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Incidence of Olfactory Dysfunction in Patients with COVID-19 in a Tertiary Hospital in Saudi Arabia. 沙特某三级医院新冠肺炎患者嗅觉功能障碍发生率分析
IF 2.2
Allergy & Rhinology Pub Date : 2022-11-25 eCollection Date: 2022-01-01 DOI: 10.1177/21526575221140809
Rayan Alfallaj, Ghada AlSkait, Nouf Alamari, Lama Alfawzan, Mohammed Abualgasem, Naif H Alotaibi, Ibrahim Sumaily, Ibrahim Alarifi, Saad Alsaleh
{"title":"Incidence of Olfactory Dysfunction in Patients with COVID-19 in a Tertiary Hospital in Saudi Arabia.","authors":"Rayan Alfallaj,&nbsp;Ghada AlSkait,&nbsp;Nouf Alamari,&nbsp;Lama Alfawzan,&nbsp;Mohammed Abualgasem,&nbsp;Naif H Alotaibi,&nbsp;Ibrahim Sumaily,&nbsp;Ibrahim Alarifi,&nbsp;Saad Alsaleh","doi":"10.1177/21526575221140809","DOIUrl":"https://doi.org/10.1177/21526575221140809","url":null,"abstract":"<p><strong>Background: </strong>Coronavirus disease (COVID-19) is caused by the severe acute respiratory syndrome coronavirus 2, a novel virus that emerged in China in December 2019. In many cases of COVID-19, olfactory dysfunction (OD) is the only symptom.</p><p><strong>Objectives: </strong>This study aimed to examine the incidence of OD in patients with COVID-19 and identify an association between OD and COVID-19-related morbidity and admission.</p><p><strong>Design: </strong>This was a cross-sectional study.</p><p><strong>Methods: </strong>Real-time reverse transcription polymerase chain reaction-confirmed cases of COVID-19 from the Security Forces Hospital electronic registry from June 2020 to September 2020 were included in our study. Data on medical background, severity of the disease, and other related factors were collected through phone calls and electronic healthcare systems and analyzed to investigate OD in the participants.</p><p><strong>Results: </strong>Of the participants, 68% had OD, with a mean recovery time of 18 days and a mean follow-up time of 129 days (76-211 days). OD was negatively correlated with admission and morbidity.</p><p><strong>Conclusion: </strong>OD is a common presentation of COVID-19 and is more prevalent in mild cases of infection.</p>","PeriodicalId":45192,"journal":{"name":"Allergy & Rhinology","volume":" ","pages":"21526575221140809"},"PeriodicalIF":2.2,"publicationDate":"2022-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/23/f4/10.1177_21526575221140809.PMC9703475.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40491210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Inverted Papilloma of the Middle Ear: Two New Cases and Systematic Review. 中耳内翻性乳头状瘤:2例新病例及系统回顾。
IF 2.2
Allergy & Rhinology Pub Date : 2022-10-26 eCollection Date: 2022-01-01 DOI: 10.1177/21526575221130711
Peter L Miller, Erika Walsh, Do-Yeon Cho, Bradford A Woodworth, Jessica W Grayson
{"title":"Inverted Papilloma of the Middle Ear: Two New Cases and Systematic Review.","authors":"Peter L Miller,&nbsp;Erika Walsh,&nbsp;Do-Yeon Cho,&nbsp;Bradford A Woodworth,&nbsp;Jessica W Grayson","doi":"10.1177/21526575221130711","DOIUrl":"https://doi.org/10.1177/21526575221130711","url":null,"abstract":"<p><strong>Introduction: </strong>Inverted papillomas of the middle ear are extremely rare tumors that carry an increased risk of recurrence and malignant transformation. There are currently 59 cases of middle ear inverted papillomas reported in the literature. The objective in this study was to systematically evaluate outcomes regarding middle ear inverted papillomas with respect to demographics, anatomical tumor sites, malignant transformation status, recurrence rate and HPV status.</p><p><strong>Study design: </strong>Retrospective case series and systematic review.</p><p><strong>Methods: </strong>A systematic review was completed on June 25, 2020 with a search strategy including PubMed, Embase, Scopus and Google Scholar. This revealed 181 articles. Full-text review was completed, and 66 articles were included. 115 articles were eliminated due to duplication of articles from databases, article titles not applicable to the aims of the systematic review and articles describing inverted papilloma of body sites other than middle ear.</p><p><strong>Discussion: </strong>Thirty-one cases of primary inverted papillomas of the middle ear were found in the literature with an additional 26 cases of secondary tumors. Four case reports did not specify primary versus secondary. The malignant transformation rate was 34.4% with a 53.6% recurrence rate. Treatment of middle ear inverted papillomas is primarily surgical with adjuvant radiation therapy considered for patients with recurrence or malignant transformation. Frequent clinical follow up of these patients is critical due to the increased rate of recurrence and malignant transformation.</p><p><strong>Conclusion: </strong>Inverted papillomas of the middle ear are rare tumors that carry a high risk of recurrence and malignant transformation necessitating complete resection and frequent clinical follow up.</p>","PeriodicalId":45192,"journal":{"name":"Allergy & Rhinology","volume":" ","pages":"21526575221130711"},"PeriodicalIF":2.2,"publicationDate":"2022-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3e/2e/10.1177_21526575221130711.PMC9618760.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40443701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Management Strategy of Intracranial Complications of Sinusitis: Our Experience and Review of the Literature. 鼻窦炎颅内并发症的处理策略:我们的经验及文献复习。
IF 2.2
Allergy & Rhinology Pub Date : 2022-09-25 eCollection Date: 2022-01-01 DOI: 10.1177/21526575221125031
Bassel Hallak, Salim Bouayed, Joseph André Ghika, Pedro S Teiga, Vincent Alvarez
{"title":"Management Strategy of Intracranial Complications of Sinusitis: Our Experience and Review of the Literature.","authors":"Bassel Hallak,&nbsp;Salim Bouayed,&nbsp;Joseph André Ghika,&nbsp;Pedro S Teiga,&nbsp;Vincent Alvarez","doi":"10.1177/21526575221125031","DOIUrl":"https://doi.org/10.1177/21526575221125031","url":null,"abstract":"<p><strong>Objective: </strong>Sinusitis or rhinosinusitis is a very common disease worldwide, and in some cases, it leads to intracranial complications (ICS). These are more common in immunocompromised patients or with underlying comorbidities, but even healthy individuals, can be affected. Nowadays, ICS have become less common thanks to improved antibiotic therapies, radiological diagnostic methods, surgical techniques and skills. Nonetheless, they can still cause significant morbidity and mortality. For this reason, management of these complications requires a multidisciplinary approach to plan and customize treatment options. This paper presents our strategy in the management of a series of intracranial complications induced by acute sinusitis and compares our experience and outcomes with the literature.</p><p><strong>Study design: </strong>Single institute experience, retrospective analysis of cases series and literature review.</p><p><strong>Methods: </strong>Adult and child patients who were treated for ICS in the Department of Otorhinolaryngology at Sion Hospital, in Switzerland from 2016 to 2020 were included. Their symptoms, medical history, clinical and radiological findings, treatment, and outcome were documented.</p><p><strong>Results: </strong>Eight patients (6 males- 2 females) aged from 14 to 88 y.o., were enrolled. None had any previous history of chronic, or recurrent sinusitis. Moreover, very few presented specific rhinological symptoms, but with neurological or other symptoms. Computed tomography (CT) and Magnetic Resonance Imaging (MRI) were used to confirm the diagnosis of all ICS. All types of known intracranial complications were observed in our cohort with a wide range of extension and severity of sinusitis. A multidisciplinary approach with individual treatments was tailored to each patient. Outcomes were favorable in almost all patients with neither recurrence, nor neurological sequels being observed in the follow-up. Only one patient was lost due to fatal complications of advanced lung cancer.</p><p><strong>Conclusion: </strong>ICS remain a challenging clinical problem due to substantial associated morbidity and mortality. The incidence of these complications is relatively low. Therapeutical management guidelines are lacking. Early detection and multidisciplinary approach are key to successful treatment.</p>","PeriodicalId":45192,"journal":{"name":"Allergy & Rhinology","volume":" ","pages":"21526575221125031"},"PeriodicalIF":2.2,"publicationDate":"2022-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5c/e7/10.1177_21526575221125031.PMC9513574.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40384583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
A Practical Clinical Protocol for Monitoring Patients with Severe Uncontrolled Chronic Rhinosinusitis with Nasal Polyposis Treated with Biologics. 生物制剂治疗严重不受控制的慢性鼻窦炎合并鼻息肉的临床监测实用方案。
IF 2.2
Allergy & Rhinology Pub Date : 2022-01-31 eCollection Date: 2022-01-01 DOI: 10.1177/21526567221074335
Stefano Millarelli, Antonella Loperfido, Fulvio Mammarella, Cristina Giorgione, Alessandra Celebrini, Massimiliano Del Ninno, Gianluca Bellocchi
{"title":"A Practical Clinical Protocol for Monitoring Patients with Severe Uncontrolled Chronic Rhinosinusitis with Nasal Polyposis Treated with Biologics.","authors":"Stefano Millarelli,&nbsp;Antonella Loperfido,&nbsp;Fulvio Mammarella,&nbsp;Cristina Giorgione,&nbsp;Alessandra Celebrini,&nbsp;Massimiliano Del Ninno,&nbsp;Gianluca Bellocchi","doi":"10.1177/21526567221074335","DOIUrl":"https://doi.org/10.1177/21526567221074335","url":null,"abstract":"<p><strong>Objectives: </strong>Chronic rhinosinusitis with nasal polyposis (CRSwNP) is a pathological condition which leads to high healthcare-related costs and low quality of life for patients. The introduction of new biological therapies (monoclonal antibodies, MAbs) in CRSwNP patients has allowed new therapeutic options for non-responders to conventional therapies and Dupilumab represents the first approved biological agent. The aim of this paper is to provide a practical clinical multidisciplinary protocol which might help clinicians involved in this field to monitor the clinical outcomes.</p><p><strong>Methods: </strong>Our centre of Rhinology and Rhino-Allergology has developed a dedicated collection form to observe the outcomes of patients treated with Dupilumab. Our research started from the indications given in EPOS 2020 as main reference. We then implemented these references in an electronic database trying to apply Evidence Based Medicine (EBM) in current clinical practice.</p><p><strong>Results: </strong>The result consists of three parts: an anamnestic collection data, a clinician reported outcome and two patient reported outcomes (PROMs) questionnaire, the visual analogue scale (VAS) and the Sino-Nasal Outcome Test-22 (SNOT-22). The tables we propose should provide an adequate correlation with the patients' adherence to therapy and their treatment outcomes. Such periodical evaluation (after a month, after 3 months, after 6 months and at one year) should quickly allow to monitor if the patient is correctly assuming the therapy and the eventual objective improvements.</p><p><strong>Conclusions: </strong>We propose a practical monitoring protocol formulated to analyse both objective and subjective aspects of patients with severe uncontrolled CRSwNP treated with MAbs, thus helping to define in future a better comparison between the clinical results of different institutes.</p>","PeriodicalId":45192,"journal":{"name":"Allergy & Rhinology","volume":" ","pages":"21526567221074335"},"PeriodicalIF":2.2,"publicationDate":"2022-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/21/91/10.1177_21526567221074335.PMC8808004.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39597591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 5
Recurrent Bilateral Lime Disease in a Young Female- Case Report. 年轻女性双侧复发性石灰病1例报告。
IF 2.2
Allergy & Rhinology Pub Date : 2022-01-24 eCollection Date: 2022-01-01 DOI: 10.1177/21526567221074944
Lakshmi Nagireddi, Rachel Raimondo, Robert Hostoffer
{"title":"Recurrent Bilateral Lime Disease in a Young Female- Case Report.","authors":"Lakshmi Nagireddi,&nbsp;Rachel Raimondo,&nbsp;Robert Hostoffer","doi":"10.1177/21526567221074944","DOIUrl":"https://doi.org/10.1177/21526567221074944","url":null,"abstract":"<p><strong>Introduction: </strong>Lime phytodermatitis, also known as margarita dermatitis, is a condition that results in a skin rash after sunlight exposure when handling certain plants. Misdiagnosis is common due to its resemblance to skin burns or allergic contact dermatitis. Detailed history and disease recognition is important to provide accurate treatment recommendations.</p><p><strong>Case report: </strong>A 32-year-old woman presented with a recurrent rash on her hands that would only occur in the summer months. She was previously misdiagnosed as allergic contact dermatitis. History revealed yearly vacations involving margaritas and squeezing lime into her drinks followed by exposure to sunlight. A presumptive diagnosis of lime phytodermatitis was made and she was advised to avoid contact with limes followed by exposure to direct sunlight.</p><p><strong>Discussion: </strong>Lime phytodermatitis occurs after direct contact with lime and sunlight exposure. A phototoxic compound found in limes, Furocoumarin, has been implicated as a cause for lime disease. Detailed history is important in establishing a diagnosis of lime disease. Treatment is symptomatic with topical corticosteroids, avoidance of furocoumarin-containing objects, cold compresses, and subsequent UV exposure.</p><p><strong>Conclusion: </strong>We present the first case of recurrent, bilateral phytodermatitis in a 32-year-old woman following contact with limes and subsequent sunlight exposure in the summer months.</p>","PeriodicalId":45192,"journal":{"name":"Allergy & Rhinology","volume":" ","pages":"21526567221074944"},"PeriodicalIF":2.2,"publicationDate":"2022-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/43/e8/10.1177_21526567221074944.PMC8796115.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39872892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Neurally Mediated Syncope Triggered by COVID-19 Nasopharyngeal Swab Specimen Collection: A Case Report. COVID-19鼻咽拭子标本采集引发神经介导晕厥1例报告
IF 2.2
Allergy & Rhinology Pub Date : 2022-01-19 eCollection Date: 2022-01-01 DOI: 10.1177/21526567211073794
William R Bloom, Thomas D Bloom
{"title":"Neurally Mediated Syncope Triggered by COVID-19 Nasopharyngeal Swab Specimen Collection: A Case Report.","authors":"William R Bloom,&nbsp;Thomas D Bloom","doi":"10.1177/21526567211073794","DOIUrl":"https://doi.org/10.1177/21526567211073794","url":null,"abstract":"<p><p>There are few reports describing adverse events associated with nasopharyngeal swab specimen collection in patients tested for SARS-Cov-2 (COVID-19). Despite the lack of data, providers should be aware of complications associated with swab collection. Instances of nasopharyngeal swab as a syncope trigger are mostly anecdotal and not well described in the medical literature. We present a case of neural reflex mediated syncope associated with the nasopharyngeal swab specimen collection process in a healthy patient undergoing COVID-19 testing prior to elective surgery. This response may be mediated by the trigeminocardiac reflex or via glossopharyngeal nerve stimulation. Less invasive collection practices, such as saliva sampling, may be warranted, particularly in those predisposed to syncopal episodes.</p>","PeriodicalId":45192,"journal":{"name":"Allergy & Rhinology","volume":" ","pages":"21526567211073794"},"PeriodicalIF":2.2,"publicationDate":"2022-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1a/4f/10.1177_21526567211073794.PMC8796065.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39872891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
Chronic Spontaneous Urticaria Triggered by the AstraZeneca/Oxford COVID-19 Vaccine with Achieved Remission: A Case Report. 阿斯利康/牛津COVID-19疫苗引发的慢性自发性荨麻疹获得缓解:一例报告
IF 2.2
Allergy & Rhinology Pub Date : 2022-01-10 eCollection Date: 2022-01-01 DOI: 10.1177/21526567211068458
Stephanie G Brooks, Anna M De Jong, Mina Abbaslou, Gordon Sussman
{"title":"Chronic Spontaneous Urticaria Triggered by the AstraZeneca/Oxford COVID-19 Vaccine with Achieved Remission: A Case Report.","authors":"Stephanie G Brooks,&nbsp;Anna M De Jong,&nbsp;Mina Abbaslou,&nbsp;Gordon Sussman","doi":"10.1177/21526567211068458","DOIUrl":"https://doi.org/10.1177/21526567211068458","url":null,"abstract":"<p><p>New adverse reactions to the COVID-19 vaccines are being identified as vaccination rates increase worldwide. Recently, there have been two reports of Moderna (mRNA-1273) vaccine induced relapse of chronic spontaneous urticaria (CSU) that was previously well controlled. Herein, we report a case of AstraZeneca/Oxford (ChAdOx1) vaccine triggered CSU in a patient with no history of CSU with achieved remission.</p>","PeriodicalId":45192,"journal":{"name":"Allergy & Rhinology","volume":" ","pages":"21526567211068458"},"PeriodicalIF":2.2,"publicationDate":"2022-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8753064/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39825490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 12
Pollen Allergy Screening with Allergen-Specific and Total Immunoglobulin E Titers 用变应原特异性和总免疫球蛋白E滴度筛选花粉变态反应
IF 2.2
Allergy & Rhinology Pub Date : 2022-01-01 DOI: 10.1177/21526575221079260
H. Yokoi, Yuma Matsumoto, M. Kawada, Hiroyuki Sakurai, Koichiro Saito
{"title":"Pollen Allergy Screening with Allergen-Specific and Total Immunoglobulin E Titers","authors":"H. Yokoi, Yuma Matsumoto, M. Kawada, Hiroyuki Sakurai, Koichiro Saito","doi":"10.1177/21526575221079260","DOIUrl":"https://doi.org/10.1177/21526575221079260","url":null,"abstract":"Background Allergic rhinitis is a typical type I hypersensitivity reaction, commonly caused by inhalant allergens. Accurate identification of the causative antigen is important for rapid diagnosis and treatment initiation. Objective This study examined the efficiency of serum-based allergen-specific immunoglobulin E and total immunoglobulin E antibody titers in screening for pollen allergy. We also examined the effect of cross-reactive carbohydrate determinants on specific immunoglobulin E titers in screening for pollen allergy, one of the causes of false positivity in specific immunoglobulin E measurements. Methods A questionnaire was used to evaluate the symptoms of pollinosis among participants who underwent a medical examination. One hundred and thirty-two participants reported pollen allergy symptoms and 127 reported an absence of symptoms. Specific immunoglobulin E levels were measured using the AlaSTAT 3g Allergy method. Seventeen components, including four types of cross-reactive carbohydrate determinant-specific immunoglobulin E antibodies, were measured and evaluated comparatively. Results The sensitivity and specificity of the tests in predicting the presence or absence of pollen allergy were analyzed. The values of the areas under the curves for immunoglobulin E antibody levels against cedar, cypress, orchard grass, and ragweed pollen were 0.87, 0.82, 0.63, and 0.56, respectively. A cross-reactive carbohydrate determinant-related false-positive effect on the pollen specific immunoglobulin E titer was noted in pollen screening. Conclusion Cedar pollen-specific immunoglobulin E titers showed sufficient accuracy for use in pollen allergy screening. The study of cross-reactive carbohydrate determinants suggested that subjects who tested positive for pollen often had false-positive results due to the impact of cross-reactive carbohydrate determinants.","PeriodicalId":45192,"journal":{"name":"Allergy & Rhinology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42531688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Resistant Chronic Spontaneous Urticaria - A Case Series Narrative Review of Treatment Options. 耐药慢性自发性荨麻疹-治疗方案的病例系列叙述回顾。
IF 2.2
Allergy & Rhinology Pub Date : 2022-01-01 DOI: 10.1177/21526575221144951
Sujoy Khan, Charu Chopra, Alaistair Mitchell, Alla Nakonechna, Patrick Yong, Mohammed Yousuf Karim
{"title":"Resistant Chronic Spontaneous Urticaria - A Case Series Narrative Review of Treatment Options.","authors":"Sujoy Khan,&nbsp;Charu Chopra,&nbsp;Alaistair Mitchell,&nbsp;Alla Nakonechna,&nbsp;Patrick Yong,&nbsp;Mohammed Yousuf Karim","doi":"10.1177/21526575221144951","DOIUrl":"https://doi.org/10.1177/21526575221144951","url":null,"abstract":"<p><strong>Background: </strong>Chronic spontaneous urticaria (CSU) can be extremely debilitating to the patient and challenging for the treating clinician. The National Institute of Health and Clinical Excellence (NICE) in the United Kingdom (UK) recommendation of omalizumab for patients who fail to respond to high-dose anti-histamines has improved treatment options and quality of life. However, there is still lack of clear guidelines for treatment of patients resistant to standard and anti-IgE therapies.</p><p><strong>Methods: </strong>We discuss the therapeutic strategies employed among nine extremely resistant CSU cases and the heterogeneity between guidelines from different societies.</p><p><strong>Results: </strong>Patients with anti-histamine-resistant urticaria either remained on omalizumab or started on immunosuppressive drugs (dapsone or ciclosporin) when they stopped responding to omalizumab. We used clinical assessment, skin biopsies (when available) and previous published reports to consider dapsone (for predominantly neutrophilic infiltration), or ciclosporin at doses between 2 and 4 mg/kg/day. One patient with ciclosporin-resistant urticaria responded to mycophenolate mofetil. Two patients remain on long-term omalizumab due to its relative safety and efficacy including 1 patient with underlying antibody deficiency where omalizumab was preferred over risks of using immunosuppressive medications.</p><p><strong>Conclusions: </strong>These case studies bring to light the real-world difficulties in managing patients with resistant CSU and the need for generating the evidence base on alternative therapeutic options such as synergistic use of biologics and immunosuppressive drugs.</p>","PeriodicalId":45192,"journal":{"name":"Allergy & Rhinology","volume":"13 ","pages":"21526575221144951"},"PeriodicalIF":2.2,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d9/53/10.1177_21526575221144951.PMC9791268.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10819111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Smell and Taste in Children with Covid-19. Covid-19患儿的嗅觉和味觉
IF 2.2
Allergy & Rhinology Pub Date : 2022-01-01 DOI: 10.1177/21526575221144950
Piero Giuseppe Meliante, Alessia Marcellino, Roger Altomari, Alessia Testa, Andrea Gallo, Massimo Ralli, Marco de Vincentiis, Riccardo Lubrano
{"title":"Smell and Taste in Children with Covid-19.","authors":"Piero Giuseppe Meliante,&nbsp;Alessia Marcellino,&nbsp;Roger Altomari,&nbsp;Alessia Testa,&nbsp;Andrea Gallo,&nbsp;Massimo Ralli,&nbsp;Marco de Vincentiis,&nbsp;Riccardo Lubrano","doi":"10.1177/21526575221144950","DOIUrl":"https://doi.org/10.1177/21526575221144950","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the frequency of loss of smell and taste in children during Covid-19 infection and their prevalence along with other symptoms, as well as the recovery of chemosensory function once healed.</p><p><strong>Methods: </strong>To evaluate symptoms during infection, we adapted the Scandinavian adaptation of the Multi-Clinic Smell and Taste Questionnaire and the modified Monel-Jefferson questionnaire. For smell analysis we used Odor Identification (OI) and two variants of the Odor Discrimination (OD) test, and we compared the results with those of a control group.</p><p><strong>Results: </strong>We enrolled nine patients in our experimental group and nine in our control group. Fever was the most frequent symptom (55% of cases), followed by anosmia and ageusia (44% of cases), muscle pain and asthenia (22% of cases) and diarrhea, abdominal pain, cough, and headache (11% of cases). In 11% of cases, olfactory symptoms were the only manifestation of the disease. There was no statistically significant difference in OI test and OD tests between the two groups (Children healed from Covid-19 and Control Group).</p><p><strong>Conclusion: </strong>Loss of smell and taste are the second most common symptoms of pediatric Covid-19, and they should always be tested because they can be the only manifestations of infection. Olfactory function in Covid-19 children decreases with increasing age and improves with the passage of time after illness.</p>","PeriodicalId":45192,"journal":{"name":"Allergy & Rhinology","volume":"13 ","pages":"21526575221144950"},"PeriodicalIF":2.2,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/97/cc/10.1177_21526575221144950.PMC9768832.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10430281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
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