Home About us Contact
|
Home About us Contact | ||
|
|
||
Different Manufacturers (different + manufacturer)
Selected AbstractsHybrid Assembly of Metal Head and Femoral Stem From Different Manufacturers During Isolated Acetabular RevisionARTIFICIAL ORGANS, Issue 8 2010Cheng-Fong Chen Abstract During revision of a failed acetabular component with well-fixed antiquated femoral stem, the same variant of metal head is usually not available in the inventory production. We gathered the stems retrieved from revision surgeries and tried to reassemble with the commercially available femoral heads. This study reports the results of suitable hybrid assembly of metal heads with the most common antiquated femoral stems from different manufacturers. Three hybrid combinations were determined and pull-off strengths of these hybrid combinations were performed through in vitro studies to evaluate the quality of the taper locks. [source] Cone-beam computed tomography of the maxillofacial region,an updateTHE INTERNATIONAL JOURNAL OF MEDICAL ROBOTICS AND COMPUTER ASSISTED SURGERY, Issue 4 2009Chung How Kau Abstract Background During the last few years, craniomaxillofacial diagnosis of the head has been confronted with an increasing number of innovations and improvements. The main progress occurred following the introduction of cone-beam technology in computed tomography in the 1990s. The number of manufacturers and devices using this technology for the maxillofacial region is growing rapidly and they are now becoming readily available. Materials This article focuses on cone-beam computed tomography (CBCT) devices applied to the maxillofacial region. CBCT serves as a bridge from two dimensions (2D) to three dimensions (3D), with lower irradiation than conventional CT. Different manufacturers and models are now available to satisfy the different needs of clinicians. Results A recent review of the manufacturers found 23 CBCT devices on the market. The specifications, applications and other issues of currently available CBCT devices are presented and discussed. Conclusions 3D imaging is developing at a very fast pace. New technologies and machines are emerging and CBCT is becoming readily available. Due to the growing demand for the technology based on the needs of clinicians, there is now a wide and growing selection of devices on the market. Some of the new advances now mean that CBCT imaging should be a well-considered option in maxillofacial imaging. Copyright © 2009 John Wiley & Sons, Ltd. [source] Pain on injection from propofol may be avoided by changing its formulationACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 4 2010J. A. ALDRETE Background: After using propofol for a decade, pain on injection had been considered routine by patients and medical personnel. When given propofol from a different manufacturer, patients did not complain. Two preparations of propofol were compared. Methods: A comparative, double-blind, randomized study was conducted in 22 adult patients undergoing pain relief procedures; they received sedation by an intravenous injection of 1.7 mg/kg of propofol and then were treated with paravertebral injections. Pain on injection was assessed by verbal complaint, movement of the extremity, of the whole body and recollection of pain at induction, when discharged. Propofol from Baxter Laboratories, mixed with either 5 ml of 2% lidocaine or 5 ml of NaCl 0.9%, was compared with propofol Laboratorios Gray, which was similarly mixed. Injections were randomly administered four times, blindly, to each of 22 patients. Statistical analysis was conducted using the analysis of variance method. Results: A total of 352 propofol injections were given. Each of the four propofol solutions was administered 88 times; of patients receiving Baxter propofol+saline, 74 (84%) had pain; when mixed with 2% lidocaine 45 (50.2%) complained. After propofol Gray with NaCl 0.9% was given, two patients (2.2%) experienced pain. Propofol Gray with 2% lidocaine produced no pain. None of the latter group remembered having pain, whereas, those given propofol Baxter 54 (61.3%) and 26 (29.5%) remembered experiencing pain at injection. Pain on injection was prevented and statistically reduced (<0.01) with the propofol from Laboratorios Gray. Conclusions: By changing the formulation (size of molecules and their dispersion) of propofol, pain on injection was avoided. [source] Zero Shrinkage of LTCC by Self-Constrained SinteringINTERNATIONAL JOURNAL OF APPLIED CERAMIC TECHNOLOGY, Issue 5 2005Torsten Rabe Low shrinkage in x and y direction and low tolerances of shrinkage are an indispensable precondition for high-density component configuration. Therefore, zero shrinkage sintering technologies as pressure-assisted sintering and sacrificial tapes have been introduced in the low-temperature co-fired ceramics (LTCC) production by different manufacturers. Disadvantages of these methods are high costs of sintering equipment and an additional process step to remove the sacrificial tapes. In this article, newly developed self-constrained sintering methods are presented. The new technology, HeraLock®, delivers LTCC modules with a sintering shrinkage in x and y direction of less than 0.2% and with a shrinkage tolerance of ±0.02% without sacrificial layers and external pressure. Each tape is self-constrained by integration of a layer showing no shrinkage in the sintering temperature range of the LTCC. Large area metallization, integration of channels, cavities and passive electronic components are possible without waviness and camber. Self-constrained laminates are an alternative way to produce zero shrinkage LTCC. They consist of tapes sintering at different temperature intervals. Precondition for a successful production of a self-constrained LTCC laminate is the development of well-adapted material and tapes, respectively. This task is very challenging, because sintering range, high-temperature reactivity and thermal expansion coefficient have to be matched and each tape has to fulfill specific functions in the final component, which requires the tailoring of many properties as permittivity, dielectric loss, mechanical strength, and roughness. A self-constrained laminate is introduced in this article. It consists of inner tapes sintering at especially low-temperature range between 650°C and 720°C and outer tapes with an as-fired surface suitable for thin-film processes. [source] MICROBIAL ANALYSIS AND TEXTURAL PROPERTIES OF CANTONESE SAUSAGEJOURNAL OF FOOD PROCESS ENGINEERING, Issue 1 2010YANTAO WU ABSTRACT Cantonese sausage is one of the traditional meat products in China. In the present study, eight Cantonese sausage samples from different manufacturers were collected. Their microbial and textural properties were characterized. The chemical compositions were determined as follows: moisture, 15.18 ± 3.40%; protein, 33.75 ± 7.26% (expressed in dry matter); fat, 42.12 ± 6.64% (expressed in dry matter); total carbohydrates, 9.11 ± 3.73%; sodium chloride, 6.13 ± 0.41%; and sodium nitrite, 35.55 ± 6.69 mg/kg. The pH was determined to be 6.22 ± 0.14, while the acid value was 2.02 ± 0.71 mg potassium hydroxide/g lipid, and the peroxide value was 0.03 ± 0.04 g potassium iodide/100 g lipid. The total viable counts were 5.55 ± 1.48 log10 cfu/g, lactic acid bacteria were 3.59 ± 0.68 log10 cfu/g, staphylococci/micrococci were 3.96 ± 0.54 log10 cfu/g and yeasts/molds were 3.55 ± 0.47 log10 cfu/g. Staphylococci/micrococci were the dominant microbial group in Cantonese sausage. This was different from other sausages. The textural profiles of Cantonese sausage were determined as follows: average values of hardness, springiness, cohesiveness, gumminess and chewiness were 3,066.56 g, 0.96 mm, 0.57, 1,736.76 g and 1,658.26 g × mm, respectively. Analysis of between-variable relationships indicated that the pH value of Cantonese sausage was significantly correlated to its microbial and textural properties. PRACTICAL APPLICATIONS Cantonese sausage has gained much popularity and acceptance in China and many other countries. Commercial products from different manufacturers were collected in this work. The microbiological and textural characteristics of Cantonese sausage as well as the chemical compositions were evaluated. It is helpful to understand this type of sausage in order to improve its quality. [source] Rapid Profiling of Swiss Cheese by Attenuated Total Reflectance (ATR) Infrared Spectroscopy and Descriptive Sensory AnalysisJOURNAL OF FOOD SCIENCE, Issue 6 2009N.A. Kocaoglu-Vurma ABSTRACT:, The acceptability of cheese depends largely on the flavor formed during ripening. The flavor profiles of cheeses are complex and region- or manufacturer-specific which have made it challenging to understand the chemistry of flavor development and its correlation with sensory properties. Infrared spectroscopy is an attractive technology for the rapid, sensitive, and high-throughput analysis of foods, providing information related to its composition and conformation of food components from the spectra. Our objectives were to establish infrared spectral profiles to discriminate Swiss cheeses produced by different manufacturers in the United States and to develop predictive models for determination of sensory attributes based on infrared spectra. Fifteen samples from 3 Swiss cheese manufacturers were received and analyzed using attenuated total reflectance infrared spectroscopy (ATR-IR). The spectra were analyzed using soft independent modeling of class analogy (SIMCA) to build a classification model. The cheeses were profiled by a trained sensory panel using descriptive sensory analysis. The relationship between the descriptive sensory scores and ATR-IR spectra was assessed using partial least square regression (PLSR) analysis. SIMCA discriminated the Swiss cheeses based on manufacturer and production region. PLSR analysis generated prediction models with correlation coefficients of validation (rVal) between 0.69 and 0.96 with standard error of cross-validation (SECV) ranging from 0.04 to 0.29. Implementation of rapid infrared analysis by the Swiss cheese industry would help to streamline quality assurance. [source] Instrumental and Expert Assessment of Mahon Cheese TextureJOURNAL OF FOOD SCIENCE, Issue 7 2000J. Benedito ABSTRACT: To improve Mahon cheese texture assessment, the relationship between instrumental and sensory measurements was sought. For that purpose 30 pieces of Mahon cheese from different batches and 2 different manufacturers were examined. Textural characteristics at different curing times were evaluated by uniaxial compression, puncture, and sensory analysis. Significant linear correlations were found between instrumental and sensory measurements. A logarithmic model (Weber-Fechner) fitted data better than a linear one. Only 1 factor was extracted when considering all the instrumental and sensory variables, thus indicating that both sets of measurements are related to the same phenomenon. The best predictors for Mahon cheese sensory attributes were found to be cheese moisture, deformability modulus, and slope in puncture. [source] Effective poxvirus removal by sterile filtration during manufacture of plasma derivatives,JOURNAL OF MEDICAL VIROLOGY, Issue 4 2005A. Berting Abstract As a consequence of the September 2001 terrorist events, programs to protect against further such acts including potentially the use of biological warfare agents have been launched in the USA and elsewhere. As part of these initiatives, Vaccinia virus was procured for the pre-emptive vaccination of key personnel against smallpox as well as population-wide protection after an eventual exposure. The introduction of this live virus into a population at a relatively large scale represents a theoretical challenge for the safety of the blood supply, and potentially for plasma for fractionation. To strengthen further the demonstration of safety margins for plasma derived products against Vaccinia virus, the capacity of sterile filtration procedures to remove the virus was investigated. An infectivity assay for the Vaccinia virus strain which represents the majority of smallpox vaccine stocks available currently was used to investigate the potential removal of this virus by sterile filtration processes during the manufacture of plasma derivatives. Vaccinia virus behaves as predicted based on its size, i.e., an artificially added virus load is removed about 10,000-fold by the sterile filtration procedures tested. As the current investigation covered a range of different protein concentrations, filter materials and filters from different manufacturers, the results obtained are considered to be widely applicable. The current investigation supports further the high safety margins of plasma derivatives against any potential Vaccinia virus content of plasma for fractionation. As the large size is a general feature of Orthopox viruses, the results would also provide assurance against poxviruses identified more recently, for example, Monkeypox virus. J. Med. Virol. 75:603,607, 2005. © 2005 Wiley-Liss, Inc. [source] Mechanical Behavior and Failure Analysis of Prosthetic Retaining Screws after Long-term Use In Vivo.JOURNAL OF PROSTHODONTICS, Issue 3 2008Part 1: Characterization of Adhesive Wear, Structure of Retaining Screws Abstract Purpose: The general aim of this study and those presented in Parts 2,4 of this series was to characterize the structure, properties, wear, and fracture of prosthetic retaining screws in fixed detachable hybrid prostheses after long-term use in vivo. This part of the overall investigation addresses whether there are differences in thread wear between the screws closest to the fulcrum and those that are farthest from the fulcrum in fixed detachable hybrid prostheses. Materials and Methods: The total number of prosthetic retaining screws used in this study was 100 (10 new and 90 used). New screws (controls) from Nobel Biocare (NB) were divided into Group 1 (slotted) and Group 2 (hexed). Ninety used screws (in service 18,120 months) were retrieved from fixed detachable hybrid prostheses in 18 patients (5 screws from each patient, 60 from NB and 30 from Sterngold). The used screws were divided into 18 groups. Additionally, each group was subdivided into A and B categories. Category A contained the middle three prosthetic screws, which were considered the farthest screws from the fulcrum line. Category B contained the most posterior two screws, which were considered the screws closest to the fulcrum line. All 100 screws were subjected to thorough, nondestructive testing. Results: Light and scanning electron microscopic examination of all used screws for each group revealed surface deterioration of the active profile of the screw threads consistent with adhesive wear. The observed thread profile deterioration ranged from mild to severe. The wear was aggressive enough to cause galling, which led to thinning of the threads and, in severe cases, to knife-edges at thread crests. In ten groups, the most anterior three screws exhibited more wear than the most posterior two screws. In addition to thread wear, severe plastic deformation was detected on the bottom part of each screw for three groups, and a long external longitudinal crack was detected in one screw of Group 2. Conclusions: The findings of this study and those presented in Parts 2,4 demonstrate that different retaining screws from the same manufacturer and/or from different manufacturers have different geometrical design, microstructures, major alloy constituents, and microhardness, and that these differences influence their preload and fractured load values. In this part of the overall investigation, the occurrence of galling as a result of wear involving prosthetic retaining screws appears to be an inevitable and unavoidable consequence of long-term use in vivo in fixed detachable hybrid prostheses regardless of the intended/original preload value. The galling rate is greater on the middle three screws compared to the most posterior two screws in fixed detachable hybrid prostheses. The wear pattern is consistent with an adhesive wear mechanism; however, this study does not provide enough data to support a definitive analysis. [source] Fracture Strength of Plate and Tubular Forms of Monolithic Silicon Carbide Produced by Chemical Vapor DepositionJOURNAL OF THE AMERICAN CERAMIC SOCIETY, Issue 3 2002Brian Vern Cockeram The fracture strength of silicon carbide (SiC) plate deposits produced by chemical vapor deposition (CVD) was determined from room temperature to 1500°C using a standard 4-point flexural test method (ASTM C1161). CVD SiC materials produced by two different manufacturers are shown to have only slightly different flexural strength values, which appear to result from differences in microstructure. Although CVD deposition of SiC results in a textured grain structure, the flexural strength was shown to be independent of the CVD growth direction. The orientation of machining marks was shown to have the most significant influence on flexural strength, as expected. The fracture strength of tubular forms of SiC produced by CVD deposition directly onto a mandrel was comparable to flexural bars machined from a plate deposit. The tubular (O-ring) specimens were much smaller in volume than the flexural bars, and higher strength values are predicted based on Weibull statistical theory for the O-ring specimens. Differences in microstructure between the plate deposits and deposits made on a mandrel result in different flaw distributions and comparable strength values for the flexural bar and O-ring specimens. These results indicate that compression testing of O-rings provides a more accurate strength measurement for tubular product forms of SiC due to more representative flaw distributions. [source] Characterization and comparison of commercially available mite extracts for in vivo diagnosisALLERGY, Issue 2 2010B. Brunetto To cite this article: Brunetto B, Tinghino R, Braschi MC, Antonicelli L, Pini C, Iacovacci P. Characterization and comparison of commercially available mite extracts for in vivo diagnosis. Allergy 2010; 65: 184,190. Abstract Background:, Assessment of sensitization by allergen-specific IgE testing and skin prick testing (SPT) are primary tools in routine clinical diagnosis of allergies. To perform a correct diagnosis, it is critical that the allergen reagent used contains an adequate amount of all relevant components. This study aimed at evaluating commercially available mite extracts for in vivo diagnosis from eight manufacturers. Methods:, Eight extracts from Dermatophagoides pteronyssinus and eight from Dermatophagoides farinae were analysed for total protein content by Bradford and for major allergen content by ELISA. SDS-PAGE, immunoblotting and SPT were also carried out. Results:, The protein amount ranged from 27.7 ,g/ml extract to 361.1 ,g/ml (D. pteronyssinus) and from 20.3 to 353.0 ,g/ml (D. farinae). In regards major allergen concentration, Der p 1 ranged from 9.6 to 36.2 ,g/ml, Der f 1 26.5,196.1 ,g/ml, mite group 2 0.7,31.7 ,g/ml in D. pteronyssinus and 1.3,10.4 ,g/ml in D. farinae. SDS-PAGE experiments showed that some components are poorly represented or absent in extracts from most manufacturers. Similar results were obtained by IgE-immunoblotting and SPT with 10 mite allergic patients confirmed a broad spectrum of reactivity of the extracts in the same subject. Conclusions:, Immunochemical analysis showed a heterogeneous amount of component/s among mite extracts from different manufacturers. These data were confirmed by in vivo testing, suggesting that, for some of the patient tested, the absence of relevant allergens could strongly affect the diagnosis. [source] Clinical Judgment Versus Decision Analysis for Managing Device AdvisoriesPACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 10 2008MITESH S. AMIN M.D. Introduction: Implantable cardioverter-defibrillator (ICD) and pacemaker (PM) advisories may have a significant impact on patient management. Surveys of clinical practice have shown a great deal of variability in patient management after a device advisory. We compared our management of consecutive patients in a single large university practice with device advisories to the "best" patient management strategy predicted by a decision analysis model. Methods: We performed a retrospective review of all patients who had implanted devices affected by an advisory at our medical center between March 2005 and May 2006 and compared our actual patient management strategy with that subsequently predicted by a decision analysis model. Results: Over 14 months, 11 advisories from three different manufacturers affected 436 patients. Twelve patients (2.8%) were deceased and 39 patients (8.9%) were followed at outside facilities. Management of the 385 remaining patients varied based on type of malfunction or potential malfunction, manufacturer recommendations, device dependency, and patient or physician preferences. Management consisted of the following: 57 device replacements (15.2%), 44 devices reprogrammed or magnets issued (11.7%), and 268 patients underwent more frequent follow-up (71.3%). No major complications, related to device malfunction or device replacement, occurred among any patient affected with a device advisory. Concordance between the decision analysis model and our management strategy occurred in 57.1% of cases and 25 devices were replaced when it was not the preferred treatment strategy predicted by the decision model (43.9%, 37.3% when excluding devices replaced based on patient preference). The decision analysis favored replacement for all patients with PM dependency, but only for four patients with ICDs for secondary prevention. No devices were left implanted that the decision analysis model predicted should have been replaced. Conclusions: We found that despite a fairly conservative device replacement strategy for advisories, we still replaced more devices when it was not the preferred device management strategy predicted by a decision analysis model. This study demonstrates that even when risks and benefits are being considered by experienced clinicians, a formal decision analysis can help to develop a systematic evidence based approach and potentially avoid unnecessary procedures. [source] Towards a universal product ion mass spectral library , reproducibility of product ion spectra across eleven different mass spectrometersRAPID COMMUNICATIONS IN MASS SPECTROMETRY, Issue 12 2008Chris Hopley Product ion spectra produced by collision-induced dissociation (CID) in tandem mass spectrometry experiments can differ markedly between instruments. There have been a number of attempts to standardise the production of product ion spectra; however, a consensus on the most appropriate approach to the reproducible production of spectra has yet to be reached. We have previously reported the comparison of product ion spectra on a number of different types of instruments , a triple quadrupole, two ion traps and a Fourier transform ion cyclotron resonance mass spectrometer (Bristow AWT, Webb KS, Lubben AT, Halket JM. Rapid Commun. Mass Spectrom. 2004; 18: 1). The study showed that a high degree of reproducibility was achievable. The goal of this study was to improve the comparability and reproducibility of CID product ion mass spectra produced in different laboratories and using different instruments. This was carried out experimentally by defining a spectral calibration point on each mass spectrometer for product ion formation. The long-term goal is the development of a universal (instrument independent) product ion mass spectral library for the identification of unknowns. The spectra of 48 compounds have been recorded on eleven mass spectrometers: six ion traps, two triple quadrupoles, a hybrid triple quadrupole, and two quadrupole time-of-flight instruments. Initially, 4371 spectral comparisons were carried out using the data from eleven instruments and the degree of reproducibility was evaluated. A blind trial has also been carried out to assess the reproducibility of spectra obtained during LC/MS/MS. The results suggest a degree of reproducibility across all instrument types using the tuning point technique. The reproducibility of the product ion spectra is increased when comparing the tandem in time type instruments and the tandem in space instruments as two separate groups. This may allow the production of a more limited, yet useful, screening library for LC/MS/MS identification using instruments of the same type from different manufacturers. Copyright © 2008 John Wiley & Sons, Ltd. [source] Status of Mammography after the Digital Mammography Imaging Screening Trial: Digital versus FilmTHE BREAST JOURNAL, Issue 2 2006D. David Dershaw MD Abstract: Well-publicized results of the recent Digital Mammography Imaging Screening Trial (DMIST) have again shown that there is no clear advantage in mammographic screening of the general population with digital versus film mammography. However, several subgroups,women less than 50 years old, pre- or perimenopausal, and denser breasts,did better with digital mammography than with film. Data also suggest that women with the opposite characteristics might do better with film mammography. This article reviews the data of the four studies comparing digital and film mammographic screening. In addition, it describes the technology involved in the two types of mammographic image capture, the advantages and disadvantages of each type of imaging, and the future possibilities opened by digital technique. Because less than one-tenth of mammography units in use in the United States are digital, the availability of this technology to women undergoing screening and to physicians referring patients to screening sites is very limited. The author suggests that the quality of mammography, rather than the technique used to capture the image, is more important in selecting a mammography facility. For those who have a facility that offers both digital and film mammography, consultation on which type of imaging might be better for an individual woman would be appropriate. Because digital mammography from different manufacturers is based on differing technologies and because data comparing the advantages or disadvantages of these differing types of equipment are not available, it is impossible to recommend which type of digital mammography equipment is best for those undergoing mammography with these types of units. [source] Passage of pathogenic microorganisms through breathing system filters used in anaesthesia and intensive careANAESTHESIA, Issue 7 2010D. H. T. Scott Summary Invasive ventilation poses a risk of respiratory infection that can be drug-resistant. One means of reducing transmission of infection is the use of a breathing system filter. Filters are intended to be used with dry gas. Current international standards do not require that filters prevent bacterial transfer when wet. It is not known whether microorganisms pass through wet filters, but theory predicts that this might occur. We tested six filters from three different manufacturers. We passed a suspension of microorganisms through the filters using the least pressure necessary, and incubated a sample of the filtrate on blood agar. All the filters tested allowed free passage of both Candida albicans and coagulase-negative staphylococci. The median (IQR [range]) pressure required for fluid to flow across the filter varied greatly between different filter types (20 (0,48 [0,138]) cmH2O). We conclude that even large microorganisms pass across moist breathing system filters in conditions that are found in clinical practice. [source] Hybrid Assembly of Metal Head and Femoral Stem From Different Manufacturers During Isolated Acetabular RevisionARTIFICIAL ORGANS, Issue 8 2010Cheng-Fong Chen Abstract During revision of a failed acetabular component with well-fixed antiquated femoral stem, the same variant of metal head is usually not available in the inventory production. We gathered the stems retrieved from revision surgeries and tried to reassemble with the commercially available femoral heads. This study reports the results of suitable hybrid assembly of metal heads with the most common antiquated femoral stems from different manufacturers. Three hybrid combinations were determined and pull-off strengths of these hybrid combinations were performed through in vitro studies to evaluate the quality of the taper locks. [source] Determination of quinocide as impurity in primaquine tablets by capillary zone electrophoresisBIOMEDICAL CHROMATOGRAPHY, Issue 5 2009Abdalla A. Elbashir Abstract A capillary zone electrophoretic method has been developed and validated for the determination of the impurity quinocide (QC) in the antimalarial drug primaquine (PQ). Different buffer additives such as native cyclodextrins and crown ethers were evaluated. Promising results were obtained when either , -cyclodextrin (, -CD) or 18-crown-6 ether (18C6) were used. Their separation conditions such as type of buffer and its pH, buffer additive concentration, applied voltage capillary temperature and injection time were optimized. The use of 18C6 offers slight advantages over , -CD such as faster elution times and improved resolution. Nevertheless, migration times of less than 5 min and resolution factors (Rs) in the range of 2,4 were obtained when both additives were used. The method was validated with respect to selectivity, linearity, limits of detection and quantitation, analytical precision (intra- and inter-day variability) and repeatability. Concentrations of 2.12 and 2.71% (w/w) of QC were found in pharmaceutical preparations of PQ from two different manufacturers. A possible mechanism for the successful separation of the isomers is also discussed. Copyright © 2008 John Wiley & Sons, Ltd. [source] A prospective Italian survey on the safety of subcutaneous immunotherapy for respiratory allergyCLINICAL & EXPERIMENTAL ALLERGY, Issue 10 2009M. Schiappoli Summary Background Subcutaneous immunotherapy is effective for the treatment of respiratory allergy, and it is largely used in Italy, but no systematic safety assessment has been carried out so far. Objective To assess prospectively the safety of injection immunotherapy in a multicentre, real-life survey. Methods Eleven Italian allergy departments recorded the clinical characteristics of systemic reactions (SRs) due to immunotherapy. Vaccines were prescribed according to guidelines; only standardized depot extracts were used. SRs were graded according to the EAACI recommendations, and were classified as immediate or delayed. Results One thousand seven hundred and thirty-eight patients (847 males, age range 5,71) received immunotherapy from eight different manufacturers, for a total of 2038 courses (300 patients received two extracts). A total of 60 785 injections were given over a mean immunotherapy duration of 3 years. Overall, 95 reactions were observed in 57 patients (3.28%), corresponding to 4.7% of the courses and 1.56/1000 injections. Twenty-five patients experienced more than one adverse event. There were 34 grade 2, 60 grade 3 and one grade 4 reactions and no fatality. SRs occurred more frequently in patients with asthma than in patients with rhinitis alone (4.1% vs. 1.1%), and were equally distributed between the build-up and the maintenance phase. Ragweed and grass extracts caused significantly more side effects than other allergens. Conclusion In this large prospective study, the rate of SRs was low, thus confirming that injection immunotherapy has an acceptable risk/benefit ratio when prescribed and carried out according to recommendations. [source] Heterogeneity of commercial timothy grass pollen extractsCLINICAL & EXPERIMENTAL ALLERGY, Issue 8 2008M. Focke Summary Background The diagnosis and specific immunotherapy of allergy is currently performed with allergen extracts prepared from natural allergen sources. Objective To analyse commercial timothy grass pollen allergen extracts used for in vivo diagnosis regarding their qualitative and quantitative allergen composition and in vivo biological activity. Methods Antibodies specific for eight timothy grass pollen allergens (Phl p 1, Phl p 2, Phl p 4, Phl p 5, Phl p 6, Phl p 7, Phl p 12, Phl p 13) were used to detect these allergens in timothy grass pollen extracts from four manufacturers by immunoblotting. ELISA assays were developed and used to quantify the three major allergens (Phl p 1, Phl p 2, Phl p 5) in the extracts. The magnitude of skin responses to the four extracts was studied by skin prick testing in 10 grass pollen-allergic patients. Results The allergen extracts showed broad variations in protein compositions and amounts (24.1,197.7 ,g/mL extract). Several allergens could not be detected in certain extracts or appeared degraded. A considerable variability regarding the contents of major allergens was found (Phl p 1: 32,384 ng/mL; Phl p 2: 1128,6530 ng/mL, Phl p 5: 40,793 ng/mL). Heterogeneous skin test results were obtained with the extracts in grass pollen-allergic patients. Conclusions Timothy grass pollen extracts from different manufacturers exhibit a considerable heterogeneity regarding the presence of individual allergens and hence yield varying in vivo test results. Problems related to the use of natural grass pollen allergen extracts may be circumvented by using defined recombinant grass pollen allergens. [source] | ||||||||||||||||||||||||||||