Browsing by Author "Sousa, N"
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- Adverse drug reactions in adults attending different consultationsPublication . Sousa, N; Machado, D; Faria, E; Chieira, C
- Anafilaxia perioperatória em Coimbra: Experiência da consulta de alergia a fármacosPublication . Faria, E; Sousa, N; Geraldes, L; Santos, A; Chieira, CBackground: The incidence of peri-operative anaphylactic reactions ranges from 1:10,000 to 1:20,000. It is crucial to identify the risk factors, the trigger agent and to fi nd adequate alternatives. Aims: To characterise patients with peri-operative anaphylactic reactions. Methods: We performed a retrospective study of patients with suspected adverse peri-operative reactions to anaesthetic drugs, observed in a Drug Allergy Outpatients Clinic from 1994 to 2005. Anaphylaxis was diagnosed based on the clinical history and skin tests to latex, neuromuscular blocking agents (NMBA), hypnotics, opioids and antibiotics. Specifi c IgE to latex was performed in patients with positive skin-prick-tests. Results: We evaluated the clinical charts of 45 patients with adverse peri-operative reactions, 39 of whom were female. Anaphylaxis was diagnosed in 16 patients (35.6%), 15 females, mean age 36.3 years. The remaining patients had non-anaphylactic (28.8%) or not well-characterised reactions (35.6%). In terms of severity, 50% presented grade III and 50% grade IV anaphylaxis. Skin-prick-tests were positive to latex in three patients and negative to all anaesthetic drugs. Intradermal skin tests were positive in 10 out of 16 patients with anaphylactic reactions: 10 to NMBA [atracurium (n = 8), vecuronium (n = 4), suxamethonium (n = 4) and pancuronium (n = 2)], one to fentanyl, one to thiopental and one to cefuroxime. In three cases, the culprit agent was not identifi ed. In four patients, at least one alternative NMBA, with no skin test reactivity, was found. Of these four patients, two underwent further surgical procedures without adverse reactions. Five patients had previously had two or more anaesthetic procedures and four had presented adverse reactions in prior surgeries. Conclusions: In our study the most common causes of anaphylaxis were NMBAs (62.5%) and latex (18.7%), in line with that described in the literature. In 81% of patients with anaphylactic reactions, skin tests were positive to at least one anaesthetic drug or to latex. A high incidence of severe anaphylaxis was found, probably because cases with less severe clinical signs were not referred to our clinic. The results emphasise the need for systematic evaluation of anaphylactic reactions during anaesthesia. This can be achieved by the creation of a specialised Allergo-Anaesthesia Clinic, as has been the case in our Department.
- Body mass index and airway hyper-responsiveness in individuals without respiratory diseasePublication . Machado, D; Tavares, B; Loureiro, G; Conde, B; Cemlyn-Jones, J; Calado, G; Sousa, N; Chieira, C; Pereira, CBACKGROUND: Overweight and obesity are major health issues in Western societies. They are related with a higher risk of different co-morbidities but their relationship with airway hyperresponsiveness (AHR) is still under discussion. Nevertheless, they are related to higher severity in asthma and other respiratory diseases. The aim of the study was to analyze the AHR in individuals with normal lung function without respiratory disorders, according to body mass index (BMI) calculation. METHODS: We performed clinical observation and basal lung function tests (LFT) in 595 consecutive individuals in order to exclude respiratory disease. 377 individuals fulfilled the criteria of normal values according international guidelines. They were submitted to standardized treadmill exercise test followed by bronchodilator test. FVC, FEV1, FEF 25/75, RV and Raw were obtained at different conditions according to BMI groups (I: lean; II: normal; III: overweight; IV obese). RESULTS: 55.2% of the sample was overweight or obese, and a signficant relationship was found with female gender and older ages (p=0.0046 and p<0.0001 respectively). The positive response to exercise test or bronchodilator beta2 agonists was not significantly frequent compared with the other groups. In obese individuals the exercise markedly reduced basal Raw and increased FEF 25/75. Lean individuals showed higher basal values of RV that was reduced upon exercise. Response to 12 agonists showed no differences according to weight biotypes. CONCLUSION: BMI hampers lung function in normal individuals, and seems not to be related to AHR. Regular exercise should be encouraged in overweight and obese individuals, since it increases their bronchial permeability as shown in lower frequency of positive exercise tests. The same is advisable for lean individuals for different reasons. Their increased basal RV and Raw improve upon exercise. Despite overweight and obesity are being related to a low-grade of basal systemic inflammation, there was no association with a higher basal bronchial hyperresponsiveness in these individuals.
- Chronic rhinosinusitis with nasal polyps in allergic patientsPublication . Sousa, N; Santos, A; Loureiro, G; Tavares, B; Loureiro, C; Faria, E; Chieira, C
- Comparison between skin prick tests and ImmunoCAP ISAC in the determination of sensitisation to aeroallergensPublication . Sousa, N; Almeida, E; Machado, D; Rodrigues, F; Carrapatoso, I; Faria, E; Ribeiro, H; Chieira, C
- Comparison of basophil activation test results in blood preserved in acid citrate dextrose and EDTAPublication . Sousa, N; Martínez-Aranguren, R; Fernández-Benitez, M; Ribeiro, F; Sanz, ML
- Contribution of in vitro methods to the study of fruit allergy clinical patternsPublication . Sousa, N; Carrapatoso, I; Faria, E; Ribeiro, F; Rodrigues, F; Ribeiro, H; Chieira, C
- Diagnosis of peri-operative anaphylaxis: 33 clinical casesPublication . Faria, E; Sousa, N; Vieira, H; Almeida, E; Nunes, M; Chieira, C
- Fruits, vegetables and latex sensitisation a pollen allergic patientsPublication . Sousa, N; Cruz, M; Carrapatoso, I; Faria, E; Chieira, C
- HLA genotyping in Portuguese asthmatic patients with nasal polypsPublication . Sousa, N; Faria, E; Nunes, R; Simões, O; Mendes, J; Chieira, C