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
29 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 29
bookPart Reações adversas a medicamentos: diagnóstico e classificação(2022) GIAVINA-BIANCHI, Pedro; AUN, Marcelo Vivolo; MOTTA, Antônio AbíliobookPart Angioedema Agudo(2015) AUN, Marcelo Vivolo; MOTTA, Antonio AbíliobookPart Reações adversas a medicamentos(2021) AUN, Marcelo Vivolo; MOTTA, Antonio AbílioconferenceObject 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.bookPart Reações adversas graves a medicamentos(2021) MOTTA, Antonio Abílio; AUN, Marcelo Vivolo- Drug-induced anaphylaxis in children: Nonsteroidal anti-inflammatory drugs and drug provocation test REPLY(2014) AUN, Marcelo Vivolo; BLANCA, Miguel; GARRO, Laila Sabino; RIBEIRO, Marisa Rosimeire; KALIL, Jorge; MOTTA, Antonio Abilio; CASTELLS, Mariana; GIAVINA-BIANCHI, Pedro
bookPart Angioedema Hereditário(2016) KELMANN, Nathália Portilho; AUN, Marcelo Vivolo; MOTTA, Antonio Abílio; BIANCHI, Pedro Giavina- 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, PedroOBJECTIVE: 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.
- 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.
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