Browsing by Subject "nose provocation test"

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    Lower respiratory tract complications during nasal provocation: Nonspecific stimulant or specific allergen?
    (American College of Allergy, Asthma and Immunology, 2007) Kirmaz C.; Degirmenci P.B.; Tunali D.; Yuksel H.
    Background: Allergic rhinitis (AR) is an allergic inflammatory disease in which allergen exposure leads to the appearance of symptoms in sensitized individuals because of histamine liberation from nasal mucosal mast cells. Comorbidity of this disease with allergic asthma is common. Therefore, the one airway one disease theory has been put forward. Lower respiratory tract provocation tests with both nonspecific (methacholine) and specific stimulants (allergen) have yielded positive results in nonasthmatic patients with AR. However, not enough research is available to demonstrate whether there is a response in the lower respiratory tract during nasal provocation tests (NPTs) performed to evaluate only nasal airway in these patients. Objectives: To determine if the lower respiratory tract was affected as a result of NPTs with nonspecific and specific stimulants in nonasthmatic patients with AR and to determine the frequency of lower respiratory tract obstruction due to NPT with nonspecific and specific stimulants. Methods: Thirty-six participants were enrolled in the study between November 2005 and January 2006 (18 AR patients and 18 healthy control subjects). Patients underwent 2 sessions of NPT. The first session was performed with nasal methacholine as a nonspecific stimulant, and the second session was performed with nasal Olea europaea extract as a specific stimulant. The control group underwent only nonspecific nasal provocation with methacholine. Basal nasal opening and nasal pressures were evaluated spirometrically by rhinomanometric measurements and basal respiratory function tests in both groups before methacholine nasal provocation. Whether or not nasal provocation was achieved, spirometric measurements were performed in all patients and controls after NPTs. Results: NPTs with methacholine resulted in a similar frequency of nasal provocation in the patient and control groups (P = .63). However, the mean methacholine dose was lower in patients with AR (P = .049). There was a decrease in parameters of asthma, including the ratio of forced expiratory volume in 1 second to forced vital capacity (P = .04), peak expiratory flow (P = .01), and forced expiratory flow between 25% and 75% (P = .004), as a result of NPTs with methacholine in the patient group. However, NPTs with allergen did not cause a change in lower respiratory tract obstruction criteria. Conclusions: Lower respiratory tract obstruction can occur after NPTs with nonspecific stimulants; therefore, tests performed with specific allergens can be regarded as safer.
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    COVID-19 pandemic: Practical considerations on the organization of an allergy clinic—An EAACI/ARIA Position Paper
    (Blackwell Publishing Ltd, 2021) Pfaar O.; Klimek L.; Jutel M.; Akdis C.A.; Bousquet J.; Breiteneder H.; Chinthrajah S.; Diamant Z.; Eiwegger T.; Fokkens W.J.; Fritsch H.-W.; Nadeau K.C.; O’Hehir R.E.; O’Mahony L.; Rief W.; Sampath V.; Schedlowski M.; Torres M.J.; Traidl-Hoffmann C.; Wang D.Y.; Zhang L.; Bonini M.; Brehler R.; Brough H.A.; Chivato T.; Del Giacco S.R.; Dramburg S.; Gawlik R.; Gelincik A.; Hoffmann-Sommergruber K.; Hox V.; Knol E.F.; Lauerma A.; Matricardi P.M.; Mortz C.G.; Ollert M.; Palomares O.; Riggioni C.; Schwarze J.; Skypala I.; Untersmayr E.; Walusiak-Skorupa J.; Ansotegui I.J.; Bachert C.; Bedbrook A.; Bosnic-Anticevich S.; Brussino L.; Canonica G.W.; Cardona V.; Carreiro-Martins P.; Cruz A.A.; Czarlewski W.; Fonseca J.A.; Gotua M.; Haahtela T.; Ivancevich J.C.; Kuna P.; Kvedariene V.; Larenas-Linnemann D.E.; Abdul Latiff A.H.; Mäkelä M.; Morais-Almeida M.; Mullol J.; Naclerio R.; Ohta K.; Okamoto Y.; Onorato G.L.; Papadopoulos N.G.; Patella V.; Regateiro F.S.; Samoliński B.; Suppli Ulrik C.; Toppila-Salmi S.; Valiulis A.; Ventura M.-T.; Yorgancioglu A.; Zuberbier T.; Agache I.
    Background: The coronavirus disease 2019 (COVID-19) has evolved into a pandemic infectious disease transmitted by the severe acute respiratory syndrome coronavirus (SARS-CoV-2). Allergists and other healthcare providers (HCPs) in the field of allergies and associated airway diseases are on the front line, taking care of patients potentially infected with SARS-CoV-2. Hence, strategies and practices to minimize risks of infection for both HCPs and treated patients have to be developed and followed by allergy clinics. Method: The scientific information on COVID-19 was analysed by a literature search in MEDLINE, PubMed, the National and International Guidelines from the European Academy of Allergy and Clinical Immunology (EAACI), the Cochrane Library, and the internet. Results: Based on the diagnostic and treatment standards developed by EAACI, on international information regarding COVID-19, on guidelines of the World Health Organization (WHO) and other international organizations, and on previous experience, a panel of experts including clinicians, psychologists, IT experts, and basic scientists along with EAACI and the “Allergic Rhinitis and its Impact on Asthma (ARIA)” initiative have developed recommendations for the optimal management of allergy clinics during the current COVID-19 pandemic. These recommendations are grouped into nine sections on different relevant aspects for the care of patients with allergies. Conclusions: This international Position Paper provides recommendations on operational plans and procedures to maintain high standards in the daily clinical care of allergic patients while ensuring the necessary safety measures in the current COVID-19 pandemic. © 2020 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.