The objective of these guidelines is to ensure efficient and effective clinical practice. The panel of experts who produced this consensus document developed a research protocol based on a review of the literature. The prevalence of allergic reactions to iodinated contrast media (ICM) is estimated to be 1:170 000, that is, 0.05%-0.1% of patients undergoing radiologic studies with ICM (more than 75 million examinations per year worldwide). Hypersensitivity reactions can appear within the first hour after administration (immediate reactions) or from more than 1 hour to several days after administration (nonimmediate or delayed reactions). The risk factors for immediate reactions include poorly controlled bronchial asthma, concomitant medication (eg, angiotensin-converting enzyme inhibitors, ß-blockers, and proton-pump inhibitors), rapid administration of the ICM, mastocytosis, autoimmune diseases, and viral infections. The most common symptoms of immediate reactions are erythema and urticaria with or without angioedema, which appear in more than 70% of patients. Maculopapular rash is the most common skin feature of nonimmediate reactions (30%-90%). Skin and in vitro tests should be performed for diagnosis of both immediate and nonimmediate reactions. The ICM to be administered will therefore be chosen depending on the results of these tests, the ICM that induced the reaction (when known), the severity of the reaction, the availability of alternative ICM, and the information available on potential ICM cross-reactivity. Another type of contrast media, gadolinium derivatives, is used used for magnetic resonance imaging. Although rare, IgE-mediated reactions to gadolinium derivatives have been reported. Key words: Iodinated. Gadolinium. Contrast media. Allergy. Hypersensitivity. Anaphylaxis. Immediate reactions. Nonimmediate reactions. PrologueThe objective of these guidelines is to ensure efficient and effective clinical practice in the diagnosis and management of hypersensitivity reactions to radiologic contrast media. The guidelines were developed by a panel of allergy specialists from the Drug Allergy Committee of the Spanish Society of Allergy and Clinical Immunology (SEAIC) with extensive clinical expertise in the evaluation and management of hypersensitivity reactions and broad research experience.We performed a systematic and independent review of the literature up to November 2015 and established a consensus of expert opinion. We evaluated the applicability of the guidelines in our daily clinical practice. The guidelines were evaluated and criticized by external reviewers with expertise in the field. MethodThe panel of experts who produced this consensus document developed a research protocol outlining the background to the subject of study, the objectives of the study, and the questions and hypotheses from which search criteria were defined.The main sources used for the literature search included electronic databases and archives (MEDLINE-PubMed, Science Direct, OVID) and a database of systematic re...

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We found no consistent evidence that SIT is effective for treating AE, but due to the low quality of evidence further research is needed to establish whether SIT has a role in AE treatment.

Background and objective Asthma and chronic obstructive pulmonary disease (COPD) are two prevalent and complex diseases that require personalized management. Although a strategy based on treatable traits (TTs) has been proposed, the prevalence and relationship of TTs to the diagnostic label and disease severity established by the attending physician in a real‐world setting are unknown. We assessed how the presence/absence of specific TTs relate to the diagnosis and severity of ‘asthma’, ‘COPD’ or ‘asthma + COPD’. Methods The authors selected 30 frequently occurring TTs from the NOVELTY study cohort (NOVEL observational longiTudinal studY; NCT02760329), a large (n = 11,226), global study that systematically collects data in a real‐world setting, both in primary care clinics and specialized centres, for patients with ‘asthma’ (n = 5932, 52.8%), ‘COPD’ (n = 3898, 34.7%) or both (‘asthma + COPD’; n = 1396, 12.4%). Results The results indicate that (1) the prevalence of the 30 TTs evaluated varied widely, with a mean ± SD of 4.6 ± 2.6, 5.4 ± 2.6 and 6.4 ± 2.8 TTs/patient in those with ‘asthma’, ‘COPD’ and ‘asthma + COPD’, respectively (p < 0.0001); (2) there were no large global geographical variations, but the prevalence of TTs was different in primary versus specialized clinics; (3) several TTs were specific to the diagnosis and severity of disease, but many were not; and (4) both the presence and absence of TTs formed a pattern that is recognized by clinicians to establish a diagnosis and grade its severity. Conclusion These results provide the largest and most granular characterization of TTs in patients with airway diseases in a real‐world setting to date.

Comparison 1 Immunotherapy versus control, Outcome 6 Use of other medications for eczema.. .. Analysis 2.1. Comparison 2 Planned subgroup analyses: immunotherapy versus control, Outcome 1 Participant-or parentreported specific symptoms of eczema-SCORAD part C by route of immunotherapy.. .. .. .. .. Analysis 2.2. Comparison 2 Planned subgroup analyses: immunotherapy versus control, Outcome 2 Participant-or parentreported specific symptoms of eczema-severity of sleep disturbance by route of immunotherapy.. .. .. Analysis 2.3. Comparison 2 Planned subgroup analyses: immunotherapy versus control, Outcome 3 Participant-or parentreported specific symptoms of eczema-SCORAD part C by allergen type.. .. .. .. .. .. .. Analysis 2.4. Comparison 2 Planned subgroup analyses: immunotherapy versus control, Outcome 4 Participant-or parentreported specific symptoms of eczema-severity of sleep disturbance by allergen type.. .. .. .. .. Analysis 2.5. Comparison 2 Planned subgroup analyses: immunotherapy versus control, Outcome 5 Participant-or parentreported specific symptoms of eczema-SCORAD part C by participant age.. .. .. .. .. .. . Analysis 2.6. Comparison 2 Planned subgroup analyses: immunotherapy versus control, Outcome 6 Participant-or parentreported specific symptoms of eczema-itch severity by participant age.. .. .. .. .. .. .. . Analysis 2.7. Comparison 2 Planned subgroup analyses: immunotherapy versus control, Outcome 7 Participant-or parentreported specific symptoms of eczema-severity of sleep disturbance by participant age.. .. .. .. . Analysis 2.8. Comparison 2 Planned subgroup analyses: immunotherapy versus control, Outcome 8 Participant-or parentreported specific symptoms of eczema-itch severity by severity at randomisation.. .. .. .. .. . Analysis 2.9. Comparison 2 Planned subgroup analyses: immunotherapy versus control, Outcome 9 Participant-or parentreported specific symptoms of eczema-severity of sleep disturbance by severity at randomisation.. .. .. Analysis 2.10. Comparison 2 Planned subgroup analyses: immunotherapy versus control, Outcome 10 Adverse events: any local reaction by route of immunotherapy.