CORD-19-Sentences  

CORD-19:2008f024274c53b0de1276f4047a6a641813fd98 JSONTXT 9 Projects

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Id Subject Object Predicate Lexical cue
TextSentencer_T1 0-30 Sentence denotes ABSTRACTS: CONCURRENT SESSIONS
TextSentencer_T2 32-40 Sentence denotes Abstract
TextSentencer_T3 43-56 Sentence denotes INTRODUCTION:
TextSentencer_T4 57-246 Sentence denotes The effect of anti IgE has been described as a function of complexing free IgE to reduce mast cell implantation and consequent reduction of mast cell degranulation upon exposure to antigen.
TextSentencer_T5 247-391 Sentence denotes Theoretically, as total free IgE drops below 10 ng/ml, improvement occurs as free and cell bound IgE equilibrate and allergic reactions subside.
TextSentencer_T6 392-430 Sentence denotes Initial observations ( Togias A et al.
TextSentencer_T7 431-454 Sentence denotes J Allergy Clin Immunol.
TextSentencer_T8 455-585 Sentence denotes 1998 ;101:S171)suggested that prick skin tests consistently reached their low point at 98 days with significant reduction in size.
TextSentencer_T9 586-682 Sentence denotes Laynadier (Leynadier F, Doudou O, Gaouar H, Le Gros V, Bourdeix I, Guyomarch-Cocco L, Trunet P :
TextSentencer_T10 683-920 Sentence denotes Effect of omalizumab in health care workers with occupational latex allergy.J Allergy Clin Immunol 2004;113:360-1) noted some reduction in skin testing in sixty percent of patients treated over a six month period with monoclonal antiIgE.
TextSentencer_T11 921-1112 Sentence denotes But clinicians since approval of the drug in 2002 have noted that even in the presence of good clinical response to asthma, skin test reactivity is still obvious, and in many cases unchanged.
TextSentencer_T12 1113-1121 Sentence denotes METHODS:
TextSentencer_T13 1122-1365 Sentence denotes Following the suggestions for standard clinical follow up by Lanier and Marshall ( Annals May 2003) , routine skin prick skin testing was completed after informed consent on 24 patients at onset of anti-IgE therapy, and repeated at 6-7 months.
TextSentencer_T14 1366-1442 Sentence denotes In all instances were skin tests done and photographed in a standard manner.
TextSentencer_T15 1443-1541 Sentence denotes In a few cases, skin tests were repeated on patients receiving anti IgE for as long as five years.
TextSentencer_T16 1542-1550 Sentence denotes RESULTS:
TextSentencer_T17 1551-1591 Sentence denotes Photographic evidence will be presented.
TextSentencer_T18 1592-1845 Sentence denotes In 22 of 24 patients on current therapy, prick skin testing remained at an almost identical photographic level to the baseline analysis, but there was a correlation between the patients with the lowest serum IgE and the likelihood of apparent reduction.
TextSentencer_T19 1846-2012 Sentence denotes There was no correlation to reduction of skin testing and clinical response to anti IgE since all 24 patients had experience significant quality of life improvements.
TextSentencer_T20 2013-2024 Sentence denotes CONCLUSION:
TextSentencer_T21 2025-2176 Sentence denotes Anti IgE has variable effects on reducing prick skin testing, with a greater likely hood associated with low or extremely low initial total IgE levels.
TextSentencer_T22 2177-2293 Sentence denotes Skin testing is more sensitive for detection of allergen-specific IgE than is immunoassay for allergen-specific IgE.
TextSentencer_T23 2294-2378 Sentence denotes For some assay methods, the qualitative cutoff of 0.35 kU/L is inappropriately high.
TextSentencer_T24 2379-2521 Sentence denotes This study was conducted in order to determine whether a particular assay system can be used to measure lower levels of allergen-specific IgE.
TextSentencer_T25 2522-2562 Sentence denotes The Pharmacia UniCAP System was studied.
TextSentencer_T26 2563-2678 Sentence denotes All reagents were purchased from the manufacturer, and the study was approved by a local human assurance committee.
TextSentencer_T27 2679-2850 Sentence denotes To determine background of the calibration curve, the fluorescent unit (FU) response of 6 replicates of assay diluent measured with an anti-IgE solid phase was determined.
TextSentencer_T28 2851-3031 Sentence denotes The background responses of 7 arbitrarily selected allergen solid phases (oak, timothy and short ragweed pollen; cat; peanut; yellow jacket venom; penicillin G) were also measured.
TextSentencer_T29 3032-3144 Sentence denotes Lower detection limits (LLD) were calculated using the mean background measurement + 3 standard deviations (SD).
TextSentencer_T30 3145-3277 Sentence denotes To examine linearity of a low-range calibration curve, 1:2 dilutions to extinction were made, starting with the 3.5 kU/L calibrator.
TextSentencer_T31 3278-3403 Sentence denotes The mean background of the anti-IgE solid phase was 15.4 FU, SD 2.7 and coefficient of variation (CV) of 18%; the LLD was 24.
TextSentencer_T32 3404-3471 Sentence denotes This LLD corresponded to a level of approximately 0.01 kU/L of IgE.
TextSentencer_T33 3472-3620 Sentence denotes The LLD of the allergen solid phases ranged from 17.2 FU (yellow jacket venom) to 71.6 FU (short ragweed); this corresponded to about 0.08 kU/L IgE.
TextSentencer_T34 3621-3777 Sentence denotes The low level dilution curve exhibited parallelism with a curve constructed using a zero (diluent) calibrator as a 7th point in the assay's reference curve.
TextSentencer_T35 3778-3888 Sentence denotes A low level method is capable of measuring specific IgE levels lower than the manufacturer's 0.35 kU/L cutoff.
TextSentencer_T36 3889-4010 Sentence denotes This would seem to be particularly important in research applications, and in the analysis of certain highrisk allergens.
TextSentencer_T37 4011-4100 Sentence denotes The clinical significance of very low levels of specific IgE in the serum warrants study.
TextSentencer_T38 4101-4194 Sentence denotes Allergists/immunologists are often consulted on patients with rashes or recurrent infections.
TextSentencer_T39 4195-4345 Sentence denotes The differential diagnosis can comprise a variety of disorders, some of which are rare syndromes that require early diagnosis and specific management.
TextSentencer_T40 4346-4407 Sentence denotes A 3 mo old WM developed persistent rash and worsening eczema.
TextSentencer_T41 4408-4625 Sentence denotes Later, he had recurrent severe skin infections, skin abscesses, recurrent sinusitis, and chronic otitis media that required multiple placement of tympanostomy tubes, yet had a persistent tympanic membrane perforation.
TextSentencer_T42 4626-4674 Sentence denotes Recurrent wheezing was noted from 3-7 yr of age.
TextSentencer_T43 4675-4756 Sentence denotes He had several episodes of pneumonia since 3 yr of age affecting different lobes.
TextSentencer_T44 4757-4842 Sentence denotes He failed to shed the primary teeth and had history of periodontitis and oral thrush.
TextSentencer_T45 4843-4923 Sentence denotes He developed scoliosis and multiple fractures of the upper extremities and ribs.
TextSentencer_T46 4924-5002 Sentence denotes At 12 yr he had staphylococcal bacteremia and osteomyelitis of the acetabulum.
TextSentencer_T47 5003-5105 Sentence denotes In spite of antibiotics prophylaxis, he continued to have recurrent skin infections and lymphadenitis.
TextSentencer_T48 5106-5254 Sentence denotes Laboratory evaluation revealed eosinophilia (up to 3138/mm3), normal levels of IgG, IgA, IgM & IgG subclasses, except for decreased IgG2 (51 mg/dl).
TextSentencer_T49 5255-5369 Sentence denotes He had protective levels of anti S. pneumoniae and H. influenzae, but low anti-tetanus and anti-diphtheria titers.
TextSentencer_T50 5370-5507 Sentence denotes At 4 yr, total IgE level was 42, 500 IU/ml which supported the diagnosis of hyper IgE (HIE) syndrome; it decreased to 197 IU/ml by 12 yr.
TextSentencer_T51 5508-5571 Sentence denotes RAST was positive to HD mite, cat, dog, egg, milk, and pollens.
TextSentencer_T52 5572-5650 Sentence denotes Flow cytomerty, NBT and phagocytic index were normal; CH50 was low (66 mg/dl).
TextSentencer_T53 5651-5679 Sentence denotes DEXA scan showed osteopenia.
TextSentencer_T54 5680-5769 Sentence denotes Chest X-ray showed bilateral infiltrate, atelectasis and scoliosis of the thoracic spine.
TextSentencer_T55 5770-5886 Sentence denotes During his hospitalization at 13 yr, his skin was fair, lichenified with widespread maculopapular erythematous rash.
TextSentencer_T56 5887-5965 Sentence denotes The palms and fingers showed open cracks and pustules, but no weeping lesions.
TextSentencer_T57 5966-6029 Sentence denotes In addition to coarse facial features, his face was eczematous.
TextSentencer_T58 6030-6189 Sentence denotes Conclusion: HIE syndrome is an autosomal dominant disorder that mimics atopic dermatitis but has severe course, multiple infections, and several complications.
TextSentencer_T59 6190-6248 Sentence denotes Although a markedly elevated total IgE level Introduction:
TextSentencer_T60 6249-6330 Sentence denotes Mannose-binding lectin (MBL) is a serum protein in the lectin complement pathway.
TextSentencer_T61 6331-6472 Sentence denotes It is important in innate immunity, and is thought to be particularly relevant in young children during the development of adaptive immunity.
TextSentencer_T62 6473-6600 Sentence denotes Deficiency in MBL has been reported in population-based studies as a risk factor in children for infection and hospitalization.
TextSentencer_T63 6601-6674 Sentence denotes Additionally, age-dependent variability of MBL has been previously noted.
TextSentencer_T64 6675-6831 Sentence denotes This study evaluates the prevalence of MBL deficiency in children with established recurrent infection who were referred for evaluation of immunodeficiency.
TextSentencer_T65 6832-6839 Sentence denotes Method:
TextSentencer_T66 6840-6923 Sentence denotes We prospectively evaluated MBL status of children referred for recurrent infection.
TextSentencer_T67 6924-6980 Sentence denotes Serum was collected from October 2002 to September 2003.
TextSentencer_T68 6981-7055 Sentence denotes Children with known primary or secondary immunodeficiencies were excluded.
TextSentencer_T69 7056-7131 Sentence denotes MBL analysis was performed by standardized ELISA using MBL oligomer assays.
TextSentencer_T70 7132-7291 Sentence denotes We performed chart and laboratory review for comorbid diagnoses, quantitative immunoglobulin levels and subclasses, and complement function with CH50 and AH50.
TextSentencer_T71 7292-7300 Sentence denotes Results:
TextSentencer_T72 7301-7349 Sentence denotes Two-hundred thirty five children were evaluated.
TextSentencer_T73 7350-7395 Sentence denotes Mean age was 4.5 years (range 0.08-17 years).
TextSentencer_T74 7396-7442 Sentence denotes Mean MBL was 1780 ng/ml (range 17-4806 ng/ml).
TextSentencer_T75 7443-7587 Sentence denotes Thirty-one of 235 children (13.1%) were MBL deficient, levels <200, and among this group the mean MBL level was 61.3 ng/ml (range 17-163 ng/ml).
TextSentencer_T76 7588-7646 Sentence denotes Mean age in this group was 3.6 years (range 0.3-16 years).
TextSentencer_T77 7647-7718 Sentence denotes Of the children with MBL deficiency, 13 (5.1%) children had levels <50.
TextSentencer_T78 7719-7779 Sentence denotes The M:F ratio of children with abnormal MBL levels was 1.08.
TextSentencer_T79 7780-7851 Sentence denotes Linear regression analysis showed no correlation of MBL level with age.
TextSentencer_T80 7852-7935 Sentence denotes Comorbid diagnoses were variable, including asthma, allergy, and atopic dermatitis.
TextSentencer_T81 7936-8012 Sentence denotes None of the children had symptoms compatible with connective tissue disease.
TextSentencer_T82 8013-8110 Sentence denotes No child with an abnormal MBL level was found to have significant deficiency of IgG, IgA, or IgM.
TextSentencer_T83 8111-8185 Sentence denotes Several children had low IgG4, which were within normal physiologic range.
TextSentencer_T84 8186-8250 Sentence denotes No other concomitant complement pathway disorders were detected.
TextSentencer_T85 8251-8263 Sentence denotes Conclusions:
TextSentencer_T86 8264-8331 Sentence denotes Our study did not reveal any correlation between MBL level and age.
TextSentencer_T87 8332-8455 Sentence denotes In children with recurrent infections, MBL deficiency was approximately twice the estimated rate of the general population.
TextSentencer_T88 8456-8545 Sentence denotes Contrary to previous studies, no other significant immunologic disorders were identified.
TextSentencer_T89 8546-8621 Sentence denotes Therefore, MBL deficiency alone is a risk factor for infection in children.
TextSentencer_T90 8622-8626 Sentence denotes T.B.
TextSentencer_T91 8627-8653 Sentence denotes Fausnight * , Hershey, PA.
TextSentencer_T92 8654-8667 Sentence denotes INTRODUCTION:
TextSentencer_T93 8668-8779 Sentence denotes The incidence of perioperative anaphylaxis is estimated to be between 1 in 10, 000 and 1 in 20, 000 procedures.
TextSentencer_T94 8780-8875 Sentence denotes Approximately 60% of cases of perioperative anaphylaxis are attributed to neuromuscular agents.
TextSentencer_T95 8876-8976 Sentence denotes Very little information is reported in the literature regarding pediatric perioperative anaphylaxis.
TextSentencer_T96 8977-9063 Sentence denotes I describe a pediatric patient with suspected perioperative anaphylaxis to rocuronium.
TextSentencer_T97 9064-9072 Sentence denotes METHODS:
TextSentencer_T98 9073-9200 Sentence denotes A 10 year-old girl with a history of sacral agenesis and neurogenic bladder was scheduled to have bladder augmentation surgery.
TextSentencer_T99 9201-9254 Sentence denotes The patient was taken to a latex-free operating room.
TextSentencer_T100 9255-9338 Sentence denotes During induction of general anesthesia, she was found to be difficult to ventilate.
TextSentencer_T101 9339-9367 Sentence denotes She also became hypotensive.
TextSentencer_T102 9368-9431 Sentence denotes Examination of the patient revealed urticaria on her right arm.
TextSentencer_T103 9432-9494 Sentence denotes She was given epinephrine, diphenhydramine, and dexamethasone.
TextSentencer_T104 9495-9521 Sentence denotes The procedure was aborted.
TextSentencer_T105 9522-9589 Sentence denotes The reaction was believed to be from either rocuronium or propofol.
TextSentencer_T106 9590-9598 Sentence denotes RESULTS:
TextSentencer_T107 9599-9752 Sentence denotes Because of the high incidence of anaphylaxis to neuromuscular agents, allergy skin testing was performed for rocuronium, vecuronium, and succinylcholine.
TextSentencer_T108 9753-9857 Sentence denotes The patient had negative percutaneous skin tests (1:10) for rocuronium, vecuronium, and succinylcholine.
TextSentencer_T109 9858-9936 Sentence denotes She had a negative intradermal skin test to rocuronium at the 1:1000 dilution.
TextSentencer_T110 9937-10014 Sentence denotes She had a positive intradermal skin test to rocuronium at the 1:100 dilution.
TextSentencer_T111 10015-10135 Sentence denotes She had negative intradermal skin tests to both vecuronium and succinylcholine at the 1:1000, 1:100, and 1:10 dilutions.
TextSentencer_T112 10136-10185 Sentence denotes She underwent surgery 2 weeks after skin testing.
TextSentencer_T113 10186-10245 Sentence denotes She received a test dose of vecuronium and had no reaction.
TextSentencer_T114 10246-10342 Sentence denotes She received 3 doses of vecuronium and multiple doses of morphine without any adverse reactions.
TextSentencer_T115 10343-10364 Sentence denotes Propofol was avoided.
TextSentencer_T116 10365-10422 Sentence denotes The surgery was completed without difficulty CONCLUSIONS:
TextSentencer_T117 10423-10524 Sentence denotes This case illustrates the usefulness of skin testing for neuromuscular agents in a pediatric patient.
TextSentencer_T118 10525-10538 Sentence denotes Introduction:
TextSentencer_T119 10539-10715 Sentence denotes Extrapulmonary pneumocystis jiroveci infection is rare in non-HIV infected individuals and, to our knowledge, it has not been reported before in a patient with Good's Syndrome.
TextSentencer_T120 10716-10798 Sentence denotes We report a case of extrapulmonary pneumocystis in a patient with Good's Syndrome.
TextSentencer_T121 10799-10811 Sentence denotes Case report:
TextSentencer_T122 10812-10942 Sentence denotes A 44-year-old African American male patient with a history of Good's Syndrome presented with left flank pain of 3 months duration.
TextSentencer_T123 10943-11017 Sentence denotes The pain was constant and associated with night sweats, fever, and chills.
TextSentencer_T124 11018-11080 Sentence denotes Furthermore, the patient also reported a 20-pound weight loss.
TextSentencer_T125 11081-11241 Sentence denotes On exam, patient was found to have multiple hypopigmented areas over his abdomen and left lower extremity, bitemporal wasting, sunken eyeballs, and oral thrush.
TextSentencer_T126 11242-11407 Sentence denotes The patient was also found to have left costovertebral angle tenderness with a palpable solid fixed mass along the left mid axillary line overlying the splenic area.
TextSentencer_T127 11408-11600 Sentence denotes ComputedTomography (CT) scan of the chest and abdomen showed a 2.2 x 2.9 cm soft tissue mass at the left lateral aspect of the T11 vertebral body and 7.0 x 5.2 cm soft tissue parasplenic mass.
TextSentencer_T128 11601-11705 Sentence denotes The parasplenic mass involved the inferior anterior aspect of the left 11th and 12th ribs (See Figure) .
TextSentencer_T129 11706-11879 Sentence denotes The Giemsastained biopsy of the parasplenic mass revealed pneumocystis jiroveci and was confirmed using immunohistochemical stain with monoclonal antipnumocystis antibodies.
TextSentencer_T130 11880-12027 Sentence denotes The patient's symptoms of night sweats and loss of appetite improved within 48 hours following initiation of Trimethoprim-Sulfamethoxazole therapy.
TextSentencer_T131 12028-12173 Sentence denotes A CT of the chest and abdomen, repeated six months post treatment, confirmed the resolution of both the paravertebral and the parasplenic masses.
TextSentencer_T132 12174-12185 Sentence denotes Conclusion:
TextSentencer_T133 12186-12303 Sentence denotes To our knowledge, this is the first case of extrapulmonary pneumocystis presenting in a patient with Good's Syndrome.
TextSentencer_T134 12304-12465 Sentence denotes Although it is rare, extrapulmonary pneumocystis should be considered in the differential diagnosis of patients with Good's Syndrome and chest or abdominal mass.
TextSentencer_T135 12466-12479 Sentence denotes Introduction:
TextSentencer_T136 12480-12567 Sentence denotes T cells are regulated by cellular interactions with the environment during development.
TextSentencer_T137 12568-12651 Sentence denotes They play a critical role in the regulation and development of autoimmune diseases.
TextSentencer_T138 12652-12763 Sentence denotes We report inflammatory myositis in a 10-year-old Caucasian female with primary T cell-deficiency since infancy.
TextSentencer_T139 12764-12772 Sentence denotes Methods:
TextSentencer_T140 12773-12852 Sentence denotes At nine months of age, our patient developed lymphoid interstitial pneumonitis.
TextSentencer_T141 12853-12912 Sentence denotes Immunologic evaluation revealed isolated T-cell deficiency.
TextSentencer_T142 12913-13063 Sentence denotes During the first 3 years of life, she had failure to thrive, recurrent sinusitis, oral candidiasis, fungal skin infections, and Pseudomonas pneumonia.
TextSentencer_T143 13064-13262 Sentence denotes At 5 years, autoimmune conditions, characterized by a purpuric rash over the nose; face and exposure area of elbows; knees and fingers; Raynaud's phenomenon; and nasal septum perforation, developed.
TextSentencer_T144 13263-13339 Sentence denotes Inflammatory markers were persistently elevated and autoantibodies detected.
TextSentencer_T145 13340-13420 Sentence denotes By age 9, she developed proximal muscle weakness with distal joint contractures.
TextSentencer_T146 13421-13485 Sentence denotes Dry gangrene of the fingers from a thrombotic incident occurred.
TextSentencer_T147 13486-13494 Sentence denotes Results:
TextSentencer_T148 13495-13736 Sentence denotes Serial immunologic evaluation revealed low CD4 9-36%, # 153-335 (normal 36-61%, # 900-2860 cell/mm3), low CD8 5-23%, #142-237 (normal 16-34%, # 630-1910 cell/mm3) , decreased lymphocyte transformation to antigens but appropriate to mitogens.
TextSentencer_T149 13737-13905 Sentence denotes IgG 1320-2560 (normal 667-1179 mg/dL); IgA 470-780 (normal 79-169 mg/dL), and IgM 215-340, (normal 40-90 mg/dL) with appropriate antibody responses to vaccine antigens.
TextSentencer_T150 13906-13950 Sentence denotes Bone marrow and thymus biopsies were normal.
TextSentencer_T151 13951-14040 Sentence denotes Further evaluation was not consistent with known primary or secondary immunodeficiencies.
TextSentencer_T152 14041-14114 Sentence denotes Several skin biopsies revealed nonspecific dermatitis without vasculitis.
TextSentencer_T153 14115-14213 Sentence denotes MRI of lower extremities showed abnormal signals involving bilateral muscles of thighs and calves.
TextSentencer_T154 14214-14340 Sentence denotes Muscle biopsy revealed inflammatory myositis with plasma cell predominance, inconsistent with dermatomyositis or polymyositis.
TextSentencer_T155 14341-14472 Sentence denotes Aldolase 8-10 IU/L (< 5), CRP 8-16 mg/dL (< 0.5), ESR 50-70 (< 20), RF 1:1280 (< 1:40) and type II collagen Ab 26-35 EI/mL (< 20) .
TextSentencer_T156 14473-14516 Sentence denotes ANA, ANCA and ACE were within normal range.
TextSentencer_T157 14517-14587 Sentence denotes Antibodies for myositis and myositis related-antibodies were negative.
TextSentencer_T158 14588-14656 Sentence denotes Diagnosis of nonspecific plasma-cell inflammatory myositis was made.
TextSentencer_T159 14657-14722 Sentence denotes A trial of monthly IVIG 2 gm/kg resulted in clinical improvement.
TextSentencer_T160 14723-14734 Sentence denotes Conclusion:
TextSentencer_T161 14735-14895 Sentence denotes This novel plasma cell myositis occurring in a child with primary T cell deficiency underscores the role T cells play in the development of autoimmune diseases.
TextSentencer_T162 14896-15028 Sentence denotes Introduction The incidence of hypersensitivity reactions (HR) is increased in patients treated with multiple courses of carboplatin.
TextSentencer_T163 15029-15204 Sentence denotes The purposes of this investigation were to evaluate the effectiveness of a 6-hour, 12-step desensitization protocol and to characterize the immune mechanism of carboplatin HR.
TextSentencer_T164 15205-15362 Sentence denotes Methods We analyzed ten consecutive patients over a two year period with documented HR to carboplatin who required continued treatment with a platinum agent.
TextSentencer_T165 15363-15455 Sentence denotes The patients were treated with carboplatin using a 6-hour, 12-step desensitization protocol.
TextSentencer_T166 15456-15499 Sentence denotes Skin tests were performed on five patients.
TextSentencer_T167 15500-15634 Sentence denotes Results Ten patients successfully completed 35 planned courses of desensitizations to carboplatin, 31 of which were without reactions.
TextSentencer_T168 15635-15795 Sentence denotes Four patients had symptoms during their first (n=3) and third (n=1) desensitizations but tolerated the re-administration of infusions without further reactions.
TextSentencer_T169 15796-15975 Sentence denotes For subsequent courses, the protocol was modified for two patients who had extracutaneous symptoms during desensitization and was unchanged for the patient who had mild urticaria.
TextSentencer_T170 15976-16064 Sentence denotes These three patients tolerated subsequent courses of desensitizations without reactions.
TextSentencer_T171 16065-16152 Sentence denotes The fourth patient with symptoms during desensitization no longer required carboplatin.
TextSentencer_T172 16153-16255 Sentence denotes Of the five patients who were skin tested to carboplatin, four had positive wheal and flare reactions.
TextSentencer_T173 16256-16348 Sentence denotes In one patient, the skin test response to carboplatin became negative after desensitization.
TextSentencer_T174 16349-16470 Sentence denotes Conclusions The 6-hour, 12-step desensitization protocol is safe and effective for treating patients with carboplatin HR.
TextSentencer_T175 16471-16549 Sentence denotes Positive skin tests to carboplatin suggest a mast cell/IgE-mediated mechanism.
TextSentencer_T176 16550-16684 Sentence denotes Conversion of the positive skin test to a negative response after desensitization supports antigen-specific mast cell desensitization.
TextSentencer_T177 16685-16696 Sentence denotes Hypothesis:
TextSentencer_T178 16697-16790 Sentence denotes There is an association between food allergies and acid reflux in atopic adults Study Design:
TextSentencer_T179 16791-16849 Sentence denotes A retrospective chart review of 60 patients was conducted.
TextSentencer_T180 16850-16945 Sentence denotes 30 people who tested positive and 30 people who tested negative for food allergy were included.
TextSentencer_T181 16946-17087 Sentence denotes The prevalence of gastroesophageal reflux disease (GERD) in the total group and each of the study arms was compared to population prevalence.
TextSentencer_T182 17088-17096 Sentence denotes Methods:
TextSentencer_T183 17097-17307 Sentence denotes Results of 70 allergen specific IgE tests (Pharmacia Immunocap, NJ) run for food allergies were reviewed to help locate charts of 60 atopic subjects, 30 with positive, and 30 with negative food allergy results.
TextSentencer_T184 17308-17462 Sentence denotes We reviewed charts for history of heartburn and acid regurgitation or the diagnosis of GERD, laryngopharyngeal reflux (LPR) or Peptic ulcer disease (PUD).
TextSentencer_T185 17463-17620 Sentence denotes Population prevalence (19.8%; CI 17.7-21.9) of acid reflux was estimated from a historical comparison that studied adults in a similar geographical location.
TextSentencer_T186 17621-17629 Sentence denotes Results:
TextSentencer_T187 17630-17780 Sentence denotes In the food allergy positive group, 26.7% of the subjects (95% CI 11.8-41.6) had either a history of heartburn and/or a diagnosis of GERD, LPR or PUD.
TextSentencer_T188 17781-17865 Sentence denotes In the food allergy negative group, 40% (95% CI 25.1-54) had acid related disorders.
TextSentencer_T189 17866-17970 Sentence denotes In the total study group of atopic subjects, the prevalence of heartburn, GERD, LPR or PUD was 33.34% ).
TextSentencer_T190 17971-18136 Sentence denotes On Chi square analysis, the prevalence of acid reflux disorders was significantly higher in the total study group when compared with population prevalence (p=0.013).
TextSentencer_T191 18137-18277 Sentence denotes The prevalence of acid reflux disorders between the food allergy study group and in the population shows no significant difference (p=0.41).
TextSentencer_T192 18278-18440 Sentence denotes The prevalence of acid reflux disorders was significantly higher in the food allergy negative group when compared with the prevalence in the population (p=0.003).
TextSentencer_T193 18441-18590 Sentence denotes There was no significant difference in the prevalence of acid reflux disorders between the two study groups with and without food allergy (p = 0.27).
TextSentencer_T194 18591-18603 Sentence denotes Conclusions:
TextSentencer_T195 18604-18752 Sentence denotes The prevalence of acid reflux disorders was higher in people with food allergy when compared to the population, but missed statistical significance.
TextSentencer_T196 18753-18873 Sentence denotes Patients without food allergy had a significantly higher prevalence of acid reflux disorders compared to the population.
TextSentencer_T197 18874-19069 Sentence denotes Atopic individuals have a statistically significant higher prevalence of acid reflux disorders, but there is no statistically significant difference between atopics with and without food allergy.
TextSentencer_T198 19070-19090 Sentence denotes Abstract Background:
TextSentencer_T199 19091-19253 Sentence denotes Analysis of dispensing patterns of injectable epinephrine offers a method to study the characteristics of school children with allergic or anaphylactic reactions.
TextSentencer_T200 19254-19264 Sentence denotes Objective:
TextSentencer_T201 19265-19424 Sentence denotes To analyze the demographics of children prescribed injectable epinephrine in Massachusetts school districts with diverse racial and ethnic enrollment patterns.
TextSentencer_T202 19425-19433 Sentence denotes Methods:
TextSentencer_T203 19434-19724 Sentence denotes School nurses in 44 schools (grades PK-12) enrolling 21, 870 students recorded the characteristics of students prescribed injectable epinephrine including the number and racial mix of students in each school, student age, grade level, race, sex, and allergic disorder requiring epinephrine.
TextSentencer_T204 19725-19909 Sentence denotes Surveyed school districts were two predominately white (98%) suburban districts enrolling 5855 students and one urban area with a minority population of 60% enrolling 16, 020 students.
TextSentencer_T205 19910-19975 Sentence denotes The use of epinephrine for peanut allergy was analyzed in detail.
TextSentencer_T206 19976-19984 Sentence denotes Results:
TextSentencer_T207 19985-20090 Sentence denotes A total of 181 of 21, 875 (0.83%) students in three school systems were dispensed injectable epinephrine.
TextSentencer_T208 20091-20129 Sentence denotes Males outnumbered females (110 to 71).
TextSentencer_T209 20130-20170 Sentence denotes Whites outnumbered non-whites 153 to 28.
TextSentencer_T210 20171-20243 Sentence denotes Two thirds (n=116) of children dispensed epinephrine had peanut allergy.
TextSentencer_T211 20244-20310 Sentence denotes The second most common allergy was stinging insect allergy (n=34).
TextSentencer_T212 20311-20475 Sentence denotes The rate of dispensed epinephrine for peanut allergy was lowest in the urban school district (0.30%) versus the two suburban districts, 1.1% and 1.26% respectively.
TextSentencer_T213 20476-20534 Sentence denotes Whites with peanut allergy outnumbered nonwhites 99 to 19.
TextSentencer_T214 20535-20570 Sentence denotes Males outnumbered females 69 to 49.
TextSentencer_T215 20571-20723 Sentence denotes The lowest rate of prescribed injectable epinephrine for peanut allergy in all three school districts was found in 9612 non-white school children-0.17%.
TextSentencer_T216 20724-20822 Sentence denotes Eighty-nine of 118 (75%) school children with peanut allergy were enrolled in grades PK through 5.
TextSentencer_T217 20823-20976 Sentence denotes There were twice as many white versus non-white (32 to 16) school children in the urban system with prescribed injectable epinephrine for peanut allergy.
TextSentencer_T218 20977-21095 Sentence denotes Only eight (.11%) of 7209 Hispanic and Asian students in the were dispensed injectable epinephrine for peanut allergy.
TextSentencer_T219 21096-21108 Sentence denotes Conclusions:
TextSentencer_T220 21109-21227 Sentence denotes This is the first study to suggest that there may be a racial disparity in the prevalence of childhood peanut allergy.
TextSentencer_T221 21228-21418 Sentence denotes One possible explanation for this disparity is that varied feeding practices in minority infants and children may induce a state of tolerance and lead to a lower incidence of peanut allergy.
TextSentencer_T222 21419-21423 Sentence denotes F.I.
TextSentencer_T223 21424-21436 Sentence denotes Hsu * , H.J.
TextSentencer_T224 21437-21451 Sentence denotes Burstein, M.C.
TextSentencer_T225 21452-21473 Sentence denotes Castells, Boston, MA.
TextSentencer_T226 21474-21487 Sentence denotes INTRODUCTION:
TextSentencer_T227 21488-21672 Sentence denotes Trastuzumab is a humanized IgG1 kappa monoclonal antibody specific for human epidermal growth factor receptor 2 protein, HER2, used in the treatment of Her2/neu positive breast cancer.
TextSentencer_T228 21673-21839 Sentence denotes We present the first report of desensitization to trastuzumab in a patient with an IgE-mediated reaction to trastuzumab and documented IgG-anti-IgG1 human antibodies.
TextSentencer_T229 21840-21849 Sentence denotes METH-ODS:
TextSentencer_T230 21850-22146 Sentence denotes A 37 year old woman with metastatic invasive ductal breast cancer (ER/PR positive, Her-2 strongly positive), unresponsive to conventional therapy, presented with an anaphylactic reaction to trastuzumab and was evaluated for rapid desensitization by skin testing and serum specific IgG antibodies.
TextSentencer_T231 22147-22195 Sentence denotes The patient had previously received trastuzumab.
TextSentencer_T232 22196-22204 Sentence denotes RESULTS:
TextSentencer_T233 22205-22329 Sentence denotes The anaphylactic reaction to trastuzumab consisted of diffuse erythema, urticaria, respiratory distress and laryngeal edema.
TextSentencer_T234 22330-22435 Sentence denotes Premedication with steroids, H1 and H2 blockade, and slow infusion did not prevent a subsequent reaction.
TextSentencer_T235 22436-22558 Sentence denotes Skin prick testing with trastuzumab (21mg/ml) was positive with 2 negative controls, confirming an IgE-mediated mechanism.
TextSentencer_T236 22559-22636 Sentence denotes IgG anti-human IgG1 antibodies (HAHA) to trastuzumab were confirmed by ELISA.
TextSentencer_T237 22637-22857 Sentence denotes The patient was desensitized to trastuzumab 2 mg/kg with an intravenous protocol that started at 0.5 mcg/h, and increased in rate every 15 minutes until a final rate of 30 mg/h, for a total infusion time of 6 to 8 hours.
TextSentencer_T238 22858-22938 Sentence denotes Premedication included diphenhydramine, prednisone, famotidine, and montelukast.
TextSentencer_T239 22939-23070 Sentence denotes Desensitization was confirmed by negative skin prick and intradermal tests (2 mg/ml and 21 mg/ml), with positive histamine control.
TextSentencer_T240 23071-23143 Sentence denotes The patient tolerated a total of 10 weekly doses of trastuzumab 2 mg/kg.
TextSentencer_T241 23144-23249 Sentence denotes Intradermal skin testing prior to her 5th and 10th courses showed reactivity, indicating resensitization.
TextSentencer_T242 23250-23327 Sentence denotes Serum levels of tratuzumab were undetectable at 1 week after desensitization.
TextSentencer_T243 23328-23339 Sentence denotes CONCLUSION:
TextSentencer_T244 23340-23411 Sentence denotes Allergic reactions to trastuzumab are rare but can include anaphylaxis.
TextSentencer_T245 23412-23651 Sentence denotes In patients with documented HAHA and/or IgE-mediated reactions to trastuzumab and clinical symptoms of type I/mast cell mediator-related symptoms, desensitization can allow continued administration of this treatment by providing tolerance.
TextSentencer_T246 23652-23762 Sentence denotes The clinical effectiveness of desensitizations in patients with IgE and HAHA antibodies remains to be defined.
TextSentencer_T247 23763-23857 Sentence denotes In contrast to reports in the medical literature, details of the medical aspects were limited.
TextSentencer_T248 23858-23946 Sentence denotes There were 2 attacks on infants bringing the total to 3 reported infant attacks to date.
TextSentencer_T249 23947-24008 Sentence denotes Two of the 3 infants suffered long term morbidity and 1 died.
TextSentencer_T250 24009-24143 Sentence denotes Like those reported in the medical literature, the majority of adults were in long term care facilities, although 2 were in hospitals.
TextSentencer_T251 24144-24214 Sentence denotes Overall, 6 of the 20 individuals stung died within one week of stings.
TextSentencer_T252 24215-24367 Sentence denotes No significant medical consequences of stings were reported in 6 of 10 of the newspaper reports as opposed to 2 of 10 reports in the medical literature.
TextSentencer_T253 24368-24379 Sentence denotes CONCLUSION:
TextSentencer_T254 24380-24565 Sentence denotes Our data suggest that increasing numbers of fire ant attacks are occurring in medical facilities, where chronically ill, frequently immobile patients come in contact with foraging ants.
TextSentencer_T255 24566-24648 Sentence denotes Unattended infants in private homes in fire ant endemic areas also appear at risk.
TextSentencer_T256 24649-24760 Sentence denotes The factors that determine why individuals are stung and the severity of injury after attacks remain uncertain.
TextSentencer_T257 24761-24895 Sentence denotes The presence of fire ants inside health care facilities and homes is a harbinger for fire ant attacks of disabled or infant occupants.
TextSentencer_T258 24896-25033 Sentence denotes We hypothesize that morbidity is determined by the number of stings, the condition of the patient and the type of treatment administered.
TextSentencer_T259 25034-25042 Sentence denotes Purpose:
TextSentencer_T260 25043-25121 Sentence denotes To determine if gender confers a risk for positive penicillin (PCN) skin test.
TextSentencer_T261 25122-25129 Sentence denotes Method:
TextSentencer_T262 25130-25318 Sentence denotes Rates of positive PCN skin tests, according to gender, were determined in patients with a history of PCN allergy undergoing an allergy pre-operative evaluation from June 2002 to June 2004.
TextSentencer_T263 25319-25482 Sentence denotes During this period, 19, 429 patients were seen in the pre-operative evaluation clinic in which 1921 had a history of PCN allergy and comprise our study population.
TextSentencer_T264 25483-25784 Sentence denotes A univariate logistic regression analysis was employed to calculate the odds ratio (OR) and the 95% confidence interval (CI) for gender differences in the rates of positive PCN skin test and a multivariate logistic regression analysis was used to adjust for age and history of multiple drug allergies.
TextSentencer_T265 25785-25850 Sentence denotes P-value of 0.05 or less was considered statistically significant.
TextSentencer_T266 25851-25859 Sentence denotes Results:
TextSentencer_T267 25860-25984 Sentence denotes Of the 1921 patients, 1759 underwent skin testing for PCN, 157 patients did not, and 5 charts were not available for review.
TextSentencer_T268 25985-26030 Sentence denotes The mean age of the study group was 60 years.
TextSentencer_T269 26031-26089 Sentence denotes Sixtyfour (3.6%) patients had a positive skin test to PCN.
TextSentencer_T270 26090-26183 Sentence denotes Of these, 53 (83%) were females and 11 (17%) were males (OR 3.6, 95% CI 1.9-7.2, p = 0.0001).
TextSentencer_T271 26184-26280 Sentence denotes Of those with a negative/equivocal PCN skin test, 960 (57%) were females versus 720 (43%) males.
TextSentencer_T272 26281-26491 Sentence denotes In a multivariate logistic regression analysis adjusted for age and history of multiple drug allergies, female gender again was more likely to have a positive PCN skin test (OR 4.7, 95% CI 2.3-10.5 p < 0.0001).
TextSentencer_T273 26492-26583 Sentence denotes 157 patients did not undergo PCN skin testing, 62 (40%) were male and 95 (60%) were female.
TextSentencer_T274 26584-26595 Sentence denotes Conclusion:
TextSentencer_T275 26596-26722 Sentence denotes This is the first report showing that a greater risk for a positive skin test to PCN exists in association with female gender.
TextSentencer_T276 26723-26835 Sentence denotes Age and a history of multiple drug allergies are unlikely to be confounding factors to the observed gender risk.
TextSentencer_T277 26836-26955 Sentence denotes Further studies are needed to identify other possible confounding factors and/or mechanisms that can explain this risk.
TextSentencer_T278 26956-26958 Sentence denotes A.
TextSentencer_T279 26959-26976 Sentence denotes Fiocchi 1* , P.A.
TextSentencer_T280 26977-26991 Sentence denotes Restani 1 , S.
TextSentencer_T281 26992-27008 Sentence denotes Cucchiara 2 , G.
TextSentencer_T282 27009-27024 Sentence denotes Lombardi 3 , G.
TextSentencer_T283 27025-27042 Sentence denotes Magazzu' 4 , G.L.
TextSentencer_T284 27043-27059 Sentence denotes Marseglia 5 , K.
TextSentencer_T285 27060-27079 Sentence denotes Pittschieler 6 , S.
TextSentencer_T286 27080-27094 Sentence denotes Tripodi 2 , R.
TextSentencer_T287 27095-27110 Sentence denotes Troncone 7 , A.
TextSentencer_T288 27111-27126 Sentence denotes Vierucci 8 , 1.
TextSentencer_T289 27127-27143 Sentence denotes Milan, Italy; 2.
TextSentencer_T290 27144-27159 Sentence denotes Roma, Italy; 3.
TextSentencer_T291 27160-27178 Sentence denotes Pescara, Italy; 4.
TextSentencer_T292 27179-27197 Sentence denotes Messina, Italy; 5.
TextSentencer_T293 27198-27214 Sentence denotes Pavia, Italy; 6.
TextSentencer_T294 27215-27233 Sentence denotes Bolzano, Italy; 7.
TextSentencer_T295 27234-27251 Sentence denotes Napoli, Italy; 8.
TextSentencer_T296 27252-27267 Sentence denotes Firenze, Italy.
TextSentencer_T297 27268-27279 Sentence denotes Background:
TextSentencer_T298 27280-27404 Sentence denotes Cow milk substitutes for children allergic to cow milk proteins (CMP) include soy-based formula and cow s milk hydrolysates.
TextSentencer_T299 27405-27447 Sentence denotes Neither can rule out a sensitisation risk.
TextSentencer_T300 27448-27458 Sentence denotes Objective:
TextSentencer_T301 27459-27612 Sentence denotes Prospective assessment of clinical tolerance to a rice-based hydrolysate formula by children allergic to cow milk proteins (CMP) who consume rice openly.
TextSentencer_T302 27613-27634 Sentence denotes Patients and methods:
TextSentencer_T303 27635-27913 Sentence denotes Ninety-seven children aged 4 to 136 months with immediate reactions to cow milk confirmed during DBPCFC were assessed for clinical tolerance to cow milk by SPT with whole milk, -lactalbumin (ALA), -lactoglobulin (BLG), -and -casein ( -Cas, -Cas) (Sigma Chemical, St. Louis, Mo).
TextSentencer_T304 27914-28031 Sentence denotes Whole milk, ALA, BLG and Cas specific IgE determinations were performed using CAP test (Pharmacia, Uppsala, Sweden) .
TextSentencer_T305 28032-28111 Sentence denotes Similarly, sensitisation to rice and HRF were investigated by SPT and CAP test.
TextSentencer_T306 28112-28212 Sentence denotes Patients sera were investigated by immunoblotting for CMP, rice and HRF (Heinz-Plada, Milan, Italy).
TextSentencer_T307 28213-28323 Sentence denotes DBPCFC was carried our with 24 g RHF powder masked in Neocate TM (equivalent to 180 mL reconstituted formula).
TextSentencer_T308 28324-28423 Sentence denotes Results: SPT: all patients were positive to cow s milk and/or CMP fractions (>3 mm wheal diameter).
TextSentencer_T309 28424-28558 Sentence denotes IgE determinations gave positive results with cow milk and/or CMP fractions (72/84 patients tested), rice (16/81) and with HRF (2/85).
TextSentencer_T310 28559-28677 Sentence denotes Immunoblots (n=87) were positive for -Cas (n=46), -Cas (n=34), ALA (n=39), BLG (n=34) and bovine serum albumin (n=52).
TextSentencer_T311 28678-28778 Sentence denotes Similarly, although patients sera largely recognized rice (78/87), only one weakly reacted with RHF.
TextSentencer_T312 28779-28824 Sentence denotes Challenge with RHF was negative in all cases.
TextSentencer_T313 28825-28837 Sentence denotes Conclusions:
TextSentencer_T314 28838-28958 Sentence denotes We conclude that, despite their frequent sensitisation to rice, children with CMA tolerate both rice and RHF clinically.
TextSentencer_T315 28959-29055 Sentence denotes Hydrolyzed rice formulas may thus represent an alternative protein source for children with CMA.
TextSentencer_T316 29056-29060 Sentence denotes R.C.
TextSentencer_T317 29061-29080 Sentence denotes Cartwright * , W.K.
TextSentencer_T318 29081-29100 Sentence denotes Dolen, Augusta, GA.
TextSentencer_T319 29101-29114 Sentence denotes Introduction:
TextSentencer_T320 29115-29272 Sentence denotes Conventional treatment of human seminal fluid allergy includes abstinence, barrier protection, or subcutaneous immunotherapy with fractionated seminal fluid.
TextSentencer_T321 29273-29509 Sentence denotes Treatment using local intravaginal desensitization with unfractionated seminal fluid has recently been described, but experience with this desensitization method is still limited and little has been reported as to its long-term results.
TextSentencer_T322 29510-29518 Sentence denotes Methods:
TextSentencer_T323 29519-29689 Sentence denotes A 30-year-old woman with a history of allergic rhinitis and asthma experienced anaphylaxis following her first unprotected intercourse since the birth of her first child.
TextSentencer_T324 29690-29886 Sentence denotes IgE-mediated sensitization was demonstrated through the use of specific IgE testing (Pharmacia CAP System) and skin prick testing using undiluted seminal fluid obtained from the patient's husband.
TextSentencer_T325 29887-30098 Sentence denotes After approval from the Human Assurance Committee, the patient underwent rush intravaginal desensitization with steadily increasing concentrations of seminal fluid, beginning with a 1:10, 000 v/v concen-tration.
TextSentencer_T326 30099-30107 Sentence denotes Results:
TextSentencer_T327 30108-30168 Sentence denotes Her specific IgE level to human seminal fluid was 0.26 kU/L.
TextSentencer_T328 30169-30278 Sentence denotes Skin prick testing was positive with a wheal of 10 mm diameter with pseudopods and a flare of 25 mm diameter.
TextSentencer_T329 30279-30398 Sentence denotes Desensitization was successful and the patient tolerated local application of whole semen without significant reaction.
TextSentencer_T330 30399-30542 Sentence denotes Following desensitization, the patient reported that she and her husband engaged in unprotected intercourse without local or systemic symptoms.
TextSentencer_T331 30543-30728 Sentence denotes Over the last year since the desensitization, she has not experienced further anaphylaxis, but she has developed local symptoms if her exposure to seminal fluid was delayed past 5 days.
TextSentencer_T332 30729-30788 Sentence denotes The longest time period between exposures has been 2 weeks.
TextSentencer_T333 30789-30866 Sentence denotes She became pregnant 5 months ago and has not had any pregnancy complications.
TextSentencer_T334 30867-30879 Sentence denotes Conclusions:
TextSentencer_T335 30880-30998 Sentence denotes Local intravaginal desensitization was a safe and effective treatment for human seminal fluid allergy in this patient.
TextSentencer_T336 30999-31181 Sentence denotes A delay in seminal fluid exposure greater than 5 days was associated with the return of symptoms emphasizing the need for frequent seminal fluid exposure to maintain desensitization.
TextSentencer_T337 31182-31184 Sentence denotes L.
TextSentencer_T338 31185-31200 Sentence denotes Terracciano, T.
TextSentencer_T339 31201-31213 Sentence denotes Sarratud, A.
TextSentencer_T340 31214-31228 Sentence denotes Fiocchi * , P.
TextSentencer_T341 31229-31240 Sentence denotes Restani, S.
TextSentencer_T342 31241-31262 Sentence denotes Guerci, Milan, Italy.
TextSentencer_T343 31263-31373 Sentence denotes BACKGROUND Kiwifruit allergy in children has been seldom reported and the reactions observed are usually mild.
TextSentencer_T344 31374-31409 Sentence denotes Anaphylaxis has not been described.
TextSentencer_T345 31410-31559 Sentence denotes We document the case of an infant who developed anaphylacic symptoms within minutes of his mother eating two kiwifruits and initiating breastfeeding.
TextSentencer_T346 31560-31742 Sentence denotes CASE HISTORY In his fourth month, the boy was admitted into an emergency department with dysphonia, breathing difficulties, generalised urticaria and angioedema of the lips and face.
TextSentencer_T347 31743-31963 Sentence denotes This episode was treated as an anaphylactic reaction with epinephrine, chlorpheniramine and hydrocortisone sodium succinate administered via a percutaneous catheter and symptomatic control was achieved within 30 minutes.
TextSentencer_T348 31964-32066 Sentence denotes After 15 days a second anaphylactic episode of similar severity occurred under the same circumstances.
TextSentencer_T349 32067-32106 Sentence denotes Neither episode required critical care.
TextSentencer_T350 32107-32197 Sentence denotes The boy presented two months later for clinical evaluation in our paediatric allergy unit.
TextSentencer_T351 32198-32492 Sentence denotes Skin prick tests (SPT) were positive only with egg white and yolk while negative to cow s milk (and protein fractions), beef, chicken, pork, codfish, rice, wheat, soybean, maize, potato, carrot, tomato, bean, pea, celery, peanut, Dermatophagoides pteronyssinus and D. farinae, grass and banana.
TextSentencer_T352 32493-32624 Sentence denotes SPT with kiwifruit was specifically ordered because exquisite contact was suspected, and induced a positive wheal (>3 mm diameter).
TextSentencer_T353 32625-32926 Sentence denotes Positive specific IgE determinations (CAP-FEIA from Pharmacia, Sweden) with kiwifruit (0.71 kU/L), cat dander (1.97 kU/L) and egg white (1.97 kU/L) were returned but determinations with other inhalant and food allergens were all below the cut-off point of 0.35 kU/L and total IgE levels were 155 kU/L.
TextSentencer_T354 32927-33056 Sentence denotes Strict avoidance of kiwifruit by the breastfeeding mother proved effective and nothing untoward happened in the intervening year.
TextSentencer_T355 33057-33126 Sentence denotes Currently aged 2.5 years, the boy is free from food-related symptoms.
TextSentencer_T356 33127-33297 Sentence denotes Prick-byprick tests with native allergens and SPT carried out with commercial extracts of allergens associated in the literature with kiwifruit allergy were all negative.
TextSentencer_T357 33298-33379 Sentence denotes COMMENT There are no reports of immediate reactions to kiwifruit under two years.
TextSentencer_T358 33380-33531 Sentence denotes In this case, severe reactions via breastmilk in an infant monosensitised to kiwifruit indicate that nursing may represent a hidden source of exposure.
TextSentencer_T359 33532-33680 Sentence denotes In older children monosensitisation without prior sensitisation to pollen has been described as the major risk associated with severity of symptoms.
TextSentencer_T360 33681-33683 Sentence denotes M.
TextSentencer_T361 33684-33699 Sentence denotes Sikora * , J.W.
TextSentencer_T362 33700-33712 Sentence denotes Sleasman, N.
TextSentencer_T363 33713-33748 Sentence denotes Tangsinmankong, St. Petersburg, FL.
TextSentencer_T364 33749-33762 Sentence denotes Introduction:
TextSentencer_T365 33763-33904 Sentence denotes Treacher-Collins Syndrome (TCS) is an autosomal dominant disorder with an abnormality of craniofacial development during early embryogenesis.
TextSentencer_T366 33905-34007 Sentence denotes There is a known relationship between new bone formation and development of lymphocytes and cytokines.
TextSentencer_T367 34008-34086 Sentence denotes The association of TCS and humoral immunodeficiency has not yet been reported.
TextSentencer_T368 34087-34199 Sentence denotes We present a novel case of a 12 year-old Caucasian female patient with TCS and common variable immunodeficiency.
TextSentencer_T369 34200-34208 Sentence denotes Methods:
TextSentencer_T370 34209-34388 Sentence denotes Our patient presented with midface hypoplasia, micrognathia, microtia, conductive hearing loss and cleft palate with a history of recurrent upper and lower respiratory infections.
TextSentencer_T371 34389-34512 Sentence denotes Patient had a 10-year history of chronic sinusitis, recurrent otitis media and pneumoniae which resulted in bronchiectasis.
TextSentencer_T372 34513-34610 Sentence denotes Haemophilus influenza and Staphylococcus aureus were persistently isolated from bronchial fluids.
TextSentencer_T373 34611-34665 Sentence denotes Laboratory work-up for immunodeficiency was initiated.
TextSentencer_T374 34666-34674 Sentence denotes Results:
TextSentencer_T375 34675-34901 Sentence denotes Immunoglobulin analysis revealed low IgG 450 (528-2190 mg/dL); low IgA 42 (44-441mg/dL); IgM 65 (48-226mg/dL); IgG 1 354 (165-1440 mg/dL); low IgG 2 59 (71-460 mg/dL); IgG 3 85 (28-125 mg/dL); and low IgG 4 <8.1 (2-143 mg/dL).
TextSentencer_T376 34902-35092 Sentence denotes Patient had no detectable response to protein-derived vaccines (diphtheria and tetanus) and to polysaccharide-derived vaccines (pneumococcal) at baseline and at 4-6 weeks after immunization.
TextSentencer_T377 35093-35194 Sentence denotes T and B lymphocyte enumeration, CH50, AH50, and mannose-binding lectin were all within normal limits.
TextSentencer_T378 35195-35286 Sentence denotes Laboratory findings were consistent with the diagnosis of common variable immunodeficiency.
TextSentencer_T379 35287-35407 Sentence denotes Patient began receiving monthly doses of 550 mg/kg/dose of intravenous immunoglobulin resulting in clinical improvement.
TextSentencer_T380 35408-35584 Sentence denotes Our patient no longer requires antibiotic therapy for her respiratory infections; pulmonary function has improved and bronchiectasis resolved 6 months after initiation of IVIG.
TextSentencer_T381 35585-35596 Sentence denotes Conclusion:
TextSentencer_T382 35597-35750 Sentence denotes Our finding shows that TCS can be associated with common variable immunodeficiency which suggests a link between skeletal dysplasia and immunodeficiency.
TextSentencer_T383 35751-35755 Sentence denotes A.S.
TextSentencer_T384 35756-35771 Sentence denotes Hartel * , J.W.
TextSentencer_T385 35772-35784 Sentence denotes Sleasman, N.
TextSentencer_T386 35785-35820 Sentence denotes Tangsinmankong, St. Petersburg, FL.
TextSentencer_T387 35821-35834 Sentence denotes Introduction:
TextSentencer_T388 35835-35927 Sentence denotes Streptococcus pneumoniae is the most common cause of invasive bacterial infection in humans.
TextSentencer_T389 35928-36027 Sentence denotes However, incidence of S. pneumoniae infections in healthy adolescents is low (5/100, 000 per year).
TextSentencer_T390 36028-36230 Sentence denotes Mannose-binding lectin (MBL) is a C-type lectin which plays a central role in the innate immune response by activating the classical complement pathway and acting as an opsonin by binding c1q receptors.
TextSentencer_T391 36231-36385 Sentence denotes Several studies have demonstrated an association between invasive bacterial infections, including S. pneumoniae and a homozygous mutation of the MBL gene.
TextSentencer_T392 36386-36489 Sentence denotes However, this association has not previously been described in patients with the heterozygous mutation.
TextSentencer_T393 36490-36498 Sentence denotes Methods:
TextSentencer_T394 36499-36595 Sentence denotes A 13-year-old Caucasian female presented with a second episode of meningitis over a 4-year span.
TextSentencer_T395 36596-36683 Sentence denotes Streptococcus pneumoniae was isolated from peripheral blood cultures on both occasions.
TextSentencer_T396 36684-36829 Sentence denotes Lumbar puncture revealed WBC 22, 600; 6% bands; 83% PMNs; glucose 3 mg/dL, protein 329 mg/dL; these results consistent with bacterial meningitis.
TextSentencer_T397 36830-36924 Sentence denotes Extensive evaluation for predisposing causes revealed benign Arnold-Chiari type1 malformation.
TextSentencer_T398 36925-36972 Sentence denotes Further immunological evaluation was initiated.
TextSentencer_T399 36973-36981 Sentence denotes Results:
TextSentencer_T400 36982-37096 Sentence denotes Evaluation revealed IgG 867 mg/dL (normal 528-2190); IgA 67 (44-441); IgM 181 (48-226), and normal IgG subclasses.
TextSentencer_T401 37097-37165 Sentence denotes Antibody responses to diphtheria and tetanus vaccines were adequate.
TextSentencer_T402 37166-37292 Sentence denotes Antibodies response to pneumococcal vaccine given 4 years prior were protective to all 10 common serotype tests (>1.4 mcg/mL).
TextSentencer_T403 37293-37344 Sentence denotes Lymphocyte subset analysis was within normal range.
TextSentencer_T404 37345-37411 Sentence denotes Howell-Jolly bodies were not detected from peripheral blood smear.
TextSentencer_T405 37412-37500 Sentence denotes Evaluation for secondary immunodeficiency was negative, including HIV antibody by ELISA.
TextSentencer_T406 37501-37611 Sentence denotes Complement analysis showed CH50 88 U/mL (65-95); AH50 71% (66-129%), and markedly low MBL of 74 ng/mL (>1000).
TextSentencer_T407 37612-37801 Sentence denotes Genetic analysis of her MBL revealed heterozygous mutation in codon 54 and mutations in two promoter regions (homozygous mutation on H/L variants and heterozygous mutation on P/Q variants).
TextSentencer_T408 37802-37813 Sentence denotes Conclusion:
TextSentencer_T409 37814-38047 Sentence denotes Heterozygous mutation of MBL codon when associated with mutation of promoter regions can result in severe impairment of MBL protein production, and may lead to increased susceptibility to invasive bacterial infections and meningitis.
TextSentencer_T410 38048-38058 Sentence denotes Rationale:
TextSentencer_T411 38059-38205 Sentence denotes Patients with similar symptoms may have allergic, non-allergic, or mixed rhinitis triggers and can differentially respond to distinct medications.
TextSentencer_T412 38206-38346 Sentence denotes We assessed ST in our clinic patient population to characterize factors that influence appropriate diagnosis and treatment of rhinitis type.
TextSentencer_T413 38347-38355 Sentence denotes Methods:
TextSentencer_T414 38356-38626 Sentence denotes We used a validated commercial questionnaire and chart review of 230 patients seen in an academic allergy clinic, to assess the number of allergic vs. irritant ST and demographic and historical factors (including pharmacotherapy) associated with differences in symptoms.
TextSentencer_T415 38627-38635 Sentence denotes Results:
TextSentencer_T416 38636-38658 Sentence denotes The population (n=189:
TextSentencer_T417 38659-38735 Sentence denotes 138 female, 51 male) consisted of individuals with a mixed rhinitis history.
TextSentencer_T418 38736-38974 Sentence denotes Women had higher ST scores than men, including: total scores [10.44+/-0.51 vs. 7.20+/-0.65, p=0.0001 (unpaired t-test)]: allergen scores (4.56+/-0.30 vs. 3.51+/-0.37, p=0.0055); and irritant scores (5.58+/-0.29 vs. 3.69+/-0.41, p=0.0003).
TextSentencer_T419 38975-39127 Sentence denotes Further, patients treated with both azelastine (Az) and intranasal steroids (INS) had lower ST scores than patients treated with either alone (Total ST:
TextSentencer_T420 39128-39201 Sentence denotes Az 10.06+/-0.94, INS 10.3+/-0.97, both 8.0+/-0.88, p=0.0348; Allergen ST:
TextSentencer_T421 39202-39303 Sentence denotes Az 4.69+/-0.54, INS 5.05+/-0.37, both 3.11+/-0.50, p=0.0416; Irritant ST: no significant difference).
TextSentencer_T422 39304-39316 Sentence denotes Conclusions:
TextSentencer_T423 39317-39404 Sentence denotes Female patients have significantly higher symptom scores; total, allergic and irritant.
TextSentencer_T424 39405-39523 Sentence denotes Rhinitis monotherapy (INS or Az) is minimally effective in reducing ST but is more effective when used in combination.
TextSentencer_T425 39524-39644 Sentence denotes These data demonstrate rhinitis population heterogeneity and address differential responsiveness to similar medications.
TextSentencer_T426 39645-39862 Sentence denotes Increased response to combined drug therapy support the heterogeneous pathophysiology of mixed rhinitis features and may relate to a combination of multiple aeroallergen and air pollution exposure in the Houston area.
TextSentencer_T427 39863-39876 Sentence denotes Introduction:
TextSentencer_T428 39877-39994 Sentence denotes Interaction between eye & nose warrants attention with regard to the propagation and treatment of allergic reactions.
TextSentencer_T429 39995-40142 Sentence denotes The role of topical therapy for rhinitis and conjunctivitis is becoming more widely considered and questions of therapeutic route have been raised.
TextSentencer_T430 40143-40151 Sentence denotes Purpose:
TextSentencer_T431 40152-40316 Sentence denotes To elucidate the anatomic and pharmacokinetic interactions of conjunctival & nasal mucosa leading to more rational selection of routes of medication administration.
TextSentencer_T432 40317-40448 Sentence denotes Methods:Our studies have investigated the effect of ocularly instilled allergen inducing signs and symptoms of rhinoconjunctivitis.
TextSentencer_T433 40449-40631 Sentence denotes 1 study compared effects of allergen administered via conjunctival allergen challenge (CAC) or nasal allergen challenge (NAC) and analyzed tear & nasal secretions for ECP & tryptase.
TextSentencer_T434 40632-40774 Sentence denotes Studies have also used the ability of the CAC model to induce rhinitis signs & symptoms to evaluate the relative effects of medication routes:
TextSentencer_T435 40775-40885 Sentence denotes 1) ocular v. nasal spray v. systemic; 2) ocular + nasal spray v. systemic + nasal spray; 3) ocular v. placebo.
TextSentencer_T436 40886-40894 Sentence denotes Results:
TextSentencer_T437 40895-41078 Sentence denotes The NAC/CAC study revealed that, following CAC (N=34), significant ocular and nasal signs & symptoms were noted; following NAC (N=39), only nasal symptoms were clinically significant.
TextSentencer_T438 41079-41223 Sentence denotes Nasal symptom scores between CAC & NAC differed significantly at 1 timepoint, representing lag in allergen & mediator movement from eye to nose.
TextSentencer_T439 41224-41377 Sentence denotes Measurable levels of ECP & tryptase were found in tears and nasal secretions for CAC, but only in nasal secretions (with exception of 1 subject) for NAC.
TextSentencer_T440 41378-41393 Sentence denotes In CAC studies:
TextSentencer_T441 41394-41569 Sentence denotes 1) ocular therapy exhibited greater efficacy in ocular itching relief (N=73;P<0.05) and was not significantly different from nasal or systemic therapy in nasal symptom relief.
TextSentencer_T442 41570-41733 Sentence denotes 2) eyedrop+nasal spray combination exhibited significantly greater prevention of overall rhinoconjunctivitis signs and symptoms than nasal+systemic therapy (N=80).
TextSentencer_T443 41734-41841 Sentence denotes 3) ocular therapy offered greater protection from nasal signs & symptoms compared to placebo (N=32;P<0.05).
TextSentencer_T444 41842-42004 Sentence denotes Conclusion: NAC and CAC results support the unidirectional flow from eye to nose, the ability of CAC to yield nasal symptoms, and the efficacy of topical therapy.
TextSentencer_T445 42005-42124 Sentence denotes Tearing, due to inflammation of the inferior turbinate would be the only ocular symptom resulting from nasal challenge.
TextSentencer_T446 42125-42324 Sentence denotes These results offer insight to the nature of the connection between ocular and nasal mucosa and the efficacy of varied medication administration routes for management of rhinoconjunctivitis symptoms.
TextSentencer_T447 42325-42338 Sentence denotes Introduction:
TextSentencer_T448 42339-42471 Sentence denotes Asthma disease management programs frequently target high utilizers because they are responsible for a large amount of asthma costs.
TextSentencer_T449 42472-42572 Sentence denotes Once identified, such "frequent fliers" usually are offered interventions including case management.
TextSentencer_T450 42573-42648 Sentence denotes Programs using this approach usually demonstrate reductions in utilization.
TextSentencer_T451 42649-42823 Sentence denotes Though the interventions may cause this decline, it could also be due to regression to the mean (RTM) which is a tendency for outliers to become more like the mean over time.
TextSentencer_T452 42824-42980 Sentence denotes In this study we measured RTM in a Medicaid HMO asthma population to determine whether targeted case management is effective independent of this phenomenon.
TextSentencer_T453 42981-43080 Sentence denotes We hypothesized that directed case management provides additional utilization reduction beyond RTM.
TextSentencer_T454 43081-43089 Sentence denotes Methods:
TextSentencer_T455 43090-43203 Sentence denotes A weighted asthma utilization score was determined quarterly for members of an HMO with asthma from 2000 to 2004.
TextSentencer_T456 43204-43321 Sentence denotes RTM was measured by determining how many patients were persistent high utilizers quarterly for 1 year after baseline.
TextSentencer_T457 43322-43466 Sentence denotes To determine the effect of utilization-directed case management, the number of frequent fliers at baseline for each quarter also was determined.
TextSentencer_T458 43467-43475 Sentence denotes Results:
TextSentencer_T459 43476-43549 Sentence denotes A total of 296 asthma frequent fliers were identified on January 1, 2001.
TextSentencer_T460 43550-43632 Sentence denotes By September 1, 2001 only 15 of these individuals continued to be frequent fliers.
TextSentencer_T461 43633-43748 Sentence denotes Similar decreases in utilization were seen for frequent fliers identified at the beginning of each quarter of 2001.
TextSentencer_T462 43749-43822 Sentence denotes The mean decrease in the number of frequent fliers is shown in the Table.
TextSentencer_T463 43823-43876 Sentence denotes This represents a substantial regression to the mean.
TextSentencer_T464 43877-44048 Sentence denotes The total number of high utilizers at baseline decreased by 27% after implementation of utilization-directed case management in 2002 independent of regression to the mean.
TextSentencer_T465 44049-44238 Sentence denotes This also represented a decrease from 1.6% of health plan members with asthma to 0.6% by the start of 2004 suggesting that the decline is not a result of diminishing health plan membership.
TextSentencer_T466 44239-44346 Sentence denotes The benefit appears to be the result of early intervention with members before they become frequent fliers.
TextSentencer_T467 44347-44359 Sentence denotes Conclusions:
TextSentencer_T468 44360-44504 Sentence denotes Utilization-directed case management can reduce overall asthma utilization by preventing members from becoming high utilizers at an early stage.
TextSentencer_T469 44505-44647 Sentence denotes Programs that claim to intervene with plan members who already are high utilizers are likely to be taking advantage of regression to the mean.
TextSentencer_T470 44648-44723 Sentence denotes Studies indicate a high incidence of asthma(AS) among school-aged children.
TextSentencer_T471 44724-44796 Sentence denotes With the prevalence increasing, significant numbers remain unidentified.
TextSentencer_T472 44797-44932 Sentence denotes They experience morbidity, including school absenteeism, which may be preventable, in part, by adherence to National Asthma Guidelines.
TextSentencer_T473 44933-45079 Sentence denotes We implemented a pilot study to detect AS, AS control and initiation of appropriate health care among 7th grade students in a suburban population.
TextSentencer_T474 45080-45174 Sentence denotes The study was coordinated with the middle school staff and the local county health department.
TextSentencer_T475 45175-45206 Sentence denotes The screen parameters included:
TextSentencer_T476 45207-45316 Sentence denotes Student questionnaires, peak flows, exercise with peak flow assessment (FRAST)2, and Spirometry as indicated.
TextSentencer_T477 45317-45364 Sentence denotes Environmental tobacco smoke (ETS) was recorded.
TextSentencer_T478 45365-45373 Sentence denotes RESULTS:
TextSentencer_T479 45374-45396 Sentence denotes 196 students screened.
TextSentencer_T480 45397-45439 Sentence denotes 131 no AS history and negative screen (D).
TextSentencer_T481 45440-45478 Sentence denotes 31 AS history and negative screen (E).
TextSentencer_T482 45479-45516 Sentence denotes 5 AS history and positive screen (A).
TextSentencer_T483 45517-45601 Sentence denotes 23 no AS history with suggestive written screen and negative screen on exercise (B).
TextSentencer_T484 45602-45642 Sentence denotes 6 no AS history and positive screen (C).
TextSentencer_T485 45643-45665 Sentence denotes ETS in groups A, B, C:
TextSentencer_T486 45666-45680 Sentence denotes 40%, 32%, 60%.
TextSentencer_T487 45681-45700 Sentence denotes ETS in groups D, E:
TextSentencer_T488 45701-45710 Sentence denotes 23%, 16%.
TextSentencer_T489 45711-45812 Sentence denotes Individual student results were mailed home with medical follow-up recommended for a positive screen.
TextSentencer_T490 45813-45939 Sentence denotes Parents of the 34 children who failed the questionnaire or exercise screen (Groups A, B, C) were phoned at a 6-12 wk interval.
TextSentencer_T491 45940-45989 Sentence denotes No student in-group A or B had medical follow-up.
TextSentencer_T492 45990-46039 Sentence denotes 2(33%) students in Group C had medical follow-up.
TextSentencer_T493 46040-46051 Sentence denotes CONCLUSION:
TextSentencer_T494 46052-46143 Sentence denotes This AS screen of 7th grade students identified 6(3%) as having significant, undetected AS.
TextSentencer_T495 46144-46207 Sentence denotes 5(14%) with known AS had uncontrolled AS at the time of screen.
TextSentencer_T496 46208-46312 Sentence denotes 23(11.7%) students with strong suspicion of AS based on questionnaire had an acceptable exercise screen.
TextSentencer_T497 46313-46411 Sentence denotes Only 2 of the 34 children with a screen suggestive of AS or uncontrolled AS had medical follow-up.
TextSentencer_T498 46412-46513 Sentence denotes ETS was increased in the homes of students with a positive screen and remains a serious health issue.
TextSentencer_T499 46514-46644 Sentence denotes School screening for AS has merit, but mail and phone follow-up was insufficient to intervene or initiate acceptable AS treatment.
TextSentencer_T500 46645-46658 Sentence denotes References 1.
TextSentencer_T501 46659-46677 Sentence denotes Redline S. et. al.
TextSentencer_T502 46678-46787 Sentence denotes Development and validation of school-based asthma and allergy screening instruments for parents and students.
TextSentencer_T503 46788-46815 Sentence denotes Ann Allergy Asthma Immunol.
TextSentencer_T504 46816-46825 Sentence denotes 2003; 90:
TextSentencer_T505 46826-46836 Sentence denotes 516-528 2.
TextSentencer_T506 46837-46858 Sentence denotes Tsanakas.J.N., et al.
TextSentencer_T507 46859-46894 Sentence denotes Free Running Asthma Screening Test.
TextSentencer_T508 46895-46941 Sentence denotes Arch Diseases in Childhood.1988; 63:261-265 3.
TextSentencer_T509 46942-47040 Sentence denotes American College of Allergy, Asthma, and Clinical Immunology Screening test ages (8-14) ACAAI.org.
TextSentencer_T510 47041-47054 Sentence denotes INTRODUCTION.
TextSentencer_T511 47055-47253 Sentence denotes Some laboratory evidence suggests that desloratadine is effective in inhibiting of inflammatory mediators, which play an important role not only in allergic but also in virally induced inflammation.
TextSentencer_T512 47254-47408 Sentence denotes The purpose of this study was to assess its efficacy in acute bronchiolitis developed in young children suffering from concomitant atopic dermatitis (AD).
TextSentencer_T513 47409-47418 Sentence denotes METH-ODS.
TextSentencer_T514 47419-47557 Sentence denotes Participants were 34 young boys and gilrs aged 18-36 who suffered from acute bronchiolitis as established by wheezing, rhinitis and fever.
TextSentencer_T515 47558-47640 Sentence denotes All patients also had concomitant AD as established by Hanifin and Rafka criteria.
TextSentencer_T516 47641-47861 Sentence denotes Patients were allocated to receive syrup formulation of desloratadine (Erius, Schering Plough) 1, 25 mg/day for 5 days (active group n=17) or no desloratadine treatment (control group n=17) using Quota Allocation System.
TextSentencer_T517 47862-48254 Sentence denotes We calculated physical global symptom score (combination of cough, wheezing, chest retractions, nasal flaring, blocked nose, runny nose, sore throat -0-5 scale) and Respiratory Distress Assessment Instrument (RDAI) to examine the patient at baseline and on day 5th after therapy was initiated, day of normalization of body temperature, respiratory rate, heart beat rate, and use of albuterol.
TextSentencer_T518 48255-48263 Sentence denotes RESULTS.
TextSentencer_T519 48264-48485 Sentence denotes Both group of patients were comparable on age, gender, family history of asthma, time of onset of the acute respiratory illness, extent of medication taken prior to entering the study, global symptom score and RDAI index.
TextSentencer_T520 48486-48591 Sentence denotes All children were evenly treated with oxygen, oral theophylline (10 mg/kg/day) and adequately rehydrated.
TextSentencer_T521 48592-48718 Sentence denotes On day 5th global symptom score of patients receiving desloratadine was 2, 51±0, 51 vs 3, 42±0, 62 in control group (p=0.035).
TextSentencer_T522 48719-48917 Sentence denotes On day 5th it was also significant difference between active and control groups on RDAI index (4, 44±1, 24 vs 7, 23±2, 30; p=0.046) especially for significant drop in wheezing score in active group.
TextSentencer_T523 48918-49056 Sentence denotes Day when respiratory/heart rate normalized, temperature returned to normal, use of albuterol did not differ significantly in these groups.
TextSentencer_T524 49057-49069 Sentence denotes CONCLUSIONS.
TextSentencer_T525 49070-49234 Sentence denotes Our preliminary study is the first to show that desloratadine is an effective agent in viral lower respiratory tract infections of young children suffering from AD.
TextSentencer_T526 49235-49349 Sentence denotes It encourages further GCP trials to explore action of desloratadine in infantile bronchiolitis and concomitant AD.
T99937 49350-49354 Sentence denotes H.J.
T43672 49355-49366 Sentence denotes Su * , W.T.
T74430 49367-49376 Sentence denotes Lin, P.J.
T95816 49377-49387 Sentence denotes Tsai, C.Y.
T58298 49388-49399 Sentence denotes Huang, P.C.
T8121 49400-49419 Sentence denotes Wu, Tainan, Taiwan.
T34201 49420-49587 Sentence denotes Increasing prevalence of childhood asthma has been observed across the world, and found to be associated with, partly, indoor pollution, including bioaerosol exposure.
T55427 49588-49818 Sentence denotes Meanwhile, adequate ventilation is shown to be effective in diluting most indoor air pollutants, while only limited data are available addressing directly how the ventilation rate is implicated with childhood respiratory symptoms.
T95543 49819-50143 Sentence denotes This study aimed to examine the concentration distribution of selected indoor air pollutants, including bioaerosols, in domestic environment, and further to assess the effects of ventilation rate, characterized by a CO2 trace gas concentration decay method, on concentration variations of the above-mentioned air pollutants.
T48484 50144-50338 Sentence denotes Study subjects were chosen from a prior city-wide questionnaire survey based on positive response to inquiry for physician-diagnosed asthmatic status and wheezing symptoms in the past 12 months.
T36286 50339-50488 Sentence denotes Environmental assessments, including ventilation and air quality measurements, were conducted twice, 1 in early winter and the other on early summer.
T3642 50489-50614 Sentence denotes Respiratory health diary and PEFR (Peak Expiratory Flow Rate) were recorded for 1 week concurrent with the sampling activity.
T42683 50615-50726 Sentence denotes Increasing ventilation rate is statistically associated with decreasing indoor concentrations of CO2 and TVOCs.
T58349 50727-50922 Sentence denotes After adjustment for sex, age, and selected housing characteristics, the OR between TVOCs concentrations and reporting cough of study children is 9.47, and 12.84 between CO2 and nasal congestion.
T34957 50923-51093 Sentence denotes The OR between indoor bacterial concentration and the morning PEFR less 80% is 10.98 in the similar multivariate logistic regression for data collected from winter study.
T30336 51094-51264 Sentence denotes In summer, the only significant relationship is between ventilation rate and the morning PEFR less 80% of study children, OR= 0.17, in a multivariate logistic regression.
T85923 51265-51552 Sentence denotes This study has identified less reporting of childhood respiratory symptoms, especially for coughing and the morning PEFR less 80% are associated with increasing ventilation rate, and higher levels of indoor air pollution appear to be present with greater frequency of the above symptoms.
T40509 51553-51705 Sentence denotes This study suggest quantitatively that proper management of ventilation efficiency may be beneficial for the control of childhood respiratory illnesses.
T9451 51706-51872 Sentence denotes *Adjusted for: sex, age, environmental tobacco exposure, use of incense and air conditioner **:p<0.05 NS:no statistical significance with whole model test Background:
T22272 51873-51991 Sentence denotes Moderate-to-severe allergic asthma can have a substantial impact on a patient's asthma-related quality of life (ARQL).
T13524 51992-52175 Sentence denotes In addition to asthma symptoms, allergic rhinitis, rhinosinusitis and other related comorbidities are often apparent in patients with more severe disease making it difficult to treat.
T59909 52176-52319 Sentence denotes Despite guideline-consistent care, many patients still experience variability in asthma control signaling an unmet need within this population.
T53903 52320-52415 Sentence denotes Omalizumab (Xolair®) has recently demonstrated clinical efficacy and safety in treating asthma.
T91888 52416-52426 Sentence denotes Objective:
T26840 52427-52556 Sentence denotes The aim of this paper is to summarize the ARQL outcomes associated with omalizumab therapy in moderate-to-severe allergic asthma.
T22910 52557-52565 Sentence denotes Methods:
T62747 52566-52688 Sentence denotes We performed a systematic review of ARQL data from the Clinical Study Reports and published clinical trials on omalizumab.
T48646 52689-52766 Sentence denotes ARQL was measured by the Juniper-Asthma Quality of Life Questionnaire (AQLQ).
T7685 52767-52775 Sentence denotes Results:
T20283 52776-52874 Sentence denotes Statistically significant results for ARQL endpoints consistently favored omalizumab over placebo.
T40234 52875-52962 Sentence denotes The magnitude of the changes in ARQL were consistently aligned with clinical endpoints.
T47296 52963-53133 Sentence denotes Moderate to large effect sizes in the omalizumab groups were maintained throughout the 28-week clinical trial program and during the 24-week double-blind extension phase.
T68696 53134-53231 Sentence denotes However, the placebo groups also experienced within-group improvements and moderate effect sizes.
T53766 53232-53474 Sentence denotes A meta-analysis indicated a 1.6 to 2.0 fold increase in large (>1.0 point) improvements in overall AQLQ scores in the omalizumab-treated group compared with placebo during the stabilization and steroid-reduction phases of the clinical trials.
T17977 53475-53487 Sentence denotes Conclusions:
T72869 53488-53691 Sentence denotes The consistently positive impact of omalizumab on ARQL outcomes during the clinical trial program provides evidence of its value as an adjunct therapy in patients with moderate-to-severe allergic asthma.
T52233 53692-53880 Sentence denotes Significant differences and large effect sizes were observed despite the fact that the control group received active, guideline-consistent treatment producing a substantial placebo effect.
T3179 53881-54095 Sentence denotes Improvements were observed in Overall, Symptom, Activity, Emotional and Environmental dimensions of the AQLQ indicating that omalizumab produced benefits in ARQL in patients with moderate-to-severe allergic asthma.
T41878 54096-54107 Sentence denotes Background:
T20291 54108-54341 Sentence denotes Omalizumab, a monoclonal anti-IgE antibody, significantly improves asthma-related quality of life (ARQL) for patients with moderatesevere allergic asthma who express symptoms despite moderate-high inhaled corticosteroids (ICS) doses.
T71473 54342-54403 Sentence denotes Mean scores can mask underlying variability in ARQL outcomes.
T74399 54404-54513 Sentence denotes This investigation examined variability in outcomes to elucidate the specific impact of omalizumab treatment.
T87828 54514-54851 Sentence denotes Methods: AQLQ data (n=948) from two randomized, double-blind, placebo-controlled clinical trials were pooled to assess underlying variability in the mean scores and to identify key drivers of ARQL treatment-effect differences (Juniper-Asthma Quality of Life Questionnaire (AQLQ)) between omalizumab and placebo (active control) patients.
T35684 54852-54860 Sentence denotes Results:
T51040 54861-54963 Sentence denotes Correlations between AQLQ and other clinical outcomes were low to moderate at best (r=0.14 to r=0.60).
T34044 54964-55048 Sentence denotes AQLQ assessment captures patient benefit that supplements clinical outcome measures.
T97940 55049-55190 Sentence denotes Across all component items of the AQLQ patients receiving omalizumab improved more than patients receiving placebo (active control) (p<0.05).
T90054 55191-55311 Sentence denotes Omalizumab patients reported the greatest improvement for reducing waking with symptoms in the morning (Symptoms domain:
T77567 55312-55391 Sentence denotes 2.06 vs. 1.50; p<0.001), limitations in all activities done (Activities domain:
T1392 55392-55478 Sentence denotes 1.18 vs. 0.68; p<0.001), the fear of not having medication available (Emotions domain:
T30135 55479-55563 Sentence denotes 0.99 vs. 0.60; p<0.01), and symptoms from being exposed to dust (Environment domain:
T3118 55564-55635 Sentence denotes 1.31 vs. 0.88; p<0.001), compared to placebo (active control) patients.
T77947 55636-55793 Sentence denotes Conclusion: ARQL assessment provides complementary and non-overlapping information on clinical benefit that is distinct from other clinical outcome measures.
T45962 55794-56071 Sentence denotes Examination of underlying variability in AQLQ mean scores and item-level response extend previously published results on omalizumab treatment effect by showing that aggregate ARQL improvements for omalizumab patients are strongly influenced by symptom and activity improvement.
T46486 56072-56074 Sentence denotes A.
T75165 56075-56088 Sentence denotes Brimer 1 , K.
T95861 56089-56098 Sentence denotes Malhi, C.
T23581 56099-56108 Sentence denotes Adams, C.
T3189 56109-56134 Sentence denotes Dinakar, Kansas City, MO.
T83580 56135-56148 Sentence denotes INTRODUCTION:
T23501 56149-56267 Sentence denotes The desire to belong to a group is a very powerful motivator and is exceptionally strong in the adolescent population.
T79337 56268-56321 Sentence denotes Asthma is a disease that makes people feel different.
T89237 56322-56396 Sentence denotes This perception may impinge on patient adherence with medication regimens.
T99309 56397-56589 Sentence denotes We hypothesize that belonging to a club where every member has asthma may encourage identification of the adolescent asthmatic with their peers, and mitigate the perception of being different.
T59700 56590-56813 Sentence denotes OBJECTIVES: (1) To investigate the factors that make the asthmatic adolescent feel different (2) To explore the hypothesis that group activities, such as an asthma club, would help adolescent asthmatics feel less different.
T5918 56814-56822 Sentence denotes METHODS:
T11575 56823-57004 Sentence denotes As part of an ongoing survey, children with asthma between the ages of 8-18 years were offered an anonymous questionnaire in the primary care and adolescent clinics at our hospital.
T92017 57005-57130 Sentence denotes The questionnaire included both multiple-choice and open-ended questions designed to explore the feelings of the respondents.
T64949 57131-57198 Sentence denotes The responses were numerically tallied and reported as percentages.
T44100 57199-57207 Sentence denotes RESULTS:
T17180 57208-57282 Sentence denotes At the present time, 31 surveys out of a proposed 100 have been completed.
T59560 57283-57384 Sentence denotes One third of the youth with asthma answering the survey had negative feelings regarding their asthma.
T78106 57385-57505 Sentence denotes Nearly forty percent of the respondents reported that their diagnosis made them feel different from their healthy peers.
T16319 57506-57643 Sentence denotes Forty-five percent responded that they have felt restricted or excluded from school activities, athletics, and clubs due to their asthma.
T55581 57644-57733 Sentence denotes Over one-third of them feel uncomfortable taking their inhaler in front of their friends.
T86041 57734-57802 Sentence denotes Most respondents (93.6%) indicated that they enjoy group activities.
T55941 57803-57893 Sentence denotes The majority of respondents (89.7%) rated playing sports as their favorite group activity.
T37347 57894-57905 Sentence denotes CONCLUSION:
T35042 57906-58092 Sentence denotes Almost forty percent of asthmatic youth surveyed indicated that having asthma made them feel different and resulted in restriction/exclusion from school activities, athletics, and clubs.
T58968 58093-58213 Sentence denotes An overwhelming majority expressed a preference for participation in group activities, particularly recreational sports.
T88751 58214-58400 Sentence denotes This social preference towards group activities may be incorporated into an intervention, such as an asthma club, to help asthmatic youth adjust to the disease and its treatment regimen.
T4586 58401-58414 Sentence denotes INTRODUCTION:
T54050 58415-58558 Sentence denotes Airway hyperresponsiveness (AHR) is an exaggerated narrowing of the airways in response to stimuli, such as allergens, histamine, and cold air.
T66952 58559-58639 Sentence denotes AHR is a characteristic feature of asthma linked to chronic airway inflammation.
T16081 58640-58754 Sentence denotes Phosphodiesterase 4 (PDE4) is an enzyme found in key inflammatory cells involved in the pathophysiology of asthma.
T53134 58755-58867 Sentence denotes Inhibitors of PDE4 prevent the breakdown of cyclic adenosine monophosphate, a natural modulator of inflammation.
T84771 58868-59000 Sentence denotes Roflumilast is an investigational, oral, once-daily PDE4 inhibitor, which has shown anti-inflammatory activity in vitro and in vivo.
T50499 59001-59158 Sentence denotes This study examined the effect of a single dose of roflumilast on changes in AHR following allergen-induced asthmatic reactions in patients with mild asthma.
T5352 59159-59167 Sentence denotes METHODS:
T82766 59168-59290 Sentence denotes This double-blind, randomized, crossover study consisted of 2 treatment periods separated by a 2-to 5-week washout period.
T6015 59291-59667 Sentence denotes A total of 13 patients (forced expiratory volume in one second [FEV 1 ] 70% predicted) who were hyperresponsive to histamine (provocative concentration causing a 20% drop in FEV 1 [PC 20 FEV 1 ] 16 mg/mL) were randomized to receive a single dose of oral roflumilast 1000μg or placebo on Day 1 of each treatment period followed by an allergen challenge 60 min after medication.
T96289 59668-59747 Sentence denotes Histamine provocation was performed before and 24 h after intake of study drug.
T50984 59748-59756 Sentence denotes RESULTS:
T95107 59757-59885 Sentence denotes There was no change in FEV 1 60 min after roflumilast administration, suggesting the absence of direct or acute bronchodilation.
T71141 59886-60009 Sentence denotes Allergen challenge elicited early and late asthmatic reactions that were attenuated by a single dose of roflumilast 1000μg.
T16382 60010-60146 Sentence denotes The histamine PC 20 FEV 1 in patients treated with roflumilast decreased to a lesser extent than in those patients treated with placebo.
T38960 60147-60289 Sentence denotes The change in PC 20 FEV 1 from baseline after challenge was 2.51 ± 2.95 mg/mL (mean ± SD) with placebo and 1.23 ± 2.75 mg/mL with roflumilast.
T15637 60290-60438 Sentence denotes The magnitude of the change in PC 20 FEV 1 was statistically significantly different between the placebo and roflumilast treatment groups (p=0.002).
T46971 60439-60530 Sentence denotes Thus, roflumilast decreased the development of AHR by approximately 1.1 doubling-dilutions.
T73738 60531-60543 Sentence denotes CONCLUSIONS:
T5037 60544-60617 Sentence denotes A single dose of oral roflumilast 1000μg attenuated allergen-induced AHR.
T28824 60618-60777 Sentence denotes These data provide further evidence that roflumilast may provide anti-inflammatory activity in vivo and may be an effective treatment for patients with asthma.
T34012 60778-60914 Sentence denotes INTRODUCTION For the past 7 years we have been tracking pediatric asthma admissions and evaluations at the Huntington Memorial Hospital.
T18842 60915-61190 Sentence denotes During the fall and winter months (Oct-March) from 1996 to 2002, we noted a 1.6 X increase in the number of asthma admissions and evaluations compared with the spring and summer (April -September; 4, 993 patient encoun-ANNALS OF ALLERGY, ASTHMA & IMMUNOLOGY ters in 7 years).
T44900 61191-61243 Sentence denotes We have analyzed potential causes for this increase.
T29161 61244-61388 Sentence denotes Diesel particulate was estimated in 1998-9, and a 2.5-fold increase in the fall versus spring was found in Burbank, a city adjacent to Pasadena.
T74426 61389-61578 Sentence denotes Pollutant particles from the combustion of fossil fuels may act as immuno-adjuvants to allergen exposure as has been demonstrated experimentally in mice and in human nasal exposure studies.
T32722 61579-61740 Sentence denotes METHODS Computerized analysis of asthma admissions and evaluations were calculated according to established codes for acute and chronic reactive airways disease.
T81053 61741-61820 Sentence denotes Infectious diseases in patients were analyzed by standard asthma questionnaire.
T8237 61821-61925 Sentence denotes Also, pollen and mold counts, as well as diesel particulates and meteorological conditions were studied.
T25019 61926-62018 Sentence denotes RESULTS Similar numbers of viral infections occurred in the fall of 2001 and spring of 2002.
T31117 62019-62178 Sentence denotes Among the most prevalent pollens and molds are Chinese Elm pollen (Sept -Oct) weed pollens (July -Dec), and a newly recognized Aureobasidium mold (Nov -March).
T65865 62179-62313 Sentence denotes Pollen grains can fragment and release respirablesized debris that are loaded with allergens (Taylor et al 2002 (Taylor et al , 2004 .
T87055 62314-62412 Sentence denotes The conidia of Aureobasidium are also of respirable size and were identified by sequence analysis.
T25309 62413-62541 Sentence denotes Fine particulate air pollution (PM2.5), containing diesel particles, is increased in the fall and winter in Southern California.
T6239 62542-62653 Sentence denotes CON-CLUSIONS The incidence of asthma outbreaks may vary with air pollution levels in the immediate environment.
T38761 62654-62765 Sentence denotes Pollen fragments and particles from fossil fuel combustion can deposit in similar regions of the lower airways.
T76173 62766-62866 Sentence denotes Rainfall increases in the fall and winter and this coincides with increased molds and Aureobasidium.
T64527 62867-63009 Sentence denotes Aureobasidium was recently discovered in high concentrations in Pasadena, is known to be allergenic and could be a factor in increased asthma.
T95614 63010-63167 Sentence denotes A mixture of pollens and molds and fine combustion particles may be relevant to this increased incidence of asthma in the fall and winter months in Pasadena.
T49713 63168-63353 Sentence denotes Background We have previously noted that tree and ragweed pollen grains can be airborne for most if not all daily periods during their respective seasons (AAAAI, 2003) , (ACAAI, 2003) .
T96414 63354-63543 Sentence denotes Because grass levels are lower than those of trees & weeds (AAAAI / NAB), we chose a longer daily interval to examine (six hours) that we had for trees (one hour) and ragweed (three hours).
T54492 63544-63669 Sentence denotes Methods Twenty-four hour microscope slide samples were collected using a Burkard 7 day air sampler from 05/01/04 to 06/30/04.
T137 63670-63740 Sentence denotes The slides were examined @ 100 X along a single longitudinal traverse.
T40613 63741-63836 Sentence denotes The presence or absence of grass pollen was noted per six-hour segment (six successive fields).
T45971 63837-63949 Sentence denotes Results The presence of airborne grass pollen during the 4 daily segments was sparse the first two weeks of May.
T29613 63950-64081 Sentence denotes It gradually increased during the next 10 days, and then was detected during most of the daily segments through to the end of June.
T50198 64082-64277 Sentence denotes # Ammophila arenaria (AA) is a highly resilient grass with habitat in Europe, North America, Australia, New Zealand, South Africa and the Mediterranean, used predominantly for dune stabilization.
T86294 64278-64419 Sentence denotes Patients with atopic diseases including allergic reactions to pollen are transferred to coastal regions in order to minimize pollen exposure.
T22816 64420-64508 Sentence denotes In spite of the presence of AA pollens, patients experience allergy relief at the coast.
T3739 64509-64743 Sentence denotes Our study examines the contradiction between the presence of strong grass allergens and the absence of allergic symptoms in atopic patients, and whether allergic cross-reactions among different types of grass pollen include AA pollen.
T78760 64744-64890 Sentence denotes 9 adult patients presenting symptoms of grass pollen allergy underwent prick testing and RAST testing to grass pollen mix and extracted AA pollen.
T82443 64891-65062 Sentence denotes 4 subjects showed positive results in prick and RAST testing to AA extracts and were subsequently tested via rhinomanometry for reactions to AA using prick test solutions.
T85134 65063-65189 Sentence denotes 2 subjects showed positive reactions to prick tests for AA extract and grass pollen mix, but did not show specific antibodies.
T59951 65190-65291 Sentence denotes All other sera showed elevated specific IgE levels, with specific reactions on 8 protein bands of AA.
T85696 65292-65410 Sentence denotes In sera incubated with grass pollen extract, almost all specific bands previously detected with AA were now inhibited.
T15976 65411-65545 Sentence denotes 3 patients with high levels of total and specific IgE to AA showed weak bands after inhibition, demonstrating the allergenicity of AA.
T19413 65546-65736 Sentence denotes Comparing data from coastal and mainland weather stations in June and July from 1961 to 1990, coastal wind speeds average 6.6 to 6.9 m/s while inland wind speeds average only 3.6 to 3.7 m/s.
T84720 65737-65790 Sentence denotes High wind speeds likely dilute pollen concentrations.
T599 65791-65994 Sentence denotes Based on findings of an inverse relationship between wind speed and pollen concentration in the dispersion of ragweed pollen, we hypothesize that concentrations of AA pollens may be similarly influenced.
T20276 65995-66303 Sentence denotes No sensitized patient reported allergic symptoms in coastal areas inhabited by AA plants, indicating that under natural conditions, either the plant modifies its pollen allergenicity or that environmental conditions including salt aerosols, wind patterns, topography or light exposure cause the modification.
T23979 66304-66501 Sentence denotes As such patterns are likely to become more dramatic as the effects of global climate change transform the natural environment, these findings may also become relevant for other grass allergy types.
T46109 66502-66619 Sentence denotes Asthma is the most common chronic inflammatory disorders of the airways with increased prevalence in the past decade.
T91645 66620-66744 Sentence denotes It is characterized by airway obstruction, airway inflammation and airway hyperresponsiveness (AHR) to non-specific stimuli.
T72173 66745-66971 Sentence denotes In this study, we examined the effect of a novel class of molecule, OCID1001, in inhibiting antigen-induced early and late allergic response (EAR and LAR), AHR, and airway eosinophilia in mouse and guinea pig models of asthma.
T13490 66972-67070 Sentence denotes Pulmonary functions were measured in conscious unrestrained animals by whole-body plethysmography.
T11741 67071-67232 Sentence denotes Animals were sensitized with ovalbumin (OVA; 20mg, intraperitoneally) with 2mg alum followed by treatment with OCID1001 (120mg/kg, i.p. twice daily for 10 days).
T29028 67233-67293 Sentence denotes After the last dose, animals were challenged with ovalbumin.
T23857 67294-67369 Sentence denotes Pulmonary functions were recorded for EAR and LAR and 24 hrs later for AHR.
T93819 67370-67448 Sentence denotes This was followed by bronchoalveolar lavage, blood and lung tissue collection.
T29461 67449-67588 Sentence denotes Treatment with OCID1001 (120mg/kg) significantly attenuated LAR in OVA-sensitized and challenged mice or guinea pigs with no effect on EAR.
T48414 67589-67691 Sentence denotes AHR to methacholine in mice and to histamine in guinea pigs were prevented by treatment with OCID1001.
T66484 67692-67874 Sentence denotes OCID1001 attenuated the rise in total number of inflammatory cells in the lung and almost ablated the rise in BAL eosinophilia in the lung due to antigen sensitization and challenge.
T78464 67875-68045 Sentence denotes Effect of OCID1001 on pulmonary functions and airway inflammation in OVA-sensitized and challenged mice were comparable to that of dexamethasone in both models of asthma.
T63545 68046-68235 Sentence denotes These data suggest that OCID1001prevents the underlying pathophysiological changes in allergic airway inflammation and therefore could prove beneficial in the treatment of bronchial asthma.
T66119 68236-68242 Sentence denotes MA; 2.
T8611 68243-68258 Sentence denotes Madison, WI; 3.
T13932 68259-68275 Sentence denotes Portland, OR; 4.
T48966 68276-68293 Sentence denotes Milwaukee, WI; 5.
T52370 68294-68308 Sentence denotes Normal, IL; 6.
T53157 68309-68323 Sentence denotes Denver, CO; 7.
T82842 68324-68343 Sentence denotes Los Angeles, CA; 8.
T70614 68344-68356 Sentence denotes Fremont, CA.
T13792 68357-68370 Sentence denotes Introduction.
T41422 68371-68579 Sentence denotes Daclizumab (Zenapax®), a humanized monoclonal antibody directed against the IL-2 receptor chain (CD25), is approved for prevention of renal allograft rejection and is under evaluation for treatment of asthma.
T63508 68580-68735 Sentence denotes Daclizumab inhibits activation of human T lymphocytes by blocking IL2induced proliferation, and by reducing production of Th2-and Th1-associated cytokines.
T5067 68736-68910 Sentence denotes We recently reported that daclizumab improved pulmonary function in a phase II trial of patients with moderate to severe chronic persistent asthma (JACI, 2004, 113 (2):S286).
T98157 68911-69051 Sentence denotes We now report additional data from this trial on the possible role of daclizumab as an anti-inflammatory agent that affects asthma outcomes.
T32369 69052-69060 Sentence denotes Methods.
T43863 69061-69290 Sentence denotes 116 non-smoking asthmatics age 18-70 with baseline FEV1 50-80% predicted despite use of 1200 mcg daily inhaled triamcinolone (TAA) or equivalent were enrolled in a randomized, multi-center, double-blind, placebo-controlled trial.
T88077 69291-69421 Sentence denotes Patients were randomized (3:1) to i.v. daclizumab (2 mg/kg followed by 1 mg/kg every 2 weeks) or placebo added to stable dose TAA.
T82438 69422-69536 Sentence denotes Starting at week 12, patients underwent 25% reduction of TAA every 2 weeks while continuing study drug to week 20.
T35190 69537-69545 Sentence denotes Results.
T86738 69546-69688 Sentence denotes Patients on daclizumab demonstrated a prolonged time to exacerbation requiring systemic steroid rescue compared to placebo patients (p=0.024).
T85371 69689-69857 Sentence denotes Exacerbation rates were reduced in the daclizumab group compared to the placebo group for the 20-week steroid-stable and steroid-taper phases (11.6% vs. 28.6%, p=0.09).
T94665 69858-70008 Sentence denotes Patients on daclizumab demonstrated decreased peripheral eosinophil counts from baseline to week 20 (-30±20 /mm 3 vs. placebo +60±30 /mm 3 , p=0.004).
T92909 70009-70199 Sentence denotes Daclizumab-treated patients with elevated baseline serum eosinophil cationic protein (sECP) had a significant reduction in sECP from baseline to day 56 compared to placebo patients (p<0.01).
T31352 70200-70398 Sentence denotes Peripheral eosinophils decreased significantly in daclizumab patients who had no asthma exacerbations compared to an increase in daclizumab-treated patients with at least one exacerbation (p=0.032).
T75943 70399-70411 Sentence denotes Conclusions.
T44249 70412-70491 Sentence denotes Daclizumab reduces time to and frequency of exacerbation in treated asthmatics.
T19834 70492-70704 Sentence denotes The mechanisms of this effect remain to be fully elucidated, but initial findings suggest that associated reductions in circulating eosinophil and eosinophil products may play a role in these therapeutic effects.
T75700 70705-70784 Sentence denotes HAE is a genetic deficiency causing a decrease in C1 esterase inhibitor levels.
T44894 70785-70864 Sentence denotes It is a rare condition (approximate prevalence 1:10000 to 1:50000 individuals).
T99716 70865-71150 Sentence denotes It is manifest by acute attacks of swelling which can involve the larynx (a potentially life threatening condition), the GI tract (causing a syndrome similar to an acute abdominal catastrophe) or the skin and soft tissue of the patient including the limbs, face and external genitalia.
T8682 71151-71209 Sentence denotes There is no approved therapy for acute attacks in the USA.
T26100 71210-71317 Sentence denotes Pathogenesis of this potentially fatal condition is thought due to excessive activity of plasma kallikrein.
T53714 71318-71472 Sentence denotes DX-88 is a specific and highly active (Ki 40 pM) recombinant inhibitor of human plasma kallikrein undergoing evaluation in HAE and cardiopulmonary bypass.
T31691 71473-71502 Sentence denotes It is an animal free product.
T83116 71503-71667 Sentence denotes A double blind, randomised (5:1 drug to placebo) placebo controlled dose ascending study of DX-88 in acute attacks of HAE was run in the USA and the European Union.
T3696 71668-71733 Sentence denotes Four dose groups of 12 patients were to be included in the study.
T97952 71734-71772 Sentence denotes The doses were 5, 10, 20 and 40 mg/m2.
T40780 71773-71929 Sentence denotes The primary outcome variables were proportion of patients achieving a significant clinical response within 4 hours of administration of therapy, and safety.
T87089 71930-72052 Sentence denotes Secondary endpoints included site response, dose response, and median time to significant response by site and dose group.
T27482 72053-72207 Sentence denotes DX-88 met its primary endpoint; 72% of DX-88 patients had a significant improvement within 4 hours, (placebo response rate 25%, difference 47% p= 0.0169).
T38593 72208-72274 Sentence denotes Patients receiving DX-88 responded in a median time of 70 minutes.
T29701 72275-72388 Sentence denotes There was no difference in proportions of cases that responded within 4 hours between the three anatomical sites.
T12973 72389-72488 Sentence denotes Time to significant response did not significantly differ between dose groups and anatomical sites.
T92646 72489-72593 Sentence denotes The safety profile was comparable for patients treated with DX-88 and placebo, in terms of SAEs and AEs.
T13705 72594-72737 Sentence denotes In conclusion, DX-88 in this double blind study was shown to be statistically superior by 47% to placebo and to be at least as safe as placebo.
T75477 72738-72807 Sentence denotes The drug is effective at treating any HAE site, including the larynx.
T19921 72808-72871 Sentence denotes DX-88 represents an important advance in the management of HAE.
T25006 72872-73014 Sentence denotes AR is among the most common chronic childhood disorders, and is most effectively treated with intranasally inhaled glucocorticosteroids (ICS).
T1844 73015-73128 Sentence denotes Recent evidence suggests that intranasal ICS therapy may suppress HPA axis function and decrease growth velocity.
T31222 73129-73340 Sentence denotes This study reports 1-year follow-up data on 24 children (12 female, 9 African American), aged 6 to 14 years (mean 10.4 years) at entry, enrolled in a long-term growth trial of intranasal TAA for treatment of AR.
T42571 73341-73459 Sentence denotes Primary measures included height velocity, bone mineral density (BMD), serum osteocalcin and salivary cortisol levels.
T4015 73460-73531 Sentence denotes All subjects followed their expected age-appropriate growth velocities.
T59601 73532-73706 Sentence denotes Average growth velocities were 5.6 and 5.8 cm/year for girls and boys aged < 12 years, respectively, and 5.5 and 7.7 cm/year for girls and boys aged > 12 years, respectively.
T84932 73707-73949 Sentence denotes Mean (+ STD) BMD was 1.27 + 0.12 and 1.22 + 0.14 gm/cm2, mean serum osteocalcin levels were 89.1 + 25.5 and 114.5 + 32.7 ng/ml, and mean salivary cortisol levels were 16.7 + 8.0 and 11.5 + 6.5 nM/L at entry and 1-year follow-up, respectively.
T17765 73950-74098 Sentence denotes These results demonstrate no significant effect of one year of intranasal treatment with TAA on growth velocity or HPA function in children with AR.
T59532 74099-74245 Sentence denotes 13 patients 6 males, 7 females ranging in age from 66 years to 12 years, received (O) in doses ranging from 2 to 17 injections over 4 to 34 weeks.
T76558 74246-74386 Sentence denotes Patients were evaluated with symptoms scores, pulmonary function (PFT), blood eosinophil count (BEC), medication use, and allergy skin test.
T99419 74387-74516 Sentence denotes ST were initially performed by prick and if negative, by intradermal (ID) (1/1000 w/v) and if further negative by ID (1/500 w/v).
T95025 74517-74607 Sentence denotes Skin tests were performed immediately before and 20 minutes after the administration of O.
T4010 74608-74642 Sentence denotes There was no change in PFT or BEC.
T19589 74643-74798 Sentence denotes However there were significant reductions in symptom scores, including nocturnal asthma (<.0001), exercise tolerance (<.0001), sense of well being(<.0001).
T3769 74799-74877 Sentence denotes In addition, parenthetically there was a reduction in nasal symptoms (<.0001).
T81773 74878-74967 Sentence denotes There were also significant declines in medication use especially for albuterol (<.0001).
T22141 74968-75031 Sentence denotes ST declined in all patients evaluated and dramatically in many.
T75267 75032-75120 Sentence denotes For several individual allergens ST went from prick positive to ID (1/500 w/v) negative.
T8488 75121-75231 Sentence denotes Moreover ST declined in all instances further, 20 minutes after the administration of O except for 2 patients.
T99660 75232-75360 Sentence denotes In addition to asthma one of the patients had allergic bronchopulmonary aspergillosis and another had allergic fungal sinusitis.
T48310 75361-75547 Sentence denotes Three of the patients tested positive on prick test to mouse antigen and in each instance this became negative after administration of O with all 3 patients tolerating O without problem.
T24362 75548-75984 Sentence denotes We conclude: (1.) Administration of O is associated with an improvement in symptoms and decreased use of medications (2.) In addition there is a prominent decline in ST which is more marked 20 minutes after administration of O compared to immediately prior to administration the explanation of this finding is not apparent. (3.) O appears to be safe to administer to patients even if they demonstrate specific IgE to mouse antigen by ST
T59603 75985-75989 Sentence denotes A.P.
T30304 75990-76006 Sentence denotes Baptist * , T.S.
T98467 76007-76017 Sentence denotes Tang, J.L.
T19877 76018-76041 Sentence denotes Baldwin, Ann Arbor, MI.
T79752 76042-76055 Sentence denotes Introduction:
T5446 76056-76195 Sentence denotes Academic medical institutions are under pressure to shorten or eliminate resident elective rotations due to federal work-hour restrictions.
T9186 76196-76298 Sentence denotes It is unknown if this will affect knowledge and referral patterns for resident and faculty physicians.
T10279 76299-76466 Sentence denotes The objective of this study was to examine the factors associated with resident and faculty perceived knowledge and referral patterns towards allergy/immunology (A/I).
T15006 76467-76475 Sentence denotes Methods:
T38461 76476-76555 Sentence denotes A questionnaire was sent to 375 primary care physicians at one academic center.
T84756 76556-76695 Sentence denotes It addressed past history of A/I referrals, referral intentions for conditions that may be seen by allergists, and perceived A/I knowledge.
T80423 76696-76843 Sentence denotes Independent variables included history of an A/I rotation, gender, department, years in training/practice, and history of referral to an allergist.
T15694 76844-76852 Sentence denotes Results:
T97838 76853-76895 Sentence denotes 228 (61%) completed surveys were returned.
T36975 76896-77295 Sentence denotes Using logistic regression with forward selection, we found in the resident physician cohort those with advanced years in training or history of an A/I rotation were more likely to have increased past history of referral to an allergist (OR = 4.09, OR = 3.81), increased referral intention for chronic sinusitis to an allergist (OR = 3.51, OR = 5.18), and increased perceived A/I knowledge (OR = 2. .
T26963 77296-77455 Sentence denotes For the faculty physician cohort, those with a history of an A/I rotation were more likely to have an increased perceived knowledge about A/I (OR = 5.64-6.18).
T12777 77456-77627 Sentence denotes In addition, pediatric faculty physicians were more likely to refer asthma (OR = 5.62) and chronic eczema (OR = 17.09) to an allergist than faculty from other departments.
T10082 77628-77805 Sentence denotes Finally, faculty physicians with a past history of referral to an allergist were more likely to have refer asthma (OR = 10.64) and allergic rhinitis (OR = 9.78) to an allergist.
T402 77806-77817 Sentence denotes Conclusion:
T9325 77818-77959 Sentence denotes The factors associated with resident and faculty physician perceived knowledge, referral history, and referral intentions towards A/I differ.
T78052 77960-78052 Sentence denotes For residents, senior training level and a history of an A/I rotation appear most important.
T51940 78053-78183 Sentence denotes For faculty, history of an A/I rotation, pediatric department, and past history of referral to an allergist appear most important.
T65679 78184-78408 Sentence denotes Given that a history of an A/I rotation may increase perceived knowledge and referral patterns towards A/I, eliminating A/I rotations in medical institutions may have important consequences for patients and the field of A/I.
T11884 78409-78643 Sentence denotes Because recent anecdotal reports suggest that HBV may be an effective treatment for patients with multiple sclerosis (MS), there has been a movement of patients to zealous lay practitioners to receive multiple and repeated bee stings.
T24617 78644-78817 Sentence denotes Since this practice has real risk of possible fatal allergic reactions as well as emotional and economic costs, properly conducted studies of safety and efficacy are needed.
T98474 78818-78929 Sentence denotes The purpose of the present Phase I pilot study was to evaluate the safety of HBV extract in patients with PFMS.
T29133 78930-79142 Sentence denotes A total of 9 evaluable bee venom non-allergic patients with PFMS (21-55 years) were enrolled and were randomly divided into 4 groups, each receiving an increasing allergen dose immunization schedule for one year.
T16015 79143-79271 Sentence denotes Hyperreactivity to HBV was evaluated by questionnaire, Px and hematologic, metabolic and immunologic tests including skin tests.
T55245 79272-79497 Sentence denotes Any possible beneficial responses to therapy were evaluated by questionnaire, functional neurologic tests (FNT) and changes in measurement of somatosensory-evoked potentials (SEPs) prior to and at the completion of the study.
T67947 79498-79622 Sentence denotes No serious adverse allergic reactions were observed in any of the 9 subjects even at the highest doses of bee venom therapy.
T52544 79623-79969 Sentence denotes Although 4 of 9 subjects had worsening of neurologic symptoms during the course of bee venom therapy, requiring termination, this response could not be ascribed to side effects of the HBV or to a spontaneous worsening of the neurologic disease independent of treatment since there was no correlation of these events with the bee venom injections.
T43826 79970-80099 Sentence denotes Of the remaining 5, 3 felt that the therapy was beneficial.There were no changes either in FNT or SEPs measured during the study.
T64793 80100-80244 Sentence denotes The present report represents the first controlled study evaluating the safety of HBV as a possible adjunctive treatment for multiple sclerosis.
T39718 80245-80658 Sentence denotes While this preliminary safety study suggests that administration of repeated injections of HBV in a step-up dosage regimen in appropriately selected non-HBV allergic patients with MS had no serious adverse allergic reactions, because of the small number of subjects studied, it does not permit conclusions regarding efficacy and therefore provides little evidence to support the use of HBV in the treatment of MS.
T54135 80659-80752 Sentence denotes Much larger carefully conducted multi-center studies would be required to establish efficacy.
T97292 80753-80755 Sentence denotes I.
T50221 80756-80782 Sentence denotes Finegold * , New York, NY.
T56697 80783-80921 Sentence denotes Rush immunotherapy (RIT) has benefits for inducing immunologic desensitization in shorter periods of time than conventional immunotherapy.
T58164 80922-81012 Sentence denotes However, there is an increased risk of systemic reactions utilizing accelerated schedules.
T46832 81013-81117 Sentence denotes In the past radiocontrast media reactions have been significantly reduced using a standardized protocol.
T22664 81118-81172 Sentence denotes A modification of this protocol was used prior to RIT.
T85644 81173-81388 Sentence denotes The oral premedication consisted of 50 mgm Prednisone 12 hours, 7 hours and 1 hour prior to RIT, Fexofenadine 180 mgm at 7 hours and again 1 hour prior to the procedure, and ranitidine 300 mgm, 7 hours prior to RIT.
T98096 81389-81432 Sentence denotes Patients tolerated the premedications well.
T32715 81433-81476 Sentence denotes A signed consent was obtained prior to RIT.
T66854 81477-81615 Sentence denotes Patients were desensitized in an office setting with appropriate therapy for anaphylaxis available without an indwelling intravenous line.
T51196 81616-81836 Sentence denotes Injections generally began with 1/100 dilution of the anticipated maintenance solu-tions and were doubled every 20-30 minutes for about 2-3 hours and then the patients were observed for 1 hour or more prior to discharge.
T30197 81837-81904 Sentence denotes In this manner patients were desensitized in 2-3 half day sessions.
T30449 81905-81972 Sentence denotes The patient was injected again in 1 week, 2 weeks and then 4 weeks.
T86361 81973-82038 Sentence denotes Doses were increased if they were not at a full maintenance dose.
T91960 82039-82102 Sentence denotes If reactions occurred this process was appropriately decreased.
T56647 82103-82153 Sentence denotes Utilizing this technique 46 patients were treated.
T1952 82154-82295 Sentence denotes The average age was 35.5 years old (14-56 years of age) 72 % were males.72% of patients had allergic rhinitis, 25% asthma, 3% insect allergy.
T32521 82296-82354 Sentence denotes Patients with complicated medical illnesses were excluded.
T80756 82355-82430 Sentence denotes Nine patients had systemic reactions requiring an injection of epinephrine.
T36440 82431-82507 Sentence denotes Among the symptoms experienced were wheezing, nasal congestion and flushing.
T34384 82508-82602 Sentence denotes No patient required a second injection of epinephrine, intravenous fluids, or hospitalization.
T46245 82603-82737 Sentence denotes The patient reaction rate was 21 % of patients treated or 9 in 1073 injections or 1% of all injections given during the rush protocol.
T63945 82738-82806 Sentence denotes These results are typical of the increased rate of reactions to RIT.
T83870 82807-82936 Sentence denotes However, these systemics were mostly very mild and responded to therapy and in only one case was there a delayed 4 hour reaction.
T13070 82937-83085 Sentence denotes Thus premedication while not preventing systemic reactions seemed to modify them to make RIT in an office setting a practical and effective therapy.
T77335 83086-83415 Sentence denotes We have previously shown that oligonucleotides consisting a novel 3'-3'linked structure and synthetic immunostimulatory motif CpR (R is a synthetic purine moiety), referred to as second-generation immunomodulatory oligonucleotides (IMOs), induce potent Th1 immune responses and prevent OVAinduced allergic asthma in mouse models.
T3313 83416-83551 Sentence denotes In the present study, we examined local and systemic immune responses of IMOs following intranasal (i.n.) administration to naive mice.
T75642 83552-83649 Sentence denotes These studies showed that IMOs produce higher levels of serum and local IL-12 compared with IL-6.
T84140 83650-83787 Sentence denotes We next examined the ability of s.c. and i.n. administrated IMOs to reverse OVA-induced Th2 immune responses in a murine model of asthma.
T59358 83788-83998 Sentence denotes Treatment of OVA-sensitized and challenged mice with IMOs by either route of administration suppressed IL-5 and IL-13 levels with an increase in IFN-gamma secretion in spleen cell cultures and lung homogenates.
T81144 83999-84126 Sentence denotes IMOs decreased levels of serum IgE and IgG1 and induced higher levels of total and OVA-specific IgG2a titers in serum and BALF.
T65504 84127-84408 Sentence denotes While both routes of IMO delivery showed similar efficacy on serum and BALF immunoglobulin levels, s.c. delivery resulted in stronger systemic effects on the spleen cell cytokine production and the i.n. route of administration produced stronger local effects on the lung cytokines.
T40942 84409-84532 Sentence denotes IMOs also decreased eosinophils in BALF and suppressed inflammatory cell infiltration and goblet cell hyperplasia in lungs.
T24195 84533-84635 Sentence denotes These effects in lung were superior with i.n. administration of IMO than did with s.c. administration.
T36320 84636-84900 Sentence denotes Further studies to understand the effect of low multiple doses against a single higher dose of i.n. administered IMOs in naive mice suggest that low multiple doses induce strong Th1 responses locally while the single higher dose produces higher systemic responses.
T11329 84901-85403 Sentence denotes These findings suggest that second-generation IMOs containing CpR dinucleotides potently reverse OVA-induced Th2 immune responses with strong Th1 type cytokine induction in OVA-sensitized and challenged mice and i.n. delivery is superior to s.c. delivery in reversing OVAinduced airway inflammation and mucosal secretion. showed AIT was medically inappropriate, lacked documentation of necessity for initiation or continuation and/or had strong contraindications in 12/18 (67%) of the reviewed records.
T81962 85404-85411 Sentence denotes METHOD:
T71934 85412-85794 Sentence denotes We audited a convenience sample of our own records for documentation of necessity for (continuing) AIT, using a checklist based on the OIG report which included the following 6 criteria: an appropriate diagnosis; specific justification; exclusion of strong contraindications; signed, informed consent; a written physician order, and at least annual re-evaluation for continuing AIT.
T87506 85795-85803 Sentence denotes RESULTS:
T79310 85804-85886 Sentence denotes The first 50 charts in our alphabetized file of 80 total AIT charts were reviewed.
T97761 85887-85954 Sentence denotes The patients (21 M, 29 F) ranged in age from 9-63 yr (mean, 40 yr).
T11858 85955-86011 Sentence denotes The mean duration of AIT was 2.3 yr (range, 0.25-12 yr).
T974 86012-86164 Sentence denotes Indications for AIT included allergic rhinitis alone (68%) or with asthma (26%) or chronic sinusitis (2%), asthma alone (2%) and venom anaphylaxis (2%).
T54191 86165-86208 Sentence denotes All had initial documentation of necessity.
T2903 86209-86265 Sentence denotes Seven charts (14%) had no written order to initiate AIT.
T37650 86266-86306 Sentence denotes Nine (18%) lacked a signed consent form.
T61798 86307-86415 Sentence denotes No strong contraindication was found. (Peak flow documentation showed the asthma cases were well-controlled.
T42473 86416-86734 Sentence denotes Three episodes of AIT-induced anaphylaxis requiring epinephrine had occurred, but AIT was subsequently resumed and well-tolerated.) Seventeen (34%) charts had no documentation of re-evaluation during the preceding 6-12 months, including 3 with no documented re-evaluation during the previous 24 months or more, of AIT.
T65654 86735-86883 Sentence denotes Discontinuation of AIT was "considered" for 3 patients after 1.5, 7, and 10 yr of AIT, respectively, but all were still receiving maintenance doses.
T73763 86884-86954 Sentence denotes The estimated time for completing this review was 15-20 min per chart.
T50523 86955-86971 Sentence denotes INTER-PRETATION:
T48919 86972-87159 Sentence denotes An internal chart review for adherence to AIT practice parameters using a checklist such as ours can quickly and easily assess documentation for Medicare reimbursement and patient safety.
T57624 87160-87173 Sentence denotes Objective(s):
T1148 87174-87287 Sentence denotes Immunotherapy is an accepted mode of treatment for children suffering from allergic rhinitis and allergic asthma.
T85962 87288-87420 Sentence denotes This study demonstrates that rapid allergen vaccination (RAV) can be as safe as conventional allergen vaccination (CAV) in children.
T9996 87421-87460 Sentence denotes RAV may also improve patient adherence.
T16585 87461-87474 Sentence denotes Study design:
T42722 87475-87646 Sentence denotes 148 pediatric patients, 1-18 years of age, diagnosed with allergic rhinitis and/or mild to severe asthma underwent RAV over a 2 1/2 hour period in an office-based setting.
T26406 87647-87747 Sentence denotes All patients were premedicated with prednisone and H1 antagonists for 3 days prior to the procedure.
T20250 87748-87839 Sentence denotes Patients were monitored for reactions during the procedure and continued on a CAV schedule.
T55526 87840-87876 Sentence denotes Adherence was reviewed subsequently.
T44146 87877-87885 Sentence denotes Results:
T72085 87886-87966 Sentence denotes A total of 148 pediatric patients underwent RAV utilizing a 2 1/2 hour protocol.
T86490 87967-88052 Sentence denotes Of the 148 patients, 88 of them were male (59.5%) and 60 of them were female (40.5%).
T82810 88053-88165 Sentence denotes 143 (96.6%) of the patients had allergic rhinitis, 118 (79.7%) had asthma, and 23 (15.5%) had chronic sinusitis.
T59820 88166-88275 Sentence denotes During the procedure, 8 patients (5.4%) experienced systemic reaction, and none experienced true anaphylaxis.
T19172 88276-88479 Sentence denotes Seven of the eight patients who suffered a systemic reaction were patients with asthma on inhaled corticosteroids, three of the eight patients were male (37.5%) and five of the eight were female (62.5%).
T99675 88480-88548 Sentence denotes Every systemic reaction occurred within 15 minutes of the injection.
T43603 88549-88754 Sentence denotes Treatment usually included one or a combination of the following: nebulized breathing treatment with albuterol, two sprays in each nostril of azelastine, and diphenydramine taken orally or intramuscularly.
T78997 88755-88932 Sentence denotes Every patient that was treated was discharged within two hours, and no one required treatment with subcutaneous epinephrine, treatment for recurrent symptoms or hospitalization.
T61997 88933-89075 Sentence denotes All of the patients continued with a conventional allergen immunotherapy regimen following the rapid protocol to reach their maintenance dose.
T74569 89076-89125 Sentence denotes Typically, 6 months of build-up period was saved.
T59075 89126-89182 Sentence denotes Patients reached efficacious dosages almost immediately.
T4716 89183-89264 Sentence denotes Adherence rates were 95.3%, 90.5%, and 79.7% at 3, 6, and 12 months respectively.
T63724 89265-89277 Sentence denotes Conclusions:
T9656 89278-89416 Sentence denotes Effective doses of allergen vaccine can be safely reached using a 2 1/2 hour protocol ANNALS OF ALLERGY, ASTHMA & IMMUNOLOGY for children.
T25167 89417-89532 Sentence denotes Advantages of RAV over CAV include improved adherence with almost immediate clinical efficacy, and decreased costs.
T1457 89533-89546 Sentence denotes Introduction:
T31177 89547-89678 Sentence denotes Studies involving allergen immunotherapy (AIT) have furthered our understanding of cat allergen, proteases, and dust mite allergen.
T41703 89679-89726 Sentence denotes The impact of these data has not been assessed.
T85361 89727-89737 Sentence denotes Objective:
T23646 89738-89980 Sentence denotes To evaluate AIT prescribing trends over 12 years (1992) (1993) (1994) (1995) (1996) (1997) (1998) (1999) (2000) (2001) (2002) (2003) focusing on new prescriptions before and after published data regarding specific prescribing recommendations.
T19308 89981-89989 Sentence denotes Methods:
T68243 89990-90421 Sentence denotes A retrospective review of 38, 400 AIT prescriptions from a centralized allergy and extract laboratory database was performed with respect to published literature on findings and recommendations regarding the ubiquitous nature of cat allergen, effective dosing of cat antigen, combining protease containing extracts with those susceptible to degradation, dust mite antigen dosing, and the use of house dust versus dust mite antigen.
T56105 90422-90430 Sentence denotes Results:
T69655 90431-90632 Sentence denotes 1) In 1993, cat allergen was included in 10% of new allergy immunotherapy prescriptions reviewed; in 2003, it was included in 45% of new prescriptions, a statistically significant increase (p<0.00001).
T46260 90633-90762 Sentence denotes 2) Over the past 11 years, the mean quantity of cat antigen included in new prescriptions has been unchanged at 1mL/prescription.
T22595 90763-90930 Sentence denotes Only 5% of new prescriptions were written at the manufacturer recommended maintenance dose of 4ml, significantly less than those written below this level (p <0.00001).
T10607 90931-91071 Sentence denotes 3) There was no significant change in the percentage of extracts combining antigens with proteases with antigens susceptible to degradation.
T85693 91072-91271 Sentence denotes In 1992, 64% of prescriptions containing Alternaria and/or cockroach antigen were mixed with one or more antigens susceptible to degradation; in 2003, 56% of these extracts were still being combined.
T30689 91272-91368 Sentence denotes 4) The mean volume of dust mite mix contained in these prescriptions was between 2-2.99 ml/10ml.
T92138 91369-91444 Sentence denotes 5) Prescriptions containing dust mite rose from 20% in 1992 to 65% in 2003.
T54069 91445-91527 Sentence denotes The use of house dust was unchanged over the same period at 1.5% of prescriptions.
T9898 91528-91540 Sentence denotes Conclusions:
T88143 91541-91724 Sentence denotes Although the percentage of cat containing extracts has increased significantly, dosing of cat allergen has remained unchanged despite published literature recommending higher volumes.
T51828 91725-92077 Sentence denotes Protease-containing allergen prescribing patterns have not significantly changed from [1996] [1997] [1998] [1999] [2000] [2001] [2002] [2003] Young stage of life is a crucial period for aeroallergen sensitization, considering the immaturity of the neonatal immune system which may lead to T-cell anergy or a deviation towards Th2-type response in mice.
T38580 92078-92282 Sentence denotes The aim of this work was to evaluate the influence of oligodeoxynucleotides containing CpG motif (CpG-ODN) on ovalbumin (OVA) and Blomia tropicalis (Bt) immunization in early life compared to adult stage.
T12295 92283-92422 Sentence denotes Three days old A/Sn mice were immunized with OVA in Al(OH)3 and boosted on 10th and 30th day after immunization (dai) and bled on 37th dai.
T3996 92423-92523 Sentence denotes Groups of mice received 4mg of CpG-ODN or control-ODN associated with OVA on immunization and boost.
T49310 92524-92662 Sentence denotes Some animals from the three groups (OVA, OVA+CpG, OVA+Co) were killed at 20 days old and the spleen was collected and prepared to culture.
T14119 92663-92779 Sentence denotes Eight to 10 weeks old female A/Sn mice were immunized with OVA in Al(OH)3, boosted on 14th dai and bled on 21th dai.
T44610 92780-92871 Sentence denotes Groups of mice received 50mg of CpG-ODN or control-ODN associated with OVA on immunization.
T15824 92872-92968 Sentence denotes Animals from the three groups were challenged 3 months after immunization and bled 7 days later.
T4604 92969-93059 Sentence denotes Similar protocols were performed using Blomia tropicalis (Bt) extract in the place of OVA.
T13709 93060-93217 Sentence denotes Neonate and adult co-administration of CpG-ODN with OVA or Bt were able to significantly decrease specific IgE antibody levels and increase IgG2a production.
T6273 93218-93290 Sentence denotes Moreover, CpG-ODN decreased specific IgG1 levels in the Bt immunization.
T87948 93291-93375 Sentence denotes The co-administration of control-ODN in neonates decreased anti-OVA IgG1 production.
T87304 93376-93595 Sentence denotes After OVA-challenge 3 months later of adult immunization, a similar response was detected in the group that received CpG-ODN associated with OVA, which showed a decreased anti-OVA IgE and IgG1 and enhanced IgG2a levels.
T86458 93596-93740 Sentence denotes Analysis of cell division of neonate lymphocytes by flow cytometry showed a decreased proliferation in OVA+CpG mice group under OVA stimulation.
T30791 93741-93792 Sentence denotes This effect was seen either in B cells and T cells.
T5694 93793-93934 Sentence denotes The results showed that immunization with both allergens, OVA and Bt, associated with CpG-ODN decreased the type I hypersensitivity response.
T48209 93935-94062 Sentence denotes The pattern of antibody production suggests Th1-type response induced by CpG-ODN, and the establishment of memory Th1 response.
T16462 94063-94226 Sentence denotes This findings may imply that the use of CpG-ODN in early life seems to be beneficial as an strategy to modulate or to prevent the development of allergic diseases.
T91196 94227-94229 Sentence denotes N.
T96298 94230-94242 Sentence denotes Horne * , A.
T75565 94243-94257 Sentence denotes Capetandes, M.
T62932 94258-94282 Sentence denotes Frieri, East Meadow, NY.
T41700 94283-94296 Sentence denotes INTRODUCTION:
T60638 94297-94409 Sentence denotes It has been shown that dust mite allergens can affect the functioning of airway epithelial cells (Winton et. al.
T66831 94410-94438 Sentence denotes Br J Pharm 124:1048 , 1998 .
T26523 94439-94557 Sentence denotes Previous experiments showed cA549 aggregate in the presence of Dermatophagoides pteronyssinus (Dp) (Capetandes et. al.
T92181 94558-94589 Sentence denotes Am J Clin Path, 121:25, 2004) .
T45306 94590-94711 Sentence denotes It is hypothesized that epithelial damage is associated with airway remodeling characterized by fibroblast dysregulation.
T33882 94712-94893 Sentence denotes To evaluate the response of fibroblasts to damaged airway epithelial cells, the bioactivity of serum-free conditioned media from Dp-treated cA549 cells (DpCM) was assayed with NHLF.
T39297 94894-94902 Sentence denotes METHODS:
T13356 94903-94977 Sentence denotes All experiments used insulin-transferrin-selenium supplemented DMEM (ITS).
T16037 94978-95108 Sentence denotes DpCM (generated with cA549 treated with 300 AU/ml Dp; Alk-Abello) was added to 50% confluent NHLF for 24 hours at 37oC and 5% CO2.
T45817 95109-95195 Sentence denotes ITS from cultured cA549 without Dp (ITS CM) was added to 50% confluent NHLF (control).
T81371 95196-95281 Sentence denotes Cell morphology and density were evaluated by microscopy and MTT assay, respectively.
T75206 95282-95379 Sentence denotes Data were analyzed by ANOVA followed by Student-Neuman-Keuls (SNK) at p<0.05 with power analysis.
T40944 95380-95388 Sentence denotes RESULTS:
T48848 95389-95527 Sentence denotes 50% confluent NHLF treated with DpCM showed decreased cell density (Figure 1) , and increased aggregation relative to ITS CM or ITS alone.
T76184 95528-95632 Sentence denotes NHLF in ITS alone or with direct addition of 300 AU/ml Dp to ITS (Dp ITS) showed no or weak aggregation.
T49489 95633-95739 Sentence denotes Aggregated NHLF showed 100% viability and grew to confluence when subcultured to serum-supplemented media.
T42904 95740-95853 Sentence denotes CONCLUSION: NHLF aggregation was greater, and cell density was lower with DpCM than with ITS, ITS CM, and Dp ITS.
T40726 95854-95997 Sentence denotes This suggests that Dp-treated cA549 cells release an unidentified factor or factors that contribute to NHLF aggregation and possible apoptosis.
T18313 95998-96203 Sentence denotes Identification of these factors would increase the understanding of the fibroblast response to epithelial cell exposure to Dp which may be involved in airway remodeling, a feature of chronic severe asthma.
T89359 96204-96208 Sentence denotes J.T.
T79268 96209-96228 Sentence denotes Zimmermann * , Y.C.
T15401 96229-96238 Sentence denotes Huang, M.
T96849 96239-96263 Sentence denotes Frieri, East Meadow, NY.
T66694 96264-96277 Sentence denotes Introduction:
T34309 96278-96500 Sentence denotes Budesonide has been demonstrated to inhibit IL-8, TGF and GM-CSF in ragweed and dust-mite (DM) stimulated human alveolar epithelial cells (J Allergy Clin Immunol 209:3a, 2002; Ann Allergy Asthma Immunology 90: p79, 2003) .
T83582 96501-96663 Sentence denotes RANTES production and expression in DM and IL-1 -stimulated A549 cells has recently been shown to be inhibited by budesonide (Allergy Asthma Proc, In press 2004).
T57949 96664-96768 Sentence denotes Histamine is known to influence immune response by regulating cytokine synthesis (Allergy 47:024-1992) .
T5185 96769-96897 Sentence denotes In this study we examined the effect of budesonide in the presence of histamine on IL-8 production and expression by A549 cells.
T90839 96898-97070 Sentence denotes Methods: A549 pulmonary epithelial cells were cultured in DMEM for 24 hours in 5% CO2 in the presence of 1:20 of 10, 000 AU/ml DM, 10 -6 M histamine and 10 -7 M budesonide.
T75498 97071-97227 Sentence denotes IL-8 production was measured by a sensitive ELISA and IL-8 mRNA was measured by qualitative RT-PCR using standardized primers for IL-8 with a GAPDH control.
T97859 97228-97294 Sentence denotes Results: A549 cells were stimulated by DM (65-101 pg/ml) (p<0.01).
T46406 97295-97442 Sentence denotes Budesonide alone decreased IL-8 levels to 38 pg/ml (p<0.05), and in combination with histamine further decreased IL-8 levels to 23 pg/ml (p<0.001).
T83485 97443-97571 Sentence denotes Relative intensity of IL-8 mRNA expression was reduced 12-fold in DM-stimulated cells and 2-fold in control cells by budesonide.
T96791 97572-97583 Sentence denotes Conclusion:
T49955 97584-97756 Sentence denotes Budesonide in combination with histamine showed greater inhibition of IL-8 production by A549 cells than budesonide alone possibly by increasing cell membrane permeability.
T35541 97757-97761 Sentence denotes C.R.
T80102 97762-97779 Sentence denotes Oliveira * , A.E.
T51661 97780-97792 Sentence denotes Fusaro, J.R.
T63763 97793-97805 Sentence denotes Victor, E.A.
T45525 97806-97818 Sentence denotes Futata, C.A.
T12559 97819-97830 Sentence denotes Brito, A.J.
T93160 97831-97843 Sentence denotes Duarte, M.N.
T95447 97844-97868 Sentence denotes Sato, São Paulo, Brazil.
T32771 97869-98071 Sentence denotes Antigen-driven bystander suppression induced by oral tolerance could be an interesting approach in the allergy field, considering the high incidence of new allergens sensitization in atopic individuals.
T10664 98072-98304 Sentence denotes To address the influence of non-related allergen exposure on the type I hypersensitivity response to the mite Blomia tropicalis (Bt) or ovalbumin (OVA) in mice and to verify oral tolerance effect in the Bt/OVA co-immunization model.
T21291 98305-98461 Sentence denotes Groups of mice were immunized with Bt extract and two weeks later submitted to OVA-immunization, or first immunized with OVA or co-injected with Bt and OVA.
T68010 98462-98520 Sentence denotes OVA feeding was performed five days prior co-immunization.
T39963 98521-98644 Sentence denotes IgE Abs were estimated by means of passive cutaneous anaphylaxis reaction and specific Ab and cytokines secretion by ELISA.
T20050 98645-98840 Sentence denotes Mice sensitized with Bt and then exposed to OVA developed an enhanced IgE response to itself and to OVA, but such response has not been observed when OVA-immunization was prior to Btimmunization.
T2545 98841-98955 Sentence denotes Co-injection of Bt and OVA led to a dominant IgE response toward OVA over Bt and vice-versa for the IgG1 response.
T61995 98956-99128 Sentence denotes OVA feeding prior co-immunization decreased IgE, IgG1 and IgG2a Ab levels against OVA in parallel to a bystander suppression, which avoided the outcome of Bt-sensitization.
T19949 99129-99216 Sentence denotes These mice showed increased IFN-?secretion levels induced by antigen-specific stimulus.
T78260 99217-99530 Sentence denotes Furthermore, effectiveness of oral tolerance was also related with OVA amounts employed in the co-immunization since OVA feeding prior co-immunization with low amounts of OVA led to inhibition of IgE Ab response to both allergens, whereas inhibition of specific and non-related antigen IgG Ab response was broken.
T93039 99531-99680 Sentence denotes The results evidenced that, depending on allergenic potential, new allergen exposure may exert an adjuvant effect on the primary sensitized allergen.
T33285 99681-99811 Sentence denotes The bystander effect to non-related allergen by oral tolerance should be an interesting mechanism to control new aller- Rationale.
T11316 99812-99932 Sentence denotes CD4 + CD25 + regulatory T cells from patients with atopic asthma undergo apoptosis when stimulated by specific allergen.
T14914 99933-100055 Sentence denotes Antihistamines are used to control allergic inflammatory diseases, but their influence on Treg cells is currently unknown.
T65061 100056-100258 Sentence denotes The present study investigates the influence of desloratadine (D) on apoptosis of CD4 + CD25 + regulatory T cells in atopic patients having dust mite induced allergic disease, including allergic asthma.
T31259 100259-100267 Sentence denotes Methods.
T2292 100268-100488 Sentence denotes Patients (n=6) with positive skin prick tests to house dust mite allergens and a clinical history of allergic upper and/or lower respiratory symptoms were treated with D 5mg (Schering-Plough, USA) once daily for 10 days.
T81281 100489-100628 Sentence denotes No patients used systemic corticosteroids, while theophylline and other medications were stopped at least 72 hours before blood collection.
T44871 100629-100681 Sentence denotes Blood was sampled before and after treatment with D.
T28320 100682-100804 Sentence denotes The control group was comprised of 6 individuals without allergic respiratory symptoms and with negative skin prick-tests.
T40198 100805-101014 Sentence denotes Peripheral blood mononuclear cells (PBMC) were isolated over a Ficoll density gradient and stimulated by specific allergen (Dermatophagoides farinae) and in a control series by phorbol myristate acetate (PMA).
T7756 101015-101092 Sentence denotes PBMC were labeled with anti-CD4, CD25, CD95, and Bcl-2 monoclonal antibodies.
T8316 101093-101147 Sentence denotes The annex-inV-propidium iodide (AnV-PI) test was done.
T26814 101148-101220 Sentence denotes Lymphocyte subpopulations and apoptosis were analyzed by flow cytometry.
T10778 101221-101229 Sentence denotes Results.
T71999 101230-101337 Sentence denotes After treatment with D, atopic patients had no significant differences in the number of CD4 + CD25 + cells.
T28782 101338-101476 Sentence denotes During co-culturing of PBMC from patients treated with D with specific allergen a significant increase in CD4 + CD25 + cells was observed.
T3364 101477-101604 Sentence denotes Simultaneously, treatment with D led to a significant increase in expression of the antiapoptotic protein Bcl-2 in CD4 + cells.
T86035 101605-101673 Sentence denotes This data paralleled the decrease of CD95 expression on CD4 + cells.
T46567 101674-101787 Sentence denotes There was also a decrease in Treg cells in the late stages of apoptosis (AnV + PI + cells) in D treated patients.
T80769 101788-101800 Sentence denotes Conclusions.
T14051 101801-101949 Sentence denotes The antihistamine preparation desloratadine prevented allergen-specific apoptosis of CD4 + CD25 + T regulatory cells in patients with atopic asthma.
T77485 101950-102067 Sentence denotes The type 1 histamine receptor may be involved in the regulation of apoptosis and/or survival of CD4 + CD25 + T cells.
T21724 102068-102072 Sentence denotes A.G.
T1377 102073-102094 Sentence denotes Palma-Carlos * , M.L.
T4322 102095-102126 Sentence denotes Palma-Carlos, Lisboa, Portugal.
T48533 102127-102140 Sentence denotes Introduction:
T77807 102141-102273 Sentence denotes Solar urticaria porphyrin corresponds to sun sensitivity to a 4000 A wavelengths and is due to disturbances of posphorin metabolism.
T16160 102274-102394 Sentence denotes Photosensitivity can cause urticaria, erythema, polymorphic solar eruption and in more severe cases vesicles and bullae.
T66269 102395-102440 Sentence denotes Photosensitivity was confirmed by light test.
T99371 102441-102449 Sentence denotes Methods:
T24454 102450-102648 Sentence denotes Protoporhyrin in RBC, uro and coproporphyrins in urines, copro and protoporhyrins in faeces and porphyrin precursors have been studied un all the cases of solar urticaria seen in the last few years.
T47406 102649-102657 Sentence denotes Results:
T21740 102658-102759 Sentence denotes In 10 patients, 8 female, 2 males, a diagnosis of porphyria has been confirmed by laboratory methods.
T25873 102760-102859 Sentence denotes Clinically 4 patients presented solar urticaria and 6 solar erythema or polymorphic solar eruption.
T83742 102860-103070 Sentence denotes 7 patients, 8 female, 2 males (21-54) presented also neuro visceral symptoms: abdominal pains (7) vomiting (4) asthenia (7) constipation (3) muscle pains and paresia (3) depression (2) anesthesic reactions (2).
T57753 103071-103139 Sentence denotes In 2 cases the symptoms were associated with anticonceptional drugs.
T49622 103140-103389 Sentence denotes The conjunction of clinical history with laboratory data has allowed to confirm the diagnosis of 2 cases of protoporphyria erytheropoietica, one triggered by anticonceptionals, 6 cases of coporporhyria hereditaria and 2 cases of porphyria variegata.
T44203 103390-103498 Sentence denotes This group comprises one case of erythropoietic protoporphyria induced by estrogens not previously reported.
T32398 103499-103511 Sentence denotes Conclusions:
T57677 103512-103602 Sentence denotes Research of porphyrins must be done in all the patients with solar urticaria and erythema.
T60345 103603-103797 Sentence denotes The incidence of sun sensitivity in mixed hepatic porphyriaalso presenting neuro-visceral symptoms which can be drug dependent suggests that porphyria study must be mandatory in suspected cases.
T73464 103798-103802 Sentence denotes A.R.
T58463 103803-103818 Sentence denotes Narayan 1* , J.
T39777 103819-103832 Sentence denotes Kaplan 1 , V.
T7432 103833-103846 Sentence denotes Sirvan 1 , A.
T19833 103847-103868 Sentence denotes Chandrasekaran 2 , C.
T2320 103869-103883 Sentence denotes Goodwin 2 , L.
T18455 103884-103898 Sentence denotes Goodwin 2 , L.
T73510 103899-103911 Sentence denotes Guida 3 , M.
T27608 103912-103925 Sentence denotes Frieri 1 , 1.
T22920 103926-103945 Sentence denotes East Meadow, NY; 2.
T84964 103946-103963 Sentence denotes Manhasset, NY; 3.
T80158 103964-103977 Sentence denotes Bayshore, NY.
T71023 103978-103988 Sentence denotes Rationale:
T34187 103989-104166 Sentence denotes Our division has reported that nitric oxide (NO) from tracheal epithelium can mediate induction of IL-8 (American Journal of Respiratory Critical Care Medicine 151:642a, 1995) .
T8348 104167-104320 Sentence denotes Increased levels of IL-8, LTB-4, and NO in mononuclear cells (MNC) from cystic fibrosis (CF) patients were noted.(Pediatric Asthma Allergy Immunology 10:
T86556 104321-104334 Sentence denotes 101-7 1996) .
T68948 104335-104430 Sentence denotes NO in MNC from CF was increased by stimulation with Aspergillus fumigatus (Asp) and rhDNAse (J.
T11151 104431-104467 Sentence denotes Clin Allergy Immunol 105:320P 2000).
T63165 104468-104569 Sentence denotes TNF-is produced from bronchial epithelial cells (BEC) in the presence of MNC of normal controls (NC).
T88085 104570-104783 Sentence denotes RANTES, a chemokine that facilitates leukocyte migration, is associated with airway inflammation in CF, and Asp sensitization in CF patients could amplify pro-inflammatory cytokines such as IL-8, TNF-, and RANTES.
T75694 104784-104792 Sentence denotes Methods:
T64972 104793-104898 Sentence denotes We studied the mRNA and protein expression of TNF-, IL-8 and RANTES in a 65 year-old CF patient and a NC.
T33314 104899-105119 Sentence denotes 1x10 6 MNCs from the patient and NC were stimulated with 21μg/ml of Asp with BEC at 10x10 5 and 10μg/ml rhDNAse. mRNA expression was studied by real time PCR (TaqMan chemistry ABI Prism 7700) and protein levels by ELISA.
T99159 105120-105232 Sentence denotes Results: TNF-production in supernatants of MNC with BEC from NC increased from 8 pg/ml to 64 pg/ml with rhDNAse.
T89256 105233-105366 Sentence denotes Whereas in CF patients the TNF-mRNA expression was greatly enhanced over NC but declined in the presence of rhDNAse (fold difference:
T73991 105367-105378 Sentence denotes 8.37-7.70).
T48126 105379-105447 Sentence denotes There was no difference in expression levels of NC (fold difference:
T26715 105448-105480 Sentence denotes 4.0-3.9) with rhDNAse treatment.
T16379 105481-105663 Sentence denotes IL-8 expression in MNC with BEC of patients increased 2.4 fold compared to NC (1.5 fold). rhD-NAse decreased Asp stimulated levels to 1.72 fold in patients compared to NC (2.9 fold).
T20098 105664-105829 Sentence denotes MNC and BEC RANTES production in patients increased from 49 to 1025 pg/ml and decreased to 570 pg/ml with rhDNAse, but increased from 1134 pg/ml to 1775 pg/ml in NC.
T41959 105830-105970 Sentence denotes In contrast, RANTES mRNA expression in all groups was higher in NC but decreased with rhDNAse in both CF and NC (37-26 fold vs. 14-10 fold).
T72332 105971-106262 Sentence denotes Conclusion: rhDNAse can increase NO and decrease pro-inflammatory TNF-and RANTES in CF patients stimulated with Asp. rhDNAse could lead to augmented bactericidal activity and epithelial defense by enhancing NO production and decreasing the expression and production of TNF-, IL-8 and RANTES.
T75699 106263-106385 Sentence denotes This is a case report of two steroid dependent atopic dermatitis patients who both responded to treatment with omalizumab.
T41756 106386-106562 Sentence denotes Patient A is a 39 year-old white male who presented with a history of severe atopic dermatitis for 10 years along with concomitant mild persistent asthma and allergic rhinitis.
T71872 106563-106675 Sentence denotes He had previously received monthly triamcinolone injections, methotrexate and doxycycline with limited response.
T70083 106676-106812 Sentence denotes On presentation he had mild improvement on a regimen of alternate day prednisone 30mg, fexofenadine 180mg bid, and zafirlukast 20mg bid.
T39840 106813-106935 Sentence denotes However, attempts at weaning prednisone were unsuccessful. omalizumab was initiated at a dosage of 150mg every four weeks.
T83349 106936-107009 Sentence denotes The Patient remains prednisone dependent yet free from atopic dermatitis.
T28438 107010-107077 Sentence denotes Patient A's diagnostic work up determined a total IgE of 33.1 ku/L.
T70184 107078-107233 Sentence denotes The patient's specific IgE tests were positive for grass mix, weed mix, maple, white pine, peanut, strawberry, gluten, soybean, wheat, oat, and dog dander.
T63673 107234-107367 Sentence denotes Specific IgE tests were negative for cat dander, egg white, milk, goose feathers, chicken feathers, mold mix, dust mix, and fish mix.
T1206 107368-107529 Sentence denotes Patient B is a 23 year-old white male who presented with a history of severe full body atopic dermatitis along with mild persistent asthma and allergic rhinitis.
T96026 107530-107598 Sentence denotes He also was receiving triamcinolone injections with limited success.
T55320 107599-107692 Sentence denotes He responded to alternate day prednisone 30mg, desloratidine 5mg bid, and zileuton 600mg bid.
T78984 107693-107784 Sentence denotes Attempts at weaning prednisone failed until initiation of omalizumab 375mg every two weeks.
T86870 107785-107889 Sentence denotes His atopic dermatitis is now under control with once daily desloratidine and omalizumab every two weeks.
T47107 107890-107989 Sentence denotes He was successfully weaned off of corticosteroid medication and has begun an immunotherapy regimen.
T91799 107990-108063 Sentence denotes Patient B's diagnostic work up determined a total IgE level of 1159 ku/L.
T63262 108064-108260 Sentence denotes Patient B's specific IgE tests were positive for weed mix, tree mix, maple, peanut, strawberry, dust mix, cat dander, dog dander, egg white, milk, oat, wheat, goose feathers, and chicken feathers.
T39315 108261-108361 Sentence denotes Specific IgE tests were negative for grass mix, white pine, mold mix, gluten, soybean, and fish mix.
T68850 108362-108473 Sentence denotes These two case reports reveal significant response to omalizumab in severe steroid dependent atopic dermatitis.
T75824 108474-108647 Sentence denotes Further research is strongly indicated considering the quality of life issues with severe atopic dermatitis and potential side effects to long-term corticosteroid treatment.
T89403 108648-108831 Sentence denotes Eosinophilic esophagitis (EE) has been described in children and is characterized by high levels of eosinophils (>20-24 eosinophils/high powered field [hpf]) in the esophageal mucosa.
T17233 108832-108995 Sentence denotes A recent report indicates that the combined prevalence of the eosinophilic gastrointestinal disorders may be higher than that of inflammatory bowel diseases (IBD).
T70762 108996-109180 Sentence denotes The presenting symptoms of EE mimick those of gastroesophageal reflux disease (GERD), and patients of all ages may experience a delay in time from onset of symptoms to diagnosis of EE.
T41856 109181-109292 Sentence denotes There is a paucity of data in the literature regarding the delay in time from symptom onset to diagnosis of EE.
T16877 109293-109413 Sentence denotes We report the data on four children three years of age and under with EE who experienced a significant diagnostic delay.
T94675 109414-109512 Sentence denotes Four young children were referred to the pediatric allergy clinic with a diagnosis of EE (Table) .
T95431 109513-109564 Sentence denotes Three of the patients were male and one was female.
T17255 109565-109701 Sentence denotes The patients were 17-36 months of age at the time of diagnosis, and the diagnostic delay was 15.5-33 months (average delay 23.6 months).
T14883 109702-109832 Sentence denotes The most common presenting symptom was vomiting, and three of the four patients had a history of respiratory obstructive symptoms.
T92760 109833-109974 Sentence denotes All of the patients had received conventional treatment for reflux disease, and one had undergone a Nissen fundoplication prior to diagnosis.
T46636 109975-110047 Sentence denotes In all four patients the esophageal biopsy revealed >20 eosinophils/hpf.
T91232 110048-110161 Sentence denotes Three out of four patients had a family history of atopy, and two patients had a known history of a food allergy.
T42602 110162-110290 Sentence denotes Skin tests to foods were positive in two patients and RAST (radioallergoabsorbent) testing to foods was positive in one patient.
T96670 110291-110374 Sentence denotes Recent data suggests that the diagnostic delay in IBD is decreasing as much as 50%.
T38023 110375-110483 Sentence denotes It is hypothesized that this may be due in part to an increased index of suspicion by health care providers.
T34700 110484-110564 Sentence denotes There is little data available regarding the diagnostic lag in children with EE.
T66068 110565-110666 Sentence denotes It is currently believed that chronic EE can lead to progressive esophageal scarring and dysfunction.
T85303 110667-110750 Sentence denotes Stricture formation has also been described in children less than two years of age.
T66437 110751-110995 Sentence denotes Given the reported increased incidence of this allergic gastrointestinal disease over the past decade, more data regarding the diagnostic delay of these conditions may be instrumental improving health care providers' awareness of this disorder.
T95365 110996-110998 Sentence denotes A.
T63079 110999-111019 Sentence denotes Kohli-Pamnani * , E.
T53991 111020-111030 Sentence denotes Cooney, P.
T16039 111031-111040 Sentence denotes Huynh, F.
T89422 111041-111061 Sentence denotes Lobo, New Haven, CT.
T17685 111062-111075 Sentence denotes Introduction:
T64880 111076-111310 Sentence denotes Cutaneous hypersensitivity reactions to amprenavir, an HIV-1 protease inhibitor, are reported in up to 28% of treated patients, of whom 4% have severe or life-threatening rashes, with treatment discontinuation required in 3% of cases.
T69712 111311-111509 Sentence denotes We report a case of successful desensitization to amprenavir, for recurrent maculopapular exanthem, in an HIV-infected patient with late stage disease and limited antiretroviral (ARV) agent options.
T68647 111510-111518 Sentence denotes Methods:
T69751 111519-111887 Sentence denotes The patient is a 40 year-old Caucasian female with late stage HIV disease (absolute CD4 count 30 cells/mm 3 , HIV RNA 200, 000 copies/mL) and multiple ARV intolerances, who developed a severe generalized maculopapular eruption sparing mucous membranes six days following initiation of a regimen comprised of amprenavir, lopinavir/ritonavir, zidovudine, and lamivudine.
T47310 111888-112131 Sentence denotes A similar reaction occurred following re-challenge with amprenavir alone (600 mg oral formulation BID via percutaneous endoscopic gastrostomy (PEG) tube), despite concurrent administration of oral prednisone 20 mg/day and loratidine 10 mg/day.
T96691 112132-112140 Sentence denotes Results:
T94267 112141-112293 Sentence denotes Skin prick testing with amprenavir 0.01 mcg/mL was negative, whereas intradermal testing with 0.1 mcg/mL was positive with a 7 mm wheal and 20 mm flare.
T61686 112294-112366 Sentence denotes Percutaneous and intradermal testing with normal saline was nonreactive.
T98027 112367-112453 Sentence denotes The positive histamine control (skin prick only) yielded a 5 mm wheal and 20 mm flare.
T631 112454-112685 Sentence denotes Subsequently, incremental doses of 0.025 mg, 0.1 mg, 0.25 mg, 1 mg, 2.5 mg, 7.5 mg, 25 mg, 50 mg, 100 mg, 300 mg, 600 mg, and 1200 mg of amprenavir oral solution were administered via PEG tube at 20 to 30 minute intervals (Table) .
T5996 112686-112834 Sentence denotes The patient successfully tol-erated amprenavir desensitization and has remained on therapy without recurrence of rash out to 16 months of follow-up.
T32345 112835-112847 Sentence denotes Conclusions:
T97053 112848-113020 Sentence denotes Desensitization may permit continued use of amprenavir in patients with a history of amprenavirinduced maculopapular eruptions who have limited alternate treatment options.
T10587 113021-113255 Sentence denotes Efforts aimed at characterizing the mechanism of amprenavir cutaneous hypersensitivity reactions seem warranted, given the frequency of reactions and the limited number of ARV agents available for patients with late stage HIV disease.
T73191 113256-113346 Sentence denotes Doses of oral solution were administered by PEG tube at twenty to thirty minute intervals.
T16317 113347-113360 Sentence denotes Introduction:
T15038 113361-113418 Sentence denotes Beta-lactam (BL) allergy is the most common drug allergy.
T95246 113419-113480 Sentence denotes In most cases, IgE antibodies are specific to the BL nucleus.
T5659 113481-113547 Sentence denotes However, sidechain-specific IgE (SCSIgE) to BL has been described.
T27338 113548-113640 Sentence denotes Despite this, skin testing (ST) to BL other than penicillin (PCN) is not commonly performed.
T46895 113641-113778 Sentence denotes We report a case of a 31 year-old female with a selective allergy to PIP, and describe the utility of ST to this agent to confirm SCSIgE.
T65481 113779-113900 Sentence denotes Methods: ST to PrePen (PP) and PCN G was carried out with percutaneous (PC) testing followed by intradermal (ID) testing.
T87801 113901-114160 Sentence denotes ST was also carried out with ampicillin (AMP; 1 mg/ml), PIP (60 mg/ml at PC level; 1 mg/ml at ID level-a non-irritating concentration), and PIP/tazobactam (TBM; 60 mg/ml at PC level; 1 mg/ml at ID level) to exclude the possibility of selective allergy to TBM.
T45035 114161-114173 Sentence denotes Case Report:
T62938 114174-114282 Sentence denotes A 31 year-old white female with Crohn's disease was hospitalized for treatment of intra-abdominal abscesses.
T15060 114283-114382 Sentence denotes She had immediate flushing and urticaria during an infusion of PIP/TBM approximately 2 years prior.
T19213 114383-114511 Sentence denotes The Allergy/Immunology service was consulted for PCN ST because her primary service preferred to empirically treat with PIP/TBM.
T67657 114512-114593 Sentence denotes She had received imipenem approximately 8 months prior without untoward reaction.
T57583 114594-114673 Sentence denotes ST to PP and PCN G was performed with negative responses and adequate controls.
T84945 114674-114816 Sentence denotes She subsequently received PIP/TBM, but developed flushing and urticaria during her initial infusion, consistent with an IgE-mediated reaction.
T29446 114817-114867 Sentence denotes Two months later, ST to PP and PCN G was repeated.
T95783 114868-114923 Sentence denotes In addition, ST to AMP, PIP, and PIP/TBM was performed.
T91208 114924-115066 Sentence denotes She had positive responses to PIP and PIP/TBM with negative responses to PP, PCN G, and AMP, implying selective IgE-mediated potential to PIP.
T35036 115067-115169 Sentence denotes She tolerated an oral challenge with PCN VK 250 mg immediately following ST without untoward reaction.
T26342 115170-115181 Sentence denotes Conclusion:
T68916 115182-115343 Sentence denotes We have described a case in which ST to PIP was useful for diagnosing SCSIgE in our patient, who had 2 prior reactions consistent with IgE-mediated pathogenesis.
T92427 115344-115441 Sentence denotes This information will be helpful in identifying antibiotics she can safely receive in the future.
T23824 115442-115623 Sentence denotes This case supports the utility of ST to BL in addition to PCN, in evaluation and management of patients with a history of adverse reaction to BL that may reflect presence of SCSIgE.
T72719 115624-115628 Sentence denotes A.R.
T68069 115629-115646 Sentence denotes Vaishnav * , B.S.
T35248 115647-115670 Sentence denotes Bochner, Baltimore, MD.
T8379 115671-115946 Sentence denotes We report the case of a 39-year-old Caucasian male with a 15-year history of asthma, two episodes of eosinophilic pneumonia and chronic peripheral eosinophilia with baseline eosinophil counts around 1000/μL who developed amnesia and elevated cardiac enzymes in February 2004.
T90475 115947-116081 Sentence denotes Another physician had added montelukast in January 2004 and because of a good response advair was decreased from 500/50 to 250/50 BID.
T68079 116082-116223 Sentence denotes In February his eosinophil count increased to 3430/μL and soon he developed left arm numbness, diplopia as well as left arm and leg weakness.
T37525 116224-116296 Sentence denotes At his local hospital, he was found to have elevated troponins and CPKs.
T32705 116297-116388 Sentence denotes Cardiac catheterization showed normal coronary arteries and good left ventricular function.
T74345 116389-116453 Sentence denotes Soon after discharge, he developed confusion and global amnesia.
T21009 116454-116540 Sentence denotes Brain MRI showed diffuse uptake consistent with global inflammation and/or vasculitis.
T35418 116541-116654 Sentence denotes Upon hearing this story, we told him to take 60 mg of prednisone and urgently come to our hospital for admission.
T15412 116655-116716 Sentence denotes Within hours, his mental status and visual symptoms improved.
T18247 116717-116797 Sentence denotes Physical examination was unremarkable except for subungual splinter hemorrhages.
T25001 116798-116862 Sentence denotes Montelukast was stopped and 1 gm/day Solu-Medrol IV was started.
T95549 116863-116955 Sentence denotes Endomyocardial biopsy 2 days later showed mild hypertrophy and fibrosis without eosinophils.
T87099 116956-116993 Sentence denotes Repeat brain MRI and MRA were normal.
T74362 116994-117091 Sentence denotes Chest CT showed multiple patchy infiltrates with a new central cavitary lesion in the right lobe.
T77441 117092-117169 Sentence denotes Other labs included a negative ANCA, ANA of 1:40, normal complements and CSF.
T71197 117170-117332 Sentence denotes Our differential diagnosis included Churg-Strauss syndrome (CSS) versus hypereosinophilic syndrome (IHES) with myocardial, neurological and pulmonary involvement.
T23732 117333-117433 Sentence denotes Serum tryptase was normal as was fluorescent in situ hybridization for the FIP1L1-PDGFR fusion gene.
T7243 117434-117537 Sentence denotes Based on this, along with the new pulmonary cavitary lesion on chest CT, the diagnosis of CSS was made.
T68367 117538-117610 Sentence denotes After 3 days of IV steroids, he was switched to 60 mg/day of prednisone.
T77114 117611-117681 Sentence denotes Upon discharge his eosinophil count was 350/μL on 60 mg of prednisone.
T45449 117682-117818 Sentence denotes After all procedures were completed, he was also started on aspirin 325 mg daily to prevent thrombotic and thromboembolic complications.
T69343 117819-117891 Sentence denotes He was seen in follow-up in clinic and cytoxan 100 mg daily was started.
T62806 117892-117924 Sentence denotes His prednisone is being tapered.
T27062 117925-118026 Sentence denotes He is tolerating the treatment well and so far has had an excellent clinical and laboratory response.
T45690 118027-118147 Sentence denotes Introduction-C1-esterase inhibitor (C1-INH) deficiency is a rare disorder classified into acquired and hereditary forms.
T51274 118148-118234 Sentence denotes Both entities are distinguished by recurrent angioedema without pruritus or urticaria.
T37781 118235-118313 Sentence denotes The upper airway, head, neck, extremities and GI tract are typically involved.
T37542 118314-118412 Sentence denotes The inherited form usually presents in the first or second decade accompanied by a family history.
T97574 118413-118477 Sentence denotes The acquired form more commonly presents after the fifth decade.
T81416 118478-118596 Sentence denotes In acquired C1-INH deficiency, serological evaluation reveals low levels of C4, C1-INH, and C1q and a normal C3 level.
T59002 118597-118645 Sentence denotes Levels of C1q are normal in the hereditary form.
T80980 118646-118740 Sentence denotes The acquired form may be associated with lymphoproliferative disorders and autoimmune disease.
T42379 118741-118847 Sentence denotes Acquired C1-INH deficiency is typically recognized before the underlying malignant condition is diagnosed.
T40392 118848-118946 Sentence denotes Clinical regression has been reported in patients whose underlying disorder responds to treatment.
T74245 118947-119130 Sentence denotes Methods-A case report of a 57-year old female who developed repeated episodes of facial angioedema requiring hospitalization preceded by one year of vague abdominal pain and cramping.
T45809 119131-119334 Sentence denotes Data-Laboratory investigation of this patient revealed C4<10mg/dl (16-47 mg/dl), C1q<3.5mg/dl(5.0-8.6 mg/dl), CH50<20u/ml(31-66 u/ml), and C1-INH at 3 mg/dl(6-25 mg/dl) with a 51% activity (>68% normal).
T82390 119335-119366 Sentence denotes C3 was 138 mg/dl(90-180 mg/dl).
T13896 119367-119499 Sentence denotes Other laboratory evaluation was notable for a normal CBC with diff, comprehensive metabolic panel, amylase, lipase and SPEP pattern.
T34633 119500-119529 Sentence denotes IgE was elevated at 173 KU/L.
T29730 119530-119555 Sentence denotes Hematology was consulted.
T7212 119556-119608 Sentence denotes CT of chest, abdomen, and pelvis were nondiagnostic.
T28387 119609-119740 Sentence denotes Peripheral blood flow cytometry revealed a small distinct pop-ulation consistent with a clonal B-cell lymphoproliferative disorder.
T56672 119741-119807 Sentence denotes A repeat test showed skewing towards lamba light chain expression.
T86871 119808-119918 Sentence denotes Bone marrow biopsy and aspirate were essentially normal except for erythroid hyperplasia on Danazol treatment.
T1708 119919-119986 Sentence denotes The physical examination was without any masses or lymphadenopathy.
T70609 119987-120127 Sentence denotes The patient remained asymptomatic after beginning Danazol although elevations in RBC, Hgb, Hct and absolute lymphocyte count have developed.
T96610 120128-120267 Sentence denotes Conclusion-Acquired C1-INH deficiency is rare cause of recurrent angioedema that has been reported in small cohorts and case presentations.
T18317 120268-120396 Sentence denotes We report another case report that reinforces the need for physicians to evaluate for concomitant lymphoproliferative disorders.
T87656 120397-120528 Sentence denotes Chronic urticaria is a distressing condition usually associated with poor quality of life and poor response to symptomatic therapy.
T39976 120529-120636 Sentence denotes A wide variety of causes and mechanisms have been described and in some patients the cause remains unknown.
T85899 120637-120770 Sentence denotes Rare cases have been associated with thyroid antibodies and some responded to thyroxin, even in the absence of overt thyroid disease.
T19173 120771-120783 Sentence denotes CASE REPORT:
T54059 120784-120884 Sentence denotes A 54-yr-old obese white female presented with a history of persistent urticaria/angioedema for 4 mo.
T24141 120885-120976 Sentence denotes Urticaria involved various parts of the body and individual lesions usually lasted < 24 hr.
T96847 120977-121018 Sentence denotes It was often accompanied by facial edema.
T57698 121019-121080 Sentence denotes Oral diphenhydramine 25mg qid caused only little improvement.
T10879 121081-121133 Sentence denotes The patient could not suspect any offending factors.
T29486 121134-121280 Sentence denotes Review of systems and past medical history were unremarkable, except for hyperthyroidism at age 12 yr that was treated with "medication" for 3 yr.
T5276 121281-121386 Sentence denotes On physical examination there were several urticarial lesions though she has been taking diphenhydramine.
T26900 121387-121449 Sentence denotes The thyroid appeared normal regarding size, shape and texture.
T51933 121450-121523 Sentence denotes Various second generation antihistamines and doxepin were of little help.
T5852 121524-121748 Sentence denotes Laboratory evaluation revealed total serum IgE of 7 IU/ml (normal <200 IU/ml) and CH50 of 73 U/ml (normal 22-60 U/ml), but high TSH of 15.2 IU/ml (normal 0.4-5.0 IU/ml) and low free T4 of 0.58 ng/dl (normal 1.45-3.48 ng/dl).
T12092 121749-121930 Sentence denotes Her antithyroglobulin titer was 32 IU/ml (normal <100 IU/ml) but the antimicrosomal titer was highly elevated at 382 IU/ml(normal <20 IU/ml) consistent with Hashimoto's thyroiditis.
T80854 121931-122111 Sentence denotes Thyroxin therapy was initiated at a dose of 100 mcg/d which resulted in marked improvement within one week and the patient was able to discontinue doxepin and other antihistamines.
T79903 122112-122199 Sentence denotes Because of marked drop in TSH to 0.08 IU/ml, the thyroxin dose was reduced to 50 mcg/d.
T3087 122200-122259 Sentence denotes Her thyroid function tests became normal within two months.
T68430 122260-122362 Sentence denotes She did not experience any recurrence of urticaria or angioedema during over 6 mo of follow-up so far.
T85536 122363-122374 Sentence denotes CONCLUSION:
T21156 122375-122563 Sentence denotes Patients with chronic urticaria/angioedema, especially women, should be screened for thyroid autoantibodies and if positive, thyroxin therapy might bring impressive remission in urticaria.
T70056 122564-122695 Sentence denotes Hypersensitivity pneumonitis (HP) results from an abnormal immunologically mediated response to an environmental antigenic trigger.
T45378 122696-122839 Sentence denotes Typically patients with HP experience transient fever, hypoxemia, muscle and joint pain, difficulty breathing, fatigue, weight loss, and cough.
T62608 122840-122934 Sentence denotes There are two clinical presentations of HP differentiated by onset and resolution of symptoms.
T82482 122935-123109 Sentence denotes Patients experiencing acute HP experience the onset of symptoms 2 to 9 hours following exposure to a particular antigen and resolve in 1 to 3 days without specific treatment.
T60585 123110-123238 Sentence denotes However, patients with chronic HP experience symptoms that persist for months to years when exposed to a recognized cause of HP.
T36166 123239-123319 Sentence denotes A 55 year-old Caucasian male was referred to our practice with acute bronchitis.
T30220 123320-123451 Sentence denotes His referral was secondary to a history of allergic rhinitis, chronic asthma, gastro-esophageal reflux disorder, and sinus surgery.
T93901 123452-123516 Sentence denotes This non-smoking male was a machine operator at a local factory.
T73118 123517-123684 Sentence denotes He was doing well until he began working in the presence of a heat induction machine and metal lubricating spray called Multan EA20 (Hinkle Surface Technologies), I.D.
T83231 123685-123689 Sentence denotes No.:
T35709 123690-123697 Sentence denotes 238073.
T43867 123698-123883 Sentence denotes Multan EA20 is a product containing naphthenic petroleum distillates, amine salts, amine soap, triethanolamine hexyl, hexylene glycol, ethanol, sodium petroleum sulfonate, and triazine.
T75339 123884-123958 Sentence denotes This lubricant is known to irritate the eyes, skin, and respiratory tract.
T14314 123959-124107 Sentence denotes Recent studies indicate that thermal decomposition of triazine, which readily occurs during metalworking, results in the production of formaldehyde.
T26274 124108-124207 Sentence denotes Formaldehyde is a known carcinogen, as well as respiratory, skin, eye and digestive tract irritant.
T94800 124208-124323 Sentence denotes The patient developed serious respiratory health problems resulting in work absence and eventually hospitalization.
T39737 124324-124525 Sentence denotes While hospitalized he received a high resolution CT scan which showed diffuse ground glass appearance, and multiple attenuation areas of the lung which are consistent with hypersensitivity pneumonitis.
T18224 124526-124647 Sentence denotes The patient was treated with corticosteroids, and antibiotics with eventual normalization of lung parenchyma by chest CT.
T92957 124648-124807 Sentence denotes This represents the first reported case of hypersensitivity pneumonitis resulting from exposure to the metalworking fluid and respiratory irritant Multan EA20.
T92784 124808-124812 Sentence denotes A.J.
T84254 124813-124829 Sentence denotes Ham Pong 1* , F.
T14958 124830-124843 Sentence denotes Chan 1 , S.L.
T97677 124844-124856 Sentence denotes Bahna 2 , 1.
T53654 124857-124875 Sentence denotes Ottawa, Canada; 2.
T17457 124876-124891 Sentence denotes Shreveport, LA.
T59154 124892-125040 Sentence denotes Sexual intercourse has been known as the route for semen hypersensitivity reactions to the seminal fluid protein or to a contaminating drug or food.
T49783 125041-125117 Sentence denotes We report a case of anaphylaxis to cephalexin-containing semen by ingestion.
T78476 125118-125145 Sentence denotes HISTORY OF PRESENT ILLNESS:
T26803 125146-125219 Sentence denotes A 37-year-old woman developed a systemic reaction after swallowing semen.
T52810 125220-125367 Sentence denotes Since the couple frequently practiced fellatio without any reactions, her husband suspected cephalexin that he was taking over 2 days (500 mg qid).
T44270 125368-125529 Sentence denotes Her reaction began in less than 10 min and peaked over 50 min; first as itchy oral mucosa followed by wheezing, flushing of the face and upper chest, and nausea.
T86788 125530-125618 Sentence denotes Diphenhydramine 50 mg was administered po at 30 min and the reaction subsided over 1 hr.
T66540 125619-125640 Sentence denotes PAST MEDICAL HISTORY:
T38232 125641-125752 Sentence denotes She had generalized urticaria to oral penicillin more than 15 yr earlier and had positive penicillin skin test.
T58244 125753-125932 Sentence denotes She also had allergic rhinoconjunctivitis, mild intermittent asthma, and positive skin test to house dust mite, cat and dog epidermals, and pollens of grasses, trees, and ragweed.
T55887 125933-126048 Sentence denotes She also had oral allergy syndrome to certain fresh fruits and tree nuts; hazelnuts caused also diarrhea and colic.
T41462 126049-126148 Sentence denotes Neither the patient nor her husband ate any nut-containing food on the days preceding the reaction.
T46335 126149-126165 Sentence denotes FAMILY HIS-TORY:
T24886 126166-126229 Sentence denotes Allergic rhinoconjunctivitis in the mother, sister and brother.
T80652 126230-126242 Sentence denotes EVAL-UATION:
T2583 126243-126311 Sentence denotes The patient sought allergy evaluation about 2 yr after the reaction.
T95204 126312-126347 Sentence denotes She and her husband gave a consent.
T82292 126348-126505 Sentence denotes Her serum IgE was 108 IU/ml and skin test positive to penicilloyl polylysine 6x10-5 mol ID, but negative to cefazoline 10 mg/ml for prick and 3 mg/ml for ID.
T93156 126506-126634 Sentence denotes She had negative prick test to her husband's seminal plasma both before and after his intake of cephalexin 500mg qid for 2 days.
T99565 126635-126877 Sentence denotes Using a cephalexin bioassay sensitive down to 6.25 mcg/ml, the medication level in the husband's urine at 120 min post last dose was 2400 mcg/ml and in his serum at 135 min was 12 mcg/ml, but was undetectable in the semen collected at 90 min.
T60072 126878-126889 Sentence denotes CONCLUSION:
T99301 126890-126968 Sentence denotes This is probably the first case report of systemic reaction to ingested semen.
T14253 126969-127141 Sentence denotes The reaction occurred in an atopic, penicillin-sensitive woman and seems to be caused by cephalexin excreted in the semen or through urine contamination (1 drop = 120 mcg).
T7831 127142-127309 Sentence denotes In addition to her avoiding penicillin and cephalosporins, she was advised to avoid her husband's semen while him taking such drugs and for at least 3 days afterwards.
T2699 127310-127513 Sentence denotes BACKGROUND:Asthma causes serious morbidity & mortality all over yet most asthma educational evaluations and programs have an urban rather than rural focus.There is lack of data on rural North Dakota(ND).
T83475 127514-127673 Sentence denotes This ND survey aimed to study knowledge & awareness of management strategies for asthma like use of metered dose inhalers, spacer devices and peak flow meters.
T36443 127674-128190 Sentence denotes METHODS:The qualitative survey addressed attitudes and beliefs on asthma & its triggers;knowledge of medication delivery routes & use of hospitals and provider visits.A simple questionnaire was self-administered at 6 rural clinics in small towns in southeastern North Dakota.10 questions explored asthma knowledge, extent of family history of asthma & factors aggravating asthma.It was voluntary & the population surveyed included patients, family, teachers, employees at nursing homes, the local hospital & clinics.
T8336 128191-128421 Sentence denotes RESULTS:Of 297 surveys completed 61% had no asthma in the family.Of those with a family history(39%), 59% had 1 person with asthma, 28.6% had 2 & 12.3% had 3 or more.Respondents were aged 18-90 years & 81.1% were female.See Table.
T74054 128422-128582 Sentence denotes DISCUSSION:Our survey was rural & comparison with urban areas may help in planning for asthma education & resource allocation.61% denied asthma in their family.
T95180 128583-129325 Sentence denotes Similarly, nonurban Alaskan Natives have a lower incidence of asthma compared to nonnatives.Our results show a lack of awareness in our area.Grain dust exposure was perceived as an asthma trigger but without evidence, local research is needed.In our study smoking was considered a trigger by 91.5% & this may be real.There was lack of awareness of peak flow meters & their role in asthma care.A study showed that compared to other areas even rural nurses used peak flow meters less often to assess and monitor asthma.This suggests a need for comprehensive asthma educational programs in rural areas that are based on national guidelines.We had only a moderate followup rate at 60%.In comparison, one study had 21% missed scheduled follow-ups.
T64971 129326-129385 Sentence denotes Exercise induced asthma was known to only 50% of our group.
T61197 129386-129742 Sentence denotes CONCLUSION:The need for better patient-provider communication has been highlighted by the lack of awareness of proven strategies to combat asthma.The use of a simple survey has revealed many unknown facts about asthma awareness in rural ND.Further study to determine cost effective solutions to achieve national targets for asthma management are essential.
T62343 129743-129747 Sentence denotes Aim:
T60538 129748-129831 Sentence denotes In most studies of asthma, the emphasis was on changes in large and middle airways.
T98496 129832-129966 Sentence denotes The aims of this study:(1)to observe the morphologic changes in small airways and lung tissue(SALT) in guinea pig asthma models(GPAM);
T29561 129967-130267 Sentence denotes (2)investigate the role of VCAM-1, eotaxin, NF-B and AP-1 in the inflammation of asthma; (3)explore the functional variation of alveolar type 2 cells in asthma; (4)evaluate the effects of inhaled Glucocorticoids on the above ANNALS OF ALLERGY, ASTHMA & IMMUNOLOGY parameters in SALT of asthma models.
T61270 130268-130329 Sentence denotes Methods: (1)The GPAM were established by ovalbumin challenge.
T71057 130330-130453 Sentence denotes Five groups were divided: control, asthma day 4 and day 14, intraperitoneal dexamethasone, and budesonide inhalation group.
T62682 130454-130727 Sentence denotes (2)The expression of VCAM-1, eotaxin, NF-B and AP-1 was determined by immunohistochemical technology and RT-PCR; the DNA binding activity of NF-B and AP-1 by electropharetic mobility shift assay. (3)The BALF phospholipide concentration was measured by phosphorus detection.
T22122 130728-131427 Sentence denotes Results: (1)Significant inflammatiom with infiltration of eosinophils and lymphocytes in SALT was observed in asthma groups. (2)The protein levels of VCAM-1, eotaxin, NF-B and AP-1 expressed in the SALT were significantly elevated in asthma groups than those in control. (3)The mRNA expression of VCAM-1 and eotaxin of lung tissue homogenate was significantly increased in asthma group. (4)The DNA binding activity of NF-B and AP-1 of lung homogenate was significantly increased in asthma group. (5)The BALF surfactant represented by phospholipides was significantly decreased in asthma groups. (6)Glucocorticoids in different ways of intake provided significant effects on the inflammatiom of SALT.
T61839 131428-131617 Sentence denotes Conclusion: (1)Widespread and significant inflammation with eosinophilic infiltration existed in the SALT in GPAM, indicating asthma is a disease involving the whole airway and lung system.
T85992 131618-131703 Sentence denotes Not only there were structural changes, but also impaired function of alveolar cells.
T57721 131704-131916 Sentence denotes The role of small airway inflammatiom may be of great importance. (2)Eotaxin and VCAM-1 actively mediated the process of inflammatiom, NF-B and AP-1 played important roles in the regulation of VCAM-1 and eotaxin.
T30089 131917-132023 Sentence denotes The up-regulation of the above mediators in GPAM was expressed in SALT similar to that in central airways.
T20102 132024-132267 Sentence denotes We have recently reported that immunomodulatory oligonucleotides (IMOs) consisting of a novel structure and synthetic CpR or R'pG (R and R' are synthetic purine moieties) stimulatory motif effectively prevent OVAinduced asthma in mouse models.
T90578 132268-132409 Sentence denotes In the present study we examined whether these novel IMOs (HYB2055 and HYB2087) can reverse established allergic airway inflammation in mice.
T64142 132410-132537 Sentence denotes BALB/c mice sensitized and challenged with ovalbumin (OVA) were evaluated for airway hyperresponsiveness (AHR) to methacholine.
T55842 132538-132689 Sentence denotes Following OVA-sensitization, mice were randomized and treated with placebo or 30 mg or 60 mg/dose of HYB2055 or 2087 s.c. during the following 10 days.
T95303 132690-132796 Sentence denotes Two days after the final treatment, mice were rechallenged with OVA and pulmonary functions were recorded.
T67843 132797-133117 Sentence denotes Mice treated with either IMO were significantly protected from both early (EAR) and late (LAR) allergic response, airway hypersensitivity and hyperreactivity to methacholine, BAL and peribronchial eosinophilia, BAL and serum IL-5, and total serum IgE as compared to vehicle-treated OVA-sensitized and challenged animals.
T58377 133118-133422 Sentence denotes There was a significant increase in immature lung dendritic cells (CD11c+CD45R+) together with increase in serum IL-10 levels and significant decrease in lung DC2 type cells (CD11c+ CD11b+CD8a-) as compared to vehicle-treated ovalbumin-sensitized animals in the lungs following treatment with either IMO.
T80144 133423-133679 Sentence denotes These data suggest that both IMOs are effective and potent in attenuating key features of established allergic airway inflammation in bronchial asthma, and this effect could be mediated via decreasing lung DC2 cells and increasing immature dendritic cells.
T33508 133680-133830 Sentence denotes Additionally, IMOs contain a novel 3'-3'-attached structure that provides higher metabolic stability and may permit lower and/or less frequent dosing.
T86373 133831-133947 Sentence denotes HYB2055 was evaluated for its safety and immunopharmacology in a phase 1 clinical trial in healthy human volunteers.
T13940 133948-134094 Sentence denotes Introduction -Hemoglobinopathies are common in Southern Europe and Mediterranean area the more frequent being thalassemia and sickle cell disease.
T24667 134095-134227 Sentence denotes Aside of the major hematological diseases of homozygotic patients minor forms are frequent, thalassemia minor and sickle cell trait.
T72713 134228-134449 Sentence denotes In these cases mycrocytosis with decrease of red cell volume and mean corpuscular volume or abnormal erythrocytes are found and can lead to hemorheologic disturbances in bronchial circulation and bronchial hypereactivity.
T96259 134450-134998 Sentence denotes The rationale of this study is to evaluate the incidence of asthma in hemoglobinopatic patients allergic to house dust mites.Methods-From 4 000 patients seen in the last 4 years in an out-patient allergy clinic 44 cases of hemoglobinopathies have been confirmed by red cell count, hemoglobin electrophoresis, assays of hemoglobin A2, F, and S, and sickle cell test.All these patients had allergic disease characterized by clinical history, skin prick test to aeroallergens total and specific IgE (RAST-CAP-FEIA) and respiratory function evaluation.
T87542 134999-135027 Sentence denotes Results -Hemoglobinopathies:
T13782 135028-135115 Sentence denotes Betathalassemia 39 cases, Betadelta thalassemia 2, sickle cell trait 2, Hemoglobin C.1.
T85640 135116-135343 Sentence denotes Aside of 4 cases of urticaria, all the patients presented respiratory allergy, rhinitis in 12 cases of thalassemia and 1 hemoglobin C, asthma with or without rhinitis in 25 cases of thalassemia and 2 cases of sickle cell trait.
T12381 135344-135383 Sentence denotes Therefore asthma was present in 67, 5%.
T35135 135384-135497 Sentence denotes In a group 491 of respiratory allergic patients without hemoglobinopathies, 57% had asthma and 43% only rhinitis.
T46924 135498-135592 Sentence denotes Conclusions -The prevalence of asthma is higher in hemoglobinopathies.(p<005 Square chi test).
T80322 135593-135723 Sentence denotes Hemorheological changes probably greater rigidity of red blood cells and capillary bed can contribute to bronchial hypereactivity.
T53610 135724-135826 Sentence denotes Detection of hemoglobinopathies must be done in asthmatic patients with slight anemia or mycrocytosis.
T36885 135827-135960 Sentence denotes We investigated the role of aspirin-exacerbated respiratory disease (AERD) as a risk factor for the development of airway remodeling.
T35000 135961-136060 Sentence denotes Patients with aspirin intolerance develop hyperplastic sinusitis with fibrosis and nasal polyposis.
T15153 136061-136234 Sentence denotes We speculated that similar mechanisms could be acting in the lower airway and that these individuals would demonstrate more severe asthma and evidence for airway remodeling.
T21830 136235-136282 Sentence denotes The Epidemiology and Natural History of Asthma:
T92186 136283-136419 Sentence denotes Outcomes and Treatment Regimens (TENOR) study is a multicenter observational study of subjects with severe or difficult-to-treat asthma.
T65422 136420-136557 Sentence denotes Baseline data were compared between subjects 18 years who reported asthma exacerbation following aspirin ingestion and those who did not.
T99039 136558-136657 Sentence denotes The primary measure of asthma remodeling was the maximally achieved post-bronchodilator spirometry.
T7726 136658-136745 Sentence denotes Adult subjects with AERD (n=469) were compared with aspirin tolerant subjects (n=3009).
T18829 136746-136879 Sentence denotes Subjects with aspirin intolerance demonstrated evidence for airway remodeling as shown by lower post-bronchodilator predicted FEV 1 .
T85189 136880-137085 Sentence denotes In addition, they were more likely to have physician-assessed severe asthma, to have been intubated, and to have required high-dose inhaled corticosteroids or oral corticosteroids in the previous 3 months.
T28302 137086-137189 Sentence denotes We conclude that aspirin intolerance is associated with remodeling of both the upper and lower airways.
T23293 137190-137307 Sentence denotes Asthma is a complex and variable disease with two main components, airway inflammation and smooth muscle dysfunction.
T72125 137308-137563 Sentence denotes According to national and international asthma guidelines, subjects with persistent asthma can be classif ied into one of three categories (mild, moderate, or severe) based upon lung function, symptoms, nighttime awakenings, medications and exacerbations.
T32608 137564-137737 Sentence denotes Though it is widely believed that there is a high degree of variability in both pediatric and adult subjects with asthma, few studies have compared variability between them.
T48311 137738-138003 Sentence denotes Therefore, an analysis of previously conducted asthma studies was undertaken to evaluate pediatric subjects aged 4-11 years (n=276) and adult subjects (n=85) previously receiving short-acting beta 2 -agoinsts alone in seven double-blind, randomized, 12-week trials.
T21454 138004-138087 Sentence denotes The analysis is limited to subjects who were randomized to placebo in these trials.
T23257 138088-138164 Sentence denotes During the study, subjects exhibited marked fluctuations in asthma severity.
T56627 138165-138437 Sentence denotes Despite the fact that all subjects met criteria for moderate or severe asthma at baseline, 27%, 18%, 48% and 8% of weeks for pediatric subjects and 9%, 14%, 71%, and 6% of weeks for adults were spent in the intermittent, mild, moderate and severe categories, respectively.
T77607 138438-138532 Sentence denotes A summary of severity classification based upon symptoms and albuterol use is presented below.
T28759 138533-138687 Sentence denotes In addition, based upon PEF % predicted, 62% and 52% of weeks were spent in the intermittent/mild category for pediatric and adult subjects, respectively.
T31599 138688-138909 Sentence denotes However, fluctuations in PEF occurred frequently, with 46% of pediatric subjects and 30% of adult subjects experiencing 10 changes in severity based on PEF over 12 weeks, indicating more variability in pediatric subjects.
T93174 138910-139068 Sentence denotes This analysis clearly demonstrates that asthma is a variable condition and that both pediatric and adult subjects frequently move between severity categories.
T27665 139069-139176 Sentence denotes Furthermore, there are marked differences in severity classifications between pediatric and adult subjects.
T46104 139177-139398 Sentence denotes Asthma severity, and consequent optimal therapy, cannot adequately be assessed by discrete, point-intime assessments of lung function, frequency of albuterol use, or asthma symptoms, especially in the pediatric age group.
T29317 139399-139598 Sentence denotes Studies suggest that there may be an association between single nucleotide polymorphisms (SNPs) in the beta 2 -adrenergic receptor gene (ADRB2) and the response to beta 2 -adrenergic bronchodilators.
T80407 139599-139664 Sentence denotes Polymorphisms at codon 16 have been at the center of this debate.
T19209 139665-139965 Sentence denotes Therefore, a retrospective analysis of six large, randomized trials was conducted to evaluate clinical responses to salmeterol administered with fluticasone propionate (FSC) 100/50mcg BID for 12 weeks in patients ( 12 yrs) with moderate or severe asthma and differing ADRB2 polymorphisms at codon 16.
T43218 139966-140028 Sentence denotes Baseline demographics were similar for all genotype subgroups.
T55459 140029-140131 Sentence denotes All measures of asthma improved over baseline and were similar across Arg16/Gly subgroups at 12 weeks.
T77761 140132-140255 Sentence denotes Pairwise comparisons were conducted between genotypes and there were no differences other than FEV 1 as noted in the table.
T63162 140256-140420 Sentence denotes Findings from this retrospective analysis show that regardless of Arg16/Gly genotype, clinical response to salmeterol with an ICS was similar during chronic dosing.
T15221 140421-140719 Sentence denotes Although prospective studies are needed to fully understand the effect of ADRB2 polymorphisms on response to therapy with a long-acting beta 2 -agonist, this analysis suggests that therapy with salmeterol and an ICS together is appropriate for Caucasian patients with differing Arg16/Gly genotypes.
T41300 140720-140787 Sentence denotes Coronary artery disease(CAD) and asthma commonly coexist in adults.
T56266 140788-140924 Sentence denotes IV dipyridamole thallium scintigraphy is considered a safe non-invasive technique in the evaluation of CAD when patients can't exercise.
T9699 140925-141154 Sentence denotes Dipyrdamole is a purine that blocks reuptake of extracellular adenosine increasing serum adenosine levels after iv administration.This results in a transient coronary vasodilation increasing the sensitivity of the thallium study.
T67523 141155-141280 Sentence denotes Methylxanthines reverse the effects of endogenous adenosine by competitively antagonizing adenosine at local purinoreceptors.
T25819 141281-141431 Sentence denotes We report a case of a 69 yr.old female with a 30 year history of stable mild persistant asthma treated with daily salmeterol and low-dose fluticasone.
T77020 141432-141487 Sentence denotes She was referred to Cardiology for atypical chest pain.
T86425 141488-141599 Sentence denotes Within minutes of a standard iv dose of dipyridamole the patient reported chest tightness, cough, and wheezing.
T30584 141600-141799 Sentence denotes All these symptoms, typical of her past asthma flares, were abolished within 5 minutes of an aminophylline infusion and before albuterol was administered.The stress test was completed and was normal.
T16254 141800-141903 Sentence denotes Inhaled adenosine induces bronchconstriction and is used as a probe for bronchial hyper-responsiveness.
T11022 141904-142043 Sentence denotes Commercial iv adenosine preparations used in treating supraventricular tachycardia are reported to induce bronchospasm in known asthmatics.
T72216 142044-142211 Sentence denotes Since serum levels of adenosine are transiently increased following iv dipyridamole, bronchospastic symptoms during dipyridamole stress tests should not be unexpected.
T21612 142212-142389 Sentence denotes An earlier study found an increased incidence of wheezing in 39% of patients with known COPD/asthma undergoing dipyridamole stress tests despite pretreatment with beta agonists.
T47298 142390-142518 Sentence denotes The marked decline of theophylline use for chronic asthma in recent years may actually be increasing the incidence of this risk.
T88812 142519-142629 Sentence denotes Cardiologists performing thallium stress tests are familiar with the risk of asthma flares after dipyridamole.
T979 142630-142751 Sentence denotes They use iv aminophylline frequently to reverse several types of clinical dipyridamole reactions, including bronchospasm.
T60398 142752-142852 Sentence denotes On the other hand, we are impressed that allergists are relatively unfamiliar with this association.
T89196 142853-143023 Sentence denotes Allergists and asthma specialists as well as asthmatic patients should be aware of risk of acute dipyridamole induced bronchospasm during elective cardiac stress testing.
T31992 143024-143142 Sentence denotes It has been shown that adhesive molecules are involved in inflammatory diseases of the lungs such as bronchial asthma.
T98902 143143-143656 Sentence denotes The purpose of the study was to measure and establish possible difference in serum levels of soluble ICAM-1 in 42 atopic patients (patients with allergic rhinitis and patients with bronchial asthma) in comparison with 28 patients without atopy (patients with asthma without rhinitis); whether there is a difference in sICAM-1 levels between groups of 26 patients with allergic rhinitis and asthma in comparison with group of 16 patients with allergic rhinitis only and also in comparison with 10 healthy controls.
T39520 143657-144068 Sentence denotes Results of the study have substantiated statistically significant difference in sICAM-1 levels between all groups of patients in comparison to healthy control, but no statistically significant difference in sICAM-1 levels between patients with and without atopy (Z=-1.738) or between patients with allergic rhinitis and bronchial asthma in comparison with group of patients with allergic rhinitis only (Z=0.00).
T31437 144069-144204 Sentence denotes Conclusion: ICAM-1 is an important marker of inflammation in patients with allergic rhinitis as well as in those with bronchial asthma.
T81566 144205-144268 Sentence denotes Atopic status does not influence differences in sICAM-1 levels.
T9552 144269-144672 Sentence denotes Although mean sICAM-1 levels were higher in patients with allergic rhinitis and bronchial asthma (312.71 ng/ml) in comparison with mean sICAM-1 levels in patients with allergic rhinitis only (279.69 ng/ml), no statistically significant difference was noted in sICAM-1 levels between these groups of subjects, i.e. asthma itself did not contribute to statistically significant increase of sICAM-1 levels.
T80139 144673-144675 Sentence denotes K.
T71968 144676-144694 Sentence denotes Nadarajah * , G.R.
T55720 144695-144704 Sentence denotes Green, M.
T48953 144705-144726 Sentence denotes Naglak, Abington, PA.
T59472 144727-144737 Sentence denotes Objective:
T29386 144738-144982 Sentence denotes To study the various clinical outcomes of penicillin skin testing (PST) in a community-based hospital and to determine the percentage of patients who have an antibiotic modification and the choice of antibiotic used following the result of PST.
T22812 144983-144990 Sentence denotes Method:
T8889 144991-145137 Sentence denotes This study is a retrospective chart review of all in-patients who were penicillin skin tested during a period of 6.6 years(Jan 1997 to July 2003).
T41506 145138-145218 Sentence denotes Information was collected on 101 patients using a detailed data collection form.
T19608 145219-145306 Sentence denotes Data was summarized using descriptive statistics including frequencies and percentages.
T46500 145307-145315 Sentence denotes Results:
T64055 145316-145491 Sentence denotes Of the 101 patients penicillin skin tested, 92 had a negative test, five had a positive test and in four patients the test was indeterminate(histamine controls were negative).
T10325 145492-145678 Sentence denotes Eighty six percent of the patients had a history of penicillin allergy, 7.9% had a history of cephalosporin allergy and 5.9% had a history of both penicillin and cephalosporin allergies.
T55290 145679-145747 Sentence denotes The duration of antibiotic prior to PST ranged from zero to 18 days.
T48717 145748-145938 Sentence denotes There was a 72.7% (67/92) reduction in the use of vancomycin, a 24.9% (23/92) reduction in the use of floroquinolones and a 7.6% (7/92) reduction in the use of aminoglycosides following PST.
T70585 145939-146029 Sentence denotes Aztreonam was used in 19.6% (18/92) of patients before PST and in zero patients after PST.
T93506 146030-146319 Sentence denotes Use of penicillin-based drugs was 49% (45/92) after PST and cephalosporin use increased from 4.4% (4/92 (all third generation cephalosporins)) to 47.8% (44/92( second and third generation cephalosporins)). i.e., 97% of patients with a negative PST received a penicillin or a cephalosporin.
T34013 146320-146376 Sentence denotes Vancomycin usage was higher among PST positive patients.
T99499 146377-146542 Sentence denotes Endocarditis was the diagnosis in 22% of all patients skin tested and Staphylococcus aureus (23.8%) and Enterococcus (16%) were the most common organisms on culture.
T74703 146543-146726 Sentence denotes There were no serious adverse reactions to the use of penicillins or cephalosporins when used following a negative PST, and there were no adverse reactions to penicillin skin testing.
T9473 146727-146738 Sentence denotes Conclusion:
T36495 146739-146875 Sentence denotes In the population studied, PST lowers the usage of vancomycin, floroquinolones and aminoglycosides and increases the use of penicillins.
T34715 146876-146947 Sentence denotes Third generation cephalosporin usage was increased by PST in our study.
T17201 146948-147099 Sentence denotes Overall, PST results in antibiotic modification that could lower the emergence of multi-drug resistant organisms and vancomycin resistant enterococcus.
T63225 147100-147230 Sentence denotes The aim of the study was to find a new marker which could be easily done to predict about possible allergy development in infants.
T32420 147231-147377 Sentence denotes Preventive procedure is always economically better than treatment itself.Food allergens are able to stimulate lymphocytes even in prenatal period.
T55740 147378-147501 Sentence denotes Immunological maturity of newborns is still in the center of our interest because its dependence on many different factors.
T29838 147502-147623 Sentence denotes The question was if CD30 activity in cord blood and in 1-year-old children correlates with development or not of allergy?
T81484 147624-147684 Sentence denotes The examined group consists of 120 newborns(58, 2% of boys).
T76739 147685-147771 Sentence denotes Breastfed were only 87 children until 3-months-old and 62 until they were 6-monthsold.
T43340 147772-147862 Sentence denotes Total IgE from cord blood and mothers' blood taken at delivery were measured using UniCAP.
T16195 147863-147935 Sentence denotes Immunological detection was done using fluorocytometry(Becton nad DAKO).
T16398 147936-147991 Sentence denotes Additionally parents were questionaired( family atopy).
T64632 147992-148188 Sentence denotes Our reaults show that positive family atopy history(group A) or elevated level of IgE( group B) or symptoms of allergy in first 3 months of life(group C) does not correlate with CD30 antigenicity.
T84093 148189-148228 Sentence denotes In all subgroups CD30 frequency was 1%.
T59406 148229-148325 Sentence denotes Our findings show unfortunately that CD30 cannot be a predictive marker for allergy development.
T71700 148326-148336 Sentence denotes Rationale:
T11481 148337-148456 Sentence denotes The etiology of eosinophilic esophagitis (EE) is unknown and the relationship to a type I allergic response is unclear.
T62614 148457-148607 Sentence denotes Comparison of patients with positive and negative type I allergy testing may further clarify EE and determine what are the most common food allergens.
T12021 148608-148616 Sentence denotes Methods:
T8175 148617-148767 Sentence denotes This is a retrospective chart review of medical records from January 2000 to January 2001 of children 1 year of age with biopsy confirmed EE (n = 42).
T32916 148768-148858 Sentence denotes EE was defined as having 15 eosinophils per high power field on esophageal mucosal biopsy.
T44220 148859-149014 Sentence denotes Patients were grouped according to positive (n = 26) and negative (n = 16) allergic responses on skin or radioallergosorbent testing (CAP RAST, Pharmacia).
T17512 149015-149146 Sentence denotes Skin testing with commercial extracts (Hollister-Stier Laboratories and Greer Laboratories) was performed in an allergist's office.
T80159 149147-149263 Sentence denotes A wheal of 3mm greater than the negative control on skin testing or IgE > 0.35 kU/L on RAST was considered positive.
T17081 149264-149522 Sentence denotes We performed Fisher exact analysis to determine if associations existed between a type I allergic response and factors such as age, symptoms, peripheral eosinophilia, and personal and family history of atopy (asthma, allergic rhinits, and atopic dermatitis).
T28834 149523-149761 Sentence denotes Results: EE patients with a positive type I allergic response were significantly younger than those with a negative response (mean 4.6 yo, median 4.5 yo, range 1 to 10.3 yo versus mean 8.5 yo, median 7.8 yo, range 1 to 21 yo; p = 0.0065).
T68232 149762-149993 Sentence denotes Vomiting as a presenting symptom was significantly increased in the allergic population (85%, 44%; p = 0.014) and abdominal pain as a chief complaint was significantly increased in the non-allergic population (31%, 69%; p = 0.026).
T28151 149994-150087 Sentence denotes Personal and family history of atopy and peripheral eosinophilia were similar between groups.
T38220 150088-150193 Sentence denotes The most common allergens were cow s milk (54%), peanut (46%), egg (42%), soybean (38%), and wheat (27%).
T11479 150194-150205 Sentence denotes Conclusion:
T5894 150206-150394 Sentence denotes Patients diagnosed with EE who present at a young age or who present with symptoms of vomiting may have a type I allergic response contributing to the esophageal eosinophilic inflammation.
T53605 150395-150531 Sentence denotes Consistent with food allergies in children, milk, peanut, egg, soybean, and wheat were the most common foods found with allergy testing.
T12625 150532-150777 Sentence denotes Because the positive predictive accuracy of food ANNALS OF ALLERGY, ASTHMA & IMMUNOLOGY testing is only about 50%, the challenge remains to develop a specific plan to confirm causative foods such as through oral challenges or elimination trials.
T56306 150778-150788 Sentence denotes Rationale:
T54895 150789-150875 Sentence denotes The relationship between specific IgE and IgG levels in atopic individuals is unknown.
T12743 150876-150992 Sentence denotes Increasing antigen exposure is expected to increase IgG production, however, the influence on IgE levels is unclear.
T45993 150993-151067 Sentence denotes To further clarify this relationship the following studies were conducted.
T66990 151068-151076 Sentence denotes Methods:
T20604 151077-151282 Sentence denotes Three hundred and sixty tandem determinations of specific IgE and IgG levels in 65 individuals were collected using the ImmunoCAP 100 instrument (Pharmacia Diagnostics) and commercially available reagents.
T27687 151283-151427 Sentence denotes Only subjects who had IgE levels > 0.35 kU/L and IgG determinations > 2 mg/l to the same specific allergenic species were included in the study.
T72684 151428-151648 Sentence denotes Specific IgE and IgG determinations were to Alternaria alternata, Aspergillus fumigatus, Penicillium notatum, Cladosporium herbarium, Felis domesticus, Canis familaris, Dermatophagoides farina, and Periplaneta Americana.
T32515 151649-151714 Sentence denotes Correlation coefficients were calculated using Excel (Microsoft).
T4262 151715-151723 Sentence denotes Results:
T12558 151724-151841 Sentence denotes The review of this data set yielded 55 tandem determinations of specific IgE and IgG levels in 25 atopic individuals.
T13079 151842-151894 Sentence denotes The most common IgE sensitization was to Alternaria.
T1774 151895-151973 Sentence denotes Sixtyfour percent of individuals had specific IgE directed against Alternaria.
T80225 151974-152025 Sentence denotes The lowest IgE response rate was for cat and roach.
T58821 152026-152096 Sentence denotes Only 20% of individuals had an IgE response to those specific species.
T96739 152097-152226 Sentence denotes Correlation coefficients (CC) were calculated between specific IgE and IgG levels and were positive for all eight species tested.
T18614 152227-152468 Sentence denotes The highest CC was for dog (n = 6, CC = 0.92) followed by Aspergillus (n = 13, CC = 0.71), Penicillium (n = 6, CC = 0.69), Alternaria (n = 13, CC = 0.62), Cladosporium (n = 8, CC = 0.35), cat (n = 5, CC = 0.31), and roach (n = 5, CC = 0.16).
T26013 152469-152543 Sentence denotes The lowest correlation was for Dermatophagoides farina (n = 7, CC = 0.03).
T47002 152544-152555 Sentence denotes Conclusion:
T42536 152556-152740 Sentence denotes When individuals with measurable specific IgE and IgG levels are considered, there appears to be a positive correlation between specific IgE and IgG levels for many allergenic species.
T14236 152741-152828 Sentence denotes Factors that influence the correlation are likely to be both genetic and environmental.
T12481 152829-152901 Sentence denotes Identifying this link and a clinical application are our next challenge.
T64212 152902-153001 Sentence denotes Recently, protein microarray tests are competing with traditional allergenspecific in vitro assays.
T27273 153002-153244 Sentence denotes While the advantages of microarrays in allergy testing are attractive, microarray analysis alone has not been very effective in reducing analysis time and automated microarray equipment typically is much larger than its benchtop counterparts.
T47593 153245-153412 Sentence denotes We have incorporated microarray technology into an automated microfluidic cartridge that provides rapid allergen testing using a compact, low-cost, desktop instrument.
T6684 153413-153578 Sentence denotes The injection molded microfluidic cartridge (Fig. A) contains arrays of miniature pumps and valves that direct reagents independently to a solid phase reaction area.
T77254 153579-153688 Sentence denotes Standard IgE (NIBSC) as well as allergens were immobilized within the cartridge to form a protein microarray.
T12174 153689-153818 Sentence denotes A small desktop analyzer actuated the pumps in the cartridge to automatically carry out a chemiluminescence-based ELISA reaction.
T36388 153819-153880 Sentence denotes Total IgE quantitation was performed in a 10 minute reaction.
T78181 153881-153953 Sentence denotes Fig.B shows the resultant image of a dilution series of immobilized IgE.
T15033 153954-154046 Sentence denotes Concentrations ranged from 0.625 to 1000 IU/ml corresponding to 1.9 fg to 3 ng IgE per spot.
T66491 154047-154153 Sentence denotes The average CV value for IgE quantitation was 12% showing good linearity (R2 = 0.99) and 6 fg sensitivity.
T97462 154154-154240 Sentence denotes This quantitative IgE curve is used to eliminate the effects of cartridge variability.
T23850 154241-154353 Sentence denotes Specific IgE detection was demonstrated using 3 extracts, D. pteronyssinu(Dp), A.fumigatus and B. verrucosa(Bv).
T63357 154354-154412 Sentence denotes A 2-step, 20 minute reaction ELISA technique was employed.
T1574 154413-154495 Sentence denotes Fig. C and D show the resultant images for Bv and Dp positive serum, respectively.
T37359 154496-154621 Sentence denotes The sensitivity of the Dp specific IgE test was further investigated using a positive class 1 serum sample confirmed by MAST.
T91911 154622-154834 Sentence denotes Dilution of the class 1 serum with negative control serum could then be detected on the cartridge down to an 8 fold dilution, resulting in a limit of detection in the range of 0.08-0.31 IU/ml for Dp specific IgE.
T53229 154835-155030 Sentence denotes We have demonstrated total IgE and allergen-specific IgE detection with total analysis times less than 30 minutes in a convenient, low cost system using a microfluidic-based microarray cartridge.
T25990 155031-155132 Sentence denotes Such rapid diagnosis allows physicians to provide treatment while the patient is still in the office.
T14929 155133-155144 Sentence denotes Background:
T30095 155145-155234 Sentence denotes Accurate allergen skin tests (AST) are the basis of optimal care of the allergic patient.
T98409 155235-155397 Sentence denotes Completing these tests on the first visit can expedite the diagnosis and treatment and offer patients(pts.) efficient use of their time and increase satisfaction.
T14955 155398-155494 Sentence denotes Appropriate pre-visit preparation is necessary to reduce the variables that affect AST outcomes.
T86086 155495-155586 Sentence denotes Both positive and negative skin test controls are necessary to assure the AST are reliable.
T7313 155587-155595 Sentence denotes Methods:
T76728 155596-155816 Sentence denotes We conducted a retrospective chart review of 1, 248 sequential pts. skin tested at an allergy practice, in order to examine the success of our pre-visit instructions and to identify other medications that may affect AST.
T8388 155817-155982 Sentence denotes Pts. were given verbal and written instructions to discontinue antihistamines and other histamine-1 receptor antagonist medications (H-1A) 5 days before their visit.
T55682 155983-156098 Sentence denotes They then underwent AST only if adequate positive (histamine) and negative (saline/vehicle) controls were obtained.
T67159 156099-156107 Sentence denotes Results:
T57981 156108-156181 Sentence denotes Only 53(4.2%) of the 1, 248 pts. had inadequate histamine response (IHR).
T86477 156182-156247 Sentence denotes Of these 53 pts., 23(1.8%) had used H-1A within the prior 5 days.
T23737 156248-156347 Sentence denotes 18(1.4%) pts. had taken H-1A in the recent past, but stopped them at least 5 days prior to testing.
T13857 156348-156386 Sentence denotes 12(1.0%) pts. had no exposure to H-1A.
T11389 156387-156464 Sentence denotes The use of psychiatric medications in the pts. with an IHR was also examined.
T5338 156465-156733 Sentence denotes Of the 18 pts. who discontinued H-1A for more than 5 days, 13(76%) were also taking various medications drugs used in the treatment of psychiatric disorders (SSRIs, benzodiazepines, atypical antidepressants & antipsychotics) which are not usually associated with H-1A.
T83100 156734-156855 Sentence denotes The group of 12 of the pts. with no prior use of H-1A included 10 (83%) who were also on various psychiatric medications.
T56921 156856-157027 Sentence denotes The high prevalence of psychiatric medication use in these two groups is in contrast to the to 23 pts. with recent use of H-1A in whom 43% were on psychiatric medications.
T26079 157028-157039 Sentence denotes Conclusion:
T31564 157040-157264 Sentence denotes Pre-visit patient education about discontinuation of H-1A can lead to successful first visit AST in the overwhelming majority of patients (95.7%).Failure to stop H-1A at the appropriate time occurred in only 1.8% of the pts.
T31465 157265-157351 Sentence denotes 1.4% of pts. discontinued H-1 A for the recommended 5 day interval, but still had IHR.
T34621 157352-157409 Sentence denotes Another 1% of pts. had an IHR yet no obvious use of H-1A.
T60712 157410-157494 Sentence denotes A few pts. taking psychiatric medications not normally associated with H-1A had IHR.
T92837 157495-157546 Sentence denotes Further investigation into this issue is warranted.
T63878 157547-157549 Sentence denotes A.
T72515 157550-157565 Sentence denotes Blaziene * , A.
T69890 157566-157580 Sentence denotes Chomiciene, L.
T48873 157581-157597 Sentence denotes Jurgauskiene, N.
T35021 157598-157629 Sentence denotes Ciaponiene, Vilnius, Lithuania.
T51622 157630-157641 Sentence denotes Background:
T7295 157642-157772 Sentence denotes Sublingual specific immunotherapy (SIT) is accepted as an alternative treatment to subcutaneous SIT of seasonal allergic rhinitis.
T43310 157773-157937 Sentence denotes The aim of this study was to evaluate changes in allergen-specific IgE and basophil degranulation test (BDT) before and after 1 year of SIT with a grass pollen mix.
T66370 157938-157946 Sentence denotes Methods:
T55702 157947-158120 Sentence denotes 6 patients (3 male and 3 female, aged 25-44 years) having sensitization to grass pollen with seasonal allergic rhinitis were treated with standardized grass pollen extracts.
T67446 158121-158319 Sentence denotes The blood samples were collected before and after 1 year of SIT assessing allergen-specific IgE using an ELISA method and BDT using a direct immunofluorescent method employing monoclonal antibodies.
T35517 158320-158328 Sentence denotes Results:
T82509 158329-158372 Sentence denotes The SIT was well tolerated by all patients.
T92413 158373-158437 Sentence denotes An increase in total IgE after SIT was observed in all patients.
T44234 158438-158575 Sentence denotes Specific IgE concentration was increased in 2 (33.3%) patients, while the BDT result was greater in 3 (50%) patients after 1 year of SIT.
T18065 158576-158588 Sentence denotes Conclusions:
T43680 158589-158721 Sentence denotes Allergen-specific IgE and BDT may serve as markers to indicate the clinical efficacy of SIT for seasonal allergic rhinitis patients.
T68171 158722-158726 Sentence denotes A.G.
T56073 158727-158748 Sentence denotes Palma-Carlos * , S.L.
T59443 158749-158760 Sentence denotes Silva, M.L.
T78211 158761-158792 Sentence denotes Palma-Carlos, Lisboa, Portugal.
T54923 158793-158982 Sentence denotes Introduction -The incidence of primary immunodeficiencies in patients attending an Out-Patient Center for Clinical Allergy and Immunology depends on the recruitment and on patients refered.
T96247 158983-159215 Sentence denotes Methods -In the last 3 years 3 000 patients have been observed in Lisbon Clinical Allergy Center reporting allergic diseases or repeated infections or refered by specialists (ENT, gynaecology, Internal Medicine, Pediatrics, or GP.).
T98610 159216-159388 Sentence denotes Screening for primary immunodeficiencies has been done by electrophoresis, assay of immunoglobulins and complement, IgG subclasses and flux-cytometry for T, B and NK cells.
T34281 159389-159466 Sentence denotes Results -102 cases (3, 4%) of primary immunodeficiencies have been diagnosed.
T41101 159467-159475 Sentence denotes Humoral:
T12413 159476-159644 Sentence denotes 13 deficits of IgA (12, 7% of immunodeficiencies), 7 of IgG (6, 8%) 16 of IgG subclasses (15, 7%) 11 of common variable immunodeficiency CVI-(10, 8%), 2 of IgM (2, 0%).
T96817 159645-159656 Sentence denotes Complement:
T32293 159657-159718 Sentence denotes 4 cases of C1 esterase inhibitor deficiency (3, 9%) Cellular:
T23387 159719-159820 Sentence denotes 45 cases of mucocutaneous Candidiasis (44, 1%) in fertile females, 2 cases of CD4 deficiency (1, 9%).
T22830 159821-159830 Sentence denotes Combined:
T53321 159831-160079 Sentence denotes 2 cases of deficiency of the couple CD40/C40 ligand with IgG deficiency (1, 9%).Conclusions -In the present series chronic mucocutaneous Candidiasis is the prevalent primary immunodeficiency, due to the number of patients refered by gynaecologists.
T35797 160080-160264 Sentence denotes Aside of this group where a decrease of NK cells was the more common immunologic pattern, humoral immunodeficiencies are frequent, mainly CVI, IgA, IgG and IgG subclasses deficiencies.
T13001 160265-160394 Sentence denotes The search for immunodeficiencies must be done in all patients with repeated infections attending immuno-allergology departments.
T21098 160395-160439 Sentence denotes A CASE OF ATYPICAL C2 COMPLEMENT DEFICIENCY.
T45073 160440-160444 Sentence denotes C.C.
T47919 160445-160472 Sentence denotes Randolph * , Waterbury, CT.
T26567 160473-160995 Sentence denotes Introduction:C2 complemennt deficiency occurs in 1 in 10, 000 individuals .It results in decreased opsonization and chemotaxis with increased prevalence ofSLE and other rheumatic disordersas well as enhanced vulnerability to pyogenic infection.There are two types of C2complement deficiency :type 1(90%associated with SLE)with no protein translation and type II with absence of protein secretion.We present a 15 year old white female otherwise healthy with recurrent urticaria and angioedema with C2 complement deficiency.
T10157 160996-162229 Sentence denotes Method:Case Report:A 15y/o w/f athlete presented with a two month history of recurrent hives and angioedema which she associated with ingestion of Halloween candy .One week before evaluation she had hives with Coconut as well.Her history was othewise unremarkable except for recurrent UTI'S, annual sinusitis, pneumonia in 1998 as well as migraines.She denied sexual activity.Her physical exam was normal.Results:An evaluation for autoimmune disease revealed normal ESR, ANA, DSDNA, mono and hepatitis serology as well as lyme titers however her CH50 was low17u/ml(normal 26-58U/ml)and evaluation of complement revealed c4 14mg/dl(normal 16-47mg//dl)and c2 <1.3mg/dl(normal 1.6-3.5mg/dl)with normal c3, c5-c9.Her father had nor-malc4 but c2 was 1.4mg/dl (normal 1.6-3.5mg/dl)Her sister had c2 of 1.5mg/dl and normal c4 and her mother had normal c2 and c4.Her workup included positive prick skin test to ragweed, ash and grass and she was started on Rhinocort and Clarinex seasonally.She has been followed for one year with resolution of hives and is asymptomatic.Her diagnosis had been confirmed by a pediatric rheumatologist.Conclusion;We present an atypical case of C2 complement deficiency in an currently asymptomatic individual.
T35922 162230-162241 Sentence denotes Background:
T21651 162242-162342 Sentence denotes We diagnosed a 10 month old male with CGD and aspergillus brain abscesses and pulmonary infiltrates.
T21062 162343-162454 Sentence denotes Review of the literature suggests he is one of the youngest cases of CGD complicated by cerebral aspergillosis.
T75784 162455-162467 Sentence denotes Case Report:
T4779 162468-162651 Sentence denotes A ten month old male previously seen for unexplained persistent pulmonary infiltrates since 4 month of age presented to our hospital with lethargy, fevers, and increased irritability.
T28025 162652-162702 Sentence denotes CT scan of the head revealed severe hydrocephalus.
T52955 162703-162795 Sentence denotes Multiple brain abscesses were found on surgical exam and cultured for aspergillus fumigatus.
T59020 162796-162860 Sentence denotes He had a history of failure to thrive and hypotonia since birth.
T85716 162861-162929 Sentence denotes Family history was significant for parents that were second cousins.
T97111 162930-163002 Sentence denotes There was no family history of recurrent infections or childhood deaths.
T88495 163003-163203 Sentence denotes Physical examination was significant for a child with weight and height in the 25% and 75%, respectively with persistent fevers >38.5 C, hypotonia, hepatosplenomegaly, and left lower lung field rales.
T71172 163204-163279 Sentence denotes Initial immune workup was normal except for elevated total IgE of 215 KU/L.
T84633 163280-163398 Sentence denotes CD4+ (526/m3) and CD8+ (332/m3) T cells were initially low, but later increased to normal levels without intervention.
T92190 163399-163493 Sentence denotes Neutrophil oxidase activity assessed by dihydrorotamine 123 (DHR) oxidation was 0% of control.
T89066 163494-163560 Sentence denotes Superoxide production assessed by cytochrome C reduction was zero.
T81084 163561-163620 Sentence denotes The patient was treated with interferon ? for presumed CGD.
T95458 163621-163708 Sentence denotes His aspergillus brain abscesses improved with intravenous voriconazole and caspofungun.
T17474 163709-163861 Sentence denotes The responsible organism for his recurrent pulmonary infections was not identified, but improved with antifungal therapy and broad spectrum antibiotics.
T41751 163862-163916 Sentence denotes The DHR test of both parents and siblings were normal.
T89821 163917-164032 Sentence denotes Antibody testing showed a complete deficiency of the p67 protein with normal levels of gp91, p22, and p47 proteins.
T17618 164033-164116 Sentence denotes Evaluation of the exons of the NCF-2 gene that encodes the p67 protein were normal.
T7081 164117-164128 Sentence denotes Conclusion:
T5459 164129-164208 Sentence denotes Mutations due to p67 protein deficiency are responsible for 3% of cases of CGD.
T53981 164209-164385 Sentence denotes There has been only one previously reported case of p67 deficiency without NCF-2 exon mutations in which a single point mutation in an intron of the NCF-II gene was identified.
T92434 164386-164477 Sentence denotes Fungal infections may complicate CGD, however cerebral aspergillosis is seldom encountered.
T8764 164478-164644 Sentence denotes This case ANNALS OF ALLERGY, ASTHMA & IMMUNOLOGY reports a 10 month old with CGD due to a p67 deficiency without exon mutations complicated by cerebral aspergillosis.
T91171 164645-164658 Sentence denotes INTRODUCTION:
T7810 164659-164917 Sentence denotes Lymphoid interstitial pneumonia is an uncommon condition which is considered both as a disease per se or as an inflammatory pulmonary reaction to various external stimuli or systemic diseases; however, at the present time most of the cases remain idiopathic.
T56959 164918-165046 Sentence denotes We present a case of an infant who developed a lymphoid interstitial pneumonia associated to a deficit of interferon-production.
T94467 165047-165055 Sentence denotes METHODS:
T61878 165056-165118 Sentence denotes We describe a clinical case and review the medical literature.
T79134 165119-165127 Sentence denotes RESULTS:
T44540 165128-165441 Sentence denotes We present the case of a five months old male with a history of cough, respiratory distress and four previous hospital admissions regarded as a 'pneumonic' events from two months of age and four siblings dead (two of them with 'abdominal disease' and one of them with candidiasis) during their first year of life.
T15950 165442-165480 Sentence denotes The parents referred no consanguinity.
T77178 165481-165577 Sentence denotes The physical examination showed a malnourished child with signs of bilateral lung consolidation.
T75894 165578-165642 Sentence denotes Oxygen supplementation and intravenous antibiotics were started.
T79986 165643-165717 Sentence denotes Our patient didn't have neonatal history related to the present compliant.
T10381 165718-165824 Sentence denotes The chest film revealed a diffuse bilateral interstitial pattern which was confirmed by pulmonary CT scan.
T47396 165825-165905 Sentence denotes Sweat chloride test, HIV and Epstein barr virus serology test were all negative.
T66562 165906-166100 Sentence denotes An initial immunologic evaluation reported slightly increased leukocytic count, hypergammaglobulinemia, lymphocityc flow citometry and nitro blue tetrazolium reduction test in normal parameters.
T54771 166101-166223 Sentence denotes The open lung biopsy showed a thicked pulmonar interstitium with moderate number of lymphocytes with not atypical pattern.
T88996 166224-166347 Sentence denotes Our patient was discharged with clinical improvement, ambulatory oxygen supplementation and inhaled fluticasone-salmeterol.
T94477 166348-166462 Sentence denotes In an ambulatory follow-up we evaluated lymphocytic production of cytokines and we found no levels of interferon-.
T22662 166463-166520 Sentence denotes We started weekly administration of oral transfer factor.
T69812 166521-166672 Sentence denotes The patient showed an excellent clinical improvement evidenced by no more oxygen dependence, weight gaining and absence of further hospital admissions.
T69519 166673-166686 Sentence denotes CON-CLUSIONS:
T23628 166687-167047 Sentence denotes Our patient represent a new linkage between lymphoid interstitial pneumonia and primary immunodeficiency characterized by interferonproduction deficit, maybe with a non previously described molecular defect and a probably autosomic recessive inheritance pattern; also we confirmed the transfer factor usefulness to induce gamma interferon endogeous production.
T41911 167048-167058 Sentence denotes Objective:
T17134 167059-168762 Sentence denotes Marijuana is a schedule class 1 psychoactive control substance more frequently used by the oriental societies( in the event of jubilation) causing altered state of conscience, euphoria, its prolonged use is followed by addiction and dependence.It contains more than 426 chemical entities with over 60 are of the cannabinoid i.e, cannabidiol (CBD), cannabinol (CBN), and delta-9, tetrahydrocannabinol (THC) The later on use has been associated with craving for further use of narcotics just to enhance the euphorient effects .The active ingredients i.e, Delta-9-TetrahydrocannabinolTHC) and other cannabinoids(THC) are liquid soluble at high concentrations which alters membrane function, resulting in alterations in immune cell response. cannabinoid has immunosuppressant properties causing impaired cell-mediated and humoral immune system activities, cytokine production, leukocyte migration and natural killer-cell(NK) activity resulting in reduction in the host resistance to bacterial and viral infection, (PMS)with HIV infection are at higher risk of developing AIDS, infection by opportunistic bacteria, fungi, or viruses (PMS), when compared to non marijuana smokers, have more respiratory ill-ness.Cannabinoids also characteristically as being immunomodulators i.e, generally suppressing but occasionally enhance some immunological responses, some have suggested that the immunosuppressive effects of cannabinoids might be useful clinically; for example, in treating multiple sclerosis.As per clinical response cannabinoids had been found exacerbating existing allergies from antigenic complex (eliciting formation of specific antibodies/metabolites as a hapten, combining with a body proteins).
T31697 168763-169171 Sentence denotes Methods .In the follow up studies including 18individuals(all males age25-60 years) with(PMS).of more than 6 months having serum level of TCH >10um, there have been 20 times reduction in the proliferation of T lymphocytes with a proportionate increase in the proliferation of B lymphocytes, reduction in the cytotoxic activity of T lymphocytes, reduction in macrophage activities i.e, phygocytosis RATIONALE:
T68128 169172-169230 Sentence denotes Patients with XLA are subject to arthritis and cellulitis.
T24654 169231-169310 Sentence denotes These three relatives have had similar courses, suggesting infectious etiology.
T25900 169311-169319 Sentence denotes METHODS:
T62048 169320-169462 Sentence denotes Two brothers and a cousin, from an African-American family known to carry XLA, have been diagnosed with XLA and chronically treated with IVIG.
T6870 169463-169534 Sentence denotes All three have developed arthritis and cellulitis of a lower extremity.
T35815 169535-169676 Sentence denotes The eldest, now 23 years old, had a 5-month waxing and waning arthritis and cellulitis that was refractory to the oral antibiotics attempted.
T74074 169677-169809 Sentence denotes His younger brother had not yet accomplished pubertal changes at the age of 16, and was below 3rd percentiles for weight and height.
T1939 169810-169911 Sentence denotes He also had several months waxing and waning arthritis and cellulitis refractory to oral antibiotics.
T68163 169912-170080 Sentence denotes He and his cousin have had esophogastroduodenoscopies that show gastritis and duodenitis with heavy growth of an organism visualized by specific staining for H. pylori.
T8325 170081-170162 Sentence denotes The cousin has also experienced more recent weight loss and arthritis/cellulitis.
T51485 170163-170171 Sentence denotes RESULTS:
T1113 170172-170249 Sentence denotes The younger brother had a blood culture that grew a curved gram-negative rod.
T41214 170250-170337 Sentence denotes A subsequent culture at the state lab grew a similar organism that was urease-negative.
T95955 170338-170491 Sentence denotes The two brothers are at or near completion of a six-month course of Ertapenem and Gentamicin; they have had resolution of their arthritis and cellulitis.
T59857 170492-170583 Sentence denotes The younger has gained 10.3 kg and experienced his pubertal changes at the age of 17 years.
T35659 170584-170597 Sentence denotes CON-CLUSIONS:
T96825 170598-170722 Sentence denotes There are prior reports of several different related organisms that can cause arthritis and cellulitis in patients with XLA.
T60781 170723-170789 Sentence denotes These include Helicobacter, Campylobacter, and Flexispira species.
T88584 170790-170901 Sentence denotes The urease-negative organism would not be Flexispira, but may be a Campylobactor species or Helicobacter canis.
T13761 170902-171030 Sentence denotes The results from this family suggest that long-term combination IV antibiotics may be indicated for patients with this syndrome.
T19029 171031-171109 Sentence denotes Slow virus infections have been reported to affect the Central nervous system.
T46674 171110-171279 Sentence denotes Parvovirus B19, Herpes and CMV are usually not included in the diagnosis of CNS diseases nor has been associated with CNS manifestation in an immuno-compromised patient.
T44942 171280-171438 Sentence denotes In this abstract, we report on a neurological manifestation that can be linked to Ebstein-Barr/Herpes Virus and Parvovirus-B19 in an immune deficient patient.
T62791 171439-171617 Sentence denotes A 50 year old female presented to our clinic with a history of chronic fatigue symptoms, daily arthralgias, frequent sinus infections and idiopathic tremors for the past 6 years.
T9733 171618-171755 Sentence denotes The patients neurological evaluation, including MRIs was found to be within normal limit, despite worsening tremors of her head and arms.
T68790 171756-171954 Sentence denotes A full clinical and labora-tory evaluation was performed which revealed IgG subclass, low T-cell numbers and functioning, low response to specific antibodies and positive IgM for EBV, Parvo and CMV.
T4515 171955-172136 Sentence denotes The patients Common Immune Deficiency coupled with chronic viral infection and worsening tremors led us to try high dose IVIG (2g/kg divided over 3 days on cycles of every 3 weeks).
T84732 172137-172273 Sentence denotes Within three months of starting IVIG, the patient had a large reduction in her tremors and negative IgMs for Parvovirus, Herpes and CMV.
T57877 172274-172409 Sentence denotes Given our findings, we suggest that IVIG may play a role as a neuro-immune modulator, as has been shown in other neuro-immune diseases.
T33889 172410-172645 Sentence denotes We further suggest that the interaction between Parvovirus B-19, Herpes and CMV as part of the slow viruses, combined with underlying immune disorder may lead to neurological presentation and high dose of IVIG can reverse the syndrome.
T27020 172646-172654 Sentence denotes Purpose:
T83486 172655-172815 Sentence denotes To date, only two patients older than fifty years of age have been diagnosed with Velocardiofacial Syndrome (VCFS); this case represents the third such patient.
T57282 172816-172824 Sentence denotes Methods:
T92660 172825-172904 Sentence denotes Physical and laboratory findings of the patient are presented as a case report.
T39673 172905-172913 Sentence denotes Results:
T41502 172914-173094 Sentence denotes We describe a sixty-six-year-old male, recently diagnosed with VCFS, confirmed by fluorescent in-situ hybridization (FISH), was referred by his psychiatrist for comprehensive care.
T98438 173095-173222 Sentence denotes He had a history of cleft palate and learning disabilities as a child, with the onset of psychiatric illness in his late teens.
T19034 173223-173437 Sentence denotes Although there was no history of cardiac disease, the patient had agenesis of the left renal artery as well as other vascular anomalies, including hypoplasia of the left A1 segement of the anterior cerebral artery.
T1399 173438-173545 Sentence denotes Other findings included hypothyroidism, hypoparathyroidism, sensorineural hearing loss, and typical facies.
T26950 173546-173588 Sentence denotes He also suffered from chronic candidiasis.
T53252 173589-173821 Sentence denotes Immunologic laboratory studies revealed over a 2:1 ratio of CD8:CD4 T cells with a decreased CD4 percentage, markedly diminished B cell percentage, decreased T cell mitogen responses, and markedly decreased B cell mitogen responses.
T99496 173822-173922 Sentence denotes Nevertheless, total serum IgG and specific antibody responses remained normal, with a low serum IgM.
T12937 173923-173935 Sentence denotes Conclusions:
T82103 173936-174056 Sentence denotes This patient meets the criteria for the diagnosis of VCFS; only the third reported case diagnosed over the age of fifty.
T72012 174057-174196 Sentence denotes Though his immunologic findings may be consistent with his diagnosis, they may be due in some part to immunologic senescence given his age.
T99128 174197-174208 Sentence denotes Background:
T35203 174209-174413 Sentence denotes The classic presentation for patients with XLA and mutations in the Btk gene includes marked hypogammaglobulinemia, absent B cells, and significant sinopulmonary infections beginning at 4-5 months of age.
T45353 174414-174558 Sentence denotes Typically, MDS presents with anemia, leukopenia, monocytosis, and thrombocytopenia with recurrent infections, skin rash, and hepatosplenomegaly.
T26537 174559-174641 Sentence denotes Many of these subjects demonstrate chromosomal abnormalities including monosomy 7.
T80930 174642-174717 Sentence denotes We describe a case of MDS presenting with some features of both conditions.
T89212 174718-174735 Sentence denotes Clinical History:
T58044 174736-174917 Sentence denotes We present a 2 year old male with a suspected diagnosis of XLA, chronic sinopulmonary disease beginning at 12 mo, diffuse bronchiectasis, and agammaglobulinemia with absent B cells.
T65925 174918-174999 Sentence denotes He had WBC =3750 cells/ul, with 60% monocytes and platelet count of 122, 000 /ul.
T74273 175000-175051 Sentence denotes He had no anemia, hepatosplenomegaly, or skin rash.
T852 175052-175143 Sentence denotes Bone marrow biopsy showed MDS with absent plasma cells and monosomy 7 in 95 % of his cells.
T56576 175144-175193 Sentence denotes Btk expression and sequence analysis were normal.
T72175 175194-175205 Sentence denotes Conclusion:
T73389 175206-175471 Sentence denotes While XLA is the most likely primary immune deficiency that would present in a male with the clinical picture described above, this case illustrates the importance of maintaining an expanded differential diagnosis in patients with presumed primary immunodeficiency.
T31047 175472-175474 Sentence denotes J.
T77337 175475-175486 Sentence denotes Wang * , L.
T20072 175487-175496 Sentence denotes Mayer, C.
T99394 175497-175530 Sentence denotes Cunningham-Rundles, New York, NY.
T76614 175531-175542 Sentence denotes Background:
T2942 175543-175671 Sentence denotes Chronic granulomatous disease (CGD) usually results in acute or chronic infections with a defined spectrum of bacteria or fungi.
T10690 175672-175812 Sentence denotes Other characteristics include inflammatory disorders, including genitourinary or mucosal inflammation resembling inflammatory bowel disease.
T6040 175813-175944 Sentence denotes GM-CSF has been used in the treatment of mucosal inflammation in glycogen storage disease Ib and Crohn's disease with some success.
T40064 175945-175955 Sentence denotes Objective:
T18618 175956-176055 Sentence denotes To explore the use of a novel therapy in the treatment of mucosal inflammation associated with CGD.
T17965 176056-176064 Sentence denotes Methods:
T11083 176065-176213 Sentence denotes The patient was treated with daily GM-CSF (0.6 mcg/kg/dose subcutaneous injection) along with parenteral antibiotics and total parenteral nutrition.
T91732 176214-176306 Sentence denotes After 4 days on GM-CSF, hydrocortisone enemas were added due to continued pain and swelling.
T87575 176307-176315 Sentence denotes Results:
T32150 176316-176481 Sentence denotes Rectal and abdominal pain significantly improved, blood streaked stools decreased; he tolerated a regular diet and was discharged home 10 days after starting GM-CSF.
T74015 176482-176547 Sentence denotes He now has no rectal or abdominal pain and no blood in the stool.
T18206 176548-176651 Sentence denotes Conclusions: GM-CSF may be a useful therapy for the management of mucosal inflammation in CGD patients.
T72567 176652-176744 Sentence denotes It appears safe and well tolerated and permits avoidance of immune suppressive alternatives.
T36395 176745-176758 Sentence denotes Introduction:
T56215 176759-176862 Sentence denotes Management of autoimmune cytopenias in patients with cellular immunodeficiency may be very challenging.
T20213 176863-176982 Sentence denotes Treatment of these cytopenias with corticosteroids may potentiate the immune dysfunction leading to further infections.
T15286 176983-176991 Sentence denotes Methods:
T89462 176992-177167 Sentence denotes We describe a 15 month-old female with a cellular immunodeficiency and autoimmune thrombocytopenia / hemolytic anemia being treated with steroids and IVIG without improvement.
T99727 177168-177265 Sentence denotes Rituximab, a monoclonal antibody that binds to B-lymphocyte CD20 surface antigens, was initiated.
T96892 177266-177274 Sentence denotes Results:
T38237 177275-177384 Sentence denotes This patient presented at 11 months of age with failure to thrive, eczema and recurrent bacterial pneumonias.
T7426 177385-177522 Sentence denotes She was diagnosed with a T lymphocyte immunodeficiency with decreased absolute numbers of CD3 (493), CD4 (365), and CD8 (80) lymphocytes.
T35467 177523-177596 Sentence denotes T cell function was markedly decreased as measured by PHA, ConA, and PWM.
T73676 177597-177725 Sentence denotes She developed chronic thrombocytopenia with platelets of less than 20, 000 and Coombs positive anemia with hemoglobin of 6 g/dL.
T25842 177726-177837 Sentence denotes She was placed on 4mg/kg/day of prednisone with minimal improvement and continued to develop severe pneumonias.
T84613 177838-177891 Sentence denotes Rituximab 375 mg/m 2 /week was initiated for 5 doses.
T40709 177892-177993 Sentence denotes Her cytopenias improved with an increase in both platelet count (229, 000) and hemoglobin (15.1g/dL).
T21860 177994-178038 Sentence denotes Her absolute CD19 count fell from 1319 to 0.
T89708 178039-178079 Sentence denotes She was weaned off steroids permanently.
T10802 178080-178193 Sentence denotes She has also continued on IVIG, prophylactic antibiotics, and as needed rituximab pending bone marrow transplant.
T63194 178194-178206 Sentence denotes Conclusions:
T13359 178207-178381 Sentence denotes Rituximab, a monoclonal anti-CD 20 antibody, may be helpful in treating autoimmune cytopenias in patients with cellular immunodeficiency in which steroids need to be avoided.
T7739 178382-178510 Sentence denotes IVIG antibody replacement substitutes for the subsequent humoral antibody depletion due to induced secondary B cell lymphopenia.
T94801 178511-178524 Sentence denotes Introduction:
T46343 178525-178577 Sentence denotes The patient is a 3 month old male born at full term.
T42105 178578-178706 Sentence denotes During his prenatal course he was noted to have a pulmonary abnormality in his left lower lobe at approximately 12 weeks of age.
T38039 178707-178828 Sentence denotes Serial ultrasounds and fetal MRI were consistent with the diagnosis of congenital cystic adenomatoid malformation (CCAM).
T32278 178829-178935 Sentence denotes Histology from elective resection of the lesion performed at 2 months of age revealed no evidence of CCAM.
T9905 178936-179007 Sentence denotes Silver stain revealed florid Pneumocystis jiroveci (carinii) infection.
T4822 179008-179048 Sentence denotes The patient was completely asymptomatic.
T25394 179049-179207 Sentence denotes The differential diagnosis for this infection in the newborn period includes HIV infection, severe combined immunodeficiency, and x-linked hyper-IgM syndrome.
T98009 179208-179290 Sentence denotes The infection has also occurred in newborns with apparently normal immune systems.
T16069 179291-179299 Sentence denotes Methods:
T25634 179300-179385 Sentence denotes Immunology evaluation was performed to evaluate the patient for the listed diagnoses.
T75521 179386-179423 Sentence denotes A complete blood count was performed.
T43831 179424-179476 Sentence denotes Lymphocyte subsets were performed by flow cytometry.
T51042 179477-179549 Sentence denotes Quantitative immunoglobulins G,A, M and E were measured by nephelometry.
T58592 179550-179620 Sentence denotes Specific antibodies to tetanus and diptheria were determined by ELISA.
T4243 179621-179676 Sentence denotes HIV status was ascertained by western blot and DNA PCR.
T60713 179677-179717 Sentence denotes Dichlorofluorescein assay was performed.
T928 179718-179795 Sentence denotes Fluorescenceactivated cell sorter technique was used to evaluate CD40 ligand.
T27466 179796-179858 Sentence denotes Lymphocyte stimulation to mitogens and tetanus were performed.
T54111 179859-179867 Sentence denotes Results:
T63250 179868-179938 Sentence denotes The patient had negative HIV1/2 antibodies and a negative HIV DNA PCR.
T90953 179939-180033 Sentence denotes The result of the complete blood count was normal with an absolute lymphocyte count of 6, 750.
T5942 180034-180130 Sentence denotes The patient had normal percentages and numbers of CD3, CD4, CD8, CD19, and natural killer cells.
T38755 180131-180189 Sentence denotes Lymphocyte stimulation to mitogens and tetanus was normal.
T47042 180190-180211 Sentence denotes DCF assay was normal.
T63475 180212-180255 Sentence denotes FACS revealed normal levels of CD40 ligand.
T95658 180256-180370 Sentence denotes At 5 months of age he had protective titers to diptheria and tetanus titers of 0.52 IU/mL (protective >0.6 IU/mL).
T46909 180371-180454 Sentence denotes At 5 months IgG, A, M and E were 235 (normal 218-636), <6, 36, and <5 respectively.
T78665 180455-180466 Sentence denotes Conclusion:
T82921 180467-180590 Sentence denotes Immunologic testing revealed no evidence of severe combined immunodeficiency, HIV infection or x-linked hyper-IgM syndrome.
T20971 180591-180692 Sentence denotes The patient remains well clinically with normal growth and development with no subsequent infections.
T11607 180693-180786 Sentence denotes Pneumocystis jiroveci pneumonia can be seen in infants with apparently normal immune systems.
T43585 180787-180883 Sentence denotes Commercial preparations of IgG produced for IV use (IVIG), must fulfill regulatory requirements.
T14904 180884-181093 Sentence denotes The method of preparation, however, may produce alterations in the content or function of IgG subclasses such as disturbed composition which can be reflected as a lowered clinical effectiveness of the product.
T77508 181094-181343 Sentence denotes We report 2 patients with specific IgG3 immunodeficiency, that, when changed to a new IVIG preparation, had lessening of clinical effectiveness of the new product but who also experienced recovery after they were changed to a different IVIG product.
T75984 181344-181351 Sentence denotes Case 1.
T51357 181352-181489 Sentence denotes A 53 y/o male with hx of cervical lymphadenopathy associated with recurrent URI, fatigue, cognitive alterations and hypercholesterolemia.
T8062 181490-181706 Sentence denotes He was Dx in 1993 with a specific IgG3 immunodeficiency for which he was started on IVIG infusions 400mgxkg q/4 w which brought his IgG3 levels to normal values 21 mg/dL, (18-95 mg/dL) with good clinical improvement.
T29207 181707-181976 Sentence denotes When he was changed to a different IVIG product with lower IgA content his initial symptoms returned with decrease of his IgG3 to 17 mg/dL (41-129 mg/dL) He was changed to a different IVIG product with higher IgA content with disappearance of all his previous symptoms.
T8770 181977-181984 Sentence denotes Case 2.
T66474 181985-182136 Sentence denotes A 47 y/o female with history of chronic yeast infection, fatigue, joint pain, asthma, GE reflux, depression, hypothyroidism and shunt for hydrocephaly.
T51682 182137-182231 Sentence denotes She was diagnosed with IgG1 and IgG3 immunodeficiency and started on IVIG 400 mg x kg x q/4 w.
T62708 182232-182372 Sentence denotes When changed to another IVIG with lower IgA content she experienced worsening of her symptoms during the 2 months that she was receiving it.
T62619 182373-182485 Sentence denotes She was changed to a different IVIG product with a higher IgA content with complete improvement of her symptoms.
T37013 182486-183001 Sentence denotes Although the content of IgA in Product 1 (50-150 ug/mL) was significantly lower than in Prod-uct 2 (720ug/mL), the total IgG and IgG subclass distribution (including IgG3) were comparable Therefore, the lack of clinical effectiveness of Product 1 would appear to be related to qualitative alterations in the product related to methodological preparation possibly in removal of the IgA or other physicochemical alterations affecting biologic activity which contributed to a lessened clinical efficacy of the product.
T30554 183002-183144 Sentence denotes We present these cases to alert the allergist-immunologist to these observations when treating patients with IgG or IgG subclass deficiencies.
T37817 183145-183156 Sentence denotes BACKGROUND:
T94590 183157-183279 Sentence denotes Development of atopy has been known to occur in nonatopic recipients of bone marrow transplants ( BMT) from atopic donors.
T96764 183280-183407 Sentence denotes The reverse condition, with atopic recipients losing evidence of specific IgE after BMT from non-atopic donors is quite unique.
T50680 183408-183486 Sentence denotes CASE REPORT: PH is a 37 year old male referred for recurrent nasal congestion.
T84510 183487-183633 Sentence denotes As a teenager, the patient was treated for chronic allergic rhinitis and asthma, atopic dermatitis diagnosed as severe, and multiple food allergy.
T40320 183634-183755 Sentence denotes Skin testing done as a teenager showed 3+ reactions to multiple pollen, dog, cat, most seafood, cashew, walnut and pecan.
T85995 183756-183866 Sentence denotes At 16 years of age, he underwent an allogeneic BMT from his non-atopic brother for acute myelogenous leukemia.
T48858 183867-183981 Sentence denotes Asthma and atopic dermatitis were observed to clear almost completely and allergic rhinitis improve after the BMT.
T17525 183982-184019 Sentence denotes His blood type changed from 0+ to 0-.
T56563 184020-184163 Sentence denotes Skin testing done on his current visit showed unremarkable responses to all pollen, cat, dog, dust mites and foods with good histamine control.
T22636 184164-184175 Sentence denotes DISCUSSION:
T65192 184176-184272 Sentence denotes The negative skin test results suggests that his current nasal symptoms are vasomotor in nature.
T82639 184273-184396 Sentence denotes Considering the past severity of his symptoms, it appears unlikely that he lost his specific-IgE sensitivity spontaneously.
T70252 184397-184484 Sentence denotes Transfer of atopy is known to occur in non-atopic recipients of BMT from atopic donors.
T76205 184485-184657 Sentence denotes In a study of 12 patients undergoing allogeneic BMT for hematologic malignancies, nonatopic recipients developed positive skin tests with profiles similar to atopic donors.
T32634 184658-184779 Sentence denotes 1 A possible mechanism is passive transfer of memory B-cells which initiate specific-IgE production with a donor pattern.
T40215 184780-184920 Sentence denotes A reverse of this mechanism could occur with the recipient gaining lymphoid precursors with no atopic tendency leading to clearing of atopy.
T27820 184921-185202 Sentence denotes The literature yielded one report of asthma resolving after high-dose chemotherapy and autologous stem cell transplantation The authors suggested that chemotherapy could have resulted in immune system reconstitution, normalization of the T-cell repertoire and resolution of asthma.
T65226 185203-185216 Sentence denotes INTRODUCTION:
T80512 185217-185416 Sentence denotes Primary central nervous system (CNS) lymphomas constitute only a small percentage of central nervous system tumors in adults and are seen more frequently in AIDS patients and immunodeficiency states.
T55 185417-185495 Sentence denotes They are extremely rare in children, even those with primary immunodeficiency.
T69289 185496-185649 Sentence denotes We present a 4-year-old female with combined immunodeficiency who developed an EBER+ (EBV-associated) large B-cell lymphoma that was confined to the CNS.
T63247 185650-185658 Sentence denotes METHODS:
T29970 185659-185820 Sentence denotes The patient is a 4-year-old female that was being evaluated for combined immunodeficiency who presented to our institution with acute fever and seizure activity.
T79305 185821-185829 Sentence denotes RESULTS:
T95374 185830-185938 Sentence denotes The patient had a history of recurrent pneumonia, otitis media, sinusitis, and upper respiratory infections.
T50896 185939-186023 Sentence denotes She also exhibited failure to thrive, chronic diarrhea, and sen-sorineural deafness.
T42797 186024-186208 Sentence denotes She was found to have a combined immunodeficiency with severe neutropenia and lymphopenia, low IgA, low IgM, and poor specific antibody response to protein and polysaccharide antigens.
T64276 186209-186277 Sentence denotes She had no response to a Candida delayed hypersensitivity skin test.
T86537 186278-186302 Sentence denotes HIV tests were negative.
T58560 186303-186452 Sentence denotes She was thought to have acute meningoencephalitis causing the fever and seizure activity, however bacterial, viral, and fungal studies were negative.
T31545 186453-186523 Sentence denotes She received multiple anitbacterial, antifungal, and antiviral agents.
T60142 186524-186597 Sentence denotes She died secondary to brainstem compression due to severe cerebral edema.
T58900 186598-186699 Sentence denotes Autopsy revealed an EBER+ large B-cell lymphoma that involved about 80% of her brain and spinal cord.
T14165 186700-186736 Sentence denotes No tumor cells were found elsewhere.
T17715 186737-186750 Sentence denotes CON-CLUSIONS:
T60854 186751-186865 Sentence denotes This case represents a rare manifestation of combined immunodeficiency: the development of a primary CNS lymphoma.
T2931 186866-186922 Sentence denotes The tumor cells were found to be EBER+ (EBV-associated).
T41918 186923-187018 Sentence denotes EBV is known to be associated with lymphoma, especially in AIDS and immunocompromised patients.
T76072 187019-187188 Sentence denotes Only 6.5% of primary tumor sites in severe combined immune deficiency patients involved the CNS in the Immunodeficiency Cancer Registry that was instituted in the 1970s.
T8646 187189-187191 Sentence denotes V.
T73064 187192-187208 Sentence denotes Litvinova * , G.
T50805 187209-187248 Sentence denotes Muzlaev, Krasnodar, Russian Federation.
T62975 187249-187262 Sentence denotes Introduction:
T21022 187263-187371 Sentence denotes Glyoma is one of the most prevalent diseases among all brain tumors and more than 35% of them are malignant.
T55015 187372-187472 Sentence denotes In the previous investigations it has been shown the immune disorders in patients with glyoma tumor.
T42320 187473-187677 Sentence denotes At the same time it was suggested the possible anti-tumor activity of some proinflammatory cytokines (TNF, IL1, IL8), which can penetrate via haematoencephalic barrier and induce the lysis of tumor cells.
T67705 187678-187858 Sentence denotes The aim of this investigation was to study the serum and spinal fluid concentrations of one of the key immunoregulatory cytokines -gamma IFN and IL18 in patients with glyoma tumor.
T32703 187859-187867 Sentence denotes Methods:
T37712 187868-188000 Sentence denotes The concentrations of the gamma IFN and IL18 have been studied in serum and spinal fluid of 16 patients with glyoma by ELIZA method.
T10480 188001-188083 Sentence denotes In control, the same parameters have been studied in 6 patients with brain trauma.
T19391 188084-188092 Sentence denotes Results:
T59253 188093-188236 Sentence denotes It has been shown that concentrations of gamma IFN and IL18 in serum and spinal fluid was 1.5-2 times higher than in trauma patients (p<0.001).
T28998 188237-188332 Sentence denotes The serum levels of gamma IFN and IL18 in glyoma patients were 82.8 and 28.5pg/ml, accordingly.
T98642 188333-188371 Sentence denotes In trauma patients-44.3 and 16.3pg/ml.
T34175 188372-188476 Sentence denotes The concentration in spinal fluid of the studied cytokines was 1.8 time higher than in control patients.
T17906 188477-188488 Sentence denotes Conclusion:
T94423 188489-188658 Sentence denotes Proinflammatory cytokines gamma IFN and IL18 may be involved in pathogenesis of glyoma and can participate as possible anti-tumor factors of immunity in glyoma patients.
T71967 188659-188661 Sentence denotes A.
T60344 188662-188683 Sentence denotes Arrey-Mensah * , R.U.
T99043 188684-188710 Sentence denotes Sorensen, New Orleans, LA.
T13741 188711-188721 Sentence denotes Rationale:
T99062 188722-188809 Sentence denotes Immunodeficiencies need to be ruled out in infants that present with failure to thrive.
T58409 188810-189005 Sentence denotes Patients with T-cell lymphopenia, hypogammaglobulinemia and pancytopenia may have a primary immunodeficiency such as SCID, or a secondary immunodeficiency that may need to be managed differently.
T64417 189006-189014 Sentence denotes Methods:
T47980 189015-189297 Sentence denotes Evaluation of cellular and antibody-mediated immunity of a 15 month old AAF admitted with failure to thrive and chronic diarrhea. oHistory of duodenal atresia corrected by creating a blind duodenal loop and anastomosis of the stomach to the jejunum at birth. o Mass in hypogastrium.
T26400 189298-189306 Sentence denotes Results:
T15869 189307-189390 Sentence denotes Immunologic evaluation revealed: " Lymphopenia ranging 210 to 350cells/ul " Anemia:
T51354 189391-189491 Sentence denotes Hemoglobin 7.6g/dl, Retic 6.8 " ANCs ranging 700 to 2100 " Thrombocytopenia 54000L to 26500L " CD4+:
T17316 189492-189502 Sentence denotes 80 " CD8+:
T60694 189503-189517 Sentence denotes 50 " CD4/CD8R:
T42241 189518-189529 Sentence denotes 1.5 " CD19:
T40383 189530-189541 Sentence denotes 290 " CD56:
T90138 189542-189649 Sentence denotes 190 " MITOGEN RESPONSES were normal: " PHA 46, 397cpm " CON-A, 7, 690cpm " PWM, 36, 168cpm Immunoglobulins:
T89407 189650-189810 Sentence denotes IgG 102mg/dl IgA 80mg/dl IgM 55mg/dl IgE 20 IU/ml Total protein was 3.4g/dl, Albumin was 1.2g/dl The Immunoglobulin-G half-life study was 7 days in our patient:
T8097 189811-189941 Sentence denotes Metabolic imbalance: hypokalemia (1.8mmol/l) hyponatremia (127mmol/l) Hypocalcemia (4.6mg/dl) Blood, stool, urine cultures normal.
T84551 189942-189983 Sentence denotes Stool ova, parasite, virus were negative.
T82918 189984-190156 Sentence denotes HIV-PCR (-) Radiological evaluation: superior mesenteric vein thrombosis, chronic malrotation and volvulus, dilated duodenal blind loop with possible lymphatic obstruction.
T3301 190157-190282 Sentence denotes The patient improved clinically and all immunological markers normalized after surgical removal of adhesions and obstruction.
T62675 190283-190294 Sentence denotes Conclusion:
T93349 190295-190364 Sentence denotes The patient had a secondary immunodeficiency due to Lymphangiectasia.
T36796 190365-190545 Sentence denotes Lymphangiectasia should be considered in the presence of a lymphopenia with normal lymphocyte function and hypogammaglobulinemia accompanied by hypoproteinemia and hypoalbuminemia.
T98414 190546-190630 Sentence denotes Hypogammaglobulinemia and hypoproteinemia were secondary to gastrointestinal losses.
T57599 190631-190916 Sentence denotes The immunological component of 22q11.2 deletion syndrome (also known as DiGeorge syndrome;DGS), hypoplasia of the thymus, is quite variable among patients and provides the opportunity to determine the relationship between thymic function and T cell receptor (TCR) repertoire diversity.
T84476 190917-191150 Sentence denotes Using a novel measure of repertoire diversity based on CDR3 length polymorphism called Hamming Distance, TCRBV repertoire diversity in DGS was found to differ from control subjects by having an overall skewing of receptor expression.
T13397 191151-191260 Sentence denotes As expected from clinical outcomes, there was also great intra-individual variability in DGS TCR repertoires.
T34493 191261-191479 Sentence denotes The degree of repertoire diversity was directly correlated with thymic output as measured by T cell receptor excision circles (TRECS), i.e. greater thymic output resulted in more diverse repertoires (see figure below).
T57631 191480-191706 Sentence denotes This result demonstrates a quantitative relationship between thymic function and repertoire diversity in humans and may reflect the balance between thymic output and peripheral expansion to maintain an adequate TCR repertoire.
T73350 191707-191829 Sentence denotes In addition, it may suggest a basis wherein limited repertoire diversity mediates both immune deficiency and autoimmunity.
T47722 191830-191980 Sentence denotes TCR repertoire diversity in DGS, as measured by Hamming distance, correlates with thymic output, as measured by TRECS (plotted on a logarithmic scale)
T96 191981-191983 Sentence denotes A.
T46287 191984-191997 Sentence denotes Sabra 1* , S.
T27998 191998-192012 Sentence denotes Sabra 1 , H.J.
T9589 192013-192026 Sentence denotes Castro 2 , J.
T54557 192027-192046 Sentence denotes Malka-Rais 2 , J.I.
T36054 192047-192070 Sentence denotes Mendez-Inocencio 2 , G.
T18385 192071-192086 Sentence denotes Santos 1 , J.A.
T71554 192087-192102 Sentence denotes Bellanti 2 , 1.
T34161 192103-192129 Sentence denotes Rio de Janeiro, Brazil; 2.
T37643 192130-192145 Sentence denotes Washington, DC.
T48788 192146-192308 Sentence denotes A major investigative effort of our laboratory has been directed to the study of non-IgE mechanisms and their role in the immunopathogenesis of food allergy (FA).
T86353 192309-192593 Sentence denotes We have previously reported Th1 and Th2 cytokine alterations associated with several clinical entities that had overlapping disease manifestations affecting the mucosal-associated lymphoid tissues (MALT), of the GI tract (GALT), skin (SALT), nasal (NALT) and bronchial tissues (BALT).
T97693 192594-192717 Sentence denotes The objective of the present study was to evaluate specific immunologic alterations in a group of patients with non-IgE FA.
T94441 192718-192879 Sentence denotes Peripheral blood CD4 and CD8 lymphocyte subset analyses were performed in 10 patients with FA documented by double-blind placebo-control food-challenge (DBPCFC).
T594 192880-193360 Sentence denotes All patients were treated with an amino-acid based formula (AABF) and then received an open challenge using a panel of commonly offending allergenic food allergens in a normal diet.The clinical picture of all 10 patients with FA were linked to MALT-related manifestations; 8 with GALT symptoms of diarrhea, vomiting, abdominal pain and FTT, 4 with BALT symptoms of asthma, 4 with SALT symptoms of eczema, 3 with NALT symptoms of rhinitis and 2 with edema, ascites and anaphylaxis.
T3791 193361-193532 Sentence denotes All subjects had normal serum IgE and eosinophil levels, negative IgE food RAST tests, normal CD4 (mean 1562 + 368) and very low CD8 (174 + 42) levels in peripheral blood.
T50179 193533-193592 Sentence denotes Abnormal CD4/CD8 ratios >3.5 were observed in all patients.
T67907 193593-193673 Sentence denotes Age-and gender-matched controls revealed CD4/CD8 ratios ranging from 1.5 to 2.5.
T56622 193674-193727 Sentence denotes Both patients with anaphylaxis had CD4/CD8 ratios >6.
T35074 193728-193764 Sentence denotes All patients responded well to AABF.
T3674 193765-193908 Sentence denotes Open challenge to common offending foods from a regular diet (milk, soy, wheat, egg, nuts, beef and chicken), revealed multiple food allergies.
T5808 193909-194017 Sentence denotes After two years of follow-up on an AABF regimen, the 10 patients remain well but allergic to multiple foods.
T55525 194018-194225 Sentence denotes Very low CD8 levels remain as the unique immunological alteration in all 10 patients.These studies suggest that abnormalities of very low CD8 distribution may play a pathogenetic role in non-IgE mediated FA.
T88118 194226-194486 Sentence denotes Since CD8 lymphocytes play a role in immunologic tolerance (IT), it is tempting to speculate that the very low CD8 levels may signal the failure of development of IT in our patients predisposing them to the development of allergies to multiple food components.
T19116 194487-194498 Sentence denotes Background:
T95940 194499-194724 Sentence denotes Mixed connective tissue disease (MCTD) is a disease taht have caused controversy, while some authorities consider it a distinct rheumatic disease, others believe that it's an early stage of a fully defined autoimmune disease.
T4114 194725-194808 Sentence denotes The distinctive feature is the presence of the U1 small nuclear RNP autoantibodies.
T43388 194809-195011 Sentence denotes Clinical features involve Raynaud's is phenomenon, swollen hands, sclerodactyly, esophageal hypomotility, polyarthritis, and myositis, allof them can be present in others well deined rheumatic diseases.
T26862 195012-195075 Sentence denotes Only aew cases have been described in the pediatric population.
T18269 195076-195085 Sentence denotes Objetive:
T32566 195086-195377 Sentence denotes To determine the frecuency of mixed connective tissue disease in Mexican.Children in a tertiary level institution according to Kasakawa's criteria, Alarcon-Segovia's criteria and Sharp's criteria and establish if a diagnosis of a well defined autoimmune entity was made during the follow up.
T73016 195378-195480 Sentence denotes Methods:Medical charts were assessed with the diagnosis of MCTD between 1988 and 2003 in our hospital.
T71605 195481-195489 Sentence denotes Results:
T86074 195490-195700 Sentence denotes Between 1988 and 2004, 9 , 919 cases of autoinmune diseases were treated; 310 with systemic lupus erythematosus(SLE), 6544 with rheumatoid arthritis(RA), 1, 128 with scleroderma and 1, 937 with dermatomyositis.
T23354 195701-195859 Sentence denotes We found only four cases, 3 of them did not complete the Kasakawa's criteria but the diagnosis was probable according to Alarcon-Segovia and Sharp's criteria.
T67417 195860-195914 Sentence denotes One of them developed SLE after one year of follow up.
T2345 195915-196158 Sentence denotes The case that fulfilled the diagnosis criteria of MCTD; Raynaud's phenomenon, RNP antibody positive, arthritis, lymphadenopathy, restrictive pulmonary disease, sclerodactily and muscle weakness developed a full blown SLE at 10 years follow up.
T72296 196159-196170 Sentence denotes Discussion:
T86110 196171-196213 Sentence denotes The disease is extremely rare in children.
T20401 196214-196460 Sentence denotes We conclude that at least in pediatric age the disease may not exist by it's own, but it's an early stage of a defined autoimmune disease, and the terminology "un differentiated connective tissue disease" is more appropriate to define this cases.
T15491 196461-196463 Sentence denotes A.
T74567 196464-196479 Sentence denotes Baysan * , H.Y.
T85474 196480-196488 Sentence denotes Song, S.
T62754 196489-196498 Sentence denotes Gupta, L.
T33465 196499-196515 Sentence denotes Yel, Irvine, CA.
T68813 196516-196688 Sentence denotes Hereditary angioedema (HAE) is an autosomal dominant disease characterized by episodic angioedema of the skin or mucosa of the respiratory and the gastrointestinal systems.
T79631 196689-196856 Sentence denotes HAE is caused by a quantitative (Type I) and/or functional (Type II) deficiency of plasma protein C1 inhibitor, an early component of the classical complement pathway.
T79058 196857-196944 Sentence denotes Attacks of HAE may be lifethreatening and even cause death when the airway is involved.
T73633 196945-197088 Sentence denotes Here, we report a 67 year-old female patient with HAE Type II, who has seven affected family members, two of whom died of laryngeal angioedema.
T574 197089-197232 Sentence denotes The patient had a history of recurrent swelling of the eyelids, lips, tongue and extremities, and respiratory distress since five years of age.
T138 197233-197333 Sentence denotes She was hospitalized on several occasions one of which required intubation and assisted ventilation.
T8192 197334-197427 Sentence denotes Laboratory studies, between the attacks, revealed normal serum CH50 and complement C3 levels.
T96562 197428-197489 Sentence denotes Complement C4 level was decreased to 5 mg/dl (N:16-47 mg/dl).
T13002 197490-197598 Sentence denotes C1 esterase function was impaired, 46% (N: greater than 68%) in contrast to normal quantitative C1 esterase.
T78659 197599-197713 Sentence denotes The patient was on long-term danazol treatment for ten years and experienced side effects, most notably hirsutism.
T64041 197714-197790 Sentence denotes Currently, there are limited efficacious and safe treatment options for HAE.
T78495 197791-197929 Sentence denotes The treatment of choice for acute attacks and prophylaxis appears to be the C1 inhibitor concentrate, which is not yet licensed in the US.
T26318 197930-198064 Sentence denotes The present patient emphasizes the need to establish the correct diagnosis and an appropriate management plan in recurrent angioedema.
T27776 198065-198067 Sentence denotes J.
T18952 198068-198081 Sentence denotes Hajsam * , L.
T14868 198082-198124 Sentence denotes Ponomarjev, Krasnodar, Russian Federation.
T93088 198125-198136 Sentence denotes Background:
T71410 198137-198264 Sentence denotes The previous investigations indicate on the positive effects of NCIR in different chronic inflammatory and infectious diseases.
T28618 198265-198348 Sentence denotes Nevertheless, the mechanisms of the clinical efficacy of NCIR remain still unknown.
T71258 198349-198536 Sentence denotes The aim of this investigation is the study of the immune disorders in patients with chronic tonsillitis and the immunomodulatory effects of the complex treatment in combination with NCIR.
T8403 198537-198545 Sentence denotes Methods:
T61908 198546-198644 Sentence denotes 55 children with chronic tonsillitis in the age from 7 to 14 years old were under the observation.
T69944 198645-198754 Sentence denotes The T cell receptors (CD3+, CD4+, CD8+, CD16+, CD25+, HLA-DR+) have been studied using flow cytometry method.
T58657 198755-198834 Sentence denotes The cytokines (IL6, gamma IFN and IL18) have been investigated by ELIZA method.
T55816 198835-198902 Sentence denotes The treatment include traditional methods in combination with NCIR.
T73929 198903-198979 Sentence denotes Control group (without tonsillitis) consists of 56 children of the same age.
T85316 198980-198988 Sentence denotes Results:
T72760 198989-199094 Sentence denotes It has been shown that in chronic tonsillitis was dcrease of the number of CD3+, CD25+ and HLA-DR+ cells.
T27238 199095-199163 Sentence denotes The decrease of CD3+ cells was mainly due to decrease of CD4+ cells.
T44390 199164-199236 Sentence denotes At the same time it has been shown the increase in number of CD8+ cells.
T77912 199237-199361 Sentence denotes In chronic tonsillitis have been determined the increase in serum proinflammatory cytokine IL6 level in 3.6 times (p<0.001).
T81762 199362-199455 Sentence denotes At the same time the levels of gamma IFN and IL18 were lower than in control up to 3-4 times.
T88183 199456-199559 Sentence denotes The studied treatment method including NCIR resulted in increase in the number of CD4+ and CD25+ cells.
T29358 199560-199615 Sentence denotes The level of IL6 decreased from 95 pg/ml to 28.4 pg/ml.
T30327 199616-199726 Sentence denotes At the same time the serum concentration of gamma IFN and IL18 increased up to 2.4 and 1.9 times, accordingly.
T95311 199727-199738 Sentence denotes Conclusion:
T93171 199739-199852 Sentence denotes In chronic tonsillitis it has been shown the immune disorders in T cell's subpopulations and cytokine production.
T82720 199853-199995 Sentence denotes The efficacy of NCIR mainly depends on the normalisation in T cellular subpopulations and increase in the concentration of gamma IFN and IL18.
T65185 199996-200009 Sentence denotes Introduction:
T44890 200010-200110 Sentence denotes Viral hepatitis is characterized by suppression of CD4+Th1cell function related to disease severity.
T15726 200111-200360 Sentence denotes The aim of our research was the determination of total IgE concentration and anti-C1q-autoantibodies levels in patients with viral hepatitis C (VHC) and mixed viral hepatitis (VHB+C) and the investigation of their correlation with T cell parameters.
T75317 200361-200369 Sentence denotes Methods:
T6578 200370-200449 Sentence denotes 31 patients with VHC and 11 patients with VHB+C confirmed by PCR were examined.
T21239 200450-200548 Sentence denotes Evaluation of serum total IgE level was performed by ELISA kits produced by "Vector-Best", Russia.
T77709 200549-200729 Sentence denotes Immunophenotyping of peripheral blood mononuclear cells (PBMC) was done by cytometry with monoclonal antibodies to CD3, CD4, CD8, CD11b, CD16, CD20, CD25, CD95 and HLA-DR-antigens.
T76918 200730-200738 Sentence denotes Results:
T65972 200739-200942 Sentence denotes The level of serum total IgE in patients with VHC and VHB+C was significantly increased in all groups studied, especially in acute hepatitis C (526.8±129.4 MU/ml, P<0.05) compared with the control group.
T17450 200943-201046 Sentence denotes Analysis of PBMC subpopulations in patients with VHC and VHB+C was done related to the total IgE level:
T62919 201047-201094 Sentence denotes Group I -0-200 MU/ml; and Group II ->200 MU/ml.
T96653 201095-201288 Sentence denotes In patients with viral hepatitis and high total IgE level, the content of CD3+T-lymphocytes, CD4+T-cells and CD4/CD8 ratio were significantly decreased compared with the control group (P<0.05).
T91708 201289-201358 Sentence denotes More notable changes were found in patients with acute VHC and VHB+C.
T20993 201359-201456 Sentence denotes The increase in CD20+-cell content was seen in groups with both low and high levels of total IgE.
T71518 201457-201554 Sentence denotes The content of CD16+-cells in patients with high levels of total IgE was also increased (P<0.05).
T58128 201555-201566 Sentence denotes Conclusion:
T79250 201567-201682 Sentence denotes Patients with VHC and VHB+C had significantly greater levels of total IgE compared with the control group (P<0.05).
T97507 201683-201882 Sentence denotes The increase in total IgE levels in patients with viral hepatitis is associated with imbalances of T-lymphocyte subpopulations, including a decrease in CD4+T-cells, and an increase in B-and NK-cells.
T18875 201883-201889 Sentence denotes Title:
T53823 201890-201969 Sentence denotes Occupational airway allergy among health care workers (HCW) with latex allergy.
T47867 201970-201983 Sentence denotes Introduction:
T33792 201984-202048 Sentence denotes For the last years the frequency of latex allergy has increased.
T59029 202049-202110 Sentence denotes Health care workers (HCW) is the risk group of this diseases.
T83991 202111-202208 Sentence denotes Latex allergy symptoms occure in different organs -including skin, conjunctive, nose and bronchi.
T36557 202209-202324 Sentence denotes Study aim:The aim of this study was to estimate the incidence of airway allergy in group of HCW with latex allergy.
T69323 202325-202347 Sentence denotes Materials and methods:
T81286 202348-202438 Sentence denotes The investigations were carried out in a group of 252 HCW, aged 21-67 (average age 36, 3).
T61298 202439-202510 Sentence denotes There were two hundred and eight women and forty four men in the group.
T77261 202511-202651 Sentence denotes Investigation consisted of questionaire examinations, skin prick tests (latex), patch tests (rubber additives), sIgE (latex) and spirometry.
T36542 202652-202660 Sentence denotes Results:
T35832 202661-202752 Sentence denotes Seventy eight (31%) HCW reported undesirable effects after the contact with latex products.
T82366 202753-202820 Sentence denotes Fourty (15, 9%) HCW reported symptoms of airway (nose and bronchi).
T51778 202821-202911 Sentence denotes Latex allergy (SPT and/or sIgE and anamnesis positive) was diagnosed in 49 (19, 4%) cases.
T44502 202912-203170 Sentence denotes The symptoms concerned with: skin, nose and conjunctive (12 cases, 25%); skin and conjunctive (2 cases, 4%); nose and conjunctive (2 cases, 4%); nose and skin (5 cases, 10%); bronchi, skin, nose, and conjunctive (2 cases, 4%) and only skin in 26 cases (53%).
T98054 203171-203183 Sentence denotes Conclusions:
T42419 203184-203307 Sentence denotes The incidence of occupational airway allergy in group of health care workers with latex allergy is high (43% of all cases).
T58242 203308-203439 Sentence denotes Latex allergy symptoms usually affect skin, but sometimes it includes also other organs -conjunctive, nose and seldom with bronchi.
T88147 203440-203483 Sentence denotes The incidence of anaphylaxis is increasing.
T7533 203484-203618 Sentence denotes The Food Allergy and Anaphylaxis Network wishes to expand the use of injected epinephrine by first responders to allergic emergencies.
T44577 203619-203730 Sentence denotes In Indiana, there are 7, 500 First Responders, 14, 900 Basic EMTs, 1, 350 Advanced EMTs, and 2, 500 paramedics.
T24405 203731-203838 Sentence denotes The use of injected epinephrine was only permitted by paramedics and advanced EMTs (17% of all responders).
T83652 203839-203966 Sentence denotes In 2002 a bill was introduced to expand the use of injected epinephrine by EMS personnel in the event of an allergic emergency.
T46202 203967-204094 Sentence denotes It was sponsored by The Indiana Allergy Asthma and Immunology Society and the Emergency Medical Services Commission of Indiana.
T38071 204095-204127 Sentence denotes On July 1st 2003 Senate Bill No.
T69772 204128-204234 Sentence denotes 213 took effect permitting all first responders to administer, without restrictions, injected epinephrine.
T69964 204235-204384 Sentence denotes Once the legislation passed it became the responsibility of the Medical Director (MD) of each ambulance service in the state to implement the change.
T87481 204385-204523 Sentence denotes In an attempt to assess the impact of this legislation we surveyed each of the MDs in the state 9-12 months after the passage of the Bill.
T30401 204524-204589 Sentence denotes MDs were notified of the legislation by memo and public meetings.
T50892 204590-204645 Sentence denotes In addition each MD received a copy of the legislation.
T36159 204646-204695 Sentence denotes Of the 266 MDs, 56 (25%) responded to the survey.
T96591 204696-204704 Sentence denotes RESULTS:
T80251 204705-204707 Sentence denotes 1.
T66012 204708-204735 Sentence denotes Unaware of the Legislation:
T78439 204736-204747 Sentence denotes 14 (25%) 2.
T15052 204748-204791 Sentence denotes Aware of legislation but no implementation:
T37711 204792-204802 Sentence denotes 9 (16%) 3.
T52740 204803-204869 Sentence denotes Aware of legislation with implementation restricted to basic EMTs:
T57960 204870-204881 Sentence denotes 29 (52%) 4.
T10229 204882-204936 Sentence denotes Aware of legislation and implementation at all levels:
T97969 204937-204956 Sentence denotes 4 (7%) CONCLUSIONS:
T69065 204957-205012 Sentence denotes Twenty-five percent of MDs were unaware of legislation.
T86394 205013-205102 Sentence denotes Among those that implemented changes the majority (52%) permitted use by Basic EMTs only.
T8757 205103-205231 Sentence denotes Allergists, Lay organizations, and EMS commissioners need to assure implementation of legislation with all MDs within the state.
T36279 205232-205234 Sentence denotes A.
T88802 205235-205250 Sentence denotes Khadavi 1* , B.
T6418 205251-205267 Sentence denotes Silverman 2 , A.
T18976 205268-205284 Sentence denotes Schneider 2 , 1.
T74203 205285-205303 Sentence denotes Great Neck, NY; 2.
T80814 205304-205317 Sentence denotes Brooklyn, NY.
T89435 205318-205402 Sentence denotes Rabbit anaphylaxis is extremely rare, with one documented case upon inhalation only.
T64222 205403-205478 Sentence denotes We describe a patient with severe anaphylaxis upon consumption of a rabbit.
T62354 205479-205582 Sentence denotes A 6-year-old female with a 3-year history of asthma and allergic rhinitis was presented for evaluation.
T55002 205583-205696 Sentence denotes The patient complained of worsening asthma and rhinitis symptoms in the home and upon exposure to outdoor pollen.
T53744 205697-205755 Sentence denotes Further history revealed the family had a rabbit as a pet.
T8530 205756-205877 Sentence denotes Laboratory testing showed her total IgE was 865 kU/L, RAST results were normal for tree, ragweed and molds (<0.35 kIU/L).
T40970 205878-206005 Sentence denotes Positive results were found for ragweed, dust, cockroach, cat, dog, mouse, peanut and rabbit epithelium (8.43 kIU/L, class IV).
T56273 206006-206196 Sentence denotes Among other environmental control measures, the family was advised to eliminate the rabbit from the home environment, as it could be a potential trigger for their daughters allergy symptoms.
T58397 206197-206318 Sentence denotes Two days later, the patient presented to the emergency room with wheezing, coughing and angioedema of the hands and face.
T3249 206319-206385 Sentence denotes She was treated with albuterol, diphenhydramine and oral steroids.
T47645 206386-206483 Sentence denotes The parents said they followed all of our instructions and did not know why anaphylaxis occurred.
T5084 206484-206607 Sentence denotes Further questioning revealed that the family consumed the pet rabbit on the same night preceding the anaphylactic reaction.
T11422 206608-206656 Sentence denotes This was the first time the daughter ate rabbit.
T80781 206657-206812 Sentence denotes The parents assumed that only exposure to the live rabbit would worsen her allergy and asthma symptoms, never expecting an allergic reaction via ingestion.
T29107 206813-206933 Sentence denotes They were advised not to feed their daughter rabbit again and were given a prescription for self-injectable epinephrine.
T40619 206934-207146 Sentence denotes This demonstrates either complete identity, partial similarity or cross reactivity between inhaled and food allergens, as has been noted previously with certain other foods such as garlic and crustacean proteins.
T36706 207147-207284 Sentence denotes Physicians need to advise food allergic patients that an allergic reaction can develop upon inhalation of the food, as seen with peanuts.
T54692 207285-207384 Sentence denotes But also respiratory sensitization to an allergen can lead to allergic symptoms upon its ingestion.
T82852 207385-207387 Sentence denotes T.
T92157 207388-207402 Sentence denotes Nsouli 1* , J.
T52989 207403-207418 Sentence denotes Scheiner 2 , J.
T22906 207419-207438 Sentence denotes Malka-Rais 2 , J.A.
T21691 207439-207454 Sentence denotes Bellanti 2 , 1.
T87391 207455-207468 Sentence denotes Burke, VA; 2.
T14041 207469-207484 Sentence denotes Washington, DC.
T31289 207485-207666 Sentence denotes The safety of selective cyclooxygenase-2 (COX-II) inhibitors in patients with known NSAID-induced allergic reactions has not been definitely established and is still open to debate.
T71194 207667-207890 Sentence denotes In the present report, we describe two patients with hypersensitivity reactions to naproxen, the first characterized by a systemic anaphylactic reaction and the second by localized urticaria following ingestion of the drug.
T40104 207891-208089 Sentence denotes The first case was a 56 y/o WF with a history of osteoarthritis who, 15 minutes after the ingestion of 375 mg of naproxen, developed generalized pruritus, urticaria, laryngeal edema and hypotension.
T58871 208090-208173 Sentence denotes She was treated in the ER with epinephrine, diphenhydramine and IV corticosteroids.
T18673 208174-208276 Sentence denotes Epicutaneous and intradermal skin testing to celecoxib revealed negative results similar to a control.
T66666 208277-208374 Sentence denotes An oral challenge with celecoxib was well tolerated by the patient without any adverse responses.
T94512 208375-208502 Sentence denotes The second case was a 57 y/o WF with a known history of chronic urticaria and osteoarthritis requiring regular use of naproxen.
T92274 208503-208559 Sentence denotes A complete allergic and immunologic workup was negative.
T39668 208560-208631 Sentence denotes Upon discontinuation of the drug there was resolution of the urticaria.
T86944 208632-208724 Sentence denotes An oral challenge with celecoxib was well tolerated by the patient without adverse sequelae.
T32229 208725-209036 Sentence denotes These two case reports exemplify two extremes in the spectrum of adverse allergic reactions to naproxen, a non-selective COX-I and COX-II inhibitor, one systemic, the second localized and suggest that the pathogenesis of these symptoms was most likely pseudo-allergic in nature and not immunologically-mediated.
T52567 209037-209312 Sentence denotes The dissimilar chemical structures of naproxen and celecoxib together with their differing mechanisms of action suggest that the absence of allergic reactions to challenge with celecoxib, a COX-II inhibitor, may be related to a lack of cross-reactivity between the two drugs.
T45816 209313-209628 Sentence denotes Although these findings suggest that oral celecoxib could be a possible safe alternative in patients with naproxen-induced drug reactions, it would be prudent to first conduct careful challenges with the drug in a well-equipped medical setting where clinical acceptability and tolerability could be safely assessed.
T65790 209629-209642 Sentence denotes INTRODUCTION:
T73906 209643-209706 Sentence denotes Most fixed and removable dentures are made from casting alloys.
T35490 209707-209782 Sentence denotes Many orthodontic appliances are also fabricated from metallic biomaterials.
T80343 209783-209898 Sentence denotes It has been documented in vitro and in vivo, that metallic restorations release metal ions mainly due to corrosion.
T11938 209899-210067 Sentence denotes Those metallic ions may be distributed systemically and locally and could pay a significant role in the induction of oral or/and systemic immunoinflammatory conditions.
T30125 210068-210250 Sentence denotes This study determines the frequency of sensitization to metal salts and clinical characteristics in the group of patients with complaints related to adverse effects of dental alloys.
T62308 210251-210259 Sentence denotes METHODS:
T29785 210260-210381 Sentence denotes 31 patients (29 women and 2 men) aged 35-71 years with symptoms assumed to adverse effects of dental alloys were studied.
T56574 210382-210521 Sentence denotes All patients were studied with base metal salts, including Cu 2+ , Co 2+ , Cr 6+ , Mg 2+ , Mn 2+ , Ni 2+ , Ti 3+ , Zn 2+ using patch tests.
T67801 210522-210577 Sentence denotes All patch tests substances were 3% salts in petrolatum.
T2211 210578-210657 Sentence denotes The patch tests were conducted in accordance with recommendations of the ICDRG.
T41437 210658-210819 Sentence denotes Occlusion time was 2 days, and patch tests were read when removing the patches (Finn Chambers on Scanpor, Epitest Ltd Oy, Tulusa, Finland) and 2 to 4 days later.
T75160 210820-210911 Sentence denotes The total number, percentage of irritant and allergic patch test reactions were calculated.
T55381 210912-210920 Sentence denotes RESULTS:
T14355 210921-211013 Sentence denotes In 25 of 31 patients (80%) sensitivity to base metals used in dental restorations was noted.
T95759 211014-211186 Sentence denotes Symptoms included burning mouth (45%), metal taste (19%), electrical sensations (11%), dry mouth (9%), and taste irritation (12%), but 16/31 patients (54%) had no symptoms.
T56481 211187-211306 Sentence denotes Local gingivitis (19.3%), anomalies of the tongue (12%), stomatitis (12%) and lichenoid reactions (6%) were often seen.
T19348 211307-211394 Sentence denotes The most frequent patch test reactions were caused by Ni (45%), Cr (41%) and Co (19%) .
T78261 211395-211406 Sentence denotes CONCLUSION:
T14927 211407-211650 Sentence denotes This study demonstrated higher frequency of hypersensitivity reactions to Ni, Cr and Co in this group of patients often having symptoms such as burning mouth, metallic taste, electrical sensation, local gingivitis, and anomalies of the tongue.
T56580 211651-211655 Sentence denotes W.Y.
T47048 211656-211666 Sentence denotes Mak * , S.
T61377 211667-211678 Sentence denotes Kearney, B.
T3196 211679-211692 Sentence denotes Silverman, A.
T12518 211693-211717 Sentence denotes Schneider, Brooklyn, NY.
T42718 211718-211813 Sentence denotes The process of intravenous drug desensitization often involves simple but tedious calculations.
T55170 211814-211859 Sentence denotes Miscalculations may arise due to human error.
T93720 211860-211971 Sentence denotes For patients who are truly allergic to the drug in question, such errors can be life threatening, if not fatal.
T9450 211972-212044 Sentence denotes We propose the use of a spreadsheet to minimize such calculation errors.
T10670 212045-212196 Sentence denotes Spreadsheets, such as Microsoft Excel, IBM Lotus 1-2-3, and Corel Quattro Pro, are used extensively in finance for tedious and repetitive calculations.
T8478 212197-212300 Sentence denotes This property of a spreadsheet makes it an ideal tool to assist with any drug desensitization protocol.
T64878 212301-212366 Sentence denotes We chose Microsoft Excel for its availability at our institution.
T5625 212367-212552 Sentence denotes A general template was initially created with equations in specific cells which were based on the protocols listed in Patterson's Allergic Diseases, 6th Edition and Middleton's Allergy:
T41546 212553-212590 Sentence denotes Principles and Practice, 5th Edition.
T3360 212591-212791 Sentence denotes By inputting specific numbers, such as the amount of drug and volume of diluent into key cells of the spreadsheet, the program will automatically calculate the protocol for the given intravenous drug.
T62473 212792-212848 Sentence denotes An example of our Pipericillin protocol is listed below.
T29010 212849-213056 Sentence denotes We find that the use of a spreadsheet not only minimizes calculation errors and hence reduces the likelihood of avoidable reactions; but also decreases our preparation time for the desen-sitization protocol.
T90386 213057-213130 Sentence denotes We recommend its use for all allergists performing drug desensitizations.
T82682 213132-213316 Sentence denotes States 25 years ago, the infestation of homes across the Northeast, Southeast and Midwestern states with these insects during the Fall and Winter months has become increasingly common.
T18394 213317-213553 Sentence denotes In the last 5 years, several investigators have published case reports of patients with allergic rhinitis, conjunctivitis and asthma symptoms associated with suspected inhalational exposure to high levels of proteins from these beetles.
T14993 213554-213863 Sentence denotes We report a series of 5 patients who presented with a spectrum of various allergy complaints ranging from symptoms of allergic rhinitis, asthma, urticaria, angioedema and acute anaphylaxis (with documented elevated serum tryptase) on exposure to high numbers of Multi-Colored Asian Ladybeetles(MALB.) METHODS:
T38284 213864-214042 Sentence denotes We performed Western blotting with the patients' serum and a whole-body ladybeetle extract made from confirmed H. axyridis obtained from one of the infested homes in that region.
T12066 214043-214051 Sentence denotes RESULTS:
T13772 214052-214181 Sentence denotes Blots with the patients' serum revealed IgE binding to 3 different proteins with molecular weights approximately 8, 28 and 78 kD.
T5165 214182-214311 Sentence denotes The serum from two patients bound a 28 kD protein possibly similar to the 30 kD protein previously identified by Yarbrough et al.
T57324 214312-214335 Sentence denotes JACI 1999; 104; 704-5 .
T5269 214336-214408 Sentence denotes IgE from four patients bound to an 8 kD protein not previously reported.
T20649 214409-214563 Sentence denotes Lastly, serum from two patients revealed IgE binding to a 78 kD protein possibly similar to the heavier proteins mentioned in an abstract by Magnan et al.
T49005 214564-214585 Sentence denotes JACI 2002; 109; 580 .
T70505 214586-214597 Sentence denotes CONCLUSION:
T79059 214598-214706 Sentence denotes We present five patients with specific IgE to MALB and allergic symptoms on exposure to high levels of MALB.
T90891 214707-214935 Sentence denotes We conclude that MALB are likely a significant source of several different allergenic proteins and that MALB are increasingly becoming a significant cause of a wide variety of hypersensitivity reactions across the United States.
T91682 214936-215296 Sentence denotes As multiple exposed subjects and several entomologists report that these beetles bite humans, we speculate that a wide range of IgE-mediated symptoms including urticaria, angioedema and anaphylaxis can occur by exposure to proteins by inhalation, direct contact and possibly by inoculation of these proteins into the skin by the bite or scratch of this beetle.
T18212 215297-215333 Sentence denotes A CASE REPORT AND LITERATURE REVIEW.
T27352 215334-215338 Sentence denotes C.S.
T95591 215339-215353 Sentence denotes Taylor 1* , S.
T96683 215354-215367 Sentence denotes Ramesh 2 , 1.
T25171 215368-215385 Sentence denotes Getzville, NY; 2.
T13699 215386-215398 Sentence denotes Buffalo, NY.
T47846 215399-215412 Sentence denotes Introduction:
T74474 215413-215505 Sentence denotes Lentils belong to the Legume family and are the staple ingredient of the ethnic Indian diet.
T10280 215506-215579 Sentence denotes Lentils have been shown to cause allergic reactions and even anaphylaxis.
T55605 215580-215725 Sentence denotes However, little research has been done to distinguish the types of lentils used commonly in the Indian diet and their various hypersensitivities.
T74171 215726-215835 Sentence denotes Some of these lentils include the black gram (Phaseolus mungo), mung bean and split chick peas (Bengal gram).
T65992 215836-215848 Sentence denotes Case Report:
T83190 215849-215958 Sentence denotes We report a 19-month-old Indian boy who presented with severe atopic dermatitis since the age of four months.
T87516 215959-216065 Sentence denotes His dermatitis was exacerbated by the ingestion of peas and beans and resolved with the avoidance of such.
T54189 216066-216196 Sentence denotes At nine months of age, the child was introduced to boiled mung beans and subsequently developed lip swelling within a few minutes.
T40228 216197-216246 Sentence denotes A similar reaction occured with split chick peas.
T72688 216247-216300 Sentence denotes Physical exam at consultation revealed severe eczema.
T74823 216301-216419 Sentence denotes Skin tests using commercial extract revealed 5+ response to peanut (he had never eaten peanuts), soybean, pea and egg.
T31091 216420-216583 Sentence denotes Subsequent skin tests at the follow up visit to prepared reagents revealed much greater than 5+ response to mung bean, chick pea, split chick peas, and black gram.
T86631 216584-216668 Sentence denotes The patient developed a systemic response during testing which required Epinephrine.
T82196 216669-216680 Sentence denotes Discussion:
T81830 216681-216816 Sentence denotes Legume allergy (other than peanut, soy and peas) is rare in the Unites States but has been reported in Asia and the Mediterranean area.
T50450 216817-216921 Sentence denotes It has been reported in one case series that patients with lentil allergy react to more than one lentil.
T12678 216922-217017 Sentence denotes There is a five percent cross reactivity between peanut and other legumes such as soy and peas.
T85311 217018-217142 Sentence denotes However, the extent of cross reactivity between peanut and the other legume sub-groups (ie. lentils) is not well documented.
T69319 217143-217235 Sentence denotes There also appears to confusion in the labeling of the various lentils used in ethnic diets.
T78318 217236-217247 Sentence denotes Conclusion:
T46270 217248-217483 Sentence denotes This case has been presented to make allergists aware that there are many differnt types of lentils that can cause hypersenstivity reactions and the importance of considering ethnicity and dietary habits in evaulating for food allergy.
T55474 217484-217495 Sentence denotes Background:
T21627 217496-217602 Sentence denotes Epinephrine is the drug of choice for the treatment of anaphylaxis however it is frequently underutilized.
T34451 217603-217662 Sentence denotes One possible reason is the fear of adverse cardiac effects.
T95774 217663-217874 Sentence denotes The most common side effects of epinephrine are palpitations, tachycardia, sweating, nausea, vomiting, respiratory difficulty, pallor, dizziness, weakness, tremor, headache, nervousness, anxiety and arrhythmias.
T25958 217875-218080 Sentence denotes A previous study showed that administration of epinephrine, in a small number of healthy adults did not cause any significant cardiac adverse events and vitals sign changes were not clinically significant.
T16757 218081-218306 Sentence denotes The purpose of this retrospective analysis is to determine the safety profile of epinephrine in a large number of patients that were administered epinephrine for treatment of anaphylaxis that occurred in a physician's office.
T9289 218307-218315 Sentence denotes Methods:
T49831 218316-218472 Sentence denotes All patients in an allergy office, that were administered epinephrine for acute anaphylaxis between 1999-2004 were selected for this retrospective analysis.
T52570 218473-218531 Sentence denotes A chart review for adverse events and vital was conducted.
T7566 218532-218674 Sentence denotes Vital signs and side effects had been monitored every 5 to 10 minutes for minimum of 30 to 90 minutes after the administration of epinephrine.
T5718 218675-218683 Sentence denotes Results:
T6853 218684-218770 Sentence denotes 105 patients between the ages of 8yrs to 55yrs received 128 injections of epinephrine.
T94564 218771-218897 Sentence denotes After an injections of epinephrine 60% of the patients had a pulse between 50-90, 27% between 72-100, and 13% between 102-110.
T20488 218898-219045 Sentence denotes Systolic blood pressure determined 81% of patients to be between 80-140, with 10%, between 142-160, and 7% between 162-170, and 2% between 172-180.
T40325 219046-219163 Sentence denotes Concurrently, diastolic blood pressure was found to have 94% between 50-90, 3% between 92-100 and 3% betweem 102-110.
T49320 219164-219235 Sentence denotes The most common reported side effects were tremor, headache and pallor.
T14307 219236-219366 Sentence denotes Any rise in blood pressure and heart rate after epinephrine was transient and returned to normal within 90 minutes of observation.
T5073 219367-219402 Sentence denotes There were no serious side effects.
T17356 219403-219470 Sentence denotes All patients responded to the epinephrine and were able to go home.
T84039 219471-219483 Sentence denotes Conclusions:
T57857 219484-219647 Sentence denotes This retrospective analysis revealed that the administra-tion of epinephrine is safe and effective for the treatment of acute anaphylaxis in an outpatient setting.
T81292 219648-219821 Sentence denotes The use of epinephrine for treatment of anaphylaxis is life-saving and its use to treat non-cardiac or elderly patients who have anaphylactic reactions should be encouraged.
T794 219822-219830 Sentence denotes Purpose:
T13551 219831-219965 Sentence denotes A clinical pathway was established to decrease the use of vancomycin in surgical patients with self-reported penicillin (PCN) allergy.
T14574 219966-219974 Sentence denotes Methods:
T9209 219975-220080 Sentence denotes In 2001, our institution developed a preoperative evaluation (POE) clinic for elective surgical patients.
T25247 220081-220238 Sentence denotes In June 2002, on-site, same-day allergy consultation and penicillin skin testing was made available for preoperative patients with self-reported PCN allergy.
T43341 220239-220417 Sentence denotes We reviewed the antibiotic recommendations, the actual administration of vancomycin, and compliance by the surgeons with our recommendations from July 1, 2002-September 16, 2003.
T13214 220418-220426 Sentence denotes Results:
T49418 220427-220567 Sentence denotes During this time, 11, 819 patients were seen for their preoperative medical exam at the POE clinic, and 1204 were evaluated for PCN allergy.
T48583 220568-220638 Sentence denotes Of these, 1120 patients met IRB standards to participate in the study.
T49383 220639-220681 Sentence denotes The mean age of the patients was 60 years.
T1328 220682-220810 Sentence denotes The top three surgical specialties represented in the POE clinic were orthopedic (28.4%), urology (22%), and neurosurgery (15%).
T27839 220811-220877 Sentence denotes Of the 1120 patients, 1031 underwent skin testing for PCN allergy.
T8300 220878-221060 Sentence denotes Eighty-five percent (85%) or 951 of these patients with a history of PCN allergy were recommended to use -lactams such as cefazolin, and 164 (15%) were recommended to avoid -lactams.
T5377 221061-221127 Sentence denotes Forty-three (43) or 4% had one or more positive skin tests to PCN.
T64117 221128-221207 Sentence denotes Of the 1120 patients, 957 patients actually received pre-operative antibiotics.
T14808 221208-221362 Sentence denotes Of these 957 patients, 718 (75%) of those received cefazolin, 60 (6%) received clindamycin, 33 (3%) received ciprofloxacin, 25 (2%) received levofloxacin.
T73467 221363-221427 Sentence denotes Some patients received more than one antibiotic for prophylaxis.
T50519 221428-221471 Sentence denotes Only149 (16%) patients received vancomycin.
T54582 221472-221484 Sentence denotes Conclusions:
T73105 221485-221686 Sentence denotes Establishment of a clinical pathway in a preoperative clinic that includes allergy testing and consultation reduced vancomycin use to only 16% in surgical patients with a history of penicillin allergy.
T19231 221687-221689 Sentence denotes H.
T70283 221690-221709 Sentence denotes Yarmohammadi * , A.
T37228 221710-221738 Sentence denotes Nowak-Wegrzyn, New York, NY.
T1179 221739-221752 Sentence denotes Introduction:
T12504 221753-221913 Sentence denotes Anticonvulsant hypersensitivity syndrome is a potentially fatal drug reaction with cutaneous and systemic reactions to the arene oxideproducing anticonvulsants.
T25034 221914-222039 Sentence denotes In most cases, the hallmark features of fever, rash, and lymphadenopathy are accompanied by multi organ-system abnormalities.
T57058 222040-222100 Sentence denotes Fatal outcomes are most often associated with liver failure.
T46892 222101-222252 Sentence denotes Recognition of the syndrome, which may have variable presentations, is the key to prompt discontinuation of the drug, close monitoring, and management.
T55954 222253-222260 Sentence denotes Case 1:
T86908 222261-222354 Sentence denotes A 16y/o male received dilantin for seizure prophylaxis following craniopharyngioma resection.
T73392 222355-222435 Sentence denotes Fourteen days later he was readmitted for fever and CSF leak from surgical site.
T69135 222436-222525 Sentence denotes He was started on ceftriaxone and vancomycin empirically; an LP and pan culture was done.
T45585 222526-222637 Sentence denotes He continued to have low grade fever and, on the 6th day of admission, developed a maculopapular rash on trunk.
T38359 222638-222692 Sentence denotes On day 8th LFTs increased and CBC showed eosinophilia.
T67430 222693-222745 Sentence denotes Antibiotics were stopped but LFTs continued to rise.
T70483 222746-222844 Sentence denotes On Day 10, dilantin was stopped and LFTs normalized in 2 days, fever stopped and rash disappeared.
T99707 222845-222852 Sentence denotes Case 2:
T39884 222853-222957 Sentence denotes A 17 y/o girl was admitted to the hospital with generalized rash, facial edema and fever (39 degrees C).
T63911 222958-223066 Sentence denotes She developed a pruritic maculopapular erythematous rash over her trunk and face 2 weeks prior to admission.
T48691 223067-223097 Sentence denotes She then developed high fever.
T53347 223098-223209 Sentence denotes Three months prior to this visit she had been started on phenytoin (300mg/kg) for control of grand mal seizure.
T69424 223210-223271 Sentence denotes Physical exam revealed cervical and axillary lymphadenopathy.
T61088 223272-223343 Sentence denotes She had elevated WBC (13, 400), eosinophilia (20 %), and elevated LFTs.
T54671 223344-223480 Sentence denotes Phenytoin was stopped upon admission but 24 hours later she continued to have fever, elevated LFTs and devel-oped erythema in her mouth.
T38253 223481-223596 Sentence denotes Treatment with IVIG and prednisone was initiated and resolution of symptoms was seen within 2-3 days after therapy.
T63644 223597-223609 Sentence denotes Conclusions:
T48383 223610-223816 Sentence denotes The timely recognition of anticonvulsant hypersensitivity syndrome is important, because accurate diagnosis prevents potentially fatal re-exposure and influences subsequent anticonvulsant treatment options.
T26070 223817-223946 Sentence denotes IVIG and prednisone should be considered in situations where prompt improvement of the LFTs or clinical symptoms is not observed.
T15634 223947-224112 Sentence denotes The recently published results of a telephone survey about the prevalence of seafood allergy in the US indicate that seafood allergy is a significant health concern.
T54271 224113-224190 Sentence denotes Aim of the present study was to retrospectively review our data on the topic.
T52940 224191-224292 Sentence denotes We have interviewed 7391 subiects attending our Allergy outpatients about any suspected food allergy.
T70618 224293-224325 Sentence denotes Over 95% were 14 years or older.
T21180 224326-224409 Sentence denotes Any reaction to food was reported by 33% of the patients, more frequently by women.
T24903 224410-224529 Sentence denotes Of these 2419 patients, 125 reported reactions to seafood (5%) with an overall prevalence of seafood reactions of 1.7%:
T76240 224530-224615 Sentence denotes 50 to fish (0.7%), 58 to shellfish (including mollusks) (0.8%) and 17 to both (0.2%).
T3081 224616-224790 Sentence denotes In the case of the reactions to fish it is quite possible that shellfish is also included, as the patients were often unable to tell the role of finfish from shellfish apart.
T35911 224791-224926 Sentence denotes This is most probably due to the fact that seafood dishes or a complete seafood meal in Italy generally include both shell and finfish.
T50857 224927-225042 Sentence denotes In only less than half cases there was a convincing relationship between the ingestion of seafood and the reaction.
T57452 225043-225223 Sentence denotes The reactions reported were: gastrointestinal (17), non life-threatening angioedema (15), mild oral allergy syndrome (13), acute urticaria (9), asthma (3), rhinoconjunctivitis (2).
T19508 225224-225327 Sentence denotes The gastrointestinal reactions might not all be true (IgE-mediated) allergic reactions, but also toxic.
T27841 225328-225656 Sentence denotes In conclusion, even in a selected population like that attending an Allergy Clinic and using a broad definition of adverse reaction, seafood allergy appears to be a rare phenomenon and of limited clinical impact, the prevalence of moderate to severe reactions (angioedema and asthma) in the whole selected population being 0.2%.
T66744 225657-225835 Sentence denotes Clopidogrel (Plavix) is an antithrombotic agent currently used to prevent thrombotic cardiovascular events by inhibiting adenosine diphosphate (ADP)dependent platelet activation.
T98939 225836-225948 Sentence denotes Clinically, it has been used in patients with aspirin intolerance or who developed neutropenia from ticlopidine.
T26408 225949-226022 Sentence denotes There have been reported cases of clopidogrel causing rash and urticaria.
T29421 226023-226234 Sentence denotes Often these patients are told they are allergic to clopidogrel and should not take it again, despite the fact that no workup was ever performed to elucidate whether the reaction was indeed immunologic in nature.
T38340 226235-226377 Sentence denotes A review of the literature revealed no reported attempts at desensitizing a patient to clopidogrel after a presumed immunologic drug reaction.
T61079 226378-226460 Sentence denotes We present the case of a 49 year-old female who initially took clopidogrel (75 mg.
T27039 226461-226504 Sentence denotes P.O. daily) for transient ischemic attacks.
T20051 226505-226642 Sentence denotes After tolerating the medicine for five days, it was replaced with an aspirin/warfarin combination, which she took for the next five days.
T92706 226643-226804 Sentence denotes Reintroduction of clopidogrel a week later was uneventful, until she developed a pruritic, maculopapular rash on the 5th, through 7th days of restarting therapy.
T25169 226805-226919 Sentence denotes At that time, she was not taking any other medications, and had no cardiopulmonary or gastrointestinal complaints.
T62581 226920-227002 Sentence denotes She had discontinued the clopidogrel and was asymptomatic during our consultation.
T95992 227003-227096 Sentence denotes Skin testing was done using clopidogrel prepared at concentrations of 1 mg/ml and 1/10 mg/ml.
T84260 227097-227250 Sentence denotes At the same time, control skin testing on three non-atopic subjects was performed and produced no reaction to either epicutaneous or intradermal testing.
T74938 227251-227351 Sentence denotes By contrast, the patient had a positive skin reaction at both concentrations on intradermal testing.
T58711 227352-227476 Sentence denotes The patient was hospitalized for an oral desensitization where clopidogrel dilutions were prepared by the hospital pharmacy.
T16146 227477-227526 Sentence denotes The patient tolerated an initial dose of 0.02 mg.
T99363 227527-227653 Sentence denotes Serial three-fold increases in concentration were given every 15 minutes, until a total cumulative dose of 77 mg. was reached.
T40604 227654-227766 Sentence denotes The patient tolerated the entire procedure and suffered no adverse reactions upon continuation of the treatment.
T17367 227767-227902 Sentence denotes This demonstrates the utility of oral desensitization to clopidogrel in patients with a positive skin test who require this medication.
T30750 227903-227987 Sentence denotes Lamotrigine is a non-aromatic anticonvulsant with desirable pharmacological profile.
T7535 227988-228056 Sentence denotes The most common idiosyncratic reaction in children is rash (10-20%).
T67082 228057-228156 Sentence denotes Severe cutaneous adverse reactions and systemic hypersensitivity reactions are uncommonly reported.
T80169 228157-228164 Sentence denotes Method:
T12443 228165-228294 Sentence denotes Case presentation An 11-yearold Caucasian female was prescribed lamotrigine in escalating dose for her first generalized seizure.
T5248 228295-228399 Sentence denotes A week later she developed a pink rash on her cheeks gradually progressing to her trunk, hands and feet.
T19188 228400-228511 Sentence denotes Three days later she was seen in the ER and treated for possible streptococcal-pharyngitis with fever and rash.
T50047 228512-228554 Sentence denotes Oral Penicillin-V treatment was initiated.
T16376 228555-228649 Sentence denotes The rash continued to spread all over her body with mild pruritis and sores on lips and mouth.
T34243 228650-228702 Sentence denotes Few blisters were noted in left ear, hands and feet.
T69234 228703-228738 Sentence denotes Later Lamotrigine was discontinued.
T5404 228739-228769 Sentence denotes Oral steroids were prescribed.
T44482 228770-228851 Sentence denotes She continued to develope new blisters, rash and hemorrhagic plaques and dysuria.
T57911 228852-228895 Sentence denotes She was later transferred to our institute.
T60522 228896-228982 Sentence denotes The physical examination was significant for afebrile girl without pallor and icterus.
T7845 228983-229034 Sentence denotes Bilateral conjunctivitis without keratitis evident.
T77209 229035-229080 Sentence denotes Tender cervical lymphadenopathy was palpable.
T3586 229081-229127 Sentence denotes Multiple ulcers on lips and gingiva were seen.
T77667 229128-229238 Sentence denotes Several targetoid lesions on trunk and extremity were noted along with few hemorrhagic plaques on extremities.
T15353 229239-229298 Sentence denotes Superficial sloughing of distal fingers and toes was noted.
T13314 229299-229335 Sentence denotes Nikolskys sign was not demonstrable.
T79846 229336-229378 Sentence denotes The systemic examination was unremarkable.
T9371 229379-229396 Sentence denotes Laboratory tests:
T39789 229397-229456 Sentence denotes Hemoglobin 14.2g/dl, WBC-Normal range without eosinophilia.
T73433 229457-229480 Sentence denotes Normal PT/aPTT and INR.
T79738 229481-229573 Sentence denotes Liver function tests showed elevated SGPT-1380iu/ml and SGOT-225iu/ml with normal bilirubin.
T15020 229574-229600 Sentence denotes Urine analysis was normal.
T2210 229601-229663 Sentence denotes Serology for CMV, EBV, HSV and Hepatitis A and B was negative.
T9606 229664-229742 Sentence denotes Skin biopsy showed full thickness epidermal necrosis and sub epidermal clefts.
T22110 229743-229787 Sentence denotes Aggressive supportive therapy was initiated.
T82788 229788-229838 Sentence denotes Corticosteroids were continued for five more days.
T81637 229839-229921 Sentence denotes Prior to being discharged from hospital the rash had dried and most lesions faded.
T17956 229922-229962 Sentence denotes The blisters and oral ulcers had healed.
T33658 229963-229995 Sentence denotes The liver enzymes had decreased.
T54079 229996-230008 Sentence denotes Conclusions:
T44909 230009-230095 Sentence denotes We report an occurrence of Stevens-Johnson syndrome with lamotrigine in a young child.
T36006 230096-230230 Sentence denotes In the literature severe reactions are associated with higher doses or rapid escalation of the dose, and concomitant use of valproate.
T59658 230231-230314 Sentence denotes Early recognition and withdrawal of medication is necessary to improve the outcome.
T55680 230315-230328 Sentence denotes Introduction:
T22619 230329-230535 Sentence denotes In patients with a history of penicillin (PCN) allergy and negative PCN skin tests to major and minor determinants, 97-99% of patients will tolerate PCN administration without risk of an immediate reaction.
T53705 230536-230720 Sentence denotes In fact, Middletons Allergy Principle & Practice reported that no life-threatening false-negative reactions have been reported when PCN was administered after a negative PCN skin test.
T16040 230721-230943 Sentence denotes We describe a case in which a patient with a history of PCN allergy and negative PCN skin tests to the major and minor determinants experienced life-threatening anaphylactic shock when administered piperacillin/tazobactam.
T9293 230944-230957 Sentence denotes Case History:
T634 230958-231055 Sentence denotes A 38-year-old woman with Crohns disease was admitted for treatment of an enterocutaneous fistula.
T31964 231056-231245 Sentence denotes Three months before admission, the patient reported a severe reaction to either piperacillin/tazobactam or intravenous (IV) lorazepam needing respiratory support in the intensive care unit.
T62527 231246-231319 Sentence denotes In order to delineate this problem, an allergy consultation was obtained.
T33496 231320-231553 Sentence denotes Serum IgE antibodies to PCN, measured by a commercial CAP System radioallergosorbent test (RAST) fluoroenzymeimmunoassay (FEIA; Pharmacia and Upjohn, Uppsala, Sweden), and PCN skin tests to major and minor determinants were negative.
T19196 231554-231647 Sentence denotes A skin test (prick and intradermal) to piperacillin/tazobactam at 4.5mg/ml was also negative.
T89979 231648-231797 Sentence denotes Five minutes into receiving 3.375 grams of piperacillin/tazobactam IV, the patient reported feeling lightheaded, flushed, nauseated, and diaphoretic.
T39202 231798-231904 Sentence denotes The blood pressure decreased to 80/50 from a baseline of 110/60, heart rate 150/minute and appeared toxic.
T80457 231905-231959 Sentence denotes No wheezing or rash was noted on physical examination.
T81237 231960-232066 Sentence denotes Patient was treated with IV epinephrine, diphenhydramine, and dexamethasone and recovered without sequela.
T78309 232067-232203 Sentence denotes Serum tryptase, drawn 1 hour after the beginning of the reaction, was elevated at 56.3 ng/ml but decreased to 17.6 ng/ml 12 hours later.
T63786 232204-232234 Sentence denotes Complement levels were normal.
T77039 232235-232246 Sentence denotes Conclusion:
T73414 232247-232687 Sentence denotes Despite a very high negative predictive value of a negative PCN skin test to the major and minor determinants and reports that no life-threatening false-negative reactions have been reported when PCN is administered after a negative PCN skin test, physicians need to be very cautious in administering piperacillin/tazobactam and other b-lactams in patients with a history of severe reactions such as anaphylaxis to past PCN administrations.
T96927 232688-232690 Sentence denotes A.
T70698 232691-232709 Sentence denotes Majmundar * , D.A.
T95318 232710-232727 Sentence denotes Khan, Dallas, TX.
T19312 232728-232741 Sentence denotes Introduction:
T40303 232742-232828 Sentence denotes A variety of adverse drug reactions have been reported after therapy with allopurinol.
T11253 232829-232905 Sentence denotes Successful protocols for desensitization to allopurinol have been developed.
T22144 232906-233048 Sentence denotes We report a case of a patient who was successfully desensitized to allopurinol only to develop DRESS after four months of allopurinol therapy.
T86594 233049-233057 Sentence denotes Methods:
T40138 233058-233208 Sentence denotes A 57 year old man was referred to our department with a remote history of rash and fever resulting in hospitalization after initiation of allopurinol.
T83244 233209-233361 Sentence denotes Due to severe gouty arthritis unresponsive to colchicine and requirement of chronic steroids, it was recommended to attempt allopurinol desensitization.
T62283 233362-233589 Sentence denotes Based on the history of his prior reaction, a slow desensitization protocol was performed beginning with allopurinol 10μg and increasing the dose weekly to 25μg, 50μg, 100μg, 200μg, 500μg, 1mg, 5mg, 10mg, 25mg, 50mg, and 100mg.
T74549 233590-233730 Sentence denotes The patient tolerated the entire desensitization protocol without adverse reaction and was initiated on daily allopurinol at 200 mg per day.
T72412 233731-233739 Sentence denotes Results:
T40867 233740-233918 Sentence denotes Four months after desensitization and daily allopurinol use, the patient developed fevers and an acute maculopapular eruption on his back and abdomen without mucosal involvement.
T95634 233919-234030 Sentence denotes Laboratories demonstrated eosinophilia of 936 cells/mm 3 , elevated AST of 101, ALT of 102, and GGT of 163 U/L.
T61362 234031-234186 Sentence denotes He was treated with prednisone 80mg a day which was tapered weekly over 5 weeks with successful resolution of his symptoms, eosinophilia and transaminitis.
T74392 234187-234198 Sentence denotes Conclusion:
T92836 234199-234362 Sentence denotes While desensitization to allopurinol can be safely accomplished, allergists need to be cognizant of the potential for delayed serious drug reactions such as DRESS.
T45227 234363-234607 Sentence denotes Wiskott Aldrich Syndrome is an immunodeficiency characterized by eczema, pyogen infections, and mixed immunodeficiency.We describe a male seven-month old, perinatals antecedents without importance who had an ulcer in site of application of BCG.
T9667 234608-234645 Sentence denotes Non-blood relatives, healthy parents.
T70177 234646-235140 Sentence denotes At twomonths-old, he initiated with continuous fever, not quantified, treated with multiples antibiotics without resolution, he was hospitalized, plaquetopenia and anemia were diagnosed, he received a red globules and plateles transfusion, one week after he presented a disseminated dermatosis characterized by erythema and desquamation, at four-month-age presented right axillary adenomegaly, hepatoesplenomegaly and recurrent bilateral media otitis for what was hospitalized in our institute.
T16900 235141-235398 Sentence denotes He was malnutrition, bad general condition, febrile, with disseminated dermatosis affecting the head, trunk and extremities characterized by erythema and desquamation, in addition he had left ankle cellulitis, right axillary adenomegaly, hepatoespenomegaly.
T6777 235399-235596 Sentence denotes During his hospitalization he presented left hand cellulitis, hairy skin abscess, oral candidiasis, required surgical treatment by econdary compartimental syndrome because cellulitis of left ankle.
T45904 235597-235757 Sentence denotes Persistent hemogram reported thrombocytopenia with normal platelet volume, blood cultives were positive for grampositive bacterias, isoaglutinines, were normal.
T15720 235758-235859 Sentence denotes Immunoglobulines were elevated for the age range, He received antimicrobial and antifungic treatment.
T30583 235860-235872 Sentence denotes But he died.
T53684 235873-236108 Sentence denotes In the autopsy timic alymphoplasia was reported, cortical lymphoid depopulation in lymphatic ganglia and spleen, disease by disseminated cytomegalic inclusion, multifocal pulmonary pneumocystosis, BCGitis, disease graft versus guest. .
T4425 236109-236282 Sentence denotes With the previous features we concluded in a compatible mixed immunodeficiency with Wiskott-Aldrich syndrome with particular characteristics that make this case interesting.
T52265 236283-236562 Sentence denotes The patient course with cellular Immune deficiencie with thrombocytopenia and eczema, even when he didn't have platelet sizing diminished, we consider that the patient had a severe of Wiskott s Aldrich syndrome and at the moment we are Awaiting result of genetic study UASP gene.
T11095 236563-236575 Sentence denotes Background :
T11522 236576-236734 Sentence denotes Hypersensitivity to mosquito bites (HMB) is a disorder characterized by necrotic skin reaction and systemic generalized symptoms subsequent to mosquito bites.
T75186 236735-236870 Sentence denotes It has been suggested that HMB is associated with chronic Epstein-Barr virus (EBV) infection and natural killer cell leukemia/lymphoma.
T11172 236871-236991 Sentence denotes We describe here a Korean child who had HMB associated with chronic EBV infection and natural killer cell lymphocytosis.
T36168 236992-236998 Sentence denotes Case :
T30681 236999-237142 Sentence denotes A 5-year-old male was admitted with well-demarcated necrotic skin lesions and severe swelling on right ear lobe developed after mosquito bites.
T63280 237143-237243 Sentence denotes He had suffered several similar symptoms since last summer, which complicated as deep scars on skin.
T15492 237244-237310 Sentence denotes Hepatosplenomegaly or peripheral lymphadenopathy was not detected.
T42007 237311-237447 Sentence denotes Laboratory tests showed WBC 7, 280/mm3 (neutrophil 39%, lymphocyte 56%), total eosinophil count 156/mm3, IgE by PRIST above 1, 000 IU/m.
T54575 237448-237482 Sentence denotes Immunoglobulin levels were normal.
T54614 237483-237535 Sentence denotes Specific IgE for Aedes communis by CAP was negative.
T60180 237536-237644 Sentence denotes Lymphocyte subset analysis demonstrated increased NK cells (CD16+CD56, 43%) and decreased CD3 and CD4 cells.
T54514 237645-237777 Sentence denotes IgM for anti-nuclear antigen (EBNA), IgM for viral capsid antigen (VCA) and IgM for anti-early antigen (EA) DR to EBV were negative.
T59511 237778-237894 Sentence denotes But the levels of anti-VCA IgG (> 200 U/mL), anti-EA DR IgG (> 150 U/mL) and anti-EBNA IgG (62 U/mL) were increased.
T61172 237895-238038 Sentence denotes Type A EB virus was demonstrated in blood mononuclear cells by DNA PCR method, and EBER in situ hybridization was negative in necrotic tissues.
T6284 238039-238173 Sentence denotes Immunostaining with NK-cell marker (CD56) revealed many immunoreactive cells with the perivascular inflammatory infiltrates in tissue.
T46524 238174-238284 Sentence denotes Skin patch tests for Mosquito allergen (Aedes togoi and Culex pipiens) showed positive response to C. pipiens.
T99959 238285-238298 Sentence denotes Introduction:
T62348 238299-238434 Sentence denotes Scimitar syndrome is a congenital anomaly resulting in anomalous pulmonary venous return from the right lung to the inferior vena cava.
T31125 238435-238512 Sentence denotes Recurrent respiratory infections have been associated with Scimitar Syndrome.
T75843 238513-238521 Sentence denotes Methods:
T66333 238522-238628 Sentence denotes We report on a 16 year-old adolescent female who presented to Immunology Clinic with recurrent pneumonias.
T236 238629-238637 Sentence denotes Results:
T93305 238638-238737 Sentence denotes The patient presented with numerous recurrent pneumonias, multiple ER visits, and hospitalizations.
T60644 238738-238821 Sentence denotes She complained of intermittent chest pain, cough, fatigue and exercise intolerance.
T99471 238822-238915 Sentence denotes The patient had a large secundum atrial septal defect surgically corrected at 5 years of age.
T18467 238916-239005 Sentence denotes A cardiac echo obtained at 7 years of age revealed RVH, but was normal at 9 years of age.
T23215 239006-239039 Sentence denotes She was a known atopic asthmatic.
T31002 239040-239134 Sentence denotes Previous immunologic workup was normal with IgA 183 (33-202), IgG 1290 (633-1280) and IgM 97 .
T76048 239135-239217 Sentence denotes At presentation to our clinic pulmonary functions were FVC of 79% and FEV1 of 78%.
T43171 239218-239338 Sentence denotes Review of previous chest radiographs showed chronic changes with an opacity partially obscuring the right hemidiaphragm.
T17990 239339-239528 Sentence denotes A high resolution chest CT-scan showed a large irregular venous structure extending through the right chest joining the inferior vena cava above the liver consistent with Scimitar Syndrome.
T93194 239529-239614 Sentence denotes The patient was referred to Pediatric Cardiology who recommended surgical correction.
T81071 239615-239626 Sentence denotes Conclusion:
T31794 239627-239706 Sentence denotes Scimitar syndrome may present as recurrent pneumonias and chronic lung disease.
T90309 239707-239782 Sentence denotes A high resolution chest CT scan may be useful in delineating this disorder.
T19511 239783-239794 Sentence denotes Background:
T38300 239795-239933 Sentence denotes Laryngomalacia is the most common cause of stridor in infants but only rare reports exist of clinically relevant laryngomalacia in adults.
T66848 239934-239944 Sentence denotes Objective:
T90164 239945-240062 Sentence denotes To present a case of laryngomalacia in an adult with significant respiratory symptoms initially attributed to asthma.
T9426 240063-240071 Sentence denotes Methods:
T70672 240072-240332 Sentence denotes An 18 year-old female with a history of allergic rhinitis and gastroesophageal reflux disease presented to the allergy clinic for further recommendations regarding a prior diagnosis of asthma poorly controlled on inhaled fluticasone, montelukast and albuterol.
T82783 240333-240422 Sentence denotes The patient was clinically diagnosed with asthma at age 13 due exercise related symptoms.
T89524 240423-240523 Sentence denotes The symptoms progressed and intermittent trials of various inhaled steroids provided minimal relief.
T21389 240524-240644 Sentence denotes On evaluation, the patient described constant wheezing which occurred only on inhalation and originated from the throat.
T23402 240645-240776 Sentence denotes Symptoms did not respond to albuterol use three to four times a day, rhinitis control and long-term, high-dose, antireflux therapy.
T38509 240777-240808 Sentence denotes Baseline spirometry was normal.
T67197 240809-240904 Sentence denotes Histamine bronchoprovacation and fiberoptic laryngoscopy were performed for further evaluation.
T88464 240905-240913 Sentence denotes Results:
T53215 240914-240998 Sentence denotes Histamine challenge was positive with a 33% decrease in FEV1 with 1 mg/ml histamine.
T93131 240999-241237 Sentence denotes However, laryngoscopy revealed redundant airway tissue most notable over the right arytenoid cartilage, consistent with laryngomalacia, which prolapsed into the laryngeal vestibule significantly obstructing the airway on inspiration only.
T51108 241238-241422 Sentence denotes The patient was referred to otolaryngology and surgical excision using a carbon dioxide laser was performed with subsequent improvement in symptoms and decreased asthma medication use.
T83457 241423-241435 Sentence denotes Conclusions:
T27799 241436-241574 Sentence denotes We report an unusual case of laryngomalacia in an adult presenting as asthma, which was successfully treated with laser surgical excision.
T84937 241575-241675 Sentence denotes Laryngoscopy of the patient revealing redundant airway tissue most notable over the right arytenoid.
T61492 241676-241678 Sentence denotes C.
T89383 241679-241689 Sentence denotes So 1* , S.
T744 241690-241701 Sentence denotes Kuhl 2 , 1.
T29542 241702-241715 Sentence denotes Davis, CA; 2.
T72463 241716-241727 Sentence denotes Mather, CA.
T20493 241728-241730 Sentence denotes C.
T49827 241731-241737 Sentence denotes So, S.
T684 241738-241747 Sentence denotes Kuhl U.C.
T55302 241748-241833 Sentence denotes Davis Medical Center, Sacramento, CA & Sacramento VA Hospital, Mather, CA BACKGROUND:
T1017 241834-241901 Sentence denotes Wheezing is an uncommon manifestation of phrenic nerve dysfunction.
T348 241902-241912 Sentence denotes OBJECTIVE:
T96089 241913-242117 Sentence denotes We offer a description of wheezing attributable to phrenic nerve dysfunction to remind clinicians that dyspnea and wheezing can be caused by cor pulmonale which can be caused by phrenic nerve dysfunction.
T33241 242118-242126 Sentence denotes METHODS:
T54328 242127-242232 Sentence denotes A 71-year old male non-smoker presented with chronic dyspnea and occasional wheezing for the last decade.
T44267 242233-242329 Sentence denotes The patient had a remote history of pericardial stripping for presumed tuberculous pericarditis.
T50155 242330-242379 Sentence denotes He also had a non-productive cough and orthopnea.
T35296 242380-242456 Sentence denotes Dyspnea was exacerbated by putting his hands over his head and bending over.
T88829 242457-242541 Sentence denotes He had been treated with inhaled corticosteroids and bronchodilators without relief.
T83677 242542-242550 Sentence denotes RESULTS:
T80549 242551-242623 Sentence denotes Repeated chest x-rays showed a chronically elevated right hemidiaphragm.
T64281 242624-242784 Sentence denotes Pulmonary function tests showed a restrictive pattern with: FEV 1 1.2 (40%), FVC 1.59 (36%), TLC 3.23 (49%), DLCO/VA 4.54 (125%) and no bronchodilator response.
T73849 242785-242961 Sentence denotes Left heart catheterization was normal while right heart catheterization showed elevated pulmonary artery pressures (56/20) and he was subsequently diagnosed with cor pulmonale.
T19845 242962-243199 Sentence denotes Cardiopulmonary exercise testing showed an increase in minute ventilation which was achieved predominantly by an increase in respiratory rate rather than to an increase in tidal volume suggesting restrictive or interstitial lung disease.
T52114 243200-243290 Sentence denotes Chest CT showed left ventricular enlargement and no evidence of interstitial lung disease.
T31737 243291-243382 Sentence denotes A fluoroscopic sniff test was performed and showed paradoxical movement of both diaphragms.
T13671 243383-243505 Sentence denotes He was diagnosed as having diaphragmatic dysfunction as a result of phrenic nerve injury from prior pericardial stripping.
T18702 243506-243518 Sentence denotes CONCLUSIONS:
T34099 243519-243592 Sentence denotes Wheezing and chronic dyspnea can be related to phrenic nerve dysfunction.
T25565 243593-243705 Sentence denotes A review and discussion of various causes of phrenic nerve dysfunction, including autoimmune causes, is offered.
T91272 243706-243871 Sentence denotes Patients with a history of prior cardiothoracic surgery who present with recalcitrant dyspnea and wheezing may benefit from evaluation for phrenic nerve dysfunction.
T83506 243872-243883 Sentence denotes Background:
T11289 243884-244033 Sentence denotes Sudden sensorineural hearing loss (SSNHL) is defined by a loss of at least 30 dB in 3 contiguous frequencies over a time course of 72 hours or fewer.
T48200 244034-244209 Sentence denotes Etiologies of SSNHL include viral infections, ototoxic drugs, autoimmune diseases, trauma, neoplasms, and vascular occlusion, but viral labyrinthitis is the most common cause.
T58735 244210-244334 Sentence denotes In cases of sudden hearing loss, herpes infections can be reported in approximately 70% of cases caused by viral infections.
T38906 244335-244390 Sentence denotes Typically, sensorineural hearing loss is not recurrent.
T17217 244391-244516 Sentence denotes We report a case of recurrent SSNHL is which oral herpes lesion preceded the onset of symptoms on three consecutive episodes.
T20668 244517-244529 Sentence denotes Case report:
T37356 244530-244761 Sentence denotes A 55-year-old male with a history of hypertension, hypothyroidism and chronic tinnitus of the left ear (since a gunshot wound 18 years prior) presented to clinic with a complaint of recurrent episodes of sensorineural hearing loss.
T6569 244762-244831 Sentence denotes The first episode of bilateral hearing loss occurred 14 months prior.
T60718 244832-244954 Sentence denotes An otolarnolgologist treated with a steroid taper and valacyclovir and the hearing loss resolved after one day of therapy.
T31406 244955-245155 Sentence denotes Since the initial presentation, the patient reports three subsequent episodes of SSNHL, with two of the episodes responding to prednisone and valacyclovir and one episode responding to steroids alone.
T54684 245156-245252 Sentence denotes Oral herpetic lesions preceded at least three of the episodes one day prior to the hearing loss.
T69088 245253-245342 Sentence denotes Laboratory data was significant for an elevation of varicella-zoster IgG, and of HSV IgG.
T49511 245343-245369 Sentence denotes HSV IgM was not performed.
T79052 245370-245412 Sentence denotes RPR was non-reactive and ANA was negative.
T95606 245413-245442 Sentence denotes A MRI of the head was normal.
T34251 245443-245532 Sentence denotes Audiogram demonstrated 30dB increase and speech discrimination improved from 80% to 100%.
T44483 245533-245582 Sentence denotes The rest of the laboratory data was unremarkable.
T3468 245583-245693 Sentence denotes The patient has been maintained on daily valacyclovir therapy and has had no further episodes of hearing loss.
T61051 245694-245705 Sentence denotes Conclusion:
T66849 245706-245789 Sentence denotes Our patient experienced hearing loss with concomitant evidence of HSV-1 stomatitis.
T86658 245790-245836 Sentence denotes This suggests a cause and effect relationship.
T26504 245837-246137 Sentence denotes We found that the antiviral therapy was effective for treatment of the SSNHL in this patient as demonstrated by the absence of further symptoms while on antiviral prophylaxis and conclude the most likely etiology of the recurrent hearing loss was secondary to the recurrent herpes simplex infections.
T37101 246138-246396 Sentence denotes Abstract The illness was described for the first time in 1937 in the Chinese literature by Kimm, and Szeto, the definitive histological description was published by Kimura in 1948, this illness is endemic in Asia, but rare, about 200 cases had been reported.
T73905 246397-246459 Sentence denotes Kimura Disease is extremely sporadic in the rest of the world.
T31929 246460-246702 Sentence denotes The etiology of this disease is ignored but it is believed that there is an aberrant immune reaction to an unknown antigenic stimulus, however Epstein Barr's virus, human herpes virus 8 and Candida albicans had been involved in certain cases.
T65116 246703-246918 Sentence denotes The mast cells had been implicated in its pathogenesis and a Th2 cytokine pattern with the production of interleukin 4, 5 and RANTES which regulate the synthesis of IgE and orchestrate the eosinophilic infiltration.
T4136 246919-247029 Sentence denotes On the other hand it is suggested that the eosinophils had undergone an accelerated apoptosis in this illnesS.
T92615 247030-247042 Sentence denotes Case Report.
T13303 247043-247466 Sentence denotes It is a 7 year-old boy with a 6 months evolution with the presence of bilateral subcutaneous nodules of 4x5 cm in parotid and submaxillary glands, presenting hypereosinophilia (8172 total eosinophils ) and high IgE ( 9187 total IgE), with normal renal function and negative mycotic and parasitic tests.The histopathologic findings revealed the presence of eosinophilic infiltrates with capillary proliferation and fibrosis.
T11960 247467-247478 Sentence denotes Discussion.
T36950 247479-247659 Sentence denotes For the clinical characteristics of the nodules together with the hypereosinophilia, extremely high IgE and the characteristic histological lesions the diagnosis is Kimura Disease.
T71319 247660-248056 Sentence denotes The usual clinical presentation consists on several indolent subcutaneous nodules that grow very slowly in volume, located in the neck and head, accompanied by satel-ANNALS OF ALLERGY, ASTHMA & IMMUNOLOGY lites adenophaties, and with increment in the salivary glands, there is renal affectation in half of the patients, and the laboratory detects hypereosinophilia and elevation of the total IgE.
T55329 248057-248318 Sentence denotes The histological lesions, shows hyperplastic lymphoid tissue with proliferative germinal centers, with infiltration of eosinophils in their interfollicular and perivascular zones sometimes forming an eosinophil abscess and proliferation of poscapillary venules.
T83740 248319-248430 Sentence denotes At the moment he have been treated with prednisone (1mgkdia), with great improvement in the clinical evolution.
T1419 248431-248491 Sentence denotes This is the first case reported in the literature in Mexico.
T80913 248492-248505 Sentence denotes Introduction:
T34461 248506-248632 Sentence denotes The incidence of cow's milk protein allergy (CMPA) is approximately 2-3% and presents primarily during the first year of life.
T94868 248633-248802 Sentence denotes Manifestations of CMPA in the neonatal period include gastroenteritis, colic, lethargy, metabolic acidosis, and hematochezia or melena and appear to be non-IgE mediated.
T95697 248803-248895 Sentence denotes IgE mediated reactions in the neonatal period, such as urticaria or angioedema, are unusual.
T70961 248896-248901 Sentence denotes Case:
T14728 248902-249026 Sentence denotes A 13-day-old African-American male presented with a 3 day history of rash, swelling, and erythema overlying multiple joints.
T99919 249027-249078 Sentence denotes There was no history of fever, diarrhea, or eczema.
T87177 249079-249128 Sentence denotes He had been on no medications prior to admission.
T16221 249129-249233 Sentence denotes Besides mother with a history of childhood asthma, there was no family history of atopy or food allergy.
T96526 249234-249311 Sentence denotes He had been fed cow's milk-base formula (Similac ® ) since birth exclusively.
T62601 249312-249436 Sentence denotes Physical examination revealed a diffuse erythematous, raised, macular-papular rash, with areas of duskiness and exfoliation.
T29906 249437-249512 Sentence denotes There was angioedema overlying the joints and periorbital areas (figure 1).
T7808 249513-249732 Sentence denotes Laboratory evaluation included CBC with diff, Hgb electrophoresis, lumbar puncture, urinalysis, C 1 q (qualitative and quantitative), C 2 , C 3 , C 4 , and cultures of the blood, CSF, and urine which were within normal.
T97656 249733-249924 Sentence denotes Percutaneous allergy skin testing for cow's milk allergy was performed revealing a 3 + reaction to cow's milk extract (Greer, Lenoir, NC) with positive histamine and negative saline controls.
T93849 249925-250003 Sentence denotes RAST testing showed 8.23 KU/L for -lactoglobulin and 5.10 KU/L for cow's milk.
T6329 250004-250042 Sentence denotes He was placed on an elemental formula.
T17119 250043-250105 Sentence denotes Skin lesions and swelling resolved completely within 36 hours.
T47988 250106-250169 Sentence denotes At 2 week follow-up the patient was thriving without complaint.
T56450 250170-250181 Sentence denotes Conclusion:
T40697 250182-250309 Sentence denotes Early sensitization to cow's milk protein in the neonatal period may occur, resulting in IgE mediated urticaria and angioedema.
T9083 250310-250447 Sentence denotes The rashes may be misdiagnosed as erythema multiforme or anaphylactoid purpura, since hemorrhagic lesions and cockade pattern are common.
T9942 250448-250564 Sentence denotes Physicians should be aware that these reactions may occur so that early recognition and management may be initiated.
T5149 250565-250634 Sentence denotes Neonate with periorbital angioedema and exfoliating, urticarial rash.
T82519 250635-250645 Sentence denotes Rationale:
T4942 250646-250773 Sentence denotes Two patients, presenting with invasive fungal CNS infections, were found to have NK cell dysfunction and hypogammaglobulinemia.
T38103 250774-250782 Sentence denotes Methods:
T56055 250783-250804 Sentence denotes Case reports Results:
T20876 250805-250816 Sentence denotes Patient #1:
T76743 250817-250947 Sentence denotes A 47 year old Caucasian male presented with headache, double vision, periorbital swelling, and bilateral sinus disease on CT scan.
T2140 250948-251000 Sentence denotes Biopsies showed invasive rhinocerebral mucormycosis.
T713 251001-251156 Sentence denotes He continued to deteriorate in spite of IV and intrathecal amphotericin B, hyperbaric oxygen, many debridement procedures, and a left orbital exenteration.
T7449 251157-251250 Sentence denotes Immune evaluation revealed low IgG, low IgM and a barely detectable NK cell killing activity.
T92596 251251-251291 Sentence denotes Neutrophil respiratory burst was normal.
T44625 251292-251340 Sentence denotes He continued to worsen despite IVIG replacement.
T72576 251341-251382 Sentence denotes He had intolerable side effects to IFN-a.
T41741 251383-251454 Sentence denotes GM-CSF (500 mcg QOD) was initiated, in order to boost NK cell activity.
T90253 251455-251503 Sentence denotes This resulted in stabilization of his infection.
T50993 251504-251583 Sentence denotes He was discharged on oral anti-fungal therapy (posaconazole), IVIG, and GM-CSF.
T67712 251584-251687 Sentence denotes Sixteen months later, he continues to remain stable clinically and radiographically on IVIG and GM-CSF.
T71646 251688-251699 Sentence denotes Patient #2:
T37318 251700-251788 Sentence denotes A 62-year-old Caucasian male presented with headache, mental status changes, and ataxia.
T71492 251789-251840 Sentence denotes A head CT scan showed a left mass effect and edema.
T81097 251841-251953 Sentence denotes He underwent surgical debridement for ventriculitis and Zygomycetes (the same family as mucormycosis) was found.
T27780 251954-252012 Sentence denotes He was started on IV amphotericin B and oral posaconazole.
T15742 252013-252085 Sentence denotes His immune evaluation revealed low IgG and IgM and low NK cell activity.
T84472 252086-252126 Sentence denotes Neutrophil respiratory burst was normal.
T71703 252127-252217 Sentence denotes He was started on IVIG and GM-CSF after which his NK cell function improved significantly.
T46921 252218-252327 Sentence denotes He remains clinically stable on IVIG and GM-CSF with persistent radiographic evidence of enlarged ventricles.
T65614 252328-252339 Sentence denotes Conclusion:
T2755 252340-252527 Sentence denotes Hypogammaglobulinemia is usually not associated with invasive CNS fungal infections, suggesting that NK cell dysfunction was likely responsible for the clinical courses of these patients.
T11516 252528-252692 Sentence denotes NK cell deficiency has been reported to be associated with recurrent mucosal candidiasis, suggesting an important role for these cells in the control of some fungi.
T59826 252693-252834 Sentence denotes The spectrum of the clinical presentations of NK cell deficiency is not known since it is not normally included in immune system evaluations.
T8451 252835-252956 Sentence denotes These patients illustrate the importance of including functional NK cell assessment in any evaluation of immune function.
T66426 252957-252970 Sentence denotes Introduction:
T141 252971-253144 Sentence denotes To report a case of successful systemic hydrocortisone desensitization, since allergic reactions and systemic desensitization to corticosteroids have rarely been documented.
T87780 253145-253152 Sentence denotes Method:
T40753 253153-253303 Sentence denotes We present a patient with multiple medical problems who has a history of both radiocontrast induced anaphylactoid reaction and corticosteroid allergy.
T6623 253304-253428 Sentence denotes This patient had to undergo cardiac catheterization and corticosteroid desensitization was performed prior to the procedure.
T52425 253429-253437 Sentence denotes Results:
T49925 253438-253671 Sentence denotes Skin testing to radiocontrast is not considered helpful, therefore patients with suspected reactions to radiocontrast are generally premedicated with corticosteroids and antihistamines to decrease the risk and severity of a reaction.
T78839 253672-253814 Sentence denotes 1, 2 Since this patient experienced an allergic reaction to a corticosteroid previously, she was skin tested to two different corticosteroids.
T92220 253815-253904 Sentence denotes The least reactive skin test revealed a 3+ positive immediate reaction to hydrocortisone.
T39011 253905-254041 Sentence denotes Cardiac catheterization with contrast was considered absolutely necessary in this case and corticosteroid desensitization was performed.
T44288 254042-254210 Sentence denotes The half-life of hydrocortisone is the shortest among the tested corticosteroids (80-118 minutes), so a protocol was developed with short intervals of escalating doses.
T18101 254211-254323 Sentence denotes Each dose was diluted yielding a total volume of 75mL to avoid fluid overload because patient has renal failure.
T47226 254324-254471 Sentence denotes During desensitization, patient developed pruritus and erythema between the 3 rd and 4 th dose that resolved immediately with 50mg diphenhydramine.
T33956 254472-254578 Sentence denotes After desensitization, the patient continued to be on hydrocortisone 200mg intravenously every four hours.
T82936 254579-254746 Sentence denotes One hour prior to the procedure, the patient was premedicated with hydrocortisone and diphenhydramine and was administered radiocontrast without any adverse reactions.
T83450 254747-254758 Sentence denotes Conclusion:
T45384 254759-254916 Sentence denotes We successfully desensitized our patient to a corticosteroid and premedicated her with hydrocortisone and diphenhydramine before administering radiocontrast.
T79372 254917-255098 Sentence denotes This case illustrates that intravenous desensitization may be a suitable approach to therapy in corticosteroid allergic patients who require systemic corticosteroids administration.
T77691 255099-255244 Sentence denotes Autoimmune neutropenia is defined as a decrease in the absolute number of peripheral neutrophils caused by an immunologically-mediated mechanism.
T26255 255245-255384 Sentence denotes Autoantibodies directed to neutrophils can lead to the peripheral destruction of neutrophils and/or inhibit myelopoesis in the bone marrow.
T92424 255385-255654 Sentence denotes Although recurrent aphthous stomatitis is often the heralding sign of neutropenia, the diagnosis of AIN requires the demonstration of specific antineutrophil antibody which acts by promoting the immune destruction and clearance of neutrophils by mononuclear phagocytes.
T49004 255655-255738 Sentence denotes The present case report describes the rare clinical association of RAS in an adult.
T59589 255739-255849 Sentence denotes A 66 yr-old black male presented with a 3 year history of recurrent and repeated painful multiple oral ulcers.
T92380 255850-256011 Sentence denotes Initially the oral ulcers occurred on a monthly basis then over time the ulcerations on the oral mucosa and tongue began to appear weekly and later continuously.
T56490 256012-256099 Sentence denotes Past medical history revealed no drug allergies but a positive history of hypertension.
T46017 256100-256190 Sentence denotes Physical exam revealed an otherwise healthy male with no lymphoadenopathy or splenomegaly.
T81639 256191-256460 Sentence denotes Laboratory workup revealed : HIV negative, viral culture for H. simplex negative, mild increase in CD8, cyroglobulins negative, anti dsDNA negative anti-Smith and RNP negative, WBC count 3300/mL, neutrophils 29% (ANC 957), lymphocytes 54%, monocytes 11%, and platelets:
T77108 256461-256470 Sentence denotes 243, 000.
T14642 256471-256534 Sentence denotes Bone marrow biopsy revealed a normal production of neutrophils.
T35492 256535-256621 Sentence denotes A direct neutrophil antibody assay: revealed an elevated value of 6, 576 (N= <4, 000).
T17960 256622-256755 Sentence denotes Although following initiation of prednisone (60 mg) an immediate increase in ANC was seen, the levels fell as the dosage was tapered.
T88221 256756-256855 Sentence denotes The figure below shows the time course and dose-response relationship of ANC and prednisone dosage.
T64147 256856-257021 Sentence denotes This case report illustrates the importance of recognition of the relationship of RAS and neutropenia, an association that can masquerade as other clinical entities.
T43423 257022-257033 Sentence denotes Background:
T76733 257034-257097 Sentence denotes Dyspnea, wheezing, and decreased FEV1 are suggestive of asthma.
T53997 257098-257248 Sentence denotes It is essential for the clinician to consider a broad differential diag-nosis as the outcome could be catastrophic if the correct diagnosis is missed.
T64941 257249-257267 Sentence denotes Case Presentation:
T98444 257268-257298 Sentence denotes We present a case of a 48 y.o.
T10615 257299-257512 Sentence denotes Filipino female who was referred to our clinic for the evaluation of cough, shortness of breath, and wheezy respiration associated with changes in voice quality, nasal and palatal pruritus, and postnasal drainage.
T20124 257513-257745 Sentence denotes Her initial evaluation revealed mold spore hypersensitivity by prick puncture testing and spirometry with an obstructive pattern with FVC-3.05 L (99%) and FEV1-1.25 L (50%) predicted and a 15% reversibility post nebulized albuterol.
T49635 257746-257896 Sentence denotes An initial diagnosis of allergic rhinitis with adult onset asthma was made and she was started on salmeterol, budesonide, montelukast, and pirbuterol.
T39861 257897-257989 Sentence denotes Her symptoms persisted and rabeprazole was added to treat possible laryngopharyngeal reflux.
T96902 257990-258105 Sentence denotes Repeat spirometry revealed FEV1-0.84 L prompting treatment with systemic corticosteroids again with no improvement.
T65174 258106-258155 Sentence denotes Fiberoptic laryngoscopy was within normal limits.
T95657 258156-258297 Sentence denotes A high resolution computed tomography was obtained and showed a mass in the left side of the trachea which was obstructing 60% of the airway.
T7175 258298-258438 Sentence denotes Bronchoscopy revealed a tumor 4-5 cm below the vocal cords with the appearance of adenoid cystic carcinoma which was confirmed by pathology.
T35291 258439-258559 Sentence denotes The tumor was resected by removal of 7 cm trachea with re-anastomosis, followed by a 6 week course of radiation therapy.
T69272 258560-258594 Sentence denotes All medications were discontinued.
T18891 258595-258660 Sentence denotes Her symptoms of wheezing, dyspnea, and cough completely resolved.
T46279 258661-258734 Sentence denotes Repeat spirometry was within normal limits and she remained asymptomatic.
T39179 258735-258801 Sentence denotes Surveillance bronchoscopies have been negative for any recurrence.
T83034 258802-258813 Sentence denotes Discussion:
T5776 258814-258926 Sentence denotes Adenoid cystic carcinoma (ACC) is an uncommon form of malignant neoplasm that occurs within the salivary glands.
T39247 258927-259015 Sentence denotes Tracheobronchial ACC typically presents with symptoms of cough, dyspnea, and hoarseness.
T90788 259016-259077 Sentence denotes Due to its slow growth, ACC has a relatively indolent course.
T68539 259078-259182 Sentence denotes In a recent study of a cohort of 160 ACC patients, survival was 89% at 5 years but only 40% at 15 years.
T83748 259183-259253 Sentence denotes Standard therapy is surgical resection often followed by radiotherapy.
T72960 259254-259265 Sentence denotes Conclusion:
T77480 259266-259432 Sentence denotes In patients who fail conventional therapies for asthma it is important to entertain other diagnosis and have a systematic approach to establish the correct diagnosis.
T12756 259433-259630 Sentence denotes IPEX is an extremely rare, hereditary condition characterized by Immune dysfunction, Polyendocrinopathy, Enteropathy and X-linked recessive inheritance that leads to death without prompt diagnosis.
T34681 259631-259730 Sentence denotes Patients usually present by 4 months with severe diarrhea, failure to thrive, and early onset IDDM.
T72417 259731-259794 Sentence denotes Most children die by one year without a bone marrow transplant.
T22589 259795-259896 Sentence denotes Immunologic evaluation is typically normal except for elevated IgE, eosinophilia, and autoantibodies.
T5953 259897-260008 Sentence denotes We report a case of IPEX in an infant who presented at birth and died at 79 days of multi-organ system failure.
T96140 260009-260080 Sentence denotes This male infant was born at 30 weeks due to chorioamnionitis and PROM.
T28597 260081-260188 Sentence denotes At birth, copious green fluid appeared from his rectum and NG tube which evolved into a secretory diarrhea.
T71244 260189-260221 Sentence denotes Workup for fistula was negative.
T69792 260222-260321 Sentence denotes At 2 weeks, the patient developed ascites and explorative laparotomy revealed an inflamed appendix.
T9714 260322-260418 Sentence denotes After the laparotomy, the patient had no further stool output and never tolerated enteric feeds.
T39295 260419-260486 Sentence denotes He remained intubated and had problems with apnea and coagulapathy.
T38341 260487-260545 Sentence denotes Pathology of the appendix showed an excess of lymphocytes.
T87056 260546-260615 Sentence denotes Immune system investigation showed elevated IgE (5320) and IgG (979).
T38489 260616-260706 Sentence denotes Serum anti-enterocyte IgG antibody was positive in the patient and negative in his mother.
T62365 260707-260778 Sentence denotes Based on this data, IPEX was suspected which autopsy seemed to confirm.
T40886 260779-260822 Sentence denotes Autopsies are scarce in patients with IPEX.
T33349 260823-260940 Sentence denotes The findings revealed many organs affected by fibrosis but lymphocyte infiltration of only the pancreas and GI tract.
T67760 260941-261068 Sentence denotes The pancreas revealed almost complete loss of the exocrine structure, with invasion of fibrosis and chronic inflammatory cells.
T21201 261069-261211 Sentence denotes The mucosa of the GI tract from the stomach to rectum showed columnar epithelium taken over by fibrosis, capillaries and chronic inflammation.
T65554 261212-261295 Sentence denotes These inflammatory cells were CD3+ lymphocytes and plasma cells on immunochemistry.
T29498 261296-261398 Sentence denotes The lymphoreticular system was consistent with lymphoid paucity in the thymus, lymph nodes and spleen.
T85139 261399-261478 Sentence denotes Preliminary data suggests this patient has a splice mutation of the FOXP3 gene.
T56113 261479-261567 Sentence denotes IPEX is an extremely rare disease, often difficult to diagnose while a patient is alive.
T12124 261568-261641 Sentence denotes Infants will present in early infancy with diarrhea and endocrinopathies.
T44496 261642-261688 Sentence denotes Without prompt diagnosis, death is inevitable.
T47292 261689-261860 Sentence denotes As a result, one must be aware of atypical presentations and considered in patients with total villous atrophy and one other clinical feature such as IDDM or autoimmunity.
T76992 261861-261874 Sentence denotes Introduction:
T4744 261875-262045 Sentence denotes DiGeorge syndrome (DGS) is characterized by thymic hypoplasia, parathyroid hypoplasia, and conotruncal cardiac defects, but has a wide variety of clinical manifestations.
T52128 262046-262142 Sentence denotes There is also an increased risk for autoimmune phenomena in later life due to thymic hypoplasia.
T19958 262143-262155 Sentence denotes Case report:
T95120 262156-262453 Sentence denotes A 13 year-old AA girl with Tetralogy of Fallot (repair at age 2), developmental delay, asthma, recurrent sinopulmonary infections/skin abscesses, GERD, arthralgias and seizure disorder (due to hypoxic encephalopathy during cardiac surgery) presented to Allergy/Immunology clinic for immune workup.
T87597 262454-262502 Sentence denotes There was no history of documented hypocalcemia.
T38991 262503-262571 Sentence denotes At age 10, she developed persistent annular patches on her left leg.
T5956 262572-262630 Sentence denotes A skin biopsy appeared consistent with sarcoid dermatitis.
T32508 262631-262713 Sentence denotes There was no other evidence of sarcoidosis except for slightly elevated ACE level.
T76787 262714-262812 Sentence denotes Given lack of systemic involvement, the skin lesions were not treated, but resolved spontaneously.
T24936 262813-263086 Sentence denotes At age 12, she developed swelling of the right mandible, and a bone biopsy revealed Garre's osteomyelitis (sterile hyperproliferative osteomyelitis), likely triggered by dental caries, with elevated ESR (40) and polyclonal hypergammaglobulinemia (IgG 2640), but normal CRP.
T37299 263087-263368 Sentence denotes Immune workup revealed a decrease in CD4 and CD8 cells (CD4/CD8 ratio 2.44), slightly elevated B cells, high-normal range NK cells, normal range T cell cytokine production in response to mitogens and IL-12, but excessive production of proinflammatory cytokines in responses to LPS.
T26909 263369-263477 Sentence denotes In conjunction with facial dysmorphism, DGS was suspected, and FISH analysis revealed 22q11.2 microdeletion.
T31316 263478-263613 Sentence denotes A repeat workup did not reveal evidence of systemic sarcoidosis, and autoantibody screening was negative including lupus anticoagulant.
T18137 263614-263811 Sentence denotes She was treated with a COX-2 inhibitor, secondary to GERD and mild thrombocytopenia, and her joint symptoms resolved with a concurrent decline in ESR (to 30) and IgG level (to 2390) after 2 months.
T75652 263812-263823 Sentence denotes Conclusion:
T84236 263824-264059 Sentence denotes Recurrent infections with fragmented care and resultant chronic inflammation (hence overstimulation of the immune system) may have led this DGS patient to develop atypical autoimmune phenomena and other unusual clinical manifestations.
T59251 264060-264213 Sentence denotes This case illustrates the importance of recognizing the phenotypic features of DGS early in life, and of providing close monitoring and coordinated care.
T79596 264214-264224 Sentence denotes Rationale:
T1402 264225-264450 Sentence denotes We report a case of a patient with Celiac Disease who continues to have symptoms of fevers, nausea, vomiting, night sweats and fatigue despite being on a gluten free diet whose symptoms have been responsive to antihistamines.
T9218 264451-264459 Sentence denotes Methods:
T45440 264460-264472 Sentence denotes Case report.
T965 264473-264481 Sentence denotes Results:
T47807 264482-264575 Sentence denotes In 1998, this 41 year-old white male suffered from mononucleosis and episodes of prostatitis.
T63319 264576-264681 Sentence denotes He began suffering from fatigue and fevers and was followed at a Chronic Fatigue Syndrome center in 1999.
T73750 264682-264757 Sentence denotes In November 2000, patient was placed on famvir alleviating his sore throat.
T74479 264758-264866 Sentence denotes He was later placed on Interferon gamma which was discontinued due to increased fevers, nausea and vomiting.
T20527 264867-264923 Sentence denotes After stopping medication, symptoms abated for sometime.
T1825 264924-264982 Sentence denotes In 2002, patient's father was diagnosed with Celiac Sprue.
T96885 264983-265056 Sentence denotes In April of 2003, the patient developed a pruritic rash on his right arm.
T5571 265057-265137 Sentence denotes Biopsy revealed subepidermal vesicles with PMN's at the tips of dermal papillae.
T74725 265138-265202 Sentence denotes In May of 2003, he developed oral ulcers as well as joint pains.
T1345 265203-265301 Sentence denotes Patient underwent endoscopy with biopsies revealing intraepithelial lymphocytosis in the duodenum.
T40887 265302-265367 Sentence denotes Patient has been on a strict gluten free diet since October 2003.
T10904 265368-265455 Sentence denotes He reports that some symptoms have improved: skin lesions, itchy eyes, and oral ulcers.
T29283 265456-265585 Sentence denotes However, he has begun to suffer from constipation and continues to intermittently have night sweats, fevers, nausea and vomiting.
T77937 265586-265662 Sentence denotes In February of 2004, he had pruritus that was not alleviated by hydroxyzine.
T72671 265663-265733 Sentence denotes A regimen of Benadryl and Pepcid was started to aid with the pruritus.
T55032 265734-265822 Sentence denotes The patient reported in the improvement of his symptoms of pruritis, sweats, and emesis.
T96109 265823-265835 Sentence denotes Conclusions:
T50811 265836-265846 Sentence denotes Diagnosis:
T56904 265847-266037 Sentence denotes Celiac Disease(CD) patient with persistent nausea, vomiting, sporadic fevers, and fatigue despite maintaining a strict gluten free diet has shown improvement of symptoms with antihistamines.
T94250 266038-266109 Sentence denotes Patient has history of chronic infections: prostatitis and chronic EBV.
T28748 266110-266241 Sentence denotes Patient also reported alleviation of symptoms after interferon therapy suggesting some autoimmune component to his current illness.
T30952 266242-266328 Sentence denotes CD prevalence in the United States is much higher than once thought 0.5-1% of the U.S.
T7896 266329-266447 Sentence denotes Celiac disease has been associated with increased risk of lymphoma and malabsorption leading to neurological diseases.
T288 266448-266523 Sentence denotes This is a rare case of CD associated pruritus responding to antihistamines.
T4461 266524-266534 Sentence denotes Rationale:
T77989 266535-266632 Sentence denotes Eosinophilic cystitis is a relatively rare condition in children and adults with a varied course.
T82594 266633-266693 Sentence denotes It usually responds to short-term NSAID and steroid therapy.
T38265 266694-266770 Sentence denotes We report a man with a severe case who responded to prolonged oral steroids.
T88062 266771-266783 Sentence denotes Case Report:
T29782 266784-267020 Sentence denotes A 54 year old Caucasian man with a prior esophageal cancer s/p esophagectomy, diabetes, hypertension, allergic rhinitis and chronic obstructive pulmonary disease presented with suprapubic pain, urinary frequency, dysuria, and hematuria.
T61963 267021-267115 Sentence denotes Urinalysis showed numerous red blood cells and bacteria but no malignant cells or eosinophils.
T63796 267116-267176 Sentence denotes He was treated with antibiotics with resolution of symptoms.
T63379 267177-267299 Sentence denotes Several weeks later he experienced severe suprapubic pain and hematuria resulting in a symptomatic drop in his hemoglobin.
T98833 267300-267434 Sentence denotes He underwent a cystoscopy and biopsy that revealed a chronic cystitis with an inflammatory infiltrate containing numerous eosinophils.
T77233 267435-267540 Sentence denotes He was unresponsive to treatment with NSAID and intravesicular DMSO and was then referred to our service.
T66827 267541-267613 Sentence denotes We started prednisone 20 mg/day but the dysuria and hematuria persisted.
T40483 267614-267681 Sentence denotes Prednisone was doubled plus a third generation quinolone was added.
T58923 267682-267759 Sentence denotes Three weeks later the hematuria and dysuria resolved and he was asymptomatic.
T33149 267760-267843 Sentence denotes The antibiotic was stopped and prednisone was gradually tapered over several weeks.
T5565 267844-267941 Sentence denotes Whenever his steroid dose dropped below 20 mg/day he experienced an exacerbation of his symptoms.
T73898 267942-268051 Sentence denotes Over the last three years this dose of prednisone has kept his symptoms abated and his renal function stable.
T45740 268052-268063 Sentence denotes Conclusion:
T46605 268064-268131 Sentence denotes Eosinophilic cystitis is an uncommon diagnosis of unknown etiology.
T33038 268132-268268 Sentence denotes We describe a patient with debilitating suprapubic pain and symptomatic anemia from the hematuria associated with eosinophilic cystitis.
T39261 268269-268389 Sentence denotes For over three years since we first saw him, continued therapy with 20 mg of prednisone/day has prevented exacerbations.
T58981 268390-268534 Sentence denotes This case is unique in the severity of the hematuria experienced and the prolonged relatively low steroid dose needed to suppress exacerbations.
T6207 268535-268712 Sentence denotes We propose that in eosinophilic cystitis patients with severe hematuria who may otherwise be candidates for a cystectomy, a trial of prolonged oral prednisone may be beneficial.
T86124 268713-268723 Sentence denotes Rationale:
T24902 268724-268829 Sentence denotes Allergic reactions to insulin occurred more frequently in the past, with porcine and bovine preparations.
T79766 268830-268949 Sentence denotes In contrast, allergic reactions to human insulin preparations are now reported in <1% of patients treated with insulin.
T21775 268950-269150 Sentence denotes Insulin allergy may be manifested as an immediate-type 1 IgE-mediated reaction, delayed type hypersensitivity or as serum sickness, varying in severity from mild discomfort to life-threatening events.
T60478 269151-269264 Sentence denotes We present a case to illustrate that an insulin allergy may complicate hospitalization and often be misdiagnosed.
T92468 269265-269273 Sentence denotes Methods:
T51102 269274-269350 Sentence denotes A 66 y.o. diabetic female with a history of "Insulin Allergy" was evaluated.
T84976 269351-269489 Sentence denotes The patient is a long standing diabetic controlled on oral hypoglycemics but required insulin during acute illnesses and hospitalizations.
T98492 269490-269566 Sentence denotes The patient was unable to recall previous types of insulin she had received.
T64659 269567-269703 Sentence denotes During previous hospitalizations, the patient complained of vague symptoms of fatigue, parasthesia, sweating, anxiety, and palpitations.
T66446 269704-269864 Sentence denotes On one occasion the patient had a syncopal episode with hypotension and on another occasion the patient developed a rash and dyspnea after receiving SQ insulin.
T6858 269865-269930 Sentence denotes The physcian intrepreted the findings may be due to hypoglycemic.
T7345 269931-270014 Sentence denotes An allergic reaction was not suspected and the patient never underwent any testing.
T46893 270015-270125 Sentence denotes During a recent hospitalization, the patient's history was reviewed and a formal allergy consult was obtained.
T60197 270126-270207 Sentence denotes She underwent epicutaneous and intradermal testing to human insulin preparations.
T89966 270208-270251 Sentence denotes Insulin antibody levels were also obtained.
T44365 270252-270260 Sentence denotes Results:
T90667 270261-270341 Sentence denotes The patient had negative epicutaneous testing to all human insulin preparations.
T44183 270342-270507 Sentence denotes However, on intradermal testing, the patient had positive reactions to lispro, NPH, and lente and negative intradermal tests to insulin glargine and regular insulin.
T91892 270508-270559 Sentence denotes IgG and IgE insulin antibody test results were < 1.
T20506 270560-270571 Sentence denotes Conclusion:
T79877 270572-270694 Sentence denotes Hospitalized patients receiving multiple medications commonly experience pharmacologic, adverse and/or allergic reactions.
T59499 270695-270833 Sentence denotes It is necessary to obtain a thorough history and document all reactions that patients experience to determine what type of event occurred.
T26239 270834-270956 Sentence denotes With a suspicion of drug allergy, skin testing and/or RAST assay may provide insight into possible IgE mediated reactions.
T74507 270957-271139 Sentence denotes In this case we advised the patient that she may use regular insulin during hospitalizations and that insulin glargine can be used to help achieve optimal glycemic long term control.
T59244 271140-271151 Sentence denotes Background:
T77250 271152-271344 Sentence denotes Hereditary angioedema type III (HAE III) is a recently described form of angioedema occurring exclusively in females and characterized by normal C4, C1 inhibitor (C1 INH) protein and function.
T32765 271345-271426 Sentence denotes HAE III is thought to have an X-linked or autosomal dominant mode of inheritance.
T47229 271427-271598 Sentence denotes We evaluated a 13 year old female with recurrent facial swelling, abdominal pain and laryngeal edema with a family history of similar symptoms in several female relatives.
T82508 271599-271611 Sentence denotes Case Report:
T12880 271612-271729 Sentence denotes A 13 year old African American female presented with a two year history of recurrent lip, tongue and facial swelling.
T68221 271730-271792 Sentence denotes She also had abdominal pain, diarrhea and shortness of breath.
T9465 271793-271833 Sentence denotes Episodes were not associated with hives.
T14282 271834-271912 Sentence denotes Her symptoms predated menarche and did not correlate with her menstrual cycle.
T26124 271913-272079 Sentence denotes At the time of presentation she described an increase in frequency of her symptoms that did not respond to antihistamines (diphenhydramine, cetirizine) or prednisone.
T76015 272080-272122 Sentence denotes The patient had no other medical problems.
T99513 272123-272266 Sentence denotes Family history was significant for recurrent episodes of facial, lip and tongue swelling in a maternal aunt, grandmother and great grandmother.
T29531 272267-272380 Sentence denotes The patient's great grandmother required tracheal intubation with ventilator support for upper airway compromise.
T34649 272381-272426 Sentence denotes The patient's physical exam was unremarkable.
T36783 272427-272622 Sentence denotes Laboratory values drawn during an acute episode of swelling revealed: C1 INH function = >68% (normal >68%), C1 INH protein = 323mg/mL (normal 158-413 mg/mL), C4= 21.70 mg/dL (normal 20-59 mg/dL).
T18628 272623-272781 Sentence denotes DNA sequencing at exon 8 to investigate the possibility of an unusual C1 INH mutation with normal C1s binding but abnormal kallikrein inhibition was negative.
T50074 272782-273019 Sentence denotes Other lab tests included a normal mast cell tryptase of 2.9 mcg/L, a negative RF and ANA, a normal angiotensin converting enzyme of 62 U/L (normal 6-64 U/L) and positive skin prick tests to a variety of foods which the patient tolerates.
T20150 273020-273162 Sentence denotes Based on two case reports of treatment of HAE III with androgens, the patient was started on Danazol 200mg daily with symptomatic improvement.
T18544 273163-273234 Sentence denotes Conclusion: HAE III is a rare disease that affects females exclusively.
T84988 273235-273293 Sentence denotes Clinically it is indistinguishable from C1 INH deficiency.
T46828 273294-273348 Sentence denotes The mechanism of inheritance remains to be elucidated.
T59200 273349-273524 Sentence denotes It is unclear why Danazol appears to ameliorate symptoms even though there is no evidence for C1 ANNALS OF ALLERGY, ASTHMA & IMMUNOLOGY inhibitor dysfunction in this disorder.
T79947 273525-273606 Sentence denotes We believe this to be the first kindred of HAE III reported in the United States.
T21270 273607-273609 Sentence denotes R.
T2556 273610-273624 Sentence denotes Dworski * , M.
T77610 273625-273647 Sentence denotes Peters, Nashville, TN.
T805 273648-273744 Sentence denotes A four-month-old female identical twin was evaluated for noisy breathing and recurrent cyanosis.
T62752 273745-273840 Sentence denotes She was delivered at 32 weeks of an estimated gestational age after an uncomplicated pregnancy.
T81917 273841-273961 Sentence denotes At birth she was intubated for 3 hours for respiratory distress but the remainder of her neonatal period was uneventful.
T67139 273962-274091 Sentence denotes At age 3 weeks she developed a noisy breathing often associated with cyanosis, particularly in a supine position or while crying.
T3370 274092-274160 Sentence denotes Treatments with inhaled albuterol and prednisolone were ineffective.
T58465 274161-274242 Sentence denotes She had no respiratory infections or symptoms of gastroesophageal reflux disease.
T5846 274243-274265 Sentence denotes Her growth was normal.
T13777 274266-274292 Sentence denotes Her twin sibling was well.
T68459 274293-274365 Sentence denotes The family history was negative for allergies or respiratory conditions.
T4315 274366-274414 Sentence denotes Initially she was diagnosed with tracheomalacia.
T42872 274415-274502 Sentence denotes However, the history of cyanotic episodes prompted a search for a definitive diagnosis.
T40196 274503-274660 Sentence denotes She underwent bronchoscopy which showed tracheomalacia when breathing spontaneously and circumferential narrowing of lower trachea likely due to compression.
T68584 274661-274706 Sentence denotes Echocardiogram revealed a double aortic arch.
T90185 274707-274928 Sentence denotes The finding was confirmed by computed tomography angiography which demonstrated the presence of a vascular ring composed of double patent aortic arches, each giving rise to the ipsilateral carotid and subclavian arteries.
T44675 274929-275025 Sentence denotes The airway was normal at the aortic inlet, but narrowed markedly at the level of the two arches.
T12017 275026-275120 Sentence denotes A surgical division of the ductus ligamentous and distal anterior vascular arch was performed.
T74920 275121-275290 Sentence denotes Aortic arch abnormalities should be suspected in all infants with hoarse coughing or noisy breathing, especially during inspiration but sometimes also during expiration.
T13827 275291-275388 Sentence denotes The diagnosis should also be considered in older children with recurrent bronchitis or pneumonia.
T54450 275389-275465 Sentence denotes Respiratory symptoms are more frequent than gastrointestinal manifestations.
T57204 275466-275517 Sentence denotes Diagnosis usually occurs in the first year of life.
T49816 275518-275561 Sentence denotes A surgery is often the treatment of choice.
T56083 275562-275610 Sentence denotes Postoperative complications are relatively rare.
T62687 275611-275701 Sentence denotes Outcome of surgery should be judged after 12 months, including at least one winter season.
T50003 275702-275762 Sentence denotes Malacia can delay extubation and recovery following surgery.
T90096 275763-275817 Sentence denotes Surgical cure occurs in approximately 70% of patients.
T62426 275818-275897 Sentence denotes Surgery is probably less successful in children with double arches and malacia.
T38571 275898-275900 Sentence denotes A.
T14186 275901-275922 Sentence denotes Thatayatikom * , A.J.
T81803 275923-275944 Sentence denotes White, St. Louis, MO.
T75044 275945-275956 Sentence denotes Background:
T3683 275957-276165 Sentence denotes Common variable immunodeficiency (CVID) is the commonest symptomatic primary antibody deficiency syndrome in which B lymphocytes produce low levels of immunoglobulin, leading to recurrent bacterial infection.
T84514 276166-276377 Sentence denotes Although hypogammaglobulinemia and susceptibility to the recurrent infection are seen in all patients, other associated conditions such as a non-infectious granulomatous disease have been well described in CVID.
T57504 276378-276561 Sentence denotes Corticosteroid therapy has been used with improvement in a subset of CVID with granulomatous disease; however, its treatment remains problematic and a new therapeutic agent is needed.
T35493 276562-276674 Sentence denotes Tumor necrosis factor (TNF ) has been demonstrated as a primary mediator in granuloma formation and maintenance.
T88005 276675-276771 Sentence denotes Therefore, anti-TNF medications are potentially therapeutic agents of the granulomatous disease.
T99091 276772-276784 Sentence denotes Case Report:
T21005 276785-276939 Sentence denotes A 22-year-old Caucasian male with CVID and severe granulomatous disease was treated successfully with infliximab, a chimeric anti-TNF monoclonal antibody.
T80230 276940-277109 Sentence denotes The patient initially presented with high fever, chills and abdominal pain; subsequently, he developed acute respiratory failure and adult respiratory distress syndrome.
T64977 277110-277195 Sentence denotes The patient was hospitalized and he required intensive care with ventilatory support.
T12358 277196-277312 Sentence denotes His diagnostic tests revealed elevated sedimentation rate and positive Epstein-Barr virus (EBV) capsid IgM antibody.
T65276 277313-277405 Sentence denotes Imaging studies demonstrated bilateral diffuse pulmonary infiltrates and hepatosplenomegaly.
T5110 277406-277525 Sentence denotes Open lung and liver biop-sies revealed non-caseating granulomatous lesions without evidence of EBV or other infections.
T71444 277526-277676 Sentence denotes High dose corticosteroid therapy was given with partial improvement, then high dose infliximab (10mg/kg) was given weekly with remarkable improvement.
T54805 277677-277800 Sentence denotes The patient was able to wean off ventilator successfully within 3 weeks and his prednisone dose was dramatically decreased.
T99895 277801-277883 Sentence denotes Infliximab infusion (5mg/kg) every 8 weeks and low dose prednisone were continued.
T58687 277884-277974 Sentence denotes A follow-up liver biopsy after 6 months of the infliximab showed no granulomatous lesions.
T49140 277975-278036 Sentence denotes Infliximab was discontinued after 12 months of the treatment.
T4897 278037-278115 Sentence denotes There was no serious infection or complication during the period of treatment.
T35780 278116-278127 Sentence denotes Conclusion:
T97920 278128-278227 Sentence denotes Anti-TNF therapy may be a safe and effective treatment and may allow corticosteroid dose reduction.
T22484 278228-278321 Sentence denotes Future clinical studies of anti-TNF therapy in CVID with granulomatous disease are warranted.
T43530 278322-278333 Sentence denotes Background:
T64493 278334-278467 Sentence denotes Chrug-Strauss syndrome is a disorder characterized by hypereosinophilia and systemic vasculitis occurring in individuals with asthma.
T10562 278468-278477 Sentence denotes Objetive:
T67830 278478-278543 Sentence denotes To present a pediatric case suffering from a systemic vasculitis.
T95631 278544-278676 Sentence denotes This case fulfilled the Churg-Strauss syndrome clinical criteria and the histophatology findings were compatible with the diagnosis.
T37577 278677-278824 Sentence denotes Case: a 14 year female came to our institution with the diagnosis of severe asthma, chronic sinusisits and polyps requiring high doses of steroids.
T17013 278825-278904 Sentence denotes There was no history of administration of antileukotriene receptor antagonists.
T71248 278905-278990 Sentence denotes 2 months before her admission she presented weight loss, fatigue, cephalea and cough.
T68167 278991-279086 Sentence denotes On physical examination, pallor, respiratory difficulty and signs of bronchospasm were evident.
T97034 279087-279137 Sentence denotes Tachycardia and hepatomegaly were also documented.
T70058 279138-279247 Sentence denotes The laboratory test showed anemia, eosinophilia 1300/dl, ANCA+, SGOT 246, STGOP 253, IgE elevated 1345 UI/ml.
T4473 279248-279319 Sentence denotes The chest-X ray showed patchy opacities in both lungs and cardiomegaly.
T14458 279320-279492 Sentence denotes Pulmonary scintigraphy reported low perfusion in both lungs, predominantly in the left lung.Echocardiography demonstrated signs of myocarditis and eyection fraction of 32%.
T10218 279493-279612 Sentence denotes An open lung biopsy was executed and vasculitis with fibrinoid changes affecting small and medium vessels was reported.
T80213 279613-279724 Sentence denotes Treatment was started with oral prednisone 2 mg/kg/d and cyclophosphamide pulses with a satisfactory evolution.
T56177 279725-279736 Sentence denotes Discussion:
T23803 279737-279813 Sentence denotes To our Knowledge this is the first pediatric case of CSS reported in Mexico.
T72971 279814-279933 Sentence denotes She fulilled the following criteria. asthma, eosinophilia and systemic vasculitis involving the heart, liver and lungs.
T50634 279934-279985 Sentence denotes The disease is extremely rare, specially in Mexico.
T52337 279986-280062 Sentence denotes Aggressive treatment is necessary as in this case, with a favorable outcome.
T58826 280063-280151 Sentence denotes Introduction "All that wheezes is not asthma" is a well-known aphorism among physicians.
T6929 280152-280249 Sentence denotes This same principle exists for patients that present with lip swelling in the allergist's office.
T80897 280250-280373 Sentence denotes We describe a patient who presented with fluctuating lip swelling who was ultimately found to have cheilitis granulomatosa.
T83840 280374-280543 Sentence denotes Case History A 26-year-old male with a history of allergic rhinitis and asthma presented to the allergy clinic with lower lip swelling and occasional upper lip swelling.
T74476 280544-280609 Sentence denotes He was receiving allergen immunotherapy for dust mites and trees.
T97172 280610-280719 Sentence denotes The swelling had been waxing and waning for 13 years, but became more persistent for the previous six months.
T51798 280720-280820 Sentence denotes He denied tongue/throat swelling, dysphagia, respiratory distress, or any triggers for the swelling.
T61960 280821-280878 Sentence denotes ChapStick® and Vaseline® were used topically on his lips.
T98967 280879-280972 Sentence denotes Failed treatments included loratadine, ranitidine, cetirizine, fexofenadine, and montelukast.
T72656 280973-281107 Sentence denotes He was placed on a one-week course of prednisone, which decreased his lip swelling, but it recurred after completion of the treatment.
T27084 281108-281201 Sentence denotes Physical exam was significant for diffuse, firm lower lip edema to 3-4 times the normal size.
T51506 281202-281248 Sentence denotes There were no oral lesions or tongue swelling.
T17663 281249-281346 Sentence denotes Patch testing to a standard panel, preservatives, oral flavors, and dental acrylate was negative.
T11634 281347-281463 Sentence denotes Punch biopsy revealed a noncaseating epithelioid granulomatous inflammation consistent with granulomatous cheilitis.
T24511 281464-281541 Sentence denotes He was placed on minocycline 100 mg by mouth twice daily with little benefit.
T14990 281542-281622 Sentence denotes An 8-week course of oral prednisone resulted in improvement of the lip swelling.
T44723 281623-281833 Sentence denotes Conclusion Melkersson-Rosenthal syndrome (MRS) is a rare syndrome that is characterized by a triad of recurrent facial paralysis, chronic edema of the face and lips, and hypertrophy and fissuring of the tongue.
T83046 281834-281987 Sentence denotes Cheilitis granulomatosa is considered a monosymptomatic form of MRS and manifests as a chronic swelling of the lips caused by granulomatous inflammation.
T96408 281988-282056 Sentence denotes The swelling is typically not tender and may be either soft or firm.
T73511 282057-282131 Sentence denotes Allergists are often consulted for lip swelling thought due to angioedema.
T35109 282132-282306 Sentence denotes However, as this case illustrates, not all lip swelling is angioedema and one must consider other diagnoses such as Melkersson-Rosenthal syndrome and cheilitis granulomatosa.
T21784 282307-282441 Sentence denotes Progressive multifocal leukoencephalopathy (PML) is a disorder of the nervous system that affects individuals with immune suppression.
T65808 282442-282566 Sentence denotes It has been associated with HIV infection and is present in nearly 10% of patients with acquired immune deficiency syndrome.
T43478 282567-282645 Sentence denotes The JC virus, a common human polyomavirus, causes this demyelinating disorder.
T57885 282646-282830 Sentence denotes Progressive symptoms reflect the multifocal distribution of brain lesions, and include mental deterioration, vision loss, speech disturbances, ataxia, paralysis, and, ultimately, coma.
T31935 282831-282865 Sentence denotes In rare cases, seizures may occur.
T3163 282866-282902 Sentence denotes There is no known treatment for PML.
T43387 282903-283067 Sentence denotes We report a 21 year-old (y/o) male with 6 months weight loss and a sudden onset of confusion, lethargy, and progressive loss of cognition requiring hospitalization.
T38553 283068-283207 Sentence denotes Upon questioning he was found to have had recurrent upper respiratory tract infections since infancy successfully treated with antibiotics.
T49811 283208-283305 Sentence denotes As a child he had atopic dermatitis, exercise induced asthma, and myringotomy tubes placed twice.
T14962 283306-283350 Sentence denotes At 12 y/o, he underwent a nasal polypectomy.
T58125 283351-283476 Sentence denotes In 2002, at 19 y/o, a squamous cell carcinoma was removed, and he developed benign cervical lymphadenopathy and common warts.
T81190 283477-283519 Sentence denotes A year later he developed HSV esophagitis.
T38107 283520-283680 Sentence denotes The remainder of his history was unremarkable with normal development and growth and no history of drug abuse, multiple sexual partners, or homosexual contacts.
T79655 283681-283847 Sentence denotes On physical examination, he was thin, ill appearing, with oral ulcers, generalized scanty lymphoadenopathy, multiple common warts on both feet, and occasional ronchi.
T83042 283848-283911 Sentence denotes A brain MRI showed a demyelinating process consistent with PML.
T15384 283912-284213 Sentence denotes PCR for JC virus was positive, while HIV PCR was negative; total immunoglobulins and CD4 counts were low ( We are reporting a 47 year old female with a 10 year history of moderate persistent asthma, who was started on Xolair 150mg SQ q 4 wks., and who then presented with a presumed allergic reaction.
T49568 284214-284371 Sentence denotes Three hours after her second Xolair injection, patient reported developing dizziness, shortness of breath, and felt like she was having an allergic reaction.
T43775 284372-284444 Sentence denotes She was evaluated and observed for two hours in an emergency department.
T32657 284445-284530 Sentence denotes The treating physician reported no wheezing and felt there was no need for treatment.
T86742 284531-284626 Sentence denotes To rule out psychogenic factors, she was given a placebo injection at the next scheduled visit.
T74868 284627-284710 Sentence denotes Ten minutes later she reported developing throat tightness and shortness of breath.
T33082 284711-284773 Sentence denotes She had no changes in her peak flows and her lungs were clear.
T23100 284774-284887 Sentence denotes Her "symptoms" resolved completely within 5 minutes of receiving placebo epinephrine and nebulized normal saline.
T81709 284888-285009 Sentence denotes Patient was informed she had reacted to a placebo injection, as well as placebo epinephrine and albuterol, and counseled.
T99396 285010-285111 Sentence denotes The patient returned to the office every week for the next three weeks to receive blinded injections.
T74616 285112-285180 Sentence denotes She subsequently did not react to either doses of placebo or Xolair.
T68144 285181-285252 Sentence denotes She has since tolerated her monthly Xolair injections without incident.
T33225 285253-285354 Sentence denotes This case illustrates the importance of ruling out psychologic causes of presumed allergic reactions.
T24525 285355-285520 Sentence denotes Introduction :Latex allergy, type I IgE mediated hipersensitivity, occurs specially in high risk populations, like in patients that have undergone various surgeries.
T42555 285521-285750 Sentence denotes Case: a 10 year old boy with asthma and allergic rhinitis since 1996, penicillin allergy and retrospectively, his mother refers lip edema with balloon inflating.At 4 years of age (1998): left orchiorrhaphy because of cryptorchis.
T7840 285751-285769 Sentence denotes Between 1999-2004:
T95261 285770-286044 Sentence denotes 4 surgeries because of sacral giant melanocitic naevus.During the fourth surgical intervention (0ct 8 -2004) to collocate a tissue expander, the patient presents perioral and fingertip cyanosis, generalized cutaneous rash and severe bronchospasm.AP:40/22 mmHg, HR 140 x/min.
T63602 286045-286178 Sentence denotes He was treated with IV fluids, steroids, antihistamines and inhaled racemic epinephrine.At the ICU his final outcome is satisfactory.
T52834 286179-286190 Sentence denotes Laboratory:
T51696 286191-286386 Sentence denotes Total Ige :27.4IU/L, skin prick test with glove extract, raw and natural latex extract and purified latex proteins(pseudoeveine, molecular hevein, Hev b 6.02 and modified hevein)all positive +++.
T37434 286387-286504 Sentence denotes Western Blot with protein extract of latex positive and ELISA with purified latex proteins ( same as above) positive.
T84781 286505-286624 Sentence denotes The last surgery to withdraw the tissue expander was performed with latex free surgical equipment without any problems.
T26595 286625-286636 Sentence denotes Discussion:
T51681 286637-286753 Sentence denotes The patient's risk factors for latex allergy are atopy and repetitive exposure to latex articles because of surgery.
T74552 286754-286852 Sentence denotes He presents mild manifestations of latex allergy, till he finally develops full-blown anaphylaxis.
T87734 286853-286988 Sentence denotes Diagnosis was made based on clinical history, skin prick test, Western Blot with protein extract and Elisa with purified latex protein.
T37136 286989-287058 Sentence denotes He had a favorable outcome withdrawing latex during the last surgery.
T45406 287059-287072 Sentence denotes Introduction:
T34824 287073-287181 Sentence denotes Churg-Strauss Syndrome (CSS) is a form of primary vasculitis that is a rare diagnosis in an elderly patient.
T28974 287182-287194 Sentence denotes Case Report:
T73930 287195-287328 Sentence denotes A 75 year old woman presented with a 3 week history of fatigue, vomiting, diarrhea, abdom-inal pain, and right lower leg paresthesia.
T38815 287329-287434 Sentence denotes Prior to admission she was being treated for left neck erythema and adenopathy presumed to be cellulitis.
T53711 287435-287663 Sentence denotes She was in good health with no history of atopy until the age of 72, when she developed both chronic sinusitis, requiring bilateral sinus surgery and polypectomy, * and new onset asthma, * that required systemic steroid control.
T88061 287664-287714 Sentence denotes Prednisone was tapered 1 month prior to admission.
T12907 287715-287900 Sentence denotes Objective findings included coalescent non-blanching petechiae on her abdomen, peripheral eosinophilia of 4800(50%), * normochromic normocytic anemia, RF=124, ESR=90, IgE=232, IgG=1645.
T3770 287901-287933 Sentence denotes ANA, P and C-ANCA were negative.
T27076 287934-287974 Sentence denotes CT showed ascites and pleural effusions.
T28324 287975-288055 Sentence denotes EGD revealed duodenitis with ulceration and eosinophilic infiltration on biopsy.
T93975 288056-288119 Sentence denotes ECHO showed pericardial effusion and septal motion abnormality.
T23037 288120-288193 Sentence denotes Troponin of 31 without CAD was consistent with subepicardial myocarditis.
T7473 288194-288346 Sentence denotes EMG confirmed right peroneal neuropathy.* Skin biopsy revealed a dense superficial and mid-dermal perivascular and interstitial eosinophilic infiltrate.
T88440 288347-288410 Sentence denotes Additional evaluation excluded malignancy, infection, and ABPA.
T69431 288411-288463 Sentence denotes Treatment with Prednisone, 1mg/kg/day was initiated.
T29250 288464-288543 Sentence denotes A rapid clinical improvement ensued and has persisted. {*ACR criteria for CSS}.
T77368 288544-288555 Sentence denotes Discussion:
T62236 288556-288666 Sentence denotes Churg-Strauss Syndrome is a rare form of vasculitis with mean age of onset within the third and fifth decades.
T95364 288667-288746 Sentence denotes It is an uncommon cause (<5%) of systemic vasculitis in patients older than 65.
T45505 288747-288945 Sentence denotes The Formes Frustes of CSS is a variant in which early manifestations of the syndrome are hidden by oral and systemic steroids employed in the treatment of worsening asthma often associated with CSS.
T60519 288946-289014 Sentence denotes This variant makes expedient identification of CSS more challenging.
T57828 289015-289154 Sentence denotes Delayed recognition contributes to a relentless progression of this entity resulting in a systemic vasculitis with multi-organ involvement.
T72740 289155-289238 Sentence denotes Early diagnosis, especially in the prodromal and eosinophilic phases, is essential.
T80244 289239-289297 Sentence denotes Untreated, CSS has a high rate of morbidity and mortality.
T8783 289298-289478 Sentence denotes Therefore, CSS and the Formes Frustes variant must be an integral component in the differential diagnosis of patients presenting with adult onset asthma and/or recurrent sinusitis.
T92750 289479-289582 Sentence denotes Common variable immunodeficiency (CVID) is the most prevalent of the primary immunodeficiency diseases.
T33062 289583-289747 Sentence denotes CVID is a heterogeneous group of immunologic disorders of unknown etiology, characterized by impaired antibody responses, hypogammaglobulinemia with normal B cells.
T38229 289748-289919 Sentence denotes The common immunologic defect in patients with CVID is defective antibody formation, and many different immune system defects have been reported in this group of patients.
T32289 289920-289982 Sentence denotes Most patients, really, have no identified molecular diagnosis.
T263 289983-290034 Sentence denotes CVID consists of several different genetics defect.
T60177 290035-290128 Sentence denotes The immunologic defect in CVID is a failure of B-lymphocyte differentiation into plasmacells.
T33607 290129-290300 Sentence denotes B lymphocytes from these patients failed to differentiate into Ig-producing cells when stimulated with pokeweed mitogen in vitro, even when cocultured with normal T cells.
T49032 290301-290422 Sentence denotes An overwhelming body of literature suggests that most patients with CVID have intact B lymphocytes of immature phenotype.
T910 290423-290535 Sentence denotes However the functional classification of CVID patients on the basis of in vitro ig production is time consuming.
T21183 290536-290688 Sentence denotes Recently has been proposed a new classification based on the quantitative repartition of memory B cell according to the dual expression of IgD and CD27.
T2471 290689-290726 Sentence denotes We present a case of a 14 yr old boy.
T24371 290727-290875 Sentence denotes He presented soon in his life frequent infections, of particular severity: pneumonia, meningoencefalitis, sepsis, bronchitis, otitis, linfoadenitis.
T9886 290876-290914 Sentence denotes He also had a -thalassemia intermedia.
T77510 290915-290974 Sentence denotes This clinical manifestations suggested an immunodeficiency.
T14124 290975-291223 Sentence denotes For this reason at 2 years of age serum immunoglobulin and antibody detection showed a reduction in IgG2 subclass and in CD19+ cells, with normal total IgG, IgA, IgM, normal CD4/CD8 ratio, normal CD3, isohemagglutinins and in vitro T cell function.
T12706 291224-291321 Sentence denotes There was also a defective antibody production after Tetanus, Diphtheria, Pertussis immunization.
T75623 291322-291398 Sentence denotes These laboratory findings did not allow, however, a sure diagnosis for CVID.
T83265 291399-291606 Sentence denotes A new immunological evaluation at the age of 11 years old, after the onset of splenomegaly, and enlarged lymph nodes, demonstrated a B memory defect, with a severe deficit of T lymphocytes function in vitro.
T2954 291607-291757 Sentence denotes It was also possible to find a severe deficiency of CD 27 + cells, meaning a defect in memory B cells: we can therfore label this condition as a CVID.
T94625 291758-291891 Sentence denotes In the past two decades there have been conflicting views regarding the clinical importance of IgG subclass deficiencies in children.
T92446 291892-291974 Sentence denotes IgG2 subclass plays a vital role in the immune response to polysaccharide antigen.
T59309 291975-292062 Sentence denotes Isolated IgG2 subclass deficiency may be widespread and often asymptomatic in children.
T8683 292063-292194 Sentence denotes However, in association with other subclasses and/or other immunoglobulin classes, there may be a significant, symptomatic outcome.
T68292 292195-292335 Sentence denotes The reported patient was diagnosed with familial dysautonomia (FD) at the age of five weeks, presenting with severe hypotonia and tachypnea.
T560 292336-292487 Sentence denotes Hindered by poor pulmonary function, he was hospitalized over fifteen times for recurrent pneumonias, including four lengthy intensive care admissions.
T92513 292488-292630 Sentence denotes Daily inhaled-corticosteroids and brochodilator therapies were initiated, along with chest therapy via a high frequency chest wall oscillator.
T43929 292631-292739 Sentence denotes Immunoglobulin levels were measured recently and point to low levels of IgG2, IgG4 and total IgA antibodies:
T87533 292740-292891 Sentence denotes IgG1 443 mg/dL (N 330-1065), IgG2 57 mg/dL (N 57-345), IgG3 50.5 mg/dL (N 7.5-125.6), IgG4 <2.0 mg/dL (N 1.8-115.5), and total IgA 28 mg/dL (N 33-235).
T37683 292892-293036 Sentence denotes Since receiving monthly IVIG therapy he had no further recurrence of pulmonary infections and was slowly weaned off daily brochodilator therapy.
T60692 293037-293187 Sentence denotes The currently accepted theory is that low IgG2 subclass levels may be associated with increased risk of bacterial infections only in selective groups.
T5293 293188-293283 Sentence denotes FD patients may be in a distinctively susceptible population in which IgG2 levels are critical.
T5593 293284-293454 Sentence denotes The older brother, who was also diagnosed with FD, demonstrated IgG2, IgG4 and IgA levels that were slightly higher but nevertheless on the lower end of the normal range.
T69736 293455-293524 Sentence denotes He suffers from less invasive and less frequent bacterial infections.
T98664 293525-293605 Sentence denotes This may support a genetic association between the FD and hypogammaglobulinemia.
T23261 293606-293727 Sentence denotes Alternatively, it may signal that FD patients may have a prolonged variant of transient hypogammaglobulinemia of infancy.
T79591 293728-293907 Sentence denotes Follow-up immune profile studies, post-IVIG trough levels and broader investigations of the FD population are necessary to determine the severity and prevalence of these findings.
T20434 293908-293977 Sentence denotes Pulmonary failure is the dominant cause of death in patients with FD.
T98373 293978-294128 Sentence denotes Prompt diagnosis and effective treatment of the associated immune deficiency may be proven essential in the effort to enhance and prolong their lives.
T87247 294129-294131 Sentence denotes S.
T37696 294132-294147 Sentence denotes Hassan * , J.A.
T97568 294148-294169 Sentence denotes Grant, Galveston, TX.
T16614 294170-294180 Sentence denotes Rationale:
T16840 294181-294412 Sentence denotes Common variable immunodeficiency (CVID), a rare primary immunodeficiency presenting in young adults with repeated sinopulmonary infections as a result of profound hypogammaglobulinemia, was first described by Suri et al. (Ann Acad.
T47903 294413-294417 Sentence denotes Med.
T99242 294418-294436 Sentence denotes Singapore, 1988) .
T41645 294437-294519 Sentence denotes We describe a young man with diagnosed but untreated CVID and its eventual course.
T42991 294520-294537 Sentence denotes Case description:
T81596 294538-294690 Sentence denotes A 27-yr-old Caucasian male hospitalized secondary to chronic pneumonia and respiratory failure was noted to have non-existent levels of immunoglobulins.
T72717 294691-294777 Sentence denotes History revealed IVIG treatment at age 12, stopped after a year due to non-compliance.
T76376 294778-294943 Sentence denotes Although untreated, he denied recurrent sinusitis, otitis media, or bronchitis for almost 14 years but notes a recent inability in keeping up with baseball practice.
T97988 294944-294983 Sentence denotes He is the last of ten healthy siblings.
T82229 294984-295182 Sentence denotes Patient started monthly IVIG infusions but was noted to have hypertension (150/90), tachycardia (120-130), tachypnea (25-30) on the 4th month with O2 saturation of 87-93% and PO2 of 49% on room air.
T99105 295183-295336 Sentence denotes With a 2-day history of acute dyspnea, calf muscle and right abdominal pain, he was admitted to the hospital and pulmonary thromboembolism was ruled out.
T29284 295337-295353 Sentence denotes Laboratory Data:
T58456 295354-295712 Sentence denotes Humoral functions (Pneumococcal, Tetanus toxoid, and Hepvac) -undetectable T cell function (Mumps, Candida, PPD) -normal Immunoglobulin (IgG, IgA, IgM) -undetectable Flow cytometry -B and NK cell markers normal, mild decrease in the CD4/CD8 ratio High resolution CT thorax -bronchiectasis, bronchial wall thickening, and obstructive changes with airtrapping.
T9363 295713-295837 Sentence denotes 6 minute walk -desaturation to 78% on 4L O2 by NC BNP -462 Echocardiogramestimated EF 40-45%; severe pulmonary hypertension.
T79608 295838-295939 Sentence denotes Cardiac catheterization -normal coronary arteries, severe pulmonary hypertension (PA pressure 70/40).
T54085 295940-296012 Sentence denotes Conclusion: CVID patients have a reasonably good prognosis on treatment.
T40272 296013-296135 Sentence denotes Untreated CVID is associated with chronic lung infections, bronchiectasis, pulmonary hypertension and right heart failure.
T21559 296136-296365 Sentence denotes Although, lung transplant became available during the early eighties (NEJM 1982), this extremely invasive but life saving procedure was undertaken in a patient with CVID and end-stage pulmonary hypertension in 1998 (Thorax 1998).
T19271 296366-296440 Sentence denotes Lung transplant may be the only way of ensuring survival for this patient.
T55172 296441-296631 Sentence denotes Introduction Chronic Eosinophilic Pneumonia (CEP) is a rare disorder of unknown etiology characterized as a chronic and relapsing interstitial lung disease with blood or tissue eosinophilia.
T46781 296632-296695 Sentence denotes CEP occurs more often in women with preexisting atopic disease.
T11890 296696-296817 Sentence denotes Patients with CEP respond rapidly to systemic corticosteroids, but often relapse with short, low-dose courses of therapy.
T75243 296818-296949 Sentence denotes While uncommon, extrapulmonary involvement, such as arthralgia, cutaneous purpura, pericarditis, and hepatitis, have been reported.
T76674 296950-297019 Sentence denotes We present a case of a patient who has CEP with pericardial effusion.
T92856 297020-297328 Sentence denotes Case Report The patient is a non-smoking 60-year-old woman with a past medical history significant for allergic rhinitis and asthma who initially presented with a four-month history of worsening shortness of breath, dyspnea on exertion, dry, non-productive cough, and weight loss (approximately five pounds).
T37802 297329-297402 Sentence denotes Her symptoms were refractory to increased dosages of inhaled fluticasone.
T42449 297403-297453 Sentence denotes She then developed intermittent fever up to 102°C.
T59184 297454-297504 Sentence denotes Chest x-ray revealed bilateral apical infiltrates.
T17518 297505-297613 Sentence denotes Treatment with levofloxacin for seven days resulted in no improvement of symptoms or roentographic findings.
T13756 297614-297696 Sentence denotes Thereafter, she presented with chest and abdominal pain, hypotension, and hypoxia.
T22032 297697-297848 Sentence denotes Blood work revealed a white cell count of 6800 c/mm 3 with a differential significant for 34% eosinophilia (absolute eosinophil count of 2300 c/mm 3 ).
T69850 297849-298006 Sentence denotes Chest CT showed dense consolidation predominantly along the peripheral aspect of the upper and superior segment of the lower lobes, and pericardial effusion.
T55667 298007-298099 Sentence denotes Moderate pericardial effusion without evidence of tamponade was confirmed on echocardiogram.
T1777 298100-298285 Sentence denotes Left upper lobe wedge biopsy findings included significant tissue eosinophilia, scattered foci of active organizing exudates, and no evidence of granulomatous or necrotizing vasculitis.
T38227 298286-298452 Sentence denotes The patient was treated for CEP with a six-month course of prednisone, starting at 60 mg daily, resulting in rapid improvement of her pulmonary and systemic symptoms.
T52174 298453-298464 Sentence denotes Background:
T62987 298465-298571 Sentence denotes Immunologists are consulted for evaluation of immunodeficiency in patients with recurrent skin infections.
T89369 298572-298650 Sentence denotes Disorders of the phagocyte system may be associated with cutaneous infections.
T6822 298651-298659 Sentence denotes Methods:
T16619 298660-298677 Sentence denotes Case report Case:
T26972 298678-298763 Sentence denotes A 15-month-old African American girl (twin A) presents with recurrent skin abscesses.
T99006 298764-298880 Sentence denotes At 13 months of age, she had her first buttocks abscess, which required incision and drainage with oral antibiotics.
T15223 298881-299009 Sentence denotes A month later, she developed another abscess and was found to be neutropenic, with an absolute neutrophil count (ANC) of 264/μL.
T50013 299010-299147 Sentence denotes Cyclic neutropenia was considered and her pediatrician monitored CBCs, which all showed persistent neutropenia (ANCs between 68 and 264).
T51185 299148-299217 Sentence denotes At 15 months of age, she was hospitalized for fever with neutropenia.
T84717 299218-299273 Sentence denotes Immunology was consulted for evaluation of neutropenia.
T31890 299274-299328 Sentence denotes The rest of the past medical history was unremarkable.
T94654 299329-299402 Sentence denotes She was healthy appearing and growth parameters were appropriate for age.
T46495 299403-299445 Sentence denotes Her physical examination was unremarkable.
T30520 299446-299585 Sentence denotes Immunoglobulins, B-and T-cell markers, nitroblue tetrazolium, complement assay, hemoglobin, platelets and the peripheral smear were normal.
T77286 299586-299648 Sentence denotes Antibodies for HIV, CMV, EBV and parvovirus were undetectable.
T218 299649-299758 Sentence denotes Anti-neutrophil antibodies were positive, establishing the diagnosis of primary autoimmune neutropenia (AIN).
T87394 299759-299800 Sentence denotes The abscess healed with oral antibiotics.
T96891 299801-299897 Sentence denotes Severe neutropenia (ANC 0-280) persisted for three subsequent months without further infections.
T33823 299898-300007 Sentence denotes Twin (B) was also found to have persistent severe neutropenia without morbidities, suggestive of primary AIN.
T53597 300008-300150 Sentence denotes Primary AIN is less known among physicians and is typically diagnosed after extensive investigations that exclude other causes of neutropenia.
T97133 300151-300189 Sentence denotes The exact incidence of AIN is unknown.
T91442 300190-300322 Sentence denotes It is usually seen in children between 5 and 38 months of age, often with severe neutropenia and self-limiting bacterial infections.
T49900 300323-300430 Sentence denotes The clinical course and presence of antibodies to neutrophil antigens (NA1, NA2 or CD11b/18) is diagnostic.
T4776 300431-300500 Sentence denotes Familial occurrence of primary AIN is not reported in the literature.
T80371 300501-300512 Sentence denotes Conclusion:
T76427 300513-300600 Sentence denotes Primary AIN may remain under diagnosed due to lack of characteristic clinical features.
T44824 300601-300728 Sentence denotes Although a benign clinical course is likely, severe infections, including pneumonia, sepsis and meningitis, have been reported.
T88936 300729-300806 Sentence denotes Genetics may play a role in this disease, as we present primary AIN in twins.
T74608 300807-300818 Sentence denotes Background:
T88417 300819-301077 Sentence denotes Atopic Dermatitis (AD) is a chronic inflamatory disease of skin that affects 5% of the wordl population.The natural history of AD in some patients, evolve to the coexistence with other allergic diseases: allergic rhinitis, allergic conjunctivitis and asthma.
T10044 301078-301261 Sentence denotes The sublingual immunotherapy has demonstrated utility in some patients; however, semi-rush immunotherapy to pollens has only showed utility in one animal case published few years ago.
T53249 301262-301274 Sentence denotes Case report:
T57229 301275-301314 Sentence denotes A 2-year-old infant was referred to us.
T43960 301315-301439 Sentence denotes He began one year before with skin lesions compatible with AD, six months later began perennial rinhorrea and nasal itching.
T90798 301440-301576 Sentence denotes Multiple treatments with topic corticosteroids, moisturizing, antihistamines and topic/systemic antibiotics did not demonstrate utility.
T13157 301577-301869 Sentence denotes Our evaluation revealed AD lessions that affected 60% of the total body surface and clinical features of Allergic Rhinitis (AR).The lab tests revealed eosinophylia (600cell/mm3) in blood cell count, normal levels of total IgE but specific IgE to Dermatophagoides pteronissinus (DPT) was high.
T19789 301870-301916 Sentence denotes The skin prick test reveales the same results.
T88103 301917-301990 Sentence denotes We added environmental control, oral costicosteroids and Transfer factor.
T81772 301991-302041 Sentence denotes Despite our treatment no improvement was observed.
T10192 302042-302134 Sentence denotes We considered DPT as the principal factor in the maintenance of AD lessions and AR episodes.
T88530 302135-302243 Sentence denotes In the absence of sublingual immunotherapy in our hospital, we decided for semi-rush immunotherapy schedule.
T9964 302244-302391 Sentence denotes We began from 0.1 ml of 1:10, 000 w/v concentrations of DPT until 0, 5 ml of 1:100 w/v concentrations in two months receiving three doses per week.
T83456 302392-302526 Sentence denotes No local or systemic adverse events was reported and the AD lesions and AR symptomatology disappeared in the first month of treatment.
T16897 302527-302579 Sentence denotes At this time, no exacerbations have been documented.
T84300 302580-302591 Sentence denotes Conclusion:
T91506 302592-302741 Sentence denotes The semi-rush immunotherapy can be useful and safe for treatmente of AD in some patients in whom specific IgE to aeroallergens has been demonstrated.
T60378 302742-302755 Sentence denotes Introduction:
T19666 302756-302877 Sentence denotes Eosinophilic gastrointestinal disorders are a rare group of disorders that can involve the entire gastrointestinal tract.
T3121 302878-302987 Sentence denotes Presentations are varied but may include vomiting, dysphagia, abdominal pain, diarrhea and failure to thrive.
T62930 302988-303124 Sentence denotes The diagnosis is made by endoscopic biopsies which reveals eosinophil rich inflammation in the absence of known causes for eosinophilia.
T50775 303125-303190 Sentence denotes Peripheral eosinophils and IgE may be elevated but can be normal.
T12157 303191-303297 Sentence denotes We report a patient with eosinophilic gastroenteritis associated with an ampullary tubulovillous adnenoma.
T23013 303298-303425 Sentence denotes Methods:A 71-year-old white male with allergic rhinitis and a family history of atopy was admitted for profuse watery diarrhea.
T61117 303426-303492 Sentence denotes He denied any new medications, eating raw foods or recent travels.
T30036 303493-303567 Sentence denotes Eosinophils were elevated to 2.4(29% of WBC) and IgE was elevated to 3259.
T88449 303568-303649 Sentence denotes Multiple stool specimens were negative for ova & parasites and enteric pathogens.
T43073 303650-303706 Sentence denotes Serology was negative for Strongyloides, Trichinella, E.
T42937 303707-303732 Sentence denotes Histolytica and Toxocara.
T45533 303733-303843 Sentence denotes AST, ALT & bilirubin were elevated and a CT scan showed dilated billiary ducts with a possible ampullary mass.
T17763 303844-303906 Sentence denotes Biopsy of the ampullary mass revealed a tubulovillous adenoma.
T83113 303907-304125 Sentence denotes Biopsies of the duodenum, terminal ileum, colon and rectum were remarkable for focal eosinophilic cryptitis & chronic inflammation in the lamina propria consisting of eosinophils, scattered lymphocytes and histiocytes.
T96056 304126-304208 Sentence denotes All specimens were negative for parasitic infections including duodenal aspirates.
T47084 304209-304333 Sentence denotes He was empirically started on metronidazole and singulair with gradual improvement of symptoms, eosinophils and liver tests.
T91425 304334-304428 Sentence denotes Two months after discharge, the patient remained diarrhea free with a normal eosinophil count.
T6256 304429-304440 Sentence denotes Conclusion:
T61381 304441-304573 Sentence denotes We report a patient with eosinophilic gastroenteritis and an ampullary tubulovillous adenoma with obstruction of the biliary system.
T73902 304574-304702 Sentence denotes This unique presentation illustrates the diverse nature of gastrointestinal manifestations seen in eosinophilic gastroenteritis.
T16461 304703-304714 Sentence denotes Background:
T65922 304715-304837 Sentence denotes Zonisamide is an anti-seizure medication chemically classified as a sulfonamide and unrelated to other ant seizure agents.
T185 304838-304900 Sentence denotes We report a case of hypersensitivity to this agent in a child.
T35486 304901-304908 Sentence denotes Method:
T30647 304909-304929 Sentence denotes Case Report Results:
T72559 304930-305040 Sentence denotes This patient is a 22-month-old girl who developed "peeling of her lips" three weeks after starting Zonisamide.
T5213 305041-305169 Sentence denotes One week later she developed a rash that began on her face and generalized over several days to her neck, trunk and extremities.
T86793 305170-305341 Sentence denotes There was no respiratory distress, joint complaints and no angioedema associated with the episode, but fever to 103 prompted referral to our hospital on day 6 of the rash.
T55760 305342-305407 Sentence denotes The rash was macular-papular without discrete urticarial lesions.
T10386 305408-305476 Sentence denotes The rash coalesced with underlying erythema on face, chest and neck.
T48062 305477-305638 Sentence denotes The patient has a known history of seizure disorder, asthma, mild eczema, gastro esophageal reflux, development delay, lactose intolerance and failure to thrive.
T1733 305639-305707 Sentence denotes Her other medications were, lansoprazole, topiramate, and Albuterol.
T25133 305708-305822 Sentence denotes Labs revealed a normal white cell count, an elevated sed rate ( 51) and elevated LFT's, i.e. SGOT 80 and SGPT 180.
T63296 305823-305884 Sentence denotes The only new medication was Zonisamide that was discontinued.
T67532 305885-305934 Sentence denotes She was treated with IV steroids and hydroxyzine.
T18186 305935-306027 Sentence denotes The rash started fading by day 2 and the patient's fever resolved by the third hospital day.
T59050 306028-306070 Sentence denotes Liver enzymes returned to normal by day 7.
T97080 306071-306082 Sentence denotes Conclusion:
T42690 306083-306184 Sentence denotes This relatively new anti-seizure agent can be associated with hypersensitivity reactions in children.
T3773 306185-306198 Sentence denotes Introduction:
T68555 306199-306253 Sentence denotes Kawasaki disease (KD) is an acute chilhood vasculitis.
T53922 306254-306584 Sentence denotes In addition to the diagnostic criteria a broad range of nonspecific clinical features may be observed including aseptic meningitis, vomiting, diarrhea, abdominal pain, sterile pyuria, arthralgia and arthrtis, pulmonary infiltration, pleural effusion and nonspecific paralytic ileum as manifestation of gastrointestinal vasculitis.
T65459 306585-306686 Sentence denotes We describe a child who developed all features of Kawasaki disease included the most rarely reported.
T11898 306687-306702 Sentence denotes Patient report:
T72433 306703-306951 Sentence denotes A 2 year-old female presented 15 days of high fever, nonsuppurative cervical lymphadenopathy, petequial rash in legs, swelling of feet, distended abdomen, vomiting, obnubilated and hypoactive, incongruent speech, fisured lips and distended abdomen.
T84719 306952-307151 Sentence denotes Lab tests showed: anemia (9.8g/dl), high WBC count (24, 200cells/mm3), thrombocytopenia (47, 000/mm3), hypoalbuminemia (1.1g/dl), lactate dehydrogenase (LDH) 209mcg/l, glutamin transferase (GGT) 190.
T7720 307152-307258 Sentence denotes CSF total proteins 129, glucose 60, cells 23, PM 5%, mn 95%, seric complement 88, cultures were negatives.
T15231 307259-307336 Sentence denotes She developed myocarditis, aneurysms in the right and left coronary arteries.
T19446 307337-307479 Sentence denotes On the 25th day presented cardiac failure, pleural effusion, paralytic ileum, hydrops vesicular, mechanic ventilatory assistance was required.
T89501 307480-307579 Sentence denotes The first dose of intravenous immunoglobulin (IVIG) (2g/k) was infused, heparin and hydrocortisone.
T60389 307580-307669 Sentence denotes On 45 day a second doses of IVIG was infused, because of fever, and abdominal vasculitis.
T80909 307670-307759 Sentence denotes Steroids ware discontinued, heparin was suspended and aspirin was added as antiaggregant.
T14946 307760-308027 Sentence denotes Discussion: our patient presented an unusual and severe presentation of KD with pleural effusion, nonspecific ileum, cardiac failure secondary to myocarditis, aseptic meningitis and thrombocytopenia; all those manifestations had rarely been reported at the same time.
T75139 308028-308100 Sentence denotes She presented with a devastating evolution. complications were resolved.
T36190 308101-308248 Sentence denotes The lastest studies have shown that treatment with IVIG plus corticosteroids significantly reduce serum concentrations of proinflamatory cytokines.
T74755 308249-308365 Sentence denotes In this case antiinflamatory doses of aspirin were contraindicated and steroids were used with satisfactory outcome.
T61 308366-308436 Sentence denotes Limited data is available for nonresponding patients to guide therapy.
T56559 308437-308782 Sentence denotes Although multiple doses of IVIG are sufficient in some patients, some of them remain refractory to therapy and they need corticosteroids to control the vasculitis process Eosinophilia is defined by an absolute eosinophil count above 0.7 X 10 9 and can be seen in association with a broad spectrum of disorders ranging from allergic to malignant.
T18751 308783-309062 Sentence denotes Idiopathic hypereosinophilic syndrome (HES) should be considered in any patient with an eosinophil count above 1.5 X 10 9 for more than 6 months without commonly recognized causes of eosinophilia and with evidence for organ damage not otherwise explained in the clinical setting.
T78967 309063-309160 Sentence denotes It is potentially an aggressive disease with mean survival of less than a year without treatment.
T88071 309161-309251 Sentence denotes We present a 39 year old male horse breeder, with eosinophilia lasting more than 10 years.
T31534 309252-309495 Sentence denotes Prior to coming to our institution, he underwent extensive medical evaluation including bone marrow and GI biopsies, multiple imaging studies with MRI and CT scans of the chest and the head as well as detailed evaluation of his cardiac status.
T97158 309496-309804 Sentence denotes All these tests were normal and the patient was empirically started on treatment for possible HES including trials of prednisone, hydroxyurea, interferon alfa, and imatinib, all without lasting resolution of his eosinophilia and causing significant side effects with profound depression of his immune status.
T3842 309805-309932 Sentence denotes Finally, in light of the patient's profession, a Strongyloides enzyme immunoassay was done and found to be remarkably positive.
T66049 309933-309996 Sentence denotes Duodenal drainage confirmed the infestation with this nematode.
T97074 309997-310114 Sentence denotes Within a week of starting treatment with ivermectin, his eosinophil count came down by 50% and eventually normalized.
T89735 310115-310224 Sentence denotes We learn that one should be persistent in excluding all common causes of eosinophilia before considering HES.
T93359 310225-310389 Sentence denotes In case of parasite infestation, premature treatment with immunosuppressors can result in worsening of the infection with potential for poor and even fatal outcome.
T46861 310390-310553 Sentence denotes Stool evaluation might not be sensitive enough for detection of parasites and it is therefore necessary to complete a diagnostic work up with appropriate serology.
T76133 310554-310693 Sentence denotes Doxil is the pegylated liposomal form of doxorubicin and has been used successfully as a cancer chemotherapy agent in many types of tumors.
T76902 310694-310799 Sentence denotes A hypersensitivity reaction can occur, usually during the first infusion, and appears to be rate related.
T34102 310800-310899 Sentence denotes The symptoms include dyspnea, tachypnea, facial swelling, chills, hives, chest pain, and back pain.
T37553 310900-311004 Sentence denotes We report a case of a hypersensitivity reaction to Doxil in a 26 year-old woman with Hodgkin's lymphoma.
T84727 311005-311126 Sentence denotes During her first outpatient Doxil infusion at 1 mg/min, she developed urticaria, chest tightness, dyspnea, and back pain.
T44233 311127-311265 Sentence denotes These reactions persisted despite being medicated with antihistamines and steroids and immediately resolved during pauses in the infusion.
T45094 311266-311318 Sentence denotes After 23 mg of Doxil, the infusion was discontinued.
T90233 311319-311391 Sentence denotes Six days later, she was admitted to complete the other half of the dose.
T55758 311392-311462 Sentence denotes She had a negative intradermal skin test to a 1:100 dilution of Doxil.
T93915 311463-311555 Sentence denotes She was then premedicated with diphenydramine, dexamethasone, acetaminophen, and famotidine.
T44586 311556-311660 Sentence denotes The Doxil infusion was started at 0.4 mg/min and was soon stopped due to flushing of the hands and face.
T73052 311661-311702 Sentence denotes The infusion was decreased to 0.2 mg/min.
T43092 311703-311785 Sentence denotes She was able to tolerate this slow infusion with only mild and tolerable symptoms.
T21934 311786-311860 Sentence denotes When her symptoms worsened, the infusion was stopped for 30 to 60 minutes.
T563 311861-311918 Sentence denotes She completed the 23 mg infusion of Doxil after 13 hours.
T93127 311919-312022 Sentence denotes Pre-infusion and post-infusion complement levels were drawn during this second administration of Doxil.
T84845 312023-312096 Sentence denotes Her pre-infusion C2, C3, C3a, C4, C5, C5a, and Bb levels were all normal.
T3402 312097-312267 Sentence denotes Her pre-infusion C4a and SC5b-9 levels were high, indicating that she might have had some residual or persistent complement activation caused by her first Doxil infusion.
T23636 312268-312342 Sentence denotes Her post-infusion C2, C3, C3a, C4, C5, C5a, and Bb levels were all normal.
T67391 312343-312478 Sentence denotes However, her post-infusion SC5b-9 levels significantly increased, suggesting complement was activated during the second Doxil infusion.
T57645 312479-312647 Sentence denotes Given her reaction during her first Doxil infusion and a negative skin test to Doxil, it is highly unlikely that her Doxil hypersensitivity was an IgE-mediated process.
T57602 312648-312914 Sentence denotes Therefore, in patients with a similar Doxil hypersensitivity, we suggest a slow rate of infusion of 0.1-0.2 mg/min, toleration of mild symptoms, 30 to 60 minute pauses during more severe symptoms, and continuation of premedication during the entire lengthy infusion.
T44025 312915-313005 Sentence denotes Introduction Eosiniphilic esophagitis (EE) is an isolated, severe esophageal eosinophilia.
T45629 313006-313138 Sentence denotes Patients are usually young males presenting with vomiting, epigastric or chest pain, dysphagia and obstructive respiratory problems.
T44005 313139-313237 Sentence denotes They are often initially misdiagnosed with and treated for gastroesophageal reflux disease (GERD).
T23699 313238-313326 Sentence denotes Distinction between the two diseases can be made with biopsies of the esophageal mucosa.
T91527 313327-313551 Sentence denotes While any eosinophils in the esophageal mucosa indicate pathology, GERD typically presents with up to 7 eosinophils per high powered field (HPF, 400X) while EE most often presents with greater than 20-24 eosinophils per HPF.
T80704 313552-313678 Sentence denotes Case Report The patient is a 3 and one half year old boy who has experienced severe symptoms of GERD from the age of 6 months.
T18511 313679-313728 Sentence denotes He vomits after meals at least 1-2 times per day.
T99149 313729-313811 Sentence denotes He coughs when he lies down at night and regurgitates phlegm in the early morning.
T24312 313812-313876 Sentence denotes He has complained of discomfort in his lower chest after eating.
T11561 313877-313938 Sentence denotes His weight has remained at 35 pounds for the last six months.
T95833 313939-314057 Sentence denotes The patient was diagnosed with asthma at age 2 and a half; however, there is no family history of asthma or allergies.
T9044 314058-314224 Sentence denotes The patient initially experienced improvement on lansoprazole, but his symptoms recurred when the medication was discontinued and subsequent courses were ineffective.
T70637 314225-314298 Sentence denotes His physical exam was normal barring slightly edematous nasal turbinates.
T68316 314299-314417 Sentence denotes An endoscopic biopsy showed "numerous eosinphils" (later clarified to 38 eosinophils per HPF) in his distal esophagus.
T68044 314418-314501 Sentence denotes The patient showed allergy to milk and wheat on radioallergosorbent (RAST) testing.
T62314 314502-314649 Sentence denotes The patient was started on swallowed fluticasone 2 puffs twice daily and advised to see a nutritionist regarding a wheat and milk elimination diet.
T26845 314650-314728 Sentence denotes Conclusion EE is an important differential of GERD-like symptoms in childhood.
T31509 314729-314875 Sentence denotes To avoid misdiagnosis it is critical to evaluate the number of eosinophils present in a biopsy specimen to help differentiate between GERD and EE.
T90768 314876-314978 Sentence denotes Children with EE are at increased risk of developing esophageal dysmotility and esophageal strictures.
T96763 314979-315060 Sentence denotes Patients often have positive skin prick or RAST tests to foods and aeroallergens.
T38787 315061-315236 Sentence denotes Alternative treatments such as food elimination diets and glucocorticoids (systemic or topical) are effective in treating symptoms which may not respond to reflux medications.
T4587 315237-315490 Sentence denotes Introduction In 1992 Asherton introduced the term catastrophic antiphospholipid syndrome (CAPS) to describe patients sharing clinical evidence of multiple (three or more) organ involvement and/or histopathological evidence of multiple vessel occlusions.
T20492 315491-315655 Sentence denotes Case Report We present a 13 year old female, with lumbar pain, arthralgias, weight loss, fever, malaise, Raynaud phenomenom, alopecia, oral ulcers and hepatomegaly.
T81737 315656-315756 Sentence denotes On arrival, she was polypneic with tachycardia, basal hypoventilation, and hepatomegaly was evident.
T20708 315757-315760 Sentence denotes Hb:
T2138 315761-315777 Sentence denotes 8.8, Leucocytes:
T11023 315778-315805 Sentence denotes 39.300, Total Lymphocyctes:
T90372 315806-315833 Sentence denotes 8, 300, Total Neutrophyles:
T44688 315834-315862 Sentence denotes 28, 700, Platelets 393, 000.
T52060 315863-315879 Sentence denotes Coombs positive.
T5310 315880-315936 Sentence denotes Urin exam: proteinuria, leucocyturia and erythrocyturia.
T65423 315937-315952 Sentence denotes Creatinine 1.3.
T24888 315953-316172 Sentence denotes Diagnosed as SLE with pericarditis, cardiac failure and acute pulmonary edema, urinary tract infection and pneumonia, requiring mechanical ventilation and inotropic support, intravenous gammaglobulin and hydrocortisone.
T8769 316173-316237 Sentence denotes Acute renal failure and hemodialysis was begun with improvement.
T10737 316238-316423 Sentence denotes Suddenly she presented seizures crisis, stuporous, livido reticularis skin and acrocyanosis, external opthamalplexia, bilateral facial diplexia, ocular fundus with arteriolar vasospasm.
T4036 316424-316546 Sentence denotes Right facio-corporal hemiparesia, cortical and progressive medular ANNALS OF ALLERGY, ASTHMA & IMMUNOLOGY segment changes.
T19551 316547-316642 Sentence denotes CT showed multiple left fronto-occipital parietal hypodensities suggestive of lacunar infarcts.
T95571 316643-316676 Sentence denotes Diagnosed as neurolupus and CAPS.
T4363 316677-316753 Sentence denotes Initially anti b2 GLP1 and anti CLP were negative with later positivization.
T77271 316754-316880 Sentence denotes Urinary tract infection contraindicated high doses of steroids and, intravenous gamaglobulin and anticoagulation were started.
T40288 316881-316910 Sentence denotes With significant improvement.
T54949 316911-316967 Sentence denotes Currently the patient is evolving in a satisfactory way.
T55516 316968-317067 Sentence denotes Discussion The literature establishes that catastrophic APS is characterized by elevated mortality.
T14064 317068-317141 Sentence denotes In this patient damage was evident to the CNS, PNS, kidneys and the skin.
T33927 317142-317337 Sentence denotes With the presence of positive antiphospholipid antibodies with an energic antiinflamatory, immunoregulatory and immunosupressive therapy, the function of each affected organ completely recovered.
T51351 317338-317485 Sentence denotes This case exemplifies that the therapy of CAPS should be undertaken in a sufficient and early manner given the elevated mortality of this syndrome.
T39124 317486-317649 Sentence denotes Patient, a 70-year-old white, male non-smoker physician on high-dose regimen of Advair and Singulair presents with an 8-day history of progressive chest tightness.
T86689 317650-317718 Sentence denotes Pulmonary function tests showed normal (FEV 1 of 96%) lung function.
T2454 317719-317884 Sentence denotes In the past, whenever inhaled steroid dosages were lowered, patient experienced a reoccurrence of asthma symptoms, despite consistently normal lung function results.
T90594 317885-318054 Sentence denotes To rule out the possibility of a psychologically induced asthma exacerbation, the patient's fractional concentration of exhaled nitric oxide (FENO) levels were measured.
T54569 318055-318105 Sentence denotes The patient's FENO level was elevated at 48.9 ppb.
T46556 318106-318192 Sentence denotes Values greater than 30 ppb have been described as consistent with airway inflammation.
T33788 318193-318299 Sentence denotes With an increase in the patient's inhaled steroids, the patient had a remission of symptoms within a week.
T21535 318300-318444 Sentence denotes This case is illustrative of an increasingly common clinical picture where a symptomatic asthmatic may have normal spirometry but elevated FENO.
T91669 318445-318715 Sentence denotes As devices for measuring FENO become more available in the outpatient clinic setting, elevated FENO may be an excellent diagnostic marker in assessing whether airway inflammation is being adequately treated in situations where spirometry values are within normal ranges.
T55819 318716-318843 Sentence denotes Introduction The autoimmune thrombocytopenic purpura (ATP) is characterized by thrombocytopenia and megakaryocytic hyperplasia.
T49392 318844-319041 Sentence denotes The first choice of treatment consists of intravenous gamma globulin (IVIG), corticosteroids and anti-D antibodies and the second line measures are immunosuppressant drugs, splenectomy and Danazol.
T72214 319042-319164 Sentence denotes Case Report A 4 years old male presented in the first year of life ecchymosis in several parts of the body intermittently.
T89987 319165-319239 Sentence denotes In April 2003 he presented ephistaxis and lower gastrointestinal bleeding.
T55844 319240-319297 Sentence denotes Complete blood count showed platelet count of 45, 000/uL.
T1706 319298-319351 Sentence denotes Prednisone was started (2 mg/kg) with no improvement.
T38750 319352-319423 Sentence denotes At that time, Danazol, anti-D antibodies, and IVIG (2 g/kg) were added.
T96783 319424-319486 Sentence denotes Subsequently, the platelet average count diminished to 5, 000.
T46167 319487-319531 Sentence denotes The patient was transferred to our hospital.
T9274 319532-319617 Sentence denotes At his admission he presented Cushingoid habitus (figure 1) and acanthosis nigricans.
T76578 319618-319739 Sentence denotes The immunological tests (AAN, CH50, C3, C4, immunoglobulins, anticardiolipins and B2 glycoprotein) showed no alterations.
T26711 319740-319806 Sentence denotes Bone marrow aspirate demonstrated megakaryocytic hypercellurarity.
T59651 319807-319882 Sentence denotes Prednisone dose was tampered when the patient presented secondary glaucoma.
T89940 319883-320024 Sentence denotes Patient continued his treatment with Danazol and IVIG (2 dosages of 2g/kg each), hydroxychloroquine and cyclophosphamide with no improvement.
T99850 320025-320136 Sentence denotes Thus, 3 months after the immunosuppressant treatment, splenectomy was performed, obtaining partial improvement.
T41229 320137-320248 Sentence denotes At that time ranitidine and hydroxychloroquine were suspended and cyclophosphamide was changed to Azathioprine.
T78372 320249-320285 Sentence denotes Last platelet count was 106, 000/uL.
T1208 320286-320399 Sentence denotes Conclusion Chronic ATP in childhood as the present case account for approximately 4-5% of the total ATP patients.
T7061 320400-320487 Sentence denotes Chronic ATP that does not respond to conventional treatment is a therapeutic challenge.
T17571 320488-320656 Sentence denotes In this patient we used first choice and second choice drugs with no improvement, consequently a splenectomy was indicated, not obtaining the desired response at first.
T71957 320657-320803 Sentence denotes The use of immunosuppressant drugs is not common for this disease, but it could be a good alternative for ATP resistant to conventional treatment.
T94480 320804-320863 Sentence denotes This are the most important laboratory test of our patient.
T24357 320864-320875 Sentence denotes Background:
T96365 320876-321013 Sentence denotes Budesonide is the only corticosteroid available for inhalation by jet nebulizer and is indicated for the treatment of asthma in children.
T35286 321014-321024 Sentence denotes Objective:
T37061 321025-321161 Sentence denotes To evaluate the distribution and clinical efficacy of inhaled budesonide administered by nebulization with a modified commercial device.
T878 321162-321170 Sentence denotes Methods:
T27239 321171-321289 Sentence denotes A 23 year old male with severe persistent asthma underwent a LeFort procedure for multiple craniofacial abnormalities.
T79187 321290-321386 Sentence denotes The external device maintained his mouth open impeding the proper use of controller medications.
T90659 321387-321447 Sentence denotes As a result he developed an increase in his asthma symptoms.
T5492 321448-321596 Sentence denotes He was subsequently treated with nebulized budesonide delivered with a modified jet nebulizer through the end of a plastic tube in a flow-by manner.
T8273 321597-321741 Sentence denotes We then performed dynamic ventilation imaging after administering 33.40 mCi of nebulized technetium 99m-DTPA diluted in two mL of normal saline.
T35346 321742-321807 Sentence denotes Images were obtained for five minutes at three seconds per frame.
T88759 321808-321897 Sentence denotes Spirometry monitoring was not possible given the obstructive nature of the facial device.
T53286 321898-321906 Sentence denotes Results:
T90311 321907-321967 Sentence denotes The patient demonstrated improvement of his asthma symptoms.
T42930 321968-322130 Sentence denotes The ventilation scan showed that the patient breathed the technetium DTPA through the specialized device with delivery to his full lung volumes within 12 seconds.
T13844 322131-322143 Sentence denotes Conclusions:
T42290 322144-322280 Sentence denotes We report the successful treatment of a patient unable to use the commercially available methods for administration of inhaled steroids.
T51466 322281-322421 Sentence denotes Rationale: HP is a non-IgE mediated inflammatory response in the lungs due to a variety of organic antigens, including metal working fluids.
T27565 322422-322499 Sentence denotes The wideranging clinical features include acute, subacute, and chronic forms.
T77998 322500-322699 Sentence denotes Elevated antineutrophilic cytoplasmic antibodies and platypnea, defined as dypsnea induced by the upright position and relieved with recumbency, have not been previously reported in patients with HP.
T39687 322700-322705 Sentence denotes Case:
T3628 322706-322831 Sentence denotes 35-year-old white male tool and dye machinist presented with progressive cough, weakness, dyspnea on exertion, and platypnea.
T56970 322832-322897 Sentence denotes Symptoms began 15 weeks earlier with coryza and diffuse myalgias.
T67215 322898-322953 Sentence denotes He had lost 12% of his body weight since symptom onset.
T4785 322954-323039 Sentence denotes Examination revealed a pulse of 140, respiratory rate 18, and right basilar crackles.
T77055 323040-323113 Sentence denotes Resting pulse ox on room air was 95%, but dropped to 91% upon ambulation.
T20242 323114-323264 Sentence denotes PFT's revealed severe obstruction (FEV1 42% predicted) with significant reversibility (FEV1 +19%), and a DLCO of 82% (adjusted for VA and Hemoglobin).
T59101 323265-323332 Sentence denotes Hemoglobin was 17.5 with a normal leukocyte count and differential.
T39418 323333-323428 Sentence denotes C-ANCA (anti-PR3) was 19.3 (<5), and P-ANCA (anti-MPO) was 15.9 (<15), both performed by ELISA.
T24916 323429-323522 Sentence denotes Echocardiogram showed an EF of 50-55% with mild pulmonary hypertension; no shunt was present.
T90515 323523-323646 Sentence denotes Chest roentogram was normal, but a chest CT revealed a diffuse ground-glass pattern with scattered centrilobular opacities.
T85953 323647-323677 Sentence denotes Biopsy was consistent with HP.
T32609 323678-323804 Sentence denotes He was removed from his work exposure to metal working fluids with full recovery of lung function and resoulution of symptoms.
T57789 323805-323906 Sentence denotes Conclusions: HP presents as a constellation of symptoms without a single, unique identifying pattern.
T71323 323907-324029 Sentence denotes Platypnea and elevated ANCA's have been observed in a wide range of disorders, all of which were excluded in this patient.
T55663 324030-324198 Sentence denotes Platypnea has been associated with hereditary hemorrhagic telangiectasia, pulmonary AVM, hepatopulmonary syndrome, recurrent pulmonary emboli, and patent foramen ovale.
T65848 324199-324380 Sentence denotes Elevated ANCA's has been associated with Wegener's granulomatosis, Goodpasture's syndrome, Churg-Strauss vasculitis, drug-induced vasculitis, inflammatory bowel disease, and others.
T48384 324381-324485 Sentence denotes ELISA is a more specific modality for ANCA's than indirect immunofluorescence, but it is less sensitive.
T23715 324486-324580 Sentence denotes The possibility of HP should be considered in patients with either of these two abnormalities.
T85818 324581-324591 Sentence denotes Rationale:
T43098 324592-324737 Sentence denotes Heart disease is the leading cause of death in America and 70% of persons between 70 and 80 years of age have coronary athersclerosis at autopsy.
T19297 324738-324791 Sentence denotes The presentation in the elderly is commonly atypical.
T59648 324792-324875 Sentence denotes 45% of myocardial infarctions were silent or unrecognized in the Framingham cohort.
T96041 324876-324989 Sentence denotes In patients 65 and older, it is estimated that 8-25% will present with dyspnea without any associated chest pain.
T50478 324990-325065 Sentence denotes We present a case of unstable angina presenting as exercise-induced asthma.
T61884 325066-325071 Sentence denotes Case:
T67790 325072-325302 Sentence denotes An 81 year-old white male with moderate persistent asthma, hypertension, dyslipidemia, and a long history of allergic rhinitis presented having had an abrupt increase in his usual exercise-induced asthma symptoms four weeks prior.
T33691 325303-325428 Sentence denotes Asthma had been diagnosed at age 69 with spiromety showing moderate obstruction and significant but incomplete reversibility.
T21641 325429-325503 Sentence denotes He had a remote history of pipe and cigar smoking, but had quit at age 50.
T78663 325504-325664 Sentence denotes He had been well-controlled since that time with his most recent regimen consisting of fluticasone 100 mcg/salmeterol 50 mcg diskus, one inhalation twice daily.
T48963 325665-325820 Sentence denotes His typical exercise-induced asthma symptoms included dyspnea on exertion and chest tightness without radiation, and were relieved with rest and albuterol.
T28190 325821-326010 Sentence denotes The amount of exertion needed to trigger his symptoms, however, was much less than he had previously experienced, and this remained constant during the four weeks prior to his presentation.
T93738 326011-326086 Sentence denotes One week prior he had a normal ECG evaluation by his primary care provider.
T61603 326087-326148 Sentence denotes Six months prior he had a normal nuclear cardiac stress test.
T10620 326149-326273 Sentence denotes Physical examination was unremarkale except for moderately decreased aeration and 1+ pitting edema of his lower extremities.
T39723 326274-326349 Sentence denotes Cardiology performed a nuclear stress test the next day which was abnormal.
T38793 326350-326408 Sentence denotes Catheterization revealed 99% steonsis of his proximal LAD.
T98397 326409-326469 Sentence denotes He succefully underwent CABG and is doing well on follow-up.
T26296 326470-326481 Sentence denotes Conclusion:
T68335 326482-326635 Sentence denotes The elderly present many challenges to the diagnostician; these include multiple co-morbidities as well as atypical and often late disease presentations.
T99323 326636-326875 Sentence denotes The key to raising suspicion for cardiac involvement in this case was the recognition of the patient's cardiac risk factors in the setting of an abrupt onset of exercise symptoms while lacking other asthma symptoms such as nocturnal cough.
T10830 326876-326933 Sentence denotes Cold urticaria is an uncommon form of physical urticaria.
T39429 326934-327085 Sentence denotes This case of a 9-year-old with cold urticaria and angioedema provides additional information regarding an unusual disorder in the pediatric population.
T36046 327086-327222 Sentence denotes An otherwise healthy 9-year-old female presented with a complaint of urticaria precipitated by cold exposure over the preceding 5 weeks.
T30575 327223-327311 Sentence denotes She had no recent illnesses and a past medical history significant only for cat allergy.
T33053 327312-327454 Sentence denotes On multiple occasions the patient noted erythema and pruritus of her arms and face after walking through the freezer aisle of a grocery store.
T93228 327455-327553 Sentence denotes Urticaria would then develop on regions where she scratched, spontaneously resolving in 2-3 hours.
T24751 327554-327658 Sentence denotes On one occasion, urticaria appeared diffusely while taking a shower after the patient had been swimming.
T25500 327659-327759 Sentence denotes The urticaria resolved within a few hours after the patient was given diphenhydramine by her mother.
T14063 327760-327931 Sentence denotes Three days prior to presentation the patient experienced upper lip angioedema with erythema, globus sensation and difficulty swallowing after drinking a strawberry slushy.
T76185 327932-328076 Sentence denotes The patient denied any respiratory complaints at that time and her symptoms again ANNALS OF ALLERGY, ASTHMA & IMMUNOLOGY resolved spontaneously.
T75731 328077-328153 Sentence denotes Family history was significant for a maternal history of seasonal allergies.
T17444 328154-328204 Sentence denotes Upon physical exam the patient was well appearing.
T17636 328205-328249 Sentence denotes She had 2-3 discrete urticaria on each calf.
T96851 328250-328418 Sentence denotes The patient's mother noted that recently these would appear on "cold and rainy" days, attributing them to the fact that the patient's pants left her lower legs exposed.
T60363 328419-328487 Sentence denotes The remainder of her exam was normal and dermatographism was absent.
T37838 328488-328586 Sentence denotes Laboratory evaluation consisted of cryoglobulins and strawberry RAST, both of which were negative.
T51327 328587-328722 Sentence denotes Application of an ice cube to the patient's forearm for 5 minutes resulted in a 9x6 centimeter wheal noted 3 minutes after ice removal.
T37987 328723-328789 Sentence denotes A diagnosis of cold urticaria with associated angioedema was made.
T68495 328790-328896 Sentence denotes The patient's mother opted to use diphenhydramine as needed and an epinephrine autoinjector was dispensed.
T51594 328897-329009 Sentence denotes By 3 months after symptom onset, the patient's only complaint was pruritus of her hands if they became too cold.
T44636 329010-329034 Sentence denotes No urticaria were noted.
T35111 329035-329148 Sentence denotes At 6 month follow-up the patient denied any symptoms for the preceding 2 months and had a negative ice cube test.
T99741 329149-329233 Sentence denotes Cold urticaria in the pediatric population is a rare entity and not well understood.
T14130 329234-329348 Sentence denotes This case of a 9-year-old with cold urticaria and angioedema offers additional insight into this unusual disorder.
T22364 329349-329351 Sentence denotes A.
T79127 329352-329366 Sentence denotes Khuntia * , M.
T97162 329367-329391 Sentence denotes McMorris, Ann Arbor, MI.
T99130 329392-329405 Sentence denotes INTRODUCTION:
T25906 329406-329613 Sentence denotes Chronic granulomatous disease(CGD) is a heterogeneous group of disorders characterized by genetic defects in the ability of phagocytes to generate microbicidal reactive superoxide anions and its metabolites.
T2091 329614-329833 Sentence denotes It manifests early in life, primarily as recurrent infections, caused by catalase-producing bacteria such as Staphylococcus aureus, Burkholderia cepacia, and Serratia Marcescens and fungus such as Aspergillus fumigatus.
T1847 329834-329962 Sentence denotes The disease may be inherited in an X-linked or autosomal recessive manner, with X-linked disease accounting for 65-70% of cases.
T27983 329963-330118 Sentence denotes The US incidence of CGD is 1/250, 000 live births with an average age at presentation of 3 years for Xlinked and 7.8 years for autosomal recessive disease.
T7309 330119-330131 Sentence denotes CASE REPORT:
T57763 330132-330222 Sentence denotes 18 year old male with history of three separate episodes of pneumonia beginning at age 16.
T4147 330223-330341 Sentence denotes Each episode resulted in a hospital admission and intravenous antibiotic therapy after failed oral antibiotic therapy.
T84205 330342-330496 Sentence denotes An extensive pulmonary evaluation was initiated after the third episode of pneumonia, including a chest CT, viral, bacterial and immunodeficiency studies.
T52766 330497-330591 Sentence denotes CBC, complement, immunoglobulins, flow cytometry, viral and bacterial studies were all normal.
T21966 330592-330729 Sentence denotes The CT scan revealed dense nodular opacities in the right upper lobe with surrounding ground-glass opacification and mild bronchiectasis.
T34646 330730-330808 Sentence denotes A subsequent bronchoscopy demonstrated necrotizing granulomatous inflammation.
T77429 330809-330870 Sentence denotes Open lung biopsy grew Burkholderia cepacia on tissue culture.
T56188 330871-331008 Sentence denotes The clinical history, tissue histopathology and atypical organism found on culture were all suggestive of an underlying immunodeficiency.
T63071 331009-331158 Sentence denotes A neutrophil oxidative burst assay was performed which demonstrated minimal neutrophil activity upon stimulation, suggestive of the diagnosis of CGD.
T60779 331159-331292 Sentence denotes A chemilluscence assay verified the diagnosis of CGD, with minimal fluorescence noted on flow cytometry after neutrophil stimulation.
T58591 331293-331434 Sentence denotes DNA analysis demonstrated a p47-phox deficiency, resulting in one of the autosomal recessive and less clinically severe forms of the disease.
T53747 331435-331447 Sentence denotes CONCLUSIONS:
T33498 331448-331512 Sentence denotes This case of CGD is unusual because of the delayed presentation.
T93774 331513-331820 Sentence denotes It demonstrates the importance of a complete immunological evaluation including an evaluation for neutrophil disorders such as CGD in patients of all ages who present with recurrent and recalcitrant episodes of pneumonia, especially when atypical organisms such as Burkholderia cepacia are found on culture.
T84710 331821-331952 Sentence denotes Autoimmunity may play a role in the development of premature ovarian failure (POF), but the exact mechanism is not well understood.
T58849 331953-332047 Sentence denotes POF is mainly diagnosed after 19 years of age and most women complain of secondary amenorrhea.
T8557 332048-332151 Sentence denotes POF has been reported in combination with presence of ANA and autoimmune diseases, but rarely with JRA.
T33462 332152-332258 Sentence denotes Here we report two cases of POF and positive ANA in pediatric patients, one with clinical features of JRA.
T27170 332259-332508 Sentence denotes The first patient, an African American 17-year-old girl, height in 50th percentile, weight in 10th percentile, with tenosynovitis of wrists and arthritis of knees and elbows for the past two years, was referred for further evaluation and management.
T3885 332509-332594 Sentence denotes She did not have her menarche yet and laboratory investigation revealed positive ANA.
T42544 332595-332901 Sentence denotes The second patient, an African American 17-year-old girl, 50th percentile for height and weight, was referred to the immunology clinic with chief complaint of primary amenorrhea and delayed development of secondary sexual characteristics and was found to have positive ANA without clinical findings of JRA.
T71291 332902-332997 Sentence denotes Both patients were Tanner stage 2 for breasts and Tanner stage 2-3 for pubic and axillary hair.
T62057 332998-333099 Sentence denotes Both had elevated FSH and LH, karyotype 46XX and small uterus and small ovaries on pelvic ultrasound.
T9412 333100-333165 Sentence denotes Antiovarian antibody was not detected in any of the two patients.
T82532 333166-333205 Sentence denotes The bone age was significantly delayed.
T38185 333206-333299 Sentence denotes POF in karyotypically normal women is frequently seen in combination with elevated serum ANA.
T23087 333300-333435 Sentence denotes The clinical spectrum of rheumatoid disease associated with POF ranges from asymptomatic ANA positivity to typical presentation of JRA.
T51807 333436-333612 Sentence denotes Women with POF should be monitored for the emergence of autoimmune disorders including JRA, and women with JRA should be followed for menstrual irregularities and signs of POF.
T49006 333613-333626 Sentence denotes Introduction:
T44497 333627-333634 Sentence denotes Many U.
T27223 333635-333774 Sentence denotes S. military personnel deployed to the Middle East continue to develop infection with Leishmaniasis, a parasite transmitted by the sand fly.
T24330 333775-333873 Sentence denotes Pentavalent antimonials have been used as an effective treatment for Leishmaniasis for many years.
T89054 333874-334029 Sentence denotes In the United States, Sodium Stibogluconate (Pentostam) is the pentavalent antimonial of choice, and is currently being administered under an IND protocol.
T9346 334030-334161 Sentence denotes Side effects of therapy include myalgias, arthralgias, rash, malaise, abdominal pain, pancreatitis, and hypersensitivity reactions.
T50430 334162-334234 Sentence denotes The true incidence of hypersensitivity reactions is not currently known.
T64617 334235-334248 Sentence denotes Case reports:
T90928 334249-334255 Sentence denotes Two U.
T29676 334256-334528 Sentence denotes S. soldiers receiving Pentostam for the treatment of cutaneous Leishmaniasis were evaluated in our clinic at Walter Reed Army Medical Center after experiencing urticaria, angioedema, wheezing and dyspnea after medication infusion during the 20-day course of daily therapy.
T55891 334529-334613 Sentence denotes Due to the concern of a potential IgE-mediated reaction, skin testing was performed.
T15220 334614-334727 Sentence denotes After informed consent, skin testing included a prick test at full strength, followed by intradermal (ID)testing.
T20685 334728-334859 Sentence denotes Soldier #1 was a 23-year old male reporting lip swelling, throat tingling, dyspnea and chest pain 7-8 hours after treatment #10/20.
T62418 334860-334989 Sentence denotes Skin testing to both lots used during the treatment course showed positive values of 8x20mm and 9x14mm respectively at ID 1:1000.
T33865 334990-335116 Sentence denotes Soldier #2 was a 28-year old male reporting diffuse pruritus, hives, dyspnea, and chest pain 15 minutes after infusion #16/20.
T10625 335117-335200 Sentence denotes Skin testing showed positive values of 7x14mm and 8x12mm respectively at ID 1:1000.
T60300 335201-335291 Sentence denotes Due to clinical symptoms and positive skin testing, therapy was discontinued in each case.
T27940 335292-335390 Sentence denotes One control individual showed negative testing to prick at full strength, ID 1:1000, and ID 1:100.
T81693 335391-335402 Sentence denotes Conclusion:
T60260 335403-335525 Sentence denotes Skin testing with Pentostam may provide an objective tool for accurate classification of adverse reactions as IgEmediated.
T40644 335526-335680 Sentence denotes Reliance on skin prick testing alone may not be sufficient to detect Pentostam skin test reactivity, as both of these patients reacted to ID testing only.
T52764 335681-335931 Sentence denotes A prospective study including pre-and post-treatment skin testing should provide more information on the value of skin testing in providing objective evidence for an IgE-mediated process and determining the incidence of hypersensitivity to Pentostam.
T84017 335932-335945 Sentence denotes Introduction:
T8788 335946-336057 Sentence denotes A 3-year-old girl with a history of multiple infections was hospitalized with respiratory distress and hypoxia.
T83045 336058-336161 Sentence denotes Her past medical history was significant for hypothyroidism, psoriasis, asthma and multiple pneumonias.
T90246 336162-336203 Sentence denotes A CBC revealed an absence of lymphocytes.
T22854 336204-336215 Sentence denotes Laboratory:
T1175 336216-336289 Sentence denotes T and B cell subsets showed no B-cells and very low T cells (<100 cells).
T66149 336290-336358 Sentence denotes Inadequate lymphocytes were present for mitogen and antigen studies.
T53381 336359-336456 Sentence denotes Serum immunoglobulins were normal and she had antibodies to Streptococcus Pneumoniae and Tetanus.
T40422 336457-336513 Sentence denotes Antibodies to RSV, Influenza and Mycoplasma were absent.
T38285 336514-336572 Sentence denotes Chest x-ray revealed interstitial infiltrates bilaterally.
T15130 336573-336666 Sentence denotes A High resolution CT scan revealed septal thickening and confirmed interstitial infiltration.
T12855 336667-336770 Sentence denotes Open lung biopsy was consistent with non-specific inflammation with extensive lymphocytic infiltration.
T69374 336771-336855 Sentence denotes BAL fluids and biopsy were negative for bacteria, fungi and opportunistic pathogens.
T60097 336856-336872 Sentence denotes Clinical Course:
T69678 336873-336944 Sentence denotes The patient did not improve with antibiotics and steroids were started.
T96374 336945-337001 Sentence denotes The patient improved rapidly and was discharged to home.
T28694 337002-337130 Sentence denotes Biochemical analysis demonstrated a deficiency of adenosine deaminase (ADA), a form of severe combined immune deficiency (SCID).
T78622 337131-337182 Sentence denotes The patient was started on replacement ADA, Adagen.
T58594 337183-337240 Sentence denotes A repeat high resolution CT scan showed some improvement.
T65270 337241-337330 Sentence denotes However, the patient continues to be steroid dependant to control her pulmonary symptoms.
T27097 337331-337425 Sentence denotes Lymphocyte numbers remain low despite effective ADA replacement and the absence of serum dATP.
T35574 337426-337499 Sentence denotes She remains clinically stable and receives Adagen injection twice weekly.
T94712 337500-337625 Sentence denotes Discussion: ADA deficiency is a condition, which leads to accumulation of the metabolite dATP, which is toxic to lymphocytes.
T63456 337626-337724 Sentence denotes This disease most commonly presents in the first year of life as SCID and is fatal unless treated.
T98622 337725-337861 Sentence denotes Our case is unusual due to the late onset of severe disease, normal serum immunoglobulin and the presence of some protective antibodies.
T67393 337862-337978 Sentence denotes Despite adequate replacement of ADA the patient continues to be profoundly lymphopenic, most likely due to steroids.
T33447 337979-338140 Sentence denotes Although we do not yet completely understand the underlying lung disease we suspect that the patient has an autoimmune process causing interstitial inflammation.
T32884 338141-338152 Sentence denotes Background:
T12464 338153-338215 Sentence denotes Atopic dermatitis has a broad range of differential diagnoses.
T74660 338216-338359 Sentence denotes Human sarcoptic infestation is characterized by severely pruritic lesions of variable appearance and distribution and may masquerade as eczema.
T40916 338360-338414 Sentence denotes Infestation may be difficult to confirm and eradicate.
T73805 338415-338484 Sentence denotes Animal transmission has been reported as a source of human infection.
T54714 338485-338495 Sentence denotes Objective:
T13491 338496-338615 Sentence denotes To report a case of persistent sarcoptic infestation masquerading as eczema and associated with delusional parasitosis.
T77467 338616-338624 Sentence denotes Methods:
T66235 338625-338787 Sentence denotes A 58-year-old female was referred to Allergy Clinic for evaluation with a two year history of recurrent, pruritic rash thought to be refractory atopic dermatitis.
T27854 338788-338922 Sentence denotes Previous ineffective treatments included topical steroid creams, Lindane, topical anti-fungals and multiple OTC antiitch preparations.
T5421 338923-339034 Sentence denotes At initial evaluation, she had widespread excoriated papules in various stages of healing over 70% of her body.
T95814 339035-339152 Sentence denotes She reputed her dog was diagnosed with recalcitrant mange, which necessitated giving him medicated baths twice daily.
T47878 339153-339161 Sentence denotes Results:
T14711 339162-339306 Sentence denotes A clinical diagnosis of subacute sarcoptic infection was made and the patient was prescribed two courses of Elimite followed by oral Ivermectin.
T50762 339307-339380 Sentence denotes Her rash quickly resolved except for post-inflammatory hyperpigmentation.
T61252 339381-339590 Sentence denotes Three weeks after resolution of primary lesions, she again complained of pruritic eruptions occurring on easily accessible areas and began bringing in medicine bottles of skin debris and scabs for examination.
T86558 339591-339706 Sentence denotes Scrapings, KOH preparation and skin biopsy examined microscopically showed no evidence of sarcoptic re-infestation.
T77050 339707-339754 Sentence denotes A diagnosis of delusional parasitosis was made.
T1741 339755-339767 Sentence denotes Conclusions:
T50293 339768-339900 Sentence denotes The animal to human transmission of sarcoptic infection seen in this patient is rare and responded quickly to appropriate treatment.
T67286 339901-340090 Sentence denotes Despite eradication of the infection, she developed delusional parasitosis, a rare psychiatric disorder characterized by fixed, false belief of an infestation by insects or other creatures.
T65705 340091-340213 Sentence denotes She displayed the classic matchbox sign in which samples of skin, scabs and other detritus are brought in for examination.
T72414 340214-340258 Sentence denotes She is currently receiving psychiatric care.
T16332 340259-340270 Sentence denotes Background:
T99654 340271-340341 Sentence denotes Thimerosal is a mercury derivative that has been used since the 1930s.
T61407 340342-340460 Sentence denotes It is a commonly used preservative in ophthalmic solutions, otic drops, and vaccines due to its bactericidal property.
T67192 340461-340471 Sentence denotes Objective:
T93371 340472-340567 Sentence denotes To report the first case of a generalized reaction to thimerosal found in an influenza vaccine.
T61641 340568-340576 Sentence denotes Methods:
T28282 340577-340707 Sentence denotes We present a patient who developed a generalized maculopapular eruption after receiving a thimerosal containing influenza vaccine.
T92725 340708-340787 Sentence denotes Patch testing was performed to determine if there was an allergy to thimerosal.
T69263 340788-340796 Sentence denotes Results:
T66482 340797-340978 Sentence denotes Patch testing confirmed a Type IV (T cell mediated) sensitivity to thimerosal, further supported by the prior history of a reaction to a thimerosal containing contact lens solution.
T9529 340979-341136 Sentence denotes The patient was asked to avoid thimerosalcontaining products, including vaccinations, unless the benefit clearly outweighed the potential risk of a reaction.
T30321 341137-341148 Sentence denotes Conclusion:
T34713 341149-341242 Sentence denotes Physicians need to be aware that thimerosal is found in many products including vaccinations.
T9881 341243-341353 Sentence denotes Clinicians should also be aware that allergic reactions do occur with exposure to thimerosal even in vaccines.
T27473 341354-341590 Sentence denotes This is the first case report in the literature of a generalized reactions to thimerosal from an influenza vaccine Angioedema is a rare condition that has been described in the literature and exists in both inherited and acquired forms.
T3416 341591-341694 Sentence denotes A defect of the innate immune system, more particularly the complement system, is the inciting culprit.
T93236 341695-341855 Sentence denotes The acquired form of C1 esterase inhibitor deficiency has been divided into two classes and is generally not commonly seen until after the forth decade of life.
T35976 341856-342050 Sentence denotes Type 1 acquired angioedema has been described in association with lymphoproliferative disorders, while type 2 is related to excessive complement activation and consumption due to autoantibodies.
T63122 342051-342159 Sentence denotes Our case is a 67-year old man referred from an outside physician for further management of idiopathic edema.
T66143 342160-342249 Sentence denotes He first experienced facial edema in April 2002 attributed to sweet myrrh root ingestion.
T28475 342250-342373 Sentence denotes Subsequently, in November 2002 he developed diffuse swelling of his upper extremities and tongue without airway compromise.
T1022 342374-342422 Sentence denotes A minimal work-up at that time was inconclusive.
T57194 342423-342557 Sentence denotes He fortunately remained asymptomatic until January 2004 at which time he experienced two episodes of tongue swelling without etiology.
T81017 342558-342730 Sentence denotes He was seen in his local emergency department and treated with diphenhydramine, corticosteroids, and epinephrine on both occasions with gradual improvement of his symptoms.
T97550 342731-342841 Sentence denotes The patient was not on medications commonly associated with angioedema and did not report insect envenomation.
T68000 342842-342992 Sentence denotes Subsequently, he was seen by his primary care physician who ordered a number of laboratory tests including a CH50, which was significantly suppressed.
T35099 342993-343072 Sentence denotes In light of this finding, he was referred to our clinic for further evaluation.
T8726 343073-343145 Sentence denotes At the time of presentation to our office, the patient was symptom free.
T32258 343146-343189 Sentence denotes His physical exam was within normal limits.
T25379 343190-343322 Sentence denotes Further laboratory evaluation was essentially unremarkable with the exception of comple-ment studies, which are listed in the table.
T34323 343323-343401 Sentence denotes Our case demonstrates an elderly patient with evidence of idiopathic swelling.
T75884 343402-343525 Sentence denotes We arrived at our diagnosis of acquired angioedema based on clinical presentation and confirmatory serum complement levels.
T73653 343526-343631 Sentence denotes A low CH50 at time of presentation allowed us to further delineate the etiology of complement deficiency.
T79342 343632-343820 Sentence denotes The fact that our patient did not present with swelling until after age 60 and the paucity of a family history of idiopathic angioedema makes the diagnosis of acquired angioedema probable.
T85444 343821-343872 Sentence denotes Measure of serum C1q level confirmed the diagnosis.
T89223 343873-343886 Sentence denotes INTRODUCTION:
T77292 343887-344092 Sentence denotes Certain diseases, widely believed to be of allergic etiology, including atopic dermatitis and episodes of wheezing might be the result of interplay of genetic and environmental factors, at least partially.
T83645 344093-344226 Sentence denotes We describe a child with a rare chromosomal disorder presenting with typical features of atopic dermatitis and recurrent mild wheeze.
T69004 344227-344249 Sentence denotes MATERIALS AND METHODS:
T42558 344250-344349 Sentence denotes A new born African-American male was noted to have unusual facial features immediately after birth.
T40059 344350-344419 Sentence denotes The baby was born naturally, without antenatal and neonatal problems.
T90524 344420-344615 Sentence denotes On physical examination, the infant had unusual facial characteristics with tight and taut facial skin, relatively diminished facial pad of fat, pointed chin, and markedly hypertonic extremities.
T51939 344616-344692 Sentence denotes Additionally, cardiac exam revealed mumur consistent with uncomplicated ASD.
T72908 344693-344765 Sentence denotes Frequent reassessments of the infant in the outpatient clinic were done.
T4356 344766-344885 Sentence denotes The child had repeated bouts of wheezing attacks, and facial rashes compatible with the diagnosis of atopic dermatitis.
T85746 344886-345064 Sentence denotes The wheezes were treated in the clinic with nebulaized bronchodilators, and the atopic dermatitis responded reasonably to topical steroid applications and moisturizers as needed.
T71615 345065-345216 Sentence denotes Chromosomal analysis of the peripheral blood of the chid confirmed the diagnosis of deletion of long arm (q) of chromosome 1 [46, XY, del (1)(q42q43)].
T18202 345217-345274 Sentence denotes Karyotypic analyses of the mother and father were normal.
T59827 345275-345351 Sentence denotes The child exhibited features of developmental delay, and seizure activities.
T80945 345352-345395 Sentence denotes Anti-epileptic drugs (AED) were instituted.
T30513 345396-345483 Sentence denotes Initial EEG was normal and the subsequent EEG showed findings of static encephalopathy.
T27480 345484-345537 Sentence denotes CT scan of the brain revealed absent corpus callosum.
T10013 345538-345633 Sentence denotes Neurologic evaluations and physiotherapies were requested for improvement of fine motor skills.
T36376 345634-345717 Sentence denotes He did not seem to suffer from any serious infectious or immunodeficient illnesses.
T5774 345718-345737 Sentence denotes His CBC was normal.
T48668 345738-345816 Sentence denotes He continued to have fair gains in his weight, height, and head circumference.
T5620 345817-345884 Sentence denotes His atopic dermatitis and wheezing episodes remained under control.
T27106 345885-345983 Sentence denotes There were a few hospitalizations for break-through seizures and dehydration from gastroenteritis.
T39956 345984-346039 Sentence denotes A subsequent echocardiography confirmed closure of ASD.
T21716 346040-346052 Sentence denotes CON-CLUSION:
T99851 346053-346147 Sentence denotes A child with chromosomal anamoly, atopic dermatitis, and mild intermittent wheeze is reported.
T76644 346148-346239 Sentence denotes Despite multiple congenital problems, the child continued to have a stable clinical course.
T42296 346240-346322 Sentence denotes Etoposide is a chemotherapeutic agent used to treat many solid tumor malignancies.
T82419 346323-346428 Sentence denotes Hypersensitivity reactions have been well described and there are a few reported deaths from anaphylaxis.
T32866 346429-346540 Sentence denotes Some suggest that the hypersensitivity is an anaphylactoid type reaction as it may occur during the first dose.
T88414 346541-346653 Sentence denotes Case reports of cutaneous complications include Stevens-Johnson syndrome, radiation recall and diffuse erythema.
T56084 346654-346747 Sentence denotes There are four cases in which diffuse erythematous papules developed after etoposide therapy.
T12261 346748-346864 Sentence denotes All rashes spontaneously resolved within three weeks and biopsies demonstrated keratinocytes in a starburst pattern.
T25217 346865-346992 Sentence denotes We report the first case of an immediate etoposide induced skin reaction that evolved into long lasting hyperpigmented plaques.
T38400 346993-347096 Sentence denotes Pretreatement was able to prevent this immediate and late reaction on subsequent exposure to etoposide.
T51227 347097-347192 Sentence denotes A 27 year old female with ovarian cancer was treated with bleomycin, etoposide and vinblastine.
T58753 347193-347347 Sentence denotes Three hours after initiation of the third dose of etoposide, patient developed pruritic, erythematous macules on her chest, abdomen, face and extremities.
T65214 347348-347399 Sentence denotes The infusion was stopped and decadron administered.
T7113 347400-347519 Sentence denotes Over forty-eight hours, the pruritic macules became hyperpigmented plaques on her chest, abdomen, extremities and face.
T34980 347520-347571 Sentence denotes Pruritus resolved after a slow taper of prednisone.
T44662 347572-347676 Sentence denotes The darken plaques were treated with multiple topical preparations but persisted for about three months.
T54070 347677-347804 Sentence denotes Biopsies demonstrated superficial perivascular infiltration of lymphocytes and a few eosinophils suggestive of a drug eruption.
T70406 347805-347882 Sentence denotes Etoposide was considered essential for this patient so allergy was consulted.
T7997 347883-348027 Sentence denotes The literature supports cautious readministration of etoposide with pretreatment and slower infusion rate to prevent immediate hypersensitivity.
T1895 348028-348098 Sentence denotes We could not guarantee prevention of the late hyperpigmented reaction.
T49881 348099-348157 Sentence denotes The patient was pretreated with prednisone and cetirizine.
T31868 348158-348226 Sentence denotes Etoposide was administered in an ICU with a slower rate of infusion.
T65360 348227-348303 Sentence denotes Etoposide was tolerated without immediate pruritus or erythematous reaction.
T88782 348304-348361 Sentence denotes The patient did not develop the delayed darkened plaques.
T28946 348362-348533 Sentence denotes Cautious administration of etoposide after premedication and a slow rate of infusion prevented both the immediate and late reaction previously experienced by this patient.
T88123 348534-348607 Sentence denotes Eosinophils normally comprise 1-3% of peripheral white blood lymphocytes.
T42452 348608-348782 Sentence denotes Peripheral blood eosinophilia is defined as an absolute eosinophil count >500 cells/mm3 and is most often caused by atopy, helminth infections, or collagen vascular diseases.
T30188 348783-348857 Sentence denotes Less common causes include adrenal insufficiency and neoplastic processes.
T66277 348858-348979 Sentence denotes Eosinophilia can be characterized as mild (<1500 cells/mm3), moderate (1500-5000 cells/mm3) or severe (> 5000 cells/mm3).
T53184 348980-349189 Sentence denotes Although severe eosinophilia has been reported in association with adult HIV infection, studies of HIV-infected children have not shown peripheral blood eosinophilia to be a feature of pediatric HIV infection.
T11922 349190-349324 Sentence denotes We report an unusual case of severe peripheral blood eosinophilia in an adolescent male who was subsequently found to be HIV-infected.
T69690 349325-349504 Sentence denotes A previously healthy 15-year-old male presented with 2 week history of fever, diarrhea, cough, vomiting, abdominal pain, anorexia and a 5lb weight loss over the previous 2 months.
T14240 349505-349630 Sentence denotes The patient had recently emigrated from Guyana and denied sexual activity, intravenous drug abuse, or other HIV risk factors.
T26591 349631-349673 Sentence denotes There was no known maternal HIV infection.
T88023 349674-349735 Sentence denotes Repeated stool specimens were negative for ova and parasites.
T5324 349736-349810 Sentence denotes Serologies for E. histolytica, T. canis, and S. stercoralis were negative.
T66685 349811-349924 Sentence denotes An abdominal ultrasound, chest X-ray, serum electrolytes, and liver function tests were all within normal limits.
T48297 349925-350029 Sentence denotes Total white blood cell was 16, 500 with 59% eosinophils (absolute eosinophil count of 9, 735 cells/mm3).
T74122 350030-350108 Sentence denotes ELISA and Western Blot were positive for human immunodeficiency virus (HIV-1).
T80437 350109-350196 Sentence denotes CD4+ Tlymphocyte count was 1277 cells/mm3 with an HIV-1 RNA level of 11, 000 copies/ml.
T23708 350197-350268 Sentence denotes The patients symptoms resolved over the next 10 days without treatment.
T31760 350269-350372 Sentence denotes He was started on combination antiretroviral therapy (zidovudine, lamivudine, abacavir, and efavirenz).
T63019 350373-350534 Sentence denotes Absolute eosinophil count continues to slowly decrease with the last count of 3, 605 cells/mm3 three months following the introduction of antiretroviral therapy.
T34949 350535-350632 Sentence denotes Severe peripheral blood eosinophilia may be a presenting feature of HIV infection in adolescents.
T3373 350633-350768 Sentence denotes HIV testing should be considered in cases where more common causes of eosinophilia such as atopy and parasitic infections are excluded.
T22856 350769-350846 Sentence denotes Triad asthma is well described in adults but not in the pediatric literature.
T20641 350847-350967 Sentence denotes This case highlights the successful treatment of a severe pediatric asthmatic with nasal polyps and aspirin sensitivity.
T59345 350968-351114 Sentence denotes A 13 year-old female presented with severe persistent asthma, EIB, allergic rhinitis, chronic sinusitis, nasal polyps, and a history of pneumonia.
T18345 351115-351171 Sentence denotes Her asthma symptoms were minimal from age 2 until age 9.
T48785 351172-351258 Sentence denotes She then started Flovent and required increasing amounts of inhaled and oral steroids.
T84327 351259-351318 Sentence denotes She required 6 courses of oral steroids per year by age 13.
T83257 351319-351452 Sentence denotes In addition, she had snoring, fatigue, chronic nasal congestion, rhinorhea, and sneezing despite treatment withAllegra and Rhinocort.
T15397 351453-351530 Sentence denotes She had received immunotherapy from age 8 to 10 with no clinical improvement.
T31676 351531-351604 Sentence denotes Since age 8 she had recurrent sinusitis and had required 2 polypectomies.
T87518 351605-351690 Sentence denotes She noted aspirin caused nasal stuffiness and mild wheezing and therefore avoided it.
T84903 351691-351792 Sentence denotes On exam she had allergic shiners, Dennie lines, boggy turbinates, nasal polyps, and diffuse wheezing.
T86020 351793-351841 Sentence denotes On evaluation she had severe airway obstruction.
T23851 351842-351892 Sentence denotes Her FEV1 increased from 36% to 51% with albuterol.
T41914 351893-351980 Sentence denotes Her chest CT had a mosaic pattern due to severe air trapping, and her NO level was 177.
T89296 351981-352052 Sentence denotes A sleep study showed severe hypopneas, and she had pan-sinusitis on CT.
T37423 352053-352131 Sentence denotes She had multiple positive SPTs, an eosinophil count of 1100 and an IgE of 700.
T34889 352132-352294 Sentence denotes She had a normal sweat chloride and pH probe.The differential diagnosis included Churg-Strauss, ABPA, cystic fibrosis, bronchiolitis obliterans, and triad asthma.
T17203 352295-352360 Sentence denotes After a thorough evaluation, she was diagnosed with triad asthma.
T3851 352361-352443 Sentence denotes With 6 weeks of treatment with oral prednisone, her FEV1 improved from 36% to 83%.
T27824 352444-352518 Sentence denotes Her inhaled controller therapy was increased and she was placed on Xolair.
T22285 352519-352584 Sentence denotes She had a polypectomy and then underwent aspirin desensitization.
T72111 352585-352640 Sentence denotes One year after starting treatment her FEV1 remains 83%.
T24265 352641-352705 Sentence denotes She requires albuterol 1x/month and has not required prednisone.
T38331 352706-352770 Sentence denotes Her EIB, allergic rhinitis and congestion are markedly improved.
T64294 352771-352853 Sentence denotes She has had no further episodes of sinusitis, and a repeat sleep study was normal.
T20823 352854-352951 Sentence denotes In conclusion, we treated a severe pediatric asthmatic with nasal polyps and aspirin sensitivity.
T22728 352952-353157 Sentence denotes This is not frequently reported in the pediatric population, and raises questions about the incidence, optimal long term treatment of triad asthma, and the differences from the adult onset of this disease.
T3892 353158-353162 Sentence denotes A.A.
T34481 353163-353177 Sentence denotes White * , R.A.
T2668 353178-353198 Sentence denotes Simon, La Jolla, CA.
T47332 353199-353210 Sentence denotes Background:
T64639 353211-353331 Sentence denotes Human disease from mold has traditionally been isolated to infection, allergic disease, or hypersensitivity pneumonitis.
T87418 353332-353432 Sentence denotes Specific diseases or pathologic findings other than those listed above have not been well described.
T94479 353433-353507 Sentence denotes We report a case of acute eosinophilic pneumonia related to mold exposure.
T87212 353508-353526 Sentence denotes Case Presentation:
T30752 353527-353642 Sentence denotes A 50 year old woman developed dry cough and shortness of breath after Stachybotrys mold was discovered in her home.
T88892 353643-353733 Sentence denotes A chest radiograph showed bilateral upper lobe infiltrates which worsened two weeks later.
T23657 353734-353807 Sentence denotes Treatment with macrolide and flouroquinolone antibiotics was ineffective.
T72198 353808-353871 Sentence denotes A white blood cell count was 12, 000/cumm with 35% eosinophils.
T87994 353872-353919 Sentence denotes An erythrocyte sedimentation rate was 99 mm/hr.
T28347 353920-353949 Sentence denotes Aspergillus IgE was negative.
T87400 353950-354089 Sentence denotes Treatment with prednisone led to complete resolution of the chest radiographic abnormalities and improvement in pulmonary function testing.
T76045 354090-354193 Sentence denotes This patient was given a diagnosis of acute eosinophilic pneumonia with mold as a likely causal factor.
T63809 354194-354205 Sentence denotes Discussion:
T79641 354206-354353 Sentence denotes There is dispute amongst health care professionals regarding the significance of environmental mold contamination in the etiology of human disease.
T37877 354354-354444 Sentence denotes This case represents well characterized disease occurring in the setting of mold exposure.
T72259 354445-354598 Sentence denotes While a causal relationship cannot be established, the temporal relationship of mold contamination, symptom onset, and disease progression is compelling.
T56901 354599-354726 Sentence denotes Interestingly, a recent report of mold contamination leading to nonspecific interstitial pneumonia/fibrosis has been described.
T61280 354727-354844 Sentence denotes We have observed a patient in our clinic with similar pathology on biopsy and temporal relationship to mold exposure.
T80149 354845-354948 Sentence denotes To our knowledge, acute eosinophilic pneumonia has not been reported in conjunction with mold exposure.
T61328 354949-354960 Sentence denotes Conclusion:
T6482 354961-355035 Sentence denotes This case highlights a new condition in which mold may have a causal role.
T51592 355036-355123 Sentence denotes The mechanism is unknown, but likely is through a non-IgE mediated immunologic pathway.
T32407 355124-355183 Sentence denotes Public awareness of mold as a health concern is increasing.
T37777 355184-355319 Sentence denotes Perhaps similar cases will emerge as a history of mold exposure is offered by patients at the time they are evaluated for lung disease.
T27560 355320-355359 Sentence denotes A stronger correlation may then emerge.
T9730 355360-355448 Sentence denotes Scuba diving is a commonly practiced activity which normally carries only minimal risks.
T26970 355449-355673 Sentence denotes Any severe allergic reaction such as anaphylaxis, however, occurring during this activity could be a particularly dangerous not only because the swimmer is submerged but also because of the lack of proximity to medical care.
T9460 355674-355829 Sentence denotes We report a case of anaphylaxis occurring during scuba diving resulting from an unsuspected hypersensitivity to a latex component of the scuba diving suit.
T11074 355830-356031 Sentence denotes A 21 yr-old white male developed a severe generalized urticarial rash with angioedema of his lips and eyelids, and difficulty breathing within 5 minutes of his applying the suit and entering the water.
T23975 356032-356228 Sentence denotes After being rescued, he was transported to a nearby emergency department where he received epinephrine, antihistamines, corticosteroids and IV fluids with gradual improvement over a 4 hour period.
T86225 356229-356374 Sentence denotes The patient denied being stung by a marine aquatic organism and there was no prior history of allergy or medications usage prior to his reaction.
T49513 356375-356551 Sentence denotes Since subsequent investigation revealed that the scuba diving suit contained latex (Brazilian rubber), a specific IgE RAST was found to be strongly positive (Class V) to latex.
T71772 356552-356692 Sentence denotes Therefore, the patient was advised to use a suit made of Neoprene synthetic rubber (polychloroprene) which is a nonlatex containing product.
T64300 356693-356872 Sentence denotes This case report illustrates the importance of a diligent search for hidden sources of latex products which can produce life-threatening allergic reactions in sensitized patients.
T68819 356873-356996 Sentence denotes There has been considerable debate concerning the safety of immunizing egg-allergic children with the combined MMR vaccine.
T14624 356997-357172 Sentence denotes This concern derives from the possibility of an anaphylactic reaction since the MMR vaccine is prepared from attenuated viruses grown on chick embryo fibroblast cell cultures.
T34789 357173-357340 Sentence denotes We have previously reported the safe administration of the MMR vaccine to 6 severe egg-allergic children without development of an adverse reaction (Nsouli, TM, et al.
T7537 357341-357368 Sentence denotes Ann Allergy Asthma Immunol.
T32736 357369-357508 Sentence denotes 2004; 90:163) , a finding consistent with the current Report of the Committee on Infectious Diseases, American Academy of Pediatrics, 2003.
T85186 357509-357730 Sentence denotes The present case report describes an anaphylactic reaction in an egg allergic 4 yr-old-white male consisting of generalized urticaria, angioedema, wheezing immediately following the administration of a second MMR vaccine.
T45990 357731-357832 Sentence denotes The history of hives following ingestion of eggs was confirmed by positive specific IgE RAST testing.
T88612 357833-357987 Sentence denotes The patient's anaphylactic reaction necessitated emergency treatment including epinephrine, diphenhydramine, and corticosteroids in addition to IV fluids.
T9710 357988-358341 Sentence denotes Although the administration of MMR vaccine in egg-allergic children is not considered as an absolute contraindication, the present case report suggests that caution should be observed when administering the MMR vaccine in such patients and that careful medical observation be included together with the ready availability of emergency medical equipment.
T98494 358342-358344 Sentence denotes P.
T89335 358345-358359 Sentence denotes Buddiga * , R.
T88114 358360-358370 Sentence denotes Turbin, A.
T85490 358371-358381 Sentence denotes Baisre, L.
T16722 358382-358402 Sentence denotes Bielory, Newark, NJ.
T13513 358403-358416 Sentence denotes Introduction:
T61811 358417-358617 Sentence denotes Sarcoidosis is a chronic granulomatous disease of unknown etiology that may have a multi-organ system manifestation and is characterized by the histopathological evidence of nonnecrotizing granulomas.
T92895 358618-358630 Sentence denotes Case Report:
T96040 358631-359314 Sentence denotes A 53 year old African American woman with a 10 year history of Type II Diabetes mellitus, hypertension and sinusitis recalcitrant to multiple courses of antibiotics over 3 months was admitted to the hospital with complaints of right eye proptosis, diplopia, headache and right facial numbness.Her exam was consistent with an ipsilateral mild optic neuropathy, complete sixth (VI)nerve palsy, trigeminal, ophthalmic and maxillary division numbness.CT and MRI of the face, orbit and brain revealed an extensive process infiltrating ethmoid, maxillary and frontal sinuses;orbits and deep facial structures.Chest CT revealed bilateral interstitial nodules and symmetric hilar adenopathy.
T25510 359315-359520 Sentence denotes Differential diagnoses included sarcoidosis, lymphoma/tumor, Wegener's granulomatosis or fungal infection.Labs-Purified protein derivative test=negative(neg), Antineutrophil cytoplasmic Autoantibodies=neg.
T60602 359521-359718 Sentence denotes Angiotensin converting enzyme=83[8-52 U/L], Fungal & Anaerobic and Acidfast bacilli culture of sinus secretions=neg.Ethmoid, adenoid and maxillary sinus biopsies=multiple nonnecrotizing granulomas.
T8891 359719-359909 Sentence denotes On the basis of compatible clinical and radiographic findings, histopathological evidence and exclusion of other diseases with similar findings, the diagnosis of sarcoidosis was established.
T46980 359910-360332 Sentence denotes She was started on parenteral methylprednisolone and subsequently tapered to oral prednisone after 5 days.Concomitantly she was started on methotrexate as a steroid sparing agent.Most recent chest x-ray after 4 months of treatment reveals near complete resolution of the hilar lymphadenopathy.At 5 months her optic neuropathy and facial dysesthesia had resolved, and she was left with mild persistent VI nerve dysfunction.
T8443 360333-360821 Sentence denotes Conclusion:Sarcoidosis that manifests itself as sinusitis is an uncommon presentation and the mechanism involved is thought to be a consequence of the destruction of cilia and mucus producing glands by the granulomatous process.Review of the literature indicates that this is the eighth case reported and illustrates that a high index of suspicion of other etiologies must be maintained when there is a refractory response to multiple courses of antibiotics in the treatment of sinusitis.
T33395 360822-360826 Sentence denotes J.B.
T74653 360827-360838 Sentence denotes Hein * , P.
T85340 360839-360848 Sentence denotes Patel, L.
T59425 360849-360869 Sentence denotes Bielory, Newark, NJ.
T62557 360870-360959 Sentence denotes Introduction: CID may result in opportunistic infections such as cryptococcal meningitis.
T46488 360960-361073 Sentence denotes We present an unusual case of cryptococcal meningitis in an HIV-negative patient with severe CD4 lymphocytopenia.
T43116 361074-361079 Sentence denotes Case:
T24442 361080-361195 Sentence denotes A 40 yearold male with a three year history of sarcoidosis presented with acute onset of right-sided body numbness.
T28795 361196-361276 Sentence denotes The patient had been on prednisone 40 mg/day for 5 months prior to presentation.
T1552 361277-361378 Sentence denotes CT and MRI scanning showed no vascular defects, meningeal enhancement, hydrocephalus or mass lesions.
T80802 361379-361539 Sentence denotes Gallium scanning revealed normal uptake in the liver and spleen, mild uptake in the lungs and nasopharyngeal region, and asymmetric uptake in bilateral kidneys.
T55241 361540-361715 Sentence denotes The patient's initial WBC was 8, 000 cells/mm 3 , composed of 6970 neutrophils/mm 3 , 50 eosinophils/mm 3 , 50 basophils/mm 3 , 530 lymphocytes/mm 3 , and 400 basophils/mm 3 .
T37295 361716-361897 Sentence denotes Repeat studies revealed the total lymphocyte count decreased at 240 cells/mm 3 with CD19 (Pan B) cells decreased at 29 cells/mm 3 and CD3 (Pan T) cells decreased at 189 cells/mm 3 .
T88490 361898-361983 Sentence denotes CD4 count was 144 cells/mm 3 and CD8 count 50 cells/mm 3 with a CD4/CD8 ratio of 2.9.
T36935 361984-362020 Sentence denotes IgG levels were normal at 716 mg/dl.
T76288 362021-362087 Sentence denotes ELISA was negative for HIV, and HIV-1 RNA by PCR was not detected.
T47912 362088-362144 Sentence denotes Serum ACE level was 19 u/l and CSF ACE level was 23 u/l.
T69475 362145-362254 Sentence denotes CSF obtained by lumbar puncture stained positive with India ink and culture revealed Cryptococcus neoformans.
T76718 362255-362382 Sentence denotes The patient responded to Amphotericin B lipid complex 5 mg/kg/day, and his neurological status eventually returned to baseline.
T20883 362383-362395 Sentence denotes Conclusions:
T58740 362396-362499 Sentence denotes The severe lymphopenia in this patient caused predisposition to infection with Cryptococcus neoformans.
T23488 362500-362669 Sentence denotes The etiology of the profound lymphopenia likely was multifactorial, including mild sarcoidosis activity (lung uptake on gallium scan) and chronic corticosteroid therapy.
T22652 362670-362818 Sentence denotes However, once Cryptococcus became entrenched in the patient's CSF, the infection itself likely depressed peripheral lymphocyte numbers even further.
T88280 362819-362933 Sentence denotes This case demonstrates the importance of exploring a broad differential diagnosis when faced with lymphocytopenia.
T46573 362934-362945 Sentence denotes Background:
T64097 362946-363019 Sentence denotes Isosulfan blue 1% is a common dye used in sentinel lymph node dissection.
T49574 363020-363158 Sentence denotes The usage of the procedure and dye has increased in numbers, and although rare, several cases of anaphylactic reaction have been reported.
T47324 363159-363169 Sentence denotes Objective:
T65352 363170-363320 Sentence denotes We are reporting a patient who had an anaphylactic reaction to isosulfan blue while undergoing breast cancer excision with sentinel lymph node biopsy.
T77304 363321-363329 Sentence denotes Methods:
T92168 363330-363384 Sentence denotes The patient is a 44 year-old woman with breast cancer.
T40779 363385-363503 Sentence denotes She underwent breast mass excision with sentinel lymph node biopsy using the Lymphazurin 1% blue dye (isosulfan blue).
T52804 363504-363580 Sentence denotes She has a history of penicillin induced hives but has no other drug allergy.
T80429 363581-363663 Sentence denotes As soon as the dye was injected, she became flushed, hypotensive, and tachycardic.
T48682 363664-363710 Sentence denotes Hypotension was refractive to fluid challenge.
T25419 363711-363820 Sentence denotes She was then treated with epinephrine as well as intravenous steroids and cimetidine with relief of symptoms.
T68511 363821-364023 Sentence denotes Subsequently, she was evaluated in Allergy and skin tests with isosulfan blue 1% at 1:100, 1:10 dilution, and undiluted were performed using histamine as positive control and saline as negative control.
T98236 364024-364082 Sentence denotes This procedure was also performed on two control subjects.
T18664 364083-364091 Sentence denotes Results:
T7421 364092-364264 Sentence denotes The patient had a positive skin test (wheal and flare) to isosulfan blue 1% (undiluted) with the control being appropriately positive for histamine and negative for saline.
T89748 364265-364357 Sentence denotes Control subjects had negative response to dye and saline and positive response to histamine.
T48715 364358-364370 Sentence denotes Conclusions:
T84381 364371-364483 Sentence denotes Isosulfan blue 1-% dye may cause anaphylactic reactions in patients undergoing sentinel lymph node dissection. .
T95963 364484-364646 Sentence denotes The positive skin test result to the dye plus the negative skin test responses in the controls suggests that the reaction may be immunoglobulin E (Ig E) mediated.
T23353 364647-364822 Sentence denotes Eosinophilic duodenitis (ED) and gluten-sensitive enteropathy (GSE) or Celiac disease (CD) are distinct clinical entities with well-defined clinical and laboratory parameters.
T67251 364823-364972 Sentence denotes ED is a rare condition of unknown etiology, which is manifest by eosinophilic infiltration of the gastrointestinal tract and peripheral eosinophilia.
T99589 364973-365070 Sentence denotes GSE or CD is a form of non-IgE food allergy caused by immune hypersensitivity to ingested gluten.
T90322 365071-365145 Sentence denotes The simultaneous occurrence of the two entities, however, is a rare event.
T45538 365146-365244 Sentence denotes The following presentation is a case report in which both entities were found in the same patient.
T58889 365245-365364 Sentence denotes An 11 y/o white hispanic male presented with severe, chronic, colicky abdominal pain and headache of 5 months duration.
T20734 365365-365427 Sentence denotes Hematologic and immunologic studies were within normal limits.
T91411 365428-365518 Sentence denotes Serum IgE levels were 356 IU/mL (n= < 200 IU/mL), Anti-endosomial Ab (+), IgG Antigliadin:
T75071 365519-365531 Sentence denotes 16 U/mL (n=:
T1339 365532-365613 Sentence denotes 0-12 u/mL), Skin tests for food and inhalant allergens were weakly positive (1+).
T55534 365614-365832 Sentence denotes Biopsy of the inferior third of esophagus revealed chronic moderate esophagitis; biopsy of gastric antrum revealed lymphatic hyperplasia; duodenal biopsy showed shortening of the villi with the presence of eosinophils.
T51966 365833-366084 Sentence denotes Following treatment with esomeprazole 40 mg BID, famotidine 20 mg QD, montelukast 20 md QD, lactobacillus, a diet free of gluten, rofecoxib 25 mg QD and betamethasone for 15 days, betamethasone the patient improved with partial resolution of symptoms.
T18460 366085-366215 Sentence denotes The presence of duodenal eosinophils persisted despite a gluten free diet, and continued to require repeated bursts of prednisone.
T99532 366216-366462 Sentence denotes Since to our knowledge this is rare finding in which ED occurred in association with GSE, a high index of suspicion for simultaneous occurrence of ED should be raised in any case of GSE that fails to respond to a conventional gluten free regimen.
T56680 366463-366574 Sentence denotes We report the evaluation of a 6 month old male presenting with a pustular rash and choking episodes from birth.
T81686 366575-366677 Sentence denotes By age 6 weeks, he had experienced two pneumonias, one with fleeting infiltrates requiring intubation.
T85429 366678-366762 Sentence denotes Persistent eosinophilia (5000-9000/ml) and eosinophils on pustule biopsy were noted.
T74632 366763-366865 Sentence denotes Persistence of these and subsequent RSV pneumonia and recurrent draining otitis media led to referral.
T73028 366866-367006 Sentence denotes Physical examination showed a thriving male infant with multiple erythematous papules and pustules along the scalp, face, axilla, and trunk.
T18218 367007-367034 Sentence denotes Eosinophilia was confirmed.
T13574 367035-367108 Sentence denotes Quantitative immunoglobulins were abnormal for IgG 179 and IgE 255 IU/ml.
T72535 367109-367138 Sentence denotes Peanut CAP RAST was 23 kUA/L.
T99994 367139-367219 Sentence denotes HIB post-vaccination titer, T cell enumeration/stimulation, and NBT were normal.
T1510 367220-367285 Sentence denotes HIV testing, stool eosinophils, O&P, and hemoccult were negative.
T74218 367286-367333 Sentence denotes CXR, HRCT, EKG, and echocardiogram were normal.
T87008 367334-367397 Sentence denotes Pustule cultures for bacteria, virus, and fungus were negative.
T13919 367398-367501 Sentence denotes Skin biopsy revealed numerous eosinophils in the pustule, dermis, epidermis, and perifollicular region.
T38725 367502-367570 Sentence denotes CD1a+ and S-100 staining were negative for histiocytic infiltration.
T92680 367571-367668 Sentence denotes NEMO defect/incontinentia pigmenti were considered but testing was negative and karyotype 46, XY.
T13854 367669-367801 Sentence denotes Bone marrow biopsy revealed numerous eosinophils at different stages of maturation, and no myeloproliferative or neoplastic changes.
T76191 367802-367858 Sentence denotes Bronchoscopy was remarkable for 15% eosinophils on BALF.
T54534 367859-367914 Sentence denotes 24-hour pH probe and impedence evaluation was negative.
T21401 367915-368021 Sentence denotes EGD with biopsy was normal except for mild eosinophilic infiltration of the proximal and distal esophagus.
T83081 368022-368234 Sentence denotes With the clinical picture of recurrent pruritic crops of sterile pustules and characteristic skin biopsy demonstrating eosinophil infiltration, the diagnosis of eosinophilic pustulosis (EP) of childhood was made.
T15244 368235-368453 Sentence denotes Despite no longterm sequelae or other end-organ involvement in EP, the degree and duration of eosinophilia, and presence of eosinophils in the airways and esophagus, raises the concern for other eosinophilic syndromes.
T76300 368454-368517 Sentence denotes Following cardiac, CNS, pulmonary, and GI systems is warranted.
T67747 368518-368685 Sentence denotes The infants pneumonias were felt to be due to aspiration, and ear infections the result of humoral immunity nadir or draining pustules in the external auditory canals.
T82053 368686-368726 Sentence denotes Immunoglobulin levels will be monitored.
T94330 368727-368882 Sentence denotes This case illustrates the heterogeneity of eosinophilic diseases and raises the question of what drives the mechanisms behind malignant and benign disease.
T4719 368883-368896 Sentence denotes INTRODUCTION:
T62537 368897-369088 Sentence denotes Behcet's disease is a chronic, relapsing vasculitic disease characterized by recurrent oral, genital, and gastrointestinal ulcerations, a wide variety of skin lesions, uveitis, and arthritis.
T10189 369089-369213 Sentence denotes Pediatric cases of Behcet's disease are uncommon with an estimated prevalence of 1 in 600, 000 children under the age of 15.
T24804 369214-369370 Sentence denotes Although the disease in children shows similar characteristics as adults, the diagnosis of Behcet's disease in the pediatric population remains a challenge.
T77800 369371-369557 Sentence denotes This report describes an 18 year old girl referred to our pediatric immunology clinic for evaluation of recurrent painful oral ulcerations since the age of 7 with no genital ulcerations.
T31713 369558-369660 Sentence denotes The oral ulcers would last for two weeks and heal spontaneously but would reappear 2 to 3 weeks later.
T90614 369661-369772 Sentence denotes The patient had a history of Raynaud's Phenomenon for the last 6 to 7 years and the recent onset of joint pain.
T33312 369773-369904 Sentence denotes Physical examination revealed 4-5 white elliptoid lesions 5-7 mm in diameter on an erythematous base on the tongue and soft palate.
T99871 369905-369998 Sentence denotes Skin examination was significant for hyperpigmented patches over the neck, abdomen, and back.
T56890 369999-370108 Sentence denotes There were erythematous, serpigenous lesions on the palms and punctuated necrotic lesions on the finger-tips.
T7379 370109-370136 Sentence denotes Pathergy test was positive.
T71099 370137-370231 Sentence denotes Laboratory investigation was unremarkable and cultures from the oral ulcers remained negative.
T36442 370232-370289 Sentence denotes The patient was diagnosed with Juvenile Behcet's disease.
T667 370290-370374 Sentence denotes She was started on immunosuppressive therapy with low dose prednisone and responded.
T7200 370375-370386 Sentence denotes CONCLUSION:
T55030 370387-370465 Sentence denotes Behcet's disease is a difficult diagnosis to make in the pediatric population.
T84913 370466-370632 Sentence denotes This case demonstrates that in children, recurrent oral ulcerations may be the only initial manifestation of Behcet, and an important clinical marker for the disease.
T91781 370633-370643 Sentence denotes Rationale:
T56117 370644-370777 Sentence denotes Relapsing polychondritis is an uncommon severe inflammatory condition with unknown etiology that can present in a variety of manners.
T16175 370778-370940 Sentence denotes We report a 14 year old patient who initially presented with signs and symptoms of anaphylaxis to shellfish and was later diagnosed with relapsing polychondritis.
T37397 370941-370953 Sentence denotes Case Report:
T20307 370954-371154 Sentence denotes A 14 year old African-American boy with a 6 year history of asthma and fish and shrimp allergy presented to the Pediatric Intensive Care Unit on 4/23/03 after an episode of severe shortness of breath.
T5668 371155-371220 Sentence denotes His symptoms started shortly after accidental exposure to shrimp.
T49120 371221-371292 Sentence denotes In the intensive care unit, he was noted to be wheezing and stridorous.
T55311 371293-371390 Sentence denotes An initial chest Xray as well as subsequent fiber optic laryngoscopy showed sub-glottic stenosis.
T14916 371391-371468 Sentence denotes He was intubated and received mechanical ventilation for greater than a week.
T43097 371469-371561 Sentence denotes After extubation, he stated that he felt fine, but continued to demonstrate audible stridor.
T40584 371562-371762 Sentence denotes Pulmonary function tests demonstrated extra-thoracic obstruction, laryngoscopy continued to show sub-glottic stenosis, and esophagogastroduodenoscopy showed erosive esophagitis consistent with reflux.
T57623 371763-371897 Sentence denotes Initial lab tests demonstrated a normal eosinophil count, elevated IgE (969 IU/ml), and positive immunocaps testing to multiple foods.
T44815 371898-371967 Sentence denotes The patient was discharged home with minimal stridor and no wheezing.
T90113 371968-372129 Sentence denotes Over the next nine months, the severity of his stridor waxed and waned, but in general it worsened in spite of a strict elimination diet and anti-reflux therapy.
T34861 372130-372179 Sentence denotes On 9/25/03 he received an emergency tracheostomy.
T49105 372180-372239 Sentence denotes On 1/26/04, the patient was again admitted to the hospital.
T99027 372240-372325 Sentence denotes At this time he complained of bilateral knee pain as well as significant weight loss.
T74785 372326-372462 Sentence denotes Physical exam demonstrated arthritis with effusions of both knees as well as unilateral auricular chondritis and bilateral episcleritis.
T31133 372463-372526 Sentence denotes Antibodies against type II collagen were positive (42.1 EU/ml).
T67632 372527-372583 Sentence denotes The diagnosis of relapsing polychondritis was suggested.
T87735 372584-372595 Sentence denotes Conclusion:
T23537 372596-372717 Sentence denotes Relapsing polychondritis is a rare inflammatory disorder of the cartilage and connective tissue with an unknown etiology.
T26064 372718-372865 Sentence denotes The wide array of presenting complaints as well as the relapsing nature of this disorder often causes significant delay in diagnosis and treatment.
T85801 372866-373009 Sentence denotes In our case there was a period of nine months between the initial presentation and the time when the diagnosis of polychondritis could be made.
T38614 373010-373014 Sentence denotes D.K.
T51900 373015-373028 Sentence denotes Geller * , M.
T35006 373029-373049 Sentence denotes Ballow, Buffalo, NY.
T45896 373050-373063 Sentence denotes Introduction:
T76977 373064-373155 Sentence denotes An 11 yo male previously diagnosed with PANDAS presented to our immunology clinic for IVIG.
T15934 373156-373285 Sentence denotes The patient was healthy until age 8 when he developed facial motor tics associated with group A beta hemolytic strep pharyngitis.
T98546 373286-373351 Sentence denotes He was treated with antibiotics and the tics resolved completely.
T7222 373352-373433 Sentence denotes He has had multiple recurrences associated with strep and other viral infections.
T34062 373434-373499 Sentence denotes The tics improve or resolve completely when he is infection free.
T24901 373500-373623 Sentence denotes He has no history of vocal tics, attention deficit/hyperactivity disorder, or obsessional thinking or compulsive behaviors.
T76461 373624-373635 Sentence denotes Laboratory:
T29134 373636-373765 Sentence denotes Multiple throat cultures positive for group A beta hemolytic strep, positive antistreptolysin and antideoxyribonuclease B titers.
T2198 373766-373941 Sentence denotes Discussion: PANDAS identifies a subgroup of children with an obsessive compulsive disorder and/or tic disorder whose symptoms seem to be triggered by streptococcal infections.
T76580 373942-374156 Sentence denotes The proposed pathophysiology is an immune-mediated mechanism in which antistreptococcal antibodies, antistreptolysin and antideoxyribonuclease B, cross react with the basal ganglia of genetically susceptible hosts.
T25332 374157-374327 Sentence denotes A few studies have looked at immunomodulatory therapies including IVIG for neuropsychiatric symptoms including tic disorders secondary to post-streptococcal autoimmunity.
T94727 374328-374469 Sentence denotes We plan a trial of IVIG for this patient given the recurrent nature of his tics and the relation to streptococcal and other viral infections.
T12085 374470-374483 Sentence denotes Introduction:
T16701 374484-374630 Sentence denotes The Chronic Granulomatous Disease (CGD) is an inheritable disorder of phagocyte cell respiratory burst that result in life-threatening infections.
T96713 374631-374789 Sentence denotes The pulmonary infection is the primary cause of death in greater that 50% of the cases and the role of surgery in management of this entity remains undefined.
T75828 374790-374802 Sentence denotes Case report:
T89901 374803-375007 Sentence denotes A lobectomy was performed in a 2 year-old male who presented a persistent opacity of the medial right lobe with fever, cough, malaise an rapid onset of respiratory failure; skin abcesses were concomitant.
T13791 375008-375046 Sentence denotes His familiar history was unremarkable.
T93176 375047-375147 Sentence denotes A chest tube was placed in a first instance in order to drain empyema, but no progress was observed.
T48452 375148-375281 Sentence denotes A CT scan showed necrotizing pneumonia of the right lung, mediastinal and retroperitoneal limphadenopathy and bronchopleural fistula.
T27509 375282-375384 Sentence denotes A second surgical intervention was undertaken to correct the fistula and pleural debridement was done.
T39754 375385-375499 Sentence denotes At this time, Serratia marcenses was isolated from blood culture and lung; a primary immunodefiency was suspected.
T55212 375500-375625 Sentence denotes Our evaluation showed NBT reduction on 0% and Dyhidrorhodamine assay (DHRA) didn't demonstrate and effective oxidative burst.
T19347 375626-375743 Sentence denotes The subsecuent management was based on specific antibiotic to Serratia and prophylaxis with TMP-SMZ and Itraconazole.
T71841 375744-375800 Sentence denotes Transfer Factor to improve the IFN levels was initiated.
T29060 375801-375899 Sentence denotes The patient's mother showed on DHRA two granulocyte populations, with and without oxidative burst.
T70121 375900-375930 Sentence denotes A X linked CGD was consistent.
T3057 375931-375978 Sentence denotes Medical progress was observed in the next days.
T76780 375979-375990 Sentence denotes Conclusion:
T51687 375991-376446 Sentence denotes Despite the poor utility showed by the surgical procedures in the complicated pneumonia in CGD patients in many series, attending to the unusual nature of the pulmonary infections and the high mortality and morbidity associated with thoracic surgery; the management of this case showed that an aggressive approach in the diagnosis combined with some procedures used in immunocompetent patients pneumonia may improve the clinical condition in CGD patients.
T5700 376447-376458 Sentence denotes Background:
T58713 376459-376554 Sentence denotes Takayasu arteritis is a large vessel vasculitis primarily affecting the aorta and its branches.
T71355 376555-376625 Sentence denotes It is most prevalent in women in the second and third decades of life.
T71640 376626-376777 Sentence denotes Initial symptoms are systemic and often self-limited, but the disease may progress undetected over years until signs of vascular insufficiency develop.
T47001 376778-376930 Sentence denotes Arteritis is commonly seen in the aortic arch and its branches, although the disease is a panarteritis and vascular compromise can occur in many organs.
T85437 376931-377040 Sentence denotes Pathologically, involved vessels show intimal proliferation and fibrosis, and scarring of the elastic lamina.
T8719 377041-377053 Sentence denotes Case Report:
T98139 377054-377184 Sentence denotes We report the case of a 31 year old Southeast Asian woman who presented with diplopia, ptosis, dizziness, and progressive dyspnea.
T38746 377185-377301 Sentence denotes Past medical history was significant for rheumatic fever complicated by aortic valve insufficiency and hypertension.
T90646 377302-377533 Sentence denotes Physical findings on admission included hypertension, asymmetric upper extremity blood pressure (left arm 95/50mm Hg, right arm 200/50 mm ANNALS OF ALLERGY, ASTHMA & IMMUNOLOGY Hg), wide pulse pressure and a harsh diastolic murmur.
T52259 377534-377575 Sentence denotes Admission labs showed anemia (hemoglobin:
T55800 377576-377658 Sentence denotes 11g/dL, hematocrit 33%) and an elevated erythrocyte sedimentation rate of 31mm/hr.
T97673 377659-377865 Sentence denotes Transesophageal echocardiography revealed severely dilated aortic root aneurysm with secondary severe chronic aortic valve insufficiency and calcified aortic leaflets not typical of rheumatic heart disease.
T69978 377866-377923 Sentence denotes Resection of the aortic valve and aneurysm was performed.
T18451 377924-378135 Sentence denotes Pathologic examination of the aortic aneurysm revealed intimal and adventitial fibrosis with focal chronic inflammation and partial loss and fibrosis of media, findings compatible with healed Takayasu arteritis.
T33948 378136-378253 Sentence denotes The patient was started on prednisone 100mg by mouth daily for Takayasu arteritis and discharged in stable condition.
T74991 378254-378265 Sentence denotes Discussion:
T55631 378266-378343 Sentence denotes This is a case of Takayasu arteritis masquerading as rheumatic heart disease.
T99355 378344-378489 Sentence denotes The episode of rheumatic fever was likely the initial presentation of Takayasu arteritis, as the systemic symptoms of these diseases can overlap.
T86139 378490-378617 Sentence denotes Takayasu arteritis is an insidious disease that often leads to a delayed diagnosis with considerable morbidity for the patient.
T31142 378618-378844 Sentence denotes Since Takayasu arteritis may go undiagnosed until ischemic symptoms develop, physicians should be alert to the possibility of this disease in young women to avert end organ damage and achieve early remission with drug therapy.
T58811 378845-378954 Sentence denotes We present a fifteen year old boy with disseminated papillomatosis and idiopathic CD4+ lymphocytopenia (ICL).
T4499 378955-379041 Sentence denotes The warts have been present since he was one year old and have progressively worsened.
T3040 379042-379095 Sentence denotes There are more than fifty warts on each of his hands.
T69159 379096-379196 Sentence denotes His legs have multiple warts and about ten warts recently appeared on his lips and around his mouth.
T23714 379197-379287 Sentence denotes His past medical history is significant for no hospitalizations and no blood transfusions.
T60939 379288-379407 Sentence denotes He has never had problems with other infections, and he had a benign course of chicken pox that spontaneously resolved.
T90560 379408-379469 Sentence denotes He has been on cimetidine for six months without improvement.
T9711 379470-379530 Sentence denotes Several topical therapies, including imiquimod, have failed.
T47910 379531-379658 Sentence denotes He has a total lymphocyte count of 1484/uL (normal range, 1288-4512/uL) and a CD4+ count of 301/uL (normal range, 361-1715/uL).
T69970 379659-379719 Sentence denotes The CD8+, Natural Killer Cells, and CD19+ cells were normal.
T65107 379720-379745 Sentence denotes His HIV test is negative.
T68737 379746-379792 Sentence denotes The serum immunoglobulins were normal as well.
T21327 379793-379921 Sentence denotes Lymphoctye proliferation studies reveal an absent response to antigens (Candida and Tetanus) with a normal response to mitogens.
T26959 379922-379984 Sentence denotes Further studies showed no other cause of CD4+ lymphocytopenia.
T2270 379985-380150 Sentence denotes This case shows that the diagnosis of Idiopathic CD4+ lymphocytopenia should be considered in any patient with widespread viral infection whose HIV test is negative.
T17809 380151-380210 Sentence denotes Appropriate evaluation of the CD4+ count should be pursued.
T84572 380211-380213 Sentence denotes J.
T92271 380214-380223 Sentence denotes Ko * , A.
T47190 380224-380252 Sentence denotes Nowak-Wegrzyn, New York, NY.
T11419 380253-380266 Sentence denotes INTRODUCTION:
T86786 380267-380364 Sentence denotes Approximately 40% of children with moderate to severe atopic dermatitis (AD) have food allergies.
T96410 380365-380472 Sentence denotes Complementary and alternative medicine (CAM) is utilized by an estimated 16-27% of patients with allergies.
T79004 380473-380594 Sentence denotes We present a case of a 4 year-old boy with AD referred after receiving a diagnosis of food allergy by a CAM practitioner.
T16390 380595-380608 Sentence denotes METHODS/CASE:
T2600 380609-380700 Sentence denotes A 4 year-old boy was referred for evaluation of mild AD and possible food hypersensitivity.
T75053 380701-380761 Sentence denotes His AD started at 1 year of age and was limited to the face.
T21049 380762-380848 Sentence denotes He was initially breast-fed and was switched to milk-based formula at 4 months of age.
T44242 380849-380910 Sentence denotes Solids were introduced at 5 months of age without difficulty.
T44408 380911-380979 Sentence denotes He had no immediate reactions or noted worsening of AD due to foods.
T20078 380980-381041 Sentence denotes The patient presented to a naturopath for allergy evaluation.
T10487 381042-381198 Sentence denotes Based on electrodermal skin testing results, he was reported to be allergic to milk, egg, peanut, rice, and beef (all of which he had tolerated previously).
T94739 381199-381355 Sentence denotes He was restricted from milk and egg for 4 weeks without noticeable change in his AD, which was limited to the cheeks and controlled on topical pimecrolimus.
T30011 381356-381364 Sentence denotes RESULTS:
T64587 381365-381413 Sentence denotes His weight and height were both 75th percentile.
T24061 381414-381559 Sentence denotes Physical exam was normal except for 2-3 cm dry, erythematous patches on both cheeks and mildly dry skin on flexor/extensor surfaces of both arms.
T11681 381560-381639 Sentence denotes Skin prick testing revealed negative tests to milk, egg, peanut, and dust mite.
T41786 381640-381676 Sentence denotes Serum IgE testing was also negative.
T16762 381677-381842 Sentence denotes Since he had no evidence of IgE sensitization to commonly allergenic foods, he was recommended to continue an unrestricted diet and discontinue use of a "Sippy" cup.
T95765 381843-381954 Sentence denotes His AD subsequently improved on a skin care regimen of postbathing moisturization and topical pimecrolimus prn.
T17804 381955-382016 Sentence denotes Asthma and allergies are the #2 reason for CAM use in the US.
T89373 382017-382122 Sentence denotes Electrodermal skin testing is a method utilized by naturopathic doctors to detect allergen "sensitivity".
T68792 382123-382317 Sentence denotes However, in two double-blinded trials examining atopic and non-atopic patients, electrodermal testing did not correlate with skin prick testing results, regardless of inter-operator variability.
T54185 382318-382330 Sentence denotes CONCLUSIONS:
T3109 382331-382482 Sentence denotes Allergy patients are seeking CAM treatment, and it is important for physicians to be aware of the safety and efficacy of alternative medical practices.
T37797 382483-382619 Sentence denotes The use of electrodermal skin testing has not been proven to detect allergen sensitivity and use of this modality should be discouraged.
T84626 382620-382624 Sentence denotes E.E.
T33908 382625-382642 Sentence denotes McGintee * , K.E.
T28406 382643-382670 Sentence denotes Sullivan, Philadelphia, PA.
T30034 382671-382684 Sentence denotes Introduction:
T32470 382685-382806 Sentence denotes Hematopoietic stem-cell transplantation causes profound Tcell immunodeficiency due to the rigorous conditioning involved.
T83747 382807-382929 Sentence denotes Following transplant, the T-cell compartment is initially reconstituted through expansion of mature donor-derived T-cells.
T25061 382930-383017 Sentence denotes However, thymopoiesis is necessary to generate naive T-cells with a diverse repertoire.
T4862 383018-383117 Sentence denotes Factors affecting thymic function impact the ability of the body to reconstitute the immune system.
T73736 383118-383301 Sentence denotes We report a case of severe T-cell immunodeficiency after two stem-cell transplants for neuroblastoma in a patient with a history of thymic hemorrhage secondary to mediastinal surgery.
T76734 383302-383307 Sentence denotes Case:
T27324 383308-383493 Sentence denotes A 5-year-old female with a history of high-risk neuroblastoma was referred for immunologic evaluation due to a significant infectious history since completing her neuroblastoma therapy.
T17520 383494-383604 Sentence denotes She initially presented at 21 months of age with a right atrial mass that was presumed to be an atrial myxoma.
T90625 383605-383755 Sentence denotes She underwent mediastinal surgery to resect the tumor, which was found to be neuroblastoma extending from her right adrenal gland along the vena cava.
T81230 383756-383839 Sentence denotes A CT scan following her surgery revealed an area of hemorrhage in her right thymus.
T42793 383840-383930 Sentence denotes She subsequently received high-dose chemotherapy and two autologous stem-cell transplants.
T21222 383931-384105 Sentence denotes Her infection history was significant for multiple episodes of upper respiratory illnesses, sinusitis, and otitis media requiring myringotomy tube placement on two occasions.
T34106 384106-384284 Sentence denotes Immunologic evaluation revealed a dramatically low absolute lymphocyte count with deficits primarily in the T-cell compartment, and reduced proliferation in response to mitogens.
T93247 384285-384419 Sentence denotes Immunoglobulin levels were normal; she formed protective titers to diphtheria and tetanus but not to any of 14 pneumococcal serotypes.
T45050 384420-384431 Sentence denotes Conclusion:
T26424 384432-384506 Sentence denotes Stem-cell transplantation often results in severe T-cell immunodeficiency.
T52530 384507-384672 Sentence denotes The thymus plays an important role in reconstituting the T-cell compartment with naive T-cells generated from hematopoietic stem-cells, which restores TCR diversity.
T74048 384673-384796 Sentence denotes As this case illustrates, damage to the thymus can significantly impair the ability to reconstitute the T-cell compartment.
T25767 384797-384801 Sentence denotes A.K.
T18479 384802-384815 Sentence denotes Knight * , C.
T2636 384816-384849 Sentence denotes Cunningham-Rundles, New York, NY.
T41458 384850-384860 Sentence denotes Rationale:
T84066 384861-384942 Sentence denotes This is the first case report of oxcarbazepine induced immunoglobulin deficiency.
T78652 384943-384951 Sentence denotes Methods:
T61157 384952-385104 Sentence denotes A 49 y/o white female was referred for further investigation of low serum immunoglobulin found as part of an evaluation for chronic bacterial vaginitis.
T70724 385105-385151 Sentence denotes She was taking oxcarbazepine for chronic pain.
T73554 385152-385244 Sentence denotes This was discontinued and immunoglobulin levels and B cell numbers were tested at intervals.
T93948 385245-385309 Sentence denotes Specific antibody responses to pneumococcal vaccine were tested.
T49110 385310-385318 Sentence denotes Results:
T42003 385319-385506 Sentence denotes At presentation, on oxcarbazepine, immunoglobulin levels were low [IgG 576, IgA <11, and IgM <4 mg/dL] and she had a B cell deficiency [1%, 18 B cells (normal 5-15%, 75-375 cells/cu mm)].
T59408 385507-385684 Sentence denotes Antibody response one month after pneumococcal vaccine was poor (protective antibody to 2/12 serotypes). (7%)] with protective antibody responses to 5/12 pneumococcal serotypes.
T10321 385685-385722 Sentence denotes She continued to have IgA deficiency.
T90809 385723-385735 Sentence denotes Conclusions:
T80023 385736-385890 Sentence denotes The patient's initial evaluation suggested the diagnosis of Common Variable Immune Deficiency with hypogammaglobulinemia and specific antibody deficiency.
T43746 385891-385959 Sentence denotes However, these defects reversed when oxcarbazepine was discontinued.
T13503 385960-386136 Sentence denotes It is unclear if persistent IgA deficiency was a pre-existing condition, possibly predisposing her to this adverse reaction to oxacarbazepine, or induced by the oxacarbazepine.
T74025 386137-386322 Sentence denotes Immunoglobulin deficiency is a known, though rare, reaction to carbazepine, the parent drug of oxacarbazepine; this adverse reaction can occur with its derivative oxcarbazepine as well.
T60331 386323-386495 Sentence denotes Secondary hypogammaglobulinemia should be considered before diagnosing primary immunodefiencies such as CVID and committing the patients to lifelong immunoglobulin therapy.
T58030 386496-386509 Sentence denotes INTRODUCTION:
T72242 386510-386634 Sentence denotes Interferon and glatiramer acetate (Copaxone) are indicated for the treatment of relapsing-remitting multiple sclerosis (MS).
T9561 386635-386729 Sentence denotes Anaphylactic reaction has been reported as a rare complication of interferon and Copaxone use.
T48955 386730-386889 Sentence denotes We report a case of interferon -1a (Rebif) and Copaxone hypersensitivity associated with positive skin tests and desensitization to interferon -1b (Betaseron).
T51083 386890-386902 Sentence denotes CASE REPORT:
T79464 386903-387079 Sentence denotes The patient is a 28 year-old woman with asthma and allergic rhinitis who was diagnosed with MS in Oct '04 after an uncomplicated pregnancy and was subsequently placed on Rebif.
T77815 387080-387199 Sentence denotes One month after starting therapy, patient developed wheezing and generalized urticaria after receiving a dose of Rebif.
T25763 387200-387235 Sentence denotes The symptoms recurred the next day.
T39514 387236-387298 Sentence denotes Her neurologist stopped the Rebif and started her on Copaxone.
T53574 387299-387364 Sentence denotes Two months later she developed episodes of generalized urticaria.
T95058 387365-387542 Sentence denotes The patient was then evaluated in our center and underwent skin testing with interferon -1a intramuscular (Avonex), interferon -1a subcutaneous (Rebif), Betaseron, and Copaxone.
T25063 387543-387703 Sentence denotes She had a positive skin prick reaction to Copaxone and positive intradermal skin tests to Avonex (1:10 strength), Rebif (1:1), and Betaseron (1:1) after 24 hrs.
T64718 387704-387797 Sentence denotes The intradermal reactions to all 3 interferon formulations continued to progress upto 48 hrs.
T27502 387798-387865 Sentence denotes Her neurologist felt that she would benefit from Betaseron therapy.
T1147 387866-388004 Sentence denotes The positive intradermal skin test to Betaseron was sufficient to warrant desensitization to prevent immediate hypersensitivity reactions.
T39090 388005-388070 Sentence denotes She underwent subcutaneous desensitization as shown in the Table.
T30012 388071-388258 Sentence denotes The desensitization was halted at 240 minutes after the patient developed itching of the hands.* She returned in 24 hrs and we restarted by administering 0.1 mL of 1:1 strength Betaseron.
T93004 388259-388355 Sentence denotes Increasing doses were given until the patient received a full therapeutic dose (0.3 mg in 1 mL).
T49755 388356-388426 Sentence denotes She has since done well with daily doses of Betaseron (4.5 mil units).
T52646 388427-388438 Sentence denotes CONCLUSION:
T96178 388439-388557 Sentence denotes We report a MS patient who developed urticaria and asthma exacerbation in response to Rebif and urticaria to Copaxone.
T11041 388558-388613 Sentence denotes Skin tests confirmed an IgE-mediated allergic reaction.
T25447 388614-388668 Sentence denotes She underwent successful desensitization to Betaseron.
T37383 388669-388838 Sentence denotes To our knowledge, this is the 1st report of desensitization to Betaseron as well as extension to previous reported cases of systemic reaction to interferon and Copaxone.
T71510 388839-388998 Sentence denotes Pentoxifylline (PTX) is a phosphodiesterase inhibitor that has been used for ischemic vascular disease because of its effects on red blood cells and platelets.
T57826 388999-389167 Sentence denotes It has been used for systemic inflammatory diseases such as sarcoidosis because of its ability to inhibit production of cytokines such as tumor necrosis factor (TNF-a).
T56099 389168-389329 Sentence denotes We decided to offer a trial to a patient with chronic urticaria since agents that increase intracellular cAMP have been shown to inhibit mast cell degranulation.
T21984 389330-389509 Sentence denotes We report a case of a 50 year-old female with a history of allergic rhinitis, hypothyroidism, and diabetes mellitus with recurrent episodes of chronic urticaria since adolescence.
T49850 389510-389634 Sentence denotes She had known allergies to various antibiotics but otherwise had an unremarkable history, family history and social history.
T98480 389635-389889 Sentence denotes She was being treated with fexofenadine 180mg qd, azelastine nasal spray, zafirlukast 20mg bid, hydroxychloroquine 200mg bid, levothyroxine 25mcg qd, doxepin 25mg qHS, metformin 500mg bid, and spironolactone 25mg qd at the time of her initial evaluation.
T95702 389890-390044 Sentence denotes Her physical exam was notable only for scattered 2-3 cm urticarial skin lesions as well as areas of hypo and hyperpigmentation from previous excoriations.
T5711 390045-390108 Sentence denotes Her nasal turbinates were mildly congested with dull membranes.
T98105 390109-390191 Sentence denotes A previous skin biopsy showed only urticaria with increased numbers of mast cells.
T98928 390192-390325 Sentence denotes Her workup included normal CBC, urinalysis, SPEP and complete chemistry profile, as well as negative ANA and anti-thyroid antibodies.
T49400 390326-390386 Sentence denotes Pentoxifylline 400mg tid was added to the patient`s regimen.
T11837 390387-390475 Sentence denotes Her urticaria resolved within 2-3 weeks and was no longer visible at 2 months follow-up.
T11665 390476-390709 Sentence denotes Pentoxifylline is a safe medication with few side effects that may benefit patients with chronic urticaria via several mechanisms, including the inhibition of mast cell degranulation and secretion of various cytokines and chemokines.
T91267 390710-390829 Sentence denotes The beneficial effects of pentoxifylline in the treatment of this patient`s urticaria have been seen in other patients.
T72093 390830-391060 Sentence denotes Further study is indicated to determine which patients with urticaria are most likely to benefit from pentoxifylline, as well as elucidate the mechanisms of action by which pentoxifylline ameliorates symptoms of chronic urticaria.
T10377 391061-391065 Sentence denotes C.M.
T41615 391066-391080 Sentence denotes Mjaanes * , M.
T454 391081-391105 Sentence denotes Boguniewicz, Denver, CO.
T83002 391106-391238 Sentence denotes We report the case of an 11-year-old male who since the age of 6 years has suffered from recurrent episodes of left tongue swelling.
T25563 391239-391344 Sentence denotes Onset of the swelling is usually abrupt, and generally occurs during the night, awakening him from sleep.
T87289 391345-391448 Sentence denotes He describes a sensation of pain in his tongue but denies any pruritus, throat, lip or eyelid swelling.
T66860 391449-391512 Sentence denotes He has no cough, dyspnea, wheezing, rash, or itchy/watery eyes.
T49819 391513-391579 Sentence denotes The episodes occur infrequently, approximately once every spring .
T98870 391580-391699 Sentence denotes They tend to resolve spontaneously within 4 to 6 hours, however, on 2 occasions, the swelling has lasted for 7-21 days.
T18267 391700-391778 Sentence denotes The patient's current episode has been present for 3 weeks and is progressing.
T32141 391779-391829 Sentence denotes Today he reports more pain and increased swelling.
T4829 391830-391884 Sentence denotes The child reports no benefit from oral antihistamines.
T53482 391885-391997 Sentence denotes He was treated with dexamethasone during his initial episode and experienced gradual resolution of the swelling.
T28855 391998-392105 Sentence denotes He has never been treated with topical or systemic epinephrine, or additional courses of systemic steroids.
T32177 392106-392147 Sentence denotes There is no family history of angioedema.
T51924 392148-392256 Sentence denotes The child was referred for evaluation of an immunologic/allergic etiology of his unilateral tongue swelling.
T74042 392257-392483 Sentence denotes Laboratory studies obtained early in the course of his current episode revealed the following: C3 level 84 mg/dL; C4 level 14.4 mg/dL; C2 level 22.5 mug/mL; C4D level 0.94 mug/mL; C1 esterase inhibitor function 115% of normal.
T82928 392484-392628 Sentence denotes C1 esterase inhibitor level 17.4 mg/dL; CH50 223 units/mL; ANA 1:40, negative; beta-tryptase < 1.0 ng/mL; total tryptase 7.0 ng/mL (all normal).
T70644 392629-392790 Sentence denotes Initial evaluation revealed marked swelling along with erythematous and violaceous discoloration of the left lateral and anterior portions of the child's tongue.
T67426 392791-392835 Sentence denotes The remainder of his examination was normal.
T89255 392836-392973 Sentence denotes The patient was referred to the pediatric otolaryngology clinic with a presumptive diagnosis of a glossal hemangioma versus lymphangioma.
T27808 392974-393123 Sentence denotes He underwent a magnetic resonance imaging study which revealed a poorly defined, mass-like enlargement of the anterior and left aspect of the tongue.
T13734 393124-393178 Sentence denotes He was treated with a five day course of prednisolone.
T79281 393179-393288 Sentence denotes After initial regression of the lesion a planned surgical excision was carried out without any complications.
T90651 393289-393412 Sentence denotes In conclusion, this rare case illustrates the unique presentation of glossal hemangioma presenting as recurrent angioedema.
T38143 393413-393524 Sentence denotes Highlighted are the differential diagnoses, laboratory studies and clinical features of oropharyngeal swelling.
T94311 393525-393548 Sentence denotes Severe tongue swelling.
T28543 393549-393729 Sentence denotes Rare skin conditions such as leprosy need to be considered in the differential diagnosis of apparent urticaria and angioedema that is atypical in appearance or response to therapy.
T25982 393730-393996 Sentence denotes A 28 year old male originally from Laos presented with chronic recurrent nonpruritic indurated plaques on his face and trunk, and was referred to allergy by his primary physician with a diagnosis of urticaria and angioedema to rule out an allergic reaction to foods.
T14572 393997-394100 Sentence denotes He was otherwise healthy and on no medication, and had a negative personal and family history of atopy.
T49128 394101-394208 Sentence denotes He had moved to the United States from Southeast Asia in 1990, and visited for several weeks again in 2003.
T66225 394209-394424 Sentence denotes He was treated with prednisone and hydroxyzine without benefit; skin testing to foods was negative, and CBC, differential, sedimentation rate, antinuclear antibody, and liver function testing was normal or negative.
T13377 394425-394584 Sentence denotes A skin punch biopsy from an indurated area on the back showed granulomas with clusters of acid-fast organisms on AFB stain consistent with tuberculoid leprosy.
T17480 394585-394755 Sentence denotes As the patient was G6PD deficient, he could not be treated with dapsone and was treated alternatively with minocycline 100mg, rifampin 600mg, and clofazimine 50 mg daily.
T49862 394756-394885 Sentence denotes He was subsequently started on prednisone as he was determined to be having a reversal reaction; his lesions continue to improve.
T39742 394886-394979 Sentence denotes This patient had a rare condition, leprosy, which was confused with urticaria and angioedema.
T43939 394980-395185 Sentence denotes In patients presenting with atypical apparent urticaria or angioedema, especially if response to standard pharmacologic treatment is poor, a skin biopsy is indicated, and may be diagnostic as in this case.
T87249 395186-395199 Sentence denotes Introduction:
T20352 395200-395355 Sentence denotes Cutaneous flushing about the face of a toddler within minutes of eating specific foods prompts parents and clinicians alike to pursue food allergy testing.
T62060 395356-395532 Sentence denotes Auriculotemporal Syndrome, also known as Frey Syndrome, is an isolated and transient facial erythema about the distribution of the auriculotemporal nerve following mastication.
T97913 395533-395642 Sentence denotes We report a child who was referred for food allergy testing and was diagnosed with Auriculotemporal Syndrome.
T75353 395643-395656 Sentence denotes Case History:
T22714 395657-395797 Sentence denotes A 2 yo WF, prior full-term forceps-assisted delivery, has a history of facial flushing within minutes following ingestion of specific foods.
T50580 395798-395965 Sentence denotes The flushing can be induced by a variety of foods, specifically spaghetti, crackers, potato chips and hard candies, and typically resolves within minutes after eating.
T30283 395966-396052 Sentence denotes The child has no respiratory or gastrointestinal distress during the flushing episode.
T90049 396053-396124 Sentence denotes There is no angioedema, urticaria, or other rash elsewhere on her body.
T53288 396125-396315 Sentence denotes Within ten minutes of eating a lollipop in clinic, an erythematous, warm macular eruption appeared in a band-like region anterior to her ear extending from her temporal bone to her mandible.
T9415 396316-396414 Sentence denotes This response occurred bilaterally, with a mildly greater intensity on the right side of her face.
T94849 396415-396527 Sentence denotes No sweating or other symptoms developed, and the flushing began to diminish after thirty minutes of observation.
T19972 396528-396539 Sentence denotes Discussion:
T73801 396540-396667 Sentence denotes Auriculotemporal Syndrome is commonly seen in patients who have undergone facial surgery, specifically about the parotid gland.
T58631 396668-396759 Sentence denotes It is believed to be secondary to a disruption in the fibers of the auriculotemporal nerve.
T24002 396760-396930 Sentence denotes It is theorized that the nerve regeneration following an injury may join the parasympathetic fibers of the salivary gland with sympathetic fibers of eccrine sweat glands.
T17831 396931-397123 Sentence denotes Mastication then could result in flushing and sweating over the cutaneous distribution of the auriculotemporal nerve that extends from the temporal region to the mandible, anterior to the ear.
T42975 397124-397219 Sentence denotes Although rare in children, auriculotemporal syndrome has been associated with forceps delivery.
T55071 397220-397322 Sentence denotes Therapy is seldom of benefit or needed, and the syndrome often resolves spontaneously over many years.
T50341 397323-397334 Sentence denotes Conclusion:
T45811 397335-397436 Sentence denotes Auriculotemporal Syndrome leads to a cutaneous eruption temporally related to the ingestion of foods.
T2807 397437-397606 Sentence denotes Allergists should maintain an awareness of this rare syndrome to minimize food allergy testing or eliminate unnecessary food provocation challenges or restrictive diets.
T95454 397607-397609 Sentence denotes M.
T74945 397610-397627 Sentence denotes Al-Ahmad * , S.S.
T8430 397628-397650 Sentence denotes Mace, Toronto, Canada.
T82413 397651-397664 Sentence denotes Introduction:
T26829 397665-397715 Sentence denotes Ranitidine is a well-known H2-receptor antagonist.
T9960 397716-397794 Sentence denotes Anaphylactic reactions are seldom reported despite widespread use of the drug.
T59677 397795-397864 Sentence denotes We report a patient with anaphylactic reaction to ranitidine Methods:
T75300 397865-397923 Sentence denotes We report a case of anaphylactic reaction with Ranitidine.
T39237 397924-397932 Sentence denotes Results:
T91607 397933-398119 Sentence denotes A 45-year-old female with a history of urticaria over one year period, presented with 4 episodes of anaphylactic reactions of increasing severity over 1 year, after ranitidine ingestion.
T64881 398120-398315 Sentence denotes The first two episodes, occurred one hour after ranitidine ingestion, began with a sensation of burning, and itching in the head followed by dizziness, hypotension and near loss of consciousness.
T52870 398316-398379 Sentence denotes The patient had no significant pulmonary or laryngeal symptoms.
T39792 398380-398492 Sentence denotes The fourth episode, occurred 12 minutes after taking ranitidine tablet, was characterized by severe hypotension.
T58238 398493-398547 Sentence denotes Two episodes were managed at the emergency department.
T82492 398548-398677 Sentence denotes A skin prick test with a crushed ranitidine tablet demonstrated a positive 20 mm wheal response, which was negative in a control.
T51808 398678-398756 Sentence denotes Investigations for carcinoid syndrome and systemic mastocytosis were negative.
T13801 398757-398768 Sentence denotes Conclusion:
T95496 398769-398819 Sentence denotes An IgE mediated allergy to ranitidine is possible.
T65615 398820-398885 Sentence denotes Anaphylactoid reaction to ranitidine is a well recognized entity.
T56248 398886-398982 Sentence denotes However, to our knowledge, few cases of anaphylactic reaction to ranitidine have been described.
T81141 398983-399097 Sentence denotes Hypersensitivity reaction to ranitidine should be considered in patients suspected of having drug-related allergy.
T37306 399098-399111 Sentence denotes Introduction:
T81006 399112-399288 Sentence denotes Severe Combined Immune Deficiency(SCID) and Cystic Fibrosis(CF) may both present in infancy with a history of failure to thrive, diarrhea, and recurrent respiratory infections.
T57401 399289-399488 Sentence denotes Although CF is the most common genetic disease occurring in Caucasians with an incidence of 1 in 2500 births, SCID is a rare condition estimated to occur between 1 in 50, 000 to 1 in 500, 000 births.
T12068 399489-399638 Sentence denotes We report a case of X-linked SCID where the diagnosis of CF was originally entertained due to similar presentation and misleading laboratory results.
T25085 399639-399644 Sentence denotes Case:
T44337 399645-399794 Sentence denotes 5-month-old Caucasian male with 3 month history of recurrent respiratory illnesses, fever, loose stools, thick nasal discharge and failure to thrive.
T95385 399795-399853 Sentence denotes This was his second admission for a respiratory infection.
T24127 399854-400070 Sentence denotes Relevant lab results consisted of cultures which grew parainfluenza A virus on NP wash and Pseudomonas aeruginosa on deep throat culture, Chest Xray showed patchy infiltrates and a borderline sweat test of 51 MMOL/L.
T13800 400071-400203 Sentence denotes Despite being treated with broad spectrum antibiotic coverage, albuterol and pulmozyme, his respiratory symptoms were not improving.
T19433 400204-400379 Sentence denotes Physical exam revealed a thin infant with palpable though small lymph nodes cervical and groin, diffuse scattered rhonchi and liver edge palpable 3 cm below the costal margin.
T46258 400380-400477 Sentence denotes Quantative Immunoglobulins were obtained and resulted as an IgG of 75, IgA of <10, and IgM of 13.
T82077 400478-400545 Sentence denotes Review of his chest x-ray was significant for absent thymic shadow.
T64580 400546-400600 Sentence denotes Lymphocyte count since admission ranged from 400-1000.
T98557 400601-400715 Sentence denotes Flow cytometry revealed a CD3/CD4 count of 0%, CD3/CD8 count of 0%, CD56 of 1% and CD19 of 99% of all lymphocytes.
T23977 400716-400794 Sentence denotes T-cell stimulation tests were markedly diminished to both antigen and mitogen.
T1106 400795-400907 Sentence denotes A presumed diagnosis of X-linked SCID was made and patient undrewent haploidentical bone marrow transplantation.
T3493 400908-400960 Sentence denotes Subsequently, CF gene analysis resulted as negative.
T54133 400961-400972 Sentence denotes Discussion:
T51830 400973-401144 Sentence denotes As outlined in the case it is essential to recognize the similarities between the presenting symptoms of CF, a relatively common genetic disease and SCID, an uncommon one.
T24644 401145-401326 Sentence denotes Although Pseudomonas is seen in increased frequency in patients with CF, it is essential to recognize that it is also a leading pathogen affecting patients with antibody deficiency.
T73376 401327-401504 Sentence denotes Review of the literature did not reveal any previous cases of individuals with SCID reported as having an increased sweat chloride, nor any explanations of why this would occur.
T77560 401505-401717 Sentence denotes While immunodeficiency has previously been associated with some forms of dwarfism, we report the first described case of Common Variable Immune Deficiency in a patient with Seckel Syndrome (Bird Headed Dwarfism).
T60451 401718-401986 Sentence denotes The diagnosis of Seckel Dwarfism, an autosomal recessive disorder, was made at 6 months of age in this boy based on intrauterine growth retardation, proportional dwarfism, microcephaly, micrognathia, and narrow face with "bird-like" large eyes and beaking of the nose.
T12 401987-402128 Sentence denotes Hematologic abnormalities are reported in an estimated 15% of such patients, and this child developed thrombocytopenia at the age of 3 years.
T29108 402129-402189 Sentence denotes By age 7, he had pancytopenia with hypocellular bone marrow.
T26701 402190-402266 Sentence denotes A low CD4 count (117/uL) was noted and both Bactrim and Neupogen were begun.
T99680 402267-402468 Sentence denotes His only significant infections, rotavirus and salmonella gastroenteritis, occurred at that time along with frequent otitis leading to PE tube placement at ages 7 and 8 but which subsequently resolved.
T2568 402469-402521 Sentence denotes He has never had opportunistic infections or thrush.
T45905 402522-402606 Sentence denotes By the age of 10 years, he required monthly red cell transfusions for severe anemia.
T88426 402607-402787 Sentence denotes After several months of transfusions, the blood bank reported that he no longer had detectable blood group antibodies during crossmatch; this led to measurement of immunoglobulins.
T11813 402788-402857 Sentence denotes IgM was undetectable with low IgA (35 mg/dL) and low IgG (545 mg/dL).
T98850 402858-402987 Sentence denotes He demonstrated no protective titers to any Pneumococcal serotypes after either conjugated or unconjugated Pneumococcal vaccines.
T53171 402988-403066 Sentence denotes Response to diphtheria, tetanus, rubeola, and influenza vaccines was adequate.
T48125 403067-403105 Sentence denotes Total hemolytic complement was normal.
T90983 403106-403170 Sentence denotes He remains lymphocytopenic (ALC = 552/uL) with low CD4 (211/uL).
T89360 403171-403313 Sentence denotes After five doses of IVIG at 400mg/kg monthly, platelets have remained between 15-20 K/uL and there has not been any improvement in the anemia.
T81562 403314-403468 Sentence denotes Although the mechanism for the bone marrow failure in these patients is presumed to be chromosomal breakage, this has not been demonstrated in this child.
T77748 403469-403551 Sentence denotes His karyotype is 46XY with no chromosomal fragility or deletions detected to date.
T72692 403552-403801 Sentence denotes Hypogammaglobulinemia should be investigated in any patient undergoing frequent transfusions who loses blood group antibodies, and suspicion of immune deficiency should remain particularly high in patients with severe growth retardation or dwarfism.
T84774 403802-403806 Sentence denotes N.L.
T65562 403807-403819 Sentence denotes Rider * , T.
T25701 403820-403839 Sentence denotes Craig, Hershey, PA.
T14154 403840-404004 Sentence denotes The objective of this study was to assess the effectiveness of physicians at a university primary care clinic in diagnosing and managing adult patients with asthma.
T80174 404005-404086 Sentence denotes A retrospective chart review of 63 adult patients from this clinic was performed.
T8096 404087-404245 Sentence denotes Each chart was evaluated using a survey instrument developed from the National Asthma Education and Prevention Program (NAEPP), which consisted of 22 queries.
T22438 404246-404296 Sentence denotes Of the charts evaluated 50 met our entry criteria.
T91616 404297-404355 Sentence denotes Overall compliance with the NAEPP recommendations was 34%.
T78494 404356-404509 Sentence denotes Adherences to the asthma guidelines in the following areas were: diagnosis (42%), treatment/disease control (60%), monitoring (15%), and education (18%).
T56865 404510-404713 Sentence denotes These data suggest that there is an opportunity to improve the care provided to patients with asthma, especially in the areas of asthma education and monitoring, even in a university outpatient facility.
T70268 404714-404827 Sentence denotes These data also suggest that NAEPP guidelines have not been effectively incorporated into primary care practices.
T31846 404828-404832 Sentence denotes B.M.
T64550 404833-404847 Sentence denotes Wahlers * , L.
T8951 404848-404860 Sentence denotes Sherwood, T.
T41601 404861-404880 Sentence denotes Craig, Hershey, PA.
T5161 404881-404891 Sentence denotes Objective:
T30715 404892-405127 Sentence denotes Our aim was to evaluate adherence to the National Heart Lung and Blood Institute (NHLBI), National Asthma Education and Prevention Program (NAEPP) diagnosis and management guidelines, regarding asthma admissions at a teaching hospital.
T98356 405128-405136 Sentence denotes Methods:
T88240 405137-405444 Sentence denotes A retrospective chart review of 197 patients over the age of 18 years admitted to the Hershey Medical Center between 1997 and 2002 with a primary diagnosis of asthma or asthma exacerbation was conducted using a 21-item questionnaire focused on key aspects of asthma care as outlined in the NAEPP guidelines.
T28488 405445-405453 Sentence denotes Results:
T90593 405454-405501 Sentence denotes Overall compliance to the guidelines was 61.5%.
T35100 405502-405600 Sentence denotes Maximal areas of compliance were noted in regards to pharmacologic treatments utilized (99%, 95%).
T28908 405601-405893 Sentence denotes Much lower levels of compliance were noted in areas of patient education (58%), instruction in written action plan prior to discharge (11%), provision of peak flow meter for home use (47%), assessment of asthma symptoms and severity (58%), and inhaled steroid prescription on discharge (69%).
T65946 405894-405905 Sentence denotes Conclusion:
T86388 405906-406033 Sentence denotes Adequate care in terms of pharmacologic treatments is being given but sub-optimal cares in other areas of the guidelines exist.
T62038 406034-406258 Sentence denotes There continues to be room for improvement in regards to asthma management, most notably in the area of education, documentation of triggers, and preparation for discharge with adequate tools to monitor and control symptoms.
T11906 406259-406270 Sentence denotes Background:
T35630 406271-406418 Sentence denotes Asthma is one of the most common problems of childhood, responsible for a significant proportion of absence from school because of chronic illness.
T64479 406419-406429 Sentence denotes Objective:
T90235 406430-406583 Sentence denotes This study was carried out among the school-aged children (7-18 years) in Tehran schools during 2002-2003, in order to determine the frequency of asthma.
T60736 406584-406592 Sentence denotes Methods:
T22428 406593-406777 Sentence denotes According to the recommendation of WHO, a questionnaire was designed, containing 8 standard questions, and the students were given necessary information to complete the questionnaires.
T65359 406778-406917 Sentence denotes The guidance and high school students completed the questionnaires but the parents of primary school students completed them by themselves.
T6417 406918-406926 Sentence denotes Results:
T82863 406927-407084 Sentence denotes Seven hundred and eight children out of 2000 children had asthma (35.4%); this prevalence was higher in the boys (37.1%), when compared to the girls (33.5%).
T48818 407085-407220 Sentence denotes The prevalence of this disease has been estimated about 39.5% in guidance schools, 35.4% in high schools and 31.6% in primary students.
T52376 407221-407456 Sentence denotes Based on this survey, the most common clinical manifestations in asthma were included: prolonged cough lasting more than 10 days (22.4%), and exerciseinduced wheezing or dyspnea (16.9%), followed by repeated dyspnea or wheezing (6.4%).
T4387 407457-407646 Sentence denotes Based on the drug responses after receiving solbutamol, the prevalence of asthma was evaluated in the range of 32.2% in primary schools, 16.7% in guidance schools and 22.9% in high schools.
T12052 407647-407659 Sentence denotes Conclusions:
T49742 407660-407857 Sentence denotes The prevalence of asthma is high among the students of Tehran schools and it needs more careful screening programmes and either more information given to the patients and parents about the disease.
T69491 407858-407969 Sentence denotes In the US, asthma is the most common chronic disease of childhood and affects approximately 5 million children.
T8493 407970-408140 Sentence denotes Reasons for inadequate asthma control include: inappropriate therapy, incorrect inhaler technique, poor compliance with treatment, and exposure to environmental triggers.
T16689 408141-408335 Sentence denotes Rates for asthma prevalence, hospitalization, and death are highest among children residing in inner cities, and important risk factors for asthma-related mortality include being poor and black.
T91875 408336-408482 Sentence denotes The communities of Braddock, North Braddock and Rankin are among the poorest in Allegheny County and are designated areas of greatest health risk.
T58079 408483-408593 Sentence denotes Recent statistics have demonstrated an increase in the number of asthma hospitalizations in these communities:
T92269 408594-408743 Sentence denotes 13.6 children per 1000, which is double the average for Allegheny County and greater than seven-times the overall US rate of asthma hospitalizations.
T34263 408744-408991 Sentence denotes Our goals were to assess asthmatic severity and appropriateness of treatment, provide asthma education, and to ensure access to healthcare for asthmatic children living in these medically underserved and predominantly African-American communities.
T68006 408992-409040 Sentence denotes Twenty-seven asthmatic children were identified.
T99649 409041-409156 Sentence denotes Of the children assessed 7% were under the age of 2 years, 19% were aged 2-5 years, and 74% were 6-14 years of age.
T88899 409157-409234 Sentence denotes Based on NHLBI guidelines the severity of each child's asthma was determined:
T21297 409235-409372 Sentence denotes 41% had mild-intermittent asthma, 15% had mildpersistent asthma, 26% had moderate-persistent asthma, and 18% had severepersistent asthma.
T37259 409373-409444 Sentence denotes The appropriateness of treatment based on severity was also determined.
T75138 409445-409693 Sentence denotes We found that 27% of the children with mild-intermittent asthma, 50% of children with mild-persistent asthma, 60% of children with moderate-persistent asthma and 100% of children with severe-persistent asthma were receiving inappropriate treatment.
T92950 409694-409769 Sentence denotes Furthermore, of the inappropriately treated children 92% were undertreated.
T3689 409770-409951 Sentence denotes Following the assessment, patients and parents were educated with regard to asthma triggers, pathophysiology, use of peak flow meters, inhaler technique and pharmacologic treatment.
T95300 409952-410011 Sentence denotes Patients were also scheduled for outpatient follow-up care.
T71617 410012-410271 Sentence denotes These results demonstrate that inappropriate treatment, especially undertreatment, may be a significant cause of the increased asthma morbidity in this population and underscore the need for aggressive education and innovative methods of ensuring health care.
T45392 410272-410274 Sentence denotes W.
T69314 410275-410289 Sentence denotes Li-Ling * , T.
T33146 410290-410306 Sentence denotes Keng-Leong, F.C.
T57555 410307-410320 Sentence denotes Stephanie, E.
T86357 410321-410339 Sentence denotes Philip, Singapore.
T72348 410340-410351 Sentence denotes BACKGROUND:
T64066 410352-410415 Sentence denotes Asthma admission is an important indicator of asthma morbidity.
T42138 410416-410515 Sentence denotes Little is known about the risk factors associated with asthma admission among high-risk asthmatics.
T59284 410516-410524 Sentence denotes PURPOSE:
T31573 410525-410620 Sentence denotes 1) To characterise the profile of high-risk asthmatics who had previous asthma hospitalization.
T2735 410621-410712 Sentence denotes 2) To identify predictors and risk factors that are associated with asthma hospitalization.
T6076 410713-410721 Sentence denotes METHODS:
T49066 410722-410881 Sentence denotes Data for consecutive high-risk asthmatics who were enrolled into our asthma program from October 2001 to May 2004 were retrieved from our prospective database.
T13053 410882-411196 Sentence denotes High-risk asthmatics were defined as patients who had a clinical diagnosis of asthma and who had at least one hospital admission for exacerbation of asthma in the preceding 12 months or at least one severe exacerbation of asthma in the preceding 6 months requiring unscheduled visit for beta2-agonist nebulisation.
T56486 411197-411399 Sentence denotes A comparison was made among high-risk asthmatics who had at least one or more hospitalization for asthma in the past 12 months prior to the asthma program enrolment with those who were not hospitalized.
T595 411400-411472 Sentence denotes Statistical analyses were performed using SPSS Version 10.1 for Windows.
T50708 411473-411481 Sentence denotes RESULTS:
T30132 411482-411643 Sentence denotes Among 521 high-risk asthmatics, 252 (48.4%) had at least one or more asthma hospitalization in the past 12 months prior to the enrolment into the asthma program.
T12536 411644-411772 Sentence denotes Hospitalization was significantly associated with female gender (63.1% with asthma admission v 43.1% without asthma admnission).
T89750 411773-412034 Sentence denotes A significantly higher proportion of asthmatics with no formal education (19.4% v 17.7%), primary education (23.8% v 16.6%) and secondary education (32.1% v 29.3%) were hospitalized for asthma as compared to the those who had tertiary education (24.6% v 36.5%).
T29286 412035-412182 Sentence denotes Those admitted were predominantly in lower income group, had poor inhaler technique and have no ownership of an asthma action plan (33.3% v 76.6%).
T37373 412183-412352 Sentence denotes Those hospitalized were also younger, median age 37years (19, 62) v 35years (15, 84) and had a lower first peak flow reading, 260L/Min (130, 500) v 300L/Min (150, 480) .
T32961 412353-412364 Sentence denotes CONCLUSION:
T93610 412365-412473 Sentence denotes Among high-risk asthmatics, certain population subgroups are at greater risk for hospitalization for asthma.
T96316 412474-412570 Sentence denotes Intervention aimed to reduce asthma morbidity should take the above findings into consideration.
T91873 412571-412737 Sentence denotes Introduction An association between asthma symptoms and air quality is well established, but controversy exists concerning the role of various air quality indicators.
T63060 412738-412882 Sentence denotes The association of San Antonio air quality with emergency department (ED) visits for asthma at our military medical center has not been defined.
T33904 412883-413084 Sentence denotes The objective of this study is to determine the correlation of selected air quality indicators in San Antonio with ED visits for asthma for both the general population and for the pediatric population.
T93583 413085-413278 Sentence denotes Methods Selected air quality indicators were the 8-hr air quality index (AQI) for ozone, 24-hr AQI for particulate matter < 2.5 μm, pollen counts, mold spore counts, and daily high temperature.
T58043 413279-413355 Sentence denotes The number of daily ED visits coded for asthma was obtained retrospectively.
T45365 413356-413428 Sentence denotes Pediatric visits (patients < 18 years-old) were evaluated as a subgroup.
T17519 413429-413501 Sentence denotes Pearson correlation coefficients (r) were calculated for all data pairs.
T88897 413502-413584 Sentence denotes Results During the 331 days of the study period, there were 491 visits for asthma.
T45964 413585-413621 Sentence denotes Of these visits, 151 were pediatric.
T56780 413622-413724 Sentence denotes The number of daily visits ranged from 0 to 6 for all visits and from 0 to 3 for the pediatric visits.
T85964 413725-414017 Sentence denotes R values for all visits were -0.067, -0.069, 0.110, -0.011, and -0.218; for pediatric visits, -0.055, -0.036, 0.033, -0.010, and -0.074 for the 8-hr AQI for ozone, 24-hr AQI for particulate matter < 2.5 μm, total pollen grains/m 3 , mold spores/m 3 , and daily high temperature, respectively.
T7378 414018-414200 Sentence denotes In addition to calculating r values for same-day air quality indicators and ED visits, r values were also calculated for a 3-day average of air quality indicators with the ED visits.
T16154 414201-414538 Sentence denotes For the 3-day averages, r values for all visits were -0.113, -0.117, 0.127, -0.071, and -0.267; for pediatric visits, -0.081, -0.011, 0.025, 0.017, and -0.063 for the 3-day averages of the 8-hr AQI for ozone, 24-hr AQI for particulate matter < 2.5 μm, total pollen grains/m 3 , mold spores/m 3 , and daily high temperature, respectively.
T2137 414539-414715 Sentence denotes Conclusion There was no significant correlation between the selected air quality indicators and ED visits for asthma, either for the general population or for pediatric visits.
T60552 414716-414905 Sentence denotes This study provides no evidence that air quality is linked to ED visits for asthma in San Antonio but the degree to which air quality in San Antonio affects asthma symptoms remains unclear.
T26343 414906-414919 Sentence denotes Introduction:
T30914 414920-415034 Sentence denotes The aim of this study was to evaluate the level of NO in the exhaled air of patients suffering from chronic cough.
T39189 415035-415043 Sentence denotes Methods:
T92084 415044-415196 Sentence denotes The study was performed on 213 young (mean age 28.5 +/-8.2 years), nonsmoking patients with chronic cough referred to the Allergy Clinic for evaluation.
T53703 415197-415290 Sentence denotes Bronchial provocation challenge with histamine was performed according to the method of Ryan.
T58928 415291-415373 Sentence denotes Exhaled NO was measured on-line using a chemiluminescence analyzer (Sievers, USA).
T74808 415374-415431 Sentence denotes All patients had resting spirometry within normal values.
T78220 415432-415440 Sentence denotes Results:
T4045 415441-415592 Sentence denotes Significant bronchoconstrictive response to histamine at a concentration equal to or lower than 8 mg/ml (PC20 8mg/ml) was found in 65 patients (30.5%).
T57947 415593-415757 Sentence denotes These patients had a significantly greater mean concentration of NO in the exhaled air (80.6+/-59.4 ppb) than those with a PC20>8mg/ml (28.4 +/-29.2 ppb; p<0.0001).
T28685 415758-415965 Sentence denotes Receiver Operating Characteristic (ROC) curve analysis revealed that it is possible to identify from among patients suffering chronic cough those who have significant bronchial hyperreactivity (PC20 8mg/ml).
T1628 415966-416110 Sentence denotes Using 40 ppb as a cut-off value for the exhaled NO concentration, the specificity for bronchial hyperreactivity was 86.5% and sensitivity 72.3%.
T688 416111-416122 Sentence denotes Conclusion:
T17035 416123-416245 Sentence denotes Assessment of NO concentration is helpful in the assessment of bronchial hyperreactivity in patients having chronic cough.
T5202 416246-416248 Sentence denotes L.
T63384 416249-416262 Sentence denotes Abetz 1* , J.
T58131 416263-416278 Sentence denotes Bousquet 2 , E.
T25189 416279-416293 Sentence denotes Juniper 3 , E.
T6178 416294-416308 Sentence denotes Bateman 4 , H.
T4950 416309-416323 Sentence denotes Boushey 5 , W.
T76127 416324-416336 Sentence denotes Busse 6 , T.
T54665 416337-416349 Sentence denotes Clark 7 , R.
T82466 416350-416364 Sentence denotes Pauwels 8 , S.
T21042 416365-416380 Sentence denotes Pedersen 9 , 1.
T42327 416381-416411 Sentence denotes Manchester, United Kingdom; 2.
T12183 416412-416434 Sentence denotes Montpelier, France; 3.
T46716 416435-416455 Sentence denotes Ancaster, Canada; 4.
T62255 416456-416483 Sentence denotes Cape Town, South Africa; 5.
T38642 416484-416505 Sentence denotes San Francisco, CA; 6.
T5215 416506-416521 Sentence denotes Madison, WI; 7.
T28358 416522-416548 Sentence denotes London, United Kingdom; 8.
T48174 416549-416567 Sentence denotes Ghent, Belgium; 9.
T44753 416568-416585 Sentence denotes Kolding, Denmark.
T44273 416586-416599 Sentence denotes Introduction:
T35564 416600-416709 Sentence denotes The ACQ has been developed as a measure of asthma control for use in clinical practice or in clinical trials.
T24717 416710-416930 Sentence denotes The reliability, validity and responsiveness have previously been demonstrated for the original 7 item ACQ, the 6 item (minus FEV1 question) and 5 item (minus FEV1 and short acting bronchodilator use questions) versions.
T36597 416931-417112 Sentence denotes Data from the 1-year Gaining Optimal Asthma controL (GOAL) study was used to assess the predictive value of the ACQ s 7, 6, and 5 item versions in determining asthma control status.
T72243 417113-417120 Sentence denotes Method:
T69523 417121-417355 Sentence denotes Receiver operating characteristic curves (ROC curves), plotting true positive rates versus false positive rates for different ACQ cut-points, were used to determine optimum cut points for Totally Controlled and Well-Controlled asthma.
T94907 417356-417440 Sentence denotes Scores for the 7, 6, and 5 item versions of the ACQ were examined at 0.25 intervals.
T78411 417441-417449 Sentence denotes Results:
T85315 417450-417706 Sentence denotes When predicting Totally Controlled asthma, the areas under the ROC curves (AROCC) were 0.88/0.88/0.86 for the 7, 6 and 5 item versions, respectively; and when predicting Well-Controlled asthma the AROCC were 0.86/0.86/0.84 for the 7, 6 and 5 item versions.
T34343 417707-417784 Sentence denotes In both predictive models, the 7 and 6 item versions provided the best AROCC.
T37629 417785-417999 Sentence denotes For the 7 and 5 item versions, the best cut-off point to predict Totally Controlled asthma was <=0.75, with AROCC of 0.81/0.79, and corresponding sensitivity of 0.74/0.71 and specificity of 0.89/0.88, respectively.
T54969 418000-418121 Sentence denotes For the 6 item version the best cut-off point was <=0.5, with AROCC of 0.82, sensitivity of 0.76 and specificity of 0.87.
T68579 418122-418391 Sentence denotes The best cut-off points for predicting Well-Controlled asthma were <=1.25 for the 7 item version (AROCC=0.77; sensitivity=0.70; specificity=0.83), and <=1 point for the 6 and 5 item versions (AROCC=0.77/0.75; sensitivity=0.70/0.69; specificity=0.83/0.81, respectively).
T31684 418392-418403 Sentence denotes Conclusion:
T73370 418404-418500 Sentence denotes Results indicate the sensitivity and specificity of the ACQ in predicting asthma control status.
T34007 418501-418717 Sentence denotes A 29 yo black male with asthma and allergic rhinitis developed gradually worsening cough productive of clear to yellow sputum despite treatment with high dose fluticasone, salmeterol, monteleukast, and PRN albuterol.
T92265 418718-418801 Sentence denotes Asthma history was significant for an intubation at age 10 and pneumonia at age 28.
T39975 418802-418864 Sentence denotes Physical exam revealed pale turbinates and expiratory wheezes.
T17213 418865-419011 Sentence denotes Pulmonary function test showed a severe obstructive lung defect with FEV1 1.52 (38%), improving by 4% after bronchodilator and FEV1/FVC ratio 54%.
T26727 419012-419114 Sentence denotes A chest CT revealed significant bronchiectasis in the right middle lobe, lingula and both lower lobes.
T55387 419115-419270 Sentence denotes Evaluation for bronchiectasis showed normal quantitative immunoglobulins, subclasses, and humoral responses, rendering innate immunodeficiency less likely.
T38532 419271-419402 Sentence denotes The diagnosis of allergic bronchopulmonary aspergillosis was entertained, but IgE was 500kU/L and aspergillus titers were negative.
T91795 419403-419532 Sentence denotes A sinus CT failed to show active disease, yet the patient reported chronic yellow nasal discharge despite courses of antibiotics.
T82004 419533-419643 Sentence denotes Although he was sexu-ally active with several male partners, HIV testing was negative 2 times, 6 months apart.
T8332 419644-419742 Sentence denotes Evaluation for cystic fibrosis (CF) showed no symptoms of malabsorption and a negative sweat test.
T5189 419743-419980 Sentence denotes Other tests revealed normal -1 antitrypsin level, P-ANCA, ESR, ACE level, and negative sputum for AFB and mycobacteria, helping to exclude other conditions such as 1-antitrypsin deficiency, vasculitis, sarcoidosis, and chronic infection.
T31673 419981-420096 Sentence denotes With no definitive answer, the diagnosis of CF was pursued, but genetic screening as well as mapping were negative.
T69073 420097-420245 Sentence denotes The diagnosis of primary ciliary dyskinesia was then entertained; however, a mucosal biopsy of the nose did not reveal any structural abnormalities.
T88289 420246-420442 Sentence denotes Finally, a sperm analysis revealing azoospermia confirmed the diagnosis of Young's syndrome, a rare disease with features similar to CF including bronchiectasis, chronic sinusitis and azoospermia.
T2450 420443-420623 Sentence denotes In Young's syndrome however, there is an obstructive process rather than a lack of vas deferens resulting in azoospermia and normal sweat chloride, genetic, and pancreatic testing.
T47941 420624-420820 Sentence denotes This case demonstrates the importance of investigating a persistently productive cough in an asthmatic patient and the differential diagnosis as well as the appropriate work up for bronchiectasis.
T85296 420821-420928 Sentence denotes A final diagnosis is important since appropriate management in each situation may affect long term outcome.
T20875 420929-420933 Sentence denotes A.G.
T15440 420934-420955 Sentence denotes Palma-Carlos * , M.L.
T91647 420956-420987 Sentence denotes Palma-Carlos, Lisboa, Portugal.
T77921 420988-421001 Sentence denotes Introduction:
T68870 421002-421174 Sentence denotes Bronchial challenges are currently done in allergic asthma with allergen, histamine or metacholine.Bronchial reactivity to allergens and histamine can probably be variable.
T85722 421175-421324 Sentence denotes Purpose to evaluate if the dose of allergen and histamine triggering a significant bronchial obstruction are always correlated in asthmatic patients.
T12376 421325-421333 Sentence denotes Methods:
T98828 421334-421397 Sentence denotes A Vitalograph model Compact has been used throughout the study.
T81611 421398-421476 Sentence denotes Allergen challenge has been done with an acqueous solution of house dust mite.
T96527 421477-421583 Sentence denotes Bronchial challenges with placebo (sodium chloride) histamine or allergens have been done in all patients.
T63283 421584-421775 Sentence denotes For the provocations with histamine or allergens the threshold dose, inducing a decrease in FEV1 greater than 15% has been determined in all the cases, as well for histamine as for allergens.
T69196 421776-421923 Sentence denotes A second challenge has been done in all patients with a supra-threshold dose of histamine or allergen corresponding to the double of the threshold.
T11373 421924-421932 Sentence denotes Results:
T21626 421933-422013 Sentence denotes 30 provocations have been done in 10 patients either with histamine or allergen.
T18951 422014-422049 Sentence denotes 6 were allergic and 4 non allergic.
T85285 422050-422289 Sentence denotes The threshold dose for histamine were between 5 and 25 ug. in allergic patients and 250 and 500 ug. in non allergic patients.In allergic patients after histamine threshold challenge mean decrease was for FEV1 19, 2% and for FEV1/VC 17, 3%.
T19195 422290-422356 Sentence denotes For supra-threshold dose FEV1 decreases 37, 8% and FEV1/VC 32, 8%.
T90921 422357-422423 Sentence denotes After allergen challenge FEV1 decreases 20, 3% and FEV1/VC 15, 8%.
T77729 422424-422492 Sentence denotes With supra threshold doses FEV1 decreases 28, 6% and FEV1/VC 29, 3%.
T72338 422493-422566 Sentence denotes In 4 non allergic patients there was no changes after allergen challenge.
T67644 422567-422766 Sentence denotes A good correlation in constriction induced by histamine or allergen either for threshold or supra threshold doses (p<0.001) was observed but not between the threshold doses of histamine and allergen.
T6722 422767-422779 Sentence denotes Conclusions:
T88624 422780-423054 Sentence denotes These results confirm that bronchial obstruction can be triggered by allergens and mediators that the sensitivity of FEV1 and FEV1/VC for evaluation are roughly comparable after challenge and points to a better sensitivity of a supra threshold dose of allergen or mediators.
T1838 423055-423121 Sentence denotes Allergen and histamine challenges don't give the same information.
T7886 423122-423135 Sentence denotes Introduction:
T6617 423136-423410 Sentence denotes Peak expiratory flow rate (PFR) and forced expiratory volume in the first second (FEV1) are currently used in functional evaluation of asthmatic patients but his degree of correlation in obstructive, restrictive and mixed spirometric ventilatory patterns are not well known.
T31068 423411-423606 Sentence denotes The purpose of this study was to evaluate if the correlation between PFR and FEV1 2 markers of global airways obstruction is comparable in asthmatic patients with obstruction restriction or both.
T23523 423607-423615 Sentence denotes Methods:
T8035 423616-423779 Sentence denotes 152 asthmatic patients, 69 males, 83 females have been studied by spirometry with a Vitalograph Compact in absence of bronchodilatory or anti-inflammatory therapy.
T64885 423780-423864 Sentence denotes Patients have been classified in 4 functional patterns according to VC, and FEV1/CV:
T66598 423865-424159 Sentence denotes Normal : VC greater than 90% of expected value and FEV1/VC greater than 70%, obstructive:VC greater than 90% and FEV1/VC greater than 70% restrictive VC, less than 90% and FEV1/VC greater than 70% and mixed VC less than 90% and FEV1/VC less than 55% presenting a so called functional emphysema.
T45033 424160-424168 Sentence denotes Results:
T55733 424169-424266 Sentence denotes According to these criteria 15 patients were normal, 44 restrictive, 15 obstructive and 78 mixed.
T29110 424267-424398 Sentence denotes In all the group the correlation between PFR and FEV1 was statiscally significant (P<001) but the correlation coefficient variable.
T50194 424399-424568 Sentence denotes In functionally normal patients r =+0, 74 in restrictive patients + 0, 67 in obstructive + 0, 66 in mixed + 0, 84 and in the sub-group with functional emphysema + 0, 96.
T71089 424569-424656 Sentence denotes For this sub-group the correlation coefficient R allows to define FEV1 = 91 + 5, 6 PFR.
T19174 424657-424669 Sentence denotes Conclusions:
T68398 424670-424964 Sentence denotes The report between the two most usual assays of global bronchial obstruction depends on the balance between restriction, (either by interstial fibrosis or hyperinflation) and obstruction and is more close when a more marked obstruction coexist with a restrictive pattern (functional emphysema).
T84469 424965-425059 Sentence denotes In practice PFR has the same value that FEV1 only in more severe cases of ventilatory failure.
T14433 425060-425175 Sentence denotes The dispersion of values and the standard error or regression do not allow to correlate both data in most patients.
T34223 425176-425189 Sentence denotes Introduction:
T66272 425190-425303 Sentence denotes The TENOR study longitudinally observes the natural history of subjects with severe or difficult-to-treat asthma.
T90591 425304-425401 Sentence denotes This analysis assessed the association between previous and future asthma exacerbations in TENOR.
T9008 425402-425410 Sentence denotes Methods:
T72189 425411-425543 Sentence denotes Subjects eligible for this analysis were 12 years of age at baseline and had at least one follow-up assessment in year 1 and year 2.
T65331 425544-425797 Sentence denotes Recent asthma exacerbations in the past 3 months were defined as: asthma-related emergency room (ER) visits, nights of hospitalization, unscheduled physician office contacts; or as a composite measure of at least one of the previous exacerbation events.
T79210 425798-425921 Sentence denotes Relative risks (RRs) and 95% confidence limits (95%CI) were generated comparing exacerbations in year 2 relative to year 1.
T70138 425922-426018 Sentence denotes Exacerbation rates were defined as the number of events divided by total patient follow-up time.
T14788 426019-426076 Sentence denotes No adjustment was performed for baseline characteristics.
T36064 426077-426085 Sentence denotes Results:
T10368 426086-426132 Sentence denotes 2826 subjects were eligible for this analysis.
T66626 426133-426163 Sentence denotes RRs in year 2 vs. year 1 were:
T70800 426164-426175 Sentence denotes 3.9 (95%CI:
T6152 426176-426229 Sentence denotes 3.3-4.6) for unscheduled office contacts, 4.1 (95%CI:
T45627 426230-426293 Sentence denotes 3.48-4.82) for the composite exacerbation measure, 10.2 (95%CI:
T71613 426294-426334 Sentence denotes 7.8-13.4) for ER visits and 15.1 (95%CI:
T93135 426335-426375 Sentence denotes 9.8-23.3) for nights of hospitalization.
T80175 426376-426613 Sentence denotes Over 37% of subjects with 5 or more exacerbations (composite measure) in year 1 had a similarly high rate in year 2 compared to 3% of patients without an event in year 1 who went on to have 5 or more exacerbations in year 2 (see Table) .
T49859 426614-426852 Sentence denotes Conclusion: TENOR subjects who experienced an asthma exacerbation in year 1 were at statistically significantly increased risk of subsequent exacerbations the following year compared to subjects not experiencing an exacerbation in year 1.
T67564 426853-426978 Sentence denotes This increased risk was consistent for all asthma exacerbation outcomes and most elevated for hospitalizations due to asthma.
T17568 426979-427133 Sentence denotes Assessment of recent asthmarelated healthcare use is a critical component of the clinical evaluation of subjects with severe or difficult-to-treat asthma.
T89184 427134-427193 Sentence denotes Funded by Genentech Inc. and Novartis Pharmaceuticals Corp.
T12095 427194-427205 Sentence denotes BACKGROUND:
T97016 427206-427291 Sentence denotes Preliminary studies investigating yoga and breathwork for asthma have been promising.
T33984 427292-427480 Sentence denotes Several randomized controlled trials have shown a benefit from yoga postures and/or breathing versus control, but the control in these cases involved no intervention other than usual care.
T84705 427481-427542 Sentence denotes This study advances the field by providing an active control.
T80919 427543-427551 Sentence denotes METHODS:
T66479 427552-427836 Sentence denotes A randomized, controlled, double-blind clinical trial was conducted from October 2001 to March 2003 to determine the effectiveness and feasibility of a yoga and breathwork intervention for improving clinical indices and quality of life for adult patients with mild to moderate asthma.
T18357 427837-427979 Sentence denotes Random assignment was made to either a 4-week yoga intervention that included both postures and breathwork, or a stretching control condition.
T59479 427980-428185 Sentence denotes Outcome measures were assessed at 4, 8, 12 and 16-weeks and included the Mini Asthma Quality of Life Questionnaire (Mini-AQLQ), rescue inhaler use, spirometry, symptom diaries, and health care utilization.
T35242 428186-428194 Sentence denotes RESULTS:
T68541 428195-428322 Sentence denotes Sixty-two participants were randomized into the intervention and control groups, and 45 completed the final follow-up measures.
T21791 428323-428365 Sentence denotes Intention-to-treat analysis was performed.
T52789 428366-428631 Sentence denotes Significant within-group differences in post-bronchodilator FEV1 and morning symptom score were apparent in both intervention and control groups at 4 and 16 weeks; however, no significant differences between groups were observed on any outcome measures.CONCLUSIONS:
T9601 428632-428705 Sentence denotes Iyengar yoga conferred no appreciable benefit in mild to moderate asthma.
T83314 428706-428805 Sentence denotes Circumstances under which yoga is of benefit in asthma management, if any, remain to be determined.
T14417 428806-428864 Sentence denotes In order to investigate asthma mortality trends for the U.
T68981 428865-428867 Sentence denotes S.
T10513 428868-428970 Sentence denotes Hispanic population, I have collected and graphed data from the National Center for Health Statistics.
T21900 428971-429128 Sentence denotes Mortality data for the Hispanic population have been available for the entire United States only since 1997 and readily available for asthma only since 1999.
T48639 429129-429303 Sentence denotes These data indicate decreases in deaths from asthma (J45-J46) from 320 in 1999 to 274 in 2001 with decreases in the non-Hispanic population from 4324 in 1999 to 3976 in 2001.
T1867 429304-429485 Sentence denotes Rates of death from asthma decreased for the Hispanic population from 1.0 per 100, 000 in 1999 to 0.7 in 2001, while that for the non-Hispanic population decreased from 1.84 to 1.6.
T19227 429486-429550 Sentence denotes Rates for non-Hispanic whites decreased from 1.5 to 1.4 in 2001.
T97359 429551-429630 Sentence denotes Rates of death from asthma have been twice as high among Hispanic women as men.
T8777 429631-429822 Sentence denotes Rates of death from asthma for non-Hispanic blacks have been more than twice as high as those for non-Hispanic whites. (National Center for Health Statistics data dictate racial terminology).
T36177 429823-429885 Sentence denotes Data for people of Hispanic origin include people of any race.
T30015 429886-430070 Sentence denotes These data are affected by both underreporting of Hispanic origin on death certificates and undercoverage in the census and resultant population estimates for a net correction of 1.6%.
T39419 430071-430221 Sentence denotes Thus, rates of death from asthma have been lower and have been decreasing faster among Hispanics than the rest of the population in the United States.
T50504 430222-430316 Sentence denotes Allergic rhinitis and asthma are both highly prevalent diseases and often coexist in patients.
T23448 430317-430378 Sentence denotes Rhinitis symptoms have been shown to impact the lower airway.
T5387 430379-430500 Sentence denotes As such, the impact of rhinitis on asthma control may be the greatest in patients with the most severe rhinitis symptoms.
T52525 430501-430815 Sentence denotes Therefore, this analysis was performed to determine the impact of baseline rhinitis severity on asthma control in patients with both asthma and allergic rhinitis who received either fluticasone propionate aqueous nasal spray (FPANS) or montelukast (MON) added to fluticasone propionate/salmeterol 100/50 mcg (FSC).
T51027 430816-431006 Sentence denotes A total of 863 patients (>15 years) with persistent asthma and seasonal allergic rhinitis received FPANS 200mcg QD, MON 10mg QD or placebo (PBO) in addition to FSC 100/50mcg BID for 4 weeks.
T22328 431007-431076 Sentence denotes At baseline, total nasal symptom scores (TNSS) ranged from 44 to 400.
T91176 431077-431173 Sentence denotes The analysis was restricted to patients whose pre-enrollment asthma therapy did not include FSC.
T32568 431174-431374 Sentence denotes Regardless of baseline rhinitis severity, in patients with both asthma and allergic rhinitis, MON added to FSC resulted in no additional improvements in overall asthma control compared with FSC alone.
T96312 431375-431667 Sentence denotes These data suggest that optimal treatment of the individual conditions should be the goal of treatment for patients with coexistent allergic rhinitis and asthma. (SAM40066) Introduction Recent studies have demonstrated that parainfluenza and coronaviruses are as important triggers of asthma.
T76064 431668-431753 Sentence denotes Parainfluenza viruses are one of the main triggers of virus-induced asthma at summer.
T87246 431754-431906 Sentence denotes Parainfluenza viruses often cause severe low respiratory tract infections in immuncompromised patients and in patients with bone marrow transplantation.
T3734 431907-432060 Sentence denotes A retrospective study found that 41% of pediatric BMT patients with HPIV infection (47% of viral respiratory infections) developed pneumonia and 6% died.
T44895 432061-432102 Sentence denotes Both viruses contributed to fatal asthma.
T20416 432103-432367 Sentence denotes Materials and methods For amplification of these viruses, primers which anneal to specific regions of viral genomes: HN-gene for PIV1, PIV2 and PIV3 and spike glycoprotein gene for coronavirus OC43 and nucleocapsid glycoprotein gene for coronavirus 229E were used.
T17997 432368-432475 Sentence denotes PCRdiagnostics was performed on nasal and throat swabs taken from children with atopic asthma exacerbation.
T84879 432476-432578 Sentence denotes Results From 02/04 to 05/04 a total of 56 samples (including 28 negative controls) were tested by PCR.
T14826 432579-432707 Sentence denotes 11 positive for respiratory viruses samples noted in children having asthma exacerbations including 23.9% of all tested samples.
T17458 432708-432805 Sentence denotes PIV3 was detected in 54.5% of all positive samples, PIV2 in 18.2%, and coronavirus OC43 in 27.3%.
T70305 432806-432868 Sentence denotes PIV2 and coronavirus 229E were not detected during this study.
T36076 432869-432956 Sentence denotes For negative controls samples were taken from children with atopic asthma in remission.
T67834 432957-433012 Sentence denotes All 10 controls were found to be negative by viral PCR.
T68844 433013-433105 Sentence denotes Conclusions Respiratory viruses are an important factor in asthma exacerbations in children.
T29677 433106-433171 Sentence denotes PIV3 was the most frequently detected among the positive samples.
T8632 433172-433372 Sentence denotes Although HPIV-2 was less often positive than HPIV-1 and HPIV-3 infections in this study, the frequency of the detected coronaviruses may have been influenced by the seasonal activity of these viruses.
T98068 433373-433386 Sentence denotes Introduction.
T70557 433387-433484 Sentence denotes In Budapest all children come under the regular supervision of a specially trained paediatrician.
T40586 433485-433588 Sentence denotes Each paediatrician is responsible for an average of 950 children, often seen up to the age of 18 years.
T74732 433589-433597 Sentence denotes Methods.
T76023 433598-433715 Sentence denotes A questionnaire was sent to the district paediatricians of Budapest in 1995 Budapest in , 1999 Budapest in and 2003 .
T78833 433716-433809 Sentence denotes The total number of children in their practice and the number of the asthmatics was assessed.
T81315 433810-433944 Sentence denotes The diagnosis of asthma in every case was established in a paediatric hospital, or a special allergy or pulmonology outpatient clinic.
T34896 433945-433953 Sentence denotes Results.
T88405 433954-434130 Sentence denotes In 1995, replies were received from 118 paeditricians, who were responsible for the supervision of 104, 087 children, of which 1.88 ± 0.87% had been diagnosed as having asthma.
T274 434131-434289 Sentence denotes In 1999 replies were sent by 153 physicians, who had a total of 142, 684 children under their care, including 3, 228 asthmatics, a prevalence of 2.26 ± 0.95%.
T84468 434290-434425 Sentence denotes At the end of 2003, 151 paediatricians having 141, 276 children answered, noting 3, 831 asthmatics, a 2.71 ± 1.2% prevalence of asthma.
T53433 434426-434437 Sentence denotes Conclusion.
T58346 434438-434535 Sentence denotes The current survey of prevalence of asthma in childhood is by far the largest that has been made.
T71648 434536-434704 Sentence denotes An increasing prevalence of the diagnosis of asthma based on clinical investigations was noted, the differences between the investigated years being highly significant.
T67481 434706-434859 Sentence denotes Panel Report Guidelines for the Diagnosis and Management of Asthma have been available since 1991, to standardize and improve the quality of asthma care.
T18117 434860-434948 Sentence denotes However, asthma remains the leading cause of hospitalization for New York City children.
T33563 434949-435038 Sentence denotes Implementation of the guidelines has not been fully embraced in the primary care setting.
T29884 435039-435150 Sentence denotes We attempted to increase primary care practitioners' compliance with the guidelines through extensive training.
T57830 435151-435382 Sentence denotes A hospital based pediatric clinic and 4 school based health clinics in the Brooklyn inner city, participated from April 2002 to March 2003 in the program as part of New York City's Education and Quality Improvement Project (EQuIP).
T21824 435383-435522 Sentence denotes Initially an asthma physician specialist and asthma educator trained the primary care physicians and nurse practitioners in the guidelines.
T48722 435523-435584 Sentence denotes The training was reinforced during monthly luncheon sessions.
T48997 435585-435699 Sentence denotes Clinical exam rooms were also supplied with asthma education materials, peak flow meters, and asthma action plans.
T94254 435700-435861 Sentence denotes Goals were to identify asthmatics, document asthma severity, give persistent asthmatics written management plans, and utilize appropriate controller medications.
T22995 435862-435939 Sentence denotes Compliance was measured by tracking asthma visits with an asthma intake form.
T5703 435940-436138 Sentence denotes Prior to this project no consistent attempt had been made in the clinics to regularly classify asthmatic severity, provide written asthma action plans or to place patients on controller medications.
T89345 436139-436298 Sentence denotes After onset of the project a total of 216 asthma visits were evaluated; 104 were from school based health centers and 113 from hospital based pediatric clinic.
T30668 436299-436356 Sentence denotes Severity was classified in 83%(179/216) of asthma visits.
T20980 436357-436524 Sentence denotes Patients classified as persistent received updated written management plan during 90%(100/110) of asthma visits and 92%(102/110) were placed on controller medications.
T18108 436525-436662 Sentence denotes This asthma management program demonstrated success in improving primary care practitioners' compliance with the NAEPP Asthma guidelines.
T73901 436663-436837 Sentence denotes Further studies are needed to determine if compliance with the guidelines persisted after cessation of the extensive training and if such compliance improves asthma outcomes.
T76607 436838-436890 Sentence denotes Numerous studies have associated asthma and obesity.
T1768 436891-437031 Sentence denotes Although obesity has been identified as a risk factor for asthma, there is limited information on the impact of obesity on childhood asthma.
T1002 437032-437137 Sentence denotes This study examines the effect of body composition on asthma severity and pulmonary function in children.
T21822 437138-437300 Sentence denotes We retrospectively reviewed charts from asthmatic children ages 5 to 18 years, referred to a community-based pediatric pulmonology practice between 1999 and 2003.
T15804 437301-437400 Sentence denotes Data were included if asthma was the the primary diagnosis and a baseline spirometry was available.
T74485 437401-437504 Sentence denotes Asthma severity was classified and body mass Index(BMI) was classified as normal, overweight and obese.
T86575 437505-437538 Sentence denotes Spirometry results were reviewed.
T74956 437539-437574 Sentence denotes Eighty-five patients were reviewed.
T90239 437575-437672 Sentence denotes Thirtyone(36.5%) patients were normal weight; 21(24.7%) were overweight and 33(38.8%) were obese.
T25868 437673-437750 Sentence denotes Baseline characteristics such as age, gender and race/ethnicity were similar.
T56472 437751-437843 Sentence denotes Asthma severity classification did not differ between normal, overweight and obese children.
T56987 437844-437965 Sentence denotes Overall, 34% were classified as intermittent, 53% as persistent mild asthma and 13% as persistent moderate-severe asthma.
T87522 437966-438128 Sentence denotes 21% of children with intermittent asthma were receiving controller therapy compared to 62.5% with persistent mild and 81.8% with moderate-severe asthma(p=0.0001).
T37885 438129-438406 Sentence denotes Although healthcare utilization for asthma(emergency room visits/admissions) were significantly different between children with intermittent, persistent mild and moderate-severe asthma(p=0.0004), there was no difference when normal, overweight and obese children were compared.
T9219 438407-438575 Sentence denotes Spirometry results showed comparable peak expiratory flow rates(PFR) in all groups; 75% of predicted in normal weight and 79% of predicted in both overweight and obese.
T65762 438576-438729 Sentence denotes Mean forced vital capacity(FVC) was 93.9%, 88.5% and 95% and the mean forced expiratory volume in 1 second(FEV1) was 85.9%, 81.2% and 86.6% respectively.
T45142 438730-438883 Sentence denotes There was no difference in FEV1/FVC; 82.3%, 83.1% and 81.8% and forced expiratory flow in mid-lung volumes (FEF25-75); 74.4%, 73% and 76.9% of predicted.
T56950 438884-438994 Sentence denotes In this study we retrospectively reviewed asthmatic children and compared BMI, asthma severity and spirometry.
T8888 438995-439097 Sentence denotes We found no difference in asthma severity classification between normal and overweight/obese patients.
T63419 439098-439160 Sentence denotes Regardless of the BMI, all indices of spirometry were similar.
T95129 439161-439266 Sentence denotes Further studies are needed to examine the impact of obesity on different asthma related disease outcomes.
T85068 439267-439463 Sentence denotes Our objective is to further investigate the effect of budesonide, formoterol, and levalbuterol, alone, and in combination, on TGF-1 production and expression in ragweed (RA) stimulated A549 cells.
T82758 439464-439609 Sentence denotes METH-ODS: A549 cells were cultured in duplicate for 24 hours at 37 degrees celcius with 5% CO 2 in serum free DMEM with or without the following:
T73440 439610-439711 Sentence denotes 10μg/ml of RA, 1.0 x 10 -7 M of budesonide, 1.3 x 10 -7 M formoterol, and 1.0 x 10 -5 M levalbuterol.
T88946 439712-439826 Sentence denotes TGF-1 production and expression was measured by a sensitive ELISA and mRNA assay in cell supernatants and pellets.
T15562 439827-440158 Sentence denotes RESULTS: TGF-1 production and expression from A549 cells rose markedly in the presence of RA (952.35 -1268 pg/ml) (59 -71 amol/ml) with significant inhibition following the addition of budesonide, and the combinations of budesonide and formoterol, budesonide and levalbuterol, and budesonide, formoterol, and levalbuterol (p<0.05).
T33034 440159-440295 Sentence denotes Combined treatment with budesonide and levalbuterol versus budesonide alone reached significance for production and expression (p<0.05).
T55487 440296-440404 Sentence denotes Budesonide and formoterol compared with budesonide alone reached significance for TGF-1 production (p<0.05).
T87614 440405-440416 Sentence denotes CONCLUSION:
T70685 440417-440566 Sentence denotes Combination therapy with budesonide and a long or short acting beta-agonist showed greater effect of TGF-1 inhibition compared with budesonide alone.
T85373 440567-440682 Sentence denotes This synergistic effect on the distal airways may prevent a subset of asthmatics from developing airway remodeling.
T56314 440683-440685 Sentence denotes G.
T43971 440686-440700 Sentence denotes Tamura 1* , Y.
T19552 440701-440712 Sentence denotes Sano 2 , K.
T33142 440713-440726 Sentence denotes Hirata 3 , S.
T70878 440727-440741 Sentence denotes Ishioka 4 , M.
T18657 440742-440758 Sentence denotes Nakashima 5 , T.
T87044 440759-440774 Sentence denotes Miyamoto 2 , 1.
T30684 440775-440792 Sentence denotes Sendai, Japan; 2.
T37547 440793-440809 Sentence denotes Tokyo, Japan; 3.
T76619 440810-440826 Sentence denotes Osaka, Japan; 4.
T43479 440827-440847 Sentence denotes Hiroshima, Japan; 5.
T76711 440848-440865 Sentence denotes Hamamatsu, Japan.
T13840 440866-441013 Sentence denotes Tulobuterol tape is the world's first long-acting transdermal preparation of a beta2-agonist designed to release tulobuterol in an optimal fashion.
T13284 441014-441167 Sentence denotes When it is applied once daily at bedtime, the blood concentration of tulobuterol peaks early in the morning and is kept at effective levels for 24 hours.
T22417 441168-441378 Sentence denotes Tulobuterol tape has milder and less frequent adverse events than conventional oral tulobuterol preparations, and when used at bedtime can prevent marked drop in peak expiratory flow (PEF) early in the morning.
T82037 441379-441473 Sentence denotes Consequently, tulobuterol tape has been commonly used in Japan as a long-acting beta2-agonist.
T64991 441474-441735 Sentence denotes In the present study, to evaluate its efficacy as a long-acting beta2-agonist and to compare its effects at two different doses, we administered tulobuterol tape at doses of 1 or 2 mg/day to patients with persistent asthma already using inhaled corticosteroids.
T58655 441736-441846 Sentence denotes This study was a randomized, double-blind, double-dummy, parallel-group, multicenter trial of 4-week duration.
T82923 441847-442063 Sentence denotes Mean PEF in the 1 and 2 mg/day groups were significantly increased from the baseline value by 15.1 and 28.2 at week 1, 19.5 and 32.6 at week 2, 22.6 and 35.3 at week 3 and 23.8 and 35.9 L/min at week 4, respectively.
T47803 442064-442208 Sentence denotes The increase in mean morning PEF in the 2 mg/day group was significantly higher than that in the 1 mg/day group at every point of determination.
T77597 442209-442346 Sentence denotes The mean evening PEF was significantly increased in both treatments groups compared with baseline values at every point of determination.
T17410 442347-442542 Sentence denotes Although the increase in the 2 mg/day group was greater than that in the 1 mg/day group at each point of determination, the difference between groups was statistically significant only at week 1.
T17829 442543-442598 Sentence denotes The safety profiles of the two treatments were similar.
T72994 442599-442816 Sentence denotes In patients with persistent asthma who require inhaled short-acting beta2-agonists while receiving inhaled corticosteroids, tulobuterol tape 2 mg/day significantly improved PEF compared with tulobuterol tape 1 mg/day.
T66828 442817-442830 Sentence denotes Introduction:
T47747 442831-442984 Sentence denotes On an average, 4% of the 1500 children admitted annually for asthma to Children s Hospital require admission to the Pediatric Intensive Care Unit (PICU).
T51470 442985-443061 Sentence denotes These admissions are highest in the months of August, September and October.
T89226 443062-443239 Sentence denotes Aeroallergens such as Alternaria and ragweed predominate during this season, and allergies to these allergens may account for the increased number of PICU admissions for asthma.
T40878 443240-443250 Sentence denotes Objective:
T64663 443251-443448 Sentence denotes We hypothesized that the seasonal increase in the admission rate could be related to allergen sensitivity, particularly to Alternaria and/or to ragweed that predominate during late summer and fall.
T61181 443449-443456 Sentence denotes Method:
T59285 443457-443593 Sentence denotes Data was collected from a retrospective chart review of all patients admitted to the PICU for asthma exacerbation between 1997 and 2003.
T29261 443594-443698 Sentence denotes Skin prick testing (SPT) within one year of PICU admission was the criteria for inclusion in this study.
T52445 443699-443707 Sentence denotes Results:
T90641 443708-443886 Sentence denotes There was a higher prevalence of admissions to the PICU for asthma exacerbation during August, September and October (168 out of 416 admissions = 40% of all admissions, p<0.001).
T5720 443887-443949 Sentence denotes Sixty-one subjects met the one-year SPT criteria for analysis.
T1411 443950-444077 Sentence denotes Subjects admitted during August, September and October were categorized as Group A, and all others were categorized as Group B.
T75113 444078-444263 Sentence denotes Sensitivity to a total of 11 aeroallergens (tress, grasses, weeds, ragweed, outdoor molds, indoor molds, Alternaria, cat, dog, roach and dust mites) was compared between the two groups.
T44683 444264-444504 Sentence denotes There was no statistical significance in aeroallergen sensitivity to Alternaria or ragweed between subjects admitted to the PICU in August, September and October (group A) and subjects admitted during the other months of the year (Group B).
T38446 444505-444516 Sentence denotes Conclusion:
T92187 444517-444632 Sentence denotes Asthma exacerbation requiring PICU admissions is more prevalent during the months of August, September and October.
T75356 444633-444788 Sentence denotes The increased rated of PICU admissions did not correlate with the aeroallergen sensitivity to the prevalent allergens during August, September and October.
T46920 444789-445000 Sentence denotes Therefore we suspect other factors such as, viral upper respiratory infections, in addition to aeroallergen sensitivity, which may contribute to severe asthma exacerbation during the late summer and fall months.
T81030 445001-445003 Sentence denotes K.
T52150 445004-445039 Sentence denotes Kuzume * , Shigenobu, Ehime, Japan.
T61469 445040-445101 Sentence denotes Infantile wheezing may be the result of different phenotypes.
T17736 445102-445272 Sentence denotes The aim of this study was to evaluate the risk factors for allergies and the results of allergyrelated blood tests among infants with different types of allergy symptoms.
T21472 445273-445468 Sentence denotes 2130 infants were examined physically at birth and at 1, 3, 6, 9, and 12 months of age, and questionnaires about number of siblings, the family history of allergy, and feeding methods were given.
T6010 445469-445782 Sentence denotes Allergic diseases were diagnosed at 12 months of age, and the subjects were divided into 4 groups: infants with atopic dermatitis (AD) only (A group, n=447), infants with both AD and wheezing (A/W group, n=175), infants with wheezing only (W group, n=155), and infants without allergic symptoms (C group, n=1353).
T89173 445783-445816 Sentence denotes Risk factors were then evaluated.
T60433 445817-446044 Sentence denotes 332 patients (198 from the A group, 109 from the A/W group, and 25 from the W group) were given allergy-related blood tests, total serum IgE levels, and RAST with egg white, milk, and house dust mites at 6 and 12 months of age.
T20153 446045-446152 Sentence denotes The results of the blood tests in 36 control subjects at 6 months of age were compared to the other groups.
T9404 446153-446284 Sentence denotes As shown in Table1, there were more male infants in the A/W and A groups than in the C group (p<0.001, A/W vs. C; p<0.01, A vs. C).
T21114 446285-446436 Sentence denotes Numbers of siblings were greater in the W and A/W group than in the A or C group (p<0.0001, W vs. A and W vs. C; p<0.01, A/W vs. A; p<0.05, A/W vs. C).
T20074 446437-446610 Sentence denotes The rate of positive family history of allergic diseases was high in the A and A/W groups, compared to the W or C group (p<0.0001, A vs. C and A/W vs. C; p<0.05, A/W vs. W).
T18588 446611-446723 Sentence denotes The rate of breastfeeding at 3 months of age was high in the A group compared to the others (p<0.0001, A vs. C).
T57232 446724-446870 Sentence denotes Patients in the W group had lower levels of total serum IgE at 12 months of age, compared to patients in A or A/W (p<0.01, W vs. A/W and W vs. A).
T20978 446871-447025 Sentence denotes Also patients in the W group had lower levels of RAST with egg white at 12 months of age, compared to patients A or A/W (p<0.0001, W vs. A/W and W vs. A).
T95509 447026-447167 Sentence denotes The median of total serum IgE levels at 6 months of age was higher in A and A/W but not in W, compared to C (p<0.001, A/W vs. C and A vs. C).
T19585 447168-447266 Sentence denotes In conclusion, there were two different phenotypes of wheezing in infants before 12 months of age.
T45173 447267-447370 Sentence denotes Wheezing with AD might be "allergy-related", while wheezing without AD may be related to other factors.
T37853 447371-447468 Sentence denotes As compared to C group: a), p<0.05; b), p<0.01; c), p<0.001; d), p<0.0001 As compared to A group:
T54354 447469-447764 Sentence denotes 1), p<0.05; 2), p<0.01; 3), p<0.001; 4), P<0.0001 As compared to A/W group: f), p<0.05; g), p<0.01; h), p<0.0001 A group, infants with atopic dermatitis only; A/W group, infants with atopic dermatitis and wheezing; W group, infants with wheezing only; C group, infants without allergic symptoms.
T50727 447765-447820 Sentence denotes RAST, radioallergosorbent test, N/A, data not available
T51826 447821-447823 Sentence denotes R.
T15390 447824-447838 Sentence denotes Amelio 1* , C.
T82323 447839-447854 Sentence denotes Capristo 1 , A.
T34365 447855-447869 Sentence denotes Capasso 1 , M.
T85890 447870-447897 Sentence denotes Miraglia del Giudice 2 , N.
T74922 447898-447912 Sentence denotes Maiello 1 , F.
T26089 447913-447926 Sentence denotes Decimo 1 , 1.
T51464 447927-447944 Sentence denotes Naples, Italy; 2.
T5795 447945-447959 Sentence denotes Napoli, Italy.
T66469 447960-448163 Sentence denotes Forced oscillation technique (FOT) is considered a sensible and specific method to estimate breathing functionality in asthmatic children aged 3 to 6 years, because it doesn't need special collaboration.
T22336 448164-448339 Sentence denotes The aim of our study was to value baseline respiratory resistances with the FOT in preschool-aged children with asthma under high dose of Budesonide and Flunisolide treatment.
T28892 448340-448573 Sentence denotes At this purpose, 40 asthmatic children aged 3 to 6 years were selected: at a first examination (T0) all the patients showed basal value FOT at 6Hz frequency (Rr6) changes major or equal than 35% under 200 mcg of salbutamol treatment.
T62559 448574-448887 Sentence denotes 30 days before the study, children selected didn't take systemic and inhaled steroids, cromons, leukotrienes antagonists, teophylline or anti-histamines and they didn't present upper and lower airways infections; then, two weeks before run-in, all selected patients took beta-2-agonists at least 3 times per week.
T78094 448888-448932 Sentence denotes All the patients were divided in two groups:
T49424 448933-449394 Sentence denotes Group I (20 children) under inhalation of Flunisolide 40mcg/Kg/dose + Salbutamol 1500 mcg b.i.d. for 7 days and, for the following two weeks, under inhalation of Flunisolide 20 mcg/Kg/dose + Salbutamol 200 mcg by pMDI+Spacer prn.; Group II (20 children) under inhalation of Budesonide 0, 5 mg b.i.d. + Salbutamol 1500 mcg b.i.d. for 7 days, and for the following two weeks, under inhalation of Budesonide 0, 25 mg b.i.d. + Salbutamol 200 mcg by pMDI+Spacer prn.
T3351 449395-449536 Sentence denotes Moreover, we gave diary-card with a simple symptoms score (at T0 and T7 ), to get the real perception of the symptoms in the course of study.
T7978 449537-449607 Sentence denotes However, during the treatment, 4 children have ritired from the study.
T21789 449608-449676 Sentence denotes The results obtained were statistically analysed (t Student's test).
T53717 449677-449769 Sentence denotes Significant Rr6 pre beta-2-agonists and ? value reduction was obtained at T7 and T21 vs. T0.
T39962 449770-449863 Sentence denotes Group I had (at T7) such a quick action than Group II reducing airways resistances (p<0, 01).
T32563 449864-450029 Sentence denotes Children treated with Flunisolide had lower frequency of breathless and nocturnal cough at T7 and lower salbutamol use from T7 to T21 than Budesonide group (p=N.S.).
T76382 450030-450154 Sentence denotes In conclusion, FOT is actually a safety method to value efficacy of inhaled steroids in preschool-aged children with asthma.
T54443 450155-450168 Sentence denotes Introduction:
T90166 450169-450372 Sentence denotes Approximately 7.5% of U.S. adults and 6.0% of Louisiana (LA) adults have current asthma, and over 25% currently smoke cigarettes, according to the 2002 Behavioral Risk Factor Surveillance System (BRFSS).
T8505 450373-450464 Sentence denotes The purpose of this study is to compare asthmatic smokers vs. nonsmokers in LA and the U.S.
T79425 450465-450687 Sentence denotes Here we address whether asthmatic smokers utilize more medical care services in the ER and outpatient clinics, and whether they were able to fully participate in activities of daily living compared to nonsmoker asthmatics.
T37255 450688-450753 Sentence denotes Methods: BRFSS is a state-based, telephone survey of U.S. adults.
T67353 450754-450851 Sentence denotes The survey collects self-reported information about modifiable risk factors for chronic diseases.
T56337 450852-450923 Sentence denotes This study analyzed data from the 2002 BRFSS survey using SAS software.
T44198 450924-450929 Sentence denotes Data:
T6097 450930-450998 Sentence denotes Out of the current asthmatics, 25% are cigarette smokers in the U.S.
T41349 450999-451121 Sentence denotes In Louisiana, 31% of asthmatics are currently smoking, which is significantly higher than the national average (p<0.0001).
T42568 451122-451261 Sentence denotes Within the past year, the average number of emergency room visits due to asthma was similar for both locations (LA 0.53, US 0.48, p=0.46) .
T24106 451262-451369 Sentence denotes Nationally, smokers visited the ER significantly more frequently than nonsmokers (S 0.61, NS 0.43, p<0.01).
T38748 451370-451573 Sentence denotes In LA, smokers visited the ER twice as often as nonsmokers (S 0.80, NS 0.40, p<0 .01) The number of annual routine outpatient checkups for asthma was similar based on location (LA 1.39, US 1.66, p=0.06).
T82422 451574-451710 Sentence denotes Smokers and nonsmokers had a similar number of checkups nationally (S 1.74, NS 1.64, p=0.32) and in Louisiana (S 1.79, NS 1.21, p=0.06).
T2095 451711-451866 Sentence denotes The number of days where asthmatics were unable to perform their usual activities was significantly fewer in LA than nationally (LA 3.6, US 11.6, p<0.001).
T62772 451867-451962 Sentence denotes Smokers had a significantly higher number of missed days nationally (S 17.8, NS 9.6, p<0.0001).
T950 451963-452086 Sentence denotes In LA, there was not a significant difference in the number of missed days based on smoking status (S 4.9, NS 2.9, p=0.47).
T66466 452087-452098 Sentence denotes Conclusion:
T619 452099-452241 Sentence denotes Even though Louisiana has a lower prevalence of asthmatics compared to the national average, significantly more of our asthmatics are smokers.
T73625 452242-452335 Sentence denotes Asthmatic smokers in LA and the U.S. utilized the ER more than their nonsmoking counterparts.
T92922 452336-452408 Sentence denotes Smokers and nonsmokers had similar numbers of routine outpatient visits.
T43584 452409-452509 Sentence denotes Asthmatic smokers missed more days, but this was only significantly different at the national level.
T46646 452510-452675 Sentence denotes Other research has shown that young age is highly associated with improper use in children using a MDI and holding chamber (Arch Pediatr Adolesc Med 2002; 156:378) .
T15072 452676-452910 Sentence denotes The objective of this study was to compare health outcomes achieved by children with asthma using inhaled corticosteroids (ICSs) delivered by a nebulizer compared with outcomes of children using ICSs delivered by non-nebulized device.
T51332 452911-452919 Sentence denotes Methods:
T25739 452920-453225 Sentence denotes Using a managed care organization database (PHARMetrics Integrated Outcomes Database), we identified children aged 8 years with an asthma diagnosis and asthmarelated hospitalization/emergency department (ED) visit (July 2000 -June 2002 and with a prescription claim for an ICS within 30 days of discharge.
T35088 453226-453587 Sentence denotes We compared relative risk of hospitalization/ED recurrence from day 31-180 (Cox proportional hazards regression, covariates=sex, age, current and prior asthma medications, prior oral corticosteroid and short-acting 2 -adrenergic agonist use, initial type of index event) for patients receiving nebulized ICS vs other ICS by age groups (0-4 years and 5-8 years).
T27906 453588-453596 Sentence denotes Results:
T99956 453597-453758 Sentence denotes Of 1552 patients with claims for ICS, 729 received nebulized ICS, of which 480 were aged 4 years; 823 received non-nebulized ICS, of which 292 were aged 4 years.
T77447 453759-453805 Sentence denotes Postindex hospitalization/ED rates were 12.4%.
T38407 453806-453862 Sentence denotes Refill rate was higher for patients using nebulized ICS.
T33584 453863-454017 Sentence denotes After model risk adjustment, patients using nebulized ICS had a 53% risk reduction for hospitalization/ED recurrence vs those not using nebulized ICS (HR:
T65704 454018-454031 Sentence denotes 0.47, 95% CI:
T20027 454032-454044 Sentence denotes 0.28, 0.78).
T36269 454045-454177 Sentence denotes In the 0-to 4-year age group, patients on nebulized ICS had a 62% risk reduction compared with patients not using nebulized ICS (HR:
T36090 454178-454191 Sentence denotes 0.38, 95% CI:
T16677 454192-454204 Sentence denotes 0.21, 0.69).
T87022 454205-454290 Sentence denotes In the 5-to 8-year age group, patients on nebulized ICS had a 52% risk reduction (HR:
T47198 454291-454304 Sentence denotes 0.48, 95% CI:
T36719 454305-454317 Sentence denotes 0.16, 1.46).
T65771 454318-454329 Sentence denotes Conclusion:
T26490 454330-454559 Sentence denotes In actual practice, treatment with nebulized ICS after an asthma exacerbation is associated with a significant reduction of recurrent hospitalization/ED visits in young children, possibly due to improved technique and compliance.
T43646 454560-454673 Sentence denotes Introduction: TENOR is a 3-year, multi-center, cohort study of patients with severe or difficult-to-treat asthma.
T63870 454674-454803 Sentence denotes The objective of the TENOR study is to better understand the natural history of patients with severe or difficult-totreat asthma.
T80609 454804-454965 Sentence denotes This analysis assessed the frequency of skin testing in this population and characterized the differences between the positive (ST+) and negative (ST ) subjects.
T40511 454966-454974 Sentence denotes Methods:
T2338 454975-455063 Sentence denotes Subjects were asked whether they had ever been skin tested and, if so, the test results.
T11421 455064-455194 Sentence denotes Those who were ST+ were compared to both ST and those never tested (STND) using clinical and other asthma-related characteristics.
T32953 455195-455251 Sentence denotes Subjects 12 years of age were included in this analysis.
T42323 455252-455260 Sentence denotes Results:
T94310 455261-455307 Sentence denotes 2985 subjects were eligible for this analysis.
T64590 455308-455432 Sentence denotes 85.8% were skin tested in the past, with STND frequency of 5.1% from allergist sites and 33% from pulmonologist/other sites.
T47244 455433-455515 Sentence denotes Of those tested, 93.5% were positive (allergist 95.7%, pulmonologist/other 87.3%).
T93794 455516-455604 Sentence denotes Baseline IgE for ST+ subjects was 104.6 IU/ml vs. 32.4 IU/ml for ST ; p<0.0001 (Table) .
T42553 455605-455787 Sentence denotes As shown, the age at asthma onset, duration of asthma, rate of atopic disorders, and the rate at which asthma was triggered by aeroallergens differentiated the ST+ from the ST group.
T89063 455788-455917 Sentence denotes Disease severity as evaluated by FEV 1 , healthcare utilization, and medication use, however, was similar between the two groups.
T95269 455918-456085 Sentence denotes In general, STND were more likely to have values closer to the ST+ group, suggesting that the majority of those not tested would have been ST+, if administered a test.
T96197 456086-456098 Sentence denotes Conclusions:
T89873 456099-456282 Sentence denotes The prevalence of ST+ subjects from both allergy and pulmonary practices was high, demonstrating that the majority of these severe or difficult-to-treat patients have allergic asthma.
T93419 456283-456449 Sentence denotes ST+ patients showed differences in clinical characteristics compared to ST , including a greater likelihood of their asthma symptoms being triggered by aeroallergens.
T41119 456450-456638 Sentence denotes These data also show that the clinical profile of STND patients may be similar to that of ST+ patients, suggesting the utility of a more universal allergic evaluation in severe asthmatics.
T45184 456639-456693 Sentence denotes Funded by Genentech and Novartis Pharmaceuticals Corp.
T61897 456694-456968 Sentence denotes Background Current national guidelines for the diagnosis and management of asthma such as the NAEPP EPR 2002, classify asthma severity based on frequency of asthma symptoms, medication use, and measurements of lung function by spirometry or peak expiratory flow variability.
T63940 456969-457071 Sentence denotes Recently, the utility of spirometry measurements for assigning asthma severity has come into question.
T69146 457072-457227 Sentence denotes Here we evaluate the correlation of spirometry measurements with asthma severity in school-aged children who are mostly naive to anti-inflammatory therapy.
T30586 457228-457335 Sentence denotes Methods Children were participants in a school-based lowincome asthma mobile van program, the Breathmobile.
T1870 457336-457489 Sentence denotes Recruitment was through referrals by school nurses and community public health clinics, parental response to flyers, and asthma screening questionnaires.
T58767 457490-457604 Sentence denotes Spirometry was performed on all children greater than 4 years of age as part of a comprehensive asthma evaluation.
T85749 457605-457691 Sentence denotes Asthma severity was assigned based on symptoms only, according to the NAEPP EPR 2002 .
T59554 457692-457821 Sentence denotes Results From April 2002 to April 2004 of the 620 children evaluated on the Breathmobile, 540 patients were diagnosed with asthma.
T27734 457822-458045 Sentence denotes Classification of severity by symptom frequency according to NAEPP EPR guidelines resulted in 28% as mild intermittent (MI), 28% as mild persistent (MiP), 32% as moderate persistent (MoP), and 12% as severe persistent (SP).
T59019 458046-458182 Sentence denotes The percentage of patients and their mean lung functions at baseline evaluation without bronchodilator challenge are shown in the table.
T16985 458183-458378 Sentence denotes There were statistically significant differences (p<.05) between severity groups which was most pronounced for the FEF25-75% when comparing the severe persistent group and the intermittent group.
T47868 458379-458537 Sentence denotes However, mean values appear to be "normal" for all degrees of asthma given current accepted cut-off values, FVC 80%, FEV1 80%, FEV1/FVC 80%, and FEF25-75 60%.
T38114 458538-458701 Sentence denotes Conclusion In our study, airflow impairment did correlate with asthma severity, although it was "normal" (FEV1 80%) even in children with severe persistent asthma.
T67094 458702-458820 Sentence denotes Therefore, a "normal" lung function measurement may be misleading as sole criteria for asthma severity classification.
T9331 458821-458921 Sentence denotes Perhaps a higher cutoff point (FEV1<90%) might be a better indicator of asthma severity in children.
T64790 458922-459278 Sentence denotes Asthma is the most frequently chronic disease in childhood.Our main was to know the prevalence of bronchial asthma in children (6-7 and 13-14 years) in the north zone of Mexico City and to compare the prevalence obtained by the written questionnaire versus the video questionnaire in the group of 13 to 14 years, according to methodology proposed by ISAAC.
T76349 459279-459300 Sentence denotes Material and Methods:
T26306 459301-459439 Sentence denotes By means of a validated and standardized questionnaire (ISAAC) that was applied to 3500 children from 6 to 7 years and 3899 from 13 to 14.
T35738 459440-459509 Sentence denotes The questionnaires of 6 and 7 years were filled out by their parents.
T12616 459510-459591 Sentence denotes The group from 13 to 14 years answered a questionnaire and a video questionnaire.
T87710 459592-459720 Sentence denotes According to ISAAC specification and based on a studied population, it was calculated by STATcal program the size of the sample.
T77144 459721-459866 Sentence denotes It was choose a haz-ardous sample of 3000 children between 6-7 years and 3000 of the 13-14 group years, both sexes in elementary and high school.
T92698 459867-459915 Sentence denotes Measures of central tendency and Chi2 were used.
T73187 459916-459924 Sentence denotes Results:
T59122 459925-460043 Sentence denotes The final sample size for both groups was 7110 children (3211 of 6-7 and 3899 adolescents), 51.5% men and 48.5% women.
T56317 460044-460420 Sentence denotes The prevalence of the asthma diagnosis for teenagers was of 8 % (p<0.05 IC 7.1-8.7) and it was 4.5% in children (p<0.05 IC 3.8-5.2), wheezing in the last 12 months was 6.8% (p<0.05 IC 5.9-7.6) in children and of 9.9% (p<0.05 IC 9-10.8) for 13-14 years. wheezing induced exercise appeared in 13.1% (p<0.05 IC 12-14.1) in teenager and 3.4 % (p<0.05 IC 2.7-4) in the other group.
T38745 460421-460598 Sentence denotes The severity of asthma showed by nocturnal awakness was 4.3% and 2.6% (p<0.05), number of crisis in the last year 6.3% and 9.3% for children and teenagers respectively (p<0.05).
T58445 460599-460783 Sentence denotes In the video questionnaire of teenagers 7.3% (IC 6.5-8.1) answered affirmative on have displayed a shaken breathing on the last year resting and only 6.8% (IC 6-7.6) in the last month.
T6112 460784-460927 Sentence denotes About exercise question 16.5% confirmed have displayed symptoms, 14.6%(IC 13-15.8) in the last year and 11.1% (IC 10.1-12.1) in the last month.
T43670 460928-461012 Sentence denotes Wide-awake at night 7.5% (IC 6.7-8.3) in the last year and 5.2% ) in the last month.
T28847 461013-461025 Sentence denotes Conclusions:
T69512 461026-461117 Sentence denotes The prevalence of asthma by diagnosis was higher in teenagers group than in children group.
T71596 461118-461173 Sentence denotes The prevalence of asthma was higher also in this group.
T26636 461174-461184 Sentence denotes Rationale:
T26364 461185-461391 Sentence denotes We investigated the relationship of pet exposure and healthcare utilization (HCU) in a cohort of pediatric patients with severe or difficult-totreat asthma in The Epidemiology and Natural History of Asthma:
T30897 461392-461452 Sentence denotes Outcomes and Treatment Regimens (TENOR) observational study.
T76982 461453-461543 Sentence denotes We hypothesized that pet exposure would increase HCU due to increased airway inflammation.
T53982 461544-461649 Sentence denotes Methods: TENOR is a 3-year multicenter cohort study of patients with severe or difficult-to-treat asthma.
T59094 461650-461752 Sentence denotes Children ages 6-12 were interviewed at baseline regarding asthma-related HCU in the previous 3 months.
T28208 461753-461856 Sentence denotes Patients with pet exposure (PPE, n=370) were compared with patients with no pet exposure (PNPE, n=382).
T97876 461857-461907 Sentence denotes Responses were analyzed using Fisher's exact test.
T71260 461908-462006 Sentence denotes Results: PPE were less likely to have severe asthma by physician assessment (32% vs. 40%; p=0.01).
T87643 462007-462176 Sentence denotes In addition, PPE were less likely to have an emergency room (ER) visit (18% vs. 26%; p=0.006) or to have been hospitalized (7% vs. 12%; p=0.02) in the previous 3 months.
T14043 462177-462238 Sentence denotes More PNPE had an IgE level >100 IU/ml (74% vs. 63%; p=0.001).
T88199 462239-462335 Sentence denotes PPE and PNPE were similar with regard to presence of allergic rhinitis and skin test positivity.
T84178 462336-462432 Sentence denotes Compared with PNPE, fewer PPE with two or more pets had ER visits and hospitalizations (Table) .
T19680 462433-462536 Sentence denotes Among PPE, there were no differences in IgE levels or in asthma severity related to the number of pets.
T88991 462537-462549 Sentence denotes Conclusions:
T81492 462550-462740 Sentence denotes Pet exposure was associated with reduced HCU in the TENOR pediatric cohort, with the most pronounced effect seen in reduced ER visits and hospitalizations needed by those with multiple pets.
T57610 462741-462831 Sentence denotes PPE had significantly lower IgE levels compared to PNPE, regardless of the number of pets.
T76783 462832-462964 Sentence denotes These data support the hypothesis that exposure to pets may paradoxically protect individuals from the development of severe asthma.
T75835 462965-463100 Sentence denotes Alternatively, these data may reflect a self-selection in patients with severe or allergic asthma who are likely to avoid having a pet.
T40019 463101-463222 Sentence denotes However, there may be other confounding factors in families with pets that confer a protective effect on asthma severity.
T50768 463223-463236 Sentence denotes INTRODUCTION:
T4042 463237-463425 Sentence denotes In asthma and other chronic obstructive airway diseases, phosphodiesterase 4 (PDE4) is involved in the pathophysiology of the disease and is expressed abundantly in key inflammatory cells.
T70589 463426-463589 Sentence denotes Inhibitors of PDE4 are investigational, anti-inflammatory agents that prevent the breakdown of cyclic adenosine monophosphate, a natural modulator of inflammation.
T56487 463590-463785 Sentence denotes Roflumilast is an investigational, oral, once-daily PDE4 inhibitor with demonstrated in vitro and in vivo anti-inflammatory activity, which may translate into clinical efficacy in asthma therapy.
T74057 463786-463924 Sentence denotes This study examined the ability of roflumilast to exert direct or acute bronchodilatory activity in patients with mild to moderate asthma.
T20704 463925-463933 Sentence denotes METHODS:
T16953 463934-464104 Sentence denotes This was a double-blind, randomized, placebo-controlled, crossover study consisting of three treatment periods of one day each, separated by a 7-to 14-day washout period.
T4865 464105-464302 Sentence denotes During each treatment period, 15 patients with a forced expiratory volume in one second (FEV 1 ) of 50% to 90% of predicted received either oral roflumilast 1000 μg, roflumilast 500 μg, or placebo.
T37333 464303-464403 Sentence denotes The FEV 1 was measured twice prior to administration and periodically up to 6 h following treatment.
T85937 464404-464511 Sentence denotes After 6 h, patients inhaled 200 μg salbutamol from a metered-dose inhaler; FEV 1 was measured 15 min later.
T73648 464512-464607 Sentence denotes Adverse events, vital signs, and electrocardiogram results were monitored throughout the study.
T1468 464608-464616 Sentence denotes RESULTS:
T42640 464617-464683 Sentence denotes Median baseline FEV 1 was similar for the three treatment periods.
T32273 464684-464863 Sentence denotes Both doses of roflumilast did not lead to statistically significant differences versus placebo in the time-averaged FEV 1 over the first or up to 6 h after drug intake (p > 0.05).
T69985 464864-464994 Sentence denotes Thus, there was no evidence of a direct or acute bronchodilatory effect with either single doses of roflumilast 1000 μg or 500 μg.
T87324 464995-465275 Sentence denotes In contrast, inhalation of the short-acting bronchodilator salbutamol led to a distinct improvement in FEV 1 versus baseline in all treatments groups with median FEV 1 increases of 19%, 21%, and 14% in the roflumilast 1000 μg, roflumilast 500 μg, and placebo groups, respectively.
T18395 465276-465307 Sentence denotes Roflumilast was well tolerated.
T23909 465308-465320 Sentence denotes CONCLUSIONS:
T65091 465321-465495 Sentence denotes Oral, once-daily roflumilast exhibits no direct or acute bronchodilatory activity in patients with mild to moderate asthma as could be achieved with short-acting 2 -agonists.
T34630 465496-465592 Sentence denotes These data support the proposed mechanism of action of roflumilast as an antiinflammatory agent.
T73349 465593-465609 Sentence denotes South Africa; 2.
T46981 465610-465632 Sentence denotes Guadalajara, Spain; 3.
T56973 465633-465652 Sentence denotes Munich, Germany; 4.
T28120 465653-465674 Sentence denotes Weinheim, Germany; 5.
T62295 465675-465696 Sentence denotes Budapest, Hungary; 6.
T84402 465697-465715 Sentence denotes Konstanz, Germany.
T30235 465716-465729 Sentence denotes INTRODUCTION:
T57418 465730-465876 Sentence denotes Phosphodiesterase 4 (PDE4) is found in key inflammatory cells involved in the pathophysiology of chronic obstructive pulmonary disease and asthma.
T93966 465877-466034 Sentence denotes Inhibitors of the PDE4 enzyme are anti-inflammatory agents that prevent the breakdown of cyclic adenosine monophosphate, a natural modulator of inflammation.
T24070 466035-466167 Sentence denotes Roflumilast is an investigational, oral, oncedaily PDE4 inhibitor with demonstrated in vitro and in vivo anti-inflammatory activity.
T86226 466168-466253 Sentence denotes This study examined the dose-related efficacy of roflumilast in patients with asthma.
T11295 466254-466262 Sentence denotes METHODS:
T3906 466263-466436 Sentence denotes Patients with stable asthma (forced expiratory volume in 1 second [FEV 1 ] 50% to 85% of predicted) were enrolled in this randomized, double-blind, dose-range finding study.
T54622 466437-466625 Sentence denotes After a single-blind placebo run-in period of up to three weeks, patients received oral roflumilast 100 μg, 250 μg, or 500 μg once daily (N = 229, 228, and 233, respectively) for 12 weeks.
T7654 466626-466826 Sentence denotes Efficacy was assessed by change from baseline in spirometric lung function FEV 1 and forced vital capacity (FVC), as well as morning and evening peak expiratory flow (PEF) recorded in patient diaries.
T82808 466827-466898 Sentence denotes Safety and tolerability parameters were monitored throughout the study.
T63396 466899-466907 Sentence denotes RESULTS:
T98067 466908-467061 Sentence denotes Treatment with roflumilast led to dose-dependent and statistically significant increases in FEV 1 , FVC (both p < 0.0001), and in morning PEF (p < 0.01).
T54482 467062-467243 Sentence denotes At last visit, FEV 1 improved from baseline by 260 mL (11%), 320 mL (13%), and 400 mL (16%) in patients treated with roflumilast 100 μg, 250 μg, and 500 μg once daily, respectively.
T97252 467244-467361 Sentence denotes Similarly, dose-dependent improvements of 10 L/min, 12 L/min, and 20 L/min in morning PEF from baseline were reached.
T4601 467362-467419 Sentence denotes Roflumilast was well tolerated at all dose levels tested.
T98830 467420-467547 Sentence denotes The most frequent drug-related adverse events were headache followed by gastrointestinal disorders such as diarrhea and nausea.
T25614 467548-467650 Sentence denotes There were no clinically relevant changes in vital signs, electrocardiogram, or laboratory parameters.
T34923 467651-467663 Sentence denotes CONCLUSIONS:
T35551 467664-467810 Sentence denotes Oral, once-daily roflumilast was associated with dose-dependent, clinically relevant improvements of lung function in patients with stable asthma.
T14016 467811-467842 Sentence denotes Roflumilast was well tolerated.
T74761 467843-467847 Sentence denotes J.L.
T57793 467848-467867 Sentence denotes Izquierdo 1* , E.D.
T51443 467868-467882 Sentence denotes Bateman 2 , P.
T8176 467883-467896 Sentence denotes Magyar 3 , U.
T63553 467897-467911 Sentence denotes Harnest 4 , P.
T32697 467912-467927 Sentence denotes Hofbauer 5 , A.
T60333 467928-467940 Sentence denotes Varga 6 , C.
T17516 467941-467964 Sentence denotes Schmid-Wirlitsch 7 , D.
T81770 467965-467987 Sentence denotes Bredenbroeker 7 , T.D.
T33822 467988-468001 Sentence denotes Bethke 7 , 1.
T74752 468002-468024 Sentence denotes Guadalajara, Spain; 2.
T75349 468025-468052 Sentence denotes Cape Town, South Africa; 3.
T51618 468053-468074 Sentence denotes Budapest, Hungary; 4.
T35475 468075-468094 Sentence denotes Munich, Germany; 5.
T51465 468095-468116 Sentence denotes Weinheim, Germany; 6.
T18753 468117-468139 Sentence denotes Tatabanya, Hungary; 7.
T2898 468140-468158 Sentence denotes Konstanz, Germany.
T45988 468159-468172 Sentence denotes INTRODUCTION:
T41523 468173-468307 Sentence denotes Phosphodiesterase 4 (PDE4) inhibitors are a new class of anti-inflammatory agents for therapeutic use in inflammatory airway diseases.
T22079 468308-468507 Sentence denotes In several studies, the investigational, oral, once-daily PDE4 inhibitor roflumilast has provided clinically meaningful improvements in patients with chronic obstructive pulmonary disease and asthma.
T78726 468508-468619 Sentence denotes This study examined the long-term safety and tolerability of roflumilast over 40 weeks in patients with asthma.
T70219 468620-468628 Sentence denotes METHODS:
T90820 468629-468875 Sentence denotes Patients with persistent, stable asthma (FEV 1 50% to 85% of predicted at randomization) participated in a double-blind, randomized dose-range finding study and were treated with oral roflumilast 100 μg, 250 μg, or 500 μg once daily for 12 weeks.
T71579 468876-468996 Sentence denotes Patients completing the 12-week study per-protocol, then continued treatment in this open-label 40-week extension study.
T987 468997-469082 Sentence denotes All patients received oral roflumilast 500 μg once daily during the extension period.
T89432 469083-469243 Sentence denotes Adverse events (AEs), clinical laboratory parameters, vital ANNALS OF ALLERGY, ASTHMA & IMMUNOLOGY signs, and ECG were assessed throughout the extension period.
T42628 469244-469252 Sentence denotes RESULTS:
T45239 469253-469322 Sentence denotes A total of 456 patients were enrolled in the 40-week extension study.
T42710 469323-469391 Sentence denotes Overall, the most common AEs were related to the respiratory system.
T76886 469392-469511 Sentence denotes Only a small number of patients (6%) experienced AEs that were assessed as at least likely related to study medication.
T54907 469512-469650 Sentence denotes The most frequent drug-related adverse events were headache, diarrhea, and nausea as reported by 3%, 1%, and 1% of patients, respectively.
T33707 469651-469771 Sentence denotes Most AEs were mild to moderate in intensity and transient in duration; 6% of patients discontinued the study due to AEs.
T71251 469772-469886 Sentence denotes Most (60%) of these AEs leading to discontinuation were assessed as not related or unlikely related to study drug.
T9759 469887-470007 Sentence denotes Out of 456 patients, 16 reported serious AEs, which were all assessed as not related or unlikely related to roflumilast.
T40123 470008-470125 Sentence denotes No clinically relevant changes in clinical laboratory parameters, vital signs, ECG, or physical examination occurred.
T76502 470126-470138 Sentence denotes CONCLUSIONS:
T29591 470139-470263 Sentence denotes Oral, once-daily roflumilast 500 μg administered for 40 weeks was well tolerated in patients with persistent, stable asthma.
T5117 470264-470497 Sentence denotes This study provides evidence that roflumilast is associated with a low incidence of AEs, which are mostly mild to moderate in intensity and transient in nature, thus, supporting the potential therapeutic use of roflumilast in asthma.
T42518 470498-470515 Sentence denotes Paris, France; 3.
T59957 470516-470533 Sentence denotes Madrid, Spain; 4.
T31825 470534-470556 Sentence denotes Guadalajara, Spain; 5.
T88525 470557-470583 Sentence denotes Harrow, United Kingdom; 6.
T25601 470584-470605 Sentence denotes Weinheim, Germany; 7.
T21116 470606-470627 Sentence denotes Augsburg, Germany; 8.
T494 470628-470647 Sentence denotes Munich, Germany; 9.
T46255 470648-470672 Sentence denotes Kaufbeuren, Germany; 10.
T87864 470673-470691 Sentence denotes Konstanz, Germany.
T26267 470692-470705 Sentence denotes INTRODUCTION:
T43236 470706-470795 Sentence denotes In asthma, inhaled corticosteroids (ICS) have been the mainstay of maintenance treatment.
T29413 470796-470939 Sentence denotes New therapeutic agents are needed that target key inflammatory processes in asthma as effectively as ICS but overcome known limitations of ICS.
T57962 470940-471105 Sentence denotes Phosphodiesterase 4 (PDE4) inhibitors are anti-inflammatory agents that prevent the breakdown of cyclic adenosine monophosphate, a natural modulator of inflammation.
T89371 471106-471227 Sentence denotes Roflumilast is an investigational, oral, once-daily PDE4 inhibitor for potential use in anti-inflammatory asthma therapy.
T4066 471228-471402 Sentence denotes This study compared the standard corticosteroid treatment of twice-daily, inhaled beclomethasone dipropionate (BDP) with oral, once-daily roflumilast in patients with asthma.
T60810 471403-471411 Sentence denotes METHODS:
T39378 471412-471670 Sentence denotes In a randomized, double-blind, double-dummy study, patients (forced expiratory volume in one second [FEV 1 ], 50% to 85% of predicted) received either oral roflumilast 500μg once daily (N=207) or inhaled BDP 200μg twice daily (400μg/day; N=214) for 12 weeks.
T58639 471671-471873 Sentence denotes Mean change (LSMean and SEM) in lung function parameters FEV 1 , forced vital capacity (FVC), and morning and evening peak expiratory flow (PEF) from baseline was determined after 12 weeks of treatment.
T12067 471874-471937 Sentence denotes Further, symptom score and rescue medication use were assessed.
T48591 471938-471946 Sentence denotes RESULTS:
T79246 471947-472102 Sentence denotes Both roflumilast 500μg and BDP 400μg improved FEV 1 from baseline to clinically meaningful levels (300 ± 40mL and 370 ± 30mL, respectively; both p<0.0001).
T95033 472103-472250 Sentence denotes Similarly, roflumilast and BDP improved FVC (300 ± 40mL and 360 ± 40mL, respectively; both p<0.0001) as well as morning and evening PEF (p 0.0003).
T45025 472251-472313 Sentence denotes Roflumilast 500μg was statistically non-inferior to BDP 400μg.
T23057 472314-472443 Sentence denotes Roflumilast and BDP led to statistically significant and comparable improvements in asthma symptoms and use of rescue medication.
T81223 472444-472605 Sentence denotes Adverse events were generally mild to moderate; the most common drugrelated adverse events reported in the roflumilast group were nausea, headache, and diarrhea.
T70239 472606-472694 Sentence denotes There were no clinically relevant changes in vital signs, ECG, or laboratory parameters.
T21837 472695-472707 Sentence denotes CONCLUSIONS:
T46687 472708-472868 Sentence denotes Roflumilast 500μg provided clinically meaningful improvement of lung function parameters, reduced asthma symptoms, and decreased the need for rescue medication.
T77462 472869-472970 Sentence denotes Oral, once-daily roflumilast was as effective as inhaled, twice-daily BDP in the treatment of asthma.
T35573 472971-473013 Sentence denotes Oral roflumilast 500μg was well tolerated.
T37249 473014-473024 Sentence denotes Rationale:
T10647 473025-473155 Sentence denotes Evaluation of medical claims from commercial health plans permits assessment of therapeutic interventions on resource utilization.
T27539 473156-473265 Sentence denotes This study investigated the impact of controller therapy in children starting asthma maintenance medications.
T49011 473266-473415 Sentence denotes The risk of obtaining prescriptions for oral corticosteroids (OCS), short-acting beta-agonists (SABA) or adding another asthma therapy was evaluated.
T8306 473416-473424 Sentence denotes Methods:
T65607 473425-473578 Sentence denotes This was a retrospective observational study utilizing medical and pharmacy claims from a large representative managed care plan from 1/1/2000-5/31/2003.
T54415 473579-474010 Sentence denotes Children aged 4-17 years old with an asthma diagnosis (ICD-9, 493.xx) and an initial pharmacy claim for one of the following regimens: fluticasone/salmeterol in a single inhaler, n=1, 168 (FSC), fluticasone propionate alone, n=2, 473 (FP), montelukast, n=4, 246 (MON), any inhaled corticosteroid plus montelukast, n=1, 009 (ICS+MON), and an ICS plus salmeterol from separate inhalers, n=296 (ICS+SAL) were included in the analysis.
T31416 474011-474139 Sentence denotes Subjects were excluded if they had received any asthma controller medication in the 6 months prior to the initiation of therapy.
T8988 474140-474348 Sentence denotes Regression was used to estimate the incidence rate ratio (IRR) for OCS and SABA use (negative binomial) and the odds ratio (OR) of adding a controller (ADD) and an ED or hospitalization (IP) event (logistic).
T11076 474349-474480 Sentence denotes All models controlled for demographics, pre-controller asthma-related medications and events, and baseline total health care costs.
T77080 474481-474489 Sentence denotes Results:
T39262 474490-474647 Sentence denotes The ratios in the table with a confidence interval excluding unity indicate significantly increased use or likelihood of an event compared to the FSC cohort.
T13269 474648-474878 Sentence denotes Controller naïve children started on FSC were less likely to add another controller than MON, FP or ICS+SAL, and had less use of OCS or SABA than the 4 cohorts when studied for 12 months after the initiation of controller therapy.
T62927 474879-474989 Sentence denotes In addition, children treated with ICS + MON had a significantly greater OR of an ED/IP visit compared to FSC.
T33352 474990-475001 Sentence denotes Conclusion:
T86085 475002-475285 Sentence denotes Use of FP + SAL (FSC) in a single inhaler assures that children are getting more optimal inhaled corticosteroid therapy as well as the benefits from the long acting bronchodilator while avoiding the potential for selective discontinuation of ICS in the 2 multiple controller cohorts.
T24404 475286-475290 Sentence denotes A.S.
T7312 475291-475304 Sentence denotes Nayak 1* , R.
T58488 475305-475318 Sentence denotes Nathan 2 , J.
T35184 475319-475334 Sentence denotes Williams 3 , S.
T2469 475335-475347 Sentence denotes Kundu 3 , M.
T92968 475348-475360 Sentence denotes Lloyd 3 , D.
T1115 475361-475375 Sentence denotes Banerji 3 , 1.
T63639 475376-475390 Sentence denotes Normal, IL; 2.
T57744 475391-475415 Sentence denotes Colorado Springs, CO; 3.
T28257 475416-475432 Sentence denotes Bridgewater, NJ.
T66276 475433-475446 Sentence denotes INTRODUCTION:
T27331 475447-475541 Sentence denotes Inhaled corticosteroids (ICS) are recommended firstline therapy for severe, persistent asthma.
T19105 475542-475688 Sentence denotes Systemic exposure to ICS may suppress hypothalamic-pituitary-adrenal (HPA)-axis function, particularly at doses required to control severe asthma.
T71175 475689-475880 Sentence denotes Ciclesonide (CIC) hydrofluoroalkane (HFA) metered dose inhaler (MDI) is a novel and effective ICS that is converted in the lungs to its active metabolite, desisobutyryl ciclesonide (des-CIC).
T63544 475881-476131 Sentence denotes Previously, in short-term studies, CIC has been shown to have no effect on serum or urinary cortisol levels, which may be attributed to the low oral bioavailability, high serum protein binding and high clearance rate of CIC and its active metabolite.
T69980 476132-476302 Sentence denotes This HPA axis analysis was part of a long-term study evaluating the safety of CIC and beclomethasone dipropionate (BDP) HFA-MDI in patients with severe persistent asthma.
T94198 476303-476311 Sentence denotes METHODS:
T74457 476312-476468 Sentence denotes This was a multicenter, double-blind, parallel-group, 12-month extension of a 12-week double-blind trial of patients 12 years with severe persistent asthma.
T88130 476469-476588 Sentence denotes Patients were randomized in a 2:1 ratio (CIC:BDP) to receive CIC (320 g bid) exactuator or BDP (320 g bid) ex-actuator.
T97799 476589-476694 Sentence denotes After 2 weeks, the doses of both medications could be titrated to 160 g bid as needed for asthma control.
T19935 476695-476968 Sentence denotes HPA-axis function was assessed at selected centers in a subset of patients at baseline and end of study (at month 12 or early termination) by measuring both peak serum cortisol induced by low dose (1-μg) cosyntropin and 24-hr urinary free cortisol corrected for creatinine.
T87242 476969-476977 Sentence denotes RESULTS:
T21591 476978-477072 Sentence denotes Data were available for a small number of patients at 13 centers evaluating HPA-axis (Table) .
T39103 477073-477225 Sentence denotes Mean baseline levels and change from baseline to end of study values in low-dose cosyntropin peak serum cortisol levels for CIC and BDP were comparable.
T4904 477226-477408 Sentence denotes Likewise, baseline levels and mean change from baseline to end of study values in 24-hr urinary free cortisol corrected for creatinine were comparable among the two treatment groups.
T74582 477409-477420 Sentence denotes CONCLUSION:
T8166 477421-477550 Sentence denotes These findings demonstrate that CIC 320 to 640 μg daily for 12 months is safe and has no significant effect on HPA-axis function.
T33905 477551-477553 Sentence denotes A.
T64315 477554-477566 Sentence denotes Long 1* , A.
T6347 477567-477580 Sentence denotes Rahman 2 , 1.
T72179 477581-477595 Sentence denotes Boston, MA; 2.
T53930 477596-477611 Sentence denotes Wilmington, DE.
T47894 477612-477625 Sentence denotes INTRODUCTION:
T73345 477626-477760 Sentence denotes Little information is available regarding the relationships between asthma severity, disease control, and compliance with medications.
T7620 477761-477769 Sentence denotes METHODS:
T97502 477770-478087 Sentence denotes Physicians' perceptions regarding these variables were determined by Internet-based general asthma medication usage survey and patient-specific asthma medication usage surveys between December 18 and 29, 2003, for 406 physicians (100 PCPs, 106 pediatricians, 100 allergists and immunologists, and 100 pulmonologists).
T56694 478088-478218 Sentence denotes The patient-specific surveys were based on chart information of 3 randomly chosen patients per physician on controller medication.
T12608 478219-478227 Sentence denotes RESULTS:
T80787 478228-478395 Sentence denotes Of 1218 patients, 12%, 31%, 43%, and 14% were categorized by their physicians as having mild intermittent or mild, moderate, or severe persistent asthma, respectively.
T13013 478396-478534 Sentence denotes Overall, 45% of patients were categorized as having "very controlled" asthma and 58% as being "very compliant" with their current regimen.
T5812 478535-478676 Sentence denotes Worse asthma control, decreased compliance, and increased physician visits were all associated with increased asthma severity classification.
T30934 478677-478859 Sentence denotes Physicians reported that only 5% of patients with severe persistent disease (n=169) had "very controlled" asthma in contrast to 77% of patients with mild intermittent asthma (n=143).
T85978 478860-479051 Sentence denotes Patients with mild intermittent asthma, and mild, moderate, and severe persistent asthma, had a mean of 2.9, 3.4, 4.5, and 5.5 physician visits for asthma, respectively, within the past year.
T40245 479052-479340 Sentence denotes Physician perception of patient compliance varied less across the groups, with 55% of patients with severe persistent asthma and 66% of patients with mild intermittent asthma being rated as "very compliant." The incidence of allergic rhinitis was similar among all severity levels (range:
T58746 479341-479597 Sentence denotes 50%-56%), but patients with severe persistent asthma were more likely to have comorbid conditions, including hypertension, chronic obstructive pulmonary disorder, chronic bronchitis, and osteoporosis, compared with patients in other asthma severity levels.
T3533 479598-479610 Sentence denotes CONCLUSIONS:
T89281 479611-479797 Sentence denotes Decreased asthma control and rates of com-pliance, as well as increased physician visits and comorbid medical conditions, may be associated with increased asthma severity classification.
T24975 479798-479808 Sentence denotes Rationale:
T11407 479809-479898 Sentence denotes Children with asthma frequently have co-morbid allergic conditions requiring medications.
T89016 479899-480140 Sentence denotes The purpose of this study was to assess whether the controller asthma medication selected would reduce the utilization of intranasal steroids (INS) and prescription nonsedating antihistamines (NSA) for children treated for co-morbid allergy.
T10376 480141-480149 Sentence denotes Methods:
T2929 480150-480374 Sentence denotes This was an observational retrospective study that utilized the PharMetrics Integrated Outcomes Database that contains administrative medical and pharmacy claims data from over 30 managed care plans across the United States.
T63083 480375-480560 Sentence denotes Children age 4-17 years old with a new diagnosis of asthma (ICD-9, 493.xx) were identified and observed for 12 months after their initial diagnosis and treatment of asthma (post-index).
T85836 480561-480764 Sentence denotes Four cohorts were established based on their controller medication dispensed: montelukast, n=1906 (MON), fluticasone propionate, n=2455 (FP), FP+MON n=287, FP/salmeterol in a single inhaler, n=599 (FSC).
T43191 480765-480773 Sentence denotes Results:
T6309 480774-480862 Sentence denotes Baseline comorbid diagnosis of allergic rhinitis was observed in 14-20% of the children.
T96191 480863-481002 Sentence denotes The patterns of use of INS and NSA were similar in the 12 months before and the 12 months after the initial asthma diagnosis and treatment.
T27288 481003-481102 Sentence denotes Children with a diagnosis of allergic rhinitis were nearly twice as likely to receive a NSA or INS.
T9348 481103-481176 Sentence denotes All 4 treatment cohorts used a similar amount of each allergy medication.
T46837 481177-481264 Sentence denotes The presence or absence of a diagnosis of allergic rhinitis did not alter the findings.
T42 481265-481379 Sentence denotes The adjusted odds ratio (95%CI) of using a NSA or INS relative to the use of FSC in the post-index period was MON:
T57105 481380-481405 Sentence denotes 0.989 (0.809, 1.208); FP:
T79266 481406-481435 Sentence denotes 0.828 (0.682, 1.007); FP+MON:
T90474 481436-481459 Sentence denotes 1.095 (0.804, 1, 489 ).
T39770 481460-481536 Sentence denotes The table below shows the percent of children dispensed a NSA and/or an INS.
T12582 481537-481622 Sentence denotes The number of units of each allergy medication was also similar across all 4 cohorts.
T49808 481623-481634 Sentence denotes Conclusion:
T63744 481635-481828 Sentence denotes The use of MON, FP, FP+MON or FSC for asthma did not alter the rate or quantity of either intranasal corticosteroid or nonsedating antihistamines dispensed to children over the 12-month period.
T88799 481829-482040 Sentence denotes Although allergic rhinitis is a common comorbidity of pediatric asthma, the selection of a regimen containing montelukast did not reduce the use of either NSA or INS compared to asthma treatments with FP or FSC.
T4445 482041-482051 Sentence denotes Rationale:
T64882 482052-482485 Sentence denotes Medication compliance is recognized as a significant challenge in pediatrics.The purpose of this study was to compare inhaled corticosteroid (ICS) persistence in pediatric patients using a single inhaler, containing both an inhaled corticosteroid (fluticasone propionate, FP) and an inhaled long-acting beta-agonist (salmeterol, SAL) (FSC), to patients receiving FP alone, FP + SAL from separate inhalers, or ICS + montelukast (MON).
T1637 482486-482494 Sentence denotes Methods:
T7060 482495-482580 Sentence denotes Retrospective 24-month pre-post database study utilizing medical and pharmacy claims.
T11714 482581-482760 Sentence denotes A total of 4946 subjects 4-17 years of age with a diagnosis of asthma (ICD9 493) were grouped into 4 cohorts: FSC [n=1168]; FP only [n=2473] ICS+SAL [n=296]; and ICS+MON [n=1009].
T47468 482761-482885 Sentence denotes Patients were controller naïve for 6 months prior to the index event (the first prescription of the medication of interest).
T61751 482886-482979 Sentence denotes Subjects were required to have continuous enrollment of 6 months pre-and 12 months postindex.
T86881 482980-483091 Sentence denotes Subjects with cystic fibrosis, COPD, bronchopulmonary dysplasia or respiratory distress syndrome were excluded.
T86204 483092-483242 Sentence denotes ICS refill rates, as a measure of persistence, were compared between FSC and the ICS components of the other cohorts over a 12-month follow-up period.
T34100 483243-483251 Sentence denotes Results:
T36573 483252-483480 Sentence denotes Mean refill rates over the 12-month follow-up period was significantly greater (p=< 0.05) for FSC (4.48) compared with the mean ICS refill rate in the FP alone (3.39) cohort, the ICS + SAL (3.61) and the ICS + MON (3.92) cohort.
T96753 483481-483608 Sentence denotes Patients on FSC filled 32% more ICS prescriptions than patients on FP alone, 24% more than ICS+SAL and 14% more than ICS + MON.
T48114 483609-483800 Sentence denotes Mean refills were generally higher than the median fills as a considerable number of children had only one fill: FSC (35.6%), FP (49.1%), ICS (48.3%) + SAL (50.0%), ICS (36.0%) + MON (18.6%).
T64819 483801-483812 Sentence denotes Conclusion:
T36544 483813-484002 Sentence denotes Patients using FSC, are likely to fill their inhaled corticosteroids more often over 12-months compared with patients using ICS + SAL in 2 separate inhalers, ICS+MON, and FP as monotherapy.
T47563 484003-484111 Sentence denotes Improved persistence with ICS has been shown in other studies to decrease morbidity and mortality of asthma.
T57682 484112-484378 Sentence denotes Use of FSC, a single inhaler, assures that children are getting more optimal inhaled corticosteroid therapy as well as the benefits from the long acting bronchodilator while avoiding selective discontinuation of ICS that may occur when two medications are dispensed.
T66407 484379-484482 Sentence denotes The National Health Interview Survey (NHIS) estimates 14.5 million United States residents with asthma.
T80732 484483-484553 Sentence denotes Noncompliance with treatment has been estimated as between 20 and 80%.
T52410 484554-484741 Sentence denotes The consequences of noncompliance include absences from work or school, increased emergency room visits, more severe attacks, increased drug side effects, greater cost of care, and death.
T90064 484742-485019 Sentence denotes We questioned compliance in a 47yo man with severe, prednisone dependent eosinophilic asthma because he had persistent symptoms despite treatment with fluticasone propionate/salmeterol xinafoate 500/50 bid, prednisone 20mg to 40mg qd, and budesonide (200 mcg/puff) 2 puffs bid.
T15549 485020-485263 Sentence denotes After discontinuation of budesonide and prednisone and initiation of methylprednisolone 16mg bid for 24 hours and then 16mg qd and beclomethasone dipropionate 2 puffs (80mcg) HFA bid with a spacer, clinical improvement was unexpectedly abrupt.
T22172 485264-485308 Sentence denotes FEV1 increased from 58% to 90% of predicted.
T41776 485309-485359 Sentence denotes Sputum eosinophil counts decreased from 78% to 2%.
T16854 485360-485489 Sentence denotes Because of the sudden improvement with the change to methylprednisolone, compliance to prednisone and fluticasone was questioned.
T97209 485490-485643 Sentence denotes To evaluate compliance, the patient's blood, urine, and sputum were tested for synthetic corticosteroids, without his knowledge, using mass spectrometry.
T87209 485644-485808 Sentence denotes The blood level of methylprednisolone was 2.6mcg/dl and prednisolone was 0.35mcg/dl, documenting use of methylprednisolone and the recently discontinued prednisone.
T75269 485809-485966 Sentence denotes The urine levels were 13mcg/dl of methylprednisolone, 1.3mcg/dl of prednisolone and 0.74mcg/dl of prednisone that further confirmed recent use of prednisone.
T21712 485967-486163 Sentence denotes The sputum testing revealed 0.8mcg/dl beclomethasone, 33mcg/dl fluticasone and 1.8mcg/dl methylprednisolone confirming compliance to inhaled fluticasone and beclomethasone at the time of the test.
T25196 486164-486332 Sentence denotes Thus, contrary to our clinical suspicion, the patient was indeed compliant with his inhaled glucocorticoids and prednisone and subsequently with the methylprednisolone.
T21320 486333-486530 Sentence denotes To our knowledge, this is the first case report to document compliance to inhaled and oral corticosteroids by analysis of synthetic corticosteroid concentrations in blood, urine, as well as sputum.
T72851 486531-486744 Sentence denotes If compliance could be documented with certainty, it could potentially minimize the adverse effects of needless escalating steroid doses, reduce the cost of treatment, and minimize morbidity and mortality as well.
T62946 486745-486841 Sentence denotes Rationale:The burden of pediatric asthma extends beyond those children with an asthma diagnosis.
T85568 486842-486995 Sentence denotes Children with wheezing frequently have a delay in the diagnosis of asthma that may impede instituting appropriate therapy and reducing disease morbidity.
T2603 486996-487239 Sentence denotes This observational study was designed to assess the treatment patterns of children 4-17 years old receiving asthma medication(s) without a diagnosis of asthma compared with children diagnosed with asthma and children without claims for asthma.
T71420 487240-487470 Sentence denotes Methods:This was a retrospective cross-sectional study that utilized the PharMetrics Integrated Outcomes Database containing administrative medical and pharmacy claims data from over 30 managed care plans across the United States.
T33004 487471-487792 Sentence denotes Three cohorts were selected: children with an asthma diagnosis (ICD-9, 493.xx) (Dx cohort), children with prescription claims for asthma controllers or rescue medications without an asthma diagnosis (Rx cohort) and children with neither an asthma diagnosis nor prescription claims for asthma medications (Control cohort).
T69857 487793-487888 Sentence denotes Utilization of asthma medications, asthma specific costs and total costs of care were assessed.
T50 487889-487897 Sentence denotes Results:
T45082 487898-487943 Sentence denotes A total of 295, 000 children were identified:
T79827 487944-488021 Sentence denotes 6.7% in the Dx cohort, 4.4% in the Rx cohort and 88.9% in the control cohort.
T76074 488022-488060 Sentence denotes The potential asthma cohort was 11.1%.
T48837 488061-488188 Sentence denotes Total annual non-asthma related costs for the Dx cohort was $1, 642 for the Rx cohort was $1, 306 and for the control was $802.
T31953 488189-488298 Sentence denotes Only 19% and 5% of the total healthcare charges in the Dx and Rx cohorts retrospectively were asthma related.
T33351 488299-488407 Sentence denotes Non-asthma charges were significantly higher in both the Dx and Rx cohorts compared with the control cohort.
T85297 488408-488536 Sentence denotes In the Rx cohort, the ratio of SABA prescription claims to asthma controller claims were 1.85-fold higher than in the Dx cohort.
T66315 488537-488548 Sentence denotes Conclusion:
T93863 488549-488770 Sentence denotes Children treated with asthma medications without an asthma diagnosis consume greater health care resources resembling the pattern of health care utilization of children with an asthma diagnosis more closely than controls.
T6132 488771-488949 Sentence denotes Further, children with treatment in the absence of an asthma diagnosis appear to be under-treated with controller therapy as recommended by national and international guidelines.
T48802 488950-488961 Sentence denotes BACKGROUND:
T63375 488962-489166 Sentence denotes A recent retrospective study assessed asthma variability in inner-city patients 6 months before and 6 months after enrollment into an NAEPP guidelines-directed clinical management and educational program.
T99444 489167-489318 Sentence denotes While guidelines-directed care improved asthma symptoms and outcomes, significant variability in disease indices were observed over the 6-month period.
T43136 489319-489404 Sentence denotes The present analysis evaluates resource utilization associated with this variability.
T90248 489405-489412 Sentence denotes METHOD:
T70297 489413-489818 Sentence denotes Economic end points, including hospital/emergency department (ED) visits, total unscheduled office visits, sick visits, and days lost from work or school, were collected from 125 inner-city patients aged 18 years (74% female, 69% minority, 80% treated by primary care physicians) enrolled in a guidelines-directed asthma clinical management and education program aimed at minimizing barriers to adherence.
T9329 489819-490201 Sentence denotes Patients were stratified into 2 groups: those with high variability in asthma (n=62) and those with low variability in asthma (n=63), with variability defined as number of fluctuations in NAEPP symptom class in the 6-month postintervention period (high variability = patients with fluctuations higher than the mean; low variability = patients with fluctuations lower than the mean).
T59745 490202-490210 Sentence denotes RESULTS:
T73019 490211-490334 Sentence denotes Guidelines-directed therapy was associated with improvements in asthma during the 6-month treatment period for both groups.
T34675 490335-490516 Sentence denotes Patients in the high-variability group had more ED visits, sick visits, total unscheduled visits, and office visits compared with patients in the low-variability group (see table) .
T95147 490517-490529 Sentence denotes CONCLUSIONS:
T38177 490530-490741 Sentence denotes Despite guidelines-directed therapy and overall improvement in asthma control, patients experienced variability in asthma, indicating that even when their disease is stable, their symptoms continue to fluctuate.
T25552 490742-490823 Sentence denotes As a result, asthma variability may contribute to increased resource utilization.
T55252 490824-490837 Sentence denotes INTRODUCTION:
T57727 490838-490938 Sentence denotes Inhaled corticosteroids (ICS) are considered first-line therapy for patients with persistent asthma.
T15770 490939-491035 Sentence denotes ICS can lead to oropharyngeal adverse events, which may affect treatment outcomes and adherence.
T50164 491036-491163 Sentence denotes The occurrence of these local adverse events is dependent upon several factors, including dosage and duration of ICS treatment.
T90712 491164-491308 Sentence denotes Ciclesonide (CIC) hydrofluoroalkane (HFA)-metered dose inhaler (MDI) is a novel and effective ICS, with relatively low oropharyngeal deposition.
T67880 491309-491401 Sentence denotes CIC is converted in the lungs to its active metabolite, desisobutyryl-ciclesonide (des-CIC).
T77002 491402-491517 Sentence denotes Furthermore, CIC undergoes limited conversion in the oropharynx, which may account for its improved safety profile.
T46533 491518-491715 Sentence denotes This oropharyngeal safety profile analysis was part of a long-term study evaluating the safety of CIC HFA-MDI vs beclomethasone dipropionate (BDP) HFA-MDI in patients with severe persistent asthma.
T33268 491716-491724 Sentence denotes METHODS:
T73861 491725-491880 Sentence denotes This was a multicenter, double-blind, parallelgroup, 12-month extension of a 12-week double-blind study of patients 12 years with severe persistent asthma.
T86479 491881-491996 Sentence denotes Patients were randomized in a 2:1 ratio (CIC:BDP) to receive CIC (320 g bid) or BDP (320 g bid) (both ex-actuator).
T49026 491997-492220 Sentence denotes After 2 weeks, the doses of both medications could be titrated to 160 g bid as needed for asthma control.) Oropharyngeal adverse events were monitored, and suspected oral fungal infections were verified by positive culture.
T58006 492221-492229 Sentence denotes RESULTS:
T2996 492230-492360 Sentence denotes The incidence of oral candidiasis was lower in subjects receiving CIC (4.1%), compared with those receiving BDP (10.4%) ( Table) .
T48160 492361-492508 Sentence denotes The incidence of pharyngitis and hoarseness was 3.6% and 2.5%, respectively, for the CIC group, and 5.2% and 1.0%, respectively, for the BDP group.
T22760 492509-492646 Sentence denotes All local adverse events resolved without sequelae, and there were no withdrawals due to oropharyngeal treatment-emergent adverse events.
T60222 492647-492658 Sentence denotes CONCLUSION:
T19175 492659-492781 Sentence denotes After 12-months of treatment with CIC 160 μg or 320 μg twice-daily, the incidence of oropharyngeal adverse events was low.
T84718 492782-492924 Sentence denotes CIC treatment resulted in a much lower incidence of oral candidiasis, compared with similar doses of BDP, reflecting a better local tolerance.
T30560 492925-492935 Sentence denotes Objective:
T38087 492936-493063 Sentence denotes To determine the prevalence of asthma and asthma-related morbidity, treatment and asthma-risk factors in a selected population.
T8863 493064-493071 Sentence denotes Method:
T86419 493072-493198 Sentence denotes A routine health screening, including tests for asthma, was conducted at the New Orleans Center for Creative Arts High School.
T93335 493199-493314 Sentence denotes Participants (204) identified their medications and asthma tools in addition to completing the ISAAC questionnaire.
T56971 493315-493408 Sentence denotes Prevalence data included lifetime wheezing, 12 month wheezing, and previous asthma diagnosis.
T64481 493409-493525 Sentence denotes Asthma-related morbidity included sleep disturbance, wheezing with exercise, asthma attack rate and night awakening.
T62323 493526-493782 Sentence denotes Results: " Participants were aged 13-9 years (50.5% African American, 45.1% white) with 31.4% male, 68.6% female. " Cumulative asthma prevalence was 18.8%, lifetime wheezing (24%), 12-month wheezing 12.7% with girls reporting 3.36 times more often (95% CI:
T79161 493783-493996 Sentence denotes 1.54, 7.36), and wheezing more than 4 times in 12 months 4.7%. " There was a significant association between race and wheezing in the last 12 months (p < 0.024) with whites reporting 3.78 times more often (95% CI:
T73356 493997-494009 Sentence denotes 2.01, 7.10).
T36158 494010-494054 Sentence denotes Asthma morbidity was reported as follows: a.
T71372 494055-494076 Sentence denotes Night cough -10.5% b.
T48902 494077-494197 Sentence denotes Wheezing with exercise -10.9% " Parents with a less education (high school or less) were 8.33 times more likely (95% CI:
T95524 494198-494399 Sentence denotes 7.46, 9.30) to have children who developed wheezing in the past 12 months. " Higher Body Mass Index (BMI = 25) was associated with wheezing after exercise (p < 0.008) with a 3.27-fold increase (95% CI:
T98491 494400-494562 Sentence denotes 2.46, 4.31). " Among those with current asthma (15/204), 4 were not on any medication, 10 were using bronchodilators, and 5 were on anti-inflammatory medications.
T92532 494563-494632 Sentence denotes Three reported using a spacer and 6 reported using a peak flow meter.
T35847 494633-494644 Sentence denotes Conclusion:
T60167 494645-494725 Sentence denotes Asthma prevalence is higher in this school population than the national average.
T99544 494726-494825 Sentence denotes Less parental education, female gender, and BMI = 25 were associated with greater asthma morbidity.
T42681 494826-494961 Sentence denotes The majority of the participants with current asthma reported receiving episodic and inadequate treatment with inhaled corticosteroids.
T20925 494962-494973 Sentence denotes Objectives:
T27219 494974-495098 Sentence denotes To determine the prevalence of asthma and asthma related symptoms; to assess its severity among New Orleans school children.
T59431 495099-495107 Sentence denotes Methods:
T72573 495108-495264 Sentence denotes Seven elementary, middle, and high schools in New Orleans participated in the screening of 1511 students, 54% female, 45% male, ages 5-18 in the Fall, 2000.
T18907 495265-495431 Sentence denotes The 8-item questionnaire was designed by the International Study of Asthma and Allergies in Childhood (ISAAC) to determine asthma prevalence and severity in children.
T18981 495432-495527 Sentence denotes The ISAAC questionnaire is a validated protocol used on over 500, 000 children in 56 countries.
T53096 495528-495598 Sentence denotes Asthma is defined as cur-rent wheezing for the purposes of this study.
T76190 495599-495662 Sentence denotes Data was entered using SPSS 10 and SAS 8 software for analysis.
T53570 495663-495671 Sentence denotes Results:
T68787 495672-495678 Sentence denotes Table:
T26514 495679-495731 Sentence denotes Presence of asthma symptoms by ethnicity Conclusion:
T17899 495732-495886 Sentence denotes Asthma prevalence is significantly higher in inner-city school children in New Orleans when compared to the national prevalence (24.6% to 26.4% vs. 7.5%).
T28111 495887-496058 Sentence denotes Asthma prevalence and severity do not differ significantly between African-American and Caucasian children in New Orleans even after removing the effect of gender and age.
T95227 496059-496122 Sentence denotes Video is an effective method of teaching pollen identification.
T70280 496123-496235 Sentence denotes Projected digital images offer three-dimensional views of unique pollen detail similar to focusing a microscope.
T58660 496236-496316 Sentence denotes The National Allergy Bureau™(NAB) currently provides pollen counts to the media.
T48026 496317-496472 Sentence denotes These reported levels are obtained by standardized counting methods rather than forecasts based on historical pollination predictions and weather patterns.
T98841 496473-496669 Sentence denotes The American College of Allergy, Asthma and Immunology and the American Academy of Allergy, Asthma and Immunology have an interest in ensuring consistent counting and accurate reporting practices.
T79471 496670-496871 Sentence denotes Both organizations offer pollen identification training in conjunction with their annual meetings and have used the video for initial training sessions and for experienced counters in advanced courses.
T54153 496872-497002 Sentence denotes There are 112 certified pollen counting stations in the United States and Canada with approximately 80 currently active locations.
T8272 497003-497104 Sentence denotes The NAB requires the demonstration of ability to count and accurately identify pollen on test slides.
T9187 497105-497199 Sentence denotes An updated recertification process using an interactive web site is currently being developed.
T16992 497200-497307 Sentence denotes Ongoing pollen identification training is essential for the continued success of this aeroallergen network.
T49634 497308-497467 Sentence denotes Most observers found that the video provided a quality emulation of microscopic viewing and enhanced the depth and detail of individual pollen characteristics.
T87349 497468-497536 Sentence denotes The video received the highest possible ratings by course attendees.
T1440 497537-497670 Sentence denotes In conclusion the video plays a positive role in pollen identification training and the continuing education of experienced counters.
T46446 497671-497874 Sentence denotes The diagnosis and treatment of mold allergies are complicated by the genetic diversity of individual fungal species and the influence of endogenous fungal proteases on extract compositions and potencies.
T54074 497875-498096 Sentence denotes Studies examining the biochemical comparability of mold extracts from different sources and their compatibility with other allergens in immunotherapy mixtures are essential to the clinical effectiveness of these products.
T13468 498097-498367 Sentence denotes Compositional comparisons of extracts prepared from Alternaria, Aspergillus and Penicillium source materials by 7 U.S. allergen manufacturers revealed variable SDS-PAGE protein banding patterns and noticeable differences in total protein and carbohydrate concentrations.
T4069 498368-498517 Sentence denotes Alt a 1 levels in Alternaria extracts did not correlate closely with total protein levels or with IgE-binding potencies measured by ELISA inhibition.
T81766 498518-498731 Sentence denotes Immunoblot profiles of fungal extracts were more closely related to one another compared to SDS-PAGE patterns, suggesting that similar allergenic or antigenic epitopes may be retained in molecules of varying size.
T90023 498732-498882 Sentence denotes Parallel ELISA inhibition dose-response curves provided statistical evidence that a repertoire of IgE epitopes is conserved in many of these products.
T62479 498883-499051 Sentence denotes Variations in the potencies of fungal extracts from different manufacturers may result from differences in source materials and/or conditions of extraction and storage.
T80266 499052-499233 Sentence denotes The stability and compatibility of allergen mixtures containing mold extracts were assessed after storage for up to 6 months at 2-8°C using specific immunoblot and ELISA procedures.
T4435 499234-499328 Sentence denotes Grass and mite allergens compromised by mixing with mold extracts were stabilized by glycerin.
T38905 499329-499451 Sentence denotes Alternaria extracts from different sources produced similar effects on grass allergens when added at comparable strengths.
T80568 499452-499609 Sentence denotes Degradative effects caused by Aspergillus or Penicillium products were more closely related to total fungal protein concentrations than to extraction ratios.
T2989 499610-499867 Sentence denotes Structural epitopes on cat, ragweed and fungal allergens were stable after mixing with protease-containing mold extracts, indicating the presence of natural protease inhibitors or allergenic protein sequences distinct from those recognized by these enzymes.
T37036 499868-499984 Sentence denotes Allergenic extracts labeled as weight/volume or by PNU have no regulatory requirement for determination of activity.
T8353 499985-500076 Sentence denotes Alum-adsorbed allergenic extracts are labeled in PNU and are felt to be depot formulations.
T34979 500077-500314 Sentence denotes The purpose of this study was to develop methods to measure important allergen proteins and specific IgE binding capability of these alum-adsorbed allergenic extracts and to begin to assess the potency of these non-standardized extracts.
T8782 500315-500399 Sentence denotes Allergen proteins are adsorbed to alum particles making their measurement difficult.
T93406 500400-500526 Sentence denotes In this study allergens were released from Center-Al ® alum precipitated allergenic extracts using 0.3 M Citrate buffer, pH 5.
T96551 500527-500731 Sentence denotes The major allergen contents of several lots of each product were measured using monoclonal antibody ELISAs for Group 5 grasses, Cyn d 1 Bermuda, Bet v 1 birch, Ole e 1 olive, and Pla l 1 English plantain.
T53028 500732-500835 Sentence denotes These assays were developed and validated by ALK-Abello and optimized for the citrate releasing buffer.
T51379 500836-500999 Sentence denotes Direct binding IgE was performed by immobilizing serial dilutions of extract to microtiter plates and then adding specific atopic sera and enzyme labeled anti-IgE.
T66278 501000-501095 Sentence denotes The methods used were able to measure in vitro allergen activity in the alum-adsorbed extracts.
T77573 501096-501207 Sentence denotes Major allergen content was successfully measured in the extracts and the amount was related to the PNU content.
T47647 501208-501367 Sentence denotes As expected, the variability of the major allergens within a particular extract species was higher than in standardized extracts that are adjusted for potency.
T7454 501368-501444 Sentence denotes The extracts demonstrated specific IgE binding ability in the binding assay.
T94322 501445-501535 Sentence denotes The IgE binding capability at various dilutions was related to the major allergen content.
T11816 501536-501631 Sentence denotes In conclusion, methods were developed to release adsorbed allergen proteins from alum extracts.
T38228 501632-501721 Sentence denotes The extracts were then analyzed for major allergen pro-teins and the ability to bind IgE.
T93998 501722-501962 Sentence denotes Major allergen content is currently used to monitor the activity of aqueous and glycerinated extracts and this study demonstrates that implementing these testing procedures will improve the consistency and quality of alum-adsorbed extracts.
T60533 501963-502027 Sentence denotes Introduction There are over 5000 species of smut and rust fungi.
T39209 502028-502111 Sentence denotes Ustilago maydis, or corn smut, is a basidiomycete fungus that infects ears of corn.
T35096 502112-502216 Sentence denotes It is responsible for a percentage of grain loss in the United States but eaten as a delicacy in Mexico.
T45243 502217-502574 Sentence denotes It grows into large tumor-like structures, called galls, dispersing soot-like spores responsible for the common name, "smut." It is readily airborne and believed to be a causal agent for allergic rhinoconjunctivitis. "Corn smuts" was added to the standard screening panel for patients presenting for evaluation of rhinitis in the region of middle Tennessee.
T61321 502575-502724 Sentence denotes Methods Using Greer Laboratories™ Corn Smut Extract 1:20 w/v, patients were tested by prick/puncture method with the Hollister-Stier Quintip™ device.
T7188 502725-502772 Sentence denotes If negative, intradermal testing was performed.
T47175 502773-502818 Sentence denotes Positive and negative controls were assessed.
T63119 502819-503051 Sentence denotes Based on current national recommendations, wheals 3 mm greater than negative control were considered positive for prick/puncture testing and wheals 8 mm greater than negative control were considered positive for intradermal testing.
T98581 503052-503125 Sentence denotes Results 105 patients were tested between November, 2003 and March, 2004 .
T98889 503126-503184 Sentence denotes 14/105 (13.3%) met criteria for prick/puncture positivity.
T75605 503185-503240 Sentence denotes 52/105 (49.5%) met criteria for intradermal positivity.
T97980 503241-503520 Sentence denotes Patients prick positive to corn smut had the following prick positive tests: dust mites 12/14 (85.7%); cat 11/14 (78.6%); local grass mix 10/14 (71.4%); local tree mix 10/14 (71.4%); local weed mix 10/14 (71.4%), mold mix 8/14 (57.1%); cockroach 7/14 (50%); and dog 4/14 (28.6%).
T78003 503521-503650 Sentence denotes Discussion Allergy testing for aeroallergens is available to a limited number of antigens, of which, only a few are standardized.
T91969 503651-503740 Sentence denotes As time passes, relevant antigens are discovered and their importance further elucidated.
T13568 503741-503903 Sentence denotes This assessment reveals a significant presence of corn smut IgE largely accounted for by intradermal positivity which may or may not reflect clinical sensitivity.
T58312 503904-504009 Sentence denotes These numbers are provided so that other clinicians may compare to prevalence in their geographical area.
T50166 504010-504106 Sentence denotes Further studies are needed to determine the association of corn smut IgE with clinical symptoms.
T10767 504107-504202 Sentence denotes H 1 antihistamines are the mainstay of therapy for allergic disorders, including skin diseases.
T81695 504203-504410 Sentence denotes The most common side-effect of marketed antihistamines is sedation, especially when the clinical symptoms require a higher dose than recommended, a condition commonly encountered in dermatological disorders.
T98246 504411-504516 Sentence denotes The present study describes the pharmacology of a new non-sedating H 1 antihistamine, R129160 (Hivenyl™).
T83904 504517-504592 Sentence denotes R129160 binds to the cloned human H 1 receptor with a similar affinity (Ki:
T42653 504593-504647 Sentence denotes 19 nM) as the reference antihistamines cetirizine (Ki:
T36343 504648-504674 Sentence denotes 50 nM) and loratadine (Ki:
T43860 504675-504682 Sentence denotes 37 nM).
T60203 504683-504811 Sentence denotes In vivo, R129160 protects rats and guinea pigs from lethal shock, induced by compound 48/80 and histamine, respectively (ED 50 :
T84238 504812-504847 Sentence denotes 0.06 and 0.055 mg/kg respectively).
T29736 504848-504915 Sentence denotes The compound is at least as effective as cetirizine and loratadine.
T51887 504916-505005 Sentence denotes In rats, R129160 inhibits the histamine-and allergen-induced cutaneous reactions (ED 50 :
T25216 505006-505070 Sentence denotes 1.4 and 2.3 mg/kg) with a similar potency as cetirizine (ED 50 :
T69729 505071-505113 Sentence denotes 0.7 and 2.7 mg/kg) and loratadine (ED 50 :
T86997 505114-505133 Sentence denotes 1.8 and 1.6 mg/kg).
T25586 505134-505238 Sentence denotes Even so, in guinea pigs the compound inhibits the histamine-and allergen-induced skin reactions (ED 50 :
T97669 505239-505308 Sentence denotes 0.14 and 1.2 mg/kg) to a similar extent as loratadine and cetirizine.
T65500 505309-505415 Sentence denotes However, in dogs R129160 is more potent in inhibiting the Ascaris allergen-induced wheal reaction (ED 50 :
T32017 505416-505453 Sentence denotes 0.024 mg/kg) than cetirizine (ED 50 :
T14989 505454-505488 Sentence denotes 0.14 mg/kg) or loratadine (ED 50 :
T22322 505489-505501 Sentence denotes 0.20 mg/kg).
T83272 505502-505627 Sentence denotes R129160 fails to occupy central H 1 receptors in the guinea pig cerebellum up to 40 mg/kg, in contrast to loratadine (ED 50 :
T46516 505628-505639 Sentence denotes 2.2 mg/kg).
T91432 505640-505793 Sentence denotes In vitro and in vivo cardiovascular safety experiments indicate that R129160 lacks the intrinsic capacity to prolong the QT-interval, even at high doses.
T45665 505794-505898 Sentence denotes As such, R129160 (Hivenyl™) is characterized as a potent, non-sedating and cardiosafe H 1 antihistamine.
T3726 505899-505989 Sentence denotes It has been selected for further clinical development, mainly in the field of dermatology.
T36660 505990-506234 Sentence denotes The compound will be a suitable tool to explore the activity of a selective H 1 antihistamine in various indications, without the contamination of the sedative activity often observed with other marketed antihistamines when increasing the dose.
T45350 506235-506345 Sentence denotes CIU represents one of the most clinically perplexing disorders which the allergist-immunologist is faced with.
T54171 506346-506509 Sentence denotes We have previously reported the clinical efficacy of FXT (Prozac), an SSRI widely used for the treatment of depression, in the management of CIU (Nsouli TM, et al.
T64205 506510-506551 Sentence denotes Ann Allergy Asthma Immunol 2002; 88:60) .
T63080 506552-506663 Sentence denotes In this presentation we report 2 additional cases of CIU which responded dramatically following the use of FXT.
T89014 506664-506925 Sentence denotes A 41 yr-old female and a 21 yr-old male presented with CIU of 18 and 24 months duration, respectively, requiring oral corticosteroid (CS) therapy for control of their CIU after failure of high dose anti-H1 (hydroxyzine) and anti-H2 (ranitidine) agents (Table) .
T90930 506926-507048 Sentence denotes Testing for food and latex allergy, viral hepatitis, autoimmune thyroid disease and parasitic infection were all negative.
T26467 507049-507132 Sentence denotes A skin biopsy performed in subject #1 was consistent with an urticarial vasculitis.
T65815 507133-507370 Sentence denotes Following one week of oral FXT (40 mg qd [Subject #1] 20 mg qd [Subject #2]) a striking and complete resolution of urticaria in each patient was observed within 7 to 10 days during which time it was possible to successfully taper the CS.
T1333 507371-507456 Sentence denotes Both patients have been maintained on FXT therapy with complete control of their CIU.
T41182 507457-507658 Sentence denotes The very favorable response to FXT therapy in these 2 patients in addition to our first case report suggests that this drug may have a new therapeutic application in the management of recalcitrant CIU.
T71222 507659-507670 Sentence denotes Background:
T47709 507671-507859 Sentence denotes Ipratropium bromide nasal spray (IB) is indicated for treatment of rhinorrhea caused by common cold (CC), seasonal and perennial allergic rhinitis (AR) in adults and children age 5 and up.
T80644 507860-508016 Sentence denotes Symptoms of rhinorrhea from CC or AR in children are similar to those in adults, yet there is little data on the use of IB in children under 5 years of age.
T33130 508017-508027 Sentence denotes Objective:
T10593 508028-508152 Sentence denotes Evaluate the safety and efficacy of IB nasal spray 0.06% in 2-5 year-old children with symptoms of rhinorrhea from CC or AR.
T81063 508153-508161 Sentence denotes Methods:
T56296 508162-508255 Sentence denotes A total of 230 children (43 CC and 187 AR) were treated in an open-label, multi-center study.
T12149 508256-508410 Sentence denotes The CC patients received IB nasal spray (84 mcg per nostril) tid for 4 days, the AR patients received IB nasal spray (42 mcg per nostril) tid for 14 days.
T71714 508411-508526 Sentence denotes Effectiveness was measured using a global assessment questionnaire and daily symptom scores reported by the parent.
T6879 508527-508535 Sentence denotes Results:
T74277 508536-508693 Sentence denotes From the global assessment questionnaire, 91% and 90% of the parents found IB either "very useful" or "somewhat useful" in the CC and AR groups respectively.
T78827 508694-508845 Sentence denotes Regarding effectiveness, 98% (CC) and 87% (AR) of the parents reported that IB had either a "good effect" or "excellent effect" in treating rhinorrhea.
T65934 508846-509087 Sentence denotes Moreover, 67% (CC) and 91% (AR) of parents found administration of a nasal spray either "extremely easy" or "very easy." Eighty-one percent (CC) and 89% (AR) of the parents reported they would use IB again for their child's allergy symptoms.
T77531 509088-509355 Sentence denotes The daily symptom score (0 = none to 5 = unbearable) for rhinorrhea decreased from 2.9 to 1.3 (-55%, p<0.0001) for CC and from 2.1 to 1.1 (-48%, p<0.0001) from baseline compared to the average on-treatment score, with decreases also seen for stuffy nose and sneezing.
T57998 509356-509461 Sentence denotes The nasal spray was well tolerated with adverse events (AE) reported in 28% of CC and 35% of AR patients.
T76087 509462-509572 Sentence denotes The AEs were mostly mild to moderate and no potentially systemic anticholinergic or serious AEs were reported.
T23793 509573-509812 Sentence denotes Conclusions: IB nasal spray 0.06% administered at a dose of either 42 or 84 mcg per nostril tid is an easy to use, safe, and effective therapy for control of rhinorrhea in children 2 to 5 years of age with common cold or allergic rhinitis.
T35304 509813-509954 Sentence denotes Chronic idiopathic urticaria (CIU) represents one of the most clinically perplexing disorders which the allergist-immunologist is faced with.
T99648 509955-510289 Sentence denotes The pathogenesis of the condition derives from the release of potent vasoactive substances including histamine, and products of arachidonic acid metabolism, e.g., prostaglandins and thromboxanes formed by the action of the enzymes cyclooxygenase (COX) of which COX-2 is responsible for pseudoallergic and other inflammatory responses.
T76675 510290-510514 Sentence denotes Although a number of therapeutic options exist owing to the plethora of mediators produced, treatment has focused largely on the use of H1 antihistamines and, unsurprisingly, at times without complete resolution of symptoms.
T33812 510515-510625 Sentence denotes In this presentation we report the successful use of a COX-2 inhibitor for the treatment of chronic urticaria.
T64925 510626-510892 Sentence denotes A 10 y/o white hispanic female presented with a 4 month history of chronic urticaria predominantly on the soles of the feet, with unknown precipitating factors, and fail-ure to respond to prior treatment with: cetirizine, steroids, benadryl, ebastine and epinastine.
T17108 510893-510990 Sentence denotes The patient received a blood transfusion 3 years ago and there was no prior history of allergies.
T18306 510991-511155 Sentence denotes Skin testing revealed 3+ reactions to dust mite, pollen, cockroach, shellfish, 2+ reactions to corn, milk and IgE = 262 IU (NV < 90 IU), ASO = 400 UI (NV < 200 UI).
T45111 511156-511245 Sentence denotes After 2 weeks of treatment with Rofecoxib (Vioxx) 25 mg, and benadryl, the rash resolved.
T98481 511246-511327 Sentence denotes Vioxx was continued for 2 more weeks until complete resolution of symptomatology.
T66292 511328-511551 Sentence denotes This case illustrates that the addition of a selective COX-2 inhibitor (i.e., Rofecoxib) with an H1 antihistamine may be a more effective regimen for patients with CIU who fail to respond adequately to conventional therapy.
T87350 511552-511565 Sentence denotes Introduction:
T66798 511566-511705 Sentence denotes Elderly asthmatic patients whose symptoms are controlled by inhaled corticosteroid (ICS) therapy may still have breathlessness on exertion.
T44948 511706-512022 Sentence denotes We randomized elderly asthmatic patients stabilized by medium-dose ICS therapy into two groups, treated one group with medium-dose ICS therapy plus montelukast, a leukotriene receptor antagonist, and the other with increased-dose ICS therapy, and compared the effects of the treatment regimens on exercise tolerance.
T85885 512023-512297 Sentence denotes Methods:The subjects were 24 patients with bronchial asthma (16 males and 8 females, 70.6±3.9 years) stabilized by ICS therapy (with fluticasone proprionate, FP; 400 mg/day) for three months or more with low peak expiratory flow (PEF) rates (<80%predicted, variability<15%).
T51134 512298-512517 Sentence denotes They were randomly divided into two groups (12 patients each) to be treated with ICS therapy plus montelukast (400 mg/day FP + 10 mg/day montelukast; M group) or with increased-dose ICS therapy (600 mg/day FP; F group).
T26943 512518-512767 Sentence denotes Pulmonary function tests, a six-minute walking test, respiratory gas analysis during incremental (15W/min) cycle ergometer exercise were conducted, and exhaled nitric oxide (NO) levels were measured before and after two weeks of the study treatment.
T65795 512768-512776 Sentence denotes Results:
T98547 512777-512989 Sentence denotes Pulmonary function tests showed significant increases in maximal mid-expiratory flow (MMF) and forced expiratory flow at 50% vital capacity (V50) in the M group (p<0.01) but no significant changes in the F group.
T34501 512990-513144 Sentence denotes Exhaled NO levels decreased significantly in both groups (40.7±13.9 to 27.5±9.1 ppb in the M group and 53.1±17.6 to 38.0±10.4 ppb in the F group; p<0.01).
T6888 513145-513456 Sentence denotes The six-minute walking distance extended from 531±64 to 575±58 m in the M group and from 553±60 to 570±58 m in the F group.The peak oxygen uptake (peakVO2) increased significantly in the M group (%peakVO2/W from 76.2±12.7 to 84.4±14.6%; p<0.01) but not in the F group (%peak VO2/W from 76.2±10.7 to 76.4±10.3%).
T74620 513457-513609 Sentence denotes The peak exercise load also increased significantly in the M group (76.6±22.0 to 96.1±23.1 W; p<0.01) but not in the F group (81.2± 16.2 to 82.2±14.3W).
T91705 513610-513622 Sentence denotes Conclusions:
T94550 513623-513819 Sentence denotes The results indicate that concomitant administration of montelukast is more effective than dose escalation of ICS on exercise tolerance in elderly asthmatic patients under medium-dose ICS therapy.
T35175 513820-513822 Sentence denotes E.
T32176 513823-513838 Sentence denotes Meltzer 1* , Y.
T80138 513839-513849 Sentence denotes Luo 2 , L.
T50783 513850-513861 Sentence denotes Shen 2 , Z.
T26795 513862-513872 Sentence denotes Guo 2 , C.
T85792 513873-513886 Sentence denotes Schemm 2 , Y.
T36715 513887-513899 Sentence denotes Huang 2 , K.
T19169 513900-513911 Sentence denotes Chen 2 , P.
T70187 513912-513923 Sentence denotes King 2 , R.
T73790 513924-513935 Sentence denotes Nave 3 , D.
T62847 513936-513950 Sentence denotes Banerji 2 , S.
T96954 513951-513966 Sentence denotes Rohatagi 2 , 1.
T52653 513967-513984 Sentence denotes San Diego, CA; 2.
T76120 513985-514004 Sentence denotes Bridgewater, NJ; 3.
T67952 514005-514023 Sentence denotes Konstanz, Germany.
T36122 514024-514037 Sentence denotes Introduction:
T50075 514038-514115 Sentence denotes Inhaled corticosteroids (ICS) are first-line treatment for persistent asthma.
T79503 514116-514181 Sentence denotes Ciclesonide (CIC) is a novel and effective ICS under development.
T10871 514182-514324 Sentence denotes Freely circulating, unbound ICS is available to cause systemic adverse effects, such as hypothalamic-pituitary-adrenal (HPA) axis suppression.
T87259 514325-514396 Sentence denotes Hence, it is important to determine the free fraction of ICS in plasma.
T11359 514397-514591 Sentence denotes In separate studies, the protein binding of the active metabolite of CIC, desisobutyryl-ciclesonide (des-CIC), was evaluated, and the effects of inhaled CIC on HPA axis function were determined.
T33801 514592-514600 Sentence denotes Methods:
T85565 514601-514700 Sentence denotes Human plasma protein bind-ing of des-CIC (0.5-500 ng/mL) was determined using equilibrium dialysis.
T91790 514701-514823 Sentence denotes Dialyzed samples were analyzed by liquid chromatography with tandem mass spectroscopy to determine free and bound des-CIC.
T63691 514824-515237 Sentence denotes In 3 separate clinical studies, the effects of CIC (HFA; 320-1280 μg daily) and placebo (PBO), via metered-dose inhaler (ex-actuator doses), over 9 days, 4 or 12 weeks, on basal HPA axis function (24-hour area-under-the-curve [AUC0-24h] serum or urinary cortisol corrected for creatinine) or stimulated (low-dose [1 μg] cosyntropin) serum cortisol were investigated in patients ( 18 years) with persistent asthma.
T28087 515238-515246 Sentence denotes Results:
T45115 515247-515310 Sentence denotes The mean % of human plasma protein binding for des-CIC was 99%.
T68055 515311-515417 Sentence denotes In 2 studies measuring serum cortisol AUC0-24h, there was no difference between PBO and CIC (320-1280 μg).
T50873 515418-515500 Sentence denotes Similar results were observed for 24-hr urinary cortisol corrected for creatinine.
T72703 515501-515749 Sentence denotes In the 3rd study measuring low-dose (1 μg) cosyntropin-stimulated peak serum cortisol, after 12 weeks of treatment, there was no significant difference in the mean change from baseline versus placebo for either CIC320 (P=0.383) or CIC640 (P=0.911).
T51133 515750-515762 Sentence denotes Conclusions:
T82981 515763-515905 Sentence denotes The favorable pharmacokinetic profile of CIC, in particular the high protein binding of des-CIC, may explain the lack of HPA-axis suppression.
T28710 515906-515956 Sentence denotes This appears to result in greater systemic safety.
T17974 515957-515965 Sentence denotes Purpose:
T18483 515966-516054 Sentence denotes Unscheduled office and ED visits for urgent asthma care are an ongoing point of concern.
T62745 516055-516191 Sentence denotes Determining preventive variables regarding these unscheduled visits could have a significant impact on asthma costs and quality of life.
T73729 516192-516205 Sentence denotes Objective(s):
T96767 516206-516518 Sentence denotes This research addresses the following question: when stratifying by race, gender, age, metropolitan/rural place of residence and comorbidity, do adults with asthma have fewer ED or unscheduled office visits for urgent asthma care if they: a) have an identified primary care provider, or b) have health insurance?
T78086 516519-516529 Sentence denotes Method(s):
T21753 516530-516681 Sentence denotes Univariate and stratified bivariate contingency table analyses were performed on weighted 2001 Behavioral Risk Factor Surveillance Survey (BRFSS) data.
T8370 516682-516692 Sentence denotes Result(s):
T129 516693-516866 Sentence denotes Adults with asthma who had an identified primary care provider were more likely to have no unscheduled office visits (OR=1.87) or ED visits (OR=2.07) for urgent asthma care.
T25311 516867-517006 Sentence denotes This was also true for adults with asthma who had health insurance (OR=1.38 for no unscheduled office visits and OR=1.71 for no ED visits).
T71774 517007-517073 Sentence denotes These relationships held when stratifying by race, gender and age.
T54836 517074-517129 Sentence denotes The relationships also held for metropolitan residents.
T54106 517130-517216 Sentence denotes The analysis was inconclusive for rural residency and the existence of co-morbidities.
T40373 517217-517231 Sentence denotes Conclusion(s):
T36909 517232-517464 Sentence denotes Despite race, gender, age and metropolitan residency, having a primary care provider or having health insurance impact whether or not adults with asthma are more likely to have unscheduled office or ED visits for urgent asthma care.
T43335 517465-517605 Sentence denotes Further investigations are needed to examine how these factors impact adults with asthma who are rural residents or who have co-morbidities.
T30730 517606-517608 Sentence denotes D.
T17039 517609-517627 Sentence denotes Bukstein 1* , G.A.
T75963 517628-517643 Sentence denotes Cherayil 2 , 1.
T12373 517644-517659 Sentence denotes Madison, WI; 2.
T39536 517660-517675 Sentence denotes Brookfield, WI.
T82063 517676-517689 Sentence denotes Introduction:
T83576 517690-517817 Sentence denotes Costs for plans to process prior authorizations for non-formulary medications, has been estimated to be $20 to $25 per request.
T29598 517818-517898 Sentence denotes Costs for physicians to process these requests has not been extensively studied.
T29647 517899-517907 Sentence denotes Methods:
T14377 517908-517981 Sentence denotes Dr.Bukstein, board certified allergist, developed a data collection tool.
T43202 517982-518087 Sentence denotes The form was utilized by physicians and nurses to document time spent on processing prior authorizations.
T64373 518088-518364 Sentence denotes Data collected included, class of medicines requiring the PA, nursing time spent on calling the patient, pharmacist, health plan, nursing time spent completing forms, nursing time clarifying the information for the PA, as well as physician time spent completing PA activities.
T58727 518365-518373 Sentence denotes Results:
T27314 518374-518537 Sentence denotes Data was collected over 8 weeks in 2003 and 117 requests were processed.The class of medicines most often processed was antihistamines, comprising 66% of requests.
T81400 518538-518633 Sentence denotes Nursing calls were tracked and calls to and from patients were the most common call documented.
T44602 518634-518683 Sentence denotes They averaged 5.6 +/-6.5 calls per day per nurse.
T87229 518684-518743 Sentence denotes The nurses spent an average of 17 minutes per patient call.
T34820 518744-518871 Sentence denotes Calls to health plans averaged 1.8 +/-1.5 calls per nurse per day and time spent on these call was 8.4 +/-9.5 minutes per call.
T38817 518872-518967 Sentence denotes Physician calls documented included 154 calls averaging 1.9 +/-1.2 calls per physician per day.
T58809 518968-519104 Sentence denotes These calls averaged 5.8 +/-5.0 minutes per call.Often the results of the prior authorizations were not known on the day of the request.
T3216 519105-519160 Sentence denotes Originally 30.8% of requests were granted the same day.
T35440 519161-519246 Sentence denotes Retrospective review revealed 98.7% were approved the first time they were processed.
T46734 519247-519309 Sentence denotes Salary and benefits were calculated for nurses and physicians.
T12285 519310-519401 Sentence denotes The hourly rate was defined as $21.50 per hour for nurses and $150 per hour for physicians.
T79458 519402-519479 Sentence denotes The costs for the time spent on the 117 prior authorizations were calculated.
T93854 519480-519641 Sentence denotes During the 8 week study period, over 40 hours was spent by nurses on 231 calls and over 8 hours was spent by physicians on 154 calls during the same time period.
T91846 519642-519741 Sentence denotes The total nursing and physician cost in this specialty practice was $17.77 per prior authorization.
T69041 519742-519753 Sentence denotes Conclusion:
T30938 519754-519947 Sentence denotes There are substantial costs with processing of prior authorization requests for non-formulary drugs on the physician office side of managed care as well as on the insurance side of the process.
T21182 519948-520089 Sentence denotes Specialty physicians should have a different process for obtaining non-formulary medications since almost 100% of their requests are granted.
T7821 520090-520103 Sentence denotes Introduction:
T21081 520104-520196 Sentence denotes Diabetes mellitus can adversely impact the course and outcome of myocardial infarction (MI).
T23513 520197-520347 Sentence denotes One of the mechanisms underlying this phenomenon is alteration of the course of inflammation and the reparative process following myocardial necrosis.
T30548 520348-520527 Sentence denotes Abnormal wound healing, tissue reparation and immune responses in diabetic patients have been intensively studied, but the cellular and the molecular mechanisms are still unclear.
T1605 520528-520769 Sentence denotes Transforming growth factor-beta (TGF-beta) is a multifunctional cytokine which plays a critical role in coordination of the course of inflammation and reparation, acting as a potent depressor of inflammation and a stimulator of regeneration.
T67983 520770-520962 Sentence denotes This study investigates the dynamics of serum concentrations of the active form of TGF-beta1 during the period up to the 20th day after the onset of a MI in diabetic and non-diabetic patients.
T41062 520963-520971 Sentence denotes Results:
T60093 520972-521199 Sentence denotes In non-diabetics a significant increase was observed in TGF-beta1 on day 2 (5-fold greater than in controls; 1370.0±306.2 and 269.3±214.5 pg/ml respectively) with further increases reaching a peak on day 7 (1723.1±127.6 pg/ml).
T10979 521200-521328 Sentence denotes On day 20 TGF-beta1 decreased to levels less than on day 2, but was still greater than in healthy controls (1265.3±369.8 pg/ml).
T61744 521329-521493 Sentence denotes In diabetics, concentrations of TGF-beta1 on days 2 (939.7±155.2 pg/ml) and 7 (965.8±150.4 pg/ml) after MI were similar to diabetics without MI (724.6±233.5 pg/ml).
T10501 521494-521622 Sentence denotes Only on day 20 was TGF-beta1 increased to levels (1502.8±285.6 pg/ml) which were 2 fold greater than in diabetics without an MI.
T54683 521623-521742 Sentence denotes Thus, in diabetic patients serum concentrations of the active form of TGF-beta1 are much greater than in non-diabetics.
T29643 521743-521858 Sentence denotes MI in patients with diabetes mellitus is associated with a reduced and significantly delayed increase in TGF-beta1.
T52064 521859-521987 Sentence denotes Conclusion: TGF-beta deficiency may be a factor associated with low activity of tissue reparation after MI in diabetic patients.
T4242 521988-522167 Sentence denotes Introduction Helicobacter pylori (HP) is the most common gastrointestinal infection worldwide, but only 10-15% of those infected develop chronic gastritis or peptic ulcer disease.
T2466 522168-522429 Sentence denotes The pathogenesis of ulceration, mechanisms of HP lifelong persistence in gastric mucosa and local immune disturbances induced by this infection are well known, but the mechanisms of resistance and elimination of this infection have not been extensively studied.
T52829 522430-522580 Sentence denotes Most study is based only on phenomenological findings, such as absence or low HP colonization in subjects spontaneously producing high levels of IL-2.
T92140 522581-522765 Sentence denotes The aim of this investigation was the analysis of the efficacy of the recombinant Interleukin (rIL-2) Roncoleukin (Biotech, Russia) in treatment of HP-associated gastric ulcer disease.
T51247 522766-522825 Sentence denotes Methods 108 patients were randomly divided into two groups.
T91859 522826-523001 Sentence denotes The first group of patients was treated with standard therapy including of two antibiotics (Claritromycin and Amoxicillin), proton pomp inhibitors and H2 receptor antagonists.
T7976 523002-523296 Sentence denotes Patients of the second group were treated with the same therapy, but instead of antibiotics they received 0.1 mg Roncoleukin into four to six areas submucously using a gastroscopic method and 0.4 mg Roncoleukin dissolved in 400 ml of 0.9% NaCl with 4 ml 10% human albumin infused intravenously.
T6857 523297-523365 Sentence denotes This procedure was performed three times at an interval of 72 hours.
T35318 523366-523495 Sentence denotes Results Immunological findings demonstrated that Roncoleukin results in an increase of CD25+, HLA-DR+ and CD16+CD56+ cell levels.
T56823 523496-523656 Sentence denotes There was an increase in the serum concentrations of IL1 (3 fold), IL6 (4 fold) and IFN (more than 20 fold) while the level of TNF and IL8 profoundly decreased.
T24768 523657-523808 Sentence denotes One month after the end of treatment, the group treated with rIL-2 had HP eradication achieved in 95.4% in comparison to 81.5% of the control patients.
T24965 523809-523966 Sentence denotes In the rIL-2 treated group, the ulcer epithelization period was 10.79±0.46 days while in the normal treatment control group it was 35.23±1.58 days (p<0.001).
T19905 523967-524178 Sentence denotes Conclusion Immunotherapy with rIL-2 is a more effective method of treatment of Helicobacter pylori-associated gastric ulcer disease when compared with traditional methods of treatment employing only antibiotics.
T95812 524179-524307 Sentence denotes INTRODUCTION The role of different cytokines and the growth factors is now appreciated in progression of essential hypertension.
T13210 524308-524603 Sentence denotes The participation of ET-1 and TGF 1 in pathogenesis of essential hypertension especially in the process of fibrosis, hypertrophia of vascular smooth muscular fibers, and cardiomyocytes, and the activation of renin-angiotensin system is now recognized, in addition to effects on myocyte cultures.
T31797 524604-524718 Sentence denotes The aim of the investigation was the study of serum ET-1 and TGF 1 levels in patients with essential hypertension.
T91262 524719-524854 Sentence denotes MATERIALS AND METHODS 60 patients with essential hypertension (40 males and 20 females) with average age 54.0 ± 5.3 years were studied.
T80085 524855-524940 Sentence denotes All patients suffered from left ventricle hypertrophy documented by echocardiography.
T92041 524941-525046 Sentence denotes The control group consisted of 20 healthy volunteers similar to the investigated patients in sex and age.
T29769 525047-525157 Sentence denotes In all patients the serum concentrations of ET-1 and TGF 1 were determined using ELISA (Biomedica, Biosource).
T85171 525158-525295 Sentence denotes RESULTS An increase in the serum concentrations both growth factors were noted in the studied group when compared with the control group.
T15182 525296-525398 Sentence denotes The average concentration of ET-1 in patients with essential hypertension was 0.64 (0.32-0.91) pmol/l.
T85521 525399-525474 Sentence denotes The level of ET-1 in the control group was 0.1 (0.05-0.17) pmol/l (p=0.04).
T24535 525475-525555 Sentence denotes The concentration TGF 1 in essential hypertension patients was 224.2 (125.4-314.
T53827 525556-525622 Sentence denotes 3) pg/ml and in control group was 68.2 (42.5-81.8) pg/ml (p=0.02).
T30658 525623-525745 Sentence denotes There was a positive correlation between the concentrations (Spearmen's rank coefficient of correlation was 0.42; p=0.01).
T60488 525746-525980 Sentence denotes CON-CLUSION The increase of the serum concentration of growth factors ET-1 and TGF 1 and their co-influence in patients with essential hypertension, suggests a role of these growth factors in the pathogenesis of arterial hypertension.
T91856 525981-525983 Sentence denotes U.
T85202 525984-525996 Sentence denotes Kaza 1* , C.
T60439 525997-526010 Sentence denotes Lauter 2 , 1.
T25024 526011-526035 Sentence denotes Bloomfield Hills, MI; 2.
T50851 526036-526050 Sentence denotes Royal Oak, MI.
T47771 526051-526064 Sentence denotes Introduction:
T82531 526065-526188 Sentence denotes Few studies have examined the referral patterns for allergy and immunology inpatient consultations in a community hospital.
T70736 526189-526271 Sentence denotes Consequently, an invaluable part of physician and housestaff education is missing.
T76401 526272-526465 Sentence denotes Our objective was to examine the number of inpatient allergy and immunology consultations, the reasons for consultations and the outcome of the patients in order to improve physician education.
T91382 526466-526736 Sentence denotes Methods:We performed a retrospective chart review of all inpatient allergy and immunology consultations in the years 1996-1997 and in 2002-2003 to determine the reasons for consultation, the recommendations made and if they were followed and the outcomes of the patient.
T57015 526737-526819 Sentence denotes Results:We reviewed a total of 408 inpatient allergy and immunology consultations.
T59954 526820-526927 Sentence denotes In the 1996-1997 time period 26% of inpatient consults were for asthma, 22% for drug allergy, 12% for rash.
T31439 526928-527035 Sentence denotes In the 2002-2003 time period 25% of inpatient consults were for rash, 21% for drug allergy, 16% for asthma.
T11771 527036-527121 Sentence denotes The top three reasons for consultations remained the same although the order changed.
T8979 527122-527249 Sentence denotes Consultations for immune deficiency, angioedema and rashes increased, whereas consultations for asthma and allergies decreased.
T80400 527250-527325 Sentence denotes There were a total of 202 consultations in 1996-1997 and 206 in 2002-2003 .
T80531 527326-527474 Sentence denotes The number of consultations remained the same despite an increase in overall number of hospital admissions from 44, 677 in 1996 to 58, 348 in 2003 .
T49902 527475-527555 Sentence denotes In greater than 95% of consultations, allergists' recommendations were followed.
T1876 527556-527730 Sentence denotes In both of the time periods studied, greater than 70% of patients improved, with less than 9% having no improvement, in the remainder of cases improvement was not applicable.
T29353 527731-527991 Sentence denotes Conclusion:In conclusion, we believe that identifying the reasons for inpatient allergy and immunology consultations and examining the most common recommendations, as well as the outcomes of patients will be a valuable guide in the education of our physicians.
T9159 527992-528257 Sentence denotes By incorporating this information into grand rounds and resident conferences, physicians will benefit from learning about when an allergist can be helpful and how to manage some of the more common allergic and immunologic problems in patients that are hospitalized.
T74786 528258-528417 Sentence denotes The high percentage of providers who follow the advice of allergists indicate that allergists have a great deal of educational value to offer other physicians.
T58476 528418-528578 Sentence denotes While Complementary and Alternative Medicine (CAM) has generally experienced increased popularity, its utilization by allergy/asthma patients remains uncertain.
T40177 528579-528670 Sentence denotes Our private allergy practice surveyed the use of CAM in allergy/asthma patients in 1998(1).
T37030 528671-528816 Sentence denotes Using a similar questionnaire, we assessed the current interest in CAM with our allergy/asthma patients and compared the data to our 1998 survey.
T60309 528817-528899 Sentence denotes We analyzed 103 completed questionnaires from 113 sequential surveys administered.
T92976 528900-528965 Sentence denotes The results were compared to 113 questionnaires reported in 1998.
T77574 528966-529097 Sentence denotes They indicated that in both study periods (1998 & 2004) , the majority of patients wanted to discuss CAM (65 and 69% respectively).
T81327 529098-529188 Sentence denotes An equal number (18%) in each study period discussed CAM with their primary care provider.
T91163 529189-529306 Sentence denotes Sixteen percent (16%) of our respondents sought a CAM practitioner for general medical needs in 1998 vs. 19% in 2004.
T14554 529307-529447 Sentence denotes However, there was an increase from 4% to 10% of our patients seeing a CAM practitioner for their allergies and/or asthma from 1998 to 2004.
T12125 529448-529566 Sentence denotes Sixty-two percent (62%) would like to consider pursuing CAM through our allergy spe-cialty practice or other provider.
T53980 529567-529735 Sentence denotes When asked regarding preferred treatment, 62% stated combination traditional with CAM, 8% preferred traditional only, 3% CAM only, and 27% did not know/doctor s choice.
T2601 529736-529826 Sentence denotes More patients are now seeking chiropractic care (36% to 52%) compared to our 1998 results.
T41387 529827-529931 Sentence denotes Acupuncture was the first choice CAM modality at 48% in 2004 surpassing vitamin/mineral therapy in 1998.
T62652 529932-530025 Sentence denotes Currently, the second and third choices were vitamin/mineral therapy and deep tissue massage.
T48653 530026-530228 Sentence denotes While these numbers were small, we were impressed that currently 10% (two and a half times more since 1998) of patients in our practice were seeking CAM allergy/asthma care from outside of our practice.
T52667 530229-530367 Sentence denotes These results demonstrated that more than half of our patients were interested in pursuing traditional with CAM options within our office.
T56319 530368-530573 Sentence denotes Given this trend, we have begun discussing the concept of Integrative Allergy, which to us means Integrating evidenced-based CAM modalities within our traditional allergy/asthma practice. (1) Introduction:
T80984 530574-530646 Sentence denotes Clinical immunization knowledge is complex and demands ongoing training.
T28666 530647-530778 Sentence denotes Nationally, basic immunization and vaccine safety education is limited within traditional medical, nursing, and provider education.
T77361 530779-531030 Sentence denotes Project Immune Readiness (PIR), a peer-reviewed, web-based, interactive course, was developed in response to this deficit and the need for standardized resources to provide initial and sustainment training for safe and effective immunization services.
T57832 531031-531105 Sentence denotes It is designed for medical personnel with diverse educational preparation.
T21679 531106-531308 Sentence denotes Currently, PIR offers 21 course modules addressing 42 hours of instruction on specific vaccines, their respective diseases, and general information on immunization healthcare and vaccination procedures.
T61809 531309-531317 Sentence denotes Methods:
T61333 531318-531488 Sentence denotes Users completed a pre-test (establishes baseline knowledge), an interactive module, followed by a post-test (to observe change from baseline) for each course in sequence.
T87753 531489-531595 Sentence denotes Anonymous user and score data were collected as part of a quality assurance and course validation process.
T31351 531596-531792 Sentence denotes Learning Gain Indices (LGI) were calculated based on average mean pre-test and post-test scores for each module LGI of all modules demonstrated substantial increases in user vaccination knowledge.
T9017 531793-531872 Sentence denotes Comparing pre and post-testing is an effective method to assess learning gains.
T65209 531873-532041 Sentence denotes The findings support PIR as a successful and valid distance-learning tool that establishes and documents core knowledge of medical personnel administering vaccinations.
T90355 532042-532196 Sentence denotes Further research is needed to assess the effectiveness of knowledge acquisition and retention, in addition to variance in vaccine delivery after training.
T892 532197-532353 Sentence denotes This approach to learning may have value as a resource that supports smallpox and influenza pandemic emergency preparedness plans for just in time training.
T2330 532354-532367 Sentence denotes Introduction:
T71594 532368-532527 Sentence denotes Variances from practice guidelines for the prescription of auto-injectable epinephrine are well documented among practicing physicians, families, and patients.
T91120 532528-532585 Sentence denotes Effective patient education requires provider competency.
T16863 532586-532747 Sentence denotes The current study was designed to survey resident physician perceptions regarding auto-injectable epinephrine education, use, and patient education requirements.
T20104 532748-532756 Sentence denotes Methods:
T7957 532757-532893 Sentence denotes Residents from primary care disciplines at a tertiary care medical center were invited to complete a voluntary, anonymous questionnaire.
T98056 532894-532946 Sentence denotes A total of 58 surveys were distributed and returned:
T15105 532947-533066 Sentence denotes 22 Emergency Medicine, 11 Family Practice, 9 Internal Medicine, and 16 Pediatric residents completed the questionnaire.
T92644 533067-533171 Sentence denotes Due to the small sample size, responses from physicians in various disciplines were reviewed as a whole.
T12328 533172-533180 Sentence denotes Results:
T76067 533181-533300 Sentence denotes 40 respondents (69%) reported that they had previously prescribed auto-injectable epinephrine for allergic emergencies.
T63797 533301-533385 Sentence denotes The majority (63%) of these prescribers reported that their training was inadequate.
T59458 533386-533533 Sentence denotes 14 respondents (35%) reported no training, while 11 respondents (28%) reported that their training was less than that needed to ensure proficiency.
T66038 533534-533619 Sentence denotes 15 respondents (37%) reported that their training was adequate to ensure proficiency.
T23821 533620-533644 Sentence denotes None reported expertise.
T64327 533645-533776 Sentence denotes Only 7 of 40 prescribers (17.5%) reported that either they or their staff always demonstrated proper medication use to the patient.
T88891 533777-533864 Sentence denotes Interestingly, 2 of these 7 providers reported they had not been trained on proper use.
T1268 533865-533942 Sentence denotes The table below summarizes resident training and patient education practices.
T63302 533943-534128 Sentence denotes Additional physician knowledge deficits included the proper site of medication administration, the proper interval for replacing medication, and the proper place for medication storage.
T69257 534129-534141 Sentence denotes Conclusions:
T9097 534142-534266 Sentence denotes Of the residents surveyed, who have previously prescribed auto-injectable epinephrine, 63% identified training deficiencies.
T9163 534267-534392 Sentence denotes Only 17.5% of prescribers reported that the standard of care requirement to demonstrate proper medication use was always met.
T86449 534393-534499 Sentence denotes There is a clear need to improve auto-injectable epinephrine education in all residency training programs.
T52040 534500-534502 Sentence denotes R.
T1829 534503-534521 Sentence denotes Bloebaum 1* , R.K.
T68518 534522-534538 Sentence denotes Calabrese 2 , M.
T13483 534539-534541 Sentence denotes 1.
T24814 534542-534557 Sentence denotes Houston, TX; 2.
T23136 534558-534571 Sentence denotes New York, NY.
T42734 534572-534585 Sentence denotes Introduction:
T62434 534586-534689 Sentence denotes Pneumocystis carinii pneumonia (PCP) is a major cause of morbidity and mortality in patients with AIDS.
T62441 534690-534844 Sentence denotes Adverse reactions occur frequently to the most effective medication for both the prevention and treatment of PCP, trimethoprim-sulfamethoxazole (TMP-SMX).
T87909 534845-534948 Sentence denotes We looked at the immediate safety and efficacy of three protocols for desensitization in AIDS patients.
T15379 534949-534957 Sentence denotes Methods:
T71933 534958-535138 Sentence denotes By retrospective chart review, we identified 49 patients with AIDS who had experienced previous mild to moderate hypersensitivity reactions to TMP-SMX and required desensitization.
T7939 535139-535359 Sentence denotes Patients received one of three desensitization protocols based on illness severity or ward attending preference: a 6-hour intravenous (IV) desensitization, an 8-day oral desensitization, or a 10-day oral desensitization.
T50209 535360-535368 Sentence denotes Results:
T68425 535369-535453 Sentence denotes Of the 49 patients that received desensitization, 38 (77.5%) completed successfully.
T62947 535454-535610 Sentence denotes Of these, 33 subjects had no reaction during the desensitization process; however, seven of these subjects were on steroids for treatment of other diseases.
T67890 535611-535747 Sentence denotes The remaining five successful patients had mild reactions which were treated symptomatically with acetaminophen, antihistamines or both.
T49506 535748-535876 Sentence denotes Eleven patients failed to complete the desensitization: six stopped by the attending physician and four dropped out voluntarily.
T94101 535877-535992 Sentence denotes One patient expired during desensitization from extensive disease complications related to the admitting diagnosis.
T33045 535993-536180 Sentence denotes All protocols were equally successful when comparing the immediate success rates, 6/7 (86%) of the 6hour protocol, 4/5 (80%) of the 8-day protocol and 28/37 (75.7%) of the 10day protocol.
T13346 536181-536299 Sentence denotes The 6-hour IV desensitization protocol was most frequently used in the Intensive Care Unit on critically ill patients.
T68547 536300-536481 Sentence denotes Two of these patients, counted as successfully desensitized, died 5 and 28 days post protocol completion secondary to extensive comorbid conditions unrelated to the desensitization.
T14841 536482-536493 Sentence denotes Conclusion:
T90171 536494-536669 Sentence denotes Given the insignificant differences between the success of the 6hour IV desensitization and the oral desensitization protocols, we believe that either may be used effectively.
T77981 536670-536865 Sentence denotes Further, in patients with mild to moderate hypersensitivity reactions to TMP-SMX, an oral desensitization protocol may be used safely in the outpatient setting if given appropriate lab follow up.
T71845 536866-536868 Sentence denotes A.
T54286 536869-536883 Sentence denotes Morales * , E.
T72297 536884-536896 Sentence denotes Gonzalez, A.
T14870 536897-536910 Sentence denotes Contreras, D.
T11163 536911-536920 Sentence denotes Lopez, G.
T78191 536921-536948 Sentence denotes Lopez, Mexico City, Mexico.
T45129 536949-537127 Sentence denotes INTRODUCTION In 1966 Davis describes Job Syndrome in two women, in 1971 Dr Buckley reports two children, being known as Hyper-IgE syndrome (Job's syndrome or Buckley's syndrome).
T53239 537128-537278 Sentence denotes Defined as a primary immunodeficiency, dominant autosomic, characterized by multi-systematic alterations (immunological, skeletal, dermal and dental).
T75282 537279-537486 Sentence denotes It's diagnostic criteria are levels of IgE 2000 UI/ml, chronic dermatitis, recurring respiratory infections, cold abscesses, pneumatoceles, infections caused by candida, and finally craniofacial alterations.
T13569 537487-537676 Sentence denotes On another front, extraordinary high levels of IgE have been reported in patients with allergic illnesses that increase the risk of anaphylaxis, but do not have the Job's syndrome criteria.
T90616 537677-537793 Sentence denotes OBJETIVE To determine if allergic patients with IgE levels higher than 2000 UI/ml have diagnostic of Job's syndrome.
T96796 537794-538056 Sentence denotes MATERIAL AND METHODS A retrospective revision was realized from May 2001 to April 2004 in files of 27 patients treated in allergy services at the Instituto Nacional de Pediatria with a total IgE greater than 2000 UI/ml, by means of a page with recollected dates.
T10932 538057-538318 Sentence denotes RESULTS Nine women and 18 men were included with an age range of 3 to 18 years, and an average age to 9 years; 22 (81.5%) were diagnosed with allergies; of which 55.6% rhinitis allergy, 51.9% asthma, and 40.7% topical dermatitis of which co-existed in patients.
T40445 538319-538368 Sentence denotes 51.9% presented hereditary antecedents of atopic.
T59929 538369-538462 Sentence denotes The cutaneous tests were positive in 11 (40.7%) with a greater reactivity of dermatophagoids.
T5009 538463-538502 Sentence denotes One syndrome of hyper IgE was detected.
T4993 538503-538587 Sentence denotes Others diagnosed were found as not allergic were Hunter's syndrome and toxocariasis.
T2917 538588-538729 Sentence denotes CONCLUSION There are patients with allergies that have total levels of IgE as elevated as 49, 560 UI/ml without correspond to Job's syndrome.
T27950 538730-538820 Sentence denotes By which a multi-allergic clinical entity is proposed with levels greater than 2000 UI/ml.
T24577 538821-539010 Sentence denotes Introduction Home monitoring of lung function in asthmatic patients is used extensively in both clinical and research settings, however, little attention is given to device quality control.
T89807 539011-539180 Sentence denotes Objective The purpose of this study was to determine the accuracy, precision and usefulness of the AirWatch System (ENACT Health Management Systems, Palo Alto, CA, USA).
T99553 539181-539344 Sentence denotes Methods The subjects included in this study were submitted to spirometry following American Thoracic Society guidelines (ATS 1995), using Collins GS 4G PFT System.
T78570 539345-539470 Sentence denotes Afterwards, peak expiratory flow rate (PEF) and forced expiratory volume in one second (FEV1) were determined using AirWatch.
T72886 539471-539589 Sentence denotes FEV1 and PEF measures from both devices were compared, by using two sample t-test and Pearson correlation coefficient.
T88042 539590-539700 Sentence denotes Results A total of 115 patients (75 females) were enrolled, and their mean age was 43.7 years (9 to 76 years).
T31668 539701-539834 Sentence denotes FEV1 measures ranged from 0.54 to 5.81 L (mean 2.43 L), and from 0.62 to 7.44 L (mean 2.51 L), in Collins and AirWatch, respectively.
T57360 539835-539950 Sentence denotes PEF ranged from 107 to 871 L/min (mean 384 L/min) in Collins and from 61 to 794 L/min in AirWatch (mean 353 L/min).
T91650 539951-540146 Sentence denotes Significant difference was noted for PEF measures (p< 0.05 and Pearson correlation R= 0.61) between the two devices; however, we did not observe this difference when FEV1 measures were concerned.
T95228 540147-540238 Sentence denotes Regarless the degree of obstruction (high or low flow rates), these results did not change.
T27670 540239-540334 Sentence denotes Conclusion AirWatch showed great utility for FEV1 measures when compared to Collins spirometer.
T28911 540335-540448 Sentence denotes Although AirWatch is able to assess lung function at home, on a daily basis, it is not reliable for PEF measures.
T62674 540449-540462 Sentence denotes Introduction:
T74915 540463-540552 Sentence denotes Epidemiologic data show that poorly controlled asthma is a serious public health problem.
T52338 540553-540653 Sentence denotes The degree of implementation of the NAEPP Guidelines in primary care practice remains to be defined.
T52875 540654-540870 Sentence denotes The objective of this survey was to determine if introduction of an assessment tool into primary care practices along with a specially designed program to implement the Guidelines would improve diagnosis and therapy.
T54989 540871-540879 Sentence denotes Methods:
T9906 540880-541342 Sentence denotes The Asthma Care Network (ACN), a program designed to assist healthcare providers in the assessment and management of their patients with asthma, employs a team of specially trained Respiratory Care Associates (RCAs), 100 RNs and RTs, who visit primary care offices to inform staff about various components of the NAEPP Guidelines and assist in their implementation. .A total of 4901 primary care providers in 2876 sites were recruited as part of the ACN program.
T64023 541343-541450 Sentence denotes Data from more than 60, 000 patient visits were collected and analyzed between March 2002 and January 2004.
T16336 541451-541539 Sentence denotes The program assessment tool surveyed asthma control and medication prescribing patterns.
T53170 541540-541700 Sentence denotes Outcome measures included degree of symptom control, limitation of activity, sleep disruption, use of rescue medication and utilization of urgent care services.
T36733 541701-541808 Sentence denotes These data were collected on an Office Visit Assessment Form (OVA) completed by both patient and physician.
T42778 541809-541997 Sentence denotes The RCAs provided information, education, device training in the use of inhalers and spacers, and a CE course for the staff discussing pathophysiology, assessment and management of asthma.
T98573 541998-542006 Sentence denotes Results:
T643 542007-542051 Sentence denotes A total of 60, 248 OVA forms were completed.
T65125 542052-542231 Sentence denotes Among all patient including adults (older than 18 years of age) and children (<4-17 years of age), 74% (range 69% to 81%) reported symptoms consistent with lack of asthma control.
T6985 542232-542317 Sentence denotes Approximately 70% of the survey group had more than 2 markers of uncontrolled asthma.
T19950 542318-542445 Sentence denotes As a result of this assessment, controller medication use increased by over 30%, 52% of which was an ICS-containing medication.
T22478 542446-542457 Sentence denotes Conclusion:
T46135 542458-542695 Sentence denotes The information provided to the primary care health care providers resulted in a considerable increase in prescription of controller therapy, and in particular, increased use of ICS controller medication consistent with NAEPP guidelines.
T54045 542696-542707 Sentence denotes Background:
T67551 542708-542827 Sentence denotes Patients with allergic rhinitis (AR) demonstrate symptoms of allergy to fruits, vegetables and nuts in 48-72% of cases.
T59021 542828-543021 Sentence denotes Oral allergy syn-drome (OAS), typical for hypersensitivity to plant food, is based on cross-reaction of pollen-allergen specific immunoglobulin E (IgE) antibodies with homologous food proteins.
T41658 543022-543177 Sentence denotes The production of Th1 and Th2 cytokines in allergic rhinitis patients with or without sensitization to food (fruits and vegetables) allergens was assessed.
T11867 543178-543186 Sentence denotes Methods:
T18472 543187-543261 Sentence denotes Fifty five patients aged 18-38 years with allergic rhinitis were observed.
T51495 543262-543330 Sentence denotes Group I -20 patients with AR; Group II -35 patients with AR and OAS.
T98069 543331-543394 Sentence denotes Sensitivity to pollen allergens was tested by skin prick tests.
T7050 543395-543597 Sentence denotes The allergic reaction to food in patients with OAS was proved by a positive history of oral symptoms caused by eating fruits and vegetables and a positive skin prick test with respective food allergens.
T38981 543598-543705 Sentence denotes Blood eosinophil counts and total IgE levels were determined during the peak of allergic rhinitis symptoms.
T32986 543706-543764 Sentence denotes IL-5, IL-10 and -interferon levels were measured by ELISA.
T36626 543765-543773 Sentence denotes Results:
T91621 543774-543913 Sentence denotes 24.5% of patients were sensitized only to grass pollen, 23.3% only to tree pollen and 52.2% reacted to pollens of grasses, trees and weeds.
T97654 543914-544025 Sentence denotes In patients with OAS, skin tests were more often positive to birch (57.8%), alder (46.3%), and mugwort (26.7%).
T12594 544026-544147 Sentence denotes The most common food products implicated in OAS were hazelnut (69.3%), apple (29.2%), carrot (16.4%), and peanut (12.7%).
T4390 544148-544231 Sentence denotes The allergy to fruits and vegetables was confirmed by positive prick test in 78.4%.
T48301 544232-544324 Sentence denotes During the season blood eosinophil count and total IgE levels were elevated in all patients.
T77125 544325-544466 Sentence denotes There was an increase in the production of IL-5 to 187.3±5.4 pcg/ml in Group I and to 221.5±6.2 pcg/ml in Group II (nor-mal=74.3±3.3 pcg/ml).
T98152 544467-544695 Sentence denotes The levels of IL-10 increased to 186±12 pcg/ml in Group I and to 197±10 pcg/ml in Group II (normal=5.8±0.25 pcg/ml); the level of -IFN decreased to 287.6±7.4 pcg/ml in Group I and to 272.6±5.2 in Group II (normal=331±35 pcg/ml).
T3697 544696-544816 Sentence denotes After SIT with pollen allergens the clinical manifestations of allergic rhinitis and OAS decreased in 84.6% of patients.
T10030 544817-544828 Sentence denotes Conclusion:
T26659 544829-544982 Sentence denotes Allergic rhinitis patients' sensitivity to food allergens may cause OAS in these patients associated with increased functional activity of Th2 responses.
T37281 544983-545046 Sentence denotes PATIENT KNOWLEDGE AND IMPROVEMENT WITH ALLER-GEN IMMUNOTHERAPY.
T89629 545047-545051 Sentence denotes C.C.
T54255 545052-545079 Sentence denotes Randolph * , Waterbury, CT.
T88793 545080-545093 Sentence denotes Introduction:
T28392 545094-545173 Sentence denotes There is no consensus on objective parameters for improvement in immunotherapy.
T60253 545174-545245 Sentence denotes Similarly little is known regarding patient knowledge of immunotherapy.
T42757 545246-545396 Sentence denotes Utilizing two published questionnaires (1-2), we assessed clinical improvement based on symptom and medication scoring and knowledge of immunotherapy.
T78075 545397-545405 Sentence denotes Methods:
T32968 545406-545939 Sentence denotes The charts of 219 patients of an estimated 530(41%), 109(50%) with allergic rhinitis only and 116 (53%) with concomitant asthma, were retrospectively or prospectively reviewed who had been on immunotherapy to inhalants for 6 months to 6 years, mean 2.7 years, age range 7y-64y, mean 25y, 108 male(49%), 111 female(51%) with 213 caucasian (97%), 2 oriental (1%) and 4(2%) Afroamericans .They completed symptom and medication survey (1) every 6 months with range of improvement using a decline in Likert scale (+)20 to (-)104, mean 24.
T9693 545940-546082 Sentence denotes 186 (85%) indicated improvement in their symptoms and/or medication .111(50%) completed (2) a 7 question survey of knowledge of immunotherapy.
T62463 546083-546272 Sentence denotes There were 7 questions regarding the outcome of immunotherapy, the years to onset of immunity, the duration until onset of immunity, the danger of immunotherapy and the extract in the vial.
T70217 546273-546426 Sentence denotes The correct responses were recorded to 2/7 (2/111=1.8%), 11(9.9%) 3/7, 19(17%)4/7, 10(9%)5/7, 18(16%)6/7.39(35%) had a perfect response to all questions.
T95877 546427-546460 Sentence denotes 12(11%) had no correct responses.
T84177 546461-546472 Sentence denotes Conclusion:
T48635 546473-546659 Sentence denotes The majority of immunotherapy patients improved (85%) by symptom and medication scoring over the mean of 2.7 years but only 35% had complete knowledge of the rationale for immunotherapy.
T23177 546660-546846 Sentence denotes Further education and repeated surveying of patients on immunotherapy to assure comprehensive knowledge of immunotherapy and achieve better outcomes is recommended by this investigation.
T94370 546847-547124 Sentence denotes As is unique in this study symptom and medication scoring using the Rhinitis /Sinusitis questionnaire approved by the ACAAI and a comprehensive questionnaire assessing knowledge should be conducted periodically ie every 6 months to provide objective parameters for improvement.
T72300 547125-547136 Sentence denotes References:
T13195 547137-547448 Sentence denotes 1.Santilli J, Nathan R, Glassheim J .Patient receiving immunotherapy report it is effective as assesses by rhinitis outcomes questionnaire(RAQ) in private (42)) is a protein involved in the parasite invasion of host erythrocytes and is a leading vaccine candidate for the erythrocyte stage of malaria infection.
T36234 547449-547558 Sentence denotes An increasing number of vaccine clinical trials are being undertaken using various formulations of MSP-1(42).
T95044 547559-547695 Sentence denotes Comparison of humoral responses among these trials has been limited by the lack of a universal reference standard for specific antibody.
T54287 547696-547887 Sentence denotes The purpose of this study was to develop a human reference standard for MSP-1(42) antibody measured in absolute quantity units that could facilitate comparison of interstudy vaccine response.
T10067 547888-547895 Sentence denotes Method:
T37833 547896-548016 Sentence denotes We formulated the reference standard by pooling human plasma samples known to contain high titers of MSP-1(42) antibody.
T25520 548017-548180 Sentence denotes The specific antibody within the pooled plasma was captured by MSP-1(42) adsorbed to nickel resin in a process of immobilized metal affinity chromatography (IMAC).
T70696 548181-548351 Sentence denotes The intact MSP-1(42) antibody-antigen complexes were separated from the nickel resin and total IgG in the complexes measured by enzyme-linked immunosorbent assay (ELISA).
T55694 548352-548360 Sentence denotes Results:
T71176 548361-548481 Sentence denotes Our antibody quantitation method yielded a concentration of 48.3 mcg/ml of MSP-1(42) antibody in the reference standard.
T71049 548482-548493 Sentence denotes Conclusion:
T80518 548494-548680 Sentence denotes The reference standard characterized in this study may be useful as a quantitative working standard for MSP-1(42) antibody response in future vaccine clinical trials involving MSP-1(42).
T58063 548681-548800 Sentence denotes This standardization may facilitate the clinical development of MSP-1(42) as a candidate vaccine for malaria infection.
T53002 548801-548812 Sentence denotes Background.
T4921 548813-548953 Sentence denotes Specific immunotherapy (SIT) is currently one of the most effective and widely used treatment methods of allergic diseases including asthma.
T6405 548954-549078 Sentence denotes Efficacy of SIT depends on the correct choice of patients, severity of asthma and patient's condition when the SIT is begun.
T82232 549079-549178 Sentence denotes According to WHO recommendations, SIT is approved for use in patients with mild to moderate asthma.
T74644 549179-549187 Sentence denotes Methods.
T19380 549188-549306 Sentence denotes SIT with a saline extract of house dust allergen was administered to 30 patients with mild persistent allergic asthma.
T61604 549307-549360 Sentence denotes Injections were performed subcutaneously 2-3 per day.
T34497 549361-549428 Sentence denotes The course consisted of 6766 PNU of allergen and lasted 12-14 days.
T89142 549429-549509 Sentence denotes Patients were repeatedly surveyed at 3, 6 and 12 months after SIT was completed.
T44781 549510-549725 Sentence denotes Dyspnea attacks occurring during daytime and at night were assessed, as was the influence of physical exertion on dyspnea and lung function, and also the number of utilizations of short-acting beta-agonists per day.
T86818 549726-549824 Sentence denotes Pulmonary function measurements were performed as was assessment of concomitant allergic rhinitis.
T52594 549825-549994 Sentence denotes 50% of patients received treatment including cromones, and 30% utilized inhaled corticosteroids among whom 13.3% had a dose of 400 mcg per day and 16.7% 200 mcg per day.
T30037 549995-550118 Sentence denotes SIT efficacy was assessed by clinical symptoms, pulmonary function measurements and amount of concomitant therapy received.
T88140 550119-550127 Sentence denotes Results.
T92364 550128-550309 Sentence denotes The number of daytime dyspnea attacks reduced from 10.70 ± 3.40 per month to 1.20 ± 0.09 during the 3 months following SIT, and 76.7% of patients reduced concomitant asthma therapy.
T15786 550310-550418 Sentence denotes At 6 months, dyspnea attacks increased to 2.90 ± 0.75 per month, still significantly less then prior to SIT.
T54640 550419-550618 Sentence denotes Nocturnal symptoms followed the same pattern, occurring 7.20 ± 1.62 per month prior to SIT, 1.01 ± 0.01 per month 3 months after SIT and 1.99 ± 0.25 per month at the end of the sixth month after SIT.
T64573 550619-550817 Sentence denotes 26.7% of patients had no symptoms of bronchial obstruction during the 6 months after SIT and their pulmonary function approached normal values, although 36.7% of patients returned to asthma therapy.
T98203 550818-550989 Sentence denotes Nasal congestion decreased from 3.28 ± 1.20 points to 1.98 ± 0.08 (p<0.05), clinical improvement still present for 3 months after SIT, but recurring at 6 months after SIT.
T79837 550990-551001 Sentence denotes Conclusion.
T56051 551002-551199 Sentence denotes SIT may be an effective treatment method that improves both asthma and allergic rhinitis for more than 3 months following a brief course, allowing a decrease in the amount of symptomatic treatment.
T41090 551200-551316 Sentence denotes A safe therapeutic vaccine that can alter the allergic response to peanuts would serve a serious unmet medical need.
T36021 551317-551507 Sentence denotes Peanut allergy responses are largely associated with downstream events related to antigen specific IgE crosslinking of IgE receptors and subsequent degranulation of mast cells and basophils.
T57554 551508-551752 Sentence denotes Our clinical studies with ragweed have shown that linking immunostimulatory DNA (ISS) to allergens can decrease IgE recognition of the allergen and generate an immunogen that generates protective Th1 responses and reduces harmful Th2 responses.
T9131 551753-551879 Sentence denotes To test this approach to peanut immunotherapy, we focused on the clinically relevant allergen, Ara h 2, as a proof of concept.
T38629 551880-552002 Sentence denotes ISS oligonucleotides were linked to Ara h 2 at two different ratios: PIC (2 ISS per protein) and HPIC (4 ISS per protein).
T87654 552003-552122 Sentence denotes Immunogenicity of PIC and HPIC was evaluated in C3H/HeJ female mice immunized twice with 5 ug of PIC, HPIC, or Ara h 2.
T65248 552123-552184 Sentence denotes Sera were analyzed for anti-Ara h 2 IgG1 and IgG2a responses.
T16750 552185-552276 Sentence denotes Spleens were harvested and Ara h 2-specific IFNg and IL-5 responses were measured in vitro.
T91773 552277-552392 Sentence denotes Mice were immunized with Ara h 2 elicited predominantly IgG1 and IL-5 responses, indicative of a Th2-type response.
T93166 552393-552526 Sentence denotes Animals immunized with PIC showed significantly enhanced IgG2a responses and strong IFNg responses, indicative of Th1-type responses.
T71010 552527-552660 Sentence denotes HPIC immunized mice elicited little antibody response, presumably due to ISS blocking B cell epitopes, but did induce IFNg responses.
T72326 552661-552815 Sentence denotes To assess allergenicity of PIC and HPIC, histamine release was measured in blood from peanut allergic donors treated in vitro with PIC, HPIC, and Ara h 2.
T81070 552816-552888 Sentence denotes Histamine release was detected at very low concentrations of Ara h 2 (0.
T21131 552889-553031 Sentence denotes 01 ng/ml), 10-fold higher concentrations for PIC (0.1 ng/ml) and was undetectable at concentrations up to 1000fold higher for HPIC (10 ng/ml).
T20323 553032-553161 Sentence denotes An IgE binding competition assay also confirmed reduction in allergenicity following the same trend for the ISS-linked allergens.
T80953 553162-553274 Sentence denotes Linking ISS to Ara h 2 increases Th1 responses to the allergen, blocking IgE recognition of epitopes on Ara h 2.
T60089 553275-553407 Sentence denotes Thus, ISS-linked Ara h 2 appears to be a promising candidate for a safe immunotherapy product for treating peanut allergic subjects.
T35104 553408-553421 Sentence denotes Introduction:
T44869 553422-553591 Sentence denotes Immunotherapy has been studied for its adverse effects in some sensitive patients as with worsening of therapeutic response in some amounting to withdrawal of the later.
T85137 553592-553600 Sentence denotes Methods:
T58293 553601-554093 Sentence denotes In the allergy center therapeutic trials of Immunotherapy(house dust, mixmite) had been undertaken since 1998, in therapeutic dose of 0.02Pnu/ml, 0.2Pnu/ml, 2Pnu/ml, 20Pnu/ml, 200Pnu/ml2000Pnu/ml, 4000Pnu/ml(Housedust), 0.01Au/ml, 0.1Au/ml, 1Au/ml10Au/ml 100Au/ml 1000Au/ml 2000Au/ml(mixmite).Patients age 2-65 years, both sex after diagnostic scratch/prick tests with appropriate antigenic preparations reported for local/systemic adverse effects the details of which were as under, Results:
T55183 554094-554433 Sentence denotes Please see the attached table for details, In some cases worsening of the existing allergic status was noted, which on analysis revealed initially a slow rise in the allergen -specific IgE to be later on fol-lowed by rise of IgG1 & IgG4 & gradual fall of IgE.Only 1/100 patient could not complete immunotherapy for fear of adverse effects.
T23516 554434-554446 Sentence denotes Conclusions:
T20789 554447-554692 Sentence denotes With utmost care/follow-up, no incidence of mortality outcome was reported from 1998to late 2003 The incidence of adverse effects were significantly lowered on pre-medication with anti-histamines significantly more with elderly than younger age.
T289 554693-554788 Sentence denotes Even with all these documented hazards the beneficial effects far exceeded the harmful effects.
T90078 554789-554800 Sentence denotes Background:
T76420 554801-554884 Sentence denotes The prevalence of allergic disease in most human population is steadily increasing.
T67409 554885-555081 Sentence denotes Seafood allergy is a serious food allergy, although hypersensitive reactions caused by seafood has long been know, biochemical and Immunological studies on seafood allergies had only begun lately.
T25259 555082-555166 Sentence denotes Shrimp and abalone are the most frequently reported causes early asthmatic response.
T10893 555167-555177 Sentence denotes Objective:
T94704 555178-555239 Sentence denotes To investigate cross-reactivity of shrimp, abalone and Derp1.
T42136 555240-555248 Sentence denotes Methods:
T5408 555249-555307 Sentence denotes Shrimp and abalone extracts were prepare from raw seafood.
T1700 555308-555401 Sentence denotes Sera from 17 patients from HongKong were studied who had asthma after consumption of seafood.
T18141 555402-555487 Sentence denotes IgE ELISA analyses comfirmed the combined sensitization to shrimp, abalone and Derp1.
T17826 555488-555662 Sentence denotes Specific-IgE ELISA assays were accomplished for shrimp and abalone extracts inhibited by Derp1 and Derp1 ELISA and Immunoblot assays inhibited by shrimp and abalone extracts.
T66461 555663-555855 Sentence denotes Results: ELISA inhibition showed that most IgE antibodies against shrimp and abalone were cross-reactive with Derp1 and the same time, Derp1 ELISA was inhibition by shrimp and abalone extract.
T39230 555856-556066 Sentence denotes The ELISA inhibition percent (%)of shrimp extract (GM:53.28%) and abalone extract(GM:36.75%) by Derp1 were significantly higher than Derp1 by shrimp extract(GM:26.64%) and abalone extract (GM:17.59%). (P<0.01).
T96703 556067-556310 Sentence denotes Furthermore, and there was a significant correlation of ELISA inhibition percent between shrimp extract, abalone extract and Derp1 inhibited by each other; SDS-PAGE and immunoblot of shrimp and abalone is the 38 and 49kD allergen respectively.
T67620 556311-556322 Sentence denotes Conclusion:
T43396 556323-556373 Sentence denotes This indicates that Derp1 was the sensitive agent.
T23960 556374-556441 Sentence denotes Shrimp, abalone and Derp1 demonstrate significant cross-reactivity.
T37257 556442-556568 Sentence denotes These findings confirm that the primary crossreactive allergen of shrimp and abalone is the 38 and 49kD allergen respectively.
T52897 556569-556571 Sentence denotes B.
T29774 556572-556583 Sentence denotes Sun 1* , A.
T11245 556584-556593 Sentence denotes Wu 2 , N.
T85217 556594-556606 Sentence denotes Zhong 1 , 1.
T39460 556607-556627 Sentence denotes Guangzhou, China; 2.
T70675 556628-556638 Sentence denotes Hong Kong.
T27307 556639-556650 Sentence denotes Background:
T52606 556651-556851 Sentence denotes The house dust mites (Dermatophagoides farinae (Derf) are a major source of aeroallergens implicated in the expression of atopic disorders, including asthma, allergic rhinitis, and atopic dermatitis .
T55838 556852-556984 Sentence denotes In particular, strong circumstantial evidence suggests that house dust mites antigens are important precipitating factors of Asthma.
T37962 556985-557136 Sentence denotes Many house duse mite allergens are proteases that can elicit airway inflammation by stimulating the release of cytokines in bronchial epithelial cells.
T12889 557137-557269 Sentence denotes Objectives: we have investigated whether Der f allergen proteases induced cytokine production from the epithelial cell line BEAS-2B.
T16263 557270-557278 Sentence denotes Methods:
T74186 557279-557471 Sentence denotes Cells were exposed to four different concentrations with serial additions of Der f (0.02, 0.2, 2, 20ug/ml) were incubated for 24h to 96h. and compare with those without incubation of allergen.
T78056 557472-557569 Sentence denotes Cytokine in the supernatants were assayed by ELISA, Reverse transcription?PCR was also performed.
T78313 557570-557578 Sentence denotes Results:
T10708 557579-557672 Sentence denotes Cells treated with Der f allergen showed serial changes in the cohesiveness of the monolayer.
T58381 557673-557776 Sentence denotes There was a significant increase in the level of cytokine production compared with the untreaed sample.
T13538 557777-557940 Sentence denotes Statistically Significantly increased with addition of Der f caused the release of IL-6 and IL-8 in time and concentration-dependent manner (p<0.05, respectively).
T34729 557941-558135 Sentence denotes Levels of IL-6 and IL-8 were elevated 24 h and 48 h after allergen exposure, increasing with time, continued increased levels to be present of IL-6 and IL-8 in the supernatants at 72 h and 96 h.
T95641 558136-558290 Sentence denotes At the same time show the concentration dependence of induction of IL-6 and IL-8 expression as well as an increase in the expression of IL-6 and IL-8mRNA.
T14235 558291-558528 Sentence denotes Conclusion: HDM-induced airway inflammation may include Der f-mediated release of inflammatory mediators, and the proteolytic activity of an allergen may stimulate the release of proinflammatory cytokines from human bronchial epithelium.
T49119 558529-558655 Sentence denotes Suggesting that IL-6 and IL-8 production by bronchial epithelial cells may play a role in the pathogenesis of allergic asthma.
T84332 558656-559001 Sentence denotes The purpose of this study is to delineate the immune injury mechanisms that involved in the autoimmune inner ear disease by introducing plasmid DNA encoding of TH1 cytokines (INF-g) into the inner ear. b-tubulin is a microtubular protein which we found as an important autoantigenic in Meniere's Disease as well as other autoimmune hearing loss.
T4517 559002-559102 Sentence denotes Hearing loss was induced in mice and guinea pigs when they are immunized with the tubulin molecules.
T70964 559103-559197 Sentence denotes Autoimmune hearing loss could be the results of TH1 cytokine responses from autoimmune injury.
T15990 559198-559300 Sentence denotes To test the hypothesis, guinea pigs were immunized with 200mg of tubulin in CFA and boosted once more.
T20589 559301-559435 Sentence denotes Two weeks later, we introduced 100ug (5ul) of naked DNA encoding INF-g was injected into the left side inner ear through round window.
T62977 559436-559500 Sentence denotes Same volume of 0.1M PBS was injected into right side as control.
T60482 559501-559549 Sentence denotes ABR was recorded before and after the injection.
T59976 559550-559688 Sentence denotes 15 weeks after the injection, the animals were sacrificed and temporal bones were examined with H-E and INF-g immunocytochemical staining.
T86716 559689-559836 Sentence denotes The ears injected with the plasmid DNA-INF-g had an enhanced hearing loss (30 dB), and degeneration of the spiral ganglion was found in these ears.
T96831 559837-559953 Sentence denotes However, the injection of the naked DNA encoding INF-g did not change the expression of the INF-g in the inner ears.
T20119 559954-560277 Sentence denotes These results suggest that autoimmune hearing loss could be the result of TH1 responses to inner ear autoantigens. -Tubulin is an important molecule in the hair cells supporting cells within the sensory epithelium of organ of corti and found to be an auto autoantigen in autoimmune hearing loss including Mèniére's disease.
T31856 560278-560451 Sentence denotes The object of the study is to induce hearing loss in mice with varying doses of antigen and evaluate the pathogenesis of autoimmune hearing loss induced by -tubulin in mice.
T47615 560452-560628 Sentence denotes Mice were immunized with 100, 200 or 300 μg of -tubulin and hearing was evaluated by auditory brainstem responses (ABR) and distortion product of otoaccoustic emission (DPOAE).
T67703 560629-560824 Sentence denotes All mice had hearing loss by ABR and DPOAE tests and morphological study of temporal bone showed spiral ganglion degeneration and TUNEL staining positive cells were noted in these immunized mice.
T6304 560825-560986 Sentence denotes Thus this study showed that -tubulin is an autoantigen for hearing loss in animal model as in human autoimmune hearing loss patients including Mèniére's disease.
T88345 560987-561031 Sentence denotes Supported by NIH R0DC005010-01 Introduction:
T97469 561032-561169 Sentence denotes Oral Polio Vaccination (OPV) in the United States is currently being replaced with Inactivated Polio Vaccination (IPV) given parentrally.
T44149 561170-561369 Sentence denotes While past studies have looked into the relationship of vaccination and asthma prevalence, none have investigated this relationship with regards to vaccination route namely orally versus parentrally.
T45385 561370-561633 Sentence denotes This study investigates the relationship between vaccination rates for the live attenuated orally administered Polio vaccine and parentrally administered vaccines(DTP, MMR)and two potentially dependent factors; asthma prevalence rate and asthma-caused death rate.
T95106 561634-561642 Sentence denotes Methods:
T35070 561643-561835 Sentence denotes We looked at data from the National Center for Health Statistics yearly publications of Health, United States (1983 -1999 and the Morbidity and Mortality Weekly Report Surveillance Summaries .
T58193 561836-561975 Sentence denotes Two databases were compiled to cover the 0-4 age population in the United States since this is the primary period of childhood vaccination.
T41017 561976-562263 Sentence denotes One database contained information for asthma related deaths and vaccination rate (DTP, MMR, OPV) covering the years 1970-1999 and the other database compiled information for self reported asthma prevalence and vaccination rates(DTP, measles, rubella, OPV) covering the period 1983-1999.
T39695 562264-562307 Sentence denotes A T-test was used for statistical analysis.
T75057 562308-562316 Sentence denotes Results:
T16000 562317-562419 Sentence denotes Statistically significant correlation was found between vaccination rates and asthma prevalence rates.
T15935 562420-562573 Sentence denotes Data for DTP (p = 0.012), measles (p = 0.024), and rubella (p = 0.023) indicated a statistically significant positive correlation with asthma prevalence.
T37409 562574-562721 Sentence denotes The Oral Polio Vaccine was the only one of the vaccines that failed to display a significant relationship with asthma prevalence rates (p = 0.133).
T12484 562722-562884 Sentence denotes Statistical analysis proved that a correlation between vaccination rates of United States children ages 0-4 and asthma-caused deaths was insignificant (p > 0.05).
T82442 562885-562897 Sentence denotes Conclusions:
T76083 562898-563010 Sentence denotes The OPV, which is administered orally rather than parentrally, displayed no relationship with asthma prevalence.
T61992 563011-563184 Sentence denotes This could be due to the fact that live attenuated orally administrated polio vaccine may induce mucosal immunity, simulating a normal pathogen route of entry into the body.
T50320 563185-563258 Sentence denotes Childhood vaccination had no relationship with asthma-caused death rates.
T72725 563259-563263 Sentence denotes A.S.
T99201 563264-563297 Sentence denotes Alfrayh * , Riyadh, Saudi Arabia.
T75973 563298-563574 Sentence denotes introduction: heredity plays a major role in asthma and other allergic diseases, mechanisms underlying the inheritance of these disorders are poorly understood. this study therefore analyzed the risk conferred by family history of asthma and atopy for having childhood asthma.
T17226 563575-563584 Sentence denotes Methods :
T30566 563585-563715 Sentence denotes A total of 1601 children between 1-16 yrs selected randomly in three cities in Saudi Arabia ( Hail, Taif and Gizan )in 1995-1996 .
T66794 563716-564126 Sentence denotes The questionnaire which is similar to the one used in the international study of allergy and asthma in childhood ISAAC. were self administerd under medical supervision.Apart from the demogrphic details, the questionnaire included questions on symptoms and physician diagnosis of asthma, rhinitis, eczema and family history of these conditions. the family members were grouped as immediate family and relatives.
T40940 564127-564346 Sentence denotes Asthma and atopy were defined as ever having had physician diagnosis of such conditions information was also available about exposure to cigarette somke at least one member was a smoker in the household and having pets.
T98790 564347-564523 Sentence denotes Relative risk for developing asthma was estimated in terms of odds ratio by bivariate analyses using Chi square test and P value was considered significant when less than 0.05.
T35987 564524-564533 Sentence denotes Results :
T77212 564534-564786 Sentence denotes History of asthma in the immediate family and relatives conferred a 4 fold and 3 fold risk for development of childhood asthma odd ratio ( OR )=4.2, 95% confidence interval(CI)=3.3 to 5.5, p=0.00001 and OR=3.3, 95%CI=2.5 to 4.3, p=0.00001 respectively.
T25580 564787-565386 Sentence denotes Rhinitis in immediate family and the relatives was associated with 3 folds increased risk for childhood asthma OR = 3.0, 95% CI = 2.2 to 4.0, p=0.0001 respectively whereas history of eczema conferred over 3 folds risk OR=3.4, 95% CI = 2.4 to 4.7, p=0.00001 for childhood asthma when present only in the immediate family. history of eczema in relatives was not associated with any risk. of the environmental factors, exposure to cigarette smoke conferred 2 folds risk of developing childhood asthma OR = 2.6, 95% CI = 2.0 to 3.3, p= 0.0001, whereas exposure to pets was not a significant risk foctor.
T84518 565387-565399 Sentence denotes Conclusion :
T70313 565400-565583 Sentence denotes Presence of asthma and atopy either in the biological parents or relatives constitute a significant risk for childhood asthma.Paricularly in the presence of evironmental risk factors.
T12917 565584-565741 Sentence denotes The murine local lymph node assay (LLNA) has been developed as an alternative to guinea pig models for the assessment of the contact sensitization potential.
T57791 565742-565899 Sentence denotes However, there is a need to develop a non-radioisotopic endpoint for the LLNA, because of the radioisotopic method's requiring the use of special facilities.
T53507 565900-566039 Sentence denotes In this study, we investigated to evaluate the lymphocyte subpopulations in the lymph node cells following allergen and irritant treatment.
T16237 566040-566323 Sentence denotes Female Balb/c mice were treated by the topical application on the dorsum of both ears with sensitizers, 2, 4-dinitrochlorobenzene (DNCB), toluene diisocyanate (TDI), and a-hexylcinnamaldehyde (HCA), and an irritant, sodium lauryl sulfate (SLS), once daily for three consecutive days.
T26615 566324-566395 Sentence denotes The lymph node (LN) cells were harvested 72h after the final treatment.
T48069 566396-566475 Sentence denotes Phenotypic analysis of lymphocytes subsets was performed with a flow cytometry.
T34525 566476-566576 Sentence denotes The allergens DNCB, TDI, and HCA and an irritant, SLS increased cell number compared to the vehicle.
T63700 566577-566733 Sentence denotes There was an increase in the percentage of B220+ cells in mice treated with DNCB and TDI compared to the vehicle control, but not in those treated with SLS.
T67533 566734-566892 Sentence denotes Mice were treated with DNCB, HCA and TDI showed a preferential increase in the percentage of B220+CD40+ cells compared with vehicle and irritant-treated mice.
T60176 566893-567043 Sentence denotes There was an increase in B220+CD86+ cells of mice treated with DNCB, TDI and HCA, but no significant increases were observed in mice treated with SLS.
T51486 567044-567186 Sentence denotes Mice were treated with DNCB, and TDI showed an increase in the percentage of B220+CD23+ cells compared with vehicle and irritant-treated mice.
T53016 567187-567388 Sentence denotes These results suggest that analysis of B cell activation marker, CD40 on B cells may be useful in differentiating allergen and irritant responses in the draining lymph nodes of chemically treated mice.
T74927 567389-567391 Sentence denotes M.
T1748 567392-567407 Sentence denotes Frieri * , Y.C.
T93592 567408-567431 Sentence denotes Huang, East Meadow, NY.
T44223 567432-567445 Sentence denotes Introduction:
T91871 567446-567578 Sentence denotes Nitric oxide (NO) is an important biomarker for inflammation in airway epithelial cells and in exhaled breath of asthmatic subjects.
T37384 567579-567787 Sentence denotes We have previously demonstrated NO production in antigen-stimulated human bronchial epithelial cells and an effect of omalizumab (monoclonal anti-IgE antibody) on NO production in those cells [Leyko BT et al.
T85468 567788-567839 Sentence denotes J Allergy Clin Immunol 2004; 113(suppl 193) :A668].
T51903 567840-568060 Sentence denotes In this study, we investigated the potential role of IgE and its receptors on A549 cells by characterizing the effect of omalizumab on antigen, EGF, and IL-1 stimulation of A549 cells in a medium containing atopic serum.
T42526 568061-568305 Sentence denotes Methods: A549 human alveolar epithelial cells were stimulated with 100 IU/mL of IL-1 , 10 μg/mL of ragweed (RA), 1000 AU of dust mite (DM), and 40 ng/mL of EGF, and exposed to either 10 -7 M budesonide or 0.1 μg/mL omalizumab for 6 or 24 hours.
T85127 568306-568374 Sentence denotes NO production was measured in duplicate by a highly sensitive ELISA.
T54903 568375-568383 Sentence denotes Results:
T77790 568384-568553 Sentence denotes Omalizumab but not budesonide inhibited NO production at 6 hours in A549 cells stimulated with IL-1 (17-13μM, p<.05)and IL-1 +DM (18-14μM, p=.08), but not with RA alone.
T12167 568554-568745 Sentence denotes However, at 24 hours omalizumab and budesonide each significantly inhibited NO production stimulated by IL-1 (29-9μM; 29-17μM), IL-1 +DM (22-12μM; 20-14μM), and EGF (17-9μM; 17-13μM) (p<.05).
T86452 568746-568801 Sentence denotes Conclusion: NO production is a marker for inflammation.
T36905 568802-568992 Sentence denotes Omalizumab demonstrated a significant anti-inflammatory effect in distal alveolar cells by inhibiting NO production stimulated by antigen, IL-1 , and EGF in a medium containing atopic serum.
T71733 568993-569178 Sentence denotes As persistent inflammation in asthma may play a role in airway remodeling, treatment with omalizumab may have a beneficial effect on chronic airway inflammation in patients with asthma.
T92450 569179-569285 Sentence denotes Oral tolerance trigger regulatory mechanisms able to down-modulate antigen-specific T and B cell response.
T49623 569286-569434 Sentence denotes To address the lasting effect of several regimens of oral tolerance to ovalbumin, in naive or antigen primed mice, B-cell function has been focused.
T31828 569435-569636 Sentence denotes Furthermore, we analyze specific antibody response up to eight months of post-immunization, proliferative response, B7 (CD80/CD86) expression on B cells and T cell CTLA-4 involvement in oral tolerance.
T60130 569637-569755 Sentence denotes A/Sn mice were immunized by intraperitoneal route with 50μg of OVA/0, 1 mg-alum and boost 10 days after priming (dap).
T70816 569756-569837 Sentence denotes OVA feeding was done with 25mg at different days before or after antigen priming.
T90353 569838-569933 Sentence denotes In others protocols, mice were fed twice, before and after priming with a total of 50mg of OVA.
T25870 569934-569989 Sentence denotes All groups were boosted at 60 or 120 or 180 or 240 dap.
T24477 569990-570183 Sentence denotes The results showed that only mice fed at naive status and those fed twice before and after immunization demonstrated a long lasting of IgE Ab response inhibition up to 8 months of immunization.
T65722 570184-570323 Sentence denotes These mice showed a marked inhibition of antigen-specific proliferative response that was restored with anti-CD28 mAb in vitro stimulation.
T74539 570324-570549 Sentence denotes Evaluation by flow cytometry of spleen cells cultured for 48 hours upon OVA stimulation, showed an important decrease of B 7.2 expres-sion on B cells of naive fed mice, which remained inhibited until 8 months of immunization.
T16062 570550-570660 Sentence denotes After addition of anti-CTLA-4 mAb an enhancement of B7.2 expression was detected on B cells of naive fed mice.
T462 570661-570851 Sentence denotes CTLA-4 molecules expression on CD4+ T cells of naive fed mice remained unchanged following OVA stimulation while a peak of expression was detected at 96h of OVA stimulation in control group.
T97517 570852-571011 Sentence denotes This finding reinforce the T cell anergic status of naive fed mice, due to the less cell division and consequently a low rate of CD4+/CD44high activated cells.
T33609 571012-571285 Sentence denotes The results showed that antigen feeding before immunization induce a long lasting anergy mediated by an impaired T-B cell cooperation and Ab production due to the decrease of costimulatory molecules expression on B cells and negative signaling effects by CTLA-4 expression.
T17417 571286-571299 Sentence denotes Introduction:
T29268 571300-571622 Sentence denotes Vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF) and fibronectin (FN) can promote angiogenesis, a putative component of airway remodeling. (S)-albuterol can exacerbate airway hyperresponsiveness, bronchospasm and release pro-inflammatory cytokines from small airway and smooth muscle cells.
T79741 571623-571858 Sentence denotes Our study evaluated the effects of (S)-albuterol ((S))-and (R)-albuterol ((R)) on secretion of these factors on normal human lung fibroblasts (NHLF) and myofibroblasts (myoNHLF) in the presence or absence of TGF 2, IL-1 , or allergens.
T18843 571859-571938 Sentence denotes Methods: NHLF were stimulated to differentiate to myoNHLF with 1000 pg/mL TGF .
T34550 571939-572270 Sentence denotes Dose-dependent effects of (S) and (R) [10 -8 to 10 -4 M] were evaluated for secretion of VEGF, bFGF and FN by NHLF and myoNHLF with and without 1000 AU/ml D. pteronyssinus (Dp), 1000 PNU/ml ragweed (RA), 100 U/ml IL-1 , or 1000 pg/mL TGF 2 into serum-free media (ITS) at 37 o C with 5% CO 2 collected at 24 hr and assayed by ELISA.
T53432 572271-572279 Sentence denotes Results:
T1702 572280-572468 Sentence denotes In NHLF the following was observed: VEGF secretion was 2-fold higher with 10 -7 M (R) relative to (S), p<0.05; bFGF secretion was increased 50%-100% by 10 -5 M (S) relative to (R), p<0.05.
T11642 572469-572615 Sentence denotes A lower concentration of (S) (10 -6 M) in the presence of either Dp or IL-1 caused a 2-fold increase in secretion of bFGF relative to (R), p=0.02.
T70189 572616-572670 Sentence denotes In the presence of myoNHLF the following was observed:
T55897 572671-572755 Sentence denotes 10 -7 and 10 -5 M (S) caused a 50%-100% increase in secretion of FN relative to (R).
T85428 572756-572843 Sentence denotes At 10 -7 M (S), this effect was further increased with the addition of IL-1 , p=0.022).
T42755 572844-572855 Sentence denotes Conclusion:
T21451 572856-572970 Sentence denotes In a dose-dependent manner, (S)-albuterol stimulated the release of bFGF and FN by NHLF and myoNHLF, respectively.
T46123 572971-573093 Sentence denotes This was enhanced by dust mite and/or IL-1 , potentially contributing to the matrix remodeling observed in chronic asthma.
T73963 573094-573212 Sentence denotes VEGF over-expression can have a protective effect against chronic hypoxia and can recruit immune cells to the alveoli.
T7457 573213-573419 Sentence denotes Increased VEGF by (R)-albuterol could contribute to such an effect in vivo in asthmatics. bFGF, in BAL and sputum of asthmatics, and FN which contributes to subepithelial fibrosis, can promote angiogenesis.
T47668 573420-573562 Sentence denotes Increased bFGF and FN by (S)-albuterol could be detrimental over time by enhancing matrix deposition and remodeling in a subset of asthmatics.
T55211 573563-573565 Sentence denotes O.
T15960 573566-573581 Sentence denotes Ozdemir 1* , C.
T92905 573582-573594 Sentence denotes Moore 2 , Y.
T83902 573595-573614 Sentence denotes Ravindranath 1 , S.
T31741 573615-573629 Sentence denotes Savasan 1 , 1.
T65290 573630-573645 Sentence denotes Detroit, MI; 2.
T95376 573646-573662 Sentence denotes New Orleans, LA.
T52336 573663-573674 Sentence denotes Background:
T94425 573675-573817 Sentence denotes Mast cells (MC) have been shown to demonstrate natural cytotoxicity against mouse fibrosarcoma cell line in culture when incubated for 24-48h.
T8960 573818-573904 Sentence denotes This effect has been postulated to be mediated through soluble and/or membranous TNF-.
T22198 573905-574056 Sentence denotes More recently; FasL, MC chymase and serine protease granzyme H with its chymase activity were proposed as mediators of mast cell-mediated cytotoxicity.
T17649 574057-574239 Sentence denotes Thus, both 'granule-exocytosis' through chymase, granzyme H and soluble TNF-and 'death receptors' through membrane-bound TNF-and FasL pathways appear to be operative in this process.
T18761 574240-574245 Sentence denotes Aims:
T77894 574246-574614 Sentence denotes Following our earlier observations on long-term liquid culture-grown human bone marrow mast cell cytotoxicity against human leukemia cells in 24-48h co-incubation experiments, we investigated mast cell-mediated cytotoxicity against natural killer/lymphokine-activated killer cell-sensitive cells in short term (12h) cultures without any stimulation for the first time.
T75795 574615-574623 Sentence denotes Methods:
T17078 574624-574728 Sentence denotes Human bone marrow mononuclear cells were cultured in methyl cellulose supported with IL-3, IL-6 and SCF.
T60358 574729-574857 Sentence denotes Mast cell colonies that developed in six weeks were transferred to liquid medium and maintained for 18 weeks before experiments.
T82432 574858-575031 Sentence denotes Cytotoxicity was investigated against K562, Raji and Daudi cells at 12, 24 and 48 hours of co-incubation by our established flow cytometric cell-mediated cytotoxicity assay.
T84251 575032-575040 Sentence denotes Results:
T95102 575041-575276 Sentence denotes After 12h co-incubation, 61% (11% early apoptotic and 50% late apoptotic or necrotic death) and 29% (21% early apoptotic and 8 % late apoptotic or necrotic death) target cell kill was demonstrated in Daudi and Raji cells, respectively.
T6140 575277-575371 Sentence denotes Daudi cell killing has stayed stable at 24h (67%; 27% early apoptotic and 40% late apoptotic).
T1451 575372-575513 Sentence denotes Despite a small numbers of experiments, Daudi cell kill was statistically significant at 12h (p:0.011) and 24h (p:0.011) compared to control.
T6726 575514-575578 Sentence denotes However, K562 cell elimination (18%) has not occurred until 48h.
T55509 575579-575659 Sentence denotes Mast cell-Daudi cell conjugates were seen on the Wright/Giemsa slides (Figure) .
T27919 575660-575671 Sentence denotes Conclusion:
T69400 575672-575794 Sentence denotes Our results demonstrate that human MC can cause cell-mediated cytotoxicity against certain cells in relatively short-term.
T65150 575795-575954 Sentence denotes This further suggests possible contribution of 'granule-exocytosis' pathway to MC natural cytotoxicity, indicating a faster MC response in immune surveillance.
T44072 575955-575957 Sentence denotes O.
T55568 575958-575973 Sentence denotes Ozdemir 1* , M.
T65266 575974-575990 Sentence denotes Buyukavci 2 , Y.
T85239 575991-576010 Sentence denotes Ravindranath 1 , S.
T46062 576011-576025 Sentence denotes Savasan 1 , 1.
T87057 576026-576041 Sentence denotes Detroit, MI; 2.
T67263 576042-576058 Sentence denotes Erzurum, Turkey.
T66959 576059-576070 Sentence denotes Background:
T21279 576071-576145 Sentence denotes The effect of melatonin (MLT) on cellular immunity has been controversial.
T10281 576146-576265 Sentence denotes Recently, MLT has been demonstrated to activate T and NK cells through its membrane or nuclear high affinity receptors.
T22526 576266-576384 Sentence denotes It was also shown that pharmacological concentrations of MLT (>nM) could be cytotoxic against different human cancers.
T10955 576385-576390 Sentence denotes Aims:
T24301 576391-576580 Sentence denotes Our aim was to investigate the effect of MLT alone or in combination with IL-2 on peripheral blood lymphocytes (PBL), lymphokine activated killer (LAK) cell generation and its cytotoxicity.
T68165 576581-576728 Sentence denotes Methods: PBL were cultured for 7 days in the presence of MLT at different concentrations (10 -3 , 10 -5 , 10 -7 M) with or without IL-2 (100 U/ml).
T74118 576729-576789 Sentence denotes Cell viability was determined by trypan blue exclusion test.
T58943 576790-576955 Sentence denotes Cell-mediated cytotoxicity of lymphocytes/LAK cells against K-562 and Daudi cells was studied using our established flow cytometric cell-mediated cytotoxicity assay.
T18983 576956-576964 Sentence denotes Results:
T47465 576965-577166 Sentence denotes Although 10 -3 M concentration of MLT did not affect cell proliferation much on day 3, it significantly inhibited proliferation by day 7 (p<0.05) consistent with known anti-proliferative effect of MLT.
T6288 577167-577324 Sentence denotes 10 -5 and 10 -7 M concentration of MLT also mildly inhibited proliferation on day 3; however there was a minimal rebound with 10 -7 M concentration by day 7.
T31956 577325-577566 Sentence denotes Consistent with the reported MLT-treated PBL's reduced response to mitogens, IL-2 and MLT (10 -3 M) combination suppressed proliferation on days 3 and 7; however, with 10 -5 M MLT concentration PBL counts increased gradually from day 3 to 7.
T27746 577567-577787 Sentence denotes Although MLT treatment alone did not enhance cell-mediated cytotoxicity, IL-2 and MLT combinational treatment at both concentrations (10 -3 and 10 -5 M) increased it significantly compared to baseline activity (Figure) .
T80406 577788-577937 Sentence denotes Conclusion: IL-2 and MLT combination at 10 -5 M concentration resulted in superior lymphocyte proliferation and LAK cell-mediated leukemia cell kill.
T30838 577938-578044 Sentence denotes MLT-induced increase in IL-2R-expression of PBL shown earlier might be the mechanism for our observations.
T39397 578045-578116 Sentence denotes MLT can be considered in immunotherapy as an adjunct to IL-2 treatment.
T63957 578117-578121 Sentence denotes A.E.
T18059 578122-578137 Sentence denotes Fusaro * , J.R.
T7591 578138-578150 Sentence denotes Victor, C.R.
T68785 578151-578165 Sentence denotes Oliveira, C.A.
T11491 578166-578177 Sentence denotes Brito, E.A.
T55260 578178-578188 Sentence denotes Futata, M.
T48029 578189-578201 Sentence denotes Maciel, A.J.
T94841 578202-578214 Sentence denotes Duarte, M.N.
T68556 578215-578239 Sentence denotes Sato, São Paulo, Brazil.
T78320 578240-578406 Sentence denotes The maternal exposure to allergens during pregnancy or even in postnatal period may influence the allergy onset to newborns, through antigen or antibody transmission.
T575 578407-578584 Sentence denotes We sought to verify the effect of maternal antigen exposure before conception, during gestation or in the breastfeeding period on the offspring type I hypersensitivity response.
T78915 578585-578757 Sentence denotes Female Balb/c mice were immunized or not with OVA extract/alum, boosted twice at 10th and 20 th and mated with normal Balb/c male on the 21th day after sensitization (das).
T56069 578758-578917 Sentence denotes Others groups of immunized mothers also received oral administration with OVA along pregnancy, or non-immunized mothers received OVA only during breastfeeding.
T85280 578918-579037 Sentence denotes Offspring from immunized or normal mice were immunized intraperitoneally with OVA at 25 do and boosted on the 10th das.
T305 579038-579207 Sentence denotes The results showed a important decreased of TGF-levels in the amniotic fluid and milk from immunized mothers before mating in comparison to obtained from normal mothers.
T9986 579208-579398 Sentence denotes OVA exposure during pregnancy of immunized mothers decrease significantly the transference of TGF-by breastfeeding, while both TGF-isoforms were founded at high levels in the amniotic fluid.
T9467 579399-579506 Sentence denotes Similar levels of TGF-transference by placenta to the newborn was detected in both immunized mother groups.
T82929 579507-579730 Sentence denotes Pups from mothers exposed with Ag during pregnancy showed an increased spleen cell number, whereas did not produced IL-2, IL-4, IL-10 e IFN-secretion induced by antigen neither altered responsiveness to anti-CD3 or mitogen.
T88642 579731-579991 Sentence denotes Maternal OVA-immunization induced a marked inhibition of spe-cific IgE antibody response in the immunized pups, contrasting to the enhancement of IgE responsiveness detected in the immunized pups from mothers which were exposed to OVA only at postnatal period.
T79226 579992-580200 Sentence denotes These results showed that preconceptional immunization exert a protective effect on the offspring IgE development and an exacerbation of IgE responsiveness due to mother antigen exposure during breastfeeding.
T81258 580201-580346 Sentence denotes The findings suggest that rather than in utero antigen priming occurrence, postnatal period may contribute to offspring early life sensitization.
T5930 580347-580402 Sentence denotes Financial support: FAPESP and LIM56-FMUSP INTRODUCTION:
T70085 580403-580507 Sentence denotes The reasons for the increased incidence of allergic diseases in westernized countries are still unknown.
T48358 580508-580590 Sentence denotes Mercury is an important pollution factor to which humans are increasingly exposed.
T36385 580591-580772 Sentence denotes Prior studies on the effect of mercury on mitogen stimulated human lymphocytes indicated a TH2weighted immune response, but the results were inconsistent and difficult to reproduce.
T2594 580773-580930 Sentence denotes Phorbol myristate acetate (PMA) is a direct activator of protein kinase C, which has been shown to play a role in mercury induced IL-4 production in animals.
T45057 580931-581043 Sentence denotes Therefore we investigated the effect of mercury on PMAactivated human peripheral blood mononuclear cells (PBMC).
T1414 581044-581205 Sentence denotes METHODS: PBMC from 8 individuals were cultured for 4 days in culture medium containing PMA and ionomycin in the presence or absence of mercuric chloride (HgCl2).
T79328 581206-581287 Sentence denotes IL-4 and gamma-IFN concentrations were measured by ELISA of culture supernatants.
T44745 581288-581406 Sentence denotes Cell death and apoptosis were determined by 7-AAD and annexin staining and fluorescence activated cell sorting (FACS).
T10364 581407-581468 Sentence denotes Cell-proliferation was assessed by 3H-Thymidin-incorporation.
T63045 581469-581477 Sentence denotes RESULTS:
T90562 581478-581623 Sentence denotes After 4 days of culture, PMA/ionomycin-stimulated a small amount of IL-4 compared to untreated PBMC (1.7 +/-0.92 pg/ml versus 0.36 +/-1.0 pg/ml).
T70367 581624-581760 Sentence denotes However, mercury induced a more than 30 fold increase in IL-4 production when added to PMA-activated cells (57.4 +/-45.2 pg/ml, p<0.01).
T1991 581761-581981 Sentence denotes Gamma IFN production was strongly increased in PBMC that were treated with PMA/ionomycin (>3500 pg/ml versus 417 +/-1045 pg/ml in unstimulated cells) but dropped markedly in cells treated with mercury plus PMA/Ionomycin.
T33060 581982-582074 Sentence denotes In addition, mercury induced increased cell death, apoptosis and reduced cell proliferation.
T49906 582075-582087 Sentence denotes CONCLUSIONS:
T66663 582088-582225 Sentence denotes HgCl2 strongly stimulates IL-4 production in PMA/ionomycin treated PBMC while cell viability and gamma-IFN production drop significantly.
T17898 582226-582408 Sentence denotes These preliminary results suggest that human exposure to mercury may be playing a role in the observed increased incidence of allergic disease in the industrialized world Background:
T29533 582409-582534 Sentence denotes Mast cells (MC) have been shown to induce natural cellmediated cytotoxicity in long-term (24-48 hrs.) in vitro assay systems.
T59867 582535-582768 Sentence denotes The cytotoxicity is mediated by at least two pathways: secretory via exocytosis of MC granules containing serine proteases such as granzymes, chymase and soluble TNF-and nonsecretory (cell-to-cell contact) via membranous TNFand FasL.
T11244 582769-582865 Sentence denotes Chymase induces apoptosis in neonatal rat cardiomyocytes and human vascular smooth muscle cells.
T50586 582866-583015 Sentence denotes The objective of this study was to investigate MC mediated cytotoxicity against NK/LAK-sensitive cells in short term (12 hrs.) unstimulated cultures.
T23373 583016-583024 Sentence denotes Methods:
T62215 583025-583142 Sentence denotes Human bone marrow mononuclear cells were cultured in methylcellulose supported with IL-3, IL-6, and Stem Cell Factor.
T78685 583143-583247 Sentence denotes Mast cell colonies developed at 6 weeks and were transferred to liquid IMDM and maintained for 18 weeks.
T7919 583248-583395 Sentence denotes A flow cytometric cytotoxicity assay was used to determine cytotoxicity against Daudi, Raji, and K562 cell lines at 12 hrs., 24 hrs., and 48 hours.
T64734 583396-583486 Sentence denotes The controls consisted of cell lines without Mast cells at 12 hrs., 24 hrs., and 48 hours.
T71476 583487-583495 Sentence denotes Results:
T75692 583496-583506 Sentence denotes Rationale:
T30589 583507-583654 Sentence denotes To establish the antibody response rate in children with recurrent infections and fully immunized with the Pneumococcal 7-valent Conjugate vaccine.
T87405 583655-583663 Sentence denotes Methods:
T68257 583664-583859 Sentence denotes We have analyzed 39 patients referred to our clinic with recurrent infections despite complete immunization with the Pneumococcal 7-valent Conjugate vaccine for age, according to ACIP guidelines.
T81629 583860-584077 Sentence denotes We assessed the patients by checking their immunization status and the antibody titers to all 7 Streptococcus pneumoniae serotypes included in the vaccine (4, 6B, 9V, 14, 18C, 19F, 23F) assessed by standardized ELISA.
T34300 584078-584320 Sentence denotes The patients were assembled into 3 groups, a non-immunized group with laboratory data prior to the vaccine, and an immunized group consisting of responders and nonresponders according to their antibody titer (<1.3 or >1.3 IU/ml respectively).
T94404 584321-584368 Sentence denotes The data were analyzed using Epi Info and SPSS.
T94150 584369-584377 Sentence denotes Results:
T2323 584378-584453 Sentence denotes The mean age was 3.3 years for non-responders and 3.8 years for responders.
T99233 584454-584549 Sentence denotes There was no significant statistical difference between the groups regarding age, race and sex.
T52651 584550-584676 Sentence denotes Ten patients were identified who failed to respond to all 7 serotypes included in the Pneumococcal 7-valent Conjugate vaccine.
T33947 584677-584802 Sentence denotes There was no significant statistical difference between the non-immunized and the immunized nonresponders to all 7 serotypes.
T54337 584803-584815 Sentence denotes Conclusions:
T17808 584816-585060 Sentence denotes We have identified a special immunological phenotype of specific antibody deficiency (SAD) patients with normal total immunoglobulins and normal responses to protein antigens, but who failed to respond to conjugate pneumococcal polysaccharides.
T97471 585061-585063 Sentence denotes A.
T9276 585064-585092 Sentence denotes Yates 1* , R. deShazo 1 , J.
T90993 585093-585106 Sentence denotes Butler 1 , G.
T10236 585107-585120 Sentence denotes Howell 1 , J.
T56463 585121-585134 Sentence denotes Farley 1 , H.
T89429 585135-585145 Sentence denotes Liu 1 , N.
T56642 585146-585175 Sentence denotes Nanayakkura 2 , G.B.Yi 1 , R.
T17072 585176-585191 Sentence denotes Rockhold 1 , 1.
T96291 585192-585207 Sentence denotes Jackson, MS; 2.
T65978 585208-585219 Sentence denotes Oxford, MS.
T33475 585220-585233 Sentence denotes INTRODUCTION:
T41379 585234-585355 Sentence denotes Venom from S. invicta consists of 95% disubstituted piperidine alkaloids and is toxic to insects, birds and farm animals.
T18522 585356-585502 Sentence denotes Recent reports of morbidity and mortality in elderly patients after massive fire ant stings suggest the potential for systemic mammalian toxicity.
T17732 585503-585728 Sentence denotes We evaluated the toxic responses to systemic administration of two structurally verified, synthetic S. invicta venom alkaloids, solenopsin A (trans-2-methyl-6-n-undecylpiperidine) and its cis-isomer, isosolenopsin A, in rats.
T80708 585729-585737 Sentence denotes METHODS:
T65123 585738-585987 Sentence denotes Sprague Dawley rats were anesthetized with isoflurane, paralyzed with gallamine, artificially ventilated and instrumented to record arterial blood pressure (BP; mm Hg), heart rate (HR; bpm) and % change in left ventricular contractility (LVC; P/ t).
T22706 585988-586117 Sentence denotes In addition, a group of rats was chronically instrumented to record BP and HR while the animals were conscious and freely-moving.
T52798 586118-586126 Sentence denotes RESULTS:
T84458 586127-586200 Sentence denotes Solenopsin A at 3 to 30 mg/kg IV dose-dependently lowered BP, HR and LVC.
T20799 586201-586312 Sentence denotes At 30 mg/kg IV, hypotension (-40±12 mmHg), bradycardia (-27±8 bpm) and decreased LVC (-41±17 P/ t) were marked.
T85344 586313-586398 Sentence denotes Isosolenopsin A, 15 mg/kg IV, produced responses similar to solenopsin A 15 mg/kg IV.
T42816 586399-586514 Sentence denotes Solenopsin A 30 mg/kg IV elicited tonic-clonic convulsions and respiratory arrest in conscious, freely-moving rats.
T94596 586515-586577 Sentence denotes Hematuria was seen with solenopsin A, but not isosolenopsin A.
T9977 586578-586763 Sentence denotes Superfusion of a working, isolated, perfused rat heart with 10 uM of solenopsin A elicited a marked, reversible decrease in LVC, and cardiac arrest occurred with 100 uM of solenopsin A.
T35909 586764-586775 Sentence denotes CONCLUSION:
T9057 586776-586908 Sentence denotes The results demonstrate that these alkaloids possess significant depressant activity on the cardiac and respiratory systems of rats.
T30742 586909-587109 Sentence denotes The neurologic and cardiorespiratory effects can account for lethality to small mammals in the wild, and may contribute to adverse cardiovascular effects noted in humans after massive fire ant stings.
T55111 587110-587123 Sentence denotes Introduction:
T40095 587124-587289 Sentence denotes During asthma attacks, the pH of exhaled breath condensate (EBC) decreases two log orders (pH=5.0), returning to normal levels after corticosteroid therapy (pH=7.0).
T60693 587290-587432 Sentence denotes Ion channels, once thought to participate only in the transport of ions, are now suspected of mediating airway inflammation in asthma as well.
T79067 587433-587620 Sentence denotes To determine whether allergen directly alters airway mucosal pH and ion function, we measured nasal pH and nasal potential difference (PD) before and after nasal allergen challenge (NAC).
T92482 587621-587629 Sentence denotes Methods:
T82805 587630-587911 Sentence denotes Ten allergic rhinitic subjects (mean±SEM age 28.3 years±2.9, 7 females) underwent a crossover, single-blinded, placebo-controlled study, where they were challenged with allergen (dust mite, grass, cat) and control diluent in two different occasions in random order via nasal spray.
T88327 587912-587981 Sentence denotes Nasal pH was measured on the surface of nasal mucosa with a pH probe.
T17352 587982-588049 Sentence denotes Nasal mucosa PD was measured between nasal mucosa and forearm skin.
T8918 588050-588097 Sentence denotes Subjects also filled out a nasal symptom scale.
T45202 588098-588175 Sentence denotes Measurements were taken at baseline, 1 hour, 4 hours, and 24 hours after NAC.
T84668 588176-588184 Sentence denotes Results:
T17828 588185-588335 Sentence denotes The nasal symptom score increased significantly immediately after allergen compared to control challenge (13.0±2.4 vs. 3.7±1.1 respectively, p=0.003).
T37935 588336-588508 Sentence denotes There were no statistically significant differences in the nasal pH at 1h and 4h, but a significant decrease at 24h compared with baseline (-0.2±0.1 vs. +0.14±0.1, p=0.02).
T21625 588509-588681 Sentence denotes The change in pH from 0h to 24h correlated significantly and inversely with change in symptoms (r=-0.59, p=0.007) and number of sneezes (r=-0.65, p=0.002) after challenges.
T85773 588682-588737 Sentence denotes Nasal PD did not change significantly after challenges.
T19852 588738-588749 Sentence denotes Conclusion:
T85147 588750-588855 Sentence denotes Allergen decreases nasal mucosal pH in the very late phase after challenge in allergic rhinitic subjects.
T61465 588856-588968 Sentence denotes Decrease in airway mucosal pH during asthma exacerbations may be caused by aggravation of allergic inflammation.
T74962 588969-589037 Sentence denotes Nasal potential difference does not change after allergen challenge.
T60066 589038-589268 Sentence denotes Funding: NIAID, ACAAI Foundation Introduction: UV induces differentiation of T-and B-lymphocytes, suppresses natural killer cells, renders a tolerogenic effect and induces apoptosis resulting in local and system immunosuppression.
T82825 589269-589277 Sentence denotes Methods:
T4648 589278-589688 Sentence denotes Lymphocytes were studied using indirect immunofluorescence methods employing monoclonal antibodies to CD-markers CD4, CD8, CD16, CD25, CD95, HLA-I, and HLA-II, from the blood of 14 volunteers (aged 18-24 years) before UV exposure (control), after an exposure of blood in vitro to a dose 1.12 kJ, and after 24 hours of exposure of the medial surface of the elbow joint in vivo (S=200 cm2), to a dose of 1.12 kJ.
T95598 589689-589697 Sentence denotes Results:
T95342 589698-589834 Sentence denotes The direct exposure of blood results in a significant reduction in the number of lymphocytes, probably due to direct phototoxic effects.
T47007 589835-589973 Sentence denotes Significant modifications both of the aggregate number of lymphocytes and amount of T-helpers after UV exposure of the skin were not seen.
T65267 589974-590060 Sentence denotes After UV the number of cells which express the marker CD8 is sig-nificantly increased.
T95979 590061-590130 Sentence denotes Exposure to UV in vitro induces reduced number of cells bearing CD16.
T51511 590131-590234 Sentence denotes However on in vivo exposure, a significant increase in number of cells which express CD16 was observed.
T28567 590235-590383 Sentence denotes UV exposure of blood reduced significantly the HLA-I (9.67±0.72 reduced to 0.32±0.54) and HLA-II (DR) (21.56±1.19 reduced to 18.45±1.15) expression.
T58138 590384-590511 Sentence denotes UV exposure of skin increased significantly HLA-I to 11.56±0.81, while HLA-II (DR) was insignificantly decreased to 20.65±2.01.
T5304 590512-590732 Sentence denotes CD95 expression increased from 22.43±1.12 to 25.95±1.08 due to blood UV exposure, while there were insignificant reductions in CD4 (39.33±2.14 reduced to 36.62±2.34) and CD8 (36.50±2.03 reduced to 25.75±2.74) expression.
T2084 590733-590933 Sentence denotes Conclusion: UV starts a cascade-like response, including apoptosis, leading to changes in NK cell, helper and suppression lymphocyte numbers consistent with an immunomodulating effect of UV radiation.
T13361 590934-590945 Sentence denotes Background:
T4717 590946-591119 Sentence denotes Previous investigations have shown the involvement of histamine and histamine receptors (H 1 , H 2 , H 3 , H 4 ) in IgE synthesis in atopic and lymphoproliferative diseases.
T73328 591120-591228 Sentence denotes IgE responses may depend on the concentrations of histamine and histamine receptor antagonists and agonists.
T94223 591229-591429 Sentence denotes The goal of this investigation was to evaluate the role of the concentration of histamine and H 3 /H 4 antagonists along with the importance of pre-existing levels of IgE in determining IgE responses.
T51391 591430-591438 Sentence denotes Methods:
T18183 591439-591549 Sentence denotes IgE synthesis was studied in MNC cultures of patients (7-14 years old) having mild atopic asthma and rhinitis.
T33474 591550-591673 Sentence denotes All patients had high levels of total IgE and specific IgE to ragweed pollen, house dust mite, epidermal or mold allergens.
T95243 591674-591867 Sentence denotes Patients were divided into two groups according to the serum IgE and levels of spontaneous IgE synthesis: group A -with low levels (4.8±1.2 IU/ml) and group B -with high levels (9.7±1.4 IU/ml).
T10351 591868-591965 Sentence denotes The serum level of total IgE in group A was 426.1±24.3 IU/ml and in group B was 570.2±26.5 IU/ml.
T71972 591966-592034 Sentence denotes FUB 181 hydrogenmaleate was used as an H 3 /H 4 specific antagonist.
T9500 592035-592043 Sentence denotes Results:
T39798 592044-592171 Sentence denotes Histamine in high concentrations (10 -5 M) suppressed and in low concentrations (10 -8 M) stimulated spontaneous IgE synthesis.
T70707 592172-592255 Sentence denotes The H 3 /H 4 antagonist FUB 181 activity depends on the pre-existing levels of IgE.
T19594 592256-592413 Sentence denotes In high concentrations (10 -5 M), the antagonist increased IgE synthesis only in group A, but not in group B having high spontaneous levels of IgE synthesis.
T12694 592414-592575 Sentence denotes The synthesis in group A increased 1.36 fold (p<0.001), but H 3 /H 4 blockade cancelled the IgE suppressive effect of high concentrations of histamine (10 -5 M).
T32342 592576-592658 Sentence denotes The addition of histamine into the MNC culture stimulated IgE synthesis 1.56 fold.
T8543 592659-592753 Sentence denotes FUB 181 had no effect on IgE-stimulatory effects of low concentrations of histamine (10 -8 M).
T12868 592754-592874 Sentence denotes In allergen (ragweed)-stimulated MNC culture, FUB 181 had a co-stimulatory effect on IgE synthesis induced by histamine.
T75345 592875-592887 Sentence denotes Conclusions:
T14406 592888-593062 Sentence denotes The IgE stimulating response depends on the concentrations of histamine and the H 3 /H 4 antagonist as well as pre-existing levels of serum IgE and IgE spontaneous synthesis.
T44867 593063-593076 Sentence denotes Introduction:
T48508 593077-593194 Sentence denotes Preliminary data has shown that oral contraceptives can precipitate or worsen attacks of hereditary angioedema (HAE).
T97331 593195-593296 Sentence denotes It is thought that estrogens affect the synthesis and degradation of bradykinin with resulting edema.
T5059 593297-593307 Sentence denotes Objective:
T42377 593308-593573 Sentence denotes Our objective is to determine if there is a difference among the various oral hormonal preparations, namely, combined monophasic, combined multiphasic, progesterone only, and hormone replacement therapy, in regards to their effect on frequency of HAE exacerbations.
T76664 593574-593582 Sentence denotes Methods:
T13335 593583-593825 Sentence denotes Patients in this study consisted of women over the age of 18 diagnosed with HAE who receive their care at our institution and women meeting the same criteria who are active in the HAE Foundation and have access to this association's web page.
T30724 593826-594004 Sentence denotes All patients answered a sixteen item questionnaire about past or present birth control pill or hormone replacement therapy usage and its impact on the frequency of exacerbations.
T59338 594005-594013 Sentence denotes Results:
T77886 594014-594158 Sentence denotes Of the patients who completed the questionnaire, 94% had taken or were currently taking oral contraceptive pills or hormone replacement therapy.
T3080 594159-594285 Sentence denotes Of the women whom had taken monophasic birth control pills, 100% worsened with increased number and severity of exacerbations.
T8670 594286-594381 Sentence denotes However, only 75% of the women that had used combined multiphasic birth control pills worsened.
T22347 594382-594460 Sentence denotes All of the women who had tried progesterone only birth control pills worsened.
T327 594461-594561 Sentence denotes Of those on isolated estrogen for hormone replacement, 67% had an increased number of exacerbations.
T39412 594562-594693 Sentence denotes When androgens were used concurrently with oral contraceptive pills or hormone replacement therapy, exacerbations decreased to 60%.
T84803 594694-594705 Sentence denotes Conclusion:
T71715 594706-594842 Sentence denotes We are not able to demonstrate a statistical benefit of one oral contraceptive pill preparation over another because of our sample size.
T38946 594843-595033 Sentence denotes However, our preliminary data supports that the oral contraceptive pill which produces less exacerbations and less symptoms is a combined multiphasic pill with concurrent androgen treatment.
T40263 595034-595241 Sentence denotes INTRODUCTION Atopic dermatitis (AD) is associated with multiple immunological abnormalities including imbalances in the subsets of blood circulating lymphocytes forming cellular infiltrates in inflamed skin.
T66914 595242-595398 Sentence denotes Many studies of the functional and phenotypic properties of lymphocytes in AD have been limited to either peripheral blood or skin-infiltrating lymphocytes.
T16734 595399-595554 Sentence denotes The purpose of our study was to evaluate and compare the content and phenotypic properties of CD4+ lymphocytes from blood and inflamed skin of AD patients.
T53852 595555-595670 Sentence denotes MATERIALS AND METHODS 15 adult (age 18-43 years) patients with chronic AD were selected by the criteria of Hanifin.
T37879 595671-595714 Sentence denotes All patients gave written informed consent.
T72187 595715-595790 Sentence denotes The CD4+ lymphocytes of peripheral blood were phenotyped by flow cytometry.
T94327 595791-595905 Sentence denotes Skin biopsies were obtained from eczematous areas, then cryosected and double immuno-histochemistry was performed.
T57927 595906-596043 Sentence denotes For phenotyping of lymphocytes in blood and skin a panel of monoclonal antibodies was used including CD3, CD4, CD8, CD25, HLA-DR and CLA.
T80659 596044-596164 Sentence denotes RESULTS Immunophenotype analyses of the peripheral blood lymphocytes showed a predominance of CD3+CD4+ cells (86%±21.3).
T85466 596165-596239 Sentence denotes Most cells were CD4+HLA-DR+ (14%±12.6) and CD4+CD25+ phenotype (26%±13.5).
T20397 596240-596426 Sentence denotes Double immunohistochemistry of the skin biopsies revealed in the epidermis rare but constant presence of CD4+CD25+cells (1.0±6.4 cells/mm 2 ) and CD4+HLA-DR+ cells (1.2±1.3 cells/mm 2 ).
T80754 596427-596565 Sentence denotes In the dermal inflammatory infiltrates the predominant cells were CD4+CD25+ (21.0±9.7 cells/mm 2 ) and CD4+HLA-DR+ (45.0±6.7 cells/mm 2 ).
T12572 596566-596665 Sentence denotes The dominant inflammatory infiltrate consisted of CD4+CLA+ phenotype (62.9±23.5 cells/mm 2 ) cells.
T60085 596666-596861 Sentence denotes CONCLUSION In AD skin inflammation is associated with the appearance in the circulation of CD4+ lymphocytes in activated form (CD4+HLA-DR+) and lymphocytes with regulatory properties (CD4+CD25+).
T32419 596862-597030 Sentence denotes These lymphocytes are recruited from the circulation, having the skin homing properties (CD4+CLA+), and form the main constituent of the dermal inflammatory infiltrate.
T21192 597031-597195 Sentence denotes Contact dermatitis (CD) comprises a spectrum of inflammatory skin reactions usually caused by exposure to non-immunogenic low molecular weight substances (haptens).
T76749 597196-597308 Sentence denotes Failure to diagnose the condition may result in a chronic and disabling condition with impaired quality of life.
T34977 597309-597443 Sentence denotes A 28 yr-old white male presented with a severe, symmetrically distributed facial maculopapular rash with secondary excoriated lesions.
T61695 597444-597556 Sentence denotes Prior to the appearance of the rash, the patient had been applying Lubriderm as a skin moisturizer for dry skin.
T20690 597557-597741 Sentence denotes A standardized thin layer rapid use epicutaneous (TRUE) test containing 23 chemical agents suspended in a vehicle and attached to an adhesive backing was applied to the patient's back.
T63667 597742-597834 Sentence denotes At 48 hrs, a positive reaction was observed at the skin site of the paraben mix application.
T69316 597835-597986 Sentence denotes The Lubriderm preparation used by the patient contained paraben, in contrast to a newer preparation, Advanced Therapy Lubriderm, which is paraben-free.
T37142 597987-598136 Sentence denotes Complete resolution of the facial lesions occurred following discontinuation of the Lubriderm and the use of oral and topical corticosteroid therapy.
T82554 598137-598370 Sentence denotes This case report illustrates how a commonly used moisturizer can contain a sensitizing agent that could be detected by standardized patch testing which should be a part of the diagnostic armamentarium of every allergist-immunologist.
T2757 598371-598638 Sentence denotes We report how a commonly used and effective moisturizer (Lubriderm) can cause severe allergic CD and that the use of a standardized thin layer rapid use epicutaneous (TRUE) patch test panel can be an effective diagnostic tool for the detection of the offending agent.
T2232 598639-598649 Sentence denotes Rationale:
T39239 598650-598786 Sentence denotes This study aimed to establish the possible differences of cutaneous sensitization to common aeroallergens in children under 1 years old.
T95373 598787-599089 Sentence denotes Methods:The study was conducted between 2003-2004 and included 120 infants from Silesia/southern part of Poland/.These infants were refered to our allergy unit due to respiratory symptoms like rhinitis, otitis, pharyngitis, cough, bronchitis recurring;eye's symptoms/ conjunctivitis/ and oral symptoms.
T98013 599090-599254 Sentence denotes The skin prick test/ SPT/ to major aerollergens in our environment(HDII, Birch, Alternaria, Cladosporium and trees)were done to 6-months-old and 1-yearold children.
T39680 599255-599306 Sentence denotes A SPT of 3 mm or larger was considered as positive.
T34756 599307-599512 Sentence denotes Patients were classified into three groups: I:positive family atopy II:smoking ciggarettemother/ or father III:cat or dog at home IV: coexisting food allergy Results:58, 8 % of examined children were boys.
T15415 599513-599646 Sentence denotes The prevalence of sensitisation found were as follows:latex 38, 1%, birch 32, 8%, DPII-28, 6%, grass pollen 28, 1%, Alternaria-8, 4%.
T93276 599647-599767 Sentence denotes Positive SPTs to latex were first seen in the 6-months-old group and this prevelance doubled until they finished 1 year.
T58881 599768-599779 Sentence denotes Conclusion:
T66891 599780-599859 Sentence denotes In our study, cutaneuos sensitisation start to appear in 6-months-old chlidren.
T58019 599860-599871 Sentence denotes Background:
T24037 599872-599967 Sentence denotes Propylene glycol (PG) may induce allergic contact dermatitis (ACD) and skin irritant reactions.
T15775 599968-600011 Sentence denotes Topical formulations frequently contain PG.
T5957 600012-600124 Sentence denotes It is present in low concentration (5%) in pimecrolimus cream 1%, a non-steroid inflammatory cytokine inhibitor.
T9517 600125-600136 Sentence denotes Objectives:
T17775 600137-600320 Sentence denotes This study was designed to assess the incidence of cutaneous responses to pimecrolimus cream in patients allergic to PG and to determine their nature (ACD or irritation) and severity.
T18152 600321-600329 Sentence denotes Methods:
T51076 600330-600571 Sentence denotes In this double-blind, randomized, vehicle-controlled, withinpatient study, 20 subjects allergic to PG underwent 48-hour patch-testing (PG 30 and 100%, pimecrolimus cream and vehicle) followed by a 7-day repeated open application test (ROAT).
T35157 600572-600779 Sentence denotes Application sites were assessed by the investigator using a scale ranging from 0 (no reaction) to 7 (spreading bullous reaction) at 0, 48, and 120 hours after patch removal and at the completion of the ROAT.
T87171 600780-600846 Sentence denotes Results: PG allergy was confirmed by patch-testing in 16 patients.
T58861 600847-600953 Sentence denotes Two patients showed a positive patch-test reaction with pimecrolimus cream and vehicle, indicating an ACD.
T14461 600954-601095 Sentence denotes In contrast, no patient demonstrated signs of ACD when pimecrolimus cream was applied under normal conditions, i.e. without occlusion (ROAT).
T4265 601096-601455 Sentence denotes The statistical analysis showed that there were significantly less reactions at pimecrolimus patch-test sites than at the PG patch-test sites (p<0.01 for both PG concentrations, one-sided exact binomial test) and that the median severity was lower with pimecrolimus cream vs. PG (p=0.02 and p<0.01 for PG 30% and 100% respectively, Wilcoxon signed-rank test).
T84890 601456-601468 Sentence denotes Conclusions:
T87515 601469-601608 Sentence denotes This pilot study suggests that pimecrolimus cream 1%, when applied under normal conditions, can be used safely in patients with PG allergy.
T28528 601609-601622 Sentence denotes Introduction:
T22038 601623-601702 Sentence denotes Chronic idiopathic urticaria is not always responsive to antihistamine therapy.
T75420 601703-601747 Sentence denotes Multiple alternative agents have been tried.
T31197 601748-601832 Sentence denotes We report two cases where tacrolimus has been successful in treating this condition.
T22874 601833-601841 Sentence denotes Methods:
T34613 601842-601956 Sentence denotes This is a case report of two patients who have chronic idiopathic urticaria and have been treated with tacrolimus.
T58805 601957-602051 Sentence denotes Patient #1 is a 27 y/o WM who pre-sented with urticaria that had been going on several months.
T7373 602052-602245 Sentence denotes The duration of his urticarial lesions was <24 hours His urticaria was treated with several medications including: hydroxyzine, cyproheptadine, ceterizine, montelukast, colchicine, and dapsone.
T37039 602246-602286 Sentence denotes He was intolerant to hydroxychloroquine.
T82721 602287-602427 Sentence denotes Montelukast seemed to provide some modest benefit but he continued to have daily urticaria with >50 lesions/day after two months of therapy.
T32670 602428-602475 Sentence denotes Tacrolimus was added to montelukast at 1mg BID.
T21240 602476-602543 Sentence denotes Patient #2 is a 64 y/o WF with a history of biopsyproven urticaria.
T29624 602544-602647 Sentence denotes She had suffered from episodic urticaria since the age of six that was responsive to systemic steroids.
T17027 602648-602735 Sentence denotes After thirty years of having no urticaria, she developed recurrent urticaria at age 62.
T89581 602736-602926 Sentence denotes At this time, she was treated with hydroxyzine, doxepin, montelukast, loratadine, ceterizine, fexofenadine, colchicine, dapsone, and even prednisone with very little improvement in symptoms.
T69581 602927-603022 Sentence denotes She was then started on tacrolimus 1mg BID as monotherapy while she was having daily urticaria.
T36130 603023-603031 Sentence denotes Results:
T49094 603032-603139 Sentence denotes After one month of treatment with tacrolimus 1mg BID, patient #1 had a decrease in the number of urticaria.
T23970 603140-603234 Sentence denotes His dose of tacrolimus was increased to 3mg/day, and after four weeks, his urticaria resolved.
T59792 603235-603322 Sentence denotes He remained on tacrolimus for a total of six months which was tapered and discontinued.
T13240 603323-603370 Sentence denotes He continues to be in remission from urticaria.
T73293 603371-603454 Sentence denotes Patient #2 had complete resolution of her hives after just two doses of tacrolimus.
T14434 603455-603525 Sentence denotes After two months, she remains free of urticaria on tacrolimus 1mg BID.
T54217 603526-603537 Sentence denotes Conclusion:
T27357 603538-603667 Sentence denotes For patients with severe chronic urticaria unresponsive to multiple therapies, tacrolimus, like cyclosporine, may be efficacious.
T37402 603668-603761 Sentence denotes Tacrolimus may also be truly immunomodulatory and capable of inducing remission of urticaria.
T4694 603762-603766 Sentence denotes S.V.
T63579 603767-603795 Sentence denotes Gerasimov * , Lviv, Ukraine.
T15081 603796-603809 Sentence denotes INTRODUCTION.
T36394 603810-603929 Sentence denotes Recent studies suggest that probiotics can be useful in prevention and treatment of atopic dermatitis (AD) in children.
T3193 603930-604153 Sentence denotes As clinical effect of probiotics varies greatly depending on the specific strain, we are currently conduct a search for the most promising probiotic to be used as complementary therapy in infants and young children with AD.
T27637 604154-604162 Sentence denotes METHODS.
T14666 604163-604262 Sentence denotes We studied 23 infants aged 25-51 weeks (36±8) with AD established using Hanifin and Rafka criteria.
T79508 604263-604388 Sentence denotes Patients were evenly allocated among probiotic (n=11) and nonprobiotic (n=12) treatment groups using Quota Allocation System.
T80368 604389-604495 Sentence denotes Severity of AD was defined using SCORAD index and infant`s quality of life was assessed using IDQOL index.
T98508 604496-604686 Sentence denotes Patients were examined before and 4 weeks after the treatment with/without probiotic powder formulation (B. infantis, L. acidophilus DDS-1, 10 billion CFU/day, DDS-Junior, UAS Laboratories).
T84296 604687-604825 Sentence denotes We compared pre/posttreatment values of indices above and amount of mometasone furoate (0, 1%) used employing a paired or unpaired t-test.
T93200 604826-604834 Sentence denotes RESULTS.
T34641 604835-605002 Sentence denotes At baseline, infants in either groups were comparable on age, gender, duration of the disease, SCORAD and IDQOL indices, and medication taken for the previous 4 weeks.
T69288 605003-605121 Sentence denotes Before entering the study all patients were maintained on allergen elimination diet due to milk and egg white allergy.
T96333 605122-605276 Sentence denotes After the treatment with/without probiotics the mean SCORAD index decreased from 42, 2 to 32, 7 (p=0, 14) and from 51, 5 to 31, 3 (p=0, 06), respectively.
T33213 605277-605482 Sentence denotes However, the mean amount of mometasone furoate used in non-probiotic treatment group was significantly greater (7, 8 g vs 2, 1 g, p=0, 03), despite the same recommendation on the use of the drug was given.
T59040 605483-605656 Sentence denotes Additionally, parents of children taking probiotics reported an improvement in infant`s quality of life as seen on the decrease of IDQOL index from 21, 1 to 12, 0 (p=0, 04).
T20383 605657-605745 Sentence denotes In non-probiotic group decrease in IDQOL was not significant (24, 2 to 19, 5; p=0, 14) .
T27368 605746-605806 Sentence denotes There were no adverse events in any of the treatment groups.
T71206 605807-605819 Sentence denotes CONCLUSIONS.
T11462 605820-605961 Sentence denotes Our preliminary results suggest that some probiotics may have a corticosteroid-sparing effect and improve quality of life of infants with AD.
T1792 605962-606110 Sentence denotes There is a clear trend towards reduction of SCORAD index, which did not change significantly, probably due to a limited number of patients involved.
T11789 606111-606125 Sentence denotes Introduction :
T81064 606126-606242 Sentence denotes The aim of this study was to analyze the risk factors of severe atopic dermatitis(AD) in the first 6 months of life.
T39833 606243-606252 Sentence denotes Methods :
T65599 606253-606393 Sentence denotes The children aged less than 6 months with AD were divided into two groups according to Six Area Six Sign in Atopic Dermatitis(SASSAD) Score.
T11229 606394-606508 Sentence denotes Children with score less than 14 was classified as Mild AD(n=90) and those with score above 15 as severe AD(n=44).
T63358 606509-606638 Sentence denotes These patients were fed with breast milk or cow's milk formula, and no allergenic food was given except rice and some vegetables.
T76773 606639-606834 Sentence denotes We analyzed the gender, feeding patterns, family history of allergy, number of siblings, total IgE and specific IgE to common food allergens (egg white, cow's milk, wheat, soy) by CAP-FEIA assay.
T44514 606835-606925 Sentence denotes Total eosinophil count was 1863±2032 /ul in severe AD and 686±539 /ul in mild AD(p<0.001).
T76408 606926-606935 Sentence denotes Results :
T51381 606936-607022 Sentence denotes 1) Total IgE was 180.6±245.1 U/mL in severe AD and 32.2±50.7 U/mL in mild AD(p=0.002).
T22164 607023-607319 Sentence denotes Specific IgE to Egg white, wheat and soy (19.03±29.72 U/mL, 4.68±10.62 U/mL, 7.07±22.01 U/mL in severe AD; 1.78±3.54 U/mL, 0.15±0.99 U/mL, 0.09±0.30 U/mL in mild AD; p<0.05) were associated with severe AD, but cow milk(4.34±16.6 U/mL in severe AD, 0.80±4.17 U/mL in mild AD) showed no difference.
T86274 607320-607451 Sentence denotes 2) Gender, feeding patterns, family history of allergy and the number of siblings were not significantly associated with severe AD.
T8913 607452-607464 Sentence denotes Conclusion :
T46993 607465-607600 Sentence denotes Severe AD is associated with sensitization to food allergens in the first 6 months of life, although they are not fed with those foods.
T55077 607601-607612 Sentence denotes BACKGROUND:
T13388 607613-607765 Sentence denotes Atopic dermatitis (AD), an inflammatory skin disease diagnosed primarily in children, has been shown to have a negative impact on quality of life (QoL).
T98522 607766-607936 Sentence denotes Pimecrolimus cream 1% is a non-steroid, topical calcineurin inhibitor with demonstrated efficacy in the acute treatment and longterm management of pediatric and adult AD.
T20384 607937-608153 Sentence denotes In a 24-week, double-blind, vehicle-controlled study, a secondary aim was to evaluate the impact on parent's quality of life of a pimecrolimus-based or corticosteroid (CS)-based treatment regimen of children with AD.
T13061 608154-608162 Sentence denotes METHODS:
T87408 608163-608316 Sentence denotes 275 children aged 3 months to 11 years (mean 5 years) with mild to severe AD were randomized 2:1 to receive treatment with pimecrolimus or vehicle cream.
T73685 608317-608411 Sentence denotes Emollients for dry skin and pimecrolimus or vehicle bid were applied at the first signs of AD.
T83581 608412-608613 Sentence denotes For severe flares, a mid-potency topical CS (fluticasone or mometasone) indicated for once-daily use in AD replaced the evening study drug application for a maximum of 3 weeks or until all AD resolved.
T15521 608614-608819 Sentence denotes Parents completed the Parent's Index of Quality of Life-Atopic Dermatitis (PIQoL-AD), a 28-item validated questionnaire, which measures parent's needs-based QoL, at baseline, week 12, and study completion.
T98924 608820-608903 Sentence denotes Change in PIQoL-AD scores at baseline and week 24 were compared between treatments.
T79097 608904-608944 Sentence denotes A negative change indicated improvement.
T31559 608945-608953 Sentence denotes RESULTS:
T67730 608954-609093 Sentence denotes Parents of patients in both groups reported improvement in PIQoL-AD scores at week 24, with greater improvement for the pimecrolimus group.
T71490 609094-609273 Sentence denotes The mean change in PIQoL-AD score from baseline to week 24 was -3.3 in the pimecrolimus group vs. -2.6 in the CS-based treatment group (37.6% vs. 26.8% improvement, respectively).
T45794 609274-609431 Sentence denotes ANCOVA analysis, using treatment and center as main effects and baseline score as a covariate, compared the change in PIQoL-AD score in two treatment groups.
T87947 609432-609571 Sentence denotes Pimecrolimus treatment demonstrated a more favorable change (-1.2) which approached statistical significance [p=0.056; 95%CI= (-2.5, 0.0)].
T68271 609572-609583 Sentence denotes CONCLUSION:
T56542 609584-609731 Sentence denotes A treatment regimen utilizing pimecrolimus cream 1% had a beneficial effect on parent's quality of life compared to a corticosteroid-based regimen.
T50220 609732-609800 Sentence denotes This benefit was consistent with other measures of efficacy studied.
T71007 609801-609814 Sentence denotes Introduction:
T48732 609815-609889 Sentence denotes Atopic dermatitis is a chronic, inflammatory and recurrent skin disorder .
T96277 609890-609981 Sentence denotes Its prevalence has increased in recent decades but little is known about it in Mexico city.
T85730 609982-610091 Sentence denotes The aim of this study was to evaluate the prevalence and severity of atopic eczema in a pediatric population.
T7933 610092-610100 Sentence denotes Methods:
T14429 610101-610325 Sentence denotes A cross-sectional questionnaire survey (ISAAC phase I questionnaire) was conducted on random samples of schoolchildren aged 6 to 7 years and 13 to 14 years from educational centers of four northern counties from Mexico city.
T27374 610326-610501 Sentence denotes Those children with a positive response to being questioned about the presence of an itchy relapsing skin rash in the last 12 months were considered to have atopic dermatitis.
T1887 610502-610631 Sentence denotes Children whose symptoms resulted in sleep disturbance for 1 or more nights per week were considered to have severe atopic eczema.
T87292 610632-610702 Sentence denotes Statistical analyses were done with SPSS 6.0 for Windows, chi square .
T10792 610703-610815 Sentence denotes The size of the sample was determined folowing the ISAAC specifications and calculated with the STATcal program.
T3266 610816-610824 Sentence denotes Results:
T73263 610825-610960 Sentence denotes Complete data was available for 3211 children aged 6 to 7 years in 45 schools and 3899 children aged 13 to 14 years in 47 high schools.
T84187 610961-610991 Sentence denotes 51.5% males and 48.5% females.
T50841 610992-611094 Sentence denotes Response rates were high ( 91.4 % for those aged 6 to 7 years and 100% for those aged 13 to 14 years).
T8249 611095-611219 Sentence denotes The prevalence of symptoms of atopic dermatitis in the last 12 months was 9.6 % at age 6 to 7 and 9 % at age 13 to 14 years.
T25262 611220-611336 Sentence denotes Medical diagnose of atopic eczema was 4 % and 2.4 % for children aged 6 to 7 years and 13 to 14 years, respectively.
T53137 611337-611432 Sentence denotes Reported eczema accounted for 12.4 % and 11.3 % at age 6 to 7 and 13 to 14 years, respectively.
T46629 611433-611550 Sentence denotes Children with symptoms of severe atopic dermatitis accounted for 1 % of all those with symptoms of atopic dermatitis.
T72599 611551-611681 Sentence denotes We also found that the majority of the children begun with skin manifestations of atopic dermatitis before the age of 4 years old.
T75490 611682-611694 Sentence denotes Conclusions:
T18797 611695-611768 Sentence denotes The prevalence of atopic eczema was very similar for both groups of ages.
T42575 611769-611975 Sentence denotes Our results agree with those found in other two studies acomplished in other mexican cities (Cuernavaca and Chihuahua) and with those from other countries of Latin America like Brazil, Chile and Costa Rica.
T46226 611976-612053 Sentence denotes Although, we found lowest values than those from Sweden, Japan and Australia.
T41429 612054-612141 Sentence denotes Studies that include objective skin examination are required to confirm these findings.
T16760 612142-612144 Sentence denotes A.
T67804 612145-612159 Sentence denotes Kaplan 1* , S.
T77434 612160-612173 Sentence denotes Meeves 2 , Y.
T92580 612174-612187 Sentence denotes Liao 2 , S.T.
T51862 612188-612203 Sentence denotes Varghese 2 , G.
T66386 612204-612218 Sentence denotes Georges 2 , 1.
T50767 612219-612237 Sentence denotes Charleston, SC; 2.
T61892 612238-612254 Sentence denotes Bridgewater, NJ.
T77964 612255-612268 Sentence denotes Introduction:
T10859 612269-612385 Sentence denotes The symptoms of chronic idiopathic urticaria (CIU) can have a profound impact on patient health and quality of life.
T66367 612386-612565 Sentence denotes The safety and efficacy of fexofenadine (FEX) BID for the treatment of CIU has been previously established in two multicenter, double-blind, randomized, placebo-controlled trials.
T58634 612566-612737 Sentence denotes This study evaluated the efficacy and safety of a QD dose of FEX HCl 180 mg, as this dosing schedule could offer advantages in terms of patient compliance and convenience.
T96058 612738-612746 Sentence denotes Methods:
T12463 612747-612938 Sentence denotes This multicenter, randomized, double-blind, parallel-group, placebo-controlled study consisted of a single-blind placebo run-in period of 2-5 days, followed by a 28 (±4)-day treatment period.
T65950 612939-613033 Sentence denotes Males and females aged 12 years with a diagnosis of CIU and with active disease were enrolled.
T82935 613034-613113 Sentence denotes Patients were randomized 2:1 to receive either FEX HCl 180 mg QD or placebo QD.
T37565 613114-613345 Sentence denotes The primary endpoints were change from baseline in Mean daily Number of Wheals (MNW score) and mean daily severity of pruritus (measured on a 5-point scale) over the 28-day treatment period, as assessed reflectively by the patient.
T1511 613346-613515 Sentence denotes Secondary efficacy measures included a modified total symptom score (MoTSS), comprising sum of number, frequency, size and duration of lesions, and severity of pruritus.
T88371 613516-613629 Sentence denotes MNW and pruritus severity were also assessed instantaneously at trough drug levels (immediately prior to dosing).
T33407 613630-613638 Sentence denotes Results:
T22440 613639-613840 Sentence denotes Over the 28-day treatment period, patients treated with FEX (n=167) experienced significantly greater improvements in MNW and pruritus scores compared with the placebo group (n=92) (p<0.0001 for both).
T70951 613841-614118 Sentence denotes Similarly, over the treatment period, and at individual weekly timepoints, the mean reductions in AM reflective, PM reflective and mean daily MoTSS were significantly greater for patients in the FEX group compared with those in the placebo group (p 0.0052 for all comparisons).
T56847 614119-614296 Sentence denotes The mean reductions in instantaneous MNW and pruritus scores were greater with those who received FEX than those who received placebo (MNW: p=0.0154; pruritus score: p=0.00088).
T43880 614297-614534 Sentence denotes There were no significant differences in the frequency of treatment emergent adverse events between the two treatment groups, and no clinically relevant changes were observed with respect to clinical laboratory data, vital signs or ECGs.
T29783 614535-614546 Sentence denotes Conclusion:
T77406 614547-614672 Sentence denotes This study demonstrated that a QD dose of FEX HCl 180 mg offers effective and well-tolerated relief from the symptoms of CIU.
T29079 614673-614686 Sentence denotes Introduction:
T15294 614687-614848 Sentence denotes The wheals and pruritus associated with chronic idiopathic urticaria (CIU) are often so debilitating that they have a profound impact on patient quality of life.
T85210 614849-614986 Sentence denotes Specifically, CIU has been shown to negatively affect patient mobility, sleep, energy levels, social interaction and emotional wellbeing.
T62052 614987-615152 Sentence denotes The purpose of this study was to examine the impact of treatment with fexofenadine HCl (FEX) 180 mg on health-related quality of life (HRQL) among patients with CIU.
T70681 615153-615161 Sentence denotes Methods:
T31967 615162-615394 Sentence denotes As part of a multicenter, randomized, double-blind, parallel-group, placebo-controlled study, designed to evaluate the efficacy and safety of a once-daily dose of FEX 180 mg in CIU, the impact of treatment on HRQL was also examined.
T50623 615395-615608 Sentence denotes Patients were asked to complete the Dermatology Life Quality Index (DLQI) and the Work Productivity and Activity Impairment Questionnaire (WPAI) at baseline and at Weeks 2 and 4 (final visit or early termination).
T84761 615609-615772 Sentence denotes The primary endpoint was mean change from baseline in DLQI total score, using the mean data of evaluations performed at Weeks 2 and 4 as the post-baseline measure.
T32689 615773-615866 Sentence denotes Secondary endpoints included change from baseline in individual DLQI domains and WPAI scores.
T42599 615867-615979 Sentence denotes Additional analyses were conducted to examine the reliability, validity and responsiveness of the HRQL measures.
T25378 615980-615988 Sentence denotes Results:
T24067 615989-616075 Sentence denotes A total of 254 patients were included in the HRQL population: n=163 FEX, n=91 placebo.
T8693 616076-616221 Sentence denotes Patients in the FEX group experienced significantly greater improvements in the mean DLQI total score than those in the placebo group (p=0.0029).
T48342 616222-616409 Sentence denotes This pattern was repeated with respect to the individual domains of symptoms and feelings (p=0.0071), daily activities (p=0.013), leisure (p=0.0425) and personal relationships (p=0.0023).
T48373 616410-616522 Sentence denotes Both treatment groups reported improvements in productivity, as measured by change from baseline using the WPAI.
T80560 616523-616686 Sentence denotes Patients randomized to FEX experienced significantly less impairment while working (p=0.0455) and performing activities (p=0.0088) than those who received placebo.
T97788 616687-616849 Sentence denotes The DLQI was demonstrated to be reliable (Cronbach's alpha=0.87); both the DLQI and WPAI were found to be valid and responsive instruments in this CIU population.
T68542 616850-616861 Sentence denotes Conclusion:
T70278 616862-617005 Sentence denotes This study demonstrated that a once-daily dose of FEX 180 mg improves the HRQL of patients with CIU, as assessed by change in DLQI total score.
T26771 617006-617008 Sentence denotes T.
T99941 617009-617026 Sentence denotes Algozzine 1* , A.
T44943 617027-617037 Sentence denotes Lee 2 , S.
T37689 617038-617049 Sentence denotes Wong 3 , L.
T99634 617050-617063 Sentence denotes Anzisi 4 , 1.
T47521 617064-617082 Sentence denotes Manchester, NH; 2.
T39692 617083-617101 Sentence denotes Centerport, NY; 3.
T24770 617102-617117 Sentence denotes Syosset, NY; 4.
T95757 617118-617133 Sentence denotes Mamaroneck, NY.
T52282 617134-617314 Sentence denotes Symptoms of allergic and non-allergic rhinitis may significantly impact a patient's quality of life, by causing fatigue, headache, cognitive impairment and other systemic symptoms.
T15733 617315-617496 Sentence denotes Appropriate management of allergic rhinitis is important in the effective management of coexisting or complicating respira-tory conditions (e.g. asthma, sinusitis, or otitis media).
T91333 617497-617633 Sentence denotes In addition, many commonly used over-the-counter (OTC) antihistamines can cause performance impairment that may impact daily activities.
T20618 617634-617945 Sentence denotes We designed a brief ten-question allergy survey in an attempt to determine how patients were being treated for their allergies, evaluate a patient's self-assessed impact of their allergies on their daily activities, and identify any difference in treatment outcomes between primary care and allergist practices.
T80712 617946-618004 Sentence denotes Patients were invited to complete the surveys anonymously.
T17173 618005-618098 Sentence denotes Completed surveys were collected and entered into a Microsoft Access database for evaluation.
T75908 618099-618149 Sentence denotes Minitab was utilized for statistical calculations.
T14825 618150-618210 Sentence denotes Four hundred and thirty seven patients completed the survey.
T28781 618211-618294 Sentence denotes Fifty-eight percent of survey respondents were women and 89% were adults (age >18).
T8023 618295-618371 Sentence denotes Of those patients surveyed, 53% (n=233) were under the care of an allergist.
T50059 618372-618541 Sentence denotes Compared to primary care, patients treated by allergists reported more allergies (3.4 vs. 1.8, p <0.001) and received more medications on average (2.3 vs. 1.4, p<0.001).
T33693 618542-618610 Sentence denotes Pollen was the most common allergy type reported among all patients.
T22023 618611-618815 Sentence denotes While the majority of all patients (69%) received prescription medications, more primary care patients received no therapy or only OTC treatment when compared to allergist patients (46% vs. 17%, p<0.001).
T62816 618816-618957 Sentence denotes Seventy-four percent of primary care patients reported their allergy symptoms were controlled compared to 63% of allergist patients (p<0.05).
T3073 618958-619170 Sentence denotes Patients receiving treatment from an allergist reported less impact of their allergies on daily activities (a lower score signified less impact) compared to patients seen in primary care (2.27 vs. 3.84, p<0.001).
T18876 619171-619249 Sentence denotes The results of our survey suggest that allergists treat more complex patients.
T19194 619250-619360 Sentence denotes These patients had multiple allergies, more uncontrolled symptoms, and utilized more prescription medications.
T35994 619361-619476 Sentence denotes Despite these findings, patients treated by allergists reported less impact of allergies on their daily activities.
T84231 619477-620530 Sentence denotes INTRODUCTION The patogenic mechanism of nasal polyps are unknow.They frecuently are associated with aspirin intolerance, intrinsic asthma, chronic sinusitis, Young sindrome, cystic fibrosis, Kartagener syndrome and Churg-Strauss syndrome.Chemical mediators found in nasal polyps are as follows: histamine, serotonin, leukotrienes, norepinefrine and possibly PGD2.Recently, leukotrienes have been implicated in mediation of bronchoconstriction and inflammatory Leukotriene levels have also been shown to be elevated in some patients with sinonasal polyposis (Figure 1 ) HYPOTHESIS Antileukotrienes might play a significant role in controlling polyposis and symptoms secundary to sinonasal disease, and they might viable alternative to longterm, oral steroid therapy and repeat surgical debridement PURPOSE This study was undertaken to evaluate the potential role of leukotriene receptor antagonist on recurrent polyposis associated with asthma and improvement of some factor implicated with them DESIGN OF STUDY:Clinical assay, prospective, triple blind.
T50395 620531-620702 Sentence denotes MATERIALSAND METHODS:The study involved 30 patients 12 (40%) males and 18 (60%) women, mean age 20.7 years, with a range 16-45 years selection criteria:INCLUSION CRITERIA:
T71693 620703-620783 Sentence denotes Nasal polyps associated with astha, allergic or non allergic.EXCLUSION CRITERIA:
T40260 620784-621376 Sentence denotes Patients with any concurrent illness, use of sistemic or local corticosteroidsor any kind of antileukotriene within 1 month prior to the beggining of the study.We made an alleatory selection 10 patients recived Montelukast (10 mgs/day), and nasal steroids, beclometasone (600 mgs/day) for 6 months.10 patients recived loratadine plus pseu-doefedrin5mgs/120 mgs/day and nasal steroids, beclometasone, 10 patints were operated of FEES and transnasal endoscipic polypectomy plus Montelukast and nasal steroids, beclometasone IgE serum levels 2.Skin Prick test 3.Sensitivity in vitro 4.CT Scan 5.
T62287 621377-621505 Sentence denotes Celullarity on nasal lavage (Eosinophils and Neutrophils)6.Proinflamatory cytokines (IL4-IL5-IL8) on nasal lavege by ELISA test.
T92791 621506-621853 Sentence denotes RESULTS Ther was a tendency for more improvement of the group 3 ( Surgery-Montelukast-local steroid) of symptoms and objective measurments, in second place of improvement the group 1 Montelukast-local steroid) and the worse on improvement subjective and objetive was group 2 local steroid and loratadine-pseudoefedrine use as placebo Introduction:
T50776 621854-621984 Sentence denotes Sensory perceptions of intranasal corticosteroids (INS) vary among products and can be unpleasant and affect adherence to therapy.
T45124 621985-621993 Sentence denotes Methods:
T87783 621994-622108 Sentence denotes We conducted a cross-sectional study of 120 patients across 4 allergy and immunology clinics in the United States.
T45189 622109-622223 Sentence denotes Respondents were asked to choose between pairs of hypothetical INS that differed by sensory attribute composition.
T48559 622224-622379 Sentence denotes Based on prior research, we measured 6 salient sensory attributes: smell, taste, aftertaste, throat rundown, nose runout, and feel of spray in nose/throat.
T27949 622380-622519 Sentence denotes Each attribute was described in 3 intensity levels, such as "no taste" (low), "weak taste" (moderate), and "strong taste" (high) ( Table) .
T62857 622520-622725 Sentence denotes Other outcomes included an importance score for each sensory attribute and patients' willingness to adhere to an INS having the lowest levels of each sensory attribute compared to one with moderate levels.
T58472 622726-622734 Sentence denotes Results:
T90675 622735-622815 Sentence denotes Preferences decreased with increasing intensity level of each sensory attribute.
T75178 622816-622975 Sentence denotes The most important attribute was aftertaste in 28% of patients, taste in 19%, throat rundown in 18%, nose runout in 12%, smell in 11%, and feel of spray in 7%.
T1038 622976-623036 Sentence denotes Only 5% had more than one attribute tied for most important.
T8703 623037-623320 Sentence denotes If instructed to take INS daily for 3 months, 77% of patients stated that they would definitely be able to follow their doctor's advice (willing to adhere) if given an INS containing the lowest level of each sensory attribute compared with 4% for one having moderate levels (P<0.01).
T70225 623321-623333 Sentence denotes Conclusions:
T32993 623334-623467 Sentence denotes Patients' preferences decrease with increasing intensity levels of each sensory attribute and affect patients' willingness to adhere.
T96323 623468-623563 Sentence denotes Tailoring INS to patient preferences may lead to improved treatment satisfaction and adherence.
T24043 623564-623701 Sentence denotes Introduction:A high prevalence of rhinitis and asthma comorbidity has been persistently noticed in epidemiological studies in last years.
T12804 623702-623855 Sentence denotes Our objective was to evaluate the prevalence of rhinitis and asthma comorbidity in a Portuguese population including both atopic and non-atopic patients.
T91769 623856-623864 Sentence denotes Methods:
T47798 623865-623901 Sentence denotes A retrospective study was performed.
T14387 623902-624050 Sentence denotes Clinical records from patients attending an immunoallergology outpatients'clinic during 39 months (from January 1998 until June 2001) were reviewed.
T80194 624051-624193 Sentence denotes Data were collected concerning clinical history of rhinitis and/or asthma, aeroallergens'skin prick tests and respiratory function evaluation.
T40217 624194-624202 Sentence denotes Results:
T53582 624203-624360 Sentence denotes Among the 3582 patients attending an appointment during the study period, 2448 (68.3%) had rhinitis and/or asthma (56.2% F; 43.8% M;mean age 26 +/-19 years).
T29435 624361-624448 Sentence denotes Patients with respiratory disease included 1983 atopic (81.0%) and 465 non-atopic 19%).
T46106 624449-624670 Sentence denotes Diagnosis of asthma, rhinitis or of both diseases was made in 170 (8.6%), 581 (29.3%) and 1232 (62.1%), respectively, in atopic patients and in 56 (12.0%, 265 (57.0%) and 144 (31.0%), respectively, in non-atopic patients.
T9551 624671-624771 Sentence denotes Rhinitis was diagnosed in 87.9% of atopic asthmatic and in 72-0% of non-atopic patients with asthma.
T39696 624772-624886 Sentence denotes In patients with rhinitis, asthma was also diagnosed in 67.9% of atopic patients and 35.2% on non-atopic patients.
T75767 624887-624899 Sentence denotes Conclusions:
T91870 624900-625056 Sentence denotes In this study population rhinitis was frequently diagnosed in patients with asthma and vice-versa, thereby leading to a high prevalence of this comorbodity.
T51877 625057-625111 Sentence denotes This association was more frequent in atopic patients.
T41026 625112-625175 Sentence denotes Our data are comparable to those we found in recent literature.
T91353 625176-625391 Sentence denotes These results suggest that clinical investigation of asthma should be mandatory in management of patients with rhinitis as well as asthmatic patients should be routinely submitted to clinical evaluation of rhinitis.
T29485 625392-625405 Sentence denotes Introduction:
T70191 625406-625640 Sentence denotes Cetirizine HCl (C) has been shown to be more effective than fexofenadine HCl (F) in controlling seasonal allergic rhinitis (SAR) symptoms at 21-24 hr post-dose, however, the efficacy of C and F was comparable between 0-5 hr post-dose.
T16163 625641-625723 Sentence denotes Response to treatment in the middle of the dosing interval needed to be addressed.
T52825 625724-625732 Sentence denotes Methods:
T16539 625733-625951 Sentence denotes This randomized, double blind, placebo (P)-controlled study was designed to compare the efficacy and tolerability of a single dose of C 10 mg, F 180 mg, and P between 5-12 hr postdose in ragweed-sensitive SAR subjects.
T60859 625952-626104 Sentence denotes Subjects meeting entry criteria were exposed to pre-determined controlled levels of ragweed pollen in the EEU during priming and double blind treatment.
T31018 626105-626264 Sentence denotes Subjects assessed rhinitis symptoms at half hr intervals during pollen exposure; at priming, at the qualifying period, at baseline, and from 5-12 hr post-dose.
T22826 626265-626390 Sentence denotes The primary efficacy endpoint was the change from baseline in Total Symptom Severity Complex (TSSC) score at 12 hr post-dose.
T68532 626391-626542 Sentence denotes TSSC score was the sum of severity ratings (0=absent to 3=severe) for 4 symptoms: runny nose, sneezing, itchy nose/palate/throat and itchy/watery eyes.
T69544 626543-626551 Sentence denotes Results:
T38011 626552-626649 Sentence denotes A total of 599 subjects (mean age 32.8 y; 58.9% females) were randomized: C, 249; F, 250; P, 100.
T4643 626650-626731 Sentence denotes Baseline characteristics were comparable among groups; TSSC: C=9.2, F=9.2, P=8.9.
T82876 626732-626952 Sentence denotes C produced a 26% greater reduction in TSSC score at 12 hr (-4.3, p=0 .001) and a 14% greater reduction overall (i.e., average over the 5-12 hr post-dose period) (-5.0, p=0.006) compared with F (-3.4, -4.4, respectively).
T65699 626953-627078 Sentence denotes Both C and F reduced TSSC score more than P (12 hr, -1.9; overall, -2.3, p<0.001) including all individual symptoms (p<0.05).
T67211 627079-627240 Sentence denotes C however, was more effective than F for runny nose and sneezing at 12 hr and overall, itchy/watery eyes at 12 hr, and itchy nose/throat/palate overall (p<0.05).
T2897 627241-627328 Sentence denotes Rates of discontinuation due to adverse events (AEs) were low: C, 0.4%; F, 0%; P, 1.0%.
T17278 627329-627410 Sentence denotes The incidence of treatmentemergent AEs was similar: C, 25.3%; F, 29.6%; P, 35.0%.
T88966 627411-627474 Sentence denotes Somnolence occurred in 0.8% of subjects on C, and 0% on F or P.
T70015 627475-627486 Sentence denotes Conclusion:
T2746 627487-627621 Sentence denotes C produced a greater improvement in rhinitis symptoms compared with F and P, at 12 hr post dose and over the 5-12 hr post-dose period.
T64707 627622-627666 Sentence denotes All treatments were safe and well tolerated.
T93381 627667-627678 Sentence denotes Background:
T89275 627679-627931 Sentence denotes Medication utilization patterns of patients suffering from seasonal allergic rhinitis (SAR) are not well documented, and although many anti-allergic medications are prescribed for daily use, actual usage is unknown, but recognized to be quite variable.
T44911 627932-627940 Sentence denotes Methods:
T45413 627941-628168 Sentence denotes 1821 subjects with positive ragweed skin tests were mailed a survey during the third week of ragweed season, soliciting the nature and severity of SAR symptoms, usage patterns and reasons for choice of anti-allergic medication.
T36983 628169-628177 Sentence denotes Results:
T91311 628178-628220 Sentence denotes 550 subjects completed the survey (30.2%).
T27394 628221-628582 Sentence denotes The prevalence of symptoms were, in decreasing order: sneezing (91.5%), runny nose (82.4%), itchy/gritty eyes (80.4%), stuffiness (78.5%), itchy nose (71.3%), watery eyes (64.7%), itchy palate/throat (56.9%), post-nasal drip (55.6%), red/burning eyes (49.1%), headache (36.5%), itchy ears (34.0%), cough (30.0%), shortness of breath (15.7%), and wheeze (15.5%).
T2215 628583-628774 Sentence denotes SAR patients used antihistamines most frequently (94.7%), followed by decongestants (63.1%), combination (antihistamine/decongestant) products (52.0%), and intranasal corticosteroids (42.5%).
T33102 628775-628902 Sentence denotes Medications were mostly taken intermittently rather than daily (antihistamines 68.0%; nasal corticosteroids 71.8%), Conclusion:
T43406 628903-629039 Sentence denotes A constellation of nasal symptoms were the most common seasonal allergic manifestations, followed by ocular, palatal and ear irritation.
T59750 629040-629168 Sentence denotes Antihistamines were the most frequently used medication to treat symptoms, succeeded by decongestants (alone or in combination).
T33860 629169-629379 Sentence denotes A significant proportion of subjects took their allergy medication, including nasal corticosteroids, intermittently rather than regularly, underscoring the relevance of single-dose evaluations of drug efficacy.
T90707 629380-629384 Sentence denotes A.K.
T21467 629385-629397 Sentence denotes Ellis * , E.
T35267 629398-629411 Sentence denotes Rafeiro, J.D.
T74684 629412-629422 Sentence denotes Ratz, J.H.
T82739 629423-629445 Sentence denotes Day, Kingston, Canada.
T57761 629446-629457 Sentence denotes Background:
T63910 629458-629600 Sentence denotes Traditional assessment of seasonal allergic rhinitis (SAR) medication efficacy utilizes randomized controlled trials over 2-4 weeks in season.
T37716 629601-629740 Sentence denotes An additional study method employs single-dose responses using controlled allergen challenge such as the Environmental Exposure Unit (EEU).
T72895 629741-629882 Sentence denotes A comparison of allergic symptoms generated by controlled allergen challenge to those occurring in ragweed season symptoms has not been done.
T54129 629883-629891 Sentence denotes Methods:
T39493 629892-630045 Sentence denotes 1821 subjects with known SAR to ragweed were mailed a survey during the third week of ragweed season, soliciting the nature and severity of SAR symptoms.
T82279 630046-630231 Sentence denotes Subjects participating in a subsequent controlled allergen challenge study using the EEU, were again asked to complete a similar survey that documented symptoms generated in this model.
T92896 630232-630302 Sentence denotes Those who completed both surveys comprised the primary analysis group.
T12078 630303-630311 Sentence denotes Results:
T56726 630312-630424 Sentence denotes 550 subjects completed the ragweed season survey, 516 subjects completed the EEU survey, and 270 completed both.
T39894 630425-630579 Sentence denotes Symptoms generated by EEU exposure were similar to those elicited during ragweed season, with the exception of cough (68% vs. 27%, respectively, p <0.01).
T16430 630580-630755 Sentence denotes Subjects reported that symptoms were more severe in the EEU than those experienced on a typical ragweed season day, but less severe than those during peak ragweed season days.
T84150 630756-630767 Sentence denotes Conclusion:
T53160 630768-631018 Sentence denotes Allergic upper respiratory tract symptoms produced during controlled ragweed pollen exposure in the EEU were similar in nature and degree to those expe-rienced during ragweed season, supporting evidence that the EEU is a valid model for studying SAR.
T73793 631019-631021 Sentence denotes R.
T9224 631022-631035 Sentence denotes Nave 1 , M.A.
T36479 631036-631055 Sentence denotes Wingertzahn 2* , S.
T19726 631056-631071 Sentence denotes Brookman 3 , S.
T43784 631072-631084 Sentence denotes Kaida 4 , T.
T15541 631085-631096 Sentence denotes Shah 2 , 1.
T35639 631097-631118 Sentence denotes Konstanz, Germany; 2.
T92385 631119-631139 Sentence denotes Florham Park, NJ; 3.
T90318 631140-631157 Sentence denotes Princeton, NJ; 4.
T35558 631158-631171 Sentence denotes Tokyo, Japan.
T48392 631172-631182 Sentence denotes RATIONALE:
T97160 631183-631283 Sentence denotes Ciclesonide (CIC) is a new corticosteroid under development for treatment of allergic rhinitis (AR).
T32895 631284-631403 Sentence denotes CIC is a pro-drug that is hydrolyzed to the active metabolite desisobutyryl-ciclesonide (des-CIC) in the target tissue.
T72880 631404-631576 Sentence denotes CIC has low oral bioavailability and is highly bound to plasma proteins; therefore CIC administered as a nasal spray is expected to have minimal local and systemic effects.
T39951 631577-631587 Sentence denotes OBJECTIVE:
T60870 631588-631788 Sentence denotes The primary objective was to evaluate the safety and tolerability of repeated escalating doses of CIC (50-800 mcg/day) given as a nasal spray for 14 days to healthy and asymptomatic subjects with SAR.
T7217 631789-631907 Sentence denotes Secondary objectives were to determine PK of CIC and des-CIC and to evaluate the effect of CIC on endogenous cortisol.
T64178 631908-631916 Sentence denotes METHODS:
T52134 631917-632020 Sentence denotes This was a single-center, randomized, placebo-controlled, double blind, modified sequential dose study.
T83233 632021-632049 Sentence denotes Six cohorts were randomized.
T70728 632050-632129 Sentence denotes Cohorts I-V consisted of healthy subjects given doses of CIC up to 400 mcg BID.
T84934 632130-632189 Sentence denotes Cohort VI (asymptomatic SAR subjects) received 400 mcg BID.
T38824 632190-632283 Sentence denotes Each cohort was comprised of 6 subjects who received CIC and 2 subjects who received placebo.
T20482 632284-632410 Sentence denotes Safety assessments were conducted by recording adverse events (AEs), clinical laboratory, eye, and nasal examination findings.
T89178 632411-632480 Sentence denotes Serum and urine samples were taken for evaluation of cortisol levels.
T19220 632481-632546 Sentence denotes CIC and des-CIC serum concentrations were determined by LC-MS/MS.
T72123 632547-632555 Sentence denotes RESULTS:
T87519 632556-632627 Sentence denotes No trend was observed for AEs when comparing CIC and placebo treatment.
T48719 632628-632735 Sentence denotes Additionally, no subject experienced a serious AE or withdrew from the study due to an AE during the trial.
T31014 632736-632861 Sentence denotes Cortisol levels showed no differences between the dose groups or between activetreated subjects and placebo-treated subjects.
T75956 632862-633113 Sentence denotes Additionally, serum concentrations of CIC and des-CIC in the majority of serum samples were shown to be below the lower limit of quantification (LLOQ; 25 pg/ml for CIC and 10 pg/ml for des-CIC), therefore no descriptive statistics could be calculated.
T96381 633114-633127 Sentence denotes CON-CLUSIONS:
T35262 633128-633329 Sentence denotes Ciclesonide nasal spray, at the doses evaluated, was safe and well tolerated in healthy and asymptomatic SAR subjects with no detectable effects of CIC on serum or urinary free cortisol concentrations.
T17515 633330-633481 Sentence denotes Additionally, no PK parameters could be calculated for CIC nasal spray, as it was virtually undetectable in serum despite the use of a sensitive assay.
T81026 633482-633533 Sentence denotes The preferred treatment for allergies is avoidance.
T21250 633534-633613 Sentence denotes Air filtration is logical but room air purifiers have been of limited efficacy.
T71676 633614-633743 Sentence denotes ZEPHYR™ is a new device which creates an envelope of air 99% free of allergenic particles around the head of the sleeping person.
T25297 633744-633799 Sentence denotes Allergic rhinitis frequently causes daytime somnolence.
T25083 633800-633941 Sentence denotes This is a pilot study of the effectiveness of ZEPHYR on symptoms of seasonal allergic rhinitis (ragweed hay fever) and on daytime sleepiness.
T27092 633942-633950 Sentence denotes Methods:
T64107 633951-634073 Sentence denotes Subjects age 12 to 45 with ragweed hay fever were studied in the ragweed season using each subject as his/her own control.
T98710 634074-634145 Sentence denotes Usual allergy medicines were not allowed, except loratadine for rescue.
T34396 634146-634285 Sentence denotes Outcome measures were a symptom score, Juniper Rhinitis Quality of Life Questionnaire, a tolerability rating, and Epworth Sleepiness Scale.
T81409 634286-634401 Sentence denotes During the first week subjects qualified by symptom scores, then entered the one-week treatment period with ZEPHYR.
T89857 634402-634457 Sentence denotes The third week was a post-treatment observation period.
T3694 634458-634466 Sentence denotes Results:
T25964 634467-634523 Sentence denotes Of 13 participants, 10 (77%) showed symptom improvement.
T38315 634524-634621 Sentence denotes The whole group averaged 26% reduction in morning symptoms and 24% reduction in evening symptoms.
T23907 634622-634653 Sentence denotes Sleepiness scores improved 29%.
T94884 634654-634680 Sentence denotes Rhinitis QOL improved 33%.
T95177 634681-634817 Sentence denotes The ZEPHYR system was well tolerated as evidenced by the response to several statements regarding ZEPHYR use and tolerability: (Scoring:
T76283 634818-635280 Sentence denotes 1 = Strongly Disagree, 5 = Strongly Agree) "The system did not bother me while I was sleeping." (Mean Score 4.8) "The noise level did not affect my ability to sleep." (Mean Score 4.7) "The temperature was just fine for me." (Mean Score 4.8) "The system did not get in my way during sleep." (Mean Score 5.0) Conclusions: ZEPHYR significantly reduced seasonal hay fever symptoms and daytime sleepiness, improved quality of life, and was well-tolerated by subjects.
T22391 635281-635420 Sentence denotes ZEPHYR may provide maximal environmental control of bedroom allergen exposure irrespective of ambient airborne allergen levels in the room.
T10422 635421-635533 Sentence denotes Nasal congestion is an important symptom that is associated with significant morbidity in the rhinitis sufferer.
T73720 635534-635666 Sentence denotes Disrupted sleep leading to daytime fatigue, loss of concentration, and decreased productivity are potential results of this symptom.
T51928 635667-635923 Sentence denotes A study employing online interviews with 1200 rhinitis sufferers from Harris Interactive's online database was conducted in order to understand the symptoms they identify with most and to determine the impact nasal congestion had on their daily activities.
T79875 635924-636082 Sentence denotes Respondents were at least 18 years of age and experienced nasal congestion from seasonal allergic, perennial allergic, and/or perennial non-allergic rhinitis.
T32370 636083-636286 Sentence denotes The results showed that 60% of the respondents agreed nasal congestion is the most bothersome symptom of rhinitis; 37% experienced nasal congestion daily, while 35% experienced it several times per week.
T55253 636287-636370 Sentence denotes Not surprisingly, sleep was the most important factor affected by nasal congestion.
T88274 636371-636587 Sentence denotes Two-thirds (66%) of the respondents felt their sleep had been moderately or significantly impacted by nasal congestion, and more than half (56%) felt it was difficult to get a good night's rest because of congestion.
T2317 636588-636687 Sentence denotes Sleep was interrupted or disturbed by nasal congestion approximately 3 nights per week, on average.
T97256 636688-636901 Sentence denotes Furthermore, sleep disruption from nasal congestion contributed to daytime fatigue; 62% of the respondents indicated that they were typically tired or fatigued during the day when they experience nasal congestion.
T39235 636902-637044 Sentence denotes In addition, 42% felt that activities requiring concentration, such as reading, were moderately or significantly impacted by nasal congestion.
T86399 637045-637171 Sentence denotes This study confirms that nasal congestion causes the rhinitis sufferer significant problems beyond that of just a stuffy nose.
T38789 637172-637328 Sentence denotes Consequently, healthcare providers need to ensure that their rhinitis patients who have nasal congestion as their primary complaint are managed effectively.
T41018 637329-637429 Sentence denotes Desloratadine (DL, Clarinex ® ) is a non-sedating oral antihistamine that is metabolized to 3-OH DL.
T31572 637430-637545 Sentence denotes However, a phenotypic polymorphism has been observed in some patients that results in reduced formation of 3-OH DL.
T71042 637546-637666 Sentence denotes The prevalence and safety profiles of such poor metabolizers of DL were examined in pharmacokinetic and clinical trials.
T94074 637667-637784 Sentence denotes A poor metabolizer was defined as a subject having a 3-OH DL to DL AUC ratio of <0.10, or a DL half-life of 50 hours.
T32248 637785-637997 Sentence denotes In pediatric studies, where a sparse sampling approach was uti-lized to screen for poor metabolizers, a plasma concentration ratio of 3-OH DL to DL of <0.10 at 12 hours classified a subject as a poor metabolizer.
T19529 637998-638117 Sentence denotes A total of 3, 748 adult and pediatric subjects (2-70 years old) were phenotyped with a single dose of DL or loratadine.
T34356 638118-638193 Sentence denotes The overall prevalence of the poor metabolizer phenotype was 6% (228/3748).
T25860 638194-638401 Sentence denotes This prevalence was comparable for adult (70/1194, 6%) and pediatric subjects (158/2554, 6%), and greater in both populations among Blacks (16% pediatric, 18% adult) than Caucasians (3% pediatric, 2% adult).
T5174 638402-638535 Sentence denotes Pharmacokinetic analysis found that exposure to DL was approximately 6-times higher in poor metabolizers than in normal metabolizers.
T85949 638536-638740 Sentence denotes There was no apparent difference in DL exposure among poor metabolizers in different age groups (6-months to <2-years, 2-to <6-years, 6-to <12-years, and 12-years) when treated with age-appropriate doses.
T63207 638741-638952 Sentence denotes The multiple-dose (7-35 days) safety profile of DL was examined in pediatric poor metabolizers (2-11 years) in 5 placebo-controlled trials, and in adult poor metabolizers (20-70 years) in pharmacokinetic trials.
T21082 638953-639177 Sentence denotes Pooled AE rates were low and comparable between the poor metabolizer and placebo subjects, as shown in the table below with all AEs that appeared in >2% of subjects in any treatment group (or >3% in adult poor metabolizers).
T7871 639178-639294 Sentence denotes There was no difference in cardiovascular safety profile or ECG results (including QTc interval) among these groups.
T88575 639295-639658 Sentence denotes In conclusion, (1) expression of the DL poor metabolizer phenotype is independent of age, but higher in Blacks than in Caucasians, (2) exposure to DL in poor metabolizers is independent of age when administered at age-appropriate doses, (3) the safety profile of DL poor metabolizers is not different from that of placebo at all ages down to at least 2-years old.
T98044 639659-639726 Sentence denotes These results are consistent with the high therapeutic index of DL.
T47523 639727-639827 Sentence denotes Desloratadine (DL, Clarinex®) is extensively metabolized to 3-OH DL and subsequently glucuronidated.
T18619 639828-639906 Sentence denotes The enzyme responsible for the formation of this active metabolite is unknown.
T44669 639907-640011 Sentence denotes Poor metabolizers of DL represent a subset of the population that has a reduced ability to form 3-OH DL.
T83600 640012-640128 Sentence denotes A poor metabolizer was defined as a subject having a 3-OH DL to DL exposure ratio of <10%, or DL half-life of 50 hr.
T92343 640129-640317 Sentence denotes PK parameters from adult and pediatric poor metabolizers following repetitive administration of DL were characterized in Clinical Pharmacology trials and are summarized in the table below.
T86191 640318-640483 Sentence denotes Exposure to DL [AUC(0-24hr)] in poor metabolizers was approximately 6-fold greater than the corresponding values in normal metabolizers; Cmax was 3to 4-fold greater.
T31041 640484-640705 Sentence denotes The magnitude of the reduction in the formation of 3-OH DL and the concurrent increase in exposure to DL associated with the poor metabolizer phenotype was similar in pediatric and adult subjects at age-appropriate doses.
T61459 640706-640860 Sentence denotes Despite the increased exposure to DL in poor metabolizers, there was no increase in adverse event frequency or changes in electrocardiographic parameters.
T42086 640861-640863 Sentence denotes a:
T94638 640864-640891 Sentence denotes Dose normalized to 5 mg. b:
T39787 640892-641020 Sentence denotes Least Squares Mean Ratio: ANOVA of log-transformed data extracting sources of variation due to age group and metabolizer status.
T34306 641021-641070 Sentence denotes The ratio is a contrast of metabolizer status. c:
T64102 641071-641141 Sentence denotes Lower and upper 90% confidence interval based on log-transformed data.
T12938 641142-641155 Sentence denotes INTRODUCTION:
T33415 641156-641247 Sentence denotes Many patients with seasonal allergic conjunctivitis (SAC) complain of symptoms of dry eyes.
T97791 641248-641461 Sentence denotes We have previously reported that patients with SAC experience discomfort from dry eyes anywhere between 2 to 6 days per week and that the overall severity of the dry eye symptoms tend to range from mild to severe.
T75488 641462-641751 Sentence denotes This preliminary cross over study evaluated the benefits of Nedocromil sodium 2% ophthalmic solution used twice daily, compared with Nedocromil sodium 2% ophthalmic solution used with Refresh (ocular lubricant), for the treatment of dry eye symptoms in association with SAC during 8 weeks.
T97174 641752-641760 Sentence denotes METHODS:
T26245 641761-641924 Sentence denotes Patients who had a minimum of two-year history of SAC and dry eyes, a positive skin prick test towards grass pollen and between the ages of 18 to 65 were enrolled.
T51728 641925-642072 Sentence denotes Patients were evaluated on four visits and completed a daily diary, which included scales for grading allergic conjunctivitis and dry eye symptoms.
T63156 642073-642172 Sentence denotes At each clinic visit they completed the OSDI and the RQLQ (Rhinitis Quality of Life Questionnaire).
T43739 642173-642299 Sentence denotes The OSDI (ocular surface disease index) was developed to assess dry eye symptoms and the impact on vision related functioning.
T52862 642300-642376 Sentence denotes The RQLQ evaluates quality of life in patients with allergic conjunctivitis.
T88777 642377-642556 Sentence denotes At the last visit, both the patient and the physician assessed the treatment and the effectiveness, if any, of the addition of Refresh to Nedocromil sodium 2% ophthalmic solution.
T66383 642557-642623 Sentence denotes Daily grass pollen counts were preformed using a Burkhard sampler.
T33953 642624-642632 Sentence denotes RESULTS:
T67939 642633-642700 Sentence denotes 19 patients (7 male and 12 female) were enrolled and 3 dropped out.
T73832 642701-642807 Sentence denotes Patients experienced minimal symptoms at the start of the season due to low concentration of grass pollen.
T18490 642808-642936 Sentence denotes Preliminary analysis carried out using a paired t-test was preformed on the ocular average scores for the two treatment periods.
T40114 642937-643059 Sentence denotes There was no significant difference between the 2 treatment groups for redness, light sensitivity and tearing of the eyes.
T37988 643060-643202 Sentence denotes A reduction in dry eye symptoms was reported in all patients using Refresh eye drops and the number of drops required varied between patients.
T5728 643203-643271 Sentence denotes During the treatment periods there was improvement in patients RQLQ.
T21333 643272-643283 Sentence denotes CONCLUSION:
T12805 643284-643376 Sentence denotes Patients preferred the addition of Refresh eyedrops in alleviating SAC and dry eye symptoms.
T36999 643377-643495 Sentence denotes Further studies need to be carried using Refresh eye drops in larger number of patients with SAC and dry eye symptoms.
T4290 643496-643498 Sentence denotes C.
T1458 643499-643523 Sentence denotes LaForce * , Raleigh, NC.
T38780 643524-643537 Sentence denotes Introduction:
T77376 643538-643776 Sentence denotes The objective of this study was to determine the ability of azelastine nasal spray to improve rhinitis symptoms and quality of life parameters in seasonal allergic rhinitis patients remaining symptomatic after treatment with fexofenadine.
T95807 643777-643785 Sentence denotes Methods:
T58540 643786-643932 Sentence denotes This placebo-controlled, double-blind study began with a 1-week, open-label lead-in period, during which patients received fexofenadine 60 mg bid.
T57264 643933-644142 Sentence denotes After 7 days, patients who improved less than 25% to 33% on fexofenadine were randomized to treatment for 2 weeks with: (1) azelastine nasal spray, (2) azelastine nasal spray plus fexofenadine, or (3) placebo.
T68513 644143-644377 Sentence denotes The primary efficacy variable was the change from baseline to Day 14 in theTotal Nasal Symptom Score (TNSS), which consisted of runny nose, sneezing, itchy nose, and nasal congestion scores recorded twice daily in patient diary cards.
T24919 644378-644476 Sentence denotes In addition, quality of life was assessed using the Rhinitis Quality of Life Questionnaire (RQLQ).
T68275 644477-644485 Sentence denotes Results:
T77245 644486-644649 Sentence denotes After 2 weeks of treatment, azelastine nasal spray (P<.01) and azelastine nasal spray plus fexofenadine (P<.01) significantly improved theTNSS compared to placebo.
T88574 644650-644788 Sentence denotes Based on 90 patients with complete TNSS and RQLQ data, the overall RQLQ score also was significantly (P<.01) improved compared to placebo.
T92438 644789-644801 Sentence denotes Conclusions:
T91717 644802-645012 Sentence denotes Azelastine nasal spray was an effective treatment for patients with seasonal allergic rhinitis who did not respond well to fexofenadine and significantly improved quality of life parameters compared to placebo.
T58893 645013-645208 Sentence denotes The results of this study indicate that azelastine nasal spray is an important alternative to oral antihistamines and should be considered in the initial management of seasonal allergic rhinitis.
T57641 645209-645211 Sentence denotes W.
T15788 645212-645241 Sentence denotes Berger * , Mission Viejo, CA.
T69707 645242-645252 Sentence denotes Objective:
T21777 645253-645474 Sentence denotes To evaluate improvement over time with azelastine nasal spray in the treatment of patients with moderate-to-severe seasonal allergic rhinitis (SAR) who remained symptomatic after treatment with loratadine or fexofenadine.
T77161 645475-645483 Sentence denotes Methods:
T90329 645484-645678 Sentence denotes The studies were 2-week, multicenter, double-blind, placebo-controlled trials that began with a 1-week, open-label lead-in period in which patients received either loratadine 10 mg qd (Study No.
T78940 645679-645721 Sentence denotes 1) or fexofenadine 60 mg bid (Study No.2).
T62253 645722-645969 Sentence denotes Patients who improved <25%-33% with loratadine were randomized to treatment with: (1) azelastine nasal spray 2 sprays/nostril bid, (2) azelastine nasal spray 2 sprays/nostril bid plus loratadine 10 mg qd, (3) desloratadine 5 mg qd, or (4) placebo.
T14604 645970-646195 Sentence denotes Patients who improved <25%-33% with fexofenadine were randomized to treatment with: (1) azelastine nasal spray 2 sprays/nostril bid, (2) azelastine nasal spray 2 sprays/nostril bid plus fexofenadine 60 mg bid, or (3) placebo.
T32058 646196-646375 Sentence denotes The primary efficacy variable was the change from baseline to Day 14 in the Total Nasal Symptom Score (TNSS), consisting of runny nose, sneezing, itchy nose, and nasal congestion.
T60675 646376-646488 Sentence denotes Symptom severity was recordedAM and PM in diary cards on a 4-point scale (0=none; 1=mild; 2=moderate; 3=severe).
T36717 646489-646497 Sentence denotes Results:
T2013 646498-646820 Sentence denotes In both studies, patients treated with azelastine nasal spray experienced increasing improvement inTNSS over 14 days of treatment.The improvements were approximately 2-fold greater than placebo at each day of the study, and the differences from placebo were statistically significant (P<.05) at Days 2, 7, 14, and overall.
T9782 646821-646833 Sentence denotes In Study No.
T98874 646834-646943 Sentence denotes 1, 33% of patients treated with azelastine had >30% improvement in TNSS compared to 17% in the placebo group.
T78079 646944-646956 Sentence denotes In Study No.
T86857 646957-647066 Sentence denotes 2, 29% of patients treated with azelastine had >30% improvement in TNSS compared to 12% in the placebo group.
T61085 647067-647079 Sentence denotes Conclusions:
T86958 647080-647246 Sentence denotes Azelastine nasal spray was effective in treating patients with moderate-to-severe SAR who remained symptomatic after treatment with either loratadine or fexofenadine.
T63932 647247-647579 Sentence denotes Azelastine demonstrated first-day effectiveness, and patients treated with azelastine experienced increasing improvements in rhinitis symptoms over the 14-day study periods.Azelastine nasal spray is an effective treatment alternative to oral loratadine or fexofenadine and an appropriate first-line therapy in the management of SAR.
T7779 647580-647593 Sentence denotes Introduction:
T76456 647594-647778 Sentence denotes A large, open-label, azelastine (Astelin) nasal spray patient experience trial was conducted in patients with SAR, VMR, or mixed rhinitis (allergic rhinitis with nonallergic triggers).
T11876 647779-647932 Sentence denotes This analysis evaluated the effect of azelastine nasal spray in treating rhinitis symptoms in a subset of patients with a history of asthma or sinusitis.
T66634 647933-647941 Sentence denotes Methods:
T93867 647942-648084 Sentence denotes Patients were entered into an open-label protocol and treated for 2 weeks with azelastine nasal spray at a dosage of 2 sprays per nostril bid.
T41192 648085-648238 Sentence denotes After 2 weeks, the patients completed a questionnaire that assessed onset of action, symptom improvement, satisfaction with therapy, and quality of life.
T16021 648239-648247 Sentence denotes Results:
T28599 648248-648428 Sentence denotes From a total of 4364 rhinitis patients who received azelastine monotherapy during the 2-week study period, data were analyzed for patients with asthma (n=260) or sinusitis (n=346).
T86027 648429-648523 Sentence denotes A greater percentage of these patients had severe rhinitis compared to the overall population.
T72139 648524-648615 Sentence denotes Nasal congestion and postnasal drip were reported as the most bothersome rhinitis symptoms.
T32992 648616-648804 Sentence denotes After 2 weeks of treatment with azelastine nasal spray, >80% of patients with asthma and >85% of patients with sinusitis reported some or complete control of congestion and postnasal drip.
T62432 648805-649106 Sentence denotes In addition, >62% of patients with asthma reported chest tightness, shortness of breath, and wheezing were somewhat or completely controlled, and >77% of patients with sinusitis reported that headache and facial pain were somewhat or completely controlled during treatment with azelastine nasal spray.
T21286 649107-649118 Sentence denotes Conclusion:
T14328 649119-649288 Sentence denotes Azelastine nasal spray provided effective control of rhinitis symptoms, including nasal congestion and postnasal drip, in patients with a history of asthma or sinusitis.
T96280 649289-649302 Sentence denotes Introduction:
T3344 649303-649396 Sentence denotes Epinastine is an antihistamine with mast cell stabilization and anti-inflammatory properties.
T3336 649397-649542 Sentence denotes Epinastine 0.05% ophthalmic solution was evaluated for treatment of allergic signs and symptoms elicited by feline dander in a cat exposure room.
T68093 649543-649551 Sentence denotes Methods:
T75560 649552-649773 Sentence denotes Participants (n=30) were aged 18 years, with a history of ocular allergy to cats, a positive skin prick reaction to cat dander, and an ocular itching score of 2 (on a 0-4 scale) within 30 minutes of entering the cat room.
T35343 649774-649862 Sentence denotes Subjects wore a TB mask while in the cat room to reduce the effects of inhaled allergen.
T37738 649863-650003 Sentence denotes After 30 minutes of exposure, 1 drop of epinastine HCl 0.05% was instilled in one eye, and olopatadine 0.1% was instilled in the fellow eye.
T36263 650004-650074 Sentence denotes Environmental exposure to cat dander continued for another 60 minutes.
T53131 650075-650308 Sentence denotes Prior to instillation, and at 5, 15, 30, 45 and 60 minutes after instillation, conjunctival hyperemia and chemosis (scales of 0-3), and ocular itching, tearing, ocular burning, nasal itching and rhinorrhea (scales 0-4) were assessed.
T34954 650309-650317 Sentence denotes Results:
T45953 650318-650587 Sentence denotes Instillation of a single drop of ophthalmic epinastine significantly reduced ocular itching from a mean pre-instillation score of 2.27 to a mean score of 0.37 at 60 minutes after instillation (P<.001), despite continuous exposure to cat dander during the entire period.
T63589 650588-650698 Sentence denotes Similarly, ocular burning, tearing, and hyperemia were significantly reduced by epinastine treatment (P<.002).
T36403 650699-650859 Sentence denotes Chemosis was only weakly induced by cat room exposure, with a mean pre-instillation score of 0.167; however, epinastine treat-ment decreased that to 0 (P=.023).
T25910 650860-650959 Sentence denotes Instillation of epinastine also significantly reduced nasal itching and rhinorrhea scores (P<.043).
T28634 650960-651190 Sentence denotes Results for olopatadine were not statistically different; however, the change from baseline in itching scores in the epinastine-treated eyes was greater than that seen in the olopatadine-treated eyes at the majority of timepoints.
T35779 651191-651202 Sentence denotes Conclusion:
T50072 651203-651530 Sentence denotes Ophthalmic epinastine is indicated for the prevention of itch associated with allergic conjunctivitis.This study shows that treatment of cat-sensitive subjects with ophthalmic epinastine following environmental exposure to cat dander significantly reduced ocular itching and other signs and symptoms of allergic conjunctivitis.
T68113 651531-651541 Sentence denotes Objective:
T16625 651542-651752 Sentence denotes The objective of this study was to evaluate azelastine (Astelin®) nasal spray, cetirizine (Zyrtec®), fluticasone (Flonase®), and placebo in the treatment of patients with symptomatic seasonal allergic rhinitis.
T78970 651753-651761 Sentence denotes Methods:
T19245 651762-651864 Sentence denotes This was a double-blind placebo-controlled pilot trial in 60 patients with seasonal allergic rhinitis.
T97653 651865-651983 Sentence denotes The study began with a 1-week, placebo lead-in period, followed by a 1-week blinded treatment period (Day 1 to Day 7).
T12575 651984-652153 Sentence denotes Efficacy variables were: (1) change from baseline to Day 7 in the total nasal symptom score (TNSS; consisting of rhinorrhea, sneezing, itchy nose, and nasal congestion);
T34556 652154-652317 Sentence denotes (2) onset of action based on TNSS over the 4 hours following initial administration of study drugs; and (3) change from baseline to Day 2 (24-hour change) in TNSS.
T32620 652318-652423 Sentence denotes TNSS was scored twice daily (AM and PM) on a 4-point rating scale (0=none, 1=mild, 2=moderate, 3=severe).
T542 652424-652584 Sentence denotes Patients recorded a minimum 12-hour TNSS of 8 on at least 3 days during the lead-in period, and a congestion score of 3 on at least 3 days to qualify for entry.
T3378 652585-652890 Sentence denotes Qualified patients were randomized to treatment with: (1) azelastine nasal spray 2 sprays per nostril bid plus placebo capsules qd; (2) cetirizine 10-mg tablets qd plus placebo nasal spray; (3) fluticasone 2 sprays per nostril qd plus placebo capsules qd; or (4) placebo nasal spray plus placebo capsules.
T29303 652891-652899 Sentence denotes Results:
T30119 652900-653214 Sentence denotes Azelastine significantly (P<.05) improved the TNSS compared to cetirizine, fluticasone, and placebo beginning 30 minutes after initial administration; cetirizine significantly improved TNSS versus placebo at 150 minutes; fluticasone showed no significant differences from placebo over the 4-hour evaluation period.
T42919 653215-653355 Sentence denotes Azelastine significantly (P<.05) improved the TNSS at Day 2 (24-hour change from baseline) compared to cetirizine, fluticasone, and placebo.
T99152 653356-653368 Sentence denotes Conclusions:
T71782 653369-653473 Sentence denotes Azelastine nasal spray improved the TNSS in patients with moderate-to-severe seasonal allergic rhinitis.
T51195 653474-653665 Sentence denotes In addition, azelastine nasal spray demonstrated a 30-minute onset of action and significantly improved TNSS versus cetirizine, fluticasone, and placebo 24 hours after initial administration.
T23874 653666-653679 Sentence denotes Introduction:
T26241 653680-653836 Sentence denotes Epinastine, an antihistamine with mast cell stabilization and anti-inflammatory properties, has been developed for the treatment of allergic conjunctivitis.
T25961 653837-653926 Sentence denotes The efficacy and tolerability of epinastine was assessed and compared with levocabastine.
T89560 653927-653935 Sentence denotes Methods:
T66312 653936-654134 Sentence denotes Eligible patients for this randomized, double-masked, parallel-group, active-controlled environmental clinical trial were 18-65 years old with a recent diagnosis of seasonal allergic conjunctivitis.
T24707 654135-654253 Sentence denotes Patients instilled 1 drop epinastine HCl 0.05% or levocabastine 0.05% ophthalmic solution in each eye BID for 6 weeks.
T24282 654254-654434 Sentence denotes Patients and investigators assessed efficacy and tolerability at study visits on Days 0 (baseline), 7, 14, 28, and 42, and assessed overall efficacy and tolerability at study exit.
T34911 654435-654465 Sentence denotes Adverse events were monitored.
T47389 654466-654474 Sentence denotes Results:
T36453 654475-654757 Sentence denotes Epinastine provided superior itch relief compared with levocabastine (P=.048; see figure) ; mean ocular itch scores over 4 treatment visits were 0.79 for epinastine and 0.97 for levocabastine (0-3 scale; 3=worst; baseline scores were 2.08 for epinastine and 2.06 for levocabastine).
T18579 654758-655087 Sentence denotes The mean summed score (ocular itching, tearing, and foreign body sensation) over 4 treatment visits was significantly better for epinastine than levocabastine (P=.010).At study exit, 53% of epinastine-treated patients rated overall efficacy "very good" (the highest possible rating), versus 34% of levocabastine-treated patients.
T68724 655088-655218 Sentence denotes At 5 minutes postinstillation, 77% of epinastine-treated and 75% of levocabastine-treated patients rated tolerability "very good".
T74376 655219-655382 Sentence denotes At study exit, 80% of epinastine-treated and 75% of levocabastine-treated patients rated overall tolerability "very good", with investigator ratings being similar.
T55089 655383-655662 Sentence denotes Treatment-related adverse events occurred in 7.1% of epinastine-treated patients (most frequent: eye pain and skin itching, 1.2% each) and 10.3% of levocabastine-treated patients (most frequent: double vision, 3.4%; influenza-like symptoms, 2.3%); most AEs were mild or moderate.
T45370 655663-655674 Sentence denotes Conclusion:
T40519 655675-655821 Sentence denotes Our results confirm the therapeutic potential for epinastine as an efficacious treatment suitable for long-term use throughout the allergy season.
T81839 655822-655968 Sentence denotes Ophthalmic epinastine was superior to levocabastine for relief of ocular symptoms in patients with allergic conjunctivitis and was well-tolerated.
T45894 655969-656313 Sentence denotes Since chronic inflammation is the histopathologic landmark of otitis media with effusion, clinical observations have led us to believe that the combination of a cysteinyl leukotriene receptor antagonist Montelukast with an oral antibiotic may be more efficacious than monotherapy with an oral antibiotic in the treatment of serous otitis media.
T59116 656314-656772 Sentence denotes We studied twenty pediatric patients (age 3 years to 6 years) in a randomized open labeled 2-week trial to compare the efficacy of the combination Montelukast (4 mg or 5 mg chewables tablets QD dosed according to patient's age) with an oral antibiotic Amoxicillin/Clavulanate potassium (90 mg/kg/day in 2 divided doses every 12 hours) to a monotherapy with an oral antibiotic Amoxicillin/Clavulanate potassium for the treatment of otitis media with effusion.
T64717 656773-656968 Sentence denotes The efficacy of treatment options was assessed using pneumatic otoscopy, impedance tympanometry, and audiometry to monitor the clinical course of the middle ear effusion in both treatment groups.
T31138 656969-657087 Sentence denotes In the combination group Montelukast and antibiotic a resolution of otitis media with effusion occured at the 7th day.
T8116 657088-657232 Sentence denotes In contrast in the group treated with monotherapy with the oral antibiotic the resolution of otitis media with effusion occured on the 14th day.
T27385 657233-657514 Sentence denotes In conclusion, the combination of Montelukast plus an oral antibiotic is more effective than monotherapy with an oral antibiotic.The combination of Montelukast plus an antibiotic may be a safer and shorter therapy given the safety issues with long term use of systemic antibiotics.
T85270 657515-657528 Sentence denotes Introduction:
T7686 657529-657798 Sentence denotes A randomized, double-blind, placebo-controlled study was conducted in an environmental exposure chamber (EEC) to compare the efficacy of three doses of olopatadine nasal spray, a topical anti-allergy treatment for Seasonal Allergic Rhinitis (SAR), versus placebo spray.
T12897 657799-657807 Sentence denotes Methods:
T97922 657808-657981 Sentence denotes Patients aged 17-65 years old with a history of SAR were screened, consented, evaluated for a positive skin test to ragweed allergen, and enrolled in this IRBapproved study.
T90490 657982-658224 Sentence denotes A total of 320 "primed" patients were exposed to ragweed allergen in the EEC and randomized to olopatadine 0.2% (N=80), olopatadine 0.4% (N=80), olopatadine 0.6% (N=80), or placebo (vehicle) (N=80) spray, 2 sprays/nostril once in the morning.
T30729 658225-658427 Sentence denotes Symptoms were self-assessed using a 4point scale (total nasal symptom score, TNSS, comprised of sneezing, runny, itchy and stuffy nose) via diaries at periodic intervals during the 12-hour study period.
T41434 658428-658453 Sentence denotes Safety was also assessed.
T2552 658454-658462 Sentence denotes Results:
T74188 658463-658620 Sentence denotes Obvious trends indicated a dosedependent response to olopatadine 0.2%, 0.4% and 0.6%, though concentrations were not statistically different from each other.
T44011 658621-658792 Sentence denotes All three concentrations of olopatadine were clearly more efficacious than placebo spray at the first time point, 30 minutes, continuing to the end of the 12-hour session.
T1260 658793-658854 Sentence denotes Olopatadine exhibited a safety profile comparable to placebo.
T63964 658855-658867 Sentence denotes Conclusions:
T36741 658868-658947 Sentence denotes Olopatadine nasal spray 0.2%, 0.4% and 0.6% exhibited dose-dependent responses.
T14872 658948-659124 Sentence denotes Onset of action for all three concentrations of olopatadine was apparent at the first post-dose timepoint, 30 minutes, and efficacy was maintained throughout the next 12 hours.
T818 659125-659233 Sentence denotes Olopatadine nasal spray was safe, well-tolerated, and effective for the treatment of SAR in the EEC chamber.
T68296 659234-659236 Sentence denotes C.
T66227 659237-659258 Sentence denotes Slonim * , Tampa, FL.
T82403 659259-659269 Sentence denotes OBJECTIVE:
T51002 659270-659404 Sentence denotes To assess patient subjective responses to the treatment of allergic conjunctivitis using azelastine hydrochloride ophthalmic solution.
T94952 659405-659413 Sentence denotes METHODS:
T4463 659414-659589 Sentence denotes Participating physicians selected 20 patients from their practice to receive azelastine hydrochloride 0.05% ophthalmic solution 1 drop per affected eye twice daily for 5 days.
T27068 659590-659663 Sentence denotes Patients on prior ocular allergy medications were allowed to participate.
T73276 659664-659826 Sentence denotes After 5 days of treatment with azelastine hydrochloride, patients (n=2, 887) rated their experiences with azelastine hydrochloride via a self-administered survey.
T23982 659827-659875 Sentence denotes Not all questions were answered by each patient.
T10527 659876-659884 Sentence denotes RESULTS:
T48546 659885-660024 Sentence denotes At baseline, 88% of patients reported that their ocular itching affected their work, school, and/or leisure activities at least "somewhat".
T87001 660025-660206 Sentence denotes After using azelastine hydrochloride, 70% of patients achieved either "moderate" or "complete" relief from ocular itching, including 30% who reported "complete" relief from itching.
T23119 660207-660350 Sentence denotes Seventy-one percent (71%) of patients had been treated previously with a topical prescription anti-allergy medication for their ocular itching.
T90021 660351-660632 Sentence denotes Seventy percent (70%) of patients (n=836) who had not been previously treated with a topical prescription anti-allergy medication treatment and 71% of previous medication users (n=2, 192) experienced at least "moderate" relief of itching when treated with azelastine hydrochloride.
T74523 660633-660793 Sentence denotes Sixty-five percent (65%) of the previously-treated patients rated azelastine hydrochloride as "somewhat better" or "much better" than their previous medication.
T5839 660794-660806 Sentence denotes CONCLUSIONS:
T20194 660807-661094 Sentence denotes Results suggest that azelastine hydrochloride ophthalmic solution is an effective treatment for the ocular itching associated with allergic conjunctivitis as rated by the patient, regardless of whether they had been treated previously with a topical prescription anti-allergy medication.
T76309 661095-661105 Sentence denotes Objective:
T10344 661106-661181 Sentence denotes To determine an association between food allergy and acid reflux in adults.
T89928 661182-661189 Sentence denotes Method:
T41475 661190-661304 Sentence denotes We conducted a retrospective chart review of 60 atopic adult patients in an academic otolaryngic allergy practice.
T46943 661305-661413 Sentence denotes 30 adults who tested positive and 30 adults who tested negative for food allergy were included in the study.
T94353 661414-661495 Sentence denotes Charts were reviewed for a diagnosis of gastroesophageal reflux disorders (GERD).
T85274 661496-661585 Sentence denotes This included a history of laryngopharyngeal reflux (LPR) and peptic ulcer disease (PUD).
T89160 661586-661699 Sentence denotes Population prevalence (19.8%; CI 17.7-21.9) of acid reflux was estimated from a historical study (Locke GR et al.
T82411 661700-661816 Sentence denotes Prevalence and clinical spectrum of gastroesophageal reflux: a population-based study in Olmstead County, Minnesota.
T33766 661817-661891 Sentence denotes Gastroenterology 1997; 112:1448-56) that had a similar subject population.
T33862 661892-662027 Sentence denotes The prevalence of GERD in each study arm, as well as in the total study group of atopic adults, was compared to the historical control.
T10970 662028-662036 Sentence denotes Results:
T45966 662037-662141 Sentence denotes Subjects testing positive for food allergy had a diagnosis of GERD in 26.7% (95% CI 11.8-41.6) of cases.
T74236 662142-662252 Sentence denotes Those subjects who did not demonstrate a food allergy were positive for GERD in 40% (95% CI 25.1-54) of cases.
T40133 662253-662332 Sentence denotes In the total study group, the prevalence of GERD was 33.34% (95% CI 22.8-43.8).
T43848 662333-662482 Sentence denotes On Chi square analysis, the prevalence of GERD was significantly higher in the total study group when compared with the historical control (p=0.013).
T20331 662483-662631 Sentence denotes Those subjects who tested negative for food allergy had a statistically significant higher prevalence of GERD than the control population (p=0.003).
T73188 662632-662764 Sentence denotes The prevalence of GERD between the group testing positive and the historical control did not show a significant difference (p=0.41).
T27970 662765-662881 Sentence denotes When comparing the study arms to each other, there was no significant difference in the prevalence of GERD (p=0.27).
T36747 662882-662894 Sentence denotes Conclusions:
T53637 662895-663018 Sentence denotes The prevalence of acid reflux disorders was not higher in subjects with food allergy when compared to a historical control.
T67767 663019-663342 Sentence denotes Although a statistical significance was noted between adults who tested negative for food allergy and the control population with regards to the prevalence of GERD, this may reflect the fact that individuals examined in an Otolaryngologist's office are more likely to have acid reflux disorders than the general population.
T40068 663343-663515 Sentence denotes Overall, the atopic subjects did have a higher incidence of acid reflux disorders, but there was no statistical significance between subjects with and without food allergy.
T8202 663516-663518 Sentence denotes A.
T21905 663519-663539 Sentence denotes Suryadevara * , D.L.
T73070 663540-663560 Sentence denotes Hamilos, Boston, MA.
T31356 663561-663574 Sentence denotes Introduction:
T56902 663575-663717 Sentence denotes Recent studies suggest that CRS without nasal polyposis (CRSsNP) and CRS with nasal polyposis (CRScNP) represent distinct pathologic entities.
T97354 663718-663806 Sentence denotes We wished to determine whether these conditions differed in their clinical presentation.
T35745 663807-663815 Sentence denotes Methods:
T99689 663816-663959 Sentence denotes Over a two-year period, new patients coming to a University based specialty clinic meeting criteria for CRS were enrolled in an outcomes study.
T83613 663960-664193 Sentence denotes Patients indicated which of four major (facial pain/pressure/headache, nasal obstruction, nasal purulence/discharge, and hyposmia/anosmia) and four minor (fever, halitosis, dental pain, cough) criteria for CRS they were experiencing.
T84734 664194-664281 Sentence denotes Rhinoscopy was performed to look for nasal polyps or polypoid tissue in any sinus area.
T6177 664282-664363 Sentence denotes The prevalence of each symptom was compared in the groups by chi square analysis.
T51419 664364-664372 Sentence denotes Results:
T54601 664373-664512 Sentence denotes The population (N=126) had a mean age of 46 +/-13.6 and was 59% female, 86% Caucasian, 8.7% African-American, 1.6% Asian and 1.6% Hispanic.
T76828 664513-664550 Sentence denotes Most patients (87%) were non-smokers.
T70082 664551-664637 Sentence denotes All had at least 2 major criteria or 1 major + 1 minor criteria for CRS at enrollment.
T69339 664638-664676 Sentence denotes Forty-one patients (32.5%) had CRScNP.
T75951 664677-664773 Sentence denotes The mean number of major criteria was greater in the CRScNP than CRSsNP (3.27 vs 2.91, P=0.017).
T37209 664774-664873 Sentence denotes Nasal obstruction and hyposmia/anosmia were more prevalent in CRScNP (P= 0.05, 0.025 respectively).
T59380 664874-664943 Sentence denotes Facial pain/pressure/headache was more prevalent in CRSsNP (P=).025).
T26890 664944-665109 Sentence denotes The most prevalent symptoms in CRScNP were: nasal purulence/discharge (97.6%)>hyposmia/anosmia (85.4%)>facial pain/pressure/headache (82.9%)>nasal obstruction (61%).
T1760 665110-665290 Sentence denotes In contrast, the most prevalent symptoms in CRSsNP were: facial pain/pressure/headache (95.3%)>nasal purulence/discharge (88.2%)>hyposmia/anosmia (64.7%)>nasal obstruction (42.4%).
T303 665291-665363 Sentence denotes None of the symptoms were absolutely distinguishing of these conditions.
T85880 665364-665456 Sentence denotes No differences were found between the two groups for fever, halitosis, dental pain or cough.
T15649 665457-665468 Sentence denotes Conclusion:
T92937 665469-665597 Sentence denotes We conclude that patients with CRScNP have a greater burden of symptoms of CRS and a much higher prevalence of hyposmia/anomsia.
T87345 665598-665843 Sentence denotes These findings are consistent with other studies showing that, in comparison to CRSsNP, CRScNP tends to be more difficult to treat and have a higher rate of relapse after intensive medical therapy (Subramanian et al, Am J Rhinology 2002;16:303).
T10253 665844-665848 Sentence denotes L.E.
T50572 665849-665868 Sentence denotes Mansfield 1* , E.E.
T88145 665869-665883 Sentence denotes Philpot 2 , C.
T59295 665884-665896 Sentence denotes Posey 1 , 1.
T58570 665897-665912 Sentence denotes El Paso, TX; 2.
T33605 665913-665940 Sentence denotes Research Triangle Park, NC.
T10224 665941-665989 Sentence denotes Daytime sleepiness is a common complaint in SAR.
T85166 665990-666076 Sentence denotes Patients often complain of mental slowness, difficulty in concentrating, and thinking.
T13451 666077-666196 Sentence denotes The present study evaluated whether effective therapy of SAR would decrease DSS and improve an objective measure of CP.
T65772 666197-666250 Sentence denotes DSS was measured using the Epworth Sleep Scale (ESS).
T93553 666251-666343 Sentence denotes Objective CP was measured using the Test of Variables of Attention (TOVA), a validated test.
T31583 666344-666563 Sentence denotes Thirty two adults (15 Males, 17 Females with a 2 year history of SAR, a compatible physical exam, and corresponding positive allergy testing) volunteered for this 3 week randomized double blind placebo controlled study.
T31982 666564-666664 Sentence denotes After a one week INF placebo (Pl) baseline, the subjects received either active INF or continued Pl.
T18002 666665-666717 Sentence denotes They maintained daily nasal symptom dairies and ESS.
T68244 666718-666780 Sentence denotes The subjects took the TOVA test at the end of Week1 and Week3.
T2175 666781-666861 Sentence denotes Weekly Nasal Symptom Scores significantly improved with the INF, but not the Pl.
T62045 666862-667025 Sentence denotes W1 vs. W3 Nasal Congestion INF 29, 24 p=.03, Pl 29, 26 p=ns; Runny Nose INF 22.5, 19.9 p=ns; Pl 21.75, 21.38 p=ns; Sneezing INF 26.5, 19 p=.01; Pl 24.9, 21.1 p=ns.
T35879 667026-667122 Sentence denotes Total weekly ESS was abnormal and decreased significantly in the INF group, but not in PL group.
T18031 667123-667175 Sentence denotes W1 vs. W3 INF 60.5, 46.5 p=.001, Pl 52.6, 46.8 p=ns.
T48336 667176-667288 Sentence denotes Response time of the TOVA testing, initially somewhat slow, significantly decreased in INF but not PL treatment.
T20136 667289-667356 Sentence denotes W1 vs. W3 INF 435 msec, 385 msec p=.02; Pl 360 msec, 359 msec p=ns.
T14424 667357-667431 Sentence denotes These results demonstrate that SAR is associated with DSS and CP problems.
T28542 667432-667541 Sentence denotes The mechanism is likely to be sleeping disordered breathing associated with nasal congestion and obstruction.
T7527 667542-667647 Sentence denotes Effective treatment of nasal congestion with INF led to decreased DSS and improved cognitive performance.
T63649 667648-667652 Sentence denotes L.E.
T75051 667653-667670 Sentence denotes Mansfield 1* , C.
T75520 667671-667684 Sentence denotes Graham 2 , 1.
T13722 667685-667700 Sentence denotes El Paso, TX; 2.
T60846 667701-667714 Sentence denotes New York, NY.
T266 667715-667815 Sentence denotes There is increasing recognition that sleep disturbance and daytime tiredness occur during active AR.
T94983 667816-667951 Sentence denotes The mechanism appears to be nasal congestion and obstruction leading to sleep disordered breathing and resultant poor quality of sleep.
T54420 667952-668083 Sentence denotes In our practice, as part of the initial history, questions regarding fatigue, snoring, sleep problems, and tiredness are addressed.
T48418 668084-668157 Sentence denotes Sleep problems and Tiredness are graded according to the following scale:
T34691 668158-668283 Sentence denotes Effect on Daily Activity ; 0=not troubled;1= a little trouble; 2=somewhat troubled ;3= trou-bled a lot ; 4= total disruption.
T72836 668284-668418 Sentence denotes We reviewed 272 consecutive charts of patients with allergic rhinitis documented by history, physical examination and allergy testing.
T45405 668419-668477 Sentence denotes There were 169 females and 103 males; age range 5y to 84y.
T46153 668478-668543 Sentence denotes 127 (47%) of patients or parents recognized they commonly snored.
T50834 668544-668591 Sentence denotes 40 (15%) stated they were chronically fatigued.
T64116 668592-668823 Sentence denotes The graded answers concerning sleep problems and tiredness were even more revealing of AR patient's perception of their problems See Table In general, the higher sleep problem responses were associated with higher tiredness scores.
T72680 668824-668950 Sentence denotes National surveys of unselected populations suggest that about 10 percent of adults consider themselves to have sleep problems.
T66595 668951-669124 Sentence denotes The high frequency of sleep related problems and tiredness in our sample has prompted us to add more detailed questions regarding sleep related events to our intake history.
T53119 669125-669270 Sentence denotes It is our opinion that questions specifically related to sleep and daytime tiredness should be included in all evaluations for allergic rhinitis.
T53617 669271-669402 Sentence denotes We conclude that sleep related problems and tiredness may be more common in patients with allergic rhinitis than previous reported.
T34658 669403-669407 Sentence denotes R.W.
T17944 669408-669421 Sentence denotes Weber 1* , J.
T44130 669422-669435 Sentence denotes Garcia 2 , R.
T86485 669436-669449 Sentence denotes Faruqi 2 , D.
T10387 669450-669464 Sentence denotes Banerji 2 , G.
T82655 669465-669516 Sentence denotes Georges 2 , The Study 405 Investigator Group 3 , 1.
T93835 669517-669531 Sentence denotes Denver, CO; 2.
T74773 669532-669552 Sentence denotes Bridgewater, NJ; NJ.
T81369 669553-669566 Sentence denotes Introduction:
T71958 669567-669705 Sentence denotes The intranasal glucocorticosteroid triamcinolone acetonide (TAA) is a safe and effective treatment for persistent allergic rhinitis (PAR).
T70106 669706-669805 Sentence denotes A new hydrofluroalkane-134a (HFA) propellant delivery system (TAA-HFA) has recently been developed.
T60 669806-669929 Sentence denotes This study primarily assessed the long-term safety of TAA delivered via this new device, as well as its long-term efficacy.
T45638 669930-669938 Sentence denotes Methods:
T34193 669939-670050 Sentence denotes 396 patients aged 12-69 yrs (mean=32) with PAR enrolled in this 1-yr, open-label study at 10 centers in the US.
T8643 670051-670205 Sentence denotes Patients received TAA-HFA 220 μg once daily for a 2-week run-in period before adjusting the dose to 440 μg or 110 μg once daily based on symptom severity.
T9746 670206-670347 Sentence denotes Doses were standardized to 440 μg once daily across all patients at ~4 months to ensure sufficient long-term safety data at the maximum dose.
T85160 670348-670476 Sentence denotes Physical exams, including measurement of vital signs and laboratory measurements were taken at baseline, 6 months and study end.
T49260 670477-670600 Sentence denotes Independent patient and physician global symptom evaluations were performed at baseline, week 2 and months 1-12 thereafter.
T10498 670601-670665 Sentence denotes Patients recorded any adverse events (AEs) on daily diary cards.
T56990 670666-670674 Sentence denotes Results:
T35453 670675-670743 Sentence denotes Of the 396 patients included in the study, 349 (88.1%) reported AEs.
T45689 670744-670841 Sentence denotes The incidence of AEs was similar to that of other comparable allergic rhinitis long-term studies.
T27794 670842-670965 Sentence denotes The most frequently reported AEs were pharyngitis, rhinitis, local reactions, headache, epistaxis and sinusitis (Table 1) .
T89511 670966-671058 Sentence denotes Most AEs were mild-to-moderate in intensity; 34 patients withdrew from the study due to AEs.
T97624 671059-671159 Sentence denotes There were no clinically relevant changes in physical exams, vital signs or laboratory measurements.
T19421 671160-671323 Sentence denotes A total of 4 serious AEs (SAEs) were reported; breast carcinoma (n=1), depression (n=1), post-operative spinal fluid leak (n=1) and staphylococcal infection (n=1).
T5567 671324-671378 Sentence denotes SAEs were thought to be not related to the study drug.
T11131 671379-671497 Sentence denotes At final visit, 83% of patients had either moderate or marked/complete relief of symptoms using global symptom scores.
T43567 671498-671600 Sentence denotes Similarly, 86% of physicians rated their patients as having either moderate or marked/complete relief.
T9437 671601-671613 Sentence denotes Conclusions:
T34864 671614-671804 Sentence denotes Long-term administration of TAA-HFA 440 μg exhibited a good safety and tolerability profile, while providing moderate-to-complete symptom relief in more than 80% of patients treated for PAR.
T27855 671805-671818 Sentence denotes Introduction:
T53516 671819-672002 Sentence denotes Second-generation, 'non-sedating' antihistamines (AHs) have lower tendency to cross the blood-brain barrier and cause central nervous system side effects than first-generation agents.
T243 672003-672117 Sentence denotes However, studies have suggested differences between second-generation AHs regarding cognitive function impairment.
T32402 672118-672126 Sentence denotes Methods:
T45134 672127-672455 Sentence denotes A MEDLINE literature search was performed using the search terms 'antihistamine AND impairment', 'antihistamine AND psychomotor' and 'antihistamine AND central effects', as well as with individual AH names (acrivastine, cetirizine, desloratadine, ebastine, fexofenadine, levocetirizine, loratadine, mequitazine and mizolastine).
T44301 672456-672641 Sentence denotes The findings for second-generation AHs were reviewed and well-designed, placebo-and positive-controlled studies in humans using objective measures of cognitive impairment were included.
T25667 672642-672650 Sentence denotes Results:
T83947 672651-672709 Sentence denotes 43 publications were identified as the inclusion criteria.
T54210 672710-672826 Sentence denotes All included objective assessments such as driving performance, critical flicker fusion and divided attention tasks.
T66726 672827-672975 Sentence denotes There was a large variation in the numbers of available well-designed studies; the most rigorously assessed agents were fexofenadine and cetirizine.
T83483 672976-673127 Sentence denotes A number of the AHs (ebastine, acrivastine, loratadine, mequitazine and mizolastine) were not impairing at recommended doses, but were at higher doses.
T80310 673128-673311 Sentence denotes In a small number of available studies, the newer AHs desloratadine and levocetirizine produced no impairment at recommended doses (5 mg); however, higher doses were not investigated.
T82007 673312-673429 Sentence denotes Cetirizine studies were variable; impairment at the recommended 10 mg dose or higher was seen in a number of studies.
T62782 673430-673532 Sentence denotes In contrast, fexofenadine HCl, up to a dose of 360 mg, was non-impairing in a large number of studies.
T44844 673533-673809 Sentence denotes Only one study indicated impairment in one task (critical tracking) and this was only observed with the first doses of fexofenadine HCl (120 and 180 mg) and not subsequent doses; however, the authors concluded that doses up to 240 mg/day should be safe for patients who drive.
T84669 673810-673821 Sentence denotes Conclusion:
T75990 673822-673963 Sentence denotes While second-generation AHs are less impairing than the first-generation, some newer AHs produce impairment at or above the recommended dose.
T49655 673964-674093 Sentence denotes These differences become important to the patient when agents cause sedation or if patients over use beyond the recommended dose.
T49492 674094-674219 Sentence denotes In conclusion, Fexofenadine was the only AH found to be non-impairing in all studies, even at double the recommended US dose.
T7674 674220-674222 Sentence denotes S.
T86254 674223-674238 Sentence denotes Shaver 1 , R.B.
T5636 674239-674256 Sentence denotes Berkowitz 1* , C.
T40336 674257-674268 Sentence denotes Lutz 1 , P.
T532 674269-674281 Sentence denotes Jones 1 , C.
T11472 674282-674292 Sentence denotes Qiu 2 , S.
T7925 674293-674308 Sentence denotes Meeves 2 , S.T.
T10435 674309-674324 Sentence denotes Varghese 2 , G.
T23283 674325-674339 Sentence denotes Georges 2 , 1.
T25414 674340-674357 Sentence denotes Woodstock, GA; 2.
T23306 674358-674374 Sentence denotes Bridgewater, NJ.
T30927 674375-674388 Sentence denotes Introduction:
T87554 674389-674501 Sentence denotes Fexofenadine (FEX) is a H1-receptor antagonist, with proven efficacy in the treatment of allergic rhinitis (AR).
T96091 674502-674607 Sentence denotes To date, no live cat-room challenge studies have assessed the efficacy of FEX in cat-allergen induced AR.
T23515 674608-674765 Sentence denotes This study assessed the efficacy of a single dose of FEX HCI 180 mg in preventing and controlling cat-allergen induced AR using the cat-room challenge model.
T56729 674766-674774 Sentence denotes Methods:
T12339 674775-674998 Sentence denotes This single-center, prospective, randomized, doubleblind, placebo-controlled, two-way crossover study consisted of a screening visit, one or two priming visits and two treatment periods, separated by a 14 (±3)-day wash-out.
T92093 674999-675116 Sentence denotes Qualifying subjects were randomized to treatment Sequence 1 (placebo followed by FEX) or 2 (FEX followed by placebo).
T10188 675117-675262 Sentence denotes Baseline endpoints were obtained prior to study drug administration, and 5 minutes before entering the cat challenge room for allergen challenge.
T88748 675263-675346 Sentence denotes Allergen challenges were initiated 1.5 hours post-dose, for both treatment periods.
T27243 675347-675589 Sentence denotes The primary endpoint was the change from baseline in total symptom score (TSS; sum of rhinorrhea, itchy nose/palate/throat, sneezing and itchy/watery/red eyes) after 30 minutes of allergen exposure at 2 hours post-dose, compared with placebo.
T78276 675590-675680 Sentence denotes Other endpoints included changes in individual symptom scores, including nasal congestion.
T16216 675681-675754 Sentence denotes Levels of airborne Felis domesticus allergen 1 (Fel d 1) were determined.
T43607 675755-675763 Sentence denotes Results:
T9549 675764-675881 Sentence denotes Of 211 subjects screened, 66 were randomized and 63 completed the study; 32 and 31 in Sequence 1 and 2, respectively.
T52768 675882-676041 Sentence denotes Mean change in TSS from baseline was significantly less with FEX compared with placebo at 30 minutes after initiation of the cat allergen challenge (p=0.0327).
T25976 676042-676248 Sentence denotes Significantly greater percentage reductions in the individual symptom scores for sneezing (p=0.0037) and nasal congestion (p=0.0455) were observed with FEX compared with placebo, 30 minutes after challenge.
T1945 676249-676335 Sentence denotes Although levels of Fel d 1 varied widely, they were balanced between treatment groups.
T20563 676336-676464 Sentence denotes The overall incidence of treatment-emergent adverse events (AEs) was low and comparable between groups; no serious AEs occurred.
T71447 676465-676476 Sentence denotes Conclusion:
T58796 676477-676662 Sentence denotes This study demonstrated that a single dose of FEX HCI 180 mg is effective and well tolerated as a prophylactic agent for alleviating the AR symptoms induced by exposure to cat allergen.
T68666 676663-676739 Sentence denotes Further large-scale clinical trials are warranted to confirm these findings.
T86736 676740-676750 Sentence denotes Rationale:
T59035 676751-676842 Sentence denotes Allergic rhinitis in children is thought to be associated with several co-morbid disorders.
T36259 676843-677146 Sentence denotes We conducted the following study to assess whether children with diagnosed hypertrophy of tonsils and/or adenoids evaluated by an allergist were more likely to demonstrate objective evidence of allergen sensitization than children similarly evaluated without evidence of these upper airway obstructions.
T10974 677147-677155 Sentence denotes Methods:
T66556 677156-677329 Sentence denotes Records from the past ten years were identified in the hospital database by presence of an Allergy clinic visit and an ICD-9 code for hypertrophy of adenoids and/or tonsils.
T29186 677330-677399 Sentence denotes We reviewed these records to confirm that the diagnosis was accurate.
T39204 677400-677512 Sentence denotes We included subjects if reliable skin prick or in vitro testing for specific IgE to aeroallergens was performed.
T93217 677513-677589 Sentence denotes For comparison, we randomly obtained an age and testing-type similar sample.
T90767 677590-677647 Sentence denotes First group subjects were excluded from the second group.
T51806 677648-677734 Sentence denotes Skin testing was performed with commercial allergen extracts applied with a Dermapik©.
T45891 677735-677772 Sentence denotes In vitro testing was by UniCAP© FEIA.
T24805 677773-677870 Sentence denotes Positive skin testing had at least a wheal 3 mm or flare 10 mm greater than the negative control.
T1566 677871-677946 Sentence denotes Positive in vitro values were 0.7 KU/L or greater or a positive pollen mix.
T41636 677947-678078 Sentence denotes Additionally, we performed a search in an insurance database to determine how many local children had a code for allergic rhinitis.
T95390 678079-678087 Sentence denotes Results:
T11228 678088-678219 Sentence denotes Of 202 pediatric Allergy patients with adenoid/tonsillar hypertrophy tested, 41.6% (95% CI +/-6.8%) had at least one positive test.
T7573 678220-678320 Sentence denotes In 802 without adenoid/tonsillar hypertrophy, 50.7% (95% CI +/-3.5%) had at least one positive test.
T42321 678321-678372 Sentence denotes The observed difference was 9.1 % (95% CI +/-7.6%).
T8990 678373-678454 Sentence denotes The Standard error of the difference in percentage was 3.94; the Z score was 2.3.
T36466 678455-678489 Sentence denotes The corresponding P value is 0.02.
T31456 678490-678584 Sentence denotes The percentage of 70, 356 children with an allergic rhinitis ICD-9 was 15.6% (95% CI +/-0.3%).
T69536 678585-678596 Sentence denotes Conclusion:
T92302 678597-678812 Sentence denotes The number of allergist-referred children with adenoid and/or tonsillar hypertrophy testing positive for an aeroallergen is slightly less than the number of similar children without these diagnoses testing positive.
T34948 678813-678918 Sentence denotes It is not clear that adenoid/tonsillar hypertrophy is associated with a higher risk of allergic rhinitis.
T19984 678919-679079 Sentence denotes A prospective study with allergy testing of all children with adenoid and/or tonsillar hypertrophy might provide information that could alter referral patterns.
T28240 679080-679084 Sentence denotes W.E.
T1207 679085-679099 Sentence denotes Berger 1* , W.
T75948 679100-679113 Sentence denotes Storms 2 , S.
T55270 679114-679127 Sentence denotes Kimura 3 , M.
T17172 679128-679139 Sentence denotes Beck 4 , S.
T21510 679140-679153 Sentence denotes Galant 5 , T.
T41213 679154-679170 Sentence denotes Westbrook 3 , 1.
T63780 679171-679192 Sentence denotes Mission Viejo, CA; 2.
T80433 679193-679217 Sentence denotes Colorado Springs, CO; 3.
T18189 679218-679235 Sentence denotes Pensacola, FL; 4.
T32913 679236-679249 Sentence denotes Miami, FL; 5.
T76163 679250-679261 Sentence denotes Orange, CA.
T29251 679262-679273 Sentence denotes Background:
T23151 679274-679439 Sentence denotes Patients having allergic rhinoconjunctivitis are often treated with nasal spray or systemic allergy therapy, forgoing therapy specifically targeting ocular symptoms.
T57308 679440-679644 Sentence denotes The rhinitis quality of life questionnaire (RQLQ) and allergic conjunctivitis quality of life questionnaire (ACQLQ) instruments can be used to quantify the relative benefit of varying medication regimens.
T6632 679645-679655 Sentence denotes Objective:
T51854 679656-679869 Sentence denotes To determine the extent of benefit gained in quality of life when an eye drop treatment for ocular allergy (olopatadine) was added to rhinitis patients' preexisting regimen of nasal or systemic allergic treatment.
T49107 679870-679878 Sentence denotes Methods:
T90754 679879-680003 Sentence denotes This was a four week prospective, multi-center, open-label crossover, quality of life study occurring during allergy season.
T53151 680004-680104 Sentence denotes At visit 1, patients completed the RQLQ and ACQLQ questionnaires to assess baseline quality of life.
T70815 680105-680352 Sentence denotes Patients were randomized to receive ocular allergy therapy (olopatadine, Patanol BID) concomitant with their systemic or nasal rhinitis treatment(s) for 2 weeks between either visit 1 and Visit 2 (Group A) or between Visit 2 and Visit 3 (Group B).
T29555 680353-680415 Sentence denotes At Visit 2 and Visit 3, patients completed the RQLQ and ACQLQ.
T20617 680416-680424 Sentence denotes Results:
T40796 680425-680470 Sentence denotes A total of 200 patients completed this study:
T62767 680471-680501 Sentence denotes 97 in Group A, 103 in Group B.
T94680 680502-680631 Sentence denotes Of these, 181 (90.5%) experienced eye allergy symptoms at least 1 day during the previous week as reported in the baseline ACQLQ.
T86683 680632-680702 Sentence denotes Baseline scores of the RQLQ and ACQLQ for both groups were comparable.
T65987 680703-680879 Sentence denotes Clinically significant improvement from baseline in global RQLQ and ACQLQ was seen following addition of ocular therapy for both groups (RQLQ: -1.07, -0.94; ACQLQ: -1.2, -1.2).
T63950 680880-680951 Sentence denotes Similar improvement was seen across all domains of both questionnaires.
T83684 680952-681013 Sentence denotes The ACQLQ correlated with the RQLQ in the applicable domains.
T88477 681014-681025 Sentence denotes Conclusion:
T85904 681026-681135 Sentence denotes Many allergic rhinitis patients using nasal or systemic medication also suffer from ocular allergic symptoms.
T42208 681136-681301 Sentence denotes For these patients, quality of life improvement is not maximized; the addition of a topical antiallergy eye drop can result in beneficial effects on quality of life.
T56128 681302-681517 Sentence denotes In this study, the addition of olopatadine eye drops to these patients' medication regimens resulted in significant improvement in not only eye symptom related quality of life domains but in overall quality of life.
T99755 681518-681520 Sentence denotes H.
T35636 681521-681536 Sentence denotes Milgrom 1* , R.
T20635 681537-681552 Sentence denotes Lanier 2 , F.C.
T54411 681553-681566 Sentence denotes Hampel 3 , B.
T929 681567-681581 Sentence denotes Kittner 4 , 1.
T89775 681582-681596 Sentence denotes Denver, CO; 2.
T43220 681597-681615 Sentence denotes Fort Worth, TX; 3.
T14951 681616-681637 Sentence denotes New Braunfels, TX; 4.
T9453 681638-681654 Sentence denotes Bridgewater, NJ.
T20083 681655-681668 Sentence denotes Introduction:
T15488 681669-681922 Sentence denotes Fexofenadine, a non-sedating, selective H1-receptor antagonist, is currently indicated for use in children aged 6-11 years with seasonal allergic rhinitis in a number of countries, including the US, and has an excellent safety profile in this age group.
T2802 681923-682056 Sentence denotes This study was designed to assess the safety and tolerability of fexofenadine in children aged 2-5 years with allergic rhinitis (AR).
T25393 682057-682065 Sentence denotes Methods:
T70959 682066-682163 Sentence denotes The study had a multicenter, double-blind, randomized, placebo-controlled, parallel-group design.
T81302 682164-682318 Sentence denotes Children aged 2-5 years (n=453) with AR were randomized 1:1 to either placebo twice daily (BID; n=231) or fexofenadine HCl 30 mg BID (n=222), for 2 weeks.
T53166 682319-682433 Sentence denotes Both treatments were given orally as granulated powders (capsule content) mixed with two teaspoons of apple sauce.
T93387 682434-682559 Sentence denotes Treatment-emergent adverse events (TEAEs) were recorded for all subjects by parents/caregivers and assessed by investigators.
T70202 682560-682727 Sentence denotes Clinical laboratory variables, physical examinations, vital signs and ECG evaluations were also assessed in a subgroup of children (placebo, n=79; fexofenadine, n=71).
T36308 682728-682736 Sentence denotes Results:
T61827 682737-682797 Sentence denotes Baseline demographics were similar in both treatment groups.
T73863 682798-682951 Sentence denotes While approximately 50% of children in both groups experienced at least one TEAE, no unusual or unexpected TEAEs were observed in the fexofenadine group.
T60024 682952-683163 Sentence denotes When the total group was analyzed for TEAEs by body system, or assessed separately by age groups of 2-, 3-, 4-and 5-year-olds, no clinically meaningful differences were observed between the two treatment groups.
T69910 683164-683302 Sentence denotes In both treatment groups, the majority of subjects overall and in each age group experienced TEAEs rated as mild or moderate in intensity.
T31164 683303-683391 Sentence denotes Few subjects experienced TEAEs considered possibly related to study medication (placebo:
T16072 683392-683420 Sentence denotes 8.2% [19/231]; fexofenadine:
T11729 683421-683436 Sentence denotes 9.5% [21/222]).
T99853 683437-683539 Sentence denotes The percentage of discontinuations due to TEAEs was also comparable between treatment groups (placebo:
T44152 683540-683568 Sentence denotes 6.9% [16/231]; fexofenadine:
T8728 683569-683585 Sentence denotes 5.0% [11/222] ).
T47461 683586-683764 Sentence denotes In the subgroup assessment, no clinically relevant changes were seen from baseline for laboratory variables, vital signs, ECGs or physical examinations in either treatment group.
T59714 683765-683778 Sentence denotes Introduction:
T25415 683779-683953 Sentence denotes The efficacy and safety of fexofenadine HCl 30 mg BID has been proven in two large Phase III studies in pediatric subjects aged 6 to 11 years with seasonal allergic rhinitis.
T1973 683954-684086 Sentence denotes In addition, the safety of fexofenadine has been demonstrated in pediatric subjects 2 to 5 years of age with allergic rhinitis (AR).
T89919 684087-684272 Sentence denotes Subsequently, two studies (T/3001; T/3002) have assessed the pharmacokinetics, safety and tolerability of fexofenadine 15 and 30 mg BID in pediatric subjects 6 months to 2 years of age.
T54920 684273-684281 Sentence denotes Methods:
T47983 684282-684504 Sentence denotes Both studies were of multicenter, randomized, double-blind, placebo-controlled, parallelgroup design and enrolled pediatric subjects aged 6 months to <1 year weighing 10.5 kg and aged ±1 year to <2 years weighing >10.5 kg.
T34840 684505-684622 Sentence denotes All subjects had a diagnosis of AR as assessed by previous medical history, pattern, or suggestive physical findings.
T24674 684623-684777 Sentence denotes Subjects were randomized to receive fexofenadine HCl 15 mg (T/3001), or 30 mg (T/3002) granulation powder twice-daily, or placebo for a minimum of 7 days.
T30645 684778-684904 Sentence denotes Safety was evaluated based on adverse events (AEs), vital signs, 12-lead electrocardiograms (ECGs), and physical examinations.
T67799 684905-684913 Sentence denotes Results:
T66516 684914-685107 Sentence denotes A total of 174 and 218 subjects were randomized in studies T/3001 (fexofenadine HCl 15 mg BID: n=85, placebo: n=89) and T/3002 (fexofenadine HCl 30 mg BID: n=108, placebo: n=110), respectively.
T98512 685108-685258 Sentence denotes In T/3001, 40.0% (34/85) of children receiving fexofenadine and 42.7% (38/89) receiving placebo experienced at least one treatment-emergent AE (TEAE).
T20087 685259-685347 Sentence denotes In T/3002, the incidences of TEAEs were 35.2% (38/108) and 52.7% (58/110), respectively.
T33971 685348-685430 Sentence denotes In both studies, most of the TEAEs experienced were mild or moderate in intensity.
T85871 685431-685522 Sentence denotes The incidence of possibly-related TEAEs was also similar for both treatments in each study.
T96532 685523-685643 Sentence denotes No clinically relevant changes from baseline to study end were observed for vital signs, ECGs and physical examinations.
T32183 685644-685656 Sentence denotes Conclusions:
T80687 685657-685841 Sentence denotes The findings of this study show that fexofenadine 15 mg and 30 mg BID are well tolerated and have a safety profile comparable to placebo in pediatric subjects aged 6 months to 2 years.
T65620 685842-686197 Sentence denotes For Seasonal Allergic Rhinitis (SAR) patients that remain symptomatic on an H1-receptor antagonist, Cetirizine, and a nasal glucocorticosteroid, Mometasone furoate, the addition of Omalizumab, a recombinant, humanized, chimeric, anti-IgE monoclonal antibody, may provide additional efficacy in sub-optimally controlled Seasonal Allergic Rhinitis patients.
T1128 686198-686602 Sentence denotes In this open labeled 12week trial, 20 patients with symptomatic SAR currently using Cetirizine, 10 mg QD, + Mometasone furoate, 100 mcg/nostril QD, were randomized to continue the existing therapy Cetirizine + Mometasone or to add-on Omalizumab subcutaneously (every 2 weeks to 4 weeks) dosed according to patient's weight, and baseline IgE levels to the existing therapy Cetirizine + Mometasone furoate.
T83049 686603-686815 Sentence denotes The endpoints of the trial include: rhinomanometry, nasal symptom score (composite score of nasal congestion, rhinorrhea, sneezing, post nasal drip and itching) and flexible rhinopharyngolaryngoscopy examination.
T13297 686816-687047 Sentence denotes Mean efficacy measurements at the end of the 12-week trial revealed a significant improvements in all parameters examined in the treatment group receiving Omalizumab (as add-on to the existing therapy), compared to the other group.
T78359 687048-687282 Sentence denotes In conclusion, the addition of Omalizumab to the combination of Cetirizine plus Mometasone furoate, is more effective than the combination of cetirizine plus Mometasone furoate, for the treament of Seasonal Allergic Rhinitis patients.
T20262 687283-687510 Sentence denotes It appears that when Omalizumab is added to the combination H1receptor antagonist, Cetirizine, and nasal corticosteroid, Mometasone furoate, the primary end points (rhinomanometry and symptom scores) are significantly improved.
T38670 687511-687522 Sentence denotes Background:
T96262 687523-687715 Sentence denotes Based on the official statistic data, the prevalence of allergic diseases in Russia has increased more than 3 times during the past 10-15 years, but still the lowest of all European countries.
T56233 687716-687919 Sentence denotes In some studies done in some regions of Russia based on ISAAC program, it has been shown that the prevalence allergies is significantly higher than indicated in official statistics of health departments.
T88879 687920-688037 Sentence denotes The goal of this investigation was to study the prevalence of allergic diseases, in children of South Russian region.
T63054 688038-688047 Sentence denotes Meth-ods:
T92032 688048-688119 Sentence denotes This study was done in two steps according to ISAAC program guidelines.
T6673 688120-688324 Sentence denotes In the first step a questionnaire was given to a total of 6558 school children, ages 7 to 8 (group A) and 13 to14 years old (group B), from the two cities of Krasnodar and Novorossiysk in Southern Russia.
T45977 688325-688494 Sentence denotes In the second step a physical exam, skin prick tests with different allergens (pollens, molds, cat, dust mites, foods etc.), and pulmonary function tests were performed.
T73830 688495-688503 Sentence denotes Results:
T21040 688504-688602 Sentence denotes Wheezing was reported in 12.9% of group A and 15.3% of group B children within the past 12 months.
T4003 688603-688785 Sentence denotes The severity of asthma reported was mild in 72% (group A)-84% (group B); moderate in 16.7% (group A)-10.7% (group B) and severe in 3.4% (group A)-5.8% (group B) in studied children).
T91743 688786-688850 Sentence denotes Majority of the cases of asthma was noted to be allergic asthma.
T1486 688851-689037 Sentence denotes In both groups of children there was a high incidence of allergies to perennial allergens such as dust mites, cats, molds and other indoor allergens, 18.7% (group A) and 77.3% (group B).
T30928 689038-689110 Sentence denotes The percentage of allergies to pollens was 19.1% and 33.0%, accordingly.
T39411 689111-689192 Sentence denotes Allergic rhinitis symptoms were noted in 26.6% (group A) and in 38, 6% (group B).
T20949 689193-689297 Sentence denotes Atopic dermatitis symptoms with skin itching observed in 8.3% (7-8 years old)and 5.3% (13-14 years old).
T51011 689298-689384 Sentence denotes Family history of atopy was noticed in 34.6% of group A and 41.6% of group B children.
T77550 689385-689397 Sentence denotes Conclusions:
T13590 689398-689507 Sentence denotes The prevalence of allergic diseases in South Russia is similar to the ones in most of the European countries.
T32814 689508-689627 Sentence denotes The prevalence of asthma has been associated with increased incidence of allergies, due to indoor and pollen allergens.
T58720 689628-689715 Sentence denotes The prevalence in rhinitis and atopic dermatitis in South Russia is parallel to asthma.
T82389 689716-689732 Sentence denotes Acknowledgement:
T51397 689733-689822 Sentence denotes We would like to thank Hollister-Stier Lab., Greer and Antigen Lab. for allergen samples.
T6518 689823-689833 Sentence denotes Objective:
T18513 689834-689993 Sentence denotes To examine the cost and effectiveness of telithromcyin vs. azithromycin for treatment of mild acute sinusitis under current levels of antimicrobial resistance.
T61575 689994-690002 Sentence denotes Methods:
T36708 690003-690084 Sentence denotes We considered an adult with mild acute sinusitis, and symptom duration of 7 days.
T25922 690085-690318 Sentence denotes A decision analytic model was created to compare 2 strategies of 1st-, 2nd-and 3rd-line therapies: azithromycin/amoxicillin-clavulanate/levofloxacin (AZI/AMC/LEV), and telithromycin/amoxicillin-clavulanate/levofloxacin (TEL/AMC/LEV).
T64202 690319-690429 Sentence denotes We considered 3 outcomes: response to initial therapy, cost, and time to completion of all antibiotic therapy.
T35134 690430-690514 Sentence denotes Clinical resolution was due to response to antibiotic, or to spontaneous resolution.
T70922 690515-690612 Sentence denotes We assumed bacteria that were resistant in vitro would only be resistant in vivo 50% of the time.
T42932 690613-690689 Sentence denotes Resistance levels were based on the 2000-2001 US PROTEKT surveillance study.
T51556 690690-690861 Sentence denotes Model parameters, such as prevalence of bacterial infection, frequency of causative pathogens, and rates of spontaneous resolution, were based on the published literature.
T3911 690862-690935 Sentence denotes Those failing to improve after 5 days were switched to next line therapy.
T34963 690936-691094 Sentence denotes We analyzed claims data from 8 managed care organizations to estimate non-drug charges for initial and follow-up care, and applied a 60% cost-to-charge ratio.
T30039 691095-691194 Sentence denotes Drug costs were estimated using the wholesale acquisition cost plus $8 for overhead and dispensing.
T4819 691195-691236 Sentence denotes All costs were adjusted to year 2004 $US.
T68636 691237-691245 Sentence denotes Results:
T90648 691246-691367 Sentence denotes The model predicted the TEL/AMC/LEV strategy would result in 71.8% improving by 5 days compared to 65.4% for AZI/AMC/LEV.
T82611 691368-691430 Sentence denotes The telithromycin strategy had lower mean cost, $172 vs. $176.
T14024 691431-691608 Sentence denotes Although telithromycin cost more than azithromycin, the TEL/AMC/LEV strategy had slightly lower total drug costs ($95 vs $96) due to less need for additional antibiotic courses.
T68290 691609-691702 Sentence denotes Mean time to completion of therapy was 8.4 days for TEL/AMC/LEV and 9.1 days for AZI/AMC/LEV.
T98989 691703-691855 Sentence denotes Sensitivity analyses showed that TEL/AMC/LEV had superior health outcomes even when only 5% of in vitro resistant organisms were also resistant in vivo.
T1463 691856-692000 Sentence denotes TEL/AMC/LEV also had lower cost if at least 30% of cases were bacterial, or if in vitro resistant organisms were at least 30% resistant in vivo.
T4186 692001-692012 Sentence denotes Conclusion:
T81751 692013-692229 Sentence denotes Based on results obtained using this decision analytic model, initial treatment of mild acute rhinosinusitis with telithromycin may result in improved outcomes and lower cost than initial treatment with azithromycin.
T81245 692230-692340 Sentence denotes Rationale: "Delta crud" is the term used to describe rhinosinusitis syndromes in the Mississippi Delta region.
T15449 692341-692478 Sentence denotes Local perception is that it is associated with chemical crop dusting, regional produce, especially cotton, or high rates of mold allergy.
T91980 692479-692562 Sentence denotes The climate is extreme with mild winters, hot humid summers, and large volume rain.
T55706 692563-692653 Sentence denotes Thirty-five percent of inhabitants live below the poverty level, 62% are African American.
T92666 692654-692781 Sentence denotes Patients from the agriculturally intensive Delta suffer from asthma at almost twice the rate of those in the neighboring hills.
T21110 692782-692841 Sentence denotes Rates of pesticide use are among the highest in the nation.
T34310 692842-693057 Sentence denotes There are no prevalence estimates for rhinosinusitis in this region. "Delta Crud" is chronic in many patients with exacerbations occurring in the summer and fall, especially during chemical spraying and defoliation.
T17389 693058-693187 Sentence denotes We conducted this cross-sectional questionnaire based pilot study to begin characterization of rhinosinusitis in this population.
T90095 693188-693195 Sentence denotes Method:
T44670 693196-693448 Sentence denotes The Sinusitis Treatment Outcome Questionnaire, with two modifications, was given to consecutive patients presenting to the North Sunflower regional hospital ER and the Sunflower outpatient clinic one month prior to the beginning of summer crop dusting.
T95263 693449-693499 Sentence denotes The question, "Do you have Delta Crud?" was added.
T29978 693500-693549 Sentence denotes The survey was anonymous, allowing IRB exemption.
T94181 693550-693558 Sentence denotes RESULTS:
T66736 693559-693617 Sentence denotes 91 consecutive patients returned completed questionnaires.
T94338 693618-693658 Sentence denotes 46(50%) admitted to having "Delta Crud".
T26749 693659-693802 Sentence denotes Patients who claimed to have Delta Crud had significantly more sinus headache, nasal pruritus, conjunctivitis, and chest symptoms (see table) .
T97141 693803-693895 Sentence denotes There was no significant difference in antibiotic prescriptions, ER visits, and missed work.
T40711 693896-694017 Sentence denotes Six patients with Delta Crud had been hospitalized for "allergy reasons" compared with three patients without Delta Crud.
T67681 694018-694082 Sentence denotes Despite severe symptoms just 4 patients received sinus CT scans.
T86475 694083-694146 Sentence denotes Only 10/46 patients were prescribed intranasal corticosteroids.
T7690 694147-694158 Sentence denotes Conclusion:
T8119 694159-694299 Sentence denotes In our pilot study, the prevalence of chronic rhinosinusitis symptoms (Delta Crud) is 50%, with severe sinus, pulmonary and ocular symptoms.
T35434 694300-694391 Sentence denotes Evaluation and treatment may be suboptimal in this economically disadvantaged rural region.
T33387 694392-694553 Sentence denotes Further characterization of "delta crud", pollen counts, IgE mediated disease, environmental contributions and comparative studies of related regions are needed.
T45573 694554-694567 Sentence denotes Introduction:
T80935 694568-694642 Sentence denotes Patients with rhinitis commonly experience sinus pain and pressure (SP+P).
T15256 694643-694788 Sentence denotes Many patients with recurrent acute bacterial sinusitis (RABS) base the presence of a recurrence on the severity of SP+P and other nasal symptoms.
T54433 694789-695012 Sentence denotes The ability of patients to differentiate between rhinitis and RABS was evaluated by reviewing the subject screening logs of 4 previously reported clinical trials of Flonase (fluticasone propionate) Nasal Spray, 50 mcg (FP).
T62329 695013-695021 Sentence denotes Methods:
T22338 695022-695206 Sentence denotes The efficacy of FP was studied in two trials in subjects with SP+P due to allergic rhinitis and in two trials of subjects receiving cefuroxime axetil to treat an acute episode of RABS.
T20601 695207-695371 Sentence denotes SP+P screening logs were examined to determine how many subjects who thought they had SP+P were excluded from the study for an upper respiratory or sinus infection.
T35939 695372-695546 Sentence denotes RABS screening logs were examined to determine how many subjects with symptoms of an acute episode of RABS were excluded from the study for a negative sinus x-ray or CT scan.
T83463 695547-695656 Sentence denotes RABS symptoms experienced at the screening visit by subjects who qualified for the study were also evaluated.
T46642 695657-695665 Sentence denotes Results:
T52786 695666-695845 Sentence denotes Of 505 subjects screened in the SP+P studies, only 4 (0.8%) were excluded for evidence of sinus or upper respiratory tract infections, as clinically diagnosed by the investigator.
T44121 695846-695976 Sentence denotes Out of 1502 subjects with screening log data in the RABS studies, 649 (43.2%) were excluded for a negative sinus x-ray or CT scan.
T64514 695977-696213 Sentence denotes Of the 704 subjects who qualified for the RABS study, the most prevalent symptoms included nasal congestion (100%), mucopurulent discharge (97%), facial pain or tenderness in the sinus area (93%), sinus headache (90%) and malaise (90%).
T36314 696214-696247 Sentence denotes Only 15% of subjects had a fever.
T58249 696248-696381 Sentence denotes Only one symptom, nasal congestion, was rated by clinicians as severe for greater than 40% of subjects in either study (46% and 43%).
T58241 696382-696394 Sentence denotes Conclusions:
T73163 696395-696534 Sentence denotes While most subjects can determine when SP+P is due to allergic rhinitis, many cannot determine when symptoms progress to a sinus infection.
T39430 696535-696702 Sentence denotes Symptoms experienced by subjects with RABS were consistent with inflammation, but did not include fever as may be expected with an untreated bacterial sinus infection.
T40989 696703-696864 Sentence denotes Under appreciation by patients for the role of inflammation in sinus disease may result in over self-diagnosis of sinus infection and the demand for antibiotics.
T78410 696865-697032 Sentence denotes Liposomes are small particles consisting of lipid bilayer membranes, which are used to deliver drugs including amphotericin B, more efficiently and with less toxicity.
T85898 697033-697120 Sentence denotes Very few cases of allergy to liposomal amphotericin B (LAB) have been reported to date.
T44140 697121-697273 Sentence denotes Although there is a report on conventional amphotericin B (CAB) desensitization, to our knowledge no case of LAB desensitization has been described yet.
T68692 697274-697354 Sentence denotes A 75 y/o patient with lymphoma was treated with LAB for pulmonary aspergillosis.
T25938 697355-697505 Sentence denotes Within 30 minutes of infusion he developed urticaria, hypotension and tachycardia for which he was treated with the appropriate drugs for anaphylaxis.
T1337 697506-697588 Sentence denotes A second attempt to re administer LAB resulted in a similar anaphylactic reaction.
T22901 697589-697725 Sentence denotes Desensitization to LAB was then successfully completed using a modified protocol based on desensitization to CAB (JACI 1995; 96:425-7) :
T52800 697726-698100 Sentence denotes 0.0005 mg infusion over 10 minutes 0.005 mg infusion over 10 minutes 0.05 mg infusion over 10 minutes 0.5 mg infusion over 30 minutes 5 mg infusion over 30 minutes 50 mg infusion over 30 minutes 100 mg infusion over 30 minutes 200 mg infusion over 120 minutes Conclusion: desensitization to LAB, a lifesaving drug for invasive fungal diseases, can be performed successfully.