ABSTRACT
OBJECTIVE: This study aimed to evaluate the clinical efficacy and antibody response changes after specific immunotherapy (SIT) using Dermatophagoides pteronyssinus (Dpt) allergens with or without bacterial extracts in Brazilian mite-atopic patients. METHODS: One-hundred patients with allergic rhinitis were selected for a randomized double-blind, placebo-controlled trial and distributed into 4 groups: Dpt (Dpt allergen extract), Dpt+MRB (Dpt allergen plus mixed respiratory bacterial extracts), MRB (MRB extract only) and placebo. Rhinitis symptom and medication scores; skin prick test (SPT) to Dpt extract; and serum immunoglobulin (Ig) E, IgG4, and IgG1 levels to Dpt, Der p 1, and Der p 2 allergens were evaluated before and after a year of treatment. RESULTS: After 1 year, the SPT response was reduced in the Dpt group (P=.03), whereas IgE levels to Der p 2 decreased only in the Dpt (P = .048) and Dpt+MRB (P = .005) groups. IgG4 and IgG1 levels to Dpt and Der p 1 increased in the Dpt group (P < .05), whereas in the Dpt + MRB group the IgG1 level only increased to Dpt (P=.001) and the IgG4 only increased to Der p 1 (P=.049). IgE levels to Dpt decreased only in the MRB (P= .005) and Dpt + MRB (P= .001) groups. Rhinitis symptom and medication scores fell in all groups, including the placebo group (P<.001). CONCLUSIONS: SIT using Dpt extract alone was effective in reducing SPT response and IgE levels to Der p 2 allergen, while bacterial extracts induced decreases in IgE levels to whole Dpt extract. However, only groups receiving Dpt allergen had higher levels of IgG1 and IgG4 to Dpt and Der p 1 after a year of treatment.
Subject(s)
Antigens, Dermatophagoides/immunology , Antigens, Dermatophagoides/therapeutic use , Bacteria/immunology , Dermatophagoides pteronyssinus/immunology , Immunotherapy , Rhinitis, Allergic, Perennial/therapy , Adolescent , Adult , Animals , Bacteria/cytology , Brazil , Child , Double-Blind Method , Drug Combinations , Female , Humans , Immunoglobulins/blood , Immunoglobulins/immunology , Immunotherapy/adverse effects , Male , Middle Aged , Rhinitis, Allergic, Perennial/blood , Rhinitis, Allergic, Perennial/immunologyABSTRACT
Pelvic injuries are serious, with mortality higher than 40% if the patient is in shock upon arrival at the hospital. These injuries are generally secondary to traffic accidents with violent kinetics, which explains the frequency of the associated extrapelvic lesions. With the vital prognosis at stake, management of these patients is a true challenge from both the radiographic and emergency care points of view. The objectives of this review are to present the epidemiological and physiological issues involved in pelvic injuries and the place of imaging today, necessarily integrated within a multidisciplinary team associating emergency physicians, surgeons, radiologists, and biologists.
Subject(s)
Angiography , Blood Vessels/injuries , Fractures, Bone/complications , Pelvic Bones , Tomography, X-Ray Computed , Humans , Wounds and Injuries/therapyABSTRACT
Thirty-nine patients with rheumatoid arthritis were randomly assigned to receive 200 mg of etodolac or 500 mg of naproxen twice daily for 12 weeks. In both treatment groups, significant improvements in the number of tender and swollen joints, in the global evaluations of both patients and physician, in pain intensity scores, grip strength, and duration of morning stiffness, and in the erythrocyte sedimentation rate were noted. One etodolac-treated patient withdrew from treatment because of a rash; three etodolac-treated patients and two naproxen-treated patients reported minor upper gastrointestinal discomfort. No abnormal laboratory test results were found. It is concluded that both etodolac and naproxen are safe and effective in the treatment of rheumatoid arthritis.
