Drug rash with eosinophilia and systemic symptoms (DRESS) is a rare but potentially life-threatening condition with high mortality. Diagnosis is challenging due to variable clinical presentation and a protracted latency period following initiation of the offending drug. DRESS is a complex interplay that starts by introduction of the offending drug, reactivation of viruses and activation of the immune system. Herpes virus reactivation is considered a diagnostic marker and indicator of illness severity. Prompt recognition and the removal of offending agent remain the key to successful treatment. In cases of severe organ involvement, corticosteroids, immunoglobulins, antiviral and specialist consultation may be helpful. Here we present a case of a 36-year-old African-American male who presented with symptoms mimicking sepsis with an associated skin eruption that was diagnosed as DRESS.

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Mice with a deletion of the hypothalamic basic helix-loop-helix transcription factor Nhlh2 (N2KO) display adult onset obesity, implicating Nhlh2 in the neuronal circuits regulating energy availability. Nhlh2 co-localizes with the hypothalamic thyrotropin-releasing hormone (TRH) neurons in the paraventricular nucleus (PVN) and proopiomelanocortin (POMC) neurons in the arcuate nucleus. N2KO mice become obese due to reduced physical activity in the absence of hyperphagia making them a unique mouse model for the study weight gain, obesity and energy expenditure. Signals that regulate Nhlh2 and the effects of Nhlh2 on peripheral tissues remain largely unknown. The research presented here utilized numerous techniques to investigate the effects of changes in energy availability on Nhlh2 expression. We show that Nhlh2 expression decreases significantly with food deprivation and cold exposure. Nhlh2 expression is stimulated with food return or leptin injection following food deprivation or return to room temperature following cold exposure. These data suggest that Nhlh2 gene expression responds positively to increased energy availability and negatively to reduced energy availability. These findings combined with the phenotype of N2KO mice led us to propose that Nhlh2 integrates energy availability inputs in various hypothalamic nuclei to drive expression of genes required for body weight maintenance. Investigation into peripheral tissues in N2KO mice revealed that responses of genes in the hypothalamus-pituitary-thyroid axis, muscle, and brown and white adipose tissue to changes in energy availability require Nhlh2 expression. The responses of serum total T4 levels and UCP1 mRNA and UCP3 mRNA to energy availability signals are altered in N2KO mice. In addition, N2KO mice maintain body temperature with cold exposure but are unable to maintain body weight. In summary, my work provides new insight into the role of Nhlh2 in coordinating energy availability signals to downstream genes required for body weight maintenance and thermoregulation.

Thesis (Ed.D.)--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 open-help@bu.edu. Thank you. / The performance of a group of twenty brain-injured boys (mean IQ 117.4; mean chronological age 120.6 months) was compared with that of a control group of non-brain-injured boys (mean IQ 118.2; mean chronological age 128.6 months) on a battery of tests designed to measure perceptual processes underlying conceptual thinking. The experimental group was selected from the out-patient files of the Seizure Unit at Ohildrens Medical Center in Boston. The control group was drawn from a large elementary school in the greater Boston area. All children in both groups were enrolled in regular classrooms and groups were matched on the variable• ot WISC Full Scale IQ, chronological age, sex and socio-economic level. The battery of tests consisting of the WISC, the Grahm-Kendall Memory for Design, the Wisconsin Card sorting Teat, the Porteua Mazes and the Gilmore Sentence Completion Test was administered to each child in his own home. [TRUNCATED] / 2031-01-01

Many pharmaceuticals are stable molecules and after human excretion they enter the wastewater facilities where roughly 60 % is removed. The remaining residues will affect the concentration in close by streams and at the effluent, where fish like to spawn. Therefore, the development and behaviour of aquatic life is potentially at risk. I studied the effects of fluoxetine on zebrafish (Danio rerio) younger than 1 month which were exposed from fertilized egg until 6 days post fertilization (dpf). The concentrations tested were related to previous findings in the effluent waters, 1 µg/L and 100 µg/L. With Daniovision it was found that there were most differences at 10 dpf, all three variables tested (distance moved, velocity and time in zone) showed differences between the high and low exposure. These results shed light on the rising problem with anti-depressants in the aquatic environment, affecting fish behaviour, withpotential effect on fish population and in the species.

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