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MAST CELL ACTIVATION SYNDROME IN THE SETTING OF ACUTE HYPOTENSION AND ALTERED MENTAL STATUS (Hall B (1st Floor); Monitor 01) - Nov 2, 2021 - Abstract #ACAAI2021ACAAI_698; A broad differential diagnosis should be considered when assessing patients with MCAS during acute decompensation. Symptoms triggered by mast cell mediator release, especially isolated hypotension, have a broad differential and failure to consider other treatable conditions may delay recognition of emergent diagnoses, including sepsis and hemorrhage.
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Trial completion date: COURAGE: COrticosteroids in acUte uRticAria in emerGency dEpartment (clinicaltrials.gov) - Oct 12, 2021 P3, N=240, Recruiting, Symptoms triggered by mast cell mediator release, especially isolated hypotension, have a broad differential and failure to consider other treatable conditions may delay recognition of emergent diagnoses, including sepsis and hemorrhage. Trial completion date: Oct 2021 --> Mar 2022
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Trial completion date, Trial primary completion date: COURAGE: COrticosteroids in acUte uRticAria in emerGency dEpartment (clinicaltrials.gov) - Sep 9, 2021 P3, N=240, Recruiting, No abstract available Trial completion date: Jan 2021 --> Oct 2021 | Trial primary completion date: Nov 2020 --> Sep 2021
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Clinical, Journal: Recurrent Cellulitis-Like Episodes of the Lower Limbs and Acute Diarrhea in a 30-Year-Old Woman: A Case Report. (Pubmed Central) - Sep 8, 2021 CONCLUSIONS This report emphasizes the need for greater vigilance by physicians before making a final diagnosis of infectious cellulitis. Thus, excluding from their differential diagnosis, other dermatological diseases mimicking infectious cellulitis and preventing a possible misdiagnosis, delay of appropriate treatment, future antibiotic-associated complications, and the evolution of antimicrobial-resistant microbes in the community.
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Phase classification: Characterization of the Role of Histamine in Children With Asthma (clinicaltrials.gov) - Aug 30, 2021 P2/3, N=211, Completed, Thus, excluding from their differential diagnosis, other dermatological diseases mimicking infectious cellulitis and preventing a possible misdiagnosis, delay of appropriate treatment, future antibiotic-associated complications, and the evolution of antimicrobial-resistant microbes in the community. Phase classification: P=N/A --> P2/3
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Clinical, Journal: The efficacy and safety of herbal combination of Unani Medicine in chronic urticaria: A randomized, controlled study. (Pubmed Central) - Jul 2, 2021 Data analysis showed a significant decrease (P=<0.001) in the scores of UAS7 (32.43 ± 2.34-14.03 ± 2.16 and 32.10 ± 2.33-28.40 ± 3.78) and CU-Q2oL (67.57 ± 9.56-36.50 ± 3.01 and 65.20 ± 11.78-59.60 ± 11.13) in HCUM and Levocetirizine groups respectively. As an alternative treatment in terms of safety, efficacy, tolerability, and quality of life the HCUM treatment proved to be more effective than Levocetirizine 5 mg in moderate to severe CU.
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IgE-mediated hypersensitivity to carboxymethylcellulose confirmed by basophil activation test: two case reports () - May 30, 2021 - Abstract #EAACI2021EAACI_1530; Within 5 minutes, she developed generalized urticaria, cough, angioedema of the foot and eyelids, which resolved after administration of levocetirizine and prednisone...Moreover, IgE-mediated sensitization to CMC could be confirmed by BAT in both patients. Thus, we demonstrate that IgE-mediated sensitization to CMC represents a rare, but important cause of anaphylaxis in patients with reactions to intra-articular injections and that the BAT is useful in confirming this sensitization.
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Trial completion date, Trial primary completion date, Combination therapy: TACUS: Tranexamic Acid and Spontaneous Chronic Urticaria (clinicaltrials.gov) - Apr 28, 2021 P4, N=80, Recruiting, Cetirizine was significantly less sedating than diphenhydramine when administered as premedication to prevent paclitaxel-associated IRR. Trial completion date: Jan 2021 --> Sep 2022 | Trial primary completion date: Jan 2021 --> Sep 2022
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Biomarker, Journal: Evaluation of the Effect of 5 QT-Positive Drugs on the JTpeak Interval - An Analysis of ECGs From the IQ-CSRC Study. (Pubmed Central) - Feb 4, 2021 In contrast, dolasetron and quinine, both with additional ion channel effects, prolonged QTcF with a positive C-ΔQTcF slope and predicted ΔΔQTcF effect on day 1 of 6.2 and 11.4 milliseconds, whereas the C-ΔJTpeak_c slope and the predicted ΔΔJTpeak on day 1 were negative (-0.3 and -7.5 milliseconds per ng/mL). Pure hERG-blocking drugs prolonged both the QTc and the JTpeak_c intervals, whereas drugs with mixed ion channel effects, including peak sodium inhibition, prolonged QTcF but not the JTpeak_c interval.
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[VIRTUAL] Characteristics of Baked Cheese Challenge () - Feb 3, 2021 - Abstract #AAAAI2021AAAAI_701; The other positive OFC involved pruritic rash and abdominal pain that resolved without intervention. Conclusions Among patients with CM allergy, BC is likely to be tolerated or result in only mild reactions. OFCs or home introduction should be considered for BM-tolerant children remaining allergic to CM to increase dietary consumption of CM and limit social isolation.
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[VIRTUAL] CONFUSING PAPULES: TRICHOFOLLICULOMA () - Dec 26, 2020 - Abstract #IDEA2020IDEA_47; It has been found that pluripotent skin cells undergo a failed differentiation against hair follicles.Trichofolliculoma is caused by the growth of abnormal cytokeratin 15-positive hair follicle stem cells and is confused basal cell carcinoma, dermal nevus, epidermoid cyst,trichoepithelioma and papulonecrotic tuberkulid. Bcc and trichofolliculoma can be distinguished histologically.Trichofolliculomas stain positive for CD34, while basal cell carcinoma stain negative for CD34 and BCC show more nuclear atypia, often an infiltrative growth pattern.Papulonecrotic tuberculid is characterized by chronic, symmetrical scar-healing papules and prefers acral and extensor surfaces and rarely affects the face.
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[VIRTUAL] LICHEN PLANUS DUE TO HIRUDOTHERAPY () - Dec 26, 2020 - Abstract #IDEA2020IDEA_46; Bcc and trichofolliculoma can be distinguished histologically.Trichofolliculomas stain positive for CD34, while basal cell carcinoma stain negative for CD34 and BCC show more nuclear atypia, often an infiltrative growth pattern.Papulonecrotic tuberculid is characterized by chronic, symmetrical scar-healing papules and prefers acral and extensor surfaces and rarely affects the face. As far as is known,the case of lichen planus developing with hirudotherapy has not been reported in the literature.In recent years, interest in TCM methods, including hirudotherapy, has increased.Lichen planus and similar dermatoses may be triggered after hirudotherapy and adverse side effects of hirudotherapy should always be kept in mind by dermatologists and all other physicians.
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Clinical, Journal, Real-World Evidence: Levocetirizine for the Treatment of Itch in Psoriasis Patients: An Open-label Pilot Study in a Real-world Setting. (Pubmed Central) - Nov 27, 2020 As far as is known,the case of lichen planus developing with hirudotherapy has not been reported in the literature.In recent years, interest in TCM methods, including hirudotherapy, has increased.Lichen planus and similar dermatoses may be triggered after hirudotherapy and adverse side effects of hirudotherapy should always be kept in mind by dermatologists and all other physicians. No abstract available
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[VIRTUAL] A RARE NEUROLOGICAL DISORDER MIMICKING RECURRENT ANGIOEDEMA () - Nov 21, 2020 - Abstract #ACAAI2020ACAAI_662; Antihistamine regimen of levocetirizine 5 mg daily, fexofenadine 180 mg daily and famotidine 20 mg twice daily led to slight reduction in symptom frequency, but episodes continued to occur weekly...She is currently receiving treatment with intra-lesional triamcinolone acetonide injections every 3 to 6 months.Discussion Melkersson-Rosenthal Syndrome should be considered as part of the differential for lip swelling...Some individuals also display facial palsy and/or fissured tongue. This case highlights that it is vital for Allergy/Immunology specialists to thoroughly understand the many mimics of angioedema—a condition they commonly diagnose and treat.
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[VIRTUAL] DESENSITIZATION TO INTRAVENOUS IRON FOLLOWING SEVERE ANAPHYLAXIS IN A HIGH-RISK PATIENT () - Nov 21, 2020 - Abstract #ACAAI2020ACAAI_621; IV ferumoxytol was initially administered at 2mL/hr (concentration of 0.002 mg/mL), uptitrated every 15 minutes to a final rate of 80mL/hr (concentration of 2.024 mg/mL). She received IV methylprednisolone 60mg, oral famotidine 20mg, oral cetirizine 10mg and oral montelukast 10mg prior.Conclusions Patient with severe anaphylaxis to IV iron may receive subsequent iron products through careful selection of a low osmolar iron compound, a slow desensitization protocol and a comprehensive pre-medication regimen.
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Clinical, Journal: Cardiac safety of second-generation H -antihistamines when updosed in chronic spontaneous urticaria. (Pubmed Central) - Sep 21, 2020 Blockade of these channels causes QT prolongation leading to torsade de pointes that may possibly degenerate into ventricular fibrillation and sudden death. We considered in detail bilastine, cetirizine, levocetirizine, ebastine, fexofenadine, loratadine, desloratadine, mizolastine and rupatadine and conclude that all these drugs have an excellent safety profile with no evidence of cardiotoxicity even when updosed up to four times their standard licensed dose, provided that the prescribers carefully consider and rule out potential risk factors for cardiotoxicity, such as the presence of inherited long QT syndrome, older age, cardiovascular disorders, hypokalemia and hypomagnesemia, or the use of drugs that either have direct QT prolonging effects or inhibit sgAH metabolism.
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Clinical, Journal: Antipruritic placebo effects by conditioning H1-antihistamine. (Pubmed Central) - Aug 27, 2020 Limited support was found for the efficacy of antipruritic behavioral conditioning, regardless of whether participants were informed about the conditioning procedure. The application of open-label conditioning in patient populations should be further researched.
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