Latex Hypersensitivity

乳胶超敏反应
  • 文章类型: English Abstract
    OBJECTIVE: Determine the electrophoretic profiles of the extracts of Manihot esculenta, Actinidia Deliciosa and Persea Americana and their possible relationship with Latex-Fruit Syndrome.
    METHODS: Protein extracts of M. esculenta, P. Americana and A. Deliciosa were prepared through the processes of maceration and solvent extraction from plant samples. In the case of the avocado, a prior extraction by soxhlet was carried out to eliminate the fat. The extracts were vacuum filtered, dialyzed and finally lyophilized. Separation of proteins based on molecular weight was performed by SDS PAGE electrophoresis. The electrophoretic profiles obtained were compared with the allergenic proteins previously identified in the latex extract, in order to determine a possible relationship with Latex-Fruit Syndrome, depending on the molecular weight.
    RESULTS: The extracts of M. esculenta and P. Americana showed a wide range of protein fractions with molecular weights varying from 10 to 250 KD, finding that the region with the highest concentration of bands was between 20 and 89 KD, (60 and 65%), respectively. A 20-band profile was obtained for the M. esculenta extract (Figure 1), with seven bands sharing similar weights with the latex allergens (Hev b 1, Hev b 2, Hev b3, Hev b 4, Hev b 5, Hev b 6.03, Hev b 8 and Hev b 10) (3-5). For the P. Americana extract, 20 bands were also observed (Figure 2), seven of which presented approximate weights to the Latex allergens (Hev b 1, Hev b 2 Hev b 4 Hev b 6.01 Hev b 6.03 Hev b 8 , Hev b 10 Hev b 11 Hev b 14). The Kiwi extract showed two bands of 19.1 and 22.9 KD, with weights close to latex proteins (figure 3), (Hev b 3 and Hev b 6.01), and allergens (Act d 2 and Act d 6), reported in the literature for this fruit.
    CONCLUSIONS: When analyzing the relationship between the separated protein fractions and the latex allergens described in the literature, a possible association of 35% was found for the extracts of M. esculenta and P. Americana, and 10% for A. Delicious, with great relevance being the association found with the allergens Hev b 4, Hev b 2, Hev 8 and Hev b 11, which are involved in Latex-Fruit Syndrome. The electrophoretic profiles of the prepared extracts were determined and compared with the Latex allergens. This information generates a contribution for the development of new research and advances in the standardization of these extracts on a large scale and for their future use in diagnostic tests.
    OBJECTIVE: Determinar los perfiles electroforéticos de los extractos de Manihot esculenta, Actinidia deliciosa y Persea americana y su posible relación con el Síndrome de Látex – Fruta.
    UNASSIGNED: Se prepararon extractos proteicos de M. esculenta, P. Americana y A. Deliciosa, a través de los procesos de macerado y extracción con solventes a partir muestras vegetales. En el caso del aguacate, se realizó una extracción previa por soxhlet, para eliminar la grasa. Los extractos se filtraron al vacío, se sometieron a diálisis y por último se liofilizaron. La separación de las proteínas en función del peso molecular se realizó mediante electroforesis SDS PAGE. Se compararon los perfiles electroforéticos obtenidos con las proteínas alergénicas previamente identificadas en el extracto de látex, con el fin de determinar una posible relación con el Síndrome de Látex-Fruta, en función del peso molecular.
    RESULTS: Los extractos de M. esculenta y P. americana mostraron una amplia gama de fracciones proteicas con pesos moleculares que varían desde 10 a 250 KD, encontrando que la región con mayor concentración de bandas se situó entre 20 y 89 KD, (60 y 65 %), respectivamente. Se obtuvo un perfil de 20 bandas para el extracto de M. esculenta (figura 1), con siete bandas que comparten pesos similares con los alérgenos del látex (Hev b 1, Hev b 2, Hev b3, Hev b 4, Hev b 5, Hev b 6.03, Hev b 8 y Hev b 10) (3-5). Para el extracto de P. americana, también se observaron 20 bandas (figura 2), siete de las cuales presentaron pesos aproximados a los alérgenos de Látex (Hev b 1, Hev b 2 Hev b 4 Hev b 6.01 Hev b 6.03 Hev b 8, Hev b 10 Hev b 11 Hev b 14). El extracto de Kiwi mostró dos bandas de 19,1 y 22,9 KD, con pesos cercanos a proteínas de látex (figura 3), (Hev b 3 y Hev b 6.01), y los alérgenos (Act d 2 y Act d 6), reportados en la literatura para esta fruta.
    CONCLUSIONS: Al analizar la relación existente entre las fracciones proteicas separadas y los alérgenos de los látex descritos en la literatura, se encontró una posible asociación del 35% para los extractos de M. esculenta y P. Americana, y del 10% para A. Deliciosa, siendo de gran relevancia la asociación encontrada con los alérgenos Hev b 4, Hev b 2, Hev 8 y Hev b 11, los cuales se encuentran implicados en el Síndrome de Látex-Fruto. Se lograron determinar los perfiles electroforéticos de los extractos elaborados y se compararon con los alérgenos del Látex. Está información genera un aporte para el desarrollo de nuevas investigaciones y avances en la estandarización de estos extractos a gran escala y para su uso futuro en pruebas diagnósticas.
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  • 文章类型: Journal Article
    背景:2019年冠状病毒(COVID-19)大流行导致护士使用乳胶手套的显着增加。然而,由于这种增加,对乳胶过敏和相关投诉增加的担忧仍然不确定。目的:本研究旨在评估COVID-19大流行期间在医院工作的护士的乳胶手套使用率和与过敏相关的投诉。
    方法:在2021年5月15日至6月15日之间,一项涉及448名志愿者护士的横断面研究获得了伦理批准。描述性统计数据用于表示分类值,如计数(n)和百分比(%),而连续值表示为平均值±标准偏差。使用Kolmogorov-Smirnov和Shapiro-Wilk检验评估数据的正态分布。使用配对样本t检验进行比较分析,皮尔森卡方(x2)检验,McNemar的卡方(x2)检验,和Spearman相关分析。
    结果:在大流行之前,侵入性手术的平均数量为45.13±26.48,而在大流行期间,这一比率增加到50.23±29.14。在大流行期间,平均手套使用时间从7.69±3.13小时增加到14.73±3.68小时。在护士中,过敏症状的发生率,以前是31.5%,在大流行期间上升到33.3%。结论:这项研究表明,在大流行期间,护士的日常侵入性手术和乳胶手套的使用显着增加。同时,过敏症状的频率也上升了。这些发现强调了提高认识和预防措施的重要性,特别是关于乳胶过敏,在医疗保健领域。
    UNASSIGNED: The coronavirus 2019 (COVID-19) pandemic has led to a significant increase in the use of latex gloves among nurses. However, concerns about the rise in latex allergies and related complaints due to this increase remain uncertain.
    UNASSIGNED: This study aims to assess the rates of latex glove usage and allergy-related complaints among nurses working in hospitals during the COVID-19 pandemic.
    UNASSIGNED: Between May 15 and June 15, 2021, ethical approvals were obtained for a cross-sectional study involving 448 volunteer nurses. Descriptive statistics were used to represent categorical values as counts (n) and percentages (%), while continuous values were represented as mean±standard deviation. The normal distribution of the data was assessed using the Kolmogorov-Smirnov and Shapiro-Wilk tests. Comparative analyses were conducted using paired sample t-test, Pearson\'s chi-squared (x2) test, McNemar\'s chi-squared (x2) test, and Spearman correlation analysis.
    UNASSIGNED: Before the pandemic, the average number of invasive procedures was 45.13±26.48, whereas during the pandemic, this rate increased to 50.23±29.14. The average glove usage duration went from 7.69±3.13 hours to 14.73±3.68 hours during the pandemic. Among nurses, the rate of allergic symptoms, which was previously at 31.5%, rose to 33.3% during the pandemic.
    UNASSIGNED: This study revealed a significant increase in daily invasive procedures and the use of latex gloves among nurses during the pandemic period. Simultaneously, the frequency of allergic symptoms also rose. These findings underscore the importance of awareness and preventive measures, particularly regarding latex allergies, in the healthcare field.
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  • 文章类型: Journal Article
    目的:在EUS中使用气球来改善可视化。然而,乳胶过敏患者的乳胶气球安全性数据有限,和非乳胶替代品可能是昂贵的。我们调查了在EUS期间使用乳胶气球的安全性。
    方法:在2019年至2022年之间在三级中心进行了回顾性审查。包括报告有乳胶过敏并接受线性EUS的患者。基线人口统计,EUS特性,并收集不良事件。主要结果是不良事件的发生率。
    结果:对57名独特患者进行了87次手术(平均年龄,65.3±14.5年)。在59个手术中使用了乳胶气球(67.8%),只有8个程序(13.6%)使用预防性药物。术中或术后无不良事件发生,无论药物使用或过敏反应史。
    结论:乳胶过敏患者使用EUS乳胶球与无不良事件相关。
    Balloons are used in EUS to improve visualization. However, data on the safety of latex balloons in patients with latex allergies are limited, and nonlatex alternatives can be costly. We investigated the safety of latex balloon use during EUS.
    A retrospective review was conducted at a tertiary center between 2019 and 2022. Patients with reported latex allergies who underwent linear EUS were included. Baseline demographics, EUS characteristics, and adverse events were collected. The primary outcome was the rate of adverse events.
    Eighty-seven procedures were performed on 57 unique patients (mean age, 65.3 ± 14.5 years). Latex balloons were used in 59 procedures (67.8%), with only 8 procedures (13.6%) using prophylactic medications. No adverse events occurred during or after procedures, regardless of medication use or history of anaphylaxis.
    The use of EUS latex balloons in patients with a latex allergy was associated with no adverse events.
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  • 文章类型: Journal Article
    新生物材料的发现和进展开辟了再生医学的新领域。这些生物材料通过改善生活质量甚至挽救数百万人的生命,在当前医学中发挥着关键作用。自2000年以来,天然橡胶胶乳(NRL)已被用作伤口敷料,引导骨再生(GBR)的机械屏障,用于药物输送的基质,和嫁接。NRL是一种能刺激细胞增殖的天然聚合物,新血管生成,和细胞外基质(ECM)形成。此外,众所周知,天然胶乳血清(NLS)中存在的蛋白质和其他生物活性分子负责NRL的生物学特性。NLS可以通过三种主要方法从NRL获得,即(I)离心(NRL在不同馏分中的分馏),(ii)凝结和沉淀(凝结NRL以将NLS与橡胶颗粒分离),和(iii)替代提取方法(从NRL膜洗脱)。在这次审查中,化学成分,物理化学性质,毒性,和其他生物信息,如成骨,血管生成,附着力,扩散,抗菌行为,和NLS的抗肿瘤活性,以及它的一些医疗仪器和设备进行了讨论。NLS在生物医学领域的应用进展,更具体地说,在细胞培养中,替代动物,普通动物,和临床试验也进行了讨论。还概述了NLS及其衍生物在组织工程中用于硬组织和软组织再生的应用面临的挑战和未来方向。
    Advances and the discovery of new biomaterials have opened new frontiers in regenerative medicine. These biomaterials play a key role in current medicine by improving the life quality or even saving the lives of millions of people. Since the 2000s, Natural Rubber Latex (NRL) has been employed as wound dressings, mechanical barrier for Guided Bone Regeneration (GBR), matrix for drug delivery, and grafting. NRL is a natural polymer that can stimulate cell proliferation, neoangiogenesis, and extracellular matrix (ECM) formation. Furthermore, it is well established that proteins and other biologically active molecules present in the Natural Latex Serum (NLS) are responsible for the biological properties of NRL. NLS can be obtained from NRL by three main methods, namely (i) Centrifugation (fractionation of NRL in distinct fractions), (ii) Coagulation and sedimentation (coagulating NRL to separate the NLS from rubber particles), and (iii) Alternative extraction process (elution from NRL membrane). In this review, the chemical composition, physicochemical properties, toxicity, and other biological information such as osteogenesis, vasculogenesis, adhesion, proliferation, antimicrobial behavior, and antitumoral activity of NLS, as well as some of its medical instruments and devices are discussed. The progress in NLS applications in the biomedical field, more specifically in cell cultures, alternative animals, regular animals, and clinical trials are also discussed. An overview of the challenges and future directions of the applications of NLS and its derivatives in tissue engineering for hard and soft tissue regeneration is also given.
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  • 文章类型: Journal Article
    天然橡胶胶乳是广泛用于生产许多消费和商业产品的工业原料。长期暴露于成品中残留的乳胶致敏蛋白可促进过敏性免疫反应,这影响了全世界数百万工人和公众。研究表明,全球范围内乳胶过敏的平均患病率在医护人员中仍然约为10%,7%的易感患者,在一般人群中占4%。虽然最有效的预防乳胶过敏,完全避免接触乳胶衍生产品是极具挑战性的,考虑到数以百万计的产品可能含有乳胶,但很少有人受到监管和适当的标签。由于难以确保产品完全不存在乳胶过敏原,美国食品和药物管理局建议停止使用“无乳胶”或“不含乳胶”等标签。“这里我们评估公布的数据,工业标准和法规,确定可能的对策,并提出综合战略,包括一些更可行的方法(例如,教育/培训,产品标签,使用适当的个人防护设备,职业选择,和可搜索的产品数据库)和新颖的医疗方法(例如,免疫疗法),以帮助降低乳胶过敏的患病率。
    Natural rubber latex is a widely used industrial raw material to produce many consumer and commercial products. Chronic exposures to latex allergenic proteins residual in the finished products can promote hypersensitive immune responses, which affects millions of workers and the general public worldwide. Research has shown the average prevalence of latex allergy worldwide remains approximately 10% among healthcare workers, 7% among susceptible patients, and 4% among general population. Although most effective in preventing latex allergy, completely avoiding contact to latex-derived products is extremely challenging, given the fact that millions of products possibly contain latex, but few are regulated and properly labeled. Due to the difficulty to assure a product completely absent of latex allergens, the United States Food and Drug Administration has recommended to stop using labels like \"latex-free\" or \"does not contain latex.\" Here we evaluate published data, industrial standards and regulations, identify possible countermeasures, and propose an integrated strategy, including some more practicable approaches (e.g., education/training, product labeling, the use of proper personal protective equipment, occupational selection, and searchable product database) and novel medical treatments (e.g., immunotherapy) to help decreasing latex allergy prevalence.
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  • 文章类型: Observational Study
    背景:橡胶促进剂用于橡胶手套的生产,可能会引起接触过敏。
    目的:评估丹麦对橡胶促进剂接触过敏30年的长期趋势和患病率,高风险职业,和曝光。
    方法:分析了1990年至2019年在皮肤和过敏Gentofte医院使用欧洲基线系列(EBS)的橡胶加速器连续贴片测试的所有接触性皮炎患者的数据。Further,从2005年至2019年,怀疑有橡胶促进剂接触过敏的患者还接受了来自专业橡胶系列的橡胶促进剂的斑贴试验,并对这些患者进行了额外提取.
    结果:对来自EBS系列的一种或多种橡胶促进剂的接触过敏的总体患病率为2.7%,在最初的12年内显着下降,其次是过去18年的稳定频率。与职业性接触性皮炎有关,手部皮炎,发现了腿/足皮炎。湿工职业最常受到影响,手套最常暴露。
    结论:对来自EBS的一种或多种橡胶促进剂的接触过敏是常见的,并且几十年来一直没有变化,这就需要预防。
    BACKGROUND: Rubber accelerators are used in the production of rubber gloves and may cause contact allergy.
    OBJECTIVE: To estimate long-term trend and prevalence of contact allergy to rubber accelerators for a 30-year period in Denmark, high-risk occupations, and exposures.
    METHODS: Data from all patients with contact dermatitis consecutively patch tested at the department of Skin and Allergy Gentofte hospital with the rubber accelerators from the European baseline series (EBS) from 1990 to 2019, were analysed. Further, patients under suspicion of rubber accelerator contact allergy were additionally patch-tested with rubber accelerators from the specialised rubber series from 2005 to 2019 and these were additional extracted.
    RESULTS: The overall prevalence of contact allergy to one or more of the rubber accelerators from the EBS series was 2.7% with a significant decline in the first 12-years, followed by a stable frequency in the past 18-years. Associations with occupational contact dermatitis, hand dermatitis, and leg/foot dermatitis were found. Wet-work occupations were most often affected and gloves the most frequent exposure.
    CONCLUSIONS: Contact allergy to one or more of the rubber accelerators from the EBS is frequent and has been unchanged for several decades, which calls for prevention.
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  • 文章类型: Journal Article
    乳胶过敏是对用于制造乳胶产品的天然橡胶乳胶(NRL)蛋白或橡胶化学品的超敏反应。准确的诊断是有效管理乳胶过敏患者的第一步,尤其是高危人群,例如医护人员和受脊柱裂影响的人。诊断基于临床病史和准确的变态反应学评估。在I型IgE介导的超敏反应的情况下,可以表现为荨麻疹,血管性水肿,鼻结膜炎,乳胶暴露后的哮喘和过敏反应,可以进行皮肤点刺试验或使用血清学测定的乳胶特异性IgE(sIgE)抗体检测以确认致敏。相反,在接触性皮肤病的情况下,斑贴试验可用于确认IV型T细胞介导的对橡胶促进剂或添加剂的超敏感性反应的存在。如果临床病史与体内和体外试验结果不一致,可进行嗜碱性粒细胞活化试验或攻击试验。这篇综述的目的是分析乳胶过敏诊断技术的现状和临床实践中采用的算法以及该领域未来可能的发展。
    Latex allergy is a hypersensitivity response to natural rubber latex (NRL) proteins or rubber chemicals used in the manufacture of latex products. An accurate diagnosis is the first step in the effective management of individuals with latex allergy, especially in high-risk groups, such as healthcare workers and those affected by spina bifida. Diagnosis is based on the clinical history and an accurate allergological evaluation. In the case of type I IgE-mediated hypersensitivity reactions, which can manifest urticaria, angioedema, rhinoconjunctivitis, asthma and anaphylaxis after latex exposure, skin prick tests or latex-specific IgE (sIgE) antibody detection using serological assays can be performed to confirm sensitization. Instead, in the case of contact dermatitis, a patch test can be applied to confirm the presence of a type IV T cell-mediated hypersensitivity reaction to rubber accelerators or additives. Basophils activation tests or challenge tests may be performed if there\'s an incongruity between the clinical history and the results of in vivo and in vitro tests. The aim of this review is to analyze the current state of the art of diagnostic techniques for latex allergy and algorithms employed in clinical practice and possible future developments in this field.
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  • 文章类型: Journal Article
    牙医应该接受治疗牙科诊所任何过敏反应的培训,在这种情况下,说明了对乳胶基产品(橡胶坝)的过敏反应。识别与乳胶过敏相关的体征和症状至关重要,所有牙医都应接受适当管理此类患者的培训。该方案的牙科管理描述了成人和儿童牙科诊所中乳胶相关过敏的诊断和管理的细节。
    Dentists should be trained to treat any allergic reaction in a dental office, and in this scenario, allergic reaction to latex-based product (rubber dam) is illustrated. Identification of signs and symptoms related to latex allergies is vital, and all dentists should be trained in the appropriate management of such a patient. The dental management of the scenario describes details of the diagnosis and management of latex-related allergies in a dental office for both adults and children.
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  • 文章类型: Journal Article
    目的:本研究旨在调查生产基于橡胶的车辆密封件的工作场所中乳胶敏感性的患病率。
    方法:血清乳胶特异性IgE水平,呼吸不适,PFT,血清白细胞介素(IL)-4,IL-5,IL-8,IL-10,IL-13水平的所有男性工人(n=108)在工作场所暴露于乳胶,生产橡胶密封件,与对照组(n=52)进行比较。
    结果:工人和对照组的乳胶特异性IgE>0.10kU/L的比率分别为12.3%和4.1%,分别(p=0.147)。乳胶特异性IgE阳性和阴性参与者之间的IL-4,IL-5,IL-10和IL-13水平没有差异。
    结论:使用橡胶作为原料的工人的胶乳敏感性高于对照组,但没有统计学意义。
    To present study aimed to investigate the prevalence of latex sensitivity in a workplace that produced rubber-based vehicle seals.
    The serum latex-specific IgE levels, respiratory complaints, PFT, serum interleukin (IL)-4, IL-5, IL-8, IL-10, IL-13 levels of all male workers (n = 108) exposed to latex in the workplace, which produced rubber seals, were compared with the control group (n = 52).
    The rates of latex-specific IgE >0.10 kU/L in the workers and control group were 12.3% and 4.1%, respectively ( P = 0.147). There was no difference in IL-4, IL-5, IL-10, and IL-13 levels between latex-specific IgE-positive, and -negative participants.
    Latex sensitivity was higher in workers who used rubber as a raw material than in the control group but it was not statistically significant.
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  • 文章类型: Journal Article
    Central venous catheters (CVCs) and pulmonary artery catheters (PACs) containing chlorhexidine, silver sulfadiazine, or latex can cause perioperative anaphylaxis. We examined the incidence of and outcomes associated with anaphylaxis caused by CVCs/PACs.
    In a historical cohort study, we retrospectively identified adult patients fitted with CVCs/PACs at the Mayo Clinics in Minnesota, Arizona, and Florida from 1 January 2008 to 1 March 2018. Potential and confirmed cases of perioperative anaphylactic reactions were individually reviewed and classified.
    During the study period, 39,505 procedures were performed during which CVCs/PACs were inserted. Of these, 2,937 patients with pre-existing chlorhexidine, sulfonamide (sulfa), and/or latex allergies had CVCs/PACs inserted that contained these substances. Perioperative anaphylaxis, in which CVCs/PACs were the confirmed or potential causative agent, occurred during 53 procedures. Seven patients had a preoperatively reported sulfa or latex allergy; no patients had a preoperative chlorhexidine allergy. Six of the seven patients with reported allergies to sulfa or latex had a CVC/PAC inserted that contained these substances. Twenty-four patients with anaphylaxis had postoperative allergic disease consultation; ten of these (42%) underwent skin testing.
    Perioperative anaphylactic reactions related to CVCs/PACs containing chlorhexidine, silver sulfadiazine, or latex were rare in this large historical cohort study. We identified 2,937 patients with pre-existing chlorhexidine, sulfa, and/or latex allergies and had CVCs/PACs inserted that contained these substances. Although few cases of perioperative anaphylaxis attributable to these substances were observed in patients with corresponding allergies, the potential for substantial complication exists. Providers should be aware of the potential for these hidden exposures.
    RéSUMé: OBJECTIF: Les cathéters veineux centraux (CVC) et les cathéters artériels pulmonaires (CAP) contenant de la chlorhexidine, de la sulfadiazine argentique ou du latex peuvent provoquer une anaphylaxie périopératoire. Nous avons examiné l’incidence et les devenirs associés à l’anaphylaxie causée par les CVC/CAP. MéTHODE: Dans une étude de cohorte historique, nous avons identifié rétrospectivement des patients adultes chez lesquels un CVC/CAP avait été installé aux cliniques Mayo du Minnesota, de l’Arizona et de la Floride du 1er janvier 2008 au 1er mars 2018. Les cas potentiels et confirmés de réactions anaphylactiques périopératoires ont été examinés et classés individuellement. RéSULTATS: Au cours de la période à l’étude, 39 505 interventions ont été réalisées au cours desquelles des CVC/CAP ont été insérés. Parmi celles-ci, des CVC/CAP contenant de la chlorhexidine, des sulfamides et/ou du latex ont été insérés chez 2937 patients présentant des allergies préexistantes à ces substances. Une anaphylaxie périopératoire, dont l’agent causal confirmé ou potentiel était le CVC/CAP, s’est produite dans 53 interventions. Sept patients présentaient une allergie aux sulfamides ou au latex signalée avant l’opération; aucun patient n’a eu d’allergie préopératoire à la chlorhexidine. Un CVC/CAP contenant des sulfamides ou du latex a été inséré chez six des sept patients ayant signalé des allergies à ces substances. Vingt-quatre patients atteints d’anaphylaxie ont eu une consultation postopératoire pour une maladie allergique; dix d’entre eux (42 %) ont subi des tests cutanés. CONCLUSION: Les réactions anaphylactiques périopératoires liées aux CVC/CAP contenant de la chlorhexidine, de la sulfadiazine argentique ou du latex étaient rares dans cette vaste étude de cohorte historique. Nous avons identifié 2937 patients présentant des allergies préexistantes à la chlorhexidine, aux sulfamides et/ou au latex chez lesquels des CVC/CAP contenant ces substances ont été insérés. Bien que peu de cas d’anaphylaxie périopératoire attribuable à ces substances aient été observés chez des patients présentant des allergies correspondantes, il existe un risque de complication importante. Les fournisseurs doivent être conscients du potentiel de ces expositions cachées.
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