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A 41-yr-old, previously healthy male was stung once by a hornet. The patient had no history of allergy or hornet stings. Physical examination revealed swelling of the right side of his body with blister formation on the extremities. Rhabdomyolysis developed. Treatment included corticosteroids, antihistamines, and cyproheptadine. The patient was discharged without sequellae after being hospitalized for 7 days. [ABSTRACT FROM AUTHOR]

Food allergy has become a major public health problem all over the world. Evidence showed that allergic reactions induced by food proteins often lead to disturbances in the gut microbiota (symbiotic bacteria). Gut microbiota plays an important role in maintaining the balance between intestinal immune tolerance and allergic reactions. Dietary intervention has gradually become an important method for the prevention and treatment of allergic diseases, and changing the composition of gut microbiota through oral intake of prebiotics and probiotics may serve as a new effective adjuvant treatment measure for allergic diseases. In this paper, the main mechanism of food allergy based on intestinal immunity was described firstly. Then, the clinical and experimental evidence showed that different prebiotics and probiotics affect food allergy by changing the structure and composition of gut microbiota was summarized. Moreover, the molecular mechanism in which the gut microbiota and their metabolites may directly or indirectly regulate the immune system or intestinal epithelial barrier function to affect food immune tolerance of host were also reviewed to help in the development of food allergy prevention and treatment strategies based on prebiotics and probiotics. [ABSTRACT FROM AUTHOR]

Autism spectrum disorder (ASD) is an etiologically heterogeneous neurodevelopmental condition that eludes a single explanation or cure. Epidemiological studies reveal risk factors, relevant comorbidities, and behavioral correlates to reach a better understanding of ASD. To contribute such data from an understudied ASD population, this paper presents epidemiological data from a Turkish sample of individuals with ASD (n = 911, 748 boys (82.1%) and 163 girls (17.9%) between 1 and 18 years of age). Average age at diagnosis was 31.06 ± 11.88 months, and the male-to-female ratio was 4.6:1. Three in 4 individuals with ASD had obsessive behaviors, and 1 in 4 had allergic conditions, inappropriate sexual behaviors, self-harming behaviors, and harmful behaviors towards others. One in 3 received a dietary treatment for at least 3 months; almost half received vitamin supplements; the majority (70%) did not experience constipation; and 2 in 3 were picky eaters. This paper presents data on the age of diagnosis, gender ratios, accompanying behaviors, and dietary interventions in Turkish individuals with ASD, which are topics of current research interest about ASD. Such data from non-Western populations may supplement epidemiological knowledge gained from Western populations to help reach a more comprehensive understanding of this condition with many unknowns. [ABSTRACT FROM AUTHOR]

Allergic bronchopulmonary aspergillosis (ABPA), a severe inflammatory respiratory disease, is caused by a hypersensitivity reaction to the colonization of the airways with Aspergillus fumigatus. It is most often described in patients with asthma or cystic fibrosis. The diagnosis of ABPA is based on a combination of clinical, radiological, and immunological findings that have been included in different diagnostic criteria over the years. In this paper, we review the biomarkers included in these diagnostic criteria and novel research biomarkers that may be used in the diagnosis and treatment follow-up of ABPA in cystic fibrosis. [ABSTRACT FROM AUTHOR]

There is a continuing interest in whether Bisphenol A (BPA) is able to cause adverse health effects through interaction with elements of the immune system. That interest has been fuelled further by the recent publication of a draft opinion on BPA prepared by the European Food Safety Authority (EFSA) Panel on Food Contact Materials, Enzymes and Processing Aids (CEP). This draft opinion judged effects on the immune system to be the most sensitive health outcome, and identified BPA-induced changes in the frequency of T-helper (TH)-17 cells in the spleens of mice as being the critical effect based on an association of these cells with inflammation. Based on these evaluations the CEP Panel recommended that a revised Tolerable Daily Intake (TDI) for BPA of 0.04 ng/kg bw/day should be adopted; representing a very substantial reduction (100,000-fold) compared with the existing TDI. The purpose of this commentary is to summarize briefly the role of TH17 cells in immune responses, and to review relevant literature regarding the influence of BPA on these cells, and on inflammatory responses in the lung and respiratory allergy. The conclusion drawn is that based on uncertainties about the effects of BPA on TH17 cells and lung inflammation in mice, the absence of consistent or persuasive evidence from human studies that exposure of BPA is associated with inflammation or allergy, and unresolved questions regarding the species selectivity of immune effects induced by BPA, it is inappropriate to adopt the revised TDI. Additional research is required to explore further the influence of BPA on the immune system and immune responses. [ABSTRACT FROM AUTHOR]

Adverse drug reactions represent a major public health problem, both from an economic point of view and, mainly, from the point of view of the induced pathology (iatrogenic diseases), being difficult to differentiate from other pathological conditions or even from the treated disease. Thus, these aspects prevent the use of the first-choice drugs needed for a particular treatment, in different therapeutic classes: beta-lactam antibiotics; sulfonamides; macrolide antibiotics; quinolones; non-steroidal anti-inflammatories; corticosteroids; Angiotensin converting enzyme (ACE) inhibitors; general anesthetics; biological drugs; antiepileptic drugs etc. On the other hand, adverse drug reactions represent a major problem for both clinical practice and preclinical research, in order to develop new drugs. Hypersensitivity reactions mainly refer to the adverse effects that can be harmful, disturbing, and sometimes fatal, that appear under the conditions of a normal immune system, including allergies and autoimmune reactions, both triggered by an immunological-allergic mechanism. The main purpose of this paper is to review the main classes of drugs involved in inducing hypersensitivity reactions. [ABSTRACT FROM AUTHOR]

A precise diagnosis is key for the optimal management of allergic diseases and asthma. In vivo or in vitro diagnostic methods that use allergen extracts often fail to identify the molecules eliciting the allergic reactions. Component-resolved diagnosis (CRD) has solved most of the limitations of extract-based diagnostic procedures and is currently valuable tool for the precision diagnosis in the allergy clinic, for venom and food allergy, asthma, allergic rhinitis, and atopic dermatitis. Its implementation in daily practice facilitates: a) the distinction between genuine multiple sensitizations and cross-reactive sensitization in polysensitized patients; b) the prediction of a severe, systemic reaction in food or insect venom allergy; c) the optimal selection of allergen immunotherapy based on the patient sensitization profile. This paper describes its main advantages and disadvantages, cost-effectiveness and future perspectives. The diagnostic strategy based on CRD is part of the new concept of precision immunology, which aims to improve the management of allergic diseases. [ABSTRACT FROM AUTHOR]

The purpose of this case report is to highlight silicone allergy as a rare cause of ventriculo-peritoneal shunt complication, often mimicking infection. Information regarding the patient presented was obtained by review of their medical notes, both paper and electronically. A literature review was performed by searching Pubmed using the following terms; silicone allergy and shunt allergy, to identify similar publications. Nine publications between 1994 and 2019 formed the basis of the literature review. The primary aim was to identify clinical presentations that may help to identify silicone allergy as the cause of shunt complication. Silicone allergy is a rare cause of ventriculo-peritoneal (V-P) shunt failure and can mimic infection. This diagnosis should be consideredwith a predominantly lymphocytic CSF leucocytosis and no bacteriological evidence of a responsible organism, a peripheral eosinophilia and an intense fibrosis around a recently placed V-P shunt, as described in this case report. [ABSTRACT FROM AUTHOR]

Increasingly, people employ the term ‘allergy’ to define various pathological conditions, although the biomedical community lacks a consensus on a definition of the term. It has become a widespread and convenient label for diverse conditions, often going beyond biomedical diagnosis. The aim of this paper is to explore how allergic people narrate their illness experiences, focusing specifically on the relationship between words, senses and bodies. This paper is based on an ethnographic study in a medium-sized north Italian city conducted from 2004 to 2008, starting in a public hospital Allergy Unit, and then developing through snowball recruitment and referral methods. Interviews were conducted with 37 allergic people, four allergologists and four nurses. Allergic people's narratives constantly drew upon two main concepts: weakness and pollution. These are interpreted as sensorial dimensions expressing a conflicting relationship with the outside environment. It is argued that in times of marked individualism and social transformations, bodily states are of fundamental importance and the mobilisation of sensory concepts is an attempt to give order and meaning to a world that is perceived as constituted by threatening aspects, polluted and out of order. [ABSTRACT FROM PUBLISHER]

Seafoods are fashionable delicacies with high nutritional values and culinary properties, while seafood belongs to worldwide common food allergens. In recent years, many seafood allergens have been identified, while the diversity of various seafood species give a great challenge in identifying and characterizing seafood allergens, mapping IgE-binding epitopes and allergen immunotherapy development, which are critical for allergy diagnostics and immunotherapy treatments. This paper reviewed the recent progress on seafood (fish, crustacean, and mollusk) allergens, IgE-binding epitopes and allergen immunotherapy for seafood allergy. In recent years, many newly identified seafood allergens were reported, this work concluded the current situation of seafood allergen identification and designation by the World Health Organization (WHO)/International Union of Immunological Societies (IUIS) Allergen Nomenclature Sub-Committee. Moreover, this review represented the recent advances in identifying the IgE-binding epitopes of seafood allergens, which were helpful to the diagnosis, prevention and treatment for seafood allergy. Furthermore, the allergen immunotherapy could alleviate seafood allergy and provide promising approaches for seafood allergy treatment. This review represents the recent advances and future outlook on seafood allergen identification, IgE-binding epitope mapping and allergen immunotherapy strategies for seafood allergy prevention and treatment. [ABSTRACT FROM AUTHOR]

Many countries in Europe now recommend and enforce mandatory vaccinations to improve vaccination coverage. Thus, the number of adverse events following immunization (AEFI) may show an increase. Among these events, severe hypersensitivity reactions to vaccines are rare. However, it is important that they be identified and recognized so that they may be adequately managed. The literature search was undertaken through PubMed and Embase to identify English-language papers focusing on hypersensitivity to vaccines. Hypersensitivity reactions following vaccinations are rare and are classified according to their chronology and extension: immediate when they occur within the first 4 hours following administration and non-immediate when they occur later. Local reactions are the most common adverse event following injection of vaccines and generally do not require any allergy workup. Immediate reactions, however, are potentially IgE-mediated and require an allergy workup. In general, a previously known food allergy (i.e., egg or milk) is not a contraindication to immunizations. Patients with a known allergy to gelatin, yeast, latex, antibiotics, or other specific components of vaccines require an allergy workup before administration of the vaccine. [ABSTRACT FROM AUTHOR]

Food provides energy and various nutrients and is the most important substance for the survival of living beings. However, for allergic people, certain foods cause strong reactions, and sometimes even cause shock or death. Food allergy has been recognized by the World Health Organization (WHO) as a major global food safety issue which affect the quality of life of nearly 5% of adults and 8% of children, and the incidence continues to rise but there is no effective cure. Drug alleviation methods for food allergies often have shortcomings such as side effects, poor safety, and high cost. At present, domestic and foreign scientists have turned to research and develop various new, safe and efficient natural sources of hypoallergenic or anti-allergic drugs or foods. There are many kinds of anti-allergic substances obtained from the plants and animals have been reported. Besides, probiotics and bifidobacteria also have certain anti-allergic effects. Of all the sources of anti-allergic substances, the ocean is rich in effective active substances due to its remarkable biodiversity and extremely complex living environment, and plays a huge role in the field of anti-food allergy. In this paper, the anti-food allergic bioactive substances isolated from marine organisms encompassing marine microbial, plant, animal sources and their mechanism were reviewed and the possible targets of anti-allergic substances exerting effects are illustrated by drawing. In addition, the development prospects of marine anti-allergic market are discussed and forecasted, which can provide reference for future research on anti-allergic substances. [ABSTRACT FROM AUTHOR]

Background: Administration of allergen mixtures of many components comprises the most common approach for American allergists regarding the management of polyallergic patients. European allergists, however, are more reluctant to this type of treatment due to the potential drawbacks of mixing extracts. Research design and methods: To assess the efficacy and safety of subcutaneous immunotherapy (SCIT) with polymerized allergen mixtures without dilutional effect in polyallergic patients. This observational, prospective, multicenter study included patients (between 5 and 60 years) with respiratory allergic diseases that had been prescribed with SCIT with mixtures of two pollen or mite extracts. Changes in Symptoms and Medication Score (SMS) and in rhinitis quality of life questionnaire (RQLQ), subjective clinical improvement, treatment satisfaction and tolerability were assessed after the 1-year treatment. Results: A total of 115 patients were included in the assessment. Mean global SMS decreased from 3.5 (SD = 1.1) to 1.6 (SD = 1.2) points, with a mean absolute reduction of 1.6 (SD = 1.3) points in the RQLQ score (p < 0.001, Wilcoxon test). General subjective clinical improvements and a good treatment satisfaction and tolerability were observed. Conclusion: SCIT with polymerized allergen mixtures from either pollen or mite extracts proved to be an effective and safe treatment option for polyallergic patients suffering from allergic respiratory diseases. [ABSTRACT FROM AUTHOR]

Fexofenadine is a second-generation inverse agonist of H1-receptor of histamine which is highly selective with proven efficacy in relieving symptoms associated with allergic conditions. It has an additional benefit of not penetrating the blood–brain barrier and therefore do not induce sedation and not impair the cognitive function/psychomotor performance. This review aimed at providing evidence based on available controlled studies to reinforce the non-sedative property of fexofenadine for treating patients with allergic rhinitis and urticaria. We performed an electronic literature search using keywords such as fexofenadine, drowsiness, somnolence, sedation, fatigue, cognitive, impairment, psychomotor, driving performances, sleep, rapid eye movement, alertness, clinical study, in vitro study, in vivo study, and pharmacodynamics in the Embase search engine. The review included randomized controlled trials, review articles, systematic reviews, and meta-analyses, together with post-marketing analysis conducted in healthy subjects and patients with allergy and were focused on comparing the antihistaminic potential or safety of fexofenadine with other antihistamines or placebo. Positron emission tomography (PET) and proportional impairment ratio (PIR) data along with other objective tests from various studies confirmed the non-sedative property of fexofenadine. Results of brain H1-receptor occupancy (H1RO) obtained from PET showed no H1RO by fexofenadine, the receptor which is known to cause sedation of H1 antihistamines. Most studies calculating PIR value as 0 showed fexofenadine to be a non-impairing oral antihistamine regardless of dose. Clinical trials in adults and children showed fexofenadine to be well tolerated without sedative effect or impairment of cognitive/psychomotor function even at higher than recommended doses. Published literature based on various parameters and clinical trials conducted for evaluating the effect of fexofenadine on sedation and central nervous system shows fexofenadine is both clinically effective and non-sedating. [ABSTRACT FROM AUTHOR]

A growing number of tick species have now been demonstrated to induce red meat allergies through biting humans. During the course of the bite, Galactose alpha-1,3-Galactose, commonly abbreviated as alpha-Gal, a carbohydrate not found in humans, but common in four-legged mammals, makes its way through to the bloodstream, triggering antibody production. Subsequent consumption of red meat by bite victims sets off a peculiarly delayed immunological reaction that may range from hives through to anaphylaxis. This paper documents the discovery of its linkage with tick bites. The spread of this syndrome worldwide warrants the attention of scientific and clinical librarians serving allergists, immunologists, dieticians, and entomologists. [ABSTRACT FROM AUTHOR]

Exposure to flour dust can be found in the food industry and animal feed production. It may result in various adverse health outcomes from conjunctivitis to baker's asthma. In this paper, flour dust exposure in the above-mentioned occupational environments is characterized and its health effects are discussed. A peer-reviewed literature search was carried out and all available published materials were included if they provided information on the above-mentioned elements. The hitherto conducted studies show that different components of flour dust like enzymes, proteins and baker's additives can cause both non-allergic and allergic reactions among exposed workers. Moreover, the problem of exposure to cereal allergens present in flour dust can also be a concern for bakers' family members. Appreciating the importance of all these issues, the exposure assessment methods, hygienic standards and preventive measures are also addressed in this paper. [ABSTRACT FROM AUTHOR]

Introduction: With increasing focus on nutritional strategies to counter the rising global burden of allergic disease, there has been a particular focus on prebiotic nutrients that are selectively utilized by host microorganisms to confer potential immunomodulatory benefits for disease prevention. Areas covered: In this review we examine maternal and infant dietary sources of prebiotics with a particular focus on non-digestible oligosaccharides, which undergo microbial fermentation by commensal gut bacteria to produce short chain fatty acids (SCFA). We summarize the major proposed health benefits of SCFA in early life immune development, together with the current evidence for maternal and/or infant prebiotic consumption in abrogating the risk of early childhood allergic diseases. Medline searches (to August 2017) for English language papers included prebiotics and SCFA search terms in combination with relevant allergic disease terms. Expert commentary: The potential beneficial effects of maternal and infant prebiotic consumption for allergy prevention are promising, but still require considerably further investigation through high-quality randomised controlled trials and detailed mechanistic studies. This should be coupled with more research on the biological effects of human milk oligosaccharides (HMO), including their influence on infant immune development, and the maternal nutritional factors that optimise HMO composition and infant outcomes. [ABSTRACT FROM AUTHOR]

This study summarizes and reviews the available health information on ortho-phthalaldehyde (OPA), a recently introduced and widespread disinfectant for heat-sensitive medical equipment, particularly focusing on its possible immunological effects in the healthcare setting. OPA properties derived from laboratory and clinical studies, and in vivo and in vitro tests for the diagnosis of OPA allergy are described. The available evidence suggests the spreading of OPA as disinfectant in endoscopy units despite the little available scientific evidence on its safety. Indeed, some papers reported on serious adverse reactions to OPA in patients and, to a lesser extent, in exposed workers, and in vivo studies suggested that OPA is a dermal and respiratory sensitizer. Finally, until more definite safety data become available only suggestions on possible preventive measures can be provided. [ABSTRACT FROM AUTHOR]

The aim of this paper is to understand how local residents participate in the construction of local environmental problems and to evaluate a particular analytical approach in environmental sociology to study this phenomenon. The paper is based on an interview study with a sample of local residents. The analysis demonstrates how the local residents attempt to construct a local environmental problem. In particular, the study focuses on how involved actors are positioned, how different sorts of knowledge claims are used, and how the neglect the residents perceive from the authorities affects the attempt to construct a local environmental problem. The study shows that the local residents play a central role in the construction of the situation and that the evaluated model could be very helpful as an analytical tool in the investigation of local residents' participation in the construction of environmental problems. [ABSTRACT FROM AUTHOR]

This paper analyses the political process for handling an outbreak of an insect causing human allergic reactions. In the southern part of the Swedish island Gotland in the Baltic Sea, an outbreak of the northern pine processionary moth, Thaumetopoea pinivora, has occurred. With regard to the human nuisance and long-term effects on the tourist industry, demands have been raised for intervention to reduce and control the insect population. At the same time, there have been warnings against treating the insect population because there are knowledge gaps concerning the wider ecological consequences, including effects on biodiversity. This paper analyses the political process and its problem-solving efforts. Of particular interest is how it dealt with the issue of uncertainty. It was found that the uncertainty associated with the issue hindered the development of a shared understanding of the problem and a possible solution. There seems to be a growing need in society to develop the institutional capacity to handle complex issues that cross different sectors, regulatory frameworks and policy targets. [ABSTRACT FROM AUTHOR]

Allergic contact dermatitis (ACD) is a delayed-type hypersensitivity (DTH) reaction induced by repeated contact with sensitizers. The ability of a chemical to act as a sensitizer has most frequently been tested in animals. As the use of animals for these purposes is gradually and globally being phased out, there is a need for reliable in vitro surrogate assays. Currently proposed in vitro assays are designed to test four key events of the adverse outcome pathway (AOP) involving covalent modification of self-proteins by sensitizers (haptenation) and presentation of new antigens (hapten/carrier complexes) to the immune system. There appears to be imperfect alignment of in vitro assays with clinical and/or animal data, suggesting possibly additional mechanisms of ACD development. Indeed, studies on allergies to small drugs, small chemical-induced HLA-peptide exchange for vaccination purposes and cosmetic ingredient-induced exposure of autoantigens suggest a possibility of DTH response promotion by hapten/carrier-independent mechanisms. Therefore, there is a need for additional appropriate in vitro assays, in order to achieve maximal concordance between clinical and/or animal data and in vitro assays. In this paper, we will review evidence supporting the idea of diverse mechanisms of ACD development. We will also discuss the impact of these multiple mechanisms, on the AOP and on the in vitro assays that should be used for allergen detection. We will propose alloreactivity-like reactions, aided by computer modeling and biochemical tests of compound-HLA binding, as additional tools for better prediction of DTH reactions, resulting from exposure to ingredients in cosmetic products. The combination of the proposed tests, along with the existing assays, should further enhance animal-free assessment of sensitizing potential of individual chemicals. [ABSTRACT FROM AUTHOR]

Asparaginase is a key component of therapy for acute lymphoblastic leukemia (ALL). Traditionally, asparaginase was administered intramuscularly but is now commonly given intravenously. Although intravenous administration is less painful, it can be challenging to differentiate hypersensitivity versus infusion-related reactions. The ability to distinguish between asparaginase-mediated reactions is critical to ensure optimal asparaginase treatment. In this paper, we will review the differences in pharmacokinetics and toxicities, when asparaginase is administered intravenously versus intramuscularly in pediatric patients with ALL. Differences between antibody-mediated hypersensitivity events and nonantibody-mediated infusion reactions will be addressed to assist practitioners in distinguishing between these clinically similar asparaginase-associated toxicities. [ABSTRACT FROM AUTHOR]

Allergic eye disease or ocular allergy is a debilitating condition with a significant impact on quality of life and productivity. As atopy continues to be on the rise, primary care providers are likely to encounter increasing numbers of patients with allergic eye disease. This review outlines the classification and pathophysiology of allergic eye disease and its clinical presentation. This paper does not detail traditional first‐line therapies of allergic eye disease but describes the interdisciplinary management between the eye‐care provider and allergist. It is recommended that patients with ongoing signs and symptoms of ocular allergy despite first‐line therapies be referred for allergen immunotherapy, as it is highly effective for treatment of allergic eye disease. Through induction of immune tolerance, allergen immunotherapy is a disease‐modifying therapy that can result in long‐term improvement of ocular allergy. A thorough literature review was conducted on the efficacy and safety of allergen immunotherapy, including subcutaneous immunotherapy and sublingual immunotherapy, and its role in allergic eye disease. [ABSTRACT FROM AUTHOR]

Skin is the largest organ of the body and is constantly exposed to physical, chemical, bacterial, and fungal challenges. It is well known that probiotics are helpful for specific disorders and different clinical studies have indicated that probiotics have special effects in cutaneous apparatus directly or indirectly that can be considerable from versatile aspects. Probiotic bacteriotherapy can have great potential in preventing and treating the skin diseases including eczema, atopic dermatitis, acne, and allergic inflammation or in skin hypersensitivity, UV-induced skin damage, wound protection, and as a cosmetic product. The current paper comprehensively reviews the different health effects of probiotics on the skin. [ABSTRACT FROM PUBLISHER]

Vector-borne diseases are a growing burden worldwide. In particular, the risks of allergic reactions to bites are associated with growing arthropod populations in contact with the public. The diversity of allergic reactions associated with host and arthropod factors difficult disease diagnosis, prognosis and prevention. Therefore, arthropod-associated allergies are underdiagnosed and require better surveillance of arthropod populations and disease diagnosis and management. To face these challenges, in this study, we describe five cases to illustrate arthropod-associated allergies with different symptomatology, including alpha-gal syndrome (AGS) associated with anti-alpha-gal IgE antibody titres. Information on symptoms in response to arthropod bites was collected from patients and medical doctors. The five cases included patients bitten by a robber fly and different tick species. Cases were in Spain or U.S.A. Two cases were diagnosed with AGS and one case was diagnosed with anaphylaxis in response to tick bite with high anti-alpha-gal IgE levels. The symptoms in response to arthropod bites vary between different cases. Allergic reactions and symptoms in response to arthropod bites vary in association with host and arthropod factors. Herein we propose recommendations to control allergic symptoms, associated disease risk factors and the way forward to advance in the prevention and control of arthropod-associated allergies. [ABSTRACT FROM AUTHOR]

The aim of this study was to identify allergenic cross-reacting allergens in patients with inhalation and food allergy using molecular diagnostics ISAC test. The study group consisted of 50 adult patients. The control group contained 20 healthy people. In the study group 92% patients were found to have the asIgE component responsible for cross-allergy between plant pollens and foods. The presence of asIgE was the most common for the Bet v 1 component. AsIgE was also detected for the component responsible for the presence of a true allergy to 26% patients. A statistically significant frequency of sensitization to 12 crossreactive components was demonstrated, 10 of them belonged to the PR-10 proteins. An allergy profile of the studied population was created based on the ISAC results. The results of the study suggest that cross-reactions are the main cause of food allergy, and their frequency rises with increased sensitization to inhaled allergens. [ABSTRACT FROM AUTHOR]

Being an important crop, soybean is widely used in the world and plays a vital role in human and animal nutrition. However, it contains several antinutritional factors (ANFs) including soybean agglutinin, soybean protease inhibitors, soybean allergenic proteins, etc., that may result in poor food utilization, decreased growth performance, and even disease. Among these ANFs, soybean allergenic proteins can lead to allergic reactions in human and animals, which has become a public problem all over the world, but our knowledge on it is still inadequate. This paper aims to provide an update on the characteristics, detection or exploration methods, and in vivo research models of soybean allergenic proteins; especially glycinin and β-conglycinin are deeply discussed. Through this review, we may have a better understanding on the advances of research on these two soybean allergenic proteins. Besides, the ingredient processing used to reduce the allergenicity of soybean is also reviewed. [ABSTRACT FROM AUTHOR]

Allergic colitis (AC) typically develops in the first weeks or months of life and is characterized by the presence of red blood in the stools of healthy breastfed or formula fed infants. In this paper, we describe a case of rectal bleeding in monozygotic preterm twins that was resolved with the introduction of a cow's milk protein-free diet (CMPFD). The occurrence of this disorder in monozygotic twins raises the question as to whether the underlying abnormality in the immune regulation, which leads to poor acquisition of tolerance to cow's milk proteins, might be inherited or environmentally acquired. The case also highlights the use of the probiotic Lactobacillus GG (LGG) in the treatment of allergic colitis. [ABSTRACT FROM AUTHOR]

Leptosphaeria maculans and L. biglobosa are fungal pathogens able to cause allergic reactions in humans and infect plants of Brassica species. The rate of their development and subsequent spore release depend on weather conditions. The aim of this paper was to pinpoint the exact meteorological conditions triggering the release of L. maculans and L. biglobosa ascospores in central and eastern Poland. Multiple regressions indicated that the frequency and amount of rainfall over short periods were important in mediating spore release. The first ascospore event depended mainly on the number of rainy days during the first 10 days of July and the cumulative precipitation during July and September. The most important variables for maximum spore release were cumulative rainfall in the beginning of July and the end of September, as well as the number of days with precipitation events in the first 10 days of August. The results highlighted for the first time the importance of the days preceding the collection of oilseed rape plants from the field. Higher moisture content of senescing but still living stems play a crucial role in the early start of the ascospore season and the maximum release of ascospores. This was not yet considered to date. [ABSTRACT FROM PUBLISHER]

The guidelines for the management of urticaria in adults and children have been published in outstanding position papers. By contrast, the onset of urticaria in the elderly has not yet had a clear definition. In order to approach diagnosis and treatment in a population of elderly patients, we have performed an epidemiological study on a population of elderly people observed in the Immuno Allergology Unit in Bari University Hospital. The patients underwent skin prick test for food allergy and laboratory and instrumental tests. From the data it resulted that 49% of cases have had urticaria because of adverse drug reactions (ADRs), 16% of cases were positive to food, while in 21% of cases systemic and metabolic diseases (SMDs) have been diagnosed. If we consider the young controls, urticaria for ADR was present in 48% of cases; however, in 28% it was possible to make the diagnosis of food allergy, 12% cases had a SMD. Our results show that the main cause of urticaria in the elderly is related to drug assumption because of the high number of drugs taken, followed by internal pathologies correlated to the typical immune and metabolic changes of the elderly. Furthermore, from the observation of our data it was possible to give guidelines for the treatment of urticaria in geriatric age. [ABSTRACT FROM AUTHOR]

This paper discusses how interracial couples both resist and comply with the prevailing ideology and racial logic of homogamy through their use of dominant and subordinate discourses around (1) hypersensitivity of the partner of color and (2) history's insignificance. Qualitative interviews with interracial couples reveal their strategic responses to racism in the public context and to racial and ethnic differences in the relationship context. The narratives highlight marginalized “truths” crucial to effective clinical work with interracial couples. Implications for intervention with interracial and intercultural couples are discussed. [ABSTRACT FROM PUBLISHER]

This paper analyses the process of establishing a risk object – electromagnetic fields. This example will be used to examine risk categorisation as such, and to explore how individual and collective attempts to establish a new risk interact with health policy. We studied people who claim to suffer from electro-hypersensitivity. We conducted participant observation and repeated interviews with 18 electro-hypersensitivity sufferers, and interviewed representatives of ‘patient’ organisations and health policy-makers in the Netherlands. In their attempts to trace particular outcomes (electro-hypersensitivity) to a specific risk factor (electromagnetic fields), we observed electro-hypersensitivity sufferers assembling complaints and complainants into a single illness category, distinguishing ‘real’ from ‘fake’ cases, and turning to measurement and experiments in order to show that others are at risk. Although electro-hypersensitivity sufferers mimic scientific practices, they have thus far failed to have their illness recognised. To non-sufferers, electro-hypersensitivity remains a psychosomatic condition. This position entails a dual failure for electro-hypersensitivity sufferers – they suffer from medically unexplained symptoms while identifying with a politically and medically unrecognised label. This very failure, however, provides perceived legitimacy for political activism. Although those who categorise themselves as having electro-hypersensitivity have failed to establish electromagnetic fields as a risk, their suffering is increasingly recognised. This partial recognition, we argue, is an attempt to depoliticise the issue. [ABSTRACT FROM PUBLISHER]

This paper describes an EEG pattern the author has found to be associated with an allergic response. A consistent 22 Hz frequency pattern has now been observed in more than 100 cases in recordings made with a bipolar (sequential) montage at F4-T4. Case illustrations with examples of this EEG pattern are provided. [ABSTRACT FROM AUTHOR]

The public health implications of vehicular emissions are substantial. The particulate matter, particularly that less than 10 µ in size, can pass through the natural protective mechanism of human respiratory system and plays an important role in genesis and augmentation of allergic disorders. A fact-finding survey was conducted in an Indian city This paper discusses the approach for the selection of air monitoring stations, the methodology adopted for sampling and subsequent analysis. It focuses on the results of SPM, RPM, NOx, SO2, CO and Pb levels; indicated that they are currently at levels dangerous to human health. A questionnaire survey was conducted to evaluate the impact of vehicular emissions on human health, particularly in the increase of suspected allergic population. Based on the survey of SPM related RDs, the incidence of each disease within the middle-class sub-population (activity-wise) was recorded for indexing the imprint class. In order to mitigate air pollution in the city a strategic air pollution management plan has been proposed and the possible different measures that could be adopted to maintain the balance between sustainable development and environmental management have been discussed. [ABSTRACT FROM AUTHOR]

This paper aims to present to colleagues as broad a picture as possible within the confines of a reasonable length information about the range of mites and insects known to cause allergy problems. In addition it provides a reference list, and may stimulate thoughts about possible causes for unresolved clinical problems. [ABSTRACT FROM AUTHOR]

A very successful 2 day symposium on the health hazards of milk was held at Manchester University in 1983, and David Freed edited the proceedings which were published the following year. Since then, the incidence of allergic diseases, especially food allergies, has increased at an alarming rate for reasons which have not yet been clearly defined. While the unravelling of the immunology of IgE-mediated allergy is proceeding rapidly, progress in understanding the causative mechanisms of intolerance is slow by comparison. The lack of properly authenticated laboratory tests which can indicate accurately which food is the cause of a problem must inevitably retard progress in the recognition of food intolerance. Until such tests are available food intolerance will not be recognized as a cause of serious chronic ill health, and the prescription of expensive drugs which suppress symptoms but do not cure will continue to be the usual approach. This paper is an expansion of the illustrated talk I gave at the symposium in June 2001, and is not only an attempt to review the subject, but also to demonstrate, by recounting some of my experiences over the last 45 years, how milk intolerance can affect any system of the body in innumerable subtle ways which are seldom recognized. At the present time the only diagnostic test for milk intolerance is to find out what will happen if milk products are totally avoided, but to many the very idea of doing without such an essential food is anathema. Considering all the other health hazards of milk which have been recognized would suggest that the cows have been inflicting a subtle revenge on us all for the last century. [ABSTRACT FROM AUTHOR]

Latex allergy is an increasingly common condition, because use of latex products is widespread. The reactions to latex manufactures can be classified as allergic and non-allergic, these are the most common. Latex proteins are responsible for immediate IgE-mediated hypersensitivity allergic reactions. Symptoms range from rhinitis, conjunctivitis and urticaria to anaphylactic shock. Chemical additives can cause allergic contact dermatitis. The clinical symptoms of latex allergy could arise from direct contact with latex products, but may also result from inhalation of airborne allergens. Subpopulations at particular risk include: atopics, children with spina bifida or individuals who required frequent surgical instrumentations, health care workers, and all persons who have regular contact with latex products. Diagnosis of allergy is based initially on history; search for specific serum IgE, skin prick test and provocation test may confirm the suspicion. The most effective strategy in the treatment of latex allergy is avoidance, however this is virtually impossible, given large number of latex products we encounter since childhood. In this paper we review the current state of knowledge concerning latex allergy, including the clinical spectrum, identified allergens, the cross-reactions regarding the latex-fruit syndrome, diagnostic procedures and preventive measures. Several personal data increase awareness on this issue. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of this paper is to review whether the time has come to reconsider the use of the term ''fibromyalgia'' to describe this syndrome. Findings: The term ''fibromyalgia'' suggests that fibrous and muscular abnormalities are causally involved in the etiology of the syndrome or that muscle pain is the most relevant clinical finding, however, current research suggests that there are no significant structural or functional differences between fibromyalgia and normal muscles. Persons with fibromyalgia have altered nociception, hyperalgesia, allodynia, and hypervigilance. The hyperalgesia is present not only over fibromyalgia tender points but also in nonpainful regions. Several studies have suggested that fibromyalgia is due to hypersensitivity of the central nervous system rather than pathologically painful muscles. Conclusions: The etiology and symptoms of fibromyalgia are not due to structural or functional changes in muscle or fibrous tissues. Hence, the term ''fibromyalgia'' does not describe the etiology of the syndrome adequately. The International MYOPAIN Society could be a conduit for a change in taxonomy from ''fibromyalgia'' to for example, ''complex widespread pain syndrome,'' or other name that adequately reflects the etiology and complexity of the syndrome that is now known as ''fibromyalgia.'' [ABSTRACT FROM PUBLISHER]

The purpose of this study was to examine the association between farm exposures and asthma and allergic disease in children while also highlighting the experiences of non-farm rural children. This was a cross-sectional analysis of data collected from across the province of Saskatchewan, Canada in 2014. Surveys were completed by parents of 2275 rural dwelling children (farm and non-farm) aged 0 to 17 years within 46 rural schools. Questionnaires were distributed through schools for parents to complete. Asthma prevalence was 7.6%, of which 29.5% of cases were allergic. After adjustment for potential confounders, home location (farm vs non-farm) and other farm exposures were not associated with asthma and asthma phenotypes. Those who completed farm safety education were more likely to have asthma (11.7% vs. 6.7%; p =.001) compared to children without asthma. In sub-analyses among 6–12-year-old children, boys were more likely to have asthma (non-allergic) and use short-acting beta-agonists compared to girls. Doing farm work in the summer was associated with an increased risk of asthma [adjusted OR (aOR) = 1.71 (1.02–2.88); p =.041]. Doing routine chores with large animals was associated with an increased risk of asthma [aOR = 1.83 (1.07–3.15); p =.027] and allergic asthma [aOR = 2.37 (95%CI = 1.04–5.40); p =.04]. The present study showed that the prevalence of asthma and asthma phenotypes were similar between farm and non-farm rural children. There did not appear to be differential involvement in farming activities between those with and without asthma although those with asthma had more training suggesting possible attempts to mitigate harm from farm exposures. [ABSTRACT FROM AUTHOR]

Toothpaste has importance in environmental and biological studies because of its daily usage by humans and its ability to transport radon gas to the teeth when this sample contains radiation like alpha particles; therefore, the purpose of this study is to determine and measure the concentration of radon concentration (alpha particles) emitters from the toothpaste samples with the impact of radioactivity in the toothpaste on the teeth and transfer this effect to the teeth of the volunteer, by using CR-39 NTDs and natural method (passive method) and PVC tube. The alpha emitter's concentration in the toothpaste samples varies from 0.3557 to 0.7193 ppm and in teeth samples from 0.0089 ppm to 0.0161 ppm. The results showed that the radon concentration in toothpaste samples was lower than the global permissibility limiting of exposure to radon 200 Bq m−3 and the average annual effective dose in the studied samples was in the range of about (1.837 mSvy−1), which was below range (3–10 mSvy−1) reported by the ICRP (1993). Therefore, there is no evidence of health problems and human teeth in safe. A significant strong positive correlation was found (r = 1, p < 0.000) between the concentrations of alpha emitters in toothpaste and in teeth, depending on the volunteer's age, the allergic reaction of the body to radiation because the concentrations of alpha emitters increase with an increase in age. [ABSTRACT FROM AUTHOR]

Allergic diseases (AD) are significant and hence rapid and accurate immunoglobulin E (IgE) determination is critical for diagnosis and treatment. Herein, a rapid, sensitive, and quantitative immunochromatographic test strip was designed for assaying IgE in human serum based on laboratory-constructed time-resolved fluorescent nanospheres (LTRFNs) which have large specific surface areas and multiple carboxyl groups in the outer layer with efficient coupling to the antibodies. Using the stable fluorescence created by the LTRFNs, the test strip accurately quantified IgE for early diagnosis with a detection limit of 4.2 ng/mL. The test strip has a long working range from 8 to 1024 ng/mL, and excellent performance, including high sensitivity, good inter-batch repeatability, and stability. Furthermore, the analysis of 30 clinical serum samples showed good correlation with a commercial chemiluminescence protocol. Therefore, the laboratory-constructed test strip has potential as a novel tool for clinical diagnosis and a rapid home test for allergic diseases. [ABSTRACT FROM AUTHOR]

Workers on dairy farms face exposures to organic dusts and endotoxin. At the same time, a number of studies of farmers have reported a lower prevalence of asthma in farmworkers compared to persons without farm contact. The "hygiene hypothesis" suggests that early life exposures on farms could be protective against allergic disease and asthma. Such protective relationships are less well studied in adult farm workers. A cross-sectional analysis of respiratory function and allergy status was performed in a sample of dairy farm workers (n = 42) and community controls (n = 40). Measures of respiratory status (spirometry, exhaled nitric oxide FeNO, self-reported symptoms) and levels of total and bovine-specific IgE were compared between the groups. Prevalence of self-reported asthma and most respiratory symptoms was similar in the two groups, with the exception of increased report of dyspnea among dairy workers. In the dairy workers, level of lung function was not reduced and FeNO was not increased. In unadjusted and adjusted models, dairy work was not associated with reduced lung function or increased airway inflammation. Mean IgE levels did not differ significantly between workers and controls, but elevated bovine-specific IgE was detected only among dairy workers, with an apparent association between elevated bovine IgE and increased FeNO. While dairy workers did not demonstrate increased asthma prevalence compared to controls, sensitization to bovine antigen in several workers appeared to be associated with airway inflammation. Occupational health programs for dairy workers should consider the risk of animal allergy as part of respiratory health protection efforts. [ABSTRACT FROM AUTHOR]

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Anaphylaxis is an acute systemic and potentially fatal allergic reaction. We evaluated trends in yearly rates of anaphylaxis in a pediatric Emergency Department (ED) in Montreal, Canada. A prospective and retrospective recruitment process was used to find families of children who had presented with anaphylaxis at the Montreal Children's Hospital between April 2011 and April 2021. Using a uniform recruitment form, data were collected. Anaphylaxis patterns were compared to clinical triggers using descriptive analysis. Among 830,382 ED visits during the study period, 2726 (26% recruited prospectively) presented with anaphylaxis. The median age was 6 years (IQR: 0.2, 12.00), and 58.7% were males. The relative frequency of anaphylaxis cases doubled between 2011–2015, from 0.22% (95% CI, 0.19, 0.26) to 0.42 March 2020, the total absolute number of anaphylaxis cases and relative frequency declined by 24 cases per month (p < 0.05) and by 0.5% of ED visits (p < 0.05). The rate of anaphylaxis has changed over the years, representing modifications in food introduction strategies or lifestyle changes. The decrease in the frequency of anaphylaxis presenting to the ED during the COVID pandemic may reflect decreased accidental exposures with reduced social gatherings, closed school, and reluctance to present to ED. [ABSTRACT FROM AUTHOR]

Peanut allergy can result in severe, sometimes fatal hypersensitivity reactions that place a considerable burden on the lives of patients. This article reviews the first approved immunotherapy for the mitigation of allergic reactions following accidental peanut exposure, peanut (Arachis hypogaea) allergen powder-dnfp (PTAH; Palforzia®, Aimmune Therapeutics). This article highlights the unmet need for patients with peanut allergy, describes the therapeutic landscape, and reviews the development of and clinical data for PTAH. PTAH offers a standardized preparation of peanut allergen, with a tolerability and efficacy profile clearly defined through its robust clinical development and trial program. In children 4–17 years old, PTAH provides a standardized, approved product that many clinicians sought prior to initiating oral immunotherapy. PTAH reduced the likelihood of more severe reactions following exposure to peanut protein; although peanut avoidance remains essential, PTAH will enable more individuals with peanut allergy to participate in activities of daily life with less anxiety. Peanut allergy is a serious, potentially fatal condition. It often starts in childhood, and the only treatment used to be emergency medicine after contact with peanuts. Children are recommended to avoid any contact with peanuts or products made with peanuts, which can be difficult and stressful, especially in social situations such as school. A treatment called oral immunotherapy, based on very small amounts of protein from peanut, was developed to help the body get used to coming into contact with peanuts without a dangerous reaction. PTAH (Peanut [Arachis hypogaea] allergen powder-dnfp) is a type of oral immunotherapy that doctors can prescribe for children with peanut allergy. It is the first medicine of its kind to be allowed and is prepared specially to make sure that the right amount of peanut is given to children. In controlled tests, children with peanut allergy were given increasing amounts of peanut to see how much they could eat before they had a bad reaction. Children who had been given PTAH for a few months could eat more peanut (without a bad reaction) than children who had been given a placebo. Although there are some side effects from PTAH, particularly tummy upsets, most children who took it in the trials were able to keep taking it. Although children with peanut allergy will still need to avoid peanuts, PTAH may allow them to lead a more normal life with less worry about accidentally coming into contact with peanuts. [ABSTRACT FROM AUTHOR]

The purpose of this study is to determine the effects of radon concentration (alpha particles) on cancer patients in the Kurdistan Iraq region; therefore, this study was carried out to detect and measure the concentration of radon in powdered blood samples from the humans who have cancer in Kurdistan Iraqi region (Sulaymaniya and Erbil) using CR-39 NTD (passive method). The results showed the activity concentrations of radon in the blood of cancer patients ranged from the highest value of 146.328 Bq m−3 in CP26-Colon cancer in Mawat to the lowest value of 7.376 Bq m−3 in CP32-Lung cancer in Zargatay taza with an average value of 34.312 Bq m−3 in Sulamaniya governorate (Hewa center for cancer) and concentrations of radon ranged from highest value of 56.996 Bq m−3 to lowest value 11. 610 Bq m−3 with an average value of activity concentrations of radon 29.183 Bq m−3 in Erbil governorate (Nana kaly center for cancer). The results showed that the radon concentration in powdered blood samples was lower than the global permissibility limiting of exposure to radon 200 Bq m−3, and the average annual effective dose in the studied blood samples was in the range of about 0.635 mSvy−1, which was below the range of 3–10 mSvy−1 reported by the ICRP (1993). The variation in concentrations of radon in different locations may be arisen due to the difference in the nature of blood samples and nuclei content in these samples, also depending on the allergic reaction of the body to radiation. This work owes its importance to the fact that it aims at knowing and measuring the concentrations of radon in the blood samples and its impact on cancer in particular. Knowledge of these concentrations is extremely important since it reveals whether the human has received the radiation in high value or not. The issues in this research are very important in strengthening the link between radon, radon progeny, uranium, and blood of patients with cancer in the Kurdistan Iraqi region. [ABSTRACT FROM AUTHOR]

To determine the prevalence of self-reported pre-race chronic medical conditions and allergies in ultramarathon race entrants and to explore if these are associated with an increased risk of race-day medical encounters (MEs). Data from two voluntary open-ended pre-race medical screening questions (Q1 – history of allergies; Q2 – history of chronic medical conditions/prescription medication use) were collected in 133641 Comrades Marathon race entrants (2014–2019). Race-day ME data collected prospectively over 6 years are reported as incidence (per 1000 starters) and incidence ratios (IR: 95%CI's). Pre-race medical screening questions identified race entrants with a history of chronic medical conditions and/or prescription medication use (6.9%) and allergies (7.4%). The % entrants with risk factors for cardiovascular disease (CVD) was 30% and being older (>45 years) or male (27.5%) were the most frequent CVD risk factors. 0.3% of entrants reported existing CVD. The overall incidence of MEs was 20/1000 race starters. MEs were significantly higher in race entrants reporting a 'yes' to Q1 (allergies) (IR = 1.3; 1.1–1.5) (p = 0.014) or Q2 (chronic medical conditions and/or prescription medication use) (IR = 1.3; 1.1–1.5) (p = 0.0006). Voluntary completion of two open-ended questions identified chronic medical conditions and/or prescription medication use in 6.9% and allergies in 7.4% of ultramarathon race entrants. This is lower than that reported for other races that implemented compulsory completion of a more comprehensive pre-screening questionnaire. Despite potential under-reporting, a pre-race self-reported history of chronic medical conditions and allergies was associated with a higher risk of race-day MEs. [ABSTRACT FROM AUTHOR]

Our study analyses the sensitisation profile to kiwi allergens in patients suffering from atopic dermatitis with the use of ALEX2 Allergy Explorer test. The sensitisation to molecular components of latex, banana, avocado, pollen, seeds within latex fruit syndrome was also evaluated. Altogether 100 atopic dermatitis patients were examined. The incidence of clinical reaction to kiwi was observed in 15% of patients; a combination of the kiwi allergens Act d 1, Act d 2 and Act d 10 gave a diagnostic sensitivity of 33.3%. The latex fruit syndrome was recorded in one patient (1%) with the positive result to Hev b 6.02, to (Pers a) and oral allergy syndrome after kiwi ingestion. The sensitisation both to molecular components of kiwi and latex was recorded in 7% of patients. Further research on kiwi allergy should focus on the importance of chitinase and 2S albumins. [ABSTRACT FROM AUTHOR]

Context: Saposhnikovia divaricata (Turcz.) Schischk (Apiaceae) (SD) has various pharmacological activities, but its effects on type I allergy (TIA) have not been comprehensively studied. Objective: This study evaluates the treatment and molecular mechanisms of SD against TIA. Materials and methods: The effective components and action targets of SD were screened using TCMSP database, and allergy-related targets of SD were predicted using GeneCards and OMIM database. The obtained target intersections were imported into David database for GO analysis, and used R software to perform KEGG analysis. The RBL-2H3 cells sensitised by DNP-IgE/DNP-BSA were treated with different concentrations of SD (root decoction, 0.5, 1, and 2 mg/mL), prim-O-glucosylcimifugin (POG, 10, 40, and 80 μg/mL) and the positive control drug-ketotifen fumarate (KF, 30 μM) for 12 h, then subjected to cell degranulation and qPCR analysis. Results: Eighteen active compounds of SD and 38 intersection targets were obtained: TIA-related signal pathways mainly include calcium signal pathway, PI3K-Akt signal pathway and MAPK signal pathway. Taking the β-Hex release rate of the model group as the base, the release rate of SD and POG in high dose groups were 43.79% and 57.01%, respectively, which were significantly lower than model group (p < 0.01), and significantly lower than KF group (63.83%, p < 0.01, p < 0.05). SD and POG could down-regulate the expression of related proteins in the Lyn/Syk, PI3K/AKT and MAPK signalling pathways. Discussion and conclusion: Saposhnikovia divaricata could inhibit IgE-induced degranulation of mast cells, providing a scientific basis for further research and clinical applications of SD in TIA treatment. [ABSTRACT FROM AUTHOR]

Conclusions: The preliminary finding of significantly lower eosinophilic-type CRSwNP recurrence rates in patients with associated asthma or ASA intolerance treated post-operatively with local nasal and oral steroids warrants further investigation in larger, prospective series. Objective: A high recurrence rate after functional endoscopic sinus surgery (FESS) has been widely reported in patients with eosinophilic-type chronic rhinosinusitis with nasal polyps (CRSwNP). This study compared the influence of two post-operative medical treatments – local nasal steroids alone vs local nasal and oral steroids – on the recurrence of eosinophilic-type CRSwNP. Method: Between January 2009–December 2010, 32 patients with eosinophilic-type CRSwNP received local steroid nasal therapy after FESS (Group A); from January 2011 onwards, another 28 patients were treated post-operatively with the same nasal treatment plus two cycles a year of oral steroids (Group B). All patients in both groups had a follow-up of at least 36 months. Results: Groups A and B did not differ significantly in recurrence rate (31.25% vs 32.14%, p = 1) or disease-free interval (p = 0.91), but Group B patients who were asthmatic or ASA-intolerant had a significantly lower recurrence rate than Group A patients with asthma or ASA intolerance (p = 0.04 and p = 0.004, respectively). [ABSTRACT FROM AUTHOR]