7th Drug hypersensitivity meeting: part two

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Allergie à l’hemisuccinate de methylprednisolone chez une patiente atteinte d’une dysfonction des cordes vocales à l’effort

International audienceVocal cord dysfunction, defined as involuntary folding of the vocal cords during inhalation resulting in sudden inspiratory dyspnoea, is rare. Diagnosis is difficult due to more frequent potential differential diagnoses, including asthma. Hypersensitivity to systemic glucocorticosteroids is another rare disease. Herein we report the case of a 19-year old girl, initially consulting for asthma, who presented several episodes of brutal inspiratory dyspnoea followed by generalized urticaria during sports activities. The allergy, respiratory and ear/nose/throat work-up made us suspect a vocal cord dysfunction associated with an immediate IgE-mediated allergy to méthylprednisolone hemisuccinate (with tolerance to prednisolone and méthylprednisolone). Treatment consisted of speech therapy, contraindication to sports, and withdrawal of méthylprednisolone hemisuccinate. No relapses occurred during follow-up

Allergic Rhinitis Control Test questionnaire-driven stepwise strategy to improve allergic rhinitis control: a prospective study

International audienceBACKGROUND:Allergic Rhinitis Control Test (ARCT) has been validated for assessing allergic rhinitis (AR) control and identifying severe AR. The aim of the study was to assess the ARCT questionnaire as a tool for stepwise pharmacotherapy.METHODS:A standard pharmacotherapy regimen from Step 1 (oral second-generation H1 antihistamine as needed) to Step 5 (oral corticosteroid) was carried out prospectively in a Chinese AR population. The AR patients were initiated with Allergic Rhinitis and its Impact on Asthma (ARIA) appropriate step treatment and assessed with ARCT every 15 days. If ARCT score was equal or above 20 (controlled AR) and maintained for 15 days, the patient would finish the study; if ARCT score was strictly <20 (uncontrolled AR), the patient would receive higher step treatment according to a predefined open design up to Step 5. The different AR control subgroups were compared.RESULTS:A total of 255 patients were enrolled in the study; 5 patients dropped out and 2 (0.8%) were controlled at day 0, 85 (34.0%) at day 15, 177 (70.8%) at day 30, 222 (88.8%) at day 45, 241 (96.4%) at day 60 and 242 (96.8%) at day 75. Only 8 (3.2%) patients remained uncontrolled at the endpoint of the study. Patients with ARIA moderate/severe or persistent symptoms, moderate/severe impaired quality of life, asthma history, rhinorrhea and cough symptoms always needed up to Step 4 (nasal corticosteroid plus antihistamine) and prolonged treatments to achieve disease control.CONCLUSIONS:The majority of AR can be controlled with standard stepwise treatment. ARCT offers an objective criterion for the stepwise pharmacotherapy of AR

Thermal effect on structural and magnetic properties of Fe 78

In the present work, we study the influence of thermal treatments on the magnetic properties of as-quenched and pre-crystallized Fe78Si9B13 after stress relaxation. The crystallization behavior of amorphous and treated Fe78Si9B13 ribbons was revisited. The measurements were carried out by means of Differential Scanning Calorimetry, by X-ray diffraction and by Vibrating Sample Magnetometer, Susceptometer and fluxmeter. Relaxed samples were heated in the resistivity device up to 700°C and annealed near the onset temperature about 420°C for respectively 1, 3, 5, 8 hours. In as-quenched samples, two transition points occur at about 505°C and 564°C but in relaxed sample, the transition points have been found about 552°C and 568°C. Kinetics of crystallization was deduced for all studied samples. Annealing of the as-purchased ribbon shows the occurrence of α-Fe and tetragonal Fe3B resulting from the crystallization of the remaining amorphous phase. The effects on magnetic properties were pointed out by relating the structural evolution of the samples. The magnetic measurements show that annealing change the saturation magnetization and the coercive magnetic field values, hence destroying the good magnetic properties of the material. The heat treatment shows that the crystallization has greatly altered the shape of the cycles and moved the magnetic saturation point of the samples. The effect of treatment on the magneto-crystalline anisotropy is also demonstrated