Assuntos
Hipersensibilidade Alimentar/epidemiologia , Rotulagem de Alimentos/estatística & dados numéricos , Poder Familiar , Fatores Socioeconômicos , Alérgenos/efeitos adversos , Canadá , Defesa do Consumidor , Progressão da Doença , Feminino , Hipersensibilidade Alimentar/dietoterapia , Hipersensibilidade Alimentar/imunologia , Hipersensibilidade Alimentar/psicologia , Geografia , Humanos , Imunoglobulina E/imunologia , Masculino , Pessoa de Meia-IdadeAssuntos
Protocolos Clínicos , Dessensibilização Imunológica , Hipersensibilidade a Drogas/tratamento farmacológico , Esclerose Múltipla/tratamento farmacológico , Peptídeos/efeitos adversos , Adulto , Quimioterapia Adjuvante , Difenidramina/uso terapêutico , Cálculos da Dosagem de Medicamento , Hipersensibilidade a Drogas/imunologia , Hipersensibilidade a Drogas/fisiopatologia , Feminino , Acetato de Glatiramer , Humanos , Esclerose Múltipla/imunologia , Obstrução Nasal , Peptídeos/administração & dosagem , Peptídeos/uso terapêutico , Prednisona/uso terapêutico , Prurido , UrticáriaRESUMO
BACKGROUND: Little is known about the impact of food labeling on the allergic consumer. OBJECTIVE: To determine the proportion of food-allergic individuals attributing an accidental exposure to inappropriate labeling, failure to read a food label, or ignoring a precautionary statement and to identify factors associated with accidental exposures. METHODS: Food-allergic individuals or their caregivers were recruited from a Canadian registry of individuals with a physician-confirmed diagnosis of peanut allergy and from allergy awareness organizations. Participants completed questionnaires regarding accidental exposures due to specific food labeling issues. The association between accidental exposures and characteristics of food-allergic individuals or their caregivers was estimated using multivariate logistic regression models. RESULTS: Of 1,862 potential participants, 1,454 (78.1%) responded. Of the 47.8% (95% confidence interval [CI], 45.1%-50.5%) of respondents who experienced an accidental exposure, 47.0% (95% CI, 43.1%-50.9%) attributed the event to inappropriate labeling, 28.6% (95% CI, 25.1%-32.2%) to failure to read a food label, and 8.3% (95% CI, 6.3%-10.7%) to ignoring a precautionary statement. Food-allergic individuals who were allergic to peanut, tree nut, fish, or shellfish were less likely to experience an accidental exposure due to the allergen not being identified in plain language. CONCLUSIONS: A considerable proportion of accidental exposures are attributed to inappropriate labeling, failure to read labels, and ignoring precautionary statements. Clear and consistent labeling of food allergens combined with increased consumer education is necessary to improve consumer confidence and compliance and to reduce accidental exposures.
Assuntos
Rotulagem de Alimentos/estatística & dados numéricos , Hipersensibilidade a Amendoim/epidemiologia , Sistema de Registros , Adulto , Arachis/efeitos adversos , Canadá , Cuidadores/estatística & dados numéricos , Criança , Exposição Ambiental/efeitos adversos , Feminino , Humanos , Masculino , Educação de Pacientes como Assunto , Hipersensibilidade a Amendoim/etiologia , Hipersensibilidade a Amendoim/prevenção & controle , Inquéritos e QuestionáriosRESUMO
We present two cases of catecholamine-refractory and vasopressin-refractory vasoplegic syndrome associated with intraoperative anaphylaxis during cardiac surgery. One case was related to the administration of protamine and the other case to the administration of aprotinin. Both cases were successfully managed using intravenous methylene blue. The use of methylene blue blocks accumulation of cyclic guanosine monophosphate by competitively inhibiting the enzyme guanylate cyclase. This results in reduced responsiveness of the vasculature to cyclic guanosine monophosphate-mediated vasodilators, such as nitric oxide. This report provides a description of severe anaphylaxis induced by different agents, in which the use of methylene blue was associated with a significant clinical response.
