Potential New Therapeutic Target For Asthma, Allergies And Cancer
Virginia Commonwealth University researchers have identified how a bioactive molecule involved with allergy, inflammation and cancer is transported out of mast cells, according to findings published online this week in the Proceedings of the National Academy of Sciences.
Mast cells are specialized cells that react to allergy-causing agents by releasing substances that trigger the body's allergic response, leading to conditions like asthma and hives. Among the molecules released by mast cells that participate in the allergic response is sphingosine-1-phosphate. This molecule is also implicated in cancer.
The work by the VCU investigators opens up a new approach to treating asthma, which affects about 15 million Americans and is increasing in incidence and mortality, especially among African-Americans. It also has implications for other allergic disorders and for cancer in terms of developing drugs that inhibit the transport of SIP out of cells.
Sarah Spiegel, Ph.D., professor and chair, VCU Department of Biochemistry, and colleagues reported how S1P, which also regulates many important physiological functions in cells, is transported out of mast cells. S1P is produced by all cells and secreted by some cells into the circulation where it can bind to specific S1P receptors. Until now, researchers have not known the mechanism by which S1P is transported out of cells.
"Our study shows that mast cells can use a special kind of transporter that has long been known to be used by cancer cells to push anti-cancer drugs out and help them survive the treatment," said Spiegel. "Our study is the first to establish a mechanism by which S1P can be exported out of mast cells and perhaps by cancer cells as well."
In previous research, Spiegel's team found that S1P levels are significantly elevated in fluid collected from the lungs of asthmatic patients after exposure to an allergen. Those findings led Spiegel's team to believe that mast cells could be a source of S1P. Mast cells are found in all body tissues and rapidly produce and secrete a number of inflammatory substances such as histamine and S1P when activated by an inflammatory stimulus. Spiegel said that S1P in turn amplifies allergic and inflammatory responses. Therefore, S1P secreted from mast cells can orchestrate many allergic responses, including asthma.
This work was supported by a grant from the National Institutes of Health.
The team included researchers Poulami Mitra, a Ph.D. candidate, Carole A. Oskeritzian, Ph.D., Shawn G. Payne, Ph.D., from the VCU Department of Biochemistry; Michael A. Beaven, Ph.D., a researcher with the National Heart, Lung, and Blood Institute; and Sheldon Milstien, Ph.D., a neuroscientist with the National Institute of Mental Health.
Jan 20, 2009
Using Air Filters Can Help Reduce Allergies And Asthmatic Attacks
Studies Have Shown That Using Air Filters Can Help Reduce Allergies And Asthmatic Attacks
What Causes Asthma?
Asthma is an allergic reaction that can be brought on by a variety of triggers including certain foods, medicines, organisms, dander, mold and airborne pollution. An asthmatic attack can be very frightening for both the asthmatic and their friends and family. While an air purifier alone is not sufficient to remove all allergens and asthmatic triggers from a home, they can be an effective component in your arsenal.
Including Air Purifiers in your Arsenal to help Combat Asthma Attacks
A quality air purifier alone cannot trap all household allergens that may contribute to asthmatic attacks. The reason for this is that not all allergens are or remain airborne. For example, many people with allergies are allergic to dust mite droppings (feces) which fall out of the air and into carpeting, upholstery and linens rather quickly due to their relatively large size. In addition, allergy attacks can be brought on by the presence of certain organisms which are immune to air purification, such as cockroaches.
In a September, 2004 study co-funded by the National Institute of Allergy and Infectious Diseases (NIAID) and the National Institute of Environmental Health Sciences (NIEHS), and published in the New England Journal of Medicine it was found that a HEPA air filter, when used in conjunction with dust mite proof mattress and pillow covers, cockroach extermination and a HEPA vacuum, dramatically reduced asthma symptoms.
Though no air cleaning system can remove all allergens from a home, studies have shown they can significantly reduce the levels of air born allergens and irritants, in some cases, by up to 90%. The HEPA filter has long been used in laboratory experiments, and has been proven to reduce the level of particles in the air. Many air filtration systems rely solely on HEPA technology, or, include a HEPA filter as part of a multi-filtration system.
Multi Filter Air Cleaning Systems
There are purifiers available today that combine more than one type of air filtration technology. The HEPA filter is a widely known, effective and popular air filter. Newer technologies include ionization and UV filters, which, when combined with a HEPA, can trap or kill allergens and particles that are much smaller in size than was previously possible. There are some UV filters that can effectively treat airborne pollutants that are down to 0.001 microns in size. The HEPA air filter traps particles as tiny as 0.3 microns. Ionization technology for air filtration works by negatively producing negatively charged ions which attach themselves to contaminants. These contaminants then drop from the air, resulting in cleaner air to breathe. The HEPA operates by physically trapping particles that go through the filter. While the UV method works by killing or destroying germs.
While no air filtration system alone can remove all potential allergens from the air, they can definitely help reduce them. Subsequently helping to reduce the number of allergic or asthmatic attacks an individual may experience. Much of this depends on what the individual is allergic to, what filtration system they choose, and what other allergen-removal methods they employ in their home environment. A quality air purifier can be a valuable tool in fighting allergies and the effects of asthma.
What Causes Asthma?
Asthma is an allergic reaction that can be brought on by a variety of triggers including certain foods, medicines, organisms, dander, mold and airborne pollution. An asthmatic attack can be very frightening for both the asthmatic and their friends and family. While an air purifier alone is not sufficient to remove all allergens and asthmatic triggers from a home, they can be an effective component in your arsenal.
Including Air Purifiers in your Arsenal to help Combat Asthma Attacks
A quality air purifier alone cannot trap all household allergens that may contribute to asthmatic attacks. The reason for this is that not all allergens are or remain airborne. For example, many people with allergies are allergic to dust mite droppings (feces) which fall out of the air and into carpeting, upholstery and linens rather quickly due to their relatively large size. In addition, allergy attacks can be brought on by the presence of certain organisms which are immune to air purification, such as cockroaches.
In a September, 2004 study co-funded by the National Institute of Allergy and Infectious Diseases (NIAID) and the National Institute of Environmental Health Sciences (NIEHS), and published in the New England Journal of Medicine it was found that a HEPA air filter, when used in conjunction with dust mite proof mattress and pillow covers, cockroach extermination and a HEPA vacuum, dramatically reduced asthma symptoms.
Though no air cleaning system can remove all allergens from a home, studies have shown they can significantly reduce the levels of air born allergens and irritants, in some cases, by up to 90%. The HEPA filter has long been used in laboratory experiments, and has been proven to reduce the level of particles in the air. Many air filtration systems rely solely on HEPA technology, or, include a HEPA filter as part of a multi-filtration system.
Multi Filter Air Cleaning Systems
There are purifiers available today that combine more than one type of air filtration technology. The HEPA filter is a widely known, effective and popular air filter. Newer technologies include ionization and UV filters, which, when combined with a HEPA, can trap or kill allergens and particles that are much smaller in size than was previously possible. There are some UV filters that can effectively treat airborne pollutants that are down to 0.001 microns in size. The HEPA air filter traps particles as tiny as 0.3 microns. Ionization technology for air filtration works by negatively producing negatively charged ions which attach themselves to contaminants. These contaminants then drop from the air, resulting in cleaner air to breathe. The HEPA operates by physically trapping particles that go through the filter. While the UV method works by killing or destroying germs.
While no air filtration system alone can remove all potential allergens from the air, they can definitely help reduce them. Subsequently helping to reduce the number of allergic or asthmatic attacks an individual may experience. Much of this depends on what the individual is allergic to, what filtration system they choose, and what other allergen-removal methods they employ in their home environment. A quality air purifier can be a valuable tool in fighting allergies and the effects of asthma.
Associations Between Exposure To Traffic-Related Air Pollution And The Allergic Diseases In Children
Under the direction of the Helmholtz Zentrum Munchen, a German research group studied in a longitudinal study, over six years, whether associations are identifiable between the onset of a topic diseases and exposure to air pollutants originating from traffic.
The scientists based their analysis, on the one hand, on the corresponding distance of the parental home to streets busy with traffic, and on the other hand, modeled values, for the respective residential addresses of the children, of air pollution with fine dust, diesel soot and nitrogen dioxide.
The research team led by Dr. Joachim Heinrich of the Institute of Epidemiology of the Helmholtz Zentrum München compared, with this, the data of 3,061 six-year old children from Munich and its surroundings.
From birth, their development has been tracked within the scope of the so-called GINI and LISA studies. The studies are led by Prof. Dr. H.-Erich Wichmann of the Helmholtz Zentrum München, and, among other things, are aimed at the study of behavioral and environmental risk factors for allergic diseases. In the current analysis, the results of medical research and regular parental interviews were considered. Moreover, the appearance of the specific IgE antibodies against common allergens in blood serum was tested in children at the age of 6.
The scientists were able to estimate individual values of exposure of children to fine dust and nitrogen dioxide, with the help of calculation models. It was shown that an escalation of asthmatic bronchitis and allergic sensitization to pollen and other common allergens occurred with increasing exposure to fine dust. Increased exposure to nitric oxide was linked to increases in eczema.
Connections were noted, in particular, between the appearance of asthmatic bronchitis, hay fever, eczema and allergic sensitization, on the one hand, and residential environment, on the other: compared with their contemporaries living in more distant places, children who lived less than 50 m from a very busy main road were between 1 % and 50 % more likely to contract these diseases.
Statistical analysis of the data showed a lower risk with increasing distances to the main roads.
Joachim Heinrich and his colleagues consider the results of their research to be clear evidence of the disadvantageous effects of air pollution from traffic on the causes of allergies and a topic diseases. In the past, epidemiological studies on this subject failed to supply a clear picture, although the effects of laboratory experiments and inhalation studies are well-known.
The scientists based their analysis, on the one hand, on the corresponding distance of the parental home to streets busy with traffic, and on the other hand, modeled values, for the respective residential addresses of the children, of air pollution with fine dust, diesel soot and nitrogen dioxide.
The research team led by Dr. Joachim Heinrich of the Institute of Epidemiology of the Helmholtz Zentrum München compared, with this, the data of 3,061 six-year old children from Munich and its surroundings.
From birth, their development has been tracked within the scope of the so-called GINI and LISA studies. The studies are led by Prof. Dr. H.-Erich Wichmann of the Helmholtz Zentrum München, and, among other things, are aimed at the study of behavioral and environmental risk factors for allergic diseases. In the current analysis, the results of medical research and regular parental interviews were considered. Moreover, the appearance of the specific IgE antibodies against common allergens in blood serum was tested in children at the age of 6.
The scientists were able to estimate individual values of exposure of children to fine dust and nitrogen dioxide, with the help of calculation models. It was shown that an escalation of asthmatic bronchitis and allergic sensitization to pollen and other common allergens occurred with increasing exposure to fine dust. Increased exposure to nitric oxide was linked to increases in eczema.
Connections were noted, in particular, between the appearance of asthmatic bronchitis, hay fever, eczema and allergic sensitization, on the one hand, and residential environment, on the other: compared with their contemporaries living in more distant places, children who lived less than 50 m from a very busy main road were between 1 % and 50 % more likely to contract these diseases.
Statistical analysis of the data showed a lower risk with increasing distances to the main roads.
Joachim Heinrich and his colleagues consider the results of their research to be clear evidence of the disadvantageous effects of air pollution from traffic on the causes of allergies and a topic diseases. In the past, epidemiological studies on this subject failed to supply a clear picture, although the effects of laboratory experiments and inhalation studies are well-known.
Omega 3 Fats Active Against Child Allergies
Omega-3 fats seem to have a protective effect on allergies in children.
One year olds whose mothers had ingested fish oil during pregnancy and breastfeeding had considerably fewer allergic reactions than children whose mothers did not take this supplement, according to a study from Linkoping University in Sweden.
The study, which started in 2005, comprised 145 pregnant mothers with families at heightened risk of developing allergy and asthma. From the 25th week of pregnancy through the third month of nursing, they were asked to take nine capsules of oil every day. Half of them were given fish oil with high levels of omega-3 fatty acids, and the other half were given a placebo in the form of soybean oil.
The study was doubly blind, that is, neither the participants nor the researchers knew who had received what.
It turned out that the "fish-oil children" had fewer than half as many reactions to eggs at the age of one year as the placebo group did. This is an important discovery, since allergic reactions to eggs early in life are strongly correlated with the later development of allergic disorders like eczema and asthma.
All of the children are now two years old and have undergone a clinical examination regarding eczema, been scratch-tested for eggs, milk, and cats, and left a blood sample.
The idea that the difference is truly an effect of the omega-3 fats is supported by an immunological study of the mothers' blood. The women who were given fish oil had less prostaglandin E2 in their blood than the others. This is a substance that triggers allergic immune responses, and it is known that it is depressed when the concentration of omega-3 increases.
"We have been able to show that omega-3 influences the mother's immunological profile in a less inflammatory direction.
Theoretically this can also affect the child's immune system, which is supported by the results of the scratch-tests," says the immune biologist Malin Fageras Bottcher, who led the study together in collaboration with the child allergist Karel Duchen.
One year olds whose mothers had ingested fish oil during pregnancy and breastfeeding had considerably fewer allergic reactions than children whose mothers did not take this supplement, according to a study from Linkoping University in Sweden.
The study, which started in 2005, comprised 145 pregnant mothers with families at heightened risk of developing allergy and asthma. From the 25th week of pregnancy through the third month of nursing, they were asked to take nine capsules of oil every day. Half of them were given fish oil with high levels of omega-3 fatty acids, and the other half were given a placebo in the form of soybean oil.
The study was doubly blind, that is, neither the participants nor the researchers knew who had received what.
It turned out that the "fish-oil children" had fewer than half as many reactions to eggs at the age of one year as the placebo group did. This is an important discovery, since allergic reactions to eggs early in life are strongly correlated with the later development of allergic disorders like eczema and asthma.
All of the children are now two years old and have undergone a clinical examination regarding eczema, been scratch-tested for eggs, milk, and cats, and left a blood sample.
The idea that the difference is truly an effect of the omega-3 fats is supported by an immunological study of the mothers' blood. The women who were given fish oil had less prostaglandin E2 in their blood than the others. This is a substance that triggers allergic immune responses, and it is known that it is depressed when the concentration of omega-3 increases.
"We have been able to show that omega-3 influences the mother's immunological profile in a less inflammatory direction.
Theoretically this can also affect the child's immune system, which is supported by the results of the scratch-tests," says the immune biologist Malin Fageras Bottcher, who led the study together in collaboration with the child allergist Karel Duchen.
Peak Pollen Season Is Now - Australia
Hay fever sufferers and people with asthma; beware - peak pollen season is now until late November, according to the latest asthma alert issued by the National Asthma Council Australia.
"There is so much hype at the start of spring about pollen-triggered asthma and allergy that many people don't realize that the real danger period is actually late spring and sometimes even early summer," warned Professor John Wilson, National Asthma Council Australia chairman.
"These are the four to six weeks of the year when plant-based and pollen-related asthma is at its peak," Prof Wilson explained. "Then as summer progresses, pollen distribution tends to fall off and prevailing winds make pollen less of an issue."
For people with asthma, major thunderstorms at this time of the year can also compound the problem, triggering sudden and severe asthma attacks and an increase in hospital admissions.
"The combination of plenty of pollen in the atmosphere and heavily laden rain clouds, characteristic of thunderstorms, is hazardous," Prof Wilson said.
"When precipitation occurs, the pollen grains become wet and expand and then burst into smaller particles which can be breathed deep into the lungs, triggering asthma.
"Consequently, thunderstorms increase the allergen load caused by plant species such as rye grass, Bermuda grass and birch and a range of others, exacerbating asthma symptoms."
To minimize the impact of seasonal asthma and allergy, the National Asthma Council Australia encourages people with known allergies to continue to take their preventative medications to reduce hay fever, rhinitis and asthma, as well as their symptom reliever.
"People with asthma must have an up-to-date written asthma action plan, detailing what to do when symptoms worsen and it is important to avoid exposure to triggers," Prof Wilson stressed.
"For many, at this time of the year, it's better indoors than out."
"There is so much hype at the start of spring about pollen-triggered asthma and allergy that many people don't realize that the real danger period is actually late spring and sometimes even early summer," warned Professor John Wilson, National Asthma Council Australia chairman.
"These are the four to six weeks of the year when plant-based and pollen-related asthma is at its peak," Prof Wilson explained. "Then as summer progresses, pollen distribution tends to fall off and prevailing winds make pollen less of an issue."
For people with asthma, major thunderstorms at this time of the year can also compound the problem, triggering sudden and severe asthma attacks and an increase in hospital admissions.
"The combination of plenty of pollen in the atmosphere and heavily laden rain clouds, characteristic of thunderstorms, is hazardous," Prof Wilson said.
"When precipitation occurs, the pollen grains become wet and expand and then burst into smaller particles which can be breathed deep into the lungs, triggering asthma.
"Consequently, thunderstorms increase the allergen load caused by plant species such as rye grass, Bermuda grass and birch and a range of others, exacerbating asthma symptoms."
To minimize the impact of seasonal asthma and allergy, the National Asthma Council Australia encourages people with known allergies to continue to take their preventative medications to reduce hay fever, rhinitis and asthma, as well as their symptom reliever.
"People with asthma must have an up-to-date written asthma action plan, detailing what to do when symptoms worsen and it is important to avoid exposure to triggers," Prof Wilson stressed.
"For many, at this time of the year, it's better indoors than out."
Food Allergies Could Be Fought With Friendly Bacteria In Alcoholic Milkshake
Feeding babies alcoholic milk may help to protect against some food allergies. Kefir, a traditional fermented drink, is consumed in Eastern Europe as a health food, and is often used to wean babies, as it is easily digested.
Food allergy prevalence is especially high in children under the age of three, with around 5-8% of infants at risk. Currently the only treatment is avoidance of the problematic food.
"Friendly" bacteria in kefir may play a role in blocking the pathway involved in allergic responses, Lisa Richards reports in Chemistry & Industry, SCI's fortnightly magazine. Research published 16 October 2006(DOI 10.1002/jsfa2469) in the SCI's Journal of the Science of Food and Agriculture has shown that the milk drink inhibits the allergen specific antibody Immunoglobulin E (IgE). IgE is involved in immune responses to inactivate organisms that might cause disease. However, in the presence of allergens it can also activate cells responsible for the release of histamine, a chemical which stimulates allergic responses, such as inflammation and constriction of airways.
Ji-Ruei Liu's team of scientists at the National Formosa University, Yunlin, Taiwan, fed mice the milky drink, and found that after 3 weeks, the amount of ovalbumin (OVA) specific IgE was reduced three-fold. Ovalbumin is an allergenic protein found in egg whites, which cause most allergies in young children. Kefir is also reported to prevent food antigens from passing through the intestinal wall.
Liu believes that the milky drink could be a promising tool in the prevention of allergies. "In the future, maybe we can screen out the certain components (bacterial strains or bioactive peptides) from kefir and utilize them in medicine," he said.
Also in this weeks Chemistry & Industry, UK firm Rigest are looking for backers to develop an air sanitizing system using an enzyme found naturally in human tears. Lactoperoxidase can attack and kill microbes such as 'flu viruses and the bacteria responsible for MRSA. The system could be used to sanitize the air in airplanes and hospital sick bays.
Food allergy prevalence is especially high in children under the age of three, with around 5-8% of infants at risk. Currently the only treatment is avoidance of the problematic food.
"Friendly" bacteria in kefir may play a role in blocking the pathway involved in allergic responses, Lisa Richards reports in Chemistry & Industry, SCI's fortnightly magazine. Research published 16 October 2006(DOI 10.1002/jsfa2469) in the SCI's Journal of the Science of Food and Agriculture has shown that the milk drink inhibits the allergen specific antibody Immunoglobulin E (IgE). IgE is involved in immune responses to inactivate organisms that might cause disease. However, in the presence of allergens it can also activate cells responsible for the release of histamine, a chemical which stimulates allergic responses, such as inflammation and constriction of airways.
Ji-Ruei Liu's team of scientists at the National Formosa University, Yunlin, Taiwan, fed mice the milky drink, and found that after 3 weeks, the amount of ovalbumin (OVA) specific IgE was reduced three-fold. Ovalbumin is an allergenic protein found in egg whites, which cause most allergies in young children. Kefir is also reported to prevent food antigens from passing through the intestinal wall.
Liu believes that the milky drink could be a promising tool in the prevention of allergies. "In the future, maybe we can screen out the certain components (bacterial strains or bioactive peptides) from kefir and utilize them in medicine," he said.
Also in this weeks Chemistry & Industry, UK firm Rigest are looking for backers to develop an air sanitizing system using an enzyme found naturally in human tears. Lactoperoxidase can attack and kill microbes such as 'flu viruses and the bacteria responsible for MRSA. The system could be used to sanitize the air in airplanes and hospital sick bays.
Jan 19, 2009
Urticaria
Urticaria
Definition
Urticaria - the notion that covers a group of diseases, the main symptom of which is an urticarial element on the skin. With all the variety of etiological factor for all types of urticaria characterized by a common pathogenetic mechanism-increase vascular permeability of micro circulatory course and bed acute edema development in the area of surrounding the vessels. In case of spreed affection on subcutaneous and submucosal layers of dermis develops angioneurotic edema (Bannister's disease). According to flow can be acute and chronic (more than 6 weeks) case.
Rash is characterized by itch of varying intensity, complete reversibility of elements.
On the basis of etiological among the most frequent forms of urticaria mark out the following types:
Allergic
Idiopathic
Temperature
Demographic
Vibration
cholinergic
Contact
Another rash
unspecified urticaria
Angioneurotic edema (swelling Quincke's)
Survey
1. Mandatory laboratory studies:
Clinical analysis of blood;
An overall analysis of urine;
Biochemical analysis of blood (total protein, total bilirubin and direct), ALT, ACT, blood glucose, creatinine, uric acid);
RW, HIV;
Coprogramma.
This amount of mandatory testing is adequate for patients with allergic, contact, vibration, temperature urticaria forms.
In case of unspecified, idiopathic electrodermatogramic urticaria, it is recommend to include in the list of mandatory following of survey to identify the functional or organic violations:
Revmtests (ANF, AT to DNA, DRR cryoprecipitate);
Bacteriological study (excrements, material from the mucous oropharynx);
Coprocystoscopy;
Differential detection of AT to AG toxocariasis, echinococcus, opisthorchid flukes, trichina and (or) other parasites, given the regional pathology.
2. Allergological survey:
Allergologic anamnesis (including pharmacological and food);
Prick and scarification skin tests with atopic allergens and intradermal tests with infectious allergens;
Tests: cold (Duncan-test), the heat, with the rovings;
In patients with suspected urticaria, are available in this hospital tests in vitro or in vivo.
The second and third paragraphs of the survey are sick outside exacerbation urticaria and receive antihistamine and GMP drugs.
3. Mandatory instrumental studies.
Bicycle ergometry to exclude cholinergic urticaria.
In the case of idiopathic, unspecified, dermographism urticaria are following tool shed research for the purpose to find the functional and organic violations:
Ultrasound of the abdominal cavity;
EGDS;
ECG.
4 Further research tool.
R-grafia WGCs and PIP (for reasons).
5. Consultations of experts:
Allergist (optional)
In idiopathic, unspecified, demographic urticaria are hold further consultations: the gynecologist, rheumatology, dentist, ENT, parasitology, endocrinology and others (for reasons).
Additional instrumental and laboratory tests are appointed on the advice of consultants.
Description: The wide range of surveys with idiopathic, unspecified, demographic forms of urticaria can be justified with the urticaria reaction may be a symptom of various diseases such as autoimmune, parasitic, cancer, or the result of functional disorders of the gastrointestinal tract, chronic inflammatory diseases (disbacteriosis bowel , periodontitis, etc.).
Definition
Urticaria - the notion that covers a group of diseases, the main symptom of which is an urticarial element on the skin. With all the variety of etiological factor for all types of urticaria characterized by a common pathogenetic mechanism-increase vascular permeability of micro circulatory course and bed acute edema development in the area of surrounding the vessels. In case of spreed affection on subcutaneous and submucosal layers of dermis develops angioneurotic edema (Bannister's disease). According to flow can be acute and chronic (more than 6 weeks) case.
Rash is characterized by itch of varying intensity, complete reversibility of elements.
On the basis of etiological among the most frequent forms of urticaria mark out the following types:
Allergic
Idiopathic
Temperature
Demographic
Vibration
cholinergic
Contact
Another rash
unspecified urticaria
Angioneurotic edema (swelling Quincke's)
Survey
1. Mandatory laboratory studies:
Clinical analysis of blood;
An overall analysis of urine;
Biochemical analysis of blood (total protein, total bilirubin and direct), ALT, ACT, blood glucose, creatinine, uric acid);
RW, HIV;
Coprogramma.
This amount of mandatory testing is adequate for patients with allergic, contact, vibration, temperature urticaria forms.
In case of unspecified, idiopathic electrodermatogramic urticaria, it is recommend to include in the list of mandatory following of survey to identify the functional or organic violations:
Revmtests (ANF, AT to DNA, DRR cryoprecipitate);
Bacteriological study (excrements, material from the mucous oropharynx);
Coprocystoscopy;
Differential detection of AT to AG toxocariasis, echinococcus, opisthorchid flukes, trichina and (or) other parasites, given the regional pathology.
2. Allergological survey:
Allergologic anamnesis (including pharmacological and food);
Prick and scarification skin tests with atopic allergens and intradermal tests with infectious allergens;
Tests: cold (Duncan-test), the heat, with the rovings;
In patients with suspected urticaria, are available in this hospital tests in vitro or in vivo.
The second and third paragraphs of the survey are sick outside exacerbation urticaria and receive antihistamine and GMP drugs.
3. Mandatory instrumental studies.
Bicycle ergometry to exclude cholinergic urticaria.
In the case of idiopathic, unspecified, dermographism urticaria are following tool shed research for the purpose to find the functional and organic violations:
Ultrasound of the abdominal cavity;
EGDS;
ECG.
4 Further research tool.
R-grafia WGCs and PIP (for reasons).
5. Consultations of experts:
Allergist (optional)
In idiopathic, unspecified, demographic urticaria are hold further consultations: the gynecologist, rheumatology, dentist, ENT, parasitology, endocrinology and others (for reasons).
Additional instrumental and laboratory tests are appointed on the advice of consultants.
Description: The wide range of surveys with idiopathic, unspecified, demographic forms of urticaria can be justified with the urticaria reaction may be a symptom of various diseases such as autoimmune, parasitic, cancer, or the result of functional disorders of the gastrointestinal tract, chronic inflammatory diseases (disbacteriosis bowel , periodontitis, etc.).
Jan 6, 2009
Atopic dermatitis (AD)
Definition of Atopic Dermatits
Atopic dermatitis - chronic allergic inflammation of the skin surface, accompanied by itch, often combined with the presence of respiratory manifestations of immediate allergy: allergic rinoconjuctivitis's, atopic bronchial asthma.
The degree of severity of AD is determined by the prevalence of skin, location, availability of respiratory manifestations of atopic and the availability of secondary purulent infection.
To assess the severity of the skin, as well as to the effectiveness of therapy should be used Semiquantitative method - scale SCORAD (Scoring of Atopic Dermatitis), a score of six of objective and subjective symptoms, which are recorded in the grade sheet.
AD is characterized by a high content of total serum IgE and sensitization to multiple allergens atopic (domestic, epidermal, fungi, pollen, food).
At AD there are violation of blood of T-cell regulation (the predominance of Th2-response), which may determine the presence of IgE-indirect reactions. For the AD is characterized by a high degree of colonization of Staph. aureus; viral infection caused by Herpes simplex, Varicella, by virus of warts and molluscum contagiosa, as well as fungal infections (dermatomycosis caused by Trichophyton, high procent of colonization conditionally pathogenic mushroom genus Candida albicans, parapsilosis, Rhizopus spp., Spegazzinia tessarthra, Pitirosporum ovale). Of the opportunistic diseases most frequent is range pathology of the gastrointestinal tract: stomach ulcer and a duodenum, a violation of Intestinal microflora, as well as pockets of chronic infection, disease of ENT organs,of mental disturbances and of cataracts.
Survey
1. Mandatory laboratory and instrumental studies:
Clinical analysis of blood (in deviation from the norm, 1 time every 10 days);
Biochemical analysis of blood (total protein, bilirubin, ALT, AST, urea, creatinine, fibrinogen, C-reactive protein, glucose) once, in the case of plasmapheresis - control of total protein before each session;
Determination of blood group, Rh-factor;
RW, HIV;
An overall analysis of urine, if necessary - an analysis of urine on Nechiporenko once;
Immunological examination (level of total serum IgE, subpopulations of lymphocytes);
Bacteriological study of faeces (stool analysis on dysbacteriosis) upon receipt and check in 2 weeks after the end of corrigent treatment;
Esophagogastroduodenofiberscopy - when you are admission;
ECG (electrocardiogram);
X-ray research of accessory sinuses of nose - when you receive.
2. Additional studies:
Ultrasound of the abdominal cavity, pelvic, kidney - on medical testimony;
X-ray of the chest - on medical testimony.
3. Allergological survey:
Allergologic histories;
Skin tests with atopic allergens (scarifications, prick);
Determination of specific IgE antibodies to atopic allergens (using the methods of MAST, RAST);
Provocative tests if necessary (nasal, conjunctival).
4. Mandatory consultation:
Allergist;
Dermatologist;
Therapist;
Gastroenterologist;
ENT;
Endocrinologist;
Neuropsychiatrist.
In diffuse AD staging of skin tests can be conducted only after a remission / relative remission of the skin.
Characteristics of treatment
We recommend that you stick gipoallergennoy diet.
Treatment.
Step 1 - blocking of worsening (in the case of expressed aggravation of skin process with the phenomen of partial erythrodermatitis, eczema, lymphadenopathy, hypothermia) shall take place within 3 -7 days, in some cases - for 10 days:
intravenously(i.v.) drop-by-drop introduction: hemodez-n 200 ml per day - every day;
Clemastin (tavegil) 2.0 ml per 100 ml of 0.9% solution, sodium chloride 1-2 times a day;
Dexamethasone (dexone) 4-8 mg per 100 ml of 0.9% solution, sodium chloride 1-2 times per day (total dose of dexone course are 8-64 mg depending on the severity and incidence of skin).
Therapeutic plasmapheresis in the blood or intermittent fraktsionatore method: 3-4 session with removal for 1 session 1000 ml of plasma. Replacement is done protein solution is equivalent in terms of protein and saline. Plasmapheresis is contraindicated in case of aggravation of pyodermia and other pockets of chronic infection. Multiplicity sessions, 2 times a week.
Step 2 - correction of associated diseases, and rehabilitation centers of chronic infection.
3rd stage - per achievement of clinical remission, a specific immunotherapy (SIT) causallymarking allergens expedited basis, if necessary - against the backdrop of antihistamine medications or ketotifen. SIT should be conducted annually for 3 years.
Psychotropic drugs with sedative effects (appointed, if it's necessary):
alimemazine - 2,5-5mg 2 times a day or night courses within 1 month;
tioridazin (sonapax) - 10 mg 2-3 times daily rates for 1 month;
oxazepam (tazepam) - 10 mg at night;
fenazepam - 0.0005 g per night.
Antihystamine medications are appoint with rates for 7-10 days, as well as preventive purpose:
Suprastin per one pill for 2-3 times a day;
Tavegyl per 1 pill 2 times a day;
Claritin per 1 pill 1 times a day;
Stabilizers fat cell membranes:
ketotifen per one pill for 2 times a day rate of not less than 3 months to 6 - 12 - 24 months;
bisodium salt chrom glicerine acid (nalcrom) per 1 capsule 3 times a day for 10-15 minutes before eating, course per 1-2 months.
In the case of aggravation pyodermia should undertake a course of antibacterial therapy (against the background of antihystamine medications).
Absolutely contraindicated medications penicillin series!
In low treatment of purulent processes to antibacterial therapy should be combined with immunologically drugs.
Patients with respiratory manifestations of atopic need to make corrigent therapy.
Correction of associated diseases
Dysbacteriosis:
Piobacteriophage (combined or polivalent) eubiotics depending on the expression violations Intestinal microflora (bificol, bifidumbacterius, acylact, primadofilus, floradofilus, normadofilus, linecs) in combination with enzyme preparations: pankreatin (festal, espumisan, maalox) .
Terms of skin care:
1. The daily shower gels with non-soap.
2. Extenuating, nourishing cream, cream with olive oil with the addition of steroid creams or ointments in the proportion of 1:1 (advantan). At perioral area zaeds - a combination of drugs: triderm, travochort etc.
3. With escalating piodermia: leather 3% solution of hydrogen peroxide to remove purulent content and korochek, after which - 0.2% chlorhexidine solution or a solution furatsillina, then - fukocin or green diamond, and as the final stage - the local antibacterial drugs ( baneocin, oxyciclozol, levavinizol, etc.). Sports hold 1-2 times a day.
In the course of treatment is necessary to educate patients and their families the rules of care, compliance with hygiene measures, especially in the presence of domestic and epidermology of sensibilization (Appendix N2), prevention of exacerbations.
Recommended physiotherapy mud, MSS, selective phototherapy, PUVA therapy, climatic therapy at sea.
Length of hospital
Hospitalization, if necessary, be divided into 2 stages:
Step 1 - stopping worsening, a survey and correction of associated diseases, duration of phase from 20 to 35 days.
Step 2 - take SIT allergens; phase duration 14-20 days.
Requirements for the results of treatment
The disappearance of itching, reducing the size and intensity of skin lesions to the clinical remission, normalization of sleep, the improvement of psycho-emotional and general condition of patients, stabilization of respiratory manifestations atopic and associated diseases. Patients with AD are subject to a dispensary observation allergist for timely treatment and preventive measures to reduce temporary disability.
Patients with a limited form of blood to be outpatient treatment for patients with generalized form of AD is shown hospitalization period of 20-35 days.
Atopic dermatitis - chronic allergic inflammation of the skin surface, accompanied by itch, often combined with the presence of respiratory manifestations of immediate allergy: allergic rinoconjuctivitis's, atopic bronchial asthma.
The degree of severity of AD is determined by the prevalence of skin, location, availability of respiratory manifestations of atopic and the availability of secondary purulent infection.
To assess the severity of the skin, as well as to the effectiveness of therapy should be used Semiquantitative method - scale SCORAD (Scoring of Atopic Dermatitis), a score of six of objective and subjective symptoms, which are recorded in the grade sheet.
AD is characterized by a high content of total serum IgE and sensitization to multiple allergens atopic (domestic, epidermal, fungi, pollen, food).
At AD there are violation of blood of T-cell regulation (the predominance of Th2-response), which may determine the presence of IgE-indirect reactions. For the AD is characterized by a high degree of colonization of Staph. aureus; viral infection caused by Herpes simplex, Varicella, by virus of warts and molluscum contagiosa, as well as fungal infections (dermatomycosis caused by Trichophyton, high procent of colonization conditionally pathogenic mushroom genus Candida albicans, parapsilosis, Rhizopus spp., Spegazzinia tessarthra, Pitirosporum ovale). Of the opportunistic diseases most frequent is range pathology of the gastrointestinal tract: stomach ulcer and a duodenum, a violation of Intestinal microflora, as well as pockets of chronic infection, disease of ENT organs,of mental disturbances and of cataracts.
Survey
1. Mandatory laboratory and instrumental studies:
Clinical analysis of blood (in deviation from the norm, 1 time every 10 days);
Biochemical analysis of blood (total protein, bilirubin, ALT, AST, urea, creatinine, fibrinogen, C-reactive protein, glucose) once, in the case of plasmapheresis - control of total protein before each session;
Determination of blood group, Rh-factor;
RW, HIV;
An overall analysis of urine, if necessary - an analysis of urine on Nechiporenko once;
Immunological examination (level of total serum IgE, subpopulations of lymphocytes);
Bacteriological study of faeces (stool analysis on dysbacteriosis) upon receipt and check in 2 weeks after the end of corrigent treatment;
Esophagogastroduodenofiberscopy - when you are admission;
ECG (electrocardiogram);
X-ray research of accessory sinuses of nose - when you receive.
2. Additional studies:
Ultrasound of the abdominal cavity, pelvic, kidney - on medical testimony;
X-ray of the chest - on medical testimony.
3. Allergological survey:
Allergologic histories;
Skin tests with atopic allergens (scarifications, prick);
Determination of specific IgE antibodies to atopic allergens (using the methods of MAST, RAST);
Provocative tests if necessary (nasal, conjunctival).
4. Mandatory consultation:
Allergist;
Dermatologist;
Therapist;
Gastroenterologist;
ENT;
Endocrinologist;
Neuropsychiatrist.
In diffuse AD staging of skin tests can be conducted only after a remission / relative remission of the skin.
Characteristics of treatment
We recommend that you stick gipoallergennoy diet.
Treatment.
Step 1 - blocking of worsening (in the case of expressed aggravation of skin process with the phenomen of partial erythrodermatitis, eczema, lymphadenopathy, hypothermia) shall take place within 3 -7 days, in some cases - for 10 days:
intravenously(i.v.) drop-by-drop introduction: hemodez-n 200 ml per day - every day;
Clemastin (tavegil) 2.0 ml per 100 ml of 0.9% solution, sodium chloride 1-2 times a day;
Dexamethasone (dexone) 4-8 mg per 100 ml of 0.9% solution, sodium chloride 1-2 times per day (total dose of dexone course are 8-64 mg depending on the severity and incidence of skin).
Therapeutic plasmapheresis in the blood or intermittent fraktsionatore method: 3-4 session with removal for 1 session 1000 ml of plasma. Replacement is done protein solution is equivalent in terms of protein and saline. Plasmapheresis is contraindicated in case of aggravation of pyodermia and other pockets of chronic infection. Multiplicity sessions, 2 times a week.
Step 2 - correction of associated diseases, and rehabilitation centers of chronic infection.
3rd stage - per achievement of clinical remission, a specific immunotherapy (SIT) causallymarking allergens expedited basis, if necessary - against the backdrop of antihistamine medications or ketotifen. SIT should be conducted annually for 3 years.
Psychotropic drugs with sedative effects (appointed, if it's necessary):
alimemazine - 2,5-5mg 2 times a day or night courses within 1 month;
tioridazin (sonapax) - 10 mg 2-3 times daily rates for 1 month;
oxazepam (tazepam) - 10 mg at night;
fenazepam - 0.0005 g per night.
Antihystamine medications are appoint with rates for 7-10 days, as well as preventive purpose:
Suprastin per one pill for 2-3 times a day;
Tavegyl per 1 pill 2 times a day;
Claritin per 1 pill 1 times a day;
Stabilizers fat cell membranes:
ketotifen per one pill for 2 times a day rate of not less than 3 months to 6 - 12 - 24 months;
bisodium salt chrom glicerine acid (nalcrom) per 1 capsule 3 times a day for 10-15 minutes before eating, course per 1-2 months.
In the case of aggravation pyodermia should undertake a course of antibacterial therapy (against the background of antihystamine medications).
Absolutely contraindicated medications penicillin series!
In low treatment of purulent processes to antibacterial therapy should be combined with immunologically drugs.
Patients with respiratory manifestations of atopic need to make corrigent therapy.
Correction of associated diseases
Dysbacteriosis:
Piobacteriophage (combined or polivalent) eubiotics depending on the expression violations Intestinal microflora (bificol, bifidumbacterius, acylact, primadofilus, floradofilus, normadofilus, linecs) in combination with enzyme preparations: pankreatin (festal, espumisan, maalox) .
Terms of skin care:
1. The daily shower gels with non-soap.
2. Extenuating, nourishing cream, cream with olive oil with the addition of steroid creams or ointments in the proportion of 1:1 (advantan). At perioral area zaeds - a combination of drugs: triderm, travochort etc.
3. With escalating piodermia: leather 3% solution of hydrogen peroxide to remove purulent content and korochek, after which - 0.2% chlorhexidine solution or a solution furatsillina, then - fukocin or green diamond, and as the final stage - the local antibacterial drugs ( baneocin, oxyciclozol, levavinizol, etc.). Sports hold 1-2 times a day.
In the course of treatment is necessary to educate patients and their families the rules of care, compliance with hygiene measures, especially in the presence of domestic and epidermology of sensibilization (Appendix N2), prevention of exacerbations.
Recommended physiotherapy mud, MSS, selective phototherapy, PUVA therapy, climatic therapy at sea.
Length of hospital
Hospitalization, if necessary, be divided into 2 stages:
Step 1 - stopping worsening, a survey and correction of associated diseases, duration of phase from 20 to 35 days.
Step 2 - take SIT allergens; phase duration 14-20 days.
Requirements for the results of treatment
The disappearance of itching, reducing the size and intensity of skin lesions to the clinical remission, normalization of sleep, the improvement of psycho-emotional and general condition of patients, stabilization of respiratory manifestations atopic and associated diseases. Patients with AD are subject to a dispensary observation allergist for timely treatment and preventive measures to reduce temporary disability.
Patients with a limited form of blood to be outpatient treatment for patients with generalized form of AD is shown hospitalization period of 20-35 days.
Dec 26, 2008
Bronchial asthma (BA)
Definition
BA - inflammatory diseases of the respiratory tract, binding mechanism which is hyperactivity of bronchus and reversible bronchial obstruction caused by acute bronhospasm, edema bronchial wall, the formation of mucous plugs, followed by restructuring of bronchial wall. Bronchial asthma is a predisposing factor for atopy.
The basic principles of treatment of bronchial asthma are:
1. Elimination (termination), or reducing exposure to casual sense allergen;
2. Pharmacy therapy;
3. Specific immunotherapy.
Pharmacotherapy of Bronchial asthma is determined the gravity of disease (see below). IT is the main method of treating patients with atopic BA.
Indications for IT in patients with atopic BA are standard:
1. the impossibility of ending contact with the patient and allergen;
2. clear evidence of the role of allergens (pollen plants, household allergens, house dust mites, poison Hymenoptera, fungi, bacteria);
3. confirmation of IgE-dependent mechanism of sensitization;
4. age from 5 to 50 years.
Contraindications to the SIT in patients with BA:
BA worsening, the availability expressed complications, pulmonary heart with the phenomenon of chronic insufficiency of the functions of external respiration and blood circulation, pregnancy, tumors, chronic infection in the process worsening, autoimmune disease, severe diseases of internal organs , Nervous and endocrine systems, mental illness in the process of worsening, acute infectious diseases, blood diseases.
Survey
1. Required laboratory tests:
Analysis of clinical blood (1 every 10 days);
Analysis of blood biochemistry (bilirubin, ALT, AST, urea, glucose);
RW, HIV;
An analysis of sputum general;
Bacteriology sputum flora and sensitivity to antibiotics;
Analysis of urine common.
2. Additional laboratory studies:
Determination of protein fractions;
Determining the level of IgA, IgM, IgG in serum;
Blood tests: cortisol;
Urine analysis of the 17-CDR (for patients receiving GKS systemic action).
3. Allergy mandatory survey:
Skin tests with allergens;
Determining the level of total IgE;
Determining the level of specific IgE.
4. Allergy survey added:
Provocative tests with allergens (conjunctival, nasal, inhalation);
Determining the level of specific IgG;
Test braking natural emigration of leukocytes.
5. Binding Instrument Research:
X-ray of the thorax;
Radiography subordinate nasal sinus;
electrocardiogram (ECG), 1 times (in pathology - again);
Study external respiration 2 times.
6. Additional research tool:
Diagnostic bronchoscopy;
bronchomotor tests (estimate external respiration after exposure bronchial spasmolytic, bronchoconstrictors, physical exertion).
7. Mandatory counseling professionals:
ENT;
Allergist;
Pulmonology.
8. For more expert advice - on the grounds.
Characteristics of treatment
Treatment of patients with BA, is provide to reduce the specific and nonspecific hyperactivity of bronchus.
Recommended:
To ensure peace, to create an environment of comfort;
Delete the emotional and physical stress;
Delete or reduce contact with allergens;
Exclude the impact of provocative attacks of suffocation factors (smoking, household goods, cosmetics, etc.);
Exclude the possibility of the use of drugs in their intolerance;
Ensure hypoallergic diet;
Recommend to eliminate the influence of adverse occupational factors.
Medication.
Medication should be directed to stopping acute attacks bronchospasm, bronchospasm prevention, rescue pockets of chronic infection.
Means of emergency (stopping acute attacks):
sympathomimetics, beta2-agonists short steps;
Methylxanthine with short steps;
Glucocorticosteroids systemic action;
Anticholinergic drug.
In case of heavy and medium attack of BA used drugs for parenteral introduction.
For stopping touch suffocation can be used drugs in metered-dose inhalers or enteral(oral).
In order to prevent attacks bronhospazma used reference tools and anti protivoallergicheskoy therapy: GKS, drugs kromoglitsievoy acid receptor antagonists leykotrienovyh, Antihistamines drugs with a stabilizing effect on mast cell membranes (ketotifen), mucolytic - in accordance with the severity of BA.
BA - inflammatory diseases of the respiratory tract, binding mechanism which is hyperactivity of bronchus and reversible bronchial obstruction caused by acute bronhospasm, edema bronchial wall, the formation of mucous plugs, followed by restructuring of bronchial wall. Bronchial asthma is a predisposing factor for atopy.
The basic principles of treatment of bronchial asthma are:
1. Elimination (termination), or reducing exposure to casual sense allergen;
2. Pharmacy therapy;
3. Specific immunotherapy.
Pharmacotherapy of Bronchial asthma is determined the gravity of disease (see below). IT is the main method of treating patients with atopic BA.
Indications for IT in patients with atopic BA are standard:
1. the impossibility of ending contact with the patient and allergen;
2. clear evidence of the role of allergens (pollen plants, household allergens, house dust mites, poison Hymenoptera, fungi, bacteria);
3. confirmation of IgE-dependent mechanism of sensitization;
4. age from 5 to 50 years.
Contraindications to the SIT in patients with BA:
BA worsening, the availability expressed complications, pulmonary heart with the phenomenon of chronic insufficiency of the functions of external respiration and blood circulation, pregnancy, tumors, chronic infection in the process worsening, autoimmune disease, severe diseases of internal organs , Nervous and endocrine systems, mental illness in the process of worsening, acute infectious diseases, blood diseases.
Survey
1. Required laboratory tests:
Analysis of clinical blood (1 every 10 days);
Analysis of blood biochemistry (bilirubin, ALT, AST, urea, glucose);
RW, HIV;
An analysis of sputum general;
Bacteriology sputum flora and sensitivity to antibiotics;
Analysis of urine common.
2. Additional laboratory studies:
Determination of protein fractions;
Determining the level of IgA, IgM, IgG in serum;
Blood tests: cortisol;
Urine analysis of the 17-CDR (for patients receiving GKS systemic action).
3. Allergy mandatory survey:
Skin tests with allergens;
Determining the level of total IgE;
Determining the level of specific IgE.
4. Allergy survey added:
Provocative tests with allergens (conjunctival, nasal, inhalation);
Determining the level of specific IgG;
Test braking natural emigration of leukocytes.
5. Binding Instrument Research:
X-ray of the thorax;
Radiography subordinate nasal sinus;
electrocardiogram (ECG), 1 times (in pathology - again);
Study external respiration 2 times.
6. Additional research tool:
Diagnostic bronchoscopy;
bronchomotor tests (estimate external respiration after exposure bronchial spasmolytic, bronchoconstrictors, physical exertion).
7. Mandatory counseling professionals:
ENT;
Allergist;
Pulmonology.
8. For more expert advice - on the grounds.
Characteristics of treatment
Treatment of patients with BA, is provide to reduce the specific and nonspecific hyperactivity of bronchus.
Recommended:
To ensure peace, to create an environment of comfort;
Delete the emotional and physical stress;
Delete or reduce contact with allergens;
Exclude the impact of provocative attacks of suffocation factors (smoking, household goods, cosmetics, etc.);
Exclude the possibility of the use of drugs in their intolerance;
Ensure hypoallergic diet;
Recommend to eliminate the influence of adverse occupational factors.
Medication.
Medication should be directed to stopping acute attacks bronchospasm, bronchospasm prevention, rescue pockets of chronic infection.
Means of emergency (stopping acute attacks):
sympathomimetics, beta2-agonists short steps;
Methylxanthine with short steps;
Glucocorticosteroids systemic action;
Anticholinergic drug.
In case of heavy and medium attack of BA used drugs for parenteral introduction.
For stopping touch suffocation can be used drugs in metered-dose inhalers or enteral(oral).
In order to prevent attacks bronhospazma used reference tools and anti protivoallergicheskoy therapy: GKS, drugs kromoglitsievoy acid receptor antagonists leykotrienovyh, Antihistamines drugs with a stabilizing effect on mast cell membranes (ketotifen), mucolytic - in accordance with the severity of BA.
Dec 22, 2008
Allergic conjunctivitis (AC)
Definition
Allergic conjunctivitis (AC)- allergic inflammation of the eye conjunctiva, manifested itchy century, hyperemia, watering, due to exposure to causal allergen.
Survey
1. Required laboratory tests:
Clinical analysis of blood - one-time (with changes in repeated studies 1 every 10 days);
RW, HIV;
An overall analysis of urine - on one occasion;
Cytological study separable from the eye - once.
2. Additional laboratory studies (single):
Bacteriology separable from the eye;
Virology research;
Biochemical investigation of blood (bilirubin, ALT, AST, urea, blood glucose).
3. Mandatory allergically survey:
Skin tests with atopic allergens (prick, scarification).
4. Additional allergically and immunological survey:
Determination of total serum IgE;
Specific IgE;
5. Additional research tool:
Conjunctival provocative tests.
6. Consultation specialists.
Required: allergist-immunologist, oculist, ENT doctor.
Characteristics of treatment
1. Appointment hypoallergenic diets, as well as recommendations on changing lifestyles in response to identified allergens causes.
2. Drug therapy.
Antihistamines systemic medications 1 generation (with acute AC heavy and mid flow) - chloropiramin (suprastin) hifenadin (fenkarol) klemastin (tavegil) to 1 pill for 2 times a day rate for 10-14 days; ketotifen (zaditen) to 1 pill for 2 times a day long courses;
Antihistamines systemic drugs 2 generation (with AC light and medium-severe) loratadin (klaritin) astemizol (gismanal) and others on Table 1. on the day of 10-14-day course.
Drugs of choice:
Preparations chromoglycidol in the form of eye drops (high-Krom, kromogeksal, optikrom, etc.) to 2 pills for 3-4 times a day long courses.
GKS topical - with heavy flow AC (hydrocortisone eye drops, oftan-dexamethasone drops, etc.) - in individual doses.
Antihistamines topical medications: levokabastin (gistimet) to 2 drops for 2 times a day or azelastin (allergodil) to 2 pills for 2 times a day.
3. Implementation of the SIT in a specialized institution allergological with no contraindications.
The length of hospital
Treatment is carried out, mainly in the outpatient polyclinic conditions for 10-14 days.
Requirements for the Treatment Results
Full recovery.
Patients are subject to medical check-up allergist-immunologist.
If you can not carry out treatment in the outpatient conditions - inpatient treatment (10-14 days).
Allergic conjunctivitis (AC)- allergic inflammation of the eye conjunctiva, manifested itchy century, hyperemia, watering, due to exposure to causal allergen.
Survey
1. Required laboratory tests:
Clinical analysis of blood - one-time (with changes in repeated studies 1 every 10 days);
RW, HIV;
An overall analysis of urine - on one occasion;
Cytological study separable from the eye - once.
2. Additional laboratory studies (single):
Bacteriology separable from the eye;
Virology research;
Biochemical investigation of blood (bilirubin, ALT, AST, urea, blood glucose).
3. Mandatory allergically survey:
Skin tests with atopic allergens (prick, scarification).
4. Additional allergically and immunological survey:
Determination of total serum IgE;
Specific IgE;
5. Additional research tool:
Conjunctival provocative tests.
6. Consultation specialists.
Required: allergist-immunologist, oculist, ENT doctor.
Characteristics of treatment
1. Appointment hypoallergenic diets, as well as recommendations on changing lifestyles in response to identified allergens causes.
2. Drug therapy.
Antihistamines systemic medications 1 generation (with acute AC heavy and mid flow) - chloropiramin (suprastin) hifenadin (fenkarol) klemastin (tavegil) to 1 pill for 2 times a day rate for 10-14 days; ketotifen (zaditen) to 1 pill for 2 times a day long courses;
Antihistamines systemic drugs 2 generation (with AC light and medium-severe) loratadin (klaritin) astemizol (gismanal) and others on Table 1. on the day of 10-14-day course.
Drugs of choice:
Preparations chromoglycidol in the form of eye drops (high-Krom, kromogeksal, optikrom, etc.) to 2 pills for 3-4 times a day long courses.
GKS topical - with heavy flow AC (hydrocortisone eye drops, oftan-dexamethasone drops, etc.) - in individual doses.
Antihistamines topical medications: levokabastin (gistimet) to 2 drops for 2 times a day or azelastin (allergodil) to 2 pills for 2 times a day.
3. Implementation of the SIT in a specialized institution allergological with no contraindications.
The length of hospital
Treatment is carried out, mainly in the outpatient polyclinic conditions for 10-14 days.
Requirements for the Treatment Results
Full recovery.
Patients are subject to medical check-up allergist-immunologist.
If you can not carry out treatment in the outpatient conditions - inpatient treatment (10-14 days).
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