The Journal of allergy and clinical immunology
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J. Allergy Clin. Immunol. · Feb 1999
A clinical analysis of gelatin allergy and determination of its causal relationship to the previous administration of gelatin-containing acellular pertussis vaccine combined with diphtheria and tetanus toxoids.
The number of patients with allergic reactions after administration of gelatin-containing live vaccines is increasingly reported in Japan. These allergic reactions appear to be caused by gelatin allergy. It is still unknown how the patients were sensitized to gelatin. ⋯ Most anaphylactic reactions and some urticarial reactions to gelatin-containing measles, mumps, and rubella monovalent vaccines are associated with IgE-mediated gelatin allergy. DTaP immunization histories suggest that the gelatin-containing DTaP vaccine may have a causal relationship to the development of this gelatin allergy.
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J. Allergy Clin. Immunol. · Feb 1999
Randomized Controlled Trial Clinical TrialFluticasone propionate powder: oral corticosteroid-sparing effect and improved lung function and quality of life in patients with severe chronic asthma.
Many patients with severe asthma are dependent on oral corticosteroids for maintenance control of their disease. Treatments that allow patients to be weaned off oral corticosteroids may help to minimize the risk of side effects associated with their chronic use. ⋯ Fluticasone propionate powder (500 or 1000 microg twice daily) effectively improved lung function, adrenal function, and asthma-specific quality of life in patients with severe chronic asthma previously treated with oral prednisone while allowing most patients to be weaned off oral corticosteroid therapy.
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J. Allergy Clin. Immunol. · Jan 1999
Randomized Controlled Trial Clinical TrialA high dose of albuterol does not overcome bronchoprotective subsensitivity in asthmatic subjects receiving regular salmeterol or formoterol.
Regular treatment with inhaled, long-acting beta2 -agonists is associated with subsensitivity for bronchoprotective effects. It is not known whether a high dose of short-acting beta2 -agonist could overcome this subsensitivity. ⋯ Thus in stable asthmatic subjects receiving regular salmeterol or formoterol, bronchoprotective subsensitivity was not overcome by administering a high dose of albuterol. Further studies are required to evaluate the clinical relevance of this pharmacologic phenomenon when albuterol is used in acute asthma.
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Inhaled corticosteroids have now become established as first-line therapy for patients with persistent asthma. Corticosteroids are the only currently available asthma therapy that suppress inflammation in asthmatic airways, and they inhibit almost every aspect of the inflammatory process in asthma. Inhaled corticosteroids are effective in most patients with asthma, irrespective of age or asthma severity. ⋯ Inhaled corticosteroids are convenient to use and are the most cost-effective treatment currently available for long-term asthma control. A small proportion of patients are resistant to the antiinflammatory effects of corticosteroids. Future developments may include inhaled corticosteroids with even fewer systemic effects or more specific antiinflammatory drugs.
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J. Allergy Clin. Immunol. · Oct 1998
Comparative Study Clinical Trial Controlled Clinical TrialEffectiveness and safety of inhaled corticosteroids in controlling acute asthma attacks in children who were treated in the emergency department: a controlled comparative study with oral prednisolone.
Inhaled corticosteroids have a greater antiinflammatory potency and fewer systemic effects than intravenous, intramuscular, or oral corticosteroids. However, their role in acute asthma has not been established. We prospectively investigated the efficacy and safety of inhaled corticosteroids in controlling moderately severe acute asthma attacks in children who were treated in the emergency department. ⋯ In children with moderately severe asthma attacks who were treated in the emergency department, a short-term dose schedule of inhaled budesonide turbohaler, starting with a high dose and followed by a decrease over 1 week, is at least as effective as oral prednisolone, without suppressing serum cortisol concentration.