How to Take a Good Clinical History in Cases of Allergic Reactions to Medications.

The clinical history is the cornerstone of the doctor´s work. When assessing patients consulting for a suspected hypersensitivity reaction to a drug, the details collected in the patient´s clinical history are essential when deciding which tests to perform and for making recommendations about which drugs the patient should avoid and which can be taken. This area is especially important today, since many patients are labeled as allergic to drugs, especially penicillins, without this being the case.

Prone position in covid-19: Can we tackle rising dead space?

Little is known about the impact of proning on oxygenation and ventilatory efficiency on patients with severe Covid-19. In this retrospective observational study we calculated Pa/FiO2 ratio (P/F) as a marker of oxygenation and dead space fraction (Vd/Vt) to assess ventilation. 12 patients who were proned twice or more were included.

Galactose-α-1,3-galactose (alpha-gal) allergy: first pediatric case in a series of patients in Spain.

Introduction And Objectives: Allergy to galactose-α-1,3-galactose (alpha-gal) is a peculiar form of food allergy generally manifesting as an anaphylactic reaction hours after mammalian meat consumption, due to the presence of specific IgE against this oligosaccharide. In addition, immediate anaphylaxis may develop after exposure to other sources of alpha-gal, such as monoclonal antibody cetuximab, vaccines, plasma expanders or anti-snake venoms. Sensitization to alpha-gal has also been implicated in the rapid degeneration of biological valve implants, and recognized as a cause of occupational disease in cattle raisers.

Postpartum Bilateral Tension Pneumothoraces.

We report the first case report of postpartum bilateral tension pneumothoraces. A 31-year-old primigravida presented with obstructive shock and respiratory failure five days following a normal spontaneous vaginal delivery. Bilateral surgical chest drains were inserted and following computed tomography suggestive of an underlying interstitial lung disease she was transferred to a tertiary cardiothoracic centre.

Metformin poisoning treated with high dose insulin dextrose therapy: a case series.

Purpose: We describe the compassionate use of high dose insulin dextrose (HID) for life threatening metformin associated lactic acidosis (MALA) in four patients admitted to intensive care.

Methods: Patients presenting with refractory lactic acidosis believed to be secondary to metformin poisoning were included.High dose insulin dextrose at 0.

Effectiveness of high-flow nasal oxygen therapy in management of acute hypoxemic and hypercapnic respiratory failure.

Background: High-flow nasal oxygen therapy (HFNOT) therapy has been increasingly used in patients with acute hypoxemic (Type I) respiratory failure (RF). Meanwhile indications and clinical effectiveness of HFNOT in patients with hypercapnic (Type II) RF remain controversial. The aim of our study was to evaluate the outcomes of primary HFTNOT in patients with hypoxemic and hypercapnic RF.

Chronic pericardial effusion secondary to a influenza virus A (H1N1)/2009 infection.

We report, to our knowledge, the first successful treatment of novel Influenza A (H1N1)/2009 chronic pericardial effusion in an adult. This patient presented on admission respiratory failure and cardiac tamponade which required non invasive ventilation and drainage. Pericardial fluid polymerase chain reaction sequences were positive for Influenza A (H1N1)/2009 virus.

Hepatopathy-thrombocytopenia syndrome after actinomycin-D therapy: treatment with defibrotide.

We report a case of administration compassionate use defibrotide in a 13-year-old girl with Sinusoidal Obstructive Syndrome and thrombocytopenia, also known as Hepatopathy--Thrombocytopenia Syndrome (HTS) during chemotherapy for Wilms' tumor.

Potential hypersensitivity due to the food or food additive content of medicinal products in Spain.

The Drug Allergy Committee of the Spanish Society of Allergology and Clinical Immunology reviewed the allergenic potential of several substances of food origin that are found in the composition of some drugs. Despite recent legislation on labeling, many labels do not clearly state whether the drug contains raw material (active ingredients, excipient, or other manufacturing intermediate) with an origin in any of the substances in the list of the 14 groups of food allergens that are subject to mandatory declaration. The objective of legislation is that the drug package, the Summary of Product Characteristics, and the patient information leaflet clearly state the food content in order to improve the safety of allergic patients.

Smoking, environmental tobacco smoke, and aspirin-exacerbated respiratory disease.

Background: Tobacco smoke is a widely recognized environmental pollutant and is a major public health hazard worldwide. Although environmental tobacco smoke (ETS) has a clear link with many conditions, including asthma, ear infections, and sinus cancer, evidence related to aspirin-exacerbated respiratory disease (AERD) requires further investigation.

Objective: To investigate whether active smoke or ETS exposures are associated with an increased risk of developing AERD.

Occupational asthma caused by turbot allergy in 3 fish-farm workers.

We report 3 patients (26, 31, and 33 years) who worked at the same fish farm for several years. They experienced symptoms of rhinoconjunctivitis and bronchial asthma while classifying fish by size. Their asthma gradually worsened to the extent that it became persistent and required daily medication with inhaled corticosteroids and bronchodilators.

Allergic reactions to nonsteroidal anti-inflammatory drugs: is newer better?

In clinical practice, physicians may find it difficult to recognize the differences between allergic and pseudo-allergic reactions to nonsteroidal anti-inflammatory drugs (NSAIDs) and to manage each type of reaction. This paper reviews all the information presently available in order to clarify main problems related to NSAID reactions and to highlight key strategies to handle these reactions.