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Portnoy J, Wade RL, Kessler C. Patient Carrying Time, Confidence, and Training with Epinephrine Autoinjectors: The RACE Survey. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2019; 7:2252-2261. [DOI: 10.1016/j.jaip.2019.03.021] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 03/06/2019] [Accepted: 03/13/2019] [Indexed: 12/18/2022]
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Waller M, Taylor L, Portnoy J. The Medical Virtualist: Is Pediatric Patient Care Using Telemedicine, a New Specialty? Pediatr Ann 2019; 48:e243-e248. [PMID: 31185116 DOI: 10.3928/19382359-20190520-01] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Telemedicine (TM) is undergoing unprecedented growth that is being driven by numerous factors, one of which is patient preference. Providers who use this tool to deliver health care tend to be early adoptors of new technology, but do they also represent a nascent specialty of pediatric virtualist? We believe that such practitioners, although exhibiting characteristics common to all early adopters, represent the cutting edge of what will become routine medical care. They tend to engage in less small talk with patients, focus more on efficient problem-solving, and collect less data while achieving patient outcomes and satisfaction that are as good as, or possibly even better than, their colleagues who practice in traditional settings. In doing so, they are leading the way for all providers to deliver care to patients using this new technology. Eventually, we feel that medical encounters using TM will be referred to simply as "patient care." [Pediatr Ann. 2019;48(6):e243-e248.].
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Portnoy J, Cox LS. Is the Benefit From Prescribing Epinephrine Autoinjectors for Sublingual Immunotherapy Worth the Cost? Lessons Learned From Clinical Trials. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2018; 5:90-91. [PMID: 28065345 DOI: 10.1016/j.jaip.2016.11.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Received: 11/13/2016] [Accepted: 11/14/2016] [Indexed: 11/28/2022]
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Golden DBK, Demain J, Freeman T, Graft D, Tankersley M, Tracy J, Blessing-Moore J, Bernstein D, Dinakar C, Greenhawt M, Khan D, Lang D, Nicklas R, Oppenheimer J, Portnoy J, Randolph C, Schuller D, Wallace D. Stinging insect hypersensitivity: A practice parameter update 2016. Ann Allergy Asthma Immunol 2017; 118:28-54. [PMID: 28007086 DOI: 10.1016/j.anai.2016.10.031] [Citation(s) in RCA: 140] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Accepted: 10/31/2016] [Indexed: 10/20/2022]
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Elliott T, Shih J, Dinakar C, Portnoy J, Fineman S. American College of Allergy, Asthma & Immunology Position Paper on the Use of Telemedicine for Allergists. Ann Allergy Asthma Immunol 2017; 119:512-517. [PMID: 29103799 DOI: 10.1016/j.anai.2017.09.052] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 09/08/2017] [Indexed: 11/17/2022]
Abstract
The integration of telecommunications and information systems in health care first began 4 decades ago with 500 patient consultations performed via interactive television. The use of telemedicine services and technology to deliver health care at a distance is increasing exponentially. Concomitant with this rapid expansion is the exciting ability to provide enhancements in quality and safety of care. Telemedicine enables increased access to care, improvement in health outcomes, reduction in medical costs, better resource use, expanded educational opportunities, and enhanced collaboration between patients and physicians. These potential benefits should be weighed against the risks and challenges of using telemedicine. The American College of Allergy, Asthma, and Immunology advocates for incorporation of meaningful and sustained use of telemedicine in allergy and immunology practice. This article serves to offer policy and position statements of the use of telemedicine pertinent to the allergy and immunology subspecialty.
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Portnoy J, Altaras C, Miller J, Foley F. A-67Cognition, Depression, and Physical Disability in Multiple Sclerosis as Predictors of Illness Intrusiveness. Arch Clin Neuropsychol 2017. [DOI: 10.1093/arclin/acx076.67] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Portnoy J, Weiss E, Facchini R, Masur D, Mcginley J. PGR-3A Case of Autism Spectrum Disorder Associated with Chromosome 17p13.3 Duplication: Implications for Pediatric Neuropsychological Practice. Arch Clin Neuropsychol 2017. [DOI: 10.1093/arclin/acx073.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Abstract
INTRODUCTION fungi produce substances that contain pathogen-associated molecular patterns (pamps) and damage-associated molecular patterns (damps) which bind to pattern recognition receptors, stimulating innate immune responses in humans. they also produce allergens that induce production of specific ige. Areas covered: In this review we cover both innate and adaptive immune responses to fungi. Some fungal products can activate both innate and adaptive responses and in doing so, cause an intense and complex health effects. Methods of testing for fungal allergy and evidence for clinical treatment including environmental control are also discussed. In addition, we describe controversial issues including the role of Stachybotrys and mycotoxins in adverse health effects. Expert commentary: Concerns about long-term exposure to fungi have led some patients, attorneys and fungus advocates to promote fears about a condition that has been termed toxic mold syndrome. This syndrome is associated with vague symptoms and is believed to be due to exposure to mycotoxins, though this connection has not been proven. Ultimately, more precise methods are needed to measure both fungal exposure and the resulting health effects. Once that such methods become available, much of the speculation will be replaced by knowledge.
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Alsayegh MA, Alshamali H, Khadada M, Ciccolini A, Ellis AK, Quint D, Powley W, Lee L, Fiteih Y, Baksh S, Vliagoftis H, Gerega SK, Millson B, Charland K, Barakat S, Sun X, Jimenez R, Waserman S, FitzGerald MJ, Hébert J, Cognet-Sicé J, Renahan KE, Huq S, Chooniedass R, Sawyer S, Pasterkamp H, Becker A, Smith SG, Zhang S, Jayasundara K, Tacon C, Simidchiev A, Nadeau G, Gunsoy N, Mullerova H, Albers F, Kim YW, Shannon CP, Singh A, Neighbour H, Larché M, Tebbutt SJ, Klopp A, Vehling L, Becker AB, Subbarao P, Mandhane PJ, Turvey SE, Sears MR, Azad MB, Loewen K, Monchka B, Mahmud SM, Jong G‘, Longo C, Bartlett G, Ducharme FM, Schuster T, MacGibbon B, Barnett T, North ML, Brook J, Lee E, Omana V, Thiele J, Steacy LM, Evans G, Diamond M, Sussman GL, Amistani Y, Abiteboul K, Tenn MW, Yang C, Carlsten C, Conway EM, Mack D, Othman Y, Barber CM, Kalicinsky C, Burke AE, Messieh M, Nair P, Che CT, Douglas L, Liem J, Duan L, Miller C, Dupuis P, Connors LA, Fein MN, Shuster J, Hadi H, Polk B, Raje N, Labrosse R, Bégin P, Paradis L, Roches AD, Lacombe-Barrios J, Mishra S, Lacuesta G, Chiasson M, Haroon B, Robertson K, Issekutz T, Leddin D, Couban S, Connors L, Roos A, Kanani A, Chan ES, Schellenberg R, Rosenfield L, Cvetkovic A, Woodward K, Quirt J, Watson WTA, Castilho E, Sullivan JA, Temple B, Martin D, Cook VE, Mills C, Portales-Casamar E, Fu LW, Ho A, Zaltzman J, Chen L, Vadas P, Gabrielli S, Clarke A, Eisman H, Morris J, Joseph L, LaVieille S, Ben-Shoshan M, Graham F, Barnes C, Portnoy J, Stagg V, Simons E, Lefebvre D, Dai D, Mandhane P, Sears M, Tam H, Simons FER, Alotaibi D, Dawod B, Tunis MC, Marshall J, Desjardins M, Béland M, Lejtenyi D, Drolet JP, Lemire M, Tsoukas C, Noya FJ, Alizadehfar R, McCusker CT, Mazer BD, Maestre-Batlle D, Gunawan E, Rider CF, Bølling AK, Pena OM, Suez D, Melamed I, Hussain I, Stein M, Gupta S, Paris K, Fritsch S, Bourgeois C, Leibl H, McCoy B, Noel M, Yel L, Scott O, Reid B, Atkinson A, Kim VHD, Roifman CM, Grunebaum E, AlSelahi E, Aleman F, Oberle A, Trus M, Sussman G, Kanani AS, Chambenoi O, Chiva-Razavi S, Grodecki S, Joshi N, Menikefs P, Holt D, Pun T, Tworek D, Hanna R, Heroux D, Rosenberg E, Stiemsma L, Turvey S, Denburg J, Mill C, Teoh T, Zimmer P, Avinashi V, Paina M, Darwish Hassan AA, Oliveria JP, Olesovsky C, Gauvreau G, Pedder L, Keith PK, Plunkett G, Bolner M, Pourshahnazari P, Stark D, Vostretsova K, Moses A, Wakeman A, Singer A, Gerstner T, Abrams E, Johnson SF, Woodgate RL. Canadian Society of Allergy and Clinical Immunology annual scientific meeting 2016. Allergy Asthma Clin Immunol 2017. [PMCID: PMC5390240 DOI: 10.1186/s13223-017-0192-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Jara D, Portnoy J, Dhar M, Barnes C. Relation of indoor and outdoor airborne fungal spore levels in the Kansas City metropolitan area. Allergy Asthma Proc 2017; 38:130-135. [PMID: 28234050 DOI: 10.2500/aap.2017.38.4030] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Environmental control is an important component of asthma management for persons with asthma. A damp indoor environment and elevated airborne spore levels are factors in housing environmental control. OBJECTIVES We investigated if indoor airborne fungal spore levels correlated with outdoor ground-level airborne fungal spores or outdoor centrally collected spore levels as to types and abundance. METHODS Air collections were taken from home interiors, outdoor areas adjacent to the homes, and at a central location in the metropolitan area at the approximate same time. All air collections were examined and enumerated microscopically, and airborne spore estimates per cubic meter of air were reported for total fungal spores and for 11 identifiable spore groups. RESULTS The 244 homes in the study were typical of the North American Midwest. The overall mean total spore counts in spores per cubic meter of air was indoors (4076 spores/m3), outdoors at ground level (8899 spores/m3), and outdoor metropolitan area (8342 spores/m3). All of the major indoor taxa were strongly correlated with the mean total spores present in the home. Total outdoor ground spore levels were highly correlated with levels of major outdoor taxa, such as ascospores and Cladosporium. Correlations of indoor spore levels with outdoor spore levels are strong for most major outdoor taxa. Indoor Aspergillus-Penicillium and Chaetomium are significantly correlated between indoor and local ground-level outdoor air. CONCLUSION Although conditions may exist where indoor or outdoor spore levels were not well aligned, in most circumstances, the outdoor airborne spore community was reflected in the indoor airborne spore community.
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Allenbrand R, Barnes CS, Mohammed M, Gard L, Pacheco F, Kennedy K, DiDonna A, Portnoy J, Dinakar C. Comparison of allergens collected from furnace filters and vacuum floor dust. Ann Allergy Asthma Immunol 2016; 118:108-109. [PMID: 27839669 DOI: 10.1016/j.anai.2016.10.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Revised: 09/29/2016] [Accepted: 10/01/2016] [Indexed: 11/24/2022]
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Fonacier L, Bernstein DI, Pacheco K, Holness DL, Blessing-Moore J, Khan D, Lang D, Nicklas R, Oppenheimer J, Portnoy J, Randolph C, Schuller D, Spector S, Tilles S, Wallace D. Contact dermatitis: a practice parameter-update 2015. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2016; 3:S1-39. [PMID: 25965350 DOI: 10.1016/j.jaip.2015.02.009] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Accepted: 02/26/2015] [Indexed: 01/08/2023]
Abstract
This parameter was developed by the Joint Task Force on Practice Parameters, which represents the American Academy of Allergy, Asthma & Immunology (AAAAI); the American College of Allergy, Asthma & Immunology (ACAAI); and the Joint Council of Allergy, Asthma & Immunology. The AAAAI and the ACAAI have jointly accepted responsibility for establishing "Contact Dermatitis: A Practice Parameter-Update 2015." This is a complete and comprehensive document at the current time. The medical environment is changing and not all recommendations will be appropriate or applicable to all patients. Because this document incorporated the efforts of many participants, no single individual, including members serving on the Joint Task Force, are authorized to provide an official AAAAI or ACAAI interpretation of these practice parameters. Any request for information or interpretation of this practice parameter by the AAAAI or ACAAI should be directed to the Executive Offices of the AAAAI, the ACAAI, and the Joint Council of Allergy, Asthma & Immunology. These parameters are not designed for use by the pharmaceutical industry in drug development or promotion. Previously published practice parameters of the Joint Task Force on Practice Parameters for Allergy & Immunology are available at http://www.JCAAI.org or http://www.allergyparameters.org.
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Portnoy J, Waller M, Dinakar C. TeleAllergy: a new way to manage asthma. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2015; 3:302-3. [PMID: 25754720 DOI: 10.1016/j.jaip.2014.10.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Accepted: 10/20/2014] [Indexed: 01/18/2023]
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Hanson JR, Lee BR, Williams DD, Murphy H, Kennedy K, DeLurgio SA, Portnoy J, Reddy M. Developing a risk stratification model for predicting future health care use in asthmatic children. Ann Allergy Asthma Immunol 2015; 116:26-30. [PMID: 26553446 DOI: 10.1016/j.anai.2015.10.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Revised: 10/02/2015] [Accepted: 10/12/2015] [Indexed: 11/16/2022]
Abstract
BACKGROUND Previous studies have stratified pediatric asthma patients for risk of future exacerbation and/or health care use, but most incorporate multiple clinical parameters. OBJECTIVE To determine whether historical acute care visits (ACVs) alone could predict risk of future health care use. METHODS Children seen for asthma in an outpatient visit during a 3-year period were identified. The number of ACVs in the 12 months before and after the outpatient visit was determined. Logistic regression models were used to determine the odds of a future ACV. Models were adjusted for age, sex, race, and insurance status. RESULTS Of 28,047 outpatient visits, 21,099 (75.2%) had no historical ACVs. The probability of a future ACV increased from 30% with one historical ACV to 87% with 5 or more historical ACVs. Outpatient visits with one historical ACV had significantly higher odds of a future ACV compared with those with no historical ACVs (adjusted odds ratio [OR], 3.60; 95% confidence interval [CI], 3.14-4.12; P < .001). The OR increased with each additional historical ACV to an adjusted OR of 58.71 (95% CI, 24.34-141.61; P < .001) with 5 or more historical ACVs. Outpatient visits with 5 or more historical ACVs represented only 1.1% of the study sample but accounted for a higher mean number of future ACVs. CONCLUSION The historical count of ACVs was predictive of future ACVs. A significant increase in the probability of future ACVs was observed with each additional historical visit, effectively stratifying risk by the historical visit count. Notably, a small group of patients accounted for a disproportionate number of future ACVs.
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Ciaccio CE, Barnes C, Kennedy K, Chan M, Portnoy J, Rosenwasser L. Home dust microbiota is disordered in homes of low-income asthmatic children. J Asthma 2015; 52:873-80. [PMID: 26512904 DOI: 10.3109/02770903.2015.1028076] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
OBJECTIVE Exposure to microorganisms has repeatedly been found to influence development of atopic diseases, such as asthma. Innovative techniques have been developed that can comprehensively characterize microbial communities. The objective of this study was to characterize the home microbiota of asthmatic children utilizing 16S rRNA-based phylogenetic analysis by microarray. METHODS In this cross-sectional study, DNA was extracted from home dust and bacterial 16S rRNA genes amplified. Bacterial products were hybridized to the PhyloChip Array and scanned using a GeneArray scanner (Affymetrix, Santa Clara, CA). The Adonis test was used to determine significant differences in the whole microbiome. Welch's t-test was used to determine significant abundance differences and genus-level richness differences. RESULTS Nineteen homes were included in the analysis (14 asthma and five no asthma). About 1741 operational taxonomic units (OTUs) were found in at least one sample. Bacterial genus richness did not differ in the homes of asthmatics and non-asthmatics (p = 0.09). The microbial profile was significantly different between the two groups (p = 0.025). All the top 12 OTUs with significant abundance differences were increased in homes of asthmatics and belonged to one of the five phyla (p = 0.001 to p = 7.2 × 10(-6)). Nearly half of significant abundance differences belonged to the phylum Cyanobacteria or Proteobacteria. CONCLUSIONS These results suggest that home dust has a characteristic microbiota which is disturbed in the homes of asthmatics, resulting in a particular abundance of Cyanobacteria and Proteobacteria. Further investigations are needed which utilize high-throughput technology to further clarify how home microbial exposures influence human health and disease.
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D'Amato G, Holgate ST, Pawankar R, Ledford DK, Cecchi L, Al-Ahmad M, Al-Enezi F, Al-Muhsen S, Ansotegui I, Baena-Cagnani CE, Baker DJ, Bayram H, Bergmann KC, Boulet LP, Buters JTM, D'Amato M, Dorsano S, Douwes J, Finlay SE, Garrasi D, Gómez M, Haahtela T, Halwani R, Hassani Y, Mahboub B, Marks G, Michelozzi P, Montagni M, Nunes C, Oh JJW, Popov TA, Portnoy J, Ridolo E, Rosário N, Rottem M, Sánchez-Borges M, Sibanda E, Sienra-Monge JJ, Vitale C, Annesi-Maesano I. Meteorological conditions, climate change, new emerging factors, and asthma and related allergic disorders. A statement of the World Allergy Organization. World Allergy Organ J 2015; 8:25. [PMID: 26207160 PMCID: PMC4499913 DOI: 10.1186/s40413-015-0073-0] [Citation(s) in RCA: 244] [Impact Index Per Article: 27.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Accepted: 05/29/2015] [Indexed: 01/08/2023] Open
Abstract
The prevalence of allergic airway diseases such as asthma and rhinitis has increased dramatically to epidemic proportions worldwide. Besides air pollution from industry derived emissions and motor vehicles, the rising trend can only be explained by gross changes in the environments where we live. The world economy has been transformed over the last 25 years with developing countries being at the core of these changes. Around the planet, in both developed and developing countries, environments are undergoing profound changes. Many of these changes are considered to have negative effects on respiratory health and to enhance the frequency and severity of respiratory diseases such as asthma in the general population. Increased concentrations of greenhouse gases, and especially carbon dioxide (CO2), in the atmosphere have already warmed the planet substantially, causing more severe and prolonged heat waves, variability in temperature, increased air pollution, forest fires, droughts, and floods – all of which can put the respiratory health of the public at risk. These changes in climate and air quality have a measurable impact not only on the morbidity but also the mortality of patients with asthma and other respiratory diseases. The massive increase in emissions of air pollutants due to economic and industrial growth in the last century has made air quality an environmental problem of the first order in a large number of regions of the world. A body of evidence suggests that major changes to our world are occurring and involve the atmosphere and its associated climate. These changes, including global warming induced by human activity, have an impact on the biosphere, biodiversity, and the human environment. Mitigating this huge health impact and reversing the effects of these changes are major challenges. This statement of the World Allergy Organization (WAO) raises the importance of this health hazard and highlights the facts on climate-related health impacts, including: deaths and acute morbidity due to heat waves and extreme meteorological events; increased frequency of acute cardio-respiratory events due to higher concentrations of ground level ozone; changes in the frequency of respiratory diseases due to trans-boundary particle pollution; altered spatial and temporal distribution of allergens (pollens, molds, and mites); and some infectious disease vectors. According to this report, these impacts will not only affect those with current asthma but also increase the incidence and prevalence of allergic respiratory conditions and of asthma. The effects of climate change on respiratory allergy are still not well defined, and more studies addressing this topic are needed. Global warming is expected to affect the start, duration, and intensity of the pollen season on the one hand, and the rate of asthma exacerbations due to air pollution, respiratory infections, and/or cold air inhalation, and other conditions on the other hand.
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Dinakar C, Portnoy J. Sailing to the port of best practice on the A/I practice parameters Mayflower. Ann Allergy Asthma Immunol 2014; 113:123-4. [PMID: 25065348 DOI: 10.1016/j.anai.2014.05.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Accepted: 05/27/2014] [Indexed: 11/19/2022]
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Dinakar C, Oppenheimer J, Portnoy J, Bacharier LB, Li J, Kercsmar CM, Bernstein D, Blessing-Moore J, Khan D, Lang D, Nicklas R, Randolph C, Schuller D, Spector S, Tilles SA, Wallace D. Management of acute loss of asthma control in the yellow zone: a practice parameter. Ann Allergy Asthma Immunol 2014; 113:143-59. [PMID: 25065350 DOI: 10.1016/j.anai.2014.05.017] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Accepted: 05/15/2014] [Indexed: 10/25/2022]
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Sampson HA, Aceves S, Bock SA, James J, Jones S, Lang D, Nadeau K, Nowak-Wegrzyn A, Oppenheimer J, Perry TT, Randolph C, Sicherer SH, Simon RA, Vickery BP, Wood R, Bernstein D, Blessing-Moore J, Khan D, Lang D, Nicklas R, Oppenheimer J, Portnoy J, Randolph C, Schuller D, Spector S, Tilles SA, Wallace D, Sampson HA, Aceves S, Bock SA, James J, Jones S, Lang D, Nadeau K, Nowak-Wegrzyn A, Oppenheimer J, Perry TT, Randolph C, Sicherer SH, Simon RA, Vickery BP, Wood R. Food allergy: a practice parameter update-2014. J Allergy Clin Immunol 2014; 134:1016-25.e43. [PMID: 25174862 DOI: 10.1016/j.jaci.2014.05.013] [Citation(s) in RCA: 508] [Impact Index Per Article: 50.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2014] [Revised: 05/02/2014] [Accepted: 05/06/2014] [Indexed: 02/06/2023]
Abstract
This parameter was developed by the Joint Task Force on Practice Parameters, representing the American Academy of Allergy, Asthma & Immunology (AAAAI); the American College of Allergy, Asthma & Immunology (ACAAI); and the Joint Council of Allergy, Asthma & Immunology (JCAAI). The AAAAI and the ACAAI have jointly accepted responsibility for establishing "Food Allergy: A practice parameter update-2014." This is a complete and comprehensive document at the current time. The medical environment is a changing one, and not all recommendations will be appropriate for all patients. Because this document incorporated the efforts of many participants, no single individual, including those who served on the Joint Task Force, is authorized to provide an official AAAAI or ACAAI interpretation of these practice parameters. Any request for information about or an interpretation of these practice parameters by the AAAAI or ACAAI should be directed to the Executive Offices of the AAAAI, ACAAI, and JCAAI. These parameters are not designed for use by pharmaceutical companies in drug promotion.
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Portnoy J, Miller JD, Williams PB, Chew GL, Miller JD, Zaitoun F, Phipatanakul W, Kennedy K, Barnes C, Grimes C, Larenas-Linnemann D, Sublett J, Bernstein D, Blessing-Moore J, Khan D, Lang D, Nicklas R, Oppenheimer J, Randolph C, Schuller D, Spector S, Tilles SA, Wallace D. Environmental assessment and exposure control of dust mites: a practice parameter. Ann Allergy Asthma Immunol 2013; 111:465-507. [PMID: 24267359 PMCID: PMC5156485 DOI: 10.1016/j.anai.2013.09.018] [Citation(s) in RCA: 91] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2013] [Accepted: 09/20/2013] [Indexed: 12/15/2022]
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Portnoy J, Chew GL, Phipatanakul W, Williams PB, Grimes C, Kennedy K, Matsui EC, Miller JD, Bernstein D, Blessing-Moore J, Cox L, Khan D, Lang D, Nicklas R, Oppenheimer J, Randolph C, Schuller D, Spector S, Tilles SA, Wallace D, Seltzer J, Sublett J. Environmental assessment and exposure reduction of cockroaches: a practice parameter. J Allergy Clin Immunol 2013; 132:802-8.e1-25. [PMID: 23938214 DOI: 10.1016/j.jaci.2013.04.061] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2013] [Revised: 03/27/2013] [Accepted: 04/22/2013] [Indexed: 12/15/2022]
Abstract
This parameter was developed by the Joint Task Force on Practice Parameters, representing the American Academy of Allergy, Asthma & Immunology (AAAAI); the American College of Allergy, Asthma & Immunology (ACAAI); and the Joint Council of Allergy, Asthma & Immunology. The AAAAI and the ACAAI have jointly accepted responsibility for establishing "Environmental assessment and remediation: a practice parameter." This is a complete and comprehensive document at the current time. The medical environment is a changing environment, and not all recommendations will be appropriate for all patients. Because this document incorporated the efforts of many participants, no single person, including those who served on the Joint Task Force, is authorized to provide an official AAAAI or ACAAI interpretation of these practice parameters. Any request for information about or an interpretation of these practice parameters by the AAAAI or ACAAI should be directed to the Executive Offices of the AAAAI, the ACAAI, and the Joint Council of Allergy, Asthma & Immunology. These parameters are not designed for use by pharmaceutical companies in drug promotion. The findings and conclusions in this manuscript are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention (CDC).
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Schneider L, Tilles S, Lio P, Boguniewicz M, Beck L, LeBovidge J, Novak N, Bernstein D, Blessing-Moore J, Khan D, Lang D, Nicklas R, Oppenheimer J, Portnoy J, Randolph C, Schuller D, Spector S, Tilles S, Wallace D. Atopic dermatitis: a practice parameter update 2012. J Allergy Clin Immunol 2013; 131:295-9.e1-27. [PMID: 23374261 DOI: 10.1016/j.jaci.2012.12.672] [Citation(s) in RCA: 269] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2012] [Accepted: 12/18/2012] [Indexed: 10/27/2022]
Abstract
This parameter was developed by the Joint Task Force on Practice Parameters, representing the American Academy of Allergy, Asthma & Immunology (AAAAI); the American College of Allergy, Asthma & Immunology (ACAAI); and the Joint Council of Allergy, Asthma and Immunology. The AAAAI and the ACAAI have jointly accepted responsibility for establishing "Atopic dermatitis: a practice parameter update 2012." This is a complete and comprehensive document at the current time. The medical environment is a changing environment, and not all recommendations will be appropriate for all patients. Because this document incorporated the efforts of many participants, no single individual, including those who served on the Joint Task Force, is authorized to provide an official AAAAI or ACAAI interpretation of these practice parameters. Any request for information about or an interpretation of these practice parameters by the AAAAI or ACAAI should be directed to the Executive Offices of the AAAAI, the ACAAI, and the Joint Council of Allergy, Asthma & Immunology. These parameters are not designed for use by pharmaceutical companies in drug promotion. Published practice parameters of the Joint Task Force on Practice Parameters for Allergy & Immunology are available online at http://www.jcaai.org.
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Haahtela T, Holgate S, Pawankar R, Akdis CA, Benjaponpitak S, Caraballo L, Demain J, Portnoy J, von Hertzen L. The biodiversity hypothesis and allergic disease: world allergy organization position statement. World Allergy Organ J 2013; 6:3. [PMID: 23663440 PMCID: PMC3646540 DOI: 10.1186/1939-4551-6-3] [Citation(s) in RCA: 200] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2013] [Accepted: 01/17/2013] [Indexed: 12/21/2022] Open
Abstract
Biodiversity loss and climate change secondary to human activities are now being associated with various adverse health effects. However, less attention is being paid to the effects of biodiversity loss on environmental and commensal (indigenous) microbiotas. Metagenomic and other studies of healthy and diseased individuals reveal that reduced biodiversity and alterations in the composition of the gut and skin microbiota are associated with various inflammatory conditions, including asthma, allergic and inflammatory bowel diseases (IBD), type1 diabetes, and obesity. Altered indigenous microbiota and the general microbial deprivation characterizing the lifestyle of urban people in affluent countries appear to be risk factors for immune dysregulation and impaired tolerance. The risk is further enhanced by physical inactivity and a western diet poor in fresh fruit and vegetables, which may act in synergy with dysbiosis of the gut flora. Studies of immigrants moving from non-affluent to affluent regions indicate that tolerance mechanisms can rapidly become impaired in microbe-poor environments. The data on microbial deprivation and immune dysfunction as they relate to biodiversity loss are evaluated in this Statement of World Allergy Organization (WAO). We propose that biodiversity, the variability among living organisms from all sources are closely related, at both the macro- and micro-levels. Loss of the macrodiversity is associated with shrinking of the microdiversity, which is associated with alterations of the indigenous microbiota. Data on behavioural means to induce tolerance are outlined and a proposal made for a Global Allergy Plan to prevent and reduce the global allergy burden for affected individuals and the societies in which they live.
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Duncan CL, Hogan MB, Tien KJ, Graves MM, Chorney JM, Zettler MD, Koven L, Wilson NW, Dinakar C, Portnoy J. Efficacy of a parent-youth teamwork intervention to promote adherence in pediatric asthma. J Pediatr Psychol 2012; 38:617-28. [PMID: 23248342 DOI: 10.1093/jpepsy/jss123] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To determine whether a parent-youth teamwork intervention improved medication adherence and related outcomes among youth with asthma. METHODS We used a randomized clinical trial with 48 youth (aged 9-15 years) assigned to 1 of 3 groups: Teamwork Intervention (TI), Asthma Education (AE), or Standard Care (SC). Treatment occurred across 2 months, with a 3-month follow-up assessment. Adherence to inhaled corticosteroids was assessed via the MDILog-II. Parent-adolescent conflict, asthma functional severity, and spirometry assessments were obtained pre-treatment, post-treatment, and on follow-up. Mixed linear model analysis was used to evaluate group and time effects for outcome measures. RESULTS TI group had significantly higher adherence and lower functional severity scores than AE or SC conditions, and lower parent-reported conflict and a trend for higher spirometry values compared with the SC group. CONCLUSIONS Results suggest support for the efficacy of TI for improving medication adherence as youth acquire more responsibility for their asthma management.
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Phipatanakul W, Matsui E, Portnoy J, Williams PB, Barnes C, Kennedy K, Bernstein D, Blessing-Moore J, Cox L, Khan D, Lang D, Nicklas R, Oppenheimer J, Randolph C, Schuller D, Spector S, Tilles SA, Wallace D, Sublett J, Bernstein J, Grimes C, Miller JD, Seltzer J. Environmental assessment and exposure reduction of rodents: a practice parameter. Ann Allergy Asthma Immunol 2012; 109:375-87. [PMID: 23176873 PMCID: PMC3519934 DOI: 10.1016/j.anai.2012.09.019] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2012] [Accepted: 09/26/2012] [Indexed: 11/19/2022]
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