scholarly journals Heart Rate Variability Signal Precedes Clinical Symptoms in Hypersensitivity Reactions during Drug Provocation Tests

2020 ◽  
Vol 28 (5) ◽  
Author(s):  
Arantza Vega Castro
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Clinical Symptoms ◽  
Hypersensitivity Reactions ◽  
Provocation Tests ◽  
Drug Provocation Tests

scholarly journals Predictive Value of Subacute Heart Rate Variability for Determining Outcome Following Adolescent Concussion

2021 ◽  
Vol 10 (1) ◽  
pp. 161
Author(s):  
Colt A. Coffman ◽  
Jacob J. M. Kay ◽  
Kat M. Saba ◽  
Adam T. Harrison ◽  
Jeffrey P. Holloway ◽  
...  
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Cognitive Performance ◽  
Predictive Value ◽  
System Integration ◽  
Sports Medicine ◽  
Clinical Symptoms ◽  
Physiological Stress ◽  
Neurological Dysfunction ◽  
Neurobehavioral Function

Objective assessments of concussion recovery are crucial for facilitating effective clinical management. However, predictive tools for determining adolescent concussion outcomes are currently limited. Research suggests that heart rate variability (HRV) represents an indirect and objective marker of central and peripheral nervous system integration. Therefore, it may effectively identify underlying deficits and reliably predict the symptomology following concussion. Thus, the present study sought to evaluate the relationship between HRV and adolescent concussion outcomes. Furthermore, we sought to examine its predictive value for assessing outcomes. Fifty-five concussed adolescents (12–17 years old) recruited from a local sports medicine clinic were assessed during the initial subacute evaluation (within 15 days postinjury) and instructed to follow up for a post-acute evaluation. Self-reported clinical and depressive symptoms, neurobehavioral function, and cognitive performance were collected at each timepoint. Short-term HRV metrics via photoplethysmography were obtained under resting conditions and physiological stress. Regression analyses demonstrated significant associations between HRV metrics, clinical symptoms, neurobehavioral function, and cognitive performance at the subacute evaluation. Importantly, the analyses illustrated that subacute HRV metrics significantly predicted diminished post-acute neurobehavioral function and cognitive performance. These findings indicate that subacute HRV metrics may serve as a viable predictive biomarker for identifying underlying neurological dysfunction following concussion and predict late cognitive outcomes.

scholarly journals Diagnosing and Managing Patients with Reactions to Radiocontrast Media

2021 ◽  
Vol 8 (3) ◽  
pp. 210-221
Author(s):  
Knut Brockow
Keyword(s):  
Skin Testing ◽  
Drug Hypersensitivity ◽  
Skin Tests ◽  
Hypersensitivity Reactions ◽  
Positive Skin ◽  
Provocation Tests ◽  
Ring Molecules ◽  
Allergic Skin ◽  
Drug Hypersensitivity Reactions ◽  
Drug Provocation Tests

Abstract Purpose of the review Iodinated radio contrast media (RCM) belong to the most common elicitors of drug hypersensitivity reactions (HR). Urticaria or anaphylaxis may occur ≤ 1(−6) hour(s) (immediate HR) and exanthems (non-immediate HR) develop > 6 h after application of RCM. Evidence for an immunologic mechanism of RCM HR against the different RCM benzene ring molecules and the benefit of allergological testing in patients with previous hypersensitivity reactions is progressively increasing. Recent findings Positive skin tests can confirm allergy in patients with previous reactions to RCM and help to select alternative better tolerated RCMs. Severe hypersensitivity reactions are mainly caused by an allergic mechanism, whereas the majority of non-severe reactions appear to be non-allergic. Skin testing is highly recommended to help identify allergic hypersensitivity reactions and to select alternatives. Using structurally different RCM is more effective than premedication for the prevention of future reactions. Drug provocation tests to RCM have been increasingly used, but are not yet standardized among different centers. Summary In patients with previous severe hypersensitivity reactions to RCM, skin testing is recommended. For future RCM-enhanced examinations in patients with previous reactions, structurally different, skin test-negative preparations should be applied. Drug provocation tests do confirm or exclude RCM hypersensitivity or may demonstrate tolerability of alternative RCMs.

Drug Provocation Tests in the Diagnosis of Hypersensitivity Reactions to Non-Steroidal Anti-Inflamatory Drugs in Children

2013 ◽  
Vol 131 (2) ◽  
pp. AB168
Author(s):  
Maria Angeles Zambonino ◽  
María José Torres ◽  
Candelaria Muñoz ◽  
Gloria Requena ◽  
Cristobalina Mayorga ◽  
...  
Keyword(s):  
Hypersensitivity Reactions ◽  
Provocation Tests ◽  
Drug Provocation Tests

Ipersensibilità ai FANS: intolleranza o allergia?

2021 ◽  
Vol 40 (1) ◽  
pp. 37-43
Author(s):  
Laura Levantino ◽  
Cristiana Corrado ◽  
Laura Badina ◽  
Sara Lega ◽  
Egidio Barbi
Keyword(s):  
Drug Hypersensitivity ◽  
Clinical Manifestations ◽  
Hypersensitivity Reactions ◽  
Provocation Tests ◽  
Immunological Mechanisms ◽  
Drug Hypersensitivity Reactions ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Drug Provocation Tests ◽  
Cox 1

Non-steroidal anti-inflammatory drugs (NSAIDs) are the main triggers of drug hypersensitivity reactions in children. According to the EAACI latest classification NSAIDs hypersensitivity reactions are differentiated into cross-reactive reactions, with non-immunological mechanisms (based on COX-1 inhibition), and selective reactions, with immunological mechanisms. Paediatric clinical manifestations of NSAID hypersensitivity are typically cutaneous, but sometimes, similarly to anaphylaxis, can involve other systems, especially the respiratory one. Differentiating between NSAID intolerance and NSAID allergy through drug provocation tests is crucial for the patient because the two clinical entities require different management.

Drug provocation tests in the diagnosis of hypersensitivity reactions to non-steroidal anti-inflammatory drugs in children

2013 ◽  
Vol 24 (2) ◽  
pp. 151-159 ◽  
Author(s):  
Maria A. Zambonino ◽  
Maria J. Torres ◽  
Candelaria Muñoz ◽  
Gloria Requena ◽  
Cristobalina Mayorga ◽  
...  
Keyword(s):  
Hypersensitivity Reactions ◽  
Provocation Tests ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Drug Provocation Tests

Utility of drug provocation tests in the evaluation of quinolone hypersensitivity reactions

2020 ◽  
Author(s):  
Anca Mirela Chiriac ◽  
Luciana Kase Tanno ◽  
Quentin Landry ◽  
Anouchka Fillard ◽  
Maria Grylaki ◽  
...  
Keyword(s):  
Hypersensitivity Reactions ◽  
Provocation Tests ◽  
Drug Provocation Tests

scholarly journals Differential Effects of Injury Etiology on Pediatric Concussion Recovery

Neurology ◽  
2019 ◽  
Vol 93 (14 Supplement 1) ◽  
pp. S32.2-S32
Author(s):  
Kat Saba ◽  
Jacob Kay ◽  
Colt Coffman ◽  
Cameron Morrison ◽  
Jeff Holloway ◽  
...  
Keyword(s):  
Mental Health ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Acute Phase ◽  
Autonomic Function ◽  
Clinical Symptoms ◽  
Health Concern ◽  
Prior History ◽  
Clinical Practices ◽  
Pediatric Concussion

ObjectiveTo investigate the relation between mechanism of injury and pediatric concussion outcomes. We hypothesize that individuals injured during sport (sport related concussions; SRC’s) will demonstrate better outcomes than those with non-sport injuries (mild Traumatic Brain Injuries; mTBI’s), specifically in terms of clinical symptoms, mental health, cognition, and cardio-autonomic function.BackgroundConcussions are a growing health concern; however, little is known how different injury etiologies (sport vs. non-sport) effect recovery. Therefore, it is critical to better understand how different injury etiologies effect recovery from concussion to more efficiently guide clinical practices.Design/MethodsData collected from a local pediatric concussion clinic were analyzed. SRC and mTBI participants were matched on key demographics (age, body mass index, education) and injury characteristics (time between injury and clinical evaluations, prior history of concussion, pre- and post-injury physical activity). Clinical symptoms were measured using the Rivermead Post-Concussion Symptom Questionnaire (R-PCS). Mental health was measured using the Beck Youth Inventory of Depression (BYI-D). Cognition was measured using a modified CogState Brain Injury Test Battery. Cardio-autonomic function was assessed via heart rate variability (HRV). Participants were evaluated during the acute phase of injury, and again in the post-acute phase.ResultsAt both time points, adolescents with mTBI reported greater clinical and depressive symptoms than those with an SRC (p’s < 0.05). During the acute phase, adolescents with SRC and mTBI significantly differed on multiple metrics of heart rate variability (p’s < 0.05). There were no group differences in cognition at either time point.ConclusionsOur results suggest those incurring a SRC may demonstrate better outcomes than those incurring an mTBI. Future longitudinal research including baseline measurements is necessary to determine the validity of these findings.

scholarly journals PERIOPERATIVE IMMEDIATE DRUG HYPERSENSITIVITY: CLINICAL FEATURES, DIAGNOSTICS, RISK ASSESSMENT

2014 ◽  
Vol 11 (6) ◽  
pp. 9-19
Author(s):  
D G Zhukova ◽  
E S Fedenko ◽  
A A Yudin ◽  
O Y Rakhimova
Keyword(s):  
Clinical Features ◽  
Clinical Symptoms ◽  
Drug Hypersensitivity ◽  
Clinical Manifestations ◽  
Diagnostic Algorithm ◽  
Respiratory Arrest ◽  
Skin Tests ◽  
Hypersensitivity Reactions ◽  
Cutaneous Manifestations ◽  
Provocation Tests

Background. To evaluate clinical features and to develop the diagnostic algorithm of perioperative drug’s hypersensitivity reactions. Methods. 40 patients who presented perioperative immediate drug’s hypersensitivity reactions were studied in the Central Clinical hospital of the Russian Academy of sciences during 2010-2012. The diagnostic protocol consisted of 2 steps: at the 1 step (during the acute clinical manifestation period) a case history, grade of severity of immediate hypersensitivity reactions, serum tryptase levels have been studied; at the 2 step (6-12 weeks after symptoms were over) inhibition test of natural emigration of leukocytes by Ado, sublingual, skin tests and drug provocation tests have been performed. Results. Clinical manifestations of drugs hypersensitivity were as follows: hypersensitivity reactions grade I (isolated cutaneous manifestations) - in 20 patients (50%), anaphylactic-type reactions - in 20 patients (50%): grade II (moderate anaphylaxis) - in 13 patients (32,5%), grade III (severe life-threatening anaphylaxis) - in 6 (15%), and grade IV (cardiac and respiratory arrest) - in 1 patient (2,5%). Positive tests at least with 1 drug had 28 patients (70%): neuromusculars blockers (22,5%); antibiotics (22,5%); lidocaine (10%); amidotrizoate (7,5%); NSAID (7,5%). Other 12 patients had negative tests (30%) with all suspected agents and moderate clinical symptoms if to compare with others 28 patients (p

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