No abstract

This 3-week prospective, randomized, double-masked, parallel-group study compared ketotifen fumarate 0.025% ophthalmic solution and olopatadine hydrochloride 0.1% ophthalmic solution in 66 patients with seasonal allergic conjunctivitis. The drugs were instilled twice daily. Signs and symptoms were assessed on days 5 (visit 2) and 21 (visit 3). Other efficacy variables were the responder rate (patients with excellent or good global efficacy on days 5 and 21) and patient and investigator ratings of global efficacy. Comfort was evaluated immediately after instillation of the first drop and at each follow-up visit. The frequency of adverse events was the safety assessment. The responder rate was higher with ketotifen than with olopatadine on day 5 (72% vs 54% for patient assessment, 88% vs 55% for investigator assessment) and day 21 (91% vs 55%, 94% vs 42%). Global efficacy ratings were higher with ketotifen, and severity scores for hyperemia and itching were significantly lower. Both drugs elicited comparable comfort ratings. The most common adverse events were burning/stinging and headache.

Children with asthma in low-income households in Chicago were participants in a school-based mobile van clinic, Mobile C.A.R.E. Our objective was to investigate whether long-term follow-up changed clinical markers and resource utilization. Children were evaluated by a pediatrician in a mobile allergy clinic and classified and treated based on National Asthma Education and Prevention Program (NAEPP) guidelines. Intervention consisted of assessment of allergic environment with avoidance recommendations, institution of appropriate controller therapy and inhaler technique, education on asthma and asthma management, and expectations for asthma control. Over 20,000 children were screened, 2041 were examined at least once, and 677 children had four follow-up visits. With follow-up, there was a decrease in hospitalizations and emergency room visits. Symptomatic markers (daytime and nighttime cough, wheezing, and dyspnea symptoms), frequency of rescue inhaler use, and a quality-of-life score improved from baseline. These findings suggest that ongoing school interventions may reduce resource utilization and improve clinical symptoms. Primary care physicians may be able to deliver specialized care to large numbers of inner-city children with asthma.

No abstract

We describe a 36-year-old man with recurrent Stevens-Johnson syndrome, which became progressively more severe over a 13-year period. His episodes were apparently preceded by herpes simplex virus oral mucosal infections. A management protocol, including immediate therapy with acyclovir and prednisone at the onset of herpes simplex virus oropharyngitis, is outlined. This management strategy has successfully prevented four subsequent episodes of progression to Stevens-Johnson syndrome. Thus, Stevens-Johnson syndrome associated with herpes simplex virus may be prevented by early use of acyclovir and prednisone.