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temporada polen sintomas

Pollen season is reflected on symptom load for grass and birch pollen-induced allergic rhinitis in different geographic areas – an EAACI Task Force Report

By Selected articles

Pfaar O, Karatzas K, Bastl K, Berger U, Buters J, Darsow U, Demoly P, Durham SR, Galán C, Gehrig R, Gerth van Wijk R, Jacobsen L, Katsifarakis N, Klimek L, Saarto A, Sofiev M, Thibaudon M, Werchan B, Bergmann KC.

Allergy. 2019 Nov 13. doi: 10.1111/all.14111. [Epub ahead of print]

Allergic rhinitis is a condition that affects quality of life and has a high economic burden. Allergen immunotherapy (AIT) may be effective in seasonal and perennial allergic rhinitis, depending on the intensity and duration of pollen exposure. The European Academy of Allergy and Clinical Immunology (EAACI) task force evaluated pollen and symptom data from German and aimed at extrapolating these data in other European geographical areas such as Austria, Finland and France and assess their suitability for AIT and clinical support.

They used data from 23 pollen monitoring stations from Austria, Finland and France from 2014-2016. Afterwards, they studied the correlation between birch and grass pollen concentration during the birch and grass pollen season defined by the EAACI criteria and total nasal symptoms and medication scores reported by allergic rhinitis patients.

The analysis showed that there is a correlation of peak pollen period start and end and pollen-induced symptom loads reported by allergic rhinitis patients during birch and grass pollen season.

This task force concluded that the EAACI definitions on pollen season for both birch and grass are also valid for Austria, Finland and France, which may be of interest of use in clinical trials on AIT and also in daily clinical routine.

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vitamina modulador rinitis

Vitamin D: A Modulator of Allergic Rhinitis

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Agarwal S, Singh SN, Kumar R, Sehra R.

Indian J Otolaryngol Head Neck Surg. 2019 Nov;71(Suppl 3):2225-2230. doi: 10.1007/s12070-019-01697-9. Epub 2019 Jun 27.

Allergic rhinitis is a disease with an increasing prevalence and impact on medical practice. People suffering from allergic rhinitis often see their quality of life decreased. Allergic rhinitis treatment consists of a set of oral treatments and nasal drops and sprays, and many patients often don’t see their symptoms fade with this common approach.

This case-control observational study reviewed vitamin D as a therapeutic agent for allergic rhinitis. 80 participants were included, 40 healthy participants and 40 allergic rhinitis patients. Participants with allergic rhinitis were supplemented with oral vitamin D (cholecalciferol-1000 IU once daily). Serum vitamin D, total nasal symptom score (TNSS) and total eosinophilic count (TEC) were calculated and compared at baseline, 1 and 3 months. Serum vitamin D levels at baseline were 20.15 + 10.26 ng/ml for patients and 27.94 + 13.38 ng/ml for healthy controls. The TNSS score of allergic rhinitis of patients was 7.43 + 1.87 and of controls was 5.00 + 1.52. TEC of people with allergic rhinitis was 546.15 + 113.39 and of healthy controls was 313.33 + 125.08. After vitamin D treatment, participants with allergic rhinitis, serum vitamin D level was 38.05 + 14.62 and of controls was 27.43 + 12.76. TNSS of people with allergic rhinitis was 3.53 + 0.68 and 4.43 + 1.17 in healthy control group, TEC of participants with allergic rhinitis was 68.13 + 38.95 and of healthy controls was 197.03 + 123.36. Investigators concluded that vitamin D can act as disease modulator and that in people with allergic rhinitis, vitamin D supplementation offers symptomatic relief and lowers TNSS and TEC values.

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interacciones contaminacion rinitis

Interactions between air pollution and pollen season for rhinitis using mobile technology: a MASK-POLLAR study

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Bédard A, Sofiev M, Arnavielhe S, Antó JM, Garcia-Aymerich J, Thibaudon M, Bergmann KC, Dubakiene R, Bedbrook A, Onorato G, Annesi-Maesano I, Pépin JL, Laune D, Zeng S, Bousquet J, Basagaña X.

J Allergy Clin Immunol Pract. 2019 Nov 28. pii: S2213-2198(19)30962-6. doi: 10.1016/j.jaip.2019.11.022. [Epub ahead of print]

The POLLAR project (Impact of Air POLLution in Asthma and Rhinitis) assesses if there are associations between major air pollutants and allergic rhinitis control. Former studies have suggested an interaction between air pollution and pollen exposure with an impact on symptoms.

This study included 3323 participants from Northern and Central Europe who recorded the daily impact of allergic symptoms in a validated mobile tool for rhinitis management using visual analogue scales during 2017 and 2018. Pollutant levels were assesses using a system for integrated modelling of atmospheric composition and pollens were assessed by regions using Google Trends. Generalized estimating equation models were used to account for repeated measures per user, adjusting for gender, age, treatment and country. Analyses were stratified by pollen seasons to investigate interactions between air pollutants and pollen exposure.

Stronger associations between uncontrolled rhinitis and pollutants were observed during the grass pollen season. Also, days with uncontrolled allergic rhinitis increased by 25% for an interquartile range increase in pollutants levels during the grass pollen season.

The MASK-POLLAR study concluded that there may be a relationship between uncontrolled allergic rhinitis and air pollution and that this relationship is modified in the grass pollen season.

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serum ige eosinofilos

Determination of Serum IgE and Eosinophils as a Diagnostic Indicator in Allergic Rhinitis

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Sharma M, Khaitan T, Raman S, Jain R, Kabiraj A.

Indian J Otolaryngol Head Neck Surg. 2019 Nov;71(Suppl 3):1957-1961. doi: 10.1007/s12070-018-1383-7. Epub 2018 May 2.

Allergic rhinitis is the most increasing allergic respiratory disorder. It affects 10-20% of the population and is clinically identified by symptoms such as nasal discharge, itching, sneezing and nasal congestion. The objectives of this study were to determine if serum IgE and eosinophil levels have a correlation with allergic rhinitis. A total of 155 participants (113 patients and 42 healthy controls, 81 women) of different ages (1 month – 75 years old) were included in this retrospective study. Blood samples were collected from all participants and analysed to determine serum IgE and eosinophil levels. A Pearson’s correlation was performed to establish a relationship between serum log IgE and eosinophil levels. The statistical analysis of the samples demonstrated that the mean values of serum found that these were higher in participants with allergic rhinitis than in healthy controls. Also, in participants with allergic rhinits, a predominance in men was seen in mean serum log IgE levels, whereas women predominance was seen in mean eosinophil counts. A small positive correlation was established between serum log IgE and eosinophil levels. This study showed that elevated serum IgE and eosinophil levels were observed in patients with allergic rhinitis with predominance in men and younger age group.

Serum IgE and eosinophils can serve as a simple, non-invasive and reliable tool for allergic rhinitis diagnosis.

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enfoque rinitis alergica

Approach to Patients with Allergic Rhinitis: Testing and Treatment

By Selected articles

Cox L.

Med Clin North Am. 2020 Jan;104(1):77-94. doi: 10.1016/j.mcna.2019.09.001. Review.

Allergic rhinitis is a very common condition, affecting approximately 113 million in Europe and 30 to 60 million in the United States. Allergic rhinitis treatment is usually symptomatic, nevertheless it has both high economic burden and impact in the quality of life of patients.

Allergen immunotherapy (AIT) is a well-established and proven effective treatment of allergic rhinitis because it treats its symptoms but also the underlying cause of allergic rhinitis by stimulating immunologic changes that produce long-term allergen-specific tolerance.

The investigator produced a literature review on AIT and concluded that besides reducing symptoms, it improves overall quality of life of patients with allergic rhinitis. The 2 most commonly prescribed AIT routes are SCIT (subcutaneous immunotherapy) and SLIT (sublingual immunotherapy), which have comparable efficacy. The safety profile of SLIT is superior to SCIT, but both have been shown to have poor adherence in real-life studies. AIT has shown to prevent the progression of allergic rhinitis to asthma and may provide long-term clinical benefits after discontinuation of medications, which can translate into cost savings, when compared to standard treatment. However, more research is needed.

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historia rinitis alergica

History of allergic rhinitis and risk of asthma; a systematic review and meta-analysis

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Tohidinik HR, Mallah N, Takkouche B.

Allergic rhinitis has been suspected to be a risk factor for asthma in several studies but this association is not firmly established. The objective of this study was to synthesize the evidence of the association between allergic rhinitis and the risk of asthma through a systematic review and meta-analysis.

We performed a search in Medline, Scopus, ISI Proceedings databases and other databases from inception until February 2019, followed by manual search to identify potentially relevant case-control and cohort studies that reported relative risk estimates and confidence intervals of the association between allergic rhinitis and asthma. Cross-sectional studies were excluded. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using fixed and random effects models and quality of studies was assessed through a modified version of the Newcastle-Ottawa scale.

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bilastina

Bilastine: a lifetime companion for the treatment of allergies

By Articles about Bilastine

Martin K. Church, Marysia Tiongco-Rectob, Erminia Ridoloc and Zoltan Novàk.

Bilastine is a potent and highly selective H1-antihistamine approved for the treatment of allergic rhinoconjunctivitis and urticaria. This article summarizes available data on the use of bilastine in the treatment of allergic disorders in different age groups, including younger and older adults, and school-age children and adolescents.

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Next-generation ARIA care pathways for rhinitis and asthma: a model for multimorbid chronic diseases

By Selected articles

Bousquet JJ.

(2019) Clin Transl Allergy. 2019 Sep 9;9:44. doi: 10.1186/s13601-019-0279-2. eCollection 2019. Review.Gerasimos N.

ARIA (Allergic rhinitis and its impact on asthma) proposes an innovative patient-centered approach for rhinitis and asthma multimorbidity to be scaled up to chronic diseases. The European Union and global political agendas are of great importance in supporting supporting the digital transformation of health and care with integrated care.

The burden and cost of allergic and chronic respiratory diseases are increasing rapidly, with economies struggling to deliver modern health care effectively. Budgets will continue to be challenged with the move towards universal health coverage as demand increases and newer, more expensive technologies become available. Allergic rhinitis and asthma multimorbidity can be considered a model for chronic diseases because there is a broad agreement on the gold standard of care. In allergic rhinitis and asthma, adherence to treatment is a major unresolved problem. Patients self-treat based on their personal experiences, showing a major disconnect between physicians and patients.

Integrated care pathways (ICPs) are structured multidisciplinary care plans detailing the key steps of patient care, supporting self-care through mobile devices. Three aspects of care pathways are being developed and proposed by ARIA: (i) patient participation, health literacy and self-care through technology-assisted patient activation; (ii) implementation of care pathways by pharmacists and (iii) next-generation guidelines assessing the recommendations of guidelines in allergic rhinitis and asthma using real-world evidence obtained through mobile technology.

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Recent developments and highlights in allergic rhinitis

By Selected articles

Meng Y, Wang C, Zhang L.

(2019) Allergy. 2019 Sep 30. doi: 10.1111/all.14067. [Epub ahead of print] Review.

Allergic rhinitis is characterized by symptoms of sneezing, rhinorrhea, nasal obstruction, and pruritus caused by inhaled allergens and involving mucosal inflammation. Allergic rhinitis is a disease with high prevalence all over the world.

This review aimed at highlighting recent developments in the etiology and management of allergic rhinitis.

Exposure of atopic individuals to external environmental factors such as ambient air pollutants, aeroallergens and climate play a crucial role in the pathogenesis of allergic rhinitis. When the nasal mucosa is exposed to inciting allergens such as pollen and dust mites, innate and adaptive immune cells are involved in the pathophysiologic mechanism of allergic rhinitis, which induce specific immunoglobulin E (IgE) production, activation of eosinophils, and degranulation of mast cells and basophils, with the consequent clinical symptoms.

At a cellular and molecular mechanism, several studies reported the role of IL-17 in allergic rhinitis. Serum IL-17 levels are significantly associated with allergy severity during the pollen season and are considered a marker of allergy severity in allergic rhinitis patients.

Current treatment options include patient education, irritant and allergen avoidance measures, pharmacotherapy, allergen immunotherapy, nasal irrigation and other less common measures such as acupuncture and surgery. Recent studies have strengthened the evidence base for the treatment of all aspect of allergic rhinitis.

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The Role of Mobile Health Technologies in Allergy Care: an EAACI Position Paper.

Quality of Life and Work Productivity Impairment of Patients with Allergic Occupational Rhinitis

By Selected articles

Maher Maoua, et al.

(2019) Tanaffos

Allergic rhinitis impacts negatively the quality of life and occupational activities of patients.

A 10-year duration cross-sectional study evaluated the quality of life and work productivity of patients diagnosed with allergic occupational rhinitis. Quality of Life was assessed by the Mini-RQLQ (rhinitis quality of life questionnaire) and work impairment was assessed by the Work Productivity and Activity Impairment questionnaire.

This study included 414 participants from both genders and with a mean age of 38 years old. Most of them were workers from the textile and clothing industry. Absenteeism was not relevant, however participants experienced activity limitations and practical problems, reducing productivity and quality of life.

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Salud y tecnología móvil

Mobile technology in allergic rhinitis: evolution in management or revolution in health and care?

By Selected articles

Jean Bousquet, Ignacio J. Ansotegui, Josep M. Anto, Sylvie Arnavielhe, Claus Bachert, et al.

(2019) The Journal of Allergy and Clinical Immunology: In Practice

Mobile technology has spread rapidly around the globe. Over 5 billion people have mobile devices, with over half of which are smartphones. Mobile health (mHealth) is the use of information and communication technology for health services and information transfer. Internet-based applications and smart devices are already used in allergic rhinitis and may help to undress some unmet needs, including improving quality of life especially in those with asthma.

This study reviewed existing mHealth applications for allergic rhinitis with published studies, discussed applications that included risk factors of allergic rhinitis, examined its impact in phenotype discovery, provided real-word evidence and discussed mHealth tools that enable digital transformation.

WHO recognizes the significant role that digital technologies can play in strengthening the health systems in countries to achieve universal health coverage, the health-related Sustainable Development Goals and other health objectives. mHealth has the potential to profoundly impact healthcare as existing apps represent an important evolution of health and care for rhinitis. Real world evidence has identified patients’ behaviours and practices, and this will have a profound impact on current guidelines and care pathways. Allergic rhinitis is not a severe disease but it does have a major impact on social life, school and work productivity.

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Rinitis Alergica Local

VAS for assessing the perception of antihistamines use in allergic rhinitis

By Selected articles

Ciprandi G, La Mantia I.

Antihistamines are commonly prescribed for the management of allergic rhinitis and urticaria. The quantification of their consumption is relevant in clinical practice, as their use is usually associated with severe symptoms. In addition, symptomatic use of antihistamines is a useful parameter for evaluating allergen immunotherapy effectiveness. However, the use of a diary for recording the number of tablets is frequently negligenced as patients forget to register the actual quantity of tablets taken.

A visual analogue scale (VAS) measures the patient’s perception of symptom severity, emotions and pain.

This study aimed at measuring the VAS for assessing the patient’s perception about antihistamines use in allergic rhinitis. A total of 103 patients with allergic rhinitis due to Parietaria pollen were retrospectively evaluated. They recorded monthly the number of antihistamine tablets taken during the pollen season.

There was a strong relationship between the number of tablets and the VAS score, which represents a possibility of using VAS to estimate the patient’s perception of antihistamines use in clinical practice.

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Allergic Rhinitis Nasal Mucosa

ARIA masterclass 2018: From guidelines to real-life implementation

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Hellings PW, Seys SF, Marien G, Agache I, Canonica W, Gevaert P, Haahtela T, Klimek L, Mullol J, Pfaar O, Scadding G, Scadding G, Valiulis A, Aria AMD, Bousquet J, Pugin B; ARIA masterclass discussants.

Around 20-30% of the European populations suffer from allergic rhinitis, which affects their social life, sleep and work productivity, indirectly rising the economic burden for society.

The ARIA (allergic rhinitis and its impact on asthma) initiative has been developing guidelines for the treatment of allergic rhinitis and asthma to ensure the highest level of best practices in real-life settings, and has evolved towards integrated care pathways using mobile technology and further to management as the key to provide an active and healthy life to all allergic rhinitis patients.

In September 2018, the first ARIA masterclass was held in Brussels with the following key objectives:

  • To provide unbiased education on the best-practices for allergic rhinitis diagnosis, treatment and follow-up
  • To update clinicians about recent research data in allergic rhinitis and asthma, from clinical trials to real-world evidence
  • To share next generation care pathways for the optimal management of patients with allergic rhinitis and asthma
  • To inform clinicians about change management and its impact on healthcare
  • To support clinicians with the adoption of digital solutions in daily practice.

A recent study showed that allergic rhinitis specialists behave like patients, showing a real disconnection between physician’s prescription and patient’s behavior for allergic rhinitis treatment.

The majority of allergists prescribe medications for the entire pollen season, but the vast majority of patients use their medications on-demand when their symptoms are not well controlled.

The objective of the ARIA masterclass was to anticipate a reconnection between physicians and patients, by promoting a patient-centered approach, with a therapeutic strategy tailored to the patient needs but also to their preferences. The use of integrated care pathways and mobile Apps can facilitate this change in care management. In turn, this would result in better symptoms controls for patients, and a substantial reduction of indirect cost for the society.

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Identifying an effective mobile health application for the self-management of allergic rhinitis and asthma in Australia

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Tan R, Cvetkovski B, Kritikos V, O’Hehir RE, Lourenço O, Bousquet J, Bosnic-Anticevich S.

Up to 40% of the population worldwide is affected by allergic rhinitis, which carries a significant burden on individuals and society. Allergic rhinitis symptoms are often self-managed in the community pharmacy setting, with patients underestimating their symptoms and overestimating their ability for effective self-management. In the current technology world, the use of mobile Apps has become more and more popular and represents a promising tool for management of different conditions.

The objective of this study was to identify an effective App for the management of allergic rhinitis and/or asthma. All English and free of charge mobile health-related Apps from the Australian Apple store and Android Google Play store were included in this study and evaluated regarding three domains: accessibility in both App stores, alignment with theoretical principles of the self-management of allergic rhinitis and/or asthma and usability of the App using a mobile App rating scale.

Of a total of 418 Apps retrieved, 31 were evaluated. Many of the evaluated Apps fall short of the self-management principles and most within the field of allergic rhinitis and asthma only deal with either one or other condition. The MASK-air App achieved the highest mean rank and covered all self-management principles except a doctor appointment reminder, with a high rate of engagement.

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Investigación en laboratorio alergias

Concomitant Bilastine and Montelukast as Additive Therapy for Seasonal Allergic Rhinoconjunctivits and Mild-to-Moderate Asthma. The SKY Study

By Articles about Bilastine

Lavorini F, Matucci A, Rossi O, Pistolesi M; SKY study investigators.

A double-blind, double-dummy, randomised, active-controlled, parallel group design (The SKY study) compared the efficacy and efficacy of concomitant therapy with bilastine and montelukast with each substance alone in patients with seasonal allergic rhinoconjunctivitis and asthma for four weeks.

419 adults with seasonal allergic rhinoconjunctivitis and mild-to-moderate asthma partially controlled by beclomethasone dipropionate or equivalent were included. They had a forced expiratory volume (FEV1) >70%, a positive skin prick test to one or more allergens and nasal/ocular total symptom score (TSS) >3. Participants were screened for one week and then a twelve weeks treatment.

Allergic rhinoconjunctivitis score (TSS), daytime nasal and non-nasal symptom scores and use of rescue medications were registered.

Contrary to the original hypothesis, concomitant administration of bilastine with montelukast was as effective as either agent alone for allergic rhinoconjunctivitis symptoms, however bilastine alone improved allergic rhinoconjunctivitis symptoms more than montelukast in the first two weeks of treatment.

The SKY study investigators concluded that there is no benefit of using bilastine plus montelukast to provide relief of allergic rhinoconjunctivitis in patients with mild-to-moderate asthma.

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