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Sample records for advocacy anaphylaxis diagnosis

  1. Anaphylaxis: diagnosis and management.

    PubMed

    Brown, Simon G A; Mullins, Raymond J; Gold, Michael S

    2006-09-01

    Anaphylaxis is a serious, rapid-onset, allergic reaction that may cause death. Severe anaphylaxis is characterised by life-threatening upper airway obstruction, bronchospasm and/or hypotension. Anaphylaxis in children is most often caused by food. Bronchospasm is a common symptom, and there is usually a background of atopy and asthma. Venom- and drug-induced anaphylaxis are more common in adults, in whom hypotension is more likely to occur. Diagnosis can be difficult, with skin features being absent in up to 20% of people. Anaphylaxis must be considered as a differential diagnosis for any acute-onset respiratory distress, bronchospasm, hypotension or cardiac arrest. The cornerstones of initial management are putting the patient in the supine position, administering intramuscular adrenaline into the lateral thigh, resuscitation with intravenous fluid, support of the airway and ventilation, and giving supplementary oxygen. If the response to initial management is inadequate, intravenous infusion of adrenaline should be commenced. Use of vasopressors should be considered if hypotension persists. The patient should be observed for at least 4 hours after symptom resolution and referred to an allergist to assist with diagnosis, allergen avoidance measures, risk assessment, preparation of an action plan and education on the use of self-injectable adrenaline. Provision of a MedicAlert bracelet should also be arranged. PMID:16948628

  2. Anaphylaxis and Anaphylactoid Reactions: Diagnosis and Management.

    PubMed

    Luskin, Allan T.; Luskin, Susan S.

    1996-07-01

    Anaphylaxis is an acute fatal or potentially fatal hypersensitivity reaction. Anaphylaxis represent a clinical diagnosis based on history and physical examination and includes symptoms of airway obstruction, generalized skin reactions, particularly flushing, itching, urticaria, angioedema cardiovascular symptoms including hypotension and gastrointestinal symptoms. These symptoms result from the action of mast cell mediators, especially histamine and lipid mediators such as leukotrienes and platelet activating factor on shock tissue. The shock tissue includes blood vessels, mucous glands, smooth muscle, and nerve endings. Anaphylaxis follows the typical immediate hypersensitivity time course, with a reaction beginning within minutes of antigen exposure. A late-phase reaction hours after the initial reaction may occur. Mast cell mediator release can be triggered by both IgE and non--IgE-mediated factors. Therefore, anaphylaxis may be termed anaphylaxis (IgE mediated) or anaphylactoid (non--IgE mediated). The most common IgE-mediated triggers are drugs, typically penicillin or other beta-lactam antibiotics, foods, most commonly nuts, peanuts, fish and shellfish, or hymenoptera stings. Non-IgE-mediated causes include factors causing marked complement activation such as plasma proteins or compounds which act directly on the mast cell membrane, such as vancomycin, quinolone antibiotics, or radiographic contrast media. The pathophysiology of some trigger factors, such as aspirin, remains unclear. Therapy of anaphylaxis revolves around patient education, avoidance, desensitization or pharmacologic pretreatment when agents causing anaphylaxis need to be readministered, and early recognition and prompt therapy of reactions should they occur. PMID:11862283

  3. Anaphylaxis.

    PubMed

    Hernandez, Lorenzo; Papalia, Sarah; Pujalte, George G A

    2016-09-01

    Anaphylaxis is an acute, systemic reaction mediated by immunoglobulin E hypersensitivity. Release of bioactive factors causes vasodilation and bronchiole constriction that can lead to hypotensive shock and asphyxiation. Differential diagnosis includes acute asthma, localized angioedema, syncope, and anxiety/panic attacks. Diagnostic tests lack specificity. Clinical diagnosis is based on demonstration of specific airway or cardiovascular compromise within proximity of allergen exposure. Treatment includes epinephrine, antihistamines, fluid resuscitation, and airway management. Prevention focuses on awareness/avoidance of triggers, implementation of personalized action plans, as well as immune modulation by desensitization in a closely controlled setting where available. PMID:27545736

  4. Anaphylaxis.

    PubMed

    Ring, Johannes; Grosber, Martine; Brockow, Knut; Bergmann, Karl-Christian

    2014-01-01

    The term anaphylaxis was coined by Charles Richet and Paul Portier when they tried to immunize dogs with actinia extracts, but after a repeated injection of a small amount of the toxin the dog died within 25 min. The new term rapidly spread all over the world. The discovery of the phenomenon of anaphylaxis showed that by immunization not only protection but also harmful events could be induced. For this discovery Richet received the Nobel Prize in 1913, but he still believed the condition of anaphylaxis was a lack of protection to the poisonous effect of the substance. Already earlier similar clinical phenomena had been observed but not well described. A major breakthrough in understanding the pathophysiology came through the experiments of Dale and Laidlaw who showed that the newly discovered histamine was able to induce quite similar symptoms to anaphylaxis. For decades reactions mimicking anaphylaxis but without involvement of the immune systems were called 'anaphylactoid', 'allergy-like' or 'pseudo-allergic'. Since the new definition of the World Allergy Organization (WAO) anaphylaxis is defined on the basis of clinical symptoms independent of pathomechanisms involved: one distinguishes between allergic and non-immune anaphylaxis. Epinephrine (Adrenalin) was soon recognized as treatment of choice of this dramatic condition. PMID:24925384

  5. Anaphylaxis

    MedlinePlus

    ... All » Peanut allergy prevention strategy does not impact growth or nutrition » Trends, characteristics, and incidence of anaphylaxis: A population-based study » Transcriptome analysis reveals clues into the ...

  6. Anaphylaxis

    MedlinePlus

    ... being exposed to a substance such as bee sting venom, the person's immune system becomes sensitized to ... causes include: Drug allergies Food allergies Insect bites/stings Pollen and other inhaled allergens rarely cause anaphylaxis. ...

  7. Anaphylaxis

    MedlinePlus

    ... products in your home Insect stings, especially from bees, wasps, hornets, yellow jackets, sawflies, and fire ants ... If you have had anaphylaxis because of a bee or wasp sting, desensitization shots are almost always ...

  8. Idiopathic anaphylaxis.

    PubMed

    Greenberger, Paul A

    2007-05-01

    Idiopathic anaphylaxis is a prednisone-responsive condition without external cause, but it can coexist with food-, medication-, or exercise-induced anaphylaxis. Mast cell activation may occur at night or after foods that have been eaten with impunity many times previously. Idiopathic anaphylaxis can be classified into frequent (if there are six or more episodes per year or two episodes in the last 2 months) or infrequent (if episodes occur less often). Idiopathic anaphylaxis-generalized consists of urticaria or angioedema associated with severe respiratory distress, syncope or hypotension, and gastrointestinal symptoms. Idiopathic anaphylaxis-angioedema consists of massive tongue enlargement or severe pharyngeal or laryngeal swelling with urticaria or peripheral angioedema. The differential diagnosis of idiopathic anaphylaxis is reviewed, and treatment approaches are presented. PMID:17493503

  9. Peri-operative anaphylaxis

    PubMed Central

    Nel, Linda; Eren, Efrem

    2011-01-01

    Peri-operative anaphylaxis is an important cause for mortality and morbidity associated with anaesthesia. The true incidence is unknown and is most likely under reported. Diagnosis can be difficult, particularly as a number of drugs are given simultaneously and any of these agents can potentially cause anaphylaxis. This review covers the clinical features, differential diagnosis and management of anaphylaxis associated with anaesthesia. The investigations to confirm the clinical suspicion of anaphylaxis and further tests to identify the likely drug(s) are examined. Finally the salient features of common and rare causes including non-drug substances are described. PMID:21235622

  10. Advocacy.

    ERIC Educational Resources Information Center

    Scarr, Margaret, Ed.; Varro, Tim, Ed.

    1993-01-01

    This theme issue presents art advocacy as a necessary means of bringing art and art education to an elevated status in the elementary secondary curriculum and educational system. Articles include: (1) "Editor's View" (Margaret Scarr); (2) "Art Education: Why Is It Important" (Arts Education Partnership Working Group); (3) "Why Art in Education and…

  11. International consensus on (ICON) anaphylaxis

    PubMed Central

    2014-01-01

    ICON: Anaphylaxis provides a unique perspective on the principal evidence-based anaphylaxis guidelines developed and published independently from 2010 through 2014 by four allergy/immunology organizations. These guidelines concur with regard to the clinical features that indicate a likely diagnosis of anaphylaxis -- a life-threatening generalized or systemic allergic or hypersensitivity reaction. They also concur about prompt initial treatment with intramuscular injection of epinephrine (adrenaline) in the mid-outer thigh, positioning the patient supine (semi-reclining if dyspneic or vomiting), calling for help, and when indicated, providing supplemental oxygen, intravenous fluid resuscitation and cardiopulmonary resuscitation, along with concomitant monitoring of vital signs and oxygenation. Additionally, they concur that H1-antihistamines, H2-antihistamines, and glucocorticoids are not initial medications of choice. For self-management of patients at risk of anaphylaxis in community settings, they recommend carrying epinephrine auto-injectors and personalized emergency action plans, as well as follow-up with a physician (ideally an allergy/immunology specialist) to help prevent anaphylaxis recurrences. ICON: Anaphylaxis describes unmet needs in anaphylaxis, noting that although epinephrine in 1 mg/mL ampules is available worldwide, other essentials, including supplemental oxygen, intravenous fluid resuscitation, and epinephrine auto-injectors are not universally available. ICON: Anaphylaxis proposes a comprehensive international research agenda that calls for additional prospective studies of anaphylaxis epidemiology, patient risk factors and co-factors, triggers, clinical criteria for diagnosis, randomized controlled trials of therapeutic interventions, and measures to prevent anaphylaxis recurrences. It also calls for facilitation of global collaborations in anaphylaxis research. In addition to confirming the alignment of major anaphylaxis guidelines, ICON

  12. The mechanisms, causes, and treatment of anaphylaxis.

    PubMed

    Montanaro, Anthony; Bardana, Emil J

    2002-01-01

    Anaphylaxis is a severe life-threatening systemic reaction that offers many challenges to the clinician. The incidence of anaphylaxis is significant in the general population and an important cause of morbidity and mortality. While the most common causes of anaphylaxis include drugs, foods, and venoms, other important etiologies must be considered. The etiology of anaphylaxis is classically based on IgE mediated hypersensitivity but multiple mechanisms may be involved. The clinical presentation of anaphylaxis may be extremely variable with a broad differential diagnosis which will be outlined. Although the diagnosis of anaphylaxis can many times be based on a careful history and physical examination, there are laboratory and skin tests which may be helpful in establishing a diagnosis in some cases. The cornerstone of treatment of anaphylaxis remains epinephrine. Other supportive therapies will be discussed. PMID:12109526

  13. Management and Prevention of Anaphylaxis

    PubMed Central

    Irani, Anne-Marie; Akl, Elias G.

    2015-01-01

    Anaphylaxis prevalence has increased within the last few years. This may be due to a marked increase in allergic sensitization to foods especially in the pediatric population, as well as to an increase in outdoor recreational habits and the availability of new biologic medications.  Furthermore, guidelines for the diagnosis of anaphylaxis have been published, thus facilitating the recognition of this disorder. Diagnosis of anaphylaxis is mainly based on history and clinical criteria of organ system involvement. The serum tryptase assay is now commercially available and may be a helpful diagnostic tool in certain clinical situations involving hypotension, but not in the context of food-induced anaphylaxis. Treatment of anaphylaxis mainly involves the use of epinephrine as a first line medication for severe manifestations followed by  symptomatic management of specific  symptoms, such as antihistamines for urticaria and albuterol for wheezing. Although commonly practiced, treatment with systemic corticosteroids  is not supported by evidence-based literature. Observation in a medical facility for 4-6 hours is recommended to monitor for late phase reactions, although these rarely occur. Education is an essential component of management of a patient with a previous history of anaphylaxis, emphasizing early use of epinephrine and providing a written action plan. Referral to a board-certified allergist/immunologist is recommended to determine  the cause of the anaphylaxis as well as to rule out other potential conditions. In this review, our main focus will be on the treatment and prevention of anaphylaxis while providing our readers with a brief introduction to the diagnosis of anaphylaxis, its prevalence and its most common causes. PMID:26918144

  14. Utility of rotational thromboelastometry for the diagnosis of asymptomatic hyperfibrinolysis secondary to anaphylaxis.

    PubMed

    Koami, Hiroyuki; Sakamoto, Yuichiro; Furukawa, Takashi; Imahase, Hisashi; Iwamura, Takashi; Inoue, Satoshi

    2016-06-01

    We present a case of hyperfibrinolysis induced by oxaliplatin-derived anaphylactic shock, which was diagnosed with rotational thromboelastometry (ROTEM). A 57-year-old male patient underwent a second course of oxaliplatin (126 mg/m/course)-based chemotherapy for stage IV metastatic rectal cancer. Two minutes after the infusion of oxaliplatin, the patient lost consciousness and developed generalized urticarial lesions, followed by hemodynamic instability and respiratory insufficiency. He was diagnosed anaphylactic shock and transported to emergency department (ED) after intramuscular injection of 0.2 mg of adrenaline, an intravenous injection of 100 mg of hydrocortisone, and 500 mg of methylprednisolone. After arriving in the ED, the patient remained in shock and early resuscitation with administration of 5 mg of D-chlorpheniramine maleate and 20 mg of famotidine was performed. He recovered from his state of shock 30 min after the resuscitation. ROTEM findings showed fulminant hyperfibrinolysis with minimal changes in standard coagulation tests (SCTs) and no remarkable coagulopathy. Seven hours after the attack, he became asymptomatic and follow-up ROTEM revealed values within normal limits with the exception of sustained slight abnormalities of SCTs. He was discharged the next day without any signs of spontaneous bleeding and has continued his outpatient chemotherapy uneventfully. A review of the literature on anaphylaxis-induced hyperfibrinolysis and a discussion of the mechanism between anaphylactic shock and hyperfibrinolysis were performed. Although administration of tissue-type plasminogen activator can play a vital role in anaphylactic shock-induced hyperfibrinolysis, early effective resuscitation is imperative to prevent severe hemorrhagic complications. Therefore, ROTEM is a useful tool that can detect these dynamic changes faster and more accurately than SCTs. PMID:26569513

  15. Exercise–induced Anaphylaxis: the Role of Cofactors

    PubMed Central

    Zogaj, Dukagjin; Ibranji, Alkerta; Hoxha, Mehmet

    2014-01-01

    Introduction: Anaphylaxis is a dramatic clinical emergency. It is a very severe, life-threatening generalized or systemic hypersensitivity reaction. Based on immunologic mechanism the anaphylaxis is divided in IgE, IgG, complement, or immune complexes-mediated vs non allergic anaphylaxis. There are a lot of etiologic factors of anaphylaxis, but the three principal immunologic triggers are drugs, insect stings, and foods. Regarding the clinical severity there are several proposed grading systems. The diagnosis of anaphylaxis is mainly clinical. Discussion: The anaphylaxis markers measured in clinical laboratories are total tryptase and histamine. There are some conditions that modulate the onset of anaphylaxis, acting as co- or augmentation factors, which significantly lower the allergen dose necessary for triggering anaphylaxis. The well-documented cofactors of anaphylaxis are physical exercise, alcohol consumption, some foods, co-administration of nonsteroidal anti-inflammatory drugs (NSAID), and concomitant infectious diseases. Development of anaphylaxis depends on the sensitization pattern, the proportion of the involved immunoglobulin classes, characteristics of the allergen, the proportion of the involved immunoglobulin classes, the avidity and affinity of immunoglobulins to bind an allergen, the route of allergen application, and, last but not least, the presence of cofactors of anaphylaxis. Conclusion: Anaphylaxis remains a continuous challenge for the diagnosis and treatment. The adequate management of anaphylaxis requires rapid diagnosis, implementation of primary and secondary prevention measures, and immediate administration of subcutaneous epinephrine. PMID:25685088

  16. [Anaphylaxis as part of a clinical diagnosis of mastocytosi - case demonstration].

    PubMed

    Stobiecki, Marcin; Sacha, Małgorzata; Czarnobilska, Ewa

    2015-01-01

    Mastocytosis is a heterogeneous group of diseases characterized by excessive proliferation and accumulation of mast cells--in one or more organs. The number of symptoms and clinical prognosis vary depending on the disease. One of the most severe potential outcome of mastocytosis is anaphylactic shock. Early diagnosis and identification of triggers enables education and avoidance them. We describe the case of a 31-year-old woman with systemic mastocytosis (SM) without skin symptoms with multiple anaphylactic reactions, including two severe. Systemic mastocytosis was confirmed in bone marrow and genetic studies. We identify allergic triggers: latex and cefuroxime and also other non-immunological triggers as non-steroidal anti-inflammatory drugs (NSAIDs). The patient never had any allergic reaction after Hymenoptera stings. Only one result of serum tryptase was elevated. There was a need to determine the safety of antibiotic use and anesthetic drugs before cesarean. The moment when the disease was diagnosed and triggers were identifie, helped avoid further severe reactions. PMID:27024961

  17. Delayed Anaphylaxis to Red Meat Masquerading as Idiopathic Anaphylaxis

    PubMed Central

    Tripathi, Anubha; Commins, Scott P.; Heymann, Peter W.; Platts-Mills, Thomas A.E.

    2014-01-01

    Anaphylaxis is traditionally recognized as a rapidly developing combination of symptoms often including hives and hypotension or respiratory symptoms. Furthermore, when a specific cause is identified, exposure to this cause is usually noted to have occurred within minutes to 2 hours before the onset of symptoms. This case is of a 79 year-old female who developed a severe episode of anaphylaxis 3 hours after eating pork. Prior to 2012, she had not experienced any symptoms after ingestion of meat products. Delayed anaphylaxis to mammalian meat has many contrasting features to immediate food-induced anaphylaxis. The relevant IgE antibody is specific for the oligosaccharide galactose-alpha-1,3-galactose (alpha-gal), a blood group substance of non-primate mammals. Evidence from Australia, Sweden, and the U.S. demonstrates that the primary cause of this IgE antibody response is tick bites. These bites characteristically itch for ten days or more. Diagnosis can be made by the presence of specific IgE to beef, pork, lamb, and milk and lack of IgE to chicken, turkey, and fish. Prick skin tests (but not intradermal tests) are generally negative. Management of these cases, now common across the southeastern U.S., consists of education combined with avoidance of both red meat and further tick bites. PMID:24811014

  18. Chlorhexidine: an unrecognised cause of anaphylaxis.

    PubMed

    Odedra, Katy Mara; Farooque, Sophie

    2014-12-01

    Chlorhexidine is a highly effective antiseptic and disinfectant. In the past 20 years there has been a substantial increase in the number of chlorhexidine containing products used in healthcare. Anaphylaxis to chlorhexidine was first reported in 1984 and was almost always seen in men. However, in the last 4 years we have observed a surge in confirmed cases of anaphylaxis to chlorhexidine, with increasing numbers of female patients recently diagnosed. Yet, awareness of chlorhexidine as a cause of anaphylaxis is low because it is not a drug but a 'hidden' allergen, for example as a coating on medical devices such as central lines and urinary catheters. Patients will often have more than one allergic/anaphylactic reaction before the diagnosis is suspected. We have observed that there is poor recognition of an initial allergic reaction to chlorhexidine, which is well described. This, alongside poor labelling of chlorhexidine containing products, has resulted in further inadvertent exposure resulting in severe anaphylaxis. Prompt referral to a specialist allergy centre ensures appropriate investigations, diagnosis and management. Increasing awareness of the potential risk of life-threatening anaphylaxis associated with chlorhexidine use is vital, particularly in perioperative procedures. Healthcare workers are fundamental in avoiding and preventing further reactions to chlorhexidine containing products in patients diagnosed with anaphylaxis to chlorhexidine. PMID:25352674

  19. [Approach and Registry of Anaphylaxis in Portugal].

    PubMed

    Mota, Inês; Pereira, Ana Margarida; Pereira, Celso; Tomaz, Elza; Ferreira, Manuel Branco; Sabino, Filipa; Coelho, Anabela; Santos, Anabela; Martins, Henrique; Morais-Almeida, Mário

    2015-01-01

    Anaphylaxis has a growing incidence, especially in children. It represents a medical emergency and its successful therapy depends on early and proper intervention. Intramuscular epinephrine, with dose adjustment according to weight and age, is the drug of choice for anaphylaxis treatment. After resolution of the acute reaction, the patient should be kept under clinical surveillance for 6 to 24 hours, due to possible biphasic reactions. Prescription of an epinephrine auto injectable device should be considered in all patients with diagnosed or suspected anaphylaxis; additionally these patients should always be referred to an Immunoallergy consultation, to perform adequate investigation and management in order to reduce future risk. All anaphylaxis episodes must be recorded in The Portuguese Catalogue of Allergies and other Adverse Reactions (Catálogo Português de Alergias e outras Reações Adversas, CPARA), which represents a fundamental tool to share clinical information within the Health System. The present manuscript intends to disclose the most recent Portuguese guidelines for the diagnosis and treatment of anaphylaxis, making its clinical approach more effective and homogeneous, and to promote the use of The Portuguese Catalogue of Allergies and other Adverse Reactions as an essential tool to register and share information on anaphylaxis in Portugal. PMID:26849768

  20. Anaphylaxis: a payor's perspective on epinephrine autoinjectors.

    PubMed

    Dunn, Jeffrey D; Sclar, David A

    2014-01-01

    The scope of expenditures due to anaphylaxis likely is underestimated by health care payors because anaphylaxis is underdiagnosed and, when reported, most costs of anaphylaxis borne by payors relate to direct medical expenses. Direct costs of anaphylaxis have been estimated at $1.2 billion per year, with direct expenditures of $294 million for epinephrine, and indirect costs of $609 million. More accurate diagnostic coding will allow payors to improve their understanding of the full impact of anaphylaxis on health care plans, employers, patients, and their families. Similarly, more accurate diagnosis and treatment of anaphylaxis should have a direct effect on overall cost savings achieved in this disease state. This includes savings in both direct costs, such as emergency department visits, and indirect costs, such as lost productivity of patients and caregivers. Educating medical personnel on treatment guidelines regarding the specific use of appropriate epinephrine autoinjectors will contribute to cost savings. Even though the cost of autoinjectors has been increasing, evidence indicates that the cost of improper response to, and treatment of, anaphylaxis outweighs that increase. At this time, there are several branded epinephrine autoinjectors and one generic equivalent for one of these branded products available on the US market; the branded autoinjectors are not considered equivalents for substitution. Barriers to coverage and access, such as managed care organization tier classification, medication copay, and socioeconomic status of specific patients, need to be examined more closely and addressed. Education in the proper use of epinephrine autoinjectors, including regular checking of medication expiration dates, is critical for proper management of anaphylaxis and minimizing the costs of anaphylactic events. Managed care organizations can play a role in educational initiatives. PMID:24384137

  1. Anesthetic-induced anaphylaxis.

    PubMed

    Norred, Carol L

    2012-04-01

    The purpose of this course is to update nurse anesthetists about anesthetic-induced anaphylaxis. This course discusses the pathophysiologic process of anaphylaxis with descriptions of the allergic immune response and the mediators and mechanisms of mast cell activation. The preoperative identification of patients at high risk and the assessment of potential anesthetic triggers of a hypersensitivity and/or allergic reaction are prudent strategies to minimize the risk of anaphylaxis. Other practices recommended for clinicians include suggestions for anesthetic management to decrease threat of an allergic response in high-risk patients. Furthermore, the identification of the severity grade of hypersensitivity reactions and the appropriate treatment of perioperative anaphylaxis is discussed. In addition, postoperative and follow-up interventions, including testing for patients who have had an anesthetic-induced hypersensitivity reaction, are considered. PMID:22586882

  2. Marking nut anaphylaxis

    PubMed Central

    Kral, Anita Christine; Hayball, John; Smith, William B

    2016-01-01

    Marking nut Semecarpus anacardium, so-called because it contains a pigment that has been used in the past to mark fabrics, is a known cause of contact hypersensitivity. It may be ingested as an ingredient of some traditional Hindi foods. We describe the first reported case of anaphylaxis to marking nut. PMID:27489793

  3. Marking nut anaphylaxis.

    PubMed

    Fok, Jie Shen; Kral, Anita Christine; Hayball, John; Smith, William B

    2016-07-01

    Marking nut Semecarpus anacardium, so-called because it contains a pigment that has been used in the past to mark fabrics, is a known cause of contact hypersensitivity. It may be ingested as an ingredient of some traditional Hindi foods. We describe the first reported case of anaphylaxis to marking nut. PMID:27489793

  4. Ranitidine-induced perioperative anaphylaxis: A rare occurrence and successful management

    PubMed Central

    Neema, Shekhar; Sen, Subrato; Chatterjee, Manas

    2016-01-01

    Perioperative anaphylaxis is a rare and catastrophic event. Anaphylaxis during perioperative period changes the entire management plan for the patient. Since a large number of drugs are administered to the patient during the short span of time, it becomes difficult to identify the culprit drug. This has an impact on the management of the patients who have to undergo surgery. Ranitidine is considered a safe drug used in perioperative period; however, rarely it can lead to perioperative anaphylaxis. We present one such case of ranitidine-induced perioperative anaphylaxis which was successfully managed by early diagnosis and avoidance of drug. PMID:27127327

  5. Ranitidine-induced perioperative anaphylaxis: A rare occurrence and successful management.

    PubMed

    Neema, Shekhar; Sen, Subrato; Chatterjee, Manas

    2016-01-01

    Perioperative anaphylaxis is a rare and catastrophic event. Anaphylaxis during perioperative period changes the entire management plan for the patient. Since a large number of drugs are administered to the patient during the short span of time, it becomes difficult to identify the culprit drug. This has an impact on the management of the patients who have to undergo surgery. Ranitidine is considered a safe drug used in perioperative period; however, rarely it can lead to perioperative anaphylaxis. We present one such case of ranitidine-induced perioperative anaphylaxis which was successfully managed by early diagnosis and avoidance of drug. PMID:27127327

  6. Library Advocacy

    ERIC Educational Resources Information Center

    Plunkett, Kate

    2010-01-01

    This paper is about the issue of advocacy. Standing at the vanguard of literacy, library media specialists have a unique role. However, it is time for media specialists to advocate their services in a proactive way. If library media specialists cannot, both individually and collectively, put advocacy at the forefront, then students will suffer the…

  7. Advocacy Simplified

    ERIC Educational Resources Information Center

    Dowd, Karen J.; Curva, Fely

    2008-01-01

    Most state professional associations promote and fund at some level, an advocacy program. These advocacy programs usually aim to support or plead for a program, policy, or proposal. They can range from simple communication to complex strategies, from daily interactions to annual productions, and from position papers to onsite, legislative visits.…

  8. Inadvertent advocacy.

    PubMed

    Wilhere, George F

    2012-02-01

    Policy advocacy is an issue regularly debated among conservation scientists. These debates have focused on intentional policy advocacy by scientists, but advocacy can also be unintentional. I define inadvertent policy advocacy as the act of unintentionally expressing personal policy preferences or ethical judgments in a way that is nearly indistinguishable from scientific judgments. A scientist may be well intentioned and intellectually honest but still inadvertently engage in policy advocacy. There are two ways to inadvertently engage in policy advocacy. First, a scientist expresses an opinion that she or he believes is a scientific judgment but it is actually an ethical judgment or personal policy preference. Second, a scientist expresses an opinion that he or she knows is an ethical judgment or personal policy preference but inadvertently fails to effectively communicate the nature of the opinion to policy makers or the public. I illustrate inadvertent advocacy with three examples: recovery criteria in recovery plans for species listed under the U.S. Endangered Species Act, a scientific peer review of a recovery plan for the Northern Spotted Owl (Strix occidentalis caurina), and the International Union for Conservation of Nature's definition of threatened. In each example, scientists expressed ethical judgments or policy preferences, but their value judgments were not identified as such, and, hence, their value judgments were opaque to policy makers and the public. Circumstances suggest their advocacy was inadvertent. I believe conservation scientists must become acutely aware of the line between science and policy and avoid inadvertent policy advocacy because it is professional negligence, erodes trust in scientists and science, and perpetuates an ethical vacuum that undermines the rational political discourse necessary for the evolution of society's values. The principal remedy for inadvertent advocacy is education of conservation scientists in an effort to

  9. [Cereal-dependent exercise-induced anaphylaxis].

    PubMed

    Seoane-Rodríguez, Marta; Caralli, María Elisa; Morales-Cabeza, Cristina; Micozzi, Sarah; De Barrio-Fernández, Manuel; Rojas Pérez-Ezquerra, Patricia

    2016-01-01

    Wheat-dependent exercise-induced anaphylaxis (WDEIA) is increasing. In vitro test such as omega-5-gliadin levels are useful in the diagnosis, while oral single blind challenge tests (OCT) with wheat plus exercise continuous being the gold standard diagnostic method. This paper reports the case of a 38-year-old woman, with several episodes of anaphylaxis after eating different foods and doing exercise after ingestion. An allergy study was performed with positive skin prick tests for wheat, barley and rye. Total IgE 238.0KU/L, positive specific IgE (>100KU/L) to wheat, barley and rye, and negative to rTri-a-19 omega-5 gliadin. OCT with bread and exercise was positive. In this case of wheat-dependent exerciseinduced anaphylaxis (WDEIA) with negative serum specific IgE to omega-5-gliadin, negative results with gamma, alpha, bheta y omega-gliadin doesn't exclude the diagnosis of WDEIA. PMID:26943835

  10. Exercise-induced anaphylaxis: A clinical view

    PubMed Central

    2012-01-01

    Exercise-induced anaphylaxis (EIA) is a distinct form of physical allergy. The development of anaphylaxis during exertion often requires the concomitant exposure to triggering factors such as intake of foods (food dependent exercise-induced anaphylaxis) or drugs prior to exercise, extreme environmental conditions. EIA is a rare, but serious disorder, which is often undetected or inadequately treated. This article summarizes current evidences on pathophysiology, diagnosis and management. We reviewed recent advances in factors triggering the release of mediators from mast cells which seems to play a pathogenetic role. A correct diagnosis is essential to avoid unnecessary restricted diet, to allow physical activity in subjects with EIA dependent from triggering factors such as food, and to manage attacks. An algorithm for diagnosing EIA based on medical history, IgE tests and exercise challenge test has been provided. In the long-term management of EIA, there is a need for educating patients and care-givers to avoid exposure to precipitating factors and to recognize and treat episodes. Future researches on existing questions are discussed. PMID:22980517

  11. Histamine and antihistamines in anaphylaxis.

    PubMed

    Winbery, Stephen L; Lieberman, Philip L

    2002-01-01

    Anaphylaxis and anaphylactoid reactions are potentially fatal. These disorders are sometimes iatrogenic, and increase with increased exposure to drugs, synthetic substances, and medical procedures. Non-IgE-mediated anaphylactoid reactions are common in medical settings and are clinically indistinguishable from anaphylaxis. These reactions may be unrecognized if a rigid classic definition of anaphylaxis is used. Histamine is a primary mediator of anaphylaxis and signs and symptoms of anaphylaxis can be reproduced by histamine infusion. Histamine triggers a cascade of inflammatory mediators and modulates its own release. H1-antihistamines are adjunctive treatment therapy for acute anaphylaxis and anaphylactoid reactions, in which many mediators of inflammation are involved. Compared with epinephrine, the first-response medication of choice, antihistamines have a slow onset of action, and they cannot block events that occur subsequent to histamine binding to its receptors. Antihistamines are an important component of regimens for the prevention of anaphylaxis and anaphylactoid reactions in patients at risk, and may eventually have more widespread application in the perioperative setting. In some instances, such as with exercise-induced anaphylaxis and reactions to latex in sensitized individuals, prophylaxis regimens are not always effective. H2-antagonists are not detrimental in the therapy of anaphylaxis and many studies show a favorable outcome when combining H1- and H2-antagonist therapy for prophylaxis. They should be added to therapy at the discretion of the treating physician. Because of decreased antimuscarinic and central nervous system side effects, the newer antihistamines can be given in high doses, allowing more complete blockade of histamine receptors. These agents should lead to a reevaluation of the usefulness of antihistamines in both the treatment of acute anaphylaxis and in prophylactic regimens. The unavailability of parenterally administered

  12. World Allergy Organization Guidelines for the Assessment and Management of Anaphylaxis

    PubMed Central

    Ardusso, Ledit R. F.; Bilò, M. Beatrice; El-Gamal, Yehia M.; Ledford, Dennis K.; Ring, Johannes; Sanchez-Borges, Mario; Senna, Gian Enrico; Sheikh, Aziz; Thong, Bernard Y.

    2011-01-01

    Abstract: The illustrated World Allergy Organization (WAO) Anaphylaxis Guidelines were created in response to absence of global guidelines for anaphylaxis. Uniquely, before they were developed, lack of worldwide availability of essentials for the diagnosis and treatment of anaphylaxis was documented. They incorporate contributions from more than 100 allergy/immunology specialists on 6 continents. Recommendations are based on the best evidence available, supported by references published to the end of December 2010. The Guidelines review patient risk factors for severe or fatal anaphylaxis, co-factors that amplify anaphylaxis, and anaphylaxis in vulnerable patients, including pregnant women, infants, the elderly, and those with cardiovascular disease. They focus on the supreme importance of making a prompt clinical diagnosis and on the basic initial treatment that is urgently needed and should be possible even in a low resource environment. This involves having a written emergency protocol and rehearsing it regularly; then, as soon as anaphylaxis is diagnosed, promptly and simultaneously calling for help, injecting epinephrine (adrenaline) intramuscularly, and placing the patient on the back or in a position of comfort with the lower extremities elevated. When indicated, additional critically important steps include administering supplemental oxygen and maintaining the airway, establishing intravenous access and giving fluid resuscitation, and initiating cardiopulmonary resuscitation with continuous chest compressions. Vital signs and cardiorespiratory status should be monitored frequently and regularly (preferably, continuously). The Guidelines briefly review management of anaphylaxis refractory to basic initial treatment. They also emphasize preparation of the patient for self-treatment of anaphylaxis recurrences in the community, confirmation of anaphylaxis triggers, and prevention of recurrences through trigger avoidance and immunomodulation. Novel strategies

  13. A pharmacologic review of anaphylaxis.

    PubMed

    Yunker, Nancy S; Wagner, Bradley J

    2014-01-01

    Anaphylaxis occurs in the surgical population and may have devastating consequences. Anaphylaxis and anaphylactoid reactions are immediate hypersensitivity reactions that are most commonly precipitated by medications, insect stings, and foods. In the surgical population, 47.4% of immediate hypersensitivity reactions were precipitated by neuromuscular blocking agents, followed by latex and antibiotics in 20% and 18.1% of cases, respectively. Initial treatment consists of removing the precipitating trigger, administering epinephrine, and correct patient positioning. Secondary prevention measures should be instituted to prevent future occurrences. All health care professionals should have an understanding of the clinical presentation and medical management of anaphylaxis to improve patient outcomes. PMID:25461639

  14. Anaphylaxis Due to Head Injury

    PubMed Central

    Bruner, Heather C.; Bruner, David I.

    2015-01-01

    Both anaphylaxis and head injury are often seen in the emergency department, but they are rarely seen in combination. We present a case of a 30-year-old woman who presented with anaphylaxis with urticaria and angioedema following a minor head injury. The patient responded well to intramuscular epinephrine without further complications or airway compromise. Prior case reports have reported angioedema from hereditary angioedema during dental procedures and maxillofacial surgery, but there have not been any cases of first-time angioedema or anaphylaxis due to head injury. PMID:25987924

  15. Anaphylaxis induced by lentil inhalation.

    PubMed

    Ayşenur, Kaya; Akan, Ayşegül; Mustafa, Erkoçoğlu; Müge, Toyran; Kocabaş, Can Naci

    2012-06-01

    Anaphylaxis is a rapid onset serious allergic reaction which may be fatal. Foods are the most common allergens leading to anaphylaxis especially for childhood. Most of the food-induced anaphylactic reactions take place after ingestion of the allergic food and only a few cases exist with anaphylactic reactions induced by inhalation of foods such as peanut, soybean and lupine. The case we present is unusual in that an 8 1/2-year-old boy developed anaphylaxis with the inhalation of steam from boiling lentils. PMID:22830298

  16. Munchausen Stridor-A Strong False Alarm of Anaphylaxis

    PubMed Central

    Oldham, Jennifer L.

    2014-01-01

    The diagnosis of anaphylaxis is often based on reported symptoms which may not be accurate and lead to major psychosocial and financial impacts. We describe two adult patients who were diagnosed as having recurrent anaphylaxis witnessed by multiple physicians based on recurrent laryngeal symptoms. The claimed cause was foods in one and drugs in the other. We questioned the diagnosis because of absent documentation of objective findings to support anaphylaxis, and the symptoms occurred during skin testing though the test sites were not reactive. Our initial skin testing with placebos reproduced the symptoms without objective findings. Subsequent skin tests with the suspected allergens were negative yet reproduced the symptoms without objective findings. Disclosing the test results markedly displeased one patient but reassured the other who subsequently tolerated the suspected allergen. In conclusion, these 2 patients' symptoms and evaluation were not supportive of their initial diagnosis of recurrent anaphylaxis. The compatible diagnosis was Munchausen stridor which requires psychiatric evaluation and behavior modification, but often rejected by patients. PMID:25374759

  17. Munchausen stridor-a strong false alarm of anaphylaxis.

    PubMed

    Bahna, Sami L; Oldham, Jennifer L

    2014-11-01

    The diagnosis of anaphylaxis is often based on reported symptoms which may not be accurate and lead to major psychosocial and financial impacts. We describe two adult patients who were diagnosed as having recurrent anaphylaxis witnessed by multiple physicians based on recurrent laryngeal symptoms. The claimed cause was foods in one and drugs in the other. We questioned the diagnosis because of absent documentation of objective findings to support anaphylaxis, and the symptoms occurred during skin testing though the test sites were not reactive. Our initial skin testing with placebos reproduced the symptoms without objective findings. Subsequent skin tests with the suspected allergens were negative yet reproduced the symptoms without objective findings. Disclosing the test results markedly displeased one patient but reassured the other who subsequently tolerated the suspected allergen. In conclusion, these 2 patients' symptoms and evaluation were not supportive of their initial diagnosis of recurrent anaphylaxis. The compatible diagnosis was Munchausen stridor which requires psychiatric evaluation and behavior modification, but often rejected by patients. PMID:25374759

  18. [Food-induced anaphylaxis - data from the anaphylaxis registry].

    PubMed

    Worm, Margitta; Grünhagen, Josefine; Dölle, Sabine

    2016-07-01

    Anaphylactic reactions due to food occur in the context of food allergy and, together with venom and drugs, are the most frequent elicitors of severe allergic reactions. In small children the most frequent elicitors of severe allergic reactions according to data from the anaphylaxis registry are hen's egg and milk, whereas in school children peanut and hazelnut are frequent elicitors of allergic reactions. Other frequent elicitors of anaphylactic reactions in childhood are wheat and soy. In adults the most frequent elicitors of severe allergic reactions due to food, based on data from the anaphylaxis registry, are wheat, soy, celery, shellfish and hazelnut. Rare elicitors of food-induced anaphylaxis in German-speaking countries are mustard and cabbage. However, the panel of rare elicitors of food-induced anaphylaxis show regional differences. As of March 2015, 17 cases of fatal anaphylaxis were registered and among these seven were food-induced. Co-factors can either trigger the elicitation of a severe allergic reaction or affect its severity. Among such co-factors are physical activity, the intake of certain drugs, and psychological stress. The data on the role of cofactors is sparse. The management of food-induced anaphylaxis includes acute management according to current guidelines, but also long-term management, which should include educational measures regarding treatment but also information about the food allergen in daily life. PMID:27255298

  19. Anaphylaxis in the pediatric patient: optimizing management and prevention.

    PubMed

    Wagner, Christine W

    2013-01-01

    Recent reports describing a rise in serious allergies and life-threatening reactions have prompted the need for pediatric nurse practitioners to re-evaluate and hone their clinical skills with regard to the recognition of anaphylaxis. An accredited symposium entitled, "Anaphylaxis in the Pediatric Patient: Optimizing Management and Prevention" was held in conjunction with the 2012 Annual Conference of the National Association of Pediatric Nurse Practitioners. This article is an accredited enduring activity from that symposium. Goals of this activity are to (a) provide participants with information regarding current trends in serious allergies and anaphylaxis, (b) discuss recommendations from clinical guidelines designed to standardize practice, and (c) address medical and educational needs of patients with anaphylaxis. This article focuses on the point of care where pediatric nurse practitioners require the diagnostic skills to determine whether a patient's acute symptoms are consistent with a diagnosis of anaphylaxis and whether epinephrine should be used to treat those symptoms. The rationale for the use of intramuscular epinephrine, insights into the development and execution of an emergency action plan, and patient education also are discussed. PMID:23419548

  20. A regional approach to unmet needs in anaphylaxis.

    PubMed

    Minale, P; Bignardi, D; Troise, C; Voltolini, S; Dignetti, P

    2016-05-01

    Allergic diseases are under-diagnosed and undertreated despite their wide prevalence, and particularly anaphylaxis is often under-estimated. Evidence-based anaphylaxis guidelines developed by principal allergy organizations agree on increased prevalence of anaphylaxis, especially in patients younger than 18 years (18-27,30): this trend highlights the need for actions on anaphylaxis management and prevention (3,4). Lack of prompt connection between emergency department and allergy unit after discharge, and of a dedicated ICD-9th identification code (18-26), can delay diagnosis and treatment of anaphylaxis (28,29). Also in the experience of our Allergy Unit, patients reach the allergist office after several attacks treated in ED (17), without a previous evaluation and risk assessment. Keeping in mind unmet needs in anaphylaxis (4), we focused on regional approaches to health care delivery. The key point of our project was to establish an active collaboration between allergist clinicians and their counterparts in emergency medicine, with a system of quick filing report of patients discharged from ED with the suspect of anaphylactic reaction, directed to a central allergy unit, acting in a hub and spoke model with the Ligurian allergy network (31). Aim of the project was to improve epidemiological data collection via direct connection among ED and allergy network; moreover, we tried to provide a quick and proper evaluation of all reported patients, identifying, when possible, the agent responsible for anaphylaxis, to provide instructions on how to minimize future exposure; as all individuals at risk for anaphylaxis should carry and know how to self-administer epinephrine, we managed to provide auto injector and proper training when appropriate. A follow up on readmissions was carried out during the study and four months later. In a 20 months observation period (2013/2014), 205 patients were reported: it was possible to reach a diagnosis and risk assessment in 64

  1. Severe anaphylaxis: the secret ingredient.

    PubMed

    Buergi, Andreas; Jung, Barbara; Padevit, Christian; John, Hubert; Ganter, Michael T

    2014-02-01

    In this case report, we describe a healthy urological patient who suffered severe intraoperative anaphylaxis to chlorhexidine, an ingredient contained in frequently used lubricants (Instillagel, Endosgel). Chlorhexidine is a well-known skin disinfectant and antiseptic component in mouthwash or other over the counter antiseptic pharmaceuticals. There is little awareness that commonly used lubricants may contain hidden chlorhexidine. After severe intraoperative anaphylaxis, it is important to investigate all potential (including hidden) agents that might have caused this life-threatening reaction. PMID:25611155

  2. History and classification of anaphylaxis.

    PubMed

    Ring, Johannes; Behrendt, Heidrun; de Weck, Alain

    2010-01-01

    Anaphylaxis as the maximal variant of an acute systemic hypersensitivity reaction can involve several organ systems, particularly the skin, respiratory tract, gastrointestinal tract and the cardiovascular system. The severity of anaphylactic reaction is variable and can be classified into severity grades I-IV. Some reactions are fatal. Most frequent elicitors of anaphylaxis are foods in childhood, later insect stings and drugs. The phenomenon itself has been described in ancient medical literature, but was actually recognized and named at the beginning of the 20th century by Charles Richet and Paul Portier. In the course of experiments starting on the yacht of the Prince of Monaco and continued in the laboratory in Paris, they tried to immunize dogs with extracts of Physalia species in an attempt to develop an antitoxin to the venom of the Portuguese man-of-war. While Charles Richet believed that anaphylaxis was a 'lack of protection', it has become clear that an exaggerated immune reaction, especially involving immunoglobulin E antibodies, is the underlying pathomechanism in allergic anaphylaxis besides immune complex reactions. Non-immunologically mediated reactions leading to similar clinical symptomatology have been called 'anaphylactoid' or 'pseudo-allergic'--especially by Paul Kallos--and are now called 'non-immune anaphylaxis' according to a consensus of the World Allergy Organization (WAO). The distinction of different pathophysiological processes is important since non-immune anaphylaxis cannot be detected by skin test or in vitro allergy diagnostic procedures. History and provocation tests are crucial. The intensity of the reaction is not only influenced by the degree of sensitization but also by concomitant other factors as age, simultaneous exposure to other allergens, underlying infection, physical exercise or psychological stress or concomitant medication (e.g. beta-blockers, NSAIDs); this phenomenon has been called augmentation or summation

  3. Improving Diagnostic Accuracy of Anaphylaxis in the Acute Care Setting

    PubMed Central

    Bjornsson, Hjalti M.; Graffeo, Charles S.

    2010-01-01

    The identification and appropriate management of those at highest risk for life-threatening anaphylaxis remains a clinical enigma. The most widely used criteria for such patients were developed in a symposium convened by National Institute of Allergy and Infectious Disease/Food Allergy and Anaphylaxis Network. In this paper we review the current literature on the diagnosis of acute allergic reactions as well as atypical presentations that clinicians should recognize. Review of case series reveals significant variability in definition and approach to this common and potentially life-threatening condition. Series on fatal cases of anaphylaxis indicate that mucocutaneous signs and symptoms occur less frequently than in milder cases. Of biomarkers studied to aid in the work-up of possible anaphylaxis, drawing blood during the initial six hours of an acute reaction for analysis of serum tryptase has been recommended in atypical cases. This can provide valuable information when a definitive diagnosis cannot be made by history and physical exam. PMID:21293765

  4. A 71-year-old man with anaphylaxis after eating grits

    PubMed Central

    Posthumus, Jonathon; Borish, Larry

    2014-01-01

    The allergist is frequently called on to evaluate patients after episodes of anaphylaxis to determine the cause and implement preventive measures that will reduce the patient’s risk from future episodes. The etiology of anaphylaxis can be the result of numerous causes that may go undiagnosed if a thorough evaluation is not performed. We present a 71-year-old man with no history of food allergy or atopy who presented to the emergency room and then our allergy clinic for evaluation after suffering anaphylaxis after a meal of grits and shrimp. The underlying diagnosis, which was subsequently determined, requires a high index of suspicion and should be included in the differential diagnosis of any patient presenting with unexplained anaphylaxis. PMID:22370536

  5. Anaphylaxis following a transvaginal ultrasound.

    PubMed

    Jakubovic, Baruch D; Saperia, Corey; Sussman, Gordon L

    2016-01-01

    Polyethylene glycol is a ubiquitous, water-soluble, organic compound found in a wide variety of commercially available products. While generally a benign substance, in rare instances, it can induce hypersensitivity reactions. Herein, we describe a case of anaphylaxis to polyethylene glycol-containing lubricating gel used for a transvaginal ultrasound. This case highlights the importance of early recognition of a rare cause of anaphylaxis that may occur in the health-care setting. It is of particular importance given the widespread use of similar lubricating materials in multiple practice settings for the use of internal examinations and ultrasonography. PMID:26807134

  6. The epidemiology of anaphylaxis in Europe: protocol for a systematic review

    PubMed Central

    2013-01-01

    Background The European Academy of Allergy and Clinical Immunology is in the process of developing its Guideline for Food Allergy and Anaphylaxis, and this systematic review is one of seven inter-linked evidence syntheses that are being undertaken in order to provide a state-of-the-art synopsis of the current evidence base in relation to epidemiology, prevention, diagnosis and clinical management and impact on quality of life, which will be used to inform clinical recommendations. The aims of this systematic review will be to understand and describe the epidemiology of anaphylaxis, i.e. frequency, risk factors and outcomes of anaphylaxis, and describe how these characteristics vary by person, place and time. Methods A highly sensitive search strategy has been designed to retrieve all articles combining the concepts of anaphylaxis and epidemiology from electronic bibliographic databases. Discussion This review will aim to provide some estimates of the incidence and prevalence of anaphylaxis in Europe. The occurrence of anaphylaxis can have a profound effect on the quality of life of the sufferer and their family. Estimates of disease frequency will help us to ascertain the burden of anaphylaxis and provide useful comparators for management strategies. PMID:23537345

  7. Odor-associated idiopathic anaphylaxis. A case report.

    PubMed

    Saunders, R L; Halpern, G M; Gershwin, M E

    1995-01-01

    A 44 year old woman is described who appears to have idiopathic anaphylaxis triggered by chemical odors. Her case and a general discussion of anaphylaxis are presented. The known causes of anaphylaxis and a discourse on idiopathic anaphylaxis are given. The treatment of idiopathic anaphylaxis is discussed. PMID:7631593

  8. Fatal anaphylaxis in the United States 1999-2010: temporal patterns and demographic associations

    PubMed Central

    Jerschow, Elina; Lin, Robert Y.; Scaperotti, Moira M.; McGinn, Aileen P.

    2014-01-01

    Background Anaphylaxis-related deaths in the United States (US) have not been well characterized in recent years. Objectives To define epidemiological features and time trends of fatal anaphylaxis in the US from 1999 to 2010. Methods Anaphylaxis-related deaths were identified by the 10th clinical modification of the International Classification of Diseases (ICD-10) system diagnostic codes on death certificates from the US National Mortality Database. Rates were calculated using census population estimates. Results There were a total of 2,458 anaphylaxis deaths in the US from 1999 to 2010. Medications were the most common cause (58.8%), followed by unspecified anaphylaxis (19.3%), venom (15.2%), and food (6.7%). There was a significant increase in fatal drug anaphylaxis over twelve years: from 0.27 (95%CI: 0.23-0.30) in 1999-2001 to 0.51 (95%CI: 0.47-0.56) per million in 2008-2010, P<0.001. Fatal anaphylaxis due to medications, food, and unspecified allergens was significantly associated with African-American race and older age, P<0.001. Fatal anaphylaxis to venom was significantly associated with White race, older age, and male gender, P<0.001. The rates of fatal anaphylaxis to foods in African-American males increased from 0.06 (95%CI 0.01-0.17) in 1999-2001 to 0.21 (95%CI 0.11-0.37) per million in 2008-2010, P<0.001. The rates of unspecified fatal anaphylaxis decreased overtime from 0.30 (95%CI: 0.26-0.34) in 1999-2001 to 0.09 (95%CI: 0.07-0.11) per million in 2008-2010, P<0.001. Conclusion There are strong and disparate associations between race and specific classes of anaphylaxis mortality in the United States. The increase in medication-related anaphylaxis deaths likely relates to increased medication and radiocontrast use, enhanced diagnosis, and coding changes. PMID:25280385

  9. Anaphylaxis and cardiovascular disease: therapeutic dilemmas.

    PubMed

    Lieberman, P; Simons, F E R

    2015-08-01

    Cardiovascular disease (CVD) increases the risk of severe or fatal anaphylaxis, and some medications for CVD treatment can exacerbate anaphylaxis. The aim of this article is to review the effect of anaphylaxis on the heart, the potential impact of medications for CVD on anaphylaxis and anaphylaxis treatment, and the cardiovascular effects of epinephrine. The therapeutic dilemmas arising from these issues are also discussed and management strategies proposed. PubMed searches were performed for the years 1990-2014 inclusive, using terms such as angiotensin-converting enzyme (ACE) inhibitors, adrenaline, allergic myocardial infarction, anaphylaxis, angiotensin-receptor blockers (ARBs), beta-adrenergic blockers, epinephrine, and Kounis syndrome. Literature analysis indicated that: cardiac mast cells are key constituents of atherosclerotic plaques; mast cell mediators play an important role in acute coronary syndrome (ACS); patients with CVD are at increased risk of developing severe or fatal anaphylaxis; and medications for CVD treatment, including beta-adrenergic blockers and ACE inhibitors, potentially exacerbate anaphylaxis or make it more difficult to treat. Epinephrine increases myocardial contractility, decreases the duration of systole relative to diastole, and enhances coronary blood flow. Its transient adverse effects include pallor, tremor, anxiety, and palpitations. Serious adverse effects (including ventricular arrhythmias and hypertension) are rare, and are significantly more likely after intravenous injection than after intramuscular injection. Epinephrine is life-saving in anaphylaxis; second-line medications (including antihistamines and glucocorticoids) are not. In CVD patients (especially those with ACS), the decision to administer epinephrine for anaphylaxis can be difficult, and its benefits and potential harms need to be carefully considered. Concerns about potential adverse effects need to be weighed against concerns about possible death from

  10. Anaphylaxis: guidelines from the European Academy of Allergy and Clinical Immunology.

    PubMed

    Muraro, A; Roberts, G; Worm, M; Bilò, M B; Brockow, K; Fernández Rivas, M; Santos, A F; Zolkipli, Z Q; Bellou, A; Beyer, K; Bindslev-Jensen, C; Cardona, V; Clark, A T; Demoly, P; Dubois, A E J; DunnGalvin, A; Eigenmann, P; Halken, S; Harada, L; Lack, G; Jutel, M; Niggemann, B; Ruëff, F; Timmermans, F; Vlieg-Boerstra, B J; Werfel, T; Dhami, S; Panesar, S; Akdis, C A; Sheikh, A

    2014-08-01

    Anaphylaxis is a clinical emergency, and all healthcare professionals should be familiar with its recognition and acute and ongoing management. These guidelines have been prepared by the European Academy of Allergy and Clinical Immunology (EAACI) Taskforce on Anaphylaxis. They aim to provide evidence-based recommendations for the recognition, risk factor assessment, and the management of patients who are at risk of, are experiencing, or have experienced anaphylaxis. While the primary audience is allergists, these guidelines are also relevant to all other healthcare professionals. The development of these guidelines has been underpinned by two systematic reviews of the literature, both on the epidemiology and on clinical management of anaphylaxis. Anaphylaxis is a potentially life-threatening condition whose clinical diagnosis is based on recognition of a constellation of presenting features. First-line treatment for anaphylaxis is intramuscular adrenaline. Useful second-line interventions may include removing the trigger where possible, calling for help, correct positioning of the patient, high-flow oxygen, intravenous fluids, inhaled short-acting bronchodilators, and nebulized adrenaline. Discharge arrangements should involve an assessment of the risk of further reactions, a management plan with an anaphylaxis emergency action plan, and, where appropriate, prescribing an adrenaline auto-injector. If an adrenaline auto-injector is prescribed, education on when and how to use the device should be provided. Specialist follow-up is essential to investigate possible triggers, to perform a comprehensive risk assessment, and to prevent future episodes by developing personalized risk reduction strategies including, where possible, commencing allergen immunotherapy. Training for the patient and all caregivers is essential. There are still many gaps in the evidence base for anaphylaxis. PMID:24909803

  11. Food-dependent exercise-induced anaphylaxis due to wheat in a young woman.

    PubMed

    Ahanchian, Hamid; Farid, Reza; Ansari, Elham; Kianifar, Hamid Reza; Jabbari Azad, Farahzad; Jafari, Seyed Ali; Purreza, Reza; Noorizadeh, Shadi

    2013-03-01

    Food Dependent Exercise-Induced Allergy is a rare condition. However, the occurrence of anaphylaxis is increasing especially in young people. The diagnosis of anaphylaxis is based on clinical criteria and can be supported by laboratory tests such as serum tryptase and positive skin test results for specific IgE to potential triggering allergens. Anaphylaxis prevention needs strict avoidance of confirmed relevant allergen. Food-exercise challenge test may be an acceptable method for diagnosis of Food Dependent Exercise-Induced Allergy and dietary elimination of food is recommended to manage it. In this study, a 32 year-old woman visited the allergy clinic with a history of several episodes of hives since 11 years ago and 3 life-threatening attacks of anaphylaxis during the previous 6 months. The onsets of majority of these attacks were due to physical activity after breakfast. On Blood RAST test, the panel of common food Allergens was used and she had positive test only to wheat flour. On skin prick tests for common food allergens she showed a 6 millimeter wheal with 14 mm flare to Wheat Extract. The rest of allergens were negative.The patient was diagnosed as wheat-dependent exercise-induced, and all foods containing wheat were omitted from her diet. In this report we emphasized on the importance of careful history taking in anaphylaxis diagnosis. PMID:23454785

  12. [Self-Advocacy.

    ERIC Educational Resources Information Center

    Carr, Theresa, Ed.

    1994-01-01

    This theme issue presents personal perspectives and approaches to self-advocacy from individuals who are deaf-blind. Individual articles are: (1) "Self-Advocacy: Attaining Personal Stature" by Michelle J. Smithdas; (2) "The American Association of the Deaf-Blind: A National Consumer Advocacy Organization" by Jeffrey S. Bohrman; (3) a description…

  13. Recognition and management of food induced anaphylaxis

    PubMed Central

    Keet, Corinne

    2011-01-01

    Synopsis Food-induced anaphylactic reactions are common and increasing in frequency. Despite the existence of a consensus definition of anaphylaxis, many cases are missed, recommended treatments are not given and follow-up is inadequate. New aspects of its pathophysiology and causes, including atypical food-induced causes., are still being uncovered. Epinephrine remains the cornerstone for successfully treating anaphylaxis; H1 and H2 antihistamines, glucocorticoids and β-agonists are ancillary medications that may be used in some cases in addition to epinephrine. However, the added utility of these secondary medications in anaphylaxis has not been conclusively demonstrated. Early recognition of anaphylaxis, appropriate emergency treatment and follow-up, including prescription of self-injectable epinephrine, are essential to prevent death and significant morbidity from anaphylaxis. PMID:21453808

  14. Occupational anaphylaxis--an EAACI task force consensus statement.

    PubMed

    Siracusa, A; Folletti, I; Gerth van Wijk, R; Jeebhay, M F; Moscato, G; Quirce, S; Raulf, M; Ruëff, F; Walusiak-Skorupa, J; Whitaker, P; Tarlo, S M

    2015-02-01

    Anaphylaxis is a systemic allergic reaction, potentially life-threatening that can be due to nonoccupational or, less commonly, to occupational triggers. Occupational anaphylaxis (OcAn) could be defined as anaphylaxis arising out of triggers and conditions attributable to a particular work environment. Hymenoptera stings and natural rubber latex are the commonest triggers of OcAn. Other triggers include food, medications, insect/mammal/snake bites, and chemicals. The underlying mechanisms of anaphylactic reactions due to occupational exposure are usually IgE-mediated and less frequently non-IgE-mediated allergy or nonallergic. Some aspects of work-related allergen exposure, such as route and frequency of exposure, type of allergens, and cofactors may explain the variability of symptoms in contrast to the nonoccupational setting. When assessing OcAn, both confirmation of the diagnosis of anaphylactic reaction and identification of the trigger are required. Prevention of further episodes is important and is based on removal from further exposure. Workers with a history of OcAn should immediately be provided with a written emergency management plan and an adrenaline auto-injector and educated to its use. Immunotherapy is recommended only for OcAn due to Hymenoptera stings. PMID:25369880

  15. Mechanisms of Anaphylaxis Beyond IgE.

    PubMed

    Muñoz-Cano, R; Picado, C; Valero, A; Bartra, J

    2016-01-01

    Anaphylaxis is an acute, life-threatening, multisystem syndrome resulting from the sudden release of mediators derived from mast cells and basophils. Food allergens are the main triggers of anaphylaxis, accounting for 33%-56% of all cases and up to 81% of cases of anaphylaxis in children. Human anaphylaxis is generally thought to be mediated by IgE, with mast cells and basophils as key players, although alternative mechanisms have been proposed. Neutrophils and macrophages have also been implicated in anaphylactic reactions, as have IgG-dependent, complement, and contact system activation. Not all allergic reactions are anaphylactic, and the presence of the so-called accompanying factors (cofactors or augmenting factors) may explain why some conditions lead to anaphylaxis, while in other cases the allergen elicits a milder reaction or is even tolerated. In the presence of these factors, allergic reactions may be induced at lower doses of allergen or become more severe. Cofactors are reported to be relevant in up to 30% of anaphylactic episodes. Nonsteroidal anti-inflammatory drugs and exercise are the best-documented cofactors, although estrogens, angiotensin-converting enzyme inhibitors, β-blockers, lipid-lowering drugs, and alcohol have also been involved. The mechanisms underlying anaphylaxis are complex and involve several interrelated pathways. Some of these pathways may be key to the development of anaphylaxis, while others may only modulate the severity of the reaction. An understanding of predisposing and augmenting factors could lead to the development of new prophylactic and therapeutic approaches. PMID:27164622

  16. Two cases of food-dependent exercise-induced anaphylaxis with different culprit foods

    PubMed Central

    Mobayed, Hassan M.S.; Ali Al-Nesf, Maryam

    2014-01-01

    Food-dependent exercise-induced anaphylaxis (FDEIA) is one of the severe allergic reactions in which symptoms develop only if exercise takes place within a few hours of eating a specific food. It is important to consider FDEIA in cases of unexplained anaphylaxis as reactions can occur several hours after ingesting the culprit food(s). We herein report the first two cases of FDEIA in the Middle East. The first one is induced by wheat, while the other by peanut. The pathophysiology, predisposing factors, diagnosis, and treatment of FDEIA are also summarized here. PMID:24551018

  17. Anaphylaxis

    MedlinePlus

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  18. Anaphylaxis

    MedlinePlus

    ... After being exposed to a substance such as bee sting venom, the person's immune system becomes sensitized ... person. If the allergic reaction is from a bee sting, scrape the stinger off the skin with ...

  19. Anaphylaxis

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  20. Pathophysiological mechanisms of exercise-induced anaphylaxis: an EAACI position statement.

    PubMed

    Ansley, L; Bonini, M; Delgado, L; Del Giacco, S; Du Toit, G; Khaitov, M; Kurowski, M; Hull, J H; Moreira, A; Robson-Ansley, P J

    2015-10-01

    This document is the result of a consensus on the mechanisms of exercise-induced anaphylaxis (EIAn), an unpredictable and potentially fatal syndrome. A multidisciplinary panel of experts including exercise physiologists, allergists, lung physicians, paediatricians and a biostatistician reached the given consensus. Exercise-induced anaphylaxis (EIAn) describes a rare and potentially fatal syndrome in which anaphylaxis occurs in conjunction with exercise. The pathophysiological mechanisms underlying EIAn have not yet been elucidated although a number of hypotheses have been proposed. This review evaluates the validity of each of the popular theories in relation to exercise physiology and immunology. On the basis of this evidence, it is concluded that proposed mechanisms lack validity, and it is recommended that a global research network is developed with a common approach to the diagnosis and treatment of EIAn in order to gain sufficient power for scientific evaluation. PMID:26100553

  1. Allergy evaluation after emergency treatment: anaphylaxis to the over-the-counter medication clobutinol.

    PubMed

    Seitz, Cornelia S; Bröcker, Eva-B; Trautmann, Axel

    2007-03-01

    Anaphylaxis is traditionally diagnosed and treated as an acute emergency but should be always followed by a search for specific triggers, resulting in avoidance strategies. This case report highlights the relevance of a detailed evaluation after anaphylaxis for diagnosis of a rare but potentially life-threatening allergy. Considering the high frequency of clobutinol application, IgE-mediated allergic hypersensitivity seems extremely rare and has to be distinguished from infection-associated urticaria and angioedema as well as non-specific summation effects. Accidental re-exposure has to be strictly avoided and therefore after identification of clobutinol as the anaphylaxis trigger, the patient received detailed allergy documents including international non-proprietary and trade names of the culprit drug. PMID:17351213

  2. Allergy evaluation after emergency treatment: anaphylaxis to the over‐the‐counter medication clobutinol

    PubMed Central

    Seitz, Cornelia S; Bröcker, Eva‐B; Trautmann, Axel

    2007-01-01

    Anaphylaxis is traditionally diagnosed and treated as an acute emergency but should be always followed by a search for specific triggers, resulting in avoidance strategies. This case report highlights the relevance of a detailed evaluation after anaphylaxis for diagnosis of a rare but potentially life‐threatening allergy. Considering the high frequency of clobutinol application, IgE‐mediated allergic hypersensitivity seems extremely rare and has to be distinguished from infection‐associated urticaria and angioedema as well as non‐specific summation effects. Accidental re‐exposure has to be strictly avoided and therefore after identification of clobutinol as the anaphylaxis trigger, the patient received detailed allergy documents including international non‐proprietary and trade names of the culprit drug. PMID:17351213

  3. [Emergency treatment and management of anaphylaxis].

    PubMed

    Brockow, K; Ring, J

    2013-02-01

    Anaphylaxis, the maximal manifestation of an immediate allergic reaction, is a life-threatening systemic reaction. The immediate therapy is chosen according to the clinical manifestations and new German guidelines are in preparation. Required measures include immediate removal of allergen, adequate positioning, assessment of severity and organ involvement and activation of emergency medical services. In anaphylaxis with primarily cardiovascular involvement, epinephrine is the treatment of choice and given together with volume substitution, oxygen, H(1)-antihistamines and corticosteroids. Obstruction of the airways is treated with intramuscular and inhaled epinephrine, or alternatively β(2)-sympathicomimetics, and oxygen. Abdominal or cutaneous involvement, such as generalized urticaria, usually can be treated with intravenous H(1)-antihistamines, glucocorticoids and surveillance. In patients with anaphylaxis, the elicitor of the reaction has to be diagnosed by allergy testing. Patients with sustained risk for anaphylaxis should receive a self-medication kit and should be educated about behavioral patterns needed for prophylaxis and therapy of anaphylactic reactions. Patient educational intervention increases knowledge about anaphylaxis, and practical competence and thus, is a basis of a successful management of anaphylaxis. PMID:23385622

  4. Management of anaphylaxis: a systematic review.

    PubMed

    Dhami, S; Panesar, S S; Roberts, G; Muraro, A; Worm, M; Bilò, M B; Cardona, V; Dubois, A E J; DunnGalvin, A; Eigenmann, P; Fernandez-Rivas, M; Halken, S; Lack, G; Niggemann, B; Rueff, F; Santos, A F; Vlieg-Boerstra, B; Zolkipli, Z Q; Sheikh, A

    2014-02-01

    To establish the effectiveness of interventions for the acute and long-term management of anaphylaxis, seven databases were searched for systematic reviews, randomized controlled trials, quasi-randomized controlled trials, controlled clinical trials, controlled before-after studies and interrupted time series and - only in relation to adrenaline - case series investigating the effectiveness of interventions in managing anaphylaxis. Fifty-five studies satisfied the inclusion criteria. We found no robust studies investigating the effectiveness of adrenaline (epinephrine), H1-antihistamines, systemic glucocorticosteroids or methylxanthines to manage anaphylaxis. There was evidence regarding the optimum route, site and dose of administration of adrenaline from trials studying people with a history of anaphylaxis. This suggested that administration of intramuscular adrenaline into the middle of vastus lateralis muscle is the optimum treatment. Furthermore, fatality register studies have suggested that a failure or delay in administration of adrenaline may increase the risk of death. The main long-term management interventions studied were anaphylaxis management plans and allergen-specific immunotherapy. Management plans may reduce the risk of further reactions, but these studies were at high risk of bias. Venom immunotherapy may reduce the incidence of systemic reactions in those with a history of venom-triggered anaphylaxis. PMID:24251536

  5. A History of Music Education Advocacy.

    ERIC Educational Resources Information Center

    Mark, Michael L.

    2002-01-01

    Provides a history of advocacy in music education discussing when formal advocacy started as well as advocacy with government agencies, the state level, and other types of advocacy. Includes a bibliography of resources related to music advocacy. (CMK)

  6. Improving Music Education Advocacy

    ERIC Educational Resources Information Center

    Elpus, Kenneth

    2007-01-01

    Music education has always required advocacy to solidify its place in the school curriculum. Music teachers are increasingly called on to justify their existence and importance in the schools, and yet, are often unprepared to advocate on their own behalf without the use of advocacy materials that are created on the basis of questionable research,…

  7. Philosophy + Advocacy = Success

    ERIC Educational Resources Information Center

    Tutt, Kevin; Townley, Marc

    2011-01-01

    Knowledge about music advocacy strategies has long been promoted as important for music educators, not only for the benefit of their individual programs but also for the specific benefit of music students and the general public. This article suggests an approach to advocacy grounded in the teacher's professional beliefs, phrased in terms…

  8. Community health advocacy

    PubMed Central

    Loue, Sana

    2006-01-01

    Competing health needs of diverse populations and ever shrinking resources available to support these needs often serve as the impetus for the initiation of advocacy efforts to improve community health. However, perceptions of what constitutes a community differ, as do approaches to advocacy itself. This glossary addresses five key questions: (1) What is advocacy?; (2) What is meant by community?; (3) What are the different approaches to community health advocacy?; (4) How are priorities established in the face of competing health advocacy goals?; (5) How can community health advocacy efforts be evaluated?; and (6) What challenges may be encountered in advocating for community health? Each of these issues could serve as the basis for a text on that subject alone. Accordingly, this article is not meant to be comprehensive text on these issues but is, instead, intended to highlight key foundational issues. And, although advocacy efforts can be conducted by individuals, this article focuses specifically on advocacy efforts of communities, however they may be defined and characterised. PMID:16698972

  9. Handbook for Rehabilitation Advocacy.

    ERIC Educational Resources Information Center

    National Rehabilitation Association, Alexandria, VA.

    This handbook is intended to help advocates for persons with disabilities organize for advocacy, build effective coalitions, frame key issues, package critical information, and use the media to advance the cause. Individual sections address the following topics: how to change public policy; myths about advocacy; what makes politicians tick;…

  10. Anaphylaxis: incidence, presentation, causes and outcome in patients in a tertiary-care hospital in Karachi, Pakistan

    PubMed Central

    Shakeel, N.; Makda, A.; Mallick, A.S.; Ali Memon, M.; Hashmi, S.H.; Khan, U.R.; Razzak, J.A.

    2013-01-01

    Background: Anaphylaxis is a potentially fatal condition requiring immediate resuscitation. Data regarding the epidemiology of anaphylaxis are limited and inconsistent. A reason for the variability was unavailability of a universally acceptable case definition till 2005. We reviewed cases using this new definition Aim: To review the incidence, clinical presentation, cause and outcome of anaphylaxis at a tertiary-care centre in a low-income country. Design: Retrospective, case series Methods: Chart review of all patients discharged from Aga Khan University Hospital between January 1988 and December 2012 (24 years) with anaphylaxis definition as per second National Institute of Allergy and Infection disease/Food Allergy and Anaphylaxis Network Symposium Results: Total of 129 cases were found with mean age of 41.6 years (SD 18.8). Majority of patients had cutaneous features (76.7%), followed by respiratory (68.9%), cardiac (64.3%) and gastrointestinal (20.9%) symptoms, respectively. About 22.4% of patients had positive history for allergens out of which 31% (n = 9) were exposed to the same allergens. The common causes identified for anaphylaxis were drugs (60.5%), food (16.3%) and intravenous contrast (10.9%), respectively. Only 22.5% of cases received epinephrine as a part of their initial management. In four patients (3.1%) the cause of death was attributed to anaphylaxis. Conclusion: Anaphylaxis is a rare but life-threatening condition. Though cutaneous features are most common, their absence does not exclude the diagnosis. Drugs were the most common cause and epinephrine was not commonly used as first-line agent for its management. PMID:24082151

  11. Anaphylaxis in the young adult population.

    PubMed

    Gupta, Ruchi S

    2014-01-01

    It is critical that clinicians treating young adults understand the presentation and management of anaphylaxis. The most common trigger for anaphylaxis in this population is food. The prevalence of food allergy is growing, with 8% of US children and adolescents affected. All patients at risk for anaphylaxis should be prescribed epinephrine autoinjectors, as epinephrine is the only life-saving medication for a severe anaphylactic reaction. The presentation of anaphylaxis can involve multiple organ systems (eg, mucocutaneous, respiratory, cardiovascular, gastrointestinal) and, as such, patient education is needed to assist in prompt recognition. Appropriate training of patients and caregivers about how to identify anaphylaxis and what to do in an emergency is critical. Training of school and college staff also is essential, as 1 in 4 first-time reactions occurs outside the home. Additional counseling for adolescents at risk for anaphylactic reactions should address increased risk-taking behavior, decreased adult supervision, dating, and the transition of disease management from an adult to the patient. PMID:24384134

  12. Self-Advocacy. Feature Issue.

    ERIC Educational Resources Information Center

    Hayden, Mary F., Ed.; Ward, Nancy, Ed.

    1994-01-01

    This feature issue newsletter looks at issues the self-advocacy movement is raising and the contributions it is making to the lives of people with developmental disabilities. Articles by self-advocates and advisors to self-advocacy organizations talk about their self-advocacy experiences, barriers to self-advocacy, and ways to support it. Primary…

  13. Jackfruit anaphylaxis in a latex allergic patient.

    PubMed

    Wongrakpanich, Supakanya; Klaewsongkram, Jettanong; Chantaphakul, Hiroshi; Ruxrungtham, Kiat

    2015-03-01

    Several fruits have been reported to crossreact with latex antigen in latex allergy patients but little is known regarding tropical fruits in particular. Here we report the case of a 34-year old nurse who developed anaphylaxis following the ingestion of dried jackfruit (Artocarpus heterophyllus). The patient had a history of chronic eczema on both hands resulting from a regular wear of latex gloves. She and her family also had a history of atopy (allergic rhinitis and/or atopic dermatitis). The results of skin prick tests were positive for jackfruit, latex glove, kiwi and papaya, but the test was negative for banana. While we are reporting the first case of jackfruit anaphylaxis, further research needs to be conducted to identify the mechanisms underlying it. In particular, in-vitro studies need to be designed to understand if the anaphylaxis we describe is due to a cross reactivity between latex and jackfruit or a coincidence of allergy to these 2 antigens. PMID:25840636

  14. Exercise-induced anaphylaxis and antileukotriene montelukast.

    PubMed

    Gajbhiye, Sapna; Agrawal, Rajendra Prasad; Atal, Shubham; Tiwari, Vikalp; Phadnis, Pradeep

    2015-01-01

    We report a rare case of exercise-induced anaphylaxis (EIA), occurring exclusively with exercise, without any other associated trigger, detected in the prodromal phase, and prevented from additional anaphylaxis episodes by treatment with cetirizine and 10 mg daily of antileukotriene montelukast to date. EIA is a syndrome in which patients experience a spectrum of the symptoms of anaphylaxis ranging from mild cutaneous signs to severe systemic manifestations such as hypotension, syncope, and even death after increased physical activity. Many people have triggers, such as, a variety of foods, various medications, alcohol, cold weather, humidity, and seasonal and hormonal changes along with exercise that cause the symptoms. Typically, either exercise or the specific trigger alone will rarely cause symptoms. It is differentiated from cholinergic urticaria by the absence of response to passive body warming and emotional stress. PMID:26312002

  15. An unexpected cause of anaphylaxis: potato.

    PubMed

    Eke Gungor, H; Uytun, S; Murat Sahiner, U; Altuner Torun, Y

    2016-07-01

    Immediate reactions against contact to raw potato has been reported in adults with generally being in the form of an oral contact dermatitis or contact urticaria, but it may also manifest as rhinitis symptoms, wheezing or even anaphylaxis. Cooked or raw potato allergy has been rarely reported in children as some is being immediate and others being late reactions, and it usually results from ingestion. Herein, we report two cases with a background of allergic diseases developed anaphylaxis one with cooked potato and the other one with raw potato. PMID:27425172

  16. Bladder Cancer Advocacy Network

    MedlinePlus

    ... future bladder cancer research through the Patient Survey Network. Read More... Don’t Miss the 2016 BCAN ... Click here for more details Bladder Cancer Advocacy Network 4915 St. Elmo Avenue, Suite 202 Bethesda, Maryland ...

  17. Anaphylaxis avoidance and management: educating patients and their caregivers

    PubMed Central

    Järvinen, Kirsi M; Celestin, Jocelyn

    2014-01-01

    Anaphylaxis is an increasingly prevalent problem in westernized countries. Therefore, it is of utmost importance that the increasing numbers of patients at risk for anaphylaxis receive proper education on the etiology and risk factors as well as appropriate treatment of anaphylaxis with epinephrine. The physician’s role is crucial in order to educate the patients and care takers on effective measures to prevent anaphylaxis and empower them to take charge of early recognition and proper management of an anaphylactic reaction to prevent poor outcomes. This review summarizes the clinical presentation, triggers, avoidance, and management of anaphylaxis. PMID:25031541

  18. Advocacy and technology assessment

    NASA Technical Reports Server (NTRS)

    Jones, E. M.

    1975-01-01

    A highly structured treatment is presented of adversarial systems as they apply to technology assessment. One approach to the problem of adequate criteria of assessment focuses upon the internal operations of assessment entities; operations include problem perception, problem formulation, selection, utilization, determination, and evaluation. Potential contributions of advocacy as a mode of inquiry in technology are discussed; advocacy is evaluated by representative sets of criteria of adequate assessment which include participant criteria, perspectives criteria, situations criteria, base values criteria, and strategies criteria.

  19. Anaphylaxis presentations to an emergency department in Hong Kong: incidence and predictors of biphasic reactions.

    PubMed

    Smit, De Villiers; Cameron, Peter A; Rainer, Timothy H

    2005-05-01

    We describe the epidemiology, clinical features and management of anaphylaxis in a population in Hong Kong, including the features associated with progression to biphasic reactions and the nature of these reactions. A retrospective review was undertaken of patients of all age groups, presenting consecutively to the resuscitation room of a large Hong Kong emergency department with the diagnosis of anaphylaxis, from March 1999 to February 2003. There were 282 patients included. Median age was 28 years, with 59% male. A precipitant was identified in 89%, with 19% of patients claiming a known allergy to the precipitant. Seafood was responsible for 71% of all food-related reactions. More patients reacted to nonsteroidal anti-inflammatory drugs rather than antibiotics. Cutaneous features were present in 79%, and 12% presented with hypotension. Ninety-five percent received H1 antagonist, and 67% received epinephrine. Biphasic reactions were reported in 15 (5.3%) cases with 20% of these patients having unstable vital signs. The mean time from treatment to onset of biphasic reaction was 8 h (range 1-23). Patients with respiratory features on initial presentation were less likely to develop biphasic reactions. It is concluded that prolonged observation of patients with anaphylaxis is important, because of the risk of biphasic reactions. Better education could prevent recurrent anaphylaxis. PMID:15837017

  20. Anaphylaxis: a one-year survey on Medical Emergency Service in Liguria (Italy).

    PubMed

    Ruffoni, S; Furgani, A; Schiavetti, I; Ciprandi, G

    2015-05-01

    Anaphylaxis is a severe, life-threatening, generalized or systemic hypersensitivity reaction. The diagnosis is mainly based on clinical ground. This study aimed at evaluating the records of phone calls and medical visits for anaphylaxis occurred in Region Liguria during 2013. The phone call is managed in each headquarter, and classified according to a level of care intensity and a presumed level of criticality, according to established criteria. Criticality is then re-evaluated (detected criticality) at the end of medical visit, following the same score adding the black code defining died patients. Most of the phone calls (553) to the MES were recorded in summer (37.4%). Anaphylaxis was confirmed in about half of patients. There was a fair agreement between presumed and detected criticality (k=0.322, p<0.001). In addition, 530 patients (95.8%) were transported to Emergency Room. In conclusion, the present study shows that anaphylaxis represents a serious and relevant medical problem in the general population at any age, and should always be carefully managed. PMID:25951146

  1. Anaphylaxis: How Do You Live with It?

    ERIC Educational Resources Information Center

    Mandell, Deena; Curtis, Ruth; Gold, Milton; Hardie, Susan

    2005-01-01

    This article reports on a study of the needs of families coping with life-threatening allergies in a child. Due to the scarcity of publications on the psychosocial dimensions of anaphylaxis, the authors draw on selected literature on family coping with chronic illness, asthma, and allergy to provide a conceptual context for the research and…

  2. Preparedness for Students and Staff with Anaphylaxis

    ERIC Educational Resources Information Center

    Morris, Patty; Baker, Dian; Belot, Carol; Edwards, Audrey

    2011-01-01

    Background: Schools are responsible for handling life-threatening events due to a variety of conditions, including anaphylaxis. California is one of a few states that permits school districts to stock emergency epinephrine auto-injectors and to train unlicensed assistive personnel to administer epinephrine for a life-threatening event. We surveyed…

  3. Pediatric Anaphylaxis Management in the Prehospital Setting

    PubMed Central

    Arnold, Linda; Cone, David C.; Langhan, Melissa

    2013-01-01

    Purpose Anaphylaxis is a life-threatening systemic allergic reaction that occurs after contact with an allergy-causing substance. Timely administration of intramuscular epinephrine is the treatment of choice for controlling symptoms and decreasing fatalities. Our purpose was to investigate the prehospital management of anaphylaxis among patients receiving care in an urban tertiary care pediatric emergency department (PED). Methods We performed a retrospective chart review from May, 2008 to January, 2010 of patients 18 years or younger who received care in the PED for anaphylaxis. Data were extracted by one investigator and included demographic information, patient symptoms, past medical history, medications administered (including route and provider), and final disposition. Results We reviewed 218 cases of anaphylaxis in 202 children. Mean age of patients was 7.4 years; 56% of patients were male. Two hundred and fourteen (98%) manifested symptoms in the skin/mucosal system, 68% had respiratory symptoms, 44% had gastrointestinal symptoms, and 2% had hypotension. Sixty-seven percent had a previous history of allergic reaction and 38% had a history of asthma. Seventy-six percent of the patients presented with anaphylaxis to food products, 8% to medications, 1% to stings, and 16% to unknown allergens. Reactions occurred at home or with family members 87% of the time, and at school 12% of the time. Only 36% of the patients who met criteria for anaphylaxis had epinephrine administered by emergency medical services (EMS). Among 26 patients with anaphylactic reactions at school, 69% received epinephrine by the school nurse. Of the 117 patients with known allergies who were with their parents at the time of anaphylactic reaction, 41% received epinephrine. Thirteen patients were seen by a physician prior to coming to the PED; all received epinephrine at the physician’s office. In total, epinephrine was given to 41% (89) of the 218 cases prior to coming to the PED

  4. Wheat-Induced Anaphylaxis in Korean Adults: A Report of 6 Cases

    PubMed Central

    Lee, Seung-Eun; Lee, Suh-Young; Jo, Eun-Jung; Kim, Mi-Young; Kim, Sae-Hoon

    2013-01-01

    Wheat is a common cause of food allergy. Wheat-induced anaphylaxis (WIA) and wheat-dependent exercise induced anaphylaxis (WDEIA) are severe forms of immunoglobulin E (IgE) mediated allergic reaction to wheat protein. As the diagnosis of WIA or WDEIA is not easy because of the risk of oral challenge, identification of specific IgE of various wheat proteins is helpful for diagnosis. In Korea, there are only a few reports on WIA in adults. We report six cases of WIA diagnosed on the basis of clinical history and specific IgE of wheat proteins or provocation test. For immunologic evaluation of severe wheat allergy including WIA and WDEIA, it is important to measure specific IgE to each component of wheat including gluten and ω-5 gliadin not just measuring wheat-specific IgE. PMID:23429235

  5. Common Causes of Anaphylaxis in Children: The First Report of Anaphylaxis Registry in Iran

    PubMed Central

    2010-01-01

    Background Anaphylaxis is an acute, systemic, and potentially fatal allergic reaction. Many things can cause anaphylaxis potentially but some agents are more common like some foods (milk, egg, soy, wheat, peanut, tree nut, shellfish, and fish), insect stings, medications, latex, and food-dependent exercise-induced anaphylaxis. The goal of this study is to show the common causes of anaphylaxis among the children with anaphylaxis history who were referred to the Immunology, Asthma and Allergy Research Institute (IAARI) during a 4-year period (2005-2009). Methods and Materials During those 4 years, we registered all children (<14 years old) with a history of anaphylactic reaction. To prove the cause of anaphylaxis, we performed skin prick tests with suspected agents according to their history and measured specific IgE against them by the ImmunoCAP test. Recognition of common allergens was based on having a positive history for 1 allergen and positive skin prick test or specific IgE for that at the same time, or having positive results from both tests when the allergen was unclear. Idiopathic anaphylaxis was a reaction when any known allergen and positive tests were not obtained. Results One hundred ninety-three nonfatal anaphylactic attacks among 63 children were recognized. In total, the most current cause of anaphylaxis in children was food (89.7%). Milk (49.3%) and wheat (26.1%) were the most common. Other foods were egg (8.7%), nuts (2.8%), and spices (2.8%). Six children (8.7%) were sensitive to multiple food allergens like milk, egg, and wheat. Five (7.1%) of 63 patients had anaphylactic attack because of stinging. Wasp was the trigger in 3 (4.3%) of them and honeybee was the cause in 1 (1.4%). The last one was because of unknown hymenoptera. There were 2 idiopathic cases of all 63 patients. Conclusions Food allergens, especially milk and wheat, are the most common cause of anaphylaxis in children. Because anaphylaxis can be fatal, it is advisable to recognize

  6. Exercise-induced anaphylaxis in a cardiopathic patient on chronic aspirin therapy.

    PubMed

    Micucci, C; Amico, D; Braconi, M; Pareo, C; Cimarelli, M E; Subiaco, S

    2014-03-01

    We report the case of a 73 year old man on chronic aspirin therapy who went in anaphylactic shock during his daily farm chores following a meal rich in wheat products. The serum specific IgE assay (ImmunoCAP) showed strong positive specific IgE responses to ω-5 gliadin. A two-year period avoiding wheat meals 3 hours prior to exercise, resulted in a lack of further anaphylaxis; this results aided us in making the diagnosis. PMID:24739129

  7. Social Justice Advocacy: Community Collaboration and Systems Advocacy

    ERIC Educational Resources Information Center

    Lopez-Baez, Sandra I.; Paylo, Matthew J.

    2009-01-01

    This article discusses the community collaboration and systems advocacy domains of the ACA (American Counseling Association) Advocacy Competencies (J. A. Lewis, M. S. Arnold, R. House, & R. L. Toporek, 2002). A case illustration is presented, and the 8 Advocacy Competencies within each domain are applied to the case study.

  8. Anaphylaxis to muscle relaxants: rational for skin tests.

    PubMed

    Moneret-Vautrin, D A; Kanny, G

    2002-09-01

    IgE-dependent allergy to muscle relaxants (MR) has an estimated prevalence of 1 out of 6500 General Anesthesias (GA). 62% of anaphylaxis during surgery are due to MR anaphylaxis. All the molecules are divalent, carrying two NH4+ epitopes (quaternary ammonium ions), either structurally or after rapid in vivo protonization (vecuronium). The excellent overall performance of skin test makes them the golden standard for the diagnosis of anaphylactoid reactions. Techniques include intradermal tests and prick-tests. The current localizations are the forearm and the back. Positivity criteria are 3 mm for prick-tests. For IDTs, the criterium is the doubling of the size of the injection papula, when 0.02 to 0.04 ml is injected: 8 mm. The recommended concentrations are not falsely negative. Commercial concentrations can be tested by prick tests, except for mivacurium and atracurium tested of 1:10 dilution. A scale of concentrations is advised for IDT starting with 1:10,000, up to a normally non reactive concentration that is: 100 micrograms/ml (succinylcholine), 200 micrograms/ml (gallamine), 10 micrograms/ml (atracurium), 2 micrograms/ml (mivacurium), 200 micrograms/ml (pancuronium), 400 micrograms/ml (vecuronium), 1,000 micrograms/ml (rocuronium), 200 micrograms/ml (cis atracurium). The specificity and sensitivity of the skin tests to MRs are greater than 95%. The reproducibility over years is 88%. The overall concordance of PT and IDR is 97%. Both types of tests can be used for the diagnosis. IDT have to be carried out for the search of the cross sensitization. 84% of patients do have cross sensitization to MRs but only 16% react to all MRs. The further use of MRs selected by negative IDTs has been proved to be safe. PMID:12389445

  9. Anaphylaxis treatment: current barriers to adrenaline auto-injector use.

    PubMed

    Song, T T; Worm, M; Lieberman, P

    2014-08-01

    Anaphylaxis is a life-threatening condition that is increasing in prevalence in the developed world. There is universal expert agreement that rapid intramuscular injection of adrenaline is life-saving and constitutes the first-line treatment of anaphylaxis. The unpredictable nature of anaphylaxis and its rapid progression makes necessary the availability of a portable emergency treatment suitable for self-administration. Thus, anaphylaxis treatment guidelines recommend that at-risk patients are provided with adrenaline auto-injectors (AAIs). Despite these clear recommendations, current emergency treatment of anaphylaxis continues to be inadequate in many cases. The aim of this review is to highlight the barriers that exist to the use and availability of AAIs and that prevent proper management of anaphylaxis. In addition, we review the characteristics of all AAIs that are presently available in Europe and the USA and discuss the need for regulatory requirements to establish the performance characteristics of these devices. PMID:24835773

  10. Acute treatment of anaphylaxis in children

    PubMed Central

    Goldman, Ran D.

    2013-01-01

    Abstract Question A 3-year-old was rushed to my office after eating a friend’s chocolate bar that contained nuts. He immediately developed urticaria on his face and swelling of his lips, and he had a persistent cough. What is the best treatment for a child with anaphylaxis? Should this family receive a prescription for an epinephrine autoinjector device? Answer Intramuscular epinephrine injection is a safe and effective treatment of anaphylaxis in children. Children with systemic allergic reactions should carry epinephrine autoinjectors at all times, and should certainly have one with them at school. In order for epinephrine autoinjectors to be effective, children and their families need to be educated on how to properly use the devices, as well as keep in mind the product’s expiration date. PMID:23851537

  11. Anaphylaxis as a Manifestation of Horse Allergy

    PubMed Central

    2009-01-01

    Allergic disease induced by animal exposure is a common phenomenon worldwide. Whereas cat and dog dander exposure are well recognized as causative of allergic rhinitis, allergic asthma, and contact urticaria, horse allergy can present with anaphylaxis. Horse allergy is induced by exposure to the major horse allergens Equ 1 through 5. The severity of the symptoms may be related to the level of exposure. Greatest risk of anaphylaxis occurs in those sensitized patients who have large amounts of animal allergen exposure, such as when in a barn, or when an animal bite occurs exposing sensitized persons to large quantities of the animal allergen that resides in the saliva. Horse allergy may be successfully treated with allergen specific immunotherapy. PMID:23283110

  12. Public health and media advocacy.

    PubMed

    Dorfman, Lori; Krasnow, Ingrid Daffner

    2014-01-01

    Media advocacy blends communications, science, politics, and advocacy to advance public health goals. In this article, we explain how media advocacy supports the social justice grounding of public health while addressing public health's "wicked problems" in the context of American politics. We outline media advocacy's theoretical foundations in agenda setting and framing and describe its practical application, from the layers of strategy to storytelling, which can illuminate public health solutions for journalists, policy makers, and the general public. Finally, we describe the challenges in evaluating media advocacy campaigns. PMID:24328989

  13. A case of trimebutine-induced anaphylaxis.

    PubMed

    Lee, Suh-Young; Kim, Mi-Yeong; Kang, Sung-Yoon; Song, Woo-Jung; Kang, Hye-Ryun

    2011-12-01

    Trimebutine maleate [2-dimethylamino-2-phenylbutyl 3,4,5-trimethoxybenzoic acid] has been demonstrated to be active for relieving abdominal pain and it is widely used for patients with irritable bowel syndrome. Adverse drug reactions are mostly mild and well-tolerated. To our knowledge, only two cases of trimebutine induced hypersensitivity have been reported, and both were delayed type reactions. Here, we report the first case of trimebutine maleate-induced anaphylaxis. PMID:22113162

  14. Recognition and first-line treatment of anaphylaxis.

    PubMed

    Lieberman, Phillip L

    2014-01-01

    The International Classification of Diseases (ICD)-9 included a code only for anaphylactic shock. The improved ICD-10 coding defines the different symptoms and types of anaphylaxis and includes coding for anaphylaxis without shock. This new coding is consistent with the efforts of the National Institute of Allergy and Infectious Diseases (NIAID) and the Food Allergy and Anaphylaxis Network (FAAN), who convened a panel to formulate a definition of and the diagnostic criteria for anaphylaxis. Anaphylaxis is a serious reaction that has a rapid onset and may cause death. It is a systemic immunoglobulin E-mediated reaction resulting from the sudden release of multiple mediators from mast cells and basophils. Foods are the most common triggers for anaphylactic reactions, followed by drugs, insect stings, and idiopathic anaphylaxis (anaphylaxis of unknown cause). If the NIAID/FAAN criteria are met and anaphylaxis is diagnosed, epinephrine administration is mandatory. Delays in epinephrine administration have been associated with fatalities. Patients should have ready access to >1 epinephrine autoinjector in the outpatient setting. An individualized emergency action plan should be developed for each patient at risk for anaphylaxis. PMID:24384138

  15. Hypothesis: Hemolytic Transfusion Reactions Represent an Alternative Type of Anaphylaxis

    PubMed Central

    Hod, Eldad A.; Sokol, Set A.; Zimring, James C.; Spitalnik, Steven L.

    2009-01-01

    Classical anaphylaxis is the most severe, and potentially fatal, type of allergic reaction, manifested by hypotension, bronchoconstriction, and vascular permeability. Similarly, a hemolytic transfusion reaction (HTR) is the most feared consequence of blood transfusion. Evidence for the existence of an alternative, IgG-mediated pathway of anaphylaxis may be relevant for explaining the pathophysiology of IgG-mediated-HTRs. The purpose of this review is to summarize the evidence for this alternative pathway of anaphylaxis and to present the hypothesis that an IgG-mediated HTR is one example of this type of anaphylaxis. PMID:18830382

  16. Anaphylaxis to topically applied sodium fusidate.

    PubMed

    Park, Mi-Ran; Kim, Do-Soo; Kim, Jihyun; Ahn, Kangmo

    2013-03-01

    Fusidic acid is a bacteriostatic antibiotic that is effective primarily on gram-positive bacteria, such as Staphylococcus and Corynebacterium species. It is often topically applied to the skin, but is also given systemically as a tablet or injection. Allergic contact dermatitis, or urticaria, has been reported as a side effect of fusidic acid treatment, whereas anaphylaxis to topically administered fusidic acid has not been reported previously. A 16-year-old boy visited an outpatient clinic for further evaluation of anaphylaxis. He suffered abrasions on his arms during exercise, which were treated with a topical ointment containing sodium fusidate. Within 30 minutes, he developed urticaria and eyelid swelling, followed by a cough and respiratory difficulty. His symptoms were relieved by emergency treatment in a nearby hospital. To investigate the etiology, oral provocation with fusidate was performed. After 125 mg (1/2 tablet) of sodium fusidate was administered, he developed a cough and itching of the throat within 30 minutes, which was followed by chest discomfort and urticaria. Forced expiratory volume in 1 second (FEV1) dropped from 4.09 L at baseline to 3.50 L after challenge, although wheezing was not heard in his chest. After management with an inhaled bronchodilator using a nebulizer, chest discomfort was relieved and FEV1 rose to 3.86 L. The patient was directed not to use fusidate, especially on abrasions. Here we report the first case of anaphylaxis resulting from topical fusidic acid application to abrasions. PMID:23450038

  17. Galactose-α-1,3-galactose and Delayed Anaphylaxis, Angioedema, and Urticaria in Children

    PubMed Central

    Kennedy, Joshua L.; Stallings, Amy P.; Platts-Mills, Thomas A.E.; Oliveira, Walter M.; Workman, Lisa; James, Haley R.; Tripathi, Anubha; Lane, Charles J.; Matos, Luis; Heymann, Peter W.

    2013-01-01

    BACKGROUND AND OBJECTIVE: Despite a thorough history and comprehensive testing, many children who present with recurrent symptoms consistent with allergic reactions elude diagnosis. Recent research has identified a novel cause for “idiopathic” allergic reactions; immunoglobulin E (IgE) antibody specific for the carbohydrate galactose-α-1,3-galactose (α-Gal) has been associated with delayed urticaria and anaphylaxis that occurs 3 to 6 hours after eating beef, pork, or lamb. We sought to determine whether IgE antibody to α-Gal was present in sera of pediatric patients who reported idiopathic anaphylaxis or urticaria. METHODS: Patients aged 4 to 17 were enrolled in an institutional review board–approved protocol at the University of Virginia and private practice allergy offices in Lynchburg, VA. Sera was obtained and analyzed by ImmunoCAP for total IgE and specific IgE to α-Gal, beef, pork, cat epithelium and dander, Fel d 1, dog dander, and milk. RESULTS: Forty-five pediatric patients were identified who had both clinical histories supporting delayed anaphylaxis or urticaria to mammalian meat and IgE antibody specific for α-Gal. In addition, most of these cases had a history of tick bites within the past year, which itched and persisted. CONCLUSIONS: A novel form of anaphylaxis and urticaria that occurs 3 to 6 hours after eating mammalian meat is not uncommon among children in our area. Identification of these cases may not be straightforward and diagnosis is best confirmed by specific testing, which should certainly be considered for children living in the area where the Lone Star tick is common. PMID:23569097

  18. Suspected Intraoperative Anaphylaxis to Gelatin Absorbable Hemostatic Sponge

    PubMed Central

    Ji, Joonyoung; Barrett, Edward J.

    2015-01-01

    Anaphylaxis under anesthesia is a life-threatening medical emergency that requires rapid identification and treatment. Allergies to agents with which the general population are likely to come into contact are usually identified, but patients are exposed to uncommon agents during anesthesia and surgery. Here, we describe a case of anaphylaxis under anesthesia implicating Gelfoam sponges. PMID:25849471

  19. A Simple Allergist-Led Intervention Improves Resident Training in Anaphylaxis

    PubMed Central

    Jongco, Artemio M.; Bina, Sheila; Sporter, Robert J.; Cavuoto Petrizzo, Marie A.; Kaplan, Blanka; Kline, Myriam; Schuval, Susan J.

    2016-01-01

    Physicians underrecognize and undertreat anaphylaxis. Effective interventions are needed to improve physician knowledge and competency regarding evidence-based anaphylaxis diagnosis and management (ADAM). We designed and evaluated an educational program to improve ADAM in pediatrics, internal medicine, and emergency medicine residents from two academic medical centers. Anonymous questionnaires queried participants' demographics, prior ADAM clinical experience, competency, and comfort. A pretest assessing baseline knowledge preceded a 45-minute allergist-led evidence-based presentation, including practice with epinephrine autoinjectors, immediately followed by a posttest. A follow-up test assessed long-term knowledge retention twelve weeks later. 159 residents participated in the pretest, 152 participated in the posttest, and 86 participated in the follow-up test. There were no significant differences by specialty or site. With a possible score of 10, the mean pretest score (7.31 ± 1.50) was lower than the posttest score (8.79 ± 1.29) and follow-up score (8.17 ± 1.72) (P < 0.001 for both). Although participants' perceived confidence in diagnosing or managing anaphylaxis improved from baseline to follow-up (P < 0.001 for both), participants' self-reported clinical experience with ADAM or autoinjector use was unchanged. Allergist-led face-to-face educational intervention improves residents' short-term knowledge and perceived confidence in ADAM. Limited clinical experience or reinforcement contributes to the observed decreased knowledge. PMID:26997960

  20. A case of anaphylaxis apparently induced by sugammadex and rocuronium in successive surgeries.

    PubMed

    Yamada, Yuko; Yamamoto, Takuji; Tanabe, Kumiko; Fukuoka, Naokazu; Takenaka, Motoyasu; Iida, Hiroki

    2016-08-01

    Rocuronium is the agent most frequently involved in perioperative anaphylaxis, and sugammadex has also been known to induce anaphylactic reactions. We describe a case of successive anaphylactic episodes that seemed to be induced by clinical doses of rocuronium and sugammadex. The patient was a 19-year-old woman who had a medical history of asthma, but no history of surgery. She had been injured in a fall, and several surgeries were scheduled for multiple bone fractures. At the first surgery under general anesthesia, she developed anaphylaxis 5 min after sugammadex administration. A second general anesthesia for treatment of calcaneal fracture was induced uneventfully without neuromuscular blockade after 10 days. A third general anesthesia was scheduled to reinforce the spinal column 12 days after the first surgery. She developed anaphylaxis 8 min after rocuronium administration. The level of plasma histamine was elevated, but serum tryptase level remained normal. This surgery was canceled and rescheduled without use of a neuromuscular blockade. Skin tests were performed in a later investigation. The patient showed positive results on intradermal tests for sugammadex and rocuronium, supporting a diagnosis of allergic reactions to both drugs. Clinicians must be aware that anaphylactic reactions can be induced by both sugammadex and rocuronium. PMID:27290941

  1. IPPF focuses on advocacy. Advocacy for reproductive health: worldwide.

    PubMed

    Puri, S; Ketting, E

    1996-01-01

    The International Planned Parenthood Federation has been advocating human rights since its establishment in 1952. Since the adoption of its global strategic plan, Vision 2000, it has dealt with advocacy in a more systematic manner. Advocacy aims to gain broader support for a cause. In family planning and reproductive health, advocacy is important in counteracting conservative opposition movements. Its most effective tool is high-quality information and services for meeting people's needs. Its target groups are women's groups, youth organizations, parliamentarians, media representatives, and religious leaders. Information, education, and communication (IEC) campaigns differ from advocacy, because the latter is deliberately persuasive and campaign-oriented. An Advocacy Working Group was convened by IPPF and an Advocacy Guide was produced in 1995. Advocacy is needed for the promotion of sexual and reproductive health in the face of opposition from traditional and cultural forces represented by small, vocal, well-financed and organized groups. In 1984 they succeeded in halting funding for IPPF by the United States. This made IPPF resolute in strategic planning and setting goals as contained in Vision 2000. The goals include advocacy for family planning, the prevention of unsafe abortion, women's empowerment, the involvement of youth, the responsibility of men for family life, and the improvement of the status of the female child. The IPPF's 1985 Central Council discussed new initiatives and an Issues Manual was published. The 1989 Members' Assembly held a seminar on critical issues in advocating family planning. A further 1993 resolution urged support for advocacy initiatives. A Public Response Guide was published in 1991 and Language Guidelines were also produced for correct family planning terminology. In addition, an Interregional Training Workshop was held in London in 1995 on the use of the Advocacy Guide. Recommendations were also submitted by participants for

  2. Diagnostic utility of two case definitions for anaphylaxis: a comparison using a retrospective case notes analysis in the UK.

    PubMed

    Erlewyn-Lajeunesse, Michel; Dymond, Sandra; Slade, Ingrid; Mansfield, Helen L; Fish, Rosie; Jones, Owen; Benger, Jonathan R

    2010-01-01

    Anaphylaxis is a clinical diagnosis with no gold-standard test. Recent case definitions have attempted to provide objective criteria for diagnosis. The aim of this study was to compare the diagnostic concordance of the Brighton Collaboration case definition (the 'Brighton' case definition) to the consensus case definition from the Second Symposium on the Definition and Management of Anaphylaxis (the 'Symposium' definition). The study setting was a hospital-based emergency department in the UK. We identified cases of anaphylaxis by physicians' discharge diagnoses over a 2-year period from 2005 to 2006, and used randomly selected cases of allergic reaction, asthma and urticaria as a control group. Data was extracted by clinicians (who were unaware of the content of either case definition), and the two case definitions were applied by Boolean operators in a Microsoft Excel spreadsheet. Concordance between the case definitions was measured using Cohen's kappa (kappa) statistic. We reviewed 128 sets of notes, with 47 cases of anaphylaxis. Brighton and Symposium definitions had sensitivities of 0.681 and 0.671, respectively, and specificities of 0.790 and 0.704, respectively. A discordant result was found in 36/128 cases (28.1%; kappa = 0.414 [95% CI 0.253, 0.574]), which represents a moderate level of agreement between case definitions. The Brighton case definition has a similar diagnostic concordance to the Symposium case definition. It does not seem to over- or underestimate cases and is sufficiently unique that the identification of an allergic trigger does not have to form part of the case definition. This will be important in the recognition of anaphylaxis resulting from the administration of drug and vaccines, where causality should be examined separately from case ascertainment. PMID:20000867

  3. Patient's perspective and public policy regarding anaphylaxis.

    PubMed

    Muñoz-Furlong, Anne

    2004-01-01

    It is estimated that dose to 7 million Americans have food allergy. The incidence of food allergy, particularly peanut allergy, is believed to be on the rise. Several studies have shown that in spite of a patient's best efforts to avoid ingesting the allergy-causing food, reactions will occur. These reactions occur from incorrect ingredient information in food service or restaurant settings, incorrect product labels, or mistakes in label reading. In the hospital setting, patients are sometimes treated for an anaphylactic reaction in the emergency room but are not given instructions to see a specialist to determine the cause of their reaction, nor are they given a prescription for epinephrine to arm them to treat future allergic emergencies. Two studies of fatal and near fatal allergic reactions concluded that a delay in administration of epinephrine could have been a factor in the fatal outcomes. However, schools often do not have written emergency action plans in place for children with documented food allergy, and patients and caregivers often report not knowing when to use the epinephrine kit or how to use it. Until there is a cure for food allergy and anaphylaxis, avoidance of the allergen is key. There is much work to be done in education and public policy regarding anaphylaxis. PMID:15025404

  4. A review of perioperative anaphylaxis at a Singapore tertiary hospital

    PubMed Central

    Chen, Xuanxuan; Thong, Sze Ying; Chong, Yong Yeow; Ng, Shin Yi

    2016-01-01

    INTRODUCTION Perioperative anaphylaxis is an anaesthetic emergency, but its incidence is not well described in the local literature. This retrospective study aims to look at a group of patients who had perioperative anaphylaxis in our institution. METHODS We conducted a retrospective review of electronic databases and clinical case sheets, and identified 34 patients who had possible perioperative anaphylaxis during anaesthesia in our institution between 1 January 2007 and 30 April 2012. RESULTS After reviewing clinical and biochemical data, we found that 16 out of 151,876 patients who underwent surgery had confirmed perioperative anaphylaxis, an incidence of 1:10,000. Neuromuscular blockers were identified as the most common causative agent for perioperative anaphylaxis. The offending agent could not be identified in seven patients. CONCLUSION To the best of our knowledge, this is the first study in Southeast Asia on the incidence of perioperative anaphylaxis. Having a preoperative history of allergy did not seem to predispose patients to the subsequent development of perioperative anaphylaxis. PMID:26996282

  5. Anaphylaxis: a history with emphasis on food allergy

    PubMed Central

    Boden, Stephen R.; Burks, A. Wesley

    2011-01-01

    Summary In the century since Paul Portier and Charles Richet described their landmark findings of severe fatal reactions in dogs re-exposed to venom after vaccination with sea anemone venom, treatment for anaphylaxis continues to evolve. The incidence of anaphylaxis continues to be difficult to measure. Underreporting due to patients not seeking medical care as well as failure to identify anaphylaxis affects our understanding of the magnitude of the disease. Treatment with intramuscular epinephrine continues to be the recommended first line therapy although studies indicate that education of both the patients and the medical community is needed. Adverse food reactions continue to be the leading cause of anaphylaxis presenting for emergency care. Current therapy for food-induced anaphylaxis is built on the foundation of strict dietary avoidance, rapid access to injectable epinephrine, and education to recognize signs and symptoms of anaphylaxis. Investigation into therapy with oral and sublingual immunotherapy as well as other modalities holds hope for improved treatment of food-induced anaphylaxis. PMID:21682750

  6. Clinical Characteristics of Inpatients with Anaphylaxis in China

    PubMed Central

    Tang, Rui; Xu, Han-Yi; Chen, Shi; Sun, Jin-Lu; Hu, Hong; Li, Hai-Chao; Diao, Ying; Li, Zhi

    2015-01-01

    Objective. To analyze the clinical characteristics of inpatients with anaphylaxis and the factors that influenced those characteristics. Methods. Using the patient records from 1990 to 2013 from three highly ranked Chinese hospitals, we retrospectively analyzed the characteristics of 108 inpatients with anaphylaxis (not anaphylaxis admitted). Results. The mean patient age was 42 ± 20 years old and male-to-female ratio was 1 : 1.3. The number of patients with anaphylaxis increased gradually, and cases diagnosed after 2005 accounted for 68.5% of the 108 total cases. The most common trigger was medications. The most common clinical manifestations included cutaneous, nervous, respiratory, circulatory, and digestive signs and symptoms. Male patients were more likely to experience loss of consciousness. Multisystem involvement was more likely to develop in patients with low BP, whereas it was uncommon in those with anaphylaxis induced by antibiotics or anesthetics. Epinephrine was used as the first-line treatment for 56 cases. Conclusions. Inpatient with anaphylaxis was more common in female patients and the number increased gradually during the study period. The most common trigger was medications. Patients with low BP were prone to having multisystem involvement, whereas the cases of anaphylaxis induced by antibiotics and anesthetics were less likely to involve multiple organ systems. PMID:26064911

  7. Media Advocacy. Technical Assistance Packet.

    ERIC Educational Resources Information Center

    Join Together, Boston, MA.

    Media advocacy is an environmental strategy that can be used to support alcohol and other drug prevention and policy development efforts. It helps shift the focus from understanding public health issues as individual problems to understanding them as social conditions that require collective behavior changes. Successful media advocacy uses the…

  8. Anaphylaxis cases presenting to primary care paramedics in Quebec.

    PubMed

    Kimchi, Nofar; Clarke, Ann; Moisan, Jocelyn; Lachaine, Colette; La Vieille, Sebastien; Asai, Yuka; Joseph, Lawrence; Mill, Chris; Ben-Shoshan, Moshe

    2015-12-01

    Data on anaphylaxis cases in pre-hospital settings is limited. As part of the Cross Canada Anaphylaxis Registry (C-CARE), we assessed anaphylaxis cases managed by paramedics in Outaouais, Quebec. A software program was developed to prospectively record demographic and clinical characteristics as well as management of cases meeting the definition of the anaphylaxis. Univariate and multivariate logistic regressions were compared to assess factors associated with severity of reactions and epinephrine use. Among 33,788 ambulance calls of which 23,486 required transport, 104 anaphylaxis cases were identified (anaphylaxis rate of 0.31% [95%CI, 0.25%, 0.37%] among all ambulance calls and 0.44% [95%CI, 0.36%, 0.54%] among those requiring transport). The median age was 46.8 years and 41.3% were males. The common triggers included food (32.7% [95%CI, 24.0%, 42.7%]), drugs (24.0% [16.4%, 33.6%]), and venom (17.3% [10.8%, 26.2%]). Among all reactions, 37.5% (95%CI, 28.4%, 47.6%) were severe. Epinephrine was not administered in 35.6% (95%CI, 26.6%, 45.6%) of all cases. Males were more likely to have severe reactions (Odds ratio [OR]: 2.50 [95%CI, 1.03, 6.01]). Venom-induced reactions and severe anaphylaxis were more likely to be managed with epinephrine (OR: 6.9 [95%CI, 1.3, 35.3] and 4.2 [95%CI, 1.5, 12.0], respectively). This is the first prospective study evaluating anaphylaxis managed by paramedics. Anaphylaxis accounts for a substantial proportion of the cases managed by paramedics in Outaouais, Quebec and exceeds prior reports of the proportion of Quebec emergency room visits attributed to anaphylaxis. Although guidelines recommend prompt use of epinephrine for all cases of anaphylaxis, more than a third of cases did not receive epinephrine. It is crucial to develop educational programs targeting paramedics to promote the use of epinephrine in all cases of anaphylaxis regardless of the specific trigger. PMID:26734462

  9. Anaphylaxis treatment: ergonomics of epinephrine autoinjector design.

    PubMed

    Dennerlein, Jack T

    2014-01-01

    Epinephrine administration is a critical component of individualized emergency action plans for patients at risk for anaphylaxis. Fundamental ergonomic principles can be used to facilitate rapid and effective use of an epinephrine autoinjector when appropriate. Specific patient characteristics, including age and strength, that impact physical and cognitive capabilities, should be considered when choosing an epinephrine autoinjector. Considerations in the optimal functioning of an autoinjector include the device being portable, identifiable, safe, and effective. Size, shape, coloring, and labeling of the device all contribute to the device being portable and identifiable. Trigger-lock features, designs resistant to physical perturbations, and safety technology to prevent injury after use contribute to safety and reliability. Optimal grip designs, tailored in size and/or shape to specific patient types, contribute to reliability and effectiveness. After selection of the most appropriate autoinjector, hands-on training, practice, and drills should be implemented. PMID:24384133

  10. Long-term Effectiveness of Online Anaphylaxis Education for Pharmacists

    PubMed Central

    Vale, Sandra; Sanfilippo, Frank M; Loh, Richard; Clifford, Rhonda M

    2014-01-01

    Objective. To evaluate the long-term effectiveness of an Australasian Society of Clinical Immunology and Allergy (ASCIA) anaphylaxis e-learning program compared to lectures or no training. Design. A controlled interrupted-time-series study of Australian pharmacists and pharmacy students who completed ASCIA anaphylaxis e-learning or lecture programs was conducted during 2011-2013. Effectiveness was measured using a validated test administered pretraining, posttraining, and 3 and 7 months after training. Assessment. All learning groups performed significantly better on all posttests compared to the pretest, and compared to a control group (p<0.001). The proportion of e-learners achieving the minimum standard for anaphylaxis knowledge improved from 45% at pretest to 87% at 7 months. Conclusion. The ASCIA e-learning program significantly increased anaphylaxis knowledge. The high proportion of participants achieving the minimum standard at 7 months indicates long-term knowledge change. PMID:25258441

  11. Anaphylaxis to Pegylated Liposomal Doxorubicin: A Case Report

    PubMed Central

    Sharma, LR; Subedi, A; Shah, BK

    2014-01-01

    Liposomal doxorubicin is used for the treatment of various cancers like epithelial ovarian cancers, multiple myeloma and sarcomas. We report the first case of anaphylaxis to pegylated liposomal doxorubicin. PMID:25429486

  12. CLINICAL FACTORS FOR DEVELOPING SHOCK IN RADIOCONTRAST MEDIA INDUCED ANAPHYLAXIS.

    PubMed

    Kim, Sang Min; Ko, Byuk Sung; Kim, Ji Yeon; Ha, Sang Ook; Ahn, Shin; Sohn, Chang Hwan; Seo, Dong Woo; Kim, Tae-Bum; Kim, Won Young

    2016-03-01

    The aim of this study was to investigate the time interval between radiocontrast media (RCM) administration and the development of anaphylactic shock, and risk factors associated with RCM-induced anaphylactic shock. We reviewed the medical records of 154 patients with RCM-induced anaphylaxis presenting to the emergency department of a tertiary care hospital between January 2005 and December 2014. Clinical features of RCM-induced anaphylaxis were analyzed, and patients were categorized into shock and non-shock groups to identify associated factors in affected patients. Of the 154 cases of RCM-induced anaphylaxis, 101 (65.9%) patients experienced shock. The median time between RCM exposure and the onset of shock was 11 min (interquartile range, 7.0-18.8). In patients with RCM-induced anaphylaxis accompanying shock, the median time from RCM to the first symptom onset was 6 min (interquartile range, 5.0-10.0). In the multivariate analysis, age, neurological manifestations, and allergy history except RCM were associated with the development of shock. RCM-induced anaphylaxis was commonly accompanied with shock, and the time interval between RCM exposure and the onset of shock was short. Physicians should pay attention to the development of potential cardiovascular collapse in anaphylaxis patients of old age and with neurologic manifestations. PMID:26506069

  13. Anaphylaxis in Israel: experience with 92 hospitalized children.

    PubMed

    Hoffer, V; Scheuerman, O; Marcus, N; Levy, Y; Segal, N; Lagovsky, I; Monselise, Y; Garty, B Z

    2011-03-01

    Little is known about the courses, causes, and clinical features of anaphylaxis in children outside the USA and Europe. Our objective was to evaluate the events of anaphylaxis in children admitted to the Schneider Children's Medical Center of Israel, a major tertiary facility, over a 12-year period. Ninety-two children with anaphylaxis (50 boys, 42 girls) aged 14 days to 18 yr (mean, 7.4 yr) were hospitalized during the study period. The event occurred at home in 52 children (56%), in a medical institution in 24 (26%), outdoors in 13 (15%), at school in 2 (2%), and in an unspecified location in 1 (1%). The main causes were foods (43%), mainly milk and nuts, medications (22%), and hymenoptera venom (11%); in five children, anaphylaxis occurred during general anesthesia, and in 5, the causative agent could not be determined. Food-induced anaphylaxis tended to occur in younger children. Forty-eight children (52%) had a history of atopy (mainly asthma). Hospital treatment consisted of corticosteroids (85%), antihistamines (75%), epinephrine (72%), and β2 agonists (42%). Seven patients were admitted to intensive care units. There were no fatalities. EpiPen was used by only one of the 16 patients with more than one episode of anaphylaxis, indicating that patient and parent education in the application of the EpiPen needs to be improved. PMID:20536784

  14. Advocacy and AGU

    NASA Astrophysics Data System (ADS)

    In May 1982, the AGU Council approved the following policy on the Union's role in advocacy on public issues.The American Geophysical Union is an association of scientists, scholars, and interested lay public for the purpose of advancing geophysical science. The Union shares a collateral sense of responsibility to assure that the results of geophysical research are made available to benefit all mankind. The Union encourages its members to exercise their individual sense of responsibility in addressing political and social issues. Should they choose to act collectively on such issues, other organizations exist for such purposes. The American Geophysical Union, as a society, should preserve its unique position as an objective source of analysis and commentary for the full spectrum of geophysical science. Accordingly, the following policies should guide the American Geophysical Union's role as an advocate:

  15. Parliamentary advocacy in Europe.

    PubMed

    Cossey, D

    1996-01-01

    At the European Parliamentary Forum held in Brussels in May 1995 the responsibility of parliamentarians for implementing the Cairo program of action was voiced. The Danish and Finnish family planning associations are raising the awareness of parliamentarians about sexual and reproductive health and drawing attention to the commitments accepted at three international conferences on population, social development, and women's status. The British set up a parliamentary group in 1979 to deal with such issues as did the European Parliament in 1991. In 1994 and 1995 three major UN conferences were the focus of parliamentary debates to formulate national policy. In April 1994 the Danish association launched an advocacy activity in the Parliament followed by a forum on reproductive health with the goal of assisting in the drafting of national policy. In Finland collaborating with professional organizations and nongovernmental organizations (NGOs) in seminars, meetings, and consultations has been in the forefront of the issues of population and development and reproductive health. The briefing materials for parliamentarians include a pack designed by Marie Stopes International referring to development programs. A 1995 survey of parliamentarians assessed their attitudes toward development cooperation. Building links between NGOs and parliamentarians has been another scheme in this effort including the European Parliamentary Forum for Action attended by parliamentarians from 28 European countries. In January 1995 a party of European parliamentarians visited Pakistan to see problems at the grassroots. In February 1996 a meeting was held in Madrid for parliamentarians to follow up on the Beijing and Cairo conferences. Advocacy requires perseverance to create personal contacts and networks to keep the discussion on these crucial issues alive. PMID:12291105

  16. Advocacy: exploring the concept.

    PubMed

    Mardell, A

    1996-10-01

    The concept of the nurse as the patient's advocate is one that has become popular in the last fifteen years or so in both North America and the United Kingdom, having its basis in nursing theory. The UKCC first embraced the concept, stating in the Code of Professional Conduct that nurses must; 'act always in such a manner so as to promote and safeguard the interests and well being of patients and clients'. This is a laudable principle and one that nurses cannot dispute as there are many members of our society who are weak and vulnerable and may be unable to speak up for themselves. But are nurses always in a position to be an advocate for their patients? As the nature of nursing is so diverse then the nature of advocacy will be different in the multifarious settings in which nurses practise. Can theatre nurses ever be in a position to act as an advocate for a patient who is often anaesthetised? What precisely is advocacy and is the Concise Oxford Dictionary definition of 'one who pleads for another' appropriate in the nursing context? Then there is the position of nurses in the healthcare organisation in which they practise. In advocating for their patients, nurses may find they are pleading a case for a patient, or a group of patients, that could bring the nurse into conflict with their medical colleagues or with the management of the organisation by whom they are employed. Additionally, they may not posses the skills and knowledge to advocate effectively under such circumstances. Nursing is littered with the casualties of such conflicts over the years, the most publicised of whom, in the UK, was probably Graham Pink who lost his job as a charge nurse after drawing public attention to what he considered to be an unacceptable standard of care in the hospital in which he worked. PMID:8974516

  17. Diagnosis and emergent management of anaphylaxis in children.

    PubMed

    Wiener, Ethan S; Bajaj, Lalit

    2005-01-01

    Anaphylactic and anaphylactoid reactions are serious, potentially life-threatening reactions with well-described clinical manifestations. Although the pathophysiology of these reactions varies with the offending agent and route of exposure, the treatment remains the same. Attention to airway, breathing, and circulation and the prompt administration of epinephrine remain the mainstays of therapy. Once an at-risk individual is identified, the proper instruction on the avoidance of the offending agent, the use of the EpiPen, and referral to a specialist in the treatment of allergic reactions may be instrumental in the future health and safety of that patient. PMID:16124341

  18. The personal challenge of advocacy.

    PubMed

    Rocklage, M R

    1992-04-01

    Advocacy is the embracing of a cause or issue, a conversion to a mission that makes a very real claim on the advocate. It is the activity of altering structures, of changing the status quo. Like prophetic ministry, the task of advocacy is to nurture, nourish, and evoke consciousness of different ways of considering and doing things, to champion new models of organization. Effective advocacy entails three distinct steps: envisioning an alternative, challenging the status quo, and energizing persons and communities. It is characterized by the emergence of an alternative community concerned with different issues and different ways of doing things. It also involves the integration of advocacy into our daily lives and a penetration of the numbness of life. How will we know when we are truly serving as advocates of the Church's healing ministry? We will have an inkling that we are on the right track when we move from charity to justice. PMID:10116739

  19. Patient advocacy: the role of the nurse.

    PubMed

    Choi, Pin Pin

    2015-06-10

    The role of nurses as patient advocates is well recognised by healthcare professionals, yet the processes and practices involved in patient advocacy are not clearly understood. A suboptimal level of advocacy is often apparent in the literature, encompassing paternalistic concepts of protecting patients from harm. This article examines the concept of patient advocacy and its relevance to nursing, associated goals and outcomes of advocacy and the processes and practices involved. It provides insights into how nurses practise patient advocacy in healthcare settings and how they may develop this role further, through formal education, workplace learning, role modelling by expert nurses and promoting an organisational culture conducive to patient advocacy. PMID:26058653

  20. Buckwheat anaphylaxis: an unusual allergen in Taiwan.

    PubMed

    Wang, Tsung-Chi; Shyur, Shyh-Dar; Wen, Da-Chin; Kao, Yu-Hsuan; Huang, Li-Hsin

    2006-01-01

    IgE-mediated hypersensitivity to buckwheat is common in Korea, Japan, and some other Asian countries. However, buckwheat is not a common allergen in Taiwan. We report a woman with asthma who had anaphylactic shock, generalized urticaria, and an acute exacerbation of asthma five minutes after ingesting buckwheat. The patient underwent skin prick and Pharmacia CAP testing (Uppsala, Sweden) for specific IgE to buckwheat, white sesame and soybean as well as other common allergens in Taiwan including Dermatophagoides pteronyssinus (Dp), D. farinae (Df), cat and dog dander, cockroach, egg white, cow milk and codfish. The patient had a strongly positive skin prick test response to buckwheat and positive reactions to Dp and latex. Specific IgE results were class 6 for buckwheat, class 4 for Dp and Df, and class 2 for dog dander, wheat, sesame and soybean. Results of an open food challenge with white sesame and soybean were negative. Although buckwheat is a rare allergen in Taiwan, it can cause extremely serious reactions and should be considered in patients presenting with anaphylaxis after exposure to buckwheat. PMID:17136883

  1. Advances in allergic skin disease, anaphylaxis, and hypersensitivity reactions to foods, drugs, and insects in 2009.

    PubMed

    Sicherer, Scott H; Leung, Donald Y M

    2010-01-01

    This review highlights some of the research advances in anaphylaxis and hypersensitivity reactions to foods, drugs, and insects, as well as advances in allergic skin disease that were reported in the Journal in 2009. Among key epidemiologic observations, several westernized countries report that more than 1% of children have peanut allergy, and there is some evidence that environmental exposure to peanut is a risk factor. The role of regulatory T cells, complement, platelet-activating factor, and effector cells in the development and expression of food allergy were explored in several murine models and human studies. Delayed anaphylaxis to mammalian meats appears to be related to IgE binding to the carbohydrate moiety galactose-alpha-1,3-galactose, which also has implications for hypersensitivity to murine mAb therapeutics containing this oligosaccharide. Oral immunotherapy studies continue to show promise for the treatment of food allergy, but determining whether the treatment causes tolerance (cure) or temporary desensitization remains to be explored. Increased baseline serum tryptase levels might inform the risk of venom anaphylaxis and might indicate a risk for mast cell disorders in persons who have experienced such episodes. Reduced structural and immune barrier function contribute to local and systemic allergen sensitization in patients with atopic dermatitis, as well as increased propensity of skin infections in these patients. The use of increased doses of nonsedating antihistamines and potential usefulness of omalizumab for chronic urticaria was highlighted. These exciting advances reported in the Journal can improve patient care today and provide insights on how we can improve the diagnosis and treatment of these allergic diseases in the future. PMID:20109740

  2. Guidelines for the Diagnosis and Management of Food Allergy in the United States

    PubMed Central

    Boyce, Joshua A.; Assa'ad, Amal; Burks, A. Wesley; Jones, Stacie M.; Sampson, Hugh A.; Wood, Robert A.; Plaut, Marshall; Cooper, Susan F.; Fenton, Matthew J.; Arshad, S. Hasan; Bahna, Sami L.; Beck, Lisa A.; Byrd-Bredbenner, Carol; Camargo, Carlos A.; Eichenfield, Lawrence; Furuta, Glenn T.; Hanifin, Jon M.; Jones, Carol; Kraft, Monica; Levy, Bruce D.; Lieberman, Phil; Luccioli, Stefano; McCall, Kathleen M.; Schneider, Lynda C.; Simon, Ronald A.; Simons, F. Estelle R.; Teach, Stephen J.; Yawn, Barbara P.; Schwaninger, Julie M.

    2014-01-01

    Food allergy is an important public health problem that affects children and adults and may be increasing in prevalence. Despite the risk of severe allergic reactions and even death, there is no current treatment for food allergy: the disease can only be managed by allergen avoidance or treatment of symptoms. The diagnosis and management of food allergy also may vary from one clinical practice setting to another. Finally, because patients frequently confuse nonallergic food reactions, such as food intolerance, with food allergies, there is an unfounded belief among the public that food allergy prevalence is higher than it truly is. In response to these concerns, the National Institute of Allergy and Infectious Diseases, working with 34 professional organizations, federal agencies, and patient advocacy groups, led the development of clinical guidelines for the diagnosis and management of food allergy. These Guidelines are intended for use by a wide variety of health care professionals, including family practice physicians, clinical specialists, and nurse practitioners. The Guidelines include a consensus definition for food allergy, discuss comorbid conditions often associated with food allergy, and focus on both IgE-mediated and non-IgE-mediated reactions to food. Topics addressed include the epidemiology, natural history, diagnosis, and management of food allergy, as well as the management of severe symptoms and anaphylaxis. These Guidelines provide 43 concise clinical recommendations and additional guidance on points of current controversy in patient management. They also identify gaps in the current scientific knowledge to be addressed through future research. PMID:21134576

  3. The Ethics of Evaluation Neutrality and Advocacy.

    ERIC Educational Resources Information Center

    Datta, Lois-ellin

    1999-01-01

    Examines arguments for and against evaluation advocacy in terms of the American Evaluation Association's "Guiding Principles for Evaluators" and other statements on advocacy and neutrality. Suggests revision of the "Guiding Principles." (Author/SLD)

  4. Early skin and challenge testing after rocuronium anaphylaxis.

    PubMed

    Schulberg, E M; Webb, A R; Kolawole, H

    2016-05-01

    We present a case of early skin and challenge testing in a patient following severe anaphylaxis to rocuronium. The patient presented for semi-elective laparoscopic cholecystectomy and developed anaphylaxis with severe cardiovascular collapse after induction of anaesthesia. Surgery was cancelled but was considered necessary before the recommended four to six weeks for formal allergy testing. Limited skin and challenge testing was performed to rocuronium and cisatracurium while the patient was in the intensive care unit to identify a safe neuromuscular blocking drug for subsequent early surgery. The subsequent surgery, 48 hours after the initial reaction, was uneventful. The case highlights the difficulties when anaesthetising patients with recent anaphylaxis who have not yet had formal allergy testing and presents a potential management strategy involving early skin testing. PMID:27246945

  5. Severe allergic reaction: management of anaphylaxis in hospital.

    PubMed

    Jevon, Phil

    Anaphylaxis is an acute, severe, hypersensitivity reaction that can lead to asphyxia, cardiovascular collapse and cardiac arrest. This reaction is sudden, severe, and involves the whole body. Common causes include foods such as nuts, shellfish, dairy products and eggs. Non-food causes include bee/wasp stings, latex and drugs, e.g. penicillin. Common clinical features include urticaria, angioedema, respiratory distress and shock. Summoning expert help, reclining the patient flat, administering high concentration oxygen, and administering intramuscular adrenaline are key aspects of the nursing management of anaphylaxis in hospital. The aim of this article is to understand the management of anaphylaxis in hospital, with particular reference to national consensus guidelines. PMID:18414282

  6. The Hidden Culprit: A Case of Repeated Anaphylaxis to Cremophor

    PubMed Central

    Kim, Young Nam; Kim, Jun Young; Kim, Ji Won; Kim, Jin Hae; Kim, Hye In; Yune, Sehyo; Choi, Dong-Chull

    2016-01-01

    Drug-induced anaphylaxis is a big pitfall in patients receiving antineoplastic chemotherapy. We report a case of lung cancer patient who experienced two near-fatal anaphylactic reactions that resulted from paclitaxel and multivitamin, seperately. Recurrent severe reactions to different agents led to further investigation to which material the patient was hypersensitive. The skin prick test revealed sensitization to cremophor, which is a commonly used emulsifying agent. This case emphasizes the importance of correctly identifying the culprit drug of anaphylaxis to avoid potentially fatal reaction. PMID:26739412

  7. A Case of Immunoglobulin E Mediated Anaphylaxis to Levodropropizine

    PubMed Central

    Park, Kyung Hee; Yun, Il Seon; Choi, Soo-Young; Lee, Jae-Hyun; Hong, Chein-Soo

    2013-01-01

    We experienced a case of immunoglobulin E (IgE) mediated anaphylaxis to levodropropizine. The patient was an 18-year old Korean woman. After taking the common cold medication including acetaminophen, domperidone, and levodropropizine, skin rash, angioedema and anaphylaxis were developed immediately. As she was tolerable to acetaminophen alone, we thought the culprit agent was maybe a levodropropizine tablet. To confirm the culprit, she underwent skin prick test and oral drug provocation test with the suspected one. Finally we detected levodropropizine specific IgE and confirmed the specificity by inhibition enzyme-linked immunosorbent assay (ELISA). PMID:23225830

  8. Approaches to Advocacy for Health Educators.

    ERIC Educational Resources Information Center

    Mahoney, Beverly Saxton, Ed.; Brown, Kelli McCormack, Ed.

    1999-01-01

    This monograph provides a collection of articles on health educators' approaches to advocacy: "The Role of Health Education Advocacy in Removing Disparities in Health Care" (John P. Allegrante, Donald E. Morisky, and Behjat A. Sharif); "The Role of Health Education Associations in Advocacy" (M. Elaine Auld and Eleanor Dixon-Terry); "What…

  9. Patients' Rights and Advocacy: For Hispanics?

    ERIC Educational Resources Information Center

    Andrade, Sally J., Ed.

    The monograph outlines key issues in the area of patients' rights and advocacy as they relate to Hispanic mental health clients or patients. Providing background material on patients' rights and advocacy in general, the first section includes a chronological history of major litigation, a discussion of patient advocacy, a discussion of a client's…

  10. Every Voice Matters: The Importance of Advocacy

    ERIC Educational Resources Information Center

    Royea, Amber J.; Appl, Dolores J.

    2009-01-01

    Over the years parents, professionals, and politicians have come together to advocate on behalf of children's rights. Advocacy can occur individually, collectively, or a combination of both. Although some advocacy efforts are more successful than others, it is the process of the advocacy and voices behind it that matter most. In this guest…

  11. Self-Advocacy, Feature Issue of IMPACT.

    ERIC Educational Resources Information Center

    Hayden, Mary F., Ed.; Shoultz, Bonnie, Ed.

    1991-01-01

    This newsletter issue gives people with disabilities the opportunity to educate others about self-advocacy. Twelve of its 17 articles are by individuals with disabilities who are self-advocates, or by other representatives of self-advocacy organizations. It includes information on self-advocacy strategies and examples of its impact on lives.…

  12. Wheat-dependent exercise-induced anaphylaxis sensitized with hydrolyzed wheat protein in soap.

    PubMed

    Chinuki, Yuko; Morita, Eishin

    2012-12-01

    Wheat-dependent exercise-induced anaphylaxis (WDEIA) is a specific form of wheat allergy typically induced by exercise after ingestion of wheat products. Wheat ω-5 gliadin is a major allergen associated with conventional WDEIA, and detection of serum immunoglobulin E (IgE) specific to recombinant ω-5 gliadin is a reliable method for its diagnosis. Recently, an increased incidence of a new subtype of WDEIA, which is likely to be sensitized via a percutaneous and/or rhinoconjunctival route to hydrolyzed wheat protein (HWP), has been observed. All of the patients with this new subtype had used the same brand of soap, which contained HWP. Approximately half of these patients developed contact allergy several months later and subsequently developed WDEIA. In each of these patients, contact allergy with soap exposure preceded food ingestion-induced reactions. Other patients directly developed generalized symptoms upon ingestion of wheat products. The predominant observed symptom of the new WDEIA subtype was angioedema of the eyelids; a number of patients developed anaphylaxis. This new subtype of WDEIA has little serum ω-5 gliadin-specific serum IgE. PMID:23093796

  13. Advances in allergic skin disease, anaphylaxis, and hypersensitivity reactions to foods, drugs, and insects in 2013.

    PubMed

    Sicherer, Scott H; Leung, Donald Y M

    2014-02-01

    This review highlights some of the research advances in anaphylaxis; hypersensitivity reactions to foods, drugs, and insects; and allergic skin diseases that were reported in the Journal in 2013. Studies on food allergy suggest that (1) 7.6% of the US population is affected, (2) a "healthy" early diet might prevent food allergy, (3) the skin might be an important route of sensitization, (4) allergen component testing might aid diagnosis, (5) the prognosis of milk allergy might be predictable through early testing, (6) oral or sublingual immunotherapy show promise but also have caveats, and (7) preclinical studies show promising alternative modes of immunotherapy and desensitization. Studies on eosinophilic esophagitis show a relationship to connective tissue disorders and that dietary management is an effective treatment for adults. Markers of anaphylaxis severity have been determined and might inform potential diagnostics and therapeutic targets. Insights on serum tests for drug and insect sting allergy might result in improved diagnostics. Genetic and immune-mediated defects in skin epithelial differentiation contribute to the severity of atopic dermatitis. Novel management approaches to treatment of chronic urticaria, including use of omalizumab, are being identified. PMID:24373349

  14. Fatal and near-fatal anaphylaxis: factors that can worsen or contribute to fatal outcomes.

    PubMed

    Greenberger, Paul A

    2015-05-01

    Anaphylaxis implies a risk of death even in patients whose prior episodes have been considered mild and managed easily. Anaphylaxis occurs in all age groups, from infants to the elderly, but most deaths occur in adults. Factors or circumstances associated with near-fatal or fatal anaphylaxis are reviewed from the following 10 perspectives: accidents and mishaps, adulterated products, age, allergens, atopy, comorbidities, Munchausen syndrome or contrived anaphylaxis, patient factors, route of administration, and treatment-related issues. There are no absolute contraindications to self-injectable epinephrine, and epinephrine can be administered for anaphylaxis to elderly patients or to those patients receiving beta-adrenergic blockers. PMID:25841558

  15. Applying Buddhist Practices to Advocacy: The Advocacy-Serving Model

    ERIC Educational Resources Information Center

    Warren, Jane; Klepper, Konja K.; Lambert, Serena; Nunez, Johnna; Williams, Susan

    2011-01-01

    Creating and retaining empathic connections with the most disenfranchised among us can take a toll on the wellness of counselor advocates. The Advocacy-Serving Model is introduced as a creative approach to strengthening the ability of advocates to serve through enhancing awareness, focusing actions, and connecting to community. The model…

  16. Advocacy: "On the Cutting Edge..."

    ERIC Educational Resources Information Center

    Hertzog, Nancy B.

    2003-01-01

    This case study details the circumstances that led to a revised policy on gifted education in a large suburban school district. It discusses factors that affected advocacy efforts and emphasizes the importance of key individuals, commitment, tenacity, and the necessity of a system being in place for change to occur. (Contains references.)…

  17. Teacher Advocacy in Bilingual Programs

    ERIC Educational Resources Information Center

    Dubetz, Nancy E.; de Jong, Ester J.

    2011-01-01

    As a consequence of changes in federal and state policies in education, educators who believe in the value and importance of bilingualism find themselves in a contested environment where their notions of best practices for emergent bilinguals contradict those espoused in such policies. In this context, acts of advocacy that support bilingual…

  18. Internal Process of Corporate Advocacy.

    ERIC Educational Resources Information Center

    Stout, Daniel A.

    1990-01-01

    Focuses on the preliminary process of corporate advocacy, which provides direction for issues management. Provides insights into: (1) the degree to which organizational spokespersons are willing to express a position on a variety of issues; (2) how such positions come to be advocated through organizational communication; and (3) how organizational…

  19. CEC Special Education Advocacy Handbook.

    ERIC Educational Resources Information Center

    Bootel, Jaclyn A.

    This handbook, for individuals working with people who have disabilities, is designed to empower them to be a force for meeting the policy challenges in the communities in which they live and work. It is designed to help in channeling one's strength, commitment, and knowledge of the special education field into effective advocacy efforts. The…

  20. A case of anaphylaxis after the ingestion of yacon.

    PubMed

    Yun, Eun Young; Kim, Hyun Sik; Kim, You Eun; Kang, Min Kyu; Ma, Jeong Eun; Lee, Gi Dong; Cho, Yu Ji; Kim, Ho Cheol; Lee, Jong Deok; Hwang, Young Sil; Jeong, Yi Yeong

    2010-04-01

    Anaphylaxis is a potentially life-threatening systemic allergic reaction, often with an explosive onset; the symptoms range from mild flushing to upper respiratory obstruction, with or without vascular collapse. Foods are common offending allergens and remain the leading cause of outpatient anaphylaxis in most surveys. Yacon (Smallanthus sonchifolius) is a plant native to the Andes region, where its root is cultivated and consumed mainly as food. Unlike most edible roots, yacon contains large amounts of ructooligosaccharides. Traditionally, yacon tubers have been used as a source of natural sweetener and syrup for people suffering from various disorders. We report the case of a 55-year-old woman who developed syncope and generalized urticaria after ingesting yacon roots. The patient had positive skin prick and intradermal tests to yacon extract. An open food challenge test was performed to confirm food anaphylaxis and was positive 10 minutes after the consumption of yacon roots. To our knowledge, this is the first reported case of anaphylaxis after the ingestion of yacon roots. PMID:20358031

  1. A Case of Anaphylaxis After the Ingestion of Yacon

    PubMed Central

    Yun, Eun Young; Kim, Hyun Sik; Kim, You Eun; Kang, Min Kyu; Ma, Jeong Eun; Lee, Gi Dong; Cho, Yu Ji; Kim, Ho Cheol; Lee, Jong Deok; Hwang, Young Sil

    2010-01-01

    Anaphylaxis is a potentially life-threatening systemic allergic reaction, often with an explosive onset; the symptoms range from mild flushing to upper respiratory obstruction, with or without vascular collapse. Foods are common offending allergens and remain the leading cause of outpatient anaphylaxis in most surveys. Yacon (Smallanthus sonchifolius) is a plant native to the Andes region, where its root is cultivated and consumed mainly as food. Unlike most edible roots, yacon contains large amounts of ructooligosaccharides. Traditionally, yacon tubers have been used as a source of natural sweetener and syrup for people suffering from various disorders. We report the case of a 55-year-old woman who developed syncope and generalized urticaria after ingesting yacon roots. The patient had positive skin prick and intradermal tests to yacon extract. An open food challenge test was performed to confirm food anaphylaxis and was positive 10 minutes after the consumption of yacon roots. To our knowledge, this is the first reported case of anaphylaxis after the ingestion of yacon roots. PMID:20358031

  2. Management of hymenoptera sting anaphylaxis: a preventive medicine survey.

    PubMed

    McDougle, L; Klein, G L; Hoehler, F K

    1995-01-01

    The evaluation of aftercare instructions given to patients suffering from hymenoptera sting anaphylaxis was the objective of the study. Part of this evaluation included asking the physicians questions to examine the knowledge on which they based their aftercare instructions. Survey questionnaires were completed by 124 of 174 (71%) physicians who worked in an emergency department or urgent care center. Fifty-eight percent of the physicians never provided written avoidance instructions, 24% provided or prescribed anaphylaxis ID bracelets, 44% referred all of their patients to an allergist for further evaluation, and 73% reported prescribing an Epi-pen or Ana-kit to all hymenoptera sting anaphylaxis victims. Twenty-four percent of physicians did not know where to obtain anaphylaxis identification bracelets. This survey demonstrates that a substantial number of physicians practicing emergency medicine are not providing appropriate aftercare instructions to patients, and substantiates the need for educational efforts to increase the awareness of physicians concerning the implications of hymenoptera allergy and the value of proper preventive measures. PMID:7782631

  3. Anaphylaxis to Patent Blue V: a case series

    PubMed Central

    Manson, Ania L.; Juneja, Rohit; Self, Robert; Farquhar-Smith, Paul; MacNeill, Fiona

    2012-01-01

    Blue dyes such as Patent Blue V (PBV) have been used in medical procedures for decades, and in the United Kingdom they are routinely utilised in sentinel lymph node biopsy (SLNB) for staging the axilla in early breast cancer. However, it has long been recognised that such dyes are associated with anaphylaxis. It has recently been estimated in a prospective study that allergy to PBV occurs with a frequency of 0.9%. Since repeated SLNB (and therefore further exposure to PBV) is increasingly being advocated for the small proportion of patients who develop a local (in-breast) recurrence, and because anaphylaxis can be life-threatening, it is important that those individuals that are allergic to PBV are recognised on their first medical exposure. The measurement of serum mast-cell tryptase (MCT) and skin prick test (SPT) are used in the investigation of suspected anaphylaxis because positive results are supportive of type-1 mediated hypersensitivity. Here we report the clinical features, MCT results and SPT results that pertain to a series of four patients referred to our drug allergy clinic with suspected anaphylaxis following SLNB. We recommend that all patients that show clinical evidence of allergy following exposure to PBV are referred to a specialist drug allergy service for further evaluation to investigate the cause. PMID:22348211

  4. Anaphylaxis challenges on the front line: perspectives from community medicine.

    PubMed

    Bennett, John R; Fromer, Leonard; Hayden, Mary Lou

    2014-01-01

    This report reflects a discussion from the multidisciplinary Partnership for Anaphylaxis Round Table meeting, held in November 2012, in Dallas, Texas. Community medicine participants included John R. Bennett, MD, an internist who practiced in Cumming, Georgia, and whose patients were adults; Leonard Fromer, MD, a family practitioner in Los Angeles, California, who was the medical director of a network of 600 medical groups, including pediatricians, internists, and family physicians, and who in his previous practice treated children and adults, many of them with severe allergies; and Mary Lou Hayden, MS, RN, FNP-BC, AE-C, a nurse practitioner who treated adults in a university employee health clinic and in an allergy clinic in Charlottesville, Virginia, and whose prior practice focused on allergy and immunology in children and adults. This discussion was moderated by Dr Bennett. Participants provided their perspectives as primary care providers (PCPs) concerning anaphylaxis, which has become a major public health concern. The rising prevalence of severe allergies and incidence of anaphylaxis and other severe allergic reactions among children and adults is shifting more care to PCPs. This discussion provides insights into challenges faced by PCPs in treating patients at risk for anaphylaxis in the community setting and provides potential solutions to those challenges. PMID:24384135

  5. Anaphylaxis caused by stings from the Solenopsis invicta, lava-pés ant or red imported fire ant.

    PubMed

    Haddad Junior, Vidal; Larsson, Carlos Eduardo

    2015-01-01

    Ants are social insects with species of medical interest, such as the fire ants (Solenopsis sp.). The sting causes inflammation, vesicles and sterile pustules, which may cause allergic phenomena and even anaphylactic shock. We describe a patient who suffered a large number of stings and an episode of syncope with fall in blood pressure and complete regression of symptoms after resuscitation and medication for anaphylaxis. Considering the clinical manifestations and images of wheals and blisters on the patient's feet at the time of syncope, this report should serve as a warning for the diagnosis and treatment of this condition and even for counseling and prevention regarding patients exposed to this risk. PMID:26312665

  6. PERI-ANESTHESIA ANAPHYLAXIS (PAA): WE STILL HAVE NOT STARTED POST-PAA TESTING FOR INCITING ANESTHESIA-RELATED ALLERGENS.

    PubMed

    Alshaeri, Taghreed; Gupta, Deepak; Nagabhushana, Ananthamurthy

    2016-02-01

    Anaphylaxis during anesthesia is uncommon. Diagnosis of peri-anesthesia anaphylaxis (PAA) requires anesthesia providers' vigilance for prompt diagnosis and treatment. In this case report, we present a challenging case with suspected PAA including its perioperative management, intensive care unit (ICU) course, and post-discharge follow-up. A 44-year-old female (body mass index = 26) presented for elective abdominal panniculectomy. Post-intubation, severe bronchospasm occurred that was non-responsive to nebulized albuterol and intravenous epinephrine. Continuous infusion of epinephrine was initiated. After aborting surgical procedure, the patient was transferred to ICU on continuous intravenous infusion of epinephrine. Venous blood sampling showed elevated troponin level. Echocardiography revealed ejection fraction of 25% suspicious of Takotsubo cardiomyopathy (mid cavitary variant). Tracheal extubation was only possible after three days. Subsequently, patient was discharged home with a cardiology follow-up appointment and a referral to an allergy specialist. Unfortunately at our institution (an academic university hospital in United States) along with neighboring institutions in near-by areas, the only allergy skin tests available are for local anesthetics and antibiotics, while neuromuscular blocking agents (NMBAs) cannot be tested (the suspected anaphylactic agent in our case was presumably rocuronium). In summary, PAA requires and responds to emergent diagnosis and immediate treatment; however there is still a long way to go to ensure post-PAA testing for inciting anesthesia-related allergens. PMID:27382817

  7. Patient advocacy and arthritis: moving forward.

    PubMed Central

    Leong, Amye L.; Euller-Ziegler, Liana

    2004-01-01

    Patient advocacy is based on the premise that people have the right to make their own choices about their health care. Personal advocacy is centred on the experiential expertise of the individual affected by the condition, whereas group advocacy is grounded on patient-centred strategies and actions. The first patient advocacy groups for arthritis were set up over 20 years ago in the USA and have subsequently spread to many other countries. This paper discusses the growth and impact of personal advocacy as well as recent developments in group advocacy in the Asia-Pacific region, Europe, and North America, in terms of arthritis awareness, research, corporate partnerships, and the Bone and Joint Decade global initiative. PMID:15042233

  8. Anaphylaxis to chemotherapy and monoclonal antibodies.

    PubMed

    Castells, Mariana C

    2015-05-01

    Hypersensitivity reactions are increasingly prevalent, although underrecognized and underreported. Platins induce immunoglobulin E-mediated sensitization; taxenes and some monoclonal antibodies can induce reactions at first exposure. Severe hypersensitivity can preclude first-line therapy. Tryptase level at the time of a reaction is a useful diagnostic tool. Skin testing provides a specific diagnosis. Newer tests are promising diagnostic tools to help identify patients at risk before first exposure. Safe management includes rapid drug desensitization. This review provides information regarding the scope of hypersensitivity and anaphylactic reactions induced by chemotherapy and biological drugs, as well as diagnosis, management, and treatment options. PMID:25841555

  9. Research to practice: developing an integrated anaphylaxis education curriculum for school nurses.

    PubMed

    Cavanaugh, Rebecca; Strickland, C June

    2011-06-01

    The numbers of school-aged children with life-threatening allergies that cause anaphylaxis continues to increase. Many states, including Washington, have responded to this by developing specific guidelines for school districts to follow in order to provide a safe learning environment for children with medical conditions that put them at risk for anaphylaxis. School nurses require resources to assist them in providing health training for school staff on how to manage potentially life-threatening health conditions for children in their school, however, resources to address this training are limited. A search for and content analysis of currently available literature and resources about anaphylaxis and anaphylaxis training curricula revealed a lack of an integrated curriculum to train school staff. This article presents a discussion of the development of a train-the-trainer anaphylaxis education program providing school nurses with curriculum, lesson plans, teaching-learning activities, and resources for anaphylaxis education of all school staff. PMID:21444745

  10. Diagnosis of anaphylactic death in forensics: Review and future perspectives.

    PubMed

    Cecchi, Rossana

    2016-09-01

    The diagnosis of anaphylaxis in a pre- or post-mortal phase involves the formulation of problems not yet solved by the international scientific literature, due to the complexity of pathogenic factors and pathophysiological processes that characterizes it. For forensic autopsies, further problems of differential diagnosis arise and often leave the forensic pathologist unable to express an opinion of certainty, as a result of lack of case history, circumstantial and autoptical-histopathological data. Nevertheless, in routine cases the postmortem diagnosis of anaphylactic death continues to be based on exclusion and circumstantial evidence. The author, after an extensive review of the literature relating to deaths from anaphylaxis of forensic pathological interest, and a discussion of the microscopical and biochemical findings, proposes a diagnostic protocol for forensic purposes and evaluates the diagnostic perspectives enabled by the newly available analytic techniques and markers. Maybe, the application of omics methodologies could help in the future for anaphylaxis diagnosis. PMID:27591544

  11. Advocacy 201: Incorporating Advocacy Training in Health Education Professional Preparation Programs

    ERIC Educational Resources Information Center

    Thompson, Amy; Kerr, Dianne; Dowling, Jamie; Wagner, Laurie

    2012-01-01

    Involvement in advocacy is a responsibility of health educators, as identified by the National Commission on Health Education Credentialing. Of all the professional responsibilities, participation in advocacy-related activity is often neglected. This lack of participation may be due to the absence of advocacy and policy skills training in health…

  12. The ACA Advocacy Competencies: A Social Justice Advocacy Framework for Professional School Counselors

    ERIC Educational Resources Information Center

    Ratts, Manivong J.; DeKruyf, Lorraine; Chen-Hayes, Stuart F.

    2007-01-01

    The recent endorsement of the advocacy competencies by the American Counseling Association signals their relevance to the school counseling profession. This article outlines the importance of being a social change agent, the value of advocacy in K-12 schools, and how school counselors can use the advocacy competencies as a framework for promoting…

  13. Higher latitude and lower solar radiation influence on anaphylaxis in Chilean children

    PubMed Central

    Hoyos-Bachiloglu, Rodrigo; Morales, Pamela S.; Cerda, Jaime; Talesnik, Eduardo; González, Gilberto; Camargo, Carlos A.; Borzutzky, Arturo

    2014-01-01

    Background Recent studies suggest an association between higher latitude, a proxy of vitamin D (VD) status, and allergic diseases. Chile provides an ideal setting to study this association due to its latitude span and high rates of VD deficiency in southern regions. The aim of this study is to explore the associations of latitude and solar radiation with anaphylaxis admission rates. Methods We reviewed anaphylaxis admissions in Chile’s hospital discharge database between 2001 and 2010 and investigated associations with latitude and solar radiation. Results 2316 anaphylaxis admissions were registered. Median age of patients was 41 years; 53% were female. National anaphylaxis admission rate was 1.41 per 100,000 persons per year. We observed a strong north-south increasing gradient of anaphylaxis admissions (β 0.04, P=0.01), with increasing rates south of latitude 34°S. A significant association was also observed between solar radiation and anaphylaxis admissions (β −0.11, P=0.009). Latitude was associated with food-induced (β 0.05, P=0.02), but not drug-induced (β −0.002, P=0.27), anaphylaxis. The association between latitude and food-induced anaphylaxis was significant in children (β 0.01, P=0.006), but not adults (β 0.003, P=0.16). Anaphylaxis admissions were not associated with regional sociodemographic factors like poverty, rurality, educational level, ethnicity, or physician density. Conclusions Anaphylaxis admission rates in Chile are highest at higher latitudes and lower solar radiation, used as proxies of VD status. The associations appear driven by food-induced anaphylaxis. Our data support a possible role of VD deficiency as an etiological factor in the high anaphylaxis admission rates found in southern Chile. PMID:24628618

  14. 78 FR 73587 - Taxpayer Advocacy Panel Meeting Cancellation

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-06

    ... Internal Revenue Service Taxpayer Advocacy Panel Meeting Cancellation AGENCY: Internal Revenue Service (IRS... the open meeting of the Taxpayer Advocacy Panel Tax Forms and Publications Project Committee scheduled... Advocacy Panel. BILLING CODE 4830-01-P...

  15. 78 FR 73586 - Taxpayer Advocacy Panel Meeting Cancellation

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-06

    ... Internal Revenue Service Taxpayer Advocacy Panel Meeting Cancellation AGENCY: Internal Revenue Service (IRS... the open meeting of the Taxpayer Advocacy Panel Taxpayer Assistance Center Improvements Project..., Taxpayer Advocacy Panel. BILLING CODE 4830-01-P...

  16. 78 FR 73587 - Taxpayer Advocacy Panel Meeting Cancellation

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-06

    ... Internal Revenue Service Taxpayer Advocacy Panel Meeting Cancellation AGENCY: Internal Revenue Service (IRS... the open meeting of the Taxpayer Advocacy Panel Toll-Free Phone Line Project Committee scheduled for... Advocacy Panel. BILLING CODE 4830-01-P...

  17. 78 FR 73587 - Taxpayer Advocacy Panel Meeting Cancellation

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-06

    ... Internal Revenue Service Taxpayer Advocacy Panel Meeting Cancellation AGENCY: Internal Revenue Service (IRS... the open meeting of the Taxpayer Advocacy Panel Notices and Correspondence Project Committee scheduled... Advocacy Panel. BILLING CODE 4830-01-P...

  18. 78 FR 73587 - Taxpayer Advocacy Panel; Meeting Cancellation.

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-06

    ... Internal Revenue Service Taxpayer Advocacy Panel; Meeting Cancellation. AGENCY: Internal Revenue Service... cancellation of the open meeting of the Taxpayer Advocacy Panel Taxpayer Communications Project Committee..., Acting Director, Taxpayer Advocacy Panel. BILLING CODE 4830-01-P...

  19. Intravenous tacrolimus and cyclosporine induced anaphylaxis: what is next?

    PubMed Central

    Kang, Sung-Yoon; Sohn, Kyoung-Hee; Lee, Jeong-Ok; Kim, Sae-Hoon; Cho, Sang-Heon

    2015-01-01

    Tacrolimus and cyclosporine have been used in various formulations, but their hypersensitivity reactions are rare in practice. Castor oil derivatives are nonionic surfactants used in aqueous preparations of hydrophobic active pharmaceutical ingredients. Castor oil derivatives that can be used as additives to tacrolimus and cyclosporine may play a role in the development of hypersensitivity reactions, especially anaphylaxis. Various immunologic and nonimmunologic mechanisms have been implicated in hypersensitivity reactions induced by castor oil derivatives. Physicians should be aware that not only the drug itself, but also its additives or metabolites could induce hypersensitivity reactions. We report a case of anaphylaxis caused by vitamin K (phytonadine), serotonin antagonist (granisetron), intravenous tacrolimus, and cyclosporine. Interestingly, the patient tolerated oral cyclosporine, which did not contain Cremophor EL or polysorbate 80. PMID:26240796

  20. Intravenous tacrolimus and cyclosporine induced anaphylaxis: what is next?

    PubMed

    Kang, Sung-Yoon; Sohn, Kyoung-Hee; Lee, Jeong-Ok; Kim, Sae-Hoon; Cho, Sang-Heon; Chang, Yoon-Seok

    2015-07-01

    Tacrolimus and cyclosporine have been used in various formulations, but their hypersensitivity reactions are rare in practice. Castor oil derivatives are nonionic surfactants used in aqueous preparations of hydrophobic active pharmaceutical ingredients. Castor oil derivatives that can be used as additives to tacrolimus and cyclosporine may play a role in the development of hypersensitivity reactions, especially anaphylaxis. Various immunologic and nonimmunologic mechanisms have been implicated in hypersensitivity reactions induced by castor oil derivatives. Physicians should be aware that not only the drug itself, but also its additives or metabolites could induce hypersensitivity reactions. We report a case of anaphylaxis caused by vitamin K (phytonadine), serotonin antagonist (granisetron), intravenous tacrolimus, and cyclosporine. Interestingly, the patient tolerated oral cyclosporine, which did not contain Cremophor EL or polysorbate 80. PMID:26240796

  1. Anaphylaxis following intranasal challenge of mice sensitized with ovalbumin.

    PubMed Central

    McCaskill, A C; Hosking, C S; Hill, D J

    1984-01-01

    Mice sensitized with two intraperitoneal injections of ovalbumin and challenged intranasally with the same antigen developed a non-fatal anaphylactic shock peaking in severity 30 min after challenge. Increases in haematocrit were noted which corresponded to the severity of signs of shock displayed by mice. Severity of shock also correlated with IgE and IgG levels. Sensitization by the nasal route, and use of B. pertussis vaccine as adjuvant had no qualitative effect upon the response. Cobra venom factor depletion of C3 in vivo did not alter the response of mice, which suggests anaphylaxis did not involve complement activation. Sensitivity was not transferrable to non-immune mice with serum. Passive sensitization with polyclonal and monoclonal antibodies produced inconsistent results. Possible mechanisms of anaphylaxis are discussed. PMID:6706376

  2. Alpha-gal anaphylaxis: the first case report in Italy.

    PubMed

    Calamari, A M; Poppa, M; Villalta, D; Pravettoni, V

    2015-09-01

    We report the case of a 55-year-old man who went into anaphylactic shock six hours after eating a meal containing meat. He reported having had several tick bites in months before the reaction. The serum specific IgE showed strong positivity to alpha-gal. This is clearly alpha-gal anaphylaxis with delayed onset after meat ingestion caused by tick bite, confirmed by alpha-gal IgE positivity. PMID:26357002

  3. Exercise-induced anaphylaxis related to specific foods.

    PubMed

    Tilles, S; Schocket, A; Milgrom, H

    1995-10-01

    We describe the case, documented by challenge results, of a 16-year-old girl with exercise-induced anaphylaxis associated with eating pizza and a cheese sandwich. Patients in whom a specific coprecipitating food has been identified should avoid it for at least 12 hours before exercise. All patients should be instructed to avoid eating 6 to 8 hours before exercise, discontinue exercise at the first sign of symptoms, and exercise only with a companion prepared to administer epinephrine. PMID:7562280

  4. Food-dependent exercise-induced anaphylaxis: is wheat unique?

    PubMed

    Wong, Gabriel K; Krishna, Mamidipudi T

    2013-12-01

    This review draws comparisons between wheat-dependent exercise-induced anaphylaxis (WDEIA) and other food-dependent exercise-induced anaphylaxis (FDEIAs) and discusses the importance of co-factors in its pathophysiology. FDEIA remains an enigmatic condition since it was first described 30 years ago. The sporadic and unpredictable nature of its reactions has puzzled clinicians and scientists for decades, but recent studies on WDEIA have enlightened us about the pathophysiology of this condition. The identification of defined allergic epitopes such as Tri a 19, α-gliadin, β-gliadin and γ-gliadin in WDEIA enables it to become the perfect model for studying FDEIA, but WDEIA is by no means a unique condition. On a larger scale, FDEIA represents a crucial link between IgE-mediated and anaphylactoid reactions and provides supportive evidence for the concept of 'summation anaphylaxis' and the need to overcome the 'allergen threshold'. Future work should focus on identifying more of the FDEIA epitopes and understanding their distinct molecular properties. The development of a biomarker in order to identify patients susceptible to co-factor influences would be invaluable. PMID:24127054

  5. Anaphylaxis in Latin America: a report of the online Latin American survey on anaphylaxis (OLASA)

    PubMed Central

    Solé, Dirceu; Ivancevich, Juan Carlos; Borges, Mario Sánchez; Coelho, Magna Adaci; Rosário, Nelson A; Ardusso, Ledit Ramón Francisco; Bernd, Luis Antônio Guerra

    2011-01-01

    OBJECTIVES: The aims of the Online Latin American Survey of Anaphylaxis (OLASA) were to identify the main clinical manifestations, triggers, and treatments of severe allergic reactions in patients who were seen by allergists from July 2008 to June 2010 in 15 Latin American countries and Portugal (n = 634). RESULTS: Of all patients, 68.5% were older than 18 years, 41.6% were male, and 65.4% experienced the allergic reaction at home. The etiologic agent was identified in 87.4% of cases and predominantly consisted of drugs (31.2%), foods (23.3%), and insect stings (14.9%). The main symptom categories observed during the acute episodes were cutaneous (94.0%) and respiratory (79.0%). The majority of patients (71.6%) were treated initially by a physician (office/emergency room) within the first hour after the reaction occurred (60.2%), and 43.5% recovered in the first hour after treatment. Most patients were treated in an emergency setting, but only 37.3% received parenteral epinephrine alone or associated with other medication. However, 80.5% and 70.2% were treated with corticosteroids or antihistamines (alone or in association), respectively. A total of 12.9% of the patients underwent reanimation maneuvers, and 15.2% were hospitalized. Only 5.8% of the patients returned to the emergency room after discharge, with 21.7% returning in the first 6 hours after initial treatment. CONCLUSION: The main clinical manifestations of severe allergic reactions were cutaneous. The etiologic agents that were identified as causing these acute episodes differed according to age group. Following in order: drugs (31.2%), foods (23.3% and insect stings (14.9%) in adults with foods predominance in children. Treatment provided for acute anaphylactic reactions was not appropriate. It is necessary to improve educational programs in order to enhance the knowledge on this potentially fatal emergency. PMID:21808856

  6. The Advocate: The Need for Advocacy; Case Advocacy; Issue Advocacy; Legislation and Regulations: Consumer Rights; Where to Find Information and Assistance Related to Child Advocacy and Social Services.

    ERIC Educational Resources Information Center

    The Advocate, 1977

    1977-01-01

    In this journal issue, the need for child advocacy and the roles of advocates are examined. The Statewide Youth Advocacy Project is explained. Case studies illustrating the role of the advocate as mediator between parent/student and school authorities are presented. The question of how parents and students secure their rights by appeal is…

  7. School Board Advocacy: Ready, Aim, Inspire!

    ERIC Educational Resources Information Center

    Dowd, Karen

    2010-01-01

    It is said that "all politics are local," and the same can be said about advocacy and school boards. Advocacy is essential for retaining the progress that's been made in the past, and for building a foundation and network for the future. Advocating for preferred programs, curricula and initiatives has always been important. As a starting point,…

  8. Building Evidence for Music Education Advocacy

    ERIC Educational Resources Information Center

    Shorner-Johnson, Kevin

    2013-01-01

    The economic challenges facing public schools and music education are immense. In this context, music teachers and supporters will need to engage in persuasive advocacy to protect resource allocations to music programs. It is worthwhile to consider the model of music education advocacy that allowed music to be adopted into the Boston Public…

  9. Effective Advocacy and Communication with Legislators.

    ERIC Educational Resources Information Center

    American Counseling Association, Office of Public Policy and Information, Alexandria, VA.

    This pamphlet attempts to make communicating with legislators easy. Each section includes a brief paragraph and several bullet points that present techniques or advice for simplifying communication. It begins with "Rules for Effective Advocacy," which presents a core set of basic advocacy principles, followed by "What Makes Politicians Tick?" and…

  10. Professor Brand Advocacy: Do Brand Relationships Matter?

    ERIC Educational Resources Information Center

    Jillapalli, Ravi K.; Wilcox, James B.

    2010-01-01

    The trend among students to advocate their professors online continues to generate interest within marketing academia. Brand advocacy in products and services has played a vital role in marketing. However, no known research to date has embraced the idea of brand advocacy in marketing education. This research builds on the recent human brand…

  11. Advocacy: AASL Puts the Puzzle Together

    ERIC Educational Resources Information Center

    Johns, Sara Kelly

    2007-01-01

    School librarians work with people of all ages, abilities, and personalities; those people are the puzzle pieces that make advocacy for libraries effective. School librarians contribute to and use the resources of their state and national organizations' advocacy efforts. The completed picture of the puzzle is an excellent program with…

  12. New Advocacy Groups Shaking up Education Field

    ERIC Educational Resources Information Center

    Sawchuk, Stephen

    2012-01-01

    A new generation of education advocacy groups has emerged to play a formidable political role in states and communities across the country. Those groups are shaping policy through aggressive lobbying and campaign activity--an evolution in advocacy that is primed to continue in the 2012 elections and beyond. Though the record of their electoral…

  13. Advocacy in Counseling: Counselors, Clients, & Community.

    ERIC Educational Resources Information Center

    Lewis, Judy, Ed.; Bradley, Loretta, Ed.

    The sixteen chapters in this volume were selected from advocacy theme papers written by members of the American Counseling Association. They examine the role of the counselor as advocate for different groups of people, as follows: (1) "Developing a Common Language and Framework for Understanding Advocacy in Counseling," (R. L. Toporek); (2)…

  14. University-Based Planning: Faculty Advocacy Roles.

    ERIC Educational Resources Information Center

    Harris, William M.; Thagard, Aubrey

    2001-01-01

    Supports the involvement of university planning faculty in advocacy roles as change agents in urban inner city communities, discussing several roles for urban design professionals in the academic context as advocates or contractors (i.e., planner advocacy in community development, in environmental affairs, and in urban design). (SM)

  15. Autism Advocacy: A Network Striving for Equity

    ERIC Educational Resources Information Center

    Itkonen, Tiina; Ream, Robert

    2013-01-01

    In this exploratory case study, we examine the rise of autism on the policy agenda and the new generation of autism advocacy. We focus especially on interconnections between the rhetoric about autism in the media and the emergence and political effectiveness of Autism Speaks, the nation's largest autism advocacy group. We portray how…

  16. CAEA Art Education Advocacy in California.

    ERIC Educational Resources Information Center

    Greer, Dwaine; Tolladay, Kay

    1979-01-01

    The California Art Education Association has developed a statewide advocacy effort to counteract declines in art education brought about by financial pressures and the basic skills movement. This article describes the advocacy program's publicity efforts and commitments to work with the entire arts community in a "comprehensive arts" campaign.…

  17. Broadening the Discussion about Evaluator Advocacy

    ERIC Educational Resources Information Center

    Hendricks, Michael

    2014-01-01

    This issue of "American Journal of Evaluation" presents commentaries by evaluation leaders, George Grob and Rakesh Mohan, which draw upon their wealth of practical experience to address questions about evaluator advocacy, including What is meant by the word "advocacy"? Should evaluators ever advocate? If so, when and how? What…

  18. Political Advocacy Handbook: Activating Grassroots Involvement.

    ERIC Educational Resources Information Center

    Bootel, Jaclyn A.; Warger, Cynthia L.

    This handbook is designed to assist special education advocates in developing the capacity to mount an effective advocacy campaign at the state and federal levels. It is divided into the following four separate training modules: (1) "Introduction to Advocacy"; (2) "Understanding the Governmental Process"; (3) "Changing Public Policy"; and (4)…

  19. Oral food challenge to wheat: a near-fatal anaphylaxis and review of 93 food challenges in children

    PubMed Central

    2013-01-01

    Background Wheat allergy is among the most common food allergy in children, but few publications are available assessing the risk of anaphylaxis due to wheat. Methods In this study, we report the case of near-fatal anaphylaxis to wheat in a patient undergoing an oral food challenge (OFC) after the ingestion of a low dose (256 mg) of wheat. Moreover, for the first time, we analyzed the risk of anaphylaxis during an OFC to wheat in 93 children, compared to other more commonly challenged foods such as milk, egg, peanuts, and soy in more than 1000 patients. Results This study, which includes a large number of OFCs to wheat, shows that wheat is an independent risk factor that is associated with anaphylaxis requiring epinephrine administration (Odds Ratio [OR] = 2.4) and anaphylaxis requiring epinephrine administration to low dose antigen (OR = 8.02). Other risk factors for anaphylaxis, anaphylaxis requiring epinephrine administration, and anaphylaxis to low dose antigen was a history of a prior reaction not involving only the skin (OR = 1.8, 1.9 and 1.8 respectively). None of the clinical variables available prior to performing the OFC could predict which children among those undergoing OFCs to wheat would develop anaphylaxis or anaphylaxis for low dose antigen. Conclusion This study shows that wheat is an independent risk factor that is associated with anaphylaxis requiring epinephrine administration and anaphylaxis requiring epinephrine administration to low dose antigen. PMID:23965733

  20. A case of the first documented fire ant anaphylaxis in Canada

    PubMed Central

    2013-01-01

    The first documented confirmed case of an imported fire ant causing anaphylaxis in Canada is herein reported. In a patient with anaphylaxis to ants a physician in Canada should be aware that an allergic reaction to fire ant is a possibility. PMID:23837799

  1. Recognition and Treatment of Anaphylaxis in the School Setting: The Essential Role of the School Nurse

    ERIC Educational Resources Information Center

    Schoessler, Sally; White, Martha V.

    2013-01-01

    Since anaphylaxis is unpredictable, rapid in onset, and potentially life threatening, it is critical for school staff to recognize and respond to its symptoms quickly. The symptoms of anaphylaxis can be challenging to differentiate, particularly in school-age children who may have trouble explaining what they are experiencing. School staff must…

  2. Cashew nut allergy is associated with a high risk of anaphylaxis.

    PubMed

    Davoren, M; Peake, J

    2005-10-01

    Cashew allergy is an evolving clinical problem. A retrospective chart review of 213 children with peanut or tree nut allergy was undertaken over a 42 month period. Anaphylaxis to cashew nut was more common than to peanut (74.1% v 30.5%). Children with cashew allergy are at risk of anaphylaxis. PMID:16177166

  3. Intraoperative anaphylaxis due to gelofusine in a patient undergoing intramedullary nailing of the femur: a case report

    PubMed Central

    2009-01-01

    Background Although uncommon, anaphylaxis due to a colloid plasma expander can occur peri-operatively Case presentation We present a case of an intra-operative cardiac arrest in a 72 year old Caucasian male patient who underwent prophylactic intramedullary nailing for a proximal femoral metastasis from prostate cancer. The patient was resuscitated successfully and the procedure was completed uneventfully. Elevated serum tryptase levels confirmed the diagnosis of an anaphylactic reaction and positive allergy skin prick testing identified gelofusine as the causative agent. Conclusion A high index of suspicion, prompt diagnosis and rapid institution of treatment are essential for a safe outcome following such reactions. To our knowledge, this is the first published report of such a severe reaction to gelofusine infusion that occurs during an orthopaedic procedure. PMID:19126195

  4. Anaphylaxis Preparedness among Preschool Staff before and after an Educational Intervention

    PubMed Central

    Foster, Ashley A.; Campbell, Ronna L.; Lee, Sangil; Anderson, Jana L.

    2015-01-01

    Introduction. Children with severe food allergies may spend many hours in the preschool setting. Little is known about anaphylaxis recognition and management preparedness among preschool staff. The objective of this study was to assess anaphylaxis preparedness among preschool staff. Methods. Anonymous questionnaires were administered before and after a 40-minute educational seminar on anaphylaxis recognition and management. Results. In total, 181 individuals participated in the preintervention survey and 171 participated in the postintervention survey. The comfort level with recognizing anaphylaxis and administering an epinephrine autoinjector significantly increased after the intervention (P < .001 for both). Of the 5 steps needed to administer an epinephrine autoinjector, staff named a mean (SD) of 3 (1.3) steps in the correct order compared with 4.2 (1.1) steps after the educational intervention (P < .001). Conclusion. This study shows that a brief education intervention can significantly increase caregiver comfort regarding identifying anaphylaxis and administering an epinephrine autoinjector. PMID:26300926

  5. Anaphylaxis and asthma in a scrimshander due to deer bone dust.

    PubMed

    Patterson, R; Ganz, M A; Roberts, M

    1991-11-01

    A boilermaker who engraved deer bone (scrimshaw) as his artistic vocation developed recurrent anaphylaxis while scraping deer bones. These bones has been boiled in NaClO and dried, leaving residual NaOH and altered deer protein. He had recurrent episodes of anaphylaxis when exposed to the bone dust. The anaphylaxis appears to be the result of exposure of traumatized skin to NaOH and antigen with sufficient absorption of antigen to result in anaphylaxis, although inhalation may have been contributory. The most severe, near fatal episode of anaphylaxis may have been worsened by captopril. The patient's reaction by prick test to protein extracted in buffered saline from the deer bones boiled in NaClO and NaOH but not to natural deer protein suggested IgE antibody against deer protein altered by boiling in alkali. The scrimshander is now working with deer bone after prophylactic therapy and control of exposure. PMID:1958009

  6. Succeeding in Postsecondary Ed through Self-Advocacy.

    ERIC Educational Resources Information Center

    Lock, Robin H.; Layton, Carol A.

    2001-01-01

    Discussion of self-advocacy for postsecondary students with learning disabilities considers learning characteristics, self-advocacy as a critical transition skill, identification of intrinsic processing abilities, developing a self-advocacy plan, and the increasing need for postsecondary accommodations. Insets include a sample self-advocacy plan,…

  7. Chloramine-induced anaphylaxis while showering: a case report

    PubMed Central

    2012-01-01

    Introduction Sodium-N-chlorine-p-toluene sulfonamide, commonly known as chloramine-T, is a derivative of chlorine which is widely used as a disinfectant. For many years, chloramine-T has been described as a cause of immediate-type hypersensitivity, especially with regard to asthma and rhinitis, and as a cause of occupational dermatoses in cleaning personnel in hospitals, although no anaphylactic reaction has yet been reported. Hence, to the best of our knowledge we present the first case of anaphylaxis to chloramine-T with evidence of specific immunoglobulin E antibodies. Case presentation We describe the case of a 25-year-old Caucasian woman who was in good health and with a negative history for atopy, including no respiratory symptoms of rhinitis or asthma, and with no professional exposure to chloramine-T. She, while showering, applied a chloramine-T solution to a skin area with folliculitis on her leg, and within a few minutes developed generalized urticaria and angioedema, followed by vomiting and collapse with loss of consciousness. A skin prick test with a chloramine-T solution at 10mg/mL concentration was positive, and specific immunoglobulin E to chloramine-T was quantified at a value of 2.9 optical density as measured by the enzyme allergosorbent test technique. Conclusion The strict cause-effect relationship and the results of the skin test and the in vitro test make certain the causative role of chloramine-T in this case of anaphylaxis. This suggests that chloramine-T, based on its wide use as a disinfectant, should be considered a possible cause in anaphylaxis of unknown origin. PMID:23009577

  8. Anaphylaxis to honey in pollinosis to mugwort: a case report.

    PubMed

    Fuiano, N; Incorvaia, C; Riario-Sforza, G G; Casino, G

    2006-12-01

    A case of anaphylaxis to honey in a 19 year old female sensitized to Compositae pollen is described. The patient suffered from summer rhinoconjunctivitis since seven years; in January 2006, ten minutes after eating bread and honey she developed angioedema of the lips and tongue, runny nose, cough, dyspnoea, and collapse, requiring hospitalization and treatment with high dose corticosteroids and anti-histamines. After two weeks, skin prick tests (SPT) with a standard panel of inhalant allergens and prick + prick with a number of kinds of honey were performed. SPTs were positive to mugwort, ragweed, dandelion, and goldenrod. Concerning honey, the prick + prick was positive to "Millefiori" (obtained from bees foraging on Compositae) and also to sunflower, limetree, and gum tree honey, while was negative for other kinds of honey, including the frequently used chestnut honey and acacia honey. The allergenic component responsible of anaphylaxis in this case seems to be a molecule occurring in Compositae pollens, as previously reported for other three reports, but also in pollen from plants of different families. Honey contains a large number of components derived from bees, such as gland secretions and wax, as well as from substances related to their foraging activity, such flower nectar and pollens (1, 2). Honey as a food has been associated to allergic reactions and particularly to anaphylaxis (3-6). Among the pollens, the role of Compositae is somewhat controversial, since its responsibility is clear in some studies (3, 5, 6) but considered negligible in others (7). Here we present the case of a patient sensitized to Compositae pollen who had an anaphylactic reaction to the ingestion of honey obtained from bees foraging on Compositae flowers and was tested with a number of different varieties of honey. PMID:17274522

  9. Anaphylaxis following intravenous paracetamol: the problem is the solution.

    PubMed

    Jain, S S; Green, S; Rose, M

    2015-11-01

    Paracetamol is a ubiquitous analgesic and antipyretic that is widely administered, including by anaesthetists. Immediate hypersensitivity reactions to intravenous paracetamol are particularly rare. We report two cases involving four separate episodes of anaphylaxis to intravenous paracetamol in different perioperative settings without a past history of intolerance to the oral form. The allergological investigations are described, during which it became evident that both patients were allergic to an excipient (mannitol) present in the formulation and that neither was allergic to the principal agent (paracetamol). The importance of referral and investigation of perioperative drug reactions is underscored by these two cases. PMID:26603804

  10. Bortezomib treatment diminishes hazelnut-induced intestinal anaphylaxis in mice.

    PubMed

    Mudnakudu Nagaraju, Kiran Kumar; Babina, Magda; Weise, Christin; Kühl, Anja; Schulzke, Joerg; Worm, Margitta

    2016-07-01

    Food allergy is a common health problem and can cause anaphylaxis. Avoidance of the offending food allergen is still the mainstay therapeutic approach. In this study, we investigated the role of plasma cell reduction by proteasome inhibition in a murine model of food allergy and examined the impact of this treatment on the systemic and local immune response. For this purpose, intestinal anaphylaxis was induced in BALB/c mice with the food allergen hazelnut, in conjunction with different adjuvants (alum and Staphylococcal enterotoxin B SEB) and different administration routes (oral and intraperitoneal). In both models, allergy symptoms were observed, but the clinical severity was more pronounced in the hazelnut-alum model than in the hazelnut-SEB model. Accordingly, allergen-specific immunoglobulin E (IgE) against hazelnut was detectable, and mast cell protease-1 in serum was increased after allergen provocation. Treatment with the proteasome inhibitor bortezomib reduced plasma cells and resulted in an abolishment of hazelnut allergen-specific IgE, which was associated with amelioration of clinical symptoms as well as a significant decrease in both CD19(+) and follicular B lymphocytes. Our data demonstrate the importance of allergen-specific IgE in food allergy and point to B cells as potential therapeutic targets for its treatment. PMID:27111856

  11. 45 CFR 1321.13 - Advocacy responsibilities.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ..., DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION ON AGING, OLDER AMERICANS PROGRAMS GRANTS TO STATE AND COMMUNITY PROGRAMS ON AGING State Agency Responsibilities § 1321.13 Advocacy responsibilities....

  12. 45 CFR 1321.13 - Advocacy responsibilities.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ..., DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION ON AGING, OLDER AMERICANS PROGRAMS GRANTS TO STATE AND COMMUNITY PROGRAMS ON AGING State Agency Responsibilities § 1321.13 Advocacy responsibilities....

  13. 45 CFR 1321.13 - Advocacy responsibilities.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ..., DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION ON AGING, OLDER AMERICANS PROGRAMS GRANTS TO STATE AND COMMUNITY PROGRAMS ON AGING State Agency Responsibilities § 1321.13 Advocacy responsibilities....

  14. 45 CFR 1321.13 - Advocacy responsibilities.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ..., DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION ON AGING, OLDER AMERICANS PROGRAMS GRANTS TO STATE AND COMMUNITY PROGRAMS ON AGING State Agency Responsibilities § 1321.13 Advocacy responsibilities....

  15. 45 CFR 1321.13 - Advocacy responsibilities.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ..., DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION ON AGING, OLDER AMERICANS PROGRAMS GRANTS TO STATE AND COMMUNITY PROGRAMS ON AGING State Agency Responsibilities § 1321.13 Advocacy responsibilities....

  16. Synchronous Conferencing by a Community Advocacy Group

    ERIC Educational Resources Information Center

    Fahrni, Patricia

    2004-01-01

    The previous report in this series discussed how collaborative tools can be used in the development of formal and non-formal online communities. The current report describes the specific development of an online community advocacy group.

  17. Factors for success in mental health advocacy

    PubMed Central

    Hann, Katrina; Pearson, Heather; Campbell, Doris; Sesay, Daniel; Eaton, Julian

    2015-01-01

    Background Mental health advocacy groups are an effective way of pushing the mental health agenda and putting pressure on national governments to observe the right to health; however, there is limited research that highlights best practices for such groups in low-resource settings. In an effort to improve the scaling up of mental health in Sierra Leone, stakeholders came together to form the country's first mental health advocacy group: the Mental Health Coalition – Sierra Leone. Since its inception, the group has worked towards raising the profile of mental health in Sierra Leone and developing as an advocacy organisation. Design The study's aim was to investigate views on enabling factors and barriers associated with mental health advocacy in a low-income country using a community-based participatory approach and qualitative methodology. Focus groups (N=9) were held with mental health stakeholders, and key informant interviews (N=15) were conducted with advocacy targets. Investigators analysed the data collaboratively using coding techniques informed by grounded theory. Results Investigators reveal viewpoints on key factors in networking, interacting with government actors, and awareness raising that enabled mental health advocacy aims of supporting policy, service delivery, service user rights, training for service delivery, and awareness raising. The investigators outline viewpoints on barriers for advocacy aims in framing the issue of mental health, networking, interacting with government actors, resource mobilization, and awareness raising. Conclusions The findings outline enabling factors, such as networking with key stakeholders, and barriers, such as lack of political will, for achieving mental health advocacy aims within a low-resource setting, Sierra Leone. Stakeholder coalitions can further key policy development aims that are essential to strengthen mental health systems in low-resource settings. PMID:26689456

  18. Why Do People Die of Anaphylaxis?—A Clinical Review

    PubMed Central

    Kumar, Arvind; Teuber, Suzanne S.; Gershwin, M. Eric

    2005-01-01

    Anaphylaxis is a source of anxiety for patients and healthcare providers. It is a medical emergency that presents with a broad array of symptoms and signs, many of which can be deceptively similar to other diseases such as myocardial infarction, asthma, or panic attacks. In addition to these diagnostic challenges, anaphylaxis presents management difficulties due to rapid onset and progression, lack of appropriate self-treatment education and implementation by patients, severity of the allergic response, exacerbating medications or concurrent disease, and unpredictability. The most common causes of anaphylaxis are food allergies, stinging insects and immunotherapy (allergy shots) but idiopathic anaphylaxis, latex allergy and drug hypersensitive all contribute to the epidemiology. Reactions to IVP and other dyes are coined anaphylactoid reactions but have identical pathophysiology and treatment, once the mast cell has been degranulated. As many antigens can be the trigger for fatal anaphylaxis, it is useful to examine the features of each etiology individually, highlighting factors common to all fatal anaphylaxis and some specific to certain etiologies. Generally what distinguishes a fatal from non fatal reaction is often just the rapidity to apply correct therapy. Prevention is clearly the key and should identify high-risk patients in an attempt to minimize the likely of a severe reaction. Although fatal anaphylaxis is rare, it is likely underreported. PMID:16584114

  19. Advocacy evaluation: challenges and emerging trends.

    PubMed

    Devlin-Foltz, David; Fagen, Michael C; Reed, Ehren; Medina, Robert; Neiger, Brad L

    2012-09-01

    Devising, promoting, and implementing changes in policies and regulations are important components of population-level health promotion. Whether advocating for changes in school meal nutrition standards or restrictions on secondhand smoke, policy change can create environments conducive to healthier choices. Such policy changes often result from complex advocacy efforts that do not lend themselves to traditional evaluation approaches. In a challenging fiscal environment, allocating scarce resources to policy advocacy may be particularly difficult. A well-designed evaluation that moves beyond inventorying advocacy activities can help make the case for funding advocacy and policy change efforts. Although it is one thing to catalog meetings held, position papers drafted, and pamphlets distributed, it is quite another to demonstrate that these outputs resulted in useful policy change outcomes. This is where the emerging field of advocacy evaluation fits in by assessing (among other things) strategic learning, capacity building, and community organizing. Based on recent developments, this article highlights several challenges advocacy evaluators are currently facing and provides new resources for addressing them. PMID:22773623

  20. The voice of Florence Nightingale on advocacy.

    PubMed

    Selanders, Louise C; Crane, Patrick C

    2012-01-01

    Modern nursing is complex, ever changing, and multi focused. Since the time of Florence Nightingale, however, the goal of nursing has remained unchanged, namely to provide a safe and caring environment that promotes patient health and well being. Effective use of an interpersonal tool, such as advocacy, enhances the care-giving environment. Nightingale used advocacy early and often in the development of modern nursing. By reading her many letters and publications that have survived, it is possible to identify her professional goals and techniques. Specifically, Nightingale valued egalitarian human rights and developed leadership principles and practices that provide useful advocacy techniques for nurses practicing in the 21st century. In this article we will review the accomplishments of Florence Nightingale, discuss advocacy in nursing and show how Nightingale used advocacy through promoting both egalitarian human rights and leadership activities. We will conclude by exploring how Nightingale's advocacy is as relevant for the 21st century as it was for the 19th century. PMID:22320877

  1. Use of alpha-agonists for management of anaphylaxis occurring under anaesthesia: case studies and review.

    PubMed

    Heytman, M; Rainbird, A

    2004-12-01

    Anaphylaxis is an uncommon but serious complication of anaesthesia. Most current guidelines for the management of anaphylaxis list only epinephrine as a vasopressor to use in the event of cardiovascular collapse. We present two cases of anaphylaxis under anaesthesia where return of spontaneous circulation was refractory to epinephrine, but occurred following the administration of the alpha-agonist metaraminol. Potential advantages and disadvantages of using epinephrine in this setting, the role of alpha-agonists and some potential mechanisms accounting for their role in successful management are reviewed. PMID:15549981

  2. Pharmacists’ response to anaphylaxis in the community (PRAC): a randomised, simulated patient study of pharmacist practice

    PubMed Central

    Salter, Sandra M; Delfante, Brock; de Klerk, Sarah; Sanfilippo, Frank M; Clifford, Rhonda M

    2014-01-01

    Objective To evaluate how community pharmacists manage patients with anaphylaxis. Design A randomised, cross-sectional, simulated patient study of community pharmacist practice. Setting 300 metropolitan pharmacies located in Perth Australia, randomised to three groups of 100 pharmacies. Each group corresponded to a different epinephrine autoinjector: original EpiPen, new-look EpiPen or Anapen. Participants 300 pharmacies were visited with 271 simulated patient visits included in the final analysis (88=original EpiPen, 92=new-look EpiPen, 91=Anapen). Outcome measures Primary anaphylaxis preparedness (readiness to treat acute anaphylaxis). Secondary anaphylaxis engagement (willingness to engage the patient in a discussion about their anaphylaxis). Methods Simulated patients approached pharmacists, using a standardised scenario, for assistance with epinephrine autoinjector use and advice about the use of antihistamines in anaphylaxis. Scores for each outcome were obtained based on the number of predefined statements addressed by the pharmacist during the consultation (maximum score=5 for preparedness and 8 for engagement). Results The mean anaphylaxis preparedness score was 2.39 points (SD 1.17). Scores for new-look EpiPen were significantly higher than for original EpiPen and Anapen (2.75 vs 2.38 points, p=0.027; 2.75 vs 2.03 points, p<0.001, respectively). Overall, 17.3% of pharmacists correctly demonstrated the epinephrine autoinjector. The mean anaphylaxis engagement score was 3.11 points (SD 1.73). Scores for new-look EpiPen were similar to original EpiPen and Anapen (3.11 vs 3.32 points; 3.11 vs 2.90 points, both p=0.42). Engagement was associated with preparedness. For each additional engagement point, preparedness increased by 7% (0.357 points; 95% CI 0.291 to 0.424; p<0.001). Conclusions Pharmacists demonstrated reasonable knowledge of anaphylaxis symptoms and emergency care, but had poor epinephrine autoinjector technique and rarely discussed anaphylaxis

  3. Advocacy for Health Equity: A Synthesis Review

    PubMed Central

    Farrer, Linden; Marinetti, Claudia; Cavaco, Yoline Kuipers; Costongs, Caroline

    2015-01-01

    Context Health inequalities are systematic differences in health among social groups that are caused by unequal exposure to—and distributions of—the social determinants of health (SDH). They are persistent between and within countries despite action to reduce them. Advocacy is a means of promoting policies that improve health equity, but the literature on how to do so effectively is dispersed. The aim of this review is to synthesize the evidence in the academic and gray literature and to provide a body of knowledge for advocates to draw on to inform their efforts. Methods This article is a systematic review of the academic literature and a fixed-length systematic search of the gray literature. After applying our inclusion criteria, we analyzed our findings according to our predefined dimensions of advocacy for health equity. Last, we synthesized our findings and made a critical appraisal of the literature. Findings The policy world is complex, and scientific evidence is unlikely to be conclusive in making decisions. Timely qualitative, interdisciplinary, and mixed-methods research may be valuable in advocacy efforts. The potential impact of evidence can be increased by “packaging” it as part of knowledge transfer and translation. Increased contact between researchers and policymakers could improve the uptake of research in policy processes. Researchers can play a role in advocacy efforts, although health professionals and disadvantaged people, who have direct contact with or experience of hardship, can be particularly persuasive in advocacy efforts. Different types of advocacy messages can accompany evidence, but messages should be tailored to advocacy target. Several barriers hamper advocacy efforts. The most frequently cited in the academic literature are the current political and economic zeitgeist and related public opinion, which tend to blame disadvantaged people for their ill health, even though biomedical approaches to health and political short

  4. Anaphylaxis caused by stings from the Solenopsis invicta, lava-pés ant or red imported fi re ant*

    PubMed Central

    Haddad Junior, Vidal; Larsson, Carlos Eduardo

    2015-01-01

    Ants are social insects with species of medical interest, such as the fi re ants (Solenopsis sp.). The sting causes inflammation, vesicles and sterile pustules, which may cause allergic phenomena and even anaphylactic shock. We describe a patient who suffered a large number of stings and an episode of syncope with fall in blood pressure and complete regression of symptoms after resuscitation and medication for anaphylaxis. Considering the clinical manifestations and images of wheals and blisters on the patient’s feet at the time of syncope, this report should serve as a warning for the diagnosis and treatment of this condition and even for counseling and prevention regarding patients exposed to this risk. PMID:26312665

  5. Spontaneous rupture of a splenic hydatid cyst with anaphylaxis in a patient with multi-organ hydatid disease.

    PubMed

    Constantin, V; Popa, F; Socea, B; Carâp, A; Bălălău, C; Motofei, I; Banu, P; Costea, D

    2014-01-01

    Hidatid cysts of the spleen are a rare occurrence, the spleen being the third most common organ for the development of Echinococcus Granulosus. Splenic hydatid cysts are commonly part of multi-organ hydatid disease. Diagnosis is often established when investigating a splenomegaly or by chance during an unrelated consult. It can also be diagnosed after rupture, be it following trauma (the most common occurrence)or spontaneous. Splenic hydatid cyst rupture requires immediate action and is a life-threatening condition. It results, most often, in splenectomy. We present the case of a patient with multi-organ hydatid disease that presented with a ruptured splenic cyst and developed anaphylaxis. The case was resolved by splenectomy and recovered well. PMID:24956347

  6. [A case of food-dependent exercise-induced anaphylaxis caused by ingestion of orange].

    PubMed

    Ono, Rintaro; Motomura, Chikako; Takamatsu, Nobue; Kondo, Yasuto; Akamine, Yuko; Matsuzaki, Hiroshi; Murakami, Yoko; Amimoto, Yuko; Taba, Naohiko; Honjyo, Satoshi; Shibata, Rumiko; Odajima, Hiroshi

    2015-02-01

    The patient was a 10-year-old girl who presented with a history of anaphylactic episodes on three occasions, that developed in association with exercise after she ate citrus fruit. She underwent tolerance tests, as food-dependent exercise-induced anaphylaxis (FDEIA) induced by citrus fruit was suspected. The result of the test for the combination of intake of oranges and exercise was negative. The patient presented with swollen eyelid and wheezing following combined intake of orange and aspirin, based on which she was diagnosed as having FDEIA. Many patients developing an allergic reaction to fruit are diagnosed as having oral allergy syndrome (OAS), and only few cases of FDEIA are reported. Immunoblot tests revealed antigens of 9 kDa, 39 kDa and 53 kDa in this patient, and an inhibition study with oranges revealed that the 39 kDa and 53 kDa antigens were probably antigen-specific allergens. Although the studied patient showed a strongly positive result for IgE antibodies specifically directed at cedar pollen, no common antigenicity with cedar pollen could be recognized. The final diagnosis was a type of FDEIA caused by 39 kDa and 53 kDa proteins, which are different from antigens previously identified in patients with citrus fruits allergy. It should be the first report of such a case. PMID:25924908

  7. Anaphylaxis to Spirulina confirmed by skin prick test with ingredients of Spirulina tablets.

    PubMed

    Le, Thuy-My; Knulst, André C; Röckmann, Heike

    2014-12-01

    Spirulina (Arthrospira platensis), blue-green microalgae, has high content in proteins, γ-linoleic acid and vitamins and therefore gained popularity as food supplement. According to the Food and Agriculture Organization of the United Nations Spirulina is also an interesting alternative and sustainable protein source with the growing world population. We present a case of a 17-year-old male, who developed anaphylaxis the first time he ingested a Spirulina tablet. Skin prick test with diluted Spirulina tablet was positive. Further skin prick testing with separated ingredients (Spirulina platensis algae, silicon dioxide, inulin and magnesium stearate) was only positive for Spirulina platensis algae and negative in controls, confirming the allergy was caused by Spirulina and not by one of the additives. This case report shows that diagnosis of Spirulina allergy can safely be made by skin prick test with dilutions of the A. platensis or even more simple by skin prick test with the diluted tablet. Since Spirulina has gained popularity as food and nutritional supplement, it is important to realize the potential risk of this dietary supplement. Before Spirulina is produced and consumed on a wider scale, allergenicity risk assessment should be performed, including investigation of potential crossreactivity with well-known inhalant allergens and foods. PMID:25445756

  8. A case of taurine-containing drink induced anaphylaxis.

    PubMed

    Lee, Seung-Eun; Lee, Suh-Young; Jo, Eun-Jung; Kim, Mi-Young; Yang, Min-Suk; Chang, Yoon-Seok; Kim, Sae-Hoon

    2013-01-01

    Taurine is one of most abundant free amino acids in mammalian tissue. It has been used for various health functional foods as a main ingredient in food industry. A 33-year-old female patient repeatedly experienced generalized itching, urticaria, dyspnea and dizziness after drinking taurine-containing drinks. The patient showed positive response to oral challenge tests with taurine-containing drinks. The patient also showed positive response with synthetic taurine but not with natural taurine. Skin prick test and basophil activation test with the synthetic taurine were negative. To our knowledge, there has been no report of taurine-induced hypersensitivity reactions. We herein report the first case of taurine-containing drink induced anaphylaxis, especially by synthetic taurine. PMID:23404176

  9. Managing nut-induced anaphylaxis: challenges and solutions

    PubMed Central

    Lomas, Jeanne M; Järvinen, Kirsi M

    2015-01-01

    The prevalence of peanut and tree nut allergy in the USA has increased, especially in the pediatric population. Nut allergy remains the leading cause of fatal anaphylactic reactions. Management of anaphylaxis includes not only treatment of symptoms during a reaction, but strict dietary avoidance and education on potential situations, which may place the patient at high risk for accidental exposure. Cross-reactivity between various nuts along with various cross-contamination sources should be discussed with all nut-allergic individuals. Exciting research continues to emerge on other potential treatments for patients allergic to nuts, including allergen immunotherapy. Results of such interventions have been encouraging, though further studies are needed regarding safety and long-term outcomes before these can be applied to clinical practice. PMID:26604803

  10. Anaphylaxis caused by tipepidine hibenzate, a central antitussive drug

    PubMed Central

    Mochizuki, Eisuke; Shirai, Toshihiro; Noguchi, Rie; Mitsui, Chihiro; Taniguchi, Masami; Suda, Takafumi

    2015-01-01

    Tipepidine hibenzate, a central antitussive drug, is widely used in the management of cough and is generally safe and well tolerated. We present here a case of anaphylaxis caused by this drug. When the patient had caught a cold over the previous 10 years, she had received medications, including tipepidine hibenzate, from her family doctor. However, this time, she developed dyspnea, skin eruption, and anaphylactic shock after taking a Chinese herbal medicine and this drug. After her conditions improved due to adequate treatment, she was referred to our hospital to confirm the causative drug. Double-blind placebo-controlled oral challenge tests were performed after obtaining informed consent. Oral challenge with one-third tablet dose of tipepidine hibenzate caused a positive reaction. Urinary leukotriene E4 rose during the challenge with tipepidine hibenzate, but not with control. Clinicians should keep in mind that common antitussive drug use can cause anaphylactic reactions in very rare cases and can be harmful. PMID:25802739

  11. Anaphylaxis caused by tipepidine hibenzate, a central antitussive drug.

    PubMed

    Mochizuki, Eisuke; Shirai, Toshihiro; Noguchi, Rie; Mitsui, Chihiro; Taniguchi, Masami; Suda, Takafumi

    2015-03-01

    Tipepidine hibenzate, a central antitussive drug, is widely used in the management of cough and is generally safe and well tolerated. We present here a case of anaphylaxis caused by this drug. When the patient had caught a cold over the previous 10 years, she had received medications, including tipepidine hibenzate, from her family doctor. However, this time, she developed dyspnea, skin eruption, and anaphylactic shock after taking a Chinese herbal medicine and this drug. After her conditions improved due to adequate treatment, she was referred to our hospital to confirm the causative drug. Double-blind placebo-controlled oral challenge tests were performed after obtaining informed consent. Oral challenge with one-third tablet dose of tipepidine hibenzate caused a positive reaction. Urinary leukotriene E4 rose during the challenge with tipepidine hibenzate, but not with control. Clinicians should keep in mind that common antitussive drug use can cause anaphylactic reactions in very rare cases and can be harmful. PMID:25802739

  12. Anaphylaxis to scorpion antivenin and its management following envenomation by Indian red scorpion, Mesobuthus tamulus

    PubMed Central

    Bhoite, Rahul Ramesh; Bhoite, Girija Ramesh; Bagdure, Dayanand N.; Bawaskar, Himmatrao S.

    2015-01-01

    Mesobuthus tamulus is an Indian red scorpion that is responsible for numerous cases of scorpion stings in the Indian subcontinent. Antivenin, vasodilators, and benzodiazepines are medications of choice in the treatment of scorpion bites. Adverse reactions such as anaphylaxis to antivenin have been infrequently described in the literature. We, herein, present a case of a 42-year-old man stung by Indian red scorpion while gardening at home in India, who presented with extreme pain at the sting site and signs of cardio-toxicity. He was treated with scorpion antivenin and vasodilators but developed anaphylaxis to antivenin. We discuss management strategies. Anaphylaxis to antivenin should be on the differential during management of scorpion bites because classical signs of anaphylaxis may be absent. PMID:26430342

  13. Anaphylaxis to scorpion antivenin and its management following envenomation by Indian red scorpion, Mesobuthus tamulus.

    PubMed

    Bhoite, Rahul Ramesh; Bhoite, Girija Ramesh; Bagdure, Dayanand N; Bawaskar, Himmatrao S

    2015-09-01

    Mesobuthus tamulus is an Indian red scorpion that is responsible for numerous cases of scorpion stings in the Indian subcontinent. Antivenin, vasodilators, and benzodiazepines are medications of choice in the treatment of scorpion bites. Adverse reactions such as anaphylaxis to antivenin have been infrequently described in the literature. We, herein, present a case of a 42-year-old man stung by Indian red scorpion while gardening at home in India, who presented with extreme pain at the sting site and signs of cardio-toxicity. He was treated with scorpion antivenin and vasodilators but developed anaphylaxis to antivenin. We discuss management strategies. Anaphylaxis to antivenin should be on the differential during management of scorpion bites because classical signs of anaphylaxis may be absent. PMID:26430342

  14. [Bupivacaine-induced Anaphylaxis in a Parturient Undergoing Cesarean Section].

    PubMed

    Iwasaki, Mitsuo; Tachibana, Kazuya; Mitsuda, Nobuaki; Kinouchi, Keiko

    2015-02-01

    We describe a case of anaphylaxis that occurred in a 33-year-old gravida 1, para 1 term woman scheduled for cesarean delivery for breech presentation. Her past history was unremarkable except for orciprenaline allergy. Spinal anesthesia was performed at L3-4 using 2.5 ml of 0.5% hyperbaric bupivacaine and 0.1 mg morphine. Seven minutes after spinal anesthesia, she complained of hoarseness and difficulty in breathing and 3 minutes later, blood pressure decreased to 76/51 mmHg, and oxygen saturation to 87% with supplemental oxygen. Skin flushing was noted in the face and trunk of the body and anaphylaxis was diagnosed. She was treated with a rapid intravenous infusion and iv administration of phenylephrine (total dose 0.4 mg), ephedrine (total dose 25 mg), hydrocortisone and famotidine. Cesarean section was started 23 minutes after spinal anesthesia when blood pressure and oxygen saturation recovered. A male infant was delivered (18 minutes after the onset of anaphylactic event) with Apgar scores of 2 and 5 at 1 and 5 min, respectively and resuscitated with mask ventilation. Umbilical artery blood gas analysis revealed pH 6.85, base excess -20.3 mmol x l (-1) and lactate 109 mg x dl (-1). The mother was discharged from the hospital on the 6th postoperative day. The baby's electroencephalogram, however, demonstrated a pattern consistent with mild hypoxic-ischemic encephalopathy. Lymphocyte stimulation test revealed that she was allergic to bupivacaine. If maternal hypotension persists, i.m. or i.v. adrenaline should be administered immediately because maternal hypotension and hypoxemia may cause significant fetal morbidity and mortality and prompt cesarean section should be considered. PMID:26121818

  15. Increased regional vascular albumin permeation in the rat during anaphylaxis

    SciTech Connect

    Leng, W.; Chang, K.; Williamson, J.R.; Jakschik, B.A.

    1989-03-15

    The changes in vascular albumin permeation induced by systemic anaphylaxis were studied simultaneously in 21 different tissues of the same animal. Before Ag challenge sensitized rats were injected i.v. with 125I-albumin (test tracer), 51Cr-RBC (vascular space marker) and 57Co-EDTA (extravascular space marker). The index of vascular permeation used was the tissue to blood isotope ratio (tbir), which was obtained by dividing the ratio of 125I/51Cr counts in each tissue by the ratio of the same isotopes in the arterial blood sample. After Ag challenge, the increase in the tbir varied considerably among the different tissues. The most pronounced increase was noted in the lymph node (ninefold) followed by the aorta and mesentery (six- to sevenfold) and the various parts of the gastrointestinal tract (four- to sixfold). In the skin less than skeletal muscle less than lung less than liver and eye two- to fourfold increases occurred. Relatively minor increases in albumin permeation (less than twofold) were observed in the brain less than kidney less than heart and less than spleen. The testis was the only organ in which no significant change occurred. For some of the tissues there was also an increase in the tbir for 57Co/51Cr (an index of the extracellular fluid space) suggesting edema formation. The highest increase was noted in the aorta (fourfold). Minor increases occurred in the atrium of the heart, stomach, duodenum, and lymph nodes. There was also a 36% increase in hematocrit. Therefore, systemic anaphylaxis caused extensive extravasation of albumin and hemoconcentration.

  16. Fifty-six-year-old man with anaphylaxis: A novel delayed food hypersensitivity reaction.

    PubMed

    Wagner, Kendall D; Bell, Matthew C; Pesek, Robert D; Kennedy, Joshua L

    2015-11-01

    Anaphylaxis and urticaria are commonly seen in both primary care and allergy clinics. Foods, drugs, and insects are frequent culprits for immediate reactions; however, the trigger for recurring and/or chronic episodes is often unclear. We present a 56-year-old male with recurrent symptoms of urticaria, angioedema, and anaphylaxis found to be triggered by sensitization to galactose-alpha 1, 3-galactose (alpha-gal), a novel food allergen. PMID:26625604

  17. Tick-induced allergies: mammalian meat allergy, tick anaphylaxis and their significance

    PubMed Central

    2015-01-01

    Serious tick-induced allergies comprise mammalian meat allergy following tick bites and tick anaphylaxis. Mammalian meat allergy is an emergent allergy, increasingly prevalent in tick-endemic areas of Australia and the United States, occurring worldwide where ticks are endemic. Sensitisation to galactose-α-1,3-galactose (α-Gal) has been shown to be the mechanism of allergic reaction in mammalian meat allergy following tick bite. Whilst other carbohydrate allergens have been identified, this allergen is unique amongst carbohydrate food allergens in provoking anaphylaxis. Treatment of mammalian meat anaphylaxis involves avoidance of mammalian meat and mammalian derived products in those who also react to gelatine and mammalian milks. Before initiating treatment with certain therapeutic agents (e.g., cetuximab, gelatine-containing substances), a careful assessment of the risk of anaphylaxis, including serological analysis for α-Gal specific-IgE, should be undertaken in any individual who works, lives, volunteers or recreates in a tick endemic area. Prevention of tick bites may ameliorate mammalian meat allergy. Tick anaphylaxis is rare in countries other than Australia. Tick anaphylaxis is secondarily preventable by prevention and appropriate management of tick bites. Analysis of tick removal techniques in tick anaphylaxis sufferers offers insights into primary prevention of both tick and mammalian meat anaphylaxis. Recognition of the association between mammalian meat allergy and tick bites has established a novel cause and effect relationship between an environmental exposure and subsequent development of a food allergy, directing us towards examining environmental exposures as provoking factors pivotal to the development of other food allergies and refocusing our attention upon causation of allergy in general. PMID:25653915

  18. First study of pattern of anaphylaxis in a large tertiary care hospital in Saudi Arabia

    PubMed Central

    Amin, Rashid; Rehan Khaliq, Agha M.; Al Otaibi, Talal; Al Hashim, Samia; Al Gazlan, Sulaiman

    2015-01-01

    Background Anaphylaxis is a serious allergic reaction that may cause death. The signs and symptoms of anaphylaxis have not been examined in the Saudi population before. Objective The present study examined the signs, symptoms, triggers, and demographic patterns of patients treated for anaphylaxis at a large tertiary care hospital in Riyadh, Saudi Arabia. Methods All the patients who were prescribed new prescriptions of adrenaline auto-injectors (AAs) between February 1, 2010 and December 31, 2011 were included in this study. Information was collected using a standardized form. Results There were 238 patients who were analyzed. The median age at the time of first AA prescription was 15.5 years. Female to male ratio was 52:48 and 54% of the subjects were more than 18 years of age. There were some differences in the presenting signs and symptoms observed in our study compared with similar studies from around the world. Urticaria and angioedema were the most common at about 70% across all ages, followed by shortness of breath at 28%. Some triggers were found to be more common in our region. Food was the commonest trigger for anaphylaxis including tree nuts, egg, and sesame. Drug allergy was also a common trigger, with penicillins and nonsteroidal anti-inflammatory drugs being the commonest. Regarding insect allergy, samsam ant was the commonest trigger in our study. Conclusion To our knowledge, this is the first study on anaphylaxis in Saudi Arabia. Some of the manifestations of anaphylaxis are significantly different in our population study compared to previously published data from other parts of the world. While managing anaphylaxis, we should be mindful of these differences. This improved understanding should help reduce the morbidity and mortality associated with anaphylaxis in our region. PMID:26539404

  19. The Northland fluoridation advocacy programme: an evaluation.

    PubMed

    Gowda, Sunitha; Thomas, David R

    2008-12-01

    On 20 July 2006, the Far North District Council resolved to fluoridate Kaitaia and Kaikohe. This was the first such initiative by any Territorial Local Authority (TLA) in New Zealand for 23 years, and resulted from a fluoridation advocacy programme. This paper describes the programme implementation, assesses its consistency with the principles of the Treaty of Waitangi, and critically examines the collaboration between the fluoride advocate and the key stakeholders. Process evaluation identified three main categories of programme implementation: policy advocacy, community action projects, and media advocacy. The collaboration of iwi, Maori health providers and the community suggests that the programme was consistent with the principles (partnership, participation and protection) ofthe Treaty ofWaitangi. Media advocacy played an important role in reflecting and engaging community views on fluoridation, and it influenced decision-making by the Far North District Council. The simultaneous, combined 'top-down and bottom-up' approach was an effective and successful strategy for fluoridation advocacy in the community. Less integrated approaches implemented on their own (such as the 'top down' approach in Whangarei and the 'bottom-up' approach in Dargaville) were not effective. PMID:19180864

  20. Science, policy advocacy, and marine protected areas.

    PubMed

    Gray, Noella J; Campbell, Lisa M

    2009-04-01

    Much has been written in recent years regarding whether and to what extent scientists should engage in the policy process, and the focus has been primarily on the issue of advocacy. Despite extensive theoretical discussions, little has been done to study attitudes toward and consequences of such advocacy in particular cases. We assessed attitudes toward science and policy advocacy in the case of marine protected areas (MPAs) on the basis of a survey of delegates at the First International Marine Protected Areas Congress. Delegates were all members of the international marine conservation community and represented academic, government, and nongovernmental organizations. A majority of respondents believed science is objective but only a minority believed that values can be eliminated from science. Respondents showed only partial support of positivist principles of science. Almost all respondents supported scientists being integrated into MPA policy making, whereas half of the respondents agreed that scientists should actively advocate for particular MPA policies. Scientists with a positivist view of science supported a minimal role for scientists in policy, whereas government staff with positivist beliefs supported an advocacy or decision-making role for scientists. Policy-making processes for MPAs need to account for these divergent attitudes toward science and advocacy if science-driven and participatory approaches are to be reconciled. PMID:19016824

  1. Systematic review of outcome measures in trials of pediatric anaphylaxis treatment

    PubMed Central

    2014-01-01

    Background Considerable heterogeneity has been observed in the selection and reporting of disease-specific pediatric outcome measures in randomized controlled trials (RCTs). This makes interpretation of results and comparison across trials challenging. Outcome measures in pediatric anaphylaxis trials have never previously been systematically assessed. This systematic review (SR) identified and assessed outcome measures used in RCTs of anaphylaxis treatment in children. As a secondary objective, this SR assessed the evidence for current treatment modalities for anaphylaxis in the pediatric population. Methods We searched MEDLINE, EMBASE, The Cochrane Library, Cochrane Central Register of Controlled Trials (CENTRAL), and CINAHL from 2001 until December 2012. We also searched websites listing ongoing trials. We included randomized and controlled trials of anaphylaxis treatment in patients 0–18 years of age. Two authors independently assessed articles for inclusion. Results No published studies fulfilled the inclusion criteria. Conclusions There is an alarming absence of RCTs evaluating the treatments for anaphylaxis in children. High quality studies are needed and are possible to design, despite the severe and acute nature of this condition. Consensus about the selection and validation of appropriate outcome measures will enhance the quality of research and improve the care of children with anaphylaxis. Trial registration CRD42012002685 PMID:24950840

  2. Gender and advocacy in Indonesia.

    PubMed

    Ray-ross, S

    1997-01-01

    The Centre for Development and Population Activities (CEDPA) and the Indonesian Midwives Association (IBI) have developed a two-phase training program regarding gender issues for the association's midwives. The first phase focuses on the leadership, management, and advocacy skills necessary to articulate program needs and to take part in making decisions regarding family planning and reproductive health. The second phase concerns the integration of gender into project design. Proposals developed by the midwives include the following: 1) to improve counseling services for women in a district where 70% of the women using contraception do not decide for themselves which methods to use; 2) to reduce maternal mortality in a district where it has increased by 20% and where women have died while waiting for husbands or fathers-in-law to make the decision to bring them to hospitals; 3) to develop gender-sensitive materials concerning HIV/AIDS; and 4) to expand gender training to all levels of IBI, to provide follow-up technical support, and to integrate gender into the mission statement of the organization. Dr. Nafsiah Mboi (member of Parliament and vice chair of the Global Commission on Women's Health), Dr. Widyastuti Wibisana (director of community participation in the Ministry of Health), Dr. Kokila Vaidya (WHO Medical Officer), Carla Bianpoen (gender specialist with the World Bank), and Titi Sumbung (director of the Melati Foundation) helped to develop and to conduct the program. IBI, which has 65,000 members, provides family planning, reproductive health, and maternal and child health services throughout Indonesia. PMID:12292791

  3. Advocacy Evaluation: A Model for Internal Evaluation Offices.

    ERIC Educational Resources Information Center

    Sonnichsen, Richard C.

    1988-01-01

    As evaluations are more often implemented by internal staff, internal evaluators must begin to assume decision-making and advocacy tasks. This advocacy evaluation concept is described using the Federal Bureau of Investigation evaluation staff as a model. (TJH)

  4. Anaphylactic shock. Guidelines for immediate diagnosis and treatment.

    PubMed

    Costa, A J

    1988-03-01

    With the pathophysiology of anaphylaxis firmly in mind, the primary care physician can accurately diagnose and effectively treat this acute, life-threatening condition. The necessary drugs and equipment must be present in the office of any physician who performs skin testing, administers immunotherapy or intramuscular antibiotics, or uses local anesthetics. The drug of choice, epinephrine, must be administered as soon as the diagnosis is made, and hospitalization is necessary to guard against recurrent anaphylaxis. Preventive measures, including identification of the offending antigen, avoidance instructions, epinephrine for self-administration, and immunotherapy should be considered for all patients. PMID:3353345

  5. Community stakeholder responses to advocacy advertising

    SciTech Connect

    Miller, B.; Sinclair, J.

    2009-07-01

    Focus group research was used to examine how community stakeholders, a group with local industry experience, responded to coal industry advocacy messages. The stakeholders expressed beliefs about both the advertiser and the coal industry, and while their knowledge led to critical consideration of the industry campaign, they also expressed a desire to identify with positive messages about their community. Applying a postpositivist research perspective, a new model is introduced to integrate these beliefs in terms of advertiser trust and industry accountability under the existing theoretical framework of persuasion knowledge. Agent and topic knowledge are combined in this model based on responses to the industry advocacy campaign. In doing so, this study integrates a priori theory within a new context, extending the current theoretical framework to include an understanding of how community stakeholders - a common target for marketplace advocacy - interpret industry messages.

  6. Examining School Counselors' Commitments to Social Justice Advocacy

    ERIC Educational Resources Information Center

    Feldwisch, Rachel P.

    2016-01-01

    Many school counselors endorse using social justice advocacy to close achievement gaps. In this study, school counselors from a single state scored in the moderate to high range on the Social Issues Advocacy Scale. Results showed alignment between school counselors' self-endorsement of social justice advocacy and scores on the Advocacy…

  7. 76 FR 75951 - Taxpayer Advocacy Panel Meeting Cancellation

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-05

    ... Internal Revenue Service Taxpayer Advocacy Panel Meeting Cancellation AGENCY: Internal Revenue Service (IRS... the open meeting of the Taxpayer Advocacy Panel scheduled for Tuesday, December 6, 2011, and Wednesday.... ] Dated: November 30, 2011. Shawn Collins, Director, Taxpayer Advocacy Panel. BILLING CODE 4830-01-P...

  8. Promoting Self-Advocacy among Minority Students in School Counseling

    ERIC Educational Resources Information Center

    Astramovich, Randall L.; Harris, Katrina R.

    2007-01-01

    This article presents self-advocacy competencies developed to promote the academic, career, and personal/social success of minority students. The authors discuss challenges faced by minority students in today's educational environment and review principles of self advocacy. Competencies for developing self-advocacy awareness, knowledge, and skills…

  9. 77 FR 16895 - Taxpayer Advocacy Panel Meeting Cancellation

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-22

    ... Internal Revenue Service Taxpayer Advocacy Panel Meeting Cancellation AGENCY: Internal Revenue Service (IRS... open meeting of the Taxpayer Advocacy Panel Small Business/Self-Employed Decreasing Non-Filers Project... meeting is cancelled pending renewal of the Taxpayer Advocacy Panel Charter. FOR FURTHER...

  10. 77 FR 16895 - Taxpayer Advocacy Panel Meeting Cancellation

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-22

    ... Internal Revenue Service Taxpayer Advocacy Panel Meeting Cancellation AGENCY: Internal Revenue Service (IRS... the open meeting of the Taxpayer Advocacy Panel Taxpayer Burden Reduction Project Committee scheduled... cancelled pending renewal of the Taxpayer Advocacy Panel Charter. FOR FURTHER INFORMATION CONTACT: Audrey...

  11. Development and Assessment of the Social Issues Advocacy Scale

    ERIC Educational Resources Information Center

    Nilsson, Johanna E.; Marszalek, Jacob M.; Linnemeyer, Rachel M.; Bahner, Angela D.; Misialek, Leah Hanson

    2011-01-01

    This article describes the development and the initial psychometric evaluation of the Social Issues Advocacy Scale in two studies. In the first study, an exploratory factor analysis (n = 278) revealed a four-factor scale, accounting for 71.4% of the variance, measuring different aspects of social issue advocacy: Political and Social Advocacy,…

  12. Anaphylaxis in referred pediatric patients: demographic and clinical features, triggers, and therapeutic approach.

    PubMed

    De Swert, Liliane F A; Bullens, Dominique; Raes, Marc; Dermaux, Anna-Maria

    2008-11-01

    Anaphylaxis remains under-diagnosed and under-treated. A better knowledge of patterns and triggers of anaphylaxis might contribute to a better management. In this study we evaluated the demographic and clinical features of anaphylaxis in pediatric patients, as well as its triggers and therapeutic approach. From May 1st 2004 until April 30th 2006 we prospectively collected data on all patients referred for investigation of anaphylaxis to the pediatric department of the University Hospital Gasthuisberg Leuven and to two private pediatric practices. Data were stored in a MYSQL database by use of an online encrypted web form. Sixty-four cases of anaphylaxis occurred in 48 children, aged 6 months to 14.8 years. Twenty-seven episodes (42.2%) occurred at home. The symptoms were dermatologic in 62 (96.9%) episodes, respiratory in 57 (89.1%), gastrointestinal in 19 (29.7%), cardiovascular in 14 (21.8%), and neurological or behavioural in 19 (29.7%). Antihistamines were administered in 41/57 (71.9%) cases, corticosteroids in 26/57 (45.6%), beta-2-mimetics in 14/57 (24.6%), and adrenaline in 11/57 (19.3%). Out of nine cases where Epipen was available at the moment of anaphylaxis, it was administered in one case only. Food was the cause of anaphylaxis in 42/55 (76.4%) cases with identified trigger, while medication, insect stings, latex, and birch pollen triggered 5 (9.1%), 4 (7.3%), 3 (5.5%), and 1 (1.8%) case(s), respectively. Allergy to the trigger was known prior to anaphylaxis in 19/55 (34.5%) cases. In conclusion, anaphylaxis in pediatric patients generally presents with dermatologic and respiratory symptoms, while in 1/5 episodes cardiovascular symptoms occur. Food is by far the most frequent trigger. Allergy to the trigger is known in 1/3 cases only. Anaphylaxis is under-treated, even when appropriate medication is available. PMID:18204859

  13. 467 Clinical Case. Bee Venom Anaphylaxis

    PubMed Central

    Barreto-Sosa, Adriana; Velasco-Medina, Andrea Aida; Burbano-Ceron, Andres-Leonardo; Gonzalez-Carsolio, Aida; Velázquez-Sámano, Guillermo

    2012-01-01

    Background Skin testing remains the principal confirmatory test for sensitization to hymenopteravenoms. Mechanisms on how venom induces vascular permeability in the skinfollowing intradermal testing are elucidated and how tolerance is induced followinghigh-dose venom exposure. For management, venom immunotherapy remains the mosteffective treatment. Use of immunotherapy in large local reactors to reduce morbidity is discussed. Baseline serum tryptase levels have been identified as one potential markerfor severe systemic reactions to a subsequent sting. Bee venom immunotherapy is effective in most patients immediately after the conventionalmaintenance dose has been reached. In the minority of patients who are not protected withthis dose, an increased maintenance dose will provide appropriate protection immediately after itis achieved usually by 3 to 6 months withstandarding protocols. Thus, the dosage of the maintenance dose seems to be the major factor affectingprotection from re-stings rather than the accumulated venom dose or the durationon the Maintenance Dose. A rush protocol would be recommendedif the patient's risk of being stung againbefore standard immunotherapy could work wereconsidered high. Although immunotherapy is oftenadministered by allergists, it may be deliveredby any practitioner who is willing to observe the patientand to treat anaphylaxis if it should occur. Methods A 17-year-old man reported being stung by a bee in his workplace. He had been stung several times before, with no clinical manifestations. This last time, he developed face edema, respiratory distress, dyspnea, vomiting recieveing treatment with hydrocortisone. Some time later, he was stung another time, presenting more severe symptoms including dyspnea, stridor, altered mental status, hives, so he was taken to a local clinic where he received epinephrine, dextrose, was hospitalized 4 hours until clinical remission. How should his case be managed subsequently? Results Intradermal test

  14. Electronic Advocacy and Social Welfare Policy Education

    ERIC Educational Resources Information Center

    Moon, Sung Seek; DeWeaver, Kevin L.

    2005-01-01

    The rapid increase in the number of low-cost computers, the proliferation of user-friendly software, and the development of electronic networks have created the "informatics era." The Internet is a rapidly growing communication resource that is becoming mainstream in the American society. Computer-based electronic political advocacy by social…

  15. The state of advocacy in cancer.

    PubMed

    Maxwell, G Larry

    2015-12-01

    Non-profit advocacy organizations have been important in raising public awareness, promoting education, and enhancing political activism for issues related to cancer. Grassroots efforts aimed at fund-raising have substantially augmented federal funding for community outreach and research. The objective of this review was to evaluate successful accomplishments of several major non-profit organizations that are focused on cancer. A review of news media, medical literature, and financial records (using GuideStar) was performed to access the organizational structure and productivity of several successful cancer advocacy organizations. Compared to other cancer advocacy groups, the American Cancer Society is the oldest (>100years old) and worth the most with net assets of over $1.25 billion dollars and an annual total revenue of over $900 million dollars. The ACS also has the highest overhead at 41%. Most of the gynecologic cancer advocacy groups are approximately 20years old and have collective total annual revenue of over $17M dollars. The Ovarian Cancer Research Fund has been the most successful at raising funds and building net assets to date while maintaining an overhead of <10%. The most active and financially successful cancer organizations tend to be older, have higher overhead, spend less on total administration, spend more on fund-raising, have more events (rather than a limited number), and use aggressive social media strategies. PMID:26325529

  16. Enhancing Advocacy Skills of Teacher Candidates

    ERIC Educational Resources Information Center

    Holmes, Melissa A.; Herrera, Socorro G.

    2009-01-01

    This case study explores the dynamics of enhancing the capacities of teacher candidates in the Bilingual/Bicultural Education Students Interacting to Obtain Success (BESITOS) recruitment and retention program to advocate for culturally and linguistically diverse (CLD) students. Herrera and Murry's advocacy framework provides the theoretical…

  17. Advocacy: the role of health professional associations.

    PubMed

    Shaw, Dorothy

    2014-10-01

    The FIGO Leadership in Obstetrics and Gynecology for Impact and Change (LOGIC) Initiative in Maternal and Newborn Health was developed on the premise that organizational capacity strengthening in eight low- and middle-income countries would result in improved ability of member associations to take a leadership role in engaging a range of stakeholders in the health sector to discuss evidence and facilitate policy change and clinical practice in maternal and newborn health. Definitions of relevant terms, principles, and a framework for an advocacy plan are presented. The term advocacy is typically not well understood by health professionals, nor generally thought to be part of their role as a clinician, researcher, or educator. "Influence" based on expertise is often more consonant with a clinician's reality, especially where advocacy is perceived as a more political process that may present a barrier in some countries. The organizational capacity development of the FIGO member associations was integral to their ability to exert influence based on evidence, both internally in their associations and with other stakeholders, including the Ministry of Health. Examples of advocacy from each of the eight LOGIC countries are provided, noting that evaluation of impact can be challenging. PMID:25174787

  18. Child Care Advocacy: Making a Difference.

    ERIC Educational Resources Information Center

    Working for Change, 1995

    1995-01-01

    This journal issue highlights examples of state and local child care advocacy strategies that have resulted in positive legislative change or increased funding for low-income child care. Legal constraints on lobbying by nonprofit or public agencies due to limitations imposed by the U.S. Internal Revenue Service and public and private funding…

  19. Organizing Your Parents for Effective Advocacy

    ERIC Educational Resources Information Center

    Elpus, Kenneth

    2008-01-01

    In today's world of restrictive school budgets and increasing property taxes, it is an unfortunate reality that many school districts will be faced with a budget crunch crisis that unenlightened school boards may try to solve by cutting or eliminating funds for music. At the crisis stage, it is often only the effective advocacy of an organized…

  20. Parental Advocacy for Students with Autism

    ERIC Educational Resources Information Center

    Barclift, Coriann

    2010-01-01

    Students attending schools in the United States who have autism would benefit from increased parental involvement to enhance their learning. There is a lack of research regarding parental advocacy on behalf of students with autism. The purpose of this phenomenological study was to examine the lived experiences and perceptions of parents who have…

  1. The Dance of Leadership and Advocacy

    ERIC Educational Resources Information Center

    Stripling, Barbara

    2007-01-01

    Leadership and advocacy often resemble a dance more than a straight-line march toward a goal. At times the leader advocate must work the process and lead the dance; at other times, the leader must stand back and let the process work, always ready to add a step or two to the dance when necessary. In this article, the author describes how librarians…

  2. Educational Expertise, Advocacy, and Media Influence

    ERIC Educational Resources Information Center

    Malin, Joel R.; Lubienski, Christopher

    2015-01-01

    The efforts of many advocacy organizations to advance their preferred policies despite conflicting evidence of the effectiveness of these policies raise questions about factors that shape successful policy promotion. While many may like to think that expertise on an issue in question is an essential prerequisite for influence in public policy…

  3. Composite Indicators between Analysis and Advocacy

    ERIC Educational Resources Information Center

    Saltelli, Andrea

    2007-01-01

    We explore to what extent composite indicators, capable of aggregating multi-dimensional processes into simplified, stylised concepts, are up to the task of underpinning the development of data-based narratives for political advocacy. A recent OECD working paper (Nardo et al., 2005, Handbook on constructing composite indicators: methodology and…

  4. Science Advocacy in a Shifting Policy Landscape

    NASA Astrophysics Data System (ADS)

    Bickford, E. E.

    2013-12-01

    In the last 50 years, federal investment in research as a share of total spending has declined from a little more than 10% in 1963 to less than 4% in 2013 (AAAS, 2013). In an era of sequestration and shrinking budgets, more and more scientists are advocating directly to policymakers (and their staff) to gain support for research programs and funding. The best advocates understand the political and policy processes, and anticipate policy shifts that may affect them. While scientists are trained with the technical skills to conduct their science, teach it to others, and market their work in order to win grants and publish papers, the policy advocacy arena is unfamiliar territory to many. Acquiring yet another area of expertise mid-career can be daunting, but science advocacy need not require another academic degree. Connecting with policymakers is the first step, and then an understanding of each policymaker's issue history and top priorities will inform the sales pitch. Here, I present some experiences on both the pitching and receiving ends of science advocacy from my year in the US Senate as an AGU/AAAS Congressional Science Fellow, and some guidance for meeting with policymakers and successful science advocacy.

  5. Strengthening Music Programs While Avoiding Advocacy Pitfalls

    ERIC Educational Resources Information Center

    West, Chad; Clauhs, Matthew

    2015-01-01

    This article examines ways in which music education advocacy efforts have become disconnected from the unified visions and declarations of music educators espoused in the Tanglewood and Housewright declarations and are thus reifying the disconnect between what we value and what we say we value. We first analyze the policies posited by the recently…

  6. Self-Advocacy Skills: A Portfolio Approach.

    ERIC Educational Resources Information Center

    Krebs, Cathryn S.

    2002-01-01

    This article describes how an educator used a portfolio approach to teach self-advocacy skills to four middle school students with visual impairments. Students wrote about their visual impairment and learning needs, compiled lists of specific words and definitions related to their individual impairments, and wrote letters to their ninth-grade…

  7. CEC Handbook for Strengthening Grassroots Advocacy.

    ERIC Educational Resources Information Center

    Bootel, Jaclyn A.

    This handbook is designed: (1) to empower individuals working with people who have disabilities to be a force for meeting the policy challenges in the communities in which they live and work; and (2) to help them to channel their strength, commitment, and knowledge of the special education field into effective advocacy efforts. The handbook…

  8. The African cancer advocacy consortium: shaping the path for advocacy in Africa

    PubMed Central

    2013-01-01

    Although there is significant evidence of a cancer epidemic in Africa, there is limited awareness about cancer in most African countries. By partnering with international organizations and institutions such as the University of Florida and the Prostate Net, the African Organisation for Research and Training in Cancer (AORTIC) is committed to improving cancer advocacy in Africa. This paper presents some of the recent efforts on cancer advocacy in Africa, including the results of a SWOT analysis conducted for the cancer advocacy workshop and the guidelines developed by cancer advocates on best practices for cancer advocacy in Africa. One of the outcomes of these efforts is the African Cancer Advocates Consortium (ACAC) founded by cancer advocates in Africa to, “Make Cancer a Top Priority in Africa”. While we have started the work to strengthen cancer advocacy in Africa, we still have a long way to go. Our goal of making cancer a priority in Africa can mainly be achieved by: (1) increasing the manpower for cancer advocacy through education and training; and (2) strengthening the network of cancer advocates across the continent. PMID:23902674

  9. Independent donor ethical assessment: aiming to standardize donor advocacy.

    PubMed

    Choudhury, Devasmita; Jotterand, Fabrice; Casenave, Gerald; Smith-Morris, Carolyn

    2014-06-01

    Living organ donation has become more common across the world. To ensure an informed consent process, given the complex issues involved with organ donation, independent donor advocacy is required. The choice of how donor advocacy is administered is left up to each transplant center. This article presents the experience and process of donor advocacy at University of Texas Southwestern Medical Center administered by a multidisciplinary team consisting of physicians, surgeons, psychologists, medical ethicists and anthropologists, lawyers, a chaplain, a living kidney donor, and a kidney transplant recipient. To ensure that advocacy remains fair and consistent for all donors being considered, the donor advocacy team at University of Texas Southwestern Medical Center developed the Independent Donor Ethical Assessment, a tool that may be useful to others in rendering donor advocacy. In addition, the tool may be modified as circumstances arise to improve donor advocacy and maintain uniformity in decision making. PMID:24919733

  10. Recognizing new opportunities: reconceptualizing policy advocacy in everyday organizational practice.

    PubMed

    Mosley, Jennifer

    2013-07-01

    Policy advocacy is a concept that is of both practical and historical importance to the profession of social work. To keep up with developments in how advocacy is practiced at the ground level, however, social work research on advocacy needs to expand in scope. Changes in government contracting and public management practices have reshaped the opportunity structure for policy advocacy, incentivizing a kind of advocacy that is routine, professionalized, and collaborative. At the same time, these practices have raised questions about democratic representation and the degree to which social work advocacy adequately reflects client concerns. This article presents a model for how policy advocacy can be usefully reconceptualized to account for changes in the policy and funding environment and concludes by suggesting ways that social work research and theory can better reflect practice realities. PMID:24032304

  11. The history of breast cancer advocacy.

    PubMed

    Braun, Susan

    2003-01-01

    There have been four key steps in the advent of breast cancer advocacy: priming the market, engaging consumers, establishing political advocacy, and taking the advocacy mainstream. Breast cancer was surrounded by secrecy until the 1980s, when brave individuals such as former First Ladies Betty Ford and Nancy Reagan, and founder of the Susan G. Komen Foundation, Nancy Brinker (Susan Komen's sister), began speaking publicly about the personal impact of the disease, which increased awareness of breast cancer and made it more acceptable to talk about it openly. At the same time, statistics about breast cancer were presented in new ways that the public could understand. Public health advocates played a key role in the second step, engaging consumers, when they established guidelines in the 1980s that encouraged women to perform breast self-examinations (BSEs) and have screening mammograms and clinical breast examinations (CBEs). Other events that helped engage consumers were increased media coverage of breast cancer issues, the founding of the Komen Race for the Cure in 1983, and the establishment of other programs that both educated the public and raised funds. Funds from these efforts enabled advocates to hold educational forums and produce educational materials in different media and tailored to different audiences and to become active in the funding of research. The third step, political action, became possible when breast cancer advocates joined together in the 1980s and 1990s to work toward legislative, regulatory, and funding changes, such as passage of the Mammography Quality Standards Act and increased funding for the National Cancer Institute. These efforts contributed to a more than quadrupling of federal funding for breast cancer research in the 1990s. Going mainstream, the final step in the advocacy process, entailed establishing a solid base of support to ensure that the message about breast cancer stays strong and fresh. This has been achieved by engaging

  12. Anaphylaxis and generalized urticaria from eating Chinese bayberry fruit*

    PubMed Central

    Wang, Hui-ying; Gao, Zhong-shan; Yang, Zhao-wei; Shao, Jing-xin; Zhao, Xiu-zhen; Dai, Yu; Van Ree, Ronald

    2012-01-01

    Chinese bayberry myrica rubra is a very popular fruit in southeastern China. In spite of its wide consumption, no allergies to this fruit have been reported previously. Here we report on a 40-year-old woman suffering from anaphylaxis to Chinese bayberry fruit. Prick-prick skin tests revealed strong reactions to fresh Chinese bayberry fruits as well as to peach, and weaker reactions to some other fruits including apple, melon, and banana. ImmunoCAP analysis revealed identical titers of specific IgE (4.3 kUA/L) to peach extract and its lipid transfer protein (LTP, rPru p 3), which was confirmed by detection of a 9 kD band following immunoblotting. Immunoblot analysis with Chinese bayberry extract gave bands of 22, 45, and 90 kD, but no 9 kD band was recognized. There was also no evidence of LTP recognition for loquat (36 kD) or melon (24 kD). This first report of a severe allergic reaction to Chinese bayberry fruit in a patient with LTP-mediated peach allergy indicates that other as yet unidentified non-pollen related fruit allergens are involved in this new severe fruit allergy. PMID:23024053

  13. [Morphine-induced Anaphylaxis before Induction of Anesthesia].

    PubMed

    Takahashi, Kei; Suzuki, Hiroaki; Arai, Takero; Okuda, Yasuhisa

    2016-04-01

    We describe a case of anaphylaxia that occurred in a 67-year-old man. He was planned to have an operation on mitral valve prolapse (MVP) for mitral regurgitation (MR). Morphine 5 mg was injected intramusculaly 45 min before operation. Since then, he felt itchy sensation around his inguinal region. After he came to the operating room, he felt itchy sensation all over the body. Initially, his vatal signs were stable. We started to give extracellular fluid including ulinastatin 300,000 U, methylprednisolone 2 g, and ranitidine 50 mg. A few minutes later, he had nettle rash all over the body and his blood pressure decreased to 40/20 mmHg, and the heart rate increased to 120 beats x min(-1). Soon after, he had pulseless electric activity (PEA). We started chest compression and tracheal intubation. We injected adrenaline 1 mg. After doing the continuous chest compression for 2 min, he revived. He had continuous medications including dopamine 5 μg x kg(-1) x min(-1), dobutamine 5 μg x kg(-1) x min(-1), noradrenaline 0.05 μg x kg(-1) x min(-1). We cancelled the operation, and he was transfered to the high care unit (HCU), where his blood pressure was 120/65 mmHg, and heart rate 120 beats x min(-1). After 24 hours, we extubated his trachea. In this case, morphine was considered to be the most likely cause for anaphylaxis. PMID:27188106

  14. Survival after anaphylaxis induced by a bumblebee sting in a dog.

    PubMed

    Thomas, Emily; Mandell, Deborah C; Waddell, Lori S

    2013-01-01

    A 3.5 yr old castrated male miniature schnauzer was referred with a history of collapse after a bee sting to the left hind limb. At the time of presentation, 14 hr after the sting, the dog was hypotensive, comatose, seizuring, and had a brief period of cardiac arrest. Over the following 48 hr, the dog developed azotemia, severely elevated liver enzyme levels, hypertension, hematochezia, hematemesis, and disseminated intravascular coagulation (DIC). The dog's neurologic status improved slowly, but significant behavioral abnormalities remained. The dog was discharged after 7 days with ongoing polyuria, polydipsia, and behavioral changes. The polydipsia and polyuria resolved within a few days, but the behavioral changes continued for 6 wk. Reports of anaphylaxis from any cause are sparse in the veterinary literature. This is the first report of suspected anaphylaxis following a bee sting. There are no previous reports of behavioral changes after physical recovery from anaphylaxis. PMID:23535750

  15. Late Onset Anaphylaxis in a Hydatid Cyst Case Presenting with Chronic Urticaria

    PubMed Central

    Aydin, Omur; Okoh, Alexis; Misirligil, Zeynep

    2013-01-01

    Hydatid cyst is still endemic in various regions of the world. It is the most frequent cause of liver cysts worldwide. Urticaria is sometimes the first manifestation of the disease. However anaphylactic reaction and urticaria have been very rarely reported in the literature. Traditionally, surgery has been the only accepted mode of treatment; however, percutaneous treatment has recently been proposed as an alternative. Cases of anaphylaxis have been reported after percutaneous drainage of hydatid cyst. However, anaphylaxis usually develops within a few hours. Herein, we describe the case of a patient who presented with hydatid cyst causing chronic urticaria and late anaphylactic reaction following percutaneous aspiration of a liver hydatid cyst. We emphasize that physicians should be aware of hydatid cyst as a possible etiology for seemingly chronic spontaneous urticaria, especially in endemic regions. Patients should be kept under observation for at least one day due to the risk of early and late anaphylaxis after percutaneous aspiration treatment. PMID:23956751

  16. Serious Shortcomings in the Management of Children with Anaphylaxis in Scottish Schools

    PubMed Central

    Rankin, Kirsty E; Sheikh, Aziz

    2006-01-01

    Background The United Kingdom incidence of anaphylaxis has increased very sharply over the last decade, with the highest rates of hospital admissions occurring in school-aged children. This raises concerns about the extent to which schools are aware of approaches to the prevention and treatment of anaphylaxis. Methods and Findings We undertook a national postal survey of 250 Scottish schools enquiring about approaches to managing children considered to be at risk of anaphylaxis. We obtained responses from 148 (60%) schools, 90 (61%) of which reported having at least one at risk child. Most (80%) schools with children considered to be at risk reported having personalised care plans and invariably reported having at least one member of staff trained in the emergency treatment of anaphylaxis. Access to adrenaline was available on-site in 97% of these schools. However, significantly fewer schools without children considered to be at risk reported having a trained member of staff (48%, p < 0.001), with access to adrenaline being very poor (12%, p < 0.001). Overall, 59% of respondents did not feel confident in their school's ability to respond in an emergency situation. Conclusions Most schools with children considered to be at risk of anaphylaxis report using personal care plans and having a member of staff trained in the use of, and with access to, adrenaline. The picture is, however, less encouraging in schools without known at risk children, both in relation to staff training and access to adrenaline. The majority of schools with at risk children have poorly developed strategies for preventing food-triggered anaphylaxis reactions. There is a need for detailed national guidelines for all schools, which the Scottish Executive must now ensure are developed and implemented. PMID:16933965

  17. 360 Degree advocacy: a model for high impact advocacy in a rapidly changing healthcare marketplace.

    PubMed

    Postal, Karen S; Wynkoop, Timothy F; Caillouet, Beth; Most, Randi; Roebuck-Spencer, Tresa; Westerveld, Michael; Puente, Antonio; Pliskin, Neil H

    2014-01-01

    In an era of rapid changes in the healthcare marketplace the specialty of clinical neuropsychology faces a substantial increase in advocacy challenges. These include maintaining both access to services and a favorable practice climate as new healthcare structures and payment models evolve. The issue of regional variability complicates an effective response to these challenges from national professional organizations. One response to the challenge of regional variability is to strengthen our national organizations' capacity to engage in coordinated and effective advocacy, and to partner with state and regional neuro/psychological associations. The Inter-Organizational Practice Committee (IOPC) was formed in 2012 to meet this need. The IOPC has developed a model of 360 Degree Advocacy that coordinates local, regional, and national resources for high-impact, efficient advocacy. This paper describes the 360 Degree Advocacy model, and walks readers through an example of the model in action, successfully responding to a threat to patient access and practice climate with a regional Medicare carrier. PMID:24528167

  18. An unusual case of anaphylaxis. Mold in pancake mix.

    PubMed

    Bennett, A T; Collins, K A

    2001-09-01

    Anaphylactic reactions involve contact with an antigen that evokes an immune reaction that is harmful. This type of reaction is a rapidly developing immunologic reaction termed a type I hypersensitivity reaction. The antigen complexes with an IgE antibody that is bound to mast cells and basophils in a previously sensitized individual. Upon re-exposure, vasoactive and spasmogenic substances are released that act on vessels and smooth muscle. The reaction can be local or systemic and may be fatal. The authors report the death of a 19-year-old white male who had a history of "multiple allergies," including pets, molds, and penicillin. One morning, he and his friends made pancakes with a packaged mix that had been opened and in the cabinet for approximately 2 years. The friends stopped eating the pancakes because they said that they tasted like "rubbing alcohol." The decedent continued to eat the pancakes and suddenly became short of breath. He was taken to a nearby clinic, where he became unresponsive and died. At autopsy, laryngeal edema and hyperinflated lungs with mucous plugging were identified. Microscopically, edema and numerous degranulating mast cells were identified in the larynx. The smaller airways contained mucus, and findings of chronic asthma were noted. Serum tryptase was elevated at 14.0 ng/ml. The pancake mix was analyzed and found to contain a total mold count of 700/g of mix as follows: Penicillium, Fusarium, Mucor, and Aspergillus. Witness statements indicate that the decedent ate two pancakes; thus he consumed an approximate mold count of 21,000. The decedent had a history of allergies to molds and penicillin, and thus was allergic to the molds in the pancake mix. The authors present this unusual case of anaphylaxis and a review of the literature. PMID:11563743

  19. Protracted anaphylaxis developed after peginterferon α-2a administration for chronic hepatitis C.

    PubMed

    Sakatani, Akihiko; Doi, Yoshinori; Matsuda, Takaaki; Sasai, Yasutaka; Nishida, Naohiro; Sakamoto, Megumi; Uenoyama, Naoto; Matsumoto, Yoshiya; Kinoshita, Kazuo

    2015-03-01

    Peginterferon is a key drug used to treat chronic viral hepatitis that is known for causing various side effects. Side effects occurring immediately after administration include headache, nausea, and influenza-like symptoms, such as fever and joint pain. However, reports of anaphylactic shock are extremely rare. Here we report a patient with protracted anaphylaxis who suffered shock symptoms after peginterferon α-2a administration for chronic hepatitis C. Although the patient improved temporarily with shock treatment, symptoms of anaphylaxis recurred. As peginterferon is often administered on an outpatient basis, it is important to recognize life-threatening side effects that may develop in a protracted manner. PMID:25759556

  20. Acridanone alkaloid in Baliospermum montanum--evaluation of its effect against anaphylaxis.

    PubMed

    Venkatesh, Pichairajan; Mukherjee, Pulok K; Pal, Bikas C

    2011-11-01

    Baliospermum montanum leaves yielded 3-hydroxy-2,4-dimethoxy-10-methyl-9-acridanone (1), an alkaloid from the CHCl₃ fraction. Spectroscopic analysis was performed to assign the structure of the new compound (1) and its absolute configuration. The compound was evaluated for its effect in anaphylaxis by estimation of the release of histamine in systemic anaphylaxis model. The acridanone alkaloid significantly inhibited the degranulation of mast cells up to 65.22 % and 75.12 % at a dose of 50 and 75 mg/kg, respectively. PMID:21678235

  1. Epicutaneous sensitization results in IgE-dependent intestinal mast cell expansion and food anaphylaxis

    PubMed Central

    Bartnikas, Lisa M.; Gurish, Michael F.; Burton, Oliver T.; Leisten, Sabine; Janssen, Erin; Oettgen, Hans C.; Beaupré, Jacqueline; Lewis, Christopher N.; Austen, K. Frank; Schulte, Stephanie; Hornick, Jason L.; Geha, Raif S.; Oyoshi, Michiko K.

    2013-01-01

    Background Sensitization to food antigen may occur through cutaneous exposure. Objective Test the hypothesis that epicutaneous (EC) sensitization with food antigen predisposes to IgE-mediated anaphylaxis upon oral allergen challenge. Methods BALB/c mice were EC sensitized by repeated application of ovalbumin (OVA) to tape-stripped skin over 7 weeks, or orally immunized with OVA and cholera toxin (CT) weekly for 8 weeks, then orally challenged with OVA. Body temperature was monitored and serum mouse mast cell protease 1 (mMCP-1) level was determined following challenge. Tissue mast cells (MCs) were examined by chloroacetate esterase (CAE) staining. Serum OVA-specific IgE and IgG1 antibodies, and cytokines in supernatants of OVA-stimulated splenocytes, were measured by ELISA. Serum interleukin-4 (IL-4) levels were measured using an in vivo cytokine capture assay (IVCCA). Results EC sensitized mice exhibited expansion of connective tissue MC in the jejunum, increased serum IL-4 levels, and systemic anaphylaxis following oral challenge, as evidenced by decreased body temperature and increased serum mMCP-1 level. Intestinal MC expansion and anaphylaxis were IgE-dependent, as they did not occur in EC sensitized IgE−/− mice. Mice orally immunized with OVA+CT failed to increase serum IL-4 levels, expand their intestinal MCs, or develop anaphylaxis following oral challenge, despite OVA-specific IgE levels and splenocyte cytokine production in response to OVA stimulation, which were comparable to those of EC sensitized mice. Conclusion EC sensitized mice, but not mice orally immunized with antigen+CT, develop expansion of intestinal MCs and IgE-mediated anaphylaxis following single oral antigen challenge. IgE is necessary but not sufficient for food anaphylaxis, and MC expansion in the gut may play an important role in the development of anaphylaxis. Clinical Implications The skin may be an important route of sensitization to food antigens. Avoidance of cutaneous

  2. Beware of the caterpillar: Anaphylaxis to the spotted tussock moth caterpillar, Lophocampa maculata

    PubMed Central

    Sterbank, Julie; Tcheurekdjian, Haig; Hostoffer, Robert

    2014-01-01

    We present a case report of a 5-year-old boy with presumed anaphylaxis to the caterpillar, Lophocampa maculata, manifesting as the acute development of diffuse urticaria and progressive dyspnea. This reaction required prompt treatment with antihistamines and a bronchodilator. Allergen scratch testing with a homogenized caterpillar extract suggests that immunoglobulin E–mediated type I hypersensitivity as the pathophysiological mechanism responsible for the boy's anaphylaxis. This case report represents the first documented occurrence of an anaphylactic reaction to Lophocampa maculata and adds to the rare incidence of documented hypersensitivity to the order Lepidoptera. PMID:24988176

  3. Beware of the caterpillar: Anaphylaxis to the spotted tussock moth caterpillar, Lophocampa maculata.

    PubMed

    DuGar, Brandon; Sterbank, Julie; Tcheurekdjian, Haig; Hostoffer, Robert

    2014-07-01

    We present a case report of a 5-year-old boy with presumed anaphylaxis to the caterpillar, Lophocampa maculata, manifesting as the acute development of diffuse urticaria and progressive dyspnea. This reaction required prompt treatment with antihistamines and a bronchodilator. Allergen scratch testing with a homogenized caterpillar extract suggests that immunoglobulin E-mediated type I hypersensitivity as the pathophysiological mechanism responsible for the boy's anaphylaxis. This case report represents the first documented occurrence of an anaphylactic reaction to Lophocampa maculata and adds to the rare incidence of documented hypersensitivity to the order Lepidoptera. PMID:24988176

  4. Prison health advocacy and its changing boundaries.

    PubMed

    Awofeso, Niyi

    2008-01-01

    Advocacy is an important tool for translating population health objectives and research findings into policy and practice, as well as for enhancing stakeholder support for programmes and activities with a potential to improve the health of populations. At the inception of modern prisons, health advocacy approaches focused on appealing to humanitarian and religious sentiments of stakeholders to improve the well-being of prisoners. This approach achieved limited results, not least because of persistent apathy of custodial authorities and the public to prisoners' wellbeing. From the mid twentieth century onwards, a constitutional and human rights approach evolved, with courts becoming actively involved in mandating minimum health standards in prisons. Penal populism eroded public support for a judicial recourse to improving prison health services, and encouraged governments to institute procedural barriers to prisoner-initiated litigation. The author proposes an approach premised on public health principles as an appropriate platform to advocate for improvements in prison health services in this era. Such an advocacy platform combines the altruistic goals of the humanitarian and constitutional rights approaches with an appeal to community's self-interest by alerting the public to the social, financial and health implications inherent in released prisoners suffering from major communicable and chronic diseases re-entering the community. PMID:19061060

  5. Iranian Nurses' Attitudes and Perception towards Patient Advocacy

    PubMed Central

    Motamed-Jahromi, Mohadeseh; Abbaszadeh, Abbas; Borhani, Fariba; Zaher, Homa

    2012-01-01

    Patient advocacy is an inherent component of professional nursing ethics; in other words, nurses' enough knowledge would be essential to gain a positive attitude towards nursing advocacy. Using a descriptive-analytic design, this study aimed to assess the correlation between nurses' perception and attitudes towards patient advocacy, amongst 385 nurses in Kerman, Iran; hence, a three-part questionnaire was applied: part I, a demographic data sheet, part II, attitude measuring instrument, and part III, perception measuring instrument in nursing advocacy. The results implied that fairly positive attitudes and perception were found amongst the participants, and nurses' attitudes, in general, were positively correlated to their perception toward nursing advocacy. This means that with an improvement in perception, the attitude would also improve. In addition to our findings, it seems that these nurses needed more advocacy educational programs and support from responsible employers. PMID:23326680

  6. Patient advocacy in the USA: key communication role functions.

    PubMed

    Martin, Donald R; Tipton, Bryan K

    2007-09-01

    Researchers have long documented the importance of patient advocacy programs as a means of providing customer service in health-care organizations. Yet, while effective communication is often acknowledged as key to effective patient advocacy, knowledge of the specific communication role functions enacted by patient advocates remains limited, as does our understanding of the function of patient advocacy at the organizational level. This qualitative investigation not only provides a typology of communication roles enacted by patient advocates while solving problems on behalf of patients and their family members, but also integrates scholarly research on "boundary-spanning" as a means of theoretically contextualizing the advocacy role at the organizational level. PMID:17688476

  7. 78 FR 78516 - Open Meeting of the Taxpayer Advocacy Panel Taxpayer Assistance Center Improvements Project...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-26

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Taxpayer Assistance Center.... SUMMARY: An open meeting of the Taxpayer Advocacy Panel Taxpayer Assistance Center Improvements Project Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comments, ideas,...

  8. 78 FR 41194 - Open Meeting of the Taxpayer Advocacy Panel Taxpayer Assistance Center Improvements Project...

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    2013-07-09

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Taxpayer Assistance Center.... SUMMARY: An open meeting of the Taxpayer Advocacy Panel Taxpayer Assistance Center Improvements Project Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comments, ideas,...

  9. 78 FR 64064 - Open Meeting of the Taxpayer Advocacy Panel Taxpayer Assistance Center Improvements Project...

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    2013-10-25

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Taxpayer Assistance Center.... SUMMARY: An open meeting of the Taxpayer Advocacy Panel Taxpayer Assistance Center Improvements Project Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comments, ideas,...

  10. 78 FR 22947 - Open Meeting of the Taxpayer Advocacy Panel Taxpayer Assistance Center Improvements Project...

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    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Taxpayer Assistance Center.... SUMMARY: An open meeting of the Taxpayer Advocacy Panel Taxpayer Assistance Center Improvements Project Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comments, ideas,...

  11. 76 FR 10941 - Open Meeting of Taxpayer Advocacy Panel Notice Improvement Project Committee

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    ... Internal Revenue Service Open Meeting of Taxpayer Advocacy Panel Notice Improvement Project Committee... the Taxpayer Advocacy Panel Notice Improvement Project Committee will be conducted. The Taxpayer... open meeting of the Taxpayer Advocacy Panel Notice Improvement Project Committee will be held...

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    ... Internal Revenue Service Open Meeting of Taxpayer Advocacy Panel Notice Improvement Project Committee... the Taxpayer Advocacy Panel Notice Improvement Project Committee will be conducted. The Taxpayer... open meeting of the Taxpayer Advocacy Panel Notice Improvement Project Committee will be held...

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    ... Internal Revenue Service Open Meeting of Taxpayer Advocacy Panel Notice Improvement Project Committee... the Taxpayer Advocacy Panel Notice Improvement Project Committee will be conducted. The Taxpayer... open meeting of the Taxpayer Advocacy Panel Notice Improvement Project Committee will be held...

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    ... Internal Revenue Service Open Meeting of Taxpayer Advocacy Panel Notice Improvement Project Committee... the Taxpayer Advocacy Panel Notice Improvement Project Committee will be conducted. The Taxpayer... open meeting of the Taxpayer Advocacy Panel Notice Improvement Project Committee will be held...

  15. 76 FR 6190 - Open Meeting of Taxpayer Advocacy Panel Notice Improvement Project Committee

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    2011-02-03

    ... Internal Revenue Service Open Meeting of Taxpayer Advocacy Panel Notice Improvement Project Committee... the Taxpayer Advocacy Panel Notice Improvement Project Committee will be conducted. The Taxpayer... open meeting of the Taxpayer Advocacy Panel Notice Improvement Project Committee will be held...

  16. Management and treatment of anaphylaxis in children: still too low the rate of prescription and administration of intramuscular epinephrine.

    PubMed

    Calamelli, E; Mattana, F; Cipriani, F; Ricci, G

    2014-01-01

    Despite it being well known that anaphylaxis is a severe life-threatening reaction requiring prompt management and treatment, this entity is still under-recognized and not correctly managed, above all in children. The aim of this study was to analyze the most frequent features of anaphylaxis in a pediatric population (n=65 patients) and to identify factors predicting more severe reactions. Among the 70 recorded episodes, food was the main culprit of anaphylaxis, and patients with a positive history for allergic asthma had more severe episodes (P=0.008). A self-injectable adrenaline was used only in 2 of the 70 episodes and none of the 50 episodes managed in the Emergency Department was treated with intramuscular adrenaline. Only 10/65 patients (15%) had a prescription for an auto-injector prior to the first episode of anaphylaxis. The retrospective analysis of the risk factors potentially requiring an epinephrine auto-injector prescription before the first anaphylactic episode, showed that of the 55 patients without prescription, at least 10 (18%) should have been provided with a device, according to the most recent guidelines. In conclusion, notwithstanding intramuscular adrenaline being the first-line treatment of anaphylaxis, many episodes are still undertreated and the risk of anaphylaxis is still under-estimated. More efforts should be made to promote the correct management of anaphylaxis among both healthcare-providers and patients. PMID:25572739

  17. Nitric oxide decreases intestinal haemorrhagic lesions in rat anaphylaxis independently of mast cell activation

    PubMed Central

    Tavares, J. Carvalho; Moreno, A.

    1997-01-01

    The purpose of this study is to assess the role of nitric oxide (NO) in the intestinal lesions of passive anaphylaxis, since this experimental model resembles necrotizing enterocolitis. Sprague-Dawley rats were sensitized with IgE anti-dinitrophenol monoclonal antibody. Extravasation of protein-rich plasma and haemorrhagia were measured in the small intestine. Plasma histamine was measured to assess mast cell activation. The effect of exogenous NO on the lesions was assessed by using two structurally unrelated NO-donors: sodium nitroprusside and S-nitroso-Nacetyl-penicillamine (SNAP). An increased basal production of NO was observed in cells taken after anaphylaxis, associated with a reduced response to platelet-activating factor, interleukin 1beta, and IgE/DNP-bovine serum albumin complexes. The response to bacterial lipopolysaccharide and dibutyryl cyclic adenosine monophosphate (AMP) was enhanced 24 h after challenge, but at earlier times was not significantly different from that observed in controls. Treatment with either sodium nitroprusside or SNAP produced a significant reduction of the haemorrhagic lesions, which are a hallmark of rat anaphylaxis. The extravasation of protein-rich plasma was not influenced by NO-donors. The increase of plasma histamine elicited by the anaphylactic challenge was not influenced by SNAP treatment. NO-donors protect intestinal haemorrhagic lesions of rat anaphylaxis by a mechanism apparently independent of mast cell histamine release. PMID:18472830

  18. Allergy/Anaphylaxis Management in the School Setting. Position Statement. Revised

    ERIC Educational Resources Information Center

    Zacharski, Susan; DeSisto, Marie; Pontius, Deborah; Sheets, Jodi; Richesin, Cynthia

    2012-01-01

    It is the position of the National Association of School Nurses (NASN) that the safe and effective management of allergies and anaphylaxis in schools requires a collaborative, multidisciplinary team approach. The registered professional school nurse (hereinafter referred to as the school nurse), is the leader in a comprehensive management approach…

  19. Exploring the link between pholcodine exposure and neuromuscular blocking agent anaphylaxis

    PubMed Central

    Brusch, Anna M; Clarke, Russell C; Platt, Peter R; Phillips, Elizabeth J

    2014-01-01

    Neuromuscular blocking agents (NMBAs) are the most commonly implicated drugs in IgE-mediated anaphylaxis during anaesthesia that can lead to perioperative morbidity and mortality. The rate of NMBA anaphylaxis shows marked geographical variation in patients who have had no known prior exposure to NMBAs, suggesting that there may be external or environmental factors that contribute to the underlying aetiology and pathophysiology of reactions. Substituted ammonium ions are shared among NMBAs and are therefore thought to be the main allergenic determinant of this class of drugs. Substituted ammonium ions are found in a wide variety of chemical structures, including prescription medications, over-the-counter medications and common household chemicals, such as the quaternary ammonium disinfectants. Epidemiological studies have shown parallels in the consumption of pholcodine, a nonprescription antitussive drug which contains a tertiary ammonium ion, and the incidence of NMBA anaphylaxis. This link has prompted the withdrawal of pholcodine in some countries, with an ensuing fall in the observed rate of NMBA anaphylaxis. While such observations are compelling in their suggestion of a relationship between pholcodine exposure and NMBA hypersensitivity, important questions remain regarding the mechanisms by which pholcodine is able to sensitize against NMBAs and whether there are other, as yet unidentified, agents that can elicit similar hypersensitivity reactions. This review aims to explore the evidence linking pholcodine exposure to NMBA hypersensitivity and discuss the implications for our understanding of the pathophysiology of these reactions. PMID:24251966

  20. Spontaneous intraperitoneal rupture of a hepatic hydatid cyst with subsequent anaphylaxis: a case report.

    PubMed

    Tinsley, Benjamin; Abbara, Aula; Kadaba, Raghunandan; Sheth, Hemant; Sandhu, Gurjinder

    2013-01-01

    Hydatid cyst rupture into the abdomen is a serious complication of cystic hydatid disease of the liver (Cystic Echinococcosis) with an incidence of up to 16% in some series and can result in anaphylaxis or anaphylactoid reactions in up to 12.5% of cases. At presentation, 36-40% of hydatid cysts have ruptured or become secondarily infected. Rupture can be microscopic or macroscopic and can be fatal without surgery. Hydatid disease of the liver is primarily caused by the tapeworm Echinococcus granulosus and occurs worldwide, with incidence of up to 200 per 100,000 in endemic areas. Our case describes a 24-year-old Bulgarian woman presenting with epigastric pain and evidence of anaphylaxis. Abdominal CT demonstrated a ruptured hydatid cyst in the left lobe of the liver. A partial left lobe hepatectomy, cholecystectomy, and peritoneal washout was performed with good effect. She was treated for anaphylaxis and received antihelminthic treatment with Albendazole and Praziquantel. She made a good recovery following surgery and medical treatment and was well on follow-up. Intraperitoneal rupture with anaphylaxis is a rare occurrence, and there do not seem to be any reported cases from UK centres prior to this. PMID:25431702

  1. Delayed Anaphylaxis to the flu vaccine unrelated to known non-viral components.

    PubMed

    David, J; Horbal, J; Tcheurekdjian, H; Sher, T H; Hostoffer, R

    2015-09-01

    On February 4, 2010 the CDC's Advisory Committee on Immunization Practices voted for universal flu vaccination to expand protection against the flu throughout the United States. In addition to this administration expansion, six new influenza vaccines have been introduced into the market possibly introducing new allergenic potentials. We report two cases of delayed anaphylaxis to the flu vaccine. PMID:26357001

  2. Anaphylaxis Imaging: Non-Invasive Measurement of Surface Body Temperature and Physical Activity in Small Animals

    PubMed Central

    Manzano-Szalai, Krisztina; Pali-Schöll, Isabella; Krishnamurthy, Durga; Stremnitzer, Caroline; Flaschberger, Ingo; Jensen-Jarolim, Erika

    2016-01-01

    In highly sensitized patients, the encounter with a specific allergen from food, insect stings or medications may rapidly induce systemic anaphylaxis with potentially lethal symptoms. Countless animal models of anaphylaxis, most often in BALB/c mice, were established to understand the pathophysiology and to prove the safety of different treatments. The most common symptoms during anaphylactic shock are drop of body temperature and reduced physical activity. To refine, improve and objectify the currently applied manual monitoring methods, we developed an imaging method for the automated, non-invasive measurement of the whole-body surface temperature and, at the same time, of the horizontal and vertical movement activity of small animals. We tested the anaphylaxis imaging in three in vivo allergy mouse models for i) milk allergy, ii) peanut allergy and iii) egg allergy. These proof-of-principle experiments suggest that the imaging technology represents a reliable non-invasive method for the objective monitoring of small animals during anaphylaxis over time. We propose that the method will be useful for monitoring diseases associated with both, changes in body temperature and in physical behaviour. PMID:26963393

  3. Edible "bird's nest"-induced anaphylaxis: An under-recognized entity?

    PubMed

    Goh, D L; Chew, F T; Chua, K Y; Chay, O M; Lee, B W

    2000-08-01

    The Chinese delicacy "bird's nest" is the most common cause of food-induced anaphylaxis requiring hospitalization among Chinese children in Singapore. This investigation has established an immunoglobulin E-mediated cause and has characterized the major putative allergens. PMID:10931428

  4. Amniotic fluid embolism induces uterine anaphylaxis and atony following cervical laceration.

    PubMed

    Tamura, Naoaki; Nagai, Hisashi; Maeda, Hidyuki; Kuroda, Ryo-hei; Nakajima, Makoto; Igarashi, Atsuko; Kanayama, Naohiro; Yoshida, Ken-ichi

    2014-01-01

    Amniotic fluid embolism (AFE) is a rare, high-risk obstetric complication primarily found in the lungs and potentially related to anaphylaxis. Tryptase release from the mast cell reflects anaphylaxis. Case report and findings: A female, aged over 40 years, presented with uterine atony and lethal hemorrhage after induced vaginal labor. Cervical laceration was accompanied by severe hemorrhage. Stromal edema and myometrial swelling were consistent with uterine atony. Alcian blue staining and zinc coproporphyrin immunostaining disclosed AFE, which was more prominent in the uterus than in the lungs. Tryptase immunostaining was diffuse and prominent around the activated mast cells (halos) in the uterus, including the cervix. Similar distribution of findings on the AFE markers, tryptase halos, complement receptor C5aR, and atony in the uterus suggested the causality of AFE to anaphylaxis, complement activation and atony. It is probable that disseminated intravascular coagulation (DIC), induced by AFE, uterine atony and cervical laceration, caused the lethal hemorrhage. It is likely that AFE, in association with cervical laceration, induces uterine anaphylaxis, complement activation, atony, DIC and lethal hemorrhage. PMID:24925137

  5. Comparison of School Food Allergy Emergency Plans to the Food Allergy and Anaphylaxis Network's Standard Plan

    ERIC Educational Resources Information Center

    Powers, Jill; Bergren, Martha Dewey; Finnegan, Lorna

    2007-01-01

    Eighty-four percent of children with food allergies have a reaction in school, and 25% of first food reactions occur in schools. An evaluation was conducted comparing food allergy emergency plans to the Food Allergy and Anaphylaxis Network's (FAAN) Food Allergy Action Plan. Of the 94 respondents, 60 provided food allergy emergency plans for…

  6. Research to Practice: Developing an Integrated Anaphylaxis Education Curriculum for School Nurses

    ERIC Educational Resources Information Center

    Cavanaugh, Rebecca; Strickland, C. June

    2011-01-01

    The numbers of school-aged children with life-threatening allergies that cause anaphylaxis continues to increase. Many states, including Washington, have responded to this by developing specific guidelines for school districts to follow in order to provide a safe learning environment for children with medical conditions that put them at risk for…

  7. Food-Dependent Exercise-Induced Anaphylaxis: A Case Related to Chickpea Ingestion and Review

    PubMed Central

    2007-01-01

    Food-dependent exercise-induced anaphylaxis (FDEIA) is recognized as a distinct category of exercise-induced anaphylaxis (EIA) but is very likely underdiagnosed. This report describes a 41-year-old Indian woman who experienced two separate episodes of anaphylaxis while dancing after she had eaten chickpea-containing foods. The chickpea, a small legume, is a staple ingredient in culinary traditions from around the world, especially in India, the Middle East, and North Africa. Chickpea-containing dishes are also becoming more widespread in the Western world with the growing popularity of South Asian, Middle Eastern, and African cuisines. It is important to consider FDEIA in cases of unexplained anaphylaxis as reactions can occur several hours after ingesting the culprit food(s). Furthermore, no reaction occurs if a sensitized individual eats the culprit food(s) without exercising afterward; therefore, triggering foods can easily be overlooked. Current ideas on the pathophysiology, predisposing factors, workup, and treatment of FDEIA are also summarized here. PMID:20525119

  8. Cancer Advocacy in Africa: case studies of innovative practices

    PubMed Central

    2013-01-01

    In this paper, we present six case studies describing innovative cancer advocacy programs in Africa. For each case study, an example of an advocacy activity, list of factors contributing to the success of the organization, and an example of an obstacle addressed by the organization are described. PMID:23902662

  9. Speaking up about Advocacy: Findings from a Partnership Research Project

    ERIC Educational Resources Information Center

    Chapman, Melanie; Bannister, Susan; Davies, Julie; Fleming, Simon; Graham, Claire; Mcmaster, Andrea; Seddon, Angela; Wheldon, Anita; Whittell, Bridget

    2012-01-01

    This article describes a partnership research project carried out by a research team consisting of people with learning disabilities and people without learning disabilities. The research explored people's understandings of advocacy and identified gaps in advocacy provision for people with learning disabilities and their families. Four focus…

  10. Exploring Nonoffending Caregiver Satisfaction with a Children's Advocacy Center

    ERIC Educational Resources Information Center

    Bonach, Kathryn; Mabry, J. Beth; Potts-Henry, Candice

    2010-01-01

    This study is a case evaluation research report on one Children's Advocacy Center that provides a coordinated response to allegations of child maltreatment, particularly sexual abuse. The data come from a mailed survey of nonoffending caregivers measuring their satisfaction with services provided through the Children's Advocacy Center. The results…

  11. Treatments for Neurodevelopmental Disorders: Evidence, Advocacy, and the Internet

    ERIC Educational Resources Information Center

    Di Pietro, Nina C.; Whiteley, Louise; Mizgalewicz, Ania; Illes, Judy

    2013-01-01

    The Internet is a major source of health-related information for parents of sick children despite concerns surrounding quality. For neurodevelopmental disorders, the websites of advocacy groups are a largely unexamined source of information. We evaluated treatment information posted on nine highly-trafficked advocacy websites for autism, cerebral…

  12. The Big Picture of Advocacy: Counselor, Heal Society and Thyself

    ERIC Educational Resources Information Center

    Roysircar, Gargi

    2009-01-01

    This article, motivational in purpose, encourages counselors to be engaged in the growing movement for social justice advocacy in counseling. Analyses of a macrolevel framework of advocacy extend to microlevel operations of recruitment, sociopolitical education, diversity management, and self-care of counselor-advocates. Case studies and exemplars…

  13. Disability Identity of Leaders in the Self-Advocacy Movement

    ERIC Educational Resources Information Center

    Caldwell, Joe

    2011-01-01

    Life stories and perspectives of leaders in the self-advocacy movement were explored to enhance knowledge about disability identity formation. In-depth qualitative interviews were conducted with 13 leaders in the self-advocacy movement. Five major themes emerged: (a) resistance-claiming personhood and voice; (b) connection with disability…

  14. Having a Voice: An Exploration of Children's Rights and Advocacy.

    ERIC Educational Resources Information Center

    Dalrymple, Jane, Ed.; Hough, Jan, Ed.

    This book explores the concept of advocacy in British society with regard to children and young people, examining advocacy from a number of different perspectives, and taking into account the UN Convention on the Rights of the Child and legislation that affects children and young people. The three parts of the book examine why young people need an…

  15. Promoting Systemic Change through the ACA Advocacy Competencies

    ERIC Educational Resources Information Center

    Toporek, Rebecca L.; Lewis, Judith A.; Crethar, Hugh C.

    2009-01-01

    In 2003, the American Counseling Association (ACA) adopted the ACA Advocacy Competencies (J. A. Lewis, M. S. Arnold, R. House, & R. L. Toporek, 2002) to provide guidance to counselors and acknowledge advocacy as an ethical aspect of service to clients. This article provides a foundation for this special section by sharing a historical perspective…

  16. A Media Advocacy Intervention Linking Health Disparities and Food Insecurity

    ERIC Educational Resources Information Center

    Rock, Melanie J.; McIntyre, Lynn; Persaud, Steven A.; Thomas, Karen L.

    2011-01-01

    Media advocacy is a well-established strategy for transmitting health messages to the public. This paper discusses a media advocacy intervention that raised issues about how the public interprets messages about the negative effects of poverty on population health. In conjunction with the publication of a manuscript illustrating how income-related…

  17. School Counselors United in Professional Advocacy: A Systems Model

    ERIC Educational Resources Information Center

    Cigrand, Dawnette L.; Havlik, Stacey Gaenzle; Malott, Krista M.; Jones, SaDohl Goldsmith

    2015-01-01

    Limited budgets may place educational positions in jeopardy and if school counseling positions become jeopardized, then school counselors must communicate their role and impact more effectively. However, school counselors may lack training and experience in professional self-advocacy practices, and advocacy efforts may be undermined by role…

  18. Kids Speaking Up for Kids: Advocacy by Children, for Children

    ERIC Educational Resources Information Center

    Zygmunt-Fillwalk, Eva; Staley, Lynn; Kumar, Rashmi; Lin, Cecilia Lingfen; Moore, Catherine; Salakaya, Manana; Szecsi, Tunde

    2007-01-01

    This article describes a project called "Kids Speaking Up for Kids: Advocacy by Children, for Children". The project was simple in scope. The authors sought to collect stories of child advocacy--ways in which children were working on behalf of other children. They also sought to collect and profile children's voices and vision and so they issued a…

  19. Advocacy for Child Wellness in High-Poverty Environments

    ERIC Educational Resources Information Center

    Mullen, Carol A.

    2014-01-01

    Child wellness needs to be understood holistically so that children and youth from high-poverty environments can succeed in schooling and life. Teachers who foster advocacy in themselves are well equipped to teach students to take ownership of their own well-being. Such advocacy can enrich the classroom curriculum and mitigate the negative effects…

  20. What Is Self-Advocacy? NRC Fact Sheet

    ERIC Educational Resources Information Center

    Hall, Mair

    2010-01-01

    Self-advocacy is about independent groups of people with disabilities working together for justice by helping each other take charge of their lives and fight discrimination. The seeds of the self-advocacy movement go back to 1968 when a Swedish parent's organization held a meeting for people with developmental disabilities. Today, the…

  1. Using Week of the Young Child as an Advocacy Event

    ERIC Educational Resources Information Center

    Young Children, 2009

    2009-01-01

    The Week of the Young Child 2009, April 19-25, presents a public policy advocacy opportunity for early childhood programs, faculty, and families. This article offers some ways one can use Week of the Young Child (WOYC) events specifically to further advocacy efforts.

  2. Using the Decision Case Method to Teach Legislative Policy Advocacy

    ERIC Educational Resources Information Center

    Wolfer, Terry A.; Gray, Karen A.

    2007-01-01

    Social work educators have long struggled with making policy practice real "more", especially to micro-oriented students (Sundet & Kelly, 2002). The decision case method can generate excitement about social policy advocacy while educating students about current advocacy work, particularly if the case involves state or local efforts to influence…

  3. Social Justice Advocacy in Rural Communities: Practical Issues and Implications

    ERIC Educational Resources Information Center

    Bradley, Joshua M.; Werth, James L., Jr.; Hastings, Sarah L.

    2012-01-01

    The professional literature related to social justice has increased, but there has been little discussion of the practical issues and implications associated with social advocacy. However, adding new roles will result in new considerations for counseling psychologists. The need to be attuned to how the practical aspects of advocacy intersect with…

  4. Social Justice Advocacy among Graduate Students: An Empirical Investigation

    ERIC Educational Resources Information Center

    Linnemeyer, Rachel McQuown

    2009-01-01

    Although social justice advocacy has increasingly been acknowledged as important in the field of psychology (e.g., Goodman et al., 2004; Toporek et al., 2006a, Vera & Speight, 2003), there is a dearth of empirical research examining social justice advocacy across graduate psychology students. This mixed-methods study examined demographic and…

  5. Management of allergy and anaphylaxis during oral surgery.

    PubMed

    Rosenberg, Morton B; Phero, James C; Giovannitti, Joseph A

    2013-08-01

    Minor and major allergic reactions occur during oral and maxillofacial treatment. Immediate diagnosis and pharmacologic intervention are imperative. Signs and symptoms may be variable. The early administration of epinephrine is critical. PMID:23680577

  6. [Two cases of food-dependent exercise-induced anaphylaxis difficult to evoke symptoms by provocation test].

    PubMed

    Morimoto, Kenichi; Sanada, Seiko; Hara, Takeshi; Hide, Michihiro

    2006-11-01

    We report two cases of food-dependent exercise-induced anaphylaxis (FDEIA), which were hardly induced by provocation test in the hospital. Case 1: A 28-years-old Japanese female suffers repeated episodes of sternutation, nasal discharge and edema of eyelids after wheat ingestion of wheat followed by exercise. Case 2: A 14-years-old Japanese male suffers repeated episodes of wheal formation on whole body and dyspnea after lunch containing apple followed by exercise. Both of them had never developed symptoms by either ingestion or exercise alone. Provocation tests were performed on admission by combinations of the ingestion of suspected foods, exercise, and aspirin, but no symptoms were reproduced by any combination of them. After discharge, case 1 reproduced symptoms during exercise after the ingestion of wheat under prostration and cold climate. Case 2 reproduced symptoms during exercise after ingestion of apple when he suffered from common cold. Warm and comfortable condition in admission may make it harder to evoke symptoms by the provocation test. Frigidity, cold, prostration, and stress should be reckoned with in the provocation test to improve the accuracy of diagnosis for FDEIA. PMID:17159435

  7. [A case of food-dependent exercise-induced anaphylaxis caused by various foods which contained flour for thirty years].

    PubMed

    Terao, Hiroshi; Kishikawa, Reiko; Kato, Mariko; Noda, Keishi; Iwanaga, Tomoaki; Shouji, Shunsuke; Nishima, Sankei

    2004-11-01

    The patient was a 65-year-old man with chief complaints of flare, swelling, itching and loss of consciousness. He had a history of diabetes diagnosed at the age of 34 years and was receiving medication from a local doctor. He had experienced systemic flare, swelling and loss of consciousness 20 minutes after drinking beer at a party at the age of 34 years. Since that time, he had frequently experienced urticaria and loss of consciousness while taking a walk after eating various foods (all of which contained flour). In February 2001, he experienced systemic flare, swelling and loss of consciousness when he returned home from a walk after eating a meal that included meat dumplings. Laboratory tests on admission showed a serum IgE level of 253 IU/ml, and the IgE level for flour in a RAST was 2.13 UA/ml (class 2). The results of exercise tolerance tests were normal during fasting, after ingestion of food that did not include allergens (wheat, shrimps and crab) and after ingestion of half of a thick slice of white bread, but systemic wheal and flare reactions appeared during an exercise tolerance test after ingestion of one thick slice of white bread. A diagnosis of food-dependent exercise-induced anaphylaxis caused by flour was made on the basis of the results. PMID:15719649

  8. Characteristics of Anaphylaxis in 907 Chinese Patients Referred to a Tertiary Allergy Center: A Retrospective Study of 1,952 Episodes

    PubMed Central

    Jiang, Nannan; Wen, Liping; Li, Hong

    2016-01-01

    Purpose Comprehensive evaluation of anaphylaxis in China is currently lacking. In this study, we characterized the clinical profiles, anaphylactic triggers, and emergency treatment in pediatric and adult patients. Methods Outpatients diagnosed with "anaphylaxis" or "severe allergic reactions" in the Department of Allergy, Peking Union Medical College Hospital from January 1, 2000 to June 30, 2014 were analyzed retrospectively. Results A total of 1,952 episodes of anaphylaxis in 907 patients were analyzed (78% were adults and 22% were children). Foods are the most common cause (77%), followed by idiopathic etiologies (15%), medications (7%) and insects (0.6%). In food-induced anaphylaxis, 62% (13/21) of anaphylaxis in infants and young children (0-3 years of age) were triggered by milk, 59% (36/61) of anaphylaxis in children (4-9 years of age) were triggered by fruits/vegetables, while wheat was the cause of anaphylaxis in 20% (56/282) of teenagers (10-17 years of age) and 42% (429/1,016) in adults (18-50 years of age). Mugwort pollen sensitization was common in patients with anaphylaxis induced by spices, fruits/vegetables, legume/peanuts, and tree nuts/seeds, with the prevalence rates of 75%, 67%, 61%, and 51%, respectively. Thirty-six percent of drug-induced anaphylaxis was attributed to traditional Chinese Medicine. For patients receiving emergency care, only 25% of patients received epinephrine. Conclusions The present study showed that anaphylaxis appeared to occur more often in adults than in infants and children, which were in contrast to those found in other countries. In particular, wheat allergens played a prominent role in triggering food-induced anaphylaxis, followed by fruits/vegetables. Traditional Chinese medicine was a cause of drug-induced anaphylaxis. Furthermore, exercise was the most common factor aggravating anaphylaxis. Education regarding the more aggressive use of epinephrine in the emergency setting is clearly needed. PMID:27126729

  9. From Preservice Leaders to Advocacy Leaders: Exploring Intersections in Standards for Advocacy in Educational Leadership and School Counselling

    ERIC Educational Resources Information Center

    Crawford, Emily R.; Arnold, Noelle Witherspoon; Brown, Andre

    2014-01-01

    In this empirically based paper, we discuss educational leadership preparation as it relates to social justice, the concept of advocacy and the standards that guide leadership and counselling, respectively. To reveal how preservice leaders conceptualize advocacy as understood in professional standards, we draw on our research with 11 preservice…

  10. Credibility and advocacy in conservation science.

    PubMed

    Horton, Cristi C; Peterson, Tarla Rai; Banerjee, Paulami; Peterson, Markus J

    2016-02-01

    Conservation policy sits at the nexus of natural science and politics. On the one hand, conservation scientists strive to maintain scientific credibility by emphasizing that their research findings are the result of disinterested observations of reality. On the other hand, conservation scientists are committed to conservation even if they do not advocate a particular policy. The professional conservation literature offers guidance on negotiating the relationship between scientific objectivity and political advocacy without damaging conservation science's credibility. The value of this guidance, however, may be restricted by limited recognition of credibility's multidimensionality and emergent nature: it emerges through perceptions of expertise, goodwill, and trustworthiness. We used content analysis of the literature to determine how credibility is framed in conservation science as it relates to apparent contradictions between science and advocacy. Credibility typically was framed as a static entity lacking dimensionality. Authors identified expertise or trustworthiness as important, but rarely mentioned goodwill. They usually did not identify expertise, goodwill, or trustworthiness as dimensions of credibility or recognize interactions among these 3 dimensions of credibility. This oversimplification may limit the ability of conservation scientists to contribute to biodiversity conservation. Accounting for the emergent quality and multidimensionality of credibility should enable conservation scientists to advance biodiversity conservation more effectively. PMID:26041036

  11. Reducing violent injuries: priorities for pediatrician advocacy.

    PubMed

    Dolins, J C; Christoffel, K K

    1994-10-01

    A basic framework for developing an advocacy plan must systematically break down the large task of policy development implementation into manageable components. The basic framework described in detail in this paper includes three steps: Setting policy objectives by narrowing the scope of policy, by reviewing policy options, and by examining options against selected criteria. Developing strategies for educating the public and for approaching legislative/regulatory bodies. Evaluating the effectiveness of the advocacy action plan as a process and as an agent for change. To illustrate the variety of ways in which pediatricians can be involved in the policy process to reduce violent injuries among children and adolescents, we apply this systematic approach to three priority areas. Prohibiting the use of corporal punishment in schools is intended to curb the institutionalized legitimacy of violence that has been associated with future use of violence. Efforts to remove handguns from the environments of children and adolescents are aimed at reducing the numbers of firearm injuries inflicted upon and by minors. Comprehensive treatment of adolescent victims of assault is intended to decrease the reoccurrence of violent injuries. PMID:7936890

  12. Credibility and advocacy in conservation science

    PubMed Central

    Horton, Cristi C.; Peterson, Tarla Rai; Banerjee, Paulami

    2015-01-01

    Abstract Conservation policy sits at the nexus of natural science and politics. On the one hand, conservation scientists strive to maintain scientific credibility by emphasizing that their research findings are the result of disinterested observations of reality. On the other hand, conservation scientists are committed to conservation even if they do not advocate a particular policy. The professional conservation literature offers guidance on negotiating the relationship between scientific objectivity and political advocacy without damaging conservation science's credibility. The value of this guidance, however, may be restricted by limited recognition of credibility's multidimensionality and emergent nature: it emerges through perceptions of expertise, goodwill, and trustworthiness. We used content analysis of the literature to determine how credibility is framed in conservation science as it relates to apparent contradictions between science and advocacy. Credibility typically was framed as a static entity lacking dimensionality. Authors identified expertise or trustworthiness as important, but rarely mentioned goodwill. They usually did not identify expertise, goodwill, or trustworthiness as dimensions of credibility or recognize interactions among these 3 dimensions of credibility. This oversimplification may limit the ability of conservation scientists to contribute to biodiversity conservation. Accounting for the emergent quality and multidimensionality of credibility should enable conservation scientists to advance biodiversity conservation more effectively. PMID:26041036

  13. Predictors of the Severity and Serious Outcomes of Anaphylaxis in Korean Adults: A Multicenter Retrospective Case Study

    PubMed Central

    Ye, Young-Min; Kim, Mi Kyeong; Kang, Hye-Ryun; Kim, Tae-Bum; Sohn, Seong-Wook; Koh, Young-Il; Park, Hye-Kyung; Jang, Gwang Cheon; Kim, Cheol-Woo; Hur, Gyu-Young; Kim, Joo-Hee; Kim, Sang-Heon; Choi, Gil-Soon; Lee, Soo-Keol

    2015-01-01

    Purpose Differences in definitions of the condition, relevant triggers, and the geographical locations of study centers, cause estimates of the prevalence of anaphylaxis to vary. Recent epidemiological data indicate that the incidence of anaphylaxis is rising. Methods To investigate the causes and clinical features of anaphylaxis in Korean adults, factors associated with the severity of the condition, and serious outcomes, a retrospective medical record review was performed on adult patients diagnosed with anaphylaxis between 2007 and 2011 in 15 University Hospitals of South Korea. Results A total of 1,806 cases (52% male, age 16-86 years) were reported. Cutaneous symptoms (84.0%), combined with respiratory (53.9%) and/or cardiovascular (55.4%) symptoms, were the most frequent presentations. Using a recognized grading system, 1,776 cases could be classified as either mild, 340; moderate, 690; or severe, 746. Although eliciting factors varied significantly by age, gender, and regional and seasonal factors, drugs (46.5%; including nonsteroidal anti-inflammatory drugs, antibiotics, and radiocontrast media) were the most common cause of anaphylaxis, followed by foods (24.2%), insect stings (16.4%), exercise (5.9%), and unknown etiology (7.0%). All of age, multi-organ involvement, a history of allergic disease, and drug-induced anaphylaxis, were significant predictors of serious outcomes requiring hospital admission or prolongation of hospital stay. Epinephrine auto-injectors were prescribed for 7.4% of reported cases. Conclusions The principal causes of anaphylaxis in Korean adults were drugs, food, and insect stings. Drug-associated anaphylaxis, a history of allergic disease, multi-organ involvement, and older age, were identified as predictors of serious outcomes. PMID:25553259

  14. Cold-induced urticaria: challenges in diagnosis and management

    PubMed Central

    Hochstadter, Elana Fay; Ben-Shoshan, Moshe

    2013-01-01

    Cold-induced urticaria (CU) is a chronic physical urticaria that can be hard to diagnose and manage. Symptoms of CU can vary from mild localised urticaria, angio-oedema to anaphylaxis. CU may be induced by a wide range of cold triggers from aquatic activities to ingestions of cold substances. This exemplifies the importance of accurate diagnosis and management of patients with CU. We present three cases of CU that demonstrate the variability in triggers and clinical presentation. PMID:23839613

  15. Should adrenaline be used in patients with hemodynamically stable anaphylaxis? Incident case control study nested within a retrospective cohort study.

    PubMed

    Ko, Byuk Sung; Kim, Ji Yeon; Seo, Dong-Woo; Kim, Won Young; Lee, Jae Ho; Sheikh, Aziz; Bates, David W

    2016-01-01

    Although adrenaline (epinephrine) is a cornerstone of initial anaphylaxis treatment, it is not often used. We sought to assess whether use of adrenaline in hemodynamically stable patients with anaphylaxis could prevent the development of hypotension. We conducted a retrospective cohort study of 761 adult patients with anaphylaxis presenting to the emergency department (ED) of a tertiary care hospital over a 10-year period. We divided the patients into two groups according to the occurrence of hypotension and compared demographic characteristics, clinical features, treatments and outcomes. Of the 340 patients with anaphylaxis who were normotensive at first presentation, 40 patients experienced hypotension during their ED stay. The ED stay of the hypotension group was significantly longer than that of patients who did not experience hypotension (496 min vs 253 min, P = 0.000). Adrenaline use in hemodynamically stable anaphylaxis patient was independently associated with a lower risk of developing in-hospital occurrence of hypotension: OR, 0.254 [95% CI, 0.091-0.706]. Adrenaline use in hemodynamically stable anaphylaxis patients was associated with a reduced risk of developing in-hospital occurrence of hypotension. Adverse events induced by adrenaline were rare when the intramuscular route was used. PMID:26837822

  16. Advocacy for Art Education: Beyond Tee-Shirts and Bumper Stickers

    ERIC Educational Resources Information Center

    Bobick, Bryna; DiCindio, Carissa

    2012-01-01

    Advocacy is not new to art education. Over the years, Goldfarb (1979), Hodsoll (1985), and Erickson and Young (1996) have written about the importance of arts advocacy, but the concept of advocacy has evolved with the times. For example, in the 1970s, arts advocacy was described as a "movement" and brought together art educators, administrators,…

  17. 75 FR 18957 - Open Meeting of Taxpayer Advocacy Panel Notice Improvement Issue Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-13

    ... Internal Revenue Service Open Meeting of Taxpayer Advocacy Panel Notice Improvement Issue Committee AGENCY... Taxpayer Advocacy Panel Notice Improvement Issue Committee will be conducted. The Taxpayer Advocacy Panel....C. App. (1988) that an open meeting of the Taxpayer Advocacy Panel Notice Improvement...

  18. 78 FR 11277 - Open Meeting of the Taxpayer Advocacy Panel Joint Committee

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    2013-02-15

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Joint Committee AGENCY: Internal... Advocacy Panel Joint Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comments... Advocacy Panel Joint Committee will be held Wednesday, March 27, 2013 at 2:00 p.m. Eastern Time...

  19. 75 FR 55407 - Open Meeting of the Taxpayer Advocacy Panel Joint Committee

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    2010-09-10

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Joint Committee AGENCY: Internal... Advocacy Panel Joint Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comment... Advocacy Panel Joint Committee will be held Tuesday, October 26, 2010, at 3 p.m. Eastern Time via...

  20. 77 FR 20488 - Open Meeting of the Taxpayer Advocacy Panel Joint Committee

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    2012-04-04

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Joint Committee AGENCY: Internal... Advocacy Panel Joint Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comments... Advocacy Panel Joint Committee will be held Wednesday, April 25, 2012, 2 p.m. Eastern Time...

  1. 78 FR 15126 - Open Meeting of the Taxpayer Advocacy Panel Joint Committee

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    2013-03-08

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Joint Committee AGENCY: Internal... Advocacy Panel Joint Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comments... Advocacy Panel Joint Committee will be held Wednesday, April 24, 2013 at 2:00 p.m. Eastern Time...

  2. 76 FR 63717 - Open Meeting of the Taxpayer Advocacy Panel Joint Committee

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    2011-10-13

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Joint Committee AGENCY: Internal... Advocacy Panel Joint Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comments... Advocacy Panel Joint Committee will be held Wednesday, November 23, 2011, 2 p.m. Eastern Time...

  3. 78 FR 56269 - Open Meeting of the Taxpayer Advocacy Panel Joint Committee

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    2013-09-12

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Joint Committee AGENCY: Internal... Advocacy Panel Joint Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comments... Advocacy Panel Joint Committee will be held Wednesday, October 23, 2013 at 2:00 p.m. Eastern Time...

  4. 78 FR 64063 - Open Meeting of the Taxpayer Advocacy Panel Joint Committee

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    2013-10-25

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Joint Committee AGENCY: Internal... Advocacy Panel Joint Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comments... Advocacy Panel Joint Committee will be held Wednesday, November 27, 2013 at 2:00 p.m. Eastern Time...

  5. 75 FR 4141 - Open Meeting of the Taxpayer Advocacy Panel Joint Committee

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    2010-01-26

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Joint Committee AGENCY: Internal... Advocacy Panel Joint Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comment... Advocacy Panel Joint Committee will be held Tuesday, February 23, 2010, at 3 p.m. Eastern Time...

  6. 77 FR 37102 - Open Meeting of the Taxpayer Advocacy Panel Joint Committee

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    2012-06-20

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Joint Committee AGENCY: Internal... Advocacy Panel Joint Committee will be conducted. The Taxpayer Advocacy Panel is soliciting ] public... meeting of the Taxpayer Advocacy Panel Joint Committee will be held Thursday, July 19, 2012, at 8 a.m....

  7. 78 FR 41194 - Open Meeting of the Taxpayer Advocacy Panel Joint Committee

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    2013-07-09

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Joint Committee AGENCY: Internal... Advocacy Panel Joint Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comments... Taxpayer Advocacy Panel Joint Committee will be held Tuesday, August 6 from 8:00 a.m. to 4:30 p.m....

  8. 77 FR 8327 - Open Meeting of the Taxpayer Advocacy Panel Joint Committee

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    2012-02-14

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Joint Committee AGENCY: Internal... Advocacy Panel Joint Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comments... Advocacy Panel Joint Committee will be held Wednesday, March 28, 2012, 2:00 p.m. Eastern Time...

  9. 76 FR 2193 - Open Meeting of the Taxpayer Advocacy Panel Joint Committee

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    2011-01-12

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Joint Committee AGENCY: Internal... Advocacy Panel Joint Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comment... Advocacy Panel Joint Committee will be held Monday, February 24, 2011, at 2 p.m. Eastern Time via...

  10. 77 FR 55526 - Open Meeting of the Taxpayer Advocacy Panel Joint Committee

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    2012-09-10

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Joint Committee AGENCY: Internal... Advocacy Panel Joint Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comments... Advocacy Panel Joint Committee will be held Wednesday, October 24, 2012, 2:00 p.m. Eastern Time...

  11. 75 FR 76522 - Open meeting of the Taxpayer Advocacy Panel Joint Committee

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    2010-12-08

    ... Internal Revenue Service Open meeting of the Taxpayer Advocacy Panel Joint Committee AGENCY: Internal... Advocacy Panel Joint Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comment... Advocacy Panel Joint Committee will be held Tuesday, January 25, 2011, at 3 p.m. Eastern Time via...

  12. 77 FR 5313 - Open Meeting of the Taxpayer Advocacy Panel Joint Committee

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    2012-02-02

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Joint Committee AGENCY: Internal... Advocacy Panel Joint Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comments... Advocacy Panel Joint Committee will be held Wednesday, February 22, 2012, 2 p.m., Eastern Time...

  13. 77 FR 67736 - Open Meeting of the Taxpayer Advocacy Panel Joint Committee

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    2012-11-13

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Joint Committee AGENCY: Internal... Advocacy Panel Joint Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comments... Advocacy Panel Joint Committee will be held Thursday, December 13, 2012, 2:00 p.m. Eastern Time...

  14. 77 FR 74921 - Open Meeting of the Taxpayer Advocacy Panel Joint Committee

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    2012-12-18

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Joint Committee AGENCY: Internal... Advocacy Panel Joint Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comments... Advocacy Panel Joint Committee will be held Wednesday, January 23, 2013 at 2:00 p.m. Eastern Time...

  15. 76 FR 56880 - Open Meeting of the Taxpayer Advocacy Panel Joint Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-14

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Joint Committee AGENCY: Internal... Advocacy Panel Joint Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comments... Advocacy Panel Joint Committee will be held Thursday, October 27, 2011, 2 p.m. Eastern Time...

  16. 76 FR 45006 - Open Meeting of the Taxpayer Advocacy Panel Joint Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-27

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Joint Committee AGENCY: Internal... Advocacy Panel Joint Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comments... Advocacy Panel Joint Committee will be held Thursday, September 22, 2011, 2 p.m. Eastern Time...

  17. 78 FR 41194 - Open Meeting of the Taxpayer Advocacy Panel Joint Committee

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    2013-07-09

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Joint Committee AGENCY: Internal... Advocacy Panel Joint Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comments... Advocacy Panel Joint Committee will be held Wednesday, August 28, 2013 at 2:00 p.m. Eastern Time...

  18. 77 FR 47166 - Open Meeting of the Taxpayer Advocacy Panel Joint Committee

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    2012-08-07

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Joint Committee AGENCY: Internal... Advocacy Panel Joint Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comments... Advocacy Panel Joint Committee will be held Wednesday, September 26, 2012, 2:00 p.m. Eastern Time...

  19. 75 FR 62631 - Open Meeting of the Taxpayer Advocacy Panel Joint Committee

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    2010-10-12

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Joint Committee AGENCY: Internal... Advocacy Panel Joint ] Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public... Advocacy Panel Joint Committee will be held Tuesday, November 23, 2010, at 3 p.m. Eastern Time...

  20. 78 FR 3500 - Open Meeting of the Taxpayer Advocacy Panel Joint Committee

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    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Joint Committee AGENCY: Internal... Advocacy Panel Joint Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comments... Advocacy Panel Joint Committee will be held Wednesday, February 27, 2013 at 2:00 p.m. Eastern Time...

  1. 77 FR 61054 - Open Meeting of the Taxpayer Advocacy Panel Joint Committee

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    2012-10-05

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Joint Committee AGENCY: Internal... Advocacy Panel Joint Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comments... Advocacy Panel Joint Committee will be held Wednesday, November 28, 2012, 2:00 p.m. Eastern Time...

  2. 76 FR 37197 - Open Meeting of the Taxpayer Advocacy Panel Joint Committee

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    2011-06-24

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Joint Committee AGENCY: Internal... Advocacy Panel Joint Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comments... Advocacy Panel Joint Committee will be held Thursday, August 25, 2011, 2 p.m. Eastern Time...

  3. 78 FR 48231 - Open Meeting of the Taxpayer Advocacy Panel Joint Committee

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    2013-08-07

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Joint Committee AGENCY: Internal... Advocacy Panel Joint Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comments... Advocacy Panel Joint Committee will be held Wednesday, September 25, 2013 at 2:00 p.m. Eastern Time...

  4. 77 FR 40410 - Open Meeting of the Taxpayer Advocacy Panel Joint Committee

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    2012-07-09

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Joint Committee AGENCY: Internal... Advocacy Panel Joint Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comments... Advocacy Panel Joint Committee will be held Wednesday, August 22, 2012, 2:00 p.m. Eastern Time...

  5. 76 FR 32021 - Open Meeting of the Taxpayer Advocacy Panel Joint Committee

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    2011-06-02

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Joint Committee AGENCY: Internal... Advocacy Panel Joint Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comments...) that an open meeting of the Taxpayer Advocacy Panel Joint Committee will be held Monday, July 25,...

  6. 77 FR 2610 - Open Meeting of the Taxpayer Advocacy Panel Toll-Free Project Committee

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    2012-01-18

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Toll-Free Project Committee AGENCY... Taxpayer Advocacy Panel Toll-Free Project Committee will be conducted. The Taxpayer Advocacy Panel is... meeting of the Taxpayer Advocacy Panel Toll-Free Project Committee will be held Tuesday, February 7,...

  7. 76 FR 77892 - Open Meeting of the Taxpayer Advocacy Panel Toll-Free Project Committee

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    2011-12-14

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Toll-Free Project Committee AGENCY... Taxpayer Advocacy Panel Toll-Free Project Committee will be conducted. The Taxpayer Advocacy Panel is... meeting of the Taxpayer Advocacy Panel Toll-Free Project Committee will be held Tuesday, January 03,...

  8. 77 FR 40411 - Open Meeting of the Taxpayer Advocacy Panel Toll-Free Project Committee

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    2012-07-09

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Toll-Free Project Committee AGENCY... Taxpayer Advocacy Panel Toll-Free Project Committee will be conducted. The Taxpayer Advocacy Panel is... meeting of the Taxpayer Advocacy Panel Toll-Free Project Committee will be held Tuesday, August 7,...

  9. 77 FR 55526 - Open Meeting of the Taxpayer Advocacy Panel Toll-Free Project Committee

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    2012-09-10

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Toll-Free Project Committee AGENCY... Taxpayer Advocacy Panel Toll-Free Project Committee will be conducted. The Taxpayer Advocacy Panel is... meeting of the Taxpayer Advocacy Panel Toll-Free Project Committee will be held Tuesday, October 2,...

  10. Self-Advocacy and Cancer: A Concept Analysis

    PubMed Central

    Hagan, Teresa L.; Donovan, Heidi S.

    2013-01-01

    Aim This paper is a report of an analysis of the concept of self-advocacy among individuals with cancer to clarify its meaning, to differentiate this meaning with related concepts and to unify understanding of the concept in cancer research and practice. Background Cancer survivors are increasingly required to assume an active role in their healthcare. A thorough analysis of how survivors advocate for themselves is a crucial aspect in supporting survivors’ ability to engage and manage their care throughout all stages of cancer survivorship. Design Walker and Avant’s eight-step process of conducting a concept analysis was used. Data Sources PubMed, PsycINFO and CINAHL databases were searched for articles, reviews, editorials and gray literature directly addressing self-advocacy. Review Methods A broad inquiry into the literature from 1960 – 2012 that produces a definition of self-advocacy. Model and contrary cases of self-advocacy demonstrate the concept’s application and intricacies. Results Antecedents to self-advocacy include particular personal characteristics, learned skills and attainable support. The essential element of self-advocacy and what differentiates it from related concepts, is the internalization of these antecedent resources into self-advocacy thoughts and actions while incorporating personal values and priorities in a way that upholds the survivors’ goals and beliefs. A full realization of self-advocacy facilitates a cancer survivor attaining a strong self-concept, sense of control and adaptation to a life with cancer. Conclusions Self-advocacy is a process of internalizing skills and resources to act in a way that supports survivors’ needs and goals. PMID:23347224

  11. Severe anaphylaxis to Propofol: first case of evidence of sensitization to soy oil.

    PubMed

    Richard, C; Beaudouin, E; Moneret-Vautrin, D A; Kohler, C; Nguyen-Grosjean, V M; Jacquenet, S

    2016-05-01

    The growing worldwide prevalence of food allergies is drawing attention to the risk of allergenic proteins found in intravenous medicinal products, particularly anaesthetics. Propofol induced anaphylaxis has been described. The presence of soybean oil and egg lecithins in the lipid emulsion highlights their suspected responsibility in certain cases. We report a case of anaphylaxis to propofol in an adult patient without food allergy to soy, but with a latent sensitization to soy. An IgE-dependent allergy to propofol was established by a basophil activation test. Here, we document for the first time the existence of specific IgEs to a 65kDa protein, found in soybean oil and soy flour. In the absence of data on the reactogenic threshold for allergenic food proteins injected intravenously, a risk appears to be established and leads us to recommend a systematic detection for proteins in the refined soybean oil used in the pharmaceutical industry for intravenous products. PMID:27152608

  12. Perceived history of anaphylaxis and parental overprotection, autonomy, anxiety, and depression in food allergic young adults.

    PubMed

    Herbert, Linda J; Dahlquist, Lynnda M

    2008-12-01

    This study examined autonomy, anxiety, depression, and perceptions of parental behavior in 86 food allergic young adults and 344 healthy young adults between the ages of 18 and 22. Participants completed an online survey measuring self-reported autonomy, anxiety, depression, and perceptions of parental behavior. Results indicated that, as a group, food allergic young adults did not differ from healthy peers. However, food allergic young adults who reported having experienced an anaphylactic reaction described their disease as more severe, reported more worry about their disease, and rated their parents as more overprotective than food allergic young adults who reported never having experienced anaphylaxis. The experience of anaphylaxis may be a reliable indicator of food allergic individuals who are at risk for psychological distress. PMID:19104982

  13. Perspective of an advocate: best practices for Community Outreach Advocacy.

    PubMed

    Kandusi, Emmanuel J

    2013-07-15

    Of all the different types of advocacy, Community Outreach Advocacy (COA) is the best methodology. This methodology is the prolegomena to the achievement of all other advocacies including political, fundraising, research, support and education. This is because the outcome of COA awareness work is an informed group of people. Such people can comprehend and tackle any other initiatives in addressing the issue at stake and so prevent and control unnecessary suffering and deaths caused by cancer! At the end of the day, the African Cancer Advocates Consortium (ACAC) will achieve its mission to "Make Cancer a Top Priority in Africa" through informed people. PMID:23902606

  14. Climate Change: On Scientists and Advocacy

    NASA Technical Reports Server (NTRS)

    Schmidt, Gavin A.

    2014-01-01

    Last year, I asked a crowd of a few hundred geoscientists from around the world what positions related to climate science and policy they would be comfortable publicly advocating. I presented a list of recommendations that included increased research funding, greater resources for education, and specific emission reduction technologies. In almost every case, a majority of the audience felt comfortable arguing for them. The only clear exceptions were related to geo-engineering research and nuclear power. I had queried the researchers because the relationship between science and advocacy is marked by many assumptions and little clarity. This despite the fact that the basic question of how scientists can be responsible advocates on issues related to their expertise has been discussed for decades most notably in the case of climate change by the late Stephen Schneider.

  15. Nursing advocacy for women veterans and suicide.

    PubMed

    Conard, Patricia L; Armstrong, Myrna L; Young, Cathy; Hogan, La Micha

    2015-03-01

    Little is known about suicide variables in women Veterans. The authors reviewed numerous applicable health care and military literary sources regarding suicide in this population. The current article describes the surrounding circumstances, military war/conflict culture, and potential effects on women Veterans, including major collection problems with current Veteran data. Women Veterans are increasingly reporting more behavioral health issues (e.g., posttraumatic stress disorder) and attempting suicide upon civilian reintegration. Outcomes from this literature review suggest the importance of nursing advocacy to create better rapport and communication with women Veterans from Vietnam, Gulf I, Iraq, and Afghanistan wars seeking care at civilian health facilities, as some may present with suicidal ideologies. PMID:25751826

  16. Effective citizen advocacy of beneficial nuclear technologies

    SciTech Connect

    McKibben, J. Malvyn; Wood, Susan

    2007-07-01

    In 1991, a small group of citizens from communities near the Savannah River Site (SRS) formed a pro-nuclear education and advocacy group, Citizens for Nuclear Technology Awareness (CNTA). Their purpose was to: (1) counter nuclear misinformation that dominated the nation's news outlets, (2) provide education on nuclear subjects to area citizens, students, elected officials, and (3) provide informed citizen support for potential new missions for SRS when needed. To effectively accomplish these objectives it is also essential to establish and maintain good relations with community leaders and reporters that cover energy and nuclear subjects. The organization has grown considerably since its inception and has expanded its sphere of influence. We believe that our experiences over these fifteen years are a good model for effectively communicating nuclear subjects with the public. This paper describes the structure, operation and some of the results of CNTA. (authors)

  17. A Cases of Near-fatal Anaphylaxis: Parsley “Over-use” as an Herbal Remedy

    PubMed Central

    Arslan, Sevket; Ucar, Ramazan; Caliskaner, Ahmet Zafer

    2014-01-01

    The use of herbal products in patients with allergic diseases is a special problem and still controversial. But, many people often use herbs to maintain good health. The patients use self-prescribed remedies as medications but do not inform their physicians about herbal use. Unfortunately, some herbal self-medications may have unexpected effects and interactions which may lead to fatal complications. In this report, we describe a female patient who suffered near-fatal anaphylaxis to parsley. PMID:25648063

  18. Infection with influenza a virus leads to flu antigen-induced cutaneous anaphylaxis in mice.

    PubMed

    Grunewald, Susanne M; Hahn, Christian; Wohlleben, Gisela; Teufel, Martin; Major, Tamas; Moll, Heidrun; Bröcker, Eva-B; Erb, Klaus J

    2002-04-01

    It is well established, that viral infections may trigger urticaria or allergic asthma; however, as viral infections induce T helper 1 polarized responses, which lead to the inhibition of T helper 2 cell development, the opposite would be plausible. We wanted to investigate how viral infections may mediate allergic symptoms in a mouse model; therefore, we infected BALB/C mice with influenza A virus intranasally. Histologic analyses of lung sections and bronchoalveolar lavages were performed. In addition, cells from the mediastinal lymph nodes were restimulated in vitro to analyze which types of cytokines were induced by the flu infection. Furthermore, flu-specific antibody titers were determined and local anaphylaxis was measured after rechallenge with flu antigen. We found that airways inflammation consisted predominately of macrophages and lymphocytes, whereas only a few eosinophils were observed. interferon-gamma but no interleukin-4 and little interleukin-5 could be detected in the culture supernatants from in vitro restimulated T cells from the draining lymph nodes. The antibody response was characterized by high levels of virus-specific IgG2a, IgG2b, and IgG1 and, surprisingly, low levels of virus-specific IgE antibodies. Interestingly, flu-infected mice developed active and passive cutaneous anaphylaxis after rechallenge with flu-antigen. As the passive cutaneous anaphylaxis reaction persisted over 48 h and was significantly lower after passive transfer of the serum, which was IgE depleted, local anaphylaxis seemed to be mediated predominately by specific IgE antibodies. Taken together, our results demonstrate that mice infected with flu virus develop virus-specific mast cell degranulation in the skin. Our results may also have implications for the pathogenesis of urticaria or other atopic disorders in humans. PMID:11918711

  19. Key components of anaphylaxis management plans: consensus findings from a national electronic Delphi study

    PubMed Central

    Worth, Allison; Nurmatov, Ulugbek; Sheikh, Aziz

    2010-01-01

    Objectives There is no international consensus on the components of anaphylaxis management plans and responsibility for their design and delivery is contested. We set out to establish consensus among relevant specialist and generalist clinicians on this issue to inform future randomized controlled trials. Design A two-round electronic Delphi study completed by a 25-person, multidisciplinary expert panel. Participants scored the importance of a range of statements on anaphylaxis management, identified from a systematic review of the literature, on a five-point scale ranging from ‘very important’ to ‘irrelevant’. Consensus was defined a priori as being achieved if 80% or more of panel members rated a statement as ‘important’ or ‘very important’ after Round 2. Setting Primary and secondary care and academic settings in the UK and Ireland. Participants Twenty-five medical, nursing and allied health professionals. Main outcome measures Consensus on the key components of anaphylaxis management plans. Results The response rate was 84% (n = 21) for Round 1 and 96% (n = 24) for Round 2. The key components of emergency care on which consensus was achieved included: awareness of trigger factors (100%); recognition and emergency management of reactions of different severity (100%); and clear information on adrenaline (epinephrine) use (100%). Consensus on longer-term management issues included: clear written guidelines on anaphylaxis management (96%); annual review of plans (87%); and plans that were tailored to individual needs (82%). Conclusions This national consensus-building exercise generated widespread agreement that emergency plans need to be simple, clear and generic, making them easy to implement in a crisis. In contrast, long-term plans need to be negotiated between patient/carers and professionals, and tailored to individual needs. The effectiveness of this expert-agreed long-term plan now needs to be evaluated rigorously. PMID:21103134

  20. A Cases of Near-fatal Anaphylaxis: Parsley "Over-use" as an Herbal Remedy.

    PubMed

    Arslan, Sevket; Ucar, Ramazan; Caliskaner, Ahmet Zafer

    2014-12-01

    The use of herbal products in patients with allergic diseases is a special problem and still controversial. But, many people often use herbs to maintain good health. The patients use self-prescribed remedies as medications but do not inform their physicians about herbal use. Unfortunately, some herbal self-medications may have unexpected effects and interactions which may lead to fatal complications. In this report, we describe a female patient who suffered near-fatal anaphylaxis to parsley. PMID:25648063

  1. A Case of Anaphylaxis Induced by Contact with Young Radish (Raphanus sativus L).

    PubMed

    Lee, Yung-Hee; Lee, Jae-Hyoung; Kang, Hye-Ran; Ha, Jung-Hoon; Lee, Byoung-Hoon; Kim, Sang-Hoon

    2015-01-01

    Young radish (Raphanus sativus L), a member of the mustard family (Cruciferae), is a common ingredient of Kimchi. Although few reports have described anaphylaxis to cruciferous vegetables, we report the case of anaphylaxis induced by contact with young radish. A 46-year-old female with a history of contact allergy to metal presented to our emergency room (ER) with dizziness, generalized eruption and gastrointestinal upset. Her symptoms developed after re-exposure to young radish while chopping it. Hypotensive blood pressures were noted. Three days prior, the patient had experienced generalized urticaria with pruritus immediately after chopping the fresh young radish, which resolved spontaneously. In the ER, her symptoms improved by the administration of epinephrine (0.3 mL), antihistamine (chlorpheniramine) and isotonic saline hydration. A skin prick test with young radish extract showed positive reactivity. The same skin test was negative in five adult controls. IgE-mediated hypersensitivity could be an important immunologic mechanism in the development of young radish-induced anaphylaxis. PMID:25553270

  2. [Anaphylaxis Due to Ingestion of Ivy Syrup (Hedera hÈlix). Report of two Cases].

    PubMed

    Morfin-Maciel, Blanca María; Rosas-Alvarado, Alejandro; Velázquez-Sámano, Guillermo

    2012-01-01

    Common ivy is an ornamental plant, that is ubiquitous in Mexico. Its allergens can cause contact dermatitis, asthma and allergic rhinitis. We describe two cases of anaphylaxis related to common ivy syrup ingestion. We performed skin prick test with Hedera helix syrup, and using a dialized and ultrafiltered of common ivy syrup commercial presentation (dry common ivy extract: 7mg/ml), as well as using Hedera helix pollen extract. We describe two cases of anaphylaxis related to ingestion of Hedera helix syrup. Skin prick test with the commercial presentation and with the pollen extract were positive in both patients. In this study we confirmed the causal relationship of anaphylaxis due to the ingestion of ivy syrup in two patients through skin prick tests with ivy syrup and ivy pollen extract. Common ivy can cause contact dermatitis, asthma and allergic rhinitis, but we do not know the allergens that could be related to systemic and respiratory reactions, then, more studies in this topic are requiered. PMID:24007931

  3. Anaphylaxis to Polyethylene Glycol (Colyte®) in a Patient with Diverticulitis.

    PubMed

    Lee, So Hee; Hwang, Sun Hyuk; Park, Jin Soo; Park, Hae Sim; Shin, Yoo Seob

    2016-10-01

    Polyethylene glycols (PEGs) are believed to be chemically inert agents, but larger PEG polymers could have immunogenicity. A 39-year-old man was referred to emergency room for loss of consciousness and dyspnea after taking of PEG-3350 (Colyte®). In laboratory findings, the initial serum tryptase level was increased to 91.9 mg/L (normal range: 0.00-11.40 mg/L) without any other laboratory abnormalities. The intradermal test with 10 mg/mL Colyte® showed a 5 × 5 mm wheal, but basophil activation and histamine releasability tests were negative. PEG-3350 is widely used as an osmotic laxative due to its lack of absorption from the gastrointestinal tract. However, the loss of mucosal integrity at gastrointestinal membrane such as diverticulitis may be a predisposing factor for anaphylaxis to Colyte®. We report a case of anaphylaxis induced by the ingestion of PEG-3350 in a patient with diverticulitis which might be a risk factor of anaphylaxis. PMID:27550498

  4. Delayed anaphylaxis to alpha-gal, an oligosaccharide in mammalian meat.

    PubMed

    Commins, Scott P; Jerath, Maya R; Cox, Kelly; Erickson, Loren D; Platts-Mills, Thomas

    2016-01-01

    IgE-mediated hypersensitivity refers to immune reactions that can be rapidly progressing and, in the case of anaphylaxis, are occasionally fatal. To that end, identification of the associated allergen is important for facilitating both education and allergen avoidance that are essential to long-term risk reduction. As the number of known exposures associated with anaphylaxis is limited, discovery of novel causative agents is crucial to evaluation and management of patients with idiopathic anaphylaxis. Within the last 10 years several apparently separate observations were recognized to be related, all of which resulted from the development of antibodies to a carbohydrate moiety on proteins. Interestingly, the exposure differed from airborne allergens but was nevertheless capable of producing anaphylactic and hypersensitivity reactions. Our recent work has identified these responses as being due to a novel IgE antibody directed against a mammalian oligosaccharide epitope, galactose-alpha-1,3-galactose ("alpha-gal"). This review will present the historical summary of the identification of cetuximab hypersensitivity due to alpha-gal IgE and discuss the non-primate mammalian meat food allergy as well as current goals and directions of our research programs. PMID:26666477

  5. Excess subcutaneous tissue may preclude intramuscular delivery when using adrenaline autoinjectors in patients with anaphylaxis.

    PubMed

    Johnstone, J; Hobbins, S; Parekh, D; O'Hickey, S

    2015-06-01

    Intramuscular adrenaline is the gold standard treatment for anaphylaxis. Intramuscular injection provides more rapid and higher plasma concentrations than subcutaneous routes. Given the increasing epidemic of obesity patients are at increased risk of subcutaneous delivery, we therefore assessed the depth of subcutaneous tissue in a population of patients with anaphylaxis. Patients already prescribed adrenaline autoinjectors (AAIs) for anaphylaxis were examined with ultrasound, and measurements of skin-to-muscle depth (STMD) at anterolateral thigh and anterior thigh were performed. Twenty-eight patients (23 female, 5 male) with an age range of 18-75 took part in the study, and in 68%, the STMD was greater than AAI needle length (15.02 mm), using the anterolateral thigh as the recommended administration site. The key predictors for increased STMD were female gender (P=0.0003) and a BMI > 30 (P=0.04). AAIs require longer needles to ensure intramuscular administration, and ultrasound at point of prescription would aid needle length selection. PMID:25676800

  6. Suppression by Trypanosoma brucei of anaphylaxis-mediated ion transport in the small intestine of rats.

    PubMed Central

    Gould, S S; Castro, G A

    1994-01-01

    The hypothesis that failure of hosts infected with Trypanosoma brucei to express type 1 hypersensitivity is related to this parasite's ability to down-regulate IgE production, and not to an innate lack of allergenicity of T. brucei antigens, was tested by studying anaphylaxis-induced changes in net epithelial ion transport in rats. Transport changes were quantified electrophysiologically in vitro, as a change in transmural short-circuit current when sensitized intestine was challenged with homologous antigen. Rats injected parenterally with trypanosome antigen elicited intestinal anaphylaxis in response to antigenic challenge, whereas the intestine of rats infected with T. brucei failed to respond. Infection with T. brucei also suppressed the anaphylactic response in rats sensitized to and challenged with ovalbumin and T. spiralis-derived antigens. In these cases suppression was related to the ability of T. brucei to block production of IgE, and not to the physiological failure of the epithelial response. However, in rats sensitized by infection with T. spiralis, neither the anaphylactic response nor IgE production were inhibited by T. brucei. Furthermore, intestinal mastocytosis normally associated with trichinosis was unaffected by the trypanosome infection. Results support the conclusion that the failure to express anaphylaxis in T. brucei-infected rats is due to the inhibition of IgE production and not to the lack of allergenicity of trypanosome antigens. PMID:8206518

  7. Epinephrine (adrenaline) in the first-aid, out-of-hospital treatment of anaphylaxis.

    PubMed

    Simons, F Estelle R

    2004-01-01

    Epinephrine (adrenaline), the initial treatment of choice for systemic anaphylaxis, is an alpha- and beta-adrenergic agonist with bidirectional, cyclic adenosine monophosphate-mediated pharmacological effects on target organs, and a narrow therapeutic index. In a recent study, 0.95% of a geographically-defined population was found to have had epinephrine dispensed for out-of-hospital use; dispensing rates within this population varied from 1.44% for individuals under age 17 years to 0.32% for those older than 65 years. Although epinephrine is widely available in the community, it is not necessarily given in a timely manner when anaphylaxis occurs. Individuals with anaphylaxis may fail to respond to first-aid treatment with epinephrine for a variety of reasons. These include: (1) delay in treatment (in an animal model, epinephrine injection at the nadir of shock fails to provide sustained haemodynamic recovery); (2) administration of epinephrine by sub-optimal routes such as subcutaneous injection or inhalation from a pressurized metered-dose inhaler instead of intramuscular injection; (3) administration of an inappropriately low epinephrine dose due to the limitations currently imposed by the availability of only two fixed-dose auto-injectors: EpiPen Jr 0.15 mg or EpiPen 0.3 mg; and (4) injection of 'outdated' epinephrine, with inadvertent administration of an inadequate dose. Additional fixed-dose formulations of epinephrine are needed to facilitate optimal first-aid dosing in patients of all ages and sizes. PMID:15025402

  8. The Basophil Activation Test Is Safe and Useful for Confirming Drug-Induced Anaphylaxis.

    PubMed

    Kim, Suk Yeon; Kim, Joo Hee; Jang, Young Sook; Choi, Jeong Hee; Park, Sunghoon; Hwang, Yong Il; Jang, Seung Hun; Jung, Ki Suck

    2016-11-01

    The basophil activation test (BAT) has been suggested as a complementary method for diagnosing drug allergies. The aim of this study was to evaluate the clinical utility of this test in patients with drug-induced anaphylaxis. In total, 19 patients, all of whom had a history of moderate to severe anaphylaxis, were enrolled. None of the causative drugs had available in vitro tests or reliable skin tests; these drugs included, among others, first and second-generation cephalosporins, H2 blockers, and muscle relaxants. The BAT yielded positive results in 57.9% of the cases, which was similar those results of skin prick and intradermal tests (42.1% and 57.9%, respectively). When basophils were double labelled with CD63 and CD203c, both of which are basophil activation markers, the positive rate was increased from 57.9% to 73.7%. Therefore, the results of this study confirm that the BAT is a quick, reliable, and safe diagnostic tool for patients with drug-induced anaphylaxis. PMID:27582406

  9. Delayed anaphylaxis to alpha-gal, an oligosaccharide in mammalian meat

    PubMed Central

    Commins, Scott P.; Jerath, Maya R.; Cox, Kelly; Erickson, Loren D.; Platts-Mills, Thomas

    2016-01-01

    IgE-mediated hypersensitivity refers to immune reactions that can be rapidly progressing and, in the case of anaphylaxis, are occasionally fatal. To that end, identification of the associated allergen is important for facilitating both education and allergen avoidance that are essential to long-term risk reduction. As the number of known exposures associated with anaphylaxis is limited, discovery of novel causative agents is crucial to evaluation and management of patients with idiopathic anaphylaxis. Within the last 10 years several apparently separate observations were recognized to be related, all of which resulted from the development of antibodies to a carbohydrate moiety on proteins. Interestingly, the exposure differed from airborne allergens but was nevertheless capable of producing anaphylactic and hypersensitivity reactions. Our recent work has identified these responses as being due to a novel IgE antibody directed against a mammalian oligosaccharide epitope, galactose-alpha-1,3-galactose (“alpha-gal”). This review will present the historical summary of the identification of cetuximab hypersensitivity due to alpha-gal IgE and discuss the non-primate mammalian meat food allergy as well as current goals and directions of our research programs. PMID:26666477

  10. Immunologic analysis of anaphylaxis to protamine component in neutral protamine Hagedorn human insulin.

    PubMed

    Dykewicz, M S; Kim, H W; Orfan, N; Yoo, T J; Lieberman, P

    1994-01-01

    We report the clinical and immunologic analysis of two patients with diabetes who had anaphylaxis to neutral protamine Hagedorn (NPH) human insulin in the absence of allergy to regular insulin. A 36-year-old woman without a recent history of local insulin reactions or interruption of insulin therapy experienced anaphylaxis within 15 minutes of her usual morning dose of subcutaneously administered NPH human insulin. A 62-year-old man with a history of generalized reactions to NPH human insulin and of anaphylaxis to intravenously administered protamine had generalized urticaria after injection of NPH human insulin. Both patients subsequently tolerated Lente human insulin. Skin test results in both patients were negative to regular and Lente insulin preparations but positive to NPH insulin and to protamine at concentrations tested. In vitro assays demonstrated that both patients had markedly elevated serum levels of IgE and IgG to protamine, but not to regular human insulin, and that their IgE antibodies to protamine recognized protamine antigenic determinants in NPH human insulin. We conclude that the anaphylactic reactions to NPH insulin in our patients were mediated by IgE to protamine, which should be a pathogenetic consideration in the evaluation of immediate-type reactions to protamine-containing insulins. PMID:8308177

  11. Bladder Cancer Patient Advocacy: A Global Perspective

    PubMed Central

    Quale, Diane Zipursky; Bangs, Rick; Smith, Monica; Guttman, David; Northam, Tammy; Winterbottom, Andrew; Necchi, Andrea; Fiorini, Edoardo; Demkiw, Stephanie

    2015-01-01

    Abstract Over the past 20 years, cancer patient advocacy groups have demonstrated that patient engagement in cancer care is essential to improving patient quality of life and outcomes. Bladder cancer patient advocacy only began 10 years ago in the United States, but is now expanding around the globe with non-profit organizations established in Canada, the United Kingdom and Italy, and efforts underway in Australia. These organizations, at different levels of maturity, are raising awareness of bladder cancer and providing essential information and resources to bladder cancer patients and their families. The patient advocacy organizations are also helping to advance research efforts by funding research proposals and facilitating research collaborations. Strong partnerships between these patient advocates and the bladder cancer medical community are essential to ensuringsustainability for these advocacy organizations, increasing funding to support advances in bladder cancer treatment, and improving patient outcomes. PMID:27398397

  12. Advocacy communication, vaccines and the role of scientific societies.

    PubMed

    Signorelli, C; Odone, A

    2015-01-01

    In 1986 the Ottawa Charter underlined the importance of advocacy in health. This article analyzes the role of advocacy in Public Health making the case of immunization, whose coverage rates are decreasing in many countries. An effective advocacy action could counteract the growing phenomenon of the vaccine hesitancy within both the general population and an increasing share of healthcare providers as well as contrast antivax movements' action. We identify who are the advocates focusing on Italy and on the crucial role of scientific societies which share the responsibility of making the latest scientific evidence and most effective infectious diseases' control strategies available to health policy makers. The Italian Society of Hygiene (SItI) has been actively engaged for several years in a number of initiatives of advocacy communication and vaccines including research, training, media exposure and a dedicated website portal (vaccinarSì). PMID:26661915

  13. The Concept of Advocacy in Nursing: A Critical Analysis.

    PubMed

    Kalaitzidis, Evdokia; Jewell, Paul

    2015-01-01

    As health care professionals practice as a team, they take on responsibilities that are specific to their roles-responsibilities that are recognized and understood by the team and management as pertaining to their professional domain and expertise. Is advocacy part of the role of the nurse? Members of the nursing profession commonly maintain that it is, but is there a consensus on this issue, both within the profession and among other stakeholders? Is there a clear understanding of the term advocacy, and is this reflected in Codes of Practice and research into practice? An examination of significant documents and reports of empirical research reveals conflicting conceptions and opinions. There is potential for a common definition, but agreements need to be reached on whether advocacy is an essential function of nursing within the management of health care, and if so, what is advocacy's importance, focus, and limits. PMID:26506292

  14. Handicapped Infants and Euthanasia: A Challenge to Our Advocacy.

    ERIC Educational Resources Information Center

    Smith, J. David

    1985-01-01

    The issue of pediatric euthanasia for handicapped newborns is examined and contrasting viewpoints emphasizing the quality and the sanctity of life are considered. The author asserts that advocacy for handicapped children involves decisions regarding the euthanasia question. (CL)

  15. The etiology and incidence of anaphylaxis in Rochester, Minnesota: A report from the Rochester Epidemiology Project

    PubMed Central

    Decker, Wyatt W.; Campbell, Ronna L.; Manivannan, Veena; Luke, Anuradha; St. Sauver, Jennifer L.; Weaver, Amy; Bellolio, M. Fernanda; Bergstralh, Eric J.; Stead, Latha G.; Li, James T. C.

    2009-01-01

    Background Reported incidences of anaphylaxis range from 3.2 to 20 per 100,000 population. The incidence and trend over time has meaningful public health implications but has not been well characterized because of a lack of a standard definition and deficiencies in reporting of events. Objective We sought to determine the incidence and cause of anaphylaxis over a 10-year period. Methods We performed a population-based incidence study that was conducted in Rochester, Minnesota, from 1990 through 2000. Anaphylaxis episodes were identified on the basis of symptoms and signs of mast cell and basophil mediator release plus mucocutaneous, gastrointestinal tract, respiratory tract, or cardiovascular system involvement. Results Two hundred eleven cases of anaphylaxis were identified (55.9% in female subjects). The mean age was 29.3 years (SD, 18.2 years; range, 0.8–78.2 years). The overall age-and sex-adjusted incidence rate was 49.8 (95% CI, 45.0–54.5) per 100,000 person-years. Age-specific rates were highest for ages 0 to 19 years (70 per 100,000 person-years). Ingested foods accounted for 33.2% (70 cases), insect stings accounted for 18.5% (39 cases), medication accounted for 13.7% (29 cases), radiologic contrast agent accounted for 0.5% (1 case), “other” causes accounted for 9% (19 cases), and “unknown” causes accounted for 25.1% (53 cases). The “other” group included cats, latex, cleaning agents, environmental allergens, and exercise. There was an increase in the annual incidence rate during the study period from 46.9 per 100,000 persons in 1990 to 58.9 per 100,000 persons in 2000 (P = .03). Conclusion The overall incidence rate is 49.8 per 100,000 person-years, which is higher than previously reported. The annual incidence rate is also increasing. Food and insect stings continue to be major inciting agents for anaphylaxis. PMID:18992928

  16. What are the 'ideal' features of an adrenaline (epinephrine) auto-injector in the treatment of anaphylaxis?

    PubMed

    Frew, A J

    2011-01-01

    Anaphylaxis is a systemic allergic reaction that often involves respiratory symptoms and cardiovascular collapse, which are potentially life-threatening if not treated promptly with intramuscular adrenaline. Owing to the unpredictable nature of anaphylaxis and accidental exposure to allergens (such as peanuts and shellfish), patients should be prescribed intramuscular adrenaline auto-injectors and carry these with them at all times. Patients also need to be able to use their auto-injectors correctly while under high stress, when an anaphylactic attack occurs. Despite this, an alarming number of patients fail to carry their auto-injectors and many patients, carers of children with known anaphylaxis and healthcare professionals do not know how to use the device correctly, despite having had training. Currently available auto-injector devices have various limitations that may impede their use in the management of anaphylaxis. There is also a lack of validated assessment criteria and regulatory requirements for new devices. This review describes the different delivery systems used in currently available auto-injectors and discusses the key barriers to the use of adrenaline auto-injectors, with the goal of identifying the 'ideal' features/characteristics of such devices in the emergency treatment of anaphylaxis that will ensure ease of use, portability and accurate delivery of a life-saving drug. PMID:20716315

  17. Justified concern or exaggerated fear: the risk of anaphylaxis in percutaneous treatment of cystic echinococcosis-a systematic literature review.

    PubMed

    Neumayr, Andreas; Troia, Giuliana; de Bernardis, Chiara; Tamarozzi, Francesca; Goblirsch, Sam; Piccoli, Luca; Hatz, Christoph; Filice, Carlo; Brunetti, Enrico

    2011-06-01

    Percutaneous treatment (PT) emerged in the mid-1980s as an alternative to surgery for selected cases of abdominal cystic echinococcosis (CE). Despite its efficacy and widespread use, the puncture of echinococcal cysts is still far from being universally accepted. One of the main reasons for this reluctance is the perceived risk of anaphylaxis linked to PTs. To quantify the risk of anaphylactic reactions and lethal anaphylaxis with PT, we systematically searched MEDLINE for publications on PT of CE and reviewed the PT-related complications. After including 124 publications published between 1980 and 2010, we collected a total number of 5943 PT procedures on 5517 hepatic and non-hepatic echinococcal cysts. Overall, two cases of lethal anaphylaxis and 99 reversible anaphylactic reactions were reported. Lethal anaphylaxis occurred in 0.03% of PT procedures, corresponding to 0.04% of treated cysts, while reversible allergic reactions complicated 1.7% of PTs, corresponding to 1.8% of treated echinococcal cysts. Analysis of the literature shows that lethal anaphylaxis related to percutaneous treatment of CE is an extremely rare event and is observed no more frequently than drug-related anaphylactic side effects. PMID:21695106

  18. Justified Concern or Exaggerated Fear: The Risk of Anaphylaxis in Percutaneous Treatment of Cystic Echinococcosis—A Systematic Literature Review

    PubMed Central

    Neumayr, Andreas; Troia, Giuliana; de Bernardis, Chiara; Tamarozzi, Francesca; Goblirsch, Sam; Piccoli, Luca; Hatz, Christoph; Filice, Carlo; Brunetti, Enrico

    2011-01-01

    Percutaneous treatment (PT) emerged in the mid-1980s as an alternative to surgery for selected cases of abdominal cystic echinococcosis (CE). Despite its efficacy and widespread use, the puncture of echinococcal cysts is still far from being universally accepted. One of the main reasons for this reluctance is the perceived risk of anaphylaxis linked to PTs. To quantify the risk of anaphylactic reactions and lethal anaphylaxis with PT, we systematically searched MEDLINE for publications on PT of CE and reviewed the PT-related complications. After including 124 publications published between 1980 and 2010, we collected a total number of 5943 PT procedures on 5517 hepatic and non-hepatic echinococcal cysts. Overall, two cases of lethal anaphylaxis and 99 reversible anaphylactic reactions were reported. Lethal anaphylaxis occurred in 0.03% of PT procedures, corresponding to 0.04% of treated cysts, while reversible allergic reactions complicated 1.7% of PTs, corresponding to 1.8% of treated echinococcal cysts. Analysis of the literature shows that lethal anaphylaxis related to percutaneous treatment of CE is an extremely rare event and is observed no more frequently than drug-related anaphylactic side effects. PMID:21695106

  19. Microbicides 2008 conference: From discovery to advocacy

    PubMed Central

    Ramjee, Gita; Doncel, Gustavo F; Mehendale, Sanjay; Tolley, Elizabeth E; Dickson, Kim

    2008-01-01

    Recently revised statistics show the number of individuals living with HIV at over 33 million worldwide, with 68% being in sub-Saharan Africa. Current HIV prevention methods, such as condom use, monogamy and abstinence, are not always feasible. The need for improved HIV preventative technologies remains urgent. Of these, microbicides represent a promising female-initiated preventative method. Microbicides are designed to be applied vaginally to prevent HIV and STI acquisition. Research is also being undertaken to assess the safety of the product during rectal application. The biannual Microbicides conference took place in New Delhi, India from 24–27 February 2008. The conference was open to delegates from the scientific and medical fields, as well as communities and advocates. In addition to microbicide research and development, the conference afforded the opportunity for the discussion of key issues such as ethics, acceptability, access, and community involvement. In this conference report we provide brief summaries of recent advancements made and challenges experienced in microbicide research and development, including updates on basic and clinical science, social and behavioural science, and community mobilisation and advocacy activities pertaining to clinical trials. PMID:18702834

  20. Pyrazolones metabolites are relevant for identifying selective anaphylaxis to metamizole.

    PubMed

    Ariza, Adriana; García-Martín, Elena; Salas, María; Montañez, María I; Mayorga, Cristobalina; Blanca-Lopez, Natalia; Andreu, Inmaculada; Perkins, James; Blanca, Miguel; Agúndez, José A G; Torres, María J

    2016-01-01

    Non-steroidal anti-inflammatory drugs (NSAIDs) are the most common cause of hypersensitivity reactions, with pyrazolones the most frequent drugs inducing selective reactions. Immediate selective hypersensitivity to pyrazolones is thought to be mediated by specific-IgE. Sensitivity of in vitro diagnostic tests is low and this may be due to the incomplete characterization of the structures involved. Here we investigated whether main metabolites of metamizole (dipyrone) in human could be involved in the immune response using the basophil activation test (BAT). We studied subjects with confirmed selective immediate hypersensitivity to metamizole and performed BAT with metamizole and its metabolites: 4-methylamino-antipyrine (MAA), 4-aminoantipyrine (AA), 4-acetylamino-antipyrine (AAA) and 4-formylamino-antipyrine (FAA). BAT results showed an increase of positive results from 37.5% to 62.5% using metamizole plus metabolites as compared with the BAT carried out only with the parent drug, demonstrating that metamizole metabolites have a role in the reaction and can induce specific basophil activation in patients with immediate hypersensitivity to this drug. Our findings indicate that pyrazolone metabolites are useful for improving the in vitro diagnosis of allergic reactions to metamizole. PMID:27030298

  1. Pyrazolones metabolites are relevant for identifying selective anaphylaxis to metamizole

    PubMed Central

    Ariza, Adriana; García-Martín, Elena; Salas, María; Montañez, María I.; Mayorga, Cristobalina; Blanca-Lopez, Natalia; Andreu, Inmaculada; Perkins, James; Blanca, Miguel; Agúndez, José A. G.; Torres, María J.

    2016-01-01

    Non-steroidal anti-inflammatory drugs (NSAIDs) are the most common cause of hypersensitivity reactions, with pyrazolones the most frequent drugs inducing selective reactions. Immediate selective hypersensitivity to pyrazolones is thought to be mediated by specific-IgE. Sensitivity of in vitro diagnostic tests is low and this may be due to the incomplete characterization of the structures involved. Here we investigated whether main metabolites of metamizole (dipyrone) in human could be involved in the immune response using the basophil activation test (BAT). We studied subjects with confirmed selective immediate hypersensitivity to metamizole and performed BAT with metamizole and its metabolites: 4-methylamino-antipyrine (MAA), 4-aminoantipyrine (AA), 4-acetylamino-antipyrine (AAA) and 4-formylamino-antipyrine (FAA). BAT results showed an increase of positive results from 37.5% to 62.5% using metamizole plus metabolites as compared with the BAT carried out only with the parent drug, demonstrating that metamizole metabolites have a role in the reaction and can induce specific basophil activation in patients with immediate hypersensitivity to this drug. Our findings indicate that pyrazolone metabolites are useful for improving the in vitro diagnosis of allergic reactions to metamizole. PMID:27030298

  2. Anaphylaxis to protamine masquerading as an insulin allergy.

    PubMed

    Kim, R

    1993-01-01

    This is the case of a 62-year-old man referred for the evaluation of insulin allergy. This patient had reacted to the subcutaneous injection of Novolin 70/30 (Squibb, Princeton, N.J.) and Humulin NPH (Eli Lilly, Indianapolis, Ind.). These reactions were characterized by the immediate onset of diffuse pruritic urticaria and angioedema with progression to hypotension as well as a local reaction. Past history also included anaphylactic shock after intravenous administration of protamine sulfate used for heparin reversal during arterial bypass surgery. Immediate hypersensitivty skin testing to protamine containing (NPH) insulin and protamine sulfate USP were strongly positive, while Lente insulin (Eli Lilly, Indianapolis, Ind.) and controls were negative. RAST tests revealed the titers > 24 ng/ml of protamine specific IgE with 98 percent inhibition and 1163 ng/ml of protamine specific IgG with 29 percent inhibition, while levels of insulin specific antibodies were negligible. Subsequently, the patient was treated with non-protamine containing insulin preparation, Lente insulin, without further incident. This study confirms the diagnosis of Type I hypersensitivity to protamine sulfate masquerading as insulin allergy. PMID:8454092

  3. The severe adverse reaction to vitamin k1 injection is anaphylactoid reaction but not anaphylaxis.

    PubMed

    Mi, Yan-Ni; Ping, Na-Na; Xiao, Xue; Zhu, Yan-Bing; Liu, Jing; Cao, Yong-Xiao

    2014-01-01

    The severe adverse reaction to vitamin K1 injection is always remarkable and is thought to result from anaphylaxis. Paradoxically, however, some patients administered vitamin K1 injection for the first time have adverse reactions. Using beagle dogs, the present study tested the hypothesis that the response to vitamin K1 is an anaphylactoid reaction. The results showed that serious anaphylaxis-like symptoms appeared in beagle dogs after the administration of vitamin K1 injection for the first time. The plasma histamine concentration increased, and blood pressure decreased sharply. After sensitization, dogs were challenged with vitamin K1 injection and displayed the same degree of symptoms as prior to sensitization. However, when the vitamin K1 injection-sensitized dogs were challenged with a vitamin K1-fat emulsion without solubilizers such asTween-80, the abnormal reactions did not occur. Furthermore, there was no significant change in the plasma immunoglobulin E concentration after vitamin K1 challenge. Following treatment with vitamin K1 injection, the release of histamine and β-hexosaminidase by rat basophilic leukemia-2H3 cells as well as the rate of apoptosis increased. The Tween-80 group displayed results similar to those observed following vitamin K1 injection in vivo. However, the dogs in the vitamin K1-fat emulsion group did not display any abnormal behavior or significant change in plasma histamine. Additionally, degranulation and apoptosis did not occur in rat basophilic leukemia-2H3 cells. Our results indicate that the adverse reaction induced by vitamin K1 injection is an anaphylactoid reaction, not anaphylaxis. Vitamin K1 injection induces the release of inflammatory factors via a non-IgE-mediated immune pathway, for which the trigger may be the solubilizer. PMID:24594861

  4. The Severe Adverse Reaction to Vitamin K1 Injection Is Anaphylactoid Reaction but Not Anaphylaxis

    PubMed Central

    Mi, Yan-Ni; Ping, Na-Na; Xiao, Xue; Zhu, Yan-Bing; Liu, Jing; Cao, Yong-Xiao

    2014-01-01

    The severe adverse reaction to vitamin K1 injection is always remarkable and is thought to result from anaphylaxis. Paradoxically, however, some patients administered vitamin K1 injection for the first time have adverse reactions. Using beagle dogs, the present study tested the hypothesis that the response to vitamin K1 is an anaphylactoid reaction. The results showed that serious anaphylaxis-like symptoms appeared in beagle dogs after the administration of vitamin K1 injection for the first time. The plasma histamine concentration increased, and blood pressure decreased sharply. After sensitization, dogs were challenged with vitamin K1 injection and displayed the same degree of symptoms as prior to sensitization. However, when the vitamin K1 injection-sensitized dogs were challenged with a vitamin K1-fat emulsion without solubilizers such asTween-80, the abnormal reactions did not occur. Furthermore, there was no significant change in the plasma immunoglobulin E concentration after vitamin K1 challenge. Following treatment with vitamin K1 injection, the release of histamine and β-hexosaminidase by rat basophilic leukemia-2H3 cells as well as the rate of apoptosis increased. The Tween-80 group displayed results similar to those observed following vitamin K1 injection in vivo. However, the dogs in the vitamin K1-fat emulsion group did not display any abnormal behavior or significant change in plasma histamine. Additionally, degranulation and apoptosis did not occur in rat basophilic leukemia-2H3 cells. Our results indicate that the adverse reaction induced by vitamin K1 injection is an anaphylactoid reaction, not anaphylaxis. Vitamin K1 injection induces the release of inflammatory factors via a non-IgE-mediated immune pathway, for which the trigger may be the solubilizer. PMID:24594861

  5. Signs and Symptoms of Food Allergy and Food-Induced Anaphylaxis.

    PubMed

    Sharma, Hemant P; Bansil, Shweta; Uygungil, Burcin

    2015-12-01

    Food allergies are increasing in prevalence. In order for pediatric clinicians to appropriately diagnose and manage food allergies, the characteristic signs and symptoms of these potentially severe reactions must be recognized. Unlike nonimmunologic adverse food reactions (such as lactose intolerance and food poisoning), food allergies by definition are immune-mediated responses that occur reproducibly on food ingestion. The varying clinical presentations of food allergy include IgE-mediated disorders, mixed IgE- and cell-mediated disorders, and cell-mediated food allergies. This review describes the clinical manifestations of each of these categories of food allergy, with special emphasis on recognition of food-induced anaphylaxis. PMID:26456438

  6. Anaphylaxis Triggered by Benzyl Benzoate in a Preparation of Depot Testosterone Undecanoate

    PubMed Central

    Ong, Gregory S. Y.; Somerville, Colin P.; Jones, Timothy W.; Walsh, John P.

    2012-01-01

    We report the first case of an anaphylactic reaction to Reandron 1000 (depot testosterone undecanoate with a castor oil and benzyl benzoate vehicle). While considered to have a favourable safety profile, serious complications such as oil embolism and anaphylaxis can occur. In our patient, skin testing identified benzyl benzoate to be the trigger, with no reaction to castor oil or testosterone undecanoate components. As benzyl benzoate exists in multiple pharmaceuticals, foods, and cosmetics, individual components of pharmaceuticals should be tested when investigating drug allergies. Doctors should be alert to the potential for serious reactions to any of the components of Reandron 1000. PMID:22272209

  7. Patient activation and advocacy: which literacy skills matter most?

    PubMed

    Martin, Laurie T; Schonlau, Matthias; Haas, Ann; Derose, Kathryn Pitkin; Rosenfeld, Lindsay; Buka, Stephen L; Rudd, Rima

    2011-01-01

    Attention to the effect of a patient's literacy skills on health care interactions is relatively new. So, too, are studies of either structural or personal factors that inhibit or support a patient's ability to navigate health services and systems and to advocate for their own needs within a service delivery system. Contributions of the structural environment, of interpersonal dynamics, and of a variety of psychological and sociological factors in the relationship between patients and providers have long been under study. Less frequently examined is the advocacy role expected of patients. However, the complex nature of health care in the United States increasingly requires a proactive stance. This study examined whether four literacy skills (reading, numeracy, speaking, and listening) were associated with patient self-advocacy--a component of health literacy itself--when faced with a hypothetical barrier to scheduling a medical appointment. Although all literacy skills were significantly associated with advocacy when examined in isolation, greater speaking and listening skills remained significantly associated with better patient advocacy when all four skills were examined simultaneously. These findings suggest that speaking and listening skills and support for such skills may be important factors to consider when developing patient activation and advocacy skills. PMID:21951251

  8. Patient advocacy from the clinical nurses' viewpoint: a qualitative study

    PubMed Central

    Davoodvand, Shirmohammad; Abbaszadeh, Abbas; Ahmadi, Fazlollah

    2016-01-01

    One of the advanced nursing care procedures emphasized by nursing organizations around the world is patient or nursing advocacy. In addition to illustrating the professional power of nursing, it helps to provide effective nursing care. The aim of the present study was to explain the concept of patient advocacy from the perspective of Iranian clinical nurses. This was a qualitative study that examined the viewpoint and experiences of 15 clinical nurses regarding patient advocacy in nursing. The nurses worked in intensive care units (ICUs), coronary care units (CCUs), and emergency units. The study participants were selected via purposeful sampling. The data was collected through semi-structured interviews and analyzed using content analysis. Data analysis showed that patient advocacy consisted of the two themes of empathy with the patient (including understanding, being sympathetic with, and feeling close to the patient) and protecting the patients (including patient care, prioritization of patients’ health, commitment to the completion of the care process, and protection of patients' rights). The results of this study suggest that nurses must be empathetic toward and protective of their patients. The results of the present study can be used in health care delivery, nursing education, and nursing management and planning systems to help nurses accomplish their important role as patient advocates. It is necessary to further study the connections between patient advocacy and empathy. PMID:27471588

  9. 77 FR 55526 - Open Meeting of the Taxpayer Advocacy Panel Refund Processing Communications Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-10

    ...An open meeting of the Taxpayer Advocacy Panel Refund Processing Communications Project Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comments, ideas, and suggestions on improving customer service at the Internal Revenue...

  10. 77 FR 2611 - Open Meeting of the Taxpayer Advocacy Panel Return Processing Delays Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-18

    ...An open meeting of the Taxpayer Advocacy Panel Return Processing Delays Project Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comments, ideas, and suggestions on improving customer service at the Internal Revenue...

  11. 77 FR 55525 - Open Meeting of the Taxpayer Advocacy Panel Return Processing Delays Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-10

    ...An open meeting of the Taxpayer Advocacy Panel Return Processing Delays Project Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comments, ideas, and suggestions on improving customer service at the Internal Revenue...

  12. 77 FR 2610 - Open Meeting of the Taxpayer Advocacy Panel Refund Processing Communications Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-18

    ...An open meeting of the Taxpayer Advocacy Panel Refund Processing Communications Project Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comments, ideas, and suggestions on improving customer service at the Internal Revenue...

  13. 77 FR 47165 - Open Meeting of the Taxpayer Advocacy Panel Refund Processing Communications Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-07

    ...An open meeting of the Taxpayer Advocacy Panel Refund Processing Communications Project Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comments, ideas, and suggestions on improving customer service at the Internal Revenue...

  14. 77 FR 37103 - Open Meeting of the Taxpayer Advocacy Panel Return Processing Delays Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-20

    ...An open meeting of the Taxpayer Advocacy Panel Return Processing Delays Project Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comments, ideas, and suggestions on improving customer service at the Internal Revenue...

  15. 77 FR 47705 - Open Meeting of the Taxpayer Advocacy Panel Return Processing Delays Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-09

    ...An open meeting of the Taxpayer Advocacy Panel Return Processing Delays Project Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comments, ideas, and suggestions on improving customer service at the Internal Revenue...

  16. 77 FR 37101 - Open Meeting of the Taxpayer Advocacy Panel Refund Processing Communications Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-20

    ...An open meeting of the Taxpayer Advocacy Panel Refund Processing Communications Project Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comments, ideas, and suggestions on improving customer service at the Internal Revenue...

  17. 75 FR 7540 - Open Meeting of the Taxpayer Advocacy Panel Volunteer Income Tax Assistance Issue Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-19

    ...An open meeting of the Taxpayer Advocacy Panel Volunteer Income Tax Issue Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comment, ideas, and suggestions on improving customer service at the Internal Revenue...

  18. 75 FR 10864 - Open Meeting of the Taxpayer Advocacy Panel Volunteer Income Tax Assistance Issue Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-09

    ...An open meeting of the Taxpayer Advocacy Panel Volunteer Income Tax Issue Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comment, ideas, and suggestions on improving customer service at the Internal Revenue...

  19. 77 FR 37101 - Open Meeting of the Taxpayer Advocacy Panel Bankruptcy Compliance Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-20

    ...An open meeting of the Taxpayer Advocacy Panel Bankruptcy Compliance Project Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comments, ideas, and suggestions on improving customer service at the Internal Revenue...

  20. 77 FR 30590 - Open meeting of the Taxpayer Advocacy Panel Toll-Free Project Committee.

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-23

    ...An open meeting of the Taxpayer Advocacy Panel Toll-Free Project Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comments, ideas and suggestions on improving customer service at the Internal Revenue...

  1. 77 FR 30592 - Open Meeting of the Taxpayer Advocacy Panel Bankruptcy Compliance Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-23

    ...An open meeting of the Taxpayer Advocacy Panel Bankruptcy Compliance Project Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comments, ideas, and suggestions on improving customer service at the Internal Revenue...

  2. 77 FR 30590 - Open meeting of Taxpayer Advocacy Panel Taxpayer Burden Reduction Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-23

    ...An open meeting of the Taxpayer Advocacy Panel Taxpayer Burden Reduction Project Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comments, ideas and suggestions on improving customer service at the Internal Revenue...

  3. 77 FR 47165 - Open Meeting of the Taxpayer Advocacy Panel Toll-Free Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-07

    ...An open meeting of the Taxpayer Advocacy Panel Toll-Free Project Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comments, ideas, and suggestions on improving customer service at the Internal Revenue...

  4. 77 FR 37102 - Open Meeting of Taxpayer Advocacy Panel Taxpayer Burden Reduction Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-20

    ...An open meeting of the Taxpayer Advocacy Panel Taxpayer Burden Reduction Project Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comments, ideas and suggestions on improving customer service at the Internal Revenue...

  5. 78 FR 78516 - Open Meeting of the Taxpayer Advocacy Panel Notices and Correspondence Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-26

    ...An open meeting of the Taxpayer Advocacy Panel Notices and Correspondence Project Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comments, ideas, and suggestions on improving customer service at the Internal Revenue...

  6. 77 FR 37102 - Open Meeting of the Taxpayer Advocacy Panel Toll-Free Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-20

    ...An open meeting of the Taxpayer Advocacy Panel Toll-Free Project Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comments, ideas and suggestions on improving customer service at the Internal Revenue...

  7. 77 FR 47165 - Open Meeting of the Taxpayer Advocacy Panel Bankruptcy Compliance Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-07

    ...An open meeting of the Taxpayer Advocacy Panel Bankruptcy Compliance Project Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comments, ideas, and suggestions on improving customer service at the Internal Revenue...

  8. 78 FR 22948 - Open Meeting of the Taxpayer Advocacy Panel Notices and Correspondence Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-17

    ...An open meeting of the Taxpayer Advocacy Panel Notices and Correspondence Project Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comments, ideas, and suggestions on improving customer service at the Internal Revenue...

  9. 78 FR 41194 - Open Meeting of the Taxpayer Advocacy Panel Notices and Correspondence Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-09

    ...An open meeting of the Taxpayer Advocacy Panel Notices and Correspondence Project Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comments, ideas, and suggestions on improving customer service at the Internal Revenue...

  10. 76 FR 2194 - Open Meeting of Taxpayer Advocacy Panel Notice Improvement Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-12

    ...An open meeting of the Taxpayer Advocacy Panel Notice Improvement Project Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comments, ideas and suggestions on improving customer service at the Internal Revenue...

  11. 77 FR 47167 - Open Meeting of Taxpayer Advocacy Panel Taxpayer Burden Reduction Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-07

    ...An open meeting of the Taxpayer Advocacy Panel Taxpayer Burden Reduction Project Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comments, ideas and suggestions on improving customer service at the Internal Revenue...

  12. The challenge of evaluating complex interventions: a framework for evaluating media advocacy.

    PubMed

    Stead, Martine; Hastings, Gerard; Eadie, Douglas

    2002-06-01

    New health promotion and public health approaches such as media advocacy pose particular evaluation challenges. Evaluation is important to provide feedback to media advocacy practitioners on how to enhance their efforts, and to funders and researchers seeking to assess media advocacy's effectiveness as a health promotion strategy. The media advocacy evaluation literature contains some examples of promising evaluation approaches but is still evolving. A comprehensive framework for the evaluation of media advocacy is presented. Building on existing approaches to evaluation in media advocacy and on current thinking regarding evaluation in health promotion, it proposes a series of indicators and research methods for evaluating media advocacy at the levels of formative, process and outcome evaluation. The framework can be used to encourage strategic reflection on the media advocacy process, to guide evaluation of specific interventions, and to demonstrate to funders the importance and complexity of evaluation in this promising field. PMID:12120850

  13. Engaging health professionals in advocacy against gun violence.

    PubMed

    Pinto, Andrew D

    2008-01-01

    Health professionals have long been involved with advocacy around the social determinants of health, including protesting against war and mitigating the production, trade and use of specific weapon systems. Small arms and light weapons are a key area on which to focus, as they are responsible for the majority of injuries and deaths in war and their availability is related to increased levels of crime and suicide. Challenges for health professionals hoping to engage in such advocacy include a lack of adequate data, the need to confront political questions and the gun-lobby, and difficulty in measuring the effectiveness of campaigns. This article discusses some examples of successful advocacy and suggests future directions for health professionals in this area. PMID:19065869

  14. Evaluating Human Rights Advocacy on Criminal Justice and Sex Work.

    PubMed

    Amon, Joseph; Wurth, Margaret; McLemore, Megan

    2015-01-01

    Between October 2011 and September 2013, we conducted research on the use, by police and/or prosecutors, of condom possession as evidence of intent to engage in prostitution-related offenses. We studied the practice in five large, geographically diverse cities in the U.S. To facilitate our advocacy on this issue, conducted concurrent to and following our research, we developed an advocacy framework consisting of six dimensions: (1) raising awareness, (2) building and engaging coalitions, (3) framing debate, (4) securing rhetorical commitments, (5) reforming law and policy, and (6) changing practice. Using a case study approach, we describe how this framework also provided a basis for the evaluation of our work, and discuss additional considerations and values related to the measurement and evaluation of human rights advocacy. PMID:26204588

  15. Science Education & Advocacy: Tools to Support Better Education Policies

    NASA Astrophysics Data System (ADS)

    O'Donnell, Christine; Cunningham, B.; Hehn, J. G.

    2014-01-01

    Education is strongly affected by federal and local policies, such as testing requirements and program funding, and many scientists and science teachers are increasingly interested in becoming more engaged with the policy process. To address this need, I worked with the American Association of Physics Teachers (AAPT) --- a professional membership society of scientists and science teachers that is dedicated to enhancing the understanding and appreciation of physics through teaching --- to create advocacy tools for its members to use, including one-page leave-behinds, guides for meeting with policymakers, and strategies for framing issues. In addition, I developed a general tutorial to aid AAPT members in developing effective advocacy strategies to support better education policies. This work was done through the Society for Physics Students (SPS) Internship program, which provides a range of opportunities for undergraduates, including research, education and public outreach, and public policy. In this presentation, I summarize these new advocacy tools and their application to astronomy education issues.

  16. International Dengue Vaccine Communication and Advocacy: Challenges and Way Forward.

    PubMed

    Carvalho, Ana; Van Roy, Rebecca; Andrus, Jon

    2016-01-01

    Dengue vaccine introduction will likely occur soon. However, little has been published on international dengue vaccine communication and advocacy. More effort at the international level is required to review, unify and strategically disseminate dengue vaccine knowledge to endemic countries' decision makers and potential donors. Waiting to plan for the introduction of new vaccines until licensure may delay access in developing countries. Concerted efforts to communicate and advocate for vaccines prior to licensure are likely challenged by unknowns of the use of dengue vaccines and the disease, including uncertainties of vaccine impact, vaccine access and dengue's complex pathogenesis and epidemiology. Nevertheless, the international community has the opportunity to apply previous best practices for vaccine communication and advocacy. The following key strategies will strengthen international dengue vaccine communication and advocacy: consolidating existing coalitions under one strategic umbrella, urgently convening stakeholders to formulate the roadmap for integrated dengue prevention and control, and improving the dissemination of dengue scientific knowledge. PMID:26855170

  17. A Novel Education and Training Program to Enhance Student Advocacy

    PubMed Central

    Matzke, Gary R.; McCall, Kenneth L.

    2015-01-01

    Objective. To develop and implement a unique student advocacy program to train student pharmacists to be effective advocates for the profession of pharmacy and the patients it serves. Design. The Academy is a 2-day program hosted annually in Washington, DC, that combines didactic presentations on the legislative process, communication with policymakers, current legislation, and active-learning exercises such as mock congressional visits. The Academy culminates with visits to Capitol Hill where students meet with legislators and their staff to discuss pending legislation. Assessment. Nearly 350 students from 43 schools and colleges of pharmacy completed the program in its 4 years. Students are assessed following the active-learning exercises and meetings with legislators. Conclusion. Advocacy has been listed as a competency that requires more attention in pharmacy education. The Academy provides a model that schools may replicate to enhance their advocacy offerings. PMID:27168608

  18. Educating for advocacy: recommendations for professional preparation and development based on a needs and capacity assessment of health education faculty.

    PubMed

    Radius, Susan M; Galer-Unti, Regina A; Tappe, Marlene K

    2009-01-01

    An electronic survey was used to conduct a needs and capacity assessment of health education faculty to determine the extent to which advocacy instruction is present in undergraduate and graduate curricula in health education and to identify faculty members' needs and capacity to provide professional preparation and development experiences related to advocacy. An analysis of the results reveals that most undergraduate and graduate health education programs include advocacy instruction. Although faculty believe advocacy and instruction related to advocacy are important, many lack advocacy-related professional preparation and development experiences and do not participate in advocacy-related training initiatives and advocacy activities. There is wide variability in faculty confidence in their competence to provide advocacy instruction. Partnerships among professional organizations, health education practitioners, university faculty, individuals engaged in policy advocacy initiatives, and policy makers are needed to enhance the capacity of university faculty to provide professional preparation and development experiences related to advocacy. PMID:18381970

  19. In delicate balance: stem cells and spinal cord injury advocacy.

    PubMed

    Parke, Sara; Illes, Judy

    2011-09-01

    Spinal cord injury (SCI) is a major focus for stem cell therapy (SCT). However, the science of SCT has not been well matched with an understanding of perspectives of persons with SCI. The online advocacy community is a key source of health information for primary stakeholders and their caregivers. In this study, we sought to characterize the content of SCI advocacy websites with respect to their discussion of SCT and stem cell tourism. We performed a comprehensive analysis of SCI advocacy websites identified through a web search and verified by expert opinion. Two independent researchers coded the information for major themes (e.g., scientific & clinical facts, research & funding, policy, ethics) and valence (positive, negative, balanced, neutral). Of the 40 SCI advocacy websites that met inclusion criteria, 50% (N=20) contained information about SCT. Less than 18% (N=7) contained information on stem cell tourism. There were more than ten times as many statements about SCT with a positive valence (N=67) as with a negative valence (N=6). Ethics-related SCT information comprised 20% (N=37) of the total content; the largest proportion of ethics-related content was devoted to stem cell tourism (80%, N=30 statements). Of those, the majority focused on the risks of stem cell tourism (N=16). Given the still-developing science behind SCT, the presence of cautionary information about stem cell tourism at advocacy sites is ethically appropriate. The absence of stem cell tourism information at the majority of advocacy sites represents a lost educational opportunity. PMID:21161442

  20. Wrightslaw: From Emotions to Advocacy--The Special Education Survival Guide.

    ERIC Educational Resources Information Center

    Wright, Peter W. D.; Wright, Pamela Darr

    This book for parents of children with disabilities is a guide to parent advocacy and the special education system. The five sections focus on: (1) getting started in advocacy; (2) "Advocacy 101"; (3) the parent as expert; (4) special education law; and (5) tactics and strategies. Individual chapters address the following topics: learning about…

  1. 77 FR 61053 - Open Meeting of the Taxpayer Advocacy Panel Return Processing Delays Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-05

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Return Processing Delays Project... meeting of the Taxpayer Advocacy Panel Return Processing Delays Project Committee will be conducted. The.... (1988) that an open meeting of the Taxpayer Advocacy Panel Return Processing Delays Project...

  2. 77 FR 21155 - Open Meeting of the Taxpayer Advocacy Panel Return Processing Delays Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-09

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Return Processing Delays Project... meeting of the Taxpayer Advocacy Panel Return Processing Delays Project Committee will be conducted. The... Act, 5 U.S.C. App. (1988) that an open meeting of the Taxpayer Advocacy Panel Return Processing...

  3. 77 FR 8328 - Open Meeting of the Taxpayer Advocacy Panel Return Processing Delays Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-14

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Return Processing Delays Project... meeting of the Taxpayer Advocacy Panel Return Processing Delays Project Committee will be conducted. The...) that an open meeting of the Taxpayer Advocacy Panel Return Processing Delays Project Committee will...

  4. 77 FR 21156 - Open Meeting of the Taxpayer Advocacy Panel Return Processing Delays Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-09

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Return Processing Delays Project... meeting of the Taxpayer Advocacy Panel Return Processing Delays Project Committee will be conducted. The...) that an open meeting of the Taxpayer Advocacy Panel Return Processing Delays Project Committee will...

  5. 42 CFR 51.7 - Eligibility for protection and advocacy services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Eligibility for protection and advocacy services... REQUIREMENTS APPLICABLE TO THE PROTECTION AND ADVOCACY FOR INDIVIDUALS WITH MENTAL ILLNESS PROGRAM Basic Requirements § 51.7 Eligibility for protection and advocacy services. In accordance with section...

  6. 42 CFR 51.7 - Eligibility for protection and advocacy services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Eligibility for protection and advocacy services... REQUIREMENTS APPLICABLE TO THE PROTECTION AND ADVOCACY FOR INDIVIDUALS WITH MENTAL ILLNESS PROGRAM Basic Requirements § 51.7 Eligibility for protection and advocacy services. In accordance with section...

  7. 45 CFR 1386.24 - Non-allowable costs for the Protection and Advocacy System.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Advocacy System. 1386.24 Section 1386.24 Public Welfare Regulations Relating to Public Welfare (Continued... Protection and Advocacy of the Rights of Individuals with Developmental Disabilities § 1386.24 Non-allowable costs for the Protection and Advocacy System. (a) Federal financial participation is not allowable...

  8. 45 CFR 1386.24 - Non-allowable costs for the Protection and Advocacy System.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Advocacy System. 1386.24 Section 1386.24 Public Welfare Regulations Relating to Public Welfare (Continued... Protection and Advocacy of the Rights of Individuals with Developmental Disabilities § 1386.24 Non-allowable costs for the Protection and Advocacy System. (a) Federal financial participation is not allowable...

  9. Anatomy of Advocacy: A Case Study of the White House Petition

    ERIC Educational Resources Information Center

    Burns, Elizabeth; Kimmel, Sue; Dickinson, Gail

    2016-01-01

    Little research has been conducted examining advocacy efforts in the school library field despite the fact that program advocate is a prominent role for school librarians. One element of advocacy is the engagement in political initiatives that may affect school library programs. This case study investigates the effectiveness of one advocacy effort…

  10. Building Strategic Business and Industry Training Partnerships that Lead to Legislative Advocacy

    ERIC Educational Resources Information Center

    Holle, Teri L.

    2012-01-01

    Organization is essential to just about every sort of operation, but it is especially important in advocacy work. Without organization, an advocacy group may be nothing more than several individuals who agree on some large issue and try to react to threats to what they believe in. A well-functioning advocacy group has to have common goals and a…

  11. 75 FR 7542 - Open Meeting of the Taxpayer Advocacy Panel Joint Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-19

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Joint Committee AGENCY: Internal... Advocacy Panel Joint Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comment... Panel Joint Committee will be held Tuesday, March 23, 2010, at 3 p.m. Eastern Time via...

  12. 78 FR 28945 - Open Meeting of the Taxpayer Advocacy Panel Joint Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-16

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Joint Committee AGENCY: Internal... Advocacy Panel Joint Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comments... Panel Joint Committee will be held Wednesday, June 26, 2013 at 2:00 p.m. Eastern Time via...

  13. 76 FR 6190 - Open Meeting of the Taxpayer Advocacy Panel Joint Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-03

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Joint Committee AGENCY: Internal... Advocacy Panel Joint Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comments... Panel Joint Committee will be held Thursday, March 24, 2011, at 2 p.m., Eastern Time via...

  14. 77 FR 21156 - Open Meeting of the Taxpayer Advocacy Panel Joint Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-09

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Joint Committee AGENCY: Internal... Advocacy Panel Joint Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comments... Panel Joint Committee will be held Wednesday, May 23, 2012, 2 p.m. Eastern Time via teleconference....

  15. 76 FR 17996 - Open Meeting of the Taxpayer Advocacy Panel Joint Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-31

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Joint Committee AGENCY: Internal... Advocacy Panel Joint Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comments... Panel Joint Committee will be held Thursday, May 26, 2011, at 2 p.m., Eastern Time via...

  16. 78 FR 36303 - Open Meeting of the Taxpayer Advocacy Panel Joint Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-17

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Joint Committee AGENCY: Internal... Advocacy Panel Joint Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comments... Panel Joint Committee will be held Wednesday, July 24, 2013 at 2:00 p.m. Eastern Time via...

  17. 76 FR 22168 - Open Meeting of the Taxpayer Advocacy Panel Joint Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-20

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Joint Committee AGENCY: Internal... Advocacy Panel Joint Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comments... Panel Joint Committee will be held Thursday, June 23, 2011, at 2 p.m. Eastern Time via...

  18. 75 FR 25316 - Open Meeting of the Taxpayer Advocacy Panel Joint Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-07

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Joint Committee AGENCY: Internal... Advocacy Panel Joint Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comment... Panel Joint Committee will be held Tuesday, June 22, 2010, at 3 p.m. Eastern Time via...

  19. 75 FR 11999 - Open Meeting of the Taxpayer Advocacy Panel Joint Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-12

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Joint Committee AGENCY: Internal... Advocacy Panel Joint Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comment... Panel Joint Committee will be held Tuesday, April 27, 2010, at 3:00 p.m. Eastern Time via...

  20. 77 FR 30591 - Open Meeting of the Taxpayer Advocacy Panel Joint Committee.

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-23

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Joint Committee. AGENCY: Internal... Advocacy Panel Joint Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comments... Panel Joint Committee will be held Wednesday, June 27, 2012, 2:00 p.m. Eastern Time via...

  1. 76 FR 10945 - Open Meeting of the Taxpayer Advocacy Panel Joint Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-28

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Joint Committee AGENCY: Internal... Advocacy Panel Joint Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comments... Panel Joint Committee will be held Thursday, April 28, 2011, at 2 p.m., Eastern Time via...

  2. 75 FR 39332 - Open Meeting of the Taxpayer Advocacy Panel Joint Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-08

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Joint Committee AGENCY: Internal... Advocacy Panel Joint Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comment... Panel Joint Committee will be held Tuesday, August 24, 2010, at 3 p.m. Eastern Time via...

  3. 78 FR 22947 - Open Meeting of the Taxpayer Advocacy Panel Joint Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-17

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Joint Committee AGENCY: Internal... Advocacy Panel Joint Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comments... Panel Joint Committee will be held Wednesday, May 22, 2013 at 2:00 p.m. Eastern Time via...

  4. 76 FR 32020 - Open Meeting of the Taxpayer Advocacy Panel Tax Forms and Publications Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-02

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Tax Forms and Publications Project... meeting of the Taxpayer Advocacy Panel Tax Forms and Publications Project Committee will be conducted. The...) that an open meeting of the Taxpayer Advocacy Panel Tax Forms and Publications Project Committee...

  5. 75 FR 4139 - Open Meeting of the Taxpayer Advocacy Panel Volunteer Income Tax Assistance Issue Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-26

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Volunteer Income Tax Assistance Issue... meeting of the Taxpayer Advocacy Panel Volunteer Income Tax Issue Committee will be conducted. The.... (1988) that a meeting of the Taxpayer Advocacy Panel Volunteer Income Tax Issue Committee will be...

  6. 78 FR 36303 - Open Meeting of the Taxpayer Advocacy Panel Notices and Correspondence Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-17

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Notices and Correspondence Project... meeting of the Taxpayer Advocacy Panel Notices and Correspondence Project Committee will be conducted. The.... (1988) that a meeting of the Taxpayer Advocacy Panel Notices and Correspondence Project Committee...

  7. 77 FR 55525 - Open Meeting of Taxpayer Advocacy Panel Taxpayer Burden Reduction Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-10

    ... Internal Revenue Service Open Meeting of Taxpayer Advocacy Panel Taxpayer Burden Reduction Project... meeting of the Taxpayer Advocacy Panel Taxpayer Burden Reduction Project Committee will be conducted. The....C. App. (1988) that an open meeting of the Taxpayer Advocacy Panel Taxpayer Burden Reduction...

  8. 77 FR 2611 - Open Meeting of the Taxpayer Advocacy Panel Bankruptcy Compliance Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-18

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Bankruptcy Compliance Project... meeting of the Taxpayer Advocacy Panel Bankruptcy Compliance Project Committee will be conducted. The....S.C. App. (1988) that a meeting of the Taxpayer Advocacy Panel Bankruptcy Compliance...

  9. 76 FR 17993 - Open Meeting of Taxpayer Advocacy Panel Notice Improvement Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-31

    ... Internal Revenue Service Open Meeting of Taxpayer Advocacy Panel Notice Improvement Project Committee... the Taxpayer Advocacy Panel Notice Improvement Project Committee will be conducted. The Taxpayer....C. App. (1988) that an open meeting of the Taxpayer Advocacy Panel Notice Improvement...

  10. 77 FR 40410 - Open Meeting of Taxpayer Advocacy Panel Taxpayer Burden Reduction Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-09

    ... Internal Revenue Service Open Meeting of Taxpayer Advocacy Panel Taxpayer Burden Reduction Project... meeting of the Taxpayer Advocacy Panel Taxpayer Burden Reduction Project Committee will be conducted. The.... (1988) that an open meeting of the Taxpayer Advocacy Panel Taxpayer Burden Reduction Project...

  11. 75 FR 55404 - Open Meeting of Taxpayer Advocacy Panel Notice Improvement Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-10

    ... Internal Revenue Service Open Meeting of Taxpayer Advocacy Panel Notice Improvement Project Committee... the Taxpayer Advocacy Panel Notice Improvement Project Committee will be conducted. The Taxpayer...) that an open meeting of the Taxpayer Advocacy Panel Notice Improvement Project Committee will be...

  12. 75 FR 39333 - Open Meeting of Taxpayer Advocacy Panel Notice Improvement Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-08

    ... Internal Revenue Service Open Meeting of Taxpayer Advocacy Panel Notice Improvement Project Committee... the Taxpayer Advocacy Panel Notice Improvement Project Committee will be conducted. The Taxpayer...) that an open meeting of the Taxpayer Advocacy Panel Notice Improvement Project Committee will be...

  13. 75 FR 7540 - Open Meeting of Taxpayer Advocacy Panel Notice Improvement Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-19

    ... Internal Revenue Service Open Meeting of Taxpayer Advocacy Panel Notice Improvement Project Committee... the Taxpayer Advocacy Panel Notice Improvement Project Committee will be conducted. The Taxpayer...) that an open meeting of the Taxpayer Advocacy Panel Notice Improvement Project Committee will be...

  14. 78 FR 3500 - Open Meeting of the Taxpayer Advocacy Panel Notices and Correspondence Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-16

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Notices and Correspondence Project... meeting of the Taxpayer Advocacy Panel Notices and Correspondence Project Committee will be conducted. The.... (1988) that a meeting of the Taxpayer Advocacy Panel Notices and Correspondence Project Committee...

  15. 76 FR 45005 - Open Meeting of Taxpayer Advocacy Panel Notice Improvement Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-27

    ... Internal Revenue Service Open Meeting of Taxpayer Advocacy Panel Notice Improvement Project Committee... the Taxpayer Advocacy Panel Notice Improvement Project Committee will be conducted. The Taxpayer...) that an open meeting of the Taxpayer Advocacy Panel Notice Improvement Project Committee will be...

  16. 75 FR 25316 - Open Meeting of Taxpayer Advocacy Panel Notice Improvement Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-07

    ... Internal Revenue Service Open Meeting of Taxpayer Advocacy Panel Notice Improvement Project Committee... of the Taxpayer Advocacy Panel Notice Improvement Project Committee will be conducted. The Taxpayer... open meeting of the Taxpayer Advocacy Panel Notice Improvement Project Committee will be held...

  17. 78 FR 56270 - Open Meeting of the Taxpayer Advocacy Panel Notices and Correspondence Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-12

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Notices and Correspondence Project... meeting of the Taxpayer Advocacy Panel Notices and Correspondence Project Committee will be conducted. The.... (1988) that a meeting of the Taxpayer Advocacy Panel Notices and Correspondence Project Committee...

  18. 75 FR 4140 - Open Meeting of Taxpayer Advocacy Panel Notice Improvement Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-26

    ... Internal Revenue Service Open Meeting of Taxpayer Advocacy Panel Notice Improvement Project Committee... the Taxpayer Advocacy Panel Notice Improvement Project Committee will be conducted. The Taxpayer...) that an open meeting of the Taxpayer Advocacy Panel Notice Improvement Project Committee will be...

  19. 76 FR 77891 - Open Meeting of the Taxpayer Advocacy Panel Return Processing Delays Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-14

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Return Processing Delays Project... meeting of the Taxpayer Advocacy Panel Return Processing Delays Project Committee will be conducted. The.... (1988) that an open meeting of the Taxpayer Advocacy Panel Return Processing Delays Project...

  20. 75 FR 62629 - Open Meeting of Taxpayer Advocacy Panel Notice Improvement Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-12

    ... Internal Revenue Service Open Meeting of Taxpayer Advocacy Panel Notice Improvement Project Committee... the Taxpayer Advocacy Panel Notice Improvement Project Committee will be conducted. The Taxpayer...) that an open meeting of the Taxpayer Advocacy Panel Notice Improvement Project Committee will be...

  1. 76 FR 56879 - Open Meeting of Taxpayer Advocacy Panel Notice Improvement Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-14

    ... Internal Revenue Service Open Meeting of Taxpayer Advocacy Panel Notice Improvement Project Committee... the Taxpayer Advocacy Panel Notice Improvement Project Committee will be conducted. The Taxpayer...) that an open meeting of the Taxpayer Advocacy Panel Notice Improvement Project Committee will be...

  2. 76 FR 22170 - Open Meeting of Taxpayer Advocacy Panel Notice Improvement Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-20

    ... Internal Revenue Service Open Meeting of Taxpayer Advocacy Panel Notice Improvement Project Committee... of the Taxpayer Advocacy Panel Notice Improvement Project Committee will be conducted. The Taxpayer... open meeting of the Taxpayer Advocacy Panel Notice Improvement Project Committee will be held...

  3. 76 FR 77891 - Open Meeting of the Taxpayer Advocacy Panel Bankruptcy Compliance Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-14

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Bankruptcy Compliance Project... meeting of the Taxpayer Advocacy Panel Bankruptcy Compliance Project Committee will be conducted. The....C. App. (1988) that a meeting of the Taxpayer Advocacy Panel Bankruptcy Compliance Project...

  4. 77 FR 40409 - Open Meeting of the Taxpayer Advocacy Panel Return Processing Delays Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-09

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Return Processing Delays Project... meeting of the Taxpayer Advocacy Panel Return Processing Delays Project Committee will be conducted. The...) that an open meeting of the Taxpayer Advocacy Panel Return Processing Delays Project Committee will...

  5. 78 FR 64294 - Open Meeting of the Taxpayer Advocacy Panel Notices and Correspondence Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-28

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Notices and Correspondence Project... meeting of the Taxpayer Advocacy Panel Notices and Correspondence Project Committee will be conducted. The.... (1988) that a meeting of the Taxpayer Advocacy Panel Notices and Correspondence Project Committee...

  6. 77 FR 40410 - Open Meeting of the Taxpayer Advocacy Panel Bankruptcy Compliance Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-09

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Bankruptcy Compliance Project... meeting of the Taxpayer Advocacy Panel Bankruptcy Compliance Project Committee will be conducted. The.... (1988) that a meeting of the Taxpayer Advocacy Panel Bankruptcy Compliance Project Committee will...

  7. 75 FR 10864 - Open meeting of Taxpayer Advocacy Panel Notice Improvement Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-09

    ... Internal Revenue Service Open meeting of Taxpayer Advocacy Panel Notice Improvement Project Committee... the Taxpayer Advocacy Panel Notice Improvement Project Committee will be conducted. The Taxpayer...) that an open meeting of the Taxpayer Advocacy Panel Notice Improvement Project Committee will be...

  8. 77 FR 55525 - Open Meeting of the Taxpayer Advocacy Panel Bankruptcy Compliance Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-10

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Bankruptcy Compliance Project... meeting of the Taxpayer Advocacy Panel Bankruptcy Compliance Project Committee will be conducted. The.... (1988) that a meeting of the Taxpayer Advocacy Panel Bankruptcy Compliance Project Committee will...

  9. 75 FR 47348 - Open Meeting of Taxpayer Advocacy Panel Notice Improvement Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-05

    ... Internal Revenue Service Open Meeting of Taxpayer Advocacy Panel Notice Improvement Project Committee... the Taxpayer Advocacy Panel Notice Improvement Project Committee will be conducted. The Taxpayer...) that an open meeting of the Taxpayer Advocacy Panel Notice Improvement Project Committee will be...

  10. 76 FR 63717 - Open Meeting of Taxpayer Advocacy Panel Notice Improvement Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-13

    ... Internal Revenue Service Open Meeting of Taxpayer Advocacy Panel Notice Improvement Project Committee... the Taxpayer Advocacy Panel Notice Improvement Project Committee will be conducted. The Taxpayer...) that an open meeting of the Taxpayer Advocacy Panel Notice Improvement Project Committee will be...

  11. 78 FR 48230 - Open Meeting of the Taxpayer Advocacy Panel Notices and Correspondence Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-07

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Notices and Correspondence Project... meeting of the Taxpayer Advocacy Panel Notices and Correspondence Project Committee will be conducted. The.... (1988) that a meeting of the Taxpayer Advocacy Panel Notices and Correspondence Project Committee...

  12. 75 FR 25317 - Open Meeting of the Taxpayer Advocacy Panel Volunteer Income Tax Assistance Issue Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-07

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Volunteer Income Tax Assistance Issue... meeting of the Taxpayer Advocacy Panel Volunteer Income Tax Issue Committee will be conducted. The...) that a meeting of the Taxpayer Advocacy Panel Volunteer Income Tax Issue Committee will be held...

  13. 76 FR 56878 - Open Meeting of the Taxpayer Advocacy Panel Volunteer Income Tax Assistance Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-14

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Volunteer Income Tax Assistance... open meeting of the Taxpayer Advocacy Panel Volunteer Income Tax Assistance Project Committee will be....C. App. (1988) that a meeting of the Taxpayer Advocacy Panel Volunteer Income Tax Assistance...

  14. 76 FR 63716 - Open Meeting of the Taxpayer Advocacy Panel Earned Income Tax Credit Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-13

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Earned Income Tax Credit Project... meeting of the Taxpayer Advocacy Panel Earned Income Tax Credit Project Committee will be conducted. The....C. App. (1988) that an open meeting of the Taxpayer Advocacy Panel Earned Income Tax Credit...

  15. 76 FR 63716 - Open Meeting of the Taxpayer Advocacy Panel Volunteer Income Tax Assistance Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-13

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Volunteer Income Tax Assistance... open meeting of the Taxpayer Advocacy Panel Volunteer Income Tax Assistance Project Committee will be....C. App. (1988) that a meeting of the Taxpayer Advocacy Panel Volunteer Income Tax Assistance...

  16. 75 FR 25316 - Open Meeting of the Taxpayer Advocacy Panel Earned Income Tax Credit Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-07

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Earned Income Tax Credit Project... meeting of the Taxpayer Advocacy Panel Earned Income Tax Credit Project Committee will be conducted. The...) that an open meeting of the Taxpayer Advocacy Panel Earned Income Tax Credit Project Committee will...

  17. 76 FR 56879 - Open Meeting of the Taxpayer Advocacy Panel Earned Income Tax Credit Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-14

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Earned Income Tax Credit Project... meeting of the Taxpayer Advocacy Panel Earned Income Tax Credit Project Committee will be conducted. The....C. App. (1988) that an open meeting of the Taxpayer Advocacy Panel Earned Income Tax Credit...

  18. 77 FR 21155 - Open Meeting of the Taxpayer Advocacy Panel Bankruptcy Compliance Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-09

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Bankruptcy Compliance Project... meeting of the Taxpayer Advocacy Panel Bankruptcy Compliance Project Committee will be conducted. The...) that a meeting of the Taxpayer Advocacy Panel Bankruptcy Compliance Project Committee will be...

  19. 77 FR 8328 - Open Meeting of the Taxpayer Advocacy Panel Bankruptcy Compliance Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-14

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Bankruptcy Compliance Project... meeting of the Taxpayer Advocacy Panel Bankruptcy Compliance Project Committee will be conducted. The...) that a meeting of the Taxpayer Advocacy Panel Bankruptcy Compliance Project Committee will be...

  20. 77 FR 61054 - Open Meeting of the Taxpayer Advocacy Panel Bankruptcy Compliance Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-05

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Bankruptcy Compliance Project... meeting of the Taxpayer Advocacy Panel Bankruptcy Compliance Project Committee will be conducted. The.... (1988) that a meeting of the Taxpayer Advocacy Panel Bankruptcy Compliance Project Committee will...

  1. The Nature, Correlates, and Conditions of Parental Advocacy in Special Education

    ERIC Educational Resources Information Center

    Burke, Meghan M.; Hodapp, Robert M.

    2016-01-01

    Although parents often advocate for the best educational services for their children with disabilities, few studies examine parents' advocacy activities; identify parent-school relationship, parent, and student correlates of advocacy; or describe the conditions of advocacy. Responding to a national, web-based survey, 1087 parents of students with…

  2. 77 FR 74920 - Open Meeting of the Taxpayer Advocacy Panel Tax Forms and Publications Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-18

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Tax Forms and Publications Project... meeting of the Taxpayer Advocacy Panel Tax Forms and Publications Project Committee will be conducted. The.... (1988) that an open meeting of the Taxpayer Advocacy Panel Tax Forms and Publications Project...

  3. 78 FR 41193 - Open Meeting of the Taxpayer Advocacy Panel Tax Forms and Publications Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-09

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Tax Forms and Publications Project... meeting of the Taxpayer Advocacy Panel Tax Forms and Publications Project Committee will be conducted. The.... (1988) that an open meeting of the Taxpayer Advocacy Panel Tax Forms and Publications Project...

  4. 76 FR 22171 - Open Meeting of the Taxpayer Advocacy Panel Tax Forms and Publications Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-20

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Tax Forms and Publications Project... meeting of the Taxpayer Advocacy Panel Tax Forms and Publications Project Committee will be conducted. The...) that an open meeting of the Taxpayer Advocacy Panel Tax Forms and Publications Project Committee...

  5. 78 FR 56270 - Open Meeting of the Taxpayer Advocacy Panel Tax Forms and Publications Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-12

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Tax Forms and Publications Project... meeting of the Taxpayer Advocacy Panel Tax Forms and Publications Project Committee will be conducted. The.... (1988) that an open meeting of the Taxpayer Advocacy Panel Tax Forms and Publications Project...

  6. 77 FR 2612 - Open Meeting of the Taxpayer Advocacy Panel Tax Forms and Publications Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-18

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Tax Forms and Publications Project... meeting of the Taxpayer Advocacy Panel Tax Forms and Publications Project Committee will be conducted. The....C. App. (1988) that an open meeting of the Taxpayer Advocacy Panel Tax Forms and...

  7. 77 FR 47166 - Open Meeting of the Taxpayer Advocacy Panel Tax Forms and Publications Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-07

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Tax Forms and Publications Project... meeting of the Taxpayer Advocacy Panel Tax Forms and Publications Project Committee will be conducted. The.... (1988) that an open meeting of the Taxpayer Advocacy Panel Tax Forms and Publications Project...

  8. 78 FR 3501 - Open Meeting of the Taxpayer Advocacy Panel Tax Forms and Publications Project Committee.

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-16

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Tax Forms and Publications Project... meeting of the Taxpayer Advocacy Panel Tax Forms and Publications Project Committee will be conducted. The.... (1988) that an open meeting of the Taxpayer Advocacy Panel Tax Forms and Publications Project...

  9. 78 FR 22948 - Open Meeting of the Taxpayer Advocacy Panel Tax Forms and Publications Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-17

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Tax Forms and Publications Project... meeting of the Taxpayer Advocacy Panel Tax Forms and Publications Project Committee will be conducted. The...) that an open meeting of the Taxpayer Advocacy Panel Tax Forms and Publications Project Committee...

  10. 77 FR 37103 - Open Meeting of the Taxpayer Advocacy Panel Tax Forms and Publications Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-20

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Tax Forms and Publications Project... meeting of the Taxpayer Advocacy Panel Tax Forms and Publications Project Committee will be conducted. The.... (1988) that an open meeting of the Taxpayer Advocacy Panel Tax Forms and Publications Project...

  11. 76 FR 10945 - Open Meeting of the Taxpayer Advocacy Panel Tax Forms and Publications Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-28

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Tax Forms and Publications Project... meeting of the Taxpayer Advocacy Panel Tax Forms and Publications Project Committee will be conducted. The...) that an open meeting of the Taxpayer Advocacy Panel Tax Forms and Publications Project Committee...

  12. 76 FR 2196 - Open Meeting of the Taxpayer Advocacy Panel Tax Forms and Publications Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-12

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Tax Forms and Publications Project... meeting of the Taxpayer Advocacy Panel Tax Forms and Publications Project Committee will be conducted. The.... (1988) that an open meeting of the Taxpayer Advocacy Panel Tax Forms and Publications Project...

  13. 78 FR 64293 - Open Meeting of the Taxpayer Advocacy Panel Tax Forms and Publications Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-28

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Tax Forms and Publications Project... meeting of the Taxpayer Advocacy Panel Tax Forms and Publications Project Committee will be conducted. The.... (1988) that an open meeting of the Taxpayer Advocacy Panel Tax Forms and Publications Project...

  14. 78 FR 78516 - Open Meeting of the Taxpayer Advocacy Panel Tax Forms and Publications Project Committee.

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-26

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Tax Forms and Publications Project... meeting of the Taxpayer Advocacy Panel Tax Forms and Publications Project Committee will be conducted. The.... (1988) that an open meeting of the Taxpayer Advocacy Panel Tax Forms and Publications Project...

  15. 77 FR 30591 - Open Meeting of the Taxpayer Advocacy Panel Tax Forms and Publications Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-23

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Tax Forms and Publications Project... meeting of the Taxpayer Advocacy Panel Tax Forms and Publications Project Committee will be conducted. The.... (1988) that an open meeting of the Taxpayer Advocacy Panel Tax Forms and Publications Project...

  16. 77 FR 55526 - Open Meeting of the Taxpayer Advocacy Panel Tax Forms and Publications Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-10

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Tax Forms and Publications Project... meeting of the Taxpayer Advocacy Panel Tax Forms and Publications Project Committee will be conducted. The.... (1988) that an open meeting of the Taxpayer Advocacy Panel Tax Forms and Publications Project...

  17. Advocacy and Accessibility Standards in the New "Code of Professional Ethics for Rehabilitation Counselors"

    ERIC Educational Resources Information Center

    Waldmann, Ashley K.; Blackwell, Terry L.

    2010-01-01

    This article addresses the changes in the Commission on Rehabilitation Counselor Certification's 2010 "Code of Professional Ethics for Rehabilitation Counselors" as they relate to Section C: Advocacy and Accessibility. Ethical issues are identified and discussed in relation to advocacy skills and to advocacy with, and on behalf of, the client; to…

  18. Elicitors and co-factors in food-induced anaphylaxis in adults

    PubMed Central

    2013-01-01

    Food-induced anaphylaxis (FIA) in adults is often insufficiently diagnosed. One reason is related to the presence of co-factors like exercise, alcohol, additives and non-steroidal anti-inflammatory drugs. The objective of this analysis was to retrospectively investigate the role of co-factors in patients with FIA. 93 adult patients with suspected FIA underwent double-blind, placebo-controlled food challenges with suspected allergens and co-factors. The elicitors of anaphylaxis were identified in 44/93 patients. 27 patients reacted to food allergens upon challenge, 15 patients reacted only when a co-factor was co-exposed with the allergen. The most common identified allergens were celery (n = 7), soy, wheat (n = 4 each) and lupine (n = 3). Among the co-factors food additives (n = 8) and physical exercise (n = 6) were most frequent. In 10 patients more than one co-factor and/or more than one food allergen was necessary to elicit a positive reaction. The implementation of co-factors into the challenge protocol increases the identification rate of elicitors in adult food anaphylactic patients. PMID:24262093

  19. [Animal experimental studies on immunogenicity, humoral response and danger of anaphylaxis in parenteral administration of hyaluronidase].

    PubMed

    Storch, H; Dellas, T; Bellmann, H

    1978-01-01

    The widespread intravenous application of hyaluronidase rises questions for its potential immunogenicity, formation of humoral antibodies, and danger of anaphylaxis. In experiments on 21 rabbits and 40 rats, the authors searched for precipitating antibodies after subcutaneous, intramuscular, and intravenous application of hyaluronidase in doses equivalent to the human. Intravenous and intramuscular shots of 150 to 75 000 IU of Hylase were applied in order to test anaphylaxis. By all proving procedures antibodies against Hylase were found. The formation of antibodies occurred earlier and in higher concentrations after subcutaneous and intramuscular application. The antibodies belonged to the IgG group. One third of the animals showed anaphylactic responses at doses which were 13 to 630 times as high. 26 per cent of human patients developed antibodies after application of Hylase. No anaphylactic reactions were observed in 17 patients with antibodies when intravenous application of hyaluronidase was continued. In the dosage used in the man anaphylactic response is obviously rare though it is possible. PMID:654375

  20. Clonal differences in IgE antibodies affect cutaneous anaphylaxis-associated thermal sensitivity in mice

    PubMed Central

    Mack, Madison; Tonc, Elena; Ashbaugh, Alyssa; Wetzel, Abigail; Sykes, Akilah; Engblom, Camilla; Shabani, Estela; Mora-Solano, Carolina; Trier, Anna; Swanson, Linnea; Ewan, Emily; Martinov, Tijana; Chatterjea, Devavani

    2014-01-01

    Cellular and molecular mediators of immune responses are increasingly implicated in acute and chronic pain pathophysiologies. Here we demonstrate that passive cutaneous IgE/Ag anaphylaxis provokes increased thermal sensitivity in the hind paw tissue of mice. The murine anti-DNP IgE antibodies SPE-7 and ε26 are known to induce differential cytokine production in bone marrow cultured mast cells in vitro without antigen challenge. We found a novel, antigen-dependent heterogeneity in the thermal pain responses elicited in the hind paws between SPE-7 and ε26 sensitized DNP-challenged mice. Mice experienced pronounced hind paw thermal sensitivity lasting 6 hours after DNP challenge when sensitized with SPE-7 but not ε26 IgE. The two IgE clones induced equivalent hind paw edema, neutrophil influx, cytokine production, and reduction in tissue histamine content in vivo, and bound to the same or overlapping epitopes on the DNP antigen in vitro. Therefore IgE antibodies against the same antigen can induce comparable inflammation, yet contribute to markedly different anaphylaxis-associated pain within an allergic response, suggesting that non-canonical IgE binding partners such as sensory neurons may play a role in allergy-related pain responses. PMID:25149207