Immunology and allergy clinics of North America
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Immunol Allergy Clin North Am · Feb 2015
ReviewAsthma: the interplay between viral infections and allergic diseases.
Respiratory viruses and allergens synergistically contribute to disease pathogenesis in asthma. Potential mechanisms underlying this clinically relevant association are the subject of intense investigation. This review summarizes current knowledge and recent advances in this area, with an emphasis on potential mechanisms involving immunoglobulin E, type I interferon antiviral responses, epithelial factors, and the role of dendritic cells and other antigen-presenting cells in linking viral and allergic inflammatory responses relevant to asthmatic disease.
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Immunol Allergy Clin North Am · Aug 2014
ReviewLocal and general anesthetics immediate hypersensitivity reactions.
Intraoperative anaphylaxis and hypersensitivity reactions in the setting of anesthesia contribute significantly to the morbidity and mortality of surgeries and surgical procedures. Because multiple medications and products are given in a short period of time, identifying the specific cause can be difficult. ⋯ Careful review of anesthetic charts and allergy testing can help identify the underlying cause. The identification of the cause and subsequent prevention of reactions are critical to reduce overall mortality and morbidity related to anesthesia.
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Hypersensitivity reactions to excipients contained in drugs are rare but can be severe or confusing. With regard to generic versus brand drug, often the ingredients are different; for each DHR, we recommend that the physician exercises caution in considering which brand drug or generic was administered and in listing all medicine components and not only the active drug.
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Cardiac dyspnea, especially if present only with exercise, is often confused with asthma and exercise-induced bronchospasm. Cardiac dyspnea or asthma is the consequence of pulmonary edema due to pulmonary venous hypertension and not due to asthmatic bronchoconstriction. In overt, acute congestive heart failure, the diagnosis may be readily made by history and physical examination and pertinent laboratory and imaging data.
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This article provides a broad overview of the complex intersection between the connective tissue diseases (CTDs) and their pulmonary manifestations. Indirect pulmonary complications - such as respiratory infection and medication-induced lung toxicity - are briefly discussed, and the importance of a comprehensive assessment of the patient with CTD with respiratory symptoms is emphasized. A concise review of the many pulmonary manifestations of each specific CTD is provided, and particular emphasis is placed on CTD-associated interstitial lung disease.