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Impact de l’asthme sur le travail : une revue de la littérature 哮喘对工作的影响:文献综述
IF 0.3 4区 医学 Pub Date : 2024-11-27 DOI: 10.1016/j.reval.2024.104195
J. Subocz , T. Stoup , N. Just , C. Chenivesse
Asthma is a very common disease affecting young people in the age of working and therefore represents one of the leading diseases impacting occupational activity. Health condition of employees suffering from asthma is responsible for work productivity loss, through absenteeism and presenteeism, resulting among other things in significant indirect costs. Although only 10% of workers with asthma report asthma-related missing days of work throughout their live, mostly evoke a presenteeism (work attendance whereas work absence would be justified by health status). Severity and even more asthma control are the major determinants of asthma impact on work productivity. Improving asthma control through proper treatment leads to improved work productivity and reduced asthma-related costs. In severe asthma, biologics seem to reduce absenteeism but there is limited data about their effect on presenteeism.
哮喘是影响工作年龄段年轻人的一种非常常见的疾病,因此也是影响职业活动的主要疾病之一。哮喘病患者的健康状况会通过旷工和缺勤造成工作效率下降,从而产生大量间接成本。虽然只有 10%的哮喘病人报告说,在他们的一生中,因哮喘而缺勤的天数最多,但大多数人都是旷工(因健康状况而缺勤)。哮喘的严重程度以及哮喘的控制是哮喘影响工作效率的主要决定因素。通过适当的治疗改善哮喘控制,可提高工作效率,降低与哮喘相关的成本。对于严重的哮喘,生物制剂似乎可以减少缺勤,但有关其对缺勤的影响的数据却很有限。
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引用次数: 0
Commentaire méthodologique sur les recommandations EAACI sur le diagnostic des allergies alimentaires IgE-médiées : est-ce la fin du TPO et l’essor du TAB ? 关于 IgE 介导的食物过敏诊断的 EAACI 建议的方法论评论:这是否是 TPO 的终结和 TAB 的崛起?
IF 0.3 4区 医学 Pub Date : 2024-11-27 DOI: 10.1016/j.reval.2024.104180
J. Goret , C. Klingebiel
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引用次数: 0
Stratégies ciblant la peau en prévention des allergies alimentaires 针对皮肤预防食物过敏的策略
IF 0.3 4区 医学 Pub Date : 2024-11-26 DOI: 10.1016/j.reval.2024.104192
C. Braun , P. Bégin , A. Nosbaum
The strategy for preventing food allergies (FA) based on the early introduction of solid allergens appears insufficient, given the increasing incidence of FA despite changes in recommendations. The complementary strategy aimed at restoring the skin barrier by applying emollients has been studied for several years. Clinical studies evaluating the effectiveness of such strategy provided conflicting results, but the study protocols are highly heterogeneous: some emollients used are actually harmful to the skin barrier, while the frequency or area of application may be insufficient to have a positive impact on the skin barrier. These studies suggest that the application of an emollient with an acidic pH (around 5.5) and ideally ceramide-based would be beneficial in the primary prevention of FA. Additionally, it is important to avoid cosmetic products containing allergens, including food derivatives. These few simple advices can already be provided by primary care physicians.
预防食物过敏(FA)的策略是及早引入固体过敏原,尽管建议有所改变,但鉴于食物过敏的发病率仍在上升,这一策略似乎还不够。通过涂抹润肤剂来恢复皮肤屏障的补充策略已经研究了数年。评估这种策略有效性的临床研究提供了相互矛盾的结果,但研究方案差异很大:有些润肤剂实际上对皮肤屏障有害,而涂抹的频率或面积可能不足以对皮肤屏障产生积极影响。这些研究表明,使用酸性 pH 值(约 5.5)的润肤剂(最好是神经酰胺类)将有利于 FA 的一级预防。此外,避免使用含有过敏原(包括食品衍生物)的化妆品也很重要。这些简单的建议已经可以由初级保健医生提供。
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引用次数: 0
Histoire naturelle des allergies alimentaires non IgE-médiées 非 IgE 介导的食物过敏自然史
IF 0.3 4区 医学 Pub Date : 2024-11-09 DOI: 10.1016/j.reval.2024.104174
A. Lemoine , S. Bamberger
Non-IgE-mediated food allergies are adverse immune reactions to certain food allergens that are specific for a given individual, but do not involve specific serum IgE antibodies. They mainly affect infants and young children. They include allergic proctocolitis, food protein-induced enterocolis syndrome (FPIES), allergic enteropathy, aspecific digestive dysmotility (e.g., severe reflux, constipation) and certain eosinophilic oesophagitis (EoE) responding to the avoidance diet. The most common allergen involved is cow's milk, but other foods may be responsible, particularly in breast-fed infants, although this is rare. The main symptoms are haematochezia in allergic proctocolitis, acute vomiting with pallor and hypotonia in FPIES, stunted growth and chronic diarrhoea in allergic enteropathy, and reflux with feeding difficulties in infantile EoE. Eviction-reintroduction of the suspected allergen is used as a diagnostic test in allergic proctocolitis and enteropathy. In FPIES, there is a clinical definition. For EoE, histological analysis of oesophageal biopsies makes the diagnosis after elimination of differential diagnoses. Treatment involves avoiding the allergen responsible until tolerance is acquired. With the exception of EoE, the course of the disease is favourable in the first 2–3 years of life. There is a risk of developing functional intestinal disorders and atopic diseases. EoE is a chronic disease, with possible cases of remission in paediatrics. The main complications are oesophageal stenosis, food impaction and oesophageal perforation.
非 IgE 介导的食物过敏是指对某些食物过敏原产生的不良免疫反应,这种反应对特定个体具有特异性,但不涉及特异性血清 IgE 抗体。它们主要影响婴幼儿。它们包括过敏性直肠结肠炎、食物蛋白诱发肠结肠综合征(FPIES)、过敏性肠病、特异性消化道运动障碍(如严重反流、便秘)以及某些嗜酸性粒细胞性食道炎(EoE),这些病症都会对忌口饮食产生反应。最常见的过敏原是牛奶,但其他食物也可能是诱因,尤其是母乳喂养的婴儿,不过这种情况很少见。主要症状包括:过敏性直肠结肠炎的血性便秘、急性呕吐伴面色苍白和肌张力低下(FPIES)、过敏性肠病的发育迟缓和慢性腹泻,以及婴儿肠易激综合征的反流和喂养困难。在过敏性直肠结肠炎和肠病的诊断试验中,可采用驱逐-再引入可疑过敏原的方法。FPIES 有临床定义。对于肠易激综合征,食道活检组织学分析可在排除鉴别诊断后做出诊断。治疗包括避免接触致病过敏原,直到获得耐受性。除咽喉炎外,该病在出生后的头 2-3 年病程较长。但有患功能性肠病和特应性疾病的风险。肠易激综合征是一种慢性疾病,在儿科有可能缓解。主要并发症是食道狭窄、食物嵌塞和食道穿孔。
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引用次数: 0
L’allergie au cannabis et les syndromes de réactivité croisée : une feuille de route pour un diagnostic et une prise en charge corrects 大麻过敏和交叉反应综合征:正确诊断和管理路线图
IF 0.3 4区 医学 Pub Date : 2024-11-05 DOI: 10.1016/j.reval.2024.104176
D.G. Ebo , A. Toscano , H.-P. Rihs , C. Mertens , V. Sabato , J. Elst , M. Beyens , M.M. Hagendorens , M. Van Houdt , A.L. Van Gasse
With the expansion of access to cannabis and the decriminalization of its use, cases of IgE-dependent cannabis allergy and cannabis-associated food syndromes have been increasingly reported. However, the exact prevalence of cannabis allergy and associated cross-reactivity syndromes remains unknown and is likely to be underestimated due to a lack of awareness and knowledge of the subject among healthcare professionals. This practical roadmap therefore aims to familiarize readers with the early recognition and correct management of cannabis-related IgE-dependent allergies. The aim is to understand the mechanisms underlying these cross-reactivity syndromes and to enable personalised diagnosis and management. Although there are as yet no commercially available molecular cannabis allergens, a more personalized approach can be achieved by using homologs and the recombinant Can s 3 (non-specific lipid transfer protein) available as a research allergen. The predominant symptoms of cannabis allergy are rhinoconjunctivitis and contact urticaria/angioedema, but severe life-threatening anaphylaxis is also possible, as well as cross-food allergy syndromes, mainly involving fruit, vegetables, nuts and cereals. At present, diagnosis generally begins with prick tests using buds, leaves or seeds of the cannabis plant. The road to a clear understanding of food allergy and the cross-reactive food syndromes associated with it is still long and winding, but it deserves to be explored further.
随着大麻使用范围的扩大和大麻使用的非刑罪化,IgE 依赖性大麻过敏和大麻相关食物综合征病例的报道越来越多。然而,大麻过敏和相关交叉反应综合征的确切发病率仍是未知数,而且由于医护人员对这一问题缺乏认识和了解,其发病率很可能被低估。因此,本实用指南旨在让读者了解如何早期识别和正确处理与大麻相关的 IgE 依赖性过敏。其目的是了解这些交叉反应综合征的内在机制,实现个性化诊断和管理。虽然目前还没有商业化的分子大麻过敏原,但通过使用同源物和作为研究过敏原的重组 Can s 3(非特异性脂质转移蛋白),可以实现更加个性化的方法。大麻过敏的主要症状是鼻结膜炎和接触性荨麻疹/水肿,但也可能出现危及生命的严重过敏性休克,以及交叉食物过敏综合征,主要涉及水果、蔬菜、坚果和谷物。目前,诊断一般从使用大麻植物的花蕾、叶子或种子进行点刺试验开始。要清楚地了解食物过敏和与之相关的交叉反应食物综合症,道路依然漫长而曲折,但值得我们进一步探索。
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引用次数: 0
IgE-mediated hypersensitivity to clavulanic acid, a rare pediatric condition? IgE 介导的克拉维酸过敏症,一种罕见的儿科疾病?
IF 0.3 4区 医学 Pub Date : 2024-11-01 DOI: 10.1016/j.reval.2024.104177
S. Aminou, S. Benchekroun, N. El Hafidi, C. Mahraoui
Selective hypersensitivity to clavulanic acid is continuously increasing in recent decades due to the increase in its consumption. The allergological work-up is complex, mainly based on clinical history, followed by skin testing, and drug provocation test. The low sensitivity of in vitro tests is explained by the fact that clavulanic acid is highly metabolised into different products, with heterogeneous immunogenicities, being only some of them optimally recognised by the immune system. We report the case of a young girl who received one tablet of amoxicillin-clavulanic acid and developed immediate anaphylaxis, although she had previously tolerated amoxicillin. Immediate-reading skin tests performed with amoxicillin and cephalosporins were negative. A selective allergy to clavulanic acid was diagnosed by a positive response in skin tests with amoxicillin-clavulanic acid and tolerance of a provocation test with amoxicillin. No cross-reactivity was recorded between clavulanic acid and others beta-lactams.
近几十年来,由于克拉维酸消费量的增加,对克拉维酸选择性过敏的患者不断增多。过敏学检查非常复杂,主要以临床病史为基础,然后进行皮肤测试和药物激发试验。体外试验灵敏度低的原因是克拉维酸被高度代谢成不同的产物,具有不同的免疫原性,只有其中一些能被免疫系统识别。我们报告了一个年轻女孩的病例,她服用了一片阿莫西林-克拉维酸后,立即出现了过敏性休克,尽管她以前可以耐受阿莫西林。用阿莫西林和头孢菌素进行的皮试结果均为阴性。阿莫西林-克拉维酸皮试呈阳性反应,且能耐受阿莫西林激惹试验,因此被诊断为对克拉维酸选择性过敏。克拉维酸与其他β-内酰胺类药物之间没有交叉反应。
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引用次数: 0
Remerciements aux relecteurs 感谢审稿人
IF 0.3 4区 医学 Pub Date : 2024-11-01 DOI: 10.1016/S1877-0320(24)00411-1
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引用次数: 0
En 2024, bien accueillir un enfant allergique en restauration scolaire 2024 年,为过敏儿童提供餐饮服务
IF 0.3 4区 医学 Pub Date : 2024-10-30 DOI: 10.1016/j.reval.2024.104173
G. Pouessel , P. Beaumont , E. Capelli , V. Cordebar , P. Couratier , A. Deschildre , A. Doc , S. Dufay , S. Glasson , V. Grandjean-Ceccon , C. Huss , A. Jonquières , L. Lepigeon , M. Lorenzi , B. Moltrecht , G. Perole , J.-M. Rame , N. Tajan , A.-L. Vincent , C. Lapeyre-Santos
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引用次数: 0
Rhinite allergique de l’enfant : étude clinique et évaluation de la qualité de vie avant et après traitement selon l’âge 儿童过敏性鼻炎:临床研究和根据年龄评估治疗前后的生活质量
IF 0.3 4区 医学 Pub Date : 2024-10-30 DOI: 10.1016/j.reval.2024.104175
S. Mezri , C. Ben Ammar , S. Mhamdi , A. Khemaies

Aim

This study aims to investigate the characteristics of allergic rhinitis in children and evaluate the impact of treatment on their quality of life, stratified by age.

Methods

A prospective descriptive study was conducted on children aged 4 to 16 years who were diagnosed with allergic rhinitis for the first time at the beginning of the study. The study population was divided into two age groups: group 1 (4–12 years) and group 2 (12–16 years). The quality of life before and after 6 months of treatment was assessed using the Juniper Allergic Rhinoconjunctivitis Quality of Life Test (RQLQ) and the ARIA classification as endpoints.

Results

The study included 100 patients, 58 of whom were male, with a mean age of 9 ± 3.3 years. Prior to treatment, 79 children had an overall score of 4 or higher, indicating they were “rather to extremely annoyed”. Children in group 1 reported nasal discomfort as their main complaint, with a score of 5.05 indicating they were “very annoyed”. Children in group 2 reported emotional impact as their main complaint, with a mean score of 4.54 indicating they were “rather to very annoyed”. Children with asthma had a higher RQLQ score than those without (P < 0.0001). Following six months of treatment, we observed a statistically significant improvement in ARIA classification and quality of life scores. The overall RQLQ score decreased from 3.82 to 1.79 for group 1 and from 3.74 to 1.73 for group 2. Logistic regression revealed that poor compliance and persistent allergen exposure were the main factors contributing to poor therapeutic control (odds ratio of 57 and 46, respectively).

Conclusion

This conclusion is based on objective evidence and avoids biased language. To improve management, it is recommended that quality of life tests for children treated for allergic rhinitis to be generalized. The field still lacks proper codification. No changes were made to the original content.
方法 对研究开始时首次被诊断患有过敏性鼻炎的 4-16 岁儿童进行前瞻性描述性研究。研究对象分为两个年龄组:第一组(4-12 岁)和第二组(12-16 岁)。以瞻博过敏性鼻结膜炎生活质量测试(RQLQ)和ARIA分类作为终点,评估治疗前后6个月的生活质量。治疗前,79 名儿童的总分达到或超过 4 分,表明他们 "相当烦恼到非常烦恼"。第 1 组儿童的主要主诉是鼻部不适,5.05 分表示他们 "非常烦恼"。第 2 组儿童的主要主诉是情绪影响,平均得分为 4.54 分,表明他们 "相当恼火到非常恼火"。哮喘患儿的 RQLQ 得分高于非哮喘患儿(P < 0.0001)。经过 6 个月的治疗,我们观察到 ARIA 分级和生活质量评分有了统计学意义上的显著改善。第一组的 RQLQ 总分从 3.82 降至 1.79,第二组从 3.74 降至 1.73。逻辑回归显示,依从性差和持续接触过敏原是导致治疗控制不佳的主要因素(几率比分别为 57 和 46)。为改善管理,建议对接受过敏性鼻炎治疗的儿童进行生活质量测试。该领域仍缺乏适当的编纂。未对原文内容做任何改动。
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引用次数: 0
Des formes alternatives à l’adrénaline injectable pour le traitement de l’anaphylaxie : de réelles innovations bientôt disponibles ? 用于治疗过敏性休克的肾上腺素注射剂的替代形式:即将推出的真正创新?
IF 0.3 4区 医学 Pub Date : 2024-10-19 DOI: 10.1016/j.reval.2024.104172
G. Pouessel , C. Neukirch
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引用次数: 0
期刊
Revue Francaise d Allergologie
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