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1. Correction to: SIRM‑SIAAIC consensus, an Italian document on management of patients at risk of hypersensitivity reactions to contrast media

Author

Maria Teresa Costantino, Laura Romanini, Francesco Gaeta, Fulvio Stacul, Rocco Luigi Valluzzi, Matteo Passamonti, Patrizia Bonadonna, Giovanni Cerri, Stefano Pucci, Paolo Ricci, Eleonora Savi, Michele Galluzzo, Marina Mauro, Emanuele Grassedonio, Mona Rita Yacoub, Alfonso Reginelli, Sergio Testi, Erminia Ridolo, Eustacchio Nettis, Elisabetta Di Leo, Oliviero Rossi, Paolo Montuschi, Cristoforo Incorvaia, and Antonino Romano

Subjects
Immunologic diseases. Allergy, RC581-607
Published
2024
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3. Effectiveness and safety of dupilumab in patients with chronic rhinosinusitis with nasal polyps and associated comorbidities: a multicentric prospective study in real life

Author

Eustachio Nettis, Luisa Brussino, Vincenzo Patella, Laura Bonzano, Aikaterini Detoraki, Elisabetta Di Leo, Maria Maddalena Sirufo, Cristiano Caruso, Fabio Lodi Rizzini, Mariaelisabetta Conte, Mona-Rita Yacoub, Massimo Triggiani, Erminia Ridolo, Luigi Macchia, Giovanni Rolla, Raffaele Brancaccio, Amato De Paulis, Giuseppe Spadaro, Danilo Di Bona, Angela Maria D’Uggento, Lia Ginaldi, Francesco Gaeta, Eleonora Nucera, Kliljeda Jaubashi, Danilo Villalta, Lorenzo Dagna, Domenico Ciotta, Francesco Pucciarini, Diego Bagnasco, Giorgio Celi, Fulvia Chieco Bianchi, Lorenzo Cosmi, Maria Teresa Costantino, Maria Angiola Crivellaro, Simona D’Alò, Pietro del Biondo, Stefano Del Giacco, Mario Di Gioacchino, Linda Di Pietro, Elisabetta Favero, Sebastiano Gangemi, Gabriella Guarnieri, Enrico Heffler, Maria Stefania Leto Barone, Carla Lombardo, Francesca Losa, Andrea Matucci, Paola Lucia Minciullo, Paola Parronchi, Giovanni Passalacqua, Stefano Pucci, Oliviero Rossi, Lorenzo Salvati, Michele Schiappoli, Gianenrico Senna, Andrea Vianello, Alessandra Vultaggio, Yang Baoran, Cristoforo Incorvaia, and Giorgio Walter Canonica

Subjects
Immunologic diseases. Allergy, RC581-607
Abstract

Abstract Background Biologics are currently one of the main treatment options for a number of diseases. The IgG4 monoclonal antibody dupilumab targets the Interleukin-4 receptor alpha chain, thus preventing the biological effects of the cytokines IL-4 and IL-13, that are essential for the Th2 response. Several controlled trials showed that dupilumab is effective and safe in patients with atopic dermatitis (AD), severe asthma and chronic rhinosinusitis with nasal polyps (CRSwNP), thus resulting in approval by regulatory agencies. Aim of the study was to evaluate the efficacy and safety of dupilumab in adult patients with CRSwNP stratified by common overlapping comorbid conditions. Methods We performed a multicenter, observational, prospective study enrolling adult patients with severe CRSwNP who had started dupilumab treatment in the context of standard care from January 2021 to October 2021. Data were collected from twentynine Italian secondary care centers for allergy and clinical immunology, all of which were part of the Italian Society of Allergy, Asthma and Clinical Immunology (SIAAIC). A number of efficacy parameters were used. Patient data were compared using the Wilcoxon test for paired data. All statistical analyses were performed with SPSS version 20 (IBM, Armonk, NY, USA). Results In total, 82 patients with nasal polyposis were identified. A significant improvement was detected for all the applied efficacy parameters, i.e. 22-item Sino-Nasal Outcome Test (SNOT-22) and bilateral endoscopic nasal polyp score (NPS) scores for CRSwNP, Rhinitis Control Scoring System (RCSS) and Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) scores for allergic perennial rhinitis, Forced Expiratory Volume in the 1st second (FEV1) and Asthma Quality of Life Questionnaire (AQLQ) scores for asthma, Eczema Area and Severity Index (EASI) and Dermatology Life Quality Index (DLQI) scores for AD. A non-significant improvement was also obtained in the Urticaria Activity Score over 7 days (UAS7) for chronic spontaneous urticaria. Treatment with dupilumab was well tolerated. Conclusions These data suggest that dupilumab treatment in patients suffering from CRSwNP and associated comorbidities may be suitable. Such outcome, although confirmation by trials is warranted, suggests the possibility to treat different disorders with a single therapy, with favorable effects especially under the cost-effectiveness aspect.

Published
2022
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4. SIRM-SIAAIC consensus, an Italian document on management of patients at risk of hypersensitivity reactions to contrast media

Author

Maria Teresa Costantino, Laura Romanini, Francesco Gaeta, Fulvio Stacul, Rocco Luigi Valluzzi, Matteo Passamonti, Patrizia Bonadonna, Giovanni Cerri, Stefano Pucci, Paolo Ricci, Eleonora Savi, Michele Galluzzo, Marina Mauro, Emanuele Grassedonio, Mona Rita Yacoub, Alfonso Reginelli, Sergio Testi, Erminia Ridolo, Eustacchio Nettis, Elisabetta Di Leo, Oliviero Rossi, Paolo Montuschi, Cristoforo Incorvaia, and Antonino Romano

Subjects
Radiologic contrast media, Hypersensitivity reactions, Low-osmolar contrast agents, Diagnosis, Management, Immunologic diseases. Allergy, RC581-607
Abstract

Abstract Hypersensitivity reactions (HRs) to contrast media (CM) can be distinguished in immune-mediated (including allergic reactions) and non-immune-mediated reactions, even if clinical manifestations could be similar. Such manifestations range from mild skin eruptions to severe anaphylaxis, making it important for radiologists to know how to identify and manage them. A panel of experts from the Società Italiana di Radiologia Medica e Interventistica (SIRM) and the Società Italiana di Allergologia, Asma e Immunologia Clinica (SIAAIC) provided a consensus document on the management of patients who must undergo radiological investigations with CM. Consensus topics included: the risk stratification of patients, the identification of the culprit CM and of a safe alternative by an allergy workup, as well as the use of premedication and the correct procedure to safely perform an elective (i.e., scheduled) or urgent examination. The most important recommendations are: (1) in all patients, a thorough medical history must be taken by the prescribing physician and/or the radiologist to identify at-risk patients; (2) in patients with hypersensitivity reactions to CM, the radiologist must consider an alternative, non-contrast imaging study with a comparable diagnostic value, or prescribe a different investigation with another class of CM; (3) if such options are not feasible, the radiologist must address at-risk patients to a reference centre for an allergy evaluation; (4) if timely referral to an allergist is not viable, it is recommended to use a CM other than the responsible one, taking into account cross-reactivity patterns; in the case of patients with histories of severe reactions, the presence of an anesthesiologist is also recommended and a premedication is suggested.

Published
2020
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5. Severe asthma: One disease and multiple definitions

Author

Diego Bagnasco, MD, PhD, Pierluigi Paggiaro, MD, Manuela Latorre, MD, Chiara Folli, BS, Elisa Testino, MD, Arianna Bassi, MD, Manlio Milanese, MD, Enrico Heffler, MD, Andrea Manfredi, Anna Maria Riccio, BS, Laura De Ferrari, BS, Francesco Blasi, Rikki Frank Canevari, MD, Giorgio Walter Canonica, MD, Giovanni Passalacqua, MD, Gabriella Guarnieri, Vincenzo Patella, Foschino Barbaro Maria Pia, Giovanna Elisiana Carpagnano, Anna del Colle, Giulia Scioscia, Pelaia Gerolamo, Francesca Puggioni, Francesca Racca, Elisabetta Favero, Sandra Iannacone, Eleonora Savi, Marcello Montagni, Gianna Camiciottoli, Chiara Allegrini, Carlo Lombardi, Giuseppe Spadaro, Caterina Detoraki, Francesco Menzella, Carla Galeone, Patrizia Ruggiero, Monna Rita Yacoub, Alvise Berti, Nicola Scichilone, Carmen Durante, Maria Teresa Costantino, Chiara Roncallo, Mariachiara Braschi, Alice D’Adda, Erminia Ridolo, Massimo Triggiani, Roberta Parente, D’Amato Maria, Maria Vittoria Verrillo, Giovanni Rolla, Luisa Brussino, Agata Valentina Frazzetto, Zappa Maria Cristina, Marianna Lilli, Nunzio Crimi, Marco Bonavia, Angelo Guido Corsico, Amelia Grosso, Stefano Del Giacco, Margherita Deidda, Luisa Ricciardi, Stefania Isola, Francesca Cicero, Giuliana Amato, Federica Vita, Antonio Spanevello, Patrizia Pignatti, Francesca Cherubino, Dina Visca, Fabio Luigi Massimo Ricciardolo, Vitina Maria Anna Carriero, Francesca Bertolini, Pierachille Santus, Roberta Barlassina, Andrea Airoldi, Giuseppe Guida, Nucera Eleonora, Arianna Aruanno, Angela Rizzi, Cristiano Caruso, Stefania Colantuono, Gianenrico Senna, Marco Caminati, Alessandra Arcolaci, Andrea Vianello, Fulvia Chieco Bianchi, Maria Rita Marchi, Stefano Centanni, Simone Luraschi, Silvia Ruggeri, Rocco Rinaldo, Elena Parazzini, Cecilia Calabrese, Martina Flora, Lorenzo Cosmi, Linda Di Pietro, Enrico Maggi, Laura Pini, Luigi Macchia, Danilo Di Bona, Luca Richeldi, Carola Condoluci, Leonello Fuso, Matteo Bonini, Alessandro Farsi, Giulia Carli, Paolo Montuschi, Giuseppe Santini, Maria Elisabetta Conte, Elisa Turchet, Carlo Barbetta, Francesco Mazza, Simona D’Alo, Stefano Pucci, Maria Filomena Caiaffa, Elena Minenna, Luciana D'Elia, Carlo Pasculli, Vittorio Viviano, Paolo Tarsia, Joyce Rolo, Mariacarmela Di Proietto, and Salvatore Lo Cicero

Subjects
Severe asthma, Classification, Definition, Biological treatment, Immunologic diseases. Allergy, RC581-607
Abstract

Introduction: There is, so far, no universal definition of severe asthma. This definition usually relies on: number of exacerbations, inhaled therapy, need for oral corticosteroids, and respiratory function. The use of such parameters varies in the different definitions used. Thus, according to the parameters chosen, each patient may result in having severe asthma or not. The aim of this study was to evaluate how the choice of a specific definition of severe asthma can change the allocation of patients. Methods: Data collected from the Severe Asthma Network Italy (SANI) registry were analyzed. All the patients included were then reclassified according to the definitions of U-BIOPRED, NICE, WHO, ATS/ERS, GINA, ENFUMOSA, and TENOR. Results: 540 patients, were extracted from the SANI database. We observed that 462 (86%) met the ATS/ERS criteria as well as the GINA criteria, 259 (48%) the U-Biopred, 222 (41%) the NICE, 125 (23%) the WHO, 313 (58%) the Enfumosa, and 251 (46%) the TENOR criteria. The mean eosinophil value were similar in the ATS/ERS, U-Biopred, and Enfumosa (528, 532 and 516 cells/mcl), higher in WHO and Tenor (567 and 570 cells/mcl) and much higher in the NICE classification (624 cells/mcl). Lung function tests resulted similarly in all groups, with WHO (67%) and ATS/ERS-GINA (73%), respectively, showing the lower and upper mean FEV1 values. Conclusions: The present observations clearly evidence the heterogeneity in the distribution of patients when different definitions of severe asthma are used. However, the recent definition of severe asthma, provided by the GINA document, is similar to that indicated in 2014 by ATS/ERS, allowing mirror reclassification of the patients examined. This lack of homogeneity could complicate the access to biological therapies. The definition provided by the GINA document, which reflects what suggested by ATS/ERS, could partially overcome the problem.

Published
2021
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6. Economic impact of mepolizumab in uncontrolled severe eosinophilic asthma, in real life

Author

Diego Bagnasco, Massimiliano Povero, Lorenzo Pradelli, Luisa Brussino, Giovanni Rolla, Marco Caminati, Francesco Menzella, Enrico Heffler, Giorgio Walter Canonica, Pierluigi Paggiaro, Gianenrico Senna, Manlio Milanese, Carlo Lombardi, Caterina Bucca, Andrea Manfredi, Rikki Frank Canevari, Giovanni Passalacqua, Gabriella Guarnieri, Vincenzo Patella, Foschino Barbaro Maria Pia, Elisiana Carpagnano, Anna del Colle, Giulia Scioscia, Pelaia Gerolamo, Manuela Latorre, Francesca Puggioni, Francesca Racca, Elisabetta Favero, Sandra Iannacone, Eleonora Savi, Marcello Montagni, Gianna Camiciottoli, Chiara Allegrini, Giuseppe Spadaro, Caterina Detoraki, Carla Galeone, Patrizia Ruggiero, Monna Rita Yacoub, Alvise Berti, Gisella Colombo, Nicola Scichilone, Carmen Durante, Maria Teresa Costantino, Chiara Roncallo, Mariachiara Braschi, Francesco Blasi, Alice D'Adda, Erminia Ridolo, Massimo Triggiani, Roberta Parente, D'Amato Maria, Maria Vittoria Verrillo, Zappa Maria Cristina, Marianna Lilli, Nunzio Crimi, Marco Bonavia, Angelo Guido Corsico, Amelia Grosso, Stefano Del Giacco, Margherita Deidda, Luisa Ricciardi, Stefania Isola, Francesca Cicero, Giuliana Amato, Federica Vita, Antonio Spanevello, Patrizia Pignatti, Francesca Cherubino, Dina Visca, Eleonora Aletti, Fabio Luigi Massimo Ricciardolo, Vitina Maria Anna Carriero, Francesca Bertolini, Pierachille Santus, Roberta Barlassina, Andrea Airoldi, Giuseppe Guida, Nucera Eleonora, Arianna Aruanno, Angela Rizzi, Cristiano Caruso, Stefania Colantuono, Alessandra Arcolaci, Andrea Vianello, Fulvia Chieco Bianchi, Maria Rita Marchi, Stefano Centanni, Simone Luraschi, Silvia Ruggeri, Rocco Rinaldo, Elena Parazzini, Cecilia Calabrese, Martina Flora, Lorenzo Cosmi, Linda Di Pietro, Enrico Maggi, Laura Pini, Luigi Macchia, Danilo Di Bona, Luca Richeldi, Carola Condoluci, Leonello Fuso, Matteo Bonini, Alessandro Farsi, Giulia Carli, Paolo Montuschi, Giuseppe Santini, Maria Elisabetta Conte, Elisa Turchet, Carlo Barbetta, Francesco Mazza, Simona D'Alo, Stefano Pucci, Maria Filomena Caiaffa, Elena Minenna, Luciana D'Elia, Carlo Pasculli, Vittorio Viviano, Paolo Tarsia, Joyce Rolo, Mariacarmela Di Proietto, and Salvatore Lo Cicero

Subjects
Severe asthma, Mepolizumab, Anti IL-5, Pharmacoeconomics, OCS, Comorbidities, Immunologic diseases. Allergy, RC581-607
Abstract

Background and aims: Severe asthma is burdened by frequent exacerbations and use of oral corticosteroids (OCS) which worsen patients’ health and increase healthcare spending. Aim of this study was to assess the clinical and economic effect of adding mepolizumab (MEP) for the treatment of these patients. Methods: Patients >18 years old, referred to 8 asthma clinics, starting MEP between May 2017 and December 2018, were enrolled and followed-up for 12 months. Information in the 12 months before mepolizumab were collected retrospectively. The evaluation parameters included: OCS use, number of exacerbations/hospitalizations, concomitant therapies, comorbidity, and annual number of working days lost due to the disease. The primary objective was to compare the annual total cost per patient pre- and post-MEP. Secondary outcomes included rates of exacerbations and number of OCS-dependent patients. Results: 106 patients were enrolled in the study: 46 male, median age 58 years. Mean annual cost pre- and post-MEP (cost of biologic excluded) was €3996 and €1,527, respectively. Total savings due to MEP resulted in €2469 (95%CI 1945–2993), 62% due to exacerbations reduction and 33% due to productivity increase. Such savings could fund about 22% of the total cost of MEP for one year. The introduction of MEP induced a clinical benefit by reducing both OCS-dependent patients (OR = 0.12, 95%CI 0.06–0.23) and exacerbation rate (RR = 0.19, 95%CI 0.15–0.24). Conclusions: Patients with severe eosinophilic asthma experienced a clinical benefit in asthma control adding MEP to standard therapy. Biologic therapy can be, partially, funded by the savings produced by patients’ improvement.

Published
2021
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7. Convalescent Plasma for Hospitalized COVID-19 Patients: A Single-Center Experience

Author

Massimo Franchini, Claudia Glingani, Giuseppe De Donno, Giuseppe Lucchini, Massimiliano Beccaria, Massimo Amato, Gian Paolo Castelli, Leonardo Bianciardi, Mauro Pagani, Marco Ghirardini, Giuseppe Puma, Barbara Presciuttini, Maria Teresa Costantino, Marilena Frigato, Verena Crosato, Giorgio Tiecco, Alice Mulè, Dorothea Angela Papalia, Francesco Inglese, Fabio Spreafico, Martina Garuti, Antonietta Pecoriello, Giulia Cervi, Graziana Greco, Vanni Galavotti, Tiziana Santini, Angela Berselli, Carlo Montalto, Riccardo Bertoletti, Simona Aurelia Bellometti, Enrico Capuzzo, Dario Benazzi, Gianpaolo Grisolia, Fabio Pajola, Raffaello Stradoni, Matteo Zani, Adriano Verzola, Vito Codeluppi, Silvia Vesentini, Elisa Bellocchio, Marco Candini, Giorgina Ambrosi, Francesca Carandina, Cleante Scarduelli, Albino Reggiani, Salvatore Casari, and on behalf of Convalescent Plasma Study Group

Subjects
COVID-19, convalescent plasma, mortality, safety, Science
Abstract

In Winter 2020, Italy, and in particular the Lombardy region, was the first country in the Western hemisphere to be hit by the COVID-19 pandemic. Plasma from individuals recovered from COVID-19 (COVID-19 convalescent plasma, CCP) was the first therapeutic tool adopted to counteract the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). In this retrospective cohort study, we report the experience of the city hospital of Mantua, Lombardy region, on the compassionate use of CCP in patients hospitalized for severe COVID-19. Between April 2020 and April 2021, 405 consecutive COVID-19 patients received 657 CCP units with a median anti-SARS-CoV-2 neutralizing antibody (nAb) titer of 160 (interquartile range (IQR), 80–320). Their median age was 68 years (IQR, 56–78 years), and 62% were males. At enrollment, 55% of patients had an increased body mass index (BMI), and 25.6% had at least three comorbidities. The 28-day crude mortality rate was 12.6% (51/405). Young age (

Published
2022
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8. Abstracts from the Food Allergy and Anaphylaxis Meeting 2016

Author

Guillaume Pouessel, Claire Claverie, Julien Labreuche, Jean-Marie Renaudin, Aimée Dorkenoo, Mireille Eb, Anne Moneret-Vautrin, Antoine Deschildre, Stephane Leteurtre, Linus Grabenhenrich, Margitta Worm, Sabine Dölle, Kathrin Scherer, Isidor Hutteger, Morten Christensen, Carsten Bindslev-Jensen, Charlotte Mortz, Esben Eller, Henrik Fomsgaard Kjaer, Leonor Carneiro-Leão, Jenny Badas, Alice Coimbra, Dikla Pivko Levy, Moshe Ben-Shoshan, Ayelet Rimon, Shira Benor, Nicolette J. T. Arends, Nikki Edelbroek, Hans de Groot, Joyce A. M. Emons, H. Kim A. Brand, Dirk Verhoeven, Leonieke N. van Veen, Nicolette W. de Jong, Geunwoong Noh, Eun Ha Jang, Mariona Pascal, Olga Dominguez, Mònica Piquer, Montserrat Alvaro, Rosa Jimenez-Feijoo, Jaime Lozano, Adriana Machinena, Maria del Mar Folqué, Maria Teresa Giner, Ana María Plaza, Paul Turner, Nandinee Patel, Marta Vazquez-Ortiz, Sarah Lindsley, Lucy Walker, Simon Rosenberg, Adriano Mari, Claudia Alessandri, Ivana Giangrieco, Lisa Tuppo, Chiara Rafaiani, Georg Mitterer, Michela Ciancamerla, Rosetta Ferrara, Maria Livia Bernardi, Danila Zennaro, Maurizio Tamburrini, Maria Antonetta Ciardiello, Christian Harwanegg, Antonio Fernandez, Regina Selb, Philippe Egenmann, Michelle Epstein, Karin Hoffmann-Sommergruber, Frits Koning, Martinus Lovik, E. N. Clare Mills, Javier Moreno, Henk van Loveren, Jean-Michel Wal, Susanne Diesner, Cornelia Bergmayr, Barbara Pfitzner, Vera Elisabeth Assmann, Philipp Starkl, David Endesfelder, Thomas Eiwegger, Zsolt Szepfalusi, Heinz Fehrenbach, Erika Jensen-Jarolim, Anton Hartmann, Isabella Pali-Schöll, Eva Untersmayr, Soren Wille, Peter Meyer, Caroline Klingebiel, Jonas Lidholm, Angelica Ehrenberg, Jonas Östling, Isabelle Cleach, Jean-Louis Mège, Joana Vitte, Roberta Aina, Pawel Dubiela, Sabine Pfeifer, Merima Bublin, Christian Radauer, Piotr Humeniuk, Stefan Kabasser, Riccardo Asero, Gador Bogas, Francisca Gomez, Paloma Campo, Maria Salas, Inmaculada Doña, Esther Barrionuevo, Maria Auxiliadora Guerrero, Cristobalina Mayorga, Ana Prieto, Domingo Barber, Maria Jose Torres, Annette Jamin, Andrea Wangorsch, Barbara Ballmer, Stefan Vieths, Stephan Scheurer, Danijela Apostolovic, Jelena Mihailovic, Maja Krstic, Maria Starkhammar, Tanja Cirkovic Velickovic, Carl Hamsten, Marianne van Hage, Francine C. van Erp, Edward F. Knol, Hannah M. Kansen, Bo Pontoppidan, Yolanda Meijer, Cornelis K. van der Ent, André C. Knulst, Rebekah Sayers, Helen Brown, Adnan Custovic, Angela Simpson, Claire Mills, Juliane Schulz, Network for Online Registration of Anaphylaxis (NORA), Jaap Akkerdaas, Muriel Totis, Annabelle Capt, Corinne Herouet-Guicheney, Ronald van Ree, Tushar Banerjee, Antima Banerjee, Mathilde Claude, Grégory Bouchaud, Roberta Lupi, Laure Castan, Olivier Tranquet, Sandra Denery-Papini, Marie Bodinier, Chantal Brossard, Rosella De Poi, Elisa Gritti, Emiliano De Dominicis, Bert Popping, Patrizia Polverino de Laureto, Kati Palosuo, Anna Kaarina Kukkonen, Anna Pelkonen, Mika Mäkelä, Nanju Alice Lee, Johanna Rost, Sridevi Muralidharan, Dianne Campbell, Sam Mehr, Catherine Nock, Joseph Baumert, Steve Taylor, Carla Mastrorilli, Salvatore Tripodi, Carlo Caffarelli, Serena Perna, Andrea Di Rienzo Businco, Ifigenia Sfika, Arianna Dondi, Annamaria Bianchi, Carlotta Povesi Dascola, Giampaolo Ricci, Francesca Cipriani, Nunzia Maiello, Michele Miraglia del Giudice, Tullio Frediani, Simone Frediani, Francesco Macrì, Chiara Pistoletti, Iride Dello Iacono, Maria Francesca Patria, Elena Varin, Diego Peroni, Pasquale Comberiati, Loredana Chini, Viviana Moschese, Sandra Lucarelli, Roberto Bernardini, Giuseppe Pingitore, Umberto Pelosi, Roberta Olcese, Matteo Moretti, Anastasia Cirisano, Diego Faggian, Alessandro Travaglini, Mario Plebani, Maria Carmen Verga, Mauro Calvani, Paolo Giordani, Paolo Maria Matricardi, Noe Ontiveros, Francisco Cabrera-Chavez, Julie Galand, Etienne Beaudouin, The Anaphylaxis Working Group of the French Allergology SocietyThe Anaphylaxis Working Group of the French Allergology Society, Florence Pineau, Shinobu Sakai, Kayoko Matsunaga, Reiko Teshima, Colette Larré, Sandra Denery, Sebastian Tschirner, Valérie Trendelenburg, Gabriele Schulz, Bodo Niggemann, Kirsten Beyer, Youcef Bouferkas, Younes Belabbas, Djamel Saidi, Omar Kheroua, Kamel Eddine El Mecherfi, Malika Guendouz, Abir Haddi, Hanane Kaddouri, Luis Amaral, Ana Pereira, Susana Rodrigues, Mareen Datema, Laurian Jongejan, Michael Clausen, Andre Knulst, Nikolaos Papadopoulos, Marek Kowalski, Frédéric de Blay, Aeilko Zwinderman, Karin Hoffman-Sommergruber, Barbara Ballmer-Weber, Montserrat Fernandez-Rivas, Shan Deng, Jia Yin, Charlotte Eisenmann, Maria Nassiri, Rabea Reinert, Johanna P. M. van der Valk, Roy Gerth van Wijk, Yvonne Vergouwe, Ewout W. Steyerberg, Marit Reitsma, Harry J. Wichers, Huub F. J. Savelkoul, Berber Vlieg-Boerstra, Anthony E. J. Dubois, Fabrícia Carolino, Ana Rodolfo, Josefina Cernadas, Dasha Roa-Medellín, Ana Rodriguez-Fernandez, Joaquín Navarro, Vicente Albendiz, María Luisa Baeza, Sonsoles Intente-Herrero, Andrea Mikkelsen, Kirsten Mehlig, Lauren Lissner, Linda Verrill, Stefano Luccioli, Jolanda van Bilsen, Frieke Kuper, André Wolterbeek, Tanja Rouhani Rankouhi, Lars Verschuren, Hilde Cnossen, Prescilla Jeurink, Johan Garssen, Léon Knippels, Jossie Garthoff, Geert Houben, Winfried Leeman, M. Eleonore Pettersson, Afke M. M. Schins, Gerard H. Koppelman, Boudewjin J. Kollen, Svitlana Zubchenko, Sarah Kuntz, Pablo Mérida, Montserrat Álvaro, Monica Piquer, Carmen Riggioni, Juan Heber Castellanos, Rosa Jimenez, Melanie Cap, Elodie Drumez, Stéphanie Lejeune, Caroline Thumerelle, Clémence Mordacq, Véronique Nève, Sonia Ricò, Margherita Varini, Rita Nocerino, Linda Cosenza, Antonio Amoroso, Margherita Di Costanzo, Carmen Di Scala, Giorgio Bedogni, Roberto Berni Canani, Paul J. Turner, Paloma Poza-Guedes, Ruperto González-Pérez, Inmaculada Sánchez-Machín, Victor Matheu-Delgado, Erik Wambre, Anne-Sofie Ballegaard, Charlotte Madsen, Juliane Gregersen, Katrine Lindholm Bøgh, Philippe Aubert, Michel Neunlist, Antoine Magnan, Daniel Lozano-Ojalvo, Alba Pablos-Tanarro, Leticia Pérez-Rodríguez, Elena Molina, Rosina López-Fandiño, Akila Rekima, Patricia Macchiaverni, Mathilde Turfkruyer, Sebastien Holvoet, Lénaïck Dupuis, Nour Baiz, Isabella Annesi-Maesano, Annick Mercenier, Sophie Nutten, Valérie Verhasselt, Ines Mrakovcic-Sutic, Srdan Banac, Ivana Sutic, Zdenka Baricev-Novakovic, Ingrid Sutic, Valentino Pavisic, Rosa Muñoz-Cano, Teodoríkez Jiménez-Rodríguez, Daniel Corbacho, Jordi Roca-Ferrer, Joan Bartra, Aleksandar Bulog, Vladimir Micovic, Lidia Markiewicz, Agata Szymkiewicz, Anna Szyc, Barbara Wróblewska, Bryan M. Harvey, Lucien F. Harthoorn, A. Wesley Burks, Georgios Rentzos, Anna-Lena Bramstång Björk, Ulf Bengtsson, Colin Barber, Chrystyna Kalicinsky, Christine Breynaert, Lieve Coorevits, Cornelia Jansen, Erna Van Hoeyveld, Kristin Verbeke, Anne-Marie Kochuyt, Rik Schrijvers, Diana Deleanu, Adriana Muntean, Maria Konstantakopoulou, Maria Pasioti, Anastasia Papadopoulou, Anna Iliopoulou, Nikolaos Mikos, Evangelia Kompoti, Eunice Dias de Castro, Borja Bartalomé, Kok Loong Ue, Elizabeth Griffiths, Stephen Till, Kate Grimshaw, Graham Roberts, Anna Selby, Indre Butiene, Jose Ignacio Larco, Ruta Dubakiene, Ana Fiandor, Alessandro Fiocchi, Nikos Papadopoulos, Sigurveig Sigurdardottir, Aline Sprikkelman, Anne-Fleur Schoemaker, Paraskevi Xepapadaki, Thomas Keil, Zizi Cojocariu, Beatriz Secades Barbado, Vasti Iancu, Esozia Arroabarren, Marta Goñi Esarte, Miren Arteaga, Mayra Coutinho Andrade, Denise Borges, Jorge Kalil, Pedro Giavina Bianchi, Rosana Camara Agondi, Rinkesh Kumar Gupta, Akanksha Sharma, Kriti Gupta, Mukul Das, Premendra Dwivedi, Rusudan Karseladze, Liana Jorjoliani, Lali Saginadze, Mariam Tskhakaia, Katia Basello, Gabriele Piuri, Attilio Francesco Speciani, Michela Carola Speciani, Carla Camerotto, Francesco Zinno, Olga Pakholchuk, Svitlana Nedelska, Stefano Pattini, Maria Teresa Costantino, Silvia Peveri, Danilo Villalta, Eleonora Savi, Andrea Costanzi, Vera A. Revyakina, Marina A. Kiseleva, Elena D. Kuvshinova, Inna A. Larkova, Anton A. Shekhetov, Diana Silva, André Moreira, José Plácido, Hanneke van der Kleij, Esther van Twuijver, Robbert Sutorius, Pieter-Jan de Kam, Jenny van Odijk, Helen Lindqvist, Elin Lustig, Amyra Ali Azamar Jácome, Karla Leversia Borjas Aguilar, Miguel García Domínguez, David Alejandro Mendoza Hernández, Cristiano Caruso, Cono Casale, Gian Lodovico Rapaccini, Antonino Romano, Italo De Vitis, Renata R. Cocco, Carolina Aranda, Marcia C. Mallozi, Jackeline F. Motta, Lilian Moraes, Antonio Pastorino, Nelson Rosario, Ekaterini Goudouris, Arnaldo Porto, Neusa F. Wandalsen, Emanuel Sarinho, Flavio Sano, Dirceu Solé, Constantinos Pitsios, Maria Petrodimopoulou, Ekaterini Papadopoulou, Maria Passioti, Meropi Kontogianni, Nino Adamia, Ekaterina Khaleva, Ana Prieto del Prado, George Du Toit, Edyta Krzych, Urszula Samolinska-Zawisza, Konrad Furmanczyk, Aneta Tomaszewska, Filip Raciborski, Agnieszka Lipiec, Piotr Samel-Kowalik, Artur Walkiewicz, Jacek Borowicz, Boleslaw Samolinski, Aimee Lou Nano, Marysia Recto, Maria Luisa Somoza, Natalia Blanca López, Diana Pérez Alzate, Francisco Javier Ruano, Maria Isabel Garcimartín, Elisa Haroun, Maria Vázquez de la Torre, Antonia Rojas, Montserrat López Onieva, Gabriela Canto, Alexandra Rodrigues, Andreia Forno, António Jorge Cabral, Rute Gonçalves, Ilya Vorozhko, Tatyana Sentsova, Olga Chernyak, Svetlana Denisova, Lidia Ilènko, Valery Muhortnich, Caroline Zimmermann, Alexander Rohrbach, Faisal R. Bakhsh, Kollen Boudewijn, Anne-Marie Oomkes-Pilon, Dorien Van Ginkle, Mira Šilar, Anja Jeverica, Tina Vesel, Tadej Avčin, Peter Korošec, Johanna van der Valk, Irene Berends, Nicolette Arends, Maurits van Maaren, Harry Wichers, Joyce Emons, Anthony Dubois, Nicolette de Jong, Oksana Matsyura, Lesya Besh, Chung-Hsiung Huang, Tong-Rong Jan, Gary Stiefel, Jean Tratt, Kerrie Kirk, Fabricia Carolino, Stefania Arasi, Lucia Caminiti, Giuseppe Crisafulli, Chiara Fiamingo, Jlenia Fresta, Giovanni Pajno, Ben Remington, Astrid Kruizinga, W. Marty Blom, Joost Westerhout, Sabina Bijlsma, Joe Baumert, Mark Blankestijn, Henny Otten, Rob Klemans, Anouska D. Michelsen-Huisman, Harmieke van Os-Medendorp, Astrid G. Kruizinga, Astrid Versluis, Gert van Duijn, H. Mary-Lene de Zeeuw-Brouwer, Jacqueline J. M. Castenmiller, Hub P. J. M. Noteborn, Geert F. Houben, Kristian Bravin, David Luyt, Bushra Javed, Phil Couch, Christopher Munro, Phil Padfield, Matt Sperrin, Aideen Byrne, Lizalet Oosthuizen, Carina Kelleher, Fiona Ward, Niamh Brosnan, Graham King, Eva Corbet, Josué Alejandro Huertas Guzmán, Montserrat Bosque García, Oscar Asensio, Laura Valdesoiro Navarrete, Helena Larramona, Xavier Domingo Miró, Katarzyna Pyrz, Moira Austin, Yanne Boloh, Philip Couch, Deirdre Galloway, Pilar Hernandez, Jonathan O’B. Hourihane, Fiona Kenna, Barbara Majkowska-Wojciechowska, Lynne Regent, Marina Themisb, Sabine Schnadt, Aida Semic-Jusufagic, Audrey Dunn Galvin, Tiina Kauppila, Mikael Kuitunen, Nikolaos A. Kitsioulis, Nikolaos Douladiris, Sofia Kostoudi, Ioanna Manolaraki, Dimitris Mitsias, Emmanouil Manousakis, Nikolaos G. Papadopoulos, Rebecca Knibb, Jennifer Hammond, Richard Cooke, Jaakko Yrjänä, Anna-Maija Hanni, Päivi Vähäsarja, Oona Mustonen, Teija Dunder, Petri Kulmala, Eva Lasa, Carmen D’Amelio, Sara Martínez, Alejandro Joral, Gabriel Gastaminza, Maria Jose Goikoetxea, David C. A. Candy, Marleen T. J. Van Ampting, Manon M. Oude Nijhuis, Assad M. Butt, Diego G. Peroni, Adam T. Fox, Jan Knol, Louise J. Michaelis, Ines Padua, Patricia Padrao, Pedro Moreira, Renata Barros, Hanan Sharif, Manzoor Ahmed, Nehad Gomaa, Joris Mens, Koen Smit, Frans Timmermans, Tomaž Poredoš, Anja Koren Jeverica, Marjeta Sedmak, Evgen Benedik, Meta Accetto, Mirjana Zupančič, Glauce Yonamine, Gustavo Soldateli, Bruna Aquilante, Antonio Carlos Pastorino, Cleonir Lui de Moraes Beck, Andrea Keiko Gushken, Mayra de Barros Dorna, Cristiane Nunes dos Santos, Ana Paula Moschione Castro, Abdulhadi Al-Qahtani, Rand Arnaout, Agha Rehan Khaliq, Rashid Amin, Farrukh Sheikh, Jorge Alvarez, Marta Anda, Miriam Palacios, Montserrat De Prada, Carmen Ponce, Bianca Balbino, Riccardo Sibilano, Thomas Marichal, Nicolas Gaudenzio, Hajime Karasuyama, Pierre Bruhns, Mindy Tsai, Laurent L. Reber, Stephen J. Galli, Ana Reis Ferreira, Josefina R. Cernadas, Aida del Campo García, Sara Pereiro Fernández, Nerea Sarmiento Carrera, Fernando Bandrés Sánchez-Cruz, José Ramón Fernández Lorenzo, Stephanie Claus, Claudia Pföhler, Franziska Ruëff, Regina Treudler, Mercedes Escarrer Jaume, Agustin Madroñero, Maria Teresa Guerra Perez, Juan Carlos Julia, Charlotte Hands Plovdiv, Lee Gethings, Jim Langridge, Karine Adel-Patient, Hervé Bernard, Ivona Barcievic-Jones, Raditsa Sokolova, Rumyana Yankova, Mariya Ivanovska, Marianna Murdjeva, Tatyana Popova, Svetlan Dermendzhiev, Martin Karjalainen, Ulrike Lehnigk, Duncan Brown, Julie C. Locklear, Julie Locklear, Ioana Maris, Jonathan Hourihane, Cristina Ornelas, Joana Caiado, Manuel Branco Ferreira, Manuel Pereira-Barbosa, Yolanda Puente, Juan Carlos Daza, Francisco Javier Monteseirin, Natalia Ukleja-Sokolowska, Ewa Gawronska-Ukleja, Magdalena Zbikowska-Gotz, Zbigniew Bartuzi, Lukasz Sokolowski, Aine Adams, Bernard Mahon, Karen English, Nelly Gourdon-Dubois, Laetitia Sellam, Bruno Pereira, Elodie Michaud, Khaled Messaoudi, Bertrand Evrard, Jean-Luc Fauquert, Francisca Palomares, Gador Gomez, Maria Jose Rodriguez, Luisa Galindo, Ana Molina, Lorella Paparo, Maurizio Mennini, Rosita Aitoro, Adam Wawrzeńczyk, Michał Przybyszewski, Anna Wawrzeńczyk, Hulya Ercan Sarıcoban, Meltem Ugras, Zerrin Yalvac, Bertine M. J. Flokstra-de Blok, J. L. van der Velde, Andrea Vereda, Clara Ippolito, Amaranta Traversa, Daniela Adriano, Daniela Manila Bianchi, Silvia Gallina, Lucia Decastelli, Melina Makatsori, Anne Miles, Sonja Posega Devetak, Iztok Devetak, Soraya Ainad Tabet, Jeanette Fisker Trandbohus, Pernille Winther, Hans-Jørgen Malling, Kirsten Skamstrup Hansen, Lene Heise Garvey, Chia-Chi Wang, Yin-Hua Cheng, Chun-Wei Tung, Mariola Dietrich, Ingo Marenholz, Birgit Kalb, Sarah Grosche, Katharina Blümchen, Rupert Schlags, Mareike Price, Sylke Rietz, Jorge Esparza-Gordillo, Susanne Lau, Young-Ae Lee, Ali Almontasheri, Mohammad Al Bahkali, Sahar Elshorbagi, Abdullah Alfhaid, Mashary Altamimi, Eman Madbouly, Hassan Al-Dhekri, Rand K. Arnaout, Maria Basagaña, Sira Miquel, Borja Bartolomé, Bettina Brix, Stefanie Rohwer, Sandra Brandhoff, Alena Berger, Waltraud Suer, Alf Weimann, Cristina Bueno, Laura Martín-Pedraza, Sara Abián, Pablo San Segundo-Acosta, Juan Carlos López-Rodríguez, Rodrigo Barderas, Eva Batanero, Javier Cuesta-Herranz, María Teresa Villalba, Magna Correia, Filipe Benito-Garcia, Cristina Arêde, Susana Piedade, Mário Morais-Almeida, James Hindley, Ross Yarham, Anna Kuklinska-Pijanka, David Gillick, Karine Patient, Martin D. Chapman, Katrine L. Bøgh, Ana Miranda, Eugénia Matos, Anna Sokolova, Huan Rao, Ivona Baricevic-Jones, Frances Smith, Wentong Xue, Helga Magnusdottir, Anna G. Vidarsdottir, Sigrun Lund, Anders Blom Jensen, Bjorn R. Ludviksson, Reyna Simon, Robert Elfont, Sean Bennett, Robert Voyksner, Maria de Lurdes Torre, Songül Yürek, Margaretha A. Faber, Annick Bastiaensen, Evelyne Mangodt, Athina van Gasse, Ine Decuyper, Vito Sabato, Margo M. Hagendorens, Chris H. Bridts, Luc S. De Clerck, Didier Ebo, Susanne Schwarz, Mandy Ziegert, Saskia Albroscheit, Christian Schwager, Skadi Kull, Jochen Behrends, Niels Röckendorf, Frauke Schocker, Andreas Frey, Arne Homann, Wolf-Meinhard Becker, Uta Jappe, Nesrine Zaabat, Sylvia Osscini, Chantal Agabriel, Benoît Sterling, Ania Carsin, Valérie Liabeuf, Monica Maćków, Alina Zbróg, Monica Bronkowska, Justine Courtois, Romy Gadisseur, Catherine Bertholet, Pierre Lukas, Etienne Cavalier, Philippe Delahaut, Birgit Quinting, Margareta Brandt Gertmo, Ewa Ternesten Hasseus, Vladyslava Barzylovych, Júlio Oliveira, Luis F. Ensina, Carolina S. Aranda, Leire Dopazo, Rebeca Lopez, Raquel Perez, Laura Santos-Diez, Agurtzane Bilbao, Juan Miguel Garcia, Ignacio García Núñez, María Ángeles Algaba Mármol, María José Barasona Villarejo, José Antonio Bácter Martos, Marina Suárez Vergara, José María Ignacio García, Agata Michalska, Grzegorz Sergiejko, Robert Zacniewski, Ileana-Maria Ghiordanescu, Cristina Deaconu, Mihaela Popescu, Roxana Silvia Bumbacea, Alkerta Ibranji, Elida Nikolla, Gjustina Loloci, Nanna Juel-Berg, Lau Fabricius Larsen, Lars Kjaergaard Poulsen, João Marcelino, Ricardo Prata, Ana Célia Costa, Fátima Duarte, Marta Neto, Jennifer Santos, Luís Câmara Pestana, Daniel Sampaio, Paola Minale, Paola Dignetti, Donatella Bignardi, Irena Nedelea, Florin-Dan Popescu, Mariana Vieru, Florin-Adrian Secureanu, Carmen Saviana Ganea, Miguel Vieira, José Pedro Moreira Silva, Timothy Watts, Sophia Watts, Marta Lomikovska, Marina Peredelskaya, Natalia Nenasheva, Ivana Filipovic, Zorica Zivkovic, Djordje Filipovic, Jennette Higgs, Amena Warner, and Carla Jones

Subjects
Immunologic diseases. Allergy, RC581-607
Published
2017
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9. Catching allergy by a simple questionnaire

Author

Maurizio Galimberti, Giovanni Passalacqua, Cristoforo Incorvaia, Vincenzo Castella, Maria Teresa Costantino, Beniamino Cucchi, Sebastiano Gangemi, Gilda Nardi, Paolo Raviolo, Paola Rottoli, Nicola Scichilone, Nico Sciolla, Germano Bettoncelli, Massimo Landi, Erminia Ridolo, Serena Buttafava, Paola Puccinelli, Giorgio Walter Canonica, Alessandro Fiocchi, and Franco Frati

Subjects
Immunologic diseases. Allergy, RC581-607
Abstract

Background Identifying allergic rhinitis requires allergy testing, but the first-line referral for rhinitis are usually primary care physicians (PCP), who are not familiar with such tests. The availability of easy and simple tests to be used by PCP to suggest allergy should be very useful.Methods The Respiratory Allergy Prediction (RAP) test, based on 9 questions and previously validated by a panel of experts, was evaluated in this study.Results An overall number of 401 patients (48.6% males, age range 14–62 years) with respiratory symptoms was included. Of them, 89 (22.2%) showed negative results to SPT, while 312 (77.8%) had at least one positive result to SPT. Cohen’s kappa coefficient showed that all questions had an almost perfect excellent agreement between pre and post-test. The algorithm of decision-tree growth Chi-squared Automatic Interaction Detector showed that answering yes to the question 4 (Your nasal/ocular complains do usually start or worsen during the spring?), 6 (Did you ever had cough or shortness of breath, even during exercise?) and 8 (Do you use nasal sprays frequently?) gave a probability to have a positive SPT of 85%.Conclusions These findings show that RAP test can be proposed as an useful tool to be used by physician other than allergists when evaluating patients with rhinitis, suggesting the need of allergy testing. Keywords: Allergy, Allergic rhinitis, Allergy testing, Primary care physicians, Pharmacists

Published
2015
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10. Stewardship per l’utilizzo degli antibiotici

Author

Giuseppina Moccia, Grazia Cioffi, Amelia Filippelli, Francesco De Caro, and Maria Teresa Costantino

Abstract

Ridurre l’uso eccessivo, incontrollato o inappropriato degli antibiotici, è essenziale per garantire la sicurezza dei pazienti e la qualità dell’Assistenza Medica. Per prevenire e controllare le infezioni correlate all’assistenza (ICA) e lo sviluppo dell’antimicrobico-resistenza si possono utilizzare varie strategie: • adozione di programmi di sorveglianza e controllo condivisi a livello nazionale, comprendenti lo sviluppo di percorsi diagnostici e terapeutici comuni, • implementazione della stewardship antimicrobica e dei programmi di formazione rivolti al personale sanitario, finalizzati alla promozione di una maggiore osservanza delle Linee Guida, • incremento della sorveglianza, effettuando studi di prevalenza ripetuti nel tempo, per poter identificare precocemente eventuali criticità e valutare l’efficacia dei presidi messi in atto, • potenziamento delle strutture ospedaliere, aumento delle camere singole destinate all’isolamento di pazienti particolarmente a rischio, • miglioramento delle procedure di pulizia e sanificazione e dei percorsi dedicati all’igiene delle mani, • promozione di campagne di sensibilizzazione rivolte non solo al personale sanitario, ma anche ai cittadini, allo scopo di rendere i pazienti parte attiva del processo di lotta alle infezioni.

Published
2021

11. SIRM-SIAAIC consensus, an Italian document on management of patients at risk of hypersensitivity reactions to contrast media

Author

Laura Romanini, Francesco Gaeta, Matteo Passamonti, Stefano Pucci, Giovanni Cerri, Antonino Romano, Cristoforo Incorvaia, Marina Mauro, Fulvio Stacul, Mona-Rita Yacoub, Eustacchio Nettis, Rocco Luigi Valluzzi, Eleonora Savi, Michele Galluzzo, Sergio Testi, Paolo Ricci, Oliviero Rossi, Elisabetta Di Leo, Emanuele Grassedonio, Patrizia Bonadonna, Paolo Montuschi, Erminia Ridolo, Maria Teresa Costantino, Alfonso Reginelli, Costantino, M. T., Romanini, L., Gaeta, F., Stacul, F., Valluzzi, R. L., Passamonti, M., Bonadonna, P., Cerri, G., Pucci, S., Ricci, P., Savi, E., Galluzzo, M., Mauro, M., Grassedonio, E., Yacoub, M. R., Reginelli, A., Testi, S., Ridolo, E., Nettis, E., Di Leo, E., Rossi, O., Montuschi, P., Incorvaia, C., Romano, A., Costantino M.T., Romanini L., Gaeta F., Stacul F., Valluzzi R.L., Passamonti M., Bonadonna P., Cerri G., Pucci S., Ricci P., Savi E., Galluzzo M., Mauro M., Grassedonio E., Yacoub M.R., Reginelli A., Testi S., Ridolo E., Nettis E., Di Leo E., Rossi O., Montuschi P., Incorvaia C., and Romano A.

Subjects
lcsh:Immunologic diseases. Allergy, radiologic contrast media, hypersensitivity reactions, low-osmolar contrast agents, diagnosis, management, medicine.medical_specialty, Allergy, Hypersensitivity reactions, Referral, Immunology, Review, Culprit, Radiologic contrast media, 03 medical and health sciences, 0302 clinical medicine, Diagnosis, Hypersensitivity reaction, medicine, Immunology and Allergy, Medical history, In patient, Low-osmolar contrast agents, Intensive care medicine, Molecular Biology, business.industry, Low-osmolar contrast agent, medicine.disease, Management, 030228 respiratory system, Radiological weapon, Premedication, business, lcsh:RC581-607, Anaphylaxis, Diagnosi, 030215 immunology
Abstract

Hypersensitivity reactions (HRs) to contrast media (CM) can be distinguished in immune-mediated (including allergic reactions) and non-immune-mediated reactions, even if clinical manifestations could be similar. Such manifestations range from mild skin eruptions to severe anaphylaxis, making it important for radiologists to know how to identify and manage them. A panel of experts from the Società Italiana di Radiologia Medica e Interventistica (SIRM) and the Società Italiana di Allergologia, Asma e Immunologia Clinica (SIAAIC) provided a consensus document on the management of patients who must undergo radiological investigations with CM. Consensus topics included: the risk stratification of patients, the identification of the culprit CM and of a safe alternative by an allergy workup, as well as the use of premedication and the correct procedure to safely perform an elective (i.e., scheduled) or urgent examination. The most important recommendations are: (1) in all patients, a thorough medical history must be taken by the prescribing physician and/or the radiologist to identify at-risk patients; (2) in patients with hypersensitivity reactions to CM, the radiologist must consider an alternative, non-contrast imaging study with a comparable diagnostic value, or prescribe a different investigation with another class of CM; (3) if such options are not feasible, the radiologist must address at-risk patients to a reference centre for an allergy evaluation; (4) if timely referral to an allergist is not viable, it is recommended to use a CM other than the responsible one, taking into account cross-reactivity patterns; in the case of patients with histories of severe reactions, the presence of an anesthesiologist is also recommended and a premedication is suggested.

Published
2020

12. Sulphate mineral waters: A medical resource in several disorders

Author

Maria Teresa Costantino, Amelia Filippelli, Valentina Manzo, Viviana Izzo, Antonella Guida, and Valeria Conti

Subjects
Chronic disorders, Mineral, Spa therapy, lcsh:R, 0211 other engineering and technologies, lcsh:Medicine, Complementary therapy, Spa medicine, Sulphate anion, Complementary and Alternative Medicine2708 Dermatology, Review Article, 02 engineering and technology, 01 natural sciences, 0104 chemical sciences, 010404 medicinal & biomolecular chemistry, Clinical therapy, Complementary and alternative medicine, Environmental chemistry, 021105 building & construction, Environmental science
Abstract

Based on their chemical composition, salus per aquam (spa) mineral waters (or medical mineral waters) can be classified as sulphurous, sulphate, bicarbonate etc. Sulphate mineral waters where the predominant element is sulphate anion SO42−, are frequently used in clinical therapy. In this review, we describe and analyze the current scientific knowledge concerning the therapeutic effect of sulphate mineral waters in the treatment of several disorders. Moreover, we underline how important is to integrate spa treatments with other therapeutic approaches to meet the various needs that can arise during a specific pathological state., Graphical abstract Image 1, Highlights • Now, there is no systematic Review on Sulphate mineral waters in literature. • The Review focuses on the importance of spa treatment as complementary therapy. • The Review highlights the efficacy and tolerability of the spa in several disorders.

Published
2020

13. Mild/Moderate Asthma Network in Italy (MANI): a long-term observational study

Author

Fulvio, Braido, Francesco, Blasi, Giorgio Walter Canonica, Pierluigi, Paggiaro, Bianca, Beghè, Matteo, Bonini, Giovanna Elisiana Carpagnano, Stefano Del Giacco, Federico, Lavorini, Manlio, Milanese, Vincenzo, Patella, Pierachille, Santus, Marco, Contoli, Mani, Network, Chiara, Allegrini, Ilaria, Baiardini, Laura, Bonzano, Maria Filomena Caiaffa, Paolo, Castelnuovo, Angelo Guido Corsico, Lorenzo, Cosmi, Maria Teresa Costantino, Marcello, Cottini, Nunzio, Crimi, Maria Angiola Crivellaro, Simona, D'Alò, Ilenia, Folletti, Dario, Fornari, Maria Pia Foschino-Barbaro, Laura, Franceschini, Domenico, Gargano, Kim Lokar Oliani, Mauro, Maniscalco, Laura, Melissari, Marcello, Montagni, Paolo, Montuschi, Nicola, Murgia, Alessandro, Pannofino, Alberto, Papi, Roberta, Parente, Girolamo, Pelaia, Pini, Laura, Francesca, Puggioni, Nolita, Pulerà, Onofrio, Resta, Luisa, Ricciardi, Erminia, Ridolo, Eleonora, Savi, Francesca, Savoia, Guglielmo, Scala, Gianenrico, Senna, Salvatore, Tripodi, Alessandro, Vatrella, Maria Teresa Ventura, Vittorio Maria Viviano, and Mona-Rita, Yacoub

Subjects
Pulmonary and Respiratory Medicine, Pediatrics, medicine.medical_specialty, Moderate asthma, registry, immune system diseases, Cross-sectional, Administration, Inhalation, medicine, Immunology and Allergy, Humans, Anti-Asthmatic Agents, Prospective Studies, Prospective cohort study, patient-reported outcomes, prospective cohort study, health care economics and organizations, Asthma, business.industry, medicine.disease, respiratory tract diseases, Term (time), Cross-Sectional Studies, Pediatrics, Perinatology and Child Health, Disease Progression, Quality of Life, Observational study, business
Abstract

The prevalence of asthma in Italy is estimated to be around 4%; it affects approximately 2,000,000 citizens, and up to 80-90% of patients have mild-to-moderate asthma. Despite the clinical relevance of mild-to-moderate asthma, longitudinal observational data are very limited, including data on disease progression (worsening vs. improvement), the response to treatment, and prognosis. Studies are needed to develop long-term, observational, real-life research in large cohorts. The primary outcomes of this study will be based on prospective observation and the epidemiological evolution of mild and moderate asthma. Secondary outcomes will include patient-reported outcomes, treatments over time, disease-related functional and inflammatory patterns, and environmental and life-style influences.This study, called the Mild/Moderate Asthma Network of Italy (MANI), is a research initiative launched by the Italian Respiratory Society and the Italian Society of Allergology, Asthma and Clinical Immunology. MANI is a cluster-based, real world, cross-sectional, prospective, observational cohort study that includes 20,000 patients with mild-to-moderate asthma. (ClinicalTrials.gov Identifier: NCT04796844).Despite advances in asthma care, several research gaps remain to be addressed through clinical research. This study will add important new knowledge about long-term disease history, the transferability of clinical research results to daily practice, the efficacy of currently recommended strategies, and their impact on the burden and evolution of the disease.MANI:Mild/Moderate Asthma Network of ItalySANI:Severe Asthma Network ItalyGINA:Global Initiative for AsthmaSABA:short acting β2-agonistsICS:inhaled corticosteroidsCRF:Case Report Form.

Published
2021

14. Defining a Severe Asthma Super-Responder: Findings from a Delphi Process

Author

Liang-Wen Hang, Karrinda Kenny, Louis-Philippe Boulet, Jane Duke, Désirée Larenas-Linnemann, Claude S. Farah, Mónica De Gennaro, Peter A. B. Wark, Hubertus Jersmann, Maria Teresa Costantino, Dermot Ryan, Mark Hew, Vanessa M. McDonald, Mohammad Hashim Khan, Pin-Kuei Fu, Mitesh Patel, Majdy Idrees, David A. Jackson, Violina Vasileva, Constance H. Katelaris, Matthew Masoli, Nunzio Crimi, Celeste Porsbjerg, Janet Rimmer, Veronica Lawriwskyj, Ying-Chun Chien, Norma Linaker, Sally E. Wenzel, Alan Altraja, Ricardo Campos, Carlos Torres-Duque, Manlio Milanese, Enrico Heffler, Eleftherios Zervas, Andréanne Côté, Guy Brusselle, Alan James, Luis Perez-de-Llano, Jorge Maspero, David Langton, Francesca Puggioni, Mona Al-Ahmad, Riyard Al-Lehebi, Adel H. Mansur, Tom Brown, José Luis Miguel, Chris Corrigan, Arnaud Bourdin, James Fingleton, Brian J. Lipworth, Shrikant Pawar, Paula Kauppi, Philip G. Bardin, Alexandra Nanzer-Kelly, Carlos Andrés Celis-Preciado, Santus Pierachille, David Price, George Christoff, Pauline Hughes, Hitashi Rupani, João Fonseca, Nikolaos G. Papadopoulos, Naghmeh Radhakrishna, Lauri Lehtimäki, Rekha Chaudhuri, Anne-Maree Cheffins, Tara Mackenzie, Christian Taube, Kenneth R. Chapman, Charlotte Suppli Ulrik, Giorgio Walter Canonica, Mariko Koh Siyue, Maria Elisabetta Conte, Giovanna Elisiana Carpagnano, Chantal E. Le Lievre, Mohsen Sadatsafavi, Unnur S. Bjornsdottir, Praveen Akuthota, Mark FitzGerald, Andrew Menzies-Gow, Jaideep Dhariwal, Stelios Loukides, Michael E. Wechsler, Paul E Pfeffer, Matthew J. Peters, Giuseppe Guida, Zinta Harrington, Konstantinos Kostikas, Ian Clifton, Tze Lee Tan, Andriana I. Papaioannou, Li Ping Chung, John W. Upham, Parameswaran Nair, John Harrington, Aikaterini Detoraki, Liam G Heaney, Roberta Parente, Paul M. O'Byrne, Jo A Douglass, Kanok Pipatvech, Ming-Ju Tsai, Caterina Bucca, Vibeke Backer, Peter Middleton, Patrick Mitchell, Paddy Dennison, Luisa Ricciardi, Njira L Lugogo, Job F M van Boven, Flavia C.L. Hoyte, Stephen J. Fowler, Gregory Katsoulotos, Bassam Mahboub, Rovira Francisco, Nicola A. Hanania, John Corless, Mona-Rita Yacoub, Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), and Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)

Subjects
medicine.medical_specialty, Exacerbation, [SDV]Life Sciences [q-bio], Delphi method, Biologics, law.invention, 03 medical and health sciences, 0302 clinical medicine, Quality of life, Randomized controlled trial, law, medicine, Immunology and Allergy, Asthma, Asthma treatment, Consensus, Delphi Technique, Humans, Surveys and Questionnaires, Quality of Life, 030212 general & internal medicine, Intensive care medicine, ComputingMilieux_MISCELLANEOUS, business.industry, Minimal clinically important difference, medicine.disease, 3. Good health, 030228 respiratory system, Asthma Control Questionnaire, Allergists, business
Abstract

Background Clinicians are increasingly recognizing severe asthma patients in whom biologics and other add-on therapies lead to dramatic improvement. Currently, there is no agreed-upon super-responder (SR) definition. Objective To survey severe asthma experts using a modified Delphi process, to develop an international consensus-based definition of a severe asthma SR. Methods The Delphi panel was composed of 81 participants (94% specialist pulmonologists or allergists) from 24 countries and consisted of three iterative online voting rounds. Consensus on individual items, whether acceptance or rejection, required at least 70% agreement by panel members. Results Consensus was achieved that the SR definition should be based on improvement across three or more domains assessed over 12 months. Major SR criteria included exacerbation elimination, a large improvement in asthma control (two or more times the minimal clinically important difference), and cessation of maintenance of oral steroids (or weaning to adrenal insufficiency). Minor SR criteria were composed of a 75% exacerbation reduction, having well-controlled asthma, and 500 mL or greater improvement in FEV1. The SR definition requires improvement in at least two major criteria. In the future, the SR definition should be expanded to incorporate quality of life measures, although current tools can be difficult to implement in a clinical setting and further research is needed. Conclusions This international consensus-based definition of severe asthma SRs is an important prerequisite for better understanding SR prevalence, predictive factors, and the mechanisms involved. Further research is needed to understand the patient's perspective and to measure quality of life more precisely in SRs.

Published
2021

15. Hymenoptera Venom Allergy: Management of Children and Adults in Clinical Practice

Author

Vincenzo Patella, Elide A. Pastorello, G Cortellini, A. Romano, Eleonora Savi, Marcello Cilia, F Murzilli, F. Lodi Rizzini, M. Severino, V. Pravettoni, F Marengo, L Cremonte, Marina Mauro, P. Bonadonna, Domenico Schiavino, Maria Teresa Costantino, Elio Novembre, O Quercia, D. Bignardi, Luigi Macchia, Luisa Ricciardi, F. Reccardini, Erminia Ridolo, and M. B. Bilò

Subjects
Adult, medicine.medical_specialty, medicine.medical_treatment, Immunology, Disease, 03 medical and health sciences, 0302 clinical medicine, Quality of life (healthcare), Epidemiology, Hypersensitivity, medicine, Animals, Humans, Immunology and Allergy, 030212 general & internal medicine, Medical prescription, Child, Intensive care medicine, Anaphylaxis, Arthropod Venoms, business.industry, Adults, Children, Diagnosis, Efficacy, Hymenoptera, Immunotherapy, Management, Safety, Insect Bites and Stings, Hymenoptera venom allergy, Specific immunotherapy, Allergens, Immunoglobulin E, Adults. Children. Diagnosis. Efficacy. Hymenoptera. Immunotherapy. Management. Safety, Clinical Practice, Italy, 030228 respiratory system, Desensitization, Immunologic, Practice Guidelines as Topic, Quality of Life, business
Abstract

Hymenoptera venom allergy is an epidemiologically underestimated condition and a major cause of morbidity worldwide. Preventing future allergic reactions in patients who experience a systemic reaction is based on the correct management of the emergency followed by an accurate diagnosis, prescription of adrenaline autoinjectors, and, where indicated, specific venom immunotherapy. Some epidemiological studies highlight our poor knowledge of this disease and the frequent inadequacy of its management. Moreover, they emphasize the importance of such a life-saving treatment as specific immunotherapy. The availability of high-quality hymenoptera venom extracts for diagnostic and therapeutic use has dramatically improved the prognosis and quality of life of allergic patients. Subcutaneous venom immunotherapy is currently the most effective form of allergen-based immunotherapy, with a carry-over effect lasting up to several years after its interruption. This report on the management of hymenoptera venom-allergic children and adults was prepared by a panel of Italian experts. The main objective of this consensus document is to review the scientific evidence related to diagnosis, therapy, and management of patients allergic to hymenoptera venom. Thus, we can improve our knowledge of the disease and promote good clinical practices. The present document provides practical suggestions for correct diagnosis, prescription of emergency therapy and immunotherapy, and strategies for patient care.

Published
2019

16. Role of Skin Tests in the Diagnosis of Immediate Hypersensitivity Reactions to Taxanes: Results of a Multicenter Study

Author

Mauro Pagani, Maria Teresa Costantino, Sevim Bavbek, Mariana Castells, Josefina Cernadas, Giuseppe Lucchini, Patrizia Bonadonna, Adile Berna Dursun, G Cortellini, Aslı Gelincik, and Maria Caralli

Subjects
Adult, Male, medicine.medical_specialty, Paclitaxel, medicine.medical_treatment, Drug allergy, Antineoplastic Agents, Docetaxel, Culprit, Drug Hypersensitivity, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Neoplasms, Humans, Immunology and Allergy, Medicine, 030212 general & internal medicine, Prospective cohort study, Aged, Skin Tests, Desensitization (medicine), Chemotherapy, business.industry, Middle Aged, medicine.disease, Dermatology, Hypersensitivity reaction, 030228 respiratory system, chemistry, Female, business, medicine.drug
Abstract

Background Immediate hypersensitivity reactions (HSRs) to taxanes have been increasing in recent years, but the importance of skin tests in allergological workup has not been established. Objective In our study we tried to evaluate the role of prick and intradermal tests in the diagnosis of HSRs to paclitaxel and docetaxel. Methods In this multicenter prospective study, we enrolled patients with immediate HSRs to the aforesaid agents. Skin tests were performed on these subjects and if results were negative, intradermal tests with the culprit drug were conducted. Patients with grade 1 reactions subsequently underwent graded challenge; in cases of grade 2 or 3 reactions and/or positive test results, the culprit drug was administered with a desensitization schedule. Skin tests were also performed in 30 control subjects exposed to the taxanes without HSRs. Results A total of 84 patients (63 with HSRs to paclitaxel and 21 to docetaxel) were recruited in the period July 2015 to July 2017 by 8 centers; 58 patients (69%) developed grade 2 or 3 reactions. Prick test results were negative in all the cases, whereas intradermal test results were positive in 14 patients (10 with paclitaxel [15.9%] and 4 with docetaxel [19%]). The positivity of skin tests significantly correlated with grade 3 reactions and cutaneous involvement during HSRs. Graded challenge was performed in 16 patients without problems and 58 subjects underwent desensitization, which was well tolerated in all but 2 cases. In the control group, skin test results were negative in all the patients. Conclusions Skin tests for taxanes seem useful and can be performed in the allergological workup of subjects with HSRs to these agents, especially in cases of severe reactions with cutaneous involvement.

Published
2019

17. The burden of mild asthma: Clinical burden and healthcare resource utilisation in the NOVELTY study

Author

Sarowar Muhammad Golam, Christer Janson, Richard Beasley, J Mark FitzGerald, Tim Harrison, Bradley Chipps, Rod Hughes, Hana Müllerová, José María Olaguibel, Eleni Rapsomaniki, Helen K. Reddel, Mohsen Sadatsafavi, Gabriel Benhabib, Piushkumar Mandhane, Xavier Bocca Ruiz, Andrew McIvor, Ricardo del Olmo, Bonavuth Pek, Raul Eduardo Lisanti, Robert Petrella, Gustavo Marino, Daniel Stollery, Walter Mattarucco, Meihua Chen, Juan Nogueira, Yan Chen, Maria Parody, Wei Gu, Pablo Pascale, Kim Ming Christopher Hui, Pablo Rodriguez, Manxiang Li, Damian Silva, Shiyue Li, Graciela Svetliza, Lijun Ma, Carlos F. Victorio, Guangyue Qin, Roxana Willigs Rolon, Weidong Song, Anahi Yañez, Wei Tan, Stuart Baines, Yijun Tang, Simon Bowler, Chen Wang, Peter Bremner, Tan Wang, Sheetal Bull, Fuqiang Wen, Patrick Carroll, Feng Wu, Mariam Chaalan, PingChao Xiang, Claude Farah, Zuke Xiao, Gary Hammerschlag, Shengdao Xiong, Kerry Hancock, Jinghua Yang, Zinta Harrington, Jingping Yang, Gregory Katsoulotos, Caiqing Zhang, Joshua Kim, Min Zhang, David Langton, Ping Zhang, Donald Lee, Wei Zhang, Matthew Peters, Xiaohe Zheng, Lakshman Prassad, Dan Zhu, Helen Reddel, Fabio Bolivar Grimaldos, Dimitar Sajkov, Alejandra Cañas Arboleda, Francis Santiago, Carlos Matiz Bueno, Frederick Graham Simpson, Dora Molina de Salazar, Sze Tai, Elisabeth Bendstrup, Paul Thomas, Ole Hilberg, Peter Wark, Carsten Kjellerup, José Eduardo Delfini Cançado, Ulla Weinreich, Thúlio Cunha, Philippe Bonniaud, Marina Lima, Olivier Brun, Alexandre Pinto Cardoso, Pierre-Régis Burgel, Marcelo Rabahi, Christos Chouaid, Syed Anees, Francis Couturaud, John Bertley, Jacques de Blic, Alan Bell, Didier Debieuvre, Amarjit Cheema, Dominique Delsart, Guy Chouinard, Axelle Demaegdt, Michael Csanadi, Pascal Demoly, Anil Dhar, Antoine Deschildre, Ripple Dhillon, Gilles Devouassoux, J. Mark FitzGerald, Carole Egron, David Kanawaty, Lionel Falchero, Allan Kelly, François Goupil, William Killorn, Romain Kessler, Daniel Landry, Pascal Le Roux, Robert Luton, Pascal Mabire, Guillaume Mahay, Yumiko Ide, Stéphanie Martinez, Minehiko Inomata, Boris Melloni, Hiromasa Inoue, Laurent Moreau, Koji Inoue, Chantal Raherison, Sumito Inoue, Emilie Riviere, Motokazu Kato, Pauline Roux-Claudé, Masayuki Kawasaki, Michel Soulier, Tomotaka Kawayama, Guillaume Vignal, Toshiyuki Kita, Azzedine Yaici, Kanako Kobayashi, Sven Philip Aries, Hiroshi Koto, Robert Bals, Koichi Nishi, Ekkehard Beck, Junpei Saito, Andreas Deimling, Yasuo Shimizu, Jan Feimer, Toshihiro Shirai, Vera Grimm-Sachs, Naruhiko Sugihara, Gesine Groth, Ken-ichi Takahashi, Felix Herth, Hiroyuki Tashimo, Gerhard Hoheisel, Keisuke Tomii, Frank Kanniess, Takashi Yamada, Thomas Lienert, Masaru Yanai, Silke Mronga, Ruth Cerino Javier, Jörg Reinhardt, Alfredo Domínguez Peregrina, Christian Schlenska, Marco Fernández Corzo, Christoph Stolpe, Efraín Montano Gonzalez, Ishak Teber, Alejandra Ramírez-Venegas, Hartmut Timmermann, Adrian Rendon, Thomas Ulrich, Willem Boersma, Peter Velling, R.S. Djamin, Sabina Wehgartner-Winkler, Michiel Eijsvogel, Juergen Welling, Frits Franssen, Ernst-Joachim Winkelmann, Martijn Goosens, Carlo Barbetta, Lidwien Graat-Verboom, Fulvio Braido, Johannes in 't Veen, Vittorio Cardaci, Rob Janssen, Enrico Maria Clini, Kim Kuppens, Maria Teresa Costantino, Maarten van den Berge, Giuseppina Cuttitta, Mario van de Ven, Mario di Gioacchino, Ole Petter Brunstad, Alessandro Fois, Gunnar Einvik, Maria Pia Foschino-Barbaro, Kristian Jong Høines, Enrico Gammeri, Alamdar Khusrawi, Riccardo Inchingolo, Torbjorn Oien, Federico Lavorini, Yoon-Seok Chang, Antonio Molino, Young Joo Cho, Eleonora Nucera, Yong Il Hwang, Alberto Papi, Woo Jin Kim, Vincenzo Patella, Young-Il Koh, Alberto Pesci, Byung-Jae Lee, Fabio Ricciardolo, Kwan-Ho Lee, Paola Rogliani, Sang-Pyo Lee, Riccardo Sarzani, Yong Chul Lee, Carlo Vancheri, Seong Yong Lim, Rigoletta Vincenti, Kyung Hun Min, Takeo Endo, Yeon-Mok Oh, Masaki Fujita, Choon-Sik Park, Yu Hara, Hae-Sim Park, Takahiko Horiguchi, Heung-Woo Park, Keita Hosoi, Chin Kook Rhee, Ho Joo Yoon, Alyn Morice, Hyoung-Kyu Yoon, Preeti Pandya, Alvar Agusti García-Navarro, Manish Patel, Rubén Andújar, Kay Roy, Laura Anoro, Ramamurthy Sathyamurthy, María Buendía García, Swaminathan Thiagarajan, Paloma Campo Mozo, Alice Turner, Sergio Campos, Jorgen Vestbo, Francisco Casas Maldonado, Wisia Wedzicha, Manuel Castilla Martínez, Tom Wilkinson, Carolina Cisneros Serrano, Pete Wilson, Lorena Comeche Casanova, Lo’Ay Al-Asadi, Dolores Corbacho, James Anholm, Felix Del Campo Matías, Frank Averill, Jose Echave-Sustaeta, Sandeep Bansal, Gloria Francisco Corral, Alan Baptist, Pedro Gamboa Setién, Colin Campbell, Marta García Clemente, Michael A. Campos, Ignacio García Núñez, Jose García Robaina, Gretchen Crook, Mercedes García Salmones, Samuel DeLeon, Jose Maria Marín Trigo, Alain Eid, Marta Nuñez Fernandez, Ellen Epstein, Sara Nuñez Palomo, Stephen Fritz, José Olaguibel Rivera, Hoadley Harris, Luis Pérez de Llano, Mitzie Hewitt, Ana Pueyo Bastida, Fernando Holguin, Ana Rañó, Golda Hudes, José Rodríguez González-Moro, Richard Jackson, Albert Roger Reig, Alan Kaufman, José Velasco Garrido, David Kaufman, Dan Curiac, Ari Klapholz, Harshavardhan Krishna, Cornelia Lif-Tiberg, Daria Lee, Anders Luts, Robert Lin, Lennart Råhlen, Diego Maselli-Caceres, Stefan Rustscheff, Vinay Mehta, Frances Adams, James N. Moy, Drew Bradman, Ugo Nwokoro, Emma Broughton, Purvi Parikh, John Cosgrove, Sudhir Parikh, Patrick Flood-Page, Frank Perrino, Elizabeth Fuller, James Ruhlmann, Timothy Harrison, Catherine Sassoon, David Hartley, Russell A. Settipane, Keith Hattotuwa, Daniel Sousa, Gareth Jones, Peruvemba Sriram, Keir Lewis, Richard Wachs, Lorcan McGarvey, BioPharmaceuticals R&D [Gothenburg], AstraZeneca, Uppsala University, Malaghan Institute of Medical Research [Wellington, New Zealand], Vancouver Coastal Health Research Institute (VCH), AstraZeneca [Cambridge, UK], Complejo Hospitalario de Navarra, Woolcock Institute of Medical Research [Sydney], The University of Sydney, University of British Columbia (UBC), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Médecine de précision par intégration de données et inférence causale (PREMEDICAL), Inria Sophia Antipolis - Méditerranée (CRISAM), Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-Institut Desbrest de santé publique (IDESP), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)

Subjects
Pulmonary and Respiratory Medicine, MESH: Humans, MESH: Asthma, Patient-reported measures, Respiratory Medicine and Allergy, Longitudinal studies, MESH: Patient Acceptance of Health Care, Disease burden, Healthcare resource utilisation, Mild asthma, Patient Acceptance of Health Care, Asthma, MESH: Prospective Studies, MESH: Adrenal Cortex Hormones, Adrenal Cortex Hormones, Disease Progression, Humans, Longitudinal Studies, Prospective Studies, MESH: Disease Progression, MESH: Longitudinal Studies, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Lungmedicin och allergi
Abstract

Background: Patients with mild asthma represent a substantial proportion of the population with asthma, yet there are limited data on their true burden of disease. We aimed to describe the clinical and healthcare resource utilisation (HCRU) burden of physician-assessed mild asthma. Methods: Patients with mild asthma were included from the NOVEL observational longiTudinal studY (NOVELTY; NCT02760329), a global, 3-year, real-world prospective study of patients with asthma and/or chronic obstructive pulmonary disease from community practice (specialised and primary care). Diagnosis and severity were based on physician discretion. Clinical burden included physician-reported exacerbations and patient-reported measures. HCRU included inpatient and outpatient visits. Results: Overall, 2004 patients with mild asthma were included; 22.8% experienced >= 1 exacerbation in the previous 12 months, of whom 72.3% experienced >= 1 severe exacerbation. Of 625 exacerbations reported, 48.0% lasted >1 week, 27.7% were preceded by symptomatic worsening lasting >3 days, and 50.1% required oral corticosteroid treatment. Health status was moderately impacted (St George's Respiratory Questionnaire score: 23.5 [standard deviation +/- 17.9]). At baseline, 29.7% of patients had asthma symptoms that were not well controlled or very poorly controlled (Asthma Control Test score = 2 exacerbations in the previous year. In terms of HCRU, at least one unscheduled ambulatory visit for exacerbations was required by 9.5% of patients, including 9.2% requiring >= 1 emergency department visit and 1.1% requiring >= 1 hospital admission. Conclusions: In this global sample representing community practice, a significant proportion of patients with physician-assessed mild asthma had considerable clinical burden and HCRU.

Published
2022

18. Hydropinotherapy with sulphurous mineral water as complementary treatment to improve glucose metabolism, oxidative status, and quality of life

Author

Maria Teresa Costantino, Valeria Conti, Graziamaria Corbi, Amelia Filippelli, Costantino, M, Conti, V, Corbi, G, and Filippelli, A.

Subjects
Quality of life, medicine.medical_specialty, Physiology, Clinical Biochemistry, RM1-950, Oxidative phosphorylation, Carbohydrate metabolism, Hydrogen sulphide, medicine.disease_cause, Biochemistry, Gastroenterology, Article, Internal medicine, medicine, In patient, Molecular Biology, ROM, business.industry, Sulphurous mineral water, ROMs, glycaemia, oxidative stress, quality of life, sulphurous mineral water, Cell Biology, Chronic disorders, Oxidative stress, Oxidative stre, Observational study, Glycaemia, Therapeutics. Pharmacology, business
Abstract

Hydropinotherapy is a salus per aquam (Spa) treatment suitable as a complementary approach to treat several diseases, which strongly affect the quality of life (QoL). Hydropinotherapy with sulphurous mineral water exerts benefits thanks to components, such as hydrogen sulphide, which is considered mainly responsible for antioxidant and hypoglycaemic effects. Such properties, linked from each other, could favour an improvement in patients’ QoL. However, data on humans are scarce. This study aimed to investigate whether a cycle of sulphurous hydropinotherapy was able to modify plasma levels of glucose and reactive oxygen metabolites (ROMs) and improve QoL in patients suffering from several chronic disorders. A prospective, observational study involved patients with gastrointestinal diseases who received a prescription of a cycle of sulphurous hydropinotherapy (S-HT). Age- and sex-matched control group was enrolled (No S-HT). Glycaemia and plasma concentration of ROMs were measured in all subjects. The impact of spa treatment on the QoL was assessed using the Short Form 36 Health Status Survey questionnaire (SF-36). All parameters were measured at baseline and at the end of a 2-week treatment. Between the groups, no differences were found in glycaemia and ROMs at baseline. In the S-HT group, a reduction in glycaemia and ROMs, both in respect to baseline (p = 0.005 and p = 0.031, respectively) and to control group, as shown by the delta value calculated, as the difference between the values at 2 weeks and baseline (p = 0.0009 and p = 0.0001, respectively). In the S-HT, delta ROMs was the best predictor of delta glycaemia with a direct linear correlation (beta = 0.559, 95% CI 0.471 to 0.647, p &lt, 0.0001). In the S-HT, the SF-36 total score was improved both when compared with baseline (p = 0.002) and with No S-HT (p = 0.001). Sulphurous hydropinotherapy induces a decrease in glycaemia and ROM levels, also ameliorating the patients’ QoL. Therefore, it could be considered a useful complementary therapeutic approach.

Published
2021

19. Severe asthma: One disease and multiple definitions

Author

Maria Teresa Costantino, Luigi Macchia, Angelo Corsico, Andrea Airoldi, Carla Galeone, Zappa Maria Cristina, Paolo Tarsia, Foschino Barbaro Maria Pia, Silvia Ruggeri, Pierluigi Paggiaro, Lorenzo Cosmi, A. Farsi, Vitina Maria Anna Carriero, Arianna Bassi, Francesca Bertolini, Giovanni Passalacqua, Fulvia Chieco Bianchi, Carlo Lombardi, Salvatore Lo Cicero, Giovanni Rolla, Carmen Durante, Rocco Rinaldo, Elena Parazzini, Arianna Aruanno, Maria Rita Marchi, Chiara Folli, Alessandra Arcolaci, Carlo Pasculli, Fabio Luigi Massimo Ricciardolo, Vittorio Viviano, Alvise Berti, Stefano Del Giacco, Andrea Manfredi, Roberta Barlassina, Agata Valentina Frazzetto, Pierachille Santus, Luisa Brussino, Anna del Colle, Marco Bonavia, Dina Visca, Nicola Scichilone, Patrizia Pignatti, Enrico Heffler, Francesca Racca, Giuseppe Santini, Nucera Eleonora, Giovanna Elisiana Carpagnano, Linda Di Pietro, Stefano Centanni, Maria Elisabetta Conte, Vincenzo Patella, Monna Rita Yacoub, Diego Bagnasco, Nunzio Crimi, Anna Maria Riccio, Stefania Isola, Margherita Deidda, Gabriella Guarnieri, Giuseppe Guida, Elena Minenna, Manuela Latorre, Gianna Camiciottoli, Maria Vittoria Verrillo, Luca Richeldi, Marcello Montagni, Francesca Cicero, Maria Filomena Caiaffa, Antonio Spanevello, Cecilia Calabrese, Carlo Barbetta, Elisabetta Favero, Gianenrico Senna, Giuliana Amato, Amelia Grosso, Federica Vita, Francesco Blasi, Luisa Ricciardi, Carola Condoluci, Massimo Triggiani, Enrico Maggi, Mariacarmela Di Proietto, Giulia Carli, Roberta Parente, Eleonora Savi, Chiara Roncallo, Paolo Montuschi, Luciana D'Elia, Francesco Mazza, Simona D’Alo, Patrizia Ruggiero, Francesca Puggioni, Matteo Bonini, Simone Luraschi, Francesco Menzella, Leonello Fuso, Marco Caminati, Martina Flora, Mariachiara Braschi, Cristiano Caruso, Angela Rizzi, Sandra Iannacone, Rikki Frank Canevari, Andrea Vianello, D’Amato Maria, Manlio Milanese, Stefania Colantuono, Giorgio Walter Canonica, Giulia Scioscia, Laura Pini, Elisa Testino, Erminia Ridolo, Joyce Rolo, Elisa Turchet, Pelaia Gerolamo, Danilo Di Bona, Laura De Ferrari, Francesca Cherubino, Alice D’Adda, Marianna Lilli, Giuseppe Spadaro, Stefano Pucci, Caterina Detoraki, Chiara Allegrini, Bagnasco, D., Paggiaro, P., Latorre, M., Folli, C., Testino, E., Bassi, A., Milanese, M., Heffler, E., Manfredi, A., Riccio, A. M., De Ferrari, L., Blasi, F., Canevari, R. F., Canonica, G. W., Passalacqua, G., Guarnieri, G., Patella, V., Maria Pia, F. B., Carpagnano, G. E., Colle, A. D., Scioscia, G., Gerolamo, P., Puggioni, F., Racca, F., Favero, E., Iannacone, S., Savi, E., Montagni, M., Camiciottoli, G., Allegrini, C., Lombardi, C., Spadaro, G., Detoraki, C., Menzella, F., Galeone, C., Ruggiero, P., Yacoub, M. R., Berti, A., Scichilone, N., Durante, C., Costantino, M. T., Roncallo, C., Braschi, M., D'Adda, A., Ridolo, E., Triggiani, M., Parente, R., Maria, D. A., Verrillo, M. V., Rolla, G., Brussino, L., Frazzetto, A. V., Cristina, Z. M., Lilli, M., Crimi, N., Bonavia, M., Corsico, A. G., Grosso, A., Del Giacco, S., Deidda, M., Ricciardi, L., Isola, S., Cicero, F., Amato, G., Vita, F., Spanevello, A., Pignatti, P., Cherubino, F., Visca, D., Massimo Ricciardolo, F. L., Anna Carriero, V. M., Bertolini, F., Santus, P., Barlassina, R., Airoldi, A., Guida, G., Eleonora, N., Aruanno, A., Rizzi, A., Caruso, C., Colantuono, S., Senna, G., Caminati, M., Arcolaci, A., Vianello, A., Bianchi, F. C., Marchi, M. R., Centanni, S., Luraschi, S., Ruggeri, S., Rinaldo, R., Parazzini, E., Calabrese, C., Flora, M., Cosmi, L., Di Pietro, L., Maggi, E., Pini, L., Macchia, L., Di Bona, D., Richeldi, L., Condoluci, C., Fuso, L., Bonini, M., Farsi, A., Carli, G., Montuschi, P., Santini, G., Conte, M. E., Turchet, E., Barbetta, C., Mazza, F., D'Alo, S., Pucci, S., Caiaffa, M. F., Minenna, E., D'Elia, L., Pasculli, C., Viviano, V., Tarsia, P., Rolo, J., Di Proietto, M., Lo Cicero, S., Bagnasco D., Paggiaro P., Latorre M., Folli C., Testino E., Bassi A., Milanese M., Heffler E., Manfredi A., Riccio A.M., De Ferrari L., Blasi F., Canevari R.F., Canonica G.W., Passalacqua G., Guarnieri G., Patella V., Maria Pia F.B., Carpagnano G.E., Colle A.D., Scioscia G., Gerolamo P., Puggioni F., Racca F., Favero E., Iannacone S., Savi E., Montagni M., Camiciottoli G., Allegrini C., Lombardi C., Spadaro G., Detoraki C., Menzella F., Galeone C., Ruggiero P., Yacoub M.R., Berti A., Scichilone N., Durante C., Costantino M.T., Roncallo C., Braschi M., D'Adda A., Ridolo E., Triggiani M., Parente R., Maria D.A., Verrillo M.V., Rolla G., Brussino L., Frazzetto A.V., Cristina Z.M., Lilli M., Crimi N., Bonavia M., Corsico A.G., Grosso A., Del Giacco S., Deidda M., Ricciardi L., Isola S., Cicero F., Amato G., Vita F., Spanevello A., Pignatti P., Cherubino F., Visca D., Massimo Ricciardolo F.L., Anna Carriero V.M., Bertolini F., Santus P., Barlassina R., Airoldi A., Guida G., Eleonora N., Aruanno A., Rizzi A., Caruso C., Colantuono S., Senna G., Caminati M., Arcolaci A., Vianello A., Bianchi F.C., Marchi M.R., Centanni S., Luraschi S., Ruggeri S., Rinaldo R., Parazzini E., Calabrese C., Flora M., Cosmi L., Di Pietro L., Maggi E., Pini L., Macchia L., Di Bona D., Richeldi L., Condoluci C., Fuso L., Bonini M., Farsi A., Carli G., Montuschi P., Santini G., Conte M.E., Turchet E., Barbetta C., Mazza F., D'Alo S., Pucci S., Caiaffa M.F., Minenna E., D'Elia L., Pasculli C., Viviano V., Tarsia P., Rolo J., Di Proietto M., Lo Cicero S., Bagnasco, D, Paggiaro, P, Latorre, M, Folli, C, Testino, E, Bassi, A, Milanese, M, Heffler, E, Manfredi, A, Riccio, A, De Ferrari, L, Blasi, F, Frank Canevari, R, Canonica, G, Passalacqua, G, Guarnieri, G, Patella, V, Foschino Barbaro, M, Carpagnano, G, del Colle, A, Scioscia, G, Gerolamo, P, Puggioni, F, Racca, F, Favero, E, Iannacone, S, Savi, E, Montagni, M, Camiciottoli, G, Allegrini, C, Lombardi, C, Spadaro, G, Detoraki, C, Menzella, F, Galeone, C, Ruggiero, P, Yacoub, R, Verrillo, M, Rolla, G, and Lo Cicero, S

Subjects
Pulmonary and Respiratory Medicine, medicine.medical_specialty, Severe asthma, Immunology, Nice, Disease, Settore MED/10 - Malattie Dell'Apparato Respiratorio, Article, Pulmonary function testing, Internal medicine, Biological treatment, Classification, Definition, medicine, Immunology and Allergy, Respiratory function, computer.programming_language, Biological therapies, business.industry, Settore MED/09 - MEDICINA INTERNA, RC581-607, Severe asthma, Classification, Definition, Biological treatment, Biological treatment, Classification, Definition, Severe asthma, Immunologic diseases. Allergy, business, computer
Abstract

Introduction There is, so far, no universal definition of severe asthma. This definition usually relies on: number of exacerbations, inhaled therapy, need for oral corticosteroids, and respiratory function. The use of such parameters varies in the different definitions used. Thus, according to the parameters chosen, each patient may result in having severe asthma or not. The aim of this study was to evaluate how the choice of a specific definition of severe asthma can change the allocation of patients. Methods Data collected from the Severe Asthma Network Italy (SANI) registry were analyzed. All the patients included were then reclassified according to the definitions of U-BIOPRED, NICE, WHO, ATS/ERS, GINA, ENFUMOSA, and TENOR. Results 540 patients, were extracted from the SANI database. We observed that 462 (86%) met the ATS/ERS criteria as well as the GINA criteria, 259 (48%) the U-Biopred, 222 (41%) the NICE, 125 (23%) the WHO, 313 (58%) the Enfumosa, and 251 (46%) the TENOR criteria. The mean eosinophil value were similar in the ATS/ERS, U-Biopred, and Enfumosa (528, 532 and 516 cells/mcl), higher in WHO and Tenor (567 and 570 cells/mcl) and much higher in the NICE classification (624 cells/mcl). Lung function tests resulted similarly in all groups, with WHO (67%) and ATS/ERS-GINA (73%), respectively, showing the lower and upper mean FEV1 values. Conclusions The present observations clearly evidence the heterogeneity in the distribution of patients when different definitions of severe asthma are used. However, the recent definition of severe asthma, provided by the GINA document, is similar to that indicated in 2014 by ATS/ERS, allowing mirror reclassification of the patients examined. This lack of homogeneity could complicate the access to biological therapies. The definition provided by the GINA document, which reflects what suggested by ATS/ERS, could partially overcome the problem.

Published
2021

20. Biomarkers to Personalize the Treatment of Rheumatoid Arthritis: Focus on Autoantibodies and Pharmacogenetics

Author

Maria Teresa Costantino, Emanuela De Bellis, Francesca Colucci, Graziamaria Corbi, Valentina Manzo, Carmine Sellitto, Berenice Stefanelli, Valeria Conti, Amelia Filippelli, Conti, V, Corbi, G, Costantino, M, De Bellis, E, Manzo, V, Sellitto, C, Stefanelli, B, Colucci, F, and Filippelli, A.

Subjects
0301 basic medicine, medicine.medical_specialty, Treatment response, autoantibodies, lcsh:QR1-502, Review, Biochemistry, lcsh:Microbiology, methotrexate, Arthritis, Rheumatoid, 03 medical and health sciences, 0302 clinical medicine, medicine, disease-modifying antirheumatic drugs, Animals, Humans, Precision Medicine, Intensive care medicine, Molecular Biology, pharmacogenetics, 030203 arthritis & rheumatology, Animal, business.industry, autoimmune disorder, Pharmacogenetic, Antirheumatic Agent, Autoantibody, Biomarker, Disease-modifying antirheumatic drug, medicine.disease, Autoantibodie, Response Variability, 030104 developmental biology, Rheumatoid arthritis, Antirheumatic Agents, Methotrexate, Magic bullet, Antirheumatic drugs, business, Pharmacogenetics, Biomarkers, Human, medicine.drug
Abstract

Rheumatoid arthritis (RA) is a chronic inflammatory disease that is very complex and heterogeneous. If not adequately treated, RA patients are likely to manifest excess of morbidity and disability with an important impact on the quality of life. Pharmacological treatment is based on the administration of the disease-modifying antirheumatic drugs (DMARDs), subdivided into conventional synthetic (csDMARDs), targeted synthetic (tsDMARDs), and biological (bDMARDs). bDMARDs are now frequently administered in patients, both as alternative treatment and together with csDMARDs. Unfortunately, there is a therapeutic response variability both to old and new drugs. Therefore, to identify pre-therapeutic and on-treatment predictors of response is a priority. This review aims to summarize recent advances in understanding the causes of the variability in treatment response in RA, with particular attention to predictive potential of autoantibodies and DMARD pharmacogenetics. In recent years, several biomarkers have been proposed to personalize the therapy. Unfortunately, a magic bullet does not exist, as many factors concur to disease susceptibility and treatment outcomes, acting around the patient’s congenital background. Models integrating demographic, clinical, biochemical, and genetic data are needed to enhance the predictive capacity of specific factors singularly considered to optimize RA treatment in light of multidisciplinary patient management.

Published
2020

21. Defining a severe asthma super-responder: findings from a Delphi process

Author

Delphi panel: Adel Mansur, Aikaterini, Detoraki, Alan, Altraja, Alan, James, Alexandra, Nanzer-Kelly, Andréanne, Côté, Andrew, Menzies-Gow, Andriana, Papaioannou, Anne-Maree, Cheffins, Arnaud, Bourdin, Bassam, Mahboub, Brian, Lipworth, Carlos Andrés Celis-Preciado, Carlos, Torres-Duque, Caterina, Bucca, Celeste, Porsbjerg, Charlotte, Ulrik, Chris, Corrigan, Christian, Taube, Claude, Farah, Constance, Katelaris, David, Langton, Dermot, Ryan, Désirée, Larenas-Linnemann, Eleftherios, Zervas, Enrico, Heffler, Flavia, Hoyte, Francesca, Puggioni, George, Christoff, Giorgio Walter Canonica, Giovanna Elisiana Carpagnano, Giuseppe, Guida, Gregory, Katsoulotos, Guy, Brusselle, Hitashi, Rupani, Hubertus, Jersmann, Ian, Clifton, Jaideep, Dhariwal, James, Fingleton, Jane, Duke, Janet, Rimmer, Douglass, Jo, João, Fonseca, Job van Boven, John, Corless, John, Harrington, Jorge, Maspero, José Luis Miguel, Kanok, Pipatvech, Karrinda, Kenny, Kenneth, Chapman, Konstantinos, Kostikas, Lauri, Lehtimäki, Li Ping Chung, Liam, Heaney, Liang-Wen, Hang, Louis-Philippe, Boulet, Luis, Perez-de-Llano, Ricciardi, Luisa, Majdy, Idrees, Manlio, Milanese, Maria Elisabetta Conte, Maria Teresa Costantino, Mariko Koh Siyue, Mark, Fitzgerald, Mark, Hew, Matthew, Peters, Ming-Ju, Tsai, Mitesh, Patel, Mohammad Hashim Khan, Mohsen, Sadatsafavi, Mona, Al-Ahmad, Mona-Rita, Yacoub, Mónica De Gennaro, Naghmeh, Radhakrishna, Nicola Alexander Hanania, Nikolaos, Papadopoulos, Njira, Lugogo, Norma, Linaker, Nunzio, Crimi, Paddy, Dennison, Parameswaran, Nair, Patrick David Mitchell, Paul, O’Byrne, Paul, Pfeffer, Paula, Kauppi, Pauline, Hughes, Peter, Middleton, Peter, Wark, Philip, Bardin, Pin-Kuei, Fu, Praveen, Akuthota, Rekha, Chaudhuri, Ricardo, Campos, Riyard, Al-Lehebi, Roberta, Parente, Rovira, Francisco, Sally, Wenzel, Santus, Pierachille, Shrikant, Pawar, Stelios, Loukides, Stephen, Fowler, Tara, Mackenzie, Thomas, Brown, Tze Lee Tan, Unnur, Björnsdóttir, Vanessa, Mcdonald, Veronica, Lawriwskyj, Vibeke, Backer, Violina, Vasileva, Ying-Chun, Chien, and Zinta, Harrington.

Published
2020

22. Effects of a structured educational intervention in moderate-to-severe elderly asthmatic subjects

Author

Nicola Scichilone, Gabriella Guarnieri, Amelia Grosso, Ilaria Baiardini, Pietro Pirina, Antonio Molino, Federica Albicini, Vincenzo Patella, Fulvio Braido, Rita Raccanelli, Andrea Vianello, F. Di Marco, G. Steinhilber, Carolina Lombardi, Mariangiola Crivellaro, Erminia Ridolo, Alida Benfante, Erica Gini, Manlio Milanese, R. De Tullio, Mario Polverino, Maria Teresa Costantino, Angelo Corsico, Giovanni Rolla, Marcello Cottini, Silvia Terraneo, Marco Caminati, Milanese, M., Terraneo, S., Baiardini, I., Di Marco, F., Corsico, A., Molino, A., Scichilone, N., Albicini, F., Benfante, A., Braido, F., Caminati, M., Costantino, M. T., Cottini, M., Crivellaro, M., De Tullio, R., Gini, E., Grosso, A., Guarnieri, G., Lombardi, C., Patella, V., Pirina, P., Polverino, M., Raccanelli, R., Ridolo, E., Rolla, G., Steinhilber, G., Vianello, A., Milanese M., Terraneo S., Baiardini I., Di Marco F., Corsico A., Molino A., Scichilone N., Albicini F., Benfante A., Braido F., Caminati M., Costantino M.T., Cottini M., Crivellaro M., De Tullio R., Gini E., Grosso A., Guarnieri G., Lombardi C., Patella V., Pirina P., Polverino M., Raccanelli R., Ridolo E., Rolla G., Steinhilber G., and Vianello A.

Subjects
Vital capacity, ACT, asthma control test, Exacerbation, SAE, severe asthma exacerbation, SF12, chlorofluorocarbons, mental health composite score, EDUCA, elderly and device use in chronic asthma, PCS, physical health composite score, AHDS, hospital anxiety depression scale, Asthma, CFC, chlorofluorocarbons, Device misuse, Education, Elderly, FEV1, forced expiratory volume 1s second, FVC, forced vital capacity, ICS, inhaled corticosteroids, LABA, long-acting β2 agonist, LAMA, long-acting muscarinic antagonists, MCS, mental health composite score, PROs, patient-reported outcomes, SF12, short form health survey, mMRC, modified medical research council, EDUCA, FEV1, 0302 clinical medicine, Immunology and Allergy, Medicine, 030223 otorhinolaryngology, biology, severe asthma exacerbation, modified medical research council, LAMA, SAE, Lama, elderly and device use in chronic asthma, Metered-dose inhaler, Dry-powder inhaler, CFC, PCS, patient-reported outcomes, mMRC, lcsh:Immunologic diseases. Allergy, Pulmonary and Respiratory Medicine, long-acting β2 agonist, medicine.medical_specialty, Immunology, LABA, physical health composite score, Article, AHDS, 03 medical and health sciences, FEV1/FVC ratio, long-acting muscarinic antagonists, forced vital capacity, Internal medicine, forced expiratory volume 1s second, business.industry, Inhaler, asthma control test, biology.organism_classification, medicine.disease, ACT, FVC, MCS, hospital anxiety depression scale, 030228 respiratory system, ICS, PROs, short form health survey, inhaled corticosteroids, lcsh:RC581-607, business
Abstract

Background: Adherence to inhaled drugs is linked to patients’ satisfaction with their device, and an incorrect use can negatively affect the outcomes of asthma treatment. We speculated that this is particularly true in elderly asthmatic subjects. Aim: We performed a national pre-post interventional multicentre study, enrolling moderate-to-severe asthmatic subjects aged ≥65 ​years treated with fixed inhaled combination drugs by dry powder inhaler (DPI) or pressurized metered dose inhaler (pMDI). Adherence and critical errors were evaluated by means of validated questionnaires at first visit (V1) and after 3–6 months (V2). At V1, subjects underwent intensive training on the correct use of their device by physical demonstration. Results: A total of 411 asthmatics (F/M: 238/173, mean age±SD: 72 ​± ​5 ​years) participated to the study. At V1, 50% of the study subjects showed an Asthma Control Test (ACT) score ≤19 despite GINA step 3 and 4 treatment, and 40% had experienced at least one severe asthma exacerbation in the previous year. Poor adherence to treatment was recorded in 43% of subjects, and at least one error in using the device was registered in 56% of subjects. At V2, available for 318 patients, both the percentage of individuals with poor adherence and with at least one critical error significantly decreased (from 46% to 25%, and from 49% to 25%, respectively; p ​

Published
2019

23. Sulphurous mud-bath therapy for treatment of chronic low back pain caused by lumbar spine osteoarthritis

Author

Maria Teresa Costantino, Francesco Marongiu, Valeria Conti, Amelia Filippelli, Graziamaria Corbi, Mariagrazia Bathilde Marongiu, Costantino, M, Conti, V, Corbi, G, Marongiu, F, Marongiu, Mb, and Filippelli, A.

Subjects
Male, medicine.medical_specialty, Internal Medicine, Emergency Medicine, Treatment outcome, MEDLINE, Osteoarthritis, Disability Evaluation, 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, Longitudinal Studies, Prospective Studies, Prospective cohort study, Aged, 030203 arthritis & rheumatology, 030222 orthopedics, business.industry, Mud Therapy, Middle Aged, medicine.disease, Chronic low back pain, Treatment Outcome, Italy, Physical therapy, Female, Lumbar spine, Observational study, business, Low Back Pain
Published
2019

24. Omalizumab in elderly patients with chronic spontaneous urticaria: An Italian real-life experience

Author

Erminia Ridolo, Eustachio Nettis, A. Pannofino, Gianenrico Senna, Stefano Pucci, Alessia Gatta, Danilo Villalta, Enrico Heffler, Anna Radice, A. Romano, S. D'Alò, A. D'Angelo, M. Di Gioacchino, Mona-Rita Yacoub, Riccardo Senter, Sebastiano Gangemi, Elisabetta Di Leo, Michela Mineni, G. Stefanizzi, A. Martignago, Maria Pia Conte, S. Fichera, Luigi Macchia, Francesco Gaeta, A. Vignoli, Ilaria Baiardini, Enrico Maggi, Giuseppe Spadaro, A de Paulis, Donatella Macchia, Giselda Colombo, Angelo Vacca, Walter Canonica, Silvia Peveri, Maria Teresa Costantino, E. Favero, Eleonora Savi, Luca Cegolon, I. Zaza, F. Lodi Rizzini, S. Capretti, Mauro Cancian, Paola Lucia Minciullo, Oliviero Rossi, G. De Feo, M. Bisaccia, L. La Rosa, Roberta Parente, Aikaterini Detoraki, Nettis, Eustachio, Cegolon, Luca, Di Leo, Elisabetta, Canonica, Walter Giorgio, Detoraki, Aikaterini, Baiardini, I., Bisaccia, M., Cancian, M., Capretti, S., Colombo, G., Conte, M., Costantino, M. T., D'Alò, S., D'Angelo, A., De Feo, G., Di Gioacchino, M., Favero, E., Fichera, S., Gaeta, F., Gangemi, S., Gatta, A., Heffler, E., La Rosa, L., Lodi Rizzini, F., Macchia, D., Macchia, L., Maggi, E., Martignago, A., Minciullo, P., Mineni, M., Pannofino, A., Parente, R., Peveri, S., Pucci, S., Radice, A., Ridolo, E., Romano, A., Rossi, O., Savi, E., Senna, G. E., Senter, R., Spadaro, G., Stefanizzi, Antonio, Vacca, A., Vignoli, A., Villalta, D. R., Yacoub, M., Zaza, I., Nettis, E., Cegolon, L., Di Leo, E., Canonica, W. G., Detoraki, A., D'Alo, S., and Stefanizzi, G.

Subjects
Adult, Male, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Adolescent, Urticaria, Immunology, Chronic spontaneous urticaria, omalizumab, elderly patients, Drug Resistance, Drug resistance, Omalizumab, 030207 dermatology & venereal diseases, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Internal medicine, Anti-Allergic Agents, 80 and over, medicine, Humans, Immunology and Allergy, In patient, Young adult, Adverse effect, Aged, Aged, 80 and over, Chronic Disease, Female, Histamine H1 Antagonists, Middle Aged, Treatment Outcome, Histamine H1 Antagonist, Study drug, Angioedema, business.industry, Anti-Allergic Agent, 030228 respiratory system, Observational study, medicine.symptom, business, medicine.drug, Human
Abstract

Background Omalizumab therapy is effective and safe in patients with chronic spontaneous urticaria (CSU) resistant to nonsedating histamine 1 (H 1 ) antihistamines (nsAHs). Objective To evaluate the efficacy and safety of omalizumab in elderly (aged ≥65 years) patients with nonsedating H 1 -antihistamine–refractory CSU in a real-life setting. Methods Patients with nonsedating H 1 -antihistamine–refractory CSU (n = 322) treated with omalizumab administered every 4 weeks in doses of 300 mg for 24 weeks were divided into 2 groups according to age at omalizumab treatment onset: 15 to 64 years and 65 years or older. Treatment response was assessed using a 7-day urticaria activity score (UAS7). Adverse effects of omalizumab therapy were recorded. Results Among patients, 32 (9.9%) were 65 years or older. At baseline, CSU characteristics were generally similar among the groups, although the presence of angioedema was statistically significantly lower in patients younger than 65 years. Any differences in weekly itch severity score, hive score, and UAS7 between the 2 age groups were not significant at weeks 4, 12, and 24, with the exception of the hive score at 24 weeks and the UAS7 at week 24. No significant between-group differences were seen in the proportion of patients with a UAS7 of 6 or lower and with a UAS7 score of 0 at weeks 4, 12, 24, and 40. The proportion of patients with at least one adverse event reported as suspected to be caused by study drug was 10% in the younger group vs 6.3% in the older group ( P = .53). Conclusion Our study found that omalizumab is a well-tolerated and effective therapy for elderly patients with nonsedating H 1 -antihistamine–refractory CSU.

Published
2018

25. The Severe Asthma Network in Italy: Findings and Perspectives

Author

Giovanni Rolla, Girolamo Pelaia, Mariangiola Crivellaro, Maria Teresa Costantino, Maria Pia Foschino, Enrico Heffler, Alice D'Adda, Carlo Lombardi, Gabriella Guarnieri, Pierluigi Paggiaro, Nunzio Crimi, Francesco Blasi, Eleonora Savi, Manuela Latorre, Carla Galeone, Nicola Scichilone, Giselda Colombo, Giorgio Walter Canonica, Giovanni Passalacqua, M D'Amato, Francesco Menzella, Vincenzo Patella, Francesca Puggioni, Roberta Parente, Paolo Solidoro, Giuseppe Spadaro, Sarah Barbuto, Erminia Ridolo, Elisabetta Favero, Matteo Bradicich, Marco Caminati, Gianna Camiciottoli, Gianenrico Senna, Heffler, Enrico, Blasi, Francesco, Latorre, Manuela, Menzella, Francesco, Paggiaro, Pierluigi, Pelaia, Girolamo, Senna, Gianenrico, Canonica, Giorgio Walter, Barbuto, Sarah, Bradicich, Matteo, Camiciottoli, Gianna, Caminati, Marco, Colombo, Giselda, Costantino, Maria Teresa, Crimi, Nunzio, Crivellaro, Mariangiola, D'Adda, Alice, D'Amato, Mariella, Favero, Elisabetta, Foschino, Maria Pia, Galeone, Carla, Guarnieri, Gabriella, Lombardi, Carlo, Parente, Roberta, Passalacqua, Giovanni, Patella, Vincenzo, Puggioni, Francesca, Ridolo, Erminia, Rolla, Giovanni, Savi, Eleonora, Scichilone, Nicola, Solidoro, Paolo, Spadaro, Giuseppe, Heffler E., Blasi F., Latorre M., Menzella F., Paggiaro P., Pelaia G., Senna G., Canonica G.W., Barbuto S., Bradicich M., Camiciottoli G., Caminati M., Colombo G., Costantino M.T., Crimi N., Crivellaro M., D'Adda A., D'Amato M., Favero E., Foschino M.P., Galeone C., Guarnieri G., Lombardi C., Parente R., Passalacqua G., Patella V., Puggioni F., Ridolo E., Rolla G., Savi E., Scichilone N., Solidoro P., and Spadaro G.

Subjects
Adult, Male, medicine.medical_specialty, Registry, Severe asthma, Exacerbation, Bronchiectasis, Comorbidities, Late-onset asthma, Nasal polyps, SANI, Immunology and Allergy, Omalizumab, Comorbidity, Settore MED/10 - Malattie Dell'Apparato Respiratorio, Atopy, 03 medical and health sciences, Bronchiectasi, 0302 clinical medicine, Food allergy, Internal medicine, Aged, Asthma, Eosinophils, Female, Humans, Immunoglobulin E, Italy, Middle Aged, Nasal Polyps, Registries, Rhinitis, Medicine, Bronchiectasis, Comorbidities, Late-onset asthma, Nasal polyps, Registry, SANI, Severe asthma, Immunology and Allergy, 030212 general & internal medicine, business.industry, Nasal polyp, medicine.disease, 030228 respiratory system, Asthma Control Questionnaire, Comorbiditie, business, Mepolizumab, medicine.drug
Abstract

Background Severe Asthma Network in Italy (SANI) is a registry of patients recruited by accredited centers on severe asthma. Objective To analyze epidemiological, clinical, inflammatory, functional, and treatment characteristics of severe asthmatics from the SANI registry. Methods All consecutive patients with severe asthma were included into the registry, without exclusion criteria to have real-life data on demographics, asthma control, treatments (including biologics), inflammatory biomarkers, and comorbidities. Results A total of 437 patients (mean age: 54.1 years, 57.2% females, 70.7% atopics, 94.5% in Global Initiative for Asthma severity step V) were enrolled into the study. The mean annual exacerbation rate was 3.75. The mean blood eosinophil level was 536.7 cells/mcL, and the average serum total IgE was 470.3 kU/L. Approximately 64% of patients were on regular oral corticosteroid treatment, 57% with omalizumab and 11.2% with mepolizumab. Most common comorbidities were rhinitis, nasal polyposis, and bronchiectasis. Patients with nasal polyposis had higher age of disease onset, higher blood eosinophil count, and lower frequency of atopy and atopic eczema. Bronchiectasis was associated with more frequent severe exacerbations, higher blood eosinophils, and total IgE. Stratifying patients, those with late-onset asthma were less frequently atopic (with less frequent allergic rhinitis and food allergy), and more frequently with nasal polyposis and higher serum total IgE levels. Conclusions This study revealed a high frequency of relevant comorbidities and that a substantial proportion of patients have late-onset asthma; all these features define specific different disease phenotypes. Severe asthma complexity and comorbidities require multidisciplinary approaches, led by specifically trained pulmonologists and allergists.

Published
2018

26. Chronic Urticaria Patient Perspective (CUPP): The First Validated Tool for Assessing Quality of Life in Clinical Practice

Author

Maria Teresa Costantino, Giovanni Rolla, Ilaria Baiardini, Aldo Morrone, Chiara Roncallo, A. Legori, Silvia Mariel Ferrucci, Oliviero Rossi, Paolo D. Pigatto, Fulvio Braido, Gianenrico Senna, Angelo V. Marzano, Barbara Loera, Erminia Ridolo, Giorgio Walter Canonica, Giorgia Molinengo, Antonio Cristaudo, Mariangiola Crivellaro, Rosella Gallo, Marco Caminati, Massimo Triggiani, Eleonora Savi, Aurora Parodi, Anna Radice, Roberta Parente, Silvia Peveri, Anna Parolo, Irene Martignago, and Veronica Giorgis

Subjects
Adult, Male, Quality of life, medicine.medical_specialty, Adolescent, Psychometrics, Urticaria, Assessment, Clinical practice, Structural equation modeling, Young Adult, 030207 dermatology & venereal diseases, 03 medical and health sciences, 0302 clinical medicine, Cronbach's alpha, Chronic urticaria, Routine, Immunology and Allergy, Surveys and Questionnaires, medicine, Humans, Aged, Retrospective Studies, Receiver operating characteristic, business.industry, Reproducibility of Results, Patient Preference, Middle Aged, Surgery, Global Rating, Concordance correlation coefficient, 030228 respiratory system, Convergent validity, Chronic Disease, Physical therapy, Female, Perception, Patient-reported outcome, Assessment, Chronic urticaria, Clinical practice, Quality of life, Routine, Immunology and Allergy, business
Abstract

There is a need for validated tools to assess health-related quality of life (HRQoL) in routine clinical practice.The aim of this study was to validate the Chronic Urticaria Patient Perspective (CUPP) for assessment of patients with chronic urticaria (CU) in clinical practice.A provisional CUPP was developed from candidate items identified by following an iterative process in a retrospective analysis of 249 Chronic Urticaria Quality of Life Questionnaire questionnaires. The psychometric properties of the CUPP were then tested on a sample of patients enrolled in 13 Italian centers.The study population in the validation phase comprised 152 patients. The 10-item version of the CUPP showed satisfactory internal consistency (Cronbach's alpha values of 0.76 at visit 1 and 0.90 at visit 2), good criteria, and discriminative and convergent validity. Reliability was assessed in 34 patients with no changes in health (Global Rating Scale = 0 at visit 2) and was satisfactory (CCC [concordance correlation coefficient] = 0.9). Changes in CUPP scores were significantly associated with changes in Urticaria Activity Score (UAS)-Hive count (r = 0.36, P .001), UAS-Itch severity (r = 0.48, P.001), and UAS-Total score (r = 0.342, P.001), all of which indicated good responsiveness. The minimal important difference was 1.5.CUPP is a simple 10-question tool with good psychometric properties that provides a valid, reliable, and standardized measurement of HRQoL in patients with CU.

Published
2018

27. Anaphylactic Reactions After Discontinuation of Hymenoptera Venom Immunotherapy: A Clonal Mast Cell Disorder Should Be Suspected

Author

Elisa Olivieri, Fabio Lodi Rizzini, Elisa Boni, F. Reccardini, Chiara Roncallo, Massimiliano Bonifacio, Anna Rosaria Marcarelli, Mauro Pagani, Patrizia Bonadonna, Giovanni Passalacqua, Maria Beatrice Bilò, M. Franchini, Maria Teresa Costantino, Marina Mauro, Luigi Scaffidi, and Roberta Zanotti

Subjects
Male, 0301 basic medicine, Tryptase, Unconsciousness, Gastroenterology, 0302 clinical medicine, Immunology and Allergy, Mast Cells, Systemic mastocytosis, education.field_of_study, biology, medicine.diagnostic_test, Middle Aged, Anaphylaxis, Hymenoptera venom allergy, Re-sting, Systemic mastocytosis, Tryptase, Female, Hymenoptera venom allergy, medicine.symptom, Mastocytosis, Anaphylaxis, hymenoptera venom allergy, anaphylaxis, re-sting, tryptase, medicine.medical_specialty, Re-sting, Population, 03 medical and health sciences, Internal medicine, Hypersensitivity, medicine, Animals, Humans, education, Angioedema, Venoms, business.industry, Cutaneous Mastocytosis, Insect Bites and Stings, Allergens, medicine.disease, Hymenoptera, Clone Cells, Discontinuation, 030104 developmental biology, Withholding Treatment, 030228 respiratory system, Desensitization, Immunologic, Skin biopsy, biology.protein, Tryptases, business
Abstract

Background Up to 75% of patients with severe anaphylactic reactions after Hymenoptera sting are at risk of further severe reactions if re-stung. Venom immunotherapy (VIT) is highly effective in protecting individuals with ascertained Hymenoptera venom allergy (HVA) and previous severe reactions. After a 3- to 5-year VIT course, most patients remain protected after VIT discontinuation. Otherwise, a lifelong treatment should be considered in high-risk patients (eg, in mastocytosis). Several case reports evidenced that patients with mastocytosis and HVA, although protected during VIT, can re-experience severe and sometimes fatal reactions after VIT discontinuation. Objective To evaluate whether patients who lost protection after VIT discontinuation may suffer from clonal mast cell disorders. Methods The survey describes the characteristics of patients who received a full course of VIT for previous severe reactions and who experienced another severe reaction at re-sting after VIT discontinuation. Those with a Red Espanola de Mastocitosis score of 2 or more or a serum basal tryptase level of more than 25 ng/mL underwent a hematological workup (bone marrow biopsy, KIT mutation, expression of aberrant CD25) and/or skin biopsy. Results Nineteen patients (mean age, 56.3 years; 89.5% males) were evaluated. All of them had received at least 4 years of VIT and were protected. After VIT discontinuation they were re-stung and developed, in all but 1 case, severe anaphylactic reactions (12 with loss of consciousness, in the absence of urticaria/angioedema). Eighteen patients (94.7%) had a clonal mast cell disorder, 8 of them with normal tryptase. Conclusions Looking at this selected population, we suggest that mastocytosis should be considered in patients developing severe reactions at re-sting after VIT discontinuation and, as a speculation, patients with mastocytosis and HVA should be VIT-treated lifelong.

Published
2018

28. Abstracts from the Food Allergy and Anaphylaxis Meeting 2016

Author

Georgios Rentzos, Esben Eller, Annick Mercenier, Magna Correia, Pedro Moreira, Linda Verrill, Mário Morais-Almeida, Frauke Schocker, Carsten Bindslev-Jensen, Ulrike Lehnigk, Andreas Frey, Lars Verschuren, Anna-Lena Bramstång Björk, Lene Heise Garvey, Elena Molina, Katrine L. Bøgh, J. L. van der Velde, Montserrat Alvaro, Phil Padfield, Niamh Brosnan, Nelly Gourdon-Dubois, Christian Harwanegg, Manuel Branco Ferreira, Songül Yürek, Amyra Ali Azamar Jácome, Rashid Amin, José Ramón Fernández Lorenzo, Kirsten Beyer, Florin-Adrian Secureanu, Charlotte Bernhard Madsen, Julie Galand, Claudia Pföhler, Rabea Reinert, Heinz Fehrenbach, Anton Hartmann, Maria Salas, Arne Homann, Rand Arnaout, Sarah Lindsley, Nerea Sarmiento Carrera, Patrícia Padrão, Berber Vlieg-Boerstra, Alkerta Ibranji, Benoît Sterling, Maria Auxiliadora Guerrero, Maria L. Baeza, Maurizio Tamburrini, Eva Untersmayr, Tanja Cirkovic Velickovic, Farrukh Sheikh, Sarah Kuntz, Sara Martínez, Kriti Gupta, Maria de Lurdes Torre, Yvonne Vergouwe, Ross Yarham, Faisal R. Bakhsh, Marta Vazquez-Ortiz, João Marcelino, Tullio Frediani, Ricardo Prata, Anna Kaarina Kukkonen, Gustavo Soldateli, Ines Mrakovčić-Šutić, Elodie Drumez, Cristina Ornelas, Maria Vazquez de La Torre, Renata Barros, Agata Szymkiewicz, Aneta Tomaszewska, Stefanie Rohwer, Charlotte Eisenmann, Adriana Muntean, Matteo Moretti, Johanna P. M. van der Valk, Birgit Quinting, Stefan Kabasser, David Gillick, Michał Przybyszewski, Grzegorz Sergiejko, Antonio Jorge Cabral, Alba Pablos-Tanarro, Robert Elfont, Marit Reitsma, Roxana Silvia Bumbăcea, Nelson Rosario, Maria Livia Bernardi, Cristiane N. Santos, Christian Radauer, Sandra Denery-Papini, Geert F. Houben, Nicolette W. de Jong, Marta Anda, Alexander Rohrbach, Teodorikez Wilfox Jimenez-Rodriguez, María Teresa Villalba, Karine Patient, Harmieke van Os-Medendorp, Kathrin Scherer, Marta Goñi Esarte, Svetlan Dermendzhiev, Jossie Garthoff, Michelle M. Epstein, Catherine Bertholet, Bruna Pultrini Aquilante, Didier G. Ebo, Roberta Aina, Jorge Kalil, Petri Kulmala, Lars K. Poulsen, Barbara Ballmer, H. Mary-Lene de Zeeuw-Brouwer, Karin Hoffman-Sommergruber, Winfried Leeman, Anne Miles, Nehad Gomaa, Maria Teresa Costantino, Evelyne Mangodt, Maria Konstantakopoulou, Rosa Jimenez, Attilio Francesco Speciani, Helga Magnusdottir, Inmaculada Sánchez-Machín, H. Kaddouri, Raquel Perez, Astrid Versluis, Anthony E. J. Dubois, Anja Koren Jeverica, Zdenka Barićev-Novaković, Joost Westerhout, A.M. Plaza, Júlio Oliveira, Pierre Lukas, Oksana Matsyura, Giuseppe Pingitore, Mira Silar, Huub F. J. Savelkoul, Urszula Samolinska-Zawisza, Chantal Brossard, Ana Reis Ferreira, Reiko Teshima, Serena Perna, Mariola Dietrich, Dirk Verhoeven, Fiona Kenna, Paloma Poza-Guedes, Cristobalina Mayorga, Pilar Hernandez, Roberto Bernardini, Roberto Berni Canani, Maria Francesca Patria, Mariana Vieru, Julie Locklear, Esther van Twuijver, Marina A. Kiseleva, H. Kim A. Brand, Gabriele Schulz, Ileana-Maria Ghiordanescu, Nikolaos G. Papadopoulos, Danijela Apostolovic, Maria del Mar Folqué, Eva Lasa, Mohammad Al Bahkali, Arianna Dondi, Sofia Kostoudi, Simon Rosenberg, Véronique Nève, Rumyana Yankova, Barbara Ballmer-Weber, Maria Jose Goikoetxea, María José Barasona Villarejo, Teija Dunder, Tina Vesel, Elisa Gritti, Marianne van Hage, Laure Castan, Etienne Beaudouin, Margherita Di Costanzo, Natalia Ukleja-Sokołowska, Matthew Sperrin, Paul Turner, Saskia Albroscheit, Rebeca Lopez, Sonja Posega Devetak, Francisca Palomares, Laetitia Sellam, Jennifer Hammond, Astrid G. Kruizinga, Konrad Furmanczyk, Patricia Macchiaverni, Olga Pakholchuk, I V Vorozhko, Ania Carsin, Aleksandar Bulog, Joris Mens, Bianca Balbino, James P. Hindley, Jaap H. Akkerdaas, Jonathan Hourihane, Hilde Cnossen, Tatyana A Popova, Rupert Schlags, Natalia Nenasheva, A. Ehrenberg, Sigurveig T. Sigurdardottir, Anna Iliopoulou, Clara Ippolito, Piotr Samel-Kowalik, Paloma Campo, Gador Bogas, Constantinos Pitsios, Sarah Grosche, Karla Leversia Borjas Aguilar, Amena Warner, Birgit Kalb, Lénaïck Dupuis, Harry J. Wichers, Diana Silva, Gabriele Piuri, Linus Grabenhenrich, Emanuel Sarinho, M. Eleonore Pettersson, Rodrigo Barderas, Gary Stiefel, E. N. Clare Mills, Lali Saginadze, Ruta Dubakiene, Francesca Cipriani, Mindy Tsai, Marina Themisb, Michela Ciancamerla, Rebecca Knibb, Ruperto González-Pérez, Marina Peredelskaya, André C. Knulst, Irene Berends, S N Denisova, Montserrat Fernandez-Rivas, Paolo Maria Matricardi, Daniel Sampaio, Giorgio Bedogni, Sira Miquel, Koen Smit, Stefania Arasi, Sylvia Osscini, Justine Courtois, Cristina Deaconu, Srdan Banac, Kirsten Hansen, Jennette Higgs, Charlotte Hands Plovdiv, Carlotta Povesi Dascola, Noe Ontiveros, Rik Schrijvers, Carla Mastrorilli, Maria Passioti, Sebastian Tschirner, Bjorn R. Ludviksson, Joana Caiado, Daniel Corbacho, Sophie Nutten, Agustin Madroñero, Marina Suárez Vergara, Boudewjin J. Kollen, Catherine J Nock, Johanna Rost, Agnieszka Lipiec, Skadi Kull, Geert Houben, Carlo Caffarelli, Jordi Roca-Ferrer, Bolesław Samoliński, Isabelle Cleach, Colette Larré, Aideen Byrne, Corinne Herouet-Guicheney, Jonas Lidholm, Vera Assmann, W. Marty Blom, Adriano Mari, Adam T. Fox, Giuseppe Crisafulli, Afke M. M. Schins, Anastasia Papadopoulou, Flávio Sano, Richard Cooke, Franziska Ruëff, L Jorjoliani, Rebekah Sayers, Anne-Marie Kochuyt, Borja Bartalomé, Anne Moneret-Vautrin, Juan Carlos Julia, Jelena Mihailovic, Katarzyna Pyrz, Kollen Boudewijn, Margherita Varini, Paolo Giordani, Claudia Alessandri, Johanna van der Valk, Antoine Deschildre, Mariam Tskhakaia, Rosina López-Fandiño, Omar Kheroua, Nicolette J. T. Arends, Alina Zbróg, Chung-Hsiung Huang, Andrea Wangorsch, Ulf Bengtsson, Jim Langridge, Dasha Roa-Medellín, Jose Ignacio Larco, Bert Popping, Ana Prieto del Prado, José Antonio Bácter Martos, Rita Nocerino, Sophia Watts, Elisa Haroun, Danilo Villalta, Lee A. Gethings, María Ángeles Algaba Mármol, Ewa Gawrońska-Ukleja, Cornelia Jansen, André Moreira, V A Revyakina, Robert Zacniewski, Xavier Domingo Miró, Francesco Macrì, Mayra de Barros Dorna, Akanksha Sharma, Stephen J. Till, Ali Almontasheri, Chrystyna Kalicinsky, Robbert Sutorius, Akila Rekima, Mark A. Blankestijn, Nicolette Arends, Chiara Pistoletti, Merima Bublin, Manuel Pereira-Barbosa, Reyna Simon, Martin Karjalainen, Sam Mehr, Tushar Banerjee, Carmen Riggioni, Bertrand Evrard, Antonio Carlos Pastorino, Lidia Ilènko, Nikolaos Douladiris, Miguel Vieira, Erik Wambre, Francisco Cabrera-Chavez, Nikos G. Papadopoulos, Piotr Humeniuk, Gert van Duijn, Francesco Zinno, Young-Ae Lee, Lisa Tuppo, Hans de Groot, Léon M.J. Knippels, Pawel Dubiela, Henrik Fomsgaard Kjaer, Andrea Vereda, Djamel Saidi, Kok Loong Ue, Henk Van Loveren, Maria Jose Rodriguez, Marta Lomikovska, Elodie Michaud, Josefina Cernadas, Carmen Ponce, Marysia Recto, Frances Smith, Hassan Al-Dhekri, Shinobu Sakai, Thomas Eiwegger, Ana Rodolfo, Diego Peroni, Nikki Edelbroek, Waltraud Suer, Jenny van Odijk, Irena Nedelea, Borja Bartolomé, Lauren Lissner, Marjeta Sedmak, Annette Jamin, Italo De Vitis, Bo Pontoppidan, Annabelle Capt, Diego G. Peroni, Susana Rodrigues, Juan Carlos López-Rodríguez, David Endesfelder, Lesya Besh, Danila Zennaro, Charlotte G. Mortz, Kati Palosuo, María José Torres, Esozia Arroabarren, Lynne Regent, Laura Valdesoiro Navarrete, Ana Molina, Agha Rehan Khaliq, Phil Couch, Ana Miranda, Thomas Marichal, Riccardo Asero, Denise Borges, Dikla Pivko Levy, Miriam Palacios, Mireille Eb, Stephen J. Galli, Karin Hoffmann-Sommergruber, Anna Gudrun Vidarsdottir, Ifigenia Sfika, André Wolterbeek, Mauro Calvani, Edward F. Knol, Joyce A. M. Emons, Anne-Marie Oomkes-Pilon, Montserrat Bosque García, Daniel Lozano-Ojalvo, Filip Raciborski, Deirdre Galloway, Nanna Juel-Berg, Margareta Brandt Gertmo, Cornelia Bergmayr, Rob Klemans, Juliane Gregersen, Yolanda Meijer, Bettina Brix, Susanne Lau, Karine Adel-Patient, Hanneke van der Kleij, Mareike Price, Jean-Louis Mege, Lizalet Oosthuizen, Agurtzane Bilbao, Indre Butiene, Antonino Romano, Colin Barber, Rosana Camara Agondi, Nour Baïz, Soraya Ainad Tabet, Peter Korošec, Laurian Jongejan, Francine C. van Erp, José Pedro Moreira Silva, Nandinee Patel, Jaime Lozano, Prescilla V. Jeurink, Artur Walkiewicz, Bryan M. Harvey, Tiina J. Kauppila, Aida Semic-Jusufagic, Marianna Murdjeva, Miren Arteaga, Y. Bouferkas, Geunwoong Noh, Henny G. Otten, Sabine Dölle, Christopher Munro, O Dominguez, Gerard H. Koppelman, Leonieke N. van Veen, Vasti Iancu, Georg Mitterer, Patrizia Polverino de Laureto, Juliane Schulz, Ewa Ternesten Hasseus, Caroline Zimmermann, Ivona Barcievic-Jones, Shira Benor, Susanne Schwarz, Eun Ha Jang, Josefina Rodrigues Cernadas, Tadej Avcin, Joseph L. Baumert, Pernille Winther, Stéphane Leteurtre, Gabriela Canto, Louise J Michaelis, Jorge Alvarez, Gabriel Gastaminza, Michela Carola Speciani, Rute Gonçalves, Leire Dopazo, Evgen Benedik, Susanne C. Diesner, Luc S. De Clerck, A. Wesley Burks, Maurits S. van Maaren, Salvatore Tripodi, Philippe Aubert, Kamel Eddine El Mecherfi, Aline B. Sprikkelman, Ana Prieto, Margitta Worm, Edyta Krzych, Maja Krstic, Iride Dello Iacono, Melanie Cap, Alf Weimann, Maria Nassiri, Niels Röckendorf, Vladyslava Barzylovych, Marcia C. Mallozi, Pierre Bruhns, Jeanette Fisker Trandbohus, Ekaterini Papadopoulou, Vicente Albendiz, Timothy Watts, Uta Jappe, Javier Moreno, Maria Carmen Verga, Beatriz Secades Barbado, Carmen Di Scala, Roy Gerth van Wijk, Vladimir Mićović, Esther Barrionuevo, Giampaolo Ricci, Luisa Galindo, Ana Paula Beltran Moschione Castro, Oona Mustonen, Jia Yin, Lucia Caminiti, Jorge Esparza-Gordillo, N Adamia, Anna-Maija Hanni, Romy Gadisseur, Stefano Luccioli, Regina Treudler, Rosetta Ferrara, M. Guendouz, Jaakko Yrjänä, Philipp Starkl, Premendra D. Dwivedi, Javier Cuesta-Herranz, Johan Garssen, Ekaterini Goudouris, Sridevi Muralidharan, Kate Grimshaw, Carolina Sanchez Aranda, Ioana Maris, Manzoor Ahmed, Hajime Karasuyama, Stephanie Claus, Chantal Agabriel, Karen English, Dorien Van Ginkle, Eleonora Savi, Loredana Chini, Ine I. Decuyper, Sabine Schnadt, Valérie Trendelenburg, Jean-Luc Fauquert, Maurizio Mennini, Nikolaos Mikos, Ana Célia Costa, Steve L. Taylor, A. A. Schoemaker, Sara Abián, Margo M. Hagendorens, Andrea Di Rienzo Businco, Melina Makatsori, Eugénia Matos, Lucy Walker, Nikolaos A. Kitsioulis, David Alejandro Mendoza Hernández, Maria Starkhammar, Djordje Filipovic, Aine Adams, Mukul Das, Sonsoles Intente-Herrero, Natalia Blanca López, Marek L. Kowalski, Diana Deleanu, Bernard P. Mahon, Jean-Michel Wal, Lucia Decastelli, Mihaela Popescu, Aimee Lou Nano, Eva Batanero, Tong-Rong Jan, Yolanda Puente, Jacek Borowicz, Aimée Dorkenoo, J. Östling, Mashary Altamimi, Michel Neunlist, Zerrin Yalvaç, Sonia Ricò, Wentong Xue, Linda Cosenza, David C. A. Candy, Robert D. Voyksner, Montserrat De Prada, Abdulhadi Al-Qahtani, Sébastien Holvoet, Wolf-Meinhard Becker, Meropi D. Kontogianni, Bruno Pereira, F. Pineau, Eva Corbet, Kirsten Mehlig, Rosella De Poi, Jolanda H. M. van Bilsen, José Luís Plácido, Hans-Jørgen Malling, Chia-Chi Wang, Philip Couch, Kerrie Kirk, Agata Michalska, Sylke Rietz, Mariya Ivanovska, Victor Matheu-Delgado, Carl Hamsten, Francisca Gómez, Neusa Falbo Wandalsen, Mika J. Mäkelä, Tatyana Sentsova, Kristian Bravin, Philippe Delahaut, Hervé Bernard, Leonor Carneiro-Leão, Michele Miraglia del Giudice, Elena D. Kuvshinova, Jochen Behrends, Caroline Klingebiel, Meta Accetto, Claire Mills, Mariona Pascal, Miguel García Domínguez, Huan Rao, Carmen Saviana Ganea, Umberto Pelosi, Stefano Pattini, Bodo Niggemann, Annamaria Bianchi, Laura Martín-Pedraza, Anna Selby, Cristina Bueno, Stefan Vieths, Luis Felipe Ensina, Florin-Dan Popescu, Antonio Fernandez, Soren Wille, Erna Van Hoeyveld, Carina Kelleher, Athina L. Van Gasse, Anders Blom Jensen, Zorica Zivkovic, Moshe Ben-Shoshan, Sara Pereiro Fernández, Ronald van Ree, Antima Banerjee, Pablo Merida, Mandy Ziegert, Barbara Wróblewska, Morten Christensen, Gador Gomez, Pablo San Segundo-Acosta, Khaled Messaoudi, Anne-Sofie Ravn Ballegaard, Mikael Kuitunen, David Luyt, Vito Sabato, Nesrine Zaabat, Svitlana Zubchenko, Julien Labreuche, Elin Lustig, Katharina Blumchen, Guillaume Pouessel, Ana Fiandor, Stéphanie Lejeune, Paola Dignetti, Helen Brown, Anastasia Cirisano, Evangelia Kompoti, Anna Sokolova, Mercedes Escarrer Jaume, Shan Deng, Dirceu Solé, Chiara Fiamingo, Alessandro Travaglini, Nicolas Gaudenzio, Zbigniew Bartuzi, Antonia Rojas, Roberta Olcese, Nanju Alice Lee, Sandra Brandhoff, Lucien F. Harthoorn, Anna Maria Szyc, Andrea Costanzi, Sabine Pfeifer, Emiliano De Dominicis, Chiara Rafaiani, Yin-Hua Cheng, Elida Nikolla, Ignacio García Núñez, Diego Faggian, Lieve Coorevits, Ayelet Rimon, Erika Jensen-Jarolim, Jacqueline J.M. Castenmiller, Kristin Verbeke, Sean Bennett, Paraskevi Xepapadaki, Glauce Hiromi Yonamine, Anna Wawrzeńczyk, Rusudan Karseladze, Emmanouil Manousakis, Fiona Ward, Ivana Filipovic, Marie Bodinier, Viviana Moschese, Pedro Giavina Bianchi, Alice Coimbra, Alena Berger, Anton A. Shekhetov, Monica Maćków, Philippe Egenmann, Oscar Asensio, Lidia Hanna Markiewicz, Chun-Wei Tung, Zsolt Szépfalusi, Jan Knol, Frits Koning, Carolina S. Aranda, Annick Bastiaensen, Giovanni Battista Pajno, Leticia Pérez-Rodríguez, Ewout W. Steyerberg, Riccardo Sibilano, Valérie Verhasselt, Roberta Lupi, Lukasz Sokolowski, Adam Wawrzeńczyk, Dimitris I. Mitsias, Andreia Forno, Antoine Magnan, Christian Schwager, Ioanna Manolaraki, Alessandro Fiocchi, Tanja Rouhani Rankouhi, Carla Jones, Ana Pereira, Hannah M. Kansen, Michael Clausen, D. Bignardi, Assad M. Butt, Julie C. Locklear, Katrine Lindholm Bøgh, Valery Muhortnich, María Teresa Giner, Juan Miguel Garcia, Maria Luisa Somoza, Raditsa Sokolova, Maria Pasioti, Mirjana Zupancic, Joana Vitte, Duncan Brown, Arnaldo Porto, M. Turfkruyer, Lau Fabricius Larsen, Filipe Benito-Garcia, Mayra Coutinho Andrade, Meltem Ugras, Ingrid Sutic, Rand K. Arnaout, Etienne Cavalier, Marta Neto, Grégory Bouchaud, Elena Varin, Bushra Javed, Carla Camerotto, Monica Bronkowska, Cristiano Caruso, Luís Amaral, Jackeline F. Motta, Sahar Elshorbagi, Cornelis K. van der Ent, Alexandra Rodrigues, Silvia Peveri, Juan Heber Castellanos, Muriel Totis, Joan Bartra, Gjustina Loloci, Ivana Giangrieco, Ekaterina Khaleva, Joaquín Navarro, Kayoko Matsunaga, Jlenia Fresta, Jonathan O'b Hourihane, Sabina Bijlsma, Ana Rodriguez-Fernandez, Rosita Aitoro, Daniela Manila Bianchi, Rosa Jimenez-Feijoo, Mario Plebani, Marleen T. J. Van Ampting, Anthony E.J. Dubois, Clémence Mordacq, Simone Frediani, Martin Chapman, Helena Larramona, Fabrícia Carolino, Yanne Boloh, Ivona Baricevic-Jones, Mathilde Claude, Caroline Thumerelle, Päivi Vähäsarja, Mareen R. Datema, Abdullah Alfhaid, Diana Perez Alzate, Laura Santos-Diez, Graham King, Maria Teresa Guerra Perez, Jean-Marie Renaudin, Frieke Kuper, Josué Alejandro Huertas Guzmán, Harry Wichers, Thomas Keil, A. Haddi, Jennifer Santos, Regina Selb, Aida del Campo García, Maria Basagaña, Valentino Pavišić, Angela Simpson, Chris H. Bridts, Susana Piedade, Silvia Gallina, Isabella Pali-Schöll, Inês Pádua, Margaretha A. Faber, Frédéric de Blay, Luís Câmara Pestana, Ben Remington, Anna S. Pelkonen, Sandra Lucarelli, Ivana Šutić, Olivier Tranquet, Montserrat López Onieva, Antonio Amoroso, Paola Minale, Katia Basello, George Du Toit, Daniela Adriano, Adnan Custovic, Zbikowska-Gotz M, Domingo Barber, Inmaculada Doña, Christine Breynaert, Hanan Sharif, Manon M. Oude Nijhuis, Sandra Denery, Bertine M. J. Flokstra-de Blok, Rinkesh Kumar Gupta, Pieter-Jan de Kam, Dianne E. Campbell, Carmen M. D'Amelio, Nunzia Maiello, Ingo Marenholz, José María Ignacio García, Helen Lindqvist, Lilian Moraes, Cleonir Lui de Moraes Beck, Eunice Dias de Castro, Cono Casale, Barbara Majkowska-Wojciechowska, Maria Petrodimopoulou, Andrea Mikkelsen, Hub P. J. M. Noteborn, Hulya Ercan Saricoban, Moira Austin, Martinus Løvik, Graham Roberts, Isabella Annesi-Maesano, Aeilko H. Zwinderman, Sigrun H. Lund, Anouska D. Michelsen-Huisman, Fernando Bandrés Sánchez-Cruz, Francisco Javier Ruano, Valérie Liabeuf, Eman Madbouly, Pasquale Comberiati, Maria Isabel Garcimartin, Stephan Scheurer, Inna A. Larkova, Jean Tratt, Renata Rodrigues Cocco, Younes Belabbas, Lorella Paparo, Elizabeth Griffiths, Gian Lodovico Rapaccini, Audrey Dunn Galvin, Zizi Cojocariu, Isidor Hutteger, Claire Claverie, S.M. Nedelska, Anna Kuklinska-Pijanka, Jenny Badas, Mónica Piquer, Iztok Devetak, A.K.F. Gushken, Frans Timmermans, Adriana Machinena, Francisco Javier Monteseirin, Amaranta Traversa, Fátima Cabral Duarte, Tomaž Poredoš, Peter Meyer, Cristina Arêde, Rosa Muñoz-Cano, Barbara Pfitzner, Alejandro Joral, Juan Carlos Daza, Laurent L. Reber, Olga Chernyak, and Maria Antonetta Ciardiello

Subjects
Pulmonary and Respiratory Medicine, Allergy, medicine.medical_specialty, 030504 nursing, business.industry, Immunology, RC581-607, medicine.disease, Meeting Abstracts, 03 medical and health sciences, 0302 clinical medicine, Food allergy, 030225 pediatrics, Family medicine, medicine, Immunology and Allergy, Immunologic diseases. Allergy, 0305 other medical science, business, Anaphylaxis
Published
2017

29. How far from correct is the use of adrenaline auto-injectors? A survey in Italian patients

Author

Eleonora Savi, Erminia Ridolo, Mariangiola Crivellaro, Carlo Lombardi, Laura Bonzano, Silvia Peveri, Giuseppina Manzotti, Marcello Montagni, Cristoforo Incorvaia, Marco Caminati, Gianenrico Senna, and Maria Teresa Costantino

Subjects
Adult, Male, Allergy, Health Knowledge, Attitudes, Practice, Epinephrine, Self Administration, Injections, Intramuscular, Injections, Adrenaline, Auto-injector, Surveys and Questionnaires, Internal Medicine, Medicine, Humans, Medical prescription, Anaphylaxis, Intramuscular, Practice, business.industry, Health Knowledge, Drug administration, Bronchodilator Agents, Educational Status, Female, Italy, medicine.disease, Auto-Injector, Attitudes, Emergency Medicine, Allergists, Medical emergency, business
Abstract

Self-administered adrenaline through an auto-injector is the main out-of-hospital treatment for anaphylaxis, and patients should be trained to promptly and correctly use the device. The aim of the study was to verify the proper use of the device and the correct drug administration, and to identify possible misuse by patients. In seven Italian Allergy clinics, patients who were previously provided with self-injectable adrenaline were recruited at the follow-up visit required for the renewal of their prescription. All patients completed a questionnaire covering details of their allergic reactions, and knowledge of the device. The correct use was verified by the physician using a trainer with a four-step examination. 242 patients were included; 46 patients (18 %) did not always carry the auto-injector, and 35 patients (14 %) reported situations in which they were doubtful about whether to use adrenaline. Only 39 % of patients properly managed the device, while some patients (6 %) failed in all four steps. The majority of patients considered it appropriate to use adrenaline at the onset of respiratory symptoms (56 %). The factor most closely related to proper use of the device was the education of the patient (p = 0.03), while age and the time from first prescription did not affect the ability to properly use the auto-injector. Even though accurate training is conducted, many patients are still unable to properly use the adrenaline auto-injector in case of anaphylaxis. Allergists should review the instructions provided to the patients every time a renewal of the auto-injector is prescribed.

Published
2015

30. Catching allergy by a simple questionnaire

Author

Cristoforo Incorvaia, Paola Rottoli, Massimo Landi, Nicola Scichilone, Gilda Nardi, Erminia Ridolo, Vincenzo Castella, Serena Buttafava, Nico Sciolla, Giorgio Walter Canonica, Beniamino Cucchi, Paola Puccinelli, Sebastiano Gangemi, Maurizio Galimberti, Giovanni Passalacqua, Paolo Raviolo, Franco Frati, Maria Teresa Costantino, Alessandro Fiocchi, Germano Bettoncelli, Galimberti, M., Passalacqua, G., Incorvaia, C., Castella, V., Costantino, M., Cucchi, B., Gangemi, S., Nardi, G., Raviolo, P., Rottoli, P., Scichilone, N., Sciolla, N., Bettoncelli, G., Landi, M., Ridolo, E., Buttafava, S., Puccinelli, P., Canonica, G., Fiocchi, A., and Frati, F.

Subjects
lcsh:Immunologic diseases. Allergy, Pulmonary and Respiratory Medicine, Pediatrics, medicine.medical_specialty, Allergy, Referral, medicine.medical_treatment, Immunology, Allergy testing, Primary care, Settore MED/10 - Malattie Dell'Apparato Respiratorio, Pharmacists, Allergic rhinitis, Cohen's kappa, Allergic rhiniti, medicine, Immunology and Allergy, Original Research, business.industry, medicine.disease, Primary care physicians, Test (assessment), Primary care physician, Nasal spray, Pharmacist, Allergists, lcsh:RC581-607, business
Abstract

Background Identifying allergic rhinitis requires allergy testing, but the first-line referral for rhinitis are usually primary care physicians (PCP), who are not familiar with such tests. The availability of easy and simple tests to be used by PCP to suggest allergy should be very useful. Methods The Respiratory Allergy Prediction (RAP) test, based on 9 questions and previously validated by a panel of experts, was evaluated in this study. Results An overall number of 401 patients (48.6% males, age range 14–62 years) with respiratory symptoms was included. Of them, 89 (22.2%) showed negative results to SPT, while 312 (77.8%) had at least one positive result to SPT. Cohen’s kappa coefficient showed that all questions had an almost perfect excellent agreement between pre and post-test. The algorithm of decision-tree growth Chi-squared Automatic Interaction Detector showed that answering yes to the question 4 (Your nasal/ocular complains do usually start or worsen during the spring?), 6 (Did you ever had cough or shortness of breath, even during exercise?) and 8 (Do you use nasal sprays frequently?) gave a probability to have a positive SPT of 85%. Conclusions These findings show that RAP test can be proposed as an useful tool to be used by physician other than allergists when evaluating patients with rhinitis, suggesting the need of allergy testing. Electronic supplementary material The online version of this article (doi:10.1186/s40413-015-0067-y) contains supplementary material, which is available to authorized users.

Published
2015

31. Severe Anaphylactic Reactions after Stopping Hymenoptera Venom Immunotherapy. a Clonal Mast Cell Disorder Should be Suspected

Author

Chiara Roncallo, M. Franchini, F. Lodi Rizzini, Giovanni Passalacqua, Maria Teresa Costantino, Roberta Zanotti, Patrizia Bonadonna, M. Pagani, F. Reccardini, and Marina Mauro

Subjects
medicine.anatomical_structure, business.industry, medicine.medical_treatment, Immunology, medicine, Immunology and Allergy, Anaphylactic reactions, Immunotherapy, Mast cell, business, Hymenoptera venom
Published
2017

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