Blog

■ Penicillin allergy

D J McCullagh and D K Chu

CMAJ 2019, vol 191 (8): E231

1 – Penicillin allergy is commonly reported, but 9 out of 10 times, penicillin will be tolerated if administered

2 – The label of penicillin allergy is bad for patients and the health care system

3 – Patients reporting penicillin allergy can be easily risk stratified to determine whether they require specialist evaluation

4 – Penicillin allergy is lost over time, with resolution in 80% of people over 10 years, and in 50% over 5 years

5 – Allergy referral and testing is vastly under used, but is safe, accurate, rapid and cost-effective

https://www.cmaj.ca/content/191/8/E231

■ Vaccine alllergy

D K Chu, Z Abdurrahman

CMAJ 2019, vol 191 (14): E395

1 – Immunoglobulin E (IgE)-mediated vaccine allergies are uncommon, manifesting within minutes as urticaria, angioedema, wheeze or anaphylaxis

2 – The most common adverse events of vacines are fever, local pain or irritation, and local redness or swelling, whic are not signs of allergy

3 – Patients with egg allergy can be safely vaccinated with several vacines without any special

4 – Vaccine allergies are typically unpredictable specific to a single vaccine

5 – Even if patients are truly allergic to a vaccine, allergists can often safely vaccinate them

https://www.cmaj.ca/content/191/14/E395

■ Eosinophilic esophagitis

T Jevalingam, S C Grover

CMAJ 2018, vol 190 (17): E542

1 – Eosinophilic esophagitis is becoming more common

2 – Eosinophilic esophagitis should be suspected in patients presenting with dysphagia or food bolus obstruction

3 – Endoscopic findings alone are not suficiente to make a diagnosis of eosinophilic esophagitis

4 – Proton pump inhibitors should be prescribed for a histologic finding of esophageal esosinophilia

5 – Topical steroids and elimination diets are the mainstays of therapy

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5929894/

■  Dr Paulo Fernando Leite

Cardiologia/Prevenção Cardiovascular

Estratificação de Risco Cardiovascular

Consultório: Rua Padre Rolim 815/sala 601

Tel: 33245518

CRMMG: 7026

Email: pfleite1873@gmail.com

Data: Fev 2020

■ Inflammatory bowel disease in children and adolescentes

N Chanchlani, R K Russel

CMAJ 2019, vol 191 (6): E164

1 – Diagnostic delay is common in pediatric inflamm3 atory bowel disease

2 – Extraintestinal manifestation of pediatric inflammatory bowel disease can occur before diagnosis

3 – The presence of perianal disease can be a highly specific finding when Crohn disease is suspected

4 – Once infection has been excluded, investigation of nonbloody diarrhea lasting longer than 2 weeks should be started in primary care

5 – Fecal calprotectin testing cana id in the diagnosis, as high levels indicated intestinal mucosa inflammation

https://www.cmaj.ca/content/191/6/E164

■ Reactivation of hepatites B vírus associated with immunosuppression therapy

J G H Lee, M Carruthers, H H Ko

CMAJ 2019, vol 191 (43): 2884

1 – Individuals with past hepatites B vírus (HBC) infection on immunosuppressive therapy are at risk of HBC reactivation

2 – Reactivation of HBV associated with immunosuppression therapy is a preventable cause of morbidity and mortality

3 – Onset of HBC reactiviation is variable

4 – Multiple factors play a role in the risk of HBV reactivation with immunosupression therapy

5 – Prophylactic antiviral therapy should be considered for those who are at moderate or high risk of HBV reactivation

https://www.cmaj.ca/content/190/43/E1284

■ Anal fissures

M A Dykstra, W Donald Buie

CMAJ 2019, vol 191 (26): E737

1 – Anal fissure may be acute or chronic

2 – Fissures that are off midline require further investigation

3 – Most fissures will resolve with conservative or medical management

4 – Topical calcium channel blockers are recommended as first line medical therapy for chronic fissures

5 – The presence of fissure should not preclude investigation of rectal bleeding for patients at higher risk

https://www.cmaj.ca/content/191/26/E737

■ Gastroenterologia: Five Things to Know About Online (Gastroenterology: Five Things to Know About)

https://internetmedica.com.br/gastroenterologia-five-things-to-know-about-online-gastroenterology-five-things-to-know-about/

■  Dr Paulo Fernando Leite

Cardiologia/Prevenção Cardiovascular

Estratificação de Risco Cardiovascular

Consultório: Rua Padre Rolim 815/sala 601

Tel: 33245518

CRMMG: 7026

Email: pfleite1873@gmail.com

Data: Fev 2020