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Simioni L.,Allergy and Clin. Immunology | Vianello A.,Allergy and Clin. Immunology | Bonadonna P.,Allergy Unit | Marcer G.,University of Padua | And 5 more authors.
Annals of Allergy, Asthma and Immunology | Year: 2013

Background: Standard venom immunotherapy involves the administration of the maintenance dose every 4 to 6 weeks. This regimen may have adherence problems, especially in the long term; thus, extended intervals have been proposed. Objective: We prospectively compared the efficacy of 3- or 4-month extended maintenance dose vs the conventional regimen. Methods: Patients receiving immunotherapy with a single venom were offered the extended maintenance dose (EMD) and were then followed up for field re-stings. Only the re-stings by the insect for which the patients received immunotherapy were considered. A comparable group of patients receiving the conventional maintenance dose (CMD) was used for comparison by logistic regression analysis. Results: Seventy-six patients (60 male; mean age, 48 years) receiving the EMD were re-stung on 247 occasions by the insect for which they were receiving immunotherapy. The group receiving CMD included 110 patients (82 male; mean age, 44 years) certainly re-stung on 167 occasions by the specific insect. The percentage of re-sting without reaction was 93.5% in the EMD group and 81.5% in the CMD group, with a significant difference in favor of the former (P=.001). At logistic regression analysis, only age, but not maintenance dose protocol, was predictive of subsequent systemic reactions. Conclusion: The EMD is as effective and safe as the CMD. An increased maintenance seems to be the best option in term of convenience and economic savings. © 2013 American College of Allergy, Asthma & Immunology. Source


Schapowal A.,Allergy Clinic
Wiener Medizinische Wochenschrift | Year: 2013

Summary Echinaforce→ is the standardised extract of Echinacea purpurea from Bioforce, Switzerland. Recent studies show immunomodulation and broad antiviral effects against respiratory tract viruses. Haemagglutinin and Neuraminidase are blocked. In contrast to Oseltamivir no resistance is caused by Echinaforce→. A randomised, double-blind, placebo-controlled study over four months confirms that Echinaforce→ supports the immune resistance and acts directly against a series of viruses. Echinaforce→ is efficacious and safe in respiratory tract infections for long-term and short-term prevention as well as for acute treatment. © Springer-Verlag Wien 2013. Source


van Staden S.R.,Lung Function Laboratory | Groenewald M.,Allergy Clinic | Engelbrecht R.,Lung Function Laboratory | Becker P.J.,Biostatistics Unit | Hazelhurst L.T.,Tshwane University of Technology
South African Medical Journal | Year: 2013

Background. Chronic obstructive pulmonary disease and lung cancer are diseases associated with smoking tobacco cigarettes. Smokers find cessation difficult. Objectives. To determine whether smoking the Twisp electronic cigarette (e-cigarette), containing nicotine in a vegetable-based glycerine substance, would reduce carboxyhaemoglobin (COHb) levels in regular cigarette smokers by (i) comparing arterial and venous COHb levels before and after smoking the Twisp e-cigarette for 2 weeks; and (ii) evaluating changes in participants' perception of their health and lifestyle following the use of Twisp e-cigarettes. Methods. A single group within-subject design was used where tobacco cigarette smokers converted to Twisp e-cigarettes for 2 weeks. Prior to using the Twisp e-cigarette and after using this device for 2 weeks, arterial COHb, venous COHb and venous cotinine levels were determined. Additionally, the participants were asked to complete a questionnaire outlining their perceptions on health and lifestyle. Results. Thirteen participants of median age 38 years (range 23 - 46) with a smoking median of 20 cigarettes/day (range 12 - 30) completed the study. COHb levels (%) were significantly reduced after smoking Twisp e-cigarettes for 2 weeks (mean ± standard deviation (SD) arterial COHb before 4.66±1.99 v. after 2.46±1.35; p=0.014 and mean ±SD venous COHb before 4.37±2.1 v. after 2.50±1.23; p=0.018). There was excellent agreement between arterial and venous COHb levels (intraclass correlation coefficient 0.916). A decrease in cotinine levels (p=0.001) and an increase in oxygen saturation (p=0.002) were also observed. The majority of participants perceived improvements in their health and lifestyle parameters. Conclusion. Smoking the Twisp e-cigarette may be a healthier and more acceptable alternative to smoking tobacco cigarettes. Source


Valovirta E.,Allergy Clinic | Boza M.L.,University of Chile | Robertson C.F.,Murdoch Childrens Research Institute | Verbruggen N.,Merck And Co. | And 6 more authors.
Annals of Allergy, Asthma and Immunology | Year: 2011

Background: No standard, optimal treatment exists for severe intermittent (ie, episodic) asthma in children. However, evidence suggests that both daily and episode-driven montelukast are effective for this phenotype. Objective: To assess the regimen-related efficacy of montelukast in treating pediatric episodic asthma. Methods: A multicenter, randomized, double-blind, double-dummy, parallel-group, 52-week study was performed in children 6 months to 5 years of age comparing placebo with two regimens of montelukast 4 mg: (1) daily; or (2) episode-driven for 12 days beginning with signs/symptoms consistent with imminent cold or breathing problem. The main outcome measure was the number of asthma episodes (symptoms requiring treatment) culminating in an asthma attack (symptoms requiring physician visit, emergency room visit, corticosteroids, or hospitalization). Results: Five hundred eighty-nine patients were randomized to daily montelukast, 591 to intermittent montelukast, and 591 to placebo. Compared with placebo, no significant difference was seen between daily montelukast (P = .510) or intermittent montelukast (P = .884) in the number of asthma episodes culminating in an asthma attack over 1 year. Daily montelukast reduced symptoms over the 12-day treatment period of asthma episodes compared with placebo (P = .045). Beta-agonist use was reduced with both daily (P = .048) and intermittent montelukast (P = .028) compared with placebo. However, because of prespecified rules for multiplicity adjustments (requiring a positive primary endpoint), statistical significance for secondary endpoints cannot be concluded. All treatments were well tolerated. Conclusions: Montelukast did not reduce the number of asthma episodes culminating in an asthma attack over 1 year in children 6 months to 5 years of age, although numerical improvements occurred in some endpoints. © 2011 American College of Allergy, Asthma & Immunology. Source


Cortellini G.,Internal Medicine and Rheumatology | Severino M.,Allergy Clinic | Turillazzi S.,University of Florence | Spadolini I.,Anallergo | And 2 more authors.
Annals of Allergy, Asthma and Immunology | Year: 2012

Background: The honeybee sting challenge is considered a reliable procedure to evaluate the efficacy of specific immunotherapy, but it is difficult and unpractical to perform in clinical practice, because live insects are required. Objective: To assess the feasibility and reliability of a challenge test using a micro-syringe, and compared the procedure with sting challenge. Methods: Patients on bee venom immunotherapy and without systemic reactions at field sting were enrolled. They underwent a sting challenge with live bee, and large local reactions were assessed up to 48 hours. Those patients displaying systemic reactions at the sting challenge were excluded from the syringe challenge for ethical reasons. The syringe challenge was done by injecting 0.5 μL fresh unfiltered bee venom at 2 mm depth (the length of the sting left by a bee). The same follow-up as at the first challenge was performed. Bee-specific immunoglobulin E (IgE) and tryptase were measured after each challenge. Results: Nineteen patients underwent the sting challenge with live bees. Four had immediate systemic reactions (urticaria or asthma) and were excluded from the second challenge. The remaining 15 patients with large local reaction underwent the syringe challenge. No significant difference was seen in the maximum area of the large local reactions between the challenge with live bees and the syringe challenge. Also, no change was seen in tryptase and specific antibodies. Conclusion: This preliminary study suggests that the micro-syringe challenge with honeybee venom is feasible and produces results indistinguishable from those of the traditional sting challenge. © 2012 American College of Allergy, Asthma & Immunology. Source

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