Allergy and asthma proceedings :
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Allergy Asthma Proc · Nov 2010
Randomized Controlled Trial Multicenter StudyNebulized dehydroepiandrosterone-3-sulfate improves asthma control in the moderate-to-severe asthma results of a 6-week, randomized, double-blind, placebo-controlled study.
Inhaled dehydroepiandrosterone-3-sulfate (DHEAS), but not dehydroepiandrosterone (DHEA), possesses anti-inflammatory activity in in vitro assays and in models of allergen and lipopolysaccharide challenges. We postulated whether an inhaled suspension of DHEAS delivered via nebulizer would improve asthma control in moderate-to-severe asthma patients. We also characterized the safety profile of an inhaled suspension of DHEAS. ⋯ AUSTRALIAN NEW ZEALAND CLINICAL TRIALS REGISTRY ANZCTR. ORG. AU IDENTIFIER: 012607000192482.
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Since June 4, 2004, asthma diagnosed and symptomatic after the age of 12 years has been an exclusion criterion for military enlistment unless exempted via medical waiver. The Department of Defense determined that 13% of U. S. ⋯ These associations persist when stratified by gender and age group. Deployment to Iraq and Afghanistan is associated with new-onset asthma. Etiologic studies, surveillance, incidence, epidemiology, and assessing response to therapy are recommended.
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Allergy Asthma Proc · Jul 2010
ReviewThe usefulness of biomarkers of airway inflammation in managing asthma.
The goal of managing asthma is to maintain disease control. Current approaches to assessment of control do not include measurement of airway inflammation. This study was designed to assess the usefulness of biomarkers of airway inflammation in guiding asthma management decisions. ⋯ Data on the analysis of exhaled breath condensate have not yet been studied adequately in guiding management decisions. Enumeration of sputum cell counts appears to be the most useful biomarker of airway inflammation in guiding asthma management decisions. Combined approaches using simple methods of measuring airway hyperreactivity and obtaining sputum samples hold promise for the future, particularly if rapid analysis of cellular products in sputum can be developed.
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Allergy Asthma Proc · Jul 2010
Repeat epinephrine treatments for food-related allergic reactions that present to the emergency department.
To date, there are sparse data on epinephrine treatment for food-related anaphylaxis in adults. We sought to establish the frequency of more than one epinephrine treatment for adult patients who present with food-related anaphylaxis to the emergency department (ED). We performed a chart review, at two academic centers, of all adults presenting to the ED for food allergy (ICD9CM codes 693.1, 995.0, 995.1, 995.3, 995.7, 995.60-995.69, 558.3, 692.5, and 708. ⋯ At ED discharge (82% of patients), 18% were referred to an allergist and 39% were prescribed self-injectable epinephrine. Among ED patients with food-related anaphylaxis treated with epinephrine, 17% were given >1 dose. This study supports the recommendation that patients at risk for food-related anaphylaxis should carry 2 doses of epinephrine.
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Allergy Asthma Proc · May 2010
ReviewBudesonide/formoterol pressurized metered-dose inhaler for patients with persistent asthma.
The combination of budesonide and formoterol administered in one hydrofluoroalkane pressurized metered-dose inhaler (pMDI) is approved in the United States in two dosage strengths (budesonide/formoterol pMDI 80/4.5 microg x 2 inhalations [160/9 microg] or 160/4.5 microg x 2 inhalations [320/9 microg]) in a fixed-dose, twice-daily regimen for the treatment of patients > or =12 years old with persistent asthma not adequately controlled with an inhaled corticosteroid (ICS) alone. This article reviews the clinical profile of budesonide/formoterol pMDI in patients with persistent asthma, including information on pharmacogenetics, efficacy, and tolerability. Studies of budesonide/formoterol pMDI in patients with asthma were identified through PubMed and respiratory meeting abstract databases. ⋯ Short-term (12-week) and long-term (6- to 12-month) studies have established greater efficacy and similar tolerability of budesonide/formoterol pMDI compared with its monocomponents and placebo in patients with mild/moderate or moderate/severe persistent asthma. Studies evaluating patient-reported outcomes, including health-related quality of life and patient satisfaction with treatment, further support the benefits of budesonide/formoterol pMDI in patients with persistent asthma. In summary, budesonide/formoterol pMDI is an effective, well-tolerated treatment option for patients with persistent asthma for whom ICS/long-acting beta2-adrenergic agonist combination therapy is appropriate.