Can COVID-19 vaccinations cause chronic urticaria?

Rationale: Adverse reactions to COVID-19 vaccinations have garnered significant attention from both the public and medical community. Delayed onset urticaria has been described as an adverse reaction to COVID-19 vaccination, but this phenotype has not been fully characterized thus specific evaluation and treatment strategies have not been developed. Methods: We conducted a retrospective chart review of patients presenting for evaluation of urticaria (acute or chronic) to the University of Washington Allergy Clinics between 12/14/2020 and 12/14/2021. Records were reviewed for development of delayed onset, persistent urticaria occurring following receipt of a COVID-19 vaccination or a history of chronic spontaneous urticaria that worsened after COVID-19 vaccination. Demographic and clinical data including age, sex, co-morbid conditions, treatments attempted, and treatment response was obtained. Results: 22 total patients were determined to have urticaria thought to be attributed to Pfizer and Moderna COVID-19 vaccinations. Six of the 22 (27%) had pre-existing chronic spontaneous urticaria (CSU) which worsened notably after vaccination, and 16 (73%) had novel development of delayed urticaria following vaccination. Patients received a range of treatments including H1-antihistamines, H2-antihistamines, leukotriene inhibitors, oral steroids, omalizumab, cyclosporine, and acupuncture. The majority of patients had improvement or resolution while a minority had worsening urticaria despite treatments at the time of evaluation. Conclusions: COVID-19 vaccinations may result in the development of chronic urticaria in select patients and may worsen control of urticaria in some patients with previously diagnosed chronic urticaria. Additional studies are needed to characterize these patients and determine optimal management strategies

Prevalence of mastocytosis and hymenoptera venom allergy in the United States

Background : Mastocytosis is a risk factor for hymenoptera venom anaphylaxis (HVA). Current guidelines recommend measuring tryptase in HVA patients and that those with mastocytosis pursue lifelong venom immunotherapy (VIT). Available data on HVA and mastocytosis largely derives from European single-center studies and the prevalence of HVA with and without mastocytosis in the United States (US) is unknown. Objective : We sought to determine the prevalence of HVA and mastocytosis in the US using an insurance claims database and evaluate the impact of mastocytosis on VIT in HVA patients in a US cohort. Methods :The IBM Watson Database, consisting of insurance claims from approximately 27 million US patients in 2018, was queried to identify patients with HVA and/or mastocytosis. Further, a retrospective study of 161 patients undergoing VIT between 2015 – 2018 at the University of Michigan (U-M) was conducted. Results :In the IBM Watson Database, the prevalence of HVA was 167 per 100,000 (0.167%) and the prevalence of mastocytosis 10 per 100,000 (0.010%) overall and 97 per 100,000 (0.097%) among those with HVA. Mastocytosis showed a 9.7-fold increase among HVA patients versus the general population. In the U-M cohort, 2.6% of VIT patients had mastocytosis. Tryptase level did not correlate with venom reaction severity but was higher in patients with systemic VIT reactions. Conclusions :We observed a lower US HVA prevalence than previously reported. Mastocytosis was more common in US HVA patients, though at lower rates than previously reported. In VIT patients there was no correlation between tryptase level and reaction severity. Key words :Tryptasevenom allergyvenom immunotherapyanaphylaxismastocytosismast cell activation syndromemast cell disease Abbreviations Hymenoptera venom allergyHVAUnited StatesUSVenom immunotherapyVITMast Cell DiseaseMCDAmerican Academy of Allergy, Asthma, and ImmunologyWOS:000717466600002Scopus - Affiliation ID: 60105072PMID: 33895259Science Citation Index ExpandedQ1ArticleUluslararası işbirliği ile yapılan - EVETKasım2021YÖK - 2021-2

Advancing seismic resilience: Performance-based assessment of mid-rise and high-rise engineered cementitious composite (ECC) Buildings

Engineering Cementitious Composites (ECC) have received wide attention in recent years due to their enhanced mechanical properties and ductility. These properties offer an opportunity to design structures with significantly improved seismic performance having a low-damage and ductile response. However, existing research studies primarily focus on the performance of ECC at material and member scales, resulting in a knowledge gap regarding its response at the structural level. This study examines the system-level seismic response of buildings designed using ECC and compares their performance with those having conventional reinforced concrete (RC) members. For this purpose, two RC shear wall buildings (7-story and 24-story) were selected as a case study, and their elements were separately designed (for the combined gravity and lateral loads) as RC and ECC elements using the guidelines recommended by the Japan Society of Civil Engineering (JSCE) and ACI (American Concrete Institute)−318–19. The design results show that the requirement of longitudinal steel is reduced by a maximum of 24% in ECC flexural members and by 15% in compression members, in addition to a significant reduction in the required transverse reinforcement as compared to the corresponding RC members. Similarly, owing to improved tensile behavior, the ECC members also exhibited a higher shear capacity than RC members. The detailed nonlinear finite element models of the case study buildings (for both the design cases i.e., ECC and RC) were subjected to monotonic and reversed-cyclic pushover analysis, and nonlinear time history analyses (NLTHA) under a set of selected ground motions. It was observed that ECC structures exhibited significantly improved lateral capacity, revered-cyclic response, and overall seismic performance as compared to the corresponding RC structures. These results demonstrate that ECC can be effectively used to design various members for improved seismic performance of buildings