ABSTRACT
BACKGROUND: Allergic rhinitis (AR) is a common respiratory disease encompassing a variety of phenotypes. Patients can be sensitized to 1 or more allergens. There are indications that polysensitization is associated with more severe disease. However, the extent to which the level of sensitization is associated with clinical disease variability, underlying the distinct nature of AR from AR+ conjunctivitis or AR+ asthma, is not known. OBJECTIVE: To evaluate phenotypical differences between monosensitized and polysensitized patients with AR and to quantify their symptomatic variability. METHODS: A total of 565 patients with a confirmed diagnosis of AR were included in this cross-sectional study. Of those, 155 were monosensitized and 410 were polysensitized. Interactions between sensitization levels and the reporting of different symptoms of AR and co-morbidities, disease duration, and impact were assessed. Furthermore, patients were stratified into monosensitized, oligosensitized, and polysensitized to assess whether the effect of sensitization on the phenotype was ranked. RESULTS: Polysensitized patients reported itchy eyes significantly more often (P = .001) and had a higher number of ocular (P = .005), itch-related (P = .036), and total symptoms (P = .007) than monosensitized patients. In addition, polysensitized adults and children more often reported wheeze (P = .015) and throat-clearing (P = .04), respectively. Polysensitization was associated with more burdensome AR based on a visual analog scale (P = .005). Increased sensitization level was reflected in more itchy eyes, a higher number of ocular, itch-related, and total number of symptoms, and disease burden. CONCLUSION: With an increasing number of sensitizations, patients with AR experience an increased diversity of symptoms. Multimorbidity-related symptoms increase with sensitization rank, suggesting organ-specific thresholds.
Subject(s)
Allergens , Immunoglobulin E , Rhinitis, Allergic , Humans , Male , Female , Cross-Sectional Studies , Adult , Immunoglobulin E/immunology , Immunoglobulin E/blood , Rhinitis, Allergic/immunology , Rhinitis, Allergic/diagnosis , Allergens/immunology , Middle Aged , Adolescent , Young Adult , Child , Immunization , Pruritus/immunology , PhenotypeABSTRACT
INTRODUCTION: There seems to exist a specific group of people considered to be at higher risk of having Auditory Processing Disorders (APD). These patients are frequently initially referred to, or managed by various professionals such as Otolaryngologists, Speech Therapists, and Occupational Therapists. It is, therefore, essential to retain a low threshold of when to refer such individuals for a formal APD diagnostic evaluation. Under these circumstances, there might be a role for the Greek Speech-in-Babble (SinB) recognition test as a screening tool for abnormal auditory processing competency. OBJECTIVE: To explore the test-retest reliability of a diagnostically validated speech-in-babble test, the Greek SinB, as a potential screening tool. METHODS: Ten health professionals coming from various disciplines administered the SinB test twice, under conditions similar to those encountered when using it as a screening tool, and test-retest reliability was assessed. 93 Greek-speaking individuals, of whom 27 adults and 66 children or young adolescents aged five years old or more, served as our study sample. RESULTS: For the right ear, the Intraclass Correlation Coefficient (ICC) was 0.858 with a 95% confidence interval (CI) = 0.786-0.906. Slightly better conditions apply for the left ear, as the ICC was 0.873 with 95% CI = 0.809-0.916. These 95% CIs indicate a 'good' to 'excellent' level of reliability for both ears. Spearman's rho was 0.86 and 0.71 for the right and left ear, respectively. CONCLUSION: Our results suggest that the test possesses the required reliability to evaluate a subject's hearing abilities under screening conditions. On these terms, it could be used to screen populations considered as being at risk for Auditory Processing Disorders. Forthcoming research should focus on establishing its efficiency by comparing the results of the screening test with that of diagnostic tests and on fine-tuning SinB as a screening tool.