Rhinitis and Allergic Rhinitis - self-medication options Rhinitis is one of the common diseases that the patient often does not consider necessary to consult a doctor and turns directly to the pharmacist in the pharmacy, who is usually much more accessible to him. It is definitely not appropriate to consider the rhinitis. The pharmacist's role in self-medication therefore consists in trying to determine from the patient's description of his troubles what type of rhinitis it may be, to assess the degree of severity and to decide on the necessity of intervention by a doctor, or the recommendation of a therapeutic procedure with over-the-counter medicinal products. In the case of self-medication, choose the most suitable product with maximum effect and minimum risk and explain the correct handling of it.

• Klíčová slova
• rhinitis, allergic rhinitis, self-medication,
• MeSH
• alergická rýma * farmakoterapie   MeSH
• léky bez předpisu terapeutické užití   MeSH
• lidé MeSH
• rinitida farmakoterapie   MeSH
• samoléčba * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Názvy látek
• léky bez předpisu MeSH

• MeSH
• akupunkturní terapie * MeSH
• dospělí MeSH
• lidé MeSH
• sezónní alergická rýma terapie   MeSH
• vazomotorická rýma terapie   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH

Asthma, rhinitis, and atopic dermatitis (AD) are interrelated clinical phenotypes that partly overlap in the human interactome. The concept of "one-airway-one-disease," coined over 20 years ago, is a simplistic approach of the links between upper- and lower-airway allergic diseases. With new data, it is time to reassess the concept. This article reviews (i) the clinical observations that led to Allergic Rhinitis and its Impact on Asthma (ARIA), (ii) new insights into polysensitization and multimorbidity, (iii) advances in mHealth for novel phenotype definitions, (iv) confirmation in canonical epidemiologic studies, (v) genomic findings, (vi) treatment approaches, and (vii) novel concepts on the onset of rhinitis and multimorbidity. One recent concept, bringing together upper- and lower-airway allergic diseases with skin, gut, and neuropsychiatric multimorbidities, is the "Epithelial Barrier Hypothesis." This review determined that the "one-airway-one-disease" concept does not always hold true and that several phenotypes of disease can be defined. These phenotypes include an extreme "allergic" (asthma) phenotype combining asthma, rhinitis, and conjunctivitis. Rhinitis alone and rhinitis and asthma multimorbidity represent two distinct diseases with the following differences: (i) genomic and transcriptomic background (Toll-Like Receptors and IL-17 for rhinitis alone as a local disease; IL-33 and IL-5 for allergic and non-allergic multimorbidity as a systemic disease), (ii) allergen sensitization patterns (mono- or pauci-sensitization versus polysensitization), (iii) severity of symptoms, and (iv) treatment response. In conclusion, rhinitis alone (local disease) and rhinitis with asthma multimorbidity (systemic disease) should be considered as two distinct diseases, possibly modulated by the microbiome, and may be a model for understanding the epidemics of chronic and autoimmune diseases.

• Klíčová slova
• IL-33, Toll-like receptors, asthma, multimorbidity, rhinitis,
• MeSH
• alergeny MeSH
• alergická rýma * komplikace   MeSH
• bronchiální astma * diagnóza   epidemiologie   etiologie   MeSH
• lidé MeSH
• multimorbidita MeSH
• rinitida * diagnóza   epidemiologie   komplikace   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH
• Názvy látek
• alergeny MeSH

• Klíčová slova
• RHINITIS/acute *,
• MeSH
• lidé MeSH
• rinitida * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

• Klíčová slova
• BRONCHIAL DISEASES *, HAY FEVER *, RHINITIS *, SPIROMETRY *,
• MeSH
• alergická rýma * MeSH
• bronchiální nemoci * MeSH
• bronchospasmus * MeSH
• lidé MeSH
• rinitida * MeSH
• sezónní alergická rýma * MeSH
• spirometrie * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

BACKGROUND: Co-medication is common among patients with allergic rhinitis (AR), but its dimension and patterns are unknown. This is particularly relevant since AR is understood differently across European countries, as reflected by rhinitis-related search patterns in Google Trends. This study aims to assess AR co-medication and its regional patterns in Europe, using real-world data. METHODS: We analysed 2015-2020 MASK-air® European data. We compared days under no medication, monotherapy and co-medication using the visual analogue scale (VAS) levels for overall allergic symptoms ('VAS Global Symptoms') and impact of AR on work. We assessed the monthly use of different medication schemes, performing separate analyses by region (defined geographically or by Google Trends patterns). We estimated the average number of different drugs reported per patient within 1 year. RESULTS: We analysed 222,024 days (13,122 users), including 63,887 days (28.8%) under monotherapy and 38,315 (17.3%) under co-medication. The median 'VAS Global Symptoms' was 7 for no medication days, 14 for monotherapy and 21 for co-medication (p < .001). Medication use peaked during the spring, with similar patterns across different European regions (defined geographically or by Google Trends). Oral H1 -antihistamines were the most common medication in single and co-medication. Each patient reported using an annual average of 2.7 drugs, with 80% reporting two or more. CONCLUSIONS: Allergic rhinitis medication patterns are similar across European regions. One third of treatment days involved co-medication. These findings suggest that patients treat themselves according to their symptoms (irrespective of how they understand AR) and that co-medication use is driven by symptom severity.

• Klíčová slova
• Co-medication, MASK-air, allergic rhinitis, visual analogue scale,
• MeSH
• alergická rýma * farmakoterapie   epidemiologie   MeSH
• antihistaminika terapeutické užití   MeSH
• lidé MeSH
• rinitida * farmakoterapie   MeSH
• zvyky MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Evropa epidemiologie   MeSH
• Názvy látek
• antihistaminika MeSH

• Klíčová slova
• CALCIUM/metabolism *, POTASSIUM/metabolism *, RHINITIS/metabolism in *,
• MeSH
• draslík metabolismus   MeSH
• rinitida metabolismus   MeSH
• vápník metabolismus   MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• draslík MeSH
• vápník MeSH

Allergic Rhinitis and its Impact on Asthma (ARIA) has evolved from a guideline by using the best approach to integrated care pathways using mobile technology in patients with allergic rhinitis (AR) and asthma multimorbidity. The proposed next phase of ARIA is change management, with the aim of providing an active and healthy life to patients with rhinitis and to those with asthma multimorbidity across the lifecycle irrespective of their sex or socioeconomic status to reduce health and social inequities incurred by the disease. ARIA has followed the 8-step model of Kotter to assess and implement the effect of rhinitis on asthma multimorbidity and to propose multimorbid guidelines. A second change management strategy is proposed by ARIA Phase 4 to increase self-medication and shared decision making in rhinitis and asthma multimorbidity. An innovation of ARIA has been the development and validation of information technology evidence-based tools (Mobile Airways Sentinel Network [MASK]) that can inform patient decisions on the basis of a self-care plan proposed by the health care professional.

• Klíčová slova
• Allergic Rhinitis and Its Impact on Asthma, Change management, asthma, rhinitis,
• MeSH
• alergická rýma * diagnóza   terapie   MeSH
• bronchiální astma * diagnóza   terapie   MeSH
• chorobopisy MeSH
• lidé MeSH
• multimorbidita * MeSH
• řízení změn MeSH
• telemedicína * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH

BACKGROUND: Allergic and non-allergic rhinitis ranks among the common occupational health problems. However, data on the incidence of occupational rhinitis are lacking, since comprehensive studies are rare. METHODS: The study includes a group of patients in the Slovak Republic who were reported as having occupational rhinitis in the years 1990-2011. The following parameters were tracked in the investigated sample: age, gender, number of cases by individual years, occupations, causative factors and the length of exposure to the given agent. Possible progression of rhinitis to bronchial asthma was evaluated as well. The diagnostic algorithm was also analysed retrospectively, which included skin tests, the examination of specific IgE antibodies and nasal provocation tests. RESULTS: A total of 70 cases of occupational rhinitis were reported. The disease most often occurred in food industry workers (50% of cases). The most common aetiological factor was flour. Among other relatively common allergens were synthetic textile, wool, cotton and different types of moulds. Significant agents were also different chemical factors causing allergic and irritant rhinitis. The average length of exposure was 14.8 years. Exposure was shorter in men than in women (11 years vs. 16 years) (p = 0.04). Bronchial asthma as a comorbidity was diagnosed in 13 patients (19.7%). The critical diagnostic method on the basis of which the causal association between rhinitis and work environments was confirmed in 59% of cases was skin test; confirmation of the occupational cause using nasal provocation test was less frequent (18%). CONCLUSION: Food industry, textile industry and agriculture were the most risky occupational environments. Workers in these sectors require preventive intervention. In case of showing rhinitis symptoms it is necessary to confirm the occupational aetiology of the disease by the objective diagnostic methods. Since occupational rhinitis mostly precedes the occupational asthma, the elimination from the workplace is necessary.

• MeSH
• alergická rýma epidemiologie   etiologie   MeSH
• dospělí MeSH
• lidé MeSH
• nemoci z povolání diagnóza   epidemiologie   etiologie   MeSH
• pracovní expozice škodlivé účinky   MeSH
• retrospektivní studie MeSH
• rinitida diagnóza   epidemiologie   etiologie   MeSH
• sexuální faktory MeSH
• věkové faktory MeSH
• zaměstnání * MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Slovenská republika MeSH

The selection of pharmacotherapy for patients with allergic rhinitis aims to control the disease and depends on many factors. Grading of Recommendations Assessment, Development and Evaluation (GRADE) guidelines have considerably improved the treatment of allergic rhinitis. However, there is an increasing trend toward use of real-world evidence to inform clinical practice, especially because randomized controlled trials are often limited with regard to the applicability of results. The Contre les Maladies Chroniques pour un Vieillissement Actif (MACVIA) algorithm has proposed an allergic rhinitis treatment by a consensus group. This simple algorithm can be used to step up or step down allergic rhinitis treatment. Next-generation guidelines for the pharmacologic treatment of allergic rhinitis were developed by using existing GRADE-based guidelines for the disease, real-world evidence provided by mobile technology, and additive studies (allergen chamber studies) to refine the MACVIA algorithm.

• Klíčová slova
• Allergic Rhinitis and Its Impact on Asthma, Allergic rhinitis, Development and Evaluation, Grading of Recommendations Assessment, guidelines, real-world evidence,
• MeSH
• alergická rýma * diagnóza   imunologie   terapie   MeSH
• algoritmy * MeSH
• bronchiální astma * diagnóza   imunologie   terapie   MeSH
• lékařská praxe založená na důkazech * MeSH
• lidé MeSH
• směrnice pro lékařskou praxi jako téma MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH