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1.
Rev. bras. cir. cardiovasc ; 31(3): 226-231, May.-June 2016. tab, graf
Article in English | LILACS | ID: lil-796123

ABSTRACT

ABSTRACT Objective: To examine if methylene blue (MB) can counteract or prevent protamine (P) cardiovascular effects. Methods: The protocol included five heparinized pig groups: Group Sham -without any drug; Group MB - MB 3 mg/kg infusion; Group P - protamine; Group P/MB - MB after protamine; Group MB/P - MB before protamine. Nitric oxide levels were obtained by the nitric oxide/ozone chemiluminescence method, performed using the Nitric Oxide Analizer 280i (Sievers, Boulder, CO, USA). Malondialdehyde plasma levels were estimated using the thiobarbiturate technique. Results: 1) Groups Sham and MB presented unchanged parameters; 2) Group P - a) Intravenous protamine infusion caused mean arterial pressure decrease and recovery trend after 25-30 minutes, b) Cardiac output decreased and remained stable until the end of protamine injection, and c) Sustained systemic vascular resistance increased until the end of protamine injection; 3) Methylene blue infusion after protamine (Group P/MB) - a) Marked mean arterial pressure decreased after protamine, but recovery after methylene blue injection, b) Cardiac output decreased after protamine infusion, recovering after methylene blue infusion, and c) Sustained systemic vascular resistance increased after protamine infusion and methylene blue injections; 4) Methylene blue infusion before protamine (Group MB/P) - a) Mean arterial pressure decrease was less severe with rapid recovery, b) After methylene blue, there was a progressive cardiac output increase up to protamine injection, when cardiac output decreased, and c) Sustained systemic vascular resistance decreased after protamine, followed by immediate Sustained systemic vascular resistance increase; 5) Plasma nitrite/nitrate and malondialdehyde values did not differ among the experimental groups. Conclusion: Reviewing these experimental results and our clinical experience, we suggest methylene blue safely prevents and treats hemodynamic protamine complications, from the endothelium function point of view.


Subject(s)
Animals , Female , Protamines/antagonists & inhibitors , Enzyme Inhibitors/pharmacology , Hemodynamics/drug effects , Heparin Antagonists/administration & dosage , Methylene Blue/pharmacology , Swine , Endothelium, Vascular/drug effects , Protamines/adverse effects , Central Venous Pressure/drug effects , Models, Animal , Heparin Antagonists/adverse effects , Anaphylaxis/etiology , Anaphylaxis/prevention & control , Malondialdehyde/blood , Nitric Oxide/blood
2.
Rev. bras. cir. plást ; 31(3): 436-441, 2016. ilus, tab
Article in English, Portuguese | LILACS | ID: biblio-2327

ABSTRACT

INTRODUÇÃO: Analisar dados da internet relacionados a mortes por embolia gordurosa, inicio da doença, e outras informações podem determinar a realidade atual no Brasil relacionada à incidência da síndrome de embolia gordurosa e qualquer repercussão na mídia, e também revisar as metodologias de prevenção e quais são os melhores métodos disponíveis para tratar a doença. MÉTODOS: Uma pesquisa no google foi conduzida de Janeiro de 2000 a Janeiro de 2014 utilizando os descritores "cirurgia plástica" e "morte". Foram incluídos e revisados artigos contendo as palavras "embolia", "embolia gordurosa" e "complicações em (ou de) cirurgia plástica". RESULTADOS: Incluiu-se 235 matérias novas relevantes ao longo dos 14 anos. Houve 45 casos de óbito relacionados com cirurgia plástica que ofereceu poucos dados para individualização. Desses pacientes, 44 eram mulheres. As causas possíveis mencionadas foram embolia pulmonar (cinco casos), perfuração das vísceras (cinco casos), hipertermia maligna (três casos), anestesia (dois casos), choque anafilático (dois casos), embolia gordurosa (um caso confirmado), e "outros" (cinco casos). CONCLUSÃO: Diretrizes de prevenção para embolia gordurosa em cirurgia plástica são requeridas, porém, há também necessidade de mais estudos baseados em evidência para entender mais claramente quais são os melhores métodos.


INTRODUCTION: To analyze data from the internet on deaths from fat embolism, time of onset, and other information that could determine current reality in Brazil regarding fat embolism syndrome incidence and any ,media repercussions, and also to review methods of prevention and what are the best methods available to treat this disease. METHODS: A Google search was conducted from January 2000 to January 2014 using the keywords "plastic surgery" and "death." We included and reviewed articles containing the words "embolism", "fat embolism" and "complications in (or of) plastic surgery". RESULTS: We included 235 relevant news stories over the 14 included years. There were 45 cases of death related with plastic surgery that offered few data for individualization. Of these patients, 44 were women. Possible causes mentioned were pulmonary embolism (five cases), perforation of viscera (four cases), malignant hyperthermia (three cases), anesthesia (two cases), anaphylactic shock (two cases), fat embolism (one confirmed case), and "other" (five cases). CONCLUSION: Guidelines to prevent fat embolism in plastic surgery are needed, however, there is also the need of more evidence based studies to understand more clearly what methods are best.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , History, 20th Century , Viscera , Evaluation Study , Pulmonary Embolism , Pulmonary Embolism/mortality , Pulmonary Embolism/prevention & control , Surgery, Plastic , Surgery, Plastic/methods , Surgery, Plastic/mortality , Surgery, Plastic/statistics & numerical data , Embolism, Fat , Embolism, Fat/mortality , Embolism, Fat/prevention & control , Anaphylaxis , Anaphylaxis/mortality , Anaphylaxis/prevention & control , Malignant Hyperthermia , Malignant Hyperthermia/mortality , Malignant Hyperthermia/prevention & control
3.
Rev. Soc. Bras. Clín. Méd ; 10(4)jul.-ago. 2012.
Article in Portuguese | LILACS | ID: lil-646056

ABSTRACT

JUSTIFICATIVA E OBJETIVOS: Estudos recentes revelam o crescimento da incidência e prevalência da anafilaxia. Trata-se de afecção clínica potencialmente fatal e própria de ambientes de urgência e emergência, por isso sua importância para o clínico. Esse artigo objetivou revisar o assunto e apresentar os recentes conhecimentos para diagnóstico e abordagem terapêutica da anafilaxia. CONTEÚDO: As diretrizes da Organização Mundial de Alergia (WAO) para avaliação e abordagem da anafilaxia publicada em 2011 forneceu uma perspectiva global no que se refere aos fatores de risco, fatores desencadeantes, diagnóstico clínico, profilaxia e tratamento da anafilaxia. A importância do conhecimento pelo clínico para reconhecimento precoce e de aspectos particulares do tratamento e orientação do paciente que sofre episódio anafilático com encorajamento para utilização de protocolos. CONCLUSÃO: Na anafilaxia o reconhecimento precoce e o uso de protocolos de tratamento na sala de emergência são fundamentais para a boa evolução do paciente. O uso de epinefrina permanece como a base do tratamento. A fisiopatologia segue sem reconhecimento pleno. São necessários mais estudos prospectivos em humanos para melhora das evidências na abordagem.


BACKGROUND AND OBJECTIVES: Recent studies show increases in incidence and prevalence of anaphylaxis. It is potentially fatal clinical condition itself and of the urgent an demergency environments, so its importance for the clinician.This article aims to review the matter and submit to the recent clinical knowledge to diagnosis and therapeutic management of anaphylaxis. CONTENTS: The World Allergy Organization (WAO) Guidelines for the assessment and management of anaphylaxis published in early 2011 provide a global perspective on patient risk factors, triggers, clinical diagnosis, treatment, and prevention of anaphylaxis. The relevance of knowledge by the physician for early recognition and treatment of specific aspects and orientation of the patient who had anaphylaxis with encouragement for the use of protocols. CONCLUSION: Early recognition of anaphylaxis and the use of treatment protocols in the emergency room are fundamental to good patient outcomes. The use of epinephrine remains the mainstay of treatment. The pathophysiology follows without full recognition. Further prospective studies are needed in humans to improve the evidence approach.


Subject(s)
Humans , Anaphylaxis/diagnosis , Anaphylaxis/prevention & control , Emergency Medicine , Epinephrine/therapeutic use
4.
Dolor ; 20(56): 32-34, dic. 2011.
Article in Spanish | LILACS | ID: lil-682522

ABSTRACT

Las mastocitosis son un grupo heterogéneo de enfermedades que se caracterizan por la proliferación de mastocitos en uno o más órganos o tejidos. Se denomina mastocitosis sistémica (MS) cuando hay afectación de un tejido distinto a la piel. La MS es una enfermedad poco frecuente, cuya incidencia y prevalencia se desconocen. El manejo anestésico de estos pacientes debe considerar que muchos de los fármacos empleados pueden causar una liberación masiva de mediadores químicos mastocitarios. Se presenta el caso de una mujer con MS programada para una histerectomía total, valorando la importancia del correcto estudio preoperatorio así como la técnica anestésica y el tipo de analgesia elegida en este caso. Se presenta nuestro protocolo de actuación de cara a la cirugía en estos pacientes.


Mastocytoses are a heterogeneous group of entities characterized by mast cell proliferation in one or more organs or tissues. When tissues other than the skin are involved, the disease is called systemic mastocytosis (SM). SM is a highly infrequent disease, whose incidence and prevalence are unknown. The anesthetic management of these patients must consider the fact that many drugs can trigger massive release of chemical mediators of mast cells. We report the case of a patient diagnosed with SM who underwent total hysterectomy and discuss the importance of thorough preoperative study, as well as the anesthetic technique and type of analgesia chosen. We also report our protocol for anesthetic management in this disease.


Subject(s)
Humans , Female , Middle Aged , Anaphylaxis/prevention & control , Analgesics/administration & dosage , Anesthetics/administration & dosage , Preoperative Care/methods , Pain, Postoperative/prevention & control , Mastocytosis, Systemic/complications , Acute Pain , Hysterectomy , Paroxysmal Hemicrania , SUNCT Syndrome
5.
Acta cir. bras ; 26(6): 481-489, Nov.-Dec. 2011. ilus
Article in English | LILACS | ID: lil-604198

ABSTRACT

PURPOSE: To verify if the methylene blue (MB) administration prevents and/or reverses the compound 48/80 (C48/80)-induced anaphylactic shock in pigs. METHODS: Female Dalland pigs were anesthetized and had the hemodynamic parameters recorded during the necessary time to administer some drugs and observe their effect. The animals were randomly assigned to one of the five groups: 1) control; 2) MB: the animals received a bolus injection of MB (2 mg/kg) followed by continuous infusion of MB (2.66 mg/Kg/h delivered by syringe infusion pump); 3) C48/80: the animals received a bolus injection of C48/80 (4 mg/kg); 4) C48/80+MB: the animals received a bolus injection of C48/80 (4 mg/kg) and 10 minutes after the C48/80 administration the animals received a bolus injection of MB (2 mg/kg) followed by continuous infusion of MB (2.66 mg/Kg/h delivered by syringe infusion pump); 5) MB+C48/80: the animals received a bolus injection of MB (2 mg/kg) and 3 minutes later they received a bolus injection of C48/80 (4 mg/kg). RESULTS: The intravenous infusion of MB alone caused no changes in the mean arterial pressure (MAP) showing that the administered MB dose was safe in this experimental model. The C48/80 was effective in producing experimental anaphylactic shock since it was observed a decrease in both MAP and cardiac output (CO) after its administration. The MB did not prevent or reverse the C48/80-induced anaphylactic shock in this model. In fact, the MAP of the animals with anaphylactic shock treated with MB decreased even more than the MAP of the animals from the C48/80 group. On the other hand, the C48/80-induced epidermal alterations disappeared after the MB infusion. CONCLUSION: Despite our data, the clinical manifestations improvement brings some optimism and does not allow excluding the MB as a possible therapeutic option in the anaphylactic shock.


OBJETIVO: Verificar se a administração de azul de metileno (AM) previne e/ou reverte o choque anafilático induzido por composto 48/80 (C48/80) em suínos. MÉTODOS: Porcos fêmeas Dalland foram anestesiados e tiveram os parâmetros hemodinâmicos registados durante o tempo necessário para administrar algumas drogas e observar seu efeito. Os animais foram aleatoriamente destribuídos em um dos cinco grupos: 1) controle, 2) AM: os animais receberam uma injeção em bolus de AM (2mg/kg), seguido de infusão contínua de AM (2,66mg/Kg /h por bomba de infusão de seringa); 3) C48/80: os animais receberam uma injeção em bolus de C48/80 (4mg/kg); 4) C48/80 + AM: os animais receberam uma injeção em bolus de C48/80 (4mg/kg) e 10 minutos após a administração de C48/80 os animais receberam uma injeção em bolus de AM (2mg/kg), seguido de infusão contínua de AM (2,66mg/kg/h por bomba de infusão de seringa); 5) AM+C48/80: os animais receberam uma injeção em bolus de AM (2mg/kg) e três minutos depois, receberam uma injeção em bolus de C48/80 (4mg/kg). RESULTADOS: A infusão intravenosa de AM não causou mudanças na pressão arterial média (PAM), mostrando que a dose de AM administrada foi segura neste modelo experimental. O C48/80 foi eficaz na indução do choque anafilático experimental, uma vez que foi observada redução na PAM e débito cardíaco (DC), após a sua administração. O AM não preveniu ou reverte o choque anafilático induzido por C48/80 neste modelo. Na verdade, a PAM dos animais com choque anafilático tratados com AM diminuiu mais do que o PAM dos animais do grupo C48/80. Por outro lado, as alterações epidérmicas induzidas pelo C48/80 desapareceu após a infusão do AM. CONCLUSÃO: Apesar dos resultados a melhora clínica das manifestações anafiláticas permite considerar a possibilidade do azul de metileno como opção terapêutica no tratamento do choque anafilático.


Subject(s)
Animals , Female , Anaphylaxis/drug therapy , Hemodynamics/drug effects , Methylene Blue/therapeutic use , p-Methoxy-N-methylphenethylamine/toxicity , Anaphylaxis/chemically induced , Anaphylaxis/prevention & control , Blood Pressure/drug effects , Cardiac Output/drug effects , Disease Models, Animal , Hemodynamics/physiology , Random Allocation , Swine , Time Factors , Vascular Resistance/drug effects , p-Methoxy-N-methylphenethylamine/antagonists & inhibitors
8.
Gastroenterol. latinoam ; 17(3): 324-327, jul.-sept. 2006. ilus
Article in Spanish | LILACS | ID: lil-460444

ABSTRACT

La reacción alérgica grave al contraste iodado durante colangiopancreatografía retrógrada endoscópica (CPRE) es un evento poco frecuente. En pacientes con antecedentes claros de reacción anafiláctica durante otros exámenes radiológicos, el uso de mismo producto para CPRE representa un riesgo elevado. En nuestro centro, usamos Gadolinio® como medio de contraste para CPRE en 3 pacientes quienes previamente presentaron anafilaxia severa al medio de contraste iodado con requerimiento demaniobras de reanimación. La indicación de CPRE fue coledocolitiasis en dos de ellos, mientras el tercer paciente tuvo siete episodios de pancreatitis aguda sin poder precisar la etiología. El Gadolinio® fue inyectado en todos los pacientes en el colédoco, realizando pancreatografía sólo en uno de ellos. El contraste permitió localizar y posteriormente extraer el cálculo en los dos pacientes. En el tercer caso la pancreatografía contribuyó en el diagnóstico de una anomalía congénita atípica del páncreas, un páncreas anular incompleto, comprobado también con otros métodos diagnósticos. No se observó ningún efecto adverso, se encontró amilasa normal en el suero en todos los casos después del procedimiento. Recomendamos el uso de Gadolinio® como alternativa para CPRE con esta indicación poco frecuente, siendo seguro y permitiendo una calidad aceptable de imágenes radiológicas.


Severe allergic reactions to contrast media in endoscopic retrograde cholangiopancreatography (ERCP) is a rare event. However, in patients with a severe anaphylactic reactions in medical history, the injection of a similar product into the bile-pancreatic ducts can represent a high risk. In our Center, Gadolinium was used for ERCP in 3 patients with previous severe anaphylactic reaction to iodinated contrast medium that required reanimation manoeuvres in an intensive care unit. ERCP was necessary in two of them for choledocholithiasis and for seven bouts of recurrent pancreatitis in the third case. Gadolinium was injected in the common bile duct in the three patients, while pancreatography was performed in only one of them. Thanks to the images obtained, we could localize and retrieve the bile-duct stone in both patients. In the third case, the pancreatography contributed in the diagnosis of an atypical congenital abnormality of pancreas, an incomplete annular pancreas, which was confirmed by other methods. We did not observe any adverse effect of Gadolinium, even the amilasemia remained normal after the ERCP in the three cases. On the base of our experiences, we recommend the Gadolinium as an alternative contrast medium for ERCP with this rare indication, being safe and allowing an acceptable quality of radiological images.


Subject(s)
Humans , Male , Choledocholithiasis , Gadolinium , Hypersensitivity/prevention & control , Pancreatitis , Cholangiopancreatography, Endoscopic Retrograde/methods , Iodides/adverse effects , Acute Disease , Anaphylaxis/prevention & control , Cholangiography/methods , Contrast Media/adverse effects
9.
Pediatr. día ; 18(2): 38-40, mayo-jun. 2002. tab
Article in Spanish | LILACS | ID: lil-390383

ABSTRACT

La anafilaxia se define como una reacción sistémica generalizada caracterizada por síntomas y signos de rápida instalación después de la exposición a un antígeno en personas previamente sensibilizadas.


Subject(s)
Humans , Antigens , Anaphylaxis/complications , Anaphylaxis/etiology , Anaphylaxis/prevention & control , Anaphylaxis/drug therapy
11.
Rev. Inst. Med. Trop. Säo Paulo ; 43(1): 51-53, Jan.-Feb. 2001.
Article in English | LILACS | ID: lil-285681

ABSTRACT

An epizootic outbreak of rabies occurred in 1995 in Ribeiräo Preto, SP, with 58 cases of animal rabies (54 dogs, 3 cats and 1 bat) confirmed by the Pasteur Institute of Säo Paulo, and one human death. The need to provide care to a large number of people for the application of equine rabies immune globulin (ERIG) prevented the execution of the skin sensitivity test (SST) and often also the execution of desensitization, procedures routinely used up to that time at the Emergency Unit of the University Hospital of the Faculty of Medicine of Ribeiräo Preto, University of Säo Paulo (EU-UHFMRP-USP), a reference hospital for the application of heterologous sera. In view of our positive experience of several years with the abolition of SST and of the use of premedication before the application of antivenom sera, we used a similar schedule for ERIG application. Of the 1489 victims of animal bites, 1054 (71 percent) received ERIG; no patient was submitted to SST and all received intravenously anti-histamines (anti-H1 + anti-H2) and corticosteroids before the procedure. The patients were kept under observation for 60 to 180 minutes and no adverse reaction was observed. On the basis of these results, since December 1995 ERIG application has been decentralized in Ribeiräo Preto and has become the responsibility of the Emergency Unit of the University Hospital and the Central Basic Health Unit, where the same routine is used. Since then, 4216 patients have received ERIG (1818 at the Basic Health Unit and 2398 at the EU-UHFMRP), with no problems. The ideal would be the routine use of human rabies immune globulin (HRIG) in public health programs, but this is problematic, because of their high cost. However, while this does not occur, the use of SST is no longer justified at the time of application of ERIG, in view of the clinical evidence of low predictive value and low sensitivity of SST involving the application of heterologous sera. It is very important to point out that a negative SST result may lead the health team to a feeling of false safety that no adverse reaction will occur, but this is not true for the anaphylactoid reactions. The decision to use premedication, which is based on knowledge about anaphylaxis and on the pharmacology of the medication used, is left to the judgment of health professionals, who should always be prepared for eventual untoward events


Subject(s)
Humans , Animals , Immunoglobulins/adverse effects , Premedication , Rabies/prevention & control , Skin Tests , Anaphylaxis/prevention & control , Immunoglobulins/administration & dosage , Predictive Value of Tests , Rabies virus/immunology
13.
Alergia (Méx.) ; 47(1): 22-5, ene.-feb. 2000. tab
Article in Spanish | LILACS | ID: lil-280367

ABSTRACT

Antecedentes: El fenómeno de reacción alérgica y tóxica a los medios de contraste yodados ocurre con mayor frecuencia de lo que registra la literatura. Por este motivo se efectuó el presente estudio. Material y método: en un lapso de 29 años se estudiaron 178,439 casos de pacientes expuestos a medios de contraste yodado; de éstos 137,147 fueron pacientes a quienes se hizo una urografía excretora y a 41,292 una colangiografía. Se realizó un interrogatorio directo que hizo hincapié en los antecedentes personales de alergia a medios de contraste, uso de productos yodados, enfermedades del sistema nervioso y cardiovascular. Se aplicó la prueba cutánea de medios de contraste yodado. Si el resultado fue positivo no se efectuó estudio alguno con medios de contraste yodado o se hizo con medidas especiales. Resultados: se encontraron 4,302 casos positivos y 1,276 falsos negativos. Se premedicaron 287 casos positivos y se administraron medicamentos preventivos cuando hubo antecedentes de urticaria, asma o angioedema con prueba cutánea negativa. No se registraron casos de muerte. Conclusiones: los medios de contraste yodados son susceptibles de desencadenar reacciones adversas de tipo farmacológico o inmunológico. Por esta razón se destaca la utilidad de la anamnesis y las pruebas de intradermorreacción para detectar casos de reacción grave.


Subject(s)
Humans , Male , Female , Anaphylaxis/prevention & control , Contrast Media/adverse effects , Medical History Taking , Skin Tests , Iodine Radioisotopes/adverse effects , Cytotoxicity Tests, Immunologic/methods
14.
Indian J Physiol Pharmacol ; 2000 Jan; 44(1): 75-81
Article in English | IMSEAR | ID: sea-108959

ABSTRACT

The present study presents a mode of action profile of RLX (6, 7, 8, 9, 10, 12-hexahydro-azepino-[2, 1-b]-quinazoline-12-one) a bronchodilator obtained by the chemical modification in the molecule of alkaloid vasicine (Ex: Adhatoda vesica). The effect of RLX (p.o.) was observed on: (a) mast cell degranulation, (b) release of histamine and prostaglandin E (PGE), (c) 45Ca uptake and (d) activities of cAMP phosphodiesterase (PDEase) and lipoxygenase enzymes in mesenteries/peritoneal mast cells/lung tissue homogenates in rats under systemic anaphylaxis. RLX (10 and 20 mg/kg) inhibited antigen-induced mast cell degranulation and released of histamine from target tissues. An increased outflow of PGE (lungs) and an inhibited 45Ca uptake (peritoneal mast cells) were noted. Lung PDEase and lipoxygenase activities were decreased. These results suggested that RLX could be acting like disodium cromoglycate and aminophyline with additional attributes its oral efficacy and long duration of action.


Subject(s)
Anaphylaxis/prevention & control , Animals , Bronchodilator Agents/pharmacology , Calcium/metabolism , Cell Degranulation/drug effects , Electrophoresis, Polyacrylamide Gel , Histamine Release/drug effects , Horses/immunology , Hypersensitivity/immunology , Lung/drug effects , Male , Mast Cells/drug effects , Quinazolines/pharmacology , Rats
16.
Arch. argent. alerg. inmunol. clín ; 30(2): 34-8, 1999. ilus
Article in Spanish | LILACS | ID: lil-243454

ABSTRACT

La proliferación de la apicultura en la región, incrementó la población de riesgo a la anafilaxia por veneno de abeja. Objetivos: Presentar los resultados de los pacientes que pudieron ser evaluados al final de la inmunoterapia y la experiencia con los que la realizaron a distancia. Material y Métodos: Desde 1990 hasta 1995 consultaron 50 pacientes, 26 apicultores o familiares, por reacción sistémica ante picadura de abeja. Se efectuó IgE total y específica. Se testificó con veneno de abeja por intradermoreacción. Se trataron 33 pacientes. Terminaron el tratamiento 25 pacientes recibiendo 150 microgramos de veneno, cada 30 días, durante 3 años. A 20 pacientes se les proveía el veneno mensualmente. Culminando el tratamiento, 18 pacientes fueron testificados y a 9 de ellos se les efectuó IgG e IgE específica. Resultados: El 44 por ciento del total de pacientes eran atópicos. La mayoría sufrió anafilaxia por una picadura, dentro de los veinte minutos. En el accidente, sólo el 22 por ciento fue tratado correctamente. Hubo correlación positiva (88 por ciento) entre prueba cutánea e IgE específica. El 33 por ciento de los pacientes sufrieron provocaciones. La testificación se negativizó en 6 pacientes y la IgE específica en 3 pacientes. Manteniendo positivas la testificación y la IgE específica, dos pacientes fueron picados sin sufrir anafilaxia. Conclusiones: Fue válida la indicación de la inmunoterapia, aún sin reto diagnóstico con picadura. El tratamiento a distancia fue seguro. Si la testificación y la IgE específica permanecieran positivas, estaría indicado el reto con picadura; si ocurriera anafilaxia, se debería continuar el tratamiento


Subject(s)
Humans , Male , Female , Child, Preschool , Adolescent , Adult , Middle Aged , Anaphylaxis/prevention & control , Bees/pathogenicity , Insect Bites and Stings/therapy , Anaphylaxis/etiology , Bee Venoms , Desensitization, Immunologic/statistics & numerical data , Desensitization, Immunologic/standards , Immunoglobulin E/blood , Insect Bites and Stings/complications , Interleukin-4/blood , Skin Tests
18.
Rev. cuba. med. gen. integr ; 12(4): 386-8, oct.-dic. 1996.
Article in Spanish | LILACS | ID: lil-185400

ABSTRACT

Abogamos por la educacion a la poblacion para prevenir la anafilaxia, con el desarrollo de medidas de promocion y prevencion de salud. Pretendemos sensibilizar a nuestros medicos y enfermeras de la familia en la necesidad del manejo adecuado en el sitio de ocurrencia


Subject(s)
Humans , Allied Health Personnel , Anaphylaxis/drug therapy , Anaphylaxis/prevention & control , Epinephrine/therapeutic use , Physicians
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