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E Urban

Publications and source records attributed to E Urban.

79 records · Page 5Linked to original sources
PubMedDate not supplied

Single-course specific immunotherapy with mixed pollen allergoids: results of a multi-centre study.

BACKGROUND: A short-term immunotherapy vaccine for the treatment of pollen allergy has been developed utilising L-tyrosine adsorbed allergoids. The reduced number of injections could provide advantages over long-term therapy schedules. This would improve compliance and support application of specific immunotherapy (SIT) to a greater extent. We report a multicenter study to evaluate the efficacy and safety of this treatment in a clinical practice setting. METHODS: Patients (n = 1808) with a diagnosis of sensitivities to various pollens and symptoms of allergic asthma and/or allergic rhinitis and/or allergic conjunctivitis were selected. The vaccine formulation was made up according to individual sensitivities and contained L-tyrosine adsorbed allergoids. The patients were treated with a 3-injection initial course followed by a 3-injection maintenance course. Efficacy was measured by consumption of symptomatic anti-allergic medication compared with that in the previous season and by physician assessment using a 5-point scale. All adverse events were recorded. RESULTS: Efficacy was demonstrated by a considerable decrease in regular and frequent use of medication compared with that in the previous season (p < 0.001). In addition, in 80 % of the patients, the physician's assessment was either "good" or "very good". These outcomes were unaffected by the closeness of the treatment course to the onset of the pollen season. Tolerability was good and most local and systemic reactions were mild. CONCLUSIONS: The treatment of pollen-allergic patients with a short-term SIT using a 6-injection pollen allergoid/L-tyrosine vaccine in a clinical practice setting provided a high level of efficacy with a low incidence of mainly mild adverse events.

Adolescent↗
PubMedDate not supplied

Efficacy and tolerability of short-term specific immunotherapy with pollen allergoids adjuvanted by monophosphoryl lipid A (MPL) for children and adolescents.

BACKGROUND: Specific immunotherapy (SIT) with pollen allergoids formulated with the Th1-inducing adjuvant 3-deacylated monophosphoryl lipid A (MPL adjuvant, Corixa) has shown good efficacy and tolerability in the treatment of pollen allergies in adults. The aim of this study was to evaluate this treatment in children and adolescents aged 6-17 years old who were sensitive to grass/rye or tree pollens. METHODS: An open, multicenter study was performed using 90 children and adolescents. The patients received four subcutaneous injections of grass/rye (n = 64) or tree pollen allergoids (n = 26) adsorbed to L-tyrosine and containing MPL adjuvant. Efficacy was measured by symptom and medication scoring, skin prick test reactivity and IgG/IgE antibody responses. Tolerability was monitored by recording adverse events. RESULTS: Both grass/rye and tree pollen treatment groups showed significant reductions in symptom scores and anti-allergic medication use compared with the previous pollen seasons (p < 0.01 in all cases). After therapy, skin prick test reactivity was significantly reduced in both groups and pollen-specific IgG was significantly increased in both groups whereas little change was apparent in pollen-specific IgE. Overall tolerability was similar to results obtained in previous studies in adults. CONCLUSION: Short-term SIT using four injections of grass/rye or tree pollen allergoids adsorbed to L-tyrosine and with MPL adjuvant was shown to be effective with good tolerability. The treatment compared favorably with previous studies in adults.

Adjuvants, Immunologic↗
PubMedDate not supplied

Sublingual specific immunotherapy for adults and children: a post-marketing surveillance study.

BACKGROUND: Sublingual immunotherapy (SLIT) is a relatively new form of treatment for type I allergies and a good safety profile is rapidly being established. Evidence on the efficacy of SLIT is increasing, and the present study provides further supportive data. We describe the results of treatment with a SLIT vaccine formulated with a range of allergen extracts obtained by allergologists in daily clinical practice. METHODS: Adult and child patients (n = 159, 81 males, 78 females) with confirmed type I allergic sensitivities were treated with a standardized SLIT vaccine (ORALVAC) using the sublingual-swallow method. Evaluation of the efficacy of SLIT was based on the consumption of anti-allergic medication and a global assessment. Tolerability assessment was based on the incidence of local or systemic reactions. RESULTS: Medication use was significantly reduced compared with that in previous years (p = 0.023). In a large subgroup of patients treated for pollen sensitivity the significance was stronger (p = 0.016). Global assessment revealed that only 3.5 % of patients showed no change in symptoms after therapy. High tolerability was achieved and no serious or severe adverse effects were observed. CONCLUSION: Over a one-year period, adult and child patients with a variety of type I allergies were treated with a SLIT vaccine that has shown significant efficacy and was well-tolerated with no serious or severe adverse events.

Administration, Sublingual↗
PubMedDate not supplied

Why make monofilament sutures out of polyvinylidene fluoride?

In recent years some clinical reports have associated suture failures with polypropylene monofilaments. Therefore there is interest in developing an alternative suture material that is less thrombogenic than polyester and similar in handling characteristics but less prone to mechanical failure than polypropylene. To this end, Peters Laboratoire Pharmaceutique has developed a new monofilament suture material from polyvinylidene fluoride (PVDF), which has been subjected to a special treatment to modify its crystalline form and level of crystallinity. The purpose of this study was to evaluate its mechanical, chemical, and biologic properties and to compare its performance, in a peripheral vascular application, to that of a polypropylene control. A series of in vitro tests were performed to study the morphology, tensile properties, creep, surface chemistry, thermal characteristics, and resistance to iatrogenic trauma. In addition, an in vivo trial was undertaken in which vascular prostheses anastomosed with either PVDF or polypropylene sutures were implanted as a thoracoabdominal bypass for 6 months in the dog. Histologic and degradation analyses were performed on the explants. The results from the mechanical tests on 4-0, 5-0, and 6-0 PVDF and polypropylene sutures demonstrated that although both materials have similar breaking strengths, the PVDF has a higher extension at break, has less delayed extension when under tensile creep testing, and suffers less trauma than the polypropylene when compressed by a standard needle holder. While chemical analyses found evidence of surface oxidation on both types of sutures, thermal analysis confirmed that the level of crystallinity of the PVDF polymer is higher than that of the polypropylene control. During the pilot study in animals, PVDF sutures were found to have good handling and frictional characteristics that facilitated the tying of knots. Histologic analysis of the explants found no inflammatory cells in the tissue surrounding either the PVDF or polypropylene sutures, and scanning electron microscopic examination of the cleaned suture surfaces found no evidence of degradation during 6 months in vivo. Though preliminary in nature, these findings indicate that monofilament sutures made from PVDF provide an attractive alternative to those made from polypropylene for use in cardiovascular surgery. In addition to providing acceptable in vivo behavior and being easy to manipulate and more resistant to iatrogenic injury, PVDF materials can be sterilized by beta or gamma radiation and so can reduce dependence upon ethylene oxide and chlorofluorohydrocarbons.

Animals↗