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Biomedical subjects

R Lantner

Publications and source records attributed to R Lantner.

6 recordsLinked to original sources
PubMed1991

Pharmacist advice to asthmatics regarding antihistamine use.

Due to the frequency of asthmatics having concurrent allergic symptoms, patients may seek relief from antihistamines, which are currently labeled with warnings against their use in asthmatics. A survey was conducted in the Chicago area to evaluate the advice rendered by pharmacists regarding the use of antihistamines in asthmatics and their opinions about the current product labeling. Thirty percent of the surveys were returned. Nearly half (48%) of the surveyed pharmacists advise their asthmatic customers to avoid antihistamines and 75% of this group recommend avoidance because they believe antihistamines worsen asthmatic symptoms, despite the lack of sufficient clinical data to support this concern. Only 17% of pharmacists advise that antihistamines pose no problems for asthmatics. The latter group is the most aware that there is controversy surrounding the current labeling. Overall, half the pharmacists surveyed believe the current labeling is not appropriate for patients with asthma. Until the labeling is revised, physicians should be aware that pharmacists may advise their asthmatics against using antihistamines even though antihistamines should be only contraindicated in cases of proven adverse reactions.

Asthma↗
PubMed1989

Clinical and immunologic features and subsequent course of patients with severe insect-sting anaphylaxis.

One hundred fifty-eight patients were evaluated because of symptoms of potentially fatal venom anaphylaxis, as defined by hypotension, including loss of consciousness (LOC), throat/laryngeal edema, or marked respiratory distress. The demographic characteristics were 118 male and 40 female patients; age range, 3 to 80 years; mean, 29.7 years; 33 patients less than 10 years; and incidence of atopy, 20%. One hundred twenty-seven patients had had prior stings; 27 had prior systemic reactions (SR), including one with LOC. Almost all patients had venom-specific IgE; RAST titers covered a wide range. As compared to the total group, the subset of 45 patients with LOC were older, had an increased incidence of cardiac disease and beta-blocker use, stings in the head area, and re-sting reactions in patients who did not receive venom immunotherapy (VIT). One hundred six re-stings occurred in 37 patients receiving VIT with no SR. There were 38 re-stings in 18 patients who refused VIT, with 14 SRs in 11 patients. These studies suggest no distinguishing characteristics, including age, that would identify patients susceptible to severe venom anaphylaxis and confirm the prophylactic effectiveness of VIT.

Adolescent↗
PubMed1989

Further observations of stopping venom immunotherapy: comparison of patients stopped because of a fall in serum venom-specific IgE to insignificant levels with patients stopped prematurely by self-choice.

This study extends our experience applying the criterion of a fall in serum venom-specific IgE (RAST) to insignificant levels as an indication to stop venom immunotherapy (VIT) and compares the follow-up results with the results of re-stings in patients who stopped VIT "prematurely" by self-choice. All patients in both groups had a history of venom anaphylaxis, most with cardiovascular and/or respiratory symptoms and initial elevated serum venom-specific IgE; all patients received VIT. The groups were closely matched for age, sex, nature of initial sting reaction, and insect identification. In the group with low-level RAST titers, the duration of VIT was 6 months to 5 years (mean 2 1/2 years). Re-stings occurred from 1 month to 7 years (mean 2.2 years) after cessation of therapy. There were 75 re-stings in 41 patients with four systemic reactions (10% per patient and 5% per sting). All four reacting patients had tolerated several stings during cessation of VIT before the re-sting systemic reaction; two patients had subsequent stings with no reaction. In the group of patients who stopped VIT for other reasons, the duration of VIT was 5 months to 4 years (mean 1.8 years). Re-stings occurred from 4 months to 6 years (mean 2.1 years) after stopping therapy. There were 74 re-stings in 38 patients with seven systemic reactions in four patients (9.5% per patient and 10.5% per sting). Two of the reacting patients had tolerated stings before the re-sting reaction.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1983

Natural and antibody-dependent cellular cytotoxicity in children with systemic lupus erythematosus and juvenile dermatomyositis.

Thirteen children with systemic lupus erythematosus (SLE) and 5 with juvenile dermatomyositis (JDM) were studied for natural cytotoxicity (NK) and antibody-dependent cellular cytotoxicity (ADCC). In vitro prednisolone at pharmacological levels failed to alter NK or ADCC in adult controls, nor did it alter ADCC in any children studied. ADCC was normal, but NK was decreased in SLE (p less than .005) and JDM (p less than .05) compared to controls. Since NK but not ADCC is decreased in these patients, different lymphocyte populations may mediate these 2 cytotoxic functions.

Adolescent↗
PubMedDate not supplied

Fatal varicella in a corticosteroid-dependent asthmatic receiving troleandomycin.

Long-term use of corticosteroids (CSs) may result in an increased risk of disseminated varicella. Concurrent administration of troleandomycin (Tao) to treat CS-dependent asthmatics can potentiate steroid effects. We present the first case of fatal varicella in a patient concurrently receiving methylprednisolone and Tao therapy. At the time of her death she had been receiving CSs for 2 years and Tao for 1 year. She had a 2-day history of fever, lower back and abdominal pain, dysuria, and constipation. Later, when pox lesions were evident, it was learned she had been exposed to varicella 2 weeks previously. While hospitalized she developed hepatitis, gastrointestinal hemorrhage, disseminated intravascular coagulopathy, and pneumonitis, resulting in respiratory failure. She succumbed despite treatment with stress doses of steroids, intravenous acyclovir, fresh frozen plasma, and ventilatory support. Autopsy findings revealed evidence consistent with disseminated varicella. This case suggests that concurrent therapy with CSs and Tao may increase the risk for disseminated varicella, possibly by enhancing CS-induced immunosuppressive effects. We suggest that other immunologic parameters in addition to serum varicella titers might be helpful in identifying those CS-dependent patients at risk. Any CS-dependent asthmatic, whether or not receiving Tao, should receive varicella-zoster immune globulin within 96 hours of exposure and acyclovir once varicella is clinically apparent. Varicella vaccine should be considered for those not yet exposed.

Adrenal Cortex Hormones↗