ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1996.tb04611.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1996.tb04612.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

A double‐blind, placebo‐controlled study was carried out to test the clinical efficacy and safety of local nasal immunotherapy (LNIT) in powder form. Twenty‐two patients suffering from allergic rhinitis strictly associated with early spring symptoms, with positive skin prick tests and RAST for birch‐alder, all responders to a specific nasal provocation test (NPT), received randomly active or placebo treatment for 4 months. Immunotherapy consisted of administration of a set of capsules containing progressively increasing amounts of birch (Betuh pendula) and speckled alder (Alnus incana) allergens in powder form with controlled granulometry. The active (birch‐alder) and placebo (lactose) group completed the treatment according to a similar schedule. During the pollen season (March‐April), the patients who took the active treatment reported less sneezing and rhinorrhea than the placebo group, on the basis of a symptoms score, and the differences were statistically significant; the need for drugs (terfenadine) was also significantly reduced. These findings agreed well with the results of specific NPT after the treatment; only patients in the active group had a higher threshold dose of nasal specific reactivity to birch‐alder allergens than in tests be

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1996.tb04613.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

B‐cell epitopes of bovine αs1‐casein, one of the major allergens of cow's milk, were identified by a screening method based on synthetic peptides. According to the known amino acid sequence of αs1‐casein, a set of 188 overlapping sequential decapeptides shifted by one amino acid was manually synthesized on polyethylene pins by the 9‐fluorenyl‐methoxycarbonyl (Fmoc) method. Peptides were screened by an enzyme‐linked immunosorbent assay (ELISA) specific for human IgE and IgG. Bound antibodies were detected by successive incubation with up to three polyclonal antibodies, the last one conjugated to horseradish peroxidase. Tested sera were from 15 patients with acute clinical reactions to cow's milk and IgE‐specific reactions to bovine a‐casein in the ELISA and immunoblot. Sera from 10 healthy subjects without remarkable reactions to cow's milk proteins were used as controls. All sera from allergic subjects showed reactions with three regions of αs1‐casein, corresponding to amino acids 19–30, 93–98, and 141–150. Furthermore, individual sera showed reactions with other parts of the protein. No essential differences in the epitope specificity of IgE and 1gG were found. Inhibition of IgE binding to αs1‐casein with soluble synthetic peptides confirmed the results and revealed peptide CN

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1996.tb04614.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

The aims of the present study were as follows:1). to evaluate the medical outcomes of two treatment and educational asthma programs2). to determine by cost‐analysis both cost and economic outcome of the programs3). to perform a cost‐benefit analysis (determining the net cost‐benefit) and a cost‐effectiveness analysis (determining the cost per unit of effect and the incremental cost‐effectiveness ratio) from the perspective of health program policy makers (HPP; indirect costs, i.e., loss of productivity, excluded) and of society as a whole (Saw; all costs included).Patients were randomly assigned to a complete (CP;n =32) or reduced (RP; n = 33) program: the RP group received a reduced education (self‐reading of an educational booklet on asthma), while the CP group attended an “asthma school”, consisting of six lessons based on the same booklet and including educational videotapes. Both programs included peak‐flow monitoring and treatment according to international guidelines, and follow‐up. The outcome variables (asthma attacks, urgent medical examinations, admission days, working days lost) did not differ significantly between CP and RP. Morbidity savings were $1894.70 (CP) and $1697.80 (RP) according to Saw, and $1349.50 and $1301.80, respectively, according to HPP. The net cost‐benefit was $1181.50 for CP and $1028.00 for RP, and the cost‐benefit ratio per dollar spent was 1:2.6 for CP and 1:2.5 for RP, according to Saw. One day of admission prevented had a cost of $110.20 (CP) and $94.10 (RP). CP gave slightly better results and was slightly more cost‐effective than RP in improving patients' welfare. It cannot be excluded that the retrospective analysis used to determine baseline costs might have inflated differences for both groups. Sensitivity analysis was slightly in favor of RP when the outcome variables were tested

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1996.tb04615.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

A two‐centre, double‐blind, randomized, placebo (P)‐controlled, parallel‐group study was conducted in the UK to examine the efficacy and safety of mizolastine (M), a new HI‐receptor antagonist, as a once‐daily 10‐g dose in chronic idiopathic urticaria. Fifty‐six outpatients (M:n= 28; P:n= 28) with a mean age of 38 ± 15 years, a duration of disease of more than 3 years, and symptoms of urticaria at least twice a week in the absence of treatment were recruited. After a single‐blind placebo run‐in period, patients were allocated to one of two treatment groups and were evaluated after 7 and 28 days. The main characteristics (age, duration of disease, number of urticarial episodes, and total score) of the two groups were comparable at inclusion. Mizolastine was shown to improve the urticaria symptoms: at the end of the study, mizolastine produced a significantly greater decrease in the global symptom score comprising itch, wheals, and erythema (M: 2.1 ± 2.1 vs P: 0.4 ± 2.0; P = 0.002). The patient‐rated global discomfort from symptoms measured by visual analog scale was significantly improved with mizolastine (M: 31.4 ± 36.7) compared to placebo (P: 5.4 ± 27.6; P = 0.003), with respectively more M responders (74.1%) than P responders (28.6%, P = 0.00l), a responder being a patient with a ± 50% decrease in VAS. Premature dropouts due to lack of efficacy and loss to follow‐up mainly occurred at the first evaluation (day 7) and were more often observed in patients in the placebo group (n= 17) than in the mizolastine group (n= 8) (P= 0.031). No serious adverse events were recorded. Somnolence was reported in two mizolastine patients, one of whom discontinued the study. Thus, mizolastine may be considered a new treatment option for the

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1996.tb04616.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Fourteen bakers suffering from workplace‐related respiratory symptoms and sensitized to soybean were studied. Twelve of them were also allergic to wheat flour, 10 to rye flour, and five to α‐amylase ofAspergillus oryzae(Asp o 2). IgE estimation by RAST strongly indicated that the trypsin inhibitor and lipoxidase are major allergens of soybean. Various allergenic components could be characterized by immunoblotting after two‐dimensional electrophoresis. Our RAST and immunoblotting results show an interindividually different allergic response to inhalative soybean constituents, and that the trypsin inhibitor (20 kDa, pI˜4.5) is an important inhalative soybean allergen recognized by IgE antibodies in the sera of 86% of the examined sensitized

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1996.tb04617.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

The prevalence of atopy and related diseases is lower among children in Eastern European countries than in countries with a market economy. Such comparisons have not been made in adults. The European Community Respiratory Health Survey (ECRHS) postal questionnaire was mailed to random samples of 3000 inhabitants in Tartu, Estonia, and 3600 in Uppsala, Sweden, between the ages of 20 and 44 years. Asthmatic symptoms (wheeze with breathlessness occurring in the absence of colds) were less prevalent in Tartu (4.6% vs 6.8%,P<0.001), as were attacks of asthma (1.9% vs 3.3%,P<0.01), current asthma medication (0.7% vs 4.9%), and allergic rhinitis (17.8% vs 22.2%,P<0.001). Age was inversely related to allergic rhinitis in Uppsala (P<0.05), but not in Tartu. Nocturnal respiratory symptoms (wakening with chest tightness or being woken by an attack of breathlessness or an attack of cough) were more prevalent in Tartu (P<0.001), and their prevalence increased with age (P<0.05) in Tartu, but not in Uppsala. Symptoms of asthma and hay fever were less common but other respiratory problems more common in Tartu than in Uppsala. The difference in the prevalence of hay fever diminished with age, supporting the notion that the increasing prevalence of allergy among children and young adults in Western Europe is caused by a cohort effect.

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1996.tb04618.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

This report deals with clinical and immunologic studies in a butcher with work‐related asthma. Both the positive methacholine inhalation test and the significant changes observed in PEFR measurements supported the diagnosis of asthma. The significant fall observed in PEFR measurements when the patient handled aniseed supported the diagnosis of occupationa asthma. Skin prick tests carried out with 13 spices showed positive reactions only to aniseed extract. The patient had high levels of specific antianiseed IgE antibodies. The bronchial challenge test with an aniseed extract showed an immediate response without a late response. These findings suggest that the respiratory symptoms in our patient were induced by the inhalation of aniseed dust through an IgE‐mediated immunologic mechanism of immediate hypersensitivity. This study established the diagnosis of occupational asthma from aniseed dust sensitizat

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1996.tb04619.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Drug‐induced erythema multiforme is reported with many antimicrobial and antipyretic medications. We present one patient who experienced erythema multiforme and urticaria after administration of pyrazinamide for treatment of cutaneous tuberculosis. The side‐effects of pyrazinamide include hepatic or dermatologic disorders, but erythema multiforme has not yet, to our knowledge, been described. Clinical features and discontinuation and reintroduction of the drug led us to consider pyrazinamide the cause of the erythema multiforme, but allergologic studies remained negative, except for the presence of circulating immune complexes. The mechanism of this eruption remains obscure. and definite withdrawal of pyrazinamide seems to be the best therapeutic cho

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1996.tb04620.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY