Elevated autoimmunity in residents living near abandoned uranium mine sites on the Navajo Nation.

Specific autoantibodies were assessed among residents of the Navajo Nation in New Mexico chronically exposed to metal mixtures from uranium mine wastes and in drinking water supplies. Age and the extent of exposure to legacy waste from 100 abandoned uranium mine and mill sites were associated with antibodies to denatured DNA, previously known to be an early indicator of medication-induced autoimmunity. Surprisingly, autoantibodies to native DNA and/or chromatin were also linked to environmental exposure, specifically uranium consumption through drinking water for both men and women, while urinary arsenic was negatively associated with these autoantibodies in women.

Myeloid adrenergic signaling via CaMKII forms a feedforward loop of catecholamine biosynthesis.

Type 2 immune response has been shown to facilitate cold-induced thermogenesis and browning of white fat. However, whether alternatively activated macrophages produce catecholamine and substantially promote adaptive thermogenesis in adipose tissue remains controversial. Here, we show that tyrosine hydroxylase (TyrH), a rate-limiting enzyme of catecholamine biosynthesis, was expressed and phosphorylated in adipose-resident macrophages.

Biomass smoke exposure and chronic lung disease.

Purpose Of Review: Approximately 3 billion people worldwide rely on coal and biomass fuel for cooking and heating. Biomass smoke exposure is associated with several chronic lung diseases, including chronic obstructive pulmonary disease (COPD), asthma-COPD overlap syndrome, usual interstitial pneumonitis, hut lung, and bronchial anthracofibrosis. Household air pollution primarily from biomass smoke is the biggest risk factor for COPD worldwide.

Chronic obstructive pulmonary disease secondary to household air pollution.

Approximately 3 billion people around the world cook and heat their homes using solid fuels in open fires and rudimentary stoves, resulting in household air pollution. Household air pollution secondary to indoor combustion of solid fuel is associated with multiple chronic obstructive pulmonary disease (COPD) outcomes. The exposure is associated with both chronic bronchitis and emphysema phenotypes of COPD as well as a distinct form of obstructive airway disease called bronchial anthracofibrosis.

Performing a lung disability evaluation: how, when, and why?

Objectives: The objective of this review is to present a case-based clinical discussion on this topic.

Methods: The article represents part of the proceedings of the Occupational and Environmental Lung Disease conference held by the American College of Chest Physicians at Toronto, Ontario, Canada, in 2013, and is based upon a nonsystematic review of the current literature by the author.

Results: Although the American Medical Association Guides to the Evaluation of Permanent Impairment is the mainstay for evaluating respiratory impairment, many other impairment schemata are currently available in the United States.

Genome-wide association analysis identifies six new loci associated with forced vital capacity.

Forced vital capacity (FVC), a spirometric measure of pulmonary function, reflects lung volume and is used to diagnose and monitor lung diseases. We performed genome-wide association study meta-analysis of FVC in 52,253 individuals from 26 studies and followed up the top associations in 32,917 additional individuals of European ancestry. We found six new regions associated at genome-wide significance (P < 5 × 10(-8)) with FVC in or near EFEMP1, BMP6, MIR129-2-HSD17B12, PRDM11, WWOX and KCNJ2.

Body mass index is a stronger predictor than the metabolic syndrome for future asthma in women. The longitudinal CARDIA study.

Rationale: It is hypothesized that the metabolic syndrome explains the association between body mass index (BMI) and asthma in adults.

Objectives: Our objective was to longitudinally compare the relative strengths of the associations of the metabolic syndrome and BMI with incident asthma in adults.

Methods: We included 4,619 eligible participants in the Coronary Artery Risk Development in Young Adults (CARDIA) cohort followed over 25 years.

Adult-onset asthma becomes the dominant phenotype among women by age 40 years. the longitudinal CARDIA study.

Rationale: Although asthma is usually considered to originate in childhood, adult-onset disease is being increasingly reported.

Objectives: To contrast the proportion and natural history of adult-onset versus pediatric-onset asthma in a community-based cohort. We hypothesized that asthma in women is predominantly of adult onset rather than of pediatric onset.

Effect of allergen inhalation on airway oxidant stress, using exhaled breath condensate 8-isoprostane, in mild asthma.

Objective: Exhaled breath condensate (EBC) 8-isoprostane concentrations are increased in asthma, but it is not known if they acutely change following bronchoprovocation. The objective of this study was to evaluate EBC 8-isoprostane concentrations following allergen-induced bronchoprovocation in asthma.

Methods: This comparison study included eight mild atopic asthmatics and six controls.

Adiponectin in pulmonary disease and critically ill patients.

Adiponectin is a predominantly anti-inflammatory protein produced by adipose tissue with possible signalling activity in the lung. It is increasingly associated with inflammatory pulmonary diseases, such as asthma and chronic obstructive pulmonary disease (COPD), and in critical illness. Although mouse studies indicate causative associations between adiponectin and asthma and COPD, the human literature in this regard is inconclusive.

Leptin, adiponectin and pulmonary diseases.

Adipose tissue produces leptin and adiponectin - energy-regulating adipokines that may also play a role in inflammatory pulmonary conditions, as suggested by some murine studies. Leptin and adiponectin and their respective receptors are expressed in the human lung. The association between systemic or airway leptin and asthma in humans is currently controversial, particularly among adults.

Serum Adiponectin is Associated with Adverse Outcomes of Asthma in Men but Not in Women.

Background: Murine studies suggest a beneficial effect of systemic adiponectin on asthma. Our objective was to determine the association between serum adiponectin concentrations and asthma control/severity outcomes in men and women separately.

Methods: Cross-sectional and longitudinal analyses of data from years 10, 15, and 20 examinations of the prospective coronary artery risk development in young adults study in the United States were performed.

Association between asthma and serum adiponectin concentration in women.

Background: The association of murine asthma with adiposity may be mediated by adiponectin, an anti-inflammatory adipokine with reduced serum concentrations in obese subjects. A study was undertaken to examine whether the serum adiponectin concentration is associated with human asthma and whether it explains the association between adiposity and asthma, particularly in women and in premenopausal women.

Methods: A cross-sectional analysis was performed of 2890 eligible subjects at year 15 of the Coronary Artery Risk Development in Young Adults (CARDIA) cohort and its YALTA ancillary study who had either current asthma or never asthma at that evaluation.

Characteristics of smokers calling a national reactive telephone helpline.

Purpose: Although reactive telephone helplines for quitting smoking are increasingly popular in the United States, the characteristics of callers using this resource have not been adequately studied. The objective of this study was to describe the characteristics of the current smokers calling a national reactive telephone helpline (i.e.

Safety and immunogenicity of co-administered quadrivalent human papillomavirus (HPV)-6/11/16/18 L1 virus-like particle (VLP) and hepatitis B (HBV) vaccines.

Adolescents and young adults are at high risk for human papillomavirus (HPV) and hepatitis B virus (HBV) infections, which are preventable by currently available, safe and effective, prophylactic vaccines. However, development of a combined immunization strategy may lead to better compliance for these vaccines, thereby contributing to the overall goal of protection against these diseases. This study assessed the safety and immunogenicity of co-administered quadrivalent HPV-6/11/16/18 L1 VLP and HBV vaccines in women (n=1877) aged 16-23 years.

Pelvic floor symptom changes in pessary users.

Objective: The objective of the study was to compare pelvic floor symptom changes in patients who continue vs discontinue pessary use, and determine whether changes predict pessary continuation.

Study Design: Women fitted with pessaries completed the Pelvic Floor Distress Inventory-20 (PFDI-20) before and after initiating pessary use. Scores were compared in women who continued vs discontinued pessaries.

Posterior repair and sexual function.

Objective: The purpose of this study was to determine the effect of posterior repair (PR) on sexual function in patients who have undergone incontinence and/or pelvic reconstructive surgery.

Study Design: A cohort study of women who underwent incontinence and/or prolapse surgery was performed. Participants completed the pelvic organ prolapse urinary incontinence sexual questionnaire (PISQ) before and after the operation.

Association of excess weight and degree of airway responsiveness in asthmatics and non-asthmatics.

It is unclear whether obesity is associated with increasing degree of airway responsiveness in asthmatics. In this study, methacholine challenge test results of 1,725 subjects with respiratory symptoms were reviewed. Obesity was associated with asthma with an odds ratio of 1.

Teaching communications and professionalism through writing and humanities: reflections of ten years of experience.

Both professionalism and interpersonal communication are core competencies for emergency medicine residents as well as residents from other specialties. The authors describe a weekly, small-group seminar lasting one year for emergency medicine residents that incorporates didactic materials, case studies, narrative expression (stories and poems), and small-group discussion. Examples of cases and narrative expressions are provided and a rationale for utilizing the format is explained.

Postmortem lipid levels for the analysis of risk factors of sudden death: usefulness of the Ektachem and Monarch analyzers.

Elevated serum cholesterol, triglyceride, and free fatty acid levels have been identified as risk factors for sudden death from cardiovascular disease and increased risk for myocardial ischemia or arrhythmias; therefore, correlation of antemortem and postmortem lipid levels may be useful in establishing the cause, pathophysiology, or familial risk factors of sudden death. In the present study, antemortem (within 72 h) and postmortem (within 24 h) cholesterol, triglyceride, free fatty acid, and albumin levels were analyzed in seven autopsied hospitalized patients from the University of New Mexico Hospital in Albuquerque, New Mexico. The cholesterol, triglyceride, and albumin levels were measured by dry-slide technology on an Ektachem 700 analyzer, and the free fatty acid levels were measured on a Monarch analyzer with a commercially available kit from Wako Chemical.

Determinants of aerosolized albuterol delivery to mechanically ventilated infants.

An in-vitro lung model and a volume ventilator were used to evaluate the delivery of aerosolized albuterol through an infant ventilator circuit. We compared the following: continuous nebulization (CNA) and intermittent nebulization (INA); various nebulizer gas flows, 5.0, 6.