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  • 1
    Electronic Resource
    Electronic Resource
    Compliance of asthmatic families with a primary prevention programme of asthma and effectiveness of measures to reduce inhalant allergens – a randomized trial (2004)
    Oxford, UK : Blackwell Science Ltd
    Clinical & experimental allergy 34 (2004), S. 0 
    Details
    ISSN: 1365-2222
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background Compliance to and the effect of pre- and post-natal exposure reduction measures to prevent asthma in high-risk children from asthmatic families were studied.Method Families were randomized to a special care group (n=222) and a control group (n=221). Educational advice on measures to reduce their newborn's exposure to allergens and smoke was provided to the special care group during three visits (two pre-natal and one post-natal). The control group (n=221) received usual care.Result After the intervention, the special care group differed significantly (P〈0.01) from the usual care group in: use of anti-mite encasings (parental: 88% vs. 14%; baby: 98% vs. 10%); keeping pets outside (51% vs. 19%); combined breast- and hypoallergenic formula feeding (55% vs. 22%); first solids postponement until after the sixth month (71% vs. 28%); maternal post-natal smoking (52% vs. 28%). Little or no compliance was found for other sanitary measures (cleaning habits, providing a smooth floor covering, ventilation/airing, pet removal), exclusive breastfeeding, pre-natal smoking and partner smoking. In spite of pre-existent low allergen levels in both groups, there was a significant reduction of mite, cat, and dog allergens on the mattresses and mite and cat allergens in the living room in the special care group and were significantly lower compared with the usual care group after 1 year.Conclusion High compliance was found for the use of anti-mite encasings; substantial compliance for using hypoallergenic formula, solid food postponement, keeping pets outside and reported post-natal maternal smoking. There was no compliance for sanitary measures and the reduction of maternal pre-natal passive smoking. Mite and pet allergens on mattresses were strongly reduced by anti-mite encasings.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2222.2004.01991.x
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  • 2
    Electronic Resource
    Electronic Resource
    Prenatal exposure to mite and pet allergens and total serum IgE at birth in high-risk children (2005)
    Oxford, UK : Munksgaard International Publishers
    Pediatric allergy and immunology 16 (2005), S. 0 
    Details
    ISSN: 1399-3038
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: To examine the relationship between prenatal exposure to mite, cat and dog allergens and total serum IgE at birth in newborns at high risk of asthma. In the homes of 221 newborns with at least one first-degree relative with asthma, concentrations (ng/g dust) of allergens of house dust mite (mite), cat and dog were measured at the fourth to sixth month of pregnancy in dust samples from the maternal mattress and living room. At day 3–5 after birth, total IgE was measured in capillary heel blood. A total number of 174 blood samples were available (11 mothers refused newborn's blood sampling, and in 36 cases the blood sample was too small for analysis). In 24% of the newborns, total IgE was elevated (cut-off value 0.5 IU/ml). A significant dose response relationship was found between increasing mite allergen levels [divided in quartiles ng/g dust (qrt)] and the percentage of elevated IgE: first qrt (0–85 ng/g) 13%; second qrt (86–381) 19%; third qrt (382–2371) 26%; fourth qrt (≥2372) 42%, respectively, p = 0.01. This relationship remained significant after adjusting for passive smoking, maternal and paternal mite allergy, socio-demographic factors, birth characteristics and (breast) feeding practice in the first week of life. In high-risk newborns, prenatal exposure to mite allergens, but not to cat and dog allergens from dust of the living room and of the maternal mattress was associated with total serum IgE at birth.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1399-3038.2005.00243.x
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  • 3
    Electronic Resource
    Electronic Resource
    Serial monitoring ofAspergillus antigen in the early diagnosis of invasive aspergillosis. Preliminary investigations with two examples (1997)
    Springer
    Infection 25 (1997), S. 86-89 
    Details
    ISSN: 1439-0973
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A recently developed sandwich ELISA, which detectsAspergillus galactomannan, was tested retrospectively in serial serum samples from an allogeneic bone marrow transplant recipient with proven invasive aspergillosis (patient 1) and another with suspected disease (patient 2). Galactomannan was detected in the serum 4 and 28 days, respectively, before pulmonary infiltrates suggestive of fungal infection first became apparent on the chest X-ray.Aspergillus was detected by ELISA and PCR in BAL fluid samples from both patients, and in CSF from patient 1. The diagnosis was confirmed at autopsy for patient 1 by histopathology and the recovery ofAspergillus fumigatus from the lung and brain. Furthermore, in both patients the course of the antigen titer in the serum during antifungal treatment corresponded with the clinical outcome. These results confirm that the sandwich ELISA appears to be useful for the early diagnosis of invasive aspergillosis. The value of the test for monitoring the response to antifungal treatment remains to be established in prospective trials.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02113581
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  • 4
    Electronic Resource
    Electronic Resource
    Pre-emptive administration of corticosteroids prevents the development of ARDS associated withStreptococcus mitis bacteremia following chemotherapy with high-dose cytarabine (1994)
    Springer
    Annals of hematology 69 (1994), S. 69-71 
    Details
    ISSN: 1432-0584
    Keywords: ARDS ; Streptococcus mitis ; Cytarabine Corticosteroids
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Adult respiratory distress syndrome (ARDS) complicatingStreptococcus mitis bacteremia is a major cause of mortality in patients undergoing therapy for leukemia. In order to try to prevent the development of ARDS in 11 patients withS. mitis bacteremia following chemotherapy including cytarabine, high doses of corticosteroids were administered pre-emptively. None of these patients developed ARDS. In a historical control group of 21 comparable patients who had not been given corticosteroids, the incidence of ARDS was high (38%), with a death rate of 14%. Preemptive administration of high-dose corticosteroids appeared to be highly effective in suppressing the mechanisms that induce ARDS in patients withS. mitis bacteremia after cytarabine treatment. The results suggest that ARDS complicatingS. mitis bacteremia is not merely a microbiological problem but may, at least in part, represent an immunologically mediated phenomenon.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01698484
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  • 5
    Electronic Resource
    Electronic Resource
    Antibiotic strategy after the empiric phase in patients treated for a hematological malignancy (1996)
    Springer
    Annals of hematology 72 (1996), S. 273-279 
    Details
    ISSN: 1432-0584
    Keywords: Key words Neutropenia ; Infectious complications ; Leukemia ; Empiric antibiotics ; Bone marrow transplantation ; Modification of antibiotic therapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Empiric broad-spectrum antibiotic therapy has become a generally accepted strategy in the treatment of febrile neutropenic patients. Particularly in patients with prolonged neutropenia, subsequent adaptation of such a regimen will be the rule rather than exception. Since there are no uniformly accepted guidelines for the modification of antibiotic therapy during the post-empiric phase, we assessed the impact of a set of rules that evolved during the first randomized trials. Evaluation of the clinician's compliance with these rules in 1951 febrile neutropenic episodes was the subject of the present analysis. Treatment was modified in 761 (39%) cases, and these changes were made according to the rules in 76%. For 75% of the alterations in treatment during the evening and night shifts, no reasonable explanation was established, while 93% of the modifications during the normal working hours were made for objective reasons. The empiric regimen was more frequently changed in patients with a clinical focus of infection at the onset of fever than in patients who showed fever as the only symptom of a possible infection. The perceived need for modification amounted to 69% in pulmonary infections, to 51% in skin and soft-tissue infections, to 44% in patients with abdominal complaints, and to 37% in upper respiratory tract infections. Glycopeptides constituted 22% of modifications, particularly in patients with a central venous catheter, and systemically active antifungals were administered in 16% of cases. Especially inexperienced clinicians tend to adjust antibiotic therapy, in spite of the fact that persistence of fever alone seldom reflects inadequate treatment when the clinical condition of the patient is stable or improving. On the other hand, the development of subsequent infectious events emphasizes that a genuine need for modification does frequently exist.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002770050172
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