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https://www.readbyqxmd.com/read/28328326/interleukin-12-and-interleukin-23-blockade-in-leukocyte-adhesion-deficiency-type-1
#1
Niki M Moutsopoulos, Christa S Zerbe, Teresa Wild, Nicolas Dutzan, Laurie Brenchley, Giovanni DiPasquale, Gulbu Uzel, Karen C Axelrod, Andrea Lisco, Lucia D Notarangelo, George Hajishengallis, Luigi D Notarangelo, Steven M Holland
A patient with leukocyte adhesion deficiency type 1 (LAD1) had severe periodontitis and an intractable, deep, nonhealing sacral wound. We had previously found a dominant interleukin-23-interleukin-17 signature at inflamed sites in humans with LAD1 and in mouse models of the disorder. Blockade of this pathway in mouse models has resulted in resolution of the immunopathologic condition. We treated our patient with ustekinumab, an antibody that binds the p40 subunit of interleukin-23 and interleukin-12 and thereby blocks the activity of these cytokines, inhibiting interleukin-23-dependent production of interleukin-17...
March 23, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28328094/asthma-management-a-new-phenotype-based-approach-using-presence-of-eosinophilia-and-allergy
#2
REVIEW
Milan Terl, Vratislav Sedlák, Petr Cap, Renata Dvořáková, Viktor Kašák, Tomáš Kočí, Bronislava Novotna, Ester Seberova, Petr Panzner, Vladimir Zindr
Asthma is a heterogeneous disease. The Czech Pneumology and Allergology Societies commissioned 10 experts to review the literature and create joint national guidelines for managing asthma, reflecting this heterogeneity. The aim was to develop an easy-to-use diagnostic strategy as a rational approach to the widening opportunities for the use of phenotype-targeted therapy. The guidelines were presented on websites for public comments by members of both the societies. The reviewers' comments contributed to creating the final version of the guidelines...
March 22, 2017: Allergy
https://www.readbyqxmd.com/read/28326906/a-practical-guide-to-the-sublingual-immunotherapy-tablet-adverse-event-profile-implications-for-clinical-practice
#3
David I Bernstein, Jose A Bardelas, Bodil Svanholm Fogh, Amarjot Kaur, Ziliang Li, Hendrik Nolte
OBJECTIVES: Treatment with allergy immunotherapy improves allergic rhinoconjunctivitis, but can also improve comorbidities associated with allergic rhinitis such as asthma. Sublingual immunotherapy (SLIT)-tablets are a convenient and efficacious method of allergy immunotherapy. They are self-administered after the first tablet has been provided under medical supervision. Therapy may elicit local reactions or, rarely, systemic allergic reactions. The objective of this report is to inform healthcare practitioners about the safety and tolerability profile of SLIT-tablets and use this information to provide practical guidance that may inform patients regarding potential adverse reactions and how to manage them...
March 22, 2017: Postgraduate Medicine
https://www.readbyqxmd.com/read/28323676/impact-of-elimination-diets-on-nutrition-and-growth-in-children-with-multiple-food-allergies
#4
Carina Venter, Alessandra Mazzocchi, Kate Maslin, Carlo Agostoni
PURPOSE OF REVIEW: Growth and nutritional intake of children with cows' milk allergy and other food allergens has been thoroughly investigated in recent years across many different countries and age groups. An impaired growth in atopic children should not be attributed only to a high number of allergens and foods to be avoided, but to a general condition of 'sub-inflammation', which unfavorably affects the absorption and utilization of fuel and substrates. Atopic study participants may represent a good target for personalized nutrition and in this review we sought to outline many of the issues that should be taken into account when dietitians advise patients regarding food avoidance and expected effects on growth...
March 18, 2017: Current Opinion in Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28321366/climate-change-induced-range-shifts-of-three-allergenic-ragweeds-ambrosia-l-in-europe-and-their-potential-impact-on-human-health
#5
Karen Rasmussen, Jakob Thyrring, Robert Muscarella, Finn Borchsenius
Invasive allergenic plant species may have severe health-related impacts. In this study we aim to predict the effects of climate change on the distribution of three allergenic ragweed species (Ambrosia spp.) in Europe and discuss the potential associated health impact. We built species distribution models based on presence-only data for three ragweed species, using MAXENT software. Future climatic habitat suitability was modeled under two IPCC climate change scenarios (RCP 6.0 and RCP 8.5). We quantify the extent of the increase in 'high allergy risk' (HAR) areas, i...
2017: PeerJ
https://www.readbyqxmd.com/read/28314658/management-of-chronic-inducible-urticaria-according-to-the-guidelines-a-prospective-controlled-study
#6
Emek Kocatürk, Pelin Kuteyla Can, Pırıl Etikan Akbas, Mehmet Copur, Ece Nur Degirmentepe, Kübra Kızıltac, Ralfi Singer
BACKGROUND: The recommended treatment approach in chronic inducible urticarias (CIndU) is the same as that for chronic spontaneous urticaria (CSU). But there is a lack of controlled trials assessing efficacy of available treatment options. OBJECTIVE: We aimed to evaluate the efficacy of treatment algorithm recommended by the guidelines and comparison of treatment responses in CIndU vs CSU. METHODS: This prospective parallel group controlled study included 70 CIndU and 66 CSU patients...
March 1, 2017: Journal of Dermatological Science
https://www.readbyqxmd.com/read/28302660/rhabdomyolysis-induced-compartment-syndrome-secondary-to-atorvastatin-and-strenuous-exercise
#7
Louise Dunphy, Rossel Morhij, Sarah Tucker
A 50-year-old male UK resident with a history of hypertension and hypercholesterolaemia presented to the emergency department with a 48-hour history of sudden onset bilateral thigh swelling and pain unrelieved by regular analgesia. 3 days prior to presentation, he performed a vigorous workout in the gym. His medications included ramipril 5 mg once daily and atorvastatin 20 mg at night time. He was a non-smoker and did not consume alcohol. He reported no known drug allergies. Physical examination confirmed bilateral swollen thighs, with no overlying skin changes, clinically suggestive of compartment syndrome...
March 16, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28302183/reaching-multidisciplinary-consensus-on-classification-of-anaphylaxis-for-the-eleventh-revision-of-the-world-health-organization-s-who-international-classification-of-diseases-icd-11
#8
Luciana Kase Tanno, Robert J G Chalmers, Moises A Calderon, Ségolène Aymé, Pascal Demoly
BACKGROUND: Although currently misclassified in the International Classification of Diseases (ICD) and still not officially listed as a rare disease, anaphylaxis is a well-known clinical emergency. Anaphylaxis is now one of the principal headings in the "Allergic and hypersensitivity conditions" section recently compiled for the forthcoming 11(th) Revision of ICD (ICD-11). We here report the building process used for the pioneering "Anaphylaxis" subsection of ICD-11 in which we aimed for transparency as recommended in the ICD-11 revision guidelines...
March 16, 2017: Orphanet Journal of Rare Diseases
https://www.readbyqxmd.com/read/28293933/unmet-primary-physicians-needs-for-allergic-rhinitis-care-in-korea
#9
Hyeon Jong Yang, Young Hyo Kim, Bora Lee, Do Youn Kong, Dong Kyu Kim, Mi Ae Kim, Bong Seong Kim, Won Young Kim, Jeong Hee Kim, Yang Park, So Yeon Park, Woo Yong Bae, Keejae Song, Min Suk Yang, Sang Min Lee, Young Mok Lee, Hyun Jong Lee, Jae Hong Cho, Hye Mi Jee, Jeong Hee Choi, Young Yoo, Young Il Koh
Allergic rhinitis (AR) is one of the most common chronic allergic respiratory diseases worldwide. Various practical guidelines for AR have been developed and updated to improve the care of AR patients; however, up to 40% patients remain symptomatic. The unmet need for AR care is one of the greatest public health problems in the world. The gaps between guideline and real-world practice, and differences according to the region, culture, and medical environments may be the causes of unmet needs for AR care. Because there is no evidence-based AR practical guideline reflecting the Korean particularity, various needs are increasing...
May 2017: Allergy, Asthma & Immunology Research
https://www.readbyqxmd.com/read/28293116/how-french-general-practitioners-manage-and-prevent-recurrent-respiratory-tract-infections-in-children-the-sourirre-survey
#10
Bruno Chicoulaa, Hervé Haas, Jérôme Viala, Maryline Salvetat, Jean-Pierre Olives
BACKGROUND: Recurrent respiratory tract infections (RRTIs) are the most common reason for children's visits to primary care physicians in France; however, little is known about general practitioners' (GPs) opinions and expectations concerning the management and prevention of these common and recurrent pathologies. PURPOSE: To describe French GPs' daily practice in the management of respiratory infections and the prevention of their recurrence in children. METHODS: A sample group of French GPs answered a structured questionnaire on risk factors, RRTI management, antibiotic use and prevention measures...
2017: International Journal of General Medicine
https://www.readbyqxmd.com/read/28291074/contact-allergy-cross-reactions-retrospective-clinical-data-and-review-of-the-literature
#11
Andrew Scheman, Ricky Hipolito, David Severson, Nineveh Youkhanis
We discuss cross-reactions that can occur when a patient allergic to a specific allergen also reacts to a similar allergen. Currently, The American Contact Dermatitis Society Contact Allergy Management Program, which allows physicians to identify safe products for their patients, uses a 10% threshold to distinguish significant cross-reactors. New clinical data from a patch testing center along with previous data in the literature are analyzed to help determine whether current cross-reactor definitions are reasonable or should be altered...
March 2017: Dermatitis
https://www.readbyqxmd.com/read/28287363/nebulized-fentanyl-for-dyspnea-in-a-hospice-patient-with-true-allergy-to-morphine-and-hydromorphone
#12
Robert G Wahler, David B Smith, Kimberly B Mulcahy
An 86-year-old white female was admitted to hospice care with lung cancer. Even with optimal medical management, she suffered from dyspnea and required opioid therapy. However, the patient had a true morphine and hydromorphone allergy. She was administered nebulized fentanyl for symptomatic relief of dyspnea with good effect and she did not experience any allergic response.
March 2017: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/28286601/allergic-diseases-and-asthma-in-pregnancy-a-secondary-publication
#13
REVIEW
Isabella Pali-Schöll, Jennifer Namazy, Erika Jensen-Jarolim
Every fifth pregnant woman is affected by allergies, especially rhinitis and asthma. Allergic symptoms existing before pregnancy may be either attenuated, or equally often promoted through pregnancy. Optimal allergy and asthma diagnosis and management during pregnancy is vital to ensure the welfare of mother and baby. For allergy diagnosis in pregnancy, preferentially anamnestic investigation as well as in vitro testing should be applied, whereas skin testing or provocation tests should be postponed until after birth...
2017: World Allergy Organization Journal
https://www.readbyqxmd.com/read/28286522/assessment-of-105-patients-with-angiotensin-converting-enzyme-inhibitor-induced-angioedema
#14
Eva Rye Rasmussen, Christian von Buchwald, Mia Wadelius, Sumangali Chandra Prasad, Shailajah Kamaleswaran, Kawa Khaled Ajgeiy, Georg Authried, Kristine Appel U Pallesen, Anette Bygum
Objective. To asses a cohort of 105 consecutive patients with angiotensin converting enzyme-inhibitor induced angioedema with regard to demographics, risk factors, family history of angioedema, hospitalization, airway management, outcome, and use of diagnostic codes used for the condition. Study Design. Cohort study. Methods. This was a retrospective cohort study of 105 patients with angiotensin converting enzyme-inhibitor induced angioedema in the period 1995-2014. Results. The cohort consisted of 67 females and 38 males (F : M ratio 1...
2017: International Journal of Otolaryngology
https://www.readbyqxmd.com/read/28286421/pharmacoeconomics-of-sublingual-immunotherapy-with-the-5-grass-pollen-tablets-for-seasonal-allergic-rhinitis
#15
REVIEW
Carlo Lombardi, Valerie Melli, Cristoforo Incorvaia, Erminia Ridolo
Allergic rhinitis has a very high burden regarding both direct and indirect costs. This makes essential in the management of AR to reduce the clinical severity of the disease and thus to lessen its costs. This particularly concerns allergen immunotherapy (AIT), that, based on its immunological action on the causes of allergy, extends its benefit also after discontinuation of the treatment. From the pharmacoeconomic point of view, any treatment must be evaluated according to its cost-effectiveness, that is, the ratio between the cost of the intervention and its effect...
2017: Clinical and Molecular Allergy: CMA
https://www.readbyqxmd.com/read/28285065/pharmacist-use-of-the-electronic-medical-record-to-identify-adults-at-risk-for-anaphylaxis-without-epinephrine-for-self-administration
#16
Autumn Stewart, Katherine Sulkowski
OBJECTIVES: To describe an innovative pharmacist-led approach, with the use of electronic medical record (EMR) data, to identify patients at risk of anaphylaxis in need of epinephrine auto-injector (EAI) for self-administration. SETTING: An urban free health care center for an uninsured indigent adult population in Pittsburgh, PA. PRACTICE INNOVATION: In this pilot service, patients with allergy history fields containing the words "anaphylaxis," "nut," "bee," or "shellfish" were screened for inclusion...
March 8, 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28284784/trends-in-provider-management-of-patients-with-food-protein-induced-enterocolitis-syndrome
#17
Matthew Greenhawt, J Andrew Bird, Anna H Nowak-Węgrzyn
BACKGROUND: Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE-mediated food allergy. OBJECTIVE: To better understand provider-level variation in FPIES knowledge and management. METHODS: A 23-question online survey was administered to AAAAI members during the spring and summer of 2014. RESULTS: Among 470 respondents, 64% reported "full understanding" of FPIES diagnosis/management; 78.8% reported managing 1 or more patient with FPIES; and 80...
March 8, 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28284783/the-allergist-s-role-in-detection-of-severe-alpha-1-antitrypsin-deficiency
#18
Theodore Kelbel, Darren Morris, Deirdre Walker, Maria Paula Henao, Timothy Craig
BACKGROUND: Alpha-1 antitrypsin deficiency (AATD) frequently presents as difficult to manage asthma or asthma with fixed obstruction and is well documented as being underdiagnosed in the population. OBJECTIVE: This study aimed to better describe allergists'/immunologists' involvement in the care of patients with AATD and whether they currently contribute to the underdiagnosis by lack of screening for the condition. METHODS: Using the Research Electronic Data Capture tool, we submitted a questionnaire to 500 patients with severe AATD (ZZ, SZ, ZNull, and FZ) through the Alpha-1 Foundation Research Registry to collect information about patient diagnosis and treatment patterns...
March 8, 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28283156/dietary-therapy-and-nutrition-management-of-eosinophilic-esophagitis-a-work-group-report-of-the-american-academy-of-allergy-asthma-and-immunology
#19
Marion Groetch, Carina Venter, Isabel Skypala, Berber Vlieg-Boerstra, Kate Grimshaw, Raquel Durban, Alison Cassin, Michelle Henry, Kara Kliewer, Lynda Kabbash, Dan Atkins, Anna Nowak-Węgrzyn, Mark Holbreich, Mirna Chehade
Eosinophilic esophagitis (EoE) is a chronic/immune-antigen-mediated disease characterized clinically by symptoms related to esophageal dysfunction and histologically by eosinophil-predominant inflammation. Dietary elimination therapy has been shown to be an effective, drug-free prescription for the treatment of EoE. A range of different dietary elimination therapies have been used. Regardless of the elimination diet chosen, dietary therapy requires in-depth nutrition assessment and management. Elimination diets are not without risk and may impact nutritional status, eating pleasure, and overall quality of life...
March 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28283153/food-dependent-exercise-induced-anaphylaxis-diagnosis-and-management-in-the-outpatient-setting
#20
REVIEW
Anna M Feldweg
Food-dependent, exercise-induced anaphylaxis is a disorder in which anaphylaxis develops most predictably during exercise, when exercise takes place within a few hours of ingesting a specific food. IgE to that food should be demonstrable. It is the combination of the food and exercise that precipitates attacks, whereas the food and exercise are each tolerated independently. Recently, it was demonstrated that exercise is not essential for the development of symptoms, and that if enough of the culprit food is ingested, often with additional augmentation factors, such as alcohol or acetylsalicylic acid, symptoms can be induced at rest in the challenge setting...
March 2017: Journal of Allergy and Clinical Immunology in Practice
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