The Diagnosis and Management of Rhinitis: an Updated Practice Parameter
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OM-85) on Frequency of Upper Respiratory Tract Infections and Size of Adenoid Tissue in Preschool Children with Adenoid Hypertrophy
STUDY PROTOCOL Effect of Vaxoral® (OM-85) on frequency of upper respiratory tract infections and size of adenoid tissue in preschool children with adenoid hypertrophy Study Product(s) Vaxoral® (OM-85) Indication Recurrent RTIs, adenoid hypertrophy Sponsor Dr Sami Ulus Maternity and Children Research and Training Hospital, Department of Pediatric Allergy and Immunology, Ankara, TURKEY Anticipated Turkey Countries Introduction OM-85 significantly reduces RTIs in children. This effect was proved by many clinical studies and meta-analyses1. A Cochrane meta-analysis first published in 2006 and updated recently (Del- Rio-Navarro 2012) showed that immunostimulants (IS) could reduce acute RTIs (ARTIs) by almost 39% when compared to placebo. Among the different IS, OM-85 showed the most robust evidence with 4 trials of “A quality” according to the Cochrane grading criteria. Pooling six OM-85 studies, the Cochrane review reported a mean number of ARTIs reduction by -1.20 [95% CI: - 1.75, -0.66] and a percentage difference in ARTIs by -35.9% [95% CI: -49.46, -22.35] compared to placebo1. Adenoid hypertrophy (AH) is one of the most important respiratory disease in preschool children2. In normal conditions adenoid tissue enlarges up to 5 years and become smaller afterwards. But in some children who have recurrent URTIs, it keeps growing and this can be associated with complications2. AH may cause recurrent respiratory infections and each infection contributes to enlargement of adenoid tissue thus promoting a vicious cycle. Additionally enlarged adenoids are known to be reservoir for microbes and cause of recurrent or long lasting RTIs3. AH is associated with chronic cough, recurrent and chronic sinusitis, recurrent tonsillitis, recurrent otitis media with effusion, recurrent other respiratory problems such as, nasal obstruction and sleep disturbances, sleep apneas2-3. -
Caring for Children with Special Needs ALLERGIES and ASTHMA
caring for children with special needs ALLERGIES AND ASTHMA We don’t usually think of children with allergies or asthma as children with “special needs,” but they certainly are. In fact, children with these conditions are probably the most frequently encountered “special needs” children. Child care providers can do a great deal to help individual children manage their specific allergy or asthma needs and feel more comfortable in a child care setting. Allergies wastes. Every house has them, no matter how clean. Other inhaled Children with allergies face the allergens include mold, pollen (hay same social difficulties as do adults, fever), animal dander (especially but they have less maturity and from cats), chemicals, and per emotional resources to deal with fumes. them. Children find that they cannot eat what their friends eat or The most common allergy symp cannot play outside during some toms are seasons. Until a child is mature � a clear, runny nose and enough to understand why she sneezing, cannot do something, you must be � itchy or stuffed-up nose or careful to help the child through the itchy, runny eyes, and difficulties. Start teaching a child early on about what he is allergic to; � asthma (remember that not all you will not always be able to people with asthma have monitor everything. allergies and not all allergies Some foods can cause a life cause or develop into asthma). threatening reaction. The mouth, throat, and bronchial tubes swell enough to interfere with breathing. Strategies for inclusion The person may wheeze or faint. Some parents have found that by Often there are generalized hives volunteering to bring food to and/or a swollen face. -
Biofilm Forming Bacteria in Adenoid Tissue in Upper Respiratory Tract Infections
Recent Advances in Otolaryngology and Rhinology Case Report Open Access | Research Biofilm Forming Bacteria in Adenoid Tissue in Upper Respiratory Tract Infections Mariana Pérez1*, Ariana García1, Jacqueline Alvarado1, Ligia Acosta1, Yanet Bastidas1, Noraima Arrieta1 and Adriana Lucich1 1Otolaryngology Service Hospital de niños” JM de los Ríos” Caracas, Venezuela Abstract Introduction: Biofilm formation by bacteria is studied as one of the predisposing factors for chronicity and recurrence of upper respiratory tract infections. Objective: To determine the presence of Biofilm producing bacteria in patients with adenoid hypertrophy or adenoiditis. Methodology: A prospective and descriptive field study. The population consisted of 102 patients with criteria for adenoidectomy for obstructive adenoid hypertrophy or recurrent adenoiditis. Bacterial culture was performed, and specialized adenoid tissue samples were taken and quantified to determine by spectrophotometry the ability of Biofilm production. Five out of 10 samples were processed with electronic microscopy. Results: A The mean age was of 5.16 years, there were no significant sex predominance (male 52.94 %). There was bacterial growth in the 69.60% of the cultures, 80.39% for recurrent Adenoiditis and 19.61% for adenoid Hypertrophy, Staphylococcus Aureus predominating in 32.50% (39 samples). 88.37 % were producing bacteria Biofilm. 42.25% in Adenoiditis showed strong biofilm production, compared with samples from patients with adenoid hypertrophy where only 5.65 % were producers. The correlation was performed with electronic microscopy in 10 samples with 30 % false negatives. Conclusions: The adenoid tissue serves as a reservoir for biofilm producing bacteria, being the cause of recurrent infections in upper respiratory tract. Therapeutic strategies should be established to prevent biofilm formation in the early stages and to try to stop bacterial binding to respiratory mucosa. -
Allergic Bronchopulmonary Aspergillosis Revealing Asthma
CASE REPORT published: 22 June 2021 doi: 10.3389/fimmu.2021.695954 Case Report: Allergic Bronchopulmonary Aspergillosis Revealing Asthma Houda Snen 1,2*, Aicha Kallel 2,3*, Hana Blibech 1,2, Sana Jemel 2,3, Nozha Ben Salah 1,2, Sonia Marouen 3, Nadia Mehiri 1,2, Slah Belhaj 3, Bechir Louzir 1,2 and Kalthoum Kallel 2,3 1 Pulmonary Department, Hospital Mongi Slim, La Marsa, Tunisia, 2 Faculty of Medicine, Tunis El Manar University, Tunis, Tunisia, 3 Parasitology and Mycology Department, La Rabta Hospital, Tunis, Tunisia Allergic bronchopulmonary aspergillosis (ABPA) is an immunological pulmonary disorder caused by hypersensitivity to Aspergillus which colonizes the airways of patients with asthma and cystic fibrosis. Its diagnosis could be difficult in some cases due to atypical Edited by: presentations especially when there is no medical history of asthma. Treatment of ABPA is Brian Stephen Eley, frequently associated to side effects but cumulated drug toxicity due to different molecules University of Cape Town, South Africa is rarely reported. An accurate choice among the different available molecules and Reviewed by: effective on ABPA is crucial. We report a case of ABPA in a woman without a known Shivank Singh, Southern Medical University, China history of asthma. She presented an acute bronchitis with wheezing dyspnea leading to an Richard B. Moss, acute respiratory failure. She was hospitalized in the intensive care unit. The Stanford University, United States bronchoscopy revealed a complete obstruction of the left primary bronchus by a sticky *Correspondence: Houda Snen greenish material. The culture of this material isolated Aspergillus fumigatus and that of [email protected] bronchial aspiration fluid isolated Pseudomonas aeruginosa. -
Communicable Diseases of Children
15 Communicable Diseases of Children Dennis 1. Baumgardner The communicable diseases of childhood are a source of signif from these criteria, the history, physical examination, and ap icant disruption for the family and a particular challenge to the propriate laboratory studies often define one of several other family physician. Although most of these illnesses are self more specific respiratory syndromes as summarized in limited and without significant sequelae, the socioeconomic Table 15.1.3-10 impact due to time lost from school (and work), costs of medi Key points to recall are that significant pharyngitis is not cal visits and remedies, and parental anxiety are enormous. present with most colds, that most colds are 3- to 7-day Distressed parents must be treated with sensitivity, patience, illnesses (except for lingering cough and coryza for up to and respect for their judgment, as they have often agonized for 2 weeks), and that abrupt worsening of symptoms or develop hours prior to calling the physician. They are usually greatly ment of high fever mandates prompt reevaluation. Tonsillo reassured when given a specific diagnosis and an explanation of pharyngitis (hemolytic streptococci, Epstein-Barr virus, the natural history of even the most minor syndrome. adenovirus, Corynebacterium) usually involves a sore throat, It is essential to promptly differentiate serious from benign fever, erythema of the tonsils and pharynx with swelling or disorders (e.g., acute epiglottitis versus spasmodic croup), to edema, and often headache and cervical adenitis. In addition to recognize serious complications of common illnesses (e.g., var the entities listed in Table 15.1, colds must also be differenti icella encephalitis), and to recognize febrile viral syndromes ated from allergic rhinitis, asthma, nasal or respiratory tree (e.g., herpangina), thereby avoiding antibiotic misuse. -
Symptoms Related to Asthma and Chronic Bronchitis in Three Areas of Sweden
Eur Respir J, 1994, 7, 2146–2153 Copyright ERS Journals Ltd 1994 DOI: 10.1183/09031936.94.07122146 European Respiratory Journal Printed in UK - all rights reserved ISSN 0903 - 1936 Symptoms related to asthma and chronic bronchitis in three areas of Sweden E. Björnsson*, P. Plaschke**, E. Norrman+, C. Janson*, B. Lundbäck+, A. Rosenhall+, N. Lindholm**, L. Rosenhall+, E. Berglund++, G. Boman* Symptoms related to asthma and chronic bronchitis in three areas of Sweden. E. Björnsson, *Dept of Lung Medicine and Asthma P. Plaschke, E. Norrman, C. Janson, B. Lundbäck, A. Rosenhall, N. Lindholm, L. Research Center, Akademiska sjukhu- Rosenhall, E. Berglund, G. Boman. ERS Journals Ltd 1994. set, Uppsala University, Uppsala, Sweden. ABSTRACT: Does the prevalence of respiratory symptoms differ between regions? **Asthma and Allergy Research Center, Sahlgren's Hospital, University of Göteborg, As a part of the European Community Respiratory Health Survey, we present data Göteborg, Sweden. +Dept of Pulmonary from an international questionnaire on asthma symptoms occurring during a 12 Medicine and Allergology, Univer- month period, smoking and symptoms of chronic bronchitis. The questionnaire was sity Hospital of Northern Sweden, Umeå, mailed to 10,800 persons aged 20–44 yrs living in three regions of Sweden (Västerbotten, Sweden. ++Dept of Pulmonary Medicine, Uppsala and Göteborg) with different environmental characteristics. The total Sahlgrenska University Hospital, Göteborg, response rate was 86%. Sweden. Wheezing was reported by 20.5%, and the combination of wheezing without a Correspondence: E. Björnsson, Dept of cold and wheezing with breathlessness by 7.4%. The use of asthma medication was Lung Medicine, Akademiska sjukhuset, S- reported by 5.3%. -
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...& more SELF-TEST Respiratory system challenge Test your knowledge with this quick quiz. 1. Gas exchange takes place in the 8. Which continuous breath sounds are 14. Wheezes most commonly suggest a. pharynx. c. alveoli. relatively high pitched with a hissing a. secretions in large airways. b. larynx. d. trachea. or shrill quality? b. abnormal lung tissue. a. coarse crackles c. wheezes c. airless lung areas. 2. The area between the lungs is b. rhonchi d. fine crackles d. narrowed airways. known as the a. thoracic cage. c. pleura. 9. Normal breath sounds heard over 15. Which of the following indicates a b. mediastinum. d. hilum. most of both lungs are described as partial obstruction of the larynx or being trachea and demands immediate 3. Involuntary breathing is controlled by a. loud. c. very loud. attention? a. the pulmonary arterioles. b. intermediate. d. soft. a. rhonchi c. pleural rub b. the bronchioles. b. stridor d. mediastinal crunch c. the alveolar capillary network. 10. Bronchial breath sounds are d. neurons located in the medulla and normally heard 16. Which of the following would you pons. a. over most of both lungs. expect to find over the involved area b. between the scapulae. in a patient with lobar pneumonia? 4. The sternal angle is also known as c. over the manubrium. a. vesicular breath sounds the d. over the trachea in the neck. b. egophony a. suprasternal notch. c. scapula. c. decreased tactile fremitus b. xiphoid process. d. angle of Louis. 11. Which is correct about vesicular d. muffled and indistinct transmitted voice breath sounds? sounds 5. -
(CD-P-PH/PHO) Report Classification/Justifica
COMMITTEE OF EXPERTS ON THE CLASSIFICATION OF MEDICINES AS REGARDS THEIR SUPPLY (CD-P-PH/PHO) Report classification/justification of medicines belonging to the ATC group R01 (Nasal preparations) Table of Contents Page INTRODUCTION 5 DISCLAIMER 7 GLOSSARY OF TERMS USED IN THIS DOCUMENT 8 ACTIVE SUBSTANCES Cyclopentamine (ATC: R01AA02) 10 Ephedrine (ATC: R01AA03) 11 Phenylephrine (ATC: R01AA04) 14 Oxymetazoline (ATC: R01AA05) 16 Tetryzoline (ATC: R01AA06) 19 Xylometazoline (ATC: R01AA07) 20 Naphazoline (ATC: R01AA08) 23 Tramazoline (ATC: R01AA09) 26 Metizoline (ATC: R01AA10) 29 Tuaminoheptane (ATC: R01AA11) 30 Fenoxazoline (ATC: R01AA12) 31 Tymazoline (ATC: R01AA13) 32 Epinephrine (ATC: R01AA14) 33 Indanazoline (ATC: R01AA15) 34 Phenylephrine (ATC: R01AB01) 35 Naphazoline (ATC: R01AB02) 37 Tetryzoline (ATC: R01AB03) 39 Ephedrine (ATC: R01AB05) 40 Xylometazoline (ATC: R01AB06) 41 Oxymetazoline (ATC: R01AB07) 45 Tuaminoheptane (ATC: R01AB08) 46 Cromoglicic Acid (ATC: R01AC01) 49 2 Levocabastine (ATC: R01AC02) 51 Azelastine (ATC: R01AC03) 53 Antazoline (ATC: R01AC04) 56 Spaglumic Acid (ATC: R01AC05) 57 Thonzylamine (ATC: R01AC06) 58 Nedocromil (ATC: R01AC07) 59 Olopatadine (ATC: R01AC08) 60 Cromoglicic Acid, Combinations (ATC: R01AC51) 61 Beclometasone (ATC: R01AD01) 62 Prednisolone (ATC: R01AD02) 66 Dexamethasone (ATC: R01AD03) 67 Flunisolide (ATC: R01AD04) 68 Budesonide (ATC: R01AD05) 69 Betamethasone (ATC: R01AD06) 72 Tixocortol (ATC: R01AD07) 73 Fluticasone (ATC: R01AD08) 74 Mometasone (ATC: R01AD09) 78 Triamcinolone (ATC: R01AD11) 82 -
Intranasal Rhinitis Agents
Intranasal Rhinitis Agents Therapeutic Class Review (TCR) February 1, 2020 No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, digital scanning, or via any information storage or retrieval system without the express written consent of Magellan Rx Management. All requests for permission should be mailed to: Magellan Rx Management Attention: Legal Department 6950 Columbia Gateway Drive Columbia, Maryland 21046 The materials contained herein represent the opinions of the collective authors and editors and should not be construed to be the official representation of any professional organization or group, any state Pharmacy and Therapeutics committee, any state Medicaid Agency, or any other clinical committee. This material is not intended to be relied upon as medical advice for specific medical cases and nothing contained herein should be relied upon by any patient, medical professional or layperson seeking information about a specific course of treatment for a specific medical condition. All readers of this material are responsible for independently obtaining medical advice and guidance from their own physician and/or other medical professional in regard to the best course of treatment for their specific medical condition. This publication, inclusive of all forms contained herein, is intended to be educational in nature and is intended to be used for informational purposes only. Send comments and suggestions to [email protected]. -
Khan CV 9-4-20
CURRICULUM VITAE DAVID A. KHAN, MD University of Texas Southwestern Medical Center 5323 Harry Hines Boulevard Dallas, TX 75390-8859 (214) 648-5659 (work) (214) 648-9102 (fax) [email protected] EDUCATION 1980 -1984 University of Illinois, Champaign IL; B.S. in Chemistry, Magna Cum Laude 1984 -1988 University of Illinois School of Medicine, Chicago IL; M.D. 1988 -1991 Good Samaritan Medical Center, Phoenix AZ; Internal Medicine internship & residency 1991-1994 Mayo Clinic, Rochester MN; Allergy & Immunology fellowship PROFESSIONAL EXPERIENCE 1994 -2001 Assistant Professor of Internal Medicine, UT Southwestern 1997 -1998 Co-Director, Allergy & Immunology Training Program 1998 - Director, Allergy & Immunology Training Program 2002- 2008 Associate Professor of Internal Medicine, UT Southwestern 2008-present Professor of Medicine, UT Southwestern AWARDS/HONORS 1993 Allen & Hanburys Respiratory Institute Allergy Fellowship Award 1993 Von Pirquet Award 2001 Outstanding Teacher 2000-2001 UTSW Class of 2003 2004 Outstanding Teacher 2003-2004 UTSW Class of 2006 2005 Outstanding Teacher 2004-2005 UTSW Class of 2007 2006 Daniel Goodman Lectureship, ACAAI meeting 2007 Most Entertaining Teacher 2006-2007 UTSW Class of 2009 2008 Stanislaus Jaros Lectureship, ACAAI meeting 2009 Outstanding Teacher 2007-2008 UTSW Class of 2010 2011 John L. McGovern Lectureship, ACAAI meeting 2012 I. Leonard Bernstein Lecture, ACAAI meeting 2014 Distinguished Fellow, ACAAI meeting 2015 Elliot F. Ellis Memorial Lectureship, AAAAI meeting 2015 Bernard Berman Lectureship, -
Hypersensitivity Pneumonitis and Metalworking Fluids Contaminated by Mycobacteria
3 Mahn K, Ojo OO, Chadwick G, et al. Ca2+ homeostasis and structural 5 Arvizo RR, Miranda OR, Thompson MA, et al. Effect of nanoparticle and functional remodelling of airway smooth muscle in asthma. surface charge at the plasma membrane and beyond. Nano Lett 2010; Thorax 2010; 65: 547–552. 10: 2543–2548. 4 Meurs H, Gosens R, Zaagsma J. Airway hyperresponsiveness in asthma: lessons from in vitro model systems and animal models. Eur Respir J 2008; 32: 487–502. DOI: 10.1183/09031936.00042211 Hypersensitivity pneumonitis and metalworking fluids contaminated by mycobacteria To the Editors: specific challenges performed in two workers, where positive responses were seen after controlled exposure to used MWFs that We read with interest the article published by TILLIE-LEBLOND did not contain mycobacteria [3]. et al. [1] relating to hypersensitivity pneumonitis (HP) in French automobile workers exposed to metalworking fluids Although referenced by TILLIE-LEBLOND et al. [1], the detailed (MWFs). Our group was involved in the UK outbreak immunological investigation performed on workers from a investigation referenced in their article [2, 3], and have a MWF-HP outbreak in the USA, where mycobacterial contam- clinical and research interest in this area. ination was identified [11], is not discussed in any detail. In this key study [11], in vitro secretion of interleukin-8, tumour Whilst TILLIE-LEBLOND et al. [1] are correct in stating that the a c majority of MWF-HP outbreaks have occurred in the USA, the necrosis factor- and interferon- were measured in whole UK Powertrain and French outbreaks are not the only ones to blood and from peripheral blood mononuclear cells in response have occurred in Europe. -
Treatment of Allergic Conjunctivitis with Olopatadine Hydrochloride Eye Drops
REVIEW Treatment of allergic conjunctivitis with olopatadine hydrochloride eye drops Eiichi Uchio Abstract: Olopatadine hydrochloride exerts a wide range of pharmacological actions such as histamine H receptor antagonist action, chemical mediator suppressive action, and eosinophil Department of Ophthalmology, 1 Fukuoka University School of infi ltration suppressive action. Olopatadine hydrochloride 0.1% ophthalmic solution (Patanol®) Medicine, Fukuoka, Japan was introduced to the market in Japan in October 2006. In a conjunctival allergen challenge (CAC) test, olopatadine hydrochloride 0.1% ophthalmic solution signifi cantly suppressed ocular itching and hyperemia compared with levocabastine hydrochloride 0.05% ophthalmic solution, and the number of patients who complained of ocular discomfort was lower in the olopatadine group than in the levocabastine group. Conjunctival cell membrane disruption was observed in vitro in the ketotifen fumarate group, epinastine hydrochloride group, and azelastine hydrochloride group, but not in the olopatadine hydrochloride 0.1% ophthalmic solution group, which may potentially explain the lower discomfort felt by patients on instillation. Many other studies in humans have revealed the superiority of olopatadine 0.1% hydrochloride eye drops to several other anti-allergic eye drops. Overseas, olopatadine hydrochloride 0.2% ophthalmic solution for a once-daily regimen has been marketed under the brand name of Pataday®. It is expected that olopatadine hydrochloride ophthalmic solutions may be used in patients with a more severe spectrum of allergic conjunctival diseases, such as vernal keratoconjunctivitis or atopic keratoconjunctivitis, in the near future. Keywords: olopatadine, eye drop, allergic conjunctivitis, anti-histaminergic Introduction The prevalence of allergic conjunctival diseases (ACD) in Japan is estimated to be as high as 15%–20% of the population and is on the rise.