By Stephen T. Holgate MD DSc FRCP FRCPE MRC, Martin K. Church MPHARM PhD DSc, Fernando D Martinez MD, Lawrence M. Lichtenstein MD PhD
This complete, clinically orientated full-color source provides you with a wealth of distinct info at the analysis, therapy, and administration of allergic diseases—from bronchial asthma to urticaria. completely up to date to mirror cutting-edge wisdom, this third version gains all the most recent advancements in hypersensitivity and immunology. Plus, a constant, logical association places important details at your fingertips.
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Extra resources for Allergy
E. normal pO2 and very low pCO2). Paradoxical closure of the vocal cords on expiration, the so-called vocal cord syndrome, may present with typical symptoms, but in many cases it is difficult to diagnose. e. 01 × 109/L, or exhaled nitric oxide parts per billion) are all suggestive. The diagnosis should also be considered in patients who rapidly recover fully normal lung function and do not respond consistently to treatment with systemic corticosteroids. Finally, an apparently increasing number of normal people present with shortage of breath as a normal response to exercise exacerbated by poor physical condition or obesity.
Specific immunotherapy (SIT) is effective in patients with allergic rhinitis and allergic asthma if adequate doses of allergens are administered. However, the risks of systemic anaphylactic reactions must be considered. Therefore, treatment with both SIT and omalizumab would provide better clinical efficacy with less adverse events than either treatment given alone. Indeed, a recent clinical study of combined treatment with omalizumab and SIT in polysensitized children and adolescents with seasonal allergic rhinitis showed that combined treatment was more effective than SIT alone by decreasing symptom loads during the pollen season.
The afferent parasympathetic preganglionic fibers travel in the vagus nerves, and convey impulses centrally from irritant or cough receptors located next to epithelial cells lining the airways. Stimulation of these may be important in EAA because one of the signal symptoms is unexplained chronic non-productive cough. The non-adrenergic non-cholinergic nervous system has both inhibitory and excitatory limbs. g. g. substance P). There is a recent description of increased nerve growth factor (NGF) associated with pigeon fanciers’ lung suggesting a possible neuropeptide link between the cells which produce and respond to NGF, including mast cells and lymphocytes (both of which are markedly increased in number in EAA), and sensory nerve cells.