The Role of Mobile Health Technologies in Allergy Care:an EAACI Position Paper

Mobile health (mHealth) uses mobile communication devices such as smartphones and tablet computers to support and improve health-related services, data and information flow, patient self-management, surveillance, and disease management from the moment of first diagnosis to an optimized treatment. The European Academy of Allergy and Clinical Immunology created a task force to assess the state of the art and future potential of mHealth in allergology. The task force endorsed the "Be He@lthy, Be Mobile" WHO initiative and debated the quality, usability, efficiency, advantages, limitations, and risks of mobile solutions for allergic diseases. The results are summarized in this position paper, analyzing also the regulatory background with regard to the "General Data Protection Regulation" and Medical Directives of the European Community. The task force assessed the design, user engagement, content, potential of inducing behavioral change, credibility/accountability, and privacy policies of mHealth products. The perspectives of healthcare professionals and allergic patients are discussed, underlining the need of thorough investigation for an effective design of mHealth technologies as auxiliary tools to improve quality of care. Within the context of precision medicine, these could facilitate the change in perspective from clinician- to patient-centered care. The current and future potential of mHealth is then examined for specific areas of allergology, including allergic rhinitis, aerobiology, allergen immunotherapy, asthma, dermatological diseases, food allergies, anaphylaxis, insect venom, and drug allergy. The impact of mobile technologies and associated big data sets are outlined. Facts and recommendations for future mHealth initiatives within EAACI are listed

Type I Kounis Syndrome after Protracted Anaphylaxis and Myocardial Bridge—Brief Literature Review and Case Report

The term allergic angina, introduced for the first time by Nicholas Kounis in 1991, initially referred to the coexistence of acute coronary syndromes with allergy or hypersensitivity. At present, it is believed that Kounis syndrome is a particular case of systemic disease, with multiorgan arterial involvement generated during immediate hypersensitivity reactions. Myocardial bridging (MB), a condition that can induce coronary artery spasm, has long been regarded as a benign condition. Since both pathologies are associated with arterial spasm, Kounis syndrome and MB are considered to be confounding pathologies for acute coronary syndromes, and their association is quite a rare finding. To date, there are no precise data on the epidemiology, and the population affected by Kounis syndrome seems to be highly heterogeneous. Since this is a rare disease, even less is known about possible different phenotypes, including MB overlap. We report a case of type I variant Kounis syndrome associated with MB with no evidence of coronary artery disease, occurring as late presentation, following a severe systemic reaction (anaphylaxis) induced by a Hymenoptera sting. At present, only two other cases of type I and one case of type II Kounis syndrome occurring in patients with myocardial bridging have been described

Safety evaluation of two recently described delabeling algorithms for unexplored beta-lactam drug hypersensitivity reactions

International audienceObjectives: Delabeling algorithms for unexplored beta-lactam (BL) drug hypersensitivity reaction (DHR) suspicions in patients with ur-gent need of BL administration have been published in recent years. The aim of this study was to evaluate the safety (i.e. the risks as-sociated with BL exposure) of two algorithms that were applied on a retrospective cohort of patients with positive and negative drug allergy work-up to penicillins.Method: Data of patients who underwent a drug allergy workup for the identification of a penicillin DHR between January 2014 and December 2021 at the Allergy Unit of the University Hospital Montpellier were extracted from the Drug Allergy and Hypersensitivity Database (DAHD). According to their clinical history, these patients were independently stratified into risk groups, following two al-gorithms, proposed by Blumenthal K. et al 2015 and Romano A. et al 2020.Results: In total, 875 patients were included in a stepwise manner. About 44.2% had a positive drug allergy work-up, either by means of skin testing or drug provocation test. The most frequent index clini-cal history was maculopapular exanthema (321, 36.9%), followed by anaphylaxis with (106, 12.1%) or without shock (145, 16.5%) and urticaria/angioedema (170, 19.5%). Each algorithm comprised three risk classes of immediate/delayed reactions with different sever-ity. For the Blumenthal algorithm, 56% of patients were classified as high-risk, IgE-mediated reactions, while 37% as low-risk, delayed reactions. For the Romano algorithm, 50.4% were classified in the high-risk immediate reactions and 42.5% in the low-risk immediate/delayed reactions. Both algorithms classified the rest of 6.9% of pa-tients as high-risk delayed reactions. The algorithms failed in terms of safety for 10.5% of the patients in the Blumenthal algorithm and 0.5% in the Romano algorithm.Conclusions: The algorithm proposed by Romano et al was safer, fail-ing in only 0.5% of the patients, in a population tested in Southern France for penicillin allergy suspicion

The role of mobile health technologies in allergy care: An EAACI position paper

Mobile health (mHealth) uses mobile communication devices such as smartphones and tablet computers to support and improve health-related services, data and information flow, patient self-management, surveillance, and disease management from the moment of first diagnosis to an optimized treatment. The European Academy of Allergy and Clinical Immunology created a task force to assess the state of the art and future potential of mHealth in allergology. The task force endorsed the “Be He@lthy, Be Mobile” WHO initiative and debated the quality, usability, efficiency, advantages, limitations, and risks of mobile solutions for allergic diseases. The results are summarized in this position paper, analyzing also the regulatory background with regard to the “General Data Protection Regulation” and Medical Directives of the European Community. The task force assessed the design, user engagement, content, potential of inducing behavioral change, credibility/accountability, and privacy policies of mHealth products. The perspectives of healthcare professionals and allergic patients are discussed, underlining the need of thorough investigation for an effective design of mHealth technologies as auxiliary tools to improve quality of care. Within the context of precision medicine, these could facilitate the change in perspective from clinician- to patient-centered care. The current and future potential of mHealth is then examined for specific areas of allergology, including allergic rhinitis, aerobiology, allergen immunotherapy, asthma, dermatological diseases, food allergies, anaphylaxis, insect venom, and drug allergy. The impact of mobile technologies and associated big data sets are outlined. Facts and recommendations for future mHealth initiatives within EAACI are listed