Allergy and asthma proceedings :
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Allergy Asthma Proc · Mar 2005
Adverse drug reactions to a cephalosporins in hospitalized patients with a history of penicillin allergy.
Estimates on the cross-reactivity between cephalosporin and penicillin range from 1 to 16%. Patients with a history of penicillin allergy usually receive less optimal and more costly alternatives even if cephalosporins are a more viable alternative. One hundred eighty-six patients admitted to Winthrop University Hospital in a 7.5-month period, who reported penicillin allergy and received cephalosporin, were sent surveys. ⋯ Penicillin-allergic patients who receive second-generation cephalosporins, especially those with an amino benzyl side chain, are more likely to develop a reaction to cephalosporin. Although the incidence of reactions to cephalosporin in penicillin-allergic patients is low, those patients who reacted had more severe manifestations including anaphylaxis. Thus, continued caution regarding administration of cephalosporin, especially those with amino benzyl side chains, to patients who have a definite history of an immediate reaction to penicillin is advised.
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Allergy Asthma Proc · Nov 2004
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialPairwise comparison of levalbuterol versus racemic albuterol in the treatment of moderate-to-severe asthma.
The object of this study is a post hoc pairwise comparison of levalbuterol versus racemic albuterol for asthma in a multicenter, double-blind, randomized, placebo-controlled clinical trial. The participants are patients > or =12 years of age (n = 362) with FEV1 45-70% of predicted. The patients received nebulized levalbuterol (0.63 or 1.25 mg), racemic albuterol (1.25 or 2.5 mg), or placebo t.i.d. for 4 weeks. ⋯ Active treatment groups demonstrated significant improvements compared with the placebo group (p < 0.05), except for AUC FEV1 in the racemic albuterol 1.25-mg group at week 4. Levalbuterol in the absence of the (S)-isomer provided greater bronchodilation than the same quantity of (R)-albuterol delivered as the racemate. These data suggest that (S)-albuterol may compromise the efficacy of (R)-albuterol.
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Allergy Asthma Proc · Nov 2004
Practice Guideline GuidelineOptimizing childhood asthma management: the role of national institutes of health-sponsored study groups.
Advances in the National Institutes of Health (NIH)-sponsored guidelines for asthma management result in part from how these guidelines serve as a target for improvement. Taking this perspective, we can ask what features of the guidelines are of central importance but are inadequately understood? What features are difficult to implement and would benefit from a major advance in our approach? One effort to further such advancements also comes from the NIH through their support of childhood asthma study groups that aim to improve childhood asthma management. ⋯ The main objective of this article is to provide some insight to these NIH-supported childhood asthma study groups and their recently completed or ongoing studies. This should provide an understanding of the strengths of these initiatives, their contribution to the evidence basis that is a cornerstone of optimal management, and the current main themes in these efforts to improve and advance childhood asthma management.
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Allergy Asthma Proc · Sep 2004
Low incidence of complications in asthmatic patients treated with preoperative corticosteroids.
The purpose of this study is to establish the incidence of perioperative complications in asthmatic patients treated with preoperative corticosteroids and to compare these rates to the general surgical population at the same hospital. Using a retrospective cohort design, we studied 172 patients who underwent 249 procedures at our hospital between 1986 and 2002. Preoperative corticosteroids were administered in 240 of the procedures. ⋯ One death occurred intraoperatively as a result of a neurosurgical complication. There was no statistical difference in the incidence of infections between our asthma population and the general surgical population in the same hospital except in gynecologic procedures. We conclude that asthmatic patients who are treated with corticosteroids before undergoing surgery have a low incidence of complications.
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Allergy Asthma Proc · Sep 2004
IgE antithyroid antibodies in patients with Hashimoto's disease and chronic urticaria.
Although chronic urticaria may be associated with the presence of serum anti-thyroid antibodies, it is not known whether these antibodies play a causal role in the urticaria. We therefore sought to determine whether the anti-thyroid antibodies seen in patients with urticaria were of the IgE class. ⋯ Only 2 of 20 patients with urticaria and IgG anti-thyroid antibodies had detectable IgE anti-thyroid antibodies: 1 patient had anti-thyroid peroxidase IgE antibody and 1 patient had anti-thyroglobulin IgE. IgE anti-thyroid antibodies do not appear to play a causal role in urticaria in the majority of patients.