But hay fever is a misnomer, said Dr. Doctors and researchers prefer the phrase allergic rhinitis to describe the condition. More than 50 million people experience some type of allergy each year, according to the Asthma and Allergy Foundation of America. In , 8. In , spring arrived early in some parts of the country and later in others, according to the National Phenology Network NPN. Spring brings blooming plants and, for some, lots of sneezing, itchy, watery eyes and runny noses.
According to NPN data, spring reared its head about two weeks early in areas of California, Nevada and many of the Southern and Southeastern states. Much of California , for example, is preparing for a brutal allergy season due to the large amount of winter rain. On the other hand, spring ranged from about one to two weeks late in the Northwest, the Midwest and the Mid-Atlantic U.
The symptoms of allergic rhinitis may at first feel like those of a cold. But unlike a cold that may incubate before causing discomfort, symptoms of allergies usually appear almost as soon as a person encounters an allergen, such as pollen or mold. Symptoms include itchy eyes, ears, nose or throat, sneezing, irritability, nasal congestion and hoarseness.
People may also experience cough, postnasal drip, sinus pressure or headaches, decreased sense of smell, snoring, sleep apnea, fatigue and asthma, Josephson said. Many of these symptoms are the immune system's overreaction as it attempts to protect the vital and sensitive respiratory system from outside invaders.
The antibodies produced by the body keep the foreign invaders out, but also cause the symptoms characteristic of allergic responses.
People can develop hay fever at any age, but most people are diagnosed with the disorder in childhood or early adulthood, according to the Mayo Clinic. Symptoms typically become less severe as people age. Often, children may first experience food allergies and eczema, or itchy skin, before developing hay fever, Josephson said. Hay fever can also lead to other medical conditions. People who are allergic to weeds are more likely to get other allergies and develop asthma as they age, Josephson said.
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But those who receive immunotherapy, such as allergy shots that help people's bodies get used to allergens, are less likely to develop asthma, he said. It was first described as a toxic reaction to phenytoin in 1.
In the following several decades, it was named as Dilantin hypersensitivity, drug-induced lymphoma, and anticonvulsant hypersensitivity syndrome 2 — 4. The clinical manifestation of DRESS ranges from mild skin rash with eosinophilia to fatal multi-organ dysfunction. The condition often has a relapsing-remitting course despite the withdrawal of drugs and is tightly associated with reactivation of various human herpes viruses, especially HHV DRESS has a reported incidence of 1 in 10,—, new drug exposure 7.
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The characteristic features of this syndrome are the late onset, eosinophilia, and multi-systemic involvement. Another distinguishing feature is the possible persistence or worsening of symptoms, despite the discontinuation of the causative drugs. Limited studies showed that administration of corticosteroid might improve the outcome of patients with DRESS.
Although most patients will survive from the acute stage of DRESS, there is still a risk of developing autoimmune diseases several weeks or months after recovery from the syndrome, such as thyroiditis, diabetes mellitus DM , and systemic lupus erythematosus SLE , etc.
Brain hardwired to respond to others’ itching
A 9-month-old boy was admitted to the pediatric intensive care unit PICU due to tachypnea and cyanosis. Paroxysmal cough and wheezing were developed 6 days prior to admission. A few hours before hospitalization, he progressed to tachypnea and dyspnea. He was previously healthy except for an allergy to cefmenoxime. On admission, the body temperature was Chest CT scan demonstrated disseminated infiltration and multiple consolidations in bilateral lung fields. Transthoracic echocardiography showed enlargement of the right ventricle and severe tricuspid regurgitation with an estimated pulmonary artery pressure of 85 mmHg.
Severe pneumonia, acute respiratory failure, and pulmonary hypertension were diagnosed. Weaning from mechanical ventilation was successfully performed 2 weeks later. On day 19 of the hospitalization, he was transferred to the pediatric general ward. On hospital day 21 general ward day 3 , itchy maculopapular rash suddenly occurred in his face, then rapidly extended to trunk and extremities in association with facial swelling.
There was no mucosal involvement.
Antihistamine drugs and systemic steroids were administered. However, the rash progressed, and fevers persisted. Jaundice, hepatomegaly, bilateral cervical lymphadenopathy, and bilateral swelling of the parotid glands were observed on hospital day Given the risk of progressing to a life-threatening condition, he was readmitted to PICU for further monitoring and management. Laboratory studies were remarkable for leukocytosis Plasma albumin and fibrinogen decreased to Coagulopathy with a prolonged prothrombin time The thrombocyte levels were normal.
Blood culture and bacteriological tests were negative. Acute liver failure was also diagnosed according to the laboratory findings. His rash and liver damage gradually improved. Two weeks after onset, the initial skin rash began to vanish, and then he developed a severe exfoliative dermatitis followed by diffuse skin pigmentation. Figure 1. Figure 2. Figure 3. During his stay in PICU, blood glucose levels were monitored every 4 h and maintained within the normal range 4.vitewhitbeschbes.ga
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On the 41st day of hospitalization, the boy was found hyperglycemic with a blood glucose level of PH value, bicarbonate and base excess were normal. Stress hyperglycemia was suspected. Despite carbohydrates restriction in the diet and eliminating glucose from intravenous infusion, the blood glucose levels peaked up to Further laboratory studies showed a remarkable low fasting serum C-peptide 0. Plasma amylase and lipase level were both normal. Thyroid function tests and antithyroglobulin antibody were normal, while antithyroid peroxidase antibody was positive Abdominal ultrasonography showed no pancreatic abnormalities.
Fulminant type 1 diabetes mellitus F1DM was confirmed. Blood glucose management was a huge challenge in the first few weeks, and the patient experienced several hypoglycemia events. Three weeks later, regular subcutaneous insulin injections of short-acting insulin analog were administered. Although the dose titration of insulin was rather tough, blood glucose levels gradually improved Figure 4.
He experienced fluctuations of cutaneous symptoms during attempts at corticosteroid tapering, and eventually discontinued prednisone therapy 2 months later. After 13 months of follow-up, the patient still requires regular subcutaneous insulin injection, and the blood glucose levels are well-controlled. Besides, he had gained in weight by about 4 kg during month follow-up. Figure 4. We gathered the clinical characteristics of diabetes mellitus DM associated with DRESS from literature published only in English language by accessing PubMed database from to A total of 16 articles and 27 related case reports were obtained between and 10 — Their characteristics are summarized in Table 1.
Specifically, this study aimed to identify the concepts most relevant to participants through concept elicitation, validate the psychometric capabilities of the arising measures and confirm their content through cognitive debriefing with patients. The study was conducted in two components Fig. In stage two of component one, an eDiary study was conducted for 2-weeks involving all 43 participants who had taken part in the CE interviews, as well as another 31 US English speaking participants 22 adults and 9 adolescents who were newly recruited for this stage.
Thus, stage two of component one had a total of 74 participants. Additional patient-reported demographic and clinician-reported health data were collected for each participant enrolled by the study recruiter at each site. The CE interviews were conducted in-person by a trained interviewer using a semi-structured discussion guide.
The interviewer initially asked open-ended questions designed to elicit spontaneous discussion, which were then followed by in-depth probing around the concepts of interest. Interviews were conducted at a convenient location for the participant and lasted approximately 1 h. Following the concept elicitation, two point NRS items were developed, each with a h recall period.
For the daily eDiary stage, all participants received training on how to use the daily eDiary. The 7-day recall questionnaires were programmed for completion on Days 0, 7, and 14 of the 2-week period.