Vaccination against the SARS-CoV-2 virus in patients undergoing Hymenoptera venom immunotherapy.

Introduction: The SARS-CoV-2 epidemic has unquestionably left a significant mark on the global healthcare system. Implementation of the commonly available vaccinations against COVID-19 is intended to reduce the risk of a severe course of the disease. Due to a very brief development period of the new vaccines, concerns have appeared among the public with regard to the possible adverse effects of the newly-developed preparations, as well as to the risks of causing allergic reactions. Regular medical observation during the Hymenoptera venom immunotherapy provides significant possibilities to note any potential adverse effects of vaccines against COVID-19, as well as of complications of an experienced SARS CoV-2 infection. Aim: To assess the issues connected with vaccination against COVID-19, complications following vaccination, as well as incidence and course of the disease among patients undergoing venom immunotherapy (VIT) due to an allergy to Hymenoptera venom. Material and methods: We investigated 37 persons aged 19 to 70 (20 women; 17 men) undergoing Hymenoptera venom immunotherapy in our department. Results: 21.6% have experienced an infection with the SARS-CoV-2 virus, confirmed by a diagnostic test. No person participating in the study had experienced a severe infection which would require hospitalization. Elderly people have been vaccinated statistically significantly more often than young people. Conclusions: The risk related to vaccination in this group of patients does not seem to be higher than in the general population.

Application of the forced oscillation technique in diagnosing and monitoring asthma in preschool children.

The measurement of lung function in preschool children for the diagnosis of asthma is not routinely used. The need to perform forced expiratory manoeuvres requires active cooperation and thus limits the use of spirometry in this age group. The forced oscillation technique (FOT) is a simple and noninvasive method of assessing the mechanical properties of the respiratory system during tidal breathing. It is used in young patients and requires minimal cooperation. It provides an objective assessment of the respiratory system in a group of patients in whom we have not yet had appropriate diagnostic tools. In recent years, due to the availability of new technical solutions, FOT has been increasingly used and has a chance to become a method used routinely in diagnosing and monitoring treatment in preschool children. This article presents the possibility of the clinical application of FOT in diagnosing and monitoring of early childhood asthma.

Prolonged effect of allergen sublingual immunotherapy for house dust mites in elderly patients.

BACKGROUND: The prolonged effect of allergen immunotherapy is unknown, especially in older patients. OBJECTIVE: To analyze the 3-year effect of sublingual allergen-specific immunotherapy (SLIT) to house dust mites in elderly patients with allergic rhinitis. METHODS: Forty-seven elderly patients (65.78 ± 4.89 years old) underwent SLIT to house dust mites and were monitored for 3 years and compared with a placebo group. SLIT was performed with the use of oral Staloral 300 SR Der p and Der f 50/50% extract (Stallergens Greer, London, United Kingdom) or placebo. Symptoms and medication score, represented by the average adjusted symptom score (AAdSS), serum level of immunoglobulin (Ig) G4 to Dermatophagoides pteronyssinus, Dermatophagoides farinae, Der p 1, and Der p 2, and quality of life, were assessed immediately after SLIT and 3 years later. RESULTS: The AAdSS was significantly decreased after SLIT, and the level remained low during the 3 years after SLIT compared with placebo. Serum-specific IgG4 against D pteronyssinus, D farinae, Der p 1, and Der p 2 increased during the SLIT trial in the study group. For the 3 years of observation after SLIT, there were no significant changes of specific IgG4 levels against the analyzed allergens compared with results just after SLIT. Quality of life based on the Rhinoconjunctivitis Quality of Life Questionnaire score was significantly decreased in patients who received SLIT, from 1.48 (95% confidence interval 1.33-1.79) to 0.98 (95% confidence interval 0.67-1.07; P < .05) compared with 0.94 (95% confidence interval 0.55-1.04) 3 years after SLIT. CONCLUSION: The prolonged positive effect after SLIT to house dust mites was observed in elderly patients with allergic rhinitis. Further trials are needed to confirm this effect. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01605760.

[Laryngopharyngeal Reflux (LPR) in patients with persistent hoarseness]. / Refluks krtaniowo-gardlowy (LPR) u pacjentów z przewlekla chrypka

INTRODUCTION: In 2006 The Global Consensus Group in Montreal pointed out that chronic laryngitis is highly associated with gastroesophageal reflux disease (GERD). AIM OF THE STUDY: To evaluate the frequency of LPR in a selected group of patients with chronic hoarseness. We were also interested in assessment of the relationship between Reflux Symptoms Index (RSI) scores, Ryan scores from the pharyngeal pH monitoring and the morphological changes in the larynx according to Reflux Findings Score (RFS). In addition, we wanted to assess the frequency of various clinical symptoms included in the RSI questionnaire among patients with LPR. MATERIALS AND METHODS: 42 patients from an outpatient ENT clinic with chronic hoarseness and RSI ≥ 13. All subjects underwent pharyngeal pH monitoring with the Dx-pH System Restech ™ and laryngoscopy. RESULTS: Among 42 patients with chronic hoarseness, LPR was confirmed in 35 patients (83.33%). In 7 subjects pharyngeal pH monitoring was normal. Among all patients with confirmed LPR, only 5 out of 8 elements of RFS laryngoscopic changes were observed. The most frequent inflammatory changes noticed included erythema of the arytenoids and interarytenoid regions (posterior laryngitis). These findings were found in 30 out of 35 patients with LPR. Median value of RFS in patients with LPR was 4.45, which is lower than the cut off value of 7 necessary for recognition of LPR. There is statistically significant positive correlation between Ryan scores and the RFS scale results (correlation coefficient 0.91, p<0.001). CONCLUSIONS: Pharyngeal pH monitoring confirmed LPR in 83.33% selected group of patients with chronic hoarseness and RSI ≥ 13. Isolated erythema of arytenoid and interarytenoid region was the most frequent inflammatory abnormality found in the larynx. RFS values below 7 do not exclude the diagnosis of LPR. We can use RFS scales as a prognostic test of severity of LPR - due to statistically significant positive correlation between Ryan score and RFS values. The use of RSI scale revealed that the most frequent symptom among patient with LPR was throat clearing followed by hoarseness.