Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology
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Ann. Allergy Asthma Immunol. · Oct 2006
High-dose corticosteroid exposure and osteoporosis intervention in adults.
High-dose corticosteroid exposure is associated with increased risk of bone loss and osteoporotic fractures. ⋯ Approximately 1 in 125 people 20 years or older were exposed to high doses of corticosteroids; oral exposure was 3 times more common than inhaled exposure. Most exposed patients do not receive bone density testing or osteoporosis drug prophylaxis. Use of prescription databases to identify high-dose oral and inhaled corticosteroid users can enable focused intervention to reduce bone loss and potentially reduce the risk of osteoporotic fractures.
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Ann. Allergy Asthma Immunol. · Sep 2006
ReviewPathogenesis and recent therapeutic trends in Stevens-Johnson syndrome and toxic epidermal necrolysis.
To review the current pathophysiologic mechanisms and recent therapeutic trends in Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). ⋯ Both IVIG and cyclosporine have been associated with enhanced healing and better survival through inhibition of apoptosis. Multicenter, randomized, placebo-controlled trials using a standardized design are needed to validate these findings.
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Ann. Allergy Asthma Immunol. · Sep 2006
ReviewUse of the health plan employer data and information set for measuring and improving the quality of asthma care.
To discuss the Health Plan Employer Data and Information Set (HEDIS) criteria for measuring performance in asthma care and to review new strategies to improve the quality of asthma care. ⋯ The HEDIS asthma measure remains the most widely used performance tool for evaluating the quality of asthma care. Reimbursement models based on public reporting and pay for performance are expected to be a strong component of future health care payment systems.
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Ann. Allergy Asthma Immunol. · Aug 2006
Disparities in the use of urgent health care services among asthmatic children.
Urgent care composes one third of the total costs associated with asthma. Asthmatic children of African American and Latino backgrounds have higher rates of emergency department (ED) use and hospitalizations than white children, especially in urban settings. ⋯ There is a failure in asthma management in this urban population, demonstrated by the finding that almost half of all current asthmatic patients used urgent care. After controlling for different socioeconomic and disease-related factors, minority race/ethnicity, low household income, and frequent evening symptoms were found to be strong predictors of urgent care utilization. Insurance status, delaying care for any reason, and use of controller medications were found not to be associated with urgent care use.
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Ann. Allergy Asthma Immunol. · Jul 2006
Practice GuidelineFood allergy and the introduction of solid foods to infants: a consensus document. Adverse Reactions to Foods Committee, American College of Allergy, Asthma and Immunology.
To make recommendations based on a critical review of the evidence for the timing of the introduction of solid foods and its possible role in the development of food allergy. ⋯ Pediatricians and allergists should cautiously individualize the introduction of solids into the infants' diet. With assessed risk of allergy, the optimal age for the introduction of selected supplemental foods should be 6 months, dairy products 12 months, hen's egg 24 months, and peanut, tree nuts, fish, and seafood at least 36 months. For all infants, complementary feeding can be introduced from the sixth month, and egg, peanut, tree nuts, fish, and seafood introduction require caution. Foods should be introduced one at a time in small amounts. Mixed foods containing various food allergens should not be given unless tolerance to every ingredient has been assessed.