Oxidative stress (OS) plays an important role in a variety of physiological and pathological processes of the female reproductive system. In recent years the relationship between OS and endometriosis ...has been of particular interest, and a theory has been suggested that OS may be a cause of endometriosis development. While the link between endometriosis and infertility is well established, minimal or mild stages of endometriosis are not considered to cause infertility. Increasing evidence of OS as a leading agent in the development of endometriosis has brought up a theory of minimal/mild endometriosis itself being one of the manifestations of high OS rather than a separate disease which directly causes infertility. Moreover, further development of the disease is thought to contribute to an increased production of reactive oxygen species (ROS) thus leading to the progression of endometriosis itself as well as to other pathological processes in the female reproductive system. Therefore, in case of minimal or mild endometriosis, the less invasive treatment could be offered in order to stop the ongoing cycle of endometriosis-reinforced excess ROS production and to reduce their harmful effects. In this article the existing connection between OS, endometriosis, and infertility is explored.
The school environment is crucial for the child’s health and well-being. On the other hand, the data about the role of school’s aerosol pollution on the etiology of chronic non-communicable diseases ...remain scarce. This study aims to evaluate the level of indoor aerosol pollution in primary schools and its relation to the incidence of doctor’s diagnosed asthma among younger school-age children. The cross-sectional study was carried out in 11 primary schools of Vilnius during 1 year of education from autumn 2017 to spring 2018. Particle number (PNC) and mass (PMC) concentrations in the size range of 0.3–10 µm were measured using an Optical Particle Sizer (OPS, TSI model 3330). The annual incidence of doctor’s diagnosed asthma in each school was calculated retrospectively from the data of medical records. The total number of 6–11 years old children who participated in the study was 3638. The incidence of asthma per school ranged from 1.8 to 6.0%. Mean indoor air pollution based on measurements in classrooms during the lessons was calculated for each school. Levels of PNC and PMC in schools ranged between 33.0 and 168.0 particles/cm
3
and 1.7–6.8 µg/m
3
, respectively. There was a statistically significant correlation between the incidence of asthma and PNC as well as asthma and PMC in the particle size range of 0.3–1 µm (
r
= 0.66,
p
= 0.028) and (
r
= 0.71,
p
= 0.017) respectively. No significant correlation was found between asthma incidence and indoor air pollution in the particle size range of 0.3–2.5 and 0.3–10 µm.
Conclusion
: We concluded that the number and mass concentrations of indoor air aerosol pollution in primary schools in the particle size range of 0.3–1 µm are primarily associated with the incidence of doctor’s diagnosed asthma among younger school-age children.
What is Known:
• Both indoor and outdoor aerosol pollution is associated with bronchial asthma in children.
What is New:
• The incidence of bronchial asthma among younger school age children is related to indoor air quality in primary schools.
• Aerosol pollutants in the size range of 0.3–1 µm in contrast to larger size range particles can play major role in the etiology of bronchial asthma in children.
DRESS syndrome is defined as drug-induced hypersensitivity syndrome with rash, eosinophilia, and systemic symptoms. This syndrome is mostly associated with anticonvulsants, antibacterial and ...anti-inflammatory drugs. DRESS syndrome is a rare disease and is more frequently seen in adults. We present the first case report of DRESS syndrome in an 8-year-old girl, after 3 months of treatment with isoniazid and rifampicin. After discontinuation of drugs and a short course of prednisolone the girl recovered. After 5 years of follow-up, she is healthy and has no complaints but patch tests with isoniazid and rifampicin remain positive. The reported case emphasizes the importance of thorough medical history and including drug reactions in differential diagnosis.
Background: Intradermal tests (IDTs) are performed and interpreted differently in drug allergy centers making valid comparison of results difficult.Objective: To reduce method-related and intercenter ...variability of IDTs by the introduction of a standardized method.Materials and methods: In 11 centers of the European Network for Drug Allergy, IDTs were prospectively performed with saline and with amoxicillin (20 mg/ml) using (1) the local method and (2) the standardized European Network in Drug Allergy (ENDA) method (0.02 ml). The diameters of the initial injection wheal (Wi) for the different volumes and sites injected obtained from each center were analyzed.Results: The most reproducible method was to fill a syringe with test solution, then expel the excess fluid to obtain exactly 0.02 ml. The median Wi diameter with 0.02 ml injection using the standardized method was 5 mm range 2–10 mm; interquartile range (IQR) 5–5 mm; n = 1,096 for saline and 5 mm (range 2–9 mm; IQR = 4.5–5 mm; n = 240) for amoxicillin. IDT injection sites did not affect the Wi diameter. Training improved precision and reduced the variability of Wi diameters.Conclusion: Using the standardized IDT method described in this multicenter study helped to reduce variability, enabling more reliable comparison of results between individuals and centers.
To the editor, Real-world data obtained by the MASK-air® (Mobile Airways Sentinel networK for airway diseases) app have had an impact on the knowledge about the phenotypes and management of ...respiratory allergic diseases. 1 Studies assessing MASK-air® data have traditionally included users ranging in age from 16 to over 90 years, and a recent paper has shown that elderly users (≥65 years) can use the MASK-air® app after a short training period. 2 However, it is not known whether the characteristics of elderly users differ from those of younger users. 2 For comparison of different age groups, effect size measures for differences in proportions and medians were estimated. TABLE 2 Characteristics and outcomes of the days from assessed MASK-air® users with self-reported rhinitis according to the age group A. Comparison of days from patients under versus above 65 years Days from patients aged <65 years (N = 333,395) Days from patients aged ≥65 years (N = 15,650) Effect size a N users (average days per user) 19,369 (17.2) 519 (30.2) - MASK-air® adherence (%)—median (IQR) 0.3 (1.3) 0.4 (1.6) - Females—N (%) 192,513 (57.7) 5154 (32.9) 0.50 Age—mean (SD) 36.5 (12.6) 68.4 (3.0) - VAS global allergy symptoms—median (IQR) 12 (27) 13 (20) 0.06 VAS nose—median (IQR) 12 (28) 13 (21) 0.06 VAS eyes—median (IQR) 4 (17) 7 (22) 0.36 VAS asthma—median (IQR) All users 0 (10) b 1 (11) b 0.95 Users with reported asthma 7 (22) 14 (37) 0.48 Allergic rhinitis CSMS b—median (IQR) 10 (18) 11 (16) 0.06 Total days reporting rhinitis medication—N (%) 156,311 (46.9) 7193 (46.0) 0.02 Oral antihistamines monotherapy 57,097 (17.1) 2031 (13.0) 0.12 Intranasal steroids monotherapy 31,901 (9.6) 1539 (9.8) 0.01 Azelastine-fluticasone monotherapy 12,100 (3.6) 1042 (6.7) 0.14 Oral antihistamines + intranasal steroids 31,092 (9.3) 1346 (8.6) 0.03 Azelastine-fluticasone + other rhinitis medication 11,415 (3.4) 478 (3.1) 0.02 Allergen immunotherapy c—N (%) 103,792 (31.1) 4593 (29.3) 0.04 Self-reported asthma—N (%) 126,201 (37.9) 5490 (35.1) 0.06 Total days reporting asthma medication—N (%) 68,313 (20.5) 3938 (25.2) 0.11 SABA 8647 (2.6) 408 (2.6) 0 ICS 25,738 (7.7) 1484 (9.5) 0.06 ICS + LABA 37,457 (11.2) 2806 (17.9) 0.19 LAMA or biologics 2387 (0.7) 40 (0.3) 0.06 Other medications 14,979 (4.5) 829 (5.3) 0.04 Conjunctivitis—N (%) 240,481 (72.1) 10,347 (66.1) 0.13 Baseline symptoms d—median (IQR) 5 (3) 4 (4) 0.34 Baseline impact e—median (IQR) 1 (3) 1 (3) 0 B. Comparison of days from patients aged 65–74 years versus over 75 years Days from patients aged 65–74 years (N = 15,038) Days from patients aged ≥75 years (N = 612) Effect size a N users (average days per user) 455 (33.1) 70 (8.7) - MASK-air® adherence (%)—median (IQR) 0.4 (1.6) 0.2 (0.9) - Females—N (%) 4991 (33.2) 163 (26.6) 0.14 Age—mean (SD) 68.0 (2.4) 76.8 (2.2) - VAS global allergy symptoms—median (IQR) 13 (20) 16 (25) 0.23 VAS nose—median (IQR) 13 (21) 15 (23) 0.15 VAS eyes—median (IQR) 7 (22) 13 (20) 0.47 VAS asthma—median (IQR) All users 1 (10) c 9 (22) c 0.84 Users with reported asthma 14 (37) 11 (39) 0.18 Allergic rhinitis CSMS b—median (IQR) 10 (16) 15 (21) 0.42 Total days reporting rhinitis medication—N (%) 6752 (44.9) 441 (72.1) 0.56 Oral antihistamines monotherapy 1867 (12.4) 164 (26.8) 0.37 Intranasal steroids monotherapy 1519 (10.1) 20 (3.3) 0.28 Azelastine-fluticasone monotherapy 943 (6.3) 99 (16.2) 0.32 Oral antihistamines + intranasal steroids 1308 (8.7) 38 (6.2) 0.10 Azelastine-fluticasone + other rhinitis medication 395 (2.6) 83 (13.6) 0.43 Allergen immunotherapy c—N (%) 4593 (30.5) 0 (0) 1.17 Self-reported asthma—N (%) 5120 (34.0) 370 (60.5) 0.54 Total days reporting asthma medication—N (%) 3775 (25.1) 163 (26.6) 0.03 SABA 345 (2.3) 63 (10.3) 0.35 ICS 1429 (9.5) 55 (9.0) 0.02 ICS + LABA 2709 (18.0) 97 (15.9) 0.06 LAMA or biologics 37 (0.2) 3 (0.5) 0.05 Other medications 766 (5.1) 63 (10.3) 0.20 Conjunctivitis—N (%) 9894 (65.8) 453 (74.0) 0.18 Baseline symptoms d—median (IQR) 4 (4) 4 (4) 0 Baseline impact e—median (IQR) 1 (3) 1 (2) 0 Abbreviations: CSMS, Combined symptom-medication score; ICS, Inhaled corticosteroids; IQR, Interquartile range; LABA, Long-acting beta-agonists; LAMA, Long-acting muscarinic antagonists; SABA, Short-acting beta-agonists; SD, Standard-deviation; VAS, Visual analogue scale. aEffect size measures <0.2 indicate non-meaningful differences, between 0.2 and 0.5 indicate small differences, between 0.5 and 0.8 indicate moderate differences, and higher than 0.8 indicate large differences. bThe CSMS ranges from 0 to 100. Comparing days from users 65–74 years of age with those ≥75 (Table 2B), we observed small and moderate effect size measures in some clinical, medication and symptom-related variables.
BACKGROUND In this paper we report on the link between increased tryptase levels and prevalence of allergen-specific immunoglobulin E (IgE) in patients with anaphylaxis. The main aim of the study was ...to assess the corelation between elevated tryptase levels and allergen-specific immunoglobulin E (IgE) in anaphylactic reactions, mastocytosis, and other types of allergic reactions. MATERIAL AND METHODS We enrolled 60 adult patients, aged 18-68 years (mean age 45±8 years). The subjects were divided into 3 groups (20 patients in each group) according to the serum tryptase changes: group 1 consisted of patients with anaphylaxis (serum tryptase level ≥11.4 µg/l), group 2 consisted of patients with mastocytosis (serum tryptase level ≥20.0 µg/l), and group 3 consisted of patients with other allergic reactions with no anaphylaxis as an atopic control group (serum tryptase level <11.4 µg/l). The test material was venous blood serum samples. The allergen-specific IgE assay was carried out by immunoblot. Tryptase concentration was determined by immunoenzymatic assay. RESULTS Allergen-specific IgE was found in 73% of all subjects: 75% in the anaphylactic group, 55% in the mastocytosis group, and 90% in the atopic control group. Polysensitization was common and was significantly different among groups. In the atopic group, there were more patients allergic to 4-7 allergens (P<0.05). CONCLUSIONS We did not find a strong correlation between allergen-specific IgE levels and elevated tryptase levels.
This literature review discusses the use of mHealth technologies and telemedicine for monitoring various allergic diseases both in everyday life and in the context of COVID-19. Telemedicine, whose ...popularity, and demand has skyrocketed during the pandemic, rely on mHealth technologies, video calls and websites as a resource-saving and safe way of consulting patients. The incorporation of new mHealth technologies into telemedicine practice may not only be relevant in the context of pandemic restrictions but can also be applied in everyday medical practice as an effective method of patient counseling. The mobile healthcare applications include a wide range of mobile apps for patients' education, monitoring, and disease management. However, applications for the people with food allergies lack relevant information about allergies and, like most other applications, are developed without the contribution of healthcare specialists. During the COVID-19 pandemic, low-risk food-allergic patients were able to rely on telemedicine services where they could get the help, they needed without increasing risk of contracting COVID-19 while saving time. Meanwhile, some applications for allergic rhinitis and asthma patients are showing practical benefits in clinical trials by allowing an efficient assessment of treatment regimens and efficacy. The use of digital symptom diaries further facilitates the implementation of real-life studies. However, for respiratory allergic diseases, the often insufficient quality of pollen prediction needs to be taken into account. Even though studies have shown that asthma is better controlled with mHealth technologies, the quality of mobile apps for asthma patients varies widely, as many products provide information that has not been scientifically proven. Inhaler sensors – have been shown to improve the course of asthma and its monitoring, while push notifications prompting people to take their medication double the likelihood of treatment adherence. Teledermatology has a high level of patient satisfaction – as it is perceived as a more time-saving method of consultation. However, the diagnostic accuracy of contact consultations remains higher. mHealth technologies provide a patient's health data from his/her daily life, which enables insights into behavioral patterns. This closer look at the daily routine can have a significant impact on developing individualized treatment and care guidelines.
Here, we describe a case of anaphylaxis secondary to rivaroxaban in a 61-year-old woman 24 hours after orthopedic surgery. 10-15 minutes after ingestion of rivaroxaban and nimesulide, the patient's ...palms started itching, her face and lips swelled, her face flushed, she developed shortness of breath and subsequently lost consciousness. Serum tryptase levels at the time of the anaphylactic reaction were elevated, with subsequent measurement one month later returning a value within the normal range. Dabigatran and meloxicam were identified as suitable alternative drugs by oral provocation at an allergy clinic. Even though rivaroxaban rarely causes serious allergic reactions, when prescribing it, it is important to analyze patients' medical history for possible previously experienced drug-induced allergic reactions and to be aware of the risks of possible undesired drug interactions. Keywords: Xarelto, anticoagulant, DOAC, adverse drug reaction, allergy
Background
House dust mite (HDM) allergy is a prevalent global health concern, with varying sensitization profiles observed across populations. We aimed to provide a comprehensive assessment of ...molecular allergen sensitization patterns in the Lithuanian population, with a focus on Dermatophagoides pteronyssinus (Der p), and investigate patterns of concomitant reactivity among different allergens to enhance the accuracy of HDM allergy diagnostics.
Methods
A comprehensive analysis of 1520 patient test results in Lithuania from 2020 to 2022 was performed. Sensitization patterns to major (Der p 1, Der p 2, and Der p 23) and minor (Der p 5, Der p 7, and Der p 21) Der p allergen components were described using molecular‐based diagnostics. Additionally, we investigated sensitization to allergen components from other allergen sources, including tropomyosins (Der p 10, Per a 7, Pen m 1, Ani s 3, Blo t 10) and arginine kinases (Pen m 2, Bla g 9, Der p 20).
Results
This study reveals a high prevalence of HDM sensitization in Lithuania ‐ 481 individuals (45.38% of the sensitized group) exhibited sensitization to at least one Der p allergen component. Importantly, within the sensitized group, 37.21% of patients were sensitized to Der p 5, Der p 7, or Der p 21 in addition to major allergenic components. Distinct sensitization patterns were observed across different age groups, indicating the influence of age‐related factors. Furthermore, we confirmed cross‐reactivity between Der p 5 and Blo t 5 as well as between Der p 21 and Blo t 21, emphasizing the clinical relevance of these associations. We also highlighted the complexity of sensitization patterns among tropomyosins and arginine kinases.
Conclusion
This study provides valuable insights into HDM allergy sensitization profiles in Lithuania, emphasizing the importance of considering major and minor HDM allergen components for accurate diagnosis and management of HDM‐related allergic diseases. Differences between populations and age‐related factors impact sensitization patterns. Understanding concomitant reactivity among allergens, such as Der p 5 and Blo t 5, Der p 21 and Blo t 21, tropomyosins, and arginine kinases, is crucial for improving diagnostic strategies and developing targeted interventions for allergic individuals.
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