P.-M. Mertes, J.-M. Malinovsky, F. Alla, D. Studnicska, P. Tréchot, M.-C. Laxenaire, les membres du Gerap
{"title":"Épidémiologie des réactions d’hypersensibilité immédiates peranesthésiques chez l’adulte et l’enfant","authors":"P.-M. Mertes, J.-M. Malinovsky, F. Alla, D. Studnicska, P. Tréchot, M.-C. Laxenaire, les membres du Gerap","doi":"10.1016/j.allerg.2008.01.031","DOIUrl":"10.1016/j.allerg.2008.01.031","url":null,"abstract":"<div><p>Immediate hypersensitivity reactions occurring during anaesthesia, whether IgE-mediated or non IgE-mediated, remain a major cause of concern. The authors report results from an eight-year survey conducted by the GERAP. From 1 January 1997 to 31 December 2004, 2516 patients who had experienced an immediate hypersensitivity reaction were included in this survey. A non-IgE mediated reaction was diagnosed in 700 cases (27.82%) and an IgE mediated reaction in 1816 cases (72.18%). The most common causes were neuromuscular blocking agents (<em>n</em> <!-->=<!--> <!-->1067, 58.08%), latex (<em>n</em> <!-->=<!--> <!-->361, 19.65%) and antibiotics (<em>n</em> <!-->=<!--> <!-->236, 12.85%). The results were significantly different in children: latex was incriminated in more than 50% of the cases, followed by neuromuscular blocking agents (39%) and antibiotics (10.2%). The data showed a female predominance in adults but not in children, whatever the mechanism of the reaction. These results emphasize the need for systematic screening in case of an immediate hypersensitivity reaction during anaesthesia and for the development of centres specializing in perioperative allergies capable of providing expert advice to anaesthesiologists and allergists.</p></div>","PeriodicalId":92953,"journal":{"name":"Revue francaise d'allergologie et d'immunologie clinique","volume":"48 3","pages":"Pages 217-221"},"PeriodicalIF":0.0,"publicationDate":"2008-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.allerg.2008.01.031","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87717484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Faut-il agir sur l’environnement pour la prévention primaire et tertiaire des maladies allergiques ?","authors":"F. de Blay, M. Ott, M. Posa","doi":"10.1016/j.allerg.2008.02.013","DOIUrl":"10.1016/j.allerg.2008.02.013","url":null,"abstract":"<div><p>Primary and tertiary prevention of childhood allergies and asthma has progressed. It appears ever more certain that avoidance, whether primary or tertiary, should be global to be effective in the prevention of asthma. That is why it seems useful that medical home environment councilors (CMEI) who have the necessary time should audit the quality of the indoor air and give advice on the widest possible avoidance measures (including other household pollutants that may aggravate allergic asthma). With an environmental disease such as asthma, control of the environment is a therapeutic approach that should be offered to children with allergic asthma.</p></div>","PeriodicalId":92953,"journal":{"name":"Revue francaise d'allergologie et d'immunologie clinique","volume":"48 3","pages":"Pages 130-134"},"PeriodicalIF":0.0,"publicationDate":"2008-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.allerg.2008.02.013","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75411662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
D. Caillaud , H. Sarter , M. Thibaudon , J. Lecadet , A. Zeghnoun , M.C. Delmas , C. Fuhrman
{"title":"Exposition aux pollens et consommation de médicaments antiallergiques","authors":"D. Caillaud , H. Sarter , M. Thibaudon , J. Lecadet , A. Zeghnoun , M.C. Delmas , C. Fuhrman","doi":"10.1016/j.allerg.2008.01.023","DOIUrl":"10.1016/j.allerg.2008.01.023","url":null,"abstract":"<div><p>The aim of the present study was to analyze the short-term relationship between pollen exposure and antiallergic drug consumption in the general population, taking into account confounding factors such as atmospheric pollution and meteorological parameters. Data on the daily consumption of antiallergic drug by individuals in the Clermont-Ferrand urban area from January 1 2000 through December 31 2001 and from January 1 2002 through December 31 2003, was obtained from the French health insurance database. An episode of allergic rhinoconjunctivitis (ARC) was defined as the association of an oral antihistamine and a local-acting antiallergic drug on the same prescription. The relationship between daily changes in atmospheric pollen concentration and daily changes in the number of treated ARC cases was analyzed using time series analysis. The results showed that the risk of treated ARC increased significantly with an interquartile increase in pollen concentration for grasses (5%, <em>P</em> <!--><<!--> <!-->0.001), hazel (7%, <em>P</em> <!--><<!--> <!-->0.02), birch (7%, <em>P</em> <!--><<!--> <!-->0.001) and ash (2%, <em>P</em> <!--><<!--> <!-->0.001). The effect was significant on the same day for all except the grasses, for which the risk lasted three days. Time series studies of antiallergic drug consumption may be useful for assessing the risk of exposure to pollens in an ambulatory population.</p></div>","PeriodicalId":92953,"journal":{"name":"Revue francaise d'allergologie et d'immunologie clinique","volume":"48 3","pages":"Pages 187-191"},"PeriodicalIF":0.0,"publicationDate":"2008-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.allerg.2008.01.023","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86086728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Can any protein become an allergen?","authors":"H. Breiteneder","doi":"10.1016/j.allerg.2008.02.001","DOIUrl":"10.1016/j.allerg.2008.02.001","url":null,"abstract":"<div><p>Allergens of plant and animal foods and pollen belong to a highly restricted number of protein families. The AllFam Database (<span>http://www.meduniwien.ac.at/allergens/allfam/</span><svg><path></path></svg>) provides regularly updated lists of protein families that contain allergens. At present, 2% of the 9318 protein families defined by the Pfam Database (<span>http://pfam.sanger.ac.uk/</span><svg><path></path></svg>) contain allergens. Related protein families can be grouped into superfamilies placing allergenic proteins in an evolutionary context. With the exception of the prolamin superfamily, allergenic plant proteins are found in few member families of their respective superfamilies. This might indicate that allergenicity emerged rather infrequently in a very limited number of protein families. Moreover, most members of a given protein family seem to be non-allergenic. In contrast to plant allergens, the allergenicity of animal food allergens seems to be dependent on the degree of identity to a human homologue. The closer a potential animal allergen is to a human protein, the less likely it is to act as allergen.</p></div>","PeriodicalId":92953,"journal":{"name":"Revue francaise d'allergologie et d'immunologie clinique","volume":"48 3","pages":"Pages 135-138"},"PeriodicalIF":0.0,"publicationDate":"2008-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.allerg.2008.02.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75802985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Toxidermies aux médicaments du xxie siècle","authors":"M.-S. Doutre","doi":"10.1016/j.allerg.2008.01.032","DOIUrl":"10.1016/j.allerg.2008.01.032","url":null,"abstract":"<div><p>New drugs, especially biotherapies, are increasingly used for a rapidly expanding number of inflammatory and neoplastic diseases. Among these treatments, cytokines, monoclonal antibodies, anti-TNF, inhibitors of tyrosine kinase, inhibitors of epidermal growth factors receptors can induce adverse cutaneous effects. These patients need early and appropriate dermatological management. Other new drugs, such as voriconazole, lamotrigine, bupropion… are also a possible cause of skin reactions.</p></div>","PeriodicalId":92953,"journal":{"name":"Revue francaise d'allergologie et d'immunologie clinique","volume":"48 3","pages":"Pages 227-231"},"PeriodicalIF":0.0,"publicationDate":"2008-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.allerg.2008.01.032","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77284958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Les angiœdème héréditaires de type III : nouvelle maladie ou nouveau diagnostic ?","authors":"L. Bouillet","doi":"10.1016/j.allerg.2008.01.001","DOIUrl":"10.1016/j.allerg.2008.01.001","url":null,"abstract":"<div><p>Type III hereditary angiœdema (HAE) presents the same symptoms as type I and type II ones, which are associated with C1Inh deficiency. Women are principally affected. First symptoms often appear during pregnancies or with women taking combined pills. C1Inh and C4 assays are normal. Some of type III HAE can be associated with mutations of the Hageman factor gene. Type III HAE diagnosis is difficult. Kininogenase activity assay and the Hageman factor gene analysis will help us in the future. Treatment strategy is not known: tranexamic acid could be used. Also, C1Inh concentrate could be administrated for laryngeal attacks.</p></div>","PeriodicalId":92953,"journal":{"name":"Revue francaise d'allergologie et d'immunologie clinique","volume":"48 3","pages":"Pages 155-158"},"PeriodicalIF":0.0,"publicationDate":"2008-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.allerg.2008.01.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89527437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J.-M. Malinovsky , P.-M. Mertes , D. Studnicska , F. Lavaud
{"title":"Comment réduire les risque d’anaphylaxie au cours de l’anesthésie","authors":"J.-M. Malinovsky , P.-M. Mertes , D. Studnicska , F. Lavaud","doi":"10.1016/j.allerg.2008.01.027","DOIUrl":"10.1016/j.allerg.2008.01.027","url":null,"abstract":"<div><p>Perioperative allergic reactions occurring during anaesthesia are a potentially life-threatening complication. Perioperative screening for risk factors, primary prevention for latex allergy and secondary prevention for allergy to anaesthetic agents and antibiotics should result in a reduction of the incidence of this complication. The anaesthesia technique chosen should be regional when this is compatible with the surgery and the least active histamine liberators should be used when general anesthesia is necessary. To make the diagnosis of this complication during the anesthesia and then to refer the patient to an allergy consultation centre are essential for identification of the responsible agent and to prevent its being used subsequently. In spite of preoperative screening, the incidence of allergic reactions to latex remains significant. The use of latex-free medical and surgical equipment decreases this risk and it should be an institution-wide measure.</p></div>","PeriodicalId":92953,"journal":{"name":"Revue francaise d'allergologie et d'immunologie clinique","volume":"48 3","pages":"Pages 222-226"},"PeriodicalIF":0.0,"publicationDate":"2008-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.allerg.2008.01.027","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90607603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Formation initiale en allergologie dans les pays francophones : expérience marocaine","authors":"A. Alaoui Yazidi","doi":"10.1016/j.allerg.2008.01.009","DOIUrl":"10.1016/j.allerg.2008.01.009","url":null,"abstract":"<div><p>Training in allergy exists in Moroccan medical schools, but it does not have the place that it should if we take into account the increased frequency of allergic diseases in Morocco (and elsewhere) and the increase in the demand for care that results. In our country, allergy is not recognized officially as a specialty and allergic patients are cared for either by pulmonary specialists or physicians with some training in allergy, or by generalists with a French medical school diploma or with an allergy diploma. There is no explicit allergy training program in the medical schools, but instead there are sessions on allergy presented in the different medical specialities from the second to the fifth years, in which immunology, asthma, eczema and urticaria, nasosinusoidal allergies, conjunctivitis and anaphylactic shock are considered. The amount of time devoted to teaching allergy does not exceed 30<!--> <!-->h (which is 1.4% of the entire curriculum). During classes in the third cycle, allergy is not clearly separated from other subjects; only the pneumology–pthisiology specialist course includes in-hospital training in allergy. Instruction is very limited in the other specialities. Moroccan medical specialists have the possibility to learn allergy on their own by enrolling in a university course in allergy and clinical immunology that is sponsored by the Department of Pulmonary Diseases in Casablanca. In regard to continued medical education, this can be done under the aegis of specialist scientific societies and associations. In conclusion, the teaching of allergy includes only an introduction but the number of hours devoted to this subject remains limited and it is time to think about the allergy course of the future. This teaching remains underrepresented in the third cycle which is devoted to clinical practice. This speciality must be developed, and it is now time to ask whether it should not be recognized officially.</p></div>","PeriodicalId":92953,"journal":{"name":"Revue francaise d'allergologie et d'immunologie clinique","volume":"48 3","pages":"Pages 162-165"},"PeriodicalIF":0.0,"publicationDate":"2008-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.allerg.2008.01.009","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84632214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Le plan d’action personnalisé écrit (P.A.P.E.)","authors":"L. Réfabert","doi":"10.1016/j.allerg.2008.01.019","DOIUrl":"10.1016/j.allerg.2008.01.019","url":null,"abstract":"<div><p>All asthma consensus statements recommend the use of a written action plan. Patients tend to have a positive perception regarding the use of action plans for asthma. They find that action plans are useful for the management of their asthma. Nevertheless, an action plan should not be viewed as the only element in self-management strategy. It is usually part of a multifaceted intervention, including therapeutic education sessions, medical review and prescription of medications. A recent meta-analysis reported a positive effect of the use of written action plans. It is agreed that a written action plan should be tailored to each individual patient and to the type and severity of his asthma. Still, the precise elements of action plans that are responsible for their benefit have not yet been clearly identified. However, considering the different action plans that have been published, it would appear reasonable to build on prior experience and adopt a three-step approach, such as a sequence of stoplight colours, as a means to compare one action plan with others.</p></div>","PeriodicalId":92953,"journal":{"name":"Revue francaise d'allergologie et d'immunologie clinique","volume":"48 3","pages":"Pages 232-236"},"PeriodicalIF":0.0,"publicationDate":"2008-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.allerg.2008.01.019","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90526845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"La rhinite allergique au latex : du diagnostic à la prise en charge","authors":"J.-J. Braun , F. de Blay","doi":"10.1016/j.allerg.2008.01.026","DOIUrl":"10.1016/j.allerg.2008.01.026","url":null,"abstract":"<div><p>In spite of numerous publications on occupational lung diseases, latex allergy, and the relationship of nose-to-bronchi, the particularities of the clinical, epidemiological and therapeutic aspects of latex allergic rhinitis (LAR) are very little considered in the literature. Based on our own experience and on a review of the literature, we will examine the environmental context of LAR and try to define its most important diagnostic and therapeutic criteria. An early diagnosis of LAR and reduction of exposure to latex allergens before its evolution to asthma, can limit the socioeconomic impact of this condition.</p></div>","PeriodicalId":92953,"journal":{"name":"Revue francaise d'allergologie et d'immunologie clinique","volume":"48 3","pages":"Pages 237-241"},"PeriodicalIF":0.0,"publicationDate":"2008-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.allerg.2008.01.026","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85669840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}