Panminerva medica
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Asthma and allergic rhinitis are common conditions that have a substantial impact on patient quality of life, severely disrupting physical, emotional and social functioning. These diseases share many pathophysiological characteristics and recent research has provided evidence that a strong causal relationship exists between allergy and both asthma and allergic rhinitis. As a root cause of allergic diseases of the airways, immunoglobulin E (IgE) represents an appropriate target for the development of new therapies. ⋯ Omalizumab significantly improved disease symptoms and reduced the use of rescue antihistamines. In patients with concomitant asthma and perennial allergic rhinitis, omaliuzumab significantly prevented asthma exacerbations and improved quality of life compared with placebo. Taken together, these results suggest that omalizumab represents an important clinical advance in the management of allergic disease.
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Hematopoietic stem cell transplantation has become increasingly important in the treatment of hematologic malignancies over the past 20 years. While it is associated with significant morbidity, it offers the only chance of cure in many circumstances. ⋯ Timing of transplantation and selection of patients are also discussed. New innovations in stem cell transplantation including umbilical cord blood and non-myeloablative transplantation are reviewed.
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Review
Management of treatment resistant obsessive-compulsive disorder. Algorithms for pharmacotherapy.
Treatment resistant OCD subjects, defined as those patients who undergo an adequate trial of SRI (clomipramine or SSRI) and do not respond or show unsatisfactory results, account for 40-50% of all patients. Once the appropriateness of the trial has been assessed, several options exist for the clinicians. If clomipramine or citalopram have been used, an appropriate strategy consists in giving the same drug intravenously. ⋯ An unresolved question is whether augmentation should be preferred to switching. No data exist in OCD; a practical approach would suggest augmentation first, considering that response should be obtained faster than by switching compound. When all the available and effective strategies prove uneffective, clinicians should consider switching the patient to other compounds in monotherapy, such as venlafaxine, sumatriptan, inositol, although research is strongly needed before conclusions on the efficacy of such compounds can be drawn.
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Case Reports
A case of Sweet's syndrome associated with monoclonal immunoglobulin of IgG-lambada type and p-ANCA positivity.
We report a case of Sweet's syndrome associated with monoclonal gammopathy of uncertain significance (MGUS) and positivity for perinuclear antineutrophil cytoplasmic antibodies (p-ANCA). A 65-year-old man patient came to our hospital complaining of remittent-intermittent fever, weight loss, associated with papules affecting all his body and without mucosal or ocular involvement. ⋯ This is the first case of this rare syndrome associated both with MGUS and p-ANCA positivity. The monoclonal immunoglobulin, possibly directed to neutrophils like an antibody, may cause both their fragmentation and release of antigens responsible of p-ANCA appearance.
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Comparative Study
Food and headache attacks. A comparison of patients with migraine and tension-type headache.
The role of foods as headache precipitants is still matter of debate. Several studies reported that dietary constituents may precipitate migraine attacks. Some authors reported that also tension type headache attacks may be provoked by foods. The purpose of this study was to evaluate the role of foods as headache triggers in both groups of patients. ⋯ Our study suggests that foods may trigger not only migraine but also tension type headache attacks.