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The Journal of School Health Feb 2022Anaphylaxis is a life-threatening allergic reaction with significant risk for children with allergies. Access to potentially life-saving medication is critical for these... (Review)
Review
BACKGROUND
Anaphylaxis is a life-threatening allergic reaction with significant risk for children with allergies. Access to potentially life-saving medication is critical for these children. This review aims to describe state laws and policies guiding stock epinephrine in schools for allergic or anaphylactic events and detail recommendations for best practices.
METHODS
This paper is a comprehensive review of the 50 states and the District of Columbia's (DC) laws and policies for stock epinephrine at schools for children in pre-kindergarten through 12th grade.
RESULTS
All 50 states and DC allow undesignated epinephrine in schools to use for allergic or anaphylactic reactions. A key difference arises in whether states allow (N = 37) or mandate (N = 14) that schools stock epinephrine. States exhibit differences in the body responsible for developing stock epinephrine policy (N = 48), along with stakeholders responsible for developing procedures (N = 30) and implementing them (N = 19). Differences also exist in state epinephrine procurement, administration, training, and liability.
CONCLUSIONS
This review of stock epinephrine laws and policies highlights the significant variation in state legislation despite widespread adoption. Only one-quarter of states mandate that schools have stock epinephrine available for emergency use, underscoring need for a more unified approach with consistent guidelines, comprehensive training, and possible funding for implementation.
Topics: Anaphylaxis; Child; Epinephrine; Food Hypersensitivity; Humans; School Health Services; Schools
PubMed: 34825371
DOI: 10.1111/josh.13119 -
Ugeskrift For Laeger May 2014Anaphylaxis is a potentially life-threatening systemic allergic reaction involving several organ systems. Recognition of the reaction leading to prompt treatment is... (Review)
Review
Anaphylaxis is a potentially life-threatening systemic allergic reaction involving several organ systems. Recognition of the reaction leading to prompt treatment is essential for a good outcome. The lifesaving treatment is intramuscular injection of adrenaline (0.3-0.5 mg for adults and children > 40 kg, 0.3 mg for children 20-40 kg and 0.15 mg for infants < 20 kg). The patient must be placed on the back with elevated lower extremities to improve cerebral and cardiac circulation. High dose oxygen and crystalloid fluid load are needed to improve oxygenation and cardiac output.
Topics: Adult; Algorithms; Anaphylaxis; Child; Diagnosis, Differential; Epinephrine; Humans
PubMed: 25352003
DOI: No ID Found -
Indian Heart Journal 2014
Topics: Acute Coronary Syndrome; Angioplasty, Balloon, Coronary; Humans; Hypersensitivity; Prosthesis Failure; Rare Diseases; Risk Assessment; Stents; Thrombosis
PubMed: 24814107
DOI: 10.1016/j.ihj.2013.12.013 -
Allergology International : Official... Mar 2011The definition, classification, pathogenesis, test methods, clinical findings, criteria for diagnosis, and therapies of allergic conjunctival disease are summarized... (Review)
Review
The definition, classification, pathogenesis, test methods, clinical findings, criteria for diagnosis, and therapies of allergic conjunctival disease are summarized based on the Guidelines for Clinical Management of Allergic Conjunctival Disease (Second Edition) revised in 2010. Allergic conjunctival disease is defined as "a conjunctival inflammatory disease associated with a Type I allergy accompanied by some subjective or objective symptoms." Allergic conjunctival disease is classified into allergic conjunctivitis, atopic keratoconjunctivitis, vernal keratoconjunctivitis, and giant papillary conjunctivitis. Representative subjective symptoms include ocular itching, hyperemia, and lacrimation, whereas objective symptoms include conjunctival hyperemia, swelling, folliculosis, and papillae. Patients with vernal keratoconjunctivitis, which is characterized by conjunctival proliferative changes called giant papilla accompanied by varying extents of corneal lesion, such as corneal erosion and shield ulcer, complain of foreign body sensation, ocular pain, and photophobia. In the diagnosis of allergic conjunctival diseases, it is required that type I allergic diathesis is present, along with subjective and objective symptoms accompanying allergic inflammation. The diagnosis is ensured by proving a type I allergic reaction in the conjunctiva. Given that the first-line drug for the treatment of allergic conjunctival disease is an antiallergic eye drop, a steroid eye drop will be selected in accordance with the severity. In the treatment of vernal keratoconjunctivitis, an immunosuppressive eye drop will be concomitantly used with the above mentioned drugs.
Topics: Conjunctival Diseases; Humans; Hypersensitivity; Japan; Post-Exposure Prophylaxis
PubMed: 21636966
DOI: 10.2332/allergolint.11-RAI-0335 -
Tidsskrift For Den Norske Laegeforening... Dec 2011Eosinophilic oesophagitis is a chronic inflammatory condition in the oesophagus. There has been increasing awareness of this disease in recent years as a common cause of... (Review)
Review
BACKGROUND
Eosinophilic oesophagitis is a chronic inflammatory condition in the oesophagus. There has been increasing awareness of this disease in recent years as a common cause of dysfunction of the oesophagus in children and adults.
MATERIAL AND METHOD
The review is based on a search in PubMed, scrutiny of reference lists and the authors' experience of adults and children with eosinophilic oesophagitis.
RESULTS
Eosinophilic oesophagitis is being diagnosed increasingly often in western countries. Men are affected three times as often as women. The disease may start at any age, but does so most frequently in children and young adults. Dysphagia and impaction of food in the oesophagus are the most common symptoms in adolescents and adults. In children the commonest symptoms are eating problems, abdominal pain, nausea and retarded growth. In many patients the mechanism behind the condition is probably an allergic reaction in the oesophagus to food, and over half the patients have an atopic disposition. The diagnosis is based on clinical findings, typical findings on endoscopy and eosinophilic granulocytes in the oesophageal mucosa. Treatment possibilities include restriction of diet, locally acting corticosteroids and endoscopic dilatation.
INTERPRETATION
Eosinophilic oesophagitis is being diagnosed in an increasing number of patients, but it is not certain whether this is due to increased occurrence or increased awareness by doctors. Knowledge of the disease is important because simple endoscopic or medical treatment leads to a good result in most patients, and can prevent complications such as stricture formation and food impaction in the oesophagus.
Topics: Adolescent; Adult; Child; Eosinophilic Esophagitis; Esophagoscopy; Female; Food Hypersensitivity; Humans; Male; Prognosis
PubMed: 22170132
DOI: 10.4045/tidsskr.11.0417 -
Current Opinion in Otolaryngology &... Jun 2014To examine evidence supporting the association of allergy and Menière's disease. (Review)
Review
PURPOSE OF REVIEW
To examine evidence supporting the association of allergy and Menière's disease.
RECENT FINDINGS
Animal studies have shown evidence that a provoked systemic immune challenge can result in an allergic reaction within the inner ear, whereas premedication with leukotriene antagonists can prevent the development of endolymphatic hydrops. In human subjects, further data support a heightened allergic response in patients with Menière's disease, whereas pharmacological treatments that target histamine receptors help to control vertiginous symptoms. However, the relationship of migraine with a history of allergy and Menière's disease may confound this association.
SUMMARY
Although the evidence of a causal association between allergy and Menière's disease is inconclusive, the inclusion of allergy control as part of the treatment plan for Menière's disease is low risk to the patient and should be considered for patients with indications that include history of seasonal or food allergy, childhood or family history of allergy, bilateral Menière's symptoms, or a development of symptoms within a short time after exposure of food or inhaled allergen.
Topics: Humans; Hypersensitivity; Meniere Disease
PubMed: 24573125
DOI: 10.1097/MOO.0000000000000041 -
Current Allergy and Asthma Reports Nov 2018The basophil activation test (BAT) using flow cytometry has supplanted traditional methods of measuring basophil degranulation using histamine and other mediator... (Review)
Review
PURPOSE OF REVIEW
The basophil activation test (BAT) using flow cytometry has supplanted traditional methods of measuring basophil degranulation using histamine and other mediator release, and can be used for clinical applications as well as to explore the immune mechanisms of effector cell response to allergen. This review discusses the advancements made in clinical, diagnostic and laboratory research of allergy utilizing an ever-evolving BAT.
RECENT FINDINGS
Being an in vitro surrogate of the allergic reaction that happens in vivo in the sick patient, the BAT can be used to support the diagnosis of various allergic conditions, such as food, drug, respiratory and insect venom allergies, and the assessment of clinical response to allergen-specific immunotherapy and other immunomodulatory treatments. The BAT can also be used for research purposes to explore the mechanisms of allergy and tolerance at the level of the basophil, for instance by manipulating IgE and IgG and their receptors and by studying intracellular signalling cascade in response to allergen. This review covers the applications of the BAT to the clinical management of allergic patients and the increased understanding of the mechanisms of immune response to allergens as well as technological advancements made in recent years.
Topics: Basophils; Cell Degranulation; Humans; Hypersensitivity; Immunomodulation
PubMed: 30430289
DOI: 10.1007/s11882-018-0831-5 -
Allergy Jun 2016The aim of this document was to provide a critical review of the current knowledge on hypersensitivity pneumonitis caused by the occupational environment and to propose... (Meta-Analysis)
Meta-Analysis Review
The aim of this document was to provide a critical review of the current knowledge on hypersensitivity pneumonitis caused by the occupational environment and to propose practical guidance for the diagnosis and management of this condition. Occupational hypersensitivity pneumonitis (OHP) is an immunologic lung disease resulting from lymphocytic and frequently granulomatous inflammation of the peripheral airways, alveoli, and surrounding interstitial tissue which develops as the result of a non-IgE-mediated allergic reaction to a variety of organic materials or low molecular weight agents that are present in the workplace. The offending agents can be classified into six broad categories that include bacteria, fungi, animal proteins, plant proteins, low molecular weight chemicals, and metals. The diagnosis of OHP requires a multidisciplinary approach and relies on a combination of diagnostic tests to ascertain the work relatedness of the disease. Both the clinical and the occupational history are keys to the diagnosis and often will lead to the initial suspicion. Diagnostic criteria adapted to OHP are proposed. The cornerstone of treatment is early removal from exposure to the eliciting antigen, although the disease may show an adverse outcome even after avoidance of exposure to the causal agent.
Topics: Alveolitis, Extrinsic Allergic; Diagnosis, Differential; Diagnostic Imaging; Disease Management; Humans; Occupational Diseases; Outcome Assessment, Health Care; Respiratory Function Tests; Risk Factors
PubMed: 26913451
DOI: 10.1111/all.12866 -
Journal of Investigational Allergology... 2009Although eosinophilic airway inflammation is recognized as an important feature of some patients with chronic, stable asthma, evidence supports an important role for... (Review)
Review
Although eosinophilic airway inflammation is recognized as an important feature of some patients with chronic, stable asthma, evidence supports an important role for neutrophils in asthma. Neutrophils are the first cells recruited to the site of the allergic reaction. Their presence may influence clinical presentation and has been linked to the development of severe chronic asthma and sudden severe attacks. Neutrophils are eliminated by apoptosis during the resolution of the allergic response.
Topics: Asthma; Humans; Neutrophil Activation; Neutrophils
PubMed: 19862934
DOI: No ID Found -
Clinical and Experimental Allergy :... Oct 2021Understanding consumers' interpretation of allergy information is crucial for effective food safety policies. We evaluated consumer understanding of allergy information...
BACKGROUND
Understanding consumers' interpretation of allergy information is crucial for effective food safety policies. We evaluated consumer understanding of allergy information on foods in controlled, experimental studies.
METHOD
Using 18 packaged foods, we evaluated consumer understanding of information about allergens in two experiments: First, a comparison of foods with no stated allergen versus allergen as a stated ingredient versus a precautionary allergen label (PAL); second, a comparison of three common variants of PAL. In each experiment, consumers with and without self-reported food allergy were asked to estimate the risk of allergic reaction and to rate the comprehensibility of the allergen information. In the second experiment, consumers were also asked which form of PAL they preferred.
RESULTS
Risk of reaction was assessed as high and low for foods with the allergen stated as ingredient, or without any mention of allergen. However, risk assessment for PAL varied and was judged as higher by non-allergic than allergic participants (82% vs. 58%, p < .001). Understanding of risk associated with PAL also varied by health literacy (p < .001). Both allergic and non-allergic consumers judged all forms of allergy information to be unclear, especially products with no allergy information for non-allergic consumers. Products with a 'Produced in a Factory' PAL were perceived as less risky than 'May contain' or 'Traces of' PALs (p < .001), less than 40% of participants judged PAL information to be comprehensible, and participants preferred 'May contain' over the other PALs.
CONCLUSION
Both allergic and non-allergic consumers find allergen information difficult to interpret on packaged foods and misunderstand PAL, incorrectly distinguishing different risk levels for different PAL wording. Clearer allergy information guidelines are called for, and the use of only one PAL wording is recommended.
Topics: Allergens; Food; Food Hypersensitivity; Food Labeling; Food Safety; Humans
PubMed: 34288165
DOI: 10.1111/cea.13975