The Journal of allergy and clinical immunology
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J. Allergy Clin. Immunol. · Jul 2009
Sublingual immunotherapy for allergic respiratory diseases: an evaluation of meta-analyses.
Five published meta-analyses (MAs) seem to prove the efficacy of sublingual immunotherapy in allergic asthma and rhinoconjunctivitis. ⋯ Because of discrepancies, inconsistencies, and lack of robustness, the MAs on sublingual immunotherapy do not provide enough evidence to support its current routine management in patients with allergic asthma or rhinoconjunctivitis. Sensitivity to potential publication bias should be tested and reported in all MAs.
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J. Allergy Clin. Immunol. · Jun 2009
Body mass index and phenotype in subjects with mild-to-moderate persistent asthma.
Although obesity has been hypothesized to worsen asthma, data from studies of subjects with well-characterized asthma are lacking. ⋯ Increased BMI is not associated with clinically significant worsening of impairment in subjects with mild-to-moderate persistent asthma. There is a modest association between increased BMI and reduced therapeutic effect of ICS-containing regimens in this patient population. Prospective studies evaluating the effect of being overweight or obese on treatment response in asthma are warranted.
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The primary systemic vasculitides comprise a broad group of diseases identified by their clinical, histopathologic, and therapeutic characteristics. These unique entities have a broad spectrum of organ involvement and severity, which influences the approach to diagnosis and treatment. ⋯ Further research is needed to understand these diseases and discover more efficacious yet less toxic therapeutic options. This review will focus on vasculitic syndromes more likely to be presented to an allergist/immunologist in an outpatient setting.
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J. Allergy Clin. Immunol. · Jun 2009
Comparative StudyComparison of anthropometric measures of obesity in childhood allergic asthma: central obesity is most relevant.
Established indicators of central obesity include waist circumference, waist/height ratio, and the conicity index. Studies using such measures (as opposed to body mass index [BMI] percentiles) to characterize the association between obesity and asthma are lacking, despite the fact that these measures have been shown to be most relevant for many other chronic diseases. ⋯ Measures of central obesity are more associated with the presence of asthma and asthma severity in children with allergic rhinitis when compared with standard BMI measures.
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Asthma continues to disproportionately affect minority and low-income groups, with African American and Latino children who live in low-socioeconomic-status urban environments experiencing higher asthma morbidity and mortality than white children. This uneven burden in asthma morbidity has been ever increasing despite medical advancement. ⋯ Interventions to reduce individual areas of disparities have had varying successes. Because asthma is a complex disease that affects millions of persons, multifaceted comprehensive interventions that combine all evidence-based successful strategies are essential to finally closing the gap in asthma morbidity.