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Query: UMLS:C0033774 (pruritus)
 14,546 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A double blind group comparative trial comparing 2% nedocromil sodium with placebo in treating seasonal allergic conjunctivitis over a four week period is reported. Sixty-four patients were analysed. During the period of peak pollen challenge, statistically significant differences in favour of nedocromil sodium for itching and soreness were demonstrated. During a longer period of a less high pollen count, a significant difference in favour of nedocromil sodium was shown only for the symptom of soreness.
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PMID:Group comparative trial of 2% nedocromil sodium with placebo in the treatment of seasonal allergic conjunctivitis. 801 18

Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used in the treatment of ophthalmic inflammatory disease. Currently four topical preparations are available: flurbiprofen and suprofen for the prevention of miosis during surgery; diclofenac for postoperative inflammation following cataract extraction, and ketorolac for the treatment of itching associated with seasonal allergic conjunctivitis. Caution should be exercised, however, as topical and systemic adverse effects may occur including stinging, photophobia, gastric sensitivity, and increased bleeding time. The mechanism of action of NSAIDs is discussed, complications associated with use, and the current and future roles of therapy.
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PMID:Nonsteroidal anti-inflammatory drugs. Current ophthalmic therapy. 804 66

Biological hypersensitivity is the fundamental feature of atopy, and patients suffering from this syndrome are characterized by their ability to produce high levels of IgE in response to low amounts of antigen. This hypersensitivity results in a range of acute and chronic diseases, such as asthma, rhinitis, allergic conjunctivitis and atopic dermatitis. In addition to their biological effects, these diseases may have psychological consequences in terms of stress, anxiety or depression. However, atopic patients, far from displaying a typical depressive psychological profile, are characterized by their increased emotional sensitivity. Atopic individuals alert us to the presence of allergens but perhaps they also indicate something about our way of life. Are the symptoms displayed by allergic patients, their wheezing, sneezing or itching skin, more than a simple biological response?
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PMID:Psychology of the allergic patient. 854 76

TELC is a chronic allergic conjunctivitis which affects young children. The aetiology which is usually incriminated is dust, dryness or ultraviolet rays. The main symptoms of TELC are: severe pruritus, brownish pigmentation of the conjunctiva, papillae on the upper palpebral conjunctiva, severe limbitis with Trantat's spots, and finally corneal attack with risk of blindness. Treatment basis is made up with sodium chromoglycate and corticoids. We gathered the epidemiological data of TELC in the South of Benin and their links with the meteorological data (pluviometry, temperature, relative dampness rate, sun radiance and middle evaporation), from 1983 to 1992. There are two peaks of exacerbation for TELC: in March and in August. There is a good two months moved correlation between TELC and pluviometry; a positive correlation with temperature during the first peak and a reversed correlation during the second peak. Peaks of TELC are not linked with hours of sunshine rates.
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PMID:[Chronic tropical endemic limboconjunctivitis (TELC) in southern Benin: epidemiological and meteorological data]. 809 Oct 33

Conjunctivitis of allergic origin is associated with a diversity of clinical presentations. Common features include pronounced itching, a milky conjunctival appearance, a stringy or ropy discharge and papillary hypertrophy of the tarsal conjunctiva in severe cases, and a family history of allergy. The diagnosis should be based on thorough history-taking and careful ophthalmic examination, and, when necessary, confirmation by laboratory testing. An IgE-mediated immediate hypersensitivity mechanism is associated with most types of allergic conjunctivitis, although contact allergy is mediated by lymphocytes rather than antibody. Treatment is based on the diagnosis and severity of signs and symptoms. An array of medications is available to control symptoms, and the regimen of choice should be based on the response to milder forms of therapy and consideration of drug side effects.
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PMID:Conjunctivitis of allergic origin: clinical presentation and differential diagnosis. 823 3

We evaluated 148 patients with allergic conjunctivitis in a double-masked, paired comparison clinical trial comparing ketorolac 0.5% ophthalmic solution with vehicle. Patients received one drop of each study medication in preassigned eyes, four times a day, for seven days. Both treatments showed significant changes from baseline in the signs and symptoms associated with allergic conjunctivitis. Evaluations at the final visit (day 7 or 8) showed that ketorolac-treated eyes had a significant treatment response when compared to vehicle-treated eyes for conjunctival inflammation (p = 0.010), ocular itching (p = 0.006), swollen eyes (p = 0.002), discharge/tearing (p = 0.021), foreign body sensation (p = 0.035), and conjunctival injection (p = 0.016). Mean scores evaluating the overall therapeutic effect of the study treatments at the completion of the study were higher for ketorolac-treated eyes than for vehicle-treated eyes as rated by investigators (p = 0.004) and study patients (p < 0.001). Results of this study confirmed the trends of a previous study showing that ketorolac 0.5% ophthalmic solution applied topically is an effective therapy for allergic conjunctivitis.
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PMID:Clinical evaluation of ketorolac tromethamine 0.5% ophthalmic solution for the treatment of seasonal allergic conjunctivitis. 823 5

In a multicenter, double-masked, clinical study, we compared the ocular safety and efficacy of ketorolac 0.5% ophthalmic solution with placebo in alleviating the signs and symptoms of allergic conjunctivitis. The study was conducted in 93 patients who received one drop of the appropriate treatments in each eye, four times a day, for seven days. Of these subjects, 74 were evaluated for efficacy. The principal clinical sign of allergic conjunctivitis, conjunctival inflammation, and six allergic symptoms (itching, swollen eyes, burning or stinging, discharge or tearing, foreign body sensation, and photophobia) were evaluated by the investigators at midweek (day 3 or 4) and at the end of the study (day 7 or 8). Ketorolac was superior to placebo in reducing conjunctival inflammation (p = 0.003) and itching (p = 0.020), the principal clinical symptom, at the final examination. In addition, ketorolac was favored over placebo in reducing the other five symptoms evaluated. On the day of final examination, overall therapeutic response evaluated by the investigators rated ketorolac as superior to placebo (p = 0.007). A significant placebo effect was noted in this study, as has been previously reported in clinical studies of allergic conjunctivitis patients. Results of this study demonstrate that 0.5% ketorolac ophthalmic solution used topically four times daily, for seven days, was effective in alleviating the principal sign and the symptoms associated with allergic conjunctivitis.
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PMID:Double-masked, paired-comparison clinical study of ketorolac tromethamine 0.5% ophthalmic solution compared with placebo eyedrops in the treatment of seasonal allergic conjunctivitis. 823 4

An epidemiological study focusing on the home environment and lifestyle was conducted in order to analyze the differences between a group of patients with allergic conjunctivitis only and a group with other allergic diseases associated with allergic conjunctivitis. Subjects were five hundred and sixty-four patients who visited the Ophthalmologic Clinic of Tokai University Hospital during 1990, and for controls 200 households were randomly selected from an elementary school list in Yokohama city. RAST score was measured in 102 patients. A mailed questionnaire was sent to 240 patients chosen at random and to 200 controls. Sixty patients and 139 controls responded to the questionnaire. RAST score showed no statistical difference between patients with allergic conjunctivitis only and patients with other allergic diseases associated with allergic conjunctivitis. Analysis of associations between RAST score and seasonal symptoms, showed very strong positive reactions to pollens in patients with seasonal symptoms. On the other hand, in patients with constant symptoms during the year, reaction was very strong to house dust and mite. Epidemiological factors causally associated with allergic conjunctivitis were compared among the controls, patients with allergic conjunctivitis only (Group I), patients with other allergic diseases (Group II) and all patients (Group III). Compared to controls, Groups II and III had significantly higher prevalence of past history of skin itching and inflammatory symptoms (p < 0.05 and p < 0.01, respectively). Group II subjects showed more frequent use of carpets, when compared to the controls (p < 0.05). The use of Japanese mattress (futon) was more frequent in Group II and III than controls (p < 0.05 for both comparisons).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[An epidemiological study of allergic conjunctivitis]. 847 99

The term ocular allergy encompasses a group of diseases in which there is a high frequency of atopy, ocular itching, stringy discharge and a papillary conjunctival reaction. Conditions confined to the lids and conjunctiva (e.g. seasonal allergic conjunctivitis) have a good prognosis but those involving the cornea may result in visual impairment (e.g. atopic keratoconjunctivitis). Mast cell and eosinophil mechanisms are important in al the ocular allergies, but T cell inflammation is prominent only in vernal keratoconjunctivitis, atopic keratoconjunctivitis and giant papillary conjunctivitis. Therapy involves the use of antigen avoidance (where possible), nonspecific medical therapy (e.g. cold compresses, artificial tears), specific medical therapy and, in certain situations, immunotherapy and surgery. Topical antihistamines (often in combination with a vasoconstrictor) and oral antihistamines are widely used in perennial and seasonal conjunctivitis. Levocabastine is a new preparation which is more rapid and potent. Mast cell inhibitors [e.g. sodium cromoglycate (cromolyn sodium)] have a proven track record as safe and effective therapy for all ocular allergic diseases and the newer, more potent nedocromil and lodoxamide are now available. Topical steroids are only indicated in sight-threatening disease due to their serious adverse effects and other therapy should be continued to minimise the dose required. There is a lack of intermediate potency and high potency but safe topical preparations. A number of future possibilities exist, some of which have been partially explored. Cyclo-oxygenase inhibitors have proved of limited use, but inhibitors of lipoxygenase and kinin pathways are awaited. Although results with HEPP have been disappointing, other modulators of mast cell function (e.g. picumast, beta-agonists and phosphodiesterase inhibitors) may prove useful in the future. So far, results with topical cyclosporin in serious disease are very encouraging. Future developments in the manipulation of eosinophilic products, cytokines and adhesion molecules may also be relevant. However, the current situation for those with serious ocular allergy remains a disturbing dependence upon topical steroids, with all the attendant risks.
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PMID:Therapeutic options in ocular allergic disease. 852 55

The therapeutic utility of cyclooxygenase (CO) inhibitors, such as ketorolac, in reducing the inflammatory events associated with allergic conjunctivitis is not unexpected since prostanoids (PG) elicit conjunctival redness (PGD2, PGE2, PGF2 alpha), edema (PGD2, TxA2), eosinophil infiltration (PGD2, PGJ2) and mucous cell discharge (PGD2, PGJ2, TxA2). Recently, topically administered ketorolac has also been reported to alleviate the itching associated with allergic conjunctivitis. This was viewed as intriguing since CO inhibitors are not regarded as useful for treating itching dermatoses and PGs do not elicit itching when applied to the skin. In order to investigate the antipruritic activity of ketorolac, we developed a model for reproducibly measuring ocular surface itch responses. The model involves itch-scratch responses to pruritogens applied locally to the ocular surface. Painful and foreign body stimuli do not produce an itch-scratch response. Unlike reported skin studies, PGE2 was a potent itch-producing substances in the conjunctiva. PGD2 was weakly pruritogenic but PGF2 alpha and the TxA2-mimetic U-46619 were inactive. The PG precursor arachidonic acid was also a potent pruritogen and its effects were inhibited by ketorolac pretreatment. Ketorolac also dose-dependently inhibited the itching associated with experimental allergic conjunctivitis. It appears that PGs are potent itch-producing substances in the conjunctiva and the anti-itch efficacy of ketorolac in allergic conjunctivitis appears to involve inhibition of conjunctival PG biosynthesis from arachidonic acid.
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PMID:The pruritogenic and inflammatory effects of prostanoids in the conjunctiva. 859 Feb 66


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