Dental health in asthmatic children: a South Italy study.

Purpose: The purpose of this study was to examine the oral health status of children with mild intermittent or mild persistent asthma compared to healthy children.

Methods: A group of 124 asthmatic children was compared to 156 age-matched healthy children. Bitewing radiographs were taken and clinical examinations were carried out to record caries prevalence, caries experience in both dentitions, periodontal health and dental enamel defects.

Value of adding a polyvalent mechanical bacterial lysate to therapy of COPD patients under regular treatment with salmeterol/fluticasone.

Background: This study investigated the value of adding Ismigen, a polyvalent mechanical bacterial lysate, to therapy of COPD patients (FEV(1) <60% predicted) under regular treatment with salmeterol/fluticasone (SFC).

Methods: 63 patients enrolled from September to December 2007 were randomly divided into two groups (A and B). All patients were treated with salmeterol/fluticasone (SFC) 50/500 microg BID.

Horse allergens: An underestimated risk for allergic sensitization in an urban atopic population without occupational exposure.

Background: Data on allergic sensitization to horse allergen in modern urban areas are scarce. The aim of this study was to investigate the characteristics of allergic sensitization and the modality of exposure to horse allergens in atopic patients living in an urban area and without occupational exposure to horse and/or horse-derived materials.

Methods: From among 1822 consecutive outpatients, we selected all subjects who had an immediate skin reaction to horse dander.

A recombinant humanized anti-IgE monoclonal antibody (omalizumab) in the therapy of moderate-to-severe allergic asthma.

The pathogenetic aspect of allergic bronchial asthma is characterized by airway inflammation with infiltration of mast cells, basophils, eosinophils, monocytes and T-helper (Th)2 lymphocytes. Most cases of asthma are atopic in nature and aeroallergens such as those released by pollens, Dermatophagoides, moulds etc, act as sensitizer and trigger agents which induce immune response through immunoglobulin E (IgE). IgE is the key mediator of allergic inflammatory reaction and plays a central role in the pathogenesis of atopic-allergic diseases such as those of respiratory tract: rhinitis and bronchial asthma.

Rabbit allergens: a significant risk for allergic sensitization in subjects without occupational exposure.

Background: Although rabbits are becoming popular as pets, data about the characteristics of allergic sensitization to rabbit allergens in patients without professional exposure are scarce.

Aims Of The Study: To determine the characteristics of allergic sensitization to pet rabbits, and the role of direct and indirect exposure to rabbits and rabbit allergens in non-professionally exposed patients.

Methods: From among 1124 consecutive outpatients, we selected all subjects with an immediate skin reaction to rabbit dander.

Effect of formoterol/budesonide combination on arterial blood gases in patients with acute exacerbation of COPD.

Background: Patients with severe chronic airway obstruction might suffer dangerous hypoxemia after administration of a beta-agonist despite bronchodilation.

Methods: We first compared the acute effects on gas exchange of two doses of formoterol Turbuhaler (9 and 18 microg) in 10 patients with acute exacerbation of COPD. Afterwards, we compared the acute effects of formoterol Turbuhaler 9 microug with those of formoterol/budesonide combination in a single inhaler (Turbuhaler) 9/320 microg in 10 other patients with acute exacerbation of COPD.

Treatment of acute exacerbation of severe-to-very severe COPD with azithromycin in patients vaccinated against Streptococcus pneumoniae.

Sixty-five consecutive eligible adult patients, who were treated as outpatients for stable severe-to-very severe COPD, were enrolled in the study. All of them received 23-valent pneumococcal capsular polysaccharide vaccine intramuscularly. Patients were seen monthly, as well as whenever they had symptoms suggestive of an exacerbation, at our outpatient clinic.

Bronchodilator response to formoterol after regular tiotropium or to tiotropium after regular formoterol in COPD patients.

We conducted a randomized, crossover trial with tiotropium 18 microg once daily (group A), and formoterol 12 microg twice daily (group B) over a 5-day period for each drug, with a 10-day washout, in 20 COPD patients. At the end of each period, patients inhaled both drugs separated by 180 min in alternate sequence (group A: tiotropium 18 microg+formoterol 12 microg; group B: formoterol 12 microg+tiotropium 18 microg). FEV1 and FVC were measured at baseline and after 30, 60, 120, 180, 210, 240, 300 and 360 min.

Anti-IgE monoclonal antibody (omalizumab) in the treatment of atopic asthma and allergic respiratory diseases.

Since the discovery of immunoglobulin E (IgE) antibodies thirty-six years ago, our understanding of the mechanisms of allergy has improved to such an extent that we can now better differentiate allergy from non-allergic hypersensitivity, and allergic/atopic from intrinsic/non-atopic bronchial asthma. IgE antibodies are crucial immune mediators of airway inflammation in allergic atopic asthma and IgE-mediated hypersensitivity reactions are the likely mechanisms of allergen-induced airway obstruction. In addition, IgE may cause chronic airway inflammation in asthma through effector cells activated via high-affinity (Fcepsilon RI) or low-affinity (Fcepsilon RII) IgE receptors.

Salmeterol/fluticasone propionate in a Single Inhaler Device versus theophylline+fluticasone propionate in patients with COPD.

Study Objectives: The aim of this study was to compare the relative efficacy in terms of improvement in symptoms and lung function of salmeterol/fluticasone propionate (SLM/FP) combination administered through the Diskus inhaler versus theophylline (THEO) added to FP Diskus in patients with stable chronic obstructive pulmonary disease (COPD).

Methods And Measurements: Eighty patients were randomized to receive 4 months of treatment in one of two treatment groups: (1) fixed combination of SLM 50 microg and FP 500 microg Diskus, 1 inhalation twice daily; or (2) FP Diskus 500 microg, 1 inhalation twice daily, plus oral titrated THEO twice daily. Patients attended the clinic before and after 4, 8, 12 and 16 weeks of treatment for evaluations of pulmonary function, and dyspnea, which was assessed using an analogic visual scale.

Asthma treatment must be always tailored to the individual patient.

Several studies have shown that there are notable benefits in adding a long acting beta 2-agonist to an inhaled corticosteroid. Particularly, long acting beta 2-agonists allow to reduce the amount of steroid that is required to induce a specific response and, consequently, its possible side effects. Currently the pharmaceutical market promotes, and physicians tend in any case to privilege, the use of fixed combinations for the treatment of the asthmatic patient and this also in the first phases of the illness.

The pharmacologic treatment of uncomplicated arterial hypertension in patients with airway dysfunction.

Because many antihypertensive drugs can affect airway function, the treatment of hypertension in patients with airway dysfunction is complex. For example, the worsening or precipitation of asthma by beta-adrenoceptor antagonists is well-recognized, but beta(1)-adrenoceptor blockers that exert mild beta(2)-agonist effects, and those that modulate the endogenous production of nitric oxide, affect airway function to a lesser extent. Therapy with selective alpha(1)-blockers is not contraindicated in cases of chronic airway obstruction.

Comparison of the effects of single oral doses of nebivolol and celiprolol on airways in patients with mild asthma.

Objective: The respiratory effects of nebivolol, a new selective ss(1)-adrenergic blocking agent, and celiprolol, a ss-blocker possessing strong ss(1)-adrenoceptor antagonist and mild ss(2)-agonist properties, were investigated in 12 patients with mild asthma.

Design: Changes in several spirometric indexes (FVC, FEV(1), and forced expiratory flow rate at 50% of FVC) were measured. The interaction with the bronchodilator effect of the ss(2)-adrenoceptor-selective agonist albuterol also was investigated.

Parenteral antibiotic therapy in the treatment of lower respiratory tract infections. Strategies to minimize the development of antibiotic resistance.

Antibiotic use is often imputed for increases in the prevalence of infections due to antibiotic-resistant bacteria. Resistance depends on the variety of genotypes in the large bacterial population and also on the selective pressures that are produced along the antibiotic concentration gradients in the body. In effect, at certain selective concentrations the antibiotic eliminates the susceptible majority, leaving a selected remainder intact.

Effects of formoterol, salmeterol or oxitropium bromide on airway responses to salbutamol in COPD.

We examined whether a pretreatment with formoterol, oxitropium bromide, or salmeterol might modify the dose-response curves to inhaled salbutamol in patients with stable and partially reversible chronic obstructive pulmonary disease (COPD). Sixteen outpatients with partially reversible, stable COPD received 24 microg formoterol, 50 microg salmeterol, 200 microg oxitropium bromide, or placebo on four non-consecutive days. Spirometric testing was performed immediately before inhalation of treatment and after 2 h.

[Correlation between pulmonary pharmacokinetics and pharmacodynamics support the hypothesis of the usefulness of ceftazidime at a single 1g daily dose in the treatment of bacterial exacerbation of chronic obstructive bronchopneumonia with moderate functional damage].

Introduction And Background: Experimental studies have shown that cephalosporins have an antibacterial effect in vivo even when their levels are above MIC for only 40-50% of dosing intervals, whereas maximum killing is obtained when concentrations are above MIC for 60-70% of the time. Since most patients treated with antibiotics have neutrophils and other natural defence mechanisms, it is likely that a bacteriostatic effect should be sufficient to induce an effective therapeutic response.

Methods: Given that in the potential sites of lung infection ceftazidime reaches significantly higher levels than the MIC of the most commonplace respiratory pathogens, even 8-12 hours after the administration of 1 g i.

Oral allergy syndrome (OAS) in pollinosis patients after eating pistachio nuts: two cases with two different patterns of onset.

We describe two uncommon cases of oral allergy syndrome (OAS) after eating pistachio nuts (p.n.) in subjects (a 54-year-old man and a 3-year-old girl) with exclusive skin prick test (SPT) positivity to Parietaria (P.

Why are nasal and bronchial symptoms mostly perennial in patients with monosensitization to Olea europaea pollen allergens?

In the last few years interest in the clinical aspects of Olea europaea (O.e.) pollen allergy has increased.

Clinical significance of allergic sensitization to cockroaches in patients with mite related respiratory allergy.

The aim of our study was the evaluation of the clinical significance of allergic sensitization to cockroaches (C) in subjects with skin prick test (SPT) positivity only to mites, since we previously demonstrated a frequent association of SPT positivity between the allergens of these parasites. We studied 231 patients with mite related respiratory symptoms and living in the Naples area in order to obtain a highly homogeneous sample. All patients underwent anamnestic procedures, physical examination, SPT by using commercially available materials and an extract containing the whole bodies of three C.

[Allergic rhinitis due to cockroach antigenic components. An emerging pathology?].

The aim of our study was the evaluation of the role of these insects as causative agents of perennial rhinitis. We studied 317 subjects of both sexes (175 F and 142 M) living in Naples area and examined consecutively in our Centre for perennial nasal symptoms of suspected IgE mediated aetiology. All patients underwent the following diagnostic procedures: anamnestic procedures by using an internal questionnaire, clinical examination, skin prick test by using commercially available allergenic extracts and an allergenic extract containing the whole bodies of Blattella germanica and orientalis, Periplaneta americana.