Effects of pile driving sound playbacks and cadmium co-exposure on the early life stage development of the Norway lobster, Nephrops norvegicus.

There is an urgent need to understand how organisms respond to multiple, potentially interacting drivers in today's world. The effects of the pollutants anthropogenic sound (pile driving sound playbacks) and waterborne cadmium were investigated across multiple levels of biology in larval and juvenile Norway lobster, Nephrops norvegicus under controlled laboratory conditions. The combination of pile driving playbacks (170 dBpk-pk re 1 µPa) and cadmium combined synergistically at concentrations >9.62 µg[Cd] L-1 resulting in increased larval mortality, with sound playbacks otherwise being antagonistic to cadmium toxicity. Exposure to 63.52 µg[Cd] L-1 caused significant delays in larval development, dropping to 6.48 µg[Cd] L-1 in the presence of piling playbacks. Pre-exposure to the combination of piling playbacks and 6.48 µg[Cd] L-1 led to significant differences in the swimming behaviour of the first juvenile stage. Biomarker analysis suggested oxidative stress as the mechanism resultant deleterious effects, with cellular metallothionein (MT) being the predominant protective mechanism.

Clinical presentation, treatment, and outcomes in presumed intraocular tuberculosis: experience from Newcastle upon Tyne, UK.

PURPOSE: To report the clinical manifestations and treatment outcomes of patients with presumed intraocular tuberculosis (TB) seen at the Newcastle Uveitis Service, Royal Victoria Infirmary, Newcastle upon Tyne, UK over a 10-year period. METHODS: Retrospective review of case notes. RESULTS: A total of 21 patients were identified. Occlusive retinal vasculitis was the commonest ophthalmological presentation (12 patients). Eight patients (38%) were found to have underlying active systemic TB (four with mediastinal lymphadenopathy, three with pulmonary TB, one with cutaneous TB). Constitutional or respiratory symptoms, elevated inflammatory markers, and an abnormal chest radiograph were poor indicators of active TB. Two patients had inactive intrathoracic TB. Eleven patients had latent TB. Eighteen patients received anti-tuberculous treatment. Final visual acuity was better than or equal to initial visual acuity in 14 out of 16 patients who completed at least 6 months of standard anti-tuberculous treatment. CONCLUSIONS: Most patients with presumed intraocular TB have latent TB, but a significant minority has hitherto undetected active TB. Our series suggests that either proven or presumed intraocular TB occurs frequently in the absence of constitutional or respiratory symptoms, elevated inflammatory markers, or an abnormal chest radiograph. A minimum of 6 months standard anti-tuberculous treatment provides good visual outcomes in the majority of patients.

Occupational asthma caused by Arabidopsis thaliana: a case of laboratory plant allergy.

A 36-yr-old male never-smoker with an 8-yr history of hay fever but no past history of asthma undertook a 3-yr research project involving the plant Arabidopsis thaliana. The subject was based in a small laboratory with an attached growing room. After 30 months of research, he began to develop breathlessness within 5-10 min of entering the laboratory. Initial investigations confirmed asthma with airflow obstruction (forced expiratory volume in one second (FEV(1))/forced vital capacity was 3.01/4.75 L; predicted values were 3.67/4.43 L) and increased airway responsiveness. Serial peak expiratory flow measurements showed a work-related pattern. A supervised workplace challenge test led to a fall in FEV(1) from the baseline value of 3.10 L to 1.95 L within 20 min of entering the growing room. Skin-prick solutions were prepared from Arabidopsis leaves and flower heads; positive 4-mm responses were obtained to the flower heads (i.e. to the pollen). Arabidopsis is a member of the Brassicaceae family. It is used extensively in plant biology research as its genome is small, has been fully sequenced and is easily manipulated. The present article represents the first reported case of occupational asthma due to Arabidopsis thaliana.

Defining and investigating occupational asthma: a consensus approach.

BACKGROUND: At present there is no internationally agreed definition of occupational asthma and there is a lack of guidance regarding the resources that should be readily available to physicians running specialist occupational asthma services. AIMS: To agree a working definition of occupational asthma and to develop a framework of resources necessary to run a specialist occupational asthma clinic. METHOD: A modified RAND appropriateness method was used to gain a consensus of opinion from an expert panel of clinicians running specialist occupational asthma clinics in the UK. RESULTS: Consensus was reached over 10 terms defining occupational asthma including: occupational asthma is defined as asthma induced by exposure in the working environment to airborne dusts vapours or fumes, with or without pre-existing asthma; occupational asthma encompasses the terms "sensitiser-induced asthma" and "acute irritant-induced asthma" (reactive airways dysfunction syndrome (RADS)); acute irritant-induced asthma is a type of occupational asthma where there is no latency and no immunological sensitisation and should only be used when a single high exposure has occurred; and the term "work-related asthma" can be used to include occupational asthma, acute irritant-induced asthma (RADS) and aggravation of pre-existing asthma. Disagreement arose on whether low dose irritant-induced asthma existed, but the panel agreed that if it did exist they would include it in the definition of "work-related asthma". The panel agreed on a set of 18 resources which should be available to a specialist occupational asthma service. These included pre-bronchodilator FEV1 and FVC (% predicted); peak flow monitoring (and plotting of results, OASYS II analysis); non-specific provocation challenge in the laboratory and specific IgE to a wide variety of occupational agents. CONCLUSION: It is hoped that the outcome of this process will improve uniformity of definition and investigation of occupational asthma across the UK.

Outbreak of tuberculosis at a Newcastle public house: the role and effectiveness of contact screening.

We report an outbreak of tuberculosis (TB) that originated in a public house, involving 12 cases. The presumed index case was a regular patron. Initial screening of close contacts identified no further cases. Six cases of TB then presented symptomatically among other regular patrons. Contact screening was extended to include all regular patrons and bar staff. In total, 110 individuals were screened. One case was detected and three children were placed on chemoprophylaxis. Transmission of M. tuberculosis between patrons of a public house may cause community outbreaks of TB. Where cases present outside a close-contact screening program, extended contact screening must be considered.

Number and activity of inflammatory cells in bronchoalveolar lavage fluid in asthma and their relation to airway responsiveness.

Bronchial responsiveness to inhaled methacholine was measured four to six days before fibreoptic bronchoscopy in 22 asthmatic patients (10 smokers) and 20 control subjects (12 smokers). The asthmatic patients had a baseline FEV1 greater than 60% predicted and a PD20FEV1 (provocative dose of methacholine causing a 20% fall in FEV1) of 0.006-3.7 mg. The 20 control subjects had normal pulmonary function and a PD20FEV1 above the maximum cumulative dose of methacholine of 6.4 mg. Bronchoalveolar lavage of a middle lobe segment (lingula in four subjects) was performed with three sequential 60 ml aliquots of sterile saline. Cellular metabolic activity was stimulated with latex in aliquots of resuspended cells, and measured by means of luminol enhanced chemiluminescence to assess neutrophil activity and lucigenin enhanced chemiluminescence to assess macrophage activity. Mean absolute total cell counts were similar in the asthmatic and control groups but there were differences in differential cell counts, with a significant increase in eosinophil (p less than 0.05) and lymphocyte (p less than 0.005) counts in asthma. PD20FEV1 was negatively correlated with percentage neutrophil counts (p less than 0.005). Luminol enhanced chemiluminescence/1000 neutrophils was increased about twofold in asthmatic subjects (p less than 0.001), but was not correlated with PD20FEV1 Lucigenin enhanced chemiluminescence/1000 macrophages was increased nearly fourfold in asthmatic patients (p less than 0.001) and showed a negative correlation with PD20FEV1 (p less than 0.01). The macrophage count was increased twofold in current smokers in both groups, but other cell numbers were not altered significantly. Smoking did not affect cellular metabolic activity in either group. This study supports the idea that an inflammatory process is present in the airways of those with asthma, and suggests a relation between bronchial responsiveness and both neutrophil numbers and macrophage activity.