Biomedical subjects

P Taramarcaz

Publications and source records attributed to P Taramarcaz.

6 recordsLinked to original sources

PubMed2006

[Lake Geneva Region guidelines on management of adult asthma].

Asthma is a major cause of chronic morbidity throughout the world. In Switzerland, 6.9% of the adult population is suffering from asthma. The standards of treatment are unfortunately not met in most western countries, as well as in Switzerland. We put forward a complete guideline on management of adult asthma, inspired from GINA and BTS guidelines, and adapted to the specific needs of general practitioners working in french part of Switzerland. This guideline reflects a consensus between allergy, lung and emergency specialists, working in the 2 university hospitals of the Lake Geneva Region (HUG and CHUV).

Adult↗

PubMed2005

Ragweed (Ambrosia) progression and its health risks: will Switzerland resist this invasion?

The purpose of this article is to alert physicians for the environmental and health threats of Ambrosia artemisiifolia (common ragweed) in Switzerland. Switzerland borders several heavily ragweed colonised areas. Up to 12% of the population suffers from allergies (hay fever, asthma) to ragweed pollen in these areas. Switzerland is beginning to be invaded by this plant. Currently, the ragweed pollen counts are still low but can reach local peaks that induce symptoms in allergic individuals. Ragweed allergy, however, is still rare in Switzerland. Because the amount of ragweed pollen was increasing in the last few years, identification and surveillance of ragweed plant foci was started. Colonisation is currently systematically monitored in Geneva and southern Tessin. Major accumulation of ragweed foci have been detected in the canton of Geneva, the western shore of the lake of Geneva belonging to the canton of Vaud, and in the southern part of the canton of Tessin, aside from minor foci registered all over Switzerland. The routes of ragweed invasion are presented and discussed. Current measures of ragweed containment and needs for the future are presented. The urge for these measures at an early stage of ragweed spread is underlined by the impracticability of eradication in highly colonised areas. The costs of preventing ragweed spread in Switzerland are likely to be several magnitudes lower than the treatment of a significant percentage of the Swiss population for ragweed pollen allergy. Because areas can change from low to heavy ragweed colonisation within a few years, the current window of opportunity to prevent further colonisation by ragweed should not be missed.

Air Pollutants↗

PubMed2004

The effectiveness of intranasal corticosteroids in combined allergic rhinitis and asthma syndrome.

BACKGROUND: Allergic rhinitis (AR) and asthma often coexist and may represent two manifestations of the same disease recently named combined AR and asthma syndrome (CARAS). AIM: To review the common pathophysiology of combined AR and asthma and to investigate the efficacy of intranasal corticosteroids (INCS). METHODS: Medline was used to identify articles relevant to mechanisms. A Cochrane systematic review was performed to assess the efficacy of INCS in CARAS. RESULTS: There is cross-talk, evidence of a common inflammatory response in both sites, linked by a systemic component. The efficacy of anti-inflammatory INCS on asthma outcomes was assessed in a systematic review of 12 randomized controlled trials involving 425 subjects. After INCS there were non-significant trends for improvement in asthma symptom score (standardized mean difference (SMD) of 0.61; P=0.07), forced expiratory volume in 1 s (SMD of 0.31; P=0.08), and morning peak expiratory flow (weighted mean difference of 36.51; P=0.06). There was no impact on methacholine airways responsiveness (SMD of -0.20; P=0.4). The review identified two promising new treatment options in united airway disease such as INCS as monotherapy in rhinitis and mild asthma, and a combined intranasal and intrabronchial corticosteroid (IBCS) deposition technique. CONCLUSION: Common mucosal inflammatory responses occur in CARAS. This systematic review shows trends for a benefit of INCS in CARAS, but recognizes that more research is needed. At this stage, the current best practice is to treat asthma conventionally with IBCS with or without beta(2)-agonist and to add INCS to improve specific rhinitis symptoms.

Administration, Inhalation↗

PubMed2003

Intranasal corticosteroids for asthma control in people with coexisting asthma and rhinitis.

BACKGROUND: Allergic rhinitis and asthma are mediated by similar allergic mechanisms. They may represent two manifestations of the same united airway disease and therefore intranasal corticosteroids (INCS) could improve asthma. Nevertheless none of the asthma guidelines have advocated intranasal corticosteroids for asthma. OBJECTIVES: To assess the efficacy of intranasal corticosteroids on asthma outcomes in people with rhinitis and asthma. SEARCH STRATEGY: We searched the Cochrane Airways Group trials register, the Cochrane Central Register of Controlled Trials (Issue 1, 2003), MEDLINE and reference lists of articles. We also contacted researchers in the field. Last search updated in March 2003. SELECTION CRITERIA: Randomised controlled trials comparing intranasal corticosteroids to intranasal placebo or to other traditional asthma treatments were included. Intrabronchial corticosteroids were not allowed but a device combining intranasal and intrabronchial corticosteroid was considered as being a primary INCS technique and was therefore also compared to placebo. DATA COLLECTION AND ANALYSIS: Two reviewers independently assessed trial quality and extracted data. Study authors were contacted for additional information. Quality assessment for the 14 eligible studies was performed using the Jadad score and by ranking allocation concealment. Statistical analysis for continuous data was done by weighted mean difference or standardised mean difference. MAIN RESULTS: Fourteen trials involving 477 people were included. Meta-analysis for asthma outcomes failed to show a statistically significant benefit of INCS in asthma. However, for symptom scores and forced expiratory volume in one second, the trend favoured a beneficial effect of INCS. For asthma symptom scores (two parallel studies), the standardised mean difference was 0.61 (95% confidence interval (CI) -0.04 to 1.26). Meta-analysis for forced expiratory volume in one second (five parallel studies) gave a standardised mean difference of 0.31 (95% CI -0.04 to 0.65). In the parallel studies, meta-analysis of peak expiratory flow gave a standardised mean difference of -0.10 Litres/min (95% CI -0.55 to 0.35) for mean peak flow (three studies). Meta-analysis for methacholine airway responsiveness (three parallel studies) showed a standardised mean difference of -0.20 (-95% CI 0.64 to 0.24). REVIEWER'S CONCLUSIONS: Intranasal corticosteroids were well tolerated. While INCS tended to improve asthma symptoms and forced expiratory volume in one second, the results did not reach significance. The combination of intranasal plus intrabronchial corticosteroids should remain the current clinical practice until more research is done.

Administration, Intranasal↗

PubMed2001

Soy anaphylaxis.

Explore the source record for details and available documents.

Adult↗

PubMed2001

Influence of occupational exposure to latex on the prevalence of sensitization and allergy to latex in a Swiss hospital.

BACKGROUND: Replacement of powdered latex gloves has been recommended in order to prevent the development of latex allergy in health care workers. The conclusion that occupational exposure to latex gloves represents a risk factor for latex allergy is mainly based on studies without exposure controls. Atopy is also thought to be a risk factor for the development of latex allergy. OBJECTIVE: To determine the prevalence of atopy, sensitization to latex, and symptoms following latex exposure in professionally exposed and nonexposed hospital personnel by means of a cross-sectional study. METHODS: Six hundred randomly sampled individuals working in medicine and surgery departments and in surgery theaters and 300 sex- and age-matched individuals classified as administrative personnel were selected from the employee data base of the Geneva University Hospital. A questionnaire about exposure to latex and symptoms following this exposure was sent to all individuals. Skin prick test reactions and serum IgE to latex as well as standard environmental allergens were determined in both groups. RESULTS: Respiratory and skin (local) symptoms but not objective tests of latex sensitization (positive skin prick test and specific IgE to latex) were significantly associated with occupational exposure to latex (p < 0.001). Only among atopics subjects was 15 years or more of occupational exposure associated with a significantly higher prevalence of local symptoms than among those who were exposed from 1 to 9 years (odds ratio: 3.2; 95% confidence interval: 1.6-6.5). Atopy was significantly associated with sensitization to latex (odds ratio: 10.3; 95% confidence interval: 4.0-26.6) but not with local symptoms. Tests of latex sensitization were both frequently positive, less frequently negative, resulting in low kappa values. CONCLUSION: These results support the current preventive health care recommendation to replace powdered latex gloves. In atopics, increasing years of occupational exposure increase the risk of developing latex allergy. In contrast to questionnaires about local symptoms, skin prick tests and specific serum IgE to latex are of limited value in epidemiologic studies of latex allergy.

Adult↗