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Biomedical subjects

R W Honsinger

Publications and source records attributed to R W Honsinger.

14 recordsLinked to original sources

Mite, cat, and cockroach exposure, allergen sensitisation, and asthma in children: a case-control study of three schools.

BACKGROUND: The amount of allergen necessary to sensitise genetically "at risk" children is unclear. The relation between allergen exposure and asthma is also uncertain. METHODS: To ensure a wide range of allergen exposures the data from case-control studies of asthma in children aged 12-14 years attending three schools in Los Alamos, New Mexico and Central Virginia were combined. Skin prick tests to indoor and outdoor allergens and bronchial hyperreactivity to histamine were assessed in children with and without symptoms of asthma. The concentration of mite, cat, and cockroach allergens in dust from the children's homes was used as a marker of exposure. RESULTS: Three hundred and thirty two children (157 with asthmatic symptoms and 175 controls) were investigated. One hundred and eighty three were classified as atopic on the basis of allergen skin prick tests and 68 as asthmatic (symptoms plus bronchial responsiveness). The prevalence and degree of sensitisation to mite and cockroach, but not cat, was strongly associated in atopic children with increasing domestic concentrations of these allergens. Asthma was strongly associated with sensitisation to indoor allergens (p<10(-6)) and weakly to outdoor allergens (p = 0.026). There was an association between current asthma and the concentration of mite allergen amongst atopic children (p = 0.008) but not amongst those who were specifically mite sensitised (p = 0.16). CONCLUSIONS: The domestic reservoir concentration of mite and cockroach, but not cat, allergen was closely related to the prevalence of sensitisation in atopic children. However, the prevalence of current asthma had a limited relationship to these allergen measurements, suggesting that other factors play a major part in determining which allergic individuals develop asthma.

Allergens↗

Association of asthma with serum IgE and skin test reactivity to allergens among children living at high altitude. Tickling the dragon's breath.

Asthma in children and young adults is strongly associated with immediate hypersensitivity to indoor allergens, notably those derived from the house dust mite. In addition, outdoor air pollution is considered to aggravate existing asthma. We investigated the prevalence of asthma and the pattern of allergen sensitization in a mite-free environment with low levels of outdoor air pollution. A total of 567 children aged between 12 and 14 attending Los Alamos Middle School, NM (altitude 7,200 feet) were screened using a respiratory questionnaire; 120 children (53 control children) underwent allergen skin testing and serum IgE measurement, and their bronchial reactivity to histamine was measured. Dust was collected from 111 homes and the level of indoor mite and cat allergen measured. The prevalence of respiratory symptoms was high (13%), and from the detailed testing it was estimated that 6.3% of the children had asthma (defined as symptomatic bronchial reactivity). Children with asthma had elevated IgE, 367 (179 to 755) versus 38 (23 to 61), and predominant sensitization to cat, 68 versus 20% (p < 0.001). A high number of households (77%) had a pet cat or dog. The concentration of mite allergen was very low (mean 0.18 micrograms Der p milligrams sieved house dust), whereas that of cat allergen was high in homes with a cat (80.8 micrograms Fel d milligrams) but also in homes with no cat (3.2 micrograms Fel d milligrams). The results show that in a mite-free environment with low levels of outdoor air pollution, asthma was still a major cause of morbidity among schoolchildren.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Relative efficacy and safety of loratadine, hydroxyzine, and placebo in chronic idiopathic urticaria.

The efficacy and safety of a new non-sedating antihistamine, loratadine (Clarityn, CAS 79794-75-5) 10 mg q.d., was compared to the classical antihistamine, hydroxyzine 25 mg t.i.d. and placebo in a 4-week (optional 12 week) randomized, double-blind, multi-center study in 203 patients with chronic idiopathic urticaria. Efficacy evaluations included weekly physician and patient assessments of pruritus, overall disease condition, and therapeutic response to treatment. Loratadine and hydroxyzine were significantly more effective than placebo and clinically comparable to each other as measured by all efficacy evaluations at each visit. Loratadine was safe and well tolerated with sedation and dry mouth similar to placebo and significantly less than hydroxyzine.

Adolescent↗

Prolonged benefit in the treatment of chronic idiopathic urticaria with astemizole.

A double-blind clinical trial of 51 patients with chronic idiopathic urticaria using oral astemizole for 8 weeks demonstrated significant improvement in symptoms and lesions in 75% of treated patients versus 20% in the placebo group. The suppression of urticaria persisted for an average of 38 days, demonstrating the long duration of action of astemizole.

Astemizole↗

Type I hypersensitivity to rubber.

Seven patients with type I hypersensitivity reactions to rubber are reported. Radioallergosorbent testing with crude latex antigen was positive in 6/7 patients. Five patients had coexisting spina bifida, and all had undergone surgery before the development of rubber allergy. Rubber allergy is a new phenomenon that should be in the differential diagnosis of idiopathic anaphylaxis and urticaria.

Adolescent↗

Significance of tartrazine sensitivity in chronic urticaria of unknown etiology.

Of 38 patients with chronic urticaria of unknown etiology who were evaluated for food and drug additive sensitivity, 53% (20/38) had urticaria for 1 yr or more. Total eosinophil counts were not elevated in most patients, and the frequency of atopy was found to be similar to that in a general population. Of these 38 patients, 10 (26%) had a personal history of aspirin intolerance, but elimination of aspirin did not relieve the urticaria. In a double-blind crossover challenge with 0.22 mg of tartrazine and a control, tartrazine sensitivity was found in 8% (3/38) of patients with chronic urticaria and 20% (2/10) of patients with aspirin intolerance.

Adult↗

How to avoid fraud and abuse by following compliance guidelines.

Rules of the Health Care Financing Administration, United States Department of Health and Human Services, are reviewed as applied to fraud and abuse. The voluntary compliance guidelines that were released by the Office of the Inspector General in October, 2000 are also reviewed. The author demonstrates that the practicing physician can use these guidelines to enhance a medical practice and protect practitioners from accusations of fraud and abuse.

Centers for Medicare and Medicaid Services, U.S.↗