To discuss the new use of intranasal antihistamines as first-line therapies, compare and contrast this class of medication with the traditionally available medications, and discuss the potential for ...intranasal antihistamines to provide relief superior to second-generation oral antihistamines.
Review articles and original research articles were retrieved from MEDLINE, OVID, PubMed (1950 to November 2009), personal files of articles, and bibliographies of located articles that addressed the topic of interest.
Articles were selected for their relevance to intranasal antihistamines and their role in allergic rhinitis. Publications included reviews, treatment guidelines, and clinical studies (primarily randomized controlled trials) of both children and adults.
This panel was charged with reviewing the place of intranasal antihistamines in the spectrum of treatment for allergic rhinitis. Intranasal antihistamines have been shown in numerous randomized, placebo-controlled trials to be more efficacious than the oral antihistamines. Although intranasal corticosteroids are considered by some to be superior to intranasal antihistamines, multiple studies have shown an equal effect of the 2 classes of medication. Both intranasal corticosteroids and intranasal antihistamines have been shown to reduce all symptoms of allergic rhinitis. In addition, some intranasal antihistamines have a more rapid onset of action than intranasal corticosteroids.
The future of allergy treatment will likely involve a combination of both intranasal corticosteroids and intranasal antihistamines because of the benefits of local administration and their additive effect on efficacy.
Treatment recommendations for prediabetes Ratner, Robert E; Sathasivam, Anpalakan
The Medical clinics of North America,
03/2011, Letnik:
95, Številka:
2
Journal Article
Recenzirano
A variety of definitions and diagnostic cutpoints have been promulgated for prediabetes without universal agreement. Professional organizations agree that current scientific evidence justifies ...intervention in high-risk populations for the delay or prevention of progression to diabetes. Lifestyle intervention is universally accepted as the primary intervention strategy. Secondary intervention is advocated in high-risk individuals or in the absence of a clinical response to lifestyle modification.
Tendon transfer surgery to restore fundamental wrist and hand function is made possible by the redundancy that exists among the actions of our upper-extremity musculature. Potential donors for ...transfer are those muscles with adequate power to motor the recipient tendon, similar tendon excursion to the recipient, and function in phase with the recipient. Resolution of wound healing, union of fractures, and mobilization of stiff joints are prerequisites for a functioning tendon transfer. Injuries to the radial, median, and ulnar nerves occur above (high nerve injury) and below the elbow (low nerve injury). High and low nerve injuries result in different functional deficits that require unique tendon transfers to enhance function. This report discusses the various tendon transfers necessary to overcome deficits resulting from high and low radial, median, and nerve injuries.
Surface contaminants have been studied on a variety of intraocular lenses by three methods: scanning electron microscopy, energy dispersive x-ray analysis (EDXA), and electron spectroscopy for ...chemical analysis (ESCA). Many particulate contaminants were observed on both commercially available lenses packaged for implantation and experimental batches of lenses. The nature of these particles could be inferred using the EDXA technique. Thin films of sodium dodecyl sulfate (SDS) that were resistant to removal were found on many of the lenses by ESCA. Cleaning procedures were developed that did not involve SDS and that generated extremely clean lens surfaces.
Cardiovascular disease (CVD) burden remains the predominant cause of mortality and morbidity in the United States and in most of the developed world. The ongoing twin epidemics of obesity and type 2 ...diabetes mellitus provide a groundswell source for sustaining this trend for the foreseeable future (increasing the prevalence of CVD by 2–4 times), unless radical changes are made in public health policy. Oral hypoglycemic agents (OHAs) remain a mainstay for management of type 2 diabetes in most practice settings. Although these agents are primarily prescribed to achieve better glycemic control, it is important to evaluate what effects they have on cardiovascular risk and whether there are significant differences in effects among the different OHAs. This review presents the available data on the effects of the various OHAs on cardiovascular risk surrogates and actual events in retrospective and prospective study design settings.
Intranasal corticosteroids are effective in controlling allergic rhinitis (AR) symptoms; however, chronic administration of corticosteroids may suppress hypothalamic-pituitary-adrenal (HPA)-axis ...function.
To evaluate the effects of 6 weeks of treatment with beclomethasone dipropionate (BDP) hydrofluoroalkane nasal aerosol on HPA-axis function in subjects with perennial AR (PAR).
In this randomized, double-blind, placebo- and active-controlled study, subjects aged 12 to 45 years were randomized to receive BDP nasal aerosol 320 μg/day (n = 50), placebo (n = 46), or placebo/prednisone (prednisone 10 mg/day for the last 7 days of the treatment period n = 11). The primary end point was change from baseline in 24-hour serum cortisol (SC) weighted mean (expressed as geometric mean ratio GMR) in the BDP and placebo group after 6 weeks of treatment.
Geometric SC-weighted mean values were similar in the BDP and placebo groups at baseline (9.04 and 8.45 μg/dL, respectively) and after 6 weeks (8.18 and 8.01 μg/dL, respectively). After 6 weeks of treatment, BDP was noninferior to placebo with respect to the ratio from baseline in SC-weighted mean (GMR: 0.96 95% CI: 0.87, 1.06). In contrast, 7 days of prednisone treatment substantially reduced geometric SC-weighted mean values from baseline (approximate 3-fold reduction from 7.33 to 2.31 μg/dL) compared with placebo. BDP nasal aerosol was well tolerated, and the safety profile was similar to that of placebo.
Treatment with BDP nasal aerosol, 320 μg once daily, was not associated with HPA-axis suppression in adolescent and adult subjects with PAR.
Clinicaltrials.gov Identifier: NCT01133626.
