Terapia dello Shock Anafilattico - AdrenalinaFilippo Fassio
The document discusses guidelines for the assessment and management of anaphylaxis. It emphasizes the importance of promptly diagnosing anaphylaxis and administering epinephrine as the first-line treatment. While epinephrine is essential, the evidence for managing anaphylaxis is limited compared to other conditions. The guidelines focus on basic initial treatment that can be provided even in low-resource settings. Oxygen supplementation, intravenous fluids, and monitoring vitals are also recommended components of anaphylaxis management.
Terapia dello Shock Anafilattico - AdrenalinaFilippo Fassio
The document discusses guidelines for the assessment and management of anaphylaxis. It emphasizes the importance of promptly diagnosing anaphylaxis and administering epinephrine as the first-line treatment. While epinephrine is essential, the evidence for managing anaphylaxis is limited compared to other conditions. The guidelines focus on basic initial treatment that can be provided even in low-resource settings. Oxygen supplementation, intravenous fluids, and monitoring vitals are also recommended components of anaphylaxis management.
This document summarizes a presentation on molecular diagnostics in food allergy. It discusses the limitations of current diagnostic tests in establishing food allergy and differentiating sensitization from clinical allergy. Component resolved diagnostics is presented as a method to improve diagnosis by identifying specific allergenic proteins and predicting severity. Examples of molecular diagnostics for several common foods like peanuts, kiwi, tomatoes and hazelnuts are provided. The conclusions emphasize that molecular diagnostics can help risk stratification but results vary geographically and more research is still needed to fully characterize allergens for many foods.
This document summarizes a study investigating isolated natural killer (NK) cell deficiencies in children with herpetic encephalitis. The study found that NK cell deficiencies, either numeric or functional, were present in all patients affected by severe herpetic infection with encephalitis. One patient also had reduced T cells expressing NK receptors. Testing found three patients had absolute NK deficiency while two had a functional NK deficiency due to a CD16 polymorphism. The conclusions were that NK deficiencies play a role in increased incidence and severity of viral infections, and identifying high-risk patients could help prevent exposures and prompt early antiviral treatment.
This document summarizes the history and evolution of allergy testing from 1880 to present day. It discusses early methods like provocation testing and the characterization of IgE in the 1960s-1970s. Modern developments introduced recombinant allergens in 1995, allergen microarrays in 2001, and now over 103 molecular allergens can be tested. The document also presents and analyzes three case studies involving pollen, latex, and food allergies. It emphasizes that both traditional testing with extracts and newer molecular testing are still needed due to the complexity of allergies. CRD and molecular allergology are active areas of research that young allergists should learn alongside traditional diagnostics.
A 29-year-old man was referred to an immunology unit for persistent eosinophilia of over 18k/mm3 without involvement of target organs. He presented with recurrent angioedema attacks over the past 6 years without an evident trigger. He was diagnosed with Gleich's syndrome after being found to have episodic angioedema with eosinophilia. Cyclosporine A treatment failed as a steroid-sparing agent. The patient is pursuing compassionate use of mepolizumab given the syndrome's association with increased Th2 cytokines and IL-5 production.
This document summarizes a presentation on molecular diagnostics in food allergy. It discusses the limitations of current diagnostic tests in establishing food allergy and differentiating sensitization from clinical allergy. Component resolved diagnostics is presented as a method to improve diagnosis by identifying specific allergenic proteins and predicting severity. Examples of molecular diagnostics for several common foods like peanuts, kiwi, tomatoes and hazelnuts are provided. The conclusions emphasize that molecular diagnostics can help risk stratification but results vary geographically and more research is still needed to fully characterize allergens for many foods.
This document summarizes a study investigating isolated natural killer (NK) cell deficiencies in children with herpetic encephalitis. The study found that NK cell deficiencies, either numeric or functional, were present in all patients affected by severe herpetic infection with encephalitis. One patient also had reduced T cells expressing NK receptors. Testing found three patients had absolute NK deficiency while two had a functional NK deficiency due to a CD16 polymorphism. The conclusions were that NK deficiencies play a role in increased incidence and severity of viral infections, and identifying high-risk patients could help prevent exposures and prompt early antiviral treatment.
This document summarizes the history and evolution of allergy testing from 1880 to present day. It discusses early methods like provocation testing and the characterization of IgE in the 1960s-1970s. Modern developments introduced recombinant allergens in 1995, allergen microarrays in 2001, and now over 103 molecular allergens can be tested. The document also presents and analyzes three case studies involving pollen, latex, and food allergies. It emphasizes that both traditional testing with extracts and newer molecular testing are still needed due to the complexity of allergies. CRD and molecular allergology are active areas of research that young allergists should learn alongside traditional diagnostics.
A 29-year-old man was referred to an immunology unit for persistent eosinophilia of over 18k/mm3 without involvement of target organs. He presented with recurrent angioedema attacks over the past 6 years without an evident trigger. He was diagnosed with Gleich's syndrome after being found to have episodic angioedema with eosinophilia. Cyclosporine A treatment failed as a steroid-sparing agent. The patient is pursuing compassionate use of mepolizumab given the syndrome's association with increased Th2 cytokines and IL-5 production.
1. AOU Careggi SOD Immunologia e Terapie Cellulari Allergologo e Pneumologo 16 Marzo 2013
Spirometria per il follow-up
dell’asma bronchiale
CONTRO
Filippo Fassio
AOU Careggi
SOD Immunologia e Terapie Cellulari
(Direttore Prof. E. Maggi)
2. AOU Careggi SOD Immunologia e Terapie Cellulari Allergologo e Pneumologo 16 Marzo 2013
Premessa…
Spirometria per il follow-up
dell’asma bronchiale:
CONTRO
3. AOU Careggi SOD Immunologia e Terapie Cellulari Allergologo e Pneumologo 16 Marzo 2013
Valutare il controllo dell’asma…
4. AOU Careggi SOD Immunologia e Terapie Cellulari Allergologo e Pneumologo 16 Marzo 2013
Valutare il controllo dell’asma…
5. AOU Careggi SOD Immunologia e Terapie Cellulari Allergologo e Pneumologo 16 Marzo 2013
Monitorare il controllo dell’asma…
6. AOU Careggi SOD Immunologia e Terapie Cellulari Allergologo e Pneumologo 16 Marzo 2013
Monitorare il controllo dell’asma…
7. AOU Careggi SOD Immunologia e Terapie Cellulari Allergologo e Pneumologo 16 Marzo 2013
Monitorare il controllo dell’asma…
8. AOU Careggi SOD Immunologia e Terapie Cellulari Allergologo e Pneumologo 16 Marzo 2013
Spirometria e controllo dell’asma…
9. AOU Careggi SOD Immunologia e Terapie Cellulari Allergologo e Pneumologo 16 Marzo 2013
Spirometria e controllo dell’asma…
10. AOU Careggi SOD Immunologia e Terapie Cellulari Allergologo e Pneumologo 16 Marzo 2013
Spirometria e controllo dell’asma…
11. AOU Careggi SOD Immunologia e Terapie Cellulari Allergologo e Pneumologo 16 Marzo 2013
Spirometria nell’asma…
12. AOU Careggi SOD Immunologia e Terapie Cellulari Allergologo e Pneumologo 16 Marzo 2013
Spirometria e controllo dell’asma…
13. AOU Careggi SOD Immunologia e Terapie Cellulari Allergologo e Pneumologo 16 Marzo 2013
Spirometria e controllo dell’asma…
14. AOU Careggi SOD Immunologia e Terapie Cellulari Allergologo e Pneumologo 16 Marzo 2013
Spirometria e controllo dell’asma…
15. AOU Careggi SOD Immunologia e Terapie Cellulari Allergologo e Pneumologo 16 Marzo 2013
Spirometria e controllo dell’asma…
16. AOU Careggi SOD Immunologia e Terapie Cellulari Allergologo e Pneumologo 16 Marzo 2013
Spirometria e controllo dell’asma…
17. AOU Careggi SOD Immunologia e Terapie Cellulari Allergologo e Pneumologo 16 Marzo 2013
Spirometria e controllo dell’asma…
18. AOU Careggi SOD Immunologia e Terapie Cellulari Allergologo e Pneumologo 16 Marzo 2013
Spirometria e controllo dell’asma…
19. AOU Careggi SOD Immunologia e Terapie Cellulari Allergologo e Pneumologo 16 Marzo 2013
Spirometria e controllo dell’asma…
20. AOU Careggi SOD Immunologia e Terapie Cellulari Allergologo e Pneumologo 16 Marzo 2013
Spirometria e controllo dell’asma…
21. AOU Careggi SOD Immunologia e Terapie Cellulari Allergologo e Pneumologo 16 Marzo 2013
Spirometria e controllo dell’asma…
22. AOU Careggi SOD Immunologia e Terapie Cellulari Allergologo e Pneumologo 16 Marzo 2013
Spirometria e controllo dell’asma…
23. AOU Careggi SOD Immunologia e Terapie Cellulari Allergologo e Pneumologo 16 Marzo 2013
Controllo dell’asma e comorbidità…
24. AOU Careggi SOD Immunologia e Terapie Cellulari Allergologo e Pneumologo 16 Marzo 2013
Controllo dell’asma e comorbidità…
25. AOU Careggi SOD Immunologia e Terapie Cellulari Allergologo e Pneumologo 16 Marzo 2013
Controllo dell’asma e comorbidità…
26. AOU Careggi SOD Immunologia e Terapie Cellulari Allergologo e Pneumologo 16 Marzo 2013
Biomarker e controllo dell’asma…
27. AOU Careggi SOD Immunologia e Terapie Cellulari Allergologo e Pneumologo 16 Marzo 2013
Conclusioni…
La spirometria è fondamentale nella diagnosi di asma, ma:
…è solo uno degli strumenti a disposizione per il monitoraggio
…c’è una significativa discordanza tra i vari strumenti
…non è necessariamente il migliore
…scarsa evidenza di beneficio clinico con controlli seriati
…non è gratis!
…per tutti questi motivi…
28. AOU Careggi SOD Immunologia e Terapie Cellulari Allergologo e Pneumologo 16 Marzo 2013
Conclusioni…
il controllo seriato della spirometria
non è attualmente raccomandato
dalle linee guida GINA
29. AOU Careggi SOD Immunologia e Terapie Cellulari Allergologo e Pneumologo 16 Marzo 2013
fassio.filippo@gmail.com