Tolerability to Etoricoxib in Patients With Aspirin-Exacerbated Respiratory Disease

Original Article

Tolerability to Etoricoxib in Patients With Aspirin-Exacerbated Respiratory Disease

D Koschel,1 C Ninck Weber,1 G Höffken1,2

1Department of Pulmonary Diseases, Fachkrankenhaus Coswig, Centre for Pulmonary Diseases and Thoracic Surgery, Coswig, Germany 2Department of Internal Medicine I, University Hospital Carl Gustav Carus Dresden, Dresden, Germany

J Investig Allergol Clin Immunol 2013; Vol. 23(4): 275-280

Abstract Background: The use of selective cyclooxygenase (COX) 2 inhibitors as an alternative to aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) has been suggested for patients with aspirin-exacerbated respiratory disease (AERD). Objective: To evaluate tolerability to etoricoxib, a second-generation COX-2 inhibitor with high in vitro selectivity for COX-2 in patients with AERD. Methods: We conducted a retrospective review of patients with suspected aspirin intolerance seen between October 2007 and April 2012. Single-blind, placebo-controlled oral challenges with increasing doses of aspirin and etoricoxib were performed on 3 different days. Results: Of 262 patients with suspected aspirin intolerance, 248 underwent challenge testing with aspirin and 122 (49.2%) showed positive test results. In 104 of these aspirin-sensitive patients, etoricoxib was tested as an alternative drug and was tolerated in all but 3 (2.9%), who developed a positive asthmatic reaction. Conclusions: The highly selective COX-2 inhibitor etoricoxib was tolerated in most but not all patients tested. An oral provocation test is therefore recommended before prescribing etoricoxib for patients with AERD. Key words: Aspirin-exacerbated respiratory disease. Asthma. COX-II inhibitor. Etoricoxib. Hypersensitivity   Free Full-Text (PDF)   How to use PDF documents

Safety of cluster specific immunotherapy with a modified high-dose house dust mite extract

 Vol 45, No 3 (2013) > Nieto Garcìa

Safety of cluster specific immunotherapy with a modified high-dose house dust mite extract

A. Nieto Garcìa, S. Nevot Falcò, T. Carrillo Dìaz, et al.

Abstract

Introduction. Although the efficacy and safety of high dose hypoallergenic mite subcutaneousimmunotherapy (SCIT) using a conventional administration schedule has alreadybeen demonstrated, there is no reported experience on the safety of these extracts with clusterschedules.We wanted to determine whether the use of a cluster schedule of a hypoallergenicallergen with a high concentration of house dust mite allergens commonly used in normalpractice was safe and well-tolerated in patients with dust mite allergy. Material andMethods. Multicentre, observational, retrospective study of dust mite allergic patientstreated with a cluster schedule of SCIT (Acaroid®; Day 1: 300/300 therapeutic units,TU– Day 8: 1000/1000 TU- Day 15: 3000/3000 TU) in 23 Spanish sites. Results. Clusterschedule was used on 434 patients (40.1% children), with a total of 3256 doses (38.2% inchildren). There were 88 clinically relevant adverse reactions, 79 out of them local and 9systemic (but mild-moderate) that amounted to 2.7% of all the administered doses. All thepatients fulfilled the cluster schedule. Conclusions. Cluster schedule with high dose hypoallergenicmite-SCIT was safe and well-tolerated in routine clinical practice. Therefore, itsuse could reduce the costs and time needed to achieve the desired maintenance dose and increasecompliance

Keywords

Subcutaneous immunotherapy (SCIT); dust mites; high-dose allergoid cluster schedules; safety

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Research article

Comparison among nasopharyngeal swab, nasal wash, and oropharyngeal swab for respiratory virus detection in adults with acute pharyngitis

Li Li^1†, Qiao-Yan Chen^2†, Yun-Ying Li², Yan-Fang Wang³, Zi-Feng Yang^1* and Nan-Shan Zhong^1*

• *Corresponding authors: Zi-Feng Yang jeffyah@163.com - Nan-Shan Zhong nanshan@vip.163.com
• † Equal contributors

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BMC Infectious Diseases 2013, 13:281 doi:10.1186/1471-2334-13-281

Published: 20 June 2013

Abstract

Background

Acute pharyngitis is frequently seen in primary care. Acute viral pharyngitis may be easily misdiagnosed as acute bacterial pharyngitis. Laboratory-confirmed diagnosis of respiratory viruses is recommended. The purpose of this study was to compare the sensitivities among oropharyngeal swab (OPS), nasopharyngeal swab (NPS), and nasal wash (NW) in adults with acute pharyngitis.

Methods

OPS, NPS, and NW were obtained from each participant with acute pharyngitis. The specimens were tested for 15 respiratory viruses by TaqMan real-time polymerase chain reaction. A sample was considered to be a true positive if any of the specimens was positive. The sensitivities among samples were compared by chi-square test or Fisher’s exact test, as appropriate.

Results

One hundred three triple samples collected consecutively by OPS, NPS, and NW were obtained. In 73 patients, one or more viruses were detected by any of the three methods. Among all viruses, the sensitivity of NPS was significantly higher than that of NW (74% vs. 49%, respectively; p < 0.01) and OPS (74% vs. 49%, respectively; p < 0.01).

Conclusions

Flocked NPS collection may be the most effective alternative to NW and OPS for detection of respiratory viruses in adults with acute pharyngitis using TaqMan real-time polymerase chain reaction.

Keywords: 

Respiratory viruses; Acute pharyngitis; Oropharyngeal swab; Nasopharyngeal swab; Nasal wash; Sensitivity; TaqMan real-time polymerase chain reaction

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Complex interactions between host and environment in allergic diseases and the roles of integrative management

Vol. 31, No. 2, June 2013 > Klaewsongkram

Complex interactions between host and environment in allergic diseases and the roles of integrative management

Jettanong Klaewsongkram

Abstract

No abstract aavailable.

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International Journal of Chronic Obstructive Pulmonary Disease

Efficacy of levofloxacin versus cefuroxime in treating acute exacerbations of chronic obstructive pulmonary disease

Original Research

(56) Total Article Views

Authors: Yoon HI, Lee CH, Kim DK, Park GM, Lee SM, Yim JJ, Kim JY, Lee JH, Lee CT, Chung HS, Kim YW, Han SK, Yoo CG

Published Date July 2013 Volume 2013:8 Pages 329 - 334

DOI: http://dx.doi.org/10.2147/COPD.S41749

Received:	17 December 2012
Accepted:	12 April 2013
Published:	10 July 2013

Ho Il Yoon,¹ Chang-Hoon Lee,² Deog Kyeom Kim,³ Geun Min Park,⁴ Sang-Min Lee,² Jae-Joon Yim,² Jae-Yeol Kim,⁵ Jae Ho Lee,¹ Choon-Taek Lee,¹ Hee Soon Chung,³ Young Whan Kim,² Sung Koo Han,² Chul-Gyu Yoo^2
1Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Lung Institute, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea; ²Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Lung Institute, Seoul National University College of Medicine, Seoul, Republic of Korea; ³Division of Pulmonology, Department of Internal Medicine, Seoul National University Boramae Hospital, Seoul, South Korea; ⁴Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang, Republic of Korea; ⁵Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Republic of Korea

Background: Antibiotic treatment is one of the major pharmacologic treatments for acute exacerbation of chronic obstructive pulmonary disease (AECOPD). However, the choice of antibiotic depends on the local resistance pattern. A multicenter, randomized, controlled trial was done in patients with AECOPD to compare the efficacy of levofloxacin with that of cefuroxime axetil.
Methods: Patients with AECOPD and without radiographic evidence of pneumonia were enrolled and randomized to either levofloxacin 500 mg daily or cefuroxime 250 mg twice daily in the mild-moderate exacerbation group, or 500 mg twice daily in the severe exacerbation group, for seven days. Clinical efficacy and microbiologic response were evaluated 5–7 days after the last dose.
Results: Treatment was clinically successful in 90.4% of patients in the levofloxacin group, and in 90.6% of patients in the cefuroxime group (95% confidence interval -9.40 to 10.91), within a noninferiority margin of 10%. The microbiologic response appeared to be higher in the levofloxacin group, but the difference was not statistically significant. The safety profile was similar in both groups.
Conclusion: Levofloxacin is not inferior to cefuroxime with regard to clinical efficacy in treating AECOPD.

Keywords: chronic obstructive pulmonary disease, acute exacerbation, levofloxacin, cefuroxime



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New Aspects on Human Rhinovirus Infections

 May 2013 - Volume 32 - Issue 5 > New Aspects on Human Rhinovirus Infections

Pediatric Infectious Disease Journal: May 2013 - Volume 32 - Issue 5 - p 553–555 doi: 10.1097/INF.0b013e3182833c90 Reports and Reviews from the European Society for Paediatric Infectious Diseases New Aspects on Human Rhinovirus Infections Ruuskanen, Olli MD, PhD*; Waris, Matti PhD†; Ramilo, Octavio MD‡ Free Access Article Outline Author Information From the *Department of Pediatrics, Division of Infectious Diseases, Turku University Hospital; †Department of Virology, University of Turku, Turku, Finland; and ‡Division of Infectious Diseases, Nationwide Children’s Hospital and Ohio State University, Columbus, OH. The authors have no funding or conflicts of interest to disclose. Address for correspondence: Olli Ruuskanen, MD, PhD, Department of Pediatrics, Turku, University Hospital, 20520 Turku, Finland. E-mail: olli.ruuskanen@tyks.fi.Many large studies performed in 1960s detected human rhinovirus (HRV) by virus isolation in one quarter of the cases with acute upper respiratory infections, and HRV was mainly considered a common cold virus. Virus culture, the standard method for detection, was carried out in research laboratories with special expertise and the role of HRV outside common cold remained unclear. During 1990s, polymerase chain reaction (PCR) techniques for HRV became generally available and they revolutionized HRV studies bringing important new biologic and clinical observations.1–3 Many large studies performed in 1960s detected human rhinovirus (HRV) by virus isolation in one quarter of the cases with acute upper respiratory infections, and HRV was mainly considered a common cold virus. Virus culture, the standard method for detection, was carried out in research laboratories with special expertise and the role of HRV outside common cold remained unclear. During 1990s, polymerase chain reaction (PCR) techniques for HRV became generally available and they revolutionized HRV studies bringing important new biologic and clinical observations.1–3 Article as PDF (197 KB) Article as EPUB Print this Article Email To Colleague Add to My Favorites Export to Citation Manager Alert Me When Cited Request Permissions

Structural and Antigenic Definition of Hepatitis C Virus E2 Glycoprotein Epitopes Targeted by Monoclonal Antibodies

Clinical and Developmental Immunology
Volume 2013 (2013), Article ID 450963, 12 pages
http://dx.doi.org/10.1155/2013/450963

Review Article

Structural and Antigenic Definition of Hepatitis C Virus E2 Glycoprotein Epitopes Targeted by Monoclonal Antibodies

Giuseppe Sautto,¹ Alexander W. Tarr,^2,3 Nicasio Mancini,¹ and Massimo Clementi¹

¹Laboratorio di Microbiologia e Virologia, Università Vita-Salute San Raffaele, Via Olgettina 58, 20132 Milano, Italy
²School of Molecular Medical Sciences, The University of Nottingham, Nottingham NG7 2UH, UK
³Biomedical Research Unit in Gastrointestinal and Liver Diseases, The University of Nottingham, Nottingham NG7 2UH, UK

Received 9 May 2013; Accepted 10 June 2013

Academic Editor: Roberto Burioni

Copyright © 2013 Giuseppe Sautto et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Hepatitis C virus (HCV) is the major cause of chronic liver disease as well as the major indication for liver transplantation worldwide. Current standard of care is not completely effective, not administrable in grafted patients, and burdened by several side effects. This incomplete effectiveness is mainly due to the high propensity of the virus to continually mutate under the selective pressure exerted by the host immune response as well as currently administered antiviral drugs. The E2 envelope surface glycoprotein of HCV (HCV/E2) is the main target of the host humoral immune response and for this reason one of the major variable viral proteins. However, broadly cross-neutralizing monoclonal antibodies (mAbs) directed against HCV/E2 represent a promising tool for the study of virus-host interplay as well as for the development of effective prophylactic and therapeutic approaches. In the last few years many anti-HCV/E2 mAbs have been evaluated in preclinical and clinical trials as possible candidate antivirals, particularly for administration in pre- and post-transplant settings. In this review we summarize the antigenic and structural characteristics of HCV/E2 determined through the use of anti-HCV/E2 mAbs, which, given the absence of a crystal structure of this glycoprotein, represent currently the best tool available.

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Case report

A case of the first documented fire ant anaphylaxis in Canada

Jason Kihyuk Lee and Stephen Daniel Betschel

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Allergy, Asthma & Clinical Immunology 2013, 9:25 doi:10.1186/1710-1492-9-25

Published: 9 July 2013

Abstract (provisional)

The first documented confirmed case of an imported fire ant causing anaphylaxis in Canada is herein reported. In a patient with anaphylaxis to ants a physician in Canada should be aware that an allergic reaction to fire ant is a possibility.

The complete article is available as a provisional PDF. The fully formatted PDF and HTML versions are in production.