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Background Aspirin desensitization ( AD) treatment at doses of up to 1300 mg/day improves outcomes in aspirin-exacerbated respiratory disease ( AERD). The aim of this study was to investigate the efficacy of aspirin 300 mg/day in the treatment of patients with AERD. Methods The study included 40 patients diagnosed in our clinic as AERD that were desensitized and treated with aspirin 300 mg/day between December 2005 and December 2012. Changes from the baseline status were analyzed at 1 year and at 3 years of follow-up. Results Of the 40 patients included, 24 (60%) were female and median (interquartile range [ IQR]) age was 45 (40-51) years. Median ( IQR) duration of AD was 31.5 (10.5-48.5) months. In total, 29 patients continued treatment for at least 1 year and 18 patients for at least 3 years. The annual rate of use of systemic corticosteroid regimens, episodes of sinusitis, and surgery was significantly lower both at 1 year ( P = 0.002, P = 0.01, and P < 0.001, respectively) and at 3 years ( P = 0.001, P = 0.03, and P = 0.002, respectively). Significant improvement was observed in the nasal congestion score ( P = 0.01) and sense of smell score ( P = 0.05) at 1 year and in the postnasal drainage score ( P = 0.01) at 3 years. Conclusion Daily treatment with aspirin 300 mg had beneficial effects in patients with AERD, especially for the control of upper airway disease. [ABSTRACT FROM AUTHOR]

Background Data are limited about the value of skin tests in the diagnosis of proton pump inhibitor ( PPI)-induced hypersensitivity reactions and the cross-reactivity between PPIs. We aimed to assess the role of skin testing in the diagnosis of PPI-related immediate hypersensitivity reactions and the cross-reactivity patterns among PPIs. Methods The study was designed in a prospective, national, multicentre nature. Sixty-five patients with a suggestive history of a PPI-induced immediate hypersensitivity reaction and 30 control subjects were included. Standardized skin prick and intradermal tests were carried out with a panel of PPIs. Single-blind, placebo-controlled oral provocation tests ( OPTs) with the PPIs other than the culprit PPI that displayed negative results in skin tests ( n = 61) and diagnostic OPTs with the suspected PPI ( n = 12) were performed. Results The suspected PPIs were lansoprazole ( n = 52), esomeprazole ( n = 11), pantoprazole ( n = 9), rabeprazole ( n = 2), and omeprazole ( n = 1). The sensitivity, specificity, and negative and positive predictive values of the skin tests with PPIs were 58.8%, 100%, 70.8%, and 100%, respectively. Fifteen of the 31 patients with a hypersensitivity reaction to lansoprazole had a positive OPT or skin test result with at least one of the alternative PPIs (8/52 pantoprazole, 6/52 omeprazole, 5/52 esomeprazole, 3/52 rabeprazole). Conclusion Considering the high specificity, skin testing seems to be a useful method for the diagnosis of immediate-type hypersensitivity reactions to PPIs and for the evaluation of cross-reactivity among PPIs. However, OPT should be performed in case of negativity on skin tests. [ABSTRACT FROM AUTHOR]

Background: The study aimed to determine whether allergic conditions accompany analgesic intolerance. Methods: A total of 132 analgesic‐intolerant patients with bronchial asthma admitted to the adult allergy unit from January 1991 to October 1997 and 103 patients with bronchial asthma randomly selected from among the asthmatics referred to our department between January and October 1997 were enrolled in the study. Those having analgesic intolerance and bronchial asthma were accepted as group I; patients having only asthma were accepted as group II. A standard questionnaire was completed for all the patients. Physical examination, routine skin prick tests, determination of total IgE levels and blood type, and oral analgesic provocation tests were also performed. Results: The results showed that some allergic conditions were significantly more common in group I (22.7% and 7.8% for food allergy/intolerance [P<0.05], 16.7% and 7.8% for antibiotic allergy, 16.7% and 2.9% for dermographism, 9.8% and 1.0% for metal allergy, and 9.1% and 1.0% for chronic urticaria for groups I and II, respectively [P<0.001]). In addition, the mean of the total IgE level in the serum was higher in group I than group II (77.6 and 53.7 IU/ml; P<0.05), and the cumulative analgesic consumption was more in group I (14.2±17.1 and 9.1±12.5 boxes; P<0.05). Conclusions: Dermographism; chronic urticaria; antibiotic, metal, and food allergy; high levels of total IgE; and a high amount of cumulative analgesic consumption may be the conditions accompanying analgesic intolerance in asthmatics. [ABSTRACT FROM AUTHOR]

Introduction: The COVID-19 pandemic dramatically disrupts health care around the globe. The impact of the pandemic on chronic urticaria (CU) and its management are largely unknown., Aim: To understand how CU patients are affected by the COVID-19 pandemic; how specialists alter CU patient management; and the course of CU in patients with COVID-19., Materials and Methods: Our cross-sectional, international, questionnaire-based, multicenter UCARE COVID-CU study assessed the impact of the pandemic on patient consultations, remote treatment, changes in medications, and clinical consequences., Results: The COVID-19 pandemic severely impairs CU patient care, with less than 50% of the weekly numbers of patients treated as compared to before the pandemic. Reduced patient referrals and clinic hours were the major reasons. Almost half of responding UCARE physicians were involved in COVID-19 patient care, which negatively impacted on the care of urticaria patients. The rate of face-to-face consultations decreased by 62%, from 90% to less than half, whereas the rate of remote consultations increased by more than 600%, from one in 10 to more than two thirds. Cyclosporine and systemic corticosteroids, but not antihistamines or omalizumab, are used less during the pandemic. CU does not affect the course of COVID-19, but COVID-19 results in CU exacerbation in one of three patients, with higher rates in patients with severe COVID-19., Conclusions: The COVID-19 pandemic brings major changes and challenges for CU patients and their physicians. The long-term consequences of these changes, especially the increased use of remote consultations, require careful evaluation., (© 2020 The Authors. Allergy published by European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd.)

Hepatocellular carcinoma is one of the most pervasive cancers with low prognosis, high frequency of recurrence, and metastasis. Studies conducted have focused on extricating novel strategies for successful treatment. Kojic acid and its derivatives are already proven to have depigmenting, anti-inflammatory, and anti-neoplastic properties. In the present study, kojic acid and its 10 distinct derivatives were tested on HEPG2 cell line for their possible anti-cancer effect and seven of them were observed to be cytotoxic. Compound 6 was chosen to proceed as the IC 50 dosage for HEPG2 cells was lower in comparison with the other derivatives and kojic acid itself. Further experiments pointed out that intrinsic apoptotic pathway was triggered with the exposure of the cells to IC 50 concentration of the derivative as the treatment led to escalation of intracellular ROS, induction of TP53 gene, and activation of caspase 3/7. Pro-apoptotic Jnk and Bax genes were not triggered suggesting that the apoptotic pathway advance through an alternative route. Complementary experiments are in need; howbeit, the current findings suggest that the derivative offers a novel promising approach against hepatocellular carcinoma as it is not detrimental to healthy cells within the concentrations applied, and it does not induce drug resistance., (© 2019 John Wiley & Sons A/S.)

Background: Turkey is one of the four major producers of rose. Cultivation of rose is the main economic activity of many villagers in the Lakes region. Rose allergy has not been reported before. We investigated the prevalence of allergy symptoms and specific-IgE immune response due to rose in villagers who had been cultivating rose in Güneykent village in the Lakes region., Methods: A screening questionnaire including respiratory and allergic symptoms was administered to 290 villagers. The investigation team visited and studied 75 randomly selected villagers with an interviewer-administered questionnaire, pulmonary function testing, skin prick testing and serum total IgE. Specific IgE against Rosa rugosa was measured in 41 villagers., Results: Villagers reported asthma/allergy symptoms outside the rose season (17.6%), during the rose season (6.2%), and both during the rose season and outside the rose season (whole the year) (17.6%). Atopy and specific IgE against Rosa rugosa were detected in 12 (19%), and 8 (19.5%) of the villagers tested. Villagers who had symptoms whole the year reported wheeze more frequently than those who reported symptoms only outside the rose season (41.2% vs 11.1%)., Conclusions: IgE-mediated allergy could occur due to rose and/or its pollen. Symptoms mainly affect the upper airways. Further studies in the rose handlers, florists and workers of the rose industry would help elucidate the occurrence of rose allergy.