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https://www.readbyqxmd.com/read/25738669/valganciclovir-for-symptomatic-congenital-cytomegalovirus-disease
#1
RANDOMIZED CONTROLLED TRIAL
David W Kimberlin, Penelope M Jester, Pablo J Sánchez, Amina Ahmed, Ravit Arav-Boger, Marian G Michaels, Negar Ashouri, Janet A Englund, Benjamin Estrada, Richard F Jacobs, José R Romero, Sunil K Sood, M Suzanne Whitworth, Mark J Abzug, Mary T Caserta, Sandra Fowler, Jorge Lujan-Zilbermann, Gregory A Storch, Roberta L DeBiasi, Jin-Young Han, April Palmer, Leonard B Weiner, Joseph A Bocchini, Penelope H Dennehy, Adam Finn, Paul D Griffiths, Suzanne Luck, Kathleen Gutierrez, Natasha Halasa, James Homans, Andi L Shane, Michael Sharland, Kari Simonsen, John A Vanchiere, Charles R Woods, Diane L Sabo, Inmaculada Aban, Huichien Kuo, Scott H James, Mark N Prichard, Jill Griffin, Dusty Giles, Edward P Acosta, Richard J Whitley
BACKGROUND: The treatment of symptomatic congenital cytomegalovirus (CMV) disease with intravenous ganciclovir for 6 weeks has been shown to improve audiologic outcomes at 6 months, but the benefits wane over time. METHODS: We conducted a randomized, placebo-controlled trial of valganciclovir therapy in neonates with symptomatic congenital CMV disease, comparing 6 months of therapy with 6 weeks of therapy. The primary end point was the change in hearing in the better ear ("best-ear" hearing) from baseline to 6 months...
March 5, 2015: New England Journal of Medicine
https://www.readbyqxmd.com/read/25638051/characteristics-of-emergency-department-doctor-shoppers
#2
Scott G Weiner, Christopher A Griggs, Breanne K Langlois, Patricia M Mitchell, Kerrie P Nelson, Franklin D Friedman, James A Feldman
BACKGROUND: There is a need to accurately identify patients at risk for drug abuse before giving a prescription for a scheduled medication. OBJECTIVE: Our aim was to describe a subset of emergency department (ED) patients that had eight or more schedule II-V prescriptions filled from eight or more providers in 1 year, known as "doctor-shopping" (DS) behavior, to compare demographic features of DS and non-DS patients, and to determine clinical factors associated with DS...
April 2015: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/24668841/applying-human-factors-principles-to-alert-design-increases-efficiency-and-reduces-prescribing-errors-in-a-scenario-based-simulation
#3
Alissa L Russ, Alan J Zillich, Brittany L Melton, Scott A Russell, Siying Chen, Jeffrey R Spina, Michael Weiner, Elizabette G Johnson, Joanne K Daggy, M Sue McManus, Jason M Hawsey, Anthony G Puleo, Bradley N Doebbeling, Jason J Saleem
OBJECTIVE: To apply human factors engineering principles to improve alert interface design. We hypothesized that incorporating human factors principles into alerts would improve usability, reduce workload for prescribers, and reduce prescribing errors. MATERIALS AND METHODS: We performed a scenario-based simulation study using a counterbalanced, crossover design with 20 Veterans Affairs prescribers to compare original versus redesigned alerts. We redesigned drug-allergy, drug-drug interaction, and drug-disease alerts based upon human factors principles...
October 2014: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/22930159/medical-causation-and-expert-testimony-allergists-at-this-intersection-of-medicine-and-law
#4
REVIEW
Howard M Weiner, Ronald E Gots, Robert P Hein
Clinical practice always necessitates proper diagnosis and correct treatment. For most clinical fields, determining the cause of the illness is irrelevant to the intervention. An oncologist, for example, has no need to explore the "cause" of the patient's lymphoma. Allergists, by contrast, have tools and the need to examine the relevant allergen which is the putative "cause" of the patient's allergic symptomatology. In the context of a legal claim, the "cause" of the symptoms or disorder is central, because it determines financial responsibility...
December 2012: Current Allergy and Asthma Reports
https://www.readbyqxmd.com/read/21991950/oral-acyclovir-suppression-and-neurodevelopment-after-neonatal-herpes
#5
RANDOMIZED CONTROLLED TRIAL
David W Kimberlin, Richard J Whitley, Wen Wan, Dwight A Powell, Gregory Storch, Amina Ahmed, April Palmer, Pablo J Sánchez, Richard F Jacobs, John S Bradley, Joan L Robinson, Mark Shelton, Penelope H Dennehy, Charles Leach, Mobeen Rathore, Nazha Abughali, Peter Wright, Lisa M Frenkel, Rebecca C Brady, Russell Van Dyke, Leonard B Weiner, Judith Guzman-Cottrill, Carol A McCarthy, Jill Griffin, Penelope Jester, Misty Parker, Fred D Lakeman, Huichien Kuo, Choo Hyung Lee, Gretchen A Cloud
BACKGROUND: Poor neurodevelopmental outcomes and recurrences of cutaneous lesions remain unacceptably frequent among survivors of neonatal herpes simplex virus (HSV) disease. METHODS: We enrolled neonates with HSV disease in two parallel, identical, double-blind, placebo-controlled studies. Neonates with central nervous system (CNS) involvement were enrolled in one study, and neonates with skin, eye, and mouth involvement only were enrolled in the other. After completing a regimen of 14 to 21 days of parenteral acyclovir, the infants were randomly assigned to immediate acyclovir suppression (300 mg per square meter of body-surface area per dose orally, three times daily for 6 months) or placebo...
October 6, 2011: New England Journal of Medicine
https://www.readbyqxmd.com/read/21530305/baseline-variation-and-associations-between-subject-characteristics-and-five-cytokine-biomarkers-of-vaginal-safety-among-healthy-non-pregnant-women-in-microbicide-trials
#6
RANDOMIZED CONTROLLED TRIAL
Raina N Fichorova, Jaim-Jou Lai, Jill L Schwartz, Debra H Weiner, Christine K Mauck, Marianne M Callahan
Interleukins (IL)-8, IL-1α, IL-1β, and IL-1 receptor antagonist (IL-1RA) have emerged as indicators of vaginal inflammation and HIV-1 transmission risk. We provide values and factors of normal variation of these immune mediators in premenopausal women to allow their wider clinical application as biomarkers of vaginal health. Cross-sectional analyzes (Kruskal-Wallis and Wilcoxon exact tests) of cytokine concentrations in relation to sociodemographic variables and Nugent score were performed on baseline (prior to product) cervicovaginal lavage from two Phase I randomized microbicide trials...
July 2011: Cytokine
https://www.readbyqxmd.com/read/20687065/injection-allergen-immunotherapy-for-asthma
#7
REVIEW
Michael J Abramson, Robert M Puy, John M Weiner
BACKGROUND: Allergen specific immunotherapy has long been a controversial treatment for asthma. Although beneficial effects upon clinically relevant outcomes have been demonstrated in randomised controlled trials, there remains a risk of severe and sometimes fatal anaphylaxis. The recommendations of professional bodies have ranged from cautious acceptance to outright dismissal. With increasing interest in new allergen preparations and methods of delivery, we updated the systematic review of allergen specific immunotherapy for asthma...
August 4, 2010: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/20167139/forensic-approach-to-medical-causation-when-allergic-disease-is-in-the-differential-diagnosis
#8
REVIEW
Howard M Weiner
As physicians, we are advocates for our patients. As allergists, we probe patient exposures. Occasionally, our good intentions find us entwined with forensic matters. Unfortunately, we have little formal training in toxicological, epidemiological, or evidence-based medicine methodology when determining exposure-related medical causation. This article provides such an approach and suggests helpful hints of conduct.
January 2010: Allergy and Asthma Proceedings:
https://www.readbyqxmd.com/read/19625155/immunoassay-based-measurement-of-clinical-biomarkers-for-monitoring-changes-in-nasal-cavity
#9
Yan J Zhang, Sherri Luroe, Frank Schieber, Joan Kelsey, Fizal Nabbie, Giovanni Rizzi, Penny Richards, Russell Weiner, Paul W Rhyne
BACKGROUND: Many drugs for treatment of allergies, migraine headaches, inflammation, and other indications are administered into the nasal cavity providing access to the immune and central nervous systems. One of the concerns for using this route of administration is potential damage to the nasal epithelium and mucosal regions. We assembled a panel of clinical biomarkers that can be used to monitor changes in the nasal epithelium, mucosa, and olfactory regions in preparation for clinical trials involving drugs administered via intranasal route...
December 5, 2009: Journal of Pharmaceutical and Biomedical Analysis
https://www.readbyqxmd.com/read/17162357/oral-tolerance-therapeutic-implications-for-autoimmune-diseases
#10
REVIEW
Ana M C Faria, Howard L Weiner
Oral tolerance is classically defined as the suppression of immune responses to antigens (Ag) that have been administered previously by the oral route. Multiple mechanisms of tolerance are induced by oral Ag. Low doses favor active suppression, whereas higher doses favor clonal anergy/deletion. Oral Ag induces Th2 (IL-4/IL-10) and Th3 (TGF-beta) regulatory T cells (Tregs) plus CD4+CD25+ regulatory cells and LAP+T cells. Induction of oral tolerance is enhanced by IL-4, IL-10, anti-IL-12, TGF-beta, cholera toxin B subunit (CTB), Flt-3 ligand, anti-CD40 ligand and continuous feeding of Ag...
June 2006: Clinical & Developmental Immunology
https://www.readbyqxmd.com/read/16922671/the-allergy-epidemic-what-is-the-australian-response
#11
Andrew S Kemp, Raymond J Mullins, John M Weiner
No abstract text is available yet for this article.
August 21, 2006: Medical Journal of Australia
https://www.readbyqxmd.com/read/16048553/oral-tolerance
#12
REVIEW
Ana M C Faria, Howard L Weiner
Multiple mechanisms of tolerance are induced by oral antigen. Low doses favor active suppression, whereas higher doses favor clonal anergy/deletion. Oral antigen induces T-helper 2 [interleukin (IL)-4/IL-10] and Th3 [transforming growth factor (TGF)-beta] T cells plus CD4+CD25+ regulatory cells and latency-associated peptide+ T cells. Induction of oral tolerance is enhanced by IL-4, IL-10, anti-IL-12, TGF-beta, cholera toxin B subunit, Flt-3 ligand, and anti-CD40 ligand. Oral (and nasal) antigen administration suppresses animal models of autoimmune diseases including experimental autoimmune encephalitis, uveitis, thyroiditis, myasthenia, arthritis, and diabetes in the non-obese diabetic (NOD) mouse, plus non-autoimmune diseases such as asthma, atherosclerosis, graft rejection, allergy, colitis, stroke, and models of Alzheimer's disease...
August 2005: Immunological Reviews
https://www.readbyqxmd.com/read/15144465/a-novel-promoter-polymorphism-in-the-gene-encoding-complement-component-5-receptor-1-on-chromosome-19q13-3-is-not-associated-with-asthma-and-atopy-in-three-independent-populations
#13
COMPARATIVE STUDY
K C Barnes, L Caraballo, M Muñoz, A Zambelli-Weiner, E Ehrlich, M Burki, S Jimenez, R A Mathias, M L Stockton, P Deindl, L Mendoza, G K Hershey, R Nickel, M Wills-Karp
BACKGROUND: The inflammatory functions of complement component 5 (C5) are mediated by its receptor, C5R1, which is expressed on bronchial, epithelial, vascular endothelial and smooth muscle cells. A susceptibility locus for murine allergen-induced airway hyper-responsiveness was identified in a region syntenic to human chromosome 19q13, where linkage to asthma has been demonstrated and where the gene encoding C5R1 is localized. OBJECTIVE: The aim of this study was to screen for novel polymorphisms in the C5R1 gene and to determine whether any identified polymorphisms are associated with asthma and/or atopy and whether they are functional...
May 2004: Clinical and Experimental Allergy: Journal of the British Society for Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/14583928/allergen-immunotherapy-for-asthma
#14
REVIEW
M J Abramson, R M Puy, J M Weiner
BACKGROUND: Allergen specific immunotherapy has long been a controversial treatment for asthma. Although beneficial effects upon clinically relevant outcomes have been demonstrated in randomised controlled trials, there remains a risk of severe and sometimes fatal anaphylaxis. The recommendations of professional bodies have ranged from cautious acceptance to outright dismissal. With increasing interest in new allergen preparations and new methods of delivery, it was time to conduct another systematic review of allergen specific immunotherapy for asthma...
2003: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/12194159/visits-to-physicians-after-the-oxygenation-of-gasoline-in-philadelphia
#15
Peter M Joseph, Mark G Weiner
During the period between 1992 and 1997, there was an increase in levels of methyl tertiary butyl ether (MTBE) in gasoline in the Philadelphia, Pennsylvania, area. In this study, the authors analyzed billing records from clinical practices that were extensions of the University of Pennsylvania. The authors based their selections on the International Classification of Diseases-9 diagnostic codes, which were determined from (1) previous studies of methyl tertiary butyl ether conducted by the Centers for Disease Control; (2) respiratory symptoms, including asthma and wheezing; and (3) symptoms associated anecdotally with methyl tertiary butyl ether levels in gasoline...
March 2002: Archives of Environmental Health
https://www.readbyqxmd.com/read/11483782/safety-and-efficacy-of-high-dose-intravenous-acyclovir-in-the-management-of-neonatal-herpes-simplex-virus-infections
#16
D W Kimberlin, C Y Lin, R F Jacobs, D A Powell, L Corey, W C Gruber, M Rathore, J S Bradley, P S Diaz, M Kumar, A M Arvin, K Gutierrez, M Shelton, L B Weiner, J W Sleasman, T M de Sierra, S Weller, S J Soong, J Kiell, F D Lakeman, R J Whitley
OBJECTIVE: The objective of this investigation was to establish the safety of high-dose (HD) acyclovir for the treatment of neonatal herpes simplex virus (HSV) disease. In addition, an estimate of therapeutic efficacy was sought, both with respect to mortality and to morbidity. Virologic efficacy of HD acyclovir was also assessed. PARTICIPANTS: Infants who were </=28 days old and whose disease was considered to be caused by HSV were enrolled in this study. Patients with central nervous system (CNS; N = 28) or disseminated (N = 41) HSV infection were offered participation in the trial...
August 2001: Pediatrics
https://www.readbyqxmd.com/read/11483781/natural-history-of-neonatal-herpes-simplex-virus-infections-in-the-acyclovir-era
#17
MULTICENTER STUDY
D W Kimberlin, C Y Lin, R F Jacobs, D A Powell, L M Frenkel, W C Gruber, M Rathore, J S Bradley, P S Diaz, M Kumar, A M Arvin, K Gutierrez, M Shelton, L B Weiner, J W Sleasman, T M de Sierra, S J Soong, J Kiell, F D Lakeman, R J Whitley
OBJECTIVE: During the 2 decades in which effective antiviral therapies have been available for neonatal herpes simplex virus (HSV) disease, changes have been documented not only in the outcomes of infected infants, but also in the natural history of the disease itself. Numerous studies previously have reported that early institution of antiviral therapy is beneficial to the outcome of the disease. The objective of this study was to provide an update of neonatal HSV disease to identify means by which future improvements in the management of HSV-infected neonates can be made...
August 2001: Pediatrics
https://www.readbyqxmd.com/read/10867375/-evaluation-of-the-pediatric-aspects-of-the-who-document-and-meta-analysis-of-immunotherapy
#18
REVIEW
M D Ibáñez Sendín
In spite of the existence of numerous scientific studies on the beneficial effect of immunotherapy with specific allergens in the treatment of allergic diseases, their results have not been easily accepted as the methodology and the valuation of the studies have been very heterogeneous. Over the last few years the meta-analysis technology has been developed as a useful tool to globally value the results on the different research studies related to a specific problem. When meta-analyse are carried out correctly, they are accepted as an optimum way to express the results obtained from the different studies from a common view point...
May 2000: Allergologia et Immunopathologia
https://www.readbyqxmd.com/read/10796617/allergen-immunotherapy-for-asthma
#19
REVIEW
M J Abramson, R M Puy, J M Weiner
BACKGROUND: Allergen specific immunotherapy has long been a controversial treatment for asthma. Although beneficial effects upon clinically relevant outcomes have been demonstrated in randomised controlled trials, there remains a risk of severe and sometimes fatal anaphylaxis. The recommendations of professional bodies have ranged from cautious acceptance to outright dismissal. With increasing interest in new allergen preparations and new methods of delivery, it was time to conduct a systematic review of allergen specific immunotherapy for asthma...
2000: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/10430938/cpg-dna-a-potent-signal-for-growth-activation-and-maturation-of-human-dendritic-cells
#20
G Hartmann, G J Weiner, A M Krieg
DNA molecules containing unmethylated CpG-dinucleotides in particular base contexts ("CpG motifs") are excellent adjuvants in rodents, but their effects on human cells have been less clear. Dendritic cells (DCs) form the link between the innate and the acquired immune system and may influence the balance between T helper 1 (Th1) and Th2 immune responses. We evaluated the effects of CpG oligodeoxynucleotides alone or in combination with granulocyte-macrophage colony-stimulating factor (GMCSF) on different classes of purified human DCs...
August 3, 1999: Proceedings of the National Academy of Sciences of the United States of America
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