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4. Management of hypersensitivity reactions to iodinated contrast media

Author

Brockow, Knut, Christiansen, C., Kanny, G., Clément, O., Barbaud, A., Bircher, A., Dewachter, P., Guéant, J. L., Rodriguez Guéant, R. M., Mouton Faivre, C., Ring, J., Romano, A., Sainte Laudy, J., Demoly, P., Pichler, W. J., Aberer, W., Ballmer Weber, B. K., Bilo, M. B., Birnbaum, J., Blanca, M., Blõmecke, B., Campi, P., De Weck, A., Drouet, M., Dzviga, C., Fernandez, J., Gomez, E., Kapp, A., Kidon, M., Kowalski, M., Laroche, D., Mertès, M., Merk, H., Moneret Vautrin, D. A., Pascual Marcos, C., Rebelo Gomes, E., Rueff, F., Sanz, M. L., Torres, M. J., Vervloet, D., Wedi, B., MARONE, GIANNI, Brockow, Knut, Christiansen, C., Kanny, G., Clément, O., Barbaud, A., Bircher, A., Dewachter, P., Guéant, J. L., Rodriguez Guéant, R. M., Mouton Faivre, C., Ring, J., Romano, A., Sainte Laudy, J., Demoly, P., Pichler, W. J., Aberer, W., Ballmer Weber, B. K., Bilo, M. B., Birnbaum, J., Blanca, M., Blõmecke, B., Campi, P., De Weck, A., Drouet, M., Dzviga, C., Fernandez, J., Gomez, E., Kapp, A., Kidon, M., Kowalski, M., Laroche, D., Marone, Gianni, Mertès, M., Merk, H., Moneret Vautrin, D. A., Pascual Marcos, C., Rebelo Gomes, E., Rueff, F., Sanz, M. L., Torres, M. J., Vervloet, D., and Wedi, B.

Subjects
medicine.medical_specialty, Allergy, Premedication, Immunology, Drug Hypersensitivity, Iodinated contrast media, Skin test, Immediate reaction, Prevalence, Immunology and Allergy, Medicine, In patient, Iodine Compound, business.industry, Contrast media, Risk Factor, ALLERGIC/HYPERSENSITIVITY, Nonimmediate reaction, Diagnostic test, medicine.disease, Dermatology, Surgery, Skin reaction, business, Diagnosi, Human
Abstract

All iodinated contrast media (CM) are known to cause both immediate (≤1 h) and nonimmediate (>1 h) hypersensitivity reactions. Although for most immediate reactions an allergic hypersensitivity cannot be demonstrated, recent studies indicate that the severe immediate reactions may be IgE-mediated, while most of the nonimmediate exanthematous skin reactions, appear to be T-cell mediated. Patients who experience such hypersensitivity reactions are therefore advised to undergo an allergologic evaluation. Several investigators have found skin testing to be useful in confirming a CM allergy, especially in patients with nonimmediate skin eruptions. If a patient with confirmed allergy to a CM needs a new CM exposure, a skin test negative CM should be chosen and premedication may be tried. However, none of these precautional measures is a guarantee against a repeat reaction. More research focusing on pathomechanisms, diagnostic testing and premedication is therefore clearly needed in order to prevent CM-induced hypersensitivity reactions in the future.

Published
2005
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5. Relationship between bone mineral density changes with denosumab treatment and risk reduction for vertebral and nonvertebral fractures

Author

Austin, M, Yang, Yc, Vittinghoff, E, Adami, Silvano, Boonen, S, Bauer, Dc, Bianchi, G, Bolognese, Ma, Christiansen, C, Eastell, R, Grauer, A, Hawkins, F, Kendler, Dl, Oliveri, B, Mcclung, Mr, Reid, Ir, Siris, Es, Zanchetta, J, Zerbini, Ca, Libanati, C, Cummings, Sr, and Freedom, Trial

Subjects
PERCENT OF TREATMENT EFFECT EXPLAINED, SURROGATE, Bone density, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, Medicina Clínica, law.invention, Placebos, Fractures, Bone, Absorptiometry, Photon, Randomized controlled trial, Bone Density, law, Monoclonal, purl.org/becyt/ford/3.2 [https], 80 and over, Medicine, Orthopedics and Sports Medicine, Humanized, Aged, 80 and over, Bone mineral, Bone Density Conservation Agents, musculoskeletal, neural, and ocular physiology, Antibodies, Monoclonal, Middle Aged, musculoskeletal system, Photon, FRACTURE, bone mineral density, denosumab, Denosumab, Spinal Fractures, purl.org/becyt/ford/3 [https], Female, Medicina Critica y de Emergencia, medicine.drug, musculoskeletal diseases, medicine.medical_specialty, CIENCIAS MÉDICAS Y DE LA SALUD, Bone pathology, Urology, Antibodies, Monoclonal, Humanized, Placebo, Antibodies, Double-Blind Method, Humans, Absorptiometry, Bone, Reduction (orthopedic surgery), Aged, DENOSUMAB, business.industry, Original Articles, Surgery, business, Fractures, Risk Reduction Behavior, BONE MINERAL DENSITY
Abstract

Dual-energy X-ray absorptiometric bone mineral density (DXA BMD) is a strong predictor of fracture risk in untreated patients. However, previous patient-level studies suggest that BMD changes explain little of the fracture risk reduction observed with osteoporosis treatment. We investigated the relevance of DXA BMD changes as a predictor for fracture risk reduction using data from the FREEDOM trial, which randomly assigned placebo or denosumab 60 mg every 6 months to 7808 women aged 60 to 90 years with a spine or total hip BMD T-score < -2.5 and not < -4.0. We took a standard approach to estimate the percent of treatment effect explained using percent changes in BMD at a single visit (months 12, 24, or 36). We also applied a novel approach using estimated percent changes in BMD from baseline at the time of fracture occurrence (time-dependent models). Denosumab significantly increased total hip BMD by 3.2%, 4.4%, and 5.0% at 12, 24, and 36 months, respectively. Denosumab decreased the risk of new vertebral fractures by 68% (p < 0.0001) and nonvertebral fracture by 20% (p = 0.01) over 36 months. Regardless of the method used, the change in total hip BMD explained a considerable proportion of the effect of denosumab in reducing new or worsening vertebral fracture risk (35% [95% confidence interval (CI): 20%-61%] and 51% [95% CI: 39%-66%] accounted for by percent change at month 36 and change in time-dependent BMD, respectively) and explained a considerable amount of the reduction in nonvertebral fracture risk (87% [95% CI: 35% - >100%] and 72% [95% CI: 24% - >100%], respectively). Previous patient-level studies may have underestimated the strength of the relationship between BMD change and the effect of treatment on fracture risk or this relationship may be unique to denosumab. Copyright © 2012 American Society for Bone and Mineral Research. Fil: Austin, Matthew. Amgen Incorporated; Estados Unidos Fil: Yang, Yu Ching. Amgen Incorporated; Estados Unidos Fil: Vittinghoff, Eric. University of California; Estados Unidos Fil: Adami, Silvano. Universita di Verona; Italia Fil: Boonen, Steven. Katholikie Universiteit Leuven; Bélgica Fil: Bauer, Douglas C. University of California; Estados Unidos Fil: Bianchi, Gerolamo. Azienda Sanitaria Genovese; Italia Fil: Bolognese, Michael A.. Bethesda Health Research Center; Estados Unidos Fil: Christiansen, Claus Bohn. Center For Clinical And Basic Research As; Estados Unidos Fil: Eastell, Richard. University Of Sheffield; Reino Unido Fil: Grauer, Andreas. Amgen Incorporated; Estados Unidos Fil: Hawkins, Federico. Hospital Universitario 12 de Octubre; España Fil: Kendler, David L.. University of British Columbia; Canadá Fil: Oliveri, María Beatriz. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Medicina. Hospital de Clínicas General San Martín; Argentina Fil: McClung, Michael R.. Oregon Osteoporosis Center; Estados Unidos Fil: Reid, Ian R.. The University of Auckland; Nueva Zelanda Fil: Siris, Ethel S.. Columbia University; Estados Unidos Fil: Zanchetta, Jose. Universidad del Salvador; Argentina Fil: Zerbini, Cristiano A.F.. Centro Paulista de Investigação Clinica; Brasil Fil: Libanati, Cesar. Amgen Incorporated; Estados Unidos Fil: Cummings, Steven R.. University of California; Estados Unidos

Published
2012
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47. Wine for Type 2 Diabetic Patients?

Author

Christiansen, C., primary, Thomsen, C., additional, Rasmussen, O., additional, Balle, M., additional, Hauerslev, C., additional, Hansen, C., additional, and Hermansen, K., additional

Published
1993
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