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Allergy Testing (allergy + testing)
Selected AbstractsPredictive value of allergy and pulmonary function tests for the diagnosis of asthma in elite athletesALLERGY, Issue 10 2007M. Bonini Background:, Asthma is frequently found in athletes, often associated with rhinitis and allergy. Aim:, To study the predictive value of allergy and pulmonary function tests for the diagnosis of asthma in athletes. Subjects and methods:, Ninety-eight national preOlympic athletes underwent an accurate medical examination including a validated questionnaire for asthma and rhinitis, spirometric recordings and skin prick testing with a panel of the most frequent inhalant allergens. Bronchodilator and/or exercise challenge were also performed in asthmatic subjects. Results:, Clinical asthma was present in 20.4% of athletes, rhinitis in 35.3% (in 21.4% of cases alone and in 13.9% associated with asthma). Positive prick tests were recorded in 44.4% of athletes (in 60.5% of asthmatics, in 95.2% of rhinitics and in 21.0% of nonasthmatic , nonrhinitic subjects). Mean spirometric values and distribution of abnormal values were not different among asthmatics, rhinitics and nonasthmatics , nonrhinitic patients. Skin-tests positivity was not related to the abnormal spirometric data found in individual cases. Provocation tests with bronchodilators or exercise did not appear sensitive enough to diagnose mild forms of asthma in subjects with normal basal spirometric values. Conclusions:, Allergy testing and spirometry should be performed routinely in athletes because of the high prevalence of allergy, rhinitis and asthma in this population. However, the predictive value of these tests and of the bronchial provocation tests performed in this study seems too low to document mild or subclinical asthma in athletes. [source] Patterns of care and referral in children with atopic dermatitis and concern for food allergyDERMATOLOGIC THERAPY, Issue 2 2006Michele M. Thompson ABSTRACT:, Although many providers believe that up to 30% of atopic dermatitis (AD) is food induced, food challenge studies show that food-induced eczematous reactions are rare. When food allergy is suggested to cause AD, it often leads to allergy testing with a high false-positivity rate, in turn further focusing parents on food allergy. Study subjects were children less than 11 years old with AD and food allergy suspicion. Prior diagnoses, provider, and testing patterns were assessed by questionnaire given to the parents. Thirty-eight patients with AD were enrolled. Most subject's parents suspected food allergy induced AD. Initial skin diagnoses were made by pediatricians (79%) and family practitioners (18%) as eczema. Allergy was suggested by providers as cause for AD in 63% of the present study's patients. Seventy-nine percent had allergy testing. Greater than 90% of parents claimed their children had food allergy and food-induced AD. Sixty-six percent had positive food allergy tests and 37% had definite history of immediate IgE reactions to food. The majority of this population had allergy suggested as causative for eczema by their primary care provider and were subsequently evaluated by allergist and allergy testing. Consensus about the role of food allergy between the different providers of AD in children would result in more effective, efficient, and less costly health care. [source] Advanced silicon microstructures, sensors, and systemsIEEJ TRANSACTIONS ON ELECTRICAL AND ELECTRONIC ENGINEERING, Issue 3 2007Oliver Paul Non-Member Abstract This paper presents the progress in silicon-based biomedical microstructures, material characterization techniques, and mechanical microsystems by the authors' research team. Microneedle and microelectrode arrays with fluidic through-wafer vias and electrical contacts were developed. The structures are designed for dermatological and biological applications such as allergy testing, surface electromyography, and spatially resolved impedance spectroscopy. The characterization of thin films has relied on the bulge test. By the formulation of more powerful models, the application range of the bulge test was extended to elastically supported thin-film multilayers. This enables the mechanical properties of thin films to be determined reliably. Finally, progress in the operation and application of novel stress sensors based on CMOS diffusions and field effect transistors and exploiting the pseudo-Hall effect is reported. Their integration into powerful single-chip microsystems is described. Applications include stress mapping, force and torque measurements, and tactile surface probing of microcomponents. Copyright © 2007 Institute of Electrical Engineers of Japan© 2007 Institute of Electrical Engineers of Japan. Published by John Wiley & Sons, Inc. [source] A case of suspected contact dermatitis in a juvenile cynomolgus monkey (Macaca fascicularis)JOURNAL OF MEDICAL PRIMATOLOGY, Issue 2008Joanne Morris Abstract Background, A 2-year-old male cynomolgus monkey (Macaca fascicularis) presented with vesicular dermatitis exhibiting freshly ruptured blisters, crusts, and papules on the extremities and face. Methods, Complete blood count, serum chemistry, skin biopsy, skin scrape, and culture of a fresh blister were initially submitted for diagnostics. Results, Skin biopsy of the affected area revealed a non-suppurative eosinophilic dermatitis with mild thickening of the epidermis. Serum chemistry showed a marked eosinophilia (1.74 × 103/,l, 17.4%). All other results were within normal limits. Initial differentials included contact dermatitis, immune-mediated disease such as pemphigus or psoriasis. Repeated blood work and skin biopsies were collected as well as serum for allergen-specific IgE latex and food allergy testing. Herpes B virus was added to the differential list after an oral lesion was noted upon repeated physical examination and samples were collected for testing. Repeat blood work maintained a marked eosinophilia and food allergy testing was within normal limits. Serum IgE for latex was equivocal and a follow-up latex sensitivity test was performed and was within normal limits. Repeated skin biopsies were consistent with acute eosinophilic spongiotic dermatitis with vesicles most likely due to contact dermatitis. No therapy was initiated during the diagnostic period and no etiology was confirmed. Conclusions, Over time the dermatitis and eosinophilia resolved spontaneously. The animal is currently free of any lesions and maintains an eosinophil count within normal limits. [source] Eosinophilic oesophagitis and coeliac disease: is there an association?ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 3 2007L. QUAGLIETTA Aim, To report a series of 17 children affected by eosinophilic oesophagitis. Six of them also received a diagnosis of coeliac disease. Methods, Seventeen children with history of dyspeptic symptoms were investigated. Results, Six patients (M/F:2/4; mean age ± s.d.: 5.6 ± 1.3 years, range: 4,7 years; Group A) affected by eosinophilic oesophagitis also received a diagnosis of coeliac disease. The other 11 children (M/F:10/1, mean age ± s.d.:7.5 ± 2.3 years, range: 4,10 years, Group B) were affected solely by eosinophilic oesophagitis. All children underwent a change in dietary regimen. Group A received a gluten-free diet. Group B attempted dietary restriction based on the allergy testing results. After 6 months follow-up, all patients in Group A showed a complete disappearance of symptoms and three of them, who underwent upper gastrointestinal endoscopy, showed histologic remission. Patients from Group B had moderate clinical improvement and in seven of them (64%) a repeated upper gastrointestinal endoscopy showed a statistically significant reduction in eosinophilic infiltration. Conclusions, This is the first reported group of patients with an association between coeliac disease and eosinophilic oesophagitis. To date, it is not possible to exclude that in a subgroup of children with coeliac disease the oesophageal eosinophilic infiltration could be caused by coeliac disease itself. [source] Anaphylaxis to patent blue V: a case series and proposed diagnostic protocolALLERGY, Issue 3 2010R. A. Haque To cite this article: Haque RA, Wagner A, Whisken JA, Nasser SM, Ewan PW. Anaphylaxis to patent blue V: a case series and proposed diagnostic protocol. Allergy 2010; 65: 396,400. Abstract Patent blue V is widely used in the identification of sentinel lymph nodes in patients with breast cancer and other malignancies. Individual case reports of allergy to patent blue V have been described in the medical literature since the 1960s. However, there is little data on clinical features and little experience of which allergy tests are appropriate or useful. We gathered all cases of patent blue V allergy that had been seen and diagnosed in the Department of Allergy, Addenbrooke's Hospital over a 3-year period. We collected clinical details of each case including skin test results. For comparison we recruited 12 healthy control subjects who then underwent skin testing to patent blue V. Six cases of patent blue V allergy were identified, all occurring during sentinel lymph node identification for breast carcinoma. All 6 had positive skin prick tests to neat patent blue V (25 mg/ml). Skin prick testing with a 1 : 10 dilution (2.5 mg/ml) produced positive results in 3 of 4 patients tested, and intradermal testing at a 1 : 100 dilution was (0.25 mg/ml) was positive in all patients tested. Of 12 control subjects, 11 had negative skin prick tests to both neat and 1 : 10 patent blue V with one subject showing a positive reaction to the higher concentration only. On the basis of our experience of patent blue V allergy, we propose a diagnostic protocol that can be safely and reliably utilised in centres equipped for allergy testing. [source] GA2LEN skin test study II: clinical relevance of inhalant allergen sensitizations in EuropeALLERGY, Issue 10 2009G. J. Burbach Background:, Skin prick testing is the standard for diagnosing IgE-mediated allergies. A positive skin prick reaction, however, does not always correlate with clinical symptoms. A large database from a Global Asthma and Allergy European Network (GA2LEN) study with data on clinical relevance was used to determine the clinical relevance of sensitizations against the 18 most frequent inhalant allergens in Europe. The study population consisted of patients referred to one of the 17 allergy centres in 14 European countries (n = 3034, median age = 33 years). The aim of the study was to assess the clinical relevance of positive skin prick test reactions against inhalant allergens considering the predominating type of symptoms in a pan-European population of patients presenting with suspected allergic disease. Methods:, Clinical relevance of skin prick tests was recorded with regard to patient history and optional additional tests. A putative correlation between sensitization and allergic disease was assessed using logistic regression analysis. Results:, While an overall rate of ,60% clinically relevant sensitizations was observed in all countries, a differential distribution of clinically relevant sensitizations was demonstrated depending on type of allergen and country where the prick test was performed. Furthermore, a significant correlation between the presence of allergic disease and the number of sensitizations was demonstrated. Conclusion:, This study strongly emphasizes the importance of evaluating the clinical relevance of positive skin prick tests and calls for further studies, which may, ultimately, help increase the positive predictive value of allergy testing. [source] Reactivity to sodium tetrachloropalladate (Na2[PdCl4]) compared to PdCl2 and NiCl2 in lymphocyte proliferation testsALLERGY, Issue 8 2009J. Muris Background:, For patch testing, replacement of the commonly used palladium dichloride (PdCl2) by sodium tetrachloropalladate (Na2[PdCl4]) was recently demonstrated to improve test accuracy and show a significant correlation with nickel (Ni), supporting the concept of cross-reactivity between Pd and Ni. A promising alternative to metal allergy patch testing is the in vitro lymphocyte proliferation test (LTT). Objectives:, The aim of this study was to test whether Na2[PdCl4] is also more sensitive for diagnosing Pd allergy with a standardized LTT. Patients/methods:, After determining optimal nontoxic and nonmitogenic concentrations for Na2[PdCl4], blood samples from 105 patients with clinical suspicion of metal allergy were tested with an LTT called memory lymphocyte immuno stimulation assay for Na2[PdCl4], PdCl2 and NiCl2. Reaction profiles were analysed for concordant positive reactions. Results:, Using the conventional cut-off of stimulation index , 3, 74.3% showed a positive reaction to NiCl2, 15.2% to PdCl2 and 28.6% to Na2[PdCl4]. All positive results to PdCl2 were covered by Na2[PdCl4]. From the 30 positive reactions to Na2[PdCl4], 26 (87%) were concordant for NiCl2 reactivity. Conclusion:, In LTT, the use of Na2[PdCl4] results in more positive reactions in Pd allergy testing which are in concordance with positive reactions to PdCl2 and NiCl2. [source] Unawareness and undertreatment of asthma: follow-up in a different geographic area in DenmarkALLERGY, Issue 8 2009V. Backer Background:, Early detection and treatment of asthma is important to minimize morbidity and healthcare costs. The objective of this study was to investigate asthma awareness and management in a western society. Methods:, In a random sample of 10 400 subjects aged 14,44 years, 686 (6.6%) reported symptoms of asthma in a standardized screening questionnaire. All 686 were evaluated by respiratory specialists and diagnosed by history, symptoms, lung function tests, bronchial challenges and allergy testing. Of these 686 participants, 69 (10%) had asthma alone, 205 (30%) had rhinitis alone and 217 (32%) had both asthma and rhinitis; 195 (28%) had nonasthmatic respiratory reports. Results:, Awareness of asthma was found among 163 (57%) of the 286 asthmatics, and 204 (95%) had doctor-diagnosed rhinitis as well. In a multivariate regression analysis, comorbidity with rhinitis (, = 0.489, P < 0.001), smoking (, = ,0.116, P < 0.01), doctor-diagnosed bronchitis (, = 0.086, P < 0.05), and earlier emergency visits at hospital (, = 0.147, P < 0.001) was significantly associated with awareness. A difference in awareness was found between those who had asthma and rhinitis (62.2%) and those who had asthma alone (40.6%) (P < 0.01). Inhaled corticosteroids (ICS) were used by 27% of those with asthma, including 12% who used both ICS and long-acting beta-agonist. Conclusions:, More than half of the persons with asthma were aware of their disorder; and the awareness was more likely in those with comorbidity of rhinitis. In general, asthma management was inadequate. [source] Allergic rhinitis in the child and associated comorbiditiesPEDIATRIC ALLERGY AND IMMUNOLOGY, Issue 1-Part-II 2010Tania Sih Sih T, Mion O. Allergic rhinitis in the child and associated comorbidities. Pediatr Allergy Immunol 2010: 21: e107,e113. © 2009 John Wiley & Sons A/S Allergic rhinitis (AR) typically presents after the second year of life, but the exact prevalence in early life is unknown. AR affects 10,30% of the population, with the greatest frequency found in children and adolescents. It appears that the prevalence has increased in the pediatric population. As the childs' immune system develops between the 1st and 4th yr of life, those with an atopic predisposition begin to express allergic disease with a clear Th2 response to allergen exposure, resulting in symptoms. In pediatric AR, two or more seasons of pollen exposure are generally needed for sensitization, so allergy testing to seasonal allergens (trees, grasses, and weeds) should be conducted after the age of 2 or 3 years. Sensitization to perennial allergens (animals, dust mites, and cockroaches) may manifest several months after exposure. Classification of AR includes measurement of frequency and duration of symptoms. Intermittent AR is defined as symptoms for <4 days/wk or <4 consecutive weeks. Persistent AR is defined as occurring for more than 4 days/wk and more than 4 consecutive weeks. AR is associated with impairments in quality of life, sleep disorders, emotional problems, and impairment in activities such as work and school productivity and social functioning. AR can also be graded in severity , either mild or moderate/severe. There are comorbidities associated with AR. The chronic effects of the inflammatory process affect lungs, ears, growth, and others. AR can induce medical complications, learning problems and sleep-related complaints, such as obstructive sleep apnea syndrome and chronic and acute sinusitis, acute otitis media, serous otitis media, and aggravation of adenoidal hypertrophy and asthma. [source] Continued need of appropriate betalactam-derived skin test reagents for the management of allergy to betalactamsCLINICAL & EXPERIMENTAL ALLERGY, Issue 2 2007M. Blanca Summary Immediate allergic reactions to betalactams (BLs) are due to IgE antibodies that recognize the ring-derived penicilloyl determinant or side-chain structures of common BLs. The presence of specific IgE antibodies can be demonstrated by skin testing, the determination of specific IgE antibodies in sera or their binding to basophils with subsequent activation upon contact with penicillins in vitro. Skin tests are still the most sensitive technique followed by in vitro tests, which may sometimes yield useful complementary information. The diversity of the response to BLs has meant that in some instances, in addition to benzylpenicillin-derived determinants, testing for amoxycillin, cephalosporins or other BLs may also be required to establish the diagnosis. The recent withdrawal from the market of BL-derived materials for skin testing will have a serious effect on public health, resulting in a return to the pre-1960 era before these reagents became available. Because of their greater sensitivity, these skin tests cannot yet be replaced by in vitro tests. Furthermore, skin tests are the most readily available form of allergy testing for physicians. This paper reviews the results of skin tests in BL allergy and provides evidence for their continued need. [source] | ||||||||||