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Sample records for online anaphylaxis training

  1. Anaphylaxis

    MedlinePlus

    Anaphylactic reaction; Anaphylactic shock; Shock - anaphylactic; Allergic reaction - anaphylaxis ... Anaphylaxis is a severe, whole-body allergic reaction to a chemical ... that can cause an allergic reaction. After being exposed to ...

  2. 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

  3. 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 ...

  4. 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 ...

  5. 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

  6. 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

  7. Online Training in Australia

    ERIC Educational Resources Information Center

    Kuzic, Joze

    2013-01-01

    On-line training is becoming an interesting phenomenon in Australia and has attracted a lot of interest across many industries and businesses (Chan and Ngai, 2007). The research reported here looks at the use of online training in corporations in Australia. It focuses on two aspects of online training, the factors that "warrant" its…

  8. Evaluation of an Anaphylaxis Training Program for Unlicensed Assistive Personnel

    ERIC Educational Resources Information Center

    Litarowsky, Jean A.; Murphy, Susan O.; Canham, Daryl L.

    2004-01-01

    This study evaluated a training program designed to prepare unlicensed assistive personnel (UAP) in high school settings to recognize and respond effectively to an anaphylactic emergency. Subjects included 53 adults employed by a high school district in the San Francisco Bay Area of California. A training model was developed based on Bandura's…

  9. Implementation of Anaphylaxis Management Guidelines: A Register-Based Study

    PubMed Central

    Grabenhenrich, Linus; Hompes, Stephanie; Gough, Hannah; Ruëff, Franziska; Scherer, Kathrin; Pföhler, Claudia; Treudler, Regina; Mahler, Vera; Hawranek, Thomas; Nemat, Katja; Koehli, Alice; Keil, Thomas; Worm, Margitta

    2012-01-01

    Background Anaphylaxis management guidelines recommend the use of intramuscular adrenaline in severe reactions, complemented by antihistamines and corticoids; secondary prevention includes allergen avoidance and provision of self-applicable first aid drugs. Gaps between recommendations and their implementation have been reported, but only in confined settings. Hence, we analysed nation-wide data on the management of anaphylaxis, evaluating the implementation of guidelines. Methods Within the anaphylaxis registry, allergy referral centres across Germany, Austria and Switzerland provided data on severe anaphylaxis cases. Based on patient records, details on reaction circumstances, diagnostic workup and treatment were collected via online questionnaire. Report of anaphylaxis through emergency physicians allowed for validation of registry data. Results 2114 severe anaphylaxis patients from 58 centres were included. 8% received adrenaline intravenously, 4% intramuscularly; 50% antihistamines, and 51% corticoids. Validation data indicated moderate underreporting of first aid drugs in the Registry. 20% received specific instructions at the time of the reaction; 81% were provided with prophylactic first aid drugs at any time. Conclusion There is a distinct discrepancy between current anaphylaxis management guidelines and their implementation. To improve patient care, a revised approach for medical education and training on the management of severe anaphylaxis is warranted. PMID:22590513

  10. Online TESL/TEFL Training.

    ERIC Educational Resources Information Center

    Nixon, Thomas

    2003-01-01

    Discusses distance learning with a focus on online learning, which is growing in popularity at a faster rate than other types of programs. Looks at the advantages and disadvantages of online learning, the future of online learning, and specifically TESOL training online. (Author/VWL)

  11. Food anaphylaxis.

    PubMed

    Sampson, H A

    2000-01-01

    Food anaphylaxis is now the leading single cause of anaphylactic reactions treated in emergency departments in Westernized countries. In the US, it is estimated that there are 29,000 anaphylactic reactions to foods treated in emergency departments and 125-150 deaths each year. Peanuts, tree nuts, fish and shellfish account for the vast majority of severe food anaphylactic reactions. Immunopathogenic mechanisms responsible for food anaphylaxis may differ somewhat from other forms of anaphylaxis, since elevation of serum tryptase is rarely seen following food anaphylactic reactions. Education regarding the strict avoidance of food allergens, the early recognition of anaphylactic symptoms, and the early use of self-injectable epinephrine remain the mainstays of therapy. However, clinical trials are now underway for the treatment of patients with peanut anaphylaxis utilizing anti-IgE antibody therapy and novel immunomodulatory therapies utilizing 'engineered' recombinant proteins, overlapping peptides, and immunostimulatory deoxyoligonucleotide sequences are being tested in animal models of anaphylaxis.

  12. 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

  13. Training and administration of epinephrine auto-injectors for anaphylaxis treatment in US schools: results from the EpiPen4Schools® pilot survey

    PubMed Central

    Hogue, Susan L; Goss, Diana; Hollis, Kelly; Silvia, Suyapa; White, Martha V

    2016-01-01

    Background Anaphylaxis is a serious, potentially life-threatening condition. Adequate preparation for anaphylaxis management is imperative for school personnel. This descriptive pilot study assessed preparedness of US schools to manage anaphylactic reactions. Methods An exploratory, cross-sectional, web-based, pilot survey assessed the occurrence and characteristics of anaphylactic events, as well as training provided to school personnel for the recognition and treatment of anaphylaxis. Eligible US schools were participants in the EpiPen4Schools® program during the 2013–2014 school year. EpiPen4Schools provides EpiPen® (epinephrine injection) Auto-Injectors and training materials to qualifying US schools. Survey data were parsed by US Census Bureau region and state and were evaluated using descriptive statistics. Results Schools from all 50 states and the District of Columbia participated in the survey (N=6,019). Among schools that provided information on anaphylactic events, 11% (607/5,683) reported the occurrence of one or more events, with significant variability in incidence across census regions and among states. A total of 5,613 schools provided information regarding which staff members were trained to recognize the signs and symptoms of anaphylaxis. Thirty-six percent of schools (2,022/5,613) indicated that only the school nurse and select staff were trained in anaphylaxis recognition. The proportion of schools in which most or all school staff received such training differed by region/state (range, 13%–100%). A total of 5,578 schools provided information on which staff were permitted to administer epinephrine. The majority of schools (54%; 3,024/5,578) permitted only the school nurse and select staff to administer epinephrine, although percentages varied by region/state (range, 4%–100%). Conclusion Schools differed substantially in their preparedness to manage anaphylaxis, with significant disparities in staff training and permission to treat. Given

  14. Cost-Effectiveness of Online Teacher Training

    ERIC Educational Resources Information Center

    Jung, Insung

    2005-01-01

    This study aims to compare the cost-effectiveness of an online teacher training method with a face-to-face training method in teaching "ICT integration in the school curriculum". In addition, the study explores the possibilities of a school-based voluntary training method in supporting other approaches to ICT teacher training. The analyses of…

  15. Group online mindfulness training: proof of concept.

    PubMed

    Kemper, Kathi J; Yun, Jonathan

    2015-01-01

    Mindfulness-based stress reduction training is attractive, but training with an expert teacher is often inconvenient and costly. This proof-of-concept project assessed the feasibility of providing a hybrid of free online mindfulness-based stress reduction training with small group peer facilitation. Six medical students asked a family medicine resident with 5 years of meditation experience but no formal training as a teacher to facilitate 8 weekly group sessions using a free online mindfulness-based stress reduction course. They completed pre- and posttraining questionnaires online. Six of the 7 trainees completed at least half the sessions. Completers and noncompleters had similar age (29 years), gender (about half male), and health status. Changes in the expected direction were observed for perceived stress, mindfulness, resilience, and confidence in providing calm, compassionate care. The hybrid of online mindfulness-based stress reduction training with peer support is feasible. Additional research is warranted to formally evaluate the impact of this approach.

  16. Training and Support for Successful Online Instruction

    ERIC Educational Resources Information Center

    Green, Amy

    2012-01-01

    Online education is growing rapidly as colleges seek to increase enrollment without investing in physical infrastructure. To keep up with the increasing demand for courses, some colleges are asking faculty to teach classes online with little training, few resources, and minimal support. The purpose of this study was to determine how the training…

  17. Training Aids for Online Instruction: An Analysis.

    ERIC Educational Resources Information Center

    Guy, Robin Frederick

    This paper describes a number of different types of training aids currently employed in online training: non-interactive audiovisual presentations; interactive computer-based aids; partially interactive aids based on recorded searches; print-based materials; and kits. The advantages and disadvantages of each type of aid are noted, and a table…

  18. An Online Training Course to Learn How to Teach Online

    ERIC Educational Resources Information Center

    Bachy, Sylviane; Lebrun, Marcel

    2015-01-01

    This case study deals with the implementation of ongoing training, offered wholly through distance and online learning, and conducted within the framework of an inter-university partnership linking two European countries. The case story relates the experience of several instructional designers (called "Academic Advisors" in this part of…

  19. When Should You Offer Online Training?

    ERIC Educational Resources Information Center

    Bandy, Jim

    2010-01-01

    Many companies struggle with the question of when to take a manual training process online. For most, the internal conflict comes from a belief that the course development costs will be astronomical, making the process cost-prohibitive. However, the facilities expense and that of hiring qualified professors, combined with the rising trend of busy…

  20. Adaptive skin detection based on online training

    NASA Astrophysics Data System (ADS)

    Zhang, Ming; Tang, Liang; Zhou, Jie; Rong, Gang

    2007-11-01

    Skin is a widely used cue for porn image classification. Most conventional methods are off-line training schemes. They usually use a fixed boundary to segment skin regions in the images and are effective only in restricted conditions: e.g. good lightness and unique human race. This paper presents an adaptive online training scheme for skin detection which can handle these tough cases. In our approach, skin detection is considered as a classification problem on Gaussian mixture model. For each image, human face is detected and the face color is used to establish a primary estimation of skin color distribution. Then an adaptive online training algorithm is used to find the real boundary between skin color and background color in current image. Experimental results on 450 images showed that the proposed method is more robust in general situations than the conventional ones.

  1. 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

  2. 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.

  3. Anaphylaxis to insect stings.

    PubMed

    Golden, David B K

    2015-05-01

    Anaphylaxis to insect stings has occurred in 3% of adults and can be fatal even on the first reaction. Large local reactions are more frequent but rarely dangerous. The chance of a systemic reaction to a sting is 5% to 10% in large local reactors and in children with mild (cutaneous) systemic reactions, and varies between 30% and 65% in adults with previous systemic reactions, depending on the severity of previous sting reactions. Baseline serum tryptase level is increased in many patients with sting anaphylaxis. Venom immunotherapy is 75% to 98% effective in preventing sting anaphylaxis.

  4. Food-induced anaphylaxis.

    PubMed

    Cianferoni, Antonella; Muraro, Antonella

    2012-02-01

    Food-induced anaphylaxis (FIA) is a serious allergic reaction that may cause death rapidly in otherwise healthy individuals. There is no universal agreement on its definition or criteria for diagnosis. Hospital admissions for FIA have more than doubled in the last decade. Food is one of the most common causes of anaphylaxis, with most surveys indicating that food-induced reactions account for 30% to 50% of cases. The most commonly implicated foods are peanut, tree nuts, milk, eggs, sesame seeds, fish, and shellfish. The only life-saving treatment for anaphylaxis is allergen avoidance, and epinephrine injection if an anaphylactic event occurs.

  5. 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

  6. 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.

  7. 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…

  8. E-Basics: Online Basic Training in Program Evaluation

    ERIC Educational Resources Information Center

    Silliman, Ben

    2016-01-01

    E-Basics is an online training in program evaluation concepts and skills designed for youth development professionals, especially those working in nonformal science education. Ten hours of online training in seven modules is designed to prepare participants for mentoring and applied practice, mastery, and/or team leadership in program evaluation.…

  9. Online Plagiarism Training Falls Short in Biology Classrooms

    ERIC Educational Resources Information Center

    Holt, Emily A.; Fagerheim, Britt; Durham, Susan

    2014-01-01

    Online plagiarism tutorials are increasingly popular in higher education, as faculty and staff try to curb the plagiarism epidemic. Yet no research has validated the efficacy of such tools in minimizing plagiarism in the sciences. Our study compared three plagiarism-avoidance training regimens (i.e., no training, online tutorial, or homework…

  10. Online Training of Teachers Using OER: Promises and Potential Strategies

    ERIC Educational Resources Information Center

    Misra, Pradeep Kumar

    2014-01-01

    Teacher education nowadays needs a change in vision and action to cater to the demands of changing societies. Reforms, improvements, and new approaches in teacher education are an immediate need. Online training of teachers using OER has emerged as a new approach in this direction. This approach is based on the assumption that online training will…

  11. Exploring Online Graduate Students' Responses to Online Self-Regulation Training

    ERIC Educational Resources Information Center

    Dunn, Karee E.; Rakes, Glenda C.

    2015-01-01

    In this study, online graduate students participated in four brief online self-regulatory trainings for self-efficacy, achievement goal orientation, learning strategies, and attributional thinking. These variables are critical to success in learning environments, but perhaps even more so in the online academic environment (Rakes, Dunn, &…

  12. Epinephrine (adrenaline) in anaphylaxis.

    PubMed

    Simons, F Estelle R; Simons, Keith J

    2010-01-01

    Epinephrine (adrenaline) is universally recommended as the initial drug of choice for the treatment of anaphylaxis. No other medication has similar life-saving pharmacologic effects in multiple organ systems, including prevention and relief of both upper and lower airway obstruction, and of shock. Failure to inject epinephrine promptly contributes to anaphylaxis fatalities. It is most effective when given immediately after the onset of anaphylaxis symptoms. The initial recommended adult dose is 0.3-0.5 mg, injected intramuscularly in the anterolateral aspect of the mid-thigh. Injected by other routes, epinephrine appears to have a less satisfactory therapeutic window; for example, onset of action is potentially delayed when it is injected subcutaneously, and risk of adverse effects potentially increases when it is injected intravenously. The possibility of randomized, controlled trials of epinephrine in anaphylaxis should be considered. For ethical reasons, these trials will not be placebo-controlled. They might involve comparison of one epinephrine dose versus another, or one route of epinephrine administration versus another. For first-aid treatment of people with anaphylaxis in the community, novel epinephrine formulations are being developed. These include epinephrine autoinjectors that are safer and easier to use, and epinephrine formulations that can be administered through non-invasive routes.

  13. 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

  14. Anaphylaxis and emergency treatment.

    PubMed

    Sampson, Hugh A

    2003-06-01

    Food anaphylaxis is now the leading known cause of anaphylactic reactions treated in emergency departments in the United States. It is estimated that there are 30 000 anaphylactic reactions to foods treated in emergency departments and 150 to 200 deaths each year. Peanuts, tree nuts, fish, and shellfish account for most severe food anaphylactic reactions. Although clearly a form of immunoglobulin E-mediated hypersensitivity, the mechanistic details responsible for symptoms of food-induced anaphylaxis are not completely understood, and in some cases, symptoms are not seen unless the patient exercises within a few hours of the ingestion. At the present time, the mainstays of therapy include educating patients and their caregivers to strictly avoid food allergens, to recognize early symptoms of anaphylaxis, and to self-administer injectable epinephrine. However, clinical trials are now under way for the treatment of patients with peanut anaphylaxis using recombinant humanized anti-immunoglobulin E antibody therapy, and novel immunomodulatory therapies are being tested in animal models of peanut-induced anaphylaxis.

  15. Can Massively Multiplayer Online Gaming Environments Support Team Training?

    ERIC Educational Resources Information Center

    O'Connor, Debra L.; Menaker, Ellen S.

    2008-01-01

    Instructional games are created when training is deliberately added to a gaming environment or when gaming aspects are deliberately incorporated into training. One type of game that is currently attracting the attention of the education and training field is the massively multiplayer online game (MMOG). Because evidence about learning outcomes…

  16. Online Training: The Value of Capturing Trainee Reactions

    ERIC Educational Resources Information Center

    Long, Lori K.; DuBois, Cathy Z.; Faley, Robert H.

    2008-01-01

    Purpose: Despite years of advice from researchers that trainee reactions provide training evaluation information that is of very limited use, trainee reactions remain the most commonly used measure of training effectiveness. Because the technology that supports online training facilitates the collection of trainee reaction information during and…

  17. Online Tutor Training: Synchronous Conferencing in a Professional Community.

    ERIC Educational Resources Information Center

    Johanek, Cindy; Rickly, Rebecca

    1995-01-01

    Provides examples of four Daedalus Interchange transcripts from writing center staff meetings at Ball State University. Discusses goals for tutor training and rationale and benefits for choosing synchronous conferencing as a tutor-training technique. Presents survey results from tutors who participated in online tutor training, suggesting a…

  18. Anaphylaxis: clinical aspects.

    PubMed

    Sheffer, Albert L

    2004-01-01

    Anaphylaxis is a rarely anticipated, potentially life-threatening systemic allergic reaction with symptoms ranging from mild flushing to upper respiratory obstruction with or without vascular collapse. Early recognition of symptoms with prompt institution of therapy is central to a successful outcome. Anaphylaxis is IgE mediated, whereas non-IgE mediated anaphylatic reactions are termed anaphylactoid. Food-induced anaphylactic reactions, particularly peanut, are being recognized with increasing frequency. Central to appropriate therapy of the acute reaction is adminstration of intramuscular adrenalin. However, with the advent of humanized anti-IgE monoclonal antibody, such reactions may be reduced in frequency and severity.

  19. Exercise-induced anaphylaxis.

    PubMed

    Shimizu, Taro; Tokuda, Yasuharu

    2012-01-01

    A 23-year-old man presented with acute flushing, pruritus and warmth followed by collapse after vigorous exercise in a gymnasium. After resting for 30 min and receiving a rapid infusion of 0.9% sodium chloride, he was finally stable. He admitted that he had a similar experience 5 years earlier during exercise. Based on the patient's history, his symptoms were attributed to exercise-induced anaphylaxis. None of his episodes was associated with any suspicious co-triggers of anaphylaxis. He was successfully discharged from hospital without any complications after receiving guidance on how to prevent this condition. PMID:22669856

  20. Exercise-induced anaphylaxis.

    PubMed

    Shimizu, Taro; Tokuda, Yasuharu

    2012-01-01

    A 23-year-old man presented with acute flushing, pruritus and warmth followed by collapse after vigorous exercise in a gymnasium. After resting for 30 min and receiving a rapid infusion of 0.9% sodium chloride, he was finally stable. He admitted that he had a similar experience 5 years earlier during exercise. Based on the patient's history, his symptoms were attributed to exercise-induced anaphylaxis. None of his episodes was associated with any suspicious co-triggers of anaphylaxis. He was successfully discharged from hospital without any complications after receiving guidance on how to prevent this condition.

  1. [Management of anaphylaxis : part 2: treatment and emergency equipment].

    PubMed

    Klimek, L; Goebel, U; Glowania, A

    2012-12-01

    Anaphylaxis is an extreme form of allergic reaction that can be life-threatening. Early treatment of circulatory and pulmonary disturbances is decisive for prognosis. Initial management of anaphylaxis comprises, where possible, interrupting allergen exposure; ensuring a stable airway; summoning emergency services; placing the patient in a safe position, obtaining venous access and monitoring vital signs. Adrenaline, histamine-antagonists and glucocorticoids have proven effective, as has administration of oxygen and volume substitutes. Many anaphylaxis patients are unable to successfully avoid the elicitor and the feasibility of self-treatment is limited if the patient is inadequately informed. An educational program for adult patients and parents of children with a high risk of anaphylaxis has been developed by the German Working Group for Anaphylaxis Training and Education (AGATE). This program aims to help prevent anaphylactic attacks, foster optimal first-line treatment and offer psychological and social support for anaphylaxis patients. Preliminary results confirm the efficacy of the AGATE approach. This article presents an overview of the stage-wise management of anaphylaxis in accordance with the S2 position paper of the German allergological societies and international guidelines. PMID:23202869

  2. [Management of anaphylaxis : part 2: treatment and emergency equipment].

    PubMed

    Klimek, L; Goebel, U; Glowania, A

    2012-12-01

    Anaphylaxis is an extreme form of allergic reaction that can be life-threatening. Early treatment of circulatory and pulmonary disturbances is decisive for prognosis. Initial management of anaphylaxis comprises, where possible, interrupting allergen exposure; ensuring a stable airway; summoning emergency services; placing the patient in a safe position, obtaining venous access and monitoring vital signs. Adrenaline, histamine-antagonists and glucocorticoids have proven effective, as has administration of oxygen and volume substitutes. Many anaphylaxis patients are unable to successfully avoid the elicitor and the feasibility of self-treatment is limited if the patient is inadequately informed. An educational program for adult patients and parents of children with a high risk of anaphylaxis has been developed by the German Working Group for Anaphylaxis Training and Education (AGATE). This program aims to help prevent anaphylactic attacks, foster optimal first-line treatment and offer psychological and social support for anaphylaxis patients. Preliminary results confirm the efficacy of the AGATE approach. This article presents an overview of the stage-wise management of anaphylaxis in accordance with the S2 position paper of the German allergological societies and international guidelines.

  3. Education, Training and Marketing for Online Information Retrieval Systems.

    ERIC Educational Resources Information Center

    Tedd, Lucy A.

    1979-01-01

    Discusses general aspects of education, training, and marketing techniques for on-line searching, and describes methods adopted by 12 organizations in Norway, the Netherlands, France, Switzerland, Italy, Belgium, and Britain that use computers for their bibliographic information requirements. (CWM)

  4. 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

  5. International consensus on (ICON) anaphylaxis.

    PubMed

    Simons, F Estelle R; Ardusso, Ledit Rf; Bilò, M Beatrice; Cardona, Victoria; Ebisawa, Motohiro; El-Gamal, Yehia M; Lieberman, Phil; Lockey, Richard F; Muraro, Antonella; Roberts, Graham; Sanchez-Borges, Mario; Sheikh, Aziz; Shek, Lynette P; Wallace, Dana V; Worm, Margitta

    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

  6. [Anaphylaxis: facts and fallacies].

    PubMed

    Brand, P L P

    2007-03-10

    The diagnosis and management of anaphylaxis is surrounded by many misunderstandings. The diagnosis may be made ifa patient develops respiratory or circulatory symptoms, in addition to skin symptoms, after exposure to a possibly relevant allergen. The most common causes ofanaphylaxis are food allergens, such as peanut and tree nuts, insect stings, and drugs, in particular antibiotics. Many patients with peanut or tree nut allergy show only mild allergic symptoms; only a minority develop anaphylaxis upon exposure. A large local reaction to an insect sting does not constitute insect sting allergy and does not increase the risk of anaphylaxis when stung again. Intramuscular epinephrine is the drug of choice in the treatment of anaphylaxis; antihistaminic agents and corticosteroids are supportive therapeutic agents which should only be considered after epinephrine has been administered. Prevention of recurrence ofanaphylaxis comprises identification and avoidance of the causative allergen, and administration of epinephrine autoinjector when the patient develops suggestive signs of recurrence. When prescribing an epinephrine autoinjector, the patient and all caregivers should be instructed carefully in its correct use; referral to an allergist is recommended.

  7. 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

  8. 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.

  9. 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

  10. Development Strategies for Online Volunteer Training Modules: A Team Approach

    ERIC Educational Resources Information Center

    Robideau, Kari; Vogel, Eric

    2014-01-01

    Volunteers are central to the delivery of 4-H programs, and providing quality, relevant training is key to volunteer success. Online, asynchronous modules are an enhancement to a training delivery menu for adult volunteers, providing consistent, accessible options traditionally delivered primarily face to face. This article describes how Minnesota…

  11. The Students' Perspectives of Online Training at Kuwait University

    ERIC Educational Resources Information Center

    Safar, Ammar H.

    2012-01-01

    Computers, the Internet, smartphones, and telecommunication technologies have all changed the way we live--how we think, socialize, entertain, work, teach, learn, and train as well. One of the modern ICT trends of organizations involve the integration of e-learning, in general, and online training systems, in particular, as new methods for…

  12. Online plagiarism training falls short in biology classrooms.

    PubMed

    Holt, Emily A; Fagerheim, Britt; Durham, Susan

    2014-01-01

    Online plagiarism tutorials are increasingly popular in higher education, as faculty and staff try to curb the plagiarism epidemic. Yet no research has validated the efficacy of such tools in minimizing plagiarism in the sciences. Our study compared three plagiarism-avoidance training regimens (i.e., no training, online tutorial, or homework assignment) and their impacts on students' ability to accurately discriminate plagiarism from text that is properly quoted, paraphrased, and attributed. Using pre- and postsurveys of 173 undergraduate students in three general ecology courses, we found that students given the homework assignment had far greater success in identifying plagiarism or the lack thereof compared with students given no training. In general, students trained with the homework assignment more successfully identified plagiarism than did students trained with the online tutorial. We also found that the summative assessment associated with the plagiarism-avoidance training formats (i.e., homework grade and online tutorial assessment score) did not correlate with student improvement on surveys through time.

  13. History and classification of anaphylaxis.

    PubMed

    Ring, Johannes; Brockow, Knut; Behrendt, Heidrun

    2004-01-01

    Anaphylaxis is the maximal variant of an acute allergic reaction involving several organ systems. The phenomenon itself is old, but it was recognized and named at the beginning of the 20th century by Richet and Portier. The clinical symptoms of anaphylaxis affect various organs, most commonly starting in the skin and proceeding to the respiratory tract, to gastrointestinal involvement and to cardiovascular symptoms, and finally to cardiac and/or respiratory arrest. Anaphylaxis stricto sensu is an immunological reaction, mostly mediated by IgE antibodies, but also by IgG or IgM antibodies (immune complex anaphylaxis). There are cases with similar clinical symptomatology without detectable immunological sensitization which are called pseudo-allergic or anaphylactoid reactions. In the newer nomenclature, some authors tend to include these under the heading of 'anaphylaxis' which has then to be defined as an acute systemic hypersensitivity reaction. The most common elicitors of anaphylaxis include drugs, foods, additives, but also other allergens as well as physical factors (cold, heat, UV radiation). The clinical outcome--the intensity of the reaction--is not only influenced by the degree of sensitization, but also by concomitant other factors: sometimes, individuals only develop anaphylaxis after simultaneous exposure to the allergen and an infection, physical exercise, psychological stress or concomitant medication (e.g. beta blockers). The term 'summation anaphylaxis' has been proposed for this phenomenon which probably underlies many cases of so-called idiopathic anaphylaxis. In patients with insect venom anaphylaxis, decreased levels of plasma angiotensin have been measured in inverse correlation to the severity of the reaction. Certain differential diagnoses have to be distinguished from anaphylaxis. Every patient with a history of anaphylaxis should undergo allergy diagnosis with the aim to detect the eliciting agent, characterize the relevant pathomechanism (e

  14. On your time: online training for the public health workforce.

    PubMed

    Kenefick, Hope Worden; Ravid, Sharon; MacVarish, Kathleen; Tsoi, Jennifer; Weill, Kenny; Faye, Elizabeth; Fidler, Anne

    2014-03-01

    The need for competency-based training for the public health workforce is well documented. However, human and financial resource limitations within public health agencies often make it difficult for public health practitioners to attend classroom-based training programs. The Internet is an increasingly popular way of extending training beyond the workforce. Although research describes attributes of effective online learning modules, much of the available training delivered via the Internet does not incorporate such attributes. The authors describe the On Your Time training series, an effective distance education program and training model for public health practitioners, which includes a standardized process for development, review, evaluation, and continuous quality improvement. On Your Time is a series of awareness-level (i.e., addressing what practitioners should know), competency-based training modules that address topics related to regulatory responsibilities of public health practitioners (e.g., assuring compliance with codes and regulations governing housing, retail food safety, private water supplies, hazardous and solid waste, on-site wastewater systems, etc.), public health surveillance, case investigation, disease prevention, health promotion, and emergency preparedness. The replicable model incorporates what is known about best practices for online training and maximizes available resources in the interests of sustainability.

  15. Implementing an Online Vocabulary Training Program

    ERIC Educational Resources Information Center

    Robertson, Charles E.

    2015-01-01

    Although vocabulary acquisition research has shed much light on practical methods for increasing lexical knowledge (Nation, 1994), many foreign language teachers hesitate to implement focused vocabulary-training programs in their classrooms. The reasons most often cited for this hesitation are associated with the difficult tasks of creating,…

  16. On-Line Pesticide Training with Narrated Powerpoint Presentations

    ERIC Educational Resources Information Center

    Johnson, Steven B.

    2015-01-01

    UMaine Cooperative Extension is the primary educational delivery organization for pesticide recertification credits in Maine. Shrinking budgets and staff numbers are making traditional face-to-face delivery increasingly difficult to maintain. To address this issue, on-line pesticide applicator recertification training credits were developed. The…

  17. Identifying Collaborative Behaviours Online: Training Teachers in Wikis

    ERIC Educational Resources Information Center

    Vinagre Laranjeira, Margarita

    2016-01-01

    In this paper we explore the data gathered from a group of nine in-service teachers who were trained online to become future telecollaborative teachers. Participants from different countries worked in two small groups in a wiki designed specially to facilitate discussion and collaboration. Tasks included reading and reviewing articles on…

  18. 10 Things We Know So Far about Online Training.

    ERIC Educational Resources Information Center

    Kiser, Kim

    1999-01-01

    Ten tips for online courses are as follow: (1) provide technical support; (2) plan the program; (3) use it for soft skills; (4) offer training during working hours; (5) keep lessons short; (6) keep traffic moving; (7) avoid using plug-ins; (8) teach the basics; (9) retain the human touch; and (10) realize the Web won't put trainers out of…

  19. Teacher Training, Sexuality Education, and Intellectual Disabilities: An Online Workshop

    ERIC Educational Resources Information Center

    Gonzalez-Acquaro, Katia

    2009-01-01

    The focus of this study was to assess the impact of an online workshop on teachers' knowledge, attitudes, and self-efficacy beliefs toward sexuality education and intellectual disabilities. A pretest-post-test group design was implemented for this study. Sixty-eight teachers were randomly assigned to one of two training conditions or a control…

  20. Management and Prevention of Anaphylaxis.

    PubMed

    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

  1. 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

  2. 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.

  3. 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

  4. Customized online and onsite training for rabies-control officers

    PubMed Central

    Bourhy, Hervé; Troupin, Cécile; Faye, Ousmane; Meslin, François-Xavier; Abela-Ridder, Bernadette; Sall, Amadou Alpha

    2015-01-01

    Abstract Problem It is difficult to deliver adequate training for people working in rabies control in low and middle-income countries. Popular e-learning systems for low-income settings are not well suited to developing and testing practical skills, including laboratory methods. Approach We customized training in rabies control methods for African professionals and students from different disciplines. Trainees participated in preparatory online sessions, evaluations and exercises before and after a 12-day workshop. Trainees and mentors continued to interact through an online forum up to one year after the workshop. Local setting In Africa, 15 000 deaths from rabies occur each year due to a lack of awareness, inaccessibility of post-exposure prophylaxis, inadequate or absent canine rabies-control programmes and lack of governmental financial support. Relevant changes Thirty two trainees – working in health departments, hospitals, veterinary stations and research institutes – were selected to participate; 28 completed the course and passed the final evaluation. Pilot rabies investigation programmes were developed, and two manuscripts submitted for publication. An online forum facilitated further progress for a year after the workshop. Lessons learnt A combination of customized online and onsite training is suitable for teaching disease-control personnel in low-income countries. Participation in this course enabled trainees to advocate for the development of national disease-control strategies. Mentoring is needed to develop a strong network of experts in similar settings. PMID:26170509

  5. [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.

  6. [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

  7. Lessons about food anaphylaxis.

    PubMed

    Medveczky, Thomas

    2014-12-01

    Exercise-induced anaphylaxis (EIA) and its subtype food-dependent (FD)-EIA are uncommon and easily missed forms of physical allergy. The latter is triggered by exercise following the ingestion of specific food products. Treatment is identical to that for IgE-mediated allergic reactions. The disease is potentially fatal. In this case, 30-year-old woman was seen in the allergy clinic at the request of her general practitioner. She reported an episode when she had gone to a local park to exercise after dinner. Shortly thereafter, she collapsed with rash, lip swelling, and breathing difficulties. Upon admission to hospital, she was found to be hypotensive and required fluid resuscitation, systemic corticosteroids and adrenaline. She made a full and uneventful recovery. On the basis of the clinical story and specific allergy markers, her presentation was attributed to FD-EIA.

  8. 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

  9. The Effect of Online Systems Analysis Training on Aerospace Industry Business Performance: A Qualitative Study

    ERIC Educational Resources Information Center

    Burk, Erlan

    2012-01-01

    Aerospace companies needed additional research on technology-based training to verify expectations when enhancing human capital through online systems analysis training. The research for online systems analysis training provided aerospace companies a means to verify expectations for systems analysis technology-based training on business…

  10. 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

  11. Exercise-induced anaphylaxis.

    PubMed

    Sheffer, A L; Austen, K F

    1980-08-01

    Sixteen patients were seen because of possibly life-threatening exercise-associated symptoms similar to anaphylactic reactions. Asthma attacks, cholinergic urticaria and angioedema, and cardiac arrythmias are recognized as exertion-related phenomena in predisposed patients but are distinct from the syndrome described here. A syndrome characterized by the exertion-related onset of cutaneous pruritus and warmth, the development of generalized urticaria, and the appearance of such additional manifestations as collapse in 12 patients, gastrointestinal tract symptoms in five patients, and upper respiratory distress in 10 patients has been designated exercise-induced anaphylaxis, because of the striking similarity of this symptom complex to the anaphylactic syndrome elicited by ingestion or injection of a foreign antigenic substance. There is a family history of atopic desease for 11 patients and cold urticaria for two others and a personal history of atopy in six. The size of the wheals, the failure to develop an attack with a warm bath or shower or a fever, and the prominence of syncope rule against the diagnosis of conventional cholinergic urticaria. There is no history or evidence of an encounter with an environmental source of antigen during the exercise period. PMID:7400473

  12. Optimal treatment of anaphylaxis: antihistamines versus epinephrine.

    PubMed

    Fineman, Stanley M

    2014-07-01

    Anaphylaxis is a rapid, systemic, often unanticipated, and potentially life-threatening immune reaction occurring after exposure to certain foreign substances. The main immunologic triggers include food, insect venom, and medications. Multiple immunologic pathways underlie anaphylaxis, but most involve immune activation and release of immunomodulators. Anaphylaxis can be difficult to recognize clinically, making differential diagnosis key. The incidence of anaphylaxis has at least doubled during the past few decades, and in the United States alone, an estimated 1500 fatalities are attributed to anaphylaxis annually. The increasing incidence and potentially life-threatening nature of anaphylaxis coupled with diagnostic challenges make appropriate and timely treatment critical. Epinephrine is universally recommended as the first-line therapy for anaphylaxis, and early treatment is critical to prevent a potentially fatal outcome. Despite the evidence and guideline recommendations supporting its use for anaphylaxis, epinephrine remains underused. Data indicate that antihistamines are more commonly used to treat patients with anaphylaxis. Although histamine is involved in anaphylaxis, treatment with antihistamines does not relieve or prevent all of the pathophysiological symptoms of anaphylaxis, including the more serious complications such as airway obstruction, hypotension, and shock. Additionally, antihistamines do not act as rapidly as epinephrine; maximal plasma concentrations are reached between 1 and 3 hours for antihistamines compared with < 10 minutes for intramuscular epinephrine injection. This demonstrates the need for improved approaches to educate physicians and patients regarding the appropriate treatment of anaphylaxis.

  13. The Effect of Counselling-Based Training on Online Peer Support

    ERIC Educational Resources Information Center

    Lekka, Foteini; Efstathiou, Giorgos; Kalantzi-Azizi, Anastasia

    2015-01-01

    The aim of the current study is to investigate the impact of counselling-based training on online peer support by comparing the interventions of trained peer supporters as opposed to non-trained peer supporters. Two independent raters analysed 746 support posts published during a period of one year at the "Student to Student" online peer…

  14. Student Training in the Use of an Online Synchronous Conferencing Tool

    ERIC Educational Resources Information Center

    Heiser, Sarah; Stickler, Ursula; Furnborough, Concha

    2013-01-01

    With the increase of online language teaching the training needs of teachers have long been established and researched. However, the training needs of students have not yet been fully acknowledged. This paper focuses on learner training as preparation for language classes where online synchronous conferencing is used. It presents an action…

  15. 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

  16. The Practical Aspects of Online Counseling: Ethics, Training, Technology, and Competency

    ERIC Educational Resources Information Center

    Mallen, Michael J.; Vogel, David L.; Rochlen, Aaron B.

    2005-01-01

    This article addresses the practical aspects of online counseling, including ethics, training, supervision, technology, and competency issues. The authors discuss online counseling's strengths and limitations and present guidelines for what types of clients and counseling psychologists may be appropriate for online counseling. To illustrate the…

  17. The Use of Online Surveys to Measure Satisfaction in Job Training and Workforce Development

    ERIC Educational Resources Information Center

    Schmidt, Steve; Strachota, Elaine; Conceicao, Simone

    2006-01-01

    This paper examines two empirical studies that used online surveys to collect data to measure satisfaction in job training and workforce development. A description of each study, findings related to response rate, the processes used in online survey development and implementation, as well as recommendations for the future use of online surveys…

  18. The Effects of Technical Difficulties on Learning and Attrition during Online Training

    ERIC Educational Resources Information Center

    Sitzmann, Traci; Ely, Katherine; Bell, Bradford S.; Bauer, Kristina N.

    2010-01-01

    Although online instruction has many potential benefits, technical difficulties are one drawback to the increased use of this medium. A repeated measures design was used to examine the effect that technical difficulties have on learning and attrition from voluntary online training. Adult learners (N = 530) were recruited online and volunteered to…

  19. What Factors Facilitate Online Counselor Training? Experiences of Campus Alberta Graduate Students

    ERIC Educational Resources Information Center

    Ekong, Jane Ime

    2006-01-01

    Online learning is here to stay. Many studies have examined factors that facilitate online learning in many disciplines, but few exist on counselor training. This research surveyed online counseling graduate students for factors that they found facilitative. Instructor characteristics such as frequency of participation in discussion forums,…

  20. Relating Training to Job Satisfaction: A Survey of Online Faculty Members

    ERIC Educational Resources Information Center

    Hoekstra, Brian

    2013-01-01

    As the online education market continues to mature, institutions of higher education will respond to student demand by employing quality faculty members. Faculty members need unique training to successfully teach online. While the effect of training on job satisfaction has been investigated in the realm of business, it has not been tested…

  1. Building Capacity for Oman's Online Teacher Training: Making an International Partnership Work

    ERIC Educational Resources Information Center

    Sales, Gregory C.; Al-Rahbi, Fathiya

    2008-01-01

    The Sultanate of Oman recently investigated the viability of online teacher training through a joint project funded by the U.S. Middle East Partnership Initiative and the Oman Ministry of Education. One aspect of the project was to build sufficient capacity within the Ministry to enable Oman to produce online training in the future. This article…

  2. A Preliminary Evaluation of Instructional Effectiveness of Online Training Implemented at a Government Agency in Thailand

    ERIC Educational Resources Information Center

    Supanakorn-Davila, Supawan; Bolliger, Doris U.

    2012-01-01

    Online training has become popular in the professional development of government employees in Thailand. One large government agency developed an online program to provide training to its employees across the country using two systems: an Internet and Intranet-based system. With the new program implemented, the evaluation of the instructional…

  3. Researching the Size and Scope of Online Usage in the Vocational Education and Training Sector.

    ERIC Educational Resources Information Center

    Hill, Robyn; Malone, Peter; Markham, Selby; Sharma, Renu; Sheard, Judithe; Young, Graeme

    The size and scope of online usage in Australia's vocational education and training sector were examined in a four-stage study that included the numerous data collection activities, including the following: a literature review; interviews with 85 institutes; interviews with 10 training organizations and 20 organizations using online learning;…

  4. Changing College Students' Conceptions of Autism: An Online Training to Increase Knowledge and Decrease Stigma

    ERIC Educational Resources Information Center

    Gillespie-Lynch, Kristen; Brooks, Patricia J.; Someki, Fumio; Obeid, Rita; Shane-Simpson, Christina; Kapp, Steven K.; Daou, Nidal; Smith, David Shane

    2015-01-01

    College students with autism may be negatively impacted by lack of understanding about autism on college campuses. Thus, we developed an online training to improve knowledge and decrease stigma associated with autism among college students. Participants (N = 365) completed a pre-test, online training, and post-test. Women reported lower stigma…

  5. Training Therapists to Work Effectively Online and Offline within Digital Culture

    ERIC Educational Resources Information Center

    Anthony, Kate

    2015-01-01

    The speed at which technology evolves, and therefore the speed at which online mental health services evolve and the training required to keep up with them, has become a real concern for the profession. The need for training in transferring face-to-face skills to the online environment has been recognised for some years by leading professional…

  6. Online Synchronous vs. Asynchronous Software Training through the Behavioral Modeling Approach: A Longitudinal Field Experiment

    ERIC Educational Resources Information Center

    Chen, Charlie C.; Shaw, Ruey-shiang

    2006-01-01

    The continued and increasing use of online training raises the question of whether the most effective training methods applied in live instruction will carry over to different online environments in the long run. Behavior Modeling (BM) approach--teaching through demonstration--has been proven as the most effective approach in a face-to-face (F2F)…

  7. Using a Design-Based Research Study to Identify Principles for Training Instructors to Teach Online

    ERIC Educational Resources Information Center

    Shattuck, Julie; Anderson, Terry

    2013-01-01

    Within the overall framework of design-based research, this paper reports on a study that focused on evaluating an online training course for online instructors. This intervention was designed as a possible solution to the problem facing some higher education institutions of how to provide quality, accessible training for mostly part-time…

  8. A Case Study Analysis of Factors that Influence Attrition Rates in Voluntary Online Training Programs

    ERIC Educational Resources Information Center

    Long, Lori; Dubois, Cathy; Faley, Robert

    2009-01-01

    This article examines utilization of online training courses in a Midwest-based landscaping company in the United States. The company had implemented online training to facilitate employee development for their 5,000 employees who were in locations throughout the United States. The courses had been in place for about a decade before the…

  9. eGTTP - bridging distances with online training

    NASA Astrophysics Data System (ADS)

    Doran, Rosa

    2015-08-01

    The Galileo Teacher Training Program vision is to empower teachers on the use of modern tools and resources for astronomy education. Bringing modern astronomy to the hands of students all over the world represents much more than providing pieces of knowledge. It represents the construction of the building blocks of awareness about our place in the cosmos and our role as specie. In the era of fast track for information exchange, there are still some severe limitations on the provision of equal opportunities to all. Overcoming these limits is the goal of the eGTTP for Portuguese speaking countries. The aim of the project is to provide online training to teachers in the Portuguese speaking countries. With support from the Office of Astronomy for Development we are building experience on how to provide effective support to educators in several countries with different settings, experiences, barriers and needs. In this presentation we hope to share our success stories and set the road for a sustainable continuation of this effort.

  10. Identifying Training Needs of Novice Online English Language Tutors

    ERIC Educational Resources Information Center

    Rodriguez Buitrago, Carolina

    2013-01-01

    Online and blended learning are of growing interest in the English language learning community. In Colombia, national initiatives and policies promote online educational programs and online English courses specifically. As a result, new online tutors are constantly needed for new programs and courses offered by institutions as well as by private…

  11. Online colour training system for dental students: a comprehensive assessment of different training protocols.

    PubMed

    Liu, M; Chen, L; Liu, X; Yang, Y; Zheng, M; Tan, J

    2015-04-01

    The purpose of this study was to evaluate the training effect and to determine the optimal training protocol for a recently developed online colour training system. Seventy students participated in the evaluation. They first completed a baseline test with shade guides (SGT) and the training system (TST), and then trained with one of the three system training methods (Basic colour training for group E1, Vitapan Classical for E2, and Vitapan 3D-Master for E3) or shade guides (group C1) for 4 days. The control group (C2) received no training. The same test was performed after training and they finally completed a questionnaire. The correct matches after training increased in three experimental groups and group C1. Among experimental groups, the greatest improvement of correct matching number was achieved by group E3 (4·00 ± 1·88 in SGT, 4·29 ± 2·73 in TST), followed by E2 (2·29 ± 2·73 in SGT, 3·50 ± 3·03 in TST) and E1 (2·00 ± 2·60 in SGT, 1·93 ± 2·96 in TST). The difference between E3 and E1 was statistically significant (P = 0·036 in SGT, 0·026 in TST). The total average training time was shorter in group E2 (15·39 ± 4·22 min) and E3 (17·63 ± 5·22 min), with no significant difference between them. Subjective evaluations revealed that self-confidence in colour matching were improved greater in group C1 and E3. In conclusion, all tested sections of the system effectively improved students' colour-matching ability. Among system training methods, Vitapan 3D-Master showed the best performance; it enabled greater shade-matching improvement, it saved time and was superior in subjective evaluations.

  12. Online training delivery in meteorological continued education and training: Eumetcal experiences & plans

    NASA Astrophysics Data System (ADS)

    Siili, Tero; Haga, Lisa; Neitiniemi-Upola, Leena

    2013-04-01

    Eumetcal is the Education and Training (E & T) project of EUMETNET - the collaboration organ­isation of European National Meteorological and Hydrological Services (NMHSs) - with emphasis on Computer Assisted Learning (CAL) from the project's inception in 2002. Finnish Meteorological Institute has been assigned to manage the Eumetcal project since the onset of the project's pilot phase. Participat­ing NMHSs cover most of Europe, their number exceeds 20 and the scales and scopes of their in-house E & T activities vary widely. Eumetcal also collaborates with a number of E & T organisations in Europe and worldwide. Eumetcal's target group includes the meteorological staff and E & T personnel of the participant NMHSs; the target group is hence geographically widely distributed. The subject matters covered include not only scientific and technical skills and competencies, but also other types of competen­cies relevant to NMHSs' staff. Eumetcal's goal and task is to supplement the E & T activities of the participants through collabora­tion and networking, both between project participants and with other E & T organisations. The project also utilises Information and Communications Technologies extensively in delivery of E & T events and materials: Eumetcal is a Virtual Training Organisation and emphasises online and blended E & T events. In the last five years the project has organised or contributed to at least 2-4 E & T events per year. This presentation a) gives an overview of the Eumetcal project and its place among meteorological E & T organisations in Europe and globally, as well as b) describes the E & T events the project has delivered or contributed to in the last years and plans to deliver in 2013. Emphasis will be on the online and blended events and lessons learned from designing and implementing these events and the benefits of using online training.

  13. RCR online course: build an online course to augment RCR training using evidenced-based learning theory.

    PubMed

    Ratliff, Mary; Masen, Nicole; Sullivan, Stephen; Fleming, Michael F; Carney, Paula

    2012-01-01

    This article demonstrates how to apply evidenced-based instructional design principles to develop a supplemental, online Responsible Conduct of Research (RCR) course. The supplement RCR course may serve to appropriately augment the National Institutes of Health (NIH) required RCR training. The way to ensure that an online RCR course is effective is to incorporate evidence-based learning theories into the development of the course content. This article specifically demonstrates application of Bloom's taxonomy and Gagne's Nine Instructional Events to a research misconduct course. At the conclusion, the reader will be able to apply evidence-based learning theories to the development of any online course.

  14. 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

  15. 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.

  16. Comparison of Online and Traditional Basic Life Support Renewal Training Methods for Registered Professional Nurses.

    PubMed

    Serwetnyk, Tara M; Filmore, Kristi; VonBacho, Stephanie; Cole, Robert; Miterko, Cindy; Smith, Caitlin; Smith, Charlene M

    2015-01-01

    Basic Life Support certification for nursing staff is achieved through various training methods. This study compared three American Heart Association training methods for nurses seeking Basic Life Support renewal: a traditional classroom approach and two online options. Findings indicate that online methods for Basic Life Support renewal deliver cost and time savings, while maintaining positive learning outcomes, satisfaction, and confidence level of participants. PMID:26580468

  17. Instructor Training and Instructional Design in Online Courses Using Group Work

    ERIC Educational Resources Information Center

    Gibson, Patricia K.

    2013-01-01

    The purpose of this exploratory multi-case study was to examine the role of instructional design and instructor training on student learning outcomes and student satisfaction within the online class using group work, a form of collaborative learning. Group work has been strongly recommended for online classes. Data allowing insight into…

  18. Relating Training to Job Satisfaction: A Survey of Online Faculty Members

    ERIC Educational Resources Information Center

    Hoekstra, Brian

    2014-01-01

    The purpose of this study was to determine whether training affected the job satisfaction reported by online faculty members. A convenience sample of 492 Iowa Community College Online Consortium (ICCOC) faculty members were invited to participate in a quantitative survey, and 148 responded. Overall Job Satisfaction was operationalized through the…

  19. E-Business and Online Learning: Connections and Opportunities for Vocational Education and Training.

    ERIC Educational Resources Information Center

    Mitchell, John

    Australian vocational education and training (VET) providers show increasing interest in using electronic technology to provide online learning, student services, and business functions, according to a study that included a literature review, Internet search, interviews with organizations that use e-business models for online learning, analysis of…

  20. From E-Training to E-Performance: Putting Online Learning To Work.

    ERIC Educational Resources Information Center

    Bernardez, Mariano

    2003-01-01

    Discusses corporate electronic learning and describes three different operative and business paradigms: electronic training, that replaces face-to-face interaction and reduces costs; electronic learning, that measures learning outcomes and considers technological barriers, learning to learn online, and installing an online culture; and electronic…

  1. A Randomized-Controlled Trial of the Effects of Online Training on Implementation Fidelity

    ERIC Educational Resources Information Center

    Drake, Pamela M.; Firpo-Triplett, Regina; Glassman, Jill R.; Ong, Seow Ling; Unti, Lisa

    2015-01-01

    The effectiveness of evidence-based programs can be compromised if the program is not implemented with fidelity. This article describes the evaluation of an online training to improve implementation fidelity to an evidence-based HIV prevention curriculum, Reducing the Risk, through online skills-based instruction and support. Educators were…

  2. Measuring Local Anaphylaxis in Mice

    PubMed Central

    Evans, Holly; Killoran, Kristin E.; Mitre, Edward

    2014-01-01

    Allergic responses are the result of the activation of mast cells and basophils, and the subsequent release of vasoactive and proinflammatory mediators. Exposure to an allergen in a sensitized individual can result in clinical symptoms that vary from minor erythema to life threatening anaphylaxis. In the laboratory, various animal models have been developed to understand the mechanisms driving allergic responses. Herein, we describe a detailed method for measuring changes in vascular permeability to quantify localized allergic responses. The local anaphylaxis assay was first reported in the 1920s, and has been adapted from the technique published by Kojima et al. in 20071. In this assay, mice sensitized to OVA are challenged in the left ear with vehicle and in the right ear with OVA. This is followed by an intravenous injection of Evans Blue dye. Ten min after injecting Evans Blue, the animal is euthanized and the dye that has extravasated into the ears is extracted overnight in formamide. The absorbance of the extracted dye is then quantified with a spectrophotometer. This method reliably results in a visual and quantifiable manifestation of a local allergic response. PMID:25350839

  3. 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

  4. 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.

  5. Perioperative anaphylaxis: diagnosis, evaluation, and management.

    PubMed

    Kannan, Jennifer A; Bernstein, Jonathan A

    2015-05-01

    Perioperative anaphylaxis can occur during or after surgery and can have life-threatening consequences. As anesthesia protocols become more complex and incorporate multiple agents to regulate physiologic processes intraoperatively, perioperative anaphylaxis is becoming increasingly recognized. The allergist should obtain detailed records from the anesthesiologist in order to perform appropriate testing to identify the likely causative agents. Testing should ideally be performed 4 to 6 weeks after the reaction to account for a refractory period after mast cell activation. This article includes 2 cases of perioperative anaphylaxis and reviews the historical elements that must be considered after a reaction has occurred. PMID:25841554

  6. Perioperative anaphylaxis: diagnosis, evaluation, and management.

    PubMed

    Kannan, Jennifer A; Bernstein, Jonathan A

    2015-05-01

    Perioperative anaphylaxis can occur during or after surgery and can have life-threatening consequences. As anesthesia protocols become more complex and incorporate multiple agents to regulate physiologic processes intraoperatively, perioperative anaphylaxis is becoming increasingly recognized. The allergist should obtain detailed records from the anesthesiologist in order to perform appropriate testing to identify the likely causative agents. Testing should ideally be performed 4 to 6 weeks after the reaction to account for a refractory period after mast cell activation. This article includes 2 cases of perioperative anaphylaxis and reviews the historical elements that must be considered after a reaction has occurred.

  7. Facilitating Online Counseling: Perspectives from Counselors in Training

    ERIC Educational Resources Information Center

    Haberstroh, Shane; Parr, Gerald; Bradley, Loretta; Morgan-Fleming, Barbara; Gee, Robert

    2008-01-01

    To address the need for research regarding online counseling, the authors explore the experiences of 4 female and 2 male Caucasian counseling students who facilitated 5 chat-based online counseling sessions. Conducting semistructured interviews based in grounded theory methods, the authors discuss technological barriers, counseling without visual…

  8. Online Distance Learning and Music Training: Benefits, Drawbacks and Challenges

    ERIC Educational Resources Information Center

    Koutsoupidou, Theano

    2014-01-01

    This study examines online distance learning (ODL) as applied in music and music education programmes at different educational levels with a special focus on the digital tools employed in such programmes. It aims to provide an up-to-date snapshot of the current online courses focusing on the potential benefits and drawbacks of ODL from the…

  9. The Evolution of Peer Driven Training for Teaching Online Courses

    ERIC Educational Resources Information Center

    Shapiro, Peter J.

    2006-01-01

    Online courses at Bergen Community College (BCC) began in the late 1990's with an imperative from the college President to develop online courses. Senior faculty members who dared to experiment with this new mode of teaching had to learn how to design a course and how to use WebCT, a new course management system, on their own. As these faculty…

  10. Online Leader Training Course: Nebraska Equine Extension Leader Certification

    ERIC Educational Resources Information Center

    Cottle, Lena; D'Angelo, Nicole

    2015-01-01

    The Nebraska Equine Advancement Level Leader Certification Program is an online learning tool that clarifies principles of the Nebraska 4-H Equine Advancement Programs. Through an online Moodle course through eXtension.org, 4-H leaders and Extension educators are able to fulfill the certification requirement from any location before allowing youth…

  11. A National Study of Training Content and Activities for Faculty Development for Online Teaching

    ERIC Educational Resources Information Center

    Meyer, Katrina A.; Murrell, Vicki S.

    2014-01-01

    This article presents the results of a national study of 39 higher education institutions that collected information about their practices for faculty development for online teaching and particularly the content and training activities used during 2011-2012. This study found that the most frequently offered training content (97% of the…

  12. Evaluating Rater Responses to an Online Training Program for L2 Writing Assessment

    ERIC Educational Resources Information Center

    Elder, Catherine; Barkhuizen, Gary; Knoch, Ute; von Randow, Janet

    2007-01-01

    The use of online rater self-training is growing in popularity and has obvious practical benefits, facilitating access to training materials and rating samples and allowing raters to reorient themselves to the rating scale and self monitor their behaviour at their own convenience. However there has thus far been little research into rater…

  13. 75 FR 44265 - Proposed Collection; Comment Request; Online Skills Training for PCPs on Substance Abuse

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-28

    ... Training for PCPs on Substance Abuse SUMMARY: Under the provisions of Section 3506(c)(2)A of the Paperwork... Online Skills Training for PCPs on Substance Abuse, via the Web site SBIRTTraining.com , to positively..., information will be collected from primary care physicians before exposure to the Web based materials...

  14. Basic Botany On-Line: A Training Tool for the Master Gardener Program.

    ERIC Educational Resources Information Center

    VanDerZanden, Ann Marie; Rost, Bob; Eckel, Rick

    2002-01-01

    A noncredit, online training module on botany was offered to participants in the Oregon Master Gardener program. The 48 participants felt the module was a useful training tool. They also noted that the convenience of completing the material at their own pace and during a time that fit into their schedule. (SK)

  15. A Preliminary Evaluation of a Short Online Training Workshop for TPACK Development

    ERIC Educational Resources Information Center

    Alsofyani, Mohammed Modeef; bin Aris, Baharuddin; Eynon, Rebecca

    2013-01-01

    National plans in higher education institutions are being developed in various aspects of the academic world for technology integration. Short online training has the potential for accelerating and facilitating the implementation of those plans. So far, a little is known about the suitability of this mode of training for faculty members'…

  16. A case of anaphylaxis to oral minocycline.

    PubMed

    Jang, Ji Woong; Bae, Yun-Jeong; Kim, Yong Giun; Jin, Young-Joo; Park, Kyung Sun; Cho, You Sook; Moon, Hee-Bom; Kim, Tae-Bum

    2010-08-01

    Minocycline is a semisynthetic tetracycline derivative that is often used in the treatment of acne vulgaris. To date, there has been only one case report of anaphylaxis to minocycline. We report here a case of anaphylaxis to oral minocycline. A 56-yr-old woman visited our hospital after three episodes of recurrent anaphylaxis. We performed an oral challenge test, the standard method for diagnosing drug allergies, with minocycline, one of the drugs she had taken previously. She developed urticaria, angioedema, nausea, vomiting, hypotension, and dyspnea within 4 min and was treated with intramuscular epinephrine, intravenous antihistamine and systemic corticosteroid. However, she presented similar symptoms at 50 min and at 110 min. In prescribing oral minocycline, physicians should consider the possibility of serious adverse reactions, such as anaphylaxis.

  17. Anaphylaxis: lesson learned from five cases.

    PubMed

    Sundaru, Heru; Koesnoe, Sukamto; Tenggara, Jeffry Beta; Suryana, Ketut

    2008-07-01

    Anaphylaxis is a severe hypersensitivity reaction. Its clinical manifestations vary, affecting several organs at once. Skin symptom is the most frequent manifestation; however, diagnosis of anaphylaxis will only be established when involving one or both vital organs, which are cardiovascular and respiratory system. Other symptom, such as that involving central nervous system or gastrointestinal tract, may accompany. We present five cases of anaphylaxis which vary in onset of symptoms, allergen, degree of severity, therapeutic response and clinical manifestation. Anaphylactic reaction to drugs in these cases is mainly manifested as anaphylactic shock and reaction to food allergen causing obstruction of respiratory tract. Four anaphylactic events occurred at home and only one occurred in a hospital, thus education on anaphylaxis to general community is very important, especially for the patients and their families. Prompt medical assistance in patients with anaphylactic symptoms determines their therapeutic response. Skin test prior to administration of cephalosporin does not give negative predictive value toward anaphylactic event.

  18. Dispositional Employability and Online Training Purchase. Evidence from Employees' Behavior in Spain.

    PubMed

    Torrent-Sellens, Joan; Ficapal-Cusí, Pilar; Boada-Grau, Joan

    2016-01-01

    This article explores the relationship between dispositional employability and online training purchase. Through a sample of 883 employees working for enterprises in Spain, and a using principal component analysis and binomial logit probabilistic models, the research revealed two main results. First, it was found that dispositional employability is characterized by five factors: "openness to changes at work," "career motivation and work resilience," "work and career proactivity," "optimism and engagement at work," and "work identity." Second, the research also found a double causality in the relationship analysis between dispositional employability and online training purchase. However, this causality is not direct. In explaining dispositional employability, certain motivations and types of behavior of employees participating in online training are significant. In particular, greater sensitivity toward career-related personal empowerment, a greater predisposition toward developing new experiences at work, and a greater awareness of the fact that positive job outcomes are related to preparation conscientiousness. In explaining online training purchase, employees who are more motivated and who better identify with their jobs are more likely to pay. Moreover, employees who spend more time on training and have less contact with new trends in their jobs, find it hard to keep calm in difficult situations, and have a greater predisposition toward effort, and preference for novelty, variety and challenges at work are more likely to purchase online training.

  19. Dispositional Employability and Online Training Purchase. Evidence from Employees' Behavior in Spain

    PubMed Central

    Torrent-Sellens, Joan; Ficapal-Cusí, Pilar; Boada-Grau, Joan

    2016-01-01

    This article explores the relationship between dispositional employability and online training purchase. Through a sample of 883 employees working for enterprises in Spain, and a using principal component analysis and binomial logit probabilistic models, the research revealed two main results. First, it was found that dispositional employability is characterized by five factors: “openness to changes at work,” “career motivation and work resilience,” “work and career proactivity,” “optimism and engagement at work,” and “work identity.” Second, the research also found a double causality in the relationship analysis between dispositional employability and online training purchase. However, this causality is not direct. In explaining dispositional employability, certain motivations and types of behavior of employees participating in online training are significant. In particular, greater sensitivity toward career-related personal empowerment, a greater predisposition toward developing new experiences at work, and a greater awareness of the fact that positive job outcomes are related to preparation conscientiousness. In explaining online training purchase, employees who are more motivated and who better identify with their jobs are more likely to pay. Moreover, employees who spend more time on training and have less contact with new trends in their jobs, find it hard to keep calm in difficult situations, and have a greater predisposition toward effort, and preference for novelty, variety and challenges at work are more likely to purchase online training. PMID:27313557

  20. Dispositional Employability and Online Training Purchase. Evidence from Employees' Behavior in Spain.

    PubMed

    Torrent-Sellens, Joan; Ficapal-Cusí, Pilar; Boada-Grau, Joan

    2016-01-01

    This article explores the relationship between dispositional employability and online training purchase. Through a sample of 883 employees working for enterprises in Spain, and a using principal component analysis and binomial logit probabilistic models, the research revealed two main results. First, it was found that dispositional employability is characterized by five factors: "openness to changes at work," "career motivation and work resilience," "work and career proactivity," "optimism and engagement at work," and "work identity." Second, the research also found a double causality in the relationship analysis between dispositional employability and online training purchase. However, this causality is not direct. In explaining dispositional employability, certain motivations and types of behavior of employees participating in online training are significant. In particular, greater sensitivity toward career-related personal empowerment, a greater predisposition toward developing new experiences at work, and a greater awareness of the fact that positive job outcomes are related to preparation conscientiousness. In explaining online training purchase, employees who are more motivated and who better identify with their jobs are more likely to pay. Moreover, employees who spend more time on training and have less contact with new trends in their jobs, find it hard to keep calm in difficult situations, and have a greater predisposition toward effort, and preference for novelty, variety and challenges at work are more likely to purchase online training. PMID:27313557

  1. Fatal food-induced anaphylaxis.

    PubMed

    Yunginger, J W; Sweeney, K G; Sturner, W Q; Giannandrea, L A; Teigland, J D; Bray, M; Benson, P A; York, J A; Biedrzycki, L; Squillace, D L

    1988-09-01

    Fatal food-induced anaphylaxis is rarely reported. In 16 months, we identified seven such cases involving five males and two females, aged 11 to 43 years. All victims were atopic with multiple prior anaphylactic episodes after ingestion of the incriminated food (peanut, four; pecan, one; crab, one; fish, one). In six cases the allergenic food was ingested away from home. Factors contributing to the severity of individual reactions included denial of symptoms, concomitant intake of alcohol, reliance on oral antihistamines alone to treat symptoms, and adrenal suppression by chronic glucocorticoid therapy for coexisting asthma. In no case was epinephrine administered immediately after onset of symptoms. Premortem or postmortem serum samples were available from six victims; in each case elevated levels of IgE antibodies to the incriminated food were demonstrated. Food-sensitive individuals must self-administer epinephrine promptly at the first sign of systemic reaction. Emergency care providers should be aware of cricothyrotomy as a life-saving procedure.

  2. 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

  3. Kinins, airway obstruction, and anaphylaxis.

    PubMed

    Kaplan, Allen P

    2010-01-01

    Anaphylaxis is a term that implies symptoms that are present in many organs, some of which are potentially fatal. The pathogenic process can either be IgE-dependent or non-IgE-dependent; the latter circumstance may be referred to as anaphylactoid. Bradykinin is frequently responsible for the manifestations of IgE-independent reactions. Blood levels may increase because of overproduction; diseases such as the various forms of C1 inhibitor deficiency (hereditary or acquired) or hereditary angioedema with normal C1 inhibitor are examples in this category. Blood levels may also increase because of an abnormality in bradykinin metabolism; the angioedema due to ACE inhibitors is a commonly encountered example. Angioedema due to bradykinin has the potential to cause airway obstruction and asphyxia as well as severe gastrointestinal symptoms simulating an acute abdomen. Formation of bradykinin in plasma is a result of a complex interaction among proteins such as factor XII, prekallikrein, and high molecular weight kininogen (HK) resulting in HK cleavage and liberation of bradykinin. These proteins also assemble along the surface of endothelial cells via zinc-dependent interactions with gC1qR, cytokeratin 1, and u-PAR. Endothelial cell expression (or secretion) of heat-shock protein 90 or prolylcarboxypeptidase can activate the prekallikrein-HK complex to generate bradykinin in the absence of factor XII, however factor XII is then secondarily activated by the kallikrein that results. Bradykinin is destroyed by carboxypeptidase N and angiotensin-converting enzyme. The hypotension associated with IgE-dependent anaphylaxis maybe mediated, in part, by massive proteolytic digestion of HK by kallikreins (tissue or plasma-derived) or other cell-derived kininogenases. PMID:20519882

  4. Anaphylaxis

    MedlinePlus

    ... ins and viewers Order publications Related Links Allergic Diseases Environmental Allergies Food Allergy ​​​​​​ Javascript Error Your browser JavaScript is turned off causing certain features of the NIAID Institute of Allergy and Infectious Diseases web site to work incorrectly. Please visit your ...

  5. Satellite Television and Training for On-line Computer Searching.

    ERIC Educational Resources Information Center

    Simmons, Peter

    1979-01-01

    Describes an eight-week continuing education program which used the Canadian Communications Technology Satellite to provide interactive educational television in the teaching of online computer retrieval techniques to librarians in remote areas. (FM)

  6. A Security Framework for Online Distance Learning and Training.

    ERIC Educational Resources Information Center

    Furnell, S. M.; Onions, P. D.; Bleimann, U.; Gojny, U.; Knahl, M.; Roder, H. F.; Sanders, P. W.

    1998-01-01

    Presents a generic reference model for online distance learning and discusses security issues for each stage (enrollment, study, completion, termination, suspension). Discusses a security framework (authentication and accountability, access control, intrusion detection, network communications, nonrepudiation, learning resources provider…

  7. [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

  8. Anaphylaxis on reperfusion during liver transplantation with coagulopathy.

    PubMed

    Woehlck, Harvey J; Johnson, Christopher P; Roza, Allan M; Gottschall, Jerome L; Brumwell, Melanie; Cronin, David C

    2012-09-01

    We present a case in which anaphylaxis on hepatic reperfusion during liver transplantation presented only with hypotension and coagulopathy. There were no cutaneous manifestations or clinical features distinguishing anaphylaxis from postreperfusion syndrome. The recipient regularly consumed seafood, and the organ donor died of anaphylaxis to shellfish. The trigger for anaphylaxis was postulated to be passive transfer of immunoglobulin to the recipient. Anesthesiologists should be notified of donor factors to anticipate anaphylaxis. In this report, we discuss coagulopathy of anaphylaxis and contrast it with disseminated intravascular coagulation.

  9. EPA'S ON-LINE CALCULATORS AND TRAINING COURSE

    EPA Science Inventory

    EPA has developed a suite of on-line calculators called "OnSite" for assessing transport of environmental contaminants int the subsurface. The calculators are available on the Internet at http://www.epa.gov/athens/onsite, and are divided into four categories: Parameter Estimate...

  10. Using Online Delivery for Workplace Training in Healthcare

    ERIC Educational Resources Information Center

    Bryce, Elizabeth; Choi, Peter; Landstrom, Margaret; LoChang, Justin

    2008-01-01

    The potential impact of on-line learning in health care is significant. By providing access to educational material from an internet-connected computer anytime and anywhere, healthcare workers (HCWs), whose workload demands are often changing and somewhat unpredictable, have increased ability to self-educate. For example, the growing recognition…

  11. Developing and testing an online breastfeeding training among undergraduate nursing students

    PubMed Central

    Cianelli, Rosina; Villegas, Natalia; Azaiza, Khitam; Henderson, Shakira; Hooshmand, Mary; Peragallo, Nilda

    2016-01-01

    The benefits of breastfeeding for mothers and babies have been well documented in the scientific literature, with new evidence about the benefits continuing to emerge. The Surgeon General’s call to action to support breastfeeding recommends mandatory breastfeeding education and training for all healthcare providers that deliver care to mothers and babies. The purpose of this study is to analyze the development of an online computer based breastfeeding training (BT) and the preliminary outcomes of this training. The development of this training included consultation with content and technology experts. The collection of preliminary outcomes related to breastfeeding knowledge data and evaluation of the online BT was pre and posttest study. Eighty six undergraduate nursing students completed the online BT using Blackboard Learn. The online component of the BT consisted of five modules with a combined length of approximately 16 hours. After the completion of the modules, the students increased their levels of knowledge related to breastfeeding and the majority believed that they were fully able to perform skills to support breastfeeding. The results of this study indicate that a successful BT for nursing students can be effectively designed, which can in the future be disseminated to other healthcare providers and students. In addition, this online BT was cost-efficient and effective in improving students’ knowledge and skills to support breastfeeding.

  12. On-line Supervised Adaptive Training Using Radial Basis Function Networks.

    PubMed

    Luo, Wan; Billings, Steve A.; Fung, Chi F.

    1996-12-01

    A new recursive supervised training algorithm is derived for the radial basis neural network architecture. The new algorithm combines the procedures of on-line candidate regressor selection with the conventional Givens QR based recursive parameter estimator to provide efficient adaptive supervised network training. A new concise on-line correlation based performance monitoring scheme is also introduced as an auxiliary device to detect structural changes in temporal data processing applications. Practical and simulated examples are included to demonstrate the effectiveness of the new procedures. Copyright 1996 Elsevier Science Ltd.

  13. Developing Asthma-Friendly Childcare Centers with Online Training and Evaluation

    PubMed Central

    Nowakowski, Alexandra Catherine Hayes; Carretta, Henry Joseph; Pineda, Nicole; Dudley, Julie Kurlfink; Forrest, Jamie R.

    2016-01-01

    In 2011, the Florida Asthma Coalition (FAC) began offering its Asthma-Friendly Childcare Center (AFCC) training online. This course teaches childcare center employees the fundamentals of effective asthma management. It covers basic asthma physiology, ways to recognize asthma attacks, techniques to help children experiencing attacks, and strategies to create healthy environments for asthmatics. A team of health services researchers evaluated both years of the online training. Evaluators used a quasi-experimental design with pretest, posttest, and follow-up assessment. Questions measured knowledge gain and retention, user satisfaction, and implementation of management strategies. Over 650 people from nearly all 67 Florida counties took AFCC training online between 2011 and 2013. Test scores improved by a minimum of 11% points in all program years evaluated. Gains in both knowledge and confidence were substantial and highly significant across years. While individual trainees did forget some content on follow-up, they seemed to retain the specific messages most relevant for their own workplaces. Most trainees also planned to implement multiple management strategies recommended by the training. A large majority of participants rated the training as excellent on all quality metrics, including relevance of content and time efficiency of the online format. Nearly all respondents perceived the training as useful for both providing improved care and fulfilling licensure or certification requirements. Many participants also indicated that their centers would pursue formal certification as AFCCs via the program offered by FAC. The online AFCC course performed strongly in its first years, yielding both high participant satisfaction and substantial improvement in workplace asthma management activity. This training holds promise for introducing and improving multidimensional asthma management strategies at childcare facilities nationwide. PMID:27014676

  14. Developing Asthma-Friendly Childcare Centers with Online Training and Evaluation.

    PubMed

    Nowakowski, Alexandra Catherine Hayes; Carretta, Henry Joseph; Pineda, Nicole; Dudley, Julie Kurlfink; Forrest, Jamie R

    2016-01-01

    In 2011, the Florida Asthma Coalition (FAC) began offering its Asthma-Friendly Childcare Center (AFCC) training online. This course teaches childcare center employees the fundamentals of effective asthma management. It covers basic asthma physiology, ways to recognize asthma attacks, techniques to help children experiencing attacks, and strategies to create healthy environments for asthmatics. A team of health services researchers evaluated both years of the online training. Evaluators used a quasi-experimental design with pretest, posttest, and follow-up assessment. Questions measured knowledge gain and retention, user satisfaction, and implementation of management strategies. Over 650 people from nearly all 67 Florida counties took AFCC training online between 2011 and 2013. Test scores improved by a minimum of 11% points in all program years evaluated. Gains in both knowledge and confidence were substantial and highly significant across years. While individual trainees did forget some content on follow-up, they seemed to retain the specific messages most relevant for their own workplaces. Most trainees also planned to implement multiple management strategies recommended by the training. A large majority of participants rated the training as excellent on all quality metrics, including relevance of content and time efficiency of the online format. Nearly all respondents perceived the training as useful for both providing improved care and fulfilling licensure or certification requirements. Many participants also indicated that their centers would pursue formal certification as AFCCs via the program offered by FAC. The online AFCC course performed strongly in its first years, yielding both high participant satisfaction and substantial improvement in workplace asthma management activity. This training holds promise for introducing and improving multidimensional asthma management strategies at childcare facilities nationwide. PMID:27014676

  15. Teaching citizen science skills online: Implications for invasive species training programs

    USGS Publications Warehouse

    Newman, G.; Crall, A.; Laituri, M.; Graham, J.; Stohlgren, T.; Moore, J.C.; Kodrich, K.; Holfelder, K.A.

    2010-01-01

    Citizen science programs are emerging as an efficient way to increase data collection and help monitor invasive species. Effective invasive species monitoring requires rigid data quality assurances if expensive control efforts are to be guided by volunteer data. To achieve data quality, effective online training is needed to improve field skills and reach large numbers of remote sentinel volunteers critical to early detection and rapid response. The authors evaluated the effectiveness of online static and multimedia tutorials to teach citizen science volunteers (n = 54) how to identify invasive plants; establish monitoring plots; measure percent cover; and use Global Positioning System (GPS) units. Participants trained using static and multimedia tutorials provided less (p <.001) correct species identifications (63% and 67%) than did professionals (83%) across all species, but they did not differ (p =.125) between each other. However, their ability to identify conspicuous species was comparable to that of professionals. The variability in percent plant cover estimates between static (??10%) and multimedia (??13%) participants did not differ (p =.86 and.08, respectively) from those of professionals (??9%). Trained volunteers struggled with plot setup and GPS skills. Overall, the online approach used did not influence conferred field skills and abilities. Traditional or multimedia online training augmented with more rigorous, repeated, and hands-on, in-person training in specialized skills required for more difficult tasks will likely improve volunteer abilities, data quality, and overall program effectiveness. ?? Taylor & Francis Group, LLC.

  16. A trust-wide strategy for the management of anaphylaxis.

    PubMed

    Moor, Jackie; Jennison, Neil

    Anaphylaxis is a life-threatening medical emergency. Although it is uncommon, when it does occur prompt recognition and appropriate treatment are essential. This article describes how a multidisciplinary working party review of practices concerning the management of anaphylaxis in an acute hospital trust led to the introduction of standardised anaphylaxis emergency boxes.

  17. Evaluating an Online Cognitive Training Platform for Older Adults: User Experience and Implementation Requirements.

    PubMed

    Haesner, Marten; Steinert, Anika; O'Sullivan, Julie Lorraine; Weichenberger, Markus

    2015-08-01

    Decline of cognitive function is a part of aging. However, intensive cognitive training can improve important cognitive functions, such as attention and working memory. Because existing systems are not older adult-friendly and are usually not based on scientific evidence, an online platform was developed for cognitive training with information and communication features and evaluated in an 8-week field test. In a randomized clinical trial with 80 older adults, findings from log data analysis and questionnaires revealed a good use of the online platform. Communication or assistive features were not used often. Good usability ratings were given to the cognitive exercises. Subjective improvements of cognitive functions due to the training were reported. The current article presents concrete requirements and recommendations for deploying cognitive training software in older adult residential homes.

  18. Integration of Instructional Design Principles to Online Courses and Faculty Training in Three Puerto Rican Institutions of Higher Education

    ERIC Educational Resources Information Center

    Perez, Wanda W.

    2011-01-01

    Research on how the principles of instructional design are taught in faculty training courses for online teaching and how faculty members incorporate these principles into their online courses is limited. This gap in the research literature is especially pronounced when considering the relatively new online learning context of Puerto Rico's higher…

  19. Exercise-induced anaphylaxis and antileukotriene montelukast

    PubMed Central

    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

  20. 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

  1. 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

  2. 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.

  3. Professional Experiences of Online Teachers in Wisconsin: Results from a Survey about Training and Challenges. REL 2016-110

    ERIC Educational Resources Information Center

    Zweig, Jacqueline; Stafford, Erin; Clements, Margaret; Pazzaglia, Angela M.

    2015-01-01

    REL Midwest, in partnership with the Midwest Virtual Education Research Alliance, analyzed the results of a survey administered to Wisconsin Virtual School teachers about the training in which they participated related to online instruction, the challenges they encounter while teaching online, and the type of training they thought would help them…

  4. Incentive Styles, Asynchronous Online Discussion, and Vocational Training

    ERIC Educational Resources Information Center

    Lin, Shinyi; Chiu, Chou-Kang

    2008-01-01

    Vocational education and training (VET) is intended to prepare adult learners for careers that are based on practical activities. With the underlying constructivist andragogy, this study intended to examine the effects of computer-mediated group collaboration in vocational education, and how that affects the associated learning outcomes. For…

  5. Enabling SMEs to Deliver Synchronous Online Training--Practical Guidelines

    ERIC Educational Resources Information Center

    Taran, Carmen

    2006-01-01

    Purpose: While synchronous and asynchronous distance education options have fulfilled the promise to reduce travel costs and decrease the number of human resources necessary for training delivery, many corporations are faced with the need to produce learning even at a faster pace in order to gain and sustain competitive advantage. This means a…

  6. Investigating Real-Time Predictors of Engagement: Implications for Adaptive Video Games and Online Training

    ERIC Educational Resources Information Center

    Sharek, David J.

    2012-01-01

    Engagement is a worthwhile psychological construct to examine in the context of online training and video games. In this context, previous research suggests that the more engaged a person is, the more likely they are to experience overall positive affect while performing at a high level. This research builds on theories of engagement, Flow Theory,…

  7. Assess the Impact of an Online Tobacco Prevention Training Program on Teachers and Their Students

    ERIC Educational Resources Information Center

    Chen, W. William; Sheu, Jiunn-Jye; Weng, Chung-Bang

    2013-01-01

    School-based tobacco prevention programs have been proven effective in reducing tobacco use. This evaluation aimed to assess the impact of an online tobacco prevention teacher training program on teachers and their students in Florida schools. A total of 344 teachers, including 72 K-3 grade teachers, 44 4th-5th grade teachers, and 228 6th-12th…

  8. Does Powerful Language Training Affect Student Participation, Impression Formation, and Gender Communication in Online Discussions?

    ERIC Educational Resources Information Center

    Thomas, Crystal Ann

    2012-01-01

    The purpose of this dissertation was to investigate whether powerful language training affected student participation, impression formation, and gender communication style in online discussions. Powerful language was defined as a lack of the use of powerless language. Participants in this study were 507 freshmen taking a first-year college…

  9. Improved Processing Speed: Online Computer-Based Cognitive Training in Older Adults

    ERIC Educational Resources Information Center

    Simpson, Tamara; Camfield, David; Pipingas, Andrew; Macpherson, Helen; Stough, Con

    2012-01-01

    In an increasingly aging population, a number of adults are concerned about declines in their cognitive abilities. Online computer-based cognitive training programs have been proposed as an accessible means by which the elderly may improve their cognitive abilities; yet, more research is needed in order to assess the efficacy of these programs. In…

  10. The Effects of Online Feedback Training on Students' Text Revision

    ERIC Educational Resources Information Center

    Yang, Yu-Fen; Meng, Wen-Ting

    2013-01-01

    Oftentimes, college students who learn English as a Foreign Language (EFL) provide their peers with incorrect and misleading feedback during text revision. To improve the effectiveness of peer feedback, this study examined the degree to which online feedback training impacted EFL college students' text revisions. A sample of 50 college…

  11. All That Glitters Is Not Gold: Online Delivery of Education and Training. Review of Research.

    ERIC Educational Resources Information Center

    Brennan, Ros; McFadden, Mark; Law, Elizabeth

    This consolidation study concentrates on major questions about effectiveness of online delivery of education and training in Australia through the literature that describes effects of these new forms of delivery on the learner/user and provider/practitioner. Chapter 1 focuses on sources of data used in the literature review, defines online…

  12. A Preliminary Evaluation of Short Blended Online Training Workshop for TPACK Development Using Technology Acceptance Model

    ERIC Educational Resources Information Center

    Alsofyani, Mohammed Modeef; Aris, Baharuddin bin; Eynon, Rebecca; Majid, Norazman Abdul

    2012-01-01

    The use of Short Blended Online Training (SBOT) for the development of Technological Pedagogical and Content Knowledge (TPACK) is a promising approach to facilitate the use of e-learning by academics. Adult learners prefer the blend of pedagogies such as the presentation, demonstration, practice and feedback if they are structured and…

  13. Online Academic-Integrity Mastery Training May Improve Students' Awareness of, and Attitudes toward, Plagiarism

    ERIC Educational Resources Information Center

    Curtis, Guy J.; Gouldthorp, Bethanie; Thomas, Emma F.; O'Brien, Geraldine M.; Correia, Helen M.

    2013-01-01

    Some evidence has emerged in recent years that plagiarism can be reduced through the use of online mastery tests that are designed to train introductory psychology students in awareness of academic integrity and referencing conventions. Although these studies demonstrated a reduction in incidents of plagiarism they did not directly examine whether…

  14. Florida Public Health Training Center: Evidence-Based Online Mentor Program

    ERIC Educational Resources Information Center

    Frahm, Kathryn A.; Alsac-Seitz, Biray; Mescia, Nadine; Brown, Lisa M.; Hyer, Kathy; Liburd, Desiree; Rogoff, David P.; Troutman, Adewale

    2013-01-01

    This article describes an Online Mentor Program (OMP) designed to support and facilitate mentorships among and between Florida Department of Health (FDOH) employees and USF College of Public Health students using a Web-based portal. The Florida Public Health Training Center (FPHTC) at the University of South Florida (USF) College of Public Health…

  15. An Evaluation System for the Online Training Programs in Meteorology and Hydrology

    ERIC Educational Resources Information Center

    Wang, Yong; Zhi, Xiefei

    2009-01-01

    This paper studies the current evaluation system for the online training program in meteorology and hydrology. CIPP model that includes context evaluation, input evaluation, process evaluation and product evaluation differs from Kirkpatrick model including reactions evaluation, learning evaluation, transfer evaluation and results evaluation in…

  16. The Development and Validation of an Instrument to Evaluate Online Training Materials

    ERIC Educational Resources Information Center

    Conceicao, Simone C. O.; Strachota, Elaine; Schmidt, Steven W.

    2007-01-01

    The processes used when developing a survey instrument for research studies are equally as important when developing a survey for evaluation purposes. This paper presents the steps involved in the development and validation of a survey instrument that can be used to evaluate online training modules or instructional aids in both workplace and…

  17. Designing the Right Blend: Combining Online and Onsite Training for Optimal Results.

    ERIC Educational Resources Information Center

    Rowley, Kurt; Bunker, Ellen; Cole, David

    2002-01-01

    Describes two decisions in the development of effective blended instruction: selecting the instructional approach and selecting the development approach. Examines a successful training design and development case at a military continuing education college and analyzes it as an application of a blended onsite-online approach to human performance…

  18. Utilizing Online Training for Child Sexual Abuse Prevention: Benefits and Limitations

    ERIC Educational Resources Information Center

    Paranal, Rechelle; Thomas, Kiona Washington; Derrick, Christina

    2012-01-01

    The prevalence of child sexual abuse demands innovative approaches to prevent further victimization. The online environment provides new opportunities to expand existing child sexual abuse prevention trainings that target adult gatekeepers and allow for large scale interventions that are fiscally viable. This article discusses the benefits and…

  19. Teaching Citizen Science Skills Online: Implications for Invasive Species Training Programs

    ERIC Educational Resources Information Center

    Newman, Greg; Crall, Alycia; Laituri, Melinda; Graham, Jim; Stohlgren, Tom; Moore, John C.; Kodrich, Kris; Holfelder, Kirstin A.

    2010-01-01

    Citizen science programs are emerging as an efficient way to increase data collection and help monitor invasive species. Effective invasive species monitoring requires rigid data quality assurances if expensive control efforts are to be guided by volunteer data. To achieve data quality, effective online training is needed to improve field skills…

  20. 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

  1. 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

  2. A Comparative Study of Classroom and Online Distance Modes of Official Vocational Education and Training

    PubMed Central

    López Soblechero, Miguel Vicente; González Gaya, Cristina; Hernández Ramírez, Juan José

    2014-01-01

    The study discussed in this paper had two principal objectives. The first was to evaluate the distance model of official vocational education and training offered by means of a virtual learning platform. The second was to establish that both on-site classroom and online distance modes of vocational education and training can be seen as complementary in terms of responding to the majority of modern educational needs. We performed a comparative study using data and results gathered over the course of eleven academic years for 1,133 of our students enrolled in an official vocational education and training program, leading to the awarding of a certificate as an Administrative Management Expert. The classes were offered by the Alfonso de Avellaneda Vocational Education and Training School, located in the city of Alcalá de Henares near Madrid, Spain. We offered classes both in traditional classroom mode and through online distance learning. This paper begins with a descriptive analysis of the variables we studied; inferential statistical techniques are subsequently applied in order to study the relationships that help form the basis for the conclusions reached. This study’s results provide evidence that a broad offering of vocational education and training opportunities will facilitate access to such learning for students who require it, regardless of their age, employment status, or personal circumstances, with the online distance mode playing a fundamental role while also yielding results equivalent to those observed for classroom instruction. PMID:24788543

  3. A comparative study of classroom and online distance modes of official vocational education and training.

    PubMed

    López Soblechero, Miguel Vicente; González Gaya, Cristina; Hernández Ramírez, Juan José

    2014-01-01

    The study discussed in this paper had two principal objectives. The first was to evaluate the distance model of official vocational education and training offered by means of a virtual learning platform. The second was to establish that both on-site classroom and online distance modes of vocational education and training can be seen as complementary in terms of responding to the majority of modern educational needs. We performed a comparative study using data and results gathered over the course of eleven academic years for 1,133 of our students enrolled in an official vocational education and training program, leading to the awarding of a certificate as an Administrative Management Expert. The classes were offered by the Alfonso de Avellaneda Vocational Education and Training School, located in the city of Alcalá de Henares near Madrid, Spain. We offered classes both in traditional classroom mode and through online distance learning. This paper begins with a descriptive analysis of the variables we studied; inferential statistical techniques are subsequently applied in order to study the relationships that help form the basis for the conclusions reached. This study's results provide evidence that a broad offering of vocational education and training opportunities will facilitate access to such learning for students who require it, regardless of their age, employment status, or personal circumstances, with the online distance mode playing a fundamental role while also yielding results equivalent to those observed for classroom instruction. PMID:24788543

  4. The development of a TED-Ed online resident research training program

    PubMed Central

    Moreau, Katherine A.; Pound, Catherine M.; Peddle, Beth; Tokarewicz, Jaclyn; Eady, Kaylee

    2014-01-01

    Background Pediatric health research is important for improving the health and well-being of children and their families. To foster the development of physicians’ research competencies, it is vital to integrate practical and context-specific research training into residency programs. Purpose To describe the development of a resident research training program at one tertiary care pediatric academic health sciences center in Ontario, Canada. Methods We surveyed residents and pediatricians/research staff to establish the need and content for a resident research training program. Results Residents and resident research supervisors agreed or strongly agreed that research training is important for residents. However, few residents and supervisors believed that their academic health sciences center provided adequate training and resources to support resident research. As such, an online resident research training program was established. Residents and supervisors agreed that the program should focus on the following topics: 1) critically evaluating research literature, 2) writing a research proposal, 3) submitting an application for research funding, and 4) writing a manuscript. Discussion This highly accessible, context-specific, and inexpensive online program model may be of interest and benefit to other residency programs as a means to enhance residents’ scholarly roles. A formal evaluation of the research training program is now underway. PMID:25526717

  5. 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…

  6. 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

  7. Clinical Effectiveness of Online Training in Palliative Care of Primary Care Physicians

    PubMed Central

    Perez-Hoyos, Santiago; Agra-Varela, Yolanda

    2013-01-01

    Abstract Background Primary care physicians (PCPs) have a major responsibility in the management of palliative patients. Online palliative care (PC) education has not been shown to have a clinical impact on patients that is equal or different to traditional training. Objective This study tested the clinical effectiveness of online PC education of physicians through impact on symptom control, quality of life (QOL), caregiver satisfaction, and knowledge-attitude of physicians at 18 months of the intervention. Methods We conducted a randomized clinical trial. Subjects were 169 physicians randomly assigned to receive the online model or traditional training. Consecutive patients with advanced cancer requiring PC were included. Physicians and patients completed the Palliative Care Outcome Scale (POS), and patients the Brief Pain Inventory (BPI) and the Rotterdam Symptom Checklist (RSCL) twice, 7 to 10 days apart. Caregivers completed the SERVQUAL. Physicians' level of knowledge-attitude was measured at 18 months. Results Sixty-seven physicians enrolled 117 patients. The intervention group had reduced scores for pain, symptoms, and family anxiety. The global RSCL scale showed a difference between groups. There was no significant difference in the questionnaires used. Caregiver satisfaction was comparable between groups. Physicians in the intervention group significantly increased their knowledge without any differences in attitude. Online training was completed by 86.6% in the intervention group, whereas 13.4% in the control group accessed traditional training. Conclusions Participation in an online PC education program by PCPs improved patient scores for some symptoms and family anxiety on the POS and also showed improved global QOL. Significant differences were found in physicians' knowledge at short and long term. PMID:23987657

  8. Online games training aging brains: limited transfer to cognitive control functions.

    PubMed

    van Muijden, Jesse; Band, Guido P H; Hommel, Bernhard

    2012-01-01

    The prevalence of age-related cognitive decline will increase due to graying of the global population. The goal of the present study was to test whether playing online cognitive training games can improve cognitive control (CC) in healthy older adults. Fifty-four older adults (age 60-77) played five different cognitive training games online for 30 min a day over a period of seven weeks (game group). Another group of 20 older adults (age 61-73) instead answered quiz questions about documentaries online (documentary group). Transfer was assessed by means of a cognitive test battery administered before and after the intervention. The test battery included measures of working memory updating, set shifting, response inhibition, attention, and inductive reasoning. Compared with the documentary group, the game group showed larger improvement of inhibition (Stop-Signal task) and inductive reasoning (Raven-SPM), whereas the documentary group showed more improvement in selective attention (UFoV-3). These effects qualify as transfer effects, because response inhibition, inductive reasoning and selective attention were not targeted by the interventions. However, because seven other indicators of CC did not show benefits of game training and some of those that did suffered from potential baseline differences, the study as a whole provides only modest support for the potential of videogame training to improve CC in healthy older adults. PMID:22912609

  9. Online games training aging brains: limited transfer to cognitive control functions

    PubMed Central

    van Muijden, Jesse; Band, Guido P. H.; Hommel, Bernhard

    2011-01-01

    The prevalence of age-related cognitive decline will increase due to graying of the global population. The goal of the present study was to test whether playing online cognitive training games can improve cognitive control (CC) in healthy older adults. Fifty-four older adults (age 60–77) played five different cognitive training games online for 30 min a day over a period of seven weeks (game group). Another group of 20 older adults (age 61–73) instead answered quiz questions about documentaries online (documentary group). Transfer was assessed by means of a cognitive test battery administered before and after the intervention. The test battery included measures of working memory updating, set shifting, response inhibition, attention, and inductive reasoning. Compared with the documentary group, the game group showed larger improvement of inhibition (Stop-Signal task) and inductive reasoning (Raven-SPM), whereas the documentary group showed more improvement in selective attention (UFoV-3). These effects qualify as transfer effects, because response inhibition, inductive reasoning and selective attention were not targeted by the interventions. However, because seven other indicators of CC did not show benefits of game training and some of those that did suffered from potential baseline differences, the study as a whole provides only modest support for the potential of videogame training to improve CC in healthy older adults. PMID:22912609

  10. 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

  11. Enhancing Cognitive Abilities with Comprehensive Training: A Large, Online, Randomized, Active-Controlled Trial

    PubMed Central

    Hardy, Joseph L.; Nelson, Rolf A.; Thomason, Moriah E.; Sternberg, Daniel A.; Katovich, Kiefer; Farzin, Faraz; Scanlon, Michael

    2015-01-01

    Background A variety of studies have demonstrated gains in cognitive ability following cognitive training interventions. However, other studies have not shown such gains, and questions remain regarding the efficacy of specific cognitive training interventions. Cognitive training research often involves programs made up of just one or a few exercises, targeting limited and specific cognitive endpoints. In addition, cognitive training studies typically involve small samples that may be insufficient for reliable measurement of change. Other studies have utilized training periods that were too short to generate reliable gains in cognitive performance. Methods The present study evaluated an online cognitive training program comprised of 49 exercises targeting a variety of cognitive capacities. The cognitive training program was compared to an active control condition in which participants completed crossword puzzles. All participants were recruited, trained, and tested online (N = 4,715 fully evaluable participants). Participants in both groups were instructed to complete one approximately 15-minute session at least 5 days per week for 10 weeks. Results Participants randomly assigned to the treatment group improved significantly more on the primary outcome measure, an aggregate measure of neuropsychological performance, than did the active control group (Cohen’s d effect size = 0.255; 95% confidence interval = [0.198, 0.312]). Treatment participants showed greater improvements than controls on speed of processing, short-term memory, working memory, problem solving, and fluid reasoning assessments. Participants in the treatment group also showed greater improvements on self-reported measures of cognitive functioning, particularly on those items related to concentration compared to the control group (Cohen’s d = 0.249; 95% confidence interval = [0.191, 0.306]). Conclusion Taken together, these results indicate that a varied training program composed of a number of

  12. About the role and underlying mechanisms of cofactors in anaphylaxis.

    PubMed

    Wölbing, F; Fischer, J; Köberle, M; Kaesler, S; Biedermann, T

    2013-09-01

    Anaphylaxis is the systemic and most severe presentation of type I allergy. A number of conditions were identified that modulate the onset of anaphylaxis such as co- or augmentation factors, which significantly lower the allergen dose necessary for triggering anaphylaxis. Next to physical exercise or alcohol consumption, co-administration of nonsteroidal anti-inflammatory drugs (NSAID) or concomitant infectious diseases are well-documented cofactors of anaphylaxis. Registries for anaphylaxis document a role for cofactors in about 30% of anaphylactic reactions. Some disease entities such as 'wheat-dependent exercise-induced anaphylaxis' (WDEIA) are explicitly characterized by elicitation of anaphylaxis only in the presence of at least one such cofactor. Using WDEIA as a model disease, studies demonstrated that exercise increases skin prick test reactivity to and bioavailability of the allergen. Additional data indicate that alcohol consumption and NSAID administration display similar effects. Modulation of the cellular activation threshold is another mechanism underlying cofactor-induced anaphylaxis, most likely also functional when infectious diseases orchestrate elicitation of anaphylaxis. Cofactors are increasingly accepted to play a fundamental role in eliciting anaphylaxis. Consequently, to improve patient management modalities, a better understanding of the underlying mechanisms is warranted. This review aims to update clinicians and clinical scientists on recent developments.

  13. 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

  14. 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.

  15. Engaging clinicians in motivational interviewing: Comparing online with face-to-face post-training consolidation.

    PubMed

    Clancy, Richard; Taylor, Andrew

    2016-02-01

    Motivational interviewing (MI) is an evidence-based intervention that has been widely recommended in clinical settings where consumer behaviour change is a goal of treatment. Training clinicians in MI, as with other translational endeavours, does not always result in changes to clinical practice. The present study compares two post-training approaches to consolidate MI skills following a training workshop. We randomly assigned 63 clinicians working in mental health or drug and alcohol services to receive either face-to-face group consolidation sessions or to access a series of online consolidation resources. We compared clinician engagement and devised a new instrument to measure clinician outcomes. Participants who completed follow-up consolidation retained knowledge, attitudes, and practices, regardless of consolidation method. Face-to-face consolidation sessions were superior to online materials in engaging participants (mean sessions attended was 2.1 (maximum possible = 3) compared to a mean of 1.38 sessions, respectively (t(61) = -2.73, P = 0.008, d = 0.72, 95% confidence interval: 0.19-1.25). Engagement to the completion of consolidation sessions was also influenced by previous training in MI. For every additional hour of previous MI training, there was a 10% increase in the odds that the participant would complete the final consolidation session. PMID:26767548

  16. Engaging clinicians in motivational interviewing: Comparing online with face-to-face post-training consolidation.

    PubMed

    Clancy, Richard; Taylor, Andrew

    2016-02-01

    Motivational interviewing (MI) is an evidence-based intervention that has been widely recommended in clinical settings where consumer behaviour change is a goal of treatment. Training clinicians in MI, as with other translational endeavours, does not always result in changes to clinical practice. The present study compares two post-training approaches to consolidate MI skills following a training workshop. We randomly assigned 63 clinicians working in mental health or drug and alcohol services to receive either face-to-face group consolidation sessions or to access a series of online consolidation resources. We compared clinician engagement and devised a new instrument to measure clinician outcomes. Participants who completed follow-up consolidation retained knowledge, attitudes, and practices, regardless of consolidation method. Face-to-face consolidation sessions were superior to online materials in engaging participants (mean sessions attended was 2.1 (maximum possible = 3) compared to a mean of 1.38 sessions, respectively (t(61) = -2.73, P = 0.008, d = 0.72, 95% confidence interval: 0.19-1.25). Engagement to the completion of consolidation sessions was also influenced by previous training in MI. For every additional hour of previous MI training, there was a 10% increase in the odds that the participant would complete the final consolidation session.

  17. Training in outbreak investigation through use of an online discussion group.

    PubMed

    Stehr-Green, Jeanette; Gathany, Nancy

    2005-11-01

    Distance learning has been found to be effective for continuing public health training. The authors undertook a six-week pilot to teach skills in outbreak investigation through the combination of a self-instructional, interactive, computer-based case study and online discussions led by two instructors. Participants were public health practitioners with knowledge of basic epidemiology and public health. Eighteen public health practitioners participated. Overall, participants posted 113 messages to the online discussions, with a median of 5.5 messages per participant (range: 0-16). The number of postings was higher for participants who had taken part in an outbreak investigation before the pilot test than for those who had not. In general, participants enjoyed the experience and believed that the online discussions added value to the self-instructional case study. The authors conclude that the combination of the case study and the online discussions was a positive learning experience. They encourage others to consider this format for training. PMID:16334092

  18. Anaphylaxis related to avocado ingestion: a case and review

    PubMed Central

    2011-01-01

    Anaphylaxis to avocado, independent of latex sensitization, has been rarely reported in the literature. This case report describes a 15 year old male who experienced anaphylaxis within half an hour after eating avocado-containing food. Avocado consumption is common in both North America and South America. It is important to consider avocado as a cause of anaphylaxis, even in patients not sensitized to latex. PMID:21663642

  19. Anaphylaxis/angioedema caused by honey ingestion.

    PubMed

    Vezir, Emine; Kaya, Ayşenur; Toyran, Müge; Azkur, Dilek; Dibek Mısırlıoğlu, Emine; Kocabaş, Can Naci

    2014-01-01

    Honey allergy is a very rare, but serious health condition. In this study, we presented six patients who described systemic allergic reactions after ingestion of honey. Three of the six patients had suffered from anaphylaxis. Honey-specific IgE was measured and skin-prick tests for honey were performed to diagnose honey allergy. The results of honey-specific IgE of all patients were positive. Four patients had high serum-specific IgE for honey bee venom and two of five patients had also experienced anaphylaxis due to bee stings. Skin-prick tests with honey and pollens were positive in five patients. Honey is one of the foods that can cause severe systemic reactions. Specific IgE and skin-prick tests are helpful for the diagnosis of honey allergy.

  20. 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

  1. 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

  2. A Case Study of Online Learners Participating in the Oregon State University Extension Service Master Gardener Training Program.

    ERIC Educational Resources Information Center

    Rost, Bob; VanDerZanden, Ann Marie

    2002-01-01

    Learners (n=17) in the Oregon State University Extension Service's Master Gardner training program used traditional modules; 21 used an online version. Both groups performed similarly. There were correlations between experience and online course satisfaction and between convenience and satisfaction. (Contains 10 references.) (Author/JOW)

  3. Learning the Discourse of Quality Assurance: A Case of Workplace Learning in Online In-Service Training

    ERIC Educational Resources Information Center

    Lundin, Mona; Lundin, Johan

    2016-01-01

    Purpose: In this study, online in-service training for people employed in the food production industry is scrutinized. The purpose of this study is to analyse how the participants adapt to such online environments in terms of the kind of discussions they establish. The more specific interest relates to how the participants discuss current work…

  4. 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

  5. [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

  6. 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

  7. [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.

  8. 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

  9. Assessment of a Prototype Internet and Online Information System Training Program for Adjunct Personnel Removed from Campus-Based Training Resources. Report No. 97-02.

    ERIC Educational Resources Information Center

    MacFarland, Thomas W.

    This report describes a prototype training program developed at Nova Southeastern University, Florida, to provide technology training to adjunct faculty, which comprises 60 percent of the university's faculty. The program relies mainly on self-paced instruction on the use of online information systems and Internet tools, and was structured so that…

  10. Temporal Pattern of Online Communication Spike Trains in Spreading a Scientific Rumor: How Often, Who Interacts with Whom?

    NASA Astrophysics Data System (ADS)

    Sanli, Ceyda; Lambiotte, Renaud

    2015-09-01

    We study complex time series (spike trains) of online user communication while spreading messages about the discovery of the Higgs boson in Twitter. We focus on online social interactions among users such as retweet, mention, and reply, and construct different types of active (performing an action) and passive (receiving an action) spike trains for each user. The spike trains are analyzed by means of local variation, to quantify the temporal behavior of active and passive users, as a function of their activity and popularity. We show that the active spike trains are bursty, independently of their activation frequency. For passive spike trains, in contrast, the local variation of popular users presents uncorrelated (Poisson random) dynamics. We further characterize the correlations of the local variation in different interactions. We obtain high values of correlation, and thus consistent temporal behavior, between retweets and mentions, but only for popular users, indicating that creating online attention suggests an alignment in the dynamics of the two interactions.

  11. Online video-based resistance training improves the physical capacity of junior basketball athletes.

    PubMed

    Klusemann, Markus J; Pyne, David B; Fay, Tristan S; Drinkwater, Eric J

    2012-10-01

    Junior basketball athletes require a well-designed resistance training program to improve their physical development. Lack of expert supervision and resistance training in junior development pathways may be overcome by implementing an online video-based program. The aim of this study was to compare the magnitude of improvement (change) in physical performance and strength and functional movement patterns of junior basketball athletes using either a fully supervised or an online video-based resistance training program. Thirty-eight junior basketball athletes (males, n = 17; age, 14 ± 1 year; height, 1.79 ± 0.10 m; mass, 67 ± 12 kg; females, n = 21; age, 15 ± 1 year; height, 1.70 ± 0.07 m; mass, 62 ± 8 kg) were randomly assigned into a supervised resistance training group (SG, n = 13), video training group (VG, n = 13) or control group (CG, n = 12) and participated in a 6-week controlled experimental trial. Pre- and posttesting included measures of physical performance (20-m sprint, step-in vertical jump, agility, sit and reach, line drill, and Yo-Yo intermittent recovery level 1), strength (15 s push-up and pull-up), and functional movement screening (FMS). Both SG and VG achieved 3-5% ± 2-4% (mean ± 90% confidence limits) greater improvements in several physical performance measures (vertical jump height, 20-m sprint time, and Yo-Yo endurance performance) and a 28 ± 21% greater improvement in push-up strength compared with the CG. The SG attained substantially larger gains in FMS scores over both the VG (12 ± 10%) and CG (13 ± 8%). Video-based training appears to be a viable option to improve physical performance and strength in junior basketball athletes. Qualified supervision is recommended to improve functional movement patterns in junior athletes.

  12. Objective functions of online weight noise injection training algorithms for MLPs.

    PubMed

    Ho, Kevin; Leung, Chi-Sing; Sum, John

    2011-02-01

    Injecting weight noise during training has been a simple strategy to improve the fault tolerance of multilayer perceptrons (MLPs) for almost two decades, and several online training algorithms have been proposed in this regard. However, there are some misconceptions about the objective functions being minimized by these algorithms. Some existing results misinterpret that the prediction error of a trained MLP affected by weight noise is equivalent to the objective function of a weight noise injection algorithm. In this brief, we would like to clarify these misconceptions. Two weight noise injection scenarios will be considered: one is based on additive weight noise injection and the other is based on multiplicative weight noise injection. To avoid the misconceptions, we use their mean updating equations to analyze the objective functions. For injecting additive weight noise during training, we show that the true objective function is identical to the prediction error of a faulty MLP whose weights are affected by additive weight noise. It consists of the conventional mean square error and a smoothing regularizer. For injecting multiplicative weight noise during training, we show that the objective function is different from the prediction error of a faulty MLP whose weights are affected by multiplicative weight noise. With our results, some existing misconceptions regarding MLP training with weight noise injection can now be resolved. PMID:21189237

  13. Is Online Learning a Viable Training Option for Teaching Sexual Assault Forensic Examiners?

    PubMed

    Patterson, Debra; Resko, Stella M

    2015-01-01

    This study assessed knowledge attainment of healthcare professionals who participated in a nationwide sexual assault forensic examiner training program developed by the International Association of Forensic Nursing. A comprehensive curriculum was divided into 12 modules that students accessed through an online learning management system. Using a one-group pretest-posttest design, we assessed students' knowledge attainment for all 12 online modules. The results showed that the mean posttest scores were significantly greater than the mean pretest scores for all 12 online modules. On over 40% of the modules, the students exhibited at least a 25% knowledge gain. This study also examined the predictors of knowledge attainment. Using a multiple linear regression model, we found that knowledge attainment was positively associated with a reliable Internet connection, students who were drawn to the training because it was of no cost to them, and those students with higher levels of motivation. By contrast, lower knowledge gains were significantly related to students who reported more work/personal barriers and those who were drawn to sexual assault forensic examiner practice because they, or someone close to them, have personal experience with sexual assault.

  14. Evaluating an Online Resourcefulness Training Intervention Pilot Test Using Six Critical Parameters.

    PubMed

    Musil, Carol M; Zauszniewski, Jaclene A; Burant, Christopher J; Toly, Valerie B; Warner, Camille B

    2015-12-01

    Few resources are available to help grandmother caregivers to grandchildren manage their complex family situations that may have immediate and long-term consequences for themselves and their families. Resourcefulness training is an intervention designed to help grandmothers improve their ability to deal with these problems. The purpose of this pilot study was to evaluate the necessity, feasibility, acceptability, fidelity, safety, and effectiveness (i.e., effect sizes) of an online, computer-based resourcefulness training intervention that was adapted from a face-to-face intervention. Twelve grandmothers raising or living with grandchildren participated in the pilot intervention that included (a) watching an instructional video on resourcefulness, (b) completing two online questionnaires over a 6-week time period, and (c) writing in an online journal every day for 4 weeks. Data are evaluated within the context of the six parameters important to intervention development. Qualitative and quantitative results provide initial support for all six parameters. Recommendations to improve aspects of the intervention are discussed. PMID:26738997

  15. A Theoretical Model and Analysis of the Effect of Self-Regulation on Attrition from Voluntary Online Training

    ERIC Educational Resources Information Center

    Sitzmann, Traci

    2012-01-01

    A theoretical model is presented that examines self-regulatory processes and trainee characteristics as predictors of attrition from voluntary online training in order to determine who is at risk of dropping out and the processes that occur during training that determine when they are at risk of dropping out. Attrition increased following declines…

  16. Measuring the Effects of an On-Line Training Module for School Psychologists Working with Traumatized Children: A Pilot Study

    ERIC Educational Resources Information Center

    Dezen, Kristin

    2012-01-01

    The present study was designed to address the current lack of trauma training provided to school psychologists. Specifically, this study employed a randomized, controlled design to test the efficacy of an on-line training targeting school psychology graduate student trainees' awareness of the signs and symptoms of child abuse as well as their…

  17. Corporate Sector Practice Informs Online Workforce Training for Australian Government Agencies: Towards Effective Educational-Learning Systems Design

    ERIC Educational Resources Information Center

    McKay, Elspeth; Vilela, Cenie

    2011-01-01

    The purpose of this paper is to outline government online training practice. We searched individual research domains of the human-dimensions of Human Computer Interaction (HCI), information and communications technologies (ICT) and instructional design for evidence of either corporate sector or government training practices. We overlapped these…

  18. Pathogenesis, newly recognized etiologies, and management of idiopathic anaphylaxis.

    PubMed

    Kuhlen, James L; Virkud, Yamini V

    2015-02-01

    Idiopathic anaphylaxis (IA) is a life-threatening allergic disease and the most common diagnosis given to patients following an anaphylactic event. The inability of the healthcare provider and the patient to identify the trigger for anaphylaxis makes standard allergen avoidance measures ineffectual. IA is diagnosed after other causes of anaphylaxis have been excluded. Mast cell activation syndromes (MCAS), mastocytosis, IgE to galactose-alpha-1,3-galactose (α-gal), and certain medications have recently been recognized as causes of anaphylaxis that were previously labeled idiopathic. This review will describe the epidemiology and proposed theories of pathogenesis for IA, its diagnostic approach, its clinical management, and examine newly recognized disorders that were previously labeled as idiopathic anaphylaxis.

  19. 3D Online Visualization and Synergy of NASA A-Train Data Using Google Earth

    NASA Technical Reports Server (NTRS)

    Chen, Aijun; Kempler, Steven; Leptoukh, Gregory; Smith, Peter

    2010-01-01

    This poster presentation reviews the use of Google Earth to assist in three dimensional online visualization of NASA Earth science and geospatial data. The NASA A-Train satellite constellation is a succession of seven sun-synchronous orbit satellites: (1) OCO-2 (Orbiting Carbon Observatory) (will launch in Feb. 2013), (2) GCOM-W1 (Global Change Observation Mission), (3) Aqua, (4) CloudSat, (5) CALIPSO (Cloud-Aerosol Lidar & Infrared Pathfinder Satellite Observations), (6) Glory, (7) Aura. The A-Train makes possible synergy of information from multiple resources, so more information about earth condition is obtained from the combined observations than would be possible from the sum of the observations taken independently

  20. A case of anaphylaxis to peppermint

    PubMed Central

    2014-01-01

    Background Anaphylaxis, a form of IgE mediated hypersensitivity, arises when mast cells and possibly basophils are provoked to secrete mediators with potent vasoactive and smooth muscle contractile activities that evoke a systemic response. We report a case of IgE mediated anaphylaxis to peppermint (Mentha piperita) in a male shortly after sucking on a candy. Case presentation A 69 year old male developed sudden onset of lip and tongue swelling, throat tightness and shortness of breath within five minutes of sucking on a peppermint candy. He denied lightheadedness, weakness, nausea, vomiting, or urticaria. He took 25 mg of diphenhydramine, but his symptoms progressed to onset of cough, wheeze and difficulty with talking and swallowing. He was rushed to the nearest emergency department, where he was treated with intramuscular epinephrine, antihistamines and steroids. On history, he reported recent onset of mouth itchiness and mild tongue and lip swelling after using Colgate peppermint toothpaste. He denied previous history of asthma, allergic rhinitis, food or drug allergies. His past medical history was remarkable for hypercholesterolemia, gastroesophageal reflux and gout. He was on simvastatin, omeprazole, aspirin, and was carrying a self-injectable epinephrine device. He moved to current residence three years ago and cultivated mint plants in his backyard. He admitted to develop nasal congestion, cough and wheeze when gardening. Physical examination was unremarkable apart from slightly swollen pale inferior turbinates. Skin prick test (SPT) was strongly positive to a slurry of peppermint candy and fresh peppermint leaf, with appropriate controls. Same tests performed on five healthy volunteers yielded negative results. Skin testing to common inhalants including molds and main allergenic foods was positive to dust mites. Strict avoidance of mint containing items was advised. Upon reassessment, he had removed mint plants from his garden which led to resolution of

  1. 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.

  2. 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

  3. 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

  4. Food-induced anaphylaxis: who, what, why, and where?

    PubMed

    Shah, Ekta; Pongracic, Jacqueline

    2008-08-01

    Food-induced anaphylaxis is a leading cause of anaphylaxis treated in emergency departments and hospitals around the world. Peanuts, tree nuts, fish, and shellfish are the most commonly implicated foods. Food-induced anaphylaxis may occur in any age group and with any food. However, food-induced anaphylaxis fatalities disproportionately affect adolescents and young adults with peanut and tree nut allergy. Individuals who have both IgE-mediated food allergy and asthma are at a higher risk for food-induced anaphylaxis fatality. Delayed administration of epinephrine is also associated with fatal outcome. Often, in fatal reactions, the food allergen is unknowingly ingested away from home, in settings such as restaurants and schools. Although avoidance of food allergens is critical, timely administration of epinephrine is also of great importance in the treatment of food-induced anaphylaxis. Patients, families, and caregivers must be well educated regarding the signs, symptoms and risk factors for anaphylaxis. They must also be counseled on the importance of strict food avoidance of the implicated food allergens, compliance with having self-injectable epinephrine available at all times, and the importance of timely administration of epinephrine, even when cutaneous symptoms are lacking.

  5. Development of online conferencing and web-based in-service modules for preceptor training.

    PubMed

    Conway-Klaassen, Janice M; Brennecke, Patricia J; Wiesner, Stephen M; Spannaus-Martin, Donna J

    2012-01-01

    Over the past five years our clinical laboratory sciences (CLS) program more than doubled student enrollment to help address the workforce shortages in our state. At the same time, medical laboratory technician programs were also increasing enrollment, putting significant pressure on the already limited number of clinical training spaces. To help alleviate the impact on clinical sites, major changes were made to the traditional clinical rotation model; shifting from a clinical training to a clinical experience and a simultaneous decrease in length from 22 to 12 weeks. This change required extensive in-service training for clinical preceptors including rationale for the new clinical experience model, review of student campus education, expectations for preceptors and students, as well as developing and implementing new evaluation methods of student performance. Through funding from the Department of Labor, online interactive modules introducing the concepts of new clinical experience module for both preceptors and for students were developed. To provide a more in-depth and specific in-service for the preceptors, web-conferences were held to describe the students' didactic and laboratory educational background and to discuss the expectations and evaluations of students. Two course management system sites were developed, one for preceptors and one for students, so they could access clinical experience information and materials at any time and from any location. These course sites also allowed us to convert evaluation processes to an online format. Survey feedback from preceptors indicates that this system was well received providing a cost-effective method for preceptor education and communication.

  6. Development of online conferencing and web-based in-service modules for preceptor training.

    PubMed

    Conway-Klaassen, Janice M; Brennecke, Patricia J; Wiesner, Stephen M; Spannaus-Martin, Donna J

    2012-01-01

    Over the past five years our clinical laboratory sciences (CLS) program more than doubled student enrollment to help address the workforce shortages in our state. At the same time, medical laboratory technician programs were also increasing enrollment, putting significant pressure on the already limited number of clinical training spaces. To help alleviate the impact on clinical sites, major changes were made to the traditional clinical rotation model; shifting from a clinical training to a clinical experience and a simultaneous decrease in length from 22 to 12 weeks. This change required extensive in-service training for clinical preceptors including rationale for the new clinical experience model, review of student campus education, expectations for preceptors and students, as well as developing and implementing new evaluation methods of student performance. Through funding from the Department of Labor, online interactive modules introducing the concepts of new clinical experience module for both preceptors and for students were developed. To provide a more in-depth and specific in-service for the preceptors, web-conferences were held to describe the students' didactic and laboratory educational background and to discuss the expectations and evaluations of students. Two course management system sites were developed, one for preceptors and one for students, so they could access clinical experience information and materials at any time and from any location. These course sites also allowed us to convert evaluation processes to an online format. Survey feedback from preceptors indicates that this system was well received providing a cost-effective method for preceptor education and communication. PMID:23397882

  7. 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

  8. 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.

  9. Quandaries in prescribing an emergency action plan and self-injectable epinephrine for first-aid management of anaphylaxis in the community.

    PubMed

    Sicherer, Scott H; Simons, F Estelle R

    2005-03-01

    Anaphylaxis often occurs in the community in the absence of a health care professional. Prompt administration of self-injectable epinephrine as first-aid treatment in the context of a personalized emergency action plan is the key to survival. There is little argument that physicians should prescribe self-injectable epinephrine for individuals who have already experienced anaphylaxis involving respiratory distress or shock triggered by allergens that might be encountered in the community. A quandary faced by physicians is that additional individuals with identified allergy who have no recognized prior history of anaphylaxis or who have a history of mild symptoms after exposure to a known trigger might also be at risk for subsequent life-threatening anaphylaxis and might also warrant prescription of self-injectable epinephrine. Prescribing for the latter individuals requires considerable clinical judgment and has led to controversy regarding possible overprescription or underprescription of self-injectable epinephrine. A second quandary for physicians occurs with regard to the advice they should give to at-risk individuals about actual use of their self-injectable epinephrine. It is difficult for health care professionals, let alone persons with no health care training, to predict whether anaphylaxis symptoms will occur in an at-risk individual after exposure to a known trigger. Moreover, at the onset of an acute allergic reaction, it is difficult to predict the symptoms that will ultimately develop. We examine these 2 common quandaries and provide examples of clinical scenarios and potential pitfalls in the management of persons identified as being at risk for anaphylaxis in the community. Additional studies of the recognition and treatment of anaphylaxis in the community are needed to develop comprehensive, evidence-based recommendations for its management in this setting.

  10. Online human training of a myoelectric prosthesis controller via actor-critic reinforcement learning.

    PubMed

    Pilarski, Patrick M; Dawson, Michael R; Degris, Thomas; Fahimi, Farbod; Carey, Jason P; Sutton, Richard S

    2011-01-01

    As a contribution toward the goal of adaptable, intelligent artificial limbs, this work introduces a continuous actor-critic reinforcement learning method for optimizing the control of multi-function myoelectric devices. Using a simulated upper-arm robotic prosthesis, we demonstrate how it is possible to derive successful limb controllers from myoelectric data using only a sparse human-delivered training signal, without requiring detailed knowledge about the task domain. This reinforcement-based machine learning framework is well suited for use by both patients and clinical staff, and may be easily adapted to different application domains and the needs of individual amputees. To our knowledge, this is the first my-oelectric control approach that facilitates the online learning of new amputee-specific motions based only on a one-dimensional (scalar) feedback signal provided by the user of the prosthesis. PMID:22275543

  11. Occurrence of multiphasic anaphylaxis during a transcontinental air flight.

    PubMed

    Brady, W J; Bright, H L

    1999-11-01

    Anaphylaxis, a multisystem allergic reaction, represents a true medical emergency. Anaphylaxis is characterized by a combination of the following: urticaria, angioedema, distributive shock, and respiratory failure. Most often, the patient is rapidly treated with prompt resolution of the anaphylaxis in either the out-of-hospital or emergency department (ED) setting. Infrequently, recurrent, or multiphasic, anaphylaxis is encountered, involving a reappearance of allergic phenomena after complete resolution of the original reaction. Recurrence may involve nuisance-level issues such as urticaria; alternatively, multiphasic reactions may be characterized by cardiovascular collapse and/or respiratory compromise. Initially aggressive pharmacological therapy followed by prolonged observation in either the ED or the in-hospital setting is strongly recommended to monitor for potential recurrence.

  12. An Analysis of Online Courses in Research Ethics in the Fogarty-Sponsored Bioethics Training Programs

    PubMed Central

    Silverman, Henry; Strosberg, Martin; Luna, Florencia; Philpott, Sean; Hemmerle, Cheryl A.

    2014-01-01

    Several training programs sponsored by the NIH/Fogarty International Center’s International Research Ethics Education and Curriculum Development Program offer online graduate-level courses in research ethics to participants in low- and middle-income countries. This paper describes the evaluation of four of these online courses and recommendations for improvements to achieve the highest-quality design and delivery. We used an evaluation matrix consisting of 95 criteria based on recommended best practices in eLearning. Our results showed that these courses are developing or meeting nearly 73% of the criteria, while they are not meeting approximately 21% of the criteria. Together, one or more of the courses are developing or meeting 89 of the 95 criteria. These results suggest that the necessary skills and expertise exist in these programs to bring all of the eLearning courses close to 100% proficiency by sharing a common set of best practices. This paper is part of a collection of articles analyzing the Fogarty International Center’s International Research Ethics Education and Curriculum Development Program. PMID:24384517

  13. Food allergy and anaphylaxis in pediatrics: update 2010-2012.

    PubMed

    Santos, Alexandra F; Lack, Gideon

    2012-12-01

    This review highlights the progress made in food allergy (FA) and anaphylaxis research in pediatrics published in the journal Pediatric Allergy and Immunology since 2010. Putative risk factors for FA are as follows: a family history of allergic disease, particularly in the mother, low birth order, season of birth, and severe atopic eczema. Obstetric practices, antibiotic use, and home environment are factors deserving further research. Diagnostic decision levels and component-specific IgE are useful in the diagnosis of FA; however, oral food challenges remain the gold standard and may also be a means to reduce parental anxiety and to improve education. Oral immunotherapy studies show promise in increasing the threshold of reactivity of allergic patients and therefore improving their quality of life. In single-nut-allergic patients, introduction of other nuts allows broadening the diet and thus reducing the psychological impact of allergen avoidance. Nutritional deficiencies are not uncommon in food-allergic children and should be specifically assessed. The prescription of injectable adrenaline is still insufficient and not consistent among practitioners, requiring improved training and implementation of guidelines. Current research into the epidemiology and immunological mechanisms of FA and tolerance will enable us to devise strategies to both prevent and treat food allergies.

  14. Anaphylaxis to annatto dye: a case report.

    PubMed

    Nish, W A; Whisman, B A; Goetz, D W; Ramirez, D A

    1991-02-01

    Annatto dye is an orange-yellow food coloring extracted from the seeds of the tree Bixa orellana. It is commonly used in cheeses, snack foods, beverages, and cereals. Previously reported adverse reactions associated with annatto dye have included urticaria and angioedema. We present a patient who developed urticaria, angioedema, and severe hypotension within 20 minutes following ingestion of milk and Fiber One cereal, which contained annatto dye. Subsequent skin tests to milk, wheat, and corn were negative. The patient had a strong positive skin test to annatto dye, while controls had no response. The nondialyzable fraction of annatto dye on SDS-PAGE demonstrated two protein staining bands in the range of 50 kD. Immunoblotting demonstrated patient IgE-specific for one of these bands, while controls showed no binding. Annatto dye may contain contaminating or residual seed proteins to which our patient developed IgE hypersensitivity. Annatto dye is a potential rare cause of anaphylaxis. PMID:1994783

  15. [Intraoperative anaphylaxis caused by latex surgical gloves].

    PubMed

    Tomita, S; Sugawara, K; Tamakawa, S; Saitoh, Y

    1998-02-01

    A 17-year-old male encountered anaphylaxis caused by latex surgical gloves during emergency surgery under general anesthesia. He had undergone multiple surgical procedures, bladder catheterization and was suffering from atopic dermatitis. The patient developed bronchospasm and circulatory collapse 20 minutes after the start of surgery. Administration of dopamine, aminophylline and methylprednisolone helped to normalize airway pressure and blood pressure. Latex allergy occurs in persons considered at high risk including patient with spina bifida, urogenital abnormalities, atopic dermatitis, health care workers and rubber industry workers. These persons may develop hypersensitivity to latex products. If patients who are suspected to be latex allergy undergo surgical procedures, anesthesiologist should check past history and sensitivity to rubber in detail. In patients known to be allergic to latex, we must avoid latex products, such as surgical gloves, or anesthetic and surgical equipments. PMID:9513338

  16. Online Equivalence-Based Instruction about Statistical Inference Using Written Explanation Instead of Match-to-Sample Training

    ERIC Educational Resources Information Center

    Critchfield, Thomas S.

    2014-01-01

    Equivalence-based instruction of college students was adapted for use in a commercial online course-delivery system, with written explanation replacing match-to-sample training. Outcomes rivaled those of previous studies in which students were taught in low-distraction settings through match-to-sample procedures that were controlled by custom…

  17. The Effects of Training in Peer Assessment on University Students' Writing Performance and Peer Assessment Quality in an Online Environment

    ERIC Educational Resources Information Center

    Xiao, Yun

    2010-01-01

    This study was designed to examine the effects of peer-assessment skill training on students' writing performance, the quality of students' feedback, the quality (validity and reliability) of student-generated scores, and the students' satisfaction with the peer assessment method in an online environment. A quasi-experimental design was employed…

  18. 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

  19. 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.

  20. 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

  1. On-line node fault injection training algorithm for MLP networks: objective function and convergence analysis.

    PubMed

    Sum, John Pui-Fai; Leung, Chi-Sing; Ho, Kevin I-J

    2012-02-01

    Improving fault tolerance of a neural network has been studied for more than two decades. Various training algorithms have been proposed in sequel. The on-line node fault injection-based algorithm is one of these algorithms, in which hidden nodes randomly output zeros during training. While the idea is simple, theoretical analyses on this algorithm are far from complete. This paper presents its objective function and the convergence proof. We consider three cases for multilayer perceptrons (MLPs). They are: (1) MLPs with single linear output node; (2) MLPs with multiple linear output nodes; and (3) MLPs with single sigmoid output node. For the convergence proof, we show that the algorithm converges with probability one. For the objective function, we show that the corresponding objective functions of cases (1) and (2) are of the same form. They both consist of a mean square errors term, a regularizer term, and a weight decay term. For case (3), the objective function is slight different from that of cases (1) and (2). With the objective functions derived, we can compare the similarities and differences among various algorithms and various cases. PMID:24808501

  2. An Online Approach for Training International Climate Scientists to Use Computer Models

    NASA Astrophysics Data System (ADS)

    Yarker, M. B.; Mesquita, M. D.; Veldore, V.

    2013-12-01

    With the mounting evidence by the work of IPCC (2007), climate change has been acknowledged as a significant challenge to Sustainable Development by the international community. It is important that scientists in developing countries have access to knowledge and tools so that well-informed decisions can be made about the mitigation and adaptation of climate change. However, training researchers to use climate modeling techniques and data analysis has become a challenge, because current capacity building approaches train researchers to use climate models through short-term workshops, which requires a large amount of funding. It has also been observed that many participants who recently completed capacity building courses still view climate and weather models as a metaphorical 'black box', where data goes in and results comes out; and there is evidence that these participants lack a basic understanding of the climate system. Both of these issues limit the ability of some scientists to go beyond running a model based on rote memorization of the process. As a result, they are unable to solve problems regarding run-time errors, thus cannot determine whether or not their model simulation is reasonable. Current research in the field of science education indicates that there are effective strategies to teach learners about science models. They involve having the learner work with, experiment with, modify, and apply models in a way that is significant and informative to the learner. It has also been noted that in the case of computational models, the installation and set up process alone can be time consuming and confusing for new users, which can hinder their ability to concentrate on using, experimenting with, and applying the model to real-world scenarios. Therefore, developing an online version of capacity building is an alternative approach to the workshop training programs, which makes use of new technologies and it allows for a long-term educational process in a way

  3. Haeme oxygenase-1 and cardiac anaphylaxis.

    PubMed

    Ndisang, J F; Wang, R; Vannacci, A; Marzocca, C; Fantappiè, O; Mazzanti, R; Mannaioni, P F; Masini, E

    2001-12-01

    1. Haeme oxygenase (HO) is an enzyme mainly localized in the smooth endoplasmic reticulum and involved in haeme degradation and in the generation of carbon monoxide (CO). Here we investigate (1) whether the inducible isoform of HO (HO-1) is expressed in the isolated heart of the guinea-pig and (2) the functional significance of HO-1 on the response to antigen in isolated hearts taken from actively sensitized guinea-pigs. 2. Both the HO-1 expression and activity are consistently increased in hearts from guinea-pigs pretreated with hemin, an HO-1 inducer (4 mg kg(-1) i.p., 18 h before antigen challenge). The administration of the HO-1 inhibitor zinc-protoporphyrin IX (ZnPP-IX, 50 micromol kg(-1), i.p., 6 h before hemin) abolished the increase of both the HO-1 expression and activity. 3. In vitro challenge with the specific antigen of hearts from actively sensitized animals evokes a positive inotropic and chronotropic effect, a coronary constriction followed by dilation and an increase in the amount of histamine in the perfusates. In hearts from hemin-pretreated animals, antigen challenge did not modify the heart rate and the force of contraction; the coronary outflow was significantly increased and a diminution of the release of histamine was observed. The patterns of cardiac anaphylaxis were fully restored in hearts from animals treated with ZnPP-IX 6 h before hemin. 4. In isolated hearts perfused with a Tyrode solution gassed with 100% CO for 5 min and successively reoxygenated, the response to antigen was similar to that observed in hearts from hemin-pretreated animals. 5. Pretreatment with hemin or the exposure to exogenous CO were linked to an increase in cardiac cyclic GMP levels and to a decrease of tissue Ca(2+) levels. 6. The study demonstrates that overexpression of HO-1 inhibits cardiac anaphylaxis through the generation of CO which, in turn, decreases the release of histamine through a cyclic GMP- and Ca(2+)-dependent mechanism. PMID:11739245

  4. Haeme oxygenase-1 and cardiac anaphylaxis

    PubMed Central

    Ndisang, Joseph Fomusi; Wang, Rui; Vannacci, Alfredo; Marzocca, Cosimo; Fantappiè, Ornella; Mazzanti, Roberto; Mannaioni, Pier Francesco; Masini, Emanuela

    2001-01-01

    Haeme oxygenase (HO) is an enzyme mainly localized in the smooth endoplasmic reticulum and involved in haeme degradation and in the generation of carbon monoxide (CO). Here we investigate (1) whether the inducible isoform of HO (HO-1) is expressed in the isolated heart of the guinea-pig and (2) the functional significance of HO-1 on the response to antigen in isolated hearts taken from actively sensitized guinea-pigs. Both the HO-1 expression and activity are consistently increased in hearts from guinea-pigs pretreated with hemin, an HO-1 inducer (4 mg kg−1 i.p., 18 h before antigen challenge). The administration of the HO-1 inhibitor zinc-protoporphyrin IX (ZnPP-IX, 50 μmol kg−1, i.p., 6 h before hemin) abolished the increase of both the HO-1 expression and activity. In vitro challenge with the specific antigen of hearts from actively sensitized animals evokes a positive inotropic and chronotropic effect, a coronary constriction followed by dilation and an increase in the amount of histamine in the perfusates. In hearts from hemin-pretreated animals, antigen challenge did not modify the heart rate and the force of contraction; the coronary outflow was significantly increased and a diminution of the release of histamine was observed. The patterns of cardiac anaphylaxis were fully restored in hearts from animals treated with ZnPP-IX 6 h before hemin. In isolated hearts perfused with a Tyrode solution gassed with 100% CO for 5 min and successively reoxygenated, the response to antigen was similar to that observed in hearts from hemin-pretreated animals. Pretreatment with hemin or the exposure to exogenous CO were linked to an increase in cardiac cyclic GMP levels and to a decrease of tissue Ca2+ levels. The study demonstrates that overexpression of HO-1 inhibits cardiac anaphylaxis through the generation of CO which, in turn, decreases the release of histamine through a cyclic GMP- and Ca2+-dependent mechanism. PMID:11739245

  5. 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

  6. Wheat-dependent exercise-induced anaphylaxis.

    PubMed

    Scherf, K A; Brockow, K; Biedermann, T; Koehler, P; Wieser, H

    2016-01-01

    Wheat-dependent exercise-induced anaphylaxis (WDEIA) is a rare, but potentially severe food allergy exclusively occurring when wheat ingestion is accompanied by augmenting cofactors. It is clinically characterized by anaphylactic reactions ranging from urticaria and angioedema to dyspnoea, hypotension, collapse, and shock. WDEIA usually develops after ingestion of wheat products followed by physical exercise. Other cofactors are acetylsalicylic acid and other non-steroidal anti-inflammatory drugs, alcohol, and infections. The precise mechanisms of WDEIA remain unclear; exercise and other cofactors might increase gastrointestinal allergen permeability and osmolality, redistribute blood flow, or lower the threshold for IgE-mediated mast cell degranulation. Among wheat proteins, ω5-gliadin and high-molecular-weight glutenin subunits have been reported to be the major allergens. In some patients, WDEIA has been discussed to be caused by epicutaneous sensitization with hydrolysed wheat gluten included in cosmetics. Diagnosis is made based on the patient's history in combination with allergy skin testing, determination of wheat-specific IgE serum antibodies, basophil activation test, histamine release test, and/or exercise challenge test. Acute treatment includes application of adrenaline or antihistamines. The most reliable prophylaxis of WDEIA is a gluten-free diet. In less severe cases, a strict limitation of wheat ingestion before exercise and avoidance of other cofactors may be sufficient.

  7. Factors Contributing to the Development of Distance Education through Preliminary Online Training and Identifying Various Levels of Technical Competencies by Online Instructors within the University of North Carolina System

    ERIC Educational Resources Information Center

    Tillman, Makia R.

    2009-01-01

    Distance Education (DE) is one of the well-known methods of instruction and learning at many colleges and universities throughout the United States as well as other countries. Instructors teaching online courses need some form of training prior to teaching online classes. Most higher education institutions use some form of Learning Management…

  8. Instructing the Instructors: Training Instructors to Use Social Presence Cues in Online Courses

    ERIC Educational Resources Information Center

    Paquette, Paige

    2016-01-01

    Online learning has become an ever-evolving opportunity for students in all stages of life to achieve their educational goals while also participating in all of the other aspects of their lives. With all of the changes in online learning in the last decade, it is unfortunate that many online instructors have been left behind (Lackey, 2011).…

  9. Transfer and maintenance effects of online working-memory training in normal ageing and mild cognitive impairment.

    PubMed

    Vermeij, Anouk; Claassen, Jurgen A H R; Dautzenberg, Paul L J; Kessels, Roy P C

    2016-10-01

    Working memory (WM) is one of the cognitive functions that is susceptible to ageing-related decline. Interventions that are able to improve WM functioning at older age are thus highly relevant. In this pilot study, we explored the transfer effects of core WM training on the WM domain and other cognitive domains in 23 healthy older adults and 18 patients with amnestic mild cognitive impairment (MCI). Performance on neuropsychological tests was assessed before and after completion of the online five-week adaptive WM training, and after a three-month follow-up period. After training, both groups improved on the Digit Span and Spatial Span, gains that were maintained at follow-up. At an individual level, a limited number of participants showed reliable training gain. Healthy older adults, and to a lesser extent MCI patients, additionally improved on figural fluency at group level, but not at individual level. Results furthermore showed that global brain atrophy and hippocampal atrophy, as assessed by MRI, may negatively affect training outcome. Our study examined core WM training, showing gains on trained and untrained tasks within the WM domain, but no broad generalisation to other cognitive domains. More research is needed to evaluate the clinical relevance of these findings and to identify participant characteristics that are predictive of training gain.

  10. 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

  11. [A case study of anaphylaxis in a pregnant woman].

    PubMed

    Ferreres-García, Karla; de León-Luis, Juan; Seoane, Elena; García-Marqués, Enrique; Sanjuan, Cristina; Ortiz-Quintana, Luis

    2014-03-01

    We report a case of anaphylaxis in a 35+5 week of pregnancy patient who came to the Emergency Room with shortness of breath, hypotension and loss on fetal wellbeing. Due to her medical history and given the clinical picture at that time, an anaphylactic shock was suggested as the most probable diagnose. The administration of dexchlorpheniramine and methylprednisolone resulted in an immediate and positive reaction. Simultaneously, an improvement in the fetus cardiotocographic record was objectified. The patient was hospitalized for 48 hours, after which she was discharged. In case of suspicion of anaphylaxis in a pregnant woman, four aspects should be handled: the severity of the anaphylaxis chart, individual complications regarding a pregnant woman, unfavorable effects of the regularly used treatment during that specific gestation, and the need of fetal extraction based of gestational age.

  12. 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

  13. Caustic Ingestions Mimicking Anaphylaxis: Case Studies and Literature Review

    PubMed Central

    Sherenian, Michael G.; Clee, Mark; Schondelmeyer, Amanda C.; de Alarcón, Alessandro; Li, Jinzhu; Assa’ad, Amal

    2015-01-01

    Anaphylaxis presents in children with rapid involvement of typically 2 or more organ systems including cutaneous, gastrointestinal, and respiratory. Caustic ingestions (CI) may also present with acute involvement of cutaneous, gastrointestinal, and respiratory systems. We present 2 cases of “missed diagnosis” that illustrate how CI presenting with respiratory symptoms can be mistaken for anaphylaxis owing to these similarities. Both of these patients had delay in appropriate care for CI as a result. These cases demonstrate the importance of considering CI in children who have gastrointestinal symptoms, respiratory distress, and oropharyngeal edema. PMID:25583920

  14. Caustic ingestions mimicking anaphylaxis: case studies and literature review.

    PubMed

    Sherenian, Michael G; Clee, Mark; Schondelmeyer, Amanda C; de Alarcón, Alessandro; Li, Jinzhu; Assa'ad, Amal; Risma, Kimberly

    2015-02-01

    Anaphylaxis presents in children with rapid involvement of typically 2 or more organ systems including cutaneous, gastrointestinal, and respiratory. Caustic ingestions (CI) may also present with acute involvement of cutaneous, gastrointestinal, and respiratory systems. We present 2 cases of "missed diagnosis" that illustrate how CI presenting with respiratory symptoms can be mistaken for anaphylaxis owing to these similarities. Both of these patients had delay in appropriate care for CI as a result. These cases demonstrate the importance of considering CI in children who have gastrointestinal symptoms, respiratory distress, and oropharyngeal edema.

  15. The Effects of an Online Mind-Body Training Program on Stress, Coping Strategies, Emotional Intelligence, Resilience and Psychological State.

    PubMed

    Jung, Ye-Ha; Ha, Tae Min; Oh, Chang Young; Lee, Ui Soon; Jang, Joon Hwan; Kim, Jungwon; Park, Jae-Oh; Kang, Do-Hyung

    2016-01-01

    The goal of this study was to evaluate the effects of an online mind-body training (MBT) program on participants' stress, anger, coping strategies, emotional intelligence, resilience, and positive and negative affect. Forty-two healthy women participated in an online MBT program for approximately 8-10 minutes a day for 8 weeks; a control group of 45 healthy women did not participate in the program. Self-report psychological questionnaires were administered before the beginning of the program and at 4 and 8 weeks following its onset. Data from the MBT group and the control group were compared using repeated measures ANOVA and Student's t-tests. Significant time x group interaction effects were found with respect to stress, coping strategies, anger, emotional intelligence, negative affect and resilience. These results demonstrate beneficial effects of the online MBT program and significant improvements in the psychological capabilities of participants compared with the control group. The effects of online MBT program were similar with those of the previous offline MBT in psychological aspects, suggesting further studies for neuroscientific evidence related stress and emotion of online MBT effects. PMID:27479499

  16. The Effects of an Online Mind-Body Training Program on Stress, Coping Strategies, Emotional Intelligence, Resilience and Psychological State.

    PubMed

    Jung, Ye-Ha; Ha, Tae Min; Oh, Chang Young; Lee, Ui Soon; Jang, Joon Hwan; Kim, Jungwon; Park, Jae-Oh; Kang, Do-Hyung

    2016-01-01

    The goal of this study was to evaluate the effects of an online mind-body training (MBT) program on participants' stress, anger, coping strategies, emotional intelligence, resilience, and positive and negative affect. Forty-two healthy women participated in an online MBT program for approximately 8-10 minutes a day for 8 weeks; a control group of 45 healthy women did not participate in the program. Self-report psychological questionnaires were administered before the beginning of the program and at 4 and 8 weeks following its onset. Data from the MBT group and the control group were compared using repeated measures ANOVA and Student's t-tests. Significant time x group interaction effects were found with respect to stress, coping strategies, anger, emotional intelligence, negative affect and resilience. These results demonstrate beneficial effects of the online MBT program and significant improvements in the psychological capabilities of participants compared with the control group. The effects of online MBT program were similar with those of the previous offline MBT in psychological aspects, suggesting further studies for neuroscientific evidence related stress and emotion of online MBT effects.

  17. The Effects of an Online Mind-Body Training Program on Stress, Coping Strategies, Emotional Intelligence, Resilience and Psychological State

    PubMed Central

    Jung, Ye-Ha; Ha, Tae Min; Oh, Chang Young; Lee, UI Soon; Jang, Joon Hwan; Kim, Jungwon; Park, Jae-Oh; Kang, Do-Hyung

    2016-01-01

    The goal of this study was to evaluate the effects of an online mind-body training (MBT) program on participants’ stress, anger, coping strategies, emotional intelligence, resilience, and positive and negative affect. Forty-two healthy women participated in an online MBT program for approximately 8–10 minutes a day for 8 weeks; a control group of 45 healthy women did not participate in the program. Self-report psychological questionnaires were administered before the beginning of the program and at 4 and 8 weeks following its onset. Data from the MBT group and the control group were compared using repeated measures ANOVA and Student’s t-tests. Significant time x group interaction effects were found with respect to stress, coping strategies, anger, emotional intelligence, negative affect and resilience. These results demonstrate beneficial effects of the online MBT program and significant improvements in the psychological capabilities of participants compared with the control group. The effects of online MBT program were similar with those of the previous offline MBT in psychological aspects, suggesting further studies for neuroscientific evidence related stress and emotion of online MBT effects. PMID:27479499

  18. 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

  19. ANAPHYLAXIS IN CHOPPED GUINEA PIG LUNG

    PubMed Central

    Austen, K. F.; Brocklehurst, W. E.

    1961-01-01

    The quantitative release of histamine by specific antigen from perfused, chopped, sensitized guinea pig lung has been used to study the effect of peptidase substrates and inhibitors on the anaphylactic reaction. The anaphylactic release of histamine is prevented by chymotrypsin substrates and inhibitors but not by trypsin, carboxypeptidase, or leucine aminopeptidase substrates or the soybean trypsin inhibitor. The chymotrypsin substrates and inhibitors appear to be acting on an antigen-antibody-activated step because these substances fail to inhibit if the tissue is washed free of them prior to antigen addition, and because there is complete desensitization of the tissue without histamine release when the antigen is added in the presence of these inhibitors. The inhibitors work equally well in tissue from passively sensitized animals or in tissue from animals actively sensitized with either ovalbumin or bovine gamma globulin. These observations suggest that activation of a chymotrypsin-like enzyme is a necessary condition for the anaphylactic release of histamine in guinea pig lung. Diisopropylfluophosphate is inhibitory when present at the time of antigen addition but not when the tissue is washed free of unfixed diisopropylfluophosphate prior to adding antigen. This indicates that diisopropylfluophosphate must be acting exclusively on an enzyme which exists in lung tissue in a precursor form resistant to diisopropylfluophosphate until activated by the antigen-antibody interaction. Thiol alkylating or oxidizing agents also prevent the anaphylactic release of histamine, but in contrast to the situation with diisopropylfluophosphate and the other chymotrypsin inhibitors, the phase of the anaphylactic reaction inhibited by N-ethylmaleimide is available prior to the antigen-antibody interaction. The similarities and differences between immune hemolysis and anaphylaxis in chopped guinea pig lung are considered in detail. PMID:13685194

  20. An Investigation of a Computer Training Company's Migration to a New Distance Learning Platform and the Implementation of an Online Professional Development Program

    ERIC Educational Resources Information Center

    Rudd, Denis; Bernadowski, Carianne

    2015-01-01

    The purpose of the study was to determine if the Training Partner Program was successful in preparing trainers to use a new distance learning platform. Results indicate the program was a success in improving self-efficacy, engagement, and collaboration among trainers. Additionally, characteristics of online trainers are identified. Online learning…

  1. Faculty Development: An Analysis of Current and Effective Training Strategies for Preparing Faculty to Teach Online

    ERIC Educational Resources Information Center

    Lackey, Karen

    2011-01-01

    This study identifies how higher education institutions are preparing their faculty to teach online using a qualitative methodology. Six participants, three experienced and three non-experienced online faculty members, were purposely selected and interviewed. Participants were asked questions regarding their preparation experiences, the activities…

  2. Online or Face to Face? A Comparison of Two Methods of Training Professionals

    ERIC Educational Resources Information Center

    Dillon, Kristin; Dworkin, Jodi; Gengler, Colleen; Olson, Kathleen

    2008-01-01

    Online courses offer benefits over face-to-face courses such as accessibility, affordability, and flexibility. Literature assessing the effectiveness of face-to-face and online courses is growing, but findings remain inconclusive. This study compared evaluations completed by professionals who had taken a research update short course either face to…

  3. Online versus Paper-Based Instruction: Comparing Two Strategy Training Modules for Improving Reading Comprehension

    ERIC Educational Resources Information Center

    Huang, Hsin-chou

    2014-01-01

    This study investigates the effectiveness of online versus paper-based reading strategy instruction on EFL learners' reading comprehension. Fifty-seven university students from two intact reading classes with comparable proficiency levels were assigned to participate in either a paper-based or an online reading instructional module. Both…

  4. A Problem in Online Interpersonal Skills Training: Do Learners Practice Skills?

    ERIC Educational Resources Information Center

    Doo, Min Young

    2006-01-01

    One problem found when teaching interpersonal skills online is learners' lack of opportunity for skill practice. The online learning environment is deficient in face-to-face interaction, and opportunities for self-regulation make it difficult to ensure learners practice skills despite the positive effects of such practice on skill improvement. The…

  5. Staying or Leaving? Designing for Persistence in an Online Educator Training Programme in Indonesia

    ERIC Educational Resources Information Center

    Burns, Mary

    2013-01-01

    This case study discusses factors impacting the attrition and persistence rates of 60 Indonesian educators in an online programme in 2010. Course designers developed three variations of a web-based programme--a fully online, hybrid and web-facilitated model--and placed 20 learners, all with similar technology skills, in the three different models.…

  6. Online Training for Working with Student Veterans: A Social Work Elective Course

    ERIC Educational Resources Information Center

    Selber, Katherine; Biggs, Mary Jo Garcia; Chavkin, Nancy Feyl; Wright, Micah C.

    2015-01-01

    This article describes one school of social work's innovative online elective course to prepare Masters of Social Work (MSW) students for practice with the military, veterans and their families. Developed as part of a university-wide Veterans Initiative, this online course keeps the focus on the student veteran and uses the best practices of…

  7. Relationships among Faculty Training, Faculty Degree, Faculty Longevity, and Student Satisfaction in Online Higher Education

    ERIC Educational Resources Information Center

    Kane, Robert Todd; Shaw, Melanie; Pang, Sangho; Salley, Witt; Snider, J. Blake

    2015-01-01

    With the ever-increasing availability of online education opportunities, understanding the factors that influence online student satisfaction and success is vital to enable administrators to engage and retain this important stakeholder group. The purpose of this ex-post-facto, nonexperimental quantitative study was to investigate the impact of…

  8. 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

  9. 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

  10. Beta-blocker therapy and the risk of anaphylaxis.

    PubMed Central

    Toogood, J H

    1987-01-01

    Beta-blocker therapy is associated with an increase in the severity and, possibly, the incidence of acute anaphylaxis. The population at risk consists of people with allergic conditions who are given a beta-blocker for an unrelated condition. Anaphylaxis under these conditions may be severe, protracted and resistant to conventional treatment because of the beta-adrenergic blockade. Severe or fatal attacks have been triggered by insect stings, the ingestion of allergenic foods or drugs, and injections of radiocontrast media, antisera or immunotherapy antigens. These occurrences are probably infrequent, but their incidence is unknown. At least two fatal cases have recently occurred in Canada. Clinical allergists, internists and family practitioners in particular should be aware of the need for aggressive and prolonged support in patients who experience anaphylaxis while receiving beta-blocker therapy and should report all such occurrences to the federal registry of adverse drug reactions. Allergy skin testing or immunotherapy is inadvisable in patients who take a beta-blocker orally or in the form of ophthalmic eyedrops. The list of relative contraindications to beta-blocker use should be extended to include susceptibility to recurrent anaphylaxis, whether it is idiopathic or due to an identifiable cause. PMID:2882832

  11. 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

  12. Omalizumab: Practical considerations regarding the risk of anaphylaxis.

    PubMed

    Kim, Harold L; Leigh, Richard; Becker, Allan

    2010-01-01

    Omalizumab has demonstrated efficacy among patients with moderate to severe persistent allergic asthma, whose symptoms are inadequately controlled with other controller agents. This therapy is generally well tolerated, but there are some safety considerations, the most important of which is the rare, but potentially life-threatening, occurrence of omalizumab-associated anaphylaxis.In Canada, data from the manufacturer of omalizumab indicate that the frequency of anaphylaxis attributed to Xolair in post-marketing use is approximately 0.2%. Other researchers, including the American Omalizumab Joint Task Force (OJTF), have suggested a lower overall frequency of 0.09%.This paper provides a summary of the epidemiologic research carried out to date and presents a concise, practical set of recommendations for the prevention, monitoring and management of omalizumab-associated anaphylaxis. Prevention tips include advice on patient education measures, concomitant medications and optimal administration. For the first three injections, the recommendation is to monitor in clinic for two hours after the omalizumab injection; for subsequent injections, the monitoring period should be 30 minutes or an appropriate time agreed upon by the individual patient and healthcare professional.In the event that a patient does experience omalizumab-associated anaphylaxis, the paper provides recommendations for handling the situation in-clinic and recommendations on how to counsel patients to recognize the potential signs and symptoms in the community and react appropriately. PMID:21129189

  13. 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.

  14. Clonal mast cell activation syndrome with anaphylaxis to sulfites.

    PubMed

    Cifuentes, Liliana; Ring, Johannes; Brockow, Knut

    2013-01-01

    Sulfites are rarely suspected as causative agents of immediate-type hypersensitivity. We report on a 49-year-old male patient who developed recurrent severe hypotension after food ingestion. A diagnosis of monoclonal mast cell activation syndrome was established. In the double-blind, placebo-controlled food challenge, the patient reacted to potassium metabisulfite with anaphylaxis.

  15. Meeting a Growing Demand: Texas A&M AgriLife Extension Service's Early Childhood Educator Online Training Program

    ERIC Educational Resources Information Center

    Green, Stephen

    2013-01-01

    Demand for professional development training in the early childhood field has grown substantially in recent years. To meet the demand, Texas A&M AgriLife Extension Service's Family Development and Resource Management unit developed the Early Childhood Educator Online Training Program, a professional development system that currently…

  16. Development of and feedback on a fully automated virtual reality system for online training in weight management skills.

    PubMed

    Thomas, J Graham; Spitalnick, Josh S; Hadley, Wendy; Bond, Dale S; Wing, Rena R

    2015-01-01

    Virtual reality (VR) technology can provide a safe environment for observing, learning, and practicing use of behavioral weight management skills, which could be particularly useful in enhancing minimal contact online weight management programs. The Experience Success (ES) project developed a system for creating and deploying VR scenarios for online weight management skills training. Virtual environments populated with virtual actors allow users to experiment with implementing behavioral skills via a PC-based point and click interface. A culturally sensitive virtual coach guides the experience, including planning for real-world skill use. Thirty-seven overweight/obese women provided feedback on a test scenario focused on social eating situations. They reported that the scenario gave them greater skills, confidence, and commitment for controlling eating in social situations.

  17. Development of and Feedback on a Fully Automated Virtual Reality System for Online Training in Weight Management Skills

    PubMed Central

    Spitalnick, Josh S.; Hadley, Wendy; Bond, Dale S.; Wing, Rena R.

    2014-01-01

    Virtual reality (VR) technology can provide a safe environment for observing, learning, and practicing use of behavioral weight management skills, which could be particularly useful in enhancing minimal contact online weight management programs. The Experience Success (ES) project developed a system for creating and deploying VR scenarios for online weight management skills training. Virtual environments populated with virtual actors allow users to experiment with implementing behavioral skills via a PC-based point and click interface. A culturally sensitive virtual coach guides the experience, including planning for real-world skill use. Thirty-seven overweight/obese women provided feedback on a test scenario focused on social eating situations. They reported that the scenario gave them greater skills, confidence, and commitment for controlling eating in social situations. PMID:25367014

  18. Harnessing Online Peer Education (HOPE): Integrating C-POL and Social Media to Train Peer Leaders in HIV Prevention

    PubMed Central

    Jaganath, Devan; Gill, Harkiran K.; Cohen, Adam Carl; Young, Sean D.

    2011-01-01

    Novel methods, such as Internet-based interventions, are needed to combat the spread of HIV. While past initiatives have used the Internet to promote HIV prevention, the growing popularity, decreasing digital divide, and multi-functionality of social networking sites, such as Facebook, make this an ideal time to develop innovative ways to use online social networking sites to scale HIV prevention interventions among high-risk groups. The UCLA HOPE [Harnessing Online Peer Education] study is a longitudinal experimental study to evaluate the feasibility, acceptability, and preliminary effectiveness of using social media for peer-led HIV prevention, specifically among African American and Latino Men who have Sex with Men (MSM). No curriculum currently exists to train peer leaders in delivering culturally aware HIV prevention messages using social media. Training was created that adapted the Community Popular Opinion Leader (C-POL) model, for use on social networking sites. Peer leaders are recruited who represent the target population and have experience with both social media and community outreach. The curriculum contains the following elements: discussion and role playing exercises to integrate basic knowledge of HIV/AIDS, awareness of sociocultural HIV/AIDS issues in the age of technology, and communication methods for training peer leaders in effective, interactive social media-based HIV prevention. Ethical issues related to Facebook and health interventions are integrated throughout the sessions. Training outcomes have been developed for long-term assessment of retention and efficacy. This is the first C-POL curriculum that has been adapted for use on social networking websites. Although this curriculum has been used to target African American and Latino MSM, it has been created to allow generalization to other high-risk groups. PMID:22149081

  19. Harnessing Online Peer Education (HOPE): integrating C-POL and social media to train peer leaders in HIV prevention.

    PubMed

    Jaganath, Devan; Gill, Harkiran K; Cohen, Adam Carl; Young, Sean D

    2012-01-01

    Novel methods, such as Internet-based interventions, are needed to combat the spread of HIV. While past initiatives have used the Internet to promote HIV prevention, the growing popularity, decreasing digital divide, and multi-functionality of social networking sites, such as Facebook, make this an ideal time to develop innovative ways to use online social networking sites to scale HIV prevention interventions among high-risk groups. The UCLA Harnessing Online Peer Education study is a longitudinal experimental study to evaluate the feasibility, acceptability, and preliminary effectiveness of using social media for peer-led HIV prevention, specifically among African American and Latino Men who have Sex with Men (MSM). No curriculum currently exists to train peer leaders in delivering culturally aware HIV prevention messages using social media. Training was created that adapted the Community Popular Opinion Leader (C-POL) model, for use on social networking sites. Peer leaders are recruited who represent the target population and have experience with both social media and community outreach. The curriculum contains the following elements: discussion and role playing exercises to integrate basic knowledge of HIV/AIDS, awareness of sociocultural HIV/AIDS issues in the age of technology, and communication methods for training peer leaders in effective, interactive social media-based HIV prevention. Ethical issues related to Facebook and health interventions are integrated throughout the sessions. Training outcomes have been developed for long-term assessment of retention and efficacy. This is the first C-POL curriculum that has been adapted for use on social networking websites. Although this curriculum has been used to target African-American and Latino MSM, it has been created to allow generalization to other high-risk groups.

  20. Anaphylaxis after administration of amikacin containing sodium metabisulfite in a premature newborn.

    PubMed

    Kendigelen, Pinar; BaktirClinic Of Anesthesiology And Reanimation Afşin State Hospital Afşin Kahramanmaraş Tureky, Mehmet; Sucu, Asena; Kaya, Guner

    2016-06-01

    Anaphylaxis is a serious systemic hypersensitivity reaction that is rapid in onset and can cause death. Premature newborns, whose immunological system is immature, are less likely to develop anaphylaxis. Administration of amikacin, containing sodium metabisulfite, to a 3-day-old premature newborn, induced a near fatal anaphylaxis. After suspicion of sepsis, the baby was started on amikacin. Clinical improvement was observed after initiation of treatment. On the third day of treatment with amikacin, the newborn suddenly developed tachypnea, tachycardia, angioedema and cyanosis. Anaphylaxis was diagnosed and treated. Latent reaction occurred after one hour of clinical improvement. The baby was intubated immediately. Anaphylaxis is a medical emergency; therefore the clinicians should have a rapid and careful assessment about this potentially fatal reaction. Even after successful treatment of anaphylaxis, the patient should be under observation for 72 hours because of the possibility of a biphasic reaction.

  1. Rehabilitation of face-processing skills in an adolescent with prosopagnosia: Evaluation of an online perceptual training programme.

    PubMed

    Bate, Sarah; Bennetts, Rachel; Mole, Joseph A; Ainge, James A; Gregory, Nicola J; Bobak, Anna K; Bussunt, Amanda

    2015-01-01

    In this paper we describe the case of EM, a female adolescent who acquired prosopagnosia following encephalitis at the age of eight. Initial neuropsychological and eye-movement investigations indicated that EM had profound difficulties in face perception as well as face recognition. EM underwent 14 weeks of perceptual training in an online programme that attempted to improve her ability to make fine-grained discriminations between faces. Following training, EM's face perception skills had improved, and the effect generalised to untrained faces. Eye-movement analyses also indicated that EM spent more time viewing the inner facial features post-training. Examination of EM's face recognition skills revealed an improvement in her recognition of personally-known faces when presented in a laboratory-based test, although the same gains were not noted in her everyday experiences with these faces. In addition, EM did not improve on a test assessing the recognition of newly encoded faces. One month after training, EM had maintained the improvement on the eye-tracking test, and to a lesser extent, her performance on the familiar faces test. This pattern of findings is interpreted as promising evidence that the programme can improve face perception skills, and with some adjustments, may at least partially improve face recognition skills.

  2. Rehabilitation of face-processing skills in an adolescent with prosopagnosia: Evaluation of an online perceptual training programme.

    PubMed

    Bate, Sarah; Bennetts, Rachel; Mole, Joseph A; Ainge, James A; Gregory, Nicola J; Bobak, Anna K; Bussunt, Amanda

    2015-01-01

    In this paper we describe the case of EM, a female adolescent who acquired prosopagnosia following encephalitis at the age of eight. Initial neuropsychological and eye-movement investigations indicated that EM had profound difficulties in face perception as well as face recognition. EM underwent 14 weeks of perceptual training in an online programme that attempted to improve her ability to make fine-grained discriminations between faces. Following training, EM's face perception skills had improved, and the effect generalised to untrained faces. Eye-movement analyses also indicated that EM spent more time viewing the inner facial features post-training. Examination of EM's face recognition skills revealed an improvement in her recognition of personally-known faces when presented in a laboratory-based test, although the same gains were not noted in her everyday experiences with these faces. In addition, EM did not improve on a test assessing the recognition of newly encoded faces. One month after training, EM had maintained the improvement on the eye-tracking test, and to a lesser extent, her performance on the familiar faces test. This pattern of findings is interpreted as promising evidence that the programme can improve face perception skills, and with some adjustments, may at least partially improve face recognition skills. PMID:25369318

  3. 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

  4. Assessing the effectiveness of a clinical instructor online training module as measured by student perception and sustained best practices.

    PubMed

    Engelhard, Chalee; Seo, Kay Kyeong-Ju

    2015-01-01

    Due to current scrutiny of physical therapy (PT) clinical education, clinical education models require revisions with close examination of current practice, including best practices in clinical instructor (CI) education. Unfortunately, depth of research currently available to support these revisions is minimal, particularly in areas of research that investigate maintaining recently taught skills in CI training and students' perceived CI effectiveness following training. This study's purpose was to explore these areas. CIs (n=21) were assigned to either a control or treatment group. Treatment group-CIs completed an online module prior to supervising a Doctor of Physical Therapy (DPT) student during a 9-week clinical rotation and then participated in data collection activities following the rotation. Data from control group-CIs established a baseline. Data from students' assessments of their CIs' performances yielded qualitative themes demonstrating differentiated learning environments and module-taught best practices for treatment group-students. Quantitative findings did not make a distinction between the two student groups. Lastly, treatment group-CIs maintained best practices after an inactive period. This study suggests CIs were able to maintain best practices using just-in-time education, distributed clinical practice, and reflection. By continuing examination of online CI education, PT clinical education can move toward new models through evidence-based CI best practices.

  5. Recurrent perioperative anaphylaxis in a 54-year-old man.

    PubMed

    Franxman, Timothy J; Greenhawt, Matthew J; Baldwin, James L

    2013-01-01

    Reports suggest that perioperative anaphylaxis in patients undergoing general anesthesia range from 1 in 5000 to 1 in 20,000 with mortality rates as high as 9%. Because of the variety of medications that are used for general anesthesia and the rapid succession in which they are administered, it is often difficult to determine the etiology of a severe allergic episode in this setting. Antibiotics and anesthetics are notorious for precipitating allergic reactions and are often implicated. Other perioperative exposures and patient risk factors must also be considered. In this article, we describe the case of a patient who exhibited recurrent anaphylaxis episodes while trying to undergo a vital cardiac surgery. PMID:23883604

  6. Moving Beyond the Training Room: Fostering Workplace Learning through Online Journaling

    ERIC Educational Resources Information Center

    Cyboran, Vincent L.

    2005-01-01

    A variety of instructional methods have been shown to be effective in fostering employee learning in workplace training. These include problem-based learning, cooperative learning, and situated learning. Despite their success, however, there are at least two important reasons to actively foster learning beyond the training room: The transfer of…

  7. Online Training for Paraeducators to Support the Communication of Young Children

    ERIC Educational Resources Information Center

    Douglas, Sarah N.; McNaughton, David; Light, Janice

    2013-01-01

    Paraeducators are frequent sources of support for young children with disabilities in early childhood settings. However, they typically have limited training in providing communication opportunities for children with complex communication needs (CCN). The impact was investigated of providing training in a communication interaction strategy to…

  8. Relationship between Learning Style, Gender, and Satisfaction toward Training of Adjunct Online Faculty

    ERIC Educational Resources Information Center

    Lees, Teresa Dotson

    2011-01-01

    Growth in distance education programs has required academic institutions to seek and train additional adjunct faculty. Training program content and delivery methods vary among institutions: however, there is an absence of research on whether incorporating learning strategies that consider assumptions about an adult learner increases satisfaction…

  9. Direct Care Worker Training to Respond to the Behavior of Individuals With Dementia: The CARES® Dementia-Related Behavior™ Online Program

    PubMed Central

    Gaugler, Joseph E.; Hobday, John V.; Robbins, Joyce C.; Barclay, Michelle P.

    2016-01-01

    Only a handful of online training programs are available for direct care workers (DCWs) to acquire the strategic skills needed to improve dementia care in instances of challenging or inappropriate behavior. Utilizing pre- and post-test data from a convenience sample of 40 DCWs, the present study sought to determine (a) whether DCWs’ knowledge of responding to dementia-related behavior increased following participation in the CARES® Dementia-Related Behavior™ Online Training Program (or CARES® Behavior) and (b) if CARES® Behavior was acceptable and useful. The average number of correct scores on a dementia care knowledge measure was significantly higher among DCWs after viewing the online modules when compared with pre-test scores (p < .01). Descriptive empirical and open-ended data also suggested that the interactive, “real-world” content of CARES® Behavior was feasibly delivered online, acceptable, and may influence how DCWs deliver clinical care to individuals with dementia-related behavior. PMID:26894209

  10. Online Motor Imagery Training Effect for the Appearance of Event Related Desynchronization (ERD)

    NASA Astrophysics Data System (ADS)

    Takahashi, Mitsuru; Gouko, Manabu; Ito, Koji

    Stroke patients have some motor deficits, but they can regain their motor abilities by rehabilitation. In the aspect of rehabilitation, voluntary movement is very important. We propose a system which can make a closed loop in brain for stroke patients like voluntary movement. Event Related Desynchronization (ERD) is used to extract patients' motor intention, and then Functional Electrical Stimulation (FES) stimuls their paralyzed muscles. In many Brain Computer Interface (BCI) researches, subjects are trained for several months or years to do the task, because of the difficulty to extract clear ERD without training. Thinking about applying for stroke patients, motor imagery training should be shorter, because of the brain plasticity. We did a pilot study about the effect of visual feedback training for three days with healthy subjects. The result indicated that ERD could be clearly extracted in three days, but the training effect differs in each subjects.

  11. Anaphylaxis attributed to exercise: considerations for sports medicine specialists.

    PubMed

    Bennett, John R

    2015-02-01

    Anaphylaxis is an unanticipated, acute, and sometimes life-threatening systemic reaction with variable clinical presentations that is typically mediated by immunoglobulin E and causes degranulation of mast cells and basophils. The onset of symptoms can occur within minutes or hours after exposure to a known or suspected trigger, and reactions sometimes progress very rapidly, which can lead to death. One trigger of anaphylaxis in younger adults is moderately intense physical exercise, which has been termed exercise-induced anaphylaxis (EIA). Although rare, EIA should be recognized as a distinct and potentially life-threatening form of physical allergy, and is often undetected or inadequately treated. The ingestion of specific foods, including seafood, tree nuts, and wheat, or a nonspecific meal consisting of multiple food components shortly before or after physical exertion, is sometimes, but not always, the principal precipitant of EIA. This article briefly explores the current hypotheses on the role of immunoglobulin E, response mediators, and physiologic changes that bring on EIA, and discusses the current recommendations for diagnosis, including allergen challenge and laboratory testing, emergency care, and long-term prevention and patient follow-up. Accurate diagnosis of EIA is critical to providing lifesaving therapy and care plans to patients at risk. With respect to the medical management of EIA, mainstay therapy with epinephrine is described. For those with a known history of EIA, a comprehensive anaphylaxis action plan is central to successful patient management. Furthermore, patient education is necessary to heighten awareness of the signs and symptoms of EIA and appropriate strategies for allergen avoidance and self-management of anaphylactic episodes with self-injectable epinephrine.

  12. 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.

  13. Venom immunotherapy in patients with mastocytosis and hymenoptera venom anaphylaxis.

    PubMed

    González-de-Olano, David; Alvarez-Twose, Iván; Vega, Arantza; Orfao, Alberto; Escribano, Luis

    2011-05-01

    Systemic mastocytosis (SM) is typically suspected in patients with cutaneous mastocytosis (CM). In recent years, the presence of clonal mast cells (MCs) in a subset of patients with systemic symptoms associated with MC activation in the absence of CM has been reported and termed monoclonal MC activation syndromes or clonal systemic MC activation syndromes. In these cases, bone marrow (BM) MC numbers are usually lower than in SM with CM, there are no detectable BM MC aggregates, and serum baseline tryptase is often <20 µg/l; thus, diagnosis of SM in these patients should be based on careful evaluation of other minor WHO criteria for SM in reference centers, where highly sensitive techniques for immunophenotypic analysis and investigation of KIT mutations on fluorescence-activated cell sorter-purified BM MCs are routinely performed. The prevalence of hymenoptera venom anaphylaxis (HVA) among SM patients is higher than among the normal population and it has been reported to be approximately 5%. In SM patients with IgE-mediated HVA, venom immunotherapy is safe and effective and it should be prescribed lifelong. Severe adverse reactions to hymenoptera stings or venom immunotherapy have been associated with increased serum baseline tryptase; however, presence of clonal MC has not been ruled out in most reports and thus both SM and clonal MC activation syndrome might be underdiagnosed in such patients. In fact, clonal BM MC appears to be a relevant risk factor for both HVA and severe reactions to venom immunotherapy, while the increase in serum baseline tryptase by itself should be considered as a powerful surrogate marker for anaphylaxis. The Spanish Network on Mastocytosis has developed a scoring system based on patient gender, the clinical symptoms observed during anaphylaxis and serum baseline tryptase to predict for the presence of both MC clonality and SM among individuals who suffer from anaphylaxis.

  14. 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.

  15. Training Future Language Teachers to Develop Online Tutors' Competence through Reflective Analysis

    ERIC Educational Resources Information Center

    Guichon, Nicolas

    2009-01-01

    This article sets out to identify key competencies which language tutors need to develop in order to manage synchronous online teaching. In order to aptly monitor interactions with distant learners, it is proposed that three types of regulation pertaining to socio-affective, pedagogical and multimedia aspects are required. On the one hand, this…

  16. Mobile and Online Learning Journal: Effects on Apprentices' Reflection in Vocational Education and Training

    ERIC Educational Resources Information Center

    Mauroux, Laetitia; Könings, Karen D.; Zufferey, Jessica Dehler; Gurtner, Jean-Luc

    2014-01-01

    While learning journals (LJs) have been shown to support self-regulated learning strategies, reflection and learning outcomes in academic contexts, few studies have investigated their relevance in vocational education. A mobile and online learning journal (MOLJ) was developed to support reflection on workplace experiences. However, acceptance of…

  17. A Survey of Educational Needs and Online Training Perceptions in the Wood Products Industry

    ERIC Educational Resources Information Center

    Quesada-Pineda, Henry J.; Conn, Samuel S.; Sanchez, L. Scarlett

    2011-01-01

    A sample of 651 wood products industries were surveyed to determine their educational needs and quantify their interest in receiving continuing education via an online format. In the survey, respondents were asked to rank, in order of priority, their educational needs. With a 15.2% response rate, survey respondents (n=99) indicated that an online…

  18. The REEAL Model: A Framework for Faculty Training in Online Discussion Facilitation

    ERIC Educational Resources Information Center

    Bedford, Laurie

    2014-01-01

    Discussion forums are a primary tool for interactions in the online classroom. Discussions are a critical part of the learning process for students, and instructor facilitation should reflect this importance. Effective instructor discussion facilitation encourages students, provides evidence and analysis and links the discussion to subsequent…

  19. Online CKD education for medical students, residents, and fellows: training in a new era.

    PubMed

    Bhasin, Bhavna; Estrella, Michelle M; Choi, Michael J

    2013-07-01

    CKD and its complications are associated with substantial morbidity and mortality. Studies have highlighted significant deficiencies in resident knowledge and awareness of CKD and its complications. There is a need to improve CKD education through medical school and residency. There is also a need to provide alternatives to traditional teaching methods to meet the challenges of learning in the context of work-hour restrictions and increasing workload among residents and fellows. Internet-based learning resources offer various educational tools, including websites, kidney blogs, online modules, and smartphone applications, which could potentially and efficiently advance CKD knowledge among medical trainees. In this review, we describe several online resources for CKD education that could be useful for medical students, residents, and fellows. Increased awareness of these tools and their utilization may significantly influence and hopefully improve the recognition and management of patients with CKD. Future studies may help evaluate the effectiveness of these online learning methods and their effect on CKD patient outcomes. In addition, in light of increased concern about nephrology workforce issues, the potential for these online tools to augment interest in nephrology careers should be investigated. PMID:23809287

  20. Online CKD education for medical students, residents, and fellows: training in a new era.

    PubMed

    Bhasin, Bhavna; Estrella, Michelle M; Choi, Michael J

    2013-07-01

    CKD and its complications are associated with substantial morbidity and mortality. Studies have highlighted significant deficiencies in resident knowledge and awareness of CKD and its complications. There is a need to improve CKD education through medical school and residency. There is also a need to provide alternatives to traditional teaching methods to meet the challenges of learning in the context of work-hour restrictions and increasing workload among residents and fellows. Internet-based learning resources offer various educational tools, including websites, kidney blogs, online modules, and smartphone applications, which could potentially and efficiently advance CKD knowledge among medical trainees. In this review, we describe several online resources for CKD education that could be useful for medical students, residents, and fellows. Increased awareness of these tools and their utilization may significantly influence and hopefully improve the recognition and management of patients with CKD. Future studies may help evaluate the effectiveness of these online learning methods and their effect on CKD patient outcomes. In addition, in light of increased concern about nephrology workforce issues, the potential for these online tools to augment interest in nephrology careers should be investigated.

  1. 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

  2. Object-Oriented Control System Design Using On-Line Training of Artificial Neural Networks

    NASA Technical Reports Server (NTRS)

    Rubaai, Ahmed

    1997-01-01

    This report deals with the object-oriented model development of a neuro-controller design for permanent magnet (PM) dc motor drives. The system under study is described as a collection of interacting objects. Each object module describes the object behaviors, called methods. The characteristics of the object are included in its variables. The knowledge of the object exists within its variables, and the performance is determined by its methods. This structure maps well to the real world objects that comprise the system being modeled. A dynamic learning architecture that possesses the capabilities of simultaneous on-line identification and control is incorporated to enforce constraints on connections and control the dynamics of the motor. The control action is implemented "on-line", in "real time" in such a way that the predicted trajectory follows a specified reference model. A design example of controlling a PM dc motor drive on-line shows the effectiveness of the design tool. This will therefore be very useful in aerospace applications. It is expected to provide an innovative and noval software model for the rocket engine numerical simulator executive.

  3. Avoiding the great train wreck: standardizing the architecture for online curricula.

    PubMed

    Candler, C S; Andrews, M D

    1999-10-01

    The advent of the World Wide Web and related technologies has encouraged medical schools to generate a wealth of online curricular materials. Unfortunately, the diversity and abundance of user-friendly authoring tools have enabled individual instructors within and among medical schools to proliferate educational resources with often widely dissimilar architectures. Because there are no universal standards for educational technology, the resulting information islands cannot be easily managed, reused, or shared with other educators and institutions. Thoughtful planning and reuse of online educational materials could allow instructors to present subject matter more consistently across the curriculum, discover new teaching resources, easily create new materials, reduce unnecessary duplication, and better integrate the basic and clinical sciences. To make this possible, standardized, object-oriented architecture is needed. While several excellent HTML authoring tools and integrated courseware packages are available, differences in their technologies and methods impede inter-operability between the various products and the materials they create. Through the National Learning Infrastructure Initiative, the Instructional Management Systems (IMS) specification has emerged as a global standard for online teaching and learning environments. This proposed standard defines a common architecture for content management and delivery. PMID:10536630

  4. 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…

  5. 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

  6. 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

  7. Course Design and Delivery Specifications as a Tool for Ensuring Quality in an Online Training Program

    ERIC Educational Resources Information Center

    Docq, Françoise

    2015-01-01

    This case discusses the design, implementation, and regulation of a hybrid training program (60 credits over two years) organised by three business schools in Europe, and stretching over a five-year period. Following an incremental design process, the design team faced multiple challenges, from finding the added value of hybridization to choosing…

  8. 75 FR 74738 - Proposed Collection; Comment Request; Online Skills Training for PCPs on Substance Abuse

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-01

    ... Web site SBIRTTraining.com , to positively impact the knowledge, attitudes, intended behaviors and... Drug Abuse. The primary goal is to assess the impact of the training program on knowledge, attitude... Web based materials (pre-test), after exposure to the Web based materials (post-test), and 4-6...

  9. Development of an Evaluation Tool for Online Food Safety Training Programs

    ERIC Educational Resources Information Center

    Neal, Jack A., Jr.; Murphy, Cheryl A.; Crandall, Philip G.; O'Bryan, Corliss A.; Keifer, Elizabeth; Ricke, Steven C.

    2011-01-01

    The objective of this study was to provide the person in charge and food safety instructors an assessment tool to help characterize, identify strengths and weaknesses, determine the completeness of the knowledge gained by the employee, and evaluate the level of content presentation and usability of current retail food safety training platforms. An…

  10. Online Contract Training: Applying Organization Theory to Reconcile Competing Missions within Community Colleges

    ERIC Educational Resources Information Center

    Ghosh, Rajashi; Githens, Rod P.

    2011-01-01

    Community colleges in the United States have become major providers of human resource development services, particularly through offering workforce development training to local employers. The addition of workforce development services to community colleges is a fairly recent phenomenon. Some see workforce development efforts as diluting community…

  11. Online Training of TPACK Skills of Higher Education Scholars: A Cross-Institutional Impact Study

    ERIC Educational Resources Information Center

    Rienties, Bart; Brouwer, Natasa; Bohle Carbonell, Katerina; Townsend, Danielle; Rozendal, Anne-Petra; van der Loo, Janneke; Dekker, Peter; Lygo-Baker, Simon

    2013-01-01

    Higher education institutions should provide adequate training for teachers in order to increase their awareness of the complex interplay between technology, pedagogy and the cognitive knowledge in their disciplines. However, research has shown that providing effective staff development from teacher educators to support these teachers' skills…

  12. Training Needs and Preferences of Adult Public Library Clients in the Use of Online Resources

    ERIC Educational Resources Information Center

    Ruthven, Joan

    2010-01-01

    This article presents the results of a study into the provision of Internet training for adult public library clients. The study, which was completed in 2008, forms part of a larger investigation into the characteristics, preferences and needs of adult public library clients in New South Wales. The aim of this section of the investigation is to…

  13. Online Teacher Training: The Early Childhood Technology Integrated Instructional System--Phase 3

    ERIC Educational Resources Information Center

    Daytner, Gary; Robinson, Linda; Schneider, Carol; Johanson, Joyce

    2009-01-01

    Legislation, research, and practice support access to technology by young children with disabilities. Yet barriers to technology use--lack of training, inadequate funding, failure to acknowledge technology as a relevant issue, or disbelief that technology can positively impact young children with disabilities--often prevail among many disciplines…

  14. Development and Evaluation of Ning Social Network for Teaching Training Online Surveillance

    ERIC Educational Resources Information Center

    Mohd Nawi, Mohd Aliff; Jamsari, Ezad Azraai; Sulaiman, Adibah; Hamzah, Mohd Isa

    2013-01-01

    Supervision of teaching practice is an important aspect of training teachers in improving their teaching skills. Barriers such as distance and time factor are the constraints faced by the lecturers at the National University of Malaysia to communicate with the teacher trainees under their supervision. Therefore, this study aims to develop and…

  15. Motivating an Action Design Research Approach to Implementing Online Training in an Organisational Context

    ERIC Educational Resources Information Center

    Rogerson, Christine; Scott, Elsje

    2013-01-01

    The purpose of this paper is to explore the effectiveness of Action Design Research (ADR), a combination of Action Research and Design Science Research, as a methodology to examine how the implementation of e-learning will affect the learning outcomes for staff training in an organisational context. The research involves an intervention in the…

  16. Learner Support Requirements for Online Workplace Training in the South African Furniture Industry

    ERIC Educational Resources Information Center

    MacDonald, Iain S.; Bullen, Mark; Kozak, Robert A.

    2010-01-01

    A qualitative research project was conducted to evaluate the suitability of e-learning as a means of delivering training to workplace learners in the South African furniture manufacturing sector. Twenty learners participated in a three-month pilot e-learning course and were monitored throughout. While the study was designed primarily to…

  17. Computer-Aided Technical Training Using Electronic Equipment On-Line with the CAI System.

    ERIC Educational Resources Information Center

    Huggett, Geoffrey; And Others

    This report describes an experimental course in the operation and troubleshooting of a communications transceiver, the AN/URC-32, in which the transceiver is used as part of an instructional station in a CAI system. The transceiver and the CAI system are hard-wired together to form a single training system. The system is presently operating in the…

  18. Negotiating the Context of Online In-Service Training: "Expert" and "Non-Expert" Footings

    ERIC Educational Resources Information Center

    Nilsen, Mona

    2010-01-01

    This paper focuses on how people working in the Swedish food production industry engage in in-service training by means of computer-mediated communication. The empirical material consists of archived chat log files from a course concerning quality assurance and food safety hazards control in the preparation and handling of foodstuff. Drawing on…

  19. 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

  20. From Competency List to Curriculum Implementation: A Case Study of Japan's First Online Master's Program for E-Learning Specialists Training

    ERIC Educational Resources Information Center

    Suzuki, Katsuaki

    2009-01-01

    This article describes the creation of a fully online master's program for e-learning specialist training. This program is the first of its kind in Japan. As background information, Japan's general trends in e-learning are described, including activities of the e-Learning Consortium Japan and National Institute of Multimedia in Education. Such…

  1. Brief Online Training Enhances Competitive Performance: Findings of the BBC Lab UK Psychological Skills Intervention Study

    PubMed Central

    Lane, Andrew M.; Totterdell, Peter; MacDonald, Ian; Devonport, Tracey J.; Friesen, Andrew P.; Beedie, Christopher J.; Stanley, Damian; Nevill, Alan

    2016-01-01

    In conjunction with BBC Lab UK, the present study developed 12 brief psychological skill interventions for online delivery. A protocol was designed that captured data via self-report measures, used video recordings to deliver interventions, involved a competitive concentration task against an individually matched computer opponent, and provided feedback on the effects of the interventions. Three psychological skills were used; imagery, self-talk, and if-then planning, with each skill directed to one of four different foci: outcome goal, process goal, instruction, or arousal-control. This resulted in 12 different intervention participant groups (randomly assigned) with a 13th group acting as a control. Participants (n = 44,742) completed a competitive task four times—practice, baseline, following an intervention, and again after repeating the intervention. Results revealed performance improved following practice with incremental effects for imagery-outcome, imagery-process, and self-talk-outcome and self-talk-process over the control group, with the same interventions increasing the intensity of effort invested, arousal and pleasant emotion. Arousal-control interventions associated with pleasant emotions, low arousal, and low effort invested in performance. Instructional interventions were not effective. Results offer support for the utility of online interventions in teaching psychological skills and suggest brief interventions that focus on increasing motivation, increased arousal, effort invested, and pleasant emotions were the most effective. PMID:27065904

  2. Brief Online Training Enhances Competitive Performance: Findings of the BBC Lab UK Psychological Skills Intervention Study.

    PubMed

    Lane, Andrew M; Totterdell, Peter; MacDonald, Ian; Devonport, Tracey J; Friesen, Andrew P; Beedie, Christopher J; Stanley, Damian; Nevill, Alan

    2016-01-01

    In conjunction with BBC Lab UK, the present study developed 12 brief psychological skill interventions for online delivery. A protocol was designed that captured data via self-report measures, used video recordings to deliver interventions, involved a competitive concentration task against an individually matched computer opponent, and provided feedback on the effects of the interventions. Three psychological skills were used; imagery, self-talk, and if-then planning, with each skill directed to one of four different foci: outcome goal, process goal, instruction, or arousal-control. This resulted in 12 different intervention participant groups (randomly assigned) with a 13th group acting as a control. Participants (n = 44,742) completed a competitive task four times-practice, baseline, following an intervention, and again after repeating the intervention. Results revealed performance improved following practice with incremental effects for imagery-outcome, imagery-process, and self-talk-outcome and self-talk-process over the control group, with the same interventions increasing the intensity of effort invested, arousal and pleasant emotion. Arousal-control interventions associated with pleasant emotions, low arousal, and low effort invested in performance. Instructional interventions were not effective. Results offer support for the utility of online interventions in teaching psychological skills and suggest brief interventions that focus on increasing motivation, increased arousal, effort invested, and pleasant emotions were the most effective. PMID:27065904

  3. Anaphylaxis in the allergist's office: preparing your office and staff for medical emergencies.

    PubMed

    Wallace, Dana V

    2013-01-01

    All allergists who administer subcutaneous immunotherapy (SCIT) experience anaphylaxis in their offices and must devote proper planning, preparation, and practice to ensure that all staff members recognize the early signs and symptoms of anaphylaxis and can respond appropriately. Educating staff and patients, preparing an anaphylaxis emergency cart, developing and following selection criteria for SCIT and high-risk procedures, and customizing an "Action Plan for Anaphylaxis Management" create the foundation for mounting an adequate response to anaphylaxis. Strategies to prevent near-fatal and fatal reactions include (1) avoiding, when possible, the administration of SCIT to patients on beta-blockers; (2) using a preinjection questionnaire to review changes in the patient's medical condition, e.g., episodes of asthma since the previous injection; (3) using standardized forms and procedures for SCIT; (4) one might also consider an objective measure of airway function (e.g., peak flow measurement) for the asthmatic patient before allergy injections; (5) insisting on a 30-minute waiting time after SCIT; and (6) giving consideration to prescribing a dual-pack epinephrine autoinjector to all SCIT patients. Treatment of anaphylaxis should start with epinephrine administered intramuscularly at the first sign of anaphylaxis. Oxygen and i.v. fluids may be needed for moderate-to-severe anaphylaxis or anaphylaxis that is quickly developing or unresponsive to the first injection of epinephrine. Emergency medical services should be called for all patients who are experiencing moderate-to-severe (grade 2 or higher) anaphylaxis, if they require more than 1 dose of epinephrine and/or i.v. fluids, or if they do not immediately respond to treatment.

  4. 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

  5. Detecting tympanostomy tubes from otoscopic images via offline and online training.

    PubMed

    Wang, Xin; Valdez, Tulio A; Bi, Jinbo

    2015-06-01

    Tympanostomy tube placement has been commonly used nowadays as a surgical treatment for otitis media. Following the placement, regular scheduled follow-ups for checking the status of the tympanostomy tubes are important during the treatment. The complexity of performing the follow up care mainly lies on identifying the presence and patency of the tympanostomy tube. An automated tube detection program will largely reduce the care costs and enhance the clinical efficiency of the ear nose and throat specialists and general practitioners. In this paper, we develop a computer vision system that is able to automatically detect a tympanostomy tube in an otoscopic image of the ear drum. The system comprises an offline classifier training process followed by a real-time refinement stage performed at the point of care. The offline training process constructs a three-layer cascaded classifier with each layer reflecting specific characteristics of the tube. The real-time refinement process enables the end users to interact and adjust the system over time based on their otoscopic images and patient care. The support vector machine (SVM) algorithm has been applied to train all of the classifiers. Empirical evaluation of the proposed system on both high quality hospital images and low quality internet images demonstrates the effectiveness of the system. The offline classifier trained using 215 images could achieve a 90% accuracy in terms of classifying otoscopic images with and without a tympanostomy tube, and then the real-time refinement process could improve the classification accuracy by 3-5% based on additional 20 images. PMID:25889718

  6. Preliminary report: complement activation in wasp-sting anaphylaxis.

    PubMed

    van der Linden, P W; Hack, C E; Kerckhaert, J A; Struyvenberg, A; van der Zwan, J C

    1990-10-13

    The generation of the anaphylatoxin C3a was measured after a wasp-sting challenge in eight patients with previous anaphylactic reactions to wasp stings. Whereas there was no change in C3a in one patient who showed no reaction and only a slight rise in three patients with mild reactions, C3a rose substantially in the four patients with severe anaphylactic reactions. This complement activation is the first in-vitro variable which correlates with the severity of wasp-sting anaphylactic reactions. A role for complement activation in the pathophysiology of wasp-sting anaphylaxis is therefore suggested.

  7. Anaphylaxis induced by pine nuts in two young girls.

    PubMed

    Ibáñez, M Dolores; Lombardero, Manuel; San Ireneo, Mercedes Martinez; Muñoz, M Carmen

    2003-08-01

    Pine nuts are the seeds of Pinus pinea. There are few reported cases of allergy to pine nut. We describe two young girls with anaphylaxis caused by small amounts of pine nuts. Specific IgE to pine nut was demonstrated by skin prick tests and RAST but no IgE to other nuts and pine pollen was detected. The patients had IgE against a pine nut protein band with apparent molecular weights of approximately 17 kDa that could be considered as the main allergen. Our patients were monosensitized to pine nut and the 17-kDa protein could be correlated with the severe clinical symptoms.

  8. Convergence analyses on on-line weight noise injection-based training algorithms for MLPs.

    PubMed

    Sum, John; Leung, Chi-Sing; Ho, Kevin

    2012-11-01

    Injecting weight noise during training is a simple technique that has been proposed for almost two decades. However, little is known about its convergence behavior. This paper studies the convergence of two weight noise injection-based training algorithms, multiplicative weight noise injection with weight decay and additive weight noise injection with weight decay. We consider that they are applied to multilayer perceptrons either with linear or sigmoid output nodes. Let w(t) be the weight vector, let V(w) be the corresponding objective function of the training algorithm, let α >; 0 be the weight decay constant, and let μ(t) be the step size. We show that if μ(t)→ 0, then with probability one E[||w(t)||2(2)] is bound and lim(t) → ∞ ||w(t)||2 exists. Based on these two properties, we show that if μ(t)→ 0, Σtμ(t)=∞, and Σtμ(t)(2) <; ∞, then with probability one these algorithms converge. Moreover, w(t) converges with probability one to a point where ∇wV(w)=0. PMID:24808076

  9. Patients’ ability to treat anaphylaxis using adrenaline autoinjectors: a randomized controlled trial

    PubMed Central

    Umasunthar, T; Procktor, A; Hodes, M; Smith, J G; Gore, C; Cox, H E; Marrs, T; Hanna, H; Phillips, K; Pinto, C; Turner, P J; Warner, J O; Boyle, R J

    2015-01-01

    Background Previous work has shown patients commonly misuse adrenaline autoinjectors (AAI). It is unclear whether this is due to inadequate training, or poor device design. We undertook a prospective randomized controlled trial to evaluate ability to administer adrenaline using different AAI devices. Methods We allocated mothers of food-allergic children prescribed an AAI for the first time to Anapen or EpiPen using a computer-generated randomization list, with optimal training according to manufacturer's instructions. After one year, participants were randomly allocated a new device (EpiPen, Anapen, new EpiPen, JEXT or Auvi-Q), without device-specific training. We assessed ability to deliver adrenaline using their AAI in a simulated anaphylaxis scenario six weeks and one year after initial training, and following device switch. Primary outcome was successful adrenaline administration at six weeks, assessed by an independent expert. Secondary outcomes were success at one year, success after switching device, and adverse events. Results We randomized 158 participants. At six weeks, 30 of 71 (42%) participants allocated to Anapen and 31 of 73 (43%) participants allocated to EpiPen were successful – RR 1.00 (95% CI 0.68–1.46). Success rates at one year were also similar, but digital injection was more common at one year with EpiPen (8/59, 14%) than Anapen (0/51, 0%, P = 0.007). When switched to a new device without specific training, success rates were higher with Auvi-Q (26/28, 93%) than other devices (39/80, 49%; P < 0.001). Conclusions AAI device design is a major determinant of successful adrenaline administration. Success rates were low with several devices, but were high using the audio-prompt device Auvi-Q. PMID:25850463

  10. When big brother is watching: goal orientation shapes reactions to electronic monitoring during online training.

    PubMed

    Watson, Aaron M; Foster Thompson, Lori; Rudolph, Jane V; Whelan, Thomas J; Behrend, Tara S; Gissel, Amanda L

    2013-07-01

    Web-based training is frequently used by organizations as a convenient and low-cost way to teach employees new knowledge and skills. As web-based training is typically unproctored, employees may be held accountable to the organization by computer software that monitors their behaviors. The current study examines how the introduction of electronic performance monitoring may provoke negative emotional reactions and decrease learning among certain types of e-learners. Through motivated action theory and trait activation theory, we examine the role of performance goal orientation when e-learners are exposed to asynchronous and synchronous monitoring. We show that some e-learners are more susceptible than others to evaluation apprehension when they perceive their activities are being monitored electronically. Specifically, e-learners higher in avoid performance goal orientation exhibited increased evaluation apprehension if they believed asynchronous monitoring was present, and they showed decreased skill attainment as a result. E-learners higher on prove performance goal orientation showed greater evaluation apprehension if they believed real-time monitoring was occurring, resulting in decreased skill attainment.

  11. 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

  12. Combined effects of food and exercise on anaphylaxis.

    PubMed

    Kim, Cheol Woo; Figueroa, Arturo; Park, Chan Ho; Kwak, Yi Sub; Kim, Kwi Baek; Seo, Dae Yun; Lee, Hyung Rock

    2013-10-01

    Food-dependent exercise-induced anaphylaxis (FDEIAn) is induced by different types and various intensities of physical activity, and is distinct from food allergies. It has been shown that consumption of allergenic food followed by exercise causes FDEIAn symptoms. Intake of allergenic food or medication before exercise is a major predisposing factor for FDEIAn. Urticaria and severe allergic reactions are general symptoms of FDEIAn. Dermatological tests and serum IgE assays are the typical prescreening methods, and have been used for several decades. However, these screening tests are not sufficient for detecting or preventing FDEIAn. It has been found that exercise may stimulate the release of mediators from IgE-dependent mast cells that can result in FDEIAn when a certain threshold level has been exceeded. Mast cell degradation might be a major factor to induce FDEIAn but this has not been determined. A number of foods have been reported to be involved in the onset of FDEIAn including wheat, eggs, chicken, shrimp, shellfish, nuts, fruits, and vegetables. It is also known that aspirin increases the occurrence of type I allergy symptoms when combined with specific foods. Moreover, high intensity and frequent exercise are more likely to provoke an attack than low intensity and less frequent exercise. In this paper, we present the current views of the pathophysiological mechanisms underlying FDEIAn within the context of exercise immunology. We also present a detailed FDEIAn definition along with etiologic factors and medical treatment for cholinergic urticaria (UC) and exercise-induced anaphylaxis (EIA).

  13. 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

  14. A Multicenter Retrospective Case Study of Anaphylaxis Triggers by Age in Korean Children

    PubMed Central

    Lee, So-Yeon; Ahn, Kangmo; Kim, Jihyun; Jang, Gwang Cheon; Min, Taek Ki; Yang, Hyeon-Jong; Pyun, Bok Yang; Kwon, Ji-Won; Sohn, Myung Hyun; Kim, Kyung Won; Kim, Kyu-Earn; Yu, Jinho; Hong, Soo-Jong; Kwon, Jung Hyun; Kim, Sung-Won; Song, Tae Won; Kim, Woo Kyung; Kim, Hyung Young; Jeon, You Hoon; Lee, Yong Ju; Lee, Hae Ran; Kim, Hye-Young; Ahn, Youngmin; Yum, Hye Yung; Suh, Dong In; Kim, Hyun Hee; Kim, Jin-Tack; Kim, Jeong Hee; Park, Yong Mean

    2016-01-01

    Purpose Although anaphylaxis is recognized as an important, life-threatening condition, data are limited regarding its triggers in different age groups. We aimed to identify anaphylaxis triggers by age in Korean children. Methods We performed a retrospective review of medical records for children diagnosed with anaphylaxis between 2009 and 2013 in 23 secondary or tertiary hospitals in South Korea. Results A total of 991 cases (mean age=5.89±5.24) were reported, with 63.9% involving patients younger than 6 years of age and 66% involving male children. Food was the most common anaphylaxis trigger (74.7%), followed by drugs and radiocontrast media (10.7%), idiopathic factors (9.2%), and exercise (3.6%). The most common food allergen was milk (28.4%), followed by egg white (13.6%), walnut (8.0%), wheat (7.2%), buckwheat (6.5%), and peanut (6.2%). Milk and seafood were the most common anaphylaxis triggers in young and older children, respectively. Drug-triggered anaphylaxis was observed more frequently with increasing age, with antibiotics (34.9%) and nonsteroidal anti-inflammatory drugs (17.9%) being the most common causes. Conclusions The most common anaphylaxis trigger in Korean children was food. Data on these triggers show that their relative frequency may vary by age. PMID:27582405

  15. Memristor-based multilayer neural networks with online gradient descent training.

    PubMed

    Soudry, Daniel; Di Castro, Dotan; Gal, Asaf; Kolodny, Avinoam; Kvatinsky, Shahar

    2015-10-01

    Learning in multilayer neural networks (MNNs) relies on continuous updating of large matrices of synaptic weights by local rules. Such locality can be exploited for massive parallelism when implementing MNNs in hardware. However, these update rules require a multiply and accumulate operation for each synaptic weight, which is challenging to implement compactly using CMOS. In this paper, a method for performing these update operations simultaneously (incremental outer products) using memristor-based arrays is proposed. The method is based on the fact that, approximately, given a voltage pulse, the conductivity of a memristor will increment proportionally to the pulse duration multiplied by the pulse magnitude if the increment is sufficiently small. The proposed method uses a synaptic circuit composed of a small number of components per synapse: one memristor and two CMOS transistors. This circuit is expected to consume between 2% and 8% of the area and static power of previous CMOS-only hardware alternatives. Such a circuit can compactly implement hardware MNNs trainable by scalable algorithms based on online gradient descent (e.g., backpropagation). The utility and robustness of the proposed memristor-based circuit are demonstrated on standard supervised learning tasks.

  16. The NGS WikiBook: a dynamic collaborative online training effort with long-term sustainability.

    PubMed

    Li, Jing-Woei; Bolser, Dan; Manske, Magnus; Giorgi, Federico Manuel; Vyahhi, Nikolay; Usadel, Björn; Clavijo, Bernardo J; Chan, Ting-Fung; Wong, Nathalie; Zerbino, Daniel; Schneider, Maria Victoria

    2013-09-01

    Next-generation sequencing (NGS) is increasingly being adopted as the backbone of biomedical research. With the commercialization of various affordable desktop sequencers, NGS will be reached by increasing numbers of cellular and molecular biologists, necessitating community consensus on bioinformatics protocols to tackle the exponential increase in quantity of sequence data. The current resources for NGS informatics are extremely fragmented. Finding a centralized synthesis is difficult. A multitude of tools exist for NGS data analysis; however, none of these satisfies all possible uses and needs. This gap in functionality could be filled by integrating different methods in customized pipelines, an approach helped by the open-source nature of many NGS programmes. Drawing from community spirit and with the use of the Wikipedia framework, we have initiated a collaborative NGS resource: The NGS WikiBook. We have collected a sufficient amount of text to incentivize a broader community to contribute to it. Users can search, browse, edit and create new content, so as to facilitate self-learning and feedback to the community. The overall structure and style for this dynamic material is designed for the bench biologists and non-bioinformaticians. The flexibility of online material allows the readers to ignore details in a first read, yet have immediate access to the information they need. Each chapter comes with practical exercises so readers may familiarize themselves with each step. The NGS WikiBook aims to create a collective laboratory book and protocol that explains the key concepts and describes best practices in this fast-evolving field.

  17. 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

  18. 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

  19. Online training course on critical appraisal for nurses: adaptation and assessment

    PubMed Central

    2014-01-01

    Background Research is an essential activity for improving quality and efficiency in healthcare. The objective of this study was to train nurses from the public Basque Health Service (Osakidetza) in critical appraisal, promoting continuous training and the use of research in clinical practice. Methods This was a prospective pre-post test study. The InfoCritique course on critical appraisal was translated and adapted. A sample of 50 nurses and 3 tutors was recruited. Educational strategies and assessment instruments were established for the course. A course website was created that contained contact details of the teaching team and coordinator, as well as a course handbook and videos introducing the course. Assessment comprised the administration of questionnaires before and after the course, in order to explore the main intervention outcomes: knowledge acquired and self-learning readiness. Satisfaction was also measured at the end of the course. Results Of the 50 health professionals recruited, 3 did not complete the course for personal or work-related reasons. The mean score on the pre-course knowledge questionnaire was 70.5 out of 100, with a standard deviation of 11.96. In general, participants’ performance on the knowledge questionnaire improved after the course, as reflected in the notable increase of the mean score, to 86.6, with a standard deviation of 10.00. Further, analyses confirmed statistically significant differences between pre- and post-course results (p < 0.001). With regard to self-learning readiness, after the course, participants reported a greater readiness and ability for self-directed learning. Lastly, in terms of level of satisfaction with the course, the mean score was 7 out of 10. Conclusions Participants significantly improved their knowledge score and self-directed learning readiness after the educational intervention, and they were overall satisfied with the course. For the health system and nursing professionals, this type of

  20. 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

  1. CD4-Blockade Can Induce Protection from Peanut-Induced Anaphylaxis

    PubMed Central

    Duarte, Joana; Caridade, Marta; Graca, Luis

    2011-01-01

    Monoclonal antibodies (mAb) have been shown effective in inducing immune tolerance in a range of animal models of autoimmunity, allergy, and transplantation. We investigated whether CD4-blockade, effective in inducing transplantation tolerance, could prevent systemic immune responses leading to anaphylaxis. We found that treatment with a non-depleting anti-CD4 mAb could prevent peanut-induced anaphylaxis following subsequent systemic exposure to crude peanut extract (CPE). Furthermore, the effect of CD4-blockade did not interfere with overall immune competence, as anti-CD4 treated mice remained fully competent to respond to unrelated antigens. Protection from anaphylaxis correlated with increased frequency of Foxp3+ regulatory T cells (Treg), and was abrogated following Treg depletion. Taken together our data suggest that activation of T cells by CPE in presence of CD4-blockade leads to Treg expansion that can prevent peanut-induced anaphylaxis. PMID:22566846

  2. Recommendations for the management of food allergies in a preschool/childcare setting and prevention of anaphylaxis.

    PubMed

    Ford, Lara S; Turner, Paul J; Campbell, Dianne E

    2014-07-01

    Food allergy and anaphylaxis occur most commonly in children under five, the majority of whom attend preschool and early childcare. Children under five differ significantly from school-aged children, as do their care environments, yet specific strategies for managing food allergies in early childcare settings are generally lacking in existing guidelines and legislation. In this review, we outline the scope of the problem, the unique challenges encountered in the preschool environment and existing policy and legislation in Australia, the US, Canada and the UK. We outline the management guidelines and resources available from specialist societies, and the evidence base for specific management strategies including voluntary versus legislative approaches, staff training and education, banning of foods, and availability of multiple and generic adrenaline auto-injectors. We call for greater uniformity and consistency of policy in regards to the recognition and management of infants and children with food allergy in the preschool environment and specific programmes and policies tailored to this environment.

  3. Managing nut-induced anaphylaxis: challenges and solutions.

    PubMed

    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.

  4. 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

  5. Chlorpheniramine-induced anaphylaxis diagnosed by basophil activation test.

    PubMed

    Lee, Hyun-Seung; Song, Woo-Jung; Lee, Ji-Won; Cho, Young-Yoon; Park, Han-Ki; Kang, Min-Gyu; Cho, Sang-Heon; Sohn, Seong-Wook

    2015-07-01

    Chlorpheniramine is a widely prescribed H1-antihistamine for relieving urticaria or histamine-mediated allergic reactions. However, although rare, it may cause immediate hypersensitivity reactions. The diagnosis is usually made by provocation test, but its application is often limited due to comorbidities or potential risk of severe reactions. In those cases, skin tests and basophil activation tests can be considered as additional diagnostic tests for the drug allergy. Here, we report a 33-year-old female with underlying chronic urticaria, who recurrently developed anaphylaxis after chlorpheniramine administration. Intradermal test showed positive responses in the patient at 0.02 mg/mL of chlorpheniramine, but not in healthy controls. Basophil activation test showed significant up-regulation of CD63 and CD203c by chlorpheniramine. The present case reminds the rare but potential allergic risk of chlorpheniramine, and also suggests the potential utility of basophil activation test in making the diagnosis.

  6. 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.

  7. 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

  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. Hymenoptera Anaphylaxis and C-kit Mutations: An Unexpected Association.

    PubMed

    Bonadonna, Patrizia; Bonifacio, Massimiliano; Lombardo, Carla; Zanotti, Roberta

    2015-08-01

    Clinical manifestations of mastocytosis in adults comprise signs and symptoms linked to mast cell (MC) activation, including anaphylaxis. Depending on MC burden, adults can be diagnosed with systemic mastocytosis, when the WHO criteria are fulfilled, or with other clonal MC disorders, characterized by MC mediator symptoms and demonstration of activating KIT mutations and/or expression of CD25 on MCs. There is a specific link between mastocytosis and hymenoptera venom allergy (HVA): the reported frequency of HVA in mastocytosis is 20-50 % and raises to 60-80 % in patients affected by indolent systemic mastocytosis without skin lesions. The presentation of HVA characterized by severe hypotension in the absence of urticarial or angioedema is typical in patient with an underlying MC disorder, even in the presence of normal baseline serum tryptase levels.

  10. Making the grade with asthma, allergies, and anaphylaxis.

    PubMed

    Sander, Nancy

    2002-01-01

    For some students with asthma, allergies, or anaphylaxis, school attendance can be risky. School administrators and educators are ill prepared to address medical challenges of students with chronic illness. Yet, the number of school nurses employed in the United States and the nurse-student ratio is uncertain. An unknown number of schools restrict children's rights to carry prescribed lifesaving medications while at or traveling to and from school or on field trips. Additionally, school indoor air quality is often poor and adversely affects students' health. Nurses are natural educators and advocates. Both of these roles are instrumental in empowering families to ensure the health of their children with asthma and allergies while in school.

  11. 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

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

    PubMed

    van Nunen, Sheryl

    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

  13. 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

  14. Anaphylaxis-related deaths in Ontario: a retrospective review of cases from 1986 to 2011

    PubMed Central

    2014-01-01

    Background Examining deaths caused by anaphylaxis may help identify factors that may decrease the risk of these unfortunate events. However, information on fatal anaphylaxis is limited. The objectives of our study were to examine all cases of fatal anaphylaxis in Ontario to determine cause of death, associated features, co factors and trends in mortality. The identification of these factors is important for developing effective strategies to overcome gaps in monitoring and treatment of patients with food allergies and risk for anaphylaxis. Methods This was a retrospective case-series analysis of all causes of anaphylaxis-related deaths using data from the Ontario Coroner’s database between 1986 and 2011. Quantitative data (e.g. demographic) were analyzed using descriptive statistics and frequency analysis using SPSS. Qualitative data were analyzed using content analysis of grounded theory methodology. Results We found 92 deaths in the last 26 years related to anaphylaxis. Causes of death, in order of decreasing frequency, included food (40 cases), insect venom (30 cases), iatrogenic (16 cases), and idiopathic (6 cases). Overall, there appears to be a decline in the frequency of food related deaths, but an increase in iatrogenic causes of fatalities. We found factors associated with fatal anaphylaxis included: delayed epinephrine administration, asthma, allergy to peanut, food ingestion outside the home, and teenagers with food allergies. Conclusions Our findings indicate the need to improve epinephrine auto-injector use in acute reactions, particularly for teens and asthmatics with food allergies. In addition, education can be improved among food service workers and food industry in order to help food allergic patients avoid potentially fatal allergens. The increasing trend in iatrogenic related anaphylaxis is concerning, and requires monitoring and more investigation. PMID:25670935

  15. A dangerous exercise lessons from food-dependent anaphylaxis for the physician.

    PubMed

    Medveczky, Thomas

    2014-10-01

    Exercise-induced anaphylaxis (EIA) and its subtype, food dependent exercise-induced anaphylaxis are uncommon and therefore underdiagnosed forms of physical allergy. Triggers include various degrees of exercise in combination with ingestion of specific food products. Treatment remains identical to that of IgE-mediated allergic reactions. The presentation is commonly underdiagnosed and caries significant fatality risk, and this case should raise the awareness of the attending physician.

  16. 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.

  17. [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

  18. Anaphylaxis syndromes related to a new mammalian cross-reactive carbohydrate determinant

    PubMed Central

    Commins, Scott P.; Platts-Mills, Thomas A. E.

    2009-01-01

    Anaphylaxis is a severe allergic reaction that can be rapidly progressing and occasionally fatal. In instances where the triggering allergen is not obvious, establishing the etiology of anaphylaxis is pivotal to long-term management. Assigning etiology is limited, however, by the number of known exposures associated with anaphylaxis. Therefore, identification of novel causative agents can provide an important step forward in facilitating new, allergen specific approaches to management. In contrast to the view that carbohydrate-directed IgE has minimal, if any, clinical significance, recent data suggests that IgE antibodies to carbohydrate epitopes can be an important factor in anaphylaxis that may otherwise appear to be idiopathic. Specifically, IgE antibodies to the carbohydrate galactose-α-1,3-galactose (alpha-gal) were found to be capable of eliciting serious, even fatal, reactions to the monoclonal antibody (ab) cetuximab.1 Moreover, alpha-gal has recently been identified as a novel food allergen.2 Patients who have IgE to alpha-gal report delayed anaphylaxis or urticaria occurring 3-6 hours after eating beef, pork or lamb. Here, we review the evidence relating to carbohydrates in food allergy and anaphylaxis and discuss the implications of a new mammalian cross-reactive carbohydrate determinant (CCD). PMID:19815111

  19. 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

  20. Platelets in the immune response: Revisiting platelet-activating factor in anaphylaxis.

    PubMed

    Gill, Parwinder; Jindal, Nina Lakhani; Jagdis, Amanda; Vadas, Peter

    2015-06-01

    Anaphylaxis is an acute, severe, life-threatening multisystem allergic reaction resulting from the sudden systemic release of biochemical mediators and chemotactic substances. Release of both preformed granule-associated mediators and newly generated lipid-derived mediators contributes to the amplification and prolongation of anaphylaxis. Platelet-activating factor (PAF) is a potent phospholipid-derived mediator the central role of which has been well established in experimental models of both immune-mediated and non-immune mediated anaphylaxis. It is produced and secreted by several types of cells, including mast cells, monocytes, tissue macrophages, platelets, eosinophils, endothelial cells, and neutrophils. PAF is implicated in platelet aggregation and activation through release of vasoactive amines in the inflammatory response, resulting in increased vascular permeability, circulatory collapse, decreased cardiac output, and various other biological effects. PAF is rapidly hydrolyzed and degraded to an inactive metabolite, lysoPAF, by the enzyme PAF acetylhydrolase, the activity of which has shown to correlate inversely with PAF levels and predispose to severe anaphylaxis. In addition to its role in anaphylaxis, PAF has also been implicated as a mediator in both allergic and nonallergic inflammatory diseases, including allergic rhinitis, sepsis, atherosclerotic disease, and malignancy, in which PAF signaling has an established role. The therapeutic role of PAF antagonism has been investigated for several diseases, with variable results thus far. Further investigation of its role in pathology and therapeutic modulation is highly anticipated because of the pressing need for more selective and targeted therapy for the management of severe anaphylaxis.

  1. Case Fatality and Population Mortality Associated with Anaphylaxis in the United States

    PubMed Central

    Ma, Liyuan (Larry); Danoff, Theodore M.; Borish, Larry

    2013-01-01

    Background Anaphylaxis is a serious allergic reaction that may cause death; however, the actual risk of death is unclear. Objective To estimate the case fatality rate (CFR) among hospitalizations or emergency department (ED) presentations for anaphylaxis and the mortality rate associated with anaphylaxis for the general population. Methods This was a population-based epidemiologic study using 3 national databases: Nationwide Inpatient Sample (NIS, 1999-2009), Nationwide Emergency Department Sample (NEDS, 2006-2009), and Multiple Cause of Death Data (MCDD, 1999-2009). Sources for these databases are hospital, ED discharge records and death certificates, respectively. Results CFRs were between 0.25% and 0.33% among hospitalizations or ED presentations with anaphylaxis as the principal diagnosis (NIS+NEDS, 2006-2009). These rates represent 63 to 99 deaths per year in the United States, approximately 77% of which occurred in hospitalized patients. Rate of anaphylaxis hospitalizations rose from 21.0 to 25.1 per million population between 1999 and 2009 (annual percent change 2.23%; 95% CI: 1.52%–2.94%), contrasting with a declining CFR among hospitalizations (annual percent change –2.35%; 95% CI: –4.98% to 0.34%). Overall mortality rates ranged from 0.63 to 0.76 per million population (186 to 225 deaths per year, MCDD), and appeared stable in the last decade (annual percent change: –0.31%; 95% CI, –1.54% to 0.93%). Conclusion From 2006 to 2009, the overwhelming majority of hospitalizations or ED presentations for anaphylaxis did not result in death, with an average CFR of 0.3%. Anaphylaxis-related hospitalizations rose steadily in the last decade (1999-2009), but this increase was offset by the declining CFR among those hospitalized; both inpatient and overall mortality rates associated with anaphylaxis appeared stable and were well under 1 per million population. Although anaphylactic reactions are potentially life threatening, the probability of dying is

  2. A multifaceted intervention increases epinephrine use in adult emergency department anaphylaxis patients

    PubMed Central

    Manivannan, Veena; Hess, Erik P.; Bellamkonda, Venkatesh R.; Nestler, David M.; Bellolio, M. Fernanda; Hagan, John B.; Sunga, Kharmene L.; Decker, Wyatt W.; Li, James T.C.; Scanlan-Hanson, Lori N.; Vukov, Samuel C.; Campbell, Ronna L.

    2014-01-01

    Background Studies have documented inconsistent emergency anaphylaxis care and low compliance with published guidelines. Objective To evaluate anaphylaxis management before and after implementation of an emergency department (ED) anaphylaxis order set and introduction of epinephrine auto-injectors and to measure the effect on anaphylaxis guideline adherence. Methods A cohort study was conducted from April 29, 2008-August 9, 2012. Adult ED patients diagnosed with anaphylaxis were included. ED management, disposition, self-injectable epinephrine prescriptions, allergy follow-up and incidence of biphasic reactions were evaluated. Results The study included 202 patients. Median age of patients was 45.3 years (IQR 31.3 – 56.4); 139 (69%) were female. Patients who presented after order set implementation were more likely to be treated with epinephrine (51% vs. 33%, OR 2.05, 95%CI 1.04- 4.04) and admitted to ED observation unit (EDOU) (65% vs. 44%, OR 2.38, 95%CI 1.23-4.60) and less likely to be dismissed home directly from ED (16% vs. 29%, OR: 0.47, 95%CI 0.22- 1.00). Eleven patients (5%) had a biphasic reaction. Of these, five (46%) had the biphasic reaction in EDOU; one patient was admitted to intensive care unit (ICU). Six patients (55%) had reactions within 6 hours of initial symptom resolution of whom two were admitted to ICU. Conclusion Significantly greater proportions of anaphylaxis patients received epinephrine and were admitted to EDOU after introduction of epinephrine auto-injectors and order set implementation. Slightly over half of the biphasic reactions occurred within recommended observation time of 4-6 hours. These data suggest that the multifaceted approach to changing anaphylaxis management described here improved guideline adherence. PMID:24811020

  3. 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

  4. Effective Online Teachers

    ERIC Educational Resources Information Center

    Muirhead, Brent

    2006-01-01

    Effective online teaching is a popular topic in today's educational technology journals due to the vital role that educators play in the teaching and learning process. The author will provide insights into effective online teachers and highlight training and mentoring practices for online instructors at the University of Phoenix.

  5. [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

  6. 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

  7. Anaphylaxis to pine nut: cross-reactivity to Artemisia vulgaris?

    PubMed

    Rodrigues-Alves, R; Pregal, A; Pereira-Santos, M C; Branco-Ferreira, M; Lundberg, M; Oman, H; Pereira-Barbosa, M

    2008-01-01

    The use of pine nuts, the seeds of Pinus pinea, is on the increasing in the modern Mediterranean diet. Little more than 20 cases of allergy to this tree nut have been published, and cross-reactivity with pine pollen, peanut and almond has already been reported. We describe the case of a young boy with several episodes of anaphylaxis after pine nut ingestion. Specific IgE to pine nut and Artemisia vulgaris was demonstrated by skin prick tests and in vitro determination of specific IgE, although no IgE to pine pollen or other nuts was detected. Immunoblotting of Artemisia vulgaris and pine nut revealed two matching diffuse bands, just below 14 kDa and 30 kDa. The ImmunoCAP inhibition assays showed complete inhibition of pine nut specific IgE after serum incubation with Artemisia vulgaris extract. As far as we know, this is the first reported case of documented cross-reactivity between pine nut and Artemisia vulgaris.

  8. Anaphylaxis to polyvinylpyrrolidone after vaginal application of povidone-iodine.

    PubMed

    Adachi, Atsuko; Fukunaga, Atsushi; Hayashi, Kazuhiro; Kunisada, Makoto; Horikawa, Tatsuya

    2003-03-01

    A 59-year-old woman who had had several episodes of contact urticaria after hair treatment, developed anaphylaxis after vaginal application of povidone-iodine solution for disinfection. Prick tests showed wheal-and-flare responses to both povidone-iodine (0.1% aqueous) and polyvinylpyrrolidone (povidone, PVP) (0.001% aq.), but not to iodine or polyoxy-ethyrenenonylphenyl ether, both of which are also contained in povidone-iodine solution. We confirmed that basophils from her peripheral blood released considerable amounts of histamine on stimulation by PVPs. It appeared that both the shampoo and the permanent-wave solution contained polyvinylpyrrolidone N, N-dimethyl aminoethyl methacrylic acid copolymer diethyl sulphate solution and polyvinylpyrrolidone styrene-copolymer emulsion. Both these agents in the hair care products provoked an immediate skin response on prick testing. We speculate that sensitization to PVP had been established by these hair care products at a beauty parlor. She was recommended to avoid PVP-containing products and remained free from symptoms thereafter.

  9. 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.

  10. Treatment with a combination of omalizumab and specific immunotherapy for severe anaphylaxis after a wasp sting.

    PubMed

    Palgan, K; Bartuzi, Z; Gotz-Zbikowska, M

    2014-01-01

    Hymenoptera venom anaphylaxis after bee or wasp sting is a common problem that affects about 1.2 percent to 3.5 percent of the general population. Venom-specific immunotherapy (VIT) is an established mode of treatment for immunoglobulin (Ig) E-mediated Hymenoptera venom allergy. However, VIT may often be associated with immediate anaphylaxis which can lead to treatment withdrawal. Several cases published in recent years suggest that omalizumab, used as add-on therapy may be able to prevent anaphylaxis during VIT. We report the case of a 30-year-old woman, suffering from mild persistent asthma, who had a history of severe anaphylactic reactions after yellow jacket sting, and after eating peanuts, contact with guinea pig hair, and i.v. administration of dexamethasone natrium phosphate. Initial specific immunotherapy had to be stopped due to severe anaphylaxis (hypotension, dyspnea, and angioedema). The immunotherapy was reintroduced accompanied by the anti-immunoglobulin (Ig) E monoclonal antibody omalizumab. Subcutaneous omalizumab 150 mg was initiated 4 weeks after the anaphylaxis incident and 1 day before the resumption of VIT. Rush treatment was uneventful, and the usual cumulative dose of 111.1 microg was successfully reached. The combination of omalizumab and VIT is a valid option of therapy for these patients and could reduce asthma and food allergy symptoms.

  11. [Anaphylaxis secondary to prick-to-prick tests to foods and its risk factors].

    PubMed

    Galindo-Pacheco, Lucy Vania; O'Farrill-Romanillos, Patricia María; Amaya-Mejía, Adela Sisy; Almeraya-García, Priscilla; López-Rocha, Eunice

    2014-01-01

    The diagnosis of food allergy requires a proper anamnesis and diagnostic testing with skin prick tests with fresh foods and/or standardized allergen, or specific IgE tests. The risk of systemic reactions is of 15-23 per 100,000 skin tests performed by prick method, specifically anaphylaxis at 0.02%. This paper reports the case of four patients, who while performing prick to prick test with fresh food presented anaphylactic reaction. Implicated foods were fruits of the Rosaceae, Anacardiaceae and Caricaceae families. The severity of anaphylaxis was: two patients with grade 4, one patient grade 2 and one grade 3, all with appropriate response to drug treatment. The risk factors identified were: female sex, personal history of atopy, previous systemic reaction to Hymenoptera venom, prior anaphylaxis to prick tests to aeroallergens. We found that a history of positive skin test for Betulla v, can be a risk factor for anaphylaxis in patients with oral syndrome. During testing prick to prick with food anaphylaxis can occur, so it should be made with aerial red team on hand. The history of positivity Betulla v is an additional risk factor in these patients. PMID:24912999

  12. [Anaphylaxis secondary to prick-to-prick tests to foods and its risk factors].

    PubMed

    Galindo-Pacheco, Lucy Vania; O'Farrill-Romanillos, Patricia María; Amaya-Mejía, Adela Sisy; Almeraya-García, Priscilla; López-Rocha, Eunice

    2014-01-01

    The diagnosis of food allergy requires a proper anamnesis and diagnostic testing with skin prick tests with fresh foods and/or standardized allergen, or specific IgE tests. The risk of systemic reactions is of 15-23 per 100,000 skin tests performed by prick method, specifically anaphylaxis at 0.02%. This paper reports the case of four patients, who while performing prick to prick test with fresh food presented anaphylactic reaction. Implicated foods were fruits of the Rosaceae, Anacardiaceae and Caricaceae families. The severity of anaphylaxis was: two patients with grade 4, one patient grade 2 and one grade 3, all with appropriate response to drug treatment. The risk factors identified were: female sex, personal history of atopy, previous systemic reaction to Hymenoptera venom, prior anaphylaxis to prick tests to aeroallergens. We found that a history of positive skin test for Betulla v, can be a risk factor for anaphylaxis in patients with oral syndrome. During testing prick to prick with food anaphylaxis can occur, so it should be made with aerial red team on hand. The history of positivity Betulla v is an additional risk factor in these patients.

  13. 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

  14. 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.

  15. 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

  16. The syndrome of thyroid autoimmunity and idiopathic chronic urticaria and angioedema presenting as anaphylaxis.

    PubMed

    Dreyfus, David H; Fraser, Barbara; Randolph, Chris C

    2003-01-01

    Previous observations have shown that the syndrome of thyroid autoimmunity and idiopathic urticaria and angioedema (ICUA) can be associated with a marked worsening of reactive airway disease. Possibly, mediators released in this syndrome may contribute to acute bronchospasm and associated respiratory symptoms in some patients. In this study, two patients presenting with overlapping clinical presentations of the syndrome of thyroid immunity and ICUA are described in whom a diagnosis of anaphylaxis to food and antibiotics, respectively, was initially suspected but ruled out by testing and challenges. These cases illustrate clinical overlap between presentations of ICUA and anaphylaxis. We suggest that patients with idiopathic anaphylaxis be evaluated for the presence of antithyroid microsomal (peroxidase) antibodies or antithyroglobulin antibodies, particularly because the diagnosis of thyroid antibody-positive ICUA may suggest additional therapeutic options.

  17. Glucagon effects on 3H-histamine uptake by the isolated guinea-pig heart during anaphylaxis.

    PubMed

    Rosic, Mirko; Parodi, Oberdan; Jakovljevic, Vladimir; Colic, Maja; Zivkovic, Vladimir; Jokovic, Vuk; Pantovic, Suzana

    2014-01-01

    We estimated the influence of acute glucagon applications on (3)H-histamine uptake by the isolated guinea-pig heart, during a single (3)H-histamine passage through the coronary circulation, before and during anaphylaxis, and the influence of glucagon on level of histamine, NO, O2 (-), and H2O2 in the venous effluent during anaphylaxis. Before anaphylaxis, glucagon pretreatment does not change (3)H-histamine Umax and the level of endogenous histamine. At the same time, in the presence of glucagon, (3)H-histamine Unet is increased and backflux is decreased when compared to the corresponding values in the absence of glucagon. During anaphylaxis, in the presence of glucagon, the values of (3)H-histamine Umax and Unet are significantly higher and backflux is significantly lower in the presence of glucagon when compared to the corresponding values in the absence of glucagon. The level of endogenous histamine during anaphylaxis in the presence of glucagon (6.9-7.38 × 10(-8) μM) is significantly lower than the histamine level in the absence of glucagon (10.35-10.45 × 10(-8) μM). Glucagon pretreatment leads to a significant increase in NO release (5.69 nmol/mL) in comparison with the period before glucagon administration (2.49 nmol/mL). Then, in the presence of glucagon, O2 (-) level fails to increase during anaphylaxis. Also, our results show no significant differences in H2O2 levels before, during, and after anaphylaxis in the presence of glucagon, but these values are significantly lower than the corresponding values in the absence of glucagon. In conclusion, our results show that glucagon increases NO release and prevents the increased release of free radicals during anaphylaxis, and decreases histamine level in the venous effluent during cardiac anaphylaxis, which may be a consequence of decreased histamine release and/or intensified histamine capturing by the heart during anaphylaxis.

  18. Food-dependent exercise-induced anaphylaxis with a high level of plasma noradrenaline.

    PubMed

    Kato, Yukihiko; Nagai, Ayako; Saito, Masuyoshi; Ito, Tomonobu; Koga, Michiyuki; Tsuboi, Ryoji

    2007-02-01

    Ingesting certain foods sometimes triggers anaphylaxis when followed by exercise (food-dependent exercise-induced anaphylaxis, FDEIA). Specific food-induced mucocutaneous urticaria may also progress to anaphylaxis (oral allergy syndrome, OAS). A positive skin test and/or radioallergosorbent test (RAST) to the foods suggest involvement of immunoglobulin (Ig)E-anaphylaxis in both disorders. The triggering foods and initial target organs are usually different in each case. In the present study, a 32-year-old male reported dyspnea accompanied by wheals, and symptoms of low blood pressure while walking after eating Chinese noodles and donuts. He also reported uncomfortable sensations in his mouth and throat after ingesting melon. Exercise challenge tests were administered. Serum histamine, plasma adrenaline, noradrenaline and dopamine were measured pre- and post-test. No symptoms were induced by exercise or by the ingestion of any single food item before exercise. However, numerous wheals appeared when exercise followed the combined ingestion of foods. Likewise, the sequence of eating pancakes and then exercising resulted in numerous wheals and anaphylaxis. Olopatadine hydrochloride and ketotifen fumarate completely inhibited this anaphylaxis. The skin prick tests resulted in fruit-induced erythema and wheals. The results of these tests with wheat, butter and sugar were negative, and no symptoms were induced by the exercise test after ingestion of watermelon, melon or apple. The anaphylactoid symptoms were accompanied by a significant increase of plasma noradrenaline. In this case, not only wheat, but sugar and butter may induce the onset of FDEIA. There was no significant correlation between the intensity of the symptoms and the serum histamine levels in the present case. Noradrenaline may be involved in the onset of FDEIA, since noradrenaline may selectively inhibit T-helper (Th)1 functions while favoring Th2 responses. The tests showed no cross-reactivity between the

  19. 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

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

    PubMed Central

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

    2015-01-01

    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

  1. 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

  2. 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

  3. Extending the Reach of Early Intervention Training for Practitioners: A Preliminary Investigation of an Online Curriculum for Teaching Behavioral Intervention Knowledge in Autism to Families and Service Providers.

    PubMed

    Hamad, Charles D; Serna, Richard W; Morrison, Leslie; Fleming, Richard

    2010-07-01

    Early behavioral intervention, based on the methods of applied behavior analysis, has the strongest and most consistent scientific support as a means of teaching skills to young children with Autism Spectrum Disorder and reducing their restricted and maladaptive behavior. Though individual ABA-based treatment plans are usually developed, designed and supervised by a senior-level clinician, they are most often implemented by a practitioner, such as a parent, direct service provider, aide, or an early childhood professional from a related discipline. Unfortunately, few practitioner-orientated training programs are available to geographically disparate persons. Online distance-learning education offers a potential solution to this problem. Fifty-one individuals participated in an initial study of a short, three-module online course. The results showed a highly statistically significant difference between the mean pre-test and post-test score. The outcomes suggest the feasibility and user satisfaction of teaching BI knowledge acquisition online, and thus bolster confidence that future, larger-scale curricula aimed at teaching BI in a distance-learning format is warranted.

  4. Extending the Reach of Early Intervention Training for Practitioners: A Preliminary Investigation of an Online Curriculum for Teaching Behavioral Intervention Knowledge in Autism to Families and Service Providers

    PubMed Central

    Hamad, Charles D.; Serna, Richard W.; Morrison, Leslie; Fleming, Richard

    2013-01-01

    Early behavioral intervention, based on the methods of applied behavior analysis, has the strongest and most consistent scientific support as a means of teaching skills to young children with Autism Spectrum Disorder and reducing their restricted and maladaptive behavior. Though individual ABA-based treatment plans are usually developed, designed and supervised by a senior-level clinician, they are most often implemented by a practitioner, such as a parent, direct service provider, aide, or an early childhood professional from a related discipline. Unfortunately, few practitioner-orientated training programs are available to geographically disparate persons. Online distance-learning education offers a potential solution to this problem. Fifty-one individuals participated in an initial study of a short, three-module online course. The results showed a highly statistically significant difference between the mean pre-test and post-test score. The outcomes suggest the feasibility and user satisfaction of teaching BI knowledge acquisition online, and thus bolster confidence that future, larger-scale curricula aimed at teaching BI in a distance-learning format is warranted. PMID:23504540

  5. Pre-exposure to vasopressin potentiates the vasoconstrictive effect of epinephrine in rat aorta isolated during late anaphylaxis.

    PubMed

    Dewachter, Pascale; Emala, Charles W

    2010-06-01

    Clinical guidelines for anaphylaxis recommend epinephrine as first-line therapy but do not distinguish between early and late stages of anaphylaxis. The delay between the onset of anaphylaxis and initiation of treatment may influence the choice of the optimal vasoconstrictor (epinephrine versus arginine vasopressin [AVP]). Anesthetized rats were allocated into control and three anaphylaxis groups (n = 6 per group). The aortas were removed at 5 min (control) and at 5, 15, or 30 min during anaphylaxis and were contracted in organ baths by increasing concentrations of epinephrine or AVP. After washout of the initial agonist, each ring was contracted with the alternative drug. Separately, aortic rings removed during early versus late anaphylaxis were contracted by AVP +/- pretreatment with N(G)-nitro-L-arginine methyl ester (L-NAME) (10 M), a NOS inhibitor. Aortic rings removed during late versus early anaphylaxis were less responsive to epinephrine (EC50 at 5 min, 8.4 nM [4.9 - 11.8]; EC50 at 30 min, 18.2 nM [11.9 - 24.4]; P = 0.04) and AVP (EC50 at 5 min, 8.1 nM [4.9 - 11.3]; EC50 at 30 min, 19.7 nM [10.9 - 28.6]; P = 0.02). Pre-exposure to AVP enhanced the subsequent contractile effect of epinephrine in aortic rings removed during late anaphylaxis (maximal contractile effect, 1.02 g [0.76 - 1.28]) versus early anaphylaxis (maximal contractile effect, 0.44 g [0.28 - 0.59]; P = 0.005). In contrast to early anaphylaxis, pretreatment with L-NAME decreased responsiveness to AVP during late anaphylaxis (EC50, 2.47 nM [1.79 - 3.16], 1.55 nM [1.11 - 1.98] for +/- L-NAME, respectively; P = 0.03). During anaphylaxis, the vasoconstrictive effects of AVP or epinephrine were time dependent. Arginine vasopressin might have beneficial effects during late anaphylaxis via mechanisms involving NO.

  6. CoCAR: An Online Synchronous Training Model for Empowering ICT Capacity of Teachers of Chinese as a Foreign Language

    ERIC Educational Resources Information Center

    Lan, Yu-Ju; Chang, Kuo-En; Chen, Nian-Shing

    2012-01-01

    In response to the need to cultivate pre-service Chinese as a foreign language (CFL) teachers' information and communication technology (ICT) competency in online synchronous environments, this research adopted a three-stage cyclical model named "cooperation-based cognition, action, and reflection" (CoCAR). The model was implemented in an 18-week…

  7. Risk of Anaphylaxis with Repeated Courses of Rasburicase: A Research on Adverse Drug Events and Reports (RADAR) Project

    PubMed Central

    Allen, Katherine C.; Champlain, Amanda H.; Cotliar, Jonathan A.; Belknap, Steven M.; West, Dennis P.; Mehta, Jayesh; Trifilio, Steven M.

    2015-01-01

    Background Rasburicase, a recombinant urate oxidase, is used to rapidly metabolize uric acid in patients with hyperuricaemia. Rasburicase is an immunogenic therapeutic protein, which has been shown to elicit antibody response in 64 % of healthy volunteers within 1–6 weeks after the initial course, with persistent antibodies for over 1 year. Drug labelling indicates that anaphylaxis rarely occurs (in <1 % of patients) after a single course of therapy with rasburicase, but there are no data available on the incidence of anaphylaxis in patients receiving a subsequent rasburicase course. Objective To determine the incidence of anaphylaxis after multiple treatment courses of rasburicase. Methods A retrospective chart review was performed on 97 consecutively treated patients who received repeated courses of rasburicase for hyperuricaemia, to determine whether the risk of anaphylaxis is increased with repeated exposure to rasburicase. Results None of the 97 patients who were reviewed experienced anaphylaxis during the first rasburicase course; however, six patients (6.2 %) experienced anaphylaxis during a subsequent rasburicase treatment course (p = 0.03). Conclusion Anaphylaxis after a second course of rasburicase appears to occur more frequently than described in the US Food and Drug Administration-approved package insert for initial treatment courses. Given the serious nature of anaphylactic events, caution is advised when administering repeated courses of rasburicase. PMID:25566825

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

    PubMed

    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

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

    PubMed

    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.

  10. Food-dependent exercise-induced anaphylaxis: a case related to chickpea ingestion and review.

    PubMed

    Wong, Chet G; Mace, Sean R

    2007-12-15

    : 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.

  11. 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…

  12. 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…

  13. 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

  14. 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

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

    PubMed

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

    2014-07-01

    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

  16. 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…

  17. A multi-step approach to improving NASA Earth Science data access and use for decision support through online and hands-on training

    NASA Astrophysics Data System (ADS)

    Prados, A. I.; Gupta, P.; Mehta, A. V.; Schmidt, C.; Blevins, B.; Carleton-Hug, A.; Barbato, D.

    2014-12-01

    NASA's Applied Remote Sensing Training Program (ARSET), http://arset.gsfc.nasa.gov, within NASA's Applied Sciences Program, has been providing applied remote sensing training since 2008. The goals of the program are to develop the technical and analytical skills necessary to utilize NASA resources for decision-support, and to help end-users navigate through the vast data resources freely available. We discuss our multi-step approach to improving data access and use of NASA satellite and model data for air quality, water resources, disaster, and land management. The program has reached over 1600 participants world wide using a combined online and interactive approach. We will discuss lessons learned as well as best practices and success stories in improving the use of NASA Earth Science resources archived at multiple data centers by end-users in the private and public sectors. ARSET's program evaluation method for improving the program and assessing the benefits of trainings to U.S and international organizations will also be described.

  18. A prosocial online game for social cognition training in adolescents with high-functioning autism: an fMRI study.

    PubMed

    Chung, Un-Sun; Han, Doug Hyun; Shin, Yee Jin; Renshaw, Perry F

    2016-01-01

    To help patients with autism spectrum disorder (ASD) improve their social skills, effective interventions and new treatment modalities are necessary. We hypothesized that a prosocial online game would improve social cognition in ASD adolescents, as assessed using metrics of social communication, facial recognition, and emotional words. Ten ASD adolescents underwent cognitive behavior therapy (CBT) using a prosocial online game (game-CBT), and ten ASD adolescents participated in an offline-CBT. At baseline and 6 weeks later, social communication quality, correct identification of emotional words and facial emoticons, and brain activity were assessed in both groups. Social communication quality and correct response rate of emotional words and facial emoticons improved in both groups over the course of the intervention, and there were no significant differences between groups. In response to the emotional words, the brain activity within the temporal and parietal cortices increased in the game-CBT group, while the brain activity within cingulate and parietal cortices increased in the offline-CBT group. In addition, ASD adolescents in the game-CBT group showed increased brain activity within the right cingulate gyrus, left medial frontal gyrus, left cerebellum, left fusiform gyrus, left insular cortex, and sublobar area in response to facial emoticons. A prosocial online game designed for CBT was as effective as offline-CBT in ASD adolescents. Participation in the game especially increased social arousal and aided ASD adolescents in recognizing emotion. The therapy also helped participants more accurately consider associated environments in response to facial emotional stimulation. However, the online CBT was less effective than the offline-CBT at evoking emotions in response to emotional words.

  19. A prosocial online game for social cognition training in adolescents with high-functioning autism: an fMRI study.

    PubMed

    Chung, Un-Sun; Han, Doug Hyun; Shin, Yee Jin; Renshaw, Perry F

    2016-01-01

    To help patients with autism spectrum disorder (ASD) improve their social skills, effective interventions and new treatment modalities are necessary. We hypothesized that a prosocial online game would improve social cognition in ASD adolescents, as assessed using metrics of social communication, facial recognition, and emotional words. Ten ASD adolescents underwent cognitive behavior therapy (CBT) using a prosocial online game (game-CBT), and ten ASD adolescents participated in an offline-CBT. At baseline and 6 weeks later, social communication quality, correct identification of emotional words and facial emoticons, and brain activity were assessed in both groups. Social communication quality and correct response rate of emotional words and facial emoticons improved in both groups over the course of the intervention, and there were no significant differences between groups. In response to the emotional words, the brain activity within the temporal and parietal cortices increased in the game-CBT group, while the brain activity within cingulate and parietal cortices increased in the offline-CBT group. In addition, ASD adolescents in the game-CBT group showed increased brain activity within the right cingulate gyrus, left medial frontal gyrus, left cerebellum, left fusiform gyrus, left insular cortex, and sublobar area in response to facial emoticons. A prosocial online game designed for CBT was as effective as offline-CBT in ASD adolescents. Participation in the game especially increased social arousal and aided ASD adolescents in recognizing emotion. The therapy also helped participants more accurately consider associated environments in response to facial emotional stimulation. However, the online CBT was less effective than the offline-CBT at evoking emotions in response to emotional words. PMID:27051288

  20. A prosocial online game for social cognition training in adolescents with high-functioning autism: an fMRI study

    PubMed Central

    Chung, Un-sun; Han, Doug Hyun; Shin, Yee Jin; Renshaw, Perry F

    2016-01-01

    To help patients with autism spectrum disorder (ASD) improve their social skills, effective interventions and new treatment modalities are necessary. We hypothesized that a prosocial online game would improve social cognition in ASD adolescents, as assessed using metrics of social communication, facial recognition, and emotional words. Ten ASD adolescents underwent cognitive behavior therapy (CBT) using a prosocial online game (game-CBT), and ten ASD adolescents participated in an offline-CBT. At baseline and 6 weeks later, social communication quality, correct identification of emotional words and facial emoticons, and brain activity were assessed in both groups. Social communication quality and correct response rate of emotional words and facial emoticons improved in both groups over the course of the intervention, and there were no significant differences between groups. In response to the emotional words, the brain activity within the temporal and parietal cortices increased in the game-CBT group, while the brain activity within cingulate and parietal cortices increased in the offline-CBT group. In addition, ASD adolescents in the game-CBT group showed increased brain activity within the right cingulate gyrus, left medial frontal gyrus, left cerebellum, left fusiform gyrus, left insular cortex, and sublobar area in response to facial emoticons. A prosocial online game designed for CBT was as effective as offline-CBT in ASD adolescents. Participation in the game especially increased social arousal and aided ASD adolescents in recognizing emotion. The therapy also helped participants more accurately consider associated environments in response to facial emotional stimulation. However, the online CBT was less effective than the offline-CBT at evoking emotions in response to emotional words. PMID:27051288

  1. COLUG: Chicago Online Users Introductory Guide.

    ERIC Educational Resources Information Center

    Moore, Alexandra L., Ed.; Pyrce, Sharon R., Ed.

    Intended to serve as an introduction to online searching in the Chicago area, the guide answers these basic questions for those considering going online for the first time: what is online searching, starting out online, local training for online searching, how to choose a terminal, 1200 baud equipment selection, how to prepare for and evaluate a…

  2. Preparing Engineering Faculty to Teach Online

    ERIC Educational Resources Information Center

    Kearsley, Greg, Ed.

    2008-01-01

    Issues associated with the preparation of engineering faculty to teach online courses are examined. This includes: the nature of online teaching, engineering course materials, training faculty to teach online, use of online resources, course development, and evaluation of online courses. Selection of faculty and providing adequate support are…

  3. 76 FR 1622 - Submission for OMB Review; Comment Request; Online Skills Training for PCPs on Substance Abuse

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-11

    ... Web site SBIRTTraining.com , to positively impact the knowledge, attitudes, intended behaviors and... Institute on Drug Abuse. The primary goal is to assess the impact of the training program on knowledge... before exposure to the Web based materials (pre-test), after exposure to the Web based materials...

  4. University of Delaware Library/Statewide K-12 Partnership Providing Online Resources and Training: UDLib/SEARCH.

    ERIC Educational Resources Information Center

    Millard, Sandra K.

    UDLib/SEARCH is a unique partnership between the University of Delaware Library and state K-12 education in Delaware. UDLib/SEARCH provides access to 16 full text databases via the Internet on the state network to all Delaware public high schools and middle schools, and training for teachers and librarians. Using $30 million in state funds,…

  5. Effects of Group Parent-Training with Online Parent-Teacher Communication on the Homework Performance of Elementary School Students

    ERIC Educational Resources Information Center

    Beck, Richard J.

    2012-01-01

    The purpose of this study was to investigate the effectiveness of the Homework Improvement Program, a 5-week group-formatted parent training program, in enhancing the homework performance of children experiencing homework difficulties. The study was conducted in an elementary school with a sample consisting of the parents of seven students (N = 7)…

  6. 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

  7. Training from the Start.

    ERIC Educational Resources Information Center

    Cocheu, Ted

    1990-01-01

    The time to plan training is in the research and development stage of a new product. Seven major steps are online training, process validation, skills certification, development of manufacturing training instructions, skills verification, transfer training, and offline training and certification. (SK)

  8. Anaphylaxis caused by imported red fire ant stings in Málaga, Spain.

    PubMed

    Fernández-Meléndez, S; Miranda, A; García-González, J J; Barber, D; Lombardero, M

    2007-01-01

    A 27-year-old woman suffered from anaphylaxis after being stung by Solenopsis invicta ants while she was handling wood from South America. The patient reported no previous adverse reactions to stings by other hymenopteran species. Intradermal skin tests with hymenoptera venom (Vespula vulgaris, Polistes species, Apis melifera) were negative. Serum specific immunoglobulin (Ig) E yielded positive results for S invicta (5.28 kU/L) and negative results for A melifera, Ves v 5 and Pol a 5. Immunodetection assays showed the presence of serum IgE against the Sol i 2 allergen. The patient had probably been stung previously although inadvertently by red fire ants while she handled infested wood from South America, and precautionary measures are thus advisable when this material is to be handled. To our knowledge this is the first case of anaphylaxis from red fire ant stings reported in Europe.

  9. Systemic mastocytosis presenting as intraoperative anaphylaxis with atypical features: a report of two cases.

    PubMed

    Bridgman, D E; Clarke, R; Sadleir, P H M; Stedmon, J J; Platt, P

    2013-01-01

    Two cases of perioperative cardiovascular collapse are presented that were associated with markedly elevated mast cell tryptase levels shortly after the event, leading to the assumption that an immunoglobin E-mediated, drug-induced anaphylaxis had occurred. However, the clinical picture in both cases was atypical and subsequent skin testing failed to identify a triggering drug. Further blood tests, some weeks later, revealed persistently elevated baseline levels of mast cell tryptase. In both cases bone marrow biopsy and genetic testing confirmed the diagnosis of mastocytosis. We present evidence and speculate that mast cell degranulation was triggered by tourniquet release in the first case and by exposure to peanuts in the second. An atypical presentation of anaphylaxis should alert the anaesthetist to the possibility of previously undiagnosed mastocytosis. PMID:23362901

  10. 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

  11. Anaphylaxis after eating Italian pizza containing buckwheat as the hidden food allergen.

    PubMed

    Heffler, E; Guida, G; Badiu, I; Nebiolo, F; Rolla, G

    2007-01-01

    A 20-year-old woman developed anaphylaxis after eating pizza on 4 different occasions in 2 restaurants. Both restaurants made their pizza dough with a mixture of wheat and buckwheat flours. A prick-to-prick test with buckwheat flour was positive. Skin prick tests and specific immunoglobulin E responses to soybean and peanut were weakly positive while the response to buckwheat was negative. We ruled out a pathogenic role for peanut and soybean because the patient usually eats both with no signs of allergic reaction. Double-blind, placebo-controlled food challenges with buckwheat flour were positive after the administration of a cumulative dose of 2.3 g of the culprit flour. To our knowledge, our report describes the first case of anaphylaxis after intake of buckwheat flour as the hidden allergen in pizza dough.

  12. Successful treatment of acute systemic anaphylaxis in a western lowland gorilla (Gorilla gorilla gorilla).

    PubMed

    Hayman, David T S; King, Tony; Cameron, Kenneth

    2010-09-01

    This brief communication describes the successful treatment of acute systemic anaphylaxis in a wild-born but captive infant western lowland gorilla (Gorilla gorilla gorilla) in the Republic of Congo. The infant demonstrated signs of acute respiratory distress, lingual swelling, and reaction to intradermal tuberculin, given 55 hr earlier. Details of the treatment with steroids, anesthetic induction, and i.v. epinephrine are all reported, and potential antigens that may have initiated the anaphylactic shock are discussed.

  13. 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.

  14. 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

  15. 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

  16. Inhibitory effects of guarana seed extract on passive cutaneous anaphylaxis and mast cell degranulation.

    PubMed

    Jippo, Tomoko; Kobayashi, Yuko; Sato, Harumi; Hattori, Atsushi; Takeuchi, Hiroaki; Sugimoto, Keiichiro; Shigekawa, Munekazu

    2009-09-01

    This study investigated the effects of guarana seed extract (GSE) on an anti-allergic mechanism. GSE orally administered inhibited the anti-dinitrophenol IgE-induced passive cutaneous anaphylaxis reaction in mice. Furthermore, it inhibited the degranulation of rat basophilic leukemia RBL-2H3 cells. It had no cytotoxicity on RBL-2H3 cells. These results show that GSE is a candidate for effective therapeutic material for allergic diseases.

  17. IL-21 induces inhibitor of differentiation 2 and leads to complete abrogation of anaphylaxis in mice.

    PubMed

    Kishida, Tsunao; Hiromura, Yayoi; Shin-Ya, Masaharu; Asada, Hidetsugu; Kuriyama, Hiroko; Sugai, Manabu; Shimizu, Akira; Yokota, Yoshifumi; Hama, Takemitsu; Imanishi, Jiro; Hisa, Yasuo; Mazda, Osam

    2007-12-15

    IL-21 exerts pleiotrophic immunomodulatory activities on a variety of target cells including B cells that undergo class switch recombination (CSR) to IgE. In this study, we examined whether IgE-mediated systemic anaphylaxis was controlled by in vivo administration of IL-21 using the peanut allergy model in mice and investigated the molecular mechanisms underlying the IL-21-induced regulation of IgE. The anaphylactic reaction was completely abolished by the administration of recombinant mouse IL-21 or an IL-21 expression plasmid in terms of the change of body temperature and anaphylactic symptoms. The recombinant mouse IL-21 treatment remarkably suppressed IgE CSR in splenic B cells, resulting in significant decrease in serum concentrations of total as well as allergen-specific IgE. In the meanwhile, IL-21 provoked B cells in normal as well as allergic mice to express the inhibitor of differentiation 2 (Id2) gene that was shown to be crucially involved in the regulation of the activation-induced cytidine deaminase and IgE CSR. Moreover, mice genetically deficient for Id2 were completely unsusceptible to IL-21-induced prevention of IgE CSR and anaphylaxis. The present study strongly suggests that IL-21 is capable of regulating systemic allergic reactions by inducing the transcriptional regulator Id2, and the cytokine may be useful for clinical intervention for allergic diseases including anaphylaxis.

  18. 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

  19. 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

  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. [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

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

    PubMed Central

    2016-01-01

    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

  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. EAACI food allergy and anaphylaxis guidelines: managing patients with food allergy in the community.

    PubMed

    Muraro, A; Agache, I; Clark, A; Sheikh, A; Roberts, G; Akdis, C A; Borrego, L M; Higgs, J; Hourihane, J O'B; Jorgensen, P; Mazon, A; Parmigiani, D; Said, M; Schnadt, S; van Os-Medendorp, H; Vlieg-Boerstra, B J; Wickman, M

    2014-08-01

    The European Academy of Allergy and Clinical Immunology (EAACI) Food Allergy and Anaphylaxis Guidelines, managing patients with food allergy (FA) in the community, intend to provide guidance to reduce the risk of accidental allergic reactions to foods in the community. This document is intended to meet the needs of early-childhood and school settings as well as providers of non-prepackaged food (e.g., restaurants, bakeries, takeaway, deli counters, and fast-food outlets) and targets the audience of individuals with FA, their families, patient organizations, the general public, policymakers, and allergists. Food allergy is the most common trigger of anaphylaxis in the community. Providing children and caregivers with comprehensive information on food allergen avoidance and prompt recognition and management of allergic reactions are of the utmost importance. Provision of adrenaline auto-injector devices and education on how and when to use these are essential components of a comprehensive management plan. Managing patients at risk of anaphylaxis raises many challenges, which are specific to the community. This includes the need to interact with third parties providing food (e.g., school teachers and restaurant staff) to avoid accidental exposure and to help individuals with FA to make safe and appropriate food choices. Education of individuals at risk and their families, their peers, school nurses and teachers as well as restaurant and other food retail staff can reduce the risk of severe/fatal reactions. Increased awareness among policymakers may improve decision-making on legislation at local and national level.

  5. 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.

  6. Advances in allergic skin disease, anaphylaxis, and hypersensitivity reactions to foods, drugs, and insects in 2014.

    PubMed

    Sicherer, Scott H; Leung, Donald Y M

    2015-02-01

    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 2014. Studies on food allergy suggest worrisomely high rates of peanut allergy and food-induced anaphylaxis-related hospitalizations. Evidence is mounting to support the theory that environmental exposure to peanut, such as in house dust, especially with an impaired skin barrier attributed to atopic dermatitis (AD) and loss of function mutations in the filaggrin gene, is a risk factor for sensitization and allergy. Diagnostic tests are improving, with early studies suggesting the possibility of developing novel cellular tests with increased diagnostic utility. Treatment trials continue to show the promise and limitations of oral immunotherapy, and mechanistic studies are elucidating pathways that might define the degree of efficacy of this treatment. Studies have also provided insights into the prevalence and characteristics of anaphylaxis and insect venom allergy, such as suggesting that baseline platelet-activating factor acetylhydrolase activity levels are related to the severity of reactions. Advances in drug allergy include identification of HLA associations for penicillin allergy and a microRNA biomarker/mechanism for toxic epidermal necrolysis. Research identifying critical events leading to skin barrier dysfunction and the polarized immune pathways that drive AD have led to new therapeutic approaches in the prevention and management of AD.

  7. Proposed new mechanism for food and exercise induced anaphylaxis based on case studies

    PubMed Central

    2013-01-01

    We present two cases of food and exercise-induced anaphylaxis (FEIA) in patients with a diagnosis of oral allergy syndrome (OAS) to the implicated foods. Patient A had FEIA attributed to fresh coriander and tomato and Patient B to fresh celery. These food allergens have been implicated in OAS and have structural antigenic similarity to that of birch and/or grass. Both patients’ allergies were confirmed by fresh skin prick tests. In both cases, strenuous exercise was antecedent to the systemic anaphylaxis reaction and subsequent ingestion without exercise produced only local symptoms of perioral pruritus. We review the current proposed mechanisms for food and exercise induced anaphylaxis to oral allergens and propose a novel and more biologically plausible mechanism. We hypothesize that the inhibitory effects of exercise on gastric acid secretion decreases the digestion of oral allergens and preserves structural integrity, thereby allowing continued systemic absorption of the allergen whether it be profilins, lipid transfer proteins, or other antigenic determinants. PMID:23509907

  8. 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.

  9. 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

  10. EAACI food allergy and anaphylaxis guidelines: managing patients with food allergy in the community.

    PubMed

    Muraro, A; Agache, I; Clark, A; Sheikh, A; Roberts, G; Akdis, C A; Borrego, L M; Higgs, J; Hourihane, J O'B; Jorgensen, P; Mazon, A; Parmigiani, D; Said, M; Schnadt, S; van Os-Medendorp, H; Vlieg-Boerstra, B J; Wickman, M

    2014-08-01

    The European Academy of Allergy and Clinical Immunology (EAACI) Food Allergy and Anaphylaxis Guidelines, managing patients with food allergy (FA) in the community, intend to provide guidance to reduce the risk of accidental allergic reactions to foods in the community. This document is intended to meet the needs of early-childhood and school settings as well as providers of non-prepackaged food (e.g., restaurants, bakeries, takeaway, deli counters, and fast-food outlets) and targets the audience of individuals with FA, their families, patient organizations, the general public, policymakers, and allergists. Food allergy is the most common trigger of anaphylaxis in the community. Providing children and caregivers with comprehensive information on food allergen avoidance and prompt recognition and management of allergic reactions are of the utmost importance. Provision of adrenaline auto-injector devices and education on how and when to use these are essential components of a comprehensive management plan. Managing patients at risk of anaphylaxis raises many challenges, which are specific to the community. This includes the need to interact with third parties providing food (e.g., school teachers and restaurant staff) to avoid accidental exposure and to help individuals with FA to make safe and appropriate food choices. Education of individuals at risk and their families, their peers, school nurses and teachers as well as restaurant and other food retail staff can reduce the risk of severe/fatal reactions. Increased awareness among policymakers may improve decision-making on legislation at local and national level. PMID:24905609

  11. [A case of anaphylaxis caused by abalone diagosed with prick by prick test].

    PubMed

    Suzuki, Shintaro; Nakamura, Yoichi; Nishioka, Kiyoshi; Adachi, Mitsuru

    2007-06-01

    A 30-year-old man exhibited systemic edema, dyspnea and wheal immediately after eating raw fish and cuttlefish served on an abalone shell. He had history of anaphylaxis after eating abalone and beef 4 years ago and had avoided shellfish including abalone since then. He also had past history of bronchial asthma and anaphylaxis due to shrimp. CAP-FEIA was performed to determine the allergen and was positive for scallop and oyster. Refined extracts made from abalone are not commercially available in Japan. Therefore, we purchased several kinds of shellfish, which are commonly consumed by Japanese, and used them, as is, for skin testing. Prick-by-prick tests were conduced using these shellfish, and yielded positive results for abalone and effluent from washing the abalone shell. Consequently, he was diagnosed with anaphylaxis caused by abalone extracts attached to the surface of raw fish. In our case, prick-by-prick test with shellfish was useful for the diagnosis of type I food allergy. If there are no commercial reagents of suspected food allergens for skin testing or challenge-test is not available, prick-by-prick tests might be performed for the diagnosis of food allergy.

  12. Anaphylaxis in an emergency department: a 2-year study in a tertiary-care hospital.

    PubMed

    Piromrat, Kanika; Chinratanapisit, Sasawan; Trathong, Sommai

    2008-01-01

    The aim of this study was to estimate the incidence of anaphylaxis in the emergency department of a tertiary-care hospital, describe the clinical features and the management of the patients and determine those with mild manifestations. A retrospective study was conducted from 2005 to 2006 using anaphylaxis-related ICD-10 terms. Two different sets of criteria for the diagnosis of anaphylaxis were applied, first the criteria previously accepted by emergency practice, followed by the recent criteria set forth at the 2005 international meeting. Sixty-four patients fulfilled the previous criteria with an average incidence of 52.5 per 100,000 patients per year with a shift towards females in 2006. The most common presentations were cutaneous, followed by respiratory symptoms. Food allergy was the most common cause, especially prawn. After applying the recent criteria, 13 patients (20.4%) were excluded, which reduced the incidence to 42.2 per 100,000 patients per year. Long term follow up is suggested for the possible or mild cases that were re-categorized.

  13. Online cognitive behaviour training for the prevention of postnatal depression in at-risk mothers: a randomised controlled trial protocol

    PubMed Central

    2013-01-01

    Background Postnatal depression (PND) is the most common disorder of the puerperium with serious consequences for both mother and child if left untreated. While there are effective treatments, there are many barriers for new mothers needing to access them. Prevention strategies may offer a more acceptable means of addressing the problem. Internet interventions can help overcome some barriers to reducing the impact of PND. However, to date there are no published studies that investigate the efficacy of internet interventions for the prevention of PND. Methods/Design The proposed study is a two-arm double blind randomised controlled trial. 175 participants will be recruited in the immediate postnatal period at an Australian community hospital. Women who meet inclusion criteria (internet access, email address, telephone number, over 18, live birth, fluent English) will complete the Edinburgh Postnatal Depression Scale (EPDS). Those with a score above 9 will undertake the Structured Clinical Interview for DSM Disorders (SCID). Those with a clinical diagnosis of depression, or a lifetime diagnosis of bipolar disorder or psychosis on the SCID will be excluded. Following completion of the baseline battery women will be randomised using a computer-generated algorithm to either the intervention or control condition. The intervention will consist of 5 modules of automated, interactive cognitive behaviour training (CB training), completed weekly with email reminders. The control will replicate the level of contact participants experience with the intervention, but the content will be of a general health nature. Participants will complete questionnaires immediately post-intervention (6 weeks) and 3-, 6- and 12 months follow-up. There will also be a second SCID delivered via telephone at 6 months. We hypothesise that relative to the control group, the intervention group will show a greater reduction in postnatal distress on the EPDS (primary outcome measure). We also

  14. School Board Policies on Prevention and Management of Anaphylaxis in İstanbul: Where Do We Stand?

    PubMed Central

    Özen, Ahmet; Boran, Perran; Torlak, Fatih; Karakoç-Aydıner, Elif; Barış, Safa; Karavuş, Melda; Barlan, Işıl

    2016-01-01

    Background: Allergic diseases with a potential for anaphylaxis pose a critical public health issue in schools. Aims: This study was carried out to identify the current status of prevention and management of anaphylaxis in school children with the main goal of establishing such an action plan. Study Design: Cross-sectional study. Methods: Schools were randomly selected from 11 different regions of Istanbul. A questionnaire was filled out by 2596 teachers/school principals from 232 public schools. Results: A school safety committee was absent in 80% of elementary schools (ES) and 60.8% of preschools (PS). Although some form of health recording system was available in many schools, no such system was available in 24.5% of ESs and 10% of PSs. A specific inquiry for detecting children with food allergies was a routine practice in only 4% of ES and 10% of PS. Approximately 27% of teachers stated that monitoring children in school places was not possible at all times. Eighty four percent stated that no written anaphylaxis treatment protocol was available in their school and only around 2.3% in ES and 3.1% in PS stated that they would perform an epinephrine injection in the event of anaphylaxis. Conclusion: Our survey demonstrated critical gaps in the organization of schools for the management of children at risk of anaphylaxis. Data derived from this study would provide the initiative for legislators to review the current situation of school health policies along with the relevant authorities to establish school anaphylaxis guidelines. PMID:27761282

  15. Distinguishing Online and Face-to-Face Learning: Acquisition, Learning, and Online Pedagogy

    ERIC Educational Resources Information Center

    Grant, Abigail A.

    2012-01-01

    This dissertation examines the type of training currently available to potential online instructors in order to generate a graduate-level degree program design effectively offering online pedagogy. Current online teacher training is largely based on acquisition of technological skills, such as mastering the operational components of a platform…

  16. Sesame allergy in Britain: a questionnaire survey of members of the Anaphylaxis Campaign.

    PubMed

    Derby, C J; Gowland, M H; Hourihane, J O'B

    2005-03-01

    Sesame is a major allergen in countries where it is a common food. It was noted that an increasing number of members of the UK charity, the anaphylaxis campaign, were reporting allergy to sesame. This study, sought to examine features of sesame allergy among members of the Anaphylaxis Campaign (which supports those at potentially life-threatening risk from allergies) focusing on clinical symptoms and features of the foods implicated. A physician-designed questionnaire was sent by post to 400 members of the Anaphylaxis Campaign who reported avoidance of sesame. Two hundred and eighty replies were received (70%). Twenty-three replies (7%) were excluded and 96 replies (24%) came from subjects who avoided sesame but had never reacted to it. One hundred and fifty people (54%) reported 288 reactions to sesame. 89% of reactive subjects reported other atopic diseases and notably 84% were also nut/peanut allergic. One in six (17%) had suffered potentially life-threatening symptoms, with 65% of severe reactions happening on first known exposure. The age of first reaction ranged from 6 months to 65 yr. The majority of reactions reported (91%) involved foods or dishes which had sesame as a deliberate ingredient, rather than sesame as an accidental contaminant. Respondents represented a well-informed and highly selected group of people at risk from potentially life-threatening allergies. Sesame should be identified clearly as an ingredient and separately from nuts and peanuts when it may be an allergen contaminant. People at potential risk need clear allergy diagnosis and informed guidance to enable them to avoid this key allergen more easily.

  17. 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

  18. Pedagogical Professional Development Needs of Postsecondary Faculty Who Teach Online

    ERIC Educational Resources Information Center

    Zuleger, Julie A.

    2013-01-01

    The Internet has provided postsecondary institutions with many opportunities to offer online courses. The demand for trained instructors to teach online has risen concomitantly. This qualitative study investigated the pedagogical training needs of postsecondary faculty who teach online. Focus groups were used to identify the types of training, the…

  19. [Fatal anaphylaxis after eating wild boar meat in a patient with pork-cat syndrome].

    PubMed

    Drouet, M; Sabbah, A; Le Sellin, J; Bonneau, J C; Gay, G; Dubois-Gosnet, C

    2001-04-01

    Crossed allergy between pork and cat epithelia was described by us in 1994. It is due to serum albumin. Nowadays, other bio-chemical observations allow "completion" of the syndrome by extension of the crossed reactivity between other mammal meats and other epithelia of dog and horse. The authors report an observation of the pork-cat syndrome (developing in the form of anaphylaxis, and then ending in the death of the patient), following consumption of wild boar meat. Co-factors, such as effort, taking alcohol or hormonal condition may complicate the picture to make diagnosis more difficult.

  20. 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

  1. 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

  2. Online Bagging and Boosting

    NASA Technical Reports Server (NTRS)

    Oza, Nikunji C.

    2005-01-01

    Bagging and boosting are two of the most well-known ensemble learning methods due to their theoretical performance guarantees and strong experimental results. However, these algorithms have been used mainly in batch mode, i.e., they require the entire training set to be available at once and, in some cases, require random access to the data. In this paper, we present online versions of bagging and boosting that require only one pass through the training data. We build on previously presented work by presenting some theoretical results. We also compare the online and batch algorithms experimentally in terms of accuracy and running time.

  3. The Excellent Online Instructor: Strategies for Professional Development

    ERIC Educational Resources Information Center

    Palloff, Rena M.; Pratt, Keith

    2011-01-01

    "The Excellent Online Instructor" is a guide for new and seasoned faculty who teach online, those responsible for training and developing online instructors, and administrators who must evaluate online faculty performance. This comprehensive resource describes the qualities of and explains how one can become an excellent online instructor. Written…

  4. Effects of Online Sensory Feedback Restriction during the Training on Immediate and Long-Term Learning on a Finger Opposition Tapping Task

    ERIC Educational Resources Information Center

    Piemonte, Maria Elisa Pimentel; Kopczynski, Marcos Cammarosano; Voos, Mariana Callil; Miranda, Camila Souza; Oliveira, Tatiana de Paula

    2015-01-01

    Background: Online sensory feedback has been considered fundamental for motor learning. The sensory inputs experienced in previous attempts can be processed and compared to allow the online refinement of subsequent attempts, resulting on performance improvement. However, numerous studies have provided direct and indirect evidence that learning new…

  5. Examination of the Relationship between Self-Directedness and Outcomes of the Online COP Training Program in the Turkish National Police Context

    ERIC Educational Resources Information Center

    Halicioglu, Mustafa Bulent

    2010-01-01

    It is widely accepted that online learning is a self-directed learning environment and the participants need to have self-direction in learning. However, there is lack of empirical studies focusing on the relationship between online learning and self-directed learning and examining the relationship between self-directedness of learners and…

  6. [A CASE OF NATTOU (FERMENTED-SOYBEAN)-INDUCED LATE-ONSET ANAPHYLAXIS FOLLOWING SCUBA DIVING].

    PubMed

    Nagakura, Toshikazu; Tanaka, Katsuichirou; Horikawa, Satoshi

    2015-06-01

    We here report a 34-years old male who had nattou-(fermented-soybean) induced late-onset anaphylaxis following SCUBA diving to about 20 m in the ocean off a small remote Japanese island (Kuroshima, Okinawa). He had eaten nattou for breakfast at 7:30 am. He traveled by boat to the dive site, dove twice and then ate lunch at 12:30 on the diving boat (no nattou at lunch). After lunch at 14:30 he dove again (third dive of the day) during which time itchiness started. Back on the diving boat, urticarial was noticed. At 15:30, while washing his diving gear at the diving shop near the harbor, he fainted. A physician arrived on the scene at 15:45. Chest sound was clear and SpO2 was 98%, and blood pressure was 60/- mmHg. Intra-venous hydrocortisone was given, however, his recovery was not satisfactory. Then he was transferred to the Yaeyama Hospital by helicopter at 17:45. The examination of diving computer analysis reveals no sign of increased residual nitrogen, denying the possibility of decompression syndrome. Prick to prick test shows a strongly positive response to nattou. Nattou-induced late-onset anaphylaxis following SCUBA diving was suspected.

  7. Advances in allergic skin disease, anaphylaxis, and hypersensitivity reactions to foods, drugs, and insect stings.

    PubMed

    Sicherer, Scott H; Leung, Donald Y M

    2004-07-01

    This review highlights some of the research advances in allergic skin disease, anaphylaxis, and hypersensitivity reactions to foods, drugs, and insect venom that were reported primarily in the Journal of Allergy and Clinical Immunology from 2002 through 2003. Among the topics highlighted are new insights into the pathogenesis of atopic dermatitis and potential strategies for more effective treatment of the atopic march. Patients should remain supine with raised legs during anaphylactic shock because upper body elevation could result in sudden death from loss of venous return to the heart. A major advance in food allergy was that humanized, monoclonal anti-IgE antibody showed protection against peanut-induced anaphylaxis. In addition to studies elucidating mechanisms of drug hypersensitivity, a clinical study showed patients with a history of prior penicillin allergy with negative penicillin allergy test results are unlikely to experience reactions or resensitization on subsequent oral courses of penicillin. Lastly, there are new recommendations for patients with convincing insect sting reaction histories but negative skin test responses to venom.

  8. 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

  9. Advances in allergic skin disease, anaphylaxis, and hypersensitivity reactions to foods, drugs, and insects in 2012.

    PubMed

    Sicherer, Scott H; Leung, Donald Y M

    2013-01-01

    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 2012. Studies support an increase in peanut allergy prevalence in children and exposure to the antibacterial agent triclosan and having filaggrin (FLG) loss-of-function mutations as risk factors for food sensitization. The role of specific foods in causing eosinophilic esophagitis is elucidated by several studies, and microRNA analysis is identified as a possible noninvasive disease biomarker. Studies on food allergy diagnosis emphasize the utility of component testing and the possibility of improved diagnosis through stepped approaches, epitope-binding analysis, and bioinformatics. Treatment studies of food allergy show promise for oral immunotherapy, but tolerance induction remains elusive, and additional therapies are under study. Studies on anaphylaxis suggest an important role for platelet-activating factor and its relationship to the need for prompt treatment with epinephrine. Insights on the pathophysiology and diagnosis of non-IgE-mediated drug allergy are offered, with novel data regarding the interaction of drugs with HLA molecules. Numerous studies support influenza vaccination of persons with egg allergy using modest precautions. Evidence continues to mount that there is cross-talk between skin barrier defects and immune responses in patients with atopic dermatitis. Augmentation of the skin barrier with reduction in skin inflammatory responses will likely lead to the most effective intervention in patients with this common skin disease.

  10. 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.

  11. Advances in allergic skin disease, anaphylaxis, and hypersensitivity reactions to foods, drugs, and insects in 2011.

    PubMed

    Sicherer, Scott H; Leung, Donald Y M

    2012-01-01

    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 2011. Food allergy appears to be increasing in prevalence and carries a strong economic burden. Risk factors can include dietary ones, such as deficiency of vitamin D and timing of complementary foods, and genetic factors, such as filaggrin loss-of-function mutations. Novel mechanisms underlying food allergy include the role of invariant natural killer T cells and influences of dietary components, such as isoflavones. Among numerous preclinical and clinical treatment studies, promising observations include the efficacy of sublingual and oral immunotherapy, a Chinese herbal remedy showing promising in vitro results, the potential immunotherapeutic effects of having children ingest foods with baked-in milk if they tolerate it, and the use of anti-IgE with or without concomitant immunotherapy. Studies of allergic skin diseases, anaphylaxis, and hypersensitivity to drugs and insect venom are elucidating cellular mechanisms, improved diagnostics, and potential targets for future treatment. The role of skin barrier abnormalities, as well as the modulatory effects of the innate and adaptive immune responses, are major areas of investigation.

  12. [A CASE OF NATTOU (FERMENTED-SOYBEAN)-INDUCED LATE-ONSET ANAPHYLAXIS FOLLOWING SCUBA DIVING].

    PubMed

    Nagakura, Toshikazu; Tanaka, Katsuichirou; Horikawa, Satoshi

    2015-06-01

    We here report a 34-years old male who had nattou-(fermented-soybean) induced late-onset anaphylaxis following SCUBA diving to about 20 m in the ocean off a small remote Japanese island (Kuroshima, Okinawa). He had eaten nattou for breakfast at 7:30 am. He traveled by boat to the dive site, dove twice and then ate lunch at 12:30 on the diving boat (no nattou at lunch). After lunch at 14:30 he dove again (third dive of the day) during which time itchiness started. Back on the diving boat, urticarial was noticed. At 15:30, while washing his diving gear at the diving shop near the harbor, he fainted. A physician arrived on the scene at 15:45. Chest sound was clear and SpO2 was 98%, and blood pressure was 60/- mmHg. Intra-venous hydrocortisone was given, however, his recovery was not satisfactory. Then he was transferred to the Yaeyama Hospital by helicopter at 17:45. The examination of diving computer analysis reveals no sign of increased residual nitrogen, denying the possibility of decompression syndrome. Prick to prick test shows a strongly positive response to nattou. Nattou-induced late-onset anaphylaxis following SCUBA diving was suspected. PMID:26380912

  13. Wheat-dependent exercise-induced anaphylaxis in mice is caused by gliadin and glutenin treatments.

    PubMed

    Kozai, Hana; Yano, Hiromi; Matsuda, Tsukasa; Kato, Yasuko

    2006-01-15

    Various foods may be associated with food-dependent exercise-induced anaphylaxis (FDEIAn). However, although the most frequently reported cause of FDEIAn has been wheat, the mechanism of FDEIAn for wheat has remained largely uninvestigated. To investigate the effect of wheat-fractionated proteins on FDEIAn, female B10.A mice (16-20 g) were divided into four groups; i.e. salt-soluble (S-group), gliadin-rich (GLI-group), and glutenin-rich (GLU-group)-sensitized mice, and unsensitized mice. The three sensitized groups were run on a treadmill after oral intake of each wheat-fractionated protein. The mice showed a significant increase in serum IgE, especially in the GLI- and GLU-group. After oral administration of each wheat-fractionated protein, the running time until exhaustion was remarkably shorter for the GLI- and GLU-group than for the S-group and unsensitized mice. The level of intestinal erosion was higher in all the sensitized mice than that in the unsensitized ones after exhaustive running. Furthermore, moderate exercise for 30 min after oral ingestion of each wheat-fractionated protein also induced intestinal erosion in the GLI- and GLU-group. In addition, we observed leaking of gliadin and glutenin proteins out of the intestine into the liver. These results indicated that the main factor involved in wheat-dependent exercise-induced anaphylaxis might be the gliadin and glutenin in wheat proteins.

  14. Food-dependent, exercise-induced anaphylaxis: a study on 11 Japanese cases.

    PubMed

    Dohi, M; Suko, M; Sugiyama, H; Yamashita, N; Tadokoro, K; Juji, F; Okudaira, H; Sano, Y; Ito, K; Miyamoto, T

    1991-01-01

    Eleven patients with food-dependent, exercise-induced anaphylaxis were studied. Seven patients experienced anaphylactic symptoms only after eating certain foods, such as shellfish, wheat, and grape before exercise. In the remaining four patients, no specific food could be identified, but the act of eating itself predisposed to anaphylaxis. Their anaphylactic symptoms were all clearly distinguished from cholinergic urticaria by history. Patients who developed anaphylactic symptoms before 20 years of age (N = 7) were atopic themselves or had atopic first-degree relatives. Six patients had increased serum IgE levels, and IgE antibodies against the causative food allergens were detected by the skin prick test or RAST in four cases. In contrast, patients who developed the symptoms after 30 years of age (N = 4) appeared to have a less atopic background, and IgE levels were within normal range except in one case. Three of four patients in the latter group developed symptoms after ingesting food made of wheat followed by exercise. All patients were sensitive to wheat as determined by the skin prick test. In six of 11 patients, a considerable rise in plasma histamine concentration was observed after exercise challenge with treadmill alone, and food intake followed by exercise induced a further increase in one patient.

  15. Skin testing with food, codeine, and histamine in exercise-induced anaphylaxis.

    PubMed

    Lin, R Y; Barnard, M

    1993-06-01

    A 33-year-old Chinese woman with exercise-induced anaphylaxis after ingesting Chinese seafood noodle soup, was studied for skin test reactivity to food, histamine, and codeine. Prick skin tests were negative for shrimp, wheat, and chicken soup base, but were positive at 5 to 6 mm (wheal diameter) to the whole broth after it had been combined with the other ingredients. No significant (> 3 mm) wheals were observed in eight controls who were simultaneously tested with the broth. To assess the role of exercise, three series of skin tests were performed with histamine, codeine, and whole broth before and after aerobic exercise on two occasions. Codeine elicited consistent increases in wheal size after exercise compared with pre-exercise skin tests. Histamine and whole broth wheal sizes did not increase significantly. Three control subjects also had codeine and histamine skin tests before and after exercise, No exercise-associated increases were noted for codeine. Potential insights into mast cell abnormalities in exercise-induced anaphylaxis may be gained by skin testing patterns with codeine and other mast cell degranulating agents.

  16. 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.

  17. Anaphylaxis to diclofenac: nine cases reported to the Allergy Vigilance Network in France.

    PubMed

    Picaud, J; Beaudouin, E; Renaudin, J M; Pirson, F; Metz-Favre, C; Dron-Gonzalvez, M; Moneret-Vautrin, D A

    2014-10-01

    Nine cases of diclofenac hypersensitivity recorded by the Allergy Vigilance Network in France from 2002 to 2012 were studied. Data from history, symptoms, skin tests, basophil activation tests, and oral challenge (OC) were recorded. Grade 3 severe anaphylactic reactions occurred in seven cases of nine. IgE-dependent anaphylaxis was confirmed in six cases: positive intradermal tests (n = 4), a syndromic reaction during skin tests (n = 1), and one case with grade 1 reaction and negative skin tests had an anaphylactic shock to the OC. A nonimmune reaction was suspected in one case. An IgE-dependent mechanism may be the predominant cause of adverse reactions to diclofenac. Allergy skin tests must be carried out sequentially at the recommended concentrations. BATs may be helpful because they can support the diagnosis of anaphylaxis. Given the risks of a direct challenge to diclofenac, OC to aspirin should be performed first to exclude a nonimmunologic hypersensitivity to NSAIDs. Tests for specific IgEs to most frequently used NSAIDs such as diclofenac and ibuprofen are urgently needed.

  18. Anti-allergic effects of nilotinib on mast cell-mediated anaphylaxis like reactions.

    PubMed

    El-Agamy, Dina S

    2012-04-01

    Nilotinib is a new orally bioavailable potent tyrosine kinase inhibitor that is used for the treatment of BCR-ABL-positive chronic myelogenous leukemia. However, its effect on mast cell-mediated anaphylactic reaction is still not known. The present study aimed to investigate the effect of nilotinib on the anaphylactic allergic reaction and study its possible mechanism(s) of action. Nilotinib administration prevented systemic anaphylaxis in mice, mediated by compound 48/80, in a dose- and time-dependent manner. Also, nilotinib significantly inhibited (P<0.05) allergic paw edema in rats. Furthermore, nilotinib significantly decreased (P<0.05) the IgE-mediated passive cutaneous anaphylaxis in a dose dependent manner. In addition, nilotinib dose-dependently reduced histamine release from the rat peritoneal mast cells activated either by compound 48/80 or by ovalbumin. Moreover, nilotinib attenuated the secretion of pro-inflammatory cytokine, tumor necrosis factor (TNF)-α expression in the rat peritoneal mast cells. These findings provide evidence that nilotinib inhibits mast cell-derived immediate-type allergic reactions and so it could be a candidate as an anti-allergic agent.

  19. The Top Training Priorities for 2003.

    ERIC Educational Resources Information Center

    Hall, Brandon

    2003-01-01

    A survey of 222 training professionals identified current training priorities: soft skills training; technical training; enhancing the quality of training; business skills; business alignment, business impact, and return on investment; online learning; sales training; safety and compliance training; performance management; and human…

  20. Fullerene carbon-70 derivatives dampen anaphylaxis and allergic asthma pathogenesis in mice

    NASA Astrophysics Data System (ADS)

    Norton, Sarah Brooke

    Fullerenes are carbon nanospheres that can be solublized by the addition of polar chemical groups to the carbon cage, forming fullerene derivatives. One specifically derivatized fullerene compound, termed C 70-Tetragylocolate (C70-TGA), has been shown to stabilize mast cell responses in vitro thus we hypothesized it may have an effect on mast cell-driven diseases such as asthma and systemic anaphylaxis. To observe the effects of C70-TGA on systemic anaphylaxis, mice were subjected to a model of passive systemic anaphylaxis. In this model, mice were injected with DNP-specific IgE 16 hours prior to challenge, then treated with C 70-TGA. Immediately prior to DNP challenge, mice were subjected to a second injection of C70-TGA. Following DNP challenge, body temperature was recorded and blood was collected for quantitation of histamine levels. Treatment with C70-TGA significantly reduced body temperature drop associated with systemic anaphylaxis and serum histamine levels. To observe the effects of C70-TGA on chronic features of asthma in vivo, we utilized a heavily MC influenced model of asthma pathogenesis. Mice were sensitized by intraperitoneal (i.p.) injection of ovalbumin (OVA) in saline, challenged intranasally (i.n.) with OVA, and one of two treatment strategies was pursued. In one, C70-TGA was given i.n. throughout disease development. In the other, C70-TGA was given following an initial set of challenges to allow disease to develop prior to treatment; mice were then re-challenged with OVA to assess the effect on established disease. We found that C70-TGA treatment significantly reduced airway inflammation and eosinophilia and dramatically reduced bronchoconstriction in either model. Cytokines IL-4 and IL-5 and serum IgE levels are significantly reduced in C70-TGA treated animals. Interestingly, we also saw an increase in the anti-inflammatory eicosanoid 11, 12-epoxyeicosatreinoic acid (11,12-EET) in the BAL fluid, suggesting the involvement of this mediator in

  1. Prediction of anaphylaxis during peanut food challenge: usefulness of the peanut skin prick test (SPT) and specific IgE level.

    PubMed

    Wainstein, Brynn Kevin; Studdert, Jennie; Ziegler, Mary; Ziegler, John B

    2010-06-01

    Cutoffs (decision points) of the peanut skin prick test (SPT) and specific IgE level for predicting peanut allergy have been proposed. It is not known whether decision points indicating a significant risk of severe reactions on challenge differ from those indicating probable allergy. We aimed at determining the usefulness of allergy tests for predicting the risk of anaphylaxis on challenge following the ingestion of up to 12 g of peanut in peanut-sensitized children. Children attending the Allergy Clinic who had a positive peanut SPT and completed open-label in-hospital peanut challenges were included. The challenge protocol provided for challenges to be continued beyond initial mild reactions. Eighty-nine in-hospital peanut challenges were performed. Thirty-four were excluded as the challenge was not completed, leaving 55 for analysis. Children who completed the challenge and did not react (n = 28) or reacted without anaphylaxis (n = 6) represented the comparison group (n = 34). The study group comprised 21 children whose challenge resulted in anaphylaxis. The mean peanut SPT wheal size and specific IgE level were associated with the severity of reactions on challenge. Among the 21 children, who developed anaphylaxis, in only 3 cases was anaphylaxis the initial reaction. Unexpectedly, a history of anaphylaxis was not predictive of anaphylaxis on challenge. Anaphylaxis developed at cumulative doses of peanut ranging from 0.02 to 11.7 g. Provided that a fixed amount of peanut is ingested, available tests for peanut allergy may assist in predicting the risk of anaphylaxis during challenge in peanut-sensitized children.

  2. Treatment of the first known case of king cobra envenomation in the United Kingdom, complicated by severe anaphylaxis.

    PubMed

    Veto, T; Price, R; Silsby, J F; Carter, J A

    2007-01-01

    We report the first known case of envenomation following snake bite by a king cobra in the UK. The patient required tracheal intubation and ventilation. Treatment with king cobra antivenom resulted in anaphylaxis (bronchospasm and hypotension), requiring adrenaline infusion. The patient's trachea was extubated 11 h after administration of antivenom. PMID:17156231

  3. Treatment of the first known case of king cobra envenomation in the United Kingdom, complicated by severe anaphylaxis.

    PubMed

    Veto, T; Price, R; Silsby, J F; Carter, J A

    2007-01-01

    We report the first known case of envenomation following snake bite by a king cobra in the UK. The patient required tracheal intubation and ventilation. Treatment with king cobra antivenom resulted in anaphylaxis (bronchospasm and hypotension), requiring adrenaline infusion. The patient's trachea was extubated 11 h after administration of antivenom.

  4. Evaluation of IgE Antibodies to Omalizumab (Xolair®) and Their Potential Correlation to Anaphylaxis.

    PubMed

    Baker, Dana L; Nakamura, Gerald R; Lowman, Henry B; Fischer, Saloumeh Kadkhodayan

    2016-01-01

    Omalizumab (Xolair®) is a recombinant humanized monoclonal antibody that selectively binds to human immunoglobulin E (IgE). Omalizumab is used to treat IgE-mediated diseases such as chronic idiopathic urticaria (CIU) and moderate to severe allergic asthma. In pre-marketing clinical trials in patients with asthma, anaphylaxis was reported in 3 of 3,507 (0.1%) patients. In post-marketing spontaneous reports, the frequency of anaphylaxis attributed to omalizumab use was estimated to be at least 0.2% of patients based on an estimated exposure of about 57,300 patients from June 2003 through December 2006. To better understand the risk of anaphylaxis in patients with allergic asthma receiving omalizumab, a post-marketing pharmacosurveillance study was initiated in 2009. As part of this study, an assay was developed to detect antibodies of IgE isotype to omalizumab. Serum samples from patients in the study were evaluated using this assay. Our results indicated that there was no observable correlation between either anaphylaxis or skin test reactivity and the presence of antibodies of IgE isotype to omalizumab. Here, we discuss the development of this assay as well as the results of the immunogenicity assessment.

  5. Online Learning and Social Exclusion.

    ERIC Educational Resources Information Center

    Clarke, Alan

    Online learning covers a wide range of technologies and formal and informal learning methods. A key factor promoting the significant enthusiasm for online learning across all education and training sectors in Great Britain and elsewhere is its potential to overcome many of the barriers of place, pace, and time that socially and economically…

  6. Online User Group Directory

    ERIC Educational Resources Information Center

    Berger, Mary

    1978-01-01

    This list of U.S. and international online user groups includes contact persons and their addresses. The U.S. regions are divided according to the Medlars regional geographical breakdown. The user groups were formed so that data base producers or search service vendors could be invited to do training or give educational programs. (JPF)

  7. An Online Library Catalogue.

    ERIC Educational Resources Information Center

    Alloro, Giovanna; Ugolini, Donatella

    1992-01-01

    Describes the implementation of an online catalog in the library of the National Institute for Cancer Research and the Clinical and Experimental Oncology Institute of the University of Genoa. Topics addressed include automation of various library functions, software features, database management, training, and user response. (10 references) (MES)

  8. An Innovative Junior Faculty Online Development Programme

    ERIC Educational Resources Information Center

    Villar, Luis M.; Alegre, Olga M.

    2006-01-01

    This study examines whether two online courses offering educational support for junior faculty have a positive effect on their attitudes to learning and curriculum and teaching capacities (CTC). The data used in the analysis are from two 2005 online university training courses. The tasks the online courses assign to faculty, the resources they…

  9. An Innovative Junior Faculty Online Development Program

    ERIC Educational Resources Information Center

    Villar, Luis M.; de la Rosa, Olga M.

    2007-01-01

    This study examines whether two online courses offering educational support for junior faculty have a positive effect on their attitudes and curriculum and teaching capacities (CTC) learning. The data used in the analysis are from two 2005 online University training courses. The tasks the online courses assign to faculty, the resources they…

  10. Pharmacy Research Online. A Guide for Faculty.

    ERIC Educational Resources Information Center

    Parkin, Derral; And Others

    This document is a self-paced training packet developed for a pilot project at the University of Houston-University Park to teach pharmacy faculty members to do their own online searching. The training begins with general topics such as the kinds of searches that can be done effectively online, the selection of appropriate databases to search, and…

  11. Veterans' Employment and Training Service

    MedlinePlus

    ... Twitter Instagram RSS Email Share Veterans' Employment and Training Service (VETS) Menu About VETS Who We Are & ... of the U.S. Armed Forces. About USERRA Online Training USERRA 101 USERRA 102 USERRA Advisor Veterans' Preference ...

  12. Online self-administered training of PTSD treatment providers in cognitive-behavioral intervention skills: results of a randomized controlled trial.

    PubMed

    Ruzek, Josef I; Rosen, Raymond C; Garvert, Donn W; Smith, Lauren D; Sears, Katharine C; Marceau, Lisa; Harty, Brian; Stoddard, Anne M

    2014-12-01

    Despite potential advantages in scalability and efficiency of web-based training for trauma providers, few controlled trials of feasibility and effectiveness of web-based mental health training have been performed. Our study compared web-based training in 3 intervention skills (motivation enhancement [ME], goal setting [GS], behavioral task assignment [BTA]) with web-based training plus telephone consultation, and a no-training control. The primary outcome measures included objective measures of skills acquisition (standardized patient assessments). Results showed significant differences among the training conditions. The overall tests of differences among the groups were statistically significant for ME and BTA skills (p < .001 and p = .005, respectively), but not for GS (p = .245). The web training plus consultation group improved in ME skills by 0.35 units compared to 0.12 units in the web only group (p < .001) and no change in the control group (p = .001). For BTA skills, the web training plus consultation improved by 0.27 units compared to 0.17 units in the web only group (p = .175) and no change in the control group (p = .004). Overall, these findings support the use of web-based dissemination for large-scale training programs for trauma providers in health care delivery systems. Further studies are needed to clarify the specific role of consultation as an adjunct to web-based training. PMID:25522731

  13. Anaphylaxis, Intra-Abdominal Infections, Skin Lacerations, and Behavioral Emergencies: A Literature Review of Austere Analogs for a near Earth Asteroid Mission

    NASA Technical Reports Server (NTRS)

    Chough, Natacha G.; Watkins, Sharmi; Menon, Anil S.

    2012-01-01

    As space exploration is directed towards destinations beyond low-Earth orbit, the consequent new set of medical risks will drive requirements for new capabilities and more resources to ensure crew health. The Space Medicine Exploration Medical Conditions List (SMEMCL), developed by the Exploration Medical Capability element of the Human Research Program, addresses the risk of "unacceptable health and mission outcomes due to limitations of in-flight medical capabilities". It itemizes 85 evidence-based clinical requirements for eight different mission profiles and identifies conditions warranting further research and technology development. Each condition is given a clinical priority for each mission profile. Four conditions -- intra-abdominal infections, skin lacerations, anaphylaxis, and behavioral emergencies -- were selected as a starting point for analysis. A systematic literature review was performed to understand how these conditions are treated in austere, limited-resource, space-analog environments (i.e., high-altitude and mountain environments, submarines, military deployments, Antarctica, isolated wilderness environments, in-flight environments, and remote, resource-poor, rural environments). These environments serve as analogs to spaceflight because of their shared characteristics (limited medical resources, delay in communication, confined living quarters, difficulty with resupply, variable time to evacuation). Treatment of these four medical conditions in austere environments provides insight into medical equipment and training requirements for exploration-class missions.

  14. Comparison of school food allergy emergency plans to the Food Allergy and Anaphylaxis Network's standard plan.

    PubMed

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

    2007-10-01

    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 comparison. Although two-thirds used food allergy plans, only 15% used the current FAAN plan. Plans were missing essential components, including emergency contact information, medication administration instructions, and health history information. School nurses must adhere to current clinical guidelines to provide an accurate resource for personnel in charge of a food allergy reaction in school. Professional associations and state school health agencies must create and market a resource that provides easy, one-stop access to current best-practice guidelines and tool kits. PMID:17894522

  15. Motor activity as an unbiased variable to assess anaphylaxis in allergic rats

    PubMed Central

    Abril-Gil, Mar; Garcia-Just, Alba; Cambras, Trinitat; Pérez-Cano, Francisco J; Castellote, Cristina; Franch, Àngels

    2015-01-01

    The release of mediators by mast cells triggers allergic symptoms involving various physiological systems and, in the most severe cases, the development of anaphylactic shock compromising mainly the nervous and cardiovascular systems. We aimed to establish variables to objectively study the anaphylactic response (AR) after an oral challenge in an allergy model. Brown Norway rats were immunized by intraperitoneal injection of ovalbumin with alum and toxin from Bordetella pertussis. Specific immunoglobulin (Ig) E antibodies were developed in immunized animals. Forty days after immunization, the rats were orally challenged with the allergen, and motor activity, body temperature and serum mast cell protease concentration were determined. The anaphylaxis induced a reduction in body temperature and a decrease in the number of animal movements, which was inversely correlated with serum mast cell protease release. In summary, motor activity is a reliable tool for assessing AR and also an unbiased method for screening new anti-allergic drugs. PMID:25716015

  16. Comparison of school food allergy emergency plans to the Food Allergy and Anaphylaxis Network's standard plan.

    PubMed

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

    2007-10-01

    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 comparison. Although two-thirds used food allergy plans, only 15% used the current FAAN plan. Plans were missing essential components, including emergency contact information, medication administration instructions, and health history information. School nurses must adhere to current clinical guidelines to provide an accurate resource for personnel in charge of a food allergy reaction in school. Professional associations and state school health agencies must create and market a resource that provides easy, one-stop access to current best-practice guidelines and tool kits.

  17. Motor activity as an unbiased variable to assess anaphylaxis in allergic rats.

    PubMed

    Abril-Gil, Mar; Garcia-Just, Alba; Cambras, Trinitat; Pérez-Cano, Francisco J; Castellote, Cristina; Franch, Àngels; Castell, Margarida

    2015-10-01

    The release of mediators by mast cells triggers allergic symptoms involving various physiological systems and, in the most severe cases, the development of anaphylactic shock compromising mainly the nervous and cardiovascular systems. We aimed to establish variables to objectively study the anaphylactic response (AR) after an oral challenge in an allergy model. Brown Norway rats were immunized by intraperitoneal injection of ovalbumin with alum and toxin from Bordetella pertussis. Specific immunoglobulin (Ig) E antibodies were developed in immunized animals. Forty days after immunization, the rats were orally challenged with the allergen, and motor activity, body temperature and serum mast cell protease concentration were determined. The anaphylaxis induced a reduction in body temperature and a decrease in the number of animal movements, which was inversely correlated with serum mast cell protease release. In summary, motor activity is a reliable tool for assessing AR and also an unbiased method for screening new anti-allergic drugs.

  18. Aspirin-Exacerbated Diseases: Advances in Asthma with Nasal Polyposis, Urticaria, Angioedema, and Anaphylaxis.

    PubMed

    Stevens, Whitney; Buchheit, Kathleen; Cahill, Katherine N

    2015-12-01

    Aspirin-exacerbated diseases are important examples of drug hypersensitivities and include aspirin-exacerbated respiratory disease (AERD), aspirin- or non-steroidal anti-inflammatory drug (NSAID)-induced urticaria/angioedema, and aspirin- or NSAID-induced anaphylaxis. While each disease subtype may be distinguished by unique clinical features, the underlying mechanisms that contribute to these phenotypes are not fully understood. However, the inhibition of the cyclooxygenase-1 enzyme is thought to play a significant role. Additionally, eosinophils, mast cells, and their products, prostaglandins and leukotrienes, have been identified in the pathogenesis of AERD. Current diagnostic and treatment strategies for aspirin-exacerbated diseases remain limited, and continued research focusing on each of the unique hypersensitivity reactions to aspirin is essential. This will not only advance the understanding of these disease processes, but also lead to the subsequent development of novel therapeutics that patients who suffer from aspirin-induced reactions desperately need.

  19. Advances in allergic skin disease, anaphylaxis, and hypersensitivity reactions to foods, drugs, and insects in 2008.

    PubMed

    Sicherer, Scott H; Leung, Donald Y M

    2009-02-01

    This review highlights some of the research advances in anaphylaxis, and hypersensitivity reactions to foods, drugs, and insects and in allergic skin disease that were reported in the Journal in 2008. Key epidemiologic observations include a rise in anaphylaxis in a population-based study and lower rates of peanut allergy in Israel, where infants consume peanut early compared with the United Kingdom, where dietary introduction is generally delayed. Advances in food allergy diagnosis include IgE epitope mapping that discloses the likelihood and severity of allergy; studies correlating likelihood of clinical reactivity on the basis of food-specific IgE to sesame, peanut, milk, and tree nuts; and an observation that a low baseline angiotensin-converting enzyme level may be associated with having pharyngeal edema during a reaction. Molecular, immunologic, and genetic studies are discerning pathways that are key in development of food allergy, identifying new modalities to interrupt mast cell degranulation, and elucidating risks associated with penicillin allergy. Regarding treatment, clinical studies show a majority of children with milk and egg allergy tolerate these proteins in modest amounts when they are extensively heated in baked goods, and studies show promise for oral immunotherapy to treat milk allergy and sublingual immunotherapy for honey bee venom hypersensitivity. The importance of skin barrier dysfunction has continued to be highlighted in the pathophysiology of atopic dermatitis (AD). Research has also continued to identify immunologic defects that contribute to the propensity of patients with AD to develop viral and bacterial infection. New therapeutic approaches to AD, urticaria, and angioedema have been reported including use of probiotics, biologics, vitamin D, and skin barrier creams.

  20. A novel model of IgE-mediated passive pulmonary anaphylaxis in rats.

    PubMed

    Wex, Eva; Thaler, Eva; Blum, Sylvia; Lamb, David

    2014-01-01

    Mast cells are central effector cells in allergic asthma and are augmented in the airways of asthma patients. Attenuating mast cell degranulation and with it the early asthmatic response is an important intervention point to inhibit bronchoconstriction, plasma exudation and tissue oedema formation. To validate the efficacy of novel pharmacological interventions, appropriate and practicable in vivo models reflecting mast cell-dependent mechanisms in the lung, are missing. Thus, we developed a novel model of passive pulmonary anaphylaxis in rats. Rats were passively sensitized by concurrent intratracheal and intradermal (ear) application of an anti-DNP IgE antibody. Intravenous application of the antigen, DNP-BSA in combination with Evans blue dye, led to mast cell degranulation in both tissues. Quantification of mast cell degranulation in the lung was determined by (1) mediator release into bronchoalveolar lavage, (2) extravasation of Evans blue dye into tracheal and bronchial lung tissue and (3) invasive measurement of antigen-induced bronchoconstriction. Quantification of mast cell degranulation in the ear was determined by extravasation of Evans blue dye into ear tissue. We pharmacologically validated our model using the SYK inhibitor Fostamatinib, the H1-receptor antagonist Desloratadine, the mast cell stabilizer disodium cromoglycate (DSCG) and the β2-adrenergic receptor agonist Formoterol. Fostamatinib was equally efficacious in lung and ear. Desloratadine effectively inhibited bronchoconstriction and ear vascular leakage, but was less effective against pulmonary vascular leakage, perhaps reflecting the differing roles for histamine receptor sub-types. DSCG attenuated both vascular leakage in the lung and bronchoconstriction, but with a very short duration of action. As an inhaled approach, Formoterol was more effective in the lung than in the ear. This model of passive pulmonary anaphylaxis provides a tissue relevant readout of early mast cell activity and

  1. The Pholcodine Case. Cough Medicines, IgE-Sensitization, and Anaphylaxis: A Devious Connection.

    PubMed

    Florvaag, E; Johansson, S G O

    2012-07-01

    : The Scandinavian data on pholcodine (PHO) strongly indicates that there is a biological chain from PHO exposure through IgE-sensitization to IgE-mediated anaphylaxis to neuromuscular blocking agents (NMBA). PHO is probably one of the strongest inducer of an IgE antibody response known. Of individuals taking PHO in cough medicines, over-the-counter accessibility to large populations, as many as 20 to 25% may become IgE sensitized. Once sensitized, PHO re-exposure will booster IgE antibody levels and IgE by around 100-fold. PHO is monovalent for 2 non-cross-reacting epitopes the quaternary ammonium ion (QAI), the main allergenic epitope of NMBA, and a non-QAI epitope. Thus, PHO most unlikely would initiate an allergic inflammatory response. Consequently, IgE sensitization is not revealed by obvious clinical signs, neither through tests based on IgE-sensitized effector cells. Therefore, it will escape detection if not assayed serologically. However, when subjected to general anesthesia, and thus the IgE-sensitized individual is administered a bivalent NMBA intravenously, the unrecognized presence of serum IgE antibodies to QAI may increase the risk of anaphylaxis 200- to 300-fold. Severe damages to patient's health can result, and mortality rates of 3 to 10% are reported. The Scandinavian experience indicates that the chain of events can efficiently be avoided by stopping PHO exposure: Within 1 year, the prevalence of IgE sensitization to PHO and QAI decreases significantly, and after 2 to 3 years, the numbers of reported anaphylactic reactions decreases equally so. PMID:23283141

  2. IgE Immunoadsorption Knocks Down the Risk of Food-Related Anaphylaxis.

    PubMed

    Dahdah, Lamia; Ceccarelli, Stefano; Amendola, Silvia; Campagnano, Pietro; Cancrini, Caterina; Mazzina, Oscar; Fiocchi, Alessandro

    2015-12-01

    The effects of an immunoadsorption procedure, specifically designed to remove immunoglobulin E (IgE), on food-induced anaphylaxis have never been evaluated. We evaluate the effects of IgE removal on the allergic thresholds to foods. A 6-year-old boy with anaphylaxis to multiple foods and steroid-resistant unstable allergic asthma displayed serum IgE levels of 2800 to 3500 kU/L. To lower IgE serum concentrations, which could be overridden by a high dose of omalizumab, 1.5 plasma volumes were exchanged in 8 apheresis sessions. During the procedure, serum IgE levels fell to 309 kU/L. After the procedure, the threshold of reactivity to baked milk increased from 0.125 to 5 g of milk protein (full tolerance) after the first session, and the threshold of reactivity to hazelnut increased from 0.037 to 0.142 g of protein after the first session, 0.377 g after the eighth, and 1.067 g (full tolerance) after the first administration of omalizumab. Immediately after the sixth IgE immunoadsorption, we started omalizumab therapy. In the next 40 days, the threshold of reactivity to hazelnut increased to 7.730 (full tolerance). Asthma control was obtained, treatment with montelukast was stopped, and fluticasone was tapered from 500 to 175 μg/day. The boy became partially or fully tolerant to all the tested foods, and quality of life was improved. IgE immunoadsorption, used to establish the starting basis for omalizumab administration, is able to increase the tolerance threshold to foods. PMID:26620068

  3. The pholcodine Case. Cough Medicines, IgE-Sensitization, and Anaphylaxis: A Devious Connection

    PubMed Central

    2012-01-01

    The Scandinavian data on pholcodine (PHO) strongly indicates that there is a biological chain from PHO exposure through IgE-sensitization to IgE-mediated anaphylaxis to neuromuscular blocking agents (NMBA). PHO is probably one of the strongest inducer of an IgE antibody response known. Of individuals taking PHO in cough medicines, over-the-counter accessibility to large populations, as many as 20 to 25% may become IgE sensitized. Once sensitized, PHO re-exposure will booster IgE antibody levels and IgE by around 100-fold. PHO is monovalent for 2 non-cross-reacting epitopes the quaternary ammonium ion (QAI), the main allergenic epitope of NMBA, and a non-QAI epitope. Thus, PHO most unlikely would initiate an allergic inflammatory response. Consequently, IgE sensitization is not revealed by obvious clinical signs, neither through tests based on IgE-sensitized effector cells. Therefore, it will escape detection if not assayed serologically. However, when subjected to general anesthesia, and thus the IgE-sensitized individual is administered a bivalent NMBA intravenously, the unrecognized presence of serum IgE antibodies to QAI may increase the risk of anaphylaxis 200- to 300-fold. Severe damages to patient's health can result, and mortality rates of 3 to 10% are reported. The Scandinavian experience indicates that the chain of events can efficiently be avoided by stopping PHO exposure: Within 1 year, the prevalence of IgE sensitization to PHO and QAI decreases significantly, and after 2 to 3 years, the numbers of reported anaphylactic reactions decreases equally so. PMID:23283141

  4. The Pholcodine Case. Cough Medicines, IgE-Sensitization, and Anaphylaxis: A Devious Connection.

    PubMed

    Florvaag, E; Johansson, S G O

    2012-07-01

    : The Scandinavian data on pholcodine (PHO) strongly indicates that there is a biological chain from PHO exposure through IgE-sensitization to IgE-mediated anaphylaxis to neuromuscular blocking agents (NMBA). PHO is probably one of the strongest inducer of an IgE antibody response known. Of individuals taking PHO in cough medicines, over-the-counter accessibility to large populations, as many as 20 to 25% may become IgE sensitized. Once sensitized, PHO re-exposure will booster IgE antibody levels and IgE by around 100-fold. PHO is monovalent for 2 non-cross-reacting epitopes the quaternary ammonium ion (QAI), the main allergenic epitope of NMBA, and a non-QAI epitope. Thus, PHO most unlikely would initiate an allergic inflammatory response. Consequently, IgE sensitization is not revealed by obvious clinical signs, neither through tests based on IgE-sensitized effector cells. Therefore, it will escape detection if not assayed serologically. However, when subjected to general anesthesia, and thus the IgE-sensitized individual is administered a bivalent NMBA intravenously, the unrecognized presence of serum IgE antibodies to QAI may increase the risk of anaphylaxis 200- to 300-fold. Severe damages to patient's health can result, and mortality rates of 3 to 10% are reported. The Scandinavian experience indicates that the chain of events can efficiently be avoided by stopping PHO exposure: Within 1 year, the prevalence of IgE sensitization to PHO and QAI decreases significantly, and after 2 to 3 years, the numbers of reported anaphylactic reactions decreases equally so.

  5. Anaphylaxis Quiz

    MedlinePlus

    American Academy of Allergy Asthma & Immunology Menu Search Main navigation Skip to content Conditions & Treatments Allergies Asthma Primary Immunodeficiency Disease Related Conditions Drug Guide Conditions Dictionary Just ...

  6. Online Degrees.

    ERIC Educational Resources Information Center

    Dolezalek, Holly

    2003-01-01

    Discusses the trend of trainers who are getting degrees through online courses delivered via the Internet. Addresses accreditation issues and what to ask before enrolling in online degree programs. (JOW)

  7. Online Support for VET Clients: Expectations and Experiences.

    ERIC Educational Resources Information Center

    Choy, Sarojni; McNickle, Cathy; Clayton, Berwyn

    Since little research existed about services for online learners in Australia, a national study was conducted to explore the expectations and experiences of online learners in the Vocational Education and Training (VET) sector. Online learners enrolled with various Registered Training Organizations (RTOs) from the VET sector were contacted for…

  8. An Online Bioinformatics Curriculum

    PubMed Central

    Searls, David B.

    2012-01-01

    Online learning initiatives over the past decade have become increasingly comprehensive in their selection of courses and sophisticated in their presentation, culminating in the recent announcement of a number of consortium and startup activities that promise to make a university education on the internet, free of charge, a real possibility. At this pivotal moment it is appropriate to explore the potential for obtaining comprehensive bioinformatics training with currently existing free video resources. This article presents such a bioinformatics curriculum in the form of a virtual course catalog, together with editorial commentary, and an assessment of strengths, weaknesses, and likely future directions for open online learning in this field. PMID:23028269

  9. A Comparison of Classroom and Online Asynchronous Problem-Based Learning for Students Undertaking Statistics Training as Part of a Public Health Masters Degree

    ERIC Educational Resources Information Center

    de Jong, N.; Verstegen, D. M. L.; Tan, F. E. S.; O'Connor, S. J.

    2013-01-01

    This case-study compared traditional, face-to-face classroom-based teaching with asynchronous online learning and teaching methods in two sets of students undertaking a problem-based learning module in the multilevel and exploratory factor analysis of longitudinal data as part of a Masters degree in Public Health at Maastricht University. Students…

  10. Effects of Just-in-Time Online Training on Knowledge and Application of the Sheltered Instruction Observation Protocol (SIOP®) Model among In-Service Teachers

    ERIC Educational Resources Information Center

    Bose, Devshikha

    2012-01-01

    The purpose of this study was to determine whether there was a difference in knowledge and application of the SIOP ® Model among in-service teachers who participated in an online professional development course on the SIOP® Model. Although these teachers all participated in the same course, information on the number of English Language Learners…

  11. Can You Hear Me Now? Evaluation of an Online Wireless Technology to Provide Real-Time Feedback to Special Education Teachers-in-Training

    ERIC Educational Resources Information Center

    Rock, Marcia L.; Gregg, Madeleine; Thead, Beth K.; Acker, Sarah E.; Gable, Robert A.; Zigmond, Naomi P.

    2009-01-01

    In this study, the authors examine whether an advanced online technology can be used to give teacher trainees real-time feedback on their use of research-based classroom practices. Participants include 15 teachers enrolled in a field-based graduate special education teacher preparation program. Data include video-recorded teacher observations and…

  12. IgE-mediated systemic anaphylaxis and impaired tolerance to food antigens in mice with enhanced IL-4 receptor signaling

    PubMed Central

    Mathias, Clinton B.; Hobson, Suejy A.; Garcia-Lloret, Maria; Lawson, Greg; Poddighe, Dimitri; Freyschmidt, Eva-Jasmin; Xing, Wei; Gurish, Michael F.; Chatila, Talal A.; Oettgen, Hans C.

    2010-01-01

    Background In atopic individuals, food ingestion drives the production of IgE antibodies that can trigger hypersensitivity reactions. The IL-4 pathway plays critical roles in this response and genetic polymorphisms in its components have been linked to allergy. Objective To test whether an activating mutation in the IL-4 receptor (IL-4R) α chain enhances allergic responses to a food antigen. Methods F709 mice, in which the IL-4Rα immuno-tyrosine inhibitory motif (ITIM) motif is inactivated, were gavage fed with ovalbumin (OVA). Reactions to OVA challenge and immune responses including antibody production and Th2 responses were assessed. Results F709 mice, but not wild-type (WT) controls, sensitized by gavage with OVA and either cholera toxin (CT) or Staphylococcal enterotoxin B (SEB), displayed mast cell activation and systemic anaphylaxis upon enteral challenge. Anaphylaxis was elicited even in F709 mice enterally sensitized with OVA alone. Bone marrow chimera experiments established that the increased sensitivity conferred by the F709 genotype was mediated mostly by hematopoietic cells but that nonhematopoietic cells also contributed. F709 mice exhibited increased intestinal permeability to macromolecules. The F709 genotype conferred increased OVA-specific IgE but not IgG1 responses, local and systemic Th2 responses and intestinal mast cell hyperplasia as compared with WT mice. Anaphylaxis was abrogated in F709 mice lacking IgE or the high affinity receptor for IgE (FcεRI). Conclusion Augmented IL-4Rα signaling confers increased intestinal permeability and dramatically enhanced sensitivity to food allergens. Unlike anaphylaxis to injected antigens, which in rodents can be mediated by either IgE or IgG antibodies, the food-induced response in F709 mice is solely IgE-dependent. PMID:21167580

  13. Cardiac anaphylaxis: a case of acute ST-segment elevation myocardial infarction after IM epinephrine for anaphylactic shock.

    PubMed

    Tummala, Karthik; Maniyal, Vijay K; Chandrashekaran, Rajiv; Mathew, Navin; Ganeshwala, Gaurav

    2013-07-01

    A 62-year-old male smoker with no other comorbidities presented to emergency department with systemic anaphylaxis, due to oral diclofenac for toothache. He developed acute anterior wall myocardial infarction following IM epinephrine 1 mg 1:1000. Primary percutaneous coronary intervention was done, which showed a thrombus in the mid left anterior descending artery with no evidence of obstructive coronary artery disease after thrombus aspiration.

  14. Anisakis simplex allergy: a murine model of anaphylaxis induced by parasitic proteins displays a mixed Th1/Th2 pattern

    PubMed Central

    Baeza, M L; Conejero, L; Higaki, Y; Martín, E; Pérez, C; Infante, S; Rubio, M; Zubeldia, J M

    2005-01-01

    The study of the singular hypersensitivity reactions to Anisakis simplex (A.s) proteins, may help us to undestand many of the unknown immune interactions between helmiths infections and allergy. We have developed a murine model of allergy to A. simplex, that mimics human A. simplex allergy to study the specific aspects of anaphylaxis induced by parasites. Male C3H/HeJ mice were intraperitoneally sensitized to A. simplex. Mice were then intravenous or orally challenged with A. simplex. Antigen-specific immunoglobulins, polyclonal IgE, anaphylactic symptoms, plasma histamine levels and cytokine profiles were determined. Comparative IgE immunoblot analyses were also performed. Specific IgE, IgG1 and IgG2a were detected in sensitized mice since week 3. Polyclonal IgE raised and peaked with different kinetics. Intravenous A. simplex challenge produced anaphylaxis in mice, accompanied by plasma histamine release. Oral A. simplex challenge in similarly sensitized mice did not caused symptoms nor histamine release. Numerous A. simplex allergens were recognized by sensitized mouse sera, some of them similar to human serum. The A. simplex stimulated splenocytes released IL-10, IFN-γ, IL-4, IL-13 and IL-5. We describe a new animal model of anaphylaxis. It exhibits characteristics of type I hypersensitivity reactions to Anisakis simplex similar to those observed in allergic humans. Different responses to i.v. or oral A. simplex challenges emerged, which did not reflect a window tolerization period. The cytokine profile developed (mixed Th1/Th2 pattern) differed from the observed in classical models of anaphylaxis or allergy to food antigens. This model may permit to investigate the peculiar allergic reactions to parasitic proteins. PMID:16297154

  15. Online boosting for vehicle detection.

    PubMed

    Chang, Wen-Chung; Cho, Chih-Wei

    2010-06-01

    This paper presents a real-time vision-based vehicle detection system employing an online boosting algorithm. It is an online AdaBoost approach for a cascade of strong classifiers instead of a single strong classifier. Most existing cascades of classifiers must be trained offline and cannot effectively be updated when online tuning is required. The idea is to develop a cascade of strong classifiers for vehicle detection that is capable of being online trained in response to changing traffic environments. To make the online algorithm tractable, the proposed system must efficiently tune parameters based on incoming images and up-to-date performance of each weak classifier. The proposed online boosting method can improve system adaptability and accuracy to deal with novel types of vehicles and unfamiliar environments, whereas existing offline methods rely much more on extensive training processes to reach comparable results and cannot further be updated online. Our approach has been successfully validated in real traffic environments by performing experiments with an onboard charge-coupled-device camera in a roadway vehicle.

  16. [A case of anaphylaxis due to rose-flavored soft-serve ice cream with pollen food allergy syndrome].

    PubMed

    Kitabayashi, Taeru; Sato, Sayuri; Adachi, Mitsuru

    2013-05-01

    We experienced a 10-year-old boy who had anaphylaxis after eating rose-flavored soft-serve ice cream. The patient felt a sense of discomfort in his throat when eating apple, peach, loquat, Japanese pear, and kiwi fruit. Therefore, we measured specific IgE antibodies to allergen components by ImmunoCAP ISAC. Consequently, the patient gave positive results for all PR-10 proteins from birch, alder, hazel, apple, peach, peanut, hazelnut, and soybean, so we diagnosed him with Pollen Food Allergy Syndrome (PFAS) induced by cross reactivity with pollens of birch family and fruits of rose family. When we conducted the skin prick test as is for red rose syrup because of the belief that anaphylaxis was caused by the rose ingredient contained in rose-flavored soft-serve ice cream, the patient gave a strong positive result. However, the results were negative for rose essence and Food Red No. 2 contained. Subsequently, it was found that red rose syrup contained apple juice. Therefore, we conducted the prick-prick test for apple, and the patient was confirmed to be strongly positive to apple. We thus identified apple as the cause of anaphylaxis. Since there is no legal obligation of labeling specific raw materials when directly selling manufactured and processed food products to general consumers, it is possible for general consumers to mistakenly take them in without knowing the containment of allergic substances. It is believed that the labeling method should be improved in the future.

  17. Log in and breathe out: efficacy and cost-effectiveness of an online sleep training for teachers affected by work-related strain - study protocol for a randomized controlled trial

    PubMed Central

    2013-01-01

    Background Insomnia and work-related stress often co-occur. Both are associated with personal distress and diminished general functioning, as well as substantial socio-economic costs due to, for example, reduced productivity at the work place and absenteeism. Insomnia complaints by people experiencing work-related stress are correlated with a deficient cognitive detachment from work. Diffuse boundaries between work and private life can additionally complicate the use of recreational activities that facilitate cognitive detachment. Cognitive behavioral therapy for insomnia is effective but rarely implemented. Internet-based cognitive behavioral therapy for insomnia could potentially reduce this deficit given its demonstrated effectiveness. Less is known, however, about the efficacy of internet-based cognitive behavioral therapy for insomnia in populations affected by high work stress. Thus, the aim of the present study is to evaluate the efficacy and cost-effectiveness of a newly developed, guided online training which is based on Cognitive Behavioral Therapy for insomnia and tailored to teachers affected by occupational stress. Methods/Design In a two-arm randomized controlled trial (N = 128), the effects of a guided online sleep training will be compared to a waitlist-control condition. German teachers with significant clinical insomnia complaints (Insomnia Severity Index ≥15) and work-related rumination (Irritation Scale, subscale Cognitive Irritation ≥15) will be included in the study. The primary outcome measure will be insomnia severity. Additionally, an economic evaluation from a societal perspective will be conducted. Data from the intention-to-treat sample will be analyzed two and six months after randomization. Discussion To the best of our knowledge, this is the first study to evaluate an online sleep training tailored to a specific population with work stress, that is, teachers. If this type of intervention is effective, it could reduce the

  18. 422 A Rare Case of Food-induced Anaphylaxis to Pink Peppercorns

    PubMed Central

    Kim, John; Minikes, Neil

    2012-01-01

    Background The incidence and prevalence of food allergies appear to be on the rise over the past 20 years. The most common foods to produce an IgE mediated hypersensitivity reaction in adults include peanut, tree nuts, and seafood. The increased use of spices in the U.S. has resulted in a growing number of patients presenting with hypersensitivity reactions. Methods We report a case of a 26 year-old-female who developed anaphylaxis after ingesting pink peppercorn seasoning. The patient was diagnosed with a tree nut allergy at 18 years of age when she developed hives, vomiting and throat closure after ingesting cashews. More recently, she had 3 similar anaphylactic episodes requiring epinephrine and emergency room care when she unknowingly consumed tree nuts contained in foods while dining out (veggie burger, pesto sauce, almonds in Indian food). She again had similar symptoms while eating a home prepared meal in which tree nuts were not included. Intramuscular epinephrine was administered and she was subsequently treated with oral steroids and antihistamines. It was later determined that a new peppercorn medley with pink peppercorns was used for seasoning. The reaction did not occur when she ate the same meal without pink peppercorn seasoning. Food specific IgE testing revealed an elevated IgE for cashews (2.52 kUA/L) and pistachios (2.85 kUA/L). Results Pink peppercorn is not a true pepper, but dried roasted berries derived from Schinus terebinthifolius, a flowering plant in the family Anacardiaceae, native to South America. Common names include Brazilian Pepper, Rose Pepper and Christmasberry. Pink peppercorns are used as a spice to add a mild pepper-like taste to foods. It may potentially cause an irritating skin effect and has been associated with atopic dermatitis in canines. Interestingly, S. terebinthifolius is a member of the family Anacardiaceae, which include plants in the genus Anacardium (cashew nut) and Pistacia (pistachio). No allergens from this

  19. Online Tobacco Cessation Training and Competency Assessment for Complementary and Alternative Medicine (CAM) Practitioners: Protocol for the CAM Reach Web Study

    PubMed Central

    Howerter, Amy; Eaves, Emery R; Hall, John R; Buller, David B; Gordon, Judith S

    2016-01-01

    Background Complementary and alternative medicine (CAM) practitioners, such as chiropractors, acupuncturists, and massage therapists, are a growing presence in the US health care landscape and already provide health and wellness care to significant numbers of patients who use tobacco. For decades, conventional biomedical practitioners have received training to provide evidence-based tobacco cessation brief interventions (BIs) and referrals to cessation services as part of routine clinical care, whereas CAM practitioners have been largely overlooked for BI training. Web-based training has clear potential to meet large-scale training dissemination needs. However, despite the exploding use of Web-based training for health professionals, Web-based evaluation of clinical skills competency remains underdeveloped. Objective In pursuit of a long-term goal of helping CAM practitioners integrate evidence-based practices from US Public Health Service Tobacco Dependence Treatment Guideline into routine clinical care, this pilot protocol aims to develop and test a Web-based tobacco cessation training program tailored for CAM practitioners. Methods In preparation for a larger trial to examine the effect of training on CAM practitioner clinical practice behaviors around tobacco cessation, this developmental study will (1) adapt an existing in-person tobacco cessation BI training program that is specifically tailored for CAM therapists for delivery via the Internet; (2) develop a novel, Web-based tool to assess CAM practitioner competence in tobacco cessation BI skills, and conduct a pilot validation study comparing the competency assessment tool to live video role plays with a standardized patient; (3) pilot test the Web-based training with 120 CAM practitioners (40 acupuncturists, 40 chiropractors, 40 massage therapists) for usability, accessibility, acceptability, and effects on practitioner knowledge, self-efficacy, and competency with tobacco cessation; and (4) conduct

  20. 2010 Training Industry Report

    ERIC Educational Resources Information Center

    Training, 2010

    2010-01-01

    Now in its 29th year, The Industry Report is recognized as the training industry's most trusted source of data on budgets, staffing, and programs. This year, the study was conducted by an outside research firm in June-August 2010, when members from the "Training" magazine database were e-mailed an invitation to participate in an online survey.…

  1. Protective effect of relaxin in cardiac anaphylaxis: involvement of the nitric oxide pathway

    PubMed Central

    Masini, E; Zagli, G; Ndisang, J F; Solazzo, M; Mannaioni, P F; Bani, D

    2002-01-01

    Relaxin (RLX) is a multifunctional hormone best known for its role in pregnancy and parturition, that has been also shown to influence coronary perfusion and mast cell activation through the generation of endogenous nitric oxide (NO). In this study we report on the effects of RLX on the biochemical and mechanical changes of ex vivo perfused hearts isolated from ovalbumin-sensitized guinea-pigs induced by challenge with the specific antigen. The possible involvement of NO in the RLX action has been also investigated. A 30-min perfusion with RLX (30 ng ml−1) before ovalbumin challenge fully abated the positive chronotropic and inotropic effects evoked by anaphylactic reaction to the antigen. RLX also blunted the short-term coronary constriction following to antigen challenge. Conversely, perfusion with chemically inactivated RLX had no effect. The release of histamine in the perfusate and the accumulation of calcium in heart tissue induced by antigen challenge were significantly decreased by RLX, while the amounts of nitrites in the perfusate were significantly increased, as were NO synthase activity and expression and cGMP levels in heart tissue. These findings indicate that RLX has a protective effect in cardiac anaphylaxis which involves an up-regulation of the NO biosynthetic pathway. PMID:12237253

  2. 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.

  3. Advances in allergic skin disease, anaphylaxis, and hypersensitivity reactions to foods, drugs, and insects in 2010.

    PubMed

    Sicherer, Scott H; Leung, Donald Y M

    2011-02-01

    This review highlights some of the research advances in anaphylaxis; hypersensitivity reactions to foods, drugs, and insects; and allergic skin disease that were reported in the Journal in 2010. Key epidemiologic observations include an apparent increase in peanut allergy, with more than 1% of children affected, and increasing evidence that early food allergen exposure, rather than avoidance, might improve allergy outcomes. Advances in food allergy diagnosis include improved insights into prognosis and estimation of severity through component-resolved diagnostics and characterization of IgE binding to specific epitopes. Regarding treatment, oral and epicutaneous immunotherapy show promise. Studies of drug allergies show insights into pathophysiology, and studies on insect hypersensitivity reveal improved diagnostic methods. Genetic and functional studies have revealed the important role of epidermal differentiation products in the pathogenesis of atopic dermatitis. Cross-talk between the atopic immune response with the innate immune response have also been found to predispose to infection in patients with atopic dermatitis. New therapeutic approaches to control chronic urticaria have also been identified during the past year.

  4. [SIX CASES OF WHEAT-DEPENDENT EXERCISE-INDUCED ANAPHYLAXIS IN CHILDREN].

    PubMed

    Nakagawa, Tomoko; Sakai, Kazunori; Hayashi, Naofumi; Sato, Arisa; Sasaki, Kemal; Matsui, Teruaki; Sugiura, Shiro; Kando, Naoyuki; Ito, Komei

    2015-08-01

    Wheat-dependent exercise-induced anaphylaxis (WDEIA) is often reported in adults for whom the specific IgE to ω-5 gliadin can be a useful diagnostic test. However, few cases of WDEIA in children have been reported. We herein report six cases (aged 7-16 years) of children with WDEIA, who had no clinical history of immediate-type wheat allergy but who were diagnosed by a wheat ingestion + exercise provocation test. The specific IgE to wheat ranged <0.35-3.49 (median 1.64) UA/ml. Skin prick tests using wheat extract were performed on 3 patients who showed either a negative or low specific IgE titer to wheat, and all of them resulted in negative findings. The specific IgE to ω-5 gliadin was below the detection limit in all cases. Aspirin-supplemented provocation tests were performed to 4 cases who had negative results in the wheat + exercise test. All of these resulted in a positive reaction, and two of them provoked the occurrence of anaphylactic shock, which was relieved by the intramuscular injection of adrenaline. WDEIA in children cannot be ruled out by serological tests alone. On the other hand, severe symptoms might be provoked by the provocation test. Therefore, a safe procedure is warranted for the diagnosis of WDEIA in children.

  5. Anaphylaxis after hymenoptera sting: is it venom allergy, a clonal disorder, or both?

    PubMed

    Castells, Mariana C; Hornick, Jason L; Akin, Cem

    2015-01-01

    A 47-year-old man presented with loss of consciousness 5 minutes after being stung by a yellow jacket in his backyard. Epinephrine and fluids were required for resuscitation. Allergy evaluation revealed specific IgE to yellow jacket and honeybee, and the patient was started on venom immunotherapy. He had systemic reactions during buildup and a severe anaphylactic episode requiring 3 doses of intramuscular epinephrine at maintenance doses. Immunotherapy was discontinued. Serum tryptase level after 1 such episode was 29 ng/mL, with a baseline level of 25 ng/mL 4 weeks later. The physical examination was unremarkable including no skin lesions of cutaneous mastocytosis. Because of elevated baseline tryptase level, a bone marrow biopsy was performed, which revealed multifocal dense infiltrates of mast cells. A diagnosis of systemic mastocytosis was made. The patient was treated with omalizumab and was able to tolerate immunotherapy and is currently maintained on lifelong immunotherapy. He was restung in the field and has not had anaphylaxis.

  6. Imidacloprid inhibits IgE-mediated RBL-2H3 cell degranulation and passive cutaneous anaphylaxis

    PubMed Central

    Shi, Linbo; Zou, Li; Gao, Jinyan; Xu, Huaing; Shi, Xiaoyun

    2016-01-01

    Background Imidacloprid has been commonly used as a pesticide for crop protection and acts as nicotinic acetylcholine receptor agonists. Little information about the relationship between imidacloprid and allergy is available. Objective This study aims to examine the effects of imidacoprid on IgE-mediated mast cell activation. Methods The rat basophilic leukemia cell line RBL-2H3 (RBL-2H3 cells) were treated with 10-3 – 10-12 mol/L imidacloprid, followed by measuring the mediator production, influx of Ca2+ in IgE-activated RBL-2H3 cells, and the possible effects of imidacoprid on anti-dinitrophenyl IgE-induced passive cutaneous anaphylaxis (PCA). Results It was shown that imidacoprid suppressed the production of histamine, β-hexosaminidase, leukotriene C4, interleukin-6, tumor necrosis factor-α, and Ca2+ mobilization in IgE-activated RBL-2H3 cells and decreased vascular extravasation in IgE-induced PCA. Conclusion It is the first time to show that imidacloprid suppressed the activation of RBL-2H3 cells. PMID:27803884

  7. [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

  8. [SIX CASES OF WHEAT-DEPENDENT EXERCISE-INDUCED ANAPHYLAXIS IN CHILDREN].

    PubMed

    Nakagawa, Tomoko; Sakai, Kazunori; Hayashi, Naofumi; Sato, Arisa; Sasaki, Kemal; Matsui, Teruaki; Sugiura, Shiro; Kando, Naoyuki; Ito, Komei

    2015-08-01

    Wheat-dependent exercise-induced anaphylaxis (WDEIA) is often reported in adults for whom the specific IgE to ω-5 gliadin can be a useful diagnostic test. However, few cases of WDEIA in children have been reported. We herein report six cases (aged 7-16 years) of children with WDEIA, who had no clinical history of immediate-type wheat allergy but who were diagnosed by a wheat ingestion + exercise provocation test. The specific IgE to wheat ranged <0.35-3.49 (median 1.64) UA/ml. Skin prick tests using wheat extract were performed on 3 patients who showed either a negative or low specific IgE titer to wheat, and all of them resulted in negative findings. The specific IgE to ω-5 gliadin was below the detection limit in all cases. Aspirin-supplemented provocation tests were performed to 4 cases who had negative results in the wheat + exercise test. All of these resulted in a positive reaction, and two of them provoked the occurrence of anaphylactic shock, which was relieved by the intramuscular injection of adrenaline. WDEIA in children cannot be ruled out by serological tests alone. On the other hand, severe symptoms might be provoked by the provocation test. Therefore, a safe procedure is warranted for the diagnosis of WDEIA in children. PMID:26522419

  9. [Clinical courses of 18 cases with food-dependent exercise-induced anaphylaxis].

    PubMed

    Kano, H; Juji, F; Shibuya, N; Narita, M; Naritaka, S; Suko, M; Morita, Y; Iwata, T

    2000-06-01

    Eighteen cases (7 males and 11 females) of food-dependent exercise-induced anaphylaxis were observed for several years. The age of the patients at the first visit to our hospital ranged from 9 to 43 years (average 24.3 years). The offending foods were wheat in 9 cases, shrimp in 2 cases, shellfish in 1 case, fish in 1 case, and unknown foods in 5 cases. The inducing exercises were ball play games, running, riding a bicycle, swimming, kendo (Japanese fencing), walking, and so on. We advised these patients to avoid eating offending foods or taking exercises, or to take antiallergic medicine such as DSCG, and repirinast. We observed their clinical courses and laboratory data for 2 to 10 years. Only a few cases relapsed anaphylactoid reactions, but all cases have improved until now. In some cases, IgE RAST scores for wheat decreased. In other cases, the rate of histamine release on anti-IgE stimulation decreased after taking DSCG.

  10. American Academy of Allergy, Asthma & Immunology/American College of Allergy, Asthma and Immunology Joint Task Force Report on omalizumab-associated anaphylaxis.

    PubMed

    Cox, Linda; Platts-Mills, Thomas A E; Finegold, Ira; Schwartz, Lawrence B; Simons, F Estelle R; Wallace, Dana V

    2007-12-01

    The American Academy of Allergy, Asthma & Immunology and the American College of Allergy, Asthma and Immunology Executive Committees formed the Omalizumab Joint Task Force with the purpose of reviewing the Genentech Xolair (omalizumab) clinical trials and postmarketing surveillance data on anaphylaxis and anaphylactoid reactions. Using the definition of anaphylaxis proposed at a 2005 multidisciplinary symposia, the Omalizumab Joint Task Force concluded that 35 patients had 41 episodes of anaphylaxis associated with Xolair (omalizumab) administration between June 1, 2003, and December 31, 2005. With 39,510 patients receiving Xolair (omalizumab) during the same period of time, this would correspond to an anaphylaxis-reporting rate of 0.09% of patients. Of those 36 events for which the time of reaction was known, 22 (61%) reactions occurred in the first 2 hours after one of the first 3 doses. Five (14%) of the events after the fourth or later doses occurred within 30 minutes. Considering the timing of these 36 events, an observation period of 2 hours for the first 3 injections and 30 minutes for subsequent injections would have captured 75% of the anaphylactic reactions. The OJTF report provides recommendations for physicians who prescribe Xolair (omalizumab) on (1) the suggested wait periods after administration and (2) patient education regarding anaphylaxis.

  11. Delayed Anaphylaxis to Red Meat in Patients with IgE Specific for Galactose alpha-1,3-Galactose (alpha-gal)

    PubMed Central

    Platts-Mills, Thomas A. E.

    2012-01-01

    Anaphylaxis is a severe allergic reaction that can be rapidly progressing and fatal. In instances where the triggering allergen is not known, establishing the etiology of anaphylaxis is pivotal to long-term risk management. Our recent work has identified a novel IgE antibody (Ab) response to a mammalian oligosaccharide epitope, galactose-alpha-1,3-galactose (alpha-gal), that has been associated with two distinct forms of anaphylaxis: (1) immediate onset anaphylaxis during first exposure to intravenous cetuximab, and (2) delayed onset anaphylaxis 3–6 h after ingestion of mammalian food products (e.g., beef and pork). The results of our studies strongly suggest that tick bites are a cause, if not the only significant cause, of IgE Ab responses to alpha-gal in the southern, eastern and central United States. Patients with IgE Ab to alpha-gal continue to emerge and, increasingly, these cases involve children. This IgE Ab response cross-reacts with cat and dog but does not appear to pose a risk for asthma; however, it may impair diagnostic testing in some situations. PMID:23054628

  12. Comparing the Effectiveness of On-Line versus In-Person Caregiver Education and Training for Behavioral Regulation in Families of Children with FASD

    ERIC Educational Resources Information Center

    Kable, Julie A.; Coles, Claire D.; Strickland, Dorothy; Taddeo, Elles

    2012-01-01

    Different formats for delivering parent education designed to improve the functioning of children with FASD were evaluated. Participants were randomly assigned to a treatment condition: (1) Community Standard/Informational Packet, (2) Group Workshops, and (3) Internet Training. Overall satisfaction was high for all formats but the Workshop group…

  13. Development of an online training course on sustainable livestock production (poultry, sheep and goat), agroforestry and integrated operations for beginning farmers

    Technology Transfer Automated Retrieval System (TEKTRAN)

    In the last few decades, there has been a marked reduction in the number of family and small agricultural enterprises in this country. Unfortunately, high startup costs, high costs of inputs and the lack of training tend to reduce the appeal of farming as a career. To help address this situation, we...

  14. A Comprehensive Plan for Differentiating the Training of Teachers of the Gifted Online at the State, District and University Levels in Florida, USA

    ERIC Educational Resources Information Center

    Eriksson, Gillian; Weber, Christine; Kirsch, Lauri

    2012-01-01

    The training of teachers for a meaningful use of all that contemporary technology offers to developing curriculum requires constant vigilance, experimentation, innovation, revision and updating. The lifestyle of today's gifted students includes a range of ever-unfolding technologies, such as text messaging, blogging, social networking, personal…

  15. Translating Training in the NYU Caregiver Intervention in Australia: Maintaining Fidelity and Meeting Graduate Standards in an Online Continuing Professional Education Setting

    ERIC Educational Resources Information Center

    Scott, Theresa L.; Mittelman, Mary S.; Beattie, Elizabeth; Parker, Deborah; Neville, Christine

    2015-01-01

    The aim of this study was to develop an Internet-based self-directed training program for Australian healthcare workers to facilitate learning and competence in delivery of a proven intervention for caregivers of people with dementia: The New York University Caregiver Intervention (NYUCI). The NYUCI is a nonpharmacological, multicomponent…

  16. Online Pricing.

    ERIC Educational Resources Information Center

    Garman, Nancy; And Others

    1990-01-01

    The first of four articles describes the move by the European Space Agency to eliminate connect time charges on its online retrieval system. The remaining articles describe the pricing structure of DIALOG, compare the two pricing schemes, and discuss online pricing from the user's point of view. (CLB)

  17. Network analysis of possible anaphylaxis cases reported to the US vaccine adverse event reporting system after H1N1 influenza vaccine.

    PubMed

    Botsis, Taxiarchis; Ball, Robert

    2011-01-01

    The identification of signals from spontaneous reporting systems plays an important role in monitoring the safety of medical products. Network analysis (NA) allows the representation of complex interactions among the key elements of such systems. We developed a network for a subset of the US Vaccine Adverse Event Reporting System (VAERS) by representing the vaccines/adverse events (AEs) and their interconnections as the nodes and the edges, respectively; this subset we focused upon included possible anaphylaxis reports that were submitted for the H1N1 influenza vaccine. Subsequently, we calculated the main metrics that characterize the connectivity of the nodes and applied the island algorithm to identify the densest region in the network and, thus, identify potential safety signals. AEs associated with anaphylaxis formed a dense region in the 'anaphylaxis' network demonstrating the strength of NA techniques for pattern recognition. Additional validation and development of this approach is needed to improve future pharmacovigilance efforts. PMID:21893812

  18. [Wheat dependent exercise induced anaphylaxis possibly sensitized by the hydrolyzed wheat proteins in a facial cleansing soap].

    PubMed

    Kobayashi, Miwa; Okura, Risa; Yoshioka, Haruna; Hiromasa, Kana; Yoshioka, Manabu; Nakamura, Motonobu

    2012-03-01

    There are increasing cases of wheat dependent exercise-induced anaphylaxis (WDEIA) with transcutaneous or transmucosal sensitization. Hydrolyzed wheat included in a certain brand of soap was identified as a cause of sensitization. The useful clues to detect this disorder consist of the patient's past usage of a soap containing hydrolyzed wheat, the appearance of cutaneous or mucosal symptoms after the intake of wheat or washing with this soap, and a high level of specific IgE for wheat gluten. Because hydrolyzed wheat is used as an additive in a wide variety of cosmetics, we should pay careful attention to the ingredients of cosmetics when observing WDEIA.

  19. Anaphylaxis to peanut in a patient predominantly sensitized to Ara h 6.

    PubMed

    Asarnoj, A; Glaumann, S; Elfström, L; Lilja, G; Lidholm, J; Nilsson, C; Wickman, M

    2012-01-01

    Diagnosis of peanut allergy has improved thanks to component-resolved diagnostics. Peanut allergen component Ara h 2 is considered to indicate true peanut allergy. The component Ara h 6 is structurally similar to Ara h 2, but the diagnostic value of analyzing IgE antibodies to Ara h 6 is unclear. A boy sensitized (≥0.35 kU(A)/l) to Ara h 8 but not to Ara h 1, Ara h 2 and Ara h 3 was challenged with peanut and developed grade II anaphylaxis. In serum collected at the time of challenge a doubling of IgE to the peanut allergen extract was observed compared to allergy testing 9 months earlier. In contrast, IgE levels to Ara h 1, Ara h 2, Ara h 3 and to Ara h 8 were rather unchanged. After another 2 months, Ara h 6 was analyzed and revealed a level of 24 kU(A)/l whilst Ara h 2 was 0.12 kU(A)/l. We suggest that IgE sensitization to Ara h 6 caused the reaction and conclude that analyses of IgE levels to peanut and peanut components should be performed in connection with a challenge. Furthermore, levels to Ara h 2 below 0.35 kU(A)/l may still indicate a risk of severe reaction at the time of challenge since in rare cases, Ara h 6 IgE antibodies may be present without occurrence of IgE antibodies to Ara h 2.

  20. EAACI food allergy and anaphylaxis guidelines. Primary prevention of food allergy.

    PubMed

    Muraro, A; Halken, S; Arshad, S H; Beyer, K; Dubois, A E J; Du Toit, G; Eigenmann, P A; Grimshaw, K E C; Hoest, A; Lack, G; O'Mahony, L; Papadopoulos, N G; Panesar, S; Prescott, S; Roberts, G; de Silva, D; Venter, C; Verhasselt, V; Akdis, A C; Sheikh, A

    2014-05-01

    Food allergy can have significant effects on morbidity and quality of life and can be costly in terms of medical visits and treatments. There is therefore considerable interest in generating efficient approaches that may reduce the risk of developing food allergy. This guideline has been prepared by the European Academy of Allergy and Clinical Immunology's (EAACI) Taskforce on Prevention and is part of the EAACI Guidelines for Food Allergy and Anaphylaxis. It aims to provide evidence-based recommendations for primary prevention of food allergy. A wide range of antenatal, perinatal, neonatal, and childhood strategies were identified and their effectiveness assessed and synthesized in a systematic review. Based on this evidence, families can be provided with evidence-based advice about preventing food allergy, particularly for infants at high risk for development of allergic disease. The advice for all mothers includes a normal diet without restrictions during pregnancy and lactation. For all infants, exclusive breastfeeding is recommended for at least first 4-6 months of life. If breastfeeding is insufficient or not possible, infants at high-risk can be recommended a hypoallergenic formula with a documented preventive effect for the first 4 months. There is no need to avoid introducing complementary foods beyond 4 months, and currently, the evidence does not justify recommendations about either withholding or encouraging exposure to potentially allergenic foods after 4 months once weaning has commenced, irrespective of atopic heredity. There is no evidence to support the use of prebiotics or probiotics for food allergy prevention.