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1.
Ital J Pediatr ; 46(1): 146, 2020 Oct 06.
Artigo em Inglês | MEDLINE | ID: mdl-33023616

RESUMO

BACKGROUND: There is ample evidence that COVID-19 is significantly less severe in children than in adults and asthma and allergy, the most common chronic disorders in children, are not included in the top 10 comorbidities related to COVID-19 fatalities. Nevertheless, concerns about asthma and allergy are still high.. In order to evaluate the impact of paediatric COVID-19 among Italian paediatricians, we sent a 20-questions anonymous internet-based survey to 250 Italian paediatricians with particular address to allergic symptoms and those affecting the upper airways. METHODS: The questionnaire was conceived and pretested in April 2020, by a working group of experts of the Italian Paediatric Society for Allergy and Immunology (SIAIP), and structured into different sections of 20 categorized and multiple choice questions. The first part included questions about epidemiological data follows by a second part assessing the way to manage a suspected COVID-19 infection and personal experiences about that. The third part concerned questions about patients' clinical characteristics and clinical manifestations. The survey was emailed once between April and mid-May 2020. RESULTS: A total 99 participants had participated in our survey and provided responses to our electronic questionnaire. The distribution of patients reported per month varies significantly according to the geographical area (P = 0.02). Data confirmed that in the North part of Italy the rate of patients referred is higher than in the rest of Italy. Almost all respondents (98%) reported caring for up to a maximum of 10 infected children and the last 2% more than twenty. Among these patients, according to the 75% of responders, a maximum rate of 20% were affected by allergic rhino-conjunctivitis and in particular in the North of Italy while in the Centre and in the South there was a higher incidence (P = 0.09). Almost the same applies for asthma, 83% of responders declared that up to a maximum of 20% of affected children were asthmatic, from 20 to 40% for the 13,5% of responders and from 40 to 60% for the last 3,5%. As for the allergic conjunctivitis also for asthma, we found a higher incidence in the Centre and in South than in the North (P = 0.03). CONCLUSIONS: This study is the first to provide a comprehensive review of COVID-19 knowledge and impact among paediatricians in Italy about allergic asthma and upper airway involvement. From our point of view, it provides important information clearly useful for improving a good practice.


Assuntos
Conjuntivite Alérgica/epidemiologia , Infecções por Coronavirus/epidemiologia , Pandemias/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Rinite Alérgica/epidemiologia , Inquéritos e Questionários , Adolescente , Distribuição por Idade , Causalidade , Criança , Conjuntivite Alérgica/diagnóstico , Infecções por Coronavirus/prevenção & controle , Estudos Transversais , Feminino , Humanos , Incidência , Itália/epidemiologia , Masculino , Pandemias/prevenção & controle , Pediatras/estatística & dados numéricos , Pediatria/normas , Pneumonia Viral/prevenção & controle , Rinite Alérgica/diagnóstico , Medição de Risco , Distribuição por Sexo , Sociedades Médicas
2.
Yonsei Med J ; 61(9): 797-804, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32882764

RESUMO

PURPOSE: Climate and lifestyle changes increase an individual's susceptibility to various allergens and also the incidence of allergic diseases. We aimed to examine the changes in sensitization rate for aeroallergens over a 10-year period in Korean children. MATERIALS AND METHODS: We retrospectively reviewed the medical records of 4493 children who visited the allergy clinic at a tertiary hospital in Korea for allergic rhinitis or asthma from January 2009 to December 2018. The serum specific immunoglobulin E (IgE) levels were measured to confirm the sensitization against Dermatophagoides farinae (D. farinae), Alternaria, weed and tree pollen mixtures, as well as cat and dog dander through ImmunoCAP test. RESULTS: D. farinae was the most common sensitizing aeroallergen (45.9%) during the 10-year span. The sensitization rate for tree pollen mixture (p for trend <0.001), weed pollen mixtures (p for trend <0.001), dog dander (p for trend=0.025), and cat dander (p for trend=0.003) showed ascending trends during the 10-year study period. Furthermore, the sensitization rate for multiple allergens (≥2) in 2018 increased significantly compared to that in 2009 (p for trend=0.013). Compared with children without sensitization to D. farinae, those with sensitization to D. farinae showed higher sensitization rates to other aeroallergens (p for interaction <0.001). CONCLUSION: Children's sensitization rate to cat and dog dander and weed and tree pollen mixtures significantly increased during the 10-year period in Korea. Children with sensitization to D. farinae are likely to be sensitized to other aeroallergens as well.


Assuntos
Alérgenos/imunologia , Asma/imunologia , Hipersensibilidade/diagnóstico , Imunoglobulina E/sangue , Rinite Alérgica/imunologia , Alérgenos/efeitos adversos , Animais , Asma/diagnóstico , Asma/epidemiologia , Gatos , Criança , Dermatophagoides farinae , Cães , Feminino , Humanos , Hipersensibilidade/imunologia , Masculino , Pólen/imunologia , República da Coreia/epidemiologia , Estudos Retrospectivos , Rinite Alérgica/diagnóstico
3.
J Allergy Clin Immunol ; 146(4): 790-798, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32810517

RESUMO

BACKGROUND: There is inconclusive and controversial evidence of the association between allergic diseases and the risk of adverse clinical outcomes of coronavirus disease 2019 (COVID-19). OBJECTIVE: We sought to determine the association of allergic disorders with the likelihood of a positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) test result and with clinical outcomes of COVID-19 (admission to intensive care unit, administration of invasive ventilation, and death). METHODS: A propensity-score-matched nationwide cohort study was performed in South Korea. Data obtained from the Health Insurance Review & Assessment Service of Korea from all adult patients (age, >20 years) who were tested for SARS-CoV-2 in South Korea between January 1, 2020, and May 15, 2020, were analyzed. The association of SARS-CoV-2 test positivity and allergic diseases in the entire cohort (n = 219,959) and the difference in clinical outcomes of COVID-19 were evaluated in patients with allergic diseases and SARS-CoV-2 positivity (n = 7,340). RESULTS: In the entire cohort, patients who underwent SARS-CoV-2 testing were evaluated to ascertain whether asthma and allergic rhinitis were associated with an increased likelihood of SARS-CoV-2 test positivity. After propensity score matching, we found that asthma and allergic rhinitis were associated with worse clinical outcomes of COVID-19 in patients with SARS-CoV-2 test positivity. Patients with nonallergic asthma had a greater risk of SARS-CoV-2 test positivity and worse clinical outcomes of COVID-19 than patients with allergic asthma. CONCLUSIONS: In a Korean nationwide cohort, allergic rhinitis and asthma, especially nonallergic asthma, confers a greater risk of susceptibility to SARS-CoV-2 infection and severe clinical outcomes of COVID-19.


Assuntos
Asma/complicações , Betacoronavirus/patogenicidade , Doenças Cardiovasculares/complicações , Infecções por Coronavirus/complicações , Dermatite Atópica/complicações , Complicações do Diabetes/diagnóstico , Pneumonia Viral/complicações , Rinite Alérgica/complicações , Adulto , Idoso , Asma/diagnóstico , Asma/imunologia , Asma/mortalidade , Betacoronavirus/imunologia , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/imunologia , Doenças Cardiovasculares/mortalidade , Técnicas de Laboratório Clínico , Estudos de Coortes , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/imunologia , Infecções por Coronavirus/mortalidade , Dermatite Atópica/diagnóstico , Dermatite Atópica/imunologia , Dermatite Atópica/mortalidade , Complicações do Diabetes/imunologia , Complicações do Diabetes/mortalidade , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/imunologia , Diabetes Mellitus/mortalidade , Suscetibilidade a Doenças , Feminino , Humanos , Tempo de Internação/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Pandemias , Pneumonia Viral/diagnóstico , Pneumonia Viral/imunologia , Pneumonia Viral/mortalidade , Rinite Alérgica/diagnóstico , Rinite Alérgica/imunologia , Rinite Alérgica/mortalidade , Índice de Gravidade de Doença , Análise de Sobrevida
5.
Niger J Clin Pract ; 23(8): 1061-1067, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32788482

RESUMO

Background: Atopy is poorly researched in HIV children living in the developing countries. There is no previous report on this subject in Nigeria and this pioneering study is undertaken to create an awareness of the burden of this disease among health practitioners. Aims: The aim of this study was to document the atopic diseases present among HIV-infected children attending the antiretroviral (ARV) clinic of a Nigerian tertiary hospital. Methods: Information was obtained from consecutive consenting caregiver/HIV-infected child attending the pediatric ARV clinic, by the use of a proforma specifically designed for the study. The data obtained were analyzed using Statistical Package for the Social Sciences (SPSS) software program, version 16.0. Results: Seventy patients were studied and their ages ranged between 2 and 17 years. These 70 were constituted by 34 (48.6%) boys and 36 (51.4%) girls. Ten (14.3%) of the 70 studied, had atopic diseases. Nine (12.9%) patients had allergic conjunctivitis and 1 (1.4%) had allergic rhinitis. The single patient with allergic rhinitis also had bronchial asthma. No case of atopic eczema, or food allergy was recorded. Atopic disease conditions were more commonly recorded among the male sex and those whose parents have atopic diseases (P < 0.05). Atopic diseases were also more common among children without advanced HIV diseases and those with eosinophilia. Cosmetic and psychological embarrassment from eye discoloration and itching were the negative impacts on the quality of living. Conclusion: Allergic conjunctivitis is common in HIV-infected Nigerian children. Atopies are more common in boys and children with parental atopies.


Assuntos
Dermatite Atópica/complicações , Infecções por HIV/complicações , Hipersensibilidade/epidemiologia , Rinite Alérgica/complicações , Adolescente , Instituições de Assistência Ambulatorial , Fármacos Anti-HIV/uso terapêutico , Asma/epidemiologia , Criança , Pré-Escolar , Conjuntivite Alérgica/epidemiologia , Dermatite Atópica/diagnóstico , Dermatite Atópica/epidemiologia , Feminino , Infecções por HIV/tratamento farmacológico , Hospitais de Ensino , Humanos , Masculino , Nigéria/epidemiologia , Prevalência , Qualidade de Vida , Rinite Alérgica/diagnóstico , Rinite Alérgica/epidemiologia
6.
Vestn Otorinolaringol ; 85(3): 52-56, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32628384

RESUMO

OBJECTIVE: To evaluate the role of secretory immunoglobulin E in the differential diagnosis of rhinitis in pregnant women. MATERIAL AND METHODS: The study involved 97 pregnant women with rhinitis symptoms and 23 healthy pregnant women without rhinitis symptoms. The first group of the study included 37 pregnant women with previously confirmed (anamnestically and immunologically) allergic rhinitis (AR), the 2nd group of the study included 30 pregnant women with suspected beginning of the AR, the 3rd group of the study was 30 women with pregnant women's rhinitis, diagnosed on the base of follow-up study. The study included: anamnesis taking, routine examination of ENT organs, general clinical examination, study of the level of total IgE in blood, nasal secretion cytology study, secretory IgE level in nasal secretion analysis, follow-up telephone gathered catamnestic data analysis. RESULTS AND DISCUSSION: When analyzing laboratory data, an increase in the average number of eosinophils in the blood was not detected in any group. When examining secretory immunoglobulin E of the nasal secretion in the group of patients with previously confirmed AR, this indicator averaged 2.9±0.7 kE/L, in the group with AR beginning - 5.5±2.6 kE/L, which exceeded the value in the control group (1.2±0.6 kE/l, p<0.05). In the group of patients with pregnant women's rhinitis, the indices of nasal IgE did not differ significantly from the control group (1.9±0.3 and 1.2±0.6 kE/L, respectively, p<0.05). CONCLUSION: The level of secretory nasal immunoglobulin E can be used in the differential diagnosis of rhinitis in pregnancy.


Assuntos
Rinite Alérgica/diagnóstico , Rinite , Diagnóstico Diferencial , Feminino , Seguimentos , Humanos , Imunoglobulina E , Mucosa Nasal , Gravidez
7.
Ann Allergy Asthma Immunol ; 125(4): 481-483, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32717301
8.
Allergol. immunopatol ; 48(3): 244-250, mayo-jun. 2020. graf, tab
Artigo em Inglês | IBECS | ID: ibc-192026

RESUMO

INTRODUCTION AND OBJECTIVES: Eosinophilic esophagitis (EoE) is frequently miss-diagnosed or overlooked for several years because of the invasiveness of investigations and the non-specificity of symptoms in childhood. Due to the lack of specific recommendations in children, its management remains very heterogeneous, especially concerning allergy testing. The aim of this study is to analyze our population and practices, in comparison with the literature, with a focus on allergic management, to harmonize and optimize our practice. MATERIAL AND METHODS: We included all children with a diagnosis of EoE at the Hospital Femme Mere Enfant, Bron, France. Data were collected via retrospective chart review. RESULTS: 108 patients were included with an average age of 9.5 years. Average delay before diagnosis was 6.65 years. Symptoms varied with age, with a predominance of vomiting (60% of patients), feeding difficulties (72%) and growth difficulties (24%) in children < 5 years, whereas older children often presented with feeding blockage (64%) and dysphagia (61%). Cough was frequent in our cohort (18.5%), especially in children < 10 years (38.5% between three and five years). The allergic background was frequent (70.3%) and 80% of our patients benefited from allergy testing. Allergy testing was particularly useful to guide therapy as elimination diet represented an effective treatment in 60% of our patients CONCLUSIONS: Allergy testing has to be harmonized to include major allergens (egg, milk, peanut, fish, wheat, and soy), including prick and patch tests. Allergy-testing based diet seemed to be the best compromise between efficiency and constraints, especially in mono-sensitized patients


No disponible


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Esofagite Eosinofílica/imunologia , Esofagite Eosinofílica/diagnóstico , Técnicas Imunológicas , Estudos Retrospectivos , Hipersensibilidade/diagnóstico , Esofagite Eosinofílica/complicações , Hipersensibilidade Alimentar/diagnóstico , Rinite Alérgica/diagnóstico , Dermatite Atópica/diagnóstico , Endoscopia , Imunoglobulina E/análise , Testes Cutâneos
9.
Ann Otol Rhinol Laryngol ; 129(9): 910-917, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32425054

RESUMO

OBJECTIVES: Currently, epidemiological data on allergic rhinitis collected through the skin prick test are scarce. Moreover, the relationship of age and sex to allergic rhinitis is not comprehensively understood. This study aimed to characterize allergic rhinitis and the associated clinical manifestations by age and sex. METHODS: We retrospectively investigated data from 2883 patients who visited a single university hospital for rhinitis symptoms between January 2003 and December 2014. Of these 2883 patients, 1964 who underwent a skin prick test with 11 standardized allergen extracts and completed a nasal symptom questionnaire were enrolled. The clinical characteristics of allergen sensitization and nasal symptoms were analyzed by sex and age distribution. RESULTS: The prevalence of allergen sensitization progressively decreased with age after peaking at between 20 and 29 years. The sensitization rate was higher in males than in females (P = .046). The sensitization rate to house dust mites decreased with age, while sensitization to mugwort and ragweed increased. Six allergens (Dermatophagoides pteronyssinus, Dermatophagoides farinae, mugwort, trees, ragweed, and cats) were sufficient to identify >96% of patients with allergen sensitization. Nasal obstruction tended to decrease with age and was more prevalent in males (P = .002) than in females, while rhinorrhea (P = .007) and itching (P = .013) were more prevalent in females. Total nasal symptom scores did not differ by sex. CONCLUSIONS: The clinical characteristics of allergic rhinitis, including allergen-sensitization patterns and related symptoms, varied by age and sex. Six common allergens could be sufficient to generate a cost-effective tool to identify allergic rhinitis.


Assuntos
Rinite Alérgica/diagnóstico , Adolescente , Adulto , Idoso , Alérgenos/imunologia , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Rinite Alérgica/imunologia , Fatores de Tempo , Adulto Jovem
10.
Otolaryngol Head Neck Surg ; 162(6): 979-984, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32393099

RESUMO

OBJECTIVES: Budesonide nasal irrigation is currently widely used in the treatment of chronic sinusitis typically following endoscopic sinus surgery to improve inflammatory control. Its application in treatment of allergic rhinitis has not been previously studied. This study assesses the subjective and clinical response to budesonide buffered hypertonic saline nasal irrigation and hypertonic saline nasal irrigation in patients with allergic rhinitis. STUDY DESIGN: This is a prospective, single-center, double-blind, randomized placebo-controlled trial. SETTING: Tertiary care hospital. SUBJECTS AND METHODS: Fifty-two patients diagnosed with allergic rhinitis were randomized into 2 groups to receive either buffered hypertonic saline nasal irrigation with a placebo respule or buffered hypertonic saline nasal irrigation with a budesonide respule. Patients were assessed at baseline and 4 weeks subjectively using the Sino-Nasal Outcome Test-22 (SNOT-22) questionnaire and visual analog scale (VAS). Clinical assessment was done using the modified Lund-Kennedy score. RESULTS: The average SNOT-22, VAS, and modified Lund-Kennedy scores improved in both groups (P < .001). The budesonide irrigation group was found to have significantly better improvement than the saline nasal irrigation group with the SNOT-22 scores (P = .012) and VAS scores (P = .007). However, the difference in the clinical response between the 2 groups was not significant (P = .268). CONCLUSION: This study adds evidence to the use of saline nasal irrigation in allergic rhinitis but also demonstrates efficacy of the addition of budesonide to irrigations. Budesonide nasal irrigation thus appears to be a viable treatment option for allergic rhinitis.


Assuntos
Budesonida/administração & dosagem , Rinite Alérgica/tratamento farmacológico , Solução Salina/administração & dosagem , Adulto , Método Duplo-Cego , Endoscopia , Feminino , Seguimentos , Glucocorticoides/administração & dosagem , Humanos , Masculino , Pessoa de Meia-Idade , Lavagem Nasal , Estudos Prospectivos , Rinite Alérgica/diagnóstico , Resultado do Tratamento , Adulto Jovem
11.
PLoS One ; 15(4): e0231816, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32330171

RESUMO

INTRODUCTION: Existing evidence on the relationship between childhood lower respiratory tract infections (LRTI) and the subsequent atopy development is controversial. We aimed to investigate an association between viral LRTI at <5 years and the development of atopy at > 2 years. METHODS: We conducted a search at Embase, Pubmed, Web of Science, and Global Index Medicus. We collected data from the included articles. We estimated the odds ratio and the 95% confidence intervals with a random effect model. We determined factors associated with atopy development after childhood LRTI using univariate and multivariate meta-regression analyses. We recorded this systematic review at PROSPERO with the number CRD42018116955. RESULTS: We included 24 studies. There was no relationship between viral LRTI at <5 years and skin prick test-diagnosed-atopy (OR = 1.2, [95% CI = 0.7-2.0]), unknown diagnosed-atopy (OR = 0.7, [95% CI = 0.4-1.3]), atopic dermatitis (OR = 1.2, [95% CI = 0.9-1.6]), hyperreactivity to pollen (OR = 0.8, [95% CI = 0.3-2.7]), food (OR = 0.8, [95% CI = 0.3-2.5]), or house dust mite (OR = 1.1, [95% CI = 0.6-2.2]). Although not confirmed in all studies with a symmetric distribution of the 23 confounding factors investigated, the overall analyses showed that there was a relationship between childhood viral LRTI at < 5 years and serum test diagnosed-atopy (OR = 2.0, [95% CI = 1.0-4.1]), allergic rhinoconjunctivitis (OR = 1.7, [95% CI = 1.1-2.9]), hyperreactivity diagnosed by serum tests with food (OR = 5.3, [1.7-16.7]) or inhaled allergens (OR = 4.2, [95% CI = 2.1-8.5]), or furred animals (OR = 0.6, [95% CI = 0.5-0.9]). CONCLUSION: These results suggest that there is no association between viral LRTI at < 5 years and the majority of categories of atopy studied during this work. These results, however, are not confirmed for the remaining categories of atopy and more particularly those diagnosed by serum tests. There is a real need to develop more accurate atopy diagnostic tools.


Assuntos
Asma/epidemiologia , Conjuntivite Alérgica/epidemiologia , Dermatite Atópica/epidemiologia , Infecções Respiratórias/imunologia , Rinite Alérgica/epidemiologia , Alérgenos/efeitos adversos , Animais , Asma/sangue , Asma/diagnóstico , Asma/imunologia , Criança , Conjuntivite Alérgica/sangue , Conjuntivite Alérgica/diagnóstico , Conjuntivite Alérgica/imunologia , Dermatite Atópica/sangue , Dermatite Atópica/diagnóstico , Dermatite Atópica/imunologia , Dermatophagoides pteronyssinus/imunologia , Humanos , Pólen/efeitos adversos , Pólen/imunologia , Infecções Respiratórias/virologia , Rinite Alérgica/sangue , Rinite Alérgica/diagnóstico , Rinite Alérgica/imunologia , Testes Cutâneos , Fatores de Tempo
12.
J Laryngol Otol ; 134(4): 332-337, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32238199

RESUMO

OBJECTIVE: To evaluate the colour values of nasal mucosa for the purpose of presenting an objective parameter of allergic rhinitis. METHODS: Seventy-three patients with allergic rhinitis (allergy group) and 73 normal healthy individuals (control group) were included in the study. Endoscopic examinations were conducted, and endoscopic photographs of the septum and both inferior turbinates were taken. The Adobe Photoshop Elements 7.0 software program was used to measure the numerical values of red-green-blue (RGB) colour components in the endoscopic photographs of nasal mucosa. RESULTS: The G and B values were significantly higher in the allergy group compared to the control group (both p < 0.05). Cumulative R, G and B values of all measurement points were significantly higher in the allergy group compared to the control group (p < 0.05). CONCLUSION: Nasal mucosa discolouration can be measured objectively with RGB analysis to aid the diagnosis of allergic rhinitis.


Assuntos
Cor/normas , Endoscopia/métodos , Mucosa Nasal/anatomia & histologia , Fotografação/instrumentação , Rinite Alérgica/diagnóstico , Adulto , Ensaios Clínicos como Assunto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mucosa Nasal/patologia , Septo Nasal/diagnóstico por imagem , Rinite Alérgica/epidemiologia , Rinite Alérgica/patologia , Sensibilidade e Especificidade , Software , Conchas Nasais/diagnóstico por imagem
13.
Allergol. immunopatol ; 48(2): 137-141, mar.-abr. 2020. tab, graf
Artigo em Inglês | IBECS | ID: ibc-191816

RESUMO

OBJECTIVES: Mucociliary clearance (MCC) is impaired due to chronic inflammation in allergic rhinitis. Our aim was to evaluate MCC in children with allergic rhinitis, to determine its relationship with disease severity and evaluate MCC change after nasal irrigation. MATERIALS AND METHODS: Saccharin test was performed in 51 patients with allergic rhinitis and in 50 controls. Nasal irrigation was performed to the patients and saccharin test was repeated at the 10th minute. Total nasal symptom score (TNSS) and visual analogue scale (VAS) results were recorded. Patients were divided into mild/moderate-severe groups according to TNSS, VAS, and ARIA guidelines. Nasal MCC time (NMCCT) of the patients and the controls and NMCCT before and after nasal irrigation of the patients were compared. Correlations between NMCCT and TNSS/VAS were evaluated. NMCCTs of the mild and moderate-severe groups were compared. The cut-off values were calculated to discriminate the patient group. RESULTS: The mean NMCCT of the patient group was higher than the controls. Mean NMCCTs were different between before and after irrigation. NMCCT was higher in uncontrolled/moderate-severe groups than in controlled/mild groups. NMCCT correlated positively with VAS and TNSS. The sensitivity and specificity of NMCCT > 535 s were found to be 86.27% and 94%, respectively. CONCLUSIONS: In children with allergic rhinitis, the prolongation of MCC may be identified with the easily applicable saccharin test, the deterioration in MCC increases as disease severity increases. Nasal irrigation is important in children with allergic rhinitis to improve MCC


No disponible


Assuntos
Humanos , Feminino , Criança , Depuração Mucociliar/imunologia , Índice de Gravidade de Doença , Rinite Alérgica/diagnóstico , Alérgenos/imunologia , Rinite Alérgica/fisiopatologia , Estudos Transversais , Inflamação/imunologia , Sacarina/administração & dosagem , Sensibilidade e Especificidade , Curva ROC
14.
Allergol. immunopatol ; 48(2): 170-174, mar.-abr. 2020. tab
Artigo em Inglês | IBECS | ID: ibc-191821

RESUMO

INTRODUCTION AND OBJECTIVES: American cockroach is a common aeroallergen sensitization in allergic rhinitis (AR) patients. Association between skin prick test (SPT) and specific immunoglobulin E (sIgE) to American cockroach allergen remains uncertain. This study aimed to evaluate the association between SPT and sIgE to American cockroach allergen in patients with AR. MATERIALS AND METHODS: This cross-sectional study was conducted in Thai AR patients aged 6-25 years from September 2013 to October 2014. SPT and sIgE to American cockroach allergen were performed and the correlation was calculated using SPSS Statistics version 18. RESULTS: Sixty-seven AR patients, with median age of 15 years were included in this study. SPT and sIgE to American cockroach allergen showed a positive result in 68.7% and 58.2% cases, respectively. Positive SPT or positive sIgE to American cockroach was found in 79.1%. Thirty-two patients (47.8%) tested positive for both SPT and sIgE to American cockroach allergen. Fourteen from a total of 67 cases (20.9%) with negative sIgE had positive SPT to American cockroach, while seven cases (10.4%) with negative SPT had positive sIgE to American cockroach. Moderate correlation was observed between mean wheal diameter (MWD) and sIgE level to American cockroach (r = 0.465, p = 0.001). No significant correlation was found between MWD of SPT or sIgE level to American cockroach and AR severity. CONCLUSION: A moderate correlation was observed between MWD of SPT and sIgE level to American cockroach. If SPT is negative in allergic rhinitis patients highly suspected of having American cockroach allergy, serum sIgE should be considered and viceversa


No disponible


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Adulto Jovem , Adulto , Rinite Alérgica/diagnóstico , Testes Cutâneos/métodos , Imunoglobulina E/sangue , Índice de Gravidade de Doença , Hipersensibilidade/etiologia , Baratas/imunologia , Rinite Alérgica/imunologia , Estudos Transversais
15.
Allergol. immunopatol ; 48(2): 187-193, mar.-abr. 2020. tab, graf
Artigo em Inglês | IBECS | ID: ibc-191824

RESUMO

INTRODUCTION AND OBJECTIVES: Allergic rhinitis (AR) is the most common allergic disease in childhood. Nasal obstruction is a typical symptom of AR, however, its quantification by clinical examination is difficult. To provide an objective assessment of nasal patency, the peak nasal inspiratory flow (PNIF) is used. Symptoms of AR have a noticeable impact on the quality of life. The aim of this study was to assess which factors may have an impact on PNIF values and to evaluate the possible relationships between PNIF and QoL in children with AR. Patients and METHODS: We recruited patients aged 6-17 years (n = 208, 89 girls and 119 boys) with AR. All children underwent PNIF measurements. Parents and children completed KINDL-R generic questionnaires, to assess the quality of life of the children. RESULTS: The average PNIF value was 98.9 ± 37.4 L/min. A very strong (p < 0.001) relationship between the PNIF value and height, age and weight of the child was observed. The sex of the patient has no influence on the PNIF value. We showed that PNIF values significantly increased with each attempt. The children assessed their QoL at 45.6 ± 8.5 points in the KINDL-R questionnaire and the parents rated their children's QoL at 73.7 ± 10.7 points. We observed a weak negative correlation between PNIF and the QoL based on the parents' assessment and the child's self-assessment. CONCLUSIONS: PNIF values depend mostly on height, but also on the child's age and weight. A learning effect (significant increase in PNIF upon each attempt) was shown. Higher PNIF does not improve the QoL


No disponible


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Rinite Alérgica/diagnóstico , Pico do Fluxo Expiratório , Qualidade de Vida , Inquéritos e Questionários , Análise de Variância , Modelos Lineares
16.
Curr Allergy Asthma Rep ; 20(4): 10, 2020 03 14.
Artigo em Inglês | MEDLINE | ID: mdl-32172365

RESUMO

PURPOSE OF REVIEW: This review summarizes the latest information on the appropriate identification, evaluation, and treatment of patients with nonsteroidal anti-inflammatory drug (NSAID)-exacerbated respiratory disease (NSAID-ERD), also known as aspirin-exacerbated respiratory disease (AERD). Within the framework of our understanding of the underlying pathophysiology of NSAID-ERD, we also provide an update regarding new surgical techniques and newly available or upcoming medical therapies that may benefit these patients. RECENT FINDINGS: There have been considerable developments regarding recommendations for both the extent and timing of sinus surgery for NSAID-ERD. The last few years have also given us several new biologic medications that warrant consideration in the treatment of patients with recalcitrant NSAID-ERD. Further clinical trials are underway to investigate additional medications that may decrease the type 2 inflammation that dominates this disease. Despite the severe lower respiratory inflammation and recurrent nature of the nasal polyps in patients with NSAID-ERD, significant recent advances now afford much-improved quality of life for these patients. Careful collaboration between Allergy/Immunology and Rhinology specialists is imperative to ensure proper treatment of patients with NSAID-ERD.


Assuntos
Anti-Inflamatórios não Esteroides/efeitos adversos , Aspirina/efeitos adversos , Asma Induzida por Aspirina , Rinite Alérgica , Asma Induzida por Aspirina/diagnóstico , Asma Induzida por Aspirina/prevenção & controle , Asma Induzida por Aspirina/cirurgia , Diagnóstico Precoce , Humanos , Procedimentos Cirúrgicos Nasais , Qualidade de Vida/psicologia , Rinite Alérgica/induzido quimicamente , Rinite Alérgica/diagnóstico , Rinite Alérgica/prevenção & controle , Rinite Alérgica/cirurgia , Síndrome
17.
Am J Otolaryngol ; 41(3): 102410, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32098705

RESUMO

OBJECTIVES: Recent guidelines have revealed that allergic rhinitis (AR) impairs quality of life. Neuropeptides play a central role in AR. The aim of this study was to determine the efficacy of posterior nasal neurectomy (PNN) for the treatment of AR and for the suppression of neuropeptides and type 2 cytokine expression. METHODS: In total, 77 patients undergoing PNN were recruited. Subjective symptoms, including sneezing and rhinorrhea, were elicited with a questionnaire using a 10 cm visual analogue scale (VAS). Nasal lavage fluid taken from a random sample of 17 patients both preoperatively and 1 year postoperatively was screened with enzyme-linked immunosorbent assays. RESULTS: Postoperative rhinorrhea (6.03 ± 1.31vs 2.12 ± 1.40, P < 0.001) and sneezing (5.53 ± 1.25vs 2.04 ± 1.29, P < 0.001) were significantly improved relative to the preoperative levels; the mean SP and NPY concentrations in the nasal lavage fluid were 91.6 ± 20.9 pg/ml and 71.5 ± 10.5 pg/ml, which decreased significantly to 52.9 ± 16.7 pg/ml and 31.8 ± 8.2 pg/ml, respectively, and the mean periostin and IL-5 concentrations were 215.2 ± 87.7 pg/ml and 984.5 ± 181.8 pg/ml, which decreased significantly to 146.1 ± 70.1 pg/ml and 281.6 ± 74.0 pg/ml, respectively. CONCLUSIONS: PNN was safe and well tolerated, and the symptom (sneezing and rhinorrhea) scores were significantly decreased by 1 year postoperatively.


Assuntos
Denervação/métodos , Mucosa Nasal/inervação , Rinite Alérgica/cirurgia , Adulto , Biomarcadores , Rinorreia de Líquido Cefalorraquidiano , Feminino , Expressão Gênica , Humanos , Interleucina-5/genética , Interleucina-5/metabolismo , Masculino , Pessoa de Meia-Idade , Neuropeptídeo Y/genética , Neuropeptídeo Y/metabolismo , Qualidade de Vida , Rinite Alérgica/diagnóstico , Rinite Alérgica/genética , Sexo Seguro , Espirro , Resultado do Tratamento , Adulto Jovem
18.
Int J Occup Med Environ Health ; 33(2): 241-246, 2020 Mar 13.
Artigo em Inglês | MEDLINE | ID: mdl-32091011

RESUMO

Local allergic rhinitis (LAR) is a specific phenotype of allergic rhinitis. One characteristic feature of LAR is a medical history indicative of an allergic disease, negative skin-prick test results, undetectable levels of specific IgE, and a positive allergen-specific nasal provocation test. This paper presents a case of a patient with LAR and underlying house dust mite allergy, who was ultimately diagnosed >10 years after the onset of his first symptoms. Currently, there are only pharmacological treatments available for LAR. However, some studies show encouraging results with the use of allergen-specific immunotherapy in LAR, which offer hope for a future use of this causative treatment in LAR patients. Int J Occup Med Environ Health. 2020;33(2):241-6.


Assuntos
Alérgenos/efeitos adversos , Antígenos de Dermatophagoides/efeitos adversos , Testes de Provocação Nasal , Fenótipo , Rinite Alérgica/diagnóstico , Adulto , Diagnóstico Tardio , Diagnóstico Diferencial , Humanos , Imunoglobulina E/sangue , Masculino , Testes Cutâneos
19.
Ann Otol Rhinol Laryngol ; 129(7): 699-706, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32059621

RESUMO

BACKGROUND: Chronic rhinosinusitis (CRS) is a chronic inflammatory disease of the sinonasal mucosa and with strong associations to other immune-mediated comorbidities. Patients often require referral to both an otolaryngologist and an allergist/immunologist. This study is the first in the literature to describe a multidisciplinary clinic that offers patient care by subspecialists in rhinology and in allergy/immunology. METHODS: One hundred twenty-nine patients were seen in the Comprehensive Sinus and Allergy Clinic (CSAC) between January 2016 and June 2017 and 43 selected patients were seen in both the standalone allergy and rhinology clinics over the same time period. Patient satisfaction was retrospectively assessed using a modified Press-Ganey satisfaction survey. Time to evaluation and time to follow up appointment were compared between the CSAC and both the standalone rhinology and allergy/immunology clinics. RESULTS: Patients seen in the CSAC reported high satisfaction with the amount of time spent with the physicians (98.3%), quality of medical care (9.3 ± 1.0), and most importantly, the convenience of seeing two physicians in one day (9.5 ± 1.2). Time from referral placement to clinic evaluation (P ≤ .02) and time to follow up appointment (P ≤ .002) was significantly shorter for the CSAC than for the standalone Rhinology or Allergy clinics. CONCLUSION: Patients reported high satisfaction with the medical care provided and were also seen much faster in our multidisciplinary clinic as compared to standalone rhinology or allergy/immunology clinics. Overall, a multidisciplinary approach may be beneficial to patients presenting to tertiary referral centers with CRS and atopic conditions.


Assuntos
Alergia e Imunologia/organização & administração , Assistência Ambulatorial/organização & administração , Hipersensibilidade/diagnóstico , Otolaringologia/organização & administração , Otorrinolaringopatias/diagnóstico , Satisfação do Paciente , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Instituições de Assistência Ambulatorial , Asma Induzida por Aspirina/diagnóstico , Asma Induzida por Aspirina/terapia , Doença Crônica , Dessensibilização Imunológica , Eficiência Organizacional , Feminino , Humanos , Hipersensibilidade/terapia , Imunoterapia , Masculino , Pessoa de Meia-Idade , Pólipos Nasais/diagnóstico , Pólipos Nasais/terapia , Procedimentos Cirúrgicos Nasais , Otorrinolaringopatias/terapia , Seios Paranasais/cirurgia , Equipe de Assistência ao Paciente , Qualidade da Assistência à Saúde , Encaminhamento e Consulta , Rinite/diagnóstico , Rinite/terapia , Rinite Alérgica/diagnóstico , Rinite Alérgica/terapia , Sinusite/diagnóstico , Sinusite/terapia , Adulto Jovem
20.
Braz. j. otorhinolaryngol. (Impr.) ; 86(1): 63-73, Jan.-Feb. 2020. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1089372

RESUMO

Abstract Introduction The types of allergic rhinitis are roughly classified based on the causative antigens, disease types, predilection time, and symptom severity. Objective To examine the clinical typing and individualized treatment approach for allergic rhinitis and to determine the optimal treatment method for this disease using various drug combination therapies. Methods A total of 108 participants with allergic rhinitis were divided into three groups based on symptoms. Subsequently, each group was further categorized into four subgroups based on the medications received. The efficacy of the treatments was evaluated using the visual analog scale VAS scores of the total and individual nasal symptoms, decline index of the symptom score, histamine and leukotriene levels, and mRNA and protein expression levels of histamine 1 and cysteinyl leukotriene 1 receptors. Results Loratadine + mometasone furoate and loratadine + mometasone furoate + montelukast significantly improved the sneezing symptom and reduced the histamine levels compared with the other combination therapies (p < 0.05). Meanwhile, montelukast + mometasone furoate and montelukast + mometasone furoate + loratadine considerably improved the nasal obstruction symptom and decreased the leukotriene D4 levels compared with the other combination therapies (p < 0.05). Conclusion Clinical symptom evaluation combined with experimental detection of histamine and leukotriene levels can be an objective and accurate method to clinically classify the allergic rhinitis types. Furthermore, individualized treatment based on allergic rhinitis classification can result in a good treatment efficacy.


Resumo Introdução A rinite alérgica é basicamente classificada de acordo com os antígenos causadores, tipos de doença, peridiocidade e gravidade dos sintomas. Objetivo Avaliar os tipos clínicos e a abordagem terapêutica individualizada para cada tipo de rinite alérgica e determinar o método de tratamento ideal utilizando várias terapias de combinação de fármacos. Método Um total de 108 participantes com rinite alérgica foram divididos em três grupos com base nos sintomas. Posteriormente, cada grupo foi subsequentemente categorizado em quatro subgrupos com base nos medicamentos recebidos. A eficácia dos tratamentos foi avaliada utilizando os escores da escala visual analógica EVA dos sintomas nasais totais e individualmente, índice de declínio do escore de sintomas, níveis de histamina e leucotrienos e níveis de expressão de mRNA e proteína dos receptores de histamina 1 e cisteinil-leucotrieno 1. Resultados As associações entre loratadina + furoato de mometasona, assim como a de loratadina + furoato de mometasona + montelucaste melhoraram significativamente o sintoma de espirros e reduziram os níveis de histamina em comparação às outras terapias combinadas (p < 0,05). Por outro lado, a associação montelucaste + furoato de mometasona, assim como a associação montelucaste + furoato de mometasone + loratadina melhoraram consideravelmente o sintoma de obstrução nasal e diminuíram os níveis de leucotrieno D4 em comparação com as outras combinações (p < 0,05). Conclusão A avaliação clínica dos sintomas combinada com a detecção experimental dos níveis de histamina e leucotrieno pode ser um método objetivo e preciso para classificar clinicamente os tipos de rinite alérgica. Além disso, o tratamento individualizado baseado na classificação da rinite alérgica pode resultar no aumento da eficácia do tratamento.


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Adulto Jovem , Histamina/sangue , Leucotrieno D4/sangue , Quimioterapia Combinada/métodos , Medicina de Precisão/métodos , Rinite Alérgica/sangue , Quinolinas/uso terapêutico , Espirro , RNA Mensageiro/genética , Receptores Histamínicos H1/genética , Obstrução Nasal/tratamento farmacológico , Resultado do Tratamento , Loratadina/uso terapêutico , Receptores de Leucotrienos/genética , Antialérgicos/uso terapêutico , Rinite Alérgica/diagnóstico , Rinite Alérgica/tratamento farmacológico , Furoato de Mometasona/uso terapêutico , Acetatos/uso terapêutico , Mucosa Nasal
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