Epidemiologia da anafilaxia no Brasil: Registro Brasileiro de Anafilaxia (RBA) da Associação Brasileira de Alergia e Imunologia (ASBAI) / Epidemiology of anaphylaxis in Brazil: The Brazilian Registry of Anaphylaxis (RBA) of the Brazilian Association of Allergy and Immunology (ASBAI)

INTRODUÇÃO: A anafilaxia é uma reação alérgica multissistêmica grave, de início agudo e potencialmente fatal. Poucos são os dados sobre sua epidemiologia no Brasil. O Registro Brasileiro de Anafilaxia da Associação Brasileira de Alergia e Imunologia (RBAASBAI) teve como objetivo ampliar o conhecimento sobre anafilaxia em indivíduos brasileiros. MÉTODOS: Estudo observacional transversal com questionário online sobre dados demográficos, desencadeantes suspeitos, manifestações clínicas, atendimento durante a reação, investigação diagnóstica e aconselhamento após a reação de pacientes que experimentaram uma reação anafilática. RESULTADOS: Entre junho/2021 e abril/2023, foram incluídos 237 pacientes (131 femininos): 99 crianças/adolescentes; 127 adultos e 11 idosos. Houve predomínio de meninos entre crianças/adolescentes (55,5%), e de mulheres entre os adultos (64,5%), e mediana de idade de 22 anos (< 1 a 77 anos). As manifestações cutâneas (92,8%) foram as mais frequentes, seguidas pelas respiratórias (70,1%), gastrointestinais (52,3%), neurológicas (36,3%) e cardiovasculares (35,3%). Os principais desencadeantes foram: alimentos (43,0%), medicamentos (26,2%), himenópteros (21,6%) e látex (2,5%); os alimentos entre crianças (leite, ovo, amendoim/castanhas), e os fármacos (anti-inflamatórios e antibióticos) entre os adultos. Quanto ao tratamento, 61,1% recebeu adrenalina (52,7% por profissional e 8,4% via autoinjetor de adrenalina -AIA). Uma adolescente (12 anos) faleceu após picada de abelha. A maioria recebeu plano escrito de emergência (78,1%) e foi ensinada a usar o AIA (70%). CONCLUSÃO: Os alimentos foram os desencadeantes mais comuns entre crianças/adolescentes, e os fármacos entre adultos brasileiros. A adrenalina continua sendo subutilizada, reforçando a necessidade de maior disseminação do tratamento adequado da anafilaxia.

INTRODUCTION: Anaphylaxis is a life-threatening, acute, severe multisystem allergic reaction.There is little data on its epidemiology in Brazil. The Brazilian Anaphylaxis Registry of the Brazilian Association of Allergy and Immunology (RBA-ASBAI) was devised to expand knowledge about anaphylaxis in Brazilian individuals. METHODS: Cross-sectional observational study using an online questionnaire to collect data on demographics, suspected triggers, clinical manifestations, treatment during the reaction, diagnostic workup, and post-reaction counseling in patients who have experienced an anaphylactic reaction. RESULTS: Between June 2021 and April 2023, 237 patients were included (131 female): 99 children/adolescents (<18yo), 127 adults (18-64yo), and 11 older adults (65-77yo). There was a male predominance in the pediatric group (55.5%), while females were predominant among adults (64.5%). The median age was 22 years (range, <1 to 77). The most frequent clinical manifestations were cutaneous (92.8%), followed by respiratory (70.1%), gastrointestinal (52.3%), neurological (36.3%), and cardiovascular (35.3%). The most common triggers were foods (43.0%), drugs (26.2%), venoms (21.6%), and latex (2.5%). Foods (milk, egg, peanuts/tree nuts) predominated among children, versus drugs (mostly nonsteroidal anti-inflammatory drugs and antibiotics) among adults. Regarding treatment, 61.1% received epinephrine (52.7% by a healthcare professional and 8.4% via epinephrine auto-injector [EAI]). One teenager (12yo) died due to a bee sting. Most patients received a written emergency plan (78.1%) and were taught how to use the EAI (70%). CONCLUSION: Foods were the most common triggers of anaphylaxis among Brazilian children and adolescents, while drugs predominated among adults. Epinephrine continues to be underused, highlighting the need for greater awareness of proper treatment of anaphylaxis.

A Laboratory Bioassay Method to Assess the Use of Toxic Bait on Anastrepha fraterculus (Weidemann 1830).

The lack of standardization of bioassays for the evaluation of toxic bait toxicity on the South American fruit fly, Anastrepha fraterculus (Weidemann 1830), has led to erroneous interpretations of assay results. The objective of this study was to develop a methodology for the standardization and validation of toxicological tests on A. fraterculus toxic bait using the Success™ 0.02CB formulation (80 mg L-1 of spinosad). Anastrepha fraterculus adults, obtained from larvae reared on an artificial diet, showed higher susceptibility (LT50 = 48.96 h) than adults from larvae reared on cattley guava (LT50 = 53.83 h) and mango fruit (LT50 = 53.55 h). Anastrepha fraterculus adults at the age of five (LT50 = 65.30 h), 15 (LT50 = 59.01 h), and 30 (LT50 = 55.53 h) days presented similar toxicity. The consumption of toxic bait (4.74 mg) increased at 15 days, a fact also observed with insects without food deprivation. In addition, the absence of a food source (artificial diet) with the toxic bait significantly reduced adult mortality time by 7 h (LT50 = 57.42 h). In relation to exposure time, adults exposed to toxic bait for 1 h reduced consumption by 25%; however, they showed the same susceptibility as insects exposed to 2 (LT50 = 55.72 h), 4 (LT50 = 57.64 h), and 8 h (LT50 = 57.76 h). However, with 24 h of food deprivation, they had a higher susceptibility (LT50 = 46.48 h). Five-day-old A. fraterculus adults fed an artificial diet before being deprived of food for 12 or 24 h, then exposed to toxic bait for 4 h in the absence of a food source, are considered optimum conditions to evaluate the toxicity of toxic bait.

Bioassay Method for Toxicity Studies of Toxic Bait Formulations to Ceratitis capitata (Diptera: Tephritidae).

The development of appropriate methodologies for bioassays is of paramount importance to study the methodological factors that may interfere in the experimental design. Thus, laboratory bioassays have become increasingly important for the determination of data that are realistic and replicable. The objective of the study was to develop a bioassay methodology with the ready-to-use toxic bait Success™ 0.02CB, 96 mg L-1 of spinosad, in adults of Ceratitis capitata (Wiedemann) as a study model. The insect origin (laboratory population, LT50 = 11.16 h), time of toxic bait supply (4 h, LT50 = 16.85 h), food deprivation (12 h, LT50 = 15.55 h), and the adult age (5 days, LT50 = 35.31 h) of C. capitata showed higher susceptibility and a shorter LT50 lethal time to the Success™ 0.02CB toxic bait. However, the absence or presence of a food source (LT50 ≈ 31.17 h) during the bioassay did not affect the susceptibility of C. capitata. Further, adults of C. capitata who were deprived and in the absence of a food source (artificial diet) had higher consumption of toxic baits (mg) during treatment exposure. The use of a 12-h deprivation period, toxic baits offered for 4 h, and absence of an artificial diet for adults of C. capitata at 5 days of age during the bioassay are considered adequate for evaluating formulations of toxic baits under laboratory conditions.