MARCELO VIVOLO AUN
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/60 - Laboratório de Imunologia Clínica e Alergia, Hospital das Clínicas, Faculdade de Medicina
LIM/60 - Laboratório de Imunologia Clínica e Alergia, Hospital das Clínicas, Faculdade de Medicina
15 resultados
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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.conferenceObject Case report of severe anaphylaxis induced by morphine and tramadol(2018) BRUGNOLLI, R. M.; PEREIRA, A. R. F.; KALIL, J.; MOTTA, A. A.; V, M. Aun; GIAVINA-BIANCHI, P.- Spirometric values in elderly asthmatic patients are not influenced by obesity(2012) AGONDI, R. C.; BISACCIONI, C.; AUN, M. V.; RIBEIRO, M. R.; KALIL, J.; GIAVINA-BIANCHI, P.Background Studies have suggested that asthma in obese individuals differs from the classic asthma phenotype, presenting as a disease that is more difficult to control. Objective The objective of the present study was to determine whether obesity, age or a combination of the two are associated with worse spirometry parameters in patients with asthma. Methods This was an observational cross-sectional study involving patients over 18 years of age who had been diagnosed with asthma (allergic or nonallergic). We evaluated the results of their spirometric tests. The patients were classified in accordance with two criteria: body mass index (BMI) and age. Based on their BMIs, the patients were divided into three groups: normal weight, overweight and obese. Patients were also separated into two categories by age: 18-59 years of age; and >= 60 years of age. Results We evaluated 451 patients with asthma and their spirometry tests. In the present study, the pulmonary function parameters were negatively correlated with BMI and age (P < 0.05). We found that there was a statistically significant correlation between spirometric values and BMI among patients 18-59 years of age (P < 0.001), however, among patients over 60, we did not observe this negative association. Conclusions and Clinical Relevance The spirometric values decreased significantly in proportion to the increase of BMI and age in patients with asthma, especially among young adults. There was no negative correlation between BMI and FEV1 in the group >= 60 years of age, suggesting that perhaps the time of disease is a major factor in the loss of lung function than weight gain in the elderly.
- Is age associated with the development of antibodies against botulinum toxin?(2013) AUN, M. V.; CHUNG, T. M.; SANTOS, K. S.; BATTISTELLA, L. M. R.; RIZZO, L. V.; KALIL, J.; GIAVINA-BIANCHI, P.
conferenceObject Sensitisation by subcutaneous route is superior to intraperitoneal route in the induction of asthma by house dust mite in a murine model(2013) V, M. Aun; SARAIVA-ROMANHOLO, B. M.; ARANTES-COSTA, F. M.; ALMEIDA, F. M.; MARTINS, M. A.; KALIL, J.; GIAVINA-BIANCHI, P.conferenceObject Perioperative Anaphylaxis: Clinical Features of 51 Patients(2012) GARRO, L. S.; RODRIGUES, A. T.; RIBEIRO, M. R.; AUN, M. V.; KALIL, J.; MOTTA, A. A.; GIAVINA-BIANCHI, P.Rationale: Perioperative anaphylaxis is an important and life-threatening adverse reaction in clinical practice. We aimed to evaluate the prevalence and the etiology of perioperative anaphylaxis referred to an outpatient clinic specialized in adverse drug reactions (ADRs). Methods: We evaluated 806 patients with history of ADRs through the questionnaire “European Network for Drug Allergy” (ENDA) from October 2006 to June 2011. Patients with a history of perioperative anaphylaxis were selected. The diagnostic criteria for anaphylaxis were based on the World Allergy Organization Guidelines. Etiological investigation was made with skin tests for latex, neuromuscular blockers (NMBs), antibiotics, hypnotics, opioids and local anesthetics. Drug provocation tests (DPTs) for antibiotics, NSAIDs, local anesthetics and latex were also performed. Serum specific IgE was tested for antibiotics (Penicillin, Ampicillin and Amoxicillin) and latex. Results: We identified 51 (6%) patients with a history of perioperative anaphylaxis. Among them, 16 patients (31%) had hypersensitivity reactions with positive cutaneous test, 14 patients (27%) abandoned the investigation and 8 patients (16%) completed the investigation with all tests being negative. Currently 12 patients (23%) are still under investigation. The main cause of perioperative anaphylaxis was latex allergy (22%), followed by NMBs hypersensitivity (6%). Three patients had positive tests for two different agents. Conclusions: Latex allergy was the main cause of perioperative anaphylaxis in this study. The importance of testing all the possible agents involved was demonstrated by the occurrence of three cases with positive test for two agents.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.conferenceObject Is Severity Of Drug Induced Anaphylaxis Dependent Of Its Etiology?(2012) AUN, M. V.; RODRIGUES, A. T.; RIBEIRO, M. R.; GARRO, L. S.; KALIL, J.; MOTTA, A. A.; GIAVINA-BIANCHI, P.Rationale: Adverse drug reactions (ADR) are common in clinical practice. Drug induced anaphylaxis is severe and responsible for most of deaths due to ADRs, although its prevalence is unknown. We describe a sample of drug induced anaphylaxis and analyze their etiology, severity and the use of epinephrine. Methods: Retrospective cohort of patients with history of ADRs who had answered a standardized questionnaire. We included patients with a diagnosis of anaphylaxis through international diagnostic criteria. We evaluated gender and age variables, the causative agent, clinical features, frequency of anaphylactic shock and the use of epinephrine in the treatment. Results: We evaluated 806 patients, of whom 122 (15.1%) met the criteria of anaphylaxis. The average age was 38.9 years and 81.9% were female. The probable etiology was defined in 88 patients (72.1%), and nonsteroidal anti-inflammatory drugs (NSAIDs) were involved in 67%, followed by latex, local anaesthetics and antibiotics. Epinephrine was used in 33.6% of reactions. There has been hypotension and/or shock in 31.1%. Anaphylactic shock accounted for 60% of latex anaphylaxis, 50% of those due to antibiotics and 22.4% of NSAIDs induced anaphylaxis. Conclusions: The number of drug induced anaphylaxis is high, although the diagnosis of anaphylaxis is neglected and epinephrine is underutilized. NSAIDs were the drugs most commonly implicated, but antibiotics were not as involved as previously described. Latex was an important agent in perioperative anaphylaxis. Cases of anaphylactic shock were associated to IgE-mediated hypersensitivity mechanism, as we observed in latex and antibiotics allergies.- In Vitro Diagnosis of Anaphylaxis: an Update(2020) AGONDI, R.C.; KALIL, J.; GIAVINA-BIANCHI, P.; AUN, M.V.Purpose of review: The management of anaphylaxis, after a rapid clinical-based hypothesis and prompt treatment introduction, includes diagnosis confirmation. We reviewed main laboratory methods available for diagnosing anaphylaxis and its etiology. Then, we searched for new methods that can gain utility in the next few years. Recent findings: Serum tryptase is still the most accurate and available method for diagnosis during the acute phase, although it is necessary to measure baseline levels after a period of time. However, measurement of other mediators, such as histamine and lipid metabolites, is available in many sites with good accuracy. For etiologic diagnosis, serum-specific IgE, component-resolved diagnosis (CRD), and basophil activation test (BAT) are available and sometimes helpful, and the new mast cell activation test (MAT) has been recently proposed to help confirming activation of those cells by a specific trigger. Summary: In vitro tests can help clinicians to confirm anaphylaxis diagnosis and sometimes its etiology, but many triggers cannot be confirmed by laboratory methods. Then, allergist consultation after an anaphylactic reaction is mandatory to order the most appropriate tests and, if indicated, to perform in vivo tests. © 2020, Springer Nature Switzerland AG.
- Rhinoconjunctivitis elicited by skin prick test (vol 38, pg 345, 2010)(2013) GIAVINA-BIANCHI, P.; BISACCIONI, C.; AUN, M. Vivolo; CAJUELA, E.; AGONDI, R. C.; KALIL, J.