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Objective: There is currently a lack of comprehensive studies that provide clear information about the frequency and characteristics of hypersensitivity reactions associated with H1 antihistamines. The aim of our study was to evaluate the subjects with antihistamine drug allergy diagnosed in our clinic and the provocation tests performed on them with alternative agents. Materials and Methods: This retrospective study was carried out at the immunology and allergy clinic in a tertiary hospital. The study population consisted of adults who presented to our allergy clinic between January 1, 2017 and December 31, 2023 with a history of H1 antihistamine drug allergy and underwent alternative H1 antihistamine drug provocation tests, for whom records were accessible. Results: A total of 45 patients were included in the study. The mean age of the patients was 39.75 ± 13.30 years with 34 (75.55%) being female. Regarding the initial allergic reaction history to H1 antihistamine drugs, allergic reactions occurred with pheniramine hydrogen maleate in 17 (37.77%), with levocetirizine dihydrochloride in 9 (20%), with desloratadine in 7 (15.55%), with cetirizine dihydrochloride in 6 (13.33%), with bilastine in 6 (13.33%), with rupatadine fumarate in 3 (6.66%) patients, and with fexofenadine hydrochloride 1 patient (2.22%). Allergic reactions developed in 7 (15.55%) patients during oral provocation tests. Conclusion: In conclusion, caution is advised with H1 antihistamine hypersensitivity. Misinterpreting hypersensitivity symptoms as those of the primary allergic condition may lead to treatment delays or unnecessary escalation, potentially resulting in life-threatening reactions. Additionally, further research is needed to clarify which antihistamines pose higher allergic risks and to guide the selection of alternatives for testing. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the characteristics of non-immediate type hypersensitivity reactions with first-line antituberculosis drugs and determine the causative drugs by patch tests and drug provocation tests. Materials and Methods: Baseline data including patients' demographics, disease characteristics, and drug hypersensitivity reaction characteristics were recorded. Patch testing was performed with all the drugs used during hypersensitivity reaction at 1/10 and 1/1 concentrations. Drug provocation tests were performed at 3-day intervals with drugs that had negative patch test results. Results: A total of 32 patients were included in the study. The clinical phenotype was maculopapular eruption in 11(34.4%), dermatitis in 10 (31.3%), drug reaction with eosinophilia and systemic symptoms in 1 (3.1%), and Stevens-Johnson syndrome/Toxic epidermal necrolysis in 10 (31.3%) patients. Combination therapy during the index reaction consisted of isoniazid (H), rifampicin (R), pyrazinamide (Z), and ethambutol (E) in 28 (87.5%) patients, Patch tests were performed with 95 drugs consisting of 25 H, 25 R, 21 Z, and 24 E in 25 patients. Results were positive in 8 patients with 10 drugs: 8 (32%) H, 1 (4%) R, and 1 (4.2%) E positivity were detected. Drug provocation tests were performed with 78 drugs (18 H, 23 R, 15 Z, 22 E) in 25 patients and resulted positive with H, R, Z, and E in 16.7% (3 of 18), 21.7% (5 of 23), 46.7% (7 of 15), and 54.5% (12 of 22) of the patients respectively. Negative predictive values of patch tests with H, R, Z, and E were calculated as 87.5% (14/16), 81.8% (18/22), 50% (7/14), and 45% (9/20) respectively. According to the results of the patch tests and provocation tests, the most common culprit of hypersensitivity reactions was found to be E (n=12), followed by H (n=10). Multiple drug hypersensitivity was detected in 9 of 23 (39.1%) patients. Conclusion: Patch testing is useful in the management of non-immediate type hypersensitivity with first-line antituberculosis drugs. However, further studies are needed to determine its predictive value [ABSTRACT FROM AUTHOR]

Background: The standard therapeutic regimen for idiopathic chronic eosinophilic pneumonia (ICEP) involves the administration of oral corticosteroids (OCS). However, a notable proportion of individuals experience recurrent episodes after the tapering or cessation of OCS during the course of ICEP. There has been a growing interest in exploring alternative treatment modalities for patients with ICEP at heightened risk of relapse. Objective: The aim of this study was to assess the efficacy of mepolizumab at a dose of 100 mg administered every 4 weeks in preventing relapses of ICEP and its impact on the clinical outcomes. Methods: This retrospective clinical observational study used real-world data to assess the impact of mepolizumab on patients diagnosed with ICEP accompanied by severe asthma. Demographic information and clinical characteristics were extracted from medical records. The study examined the effect of mepolizumab on the annual relapse rate, OCS dose, eosinophil count, and respiratory function parameters. Results: All patients included in the study, with a median (range) follow-up period of 19 months (4–40 months), the annual relapse rate decreased from 0.33 to 0 after the initiation mepolizumab. In addition, the maintenance OCS dose, expressed in methylprednisolone equivalents, declined from 4 mg/day to 0 mg/day. A reduction in the blood eosinophil count was observed, alongside a partial improvement in respiratory function test results among the patients. Conclusıon: A dose regimen of 100 mg of mepolizumab administered every 4 weeks emerges as a promising and well-tolerated therapeutic approach for averting relapses of ICEP. [ABSTRACT FROM AUTHOR]

Allergic bronchopulmonary aspergillosis (ABPA) is an inflammatory disease that is usually seen in patients with uncontrolled asthma, who have allergic sensitization to Aspergillus antigen. However, patients without asthma may rarely develop ABPA. We present a case of a patient who was hospitalized due to chronic obstructive pulmonary disease (COPD) exacerbation and was referred to the allergy clinic due to elevated total Immunoglobulin E (IgE), leading to a diagnosis of ABPA. The patient, previously treated for pulmonary tuberculosis, had COPD and a total IgE value over 2,500 IU/mL. Aspergillus-specific IgE was positive. While receiving systemic steroid therapy, the patient's blood eosinophil count was 190 cells/µL, and the pulmonary function test showed an obstructive pattern. Radiological imaging revealed emphysema, parenchymal distortion, bronchial enlargement, and cavitation. These findings led to a diagnosis of ABPA. ABPA may develop in patients with post-tuberculosis structural lung disease or COPD who have Aspergillus sensitization. Therefore, if these patients exhibit clinical and radiological findings compatible with ABPA, an investigation for ABPA should be conducted. [ABSTRACT FROM AUTHOR]

Author(s): Onur Telli [sup.1] , Nurullah Hamidi [sup.2] , Uygar Bagci [sup.2] , Arif Demirbas [sup.3] , Ahmet Metin Hascicek [sup.3] , Tarkan Soygur [sup.1] , Berk Burgu [sup.1] Author [...], Background The optimal management of lower pole kidney (LPK) stones in children is controversial. The aim of this study was to determine the outcomes of children with asymptomatic isolated LPK stones smaller than 10 mm during follow-up. Methods A total of 242 patients with 284 stones presenting at our institution between June 2004 and December 2014 with an asymptomatic, single LPK stone with a diameter of Results The mean age and mean stone size were 9.4 ± 1.9 years and 7.4 ± 0.6 mm at admission, respectively. Stone progression rate was 61.2%, and the mean time for intervention was 19.2 ± 4.6 months. Flexible ureterorenoscopy (n = 68) or micro-percutaneous nephrolithotomy (n = 4) were performed for 72 stones (25.4%; group 1), and extracorporeal shock wave lithotripsy was performed for 102 stones (35.9%; group 2). The stone-free rates were 81.8 and 79.3% in group 1 and 2, respectively (p > 0.05). The remaining asymptomatic stones (110, 38.8%; group 3) were managed by continued observation, and at the end of the observation time (mean 40.8 ± 20.8 months) the spontaneous passage rate was 9.1% in this group. In the multivariate analysis, stone size of >7 mm, concurrent renal anomalies, and stones composed of magnesium ammonium phosphate (struvite) and cystine were statistically significant predictors of the need for intervention. Conclusions Children with stones larger than 7 mm, renal anomalies, or stones composed of metabolically active cystine or struvite are more likely to require intervention, and those with asymptomatic LPK stones smaller than 10 mm can be managed by continued observation.

Propolis is a resinous substance produced from tree buds and bark, digested by bees, and is mainly composed of resins, wax, pollen, and essential oils. Propolis is used in traditional medicine due to its anti-inflammatory, antioxidant, antiseptic, and local anesthetic properties. The increase in the use and popularity of propolis-containing products coincides with a linear increase in the incidence of propolis-related allergic contact dermatitis. In this report, we present a case of local allergic contact dermatitis that developed after local propolis application for wound care in a 69-year-old male patient. [ABSTRACT FROM AUTHOR]

Montelukast, selective leukotriene (LT) receptor antagonist specific for cysteinyl LT type 1 receptors, serves as an alternative treatment option for asthma and different allergic clinical conditions. However montelukast, itself, may rarely induce hypersensitivity reactions. Although rare, clinicians, especially those working in pulmonology and allergy clinics, should be aware of the potential for montelukast to cause hypersensitivity reactions. Herein, we present a 61-year-old female patient who was followed up with Samter's syndrome and developed urticarial rashes after montelukast treatment, and montelukast allergy was confirmed by oral drug provocation test. [ABSTRACT FROM AUTHOR]

Introduction:  Placental insufficiency is one of the reasons for the reduction of hormone production. Thus, if one of the suspected causes of hypospadias is placental insufficiency, then the neurodevelopmental status of boys with hypospadias may be impaired. The aim of this study was to evaluate the neurodevelopmental status of boys with hypospadias and guide the parents of those who need support to related departments for early intervention.Materials and Methods:  Boys were divided into two groups, those with hypospadias (group H) and healthy children undergoing traditional circumcision (group C). The parents of the boys completed the Ages and Stages Questionnaire (ASQ) and ASQ-Social Emotional (SE), both of which are screening instruments for the early identification of developmental and social-emotional problems, respectively.Results:  Seventy-eight boys had hypospadias and 59 were admitted for traditional circumcision. The group H had statistically significant more impaired scores than group C in communication, gross motor, and personal-social skill sections. The multivariate logistic regression analysis revealed that hypospadias was the independent predictive factor for communication and personal-social skills.Conclusion:  Hypospadias and neurologic impairment may share common etiologic factors. Accordingly, physicians should keep in mind that if a boy presents with hypospadias, the possibility of having neurologic impairment is higher than normal population and early intervention has crucial importance. Every boy with hypospadias should be evaluated for neurodevelopmental status. [ABSTRACT FROM AUTHOR]

Purpose: To  discuss  whether  concealed  penis  after  circumcision  lowers  perimeatal  urethral  and  glanular  sulcus  uropathogenic  bacterial  colonization  in  healthy  boys  with  no  urinary  tract  problems  and  prevents  attacks  of  febrile  urinary  tract  infections  in  non-healthy  boys  with  defined  urinary  tract  abnormalities.  Materials and Methods:  This  case-control  study  was  conducted  in  Ibn-i  Sina  Hospital  and  retrospectively  collected  data  of   471 boys  were  analyzed.  All  patients  were  scanned  for  any  urinary  tract  abnormality  and  those  with  any  defined  abnormalities  were  classified  as  non-healthy  group. (123 patients)  Non-healthy  patients  were  divided  into  two  subgroups  as  concealed  (n:31)  and  non-concealed  (n:92)  penis  after  circumcision.  Healthy  patients  with  no  urinary  problems  were  divided  into  three  groups  as  circumcised  without  concealed  penis  (n:144),  with  concealed  penis  after  circumcision  (n:104)  and  uncircumcised  control  group  (n:100).  Bacterial  cultures  were  obtained  from  both  periurethral  meatal  and  glanular  sulcus  areas  by  adhering  strictly  to  the  rules  of  obtaining  bacterial  culture  to  avoid  false-positive  or  negative  culture  results.  Also  only  uropathogenic  bacterias  were  evaluated,  irrelevant  results  were  excluded.     Results:  Mean  age  was  similar  in  healthy  population.  Comparison  of  three  groups  showed  that  there  was  a  significant  difference  in  both  cultures.(P = .026 for periurethral meatal region, P = .039 for glanular sulcus region)  In  post  hoc  analysis,  non-concealed  group  had  a  lower  rate  of  culture  positivity  in  both  areas  compared  to  other  groups.    Mean  age  was  also  similar  in  non-healthy  population.  Mean  follow-up  period  was  18.2  months.  Patients  with  concealed  penis  after  circumcision  had  a  significantly  higher  number  of  febrile  UTI  attacks  (20 attacks in 8 patients vs 7 attacks in 5 patients)  compared  to  non-concealed  group. (P = .019)  All  febrile  UTI  attacks  except  one  in  this  group  occurred  below  the  age  of  12  months. A  total  of  10 patients  in  both  healthy  and  non-healthy  groups  had  postoperative  hemorrhage  after  circumcision  and  only  1  patient  had  a  wound  infection.          Conclusion:  Concealed  penis  after  circumcision  does  not  lower  perimeatal  urethral  and  glanular  sulcus  uropathogenic  bacterial  colonization  in  healthy  patients  and does not  protect  unhealthy  patients  from  febrile  urinary  tract  infection  attacks.  If  circumcision  is  planned,  concealed  penis  should  be  avoided  and  also  parents  should  be  informed  about  the  possible  risks  due  to  concealed  penis  before  the  procedure,  particularly  in  patients  with  urinary  tract  abnormalities. [ABSTRACT FROM AUTHOR]

Introduction: In this study, we aimed to investigate the effect of prestenting on success and complication rates of pediatric ureterorenoscopy (URS) procedures. Patients and Methods: We retrospectively analyzed the data of 251 pediatric URS cases. Forty-seven of the patients were prestented. Success and complication rates of the prestented and nonprestented groups were compared and further analysis was performed with respect to stone location (renal vs ureteral) and size (7-mm cutoff). Multivariate analysis was performed to define factors associated with success rates. Results: Mean age of the population was 8.9 years. Success rate of the entire population was 80.5% and significant difference between prestented and nonprestented groups was detected (91.5% vs 77.9%, p = 0.04). Higher success rates of the prestented group were also observed in ureteral stones (94.1% vs 79.5%, p = 0.04) and stones >7mm (84.6% vs 74.1%, p = 0.72). Prestented group showed higher success rates in kidney stones, but the difference was insignificant (84.6% vs 74.1%, p = 0.72). Prestenting was also identified as an independent predictor of success in multivariate analysis. Complication rate in the prestented group was also lower, but the difference was not significant (8.5% vs 14.7%, p = 0.347). Conclusions: Prestenting was found to increase the success rate of URS in cases of larger stones and ureteral stones in pediatric population. Prestenting also provides lower, but insignificant, complication rates. However, this procedure also has significant disadvantages. Based on the results of current study, we cannot recommend routine prestenting in pediatric cases. Instead, we recommend an attempt to treat the stone in the first session and place a stent in case of failed procedure to utilize potential benefits of prestenting while avoiding disadvantages. [ABSTRACT FROM AUTHOR]