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Allergy & Rhinology

Rodrigo Collado-Chagoya, Javier Hernández-Romero, Gumaro A Eliosa-Alvarado, Rubén A Cruz-Pantoja, Rosa I Campos-Gutiérrez, Andrea A Velasco-Medina, Guillermo Velázquez-Sámano
Tolerance induction and desensitization in Stevens-Johnson syndrome (SJS) or in toxic epidermal necrolysis (TEN) have been described as an absolute contraindication by some authors, but there are cases where there is no treatment alternative. Tuberculosis (TB) remains a leading cause of morbidity and mortality in developing countries and ranks alongside HIV as a leading cause of death worldwide. Severe drug reactions, such as SJS and TEN, occurring in these individuals are lifethreatening. Since alternative therapies for TB are limited, the role of desensitization and reintroduction becomes essential...
January 2018: Allergy & Rhinology
Eduardo R Urdaneta, Mitesh K Patel, Kathleen B Franklin, Xiaoyan Tian, Mei-Miau Wu
Background: Cetirizine has been shown to be effective for relief of seasonal allergic rhinitis (SAR) symptoms. Allergic rhinitis symptoms have been reported to have circadian variations, with symptoms tending to be most bothersome overnight and in the morning. Objective: To evaluate the effects of different cetirizine dosing schedules in comparison to twice daily (BID) chlorpheniramine and placebo on SAR symptoms at 12 and 24 hours postdose. Methods: Study 1 subjects received cetirizine 10-mg once daily in the morning (QAM), cetirizine 10-mg once daily at bedtime (QHS), cetirizine 5-mg twice daily, or placebo...
January 2018: Allergy & Rhinology
Kazuhiro Hashiguchi, Kimihiro Okubo, Yoichi Inoue, Hirotaka Numaguchi, Kumi Tanaka, Nobuyuki Oshima, Anish Mehta, Chisato Nishida, Itori Saito, George Philip
Background: This study evaluated the efficacy of montelukast in reducing seasonal allergic rhinitis symptoms in Japanese children with Japanese cedar (JC) pollinosis induced in an artificial exposure chamber (OHIO Chamber). Methods: Pediatric patients aged 10 to 15 years sensitive to JC pollen entered a randomized, double-blind, single-site, crossover study. After confirmation of an allergic response to a JC pollen exposure for 3 hours in the OHIO Chamber during the screening period, subjects received either montelukast 5 mg chewable tablets or placebo for a 7-day treatment period, followed by a 3-hour pollen exposure in the chamber...
January 2018: Allergy & Rhinology
Nikhil G Rao, Ambuj Kumar, Jenny S Wong, Ravi Shridhar, Dharendra Y Goswami
Background: Photoelectrochemical oxidation (PECO) is a new air purification technology developed to reduce circulating indoor allergens. PECO removes particles as small as 0.1 nm with the destruction of organic matter otherwise not trapped by a traditional filter and removes volatile organic compounds. Objective: We hypothesized that with daily use, the device would reduce user nasal and ocular allergy total symptom scores (TSS) within 4 weeks. Methods: The study was performed among 46 individuals with self-reported allergies using a portable PECO air purifier...
January 2018: Allergy & Rhinology
Urs C Steiner, Lucas M Bachmann, Micheal B Soyka, Stephan Regenass, Lukas Steinegger, Elsbeth Probst
Background: Rhinitis is a very common disease with allergies being the most frequent causative factor. It can co-occur together with asthma and eczema in atopic as well as in nonatopic patients. Objectives: To assess the prevalence of allergic sensitization within patient groups with rhinitis in consideration of the co-occurring disorders of asthma and eczema. Methods: Students of the third year of medical school completed an anonymous questionnaire on age, gender, and clinical symptoms, such as seasonal rhinitis, perennial rhinitis, asthma, and eczema, and underwent an ImmunoCAP Rapid test...
January 2018: Allergy & Rhinology
Alexander Yao, Janet A Wilson, Stephen L Ball
Background: The autonomic nervous system (ANS) richly innervates the nose and paranasal sinuses, and has a significant role in lower airway diseases, e.g., asthma. Nonetheless, its contribution to sinonasal symptoms is poorly understood. This review aimed to explore the complex relationship between the ANS and sinonasal symptoms, with reference to systemic diseases and triggers of ANS dysfunction. Methods: A review of articles published in English was conducted by searching medical literature databases with the key words "autonomic nervous system" and ("sinusitis" or "nose" or "otolaryngology")...
January 2018: Allergy & Rhinology
James A Gallogly, Farhoud Faraji, Mejd H Jumaily, John S Schneider, Joseph D Brunworth
Background: Due to the proximity of the maxillary sinus and ethmoid sinuses to the orbit, inflammatory processes that originate in the sinonasal region have the potential to extend into the orbit. Objective: We presented a case of ptosis and restrictive strabismus of the medial rectus muscle. Methods: A case report with a literature review of possible diagnoses. Results: Biopsy, imaging, and laboratory evaluation by otolaryngology, ophthalmology, and rheumatology services were unable to identify the cause of the fibrosis after 22 months of follow-up...
January 2018: Allergy & Rhinology
Theodore A Schuman, Adam J Kimple, Claire H Edgerly, Charles S Ebert, Adam M Zanation, Brian D Thorp
Background: Epithelial-myoepithelial carcinoma (EMC) is a rare tumor of the major and minor salivary glands. Sinonasal EMC is extremely uncommon and hitherto not described within the frontal or ethmoid sinuses. Objective: To present a novel sinonasal subsite and review the literature regarding sinonasal EMC. Methods: A case of frontoethmoidal EMC was presented. A medical literature data base was queried from January 1, 1950, to August 8, 2017, for all reports of sinonasal EMC...
January 2018: Allergy & Rhinology
Shikhar Sawhney, Sandeep Bansal, Madhur Kalyan, Indu Verma, Ramandeep Singh Virk, Ashok Kumar Gupta
Background: Ever since its characterization in the 1970s, allergic fungal rhinosinusitis (AFRS) has been the subject of much controversy, especially regarding its pathogenesis. In this study, we analyzed the differential expression of genes that encode protease-activated receptors (PAR) in patients with AFRS and patients with chronic rhinosinusitis, and tried to understand the pathogenic basis of this disease. Objective: To analyze the differential expression of PAR genes in patients with AFRS and in patients with chronic rhinosinusitis...
January 2018: Allergy & Rhinology
Kyeong Ah Kim, Joo Hyun Jung, Yun Sook Choi, Gyu Kang, Seon Tae Kim
Background: Wogonin is commonly used for the treatment of allergic diseases. However, neither its precise effect in preventing allergic rhinitis (AR) nor its mechanism of action are known. Objectives: In this study, the effect of wogonin on allergic responses in ovalbumin (OVA) induced AR was investigated in mice. Methods: BALB/c mice were sensitized with intraperitoneal (i.p.) OVA and then challenged intranasally with OVA. Wogonin (10 and 30 mg/kg) was given to the treatment groups, and the effect of wogonin on the release of allergic inflammatory mediators, specifically OVA-specific immunoglobulin E (IgE) and inflammatory cytokines, was explored...
January 2018: Allergy & Rhinology
Khrystyna Ioanidis, Brian Rotenberg
Background: This report presented the case of a difficult-to-remove needle foreign body. The patient had a dental procedure in which a 30-gauge needle was lost in the gingival buccal sulcus. Several attempts at removal were unsuccessful. The patient presented to the otolaryngology clinic with trismus, pain with mastication, intermittent right otalgia, and numbness of the right cheek. Methods: The needle was finally localized in the infratemporal fossa and removed by using image guidance technology...
January 2018: Allergy & Rhinology
Merin E Kuruvilla, Neha Sanan
Hypersensitivity reactions to dihydropyridine calcium channel blockers (CCB) are exceedingly rare, although sporadic reports of isolated angioedema seem to be gradually increasing in frequency. We present a case of angioedema likely triggered by amlodipine.
January 2018: Allergy & Rhinology
Nancy I Joseph, Eileen Slavin, Brian P Peppers, Robert W Hostoffer
Fenugreek ( Trigonella foenum-graecum) is a food product that belongs to the Leguminosae family along with other legumes. It has been used in India, Greece, and Egypt for culinary and medical purposes since ancient times, and today, fenugreek is used for flavoring foods, dyes, and drugs throughout the world. Many members of the Leguminosae family have been associated with allergies including soybean, green pea, and peanut. Fenugreek is also included in this family and may result in allergic reactions. Two cases of anaphylaxis have been described in children after ingestion of curry and pastes that contain fenugreek, although the true nature of the causative agent was unclear...
January 2018: Allergy & Rhinology
Abhishek Kavati, Dominic Pilon, Benjamin Ortiz, Brandee Paknis, Ashok Vegesna, Bradd Schiffman, Maryia Zhdanava, Patrick Lefebvre, Brian Stone
Background: Indication of omalizumab in the United States was recently extended to include pediatric (6-11 years) uncontrolled moderate-to-severe allergic asthma patients. Objective: The purpose of this study was to describe baseline characteristics of this population from a real-world dataset. Methods: Allergic asthma patients and uncontrolled moderate-to-severe allergic asthma patients, aged 6-11 years, were identified in the Allergy Partners Network Electronic Medical Records (2007-2016)...
January 2018: Allergy & Rhinology
Renee S Kleris, Anjeni Keswani, Patricia Lugar
Introduction: A 79-year-old woman with macular degeneration was referred to the Allergy/Immunology clinic for the evaluation of a potential allergy to anti-vascular endothelial growth factor (anti-VEGF) treatments. The patient developed urticaria and eyelid swelling immediately following a retinal injection of aflibercept, which she had previously tolerated. She previously had allergic reactions following ranibizumab and bevacizumab injections. Injections of anti-VEGF treatments were discontinued given concern for allergy with progression of the patient's disease...
January 2018: Allergy & Rhinology
Anam F Azimuddin, Erik K Weitzel, Kevin C McMains, Philip G Chen
BACKGROUND: Musculoskeletal injuries, such as neck and back pain, during a surgeon's career are common. However, studies on ergonomics are limited with regard to seated otolaryngologic procedures. Key elements of an ergonomic operating environment include the height of operating tables and surgical chairs. Surgeons benefit from proper support and positioning to prevent musculoskeletal injuries and reduce occupational risk. OBJECTIVE: The purpose of this study was to evaluate operating table and surgical seat heights, and determine whether adjustments can be made for various surgeon physiques...
October 1, 2017: Allergy & Rhinology
Lauren W Kaminsky, Theodore Kelbel, Fay Ansary, Timothy Craig
BACKGROUND: Hereditary angioedema (HAE) is a life-long disease that often manifests by puberty. Treatment of attacks is essential to improve quality of life and to decrease morbidity and mortality. During pregnancy, treatment is limited because multiple treatment options, including icatibant, are not approved for use during pregnancy. OBJECTIVE: We report the outcomes of three pregnancies during which icatibant was used by a patient with HAE with normal C1-inhibitor for treatment of attacks...
October 1, 2017: Allergy & Rhinology
Carolyn A Orgain, Terry Y Shibuya, Lester D Thompson, David B Keschner, Rohit Garg, Jivianne T Lee
INTRODUCTION: Inverted papillomas (IP) are benign sinonasal neoplasms, which account for 0.5-4% of all nasal tumors. IPs have been known to transform into squamous cell carcinoma in 5-15% of cases. Rarely, transformations to other malignancies have been reported. Here we report a unique case of malignant transformation of an IP into sinonasal undifferentiated carcinoma (SNUC). METHODS: A case report with a literature review; institutional review board exempted. The clinical presentation, radiographic features, surgical intervention, histopathologic analysis, treatment, and outcome of the case were examined...
October 1, 2017: Allergy & Rhinology
Mark R Peterson, Christopher A Coop
Reported is a case of a 39-year-old male who was diagnosed with exercise-induced anaphylaxis (EIA). He was initially treated prophylactically with fexofenadine, montelukast, and ranitidine. He also used an epinephrine autoinjector as needed. He was refractory to these medications and continued to have episodes of EIA. He was then started on a trial of omalizumab, an immunoglobulin E monoclonal antibody, and had resolution of the EIA episodes. After discontinuation of the omalizumab, the EIA episodes returned...
October 1, 2017: Allergy & Rhinology
Paolo Meglio, Paolo Gianni Giampietro, Rossella Carello, Elena Galli
BACKGROUND: The present report was a follow-up investigation at 2.5- and 7-year intervals of a previous study of 20 children with moderate-to-severe immunoglobulin E (IgE) mediated hen's egg (HE) allergy who received oral immunotherapy (OIT) with raw HE. The study design of the previous study divided the 20 subjects into two groups of 10 each: (1) group 1, the OIT group (OIT-G), and, (2) group 2, an age-matched control group (C-G). In that study, 8 of 10 of the children in the OIT-G were successfully desensitized, one child was partially desensitized, and desensitization failed in one child...
October 1, 2017: Allergy & Rhinology
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