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1.
PLoS One ; 17(8): e0266263, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35913947

RESUMO

Equine insect bite hypersensitivity (IBH) is the most common skin disease affecting horses. It is described as an IgE-mediated, Type I hypersensitivity reaction to salivary gland proteins of Culicoides insects. Together with Th2 cells, epithelial barrier cells play an important role in development of Type I hypersensitivities. In order to elucidate the role of equine keratinocytes in development of IBH, we stimulated keratinocytes derived from IBH-affected (IBH-KER) (n = 9) and healthy horses (H-KER) (n = 9) with Culicoides recombinant allergens and extract, allergic cytokine milieu (ACM) and a Toll like receptor ligand 1/2 (TLR-1/2-L) and investigated their transcriptomes. Stimulation of keratinocytes with Culicoides allergens did not induce transcriptional changes. However, when stimulated with allergic cytokine milieu, their gene expression significantly changed. We found upregulation of genes encoding for CCL5, -11, -20, -27 and interleukins such as IL31. We also found a strong downregulation of genes such as SCEL and KRT16 involved in the formation of epithelial barrier. Following stimulation with TLR-1/2-L, keratinocytes significantly upregulated expression of genes affecting Toll like receptor and NOD-receptor signaling pathway as well as NF-kappa B signaling pathway, among others. The transcriptomes of IBH-KER and H-KER were very similar: without stimulations they only differed in one gene (CTSL); following stimulation with allergic cytokine milieu we found only 23 differentially expressed genes (e.g. CXCL10 and 11) and following stimulation with TLR-1/2-L they only differed by expression of seven genes. Our data suggests that keratinocytes contribute to the innate immune response and are able to elicit responses to different stimuli, possibly playing a role in the pathogenesis of IBH.


Assuntos
Ceratopogonidae , Doenças dos Cavalos , Hipersensibilidade , Mordeduras e Picadas de Insetos , Alérgenos , Animais , Citocinas/genética , Cavalos , Queratinócitos , Receptor 1 Toll-Like , Receptores Toll-Like/genética
2.
Pediatr Emerg Care ; 38(8): e1469-e1471, 2022 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-35904958

RESUMO

OBJECTIVES: The aims of this study, for the first time in the literature, are to evaluate the symptoms, clinical course, and treatment management of penile bee stings in children and to discuss whether bee stings can be evaluated within the scope of summer penile syndrome. METHODS: Records of all pediatric patients presented to the emergency department of our hospital from June 2020 to October 2021 due to bee sting of penis were reviewed. Only patients with isolated penile bee stings were included in the study. Patients were evaluated in terms of the age at presentation, time of occurrence, symptoms, and treatment modality. RESULTS: There were 10 patients treated for penile bee sting. Patients ranged in age from 3 to 7 years (mean, 4.2 years). The most common complaints of the patients at presentation were pain (100%), swelling (100%), and dysuria (70%). Three of the patients were unable to void. The gauze moistened with warm saline was applied to the penis of these patients who developed glob, and all of these patients urinated after the warm application. Three of the patients had progressive erythema on the penile skin. These patients were admitted to the pediatric surgery department to monitor whether skin necrosis would develop. In all patients, the erythema regressed significantly within 48 hours and regained its completely normal appearance at the end of 72 hours. CONCLUSIONS: The probability of the development of serious local reactions and urological problems in penile bee stings is low. Oral nonsteroidal anti-inflammatory drug and warm, wet dressing are usually sufficient to treat local reactions. Penile bee stings may be evaluated within the scope of summer penile syndrome because their symptoms, clinical findings, and treatments are almost similar.


Assuntos
Mordeduras e Picadas de Insetos , Animais , Abelhas , Edema , Humanos , Mordeduras e Picadas de Insetos/complicações , Mordeduras e Picadas de Insetos/terapia , Masculino , Pênis , Estações do Ano , Pele , Síndrome
3.
Digit J Ophthalmol ; 28(7): 31-33, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35854975

RESUMO

We report a case of keratopathy due to retained stinger elements following a bee sting and envenomation of the ocular adnexa. A 48-year-old woman presented with a 2-day history of right-sided eye pain, photophobia, and reduced visual acuity. Six days prior to presentation, she had been stung on the right upper eyelid by a bee. Her usual practitioner had removed the stinger and commenced a course of oral antibiotics. Anterior segment examination revealed coarse linear abrasions and superficial punctate keratitis with associated epithelial edema. Eversion of the right upper eyelid revealed the presence of retained stinger lancets near the medial eyelid margin. The retained stinger was removed, and the patient responded well to treatment with topical antibiotics, steroids, and cycloplegia.


Assuntos
Doenças da Córnea , Corpos Estranhos no Olho , Mordeduras e Picadas de Insetos , Ceratite , Animais , Antibacterianos , Abelhas , Doenças da Córnea/complicações , Doenças da Córnea/etiologia , Corpos Estranhos no Olho/complicações , Corpos Estranhos no Olho/diagnóstico , Feminino , Humanos , Mordeduras e Picadas de Insetos/complicações , Mordeduras e Picadas de Insetos/diagnóstico , Transtornos da Visão
4.
Parasit Vectors ; 15(1): 259, 2022 Jul 20.
Artigo em Inglês | MEDLINE | ID: mdl-35858931

RESUMO

BACKGROUND: Providing protection from malaria vector bites, both indoors and outdoors, is crucial to curbing malaria parasite transmission. Screening of house entry points, especially with incorporated insecticides, confers significant protection but remains a costly and labour-intensive application. Use of spatial repellents has shown promise in creating areas of protection in peri-domestic areas. METHODS: This study aimed at comparing the protection provided by transfluthrin-treated and untreated complete screens over open eave gaps with incomplete transfluthrin-treated eave strips as a potential replacement for a full screen. Human landing catches were implemented independently inside and outside an experimental hut under controlled semi-field conditions, with insectary-reared Anopheles arabiensis mosquitoes. RESULTS: The odds of a female mosquito finding a human volunteer indoors and attempting to bite were similar whether the eaves were completely open or there was an untreated fabric strip fixed around the eaves. However, when the eave gap was completely screened without insecticide, the odds of receiving a bite indoors were reduced by 70% (OR 0.30, 95% CI 0.20-0.47). Adding transfluthrin to the full screen, further increased the protection indoors, with the odds of receiving a bite reduced by 92% (0.08, 95% CI 0.04-0.16) compared to the untreated screen. Importantly, the same protection was conferred when only a narrow transfluthrin-treated fabric strip was loosely fixed around the eave gap (OR 0.07, 95% CI 0.04-0.13). The impact of the transfluthrin treatment on outdoor biting was correlated with evening temperatures during the experiments. At lower evening temperatures, a transfluthrin-treated, complete screen provided moderate and variable protection from bites (OR 0.62, 95% CI 0.37-1.03), whilst at higher evening temperatures the odds of receiving a bite outdoors was over four times lower in the presence of transfluthrin, on either a full screen (OR 0.22 95% 0.12-0.38) or a fabric strip (OR 0.25, 95% 0.15-0.42), than when no treatment was present. CONCLUSION: The findings suggest that transfluthrin-treated fabric strips can provide a substitute for complete eave screens. They are a simple, easy-to-handle tool for protecting people from malaria mosquito bites indoors and potentially around the house in climatic areas where evening and night-time temperatures are relatively high.


Assuntos
Anopheles , Mordeduras e Picadas de Insetos , Repelentes de Insetos , Inseticidas , Malária , Animais , Feminino , Humanos , Mordeduras e Picadas de Insetos/prevenção & controle , Repelentes de Insetos/farmacologia , Malária/prevenção & controle , Controle de Mosquitos , Mosquitos Vetores
5.
Allergy Asthma Proc ; 43(4): 339-343, 2022 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-35818146

RESUMO

Venom immunotherapy (VIT) with Hymenoptera venom extracts is highly effective in preventing large local, systemic allergic, and anaphylactic reactions to insect stings. VIT is not required for patients with cutaneous systemic or large local allergic reactions to stings because it is uncommon for reactions to become more severe. The clinical history, with confirmatory skin or serum tests for venom IgE, can clarify the risk for future anaphylaxis and the need for VIT. For initial treatment, rush regimens are recommended because they have the same or less risk of systemic reactions than slower traditional regimens. VIT is relatively safe with a low incidence of systemic reactions. Injection-site reactions can be bothersome but do not predict systemic reactions to venom injections. Patients who need VIT should be screened for baseline serum tryptase and possible underlying mast cell disorders. VIT can be discontinued after five years in most patients, but those with known high-risk factors should continue VIT indefinitely.


Assuntos
Anafilaxia , Venenos de Artrópodes , Venenos de Abelha , Himenópteros , Mordeduras e Picadas de Insetos , Alérgenos , Anafilaxia/induzido quimicamente , Anafilaxia/prevenção & controle , Animais , Venenos de Artrópodes/uso terapêutico , Dessensibilização Imunológica/efeitos adversos , Humanos , Imunoterapia , Mordeduras e Picadas de Insetos/terapia , Venenos de Vespas
6.
PLoS One ; 17(7): e0271833, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35877666

RESUMO

BACKGROUND: Understanding mosquito biting behaviours is important for designing and evaluating protection methods against nuisance biting and mosquito-borne diseases (e.g. dengue, malaria and zika). We investigated the preferred biting sites by Aedes aegypti and Anopheles arabiensis on adult volunteers in standing or sleeping positions; and estimated the theoretical protection limits affordable from protective clothing or repellent-treated footwear. METHODS: Adult volunteers dressed in shorts and t-shirts were exposed to infection-free laboratory-reared mosquitoes inside screened chambers from 6am to noon (for day-biting Ae. aegypti) or 6pm to midnight (night-biting An. arabiensis). Attempted bites on different body parts were recorded. Comparative observations were made on same volunteers while wearing sandals treated with transfluthrin, a vapour-phase pyrethroid that kills and repels mosquitoes. RESULTS: An. arabiensis bites were mainly on the lower limbs of standing volunteers (95.9% of bites below the knees) but evenly-distributed over all exposed body surfaces when the volunteers were on sleeping positions (only 28.8% bites below knees). Ae. aegypti bites were slightly concentrated on lower limbs of standing volunteers (47.7% below knees), but evenly-distributed on sleeping volunteers (23.3% below knees). Wearing protective clothing that leave only hands and head uncovered (e.g. socks + trousers + long-sleeved shirts) could theoretically prevent 78-83% of bites during sleeping, and at least 90% of bites during non-sleeping hours. If the feet are also exposed, protection declines to as low as 36.3% against Anopheles. The experiments showed that transfluthrin-treated sandals reduced An. arabiensis by 54-86% and Ae. aegypti by 32-39%, but did not change overall distributions of bites. CONCLUSION: Biting by An. arabiensis and Ae. aegypti occur mainly on the lower limbs, though this proclivity is less pronounced in the Aedes species. However, when hosts are on sleeping positions, biting by both species is more evenly-distributed over the exposed body surfaces. High personal protection might be achieved by simply wearing long-sleeved clothing, though protection against Anopheles particularly requires covering of feet and lower legs. The transfluthrin-treated footwear can reduce biting risk, especially by An. arabiensis. These findings could inform the design and use of personal protection tools (both insecticidal and non-insecticidal) against mosquitoes and mosquito-borne diseases.


Assuntos
Aedes , Anopheles , Dengue , Mordeduras e Picadas de Insetos , Repelentes de Insetos , Malária , Infecção por Zika virus , Zika virus , Adulto , Animais , Dengue/prevenção & controle , Humanos , Mordeduras e Picadas de Insetos/prevenção & controle , Repelentes de Insetos/farmacologia , Malária/prevenção & controle , Controle de Mosquitos/métodos , Mosquitos Vetores
7.
Toxins (Basel) ; 14(7)2022 Jun 22.
Artigo em Inglês | MEDLINE | ID: mdl-35878164

RESUMO

Inducing tolerance in Hymenoptera-allergic patients, bee venom immunotherapy (BVIT) is a widely accepted method to treat severe allergy to bee stings. In order to increase the existing knowledge on the underlying immunological mechanisms and look for possible biomarkers predictive of efficacy, a group of 20 bee-venom-allergic patients (AG) were thoroughly examined during their first year of BVIT. In addition, the results of treated patients with those of an untreated group of 20 tolerant beekeepers (TG) who had previously shown a firm suppressor-regulatory profile were compared. Tolerance in AG patients was invariably associated with a significant regulatory response characterised by the expansion of Helios- subpopulation and increased IL-10, specific IgG4 (sIgG4), and kynurenine levels. Although specific IgE (sIgE) levels increased transiently, surprisingly, the T helper type 2 (Th2) population and IL-4 levels rose significantly after one year of immunotherapy. Thus, the picture of two parallel phenomena emerges: a tolerogenic response and an allergenic one. Comparing these results with those obtained from the TG, different immunological mechanisms appear to govern natural and acquired tolerance to immunotherapy. Of particular interest, the kynurenine levels and T regulatory (Treg) Helios- population could be proposed as new biomarkers of response to BVIT.


Assuntos
Venenos de Artrópodes , Venenos de Abelha , Himenópteros , Hipersensibilidade , Mordeduras e Picadas de Insetos , Animais , Venenos de Abelha/toxicidade , Abelhas , Biomarcadores , Dessensibilização Imunológica/métodos , Hipersensibilidade/terapia , Mordeduras e Picadas de Insetos/terapia , Cinurenina
8.
Toxins (Basel) ; 14(7)2022 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-35878206

RESUMO

Corneal bee sting (CBS) is one of the most common ocular traumas and can lead to blindness. The ophthalmic manifestations are caused by direct mechanical effects of bee stings, toxic effects, and host immune responses to bee venom (BV); however, the underlying pathogenesis remains unclear. Clinically, topical steroids and antibiotics are routinely used to treat CBS patients but the specific drug targets are unknown; therefore, it is imperative to study the pathological characteristics, injury mechanisms, and therapeutic targets involved in CBS. In the present study, a CBS injury model was successfully established by injecting BV into the corneal stroma of healthy C57BL/6 mice. F-actin staining revealed corneal endothelial cell damage, decreased density, skeletal disorder, and thickened corneal stromal. The terminal-deoxynucleotidyl transferase mediated nick end labeling (TUNEL) assay showed apoptosis of both epithelial and endothelial cells. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis showed that cytokine-cytokine interactions were the most relevant pathway for pathogenesis. Protein-protein interaction (PPI) network analysis showed that IL-1, TNF, and IL-6 were the most relevant nodes. RNA-seq after the application of Tobradex® (0.3% tobramycin and 0.1% dexamethasone) eye ointment showed that Tobradex® not only downregulated relevant inflammatory factors but also reduced corneal pain as well as promoted nerve regeneration by repairing axons. Here, a stable and reliable model of CBS injury was successfully established for the first time, and the pathogenesis of CBS and the therapeutic targets of Tobradex® are discussed. These hub genes are expected to be biomarkers and therapeutic targets for the diagnosis and treatment of CBS.


Assuntos
Venenos de Abelha , Lesões da Córnea , Mordeduras e Picadas de Insetos , Animais , Venenos de Abelha/farmacologia , Abelhas/genética , Lesões da Córnea/diagnóstico , Lesões da Córnea/tratamento farmacológico , Lesões da Córnea/genética , Citocinas , Modelos Animais de Doenças , Células Endoteliais , Camundongos , Camundongos Endogâmicos C57BL , Combinação Tobramicina e Dexametasona , Transcriptoma
10.
Front Immunol ; 13: 907424, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35693761

RESUMO

In the endemic variants of pemphigus foliaceus (PF), in Brazil and Tunisia, patients generate pathogenic IgG4 anti-desmoglein 1 autoantibodies. Additionally, these patients possess antibodies against salivary proteins from sand flies that react with Dsg1, which may lead to skin disease in susceptible individuals living in endemic areas. This minireview focuses on recent studies highlighting the possible role of salivary proteins from Lutzomyia longipalpis (L. longipalpis) in EPF from Brazil and Phlebotomus papatasi (P. papatasi) in EPF from Tunisia. We will briefly discuss the potential mechanisms of molecular mimicry and epitope spreading in the initiation and development of endemic PF (EPF) in Brazil and Tunisia.


Assuntos
Doenças Autoimunes , Mordeduras e Picadas de Insetos , Pênfigo , Psychodidae , Animais , Desmogleína 1 , Humanos , Mordeduras e Picadas de Insetos/epidemiologia , Pênfigo/epidemiologia
11.
Cutis ; 109(3): 126-128, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35659146

RESUMO

Mosquito bites cause a variety of reactions ranging from pruritic papules to severe systemic hypersensitivity reactions. The salivary glands of mosquitoes have been found to contain more than 70 different allergens. Herein, we describe the pathophysiology and clinical appearance of mosquito bite reactions as well as proper management of this condition.


Assuntos
Culicidae , Hipersensibilidade , Mordeduras e Picadas de Insetos , Alérgenos , Animais , Humanos , Hipersensibilidade/etiologia , Imunoterapia , Mordeduras e Picadas de Insetos/complicações , Mordeduras e Picadas de Insetos/diagnóstico
13.
Toxicon ; 215: 69-76, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35724947

RESUMO

This study aimed to clarify whether varespladib, a phospholipase A2 (PLA2) inhibitor, can be used as a therapeutic agent for wasp sting-induced acute kidney injury (AKI). Rats were divided into control, AKI, and AKI + varespladib groups. The AKI model was established by subcutaneously injecting wasp venom at five different sites in rats. Varespladib treatment showed a significant inhibitory effect on wasp venom PLA2in vitro and in vivo. Moreover, we observed that varespladib decreased the levels of rhabdomyolysis and hemolysis markers compared with that in the AKI group. Histopathological changes in the kidney decreased significantly, and rat serum creatinine levels were reduced after varespladib administration. The significantly regulated genes in the kidney of the AKI group were mostly involved in inflammatory response pathway, and the administration of varespladib remarkably attenuated the expression of these genes. Therefore, varespladib inhibited wasp sting-induced functional and pathological damage to the kidneys. We propose that the PLA2 inhibitor varespladib protects the kidney tissue in a wasp sting-induced AKI model by inhibiting PLA2 activity.


Assuntos
Injúria Renal Aguda , Mordeduras e Picadas de Insetos , Vespas , Acetatos , Injúria Renal Aguda/tratamento farmacológico , Injúria Renal Aguda/prevenção & controle , Animais , Indóis , Cetoácidos , Fosfolipases A2/metabolismo , Ratos , Venenos de Vespas
14.
Toxicon ; 214: 130-135, 2022 Jul 30.
Artigo em Inglês | MEDLINE | ID: mdl-35613656

RESUMO

BACKGROUND: Hymenoptera stings are one of the most common causes of anaphylaxis. Vespa orientalis (red hornet) is a common and very aggressive hymenopteran endemic in central and southern areas of Iran. Allergy testing and venom immunotherapies are carried out with venom components which are expensive, have limited commercial availability, and often lack specificity. Although proteomic analysis of hymenopteran venom has been shown to be a powerful technique to identify allergens, data on the protein components of V. orientalis venom are lacking. AIM: This study was designed to characterize the allergenome profile (proteome of allergenic proteins) of this local hornet venom. METHODS: Venom was extracted from V. orientalis worker venom sacs. The venom constituents were separated by two-dimensional gel electrophoresis (2DE). Protein components were blotted and probed with serum from 10 allergic patients by immunoblotting. Reactive spots were isolated and characterized by liquid chromatography with tandem mass spectrometry. RESULTS: A total of 195 protein spots were detected on the 2DE gels. Fifteen distinct venom proteins showed reactivity to IgE in patients' sera. Four major allergens in order of allergenicity in patients were identified as hyaluronidase, arginine kinase, phospholipase A1 (PLA1) and PLA1 magnifin. CONCLUSIONS: Broadening our knowledge of V. orientalis venom constituents can contribute to improvements in diagnostic and immunotherapeutic techniques, both of which are dependent on the major allergens in venom extract. This information is also potentially helpful to develop medical uses of major allergens in this venom to improve the diagnostic specificity and the efficacy of immunotherapy.


Assuntos
Anafilaxia , Mordeduras e Picadas de Insetos , Vespas , Alérgenos/genética , Animais , Humanos , Imunoglobulina E , Proteômica , Venenos de Vespas/química
15.
Proc Natl Acad Sci U S A ; 119(21): e2104282119, 2022 05 24.
Artigo em Inglês | MEDLINE | ID: mdl-35576470

RESUMO

Malaria control interventions target nocturnal feeding of the Anopheles vectors indoors to reduce parasite transmission. Mass deployment of insecticidal bed nets and indoor residual spraying with insecticides, however, may induce mosquitoes to blood-feed at places and at times when humans are not protected. These changes can set a ceiling to the efficacy of these control interventions, resulting in residual malaria transmission. Despite its relevance for disease transmission, the daily rhythmicity of Anopheles biting behavior is poorly documented, most investigations focusing on crepuscular hours and nighttime. By performing mosquito collections 48-h around the clock, both indoors and outdoors, and by modeling biting events using circular statistics, we evaluated the full daily rhythmicity of biting in urban Bangui, Central African Republic. While the bulk of biting by Anopheles gambiae, Anopheles coluzzii, Anopheles funestus, and Anopheles pharoensis occurred from sunset to sunrise outdoors, unexpectedly ∼20 to 30% of indoor biting occurred during daytime. As biting events did not fully conform to any family of circular distributions, we fitted mixtures of von Mises distributions and found that observations were consistent with three compartments, corresponding indoors to populations of early-night, late-night, and daytime-biting events. It is not known whether these populations of biting events correspond to spatiotemporal heterogeneities or also to distinct mosquito genotypes/phenotypes belonging consistently to each compartment. Prevalence of Plasmodium falciparum in nighttime- and daytime-biting mosquitoes was the same. As >50% of biting occurs in Bangui when people are unprotected, malaria control interventions outside the domiciliary environment should be envisaged.


Assuntos
Anopheles , Ritmo Circadiano , Comportamento Alimentar , Mordeduras e Picadas de Insetos , Malária , Controle de Mosquitos , Animais , Anopheles/parasitologia , Anopheles/fisiologia , República Centro-Africana , Humanos , Mordeduras e Picadas de Insetos/parasitologia , Malária/prevenção & controle , Malária/transmissão , Controle de Mosquitos/métodos , Mosquitos Vetores , Plasmodium falciparum/isolamento & purificação
16.
J Emerg Med ; 62(6): e105-e107, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35562247

RESUMO

BACKGROUND: Myiasis, as defined by the Centers for Disease Control and Prevention, is infection with fly larvae commonly occurring in tropical and subtropical areas. Whereas the presentation of skin infection with organisms such as Dermatobia hominis (human botfly) is more easily recognized in these regions, identification of myiasis in the United States is difficult due to its rarity. Due to unspecific signs and symptoms, myiasis may initially be mistaken for other conditions, like cellulitis. CASE REPORT: This case details a patient with pain, swelling, drainage, and erythema of the right second toe. The patient recently returned from Belize and reported an insect bite to the area approximately 1 month prior. She had been seen by health care professionals twice prior to presenting to our Emergency Department (ED) due to increasing pain. At those visits, the patient was prescribed antibiotics, failing to improve her symptoms. In the ED, point-of-care ultrasound (POCUS) of the soft tissue was performed and showed evidence of a foreign body consistent with cutaneous myiasis. Given the patient's history of travel to Belize and known insect bite, it is prudent to have an increased suspicion for cutaneous myiasis. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: To prevent a delay in diagnosis and unnecessary antibiotics, clinicians should have a high level of suspicion for botfly if a patient reports recent travel in an endemic region and pain disproportionate to an insect bite. POCUS contributes to a more efficient recognition of the disease.


Assuntos
Dípteros , Corpos Estranhos , Mordeduras e Picadas de Insetos , Miíase , Animais , Antibacterianos , Celulite (Flegmão) , Feminino , Corpos Estranhos/diagnóstico por imagem , Humanos , Larva , Miíase/diagnóstico , Dor , Sistemas Automatizados de Assistência Junto ao Leito , Dedos do Pé , Viagem
17.
Artigo em Inglês | MEDLINE | ID: mdl-35409999

RESUMO

BACKGROUND: Allergic reactions to Hymenoptera stings can have varying levels of severity, according to the Müller grading system. METHODS: By an epidemiological concept, this is a retrospective cohort study. The observed cohort was represented by patients referred to the University Clinic Golnik due to Hymenoptera allergic reaction in the period from 1997 to 2015. From the immunological database of the University Clinic Golnik, we obtained laboratory data (sIgE, skin tests and basophil activation test). The clinical characteristics of patients were obtained from BIRPIS. With the help of a questionnaire, which was sent to each patient in the period from May 2019 to April 2021, we obtained epidemiological data. For the assessment of the association between the severity of allergic reaction for the observed outcome, the severity of the first allergic reaction after Hymenoptera sting was used. Other variables were grouped according to risk factors. DISCUSSION: We will identify the risk factors that could play an important role in a severe systemic reaction: the aetiology of the Hymenoptera sting, sex, age, history and severity of previous systemic reactions, being re-stung in an interval of two months, the frequency of re-stings, atopy, genetic predisposition, preventive medication use, other medication use, beekeeping or living next to beehives and why immunotherapy was not taken. Laboratory data will also be analysed to determine if there is any association with laboratory tests and the severity of the allergic reactions after Hymenoptera stings. CONCLUSIONS: Several new approaches are introduced in the study design. The most important is that the protocol covers epidemiological data gained from the questionnaire, as well as clinical data gained from the Immunological database and BIRPIS database. We expect to obtain significant results that will explain the risk factors for the natural history of Hymenoptera sting allergic reactions and will help allergologists, as well as general doctors, when facing those patients allergic to Hymenoptera venom without immunotherapy.


Assuntos
Venenos de Artrópodes , Himenópteros , Hipersensibilidade , Mordeduras e Picadas de Insetos , Adulto , Animais , Venenos de Artrópodes/efeitos adversos , Humanos , Hipersensibilidade/epidemiologia , Lactente , Mordeduras e Picadas de Insetos/epidemiologia , Estudos Retrospectivos
18.
J Equine Vet Sci ; 114: 103942, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35367519

RESUMO

The nematode Onchocerca cervicalis is the most common causative agent of equine onchocerciasis; this condition is characterised by pruritus and dermatitis and is a differential diagnosis for insect bite hypersensitivity. Onchocerciasis is currently presumed of minor importance within the UK, however prevalence may increase if macrocyclic lactone use declines amid concerns about anthelmintic resistance in gastrointestinal nematodes. This survey aimed to establish O. cervicalis awareness and knowledge levels amongst UK equine veterinarians and to determine approximate numbers of UK horses affected with unresponsive cases of dermatoses, including insect bite hypersensitivity. An online survey was distributed to UK equine vets between December 2019 and February 2020. Of 88 respondents, 78% were aware of O. cervicalis, however 49% of these answered less than half the questions presented about the parasite's lifecycle correctly. Approximately 25% of insect bite hypersensitivity cases respondents saw were deemed unresponsive to standard treatments, 84% of respondents had not previously considered onchocerciasis as a differential diagnosis in such cases. Findings suggest knowledge of O. cervicalis amongst UK equine vets is lacking, highlighting a need to raise awareness and consideration of the parasite as a differential when investigating equine dermatoses.


Assuntos
Doenças dos Cavalos , Mordeduras e Picadas de Insetos , Oncocercose , Parasitos , Médicos Veterinários , Animais , Doenças dos Cavalos/tratamento farmacológico , Cavalos , Humanos , Mordeduras e Picadas de Insetos/veterinária , Onchocerca , Oncocercose/tratamento farmacológico , Oncocercose/veterinária , Inquéritos e Questionários , Reino Unido/epidemiologia
19.
J Paediatr Child Health ; 58(7): 1228-1232, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35416342

RESUMO

AIM: Bee stings can result in allergic reactions, including anaphylaxis. Venom immunotherapy (VIT) is a definitive cure for bee venom allergy, but controversy surrounds whether accelerated protocols are safe in children. Our primary aim was to assess the safety profile of ultra-rush bee VIT compared with conventional bee VIT at a regional paediatric tertiary centre. We also sought to evaluate the impact of both approaches on time and resource use. METHODS: Data were collected retrospectively from 14 patients with bee venom allergy who were treated with ultra-rush or conventional bee VIT between 2013 and 2021 at John Hunter Children's Hospital. We compared VIT-associated adverse reactions and use of resources in both these groups. RESULTS: Overall, six patients received ultra-rush bee VIT and eight patients received conventional VIT. The ultra-rush group had a lower rate of systemic reaction (16%) compared with the conventional group (25%). One patient from the conventional group required adrenaline. Ultra-rush patients require fewer injections over a shorter time and fewer hospital visits to complete the protocol. Travel distance for families was significantly reduced. CONCLUSION: At our regional paediatric tertiary centre, ultra-rush bee VIT was a safe treatment option for children with bee venom allergy. It has many advantages over a conventional approach, especially for patients living in regional or remote areas.


Assuntos
Anafilaxia , Venenos de Abelha , Mordeduras e Picadas de Insetos , Anafilaxia/etiologia , Animais , Venenos de Abelha/efeitos adversos , Venenos de Abelha/uso terapêutico , Abelhas , Criança , Dessensibilização Imunológica/efeitos adversos , Dessensibilização Imunológica/métodos , Humanos , Imunoterapia , Mordeduras e Picadas de Insetos/induzido quimicamente , Mordeduras e Picadas de Insetos/terapia , Estudos Retrospectivos , Venenos de Vespas/efeitos adversos
20.
Wilderness Environ Med ; 33(2): 236-238, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35304029

RESUMO

Hymenoptera stings of the upper airway are rare events, but can result in rapid, life-threatening airway emergencies. The allergenic and toxic mediators that are released from the stings of bees, wasps, and hornets can cause local tissue inflammation and edema with subsequent upper airway obstruction. We report the case of a 15-y-old girl who suffered a bee sting to the uvula while zip-lining in Costa Rica. Shortly thereafter, she developed a choking sensation with associated dysphonia, odynophagia, drooling, and respiratory distress. She was brought to a rural emergency medical clinic where she was noted to have an erythematous, edematous, boggy uvula, with a black stinger lodged within it, as well as edema of the anterior pillars of the tonsils and soft palate. The stinger was removed with tweezers and she was treated with an intravenous corticosteroid and antihistamine. She had persistence of airway edema and symptoms until the administration of epinephrine, which resulted in clinical improvement shortly thereafter. In our review of this case and the existing literature, we emphasize the importance of early recognition and management of hymenoptera stings of the upper airway, which should always include immediate manual removal of the stinger, and in cases with significant upper airway edema, the administration of epinephrine should be considered.


Assuntos
Venenos de Abelha , Mordeduras e Picadas de Insetos , Vespas , Animais , Abelhas , Edema/etiologia , Epinefrina , Feminino , Humanos , Mordeduras e Picadas de Insetos/complicações , Mordeduras e Picadas de Insetos/terapia , Úvula
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