Occupational rhinoconjunctivitis and asthma in a wool worker caused by Dermestidae spp

Investigation of the presence of atopy in children visiting the paediatric cardiology department due to chest pain

BACKGROUND

The cases of chest pain in children are usually not of cardiac origin.

OBJECTIVES

To investigate asthma and other atopic diseases in children with chest pain not of cardiac origin.

PATIENTS AND METHODS

Children aged 6-18 years who were seen for chest pain were included in the study. Haematologic parameters, pulmonary function tests, and skin prick tests were performed. Atopic diseases and environmental factors were investigated.

RESULTS

The non-cardiac chest pain group (Group 1) included 88 children (female: 53.4%) with a mean age of 11.9 ± 3.4 years; the control group (Group 2) included 29 children (female: 53.8%) with a mean age of 11.4±2 years (p > 0.05). A family history of atopy (22.7%) and skin prick test positivity (28.4%) was more common in Group 1 than Group 2 (p = 0.006 and p = 0.017, respectively). The rate of presence of all environmental factors except stove use and mould was significantly higher in Group 1 (54.5%) than Group 2 (3.4%) (p < 0.001). Asthma was diagnosed in 44.3% and allergic rhinitis in 9.1% of patients in Group 1. Idiopathic chest pain, musculoskeletal system disorders, gastroesophageal reflux, and pneumonia were identified in 23.9%, 11.4%, 8%, and 3.4% of patients in Group 1, respectively.

CONCLUSIONS

In this study, the most common cause of non-cardiac chest pain was asthma. The local prevalence of asthma is higher than normal, and this may have affected the results of this study. A detailed history and physical examination will accurately establish the cause of chest pain in most children.

Reported Cases and Diagnostics of Occupational Insect Allergy: A Systematic Review

A significant part of adult-onset asthma is caused by occupational exposure to both high- and low-molecular-mass agents. Insects are occasionally described to cause occupational allergy in professions including anglers and fishers, laboratory workers, employees of aquaculture companies, farmers, bakers, sericulture workers and pet shop workers. Occupational insect allergies are often respiratory, causing asthma or rhinoconjunctivitis, but can be cutaneous as well. The European Union recently approved three insect species for human consumption, enabling an industry to develop where more employees could be exposed to insect products. This review overviews knowledge on occupational insect allergy risks and the tools used to diagnose employees. Despite the limited availability of commercial occupational insect allergy diagnostics, 60.9% of 164 included reports used skin prick tests and 63.4% of reports used specific IgE tests. In 21.9% of reports, a more elaborate diagnosis of occupational asthma was made by specific inhalation challenges or peak expiratory flow measurements at the workplace. In some work environments, 57% of employees were sensitized, and no less than 60% of employees reported work-related symptoms. Further development and optimization of specific diagnostics, together with strong primary prevention, may be vital to the health conditions of workers in the developing insect industry.

Occurrence, ecological function and medical importance of dermestid beetle hastisetae

Hastisetae are a specific group of detachable setae characterizing the larvae of Megatominae (Coleoptera: Dermestidae), commonly known as carpet and khapra beetles. These setae are located on both thoracic and abdominal tergites and they are the primary defense of the larva against invertebrate predators. According to previous studies, the main purpose of hastisetae is to work as a mechanical obstacle, but they are also capable to block and kill a predator. Hastisetae, single or aggregate, function as an extremely efficient mechanical trap, based on an entangling mechanism of cuticular structures (spines and hairs) and body appendages (antennae, legs and mouthparts). It is believed that this defensive system evolved primarily to contrast predation by invertebrates, however it has been observed that hastisetae may affect vertebrates as well. Although information on the impacts of vertebrate predators of the beetles is lacking, hastisetae have been shown to be a possible threat for human health as an important contaminant of stored products (food and fabric), work and living environment. Review of past and recent literature on dermestid larvae has revealed that despite these structures indicated as one of the distinctive characters in species identification, very little is known about their ultrastructure, evolution and mechanism of action. In the present work, we will provide the state of knowledge on hastisetae in Dermestidae and we will present and discuss future research perspectives intended to bridge the existing knowledge gaps.

ICON: Diagnosis and management of allergic conjunctivitis

Ocular allergy (OA), interchangeably known as allergic conjunctivitis, is a common immunological hypersensitivity disorder affecting up to 40% of the population. Ocular allergy has been increasing in frequency, with symptoms of itching, redness, and swelling that significantly impacts an individual's quality of life (QOL). Ocular allergy is an often underdiagnosed and undertreated health problem, because only 10% of patients with OA symptoms seek medical attention, whereas most patients manage with over-the-counter medications and complementary nonpharmacological remedies. The clinical course, duration, severity, and co-morbidities are varied and depend, in part, on the specific ocular tissues that are affected and on immunologic mechanism(s) involved, both local and systemic. It is frequently associated with allergic rhinitis (commonly recognized as allergic rhino conjunctivitis), and with other allergic comorbidities. The predominance of self-management increases the risk of suboptimal therapy that leads to recurrent exacerbations and the potential for development of more chronic conditions that can lead to corneal complications and interference with the visual axis. Multiple, often co-existing causes are seen, and a broad differential diagnosis for OA, increasing the difficulty of arriving at the correct diagnosis(es). Ocular allergy commonly overlaps with other anterior ocular disease disorders, including infectious disorders and dry eye syndromes. Therefore, successful management includes overcoming the challenges of underdiagnosis and even misdiagnosis by a better understanding of the subtleties of an in-depth patient history, ophthalmologic examination techniques, and diagnostic procedures, which are of paramount importance in making an accurate diagnosis of OA. Appropriate cross-referral between specialists (allergists and eyecare specialists) would maximize patient care and outcomes. This would significantly improve OA management and overcome the unmet needs in global health.

Dermestid Dermatitis in a 2-Year-Old Girl: Case Report and Review of the Literature

Dermatitis from contact with carpet, larder, and hide beetles (family Dermestidae) is a seemingly uncommon or underrecognized hypersensitivity reaction to the specialized hairs on the larvae of certain dermestid beetles. The erythematous papulovesicular dermatitis that may result from such contact can be mistakenly construed as evidence of bites of bedbugs or other arthropods or infestation with scabies mites or can be the basis for a diagnosis of delusory parasitosis. We present a case of dermestid dermatitis in a 2-year-old girl and provide a review of the current literature.

Recent findings on the pathogenesis of bronchial asthma. Part II. The role of hormonal predisposition, environmental influences and conditioning leading to bronchial asthma

In this second part of the review on the pathogenesis of asthma the hormonal factors and adverse external events are shortly reviewed which skew the balance of Th1 vs. Th2 CD4+ lymphocytes towards the latter ones and this way increase the probability of atopic diseases. Among other the role of transplacental priming, insulin, insulin-like and other growth factors, lack of the usual microbial infections in the early childhood (the so-called hygiene hypothesis), gender, diminished testosterone production, gastroesophageal reflux, adverse effects during pregnancy are discussed. A separate chapter deals with the role of central nervous system in the etiology and finally the most common allergizing and airway tissue damaging agents are listed in tabulated form.