Annals of allergy最新文献

{"title":"Changing asthma mortality and sales of inhaled bronchodilators and anti-asthmatic drugs.","authors":"R M Sly","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Increasing rates of death from asthma in the United States have stabilized somewhat since 1988. Case-control studies have suggested possible adverse effects of inhaled beta-adrenergic agonists that may have contributed to mortality.</p><p><strong>Objective: </strong>To examine possible relationships between changing asthma mortality and sales of inhaled antiasthmatic drugs.</p><p><strong>Methods: </strong>The National Center for Health Statistics supplied numbers and rates of death from asthma (ICD 493) by year. The Bureau of the Census supplied population data. IMS America provided estimates of total hospital and drugstore sales of inhaled beta-adrenergic agonists, cromolyn sodium, and inhaled corticosteroids by year and annual sales of AeroChambers and InspirEase kits. I calculated sales of the antiasthmatic drugs as puffs per person in the general population or doses per person for cromolyn sodium, defining a dose as a 20-mg capsule or vial or 2 mg by metered dose inhaler.</p><p><strong>Results: </strong>Rates of death from asthma in the United States increased from 0.8 per 100,000 general population in 1977 and 1978 to 2.0 in 1989, then decreased to 1.9 in 1990 before increasing again to 2.0 in 1991. Rates of death for blacks 5 through 34 years of age increased from 0.9 in 1980 to 1.3 in 1990 and decreased to 1.2 in 1991. Estimated total hospital and drugstore sales of beta-adrenergic metered dose inhalers increased from 10.3 puffs per person in the general population in 1976 to 31.0 in 1991; those for inhaled corticosteroids, from 0.44 puffs per person in 1976 to 5.44 in 1991. Sales of cromolyn increased from 0.047 doses per person in 1978 to 0.91 in 1991. Sales of AeroChambers and InspirEase kits have also increased.</p><p><strong>Conclusions: </strong>Since 1988 there has been some moderation in increases in rates of death from asthma while progressive increases in sales of inhaled antiasthmatic drugs have continued. These data are consistent with the likelihood that previous increases in rates of death from asthma were partly due to undertreatment.</p>","PeriodicalId":7931,"journal":{"name":"Annals of allergy","volume":"73 5","pages":"439-43"},"PeriodicalIF":0.0,"publicationDate":"1994-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18972454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A three-week-old infant with invasive pulmonary aspergillosis.","authors":"L A Gonzalez,&nbsp;J E Kiff,&nbsp;D T Umetsu","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":7931,"journal":{"name":"Annals of allergy","volume":"73 5","pages":"392-400"},"PeriodicalIF":0.0,"publicationDate":"1994-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18973808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tonsillectomy in a patient with hereditary angioedema after prophylaxis with C1 inhibitor concentrate.","authors":"K K Maves,&nbsp;J M Weiler","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>A 15-year-old young man with a history of recurrent streptococcal pharyngitis and hereditary angioedema presented for tonsillectomy. Preoperative physical examination was normal with the exception of enlarged pharyngeal tonsils with crypts and pustules; there was no evidence of angioedema. Laboratory studies were remarkable for a C4 level of 8 mg/dL (normal 20-50 mg/dL) and C1 inhibitor (C1 INH) level of 4 mg/dL (normal 11-26 mg/dL).</p><p><strong>Objective: </strong>To report the use of C1 INH concentrate as prophylactic treatment for a patient with hereditary angioedema who required tonsillectomy.</p><p><strong>Methods: </strong>The patient was treated with stanozolol 4 mg po quid and clindamycin 150 mg po tid during the week before the procedure. Two hours prior to surgery, he received 2300 plasma units of intravenous C1-inhibitor (Human) Vapor Heated, IMMUNO (IMMUNO Clinical Research Corporation, New York, NY).</p><p><strong>Results: </strong>Approximately eight hours after an uncomplicated tonsillectomy, the patient began to experience crampy abdominal pain, typical of his hereditary angioedema. Beginning 22 hours after surgery, he had facial swelling and complained of difficulty swallowing and the sensation of throat swelling. The symptoms resolved over the next eight hours. Serial laboratory examinations revealed: [table: see text]</p><p><strong>Conclusions: </strong>We believe that the occurrence of abdominal pain, facial swelling, and difficulty swallowing suggests that this patient may have experienced a mild, generalized flare of hereditary angioedema during the postoperative period in spite of prophylactic therapy with both anabolic steroids and C1 INH concentrate. This serves as a reminder that patients with hereditary angioedema require close observation following invasive procedures even after premedication with stanozolol and C1 INH concentrate.</p>","PeriodicalId":7931,"journal":{"name":"Annals of allergy","volume":"73 5","pages":"435-8"},"PeriodicalIF":0.0,"publicationDate":"1994-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18972453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of hypoallergenic milk.","authors":"A Cantani,&nbsp;G Arcese,&nbsp;P Lucenti","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":7931,"journal":{"name":"Annals of allergy","volume":"73 5","pages":"455"},"PeriodicalIF":0.0,"publicationDate":"1994-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18972457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aspirin intolerance.","authors":"B T Feigenbaum,&nbsp;R A Simon,&nbsp;D D Stevenson","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":7931,"journal":{"name":"Annals of allergy","volume":"73 5","pages":"455-6"},"PeriodicalIF":0.0,"publicationDate":"1994-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18972458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence, economic, and medical impact of tobacco smoking.","authors":"E O Meltzer","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>The goal of this review is to report the epidemiology and risks associated with tobacco smoking. It also suggests reasons and measures to achieve a smoke-free society.</p><p><strong>Data sources: </strong>References are limited to the English language and human subjects. All are publications from either the United States or the United Kingdom and extend back to the past 50 years. Sources include computerized databases and bibliographies of recent articles and books.</p><p><strong>Study selection: </strong>Papers were selected on the basis of their timeliness, credibility of their data, explanation of important findings, extrapolation of clinical data from large patient populations, and clarification of controversial issues. Approximately 60% of the articles initially reviewed are included in the bibliography.</p><p><strong>Results: </strong>Tobacco smoking continues to affect the lives of millions of Americans. The risks of cardiovascular diseases, cancer, and respiratory diseases are significantly increased in both the smoker and in those exposed to environmental tobacco smoke.</p><p><strong>Conclusions: </strong>Understanding the consequences of tobacco smoking is necessary to effectively mobilize the appropriate political, social, and medical resources to combat this most important health issue.</p>","PeriodicalId":7931,"journal":{"name":"Annals of allergy","volume":"73 5","pages":"381-9; quiz 388-91"},"PeriodicalIF":0.0,"publicationDate":"1994-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18973807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pertussis infection and allergic sensitization.","authors":"M Wjst,&nbsp;S Dold,&nbsp;P Reitmeir,&nbsp;C Fritzsch,&nbsp;E von Mutius,&nbsp;H H Thiemann","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>The immunogenic activity of B. pertussis infection has been described in various laboratory, animal, and clinical studies. There is, however, no information on the impact of pertussis on allergies in the total population.</p><p><strong>Objective: </strong>To compare the prevalence of allergic sensitization and allergic rhinitis in children with and without previous pertussis infection.</p><p><strong>Methods: </strong>A population-based, cross-sectional study was carried out on 13,937 10-year-old children in the western (Munich and Southern Bavaria) and eastern parts of Germany (Leipzig and the region around Halle). A total of 11,969 questionnaires (85.9%) given to the parents were collected. Data from 9,484 German children (questionnaire and skin prick tests with six different allergens) were analyzed.</p><p><strong>Results: </strong>Pertussis was much more common in the western than in the eastern part of Germany. The adjusted odds ratio for any allergic sensitization after pertussis was only slightly increased in western Germany with 1.3 (95% confidence limits 1.2 to 1.5) and in eastern Germany with 1.5, (1.2 to 1.8) but not for allergic rhinitis with 1.0 (0.7 to 1.4) and in Eastern Germany 1.3 (0.8 to 1.9).</p><p><strong>Conclusions: </strong>Infection with pertussis seems to have only a weak influence on allergic sensitization and does not explain the observed differences in allergic sensitization between western and eastern Germany.</p>","PeriodicalId":7931,"journal":{"name":"Annals of allergy","volume":"73 5","pages":"450-4"},"PeriodicalIF":0.0,"publicationDate":"1994-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18972456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rapid venom immunotherapy is safe for routine use in the treatment of patients with Hymenoptera anaphylaxis.","authors":"J A Bernstein,&nbsp;S L Kagen,&nbsp;D I Bernstein,&nbsp;I L Bernstein","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Rapid venom immunotherapy regimens have been developed to provide safe protection to individuals who have experienced Hymenoptera anaphylaxis by administering greater than 50 micrograms of venom over two to three hours on treatment day 1. A rapid venom immunotherapy protocol which consisted of administration of a cumulative dose of 58.55 micrograms of each venom on treatment day 1 followed by an accelerated build-up over 3 weeks to a final maintenance dose of 100 micrograms per venom was developed by our group in 1984.</p><p><strong>Objective: </strong>We report our 10-year cumulative experience with this rapid venom immunotherapy regimen.</p><p><strong>Methods: </strong>Seventy-seven venom-allergic patients received a cumulative dose of 58.55 micrograms per venom on treatment day 1 in an ambulatory care setting. Rapid venom immunotherapy was assessed for safety. A cost analysis was performed to compare rapid venom immunotherapy to a modified rush immunotherapy regimen.</p><p><strong>Results: </strong>Four patients (5.2%), experienced mild systemic reactions consisting of diffuse urticaria on day 1. Treatment was otherwise well tolerated. Resting events occurred in 21 patients, a mean number of 12 months (range: 3 days to 48 months) after treatment, without systemic reactions.</p><p><strong>Conclusions: </strong>This experience confirms that rapid venom immunotherapy is safe to administer in an ambulatory setting and should be considered especially for patients during the stinging insect season when rapid protection is required.</p>","PeriodicalId":7931,"journal":{"name":"Annals of allergy","volume":"73 5","pages":"423-8"},"PeriodicalIF":0.0,"publicationDate":"1994-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18972451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vancomycin anaphylaxis and successful desensitization.","authors":"S Anne',&nbsp;E Middleton,&nbsp;R E Reisman","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This report describes vancomycin anaphylaxis and successful desensitization. A 35-year-old woman who tolerated vancomycin initially, developed generalized urticaria and respiratory distress when the drug was readministered. Symptoms recurred following infusion of vancomycin at a lowered rate and dose despite premedication with antihistamines and corticosteroids. Intradermal skin tests with vancomycin were positive at a concentration of 0.1 micrograms/mL. Control subjects reacted at a concentration of 10 micrograms/mL or greater. A rapid 1-day desensitization protocol was unsuccessful. The patient then was \"desensitized\" by sequential increments in intravenous vancomycin doses over 13 days. After the full therapeutic dose was tolerated, there was a loss of skin test reactivity to vancomycin. We conclude that desensitization to vancomycin is possible and may be the only means to treat an allergic patient adequately when there are no viable therapeutic alternatives.</p>","PeriodicalId":7931,"journal":{"name":"Annals of allergy","volume":"73 5","pages":"402-4"},"PeriodicalIF":0.0,"publicationDate":"1994-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18973809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Premedication reduces the incidence of systemic reactions during inhalant rush immunotherapy with mixtures of allergenic extracts.","authors":"J Portnoy,&nbsp;K Bagstad,&nbsp;H Kanarek,&nbsp;F Pacheco,&nbsp;B Hall,&nbsp;C Barnes","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Rush immunotherapy, while having many potential benefits, is associated with an increased incidence of systemic reactions.</p><p><strong>Objective: </strong>To determine whether pretreatment with medications reduces the rate of systemic reactions during rush immunotherapy and to identify predictors of such reactions if possible.</p><p><strong>Methods: </strong>We conducted a double-blind, placebo-controlled study of 22 allergic children ages 6 to 18 years who received rush immunotherapy. Active treatment consisted of a combination of H1 and H2 histamine antagonists and a corticosteroid in gelatin capsules given prior to administration of rush immunotherapy whereas placebo patients received lactose. Rush immunotherapy consisted of eight injections of increasing doses of a mixture of allergens to which each patient was skin-reactive over 1 1/2 days. Serial skin tests and peak expiratory flow rate measurements were performed during the procedure. Following the initial series of injections, patients were followed for 8 weeks and had blood drawn at 2-week intervals for measurements of specific IgG and IgE.</p><p><strong>Results: </strong>Systemic reactions were observed in 3 (27%) active and 8 (73%) placebo patients (Fisher's exact test: P = .047). The mean time for systemic reactions was 63 minutes after a previous injection. The most common dose causing a systemic reaction was 0.3 mL of 1:1000 (wt/vol). The best predictors of development of a systemic reaction were degrees of skin sensitivity to the extract before and after premedication. Local reactions were not associated with subsequent systemic reactions. Specific IgG rose by 2 weeks while specific IgE did not change significantly during the 8-week follow-up period. Pretreatment did not change the number of systemic reactions seen with subsequent injections.</p><p><strong>Conclusions: </strong>Premedication significantly reduces the incidence of systemic reactions during rush immunotherapy and is therefore recommended. Degree of skin sensitivity to the injected extract may eventually prove to be a clinically useful predictor for the development of systemic reactions.</p>","PeriodicalId":7931,"journal":{"name":"Annals of allergy","volume":"73 5","pages":"409-18"},"PeriodicalIF":0.0,"publicationDate":"1994-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18973811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}