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3.
Ludovica pediátr ; 23(1): 11-19, marzo 2020.
Artigo em Espanhol | LILACS (Américas), BINACIS | ID: biblio-1102850

RESUMO

A partir de la sanción de la ley Nacional N.º 27447, conocida popularmente como "Ley Justina", se genera un nuevo Protocolo para el diagnóstico de cese irreversible de las funciones encefálicas. Nuestro Hospital, a través del servicio de Terapia Intensiva, tuvo la oportunidad de participar en su confección.El protocolo consta de criterios de inclusión, periodos de evaluación, métodos auxiliares y la consideración de cómo arribar al diagnóstico en diferentes situaciones especiales.Los cambios más importantes se realizaron en la edad pediátrica, donde se logró acortar los tiempos de evaluación para arribar a un diagnóstico de certeza, acortando la espera familiar


From the enactment of National Law No. 27447, popularly known as the Justina law, a new Protocol for the Diagnosis of Irreversible Cessation of Encephalic Functions was created. Our Hospital, through the Intensive Care Service, had the opportunity to participate in its preparation.The protocol consists of inclusion criteria, evaluation periods, ancillary methods and the consideration of how to arrive at the diagnosis in different special situations.The most important changes were made in the pediatric age where the evaluation times were shortened to arrive at a diagnosis of certainty, shortening the family wait


Assuntos
Pediatria , Diagnóstico , Morte Encefálica
4.
Lima; Perú. Poder Ejecutivo; 20200300. 3 p.
Não convencional em Espanhol | LILACS (Américas), LIPECS | ID: biblio-1116591

RESUMO

El Decreto contiene las medidas adicionales extraordinarias que permitan adoptar las acciones preventivas y de respuesta para reducir el riesgo de propagación y el impacto sanitario de la enfermedad causada por el virus del COVID-19, en el territorio nacional, con la finalidad de reforzar los sistemas de prevención, control, vigilancia y respuesta sanitaria, preservar la salud y el empleo de los trabajadores; y de esta forma coadyuvar a disminuir la afectación de la economía peruana por la propagación del mencionado virus a nivel nacional.


Assuntos
Testes Imunológicos , Infecções por Coronavirus , Vigilância , Decretos , Diagnóstico , Controle
5.
Biosci. j. (Online) ; 36(1): 78-86, jan./feb. 2020. graf
Artigo em Inglês | LILACS (Américas) | ID: biblio-1049198

RESUMO

The root-knot nematode (Meloidogyne spp.) is the most important plant-parasitic nematode genus, they are the most common and destructive pathogens in this group. They produce some of the most drastic symptoms in plants and can significantly reduce the yield of crops. In order to achieve deploy an efficient method of plant-parasitic nematode management, is necessary an identification and quantification accurate and reliable of plant-parasitic nematodes. The aim of this study was to analyze samples in qPCR to detect and quantify M. incognita, in the field samples, comparing different methods of extraction of DNA and its efficacy in establishing the number of individuals. For this purpose the effectiveness of different DNA methods of extraction was compared through the values of CT intervals. For standard curve and method comparisons, we used nematodes multiplied in a greenhouse and carefully separated in the specific quantities of the experiments. For the number of individuals experiment field samples previously counted under an optical microscope were used. The DNA extraction was made from 100 nematodes by the methods: CTAB, Phenol: Chloroform and commercial kit (PureLink® Genomic DNA Kit, Invitrogen). In the comparative analysis using the three methods of DNA extracting from 100 nematodes, it was observed that commercial kit and CTAB methods obtained CT values similar. The CTAB method of extraction, showed less variation in the repeats and greater linearity of standard curve in comparison with other methods tested. So, it was possible to quantify the samples through the CT value intervals, established from different numbers of individuals (1, 10, 25, 100, 250, 500 and 750), in field samples. This study demonstrated that qPCR technique is an alternative sensitive and reliable for the quantification of M. incognita to support laboratories of diagnose and field survey.


Os nematoides-das-galhas (Meloidogyne spp.) é o gênero de fitonematoide mais importante, são os patógenos mais comuns e destrutivos deste grupo. Eles produzem alguns dos sintomas mais drásticos nas plantas e podem reduzir significativamente o rendimento das culturas. Para conseguir implantar um método eficiente de manejo de nematoides parasitas de plantas, é necessária a identificação e quantificação precisa e confiável dos fitonematoides. O objetivo deste estudo foi analisar amostras em qPCR para detectar e quantificar M. incognita, em amostras de campo, comparando diferentes métodos de extração do DNA e sua eficácia no estabelecimento do número de indivíduos. Para este propósito, a eficácia de diferentes métodos de extração de DNA foi comparada através dos valores dos intervalos de Ct. Para comparações padrão de curvas e métodos, usamos nematoides multiplicados em casa de vegetação e cuidadosamente separados nas quantidades específicas dos experimentos. Para o número de indivíduos, foram utilizadas amostras de campo previamente contadas sob um microscópio óptico. A extração de DNA foi realizada a partir de 100 nematoides, pelos métodos: CTAB, Phenol: Clorofórmio e kit comercial (PureLink® Genomic DNA Kit, Invitrogen). Na análise comparativa utilizando os três métodos de extração de DNA a partir de 100 nematoides, observou-se que o kit comercial e os métodos de CTAB obtiveram valores de CT semelhantes. O método de extração CTAB apresentou menor variação nas repetições e maior linearidade da curva padrão em comparação com os demais métodos testados. O coeficiente de correlação (R2) da curva padrão foi de 0,98 indicando uma relação linear entre o valor de Ct e a quantidade de padrões de DNA variando de 90 a 0,00009 ng.µL-1. Assim, foi possível quantificar as amostras através dos intervalos de valores de CT, estabelecidos a partir de diferentes números de indivíduos (1, 10, 25, 100, 250, 500 e 750), em amostras de campo. Este estudo demonstrou que a técnica de qPCR é uma alternativa sensível e confiável para a quantificação de M. incognita, para apoiar laboratórios de diagnóstico e levantamentos de campo.


Assuntos
Tylenchoidea , Monitoramento , Diagnóstico , Nematoides , Tumores de Planta
6.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-762473

RESUMO

BACKGROUND: Although the incidence of tuberculosis (TB) is decreasing, cases of multidrug-resistant (MDR) TB and extensively drug-resistant (XDR) TB continue to increase. As conventional phenotype drug susceptibility testing (pDST) takes six to eight weeks, molecular assays are widely used to determine drug resistance. we developed QuantaMatrix Multiplexed Assay Platform (QMAP) MDR/XDR assay (QuantaMatrix Inc., Seoul, Korea) that can simultaneously detect mutations related to both first- and second-line drug resistance (rifampin, isoniazid, ethambutol, fluoroquinolones, second-line injectable drugs, and streptomycin). METHODS: We used 190 clinical Mycobacterium tuberculosis (MTB) strains isolated from Myanmar, compared QMAP and pDST results, and determined concordance rates. Additionally, we performed sequence analyses for discordant results. RESULTS: QMAP results were 87.9% (167/190) concordant with pDST results. In the 23 isolates with discordant results, the QMAP and DNA sequencing results completely matched. CONCLUSIONS: The QMAP MDR/XDR assay can detect all known DNA mutations associated with drug resistance for both MDR- and XDR-MTB strains. It can be used for molecular diagnosis of MDR- and XDR-TB to rapidly initiate appropriate anti-TB drug therapy.


Assuntos
Diagnóstico , DNA , Resistência a Medicamentos , Tratamento Farmacológico , Etambutol , Tuberculose Extensivamente Resistente a Medicamentos , Fluoroquinolonas , Incidência , Isoniazida , Mianmar , Mycobacterium tuberculosis , Fenótipo , Seul , Análise de Sequência , Análise de Sequência de DNA , Tuberculose , Tuberculose Resistente a Múltiplos Medicamentos
7.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-762469

RESUMO

The GENEDIA MTB/NTM Detection Kit (GENEDIA MTB/NTM; Green Cross Medical Science Corp., Chungbuk, Korea) is a multiplex real-time PCR assay used for differential identification of Mycobacterium tuberculosis complex (MTBC) and nontuberculous mycobacteria (NTM). While the importance of differential identification of MTB/NTM is recognized, there is limited data on the performance of GENEDIA MTB/NTM assay to date. A total of 687 consecutive sputum specimens were cultured and analyzed with the GENEDIA MTB/NTM and GENEDIA MTB assays. Nineteen specimens (2.8%) were MTBC-positive, and 69 (10.0%) were NTM-positive based on mycobacterial culture. All specimens showed concordant results for MTBC using both assays, with a kappa value of 1.00, overall sensitivity of 63.2% (12/19), and specificity of 100% (668/668). The overall NTM sensitivity and specificity were 23.2% (16/69) and 99.7% (616/618) for GENEDIA MTB/NTM. The association between NTM-positivity using GENEDIA MTB/NTM and the diagnosis of NTM pulmonary disease was not statistically significant. In conclusion, the two real-time PCR assays showed similar diagnostic performance for MTBC detection. However, the sensitivity for NTM detection was lower than that for MTBC detection.


Assuntos
Diagnóstico , Pneumopatias , Mycobacterium tuberculosis , Mycobacterium , Micobactérias não Tuberculosas , Reação em Cadeia da Polimerase em Tempo Real , Sensibilidade e Especificidade , Escarro
8.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-762461

RESUMO

BACKGROUND: Rapid and accurate diagnosis of acute myocardial infarction (AMI) is critical for initiating effective treatment and achieving better prognosis. We investigated the performance of copeptin for early diagnosis of AMI, in comparison with creatine kinase myocardial band (CK-MB) and troponin I (TnI). METHODS: We prospectively enrolled 271 patients presenting with chest pain (within six hours of onset), suggestive of acute coronary syndrome, at an emergency department (ED). Serum CK-MB, TnI, and copeptin levels were measured. The diagnostic performance of CK-MB, TnI, and copeptin, alone and in combination, for AMI was assessed by ROC curve analysis by comparing the area under the curve (AUC). Sensitivity, specificity, negative predictive value, and positive predictive value of each marker were obtained, and the characteristics of each marker were analyzed. RESULTS: The patients were diagnosed as having ST elevation myocardial infarction (STEMI; N=43), non-ST elevation myocardial infarction (NSTEMI; N=25), unstable angina (N=78), or other diseases (N=125). AUC comparisons showed copeptin had significantly better diagnostic performance than TnI in patients with chest pain within two hours of onset (AMI: P=0.022, ≤1 hour; STEMI: P=0.017, ≤1 hour and P=0.010, ≤2 hours). In addition, TnI and copeptin in combination exhibited significantly better diagnostic performance than CK-MB plus TnI in AMI and STEMI patients. CONCLUSIONS: The combination of TnI and copeptin improves AMI diagnostic performance in patients with early-onset chest pain in an ED setting.


Assuntos
Síndrome Coronariana Aguda , Angina Instável , Área Sob a Curva , Dor no Peito , Creatina Quinase , Diagnóstico , Diagnóstico Precoce , Emergências , Serviço Hospitalar de Emergência , Humanos , Infarto do Miocárdio , Prognóstico , Estudos Prospectivos , Curva ROC , Sensibilidade e Especificidade , Troponina I
9.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-762457

RESUMO

BACKGROUND: The interferon-gamma (IFN-γ) releasing assay (IGRA) is widely used for latent tuberculosis infection (LTBI) diagnosis. We evaluated the analytical performance of a new automated chemiluminescent immunoanalyzer-based IGRA (CLIA-IGRA), AdvanSure I3 (LG Life Sciences, Seoul, Korea) and compared it with that of the QuantiFERON-TB Gold In-Tube (QFT-GIT) assay. METHODS: Repeatability and reproducibility were evaluated at four levels. Detection capability, including limit of blank (LoB), limit of detection (LoD), and limit of quantification (LoQ), was evaluated using IFN-γ standard material (National Institute for Biological Standards and Control code: 87/586). Agreement between the results of two assays was evaluated using 341 blood samples from healthcare workers and patients at a tertiary care hospital. To determine the cut-off value of CLIA-IGRA for diagnosing LTBI, the ROC curve was analyzed. RESULTS: Repeatability and reproducibility were 4.86–7.00% and 6.36–7.88% CV, respectively. LoB, LoD, and LoQ were 0.022, 0.077, and 0.249 IU/mL, respectively. IFN-γ values between CLIA-IGRA and QFT-GIT showed a strong correlation within the analytical measurable range of both assays, especially when the value was low. Qualitative comparison of the two assays yielded a 99.1% overall agreement (kappa coefficient=0.98). A cut-off value of 0.35 IU/mL was appropriate for diagnosing LTBI. CONCLUSIONS: CLIA-IGRA is a reliable assay for LTBI diagnosis, with performance similar to that of QFT-GIT.


Assuntos
Disciplinas das Ciências Biológicas , Assistência à Saúde , Diagnóstico , Humanos , Interferon gama , Tuberculose Latente , Limite de Detecção , Curva ROC , Seul , Atenção Terciária à Saúde
10.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-762452

RESUMO

Evaluation of diagnostic tests requires reference standards, which are often unavailable. Latent class analysis (LCA) can be used to evaluate diagnostic tests without reference standards, using a combination of observed and estimated results. Conditionally independent diagnostic tests for Helicobacter pylori infection are required. We used LCA to construct a reference standard and evaluate the capability of non-invasive tests (stool antigen test and serum antibody test) to diagnose H. pylori infection compared with the conventional method, where histology is the reference standard. A total of 96 healthy subjects with endoscopy histology results were enrolled from January to July 2016. Sensitivity and specificity were determined for the LCA approach (i.e., using a combination of three tests as the reference standard) and the conventional method. When LCA was used, sensitivity and specificity were 83.8% and 99.4% for histology, 80.0% and 81.9% for the stool antigen test, and 63.6% and 89.3% for the serum antibody test, respectively. When the conventional method was used, sensitivity and specificity were 75.8% and 71.1% for the stool antigen test and 77.7% and 60.7% for the serum antibody test, respectively. LCA can be applied to evaluate diagnostic tests that lack a reference standard.


Assuntos
Diagnóstico , Testes Diagnósticos de Rotina , Endoscopia , Voluntários Saudáveis , Helicobacter pylori , Helicobacter , Métodos , Sensibilidade e Especificidade
11.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-762186

RESUMO

MicroRNAs (miRs) are single-stranded RNAs of 18-25 nucleotides. These molecules regulate gene expression at the post-transcriptional level; several of these are differentially expressed in asthma as well as in viral acute respiratory infections (ARIs), the main triggers of acute asthma exacerbations. In recent years, miRs have been studied in order to discover drug targets as well as biomarkers for diagnosis, disease severity and prognosis. We describe recent findings on miR expression and function in asthma and their role in the regulation of viral ARIs, according to cell tissue specificity and asthma severity. By combining the above information, we identify miRs that may be important in virus-induced asthma exacerbations. This is the first attempt to link miR profiles of asthmatic patients and ARI-induced miRs, addressing the question of whether there might be a specific miR deficit in asthmatic subjects that make them more susceptible and/or reactive to infection.


Assuntos
Asma , Biomarcadores , Diagnóstico , Progressão da Doença , Expressão Gênica , Humanos , Inflamação , MicroRNAs , Nucleotídeos , Especificidade de Órgãos , Prognóstico , Infecções Respiratórias , RNA
12.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-787135

RESUMO

Although microscopic analysis of tissue slides has been the basis for disease diagnosis for decades, intra- and inter-observer variabilities remain issues to be resolved. The recent introduction of digital scanners has allowed for using deep learning in the analysis of tissue images because many whole slide images (WSIs) are accessible to researchers. In the present study, we investigated the possibility of a deep learning-based, fully automated, computer-aided diagnosis system with WSIs from a stomach adenocarcinoma dataset. Three different convolutional neural network architectures were tested to determine the better architecture for tissue classifier. Each network was trained to classify small tissue patches into normal or tumor. Based on the patch-level classification, tumor probability heatmaps can be overlaid on tissue images. We observed three different tissue patterns, including clear normal, clear tumor and ambiguous cases. We suggest that longer inspection time can be assigned to ambiguous cases compared to clear normal cases, increasing the accuracy and efficiency of histopathologic diagnosis by pre-evaluating the status of the WSIs. When the classifier was tested with completely different WSI dataset, the performance was not optimal because of the different tissue preparation quality. By including a small amount of data from the new dataset for training, the performance for the new dataset was much enhanced. These results indicated that WSI dataset should include tissues prepared from many different preparation conditions to construct a generalized tissue classifier. Thus, multi-national/multi-center dataset should be built for the application of deep learning in the real world medical practice.


Assuntos
Adenocarcinoma , Classificação , Conjunto de Dados , Diagnóstico , Aprendizagem , Variações Dependentes do Observador , Estômago
14.
Artigo em Coreano | WPRIM (Pacífico Ocidental) | ID: wprim-786183

RESUMO

Diabetic kidney disease is a microvascular complication of diabetes mellitus and the leading cause of end-stage renal disease resulting in renal replacement therapy. Approximately 30% to 40% of diabetic patients have diabetic kidney disease, which contributes to a significant increase in morbidity and mortality. Microalbuminuria is considered the gold standard for diabetic kidney disease diagnosis; however, its predictive value is restricted. Although blood glucose control, blood pressure control, and angiotensin converting enzyme inhibitors have been the primary treatment strategies, there are no definitive treatment modalities capable of inhibiting the progression of kidney dysfunction in these patients. This study was undertaken to answer seven questions regarding the various aspects of diabetic kidney disease. Why does it develop? what kind of factors affect its development? How is it diagnosed? What are its possible biomarkers? When is a kidney biopsy necessary? What are the preventive and therapeutic options? And what are the novel treatments?


Assuntos
Inibidores da Enzima Conversora de Angiotensina , Biomarcadores , Biópsia , Glicemia , Pressão Sanguínea , Diabetes Mellitus , Nefropatias Diabéticas , Diagnóstico , Humanos , Rim , Falência Renal Crônica , Mortalidade , Terapia de Substituição Renal
15.
Artigo em Coreano | WPRIM (Pacífico Ocidental) | ID: wprim-786181

RESUMO

To maintain homeostasis of the cardiovascular system, the heart and kidney act bidirectionally. Therefore, acute or chronic dysfunction of one organ can cause dysfunction in the other. This phenomenon is characterized as cardiorenal syndrome (CRS). Concurrent dysfunction of the heart and kidney adversely affects one another and eventually worsens patient outcomes through a vicious cycle. Although a CRS classification system has been proposed, the underlying pathophysiology is multifactorial and clinical access continues to be difficult. Although several therapies, including agents that target the renin-angiotensin-aldosterone system, have been utilized, there is not enough evidence to demonstrate their effectiveness for CRS. Thus, more effort should be made to optimize the diagnosis and treatment strategies for CRS patients. This review will introduce CRS as it is currently understood, discuss the pathophysiology, and examine management strategies.


Assuntos
Lesão Renal Aguda , Síndrome Cardiorrenal , Sistema Cardiovascular , Classificação , Diagnóstico , Coração , Insuficiência Cardíaca , Homeostase , Humanos , Rim , Insuficiência Renal Crônica , Sistema Renina-Angiotensina
16.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-786140

RESUMO

Kawasaki disease (KD) is an acute febrile illness that is characterized by systemic inflammation usually involving medium-sized arteries and multiple organs during the acute febrile phase, leading to associated clinical findings. The diagnosis is based on the principal clinical findings including fever, extremity changes, rash, conjunctivitis, oral changes, and cervical lymphadenopathy. However, KD diagnosis is sometimes overlooked or delayed because other systemic organ manifestations may predominate in acute phase of KD. As a cardiovascular manifestation, an acute pericarditis usually shows a small pericardial effusion, but large pericardial effusion showing clinical signs of cardiac tamponade is very rare. Here, we described a case of incomplete KD presenting with impending cardiac tamponade, and recurrent fever and pleural effusion.


Assuntos
Artérias , Tamponamento Cardíaco , Conjuntivite , Diagnóstico , Exantema , Extremidades , Febre , Inflamação , Doenças Linfáticas , Síndrome de Linfonodos Mucocutâneos , Derrame Pericárdico , Pericardite , Derrame Pleural
17.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-785553

RESUMO

The objective of this study was to investigate factors affecting the return home one year after a stroke. The subjects of this study consisted of patients who participated in a large-scale multi-objective cohort study of initial stage stroke patients who were admitted to 9 representative hospitals in Korea. We analyzed the distribution of the subjects who had experienced stroke a year earlier by distinguishing the group who returned home and the other group that was hospitalized in rehabilitation hospitals. Based on this distribution, we evaluated the demographic, environmental, clinical, and psychological factors that can affect the return home. Overall, there were 464 subjects in the ‘Return home’ group and 99 subjects in the ‘Rehabilitation hospitalization’ group. job status, inconvenient housing structures, residential types, diagnosis, Functional Ambulation Categories, modified Rankin Scale, Korea-Modified Barthel Index, Function Independence Measure, Fugl-Meyer Assessment, Korean version of Mini-Mental State Examination, Korean version of Frenchay Aphasia Screening Test, Psychosocial Well-being Index-Short Form, Geriatric Depression Scale-Short Form, EuroQol-five Dimensional showed a significant difference between the 2 groups one year after the stroke. The factors affecting the return home one year after a stroke include functional status, activities of daily living, cognition, depression, stress, quality of life, job status. It is expected that factors affecting the rehabilitation of patients with stroke can be considered as basic data for establishing rehabilitation goals and treatment plans.


Assuntos
Atividades Cotidianas , Afasia , Cognição , Estudos de Coortes , Depressão , Diagnóstico , Habitação , Humanos , Coreia (Geográfico) , Programas de Rastreamento , Alta do Paciente , Psicologia , Qualidade de Vida , Reabilitação , Acidente Vascular Cerebral , Caminhada
18.
Asia Pacific Allergy ; (4): 1-2020.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-785464

RESUMO

BACKGROUND: In the Emergency Department (ED), diagnosis and management of anaphylaxis are challenging with at least 50% of anaphylaxis episodes misdiagnosed when the diagnostic criteria of current guidelines are not used.OBJECTIVE: Objective of our study was to assess anaphylaxis diagnosis and management in patients presenting to the ED.METHODS: Retrospective chart review conducted on patients presenting to The Medical City Hospital ED, the Philippines from 2013–2015 was done. Cases were identified based on International Statistical Classification of Diseases, 10th revision coding for either anaphylaxis or other allergic related diagnosis. Cases fitting the definition of anaphylaxis as identified by the National Institute of Allergy and Infectious Disease and the Food Allergy and Anaphylaxis Network (NIAID/FAAN) were included. Data collected included demographics, signs and symptoms, triggers and management.RESULTS: A total of 105 cases were evaluated. Incidence of anaphylaxis for the 3-year study period was 0.03%. Of the 105 cases, 35 (33%) were diagnosed as “urticaria” or “hypersensitivity reaction” despite fulfilling the NIAID/FAAN anaphylaxis criteria. There was a significant difference in epinephrine administration between those given the diagnosis of anaphylaxis versus misdiagnosed cases (61 [87%] vs. 12 [34%], χ² = 30.77, p < 0.01); and a significant difference in time interval from arrival at the ED to epinephrine administration, with those diagnosed as anaphylaxis (48%) receiving epinephrine within 10 minutes, versus ≥ 60 minutes for most of the misdiagnosed group (χ² = 52.97, p < 0.01).CONCLUSION: Despite current guidelines, anaphylaxis is still misdiagnosed in the ED. Having an ED diagnosis of anaphylaxis significantly increases the likelihood of epinephrine administration, and at a shorter time interval.


Assuntos
Anafilaxia , Classificação , Codificação Clínica , Doenças Transmissíveis , Demografia , Diagnóstico , Emergências , Serviço Hospitalar de Emergência , Epinefrina , Hipersensibilidade Alimentar , Hospitais Urbanos , Humanos , Hipersensibilidade , Incidência , Filipinas , Estudos Retrospectivos , Centros de Atenção Terciária
19.
Asia Pacific Allergy ; (4): 4-2020.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-785461

RESUMO

BACKGROUND: Banana fruit has been recognized as an important food allergen source. Nowadays banana hypersensitivity had been reported more frequently with various presentations from oral allergy syndrome to anaphylaxis.OBJECTIVE: This study aims to describe the pattern of banana hypersensitivity and the sensitivity of diagnostic test.METHODS: Six patients who experienced banana hypersensitivity were recruited from adult allergy clinic, Ramathibodi Hospital, Mahidol University between 2015–2018. Demographic data, pattern of banana allergy consisted of the onset of reaction, symptoms, severity, cross-reactivity to kiwi, avocado, latex including type and amount of banana were collected. Skin test, serum specific IgE to banana and open-label food challenge test had been applied.RESULTS: All patients experienced multiple episodes of banana anaphylaxis. Regarding the diagnostic investigation, prick-to-prick skin test had higher sensitivity (sensitivity, 100%; 95% confidence interval [CI], 54.07%–100%) than the commercial banana extract (sensitivity, 83.33%; 95% CI, 35.88%–99.58%) and serum specific IgE to banana (sensitivity, 50%; 95% CI, 11.81%–88.19%). The discordance between skin prick test using commercial banana extract and skin test was reported. The cross-reactivity between the species of banana, kiwi, the avocado was documented in all patients. Latex skin prick test and application test were applied with negative results. From the oral food challenge test, a case of banana anaphylaxis patient can tolerate heated banana.CONCLUSION: The various phenotypes of banana hypersensitivity were identified. The prick-to-prick test showed the highest sensitivity for diagnosis of banana allergy. However, component resolved diagnostics might be needed for conclusive diagnosis.


Assuntos
Adulto , Anafilaxia , Diagnóstico , Testes Diagnósticos de Rotina , Hipersensibilidade Alimentar , Frutas , Temperatura Alta , Humanos , Hipersensibilidade , Hipersensibilidade Imediata , Imunoglobulina E , Látex , Musa , Persea , Fenótipo , Pele , Testes Cutâneos , Tailândia
20.
Asia Pacific Allergy ; (4): 6-2020.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-785459

RESUMO

BACKGROUND: The prevalence of peanut allergy (PA) among children has increased significantly over the past decade. Even though the prevalence of PA in Singapore is considered low, peanut is the top trigger for food-induced anaphylaxis in Singaporean children.OBJECTIVE: To describe the demographic characteristics and clinical features of children with PA.METHODS: This is a 5-year retrospective review of children diagnosed with PA based on clinical history coupled with a positive skin prick test to peanut or positive oral food challenge results.RESULTS: There were 269 patients (53.9% males) with a clinical diagnosis of PA. The median age at first allergic presentation for the PA group was 24 months old, with interquartile range of 13–39 months. The most common form of peanut introduced was roasted peanut. The rate of peanut anaphylaxis was 7.1%. Concomitant tree nut sensitization was found in 32.3% of this cohort, predominantly to cashew nut. Majority of them have a personal history of atopy – 75.8% with eczema, 63.6% with allergic rhinitis, and 19.7% with asthma.CONCLUSION: This is the first large review of peanut-allergic children in Singapore. Prospective population-based studies are needed to establish the true prevalence and risk factors associated with the development of this potentially life-threatening condition.


Assuntos
Anacardium , Anafilaxia , Arachis , Ásia , Asma , Criança , Estudos de Coortes , Diagnóstico , Eczema , Humanos , Nozes , Hipersensibilidade a Amendoim , Prevalência , Estudos Prospectivos , Estudos Retrospectivos , Rinite Alérgica , Fatores de Risco , Singapura , Pele , Árvores
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