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Anaphylaxis

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181. Allergic acute coronary syndrome in exercise-induced anaphylaxis. (PubMed)

Allergic acute coronary syndrome in exercise-induced anaphylaxis. In this case report we present a 49-year-old male who was seen in the emergency department after collapsing due to anaphylactic shock, with ECG findings suggesting myocardial ischaemia. We linked both diagnoses to Kounis syndrome, which describes an acute coronary syndrome due to an allergic event. His circulatory collapse was explained by exercise-induced anaphylaxis.

2018 Netherlands Journal of Medicine

182. Risk factors for recurrent anaphylaxis-related emergency department visits in the United States. (PubMed)

Risk factors for recurrent anaphylaxis-related emergency department visits in the United States. Anaphylaxis is a potentially life-threatening allergic reaction with a strong risk of recurrence.To assess risk factors associated with recurrent anaphylaxis-related emergency department (ED) visits within 1 year of an ED visit for anaphylaxis in a large observational cohort study.We used an administrative claims database to identify patients seen from 2008 through 2012 in the ED for anaphylaxis (...) based on an International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis code algorithm. Patients with at least 2 years of continuous enrollment in a health plan were included. Multivariable logistic regression analysis was used to determine associations with recurrence of anaphylaxis within 1 year.During the 5-year study period, 7,367 patients (median age, 42 years; <18 years old, 23.3%) met the inclusion criteria. The most common anaphylaxis trigger was unspecified

2018 Asthma & Immunology

183. Perioperative Anaphylaxis Including Kounis Syndrome due to Selective Cefazolin Allergy. (PubMed)

Perioperative Anaphylaxis Including Kounis Syndrome due to Selective Cefazolin Allergy. Perioperative use of cefazolin has been associated with severe allergic reactions, and patients are usually labelled as allergic to penicillin afterwards. The aim of our study was to describe a group of patients with immediate reactions to cefazolin, with proven selective hypersensitivity reactions.Systematic review of all patients followed at our drug centre with cefazolin-related reactions, between January

2018 International Archives of Allergy and Immunology

184. Myths, facts and controversies in the diagnosis and management of anaphylaxis. (PubMed)

Myths, facts and controversies in the diagnosis and management of anaphylaxis. Anaphylaxis is a serious systemic allergic reaction that is rapid in onset and may cause death. Despite numerous national and international guidelines and consensus statements, common misconceptions still persist in terms of diagnosis and appropriate management, both among healthcare professionals and patient/carers. We address some of these misconceptions and highlight the optimal approach for patients who

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2018 Archives of Disease in Childhood

185. Effects of Glucocorticoids on Hospitalized Children With Anaphylaxis. (PubMed)

Effects of Glucocorticoids on Hospitalized Children With Anaphylaxis. The benefits of glucocorticoid treatment and recent trends of adjunctive treatments during episodes of anaphylaxis remain unclear.The aims of this study were to investigate the recent practice patterns and compare the effects of glucocorticoid for children hospitalized with anaphylaxis.Using the Japanese Diagnosis Procedure Combination inpatient database, we compared the length of hospital stay, risk of 10-day readmission

2018 Pediatric Emergency Care

186. Current trends in food allergy-induced anaphylaxis management at school. (PubMed)

Current trends in food allergy-induced anaphylaxis management at school. To review the evidence and current policies regarding the use of epinephrine at schools and child care centers DATA SOURCES AND STUDY SELECTIONS: A narrative review was performed based on the result of conference proceedings of a group of interprofessional stakeholders who attended the USAnaphylaxis Summit 2017 presented by Allergy & Asthma Network.Anaphylaxis is a well-recognized medical emergency that requires prompt (...) treatment with intramuscular epinephrine. Anaphylaxis can be associated with poor quality of life. There is renewed recent focus on anaphylaxis management in schools. This interest has been spurred by an increase in the number of children with food allergy who are attending school, data that support up to 25% of first-time anaphylactic events occurring on school grounds, and a well-publicized fatality that helped to initiate a movement for stock, undesignated, non-student-specific epinephrine. Stock

2018 Asthma & Immunology

187. Biphasic anaphylaxis: A review of the literature and implications for emergency management. (PubMed)

Biphasic anaphylaxis: A review of the literature and implications for emergency management. The biphasic reaction is a feared complication of anaphylaxis management in the emergency department (ED). The traditional recommended ED observation time is 4-6 h after complete resolution of symptoms for every anaphylaxis patient. However, there has been great controversy regarding whether this standard of care is evidence-based.Articles were selected using a PubMed, MEDLINE search for the keywords (...) "biphasic anaphylaxis", yielding 155 articles. Articles were filtered by English language, and the keyword biphasic in the title. Case reports and case series were excluded, narrowing to 33 articles. Then, articles were filtered by relevance to the ED setting, and studies conducted in outpatient clinic settings were excluded, narrowing the search to 16 articles. All remaining articles were reviewed and findings were discussed.The reported mean time to onset between the resolution of initial anaphylaxis

2018 American Journal of Emergency Medicine

188. Quality of the Triage of Children With Anaphylaxis at the Emergency Department. (PubMed)

Quality of the Triage of Children With Anaphylaxis at the Emergency Department. Early recognition of symptoms is essential in anaphylaxis management. The Canadian Paediatric Emergency Triage and Acuity Scale prioritizes anaphylaxis to level I or II (resuscitation or emergency). We analyzed the accuracy of pediatric anaphylaxis triage.This was a retrospective review of the triage charts (adaptation of the Canadian Paediatric Emergency Triage and Acuity Scale) of 137 children attended (...) for anaphylaxis at our pediatric emergency department. Per triages' accuracy, charts were divided into TR1 (levels I-II) and TR2 (levels III-V), comparing demographics, initial triage level given by initial assessment (Paediatric Assessment Triangle), vital signs, observations recorded by the staff, and waiting times for physician.Forty-six (33.3%) were triaged correctly (TR1 group), and 91 (66.7%) were not. Median ages were similar (TR1: 5 years [interquartile range, 13.1 years] vs TR2: 4.5 years

2018 Pediatric Emergency Care

189. Epinephrine, auto-injectors and anaphylaxis: challenges of dose, depth and device. (PubMed)

Epinephrine, auto-injectors and anaphylaxis: challenges of dose, depth and device. This review was undertaken to review epinephrine dosing, site and route of administration, focusing on special populations (patients weighing less than 15 kg, and obese patients); and to discuss storage and delivery of epinephrine in prehospital and hospital settings.Review of published literature.Relevance.The recommended 0.01-mg/kg (maximum 0.3-0.5 mg) epinephrine dose in anaphylaxis is based on limited (...) pharmacokinetic data in healthy volunteers. No pharmacokinetic or pharmacodynamics studies involving patients in anaphylaxis have been published. When epinephrine auto-injectors (EAIs) are used in infants, the dose increasingly exceeds the recommended dose as weight decreases, although the clinical significance of this is unclear. Limited data indicate that the intramuscular route and lateral thigh site are superior. Ultrasound studies suggest that 0.15 EAI needles may be too long for many patients weighing

2018 Asthma & Immunology

190. Neurologic manifestations in anaphylaxis due to subcutaneous allergy immunotherapy: A case report. (PubMed)

Neurologic manifestations in anaphylaxis due to subcutaneous allergy immunotherapy: A case report. Life-threatening anaphylactic shock is a rare (1 in 1 million) but documented occurrence in response to subcutaneous immunotherapy. Immediate administration of Epinephrine (Epi) is critical to save lives in these situations. The current protocol for systemic reactions in immunotherapy is for the prescribing physician to reassess the dosing and schedule as well as the risk:benefit assessment (...) of anaphylaxis are rare with 1 study claiming 13% of cases of anaphylaxis having LOC and only 1.5% cases with loss of bladder or bowel control.This case is one of continued subcutaneous immunotherapy after the patient had an initial systemic reaction suspicious for anaphylaxis 6 months before the life-threatening anaphylaxis, both induced by immunotherapy. In both instances, there was a significant amount of neurologic involvement. Neurologic sequela included a transient tremor and permanent deficits

2018 Medicine

191. Anaphylaxis by exclusive allergy to swordfish and identification of a new fish allergen. (PubMed)

Anaphylaxis by exclusive allergy to swordfish and identification of a new fish allergen. 29698550 2019 01 11 2019 01 11 1399-3038 29 5 2018 08 Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology Pediatr Allergy Immunol Anaphylaxis by exclusive allergy to swordfish and identification of a new fish allergen. 563-565 10.1111/pai.12916 Valverde-Monge M M Allergy Department, Niño Jesús University Hospital, Madrid, Spain. Allergy (...) , Madrid, Spain. eng Case Reports Letter 2018 05 29 England Pediatr Allergy Immunol 9106718 0905-6157 0 Allergens 0 Fish Proteins, Dietary 0 Parvalbumins 37341-29-0 Immunoglobulin E EC 2.7.1.40 Pyruvate Kinase IM Allergens immunology Anaphylaxis diagnosis immunology Animals Child Child, Preschool Fish Products Fish Proteins, Dietary immunology Fishes immunology Food Hypersensitivity diagnosis immunology Humans Immunoglobulin E metabolism Male Parvalbumins immunology Protein Binding Pyruvate Kinase

2018 Pediatric Allergy and Immunology

192. Anaphylaxis admissions to pediatric intensive care units in France. (PubMed)

Anaphylaxis admissions to pediatric intensive care units in France. 29787624 2018 08 31 1398-9995 73 9 2018 Sep Allergy Allergy Anaphylaxis admissions to pediatric intensive care units in France. 1902-1905 10.1111/all.13483 Pouessel G G http://orcid.org/0000-0003-4118-6385 Department of Pediatrics, Children's Hospital, Roubaix, France. Pediatric Pulmonology and Allergy Department, Hôpital Jeanne de Flandre, CHU Lille, Lille, France. Chagnon F F Pediatric Intensive Care Unit, CHU Lille, Lille

2018 Allergy

193. Specialist perioperative allergy clinic services in the UK 2018: Results from the Royal College of Anaesthetists Sixth National Audit Project (NAP6) Investigation of Perioperative Anaphylaxis. (PubMed)

Specialist perioperative allergy clinic services in the UK 2018: Results from the Royal College of Anaesthetists Sixth National Audit Project (NAP6) Investigation of Perioperative Anaphylaxis. The Royal College of Anaesthetists 6th National Audit Project examined Grade 3-5 perioperative anaphylaxis for 1 year in the UK.To describe the causes and investigation of anaphylaxis in the NAP6 cohort, in relation to published guidance and previous baseline survey results.We used a secure registry (...) to gather details of Grade 3-5 perioperative anaphylaxis. Anonymous reports were aggregated for analysis and reviewed in detail. Panel consensus diagnosis, reaction grade, review of investigations and clinic assessment are reported and compared to the prior NAP6 baseline clinic survey.A total of 266 cases met inclusion criteria between November 2015 and 2016, detailing reactions and investigations. One hundred and ninety-two of 266 (72%) had anaphylaxis with a trigger identified, of which 140/192 (75

2018 Clinical and Experimental Allergy

194. The orphan nuclear receptor NR4A1 promotes FcεRI-stimulated mast cell activation and anaphylaxis by counteracting the inhibitory LKB1/AMPK axis. (PubMed)

The orphan nuclear receptor NR4A1 promotes FcεRI-stimulated mast cell activation and anaphylaxis by counteracting the inhibitory LKB1/AMPK axis. Nuclear receptor subfamily 4 group A member 1 (NR4A1), an orphan nuclear receptor, has been implicated in several biological events such as metabolism, apoptosis, and inflammation. Recent studies indicate a potential role for NR4A1 in mast cells, yet its role in allergic responses remains largely unknown.The aim of this study was to clarify the role

2018 Allergy

195. Analysis of Value-Based Costs of Undesignated School Stock Epinephrine Policies for Peanut Anaphylaxis. (PubMed)

Analysis of Value-Based Costs of Undesignated School Stock Epinephrine Policies for Peanut Anaphylaxis. Children experiencing anaphylaxis at school may lack access to a personal epinephrine device, prompting recent legislation permitting undesignated (eg, non-student specific) stock epinephrine autoinjector units at school. However, epinephrine device costs vary, and the cost-effectiveness of undesignated school stock epinephrine is uncharacterized to date.To define value-based strategies

2018 JAMA pediatrics

196. Adults with EoE had an increased risk of pollen food allergy syndrome, anaphylaxis, and comorbid autoimmune and psychiatric conditions

Adults with EoE had an increased risk of pollen food allergy syndrome, anaphylaxis, and comorbid autoimmune and psychiatric conditions Allergy Notes: Adults with EoE had an increased risk of pollen food allergy syndrome, anaphylaxis, and comorbid autoimmune and psychiatric conditions Allergy, Asthma and Immunology News Updated Daily by Board-certified Allergist at Cleveland Clinic Florida Pages Adults with EoE had an increased risk of pollen food allergy syndrome, anaphylaxis, and comorbid (...) % required endoscopic removal) - 56% had strictures or fibrosis (of which 56% underwent dilatation) Therapy used was predominantly (77%) medical only. Comorbid atopy, pollen food allergy syndrome, drug allergy, anaphylaxis, autoimmunity, and psychiatric illnesses were higher in the EoE cohort compared with the general University of Pennsylvania Health Systems population. Adults with biopsy-proven EoE had an increased risk of pollen food allergy syndrome, anaphylaxis, and comorbid autoimmune

2018 Allergy Notes blog

197. Contact urticaria with anaphylaxis to chlorocresol, chloroxylenol and thiourea. (PubMed)

Contact urticaria with anaphylaxis to chlorocresol, chloroxylenol and thiourea. 30523628 2019 01 10 1600-0536 2018 Dec 06 Contact dermatitis Contact Derm. Contact urticaria with anaphylaxis caused by chlorocresol, chloroxylenol, and thiourea. 10.1111/cod.13194 Mehrtens Sarah H SH https://orcid.org/0000-0002-7335-6505 Department of Dermatology, Kent and Canterbury Hospital, East Kent Hospitals University NHS Foundation Trust, Canterbury, UK. Reckling Christine C https://orcid.org/0000-0002-7487 (...) -3563 Department of Dermatology, Kent and Canterbury Hospital, East Kent Hospitals University NHS Foundation Trust, Canterbury, UK. eng Journal Article 2018 12 06 England Contact Dermatitis 7604950 0105-1873 CAS no. 59-50-7 CAS no. 62-56-6 CAS no. 88-04-0 / 1321-23-9 anaphylaxis case report chlorocresol chloroxylenol contact urticaria thiourea 2018 09 06 2018 11 29 2018 11 30 2018 12 14 6 0 2018 12 14 6 0 2018 12 8 6 0 aheadofprint 30523628 10.1111/cod.13194

2018 Contact Dermatitis

198. Anaphylaxis admissions in pediatric intensive care units: follow up and risk of recurrence. (PubMed)

Anaphylaxis admissions in pediatric intensive care units: follow up and risk of recurrence. Data about the risk of anaphylaxis recurrence in children are lacking. We assessed anaphylaxis recurrence and medical follow-up in a cohort of children previously hospitalized in a French pediatric intensive care unit (PICU) for anaphylaxis.We conducted a telephone survey of 166 children (≤18y) hospitalized from 2003 to 2013.In all, 106 (64%) completed the survey [boys, 59%; mean age (SD):15.3y (5.5 (...) )]. The main index triggers were drugs (45%) and foods (37%). The mean duration follow-up was of 7.7y (SD: 2.4). Thirty-eight (36%) children experienced 399 new allergic reactions during a follow-up period of 282 patient-years (incidence rate: 1.4/100 patients/year; 95% CI: 0.64-2.04). Twelve children experienced 19 anaphylaxis reactions including five requiring PICU admission (anaphylaxis recurrence rate: 0.20/100 patients/year; 95%CI non-calculable). Food was the trigger for 79% of recurrent reactions

2018 Pediatric Allergy and Immunology

199. Emergency call characteristics and EMS dispatcher protocol adherence for possible anaphylaxis. (PubMed)

Emergency call characteristics and EMS dispatcher protocol adherence for possible anaphylaxis. Anaphylaxis is a medical emergency requiring prompt recognition and treatment with intramuscular epinephrine to optimize outcomes. To date, there is a paucity of data regarding the demographic characteristics of the subset of patients calling 9-1-1 for allergic reactions and the emergency medical services (EMS) dispatcher's adherence to national protocols for their response to a suspected allergic (...) Problems protocols. The calls were further reviewed for demographic characteristics, symptomatology, history of allergy, suspected trigger of the current reaction, and use and availability of medications. Calls were also classified as to whether the patient met criteria for anaphylaxis. We calculated frequencies for categorical measures and medians with ranges for continuous measures.A total of 146 calls met inclusion criteria. The median age of patients was 29 years (interquartile range 13, 52). 12.3

2018 Prehospital emergency care

200. A Case of Anaphylaxis to Intramuscular but Not to Oral Application of Thiamine (Vitamin B1). (PubMed)

A Case of Anaphylaxis to Intramuscular but Not to Oral Application of Thiamine (Vitamin B1). We report a 78 year-old non-atopic female with polyneuropathy who started to receive monthly intramuscular injections of thiamine hydrochloride. She had an anaphylaxis after the fourth injection. Skin prick test (SPT) with pure commercially available aqueous preparations was positive for thiamine hydrochloride. A titrated, single blinded, placebo-controlled oral provocation test with thiamine

2018 Iranian journal of allergy, asthma, and immunology Controlled trial quality: uncertain

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