Unexpected Populations for Deep Vein Thrombosis: Presentation in an Endurance Athlete.

This case presents an athletic 40-year-old female marathon runner who presented with a headache secondary to dural venous sinus thrombosis and right calf deep vein thrombosis (DVT). Though this is outside of the typical image we portray of a common DVT patient, athletes too experience hypercoagulable risk factors and medical issues, just as their less in-shape peers. This patient's history of oral contraceptive use, Lynch syndrome, colon cancer, and pregnancy indicates potential risk factors for DVT. Even without these though, it is important to note that every endurance athlete experiences hemoconcentration, dehydration, and inflammation during exercise, training, and competition events. This case demonstrates the need for an increased index of suspicion in endurance athletes. The case exemplifies an all-too-frequent occurrence of allowing our differential to be skewed away from potentially life-threatening conditions like DVT, and their thrombotic sequelae, because of the "textbook population" descriptions of a given disease state. We hope this case will shed needed light on the phenomenon and lead to more controlled research on the probability and pathophysiology for thrombotic events in this broadened population so that its incidence and prevalence in endurance athletes can be accurately reported in the literature.

Escalation of an Otherwise Curable Cancer: Retroperitoneal Mass Destruction Associated With Testicular Seminoma in a Psychiatric Patient.

We report the case of a 31-year-old male patient with underlying psychiatric illness and substance abuse who presented to the emergency department with a chief complaint of abdominal pain. CT scan of the abdomen revealed a large retroperitoneal mass wrapping around the aorta and obstructing the left ureter causing hydronephrosis. Physical examination found a painless left testicular mass. The ultrasound revealed a left scrotal mass measuring 32 x 24 x 16 mm with evidence of increased vascularity and calcifications. The patient underwent ureteral stent placement and left testicular orchiectomy with the pathology evaluation revealing seminoma. Although follow-up care plans were made, the patient relapsed IV heroin abuse causing failure to attend oncological treatment appointments. Two months later upon readmission, a repeat of the CT scan of the abdomen and pelvis showed a persistent large left retroperitoneal mass with an increase in size and significant mass effect. The patient would be ultimately considered for hospice if lack of compliance were to continue for his chemotherapy, along with his comorbid underlying substance abuse and psychiatric illness. This case highlights the effect of mental illness on medical care and treatment, demonstrating how a treatable malignancy may result in greater morbidity and mortality in psychiatric populations.

Adults blink more deeply: a comparative study of the attentional blink across different age groups.

The attentional blink (AB) is thought to help the visual system parse and categorize rapidly changing information by segmenting it into temporal chunks, and is elicited using Rapid Serial Visual Presentation. It is reflected in a decrease in accuracy at detecting the second of two targets presented within 200-500 ms of the first, and its development appears to be protracted on tasks that require set-shifting. Here, younger (M = 8.5 years) and older (M = 12.8 years) children and adults (M = 19.13 years) completed a simple AB task with no set-shift requirement in which participants detected two letters in a stream of numbers presented at a rate of 135 ms/item. In addition to assessing the developmental course of the AB on this simple task, we also assessed temporal order errors, or swaps. The AB and its associated characteristics are present in both groups but developmental differences were noted in the depth of the AB, and the presence or absence of lag-1 sparing. These developmental changes were explained by changes in a single parameter, inhibition, using the eTST model, which suggests that the AB is an adaptive function of the visual system.

Children with Autism Detect Targets at Very Rapid Presentation Rates with Similar Accuracy as Adults.

Enhanced perception may allow for visual search superiority by individuals with Autism Spectrum Disorder (ASD), but does it occur over time? We tested high-functioning children with ASD, typically developing (TD) children, and TD adults in two tasks at three presentation rates (50, 83.3, and 116.7 ms/item) using rapid serial visual presentation. In the Color task, participants detected a purple target letter amongst black letter distractors. In the Category task, participants detected a letter amongst number distractors. Slower rates resulted in higher accuracy. Children with ASD were more accurate than TD children and similar to adults at the fastest rate when detecting color-marked targets, indicating atypical neurodevelopment in ASD may cause generalized perceptual enhancement relative to typically developing peers.

Plant science. Genomic-scale exchange of mRNA between a parasitic plant and its hosts.

Movement of RNAs between cells of a single plant is well documented, but cross-species RNA transfer is largely unexplored. Cuscuta pentagona (dodder) is a parasitic plant that forms symplastic connections with its hosts and takes up host messenger RNAs (mRNAs). We sequenced transcriptomes of Cuscuta growing on Arabidopsis and tomato hosts to characterize mRNA transfer between species and found that mRNAs move in high numbers and in a bidirectional manner. The mobile transcripts represented thousands of different genes, and nearly half the expressed transcriptome of Arabidopsis was identified in Cuscuta. These findings demonstrate that parasitic plants can exchange large proportions of their transcriptomes with hosts, providing potential mechanisms for RNA-based interactions between species and horizontal gene transfer.

Quantification of tomato and Arabidopsis mobile RNAs trafficking into the parasitic plant Cuscuta pentagona.

The cross-species movement of mRNA from hosts to the parasitic plant Cuscuta pentagona has been reported previously, but has not been characterized quantitatively or with attention to uptake patterns and the fate of specific mRNAs. Real-time PCR and RNA-Seq approaches were used to identify and characterize mobile transcripts from tomato and Arabidopsis hosts into C. pentagona. Tomato transcripts of Gibberellic Acid Insensitive (SlGAI) and Cathepsin D Proteinase Inhibitor (SlPI) differed significantly in the rate of uptake into the parasite, but were then distributed over the length of the parasite shoot. When parasite shoots were detached from the hosts, the SlPI transcript concentrations in the parasite showed the greatest decrease within the first 8 h. Arabidopsis transcripts also varied in mobility into the parasite, and assay of specific regions of a Salt-inducible Zinc Finger Protein (AtSZF1) transcript revealed distinct patterns of abundance in the parasite. The uptake and distribution of host mRNAs into C. pentagona appears to vary among mRNAs, and perhaps even with the region of the mRNA under investigation. We propose that mRNAs traffic into the parasite via multiple routes, or that other mechanisms for selective uptake and mobility exist between host and parasite.

Optoperforation of single, intact Arabidopsis cells for uptake of extracellular dye-conjugated dextran.

A plant science research goal is to manipulate single cells in an intact organism in order to study their interactions with neighboring cells. Based on a technique previously demonstrated in isolated plant cells, mammalian cells and cyanobacteria, Arabidopsis epidermal cells were optoperforated to allow for uptake of external cascade blue-labeled dextrans. Adverse organelle responses were determined to be minimal and dye retention was demonstrated for at least 72 hours. This technique overcomes the physical challenges presented by the plant cell wall and demonstrates the feasibility of in situ optoperforation.

RNA trafficking in parasitic plant systems.

RNA trafficking in plants contributes to local and long-distance coordination of plant development and response to the environment. However, investigations of mobile RNA identity and function are hindered by the inherent difficulty of tracing a given molecule of RNA from its cell of origin to its destination. Several methods have been used to address this problem, but all are limited to some extent by constraints associated with accurately sampling phloem sap or detecting trafficked RNA. Certain parasitic plant species form symplastic connections to their hosts and thereby provide an additional system for studying RNA trafficking. The haustorial connections of Cuscuta and Phelipanche species are similar to graft junctions in that they are able to transmit mRNAs, viral RNAs, siRNAs, and proteins from the host plants to the parasite. In contrast to other graft systems, these parasites form connections with host species that span a wide phylogenetic range, such that a high degree of nucleotide sequence divergence may exist between host and parasites and allow confident identification of most host RNAs in the parasite system. The ability to identify host RNAs in parasites, and vice versa, will facilitate genomics approaches to understanding RNA trafficking. This review discusses the nature of host-parasite connections and the potential significance of host RNAs for the parasite. Additional research on host-parasite interactions is needed to interpret results of RNA trafficking studies, but parasitic plants may provide a fascinating new perspective on RNA trafficking.