Current opinion in allergy and clinical immunology
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Curr Opin Allergy Clin Immunol · Feb 2007
ReviewA review of voice and upper airway function in chronic cough and paradoxical vocal cord movement.
Chronic cough and paradoxical vocal fold movement (PVFM) are perplexing conditions. This paper reviews the recent literature in relation to the nature of PVFM and chronic cough and the management of symptoms associated with these disorders. ⋯ Chronic cough and PVFM manifest in a range of clinically significant voice and upper airway symptoms. The anatomic diagnostic protocol used in the management of chronic cough could be expanded to include PVFM as a potential cause of cough, and speech pathology intervention as treatment for chronic cough.
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Curr Opin Allergy Clin Immunol · Feb 2007
ReviewUse of diagnostic algorithms and new technologies to study the incidence and prevalence of viral upper respiratory tract infections and their complications in high risk populations.
Most studies on the natural history of viral upper respiratory tract infections and their complications rely for ascertainment on self-assessed cold/flu illness or the identification of presumed complications. The criteria for cold/flu definition, however, are variable within and between individuals and illness is not prerequisite for a viral upper respiratory tract infection. These factors bias estimates of the incidence and prevalence of viral upper respiratory tract infections and their complications. Here we review new methodologies that can be adapted for use in future studies to refine those estimates. ⋯ The methodologies and sampling strategies that we describe hold promise for better characterizing the incidence of complications for symptomatic and asymptomatic expressions of a viral upper respiratory tract infection caused by specific viruses. These data can then be used to estimate the efficacy and efficiency in a specified target population of prophylactic or intercurrent treatments to prevent the complications.
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Curr Opin Allergy Clin Immunol · Dec 2006
ReviewHemophagocytic lymphohistiocytosis and related disorders.
The rate of diagnosis of hemophagocytic lymphohistiocytosis, a genetically heterogeneous and, frequently, rapidly fatal autosomal recessive disorder of immune regulation, is increasing worldwide. Awareness has grown through the Histiocyte Society and the publication of newly-recognized genetic causes. I summarize current knowledge regarding the pathophysiology, diagnosis and treatment of hemophagocytic lymphohistiocytosis. ⋯ Bench and clinical research have advanced understanding of the pathophysiology of hemophagocytic lymphohistiocytosis and related disorders, and significantly improved clinical outcomes during the past decade.
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Curr Opin Allergy Clin Immunol · Aug 2006
ReviewRapid desensitization for hypersensitivity reactions to chemotherapy agents.
Hypersensitivity reactions (HSRs) to chemotherapy agents have limited their use for fear of inducing severe reactions or death. Alternative regimens may be limited by tumor sensitivity and the need to provide first-line therapy. Rapid desensitizations allow patients to be treated with medications to which they have presented a HSR. The purpose of this review is to highlight the indications and recent developments in chemotherapy rapid desensitization protocols. ⋯ The use of rapid desensitization protocols for cancer patients with HSRs to chemotherapy depends on their demonstrated tolerability and efficacy in selected populations. Education of nurses, pharmacists, and oncology and allergy specialists is needed to improve their universal application as standard of care.