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

A prospective, comparative, random study was conducted with 40 patients treated with ebastine vs. terfenadine. The purpose of the study was to evaluate the efficacy of both as second generation antihistamines used in the treatment of allergic rhinitis. Ten milligrams of ebastine was administered once a day before breakfast (fasting), in 5 and 10 year old children and 20 mg in 11 to 15 year olds. Ebastine was more efficient in the control of symptoms (rhinorrhea, nasal obstruction, sneezing, eye and nose itching) than terfenadine from the seventh day on, (p 0.05). Tolerance to ebastine was good, although a small number of patients (1.5%) suffered collateral symptoms: sleepiness, headaches and nausea. The two doses of ebastine (10 or 20 mg depending on the patients age) had overall efficacy rates better than terfenadine (p 0.05%).
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PMID:[Ebastine vs terfenadine in allergic rhinitis]. 790 44

Both first-generation and second-generation antihistamines effectively reduce symptoms of sneezing, rhinorrhea, and nasal pruritus in individuals with allergic disease. These agents act as competitive inhibitors of histamine (a principal mediator of the allergic response) at various target-organ sites. Although the classic, first-generation antihistamines are unable to halt the allergic reaction once it has begun, emerging evidence has suggested that newer, second-generation agents may interfere with the release of inflammatory mediators from mast cells or may inhibit eosinophil chemotaxis. These effects may confer additional clinical benefit. Also, the second-generation agents produce fewer adverse reactions, including a marked reduction in sedation. Contrary to previous recommendations, recent findings have suggested that antihistamines may not necessarily be contraindicated in patients who have both asthma and allergic rhinitis. A greater understanding of the mechanisms of action and clinical effects of both older-generation and newer-generation antihistamines should help define optimal therapeutic strategies in the future.
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PMID:Role of antihistamines in allergic disease. 790 79

The efficacy and tolerability of intranasal azelastine (0.14 mg/nostril twice daily) and oral terfenadine (60 mg twice daily) were compared under double-blind conditions in two 6-week, multicenter, parallel-group studies, including 167 patients suffering from seasonal and 52 patients suffering from perennial allergic rhinitis. In both studies, patients were symptomatic on entry and showed significant improvement on both treatments within the first 8 d of therapy, showing little further improvement with continued treatment. Symptoms most pronounced on entry--nasal itching, rhinorrhea, sneezing, and nasal obstruction--responded best to treatment (response rates 80-90%). Objective signs such as mucosal swelling and conjunctivitis improved in a manner parallel to symptoms. In perennial rhinitis, azelastine showed a trend to a superior relief of rhinorrhea and nasal obstruction, whereas terfenadine showed a trend toward better control of sneezing and nasal itchiness. No clinically relevant or statistically significant differences between treatments could be identified. The incidence of adverse effects of possible causal relationship to therapy was low. The most frequent effects in azelastine-treated patients were related to application site disorders, e.g., nasal irritation. Results indicate that with the dose used azelastine nasal spray is an effective treatment for both seasonal and perennial allergic rhinitis.
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PMID:Comparative efficacy of azelastine nasal spray and terfenadine in seasonal and perennial rhinitis. 791 Oct 10

A total of 122 infants and children up to age 17 (69 males and 53 females) who were referred for food allergy to the Pediatric Allergy and Clinical Immunology Unit were evaluated by complete history, emphasizing the implicated foods, clinical presentation and involvement of various organ systems, physical examination, and prick skin tests to food allergens. Fourteen infants with a history of egg white allergy and positive skin tests to egg white also underwent skin tests (prick and intradermal in 1:100 dilution) to measles-mumps-rubella (MMR) vaccine; 35 children under 3 years old had 41 oral challenges with the suspected foods; and 9 children over 3 years old had 12 oral challenges with the suspected foods. We found that cow milk/humanized milk formula, egg white, soybean, and peanut are the main allergenic foods in the pediatric population. Thirteen children had 13 positive oral challenges: 12 to cow milk/humanized milk formula and one to egg white. Symptoms reproduced by oral challenges included urticarial and erythematous rash, conjunctival itching, angioedema, abdominal pain, vomiting, diarrhea, and rhinorrhea. No anaphylactic shock was reported. Negative skin test has an excellent predictive accuracy for negative oral challenge with the suspected food in children > 3 years old. The negative predictive accuracy of cow milk skin test in children < 3 years was 73%. Positive skin test is not a good predictor of a clinical reaction to food. Oral food challenge performed cautiously in a medical setting is the "gold standard" for diagnosis. MMR vaccine can be safely administered to infants with egg white allergy after skin tests with the vaccine are performed.
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PMID:Food allergy in infants and children: clinical evaluation and management. 800 79

Azelastine is a novel antiallergy medication currently under investigation for the treatment of allergic rhinitis and asthma. Pharmacologic studies in laboratory animals and in vitro model systems indicate that azelastine exerts multiple actions including modulation of airways smooth muscle response, interference with inflammatory processes, and inhibition of allergic reactions. In a previous controlled clinical trial, azelastine nasal solution (ASTELIN N.S.) demonstrated effectiveness in controlling symptoms of seasonal allergic rhinitis (SAR). The objective of this 2-week double-blind, parallel-group study was to further assess the effectiveness of azelastine nasal solution in improving allergic rhinitis symptoms. Two hundred forty-seven patients (> or = 12 years) with symptomatic SAR who satisfied a minimum symptoms score during a 1-week, single-blind, baseline evaluation period were randomized to receive azelastine 2 sprays per nostril bid, azelastine 2 sprays per nostril qd, chlorpheniramine 12 mg bid, or placebo using a double-dummy technique to insure blinding. The primary efficacy variables were changes in Major Symptom Complex (nose blows, sneezes, runny nose/sniffles, itch nose, and watery eyes) and Total Symptom Complex (Major plus itchy eyes/ears/throat/palate, cough, and postnasal drip) severity scores. Patients treated with azelastine nasal solution qd and bid had mean percent improvements in the Total and Major Symptom Complex severity scores that were clinically significant (> or = 50% improvement over placebo) after both weeks, at endpoint, and overall. The improvements for the azelastine bid group were statistically significant (P < or = .05) at all evaluation points. Adverse experiences occurred infrequently, and none was considered serious or potentially limiting to the clinical utility of the nasal solution.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Effectiveness of azelastine nasal solution in seasonal allergic rhinitis. 807 37

Nasal polyps are characterized by chronic eosinophilic inflammation and often coexist with rhinitis and asthma. Many patients with polyps have no detectable allergy, and it is considered that allergy, at least in many cases, is not relevant to polyp to pathogenesis. To explore the association of nasal polyps with allergy, 16 patients with polyps and ragweed allergy (PRW +) and 16 patients with polyps who were not allergic to ragweed (PRW-) were compared with patients without polyps, 16 who were allergic to ragweed (NPRW +) and 16 who were not allergic to ragweed (NPRW-), before and during the ragweed season. The level of ragweed allergy was comparable in the PRW+ and NPRW+ populations as determined by ragweed skin test wheal diameter, ragweed IgE RAST percent binding, and total serum IgE. Symptom scores before the ragweed season recorded on visual analog scales for the symptoms of blockage, sneezing, decreased smell, itch, postnatal drip, and runny nose were high in patients in the PRW+ and PRW- groups and did not change during ragweed season. Mean symptom scores were low in the NPRW+ group before ragweed season and increased during the season to levels similar to those of patients in the PRW+ and PRW- groups. Preseason nasal lavage albumin concentration was higher in subjects with polyps than those without polyps (58.5, 98) versus (13.6, 15 micrograms/ml) (p = 0.02) and did not change significantly in any group with seasonal exposure. Data are presented as mean, 1 SD; comparisons are made with unpaired t tests.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Nasal polyps: effects of seasonal allergen exposure. 815 Oct 59

In a single-center, double-blind, crossover study of 90 subjects, fluticasone propionate aqueous nasal spray, 200 micrograms, once daily was compared with 200 micrograms twice daily in severe seasonal allergic rhinitis to ragweed. The mean percentage of days free of nasal itching and eye symptoms was significantly higher with twice daily fluticasone propionate (P = .004, P = .005, respectively). There were no significant differences between the two treatment groups for nasal blockage, rhinorrhea (runny nose), and sneezing. The median symptom scores for nasal itching were lower during twice daily treatment (P = .008) but there was no significant difference for the other symptoms. There were no significant differences between the groups in the use of rescue medication. Adverse events were infrequent, and similar in both groups. Most were considered unrelated to the treatment. Twice daily treatment with fluticasone propionate may be preferable for some patients with severe seasonal allergic rhinitis.
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PMID:Double-blind comparison of intranasal fluticasone propionate, 200 micrograms, once daily with 200 micrograms twice daily in the treatment of patients with severe seasonal allergic rhinitis to ragweed. 817 30

A total of 107 children of both sexes between 2 and 6 years of age with pollen-induced seasonal allergic rhinitis (SAR) were entered in a multicentre study of double-blind parallel group design in which the effects of 5 mg cetirizine, given as drops from a solution containing 10 mg/ml once daily each evening for two weeks, were compared with those of identical placebo. Sneezing, rhinorrhea, nasal obstruction and nasal and ocular pruritus were the symptoms evaluated by means of symptom scores by investigators and, on daily record cards, by parents. Investigators also made a global evaluation at the end of treatment. Cetirizine was more active than placebo for each symptom evaluated both by parents and investigators. There were significant by more (p = 0.002) days during which symptoms were absent or mild, in the cetirizine than in the placebo group. When the maximum symptom scores rated by investigators at each visit were compared, the difference in favour of cetirizine at the end of treatment was statistically significant (p = 0.04). Global evaluation by investigators of changes in symptoms at the end of the study showed an improvement in both groups which was significantly greater with cetirizine, providing excellent or good improvement in 34/54 patients compared with 25/53 patients on placebo (p = 0.039). Tolerance was good. Three patients on cetirizine and none on placebo experienced mild somnolence.
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PMID:Cetirizine for seasonal allergic rhinitis in children aged 2-6 years. A double-blind comparison with placebo. 822 Aug 4

A total of 124 children of both sexes aged between 6 and 12 years with pollen-associated rhino-conjunctivitis were included in a multicentre double-blind study of parallel group design to compare the effects of cetirizine 10 mg daily, given as 5 mg morning and evening for 2 weeks, with those of placebo of identical appearance. Rhinorrhea, sneezing, nasal obstruction and nasal and ocular pruritus were evaluated using symptom scores by patients on daily self-evaluation cards and by investigators who, in addition, made a global evaluation at the end of treatment. Appropriate wash-out periods for previous medicines were observed. Unchanged treatment of asthma was allowed and inhaled corticosteroids were continued in 3 placebo patients. Compliance was checked and found to be less than 80% of the prescribed dosage in 2 cetirizine patients. The mean percentage of study days when symptoms were absent or at the most mild (i.e. present but not disturbing), as reported daily by the patients, was significantly greater with cetirizine (56.2%) than placebo (29.7%). This 26.5% difference was considered clinically significant. The value of this method of expressing treatment effects in allergic rhinitis is discussed. Improvement in maximum symptom scores (severest symptoms) assessed by investigators was better for cetirizine than placebo after treatment for 1 week and 2 weeks. Improvement in individual daily symptoms was greater for cetirizine than placebo after a few days.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:A placebo-controlled trial of cetirizine in seasonal allergic rhino-conjunctivitis in children aged 6 to 12 years. 835 60

Metabisulfite sensitivity is being described with growing frequency. Sulfites are used in food, drinks, and drugs. Adverse reactions to apparently nontoxic doses have been described. Exposure of sensitive persons to sulfites has produced asthma, and occasionally other adverse reactions in nonasthmatic patients. We present a case of urticaria induced by metabisulfites. During the previous 2 years the patient had suffered episodes of urticaria and angioedema limited to the face, neck, upper thorax, and dysphonia without asthma after the ingestion of food and drinks containing sulfites. Oral challenge with 25 mg of potassium metabisulfite elicited urticaria on the face and neck, nasal itching, rhinorrhea, and dysphonia. Prick and intradermal tests were negative. Two further challenges with the same doses were also positive. One of these was controlled with placebo, 30 minutes after oral administration of 400 mg sodium cromolyn; the second was carried out 90 minutes after oral administration of 5000 micrograms cyanocobalamin. We have been unable to identify a pathogenic mechanism.
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PMID:Sulfite-induced urticaria. 837 95


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