{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T17:30:53Z","timestamp":1790875853611,"version":"4.1.0"},"reference-count":24,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2013,7,28]],"date-time":"2013-07-28T00:00:00Z","timestamp":1374969600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int Endodontic J"],"published-print":{"date-parts":[[2014,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Anaphylactic shock is a real and life threatening medical emergency which is encountered in every field of medicine. The coronary arteries seem to be the primary target of anaphylaxis resulting in the development of Kounis syndrome. Kounis syndrome is a pan\u2010arterial anaphylaxis \u2010associated syndrome affecting patients of any age, involving numerous and continuously increasing causes, with broadening clinical manifestations and covering a wide spectrum of mast cell activation disorders. Recently, Kounis\u2010like syndrome affecting the cerebral arteries was found to be associated with mast cell activation disorders. In anaphylactic shock, the decrease of cerebral blood flow is more than what would be expected from severe arterial hypotension. This is attributed to the early and direct action of anaphylactic mediators on cerebral vessels. While adrenaline is a life saving agent in the treatment of anaphylactic shock, it contains sodium betabisulfite as preservative and should be avoided in sulfite allergic patients. Potential allergens encountered in endodotic practice include formocresol, zinc compounds thiurams, sodium dimethyldithiocarbamade, and mercaptobenzothiazole that might have synergistic action. All these agents together with analgesics, antibiotics, antiseptics, formaldehyde, latex, local anaesthetics and metals used in dental practice, in general, can induce anaphylactic shock. Practitioners should be aware of these consequences. A careful history of previous atopy and reactions is of paramount importance for safe and effective management.<\/jats:p>","DOI":"10.1111\/iej.12152","type":"journal-article","created":{"date-parts":[[2013,6,18]],"date-time":"2013-06-18T07:23:45Z","timestamp":1371540225000},"page":"309-313","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Brain injury due to anaphylactic shock: broadening manifestations of <scp>K<\/scp>ounis syndrome"],"prefix":"10.1111","volume":"47","author":[{"given":"G. D.","family":"Soufras","sequence":"first","affiliation":[{"name":"Department of Cardiology \u2018Saint Andrews\u2019 State General Hospital Patras Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. N.","family":"Kounis","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences Patras Highest Institute of Education and Technology Patras Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N. 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