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This study demonstrates the induction of allergen tolerance after 3 intra-lymph node injections of MAT-Fel d 1 vaccine, mediated by increased cellular internalization of the allergen, activation of inflammasome, and generation of allergen-specific peripheral T-cell tolerance.

ABSTRACT.Purpose: To establish the efficacy and safety of timolol maleate/dorzolamide fixed combination (TDFC) versus timolol maleate/pilocarpine fixed combination (TPFC), each given twice daily, in primary open-angle glaucoma or ocular hypertensive patients. Methods: In this prospective, multicentred, double-masked trial, 37 patients were treated twice daily with timolol for 4 weeks. They were then randomized to one of the treatment medications for 6 weeks, after which they were treated with timolol again for 2 weeks before being placed on the opposite treatment medication for 6 weeks. Results: A total of 36 patients completed the trial. Their mean baseline intraocular pressure (IOP) was 22.3 AE 3.7 mmHg. Following 6 weeks of treatment, the mean trough (08.00 hours) IOP was 18.0 AE 2.2 mmHg for TDFC and 17.4 AE 2.0 mmHg for TPFC (p ¼ 0.22). The mean diurnal curve IOP was 18.1 AE 2.2 mmHg for TDFC and 16.7 AE 1.9 mmHg for TPFC (p ¼ 0.0007). At the remaining time-points (10.00, 18.00 and 20.00 hours), TPFC IOPs were statistically lower than TDFC IOPs (p < 0.03). There were statistically more unsolicited reports of vision change and ocular pain associated with TPFC (p ¼ 0.04). Six patients were discontinued early from TPFC therapy (17%) versus two from TDFC (6%) (p ¼ 0.13).

Objectives Peak nasal inspiratory flow (PNIF) measurement is an inexpensive and user-friendly method to assess nasal patency. However, the repeatability of PNIF measurements, as well as the threshold value of a change in PNIF, which can be considered significant remain unclear. This study aims to investigate the repeatability of PNIF measurements and the change in PNIF after the administration of 0.05% oxymetazoline. Methods Repeated measurements of PNIF (Clement Clarke In-Check nasal inspiratory flow meter; Clement Clarke International, Ltd, Harlow, Essex, UK) were obtained in 333 healthy volunteers (174 women). Based on age, participants were categorized into three groups (6–7 years, 13–14 years, and 20–45 years). We obtained five measurements in each participant. PNIF was remeasured in 294 subjects 30 min after administration of 0.05% oxymetazoline. The variability in PNIF measurements was assessed using the coefficient of variation (CV = standard deviation × 100%/mean). Results The first four PNIF measurements significantly differed from each other. The difference in PNIF measurements ceased to be statistically significant only between the fourth and fifth measurements (p = 0.19). PNIF repeatability was acceptable; the median CV was 15.5% (0–66), which did not significantly differ between age groups. The administration of 0.05% oxymetazoline led to a statistically significant increase in the PNIF value by 14.3% (−45, 157%) (p = 0.000000). Conclusions 1. No statistically significant difference was observed in PNIF values only between the fourth and fifth measurements; therefore, at least three measurements are essential to draw meaningful conclusions. 2. PNIF measurements were satisfactorily characterized by a relatively low CV (15%). 3. The administration of 0.05% oxymetazoline led to an increase in PNIF by approximately 14% over the baseline value.

Case series Patients: Male, 45-year-old • Female, 44-year-old Final Diagnosis: SARS-CoV-2 infection exclusion Symptoms: Post-COVID syndrome Medication: — Clinical Procedure: — Specialty: Diagnostics, Laboratory • Infectious Diseases Objective: Challenging differential diagnosis Background: The coronavirus disease 2019 (COVID-19) pandemic is becoming challenging for public health crisis management. Effective detection method such as the criterion standard real-time reverse-transcription polymerase chain reaction (rRT-PCR) test is the only reliable option for the Severe Acute Respiratory Syndrome Corona Virus-2 (SARS-CoV-2). RT-PCR detects the genetic material of the virus but does not distinguish the infectious periods. Other diagnostic methods as serological tests and computed tomography (CT) are less accurate but can provide complementary information, especially in the face of new SARS-CoV-2 variants. Here, we report 2 cases of coronavirus-infected patients with recurrent RT-PCR positivity after recovery, which raised questions about possible reinfection. Case Reports: A married couple, a 44-year-old woman and a 45-year-old man, after COVID-19 recovery, from April to August 2020 presented dynamic RT-PCR outcomes (oscillating from negative to positive). Anti-SARS-CoV-2 immunoglobulin G (IgG) levels for both patients were 1000 U/ml, indicating seroconversion. As a result of recurrent positivity, the patients were isolated and had limited access to healthcare. In the follow-up period, combining RT-PCR results with serology testing and CT allowed determination of the patients’ infectiousness. Conclusions: Due to emerging coronavirus variants, individuals with dynamic PCR results, especially with post-COVID-19 syndrome, are indistinguishable from those who are infectious. Misdiagnosis causes unnecessary quarantines and exacerbates the health care crisis. Patients who had dynamic RT-PCR for SARS-CoV-2 require different diagnostics methods from those used in patients with a first-time positive test result. Combining diagnostic methods and identification of new variants of SARS-CoV-2 allows better estimation of the risk of reinfection.

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Background: Since the outbreak of the COVID-19 pandemic, a growing number of evidence suggests that COVID-19 presents sex-dependent differences in clinical course and outcomes. Nevertheless, there is still an unmet need to stratify the risk for poor outcome at the beginning of hospitalization. Since individual C2HEST components are similar COVID-19 mortality risk factors, we evaluated sex-related predictive value of the score. Material and Methods: A total of 2183 medical records of consecutive patients hospitalized due to confirmed SARS-CoV-2 infections were analyzed. Subjects were assigned to one of two of the study arms (male vs. female) and afterward allocated to different stratum based on the C2HEST score result. The measured outcomes included: in-hospital-mortality, three-month- and six-month-all-cause-mortality and in-hospital non-fatal adverse clinical events. Results: The C2HEST score predicted the mortality with better sensitivity in female population regarding the short- and mid-term. Among secondary outcomes, C2HEST-score revealed predictive value in both genders for pneumonia, myocardial injury, myocardial infarction, acute heart failure, cardiogenic shock, and acute kidney injury. Additionally in the male cohort, the C2HEST value predicted acute liver dysfunction and all-cause bleeding, whereas in the female arm-stroke/TIA and SIRS. Conclusion: In the present study, we demonstrated the betterC2HEST-score predictive value for mortality in women and illustrated sex-dependent differences predicting non-fatal secondary outcomes.

IntroductionVarious risk factors have been attributed to coronavirus disease 19 (COVID-19) severity. Omalizumab as an immunoglobulin E blocker that enhances anti-viral immunity might be a potential cytokine storm trigger.AimOur goal was to investigate if the treatment with omalizumab due to severe asthma is a risk factor of severe COVID-19 pneumonia and if severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can trigger asthma exacerbation.Case studyWe report the case of a 65-year-old patient with severe allergic asthma receiving treatment with omalizumab for last 8 months with good results, who in December 2020 was infected with SARS-CoV-2. The patient was not vaccinated against COVID-19 (no vaccine was available at that time), and had comorbidities.Results and discussionCOVID-19 course of presented patient was asymptomatic and resolved quickly without the need for hospitalization or asthma exacerbation. There was a slightly worse score on the asthma control questionnaire after COVID-19 resolution (2.1 point vs. 1.5 points) and a threefold increase in eosinophil counts (660 cell/µL vs. 230 cell/µL). However, no wheezing or deterioration in pulmonary function tests were found. A computed tomography of the chest revealed only minor densities of pulmonary parenchyma and thickened walls of bronchi.ConclusionsOmalizumab used in the treatment of severe allergic asthma proved to be safe and beneficial for the course of COVID-19 in the case reported. Simultaneously, SARS-CoV-2 was not a factor for asthma exacerbation.