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P Demoly

Publications and source records attributed to P Demoly.

At least 37 records · Page 2Linked to original sources
PubMed2005

[Sensitization to powdered latex gloves: prevalence in hospital employees].

INTRODUCTION: The prevalence of latex allergies in industrial countries has skyrocketed since the 1980s. Between 2.6 and 22% of hospital workers are diagnosed with latex allergy, which has been recognized as an occupational hazard in France since 1997. AIM: To assess the prevalence of latex allergy among Montpellier University Hospital Center staff. METHODS: From 1999 to 2002, we interviewed and conducted skin-prick tests on 537 hospital staff members from different departments and with different degrees of exposure to airborne latex allergens. RESULTS: Symptoms while using natural-rubber latex gloves (most often contact dermatitis) were reported by 88 (16.4%) staff members. Overall work-related allergic symptoms included rhinitis, reported by 65 (12.1%), contact urticaria by 28 (5.2%), and bronchial symptoms by 16 (1.1%). In all, sensitization to latex was identified in 7.1% of our staff, and this percentage was higher (11.3%) in units where latex gloves were used more often. Sensitization was associated with high latex exposure and atopy. CONCLUSION: This high rate of latex sensitization and the risk factors are similar to those already published. Based on this study, we have eliminated powdered latex gloves, as have many other hospitals.

Adult↗
PubMed2005

Reducing the risk of anaphylaxis during anaesthesia: guidelines for clinical practice.

These guidelines represent a consensus of experts in the field of immediate hypersensitivity reactions occurring during anaesthesia. They were based on international science, and implemented in France under the auspices of the French Society for Anaesthesia and Intensive Care (SFAR: Société Française d'Anesthésie et de Reanimation). Their aim was to provide the most valid, widely accepted, effective and easily teachable guidelines that current knowledge, research and experience can provide. This paper presents the main extracts of these recommendations with the most relevant clinical implications.

Anaphylaxis↗
PubMed2005

Drug hypersensitivities: definition, epidemiology and risk factors.

Drug hypersensitivity reactions are the adverse effects of drugs taken at a dose which is tolerated by normal subjects, and which clinically resemble allergy. There is few true epidemiological data on drug hypersensitivity reactions. The available information requires a cautious interpretation as they are rarely proven. Both under diagnosis and over diagnosis must be taken into account. Drug hypersensitivity reactions represent one third of adverse drug reactions, can be life threatening and motivate changes on drug prescription. They concern more than 7% of the general population, therefore being an important public health problem. A few risk factors are already pinpointed. Future progress in genetics can help the identification of populations at risk for specific reactions. This review describes currently known data on incidence,prevalence, mor tality and risk factors of these reactions.

Adolescent↗
PubMed2004

[A revised nomenclature for allergy].

We expose you the revised nomenclature for allergy following the proposal of the European Academy of Allergy and Clinical Immunology (EAACI). We will review here, as faithfully as possible, the distinct definitions and the right terms to use in allergy and in the other medical branches.

Hypersensitivity↗
PubMed2004

Self-reported drug allergy in a general adult Portuguese population.

AIM: To estimate the prevalence of self-reported drug allergy in adults. METHODS: Cross-sectional survey of a general adult population from Porto (all of whom were living with children involved in the International Study of Asthma and Allergies in Childhood-phase three), during the year 2002, using a self-administered questionnaire. RESULTS: The prevalence of self-reported drug allergy was 7.8% (181/2309): 4.5% to penicillins or other beta-lactams, 1.9% to aspirin or other non-steroidal anti-inflammatory drugs (NSAIDs) and 1.5% to other drugs. In the group 'allergic to beta-lactams', the most frequently implicated drug was penicillin G or V (76.2%) followed by the association of amoxicillin and clavulanic acids (14.3%). In the group 'allergic to NSAIDs', acetylsalicylic acid (18.2%) and ibuprofen (18.2%) were the most frequently identified drugs, followed by nimesulide and meloxicam. Identification of the exact name of the involved drug was possible in less than one-third of the patients, more often within the NSAID group (59.5%). Women were significantly more likely to claim a drug allergy than men (10.2% vs. 5.3%). The most common manifestations were cutaneous (63.5%), followed by cardiovascular symptoms (35.9%). Most of the reactions were immediate, occurring on the first day of treatment (78.5%). Only half of the patients were submitted to drug allergy investigations. The majority (86.8%) completely avoided the suspected culprit drug thereafter. CONCLUSIONS: The results showed that self-reported allergy to drugs is highly prevalent and poorly explored. Women seem to be more susceptible. beta-lactams and NSAIDs are the most frequently concerned drugs.

Adult↗
PubMed2004

Sinus CT scans and mediator release in nasal secretions after nasal challenge with cypress pollens.

BACKGROUND: Involvement of paranasal sinuses has been suggested in allergic rhinitis but not clearly demonstrated. AIMS: To investigate the relationship between intermittent allergic rhinitis and computerized tomography (CT). METHODS: Twenty patients with intermittent rhinitis and sensitized to cypress pollens underwent unilateral nasal provocation tests (NPTs) using increasing concentrations of cypress pollens out of the pollen season. Sinus CT-scans were carried out just before a NPT and 24 h later. Nasal lavage was carried out just before a NPT, 30 min after a positive challenge and again 24 h later. Leucotriene C4/D4, intracellular adhesion molecule-1 and eosinophil cationic protein were measured in nasal secretions. RESULTS: Thirteen patients (65%) showed an alteration in their CT-scans after allergen challenge. Ten of them showed sinus changes controlateral to their allergenic provocation. Radiological changes mainly affected the osteomeatal complex and the ethmoid sinuses. Pre-existing abnormalities (13 of 20 cases) mainly concerned the maxillary sinuses. There was no correlation between CT-scan abnormalities and levels of mediators released in nasal secretions. CONCLUSIONS: We have shown that nasal allergen challenge can produce radiological changes in the paranasal sinuses. This mainly concerned the ethmoid sinuses.

Adult↗
PubMed2004

Control and exacerbation of asthma: a survey of more than 3000 French physicians.

BACKGROUND: Asthma control and prevention of exacerbations are primary objectives for asthma care. However there is a lack of universal definition of these notions which may therefore have a different meaning according to the physician's practice. METHODS: In the present survey, 1805 general practitioners, 551 pulmonologists, 176 allergologists and 470 resuscitation/emergency care physicians were randomly selected in fall 2001 and asked to answer one question on asthma control and three questions on asthma exacerbation. RESULTS: Regarding asthma control, the presence of minimum symptoms was the primary criterion for asthma specialists (pulmonologists and allergologists), while a normal respiratory function was first considered by nonspecialist physicians (general practitioners and emergency care physicians). The first criterion of mild exacerbation for asthma specialists was the occurrence during at least 2 days of an increase in the frequency of dyspnoea and/or the use of short-acting bronchodilators. For nonspecialist physicians, dyspnoea affecting daily activities and/or sleeping was the preferred notion. Hospitalization was unanimously recognized as the first criterion for severe exacerbations. A decrease in peak expiratory flow of more than 30% below the baseline value on two consecutive days and an episode requiring systemic corticosteroids were the next criteria. CONCLUSIONS: This survey emphasizes the complexity of the notions of asthma control and exacerbation and provides novel informations to orient continuing education programmes.

Asthma↗
PubMed2004

Diagnosis of nonimmediate reactions to beta-lactam antibiotics.

Nonimmediate manifestations (i.e. occurring more than 1 h after drug administration), particularly maculopapular and urticarial eruptions, are common during beta-lactam treatment. The mechanisms involved in most nonimmediate reactions seem to be heterogeneous and are not yet completely understood. However, clinical and immunohistological studies, as well as analysis of drug-specific T-cell clones obtained from the circulating blood and the skin, suggest that a type-IV (cell-mediated) pathogenic mechanism may be involved in some nonimmediate reactions such as maculopapular or bullous rashes and acute generalized exanthematous pustulosis. In the diagnostic work-up, the patient's history is fundamental; patch testing is useful, together with delayed-reading intradermal testing. The latter appears to be somewhat more sensitive than patch testing, but also less specific. In case of negative allergologic tests, consideration should be given to provocation tests, and the careful administration of the suspect agents. With regard to in vitro tests, the lymphocyte transformation test may contribute to the identification of the responsible drug. Under the aegis of the European Academy of Allergology and Clinical Immunology (EAACI) interest group on drug hypersensitivity and the European Network for Drug Allergy (ENDA), in this review we describe the general guidelines for evaluating subjects with nonimmediate reactions to beta-lactams.

Adult↗