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Part Time Allergy-Immunology Job in Rockland County New York with Community Medical and Dental Care, Inc.
Allergist Opportunity A large multi-specialty medical center in Rockland County, NY is expanding its Specialty Department and is seeking a part-time Allergist to work 6 hours/week. We offer a competitive
Permanent Allergy-Immunology Job in Missoula Montana with Providence Health
Missoula, Montana -- Providence Health & Services and a highly regarded 45-physician multispecialty group are partnering to bring an excellent Allergy and Immunology physician to serve the community.
Permanent Allergy-Immunology Job in 2nd Allergist Needed in Phoenix Arizona with Enterprise Medical Services
Allergist needed for private practice in Phoenix. The group currently consist of 1 fulltime and 1 part time Allergist there are also 3 Pulmonologists in the group. Will mainly see adults. This is

Current Opinion in Allergy and Clinical Immunology - Current Table Of Contents

Editorial introductions.
Page: viiDOI: 10.1097/ACI.0b013e328314e1d3
New insights into airway remodelling in asthma and its possible modulation.
Page: 367DOI: 10.1097/ACI.0b013e32830a7086Authors: Folli, Chiara *; Descalzi, Desideria *; Scordamaglia, Francesca; Riccio, Anna Maria; Gamalero, Cinzia; Canonica, Giorgio Walter
Challenges in asthma and allergy for the 21st Century.
Page: 376DOI: 10.1097/ACI.0b013e32830f1fa9Authors: Kabesch, Michael

International Archives of Allergy and Immunology : Last 20 articles

Insufficient Increment of CD4+CD25+ Regulatory T Cells after Stimulation in vitro with Allergen in Allergic Asthma
Thu, 09 Oct 2008 16:17:06 +0100
Int Arch Allergy Immunol 2009;148:199-210 (DOI:10.1159/000161580)
Therapeutic Effect of Kakkonto in a Mouse Model of Food Allergy with Gastrointestinal Symptoms
Thu, 09 Oct 2008 16:17:05 +0100
Int Arch Allergy Immunol 2009;148:175-185 (DOI:10.1159/000161578)
Asymptomatic Sensitization to Hymenoptera Venom Is Related to Total Immunoglobulin E Levels
Thu, 09 Oct 2008 16:17:02 +0100
Int Arch Allergy Immunol 2009;148:261-264 (DOI:10.1159/000161586)

Latest Issue of Annals of Allergy, Asthma and Immunology

On the Cover
Weber, Richard W.
The role of intradermal skin testing in inhalant allergy
Calabria, Christopher W.Hagan, Larry
Obstructive sleep apnea syndrome and asthma: the role of continuous positive airway pressure treatment
Alkhalil, MichelSchulman, Edward S.Getsy, Joanne

Surgical Endoscopy

Hand-assisted laparoscopic partial nephrectomy after 60 cases: comparison with open partial nephrectomy
Thu, 02 Oct 2008 09:28:49 -0000
Abstract Background  Partial nephrectomy is the surgical standard of care for favorably located, small renal tumors. As the incidence of renal cell carcinoma (RCC) and detection of small kidney masses have increased over the past 20 years, minimally invasive management of these lesions has become more common. We report our single-institution experience with hand-assisted laparoscopic partial nephrectomy (HALPN) compared with open partial nephrectomy (OPN). Methods  Relevant outcome and demographic information was collected prospectively for HALPNs (N = 60) and retrospectively for OPNs (N = 40). A p-value of < 0.05 denotes statistical significance. Results  Average tumor size (2.6 cm HALPN versus 2.6 cm OPN, p = 0.97) was similar. Mean operative times were shorter for HALPN compared with OPN (161 versus 191 min, p = 0.027). HALPN was also associated with less blood loss (mean 120 cc versus 353 cc, p = 0.0003). Warm ischemia time was shorter for HALPN (mean 27.0 min versus 33.0 min, p = 0.035), as was hospital stay (mean 4.9 days versus 6.9 days, p = 0.007). Although four HALPN renal tumors required intraoperative margin re-excision (based on immediate gross evaluation by a pathologist), the final positive margin rate was 0%. A 5% final positive margin rate was observed in the OPN group. There were two conversions from HALPN to HAL radical nephrectomy and no conversions to an open technique. The HALPN minor complication rate was 18.3% versus 32.5% for OPN (p = 0.10). Complications included delayed bleeding (1, 2.5% OPN), urine leak (2, 5% OPN; 2, 3.3% HALPN), hypoxia, and nausea or fever lasting >3 days. Tumor pathology was as follows: 80.7% and 80% RCC, 12.3% and 8% oncocytoma, and 7% and 12% angiomyolipoma, for HALPN and OPN, respectively in each case. Conclusions  HALPN is associated with diminished blood loss, operating time, warm ischemia time, positive margin rates, and length of stay compared with OPN. In our institution, HALPN is the standard approach for patients with small, surgically accessible renal tumors. Content Type Journal ArticleDOI 10.1007/s00464-008-0135-2Authors William B. DeVoe, Carolinas Medical Center Department of Urology 1000 Blythe Boulevard Charlotte NC 28203 USAKent W. Kercher, Carolinas Medical Center Department of General Surgery 1000 Blythe Boulevard Charlotte NC 28203 USAWilliam W. Hope, Carolinas Medical Center Department of General Surgery 1000 Blythe Boulevard Charlotte NC 28203 USAAmy E. Lincourt, Carolinas Medical Center Department of General Surgery 1000 Blythe Boulevard Charlotte NC 28203 USAH. James Norton, Carolinas Medical Center Department of General Surgery 1000 Blythe Boulevard Charlotte NC 28203 USAChris M. Teigland, Carolinas Medical Center Department of Urology 1000 Blythe Boulevard Charlotte NC 28203 USA Journal Surgical EndoscopyOnline ISSN 1432-2218Print ISSN 0930-2794
Esophageal dilation after laparoscopic adjustable gastric banding Milone et al. Surg Endosc 2008;22:1482–1486
Thu, 02 Oct 2008 09:28:49 -0000
Esophageal dilation after laparoscopic adjustable gastric banding Milone et al. Surg Endosc 2008;22:1482–1486 Content Type Journal ArticleCategory LetterDOI 10.1007/s00464-008-0163-yAuthors Alexander Klaus, Medical University Innsbruck, Center of Operative Medicine Department of Visceral, Transplant, and Thoracic Surgery Anichstrasse 35 6020 Innsbruck AustriaHelmut Weiss, Medical University Innsbruck, Center of Operative Medicine Department of Visceral, Transplant, and Thoracic Surgery Anichstrasse 35 6020 Innsbruck Austria Journal Surgical EndoscopyOnline ISSN 1432-2218Print ISSN 0930-2794
Hydroxy-propyl-methyl-cellulose is a safe and effective lifting agent for endoscopic mucosal resection of large colorectal polyps
Thu, 02 Oct 2008 09:28:49 -0000
Abstract Background  Endoscopic mucosal resection (EMR) is today the treatment of choice for flat and sessile colorectal lesion, the only concern being completeness of resection. One of the major issues is the choice of the infiltrating substance to enable a long-lasting cushion under the lesion. The aim of this study was to prospectively evaluate safety and efficacy of hydroxy-propyl-methyl-cellulose (HPMC) injection for this purpose. Patients  All flat and sessile lesions of the colon and rectum larger than 20 mm and considered suitable for EMR were included. In all cases 0.8% HPMC solution was injected through a 23G needle, in quantity according to the endoscopist’s indication. Primary endpoints of the study were: (1) ability to perform en bloc resection of the lesions by using this new injection means, (2) complete resection rate, and (3) early and late complication rate. Results  We resected 27 flat, sessile, or laterally spreading lesions up to 60 mm (28 mm average). Mean dose of HPMC injected was 10.2 ml (range 8–40 ml). Median procedure time was 32 min (range 15–105 min). En bloc resection was achieved in up to 21 cases (78%). Histologically detected complete tumour removal was achieved in 23 lesions, whereas lateral margins could not be properly evaluated in 4 cases due to coagulation artefacts. No perforation was observed. Procedural spurting bleeding was managed by epinephrine injection in one case and clip application in the remaining. Two case of local recurrence of adenomatous tissue were observed at 3 and 12 months, and treated by EMR. No complication related to the use of HPMC was observed. Conclusions  Injection of HPMC for EMR resulted safe and effective, allowing en bloc resection in the majority of cases with a limited number of complications. Continued progress in the field will include more outcomes research and techniques simplification. Content Type Journal ArticleDOI 10.1007/s00464-008-0133-4Authors A. Arezzo, Università di Torino Center for Minimally Invasive Surgery corso Achille Mario Dogliotti 14 10126 Turin ItalyN. Pagano, Istituto Clinico Humanitas Endoscopy Unit Rozzano MI ItalyF. Romeo, Istituto Clinico Humanitas Endoscopy Unit Rozzano MI ItalyG. Delconte, Istituto Clinico Humanitas Endoscopy Unit Rozzano MI ItalyC. Hervoso, Istituto Clinico Humanitas Endoscopy Unit Rozzano MI ItalyM. Morino, Università di Torino Center for Minimally Invasive Surgery corso Achille Mario Dogliotti 14 10126 Turin ItalyA. Repici, Istituto Clinico Humanitas Endoscopy Unit Rozzano MI Italy Journal Surgical EndoscopyOnline ISSN 1432-2218Print ISSN 0930-2794
Disturbances in the circadian pattern of activity and sleep after laparoscopic versus open abdominal surgery
Thu, 02 Oct 2008 09:28:49 -0000
Abstract Background  Studies on the circadian variation in bodily functions and sleep are important for understanding the pathophysiological processes in the postoperative period. We aimed to investigate changes in the circadian variation in activity after minimally invasive surgery (laparoscopic cholecystectomy, LC) and major abdominal surgery (MAS) and if these changes correlated with postoperative subjective recovery measures. Methods  We examined 76 and 44 patients undergoing LC and MAS, respectively, for 4 days before and after surgery. Subjective recovery parameters were assessed by visual analogue scale (sleep quality, general well-being and pain) and fatigue was measured by a ten-point fatigue scale. The activity levels of the patients were monitored by actigraphy (a wrist-worn device measuring patient activity). Measures of circadian activity level [interday stability (IS), intraday variability (IV) and the amplitude (AMP)] were derived after nonparametric analysis of activity data. Results  IS was significantly reduced both after MAS (0.72 before surgery and 0.58 after surgery, p < 0.0001) and after LC (0.76 before surgery and 0.66 after surgery, p < 0.0001). The IS dropped significantly more following MAS surgery compared with following LC surgery (p < 0.001). The fragmentation of the rhythm IV increased and the amplitude dropped significantly after both LC and MAS surgery. Subjective recovery parameters were worse after MAS when compared with LC, and correlated significantly to the circadian activity parameters (IS, IV and AMP). Conclusion  Severely disturbed circadian activity parameters was found after both LC and MAS with worse changes after MAS. Measures of circadian activity pattern analyses correlated significantly with postoperative subjective recovery parameters. Content Type Journal ArticleDOI 10.1007/s00464-008-0112-9Authors Ismail Gögenur, University of Copenhagen, Herlev Hospital Department of Surgical Gastroenterology D Herlev Ringvej 75 2730 Herlev DenmarkThue Bisgaard, University of Copenhagen, Glostrup Hospital Department of Surgical Gastroenterology D Ndr. Ringvej 2600 Glostrup DenmarkStefan Burgdorf, University of Copenhagen, Herlev Hospital Department of Surgical Gastroenterology D Herlev Ringvej 75 2730 Herlev DenmarkEus van Someren, Netherlands Institute for Neuroscience, an institute of the Royal Netherlands Academy of Arts and Sciences, and VU University Medical Center Department of Sleep and Cognition p/a Meibergdreef 47 1107 BA Amsterdam The NetherlandsJacob Rosenberg, University of Copenhagen, Herlev Hospital Department of Surgical Gastroenterology D Herlev Ringvej 75 2730 Herlev Denmark Journal Surgical EndoscopyOnline ISSN 1432-2218Print ISSN 0930-2794
Minimally invasive congenital diaphragmatic hernia repair: a 7-year review of one institution’s experience
Thu, 02 Oct 2008 09:28:48 -0000
Abstract Background  Minimally invasive surgery (MIS) has been described for the repair of congenital diaphragmatic hernias (CDH) in neonates, infants, and children. This report evaluates patient selection, operative technique, and clinical outcomes for MIS repair of CDHs from a single center’s experience. Methods  All cases of CDH at a tertiary care pediatric hospital with an initial attempt at MIS repair from January 2001 to December 2007 were reviewed. Results  A total of 22 children underwent an initial attempt at MIS repair of their CDH (5 Morgagni and 17 Bochdalek hernias). The children ranged in age from 1 day to 6 years (mean, 13.9 Â± 23 months) and weighed 2.2 to 21 kg (mean, 7.4 Â± 5.50 kg) at the time of the operation. All five Morgagni hernias were managed successfully with laparoscopic primary repair. Six of the Bochdalek hernias were found in infants and children (age range, 6–71 months). All these were managed successfully with primary repair by an MIS approach (2 by laparoscopy and 4 by thoracoscopy). The remaining 11 Bochdalek hernias were found in neonates (age range, 1 day to 8 weeks). Four of the Bochdalek hernias were right-sided. Nine of the Bochdalek hernias in neonates were repaired thoracoscopically. One neonate required conversion to laparotomy, and another underwent conversion to thoracotomy. Four of the neonates with Bochdalek hernias required a prosthetic patch. Two of the neonates also had significant associated congenital cardiac defects. Overall, there were two recurrences involving one 3-day-old who underwent a primary thoracoscopic repair and another 3-day-old who underwent a thoracoscopic patch repair. The follow-up period ranged from 5 months to 5 years. Conclusions  Morgagni hernias can be managed successfully by laparoscopy, whereas thoracoscopy is preferred for neonatal Bochdalek hernias. Either approach can be successful for infants and children with Bochdalek hernias. Additionally, patients with congenital cardiac defects and those requiring prosthetic patches can undergo a MIS CDH repair with a successful outcome. Content Type Journal ArticleDOI 10.1007/s00464-008-0143-2Authors Sohail R. Shah, Children’s Hospital of Pittsburgh, University of Pittsburgh Medical Center Division of Pediatric General and Thoracic Surgery 3705 Fifth Avenue, 4A-485 Pittsburgh PA 15213 USAJessica Wishnew, Children’s Hospital of Pittsburgh, University of Pittsburgh Medical Center Division of Pediatric General and Thoracic Surgery 3705 Fifth Avenue, 4A-485 Pittsburgh PA 15213 USAKatherine Barsness, Children’s Hospital of Pittsburgh, University of Pittsburgh Medical Center Division of Pediatric General and Thoracic Surgery 3705 Fifth Avenue, 4A-485 Pittsburgh PA 15213 USABarbara A. Gaines, Children’s Hospital of Pittsburgh, University of Pittsburgh Medical Center Division of Pediatric General and Thoracic Surgery 3705 Fifth Avenue, 4A-485 Pittsburgh PA 15213 USADouglas A. Potoka, Children’s Hospital of Pittsburgh, University of Pittsburgh Medical Center Division of Pediatric General and Thoracic Surgery 3705 Fifth Avenue, 4A-485 Pittsburgh PA 15213 USAGeorge K. Gittes, Children’s Hospital of Pittsburgh, University of Pittsburgh Medical Center Division of Pediatric General and Thoracic Surgery 3705 Fifth Avenue, 4A-485 Pittsburgh PA 15213 USATimothy D. Kane, Children’s Hospital of Pittsburgh, University of Pittsburgh Medical Center Division of Pediatric General and Thoracic Surgery 3705 Fifth Avenue, 4A-485 Pittsburgh PA 15213 USA Journal Surgical EndoscopyOnline ISSN 1432-2218Print ISSN 0930-2794
Hormonal evaluation following laparoscopic treatment of type 2 diabetes mellitus patients with BMI 20–34
Thu, 02 Oct 2008 09:28:48 -0000
Abstract Background  A group of patients with type 2 diabetes mellitus (T2DM) and body mass index (BMI) 20–34 kg/m2 were submitted to laparoscopic interposition of a segment of ileum into the proximal jejunum or into the proximal duodenum associated to a sleeve gastrectomy. The objective of this study is to evaluate the hormonal changes in the pre- and postoperative period. Materials and methods  Hormonal evaluation was done in 58 patients operated between April 2005 and July 2006. Mean age was 51.4 years (40–66 years). Mean BMI was 28.2 (20–34.8) kg/m2. All patients had had the diagnosis of T2DM for at least 3 years. Mean duration of T2DM was 9.6 years (3–22 years). Two techniques were performed, consisting of different combinations of ileal interposition (II) associated to a sleeve gastrectomy (SG). The following hormones were assayed in the pre- and postoperative period (mean 16 months) at the baseline and following specific food stimulation (30, 60, 120 min): glucogen-like protein 1 (GLP-1), glucose-dependent insulinotropic peptide (GIP), insulin, glucagon, C-peptide, amylin, colecystokinin (CCK), pancreatic polypeptide (PPP), somatostatin, peptide YY (PYY), ghrelin, adiponectin, resistin, leptin, and interleukin-6 (IL-6). Results  Thirty patients had II associated to sleeve gastrectomy (II-SG) and 28 had II with diverted sleeve gastrectomy (II-DSG). GLP1 exhibited an important rise following the two operations, especially after II-DSG (p < 0.001). GIP also exhibited an important rise, with both II-SG and II-DSG being equally effective (p < 0.001). Insulin and amylin showed a significant rise at 30 min. Glucagon decreased slightly. CCK measurements were very low after II-DSG. PPP was also slightly altered by the II-DSG. PYY showed an important increase with both operations (p < 0.001). Ghrelin showed a significant decrease following the two operations (p < 0.001).Somatostatin and IL-6 were not affected (p = 0.632). Both leptin and resistin blood levels decreased. Adiponectin showed a slight increase. Mean postoperative follow-up was 19.2 months. Both II-SG and II-DSG were effective in achieving adequate glycemic control (91.2%). Conclusions  There was a significant hormonal change following laparoscopic ileal interposition. These alterations may explain the promising good results associated to these operations for the treatment of T2DM in the nonmorbidly obese population. Content Type Journal ArticleDOI 10.1007/s00464-008-0168-6Authors Aureo Ludovico DePaula, Hospital de Especialidades Gastrointestinal Surgery Goiania BrazilA. L. V. Macedo, Albert Einstein Hospital Sao Paulo BrazilV. Schraibman, Albert Einstein Hospital Sao Paulo BrazilB. R. Mota, Hospital de Especialidades Department of Surgery Goiania BrazilS. Vencio, Hospital de Especialidades Department of Surgery Goiania Brazil Journal Surgical EndoscopyOnline ISSN 1432-2218Print ISSN 0930-2794

PubMed: 1088-5412

Loratadine provides early symptom control in seasonal allergic rhinitis.
Kaiser HB, Gopalan G, Chung W Related Articles Loratadine provides early symptom control in seasonal allergic rhinitis. Allergy Asthma Proc. 2008 Oct 1; Authors: Kaiser HB, Gopalan G, Chung W Allergic rhinitis (AR) affects about 500 million people worldwide, and prevalence is increasing. Second-generation nonsedating antihistamines are first-line treatments for seasonal AR (SAR). This study was performed to evaluate early SAR symptom relief with second-generation antihistamines through a retrospective analysis of previously published data. In this study, 835 subjects aged 12-60 years with a more than or equal to 2-year history of SAR were randomized to receive loratadine, 10 mg, once daily; fexofenadine, 60mg, twice daily; or placebo for 7 days. Each subject recorded the severity of five symptoms of SAR on a scale of 0-3. This primary post hoc efficacy analysis was the mean change from baseline in daily average A.M./P.M. reflective and instantaneous total symptom score (TSS) on days 2 and 3. Significantly greater mean reductions from baseline were shown with loratadine compared with fexofenadine in average A.M./P.M. reflective TSS on days 2 (-3.51versus -2.84, respectively; p less than 0.002) and 3 (-3.80 versus -3.19, respectively; p = 0.007) and in average A.M./P.M. instantaneous TSS on day 3(-3.68 versus -3.15, respectively; p = 0.022). Similar results were noted in average A.M./P.M. reflective and instantaneous total nasal symptomscores and for 10 of 20 individual symptom time points (p less than 0.05). Loratadine was significantly more effective than placebo for all time points (p less than 0.001). Early, sustained symptom relief was seen with loratadine, suggesting that it may be more effective for treating SAR symptoms. PMID: 18831859 [PubMed - as supplied by publisher]

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