Current allergy and asthma reports
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Imaging technology has played a significant role in the diagnosis and management of sinonasal disorders. Plain sinus films are almost exclusively replaced by CT in the work-up for inflammatory sinus disease. MRI provides complementary information to CT in cases of sinonasal and skull-base neoplasms. ⋯ Recent advances that are currently in clinical use have included multidetector row CT scanners and computer image-guidance systems for surgery. Three-dimensional CT angiography, image-guided CT-MR fusion, and intraoperative image-guidance are new techniques that are currently being evaluated. As imaging technology continues to advance, so does the capability to treat diseases beyond the sinuses and skull base with minimally invasive, endoscopic approaches.
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Adult food allergy is estimated at approximately 3.2% worldwide. The persistence of childhood food allergy is unusual, peanut allergies excepted. Once established in adults, food allergy is rarely cured. ⋯ The diagnosis relies on prick skin tests, detection of specific IgEs, and standardized oral challenges. Strict avoidance diets are necessary. Specific immunotherapy to pollens may be efficient for cross-reactive food allergies.
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Curr Allergy Asthma Rep · Mar 2004
ReviewFactors controlling airway smooth muscle proliferation in asthma.
Airway smooth muscle proliferation has been the focus of considerable attention, as it is a quantitatively important component of the airway wall remodeling response in asthma and has been suggested as a suitable target for the development of novel anti-asthma agents. Such agents are considered likely to reduce airway hyperresponsiveness and, consequently, airway obstruction, resulting in fewer symptoms and exacerbations. ⋯ Moreover, recent findings raise some doubt as to whether smooth muscle proliferation per se is the explanation of the increase in smooth muscle cell number in asthma, with alternative explanations including the proposal that cells migrate either from the interstitial compartment or from a circulating precursor stem cell population. Therefore, drug targeting of migration responses should be considered as an alternative approach to regulating the smooth muscle component of airway wall remodeling.
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Although most food-allergic reactions occur after ingestion of nonpackaged food products, the food industry has been subjected to increasing scrutiny of their allergen controls; the resulting impact on the industry has been remarkable. Undeclared food allergens have been responsible for many food product recalls during the past 13 years, and the food industry has made significant investment, effort, and improvements in allergen control during this time. ⋯ Labeling initiatives have been pursued to make ingredient listings more easily understood by food-allergic consumers, but further improvements could still be made. Additional research to determine eliciting doses for allergenic foods is needed to enable science-based risk assessment and risk management.
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Curr Allergy Asthma Rep · Jan 2004
Review Comparative StudyAdverse reactions to neuromuscular blocking agents.
Neuromuscular blocking agents (NMBAs) play a predominant role in the incidence of severe adverse reactions occurring during anesthesia. Most hypersensitivity reactions are of immunologic origin (IgE-mediated) or are related to direct stimulation of histamine release. The incidence of IgE-mediated hypersensitivity or anaphylaxis is estimated between 1 in 10,000 and 1 in 20,000 anesthesias, and NMBAs represent the most frequently involved substances, with a range of 50% to 70%. ⋯ This should help provide documented advice for future administration of anesthesia. There is no demonstrated evidence for systematic preoperative screening in the general population at this time. Other well-known adverse effects have been described, such as the succinylcholine-triggered cytotoxic effects on muscle cells, but these are responsible for characteristic clinical symptoms, which are usually easy to distinguish from anaphylactic reactions