Salima A. Thobani

Asthma control and need for future asthma controller therapy among inner-city Hispanic asthmatic children engaged in a pediatric asthma disease management program (the Breathmobile program, Mobile Asthma Care for Kids Network)

Abstract Objective: To determine whether significant numbers of asthmatic children with initially rated intermittent asthma later suffer poor asthma control and require the addition of controller medications. Methods: Inner-city Hispanic children were followed prospectively in an asthma-specific disease management system (Breathmobile) for a period of 2 years. Clinical asthma symptoms, morbidity treatment, and demographic data were collected at each visit. Treatment was based upon National Heart, Lung, and Blood Institute (NHLBI) Expert Panel Report 3 asthma guidelines. Primary outcome was percentage of patients with intermittent asthma who had not well or poorly controlled asthma during subsequent visits and required controller agents. Secondary outcomes were factors associated with the maintenance of asthma control. Results: About 30.9% of the patients with initial rating of intermittent asthma had not well controlled and poorly controlled asthma during subsequent visits and required the addition of controller agents. Factors associated with good asthma control were compliance, no previous emergency room visits and previous visit during spring season. Conclusion: Asthmatic children with intermittent asthma often lose asthma control and require controller therapy. This justifies asthma guideline recommendations to assess asthma control at follow-up visits and adjust therapy accordingly.

Prolonged cholestasis associated with benazepril therapy.

tin in gastrointestinal carcinogenesis. In particular, we draw attention to the studies demonstrating that adiponectin promotes apoptosis and suppresses proliferation in a cell line of esophageal adenocarcinoma (6,7) . Moreover, a recently published study found that a single-nucleotide polymorphism in the adiponectin gene is associated with a decreased risk of esophageal adenocarcinoma, adjusting for obesity (8) . L at single-nucleotide polymorphism is also associated with higher circulating level of adiponectin (9,10) , further supporting the results of our study. We conclude from these K ndings that more research is needed to understand the etiologic and prognostic roles of adiponectin and other adipokines in the development of Barrett ’ s esophagus and progression to esophageal cancer.

Successful Metronidazole Desensitization Using Modified Oral Protocol

Trichomoniasis is the most prevalent nonviral sexually transmitted infection in the United States and affects over 11% of women over the age of 40 [1]. Metronidazole and tinidazole are the only medications that are recommended by the Centers for Disease Control for the treatment of trichomoniasis1. Alternative therapies are not standardized and limited in efficacy [2]. Case reports suggest that there is cross-reactivity between metronidazole and tinidazole [3]. The body of literature describing metronidazole hypersensitivity is scarce and to date, the incidence is unknown. Skin-prick testing to metronidazole is not validated. Three metronidazole desensitization protocols have been described, including one intravenous3 and two oral protocols [4,5]. In 2008, the Centers for Disease Control and Prevention published a study documenting a total of 127 patients with suspected metronidazole hypersensitivity, among whom 15 patients underwent metronidazole desensitization2. Among those 15 patients, 7 patients underwent a 14-dose intravenous protocol3 and 8 patients underwent an 8-dose oral protocol5. All 15 patients achieved infection cure. More recently, a 12dose modified oral desensitization protocol was described by Gendelman and colleagues in 2014.