1/4. Paroxysmal sneezing in children: two new cases.Paroxysmal sneezing is an uncommon condition primarily affecting adolescents. Most of the reported cases were thought to be psychogenic, and only two were felt to be due to nasal sensitivity. This paper reports two adolescents with paroxysmal sneezing, neither of whom had apparent psychologic or emotional problems. In one child the sneezing continued during sleep. The other child was successfully treated with topical nasal anesthesia. Both children were felt to have nasal sensitivity as the etiology of their paroxysmal sneezing. The evaluation of the patient with paroxysmal sneezing requires a thorough history and physical examination. One must not assume that every case of paroxysmal sneezing is of psychogenic origin. Topical nasal anesthesia should be tried for control of intractable paroxysmal sneezing.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/4. Baker's asthma with a predominant clinical response to rye flour.BACKGROUND: Relatively little attention has been paid to rye flour as opposed to wheat flour in clinical and epidemiological research into Baker's asthma. methods: This report describes the investigation of a baker with asthma who reported a workplace response to rye flour and none to wheat flour, despite co-reactivity to both wheat and rye antigen. RESULTS: skin prick tests, RASTs and basophil stimulation tests were positive for both wheat and rye antigen, but quantitatively greater for rye than wheat. Bronchial challenge elicited a much greater response to the rye-wheat flour mix used in the bakery than to 100% wheat flour. CONCLUSIONS: The greater clinical response to rye than to wheat may be immunologically mediated, but could also be due to physical characteristics of rye flour such as greater dose of inhaled airborne particles or an irritative effect. This information may be useful for medical management and occupational hygiene control, and should stimulate further research into rye flour in Baker's asthma.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
3/4. diagnosis of allergic disease.The diagnosis of allergic disease has to be individualized to each patient. In general, it consists of a good clinical history, a physical examination, and identification of specific relevant allergies by both in vitro and in vivo tests. These will contribute to an assessment of the patient's clinical status and severity of disease. One must always be aware that nonallergic mechanisms can also trigger an attack in atopic individuals. These are clinically indistinguishable from those provoked by an allergen-IgE immune response. We predict that the computer and accurate in vitro tests will join us in our offices. Before the end of this century, this high technology will make the clinical allergist a very precise diagnostician.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
4/4. A case of iatrogenic growth retardation induced by a corticosteroid-containing anti-allergic drug.A nine-year old boy developed reduced growth velocity at the age of seven. The peak plasma growth hormone (GH) response to 3,4-dihydroxyphenylalanine, GH-releasing factor and insulin was 10.2, 8.1 and 7.6 micrograms/l, respectively, suggesting that the GH reserve was slightly reduced. serum cortisol was undetectable and urinary excretion of 17-hydroxycorticosteroid was low (0.22-0.31 mg/day), but there were no physical or biochemical signs of adrenocortical insufficiency. He had taken an anti-allergic drug containing 0.25 mg of betamethasone and 2 mg of d-chlorpheniramine maleate per tablet for about 2 years to treat allergic rhinitis. Catch-up growth occurred when this drug was stopped. The present case suggests that daily administration of 0.25 mg of betamethasone can induce growth retardation and that ingestion of corticosteroid-containing preparations needs to be excluded in children who develop short stature without other symptoms.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |