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1.
Sazonov Kocevar V Thomas J Jonsson L Valovirta E Kristensen F Yin DD Bisgaard H 《Allergy》2005,60(3):338-342
BACKGROUND: Preliminary evidence suggests that inadequately controlled allergic rhinitis in asthmatic patients can contribute towards increased asthma exacerbations and poorer symptom control, which may increase medical resource use. The objective of this study was therefore to assess the effect of concomitant allergic rhinitis on asthma-related hospital resource utilization among children below 15 years of age with asthma in Norway. METHODS: A population-based retrospective cohort study of children (aged 0-14 years) with asthma was conducted using data from a patient-specific public national database of hospital admissions during a 2-year period, 1998-1999. Multivariate linear regression, adjusting for risk factors including age, gender, year of admission, urban/rural residence and severity of asthma episode, estimated the association between allergic rhinitis and total hospital days. A multivariate Cox proportional-hazards model estimated relative hazard of readmission according to concomitant allergic rhinitis status. RESULTS: Among 2961 asthmatic children under 15 years of age with at least one asthma-related hospital admission over a 2-year period, 795 (26.8%) had a recorded history of allergic rhinitis. Asthmatic children with allergic rhinitis had a 1.72-times greater hazard of asthma-related readmissions than asthmatic children without allergic rhinitis. Multivariate analysis revealed that history of concomitant allergic rhinitis was a significant predictor of increased number of hospital days per year (least-squares mean difference 0.23 days, P < 0.05). CONCLUSIONS: Concomitant allergic rhinitis in asthmatic children was associated with increased likelihood of asthma-related hospital readmissions and greater total hospital days. 相似文献
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L C Grammer P A Greenberger R Patterson 《International archives of allergy and applied immunology》1986,79(3):246-248
The early diagnosis of allergic bronchopulmonary aspergillosis (ABPA) is is important because it may allow prevention of evolution to the fibrotic lung disease stage (stage V). In two immunotherapy studies of 62 patients recruited for allergic rhinitis, we conducted studies to exclude ABPA in any subject with asthma and positive immediate skin reactivity to Aspergillus fumigatus. The evaluation included serum precipitating antibodies against A. fumigatus, total serum IgE, blood eosinophilia, serum IgE and IgG antibody indices against A. fumigatus, and chest X-rays. Three of the 62 patients (5%) had features indicative of ABPA. This finding underscores the importance of excluding the diagnosis of ABPA in all asthmatics with skin reactivity to A. fumigatus, even if the patients major initial complaint is allergic rhinitis. 相似文献
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Dongju Su Ximei Zhang Hong Sui Fuzhen Lü Lianhong Jin Jing Zhang 《BMC medical genetics》2008,9(1):1-6
Background
Neuroimaging studies have demonstrated volumetric abnormalities in limbic structures of suicide victims. The morphological changes might be caused by some inherited neurodevelopmental defect, such as failure to form proper axonal connections due to genetically determined dysfunction of neurite guidance molecules. Limbic system-associated membrane protein (LSAMP) is a neuronal adhesive molecule, preferentially expressed in developing limbic system neuronal dendrites and somata. Some evidence for the association between LSAMP gene and behavior has come from both animal as well as human studies but further investigation is required. In current study, polymorphic loci in human LSAMP gene were examined in order to reveal any associations between genetic variation in LSAMP and suicidal behaviour.Methods
DNA was obtained from 288 male suicide victims and 327 healthy male volunteers. Thirty SNPs from LSAMP gene and adjacent region were selected by Tagger algorithm implemented in Haploview 3.32. Genotyping was performed using the SNPlex? (Applied Biosystems) platform. Data was analyzed by Genemapper 3.7, Haploview 3.32 and SPSS 13.0.Results
Chi square test revealed four allelic variants (rs2918215, rs2918213, rs9874470 and rs4821129) located in the intronic region of the gene to be associated with suicide, major alleles being overrepresented in suicide group. However, the associations did not survive multiple correction test. Defining the haplotype blocks using confidence interval algorithm implemented in Haploview 3.32, we failed to detect any associated haplotypes.Conclusion
Despite a considerable amount of investigation on the nature of suicidal behaviour, its aetiology and pathogenesis remain unknown. This study examined the variability in LSAMP gene in relation to completed suicide. Our results indicate that LSAMP might play a role in pathoaetiology of suicidal behaviour but further studies are needed to understand its exact contribution. 相似文献5.
John Field Joseph Allegra Joseph Trautlein Marilyn Gillin Robert Zelis 《The Journal of allergy and clinical immunology》1976,58(5):575-580
It has been shown that most asthmatics respond to exercise with bronchospasm. This study was undertaken to develop a safe and reliable method for quantifying exercise-induced bronchospasm in the asthmatic adult. Five normal adult volunteers and 12 stable asthmatics were exercised to 80% of their predicted maximal heart rate according to a multistage branching treadmill protocol. Their responses in terms of forced expiratory volume in 1 sec (FEV1) and maximum midexpiratory flow rate (MMEFR) at 5, 15, and 30 min after exercise were assessed, while standing, with a Jones Pulmonar II waterless spirometer. This submaximal stress test was chosen because 80% of predicted maximal heart rate could be obtained by all individuals and allowed the asthmatics to exercise long enough for inducible bronchospasm to occur. Audible wheezing was induced in 100% of the asthmatics and in none of the nonasthmatics. In the normal individuals, FEV1 and MMEFR increased significantly during the postexercise period. When compared to normal subjects, the 12 asthmatic patients demonstrated a significant reduction in FEV1 an MMEFR (ΔFEV1: 5 min, ?300; 15 min, ?304; 30 min, ?208 ml; ?18%, ?17%, and ?15%; ΔMMEFR: 5 min, ?15; 15 min, ?9; 30 min, ?1L/M; ?23%, ?18%, and ?6%) (p < 0.01). The use of a rigidly controlled exercise stress with a cardiovascular endpoint in the measurement of FEV1 and MMEFR in the postexercise period appears to be a useful tool in assessing the presence and severity of exercise-induced bronchospasm in the adult asthmatic. 相似文献
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BACKGROUND: The extent to which inhaled glucocorticoids increase the risk of intraocular pressure elevation has been controversial. OBJECTIVE: The authors attempt to assess such risk attributable to budesonide, an inhaled glucocorticoid for asthma therapy. METHODS: Data were pooled from four prospective, randomized, double-blind, parallel-group, placebo-controlled, multicenter clinical trials of 12 to 20 weeks in duration. One thousand two hundred and fifty-five patients, 6 to 70 years of age whose intraocular pressures (IOPs) were less than 23 mmHg at screening were randomized to receive placebo or inhaled budesonide at doses ranging from 100 to 800 microg, administered twice daily. Intraocular pressure was measured at screening and at the end of double-blind treatment. Intraocular change was compared between budesonide and placebo, accounting for the confounding effects of gender, race, age, history of diabetes, history of hypertension, clinical trial, systemic glucocorticoid use during the trials, ophthalmic glucocorticoid use during the trials, and prior oral glucocorticoid use. RESULTS: No budesonide treatment effect on the IOP was evident either in the crude analysis or after adjustment for possible confounding factors. For patients exposed to budesonide at a total daily dose of 1600 microg for 20 weeks, there was no difference in IOP change compared with the placebo controls. CONCLUSIONS: No association with an increased IOP was observed in asthmatic patients treated with budesonide at daily doses ranging from 200 to 1600 microg for durations of 12 to 20 weeks. The subgroup analysis, which focused on the highest dose and longer term therapy was reassuring, as was the overall result. 相似文献
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We investigated possible influence of 17 allergy-associated factors on atopic dermatitis and allergic rhinitis using Multiple factor analysis in 150 asthmatic children. Atopic dermatitis was complicated in ninety-seven cases and allergic rhinitis in ninety-seven cases. 17 allergy-associated factors were as follows: 1) sex, 2) age, 3) onset age of asthma, 4) family history of allergy, 5) peripheral eosinophil counts, 6) IgE RIST, 7) IgE RAST score to egg white, 8) IgE RAST score to milk, 9) IgE RAST score to soybean, 10) IgG4 antibody titers to egg white, 11) IgG4 antibody titers to milk, 12) IgG4 antibody titers to soybean, 13) IgE RAST score to house dust, 14) IgE RAST score to Dermatophagoides farinae, 15) severity of asthma, 16) exercise-induced asthma, 17) atopic dermatitis or allergic rhinitis. We concluded as follows: 1) Factors which more strongly influenced both atopic dermatitis and allergic rhinitis were IgE RAST score to D.f., positive family history of allergy, IgE RIST and eosinophil counts. 2) Combination with high levels of IgG4 antibody to 3 food allergens such as egg-white, milk and soybean and IgE RAST to egg-white has a strong influence on atopic dermatitis, but high levels of IgG4 antibody to 3 food allergens except high level of IgG4 antibody to soybean have a weak influence on allergic rhinitis. 相似文献
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Min-Sho Ku Ko-Huang Lue Ching Li Hai-Lun Sun Ming-Chih Chou 《Journal of microbiology, immunology, and infection》2006,39(4):297-301
BACKGROUND AND PURPOSE: Angiotensin-converting enzyme (ACE) play a role in inactivating bradykinin and tachykinins. Bradykinin and tachykinins are potent mediators of inflammatory reaction. An insertion/deletion polymorphism of the ACE gene has been shown to be associated with serum ACE levels. We hypothesized that ACE polymorphism might play a role in allergic rhinitis development. METHODS: Seventy five children aged 6-13 years with atopic allergic rhinitis and 66 age- and gender-matched healthy children were studied. ACE genotypes were determined by polymerase chain reaction. Serum total immunoglobulin E (IgE) and allergen-specific IgE levels were also measured. RESULTS: The frequencies of the DD and non-DD genotypes, and of the II and non-II genotypes did not differ significantly between healthy children and allergic rhinitis children (chi-squared test, p=1.000 and 0.438, respectively). There was no association of ACE genotype and mean IgE levels in rhinitis children or healthy controls. CONCLUSION: The results of our study indicate that polymorphism of the ACE gene is unrelated to the development of allergic rhinitis, the duration of allergic rhinitis, serum IgE levels, and allergen-specific IgE in Taiwanese children. 相似文献
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Sublingual immunotherapy (SLIT) was accepted for clinical use by the medical community only 15 years after the first controlled trial published. The acceptance of SLIT has been driven by the evidence base of a large number of clinical trials confirming the efficacy and a recent meta-analysis study. Although SLIT is self-managed by the patient, this does not generate problems with compliance. The safety profile, assessed in clinical trials and postmarketing surveillance studies, is satisfactory with no reports of systemic adverse reactions. New data are available on the persisting, long-lasting effect of SLIT and on the association with the prevention of asthma in paediatric patients. However, there is only indirect evidence for such persistence and duration of effect in adult patients. Key priorities for further investigation are the mechanisms of action, the efficacy in asthma, the cost/effectiveness and the identification of those patients who will achieve the maximum benefit with SLIT. 相似文献
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The occurrence of late asthmatic reactions after bronchial allergen challenge was studied in 50 house dust mite allergic patients subdivided in three groups: one group had asthma without nasal symptoms, another group had rhinitis without pulmonary symptoms and a third group had a combination of both asthma and rhinitis. Late asthmatic reactions were present in 80% of asthmatic patients and in 18.7% of rhinitis patients. The degree of non-specific bronchial reactivity to histamine (provocative dose 15 or PD15 histamine) and the degree of immediate reactivity to allergen (PD15 house dust mite) did not differ significantly between patients with and without late asthmatic reactions. These findings suggest that an important difference between asthma and rhinitis is the lack of late asthmatic reactions in rhinitis patients, whereas the degree of immediate bronchial reactivity to the allergen is similar in asthma and rhinitis. 相似文献
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P. SRIRAMARAO B. SELVAKUMAR C. DAMODARAN B. S. SUBBA RAO† O. PRAKASH‡ P. V. SUBBA RAO 《Clinical and experimental allergy》1990,20(5):555-560
Lymphocytes collected from rhinitis subjects with strong positive skin reactions to the pollen allergens of Parthenium hysterophorus (American feverfew) having moderate to high titres of Parthenium-specific serum IgE were analysed for association of HLA-antigens covering 13 specificities of HLA-A, 17 specificities of HLA-B and eight specificities of HLA-DR loci by the NIH two-stage microlymphocytotoxicity assay. Comparison of the phenotypic frequencies of HLA-A and B antigens between Parthenium rhinitis subjects (n = 22) and control subjects (n = 137) did not suggest any significant association when tested for these antigen specificities. A significant correlation in the association of HLA-DR3 antigen with a relative risk of 11.33, however, was observed in Parthenium rhinitis subjects (n = 30) when compared to controls (n = 50). 相似文献
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Association between corticosteroids and psychologic change in hospitalized asthmatic children 总被引:3,自引:0,他引:3
Thirty-two children (mean age 14 years) with chronic, severe asthma were evaluated through the course of short-term prednisone "burst" treatment. At high steroid day (mean dose = 61.4 mg), the children reported more symptoms of anxiety and depression and demonstrated diminished verbal memory relative to low steroid day (mean dose = 6.97 mg). Order effects (evaluation at high steroid day first versus low steroid day first) were not significant for these steroid-sensitive variables. No dose-related changes emerged on measures of hyperactivity, attention, impulsivity, or fine motor control. Five subject variables were examined as potential risk factors. No association emerged between psychologic change scores and age, socioeconomic status, IQ, or asthma severity. Significant findings indicated that, as children increasingly demonstrated emotional difficulty or were from dysfunctional families, they were more likely to experience negative psychologic changes associated with high-dose steroids. 相似文献
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Therapeutic effects of BCG vaccination in adult asthmatic patients: a randomized, controlled trial. 总被引:22,自引:0,他引:22
BACKGROUND: Bacille Calmette-Guérin (BCG) vaccination in humans induces Th1 immune responses. Th1 and Th2 cells are reciprocally regulated. Objective: To examine whether BCG vaccination of adult patients with asthma, a Th2-associated allergic disease, is clinically effective. METHODS: Forty-three moderate-to-severe asthma patients were randomly assigned into groups that received percutaneous injection of 58.2 x 10(7) CFUs BCG (n = 22) or placebo (n = 21) in a double-blinded fashion, on the first day of a 12-week treatment period. Medications were adjusted every 4 weeks to maintain optimal asthma control. Spirometric measurements were performed before treatment and at weeks 4, 8, and 12 after vaccination. The daily peak expiratory flow rate values, asthma symptoms, and medications were also recorded. Tuberculin skin tests, and sputum inflammatory cell and cytokine analyses were carried out before treatment and 12 weeks after vaccination. RESULTS: BCG vaccination significantly increased forced expiratory volume in 1 second and forced expiratory flow rate 25% to 75% at weeks 4, 8, and 12. Morning peak expiratory flow rate was significantly increased only during the first 4 weeks. Although the asthma symptom scores were not significantly changed, the weekly medication scores were significantly decreased. Tuberculin skin reactivities were significantly increased without significant alterations in induced sputum profiles. In contrast, medication scores and sputum eosinophils were significantly increased, and the interferon-gamma:interleukin-4 ratio in sputum was significantly decreased in the placebo group. CONCLUSIONS: BCG vaccination improved lung function and reduced medication use in adults with moderate-to-severe asthma. This amelioration was accompanied by a suppressed Th2-type immune response, suggesting that BCG vaccination might be an effective therapeutic modality against asthma. 相似文献
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There is evidence that the prevalence of respiratory allergy is increasing. This is mainly based on studies in children and young adults. The aim of the study was to compare the prevalences of self-reported symptoms of respiratory allergy among Danish adults in two surveys 8 years apart. Identical questionnaires were mailed to two random general population samples in 1989 and 1997. The response rates were 86.1% (n = 3603) and 86.4% (n = 817), respectively. The sampling frame and sampling method were identical in both surveys. The changes in the prevalences of symptoms were expressed by sex- and age-adjusted odds ratios comparing 1997 to 1989. We found a significant increase in the prevalence of seasonal rhinitis symptoms (OR=1.6, 95% CI 1.4-1.9), rhinitis symptoms on exposure to pollen (OR =1.6, 95% CI 1.4-1.9), rhinitis symptoms on exposure to furry animals (odds ratio 1.6, 95% CI 1.3-2.0), rhinitis symptoms on exposure to house dust (OR = 1.3, 95% CI 1.1-1.6), and breathlessness on exposure to pollen (OR = 1.5, 95% CI 1.0-2.0). The observed increases were independent of sex and age. The questionnaire was validated in relation to allergen skin test reactivity in a subgroup of the responders to the 1989 survey. When the estimated associations between symptoms and skin test reactivity were considered, the results suggested an increase in allergy to pollen and animal dander. In conclusion, we found evidence of increased prevalence of allergic rhinitis symptoms associated with skin test reactivity. 相似文献
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目的探讨白细胞介素6(IL-6)基因启动子区-634C/G和-572C/G位点多态性与变应性鼻炎的关联性。方法应用聚合酶链反应-限制性片段长度多态性法(PCR-RFLP)检测105例PHC患者和130例健康对照者IL-6基因启动子区-634和-572位点多态性。结果 IL-6基因-634C/G多态性在变应性鼻炎组和对照组的分布差异不显著性(P0.05),而IL-6基因-572C/G多态性在两组人群中的分布差异显著(P0.05)。等位基因频率的相对风险分析发现,G等位基因携带者患冠心病的风险是C等位基因的1.849倍[相对比值比(OR)=1.849,95%可信区间(CI):1.187~2.879]。结论 IL-6-572基因多态性与变应性鼻炎的发病有相关性,G等位基因可能是变应性鼻炎的遗传易感基因。 相似文献
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Chai SM Tan KL Wong JL Eng P 《Asian Pacific journal of allergy and immunology / launched by the Allergy and Immunology Society of Thailand》2004,22(2-3):81-89
We conducted a prospective, cross sectional survey on 94 asthmatic subjects using an interviewer-administered questionnaire to audit the level of knowledge of adult asthmatic outpatients at a tertiary care hospital, in order to determine the sources of asthma information and variables associated with poor asthma knowledge. Of the 94 subjects, 39.4% were ignorant of the inflammatory nature of asthma while 56.4% did not understand the role of prednisolone in acute exacerbation of asthma. Only 17.0% reported having a written action plan. Lower educational level and older age were significantly associated with lower asthma knowledge scores. The doctor was the main source of asthma information. Asthma knowledge scores were significantly higher among those who named the doctor, pamphlets, newspapers, internet and books as a source of asthma information. Our study demonstrates that many asthmatics have poor understanding of some aspects of their disease and have no written asthma action plan. 相似文献