Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology
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Ann. Allergy Asthma Immunol. · Jun 2020
Review Meta AnalysisMaking the GRADE in anaphylaxis management: Toward recommendations integrating values, preferences, context, and shared decision making.
To review GRADE (Grading of Recommendations Assessment, Development, and Evaluation) methods and discuss the clinical application of conditional recommendations in clinical guidelines, specifically in the context of anaphylaxis. ⋯ Clinical guidelines provide an important opportunity to critically appraise evidence and translate evidence to practice. Patients, practitioners, and policy makers should appreciate the strength of recommendation and certainty of evidence and understand how this affects guideline applicability and implementation.
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Ann. Allergy Asthma Immunol. · Jul 2016
Review Meta AnalysisA systematic review of epinephrine degradation with exposure to excessive heat or cold.
Epinephrine is a lifesaving drug in the treatment of anaphylaxis and cardiac resuscitation. Current US storage recommendations are for controlled room temperature (20°C-25°C), with excursions permitted from 15°C to 30°C. Maintaining epinephrine within this required range is challenging, particularly for patients carrying autoinjectors and during storage in emergency vehicles. ⋯ Temperature excursions in real-world conditions may be less detrimental than previously suggested. Freezing and limited heat excursions did not result in epinephrine degradation. Refrigeration of epinephrine appears to reduce degradation. However, the effect of extreme temperatures, particularly freezing, on autoinjectors is not sufficiently well established. More research in needed at clinically relevant high temperatures, with limited exposure to heat, and involving autoinjector devices.
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Ann. Allergy Asthma Immunol. · Jun 2016
Review Meta AnalysisOnce-daily fluticasone furoate and vilanterol for adolescents and adults with symptomatic asthma: A systematic review with meta-analysis.
Fluticasone furoate and vilanterol is a new inhaled corticosteroid (ICS) and long-acting β2-agonist (LABA) combination developed for once-daily administration via a dry powder inhaler. ⋯ Fluticasone furoate-vilanterol combination was associated with an increase in trough FEV1 compared with fluticasone furoate-fluticasone propionate; however, observed differences may not be clinically significant. Studies comparing fluticasone furoate-vilanterol with fixed twice-daily ICS-LABA combinations are required.
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Ann. Allergy Asthma Immunol. · Jun 2014
Review Meta AnalysisYoga for asthma: a systematic review and meta-analysis.
Although yoga is frequently used by patients with asthma, its efficacy in alleviating asthma remains unclear. ⋯ Yoga cannot be considered a routine intervention for asthmatic patients at this point. It can be considered an ancillary intervention or an alternative to breathing exercises for asthma patients interested in complementary interventions.