Allergy immunotherapy targets the immunological cause of allergic rhinoconjunctivitis and allergic asthma and has the potential to alter the natural course of allergic disease.
The rates of childhood allergic conditions are changing, prompting the need for continued surveillance. Examination of healthcare provider-based diagnosis data is an important and lacking methodology needed to complement existing studies that rely on participant reporting.
Single BCG vaccination has been considered as a protective factor against asthma. However the effect of a second dose of BCG on the prevalence rate of asthma and asthma-allergic rhinitis-eczema comorbidity has not been studied exclusively among adolescents. In this ISAAC protocol-based cross sectional study we assessed the association between one single versus two doses of BCG among 2213 individuals aged 13-14 years old. We found no association between BCG revaccination and asthma, associated (OR = 0.68, 95% CI, 0.37-1.25) or not to allergic rhinitis and/or atopic eczema (OR = 1.07, 95% CI, 0.84-1.36).
Allergic rhinitis is the most common atopic disorder seen in ENT clinics. It is diagnosed by history, physical exam and objective testing. Patient education, environmental control measures, pharmacotherapy, and allergen-specific immunotherapy are the cornerstones of allergic rhinitis treatment and can significantly reduce the burden of disease. Current treatment guidelines include antihistamines, intranasal corticosteroids, oral and intranasal decongestants, intranasal anticholinergics, intranasal cromolyn, and leukotriene receptor antagonists. In the mechanism of allergic rhinitis, histamine is responsible for major allergic rhinitis symptoms such as rhinorrhea, nasal itching and sneezing. Its effect on nasal congestion is less evident. In contrast, leukotrienes result in increase in nasal airway resistance and vascular permeability. Antihistamines and leukotriene receptor antagonists are commonly used in the treatment of allergic rhinitis. The published literature about combined antihistamines and leukotriene antagonists in mono- or combination therapy is reviewed and presented.
Google Trends is a web-based surveillance tool used to explore the searching trends of specific queries on Google. Recent studies have suggested the utility of Google Trends in predicting outbreaks of influenza and other diseases. However, this utility has not been thoroughly evaluated for allergic diseases. Therefore, we investigated the utility of Google Trends for predicting the epidemiology of allergic rhinitis. In the US, Google Trends for allergic rhinitis showed repetitive seasonality that peaked in late April and early May and then rapidly decreased, and a second small peak occurred in September. These trends are highly correlated with the searching trends for other queries such as ‘pollen count’, antihistamines such as loratadine and cetirizine (all r > 0.88 and all P < 0.001), and even the total pollen count collected from 21 pollen counters across the US (r = 0.928, P < 0.001). Google Trends for allergic rhinitis was similar to the monthly changes in rhinitis symptoms according to the US National Health and Nutrition Examination Survey III, sales for Claritin(®) and all over-the-counter antihistamines, and the number of monthly page views of 'claritin. com'. In conclusion, Google Trends closely reflects the real world epidemiology of allergic rhinitis in the US and could potentially be used as a monitoring tool for allergic rhinitis. This article is protected by copyright. All rights reserved.
Antrochoanal polyp is a benign polypoid lesion orginating from the maxillary sinus antrum and extending to the choana. Our aim was to assess the clinical presentation and associated rhinological findings of antrochoanal polyp patients and to evaluate results of 2 surgical treatments termed endoscopic sinus surgery (ESS) and ESS plus mini-Caldwell operation. The study included 46 patients. Factors such as patient age, sex, history of chronic sinusitis, allergic rhinitis, septal deviations, chonca bullosa, turbinate hypertrophy, and the origin of the polyp were assessed. We also evaluated ESS and ESS plus mini-Caldwell surgical procedures for recurrences, synechia, bleeding, and ostium stenosis. Overall, there were 27 men and 19 women. The ESS approach was used in 26 cases, and 20 cases had combined ESS and mini-Caldwell procedures. The statistical significant difference between the 2 groups was only recurrence (P ≤ 0.05). In the ESS group, bleeding, synechia, and ostium stenosis were seen more than in the ESS + mini-Caldwell group, but there was no significant difference between the 2 groups in bleeding, synechia, and ostium stenosis (P > 0.05). We thought that lower rate of recurrence found in ESS + Caldwell group in this study was associated with better visualization of the maxillary sinus walls and, therefore, easier resection of the remnant polyp. We concluded that higher incidences of bleeding and synechia were related to the mucosal damage occurring in the septum and the inferior concha due to excessive manipulation of endoscope and surgical instruments.
BACKGROUND: Certain foods may increase or decrease the risk of developing asthma, rhinoconjunctivitis and eczema. We explored the impact of the intake of types of food on these diseases in Phase Three of the International Study of Asthma and Allergies in Childhood. METHODS: Written questionnaires on the symptom prevalence of asthma, rhinoconjunctivitis and eczema and types and frequency of food intake over the past 12 months were completed by 13-14-year-old adolescents and by the parents/guardians of 6-7-year-old children. Prevalence ORs were estimated using logistic regression, adjusting for confounders, and using a random (mixed) effects model. RESULTS: For adolescents and children, a potential protective effect on severe asthma was associated with consumption of fruit ≥3 times per week (OR 0.89, 95% CI 0.82 to 0.97; OR 0.86, 95% CI 0.76 to 0.97, respectively). An increased risk of severe asthma in adolescents and children was associated with the consumption of fast food ≥3 times per week (OR 1.39, 95% CI 1.30 to 1.49; OR 1.27, 95% CI 1.13 to 1.42, respectively), as well as an increased risk of severe rhinoconjunctivitis and severe eczema. Similar patterns for both ages were observed for regional analyses, and were consistent with gender and affluence categories and with current symptoms of all three conditions. CONCLUSIONS: If the association between fast foods and the symptom prevalence of asthma, rhinoconjunctivitis and eczema is causal, then the findings have major public health significance owing to the rising consumption of fast foods globally.
The role of early-life vitamin D in childhood allergy is controversial.
Past evidence has suggested a role of artificial sweeteners in allergic disease; yet, the evidence has been inconsistent and unclear.
One of the most challenging aspects of the clinical management of asthma is determining how to treat patients whose condition is poorly controlled despite the use of inhaled glucocorticoids and long-acting beta-agonists (LABAs). Although most patients have a response to these treatments, it is estimated that asthma remains poorly controlled in as many as 20% of patients who use combination therapy.(1) Mainstays of the management of difficult-to-control asthma include increased adherence to treatment, avoidance of allergens and other exacerbating factors, and control of common coexisting conditions such as gastrointestinal reflux, postnasal drip, and sinusitis. Other adjuvant therapies currently available include . . .