The journal of allergy and clinical immunology. In practice
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J Allergy Clin Immunol Pract · May 2014
A multifaceted intervention for patients with anaphylaxis increases epinephrine use in adult emergency department.
Studies have documented inconsistent emergency anaphylaxis care and low compliance with published guidelines. ⋯ Significantly higher proportions of patients with anaphylaxis received epinephrine and were admitted to the ED observation unit after introduction of epinephrine autoinjectors and order set implementation. Slightly more than half of the biphasic reactions occurred within the recommended observation time of 4 to 6 hours. Analysis of these data suggests that the multifaceted approach to changing anaphylaxis management described here improved guideline adherence.
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J Allergy Clin Immunol Pract · Mar 2014
Validation of parental reports of asthma trajectory, burden, and risk by using the pediatric asthma control and communication instrument.
Despite a growing interest, few pediatric asthma questionnaires assess multiple dimensions of asthma morbidity, as recommended by national asthma guidelines, or use patient-reported outcomes. ⋯ PACCI Direction, Bother, and Risk are valid measures of parent-reported outcomes and show good discriminative validity. The PACCI is a simple clinical tool to assess multiple dimensions of parent-reported asthma morbidity, in addition to risk and control.
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J Allergy Clin Immunol Pract · Mar 2014
Alcohol-induced respiratory symptoms are common in patients with aspirin exacerbated respiratory disease.
A large percentage of patients with aspirin exacerbated respiratory disease (AERD) report the development of alcohol-induced respiratory reactions, but the true prevalence of respiratory reactions caused by alcoholic beverages in these patients was not known. ⋯ Alcohol ingestion causes respiratory reactions in the majority of patients with AERD, and clinicians should be aware that these alcohol-induced reactions are significantly more common in AERD than in controls who are aspirin tolerant.
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J Allergy Clin Immunol Pract · Jan 2014
Accountable care organizations and the allergist: challenges and opportunities.
For decades, health care policy experts have wrestled with ways to solve problems of access, cost, and quality in US health care. The current consensus is that the solution to all three lies in changing financial incentives for providers and delivering care through integrated systems. The currently favored vehicle for this, both in the public and private sectors, is through Accountable Care Organizations (ACOs). ⋯ Allergists can and should be part of the process of this transformation in our health care system. They can be integral to helping these organizations save money by reducing hospitalizations and improving the quality of allergy and asthma care in the populations served. In order to accomplish this, allergists must become more involved in their medical communities and hospitals.
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J Allergy Clin Immunol Pract · Jan 2014
Multicenter StudyOral immunotherapy for peanut allergy: multipractice experience with epinephrine-treated reactions.
Peanut allergy creates the risk of life-threatening anaphylaxis that can disrupt psychosocial development and family life. The avoidance management strategy often fails to prevent anaphylaxis and may contribute to social dysfunction. Peanut oral immunotherapy may address these problems, but there are safety concerns regarding implementation in clinical practice. ⋯ Peanut oral immunotherapy carries a risk of systemic reactions. In the context of oral immunotherapy, those reactions were recognized and treated promptly. Peanut oral immunotherapy may be a suitable therapy for patients managed by qualified allergists/immunologists.