OBJECTIVES. This work was undertaken to determine whether there are any chronic neurological sequelae to acute organophosphate pesticide poisoning. METHODS. California surveillance data were used in a study of neurological function among 128 men poisoned by organophosphate pesticides in California from 1982 to 1990 and 90 referents. Tests included a neurological physical examination, 5 nerve conduction tests, 2 vibrotactile sensitivity tests, 10 neurobehavioral tests, and 1 postural sway test. RESULTS. After correcting for confounding, the poisoned group performed significantly worse than the referent group on two neurobehavioral tests (sustained visual attention and mood scales). When the data were restricted to men with documented cholinesterase inhibition (n = 83) or to men who had been hospitalized (n = 36), the poisoned subjects also showed significantly worse vibrotactile sensitivity of finger and toe. Significant trends of increased impairment were found with increased days of disability on a wide spectrum of tests of both central and peripheral nerve function. CONCLUSIONS. While these findings are limited by low response rates and by small sample sizes for specific pesticides, this study was based on a large surveillance database and is the largest study to date of the chronic effects of organophosphate pesticide poisoning. The evidence of some long-term effects of poisoning is consistent with two prior studies.

Most, but not all, patients with EE are highly atopic individuals with frequent allergic sensitivities. Thus, serum IgE measurement of low-titer IgE antibody may be useful in identifying relevant food sensitivities and in distinguishing subgroups of patients with EE, making a more directed approach to food avoidance possible.

The purpose of this study was to evaluate the effects of various modes of training on the time-course of changes in lipoprotein-lipid profiles in the blood, cardiovascular fitness, and body composition after 16 weeks of training and 6 weeks of detraining in young women. A group of 48 sedentary but healthy women [mean age 20.4 (SD 1) years] were matched and randomly placed into a control group (CG, n = 12), an aerobic training group (ATG, n = 12), a resistance training group (RTG, n = 12), or a cross-training group that combined both aerobic and resistance training (XTG, n = 12). The ATG, RTG and XTG trained for 16 weeks and were monitored for changes in blood concentrations of lipoprotein-lipids, cardiovascular fitness, body composition, and dietary composition throughout a 16 week period of training and 6 weeks of detraining. The ATG significantly reduced blood concentrations of triglycerides (TRI) (P < 0.05) and significantly increased blood concentrations of high-density lipoprotein-cholesterol (HDL-C) after 16 weeks of training. The correlation between percentage fat and HDL-C was 0.63 (P < 0.05), which explained 40% of the variation in HDL-C, while the correlation between maximal oxygen uptake (VO2max) and HDL-C was 0.48 (P < 0.05), which explained 23% of the variation in HDL-C. The ATG increased VO2max by 25% (P < 0.001) and decreased percentage body fat by 13% (P < 0.05) after 16 weeks. Each of the alterations in the ATG had disappeared after the 6 week detraining period. The concentration of total cholesterol (TC), TRI, HDL-C and low density lipoprotein-cholesterol in the blood did not change during the study in RTG, XTG and CG. The RTG increased upper and lower body strength by 29% (P < 0.001) and 38%, respectively. The 6 week detraining strength values obtained in RTG were significantly greater than those obtained at baseline. The XTG increased upper and lower body strength by 19% (P < 0.01) and 25% (P < 0.001), respectively. The 6 week detraining strength values obtained in XTG were significantly greater than those obtained at baseline. The RTG, XTG and CG did not demonstrate any significant changes in either VO2max, or body composition during the training and detraining periods. The results of this study suggest that aerobic-type exercise improves lipoprotein-lipid profiles, cardiorespiratory fitness and body composition in healthy, young women, while resistance training significantly improved upper and lower body strength only.

Eosinophilic esophagitis (EoE) is a chronic, immune-mediated disease in which food antigens play a key role. Current therapeutic options are limited to long-term steroid medication and dietary elimination of multiple foods, each of which is challenging. Our objective was to compare single food elimination of cow's milk to swallowed fluticasone in pediatric EoE patients. This is a prospective, comparative effectiveness trial of newly diagnosed EoE patients (ages 2-18 years) treated with swallowed fluticasone (n = 24) or elimination of cow's milk (n = 20). The dual outcome measures of repeat esophageal biopsy (6-8 weeks) and change in Pediatric Quality of Life Inventor (PedsQL) EoE Module and Symptoms Scales were used to assess response to treatment. After 6-8 weeks of treatment, peak esophageal eosinophil counts decreased to below the threshold of 15 eosinophils/high-power field in 64% of patients treated with cow's milk elimination and 80% of patients treated with swallowed fluticasone (P = 0.4). Mean PedsQL EoE Module total scores (69 vs. 82; P < 0.005) and Total Symptoms scores (58 vs. 75; P = 0.001) showed significant improvement with cow's milk elimination. Among children treated with swallowed fluticasone, mean PedsQL EoE Module total scores (64 vs. 75; P < 0.05) and Total Symptoms scores (58 vs. 69; P < 0.01) were also significantly improved after 6-8 weeks of therapy. Removal of cow's milk from the diet is an effective single food elimination treatment for pediatric patients with EoE as assessed by statistically significant histologic and symptomatic improvement. Cow's milk elimination may be more desirable for EoE patients who do not want to take chronic, long-term steroid medications.