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Sheehan, William

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Sheehan

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Sheehan, William
Author's Publications: search.filters.isAuthorOfPublication.735846d3-8c37-447a-89dc-8dbe2b4b1ced

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    Ovomucoid specific immunoglobulin E as a predictor of tolerance to cooked egg
    (OceanSide Publications, Inc., 2015) Bartnikas, Lisa; Sheehan, William; Tuttle, Katherine L.; Petty, Carter R.; Schneider, Lynda; Phipatanakul, Wanda
    Background: Ovomucoid is the dominant allergen in hen's egg. Although several studies evaluated the utility of ovomucoid specific immunoglobulin E (sIgE) levels in predicting baked (e.g., muffin or cupcake) or raw egg food challenge outcomes, studies that evaluated ovomucoid sIgE as a predictor of cooked egg (e.g., scrambled or hard boiled) challenge outcomes are limited. Objective: To determine the relation of ovomucoid sIgE levels with cooked egg food challenge outcomes. Methods: A retrospective review of 44 children who underwent cooked egg food challenge and who had the ovomucoid sIgE level measured. Results: Thirty-six of 44 children (81.8%) passed cooked egg challenge. The ovomucoid sIgE level predicted cooked egg challenge outcome (passed median, <0.35 kU/L [range, <0.35–0.64 kU/L]; failed median, 0.40 kU/L [range, <0.35–3.13 kU/L]; p = 0.004). Ovomucoid sIgE levels correlated with egg white (EW) sIgE levels (Spearman correlation coefficient, 0.588; p < 0.001). Receiver operating characteristic curve analysis of ovomucoid and EW sIgE demonstrated areas under the curve of 0.711 and 0.766, respectively. No significant difference was observed among those immunologic parameters in their abilities to predict cooked egg challenge outcome (p = 0.559). Conclusion: The ovomucoid sIgE level may be helpful in predicting cooked egg challenge outcomes. However, our study did not support a role for ovomucoid sIgE replacing EW sIgE testing in evaluating egg allergy.
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    Acetaminophen versus Ibuprofen in Young Children with Mild Persistent Asthma
    (Massachusetts Medical Society, 2016-08-18) Sheehan, William; Mauger, David T.; Paul, Ian M.; Moy, James N.; Boehmer, Susan J.; Szefler, Stanley J.; Fitzpatrick, Anne M.; Jackson, Daniel J.; Bacharier, Leonard B.; Cabana, Michael D.; Covar, Ronina; Holguin, Fernando; Lemanske, Robert F.; Martinez, Fernando D.; Pongracic, Jacqueline A.; Beigelman, Avraham; Baxi, Sachin; Benson, Mindy; Blake, Kathryn; Chmiel, James F.; Daines, Cori L.; Daines, Michael O.; Gaffin, Jonathan; Gentile, Deborah A.; Gower, W. Adam; Israel, Elliot; Kumar, Harsha V.; Lang, Jason E.; Lazarus, Stephen C.; Lima, John J.; Ly, Ngoc; Marbin, Jyothi; Morgan, Wayne J.; Myers, Ross E.; Olin, J. Tod; Peters, Stephen P.; Raissy, Hengameh H.; Robison, Rachel G.; Ross, Kristie; Sorkness, Christine A.; Thyne, Shannon M.; Wechsler, Michael E.; Phipatanakul, Wanda
    BACKGROUND Studies have suggested an association between frequent acetaminophen use and asthma-related complications among children, leading some physicians to recommend that acetaminophen be avoided in children with asthma; however, appropriately designed trials evaluating this association in children are lacking. METHODS In a multicenter, prospective, randomized, double-blind, parallel-group trial, we enrolled 300 children (age range, 12 to 59 months) with mild persistent asthma and assigned them to receive either acetaminophen or ibuprofen when needed for the alleviation of fever or pain over the course of 48 weeks. The primary outcome was the number of asthma exacerbations that led to treatment with systemic glucocorticoids. Children in both treatment groups received standardized asthma-controller therapies that were used in a simultaneous, factorially linked trial. RESULTS Participants received a median of 5.5 doses (interquartile range, 1.0 to 15.0) of trial medication; there was no significant between-group difference in the median number of doses received (P = 0.47). The number of asthma exacerbations did not differ significantly between the two groups, with a mean of 0.81 per participant with acetaminophen and 0.87 per participant with ibuprofen over 46 weeks of follow-up (relative rate of asthma exacerbations in the acetaminophen group vs. the ibuprofen group, 0.94; 95% confidence interval, 0.69 to 1.28; P = 0.67). In the acetaminophen group, 49% of participants had at least one asthma exacerbation and 21% had at least two, as compared with 47% and 24%, respectively, in the ibuprofen group. Similarly, no significant differences were detected between acetaminophen and ibuprofen with respect to the percentage of asthma-control days (85.8% and 86.8%, respectively; P = 0.50), use of an albuterol rescue inhaler (2.8 and 3.0 inhalations per week, respectively; P = 0.69), unscheduled health care utilization for asthma (0.75 and 0.76 episodes per participant, respectively; P = 0.94), or adverse events. CONCLUSIONS Among young children with mild persistent asthma, as-needed use of acetaminophen was not shown to be associated with a higher incidence of asthma exacerbations or worse asthma control than was as-needed use of ibuprofen.