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Biomedical subjects

Leonard Bielory

Publications and source records attributed to Leonard Bielory.

14 recordsLinked to original sources
PubMed2003

Autoimmune optic neuropathy with anticardiolipin antibody mimicking multiple sclerosis in a child.

PURPOSE: To demonstrate that autoimmune optic neuropathy (AON) may occur in the pediatric population. DESIGN: Interventional case report. METHODS: A 4-year-old developed four episodes of bilateral optic neuritis with mild concurrent weakness, ataxia, or dizziness; one episode of unilateral optic neuritis; and one episode of weakness over a period of 4 years. RESULTS: Autoimmune optic neuropathy was diagnosed because of the presence of anticardiolipin antibody and an abnormal skin biopsy with thrombin and immunoreactant deposition. She was treated with corticosteroids, aspirin, and gammaglobulin. This diminished the frequency and intensity of her attacks. CONCLUSION: This case represents the diagnosis and treatment of AON in a child.

Antibodies, Anticardiolipin↗
PubMed2003

Alternative treatment for allergy and asthma.

Treatment of asthma remains complex. Patients who are considering alternative and complementary treatments for asthma should have a good understanding of what the treatment entails, and whether it has proven ability to make an impact in the disease. One should remember, however, these treatments are made to complement most traditional therapies and not to replace them.

Asthma↗
PubMed2002

Role of antihistamines in ocular allergy.

Although H(1) antihistamines are commonly used to treat allergic disorders and have demonstrated efficacy in allergic rhinoconjunctivitis, data on the effects of these agents specifically on ocular symptoms are limited. Oral H(1) antihistamines inhibit some symptoms of pruritus and erythema in laboratory models and have been shown to be superior to placebo for relief of symptoms in clinical trials. Eye drops typically provide faster relief of ocular symptoms than oral agents, and combination therapy with a topical agent and an oral agent has been found to be superior to the oral agent alone. In general, oral H(1) antihistamines have been considered superior to intranasal corticosteroids for relief of ocular symptoms, but some studies have shown equal efficacy for these agents, or even superior efficacy for intranasal corticosteroids.

Eye Diseases↗
PubMed2002

Complementary and alternative medicine herbal therapies for atopic disorders.

More than 42% of patients with atopic disorders use some type of complementary or alternative medicine, underscoring the importance of determining the scientific validity of such treatments. This review summarizes herbal therapies from China, Japan, Korea, and India, and provides an introduction to some Western preparations. Although well-controlled scientific studies of many of the Asian herbal therapies have been carried out, and some basic studies have been performed for various herbal components (active ingredients), additional research is needed to assess the composite effects of many of these remedies.

Complementary Therapies↗
PubMed2002

Concepts in developing health-based indicators for ozone.

OBJECTIVES: The traditional manner to evaluate whether regulatory controls meet their public health goals of reducing adverse health effects associated with exposure to environmental pollutants is to compare measured concentrations of the target pollutant in the environment with a standard. A complementary approach is also to measure health-based indicators, e.g., changes in the prevalence of adverse health outcomes attributed to the pollutant. This manuscript presents the concepts of using asthma emergency room (ER) visits and hospital admission as potential health-based indicators for ozone. METHODS: The frequency of ER visits and hospital admissions for asthma in New Jersey in 1995 was compared with daily ozone concentrations, to establish the consistency of the relationship and the presence of potential confounders, and to establish whether routinely documented adverse outcomes in asthmatics could serve as health-based indicators. RESULTS: A mathematical model relating ER visits and hospital admissions of asthmatics to ozone concentration was developed for 1995, which was to be used as a baseline year within a health-based indicator program. A coherent relationship was found between same-day ambient air ozone concentrations and ER visits and 2-day time-lagged ambient ozone and hospital admissions during 1995; pollen was identified as a confounder and the association between ER visits and ozone concentration was similar to that determined for 1986 to 1990. CONCLUSIONS: Sufficient databases exist for ER visits by asthmatics in Northern and Central New Jersey, and throughout the state for hospital admissions, for these health outcomes to be used as health-based indicators, complementing air-monitoring data in assessing whether improvements in public health are occurring because of reduction in emissions of precursors of ozone.

Air Pollutants↗
PubMed2002

Topical immunopharmacology of ocular allergies.

PURPOSE OF REVIEW: To review the histamine-1 receptor antagonists, mast cell blockers and natural agents with such actions that can be used for the topical treatment of ocular allergies. RECENT FINDINGS: Increasing evidence indicates that some histamine-1 receptor antagonists have additional actions to inhibit secretion of inflammatory mediators, especially cytokines, from ocular mast cells and other cell types. Emerging information suggests that such actions may be through regulation of intracellular calcium ion levels of NF-kappaB activation. SUMMARY: A number of available drugs and natural non-prescription agents may have anti-histaminic and anti-inflammatory actions.

Administration, Topical↗
PubMed2002

Current opinion of immunotherapy for ocular allergy.

PURPOSE OF REVIEW: Allergic conjunctivitis is common and may be the most prominent or the only feature of allergies. Immunotherapy has been used as a primary treatment for allergies since the early 1900s. Currently the use of immunotherapy for allergic rhinoconjunctivitis is well established and has been shown to decrease the development of bronchial hyperreactivity and asthma. However, the role of immunotherapy for primary treatment of allergic conjunctivitis is unclear. We reviewed the studies where immunotherapy was used with particular attention to the affects on ocular allergies. RECENT FINDINGS: There are many schedules and methods of delivering immunotherapy. Recent studies have started to assess ocular symptoms as one of the parameters to monitor efficacy of therapy. They follow the affects of immunotherapy on conjunctival provocation tests, ocular symptoms, or the use of eye drops. The literature suggests that using the various immunotherapy modalities at different schedules, ocular symptoms improved even when immunotherapy was used on a rush schedule. SUMMARY: The initiation of immunotherapy for allergic rhinoconjunctivitis has been shown to switch the immune response to T helper 1 and thus avoid the progression of other atopic conditions. Current literature shows that using many allergens with different forms of immunotherapy appear to have a significant improvement in ocular allergy symptoms and this can be achieved rapidly and safely in most patients. Whether using immunotherapy early in allergic conjunctivitis will alter the progression of other atopic conditions remains to be investigated.

Allergens↗
PubMed2002

Update on ocular allergy treatment.

Allergy affects > 15% of the world population with a higher prevalence of 30% in westernised industrialised countries, such as the US. Allergy commonly affects various target organs including the eyes, nose, sinuses, ears, lungs and skin. However, the ocular component may be the most common and initially the most prominent disabling feature. Some patients are affected for only a few weeks to months while others have symptoms that last throughout the year. The associated healthcare costs related to allergic conjunctivitis has been commonly nestled with allergic rhinitis and has been reported to be as high as US$5.9 billion in the US, with 25% (US$1.5 billion) of it related to medication use. The expenditures related to ocular prescription medication has only recently risen in the past decade from US$6 million in early 1990s to > US$200 million in the new millennium with a projected continuous expansion of 25% per year. This appears to be due to improved prescription medications and their clear benefit over the less efficacious over-the-counter products. The actual cost of the medications and their relative price increases over the past year have ranged from 0 - 49% with an average cost of < US$ day. The newer topical medications (multiple acting agents) are focusing on multiple actions that include an antihistaminic effect to provide an immediate relief and additional delayed effects to act on the mediators of the late phase reaction without steroid side effects (glaucoma, cataracts). The paradigm for the treatment of ocular allergy ranges from primary measures (avoidance measures, cold compresses and lubrication), to secondary measures (various combination of topical agents) and tertiary measures that would include topical steroids and immunotherapy. The increased interest in advancing ocular treatment will lead to the development of additional therapies, novel pharmacokinetic delivery systems and, thus, improved healthcare outcomes for patients with allergic conjunctivitis.

Administration, Topical↗
PubMed2002

Ocular allergy guidelines: a practical treatment algorithm.

The treatment of ocular allergy requires a better understanding of the spectrum of clinical disorders involving various components of the immune system, and of interactions at the conjunctival surface. The immune response focuses primarily on the different levels of activity of Th2 lymphocytes and various other immune cells associated with allergic disorders, including mast cells, eosinophils, fibroblasts, and epithelial and endothelial cells. Ocular allergic disorders include seasonal allergic conjunctivitis (SAC), perennial allergic conjunctivitis (PAC), vernal keratoconjunctivitis (VKC), giant papillary conjunctivitis (GPC) and atopic keratoconjunctivitis (AKC), which, through immunopathological and molecular immunological techniques, can all be better appreciated as being part of a larger spectrum of an atopic disease state. In SAC, pathological changes, such as increased mast-cell activation, the presence of migratory inflammatory cells, and early signs of cellular activation at the molecular level, are minimal. In PAC, these changes are more pronounced in line with the increased duration of allergenic stimulation. In more chronic forms of allergic conjunctivitis, such as VKC in children and AKC in adults, the following changes are evident: a persistent state of mast cell, eosinophil and lymphocyte activation; noted switching from connective-tissue to mucosal-type mast cells; increased involvement of corneal pathology; and follicular development and fibrosis. The treatment of acute and more chronic forms of allergic conjunctivitis has focused in the past on symptomatic relief of symptoms, but with a better understanding of the mechanisms involved we can now provide interventional therapeutic strategies and symptomatic relief. Our advances in the basic understanding of these conditions are providing the foundation for guidelines that improve the ocular health of patients with ocular allergies.

Anti-Allergic Agents↗