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1.
Costner McKenzie Jonathan I. Silverberg 《Annals of allergy, asthma & immunology》2019,122(2):198-203.e3
Background
Atopic dermatitis (AD) is influenced by multiple emotional and environmental factors. Yet, little is known about the impact of neighborhood environment characteristics on AD.Objective
To determine the association of neighborhood characteristics with AD prevalence and severity in US children.Methods
We analyzed data from the 2007-2008 National Survey of Children's Health, including a representative sample of 79,667 children and adolescents (age 0-17 years) in the United States. Multivariable weighted logistic regression models that adjusted for sociodemographics were constructed to determine the associations of neighborhood characteristics with AD prevalence and severity.Results
Atopic dermatitis prevalence or severity were significantly increased in children residing in neighborhoods where people reportedly definitely do not help each other out (adjusted odds ratio [95% confidence interval]: 1.32 [1.15-1.52]), watch out for each other's children (1.26 [1.10-1.45] and 1.66 [1.14-2.41], respectively), have people to count on (1.28 [1.13-1.45]), and trusted adults to help the child (1.16 [1.01-1.32] and 1.54 [1.05-2.27], respectively). Children also had increased odds of AD if their caregiver felt that the child was never (1.52 [1.27-1.82]) or sometimes (1.23 [1.12-1.36]) safe in his/her neighborhood. Severe AD was less common in children residing in a neighborhood with a bookmobile or library (0.68 [0.52-0.90]).Conclusion
US children residing in unsafe, unsupportive, or underdeveloped neighborhoods have higher prevalence and severity of AD. 相似文献2.
Background
Eosinophilic esophagitis (EoE) is a chronic, allergic, immune-mediated disease associated with increased risk of comorbid atopic conditions.Objective
To perform an in-depth characterization of a large cohort of manually verified adult patients with EoE, including evaluation of less studied associations, such as pollen food allergy syndrome, anaphylaxis, autoimmunity, and psychiatric comorbidities.Methods
We performed a manual retrospective electronic medical record review of 1,218 patients with EoE identified by International Classification of Diseases, Ninth Revision and International Classification of Disease, 10th Revision codes from the University of Pennsylvania Health Systems. Through manual medical record review, we evaluated patient demographics, family and smoking history, laboratory and endoscopic findings, treatment, and comorbid atopic, autoimmune, and psychiatric conditions.Results
A total of 950 of the 1,218 patients had biopsy-proven EoE. This cohort was predominantly male, white, and never-smokers who presented most commonly with dysphagia, with an initial biopsy results showing 49 eosinophils per high-powered field, a serum absolute eosinophilic count of 446,000/µL, and mean total IgE level of 243 IU/mL. Of the patients, 55% had impaction (of which 38% required endoscopic removal), and 56% had strictures or fibrosis (of which 56% underwent dilatation). Therapy used was predominantly (77%) medical only. Comorbid atopy, pollen food allergy syndrome, drug allergy, anaphylaxis, autoimmunity, and psychiatric illnesses were higher in the EoE cohort compared with the general University of Pennsylvania Health Systems population.Conclusion
Our adult cohort of manually verified, biopsy-proven EoE had an increased risk of pollen food allergy syndrome, anaphylaxis, and comorbid autoimmune and psychiatric conditions compared with the University of Pennsylvania Health Systems population. There was also an increased prevalence of impaction and stricture or fibrosis requiring endoscopic intervention compared with the pediatric population. 相似文献3.
Background
Diagnosis of almond allergy is complicated by a high rate of false-positive test results. Accurate diagnosis of almond allergy is critical because almond is a source of nutrition and milk products for children with other food allergies.Objective
We reviewed the outpatient almond oral food challenges (OFCs) performed at our institution to analyze the pass rate and identify variables that predict OFC outcome.Methods
We reviewed all almond OFCs performed at our pediatric, university-based outpatient practice between October 2015 and July 2017. Oral food challenge details, including dosing, reactions, and treatments, as well as demographic, clinical, and laboratory data, were compiled. Statistical analysis was performed using the Fisher's exact and Student's t tests.Results
We identified 400 patients who underwent consecutive almond OFCs. Of these, 375 passed (93.8%, median sIgE 1.41 kUA/L, mean skin prick test [SPT] wheal 3.23 mm), 16 failed (4.0%, sIgE 2.54 kUA/L, SPT 5.0 mm), and 9 were indeterminate (2%, sIgE 3.33 kUA/L, SPT 5.0 mm). Among children who reacted, pruritus was the most common symptom. Only 2 children had reactions that required epinephrine. No difference was seen in demographics or allergic comorbidities between those who passed and failed.Conclusion
Among patients in our cohort, the probability of passing an almond OFC was 94%. Although increasing almond sIgE level and SPT wheal size correlated with OFC failure, the pass rate remained greater than 95% for patients with sIgE up to 10 kUA/L and SPT wheal size up to 5 mm. Among the patients who had a reaction to almond, anaphylaxis was uncommon. Our data support that performing outpatient OFCs to almond is safe for select patients. 相似文献4.
5.
Hakan Guvenir Emine Dibek Misirlioglu Muge Toyran Ersoy Civelek Betul Buyuktiryaki Tayfur Ginis Can Naci Kocabas 《Annals of allergy, asthma & immunology》2019,122(1):73-78.e1
Background
Children may be referred to pediatric allergy clinics for reactions to multiple drugs. Multiple drug hypersensitivity (MDH) is defined as immunologically-mediated hypersensitivity to 2 or more chemically different drugs.Objective
The aim of this study is to report the allergy workup results of children who had a history of potential hypersensitivity reactions to 2 or more unrelated drugs.Methods
This study was conducted in the Pediatric Allergy and Immunology department of our hospital. Children who described hypersensitivity reactions to 2 or more drugs were included and were evaluated by allergy workup (skin and/or provocation tests) between January 2011 and July 2016.Results
During the study period, 886 children were evaluated for a history of drug intolerance. Of these children, 73 (8.2%) had a history of drug reactions to 2 or more chemically different drugs. The median age of the children who had a history of reactions to 2 or more drugs was 7.8 (min-max: 2.5-16.4) years, and 59% (n?=?43) were male. Among the suspected drugs, antibiotics (65.9%) ranked first, and nonsteroid anti-inflammatory drugs (34.1%) were the second. All 73 children were evaluated with skin or provocation tests with the suspected drugs, and MDH was confirmed in only 2 (2.7%) children.Conclusion
Multiple drug hypersensitivity is uncommon in children. The incidence and prevalence of MDH may vary with the specific population studied. Evaluating children with a history of MDH, by performing drug hypersensitivity testing, will help avoid the morbidity associated with unnecessary drug avoidance. 相似文献6.
Nitat Sookrung Pichade Jotikaprasardhna Chaweewan Bunnag Wanpen Chaicumpa Anchalee Tungtrongchitr 《Annals of allergy, asthma & immunology》2019,122(1):93-98
Background
Diagnosis of Periplaneta americana (American cockroach, ACR) allergy is commonly performed based on clinical history and skin prick test (SPT) or specific serum IgE (sIgE) measurement. The concordance of the findings with the SPT and sIgE results has never been investigated.Objective
To compare the results of SPT with commercial ACR-extract (C-ACE) and sIgE measurement, using commercial kit and in-house enzyme-linked immunosorbent assay (ELISA) to the locally produced ACR extract (L-ACE) and native Per a 1, Per a 5, Per a 7, and Per a 9.Methods
Sera from 66 individuals clinically diagnosed with chronic allergic rhinitis were included; 46 were positive SPT to C-ACE, and 20 were negative. Specific serum IgE levels were established by using a commercial test kit (ImmunoCap) and an in-house IgE-ELISAResults
The percentage the C-ACE SPT-positive cases that were positive by the ImmunoCap-sIgE was 32.6%, indicating low concordance of the 2 assays. With the in-house ELISA, Per a 9 gave the highest sensitivity (98.00%), positive predictive value (PPV; 95.74%), and negative predictive value (NPV; 94.74%) of the sIgE quantification. The correlation coefficients (R) of the L-ACE-SPT and sIgE to L-ACE, Per a 1, Per a 5, Per a 7, and Per a 9 and ImmunoCap sIgE were 0.133, 0.278, 0.419, 0.280, and 0.432, and 0.256, respectively.Conclusion
Skin prick test and sIgE measurement using commercial reagents have low concordance. Data of this study showed that sIgE to the native Per a 9 should be considered as an adjunct to the clinical history in diagnosis of ACR sensitization/allergy, particularly when the SPT and the nasal challenge, which is the gold standard method, cannot be performed. 相似文献7.
Background
Adequate assessment of control is critical to asthma management. The Asthma Control Questionnaire (ACQ) and the National Asthma Education and Prevention Program (NAEPP) criteria are commonly used measures of asthma control.Objective
To examine the associations between the ACQ and NAEPP criteria and compare the validity in association with lung function, asthma exacerbation, and quality of life.Methods
The ACQ and the NAEPP criteria were administered to 373 adolescents with asthma aged 12 to 20 years. The 2 measures correlated with forced expiratory volume in 1 second (FEV1), asthma exacerbation (oral corticosteroid use, hospitalization, and emergency department [ED] use) in the past 12 months, and quality of life.Results
Agreement between the ACQ and NAEPP criteria was moderate (κ?=?0.40-0.61). Neither of the 2 measures was a reliable predictor of FEV1 less than 80% because of the high rate of false-positive results for the ACQ (68%) and low sensitivity for the NAEPP (49%). The NAEPP identified more cases of uncontrolled asthma (84.6%) than the ACQ (64.6%). The ACQ was a significant predictor of recent oral corticosteroid use, hospitalization, and ED visits (area under the curve?=?0.66, 0.66, and 0.64, respectively; P < .001), as was NAEPP (area under the curve?=?0.63, 0.66, and 0.61, respectively; P < .001). Both measures were significantly associated with quality of life, and the associations were particularly strong for the ACQ (r?=??0.87 for symptom subscale, r?=??0.76 for activity subscale, and r?=??0.78 for emotional function subscale).Conclusion
Neither the ACQ nor the NAEPP appears to reliably predict lung function, whereas both measures reasonably associate with acute asthma exacerbation. The ACQ may be the superior measure in gauging the psychosocial effect of asthma control given its particularly strong associations with quality of life.Trial Registration
ClinicalTrials.gov Identifier: NCT02293499. 相似文献8.
Asthma phenotypes based on health services use for allergic diseases in a province-wide birth cohort
Miceline Mésidor Andrea Benedetti Mariam El-Zein Dick Menzies Marie-Élise Parent Marie-Claude Rousseau 《Annals of allergy, asthma & immunology》2019,122(1):50-57.e2
Background
Many previous studies on asthma phenotypes were conducted in selected clinical populations and overlooked changes throughout the life course.Objective
To identify asthma phenotypes based on use of health services for allergic diseases in 3 life periods and document transitions among phenotypes across life periods.Methods
In a population-based cohort of 78,211 individuals born in 1974 in the province of Québec, Canada, we documented medical visits and hospitalizations for asthma and other allergic diseases until 1994. Phenotypes based on clusters of health services use in childhood (8-12 years of age), adolescence (13-17 years of age), and young adulthood (18-20 years of age) were identified using a hierarchical method among 9,989 individuals (12.8%) who had at least one health encounter for asthma during follow-up. Population-level probabilities of transitioning among phenotypes were estimated in the full study population.Results
In the subset with asthma, 6 phenotypes were identified during both childhood and young adulthood and 7 during adolescence. The most common phenotype was no asthma or allergic diseases: 58% in childhood, 42% in adolescence, and 54% in adulthood. The second most common was the mild asthma and no allergic diseases phenotype, representing 36%, 31%, and 21%, respectively, in these 3 periods. In the study population, 87% of the individuals remained in the no asthma phenotype group during the follow-up. Most individuals in the asthma phenotypes transitioned over time.Conclusion
Our study uniquely contributes to a better understanding, at the population level, of the manifestations and transitions in asthma phenotypes during the life course. 相似文献9.
Andre Valcour Jonas Lidholm Magnus P. Borres Robert G. Hamilton 《Annals of allergy, asthma & immunology》2019,122(1):111-116.e1
Background
Measurement of IgE antibody to hazelnut components can aid in the prediction of allergic responses to the food.Objective
To investigate the association between patient demographics (age, location) and patterns of allergic sensitization to hazelnut components across the United States and to investigate the degree of correlation between hazelnut sensitization with sensitization to other tree nuts, peanuts, and their components.Methods
Serum samples from 10,503 individuals with hazelnut extract specific IgE (sIgE) levels of 0.35 kUA/L or higher were analyzed for IgE antibodies to Cor a 1, 8, 9, and 14 by ImmunoCAP. A subset of these patients were analyzed for IgE antibodies to peanut, walnut, and cashew nut IgE along with associated components.Results
Among hazelnut sensitized individuals, children (<3 years old) were predominantly sensitized to Cor a 9 and Cor a 14. Conversely, Cor a 1 sIgE sensitization was much higher in adults than children, especially in the Northeastern United States. Cor a 8 sensitization was relatively constant (near 10%) across all ages. Cosensitization of hazelnut with other tree nuts and peanuts was related to correlation of IgE concentrations of individual component families.Conclusion
We conclude that sensitization to individual hazelnut components is highly dependent on age and/or geographic location. Component correlations suggest that cosensitization to hazelnut and walnut may be caused by their pathogenesis-related protein 10 allergens, nonspecific lipid transfer proteins, or seed storage proteins, whereas hazelnut and peanut cosensitization is more often caused by cross-reactivity of pathogenesis-related protein 10 (Cor a 1 and Ara h 8) and nonspecific lipid transfer proteins (Cor a 8 and Ara h 9). 相似文献10.
Pamela A. Frischmeyer-Guerrerio Marjohn Rasooly Wenjuan Gu Samara Levin Rekha D. Jhamnani Joshua D. Milner Kelly Stone Anthony L. Guerrerio Joseph Jones Magnus P. Borres Erica Brittain 《Annals of allergy, asthma & immunology》2019,122(4):393-400.e2
Background
Diagnosing food allergy in patients with atopic dermatitis (AD) is complicated by their high rate of asymptomatic sensitization to foods, which can lead to misdiagnosis and unnecessary food avoidance.Objective
We sought to determine whether food-specific (sIgE) or component immunoglobulin (Ig) E levels could predict allergic status in patients with moderate to severe AD and elevated total IgE.Methods
Seventy-eight children (median age, 10.7 years) with moderate to severe AD were assessed for a history of clinical reactivity to milk, egg, peanut, wheat, and soy. The IgE levels for each food and its components were determined by ImmunoCAP. The level and pattern of IgE reactivity to each food and its components, and their ratio to total IgE, were compared between subjects who were allergic and tolerant to each food.Results
Ninety-one percent of subjects were sensitized, and 51% reported allergic reactivity to at least 1 of the 5 most common food allergens. Allergy to milk, egg, and peanut were most common, and IgE levels to each of these foods were significantly higher in the allergic group. Component IgEs most associated with milk, egg, and peanut allergy were Bos d8, Gal d1, and Ara h2, respectively. The ratio of sIgE to total IgE offered no advantage to sIgE alone in predicting allergy.Conclusion
Specific IgE levels and the pattern of IgE reactivity to food components can distinguish AD subjects allergic vs tolerant to the major food allergens and may therefore be helpful in guiding the clinical management of these patients. 相似文献11.
Piyush Patel Anne Marie Salapatek Sudeesh K. Tantry 《Annals of allergy, asthma & immunology》2019,122(2):160-166.e1
Background
GSP301 nasal spray is a fixed-dose combination of the antihistamine olopatadine hydrochloride and the corticosteroid mometasone furoate intended for seasonal allergic rhinitis (SAR) treatment.Objective
To evaluate the efficacy and safety of once-daily or twice-daily GSP301 in a ragweed pollen environmental exposure chamber.Methods
In this randomized, double-blind, double-dummy study, adults (18-65 years old) with SAR were equally randomized to 665 μg of olopatadine and 25 μg of mometasone (twice-daily GSP301), 665 μg of olopatadine and 50 μg of mometasone (once-daily GSP301), a US Food and Drug Administration–approved formulation of 137 μg of azelastine and 50 μg of fluticasone twice-daily (AzeFlu), a US Food and Drug Administration–approved formulation of 665 μg of olopatadine twice-daily, or placebo (twice-daily). During 2 visits (baseline and end of 14-day treatment), participants assessed SAR symptoms at specified time points. The primary end point—mean change from baseline in instantaneous total nasal symptom score (iTNSS) for twice-daily or once-daily GSP301 vs placebo—was analyzed by analysis of covariance. Onset of action, ocular symptoms, and adverse events were assessed.Results
A total of 180 participants were randomized. Treatment with twice-daily or once-daily GSP301 provided statistically significant improvements in iTNSS vs placebo (twice-daily GSP301: least squares mean difference, ?3.60; 95% confidence interval [CI], ?4.89 to ?2.30; once-daily GSP301: least squares mean difference, ?3.05; 95% CI, ?4.35 to ?1.76; P < .0001 for both). Significant improvements in iTNSS with twice-daily GSP301 occurred by 10 minutes after dosing (?1.26; 95% CI, ?2.30 to ?0.21; P?=?.02) and were maintained at all later time points except one (2.5 hours). Treatment-emergent adverse events occurred in 22.2%, 30.6%, 25.0%, 22.2%, and 16.7% of participants in the twice-daily GSP301, once-daily GSP301, AzeFlu, olopatadine, and placebo groups, respectively.Conclusion
In an environmental exposure chamber model, twice-daily and once-daily GSP301 treatments were well tolerated and provided statistically significant and clinically meaningful SAR symptom improvement vs placebo.Trial Registration
ClinicalTrials.gov Identifier: NCT03444506 相似文献12.
Christopher Couch Tim Franxman Matthew Greenhawt 《Annals of allergy, asthma & immunology》2017,118(5):591-596.e3
Background
Characteristics and outcomes of tree nut (TN) oral food challenges (OFCs) in patients with TN allergy or sensitization alone are poorly studied.Objective
To determine the relation between TN sensitization levels and OFC outcomes.Methods
Open TN OFCs performed from 2007 through 2015 at a referral center were analyzed to compare outcome based on skin prick test (SPT) wheal size, food-specific immunoglobulin E (sIgE), peanut co-allergy, and TN sensitization only vs TN allergy with sensitization to other TNs. Delayed OFC was defined as longer than 12 months from the time of an sIgE level lower than 2 kUA/L.Results
Overall passage rate was 86% for 156 TN OFCs in 109 patients (54 almond, 28 cashew, 27 walnut, 18 hazelnut, 14 pecan, 13 pistachio, and 2 Brazil nut). Passage rates were 76% (n = 67) in patients with a history of TN allergy who were challenged to another TN to which they were sensitized and 91% (n = 65) in those with TN sensitization only (mean sIgE 1.53 kUA/L; range 0.35–9.14). Passage rates were 89% (n = 110 of 124) for a TN sIgE level lower than 2 kUA/L and 69% (11 of 16) for a TN sIgE level of at least 2 kUA/L. In 44 challenges in patients with peanut allergy and TN co-sensitization, the TN OFC passage rate was 96%. In 41 TN OFCs with a TN SPT wheal size of at least 3 mm, 61% passed, with a mean wheal size of 4.8 mm (range 3–11) in those passing vs 9 mm (range 3–20) in those failing.Conclusion
TN challenges are frequently passed in patients with TN sensitization with or without a history of TN reactivity despite a TN SPT wheal of at least 3 mm or a TN sIgE level of at least 2 kUA/L. Nearly all patients with peanut allergy and TN co-sensitization passed the TN challenge, questioning the clinical relevance of “co-allergy.” 相似文献13.
Can asthma be well controlled with NAEPP guideline care in morbidly obese children? The Breathmobile
Background
Obesity is thought to be associated with poor asthma control, increased health resource utilization, and reduced responsiveness to inhaled corticosteroids.Objective
Based on previous experience, our hypothesis was that by improved access to comprehensive guideline care, outcomes in normal weight would be comparable in obese children with asthma.Methods
This was a retrospective cohort study of predominately Hispanic children (3-18 years of age) in underserved areas of Orange County, California, who enrolled in the Breathmobile Program from 2003 to 2012. Outcomes were examined by using Cox regression and generalized estimating equations analyses, adjusted for potential confounding factors.Results
Clinical outcomes in more than 1,200 children followed up for a mean of 6 visits (standard deviation [SD]?=?2.2) across 403 days (SD?=?112) were improved, on average, regardless of body mass index (BMI). Morbidly obese (MOB) patients were able to achieve significant reductions of approximately 60% or more in report of emergency department (ED) visits, hospitalizations, school absenteeism, usual exercise limitations, and exacerbations to levels that were comparable those of normal weight (NW) patients. The importance of close follow-up, particularly for the MOB patient, was evidenced by achieving 80% cumulative probability of well controlled asthma by visit 3, similar to patients in lower BMI risk groups with good adherence, when the visit interval did not exceed 90 days. These outcomes were achieved across all BMI groups with similar mean step of therapy, adjusted for severity (P < .001).Conclusion
Access to effective community-based care where trust, education, and continuity of care consistent with National Asthma Education and Prevention Program (NAEPP) guidelines is possible, as demonstrated by the Breathmobile Program, can provide an opportunity for children with asthma in all BMI categories to achieve well-controlled disease. 相似文献14.
Zsuzsa Nebenführer Erika Szabó Erika Kajdácsi Kinga Viktória Kőhalmi István Karádi András Zsáry Henriette Farkas László Cervenak 《Annals of allergy, asthma & immunology》2019,122(1):86-92
Background
Hereditary angioedema with C1 inhibitor deficiency (C1-INH-HAE) is a rare, potentially life-threatening disorder characterized by recurrent edematous attacks. The edema formation is the consequence of interaction of bradykinin and various vasoactive peptides with endothelium. Besides these agents, danazol, a modified testosterone derivative used in these patients to prevent edematous attacks, can also affect the function of the endothelium, because it shifts the blood lipid profile to a pro-atherogenic phenotype.Objective
To assess the endothelial function in C1-INH-HAE patients and in healthy matched controls.Methods
To evaluate the endothelial function, we used the flow-mediated dilation method measured in the region of the brachial artery in 33 C1-INH-HAE patients and in 30 healthy matched controls. Laboratory measurements of standard biochemical parameters were performed on computerized laboratory analyzers.Results
No difference was found in endothelial function (reactive hyperemia, RH) between patients (median, 9.0; 25%-75% percentile, 6.3-12.9) and controls (median, 7.37; 25%-75% percentile, 4.52-9.93). Although we found elevated cardiovascular risk (high body mass index and low-density lipoprotein/high-density lipoprotein ratio) in danazol-treated C1-INH-HAE patients, RH values did not differ between danazol-treated and nontreated patients. Furthermore, risk factors correlated with the endothelial function only in healthy controls and patients not treated with danazol.Conclusion
In summary, our results did not indicate any signs of endothelial dysfunction in C1-INH-HAE patients. Moreover, the normal endothelial function in danazol-treated patients with pro-atherogenic lipid profile suggests that elevated bradykinin level or other factor(s) involved in the pathogenesis of edematous attacks may have a protective role against endothelial dysfunction and atherosclerosis. 相似文献15.
Toby C. Lewis Ediri E. Metitiri Graciela B. Mentz Xiaodan Ren Adam M. Goldsmith Breanna N. Eder Kyra E. Wicklund Megan P. Walsh Adam T. Comstock Jeannette M. Ricci Sean R. Brennan Ginger L. Washington Kendall B. Owens Bhramar Mukherjee Thomas G. Robins Stuart A. Batterman Marc B. Hershenson 《Annals of allergy, asthma & immunology》2019,122(2):175-183.e2
Background
Upper respiratory tract viral infections cause asthma exacerbations in children. However, the impact of natural colds on children with asthma in the community, particularly in the high-risk urban environment, is less well defined.Objective
We hypothesized that children with high-symptom upper respiratory viral infections have reduced airway function and greater respiratory tract inflammation than children with virus-positive low-symptom illnesses or virus-negative upper respiratory tract symptoms.Methods
We studied 53 children with asthma from Detroit, Michigan, during scheduled surveillance periods and self-reported respiratory illnesses for 1 year. Symptom score, spirometry, fraction of exhaled nitric oxide (FeNO), and nasal aspirate biomarkers, and viral nucleic acid and rhinovirus (RV) copy number were assessed.Results
Of 658 aspirates collected, 22.9% of surveillance samples and 33.7% of respiratory illnesses were virus-positive. Compared with the virus-negative asymptomatic condition, children with severe colds (symptom score ≥5) showed reduced forced expiratory flow at 25% to 75% of the pulmonary volume (FEF25%-75%), higher nasal messenger RNA expression of C-X-C motif chemokine ligand (CXCL)-10 and melanoma differentiation-associated protein 5, and higher protein abundance of CXCL8, CXCL10 and C-C motif chemokine ligands (CCL)-2, CCL4, CCL20, and CCL24. Children with mild (symptom score, 1-4) and asymptomatic infections showed normal airway function and fewer biomarker elevations. Virus-negative cold-like illnesses demonstrated increased FeNO, minimal biomarker elevation, and normal airflow. The RV copy number was associated with nasal chemokine levels but not symptom score.Conclusion
Urban children with asthma with high-symptom respiratory viral infections have reduced FEF25%-75% and more elevations of nasal biomarkers than children with mild or symptomatic infections, or virus-negative illnesses. 相似文献16.
Johanna P.M. van der Valk Irene Berends Roy Gerth van Wijk Nicolette. J.T. Arends Maurits S. van Maaren Hans de Groot Harry J. Wichers Joyce A.M. Emons Anthony E.J. Dubois Nicolette W. de Jong 《Annals of allergy, asthma & immunology》2018,120(3):300-303
Background
Severe allergic reactions, including anaphylaxis, occur during oral food challenges (OFCs) and the first-line treatment of anaphylaxis is epinephrine.Objective
To evaluate the percentage of anaphylactic reactions treated with epinephrine during OFCs and to identify associated factors for the administration of epinephrine.Methods
Children who underwent an OFC with peanut, hazelnut, cow's milk, hen's egg, or cashew nut from 2005 through 2015 in the Netherlands were evaluated. Children with reactions meeting the criteria for anaphylaxis according to the European Academy of Allergy and Clinical Immunology guidelines for food allergy and anaphylaxis were included. Children with an anaphylactic reaction treated with vs without epinephrine were compared. Possible factors associated with the administration of epinephrine, such as age, sex, symptoms consistent with asthma, history of an allergic reaction to the tested allergen, and symptom types during the anaphylactic reaction, were evaluated using logistic regression analysis.Results
Eighty-three children in clinical and research settings (43% boys; median age, 7 years; range, 1–17) who met the criteria for anaphylaxis were included in this study. Thirty-two of 83 children (39%) with anaphylaxis were treated with epinephrine. Respiratory symptoms during the OFC were treated significantly more often with epinephrine than gastrointestinal symptoms (P = .01).Conclusion
Only 39% of children with anaphylaxis, according to the guideline criteria, were treated with epinephrine during the OFC and most of these children had respiratory symptoms. There is need for an easy-to-use international guideline for the treatment of allergic symptoms during OFCs. 相似文献17.
18.
Ju Ah Lee Sung Kyung Kim Seung Seon Ryu Soobin Jang Sunju Park 《Explore (New York, N.Y.)》2018,14(5):357-366
Introduction
This study was performed to evaluate the clinical effect of a Korean medicine treatment for livedoid vasculopathy (LV).Methods
Five patients with LV were selected who exhibited blood stasis due to qi stagnation (氣滯血瘀) caused by external cold (寒邪外襲) or dual deficiency of qi and blood (氣血兩虛) and who had suffered from chronic episodic LV for at least 2 years. The treatment consisted of Korean herbal medicine, Haechungtang (解靑湯, HC). Five cases were evaluated based on visual symptoms. The symptoms at first visit were scored on a visual analogue scale (VAS) from 1 to 10.Results
Following treatment, all of the symptoms except pigmentation disappeared completely in all cases. No symptom control with corticosteroids or warfarin was necessary.Conclusion
These case reports suggest that HC could be effective for treating LV. Follow-up studies and further clinical studies are needed to evaluate recurrence and to provide more efficient treatment. 相似文献19.
Ana Paula Port Danilo F. Santaella Shirley S. Lacerda Danielli S. Speciali Joana B. Balardin Priscila B. Lopes Rui F. Afonso João Radvany Edson Amaro Elisa H. Kozasa 《Explore (New York, N.Y.)》2018,14(5):352-356
Objective
To compare cognition and brain function in elderly Tai Chi and Water Aerobics practitioners.Methods
Eight Tai Chi (TC) and 8 Water Aerobics (WA) practitioners matched by gender, education and age underwent neuropsychological and fMRI scan during attention (Stroop Word Color Task) and working memory (N Back) tasks.Results
Groups were similar for demographic and cognitive variables. Besides anxiety (smaller in TC group), there were no differences between groups in neuropsychological variables. During the Stroop Word Color Task, TC group had smaller brain activation in the right intracalcarine cortex, lateral occipital cortex, and occipital pole, than WA. During N back, TC group presented smaller brain activation in the right frontal pole and superior frontal gyrus.Conclusion
Despite the small number of participants in this preliminary study, both groups had similar cognitive performance, however the Tai Chi group required less brain activation to perform the attention and memory tasks, therefore they may have a more efficient cognitive performance than Water Aerobics group. 相似文献20.
William Zhao Hsi-en Ho Supinda Bunyavanich 《Annals of allergy, asthma & immunology》2019,122(3):276-282