Current opinion in allergy and clinical immunology
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Curr Opin Allergy Clin Immunol · Apr 2009
ReviewInduced sputum and occupational diseases other than asthma.
Induced sputum noninvasively provides information on cellular and soluble material from airways. It has been successfully applied for assessing airway inflammation in asthma and chronic obstructive pulmonary disease, producing reliable results comparable to biopsy and bronchoalveolar lavage. Induced sputum research in the field of occupational medicine has mainly focused upon occupational asthma, and less to other types of occupational diseases. ⋯ Induced sputum is a well tolerated, noninvasive technique that is opening a new window in the field of occupational diseases of the lung and can be integrated into the well established criteria for diagnosing and monitoring these diseases, especially when invasive techniques are clinically contraindicated or impractical.
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The collection of exhaled breath condensate (EBC) is a noninvasive method for evaluation of airway inflammation. This article reviews recent data concerning the ability of EBC markers to reflect alterations in asthma and chronic obstructive pulmonary disease or environment and occupation-induced changes. ⋯ EBC might be of particular interest in preventive medicine as inflammatory processes triggered may precede changes in lung function. Robust and easy-to-handle condensing devices and analytical methods are warranted to spread the use of EBC.
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Curr Opin Allergy Clin Immunol · Feb 2009
ReviewRisk factors and treatment for obstructive sleep apnea amongst obese children and adults.
The purpose of this review is to summarize the evidence for the association between obesity and obstructive sleep apnea (OSA), as well as predisposing risk factors and treatment strategies for OSA amongst obese patients. ⋯ In view of recent findings, a direct association between body mass and upper airway obstruction should be viewed with caution. Obesity may play a more significant role in the predisposition to OSA amongst particular subgroups of the population, such as adults, and those with particular craniofacial and upper airway morphology. Healthcare prioritization and requirements may be more substantial for such groups. Further, commonly used treatment methods for OSA (such as adenotonsillectomy for children and continuous positive airway pressure for adults) may be less effective for obese individuals. Weight-reduction strategies appear important for an optimal outcome, and such strategies may be more or less invasive depending on the severity of obesity, OSA or both, and other patient complications.
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The purpose of this review is to summarize new interesting findings in both research and clinical practice of nonhymenoptera anaphylaxis with particular emphasis on food and drug allergy. ⋯ In food-related anaphylaxis, prospectively evaluated marker allergens that are indicative of a potential anaphylactic reaction are still lacking. The drug groups covered in this review are of special interest either due to their prominent role as allergens or due to new findings.
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Imported fire ants pose a real and present danger to allergic individuals living in endemic areas. This overview examines the impact of their presence, specifics of their venom and approach to the treatment of the hypersensitive individuals. ⋯ Recent work has focused on achieving more rapid protection in hypersensitive patients given the high sting attack rates in endemic area with sensitization occurring early in life among those exposed to the imported fire ant.