Résumé
The aim of this study was to estimate the incidence of anaphylaxis in the emergency department of a tertiary-care hospital, describe the clinical features and the management of the patients and determine those with mild manifestations. A retrospective study was conducted from 2005 to 2006 using anaphylaxis-related ICD-10 terms. Two different sets of criteria for the diagnosis of anaphylaxis were applied, first the criteria previously accepted by emergency practice, followed by the recent criteria set forth at the 2005 international meeting. Sixty-four patients fulfilled the previous criteria with an average incidence of 52.5 per 100,000 patients per year with a shift towards females in 2006. The most common presentations were cutaneous, followed by respiratory symptoms. Food allergy was the most common cause, especially prawn. After applying the recent criteria, 13 patients (20.4%) were excluded, which reduced the incidence to 42.2 per 100,000 patients per year. Long term follow up is suggested for the possible or mild cases that were re-categorized.
Sujets)
Adolescent , Hormones corticosurrénaliennes/usage thérapeutique , Adulte , Sujet âgé , Anaphylaxie/diagnostic , Antibactériens , Enfant , Enfant d'âge préscolaire , Hypersensibilité médicamenteuse/complications , Service hospitalier d'urgences , Épinéphrine/usage thérapeutique , Femelle , Hypersensibilité alimentaire/complications , Antihistaminiques des récepteurs H1/usage thérapeutique , Humains , Incidence , Nourrisson , Morsures et piqûres d'insectes , Mâle , Adulte d'âge moyen , Gestion des soins aux patients , Éducation du patient comme sujet , Hypersensibilité respiratoire/complications , Études rétrospectives , Indice de gravité de la maladie , Facteurs sexuels , Fruits de merRésumé
Na primeira parte desta revisäo, säo apresentados os principais agentes biológicos e näo biológicos que funcionam como poluentes atmosféricos em ambientes domiciliares. Em seguida, discutem-se os mecanismos pelos quais estes poluentes contribuem para a patogênese de doenças respiratórias, principalmente alérgicas. Finalmente, demonstra-se como o controle ambiental, instituído em uma zona industrial diariamente poluída próxima à cidade de Säo Paulo, reduziu tanto a emissäo de poluentes como a prevalência de doenças respiratórias.