Marcelo Vivolo Aun

• MD, PhD
• Medical Doctor at Faculdade Israelita de Ciências da Saúde Albert Einstein, São Paulo, Brazil

Introduction The COVID-19 pandemic necessitated a shift from in-person to remote learning, including team-based learning activities. Many studies have explored several aspects of team-based learning; however, there is still a lack of knowledge regarding the factors affecting students’ attitudes and performance. Objective To evaluate the impact of...

Background The use of artificial intelligence (AI) in scientific writing is rapidly increasing, raising concerns about authorship identification, content quality, and writing efficiency. Objectives This study investigates the real-world impact of ChatGPT, a large language model, on those aspects in a simulated publication scenario. Methods Forty-...

RESUMO Desde a sua introdução na década de 1950, os meios de contraste iodados (MCI) têm estado entre os fármacos mais frequentemente prescritos na radiologia e vêm sendo amplamente utilizados após as novas formulações, com melhor resolução e menor toxicidade. As reações adversas a esses agentes não são incomuns, mas são subnotificadas e nem sempre...

Hereditary angioedema (HAE) encompasses a group of diseases characterized by recurrent, genetically mediated angioedema associated with increased vascular permeability primarily due to bradykinin. The disease poses diagnostic challenges, leading to underdiagnosis and delayed therapy. Severe manifestations include laryngeal and intestinal angioedema...

Rapid Diagnostic Tests (RDT) are useful to identify syphilis cases, particularly for hard-to-reach populations and if laboratory services are scarce. However, RDT performance may be suboptimal. We aimed to assess the sensitivity and specificity of a syphilis RDT using well-characterized blood donors’ samples. We categorized samples from 811 blood d...

Introdução As infecções respiratórias são a principal causa de internação pediátrica no Brasil. A gravidade dos quadros clínicos é variável e a morbidade pode ser resultado direto do agente etiológico, secundária à exacerbação de condições de base ou de possíveis complicações. O conhecimento dos principais patógenos envolvidos nestes quadros pode n...

Introdução A incidência e a prevalência de sífilis vêm aumentando nos últimos anos no Brasil, e estratégias para facilitar o diagnóstico na prática clínica incluem o uso de testes rápidos (TR), que permitem o diagnóstico sem a necessidade de estrutura laboratorial. Alguns estudos sugerem que a sensibilidade e especificidade desses testes pode varia...

Introduction: Systemic Mastocytosis comprises a group of neoplastic diseases characterized by clonal expansion and infiltration of mast cells into several organs. Objective: The diagnosis and treatment of this disease may be challenging for non-specialists. Method and results: An online expert panel with 18 multidisciplinary specialists was convene...

Background: Acquired deficiency of C1 inhibitor (AAE-C1-INH) is a very rare cause of recurrent angioedema, with few cases reported in the literature. We aimed to describe a series of patients with AAE-C1-INH who were diagnosed and received care at angioedema reference centers in Brazil, affiliated to the Brazilian Group of Studies on Hereditary An...

Objectives The study describes a case series of hereditary angioedema with C1 Inhibitor Deficiency (C1INH-HAE) in order to corroborate six clinical warning signs “HAAAAE (H4AE)” to enable early identification of this disease. Methods The authors analyzed the C1INH-HAE cohort to analyze the clinical aspects of the present study's patients and corro...

A incidência e a prevalência de sífilis vêm aumentando nos últimos anos no Brasil e estratégias para facilitar o diagnóstico na prática clínica incluem o uso de testes rápidos (TR). Esses testes são de fácil execução e sua leitura simples possibilita a investigação da sífilis em locais sem infraestrutura laboratorial. Entretanto, alguns estudos sug...

Monoclonal antibodies have become a mainstay of treatment for many inflammatory diseases and malignancies. Multiple sclerosis is a chronic inflammatory, demyelinating, and neurodegenerative disease of the central nervous system and a common cause of disability in young adults. Ocrelizumab is a recombinant humanized monoclonal antibody that targets...

RESUMO O angioedema hereditário é uma doença autossômica dominante caracterizada por crises recorrentes de edema que acometem o tecido subcutâneo e o submucoso, com envolvimento de di-versos órgãos. Os principais locais afetados são face, membros superiores e inferiores, as alças intestinais e as vias respiratórias superiores. Em decorrência da fal...

RESUMO O tratamento do angioedema hereditário tem início com a educação dos pacientes e familiares sobre a doença, pois é fundamental o conhecimento da imprevisibilidade das crises, assim como os seus fatores desencadeantes. O tratamento medicamentoso se divide em terapia das crises e profilaxia das manifestações clínicas. As crises devem ser trata...

Nonsteroidal anti-inflammatory drugs are a major cause of drug hypersensitivity reactions in clinical practice. In this “Update Part 2”, we discuss the clinical picture, including the main signs and symptoms, how to distinguish clinical phenotypes, how to manage affected patients, and when to indicate additional procedures, such as skin testing, ch...

This study aimed to evaluate the clinical evolution, functional parameters and inflammatory activity of asthma in patients who submitted to an educational intervention. 58 adult patients over 18 years of age with partly controlled and uncontrolled asthma were randomized into an intervention group (IG) (N = 32) and a control group (CG) (N = 26) and...

Hereditary angioedema (HAE) is an autosomal dominant disease mostly due to the deficiency of C1 inhibitor (C1-INH). HAE with normal C1-INH was first described in 2000 and associated with mutations in the coagulation factor XII in 2006. Both diseases are associated with high bradykinin production, resulting in increased vascular permeability. Gastro...

Th17/Treg imbalance plays a pivotal role in COPD development and progression. We aimed to assess Th17/Treg-related intracellular signaling at different COPD stages in local and systemic responses. Lung tissue and/or peripheral blood samples were collected and divided into non-obstructed (NOS), COPD stages I and II, and COPD stages III and IV groups...

Background Gestational syphilis is underdiagnosed and undertreated, leading to stillbirth, prematurity, low birthweight, neonatal death, and congenital syphilis. Most patients who label as allergic to penicillin are misdiagnosed. Objective To assess the efficacy and safety of an algorithm to guide re-exposure to penicillin in pregnant women with s...

Programmed cell death ligand 1(PDL-1) is known for its inhibitory effect on the cellular immune response. Even though it is expressed on the surface of mast cells, its role in allergic diseases is unknown. We analyzed the effects of PD-L1 blockade in a murine model of active cutaneous anaphylaxis (ACA). C57BL/6 mice were sensitized and challenged w...

Betalactams are the most frequent cause of hypersensitivity reactions to drugs mediated by a specific immune mechanism. Immediate reactions occur within 1 to 6 hours after betalactam administration, and are generally IgE-mediated. They clinically translate into urticaria, angioedema and anaphylaxis. Non-immediate or delayed reactions occur after 1...

This study aimed to evaluate the clinical evolution, functional parameters and inflammatory activity of asthma in patients who submitted to an educational intervention. 58 adult patients over 18 years of age with partly controlled and uncontrolled asthma were randomized into an intervention group (IG) (N = 32) and a control group (CG) (N = 26) and...

Angioedema attacks are common causes of emergency care, and due to the potential for severity, it is important that professionals who work in these services know their causes and management. The mechanisms involved in angioedema without urticaria may be histamine- or bradykinin-mediated. The most common causes of histamine-mediated angioedema are f...

Bronchial asthma is defined by symptoms due to variable bronchial obstruction, airway hyperresponsiveness to specific and non-specific stimuli and chronic airway inflammation. Classification of severity and control level of the disease don't take into consideration biomarkers of bronchial inflammation. In the last two decades many methods have been...

Objectives: To review the efficacy and tolerability of the ultra-long-acting beta 2 agonists agents (ultra-LABA) in asthmatics. Methods: We conducted a systematic review of clinical studies that investigated the efficacy and tolerability of inhaled beta-2 agonist drugs administered once daily for the treatment of patients with bronchial asthma. The...

O conceito e a abordagem da asma grave sofreram modificações ao longo das últimas décadas. Atualmente são considerados asmáticos graves os pacientes que necessitam das etapas 4 ou 5 de tratamento da Global Initiative for Asthma (GINA) para evitar o descontrole da doença ou que permanecem não controlados apesar dessa terapêutica. O diagnóstico de as...

Resumo Esse segundo documento, escrito por especialistas da Associação Brasileira de Alergia e Imunologia (ASBAI) e da Sociedade Brasileira de Anestesiologia (SBA) interessados no tema anafilaxia perioperatória, tem por objetivo revisar os mecanismos fisiopatológicos, agentes desencadeantes (em adultos e crianças), assim como a abordagem diagnóstic...

This second joint document, written by experts from the Brazilian Association of Allergy and Immunology (ASBAI) and Brazilian Society of Anesthesiology (SBA) concerned with perioperative anaphylaxis, aims to review the pathophysiological reaction mechanisms, triggering agents (in adults and children), and the approach for diagnosis during and after...

Th17/Treg imbalance contributes to chronic obstructive pulmonary disease (COPD) development and progression. However, intracellular signaling by suppressor of cytokine signaling (SOCS) 1 and SOCS3 and the proteins signal transducer and activator of transcription (STAT) 3 and STAT5 that orchestrate these imbalances are currently poorly understood. T...

Purpose of review Quinolones are the second most common antibiotic class that may induce IgE and non-IgE-mediated immediate hypersensitivity reactions. The prevalence of true quinolone allergy still remains unknown, but its incidence has increased in recent years, probably due to the extensive utilization of this antibiotic class and the introducti...

Experts from the Brazilian Association of Allergy and Immunology (ASBAI) and the Brazilian Society of Anesthesiology (SBA) interested in the issue of perioperative anaphylaxis, and aiming to strengthen the collaboration between the two societies, combined efforts to study the topic and to prepare a joint document to guide specialists in both areas....

Resumo Especialistas da Associação Brasileira de Alergia e Imunologia (ASBAI) e da Sociedade Brasileira de Anestesiologia (SBA) interessados no tema anafilaxia perioperatória reuniram‐se com o objetivo de intensificar a colaboração entre as duas sociedades no estudo desse tema e elaborar um documento conjunto que possa guiar os especialistas de amb...

Purpose of review The management of anaphylaxis, after a rapid clinical-based hypothesis and prompt treatment introduction, includes diagnosis confirmation. We reviewed main laboratory methods available for diagnosing anaphylaxis and its etiology. Then, we searched for new methods that can gain utility in the next few years. Recent findings Serum...

Background and objective: Severe cutaneous adverse reactions to drugs (SCARs), have a high morbidity, mortality and present sequelae. Objective: To characterize patients with SCARs in eight health care institutions in Latin America. Methods: Cross-sectional, descriptive, multicenter, Latin American study of patients diagnosed with SCARs, between...

The fixed drug eruption is a non-immediate hypersensitivity reaction to drug, characterized by recurrent erythematous or violaceous, rounded, well-defined border plaques, which always appear in the same location every time the culprit drug is administered. The usual practice is to avoid the drug involved and to use a structurally different drug. Ho...

Background: Adjuvants, such as bacterial lipopolysaccharides, have been studied to improve the efficacy of allergen-specific immunotherapy. The Bordetella pertussis (Pw) vaccine has been shown to have a protective role in ovalbumin-induced asthma models. However, its role in allergy to mites is unknown. We evaluated the effects of the diphtheria-t...

Purpose of review To describe and analyze epidemiology, major triggers, diagnosis, and management of drug-induced anaphylaxis in pediatric population. Recent findings Despite the fact that foods are the most common elicitors of anaphylaxis during childhood, frequency of those reactions during adolescence seems to be increasing and they are associa...

Purpose of review: Despite many international guidelines have been published in the last 10 years, anaphylaxis continues to be underdiagnosed, undernotified, and undertreated. Anaphylactic reactions in adults and children in emergency departments are frequently not recognized, leading to underutilization of epinephrine, and a higher risk of death....

Mast cell activation disorders (MCADs) consist of episodic systemic symptoms due to mast cell mediator release. Diagnosis is based on clinical presentation and determination of high levels of tryptase or histamine. Ehlers-Danlos syndrome (EDS) and postural tachycardia syndrome (POTS) frequently coexist. It has been described that individuals with t...

OBJECTIVE To assess the incidence of intra-operative immediate hypersensitivity reactions and anaphylaxis. METHODS A cross-sectional observational study was conducted at the Department of Anesthesiology, University of São Paulo School of Medicine, Hospital das Clínicas, São Paulo, Brazil, from January to December 2010. We developed a specific ques...

Hereditary angioedema is an autosomal dominant disease characterized by recurrent angioedema attacks with the involvement of multiple organs. The disease is unknown to many health professionals and is therefore underdiagnosed. Patients who are not adequately diagnosed and treated have an estimated mortality rate ranging from 25% to 40% due to asphy...

Clinical studies in asthma are not able to clear up all aspects of disease pathophysiology. Animal models have been developed to better understand these mechanisms and to evaluate both safety and efficacy of therapies before starting clinical trials. Several species of animals have been used in experimental models of asthma, such as Drosophila, rat...

Purpose of review: The present review addresses the epidemiology, analyzes the current data and promotes global awareness of drug-induced anaphylaxis. Recent findings: Anaphylaxis is a medical emergency that may cause death! In the last decade, studies have shown an increasing incidence and prevalence of anaphylaxis. Summary: Drug-induced anap...

Background: Asthma in the elderly population (60 years of age and older) is frequently underdiagnosed, as well as atopy. Atopy, although more prevalent in younger patients, can be a major cause of asthma in the elderly. Chronic obstructive pulmonary disease (COPD) and cardiovascular disease are common differential diagnoses, especially in elderly...

Opinion Statement Drugs are between the main triggers of anaphylaxis. They have been described as major cause of fatal anaphylaxis. Non-steroidal anti-inflammatory drugs (NSAIDs) are the most frequently prescribed drugs around the world because of their analgesic, anti-inflammatory, antipyretic, and antithrombotic effects. This class of drug is the...

Drugs are among the main triggers of anaphylaxis, but identification of the culprit drug is frequently difficult. To confirm diagnosis of the causative agent, medical records and clinical history are fundamental. There are a few in vitro tests available in clinical practice, such as serum-specific IgE and basophil activation test. Skin tests are of...

The importance of the adaptive immune response, specifically the role of regulatory T (Treg) cells in controlling the obstruction progression in smokers, has been highlighted. To quantify the adaptive immune cells in different lung compartments, we used lung tissues from 21 never-smokers without lung disease, 22 current and/or ex-smokers without lu...

Importance: Hereditary angioedema (HAE) is a rare but severe disease, with high risk of death, and attacks have been associated to high estrogen levels. Polycystic ovary syndrome (PCOS) is a common hyperandrogenic condition, which is frequently treated with combined oral contraceptives. Objective: The aim of this study was to describe 2 clinical...

Background: Identification of asthma phenotypes enables a better understanding and management of this heterogeneous disease. Studies have reported associations between human leukocyte antigens (HLA) and asthma in different populations, but the results have been inconclusive and they have rarely considered the distinct disease phenotypes. Our objec...

do Rio Preto (FAMERP), São José do Rio Preto, SP. 23 O angioedema hereditário é uma doença autossômica dominante caracterizada por crises de edema com o envolvimento de múl‑ tiplos órgãos. A doença é desconhecida por muitos profissionais da área da saúde e, portanto, subdiagnosticada. Os pacientes que não são diagnosticados e tratados adequadamente...

do Rio Preto (FAMERP), São José do Rio Preto, SP. 23 O angioedema hereditário é uma doença autossômica dominante caracterizada por crises de edema com o envolvimento de múl‑ tiplos órgãos. A doença é desconhecida por muitos profissionais da área da saúde e, portanto, subdiagnosticada. Os pacientes que não são diagnosticados e tratados adequadamente...