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R Ariano

Publications and source records attributed to R Ariano.

At least 37 records · Page 2Linked to original sources

New clinical data and therapeutic prospects in Cupressaceae pollen allergy.

The authors emphasize, thanks to their clinical data over the last 20 years: The steady increase of allergy to C. sempervirens pollen compared to other pollinosis and to atopy. The frequency of cross-reactivity between C. sempervirens and other pollens belonging to Cupressaceae and Taxodiaceae families, in order, in the absence of a very good standardization and of a purification of this pollen, to try to undertake a sound specific immunotherapy using the most cross-reactive pollen mixed with C. sempervirens extracts. As a matter of fact the partially purified extracts of C. japonica gave the higher incidence (91%) of cross-reactivity. Consequently, a mixture of C. sempervirens and C. japonica extracts was used since 1993 with good results in a double blind study.

Air Pollution↗

HLA-DRB1* and allergy to Parietaria: linkage and association analyses.

In this study, we used the affected sibling-pairs approach to investigate the linkage of HLA (human leukocyte antigen)-DRB* with phenotypes related to allergy to Parietaria, the most common pollinosis in Mediterranean countries. The study population consisted of 51 nuclear families (235 subjects). Linkage was detected with Parietaria skin test positivity (p < (0.01), presence of IgG and IgE antibodies specific for the major allergen Par o 1 (p < 0.020 and p < 0.025, respectively), and absence of Par o 1-specific IgE (p < 0.020). High levels of Par o 1-specific IgG were associated with DRB1*1101 and/or DRB1*1104 (p < 0.0001 and p < 0.0119, respectively) in parents and probands. High levels of Par o 1-specific IgE were associated with DRB*1104 in parents (p < 0.017) and with DRB1*1101 in probands (p < 0.0146). When siblings were categorized according to high/low total IgE levels (> or =125 IU/ml and <125 IU/ml, respectively), high IgE antibody response was associated with DRB1*1104 in siblings with low total IgE (p < 0.034) and with DRB1*1101 in siblings with high total IgE (p < 0.05). These results demonstrate that HLA-DRB1*, or genes in linkage disequilibrium, contributes to susceptibility to Parietaria allergy and that total IgE levels can discriminate population subsets where different alleles (at the HLA region or at loci in linkage disequilibrium) contribute to control allergen-specific IgE synthesis.

Adult↗

Long-term treatment with allergoid immunotherapy with Parietaria. Clinical and immunologic effects in a randomized, controlled trial.

BACKGROUND: Specific immunotherapy (SIT) is a valuable treatment for respiratory allergy, and the use of chemically modified allergens (allergoids) has improved its safety, as testified by several studies. We evaluated the effects of a SIT course with an allergoid extract of Parietaria pollen in a double-blind, placebo-controlled trial. METHODS: The study was double-blind in the first year; then it was prolonged up to 3 years with all patients on active treatment. Clinical effectiveness, safety, skin reactivity, systemic immunologic parameters, and subjective assessment were evaluated. We also had available a self-evaluation recorded in a follow-up visit 4 years after the discontinuation of SIT. RESULTS: A significant reduction of the symptoms plus drug intake scores during the pollen seasons was observed in the patients receiving active SIT. The placebo patients, after switching to active SIT, also showed significant clinical improvement. The clinical efficacy persisted during years 2 and 3 of treatment. After year 1, the actively treated patients reported a significant subjective improvement (frequency of symptoms, P = 0.001; duration of symptoms, P = 0.024; physical performance, P = 0.043) compared with the placebo group. The self-evaluation by visual analog scale showed that all patients maintained a significant clinical improvement up to 4 years after discontinuing SIT (year 1: active=+31.6%, placebo=-15.7%; year 7: active=+35.8%, placebo=+31.3%). The systemic immunologic changes after active SIT paralleled those described elsewhere (IgE decreased from 22 to 9 and from 21 to 8 IU/ml; IgG4 increased from 43 to 87 and from 18 to 60 IU/ml). A significant decrease in skin reactivity to three different allergen concentrations was observed at year 3 compared with pretreatment values (P<0.05). CONCLUSIONS: The investigational SIT with Parietaria appeared to be effective and safe; a 3-year course of treatment achieved a long-lasting efficacy.

Adolescent↗

Effect of on-line conductivity plasma ultrafiltrate kinetic modeling on cardiovascular stability of hemodialysis patients.

The aim of this multicenter, prospective, randomized cross-over study was to clarify whether on-line conductivity ultrafiltrate kinetic modeling (treatment B), as a substitute for sodium kinetic modeling, is capable of reducing intradialytic cardiovascular instability in comparison with standard treatment (treatment A), by reducing the sodium balance variability. Both treatments were performed by means of a modified hemodiafiltration technique. Treatment A was performed using fixed dialysate conductivity; treatment B made use of the dialysate conductivity derived from a conductivity kinetic model, in order to obtain an end-dialysis ultrafiltrate conductivity at each dialysis session that was equal to the mean value determined in the same patient during the four-week run-in period. Thus, during treatment B, the expected end-dialysis ultrafiltrate conductivity value of each patient should have been constant. The study was carried out according to a multicenter cross-over design of 16 weeks with two treatments (A or B), two sequences (1 = ABB and 2 = BAA), a run-in period of four weeks (period 1, treatment A), and three consecutive experimental periods of four weeks each. Analysis of variance for a cross-over design was used for the statistical analysis. Forty-nine hemodialysis patients prone to intradialytic hypotension (> 25% of sessions) were enrolled from 16 participating centers, and randomly assigned to either sequence 1 (26 patients) or sequence 2 (23 patients). Six patients dropped out and four were protocol violators, which left 39 patients selected for statistical analysis. There was no difference in the average dialysate conductivity, predialysis and end-dialysis plasma water ultrafiltrate conductivity or body weight between treatment A and treatment B. Thus, the observed mean sodium balance was not different and, as expected, only the intra-patient variability of end-dialysis ultrafiltrate conductivity (index of sodium balance variability) was reduced (21%). During treatment A, systolic blood pressure decreased by 23 mm Hg (95% confidence intervals 21 to 24 mm Hg) at the end of dialysis with respect to the pre-dialysis values. Treatment B reduced this intradialytic decrease (P = 0.001) with a maximum effect at the third hour of dialysis (4.4 mm Hg, 95% confidence intervals 1.9 to 6.9 mm Hg, 23% less than during treatment A, P 0.0005) without any period or carry-over effect (P = 0.53 and 0.08, respectively). There was no treatment effect on intradialytic diastolic blood pressure (P = 0.291). In conclusion, intradialytic cardiovascular stability was significantly improved by matching the interdialytic sodium load with intradialytic sodium removal using on-line conductivity ultrafiltrate kinetic modeling as an alternative to sodium kinetic modeling. Although highly significant, this effect was clinically not very large. By applying this conductivity kinetic model to patients with a more variable sodium intake from one session to another, a greater benefit can be expected.

Aged↗

Respiratory allergy to the pollen of Mercurialis annua (Euphorbiaceae).

We have described ten cases of respiratory allergy to the pollen of Mercurialis annua in the area of Bordighera (Riviera dei Fiori) on the Italian Mediterranean coast. The incidence of sensitivity is only 0.9% in a population of 1081 patients with pollinosis. Since the Euphorbiaceae family (spurges) contains strongly sensitizing allergens (eg, seeds of Ricinus communis and latex of Hevea brasiliensis) our findings raise the possibility that respiratory allergy to the pollens of Mercurialis annua and other spurges has been underestimated throughout the world.

Adult↗

[Effects of nifedipine, in primary hypertension, on calcium metabolism and on the excretion of the main urinary electrolytes].

The short term or acute intravenous administration of nifedipine has been reported to increase urine flow rate and sodium clearance but does not significantly alter the patient's serum or urine electrolytes as other vasodilators. Still comparatively little is known, however, about the effects of antihypertensive drugs on calcium metabolism. Our data, on 15 hypertensive patients with normal renal function, don't show significative changes in plasma or urine levels of calcium in short term treatment; moreover there isn't water and salt retention. Thus nifedipine is confirmed as a prime choice drug in hypertensive patients with normal renal function.

Calcium↗

Pollen allergy to mimosa (Acacia floribunda) in a Mediterranean area: an occupational disease.

We have described respiratory allergy to the pollens of mimosa (Acacia floribunda) in some Mediterranean areas of Italy and France. The incidence of sensitivity is only 1.2% in a population of atopics but 31% in an "at risk" population of floriculturists. It seems, therefore, that the pollen of Acacia floribunda, although heavy and amphiphilous, is potentially allergenic for subjects who are in close proximity.

Acacia↗

Efficacy of sublingual specific immunotherapy in Cupressaceae allergy using an extract of Cupressus arizonica. A double blind study.

BACKGROUND: non-injective routes of immunotherapy in respiratory allergy have being proposed as an alternative to conventional immunotherapy. We carried out a study to evaluate the clinical efficacy and effects sublingual immunotherapy (SLIT) in patient with Cupressaceae pollen respiratory allergy. METHODS: twenty patients with Cupressaceae pollen (C. sempervirens) rhinoconjunctivitis, mild asthma or both were randomly chosen for sublingual immunotherapy (10 patients) or placebo treatment (10 patients) using a double blind placebo controlled technique. We have used an extract of Cupressus arizonica because of its better stability in solution and its crossreactivity with Cupressus sempervirens. The patients underwent treatment for 12 months (from april 1999 to april 2000). Symptoms and drug scores as well as nasal provocation tests were recorded. The pollen counts were carried out, during all the same period. RESULTS: we found significantly lower symptom scores (p < 0.05) and drug consumption scores (p < 0.05) in the immunotherapy group than in the placebo group, during the pollen season, after the first year of therapy. Besides threshold of allergen reactivity in nasal provocation tests was increased in the active group (p < 0.01). No untoward reactions have been observed. CONCLUSIONS: SLIT with Cupressus arizonica (pollen extracts) produced, after one year treatment, a significant improvement of allergic symptoms and a decrease of drug consumption scores and allergen-specific nasal reactivity. SLIT with Cupressus arizonica appeared to be effective and safe in the treatment of Cupressaceae pollen respiratory allergy.

Administration, Sublingual↗

Airborne pollens and prevalence of pollenosis in western Liguria: a 10-year study.

During the last 15 years aerobiology has become a relevant branch of allergy, making possible the partial clarification of the relationships between clinical diseases and environment. We performed a 10-year survey of pollen counts and pollen sensitization in a confined area on the western Ligurian coast of Italy in order to evaluate possible changes in aerobiological pattern and to correlate them with the prevalence of sensitization. Pollen counts for the area surrounding Bordighera in the period from 1988-1997 were analyzed; the occurrence of skin sensitization in outpatients were also studied during the same period. We considered the following allergens: Parietaria, grasses, Compositae, Cupressaceae, olive and birch. We also examined the possible differences between patients living on the seaside and those living inland. Over the 10-year period a significant increase in the pollen counts was seen for birch and Compositae (p = 0.001); this was accompanied by a parallel significant increase in the rate of sensitization (p = 0.004 and p = 0.01, respectively). Conversely, an increase in sensitization to Cupressaceae (p = 0.001) and olive (p = 0.03) was also seen, although no change in the pollen counts was detectable. Finally, the prevalence of sensitization to Cupressaceae and Compositae was higher in the patients living in the coastal region than those residing inland. These data suggest that a positive correlation between the pollen counts and the rate of sensitization exists for certain pollens. Nevertheless, for other species such a correlation was not apparent, and additional environmental factors maybe involved in the increased prevalence of sensitization.

Air↗

An epidemiological survey on the allergological importance of some emerging pollens in Italy.

Epidemiological studies on the pollens responsible for allergic diseases throughout Italy are lacking. Routine diagnostic panels consist prevalently of grass, Parietaria, weeds, birch, olive and mugwort. Considering the great variety of Italian geographical areas and the observation of the growing allergological importance of new botanical species (e.g., ambrosia), a survey on pollen species considered "minor" was necessary. A panel of "emerging" pollens (birch, hazelnut, alder, hornbeam, cypress, ragweed) and a routine panel were used to skin prick test 2,934 consecutive outpatients with respiratory pathology of suspected allergic origin, in 21 centers across Italy. A specific questionnaire was compiled. It was found that 20.1% of patients did not react to allergens tested, 28.2% were positive for at least one emerging pollen and 51.7% did not react to emerging pollens but tested positive for at least one allergen from the routine panel. The prevalence of single pollen species was related to geographical areas. Ragweed pollen was shown to provoke asthma much more frequently than other pollens. Hitherto scarcely considered pollens play a considerable role in causing allergic diseases in Italy. In the great majority of patients, positivity for these pollens was associated with positivity to the better recognized group of pollen allergens, although in some cases they were the primary pathogenic agent. We suggest that these more recently considered allergens be included in routine diagnostic panels.

Adult↗

Marked variation in peritoneal insulin absorption in peritoneal dialysis.

OBJECTIVE: To assess both peritoneal insulin absorption and adsorption of insulin to the plastic delivery system, and to assess whether variation in peritoneal absorption is related to transport status. DESIGN: Eight insulin-dependent diabetic patients on continuous ambulatory peritoneal dialysis were studied. Insulin was added to the dialysate. The amount adsorbed by the bag tubing was determined; peritoneal absorption was measured by complete spent dialysate collection. RESULTS: Only 14% +/- 5% of added insulin was adsorbed onto the dialysate delivery system. Marked variation in peritoneal absorption occurred (38% +/- 14%, range 17%-66%). Variations in membrane transport status did not account for variation in absorption. CONCLUSION: Marked variation in peritoneal absorption of insulin occurs, accounting for some of the variation in intraperitoneal insulin requirements. This is not related to membrane transport status.

Absorption↗

Bacterial isolates and cigarette smoking in patients with chronic bronchitis: results from an Italian multicenter survey.

Patients who were cigarette smokers suffering exacerbations of chronic bronchitis were examined in eight outpatient clinics in five regions of Italy, three from the South (Campania, 82 patients; Sicily, 82 patients; and Puglia, 29 patients) and two from North (Lombardy, 33 patients; and Liguria, 50 patients). Haemophilus influenzae was the most frequently isolated bacterium in the patients' sputum (in 30% of the total group), followed by Streptococcus pneumoniae (in 20%), Staphylococcus aureus (in 25%), and Branhamella catarrhalis (in 7%). H. influenzae was the most common bacterium in the South (in 37%) and S aureus in the North (in 13%). Smoking index scores (number of cigarettes smoked daily x years of smoking) were 827 in patients in whom H influenzae was isolated; 691 in patients with S aureus; 599 in patients with S pneumoniae; 542 in patients with B catarrhalis; and 446 in patients in whom no isolates were found. Pulmonary function was most severely decreased in patients positive for H influenzae and S aureus. The results indicate an association between heavy cigarette smoking and lower respiratory tract infections that is influenced by regional differences.

Bronchitis↗

[Results of a mass screening for early diagnosis of diabetes mellitus in a small town (Airole) of the province of Imperia].

A brief review of the methods currently employed in epidemiological investigations for the early diagnosis of diabetes is followed by a description of the inland Liguria town, Airole. 228 of the 504 inhabitants came for the examination (45.2%). Known diabetics constituted 5.7% of the population examined, and diabetic-type curves were observed in 7.45% of persons negative for the presence of diabetes. Borderline curves were seen in 9.2%. A comparison is made with other epidemiological investigations of the same kind carried out in Italy, and stress is laid on their medical and social importance.

Adult↗

Local intranasal immunotherapy with allergen in powder in atopic patients sensitive to Parietaria officinalis pollen.

Local Intranasal Immunotherapy (LII) is a new approach to the treatment of allergic rhinitis due to the pollen of Parietaria officinalis. The aim of this study was to verify the usefulness of LII and to determine the proper doses. Twenty adult patients all presenting a sensitization to the pollen of Parietaria officinalis were randomly divided into two groups: 15 received the treatment and five were the control group. Treatment started before the beginning of the pollinic season of Parietaria officinalis and continued during the season. The extract used was an active extract of macronized powder Parietaria officinalis pollen in increasing doses. Doses were determined periodically with specific nasal provocation tests. Results in the treated group compared to the control group were statistically significant if one considers the increase in threshold sensitivity in the nasal provocation test, the diminution of clinical symptomatology and the quantity of drug required to control symptoms in the treated group. The side effects were few; it was only in one case that the treatment had to be interrupted. LII for allergic rhinitis due to the pollen of Parietaria officinalis seems an effective and practicable method even during the pollinic season.

Administration, Intranasal↗

Pollinosis in a Mediterranean area (Riviera Ligure, Italy): ten years of pollen counts, correlation with clinical sensitization and meteorological data.

We present in this study the results of 10 years of pollen counts in the atmosphere of San Remo, Italy. These results were compared with clinical sensitizations in 5481 pollen-allergic patients of both sexes (children and adults) living in the same area. Pollen counts showed that the pollens found in greatest quantities were the Cupressaceae (22.4%), followed by the Urticaceae (Parietaria officinalis, 17.4%), the Oleaceae (Olea europaea, 10.8%) and the Pinaceae (10.1%), the Poaceae being present in smaller quantities (5.2%). In contrast, the clinical importance of these pollens, as assessed by anamnesis, skin tests and, in some instances, nasal or bronchial provocation tests, showed a high incidence of clinical sensitization to P. officinalis (41.8%) and Poaceae (29.5%); the other pollens, i.e., O. europaea (15.4%) and Cupressaceae (5.7%), were of lesser importance. These findings differ from data obtained in similar studies in other European countries, including other parts of Italy. A statistically significant positive correlation between pollen counts and some meteorological factors, especially temperature, was observed; for instance, the higher the average temperature in July of the previous year, the greater the airborne presence of Palmaceae, P. officinalis and Cupressaceae.

Adolescent↗