Allergens, germs and asthma

Objective To explore asthma pathogenesis using data from upper and lower airways. Data Source English-language papers on human asthma and nasal polyp subjects from 1990 onwards. Study Selection High-quality studies in established journals. Results The recognition of its inflammatory nature led to a quantum leap in the understanding and treatment of asthma, with lives saved by inhaled corticosteroids. Further work at genetic, molecular, histological and clinical levels has shown that asthma is polymorphic and rarely involves isolated Th2 bronchial inflammation. Viral infections may act as an initiating event in children and adults, showing synergy with atopy. Chronic staphylococcal colonization of the mucosa may act as a promoter, as in atopic dermatitis. These two observations may be linked, with viruses providing an entry for bacteria into the mucosal epithelium. Conclusions Most asthma begins in the nose and involves allergy and infection: both viral and bacterial. The combination of atopy and infection suggests new possibilities for therapy

Getting the noise out: filtering early GNP estimates

An analysis of the U.S. Department of Commerce's provisional estimates of GNP as estimates that are contaminated with measurement error; investigates a means of adjusting the numbers to remove the error and to produce more accurate predictions of the final GNP growth estimates.Gross national product

Are we saving enough?

Saving and investment ; Crowding out (Economics) ; Budget deficits

The nature of GNP revisions

An examination of the provisional estimates of real GNP growth, concluding that these early estimates are not efficient forecasts of the final GNP numbers.Gross national product

Estimating the underlying inflation rate

Inflation (Finance)

Insurance and managing bank risk-taking

Deposit insurance ; Bank supervision ; Federal Deposit Insurance Corporation ; Risk

Monetary policy and velocity

Velocity of money ; Demand for money ; Monetary policy - United States

Liability management, bank loans and deposit "market" disequilibrium

Bank loans ; Asset-liability management ; Monetary policy - United States ; Money supply ; Federal Reserve banks ; Credit control

Optimal management of allergic rhinitis

Allergic rhinitis (AR), the most common chronic disease in childhood is often ignored, misdiagnosed and/or mistreated. Undertreated AR impairs quality of life, exacerbates asthma and is a major factor in asthma development. It can involve the nose itself, as well as the organs connected with the nose manifesting a variety of symptoms. Evidence-based guidelines for AR therapy improve disease control. Recently, paediatric AR guidelines have been published by the European Academy of Allergy and Clinical Immunology and are available online, as are a patient care pathway for children with AR and asthma from the Royal College of Paediatrics and Child Health. Management involves diagnosis, followed by avoidance of relevant allergens, with additional pharmacotherapy needed for most sufferers. This ranges, according to severity, from saline sprays, through non-sedating antihistamines, oral or topical, with minimally bioavailable intranasal corticosteroids for moderate/severe disease, possibly plus additional antihistamine or antileukotriene. The concept of rhinitis control is emerging, but there is no universally accepted definition. Where pharmacotherapy fails, allergen-specific immunotherapy, which is uniquely able to alter long-term disease outcomes, should be considered. The subcutaneous form (subcutaneous immunotherapy) in children has been underused because of concerns regarding safety and acceptability of injections. Sublingual immunotherapy is both efficacious and safe for grass pollen allergy. Further studies on other allergens in children are needed. Patient, carer and practitioner education into AR and its treatment are a vital part of management

Short-run monetary control under alternative reserve accounting rules

Bank reserves ; Monetary policy - United States