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Glass wool or vitreous fibers are non‐crystalline, fibrous inorganic substances (silicates) made primarily from rock, slag, glass, or other processed minerals. They belong to the man‐made mineral fibers (MMMFs) group and their respiratory effects are well described by De Vuyst et al. [1995]. The authors pointed out the absence of firm evidence that exposure to these fibers is associated with lung fibrosis, pleural lesions, or non‐specific respiratory disease in humans. Because of this observation, we find it of importance to present a case of interstitial fibrosis, which implies a direct association between long‐term exposure to glass wool and the clinical outcome. Am. J. Ind. Med. 49:1066–1069, 2006. © 2006 Wiley‐Liss, Inc.

Althoughmolecular mechanisms underlying steroid effects on GnRH and dopamine receptors are well documented in mammals, little is known in fish. Herein, we describe the expression of pituitary GnRH and dopamine receptors relative to gonadotropin expression and release. We exposed female tilapia to graded doses of estradiol or 17alpha,20beta-dihydroxy-4-pregnen-3-one (DHP) in vitro, and of estradiol in vivo, and determined mRNA levels ofgnrhr1,gnrhr3,drd2,lhb, andfshbby real-time PCR. We also determined gonadotropin levels using specific ELISAs. Exposure to low doses of estradiol caused increasedgnrhr3mRNA levels in vivo and in vitro, probably related to positive feedback on FSH release. Increasing concentrations of estradiol resulted in increaseddrd2mRNA levels in vivo and in vitro, inhibition of LH and FSH release, and inhibition oflhbmRNA levelsin vivo, possibly related to negative feedback. At high doses of estradiol, FSH release increased in preparation for a new generation of follicles. Exposure to nanomolar doses of DHP resulted in increaseddrd2mRNA levels, probably related to negative feedback on LH release. A decrease indrd2levels at the micromolar range of DHP (concomitant with increasedgnrhr3andfshbmRNA levels) may be related to the recruitment of a new generation of oocytes. Exposure to DHP also resulted in increasedlhbmRNA levels toward final oocyte maturation. Salmon GnRH analog (sGnRHa) increased mRNA levels ofgnrh1andgnrh3; when combined with DHP, sGnRHa synergistically increased expression ofgnrh3only. These results emphasize the role of sex steroids on positive and negative feedbacks controlling the reproductive cycle.

Induced sputum is a particularly useful procedure since it provides information on the cellular and molecular constituents in inflammation. Extensive work has demonstrated the application of induced sputum in the management of asthma, chronic obstructive pulmonary disease and chronic bronchitis, but less attention has been paid to its efficacy in diagnosing interstitial lung diseases. This review analyzes the applications of induced sputum in the assessment of sarcoidosis, nongranulomatous interstitial lung diseases, occupational lung diseases and other systemic diseases with or without lung involvement.

Pneumococcal conjugate vaccine (PCV) has been in routine use in the United States for 5 years. Prior U.S. cost-effectiveness analyses have not taken into account the effect of the vaccine on nonvaccinated persons.

The objectives of this study were to provide estimates of the prevalence and strength of association between major depression and chronic pain in a primary care population and to examine the clinical burden associated with the two conditions, singly and together.

Thin films with enantioselective properties for electrochemically active chiral probes were developed. Enantioselectivity was accomplished via molecular imprinting. The films were fabricated through the sol−gel technique and were spin-coated on ITO electrodes. The chiral selectivity recognition was detected using two enantiomer pairs:  d- and l-3,4-dihydroxyphenylalanine (d- and l-dopa) and (R)- and (S)-N,N‘-dimethylferrocenylethylamine [(R)-Fc and (S)-Fc]. A defined chiral cavity was obtained by selection of functional monomers that interact with the template molecule, followed by its removal. Chiral selection properties were measured by cyclic voltammetry and square wave voltammetry. For both template molecules, very good chiral recognition was revealed by electrochemical measurement. The nonspecific adsorption measured for reference nonimprinted films was negligible (less than 5%). Dopa imprinted films revealed both high sensitivity, by the detection of 1 nM (0.2 ppb) concentration, and excellent selectivity, when challenged with a series of catechol derivatives. Fc-imprinted films were able to detect ca. 2 ppm of the target molecule, with very good enantioselectivity and low nonspecific adsorption. To our knowledge, this is the first report of successful molecular imprinting of a ferrocene derivative.

In view of the current controversy regarding the use of antidepressants in children and adolescents, we examined trends from 1994 to 2003 in the use of antidepressants, lithium, and anticonvulsants by enrollees, aged 5–17 years, of Kaiser Permanente in Northern California. We found that the use of antidepressants more than doubled from 9.4 per 1000 enrollees to 21.3 per 1000. Most of this increase is associated with selective serotonin reuptake inhibitors (SSRIs), which increased from 4.6 to 14.5 per 1000. The use of tricyclic antidepressants (TCAs) decreased markedly, while the increase of other newer antidepressants rose from 1.3 to 6.5 per 1000. The use of anticonvulsants nearly doubled, from 3.5 to 6.9 per 1000, while lithium use was relatively stable at a rate of nearly 1 per 1000. Use of SSRIs, newer antidepressants, and anticonvulsants increased in boys as well as girls in each of three age groups: 5–9, 10–14, and 15–17 years. An increasing percentage of the antidepressant users had a diagnosis of depression, and an increasing percentage of anticonvulsant users had a diagnosis of bipolar disorder. Although the safety and efficacy of antidepressants in youths needs to be more firmly established, these findings may reflect progress in the diagnosis and treatment of mental illness.

This review covers new and emerging issues in addictions and organ transplantation. In addition to discussing alcohol and other substance use after transplantation, the authors also report recent data on the long-term effects of alcohol and tobacco after transplantation.

To assess the direct and indirect effects of the introduction of routine use of pneumococcal conjugate vaccine in infants and toddlers at risk for invasive disease caused by vaccine serotypes and nonvaccine serotypes in vaccinated children and unvaccinated children of the same age. Secondary objectives included determination of the risk of pneumococcal infections in unvaccinated older children and adults in the same population and the impact of vaccine introduction on patterns of antimicrobial resistance.

Respiratory syncytial virus (RSV) infection in infancy that causes severe bronchiolitis had been implicated as potentially responsible for the subsequent development of asthma. The CD14 receptor responds to the microbial burden in the environment and modulates the development of the allergic phenotype.

The use of cost-sharing to control healthcare expenditures is increasing, but there is scant information about patients’ knowledge of cost-sharing or its influence on behavior.

Immunosuppressants are prescribed to prevent rejection of transplanted tissues and organs and are also used in the treatment of autoimmune disorders. Consultation-liaison psychiatrists increasingly encounter patients taking these agents as the number of transplant recipients increases and the indications for the use of immunosuppressants expands. These drugs have potentially deleterious physical, mental, and biochemical side effects. In addition, transplant recipients and patients with autoimmune disorders commonly have comorbid illnesses that require pharmacologic treatment. The management of these patients is challenging secondary to the severity of these illnesses, the number of medications prescribed, and the potential for adverse drug-drug interactions. Knowledge of the pharmacokinetic properties of these drugs and the potential for serious drug-drug interactions that cause alterations in serum levels of the immunosuppressant medications is essential. Increased serum levels may cause serious toxic effects and decreased serum levels may lead to rejection of the transplanted organ or worsening of the autoimmune disorder. Adverse events may also occur when serum levels of medications prescribed for comorbid illnesses are altered by administration of immunosuppressants. The pharmacokinetic drug-drug interaction profiles of the glucocorticoids, cyclosporine, tacrolimus, sirolimus, mycophenolate mofetil, azathioprine, and monoclonal antibodies are discussed in this review.

One potential mechanism by which respiratory viruses trigger illness and complications is via the local elaboration of inflammatory mediators.

Chirally imprinted sol−gel thin films were fabricated through the molecular imprinting technique. The films were spin coated on glass plate substrates. Enantioselective discrimination of these films was observed toward three different templates. In each case a different enantiomer pair was selected as a template and a sol mixture was tailored accordingly. By extracting the template molecule a defined chiral cavity was created. The enantiomer pairs were (R)- and (S)-propranolol, (R)- and (S)-2,2,2-trifluoro-1-(9-anthryl) ethanol, and d- and l-3,4-dihydroxyphenylalanine (d- and l-dopa). Selective adsorption properties of the resulted films toward the imprinted molecules were measured by radioactive and fluorescence analysis. In all cases, preferred adsorption of one enantiomer was revealed. This preference was due to configuration match between the cavity and the adsorbed molecule. Nonspecific adsorption was remarkably low and was measured for reference nonimprinted films.

Provides information on the eDistribution computer software from Epicor Software Corp., which was chosen by California-based toy maker Wild Planet Toys for its shipping-fulfillment activities. Cost-effectiveness of the software; Features; Applications.

The heptavalent pneumococcal conjugate vaccine (PCV) is recommended for infants to protect against invasive disease, but its impact on otitis might also have public health importance.

Organ transplantation has become an accepted medical procedure in the twenty-first century. As of June 2002, more than 80,000 patients in the United States were waiting for solid organ transplants. It is recognized that organs are scarce and that the organ supply cannot keep up with the demand. The question of which patients should receive this scarce medical resource continues to be controversial. Some clinicians and ethicists suggest that those who are incarcerated should not be considered for transplant. Because the public pays the cost of health care for these people, the additional question arises whether taxpayers should finance expensive medical procedures for incarcerated people. This review focuses on ethical issues concerning allocation of this scarce resource and payment for these procedures for incarcerated people.

To determine the effectiveness of the Wyeth heptavalent pneumococcal conjugate vaccine against clinical and radiograph-confirmed pneumonia in children.

Pneumococcal conjugate vaccine for infants has recently been found to be effective for prevention of meningitis, bacteremia, pneumonia and otitis media, but it is more costly than previously introduced vaccines.

The relationship between nightmare prevalence, nightmare distress, and self-reported psychological disturbance was assessed prospectively.

To determine the efficacy, immunogenicity and safety of the heptavalent CRM197pneumococcal conjugate vaccine (PCV) in low birth weight (LBW) and preterm (PT) infants against invasive pneumococcal disease caused by vaccine types.

The economic impact and medical complication rate of viral upper respiratory infections are well documented, but many of the physiologic, inflammatory, and immune responses to respiratory viruses have only recently been investigated. A previous study demonstrated differential systemic immune and inflammatory responses in allergic rhinitis (AR) and nonallergic rhinitis (NAR) subjects during experimental infection with rhinovirus-39.

The present study prospectively investigated the relationship between nightmare prevalence, nightmare distress, and waking imaginative involvement. One hundred and sixteen individuals completed self-report indices of fantasy proneness, psychological absorption, and daydreaming as well as a sleep and dreaming questionnaire and a nightmare distress measure. Participants then kept a dreaming and nightmare log for 21 consecutive nights. As predicted, both nightmare prevalence and nightmare distress were associated with higher levels of fantasy proneness, psychological absorption, and a guilty-dysphoric daydreaming style but not with positively-toned daydreams or a highly distractible daydreaming style. Further, these results were not due to higher levels of overall dream recall. Last, these effects were additive as high scores on either fantasy proneness or absorption added significantly higher incremental validity to the prediction of nightmare prevalence and distress than just from the dysphoric daydreaming measure alone. The results are discussed within the context of emerging etiological theories of nightmare production.

High-dose cancer treatment with cis-platin (CP, cis-[Pt(NH3)2Cl2]), although of therapeutic value, is limited by its toxicity. Fast removal of excess drug shortly after administration and site-specific drug release are potential partial solutions of this problem. As a first stage toward these solutions, several adsorption/desorption properties of CP have been determined and analyzed. The main adsorbent selected for this study was silica silylated with (3-mercaptopropyl)trimethoxysilane (MPTS). The properties of this mercapto-derivatized silica (SiSH) were compared with an organically modified silica sol−gel material (Ormosil) using MPTS as modifier and with nonderivatized silica (SiOH). Although Langmuirian at first glance, a more detailed analysis of the adsorption isotherm of the CP/SiSH system revealed a cooperative mechanism of adsorption, namely, an increase in adsorption affinity with coverage. This cooperativity was detected by employing a coverage-dependent adsorption-equilibrium constant. Active shifting of the adsorption equilibrium toward the desorption side was achieved with 2,3-dimercapto-1-propane sulfonic acid sodium salt in solution. On the basis of the differences in adsorption affinities between SiSH and SiOH, we demonstrated, we believe for the first time, the ability to achieve interparticle migration of an adsorbate (CP) from one matrix to another.

Beclomethasone dipropionate (BDP) extrafine aerosol, a newly developed pressurized metered dose inhaler (pMDI) with a hydrofluoroalkane-134a (HFA) propellant (HFA-BDP; Qvar, 3M Pharmaceuticals, St. Paul, MN), has been shown to be effective in controlling asthma symptoms at approximately half the daily dose of chlorofluorocarbon (CFC)-BDP.

Background & Aims:Wireless capsule endoscopy is a new, painless method of imaging the entire small bowel. It has not been compared with push enteroscopy. We compared the sensitivity, specificity, and safety of capsule and push enteroscopy in detecting small-bowel lesions. Methods:Nine to 13 radiopaque, colored beads (3–6 mm diameter) were sewn in random order inside 9 canine small bowels, half within the first meter, and confirmed on x-ray. After recovery, the number, order, and color of beads were assessed in 23 capsule enteroscopies and 9 push enteroscopies in a random order. The surgeons, push enteroscopists, capsule video interpreters, and pathologist were blinded to the others' findings. Results:The capsules identified more beads than push enteroscopy (median, 6 [range, 2–9] vs. 3 [range, 2–6 beads]; P< 0.001). The sensitivity of the capsule was 64% compared with 37% for push enteroscopy. The specificity was 92% for capsule enteroscopy and 97% for push enteroscopy. The capsules identified significantly more beads beyond the reach of the push enteroscope (median, 4 [range, 2–7] vs. 0; P< 0.0001). Hair, ingested plastic, ulceration, submucosal swelling, and worms were clearly identified by the capsule. The capsules passed safely through the animals with no significant histologic findings. Conclusions:Wireless capsule endoscopy detected more abnormalities in the small bowel than push enteroscopy.

Exercise-induced asthma is a common phenomenon, the mechanism of which is undetermined. Eosinophils have been suggested as playing a role in its occurrence. We studied the effect of exercise-induced asthma on the cellular and mediator composition of spontaneously obtained sputum.

The adequacy of pharmacotherapy for patients with obsessive-compulsive disorder (OCD) in a large, prepaid HMO was studied. An analysis was made of the computerized records for December 1, 1994, through April 30, 1998, for members of a Kaiser Permanente plan in northern California who were six years of age or older and had had continuous membership during an index year (May 1, 1995, to April 30, 1996) (1,728 million members). A total of 880 adults and 168 children and adolescents with chart-review-confirmed OCD and a pharmacy benefit were identified. The percentage of patients with an adequate drug trial, defined as > or = 56 days of continuous treatment with a serotonin-reuptake inhibitor or phenelzine at dosages at or above established minimal effective dosages, was determined. Forty-three percent of the adults and 28% of the children and adolescents who were newly diagnosed with OCD in the index year had an adequate trial of medication in the year after their first visit for OCD. By the second six months after the index year, only 75.2% of newly treated adults and 60.9% of newly treated children and adolescents continuing in the health plan filled at least one anti-OCD prescription. During the second follow-up year, these figures fell to 60.4% and 38.9%, respectively. Continuing-care patients filling a prescription in the index year were more likely than newly diagnosed patients to fill prescriptions in the two-year follow-up period, but their treatment still decreased substantially. Despite the typically chronic course of OCD, many patients with OCD who were enrolled in a large HMO appeared not to receive an adequate trial of pharmacotherapy or ongoing pharmacotherapy.

To determine the efficacy, safety and immunogenicity of the heptavalent CRM197pneumococcal conjugate vaccine against invasive disease caused by vaccine serotypes and to determine the effectiveness of this vaccine against clinical episodes of otitis media.

ObjectiveTo estimate the effectiveness of mRNA vaccines against moderate and severe covid-19 in adults by time since second, third, or fourth doses, and by age and immunocompromised status.DesignTest negative case-control study.SettingHospitals, emergency departments, and urgent care clinics in 10 US states, 17 January 2021 to 12 July 2022.Participants893 461 adults (≥18 years) admitted to one of 261 hospitals or to one of 272 emergency department or 119 urgent care centers for covid-like illness tested for SARS-CoV-2.Main outcome measuresThe main outcome was waning of vaccine effectiveness with BNT162b2 (Pfizer-BioNTech) or mRNA-1273 (Moderna) vaccine during the omicron and delta periods, and the period before delta was dominant using logistic regression conditioned on calendar week and geographic area while adjusting for age, race, ethnicity, local virus circulation, immunocompromised status, and likelihood of being vaccinated.Results45 903 people admitted to hospital with covid-19 (cases) were compared with 213 103 people with covid-like illness who tested negative for SARS-CoV-2 (controls), and 103 287 people admitted to emergency department or urgent care with covid-19 (cases) were compared with 531 168 people with covid-like illness who tested negative for SARS-CoV-2. In the omicron period, vaccine effectiveness against covid-19 requiring admission to hospital was 89% (95% confidence interval 88% to 90%) within two months after dose 3 but waned to 66% (63% to 68%) by four to five months. Vaccine effectiveness of three doses against emergency department or urgent care visits was 83% (82% to 84%) initially but waned to 46% (44% to 49%) by four to five months. Waning was evident in all subgroups, including young adults and individuals who were not immunocompromised; although waning was morein people who were immunocompromised. Vaccine effectiveness increased among most groups after a fourth dose in whom this booster was recommended.ConclusionsEffectiveness of mRNA vaccines against moderate and severe covid-19 waned with time after vaccination. The findings support recommendations for a booster dose after a primary series and consideration of additional booster doses.

There are no data about specific IgE antibodies to food and aeroallergens in the Israeli population.

BAL, an important tool in assessing occupational lung diseases, is unsuitable for screening programs, exposure evaluation, or monitoring hazardous dust because it is an invasive technique. The results of induced sputum (IS) analysis were compared with BAL and evaluated as a possible alternative.

The objectives of this study were (1) to determine the safety and immunogenicity of heptavalent pneumococcal CRM197conjugate (PNCRM7) vaccine in infants and (2) to determine the effect of concurrent hepatitis B immunization during the primary series and the effect of concurrent diphtheria and tetanus toxoid and acellular pertussis DTaP (ACEL-IMUNE) and conjugate CRM197Haemophilus influenzaetype b HbOC (HibTITER) immunization at time of the booster dose on the safety and immunogenicity of PNCRM7 and these other concurrently administered vaccines.

Background:Recent studies have documented a link between respiratory viral infections and the expression of asthma and other allergic disorders. Results from other studies have suggested that diminished production of IL-10, an anti-inflammatory cytokine, may contribute to the pathophysiologic features of these diseases. Objective:The objective of this study was to determine whether diminished IL-10 production and TH2cytokine skewing occur in allergic, as compared with nonallergic, subjects after experimental infection with the influenza A virus. Methods:PBMCs were isolated from 11 subjects with allergy and 14 subjects with no allergy before and after influenza A infection and stimulated with either mitogen (PHA) or antigen (influenza A). Supernatants were assayed for IL-10, IL-4, and IFN-γ by ELISA. Results:PBMC IL-10 production was significantly diminished in subjects with allergy, as compared with subjects with no allergy, after experimental infection with influenza A virus. However, significant TH2skewing and enhanced airway symptoms were not observed in these same subjects. Conclusions:These data provide further support that subjects with allergy have an intrinsic inability to upregulate IL-10 production in response to inflammatory stimuli and extend this observation to include respiratory viral infections. Future studies in this area could lead to a better understanding of the pathogenesis of asthma and other allergic disorders (J Allergy Clin Immunol 1999;103:1045-8.)

A 33-year-old woman suffered a week of severe epigastric pain and subsequent weight loss. On upper-gastrointestinal endoscopy several superficial ulcers were evident in the antral region. Mucosal biopsies from the ulcers showed epithelial cell granulomas. Even though no hilar lymphadenopathy was present on the chest radiograph and computed tomographic scan, the patient underwent bronchoscopy and transbronchial biopsy, which showed noncaseating epithelial cell granuloma, and bronchoalveolar lavage, which showed a lymphocytic pattern suggestive of sarcoidosis. Reports of gastric involvement in systemic sarcoidosis with no bilateral hilar lymphadenopathy are rare. We believe this is the first report of symptomatic gastric ulcers leading to endoscopic diagnosis of the underlying sarcoidosis.