Age Characteristics and Concomitant Diseases in Patients with Angioedema

BACKGROUND: Angioneurotic oedema (AE) is an unpredictable and dangerous disease directly threatening the patient's life due to a sudden onset of upper respiratory tract obstruction. The disease is associated with various causes and triggering factors, but little is known about the conditions that accompany AE. AIM: The study aims to determine the age-specificities and the spectrum of concomitant diseases in patients with AE. MATERIAL AND METHODS: The subjects of observation were 88 patients (53 women and 35 men) with angioneurotic oedema who underwent diagnostics and treatment in the Department of Occupational Diseases and Clinical Allergology of University hospital “Saint Georgeâ€-Plovdiv. RESULTS: The highest level of disease prevalence was found in the age group over 50 years, both in males (45.71%) and females (54.72%). We found that the most often concomitant diseases in our patients with AE are cardiovascular (33%). On second place are the patients with other accompanying conditions outside of the target groups (27.3%). Patients with AE and autoimmune thyroiditis were 14.8%, and those with AE and skeletal-muscle disorders-10.2%. Given the role of hereditary factors in this disease, the profession of the patients is considered insignificant. CONCLUSION: Angioedema occurs in all age groups, but half of the cases are in people over 50 years of age. The most common concomitant diseases in angioedema are cardiovascular diseases

Allergic Contact Dermatitis, Angioneurotic Edema and Conjunctivitis in a Patient with Autoimmune Thrombocytopenia – A Clinical Case

Allergic contact dermatitis (ACD) is common in clinical practice, but the etiology of this disease is quite varied. A leading pathogenetic mechanism is cell-mediated immunity. The combinations of ACD with other allergic and systemic autoimmune diseases are relatively rare, but these conditions are undoubtedly a professional challenge for practitioners. We present a case of ACD combined with other immune-allergic conditions. Etiology and pathogenesis in these cases are not well understood

Analysis of clinical and microbiological indicators of vulvovaginal candidiasis

Vulvovaginal candidiasis (VVC) is the most common vaginal infection. It is considered to be the reason for 15%–30% of all vulvovaginal symptoms. A diagnosis based only on clinical signs and/or on a syndrome-based approach, recommended by some authors and health institutions, is in many cases incorrect. There is no indisputable diagnostic method that guarantees high specificity, sensitivity and predictive value. There is no pathognomonic clinical feature of VVC. The aim of the present study was to assess the role of selected clinical and mycological indicators in the diagnosis of VVC using the standard complex scoring system. The research is retrospective and was conducted in several stages to give a more precise and detailed assessment of the examined clinical and microbiological indicators. Clinical, microbiological and statistical methods were used. The results showed the lowest level of compliance between clinical and laboratory diagnosis in VVC: 67.65%. We did not observe a statistically significant relation between the density of the vaginal smear, inflammation, odour test and VVC (p > 0.05). The results showed a moderate association between the positive yellow swab test and VVC (p < 0.05). A significant positive association was established between VVC and presence of microscopic signs of invasiveness (p < 0.001). The most common isolate was Candida albicans: 72.81% of all vaginal Candida isolates

Angioedema associated with Helicobacter pylori and type 2 diabetes

Angioedema without wheals with duration of symptoms over six weeks is relatively rare. This applies especially for the chronic forms of angioedema associated with metabolic, infectious, malignant, and systemic connective tissue disease. Described in the literature cases are rare, especially when the etiology of isolated angioedema associated with Helicobacter pylori and type 2 diabetes. We report a case of a 66-year-old male patient with recurrent isolated angioedema without wheals, affecting the upper lip, with a disease duration of one year and no symptoms of respiratory and gastrointestinal tract. Laboratory, immunological and serological studies we found only elevated blood sugar and elevated Anti Helicobacter pylori IgG antibody. In patients with type 2 diabetes mellitus etiology of angioedema may be associated with Helicobacter pylori and poor metabolic control. To be an effective treatment, the etiology of such phenomena should be precisely clarified with the respective set of immunological and serological tests

Health Economic Data in Reimbursement of New Medical Technologies: Importance of the Socio-Economic Burden as a Decision-Making Criterion

Background: Assessment and appraisal of new medical technologies require a balance between the interests of different stakeholders. Final decision should take into account the societal value of new therapies.Objective: This perspective paper discusses the socio-economic burden of disease as a specific reimbursement decision-making criterion and calls for the inclusion of it as a counterbalance to the cost-effectiveness and budget impact criteria.Results/Conclusions: Socio-economic burden is a decision-making criterion, accounting for diseases, for which the assessed medical technology is indicated. This indicator is usually researched through cost-of-illness studies that systematically quantify the socio-economic burden of diseases on the individual and on the society. This is a very important consideration as it illustrates direct budgetary consequences of diseases in the health system and indirect costs associated with patient or carer productivity losses. By measuring and comparing the socio-economic burden of different diseases to society, health authorities and payers could benefit in optimizing priority setting and resource allocation.New medical technologies, especially innovative therapies, present an excellent case study for the inclusion of socio-economic burden in reimbursement decision-making. Assessment and appraisal have been greatly concentrated so far on cost-effectiveness and budget impact, marginalizing all other considerations. In this context, data on disease burden and inclusion of explicit criterion of socio-economic burden in reimbursement decision-making may be highly beneficial. Realizing the magnitude of the lost socio-economic contribution resulting from diseases in question could be a reasonable way for policy makers to accept a higher valuation of innovative therapies

Association between Type 2 Diabetes, Obesity and Key Immunological Components of IgE-mediated Inflammation

Background: Changes in lifestyle and obesity in recent decades have brought about a dramatic increase in type 2 diabetes mellitus (DM2) and allergic diseases. Clinical and epidemiological studies associate obesity with epidemics of allergic diseases. The link between obesity and DM2 with immunological components of IgE-mediated allergic inflammation is not yet conclusively established

Community Noise Exposure and its Effect on Blood Pressure and Renal Function in Patients with Hypertension and Cardiovascular Disease

Background: Road traffic noise (RTN) is a risk factor for cardiovascular disease (CVD) and hypertension; however, few studies have looked into its association with blood pressure (BP) and renal function in patients with prior CVD