Allergy and asthma proceedings :
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Allergy Asthma Proc · Jan 2003
Comparative StudyProduction of TNF-alpha by peripheral blood mononuclear cells through activation of nuclear factor kappa B by specific allergen stimulation in patients with atopic asthma.
Stimulation by specific allergens induces inflammatory cytokine production from peripheral blood mononuclear cells (PBMCs) in patients with atopic asthma, but the mechanism remains unknown. PBMCs were collected from six patients with atopic asthma with an immunoglobulin E-radioallergosorbent test score to Dermatophagoides farinae of > or = 4 and six nonatopic healthy subjects (score = 0) using a dish adhesion method after density gradient centrifugation. CD23 expression in PBMCs was analyzed by the fluorescence-activated cell sorting method. ⋯ A significant translocation of NF-kappa B to nuclei by D. farinae stimulation was observed in cells from subjects with asthma (p < 0.01). Our results indicated that TNF-alpha production was induced by D. farinae in PBMCs of patients with atopic asthma by the activation of NF-kappa B via CD23. In patients with atopic asthma, CD23-mediated signals may cause proinflammatory cytokine production, which may lead to airway inflammation.
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Urticaria and angioedema evoke a completely different differential diagnosis from angioedema without an associated urticarial syndrome. This review of the literature is to give the reader a global insight into the spectrum of urticaria and angioedema, focusing on differential diagnosis and pathogenic mechanisms. ⋯ Urticaria and angioedema are frustrating problems for both physicians and their patients; however, the problem can best be approached by considering urticaria as a symptom rather than a specific disease. The physical examination and medical history remain the two most important pieces of information.
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Allergy Asthma Proc · May 2002
Randomized Controlled Trial Comparative Study Clinical TrialFurosemide plus albuterol compared with albuterol alone in children with acute asthma.
Several reports have shown that inhaled furosemide protects patients with asthma from different bronchoconstrictor agents. However, the effect of this widely used diuretic in acute exacerbation in adults is unproven. There are no reports of furosemide's therapeutic effect in acute asthma in children; thus, the objective of this study was to determine the effectiveness of the combined treatment of furosemide and albuterol in pediatric patients. ⋯ An increase in FEV1 of 22.8 +/- 4.3% (mean +/- SE) in the drug combination group was noted at 60 minutes, and an increase in FEV1 of 18.0 +/- 2.6% in the albuterol group was obtained at the same time. Although the increase in FEV1 was greater in the first group after 1 hour of treatment, this was not significant. These results suggest that inhaled furosemide does not have a synergistic effect with albuterol in the treatment of asthmatic exacerbations in children.
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Allergic rhinitis is a common allergic condition. There are a variety of pharmacologic treatments, including antihistamines, oral decongestants, and intranasal corticosteroids. Leukotrienes cause significant nasal obstruction. ⋯ Similar to antihistamines, antileukotrienes appear to be less efficacious than nasal corticosteroids. Combination therapy of histamine and leukotriene antagonists produces symptomatic improvement as well as improved quality of life. Areas of study for combination antimediator therapy include expanding the initial findings with regard to nasal steroids, investigation of patient preference and compliance, use in perennial allergic rhinitis, and treatment of "one airway," i.e., treatment of concurrent allergic rhinitis and asthma.
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Allergy Asthma Proc · Jan 2002
Review Case ReportsPsychogenic cough in adults: a report of two cases and review of the literature.
Psychogenic cough, also known as "habit cough," is a well-documented condition in the pediatric and adolescent population, with numerous cases reported in the medical literature. Many of these patients are strikingly similar in their clinical characteristics and, although the data are limited, a variety of treatment options may be successful in terminating this form of cough. However, psychogenic cough in adults has been reported infrequently and is less well defined. ⋯ One case is unique in the sense that the cough responded to a distracter in the form of a throat lozenge, and this patient consumed > or = 20 lozenges/day for approximately 13 years. Psychogenic cough should be considered in adult patients who present with a chronic cough of no obvious organic basis that has failed therapy directed at postnasal drip, asthma, and gastroesophageal reflux. We propose criteria to assist in making a diagnosis of psychogenic cough in adult patients and review the limited information that exists concerning treatment modalities.