Severity Of Allergic Rhinitis Symptoms Research Articles

Skin prick test reactivity to common aeroallergens and ARIA classification of allergic rhinitis in patients of Central Greece

Allergic rhinitis (AR) is prevalent in Mediterranean countries, but there are no epidemiological studies in the Hellenic milieu in accordance with the recent ARIA guidelines. We investigated aetiological aeroallergens in AR patients of Central Greece using the ARIA classification. Between 2002 and 2006, 911 patients with rhinitis symptomatology were interviewed and underwent Skin prick testing and 623 completed the study. Seasonal rhinitis (SAR) represented 37.6%, Perennial rhinitis (PAR) 46.4% and SAR + PAR 16%. Intermittent mild and moderate/severe AR was evident in 9.3 and 24.5%, persistent mild and moderate/severe in 23.2 and 43.0%. Persistent AR appeared in overall 66.2% of patients and was prevalent in PAR and SAR + PAR (p < 0.0001). Severity of AR symptoms did not correlate more with ARIA than with the traditional subgroups. Marked statistical (p < 0.05) differences were evident for seven aeroallergens between the four geographic areas of the study. Pollen allergy was found in 77.8% but all pollens were significantly lower in coastal areas (p < 0.001), besides Parietaria (p < 0.003). Mite sensitivity manifested in 43.2%. Alternaria affected mostly the paediatric population (p < 0.0001). 12.4% (N = 77) was monosensitive, 58.7% (N = 366) oligosensitive, and 28.9% (N = 180) polysensitive. Rhinitis and asthma comorbidity was high (45.3%) and occurrence of asthma was related with PAR (p < 0.007) and SAR + PAR (p < 0.023) but not with the ARIA classification subgroups. This study provides compelling evidence of a typical Mediterranean allergic profile of patients of Central Greece with significant regional variability. Both classifications had approximately equal diagnostic value in our study besides the fact that ARIA subdivision is considered superior in determining treatment.

The voice of the patients: allergic rhinitis is not a trivial disease

Patient and physician perspectives on the impact of allergic rhinitis have previously been studied in the general population. We evaluated the burden of allergic rhinitis among patients from the members of European allergy patient organizations. The Patient Voice Allergy Survey was a quantitative, self-completion survey of 3562 patients with allergic rhinitis (16 years and older). Background information on allergic rhinitis, severity of allergic rhinitis symptoms and their impact on lives, nonmedical measures for relieving of symptoms, types of medications, and concomitant conditions were evaluated. Almost 50% of the responders reported symptoms lasting for more than a season. Preventive household adjustments are expensive with little perceived benefit. Sleep and emotional life are affected by allergic rhinitis. Most patients are satisfied with the current allergic rhinitis medications; at least one-fifth report dissatisfaction. Patients perceive that allergic rhinitis worsens other concomitant allergic diseases. Future management guidelines for allergic rhinitis must take into account the results of this survey. Such guidelines must promote relief from the emotional burden of allergic rhinitis and from the negative impact on daily activities, encourage patient education, and maintain and build on the strong partnership between patients and healthcare professionals.

Findings from a 1000-patient internet-based survey assessing the impact of morning symptoms on individuals with allergic rhinitis

Background: Although the severity of allergic rhinitis symptoms might depend on the degree of exposure to the triggering allergen, it has also been noted that symptom severity varies over the course of the day. Objectives: The aims of this study were to investigate the reported impact (influence on behavior and/or feelings) of morning symptoms on individuals with allergic rhinitis and determine their perception of the effectiveness of allergy treatment. Methods: In January 2005, online interviews basedon a 16-item questionnaire were presented to adults (aged ≥18 years) with physician-diagnosed allergic rhinitis in the United States. Participants were recruited from the Roper Public Affairs and Media US national online panel. The survey sample was balanced to reflect the US population by Census Division, ethnicity, sex, and presence of children living at home. Data were weighted by sex (65% female, 35% male) based on previous research of the adult population suffering from allergies. Results: The first 1000 respondents (sex, female,550 [55%]; age, ≥55 years, 378 [38%], race, white, 883 [88%]) that met all inclusion/exclusion criteria were included in the study results. There was no significant difference in the regional distribution of participants: South (34%), Midwest (25%), West (22%), and Northeast (19%). The majority of the sample (83%) reported experiencing morning symptoms of allergic rhinitis; 49% reported that their symptoms were most severe during the morning hours. The most common symptom on awakening was nasal congestion, reported by 85% of those with symptoms when they first woke tip. Of those with symptoms on awakening, the majority reported that these affected their feelings (96`/0) or behavior (87%). Among respondents who experienced symptoms on awakening, the majority reported that their symptoms affected the rest of their day “somewhat” or ”a great deal” (51% and 24%, respectively). Of those respondents using allergy medication, 33% reported that its effectiveness wore off before the next dose most or all of the time. A majority of respondents reported feeling that it was very important for an allergy medication to maintain effectiveness until the next dose (68%), provide relief all day and into the next morning (62%), and enable them to wake tip with their symptoms render control (63%). Conclusions: Based on the results from this largeInternet-based survey, the morning symptoms of allergic rhinitis have a negative impact on individuals, both emotionally and in terms of disruption of daily activities. Medication used for treating allergic rhinitis was reported as not always effective for the whole time interval between doses. This suggests that it might be important, when considering management options in allergic rhinitis, to select medications that offer sustained effectiveness throughout the 24-hour period.

Apakah terapi pengendalian plak dapat menurunkan keparahan rinitis alergika pada anak? (Does oral plaque control therapy reduce severity of allergic rhinitis in children?)

Allergic rhinitis is one of the most common ailments in children. In clinical practice approximately 50% of patients with symptoms of rhinitis are diagnosed with non-allergic rhinitis. Positive skin prick test or specific IgE in vitro tests that are relevant to aeroallergens are conclusive diagnostic of allergic rhinitis. However, simple diagnostic method such as sneezing sign has already proved to be reliable. Hypersensitive children have humoral immune system (Th2) which release inflammatory factors in the presence of allergen or infection that contribute to allergic response. Immunological reactions occurred and antibodies concentration arise, especially specific IgE instead of IgG because of the isotype switching. A lot of procedures such as allergen avoidance, medication and immunotherapy were done in allergic rhinitis management. However, oral plaque controls were not the point of interest in this case. The aim of this study is to find out the effectiveness of oral plaque control in the reduction of severity of allergic rhinitis symptoms using symptom scores. Fifty children, male and female aged 8–14 years, subjective diagnosed as allergic rhinitis using sneezing sign were included in this study. Oral plaque control procedures were done by polishing and flossing followed by 4 days of gargling with 1% povidone iodine. Clinical result showed that after 3 days, oral plaque control 2.925 times more effective than control group. The conclusion was oral plaque control is effective reducing the severity of allergic rhinitis symptoms.

Preliminary criteria for the definition of allergic rhinitis: a systematic evaluation of clinical parameters in a disease cohort (I).

The aim of this study is to formulate criteria for the definition of allergic rhinitis. Other studies have sought to develop scoring systems to categorize the severity of allergic rhinitis symptoms but it was never used for the formulation of diagnostic criteria. These other scoring systems were arbitrarily chosen and were not derived by any statistical analysis. To date, a study of this kind has not been performed. The hypothesis of this study is that it is possible to formulate criteria for the definition of allergic rhinitis. This is the first study to systematically examine and evaluate the relative importance of symptoms, signs and investigative tests in allergic rhinitis. We sought to statistically rank, from the most to the least important, the multiplicity of symptoms, signs and test results. Forty-seven allergic rhinitis and 23 normal subjects were evaluated with a detailed questionnaire and history, physical examination, serum total immunoglobulin E, skin prick tests and serum enzyme allergosorbent tests (EAST). Statistical ranking of variables indicated rhinitis symptoms (nasal, ocular and oronasal) were the most commonly occurring, followed by a history of allergen provocation, then serum total IgE, positive skin prick tests and positive EAST's to house dust mite, perennial rye and bermuda/couch grass. Throat symptoms ranked even lower whilst EAST's to cat epithelia, plantain and cockroach were the least important. Not all symptoms, signs and tests evaluated proved to be statistically significant when compared to a control group; this included symtoms and signs which had been considered historically to be traditionally associated with allergic rhinitis, e.g. sore throat and bleeding nose. In performing statistical analyses, we were able to rank from most to least important, the multiplicity of symptoms signs and test results. The most important symptoms and signs were identified for the first time, even though some of these were not included in our original selection criteria for defining the disease cohort i.e. sniffing, postnasal drip, oedematous nasal mucosa, impaired sense of smell, mouth breathing, itchy nose and many of the specific provocation factors.

Nasal Histamine Reactivity; Relationships to Skin-test Responses, Allergen Provocation and Symptom Severity in Patients with Long-continuing Allergic Rhinitis

It has been reported that skin-test reactivity and rhinitis symptom severity weaken in the course of time. A corresponding weakening might also be seen in non-specific nasal hyper-reactivity, but the relationships of these responses are poorly understood. Our aim was to measure nasal responsiveness to histamine in a series of patients with long-continuing allergic rhinitis and to compare these measurements with skin test responses, allergen provocation and changes in severity of allergic rhinitis symptoms. A total of 73 patients in whom allergic rhinitis had been verified over 20 years earlier were re-interviewed and re-investigated. Skin prick tests with common allergens were performed and the presence of nasal allergy was confirmed by allergen provocation. Non-specific nasal hyper-reactivity was determined with nasal histamine challenge using four concentrations of histamine phosphate. The response was registered by counting sneezes, recording changes in nasal discharge and mucosal swelling and measuring nasal airway resistance. Sneezing and discharge scores showed that milder non-specific nasal hyper-reactivity was associated with lack of reactivity in skin prick tests and nasal allergen challenge. No association was observed between allergy test results and changes in nasal airway resistance during the histamine provocation. In most patients the symptoms of rhinitis had become milder or disappeared during the follow-up, but the results of the histamine challenge showed no relationship with the changes in symptom severity. In patients with allergic rhinitis, reactivity to histamine is associated with a concomitant change in skin and nasal mucosal reactivity to allergens.