Mild Allergic Reactions Research Articles

Eosinophil–Basophil/Lymphocyte (EB/LR) and Eosinophil–Basophil–Platelet/Lymphocyte (EBP/LR) Ratios Could Serve as Useful Additional Markers for Assessing the Severity of Wasp Allergic Reactions

Wasp venom allergy can trigger severe allergic reactions, and predicting these acute responses remains challenging. This study evaluates the utility of immune system indexes, particularly the eosinophil–basophil/lymphocyte (EB/LR) and eosinophil–basophil–platelet/lymphocyte (EBP/LR) ratios, in assessing the severity of allergic reactions in patients with wasp venom allergy. A total of 61 patients with confirmed wasp venom allergy were categorized according to the Mueller scale, which classifies the severity of allergic reactions. Blood samples were analyzed for total and specific IgE levels alongside a range of hematological and biochemical parameters. This study found significant differences in the EB/LR and EBP/LR indexes between patients with mild (Mueller I–II) and severe (Mueller III–IV) allergic reactions, with higher values indicating more severe responses. However, no significant differences were observed in other immune indexes, such as the platelet-to-lymphocyte ratio, neutrophil-to-lymphocyte ratio, systemic immune-inflammation index, and systemic inflammatory response index, as well as in additional blood parameters. These findings suggest that the EB/LR and EBP/LR ratios may serve as useful markers for predicting the severity of allergic reactions in patients with wasp venom allergy. This is the first study to establish such a link, although further research with larger cohorts is necessary to confirm these results and their potential application in clinical settings.

Management and long-term outcome of recurrent idiopathic FSGS in pediatric kidney transplant recipients

Focal segmental glomerulosclerosis (FSGS) is a major cause of pediatric kidney failure. Most cases of FSGS in children are idiopathic and have a high risk of post-transplantation recurrence and graft loss. Common treatments for recurrent FSGS (rFSGS) post-transplantation include plasmapheresis, immunoadsorption, and/or immunomodulatory therapy. This study retrospectively evaluated the efficacy and safety of early plasmapheresis followed by rituximab for inducing and maintaining remission in rFSGS. Between 2014 and 2023, 8 of 65 pediatric kidney transplant recipients at our center were diagnosed with idiopathic FSGS. rFSGS was diagnosed based on nephrotic range proteinuria with no other cause and managed with plasmapheresis. Rituximab therapy was used for those who did not achieve complete remission with prolonged plasmapheresis or remained plasmapheresis dependent. 6 of 8 (75%) transplant recipients with idiopathic FSGS experienced rFSGS. All patients achieved partial or complete remission with plasmapheresis, with response times ranging from 8 to 379 days (median 13 days). Rituximab therapy was introduced for 5 plasmapheresis-dependent patients, leading to sustained remission and cessation of plasmapheresis in 3 patients, while 2 showed improved proteinuria and reduced plasmapheresis frequency. Adverse effects included rituximab-induced serum sickness in one patient and one mild allergic reaction. One patient experienced graft loss due to humoral rejection, but no grafts were lost to rFSGS, and all other grafts remained functional over an average follow-up of 50 months. Early plasmapheresis followed by rituximab therapy effectively induces remission in most post-transplantation rFSGS cases, is well tolerated, and prevents graft loss. Larger studies are needed to confirm these findings.

Non-hemolytic acute transfusion reactions: the impact of patient and blood product characteristics

ABSTRACT Background Non-hemolytic acute transfusion reactions (ATRs) are generally not fatal, but they can cause serious increases in workload and costs as a result of blood product wastage. Methods A retrospective analysis was made of the data of the 7-year period between January 2016 and December 2022 to identify the possible associations between patient and product characteristics and the development of ATRs. Results A total of 113,666 blood products were transfused during the study period. There were 146 ATRs with an estimated rate of 1.28 per 1000 blood products administered. The most common ATR was mild allergic reactions (n = 84, 57.6%). No statistically significant relationship was found in blood group distribution between patients who had and did not develop ATR (p = 0.797). Febrile Non-hemolytic Transfusion Reaction (FNHTR) was more common in patients receiving erythrocyte suspension (ES) transfusion, and Fresh Frozen Plasma (FFP) was mostly used in those with mild allergic reactions (p < 0.001). Patient age was determined as > 60 years in those who developed FNHTR or ‘others,’ and < 60 years in patients with mild allergic reactions (p = 0.046). Conclusion The results of the current study demonstrated that regardless of blood group, the probability of developing FNHTR is high when ES is transfused in elderly patients, and the probability of developing mild allergic reaction is high when FFP is used. While recognizing that ATRs are difficult to prevent, it can be emphasized that prediction and management may become easier if clinicians keep these possibilities in mind when making transfusion decisions.

Sterile gown and drape, and bouffant cap for thyroid FNA: preventing infections or producing unnecessary medical waste?

Ultrasound-guided fine needle aspiration (FNA) is a very low-risk procedure. Despite this, there remains great variability in the use of protective equipment. Given the monetary and environmental costs of protective equipment, the difference in infection rates with full versus limited protective equipment was assessed. A total of 857 consecutive patients were retrospectively reviewed after undergoing thyroid FNAs at the main hospital and outpatient clinic siteperformed from 12/1/2020 to 11/30/2023. The hospital site operated with full protective equipment (bouffant, sterile gown, sterile gloves, and full body sterile drape), and the outpatient site with limited (sterile gloves, limited sterile paper drape) protective equipment. Two patients were excluded as no procedure was performed. Review for signs of infection within 30days of procedure was performed using medical records, which was blinded to the extent of protective equipment utilization. No infections were identified in either group, with 0/629 (0%, 95%CI 0-1%) in the full protective equipment group vs. 0/226 (0%, 95%CI 0-2%) in the limited protective equipment group. There was no statistically significant difference in infection rate between full and limited protective equipment use in thyroid FNA in the included 855 procedures (95%CI 0-1%). Two patients out of 629 (0.3%) in the full protective equipment group developed mild allergic reaction to topical antiseptic. The 226 procedures with limited protective equipment represent a saving of at least 204,530g of CO2 equivalents, equivalent to driving a car for almost 3000 miles. Reducing the extent of protective equipment does not adversely affect the infection rate in thyroid FNAs. Given the inherent costs involved in the procurement and waste of protective equipment, reducing protective equipment use is warranted to reduce both the monetary and environmental impacts of waste.

Decreasing Premedication for Blood Transfusions: A Quality Improvement Project.

Premedication administration to patients who are to receive blood transfusions continues despite evidence of a lack of benefit when given to prevent febrile nonhemolytic or mild allergic transfusion reactions. Reviews of ordering practices and staff surveys on an adult inpatient hematology-oncology unit in our multisite oncology medical center indicated a lack of standardization and overuse of premedication in blood transfusions and a lack of knowledge of when it was appropriate to use premedication. A literature search was performed, and the evidence led to a proposal for a quality improvement (QI) project focused on development of an evidence-based algorithm to guide clinicians in when to administer which premedication, development of clear documentation for premedication plans, integration of the documented premedication plans into electronic orders for blood products, and staff education. Interventions included a hospital-wide algorithm and an electronic order to be integrated with a premedication plan for each patient on the adult hematology-oncology unit. Seven months after implementation of the intervention, premedication use among patients decreased by 57.6%, and the transfusion reaction rate decreased from 1% to 0.8%. Staff knowledge as measured by responses to pre- and postintervention surveys on the appropriate use of premedication also improved. Evidence-based interventions can reduce the incidence of premedication use in patients receiving blood transfusions.

Dietary Advancement Therapy Using Milk and Egg Ladders Among Children With a History of Anaphylaxis

BackgroundAnaphylaxis is increasing in recent years, with common triggers in infants being milk and eggs. Currently the mainstay of treatment for milk and/or egg allergy is strict avoidance. Recently new therapies have emerged including stepwise introduction of allergens via a ladder approach. The suitability of infants for the ladders is debated. ObjectiveThis study aims to focus on the use of food ladders in children with anaphylaxis to egg or milk. MethodsRetrospective review of paediatric patients diagnosed with IgE-mediated milk and/or egg allergy between 2011-2021. Inclusion and exclusion criteria applied. Anaphylaxis defined as per the World Allergy Organisation amended criteria 2020. Data analysis utilised SPSS Version 28. Results1552 patient charts reviewed, 1094 excluded (n=458). 70 infants had anaphylaxis at diagnosis (milk n=36, egg n=34). 77.8%-85.2% with anaphylaxis successfully completed the ladder, 88.9-92.9% without anaphylaxis were successful. Children who successfully completed the ladder did so at similar rates. 20.6-50% children presenting with anaphylaxis at diagnosis experienced allergic symptoms during treatment, compared to 17.3-40.7% without anaphylaxis. Reactions were mild, mostly cutaneous and not requiring medical attention. Patients experiencing allergic symptoms while on the ladder were less likely to successfully complete treatment. ConclusionMilk and egg ladders are a safe and effective way of inducing tolerance in infants, including those with a history of anaphylaxis at diagnosis. There are no obvious predictors for who will experience allergic reactions while on the ladder, however these children are less likely to complete the ladder so parents should be educated in management of mild allergic reactions at home.

Knowledge about Administration and Regulation of High Alert Medication among Nurses in Oncology Department

Background: High alert medications (HAMs) are associated with a higher risk of causing significant patient harm when used in error. Understanding the administration and regulation of these medications within oncology settings is critical due to the complex nature of cancer treatment regimens and the severity of potential medication errors. Objective: To assess the knowledge of nurses regarding the administration and regulation of high alert medications in an oncology department of a tertiary care hospital. Methods: A descriptive cross-sectional study was conducted among 133 registered nurses in the oncology department of Jinnah Hospital, Lahore. Data were collected using a structured questionnaire designed to evaluate nurses' knowledge of HAMs. Participants included both male (29.3%) and female (70.7%) nurses, with varying educational backgrounds and work experiences. Statistical analysis was performed using SPSS version 25, focusing on descriptive statistics such as frequencies, percentages, means, and standard deviations. Results: The results revealed moderate knowledge levels among nurses with significant gaps in critical areas. Only 20.3% correctly identified the protocol for fast IV push of 1:1000 epinephrine in mild allergic reactions, and 33.8% mistakenly believed that 10% calcium gluconate and 10% calcium chloride were interchangeable. Additionally, 44.4% incorrectly used 'Amp' or 'Vial' for dose expression instead of 'mg' or 'gm', and 53.4% failed to recognize the importance of distinctive labeling on look-alike drugs. Conclusion: The study highlights the need for enhanced educational programs and standardized protocols to improve the safe administration and regulation of HAMs in oncology settings. Strengthening nurses' knowledge and practices regarding HAMs is essential to reduce medication errors and improve patient outcomes.

Mild Allergic Reactions after Botulinum Toxin Injection: A Case Series and Literature Review.

Botulinum toxin type A (BTA) is becoming more and more prevalent as an injection agent in cosmetic surgery. However, there is an increasing amount of cases reporting unexpected adverse reactions related to BTA injection. BTA can invoke many kinds of hypersensitive reactions, some of which can be delayed-type or even fatal; hence, it is of crucial importance to pay close attention to atypical and early symptoms that may indicate the presence of BTA allergy in patients. In this study, we reported three cases of mild and unexpected BTA-related hypersensitive reaction with a symptom of nonpruritic erythema on the chest that happened after BTA treatment of upper facial wrinkles and proposed several suggestions based on our practical experience and literature review. Two patients' symptoms were alleviated spontaneously, and one patient's were alleviated after taking oral corticosteroid. According to our literature review, we believe that these incidences indicate a kind of unreported allergic reaction relevant to botulinum toxin. We suggest clinicians consider warily patients' subsequent BTA injection schedule if any suspicious reaction occurs after treatment. We suggest that patients who experience nonpruritic erythema after botulinum toxin injection should suspend subsequent injection plans for at least 3 months to prevent more severe consequences.

Randomized,double-blind,parallel controlled,multicenter clinical trial of effectiveness and safety of Shexiang Zhuifeng Zhitong Ointment in alleviating pain in knee osteoarthritis(syndrome of cold-dampness obstruction)

The Shexiang Zhuifeng Zhitong Ointment with the effects of dispelling wind, removing dampness, dissipating cold, and relieving pain is used for treating arthralgia, muscular pain, and sprain pain caused by cold-dampness obstruction. To evaluate the efficacy and safety of Shexiang Zhuifeng Zhitong Ointment in relieving the pain due to knee osteoarthritis(syndrome of cold-dampness obstruction), a randomized, double-blind, parallel controlled, multicenter clinical trial was conducted. The stratified randomization method was used to randomize the 240 subjects into a treatment group and a control group in a ratio of 1∶1. In each group, 60 patients received external application for 12 h and the other 60 patients received external application for 6 h. The treatment group received external application of Shexiang Zhuifeng Zhitong Ointment, while the control group received external application of Shexiang Zhuifeng Ointment. The treatment lasted for 21 days in both groups. Follow-up was conducted on days 7, 14, and 21 of treatment. The results based on the full analysis set were as follows.(1)In visual analog scale(VAS) score, the mean difference in the VAS score between baseline and 12 h post-treatment was 3.02 in the treatment group and 2.31 in the control group, with a significant difference(P&lt;0.05). The mean difference in the VAS score between baseline and 6 h post-treatment was 3.19 in the treatment group and 2.48 in the control group, with a significant difference(P&lt;0.05).(2)Response rate in terms of VAS score, after treatment for 12 h, the response rate was 93.22% in the treatment group and 73.33% in the control group, with a significant difference(P&lt;0.05). After treatment for 6 h, theresponse rate in the treatment group was 88.33%, which was higher than that(63.33%) in the control group(P&lt;0.05).The results showed that Shexiang Zhuifeng Zhitong Ointment applied for 12 and 6 h effectively relieved the knee joint pain of patients with knee osteoarthritis due to cold-dampness obstruction, as demonstrated by the reduced VAS score, Western Ontario and McMaster Universities Arthritis Index(WOMAC), stiffness, and joint function score. Moreover, Shexiang Zhuifeng Zhitong Ointment outperformed the positive control Shexiang Zhuifeng Ointment in terms of reducing the VAS score, demonstrating a definitetherapeutic effect on the pain due to knee osteoarthritis(syndrome of cold-dampness obstruction).In addition, Shexiang Zhuifeng Zhitong Ointment did not cause other adverse reactions except for mild allergic reactions, which were common in the external application of traditional Chinese medicine plasters on the skin, inseveral patients.Neither other adverse reactions nor abnormalities of liver and kidney functions and electrocardiogram were observed. This ointment had high safety and could be popularized in clinical application.

Blood Transfusion Procedure: Assessment of Serbian Intensive Care Nurses' Knowledge.

Many patients require administering one or more blood components during hospitalisation in the Intensive Care Unit (ICU). Therefore, nurses' knowledge of who is responsible for immediately administering blood transfusions, monitoring patients, and identifying and managing transfusion reactions is crucial. This cross-sectional descriptive-analytical study aimed to assess the knowledge of ICU nurses in tertiary healthcare institutions about blood transfusion procedures. The questionnaire about the transfusion procedure was designed and reviewed by experts. The questionnaire consisted of 29 items divided into three domains. The scores on the knowledge test ranged from 10 to 27. Generally, 57.7% of nurses had moderate, 23.4% low, and 18.9% high levels of knowledge about the transfusion procedure. Most nurses answered correctly about refreezing fresh frozen plasma, verifying the transfusion product, and identifying the patient. Of the nurses, 91.0% would recognise mild allergic reactions, and 98.2% knew about the supervision of sedated patients. Nurses showed poor knowledge of the length of usage of the same transfusion system for red blood cells, labelling, and transfusion administration in febrile patients. Nurses with higher education and longer working experience had significantly better outcomes (p = 0.000) on the knowledge test. Continuous education of ICU nurses on safe transfusion usage is recommended.

Immune Checkpoint Inhibition in Pediatric Oncology Patients: A Single-Institution Experience

Immunotherapy has emerged as a promising treatment approach in oncology, as it is specifically designed to boost the strength and accuracy of the immune system, allowing it to target tumor cells but spare non-tumor tissue. This treatment not only demonstrates potential for improved clinical outcomes but may also be associated with fewer adverse effects compared to traditional therapies. Despite its early success, the application of immunotherapy has largely been limited to adult cancer patients, with slow adoption noted in the treatment of pediatric cancer patients. Our objective is to demonstrate a single institution’s experience with immunotherapy in pediatric cancer patients and to discuss the use of these treatment modalities in this unique patient population. We performed a retrospective chart review and identified patients who received immune checkpoint inhibitors (ICIs) and/or underwent immunohistochemistry (IHC) testing for programmed death ligand 1 (PD-L1), quantification of tumor mutational burden (TMB), and classification of microsatellite instability (MSI) status. In total, we identified seven pediatric cancer patients who received therapy with ICIs. Four of these patients demonstrated positive PD-L1 expression, high TMB, and/or MSI-high status. These patients were treated with nivolumab alone or in combination with ipilimumab or brentuximab. The diagnoses included: multifocal epithelioid and spindle cell hemangioma (n = 1); metastatic melanoma (n = 2); histiocytic sarcoma (n = 1); rectal adenocarcinoma in the setting of constitutional mismatch repair deficiency syndrome (CMMRD) (n = 1); and Hodgkin lymphoma (n = 2). The patients received between four and nineteen cycles of immunotherapy. Immunotherapy-related adverse events included: mild allergic reaction; prodromal symptoms; anemia; neutropenia; transaminitis; endocrinopathies; and self-limiting neuritis. Of the seven patients, three are still being treated with immunotherapy (the patients with rectal adenocarcinoma, metastatic melanoma, and multifocal epithelioid and spindle cell hemangioma) with positive treatment responses observed on imaging, one is being treated with other modalities (the patient with Hodgkin lymphoma), two have achieved remission (the patients with metastatic melanoma and Hodgkin lymphoma), and one has relapsed (the patient with histiocytic sarcoma). The three patients who completed their immunotherapy regimens have been followed for 1 month, 4 months, and 10 months, respectively. This report of a single-institution experience with immunotherapy in pediatric cancer patients highlights the positive impact immunotherapy can have, especially when utilized to treat relapsed/refractory malignancies, as tumor regression or stabilization of disease burden was achieved in six of the patients described (CR = 2; PR = 4). Further research is needed to accurately identify pediatric oncology patients who could benefit from immunotherapy.

Non-ionic contrast material in pediatric ct scans: A statistical analysis of mild allergic reactions.

Objective: To assess allergic reactions to IV non-ionic contrast media in children. Study Design: Cross-sectional study. Setting: Faisal Hospital, Faisalabad, and Children Hospital, Faisalabad. Period: June 2022 to September 2022. Material &amp; Methods: A total of 310 patients (males and females) under the age of 14, referred for a CT scan with non-ionic contrast material were included in the study, Data were collected at the Children’s Hospital and the Faisal Hospital Faisalabad for over 4 months and statistically analyzed by SPSS V22. The Chi-square test was used to measure the association between the age of children and mild allergy reactions. Results: This study included 310 patients, 183 (59%) males, and 127 (41%) females, who received the non-ionic contrast agent. Thirteen patients (6 males and 7 females) experienced mild allergic responses including 5 cases of rash, 3 cases of itching, 2 cases of nausea, and 1 case of vomiting, flushing, and swelling. There were 10 reactions for children under five, 1 for children between five to ten years, and 2 for children older than ten years. Out of 13 reported allergic reactions, the brain region observed seven while the chest, head, and neck regions observed none. Conclusion: According to the findings of this study, imaging young children with low-osmolality non-ionic contrast material is relatively safe and has few side effects. Out of 310, only 13 children experienced mild allergic responses to non-ionic contrast material. This study found an association between the age of children (&lt;5 years) and mild allergic reactions (skin rash and itching) which was found to be statistically significant (p=0.005).

Convalescent Plasma Therapy for The Management of Covid‐19: A Single Center Experience of Chhattisgarh State of Central India

The recent outbreak of the coronavirus disease 2019 (COVID19) pandemic has caused a rethinking of the efficacy of previous convalescent plasma transfusions. In hospitalized patients with COVID-19, convalescent plasma (CP) is being used as a treatment along with other supportive therapy. There is a contradictory data on the effectiveness of CP in reducing COVID-19-related mortality to date. To evaluate the efficacy and safety of CP on mortality reduction in patients with COVID-19 admitted in intensive care unit. This retrospective observational study was carried out on patients treated in our institute at Nava Raipur, Chhattisgarh, from 1st April-2020 till 31st December 2020. A total of 138 adult patients with moderate and severe COVID-19 requiring oxygen, were reviewed. Of these, 119 patients were admitted to the intensive care unit. Out of these, 44 moderate to severely symptomatic patients received CP as well as the best supportive treatment, while the remaining 75 received only the best supportive care as either they did not consent for CP therapy or could not arranged CP donors. The data was collected from the Hospital Management Information System and analyzed to assess the effectiveness and safety of CP as well as the demographic information of the patients encountered. In the overall group of 119 patients who were admitted to the ICU, 44 received CP along with best supportive care of which 9 patients could not survived (20.45%) and 75 received only the best supportive care of which 32 patients were died (42.60%). Mortality was significantly lower in plasma group (20.45% vs 42.60%; P=0.0159; OR=0.3455 95% CI: 0.1457 to 0.8196). Mean age of the patient population was 56 years in the plasma group and 61 years in the other group. 34 patients (28.6%) had comorbidities in the form of Diabetes and Thyroid disorders and 7 patients had malignancy. Average duration of ICU stay in the CCP group was 9.1 days while in the Non CCP arm it was 7.7 days. The mean threshold value of oxygen requirement at which the CCP tx was requested - 6.6 lit/min. The mean signal cut off value (SCO) by Vitros-ECi for COVID IgG antibodies in CCP eligible donors was 9.1 (manufacturers cut off value &gt;1.0). In the survival group of CCP recipient, the average SCO value was 8.8 while in the other group it was 9.4. Mild allergic reactions noted in two patients during the CCP transfusion, which were managed conservatively with transfusion halt and anti-histaminic. Our study concluded that the use of COVID convalescent plasma was associated with the reduced mortality in moderately symptomatic COVID-19 patients who needed O2 support. The beneficial effect was associated with multiple factors including both patient as well as plasma donor related factors. Further research into the mechanism of actions of CP in COVID-19 may help predict the good responders.

Platinum desensitization therapy and its impact on the prognosis of ovary high-grade serous adenocarcinoma: a real world-data.

To examine the value of five-step platinum desensitization therapy in epithelial ovarian cancer. A retrospective study was conducted on the high-grade serous adenocarcinoma of the ovary (HGSAO) patients who developed a platinum allergy during treatment and received desensitization therapy between January, 2016 and December, 2020. The logistic-regression was adopted to analyze the relationship between platinum desensitization therapy and prognosis in HGSAO patients. 92 HGSAO patients were included in the study. Among these, 35 patients (38.0%) experienced mild allergic reactions, 51 (55.4%) experienced moderate allergic reactions, and 6 (6.5%) experienced severe allergic reactions. The desensitization therapy was successful in 86 patients (93.5%). Six patients had desensitization failure, of which five experienced severe allergic reactions during desensitization. The logistic-regression analysis revealed no significant correlation between platinum desensitization therapy and progression-free survival (PFS) or overall survival (OS) of patients (P < 0.05). However, the subgroup analysis demonstrated that the success or failure of platinum desensitization therapy significantly impacted the OS of patients who were platinum-sensitive recurrence. The patients who had successful desensitization therapy had a superior OS. Five-step platinum desensitization therapy has potential application value in patients who were platinum-sensitive recurrence after first-line treatment but may bear the risk of severe allergic reactions.

Administration of BNT162b2 mRNA COVID-19 vaccine to subjects with various allergic backgrounds.

The mRNA-based COVID-19 vaccine was introduced to the general public in December 2020. Shortly thereafter, safety concerns were raised due to the reporting of allergic reactions. Allergy-related disorders were suspected to be significant risk factors and the excipient polyethylene glycol was suggested to be a robust allergen. This is a retrospective study analysis. Subjects with putative risk factors for severe allergic reactions to the Pfizer-BioNTech BNT162b2 vaccine were referred for vaccination under observation at the Unit of Allergy and Clinical Immunology. Data was collected for each subject, including demographic details, medical history and previous reactions to any allergen. When appropriate, skin tests were done prior to vaccination. A total of 346 subjects received 623 vaccine doses under observation. The study included patients with various allergy-related disorders (n=290) and those with allergy to a previous COVID-19 vaccine dose (n=56). Both groups showed female predominance (78% and 88%, p=NS). Patients without reactions to previous doses reported more drug allergy (80% vs. 39%, p<0.001) and previous anaphylaxis (64% vs. 14%, p<0.001). There was no difference in sensitivity to other allergens, including polyethylene glycol. Under observation, mild allergic reactions were noted in 13 individuals characterized by female gender (100%), a history of anaphylaxis (69%) and drug allergy (62%). In 7 subjects, allergy was treated with antihistamines while others recovered spontaneously. Our study demonstrates that vaccination under specialist-supervision is a powerful tool for reducing over-diagnosis of systemic reactions and for rapid and reliable collection of vaccine safety data.

Comparative effectiveness and safety of Chinese medicine belly button application for childhood diarrhea: a Bayesian network meta-analysis of randomized controlled trials.

Chinese medicine belly button application (CMBBA) has been used to treat childhood diarrhea (CD) in several randomized controlled trials (RCTs), but its effectiveness and combination strategy still need to be clarified. Therefore, we aimed to evaluate the effectiveness, safety, and the optimal combination strategy of CMBBA in treating CD. Up until January 2023, we searched for studies that met our inclusion criteria in six databases, including PubMed, the Cochrane Library, Chinese SinoMed, CNKI, VIP, and Wanfang. Heterogeneity was quantified using I2 statistics. A methodological evaluation was performed using the Cochrane Risk Bias Tool 2.0. The Confidence in Network Meta-Analysis online software was employed to evaluate evidence grading. A minimally contextualized framework was used to provide a comprehensive conclusion for the network meta-analysis. This study protocol was registered with PROSPERO. We analyzed data from 33 RCTs that included 4,490 children with diarrhea. In terms of clinical effectiveness, CMBBA plus montmorillonite powder plus anti-infectives may be the most effective treatment option for children with diarrhea and concurrent infection according to a minimally contextualized framework. Either exclusive use of CMBBA or CMBBA in combination with modern medicine was beneficial in reducing the time to diarrhea disappearance (MD = -1.33 days, 95% CI: -1.59 to -1.08, Z = -10.103, p < 0.001) compared to modern medicine exclusively, and the difference was statistically significant. The combined usage of CMBBA could shorten the recovery time of dehydration by an average of 0.74 days (MD = -0.74 days, 95% CI: -1.10 to -0.37, Z = -3.931.103, p < 0.001). While some studies have reported mild allergic reactions and mild abdominal pain after CMBBA use, these symptoms can be cured in a relatively short period of time. The combination of CMBBA, montmorillonite powder, and anti-infectives may provide superior clinical effectiveness for children with diarrhea and concurrent infection. To treat CD, CMBBA can be used effectively and safely. However, the findings must be interpreted with cautiously due to the limited number of clinical trials and the low quality of the studies. In addition, the choice of treatment plan should also be based on the specific conditions of each patient. https://www.crd.york.ac.uk/prospero/, identifier: CRD42022380694.

COVID-19 patients treated with convalescent plasma.

In Norway, treatment with COVID-19 convalescent plasma has been given through the NORPLASMA project. The treatment was initially offered to critically ill patients after an individual assessment, but from December 2020, the indication was limited to critically ill, immunocompromised patients. In this article we describe clinical characteristics, comorbidity and mortality in patients who received convalescent plasma in these two periods. From 22April 2020 to 30March 2022, a total of 79 patients were included in the observational studies NORPLASMA MONITOR and the Norwegian SARS-CoV-2 study. The patients had received a total of 193 units of convalescent plasma at 15 Norwegian hospitals/nursing homes; 62 in South-Eastern Norway Regional Health Authority, 8 in Western Norway Regional Health Authority and 9 in Central Norway Regional Health Authority. Information on immune status, comorbidity and course of infection was retrieved from the patient records after informed written consent was obtained. Of 79 patients with a median age of 65 years (interquartile range 51-⁠73) who were treated with convalescent plasma, 31 (39%) died during hospitalisation. A total of 59 patients were immunocompromised, and of these, 20 died in hospital compared to 11 of 20 who were assumed to be immunocompetent. Median number of comorbidities was 2 (interquartile range 1-4). The patients received a median of two plasma units (min.-max. 1-21). Two of the patients developed mild allergic skin reactions. Convalescent plasma was well tolerated by patients with COVID-19. Immunocompromised patients may have benefitted from the treatment, with lower mortality than for those assumed to be immunocompetent.

EVALUATION OF POSSIBLE COMPLICATIONS OF IRRADIATION OF BLOOD PRODUCTS ON PATIENTS

Background: Blood transfusion is a life-saving but high-risk procedure in various medical conditions as it is not a simple fluid infusion but an organ transplant. Although blood transfusions save lives, they may cause serious, life-threatening reactions. Nowadays, the number of reactions has decreased significantly with the reduction of leucocyte content of blood products or their irradiation. &#x0D; Materials and Method: A total of 5582 patients who received irradiated blood products in our hospital between 14/08/2020 and 17/02/2023 were included in the present study. Erythrocyte suspension, platelet apheresis, and pooled platelet suspension were irradiated at doses of 25–30 Gy.&#x0D; Results: A total of 5582 blood products including 4990 erythrocyte suspensions, 282 pooled platelet suspensions, and 310 platelet apheresis were irradiated in the present study. No transfusion-associated Graft Versus Host Disease was identified in any patient included in the present study and there were only mild allergic reactions and febrile non-hemolytic transfusion reactions. &#x0D; Conclusions: Based on the data obtained here from, it was concluded that irradiation of blood products can prevent the highly fatal transfusion-related Graft Versus Host Disease.

Patients’ experiences with the application of medical adhesives to the skin: a qualitative systematic review protocol

IntroductionMedical adhesives are adhesives used in medical devices to establish and maintain contact with the body over a period of time (usually by application to the skin) and are widely...

Guideline on the investigation and management of acute transfusion reactions.

Guideline on the investigation and management of acute transfusion reactions.