TB or Not TB: Lung Nocardiosis, a Tuberculosis Mimicker.

Nocardia, a gram-positive bacterium found in soil and water, rarely causes infections in immunocompetent patients. Diagnosing and treating nocardiosis can be challenging due to its infrequency and the similarity of its symptoms to other diseases. We describe the case of a middle-aged male with a history of latent tuberculosis who presented with hemoptysis. Imaging revealed a persistent lung mass, and pathology and microbiology studies confirmed Nocardia infection. The patient was treated with antibiotics and discharged home. Pulmonary nocardiosis can mimic tuberculosis, fungal infections, or malignancies. Immunocompetent patients make up one-third of the cases. Diagnosis can be difficult, as the organism takes time to grow in culture, but molecular techniques and histology can aid in diagnosis. Treatment often involves a six- to 12-month course of trimethoprim-sulfamethoxazole (TMP-SMX). Prompt identification of the etiological agent is essential for effective treatment, especially for immunocompetent patients who may not exhibit typical risk factors.

Streptococcus anginosus Lung Abscess With Complicated Parapneumonic Empyema.

A 55-year-old female with hypertension presented to our facility with complicated pneumonia. She complained of progressively worsening shortness of breath and pleuritic chest pain. She was in her usual state of health except for an upper respiratory infection treated with oral antibiotics a month prior. At the presentation, she was febrile, tachycardic, and hypoxic on room air. A chest computed tomography (CT) showed near-complete opacification of the right lung, a cavitation with the fluid level in the right middle lobe, and moderate-to-large effusion. Broad-spectrum antibiotics were started. Sputum culture was later positive for methicillin-resistant Staphylococcus aureus, which prompted antibiotic de-escalation to vancomycin. A chest tube was placed into the right pleural space draining 700 mL of exudative fluid, which cultures grew Streptococcus anginosus group (SAG) bacteria. Due to persistent respiratory distress and residual effusion, right thoracotomy and decortication were performed. A right upper lobe abscess ruptured into the pleural space was noted during the procedure. Pathology revealed necrotic tissue, and the microbiological workup was negative. The patient clinically improved postoperatively and was discharged home with oral Linezolid.

Talking through the tough: Identifying facilitating factors to preparation for bias and racial-ethnic discrimination conversations among families from minoritized ethnic-racial groups.

Parent-child conversations about race-related issues serve a protective function for minoritized families and are needed to help children of color thrive in the United States (Hughes et al., Advances in Child Development and Behavior, 51, 2016 and 1). Despite the difficulties that parents experience in having such conversations to prepare youth to cope with discrimination (Priest et al., International Journal of Intercultural Relations, 43, 2014 and 139), parents are actively engaging in these courageous conversations with the aim of protecting their youth. In order to fully understand and support parents having these conversations, our study sought to identify conversation facilitators (i.e., strategies currently being implemented and viewed as successful and/or viewed as potentially helpful) to engage in preparation for bias and racial-ethnic discrimination conversations from the perspective of parents and youth. The current qualitative study draws upon focus group data collected from parents and youth from African American, Chinese American, Mexican American, and Indian American (South Asian) families (N = 138 individuals; 30 focus groups). Reflections were transcribed and coded by a racially and ethnically diverse research team using an inductive thematic analysis approach (Braun & Clarke, Qualitative Research in Psychology, 3, 2006 and 77). Shared and unique facilitators to engaging in preparation for bias and racial-ethnic discrimination conversations were identified across the four racial-ethnic groups. Shared facilitators broadly centered on parent-youth relationship quality, conversation characteristics, and quality, and conversation content and relevance. Unique facilitators broadly centered on communication style and needs and conversation content. Shared and unique facilitators warrant more attention to best support minoritized families. The use of findings in developing interventions to support marginalized parents, youth, and families is addressed.

Endocannabinoids enhance hKV7.1/KCNE1 channel function and shorten the cardiac action potential and QT interval.

BACKGROUND: Genotype-positive patients who suffer from the cardiac channelopathy Long QT Syndrome (LQTS) may display a spectrum of clinical phenotypes, with often unknown causes. Therefore, there is a need to identify factors influencing disease severity to move towards an individualized clinical management of LQTS. One possible factor influencing the disease phenotype is the endocannabinoid system, which has emerged as a modulator of cardiovascular function. In this study, we aim to elucidate whether endocannabinoids target the cardiac voltage-gated potassium channel KV7.1/KCNE1, which is the most frequently mutated ion channel in LQTS. METHODS: We used two-electrode voltage clamp, molecular dynamics simulations and the E4031 drug-induced LQT2 model of ex-vivo guinea pig hearts. FINDINGS: We found a set of endocannabinoids that facilitate channel activation, seen as a shifted voltage-dependence of channel opening and increased overall current amplitude and conductance. We propose that negatively charged endocannabinoids interact with known lipid binding sites at positively charged amino acids on the channel, providing structural insights into why only specific endocannabinoids modulate KV7.1/KCNE1. Using the endocannabinoid ARA-S as a prototype, we show that the effect is not dependent on the KCNE1 subunit or the phosphorylation state of the channel. In guinea pig hearts, ARA-S was found to reverse the E4031-prolonged action potential duration and QT interval. INTERPRETATION: We consider the endocannabinoids as an interesting class of hKV7.1/KCNE1 channel modulators with putative protective effects in LQTS contexts. FUNDING: ERC (No. 850622), Canadian Institutes of Health Research, Canada Research Chairs and Compute Canada, Swedish National Infrastructure for Computing.

Coping (together) with hate: Strategies used by Mexican-origin families in response to racial-ethnic discrimination.

Coping in the context of racial-ethnic discrimination is often framed as an individualistic process, where the focus is on how the individual deals with the racialized stressor to mitigate its negative effects. However, individuals exist within social contexts including the family and coping processes may operate interdependently as well. Further, racialized stressors have the potential to disrupt the entire family system, regardless of whether the experience in that moment is shared among all its members. Despite these realities, few studies have considered how Latinx youth and their parents may cope together in the face of racial-ethnic discrimination. To address this gap, we analyzed focus group data from Mexican-origin adolescents (n = 17; Mage = 12.8; 71% girls) and their parents (n = 17; Mage = 42.8; 82% mothers) to explore the coping strategies used in response to racial-ethnic discrimination. An inductive thematic analysis identified a broad range of coping strategies representing both individualistic and interdependent approaches to deal with racial-ethnic discrimination. Strategies included (a) reframing (with pride) and ignoring an encounter, (b) standing up for oneself, (c) talking issues out, (d) problem-solving together, and (e) protection tactics. These findings provide evidence for the ways in which Mexican-origin families help adolescents cope with racial-ethnic discrimination and offer a glimpse as to how adolescents may help their families cope as well. Future research is needed to further explore the interdependent nature of coping as Latinx family members protect and support one another in the face of pervasive racialized stressors. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Hypertensive Emergency as the Initial Presentation of Acquired Thrombotic Thrombocytopenic Purpura: A Case Report.

Thrombotic thrombocytopenic purpura (TTP) is a type of thrombotic microangiopathy (TMA) related to a deficiency of ADAMTS13 protein, which could lead to fatal outcomes. TTP presents a vast array of symptoms, making its diagnosis a challenge to physicians. In this report, we discuss the case of an 80-year-old male who presented with abdominal pain and hypertension with underlying severe thrombocytopenia and hemolysis. Although his presentation could also be secondary to malignant hypertension, he was promptly diagnosed with TTP based on these findings. TTP is a hematologic emergency, and it should be kept in the differential diagnosis when a patient presents with thrombocytopenia and hemolysis with or without accompanying symptoms.

Familism in action in an emerging immigrant community: An examination of indirect effects in early adolescence.

Familism values promote the positive adaptation of Latinx youth, but few studies have examined potential indirect effects associated with these positive effects. In emerging immigrant communities, where fewer resources are available to youth and families to maintain cultural values and ties, familism may be especially important. In this study of 175 primarily second-generation Latinx youth in such a community, we tested whether familism values were indirectly associated with adolescent outcomes through positive parent-child relationships, private racial/ethnic regard, meaning in life, and support seeking coping. Familism values were associated with greater academic motivation. Additionally, there were significant indirect effects in terms of positive parent-child relationships explaining the links between familism and fewer parent-reported externalizing symptoms, and for meaning in life explaining the links between familism and fewer depressive symptoms and greater academic motivation. Familism was also associated with greater support seeking coping, but this was associated with greater depressive symptoms. Our study suggests that in an emerging immigrant community familism values are primarily associated with positive adaptation through distinct mechanisms. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Computationally Designed Sesamol Derivatives Proposed as Potent Antioxidants.

Oxidative stress has been recognized to play an important role in several diseases, such as Parkinson's and Alzheimer's disease, which justifies the beneficial effects of antioxidants in ameliorating the deleterious effects of these health disorders. Sesamol, in particular, has been investigated for the treatment of several conditions because of its antioxidant properties. This article reports a rational computational design of new sesamol derivatives. They were constructed by adding four functional groups (-OH, -NH2, -COOH, and -SH) in three different positions of the sesamol molecular framework. A total of 50 derivatives between mono-, di-, and trisubstituted compounds were obtained. All the derivatives were evaluated and compared with a reference set of commercial neuroprotective drugs. The estimated properties are absorption, distribution, metabolism, excretion, toxicity, and synthetic accessibility. Selection and elimination scores were used to choose a first set of promising candidates. Acid-based properties and reactivity indexes were then estimated using the density functional theory. Four sesamol derivatives were finally selected, which are hypothesized to be potent antioxidants, even better than sesamol and Trolox for that purpose.

Coping and Culture: The Protective Effects of Shift-&-Persist and Ethnic-Racial Identity on Depressive Symptoms in Latinx Youth.

Shift-&-persist is a coping strategy that has been shown to lead to positive health outcomes in low-SES youth but has not yet been examined with respect to psychological health. This study tests whether the shift-&-persist coping strategy works in tandem with ethnic-racial identity to protect against depressive symptoms in the face of two uncontrollable stressors: economic hardship and peer discrimination. In a sample of 175 Latinx youth (51.4% female; Mage = 12.9), shift-&-persist buffered the positive relation between economic hardship and depressive symptoms. In terms of peer discrimination, among youth who reported little use of shift and persist, discrimination was related to higher depressive symptoms, whereas youth who reported higher amounts of shift and persist (at and above the mean) were protected and did not evidence this association. However, among youth with high ethnic-racial identity, shift-&-persist failed to protect against the deleterious association between peer discrimination and depressive symptoms. These findings suggest that shift-&-persist is protective for Latinx youth, although the context in which it is protective changes based on the racialized/non-racialized nature of the stressor.

Ethnic-racial socialization in Latino families: The influence of mothers' socialization practices on adolescent private regard, familism, and perceived ethnic-racial discrimination.

OBJECTIVES: Cultural value endorsement and ethnic-racial identity promote Latino/a adolescent positive adaptation and mitigate the negative impacts of perceived ethnic-racial discrimination. This study explored the intergenerational process of how adolescents develop these cultural characteristics in concert with their experiences of discrimination, focusing on the role of youth-reported maternal ethnic-racial socialization processes. METHOD: Participants included 175 Latino/a adolescent-mother dyads recruited from the 7th and 8th grades in an understudied emerging immigrant destination. We tested the effects of maternal cultural characteristics (i.e., familism, private regard, and perceived discrimination) on the same adolescent outcomes through youth-reported maternal ethnic-racial socialization practices (i.e., cultural socialization, preparation for bias, promotion of mistrust, and familism socialization, a novel construct introduced in this study). RESULTS: Three significant indirect pathways were identified. Higher maternal private regard was associated with both higher youth familism and higher youth private regard through greater youth-reported familism socialization, and higher maternal private regard was associated with more perceived youth discrimination through greater youth-reported preparation for bias. CONCLUSION: Our results highlight maternal private regard as particularly important for understanding how youth perceptions of socialization processes encourage the development of adolescent cultural characteristics and the benefit of using specific assessment tools, such as a familism socialization measure, to identify how ethnic-racial socialization processes serve as intergenerational links. Directions for future research and implications for intervention are discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Typologies of discrimination: Latinx youth's experiences in an emerging immigrant community.

Few studies examine how racial-ethnic peer discrimination experiences of Latinx youth vary across the race-ethnicity of the perpetrator. In a sample of 170 Latinx early adolescents (Mage = 12.86 years, range = 10.33-15.23; 51% female), we identified 4 latent profiles of youth: (a) relatively low likelihood of experiencing discrimination regardless of peers' racial-ethnic group (38%; low discrimination); (b) relatively high probability of experiencing discrimination from the majority outgroup peers (33%; outgroup); (c) relatively high likelihood of experiencing discrimination from ingroup peers (14%; ingroup); (d) the highest probability of discrimination experiences across the in- and outgroup (15%; high discrimination group). Overall, Latinx youth classified in a typology characterized by a higher likelihood of experiencing discrimination from both ingroup and outgroup peers also reported the worst internalizing and externalizing symptoms relative to those in the low discrimination typology. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Foreigner objectification, English proficiency, and adjustment among youth and mothers from Latinx American backgrounds.

OBJECTIVES: Understanding the experience of foreigner objectification is relevant given the possibility of ethnocentrism, xenophobia, and mistrust of immigrants in the United States. The present study examines main and interactive effects of objectification and English proficiency on developmental outcomes among immigrant mothers and children. METHOD: Our study includes 173 youth from Latinx backgrounds (52% female, Mage = 12.86 years, SD = .68; 87% United States-born) and their mothers (Mage = 38.26 SD = 5.65; all foreign-born) from emerging immigrant contexts. RESULTS: Bivariate and regression analyses suggest that lower English proficiency was associated with more objectification for youth; whereas higher English proficiency was associated with more objectification for mothers. For youth only, English proficiency was positively correlated with American identity. For both parents and youth, foreigner objectification was linked with negative psychological outcomes (e.g., mothers' depressive symptoms, youths' low self-esteem). CONCLUSIONS: Being subjected to assumptions that challenge individuals' social status can be psychologically harmful. Nuanced developmental variation, and implications regarding the dual role of objectification and English proficiency are discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Protective and Promotive Effects of Latino Early Adolescents' Cultural Assets Against Multiple Types of Discrimination.

Given adversity associated with discrimination, it is important to identify culturally relevant factors that may protect against its harmful effects. Using latent variable interactions, this study examined the moderating effects of cultural assets on the association between multiple types of discrimination and adolescents' adjustment. Participants included 174 seventh- and eighth-grade Latino adolescents (51% girls); majority were of Mexican origin. Peer discrimination was associated with higher internalizing symptoms, whereas cultural assets predicted higher academic motivation above and beyond racial-ethnic discrimination, demonstrating a promotive effect. Adolescents' Latino cultural assets also protected against higher levels of externalizing symptoms in the context of high peer discrimination and foreigner objectification. The discussion focuses on the conceptual and applied implications of these findings.

Familism and Latino adolescent depressive symptoms: The role of maternal warmth and support and school support.

OBJECTIVES: This study examined the relationship between familism and depressive symptoms across relational contexts in adolescence, and whether maternal warmth and support, and school support moderated the relationship between familism and depressive symptoms. METHOD: A total of 180 Latino adolescents (53% female) in 7th through 10th grades (average age = 14 years) participated in this cross-sectional study. The adolescents lived in an emerging Latino community in a rural area in the U.S. South. Most of the adolescents were Mexican-origin (78%) and born in the United States (60%), while the vast majority of their parents were foreign born (95%). RESULTS: Overall, familism was associated with fewer adolescent depressive symptoms. School support moderated the relationship between familism and adolescent depressive symptoms such that familism's protective effect was only evident when adolescents reported low levels of school support. In the context of average to high school support, adolescents reported low depressive symptoms regardless of familism. However, maternal warmth and support failed to moderate the relationship. CONCLUSIONS: Familism may be most protective for adolescents not feeling supported at school, suggesting that these values may offset the risk of a risky school environment. (PsycINFO Database Record

Acculturation conflict among Latino youth: Discrimination, ethnic identity, and depressive symptoms.

OBJECTIVES: Patterns of parent-adolescent conflict differ between immigrant and nonimmigrant families living in the United States (Fuligni, 1998). Despite this, there is limited empirical literature examining the nuanced nature of parent-adolescent conflict in immigrant families. To fill this gap, the current study examined the role of 2 types of conflict (i.e., general and acculturation) in predicting psychosocial outcomes (i.e., depressive symptoms and ethnic identity) among Latino adolescents, and whether these relationships differ within the context of peer discrimination. METHOD: All survey administration was completed in the participating school's cafeteria. The sample consisted of 7th through 10th graders (n = 172) with a mean age of 14.01 years (SD = 1.32.) The sample consisted of 53% females, and was primarily Mexican in origin (78%). RESULTS: As hypothesized, parent-adolescent acculturation conflict uniquely predicted greater depressive symptoms and lower ethnic private regard, even when controlling for parent-adolescent general conflict. However, acculturation conflict predicted lower ethnic private regard only in the presence of greater peer discrimination. More specifically, peer discrimination moderated the relation between acculturation conflict and ethnic private regard such that adolescents who reported the highest levels of acculturation conflict and peer discrimination reported the lowest levels of ethnic private regard. CONCLUSIONS: These results suggest that for Latino youth and their families, acculturation conflict may be particularly problematic, as compared with general conflict. In addition, youth who face ethnicity-based stressors in both familial and school contexts are especially at risk in their ethnic identity development. (PsycINFO Database Record

Socioeconomic stress and academic adjustment among Asian American adolescents: the protective role of family obligation.

Socioeconomic stress has long been found to place youth at risk, with low family income conferring disadvantages in adolescents' school achievement and success. This study investigates the role of socioeconomic stress on academic adjustment, and pinpoints family obligation as a possible buffer of negative associations. We examined direct and interactive effects at two time points in the same sample of Asian American adolescents-early high school (N = 180 9th-10th graders; 60 % female) and 2 years later in late high school (N = 156 11th-12th graders; 87% of original sample). Results suggest that socioeconomic stress is indeed associated with poor academic adjustment, measured broadly through self-reported GPA, importance of academic success, and educational aspirations and expectations. Family obligation was positively related to adjustment, and also was found to buffer the negative effects of socioeconomic stress, but only during adolescents' later high school years. Adolescents reporting more family obligation experienced less of the negative effects of financial stress on academic outcomes than those reporting lower obligation. Cultural and developmental implications are discussed in light of these direct and moderating effects.

Cultural stressors and the hopelessness model of depressive symptoms in Latino adolescents.

Depressive symptoms in Latino youth have been related to both culturally-universal and culturally-based stressors. However, few studies have examined the unique contributions of culturally-based stressors above and beyond other types of stressors. Moreover, no past studies with Latinos have examined the role of culturally-based stressors within a hopelessness model of depressive symptoms, a cognitive model with the strongest empirical support in adolescence. The current study examined these issues in a sample of 171 Latino adolescents (7th-10th grades; mean age = 14; 46 % male). The Latino adolescents were primarily Mexican-American (78 %) and born in the United States (60 %). Students completed measures during a school period on their experiences of parent-child conflict, economic stress, discrimination from peers, and acculturative stress as well as depressive symptoms and attributional style. The results indicated that culturally-based stressors (e.g., acculturative stress and discrimination) predicted greater depressive symptoms even when controlling for culturally-universal stressors (e.g., parent-child conflict, economic stress). Moreover, a negative attributional style moderated the relationship between culturally-universal stressors and depressive symptoms, but this was not the case for culturally-based stressors. Culturally-based stressors play an important role in depressive symptoms among Latino youth. These stressors predicted greater symptomatology even when controlling for other types of stressors and a negative attributional style. These findings suggest that there may be other cognitive risk factors associated with culturally-based stressors.

Gendered academic adjustment among Asian American adolescents in an emerging immigrant community.

Research on the academic adjustment of immigrant adolescents has been predominately conducted in large cities among established migration areas. To broaden the field's restricted focus, data from 172 (58% female) Asian American adolescents who reside within a non-traditional or emerging immigrant community in the Southeastern US were used to examine gender differences in academic adjustment as well as school, family, and cultural variables as potential mediators of gender differences found. Results suggest that girls report significantly higher educational goals, intrinsic academic motivation, and utility value of school compared to boys. These gender differences are statistically mediated by ethnic exploration and family processes, most prominently, family respect. School connectedness and perceived discrimination are also associated with academic adjustment at the bivariate level, suggesting that academic success may be best promoted if multiple domains of influence can be targeted.