JULIANA FOES BIANCHINI GARCIA
Projetos de Pesquisa
Unidades Organizacionais
LIM/60 - Laboratório de Imunologia Clínica e Alergia, Hospital das Clínicas, Faculdade de Medicina
12 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 12
conferenceObject Intradermal test is a relevant biomarker of the outcome of rapid desensitization in penicillin allergy(2017) GARCIA, J. F.; V, M. Aun; MOTTA, A. A.; KALIL, J.; GIAVINA-BIANCHI, P.- Algorithm to guide re-exposure to penicillin in allergic pregnant women with syphilis: Efficacy and safety(2021) GARCIA, Juliana Foes Bianchini; AUN, Marcelo Vivolo; MOTTA, Antonio Abilio; CASTELLS, Mariana; KALIL, Jorge; GIAVINA-BIANCHI, PedroResults: Ninety-one patients were enrolled. Allergy to penicillin was confirmed in 7.69% of pregnant women with syphilis and clinical history of allergy to penicillin; in all cases the diagnosis was made through intradermal testing, which predicted 100% of the breakthrough reactions observed during rapid drug desensitization (p < 0.001). Risk stratification based on the initial clinical reaction and skin testing to guide penicillin re-introduction through drug challenge or desensitization was safe (97.8%) and effective (97.8%). Conclusion: We developed and showed the efficacy and safety of an algorithm to guide reexposure to penicillin in pregnant women with syphilis and labeled as allergic to this drug. Intradermal test is an excellent biomarker in the diagnosis of immediate hypersensitivity reaction to penicillin and to predict breakthrough reaction during rapid drug desensitization. Further studies Background: Gestational syphilis is underdiagnosed and undertreated, leading to stillbirth, prematurity, low birthweight, neonatal death, and congenital syphilis. Most patients who label as allergic to penicillin are misdiagnosed. Objective: To assess the efficacy and safety of an algorithm to guide re-exposure to penicillin in pregnant women with syphilis and reporting allergy to the antibiotic. Methods: We performed a prospective study assessing pregnant women with syphilis and labeled as allergic to penicillin. Based on clinical history, patients were divided in two groups: high risk and low-risk to penicillin allergy. Low-risk patients with negative skin testing and negative serum specific IgE to penicillin underwent drug provocation test. The remaining patients underwent desensitization. Results: Ninety-one patients were enrolled. Allergy to penicillin was confirmed in 7.69% of pregnant women with syphilis and clinical history of allergy to penicillin; in all cases the diagnosis was made through intradermal testing, which predicted 100% of the breakthrough reactions observed during rapid drug desensitization (p < 0.001). Risk stratification based on the initial clinical reaction and skin testing to guide penicillin re-introduction through drug challenge or desensitization was safe (97.8%) and effective (97.8%). Conclusion: We developed and showed the efficacy and safety of an algorithm to guide re exposure to penicillin in pregnant women with syphilis and labeled as allergic to this drug. Intradermal test is an excellent biomarker in the diagnosis of immediate hypersensitivity reaction to penicillin and to predict breakthrough reaction during rapid drug desensitization. Further studies may confirm the greater safety of the intravenous protocol compared to the oral protocol.
- Brazilian Guidelines for Hereditary Angioedema Management-2017 Update Part 1: Definition, Classification and Diagnosis(2018) GIAVINA-BIANCHI, Pedro; ARRUDA, Luisa Karla; AUN, Marcelo V.; CAMPOS, Regis A.; CHONG-NETO, Herberto J.; CONSTANTINO-SILVA, Rosemeire N.; FERNANDES, Fatima R.; FERRARO, Maria F.; FERRIANI, Mariana P. L.; FRANCA, Alfeu T.; FUSARO, Gustavo; GARCIA, Juliana F. B.; KOMNINAKIS, Shirley; MAIA, Luana S. M.; MANSOUR, Eli; MORENO, Adriana S.; MOTTA, Antonio A.; PESQUERO, Joao B.; PORTILHO, Nathalia; ROSARIO, Nelson A.; SERPA, Faradiba S.; SOLE, Dirceu; TAKEJIMA, Priscila; TOLEDO, Eliana; VALLE, Solange O. R.; VERONEZ, Camila L.; GRUMACH, Anete S.Hereditary angioedema is an autosomal dominant disease characterized by recurrent angioedema attacks with the involvement of multiple organs. The disease is unknown to many health professionals and is therefore underdiagnosed. Patients who are not adequately diagnosed and treated have an estimated mortality rate ranging from 25% to 40% due to asphyxiation by laryngeal angioedema. Intestinal angioedema is another important and incapacitating presentation that may be the main or only manifestation during an attack. In this article, a group of experts from the ""Associacao Brasileira de Alergia e Imunologia (ASBAI)'' and the ""Grupo de Estudos Brasileiro em Angioedema Hereditario (GEBRAEH)'' has updated the Brazilian guidelines for the diagnosis and treatment of hereditary angioedema.
- Use of pdC1-INH concentrate for long-term prophylaxis during pregnancy in hereditary angioedema with normal C1-INH(2018) GARCIA, Juliana F. B.; TAKEJIMA, Priscila; VERONEZ, Camila Lopes; AUN, Marcelo V.; MOTTA, Antonio A.; KALIL, Jorge; PESQUERO, Joao Bosco; GIAVINA-BIANCHI, Pedro
conferenceObject Gender influence on hereditary angioedema with C1-inhibitor deficiency(2017) GARCIA, J. F.; TAKEJIMA, P. M.; V, M. Aun; MOTTA, A. A.; KALIL, J.; GIAVINA-BIANCHI, P.bookPart Alergia ao látex(2022) GARCIA, Juliana Fóes Bianchini; GIAVINA-BIANCHI, PedroconferenceObject Gender Influence on Hereditary Angioedema with C1-inhibitor Deficiency(2017) TAKEJIMA, Priscila; GARCIA, Juliana F. B.; AUN, Marcelo V.; KALIL, Jorge; MOTTA, Antonio Abilio; GIAVINA-BIANCHI, PedroconferenceObject Inlterleukin-2 as adjuvant treatment in a patient with idiopathic CD4 lymphocytopenia and disseminated tuberculosis(2016) GARCIA, J. F. B.; KOKRON, C. M.; KALIL, J.; GIAVINA-BIANCHI, P.- Clinical features of hereditary angioedema and warning signs (H4AE) for its identification(2022) GIAVINA-BIANCHI, Pedro; AUN, Marcelo Vivolo; GARCIA, Juliana Foes Bianchini; GOMES, Lais Souza; RIBERIRO, Ana Julia; TAKEJIMA, Priscila; AGONDI, Rosana Camara; KALIL, Jorge; MOTTA, Antonio AbilioObjectives: The study describes a case series of hereditary angioedema with C1 Inhibitor Deficiency (C1INH-HAE) in order to corroborate six clinical warning signs ""HAAAAE (H4AE)"" to enable early identification of this disease. Methods: The authors analyzed the C1INH-HAE cohort to analyze the clinical aspects of the present study's patients and corroborate the six clinical warning signs of the Hereditary Angioedema Brazilian Guidelines. Data regarding demographics, the onset of disease, time to diagnosis, frequency of attacks per year, organs involved, triggers, crisis duration and their outcomes, and disease treatment were collected. Then the authors developed an acronym, H4AE, to help healthcare professionals remember the warning signs. Results: The authors included 98 patients in the study, with a mean age of 38.1 years, 67.3% being female, and 75.3% with a family history of HAE. HAE diagnosis was delayed, on average, 13.7 years after its initial manifestation. Exploratory laparotomy was reported by 26.9%, and orotracheal intubation by 21.3% of the present study's patients; 61.3% and 30.3% of them were admitted at least once in the hospital and in the intensive care unit, respectively. The authors constructed an acronym ""H4AE"" with the six warning signs of HAE: Hereditary, recurrent Angioedema, Abdominal pain, Absence of urticaria, Absence of response to antihistamines, Estrogen association. Conclusion: C1INH-HAE is still underdiagnosed and associated with high morbidity. The study showed clinical features of this disease, corroborating the warning signs, which may be useful in raising awareness and improving the diagnosis of C1INH-HAE. The authors suggest the acronym ""H4AE"" to remind the warning signs.
conferenceObject HAAAAE (H4AE): Warning signs for early identification of hereditary angioedema(2021) PADULLA, G.; AUN, M.; GARCIA, J.; GOMES, L.; RIBEIRO, A. J.; TAKEJIMA, P.; AGONDI, R.; KALIL, J.; MOTTA, A.; GIAVINA-BIANCHI, P.