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Available from: John J Oppenheimer, Mar 14, 2014
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    ABSTRACT: For most asthma patients, long-term symptom control requires the frequent monitoring and aggressive medication management that family physicians are well positioned to provide.
    The Journal of family practice 04/2013; 62(4):184-90. · 0.89 Impact Factor
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    ABSTRACT: To review and interpret recent literature related to the role of environmental control in prevention and treatment of asthma. Environmental control has a clearly established role in the management of asthma, but its role as a primary prevention tool is not supported by recent clinical trials. Although some of the interventions tested in these trials reduced the risk of asthma, the interventions often included dietary modification and those trials intervening only on environmental exposures were largely negative. Environmental interventions that target multiple asthma triggers, such as a laminar airflow device and relocation to high altitude, continue to demonstrate efficacy in asthma. Several studies highlight the efficacy of portable HEPA purifiers in reduction of indoor particulate matter and improving asthma outcomes. Several recently published practice parameters provide evidence-based recommendations for environmental control practices targeting furry pet, rodent, and cockroach allergens. Emerging work highlights the potential impact of spatial-temporal aspects of exposure and the shape of the dose-response relationships on the indoor allergen exposure-asthma relationship. Environmental interventions likely have no effect on the risk of developing atopic disease, but multifaceted interventions are generally of benefit in the management of asthma, particularly in children.
    Current Opinion in Allergy and Clinical Immunology 08/2013; 13(4):417-425. DOI:10.1097/ACI.0b013e328362b776 · 3.57 Impact Factor
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    ABSTRACT: Although rodent allergy has long been recognized as an occupational disease, it has only been in the past decade that it has been recognized as a community-based disease that affects children. Most homes in the US have detectable mouse allergen, but the concentrations in inner-city homes are orders of magnitude higher than those found in suburban homes. Home mouse allergen exposure has been linked to sensitization to mouse, and children with asthma who are both sensitized and exposed to high mouse allergen concentrations at home are at greater risk for symptoms, exacerbations and reduced lung function. Rat allergen is found primarily in inner-city homes and has also been linked to asthma morbidity among sensitized children. The objective of this review is to summarize the scientific literature on rodents and their allergens, the effects of exposure to these allergens on allergic respiratory disease, and to make recommendations, based on this evidence base, for the evaluation and management of mouse allergy in the pediatric population.
    Current Allergy and Asthma Reports 08/2013; 13(6). DOI:10.1007/s11882-013-0378-4 · 2.77 Impact Factor
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