Asunto(s)
Alérgenos/inmunología , Venenos de Abeja/uso terapéutico , Desensibilización Inmunológica/métodos , Hialuronoglucosaminidasa/inmunología , Hipersensibilidad/terapia , Proteínas de Insectos/inmunología , Meliteno/inmunología , Fosfolipasas A/inmunología , Adulto , Animales , Abejas/inmunología , Biomarcadores/metabolismo , Progresión de la Enfermedad , Femenino , Humanos , Hipersensibilidad/inmunología , Inmunización , Inmunoglobulina E/sangre , Masculino , Persona de Mediana Edad , Adulto JovenRESUMEN
AIM: Few studies have compared cluster immunotherapy and conventional administration regimens. The aim of this study was to establish the safety profile of these different regimens in patients with allergic respiratory diseases who received index-of-reactivity (IR)-standardized allergen extracts by the subcutaneous route. MATERIALS & METHODS: The safety of subcutaneous immunotherapy (SCIT), administered by means of a 4-week cluster titration schedule (cluster-SCIT) or by an 8-week short conventional titration schedule (SC-SCIT), both with a target dose of 8 IR, was assessed in a retrospective, observational, multicenter study. RESULTS: A total of 658 patients (339 cluster-SCIT and 319 SC-SCIT) were recruited from 92 sites in Spain. Injection site reactions occurred in 25.1 and 27.3% of patients treated with cluster-SCIT and SC-SCIT, respectively. Systemic reactions (European Academy of Allergy and Clinical Immunology criteria) were reported for 0.2% of doses and 1.5% of patients with cluster-SCIT, and 0.7% of doses and 4.4% of patients with SC-SCIT. Most reactions were mild and there were no grade 3 or 4 systemic reactions. No life-threatening systemic reactions, anaphylactic shock, or adverse events leading to therapy discontinuation were reported. CONCLUSION: The safety profile of the cluster regimen supports the use of accelerated SCIT schedules with IR-standardized allergen extracts compared with short conventional schedules, particularly if similar extracts and application methods are used.
Asunto(s)
Sistemas de Registro de Reacción Adversa a Medicamentos/estadística & datos numéricos , Alérgenos/efectos adversos , Desensibilización Inmunológica/efectos adversos , Hipersensibilidad Respiratoria/tratamiento farmacológico , Adolescente , Adulto , Alérgenos/administración & dosificación , Alérgenos/inmunología , Asma/tratamiento farmacológico , Asma/inmunología , Desensibilización Inmunológica/métodos , Esquema de Medicación , Femenino , Humanos , Inyecciones Subcutáneas , Masculino , Persona de Mediana Edad , Evaluación de Resultado en la Atención de Salud/métodos , Evaluación de Resultado en la Atención de Salud/estadística & datos numéricos , Hipersensibilidad Respiratoria/inmunología , Estudios Retrospectivos , Rinitis/tratamiento farmacológico , Rinitis/inmunología , España , Factores de Tiempo , Adulto JovenRESUMEN
There are many disorders that may involve the left ventricular (LV) apex; however, they are sometimes difficult to differentiate. In this setting cardiac imaging methods can provide the clue to obtaining the diagnosis. The purpose of this review is to illustrate the spectrum of diseases that most frequently affect the apex of the LV including Tako-Tsubo cardiomyopathy, LV aneurysms and pseudoaneurysms, apical diverticula, apical ventricular remodelling, apical hypertrophic cardiomyopathy, LV non-compaction, arrhythmogenic right ventricular dysplasia with LV involvement and LV false tendons, with an emphasis on the diagnostic criteria and imaging features. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s13244-011-0091-6) contains supplementary material, which is available to authorized users.