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Article Outline

• Reviews and feature articles
• Asthma diagnosis and treatment
• Mechanisms of asthma and allergic inflammation
• Rhinitis, sinusitis, and ocular diseases
• Environmental and occupational respiratory disorders
• Health care education, delivery, and quality
• Food allergy, anaphylaxis, dermatology, and drug allergy
• Basic and clinical immunology
• Letters to the Editor

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The editors' choice1289

Donald Y. M. Leung, MD, PhD, Stanley J. Szefler, MD, and the Associate Editors of the JACI

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Reviews and feature articles 

Current reviews of allergy and clinical immunology

Eosinophilic disorders1291

Dagmar Simon, MD, and Hans-Uwe Simon, MD, PhD, Bern, Switzerland

Continuing Medical Education examination: Eosinophilic disorders1301

Molecular mechanisms in allergy and clinical immunology

Eosinophil trafficking in allergy and asthma1303

Helene F. Rosenberg, MD, Simon Phipps, PhD, and Paul S. Foster, PhD, Bethesda, Md, and Newcastle, Australia

Continuing Medical Education examination: Eosinophil trafficking in allergy and asthma1311

Current perspectives

Eosinophils: Singularly destructive effector cells or purveyors of immunoregulation?1313

Elizabeth A. Jacobsen, PhD, Anna G. Taranova, MD, Nancy A. Lee, PhD, and James J. Lee, PhD, Scottsdale, Ariz

Editorial

Eosinophils in the new millennium1321

Marc E. Rothenberg, MD, PhD, Cincinnati, Ohio

Rostrum

Is there any role for allergen avoidance in the primary prevention of childhood asthma?1323

Onno C. P. van Schayck, PhD, Tanja Maas, MSc, Janneke Kaper, PhD, Andre J. A. Knottnerus, MD, and Aziz Sheikh, MD, FRCGP, Maastricht, The Netherlands, and Edinburgh, United Kingdom

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Clinical pearls

Use of videography in the diagnosis of exercise-induced vocal cord dysfunction: A case report with video clips1329

Ray S. Davis, MD, Susan M. Brugman, MD, and Gary L. Larsen, MD, St Louis, Mo, and Denver, Colo

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Asthma diagnosis and treatment 

Perspectives in asthma

Acute asthma intervention: Insights from the STAY study1332

Paul M. O'Byrne, MB, FRCP(C), Hamilton, Ontario, Canada

Workshop summary

Severe asthma in adults: What are the important questions?1337

Pascal Chanez, MD, PhD, Sally E. Wenzel, MD, Gary P. Anderson, PhD, Josep M. Anto, MD, PhD, Elisabeth H. Bel, MD, PhD, Louis-Philippe Boulet, MD, Christopher E. Brightling, PhD, MRCP, William W. Busse, MD, Mario Castro, MD, MPH, Babro Dahlen, MD, PhD, Sven Erik Dahlen, MD, PhD, Leo M. Fabbri, MD, Stephen T. Holgate, MD, PhD, Marc Humbert, MD, PhD, Mina Gaga, MD, Guy F. Joos, MD, PhD, Bruce Levy, MD, PhD, Klaus F. Rabe, MD, PhD, Peter J. Sterk, MD, PhD, Susan J. Wilson, PhD, and Isabelle Vachier, PhD, Montpellier and Clamart, France, Pittsburgh, Pa, Melbourne, Australia, Barcelona, Spain, Amsterdam and Leiden, The Netherlands, Quebec City, Quebec, Canada, Leicester and Southampton, United Kingdom, Madison, Wis, St Louis, Mo, Stockholm, Sweden, Modena, Italy, Athens, Greece, Ghent, Belgium, and Boston, Mass

Work Group Report

American Academy of Allergy, Asthma & Immunology Work Group Report: Exercise-induced asthma1349

John M. Weiler, MD, Sergio Bonini, MD, Robert Coifman, MD, Timothy Craig, DO, Luís Delgado, MD, Miguel Capão-Filipe, MD, Desiderio Passali, MD, Christopher Randolph, MD, and William Storms, MD, Iowa City, Iowa, Rome and Siena, Italy, Millville, NJ, Hershey, Pa, Porto, Portugal, and Colorado Springs, Colo

Original articles

Interactions between breast-feeding, specific parental atopy, and sex on development of asthma and atopy1359

Piush J. Mandhane, MD, Justina M. Greene, Dip Comp Sys, and Malcolm R. Sears, MB, FRACP, Hamilton, Ontario, Canada

In a population-based birth cohort, the specific parental history of atopy and the sex of the child affected the effect of breast-feeding on the risk of developing asthma and atopy.

Specificity of basement membrane thickening in severe asthma1367

Arnaud Bourdin, MD, Dorine Neveu, PhD, Isabelle Vachier, PhD, Fabrice Paganin, MD, PhD, Philippe Godard, MD, and Pascal Chanez, MD, PhD, Montpellier, France

A carefully measured increase in reticular basement membrane thickness was specifically associated with severe asthma, whereas mild asthma and chronic obstructive pulmonary disease could not be differentiated. Remodeling of proximal airways was present in chronic obstructive pulmonary disease.

Placebo response in asthma: A robust and objective phenomenon1375

Margaret E. Kemeny, PhD, Lanny J. Rosenwasser, MD, Reynold A. Panettieri, MD, Robert M. Rose, MD, Steve M. Berg-Smith, MSc, and Joel N. Kline, MD, MSc, San Francisco, Calif, Kansas City, Mo, Philadelphia, Pa, Galveston, Tex, and Iowa City, Iowa

This study demonstrates a marked, objectively measured placebo response suppressing airway hyperresponsiveness in asthmatic subjects. This strongly supports a mind-body link in asthma, which has been widely accepted but remains poorly characterized.

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Mechanisms of asthma and allergic inflammation 

Update review

Inhibitory receptors on eosinophils: A direct hit to a possible Achilles heel?1382

Ariel Munitz, PhD, and Francesca Levi-Schaffer, PhD, Jerusalem, Israel

Original articles

Mechanisms of tissue inhibitor of metalloproteinase 1 augmentation by IL-13 on TGF-β1–stimulated primary human fibroblasts1388

Xiuxia Zhou, PhD, Haizhen Hu, BS, Mai-Lan N. Huynh, MD, Chakradhar Kotaru, MD, Silvana Balzar, MD, John B. Trudeau, BA, and Sally E. Wenzel, MD, Pittsburgh, Pa, and Denver, Colo

IL-13 augments the profibrotic effect of TGF-β1 on tissue inhibitor of metalloproteinase 1 through complex interactions of extracellular regulated kinase and phosphoinositde-3 kinase–Akt pathways, which modulate Smad signaling. These interactions may help explain the profibrotic state associated with T_H2 inflammation in asthma.

Connective tissue growth factor expression is regulated by histamine in lung fibroblasts: Potential role of histamine in airway remodeling1398

Steffen Kunzmann, MD, Carsten Schmidt-Weber, PhD, Jean-Marc Zingg, PhD, Angelo Azzi, PhD, Boris W. Kramer, MD, Kurt Blaser, PhD, Cezmi A. Akdis, PhD, and Christian P. Speer, MD, Würzburg, Germany, Davos and Bern, Switzerland, and Maastricht, The Netherlands

The mechanism of histamine-induced accumulation of connective tissue growth factor implies a new therapeutic option against airway remodeling in asthma by administration of histamine receptor 1 antagonist.

The IL-17F signaling pathway is involved in the induction of IFN-γ–inducible protein 10 in bronchial epithelial cells1408

Mio Kawaguchi, MD, Fumio Kokubu, MD, Shau-Ku Huang, PhD, Tetsuya Homma, MD, Miho Odaka, MD, Shin Watanabe, MD, Shintaro Suzuki, MD, Koushi Ieki, MD, Satoshi Matsukura, MD, Masatsugu Kurokawa, MD, and Mitsuru Adachi, MD, Tokyo and Yokohama, Japan, and Baltimore, Md

IL-17F induces IFN-γ–inducible protein 10 (IP-10) through activation of the Raf1–MEK1/2–ERK1/2–p90RSK–CREB pathway. The IL-17F–IP-10 axis might be especially important in the pathophysiologic events of airway inflammation.

Expression and regulation of intercellular adhesion molecule-1 on airway parasympathetic nerves1415

Zhenying Nie, PhD, Cole S. Nelson, PhD, David B. Jacoby, MD, and Allison D. Fryer, PhD, Portland, Ore

Expression of intercellular adhesion molecule-1 (ICAM-1) in parasympathetic nerves is induced by antigen challenge, TNF-α, and IFN-γ. Dexamethasone and nuclear factor κB inhibitors block ICAM-1 in nerves and might limit the neural inflammation caused by eosinophils that is characteristic of asthma.

Integrin β3 genotype influences asthma and allergy phenotypes in the first 6 years of life1423

Emma E. Thompson, PhD, Lin Pan, MS, Irina Ostrovnaya, PhD, Lauren A. Weiss, PhD, James E. Gern, MD, Robert F. Lemanske, Jr, MD, Dan L. Nicolae, PhD, and Carole Ober, PhD, Chicago, Ill, and Madison, Wis

This study replicates associations with integrin β3 single nucleotide polymorphisms and asthma and IgE, further implicating this gene early in pathogenesis. Integrin β3 appears to play an important role in asthma development and may represent a target for treatment.

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Rhinitis, sinusitis, and ocular diseases 

Fluticasone furoate nasal spray: A single treatment option for the symptoms of seasonal allergic rhinitis1430

Harold B. Kaiser, MD, Robert M. Naclerio, MD, John Given, MD, Tom N. Toler, PharmD, Anna Ellsworth, and Edward E. Philpot, MD, Minneapolis, Minn, Chicago, Ill, Canton, Ohio, and Research Triangle Park, NC

This article reports on the first phase III trial showing the efficacy of the novel enhanced-affinity glucocorticoid fluticasone furoate nasal spray for the treatment of the symptoms of ragweed-induced seasonal allergic rhinitis.

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Environmental and occupational respiratory disorders 

Omega-3 and omega-6 fatty acid exposure from early life does not affect atopy and asthma at age 5 years1438

Catarina Almqvist, MD, PhD, Frances Garden, BAppSci, Wei Xuan, MSc, PhD, Seema Mihrshahi, MPH, Steve R. Leeder, MD, PhD, Wendy Oddy, PhD, Karen Webb, MPH, PhD, and Guy B. Marks, MBBS, PhD, for the CAPS team, Sydney and Perth, Australia, and Stockholm, Sweden

There is no effect of omega-3 and omega-6 polyunsaturated fatty acids, measured in plasma as dietary intake and intake from supplements, on the prevalence of asthma, eczema, or atopy at age 5 years.

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Health care education, delivery, and quality 

Achieving and maintaining asthma control in an urban pediatric disease management program: The Breathmobile Program1445

Craig A. Jones, MD, Loran T. Clement, MD, Tricia Morphew, MS, Kenny Yat Choi Kwong, MD, Jean Hanley-Lopez, MD, Francene Lifson, BA, Lawrence Opas, MD, and Jeffrey J. Guterman, MD, MS, Los Angeles, Calif, and Mobile, Ala

This study demonstrates variable asthma control across all severity categories. The results highlight the importance and feasibility of health care programs that track patients systematically and reinforce the use of controller medications at regular visit intervals.

Real-world Evaluation of Asthma Control and Treatment (REACT): Findings from a national Web-based survey1454

Stephen P. Peters, MD, PhD, Craig A. Jones, MD, Tmirah Haselkorn, PhD, David R. Mink, MS, David J. Valacer, MD, and Scott T. Weiss, MD, Winston-Salem, NC, Los Angeles, South San Francisco, and San Francisco, Calif, and Boston, Mass

Real-world Evaluation of Asthma Control and Treatment (REACT) is the first study to assess the prevalence, morbidity, and factors associated with uncontrolled asthma in a nationally representative population of treated patients with moderate-to-severe asthma.

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Food allergy, anaphylaxis, dermatology, and drug allergy 

Advances in Asthma, Allergy, and Immunology Series 2007

Advances in allergic skin disease, anaphylaxis, and hypersensitivity reactions to foods, drugs, and insects1462

Scott H. Sicherer, MD, and Donald Y. M. Leung, MD, PhD, New York, NY, and Denver, Colo

Original articles

Chemokine responses distinguish chemical-induced allergic from irritant skin inflammation: Memory T cells make the difference1470

Stephan Meller, MD, Antti I. Lauerma, MD, PhD, Frank Michael Kopp, PhD, Franziska Winterberg, PhD, Minna Anthoni, PhD, Anja Müller, MD, Michael Gombert, PhD, Anna Haahtela, PhD, Harri Alenius, PhD, Juliane Rieker, MD, Marie-Caroline Dieu-Nosjean, PhD, Robert Christof Kubitza, Ernst Gleichmann, MD, Thomas Ruzicka, MD, Albert Zlotnik, PhD, and Bernhard Homey, MD, Düsseldorf, Germany, Helsinki, Finland, Paris, France, and San Diego, Calif

This study offers, for the first time, the possibility of distinguishing between irritant and allergic skin inflammation at the molecular level, delivering new impulses for clinical evaluation and diagnosis of chemical-induced skin inflammation.

An experimental and modeling-based approach to locate IgE epitopes of plant profilin allergens1481

Gema López-Torrejón, PhD, Araceli Díaz-Perales, PhD, Julia Rodríguez, MD, PhD, Rosa Sánchez-Monge, PhD, Jesus F. Crespo, MD, PhD, Gabriel Salcedo, PhD, and Luis F. Pacios, PhD, Madrid, Spain

A dual approach comprising the IgE-binding analysis of synthetic peptides and the 3-dimensional modeling of melon profilin, Cuc m 2, has allowed the authors to define 2 strong and 2 weak IgE epitopes of this allergen.

Clinical characteristics of soybean allergy in Europe: A double-blind, placebo-controlled food challenge study1489

Barbara K. Ballmer-Weber, MD, Thomas Holzhauser, PhD, Joseph Scibilia, MD, Diana Mittag, PhD, Guliana Zisa, MD, Claudio Ortolani, MD, Morten Oesterballe, MD, Lars K. Poulsen, PhD, Stefan Vieths, PhD, and Carsten Bindslev-Jensen, MD, Zurich, Switzerland, Langen, Germany, Milan, Italy, and Odense and Copenhagen, Denmark

Findings from this study suggest that clinical symptoms, IgE-binding profiles, and threshold doses for soy are highly variable. Threshold doses appear to be more than 1 order of magnitude higher than in peanut allergy.

Treatment of acute edema attacks in hereditary angioedema with a bradykinin receptor-2 antagonist (Icatibant)1497

Konrad Bork, MD, Jorge Frank, MD, Boris Grundt, MD, Peter Schlattmann, MD, MSc, Juerg Nussberger, MD, and Wolfhart Kreuz, MD, Mainz, Berlin, and Frankfurt, Germany, Maastricht, The Netherlands, and Lausanne, Switzerland

In hereditary angioedema, bradykinin is assumed to be the most important mediator of edema formation. The selective bradykinin receptor-2 antagonist Icatibant was shown to be effective in acute edema attacks of hereditary angioedema.

Prevalence of self-reported food allergy in American adults and use of food labels1504

Katherine A. Vierk, MPH, Kathleen M. Koehler, PhD, MPH, Sara B. Fein, PhD, and Debra A. Street, PhD, College Park, Md

This study found that the population-based prevalence of self-reported food allergy among US adults is similar to that in previous reports and provides more information about allergy to specific foods and label use among adults with food allergy.

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Basic and clinical immunology 

Editorial

Coming back to a missing immune deviation as the main explanatory mechanism for the hygiene hypothesis1511

Sergio Romagnani, MD, Florence, Italy

Original articles

Acinetobacter lwoffii and Lactococcus lactis strains isolated from farm cowsheds possess strong allergy-protective properties1514

Jennifer Debarry, MSc, Holger Garn, PhD, Anna Hanuszkiewicz, MSc, Nina Dickgreber, MSc, Nicole Blümer, PhD, Erika von Mutius, Prof Dr, Albrecht Bufe, Prof Dr, Sören Gatermann, Prof Dr, Harald Renz, Prof Dr, Otto Holst, Prof Dr, and Holger Heine, PD Dr, Borstel, Marburg, Munich, and Bochum, Germany

Acinetobacter lwoffii and Lactococcus lactis isolated from cowsheds reduced allergic reactions in mice, activated mammalian cells in vitro, and induced T_H1 polarization in dendritic cells. A potential application of cowshed bacteria in allergy protection is suggested.

Antigen coupled with Lewis-x trisaccharides elicits potent immune responses in mice1522

Shih-Chang Hsu, BS, Tsung-Hsien Tsai, MD, Hirokazu Kawasaki, PhD, Chien-Ho Chen, PhD, Beverly Plunkett, MS, Reiko T. Lee, PhD, Yuan C. Lee, PhD, and Shau-Ku Huang, PhD, Baltimore, Md, and Taipei, Taiwan

The evidence provided in this article suggests a potential role of Lewis-x trisaccharides or similar glycan structures in the generation of allergen-induced T_H2 responses.

Cross-reactivity patterns of T cells specific for iodinated contrast media1529

Marianne Lerch, MD, Monika Keller, PhD, Markus Britschgi, PhD, Gisele Kanny, MD, PhD, Valerie Tache, Daphne A. Schmid, PhD, Andreas Beeler, MSc, Basil O. Gerber, PhD, Michael Luethi, Andreas J. Bircher, MD, Cathrine Christiansen, MSc, and Werner J. Pichler, MD, Bern and Basel, Switzerland, Nancy, France, and Oslo, Norway

In vivo and in vitro cross-reactivity and precursor frequency analyses in contrast media allergy give insight into the molecular basis and might contribute to the search for a well-tolerated substance.

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Letters to the Editor 

Improved asthma outcomes with a simple inhaler technique intervention by community pharmacists1537

Iman A. Basheti, BPharm Sci, Helen K. Reddel, MBBS, PhD, FRACP, Carol L. Armour, BPharm(Hons), PhD, and Sinthia Z. Bosnic-Anticevich, BPharm(Hons), PhD, Sydney and Camperdown, Australia

Community pharmacists were trained to deliver a 2.5-minute intervention to correct dry-powder inhaler technique. Not only did the technique improve significantly, but variability in lung function, asthma quality of life, and perceived control also improved.

Phase I/II trial of intermittent subcutaneous IL-2 administration in pediatric patients with moderate immune suppression: Results of Pediatric AIDS Clinical Trials Study 4021538

Savita Pahwa, MD, Petronella Muresan, MS, John Sleasman, MD, Terry Fenton, EdD, John Moye, MD, Audra Deveikis, MD, Diane Wara, MD, Russ Van Dyke, MD, for the Pediatric AIDS Clinical Trials Study 402 team, Miami and Tampa, Fla, Boston, Mass, Bethesda, Md, Long Beach and San Francisco, Calif, and New Orleans, La

IL-2 increases CD4⁺ T-cell counts in HIV-infected pediatric patients with few severe adverse events. IL-2 is a useful treatment option for HIV-infected patients receiving highly active antiretroviral therapy who do not achieve immune reconstitution.

Vascular endothelial growth factor and plasminogen activator inhibitor-1 in children with recurrent early wheeze1541

Hai Lee Chung, MD, So Yeon Kim, MD, and Sang Gyung Kim, MD, Taegu, Korea

Findings from this study suggest that overproduction of vascular endothelial growth factor and plasminogen activator inhibitor-1 is associated with acute airway inflammation in young children with frequent relapse of wheeze and might contribute to the later development of asthma.

A novel mutation of intron 22 in Janus kinase 3–deficient severe combined immunodeficiency1542

Christopher M. Mjaanes, MD, Richard W. Hendershot, MD, Ralph R. Quinones, MD, and Erwin W. Gelfand, MD, Denver, Colo

A 5-month-old girl with T-B+NK− severe combined immunodeficiency had a novel homozygous mutation of G to A at the −1 position of intron 22 (IVS22−1 G→A) of the Janus-associated kinase gene (Jak3).

CCR5Δ32 mutation, Mycoplasma pneumoniae infection, and asthma1545

Ildikó Ungvári, MSc, Gergely Tölgyesi, MSc, Ágnes F. Semsei, MSc, Adrienne Nagy, MD, PhD, Károly Radosits, MD, Márton Keszei, MSc, Gergely T. Kozma, PhD, András Falus, DSc, and Csaba Szalai, DSc, Budapest and Siófok, Hungary

This study indicates an association between chronic Mycoplasma pneumoniae infection and physician-diagnosed asthma and between CCR5Δ32 and the chronic infection. Otherwise, carrying CCR5Δ32 might reduce the susceptibility to asthma in infected children.

Persistence of proinflammatory response after severe respiratory syncytial virus disease in children1547

Jesus F. Bermejo-Martin, MD, PhD, M. Carmen Garcia-Arevalo, MSc, Ana Alonso, MD, Raul O. De Lejarazu, MD, PhD, Maria Pino, MD, Salvador Resino, PhD, Alberto Tenorio, MD, David Bernardo, MSc, Alberto J. Leon, PhD, Jose A. Garrote, MD, PhD, Julio Ardura, MD, PhD, Marta Dominguez-Gil, MSc, Jose M. Eiros, MD, PhD, Alfredo Blanco-Quiros, MD, PhD, M. Angeles Munoz-Fernandez, PhD, David J. Kelvin, PhD, and Eduardo Arranz, MD, PhD, Valladolid and Madrid, Spain, and Toronto, Ontario, Canada

Sequential profiling of cytokines, chemokines, and growth factors evidence the immune patterns paralleling clinical recovery from respiratory syncytial virus infection and the persistence of a proinflammatory response after disease resolution.

Omalizumab for the treatment of unprovoked anaphylaxis in patients with systemic mastocytosis1550

Melody C. Carter, MD, Jamie A. Robyn, MD, PhD, Peter B. Bressler, MD, John C. Walker, MD, Gail G. Shapiro, MD, and Dean D. Metcalfe, MD, Bethesda, Md, Chapel Hill, NC, and Richland and Seattle, Wash

The authors report a significant reduction in the frequency of episodes of anaphylaxis in 2 patients with systemic mastocytosis after the administration of omalizumab.

Relevance of H₁-receptor occupancy to H₁-antihistamine dosing in children1551

Keith J. Simons, PhD, Margherita Strolin Benedetti, PhD, F. Estelle R. Simons, MD, FRCPC, Michel Gillard, PhD, and Eugene Baltes, PhD, Winnipeg, Manitoba, Canada, Nanterre, France, and Braine-l'Alleud, Belgium

High H₁-receptor occupancy might explain why once-daily dosing of the H₁-antihistamine levocetirizine can be recommended in children, as well as in adults, despite the faster clearance and shorter elimination half-life of levocetirizine in children.

Identification of 2 new sesame seed allergens: Ses i 6 and Ses i 71554

Kirsten Beyer, MD, Galina Grishina, MS, Ludmilla Bardina, MS, and Hugh A. Sampson, MD, Berlin, Germany, and New York, NY

Two new sesame seed allergens, Ses i 6 and Ses i 7, both belonging to seed storage proteins, have been identified. These findings will help to improve diagnostic and therapeutic approaches in sesame seed allergy.

Correspondence

The importance of specific airway resistance and bronchial inflammation in the lower airway pathology of rhinitis1557

Sevim Bavbek, MD, FAAAAI, and Zeynep Mısırlıgil, MD, Ankara, Turkey

Reply1558

Giorgio Ciprandi, MD, Ignazio Cirillo, MD, and Angela Pistorio, MD, PhD, Genoa and La Spezia, Italy

Airway inflammation in elite swimmers1559

Giorgio L. Piacentini, MD, Erika Rigotti, MD, Alessandro Bodini, MD, Diego Peroni, MD, and Attilio L. Boner, MD, Verona, Italy

Reply1560

Silvia Carraro, MD, Gea Bonetto, MD, Genny Gottardi, MD, and Eugenio Baraldi, MD, Padova, Italy

Natural rubber latex allergy among health care workers1561

Changyong Feng, PhD, and Hongyue Wang, PhD, Rochester, NY

Reply1561

Isabella Annesi-Maesano, DSc, PhD, and Jean Bousquet, MD, Villejuif and Montpellier, France

Are responses to treatment virus-specific in wheezing children?1561

Matti Korppi, MD, PhD, Tampere, Finland

Images in allergy and immunology

Role of eosinophils in airway remodeling1563

Susan C. Foley, MD, David Préfontaine, MSc, and Qutayba Hamid, MD, PhD, Montreal, Quebec, Canada

Beyond our pages1567

Burton Zweiman, MD, and Marc E. Rothenberg, MD, PhD, Editors

Reader services

Author index for Volume 1191571

Subject index for Volume 1191594

Instructions for authorswww.jacionline.org and January 2007, pages 33A-41A

Information for readers32A

Newsview—American Academy of Allergy, Asthma & Immunology33A

CME calendar—American Academy of Allergy, Asthma & Immunology37A

CME activities information41A

Professional opportunities43A

Change of address1429