LAILA SABINO GARRO

(Fonte: Lattes)
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  • article 1 Citação(ões) na Scopus
    Specific questionnaire detects a high incidence of intra-operative hypersensitivity reactions
    (2018) GARRO, Laila S.; V, Marcelo Aun; SOARES, Iracy Silvia C.; RIBEIRO, Marisa R.; MOTTA, Antonio A.; KALIL, Jorge; CASTELLS, Mariana C.; CARMONA, Maria Jose C.; GIAVINA-BIANCHI, Pedro
    OBJECTIVE: To assess the incidence of intra-operative immediate hypersensitivity reactions and anaphylaxis. METHODS: A cross-sectional observational study was conducted at the Department of Anesthesiology, University of Sao Paulo School of Medicine, Hospital das Clinicas, Sao Paulo, Brazil, from January to December 2010. We developed a specific questionnaire to be completed by anesthesiologists. This tool included questions about hypersensitivity reactions during anesthesia and provided treatments. We included patients with clinical signs compatible with immediate hypersensitivity reactions. Hhypersensitivity reactions were categorized according to severity (grades I-V). American Society of Anesthesiologists physical status classification (ASA 1-6) was analyzed and associated with the severity of hypersensitivity reactions. RESULTS: In 2010, 21,464 surgeries were performed under general anesthesia. Anesthesiologists answered questionnaires on 5,414 procedures (25.2%). Sixty cases of intra-operative hypersensitivity reactions were reported. The majority patients (45, 75%) had hypersensitivity reactions grade I reactions (incidence of 27.9:10,000). Fifteen patients (25%) had grade II, III or IV reactions (intra-operative anaphylaxis) (incidence of 7:10,000). No patients had grade V reactions. Thirty patients (50%) were classified as ASA 1. The frequency of cardiovascular shock was higher in patients classified as ASA 3 than in patients classified as ASA 1 or ASA 2. Epinephrine was administered in 20% of patients with grade III hypersensitivity reactions and in 50% of patients with grade II hypersensitivity reactions. CONCLUSIONS: The majority of patients had hypersensitivity reactions grade I reactions; however, the incidence of intra-operative anaphylaxis was higher than that previously reported in the literature. Patients with ASA 3 had more severe anaphylaxis; however, the use of epinephrine was not prescribed in all of these cases. Allergists and anesthesiologists should implement preventive measures to reduce the occurrence of anaphylaxis.
  • article 3 Citação(ões) na Scopus
    Anafilaxia perioperatória: A experiência brasileira
    (2016) AUN, Marcelo Vivolo; GARRO, Laila Sabino; RIBEIRO, Marisa Rosimeire; MOTTA, Antônio Abílio; KALIL, Jorge; GIAVINA-BIANCHI, Pedro
    Perioperative anaphylaxis is a rare hypersensitivity reaction, but it has a rapid onset and is potentially fatal. The true incidence is not well known and varies in accordance with the country from 1:1 250 to 1:13 000 surgeries. It may occur through an allergic (IgE-mediated or not) or non-allergic mechanism, but it is believed that the IgE-mediated reactions are the most common and severe. Any product or drug used in the procedure has the potential to be the cause of a reaction, but neuromuscular blocking agents are the most frequently reported, followed by latex and antibiotics. In this mini-review we discuss some key points of the management of these patients and w present Brazilian data, which suggest that an active search for cases by working together with anesthesiologists could lead to an increase in diagnosis and, therefore, better prevention of future reactions
  • article 103 Citação(ões) na Scopus
    Nonsteroidal Anti-Inflammatory Drugs are Major Causes of Drug-Induced Anaphylaxis
    (2014) AUN, Marcelo Vivolo; BLANCA, Miguel; GARRO, Laila Sabino; RIBEIRO, Marisa Rosimeire; KALIL, Jorge; MOTTA, Antonio Abilio; CASTELLS, Mariana; GIAVINA-BIANCHI, Pedro
    BACKGROUND: Drugs are responsible for 40% to 60% of anaphylactic reactions treated in the emergency department. A global research agenda to address uncertainties in anaphylaxis includes studies that identify factors associated with morbidity and mortality. OBJECTIVE: The present study investigated drug-induced anaphylaxis, etiologies, aggravating factors, and treatment. METHODS: A total of 806 patients with adverse drug reactions were screened, and those who had a clinical diagnosis of anaphylaxis were included in the study. Clinical and demographic characteristics of anaphylaxis were described, including etiologies, pathophysiologic mechanisms involved in the reactions, and a personal history of atopy and asthma. Factors associated with disease severity also were identified. RESULTS: Anaphylaxis was diagnosed in 117 patients (14.5%). The etiologies were defined in 76% of the cases, nonsteroidal anti-inflammatory drugs being the most frequent. Seventy-eight patients (66.7%) reported a previous reaction to the drug involved in the current reaction or to a drug from the same class and/or group. Epinephrine was used to treat 34.2% of patients who presented with anaphylaxis, and 40.8% of those with anaphylactic reactions with cardiovascular involvement. IgE-mediated reactions were associated with greater severity, manifested by the rates of cardiovascular dysfunction, hospitalization, and use of epinephrine. CONCLUSIONS: The prevalence of anaphylaxis is high in patients who seek medical assistance for drug reactions, but its diagnosis is missed in emergency services, and adrenaline is underused. Drugs were prescribed to many patients despite a history of previous reaction. Nonsteroidal anti-inflammatory drugs were implicated in most cases of anaphylaxis induced by drugs, and IgE-mediated reactions were less frequent but more severe. (C) 2014 American Academy of Allergy, Asthma & Immunology