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Anaphylaxis

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21. Angio-oedema and anaphylaxis

includes recommendations from the National Institute for Health and Care Excellence (NICE) guidance Anaphylaxis: assessment to confirm an anaphylactic episode and the decision to refer after emergency treatment for a suspected anaphylactic episode . In addition, the management section has been restructured to improve clarity and navigation. Issued in January 2012. February 2011 — technical update. The Management section of this topic has been simplified to improve clarity and navigation. There have (...) been no changes to the clinical content or meaning of the recommendations. September 2008 — minor correction to the Changes section. Issued in September 2008. April 2008 — minor update to include recommendations from the Working Group of the Resuscitation Council (UK) guideline Emergency treatment of anaphylactic reactions: Guidelines for healthcare providers (January 2008). This includes changes in the dosages of emergency drugs for anaphylaxis. Issued in May 2008. January to April 2007

2018 NICE Clinical Knowledge Summaries

22. Epidemiology and outcomes of anaphylaxis-associated out-of-hospital cardiac arrest. Full Text available with Trip Pro

Epidemiology and outcomes of anaphylaxis-associated out-of-hospital cardiac arrest. Understanding the epidemiological characteristics of anaphylaxis-associated out-of-hospital cardiac arrest (OHCA) is the first step toward developing preventative strategies and optimizing care systems. We aimed to describe and compare epidemiological features and clinical outcomes among patients with anaphylaxis-associated OHCAs according to causative agent groups.We identified emergency medical service (EMS (...) )-treated anaphylaxis-associated OHCA patients from a nationwide OHCA registry between 2008 and 2015. We compared epidemiological characteristics and outcomes according to causal agents (a natural agents group and an iatrogenic agents group) and evaluated temporal variability in incidence. Multivariate logistic regression analysis was performed to compare survival to discharge between causative agent groups.During the study period (8 years), the total number of anaphylaxis-associated OHCAs was 233

2018 PLoS ONE

23. Drug‐induced anaphylaxis in the emergency room Full Text available with Trip Pro

Drug‐induced anaphylaxis in the emergency room Anaphylaxis is a life-threatening, systemic allergic reaction that presents unique challenges for emergency care practitioners. Anaphylaxis occurs more frequently than previously believed. Therefore, proper knowledge regarding the epidemiology, mechanisms, symptoms, diagnosis, and treatment of anaphylaxis is essential. In particular, the initial treatment strategy, followed by correct diagnosis, in the emergency room is critical for preventing (...) fatal anaphylaxis, although making a diagnosis is not easy because of the broad and often atypical presentation of anaphylaxis. To this end, the clinical criteria proposed by the National Institute of Allergy and Infectious Diseases and the Food Allergy and Anaphylaxis Network are useful, which, together with a differential diagnosis, could enable a more accurate diagnosis. Additional in vitro tests, such as plasma histamine and tryptase measurements, are also helpful. It should be emphasized

2017 Acute medicine & surgery

25. ASCIA Clinical Update - Anaphylaxis

resources and phone assistance throughout Australia Allergy New Zealand www.allergy.org.nz Provides patient resources and phone assistance throughout New Zealand ASCIA INFORMATION FOR HEALTH PROFESSIONALS 12 References 1. Loh R, Mullins R, Vale S. Anaphylaxis: Investigating and managing an allergic emergency. Medicine Today 2012; 13 (9):16-25. 2. Sampson et al. Fatal and near fatal anaphylactic reactions to food in children and adolescents. New England Journal of Medicine 1992; 327 (6): 380-4. 3. Brown (...) notes 2007. 8. Stuckey M, Cobain T, Sears M, et al. Bee venom hypersensitivity in Busselton [letter]. Lancet 1982; 2: 41. 9. Thong B, Tan T. Epidemiology and risk factors for drug allergy. Br J Clin Pharmacol 2011; 71 (5): 684- 700. 10. Liew WK, Williamson E, Tang MLK. Anaphylaxis fatalities and admissions in Australia. JACI 2008; 123 (2): 434-42. 11. Bock SA. Fatal Anaphylaxis. UpToDate. 2010. 12. Bock SA. Further fatalities, caused by anaphylactic reactions to food, 2001-2006. JACI 2007; 119 (4

2016 Australasian Society of Clinical Immunology and Allergy

26. ASCIA Checklists - Anaphylaxis

ASCIA Checklists - Anaphylaxis Anaphylaxis Checklist for GPs - Australasian Society of Clinical Immunology and Allergy (ASCIA) | | Anaphylaxis Checklist for GPs Anaphylaxis Checklist for General Practice This checklist has been developed to assist General Practitioners optimise the management of patients with severe allergies who are at risk of anaphylaxis. Record history of the allergic reaction, suspected triggers and assess severity (e.g. using ASCIA anaphylaxis event record). Prescribe (...) initial adrenaline autoinjector for newly diagnosed patient and if necessary contact a specialist (allergy, respiratory, paediatrician) for authority prescription, pending specialist appointment. Refer to allergy specialist and provide relevant clinical history. Check adrenaline autoinjector expiry, renew prescription and check that the dose is appropriate for their weight/age : 10-20kg - 0.15mg device; Over 20kg - 0.30mg device. Complete and sign ASCIA Action Plan for Anaphylaxis. Complete and sign

2015 Australasian Society of Clinical Immunology and Allergy

27. ASCIA Guidelines - Prevention of anaphylaxis in schools, pre-schools and childcare: 2015 update

extensive consultation with Allergy & Anaphylaxis Australia and have been adapted and updated based on the ASCIA Guidelines for Prevention of Food Anaphylactic Reactions in Schools, Preschools and Childcare published in December 2004 in the Journal of Paediat- rics and Child Health,Volume40,Issue12,page669andupdated version, ASCIA Prevention of Anaphylaxis in Schools, Pre- schools and Childcare: 2012 update, published in the Journal of Paediatrics and Child Health, Volume 49 (2013) 342–345. References 1 (...) ASCIA Guidelines - Prevention of anaphylaxis in schools, pre-schools and childcare: 2015 update POSITION PAPER ASCIA guidelines for prevention of anaphylaxis in schools, pre-schools and childcare: 2015 update Sandra Vale, 1 Jill Smith, 1 Maria Said, 2,3 Raymond James Mullins 2,4,5 and Richard Loh 2,6 1 Australasian Society of Clinical Immunology and Allergy (ASCIA), 2 ASCIA Anaphylaxis Working Party, 3 Allergy & Anaphylaxis Australia, Sydney, New South Wales, 4 Health Sciences, University

2015 Australasian Society of Clinical Immunology and Allergy

28. AK002, a Humanized Sialic Acid-Binding Immunoglobulin-Like Lectin-8 Antibody that Induces Antibody-Dependent Cell-Mediated Cytotoxicity against Human Eosinophils and Inhibits Mast Cell-Mediated Anaphylaxis in Mice. Full Text available with Trip Pro

AK002, a Humanized Sialic Acid-Binding Immunoglobulin-Like Lectin-8 Antibody that Induces Antibody-Dependent Cell-Mediated Cytotoxicity against Human Eosinophils and Inhibits Mast Cell-Mediated Anaphylaxis in Mice. Pathologic accumulation and activation of mast cells and eosinophils are implicated in allergic and inflammatory diseases. Sialic acid-binding immunoglobulin-like lectin (Siglec)-8 is an inhibitory receptor selectively expressed on mast cells, eosinophils and, at a lower extent (...) by biolayer interferometry. Ex vivo activity of AK002 on human eosinophils from blood and dissociated human tissue was tested in apoptosis and antibody-dependent cell-mediated cytotoxicity (ADCC) assays. The in vivo activity of a murine precursor of AK002 (mAK002) was tested in a passive systemic anaphylaxis (PSA) humanized mouse model.AK002 bound selectively to mast cells, eosinophils and, at a lower level, to basophils in human blood and tissue and not to other cell types examined. AK002 induced

2019 International Archives of Allergy and Immunology

29. Preventing iatrogenic gelatin anaphylaxis. (Abstract)

Preventing iatrogenic gelatin anaphylaxis. To assess the iatrogenic risks of gelatin allergy and identify resources for patient management.A literature review was performed using PubMed and public databases provided by the National Library of Medicine.Reports of iatrogenic gelatin allergy associated with vaccines, hemostatic agents, intravenous colloids, medicinal capsules, and intraoperative surgical supplies.Gelatin ingredients may not be identified by electronic medical record safeguards

2019 Asthma & Immunology

30. Idiopathic anaphylaxis yardstick: Practical recommendations for clinical practice. Full Text available with Trip Pro

Idiopathic anaphylaxis yardstick: Practical recommendations for clinical practice. Anaphylaxis is considered idiopathic when there is no known trigger. The signs and symptoms of idiopathic anaphylaxis (IA) are identical to those of anaphylaxis because of a known cause and can include cutaneous, circulatory, respiratory, gastrointestinal, and neurologic symptoms. Idiopathic anaphylaxis can be a frustrating disease for patients and health care providers. Episodes are unpredictable (...) , and differential diagnosis is challenging. Current anaphylaxis guidelines have little specific guidance regarding differential diagnosis and long-term management of IA. Therefore, the objective of the Idiopathic Anaphylaxis Yardstick is to use published data and the authors' combined clinical experience to provide practical recommendations for the diagnosis and management of patients with IA.Copyright © 2019 American College of Allergy, Asthma & Immunology. All rights reserved.

2019 Asthma & Immunology

31. Perioperative anaphylaxis in children: aetiology, time sequence and patterns of clinical reactivity. (Abstract)

Perioperative anaphylaxis in children: aetiology, time sequence and patterns of clinical reactivity. Perioperative anaphylaxis (PA) in children is an uncommon but potentially life-threatening complication associated with anaesthesia. Early identification and management of PA is essential to optimize clinical outcomes.We performed a retrospective study of anaesthesia records from paediatric patients with PA from centres in the United Kingdom, France, and the United States over a period of ten

2019 Pediatric Allergy and Immunology

32. Food and drug allergy, and anaphylaxis in EAACI journals (2018). (Abstract)

Food and drug allergy, and anaphylaxis in EAACI journals (2018). The European Academy of Allergy and Clinical Immunology (EAACI) supports three journals: "Allergy," "Pediatric Allergy and Immunology (PAI)," and "Clinical and Translational Allergy (CTA)." One of the major goals of EAACI is to support health promotion in which prevention of allergy and asthma plays a critical role and to disseminate the knowledge of allergy to all stakeholders including the EAACI junior members. This paper (...) summarizes the achievements of 2018 in anaphylaxis, and food and drug allergy. Main topics that have been focused are anaphylaxis, mechanisms of food allergy (FA), epidemiology of FA, food allergens, diagnosis of FA, prevention and control of FA, FA immunotherapy, drug allergy, and political agenda.© 2019 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.

2019 Pediatric Allergy and Immunology

33. The time course of anaphylaxis manifestations in children is diverse and unpredictable. (Abstract)

The time course of anaphylaxis manifestations in children is diverse and unpredictable. The most current clinical definition of anaphylaxis is that proposed by Sampson et al. and different scoring systems have been proposed to assess its severity [1,2]. Anaphylaxis symptoms range from mild, self-limiting local reactions to life-threatening anaphylaxis. All anaphylaxis guidelines emphasize early recognition and the need for prompt intramuscular adrenaline injection as the first-line treatment [3 (...) ]. However, adrenaline for anaphylaxis is underused by patients, families and even by health professionals. In the European anaphylaxis registry, 27% of patients treated by a health professional received adrenaline [4].© 2019 John Wiley & Sons Ltd.

2019 Clinical and Experimental Allergy

34. Epinephrine in Severe Allergic Reactions: The European Anaphylaxis Register. Full Text available with Trip Pro

Epinephrine in Severe Allergic Reactions: The European Anaphylaxis Register. Current guidelines recommend intramuscular administration of epinephrine as the first-line drug for the emergency treatment of severe allergic reactions (anaphylaxis), but no randomized trial evidence supports this consensus.We aimed to assess anaphylaxis treatment practices over 10 years, covering several European regions, all allergen sources, and all age groups.The European Anaphylaxis Register tracks elicitors (...) , symptoms, emergency treatment, diagnostic workups, and long-term counseling for anaphylaxis incidents through web-based data entry from tertiary allergy specialists, covering information from the emergency respondent, patient, tertiary referral, and laboratory/clinical test results.We analyzed 10,184 anaphylaxis incidents. In total, 27.1% of patients treated by a health professional received epinephrine and, in total, 10.5% received a second dose. Successful administration was less frequent in German

2019 The journal of allergy and clinical immunology. In practice Controlled trial quality: uncertain

35. Acute Severe Anaphylaxis in Nepali Patients with Neurotoxic Snakebite Envenoming Treated with the VINS Polyvalent Antivenom. Full Text available with Trip Pro

Acute Severe Anaphylaxis in Nepali Patients with Neurotoxic Snakebite Envenoming Treated with the VINS Polyvalent Antivenom. Diagnosing and treating acute severe and recurrent antivenom-related anaphylaxis (ARA) is challenging and reported experience is limited. Herein, we describe our experience of severe ARA in patients with neurotoxic snakebite envenoming in Nepal. Patients were enrolled in a randomised, double-blind trial of high vs. low dose antivenom, given by intravenous (IV) push

2019 Journal of tropical medicine Controlled trial quality: uncertain

36. Severe and near-fatal anaphylactic reactions triggered by chlorhexidine-coated catheters in patients undergoing renal allograft surgery: a case series. (Abstract)

Severe and near-fatal anaphylactic reactions triggered by chlorhexidine-coated catheters in patients undergoing renal allograft surgery: a case series. Although intraoperative anaphylaxis during surgery is a rare event, we describe five patients who experienced perioperative anaphylactic reactions during renal transplantation and were referred for investigation.Skin-prick and intradermal skin tests were done to investigate potential allergies to drugs given perioperatively prior (...) to the development of anaphylaxis, including basiliximab, propofol, cefazolin, cis-atracurium, fentanyl, latex, remifentanil, and chlorhexidine. In addition, in vitro serologic testing for specific IgE was done in patients suspected to have had chlorhexidine anaphylaxis. All five patients were male, with a mean age of 48 yr (range 30-69). Skin testing for all drugs was non-reactive except for chlorhexidine, which was positive in four of five patients (one patient refused intradermal testing). In vitro test

2019 Canadian Journal Of Anaesthesia

37. Medical malpractice related to drug-induced anaphylaxis: An analysis of lawsuit judgments in South Korea. Full Text available with Trip Pro

Medical malpractice related to drug-induced anaphylaxis: An analysis of lawsuit judgments in South Korea. Drug-induced anaphylaxis (DIA) is a highly paradoxical disorder involving a fatal response to medicines prescribed for therapeutic purposes. This study aimed to improve the awareness on DIA and to prevent errors through an analysis of lawsuit judgments.Sentenced judgments involving DIA from 1998 to 2017 using the database of the Korean Supreme Court Judgment System were collected. General (...) ), respectively, suggesting insufficient time to cope with anaphylaxis. Consequently, either death (n = 18, 66.7%) or ischemic brain injury (n = 9, 33.3%) occurred in all cases. Violation of duty of care was recognized in 19 cases (70.4%) with median awarded amount of $106,060 (IQR = $70,296-$168,363). The recognized negligence included inadequate observation after drug administration (n = 6), delayed or missed epinephrine administration (n = 6), ignoring a history of allergy or drug hypersensitivity (n = 6

2019 Medicine

38. Epidemiology of acute coronary syndrome co-existent with allergic/hypersensitivity/anaphylactic reactions (Kounis syndrome) in the United States: A nationwide inpatient analysis. (Abstract)

Epidemiology of acute coronary syndrome co-existent with allergic/hypersensitivity/anaphylactic reactions (Kounis syndrome) in the United States: A nationwide inpatient analysis. The nationwide epidemiological data on Kounis Syndrome (KS), still remains indistinct in the United States (US) after it was first reported in 1991.We assessed the prevalence of KS among patients primarily hospitalized for allergic/hypersensitivity/anaphylactic reactions. We then compared baseline demographics (...) , comorbidities, and outcomes of KS with patients with only allergic/hypersensitivity/anaphylactic reactions using the National Inpatient Sample, 2007-2014.The cohort comprised of 235,420 patients primarily hospitalized with allergy/hypersensitivity/anaphylactic reactions. Of these, 2616 [1.1%; 0.2% unstable angina, 0.2% ST-elevation myocardial infarction & 0.7% non-ST-elevation myocardial infarction] patients experienced ACS and were identified as having KS. Patients with KS were older (mean 65.9 ± 14.1 vs

2019 International journal of cardiology

39. Serum Baseline Tryptase Level as a Marker for the Severity of Anaphylaxis. (Abstract)

Serum Baseline Tryptase Level as a Marker for the Severity of Anaphylaxis. Anaphylaxis is a severe and potentially fatal allergic disease or hypersensitivity reaction with variable clinical presentation. Biomarkers in anaphylaxis could be useful to improve diagnosis, to allow endotyping of patients, and to predict risk.To investigate the role of serum basal tryptase (sBT) levels in the management of patients with anaphylaxis.Patients with at least 1 episode of anaphylaxis were selected among (...) 5.17 ng/mL), with no significant differences in patients with anaphylaxis due to different triggers. Mean levels were 4.93; 5.2; 5.41, and 5.24 ng/mL for patients who had anaphylaxis due to Hymenoptera venom (n = 17), foods (n = 13), drugs (n = 13), and idiopathic disease (n = 14), respectively. Significantly higher sBT levels were observed in patients with severe anaphylaxis (grade IV) than in patients with mild-moderate disease (grades II/III) (mean levels 6.61 vs. 4.71 ng/mL, respectively).High

2019 International Archives of Allergy and Immunology

40. Anaphylaxis and anaphylactoid reactions associated with the insertion of peripherally inserted central catheters: A multiyear comparative retrospective cohort study. (Abstract)

test with Yates correction or the Fisher exact test as appropriate.Among 8,257 insertions using the TLS PICCs, 37 potential reactions (0.45%) were recorded. Using specific definitions for anaphylaxis or anaphylactoid reactions, 54.1%-91.9% met criteria. Comparator populations using data from Calgary (n = 491) and Ottawa (n = 7,889) using the BioFlo PICC insertion found no reactions. Anaphylactic or anaphylactoid reactions were significantly associated with the PowerPICC SOLO and Groshong PICC (...) Anaphylaxis and anaphylactoid reactions associated with the insertion of peripherally inserted central catheters: A multiyear comparative retrospective cohort study. Peripherally inserted central catheters (PICCs) are a mainstay of nonpermanent vascular access devices. In this study, we assessed patients displaying anaphylaxis or anaphylactoid reactions to the PowerPICC SOLO and Groshong PICC (Bard Access Systems) using the Sherlock tip locating system (TLS).Patients from 2 tertiary-care

2019 Infection control and hospital epidemiology

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