Aqua\uc2\ua9: Allergy questionnaire for athletes. Development and validation

Purpose: Despite the high and increasing prevalence of allergic diseases in athletes, allergy diagnostics is not part of the routine medical examination in sports medicine. This study reports the development and validation of an easy and reliable questionnaire for screening allergy in athletes. Methods: AQUA was derived from the European Community Respiratory Health Survey Questionnaire. On the basis of open interviews with team doctors, coaches, and athletes, questions were added about: the type, duration, and intensity of training; exercise-related allergic and infectious symptoms; social habits (smoking); drug and food supplements intake; antidoping regulations. The final version of the questionnaire, made of 25 selected questions, was validated in 128 professional soccer players who underwent accurate history taking, medical examination, skin prick testing, and/or specific IgE determination. On the basis of the correlation with objective allergy (positive skin tests to at least one allergen), questions were scored from 1 to 5 according to their positive likelihood ratio. Results: Skin tests (gold standard for validation) were positive in 46.8% of soccer players. Mean total AQUA\uc2\ua9 score was 9.4 \uc2\ub1 7.8 in allergic athletes versus 1.3 \uc2\ub1 2.3 in nonallergic athletes. A total AQUA\uc2\ua9 score of >5 was shown to have the best positive predictive value for allergy (0.94) with a specificity of 97.1% and a sensitivity of 58.3%. Conclusions: AQUA\uc2\ua9, produced in 10 European languages, is a validated, easy, and reliable tool for calling attention on the high prevalence of allergy in athletes. Copyright \uc2\ua9 2009 by The American College of Sports Medicine

House dust mite allergy in Italy. Diagnostic and clinical relevance of Der p 23 (and of minor allergens): A real life, multicenter study

House dust mites (HDM) area major cause of respiratory allergy and of perennial asthmaworldwide. 32 allergens for Dermatophagoidesfarinae(D2) and 21 for Dermatophagoides pteronyssinus(D1) have been detectedso farand novel allergens are still being reported(1). Der p 23, a gut-derived peritrophin present in the outer membrane of mite feces (2),has been recognized as a major allergen (2,3).Der p 1, Der p 2, Der p 23, and Der p 10(tropomyosin)are theonly allergens currently available for the component-resolved diagnosis of HDMallergyon ImmunoCAP.The clinical relevance of Der p 23 is only partially defined, and the prevalence and relevance of the exclusive sensitization to allergensother than groups1, 2, 10, and 23 has received little attention so far. We addressed these aspects ina large multicenter study

Emergency management in patients with haemophilia A and inhibitors on prophylaxis with emicizumab: AICE practical guidance in collaboration with SIBioC, SIMEU, SIMEUP, SIPMeL and SISET

Emicizumab has been approved in several countries for regular prophylaxis in patients with congenital haemophilia A and FVIII inhibitors because it substantially reduces their bleeding risk and improves quality of life. However, although significantly less frequent, some breakthrough bleeds may still occur while on emicizumab, requiring treatment with bypassing or other haemostatic agents. Thrombotic complications have been reported with the associated use of activated prothrombin complex concentrates. In addition, when surgery/invasive procedures are needed while on emicizumab, their management requires multidisciplinary competences and direct supervision by experts in the use of this agent. Given this, and in order to expand the current knowledge on the use of emicizumab and concomitant haemostatic agents, and reduce the risk of complications in this setting, the Italian Association of Haemophilia Centres (AICE) here provides guidance on the management of breakthrough bleeds and surgery in emergency situations in patients with haemophilia A and inhibitors on emicizumab prophylaxis. This paper has been shared with other National Scientific Societies involved in the field