scholarly journals Assessing Use of a Standardized Allergy History Questionnaire for Patients with Reported Allergy to Penicillin

2021 ◽  
Vol 74 (2) ◽  
Author(s):  
Jessica Manning ◽  
Robert T Pammett ◽  
Abu Obeida Hamour ◽  
Aleisha Enemark ◽  
Barret Barr
Keyword(s):  
British Columbia ◽  
Antimicrobial Stewardship ◽  
Immunoglobulin E ◽  
University Hospital ◽  
Type I ◽  
Hypersensitivity Reactions ◽  
Surgical Services ◽  
Paper Chart ◽  
True Type ◽  
The University

Background: Inappropriate allergy labelling is associated with significant clinical and pharmacoeconomic implications. Detailed antimicrobial allergy assessments represent a key component of antimicrobial stewardship and aid in identifying true type I (immediate hypersensitivity) reactions. The allergy history form currently used at the University Hospital of Northern British Columbia (UHNBC), in Prince George, relies on the assessor’s ability to ask appropriate prompting questions to obtain a thorough history, but it may not be sufficient to accurately identify true allergies. Objective: To compare a standardized allergy history questionnaire and the current allergy history form in terms of the quality and quantity of documentation gathered. Methods: This prospective observational study involved patients who were admitted to medical and surgical services at UHNBC from November 2018 to January 2019 with a penicillin-class allergy reported on their electronic medical record (EMR). A list of patients with EMR-reported allergies was generated by the hospital’s health information software system, and these patients were interviewed using the standardized allergy history questionnaire. Results: A total of 48 patients were assessed during the study period. Nineteen (40%) of the patients had an inappropriate allergy label on their EMR. Only 36 (75%) had an allergic reaction described on their EMR. Furthermore, only 36 (75%) of the 48 patients had the same allergy recorded on the EMR and on the allergy history form contained in their paper chart, of whom 22 had a documented reaction. The mean time to complete the standardized allergy history questionnaire was 2 minutes. Conclusions: At the study institution, documentation of allergy histories was often incomplete. Detailed allergy assessments are the first step in identifying true immunoglobulin E–mediated hypersensitivity reactions. Utilization of a standardized allergy history questionnaire is feasible and may serve to improve documentation and overall antimicrobial stewardship. RÉSUMÉ Contexte : L’étiquetage inapproprié de l’allergie est associé à des conséquences cliniques et pharmacoéconomiques importantes. Les évaluations détaillées des allergies antimicrobiennes sont une composante-clé de la gestion antimicrobienne : elles contribuent à déterminer les réactions d’hypersensibilité véritables de type 1 (immédiates). Le formulaire des antécédents d’allergies actuellement utilisé à l’University Hospital of Northern British Columbia (UHNBC), à Prince George, s’appuie sur la capacité de l’évaluateur à poser les questions appropriées pour obtenir un historique détaillé, mais il ne suffit pas de déterminer précisément les véritables allergies. Objectif : Comparer la qualité et la quantité des informations recueillies au moyen d’un questionnaire normalisé sur les antécédents d’allergies avec celles recueillies au moyen des formulaires. Méthodes : Cette étude d’observation prospective portait sur des patients admis dans les services médicaux et chirurgicaux à l’UHNBC de novembre 2018 à janvier 2019, dont les dossiers médicaux électroniques (DME) indiquaient une allergie à des médicaments de la classe de la pénicilline. Le logiciel des informations sur la santé a généré une liste des patients présentant les allergies indiquées et ces patients ont été interrogés à l’aide d’un questionnaire normalisé des antécédents d’allergies. Résultats : Un total de 48 patients a été évalué pendant la période de l’étude. Le DME de dix-neuf (40 %) patients portait une étiquette inappropriée. Seuls 36 DME des patients (75 %) décrivaient une réaction allergique. De plus, seulement 36 (75 %) des 48 patients avaient la même réaction allergique enregistrée à la fois au DME et dans le formulaire des antécédents d’allergies de leur dossier papier, et la réaction de 22 d’entre eux était documentée. Le temps de réponse moyen au questionnaire normalisé sur les antécédents d’allergies était de 2 minutes. Conclusion : Dans cette étude, la description des antécédents d’allergies était souvent incomplète. Les évaluations détaillées des allergies sont la première étape permettant de déterminer les réactions véritables d’hypersensibilité à l’immunoglobuline E. L’utilisation d’un questionnaire normalisé des antécédents d’allergies est faisable et pourrait servir à améliorer la documentation ainsi que la gestion globale des antimicrobiens.  

scholarly journals Unravelling the Features of Success of VIM-Producing ST111 and ST235 Pseudomonas aeruginosa in a Greek Hospital

2020 ◽  
Vol 8 (12) ◽  
pp. 1884
Author(s):  
Costas C. Papagiannitsis ◽  
Aggeliki Verra ◽  
Vasiliki Galani ◽  
Stelios Xitsas ◽  
Ibrahim Bitar ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
University Hospital ◽  
Type I ◽  
Illumina Platform ◽  
Minimal Inhibitory Concentrations ◽  
Greek Hospital ◽  
Clonal Spread ◽  
The University ◽  
Encoding Genes

The objective of this study was to analyze the characteristics that contribute to the successful dissemination of VIM-producing Pseudomonas aeruginosa (P. aeruginosa), belonging to ST111 and ST235, in a Greek hospital. A total of 120 non-repetitive P. aeruginosa, which had meropenem minimal inhibitory concentrations (MICs) greater than 2 mg/L, were studied. VIM-encoding genes were amplified and sequenced within their integrons. Isolates were typed by multilocus sequence typing (MLST). Six VIM-producers, representative of different integron structures and sequence types (STs), were completely sequenced using Illumina platform. Sixty-one P. aeruginosa were confirmed to produce VIM-type carbapenemases. ST111 dominated (n = 34) among VIM-producers, while 15 VIM-producers belonged to ST235. The blaVIM-like genes were located in three integron types, including In59, In595 and In1760, which were integrated into P. aeruginosa chromosomes. Whole genome sequencing (WGS) data demonstrated that ST111 and ST235 MBL producers carried several resistance and virulence genes. Additionally, the presence of type I-C and type I-E clustered regularly interspaced short palindromic repeats (CRISPR)/Cas locus was observed in ST235 and ST395 isolates, respectively. In conclusion, our findings confirmed the clonal spread of ST111 P. aeruginosa, carrying the VIM-2-encoding integron In59, in the University Hospital of Larissa (UHL). In addition, they highlighted the important role of high-risk clones, ST111 and ST235, in the successful dissemination and establishment into hospital settings of clinically important pathogens carrying resistance determinants.

scholarly journals Laryngeal cleft type I in neonate: case report

CoDAS ◽  
2014 ◽  
Vol 26 (5) ◽  
pp. 421-424 ◽  
Author(s):  
Mirella Spinoso Rossi ◽  
Karina Elena Bernardis Buhler ◽  
Gabriel Alberto Brasil Ventura ◽  
José Pinhata Otoch ◽  
Suelly Cecilia Olivan Limongi
Keyword(s):  
University Hospital ◽  
Type I ◽  
Speech Language Pathologist ◽  
Thickened Liquid ◽  
Laryngeal Cleft ◽  
The University ◽  
Thin Liquids ◽  
General Diet ◽  
Oral Diet

Laryngeal cleft (LC) is a congenital malformation that leads to the unusual communication between the esophagus and the laryngotracheal complex. It is a rare disease, mostly prevalent among male individuals. The goal of this study was to describe the evaluation and intervention by the speech language pathologist of a female newborn diagnosed with LC type I, admitted on the University Hospital of Universidade de São Paulo, in her second hospitalization due to small weight gain and pneumonia. She was submitted to a bedside clinical evaluation of the swallowing and the most important occurrence was frequent gagging. The videofluoroscopy swallowing study showed laryngotracheal aspiration level 8 for thin liquid and level 1 for thickened liquid, according to the Penetration-Aspiration Scale. The newborn was submitted to a microlaryngoscopy, in which the presence of LC type I was found. After the diagnosis, the speech language pathologist offered thickened liquid at 6% and, in 8 days, the newborn was discharged with exclusive oral diet without gagging. Eight outpatient consultations were carried out for 11 months, with emphasis on reintroduction of thin liquids. The treatment was discontinued and the patient was put on general diet for the age without modifications. Throughout follow-up, the patient remained asymptomatic and showed no respiratory complications.

scholarly journals Clinical Aspects of Food Allergy in Infants in Pleven Region, Bulgaria

2018 ◽  
Vol 11 (1) ◽  
pp. 36-40
Author(s):  
Vanya M. Nedkova-Milanova ◽  
Tsvetelina V. Miteva ◽  
Darina N. Hristova ◽  
Lyubomira D. Gadjelova ◽  
Magdalena I. Balashkova
Keyword(s):  
Food Allergy ◽  
Immunoglobulin E ◽  
Chronic Diarrhea ◽  
Venous Blood ◽  
Clinical Manifestations ◽  
University Hospital ◽  
Deficiency Anemia ◽  
Clinical Aspects ◽  
The University ◽  
Age Range

Summary Food allergy is an immunoglobulin E-meditated reaction, to which the organism’s immune system reacts to a food allergen, recognizing it as harmful. The study aimed to establish at what age cow’s milk protein allergy is manifested and determine the values of immunoglobulin E (IgE) and hemoglobin(Hb) in children with CMPA in Pleven region, Bulgaria. The study included 94 infants presenting with clinical manifestations of food allergy (age range 0 to 12 months) from Pleven and Pleven region, consulted in 2017 by a pediatrician at the University Hospital Consulting Center in Pleven. Venous blood was collected to determine the IgE and Hb values. Chronic iron-deficiency anemia could be the only clinical manifestation in children with CMPA. Out of all the children with CMPA, 17% had a pronounced anemic syndrome. The rest had normal Hb values. Anemic syndrome could have severe consequences for a growing child. Elevated IgE values were found in 73% of the children tested. CMPA is frequently seen in infants. Early diagnosis of clinical manifestations and diet could prevent severe complications of allergy such as chronic diarrhea, chronic urticaria, and asthma.

scholarly journals Antimicrobial Stewardship and Education, the Role of Pharmacists in the University Hospital

2021 ◽  
Vol 141 (11) ◽  
pp. 1253-1255
Author(s):  
Naomi Yoshinaga ◽  
Akihiro Hisato ◽  
Miwa Kitai ◽  
Yuka Hisamitsu ◽  
Hiroko Sango ◽  
...  
Keyword(s):  
Antimicrobial Stewardship ◽  
University Hospital ◽  
The University

Heat-Etching with a Bullivant Type II Simple Freeze-Cleave Device

1970 ◽  
Vol 28 ◽  
pp. 106-107 ◽  
Author(s):  
Ronald S. Weinstein ◽  
N. Scott McNutt
Keyword(s):  
New Zealand ◽  
General Hospital ◽  
Massachusetts General Hospital ◽  
Type I ◽  
Type Ii ◽  
Collaborative Effort ◽  
Temperature And Pressure ◽  
The University

The Type I simple cold block device was described by Bullivant and Ames in 1966 and represented the product of the first successful effort to simplify the equipment required to do sophisticated freeze-cleave techniques. Bullivant, Weinstein and Someda described the Type II device which is a modification of the Type I device and was developed as a collaborative effort at the Massachusetts General Hospital and the University of Auckland, New Zealand. The modifications reduced specimen contamination and provided controlled specimen warming for heat-etching of fracture faces. We have now tested the Mass. General Hospital version of the Type II device (called the “Type II-MGH device”) on a wide variety of biological specimens and have established temperature and pressure curves for routine heat-etching with the device.

Symptomatic vascular complications after vascular closure device use following diagnostic and interventional catheterisation

VASA ◽  
2004 ◽  
Vol 33 (2) ◽  
pp. 78-81 ◽  
Author(s):  
Thalhammer ◽  
Aschwanden ◽  
Jeanneret ◽  
Labs ◽  
Jäger
Keyword(s):  
Current Literature ◽  
Vascular Complications ◽  
University Hospital ◽  
Closure Device ◽  
Ultrasound Guided ◽  
Vascular Closure Device ◽  
Device Use ◽  
Arterial Stenoses ◽  
The University ◽  
Stenotic Lesions

Background: Haemostatic puncture closure devices for rapid and effective hemostasis after arterial catheterisation are a comfortable alternative to manual compression. Implanting a collagen plug against the vessel wall may become responsible for other kind of vascular injuries i.e. thrombotic or stenotic lesions and peripheral embolisation. The aim of this paper is to report our clinically relevant vascular complications after Angio-Seal® and to discuss the results in the light of the current literature. Patients and methods: We report the symptomatic vascular complications in 17 of 7376 patients undergoing diagnostic or therapeutic catheterisation between May 2000 and March 2003 at the University Hospital Basel. Results: Most patients presented with ischaemic symptoms, arterial stenoses or occlusions and thrombotic lesions (n = 14), whereas pseudoaneurysms were extremely rare (n = 3). Most patients with ischaemic lesions underwent vascular surgery and all patients with a pseudoaneurysm were successfully treated by ultrasound-guided compression. Conclusions: Severe vascular complications after Angio-Seal® are rare, consistent with the current literature. There may be a shift from pseudoaneurysms to ischaemic lesions.

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