November Medical Journal Review
by Richard F. Lockey, M.D., Editor-In-Chief
1. THE INTRADERMAL ADMINISTRATION OF 0.1 ML (1/5 THE STANDARD INTRAMUSCULAR DOSE) OF INFLUENZA VACCINE ELICITED IMMUNOGENICITY IN 100 HEALTHY ADULTS, 18 TO 40 YEARS OF AGE, SIMILAR TO OR BETTER THAN THAT ELICITED BY THE 0.5 ML INTRAMUSCULAR INJECTION. Kenney RT, et al, N Engl J Med 2004; 351:2295.
2. IN THE SECOND PAPER, AN INTRADERMAL INJECTION OF A REDUCED DOSE RESULTED IN SIMILARLY VIGGOROUS ANTIBODY RESPONSES AMONG PERSONS FROM 18 TO 60 YEARS OF AGE BUT NOT AMONG THOSE OVER THE AGE OF 60 YEARS OF AGE COMPARED TO AN INTRAMUSCULAR INJECTION OF A FULL DOSE. Belshe RB, et al, N Engl J Med 2004; 351:2286.
3. RESPIRATORY SYNCYTIAL VIRUS (RSV) IS THE MOST COMMON CAUSE OF BRONCHIOLITIS DURING INFANCY AND IS ASSOCIATED WITH SUBSEQUENT WHEEZING AND ASTHMA. RSV infection in mice caused an increase in viral-specific IgE antibodies. When p assively sensitized in vivo with virus-specific IgE, mice developed exaggerated airway responsiveness to methacholine on airway infection, suggesting that RSV may contribute to the pathophysiology of airway dysfunction in children who develop this class of specific antibody. Azzeddine D, et al, Am J Respir Crit Care Med 2004; 170:952.
4. A FIRST INFLUENZA VACCINATION WAS ASSOCIATED WITH A NON SIGNIFICANT ANNUAL REDUCTION OF MORTALITY RISK OF 10% WHILE RE-VACCINATION WAS ASSOCIATED WITH A REDUCED MORTALITY RISK OF 24%. Overall, influenza vaccination is estimated to prevent one death for every 302 vaccinees at a vaccination coverage that varied between 64% and 74%. Similar estimates were obtained for persons with and without chronic co-morbidity and those aged 70 years or older at baseline. Voordouw ACG, et al, JAMA 2004; 292:2089.
5. CHILDREN WHO OUTGREW PEANUT ALLERGY WERE EVALUATED WITH DOUBLE- BLIND, PLACEBO-CONTROLLED FOOD CHALLENGES. PATIENTS WHO CONSUMED PEANUT INFEQUENTLY OR IN LIMITED AMOUNTS HAD RECURRENCES OF PEANUT ALLERGY, COMPARED WITH THOSE WHO ATE PEANUT FREQUENTLY. Conclusion: children who outgrow peanut allergy are at risk for recurrence, and this risk is significantly higher for patients who continue largely to avoid peanut after resolution of their allergy. Fleischer DM, et al, J Allergy Clin Immunol 2004; 114:1195.
6. THESE INVESTIGATORS STUDIED WHETHER SPECIFIC IMMUNOTHERAPY WITH BIRCH POLLEN HAD AN EFFECT ON THE ORAL ALLERGY SYNDROME INDUCTED BY APPLE OR HAZELNUT IN BIRCH POLLEN-ALLERGIC INDIVIDUALS. THIRTEEN OF 15 (87%) OF THE TREATED SUBJECTS COULD EAT SIGNIFICANTLY MORE (P <0.001) APPLE OR HAZELNUT WITHOUT SYMPTOMS AND SIGNS. Thus, specific immunotherapy with vaccines including birch pollen possibly impacts the oral allergy syndrome to apple or hazelnut. However, the effect was limited. Bucher WJ et al, Allergy 2004; 59(12):1272.
7. SYMPOSIUM ON INHALED CORTICOSTEROIDS IN TREATMENT OF ASTHMA AND COPD. PRESENTATIONS ON THE CELLULAR AND MOLECULAR BASIS OF CORTICOSTEROID ACTION AND DISEASE PATHOGENESIS WERE REVIEWED, SIMILARITIES AND DIFFERENCES BETWEEN ASTHMA AND COPD, MOLECULAR BIOLOGY AND CORTICOSTEROID ACTION ARE REVIEWED. Schleimer RP, ed., Proc Am Thorac Soc 2004; 1,#3:151.
8. THE MIDDLE EAR EFFUSIONS OF ATOPIC PATIENTS HAD SIGNIFICANTLY HIGHER LEVELS OF EOSINOPHILS, T LYMPHOCYTES, AND IL-4 mRNA+ CELLS (P <.01) AND SIGNIFICANTLY LOWER LEVELS OF NEUTROPHILS AND IFN-γ mRNA+ CELLS (P < .01) COMPARED WITH NONATOPIC SUBJECTS. These studies support the concepts that the middle ear is part of the united airway in atopic individuals . Nguyen LHP, et al, J Allergy Clin Immunol 2004;114:1110.
9. GERD WAS FOUND IN 36% OF PATIENTS WITH ASTHMA. EIGHT (25%) WERE FREE FROM CLASSICAL REFLUX SYMPTOMS. FORTY-SEVEN OF 90 (52%) PRESENTED WITH TYPICAL REFLUX SYMPTOMS. In this study, one third of adult patients with asthma have GERD. Some do not have typical reflux symptoms, and even the presence of typical reflux symptoms in asthmatic patients does not guarantee the presences of an abnormal pH probe. Kiljander TO, et al, Chest 2004; 126:1490.
10. THERE ARE MORE THAN 30,000 PEER-REVIEWED ARTICLES ON HISTAMINES AND Hi-ANTIHISTAMINES PUBLISHED IN LITERATURE OVER THE PAST DECADE. This is an excellence review of the advances of Hi -antihistamines. Simons FE, N Engl J Med 2004; 351:2203.
