Background: MASK‐air^® is an app whose aim is to reduce the global burden of allergic rhinitis (AR) and asthma. A transfer of innovative practices was performed to disseminate and implement MASK‐air^® in European regions. The aim of the study was to examine the implementation of the MASK‐air^® app in Lithuanian adults in order to investigate (i) the rate of acceptance in this population, (ii) the duration of app use and (iii) the evaluation of the app after its use.Methods: In a longitudinal study, Lithuanian adults with AR and/or asthma were recruited by allergists. They were informed about how to use MASK‐air^® and were followed closely. They were reviewed after one to 3 months to evaluate satisfaction and were asked to continue using the app.Results: Among the 149 patients recruited (37.2 ± 10.4 years), 52.4% had rhinitis alone, 42.9% had rhinitis, asthma and/or conjunctivitis multimorbidity, and 2.7% isolated asthma. According to the MASK‐air^® baseline questionnaire, 88.3% of patients considered that their symptoms were troublesome. Data were available for 102 (68.4%) patients. The duration of app usage in patients ranged from 1 to 680 days (median, 25–75 percentile: 54, 23.2–151 days). Forty‐two (41.1% of patients who were reviewed) patients agreed to share their opinion on MASK‐air^®. Most users of the app were satisfied, from 46.5% thinking their allergy was treated more successfully to 90.4% recommending this app to other allergy sufferers.Discussion: When recommended by physicians, MASK‐air® was used for a longer period of time.

Background: Infertility is a pressing global public health concern, affecting millions worldwide, and the diagnosis of unexplained infertility poses particular challenges. Human seminal plasma allergy, a rarely diagnosed type I hypersensitivity reaction, emerges as a potential but often overlooked contributor to female infertility. With rare reported cases globally, the condition’s low awareness and insufficient differential diagnosis may mask its actual prevalence.Case report: This case report presents the clinical case of a 29-year-old woman with unexplained infertility who underwent two unsuccessful IVF procedures and was subsequently diagnosed with human seminal plasma allergy. The patient, known for bronchial asthma and allergic rhinitis exacerbated by inhalant allergens, exhibited eosinophilia and a history of local allergy symptoms (burning sensation, vulvar pruritus, edema, and general discomfort) as well as sneezing and nasal congestion following unprotected intercourse—symptoms compatible with human seminal plasma allergy. Molecular allergy diagnostics revealed pronounced sensitization to dust mites and Can f 5, a canine-specific allergen. A positive skin prick test using her partner’s sperm confirmed the diagnosis of human seminal plasma allergy. The patient’s medical history also includes mild endometriosis, raising questions about the interplay between allergic conditions and fertility. Treatment options such as barrier contraception, antihistamine therapy, and sperm desensitization are discussed.Conclusion: Highlighting the need for increased awareness among healthcare professionals, this case emphasizes the significance of reporting and sharing clinical experiences to enhance our understanding of this rare condition. As researchers continue to accumulate relevant information, a more comprehensive understanding of human seminal plasma allergy and its potential impact on female fertility will contribute to improved diagnostic protocols and expanded treatment options. This case report contributes to the growing body of knowledge surrounding this rare allergy, serving as a reminder of possible intricate relationships between allergic conditions and reproductive health.

Introduction and importance: Obesity is a major health problem. Obese women have an increased risk of pregnancy-related complications. Weight loss before conception is associated with improved fertility rates and pregnancy outcomes. Bariatric surgery (BS), such as laparoscopic adjustable gastric banding (LAGB), was a popular option for obese women planning pregnancy. However, long-term follow-up studies indicate high rate of failure and reoperations. The work has been reported in line with the SCARE 2020 criteria. Case presentation: We present a case of a 41-years-old multigravida who was diagnosed with intragastric penetration of the gastric band on the 27th week. Diagnostic laparoscopy and intraoperative esophagogastroduodenoscopy were performed. Gastric band was not removed and no other surgical interventions were performed. The patient underwent a caesarean section on the 37th week, due to the remaining risk of repeated gastric-band-related complications. Clinical discussion: The management of pregnancy following LAGB has not been well defined yet. Gastric band erosion with intragastric band migration is considered to be one of the most worrisome of all LAGB-related complications. Conclusion: International treatment consensus for pregnancy after BS is still missing. This case illustrates a need for practitioner to maintain a high index of suspicion of gastric-band-related complications during pregnancy. Gastric-band-related complications during pregnancy are rare with only limited number of published reports. To our knowledge, this is the first reported intragastric penetration of the gastric band in a pregnant woman, which was managed without gastric band removal during pregnancy and which had a good outcome for both, the patient and her baby. Highlights:

Sensitization to inhalant allergens is a major factor in the development of allergic diseases. Despite this, few studies have comprehensively analyzed age- and sex-specific patterns within defined populations. This study aimed to investigate the prevalence and distribution of sensitization to inhalant allergens in different demographic groups of the Lithuanian population using molecular diagnostics. We retrospectively reviewed molecular allergy profiles of 658 patients tested with the ALEX2 macroarray between 2020 and 2022. Sensitization to inhalant allergen components was assessed and compared across three age groups (44 years) and by sex. Sensitization to at least one inhalant allergen was observed in 62.16% of patients. Rates were significantly higher in males compared to females, particularly in the reproductive-age group (p = 0.0167). Children exhibited the highest prevalence, which declined with age. Tree pollen, pet dander, grass pollen, and dust mites were the dominant allergen groups. Boys were more often sensitized than men, and girls more often than women. Male patients showed higher sensitization to most allergens, except dust mites and weeds in certain female subgroups. Distinct age- and sex-related differences in sensitization patterns were identified. These results emphasize the importance of demographic factors in allergy diagnostics and highlight the need for region-specific sensitization data to inform clinical care and public health strategies.

Unexplained infertility (UI) remains a diagnostic challenge affecting a significant proportion of women of reproductive age. Vascular endothelial growth factor (VEGF), a key mediator of angiogenesis and inflammation, has been implicated in reproductive and immune processes. This prospective observational study evaluated serum VEGF levels and allergen sensitization (via ALEX² macroarray) in 70 women—51 with UI and 19 fertile controls—to assess VEGF’s potential as a biomarker in UI. Median VEGF concentrations were higher in women with UI compared to fertile controls (128.6 pg/mL vs. 82.5 pg/mL), though not statistically significantly. However, sensitized women showed significantly elevated VEGF levels compared to non-sensitized peers (115.9 pg/mL vs. 85.7 pg/mL, p = 0.028), and a stepwise increase in VEGF was observed with rising allergy severity (p = 0.045). Sensitization to pet allergens, particularly cat allergen Fel d 1, was associated with the highest VEGF levels. A literature review confirmed wide variability in VEGF concentrations and the lack of standardized norms. While VEGF alone may not serve as a definitive biomarker for infertility, elevated levels may reflect an underlying inflammatory state. Our findings suggest VEGF testing could support broader clinical evaluation in women with UI, especially in the presence of allergic sensitization.

Heterotopic pregnancy is a rare, difficult to diagnose and life-threatening pathology, which requires timely decisions made by an experienced multidisciplinary team. In this type of multiple pregnancy there are both intrauterine and ectopic pregnancies present. Its incidence increases in pregnancies conceived by assisted reproductive technology or in pregnancies with ovulation induction. This article presents an angular heterotopic pregnancy case in a 34-year-old multigravida. The patient was admitted on the 14th week of gestation due to abdominal pain on the left side with suspicion of heterotopic pregnancy. Transabdominal ultrasound and magnetic resonance imaging (MRI) were performed to confirm the diagnosis of heterotopic angular pregnancy in the left cornu of the uterus. Multidisciplinary team made a decision to keep monitoring the growth of both pregnancies by ultrasound while maternal vitals were stable. Due to intensifying abdominal pain, diagnostic laparoscopy was performed. No signs of uterine rupture were observed, and no additional surgical procedures were performed. Maternal status and ultrasonographic findings were closely monitored. The mass in the left cornu of the uterus did not change significantly and the fetal growth of the intrauterine pregnancy matched its gestational age throughout pregnancy. At the 41st week of gestation, a healthy female neonate was born via spontaneous vaginal delivery. The incidence rate of heterotopic pregnancy tends to grow due to an increased number of pregnancies after assisted reproductive technology and ovulation induction. It is important to always assess the risk factors. The main methods for diagnosing heterotopic pregnancies are ultrasonography and MRI. The main management tactics for heterotopic pregnancy include expectant management as well as surgical or medical termination of the ectopic pregnancy. Expectant management may be chosen as an option only in a limited number of cases, if the clinical situation meets the specific criteria. When applicable, expectant management may reduce the frequency of unnecessary interventions and help to prevent patients from its complications.