Publications by authors named "Mattia Giovannini"

From a taxonomic point of view, Hymenoptera are subclassified into families: Apidae, including honeybees (Apis mellifera) and bumblebees (Bombus), and Vespidae, which, in turn, are divided into the subfamilies of Vespinae (wasps, including hornets, vespules, dolichovespules) and Polistinae (paper wasp). Hypersensitivity to Hymenoptera venom can be linked to immunological (IgE-mediated or non-IgE-mediated) and non-immunological mechanisms. Reactions are classified into local reactions, large local reactions, systemic reactions, toxic reactions, and unusual reactions.

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Objectives: We aimed to analyze the episodes of esophageal food bolus impaction (EFI) occurred over a time of 15 years in children admitted to a large pediatric emergency department (PED), documenting their clinical presentation, underlying pathology, management, biopsy rate, and follow-up visits. Additionally, to combine our institutional experience with the existing literature, a comprehensive review was conducted.

Methods: We reviewed the medical records of all children presenting to our PED with EFI from 2010 to 2024.

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Article Synopsis
  • IgE-mediated food allergies are the most common type, causing quick and serious reactions that affect patients' and caregivers' lives.
  • Omalizumab is a humanized monoclonal antibody that binds to IgE, reducing allergic reactions, and has been approved by the FDA for treating these food allergies.
  • The GALEN ANACARE Consensus Statement supports omalizumab's use based on a systematic review and expert agreement, noting it is currently the only drug that can significantly reduce IgE-mediated food allergic reactions, although more evidence is needed for stronger guideline recommendations.
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This European Academy of Allergy and Clinical Immunology (EAACI) guideline provides recommendations for the management of IgE-mediated food allergy and was developed using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. Following the confirmation of IgE-mediated food allergy diagnosis, allergen avoidance and dietary advice (with support of a specialised dietitian, if possible) together with the provision of a written treatment plan, education on the recognition of allergic symptoms and prescription of medication including adrenaline using an auto-injector are essential. Patients with significant anxiety and requirement for coping strategies may benefit from support from a clinical psychologist.

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Food protein-induced enteropathy (FPE) belongs to non-IgE gastrointestinal mediated food allergies. FPE is a syndrome characterized by diarrhea, weight loss and failure to thrive in young infants. Cow milk is the culprit food that most frequently causes FPE.

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Article Synopsis
  • Researchers explored how large language models (LLMs) can aid in generating guideline questions for allergic rhinitis by using online search data and direct LLM interactions.
  • They identified 3975 unique search queries, distilling them to 37 relevant questions, with 6 new questions prioritized for the 2024 ARIA guidelines that were not initially considered by the expert panel.
  • The study suggests that LLMs can complement traditional methods in developing clinical guideline questions, although the findings are limited to a single case study.
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Purpose Of Review: The full understanding of the long-term effectiveness and safety of allergen immunotherapy (AIT) for allergic respiratory diseases cannot be achieved through randomized controlled trials (RCTs) alone. However, real-world studies designed as registries can complement RCTs.

Recent Findings: The significance of registries is highlighted by their potential to reassess contraindications and collect data on adult and pediatric patients with multiple comorbidities who are often excluded from RCTs.

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Randomized controlled trials have demonstrated responses to clinical parameters, but a significant proportion of allergy patients in real-life settings would have been excluded from such studies. Therefore, real-world research is needed, and there is a growing body of information on allergen immunotherapy's long-term effectiveness and safety. Real-world evidence can be a valuable instrument to better understand the patient's journey and the effectiveness and safety of therapies.

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Article Synopsis
  • Idiopathic anaphylaxis (IA) poses significant challenges for both patients and healthcare providers, particularly among pediatric populations.
  • This paper suggests diagnostic algorithms tailored to specific age groups—infants, children, and adolescents—due to the variability in identifying causes of anaphylactic episodes.
  • A thorough clinical history and quick recognition of symptoms are crucial for selecting appropriate diagnostic tests and ensuring accurate differential diagnosis in young patients.
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Background: Allergic rhinitis (AR) has a substantial socioeconomic impact associated with impaired work productivity.

Objective: To study the impact of AR on work productivity and estimate the corresponding indirect costs for 40 countries.

Methods: We conducted a cross-sectional study using direct patient data from the MASK-air app on users with self-reported AR.

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Breastfeeding is the most important nutrition source for infants. However, managing breastfed infants with signs and symptoms related to food allergy can be difficult. Many studies have shown the presence of different food allergens in breast milk, but the clinical role of these antigens in human milk is still much debated.

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Article Synopsis
  • - The traditional healthcare approach often overlooks patients' personal experiences and strengths, focusing mainly on disease treatment. Person-centered care aims to align medical decisions with individual values and preferences, particularly for those with chronic conditions.
  • - This paper seeks to enhance care for rhinitis and asthma by developing digital care pathways and incorporating real-world evidence to create a more patient-centered approach.
  • - Key components of the review include advancements in mHealth, the integration of artificial intelligence, a novel classification system for airway diseases, and proposals for the ARIA 2024 guidelines, all targeting a sustainable and applicable healthcare model.
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Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE-mediated food allergy characterized by gastrointestinal symptom onset within 1-4 hours from trigger food ingestion. In the literature, some authors have previously described the possibility that a patient with FPIES may develop an IgE-mediated allergy to the same trigger food, especially cow's milk (CM). We reported five cases of CM-FPIES converting to IgE-mediated CM allergy presented at our tertiary pediatric Allergy Unit and performed a review of the literature, aiming to characterize the clinical features of patients who are at risk of developing such conversion.

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  • Constipation is often seen as a common health issue in kids, but sometimes it can be linked to food allergies, especially cow's milk allergy.
  • Studies show that many kids with constipation improve when they stop eating cow's milk.
  • The Exploring Non-IgE-Mediated Allergy group is discussing how food allergies could be causing constipation in children, since there isn't enough information on this topic yet.
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  • - The European Academy of Allergy and Clinical Immunology analyzed systematic reviews using GRADE to assess the effects of environmental tobacco smoke (ETS) and active smoking on asthma-related issues, focusing primarily on longitudinal studies.
  • - Prenatal and postnatal ETS are linked to an increased risk of recurrent wheezing and new-onset asthma, with moderate to low certainty evidence indicating that combined ETS exposure heightens these risks.
  • - Active smoking is associated with severe asthma exacerbations and poor asthma control, also backed by moderate certainty evidence, alongside potential impacts on quality of life and lung function.
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  • Peanut allergy currently affects 1%-3% of children globally, and early introduction of peanuts in their diets is now recommended, although guidance on quantity and frequency is limited.
  • Oral immunotherapy has shown effectiveness for treating peanut allergies but comes with notable gastrointestinal side effects; Palforzia® is an FDA-approved option for children aged 4-17.
  • Other immunotherapy methods like sublingual and epicutaneous offer varying safety and efficacy, while new studies are exploring biological drugs and probiotics to enhance treatment approaches.
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Trichothiodystrophy (TTD) is a rare congenital disorder caused by genetic mutations, leading to hair and skin abnormalities. We report successful treatment of a TTD case using dupilumab, a monoclonal antibody targeting IL-4Rα. The patient, a 7-year-old boy, exhibited significant improvement in skin and hair conditions, suggesting the potential of dupilumab as a therapeutic option for TTD.

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  • Exercise-induced bronchoconstriction (EIB) is when airways narrow during or after exercise, causing symptoms like wheezing and shortness of breath, and it's important to differentiate it from exercise-induced asthma (EIA).
  • EIB is commonly seen in young athletes, especially those with allergies, suggesting a connection between allergic reactions and respiratory issues during exercise due to various influencing factors.
  • Effective management of EIB in children requires accurate diagnosis and a mix of medication and lifestyle changes, with recent research shedding light on the condition's relationship with allergies and sports participation.
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