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Id: 195168
Autor: Uriarte, SA; Sastre, Joaquín.
Título: Subcutaneous immunotherapy with high-dose cat and dog extracts: a real-life study
Fonte: J. investig. allergol. clin. immunol;30(3):169-174, 2020. graf.
Idioma: en.
Resumo: BACKGROUND: Data on the efficacy of immunotherapy administered to patients with cat or dog allergy are scarce. OBJECTIVE: We aimed to evaluate the safety and efficacy of subcutaneous immunotherapy (SCIT) in patients with allergy to cat and dog dander. METHODS: Consecutive patients with rhinitis and/or asthma related to sensitization to cat or dog dander were included in a pragmatic, real-life, prospective, observational study. All patients had specific IgE to cat, dog, or both. SCIT was administered using an infusion pump over 3 sessions as part of a rush protocol, followed by monthly administration over 12 months. We recorded adverse events, clinical outcomes, pulmonary function, FeNO, symptoms of rhinitis and asthma, quality of life (QoL), Asthma Control Test (ACT) score, and visual analog scale (VAS) score at baseline, 6 months, and 12 months. RESULTS: The study population comprised 66 patients (38 females, 46 allergic to cat and 20 to dog), with ages ranging from 9 to 59 years. During the up-dosing phase, in which the infusion pump was used, 8.1% of doses elicited a systemic reaction and 5.4% caused a local reaction, while 9.3% of doses administered during the maintenance phase (ie, without an infusion pump) induced a systemic reaction. No local reactions were recorded. A significant improvement in FEV1, symptoms of rhinitis and asthma, QoL, use of medication, VAS score, and ACT score was observed at 6 months and continued at 12 months. Clinical improvement with cat extract was significantly better than with dog extract. CONCLUSIONS: High-dose SCIT has substantial clinical value in many cat- and dog-allergic patients

ANTECEDENTES: Hay pocos estudios sobre la eficacia de la inmunoterapia administrada a pacientes con alergia a perro o gato. OBJETIVO: Evaluar la seguridad y la eficacia de la inmunoterapia subcutánea (SCIT) en pacientes con alergia a estos dos animales. MÉTODOS: Se incluyeron pacientes consecutivos con rinitis y/o asma relacionados con la sensibilización al gato o al perro en un estudio observacional prospectivo, pragmático, en vida real. Todos los pacientes tenían IgE específica para gato y/o perro. La SCIT se administró utilizando una bomba de infusión (IP), en 3 sesiones como parte de un protocolo rápido, seguido de la administración mensual durante 12 meses. Se recopilaron datos sobre efectos adversos y resultados clínicos, función pulmonar, FeNO, síntomas de rinitis y asma, calidad de vida (QoL), prueba de control del asma (ACT) y escala analógica visual (VAS) al inicio, a los 6 y 12 meses. RESULTADOS: Se incluyeron 76 pacientes: 38 mujeres, 46 alérgicos a gato y 20 a perro, con edades comprendidas entre los 9 y los 59 años. Durante la fase de administración ascendente, utilizando una IP, el 8,1% de las dosis provocó una reacción sistémica (SR) y el 5,4% causó una reacción local (LR), mientras que el 9,3% de las dosis administradas durante la fase de mantenimiento (es decir, sin IP) desarrolló una SR, y no se registraron LRs. Se observó una mejoría significativa en el FEV1, en los síntomas de rinitis, de asma y en los cuestionarios de la calidad de vida, uso de medicación, VAS y ACT a los 6 meses y continuó a los 12 meses. La mejoría clínica con el extracto de gato fue significativamente mayor que con el perro. CONCLUSIONES: Las dosis altas de SCIT tienen un valor clínico sustancial en muchos pacientes alérgicos a perros y gatos
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Id: 194943
Autor: Ruiz-León, B; Navas, A; Serrano, P; Espinazo, M; Labrador-Horrillo, M; Monsalve, RI; Jurado, A; Moreno-Aguilar, C.
Título: Successful adaptation of bee venom ommunotherapy in a patient monosensitized to api m 10
Fonte: J. investig. allergol. clin. immunol;30(4):296-297, 2020. tab.
Idioma: en.
Resumo: No disponible
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Id: 194116
Autor: Sánchez de Vicente, J; Gamboa, Pedro M; García-Lirio, E; Irazabal, B; Jáuregui, I; Martínez, MD; Segurola, A; Seras, Y; Galán, C.
Título: Tolerance to cephalosporins and carbapenems in penicillin-allergic patients
Fonte: J. investig. allergol. clin. immunol;30(1):75-76, 2020.
Idioma: en.
Resumo: No disponible
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Id: 194115
Autor: Guzmán, Raúl; Lemus, JA; Sastre, B; Del Pozo, V; Senent, CJ.
Título: Buckwheat: an emerging allergen
Fonte: J. investig. allergol. clin. immunol;30(1):74-75, 2020. graf.
Idioma: en.
Resumo: No disponible
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Id: 194108
Autor: García Rodríguez, Rosa; Morano Lozano, L; Extremera Ortega, A; Gonzalez Jiménez, OM; Borja Segade, J; Gomez Torrijos, E.
Título: Eosinophilic esophagitis is probably a comorbid condition in egg-allergic patients undergoing egg oral immunotherapy
Fonte: J. investig. allergol. clin. immunol;30(1):60-61, 2020.
Idioma: en.
Resumo: No disponible
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Id: 194104
Autor: Caminati, Marco; Vianello, A; Chieco Bianchi, F; Festi, G; Guarnieri, G; Marchi, MR; Micheletto, C; Olivieri, M; Tognella, S; Guerriero, M; Senna, G.
Título: Relevance of TH2 markers in the assessment and therapeutic management of severe allergic asthma: a real-life perspective
Fonte: J. investig. allergol. clin. immunol;30(1):35-41, 2020. tab, graf.
Idioma: en.
Resumo: BACKGROUND: Although blood eosinophils are currently recognized as the main clinical marker of TH2-type inflammation, their relevance in identifying asthma severity remains a matter of debate. METHODS: Our retrospective real-life study on severe asthmatics included in the NEONet Italian database aimed to investigate the relevance of blood eosinophil count and fractional exhaled nitric oxide (FeNO) in the clinical assessment of severe asthma and their role as potential predictors of responsiveness to anti-IgE therapy. The cut-off values chosen were 300 eosinophils/mm3 and FeNO of 30 ppm. RESULTS: We evaluated 132 adult patients. No significant differences were observed between the groups (high and low baseline eosinophil counts) in terms of demographic data, total IgE, lung function, patient-reported outcomes, or nasal comorbidities. The Asthma Control Test score and Asthma Quality of Life Questionnaire scores were poorer in patients with FeNO ≥30 ppb than in patients with FeNO <30 ppb. In the high FeNO subgroup, more frequent hospital admissions and a higher number of working days lost in the previous year were registered. A combined score including both eosinophils and FeNO did not improve the accuracy of the individual parameters. In the high-eosinophil subgroup, the proportion of responders to omalizumab was greater and increased at each follow-up time point. CONCLUSIONS: Our findings show that blood eosinophil count is not an unequivocal marker of asthma severity, whereas a higher FeNO level is associated with more frequent hospital admissions and more working days lost. Blood eosinophils seem to act as a predictor of response to omalizumab

ANTECEDENTES: Aunque los eosinófilos en la sangre actualmente son reconocidos como el principal marcador clínico de la inflamación Th2, su relevancia en la identificación de la gravedad del asma sigue siendo un tema de debate. MÉTODOS: Nuestro estudio retrospectivo de la vida real sobre asmáticos graves, incluido en la base de datos italiana de NEONet, tuvo como objetivo investigar la relevancia del recuento de eosinófilos en sangre y el FeNO en la evaluación clínica del asma grave y su función como posible factor predictivo de la capacidad de respuesta al tratamiento con anti-IgE. Como valores de corte se eligieron 300 eosinófilos/mm3en sangre y 30 ppm para FeNO. RESULTADOS: En total se evaluaron 132 pacientes adultos. No se pudieron observar diferencias significativas entre los grupos de eosinófilos basales altos y bajos, en términos de datos demográficos, IgE total, función pulmonar, resultados informados por el paciente (PRO) o comorbilidades nasales. Los pacientes con ≥ FeNO 30 ppb mostraron una puntuación de ACT peor y una puntuación AQLQ más baja en comparación con los de FeNO <30 ppb. En el subgrupo de FeNO alto, se registraron ingresos hospitalarios con más frecuencia y un mayor número de días de trabajo perdidos en el último año. Una puntuación combinada que incluye tanto a los eosinófilos como el FeNO no mejoró la precisión de los parámetros individuales. En el subgrupo de eosinófilos altos, la proporción de pacientes que respondieron al tratamiento con omalizumab fue mayor y aumentó significativamente en cada punto de tiempo de seguimiento. CONCLUSIONES: De acuerdo con nuestros hallazgos, los eosinófilos en sangre no representan un marcador unívoco de la gravedad del asma, mientras que un nivel más alto de FeNO se asocia con más ingresos hospitalarios y más días de trabajo perdidos. Los eosinófilos de la sangre parecen actuar como predictores de la respuesta del tratamiento al omalizumab
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Id: 192032
Autor: Karaman, S; Turedi, B.
Título: Neutrophil-lymphocyte ratio: a possible marker of remission in children with chronic spontaneous urticaria
Fonte: Allergol. immunopatol;48(3):290-294, mayo-jun. 2020. tab.
Idioma: en.
Resumo: BACKGROUND: Chronic spontaneous urticaria (CSU) is a disease that seriously disturbs the quality of life of the patient. Currently there is no prognostic marker of the disease. Our aim in this study was to determine possible prognostic markers of CSU in children. METHOD: All patients younger than 18 years of age who were followed by the Pediatric Immunology and Allergy Clinic of Diyarbakir Children's Hospital with a diagnosis of CSU between June 2017 and February 2019 were included in the study. Clinical and laboratory findings were compared between the symptomatic patient group and the patient group that remained in remission for at least three months without use of medication. RESULTS: Of the 52 cases included in the study, 32 (61.5%) were male. Mean age at time of diagnosis was 9.4 ± 4.4 years. Twenty-four cases (46.2%) went into remission. Young age at the time of diagnosis and being in the initial months of the disease were found to be associated with good prognosis (p < 0.05). Among laboratory results, elevation in absolute neutrophil count and neutrophil/lymphocyte ratio (NLR) were found to be associated with poor prognosis (p < 0.05). NLR was positively correlated with disease duration (p < 0.05). CONCLUSIÓN: For childhood CSU, younger age and initial months of the disease are good prognostic indicators, while only neutrophil/lymphocyte count can be used as a remission marker

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Id: 192028
Autor: Pierotti, Felipe Faria; Aranda, Carolina Sanchez; Cocco, Renata Rodrigues; Sarinho, Emanuel; Sano, Flávio; Porto, Arnaldo; Rosário, Nelson; Neto, Herberto José Chong; Goudouris, Ekaterini; Moraes, Lilian Sanches; Wandalsen, Neusa Falbo; Mallozi, Márcia Carvalho; Pastorino, Antônio Carlos; Motta Franco, Jackeline; Chavarria, Maria Letícia; Borres, Magnus P; Solé, Dirceu.
Título: Phadiatop, Phadiatop Infant and total IgE evaluated in allergic Brazilian children and adolescents
Fonte: Allergol. immunopatol;48(3):259-264, mayo-jun. 2020. tab.
Idioma: en.
Resumo: The clinical history is of importance in the investigation of allergic diseases but does have limitations. Many allergic conditions will be over-diagnosed if anamnesis alone is used for diagnostic criteria. Serum total immunoglobulin E (TIgE) quantification, as well as panels containing allergens prevalent in the studied population, may serve as screening tests and facilitate the diagnosis of allergic disease or its exclusion. We assessed the positivity of two versions of these tests, Phadiatop Europe® (PhEU) and Phadiatop Infant® (PhInf), as well as total IgE (TigE) values in patients with a medical diagnosis of allergic disease and non-allergic individuals. METHODS: A cross-sectional study performed in eleven Brazilian pediatric allergy centers with patients divided into groups according to the primary condition and a group of assessed control subjects. They were submitted to TIgE measurement and screening tests (PhEu and PhInf). RESULTS: TIgE mean serum levels were significantly higher among allergic patients, especially those with asthma/rhinitis or atopic dermatitis. The positivity of the screening tests, considering the total population, was 63.8% for PhEU and 72.6% for PhInf. These increased when we evaluated only the allergic subjects. The concordance index of the two tests was Kappa = 0.7 and higher among those of greater age. CONCLUSIONS: In the assessed population, there were significantly higher levels among those with positive screening tests and PhInf showed better performance in the identification of sensitized individuals, regardless of age. This is the first study to evaluate Phadiatop and Phadiatop Infant in the same population

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Id: 192027
Autor: Martín-Lázaro, J; Núñez-Orjales, R; González-Guzmán, LA; González, MT; Boquete, M; Carballada, F.
Título: Galactose-alfa-1, 3-galactose (alpha-gal) allergy: first pediatric case in a series of patients in Spain
Fonte: Allergol. immunopatol;48(3):251-258, mayo-jun. 2020. tab.
Idioma: en.
Resumo: INTRODUCTION AND OBJECTIVES: Allergy to galactose-α-1,3-galactose (alpha-gal) is a peculiar form of food allergy generally manifesting as an anaphylactic reaction hours after mammalian meat consumption, due to the presence of specific IgE against this oligosaccharide. In addition, immediate anaphylaxis may develop after exposure to other sources of alpha-gal, such as monoclonal antibody cetuximab, vaccines, plasma expanders or anti-snake venoms. Sensitization to alpha-gal has also been implicated in the rapid degeneration of biological valve implants, and recognized as a cause of occupational disease in cattle raisers. The implication of tick bites in this type of sensitization has been accepted by all the research groups dedicated to this disease. PATIENTS AND METHOD: The present study describes the clinical and sensitization characteristics of 39 patients diagnosed with alpha-gal allergy in the hospitals of our province (Lugo, Monforte de Lemos and Burela, Spain). RESULTS: Most patients were middle-age males. Of note, is the fact that the series includes the first pediatric patient reported in Spain to date. The predominant clinical manifestations were urticaria or delayed anaphylaxis after consumption of mammalian meat. Seventy-four percent of the patients reported having suffered a previous tick bite, and the clinical presentation of anaphylaxis was significantly more prevalent in those with a persistent local reaction following the bite than in those with no such reaction (p = 0.032). CONCLUSIONS: A review is also made of the disorder which, due to its variable clinical expression, is referred to as alpha-gal syndrome. The study concludes that a diagnosis of alpha-gal allergy should be considered in patients with urticaria-anaphylaxis of uncertain origin or manifesting after the administration of vaccines or products of bovine/porcine origin

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Id: 192026
Autor: Azzano, Pauline; Villard Truc, Florence; Collardeau-Frachon, Sophie; Lachaux, Alain.
Título: Children with eosinophilic esophagitis in real life: 10 years' experience with a focus on allergic management
Fonte: Allergol. immunopatol;48(3):244-250, mayo-jun. 2020. graf, tab.
Idioma: en.
Resumo: INTRODUCTION AND OBJECTIVES: Eosinophilic esophagitis (EoE) is frequently miss-diagnosed or overlooked for several years because of the invasiveness of investigations and the non-specificity of symptoms in childhood. Due to the lack of specific recommendations in children, its management remains very heterogeneous, especially concerning allergy testing. The aim of this study is to analyze our population and practices, in comparison with the literature, with a focus on allergic management, to harmonize and optimize our practice. MATERIAL AND METHODS: We included all children with a diagnosis of EoE at the Hospital Femme Mere Enfant, Bron, France. Data were collected via retrospective chart review. RESULTS: 108 patients were included with an average age of 9.5 years. Average delay before diagnosis was 6.65 years. Symptoms varied with age, with a predominance of vomiting (60% of patients), feeding difficulties (72%) and growth difficulties (24%) in children < 5 years, whereas older children often presented with feeding blockage (64%) and dysphagia (61%). Cough was frequent in our cohort (18.5%), especially in children < 10 years (38.5% between three and five years). The allergic background was frequent (70.3%) and 80% of our patients benefited from allergy testing. Allergy testing was particularly useful to guide therapy as elimination diet represented an effective treatment in 60% of our patients CONCLUSIONS: Allergy testing has to be harmonized to include major allergens (egg, milk, peanut, fish, wheat, and soy), including prick and patch tests. Allergy-testing based diet seemed to be the best compromise between efficiency and constraints, especially in mono-sensitized patients

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