Japanese guidelines for allergic rhinitis 2017

Publication date: Available online 15 February 2017
Source:Allergology International
Author(s): Kimihiro Okubo, Yuichi Kurono, Keiichi Ichimura, Tadao Enomoto, Yoshitaka Okamoto, Hideyuki Kawauchi, Harumi Suzaki, Shigeharu Fujieda, Keisuke Masuyama
Like asthma and atopic dermatitis, allergic rhinitis is an allergic disease, but of the three, it is the only type I allergic disease. Allergic rhinitis includes pollinosis, which is intractable and reduces quality of life (QOL) when it becomes severe. A guideline is needed to understand allergic rhinitis and to use this knowledge to develop a treatment plan. In Japan, the first guideline was prepared after a symposium held by the Japanese Society of Allergology in 1993. The current 8th edition was published in 2016, and is widely used today.To incorporate evidence based medicine (EBM) introduced from abroad, the most recent collection of evidence/literature was supplemented to the Practical Guideline for the Management of Allergic Rhinitis in Japan 2016. The revised guideline includes assessment of diagnosis/treatment and prescriptions for children and pregnant women, for broad clinical applications. An evidence-based step-by-step strategy for treatment is also described. In addition, the QOL concept and cost benefit analyses are also addressed. Along with Allergic Rhinitis and its Impact of Asthma (ARIA), this guideline is widely used for various clinical purposes, such as measures for patients with sinusitis, childhood allergic rhinitis, oral allergy syndrome, and anaphylaxis and for pregnant women. A Q&A section regarding allergic rhinitis in Japan was added to the end of this guideline.



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Japanese guidelines for occupational allergic diseases 2017

Publication date: Available online 15 February 2017
Source:Allergology International
Author(s): Kunio Dobashi, Kazuo Akiyama, Atsushi Usami, Hiroo Yokozeki, Zenro Ikezawa, Naomi Tsurikisawa, Yoichi Nakamura, Kazuhiro Sato, Jiro Okumura, Kaoru Takayama
In 2013, a guideline for occupational allergic diseases was published for the first time in Japan. Occupational allergic diseases are likely to worsen or become intractable as a result of continuous exposure to high concentrations of causative antigens, and are socioeconomically important diseases with which the patients might sometimes lose jobs due to work interruptions. Guidelines for occupational allergic diseases have been published in many countries. This guideline consists of six chapters about occupational asthma, occupational allergic rhinitis, occupational skin diseases, hypersensitivity pneumonitis and occupational anaphylaxis shock, and legal aspects of these diseases. The guideline is characterized with the following basic structure: Clinical Questions (CQs) are set with reference to Minds (Medical Information Network Distribution Service), statements by the committee are correspondingly listed, recommended grades and evidence levels are defined, and then descriptions and references are indicated.



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Patient-reported outcome measures and patient-reported experience measures

<span class="paragraphSection"><div class="boxedTextSection">Key points<ul><li class="bullet">Patients' perceptions of their health and experiences are key to providing excellent patient-centred care.</li><li class="bullet">Patient-reported outcome measures (PROMs) are questionnaires measuring the patients' views of their health status.</li><li class="bullet">Patient-reported experience measures (PREMs) are questionnaires measuring the patients' perceptions of their experience whilst receiving care.</li><li class="bullet">The data sets can be used for: research, quality improvement projects, clinician performance evaluation, audit, and economic evaluation.</li><li class="bullet">Limitations in the PROMs and PREMs questionnaires must be considered before implementing these tools.</li></ul></div>Improving quality, service, and patient outcomes is an important focus for health care providers. The NHS outcomes framework to improve quality of care can be broadly divided into clinical effectiveness, safety, and patient experience.<a href="#mkw060-B1" class="reflinks">¹</a> There is an increasing support for the use of patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs) in measuring the quality of care across all three areas and to guide service improvement.</span>

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Novel psychoactive substances: a practical approach to dealing with toxicity from legal highs

<span class="paragraphSection">1A022C013C00</span>

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Postoperative management of the difficult airway

<span class="paragraphSection">1C2A013A01</span>

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Aminoazobenzene in tattoo: another case of allergic contact dermatitis

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Regression of cutaneous xerosis with emollient treatment in sub-Saharan African patients

Abstract

Emollients have proven effective in improving cutaneous xerosis in various populations; however, no clinical data are available for African patients. The observational study "Xerafrica" was conducted by dermatologists in seven sub-Saharan countries to assess the evolution of xerosis after an 8-week treatment with an emollient. Patients were children above 3 years or adults. Secondary objectives were to assess pruritus, improvement in symptoms, quality of life, satisfaction, and tolerance. An analysis of 185 patients was made. After 8 weeks of emollient treatment, the relative reduction of the "Scaling Roughness Redness Cracks" (SRRC) score was −83.9% and −80.4% in children and adults, respectively. The effect was significantly stronger when topical steroids were co-prescribed with the emollient and in patients with co-dermatosis. To a lesser extent, the effect of emollient was also observed at week 4. Similarly, pruritus and quality of life strongly improved during follow-up. Skin lesions improved in almost all patients, with a high level of satisfaction noted by both dermatologists and patients. The "Xerafrica" study addressed, for the first time, the treatment of xerosis by emollients in an African population. In this specific context, the emollient markedly reduced xerosis as soon as 4 weeks and resolved it almost totally by 8 weeks. The study confirms, under real-life conditions, the efficacy and tolerability of an emollient in improving xerosis.

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