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Latest & greatest articles for Hypersensitivity Reaction
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Hypersensitivityreactions with allopurinol and febuxostat: a study using the Medicare claims data To assess the risk of hypersensitivityreactions (HSRs) with allopurinol and febuxostat in a population-based study.We used the 5% Medicare beneficiary sample (≥65 years) from 2006 to 2012 to identify people with a newly filled prescription for allopurinol, febuxostat or colchicine. We used multivariable-adjusted Cox regression analyses to compare the hazard ratio (HR) of incident HSRs
Canadian expert consensus: management of hypersensitivityreactions to intravenous iron in adults Canadian expert consensus: management of hypersensitivityreactions to intravenous iron in adults - Lim - - Vox Sanguinis - Wiley Online Library The full text of this article hosted at iucr.org is unavailable due to technical difficulties.
Effect of Epicutaneous Immunotherapy vs Placebo on Reaction to Peanut Protein Ingestion Among Children With Peanut Allergy: The PEPITES Randomized Clinical Trial. There are currently no approved treatments for peanut allergy.To assess the efficacy and adverse events of epicutaneous immunotherapy with a peanut patch among peanut-allergic children.Phase 3, randomized, double-blind, placebo-controlled trial conducted at 31 sites in 5 countries between January 8, 2016, and August 18, 2017 (...) . Participants included peanut-allergic children (aged 4-11 years [n = 356] without a history of a severe anaphylactic reaction) developing objective symptoms during a double-blind, placebo-controlled food challenge at an eliciting dose of 300 mg or less of peanut protein.Daily treatment with peanut patch containing either 250 μg of peanut protein (n = 238) or placebo (n = 118) for 12 months.The primary outcome was the percentage difference in responders between the peanut patch and placebo patch based
] AND "hypersensitivity, immediate"[Mesh]) OR "hypersensitivity/immunology"[Mesh] AND "anesthetics, local"[Mesh] Comments on The Evidence Validity: The studies by Fuzier and Sambrook were retrospective in nature and did not include randomization; however, both compiled data from large national databases over extended periods of many years. The follow-up of reported allergicreactions with allergy testing to confirm true allergy also strengthens data reported in the Fuzier study; however, this follow-up (...) a pseudoallergic psychogenic response, and can this be confirmed as an immunologic reaction to the anesthetic agent itself and not to known additives or preservatives? Clinical Bottom Line True allergy to amide local anesthetics such as lidocaine does exist and has been documented as type I and IV hypersensitivityreactions; however, the occurrence of this allergy in the population has been shown to be less than 1%. This should be differentiated from more common psychogenic responses to injection
with the common shellfish allergy had similar reactions after contrast administration, iodine must be the allergen. In fact, many patients, including the one in the anecdote above, use the terminology “iodine allergy” to describe their contrast hypersensitivity. In the survey by Shih-Wen Huang from Asthma and Allergy Proceedings , patients were also asked, “Do you think that it is the iodine in the seafood that is responsible for the allergicreaction?” Not surprisingly, 92% of these patients believed (...) . How could she possibly be allergic to something that she had tolerated without problem for 40 years? Moreover, is there any factual basis behind the common recommendation that patients with contrast reactions should avoid shellfish? Conversely, should iodinated contrast agents be avoided in patients with documented seafood allergies? Is there evidence behind this clinical practice, or is it actually just a medical myth? Although it would be virtually impossible to determine when this myth began
of reaction ? Home ? School ? Childcare ? Work ? Dining out ? Other__________________________________________________________________ Activity immediately before reaction: ? Eating ? Gardening ? Exercise ? Other: _________________________________ Other medical conditions ? Asthma ? Other: _______________________________________________________ Previous allergicreactions ? Mild-moderate ? Severe (anaphylaxis) Allergen/s________________________________________________________________ Adrenaline (...) ASCIA Event record for allergicreactions This document should be completed by the patient (to provide to their doctor or nurse practitioner) or completed by the doctor or nurse practitioner. Patient name: _____________________________________________________________ Date and time of reaction: ___________________________________________________ GP: ______________________________Specialist: ______________________________ Suspected trigger/s (if known) ? Food /s
Do parents of children with allergicreactions know how to use adrenaline autoinjectors appropriately? BestBets: Do parents of children with allergicreactions know how to use adrenaline autoinjectors appropriately? Do parents of children with allergicreactions know how to use adrenaline autoinjectors appropriately? Report By: Jennifer Lewis - 4th Year Medical Student Search checked by David Drake - Specialist Trainee in Emergency Medicine Institution: Manchester Royal Infirmary, Manchester (...) were relevant. Relevant Paper(s) Author, date and country Patient group Study type (level of evidence) Outcomes Key results Study Weaknesses Topal et al, 2013, Turkey 64 patients with history of allergicreaction whom had been prescribed an AAI (50 caregivers and 14 children>12 years old) Single centre cross sectional descriptive study Able to perform 6 steps for a successful injection on training device 39.4% of participants were able to complete all 6 steps Author assumes teaching was given
HLA-A*3101 and carbamazepine-induced hypersensitivityreactions in Europeans. Carbamazepine causes various forms of hypersensitivityreactions, ranging from maculopapular exanthema to severe blistering reactions. The HLA-B*1502 allele has been shown to be strongly correlated with carbamazepine-induced Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS-TEN) in the Han Chinese and other Asian populations but not in European populations.We performed a genomewide association study (...) ), maculopapular exanthema (odds ratio, 8.33; 95% CI, 3.59 to 19.36), and SJS-TEN (odds ratio, 25.93; 95% CI, 4.93 to 116.18).The presence of the HLA-A*3101 allele was associated with carbamazepine-induced hypersensitivityreactions among subjects of Northern European ancestry. The presence of the allele increased the risk from 5.0% to 26.0%, whereas its absence reduced the risk from 5.0% to 3.8%. (Funded by the U.K. Department of Health and others.).
reactions including, very rarely, angioedema. As at April 2011, 9 such cases have been reported worldwide in association with use in approximately 727 000 patients. Some cases have occurred in patients with a known history of hypersensitivity to clopidogrel, but others have no history of clopidogrel exposure. At present, the mechanism for these allergicreactions is unclear. The time to onset of symptoms ranged from immediately after treatment to up to 5 to 10 days later. Advice for healthcare (...) should inform their doctor immediately if they experience symptoms suggesting hypersensitivity or allergicreaction (eg, swelling of the face, neck, tongue, lips, or throat; rash; itching; or shortness of breath) Further information See BNF section Article citation: Drug Safety Update May 2011 vol 4 issue 10: A1. Published 11 December 2014 Explore the topic Is this page useful? Thank you for your feedback Help us improve GOV.UK Don’t include personal or financial information like your National
Pharmacological interventions for the prevention of allergic and febrile non-haemolytic transfusion reactions. Allergic and febrile non-haemolytic transfusion reactions (NHTRs) are the two most common forms of transfusion reaction. Pretransfusion medication with anti-inflammatory drugs is used in NHTR prevention, however its efficacy and safety remains unclear.To assess the clinical effects and safety of pharmacological interventions for preventing NHTR in patients with and without a history (...) includes three RCTs (two PD and one CD). The PD-RCTs employed disparate units of randomisation (UofR); patient or transfusion, while the CD-RCT applied the patient as the UofR. The PD-RCTs administered leukodepleted blood products. Both PD-RCTs compared acetaminophen plus diphenhydramine (ApD) at different regimens with placebo, while the CD-RCT contrasted hydrocortisone pharmacotherapy with diphenhydramine. Both PD-RCTs found no statistically significant difference in allergicreactions (RR 0.13, 95
Sublingual adrenaline tablets: How feasible is this novel approach to treatment of acute allergicreactions? BestBets: Sublingual adrenaline tablets: How feasible is this novel approach to treatment of acute allergicreactions? Sublingual adrenaline tablets: How feasible is this novel approach to treatment of acute allergicreactions? Report By: Deepak Doshi - Specialist Registrar in Emergency Medicine Search checked by Bernard A Foëx - Consultant in Emergency Medicine and Critical Care (...) Institution: Manchester Royal Infirmary Date Submitted: 23rd May 2008 Date Completed: 14th October 2009 Last Modified: 1st September 2009 Status: Green (complete) Three Part Question In a [patient with an acute allergicreaction] does [a sublingual adrenaline tablet as compared to an intramuscular injection] work [better at reversing symptoms and preventing adverse effects of adrenaline?] Clinical Scenario A 34 year Jamaican man attended the Emergency Department after having his back tattooed. He had
Hypersensitivityreactions to human papillomavirus vaccine in Australian schoolgirls: retrospective cohort study. To describe the outcomes of clinical evaluation, skin testing, and vaccine challenge in adolescent schoolgirls with suspected hypersensitivity to the quadrivalent human papillomavirus vaccine introduced in Australian schools in 2007.Retrospective cohort study.Two tertiary paediatric allergy centres in Victoria and South Australia, Australia.35 schoolgirls aged 12 to 18.9 years (...) with suspected hypersensitivityreactions to the quadrivalent human papillomavirus vaccine.Clinical review and skin prick and intradermal testing with the quadrivalent vaccine and subsequent challenge with the vaccine.35 schoolgirls with suspected hypersensitivity to the quadrivalent human papillomavirus vaccine were notified to the specialised immunisation services in 2007, after more than 380 000 doses had been administered in schools. Of these 35 schoolgirls, 25 agreed to further evaluation. Twenty three
antihistamines in histamine-induced wheal models of cutaneous allergy, and some of these suggest a benefit. Two studies have directly compared H1 against H2 (Moscati et al and Watson et al). Neither showed a benefit of H2 over H1 antihistamines. Two studies have compared H1 antihistamine against combined H1 and H2 antihistamines in the treatment of ongoing acute allergicreactions. Runge et al found no benefit. Only Lin et al have shown any benefit: relief of urticaria and improvement of angioedema (...) Combination therapy with H2 and H1 antihistamines in acute, non compromising allergicreactions BestBets: Combination therapy with H2 and H1 antihistamines in acute, non compromising allergicreactions Combination therapy with H2 and H1 antihistamines in acute, non compromising allergicreactions Report By: Dr TB Fogg and Dr D Semple - Clinical Fellow and SHO in Emergency Medicine Search checked by Dr H Simpson - Consultant in Emergency Medicine Institution: Emergency Department North Hampshire
Specific Treatment Options - anaphylaxis/allergicreactions in adults INTRODUCTION Allergicreactions exist on a continuum from mild urticaria (hives) and/or angio-oedema (swelling of the face, eyelids, lips and tongue) to major pulmonary and/or cardiovascular compromise. The extreme end of the spectrum is anaphylaxis which can affect the cardiovascular, pulmonary, cutaneous, and gastrointestinal systems. It is an acute, life-threatening response in patients previously sensitised to an allergen (...) ): Available from http://www.resus.org.uk/pages/reaction.htm, 2005. Anaphylaxis/ AllergicReactions in Adults Page 2 of 3 October 2006 Speci?c Treatment Options Speci?c Treatment Options5 Langran M, Laird C. Management of allergy, rashes and itching. Emergency Medical Journal 2004;21:728-741. 6 Lieberman P, Kemp S, Oppenheimer J, Lang D, Bernstein I, Nicklas R. The diagnosis and management of anaphylaxis: an updated practice parameter. Journal of Allergy and Clinical Immunology 2005;115:S483-523. 7