scholarly journals CSACI position statement: Newer generation H1-antihistamines are safer than first-generation H1-antihistamines and should be the first-line antihistamines for the treatment of allergic rhinitis and urticaria

2019 ◽  
Vol 15 (1) ◽  
Author(s):  
Michael N. Fein ◽  
David A. Fischer ◽  
Andrew W. O’Keefe ◽  
Gord L. Sussman
Keyword(s):  
Allergic Rhinitis ◽  
Chronic Urticaria ◽  
First Generation ◽  
Position Statement ◽  
Poor Sleep ◽  
Third Generation ◽  
First Line ◽  
H1 Antihistamines ◽  
History Of ◽  
History Of Use

Abstract Oral H1-antihistamines (AHs) are the most commonly used therapy to treat allergic rhinitis and chronic urticaria. Older, first-generation AHs (e.g. diphenhydramine, hydroxyzine) have significant and common side effects including sedation, impairment with decreased cognitive function, poor sleep quality, dry mouth, dizziness, and orthostatic hypotension. These drugs have also been found to result in death from accidents, intentional or unintentional overdoses, and sudden cardiac death. The unfavourable risk–benefit profile of first-generation AHs led to the development of newer, less-sedating second- and third-generation AHs, which first became available in Canada in the 1980s. High-quality trials have proven that newer generation AHs are superior in safety compared to older first-generation AHs. On average, they have improved potency and efficacy. Second- and third-generation AHs are the recommended first-line treatment for mild allergic rhinitis and acute and chronic urticaria. Despite this evidence, older first-generation AHs continue to be over-utilized because of their over-the-counter (OTC) status and long history of use. The Canadian Society of Allergy Clinical Immunology (CSACI) recommends that newer generation AHs should be preferred over first-generation AHs for the treatment of allergic rhino-conjunctivitis and urticaria. To promote this recommendation, education of health professionals and the public is necessary. Further, given the dangers of older first-generation AHs, we believe they should be used only as a last resort with eventual consideration given to having them only available behind the counter in pharmacies.

scholarly journals Genotyping-by-Sequencing Identifies Historical Breeding Stages of the Recently Domesticated American Cranberry

2020 ◽  
Vol 11 ◽  
Author(s):  
Luis Diaz-Garcia ◽  
Giovanny Covarrubias-Pazaran ◽  
Jennifer Johnson-Cicalese ◽  
Nicholi Vorsa ◽  
Juan Zalapa
Keyword(s):  
Phenotypic Variation ◽  
First Generation ◽  
Fruit Weight ◽  
Fruit Rot ◽  
Anthocyanin Content ◽  
Third Generation ◽  
Wild Germplasm ◽  
Crop Species ◽  
Genome Wide ◽  
History Of

The cranberry (Vaccinium macrocarpon Ait.) is a North American fruit crop domesticated less than 200 years ago. The USDA began the first cranberry breeding program in response to false-blossom disease in 1929, but after the first generation of cultivars were released in the 1950s, the program was discontinued. Decades later, renewed efforts for breeding cranberry cultivars at Rutgers University and the University of Wisconsin yielded the first modern cultivars in the 2000’s. Phenotypic data suggests that current cultivars have changed significantly in terms of fruiting habits compared to original selections from endemic populations. However, due to the few breeding and selection cycles and short domestication period of the crop, it is unclear how much cultivated germplasm differs genetically from wild selections. Moreover, the extent to which selection for agricultural superior traits has shaped the genetic and phenotypic variation of cranberry remains mostly obscure. Here, a historical collection composed of 362 accessions, spanning wild germplasm, first-, second-, and third-generation selection cycles was studied to provide a window into the breeding and domestication history of cranberry. Genome-wide sequence variation of more than 20,000 loci showed directional selection across the stages of cranberry domestication and breeding. Diversity analysis and population structure revealed a partially defined progressive bottleneck when transitioning from early domestication stages to current cranberry forms. Additionally, breeding cycles correlated with phenotypic variation for yield-related traits and anthocyanin accumulation, but not for other fruit metabolites. Particularly, average fruit weight, yield, and anthocyanin content, which were common target traits during early selection attempts, increased dramatically in second- and third-generation cycle cultivars, whereas other fruit quality traits such as Brix and acids showed comparable variation among all breeding stages. Genome-wide association mapping in this diversity panel allowed us to identify marker-trait associations for average fruit weight and fruit rot, which are two traits of great agronomic relevance today and could be further exploited to accelerate cranberry genetic improvement. This study constitutes the first genome-wide analysis of cranberry genetic diversity, which explored how the recurrent use of wild germplasm and first-generation selections into cultivar development have shaped the evolutionary history of this crop species.

scholarly journals Allergic Rhinitis during Pregnancy -an Update of Management

2017 ◽  
Vol 28 (2) ◽  
pp. 83-88
Author(s):  
Neyamat Ullah Khan ◽  
Kazi Shahnaz Begum
Keyword(s):  
Allergic Rhinitis ◽  
Medical Treatment ◽  
First Generation ◽  
Inhaled Corticosteroids ◽  
Enzyme Linked Immunosorbent Assay ◽  
First Line ◽  
Correct Treatment ◽  
Nasal Symptoms ◽  
Leukotriene Receptor

The concurrence of allergic rhinitis and pregnancy is common. The diagnosis of allergic rhinitis is easily and reliably made, by eliciting the characteristic symptoms on history. This diagnosis is easily confirmed by using the radioallergosorbent test (RAST) or enzyme-linked immunosorbent assay(ELISA) tests. Nasal symptoms, particularly obstruction, are often aggravated in pregnancy, through several possible mechanisms. The disease is often pre-existing and sometimes coincidental during pregnancy, and can worsen, improve, or stay the same during pregnancy. Besides ameliorating the detrimental effects of AR on the patient's quality of life, correct treatment is important for controlling concomitant asthma. If possible, it is important to highlight the risks of not taking such medications at a pre-conception visit. Although most medications for AR readily cross the placenta, there are several choices of treatment for controlling the symptoms during pregnancy. The choices may be varied depending on the disease course and symptoms, and inhaled corticosteroids are considered to be the first-line medical treatment. In addition, either a first-generation antihistamine, such as chlorpheniramine, or a secondgeneration antihistamine, such as cetirizine or loratadine, can be prescribed as the second-line medical treatment. As an alternative, intranasal cromolyn can be prescribed safely. Some of the leukotriene receptor antagonists and nasal decongestant sprays can only be prescribed when other methods are no longer valid and strict benefits can be expected. It is considered safe to continue immunotherapy during pregnancy.Medicine Today 2016 Vol.28(2): 83-88

Primary mediastinal large B-cell lymphoma: Treatment outcomes in 43 patients

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 17556-17556
Author(s):  
C. L. Mello ◽  
O. Feher ◽  
V. C. Lima ◽  
C. Valadares ◽  
F. A. Soares ◽  
...  
Keyword(s):  
B Cell ◽  
First Generation ◽  
Response Rate ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Third Generation ◽  
First Line ◽  
Large B Cell Lymphoma ◽  
Large B Cell

17556 Objectives: Primary mediastinal B-cell Lymphoma (PMBL) is recognized as a separate entity in the WHO classification. Treatment for PMBL is based on a combination of conventional dose chemotherapy, high dose chemotherapy and radiation therapy. The best strategy is still undefined. We conducted a retrospective analysis of patients with PBML to identify clinical prognostic factors. Methods: A retrospective analysis of 43 patients treated at Hospital do Cancer AC Camargo, Sao Paulo, Brazil, between 1989 and 2004. All patients had previous diagnosis of diffuse large B-cell lymphoma, with positive CD20 on neoplastic cells. A predominant anterior mediastinal lesion should be present. Induction chemotherapy regimens were grouped in first generation (CHOP/CHOP-like), third generation (PromaceCytabon/MACOP) and other (pediatric regimens, COP). Results: Age ranged from 16 to 82 years-old, 30 females and 13 male. Age < 35 yo was associated with a better prognosis (5 years OS - 56% × 34%, p = 0.048). Among clinical variables, female gender, stage IA-IIB, IPI 0–1, normal LDH, absence of mediastinal bulky disease were associated with better prognosis, although not statistically significant. Response rate to first generation regimens was: 37% CR (11/29), 24% PR (7/29) and 24% PD (7/29). Four patients were treated with Third generation regimens with 2 CR and 2 PR. 20 out of 25 patients with PR or CR to first line chemotherapy received mediastinal radiation therapy. More than 65% of patients had a follow up of 5 years or more. With a median follow up of 22.3 months, projected 5 year OS was 47% and for the responders the median PFS was 8,4 months. No difference in OS and PFS was observed among the three chemotherapy groups. Conclusion: Our analysis showed that response rate to first line regimens was around 60% and 25% of patients were primarily refractory to CHOP regimen. Age younger than 35 years old was associated with a better prognosis. 5 years overall survival was 45% and is in accordance with the literature. Although recent studies have demonstrated biological similarities between PMBL and Hodgkin’s Lymphoma, the prognosis of PMBL is less favorable than HL. Better understanding of the disease will help in developing more appropriate therapeutic strategies for PMBL. No significant financial relationships to disclose.

scholarly journals On the centenary of the insulin discovery

2021 ◽  
Vol 24 (1) ◽  
pp. 11-16
Author(s):  
I. I. Dedov ◽  
M. V. Shestakova
Keyword(s):  
First Generation ◽  
Insulin Analogues ◽  
Animal Origin ◽  
Third Generation ◽  
The Third ◽  
Endogenous Insulin ◽  
Patients With Diabetes ◽  
History Of ◽  
Action Profile ◽  
Natural Insulin

The discovery of insulin and the beginning of its use in 1921–1922 made a revolution in endocrinology and in medicine in general. This significant event gave millions of patients with diabetes not only the opportunity to live, but also the hope that their life with this disease would be full.The article examines the history of insulin discovery, as well as the evolution of several generations of insulin preparations and the advantages of each of the generations that have radically changed not only life expectancy, but also its quality.The first generation — insulins of animal origin and the solution of the first tasks of their sufficient production and purification. The next generation is human insulins, the purification of which was also a problem. The third generation is insulin analogues, the action of which became closer to the action profile of natural insulin. And the last generation — insulin analogues, most closely mimicking the action of endogenous insulin.Along with the development of insulin preparations, the article traces the evolution of the devices of its administration.

Modern anti-IgE therapies in children with chronic spontaneous urticaria: clinical cases

2021 ◽  
Vol 17 (4) ◽  
pp. 85-89
Author(s):  
Inna A. Larkova ◽  
Vera A. Revyakina
Keyword(s):  
Chronic Urticaria ◽  
Clinical Manifestations ◽  
Chronic Spontaneous Urticaria ◽  
First Line ◽  
Therapy Efficacy ◽  
Number Of Patients ◽  
H1 Antihistamines ◽  
Urticaria Treatment ◽  
Clinical Cases

The diagnostics and treatment of chronic urticaria is still a pressing problem for specialists of different profiles. Despite the fact that the first line drugs for urticaria treatment are non-sedating H1- antihistamines, there are a number of patients who do not respond to these medications even in their increased doses. This article presents clinical cases of anti-IgE-therapy efficacy in children suffering from urticaria and angioedema. CONCLUSION: The clinical cases demonstrate current possibilities of successful and safe anti-IgE-therapy of various clinical manifestations of chronic spontaneous urticaria and angioedema in children.

scholarly journals Towards accountability: A point of orientation for post-modern applied linguistics in the third millennium

Literator ◽  
2003 ◽  
Vol 24 (1) ◽  
pp. 83-102 ◽  
Author(s):  
A. Weideman
Keyword(s):  
First Generation ◽  
Applied Linguistics ◽  
Third Generation ◽  
Modern Approach ◽  
The Third ◽  
Sixth Generation ◽  
Post Modernism ◽  
Third Millennium ◽  
History Of

In this article three difficulties in dealing with post-modern applied linguistics are identified, and three reasons are given for taking the trouble to define this emerging tradition of doing applied linguistics. In the context of earlier analyses of the history of applied linguistics, post-modernism is identified as a sixth generation of applied linguistic work. There are overlapping and unique features in each of these traditions. The discontinuity of a post-modern approach from first generation applied linguistics is noted, as are the numerous continuities with second, fourth, fifth and especially third generation work. These continuities go a long way towards characterising post-modern applied linguistics, yet are not sufficient to define it exhaustively. The biggest difficulty with such a characterisation appears to be a divergence within a post-modern approach. What holds this latest tradition together is the seriousness with which it deals with accountability, and in that lies, at present, its defining characteristic. Wherever one locates one’s work, in earlier or in current traditions within applied linguistics, the premiss must always be to do these labours with integrity. Perhaps the latest trend towards an accountable applied linguistics has contributed more than any previous tradition to make us sensitive to this responsibility.

Third generation of the Web: libraries, librarians and Web 3.0

2015 ◽  
Vol 32 (4) ◽  
pp. 6-8 ◽  
Author(s):  
Waqar Ahmed
Keyword(s):  
First Generation ◽  
Web Applications ◽  
Third Generation ◽  
Current Form ◽  
Content Type ◽  
Web 3.0 ◽  
Advantages And Disadvantages ◽  
History Of ◽  
New Applications ◽  
The Web

Purpose – This paper aims to explain the historic development of Web from the first generation to the second generation and now to the upcoming, third generation of the Web. It describes the importance of Web 3.0 and its other sub-functions to the librarians and their importance in the libraries. The basic purpose of this study is to give librarians an insight about the upcoming technologies. Design/methodology/approach – This paper is designed as an explanatory study using historic and literature search techniques, and is presented in an essay format containing the brief history of web, its current and coming technologies and its advantages and disadvantages. Findings – The finding and results indicate how the Web was designed into its current form. Findings show that at the next level, the interactions will become three ways. The robotics, artificial intelligence and semantic systems will help human in solving their queries. Research limitations/implications – The Web is spreading while new applications and technologies are inventing every day. This research may not be containing all the Web 3.0 applications, advantages and drawbacks. Practical implications – This paper includes the details of the Web applications that are used in Web 3.0. This article not only gives an insight to the Web applications related to the libraries but also indicates the advantages and drawbacks. Originality/value – This paper points out some very important applications to be used in the libraries in Web 3.0 environment, while a consideration of advantages and drawbacks makes this research more valuable for the librarians.

Transforming Our Models of Learning and Development: Web-Based Instruction as Enabler of Third-Generation Instruction

2008 ◽  
Vol 1 (4) ◽  
pp. 454-467 ◽  
Author(s):  
Kurt Kraiger
Keyword(s):  
First Generation ◽  
Generation Model ◽  
Third Generation ◽  
Learning And Development ◽  
Web Based ◽  
Social Negotiation ◽  
The Social ◽  
Web Based Instruction ◽  
History Of ◽  
Based Instruction

In this paper, I suggest that our methods for how to train are based historically on what we understand learning to be. I briefly trace the history of instructional design models, which embody both first-generation objectivist and second-generation cognitive constructivist views of learning. I then suggest we are on the cusp of a third-generation instructional model, one that places greater emphasis on the learner forming understanding largely through a process of social negotiation, either in training or on the job. I argue that Web-based instruction offers a technology ideally suited to the social constructivist approach at the core of this third-generation model. I discuss the importance of interaction in learning and suggest why Web-based networked learning may result in more, not less, interaction during training. Finally, I discuss other applications of third-generation learning such as peer mentoring and professional forums.

Primary Mediastinal Large B-Cell Lymphoma: Treatment Outcomes in 43 Patients.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 4754-4754
Author(s):  
Celso L. Mello ◽  
Vladimir C. Lima ◽  
Christiane Valadares ◽  
Soares A. Fernando ◽  
Carvalho A. Lopes ◽  
...  
Keyword(s):  
B Cell ◽  
First Generation ◽  
Response Rate ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Third Generation ◽  
First Line ◽  
Large B Cell Lymphoma ◽  
Large B Cell

Abstract Objectives: Primary mediastinal B-cell Lymphoma (PMBL) is recognized as a separate entity in the WHO classification. Treatment for PMBL is based on a combination of conventional dose chemotherapy, high dose chemotherapy and radiation therapy. The best strategy is still undefined. We conducted a retrospective analysis of patients with PBML to identify clinical prognostic factors. Materials and Methods: Between 1989 and 2004, 43 consecutives patients treated at Hospital do Cancer AC Camargo, São Paulo, Brazil were identified and clinical and histological data were reviewed. All patients had previous diagnosis of diffuse large B-cell lymphoma, with positive CD20 on neoplastic cells. For patients with extrathoracic involvement at presentation a predominant anterior mediastinal lesion should be present. Induction chemotherapy regimens were grouped in first generation (CHOP or CHOP-like), third generation (PromaceCytabon or MACOP) and other (pediatric regimens, COP). Results: Age ranged from 16 to 82 years-old, 30 females and 13 male. Patients aged < 35 yo had better outcome compared with those older than 35 yo (5 years OS - 56% x 34%, p=0.048). Among clinical variables, female gender, stage IA-IIB, IPI 0-1, normal LDH, absence of mediastinal bulky disease were associated with better prognosis, although not statistically significant. Response rate to first generation regimens was: 37% CR (11/29), 24% PR (7/29) and 24% PD (7/29). Four patients were treated with third generation regimens with 2 CR and 2 PR. 20 out of 25 patients with PR or CR to first line chemotherapy received mediastinal radiation therapy. More than 65% of patients had a minimum time of follow up 5 years. With a median follow up of 22.3 months, projected 5 year OS was 47% and for the responders the median PFS was 8,4 months. No difference in OS and PFS was observed among the three chemotherapy groups. Conclusion: Our analysis showed that response rate to first line regimens was around 60% and 25% of patients were primarily refractory to CHOP regimen. Age younger than 35 years old was associated with a better prognosis. 5 years overall survival was 45 % and is in accordance with the literature. Although recent studies have demonstrated biological similarities between PMBL and Hodgkin’s Lymphoma, the prognosis of PMBL is less favorable than HL. Better understanding of the disease will help in developing more appropriate therapeutic strategies for PMBL.

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