Search

Prior to the national shortage of iron dextran in early 2023, it was the most commonly administered intravenous iron infusion at our institution. After the shortage impacted the health system, alternatives such as iron sucrose and sodium ferric gluconate/sucrose were required that utilized lower doses given at more frequent patient visits. Coinciding with their more prevalent use, an increase in iron infusion reactions was observed. Our study analyzed 880 patients who received iron infusions in three Henry Ford Hospital clinics in metropolitan Detroit, Michigan, from July 2022–June 2023. The 74 reactions that occurred were most commonly associated with iron sucrose at the 500 mg dose (41/74, 55.41%, p < 0.0001). Most reactions observed across all iron formulations and doses were mild, with 83.7% being Grade 0 or 1 as defined by the United States Drug Allergy Registry (USDAR) grading scale for immediate reactions. Patients who experienced an infusion reaction were less likely to complete their infusion plans (OR 0.004 for iron dextran, OR 0.128 for iron sucrose, p < 0.0001), with infusions most commonly being completely discontinued thereafter, with a minority pursuing alternative options. More patients with lower number of doses scheduled for iron dextran completed their infusion schedules than those with more doses, but the opposite was seen for iron sucrose. We assessed the impact of the national shortage of iron dextran examining infusion reactions with various iron infusions and doses. [ABSTRACT FROM AUTHOR]

Background: Chronic myeloid leukaemia (CML) is a haematopoietic stem cell disease characterised by the proliferation of granulocytes and their immature myeloid precursors. The treatments recommended are oral treatments dispensed in the outpatient unit (OU) of the hospital's pharmacy service (PS), where patient-centred pharmaceutical care (PC) is essential to enhance therapeutic adherence, detect drug interactions and create a pharmacist-patient relationship to educate the patient on the main potential toxicities derived from the treatment and warning signs or symptoms requiring immediate attention. Methodology: We present the case of a 55-year-old woman, followed up in consultation by the Haematology Service (HS) since October 2021 for CML in the chronic phase. Results: She started treatment on nilotinib 300 mg every 12 hours. The patient attended OU and was offered PC. After 12 months, nilotinib was well tolerated, but our patient experienced a loss of effectiveness, so HS decided to switch to dasatinib 100 mg daily. After one year of treatment, our patient was presented with symptoms of swelling and dyspnoea on moderate exertion. In January 2024, following a joint Haematology-Pharmacy session, a switch to bosutinib 400 mg daily was decided. After 15 days of treatment, the patient presented without an appointment due to a pruritic generalised rash on the torso, face, and extremities, being diagnosed with leukocytoclastic vasculitis. Conclusion: In conclusion, we describe case reports of a patient who has a lack of effectiveness and ARs in several TKIs and the importance of identifying side effects, through early and close PC, in order for the patient's evolution to be favourable. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Chinese Institute of Food Science & Technology / Zhongguo Shipin Xuebao is the property of Journal of Chinese Institute of Food Science & Technology Periodical Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In clinical practice， the application of surface disinfectants for skin disinfection is a prerequisite for venipuncture. Chlorhexidine， a widely recognized disinfectant， is frequently employed for this purpose. However， during intravenous infusions， minute quantities of chlorhexidine can be inadvertently introduced into the bloodstream via the puncture needle， potentially precipitating immediate-type （type ） hypersensitivity reactions. Regrettably， these reactions are often erroneously attributed to administered medications， such as antibiotics， which can result in both misdiagnosis and underdiagnosis. This article details a case of an allergic reaction that occurred subsequent to multiple intravenous infusions and was ultimately identified as chlorhexidine-induced after antibiotic allergy was ruled out. The objective of this report is to deepen the clinical physcians’ comprehension of chlorhexidine-induced allergies in the context of infusion-related allergic reactions， thereby offering a valuable reference for accurate diagnosis and effective treatment strategies.

OBJECTIVE: To explore the correlation between Tanreqing injection and suspected allergic reactions in patients with common drug combination. METHODS: Case data of patients with Tanreqing injection recorded in Bethune International Peace Hospital of the Chinese People’ s Liberation Army and Affiliated Hospital of Hebei University of Traditional Chinese Medicine from Jan. 2018 to Jun. 2023 were collected for nested case-control study. The control group cases were screened by age, gender and department by using propensity value matching method. Suspected allergic reactions were evaluated by anti-allergic drugs, and sensitivity analysis was conducted by univariate analysis and multivariate Logistic regression analysis with expanded sample size. RESULTS: Totally 403 patients with Tanreqing injection were selected as the study group. Multivariate Logistic regression analysis showed that the combination of Tanreqing injection and five drugs increased the risk of allergic reactions, namely ceftriaxone (OR = 3. 476, 95%CI = 2. 473-4. 205), lidocaine (OR = 1. 462, 95%CI = 1. 136-1. 801), ambroxol (OR = 1. 225, 95%CI = 1. 013-1. 522), moxifloxacin (OR = 1. 904, 95%CI = 1. 257-2. 469) and vitamin C (OR = 1. 436, 95% CI = 1. 107- 1. 834); while the combination of Tanreqing injection and ceftiamidine (OR = 0. 711, 95%CI = 0. 562-1. 112) reduced the risk of allergic reactions. The sensitivity analysis results were basically consistent. CONCLUSIONS: The suspected allergic reactions of Tanreqing injection may be related to drug combination of five drugs ( ceftriaxone, lidocaine, ambroxol, moxifloxacin and vitamin C), care should be taken in the clinical drug combination. [ABSTRACT FROM AUTHOR]

Copyright of Journal of New Medicine is the property of Sun Yat Sen University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This guidance updates 2021 GRADE (Grading of Recommendations Assessment, Development and Evaluation) recommendations regarding immediate allergic reactions following coronavirus disease 2019 (COVID-19) vaccines and addresses revaccinating individuals with first-dose allergic reactions and allergy testing to determine revaccination outcomes. Recent meta-analyses assessed the incidence of severe allergic reactions to initial COVID-19 vaccination, risk of mRNA-COVID-19 revaccination after an initial reaction, and diagnostic accuracy of COVID-19 vaccine and vaccine excipient testing in predicting reactions. GRADE methods informed rating the certainty of evidence and strength of recommendations. A modified Delphi panel consisting of experts in allergy, anaphylaxis, vaccinology, infectious diseases, emergency medicine, and primary care from Australia, Canada, Europe, Japan, South Africa, the United Kingdom, and the United States formed the recommendations. We recommend vaccination for persons without COVID-19 vaccine excipient allergy and revaccination after a prior immediate allergic reaction. We suggest against >15-minute postvaccination observation. We recommend against mRNA vaccine or excipient skin testing to predict outcomes. We suggest revaccination of persons with an immediate allergic reaction to the mRNA vaccine or excipients be performed by a person with vaccine allergy expertise in a properly equipped setting. We suggest against premedication, split-dosing, or special precautions because of a comorbid allergic history.

Objective To review the occurrence of allergic reactions during therapeutic plasma exchange (TPE) and to explore the risk factors of TPE allergic reactions. Methods The clinical data of 929 patients treated with TPE using plasma components by the Department of Transfusion Medicine in our medical center from 2018 to 2023 were collected. The influencing factors of allergic reactions were analyzed by univariate analysis, and the independent risk factors of allergic reactions were analyzed by logistic multivariate regression analysis. Results A total of 4 071 TPEs were performed in 929 patients.Among them, 198 patients (21.31%) experienced 349 times (8.57%) of allergic reactions, with the incidence of grade Ⅰ, Ⅱ and Ⅲ allergic reactions of 16.33%, 81.38% and 2.29%, respectively, and no deaths. The univariate analysis showed that the patient′s age, allergy history, diagnosis of immune-related diseases, ICU admission, plasma consumption, total blood volume, maximum blood flow rate and combined use of albumin were related to the occurrence of allergic reactions (P

Objective To analyze the characteristics and related influencing factors of transfusion reactions in pediatric patients, so as to provide evidence for clinical treatment and prevention of transfusion reactions. Methods A retrospective study was conducted on children who received blood transfusions at our hospital from 2019 to 2023 in terms of the incidence, types, time of occurrence, and related influencing factors of transfusion reactions. Results A total of 69 926 transfusions were performed from 2019 to 2023, with 711 cases of transfusion reactions, resulting in an incidence of 1.02%. The incidence of transfusion reactions decreased annually from 2019 (1.89%) to 2022 (0.50%). The incidence of transfusion reactions to apheresis platelets, frozen plasma, suspended leukocyte-depleted red blood cells and cryoprecipitate coagulation factor were 2.16% (551/25 565), 0.50% (92/18 277), 0.25% (65/25 679) and 0.74% (3/405), respectively, with apheresis platelet transfusion of a significantly higher incidence compared to other blood components (P

Objective: Studies examining COVID-19 vaccine reactions and reasons for parental hesitancy to COVID-19 vaccines in allergic adolescents are few. This study aimed to identify post-vaccine reactions and parental vaccine refusal/hesitancy among adolescents with allergic diseases. Materials and Methods: Between January 2022 and April 2022, a questionnaire was completed by the parents of adolescents who were followed at the Pediatric Allergy outpatient clinic. Vaccination status, characteristics of reactions after vaccination, and the frequency of parental vaccine hesitancy were recorded. Results: Among 104 patients, 70 were followed for asthma, 64 for allergic rhinitis, 12 for drug allergy, 3 for food allergy, and 1 for chronic urticaria. 63.5% (n=66) of the patients were vaccinated. The rate of vaccination was 52.5% in those with a history of COVID-19 and 70% in those without a history of COVID-19 infection (p=0.07). Eight patients were not vaccinated due to recent COVID-19 infection. Reasons for parental vaccine hesitancy/rejection (n=30) included thinking that the vaccine is harmful (63.3%), not effective (53.4%), or not suitable for children (46.7%). 14 (21.2%) children experienced symptoms within the first 2 hours after vaccination. The most common symptom (n=10) was arm pain. Urticaria and itching were reported in one patient and respiratory symptoms were reported in another patient. Both patients could receive the second dose without any reaction. Conclusion: Vaccination was more frequent among children without a history of COVID-19 infection. One third of the patients were not vaccinated, and the most common reason for vaccine hesitancy was concern about the adverse effects of the vaccine on human health in the long term and distrust of the vaccine. However, vaccinated allergic children did not experience any serious events. [ABSTRACT FROM AUTHOR]

Background: Few studies have assessed the nature of accidental allergic reactions (AAR). We assessed the prevalence and risk factors for AAR in Japanese children. Methods: This study included children with immediate‐type hen's egg (HE), cow's milk (CM), wheat, or peanut allergy who developed allergic reactions within at least 2 years and were followed up regularly at a single national allergy center in Japan. From January to December 2020, low‐dose reactivity was defined as allergic reactions to ≤250, ≤102, ≤53, or ≤ 133 mg of HE, CM, wheat, or peanut protein, respectively. The annualized AAR rate showed the number of reactions per patient per year (95% confidence interval). AAR risk factors were analyzed using multiple logistic regression. Results: Of the 1096 participants, 609, 457, 138, and 90 had HE, CM, wheat, and peanut allergies, respectively. The median (interquartile range) age was 5.0 (2.3–8.6) years, 39% had completely eliminated allergenic food, and 24% had low‐dose reactivity. The annualized AAR rate was 0.130 (0.109–0.153) in all sub‐cohorts. Moderate and severe symptoms occurred in 50% and 0.7%, respectively, of children who experienced AAR. Multiple logistic regression revealed that low‐dose reactivity was a significant risk factor for AAR in the overall and CM cohorts, respectively (p <.001 and p =.036). Conclusion: In this single‐center study in Japan, the annualized AAR rate was relatively low during the COVID‐19 pandemic; however, half of the participants with AAR had moderate to severe symptoms. Especially in the case of low‐dose reactivity, children would require careful AAR risk management. [ABSTRACT FROM AUTHOR]

To explore the diverse profiles of adverse reactions caused by oxaliplatin between colon and rectal cancer, we investigated the toxicity of oxaliplatin in patients with colon and rectal cancer. From January 2017 to December 2021, 200 cases of sporadic CRC patients with adverse reactions after oxaliplatin were collected from Harbin Medical University Cancer Hospital, Harbin, China. All patients received a chemotherapy regimen containing oxaliplatin (100 colon cancer and 100 rectal cancer). We reviewed the adverse reactions induced by oxaliplatin in patients with colon and rectal cancer. We found there was no significant difference in gastrointestinal toxicity, hematotoxicity, neurotoxicity, hepatotoxicity, respiratory toxicity, and cardiotoxicity caused by oxaliplatin between patients with colon cancer and patients with rectal cancer, but patients with rectal cancer were more prone to allergic reactions than patients with colon cancer after oxaliplatin. In addition, we found neutrophil-to-lymphocyte ratios (NLR) and platelet-to-lymphocyte ratios (PLR) were higher in patients with colon cancer than in patients with rectal cancer. This may reflect differences in immune status and inflammatory responses between colon cancer and rectal cancer, which might be the reason for more allergic reactions caused by oxaliplatin in colon cancer patients compared to rectal cancer patients. Except for a higher incidence of allergic reactions in patients with rectal cancer, no significant difference in the incidence of adverse drug reactions associated with oxaliplatin was noted between patients with colon cancer and rectal cancer. Our results suggested more attention should be paid to the allergic reaction caused by oxaliplatin in patients with colon cancer. [ABSTRACT FROM AUTHOR]

This mathematical model delves into the dynamics of the immune system during Chronic Myeloid Leukemia (CML) therapy with imatinib. The focus lies in elucidating the allergic reactions induced by imatinib, specifically its impact on T helper (Th) cells and Treg cells. The model integrates cellular interactions, drug pharmacokinetics, and immune responses to unveil the mechanisms underlying the dominance of Th2 over Th1 and Treg cells, leading to allergic manifestations. Through a system of coupled delay differential equations, the interplay between healthy and leukemic cells, the influence of imatinib on T cell dynamics, and the emergence of allergic reactions during CML therapy are explored. [ABSTRACT FROM AUTHOR]

Copyright of Environmental Medicine / Medycyna Środowiskowa is the property of Witold Chodzki Institute of Rural Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The goal of this study was to assess the safety of nab-paclitaxel in patients with ovarian cancer or endometrial cancer who had an allergic reaction to paclitaxel. We performed a retrospective review of patients with endometrial cancer or ovarian cancer with an allergic reaction to paclitaxel who were subsequently treated with nab-paclitaxel at the Mayo Clinic Florida from January 2016 to June 2023. A total of 43 patients with ovarian cancer (31) or endometrial cancer (12) and a paclitaxel allergic reaction were identified. All patients were pre-medicated against allergic reactions prior to paclitaxel and subsequent nab-paclitaxel. Allergic reactions to paclitaxel were mild in fourteen patients (33%), moderate in twenty-five patients (58%) and severe in four (9%) patients. None of the 43 patients had an allergic reaction to subsequent nab-paclitaxel. Our data suggests that the administration of nab-paclitaxel to endometrial cancer or ovarian cancer patients with allergic reactions to paclitaxel is safe and should be considered a preferable treatment option in this clinical situation.

Background: Transfusion of blood and blood products is a double-edged sword, so it should be used judiciously. The primary aim of the centralized hemovigilance program is to improve transfusion safety. Aims and Objectives: To determine the frequency, distribution, and types of transfusion reactions (TRs) occurring in patients, reported to the blood center in a tertiary care hospital in North East India. Materials and Methods: A retrospective study was conducted in State of The Art Model Blood Center, Assam Medical College and Hospital for 1 year from July 2022 to June 2023. Data were collected from TR records as per the hemovigilance reporting format and analyzed. Results: During the study, 38,165 blood products were issued. 41 (0.11%) TRs were recorded, out of which 25 (61%) occurred with packed red cell transfusion followed by whole blood transfusion (39%). The most common type was febrile non-hemolytic TR (51.2%) followed by allergic reactions (39%). Conclusion: The frequency of adverse TRs was low (0.11%), which may be due to the management of a few cases by the treating clinician itself. Most reactions occurred with packed red blood cells (PRBC) transfusion, the most common type being febrile non-hemolytic TR, which may be due to the presence of leukocytes, inflammatory mediators in leftover plasma during PRBC preparation, which can be standardized by the use of leukoreduced blood products. Hemovigilance will help to strengthen the quality and safety of blood transfusion.

The increase in mycobacteriosis, an infectious disease caused by non-tuberculous mycobacteriosis, has become an urgent issue for humane medicine. The mycobacteriosis of animals is a subject of intense study by veterinary scientists across most countries globally. In Ukraine, the number of farms with productive animals exhibiting paraallergic reactions to tuberculin is steadily rising, making the diagnosis of tuberculosis more complicated. In dairy cattle breeding, this issue also has significant economic implications. The forced slaughter of breeding young stock and high-producing cows is often a consequence. On the other hand, the identification of various non-tuberculous mycobacteria species in human mycobacteriosis patients, which can sensitize the cows, gives the issue of preventing animal mycobacteriosis both medical and social significance. All of the factors mentioned previously led to the decision to permanently retain cows that react positively to tuberculin testing on a dairy farm in the Volyn region, which has historically been free of tuberculosis. A comprehensive study was conducted from 2018 to 2023, utilizing methods of epizootological analysis as well as clinical, pathological, histological, bacteriological, and statistical research techniques. It was shown that an epizootic process, caused by the infection of cattle with non-tuberculosis mycobacteria, is occurring on the dairy farm. Mycobacterium scrofulaceum, M. fortuitum, and Nocardia spp. were isolated and identified from the lymph nodes and lymphoid tissue of the large intestine submucosa in the infected animals. These pathogens cause significant histological and pathological changes, indicating the presence of a clinically covert infectious process accompanied by sensitization of the animal organism. Epizootological analysis of the results from simultaneous allergic testing, as well as multiple bacteriological studies of samples from animals that reacted positively to both purified protein derivate tuberculin and atypical mycobacteria allergens, established that the allergic reactions to tuberculin were paraallergic in nature. This indicated the presence of an active infectious process within the animals’ bodies.

Anaphylaxis is a rare but severe, potentially life threatening allergic reaction which commonly presents with cutaneous to multi-system involvement. The overall incidence rate of anaphylaxis during general anaesthesia varies greatly, ranging from 1:20,000 to 1:38. Cold urticaria, subset of chronic urticaria, is characterised with the presence of localised wheals to systemic and anaphylactic reactions. Physical urticaria can be due to physical stimuli such as friction, pressure, sun exposure and cold. Cold urticaria mainly comprises of physical urticaria rather which ranges from 3-33.8% with a higher incidence in cold climate. A case of physical cold urticaria was reported during perioperative period in a 40-year-old male who was posted in urology OT for a planned Ureteroscopy (URS). On pre-anaesthetic evaluation, patient’s medical, surgical and personal history found to be inconclusive. Patient was fit for surgery under ASA grade 1 and advised to be kept nil per orally for six hours for solid food and two hours for clear fluid. At the conclusion of surgery, patient developed shivering and was managed with warm blankets and radiant heater. After some time, patient develop wheals over chest, abdomen and lower back. Patient was managed with warm fluids, warming the patient, maintaining ambient OT temperature and drugs like injection pheniramine, epinephrine and dexamethasone to prevent catastrophic reaction. Through evaluation during preoperative period plays a key role in anticipation of these kind of untoward events. This case report describes the occurrence and management of this rare condition.

Objective: This study aimed to explore the signal detection method for allergic reactions induced by inpatient iodixanol injection. Methods: A database of 3,719,217 hospitalized patients from 20 large Chinese general hospitals was processed and analyzed using the prescription sequence symmetry analysis (PSSA) method. Results: 126,680 inpatients who used iodixanol and were concurrently treated with anti-allergic drugs were analyzed. In the medical records of these patients, only 32 had documented iodixanol allergies. Statistical analysis identified 22 drugs in 4 categories--calcium preparations, adrenergic/dopaminergic agents, glucocorticoids, and antihistamines--as marker drugs. With time intervals of 3, 7, and 28 days, the adjusted sequence ratios (aSRs) for all anti-allergics and the 4 categories were greater than 1. The 7-day aSRs were 2.12 (95% CI: 2.08-2.15), 1.70 (95% CI: 1.68-1.73), 3.85 (95% confidence interval [CI]: 3.75-2.30), 2.30 (95% CI: 2.26-2.35), and 1.95 (95% CI: 1.89-2.02), respectively. The proportions of adverse drug events indicated by each signal were as follows: all anti-allergics (2.92%-3%), calcium gluconate (0.19%-0.52%), adrenergic/dopaminergic agents (2.20%-3.37%), glucocorticoids (3.13%-3.76%), and antihistamines (1.05%-1.32%). Conclusion: This first multi-center Chinese inpatient database study detected iodixanol-induced allergy signals, revealing that reactions may be much higher than those in collected spontaneous reports. Iodixanol risk exposure was closer to actual pharmaceutical care findings. PSSA application with =7-day intervals appears better suited for monitoring late allergic reaction signals with these drugs. [ABSTRACT FROM AUTHOR]

Animal mycobacterioses, unlike those in humans, are not in the focus of veterinary science and practice for various reasons. This fact, as well as some others, including the growing incidence of human mycobacteriosis caused by non-tuberculous mycobacteria involved in the sensitisation of productive animals, is an objective, albeit indirect, indication of the existing problem of mycobacteriosis in veterinary medicine. This study employed the comparative geographical and epizootological methods of analysis. The findings obtained from the publications of scientists from around the world helped to summarise and objectively assess the severity of the epizootic situation regarding mycobacteriosis in animals in the world and in Ukraine, to identify a range of features of the infectious and epizootic processes, and to establish the dominant aetiopathogenetic criteria for this infection in animal populations. Animal mycobacteriosis is the subject of detailed scientific research in most countries of the world, as this disease is widespread among productive and unproductive (domestic and wild) animals, as well as the fish fauna of sea and river waters. It was found that the most common causative agents of mycobacteriosis are nontuberculous mycobacteria such as Mycobacterium avium complex, M. abscessus complex, M. kansasii, and M. fortuitum, and some others. In Ukraine, animal mycobacteriosis is not given due attention, even though parallergic reactions to tuberculin in cattle lead to complications in the diagnosis of tuberculosis infection. They cause considerable losses in dairy farming due to the culling and slaughter of highly productive cows. Identification of aetiopathogenetic patterns of paraallergic reactions to tuberculin in productive animals is a key to effective control and management of the epizootic process of animal mycobacteriosis and reduction of biohazards of human infection with non-tuberculous mycobacteria through food of animal origin. [ABSTRACT FROM AUTHOR]

Background: Allergic Diseases (AD) are the most common chronic diseases in Europe. AD diagnosis poses a significant challenge due to the variety of definitions, diversity of symptoms, and the heterogeneous involvement of organs as well as the lack of diagnostic methods in our country. These problems in diagnosis, specifically in the Emergency Department (ED), occur even when differentiation is made of anaphylaxis with Anaphylactic Reactions (AR). Do you mean adverse reactions instead of anaphylactic reaction? Purpose of the study: Prevalence of allergic diseases and anaphylaxis in ED in University Clinical Center of Kosovo (UCCK), determination of the main causes that induce these reactions, the relation of the allergy trigger, and the time of symptoms' manifestation, observation of the correct approach and appropriate treatment of these cases. Materials and methods: The research is a cross-sectional study of patients over the age of 15 who presented in our center between January 1st 2020 and April 30th 2020. In the cases obtained from the recorded data, patients with a diagnosis of "Reactio allergica" (urticaria, angioedema, erythema, etc.) were selected. The data were obtained based on the anamnesis and present clinical status of the patient, where a questionnaire with 8 questions based on the questionnaire of "Agana Heights Elementary School, General Allergy and Anaphylaxis Questionnaire, Jan 2013" was used. Statistical analysis was done with SPSS program, data were not normally distributed therefore nonparametric tests were used with a confidence interval of 95% and 99%. Results: Out of 15,131 persons presented at the ED in Prishtina in UCCK for various emergency health problems, 74 allergic reactions were registered that required emergency medical assistance; gender ratio f/m=53/21 (p<0.001) with a predominance of 15 years-30 years of age (39 of them). Dominant symptoms in our patients were skin changes in the form of urticarial changes (36 of them), erythematous changes (51 of them), and angioedema manifested in 27 patients. Fortunately, during the research period 41 (55.4%) cases had mild forms of generalized reaction, 23 (31.0%) moderate and only 10 (13.6%) cases had severe form, according to Brown's classification. Of these, 18 (24.3%) cases were in anaphylaxis according to the criteria of the "Second symposium on the definition and management of anaphylaxis"; this incidence would be 0.1% of all visits in the ED, even though no patient was diagnosed with anaphylaxis by emergency doctors. The most commonly known causes were medications (44.6%). The most common causative drugs were the NSAIDs group (48.3%), ketoprofen lysine (brand name, OKI) leading the way with 25.8% of all cases of allergic reactions to the drugs. The second group of drugs was ß-lactam antibiotics with 7 (22.6%) cases, led by cephalosporins and followed by penicillin. The second most common cause was food in 12.1% of cases. Conclusion: Due to the lack of a unique protocol for anaphylaxis and AR, in our study we managed to identify 18 cases of anaphylaxis, which were not recorded with this diagnosis in the patient's medical history. Therefore, we consider that health care professionals would benefit from better education on setting criteria to distinguish an allergic reaction from an anaphylactic reaction or anaphylaxis and vice versa. [ABSTRACT FROM AUTHOR]

Objective: To assess allergic reactions to IV non-ionic contrast media in children. Study Design: Cross-sectional study. Setting: Faisal Hospital, Faisalabad, and Children Hospital, Faisalabad. Period: June 2022 to September 2022. Methods: A total of 310 patients (males and females) under the age of 14, referred for a CT scan with non-ionic contrast material were included in the study, Data were collected at the Children's Hospital and the Faisal Hospital Faisalabad for over 4 months and statistically analyzed by SPSS V22. The Chi-square test was used to measure the association between the age of children and mild allergy reactions. Results: This study included 310 patients, 183 (59%) males, and 127 (41%) females, who received the non-ionic contrast agent. Thirteen patients (6 males and 7 females) experienced mild allergic responses including 5 cases of rash, 3 cases of itching, 2 cases of nausea, and 1 case of vomiting, flushing, and swelling. There were 10 reactions for children under five, 1 for children between five to ten years, and 2 for children older than ten years. Out of 13 reported allergic reactions, the brain region observed seven while the chest, head, and neck regions observed none. Conclusion: According to the findings of this study, imaging young children with low-osmolality non-ionic contrast material is relatively safe and has few side effects. Out of 310, only 13 children experienced mild allergic responses to non-ionic contrast material. This study found an association between the age of children (<5 years) and mild allergic reactions (skin rash and itching) which was found to be statistically significant (p=0.005). [ABSTRACT FROM AUTHOR]

Background. The Coccomyxa sp. strain KJ (Coccomyxa KJ), a microalga found in Japan, has a potential function in controlling viral infections. Recently, its dry powder has been marketed as a health food product. Objectives. This pilot study investigated the effects of Coccomyxa KJ powder tablet intake on allergic reactions and immune functions in healthy participants. Materials and methods. Nine healthy volunteers (4 males and 5 females) who expressed interest in foods containing Coccomyxa KJ, and were willing to undergo blood tests, were recruited. Each individual was asked to take 2 Coccomyxa KJ powder tablets (0.3 g) before breakfast once a day for 4 weeks. The salivary immunoglobulin A (IgA) level and blood parameters (white blood cell (WBC) count, eosinophil and lymphocyte counts and percentages, natural killer (NK) cell activity, interleukin (IL)-6 level, and T helper (Th)1/Th2 cell ratio) were evaluated at baseline and weeks 2 and 4. Results. The 4-week intake of Coccomyxa KJ did not affect salivary IgA levels, WBC count, eosinophil and lymphocyte counts and percentages, or the Th1/Th2 ratio. There were significant differences in the NK cell activity after 4 weeks, with an average increase of 11.78 (95% confidence interval (95% CI): 6.80-16.76). None of the patients experienced adverse reactions during or after the study. Conclusions. Long-term Coccomyxa KJ intake improved NK cell activity without causing adverse effects on the indicators of local immunity, systemic inflammation and immune response balance. This study suggests that Coccomyxa KJ powder tablets can induce beneficial immune modifications without causing any adverse effects. [ABSTRACT FROM AUTHOR]

Background: Transfusion of blood and blood products is a double-edged sword, so it should be used judiciously. The primary aim of the centralized hemovigilance program is to improve transfusion safety. Aims and Objectives: To determine the frequency, distribution, and types of transfusion reactions (TRs) occurring in patients, reported to the blood center in a tertiary care hospital in North East India. Materials and Methods: A retrospective study was conducted in State of The Art Model Blood Center, Assam Medical College and Hospital for 1 year from July 2022 to June 2023. Data were collected from TR records as per the hemovigilance reporting format and analyzed. Results: During the study, 38,165 blood products were issued. 41 (0.11%) TRs were recorded, out of which 25 (61%) occurred with packed red cell transfusion followed by whole blood transfusion (39%). The most common type was febrile non-hemolytic TR (51.2%) followed by allergic reactions (39%). Conclusion: The frequency of adverse TRs was low (0.11%), which may be due to the management of a few cases by the treating clinician itself. Most reactions occurred with packed red blood cells (PRBC) transfusion, the most common type being febrile non-hemolytic TR, which may be due to the presence of leukocytes, inflammatory mediators in leftover plasma during PRBC preparation, which can be standardized by the use of leukoreduced blood products. Hemovigilance will help to strengthen the quality and safety of blood transfusion. [ABSTRACT FROM AUTHOR]

Background and objectives: Breast milk is an essential source of nutrients and energy for infants. The study analyzed for the levels of essential, toxic and rare earth elements in the breast milk of lactating mothers within Abeokuta metropolis. Materials and methods: Thirty-seven (37) breast milk samples were collected with consents of lactating mothers at Ogun State General Hospital in Abeokuta. The samples were digested using standard method and analyzed for essential, toxic and rare earth elements using Inductively Coupled Plasma Mass Spectrometer (ICP-MS). The data were subjected to descriptive analysis. Results: The results showed higher concentrations of toxic elements than essential elements in the breast milk of lactating mothers, where five toxic metals: Ag, Ti, V, Pb and Ba were observed to be present in 11, 14, 15, 17 and 23 breast milk samples respectively. Two essential (P and S) and two toxic (Cd and Hg (except sample 19)) elements were observed to be present in all the breast milk samples. Rare Earth Elements (except Sr, U and Rb) were below the detection limit of the instrument. Though three breast milk samples (12, 14 and 17) were observed safe, they contained two toxic (Cd and Hg) and a rare earth trace (Rb) element. Conclusion: It could be concluded that despite the inherent benefits of human breast milk with essential elements to the infants, it can still be a source of toxic and trace earth metals contamination.

Objective:This study aimed to explore the signal detection method for allergic reactions induced by inpatient iodixanol injection.Methods:A database of 3,719,217 hospitalized patients from 20 large Chinese general hospitals was processed and analyzed using the prescription sequence symmetry analysis (PSSA) method.Results:126,680 inpatients who used iodixanol and were concurrently treated with anti-allergic drugs were analyzed. In the medical records of these patients, only 32 had documented iodixanol allergies. Statistical analysis identified 22 drugs in 4 categories—calcium preparations, adrenergic/dopaminergic agents, glucocorticoids, and antihistamines—as marker drugs. With time intervals of 3, 7, and 28 days, the adjusted sequence ratios (aSRs) for all anti-allergics and the 4 categories were greater than 1. The 7-day aSRs were 2.12 (95% CI: 2.08–2.15), 1.70 (95% CI: 1.68–1.73), 3.85 (95% confidence interval [CI]: 3.75–2.30), 2.30 (95% CI: 2.26–2.35), and 1.95 (95% CI: 1.89–2.02), respectively. The proportions of adverse drug events indicated by each signal were as follows: all anti-allergics (2.92%–3%), calcium gluconate (0.19%–0.52%), adrenergic/dopaminergic agents (2.20%–3.37%), glucocorticoids (3.13%–3.76%), and antihistamines (1.05%–1.32%).Conclusion:This first multi-center Chinese inpatient database study detected iodixanol-induced allergy signals, revealing that reactions may be much higher than those in collected spontaneous reports. Iodixanol risk exposure was closer to actual pharmaceutical care findings. PSSA application with ≤7-day intervals appears better suited for monitoring late allergic reaction signals with these drugs.

We present a mathematical model that captures the dynamics of the immune system during allergic reactions. Using delay differential equations, we depict the evolution of T cells, APCs, and IL6, considering cell migration between various body compartments. The biological discussions and interpretations within the article revolve around drug desensitization, highlighting one potential application of the model. We conduct stability analysis on certain equilibrium points, demonstrating stability in some cases and only partial stability in others. Numerical simulations validate the theoretical findings. [ABSTRACT FROM AUTHOR]

Objective: Blood transfusion is a life-saving medical intervention. Transfusion reactions are undesirable consequences of this intervention and may present with various findings. Using data from our hospital and hemovigilance procedures that included electronic recording, our aim was to evaluate non-infectious transfusion reactions. Methods: We present reaction data from electronic recordings of blood products transfused between January 2017 and December 2021. Gender, age, symptoms and findings, blood pressure, fever, respiratory and heart rates before and after transfusion were analyzed according to reaction types. Reactions were classified according to clinicians definition. Analysis of the data was carried out using the SPSS 25 package program. Results: While allergic transfusion reactions and febril nonhemolitic transfusion reactions were common transfusion reactions, the most common reaction products were fresh frozen plasma, erythrocyte suspension and platelet suspension respectively. Chills, restlessness, fever, were common signs and symptoms. While allergic transfusion reactions were higher in pediatric patients, there was no difference between genders. The high number of patients who had a previous transfusion among the patients who developed a reaction suggested that exposure did not reduce the risk. More notifications were made after the use of electronic records than in previous years. Conclusion: Electronically recorded hemovigilance data can contribute to an increase in accurate classification and reporting of transfusion reactions and monitoring of blood processes. [ABSTRACT FROM AUTHOR]

Background: Beta-lactam (BL) antibiotics are among the most prescribed groups of drugs worldwide and have been implicated in a variety of allergic reactions. There is a paucity of literature regarding patient adherence to prescribed instructions following comprehensive allergy assessments. Objective: The objective was to follow up the clinical course of BL allergy in patients who underwent thorough allergological investigation for suspected BL allergy at a tertiary hospital and ascertain patients' compliance with the provided written instructions. Materials: An observational study in patients referred for suspected BL allergy who underwent a comprehensive allergy workup (in vivo ± in vitro tests, DPT in culprit and/or alternative BL) and who subsequently received written instructions was conducted. Data on the nature of the reported drug hypersensitivity reaction, the culprit BL drug, the allergological workup, and the detailed instructions provided in a written drug allergy report were collected retrospectively. Patients' compliance with the instructions was recorded by a telephone survey using a pre-defined questionnaire. Results: Among the 212 patients meeting the inclusion criteria, 87 patients (72.4% women; mean age 50.1 years; age range 6–84 years) responded to the telephone survey and were included in this study. Surprisingly, 45 out of 87 (51.7%) patients did not adhere to the written instructions. The primary factor contributing to non-compliance was the fear of re-occurrence of a drug-induced allergic reaction (personal and/or triggered by their treating physician reluctance), accounting for 77.7% of cases. The analysis demonstrated that the initial reaction's severity and type, as well as the outcomes of skin testing, did not correlate with compliance to instructions (p > 0.05). Surprisingly enough, a drug provocation test (DPT), irrespectively of the result, emerged as a negative predictor for adherence, with only 40.6% of DPT patients complying compared to 77.8% of those who did not undergo DPT (p = 0.005; odds ratio = 0.195; 95% confidence interval: 0.058–0.655). Variables such as performing DPT with alternative or incriminated drugs or the result of the DPT (positive–negative) were not associated with patient compliance. Conversely, the type of instructions provided exhibited a noteworthy correlation with compliance. Patients who were explicitly instructed to entirely avoid all BL antibiotics demonstrated markedly higher adherence rates (83.3%) compared to those who were advised to have a partial or complete release of BLs (31.8% and 58.1%, respectively; p < 0.05). Notably, among compliant patients who received either the original culprit drug or the alternative (32 out of 87, 36.7%), no allergic reactions were reported. In contrast, among the 12 patients with written avoidance of all BLs, subsequent BL intake led to immediate reactions (Grade I and IV) in 2 patients (16.6%). Conclusions: A notable disparity in patient adherence to written instructions prohibiting or releasing beta-lactams was demonstrated. Less than half of the patients ultimately complied with the provided instructions, underscoring the need for tailored patients' education and strategies to improve adherence in the management of suspected BL allergy. [ABSTRACT FROM AUTHOR]

Background: Blood is a vital human tissue and a precious health resource. Use of these components may be associated with adverse events, which compromise the efficiency and safety of blood transfusion. The incidence of adverse transfusion reactions has declined with modern facilities like improved screening and transfusion practices, but some are still observed due to alloimmunization, bacterial contamination, immunomodulation, etc. Aims and Objectives: To study the incidence and profile of acute blood transfusion reactions (ATR) in pediatric patients at our center. Materials and Methods: We monitored ATRs in patients receiving blood components among the age group of 1 month–18 years, during September 2021–August 2022. A detailed proforma was used to collect data from patients developing ATR. Results: ATRs were observed among 329 patients (3.9%) out of 9501 transfusions. In decreasing order of frequency, febrile nonhemolytic transfusion reactions (3.3%), allergies (0.5%), hemolytic reactions (0.1%) were observed. ATRs were most commonly observed with red cell concentrate transfusions (90.6%) followed by platelets (7%) and then plasma (2.2%) (P=0.059). Most of the reactions occurred within 1st 2 h (82.4%) of transfusion and the most common symptom recorded was fever (61.5%) followed by chills and rigors (20.9%). We found a significant association between ATRs and previous history of blood transfusion (81.8%) (P

Abstract Advances in cardiac implantable electronic devices (CIEDs) have prolonged life expectancy in various medical settings. However, the issue of hypersensitivity to components of CIEDs is still a concern. Since 1970, allergic reactions to metallic and nonmetallic components of CIEDs have been reported. Hypersensitivity reactions to medical devices are rare and not fully understood. In some cases, diagnosis and treatment are difficult. Cardiologists should always keep in mind pacemaker allergy when a patient appears with wound complications and no signs of infection. Patch testing should be tailored toward the specific biomaterials used in a device, in addition to testing with standard screening allergens in select cases.

In recent years, the increased population has led to an increase in the demand for various industrially processed edibles and other consumable products. These industries regularly alter the proteins found in raw materials to generate more commercially viable end-products in order to keep up with consumer demand. These modifications result in a substance that may cause allergic reactions in consumers, thereby creating a protein allergen. The detection of such proteins in various substances is essential for the prevention, diagnosis and treatment of allergic conditions. Bioinformatics and computational methods can be used to analyze the information contained in amino-acid sequences to detect possible allergens. The article presents a deep learning based ensemble approach to identify protein allergens using Extra Tree, Deep Belief Network (DBN), and CatBoost models. The proposed ensemble model achieves higher detection accuracy by combining the prediction results of the three models using majority voting. The evaluation of the proposed model was carried out on the benchmark protein allergen dataset, and the performance analysis revealed that the proposed model outperforms the other state-of-the-art literature techniques with a protein allergen detection accuracy of 89.16%. [ABSTRACT FROM AUTHOR]

Abstract Background Kounis syndrome is a rare clinical condition characterized by the occurrence of an acute coronary event induced by an acute allergic episode. The ongoing pandemic of coronavirus disease 2019 (COVID-19) has contributed to an increase in the incidence of allergic reactions to a certain extent, thereby increasing the incidence of Kounis syndrome. Timely diagnosis and effective management of this disease are important in clinical practice. Case presentation We report a 43-year-old woman who developed generalized pruritus, breathlessness, paroxysmal precordial crushing pain, and dyspnea after receiving the third dose of the COVID-19 vaccine. After anti-allergic treatment and therapy for acute myocardial ischemia, her symptoms resolved with improvement in cardiac function and resolution of ST-segment changes. The prognosis was satisfactory, and the final diagnosis was type I Kounis syndrome. Conclusion This patient with type I Kounis syndrome rapidly developed acute coronary syndrome (ACS) after an acute allergic reaction to the COVID-19 vaccine. ​Timely diagnosis of acute allergic reaction and ACS, and targeted treatment based on the relevant guidelines are the key to successful treatment of the syndrome.​

Conducting routine allergy tests of cattle with a simultaneous sample in TB-prone farms is necessary to confirm the stage of the epizootic process. The purpose of the research – to explore the pathomorphological changes in cows upon detection of para allergic reactions during diagnostic testing for tuberculosis. The diagnosis of tuberculosis in animals was performed comprehensively using all methods for tuberculosis control provided for in the guidelines – epidemiological, clinical, allergic, pathological, histomorphological, bacteriological and biological. It allowed establishing that the reactions to tuberculin in cows were of a paraallergic nature, caused by nontuberculous mycobacteria or so-called atypical mycobacteria. It was determined that cows that reacted positively to tuberculin and an atypical mycobacterial allergen and were sent for slaughter for diagnostic purposes did not demonstrate pathological changes characteristic of tuberculosis. However, pathological changes (granulomatous foci, atrophy of lymphoid and epithelioid tissue, hyperplasia of varying intensity and nature, dotted haemorrhages in the cortical zone) were observed in many lymph nodes, including mediastinal, mesenteric, pharyngeal and mandibular lymph nodes, indicating an active infectious process in the body of animals caused by nontuberculous mycobacteria. Therewith, several changes were observed in the lymph nodes during histomorphological examination: development of primary nodules of lymphocytes and reticular tissue in reactive centres, degradation and necrosis of lymphocytes, the establishment of cellular detritus in the centre of the nodules and capsules of epithelioid elements around the nodules, etc., which can be used to confirm the patterns of pathology development and, indirectly, the mechanism of sensitisation of the cow’s body, and therefore the nature of paraallergic reactions in animals. The obtained results are important for the timely detection and identification at the histomorphological level of a complex of changes in the organs and tissues of cows due to the penetration of nontuberculous mycobacteria, which is the key to the successful diagnosis of primary foci of mycobacteriosis and their effective prevention

Introduction: The management of the COVID-19 vaccine in children with mastocytosis is unclear due to a lack of data. In the current study, we aimed to evaluate the adverse reactions following COVID-19 vaccination in adolescents with cutaneous mastocytosis (CM). Methods: This study included 27 paediatric patients who were diagnosed with CM and were followed up in the paediatric allergy department of a tertiary care children's hospital. Results: The median (IQR) age of the patients at the time of COVID-19 vaccination was 180 (156–203) months. Forty-four per cent of patients were vaccinated with the COVID-19 vaccine. Among all participants, the vaccination rate was found to be higher in older children, those who had been diagnosed with MPCM, and those who had not been infected with COVID-19 (p = 0.019, p = 0.009, p = 0.002, respectively). A total of 23 doses of the COVID-19 vaccine, including two doses of Sinovac/CoronaVac and 21 doses of Pfizer/BioNTech, were administered to 12 paediatric patients with CM. One of the patients had a history of intense itch, erythematous urticarial plaques, and had an exacerbation of existing skin lesions within 24–48 h after both doses of Pfizer/BioNTech vaccination. Conclusion: The COVID-19 vaccination of patients with CM in this series seems to be safe, and the rate of adverse events was comparable to that in the general population. These results found in adolescents with CM are in line with the existing evidence that CM does not preclude vaccination in children. [ABSTRACT FROM AUTHOR]

Background: Blood is a vital human tissue and a precious health resource. Use of these components may be associated with adverse events, which compromise the efficiency and safety of blood transfusion. The incidence of adverse transfusion reactions has declined with modern facilities like improved screening and transfusion practices, but some are still observed due to alloimmunization, bacterial contamination, immunomodulation, etc. Aims and Objectives: To study the incidence and profile of acute blood transfusion reactions (ATR) in pediatric patients at our center. Materials and Methods: We monitored ATRs in patients receiving blood components among the age group of 1 month-18 years, during September 2021-August 2022. A detailed proforma was used to collect data from patients developing ATR. Results: ATRs were observed among 329 patients (3.9%) out of 9501 transfusions. In decreasing order of frequency, febrile nonhemolytic transfusion reactions (3.3%), allergies (0.5%), hemolytic reactions (0.1%) were observed. ATRs were most commonly observed with red cell concentrate transfusions (90.6%) followed by platelets (7%) and then plasma (2.2%) (P=0.059). Most of the reactions occurred within 1st 2 h (82.4%) of transfusion and the most common symptom recorded was fever (61.5%) followed by chills and rigors (20.9%). We found a significant association between ATRs and previous history of blood transfusion (81.8%) (P<0.00001) and also with storage of blood components for more than 3 days (88.8%) (P=0.019). Conclusion: The prevalence of ATR was 3.9% among pediatric patients in our setup. Knowledge of risk factors associated with transfusion reaction will help in improving transfusion practices. [ABSTRACT FROM AUTHOR]

In recent years, the increased population has led to an increase in the demand for various industrially processed edibles and other consumable products. These industries regularly alter the proteins found in raw materials to generate more commercially viable end-products in order to keep up with consumer demand. These modifications result in a substance that may cause allergic reactions in consumers, thereby creating a protein allergen. The detection of such proteins in various substances is essential for the prevention, diagnosis and treatment of allergic conditions. Bioinformatics and computational methods can be used to analyze the information contained in amino-acid sequences to detect possible allergens. The article presents a deep learning based ensemble approach to identify protein allergens using Extra Tree, Deep Belief Network (DBN), and CatBoost models. The proposed ensemble model achieves higher detection accuracy by combining the prediction results of the three models using majority voting. The evaluation of the proposed model was carried out on the benchmark protein allergen dataset, and the performance analysis revealed that the proposed model outperforms the other state-of-the-art literature techniques with a protein allergen detection accuracy of 89.16%.

Currently available vaccines are safe, but, potentially, any vaccine can cause an allergic reaction and, albeit very rare, anaphylaxis can occur. Although its rarity, the precise diagnostic management of a suspected anaphylaxis postvaccination is of paramount importance due to the risk of a potentially serious reaction after re‐exposure, while a misdiagnosis might lead to an increase in the number of children that interrupt vaccinations resulting in an unjustifiably individual and collective risk of loss of protection against immune preventable diseases. In the light that most cases of suspected allergy to a vaccine are not effectively confirmed in up to 85% of the cases referred for an allergy evaluation, patients can continue the vaccination schedule with the same formulation and tolerance of the booster doses. The patient assessment has to be done by an expert in the vaccine field, usually an allergist or an immunologist depending on the country, to select subjects at risk of allergic reactions and to perform the correct procedures for vaccine hypersensitivity diagnosis and management, in order to guarantee safe immunization practices. The aim of this review is to provide a practical guidance for the safe management of allergic children undergoing immunization procedures. The guide is referred both to the evaluation of children who have previously experienced a suspected allergic reaction to a specific vaccine and their management in case of further booster doses, and to children allergic to a component of the vaccine to be administered. [ABSTRACT FROM AUTHOR]

Advances in cardiac implantable electronic devices (CIEDs) have prolonged life expectancy in various medical settings. However, the issue of hypersensitivity to components of CIEDs is still a concern. Since 1970, allergic reactions to metallic and nonmetallic components of CIEDs have been reported. Hypersensitivity reactions to medical devices are rare and not fully understood. In some cases, diagnosis and treatment are difficult. Cardiologists should always keep in mind pacemaker allergy when a patient appears with wound complications and no signs of infection. Patch testing should be tailored toward the specific biomaterials used in a device, in addition to testing with standard screening allergens in select cases. [ABSTRACT FROM AUTHOR]

BACKGROUND. The spread of tuberculosis in Ukraine forces doctors to use intensive chemotherapy, which leads to adverse reactions and promotes to the spread of drug-resistant tuberculosis. Toxic-allergic reactions take a protracted course and are difficult to respond to corrective therapy, which requires additional research. OBJECTIVE. To determine changes in immunological reactivity in patients with pulmonary tuberculosis with allergic and toxic-allergic reactions by cellular immunity research. MATERIALS AND METHODS. The results of clinical, laboratory and immunological examination of patients were analyzed depending on the presence/absence of clinical signs of allergic reactions to antituberculosis drugs using the method of flow cytofluorimetry and assessment of phagocytic link of immunity. RESULTS AND DISCUSSION. There were detected the activation of all studied subpopulations of T- and B-lymphocytes and an increase in the absolute and percentage number of natural killers in the blood of patients without adverse reactions. It is a positive factor for the destruction of mycobacteria. The development of allergic reactions support the inhibition of the activity of the general pool of T-lymphocytes, their subpopulations, B-lymphocytes, natural killers, the absorption activity of phagocytes. It is an unfavorable factor that can lead to the formation of anergy of immunocytes. Increased activity of the inflammatory process and deepening of the immunological imbalance were detected in patients with clinical and laboratory signs of toxic-allergic reactions. It is not accompanied by an inhibitory effect on blood lymphocytes and phagocytes, is revealed. It indicates a special pathogenesis of toxic-allergic reactions with involvement of disturbed liver functions. CONCLUSSION. Identified differences in the immune status will allow to adjust the treatment.

BackgroundAnaphylaxis is a potentially fatal condition; in severe cases of anaphylaxis, the cardiovascular system is often heavily involved. Adrenaline (epinephrine) is a cornerstone of the initial treatment of anaphylaxis. The use of epinephrine remains below expectations in clinical practice. Whether the underuse of epinephrine affects the prognosis of patients with anaphylaxis is still unclear.Materials and methodsThis retrospective study included patients with anaphylaxis between 2011 and 2020 who were admitted to an emergency department (ED) in Taiwan. All patients were divided into two groups based on the use of epinephrine (or not), and we compared the demographic characteristics, allergens, clinical manifestations, management, and patient outcomes.ResultsWe reviewed the records of 314 subjects (216 males, 98 females; mean age: 52.78 ± 16.02 years) who visited our ED due to anaphylaxis; 107 (34.1%) and 207 (65.9%) patients were categorized into the epinephrine use group and the non-epinephrine use group, respectively. Arrival via ambulance (p = 0.019), hypotension (p = 0.002), airway compromise (p

Background: Kounis syndrome is a rare clinical condition characterized by the occurrence of an acute coronary event induced by an acute allergic episode. The ongoing pandemic of coronavirus disease 2019 (COVID-19) has contributed to an increase in the incidence of allergic reactions to a certain extent, thereby increasing the incidence of Kounis syndrome. Timely diagnosis and effective management of this disease are important in clinical practice. Case presentation: We report a 43-year-old woman who developed generalized pruritus, breathlessness, paroxysmal precordial crushing pain, and dyspnea after receiving the third dose of the COVID-19 vaccine. After anti-allergic treatment and therapy for acute myocardial ischemia, her symptoms resolved with improvement in cardiac function and resolution of ST-segment changes. The prognosis was satisfactory, and the final diagnosis was type I Kounis syndrome. Conclusion: This patient with type I Kounis syndrome rapidly developed acute coronary syndrome (ACS) after an acute allergic reaction to the COVID-19 vaccine. ​Timely diagnosis of acute allergic reaction and ACS, and targeted treatment based on the relevant guidelines are the key to successful treatment of the syndrome.​ [ABSTRACT FROM AUTHOR]

Conducting routine allergy tests of cattle with a simultaneous sample in TB-prone farms is necessary to confirm the stage of the epizootic process. The purpose of the research -- to explore the pathomorphological changes in cows upon detection of para allergic reactions during diagnostic testing for tuberculosis. The diagnosis of tuberculosis in animals was performed comprehensively using all methods for tuberculosis control provided for in the guidelines -- epidemiological, clinical, allergic, pathological, histomorphological, bacteriological and biological. It allowed establishing that the reactions to tuberculin in cows were of a paraallergic nature, caused by nontuberculous mycobacteria or so-called atypical mycobacteria. It was determined that cows that reacted positively to tuberculin and an atypical mycobacterial allergen and were sent for slaughter for diagnostic purposes did not demonstrate pathological changes characteristic of tuberculosis. However, pathological changes (granulomatous foci, atrophy of lymphoid and epithelioid tissue, hyperplasia of varying intensity and nature, dotted haemorrhages in the cortical zone) were observed in many lymph nodes, including mediastinal, mesenteric, pharyngeal and mandibular lymph nodes, indicating an active infectious process in the body of animals caused by nontuberculous mycobacteria. Therewith, several changes were observed in the lymph nodes during histomorphological examination: development of primary nodules of lymphocytes and reticular tissue in reactive centres, degradation and necrosis of lymphocytes, the establishment of cellular detritus in the centre of the nodules and capsules of epithelioid elements around the nodules, etc., which can be used to confirm the patterns of pathology development and, indirectly, the mechanism of sensitisation of the cow's body, and therefore the nature of paraallergic reactions in animals. The obtained results are important for the timely detection and identification at the histomorphological level of a complex of changes in the organs and tissues of cows due to the penetration of nontuberculous mycobacteria, which is the key to the successful diagnosis of primary foci of mycobacteriosis and their effective prevention [ABSTRACT FROM AUTHOR]

This study aimed at producing an updated assessment of the incidence of anaphylaxis associated with COVID-19 vaccines based on pharmacovigilance data. Anaphylactic reaction and anaphylactic shock data post-COVID-19-vaccination reported from week 52, 2020 to week 1 or week 2, 2023 were collected from the VAERS and EudraVigilance databases, respectively, and analyzed comparatively. Incidence rates were calculated using the corresponding administered vaccine doses as denominators for all licensed vaccines and both platform types (mRNA or vectored). The latest data from the present analysis showed lower anaphylaxis incidence associated with COVID-19 vaccination compared to previous estimates from week 52, 2020 to week 39, 2021 (anaphylactic reaction: 8.96 (95% CI 8.80–9.11)/million doses overall (EEA: 14.19 (95% CI 13.92–14.47)/million/US: 3.17 (95% CI 3.03–3.31)/million); anaphylactic shock: 1.46 (95% CI 1.39–1.52)/million doses overall (EEA: 2.47 (95% CI 2.36–2.58)/million/US: 0.33 (95% CI 0.29–0.38)/million)). Incidence rates varied by vaccine and were higher as captured in EudraVigilance compared to the VAERS and for vectored compared to mRNA vaccines. Most reported cases had a favorable outcome. The extremely rare fatalities (overall rates across continents 0.04 (95% CI 0.03–0.06)/million doses for anaphylactic reaction and 0.02 (95% CI 0.01–0.03)/million vaccine doses for anaphylactic shock) were also associated with vector-rather than mRNA-based vaccines. The diminished incidence of anaphylaxis post-vaccination with COVID-19 vaccines offers assurance about their safety, as does the continuous potential adverse events monitoring through specialized pharmacovigilance databases. [ABSTRACT FROM AUTHOR]