Hemoptysis Associated With Rasmussen Aneurysm.

Hemoptysis involves compromised pulmonary vasculature of bronchial versus pulmonary arterial origins, with both life-threatening and non-life-threatening causes. Life-threatening hemoptysis is uncommon. To date, published cases of Rasmussen aneurysm remain low and subsequently underrecognized. We report on a 63-year-old male from Mexico with a more than 30-pack-year smoking history, but no history of lung disease, who presented to the emergency department with cough and hemoptysis for one week. A computed tomography angiography (CTA) chest demonstrated a pseudoaneurysm and hemorrhage, consistent with a Rasmussen aneurysm. Interventional radiology performed a pulmonary angiography, and subsequent coil embolization of the tertiary feeding arteries was performed. This case demonstrates a rare pulmonary artery pseudoaneurysm, known simply as Rasmussen aneurysm, that was successfully managed with coil embolization and highlights the importance of considering the disease in the differential diagnosis for patients with hemoptysis.

Cerebral white matter hyperintensities on MRI and acceleration of epigenetic aging: the atherosclerosis risk in communities study.

BACKGROUND: Cerebral white matter hyperintensities (WMH) on magnetic resonance imaging (MRI) are part of the spectrum of brain vascular injury accompanying aging and are associated with a substantial risk of stroke and dementia. We investigated the association of cerebral WMH burden on MRI with a DNA methylation-based biomarker of aging, termed DNA methylation age acceleration, which represents the deviation of the DNA methylation-predicted age from the chronologic age. RESULTS: In this cross-sectional observational study of 713 African-American participants of the Atherosclerosis Risk in Communities study, aged 51-73 years, estimates of predicted age were obtained based on two algorithms (Hannum et al. and Horvath) from DNA methylation measured using the Illumina HM450 array on genomic DNA extracted from blood. Age acceleration, calculated as the residual values from the regression of each of the predicted age measures onto the chronologic age, was significantly associated with WMH burden after accounting for chronologic age and sex, body mass index, systolic blood pressure, hypertension, diabetes, current smoking, and blood cell composition, and results were similar for either Hannum et al.- or Horvath-derived estimates (P = 0.016 and 0.026). An age acceleration increase by 1 year was associated with an increase of WMH burden by ~1 grade. To shed light on possible biological mechanisms underlying this association, we conducted a genome-wide association study of age acceleration and identified four loci harboring genes implicated in hemostasis, cell proliferation, protein degradation, and histone methylation. However, none of these loci were associated with WMH burden. CONCLUSIONS: In this population-based study of middle-aged to older African-American adults, we report an association between accelerated epigenetic aging and increased WMH burden, independent of known risk factors, including chronologic age. Additional studies are needed to clarify whether DNA methylation age reflects biological mechanisms implicated in the aging of the cerebral white matter.

Objective measurement of erythema in psoriasis using digital color photography with color calibration.

Traditional metrics for evaluating the severity of psoriasis are highly subjective, which complicates efforts to identify effective treatments in clinical trials. We propose a method for the objective measurement of the psoriasis severity parameter of erythema (redness). This procedure is standardized for different camera systems and lighting environments through the usage of a color card with predetermined color values in order to calibrate the images. Quantitative measures based on the digital color images are shown to correlate well with subjective assessment of psoriasis severity collected using a standard numerical scale by a panel of dermatologists. Additionally, the color calibration process is shown to improve results.