1. Risk factors for systemic reactions in typical cold urticaria : results from the COLD-CE studyMojca Bizjak, Mitja Košnik, Dejan Dinevski, Simon Francis Thomsen, Daria Fomina, Elena Borzova, Kanokvalai Kulthanan, Raisa Meshkova, Dalia Melina Ahsan, Mona Al-Ahmad, Jovan Miljković, Dorothea Terhorst, Marcus Maurer, 2022, original scientific article Abstract: Background. Cold urticaria (ColdU), i.e. the occurrence of wheals or angioedema in response to cold exposure, is classified into typical and atypical forms. The diagnosis of typical ColdU relies on whealing in response to local cold stimulation testing (CST). It can also manifest with cold-induced anaphylaxis (ColdA). We aimed to determine risk factors for ColdA in typical ColdU. Methods. An international, cross-sectional study COLD-CE was carried out at 32 urticaria centers of reference and excellence (UCAREs). Detailed history was taken and CST with an ice cube and/or TempTest® performed. ColdA was defined as an acute cold-induced involvement of the skin and/or visible mucosal tissue and at least one of: cardiovascular manifestations, difficulty breathing, or gastrointestinal symptoms. Results. Of 551 ColdU patients, 75% (n=412) had a positive CST and ColdA occurred in 37% (n=151) of the latter. Cold-induced generalized wheals, angioedema, acral swelling, oropharyngeal/laryngeal symptoms, and itch of earlobes were identified as signs/symptoms of severe disease. ColdA was most commonly provoked by complete cold water immersion and ColdA caused by cold air was more common in countries with a warmer climate. Ten percent (n=40) of typical ColdU patients had a concomitant chronic spontaneous urticaria (CSU). They had a lower frequency of ColdA than those without CSU (4% vs 39%, p=0.003). We identified the following risk factors for cardiovascular manifestations: previous systemic reaction to a Hymenoptera sting, angioedema, oropharyngeal/laryngeal symptoms, and itchy earlobes. Conclusion. ColdA is common in typical ColdU. High-risk patients require education about their condition and how to use an adrenaline autoinjector.
Keywords: urticaria, risk factors, epinephrine - therapeutic use, self administration, intramuscular injections - methods, cold urticaria, systemic reactions, adrenaline autoinjector
Published in DiRROS: 31.08.2022; Views: 170; Downloads: 62
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2. Natural history of the hymenoptera venom sensitivity reactions in adults : study designSimona Perčič, Lidija Bojanić, Mitja Košnik, Andreja Kukec, 2022, original scientific article Abstract: Background: Allergic reactions to Hymenoptera stings can have varying levels of severity,
according to the Müller grading system. Methods: By an epidemiological concept, this is a retrospective
cohort study. The observed cohort was represented by patients referred to the University Clinic
Golnik due to Hymenoptera allergic reaction in the period from 1997 to 2015. From the immunological
database of the University Clinic Golnik, we obtained laboratory data (sIgE, skin tests and basophil
activation test). The clinical characteristics of patients were obtained from BIRPIS. With the help of a
questionnaire, which was sent to each patient in the period from May 2019 to April 2021, we obtained
epidemiological data. For the assessment of the association between the severity of allergic reaction
for the observed outcome, the severity of the first allergic reaction after Hymenoptera sting was used.
Other variables were grouped according to risk factors. Discussion: We will identify the risk factors
that could play an important role in a severe systemic reaction: the aetiology of the Hymenoptera
sting, sex, age, history and severity of previous systemic reactions, being re-stung in an interval of
two months, the frequency of re-stings, atopy, genetic predisposition, preventive medication use,
other medication use, beekeeping or living next to beehives and why immunotherapy was not taken.
Laboratory data will also be analysed to determine if there is any association with laboratory tests and
the severity of the allergic reactions after Hymenoptera stings. Conclusions: Several new approaches
are introduced in the study design. The most important is that the protocol covers epidemiological
data gained from the questionnaire, as well as clinical data gained from the Immunological database
and BIRPIS database. We expect to obtain significant results that will explain the risk factors for the
natural history of Hymenoptera sting allergic reactions and will help allergologists, as well as general
doctors, when facing those patients allergic to Hymenoptera venom without immunotherapy.
Keywords: hymenoptera venom allergy, risk factors, epidemiological association
Published in DiRROS: 06.04.2022; Views: 437; Downloads: 208
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3. Prevalence of and factors associated with healthcare-associated infections in Slovenian acute care hospitals : results of the third national surveyIrena Klavs, Mojca Serdt, Aleš Korošec, Tatjana Lejko-Zupanc, Blaž Pečavar, 2019, original scientific article Abstract: Introduction. In the third Slovenian national healthcare-associated infections (HAIs) prevalence survey, conducted within the European point prevalence survey of HAIs and antimicrobial use in acute care hospitals, we estimated the prevalence of all types of HAIs and identified factors associated with them. Methods. Patients were enrolled into a one-day cross-sectional study in November 2017. Descriptive analyses were performed to describe the characteristics of patients, their exposure to invasive procedures and the prevalence of different types of HAIs. Univariate and multivariate analyses of association of having at least one HAI with possible risk factors were performed to identify risk factors. Results. Among 5,743 patients, 4.4% had at least one HAI and an additional 2.2% were still treated for HAIs on the day of the survey, with a prevalence of HAIs of 6.6%. The prevalence of pneumoniae was the highest (1.8%), followed by surgical site infections (1.5%) and urinary tract infections (1.2%). Prevalence of blood stream infections was 0.3%. In intensive care units (ICUs), the prevalence of patients with at least one HAI was 30.6%. Factors associated with HAIs included central vascular catheter (adjusted odds ratio [aOR] 4.1; 95% confidence intervals [CI]: 3.1–5.4), peripheral vascular catheter (aOR 3.0; 95% CI: 2.3–3.9), urinary catheter (aOR 1.8; 95% CI: 1.4–2.3). Conclusions. The prevalence of HAIs in Slovenian acute care hospitals in 2017 was substantial, especially in ICUs. HAIs prevention and control is an important public health priority. National surveillance of HAIs in ICUs should be developed to support evidence-based prevention and control.
Keywords: healthcare-associated infections, prevalence, survey, risk factors, Slovenia
Published in DiRROS: 16.10.2020; Views: 1700; Downloads: 695
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