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P Bonadonna

Publications and source records attributed to P Bonadonna.

At least 19 recordsLinked to original sources
PubMed2005

Physical exercise does not favour adverse reactions to allergen immunotherapy by the sublingual route.

It is generally recommended in consensus documents on allergen immunotherapy to avoid any kind of physical exercise in the 24 hours following the administration of the allergen extract but such recommendation is not supported by scientific evidence. We evaluated the risk of developing adverse reactions in a group of patients submitted to sublingual immunotherapy by performing a controlled exercise test. Eleven patients were included in the study, 8 treated with grass pollen and 3 with Parietaria pollen extract by Staloral300 (Stallergénes, Antony, France), with the build-up phase in 11 days suggested by the manufacturer and a top dose of 300 IR. At the first maintenance dose, in all patients were measured heart rate, blood pressure, FEV1, and tryptase in blood. Then the maintenance dose was assumed and the physical exercise performed by cycloergometer maintaining a heart rate around 100 b/min and measuring again tryptase, blood pressure and FEV1. The results showed that no patient had adverse reaction following physical exercise, neither showed significant changes in FEV1, blood pressure, or tryptase level, which was 5.57 +/- 4.54 mcg/l before and 5.81 +/- 4.34 mcg/l after exercise. This suggests that there is no reason to advise against physical exercise, and particularly sporting activity, in patients treated with sublingual immunotherapy thus avoiding to interfere with the subject's lifestyle and consequently with his quality of life.

Abdominal Pain↗
PubMed2005

Anaphylaxis due to Brazil nut skin testing in a walnut-allergic subject.

The diagnosis and management of nut allergy can be difficult because of the possible severity of the clinical manifestations and the cross reactivity between different species. We report a case of anaphylaxis due to skin testing in a young adult with clinically ascertained walnut allergy. After an episode of anaphylaxis due to walnut ingestion, a routine diagnostic workup was carried out, involving skin prick test with commercial extracts, prick by prick with fresh food and CAP-RAST assay for different nuts. Immediately after pricking with fresh Brazil nut, a severe episode of anaphylaxis occurred, that required epinephrine and intravenous steroids. The subject had never eaten Brazil nut before. Therefore we hypothesize a cross reactivity effect, since this phenomenon is well known for tree nuts. Our case suggests that in vivo diagnosis, especially if fresh nuts are used, should be performed only if adequate equipment to treat anaphylaxis is available.

Adolescent↗
PubMed2005

Delayed selective reaction to clavulanic acid: a case report.

Clavulanic acid, an inhibitor of beta-lactamases, is widely used for antimicrobial therapy in association with beta-lactam antibiotics. Despite this, very few adverse reactions to the molecule have been described so far. We report a case of not-immediate reaction to clavulanic acid in a young adult who previously tolerated it. The patient complained of generalized itchy erythema two days after completing a course of amoxicillin-clavulanate therapy, and had no previous clinical history of adverse reactions to drugs. Intradermal and skin prick tests with beta-lactam determinants were negative, as well as the oral tolerance test with amoxicillin. Since no commercial preparation of clavulanic acid alone is available, we performed intradermal and skin prick test with the association amoxicillin-clavulanate, that elicited a delayed (24 and 48 hours) response. IgE-mediated reactions to clavulanic acid are rare, since this molecule is poorly allergenic. Based on the onset time and the specificity of the response we hypothesize that a delayed (possibly T-cell mediated) reaction has occurred.

Adult↗
PubMed2004

Evaluation of the nocebo effect during oral challenge in patients with adverse drug reactions.

The nocebo effect is the onset of untoward reactions following the administration of an indifferent substance. The oral challenge with alternative drugs plays a central role in the management of drug allergy and the use of inert substances is part of this procedure. We evaluated the occurrence and clinical characteristics of nocebo effect in patients with adverse drug reactions. Six hundred patients, seen in three different centres (Genoa, Naples and Verona) with a history of reactions to drugs, underwent a blind oral challenge with the administration of an indifferent substance and active drugs. The administration of an inert substance provoked untoward reactions in 54 patients (27%) in Verona, 60 (30%) in Naples and 48 (24%) in Genoa. The overall occurrence of nocebo effect was 27%. The majority of reactions were subjective symptoms (itching, malaise, headache etc), perceived as troublesome by all subjects. The occurrence was significantly higher in women than in men. Our data, collected in a large population, confirm that the nocebo effect occurs frequently in clinical practice. In managing adverse drug reactions through oral challenge the nocebo effect is mandatory to recognize false positive responses.

Adolescent↗
PubMed2004

Tolerability of three selective cyclo-oxygenase-2 inhibitors, meloxicam, celecoxib and rofecoxib in NSAID-sensitive patients.

BACKGROUND: Patients with aspirin-sensitive respiratory and cutaneous diseases experience cross reactions to all nonsteroidal anti-inflammatory drugs (NSAIDs) which inhibit cyclo-oxigenase (COX) enzymes. As are now available drugs which selectively inhibit COX-2, questions are raised whether cross-reactivity occurs between aspirin and these COX 2 inhibitors. OBJECTIVE: The aim of this study was to evaluate the tolerability of three COX-2 inhibitors (meloxicam, celecoxib and rofecoxib) in subjects with previous pseudoallergic respiratory and cutaneous reactions to NSAIDs. METHODS: 76 subjects with documented previous cutaneous and respiratory pseudoallergic reactions to aspirin and/or other NSAIDs underwent a single blind challenge with celecoxib, meloxicam and rofecoxib. RESULTS: All subjects with previous respiratory reactions tolerated all drugs. Three subjects with multiple-drug induced urticaria complained of a generalized reaction after challenge (Two due to celecoxib and one due to meloxicam). Among the group of patients with NSAIDs-induced urticaria five complained of a relapse of the disease due to rofecoxib (one subject), celecoxib (two subjects and meloxicam (two subjects). CONCLUSIONS: According to these results the cross-reactivity between aspirin and these COX-2 inhibitors does not occur in subjects with previous respiratory pseudoallergic reactions. A good safety profile was also demonstrated in patients with cutaneous reactions, being few reactions observed. However for this reason a controlled oral challenge with these drugs is useful for the proper management of patients sensitive to classic NSAIDs.

Adolescent↗
PubMed2004

Prevalence of allergic reactions to Hymenoptera stings in northern Italy.

The epidemiology of Hymenoptera venom allergy in Europe showed prevalence of systemic reactions of about 3%, but is scantly investigated in Italy. We studied two samples of the general and an at risk population, i.e. the foresters, in northern Italy. A standardized questionnaire dealing with allergic reactions to Hymenoptera stings was submitted to the subjects included in the study, who were factory workers in Milan and Verona and foresters in Lombardy. An overall number of 574 subjects participated to the study, 462 (299 males and 163 females, mean age 40.1 yrs, range 20-63 yrs) were factory workers and 112 (all males, mean age 38.8 yrs, range 24-59 yrs) were foresters. Among factory workers, 302 (65.4%) were stung by Hymenoptera, 49 (10.6%) had had large local reactions, and 13 (2.8%) systemic reactions. Among foresters, 76 (67.8%) were stung, 11 (9.8%) had had large local reactions, and 5 (4.5%) systemic reactions. The systemic reactions were life-threatening in 3 (0.6%) industrial workers and 2 (1.8%) foresters. The prevalence of systemic reaction of 2.8% in the general population agrees with the data reported from a number of countries with temperate climate. The prevalence of 4.5% in foresters attributed to this population a risk only slightly increased.

Adult↗
PubMed2003

Dermatological powder as hidden cause of occupational allergy due to casein: a case report.

We report a case of occupational asthma due to hidden casein, contained in a dermatological powder. A 44 year old nurse reported the recent onset of rhinitis and asthma, clearly related to the work environment. Skin tests for food allergens revealed a positivity for milk proteins. The source of dispersed milk proteins in the work environment was found to be a dermatological formulation of an inert refreshing powder, used to treat excoriated areas in the elderly. Skin prick tests confirmed the positivity to casein and to the commercial product.

Adult↗
PubMed1981

Effects of a vestibular stimulation program on stereotypic rocking behavior.

This study measures the effect of a vestibular stimulation program on the stereotypic rocking behavior of three severely mentally retarded persons within both experimental and natural settings. A multiple baseline design was used. Frequency and duration of stereotypic rocking behavior were measured by a partial-interval time sample. Results indicated a statistically significant reduction of both frequency and duration of rocking behavior directly after receiving vestibular stimulation and 1 hour after stimulation. The rocking behavior remained reduced after 6 days without the vestibular stimulation program. It was concluded that vestibular stimulation resulted in a reduction of the stereotypic rocking behavior of these subjects.

Adolescent↗
PubMedDate not supplied

Anaphylaxis due to carrot as hidden food allergen.

Carrot is frequently involved in food allergies and oral allergy syndromes, usually in association with other foods. Nevertheless, carrot alone is rarely responsible for severe systemic reactions. We report a case of anaphylactic shock due to the inadvertent ingestion of carrot as a hidden allergen contained in an ice-cream. The etiological role of carrot in provoking the symptoms was thoroughly ascertained through appropriate in vivo and in vitro assays and by excluding, through double-blind placebo-controlled challenge, the involvement of other ingredients of the food. We highlight once again the harm and risks due to hidden food allergens contained in commercial preparations and the importance of thorough patient education and information.

Adult↗
PubMedDate not supplied

Severe systemic reactions caused by poppy seed.

We describe a case of severe systemic reactions caused from poppy seed ingestion. Poppy seeds were suspected to be responsible for the symptoms on the basis of the clinical history. This suspicion was confirmed by skin testing and the prick-prick test. Moreover, a RAST assay was conducted with an extract of fresh food, confirming the presence of specific IgE to poppy seed. Although poppy seeds are not commonly used, we highlight the possible importance of such rare and often hidden sources of allergens.

Adult↗
PubMedDate not supplied

Beer-induced anaphylaxis due to barley sensitization: two case reports.

Despite the large worldwide beer consumption, allergic reactions have very rarely been reported. We describe two cases of severe systemic reactions due to beer ingestion: one case of anaphylaxis requiring emergency care and one of generalized urticaria and angioedema. The two patients underwent a detailed diagnostic procedure involving skin testing, oral challenge with additives, detection of specific IgE to the components of beer, and oral challenge with beer in one patient. The results of the tests, in the particular skin tests and IgE assay, allowed us to detect barley as the specific ingredient responsible for the observed allergic reactions to beer. Therefore, such a sensitization should always be taken into account in the case of suspected reactions following beer ingestion.

Adult↗