Allergies development risk

More recently, research has moved from studying factors that aggravate asthma and allergies and risk factors within populations, to exploring factors that influence the development in populations by studying these conditions between populations. 

The role of atopy in anaphylaxis has not completely been resolved. On the one hand there is for example no evidence of a higher risk of severe reactions in venom-allergic patients. A recent study by Sturm et al. [38] indicated that patients with high total IgE levels predominantly developed mild to moderate reactions. By contrast, atopy may increase the risk and severity of systemic reactions in beekeepers and their family numbers [39]. On the other hand, atopy and in particular allergic asthma are risk factors for food allergy and therefore are also important risk factors for food-induced anaphylaxis. This is most likely also true for exercise-induced anaphylaxis, but also non-IgE-dependent anaphylaxis induced by NSAIDs or contrast media. 

The application and development of new in vitro diagnostic techniques aims to enable physicians to reach an allergy diagnosis with no risk for the patient. This is particularly desirable in the case of serious reactions such as anaphylaxis, by confirming the existence of an anaphylactic reaction and differentiating between individuals which present with sensitization but no cUnical symptoms following exposure to the allergen from those that show a serious clinical reaction. 

Contraindications are the same as for immunotherapy for inhalant allergy, but are relative in nature because of the life-saving potential of venom immunotherapy. Elderly patients, especially with preexisting cardiovascular disease, are at a high risk to develop severe or even fatal anaphylaxis [26]. Therefore, venom immunotherapy is often recommended in patients over 50-60 years of age. Since (3-blocker treatment is associated with a significantly increased survival rate in patients with coronary heart... 

Develop a treatment plan with the patient and other health care professionals if appropriate. Choose therapeutic options based on the underlying cause of nausea and vomiting, duration and severity of symptoms, comor-bid conditions, medication allergies, presence of contraindications, risk of drug-drug interactions, and treatment adverse-effect profiles. 

Pre-exposure prophylaxis with IGIM is indicated for individuals at high risk of acquiring the HAV who cannot receive the hepatitis A vaccine (e.g., because of allergy to the components alum or 2-phenoxyethanol). Additionally, travelers who plan to depart for endemic areas within 2 weeks and have not yet received the hepatitis A vaccine should receive IGIM because active vaccine immunity takes several weeks to develop. 

Treatment guidelines developed by the Sinus and Allergy Health Partnership reflect antibiotic choices that are likely to result in favorable clinical and bacteriologic outcomes based on pathogen distribution, spontaneous resolution rates, and nationwide resistance patterns.310 These guidelines (Figs. 69-3 and 69-4) stratify therapy based on severity of disease and risk of infection with resistant organisms, defined as mild disease in patients with prior antibiotic use within 4 to 6 weeks. Other risk factors for resistance include day-care attendance or frequent... 

Cefazolin or cefuroxime are appropriate for prophylaxis in cardiothoracic and vascular surgeries. In the case of 3-lactam allergy, vancomycin or clindamycin are advised. Debate exists on the duration of antimicrobial prophylaxis. The National Surgical Infection Prevention Project cites data that extending prophylaxis beyond 24 hours does not decrease SSI rates and may increase bacterial resistance.1 American Society of Health-System Pharmacists guidelines from 1999 allow for the continuation of prophylaxis for up to 72 hours.22 Duration of therapy should be based on patient factors and risk of development of an SSI. SSIs are rare after cardiothoracic operations, but the potentially devastating consequences lead some clinicians to support longer periods of prophylaxis. 

Patients with a history of allergies, especially to penicillin, are at increased risk for developing a severe hypersensitivity reaction, marked by severe pruritus, angio-edema, bronchospasm, and anaphylaxis. 

---