Urticaria and Angioedema

2021 ◽  
Author(s):  
Justin R Chen ◽  
David A. Khan
Keyword(s):  
Chronic Urticaria ◽  
Treatment Approach ◽  
Diagnostic Algorithm ◽  
Acquired Angioedema ◽  
Emerging Therapies ◽  
The Face ◽  
Life Threatening ◽  
Superficial Dermis ◽  
Difficult Cases

Urticaria and angioedema are common diseases with diverse origins that constitute a substantial component of medical practice. Urticaria, or hives, refers to one or more areas of intensely pruritic papules or plaques with swelling of the superficial dermis (wheal) surrounded by local erythema (flare). Angioedema refers to deep dermal subcutaneous swelling that may manifest as swelling of the mucosa of the face, tongue, pharynx, larynx, or intestines that can be alarming and, in some cases, life threatening. These conditions are heterogeneous in their presentation and chronicity. Although allergies are responsible for some cases, autoimmunity and dysregulation of the bradykinin system often play a significant role, leading to challenging diagnostic and therapeutic dilemmas. This review discusses the epidemiology, natural history, pathophysiology, diagnosis, and treatment of acute and chronic urticaria and angioedema. Emphasis is placed on physical triggers, the role of proper laboratory testing, and alternative agents for refractory cases. Emerging therapies for hereditary and acquired angioedema syndromes are also covered. Tables list the causes of acute and chronic urticaria, an escalating treatment approach for difficult cases, and a comparison of available parenteral therapies specific to bradykinin-mediated angioedema. Figures illustrate the mechanisms of urticaria, photographs of typical presentations, and an evidence-based diagnostic algorithm for clinicians.  This review contains 9 figures, 8 tables, and 104 references.

Urticaria and Angioedema

2021 ◽  
Author(s):  
Justin R Chen ◽  
David A. Khan
Keyword(s):  
Chronic Urticaria ◽  
Treatment Approach ◽  
Diagnostic Algorithm ◽  
Acquired Angioedema ◽  
Emerging Therapies ◽  
The Face ◽  
Life Threatening ◽  
Superficial Dermis ◽  
Difficult Cases

Urticaria and angioedema are common diseases with diverse origins that constitute a substantial component of medical practice. Urticaria, or hives, refers to one or more areas of intensely pruritic papules or plaques with swelling of the superficial dermis (wheal) surrounded by local erythema (flare). Angioedema refers to deep dermal subcutaneous swelling that may manifest as swelling of the mucosa of the face, tongue, pharynx, larynx, or intestines that can be alarming and, in some cases, life threatening. These conditions are heterogeneous in their presentation and chronicity. Although allergies are responsible for some cases, autoimmunity and dysregulation of the bradykinin system often play a significant role, leading to challenging diagnostic and therapeutic dilemmas. This review discusses the epidemiology, natural history, pathophysiology, diagnosis, and treatment of acute and chronic urticaria and angioedema. Emphasis is placed on physical triggers, the role of proper laboratory testing, and alternative agents for refractory cases. Emerging therapies for hereditary and acquired angioedema syndromes are also covered. Tables list the causes of acute and chronic urticaria, an escalating treatment approach for difficult cases, and a comparison of available parenteral therapies specific to bradykinin-mediated angioedema. Figures illustrate the mechanisms of urticaria, photographs of typical presentations, and an evidence-based diagnostic algorithm for clinicians.  This review contains 9 figures, 8 tables, and 104 references.

Urticaria and Angioedema

2017 ◽  
Author(s):  
Justin R Chen ◽  
David A. Khan
Keyword(s):  
Chronic Urticaria ◽  
Treatment Approach ◽  
Diagnostic Algorithm ◽  
Acquired Angioedema ◽  
Emerging Therapies ◽  
The Face ◽  
Life Threatening ◽  
Superficial Dermis ◽  
Difficult Cases

Urticaria and angioedema are common diseases with diverse origins that constitute a substantial component of medical practice. Urticaria, or hives, refers to one or more areas of intensely pruritic papules or plaques with swelling of the superficial dermis (wheal) surrounded by local erythema (flare). Angioedema refers to deep dermal subcutaneous swelling that may manifest as swelling of the mucosa of the face, tongue, pharynx, larynx, or intestines that can be alarming and, in some cases, life threatening. These conditions are heterogeneous in their presentation and chronicity. Although allergies are responsible for some cases, autoimmunity and dysregulation of the bradykinin system often play a significant role, leading to challenging diagnostic and therapeutic dilemmas. This review discusses the epidemiology, natural history, pathophysiology, diagnosis, and treatment of acute and chronic urticaria and angioedema. Emphasis is placed on physical triggers, the role of proper laboratory testing, and alternative agents for refractory cases. Emerging therapies for hereditary and acquired angioedema syndromes are also covered. Tables list the causes of acute and chronic urticaria, an escalating treatment approach for difficult cases, and a comparison of available parenteral therapies specific to bradykinin-mediated angioedema. Figures illustrate the mechanisms of urticaria, photographs of typical presentations, and an evidence-based diagnostic algorithm for clinicians.    This review contains 9 highly rendered figures, 5 tables, and 100 references.

Cyclophosphamide, methotrexate, and fluorouracil with and without doxorubicin in the adjuvant treatment of resectable breast cancer with one to three positive axillary nodes.

1991 ◽  
Vol 9 (7) ◽  
pp. 1124-1130 ◽  
Author(s):  
A Moliterni ◽  
G Bonadonna ◽  
P Valagussa ◽  
L Ferrari ◽  
M Zambetti
Keyword(s):  
Randomized Study ◽  
Menopausal Status ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Treatment Groups ◽  
The Face ◽  
Life Threatening ◽  
Drug Treatments

In the attempt to improve current adjuvant results in patients with one to three positive axillary lymph nodes, in November 1981 we activated a prospective randomized study to assess the effectiveness of intravenous (IV) cyclophosphamide, methotrexate, and fluorouracil (CMF) for 12 courses versus CMF for eight courses followed by Adriamycin (doxorubicin; Farmitalia Carlo Erba, Milan, Italy) for four courses. The 5-year results were evaluated in a total of 486 patients entered into the study up to December 1987. CMF chemotherapy was delivered IV for a total of 12 courses when given alone and for eight courses when followed by four courses of Adriamycin. All drugs were recycled every 3 weeks. Rather than temporarily reducing doses, drug administration was delayed for 1 to 2 weeks in the face of myelosuppression on the planned day of treatment. After a median follow-up of 61 months, no significant differences were evident between the treatment groups in terms of relapse-free (CMF 74% v CMF followed by Adriamycin 72%) and total survival (CMF 89% v CMF followed by Adriamycin 86%). Drug treatments were fairly well tolerated and devoid of life-threatening toxicity. Present results, which were not influenced by menopausal status, indicate that Adriamycin given after CMF failed to improve treatment outcome over CMF alone. However, the role of Adriamycin in an adjuvant setting remains to be further clarified. Considering the good 5-year results achieved in this study at the expense of minimal toxicity, full-dose CMF remains, at present, the adjuvant chemotherapy of choice for patients with one to three positive nodes.

scholarly journals Angioedema, a life-threatening adverse reaction to ACE-inhibitors

2019 ◽  
Vol 9 (36) ◽  
pp. 177-181
Author(s):  
Ramona Ungureanu ◽  
Elena Madalan
Keyword(s):  
Ace Inhibitors ◽  
Neck Region ◽  
Diagnostic Algorithm ◽  
Converting Enzyme ◽  
Drug Induced ◽  
Head And Neck Region ◽  
Specific Diagnosis ◽  
Frequent Form ◽  
The Face ◽  
Life Threatening

Abstract Angioedema with life-threatening site is one of the most impressive and serious reasons for presenting to the ENT doctor. Among different causes (tumors, local infections, allergy reactions), an important cause is the side-effect of the angiotensin converting enzyme (ACE) inhibitors drugs. ACE-inhibitors-induced angioedema is described to be the most frequent form of bradykinin-mediated angioedema presented in emergency and also one of the most encountered drug-induced angioedema. The edema can involve one or more areas of the head and neck region, the most affected being the face, the lips, the tongue, followed by the larynx, when it may determine respiratory distress and even death. There are no specific diagnosis tests available and the positive diagnosis of ACE-inhibitors-induced angioedema is an exclusion diagnosis. The authors performed a review of the most important characteristics of the angioedema caused by ACE-inhibitors and present their experience emphasizing the diagnostic algorithm.

Palliative medicine: Historical record and challenges that remain

2016 ◽  
Author(s):  
David Clark
Keyword(s):  
Palliative Care ◽  
Palliative Medicine ◽  
Evidence Base ◽  
Central Place ◽  
Historical Record ◽  
Life Threatening Illness ◽  
The Face ◽  
Life Threatening ◽  
Global Coverage

With its growing recognition by the early decades of the twentieth century, palliative medicine was moving from the margins to a more central place within medicine. Much had been achieved and there was growing evidence of palliative care’s successes around the world. At the same time, there were ongoing concerns about the quality of the evidence base to support its practices. There were questions about the relationship between palliative care and end-of-life care. There was also the challenge of delivering good care to all who might need it in the face of serious and life-threatening illness in an era of population growth and ageing. There seemed to be many ways to conceptualize and deliver palliative care. Would this lead to global coverage and spread, and what would be the particular role of palliative medicine within the process? This chapter concludes with reflections on progress to date and challenges for the future.

Questions on the role of biofilms for the adaptation of microorganisms to unfavorable environmental factors by the example of P. aeruginosa

2020 ◽  
Vol 99 (4) ◽  
pp. 379-383
Author(s):  
Vasily N. Afonyushkin ◽  
N. A. Donchenko ◽  
Ju. N. Kozlova ◽  
N. A. Davidova ◽  
V. Yu. Koptev ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Environmental Factors ◽  
Barrier Function ◽  
Infectious Agent ◽  
Antagonistic Activity ◽  
The Body ◽  
Main Function ◽  
Pathogenic Potential ◽  
The Face

Pseudomonas aeruginosa is a widely represented species of bacteria possessing of a pathogenic potential. This infectious agent is causing wound infections, fibrotic cystitis, fibrosing pneumonia, bacterial sepsis, etc. The microorganism is highly resistant to antiseptics, disinfectants, immune system responses of the body. The responses of a quorum sense of this kind of bacteria ensure the inclusion of many pathogenicity factors. The analysis of the scientific literature made it possible to formulate four questions concerning the role of biofilms for the adaptation of P. aeruginosa to adverse environmental factors: Is another person appears to be predominantly of a source an etiological agent or the source of P. aeruginosa infection in the environment? Does the formation of biofilms influence on the antibiotic resistance? How the antagonistic activity of microorganisms is realized in biofilm form? What is the main function of biofilms in the functioning of bacteria? A hypothesis has been put forward the effect of biofilms on the increase of antibiotic resistance of bacteria and, in particular, P. aeruginosa to be secondary in charcter. It is more likely a biofilmboth to fulfill the function of storing nutrients and provide topical competition in the face of food scarcity. In connection with the incompatibility of the molecular radii of most antibiotics and pores in biofilm, biofilm is doubtful to be capable of performing a barrier function for protecting against antibiotics. However, with respect to antibodies and immunocompetent cells, the barrier function is beyond doubt. The biofilm is more likely to fulfill the function of storing nutrients and providing topical competition in conditions of scarcity of food resources.

The Modern Aristotle: Michael Polanyi’s Search for Truth against Nihilism

2018 ◽  
Author(s):  
Ronald Hoinski ◽  
Ronald Polansky
Keyword(s):  
Philosophy Of Science ◽  
Modern Science ◽  
Michael Polanyi ◽  
Contemporary Philosophy ◽  
The Face ◽  
Human Desire ◽  
The Mind ◽  
Theoretical Science

David Hoinski and Ronald Polansky’s “The Modern Aristotle: Michael Polanyi’s Search for Truth against Nihilism” shows how the general tendencies of contemporary philosophy of science disclose a return to the Aristotelian emphasis on both the formation of dispositions to know and the role of the mind in theoretical science. Focusing on a comparison of Michael Polanyi and Aristotle, Hoinski and Polansky investigate to what degree Aristotelian thought retains its purchase on reality in the face of the changes wrought by modern science. Polanyi’s approach relies on several Aristotelian assumptions, including the naturalness of the human desire to know, the institutional and personal basis for the accumulation of knowledge, and the endorsement of realism against objectivism. Hoinski and Polansky emphasize the promise of Polanyi’s neo-Aristotelian framework, which argues that science is won through reflection on reality.

Expansion of borders in the Kurdistan region and local and regional positions

2019 ◽  
Vol 3 (11) ◽  
pp. 1
Author(s):  
Harith Qahtan Abdullah ◽  
Abbas Fadel Atwan
Keyword(s):  
Middle East ◽  
Central Government ◽  
Kurdistan Region ◽  
War On Terrorism ◽  
National State ◽  
The Face ◽  
In The Beginning

The borders of Kurdistan represent an important point in Kurdish thought. They represent the hope of establishing their national state. The circumstances of the war on terrorism in Iraq and Syria have led to the emergence of what is known as a "propaganda" and the formation of a global front in its struggle. And with the signs of the collapse of the Syrian state and the weakness of the Iraqi state in the face of the "dashing" in the beginning. These circumstances led to the emergence of the role of the Kurdistan region in the confrontation "ISIS" and maintain the administrative border in the three provinces of Kurdistan in addition to the province of Kirkuk. That the circumstances of the war on terrorism created new international conditions on the Middle East arena, which will generate many problems between the Kurdistan region and the central government of Baghdad, as well as other problems between the region, Syria, Turkey and Iran. The war on terrorism has made countries free to fight the opposition groups under the name Terrorism by their classification. The Turkish side is fighting the PKK within the borders of the Kurdistan region, and this war can develop in a post-"warlike" phase. The war in Syria is also contradictory to vision and not resolved to a specific side and Iran's position on developments is encouraging.

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