Frequency of allergic sensitization to Can f 5 in North East Italy. An analysis of 1403 ISACs 112 (Component Resolved Diagnosis) collected retrospectively.

Summary: Recent studies have shown the increasing relevance of allergic sensitization to Can f 5, a prostatic kallicrein expressed in the prostate and detectable only in male dogs. The aim of the present study was to establish the frequency, level of sensitization and association with other dog allergens of Can f 5, as assessed by Component Resolved Diagnosis (CRD- ISAC 112, ThermoFisher Scientific, Uppsala, Sweden), in North East Italy. A total of 1403 CRD ISAC 112 were examined retrospectively. Five-hundred twenty subjects (37 %) had a positive IgE response to at least one of the available animal allergens. Among these 520 subjects, 268 (51.5 %) showed at least one sensitization to dog allergens. Among dog-sensitized individuals, 183 (69.02%) showed IgE against Can f 5, and 106 (57.92%) were sensitized exclusively against Can f 5. The average Can f 5 specific IgE was 8.810 ISU-E, with 77.6 % of individuals showing medium or high values of specific IgE according to manufacturer's specifications. In conclusions, our data confirmed that there is a high number of sensitized patients to Can f 5, which have a high degree of allergic sensitization. These results should be taken into account by allergists managing dog allergic patients. In fact, clinical consequences of this sensitization regard respiratory allergy (burden of rhinitis/asthma), systemic reactions (anaphylaxis during sexual intercourse from cross-reaction with human prostatic antigen), allergen immunotherapy-AIT (likely ineffective in patients with exclusive sensitization), and preventive measures (possibility to own a female dog and a likely reduction of allergen passive transport). Further studies are needed to better explore these aspects in "real life".

Sífilis secundaria con lesiones de la cavidad bucal como única manifestación clínica Presentación de 20 casos y revisión de la literatura / SECONDARY SYPHILIS WITH BUCAL CAVITY LESIONS AS SINGLE CLINICAL MANIFESTATION

La sífilis es una enfermedad infectocontagiosa causada por una espiroqueta: el Treponema pallidum. Se transmite por contacto directo (generalmente sexual) con las lesiones cutáneo-mucosas durante el estadio primario y secundario, por vía transplacentaria durante el embarazo o a través del pasaje por el canal uterino y por sangre. Se trata de una enfermedad sistémica con una gran variedad de manifestaciones clínicas. La sífilis secundaria cursa con manifestaciones generales de un síndrome infeccioso inespecífico y lesiones mucocutáneas características. La presentación clínica de los 20 pacientes que se describen en este trabajo es singular ya que solo poseían lesiones en la cavidad oral. Es importante considerar esta patología en el diagnóstico diferencial de lesiones mucosas orales, para realizar un diagnóstico temprano, tratamiento precoz y evitar el contagio, así como siempre descartar la asociación con infección por el retrovirus VIH

Syphilis is a sexually transmitted disease caused by the spirochete bacterium named as Treponema pallidum. Syphilis is transmitted by direct contact (generally non-protect sexual contact) with cutaneous and mucosal lesions during the primary and secondary periods, by trans-placental transmission if the mother develop the infection during pregnancy and by blood. Syphilis is a systemic disease with a wide variety of clinical manifestations. Secondary syphilis is characterized by a nonspecific infectious syndrome and mucocutaneous lesions. Here we describe a serie of 20 patients with secondary syphilis as the unique clinical manifestation. Secondary syphilis should be included in the differential diagnosis of oral cavity mucosal lesions to achieve an early diagnosis and avoid the contagion. Human immunodeficiency virus infection should be always considered

A novel method for treatment of chronic anal fissure: adipose-derived regenerative cells - a pilot study.

AIM: The purpose of this study was to investigate the safety and feasibility of autologous adipose-derived regenerative cells (ADRC) in the treatment of chronic anal fissure. METHOD: A prospective pilot study was conducted in six patients with chronic anal fissures at the First Surgical Clinic, Clinical Center of Serbia and at the BelPrime Clinic, Belgrade, Serbia. All patients were candidates for surgical treatment. The average duration of symptoms was 24 months. Pain assessment was quantified using a visual analogue scale and bowel continence was assessed using the Wexner incontinence score. Both were assessed before treatment and during each postoperative outpatient visit. Liposuction was performed under local or general anaesthesia. Extraction of ADRC was achieved with a closed automated medical device. The fat and ADRC were injected subcutaneously into the edge of the fissure. The rest of the pellet was infiltrated into the internal anal sphincter. The study has been registered at ClinicalTrials.gov (NCT02628522). RESULTS: Complete healing of the anal fissure and the disappearance of symptoms was achieved in all patients. The average time to complete pain cessation was 33.7 ± 15.0 days. All fissures healed after 3 months and remained healed 12 months after the procedure. There were no complications related to the procedure. CONCLUSION: The application of ADRC may be an alternative to lateral sphincterotomy and a reliable procedure which avoids faecal incontinence.

Pharmacoeconomics of subcutaneous allergen immunotherapy.

The current burden of allergic diseases, estimated by both direct and indirect costs, is very relevant. In fact the cost estimation for rhinitis amount globally to 4-10 billion dollars/year in the U.S. and to an average annual cost of 1089 euros per child/adolescent and 1543 euros per adult in Europe. The estimated annual costs in Northern America for asthma amounted to 14 billion dollars. Consequently, preventive strategies aimed at reducing the clinical severity of allergy are potentially able to reduce its costs. Among them, specific immunotherapy (SIT) joins to the preventive capacity the carryover effect once treatment is discontinued. A number of studies, mainly conducted in the US and Germany demonstrated a favourable cost-benefit balance. In the nineties, most surveys on patients with allergic rhinitis and asthma reported significant reductions of the direct and indirect costs in subjects treated with SIT compared to those treated with symptomatic drugs. This is fully confirmed in recent studies conducted in European countries: in Denmark the direct cost per patient/year of the standard care was more than halved following SIT; in Italy a study on Parietaria allergic patients demonstrated a significant difference in favor of SIT plus drug treatment for three years versus drug treatment alone, with a cost reduction starting from the 2nd year and increasing to 48% at the 3rd year, with a highly statistical significance which was maintained up to the 6th year, i.e. 3 years after stopping immunotherapy, corresponding to a net saving for each patient at the final evaluation of 623 euros per year; in France a cost/efficacy analysis comparing SIT and current symptomatic treatment in adults and children with dust mite and pollen allergy showed remarkable savings with SIT for both allergies in adults and children.

Economic evaluation of sublingual immunotherapy: an analysis of literature.

Allergic rhinitis and asthma constitute a global health problem because of their very high prevalence and the consequent burden of disease, concerning medical and economical issues. Among the treatments of allergy, specific immunotherapy has the capacity to favourably alter the natural history of the disease both during and after its performance and thus to reduce the direct and indirect costs of allergic rhinitis and asthma. A number of studies reported such cost reduction for traditional, subcutaneous immunotherapy and recent data demonstrate that also sublingual immunotherapy (SLIT) is associated to economic advantages and/or monetary savings, specifically in terms of reduction of disease economic burden. Only few formal economic assessments of SLIT have been carried out so far, this article will present and discuss the published studies addressed to this issue. The data obtained, although the number of studies is still limited, provide preliminary evidence supporting a SLIT effect on sparing costs for respiratory allergy.

[Update on mastalgia]. / Aggiornamento sulla mastalgia.

On the basis of recent literature, earlier contributions made by this department and personal experience, the A. report their findings and comments on mastalgia, a frequent symptom in modern female pathologies. They affirm that good results have been achieved through information, health education and treatment with non-steroid anti-inflammatory drugs, without resorting to hormone therapy except in carefully selected cases.