Objective: The objective of this study was to evaluate montelukast 10 mg daily as treatment for allergic rhinitis in patients with symptomatic allergic rhinitis and active asthma during the allergy season. Methods: This was a multicenter study of 831 patients (ages 15 - 85 years) with seasonal allergen sensitivity, active symptoms of seasonal allergic rhinitis, and active asthma. Following a single-blind, placebo run-in period of three days to five days, patients were randomized to oral montelukast 10 mg (n = 415) or placebo (n = 416) daily during the two-week, double-blind, active-treatment period. Main outcome measures: The primary endpoint was daily rhinitis symptoms score, average of daytime nasal symptoms and nighttime symptoms, as self-rated by patients on a 0 - 3 scale on daily diaries. Results: Montelukast reduced the daily rhinitis symptoms score: difference between montelukast and placebo in mean change from baseline was -0.12 (95% CI -0.18, -0.06; p < 0.001). Similar improvements were seen in daytime nasal symptoms (-0.14 (-0.21, -0.07; p < 0.001)) and nighttime symptoms (-0.10 (-0.16, -0.04; p < 0.001)). Improvements (p < 0.05) were seen in daytime eye symptoms and in the secondary endpoints of global evaluations of AR by patient and by physician, and rhinoconjunctivitis quality of life. In exploratory analyses, improvement in rhinitis symptoms was numerically (though not statistically) larger in patients with greater levels of asthma at study start. Montelukast provided benefit in the global evaluations of asthma by patient and by physician: mean differences were -0.24 (-0.41, -0.06; p = 0.008) and -0.17 (-0.33, -0.01; p = 0.037). Similarly, as needed, β-agonist use (puffs/day) was reduced with montelukast (p < 0.005). Conclusion: Montelukast provides significant relief from symptoms of seasonal allergic rhinitis, while also conferring a benefit for asthma, in patients with both allergic rhinitis and asthma.
We have developed a series of laboratory tests to evaluate the efficiency of a heat and moisture exchanger filter (Pall™ BB25) in retaining latex particles in order to protect allergic patients during anaesthesia. Latex particles were nebulised with cornstarch as a support and collected for assay in a flask, with or without the filter integrated into the experimental circuit. With the Pall BB25 filter in the circuit, no natural latex proteins were detected by measurement of either total protein or antigenic latex proteins. The Pall BB25 filter may represent a useful means of preventing inhalation of latex particles during anaesthesia in susceptible patients.
Protein and energy malnutrition and iron-deficiency anaemia are widespread among preschool children in India.Because of a poor antibody response in severely malnourished children admitted to hospital it has been suggested that mass vaccination programmes would not be effective in populations where malnutrition is widespread.Earlier studies by this institute, however, have shown that most children in the community who suffer from mild or moderate protein and energy malnutrition respond well to conventional immunisation programmes.25 Our present findings show that antibody production is also unaffected by iron deficiency.Thus conventional immunisation programmes may be effective even in undernourished communities.
