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epinephrine in anaphylaxis

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https://www.readbyqxmd.com/read/28438191/continuous-diphenhydramine-infusion-and-imatinib-for-kit-d816v-negative-mast-cell-activation-syndrome-a-case-report
#1
Faizan Malik, Naveed Ali, Syed Imran Mustafa Jafri, Ali Ghani, Mohsin Hamid, Margot Boigon, Christian Fidler
BACKGROUND: We present the first full case report of the treatment of mast cell activation syndrome with continuous diphenhydramine infusion, which resulted in the improvement of anaphylactic reactions and a decrease in hospital readmission. Furthermore, the patient received imatinib in the absence of the KIT-D816V mutation, which led to further improvement of quality of life. Currently, we are trying to wean this patient off diphenhydramine; if successful, this attempt will represent the first reported case...
April 24, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28429307/emerging-approaches-to-food-desensitization-in-children
#2
REVIEW
Ahmad Hamad, Wesley A Burks
PURPOSE OF REVIEW: The purpose of this review is to highlight the recent advances in food desensitization in children with food allergy. RECENT FINDINGS: Recent advancements in epicutaneous, sublingual, and oral immunotherapy for food allergy in the future may offer children with food allergy and their families a viable option to reduce risk or severity of anaphylaxis with phase III trials ongoing for two of these treatment modalities. Food allergy prevalence in children is estimated to be up to 8%...
May 2017: Current Allergy and Asthma Reports
https://www.readbyqxmd.com/read/28414559/evaluating-the-cost-and-utility-of-mandating-schools-to-stock-epinephrine-auto-injectors
#3
Chelsea Steffens, Benjamin Clement, William Fales, Ahel El Haj Chehade, Kevin Putman, Robert Swor
BACKGROUND: The Michigan Legislature mandated that all public schools stock epinephrine auto-injectors (EAIs). A minimal amount is known regarding the incremental value of EAIs in schools. Our primary objective was to describe the frequency of administration of epinephrine for EMS patients with acute allergic reactions in public schools. Our secondary objective was to estimate the cost of mandating public schools to stock EAIs. METHODS: We performed a retrospective cohort study of EMS cases with an impression of allergic reaction and who received epinephrine recorded in the 2014 Michigan EMS Information System (MI-EMSIS)...
April 17, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28409044/perioperative-anaphylaxis-to-chlorhexidine-during-surgery-and-septoplasty
#4
Ana Paula Teixeira de Abreu, Leonardo Ramos Ribeiro de Oliveira, Ana Flavia Teixeira de Abreu, Evandro Ribeiro de Oliveira, Michele Santos de Melo Ireno, Fernando Monteiro Aarestrup, Matheus Fonseca Aarestrup, Paula Fonseca Aarestrup
Chlorhexidine is an antiseptic and disinfectant used in surgical and clinical practice since 1954 and is available in aqueous or alcoholic solutions 0.5%-4.0% and has a broad-spectrum activity. Despite their widespread use, allergic reactions with chlorhexidine are rarely reported. We describe a case of anaphylaxis with chlorhexidine during a septoplasty, turbinectomy, and maxillary sinusectomy. The patient presented with periorbital edema, hives, hypotension, and wheezing. Immediately after the diagnosis of anaphylaxis promethazine, hydrocortisone, and epinephrine were administered with immediate clinical improvement...
2017: Case Reports in Otolaryngology
https://www.readbyqxmd.com/read/28398938/pediatric-anaphylaxis-in-the-emergency-department-clinical-presentation-quality-of-care-and-reliability-of-consensus-criteria
#5
Viginia L Goetz, Kelly Kim, Antonia S Stang
OBJECTIVES: The objective of this study was to describe the quality of emergency department (ED) care for pediatric patients with anaphylaxis. The secondary objectives were to describe (1) the clinical presentation of pediatric patients with anaphylaxis including the proportion of patients meeting each of the National Institute of Allergy and Infectious Diseases (NIAID) consensus criteria and subcriteria and (2) the Interrater reliability (IRR) for applying the NIAID criteria. METHODS: We conducted a retrospective cross-sectional chart review of patients seen in a pediatric ED during a 2-year period...
April 11, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28390586/an-analysis-of-anaphylaxis-cases-at-a-single-pediatric-emergency-department-during-a-1-year-period
#6
Christopher D Wright, Mindy Longjohn, Phillip L Lieberman, Jay Adam Lieberman
BACKGROUND: Case series of anaphylaxis can vary regarding causes, treatments, and follow-up of patients. Unfortunately, case series that are specific to the pediatric population are few. OBJECTIVE: To describe confirmed cases of pediatric anaphylaxis in patients presenting to a pediatric hospital emergency department (ED). METHODS: We identified all ED visits with the International Classification of Diseases, Ninth Revision (ICD-9) codes 995...
April 2017: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/28374596/-management-of-acute-anaphylaxis-in-clinical-practice-in-the-context-of-the-guidelines
#7
P Ch Cmorej, M Nesvadba, R Babeľa, O Slowik, R Didič
Anaphylaxis is a rapidly progressing, life-threatening allergic reaction that needs rapid diagnosis and treatment. Recent research has brought new information about the increasing incidence of anaphylaxis. Nevertheless, the prevalence and incidence of anaphylaxis are difficult to estimate due to the lack of consensus on the definition of anaphylaxis, differences between the population groups analysed, and use of different data collection methods. The most common triggers of anaphylaxis are food allergens, insect stings, and drugs...
2017: Epidemiologie, Mikrobiologie, Imunologie
https://www.readbyqxmd.com/read/28372711/outpatient-emergencies-anaphylaxis
#8
REVIEW
Scott P Commins
Anaphylactic fatalities are rare; however, mild reactions can rapidly progress to cardiovascular and respiratory arrest. The clinical course of anaphylaxis can be unpredictable. Prompt and early use of epinephrine should be considered. Most anaphylaxis episodes have an immunologic mechanism involving immunoglobulin E (IgE). Foods are the most common cause in children; medications and insect stings are more common in adults. When the cause is not completely avoidable or cannot be determined, a patient should be supplied with autoinjectable epinephrine and be instructed its use...
May 2017: Medical Clinics of North America
https://www.readbyqxmd.com/read/28356773/update-on-the-usage-and-safety-of-epinephrine-auto-injectors-2017
#9
REVIEW
Larry S Posner, Carlos A Camargo
Anaphylaxis is a serious, potentially fatal allergic reaction. Guidelines recommend prompt intramuscular injections of epinephrine as the first-line therapy for anaphylaxis. Delayed epinephrine treatment may cause undesirable clinical outcomes, including death. In the community, epinephrine auto-injectors (EAIs) are commonly used to treat anaphylaxis. This literature review examines several recent concerns regarding the safety of EAIs that may prevent the timely administration of epinephrine. Reports of cardiovascular complications are linked with epinephrine administration, although recent studies suggest that these events are much more commonly associated with intravenous epinephrine rather than with EAIs...
2017: Drug, Healthcare and Patient Safety
https://www.readbyqxmd.com/read/28339320/basic-life-support-access-to-injectable-epinephrine-across-the-united-states
#10
Ian D Brasted, Michael W Dailey
BACKGROUND:  Aggressive epinephrine administration has growing support in the treatment of anaphylaxis, a life-threatening allergic reaction. Emergency Medical Services (EMS) providers are frequently in a position to provide the first care to someone experiencing an anaphylactic reaction. Intramuscular injection of epinephrine is the definitive pharmacologic treatment for many associated symptoms. While easy to use, epinephrine autoinjectors (EAI) are prohibitively expensive, having increased in price ten-fold in ten years...
March 24, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28285065/pharmacist-use-of-the-electronic-medical-record-to-identify-adults-at-risk-for-anaphylaxis-without-epinephrine-for-self-administration
#11
Autumn Stewart, Katherine Sulkowski
OBJECTIVES: To describe an innovative pharmacist-led approach, with the use of electronic medical record (EMR) data, to identify patients at risk of anaphylaxis in need of epinephrine auto-injector (EAI) for self-administration. SETTING: An urban free health care center for an uninsured indigent adult population in Pittsburgh, PA. PRACTICE INNOVATION: In this pilot service, patients with allergy history fields containing the words "anaphylaxis," "nut," "bee," or "shellfish" were screened for inclusion...
March 8, 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28265481/anaphylaxis-in-schools-results-of-the-epipen4schools-survey-combined-analysis
#12
Martha V White, Susan L Hogue, Dawn Odom, Darryl Cooney, Jennifer Bartsch, Diana Goss, Kelly Hollis, Christopher Herrem, Suyapa Silvia
A pilot survey described the characteristics of anaphylactic events occurring in an initial set of participating U.S. schools during the 2013-2014 school year. This survey was subsequently readministered to large school districts, which were underrepresented in initial results. A cross-sectional survey was administered to the U.S. schools that were participating in the EPIPEN4SCHOOLS(®) program (Mylan Specialty L.P., Canonsburg, PA) to assess characteristics of anaphylactic events. Data from large school districts were added to initial findings in this comprehensive combined analysis...
September 1, 2016: Pediatric Allergy, Immunology, and Pulmonology
https://www.readbyqxmd.com/read/28255796/acute-myocardial-infarction-in-a%C3%A2-patient-suffering-from-penicillin-induced-laryngeal-edema-kounis-syndrome-aggravated-by-adrenaline
#13
Mahmut Yesin, Macit Kalçık, Mustafa Ozan Gürsoy, Süleyman Karakoyun, Metin Çağdaş, Mehmet Özkan
Kounis syndrome or allergic angina is defined as the coincidental occurrence of chest pain and allergic reactions accompanied by clinical and laboratory findings of classical angina pectoris. It is triggered by the action of potent vasoactive and inflammatory mediators, which are released from the mast cells during the allergic reaction. Epinephrine is a life-saving medication in anaphylaxis; however, it can aggravate ischemia and induce coronary vasospasm and arrhythmias. Here, we present a patient with Kounis syndrome that was caused by intramuscular injection of procaine penicillin G, and in whom epinephrine administration for treatment of laryngeal edema had provoked severe myocardial ischemia...
March 2, 2017: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/28226324/a-survey-of-self-reported-food-allergy-and-food-related-anaphylaxis-among-young-adult-students-at-kuwait-university-kuwait
#14
Fatima Ali
OBJECTIVES: To conduct a survey on self-reported food allergy to milk, egg, peanuts, tree nuts, fish, shellfish, wheat and sesame as well as reported food-related anaphylaxis and epinephrine prescription practices among Kuwaiti students attending Kuwait University. SUBJECTS AND METHODS: One thousand (1,000) questionnaires that included data on age, gender, presence of food allergies and associated details were distributed. All participants reporting an allergy were categorized as having a perceived food allergy...
February 22, 2017: Medical Principles and Practice: International Journal of the Kuwait University, Health Science Centre
https://www.readbyqxmd.com/read/28215605/the-high-cost-of-epinephrine-autoinjectors-and-possible-alternatives
#15
Amber N Pepper, Emma Westermann-Clark, Richard F Lockey
Epinephrine autoinjectors provide potentially life-saving therapy for pediatric and adult subjects with systemic allergic reactions, including anaphylaxis. However, the cost of these devices, specifically the EpiPen (Mylan, Canonsburg, Pa), is increasing exponentially. Epinephrine autoinjectors are commonly prescribed in the United States but are not readily available worldwide. Alternatives for the self-administration of epinephrine exist and should be considered for patients who cannot afford or do not have access to these devices...
February 10, 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28193793/guidance-on-completing-a-written-allergy-and-anaphylaxis-emergency-plan
#16
Julie Wang, Scott H Sicherer
Anaphylaxis is a potentially life-threatening, severe allergic reaction. The immediate assessment of patients having an allergic reaction and prompt administration of epinephrine, if criteria for anaphylaxis are met, promote optimal outcomes. National and international guidelines for the management of anaphylaxis, including those for management of allergic reactions at school, as well as several clinical reports from the American Academy of Pediatrics, recommend the provision of written emergency action plans to those at risk of anaphylaxis, in addition to the prescription of epinephrine autoinjectors...
March 2017: Pediatrics
https://www.readbyqxmd.com/read/28193791/epinephrine-for-first-aid-management-of-anaphylaxis
#17
Scott H Sicherer, F Estelle R Simons
Anaphylaxis is a severe, generalized allergic or hypersensitivity reaction that is rapid in onset and may cause death. Epinephrine (adrenaline) can be life-saving when administered as rapidly as possible once anaphylaxis is recognized. This clinical report from the American Academy of Pediatrics is an update of the 2007 clinical report on this topic. It provides information to help clinicians identify patients at risk of anaphylaxis and new information about epinephrine and epinephrine autoinjectors (EAs). The report also highlights the importance of patient and family education about the recognition and management of anaphylaxis in the community...
March 2017: Pediatrics
https://www.readbyqxmd.com/read/28117270/food-allergic-adolescents-at-risk-for-anaphylaxis-a-randomized-controlled-study-of-supervised-injection-to-improve-comfort-with-epinephrine-self-injection
#18
Eyal Shemesh, Christine D'Urso, Christopher Knight, Melissa Rubes, Kinga M Picerno, Ailie M Posillico, Zara Atal, Rachel A Annunziato, Scott H Sicherer
BACKGROUND: Epinephrine self-injection is a key element in the management of food allergy, yet many adolescents report that they may not be able to use the autoinjector when needed. We hypothesized that supervised self-injection with an empty syringe would increase adolescents' comfort with self-injection. OBJECTIVE: The objective of this study was to examine the effect of supervised self-injection on self- and parent-reported comfort and anxiety during and after clinic visits in a food allergy center...
January 20, 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28115856/anaphylaxis-across-two-canadian-pediatric-centers-evaluating-management-disparities
#19
Alison Ym Lee, Paul Enarson, Ann E Clarke, Sébastien La Vieille, Harley Eisman, Edmond S Chan, Christopher Mill, Lawrence Joseph, Moshe Ben-Shoshan
BACKGROUND: There are no data on the percentage of visits due to anaphylaxis in the emergency department (ED), triggers, and management of anaphylaxis across different provinces in Canada. OBJECTIVE: To compare the percentage of anaphylaxis cases among all ED visits, as well as the triggers and management of anaphylaxis between two Canadian pediatric EDs (PEDs). METHODS: As part of the Cross-Canada Anaphylaxis Registry (C-CARE), children presenting to the British Columbia Children's Hospital (BCCH) and Montreal Children's Hospital (MCH) EDs with anaphylaxis were recruited...
2017: Journal of Asthma and Allergy
https://www.readbyqxmd.com/read/28069483/epinephrine-use-in-older-patients-with-anaphylaxis-clinical-outcomes-and-cardiovascular-complications
#20
Takahisa Kawano, Frank Xavier Scheuermeyer, Robert Stenstrom, Brian H Rowe, Eric Grafstein, Brian Grunau
BACKGROUND: There is little data describing the differences in epinephrine (epi) administration and cardiac complications among older and younger patients with anaphylaxis. METHODS: This retrospective cohort study was conducted at two urban emergency departments (ED) over a 5 year-period, and included adults who met a pre-specified criteria for anaphylaxis. Patients ≥50years of age were defined as "older". Univariate logistic regression was performed to compare the difference in frequency of epi administration between the "older" and "younger" groups...
January 6, 2017: Resuscitation
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