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The Toxicant Induction of Irritant Asthma, Rhinitis, and Related Conditions

Author: William J. Meggs

Publisher: Springer Science & Business Media

Published: 2014-01-24

Total Pages: 297

ISBN-13: 1461490448

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Untoward reactions to environmental chemicals, particularly when a subject reports difficulties with exposures to chemicals of diverse classes involving more than one organ system, have been poorly understood and an area of great controversy. Studies of airway inflammation induced by respiratory irritants have established neurogenic inflammation as the mechanism for irritant asthma and rhinitis. Remodeling of the airway after an acute irritant exposure can lead to a heightened sensitivity to irritants that persists. Recognition that rhinitis, while sometimes regarded as a trivial disease, is associated with extra-airway manifestations such as fatigue and disturbances of sleep, mood, and cognition, further elucidates how chemical exposures can be serious for susceptible individuals. This book reviews current scientific understanding of irritant airway inflammation and related conditions, including cardiovascular effects of particulate exposures, airborne contact dermatitis and irritant dermatitis, and the brain as a target organ for both allergic and irritant reactions. It is essential reading for physicians and other healthcare workers caring for patients with environmental intolerances. Allergists, toxicologists, occupational and environmental physicians, and pulmonologists will find the materials particularly valuable. Patients and advocates for those with chemical intolerances will also find the book of interest.

Book Synopsis The Toxicant Induction of Irritant Asthma, Rhinitis, and Related Conditions by : William J. Meggs

Download or read book The Toxicant Induction of Irritant Asthma, Rhinitis, and Related Conditions written by William J. Meggs and published by Springer Science & Business Media. This book was released on 2014-01-24 with total page 297 pages. Available in PDF, EPUB and Kindle. Book excerpt: Untoward reactions to environmental chemicals, particularly when a subject reports difficulties with exposures to chemicals of diverse classes involving more than one organ system, have been poorly understood and an area of great controversy. Studies of airway inflammation induced by respiratory irritants have established neurogenic inflammation as the mechanism for irritant asthma and rhinitis. Remodeling of the airway after an acute irritant exposure can lead to a heightened sensitivity to irritants that persists. Recognition that rhinitis, while sometimes regarded as a trivial disease, is associated with extra-airway manifestations such as fatigue and disturbances of sleep, mood, and cognition, further elucidates how chemical exposures can be serious for susceptible individuals. This book reviews current scientific understanding of irritant airway inflammation and related conditions, including cardiovascular effects of particulate exposures, airborne contact dermatitis and irritant dermatitis, and the brain as a target organ for both allergic and irritant reactions. It is essential reading for physicians and other healthcare workers caring for patients with environmental intolerances. Allergists, toxicologists, occupational and environmental physicians, and pulmonologists will find the materials particularly valuable. Patients and advocates for those with chemical intolerances will also find the book of interest.

Asthma in the Workplace, Fourth Edition

Author: Jean-Luc Malo

Publisher: CRC Press

Published: 2013-05-10

Total Pages: 456

ISBN-13: 1842145916

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Occupational factors are responsible for a large percentage of cases of asthma in adults of working age. Any irritant generated at high concentrations can cause occupational asthma, and early diagnosis is critical because cure is still possible at this stage. This latest edition of Asthma in the Workplace reflects the rapid pace of discovery and research in workplace asthma that has taken place in recent years. This Fourth Edition retains the international flavor of prior editions, with contributions from editors and contributors from around the world. Several chapters commence with clinical histories and workplace scenarios relevant to the focus of the chapter, making it particularly germane for primary care providers to develop skills in early recognition of the disease. Topics discussed include: Definitions, historical background, epidemiology, genetics, pathophysiology, and animal models Guidelines for assessing the worker and the workplace, and proposed guidelines for management, including compensation aspects Medicolegal aspects, prevention, and surveillance Detailed information about specific agents, including a variety of high- and low-molecular weight agents Other types of work-related asthma conditions, such as irritant-induced asthma, eosinophilic bronchitis, and occupational rhinitis This new edition has been significantly restructured and places a greater emphasis on the clinical aspects of management and treatment. This heightened focus on practical considerations makes it a truly comprehensive, hands-on resource for practitioners and researchers in this fast-moving field.

Book Synopsis Asthma in the Workplace, Fourth Edition by : Jean-Luc Malo

Download or read book Asthma in the Workplace, Fourth Edition written by Jean-Luc Malo and published by CRC Press. This book was released on 2013-05-10 with total page 456 pages. Available in PDF, EPUB and Kindle. Book excerpt: Occupational factors are responsible for a large percentage of cases of asthma in adults of working age. Any irritant generated at high concentrations can cause occupational asthma, and early diagnosis is critical because cure is still possible at this stage. This latest edition of Asthma in the Workplace reflects the rapid pace of discovery and research in workplace asthma that has taken place in recent years. This Fourth Edition retains the international flavor of prior editions, with contributions from editors and contributors from around the world. Several chapters commence with clinical histories and workplace scenarios relevant to the focus of the chapter, making it particularly germane for primary care providers to develop skills in early recognition of the disease. Topics discussed include: Definitions, historical background, epidemiology, genetics, pathophysiology, and animal models Guidelines for assessing the worker and the workplace, and proposed guidelines for management, including compensation aspects Medicolegal aspects, prevention, and surveillance Detailed information about specific agents, including a variety of high- and low-molecular weight agents Other types of work-related asthma conditions, such as irritant-induced asthma, eosinophilic bronchitis, and occupational rhinitis This new edition has been significantly restructured and places a greater emphasis on the clinical aspects of management and treatment. This heightened focus on practical considerations makes it a truly comprehensive, hands-on resource for practitioners and researchers in this fast-moving field.

Advanced Drug Delivery Strategies for Targeting Chronic Inflammatory Lung Diseases

Author: Dinesh Kumar Chellappan

Publisher: Springer Nature

Published: 2022-03-23

Total Pages: 652

ISBN-13: 981164392X

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This book describes the growing clinical and healthcare relevance of nano-therapeutics in treating respiratory diseases. It begins with a brief introduction on the different types of nanoparticles in respiratory disease conditions. It further discusses the current trends in understanding the disease pathology using different in vitro and in vivo models, which are important towards the onsite clinical applications and development of new therapeutics. The book includes exciting topics such as formulation of these nanoparticles, targeting various organelles etc. It also describes the future prospects and challenges in the field. Different chapters are written by researchers actively working in the area of pulmonary diseases. This book is designed to address the requirements of both beginners and specialized scientists involved in pulmonary research. The contents include basic concepts followed by advanced state-of-art monitoring and treatment of diseases. The book is meant for researchers and industry experts in nanotechnology, pharmaceutical sciences and drug design.

Book Synopsis Advanced Drug Delivery Strategies for Targeting Chronic Inflammatory Lung Diseases by : Dinesh Kumar Chellappan

Download or read book Advanced Drug Delivery Strategies for Targeting Chronic Inflammatory Lung Diseases written by Dinesh Kumar Chellappan and published by Springer Nature. This book was released on 2022-03-23 with total page 652 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book describes the growing clinical and healthcare relevance of nano-therapeutics in treating respiratory diseases. It begins with a brief introduction on the different types of nanoparticles in respiratory disease conditions. It further discusses the current trends in understanding the disease pathology using different in vitro and in vivo models, which are important towards the onsite clinical applications and development of new therapeutics. The book includes exciting topics such as formulation of these nanoparticles, targeting various organelles etc. It also describes the future prospects and challenges in the field. Different chapters are written by researchers actively working in the area of pulmonary diseases. This book is designed to address the requirements of both beginners and specialized scientists involved in pulmonary research. The contents include basic concepts followed by advanced state-of-art monitoring and treatment of diseases. The book is meant for researchers and industry experts in nanotechnology, pharmaceutical sciences and drug design.

Novel Pathogenesis and Treatments for Cardiovascular Disease

Author: David C. Gaze

Publisher: BoD – Books on Demand

Published: 2023-08-23

Total Pages: 594

ISBN-13: 1803561165

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This book provides a comprehensive overview of cardiovascular diseases (CVDs) and associated conditions. It is organized into three sections on “Cardiovascular Pathophysiology”, “Cardiovascular Diagnostics”, and “Cardiovascular Treatments”. Chapters address such topics as the role of obesity in CVD, cardiotoxicity, cardio-oncology, CVD in different disease states, modalities for detecting CVD, interventional strategies to prevent or treat CVD, and much more.

Book Synopsis Novel Pathogenesis and Treatments for Cardiovascular Disease by : David C. Gaze

Download or read book Novel Pathogenesis and Treatments for Cardiovascular Disease written by David C. Gaze and published by BoD – Books on Demand. This book was released on 2023-08-23 with total page 594 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book provides a comprehensive overview of cardiovascular diseases (CVDs) and associated conditions. It is organized into three sections on “Cardiovascular Pathophysiology”, “Cardiovascular Diagnostics”, and “Cardiovascular Treatments”. Chapters address such topics as the role of obesity in CVD, cardiotoxicity, cardio-oncology, CVD in different disease states, modalities for detecting CVD, interventional strategies to prevent or treat CVD, and much more.

Fundamentals of Airway Surgery, Part II, An Issue of Thoracic Surgery Clinics E-Book

Author: Jean Deslauriers

Publisher: Elsevier Health Sciences

Published: 2018-08-01

Total Pages:

ISBN-13: 0323613977

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This issue of Thoracic Surgery Clinics of North America, guest edited by Drs. Jean Deslauriers, Farid Shamji, and Bill Nelems, is the second of two devoted to Fundamentals of Airway Surgery. The editors have assembled expert authors to review the following topics: From Open to Bedside Percutaneous Tracheostomy; Anterior Mediastinal Tracheostomy: Past, Present, and Future; Extended Sleeve Resections; Bronchoplasties at the Segmental Level; Challenges of Carinal Resection and Reconstruction; Carinal Pneumonectomy; Management of Post-Pneumonectomy Broncho-Pleural Fistula: From Thoracoplasty to Trans-Sternal Closure; Tracheal Transplantation: State of the Art and Key Role of Blood Supply in its Success; Autologous Tracheal Replacement; Pathophysiology and Predictors of Bronchial Complications After Lung Transplantation; Management of Bronchial Complications After Lung Transplantation and Late Sequelae; Experiences with Prosthetic Airway Replacement: From the Use of Marlex Meshes to Tissue Engineering; Management of Acquired Benign Tracheo-Esophageal Fistulas; Strategies in the Treatment of Malignant Tracheoesophageal Fistulas; Recognition and Management of Life-Threatening Tracheo-Vascular Fistulae and How to Prevent Them; Principles of Urgent Management of Acute Airway Obstruction; Tracheo-Bronchial Injuries Secondary to Blunt Chest Trauma; Cricothyroid Approach for Emergency Access to the Airway; Use of Silicone Tubes in the Management of Complex Airway Problems; Management of the Airway after Tracheal Reconstruction; Importance of a Team Effort in the Success of Airway Surgery; and more!

Book Synopsis Fundamentals of Airway Surgery, Part II, An Issue of Thoracic Surgery Clinics E-Book by : Jean Deslauriers

Download or read book Fundamentals of Airway Surgery, Part II, An Issue of Thoracic Surgery Clinics E-Book written by Jean Deslauriers and published by Elsevier Health Sciences. This book was released on 2018-08-01 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: This issue of Thoracic Surgery Clinics of North America, guest edited by Drs. Jean Deslauriers, Farid Shamji, and Bill Nelems, is the second of two devoted to Fundamentals of Airway Surgery. The editors have assembled expert authors to review the following topics: From Open to Bedside Percutaneous Tracheostomy; Anterior Mediastinal Tracheostomy: Past, Present, and Future; Extended Sleeve Resections; Bronchoplasties at the Segmental Level; Challenges of Carinal Resection and Reconstruction; Carinal Pneumonectomy; Management of Post-Pneumonectomy Broncho-Pleural Fistula: From Thoracoplasty to Trans-Sternal Closure; Tracheal Transplantation: State of the Art and Key Role of Blood Supply in its Success; Autologous Tracheal Replacement; Pathophysiology and Predictors of Bronchial Complications After Lung Transplantation; Management of Bronchial Complications After Lung Transplantation and Late Sequelae; Experiences with Prosthetic Airway Replacement: From the Use of Marlex Meshes to Tissue Engineering; Management of Acquired Benign Tracheo-Esophageal Fistulas; Strategies in the Treatment of Malignant Tracheoesophageal Fistulas; Recognition and Management of Life-Threatening Tracheo-Vascular Fistulae and How to Prevent Them; Principles of Urgent Management of Acute Airway Obstruction; Tracheo-Bronchial Injuries Secondary to Blunt Chest Trauma; Cricothyroid Approach for Emergency Access to the Airway; Use of Silicone Tubes in the Management of Complex Airway Problems; Management of the Airway after Tracheal Reconstruction; Importance of a Team Effort in the Success of Airway Surgery; and more!

Middleton's Allergy Essentials E-Book

Author: Robyn E. O'Hehir

Publisher: Elsevier Health Sciences

Published: 2015-12-09

Total Pages: 421

ISBN-13: 0323392733

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For decades, health care practitioners have relied on Middleton’s Allergy as their go-to reference for comprehensive information on allergic disorders. Now Middleton’s Allergy Essentials, by Drs. Robyn E. O'Hehir, Stephen T. Holgate, and Aziz Sheikh, offers a concise resource that’s both easily accessible and highly authoritative. Perfect for clinicians in primary and secondary care settings, this practical volume covers what is most useful in your daily practice, with a strong emphasis on disease diagnosis and management. A practical approach to evaluation, differential diagnosis, and treatment of allergic disorders, focused specifically on what the non-specialist needs to know for everyday practice. Each chapter begins with a handy summary of key concepts to help you quickly identify important information. Coverage of today’s hot topics includes asthma, drug allergies, food allergies and gastrointestinal disorders, anaphylaxis, atopic dermatitis, and allergic contact dermatitis. Concise sections on mechanisms are included where relevant, keeping you up to date with this rapidly evolving field. Authored by the same internationally recognized experts that produce Middleton’s Allergy, the definitive text in the field. Ideal for physicians, residents, general and family practitioners, nurse practitioners, primary care doctors, hospitalists, general internists – anyone who is called upon to make effective diagnostic and treatment decisions regarding allergic disorders.

Book Synopsis Middleton's Allergy Essentials E-Book by : Robyn E. O'Hehir

Download or read book Middleton's Allergy Essentials E-Book written by Robyn E. O'Hehir and published by Elsevier Health Sciences. This book was released on 2015-12-09 with total page 421 pages. Available in PDF, EPUB and Kindle. Book excerpt: For decades, health care practitioners have relied on Middleton’s Allergy as their go-to reference for comprehensive information on allergic disorders. Now Middleton’s Allergy Essentials, by Drs. Robyn E. O'Hehir, Stephen T. Holgate, and Aziz Sheikh, offers a concise resource that’s both easily accessible and highly authoritative. Perfect for clinicians in primary and secondary care settings, this practical volume covers what is most useful in your daily practice, with a strong emphasis on disease diagnosis and management. A practical approach to evaluation, differential diagnosis, and treatment of allergic disorders, focused specifically on what the non-specialist needs to know for everyday practice. Each chapter begins with a handy summary of key concepts to help you quickly identify important information. Coverage of today’s hot topics includes asthma, drug allergies, food allergies and gastrointestinal disorders, anaphylaxis, atopic dermatitis, and allergic contact dermatitis. Concise sections on mechanisms are included where relevant, keeping you up to date with this rapidly evolving field. Authored by the same internationally recognized experts that produce Middleton’s Allergy, the definitive text in the field. Ideal for physicians, residents, general and family practitioners, nurse practitioners, primary care doctors, hospitalists, general internists – anyone who is called upon to make effective diagnostic and treatment decisions regarding allergic disorders.

How Tobacco Smoke Causes Disease

Author:

Publisher:

Published: 2010

Total Pages: 728

ISBN-13:

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This report considers the biological and behavioral mechanisms that may underlie the pathogenicity of tobacco smoke. Many Surgeon General's reports have considered research findings on mechanisms in assessing the biological plausibility of associations observed in epidemiologic studies. Mechanisms of disease are important because they may provide plausibility, which is one of the guideline criteria for assessing evidence on causation. This report specifically reviews the evidence on the potential mechanisms by which smoking causes diseases and considers whether a mechanism is likely to be operative in the production of human disease by tobacco smoke. This evidence is relevant to understanding how smoking causes disease, to identifying those who may be particularly susceptible, and to assessing the potential risks of tobacco products.

Book Synopsis How Tobacco Smoke Causes Disease by :

Download or read book How Tobacco Smoke Causes Disease written by and published by . This book was released on 2010 with total page 728 pages. Available in PDF, EPUB and Kindle. Book excerpt: This report considers the biological and behavioral mechanisms that may underlie the pathogenicity of tobacco smoke. Many Surgeon General's reports have considered research findings on mechanisms in assessing the biological plausibility of associations observed in epidemiologic studies. Mechanisms of disease are important because they may provide plausibility, which is one of the guideline criteria for assessing evidence on causation. This report specifically reviews the evidence on the potential mechanisms by which smoking causes diseases and considers whether a mechanism is likely to be operative in the production of human disease by tobacco smoke. This evidence is relevant to understanding how smoking causes disease, to identifying those who may be particularly susceptible, and to assessing the potential risks of tobacco products.

Fundamentals of Toxicologic Pathology

Author: Wanda M. Haschek

Publisher: Academic Press

Published: 2009-11-23

Total Pages: 714

ISBN-13: 9780080919324

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Toxicologic pathology integrates toxicology and the disciplines within it (such as biochemistry, pharmacodynamics and risk assessment) to pathology and its related disciplines (such as physiology, microbiology, immunology, and molecular biology). Fundamentals of Toxicologic Pathology Second Edition updates the information presented in the first edition, including five entirely new chapters addressing basic concepts in toxicologic pathology, along with color photomicrographs that show examples of specific toxicant-induced diseases in animals. The current edition also includes comparative information that will prove a valuable resource to practitioners, including diagnostic pathologists and toxicologists. 25% brand new information, fully revised throughout New chapters: Veterinary Diagnostic Toxicologic Pathology; Clinical Pathology; Nomenclature: Terminology for Morphologic Alterations; Techniques in Toxicologic Pathology New color photomicrographs detailing specific toxicant-induced diseases in animals Mechanistic information integrated from both toxicology and pathology discussing basic mechanisms of toxic injury and morphologic expression at the subcellular, cellular, and tissue levels

Book Synopsis Fundamentals of Toxicologic Pathology by : Wanda M. Haschek

Download or read book Fundamentals of Toxicologic Pathology written by Wanda M. Haschek and published by Academic Press. This book was released on 2009-11-23 with total page 714 pages. Available in PDF, EPUB and Kindle. Book excerpt: Toxicologic pathology integrates toxicology and the disciplines within it (such as biochemistry, pharmacodynamics and risk assessment) to pathology and its related disciplines (such as physiology, microbiology, immunology, and molecular biology). Fundamentals of Toxicologic Pathology Second Edition updates the information presented in the first edition, including five entirely new chapters addressing basic concepts in toxicologic pathology, along with color photomicrographs that show examples of specific toxicant-induced diseases in animals. The current edition also includes comparative information that will prove a valuable resource to practitioners, including diagnostic pathologists and toxicologists. 25% brand new information, fully revised throughout New chapters: Veterinary Diagnostic Toxicologic Pathology; Clinical Pathology; Nomenclature: Terminology for Morphologic Alterations; Techniques in Toxicologic Pathology New color photomicrographs detailing specific toxicant-induced diseases in animals Mechanistic information integrated from both toxicology and pathology discussing basic mechanisms of toxic injury and morphologic expression at the subcellular, cellular, and tissue levels

Damp Indoor Spaces and Health

Author: Committee on Damp Indoor Spaces and Health

Publisher: National Academies Press

Published: 2004-08-31

Total Pages: 368

ISBN-13: 0309133394

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Almost all homes, apartments, and commercial buildings will experience leaks, flooding, or other forms of excessive indoor dampness at some point. Not only is excessive dampness a health problem by itself, it also contributes to several other potentially problematic types of situations. Molds and other microbial agents favor damp indoor environments, and excess moisture may initiate the release of chemical emissions from damaged building materials and furnishings. This new book from the Institute of Medicine examines the health impact of exposures resulting from damp indoor environments and offers recommendations for public health interventions. Damp Indoor Spaces and Health covers a broad range of topics. The book not only examines the relationship between damp or moldy indoor environments and adverse health outcomes but also discusses how and where buildings get wet, how dampness influences microbial growth and chemical emissions, ways to prevent and remediate dampness, and elements of a public health response to the issues. A comprehensive literature review finds sufficient evidence of an association between damp indoor environments and some upper respiratory tract symptoms, coughing, wheezing, and asthma symptoms in sensitized persons. This important book will be of interest to a wide-ranging audience of science, health, engineering, and building professionals, government officials, and members of the public.

Book Synopsis Damp Indoor Spaces and Health by : Committee on Damp Indoor Spaces and Health

Download or read book Damp Indoor Spaces and Health written by Committee on Damp Indoor Spaces and Health and published by National Academies Press. This book was released on 2004-08-31 with total page 368 pages. Available in PDF, EPUB and Kindle. Book excerpt: Almost all homes, apartments, and commercial buildings will experience leaks, flooding, or other forms of excessive indoor dampness at some point. Not only is excessive dampness a health problem by itself, it also contributes to several other potentially problematic types of situations. Molds and other microbial agents favor damp indoor environments, and excess moisture may initiate the release of chemical emissions from damaged building materials and furnishings. This new book from the Institute of Medicine examines the health impact of exposures resulting from damp indoor environments and offers recommendations for public health interventions. Damp Indoor Spaces and Health covers a broad range of topics. The book not only examines the relationship between damp or moldy indoor environments and adverse health outcomes but also discusses how and where buildings get wet, how dampness influences microbial growth and chemical emissions, ways to prevent and remediate dampness, and elements of a public health response to the issues. A comprehensive literature review finds sufficient evidence of an association between damp indoor environments and some upper respiratory tract symptoms, coughing, wheezing, and asthma symptoms in sensitized persons. This important book will be of interest to a wide-ranging audience of science, health, engineering, and building professionals, government officials, and members of the public.

Kendig and Chernick's Disorders of the Respiratory Tract in Children E-Book

Author: Robert W. Wilmott

Publisher: Elsevier Health Sciences

Published: 2012-02-25

Total Pages: 1163

ISBN-13: 1455740500

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Kendig, Chernick’s Disorders of the Respiratory Tract in Children is the definitive medical reference book to help you confront critical challenges using the latest knowledge and techniques. You’ll get the state-of-the-art answers you need to offer the best care to young patients. Tackle the toughest challenges and improve patient outcomes with coverage of all the common and rare respiratory problems found in newborns and children worldwide. Get a solid foundation of knowledge to better understand and treat your patients through coverage of the latest basic science and its relevance to clinical problems. Get comprehensive, authoritative coverage on today’s hot topics, such as interstitial lung disease, respiratory disorders in the newborn, congenital lung disease, swine flu, genetic testing for disease and the human genome, inflammatory cytokines in the lung, new radiologic techniques, diagnostic imaging of the respiratory tract, and pulmonary function tests. Learn from the experts with contributions from 100 world authorities in the fields of pediatrics, pulmonology, neurology, microbiology, cardiology, physiology, diagnostic imaging, anesthesiology, otolaryngology, allergy, and surgery.

Book Synopsis Kendig and Chernick's Disorders of the Respiratory Tract in Children E-Book by : Robert W. Wilmott

Download or read book Kendig and Chernick's Disorders of the Respiratory Tract in Children E-Book written by Robert W. Wilmott and published by Elsevier Health Sciences. This book was released on 2012-02-25 with total page 1163 pages. Available in PDF, EPUB and Kindle. Book excerpt: Kendig, Chernick’s Disorders of the Respiratory Tract in Children is the definitive medical reference book to help you confront critical challenges using the latest knowledge and techniques. You’ll get the state-of-the-art answers you need to offer the best care to young patients. Tackle the toughest challenges and improve patient outcomes with coverage of all the common and rare respiratory problems found in newborns and children worldwide. Get a solid foundation of knowledge to better understand and treat your patients through coverage of the latest basic science and its relevance to clinical problems. Get comprehensive, authoritative coverage on today’s hot topics, such as interstitial lung disease, respiratory disorders in the newborn, congenital lung disease, swine flu, genetic testing for disease and the human genome, inflammatory cytokines in the lung, new radiologic techniques, diagnostic imaging of the respiratory tract, and pulmonary function tests. Learn from the experts with contributions from 100 world authorities in the fields of pediatrics, pulmonology, neurology, microbiology, cardiology, physiology, diagnostic imaging, anesthesiology, otolaryngology, allergy, and surgery.