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Objectives: Multiple practice guidelines discourage indiscriminate use of broad panels of allergen-specific IgE (sIgE) tests due to increased risk of false positives and misinterpretation of results. We provide an analytical framework to identify specialty-specific differences in ordering patterns and effectiveness, which can be used to improve test utilization.Methods: Test results from a tertiary pediatric hospital were analyzed by ordering specialty to evaluate size of allergen workups. Positivity rates were analyzed to determine effectiveness in selecting tests with high positive pretest probabilities. Laboratory test menu components were also evaluated.Results: Our findings demonstrate 29% of sIgE tests are ordered as part of broad workups (>20 sIgE tests/date of service) contrary to the recommended testing approach. Detailed descriptions of ordering patterns and positivity rates are provided.Conclusions: This study provides a framework for using a cross-sectional analytical approach to assess test utilization patterns and evaluate components of laboratory testing menus. [ABSTRACT FROM AUTHOR]

ABSTRACT. Sixty-one patients with chronic sinusitis who were referred for an allergy evaluation were evaluated for immunologic competence including assessment of quantitative serum immunoglobulin levels, IgG subclass levels, and response to pneumococcal and Haemophilus influenzae vaccines. In addition to chronic sinus disease, recurrent otitis media and asthma exacerbation were common problems in this group. Five patients had an elevated age-adjusted IgE level and 22 patients had positive prick tests to one or more environmental inhalants; these findings suggest an allergic component in this subgroup. Twelve additional patients had highly reactive intradermal tests to common environmental allergens, which also may be clinically significant for underlying atopy. Eleven patients had low immunoglobulin levels, 6 had low immunologlobulin levels and vaccine hyporesponsiveness, and 17 had poor vaccine response only. Thus, 34 of 61 patients with refractory sinusitis had abnormal results on immune studies, with depressed IgG3 levels and poor response to pneumococcal antigen 7 being most common. In addition to allergy, immunologic incompetence may be an important etiologic factor in patients with chronic, refractory sinusitis. [ABSTRACT FROM AUTHOR]

The article presents a study that assessed the effectiveness of using evidence-based asthma interventions in the Community Healthcare for Asthma Management and Prevention of Symptoms (CHAMPS) study. Topics discussed include results which show that evidence-based asthma guidelines can be successfully employed with positive clinical outcomes and a review of the study.

Since first described in 1922, Stevens-Johnson syndrome has been associated frequently with pneumonia of many etiologies. This "mucosal respiratory syndrome," first reported by Stanyon and Warner in 1945, is associated with "early" pneumonia which resolves 2 to 3 weeks after onset of the rash. In our patient, pneumonia began 10 days after rash onset and was nearly resolved by day 20. The unique feature of this case was the onset of late pulmonary complications 25 days after the appearance of the exanthem, manifesting as acute noninfectious interstitial disease with superimposed airway obstruction. [ABSTRACT FROM AUTHOR]

The article discusses research on persistence of diminished lung function into adulthood among children with early lower respiratory illnesses (LRI), in which topics explored include greater risk for pneumonia among children with pre-existing small airway caliber.

The article presents a study that assessed whether a quality improvement (QI) intervention can safely reduce the hospitalization rate for children presenting with anaphylaxis. Topics discussed include results showing that using an evidence-based guideline (EBG) for anaphylaxis safely reduced unnecessary hospitalization for children with anaphylaxis and the value of employing a consensus recommendation as part of an EBG.

An abstract of the article "Effectiveness of Nebulized Beclomethasone in Preventing Viral Wheezing: An RCT" by A. Clavenna, M. Sequi, and M. Cartabia is presented.

An abstract of the article "Early Childhood Overweight and Asthma and Allergic Sensitization at 8 Years of Age," by J.Ö. Magnusson and colleagues, is presented.

The article presents a research study which determines the risk of young adults who were born prematurely to be prescribed with asthma medications. The study involves singleton infants born from 1973-1979 in Sweden. The result of the national cohort study indicates that extreme preterm birth, which is 23-27 weeks' gestation, are more prone to the risk of asthma than those who were born at term.

The article presents a study which examines the effects of prenatal smoking and low birth weight (LBW) on pediatric asthma. The study discovered an interaction of LBW and prenatal smoking on the risk of asthma. It also found that the risk of asthma was greater in the combination of LBW and prenatal smoking than in LBW or prenatal alone.

The article discusses research on the influence of hand versus machine dishwashing on the risk of allergy development among children aged 7 to 8, in which discussions include impact of early microbial exposure on allergy development and the effect of lifestyle factors on dishwashing methods.

Presents an abstract of the study 'Effective Once-Daily Administration of Budesonide Inhalation Suspension by Nebulizer With Facemasks or Mouthpieces for Persistent Asthma in Infants and Young Children,' by J.W. Georgitis, B. McWilliams, M. Cruz-Rivera, S. Fitzpatrick and J.A. Smith, from a 2001 issue of the 'Pediatric Asthma, Allergy and Immunology' journal.

An abstract of the article "Cotinine in Children Admitted for Asthma and Readmission" by J. A. Howrylak, A. J. Spanier, B. Huang is presented.

An abstract of the article "Trends in Preventive Asthma Medication Use Among Children and Adolescents, 1988-2008" by B.K. Kit and colleagues, is presented.

These parameters were developed by the Joint Task Force on Practice Parameters, representing the American Academy of Allergy, Asthma and Immunology; the American College of Allergy, Asthma and Immunology; and the Joint Council of Allergy, Asthma and Immunology. The American Academy of Allergy, Asthma and Immunology (AAAAI) and the American College of Allergy, Asthma and Immunology (ACAAI) have jointly accepted responsibility for establishing “The diagnosis and management of sinusitis: a practice parameter update.” This is a complete and comprehensive document at the current time. The medical environment is a changing environment, and not all recommendations will be appropriate for all patients. Because this document incorporated the efforts of many participants, no single individual, including those who served on the Joint Task force, is authorized to provide an official AAAAI or ACAAI interpretation of these practice parameters. Any request for information about or an interpretation of these practice parameters by the AAAAI or the ACAAI should be directed to the Executive Offices of the AAAAI, the ACAAI, and the Joint Council of Allergy, Asthma and Immunology. These parameters are not designed for use by pharmaceutical companies in drug promotion. [Copyright &y& Elsevier]

Presents an abstract of the study 'Pilot Study of a Screening Questionnaire for Asthma,' by M.M. Sockrider, S.R. Tortolero, L.K. Bartholomew, et al., from a 2001 issue of the 'Pediatric Asthma, Allergy and Immunology' journal.