When DiNozzo says "Nesia tova" to Ziva, it means "have a good trip" in Hebrew.
When DiNozzo comes into Abby's lab, he says "Oh, hi, Abby-Normal." This is a reference to Igor's answer when asked whose brain it belongs to in Frankenstein Junior (1974).
Abby says Sgt. Jack Kale received a medical discharge after being diagnosed with hypereosinophilic syndrome (H.E.S.). H.E.S. is a disease caused by chronically high levels of eosinophils in the blood for a period of at least six months, with eosinophil damage occurring in the heart, nervous system or bone marrow. Eosinophils are a type of white blood cell that plays a role in inflammation and fighting parasites, along with neutrophils they are the type of white blood cells that create pus; they normally make up a very small percentage of white blood cells (1-3%). But some conditions such as autoimmune disorders like rheumatoid arthritis, lupus, Crohn's disease and inflammatory bowel disease and certain blood cancers like leukemia can cause abnormally high levels; hypereosinophilia is when eosinophil levels rise above 15% for an extended period.
In some cases these abnormally high eosinophils cause problems due to increased swelling and preventing other blood cells from functioning properly; for example the most severe kind of asthma is eosinophilic asthma which is caused by eosinophils causing swelling in the trachea and infiltrating lung tissue, which can lead to a more serious condition called eosinophilic pneumonia. They can also begin attacking parts of the body like joints, organs & bone marrow and can progress into cancer called eosinophilic leukemia. Left untreated H.E.S. is often fatal, it is usually treated with high doses of corticosteroids like prednisone and methylprednisolone (Medrol). While high dose steroid treatment is highly effective at lowering eosinophil levels it can have a number of side effects like severe hyperglycemia, suppression of the immune system, weight gain and mood changes including increased anger and aggression, which can lead to steroid induced psychosis like in Sgt. Kale's case. While most of these side effects are fairly common, steroid psychosis is rare. If steroids alone aren't effective a drug called Mepolizumab can be added, it is a monoclonal antibody that blocks the protein the immune system uses to produce eosinophils.
In some cases these abnormally high eosinophils cause problems due to increased swelling and preventing other blood cells from functioning properly; for example the most severe kind of asthma is eosinophilic asthma which is caused by eosinophils causing swelling in the trachea and infiltrating lung tissue, which can lead to a more serious condition called eosinophilic pneumonia. They can also begin attacking parts of the body like joints, organs & bone marrow and can progress into cancer called eosinophilic leukemia. Left untreated H.E.S. is often fatal, it is usually treated with high doses of corticosteroids like prednisone and methylprednisolone (Medrol). While high dose steroid treatment is highly effective at lowering eosinophil levels it can have a number of side effects like severe hyperglycemia, suppression of the immune system, weight gain and mood changes including increased anger and aggression, which can lead to steroid induced psychosis like in Sgt. Kale's case. While most of these side effects are fairly common, steroid psychosis is rare. If steroids alone aren't effective a drug called Mepolizumab can be added, it is a monoclonal antibody that blocks the protein the immune system uses to produce eosinophils.
This is the first episode where a brown/beige cloth is used to cover a body's "private parts" in the morgue. Previously, they used really bright lights or strategically-placed trays to hide them.
McGee mentions that Mepolizumab, the experimental drug Sgt. Kale is taking, is an orphan drug. Orphan drugs are ones that are used to treat rare diseases and would not be profitable for pharmaceutical companies to research and produce without government assistance. This is due to both practical economic reasons and a bit of corporate greed, research & development of new drugs is extremely expensive and due to the small number of people that would need the drug a company would never be able sell enough of it to recover their R&D costs, let alone make a profit. For these reasons a number of rare diseases have gone without drugs to treat them. This led to governments in both the European Union and the United States creating legislature that allowed for government grants to fund the R&D of drugs for certain diseases designated by agencies like the Food & Drug Administration (FDA) in the U.S. and European Medicines Agency (EMA), thereby encouraging not only pharmaceutical companies but also universities to develop needed medications. The FDA defines an orphan drug as one that treats a rare disease or condition affecting less than 200,000 people in the U.S. (6 cases per 10,000 people); similarly the EMA defines it as one affecting not more than 5 in 10,000 people in the E.U.
Mepolizumab received orphan drug status from both the EMA & FDA in 2000 to treat eosinophilic asthma, leading to it being researched by biochemists and pharmacologists from institutions like Johns Hopkins and the London Imperial College of Medicine and developed by pharmaceutical company GlaxoSmithKline (GSK). Clinical trials began in 2007 and were completed in 2014, with mepolizumab receiving both EMA & FDA approval in 2015 for treating eosinophilic asthma. Mepolizumab also began to be used off-label to treat severe cases of H.E.S. that didn't respond to traditional steroid treatment, though it didn't receive FDA approval for treating H.E.S. until 2020.
Mepolizumab received orphan drug status from both the EMA & FDA in 2000 to treat eosinophilic asthma, leading to it being researched by biochemists and pharmacologists from institutions like Johns Hopkins and the London Imperial College of Medicine and developed by pharmaceutical company GlaxoSmithKline (GSK). Clinical trials began in 2007 and were completed in 2014, with mepolizumab receiving both EMA & FDA approval in 2015 for treating eosinophilic asthma. Mepolizumab also began to be used off-label to treat severe cases of H.E.S. that didn't respond to traditional steroid treatment, though it didn't receive FDA approval for treating H.E.S. until 2020.