Allergy and pulmonary impairment in Iowa veterinarians.

If small animal practice exposure, including the laboratory animal situations encountered in academic and other research pursuits, is more detrimental to veterinarians than large animal practice exposure for induction of allergic respiratory disease, then preventive measures such as increased ventilation, use of high efficiency particulate filters, and wearing of masks should be encouraged to reduce allergen exposures. Migration from large animal practice, likewise, should be discouraged. Failure to migrate to low occupational allergy risk situations early enough in a veterinary career can have severe and even fatal results. If the observed respiratory disease in veterinarians is in fact due to exposure, then unfortunately, it may in some cases be progressive and not just chronic. Data which could provide criteria for predicting occupational allergy and possible related respiratory disease outcome is scant at this time and career counselling is difficult. If the veterinary occupational animal allergy data should be proven correct such results can be used to help others.

The value of maintenance theophylline in steroid-dependent asthma.

We examined the value of maintenance theophylline at serum concentrations of 10 to 20 micrograms per milliliter in a placebo-controlled, randomized, double-blind trial of 33 children with steroid-dependent chronic asthma. Patients were free of all symptoms 63 +/- 6 per cent of the days (mean +/- S.E.M.) when taking theophylline as compared with 42 +/- 6 per cent when taking placebo (P < 0.01). Inhaled metaproterenol was required twice as often with placebo (P < 0.01), and additional daily corticosteroids were needed more than three times as often with placebo (P = 0.02). Daily peak flow measurements improved with theophylline (P < 0.01) as did monthly spirometric measurements and residual volume measured by plethysmography. Theophylline was associated with a 50 per cent increase in the number of patients able to complete an exercise test (P = 0.01) and with a smaller decrease in forced expiratory volume in one second among patients completing the exercise (P < 0.02). We conclude that maintenance bronchodilator therapy with theophylline can provide clinically important benefit for patients with chronic steroid-dependent asthma.