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Anaphylaxis

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161. Check out this podcast on Anaphylaxis

Check out this podcast on Anaphylaxis Check out this podcast on Anaphylaxis – PEMBlog Search for: Search for: The always reliable PEM Playbook brings you its monthly educational offering. By | 2018-09-01T21:10:46-04:00 September 1st, 2018 | | Share this post About the Author: Brad Sobolewski, MD, MEd is an Associate Professor of Pediatric Emergency Medicine and an Assistant Director for the Pediatric Residency Training Program at Cincinnati Children's Hospital Medical Center. He is on Twitter

2018 PEM Blog

162. Adrenaline in the Acute Treatment of Anaphylaxis. (PubMed)

Adrenaline in the Acute Treatment of Anaphylaxis. Anaphylaxis is the most serious manifestation of an immediate allergic reaction and the most common emergency event in allergology. Adrenaline (epi- nephrine) is the mainstay of acute pharmacotherapy for this complication. Although epinephrine has been in use for more than a century, physicians and patients are often unsure and inadequately informed about its proper administration and dosing in everyday situations.This review is based (...) on pertinent publications from the period 1 January 2012 to 30 September 2017 that were retrieved, on the basis of the existing guide- lines of 2007 and 2014, by a PubMed search employing the keywords "anaphylaxis treatment," "allergic shock," "adrenaline," and "epinephrine," as well as on further ar- ticles from the literature.Adrenaline/epinephrine administration often eliminates all manifestations of anaphylaxis. The method of choice for administering it (except in intensive-care medicine

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2018 Deutsches Arzteblatt international

163. Human factors study of a newly approved prefilled syringe of epinephrine for the treatment of anaphylaxis. (PubMed)

Human factors study of a newly approved prefilled syringe of epinephrine for the treatment of anaphylaxis. Epinephrine remains the treatment of choice for acute anaphylaxis. However, currently available autoinjectors are costly, and studies have demonstrated human factor issues that result in incorrect use as well as device failures.A recent U.S. Food and Drug Administration approved prefilled syringe of epinephrine for the treatment of anaphylaxis was examined in a prospective human factors (...) , 100% (82/82) completed category 3, 93% (71/76) completed category 4 (six participants were observed to have a device with a bent needle and were taken out of the analysis), and 99% (81/82) completed category 5.In this prospective study of human factors that effect correct epinephrine injection, a high rate of participants successfully completed the tasks when using the prefilled syringe, a newly approved epinephrine syringe for the treatment of anaphylaxis. These results indicated that the newly

2018 Allergy and Asthma Proceedings

164. "The changing face of anaphylaxis in adults and adolescents". (PubMed)

"The changing face of anaphylaxis in adults and adolescents". Our institution has published serial studies of adults and adolescents with anaphylactic events. The first series was published in 1993 and the last was published in 2006. It was our perception that the nature of anaphylactic episodes had changed over the 2 decades since the last review.To determine whether the etiologies and presentations of anaphylaxis have changed during the past decade in our population.Patient charts were (...) identified based on International Classification of Diseases, Ninth Revision codes for anaphylactic shock. Charts identified were analyzed for clinical symptoms reported, comorbidities, etiology, investigative testing, and subsequent treatment. These cases were categorized as definitive, probable, or idiopathic based on history and results from testing, similar to our prior reports.We identified 281 possible cases, of which 218 met criteria for anaphylaxis. Of these cases, median age was 42 years (range

2018 Asthma & Immunology

165. Prevalence triggers and clinical severity associated with anaphylaxis at a tertiary care facility in Saudi Arabia: A cross-sectional study. (PubMed)

Prevalence triggers and clinical severity associated with anaphylaxis at a tertiary care facility in Saudi Arabia: A cross-sectional study. Anaphylaxis is a systemic and hypersensitive allergic reaction caused by various triggers such as environmental, food, drug, and insects. The aim of this study was to identify the prevalence, triggers, and clinical severity of anaphylaxis in 2 emergency departments (EDs) in Saudi Arabia.A cross-sectional study based on a screening of medical records (...) was conducted between January 2015 and August 2017, to identify confirmed cases of anaphylaxis. Patient characteristics were age, sex, previously known allergies, and the triggering allergens. The clinical severity was measured on the basis of the anaphylaxis international assessment tool (mild, moderate, severe). Factors associated with triggers and severities were identified.The period prevalence of anaphylaxis among ED admissions was 0.00026%. Pediatric cases (age 1-16 years) were 98 (60.9%), while

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2018 Medicine

166. Pitfalls in anaphylaxis diagnosis and management at a university emergency department. (PubMed)

Pitfalls in anaphylaxis diagnosis and management at a university emergency department. Some previous reports revealed suboptimal management of anaphylaxis (ANX) in the emergency department (ED).To evaluate the recorded diagnosis and management of patients who presented with ANX at our university hospital ED and to assess how the management correlated with the severity of the case and the training level of the ED staff.A descriptive study that involved reviewing the electronic medical records

2018 Allergy and Asthma Proceedings

167. Prevalence of anaphylaxis among adults admitted to critical care for severe asthma exacerbation. (PubMed)

Prevalence of anaphylaxis among adults admitted to critical care for severe asthma exacerbation. In asthmatics, making a diagnosis of anaphylaxis could be challenging as respiratory symptoms are a common feature of both conditions. Identifying anaphylaxis is important to providing appropriate care. A prior study showed that anaphylaxis is sometimes misdiagnosed as acute asthma in children. We sought to identify the percentage of adults admitted to the intensive care unit (ICU) with asthma (...) exacerbations who met criteria for anaphylaxis.Retrospective chart review of adults admitted with acute asthma to the ICU at Jacobi Medical Center, a Level 1 trauma centre in Bronx, New York. Study period was January 2012 to December 2014. Using the criteria outlined in the World Allergy Organization's Anaphylaxis Guidelines, we identified patients who met criteria for anaphylaxis.105 patients were identified: 17 were excluded because their main reason(s) for admission was not asthma. 7 (8%) of the 88 cases

2018 Emergency Medicine Journal

168. Nationwide Survey of Hospitalization Due to Pediatric Food-Induced Anaphylaxis in the United States. (PubMed)

Nationwide Survey of Hospitalization Due to Pediatric Food-Induced Anaphylaxis in the United States. Anaphylaxis is a common, serious, systemic allergic reaction. In the United States, the change of annual hospitalization rates by anaphylaxis-trigger foods and risk factors associated with severity remain unclear.Hospital discharge records of food-induced anaphylactic reactions of individuals younger than 20 years were obtained from Kids' Inpatient Database in 2006, 2009, and 2012 and were (...) weighted to estimate the number of hospitalizations in the United States. We identified annual hospitalization rates by patients' characteristics and anaphylaxis-trigger foods and investigated factors associated with severity and use of mechanical ventilation with multivariable logistic regression.A total of 3427 hospitalizations were obtained, and annual hospitalization rates showed a significantly increasing trend from 1.2 per 100,000 children in 2006 to 1.5 per 100,000 children in 2012 (P < 0.001

2018 Pediatric Emergency Care

169. Deciphering biochemical basis of Qingkailing injection-induced anaphylaxis in a rat model by time-dependent metabolomic profiling based on metabolite polarity-oriented analysis. (PubMed)

Deciphering biochemical basis of Qingkailing injection-induced anaphylaxis in a rat model by time-dependent metabolomic profiling based on metabolite polarity-oriented analysis. Qingkailing injection (QKLI) is prepared from eight traditional Chinese medicinal materials or their extracts, which is widely used in clinical practice to treat the upper respiratory inflammation, pneumonia, high fever and viral encephalitis, nonetheless, suffering from serious anaphylaxis.This study aims to develop (...) an integrative metabolomics approach for deciphering the biochemical basis of QKLI induced anaphylaxis (QKLI-IA).The accuracy of animal modeling, the coverage of detected metabolites and the timeliness of pathological reaction are three key factors for revealing the biochemical basis of disease with untargeted metabolomics. In this study, firstly, the allergic rats (responders) were first screened by passive cutaneous anaphylaxis experiment and then were utilized for modeling. To cover a wider range

2018 Journal of Ethnopharmacology

170. Asian children living in Australia have a different profile of allergy and anaphylaxis than Australian-born children: a State-wide survey. (PubMed)

Asian children living in Australia have a different profile of allergy and anaphylaxis than Australian-born children: a State-wide survey. Asian children born in Australia have higher rates of eczema and nut allergy than non-Asian children. However, it is not known whether this country of birth differential exists for other allergies or anaphylaxis risk.We investigated the influence of maternal and child's country of birth on the prevalence of parent-reported eczema, asthma, food allergy (...) and being diagnosed by a doctor as being "at risk of anaphylaxis."We assessed the relationship between mother and child country of birth and allergies using the 2010 School Entrant Health Questionnaire, completed for 57 005 5-year old children (85.8% response rate) in Victoria, Australia. Analyses were conducted using logistic regression with results presented as odds ratios (OR) with 95% confidence intervals (CIs).Children born in Australia to Asian-born mothers were more likely to have parent-reported

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2018 Clinical and Experimental Allergy

171. An unusual case of infant seizures with anaphylaxis to wheat (PubMed)

An unusual case of infant seizures with anaphylaxis to wheat Wheat allergy is one of the commonest food allergies in childhood and it typically presents with IgE mediated reactions, including anaphylaxis. Seizures are not typically reported to be a direct manifestation of anaphylaxis, though it can occur secondary to hypoxia following significant haemodynamic compromise. We describe a case of a previously well infant, who presented with anaphylactic shock to wheat and responded well

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2018 Asia Pacific allergy

172. Recurrent anaphylaxis during cardiac catheterization due to ethylene oxide (PubMed)

Recurrent anaphylaxis during cardiac catheterization due to ethylene oxide 29715563 2018 12 02 2213-2201 6 6 2018 Nov - Dec The journal of allergy and clinical immunology. In practice J Allergy Clin Immunol Pract Recurrent anaphylaxis during cardiac catheterization due to ethylene oxide. 2148-2150 S2213-2198(18)30294-0 10.1016/j.jaip.2018.04.017 Hamad Ahmad A Department of Medicine, Division of Rheumatology, Allergy, Immunology, University of North Carolina School of Medicine, Chapel Hill, NC

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2018 The journal of allergy and clinical immunology. In practice

173. Editorial: New Insights In Anaphylaxis (PubMed)

Editorial: New Insights In Anaphylaxis 29593740 2019 01 16 1664-3224 9 2018 Frontiers in immunology Front Immunol Editorial: New Insights In Anaphylaxis. 506 10.3389/fimmu.2018.00506 Pastor-Vargas Carlos C Department of Immunology, Instituto de Investigación Sanitaria Hospital Universitario Fundacion Jimenez Diaz (IIS-FJD, UAM), Madrid, Spain. Esteban Vanesa V Department of Immunology, Instituto de Investigación Sanitaria Hospital Universitario Fundacion Jimenez Diaz (IIS-FJD, UAM), Madrid (...) , Spain. eng Editorial Introductory Journal Article Research Support, Non-U.S. Gov't 2018 03 14 Switzerland Front Immunol 101560960 1664-3224 anaphylaxis augmentine factors drug and food allergy endothelial cells molecular signaling 2018 01 30 2018 02 26 2018 3 30 6 0 2018 3 30 6 0 2018 3 30 6 1 epublish 29593740 10.3389/fimmu.2018.00506 PMC5861140

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2018 Frontiers in immunology

174. Brain Stem Ischemic Stroke Associated with Anaphylaxis (PubMed)

Brain Stem Ischemic Stroke Associated with Anaphylaxis Anaphylaxis is a serious allergic reaction that may have different manifestations including hypotension. It is reported that vertebral artery hypoplasia (VAH) may be present in up to 20% of the general population. Previous studies have demonstrated that patients with VAH have a higher risk of developing an ischemic stroke in the area supplied by this hypoplastic artery. This paper describes the case of a patient with preexistent VAH who (...) presented with lateral medullary syndrome associated with a hypotensive episode secondary to anaphylaxis. To the best of the authors' knowledge, this association has not previously reported.

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2018 Cureus

175. Food-induced fatal anaphylaxis: from epidemiological data to general prevention strategies. (PubMed)

Food-induced fatal anaphylaxis: from epidemiological data to general prevention strategies. Anaphylaxis hospitalizations are increasing in many countries, in particular for medication and food triggers in young children. Food-related anaphylaxis remains an uncommon cause of death, but a significant proportion of these are preventable.To review published epidemiological data relating to food-induced anaphylaxis and potential risk factors of fatal and/or near-fatal anaphylaxis cases, in order (...) to provide strategies to reduce the risk of severe adverse outcomes in food anaphylaxis.We identified 32 published studies available in MEDLINE (1966-2017), EMBASE (1980-2017), CINAHL (1982-2017), using known terms and synonyms suggested by librarians and allergy specialists.Young adults with a history of asthma, previously known food allergy particularly to peanut/tree nuts are at higher risk of fatal anaphylaxis reactions. In some countries, cow's milk and seafood/fish are also becoming common triggers

2018 Clinical and Experimental Allergy

176. Missed Diagnosis of Anaphylaxis in Patients With Pediatric Urticaria in Emergency Department. (PubMed)

Missed Diagnosis of Anaphylaxis in Patients With Pediatric Urticaria in Emergency Department. This study was to determine the characteristics of missed diagnosis of pediatric anaphylaxis that were registered as urticaria only at the emergency department (ED) by comparing those who had only urticaria symptoms with those who had both anaphylaxis and urticaria symptoms.Subjects were classified into missed anaphylaxis and urticaria group according to whether satisfied anaphylaxis diagnostic (...) criteria or not. Anaphylaxis group, those who were initially registered as anaphylaxis with urticaria and anaphylaxis symptoms simultaneously, were further investigated.The missed anaphylaxis group included 37 patients of 1051 pediatric urticaria patients. The anaphylaxis group included 11 patients. The time from symptom onset to ED arrival in the missed anaphylaxis group was shorter than the urticaria group. More patients in the missed anaphylaxis group had a history of past food allergy. Seafood, egg

2018 Pediatric Emergency Care

177. Highlights and recent developments in food and drug allergy, and anaphylaxis in EAACI journals (2017). (PubMed)

Highlights and recent developments in food and drug allergy, and anaphylaxis in EAACI journals (2017). This review highlights research advances and important achievements in food allergy, anaphylaxis, and drug allergy that were published in the Journals of the European Academy of Allergy and Clinical Immunology (EAACI) in 2017. Food allergy and anaphylaxis research have continued to rapidly accelerate, with increasing numbers of outstanding developments in 2017. We saw new studies (...) of allergy to all stakeholders including the EAACI junior members. This paper summarizes the achievements of 2017 in anaphylaxis, and food and drug allergy.© 2018 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.

2018 Pediatric Allergy and Immunology

178. Mucosal Injury From Calcium Oxalate Crystals Resembling Anaphylaxis and Angioedema. (PubMed)

Mucosal Injury From Calcium Oxalate Crystals Resembling Anaphylaxis and Angioedema. There are 215 families of plants that contain insoluble needle-shaped calcium oxalate crystals on the surface of their tissues. Upon mucosal contact, injury can cause extreme pain, soft-tissue swelling, salivation, dysphagia, and even aphonia. This presentation can resemble angioedema or anaphylaxis.A 55-year-old Asian female presented to the emergency department complaining of oral pain, swelling, and numbness (...) PHYSICIAN BE AWARE OF THIS?: Injury by calcium oxalate crystals is a relatively common occurrence that will present to the emergency department. Although most exposures are benign, patients can develop critical illness, requiring emergent therapies and airway management. Due to the nature of presentation, exposure can easily be misdiagnosed as anaphylaxis or hereditary and drug-induced angioedema. Severe pain and the temporal relationship to plant ingestion distinguish insoluble calcium oxalate crystal

2018 Journal of Emergency Medicine

179. Evaluation of the Potential Risk Factors for Drug-Induced Anaphylaxis in Adult Patients. (PubMed)

Evaluation of the Potential Risk Factors for Drug-Induced Anaphylaxis in Adult Patients. To investigate the potential risk factors in patients who have experienced anaphylaxis from drugs.The study included 281 adult patients (median age 40 years; 76.5% female) who experienced immediate types of hypersensitivity reaction to a drug. The patients were divided into an anaphylaxis group and a nonanaphylaxis group. The anaphylaxis group was diagnosed according to the criteria of the World Allergy (...) in the patient's history and the study evaluation was 7 months (range 1-120 months). In 52.3% of the patients, reactions were defined as anaphylaxis. The most common culprit drugs were NSAIDs (56.9%) and β-lactams (34.7%). The culprit drugs were used parenterally in 13.2% of the patients. 34.9% of the patients had comorbid diseases and 24.6% used additional drugs, the most common being antihypertensives (10%). Atopy was determined in 28.8% and 28.1% of the patients were smokers. The median serum level

2018 International Archives of Allergy and Immunology

180. Clinical and demographic characteristics of fatal anaphylaxis in Spain (1998-2011): A comparison between a series from the hospital system and a national forensic series. (PubMed)

Clinical and demographic characteristics of fatal anaphylaxis in Spain (1998-2011): A comparison between a series from the hospital system and a national forensic series. Reports of fatal anaphylaxis remain scarce because of the rarity of the condition and the fact that information is limited to a few countries.Our objective was to investigate clinical and demographic characteristics and the causes of fatal anaphylaxis in Spain using two databases of cases of fatal anaphylaxis.We analysed fatal (...) anaphylaxis in a series from the Spanish hospital system and a series from the National Institute of Toxicology and Forensic Sciences (Instituto Nacional de Toxicología y Ciencias Forenses [INTCF]), which predominantly comprise extrahospital deaths. Deaths from the Spanish hospital system were retrieved from among all deaths occurring during 1998-2011 using codes related to anaphylaxis. Deaths due to anaphylaxis in the INTCF database during the same period were retrieved by 2 allergists, who identified

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2018 Clinical and Experimental Allergy

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