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Anaphylaxis

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61. Advances in Drug Allergy, Urticaria, Angioedema and Anaphylaxis in 2018. (PubMed)

Advances in Drug Allergy, Urticaria, Angioedema and Anaphylaxis in 2018. Many notable advances in drug allergy, urticaria, angioedema and anaphylaxis were reported in 2018. Broad spectrum antibiotic use and consequently antibiotic resistance is widespread, and algorithms to clarify β-lactam allergy and optimize antibiotic use were described. Meaningful data emerged on the pathogenesis of delayed drug hypersensitivity reactions. Progress not only in defining biomarkers, but also in understanding (...) and triggers of anaphylaxis, and the mechanisms underlying anaphylaxis, were elucidated further. In summary, these disorders (and labels) cause substantial burdens for individuals and even society. Fortunately, publications in 2018 have informed on advancements in diagnosis and management and have provided better understanding of mechanisms that potentially could yield new therapies. This progress should lead to better health outcomes and paths forward in drug allergy, urticaria, hereditary angioedema

2019 Journal of Allergy and Clinical Immunology

62. Association Between Intravenous Thrombolysis and Anaphylaxis Among Medicare Beneficiaries With Acute Ischemic Stroke. (PubMed)

Association Between Intravenous Thrombolysis and Anaphylaxis Among Medicare Beneficiaries With Acute Ischemic Stroke. Background and Purpose- Allergic reactions, including anaphylaxis, can sometimes occur after intravenous thrombolysis in patients with acute ischemic stroke. However, it remains unclear whether patients with stroke who receive thrombolytic agents face a higher risk of anaphylaxis than those who do not receive thrombolytics. Methods- We performed a retrospective cohort study (...) Modification code 99.10). Our primary outcome was anaphylaxis, defined using an accepted International Classification of Diseases, Ninth Revision, Clinical Modification code algorithm (989.5, 995.0-4, 995.6x, E905, E905.3, E905.5, or E905.8-9). A secondary outcome was anaphylactic shock (995.0 or 995.6x). Multiple logistic regression was used to evaluate the association between intravenous thrombolysis and anaphylaxis after adjustment for demographics, vascular risk factors, the Charlson comorbidity index

2019 Stroke

63. Food dependent exercise induced anaphylaxis triggered by inhaled antigen. (PubMed)

Food dependent exercise induced anaphylaxis triggered by inhaled antigen. We present a unique case of food dependent exercise induced anaphylaxis (FDEIA) triggered by an inhaled allergen in a 23- year-old professional cyclist. FDEIA is considered a rare form of anaphylaxis in which the state of exercise can trigger mast cell degranulation to an allergen which normally does not cause a reaction. It is closely related to exercise induced anaphylaxis, which occurs with exercise but in the absence

2019 American Journal of Emergency Medicine

64. Changing the history of anaphylaxis mortality statistics through the World Health Organization's International Classification of Diseases-11. (PubMed)

Changing the history of anaphylaxis mortality statistics through the World Health Organization's International Classification of Diseases-11. We review the history of the classification and coding changes for anaphylaxis and provide current and perspective information in the field. In 2012, an analysis of Brazilian data demonstrated undernotification of anaphylaxis-related deaths because of the difficulties of coding using the International Classification of Diseases, 10th Revision. This work (...) -11 perspective. Coding accuracy was much improved, reaching 95% for definite anaphylaxis. As the results were provided to the WHO Mortality Reference Group, coding rules have been changed, allowing anaphylaxis to be recorded as an underlying cause of death in official mortality statistics. The mandatory use of ICD-11 from January 2022 for documenting cause of death could have 2 immediate consequences: (1) the reported number of anaphylaxis-related deaths might increase because of more appropriate

2019 Journal of Allergy and Clinical Immunology

65. Wheat-dependent exercise-induced anaphylaxis in Chinese people: a clinical research on 33 cases with antigenic analysis of wheat proteins. (PubMed)

Wheat-dependent exercise-induced anaphylaxis in Chinese people: a clinical research on 33 cases with antigenic analysis of wheat proteins. Wheat-dependent exercise-induced anaphylaxis (WDEIA) is a severe allergic condition in which wheat ingestion together followed by physical exercise induces anaphylaxis. For patients with WDEIA, omega-5 gliadin is considered to be one of the major allergens.To analyse the clinical features and allergen spectrum of WDEIA and to investigate the relationship (...) in IL-9 or IL-33 between the two groups.WDEIA is a rare type of anaphylaxis. GAPDH and omega-5 gliadin may be the most common allergy-causing wheat proteins for Chinese people. PAF may be associated with the onset and development of WDEIA.© 2019 British Association of Dermatologists.

2019 Clinical & Experimental Dermatology

66. Intubation and intensive care after laminaria anaphylaxis in second-trimester abortion. (PubMed)

Intubation and intensive care after laminaria anaphylaxis in second-trimester abortion. Laminaria are cervical dilators inserted for several days preceding second-trimester abortions and other uterine procedures. Our patient was intubated after a life-threatening anaphylactic reaction to laminaria prior to her surgical abortion. Abortions with laminaria dilators are frequently performed outpatient across the United States. Due to stigma, increasing restrictions, and forced closure of family (...) planning clinics, these procedures are often obtained covertly and remotely. Patients may present obtunded, in shock, without records or proxy, and with no external evidence of the allergen's location or continued presence. Emergency and critical care physicians may consider this etiology in obtunded women with anaphylaxis who are responding poorly to standard care.Copyright © 2019. Published by Elsevier Inc.

2019 American Journal of Emergency Medicine

67. Evaluation of Antibody Properties and Clinically Relevant Immunogenicity, Anaphylaxis, and Hypersensitivity Reactions in Two Phase III Trials of Tralokinumab in Severe, Uncontrolled Asthma. (PubMed)

Evaluation of Antibody Properties and Clinically Relevant Immunogenicity, Anaphylaxis, and Hypersensitivity Reactions in Two Phase III Trials of Tralokinumab in Severe, Uncontrolled Asthma. Tralokinumab is a monoclonal antibody (mAb) that neutralizes interleukin (IL)-13, a cytokine involved in the pathogenesis of asthma.The objectives of this study were to characterize the potential immunogenic properties of tralokinumab and report data for anti-drug antibodies (ADAs) and hypersensitivity (...) %, placebo 25.5%; STRATOS 2-Q2 W 13.2%, placebo 9.0%. External evaluation for anaphylaxis by Sampson criteria found no tralokinumab-related severe hypersensitivity or anaphylaxis reactions.Preclinical assessments suggested a low likelihood of immunogenicity for tralokinumab. In STRATOS 1 and 2, ADA incidence was low, no differences were found between tralokinumab-treated and placebo groups in reporting of hypersensitivity reactions, and there were no Sampson criteria-evaluated anaphylaxis events

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2019 Drug Safety Controlled trial quality: uncertain

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

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 (...) hospitals were systematically monitored over 4 years for adverse events following the insertion of a PICC using the Sherlock TLS. Insertion data were also collected using the BioFlo PICC (Angiodynamics)from a third hospital site and from The Ottawa Hospital over 4 years as an additional comparator. Three definitions of anaphylaxis and anaphylactoid reactions were utilized, and the Cohen κ was used to assess interrater agreement. Analysis of reactions among the patient cohorts was performed using the χ2

2019 Infection control and hospital epidemiology

69. Idiopathic anaphylaxis yardstick: Practical recommendations for clinical practice. (PubMed)

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

70. 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. (PubMed)

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

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

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

72. Food and drug allergy, and anaphylaxis in EAACI journals (2018). (PubMed)

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

73. Preventing iatrogenic gelatin anaphylaxis. (PubMed)

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

74. The time course of anaphylaxis manifestations in children is diverse and unpredictable. (PubMed)

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

75. Midazolam anaphylaxis during general anesthesia: A case report. (PubMed)

Midazolam anaphylaxis during general anesthesia: A case report. Midazolam is known as a safe drug and is widely used as a sedative and an anesthetic adjuvant. Therefore, there is a lack of awareness that midazolam can cause anaphylaxis. Midazolam anaphylaxis is rare, and only a few cases have been reported, but such a risk is always present. In this study, we report a case of midazolam anaphylaxis by an intravenous injection, in the prone position, during general anesthesia.A 62-year-old woman (...) was intravenously administered 1 mg midazolam during general anesthesia, and sudden severe hypotension, bronchospasm, decreased oxygen saturation, erythema, and diarrhea occurred.Midazolam anaphylaxis was presumptively diagnosed by clinical symptoms and was confirmed by an intradermal test after 9 weeks.The patient was treated with 100% oxygen, large volume of fluid, epinephrine, phenylephrine, ephedrine, dexamethasone and prednisolone, ranitidine, and flumazenil.Severe hypotension and decreased oxygen

2019 Medicine

76. Acute Severe Anaphylaxis in Nepali Patients with Neurotoxic Snakebite Envenoming Treated with the VINS Polyvalent Antivenom. (PubMed)

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

77. Epinephrine in Severe Allergic Reactions: The European Anaphylaxis Register. (PubMed)

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

78. Management of maternal anaphylaxis in pregnancy: a case report (PubMed)

Management of maternal anaphylaxis in pregnancy: a case report A 26-year-old woman (gravida 2, para 1) at 25 weeks' gestation was brought to the emergency department because of anaphylactic symptoms. She reported eating Japanese soba and developed symptoms of dyspnea, generalized itchy rash, abdominal pain, and severe uterine contractions within 15-30 min of eating. She was immediately treated by normal saline infusion, two injections of epinephrine (intramuscularly), and a nebulized short (...) -acting β2-receptor agonist, followed by H1-antihistamine and methylprednisolone. Obstetrical management was undertaken by an obstetrician.The patient recovered rapidly without a biphasic reaction of anaphylaxis. After 11 weeks, a healthy, neurologically intact baby was born.Management of anaphylaxis in pregnant patients is basically the same of that in non-pregnant ones. Treatment should commence immediately to prevent further development of the anaphylaxis reaction and fetal neurological deficiency.

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2016 Acute medicine & surgery

79. Anaphylaxis and ST Elevation

Anaphylaxis and ST Elevation Dr. Smith's ECG Blog: Anaphylaxis and ST Elevation Monday, October 24, 2016 This was written by one of our excellent 2nd year residents, Nathan Ansbaugh, with some editing and commentary by Smith. An otherwise healthy middle-aged male age presented as an outpatient for a routine MRI. Immediately after receiving the IV contrast load, he became anxious, nauseous, flushed, and proceeded quickly to become apneic and pulseless. The emergency response team arrived (...) approximately 2 minutes later and found the patient pulseless and in presumed cardiac arrest. They began CPR. They gave 1mg epinephrine with immediate ROSC and the patient was transported to the Emergency Department for further stabilization and further treatment of presumed anaphylaxis. An initial ECG was recorded shortly after arrival: There is sinus tachycardia. There is right bundle branch block (RBBB) with additional left posterior fascicular block (LPFB). Aside : As for LPFB, note the small inferior Q

2016 Dr Smith's ECG Blog

80. 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

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