By Rohit Katial, Guest Editor
This factor is meant relief the physician's knowing of universal allergic and immunologic ailments visible in a main care perform and in addition to offer the most recent information regarding those difficulties. as well as bronchial asthma, the difficulty contains discussions of allergic rhinitis-one of the most typical continual diseases-and urticaria, foodstuff hypersensitive reaction, and acute as opposed to persistent sinusitis.
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Additional info for Allergy, Asthma, and Immune Deficiency (Primary Care Clinics in Office Practice, Volume 35-01)
Albuterol exists as a 1:1 racemic mixture of R-albuterol and S-albuterol. These two enantiomers are mirror images of each other in terms of their molecular structure. R-albuterol is more biologically active with a higher binding aﬃnity . Although S-albuterol was originally thought to be inert, in vitro studies have suggested the possibility of some deleterious eﬀects, including smooth muscle contraction, increased hyperresponsiveness, and increased mucin production. ). Unfortunately, the results of several large studies have been conﬂicting and thus far there does not seem to be a clear advantage to levalbuterol that justiﬁes the added cost .
Viral illnesses Viral illnesses are tightly linked with asthma both as a risk factor and a trigger. Studies have shown that previous severe infection with respiratory syncytial virus (RSV), including hospitalization and/or oxygen requirement, is a risk factor for the development of asthma . What remains unclear is whether RSV infection itself results in permanent damage leading to asthma Table 1 API criteria and modiﬁed API criteria APIa Modiﬁed APIb Major criteria Parental history of asthma Physician-diagnosed atopic dermatitis Minor Criteria Physician-diagnosed allergic rhinitis Wheezing apart from viral illnesses Blood eosinophilia O4% Parental history of asthma Physician-diagnosed atopic dermatitis Allergic sensitization to at least one aeroallergen Allergic sensitization to eggs, milk, or peanuts Wheezing apart from viral illnesses a Blood eosinophilia O4% Data from Castro-Rodriquez JA, Holberg CJ, Wright AL, et al.
Nasal corticosteroids have been shown to decrease the inﬂammatory process of the nasal mucosa after nasal antigen challenge, and can modify both the early and late allergic response. As an extension, it is reasonable to consider that nasal corticosteroids may decrease the inﬂammatory response in sinusitis. Nasal corticosteroids have been studied as adjunctive therapy to antibiotic therapy and found signiﬁcant reduction in several symptom scores; in addition, they show no increase in adverse events .
Allergy, Asthma, and Immune Deficiency (Primary Care Clinics in Office Practice, Volume 35-01) by Rohit Katial, Guest Editor