11 results on '"Gabrielli, Sofianne"'
Search Results
2. Impact of Reaction Setting on the Management, Severity, and Outcome of Pediatric Food-Induced Anaphylaxis: A Cross-Sectional Study.
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Prosty C, Colli MD, Gabrielli S, Clarke AE, Morris J, Gravel J, Lim R, Chan ES, Goldman RD, O'Keefe A, Gerdts J, Chu DK, Upton J, Hochstadter E, Bretholz A, McCusker C, Zhang X, Protudjer JLP, and Ben-Shoshan M
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- Child, Male, Humans, Child, Preschool, Female, Epinephrine therapeutic use, Cross-Sectional Studies, Canada epidemiology, Emergency Service, Hospital, Anaphylaxis diagnosis, Anaphylaxis drug therapy, Anaphylaxis epidemiology, Food Hypersensitivity diagnosis
- Abstract
Background: Prompt epinephrine autoinjector (EAI) use is the primary treatment for anaphylaxis. However, limited Canadian data exist on the impact of reaction location on EAI use for food-induced anaphylaxis (FIA)., Objective: We sought to investigate the setting, management, and severity of pediatric FIA., Methods: We recruited children presenting with FIA from 11 Canadian emergency departments. Patient demographics and the setting, management, and symptoms of FIA were collected by standardized questionnaire. Factors associated with prehospital EAI use and reaction severity were determined by logistic regression., Results: We recruited 3,604 children; 60.2% were male and the median age was 5.0 years (interquartile range 1.8-11.0). Among cases with a known location of FIA (85.0%), home was the most common setting (68.1%), followed by school/daycare (12.8%), other locations (11.4%; eg, park, car), and restaurants (7.4%). In the prehospital setting, EAI was administered in 36.7% of reactions at home, 66.7% in school/daycare, 40.2% in other locations, and 44.5% in restaurants. Relative to reactions occurring at school/daycare, prehospital EAI use was less likely at home (adjusted odds ratio [aOR] 0.80; 95% CI 0.76-0.84), in restaurants (aOR 0.81; 95% CI 0.75-0.87), and in other settings (aOR 0.77; 95% CI 0.73-0.83), when data were adjusted for reaction severity, sex, age, comorbidities, and province. The FIA setting was not associated with reaction severity or hospitalization., Conclusions: Prehospital EAI use was higher at school/daycare than in other settings, potentially owing to the presence of policies and training on FIA. Setting-specific interventions including educational programs and policies/laws mandating training and stocking an EAI may improve anaphylaxis recognition and treatment., (Copyright © 2022 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.)
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- 2022
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3. Bridging Knowledge Gaps in Anaphylaxis Management Through a Video-Based Educational Tool.
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Karim J, Gabrielli S, Torabi B, Byrne A, De Schryver S, Gadoury-Lévesque V, Alizadehfar R, McCusker C, Vincent M, Morris J, Gerdts J, Zhang X, and Ben-Shoshan M
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- Male, Humans, Child, Infant, Child, Preschool, Adolescent, Female, Surveys and Questionnaires, Educational Status, Anaphylaxis drug therapy, Anaphylaxis etiology, Food Hypersensitivity complications, Food Hypersensitivity drug therapy, Communications Media
- Abstract
Introduction: We aimed to develop and test the effectiveness of an education tool to help pediatric patients and their families better understand anaphylaxis and its management, and to improve current knowledge and treatment guidelines adherence. Methods: From June 2019 to May 2022, 128 pediatric patients with history of food-triggered anaphylaxis who presented to the allergy outpatient clinics at the study institution were recruited. Consenting families were asked to complete 6 questions related to the triggers, recognition, and management of anaphylaxis at the time of presentation to the clinic. Participants were shown a 5-min animated video on the causes, presentation, and management of anaphylaxis. At the end of the video, the participants were redirected to the same 6 questions to respond again. The scores were recorded in proportion of correct answers (minimum 0.0; maximum 1.0). Results: The mean age of the patients was 5.8 ± 4.5 years (range: 0.5-18.8 years). The majority were males (70 patients; 54.7%). The mean baseline prevideo education questionnaire score was 0.76 ± 0.2 (range: 0.3-1.0), whereas the mean follow-up score was 0.82 ± 0.2 (range: 0.3-1.0). This score difference of 0.06 was statistically significant ( P < 0.001). There were no significant associations between change in scores and age or gender of the participants. Conclusion: Our video teaching method was successful in educating patients and their families to better understand anaphylaxis and its management at the moment of the clinical encounter. Retention of knowledge at long-term follow-up should be assessed.
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- 2022
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4. Sesame-induced anaphylaxis in pediatric patients from the cross-Canada anaphylaxis registry.
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Sillcox C, Gabrielli S, Clarke AE, Morris J, Gravel J, Lim R, Chan ES, Goldman RD, O'Keefe A, Gerdts J, Chu DK, Upton J, Hochstadter E, Moisan J, Bretholz A, McCusker C, Zhang X, Protudjer JLP, Abrams EM, Simons E, and Ben-Shoshan M
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- Adolescent, Allergens therapeutic use, Canada epidemiology, Child, Child, Preschool, Emergency Service, Hospital, Epinephrine therapeutic use, Female, Humans, Male, Registries, Anaphylaxis drug therapy, Anaphylaxis epidemiology, Anaphylaxis etiology, Food Hypersensitivity complications, Food Hypersensitivity drug therapy, Food Hypersensitivity epidemiology, Sesamum adverse effects
- Abstract
Background: Sesame can cause severe allergic reactions and is a priority allergen in Canada., Objective: To assess clinical characteristics and management of pediatric sesame-induced anaphylaxis and identify factors associated with epinephrine treatment., Methods: Between 2011 and 2021, children with sesame-induced anaphylaxis presenting to 7 emergency departments (ED) in 4 Canadian provinces and 1 regional emergency medical service were enrolled in the Cross-Canada Anaphylaxis Registry. Standardized recruitment forms provided data on symptoms, severity, triggers, and management. Multivariate logistic regression evaluated associations with epinephrine treatment pre-ED and multiple epinephrine dosages., Results: Of all food-induced anaphylactic reactions (n = 3279 children), sesame accounted for 4.0% (n = 130 children), of which 61.5% were boys, and the average (SD) age was 5.0 (4.9) years. Hummus containing sesame paste triggered 58.8% of reactions. In the pre-ED setting, 32.3% received epinephrine, and it was more likely to be used in boys (adjusted odds ratio [aOR], 1.27; 95% confidence interval [CI], 1.08-1.50) and those with a known food allergy (aOR, 1.36; 95% CI, 1.11-1.68]). In the ED, 47.7% of cases received epinephrine, with older children more likely to receive multiple epinephrine doses (aOR, 1.00; 95% CI, 1.00-1.02)., Conclusion: In Canada, hummus is the major trigger of sesame-induced anaphylaxis. Knowledge translation focused on prompt epinephrine use and product-labeling policies are required to limit sesame reactions in communities., (Copyright © 2022 American College of Allergy, Asthma & Immunology. All rights reserved.)
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- 2022
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5. Seafood-induced anaphylaxis in children presenting to Canadian emergency departments: Rates, clinical presentation, and management.
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Sehayek D, Gold MS, Gabrielli S, Abrams EM, Bretholz A, Chan ES, Chu DK, Clarke AE, Gerdts J, Goldman RD, Gravel J, Hochstadter E, Lim R, McCusker C, Moisan J, Morris J, O'Keefe A, Protudjer JLP, Shand G, Simons E, Upton J, Zhang X, and Ben-Shoshan M
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- Animals, Canada epidemiology, Emergency Service, Hospital, Epinephrine therapeutic use, Humans, Seafood adverse effects, Anaphylaxis diagnosis, Anaphylaxis drug therapy, Anaphylaxis epidemiology, Asthma diagnosis, Asthma drug therapy, Asthma epidemiology, Food Hypersensitivity complications, Food Hypersensitivity diagnosis, Food Hypersensitivity epidemiology
- Abstract
Background: There is a lack of data on seafood-induced anaphylaxis in children in Canada., Objective: To evaluate the rate, clinical features, and management of seafood-induced anaphylaxis in children presenting to emergency departments across Canada., Methods: Children with anaphylaxis were recruited at 6 emergency departments between 2011 and 2020 as part of the Cross-Canada Anaphylaxis REgistry. A standardized form documenting symptoms, triggers, comorbidities, and management was used to collect data., Results: There were 75 fish-induced and 71 shellfish-induced cases of suspected anaphylaxis, most of which were caused by salmon and shrimp, respectively. Mucocutaneous symptoms were most common, whereas respiratory symptoms were associated with patients with fish-induced reactions who have comorbid asthma (adjusted odds ratio [aOR], 1.18; 95% confidence interval [CI], 1.02-1.36). Prehospital epinephrine was underused (<35%), whereas in-hospital epinephrine was given to less than 60% of the patients. Among those with a known fish or shellfish allergy, prehospital epinephrine use was associated with known asthma (aOR 1.39 [95% CI, 1.05-1.84] and aOR 1.25 [95% CI, 1.02-1.54], respectively). Among children who were assessed by either skin test or specific immunoglobulin E, 36 patients (76.6%) with suspected fish-induced anaphylaxis and 19 patients (51.4%) with suspected shellfish-induced anaphylaxis tested positive., Conclusion: Prehospital epinephrine is underused in the management of seafood-induced anaphylaxis. Among children with known seafood allergy, prehospital epinephrine use is more likely if there is a known asthma comorbidity., (Copyright © 2022 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.)
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- 2022
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6. Fruit-Induced Anaphylaxis: Clinical Presentation and Management.
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Gabrielli S, Clarke AE, Morris J, Gravel J, Lim R, Chan ES, Goldman RD, O'Keefe A, Gerdts J, Chu DK, Upton J, Hochstadter E, Moisan J, Bretholz A, McCusker C, Zhang X, Protudjer JLP, Abrams EM, Simons E, and Ben-Shoshan M
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- Adult, Canada, Child, Emergency Service, Hospital, Epinephrine therapeutic use, Fruit, Humans, Male, Quebec, Anaphylaxis diagnosis, Anaphylaxis drug therapy, Anaphylaxis epidemiology, Food Hypersensitivity diagnosis, Food Hypersensitivity epidemiology
- Abstract
Background: Data are sparse regarding the clinical characteristics and management of fruit-induced anaphylaxis., Objective: To assess clinical characteristics and management of patients with fruit-induced anaphylaxis and determine factors associated with severe reactions and epinephrine use., Methods: Over 9 years, children and adults presenting with anaphylaxis to seven emergency departments in four Canadian provinces and patients requiring emergency medical services in Outaouais, Quebec were recruited as part of the Cross-Canada Anaphylaxis Registry. A standardized form documenting symptoms, triggers, and management was collected. Multivariate logistic regression was used to identify factors associated with severe reactions and epinephrine treatment in the pre-hospital setting., Results: We recruited 250 patients with fruit-induced anaphylaxis, median age 10.2 years (interquartile range, 3.6-23.4 years); 48.8% were male. The most common fruit triggers were kiwi (15.6%), banana (10.8%), and mango (9.2%). Twenty-three patients reported having eczema (9.3%). Epinephrine use was low in both the pre-hospital setting and the emergency department (28.4% and 40.8%, respectively). Severe reactions to fruit were more likely to occur in spring and among those with eczema (adjusted odds ratio [aOR] = 1.12, 95% confidence interval [CI], 1.03-1.23; and 1.17, 95% CI, 1.03-1.34, respectively). Patients with moderate and severe reactions (aOR = 1.23; 95% CI, 1.06-1.43) and those with a known food allergy (aOR = 1.38; 95% CI, 1.24-1.54) were more likely to be treated with epinephrine in the pre-hospital setting., Conclusions: Severe anaphylaxis to fruit is more frequent in spring. Cross-reactivity to pollens is a potential explanation that should be evaluated further., (Copyright © 2021 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.)
- Published
- 2021
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7. Specific IgE antibody levels during and after food-induced anaphylaxis.
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Rehimini S, Gabrielli S, Langlois A, Clarke AE, De Schryver S, McCusker C, Bretholz A, Zhang X, Shand G, and Ben-Shoshan M
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- Adolescent, Anaphylaxis blood, Child, Child, Preschool, Disease Progression, Emergency Service, Hospital, Female, Food Hypersensitivity blood, Humans, Immunoglobulin E blood, Infant, Male, Skin Tests, Tryptases blood, Anaphylaxis immunology, Food Hypersensitivity immunology, Immunoglobulin E immunology
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- 2021
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8. Management and diagnosis of exercise-associated anaphylaxis cases in the paediatric population.
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Bartolucci S, Gabrielli S, Clarke A, Chan ES, Upton J, O-Keefe A, Eisman H, and Ben-Shoshan M
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- Adolescent, Anaphylaxis diagnosis, Anaphylaxis drug therapy, Anaphylaxis etiology, Child, Epinephrine therapeutic use, Female, Histamine Antagonists therapeutic use, Humans, Injections, Intramuscular, Male, Odds Ratio, Sympathomimetics therapeutic use, Venoms adverse effects, Anaphylaxis epidemiology, Cold Temperature adverse effects, Exercise adverse effects, Food Hypersensitivity complications
- Published
- 2021
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9. Anaphylaxis as a presenting symptom of food allergy in children with no known food allergy.
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Ratnarajah K, Clarke AE, McCusker C, Gabrielli S, Morris J, Gravel J, Bretholz A, Lim R, Chan ES, Goldman RD, O-Keefe A, Gerdts J, Chu D, Upton J, and Ben-Shoshan M
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- Allergens, Child, Humans, Anaphylaxis diagnosis, Food Hypersensitivity diagnosis
- Published
- 2020
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10. Rates of anaphylaxis for the most common food allergies.
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Miles BT, Gabrielli S, Clarke A, Eisman H, Shand G, and Ben-Shoshan M
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- Humans, Anaphylaxis diagnosis, Anaphylaxis epidemiology, Food Hypersensitivity diagnosis, Food Hypersensitivity epidemiology
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- 2020
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11. Emergency Management of Anaphylaxis Due to an Unknown Trigger: An 8-Year Follow-Up Study in Canada.
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Le M, Gabrielli S, Clarke A, Eisman H, Morris J, Gravel J, Chan ES, Lim R, O'Keefe A, Shand G, and Ben-Shoshan M
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- Adolescent, Adrenal Cortex Hormones therapeutic use, Adrenergic beta-Agonists therapeutic use, Adult, Aftercare, Age Factors, Allergy and Immunology, Anaphylaxis epidemiology, Anaphylaxis etiology, Anaphylaxis metabolism, Asthma epidemiology, Canada epidemiology, Child, Child, Preschool, Comorbidity, Emergency Medical Services, Emergency Service, Hospital, Female, Fluid Therapy, Follow-Up Studies, Food Hypersensitivity complications, Food Hypersensitivity epidemiology, Humans, Infant, Logistic Models, Male, Middle Aged, Multivariate Analysis, Referral and Consultation, Registries, Skin Tests, Tryptases metabolism, Young Adult, Anaphylaxis therapy, Epinephrine therapeutic use, Food Hypersensitivity diagnosis, Histamine Antagonists therapeutic use, Sympathomimetics therapeutic use
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Background: Anaphylaxis due to unknown trigger (AUT) is anaphylaxis not explained by a proved or presumptive cause or stimulus at the time of the reaction. Research describing the management and follow-up of AUT is limited., Objective: To assess and compare the demographic and clinical characteristics and the management of adult and pediatric AUT cases across Canada., Methods: Participants were identified between 2011 and 2018 in emergency departments at 8 centers across Canada as part of the Cross-Canada Anaphylaxis Registry. A standardized form documenting the reaction and management in children and adults was completed. Patients were contacted for follow-up to determine assessment by an allergist., Results: A total of 295 AUT cases (7.5%) were recruited among 3,922 cases of anaphylaxis. In the prehospital setting, children (adjusted odds ratio [aOR], 1.20; 95% CI, 1.05-1.37) and those with a known food allergy (aOR, 1.14; 95% CI, 1.02-1.28) were more likely to receive treatment with epinephrine. Children were also more likely to be assessed by an allergist after their reaction (aOR, 1.43; 95% CI, 1.13-1.81) and were more likely to have an identified trigger for their reaction (aOR, 1.35; 95% CI, 1.07-1.70). Among patients contacted for follow-up, food was identified as the cause of reaction in 11 of 76 patients. A new food allergy was diagnosed in 4 patients (2 children and 2 adults)., Conclusions: Our findings highlight important differences between management and follow-up of adult and pediatric AUT cases. It is crucial to follow up all cases of AUT and establish appropriate treatment and management guidelines., (Copyright © 2018 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.)
- Published
- 2019
- Full Text
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