Sir: Galletly et al.1 describe a patient treated with clozapine who had severe eosinophilia (55% of WBCs) followed by neutropenia (neutrophil count of 1840/µL) 7 days later. We report a similar case of a clozapine-treated patient who developed eosinophilia (47% of WBCs) and subsequent neutropenia (neutrophil count of 1800/µL) 6 days later. Apologies and Thanks to ReviewersRegrettably, the names of six reviewers were omitted from our l997 Reviewer List.1 The prominence the Journal has achieved in the field is a direct outgrowth of the talent and commitment of our reviewers. Their work is selfless except for the one annual occasion when their contributions are recognized in our peer review tribute. To six individuals, I offer both profound apologies and sincerest thanks. Our failure to acknowledge their dedication does not diminish the magnitude of their contribution.

ABSTRACT.Background. Animal studies and investigations of adult endurance athletes indicate a transient depression of myocardial function after prolonged highintensity exercise.Purpose. To determine whether a similar decrease is observed in child distance runners after a 4-km competitive road race.Methods. Anthropometric measures, resting M-mode echocardiograms, maximal cycle exercise tests with estimation of cardiac output, and electrocardiograms were performed before a 4-km road race in nine run-trained boys (mean age, 12.2 years). Weight and resting echocardiogram and electrocardiogram were assessed immediately after the race. The entire test battery was repeated 24 hours later.Results. Small but significant decreases in mean body weight and left ventricular end-diastolic dimension were observed immediately after the race, but there were no changes in shortening fraction. These findings are consistent with the effects of dehydration. Measurements returned to prerace values by 24 hours of recovery. Peak work capacity, maximal stroke volume, and maximal cardiac output were similar on prerace and 24-hourpostrace testing. No electrocardiographic abnormalities were observed.Conclusions. No adverse cardiac effects were observed from a competitive 4-km road race in male child distance runners. Pediatrics 1997;100(3). URL: http:// www.pediatrics.org/cgi/content/full/100/3/e2; echocardiography, children, exercise.ABBREVIATIONS. LVSF, left ventricular shortening fraction; VTI, velocity time integral; LVED, left ventricular end diastolic dimension; bpm, beats per minute.T he emergence of the elite-level child athlete has raised concern regarding possible adverse physiologic and psychologic effects of intense sports training and competition during the growing years.1 Little scientific data are available, however, to evaluate the reality of these potential risks. Consequently, creating appropriate guidelines for safe participation by children in competitive sports remains difficult.Evidence does exist that high-intensity sports may impose significant acute stress on the cardiovascular system. Echocardiographic evidence of myocardial dysfunction immediately after competition in prolonged distance running events has been demonstrated in adult endurance athletes.2,3 This depressed contractility, manifested as a decrease in left ventricular shortening fraction (LVSF), typically resolves within 24 hours after a race. Findings of left ventricular dysfunction after sustained running have also been corroborated in the laboratory setting.4 Animal studies support the concept that transient myocardial fatigue after sustained high-intensity exercise may be expressed as depressed contractility, possibly related to alterations in calcium transport capacity of the sarcoplasmic reticulum. 5,6 This study was performed to determine whether cardiac functional alterations are evident after shorter distance competitions in trained child runners. Resting electrocardiograms and two-dimensional echocardiograms were performed before and immediate...

This paper reports the findings of a randomized nicotine pharmacokinetic (PK) study of a closed electronic nicotine delivery system (ENDS). The study evaluated four flavor variants of Vuse Solo ENDS where subjects used their randomized investigational product (IP) for 10 minutes ad libitum and blood samples were collected for PK assessments that included maximum plasma nicotine concentration (Cmax) and area under the nicotine concentration-vs-time curve up to 60 minutes (AUCnic0–60). Baseline-adjusted mean Cmax ranged from 6.53 to 8.21 ng/mL, and mean AUCnic0–60 ranged from 206.87 to 263.52 ng*min/mL for all ENDS IPs. Results for Cmax and AUCnic0-60 values were consistent among the ENDS IP flavor variants tested and results indicate that flavors did not affect nicotine uptake in human subjects.

We report the findings from a randomized, parallel study designed to evaluate nicotine pharmacokinetics (PK) following 10 min of ad libitum use of electronic nicotine delivery system (ENDS) in four flavor variants. Subjects were randomized an investigational product (IP) and blood samples were collected for PK assessments during a test session. Primary endpoints were baseline-adjusted values of maximum plasma nicotine concentration (Cmax) and area under the nicotine concentration-vs-time curve up to 60 min (AUCnic0–60). Baseline-adjusted mean Cmax ranged from 6.53 to 8.21 ng/mL, and mean AUCnic0–60 ranged from 206.87 to 263.52 ng min/mL for all ENDS IPs. Results of geometric mean Cmax and AUCnic0–60 values were within 95% confidence intervals (CI) among the ENDS IP flavor variants tested.