Influencing factors on the safety and effectiveness of venom immunotherapy.

BACKGROUND AND OBJECTIVE: The safety profile of venom immunotherapy (VIT) is a relevant issue and considerable differences in safety and efficacy of VIT have been reported. The primary aim of this study was to evaluate the safety of ACE inhibitors and beta-blockers during VIT, which has already been published. For a second analysis, data concerning premedication and venom preparations in relation to systemic adverse events (AE) during the up-dosing phase and the first year of the maintenance phase were evaluated as well as the outcome of field stings and sting challenges. METHODS: The study was conducted as an open, prospective, observational, multicenter study. In total, 1,425 patients were enrolled and VIT was performed in 1,342 patients. RESULTS: Premedication with oral antihistamines was taken by 52.1% of patients during the up-dosing and 19.7% of patients during the maintenance phase. Taking antihistamines had no effect on the frequency of systemic AE (p=0.11) but large local reactions (LLR) were less frequently seen (OR: 0.74; 95% CI: 0.58-0.96; p=0.02). Aqueous preparations were preferentially used for up-dosing (73.0%) and depot preparations for the maintenance phase (64.5%). The type of venom preparation neither had an influence on the frequency of systemic AE nor on the effectiveness of VIT (p=0.26 and p=0.80, respectively), while LLR were less frequently seen when depot preparations were used (p<0.001). CONCLUSION: Pretreatment with oral antihistamines during VIT significantly reduces the frequency of LLR but not systemic AE. All venom preparations used were equally effective and did not differ in the frequency of systemic AE.

Drug intolerance in patients with idiopathic environmental intolerance syndrome.

The increasing rate of the idiopathic environmental intolerance (IEI) has been observed for the last decade. The aim of this report was to analyse the allergic component of the disease in particular relation to drug intolerance. Six patients with diagnosed IEI showed a positive skin test reaction to several commonly used antibiotics, nonsteroidal anti-inflammatory drugs, myorelaxants, verapamil, etc. In three cases, the thorough diagnosis of sensitivity to anaesthetic agents enabled to perform necessary surgical treatment, in others - facilitated the proper treatment of headaches and hypertension. Symptoms related to allergy contributed to the deterioration of IEI. Thus, a consultation of IEI patients by an allergologist seems to be of a substantial importance.

[Tinnitus. I.--pathophysiology]. / Szumy uszne. Cz. 1--patofizjologia.

Tinnitus is a sound impression in one or both ears appearing without any acoustic impulses from the environment. It can be a morbid symptom coming either from different parts of the auditory path (from the external auditory meatus to the auditory area in the cerebral cortex) or other organs. Usually ear noise is accompanied by hypacusis. According to British Tinnitus Association one of ten people suffers from ear noises and about 35-45% of adults have come down with it. This number is still increasing. The older the patients is the more frequent the noises are, especially among women after 40 and men after 50 years old. Because of varying origin different therapy methods are applied (surgical, pharmacological, psychotherapy).

[Tinnitus. II.--treatment]. / Szumy uszne. Cz. 2--leczenie.

Because of varying origin different therapy of tinnitus methods are applied (surgical, pharmacological, psychotherapy). Treatment of objective tinnitus of vascular origin is usually surgical. It is similar as in the case of tinnitus of mechanical origin. The procedure of operating. Treatment of subjective tinnitus is much more complicated because of difficulties with determining of its occurence. We can separate morbus Ménière, otosclerosis, which require precise treatment. Apart from these disease treatment of subjective tinnitus is multidirectional. It may include pharmacological treatment, psychotherapy, surgical treatment and other methods.