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Background: The potential consequences of asthma in childhood and young adulthood on lung structure in older adults have not been studied in a large, population-based cohort., Objective: The authors hypothesized that a history of asthma onset in childhood (age 18 years or before) or young adulthood (age 19-45 years) was associated with altered lung structure on computed tomography in later life., Methods: The Multi-Ethnic Study of Atherosclerosis Lung Study recruited 3965 participants and assessed asthma history by using standardized questionnaires, guideline-based spirometry, and segmental airway dimensions and percentage of low attenuation area (%LAA) on computed tomographic scans., Results: Asthma with onset in childhood and young adulthood was associated with large decrements in FEV(1) among participants with a mean age of 66 years (-365 mL and -343 mL, respectively; P < .001). Asthma with onset in childhood and young adulthood was associated with increased mean airway wall thickness standardized to an internal perimeter of 10 mm (0.1 mm, P < .001 for both), predominantly from narrower segmental airway lumens (-0.39 mm and -0.34 mm, respectively; P < .001). Asthma with onset in childhood and young adulthood also was associated with a greater %LAA (1.69% and 4.30%, respectively; P < .001). Findings were similar among never smokers, except that differential %LAA in childhood-onset asthma were not seen in them., Conclusion: Asthma with onset in childhood or young adulthood was associated with reduced lung function, narrower airways, and among asthmatic patients who smoked, greater %LAA in later life., (Copyright © 2013 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.)

We compared DXA whole body and lumbar spine bone mineral density (BMD) using manufacturers software with a body size correction which derived bone mineral content (BMC) for bone area in survivors of acute lymphoblastic leukemia in Saudi Arabia (n = 51, mean age 13.5 y). With no corrections, 29 patients (57%) had lumbar spine BMD Z score < -1.0 and 21 (41%) had whole body BMD Z score < -2. After correction, only 6 (12%) had lumbar spine BMC Z score < -1.0 and 4 (8%) had whole body BMC Z score < -2. Agreement between the methods was "poor" by weighted κ analysis.

Airflow obstruction is an independent risk factor for cardiovascular events in the general population. The affected vascular bed and contribution of emphysema to cardiovascular risk are unclear. We examined whether an obstructive pattern of spirometry and quantitatively defined emphysema were associated with subclinical atherosclerosis in the carotid, peripheral and coronary circulations. The Multi-Ethnic Study of Atherosclerosis recruited participants aged 45-84 yrs without clinical cardiovascular disease. Spirometry, carotid intima-media thickness (IMT), ankle-brachial index (ABI) and coronary artery calcium (CAC) were measured using standard protocols. Percentage of emphysema-like lung was measured in the lung windows of cardiac computed tomography scans among 3,642 participants. Multiple linear regression was used to adjust for cardiac risk factors, including C-reactive protein. Decrements in forced expiratory volume in 1 s (FEV(1)) and FEV(1)/forced vital capacity ratio were associated with greater internal carotid IMT, particularly among smokers (p=0.03 and p<0.001, respectively) whereas percentage emphysema was associated with reduced ABI regardless of smoking history (p=0.004). CAC was associated with neither lung function (prevalence ratio for the presence of CAC in severe airflow obstruction 0.99, 95% CI 0.91-1.07) nor percentage emphysema. An obstructive pattern of spirometry and emphysema were associated distinctly and independently with subclinical atherosclerosis in the carotid arteries and peripheral circulation, respectively, and were not independently related to CAC.

Smoking causes endothelial dysfunction and systemic microvascular disease with resultant end-organ damage in the kidneys, eyes and heart. Little is known about microvascular changes in smoking-related lung disease. We tested if microvascular changes in the retina, kidneys and heart were associated with obstructive spirometry and low lung density on computed tomography. The Multi-Ethnic Study of Atherosclerosis recruited participants age 45-84 years without clinical cardiovascular disease. Measures of microvascular function included retinal arteriolar and venular caliber, urine albumin-to-creatinine ratio and, in a subset, myocardial blood flow on magnetic resonance imaging. Spirometry was measured following ATS/ERS guidelines. Low attenuation areas (LAA) were measured on lung fields of cardiac computed tomograms. Regression models adjusted for pulmonary and cardiac risk factors, medications and body size. Among 3,397 participants, retinal venular caliber was inversely associated with forced expiratory volume in one second (FEV(1)) (P<0.001) and FEV(1)/forced vital capacity (FVC) ratio (P = 0.04). Albumin-to-creatinine ratio was inversely associated with FEV(1) (P = 0.002) but not FEV(1)/FVC. Myocardial blood flow (n = 126) was associated with lower FEV(1) (P = 0.02), lower FEV(1)/FVC (P = 0.001) and greater percentage LAA (P = 0.04). Associations were of greater magnitude among smokers. Low lung function was associated with microvascular changes in the retina, kidneys and heart, and low lung density was associated with impaired myocardial microvascular perfusion. These cross-sectional results suggest that microvascular damage with end-organ dysfunction in all circulations may pertain to the lung, that lung dysfunction may contribute to systemic microvascular disease, or that there may be a shared predisposition.

Ethnopharmacological Relevance: Areca catechu, commonly known as betel nut, is very famous for its medicinal use in multiple disorders. It is also popular as a remedy against inflammatory disorders in the Unani (Greco-Arab) system of medicine., Objective of the Study: This study was aimed at investigating the anti-inflammatory and analgesic activities of the crude extract of Areca catechu and its respective fractions., Materials and Methods: Paw edema, formalin-induced nociception and acetic acid-induced writhing assays were carried out in vivo. Free radical scavenging activity of the plant extract was performed in vitro., Results: Preliminary experiments using a single dose (100 mg/kg) of Areca catechu and its respective fractions demonstrated an anti-inflammatory effect on carrageenan-induced edema in mice and rats, the aqueous fraction being distinctly more effective. When studied on prostaglandin E₂ (PGE₂), arachidonic acid, histamine, or serotonin (5HT)-induced edema in rats, Areca catechu and its aqueous fraction markedly repressed only the PGE₂ and arachidonic acid-induced inflammation. When studied for analgesic activity, the crude extract and its aqueous fraction produced a dose-dependent (10-100 mg/kg) inhibitory effect on formalin-induced nociception in mice and acetic acid-induced writhing in rats, similar to aspirin. In DPPH assay, Areca catechu and its aqueous fraction exhibited free radical scavenging activity with respective IC(50) values of 5.34 μg/ml (4.93-5.78, CI; 95%, n=5) and 7.28 μg/ml (6.04-7.95, n=4), like that of rutin with IC(50) value of 4.75 μg/ml (3.89-5.42, n=4)., Conclusion: These results indicate the anti-inflammatory and analgesic effects of Areca catechu and provide a rationale for its medicinal use in inflammatory disorders., (Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.)

This study examined the relationship between Executive Function (EF) and Theory of Mind (ToM) using the Delis-Kaplan Executive Function System (D-KEFS) and three tests of ToM (Reading the Mind in the Eyes test (RMET), Strange Stories test, and Faux Pas test). Separate regression analyses were conducted, and EF predictors varied by ToM test. No EF domains accounted for significant variance in RMET scores; only estimated IQ scores were significant predictors of RMET performance. Verbal fluency and deductive reasoning were significant predictors of performance on the Strange Stories test, while verbal fluency, problem solving, and gender accounted for a significant variance in the Faux Pas test. Results suggest that the ToM tests each utilized differing cognitive mechanisms.

Background: Very severe chronic obstructive pulmonary disease causes cor pulmonale with elevated pulmonary vascular resistance and secondary reductions in left ventricular filling, stroke volume, and cardiac output. We hypothesized that emphysema, as detected on computed tomography (CT), and airflow obstruction are inversely related to left ventricular end-diastolic volume, stroke volume, and cardiac output among persons without very severe lung disease., Methods: We measured left ventricular structure and function with the use of magnetic resonance imaging in 2816 persons who were 45 to 84 years of age. The extent of emphysema (expressed as percent emphysema) was defined as the percentage of voxels below -910 Hounsfield units in the lung windows on cardiac computed tomographic scans. Spirometry was performed according to American Thoracic Society guidelines. Generalized additive models were used to test for threshold effects., Results: Of the study participants, 13% were current smokers, 38% were former smokers, and 49% had never smoked. A 10-point increase in percent emphysema was linearly related to reductions in left ventricular end-diastolic volume (-4.1 ml; 95% confidence interval [CI], -3.3 to -4.9; P<0.001), stroke volume (-2.7 ml; 95% CI, -2.2 to -3.3; P<0.001), and cardiac output (-0.19 liters per minute; 95% CI, -0.14 to -0.23; P<0.001). These associations were of greater magnitude among current smokers than among former smokers and those who had never smoked. The extent of airflow obstruction was similarly associated with left ventricular structure and function, and smoking status had similar modifying effects on these associations. Percent emphysema and airflow obstruction were not associated with the left ventricular ejection fraction., Conclusions: In a population-based study, a greater extent of emphysema on CT scanning and more severe airflow obstruction were linearly related to impaired left ventricular filling, reduced stroke volume, and lower cardiac output without changes in the ejection fraction., (2010 Massachusetts Medical Society)

Purpose: Differences in prostate specific antigen awareness may contribute to differences in the frequency of prostate specific antigen testing. We investigated the association of health risk behaviors, including smoking, physical inactivity, obesity and excessive alcohol consumption, with awareness of the prostate specific antigen test in men in California at risk for prostate cancer., Materials and Methods: Using 2003 data from the California Health Interview Survey, a population based, random digit dial telephone survey, the records of 7,297 men 50 years or older without a history of prostate cancer were identified. The outcome was self-reported awareness of the prostate specific antigen test. The main independent variables were smoking status, physical activity level, body mass index and alcohol consumption. The prevalence, OR and 95% CI for prostate specific antigen awareness were calculated using SUDAAN to account for the complex sampling design., Results: The overall prevalence of prostate specific antigen awareness was 73.0%. After controlling for potential confounders the odds of being aware of the prostate specific antigen test was lower in current smokers (vs never smoked OR 0.53, 95% CI 0.41-0.68), physically inactive men (vs physically active OR 0.77, 95% CI 0.63-0.93) and obese men (vs normal weight OR 0.77, 95% CI 0.62-0.95)., Conclusions: Health risk behaviors are associated with lower prostate specific antigen awareness. Our findings suggest opportunities for focused health education interventions and quality improvement programs tailored to men who engage in unhealthy behaviors to improve their prostate specific antigen test awareness.

Purpose: Examine employee illness absence and the economic impact of overweight and obesity in a petrochemical industry workforce., Methods: A 10-year follow-up (1994-2003) of 4153 Shell Oil Company employees was conducted. Absence frequency rates and average number of workdays lost were calculated for normal weight, overweight, and obese employees with and without the presence of additional risk factors. The study also assessed the change in overweight and obesity prevalence in the study population and estimated the current and future economic impact of these conditions., Results: Overall, obese employees were 80% more likely to have absences (24.0 vs. 13.3 per 100 employees) and were absent 3.7 more days (7.7 vs. 4.0 days) per year compared with those employees with normal body weights. Among employees with no additional risk factors, overweight employees lost more than 1.5 times more days (4.2 vs. 2.6 days) per year, and obese employees more than 2.5 times more days (7.2 vs. 2.6 days) compared with their normal-weight colleagues. Similarly, absence frequency attributable to cardiovascular disease significantly increased among employees with one or two additional risk factors present, such as smoking, high blood pressure, or hypercholesterolemia. The direct cost of illness absence from overweight and obesity for this study population was $1,873,500. Furthermore, 31% of the total illness absence was attributable to overweight and obesity in 1994, and the percentage had risen to 36% by 2003., Conclusions: The economic impact to employers is great and will continue to rise unless measures are taken, particularly to reduce the number of employees moving from overweight to obesity with time.

Objective: To assess whether early retirement is associated with better survival., Design: Long term prospective cohort study., Setting: Petroleum and petrochemical industry, United States., Subjects: Past employees of Shell Oil who retired at ages 55, 60, and 65 between 1 January 1973 and 31 December 2003., Main Outcome Measure: Hazard ratio of death adjusted for sex, year of entry to study, and socioeconomic status., Results: Subjects who retired early at 55 and who were still alive at 65 had a significantly higher mortality than those who retired at 65 (hazard ratio 1.37, 95% confidence interval 1.09 to 1.73). Mortality was also significantly higher for subjects in the first 10 years after retirement at 55 compared with those who continued working (1.89, 1.58 to 2.27). After adjustment, mortality was similar between those who retired at 60 and those who retired at 65 (1.06, 0.92 to 1.22). Mortality did not differ for the first five years after retirement at 60 compared with continuing work at 60 (1.04, 0.82 to 1.31)., Conclusions: Retiring early at 55 or 60 was not associated with better survival than retiring at 65 in a cohort of past employees of the petrochemical industry. Mortality was higher in employees who retired at 55 than in those who continued working.

Complete blood counts (CBC) have been recognized as an easy and readily available screen for hematotoxicity following occupational exposure to 1,3-butadiene. This study evaluated hematology data from employees who have ever participated in the Shell Butadiene Medical Surveillance Program (BMSP), compared with employees who have not participated. This study examined potential hematopoietic toxicity in relation to the occupational exposures at two Shell facilities. This study included 404 employees who participated in the BMSP, with mean butadiene exposure (TWA-8, TWA-10, and TWA-12 together) of 4.55 ppm from 1979-1996 and 0.25 ppm from 1997-2003, and 773 comparison employees. The comparison group included employees not participating in either the benzene or butadiene surveillance programs. Abnormality of six CBC parameters, including white blood cell count, red blood cell count, lymphocyte count, hemoglobin concentration, mean corpuscular volume and platelet count, and the adjusted mean values of these parameters in the exposed group were compared with those of the comparison group. We found no significantly increased abnormality for any hematology parameter among exposed employees. The adjusted mean values (adjusted for age, sex, race, length of time between first and last exam, current smoking status, and first exam value) of the exposed employees were similar to those in the comparison group. At current occupational exposure levels for 1,3-butadiene, there is no evidence of adverse hematological effects observed in this study. These findings are consistent with results of three similar studies in the literature.

Background: Illness absence in a working population is a complex phenomenon and can be influenced by many factors, such as age, gender, and personal health risk factors. The current study used prospectively collected employee health risk and morbidity data to examine illness absence patterns for a working population and to quantify the impact of selected health risk factors on employee illness absence., Methods: The study population consisted of 2550 regular employees working at a Texas petrochemical facility. Morbidity data were extracted from the company's Health Surveillance System, and records of absences were derived from personnel and payroll systems. The morbidity frequency rate and average duration of absence per employee per year were calculated by age, gender, and selected health risk factors, including smoking, body mass index, cholesterol, triglycerides, hypertension, and fasting glucose., Results: Morbidity frequency rates and average duration of absence increased with age and with the presence of health risk factors. The absence frequency rate increased with an increase in the number of risk factors present from no risk factors (11.8 per 100 employees) to four or more risk factors (32.3 per 100 employees). The number of workdays lost also increased with the number of risk factors present, with the least number of workdays lost by employees with zero risk factors (4.1 day), followed by one (6.4 days), two (8.8 days), three (9.3 days), and four or more risk factors (12.6 days)., Conclusions: The impact of employee health risk factors has been shown in this study to be associated with absence frequency and duration of absence. Reduction in employee health risk factors can be an effective means of improving employees' health and increasing a company's productivity.

A previous study [H. Sussman, H. McCaffrey, and S. Matthews, J. Acoust. Soc. Am. 90, 1309-1325 (1991)] of American English CV coarticulation showed a remarkably linear relationship between onset frequencies of F2 transitions, plotted on the y axis, in relation to the F2 midvowel "target" frequencies, plotted on the x axis, for CVC tokens with initial [b d g] and ten medial vowel contexts. Slope and y-intercept values of regression functions fit to these scatterplots ("locus equations") were shown to serve as statistically powerful phonetic descriptors of place of articulation. The present study extends the locus equation metric to three additional languages--Thai, Cairene Arabic, and Urdu--having both two and four place contrasts for syllable-initial voiced stops. A total of 14 speakers (Thai = 6, Arabic = 3, Urdu = 5) produced 1740 CVC tokens that were acoustically analyzed using MacSpeech Lab II. Strong linear regression relationships were found for every stop category across all speakers. Slopes and y intercepts systemically varied as a function of place of articulation. Cross-language comparisons of stop place categories were performed but variability of slope and y intercept means tempered conclusions concerning the existence of CV "phonetic hot spots."

Synthesis of a series of N-(2-acetylaminothiazole-5-sulphonyl) amino acids (II-VI) and some of their corresponding methyl esters (VII-XI) is described. Coupling of N-tosyl-or N-phthalylamino acid with 2-amino-2-thiazoline using the DCC method furnishes 2-(N-tosyl- or N-phthalylamino acyl) amino-2-thiazoline (XII-XXI). Hydrazinolysis of 2-(N-Pht-L-Phe or N-Pht-L-Ala) amino-2-thiazoline in ethanol afforded 2-(L-Phe or L-Ala) amino-2-thiazoline (XXII and XXIII) respectively. Synthesis of the dipeptide 2-(N-Tos-L-Val-L-Leu) amino-2-thiazoline (XXIV) has been achieved employing the azide method. Sixteen thiazole- and thiazoline-amino acid derivatives were found to be active against a number of microorganisms.

3-Nitro-9-(N-phthalyl- and N-tosylaminoacyl)carbazoles (II-XI) have been synthesized by the action of 3-nitro-9H-carbazole (I) on N-phthalyl- or N-tosylamino acid in THF-Et3N medium using the DCC method. Treatment of the 3-nitro derivatives (II-XI) with Sn/HCl gave the corresponding 3-amino-9-(N-phthalyl- or N-tosylaminoacyl)carbazoles (XII-XIX). Hydrazinolysis of the N-phthalylcarbazoles derivatives (III-VII) in ethanol gave the corresponding 3-nitro-9-(aminoacyl) carbazoles (XX-XXIII). Compounds (II-XI and XXI, XXII) were found to be active against some microorganisms.

Synthesis of a series of 3-hydroxynaphthalene-2-carbonylamino acid methyl esters (II-XI) and some of their corresponding hydrazides (XII-XXI), dipeptide methyl esters (XXII-XXXV) and dipeptide hydrazides (XXXVI-XXXIX) is described. 3-Hydroxynaphthalene-2-CO-L-Tyr-N2H3 (XX) and the corresponding L-Val-L-Ala-N2H3 (XXXVI) were found to be active against a number of micro-organisms.

Synthesis of some new 2-(N-tosyl- or N-phthalylaminoacyl or free aminoacyl or N-tosyldipeptidyl- or N-phthalyldipeptidyl)aminopyrazine derivatives (II-XXX) are described. All 2-(aminoacyl)aminopyrazines (XIV-XVIII) have been found to be biologically active against a number of microorganism.