ABSTRACT
The salutogenic effects of green exercise are widely recognised, yet many individuals do not engage in this health-related behaviour. Using a convergent mixed methods approach, this study explored the impact of experiencing nature through Virtual Reality (VR) on the decision-making process relating to green exercise. Three experimental trials were conducted (overall n = 136), in which healthy adults were exposed to different VR scenarios reproducing a virtual walk in an existing urban green area. Participants reported medium-high rating of intent to visit the location. Significant pre-to-post increments in future green exercise intention were observed after the VR exposure, though a significance difference was not achieved in comparison with a control condition. Qualitative analysis revealed the impact of the VR experience on behaviour regulation, and highlighted the pivotal role of anticipated emotional benefits. Despite scepticism, the VR experience was effective in arousing curiosity to explore natural environments, which was associated with environmental perceptions as well as nostalgic and socio-cultural perspectives.
Subject(s)
Virtual Reality , Adult , Emotions/physiology , Exercise/physiology , Humans , IntentionABSTRACT
BACKGROUND: Emerging data have strengthened the importance of substance P (SP) as a proinflammatory mediator in human pathology. A role for SP in the pathogenesis of urticaria has long been hypothesized. METHODS: Literature data regarding the possible role of SP in chronic urticaria/chronic spontaneous urticaria (CSU) have been reviewed and summarized in this manuscript. This review is based on pertinent articles that were retrieved by a selective literature search in the PubMed database. Articles in English published up to July 2018 were taken into consideration. RESULTS: Recent studies in patients with CSU have demonstrated that circulating levels of SP are significantly elevated, in correlation with disease severity, and that SP-positive basophils are upregulated. SP has been shown to trigger degranulation in basophils derived from CSU patients. Moreover, SP can be involved in pseudoallergic reactions and may act as a histamine-releasing factor in a subset of patients with CSU. Current evidence suggests that the biological activity of SP can be exerted not only through the conventional NK-1 receptor but also through the recently identified Mas-related G protein-coupled receptors. MRGPRX2 can cause mast cell activation and has been found to be upregulated in the skin of patients with severe chronic urticaria. CONCLUSIONS: Many findings seem to support the pathogenic involvement of SP in chronic urticaria/CSU. However, further studies are necessary to elucidate the role of SP as a mediator in CSU pathogenesis and a potential new therapeutic target.
ABSTRACT
Adverse reactions (ARs) to drugs administered during general anesthesia may be very severe and life-threatening, with a mortality rate ranging from 3 to 9%. The adverse reactions to drugs may be IgE and non-IgE-mediated. Neuromuscular blocking agents (NMBA) represent the first cause of perioperative reactions during general anesthesia followed by latex, antibiotics, hypnotic agents, opioids, colloids, dyes and antiseptics (chlorhexidine). All these substances (i.e. NMBA, anesthetics, antibiotics, latex devices) may cause severe systemic non-IgE-mediated reactions or fatal anaphylactic events even in the absence of any evident risk factor in the patient's anamnesis. For this reason, in order to minimize perioperative anaphylactic reactions, it is important to have rapid, specific, sensitive in vitro diagnostic tests able to confirm the clinical diagnosis of acute anaphylaxis.
ABSTRACT
Acrylates and methacrylates are a large group of chemically reactive monomers that are polymerized into acrylic plastics. These have very broad applications in glues, coatings and various plastic materials. Allergic contact dermatitis (ACD) caused by acrylates can be occupational, mainly in dentistry workers during the manufacturing and implantation of dental prosthesis, and in nail technicians during the sculpturing and application of artificial nails. The clinical manifestations vary according to the location of the contact. In non-occupational ACD, hand eczema, pulpitis and stomatitis are more frequent. We conducted a study to investigate the frequency of sensitization to acrylates, determining the most frequently sensitizing acrylates and assessing the possible role of 2-hydroxyethyl methacrylate (2-HEMA) as a screening allergen. From January 2013 to December 2014, 217 patients with a personal history and symptoms suggestive of contact dermatitis were patch tested with an extended series of acrylates at the Dermatology and Allergology Units of the University Hospital of Bari. Seven patients (3.2%) had positive reactions. The reactions were related to artificial nails in 2 patients (28.6%), both beauticians, and dental material in 5 patients (71.4%) with dental prosthesis. 2-HEMA detected 100%of sensitized patients to acrylates.
Subject(s)
Acrylates/toxicity , Dental Prosthesis , Dermatitis, Allergic Contact/diagnosis , Dermatitis, Allergic Contact/epidemiology , Occupational Exposure/adverse effects , Adult , Aged , Female , Humans , Male , Middle AgedABSTRACT
The role and importance of thienopyridines such as ticlopidine, clopidogrel, and prasugrel is well-established for several indications, ranging from prevention of acute coronary syndromes to percutaneous coronary interventions, where the dual antiplatelet therapy represents the gold standard to avoid denovo coronary stenosis. However, there is a significant cohort of patients with coronary artery disease who may manifest hypersensitivity reactions to thienopyridines. The examination of the various case reports from medical literature leads to identify mainly four clinical patterns of hypersensitivity to thienopyridines which involves more frequently cutaneous, hematologic, and articular tissues, therefore the kind and predominance of clinical symptoms may determine a different clinical approach to overcome or neutralize thienopyridines hypersensitivity.
Subject(s)
Allergists , Cardiologists , Disease Management , Drug Hypersensitivity/classification , Drug Hypersensitivity/therapy , Thienopyridines/classification , Drug Hypersensitivity/diagnosis , Humans , Physician's Role , Thienopyridines/adverse effectsABSTRACT
The strongest and best-documented risk factor for drug hypersensitivity (DH) is the history of a previous reaction. Accidental exposures to drugs may lead to severe or even fatal reactions in sensitized patients. Preventable prescription errors are common. They are often due to inadequate medical history or poor risk assessment of recurrence of drug reaction. Proper documentation is essential information for the doctor to make sound therapeutic decision. The European Network on Drug Allergy and Drug Allergy Interest Group of the European Academy of Allergy and Clinical Immunology have formed a task force and developed a drug allergy passport as well as general guidelines of drug allergy documentation. A drug allergy passport, a drug allergy alert card, a certificate, and a discharge letter after medical evaluation are adequate means to document DH in a patient. They are to be handed to the patient who is advised to carry the documentation at all times especially when away from home. A drug allergy passport should at least contain information on the culprit drug(s) including international nonproprietary name, clinical manifestations including severity, diagnostic measures, potential cross-reactivity, alternative drugs to prescribe, and where more detailed information can be obtained from the issuer. It should be given to patients only after full allergy workup. In the future, electronic prescription systems with alert functions will become more common and should include the same information as in paper-based documentation.
Subject(s)
Documentation , Drug Hypersensitivity/diagnosis , Health Smart Cards , Documentation/methods , Drug Hypersensitivity/etiology , Drug Hypersensitivity/prevention & control , Europe , Humans , Surveys and QuestionnairesABSTRACT
Allergic reactions to mannitol have been reported rarely, despite its widespread use as a drug and as a food excipient. This is the first case report in which oral mannitol induces an immediate type hypersensitivity as a drug excipient, in a 42 year old man affected by rhinitis to olive tree pollen. Unusual and undervalued risk factors for mannitol hypersensitivity are examined.
Subject(s)
Drug Hypersensitivity/etiology , Excipients/adverse effects , Hypersensitivity, Immediate/etiology , Mannitol/adverse effects , Administration, Oral , Adrenal Cortex Hormones/therapeutic use , Adult , Drug Hypersensitivity/diagnosis , Drug Hypersensitivity/drug therapy , Excipients/administration & dosage , Histamine Antagonists/therapeutic use , Humans , Hypersensitivity, Immediate/diagnosis , Hypersensitivity, Immediate/drug therapy , Immunologic Tests , Male , Mannitol/administration & dosage , Predictive Value of Tests , Risk Factors , Treatment OutcomeABSTRACT
Corticosteroids are therapeutic drugs widely used in cases of allergic, inflammatory and autoimmune diseases, but sometimes allergic hypersensitivity reactions have been reported as a rare adverse effect of the corticosteroids themselves. Moreover, glucocorticoids can induce gastric lesions; thats why they are sometimes administered intravenously together with some drugs such as proton pump inhibitors (PPI) or inhibitors of histamine-2 receptors (antiH2) working as gastric protectors. Although it is difficult to establish which drug was responsible in case of hypersensitivity reactions, as hypersensitivity reactions following to the use of PPI or anti-H2 have been already described in literature. Here we describe two cases of immediate-type hypersensitivity triggered from the administration of a corticosteroid plus a gastroprotective agent and the diagnostic check up required in both these patients.
Subject(s)
Adrenal Cortex Hormones/adverse effects , Anaphylaxis/chemically induced , Drug Hypersensitivity/etiology , Histamine H2 Antagonists/adverse effects , Proton Pump Inhibitors/adverse effects , Adult , Anaphylaxis/diagnosis , Basophils/physiology , Female , Humans , Middle Aged , Omeprazole/adverse effects , Skin TestsABSTRACT
No disponible
Subject(s)
Humans , Female , Aged , Hypersensitivity, Immediate/diagnosis , Hydrocortisone/adverse effects , Drug Hypersensitivity/diagnosis , Risk FactorsSubject(s)
Angioedema/chemically induced , Drug Eruptions/etiology , Hydrocortisone/analogs & derivatives , Immunoglobulin E/immunology , Reagins/immunology , Urticaria/chemically induced , Aged , Anaphylaxis/chemically induced , Anaphylaxis/immunology , Angioedema/immunology , Anti-Inflammatory Agents, Non-Steroidal/adverse effects , Bronchitis/drug therapy , Drug Eruptions/immunology , Female , Humans , Hydrocortisone/adverse effects , Hydrocortisone/immunology , Immunologic Memory , Injections, Intramuscular , Intradermal Tests , Male , Methylprednisolone Hemisuccinate , Sulfonamides , Time Factors , Urticaria/immunologyABSTRACT
We present the cases of 5 patients with a positive clinical history of cutaneous symptoms due to contact with latex products. A latex allergological assessment was made through skin prick tests (SPTs) both with commercial latex extracts and extemporaneous glove extracts, and serum-specific IgE to latex and glove-use tests. In addition, serum-specific IgE to recombinant allergens for Hevea brasiliensis was dosed. Molecular diagnostics in association with the glove-use test and, to a lesser extent, the SPTs with glove eluate are useful diagnostic tests to confirm the diagnosis of latex allergy in patients with mucocutaneous symptoms.
Subject(s)
Allergens/immunology , Antigens, Plant/immunology , Chitinases/immunology , Latex Hypersensitivity/diagnosis , Latex Hypersensitivity/immunology , Latex/immunology , Plant Proteins/immunology , Adult , Cross Reactions , Female , Hevea/immunology , Humans , Immunoglobulin E/blood , Male , Middle Aged , Skin TestsSubject(s)
Anti-Bacterial Agents/adverse effects , Coronary Vasospasm/chemically induced , Electrocardiography/drug effects , Anti-Bacterial Agents/administration & dosage , Coronary Vasospasm/diagnosis , Coronary Vasospasm/physiopathology , Diagnosis, Differential , Follow-Up Studies , Humans , Infusions, Intravenous , Male , Middle Aged , Penicillanic Acid/administration & dosage , Penicillanic Acid/adverse effects , Penicillanic Acid/analogs & derivatives , Piperacillin/administration & dosage , Piperacillin/adverse effects , Piperacillin, Tazobactam Drug Combination , Pneumonia, Bacterial/drug therapy , Syndrome , beta-Lactamase InhibitorsABSTRACT
AIM: Awareness of daytime and/or seasonal variation in performance and exercise efficiency can be important for athletes and coaches in order to suitably plan training sessions and avoid over-training. The study goal was to evaluate and compare walking-speed and time-related heart rate (HR) responses to a walking task at two times of day and year. METHODS: Five healthy females (age 21-35 years) performed 9 km outdoor walking at 09:00h and 18:00h on 4 consecutive days in a period without sunlight (January) and with continuous daylight (May). Walking speed, average-heart rate (HR) and peak-HR (as %HRmax) were compared across all exercise sessions. RESULTS: In January the subjects achieved a higher peak-HR when they trained in the evening vs. morning, while average-HR and walking speed were not modified significantly. In May they achieved a higher peak-HR and kept a higher average-HR when they trained in the morning, under the same walking speed. In both training-times carried out in May, average-HR and peak-HR were lower compared with January, while the walking speed was unvaried. CONCLUSION: A lower exercise average and peak HR, that could potentially be a favourable condition for exercise conditioning, was observed at both daily test times in May vs. January, with overall lowest HR observed in May when exercise occurred at 18:00 h. These findings support the presence of both seasonal and time of day effects on HR responses to a standardized exercise.
Subject(s)
Circadian Rhythm/physiology , Exercise/physiology , Heart Rate/physiology , Seasons , Walking/physiology , Adult , Analysis of Variance , Arctic Regions , Female , Humans , MaleABSTRACT
Acquired angioedema (AAE) with C1 inhibitor deficiency is often associated to B cell lymphoproliferative disorders or autoimmune diseases. We report a case of AAE associated with IgM anti-cardiolipin antibodies, with frequent edematous attacks, that disappeared completely after a slight immunosuppression and danazol therapy.
Subject(s)
Angioedema/immunology , Antibodies, Anticardiolipin/blood , Complement C1 Inactivator Proteins/deficiency , Immunoglobulin M/blood , Aged , Angioedema/diagnosis , Angioedema/drug therapy , Azathioprine/therapeutic use , Complement C1 Inhibitor Protein , Danazol/therapeutic use , Female , Humans , Immunosuppressive Agents/therapeutic use , Ticlopidine/therapeutic use , Treatment OutcomeSubject(s)
Anti-Inflammatory Agents, Non-Steroidal/adverse effects , Conjunctivitis, Allergic/chemically induced , Dipyrone/adverse effects , Hypersensitivity, Immediate/chemically induced , Rhinitis/chemically induced , Administration, Oral , Anti-Inflammatory Agents, Non-Steroidal/administration & dosage , Aspirin/administration & dosage , Aspirin/adverse effects , Conjunctivitis, Allergic/diagnosis , Conjunctivitis, Allergic/immunology , Dipyrone/administration & dosage , Humans , Hypersensitivity, Immediate/diagnosis , Hypersensitivity, Immediate/immunology , Male , Middle Aged , Nasal Provocation Tests/methods , Rhinitis/diagnosis , Rhinitis/immunology , Rhinomanometry/methods , SpirometrySubject(s)
Allopurinol/adverse effects , Diuretics/adverse effects , Drug Hypersensitivity/etiology , Gout/drug therapy , Adrenal Cortex Hormones/administration & dosage , Adrenergic beta-Agonists/administration & dosage , Aged , Allopurinol/administration & dosage , Angioedema/chemically induced , Diuretics/administration & dosage , Drug Hypersensitivity/physiopathology , Drug Hypersensitivity/therapy , Exanthema/chemically induced , Gout/complications , Gout/physiopathology , Histamine Antagonists/administration & dosage , Humans , Hypertension , Hyperuricemia , Liver Failure, Acute/chemically induced , Male , Oxygen Inhalation Therapy , Renal Insufficiency/chemically inducedABSTRACT
AIM: The aim of the study was to evaluate the synchronizing effect of physical activity on the rest-activity cycle after a flight across different time zones, investigating the parameters linked to sleep. The purpose of this study is to evaluate the synchronizing effect of physical activity on the sleep-activity parameters after a flight across different time zones. METHODS: Eighteen volunteers flew from Milan to New York for the 2007 New York City Marathon. A training program, that consisted of running sessions three times a week for one month, was planned for the twelve athletes that participated in the marathon. The athletes were divided in two groups: Morning Training Group (MTG), trained from 7:00 to 9:00; Evening Training Group (ETG) from 19:00 to 21:00. The Control Group (CG), of 6 non-athletes, did not train before the flight and did not participate in the marathon. In New York, both groups of athletes trained in the morning. Two Actigraph monitoring sessions were performed in all three groups, before the Milan-New York flight and during the stay in New York. The actigraphy made it possible to calculate sleep and activity-specific parameters; sleep and activity patterns were continuously monitored using an actometer on the wrist of the non-dominant hand. RESULTS: Sleep analysis done on the first night in New York showed a significant difference (P<0.05) in the Movement and Fragmentation Index (MFI) between MTG and ETG. In CG and MTG, the MFI increased after the flight, while in ETG, the MFI decreased. Activity analysis demonstrated that, in ETG, evening physical activity in Milan associated with morning activity in New York produced a shift in the Cosine Peak of the rhythm of activity. CONCLUSIONS: Physical activity can have a positive effect both on sleep, by improving quality, as well as on the circadian rhythm of activity, by encouraging re-synchronization after the flight.
Subject(s)
Aircraft , Exercise Tolerance/physiology , Jet Lag Syndrome/prevention & control , Motor Activity , Running/physiology , Sleep/physiology , Actigraphy , Adult , Circadian Rhythm , Humans , Italy , Male , New York City , Oxygen Consumption , Physical Fitness , Surveys and Questionnaires , Time FactorsABSTRACT
A new class of drugs, produced with the hybridoma technique, has been introduced and employed to treat many immunological diseases. This class consists of recombinant monoclonal antibodies, which can be chimeric, humanized or human. Predictably, there has been a rise in adverse hypersensitivity reactions to these therapeutic agents, whose pathogenic mechanisms are not yet well understood. Specific IgE has been demonstrated in a very few cases, and only in some of these recombinant antibodies. Skin tests are not done as a clinical routine screening. In the present article the mechanisms underlying hypersensitivity reactions to these drugs are analyzed, also in the light of the personal experience and that reported in the literature, with the aim of identifying potential risk factors and means of prevention of these reactions. For some drugs, infusion reactions may be prevented thanks to the the use of premedication. Moreover, symptoms of acute hypersensitivity during infusion can be successfully managed in the majority of cases by slowing the speed of administration. All these findings seem to confirm that the pathogenesis is not related to a true immediate (IgE-mediated) hypersensitivity in most cases. When the substitution of the drug that has triggered a hypersensitivity reaction is required, this is only possible if such an alternative drug exists (i.e., replacement of a chimeric antibody with a humanized or human antibody sharing the same target). As an alternative, desensitization protocols have been employed to induce a state of temporary tolerance to the drug in some cases, yielding successful results for infliximab and trastuzumab.
Subject(s)
Antibodies, Monoclonal/adverse effects , Antibodies, Monoclonal/therapeutic use , Drug Hypersensitivity/diagnosis , Drug Hypersensitivity/immunology , Recombinant Fusion Proteins/adverse effects , Recombinant Fusion Proteins/therapeutic use , Recombinant Proteins/adverse effects , Recombinant Proteins/therapeutic use , Animals , Antibodies, Monoclonal/chemistry , Humans , Recombinant Fusion Proteins/immunology , Recombinant Proteins/immunology , Skin Tests/methodsABSTRACT
Levocetirizine is the pharmacologically active enantiomer of cetirizine. It is a potent histamine H-1 receptor antagonist with anti-inflammatory and antiallergic properties. The review analyses the levocetirizine's properties in terms of safety and efficacy both in allergic rhinitis and urticarioid syndromes.