Chronic Urticaria: Following Practice Guidelines.

Histamine is a key inflammatory player in the pathogenesis of urticaria, a mast-cell-driven disease characterized clinically by the development of wheals, angioedema, or both. Changes to the management of chronic spontaneous urticaria have recently been adopted due to increasing literature surrounding the efficacy and safety of up-dosing modern second-generation H1-antihistamines and the use of omalizamub, a biologic agent, as a third-line treatment. Given the prevalence of chronic urticaria and its impact on quality of life, this editorial aims to provide a summary of the proposed updated guidelines for the management of chronic urticaria as agreed upon at the 5th Consensus Conference on the Update and Revision of the EAACI/GA2LEN/EDF/WAO Guideline for Urticaria in Berlin in December 2016. The chronic urticaria treatment algorithm outlined here reflects the updates and revisions made by 43 international experts representing 40 societies from 25 countries. These guidelines have yet to be published and therefore will require approval by respective national and international boards before adoption.

Dietary compliance among salt-sensitive and salt-insensitive normotensive adults.

Little is known about the customary level of sodium intake by salt-sensitive people and the nature of obstacles they face in the adoption of a reduced-sodium diet. These issues were addressed with 12 salt-sensitive (SS) and 9 salt-insensitive (SI) normotensive adults. Information about sodium consumption, taste, and blood pressure and concerns about following a diet reduced in sodium were collected at baseline and monthly while participants followed a 100 mmol Na/day diet for 4 months. Mean sodium intakes of both groups were comparable at baseline and were reduced significantly during diet. The principal dietary concerns were reduced food availability, increased food costs, and reduced food palatability. There were no group differences. Ratings declined over time, but only the food palatability issue did so significantly because of a shift by the SI only. While the predictive value of SS classification remains uncertain, these data indicate that dietary change is feasible in SS subjects.

Use of insecticide-impregnated ear tags for the control of face flies and horn-flies on pastured cattle.

Three studies were conducted to evaluate the effectiveness of insecticide-impregnated ear tags in controlling face flies, Musca autumnalis DeGeer, and horn flies, Haematobia irritans (Linn.), on pastured beef cattle. In one 16-week trial, polyvinyl chloride (PVC) ear tags treated with stirofos (Rabon) insecticide reduced horn fly numbers by 79% (P less than .05) and face fly numbers by 30% (P less than .05). Coumaphos (Co-Ral) insecticide dust bags used in a separate herd produced an 86% (P less than .05) reduction in horn flies and an 18% (P less than .05) reduction in face flies. In the second study, 5 and 10% permethrin (Atroban), PVC-treated ear tags in a one-piece design were tested. In this 11 week trial, horn fly control averaged 95% (P less than .05) with the 10% tag and 77% (P less than .05) with the 5% tag. Face fly control averaged 49% (P less than .05) for 8 weeks with the 10% permethrin tag. No significant face fly control was achieved with the 5% permethrin tag. In a herd treated with coumaphos dust bags, horn fly control averaged 93% (P less than .05) and face fly control averaged 34% (P less than .05). The third study tested 5 and 10% permethrin, PVC-treated ear tags in a two-piece design and two-piece 5% permethrin-treated ear tags in a polyurethane matrix. Fourteen-week horn fly control averaged 88% (P less than .05) with the 10% PVC-treated tag, 83% (P less than .05) with the 5% PVC-treated tag, 71% (P less than .05) with the 5% polyurethane-treated tag and 74% (P less than .05) with coumaphos dust bags. Face fly control averaged less than 50% (P greater than .05) throughout the trial with all treatments.