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https://www.readbyqxmd.com/read/29352365/-anesthesia-problem-cards-indispensable-yet-problematic-nationwide-survey-on-experiences-from-clinical-practice
#1
M Schieren, A Böhmer, W Golbeck, J Defosse, F Wappler, H E Marcus
BACKGROUND: Anesthetic procedures may lead to severe and potentially life-threatening complications (e. g. difficult airway, allergic reactions, malignant hyperthermia). Most complications can be avoided in future anesthetic procedures with adequate preparation (e. g. awake intubation, trigger-free anesthesia). In Germany, anesthesia problem cards were introduced two decades ago to identify patients at risk and to increase patient safety by creating a standardized documentation system for anesthesia-related complications...
January 19, 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29351933/vanadium-allergy-following-total-knee-arthroplasty
#2
Fidel Peat, Ross Coomber, Adnan Rana, Alastair Vince
Allergic reactions to metals following joint arthroplasty represent a rare and poorly understood phenomenon. Much is still unknown regarding the natural history of this complication, and how it can best be prevented and managed. We present a case of a 68-year-old woman who underwent a left total knee arthroplasty for treatment of osteoarthritis. After an initial uneventful postoperative course, she developed a troublesome erythematous rash both around the incision site and over her trunk. Blood testing revealed no evidence of infection and clinically her prosthesis was functioning well...
January 18, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29348285/vancomycin-induced-coronary-artery-spasm-a-case-of-kounis-syndrome
#3
Eric Martinez, Sonu Sahni, Muhammad Ai Cheema, Asma Iftikhar
Kounis syndrome defined as the appearance of acute coronary syndrome in the context of an allergic reaction is a relatively rare phenomenon. There are three variants of this syndrome in which the patient presents with symptoms of an acute chest. Herein, we describe a case of an 83-year-old woman who demonstrated type I variant of Kounis syndrome in response to vancomycin administration. After initialisation of vancomycin, she became unresponsive and an ECG demonstrated ST changes consistent with inferior-lateral myocardial infarction...
January 17, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29345001/wheat-oral-immunotherapy-was-moderately-successful-but-was-associated-with-very-frequent-adverse-events-in-children-aged-6-18-years
#4
Petri Kulmala, Anna S Pelkonen, Mikael Kuitunen, Marita Paassilta, Sami Remes, Rüdiger Schultz, Teija Dunder, Sami Turunen, Mika J Mäkelä
AIM: This study investigated oral immunotherapy for children aged 6-18 years with wheat allergies. METHODS: Well-cooked wheat spaghetti was given to 100 children with wheat allergies every day for 17 weeks, increasing from 0.3mg to 2,000mg of wheat protein, followed by three-month and nine-month maintenance phases. Blood samples were taken before therapy and at follow-up visits. The study was carried out in 2009-2015 in four Finnish paediatric allergology units...
January 18, 2018: Acta Paediatrica
https://www.readbyqxmd.com/read/29342459/risk-factors-and-clinical-features-in-cashew-nut-oral-food-challenges
#5
Takashi Inoue, Kiyotake Ogura, Kyohei Takahashi, Makoto Nishino, Tomoyuki Asaumi, Noriyuki Yanagida, Sakura Sato, Motohiro Ebisawa
BACKGROUND: Cashew nuts (CN) are capable of causing severe allergic reactions. However, little has been reported about the details of CN oral food challenges (OFC). METHODS: CN-specific IgE (sIgE) levels were measured for 1 year in 66 patients who underwent an OFC with >3 g CN for diagnosis or confirmation of tolerance acquisition between June 2006 and August 2014. We retrospectively analyzed the OFC and patient background. RESULTS: The median (IQR) age of the 66 patients (48 boys/men and 18 girls/women) was 7...
January 18, 2018: International Archives of Allergy and Immunology
https://www.readbyqxmd.com/read/29341512/food-allergy-emergencies-in-children-to-what-extent-are-early-years-services-prepared-a-cross-sectional-survey
#6
S MacGiobuin, V Stitt, D Philbin, B Higgins, G McGuire, A M O'Regan, M Kelly
Food allergies are common in preschool children. This study's aims are to establish prevalence, to clarify management practices, levels of preparedness and the perceived role of General Practitioners amongst Early Years Services providers. This study is an anonymous, quantitative, cross sectional study. An online questionnaire was distributed to 282 Early Years Service providers. Data were analysed using SPSS. Response rate was 35% (n=98). Prevalence of food allergy was 3% (n=119). Allergic reactions to food had occurred on site in 16% (n=15)...
August 8, 2017: Irish Medical Journal
https://www.readbyqxmd.com/read/29341373/antibiotic-allergy-labels-the-impact-of-taking-a-clinical-history
#7
Adrienne Torda, Victor Chan
BACKGROUND: Many patients admitted to hospital have an antibiotic allergy (AAL) documented in their medical record. In many of these, the reaction is not a hypersensitivity reaction or may no longer be relevant. Despite this, the label adversely affects patient care directly in terms of antibiotic selection, and indirectly in terms of patient costs and the development of antimicrobial resistance. AIMS: To estimate the prevalence of AALs in a cohort of hospitalised patients, to investigate the feasibility of de-labelling through re-challenge based solely upon clinical grounds...
January 17, 2018: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/29339444/light-hvem-signaling-in-keratinocytes-controls-development-of-dermatitis
#8
Rana Herro, Jr-Wen Shui, Sonja Zahner, Daniel Sidler, Yuko Kawakami, Toshiaki Kawakami, Koji Tamada, Mitchell Kronenberg, Michael Croft
Dermatitis is often associated with an allergic reaction characterized by excessive type 2 responses leading to epidermal acanthosis, hyperkeratosis, and dermal inflammation. Although factors like IL-4, IL-13, and thymic stromal lymphopoietin (TSLP) are thought to be instrumental for the development of this type of skin disorder, other cytokines may be critical. Here, we show that the tumor necrosis factor (TNF) superfamily protein LIGHT (homologous to lymphotoxin, exhibits inducible expression, and competes with HSV glycoprotein D for binding to HVEM, a receptor expressed on T lymphocytes) is required for experimental atopic dermatitis, and LIGHT directly controls keratinocyte hyperplasia, and production of periostin, a matricellular protein that contributes to the clinical features of atopic dermatitis as well as other skin diseases such as scleroderma...
January 16, 2018: Journal of Experimental Medicine
https://www.readbyqxmd.com/read/29339127/the-basophil-activation-test-can-be-of-value-for-diagnosing-immediate-allergic-reactions-to%C3%A2-omeprazole
#9
Jose J Laguna, Gador Bogas, Maria Salas, Cristobalina Mayorga, Javier Dionicio, Rosario Gonzalez-Mendiola, Adriana Ariza, Ruben Fernández-Santamaría, Isabel Olazabal, Inmaculada Doña, Tahia D Fernandez, Maria J Torres
BACKGROUND: Proton pump inhibitors (PPIs) are commonly used to treat gastrointestinal diseases. Incidence of hypersensitivity reactions to PPIs has risen, likely because of increased consumption. Their diagnosis is difficult, with skin tests (STs) presenting low sensitivity, making it necessary to perform drug provocation tests (DPTs). The value of in vitro tests for the diagnosis of immediate reaction to PPI is unclear. OBJECTIVE: To analyze the diagnostic value of the basophil activation test (BAT) in a group of patients diagnosed with immediate allergy to omeprazole...
January 12, 2018: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/29338962/knowledge-on-asthma-food-allergies-and-anaphylaxis-assessment-of-elementary-school-teachers-parents-caregivers-of-asthmatic-children-and-university-students-in-uruguaiana-in-the-state-of-rio-grande-do-sul-brazil
#10
M Urrutia-Pereira, L P Mocellin, R B de Oliveira, L Simon, L Lessa, D Solé
INTRODUCTION: Allergic diseases have become an increasingly common reality in the last years, extending beyond the family context. OBJECTIVE: Assessing the level of knowledge on asthma, food allergies and anaphylaxis of asthmatic children's parents/caregivers (PC), elementary school teachers (EST) and university students (US) in Uruguaiana, RS, Brazil. METHOD: 577 individuals (PC - N=111; EST - N=177; US - N=299) took part in the study, answering the Newcastle Asthma Knowledge Questionnaire (validated for Portuguese) and another questionnaire on Food Allergy (FA) and anaphylaxis...
January 12, 2018: Allergologia et Immunopathologia
https://www.readbyqxmd.com/read/29338163/kounis-syndrome-induced-by-oral-intake-of-diclofenac-potassium
#11
Harun Gunes, Feruza Turan Sonmez, Ayhan Saritas, Yasin Koksal
An acute coronary syndrome (ACS) occurring during the course of an allergic reaction is called Kounis syndrome (KS). The second case of KS induced by diclofenac potassium (DP) is presented in this report. A 67-year-old man was brought to our emergency department with the possible diagnosis of anaphylactic shock by the ambulance staff. It emerged that widespread erythema and pruritus developed after taking DP. Then, he lost consciousness. Diffuse urticarial lesions were detected on physical examination at the emergency department...
December 2017: Iranian Journal of Allergy, Asthma, and Immunology
https://www.readbyqxmd.com/read/29337841/frequency-and-severity-of-acute-allergic-like-reactions-to-intravenously-administered-gadolinium-based-contrast-media-in-children
#12
Monica M Forbes-Amrhein, Jonathan R Dillman, Andrew T Trout, Bernadette L Koch, Julie M Dickerson, Richard M Giordano, Alexander J Towbin
OBJECTIVES: The purpose of this study is to determine the frequency and severity of acute allergic-like reactions to gadolinium-based contrast media (GBCM) in children before, during, and after the transition from gadopentetate dimeglumine to gadoterate meglumine as our primary clinical GBCM. MATERIALS AND METHODS: Institutional review board approval was obtained for this Health Insurance Portability and Accountability Act-compliant retrospective investigation. Allergic-like reactions to GBCM in pediatric patients were retrospectively assessed from January 2009 to January 2017, which included a departmental change of GBCM from gadopentetate dimeglumine to gadoterate meglumine...
January 15, 2018: Investigative Radiology
https://www.readbyqxmd.com/read/29336638/prehospital-administration-of-epinephrine-in-pediatric-anaphylaxis-a-statewide-perspective
#13
Leslie M Cristiano, Brian Hiestand, Jason W Caldwell, W Adam Gower, Antonio R Fernandez, Katherine Gilbert, James E Winslow
OBJECTIVE: Timely administration of epinephrine is critical in the treatment of anaphylaxis. This study sought to determine the frequency of administration of epinephrine by EMS providers caring for pediatric patients in the prehospital setting. METHODS: We examined data from the NC EMS database (PreMIS) from 2010-3 to determine frequency of epinephrine administration in pediatric patients with anaphylaxis. We studied patients <18 years of age with an EMS provider impression of "allergic reaction...
January 16, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29336282/role-of-group-2-innate-lymphocytes-in-aspirin-exacerbated-respiratory-disease-pathogenesis
#14
Andrew A White, Taylor A Doherty
Aspirin-exacerbated respiratory disease (AERD) is characterized by chronic eosinophilic nasal polyps, asthma, and airway reactions upon cyclooxygenase (COX) 1 inhibition. AERD is present in up to 7% of adult patients with asthma and the underlying pathogenesis remains largely elusive but prostaglandin D2, cysteinyl leukotrienes, mast cells, and type 2 cytokines are thought to contribute. A wealth of studies have recently implicated group 2 innate lymphoid cells (ILC2), a novel lineage-negative lymphocyte population that produces type 2 cytokines, in human allergic disease pathogenesis...
January 1, 2018: American Journal of Rhinology & Allergy
https://www.readbyqxmd.com/read/29336005/degranulation-inhibitors-from-the-arils-of-myristica-fragrans-in-antigen-stimulated-rat-basophilic-leukemia-cells
#15
Toshio Morikawa, Ikuko Hachiman, Kiyofumi Ninomiya, Hiroki Hata, Kaoru Sugawara, Osamu Muraoka, Hisashi Matsuda
A methanol extract of mace, the aril of Myristica fragrans (Myristicaceae), was found to inhibit the release of β-hexosaminidase, a marker of antigen-IgE-stimulated degranulation in rat basophilic leukemia cells (RBL-2H3, IC50 = 45.7 μg/ml). From the extract, three new 8-O-4' type neolignans, maceneolignans I-K (1-3), were isolated, and the stereostructures of 1-3 were elucidated based on spectroscopic and chemical evidence. Among the isolates, maceneolignans A (5), D (6), and H (8), (-)-(8R)-∆8'-4-hydroxy-3,3',5'-trimethoxy-8-O-4'-neolignan (13), (-)-(8R)-∆8'-3,4,5,3',5'-pentamethoxy-8-O-4'-neolignan (14), (-)-erythro-(7R,8S)-∆8'-7-acetoxy-3,4-methylenedioxy-3',5'-dimethoxy-8-O-4'-neolignan (17), (+)-licarin A (20), nectandrin B (24), verrucosin (25), and malabaricone C (29) were investigated as possible degranulation inhibitors (IC50 = 20...
January 15, 2018: Journal of Natural Medicines
https://www.readbyqxmd.com/read/29335054/orbital-mediastinal-and-cervicofacial-subcutaneous-emphysema-after-dental-rehabilitation-in-a-pediatric-patient
#16
William J Boggess, Jeanine Ronan, Neeraj Panchal
Subcutaneous emphysema is a rare possible complication of dental procedures. The majority of the dental literature describes cases of localized areas of subcutaneous emphysema following various dental procedures, with a large number of these cases seen following intraoral surgical procedures. Classically, subcutaneous emphysema occurs within minutes to hours after conclusion of dental procedures and is commonly misdiagnosed as either an allergic reaction or acute post-operative swelling. This case report describes a four-year-old male who underwent dental rehabilitation for routine restorative dentistry without extractions under general anesthesia...
November 1, 2017: Pediatric Dentistry
https://www.readbyqxmd.com/read/29334799/potential-of-epr-spin-trapping-to-investigate-in-situ-free-radicals-generation-from-skin-allergens-in-reconstructed-human-epidermis-cumene-hydroperoxide-as-proof-of-concept
#17
Salen Kuresepi, Bertrand Vileno, Philippe Turek, Jean-Pierre Lepoittevin, Elena Giménez-Arnau
The first step in the development of skin sensitisation to a chemical, and in the elicitation of further allergic contact dermatitis (ACD), is the binding of the allergen to skin proteins after penetrating into the epidermis. The so-formed antigenic adduct is then recognised by the immune system as foreign to the body. Sensitising organic hydroperoxides derived from autoxidation of natural terpenes are believed to form antigens through radical-mediated mechanisms, although this has not yet been established...
January 15, 2018: Free Radical Research
https://www.readbyqxmd.com/read/29333893/syringe-administration-of-epinephrine-by-emergency-medical-technicians-for-anaphylaxis
#18
Andrew J Latimer, Sofia Husain, Jonathan Nolan, Vinod Doreswamy, Thomas D Rea, Michael R Sayre, Mickey S Eisenberg
OBJECTIVE: In recent years, the costs of epinephrine autoinjectors (EAIs) in the United States have risen substantially. King County Emergency Medical Services implemented the "Check and Inject" program to replace EAIs by teaching emergency medical technicians (EMTs) to manually aspirate epinephrine from a single-use 1 mg/mL epinephrine vial using a needle and syringe followed by prehospital intramuscular administration of the correct adult or pediatric dose of epinephrine for anaphylaxis or serious allergic reaction...
January 15, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29331070/how-does-dose-impact-on-the-severity-of-food-induced-allergic-reactions-and-can-this-improve-risk-assessment-for-allergenic-foods
#19
REVIEW
Anthony E J Dubois, Paul J Turner, Jonathan Hourihane, Barbara Ballmer-Weber, Kirsten Beyer, Chan Chun-Han, M Hazel Gowland, Sue O'Hagan, Lynne Regent, Ben Remington, Sabine Schnadt, Thomas Stroheker, René W R Crevel
Quantitative risk assessment for food allergens has made considerable progress in recent years, yet acceptability of its outcomes remains stymied because of the limited extent to which it has been possible to incorporate severity as a variable. Reaction severity, particularly following accidental exposure, depends on multiple factors, related to the allergen, the host and any treatments which might be administered. Some of these factors are plausibly still unknown. Quantitative risk assessment shows that limiting exposure through control of dose reduces the rates of reactions in allergic populations, but its impact on the relative frequency of severe reactions at different doses is unclear...
January 13, 2018: Allergy
https://www.readbyqxmd.com/read/29331065/component-resolved-diagnostics-to-direct-in-venom-immunotherapy-important-steps-towards-precision-medicine
#20
Simon Blank, Maria Beatrice Bilò, Markus Ollert
Stings of Hymenoptera can induce IgE-mediated systemic and even fatal allergic reactions. Venom-specific immunotherapy (VIT) is the only disease-modifying and curative treatment of venom allergy. However, choosing the correct venom for VIT represents a necessary prerequisite for efficient protection against further anaphylactic sting reactions after VIT. In the past, therapeutic decisions based on the measurement of specific IgE (sIgE) levels to whole venom extracts were not always straightforward, especially when the patient was not able to identify the culprit insect...
January 13, 2018: Clinical and Experimental Allergy: Journal of the British Society for Allergy and Clinical Immunology
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