LAILA SABINO GARRO
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conferenceObject Incidence of Intraoperative Anaphylaxis in A University General Hospital in Brazil(2013) GARRO, Laila Sabino; CARMONA, Maria Jose Carvalho; SOARES, Iracy Silvia Correa; AUN, Marcelo Vivolo; RIBEIRO, Marisa Rosimeire; RODRIGUES, Adriana Teixeira; KALIL, Jorge; GIAVINA-BIANCHI, Pedro; MOTTA, Antonio AbilioRATIONALE: The epidemiology of intraoperative anaphylaxis is un-known in Brazil. We aimed to evaluate the incidence and clinical features of anaphylaxis during anesthesia in a University General Hospital in Sao Paulo, Brazil. METHODS: A cross-sectional, observational study analyzing data fromvoluntary notification sent by anesthesiologists, about occurrence of intraoperative anaphylaxis during the period between January and December 2010. The diagnostic criteria for anaphylaxis were based onthe World Allergy Organization Guidelines. We analyzed the incidence of intraoperative anaphylaxis, clinical features, severity of anaphylaxis, types of surgical procedures, classification of anesthetic risk (American Society of Anesthesiologists - ASA), culprit agent cited by the anesthesiologist and type of treatment provided. RESULTS: The incidence of intraoperative anaphylaxis was 69:10.000 surgeries. The mean age of patients with anaphylaxis was 36.7 years-old and 57% were women. The most common procedures associated with anaphylaxis were the abdominal non-vascular (17.1%) and urologic (17.1%) surgeries. Skin symptoms were the most prevalent (85.7%) and all patients who presented cardiovascular shock were classified as ASA II (42.9%) or ASA III (57.1%). Epinephrine was used preferentially in anaphylaxis grade 3 (72.7%), while a few patients with anaphylaxis grades 1 and 2 took the drug (2.1% and 16.7, respectively). The most commonly etiologic drugs cited by the anesthesiologists were the neuromuscular blocking agents (22.9%). CONCLUSIONS: Our incidence of intraoperative anaphylaxis was higher than in other studies reported in the literature. These data are a warning signal to encourage measures to reduce the incidence of these severe reactions.conferenceObject Clinical SCORE for screening of latex allergy(2013) GIAVINA-BIANCHI, P.; GARRO, L. S.; PELUZO, F.; KALIL, J.; MOTTA, A. A.conferenceObject High Rate of Food Sensitization, but Not Food Allergy, in Latex Allergy(2013) GIAVINA-BIANCHI, Pedro; GARRO, Laila Sabino; KALIL, Jorge; MOTTA, Antonio AbilioRationale: Food allergy due to cross-reactivity is one of the clinical manifestations of latex allergy, known as latex-fruit syndrome. The study analyze the rate of food sensitization and alergy in patients with latex allergy. Methods: An observational cross-sectional study with 220 children and adolescents with myelomeningocele. Patients with their family answered a questionnaire and had a blood sample collected. We selected all patients with the confirmed diagnosis of latex allergy, and therein we analyze sensitization and allergy due to allergens of plant origin. The detection of specific serum IgE was carried out by FEIA and Microarray. Results: Although 19.6% of allergic patients to latex presented anaphylaxis, we did not observed clinical reactions triggered by food. The overall rate of sensitization to foods was 43%. FEIA and Microarray positivity for serum specific IgE to food was 50% and 21%, respectively. Conclusions: Patients with latex allergy presented a high rate of sensitization to food, but did not present clinical reactions. FEIA was more sensitive for detection of food-specific serum IgE, but microarray was able to increase the diagnosis of food sensitization.conferenceObject Acetaminophen Hypersensitivity: Myth or Reality(2013) BITTAR, Renata P.; AUN, Marcelo; GARRO, Laila Sabino; RIBEIRO, Marisa Rosimeire; KALIL, Jorge; GIAVINA-BIANCHI, Pedro; MOTTA, Antonio AbilioRationale: Acetaminophen is considered safe for patients with hypersensitivity to non-steroidal anti-inflammatory drugs (NSAIDs). However, some patients also report reaction to paracetamol. We evaluated outcomes and safety of drug provocation tests (DPT) with paracetamol in patients who reported adverse reactions both to NSAIDs and acetaminophen. Methods: Retrospective observational study by analyzing the results of DPT with acetaminophen 500mg per dose, performed from January 2005 to July 2012. We evaluated patients who reported acute reactions (less than 24 hours after taking the medication) due to NSAIDs. Only patients who presented urticaria, angioedema or anaphylaxis after taking two or more NSAIDs from different groups were included. All of them reported the same symptoms after taking paracetamol. Results: We evaluated 86 patients submitted to DPT with acetaminophen. The mean age was 36.7 years and 73.2% were female. We found 7 positive challenges (8.1%), all with immediate symptoms. Six patients presented mild urticaria, one of them associated to eyelid angioedema. One patient had pruritus and mild facial angioedema. All of them were successfully treated with oral antihistamines and corticosteroids and none had to be hospitalized. Conclusions: These data confirm the hypothesis that acetaminophen 500mg is a safe therapeutic option in NSAIDs reactors, even if they report a previous reaction to that drug. We believe some of these patients have doubt about the right drug and dose involved in the reactions. Thus patients who report previous reaction both to NSAIDs and paracetamol, the first acetaminophen dose should be supervised and not exceed 500mg.conferenceObject Associated factors with sensitisation and allergy to latex(2013) GIAVINA-BIANCHI, P.; GARRO, L. S.; PELUZO, F.; KALIL, J.; MOTTA, A. A.