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Asthma is a chronic inflammatory disorder of the airways The histopathologic features include denudation of airway epithelium, collagen deposition beneath the basement membrane, airway edema, mast cell activation, and inflammatory cell infiltration with neutrophils, eosinophils, and lymphocytes (especially T lymphocytes) Hypertrophy of bronchial smooth muscle and hypertrophy of mucous glands with plugging of small airways with thick mucus can occur This airway inflammation underlies disease chronicity and contributes to airway hyperresponsiveness, airflow limitation, and respiratory symptoms (including recurrent episodes of wheezing, breathlessness, chest tightness, and cough, particularly during the nighttime and early morning hours) A genetic predisposition to asthma is recognized The strongest identifiable predisposing factor for the development of asthma is atopy Exposure of sensitive patients to inhaled allergens increases airway inflammation, airway hyperresponsiveness, and symptoms Symptoms may develop immediately (immediate asthmatic response) or 4 6 hours after allergen exposure (late asthmatic response) Common aeroallergens include house dust mites (often found in pillows, mattresses, upholstered furniture, carpets, and drapes), cockroaches, cats, and seasonal pollens Substantially reducing exposure reduces pathologic findings and clinical symptoms Nonspecific precipitants of asthma include exercise, upper respiratory tract infections, rhinitis, sinusitis, postnasal drip, aspiration, gastroesophageal reflux, changes in the weather, and stress Exposure to environmental tobacco smoke increases asthma symptoms and the need for medications and reduces lung function Increased air levels of respirable particles, ozone, SO2, and NO2 precipitate asthma symptoms and increase emergency department visits and hospitalizations Selected individuals may experience asthma symptoms after exposure to aspirin, nonsteroidal anti-inflammatory drugs, or tartrazine dyes Certain other medications may also precipitate asthma

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factors Such screening can identify persons at risk for AIDS but misses a substantial proportion of those infected Nonetheless, the yield from screening higher prevalence populations is substantially greater than that from screening the general population, and more widespread screening of the population remains controversial In immunocompromised patients, live vaccines are contraindicated but many killed or component vaccines are safe and recommended Asymptomatic HIV-infected patients have not shown adverse consequences when given live MMR and influenza vaccinations as well as tetanus, hepatitis B, H influenzae type b, and pneumococcal vaccinations all should be given However, if poliomyelitis immunization is required, the inactivated poliomyelitis vaccine is indicated In symptomatic HIV-infected patients, live virus vaccines such as MMR should generally be avoided, but annual influenza vaccination is safe Whenever possible, immunizations should be completed before procedures that require or induce immunosuppression (organ transplantation or chemotherapy), or that reduce immunogenic responses (splenectomy) However, if this is not possible, the patient may mount only a partial immune response, yet even this partial response can be beneficial Patients who undergo allogeneic bone marrow transplantation lose preexisting immunities and should be revaccinated In many situations, family members should also be vaccinated to protect the immunocompromised patient, although oral live polio vaccine should be avoided because of the risk of infecting the patient New cases of poliomyelitis have been reported in the United States, Haiti, and the Dominican Republic recently, slowing its eradication in the Western Hemisphere The 2001 anthrax attacks in the United States have raised concern about the nation s vulnerability to a smallpox attack Resumption of smallpox vaccination was undertaken for some health care workers, police, and firemen, etc However, smallpox vaccine has a higher complication rate than any other vaccine currently being used Expected adverse events in a mass smallpox vaccination campaign include fever (less than one case per five vaccine recipients), rash (less than one case per one hundred recipients), encephalitis (less than three cases per million), and death (less than two cases per million) Careful prevaccination exclusion of high-risk individuals (those with eczema or immunosuppression or coronary artery disease) is essential to minimize such complications A single-blind, randomized trial of clinical responses to undiluted and diluted smallpox vaccine in vaccinia-naive and previously vaccinated populations showed that there were no differences in antibody responses between the undiluted and diluted vaccine groups However, compared with vaccinia-naive persons, previously vaccinated persons exhibited significantly smaller and more rapidly evolving skin lesions, fewer adverse events, and lower viral shedding from lesions which diminished more rapidly The current epidemic of highly pathogenic H5N1 avian influenza within duck and poultry populations in Southeast Asia raises serious concerns that genetic reassortment will result in a human influenza pandemic In 2003 through 2005, there were 138 confirmed cases of human.

This problem can be sidestepped by setting the file-locking mode to nonstrict and making sure all developers own the file, possibly working under the same user account. However, this arrangement is highly unlikely and defeats the primary reason of using version control in the first place. In addition, developers A and C can break the lock on the file by using the u or -M option, but this goes against the design intent of RCS. Scenario 2: The group members decide to use CVS for their project. Work progresses as follows:

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Treanor JJ et al Safety and immunogenicity of an inactivated subvirion influenza A (H5N1) vaccine N Engl J Med 2006 Mar 30;354(13):1343 51 [PMID: 16571878] Willis BC et al; Task Force on Community Preventive Services: Improving influenza, pneumococcal polysaccharide, and hepatitis B vaccination coverage among adults aged < 65 years at high risk: a report on recommendations of the Task Force on Community Preventive Services MMWR Recomm Rep 2005;54(RR-5):1 [PMID: 15800472]

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