Papers by Stephen McGeady
2014 AAAAI Annual Meeting, Mar 2, 2014
The Journal of Allergy and Clinical Immunology, 1996
Pediatric Pulmonology, 1986
... Original Article. The use of oxygen for children in their homes. Dr. Edward M. Sewell MD,; Do... more ... Original Article. The use of oxygen for children in their homes. Dr. Edward M. Sewell MD,; Douglas Holsclaw MD,; Daniel Schidlow MD,; Steven McGeady MD,; Barbara Berger RN, MSN,; Susan Kolb RN, MSN. Article first published online: 20 OCT 2005. ...
Journal of Allergy and Clinical Immunology, 2004
Abstract Rationale Much of the morbidity and mortality of asthma in children and adolescents has ... more Abstract Rationale Much of the morbidity and mortality of asthma in children and adolescents has been attributed to lack of adherence to prescribed therapy. A means of improving adherence would provide an important adjunct to therapy. Methods Seven asthmatic patients ages 10-16 yrs (median 12.5 yrs) with non-adherence to fluticasone MDI by history, were enrolled into a project to identify non-adherence. Each was shown correct inhalation technique that included both shaking the MDI and one inhalation of fluticasone b.i.d.. Each device contained an electronic monitoring device (MDILog) which recorded date and time of both shaking and inhalation. Subjects were told that inhalation technique was being monitored. Results Subjects were monitored for at least 15 days and adherence data was downloaded. Adherence when defined as total percentage of study days subjects inhaled or shook the MDI for both doses was 64% for inhalation (range 0-80%) and 33% for shaking (range 0-72%). When adherence was defined as the number of inhalations or shaking the MDI actually performed as a percent of the prescribed number, inhalation adherence was 82% (range 11-90%) and shaking was 27% (range 3-83%). Conclusions The MDILog offers a unique way to monitor adherence to therapy in asthmatic subjects. By either definition adherence to shaking the MDI is poor and its importance should be emphasized. Investigators of adherence should choose the definition of adherence which provides the best clinical result as the primary outcome for interventions in non-adherent subjects.
Journal of Clinical Immunology, 2006
To better characterize infants presenting with diminished immunoglobulin levels and intact antibo... more To better characterize infants presenting with diminished immunoglobulin levels and intact antibody formation, we present 49 such infants, correlating presenting characteristics with history and time to immunoglobulin normalization. Term infants with the following characteristics were included: 1) one or more immunoglobulin classes >2SD below mean, 2) protective antibody titer to tetanus and diphtheria, 3) intact cellular immunity, 4) no features of other syndromes. The children were 69.4% male and had recurrent otitis media (77.6%), wheezing (61.2%), and atopy (26.5%). Diminished IgA (95.9%) was most common, but 65.3% had multiple isotypes diminished. During follow-up, 25/49 (51%) normalized immunoglobulins, of whom 80% were male; only 48% normalized in infancy. Female immunoglobulin normalization was significantly delayed (p < .001). No deaths or serious infections occurred. This phenotype is predominantly seen in male infants with otitis media and wheezing. Female infants have significantly delayed immunoglobulin normalization. Transient hypogammaglobulinemia of infancy can be diagnosed only retrospectively.
The Journal of Allergy and Clinical Immunology, Apr 1, 1992
The Journal of Allergy and Clinical Immunology, Mar 1, 1978
The Journal of Allergy and Clinical Immunology, 1985
The Journal of Allergy and Clinical Immunology, Feb 1, 2012
The Journal of Allergy and Clinical Immunology, 1982
The Journal of Pediatrics, Mar 1, 1983
MANAGEMENT OF SEIZURE DISORDERS in asthmatic children treated with theophylline poses a therapeut... more MANAGEMENT OF SEIZURE DISORDERS in asthmatic children treated with theophylline poses a therapeutic challenge, because several anticonvulsant drugs are reported to alter theophylline metabolism. ~,2 Carbamazepine (Tegretol) is known to hasten the metabolism of various Volume 102 Clinical and laboratory observations 4 7 3 Number 3
Pediatric Annals, Aug 1, 1977
A rational approach to the evaluation of the child with chronic asthma has been presented. The im... more A rational approach to the evaluation of the child with chronic asthma has been presented. The importance of careful historical, physical, and pulmonary assessment is stressed, especially since asthma may exist without overt wheezing. General allergic as well as sequential pharmacologic management of this disease is also discussed. A knowledge of the biochemical and pathophysiologic alterations in asthma should lead to rational and specific therapy that preserves normal function and decreases the long-term morbidity and mortality of the disease.
The Journal of Allergy and Clinical Immunology, 2002
INTRODUCTION: Chronic granulomatous disease (CGD) is a genetic disorder, characterized by the ina... more INTRODUCTION: Chronic granulomatous disease (CGD) is a genetic disorder, characterized by the inability of phagocytes to generate superoxide and other reactive oxygen species during phagocytosis. Defects causing CGD have been described in the genes encoding four protein components of the superoxide-generating NADPH oxidase, gp91-, p22, p47-and p67phox. p67-phox deficiency is an unusual, autosomal recessive form of CGD that accounts for approximately 5% of cases. As with gp91-and p22-phox deficiencies, there is a high degree of heterogeneity in the molecular alterations that produce defects in p67-phox. In 19 unrelated patients with this form ofCGD, 13 of who are homozygous, 18 different mutations have been described in NCF-2, thep67-phox gene. Here we report a CGD patient, who is a compound heterozygote for two mutations in NCF-2, one of, which is novel and unusual. CASE PRESENTATION: An 8-year old boy presented with lung abscess and bilateral pulmonary infiltrate. The infectious diseases work-up consisted of serology, microscopic exam and culture of specimens obtained by broncho-alveolar lavage, and lung biopsy, all of which were negative. A flow cytometric dihydrorhodamine test revealed <1% of neutrophils producing reactive oxygen species (normal _>75%). Flow cytometric analysis of the patient's permeabilized granulocytes using monoclonal antibodies specific for each component, revealed no p67-phox and normal levels of gp91-, p22-and p47-phox. DNA sequencing of the entire p67-phox gene revealed a mutation in exon 4 (C-304-) T) predicting Arg 102 ~ stop, and a mutation in exon 12 (G1026-) A). Although this change is silent (Lys342-)Lys), it occurs at the final base pair of the exon and alters the consensus splice site sequence. The mother was found to be heterozygous for the mutation in exon 12 and had normal sequence in exon 4. Analysis of the maternal RNA by reverse transcriptase PCR revealed a small amount of product with exon 12 spliced out confirming that the mutation causes a splicing defect. CONCLUSION: The p67-phox-deficient CGD patient reported here is a compound heterozygote, with a previously reported nonsense mutation in exon 4 of NCF-2, and a novel splice mutation at the end of exon 12.
The Journal of Allergy and Clinical Immunology, Feb 1, 2005
The Journal of Allergy and Clinical Immunology, Feb 1, 2019
RATIONALE: The ''atopic march'' has been considered a progression starting with eczema and culmin... more RATIONALE: The ''atopic march'' has been considered a progression starting with eczema and culminating with development of asthma. Not all asthma cases, however, are preceded by eczema, and not all children with early eczema develop asthma. The aim of this study was to explore the impact of allergic sensitization patterns on the association between early eczema (<4 yr) and later childhood asthma. Given reported associations of KIF3A genotype with the atopic march, we also examined the impact of KIF3A risk allele rs12186803. METHODS: We studied 505 participants in the Cincinnati Childhood Allergy and Air Pollution Study (CCAAPS), a prospective birth cohort, with longitudinal eczema and asthma outcomes as well as data regarding sensitization to foods and aeroallergens. KIF3A genotypes were available on all children. Multiple logistic regression was used to evaluate main effects and interactions between early sensitization and KIF3A genotype. The outcome was clinically diagnosed asthma at age seven. RESULTS: Two high-risk groups were identified. The high-risk group with early eczema was more likely to be sensitized to food allergens, while the group without early eczema was more likely to be poly-sensitized to aeroallergens. The KIF3A rs12186803 risk allele interacted with food sensitization to increase asthma risk in children with eczema (p50.02). In children without eczema, asthma was associated with the interaction between rs12186803 and aeroallergen sensitization (p50.007). CONCLUSIONS: Two asthma phenotypes were identified: one in children with a history of eczema and one in children without. KIF3A interacted differentially with sensitization pattern to increase the risk of asthma in both groups.
The Journal of Allergy and Clinical Immunology, 1983
The Journal of Allergy and Clinical Immunology, Feb 1, 2003
Chest physiotherapy (CPT) is a commonly used therapy for respiratory disease. According to the NI... more Chest physiotherapy (CPT) is a commonly used therapy for respiratory disease. According to the NIH Expert Panel 2 Asthma Guidelines, CPT "is not beneficial and is unnecessarily stressful for the breathless asthma patient." The purpose of our study was to determine if general pediatricians believe that CFF has a role in the treatment of acute asthma. A postcard survey was sent to 200 pediatricians from Pennsylvania, Delaware, New Jersey, and Maryland. The survey asked the following three questions: 1. Do you believe that chest physiotherapy has a role in the treatment of acute asthma? 2. Have you ever utilized chest physiotherapy in the management of a patient with an acute asthma exacerbation? 3. If the answer to question 2 is yes, was the type of chest physiotherapy percussion with or without postural drainage? The two possible answers for each question were yes or no. 85 of 200 (42.5%) were postcards were completed and returned. 50 of 85 (60.2%) physicians responded yes to question No. 1. 50 of 85 (60.2%) responded yes to question No. 2. 48 of 85 (57.8%) responded yes to question No. 3. There is little published regarding the effect of chest physiotherapy in acute asthma, and some have even suggested that this treatment may be harmful. Despite this lack of evidence, over 60% of general pediatricians surveyed believe that CPT has a role in acute asthma therapy and reported using this modality. There is a need for more definitive clinical studies on CPT in acute asthma to establish its role.
The Journal of Allergy and Clinical Immunology, Feb 1, 2012
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Papers by Stephen McGeady