An Alternate Method of Classifying Allergic Bronchopulmonary Aspergillosis Based on High-Attenuation Mucus

Allergic bronchopulmonary aspergillosis (ABPA) is classified radiologically based on the findings of central bronchiectasis (CB) and other radiologic features (ORF). However, the long-term clinical significance of these classifications remains unknown. We hypothesized that the immunological activity and outcomes of ABPA could be predicted on HRCT chest finding of high-attenuation mucus (HAM), a marker of inflammatory activity. In this study, we evaluate the severity and clinical outcomes of ABPA with different radiological classifications. specific IgE levels, eosinophil count) severity of the disease and clinical outcomes in various classifications were analyzed.Of the 234 (123 males, 111 females; mean age, 34.1 years) patients, 55 (23.5%) had normal HRCT, 179 (76.5%) had CB, 49 (20.9%) had HAM, and 27 (11.5%) had ORF. All immunological markers were consistently higher in the HAM classification, while in other classifications these findings were inconsistent. On multivariate analysis, the factors predicting frequent relapses were presence of HAM (OR 7.38; 95% CI, 3.21–17.0) and CB (OR 3.93; 95% CI, 1.63–9.48) after adjusting for ORF.The classification scheme based on HAM most consistently predicts immunological severity in ABPA. Central bronchiectasis and HAM are independent predictors of recurrent relapses in ABPA. Hence, HAM should be employed in the radiological classification of ABPA

The Parker problem:existence of smooth force-free fields and coronal heating

Parker (Astrophys J 174:499, 1972) put forward a hypothesis regarding the fundamental nature of equilibrium magnetic fields in astrophysical plasmas. He proposed that if an equilibrium magnetic field is subjected to an arbitrary, small perturbation, then—under ideal plasma dynamics—the resulting magnetic field will in general not relax towards a smooth equilibrium, but rather, towards a state containing tangential magnetic field discontinuities. Even at astrophysical plasma parameters, as the singular state is approached dissipation must eventually become important, leading to the onset of rapid magnetic reconnection and energy dissipation. This topological dissipation mechanism remains a matter of debate, and is a key ingredient in the nanoflare model for coronal heating. We review the various theoretical and computational approaches that have sought to prove or disprove Parker’s hypothesis. We describe the hypothesis in the context of coronal heating, and discuss different approaches that have been taken to investigating whether braiding of magnetic field lines is responsible for maintaining the observed coronal temperatures. We discuss the many advances that have been made, and highlight outstanding open questions.</p

Smoking, atopy, and laboratory animal allergy.

This study examined data from three cross sectional surveys of 296 laboratory workers exposed to small mammals. Four indices of laboratory animal allergy were studied: symptoms suggestive of occupational asthma, symptoms suggestive of any occupational allergy, skin weals to animal urine extracts, and serum binding in radioallergosorbent tests with urine extracts. Pooled data from the three surveys showed an association between smoking and all indices except radioallergosorbent tests; the association was significant for symptoms of occupational asthma. One of the three surveys consistently showed a stronger association of allergy indices with smoking than with atopy (defined on skin tests with non-animal aeroallergens). Associations with smoking persisted after stratifying by atopic status, suggesting that smoking may be a risk factor for laboratory animal allergy