Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology
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Ann. Allergy Asthma Immunol. · Dec 2002
Review Case ReportsLactic acidosis and status asthmaticus: how common in pediatrics?
Lactic acidosis is a well described phenomenon in adult patients with severe asthma. However, this entity is rarely reported in children with status asthmaticus. ⋯ Although rare, lactic acidosis does occur in pediatric-aged patients during status asthmaticus. It is important that this complication be recognized and treated because acidosis may inhibit the effectiveness of bronchodilator therapy, produce electrolyte disturbances, and cause serious adverse effects on the patient's cardiovascular system.
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Ann. Allergy Asthma Immunol. · Dec 2002
ReviewViral respiratory infections in association with asthma and sinusitis: a review.
Viral respiratory infections (VRIs) commonly precede asthma exacerbations in both children and adults. Likewise, VRIs may affect the paranasal sinuses, predisposing infected individuals to the development of subsequent acute bacterial sinusitis. This article discusses the role that viruses play in both the development of asthma and in acute asthma exacerbations. Mechanisms by which viral infections provoke asthma exacerbations are reviewed, and treatment of such episodes is discussed. The pathogenesis of sinusitis and association with VRIs is reviewed along with treatment recommendations. ⋯ This review highlights the prominent role that viral pathogens (especially rhinovirus) play in exacerbation of asthma and in the development of sinus disease. The specific mechanisms whereby viral infection leads to an acute asthma exacerbation or to subsequent bacterial sinusitis are described. Treatment options are outlined including the potential future application of antiviral compounds.
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Cow's milk allergy is frequently observed during the first year of life when nutritional requirements are critical. In those cases where breast-feeding is not available, a safe and adequate substitute to cow's milk should be offered. ⋯ Vegetable formulas obtained from soy and milk derived from other mammals, such as mare or donkey, homemade preparations, and elemental diet may represent valid alternatives for children with cow's milk allergy. Extensive clinical trials are needed on the safety profile of any alternative mammal-derived milk. The choice of alternative milk should take into account the clinical profile of the child allergic to cow's milk, particularly as concerns age, severity of symptoms, degree of sensitivity to cow's milk proteins, and any multiple food allergies.
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Ann. Allergy Asthma Immunol. · Nov 2002
The natural history and clinical characteristics of aspirin-exacerbated respiratory disease.
Aspirin-exacerbated respiratory disease (AERD) is a clinical syndrome characterized by chronic rhinitis, nasal polyps, asthma, and precipitation of asthma and rhinitis attacks after ingestion of aspirin (ASA) and most nonsteroidal anti-inflammatory drugs (NSAIDs). Most information about the disease in the United States has come from small samples of patients. ⋯ AERD begins in the third decade of life and in both sexes. The disease progressed over the 13 years between historical onset and current evaluation, with more sinusitis and need for controller medications over time. There was no ethnic or familial distribution of AERD.
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Ann. Allergy Asthma Immunol. · Oct 2002
The reproducibility of the allergy skin test scoring and interpretation by board-certified/board-eligible allergists.
Allergy skin testing is a cornerstone in the evaluation of the allergic patient. This seemingly simple test is subject to multiple variables that can affect the result. ⋯ The results demonstrate interphysician variation in the scoring and interpretation of epicutaneous skin tests. A questionnaire such as the one used here may serve a useful quality control instrument to ensure reproducible scoring of skin tests. In addition, the results highlight the need for greater study on the clinical utility of intradermal skin testing when epicutaneous tests are negative or equivocal.