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1.
Allergy ; 76(5): 1517-1527, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33274436

RESUMO

BACKGROUND: Peanut allergy has a rising prevalence in high-income countries, affecting 0.5%-1.4% of children. This study aimed to better understand peanut anaphylaxis in comparison to anaphylaxis to other food triggers in European children and adolescents. METHODS: Data was sourced from the European Anaphylaxis Registry via an online questionnaire, after in-depth review of food-induced anaphylaxis cases in a tertiary paediatric allergy centre. RESULTS: 3514 cases of food anaphylaxis were reported between July 2007 - March 2018, 56% in patients younger than 18 years. Peanut anaphylaxis was recorded in 459 children and adolescents (85% of all peanut anaphylaxis cases). Previous reactions (42% vs. 38%; p = .001), asthma comorbidity (47% vs. 35%; p < .001), relevant cofactors (29% vs. 22%; p = .004) and biphasic reactions (10% vs. 4%; p = .001) were more commonly reported in peanut anaphylaxis. Most cases were labelled as severe anaphylaxis (Ring&Messmer grade III 65% vs. 56% and grade IV 1.1% vs. 0.9%; p = .001). Self-administration of intramuscular adrenaline was low (17% vs. 15%), professional adrenaline administration was higher in non-peanut food anaphylaxis (34% vs. 26%; p = .003). Hospitalization was higher for peanut anaphylaxis (67% vs. 54%; p = .004). CONCLUSIONS: The European Anaphylaxis Registry data confirmed peanut as one of the major causes of severe, potentially life-threatening allergic reactions in European children, with some characteristic features e.g., presence of asthma comorbidity and increased rate of biphasic reactions. Usage of intramuscular adrenaline as first-line treatment is low and needs to be improved. The Registry, designed as the largest database on anaphylaxis, allows continuous assessment of this condition.


Assuntos
Anafilaxia , Hipersensibilidade a Amendoim , Adolescente , Anafilaxia/diagnóstico , Anafilaxia/epidemiologia , Anafilaxia/etiologia , Arachis , Criança , Epinefrina , Humanos , Hipersensibilidade a Amendoim/diagnóstico , Hipersensibilidade a Amendoim/epidemiologia , Sistema de Registros
2.
Pneumologie ; 74(8): 515-544, 2020 Aug.
Artigo em Alemão | MEDLINE | ID: mdl-32823360

RESUMO

The present guideline aims to improve the evidence-based management of children and adolescents with pediatric community-acquired pneumonia (pCAP). Despite a prevalence of approx. 300 cases per 100 000 children per year in Central Europe, mortality is very low. Prevention includes infection control measures and comprehensive immunization. The diagnosis can and should be established clinically by history, physical examination and pulse oximetry, with fever and tachypnea as cardinal features. Additional signs or symptoms such as severely compromised general condition, poor feeding, dehydration, altered consciousness or seizures discriminate subjects with severe pCAP from those with non-severe pCAP. Within an age-dependent spectrum of infectious agents, bacterial etiology cannot be reliably differentiated from viral or mixed infections by currently available biomarkers. Most children and adolescents with non-severe pCAP and oxygen saturation > 92 % can be managed as outpatients without laboratory/microbiology workup or imaging. Anti-infective agents are not generally indicated and can be safely withheld especially in children of young age, with wheeze or other indices suggesting a viral origin. For calculated antibiotic therapy, aminopenicillins are the preferred drug class with comparable efficacy of oral (amoxicillin) and intravenous administration (ampicillin). Follow-up evaluation after 48 - 72 hours is mandatory for the assessment of clinical course, treatment success and potential complications such as parapneumonic pleural effusion or empyema, which may necessitate alternative or add-on therapy.


Assuntos
Antibacterianos/uso terapêutico , Infecções Comunitárias Adquiridas/tratamento farmacológico , Pneumonia/tratamento farmacológico , Guias de Prática Clínica como Assunto , Pneumologia/normas , Adolescente , Antibacterianos/administração & dosagem , Criança , Infecções Comunitárias Adquiridas/diagnóstico , Infecções Comunitárias Adquiridas/virologia , Europa (Continente) , Alemanha , Humanos , Lactente , Pneumonia/diagnóstico , Pneumonia/virologia , Sociedades Médicas
3.
Klin Padiatr ; 226(4): 238-42, 2014 Jul.
Artigo em Alemão | MEDLINE | ID: mdl-25010129

RESUMO

BACKGROUND: Typhoid and paratyphoid infections (STP) are an important differential diagnosis for Salmonella enteritidis infections (NTS). The aim of this study is to carve out clinical differences between both infections. PATIENTS/METHODS: We retrospectively reviewed all patients admitted to our hospital between 2007 and 2011 with a diagnosis of STP infection. History, clinical course and laboratory findings were compared with age-matched patients suffering from NTS. RESULTS/DISCUSSION: All patients with an STP-infection showed had a positive travel history (as compared to 11.1% in the NTS group, p<0.01). Salmonella were mostly isolated from blood cultures (n=7/9) in the STP group as compared to 1/16 in the NTS group, where S. enteridis was mainly isolated from faecal cultures (p<0,01). The duration and height of fever as well as the time of hospitalization were significantly longer with STP infections than with NTS infections. Eosinopenia was observed both in STP-(100%) and NTS-infections (77.8%). CONCLUSION: A positive travel history is crucial to the identification of a STP infection, as well as an eosinopenia.


Assuntos
Febre Paratifoide/diagnóstico , Infecções por Salmonella/diagnóstico , Salmonella enteritidis , Salmonella paratyphi A , Salmonella typhi , Febre Tifoide/diagnóstico , Adolescente , Técnicas Bacteriológicas , Criança , Pré-Escolar , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Febre Paratifoide/transmissão , Valor Preditivo dos Testes , Estudos Retrospectivos , Infecções por Salmonella/microbiologia , Infecções por Salmonella/transmissão , Viagem , Febre Tifoide/microbiologia , Febre Tifoide/transmissão
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