Background
Iodinated contrast media (ICM) is a frequently used compound in radiology. Non‐immediate hypersensitivity reactions (HSR) appear when a patient leaves the department and usually are ...undocumented. True hypersensitivity in this group is rarely proved.
Methods
Single‐centre 2014‐2018 data were retrospectively analysed. HSR to ICM were classified and investigated according to the time of occurrence (immediate <1 hour, non‐immediate >1 hour). ENDA questionnaire and skin tests (prick or intradermal test) were performed according to ENDA/EAACI recommendations.
Results
69 patients with a clinical history of HSR to ICM were identified, 72.46% were females (n = 50). The average age was 56 (SD ± 13.16) years. Non‐immediate HSR occurred in 28.99% (n = 20) patients. The suspected culprit drugs were: iodixanol 20% (n = 4), iopromide 5% (n = 1), diatrizoate 10% (n = 2) and iohexol 10% (n = 2). Among non‐immediate HSR 96.00% (n = 19) of patients had skin rashes. A statistically significant correlation was found between the clinical symptoms and the type of reaction (p‐value <0.05): isolated skin manifestations mostly occurred in non‐immediate HSR 75.00% (n = 15). Only 13.04% (n = 9) of all the patients were proved to be allergic to a certain ICM after the proposed diagnostic workup.
Conclusions
One‐third of the hypersensitivity reactions investigated were classified as non‐immediate type. Most of them manifested with isolated skin symptoms. The most frequent culprit drug encountered was iodixanol. The overall non‐immediate hypersensitivity confirmation rate after diagnostic evaluation was only 15%.
The skin of persons with atopic dermatitis (AD) is very susceptible to cutaneous infection, and some yeast species may also aggravate AD. The total yeast population of an AD patient’s skin and its ...relation with individual age and body part remains poorly characterized. The aim of this study was to clarify the differences in cutaneous yeast flora by age and body parts of AD patients.
By swabbing affected body parts (hands, legs, face, neck or trunk), 241 samples were collected from patients with AD (132 children and 109 adults), and as controls, 40 samples were taken from healthy individuals (20 children, 20 adults).
In all, 89 (36.9%) of samples were positive; the yeast isolated belonged to three genera: Candida (27.4%), Malassezia (6.6%), and Rhodotorula (2.9%). Cutaneous colonization with yeasts was two-fold higher in the adults than in children (P<0.0001). The distribution of the yeast species was dependent on the body part sampled: Malassezia predominated in the face, neck, and trunk regions (P=0.0047); Candida more frequently colonized hands and legs (P=0.0029).
Our study showed that cutaneous yeast flora and distribution of yeast species depends significantly on the age of the AD patient and the body part affected by atopic dermatitis.
Background
MASK‐air® is an app whose aim is to reduce the global burden of allergic rhinitis (AR) and asthma. A transfer of innovative practices was performed to disseminate and implement MASK‐air® ...in European regions. The aim of the study was to examine the implementation of the MASK‐air® app in Lithuanian adults in order to investigate (i) the rate of acceptance in this population, (ii) the duration of app use and (iii) the evaluation of the app after its use.
Methods
In a longitudinal study, Lithuanian adults with AR and/or asthma were recruited by allergists. They were informed about how to use MASK‐air® and were followed closely. They were reviewed after one to 3 months to evaluate satisfaction and were asked to continue using the app.
Results
Among the 149 patients recruited (37.2 ± 10.4 years), 52.4% had rhinitis alone, 42.9% had rhinitis, asthma and/or conjunctivitis multimorbidity, and 2.7% isolated asthma. According to the MASK‐air® baseline questionnaire, 88.3% of patients considered that their symptoms were troublesome. Data were available for 102 (68.4%) patients. The duration of app usage in patients ranged from 1 to 680 days (median, 25–75 percentile: 54, 23.2–151 days). Forty‐two (41.1% of patients who were reviewed) patients agreed to share their opinion on MASK‐air®. Most users of the app were satisfied, from 46.5% thinking their allergy was treated more successfully to 90.4% recommending this app to other allergy sufferers.
Discussion
When recommended by physicians, MASK‐air® was used for a longer period of time.
BackgroundAllergic reactions after messenger RNA (mRNA)-based COVID-19 vaccines have been reported but detailed descriptions and further actions are not well characterized. ObjectiveTo describe the ...symptoms of possible allergic reactions after the mRNA COVID-19 vaccine and outcomes of further vaccination. MethodsWe descriptively analyzed data of adult (≥18 years of age) patients, who were sent for vaccination to our outpatient center for the Diagnostics and Treatment of Allergic and Immune diseases. All patients were vaccinated with the Pfizer-BioNTech Comirnaty® vaccine. ResultsFrom January 2021 to July 2021 twenty-two patients were vaccinated in our center. Six patients experienced a reaction after the first Comirnaty® dose in different vaccination centers. The majority of them complained of various types of rashes after the first dose, one case was consistent with anaphylaxis. The latter patient was tested with the skin prick using Pfizer-BioNTech Comirnaty® vaccine and the test was negative. Other sixteen patients were vaccinated in our center from the first dose because of past allergic reactions to other medication or due to concomitant mast cell disorder. All patients were vaccinated without any immediate adverse reactions. ConclusionsNone of our patients experienced repeated cutaneous reactions after the second dose. Patients with previous anaphylaxis or mastocytosis also were safely vaccinated.
Cutaneous fungal infections are common and widespread. Antifungal agents used for the treatment of these infections often have undesirable side effects. Furthermore, increased resistance of the ...microorganisms to the antifungal drugs becomes the growing problem. Accordingly, the search for natural antifungal compounds continues to receive attention. Apoptosis is highly regulated programmed cell death. During yeast cell apoptosis, amino acids and peptides are released and can stimulate regeneration of human epithelium cells. Thus, detection of chemical compounds inducing apoptosis in yeast and nontoxic for humans is of great medical relevance. The aim of this study was to detect chemical compound inducing apoptosis in pathogenic Candida species with the lowest toxicity to the mammalian cells. Five chemical compounds—acetic acid, sodium bicarbonate, potassium carbonate, lithium acetate, and formic acid—were tested for evaluation of antifungal activity on C. albicans, C. guilliermondii, and C. lusitaniae. The results showed that acetic acid and formic acid at the lowest concentrations induced yeast cells death. Apoptosis analysis revealed that cells death was accompanied by activation of caspase. Minimal inhibitory concentrations of potassium carbonate and sodium bicarbonate induced Candida cells necrosis. Toxicity test with mammalian cell cultures showed that formic acid has the lowest effect on the growth of Jurkat and NIH 3T3 cells. In conclusion, our results show that a low concentration of formic acid induces apoptosis-like programmed cell death in the Candida yeast and has a minimal effect on the survivability of mammalian cells, suggesting potential applications in the treatment of these infections.
Allergic contact dermatitis (ACD) is an inflammatory skin disease caused by repeated skin exposure to contact allergens. The severity and duration of this disease are associated with many different ...factors. Some of these factors may represent markers for monitoring disease activity and the individual response to an intervention.
We used a targeted metabolomics approach to find such factors in the serum of individuals with ACD. Metabolomics profiles were examined and compared in the acute phase of the disease and also in the absence of disease activity.
Our study identified a significant remission phase of ACD-associated systemic biochemical shifts in 2 metabolic pathways: tryptophan-kynurenine and phenylalanine-tyrosine.
Although the responsible mechanisms are unclear, these results suggest that the remission phase of ACD is linked to tryptophan metabolism via kynurenine and phenylalanine-tyrosine pathways. However, further replication studies with a larger number of subjects and their subgroups are necessary to validate our results. These studies may provide a new perspective with which to understand the mechanism of and find potential biomarkers of ACD, as well as a new reference for personalized treatment.
Allergic contact dermatitis (ACD) is an inflammatory skin disease caused by repeated skin exposure to contact allergens. The goal of this pilot study was to identify inflammatory proteins which can ...serve as biomarkers for ACD.
We measured levels of 102 cytokines, chemokines, and growth factors in the sera of 16 ACD patients during acute and remission phases, and 16 healthy volunteers.
Serum levels of adiponectin, chemokine (C-C motif) ligand 5 (CCL5), C-reactive protein (CRP), chitinase 3-like 1 (CHI3L1), complement factor D (CFD), endoglin, lipocalin-2, osteopontin, retinol-binding protein 4 (RBP4), and platelet factor 4 (PF4) were significantly higher, whereas levels of trefoil factor 3 (TFF3) were significantly lower, in ACD patients than in healthy controls. In ACD patients, serum levels of CCL5 were elevated, whereas levels of TFF3, soluble intercellular adhesion molecule-1 (sICAM-1), and platelet-derived growth factor (PDGF)-AB/BB were found to be lower during the remission phase of the disease.
Serum levels of adiponectin, CCL5, CRP, CHI3L1, CFD, endoglin, lipocalin-2, osteopontin, RBP4, PF4, and TFF3 might be exploited as biomarkers for ACD, whereas levels of CCL5, TFF3, sICAM-1, and PDGF-AB/BB might be exploited for evaluation of disease progression and efficacy of ACD treatment.
A study was performed to assess the time between drug intake and drug induced hypersensitivity reaction for patients sensitive to nonsteroidal antiinflammatory drugs (NSAID) in clinical patient ...history and after oral provocation tests. Drug hypersensitivity ENDA questionnaires were filled for the patients with suspected sensitivity to NSAID. Oral provocation tests were performed with suspected NSAID according to the ENDA/EAACI recommendations. There were 76 patients with history of hypersensitivity reactions after use of NSAID enrolled in the study. Recorded were 154 hypersensitivity reactions to NSAID in the clinical history. In the clinical history median time of immediate reactions (76 cases, 81%) between drug intake and bronchospasm was 20 minutes 15-30 minutes. Median time of nonimmediate reactions (18 cases, 19%) was 120 minutes 120-390 minutes. There were 50 oral provocation tests performed, 14 of them (28%) were positive. Median time between drug intake and immediate reactions (8; 57% of cases) was 22.5 minutes 20-30 minutes and median time of nonimmediate reactions (6; 43% of cases) was 167.5 minutes 125-206.25 minutes. Time delay between drug intake and bronchospasm in the clinical history and after oral provocation test was not statistically different.
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