Streptococcal Infections in Patients with Chronic Granulomatous Disease: Case Report and Review of the Literature

Streptococcus intermedius caused a liver abscess in a patient with chronic granulomatous disease (CGD). In contrast to typical staphylococcal abscesses in CGD, this abscess was liquid, easily drained, and resolved without surgery or steroids. This case and literature review provide insight into this organism's pathogenesis, including in CGD.     

The effect of high-fat diet on extinction and renewal

Diets high in saturated fats are linked to health problems and impairments in cognitive function in humans. Recent evidence suggests that exposure to a high-fat diet can impair rats' ability to appropriately inhibit responding to stimuli that are reinforced in some circumstances but not in others. Here, we examined the effects of exposure to a high-fat diet on the context-specific renewal of extinguished responding. Rats first received pairings of a noise stimulus with a food reinforcer. After 14 days of exclusive access to either a high-fat or a matched control diet, rats received nonreinforced presentations (extinction) of the noise in either the same context in which they were trained or a different context. Finally, responding to the noise was evaluated in the original training context in all rats. In control rats, substantial renewal was observed; that is, responding was greater if extinction was conducted in a context different from that of training and testing. Renewal was significantly less robust in rats fed the high-fat diet despite evidence that they were at least as sensitive to context change as control rats. Implications of these results for models of relapse and treatments for phobias, addiction, and overeating are discussed.     

Prevalence of Vitamin D<Subscript>3</Subscript> Deficiency in Orange County Residents

With the prevalence of sunlight exposure in Orange County, California, one would expect it to be rare and unusual to find high incidence of Vitamin D deficiencies among its residents. This study evaluated the concentration of Vitamin D3 as part of a larger study to evaluate bone health in Orange County residents. Our preliminary data shows that 19.2% of the 151 subjects evaluated had low Vitamin D3 (<30 pg/ml) and illuminates a growing problem in the United States. We speculate that the widespread sensitivity to skin cancer and sun exposure, the increased use of sun-screens and the filtering of UV waves in automobile glass has put the public at risk for low Vitamin D.     

Symptoms of Attention Deficit Hyperactivity Disorder in Children and Adults with Intellectual Disability: A Review

Background Despite a reported excess of attention deficit hyperactivity disorder (ADHD) symptoms in individuals with intellectual disability, it has been argued that ADHD symptoms have been under diagnosed and inadequately treated in individuals with intellectual disability. Materials and methods Published studies focussing on the level of ADHD symptoms in children and adults with intellectual disability are reviewed. Issues around screening for ADHD symptoms in individuals with intellectual disability and the validity of the diagnosis of ADHD are considered. Interventions including pharmacological studies are discussed with respect to published research. Results Reported prevalence rates of ADHD symptoms in individuals with intellectual disability vary significantly depending on instruments and diagnostic practices employed. Published research on interventions for individuals with ADHD has primarily focussed on pharmacological interventions. Conclusion Much less is known about ADHD in individuals with intellectual disability than about ADHD in individuals without intellectual disability. There is an urgent need to clarify baseline rates of ADHD in individuals with intellectual disability and to develop efficacious interventions to support affected individuals and their families.     

Two cases illustrating successful adjunctive interferon-γ immunotherapy in refractory disseminated coccidioidomycosis

Protective immunity and host resistance to coccidioidomycosis require a robust cell-mediated immunity with adequate production of Th1 cytokines including interleukin-12, and IFN-γ and appropriate regulation and coordinated functionality of Th1/Th2 responses and IL-12/IFN-γ cytokine axes. IFN-γ augments the anti-fungal activity of effector immune cells against a variety of fungi. Numerous animal models have demonstrated the potential efficacy of adjunctive IFN-γ in treatment of invasive mycoses. Yet, despite these promising data, a paucity of literature documents efficacious adjunctive IFN-γ administration in refractory coccidioidomycosis. We present two cases of refractory disease occurring at our institution who responded to adjunctive IFN-γ.     

Coupling mammalian cell surface display with somatic hypermutation for the discovery and maturation of human antibodies

A novel approach has been developed for the isolation and maturation of human antibodies that replicates key features of the adaptive immune system by coupling in vitro somatic hypermutation (SHM) with mammalian cell display. SHM is dependent on the action of the B cell specific enzyme, activation-induced cytidine deaminase (AID), and can be replicated in non-B cells through expression of recombinant AID. A library of human antibodies, based on germline V-gene segments with recombined human regions was used to isolate low-affinity antibodies to human β nerve growth factor (hβNGF). These antibodies, initially naïve to SHM, were subjected to AID-directed SHM in vitro and selected using the same mammalian cell display system, as illustrated by the maturation of one of the antibodies to low pM K_D. This approach overcomes many of the previous limitations of mammalian cell display, enabling direct selection and maturation of antibodies as full-length, glycosylated IgGs.