Friday, February 5, 2016

Seasonal allergies

Seasonal allergies - a concept relevant in relation to the two types of allergic reactions to insect venom and pollen (hay fever). If risk of allergy to insects is maintained for a long period (from mid-spring to mid-Autumn), the manifestations of hypersensitivity reactions to plants can continue different times - from weeks to 4 months.

An allergy is the result of hypersensitivity of the immune system, which protects the body from penetration of bacteria and viruses. In some cases, the immune system raises a "false alarm" in response to the penetration into the body of certain substances (allergens), which brings no harm, as the enemy, and take appropriate protective measures. This inadequate response is called "allergy"

Symptoms of seasonal allergies

Hay fever can occur at any age, but more often - between 8 and 20 years (at least - after 40 years).

It can manifest itself only itching in the eyes, nose and throat, and rhinitis symptoms: nasal congestion, runny nose, and sometimes coughing. There may be a loss of smell, inflammation of the sinuses (sinusitis) and the accession of asthma (especially wet summer). Atopic asthma is caused by bronchial hyperresponsiveness by inhalation of allergen, which leads to bronchospasm, accumulation of mucus and swelling of the mucous membrane, it provokes suffocation and paroxysmal cough.

plant pollen, can cause the appearance of skin allergic reactions, such as acute urticaria. Usually it lasts from several hours to several days. In contrast to acute, chronic urticaria, which exists for weeks or months, it is very rarely allergic reactions. Most often it is associated with food allergens and additives, as well as drugs.

Hives can take many forms, but it is always characterized by the presence of blisters, which can merge with each other. The rash can appear on any part of the body and be accompanied by severe itching.

Another manifestation of allergic skin reactions is angioedema or angioedema. It can affect the face, lips, eyelids, mucous membranes and other parts of the body. Itching is often lacking, there is a painful burning sensation. Angioedema become life-threatening if it spreads to the mucous membranes of the mouth and pharynx: swollen tongue and the back of the throat cover the airways and can lead to suffocation

Diagnosing Seasonal Allergies

The main diagnostic methods - examination and the patient survey. Questioning the patient or his or her parents - very detailed, includes an analysis of the complaints and possible precipitating factors, medical history, information about diseases of relatives, about the way of life and work conducted by the treatment.

If necessary, the doctor may order a variety of complementary research methods, depending on the individual case.

Determination of immunoglobulin in the blood concentration of E

For the diagnosis of allergy is very important in determining the concentration of blood IgE (immunoglobulin E). Increasing its content favors the development of the body of specific antibodies against allergens. Determination of IgE in serum is carried out, withdrawn from a vein in the patient. To test the use of more than 200 allergens, defined as total and allergen of IgE, thus indirectly judge the allergen, causes the formation of immunoglobulin E and the group responsible for the allergy.

provocation testing

If an allergic reaction develops in response to the alleged allergen, the allergen may be considered causally significant (specific).

skin tests

Adding to the skin (forearm or back) of small amounts of purified allergens in the known concentrations of allergic reactions can be evaluated after 20 minutes. The sample is considered positive if the observed formation of papules, erythema (redness), or a rash.


Basic principles of treatment of seasonal allergies

When it is a dangerous period, the first and most logical precaution - to limit their contact with the allergen. Keep windows closed at home. If possible, use air conditioning. While in the car, pick up the glass. Upon returning from the street, take a shower and rinse your hair. Do not dry laundry outdoors. Working in the garden, you can wear a protective bandage over the nose and mouth.

Minimize the residence time in the open air, especially in the countryside. If you are allergic to fungi spores, not recommended staying in places where there is rotting hay, as well as in the woods and parks with wet fallen leaves. If possible, spend the time on vacation in another climate zone, where flowering is over or not yet started, or where pollen is less than, for example, on the coast.

If possible, go out at the most opportune time. Least of all the pollen in the air is wet on rainy days, and fungal spores - on the contrary, in a dry and sunny weather. On windy days, pollen and fungal spores in the air much longer, besides, they are transported over long distances. So quiet windless days are better suited to stay outdoors. The safest time of day - morning, while still raw pollen. Most fungal spores in the air is in the evening.

Refer to the allergist. It will test, determine what is causing your allergic reaction and prescribe treatment. The most widely used for treatment of allergic diseases used antihistamines. They block the action of histamine, a substance responsible for allergic reactions. Some antihistamines - suprastin, diphenhydramine, tavegil - can often cause drowsiness, it should take into account people, sitting down behind the wheel of a car. a new generation of drugs (loratadine, cetirizine, fexofenadine, ebastine, Kestin) do not have a sedative effect. Significantly reduce the effect or even completely get rid of the allergy can use allergen immune therapy. It is dangerous that the period before subcutaneously administered dose causative allergens identified - this contributes to desensitization, i.e. reduce the sensitivity to this allergen.

Thursday, February 4, 2016

Anaphylactic shock: what is it?

Anaphylaxis - allergic reaction is instantaneous. By "instantaneous" refers to minutes and seconds in some cases that tested after direct exposure to the allergen. At the same time the blood circulation and breathing are violated to such an extent that without appropriate emergency measures people can say goodbye to life.

The condition for the occurrence of such an inadequate reaction of the immune system is the body prior to her contact with the allergen. In other words, anaphylactic shock caused by repeated hitting of the allergen into the body. We should not think that if you do not have any allergies that you are 100% insured against anaphylaxis. This is not true. Still, its probability disproportionately higher in those individuals who are allergic to a long-standing problem, for example, the same asthmatics.

In most cases, anaphylactic shock develops in response to repeated "acquaintance" with the following allergens:

  •     Various types of nuts (hazelnuts, almonds, cashews, walnuts, peanuts, etc.);
  •     poison from the bite of bees, wasps, flies;
  •     foodstuffs (citrus, "milk", fish, bananas, etc.);
  •     drugs (almost every drug, if you look in his instructions for use, is able to cause an allergic reaction);
  •     household chemicals (detergents, hair dye, etc.).


Symptoms of anaphylactic shock

Anaphylactic shock - a life-threatening condition, so the ability to quickly separate the wheat from the chaff, and anaphylactic shock from any functional ailments can be very costly. If anaphylaxis in the body marked a massive release of histamine mediator of inflammation. It negatively affects the bloodstream, causing the patient's skin turns pale and grows cold. Signs of anaphylaxis include:

  •     when a sharp change in the human condition is clearly correlated in time with exposure to potential allergens (bee sting, injection or ingestion of a drug, a non-traditional eaten food and so on.);
  •     choking, bluish color of the skin and lips;
  •     inhibition of the nervous system, loss of consciousness;
  •     rashes on the skin in varying amounts and types;
  •     swelling of the tongue and lips, hindering breathing process.

Anaphylaxis each person can have their own specifics. At one first thing in the affected skin (itching, rash, swelling, redness), others anaphylaxis immediately "has a brain", causing severe headaches, nausea, vomiting, muscle spasms, urinary incontinence, loss of consciousness. In some cases, anaphylactic shock is myocardial infarction.


Anaphylactic Shock: First aid

Here the two do not have to be considered: should immediately call the medics. At stake the risk of cardiac arrest or cessation of breathing, the other option can not be.

First aid for anaphylactic shock

If a person is already unconscious, not breathing you should independently try to resuscitate him. Immediate start for the chest compressions, clasping his fingers rhythmically (100-120 times per minute), pressing palms on the breast in such a way that they went deep into 5-6 cm. Massage should be combined with artificial respiration according to the "mouth-to -rot "approximately every 30-40 compressions. Do not forget to close with the victim's nose.

If the patient is conscious and breathing, it should be planted or placed in a reclining position. If he is very weak, it is required to lay on a flat surface with no protrusions, slightly lifting the legs (pillow).

If possible, we should try to remove the body of a potential allergen (stomach wash, induce vomiting, take out the sting of bees, etc.).

Hay fever in children: Causes, Symptoms and Treatment

Causes of hay fever in children
Hay fever in children manifestation of hay fever in a child
What determines a child's exposure to pollinosis? If a family has at least one such a "sufferer", there is a high likelihood that the disease will manifest itself and its children. Although hay fever is not a hereditary disease, research shows that children's susceptibility to pollen has its roots in their pedigree. Pollinosis - quite common in asthmatics. Eczema, passive smoking and air pollution - all of these factors can trigger hay fever.

Symptoms of hay fever in children

Hay fever in children is diagnosed primarily on two main grounds: wanton, at first glance, sneezing and profuse nasal discharge lasting for the entire period of the mass distribution of pollen in the environment. Eyes may redden, tears and unbearably itchy. There may be a photophobia and paroxysmal cough. Due to the allergic swelling of the mucous membranes of the upper respiratory tract, breathing becomes difficult, and in the beginning of the problems arise with nasal breathing, and then there is a sensation of a lump in the throat. In some cases, hay fever causes skin rashes. All these physiological problems are reflected in the general condition of the child: it is capricious, becomes restless or, on the contrary, lethargic and lack of initiative. He lost appetite, headaches, can increase the body temperature (not always). Because of complications, which are peculiar to pollen allergy, it may be mentioned bacterial infections and their consequences - sinusitis, conjunctivitis, etc.

By and large, hay fever can occur in adults, but still this nagging ailment is more peculiar to children.

Generally, hay fever develops under the influence of grass pollen, but it does not mean that the tree pollen does not fall under suspicion. For example, pollen of birch or hazel very contagious in terms of hay fever. Duration of symptoms is determined by the source of allergies, ie view caused its pollen. So, the symptoms induced by grass pollen, can plague from May to July, while the tree pollen causes sneezing and sniffing, since early spring.

Treating hay fever in children

Any treatment of the disease, aimed at suppressing its symptoms and do not address the causes, threatens to turn into a waste of time. In this regard, an important condition for the successful treatment of hay fever in children, for that matter, any other allergy, is the conclusion of a child under the "fire" of the allergen, or at least the maximum limiting contact with the allergen.

How can I hide from ubiquitous pollen? The problem solved by the time, in the flowering period Allergenic plants, changing the child's place of residence (of course, if possible).

With specific regard to the treatment of hay fever, it is desirable to participate in the process of not only the local pediatrician, and allergist. The basis of the pharmacological treatment of hay fever in children - antihistamine therapy. The mechanism of action of drugs of this group is based on the inactivation of histamine - a mediator of inflammation and allergic reactions. Antihistamines can easily cope with the itching, sneezing and watery eyes, but they are often powerless when nasal congestion. These formulations are produced in a tablet or in the form of nasal sprays and have two "playing field":

  •     as emergency aid in the event of symptoms of hay fever;
  •     as a prophylactic in cases where it is known beforehand that the child will be in the "public" allergens.

The main pharmacologically active ingredients are antihistamines cetirizine, fexofenadine and loratadine. Compared to the earlier generation drugs (remember, though, that as diphenhydramine), they practically do not cause drowsiness.

Still other drugs are effective in pollinozah - corticosteroids as nasal sprays and drops. These drugs are used only in severe cases, in view of their serious impact on the child's body. Corticosteroids have a pronounced anti-inflammatory effect, so they are able to suppress the effects of allergic reactions. For corticosteroids resort in cases where anti-histamines did not give the desired effect or when the main symptom of hay fever is a stuffy nose.

Another good option symptomatic treatment of allergic nasal congestion - Nasal decongestants in the form of sprays or drops. They narrow the blood vessels of the nasal mucosa and facilitate breathing. Often antihistamines and decongestants are combined in one product to provide maximum all-round effect.

During acute hay fever a child should be transferred to a sparing diet, necessarily excluding berries and fruits Allergenic plants. For example, if the cause of the allergy is hazel, it is necessary to remove from the diet of nuts.

Hay fever, in spite of its apparent safety ( "you just have to wait a little bit") is fraught with rather grave consequences. Therefore, parents should be very careful about any allergic reactions from your child and not postponing it indefinitely, to pay a visit to the allergist

Wednesday, February 3, 2016

Atopic dermatitis in children

Atopic dermatitis, often called eczema or atopic eczema, is a fairly common skin disease. What can I say, if it is found in about 10% of children worldwide. Despite the fact that there is a teenagers and an adult form of the disease, can reasonably be called atopic dermatitis "disease baby-faced." By the way, diathesis - another of its common and the more common name of the people.

The causes of atopic dermatitis

If we talk about the specific causes of atopic dermatitis, they remain to this day in the rank of versions and assumptions. In general, we can speak of a combination of hereditary and a number of other factors of everyday life, which act as the trigger button for atopic dermatitis.

The symptoms of atopic dermatitis in children

Period of occurrence

This kind of eczema is almost always develops within the first 5 years of life, most of all - until the child is 1 year old. Atopic dermatitis is rarely seen immediately after the birth of a baby: more likely its appearance later, after 6 weeks. Other rashes can occur at any time and go for a few days or weeks, but atopic dermatitis is coming for a long time and seriously. Periods of clinical exacerbations may be replaced by "ebb", but this disease has a marked tendency to recur.
Itching

Eruptions generated atopic dermatitis, unbearably itchy. The child can not control their unbridled desire to scratch, which ultimately leads to a natural skin damage.
Localization of lesions

In children rash emerges, primarily on the face or inner surface of the elbow and knee bends, i.e. in the places that are easily scratched. In principle, the rash can affect any area of ​​the skin. Sometimes red spots show through only the skin of hands. The rash on the scalp, feet or ears - other key locations for atopic dermatitis. However, one must bear in mind that has similar symptoms and a number of other diseases (e.g., seborrheic dermatitis).

The appearance of the rash
Atopic dermatitis on the inner surface of the knee bends.
This is perhaps the least significant criterion for the identification of atopic dermatitis in children: it is very different, it can be for each individual patient. Overall - it scratches and dry scaly skin. Sometimes the background of aggressive irrepressible scratching the skin infection is entered, and then it is covered by a yellow crust or small pustules. Constant damaging effect on the skin leads to its gradual coarsening.

Heredity

The presence of family in the incidence of atopic eczema, asthma or hay fever may be more likely to persuade a doctor to the diagnosis of "atopic dermatitis."

What causes atopic dermatitis in children? Trigger factors


First of all, you must understand that atopic dermatitis is not contagious: it is not transmitted from person to person. Atopic skin inflammation is a result of the presence in the skin of the individual large number of so-called inflammatory cells (inflammatory cells) having hyperreactivity towards irritating factors. The task of scientists today is to establish the cause of hyperactivity. Patients with atopic dermatitis, asthma or hay fever are born with an excess of these cells. And if they will be affected by any of the following factors, they will not be able to just "switch off", as do the other cells:

    Dry skin. The main function of this natural protective barrier of our body - protective. We do not pay on skin problems absolutely no attention until she did not force us to do it his dry (read: vulnerability). Individuals with atopic dermatitis are endowed with abnormally dry skin. Other causes of dry skin - too frequent washing and neglect skin moisturizer;
    Irritants. It all chemical substances and natural origin, which can cause irritation and dryness of the skin;
    Stress. With regard to children is, by the way, is also true, as they also sometimes have to experience the frustration, anger or fear. By the way, atopic dermatitis itself - too much stress;
    Sweating. Most of the patients with atopic dermatitis notice that the rash covered when their throws in the heat. It can be physical activity, increased ambient temperature or too warm underwear;
    Infections. Staph infection - a fairly common phenomenon in children. Other infections that can cause atopic dermatitis - herpes and fungal (ringworm or athlete's foot);
    Allergens i.e. all the things that can cause an allergic reaction: pollen, animal dander, dust, food. Obviously, asthma and hay fever allergy-related easier by virtue of speed clinical signs. With slowly developing atopic dermatitis it is more complicated, but in some cases it also develops under the influence of allergens, such as food.

How to treat atopic dermatitis in children

It may seem trite, but the treatment of atopic dermatitis should start with a trip to the doctor. Neither of which Internet diagnosis there can be no question: it like symptoms can occur in a number of serious illnesses and untrue tactics of treatment can be very expensive. If you try to organize all the tools and methods for the treatment of atopic dermatitis in children, can get the following list:

    Local glucocorticoids in the form of creams, ointments, gels, emulsions, etc. (tselestoderm, sinaflana, betasalik). Removing inflammation, effective for acute exacerbations of the disease. The only thing - you can not use more than 7-10 days in a row because of the increased risk of side effects, with which, unfortunately, have these potent means;
    Combination medicaments which include corticosteroids, antibacterial and antifungal agents. Apply in the case of adherence to infection in allergic inflammation;
    Antihistamines (erius, ketotifen, Claritin, Telfast). Optimal use of drugs second and third generation, because they are much less likely to have the sedative effect. On average, a standard course of treatment is about 10 days;
    Derivative pimecrolimus. These modern drugs are used for the relief of acute symptoms. Compared with glucocorticoids have a greater safety (for example, at least to the manufacturer);
    Sorbents (Polyphepanum, activated charcoal). Used as part of combination therapy to detoxification;
    Antiseptics (fukartsin, "Zelenka");
    Soft sedatives (Persia, glycine, plant-based preparations of valerian, peony).

These drugs are used primarily during exacerbation of atopic dermatitis. When the disease is receding, the treatment significantly modified: emphasis on vitamin and cosmetic correction and concomitant diseases.

Hives: causes, symptoms, types, treatment

The term "urticaria" (aka urticaria) together under a group of diseases with similar clinical picture: itchy rash of blisters on the type, resembling a trace of burning nettle. Localization rash can be limited to any one part of the body or totally distributed throughout its surface. If the rash completely disappears for a time period not exceeding 6 weeks, then one speaks of acute urticaria. In more rare cases rash persists for years have chosen not wanting to leave the territory. In such cases, it leads to chronic hives.

Symptoms and types of hives
Symptoms of hives
Overriding clinical manifestations of urticaria - voldyreobraznaya rash, some elements of which may have a size from a couple of millimeters to a dozen centimeters in diameter. Skin rashes over time fade and disappear, but in their place, and often in an absolutely pristine parts of the body before there are new blisters, causing quite a significant itching and a burning desire to scratch.

Acute urticaria
In most cases, urticaria is a temporary phenomenon: suddenly appeared, it increases the severity of their presence within 8-12 hours, and 24-48 hours later, then gradually eroding.

Chronic urticaria
Another thing - chronic urticaria, manifestations of which are sometimes unpredictable. Typically, the clinical picture of this form urticaria can be represented as a sine wave, and is characterized by 6-12-week acute attacks, which are followed by periods of remission. The sharpening can be associated with exposure to certain triggers, which will be discussed below. Approximately 10% of patients with chronic urticaria are dominated by unpleasant symptoms during the time that lasts the disease. Clinical signs of chronic urticaria tend to get worse in the evening, which can cause problems falling asleep.
Urticaria vasculitis

It is not often, but, nevertheless, it happens that affects urticaria shallow blood vessels of the skin and cause an inflammation. In this case we speak about urticaria vasculitis (angina): it lasts more than 24 hours, and basic markers of disease - blisters - is quite painful to the touch and may leave a small scar. Urticaria vasculitis treatment requires not only an allergist and dermatologist.
Causes of urticaria

Urticaria caused massive local (s.c.) release of histamine and other mediators of inflammation, catalyzing the respective skin reactions.
Causes of acute urticaria

Factors that trigger chain reactions, causing an acute urticaria, about half of the cases remain unsolved. In general, those are:

  •     food allergy, such as peanuts, shrimp eggs or cheese;
  •     allergies to environmental factors (pollen, dust mites or chemical substances);
  •     latex allergy, which is characteristic for healthcare professionals;
  •     infection: from the banal to the SARS HIV;
  •     insect bites;
  •     emotional distress;
  •     side effects of certain medications, including antibiotics, NSAIDs, and antihistamines;
  •     physical factors such as mechanical or thermal effects on the skin, sunlight and water.

The causes of chronic urticaria
Chronic urticaria, many experts associated with autoimmune disorders in which the immune system begins to attack its own tissues, leading to the release of large amounts of histamine, thereby triggering skin reactions.

However, the real cause of chronic urticaria is not established yet. It is known that it may develop in combination with other autoimmune pathologies such as rheumatoid arthritis and systemic lupus erythematosus ("lupus").

Chronic urticaria, as, indeed, and severe, often begins under the influence of any trigger factors, such as the same stress, alcohol, caffeine, hot, squeezing the skin (eg - in tight clothes), certain nutritional supplements (salicylates, and others. ).

Treatment of urticaria
Treatment of acute urticaria

In most cases, urticaria not require any special treatment, because its symptoms are relatively mild and tested within a few days.

If the situation is not so optimistic, and signs of acute urticaria are more serious and do not want to pass, it's time to call for help antihistamines that blocking the effects of histamine, relieve itching and eliminate rashes. Here are just a few representatives of this group of drugs: cetirizine (allertek, Zyrtec, tsetrin), fexofenadine (Telfast, Rapid, feksofast, dinoks), loratadine (klarisens, lomilan, allergoferon, erius).

Modern antihistamines - this is not the relic diphenhydramine, causing drowsiness and sedation, though, lightly-irresponsible "cocktail" of alcohol, even ultra antihistamines may trigger a lowering of consciousness until his loss. If due to the symptoms of urticaria in a patient are present trouble falling asleep, in this case, you can kill two birds with appointing an antihistamine that promotes falling asleep: tavegil or Atarax.

But not by antihistamines alone ... In case of severe symptoms of the disease can be cut short by a short-term (3-5 days) receiving glucocorticoids, for example, this role can perform the same test of time prednisone. Preparations of this group suppress the immune system, and thus mitigate the symptoms of urticaria. Long-term use of glucocorticoids can cause side effects like plume of high blood pressure, glaucoma, cataracts and diabetes (or worsen during the last).
Treatment of chronic urticaria

As for the treatment of chronic urticaria, the situation is somewhat more complicated. It is possible to use the same antihistamines or glucocorticoids, taking them regularly and progressively increasing the dosage under medical supervision until the moment when the symptoms start to fade. Such a new antihistamine, as Spanish rupatadin (rupafin), well proven in the treatment of difficult flowing urticaria.

In the treatment of chronic urticaria, and this method is used, known as narrowband phototherapy. It is based on impact on a patient's skin high-intensity ultraviolet irradiation. To do this, several (2 to 5) times per week visit dedicated cabinet for completion of this procedure. Total for the improvement of the clinical picture may need about 20 of these sessions.

Leukotriene receptor antagonists (montelar, singular, ektalust, akolat) may help relieve redness and swelling of the skin. In the long term, they can serve as a good alternative to glucocorticoids, as not causing such unpleasant side effects.

Powerful drug cyclosporine (panimun Bioran, ekoral) has proven effective in the treatment of urticaria in 2/3 cases. Its operating principle is similar to that of glucocorticoids: cyclosporin eliminates the negative effects of the immune system. It should be noted that, as confirmed by the results of clinical trials, the longer used cyclosporin, the less its efficiency. Therefore, you should not use this medicine for more than 5 months, after which its effectiveness is only 25%.

And, of course, if you know the triggers that cause aggravation of urticaria in the individual patient, it is good to get out of their destructive influence. Factors provocateurs, like alcohol and caffeine can be easily erased from life. Since stress is more complicated, however, you should try to pry yourself from the clutches of making another step on the way to get rid of hives. In some cases, bad trigger relaxation techniques such as meditation or hypnosis, which can relieve stress and alleviate the symptoms of the disease.

-