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Biomedical subjects

I Finegold

Publications and source records attributed to I Finegold.

At least 19 recordsLinked to original sources
PubMed2001

Immunotherapy historical perspective.

OBJECTIVE: To review early history of specific immunotherapy, particularly the contribution of Robert A. Cooke. DATA SOURCES: Review of literature. CONCLUSIONS: Cooke was an important investigator developing the basic method of immunotherapy as it is practiced today. His contributions to the field of allergy are staggering. They include the elucidation of blocking antibodies, passive transfers, dosage techniques, testing techniques, and more. It is our hope this consensus conference will lead to more national and international collaborative efforts focusing on different subtopics of allergen immunotherapy. We intend to bring cutting edge information, discussions, and consensus agreements for our own members, for other physicians, and for the public at large.

History, 19th Century↗
PubMed2001

Analyzing meta-analyses of specific immunotherapy in the treatment of asthma.

OBJECTIVE: To review the differences and similarities of the meta-analyses dealing with asthma immunotherapy (IT). DATA SOURCES: Published papers by Abramson et al (Am J Respir Crit Care Med 1995;151:969-974) and Ross et al (Clin Ther 2000;22:329-341). RESULTS: Based on the review of published data concerning meta-analyses of published clinical studies using IT to treat asthma, it is an effective treatment. IT can significantly reduce asthma symptoms and medication requirements. Both specific and nonspecific bronchial hyperresponsiveness were decreased, but improvement as measured by lung function tests was inconsistent. CONCLUSIONS: IT needs to be considered in the treatment of allergic asthmatic patients.

Asthma↗
PubMed2000

Effectiveness of specific immunotherapy in the treatment of asthma: a meta-analysis of prospective, randomized, double-blind, placebo-controlled studies.

BACKGROUND: Despite decades of positive experience with specific immunotherapy (SIT) in the treatment of asthma, outcomes associated with SIT have not been evaluated. OBJECTIVE: This meta-analysis was conducted to compare the effects of SIT plus medical treatment with those of SIT without medical treatment in patients with asthma. METHODS: All studies of SIT in patients with asthma published in English between the years 1966 and 1998 were identified through a MEDLINE search. All prospective, randomized, double-blind, placebo-controlled studies of SIT identified by the search were included in the meta-analysis. One author (R.N.R.) extracted data from these studies. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using a random-effects model. RESULTS: Data were extracted from 24 identified studies of the clinical effectiveness of SIT in the treatment of asthma, involving 962 asthmatic patients with documented allergy. Immunotherapy was judged effective in 17 (71%) of the 24 studies, ineffective in 4 (17%), and equivocal in 3 (12%) (chi2 = 15.25, df = 2, P = 0.0005). Symptoms of asthma were more likely to improve in patients who received SIT than in patients who received placebo (OR 2.76, 95% CI 2.22 to 3.42). Results also favored the immunotherapy group for improvement in pulmonary function (OR 2.87, 95% CI 1.82 to 4.52), protection against bronchial challenge (OR 1.81, 95% CI 1.32 to 2.49), and reduced need for medications (OR 2.00, 95% CI 1.46 to 2.72). CONCLUSION: The findings of this meta-analysis support the conclusion that SIT is effective in a population of patients with allergen-triggered asthma.

Adolescent↗
PubMed2000

Effectiveness of specific immunotherapy in the treatment of allergic rhinitis: an analysis of randomized, prospective, single- or double-blind, placebo-controlled studies.

BACKGROUND: The effectiveness of specific immunotherapy (SIT) in the treatment of allergic rhinitis has been supported by empirical evidence and clinical experience. OBJECTIVE: This report is an analysis of multiple studies involving patients with documented allergic rhinitis. METHODS: All studies of the effectiveness of SIT in the treatment of allergic rhinitis published in English between the years 1966 and 1996 were identified through a MEDLINE search. All prospective, single- or double-blind, placebo-controlled studies were included in the analysis. One author (R.N.R.) extracted data from the studies. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using a random-effects model for a variety of clinical measures in studies that permitted the extraction of numbers of patients with positive and negative outcomes. RESULTS: Data were extracted from 16 studies of the clinical effectiveness of SIT in the treatment of allergic rhinitis, involving 759 patients (546 adults, 53 children, 160 all ages). In 15 (94%) of the studies, investigators concluded that SIT was effective. In the remaining study (the only one conducted in children), investigators concluded that SIT was not effective. Symptoms of allergic rhinitis were more likely to improve in patients receiving SIT than in the comparison patients (OR 1.81, 95% CI 1.48 to 2.23). Symptom-medication scores were significantly lower in patients receiving SIT than in the comparison patients in all studies using such measures (P < 0.05). CONCLUSION: Results of this analysis support the conclusion that SIT is effective in the treatment of allergic rhinitis.

Adolescent↗
PubMed2000

Effectiveness of specific immunotherapy in the treatment of hymenoptera venom hypersensitivity: a meta-analysis.

BACKGROUND: For most people, Hymenoptera stings produce a transient, local inflammatory reaction (pain, redness, swelling). However, for those who are allergic to components of this venom, the reactions can be severe, frightening, and sometimes fatal. Specific immunotherapy (SIT) has been the only means of desensitizing patients who have experienced a systemic reaction to this venom. OBJECTIVE: This meta-analysis was conducted to compare the effects of SIT in the treatment of Hymenoptera venom hypersensitivity. METHODS: All studies of SIT in the treatment of Hymenoptera venom hypersensitivity published in English between the years 1966 and 1996 were identified through a MEDLINE search. Because of the ethical difficulties involved in designing a double-blind, placebo-controlled study in this patient population, most of the studies were open and not placebo-controlled. One author (R.N.R.) extracted data from the studies. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using a random-effects model. RESULTS: Data were extracted from 8 studies involving 453 patients; 1 study was conducted in adults (n = 20), 2 in children (n = 188), and 5 in all ages (n = 245). The symptoms of Hymenoptera venom hypersensitivity were prevented in 80 (79%) of the 101 patients receiving SIT versus 49 (36%) of 136 comparison patients. The symptoms were not prevented in 21 (21%) of the patients receiving SIT versus 87 (64%) of the comparison patients (OR 2.20, 95% CI 1.72 to 2.81). CONCLUSION: The findings of this meta-analysis support the conclusion that SIT is effective in the treatment of Hymenoptera venom hypersensitivity.

Adolescent↗
PubMed2000

Comparison of the clinical efficacy and comfort of olopatadine hydrochloride 0.1% ophthalmic solution and nedocromil sodium 2% ophthalmic solution in the human conjunctival allergen challenge model.

BACKGROUND: Mast cell stabilizers, such as the ocular antiallergic agent nedocromil sodium 2% ophthalmic solution, are not rapid acting and often require a loading period of > or =2 weeks for maximal efficacy. Olopatadine hydrochloride 0.1% ophthalmic solution is a member of a new class of topical antiallergic agents that have combined antihistaminic and mast cell-stabilizing properties. OBJECTIVE: The purpose of this study was to compare the clinical efficacy and comfort of olopatadine with those of nedocromil in the conjunctival allergen challenge model. METHODS: This was a single-center, 3-visit, randomized, double-masked, contralaterally controlled study. Seventy-five subjects with a history of allergic conjunctivitis were screened, and the 52 who responded to conjunctival allergen challenge at visits I and 2 were randomized by eye to receive olopatadine, nedocromil, or placebo (a "natural tears" lubricant eye drop). Because nedocromil may require a 2-week loading period for maximal efficacy, the eyes assigned to that agent received nedocromil for 14 days (between visits 2 and 3), whereas the eyes assigned to olopatadine or placebo received placebo during this period. Throughout the loading phase, subjects instilled 1 drop of the assigned masked medication in each eye twice daily. At the assessment visit (visit 3), subjects received I drop of masked olopatadine, nedocromil, or placebo in each eye and were asked to rate the comfort of each drop on a scale from 0 to 8. Fifteen minutes after instillation of medication, subjects were challenged with the allergen concentration that had elicited a positive conjunctival allergic response at the previous visits. Subjects then scored their itching on a scale from 0 to 4 at 3, 5, and 10 minutes after challenge. Mean itching scores for all eyes were compared by treatment. Paired t tests were performed on the mean itching and ocular comfort scores at each time point. At the end of the study, subjects were asked which treatment they preferred in terms of comfort and efficacy. RESULTS: Forty-nine subjects completed the study. Forty eyes received olopatadine, 36 received nedocromil, and 22 received placebo. Olopatadine was clinically and statistically superior to nedocromil at reducing itching in the conjunctival allergen challenge model (mean unit difference: -1.60 at 3 minutes, -1.68 at 5 minutes, -1.19 at 10 minutes; P < 0.001). One drop of olopatadine was more efficacious than 29 drops of nedocromil. Olopatadine-treated eyes were rated as being significantly more comfortable than nedocromil-treated eyes (0.73 vs 1.55; P = 0.034). Of the 14 subjects treated with olopatadine and nedocromil who stated a preference, 10 (71%) were more satisfied with olopatadine than with nedocromil. CONCLUSION: In the conjunctival allergen challenge model, olopatadine was more efficacious and comfortable than nedocromil in reducing the itching associated with allergic conjunctivitis.

Conjunctivitis, Allergic↗
PubMed1986

Oral desensitization to trimethoprim-sulfamethoxazole in a patient with acquired immunodeficiency syndrome.

Intravenous administration of trimethoprim-sulfamethoxazole (TMS) on three occasions resulted in fever, rash, and wheezing in a 30-year-old man with acquired immunodeficiency syndrome with Pneumocytis carinii pneumonia. Pentamidine administration produced fever, severe myositis, and clinical deterioration, and therefore, desensitization to TMS was attempted. This was done with low doses of oral suspension and then intravenous administration during a period of 60 hours. The patient reacted with fevers, arthralgia, and erythema that cleared 4 days after the desensitization was completed. This single case of successful desensitization to TMS in a patient with acquired immunodeficiency syndrome suggests that the oral route may be useful in similar situations when this drug is urgently needed.

Acquired Immunodeficiency Syndrome↗
PubMed1985

Allergy and Tourette's syndrome.

Four patients with Tourette's syndrome who presented in an allergist's office are described. The diagnostic criteria, presentation of Tourette's syndrome, and current therapy are discussed. All four patients had increased serum IgE levels and positive skin tests. Symptoms of Tourette patients may mimic allergy or present combined with allergic illness.

Adolescent↗
PubMed1976

Allergic reactions to molds.

Allergy to mold is common, and results from inhalation of mold spores or ingestion of mold related foods. Mold spores are complex, hardy organisms capable of eliciting diverse immune responses and illnesses which may be mild or severe. Diagnosis and treatment with mold antigens are outlined and environmental recommendations made. Mechanisms of reactions to treatment of mold allergy are postulated.

Air Microbiology↗
PubMed1975

A two-year pollen and spore survey of Southeast Florida.

A two-year pollen survey of southeast Florida revealed significant airborne pollen and spores. Ragweed, grass, tree pollen and mold spores were identified. Pollen and mold spores were found to be present in lower quantities than in the temperate regions but for more prolonged periods of time.

Air Pollutants↗