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Investigation of perioperative hypersensitivity reactions: an update
Purpose of review The purpose of this review is to provide an update on how best to manage the investigation of suspected perioperative hypersensitivity reactions based on recent literature and key publications. Recent findings In the past two years, several very important initiatives have been taken in the field of perioperative hypersensitivity. The 6th national audit project in the United Kingdom has provided new knowledge through a series of studies, including a nationwide prospective study, and the European Academy of Allergy and Clinical Immunology has commissioned a position paper with updated recommendations f...
Source: Current Opinion in Allergy and Clinical Immunology - June 25, 2020 Category: Allergy & Immunology Tags: DRUG ALLERGY: Edited by Miguel Blanca and Paul Whitaker Source Type: research

How A Nurse With a Hole in Her Skull Changed The Medical History of Migraines
The following is adapted from an excerpt from social and medical historian Katherine Foxhall’s new book, Migraine: A History, published by Johns Hopkins University Press, and out June 18, 2019. In 1936, Alfred Goltman, a physician from Tennessee, reported on one of his cases in the prominent medical journal Allergy. The patient was a 26-year-old woman with a history of headaches, nausea, and vomiting since childhood. Goltman believed the observations he had made on this patient helped reveal the pathological physiology of migraine. He had first met the woman, a registered nurse, in 1931. He recorded that for as lon...
Source: TIME: Health - June 18, 2019 Category: Consumer Health News Authors: Katherine Foxhall Tags: Uncategorized Headache History Migraine Source Type: news

Focused Ultrasound Improves NK-92MI Cells Infiltration Into Tumors
Conclusion In conclusion, we demonstrated that the combination of FUS and microbubbles could increase the NK-92MI cells’ infiltration into tumors in this study. The combination of FUS and NK-92MI had a much better therapeutic effect when compared with the PBS group, but no superior therapeutic effect when compared with the NK-92MI group. In total, FUS and microbubbles can improve NK cells’ infiltration into tumors, but future work is still needed to improve NK-92MI cells’ delivery efficiency for solid tumor treatment. Ethics Statement This study was carried out in accordance with the recommendations...
Source: Frontiers in Pharmacology - April 17, 2019 Category: Drugs & Pharmacology Source Type: research

Group 2 Innate Lymphoid Cells Are Redundant in Experimental Renal Ischemia-Reperfusion Injury
In this study, we sought to further characterize ILC2s in the kidney, their location within this organ and determine their functional role in IRI using a loss-of-function approach. Here, we found that kidney ILC2s constitutively express IL-5 and are primarily located in close proximity to the renal vasculature, within the adventitia. Additionally, we demonstrate that a reduction, deficiency or depletion of ILC2s had minimal impact on the severity of IRI. Whilst activation of ILC2s and the associated amplification of local type 2 immunity has been previously shown to reduce the deleterious consequences of AKI, our results r...
Source: Frontiers in Immunology - April 15, 2019 Category: Allergy & Immunology Source Type: research

The Antidepressant Mirtazapine Inhibits Hepatic Innate Immune Networks to Attenuate Immune-Mediated Liver Injury in Mice
Conclusion: Our data suggest that mirtazapine can attenuate hepatic innate immune responses that critically regulate the subsequent development of autoimmune liver injury. Therefore, given that it is a safe and widely used medication, mirtazapine may represent a novel therapeutic approach to autoimmune liver disease. Introduction Classically, autoimmune disease was considered a disorder of adaptive immunity (1). However, early innate immune responses are clearly important for driving subsequent adaptive immune responses in autoimmunity. In numerous autoimmune disease models, activation of resident tissue macrophages,...
Source: Frontiers in Immunology - April 11, 2019 Category: Allergy & Immunology Source Type: research

Histamine and Delirium: Current Opinion
This study indicated that switch from H2 blockers to PPIs reduced delirium and, thus, providing an appropriate strategy to combat drug-induced delirium using antiulcer drugs (Fujii et al., 2012). The ventrolateral preoptic nucleus is a sleep-promoting nucleus located in the basal forebrain. A commonly used intravenous anesthetic, propofol, had been reported to induce sleep and augment the firing rate of neurons in ventrolateral GABAergic preoptic nucleus, but the underlining mechanism is yet to be clearly determined. Interestingly, the propofol-induced inhibition of inhibitory postsynaptic currents on noradrenalin-inhibite...
Source: Frontiers in Pharmacology - April 8, 2019 Category: Drugs & Pharmacology Source Type: research

Specialist perioperative allergy clinic services in the UK 2016: Results from the Royal College of Anaesthetists Sixth National Audit Project
Conclusions and Clinical RelevanceDiagnostic testing is not harmonized, with marked variability in the NMBA panels used to identify safe alternatives. Chlorhexidine and latex are not part of routine testing in many centres.Poor access to services and patient information provision require attention. Harmonization of diagnostic approach is desirable, particularly with regard to a minimum NMBA panel for identification of safe alternatives.
Source: Clinical and Experimental Allergy - September 7, 2017 Category: Allergy & Immunology Authors: W. Egner, T. Cook, N. Harper, T. Garcez, S. Marinho, K. L. Kong, S. Nasser, M. Thomas, A. Warner, J. Hitchman, K. Floss, Tags: ORIGINAL ARTICLE Source Type: research

General anaesthesia for patients with a history of a contrast medium-induced anaphylaxis: a useful prophylaxis?
Abstract Contrast-enhanced radiological examinations are important diagnostic tools in modern medicine. Currently, all approved and available iodinated and gadolinium-based contrast agents are safe and well tolerated by most patients. However, approximately 2% of patients receiving iodinated contrast media (CM) exhibit hypersensitivity reactions. Patients with a history of such a reaction are at increased risk upon re-exposure. Therefore, they are subjected to a prophylaxis such as injection of anti-allergy drugs or general anesthesia. The latter procedure is expensive, can burden the patients organism, and beside...
Source: The British Journal of Radiology - September 6, 2017 Category: Radiology Authors: Boehm I, Nairz K, Morelli J, Silva Hasembank Keller P, Heverhagen JT Tags: Br J Radiol Source Type: research

Specialist Peri ‐Operative Allergy Clinic Services in the UK 2016: Results from the Royal College of Anaesthetists Sixth National Audit Project (NAP6)
Conclusions and Clinical RelevanceDiagnostic testing is not harmonised, with marked variability in the NMBA panels used to identify safe alternatives. Chlorhexidine and latex are not part of routine testing in many centres.Poor access to services and patient information provision require attention. Harmonisation of diagnostic approach is desirable, particularly with regard to a minimum NMBA panel for identification of safe alternatives.This article is protected by copyright. All rights reserved.
Source: Clinical and Experimental Allergy - August 8, 2017 Category: Allergy & Immunology Authors: William Egner, Tim Cook, Nigel Harper, Tomaz Garcez, Susana Marinho, KL Kong, Shuaib Nasser, Mark Thomas, Amena Warner, John Hitchman, Katharina Floss Tags: Original Article ‐Clinical Allergy Source Type: research

Acute kidney injury following enhanced recovery for orthopaedic joint replacement surgery —role of preoperative kidney disease?
Editor —Enhanced recovery after surgery (ERAS), a multifaceted approach to anaesthesia and surgery, has been implemented widely throughout orthopaedic lower limb arthroplasty.1 The aim is to discontinue i.v. fluids by midday on postoperative day one;2 however, there is marked variation in practice between centres. We sought to determine the incidence of acute kidney injury (AKI) in patients undergoing hip or knee arthroplasty under ERAS principles particular to our unit, where fluids are discontinued before leaving the recovery room. All patients who had undergone primary unilateral lower limb arthroplasty as part of an ...
Source: British Journal of Anaesthesia - July 27, 2017 Category: Anesthesiology Source Type: research

Multi‐centre retrospective analysis of anaphylaxis during general anaesthesia in the United Kingdom: aetiology and diagnostic performance of acute serum tryptase
Summary This is the first multi‐centre retrospective survey from the United Kingdom to evaluate the aetiology and diagnostic performance of tryptase in anaphylaxis during general anaesthesia (GA). Data were collected retrospectively (2005–12) from 161 patients [mean ± standard deviation (s.d.), 50 ± 15 years] referred to four regional UK centres. Receiver operating characteristic curves (ROC) were constructed to assess the utility of tryptase measurements in the diagnosis of immunoglobulin (Ig)E‐mediated anaphylaxis and the performance of percentage change from baseline [percentage change (PC)] and absolute...
Source: Clinical and Experimental Immunology - October 1, 2014 Category: Allergy & Immunology Authors: M. T. Krishna, M. York, T. Chin, G. Gnanakumaran, J. Heslegrave, C. Derbridge, A. Huissoon, L. Diwakar, E. Eren, R. J. Crossman, N. Khan, A. P. Williams Tags: Original Article Source Type: research

Immediate hypersensitivity to chlorhexidine is increasingly recognised in the United Kingdom.
CONCLUSION: Immediate hypersensitivity to chlorhexidine appears to be common but underreported in the UK. We recommend that centres investigating patients with reactions during anaesthesia and surgery should routinely include testing for chlorhexidine allergy. PMID: 23265264 [PubMed - as supplied by publisher]
Source: Allergologia et Immunopathologia - December 19, 2012 Category: Allergy & Immunology Authors: Nakonechna A, Dore P, Dixon T, Khan S, Deacock S, Holding S, Abuzakouk M Tags: Allergol Immunopathol (Madr) Source Type: research