) and a patent color flow tract in the immediate postbiopsy setting

Detection of Fetomaternal Genotype Associations in Early-Onset Disorders: Evaluation of Different Methods and Their Application to Childhood Leukemia

Several designs and analytical approaches have been proposed to dissect offspring from maternal genetic contributions to early-onset diseases. However, lack of parental controls halts the direct verification of the assumption of mating symmetry (MS) required to assess maternally-mediated effects. In this study, we used simulations to investigate the performance of existing methods under mating asymmetry (MA) when parents of controls are missing. Our results show that the log-linear, likelihood-based framework using a case-triad/case-control hybrid design provides valid tests for maternal genetic effects even under MA. Using this approach, we examined fetomaternal associations between 29 SNPs in 12 cell-cycle genes and childhood pre-B acute lymphoblastic leukemia (ALL). We identified putative fetomaternal effects at loci CDKN2A rs36228834 (P = .017) and CDKN2B rs36229158 (P = .022) that modulate the risk of childhood ALL. These data further corroborate the importance of the mother's genotype on the susceptibility to early-onset diseases

Appendix 7 - CCGH 2017 poster

The poster provides a project snapshot. The study examined the relationship between mosquito net ownership and use, and self-reported malaria infection in pregnant women. As well, it clarifies how pregnant women use antenatal care (ANC) that includes mosquito nets. Determining the malaria infection rate in pregnant women is critical for assessing factors that relate to the risk of infections and complications during pregnancy. Data from a cross-sectional survey confirmed that ANC attendance in Jimma Zone is lower than the Federal Ministry of Health’s target of 95% of pregnant women attending four ANC visits (by 2020).Global Affairs Canada (GAC)Canadian Institutes of Health Research (CIHR

Graph theoretical analysis of visual system functional connectivity in normal and lesioned brains

Thesis (M.A.)--Boston University PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at [email protected]. Thank you.The visual system consists of two distinct networks--the structural and functional networks. Defined anatomically by the physical connections between neurons, the structural network provides the architectural framework for information processing. The functional network, however, is determined by the situation-dependent activation of connections either set by or independent of the structural network. Therefore, these two networks are linked. Individually, these networks can be mapped and analyzed using graph theory--a specialized branch of mathematics that is used to determine characteristics of complex networks. In the case of the visual system, nodes (objects of interest) are represented by specific brain regions of the visual network, and edges represent the structural (anatomical) or functional (physiological) connections between visual regions. The objective of this study was to use graph theory to determine the extent to which the structural and functional networks of the cat visual system are linked and to use this information to generate a hierarchy of visual information flow and processing through the visual system. Using five intact and six lesioned subjects, we analyzed sixteen visual cortical areas as well as nine sub-cortical areas and their connections. These regions include cortical areas A17, A18, A19, A20a, A20b, A21a, A21b, 7, PMLS, PLLS, AMLS, ALLS, DLS, VLS, PS, and SVA and sub-cortical areas LGN, LPL, LPM, PUL, CAUD, SGS, SO, SGI, and SGP. Structural connectivity data was obtained from literary sources. Functional connectivity data was obtained from 2-Deoxy-D-Glucose stained images of the subjects' brains. We first looked at the functional networks of the intact subjects to determine the functional influence of one hemisphere on the other and to observe general trends in network connections. We found that functional connections across hemispheres were not symmetrical and that two distinct connectional patterns emerged - visual areas, or clusters, may connect to their equivalent areas across hemispheres or they may connect to a many non-equivalent areas. There also emerged a distinct clustering pattern across and within both hemispheres. Clusters were seen within the primary visual cortical areas (17, 18) and area 19; between areas PMLS, PLLS, DLS, and VLS; and between the superior colliculi and all of these regions. We also used this data to determine which functional and structural connections are linked in resting state visual network and how strongly they are linked. We found that areas 17, 18, 19, 21a, PMLS, PLLS, DLS, and VLS are the ones primarily involved in visual processing in the passive state. The second group we looked at consisted of the subjects with a lesioned hemisphere either receiving sham or real trans-cranial magnetic stimulation. This group allowed us to determine the validity of predictions concerning the existence and influence of intrinsic inhibition between hemispheres. We found that when one hemisphere is lesioned, inhibition is released and there is an increase in functional connectivity within the remaining hemisphere. When TMS was performed and inhibition reinstated, this increase in functional connectivity was lost. This confirmed that there is an inhibitory influence of the visual system between hemispheres in the cat--meaning that in intact brains, one hemisphere decreases the functional activity of the other. These finding confirmed that, functionally, there are both inter- and intra-hemispheric influences between hemispheres and that altering part of the network will subsequently alter the functional organization and activity of the whole network

Variation in the use of discourse markers in a language contact situation

Use of discourse markers by 17 speakers of Anglophone Montreal French (AMF) showed great variation in individual repertoires and frequency of use. Only five subjects manifested rates of usage comparable to those native speakers or to their own L1 usage in English. In decreasing order of frequency, the speakers used tu sais 'y'know'; la 'there' (the most frequent among L1 Montreal French speakers); bon 'good', alors 'so', comme 'like', and bien 'well'; and the local discourse conjunction fait que 'so'. The subjects occasionally made use of the English markers you know, so, like, and well. Quebecois French markers with no English equivalent were used by the speakers who had been exposed to French in their early childhood environment. The one marker that showed influence from English was comme, apparently calqued on English like. Overall, frequent use of discourse markers correlated only with the speakers' knowledge of French grammar—evidence that a higher frequency of discourse marker use is the hallmark of the fluent speaker. As a feature that is not explicitly taught in school, mastery of the appropriate use of discourse markers is thus particularly revealing of the speakers' integration into the local speech community

Associations between fruit and vegetable consumption and depressive symptoms: evidence from a national Canadian longitudinal survey

BACKGROUND: Several cross-sectional studies have demonstrated associations between diet quality, including fruit and vegetable consumption, and mental health. However, research examining these associations longitudinally, while accounting for related lifestyle factors (eg, smoking, physical activity) is scarce. METHODS: This study used data from the National Population Health Survey (NPHS), a large, national longitudinal survey of Canadians. The sample included 8353 participants aged 18 and older. Every 2 years from 2002/2003 to 2010/2011, participants completed self-reports of daily fruit and vegetable consumption, physical activity, smoking and symptoms of depression and psychological distress. Using generalised estimating equations, we modelled the associations between fruit and vegetable consumption at each timepoint and depression at the next timepoint, adjusting for relevant covariates. RESULTS: Fruit and vegetable consumption at each cycle was inversely associated with next-cycle depression (β=-0.03, 95% CI -0.05 to -0.01, p<0.01) and psychological distress (β=-0.03, 95% CI -0.05 to -0.02, p<0.0001). However, once models were adjusted for other health-related factors, these associations were attenuated (β=-0.01, 95% CI -0.04 to 0.02, p=0.55; β=-0.00, 95% CI -0.03 to 0.02, p=0.78 for models predicting depression and distress, respectively). CONCLUSIONS: These findings suggest that relations between fruit and vegetable intake, other health-related behaviours and depression are complex. Behaviours such as smoking and physical activity may have a more important impact on depression than fruit and vegetable intake. Randomised control trials of diet are necessary to disentangle the effects of multiple health behaviours on mental health