Alkerta Ibranji - Academia.edu (original) (raw)

Papers by Alkerta Ibranji

Food allergy is an immunological response to food proteins. It is also known as food hypersensiti... more Food allergy is an immunological response to food proteins. It is also known as food hypersensitivity. Food allergy reactions can be classified into two types: IgE mediated reaction and non-IgE allergic reaction. Diagnosis methods for food allergy are complicated because even the detection of specific IgE (sensitization) does not necessarily mean that the patient is food allergenic. Therefore it is very important to elaborate a careful medical history by the allergologist for each patients and then to continue with laboratory studies such as Skin Prick Test, detection of food specific IgE from blood serum. This study is a pilot project that was focused in the determination of food allergy prevalence in an Albanian population samples between the ages of 18-25. We have examined a sample of 231 patients from different regions of Albania. Also we have elaborated their historical background in food allergy by using a standardized questionnaire. After that the patients that selfdeclare food allergy were examined with Skin Prick test and with RAST test for the presence of specific IgE from a panel of food. The results obtained show that 9.9% of the patient self-declare food allergy, but only four of them have a real food allergy or 1.7%. The main types of food that cause allergic symptoms in patients that self-declare allergy are milk and eggs respectively 48% and 26%. All the data collected were analyze with statistical program SPSS 17.00. There is a correlation (R 2 =0.319) between self reported food allergy and the detection of specific IgE which is significant (p<0.05) at the 0.05 (95%) level (Pearson correlation, 2-tailed).

Clinical and Translational Allergy, 2017

Introduction: Incidence of anaphylaxis is increasing. Data regarding anaphylaxis mortality are li... more Introduction: Incidence of anaphylaxis is increasing. Data regarding anaphylaxis mortality are limited, but conflicting. Our objective was to document anaphylaxis mortality rate (deaths per million population), time trends and specificities according to triggers (iatrogenic, venom, food, unknown), age groups, sex and geographical regions (North and South) in France, between 1979 and 2011. Methods: Data were obtained (1) from database of the National Mortality Center (CEPIDC) to collect cases in which anaphylaxis was included as a cause of death, sex, age, and geographic region of death, (2) from the database of the National Institute for Economical and Statistical studies (INSEE) to define the referent populations. We used a multivariable log-linear Poisson regression model to assess the impact of time period, age, sex and geographic region on anaphylaxis deaths. Results: During the period study, 1603 deaths were collected: 1564 in adults and 39 in children (age <18 year). The overall prevalence of anaphylaxis fatalities was 0.84 per million population (95% IC 0.80-0.88), ranging from 0.08 per million (95% IC 0.05-0.10) in pediatric population to 1.12 per million (95% CI 1.06 to 1.17) in adult population. Annual percentage change for case fatality rate was −2.0% (95% CI −2.5 to −1.5; p < 10 −4) indicating a decrease in case fatality rate during the study period. Anaphylaxis fatality rate was higher in men (1.08 per million [95% IC 1.00 1.16] than women (0.86 per million [95% IC 0.80-0.92]) (p < 10 −4). Triggers of anaphylaxis fatalities were iatrogenic (63%), mostly drugs, venom (14%) and food (0.6%). Unspecified anaphylaxis was frequent (23%). The highest rate was in persons aged >70 years (3.50 per million population per year [95% IC 3.25-3.76]) and the lowest in the pediatric population (p < 10 −4). Only venom-induced mortality rate was higher in South of France (0.16 per million [95% IC 0.13-0.19]) compared with the North (0.11 per million [95% IC 0.09-0.13]) (p = 0.004). Only 8 food-induced fatalities were recorded (age <35 years in 7 cases). Conclusion: Overall anaphylaxis mortality rate is decreasing over the three last decades in France. We confirm that iatrogenic causes are the most frequent causes. Older age and male sex are risk factors of fatal anaphylaxis of any cause except for food-induced anaphylaxis.

Balkan Military Medical Review, 2015

International Journal of Clinical & Medical Allergy, 2015

This study is focused on presence of familiar history for atopic diseases, development of atopic ... more This study is focused on presence of familiar history for atopic diseases, development of atopic dermatitis and exposure to indoor risk factors during the first year of life on asthmatic children who were visited in our clinic during 2008-2010. The parents of each child respectively have provided written informed consent and completed self-administered questionnaires. They included questions about two optional answers yes or no regarding the mode of delivery (cesarean or natural), breast feeding, and exposure to high humidity in their dwellings, pets, or environmental passive smoking as well as presence of family atopic history or atopic dermatitis. The study consisted of 276 asthmatic children aged 1-14 years (m 160, f 116, mean age 5.6±1.1), and a control group composed of 100 children (m 49, f 51, mean age 5.7±1.4

Clinical and Translational Allergy, 2015

The Open Allergy Journal, 2013

Introduction: Studies conducted across Western Europe reported that bronchial asthma (BA) has an ... more Introduction: Studies conducted across Western Europe reported that bronchial asthma (BA) has an important impact on patients' lives quality. We present Albanian asthmatic patients’ views based on the questionnaire generated from the European Federation of Allergy and Airways Diseases Patients Associations (EFA). Materials and methodology: In this study participated 145 Caucasian patients consecutively and prospectively diagnosed with BA. Results: The vast majority of patients reported lifestyle' limitations because of uncontrolled BA, three-fourth of them reported restriction of physical activity, and 20% felt their professional perspectives were limited. Additionally, up to 80% of the subjects were not optimistic about achieving the guideline goals but they were optimistic regarding the availability of more qualitative medicines and improvement of healthcare level over the next years. Our patients indicated that optimal treatments should be fast-acting and long-lasting, sh...

The Open Allergy Journal, 2015

We have witnessed a dramatic increase in the prevalence of respiratory allergies during the last ... more We have witnessed a dramatic increase in the prevalence of respiratory allergies during the last decades. The role of infections in the prevalence of respiratory allergic diseases is attributed to the antagonism between: a) induction of T helper (Th) 1 immune response by human organism; and b) manipulation of the human immune response toward Th2 profile by common infective agents in order to increase their surviving opportunity. This review proposes an important role of massive antibiotics exposure during neonatal and early childhood on the increasing epidemiological trend. It is believed that the antibiotics exposure during early childhood has also provided better surviving opportunity for atopic individuals with an inadequate immune defense against common infections, deviating therefore the genetic background of general population toward Th2 profile. Taking this into account, we suggest that Th2 profile frequency (and consequently atopic phenotype prevalence) can be increased alon...

Case Reports, 2011

Gluten intolerance is an autoimmune enteropathy caused by heterogeneous mixture of wheat storage ... more Gluten intolerance is an autoimmune enteropathy caused by heterogeneous mixture of wheat storage proteins. Malabsorption symptoms imply diarrhoea, abdominal pain/bloating and weight loss. This case describes a 22-year-old female subject, who had chronic headache, joint pain, urticaria and long period of amenorrhea. Skin prick tests revealed a sensitisation to α-gliadin, while neurological, gynaecological, endocrine and clinical-laboratory examinations did not justify the above-mentioned symptoms. Gluten-free diet resolved chronic symptoms and re-established the menstrual cycle, whereas a temporary gliadin daily diet re-exacerbated all clinical symptoms. Urticaria occurred 20 min and the chronic headache the next day after exposure to the gliadin-rich diet. In addition, the missing of the expected menstrual bleeding was observed. This case demonstrates that gliadin intake can induce malabsorption and 'idiopathic' neuronal or gynaecological symptoms. ▶ Enjoy fast sympathetic peer review and rapid publication of accepted articles ▶ Access all the published articles ▶ Re-use any of the published material for personal use and teaching without further permission ▶

The Open Access Journal of Science and Technology, 2014

Introduction: Head injury (HI) is a serious morbid state, resulting from structural changes in th... more Introduction: Head injury (HI) is a serious morbid state, resulting from structural changes in the scalp, skull, and/or its contents, produced by mechanical forces. Generally, the most frequent HI cause is road traffic accident (RTA), followed by homicidal and falling from high injuries. The aim of present study is to assess demographic data, causes and patterns responsible for HI among Albanian subjects. Methodology: All HI cases (1000) are collected by the Forensic Institute of Albania, based on medical and forensic files of traumatized subjects between years 2007 and 2012. The prospectively-collected and descriptive information is focused on demographic data, responsible factors, type and level of cranial and brain injury, as well as their outcome. Results: The majority of HI victims were male (84%), and age-wise young adult to middle aged (70%). RTA was the HI cause in 88%, followed by homicides (3.8%), falling from high (3%), etc. With respect to injury mechanisms, extradural hematoma is shown in 93% of cases, followed by cerebral edema (61%), cerebral contusion (37%), skull bone fractures (35%), etc. Severe consciousness' alteration was observed in 57%, while amnesia lasted longer than 4 weeks in 44% of cases. Discussion: This survey demonstrates that the HI victims' majority consists of young and middle age males, mostly as a consequence of RTA. The increase of vehicles' use in Albania is more evident than RTA-related HI, indicating that use of newer vehicles, seat belts, air bags, or helmets can decline the potential for a fatal outcome.

Clinical Reviews in Allergy & Immunology, 2014

This review includes a variety of extremely rare and unusual hymenoptera sting (HS) circumstances... more This review includes a variety of extremely rare and unusual hymenoptera sting (HS) circumstances with regard to sting localization, geographic region, massivity of multiple stings, and particularly related to clinical symptoms. Such reactions occur in a temporal relationship to HS (s), differ from typical allergic symptomatology, and sometimes need follow-up during many months. With respect to pathogenesis, the major mechanisms involved are toxic, autoimmune, and other delayed immunological ones. While delayed inflammatory symptoms of the nervous system are considered as delayed hypersensitization or autoimmune entities, generalized rhabdomyolysis and consecutive acute kidney injury is considered a toxic reaction, mostly induced by massive envenomation to wasps or "Africanized" bees. Hemorrhagic episodes of targeted organ (s) could be additional potential risk for acute kidney injury, while the bee venom-induced hemorrhage is proposed to be a nonimmune-mediated anaphylactic symptom. The hemodynamic involvement of vital organs and systems with hypoxia and hypovolemia together with simultaneous immunoglobulin E (IgE) sensitization are considered potential indications for venom immunotherapy. In contrast, patients who have experienced various complications with unknown or nonallergic mechanisms should be informed about the importance of epinephrine's use and additional measures on future sting avoidance. In conclusion, although unusual reactions are extremely rare, it is important to keep them in mind.

Materia Socio Medica, 2014

Introduction: Anaphylaxis is a dramatic clinical emergency. It is a very severe, life-threatening... more Introduction: Anaphylaxis is a dramatic clinical emergency. It is a very severe, life-threatening generalized or systemic hypersensitivity reaction. Based on immunologic mechanism the anaphylaxis is divided in IgE, IgG, complement, or immune complexes-mediated vs non allergic anaphylaxis. Th ere are a lot of etiologic factors of anaphylaxis, but the three principal immunologic triggers are drugs, insect stings, and foods. Regarding the clinical severity there are several proposed grading systems. Th e diagnosis of anaphylaxis is mainly clinical. Discussion: Th e anaphylaxis markers measured in clinical laboratories are total tryptase and histamine. Th ere are some conditions that modulate the onset of anaphylaxis, acting as co-or augmentation factors, which signifi cantly lower the allergen dose necessary for triggering anaphylaxis. Th e well-documented cofactors of anaphylaxis are physical exercise, alcohol consumption, some foods, co-administration of nonsteroidal anti-infl ammatory drugs (NSAID), and concomitant infectious diseases. Development of anaphylaxis depends on the sensitization pattern, the proportion of the involved immunoglobulin classes, characteristics of the allergen, the proportion of the involved immunoglobulin classes, the avidity and affi nity of immunoglobulins to bind an allergen, the route of allergen application, and, last but not least, the presence of cofactors of anaphylaxis. Conclusion: Anaphylaxis remains a continuous challenge for the diagnosis and treatment. Th e adequate management of anaphylaxis requires rapid diagnosis, implementation of primary and secondary prevention measures, and immediate administration of subcutaneous epinephrine.