Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology
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Ann. Allergy Asthma Immunol. · Oct 2006
Case ReportsPostoperative ST-segment elevation: was vasospasm caused by anaphylaxis or by its treatment with epinephrine?
Anaphylaxis must be recognized and treated promptly to avoid significant morbidity and mortality. In this clinical setting, electrocardiographic changes can be multifactorial. ⋯ Cardiovascular complications, including electrocardiographic changes, may be induced by anaphylactic mediators or by medications used for its treatment.
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Ann. Allergy Asthma Immunol. · Sep 2006
ReviewPathogenesis and recent therapeutic trends in Stevens-Johnson syndrome and toxic epidermal necrolysis.
To review the current pathophysiologic mechanisms and recent therapeutic trends in Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). ⋯ Both IVIG and cyclosporine have been associated with enhanced healing and better survival through inhibition of apoptosis. Multicenter, randomized, placebo-controlled trials using a standardized design are needed to validate these findings.
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Ann. Allergy Asthma Immunol. · Sep 2006
ReviewUse of the health plan employer data and information set for measuring and improving the quality of asthma care.
To discuss the Health Plan Employer Data and Information Set (HEDIS) criteria for measuring performance in asthma care and to review new strategies to improve the quality of asthma care. ⋯ The HEDIS asthma measure remains the most widely used performance tool for evaluating the quality of asthma care. Reimbursement models based on public reporting and pay for performance are expected to be a strong component of future health care payment systems.
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Ann. Allergy Asthma Immunol. · Aug 2006
Disparities in the use of urgent health care services among asthmatic children.
Urgent care composes one third of the total costs associated with asthma. Asthmatic children of African American and Latino backgrounds have higher rates of emergency department (ED) use and hospitalizations than white children, especially in urban settings. ⋯ There is a failure in asthma management in this urban population, demonstrated by the finding that almost half of all current asthmatic patients used urgent care. After controlling for different socioeconomic and disease-related factors, minority race/ethnicity, low household income, and frequent evening symptoms were found to be strong predictors of urgent care utilization. Insurance status, delaying care for any reason, and use of controller medications were found not to be associated with urgent care use.
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Ann. Allergy Asthma Immunol. · Jul 2006
Relationship between childhood atopy and wheeze: what mediates wheezing in atopic phenotypes?
The nature of the relationship between childhood wheeze and atopy remains uncertain. ⋯ In many respects, chronic childhood atopy is the atopic phenotype associated with the most significant forms of childhood wheezing. In such children, heritable drive, allergens, and synergy with other environmental triggers seem to be crucial determinants of wheeze onset. Where such sensitization is absent, numerous environmental factors plus genetic predisposition may assume importance for wheezing.