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Sample records for skin test positivity

  1. [Hypersensitivity to fluindione (Previscan). Positive skin patch tests].

    Science.gov (United States)

    Frouin, E; Roth, B; Grange, A; Grange, F; Tortel, M-C; Guillaume, J-C

    2005-12-01

    Fluindione (Previscan) is an oral anticoagulant belonging to the vitamin K antagonist class and is very widely used in France. While bleeding is a common complication, severe immunoallergic reactions are less frequent. The authors report a case of drug-induced hypersensitivity syndrome. A 75 year-old woman was hospitalized for diffuse erythematous papular rash associated with facial oedema. These symptoms appeared 3 weeks after the beginning of treatment with fluindione, allopurinol and perindopril. Laboratory tests showed hyperleukocytosis, mixed hepatitis and moderate renal failure, with the entire picture being evocative of drug-induced hypersensitivity reaction. The eruption was associated with eosinophilia, hepatic cytolysis with cholestasis, and acute renale failure. While allopurinol and perindopril were stopped definitively, fluindione was only suspended temporarily following overdosage. On reintroduction, rapid recurrence of clinical and biologic signs was observed with increased severity. The skin rash resolved completely on withdrawal of the drug. Patch tests performed later were positive for fluindione and negative for allopurinol and perindopril. These manifestations were consistent with the diagnosis of drug-induced hypersensitivity syndrome due to fluindione. Very few cases have been described with fluindione despite widespread prescription of the treatment is in France. While there may be no skin involvement, immunoallergic signs such as fever, hepatitis and acute tubular interstitial nephritis have been described with fluindione and these may be related to this syndrome (DRESS - Drug Reaction with Eosinophilia and Systemic Symptoms). Skin patch testing, which is easily performed, can be extremely helpful in determining a causal relationship with medication.

  2. Positive Skin Test or Specific IgE to Penicillin Does Not Reliably Predict Penicillin Allergy.

    Science.gov (United States)

    Tannert, Line Kring; Mortz, Charlotte Gotthard; Skov, Per Stahl; Bindslev-Jensen, Carsten

    According to guidelines, patients are diagnosed with penicillin allergy if skin test (ST) result or specific IgE (s-IgE) to penicillin is positive. However, the true sensitivity and specificity of these tests are presently not known. To investigate the clinical relevance of a positive ST result and positive s-IgE and to study the reproducibility of ST and s-IgE. A sample of convenience of 25 patients with positive penicillin ST results, antipenicillin s-IgE results, or both was challenged with their culprit penicillin. Further 19 patients were not challenged, but deemed allergic on the basis of a recent anaphylactic reaction or delayed reactions to skin testing. Another sample of convenience of 18 patients, 17 overlapping with the 25 challenged, with initial skin testing and s-IgE (median, 25; range, 3-121), months earlier (T-1), was repeat skin tested and had s-IgE measured (T0), and then skin tested and had s-IgE measured 4 weeks later (T1). Only 9 (36%) of 25 were challenge positive. There was an increased probability of being penicillin allergic if both ST result and s-IgE were positive at T0. Positive ST result or positive s-IgE alone did not predict penicillin allergy. Among the 18 patients repeatedly tested, 46.2% (12 of 25) of positive ST results at T-1 were reproducibly positive at T0. For s-IgE, 54.2% (14 of 24) positive measurements were still positive at T0 and 7 converted to positive at T1. The best predictor for a clinically significant (IgE-mediated) penicillin allergy is a combination of a positive case history with simultaneous positive ST result and s-IgE or a positive challenge result. Copyright © 2017 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  3. Prevalence of positive tuberculin skin test and associated factors ...

    African Journals Online (AJOL)

    not consent to participate in the study and known TB patients were excluded. For each study participant a questionnaire with relevant information was completed, including age, sex, year of study, prior contact with a TB case, and BCG vaccina- tion status. A trained counselor provided pre and post- test counseling for HIV.

  4. Using ELISPOT to expose false positive skin test conversion in tuberculosis contacts.

    Directory of Open Access Journals (Sweden)

    Philip C Hill

    2007-01-01

    Full Text Available Repeat tuberculin skin tests may be false positive due to boosting of waned immunity to past mycobacterial exposure. We evaluated whether an ELISPOT test could identify tuberculosis (TB contacts with boosting of immunity to non-tuberculous mycobacterial exposure.We conducted tuberculin and ELISPOT tests in 1665 TB contacts: 799 were tuberculin test negative and were offered a repeat test after three months. Those with tuberculin test conversion had an ELISPOT, chest X-ray and sputum analysis if appropriate. We compared converters with non-converters, assessed the probability of each of four combinations of ELISPOT results over the two time points and estimated boosting with adjustment for ELISPOT sensitivity and specificity. 704 (72% contacts had a repeat tuberculin test; 176 (25% had test conversion, which increased with exposure to a case (p = 0.002, increasing age (p = 0.0006 and BCG scar (p = 0.06. 114 tuberculin test converters had ELISPOT results: 16(14% were recruitment positive/follow-up positive, 9 (8% positive/negative, 34 (30% negative/positive, and 55 (48% were negative/negative. There was a significant non-linear effect of age for ELISPOT results in skin test converters (p = 0.038. Estimates of boosting ranged from 32%-41% of skin test converters with increasing age. Three converters were diagnosed with TB, two had ELISPOT results: both were positive, including one at recruitment.We estimate that approximately one third of tuberculin skin test conversion in Gambian TB case contacts is due to boosting of immunity to non-tuberculous mycobacterial exposure. Further longitudinal studies are required to confirm whether ELISPOT can reliably identify case contacts with tuberculin test conversion that would benefit most from prophylactic treatment.

  5. Increased adverse drug reactions to cephalosporins in penicillin allergy patients with positive penicillin skin test.

    Science.gov (United States)

    Park, Miguel A; Koch, Cody A; Klemawesch, Patrick; Joshi, Avni; Li, James T

    2010-01-01

    Cephalosporin administration in patients with a history of penicillin allergy is controversial. Studies looking at the safety of cephalosporin in patients with a history of penicillin allergy lacked a control group, had a small number of patients, and/or lacked confirmation of penicillin allergy by penicillin skin testing. The purpose of this study was to determine whether patients with penicillin allergy were at increased risk of adverse drug reactions when administered cephalosporin. A cohort study of patients with a history of penicillin allergy and a positive or negative penicillin skin test when administered cephalosporin was conducted. Charts were reviewed for adverse drug reactions to cephalosporin after penicillin skin testing. Eighty-five patients with a history of penicillin allergy and positive penicillin skin test and 726 patients with a history of penicillin allergy and negative penicillin skin test were administered cephalosporin. Five (6%) of 85 cases had an adverse drug reaction to cephalosporin as compared to 5 (0.7%) of 726 of the referent population (p = 0.0019). The rate of presumed IgE-mediated adverse drug reactions to the cephalosporins amongst the cases was 2 (2%) of 85 compared to 1 (0.1%) of 726 amongst the referent population (p = 0.0304). A greater risk of an adverse drug reaction to cephalosporin exists in patients with penicillin allergy. We recommend penicillin skin testing if cephalosporin, especially a first-generation cephalosporin, is to be administered to patients with a history of penicillin allergy. Copyright © 2010 S. Karger AG, Basel.

  6. Positive Skin Test or Specific IgE to Penicillin Does Not Reliably Predict Penicillin Allergy

    DEFF Research Database (Denmark)

    Tannert, Line Kring; Mørtz, Charlotte G; Skov, Per Stahl

    2017-01-01

    INTRODUCTION: According to guidelines, patients are diagnosed with penicillin allergy if skin test (ST) result or specific IgE (s-IgE) to penicillin is positive. However, the true sensitivity and specificity of these tests are presently not known. OBJECTIVE: To investigate the clinical relevance...... of a positive ST result and positive s-IgE and to study the reproducibility of ST and s-IgE. METHODS: A sample of convenience of 25 patients with positive penicillin ST results, antipenicillin s-IgE results, or both was challenged with their culprit penicillin. Further 19 patients were not challenged......-IgE measured (T0), and then skin tested and had s-IgE measured 4 weeks later (T1). RESULTS: Only 9 (36%) of 25 were challenge positive. There was an increased probability of being penicillin allergic if both ST result and s-IgE were positive at T0. Positive ST result or positive s-IgE alone did not predict...

  7. The prevalence of skin-test-positive allergic rhinitis in Danish adults

    DEFF Research Database (Denmark)

    Linneberg, A; Jørgensen, T; Nielsen, N H

    2000-01-01

    BACKGROUND: It is disputed whether increases in self-reported respiratory allergy represent a true increase or merely increased recognition. We aimed to investigate whether the prevalence of skin-prick-test (SPT)-positive allergic rhinitis had increased in an adult general population in Copenhagen...... (participation rate 74.6%) and 482 (participation rate 53.4%) subjects were examined in 1990 and 1998, respectively. Diagnoses of SPT-positive allergic rhinitis were based on a history of nasal symptoms on exposure to allergens and SPT positivity to allergens. RESULTS: The prevalence of a diagnosis of SPT...

  8. Proof of concept testing of a positive reference material for in vivo and in vitro skin irritation testing.

    Science.gov (United States)

    Nomura, Yusuke; Lee, Michelle; Fukui, Chie; Watanabe, Kayo; Olsen, Daniel; Turley, Audrey; Morishita, Yuki; Kawakami, Tsuyoshi; Yuba, Toshiyasu; Fujimaki, Hideo; Inoue, Kaoru; Yoshida, Midori; Ogawa, Kumiko; Haishima, Yuji

    2017-12-11

    In vivo and in vitro irritation testing is important for evaluating the biological safety of medical devices. Here, the performance of positive reference materials for skin irritation testing was evaluated. Four reference standards, referred to as Y-series materials, were analyzed: a polyvinyl chloride (PVC) sheet spiked with 0 (Y-1), 1.0 (Y-2), 1.5 (Y-3), or 10 (Y-4) parts of Genapol X-080 per 100 parts of PVC by weight. Y-1, Y-2, and Y-3 did not induce skin irritation responses in an in vitro reconstructed human epidermis (RhE) tissue model, as measured by tissue viability or interleukin-1α release, or in an in vivo intracutaneous response test using rabbits. In contrast, Y-4 extracts prepared with saline or sesame oil at 37°C and 50°C clearly elicited positive irritation responses, including reduced viability (< 50%) and significantly higher interleukin-1α release compared with the solvent alone group, in the RhE tissue model and an intracutaneous response test, where substantial necrosis was observed by histopathology. The positive skin irritation responses induced in vitro under various extraction conditions, as well as those elicited in vivo, indicate that Y-4 is an effective extractable positive control material for in vivo and in vitro skin irritation tests of medical devices. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 2017. © 2017 Wiley Periodicals, Inc.

  9. Helminths and skewed cytokine profiles increase tuberculin skin test positivity in Warao Amerindians.

    Science.gov (United States)

    Verhagen, L M; Hermans, P W M; Warris, A; de Groot, R; Maes, M; Villalba, J A; del Nogal, B; van den Hof, S; Mughini Gras, L; van Soolingen, D; Pinelli, E; de Waard, J H

    2012-11-01

    The immune regulatory mechanisms involved in the acquisition of Mycobacterium tuberculosis infection in children are largely unknown. We investigated the influence of parasitic infections, malnutrition and plasma cytokine profiles on tuberculin skin test (TST) positivity in Warao Amerindians in Venezuela. Pediatric household contacts of sputum smear-positive tuberculosis (TB) cases were enrolled for TST, chest radiograph, plasma cytokine analyses, QuantiFERON-TB Gold In-Tube (QFT-GIT) testing and stool examinations. Factors associated with TST positivity were studied using generalized estimation equations logistic regression models. Of the 141 asymptomatic contacts, 39% was TST-positive. After adjusting for age, gender and nutritional status, TST positivity was associated with Trichuris trichiura infections (OR 3.5, 95% CI 1.1-11.6) and low circulating levels of T helper 1 (Th1) cytokines (OR 0.51, 95% CI 0.33-0.79). Ascaris lumbricoides infections in interaction with Th2- and interleukin (IL)-10-dominated cytokine profiles were positively associated with TST positivity (OR 3.1, 95% CI 1.1-8.9 and OR 2.4, 95% CI 1.04-5.7, respectively). A negative correlation of QFT-GIT mitogen responses with Th1 and Th2 levels and a positive correlation with age were observed (all p < 0.01). We conclude that helminth infections and low Th1 cytokine plasma levels are significantly associated with TST positivity in indigenous Venezuelan pediatric TB contacts. Copyright © 2012 Elsevier Ltd. All rights reserved.

  10. Skin malformations in a neonatal foal tested homozygous positive for Warmblood Fragile Foal Syndrome.

    Science.gov (United States)

    Monthoux, Chloé; de Brot, Simone; Jackson, Michelle; Bleul, Ulrich; Walter, Jasmin

    2015-01-31

    Skin malformations that resembled manifestations of Ehlers-Danlos-Syndrome were described in a variety of domestic animals during the last century as cutis hyperelastica, hyperelastosis cutis, dermatosparaxis, dermal/collagen dysplasia, dermal/cutaneous asthenia or Ehlers-Danlos-like syndrome/s. In 2007, the mutation responsible for Hereditary Equine Regional Dermal Asthenia (HERDA) in Quarter Horses was discovered. Several case reports are available for similar malformations in other breeds than Quarter Horses (Draught Horses, Arabians, and Thoroughbreds) including four case reports for Warmblood horses. Since 2013, a genetic test for the Warmblood Fragile Foal Syndrome Type 1 (WFFS), interrogating the causative point mutation in the equine procollagen-lysine, 2-oxoglutarate 5-dioxygenase 1 (PLOD1, or lysyl hydroxylase 1) gene, has become available. Only limited data are available on the occurrence rate and clinical characteristics of this newly detected genetic disease in horses. In humans mutations in this gene are associated with Ehlers-Danlos Syndrome Type VI (kyphoscoliotic form). This is the first report describing the clinical and histopathological findings in a foal confirmed to be homozygous positive for WFFS. The Warmblood filly was born with very thin, friable skin, skin lesions on the legs and the head, and an open abdomen. These abnormalities required euthanasia just after delivery. Histologic examination revealed abnormally thin dermis, markedly reduced amounts of dermal collagen bundles, with loosely orientation and abnormally large spaces between deep dermal fibers. WFFS is a novel genetic disease in horses and should be considered in cases of abortion, stillbirth, skin lesions and malformations of the skin in neonatal foals. Genetic testing of suspicious cases will contribute to evaluate the frequency of occurrence of clinical WFFS cases and its relevance for the horse population.

  11. Antibiotic-induced immediate type hypersensitivity is a risk factor for positive allergy skin tests for neuromuscular blocking agents.

    Science.gov (United States)

    Hagau, Natalia; Gherman, Nadia; Cocis, Mihaela; Petrisor, Cristina

    2016-01-01

    Skin tests for neuromuscular blocking agents (NMBAs) are not currently recommended for the general population undergoing general anaesthesia. In a previous study we have reported a high incidence of positive allergy tests for NMBAs in patients with a positive history of non-anaesthetic drug allergy, a larger prospective study being needed to confirm those preliminary results. The objective of this study was to compare the skin tests results for patients with a positive history of antibiotic-induced immediate type hypersensitivity reactions to those of controls without drug allergies. Ninety eight patients with previous antibiotic hypersensitivity and 72 controls were prospectively included. Skin tests were performed for atracurium, pancuronium, rocuronium, and suxamethonium. We found 65 positive skin tests from the 392 tests performed in patients with a positive history of antibiotic hypersensitivity (1 6.58%) and 23 positive skin tests from the 288 performed in controls (7.98%), the two incidences showing significant statistical difference (p = 0.0011). The relative risk for having a positive skin test for NMBAs for patients versus controls was 1.77 (1.15-2.76). For atracurium, skin tests were more often positive in patients with a positive history of antibiotic hypersensitivity versus controls (p = 0.02). For pancuronium, rocuronium and suxamethonium the statistical difference was not attained (p-values 0.08 for pancuronium, 0.23 for rocuronium, and 0.26 for suxamethonium). Patients with a positive history of antibiotic hypersensitivity seem to have a higher incidence of positive skin tests for NMBAs. They might represent a group at higher risk for developing intraoperative anaphylaxis compared to the general population. Copyright © 2015 The Authors. Production and hosting by Elsevier B.V. All rights reserved.

  12. Chronic idiopathic urticaria: Comparison of clinical features with positive autologous serum skin test

    Directory of Open Access Journals (Sweden)

    George Mamatha

    2008-01-01

    Full Text Available Background: Chronic idiopathic urticaria (CIU, in its extremely severe form, can pose a therapeutic challenge to the treating physician. It has been noted that in one third of such patients, autoantibodies against the IgE receptor are seen and such patients have more severe and unremitting urticaria. Aim: To compare clinical features of autoimmune urticaria with those of other CIU patients. Methods: We conducted a prospective study in an attempt to correlate the clinical features with autoantibodies, indirectly detected via the autologous serum skin test (ASST, which is the simplest and the best in vivo clinical test for detection of basophil histamine-releasing activity. Discussion: Out of 100 patients with chronic idiopathic urticaria, 34 showed a positive reaction to the autologous serum skin test and it was found that the frequency and severity of attacks was higher in these patients. Conclusion: ASST may be used as a simple and cost-effective test for the classification of chronic urticaria, which has proven to be a therapeutic challenge to the treating physician.

  13. Allergy Skin Tests

    Science.gov (United States)

    ... Histamine. In most people, this substance causes a skin response. If you don't react to histamine, your ... days or more to produce results. A positive skin test means that you may be allergic to a particular substance. Bigger wheals usually indicate a greater degree of sensitivity. A ...

  14. Patterns of skin prick test positivity in allergic patients: usefulness of a nationwide SPT chart review.

    Science.gov (United States)

    Larenas-Linnemann, D E; Fogelbach, G A Guidos; Alatorre, A Monteverde; Cruz, A Arias; Colín, D D Hernández; Pech, J A Luna; Hernández, A Medina; Imperial, D Alberto García; del Prado, M L Cid; Zapién, F J Linares; Huerta, R E; Martell, J A Ortega

    2011-01-01

    A previous survey on allergens used by Mexican allergists in their skin prick test (SPT) panel showed wide variation. Humidity varies in different zones of Mexico. This might lead to differences in natural exposure and allergic sensitisation throughout the country. We aim to describe the SPT sensitivity patterns in the different climatic zones in Mexico and to show the usefulness of a structured SPT chart-review including multiple clinics in obtaining these allergen sensitisation patterns. A retrospective, structured chart-review of SPT results was undertaken in allergy clinics throughout Mexico. Ratios of SPT positivity were calculated for individual allergens, per climatic zone and nation-wide. Per allergen group the most important allergens were identified. Statistically significant differences between zones and the nation-wide data were tested with Pearson's Chi-squares test. 4169 skin test charts were recollected. The most important allergens causing sensitisation were very similar in different zones, despite climate variation. The allergen with highest ratio of SPT positivity was Dermatophagoides pteronyssinus (51%), with trees (Ash-27%, Alder-22%, Oak19%), and Bermuda grass (26%) as second and third. In the hot zones (humid and dry) Aspergillus was statistically significant more frequently than in more temperate zones. Cockroaches thrive in big cities and humid zones and Mesquite and Poplar in dry zones. Weeds are less important. Mexico has its own SPT sensitisation pattern, which is different from America and Europe. A structured chart-review of SPT results is able to show this and might be a tool for allergists in other countries. Copyright © 2010 SEICAP. Published by Elsevier Espana. All rights reserved.

  15. Stress and anxiety effects on positive skin test responses in young adults with allergic rhinitis.

    Science.gov (United States)

    Heffner, Kathi L; Kiecolt-Glaser, Janice K; Glaser, Ronald; Malarkey, William B; Marshall, Gailen D

    2014-07-01

    Anxiety and psychological stress affect allergy-related immune function. How these relations influence the evaluations of patients with allergic rhinitis is unknown. To examine whether anxiety and stress exposure affect skin prick test (SPT) responses to common allergens for which patients with atopy showed no prior positive SPT response. Patients with allergic rhinitis, evidenced by clinical history and SPT results, were admitted twice to a hospital research unit for 4 hours. In a crossover design, SPT wheals were assessed before and after the Trier Social Stress Test and then the following morning; for comparison, SPT wheals were assessed before and after a laboratory session without a stressor. Analyses focused on wheal responses for common allergens that tested negative (wheal size wheal responses for allergens previously testing negative were enhanced after a stressor. Histamine (positive control) or saline (negative control) SPT responses were not affected. A laboratory stressor affected allergen SPT responses in more anxious patients with allergic rhinitis. In addition to clinical history, assessment of anxiety and current stress at the time of the SPT may provide valuable information about a patient's allergic status and aid in clinical decision making. Copyright © 2014 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  16. Controlled administration of penicillin to patients with a positive history but negative skin and specific serum IgE tests.

    Science.gov (United States)

    Torres, M J; Mayorga, C; Leyva, L; Guzman, A E; Cornejo-García, J A; Juarez, C; Blanca, M

    2002-02-01

    Although subjects with a positive history of immediate allergy to penicillin and negative skin test are traditionally considered to tolerate penicillin, current evidence indicates that they may develop an immediate reaction despite negative skin and serum specific IgE tests. It is thought that these patients require additional tests to confirm the diagnosis. To assess in a large group of patients with a history of immediate allergy to penicillins but with both skin test and CAP-FEIA-negative to classical and side chain penicillin determinants, the role of controlled administration of betalactams as a diagnostic test. A group of 330 patients with a history of immediate allergic reactions to penicillins was studied by two evaluators from the same allergy unit using the following protocol: skin tests with major and minor determinants of benzylpenicillin (benzylpenicilloyl-poly l-lysine and minor determinant mixture), amoxicillin and ampicillin, and determination of specific IgE antibodies to penicillins, by CAP-FEIA, in serum. If both tests proved negative, a controlled administration of the drug was then carried out. A total of 89 (27%) patients were skin test and CAP-FEIA-negative and therefore required controlled administration of the drug. Of these, 49 developed an immediate response and were therefore considered allergic, and the remainder had good tolerance after administration of both benzylpenicillin and amoxicillin. The clinical characteristics of this group were similar to the other allergic patients who were skin test or CAP-FEIA-positive, except that they were younger (P reactions appeared within 1 h, a positive correlation was found between the dose inducing the response and the time elapsed from drug administration, for both benzylpenicillin and amoxicillin (P reactions and younger subjects. This suggests that new diagnostic tests are required so as to limit the use of controlled administration.

  17. Allergy testing - skin

    Science.gov (United States)

    ... allergy skin tests if you have: Hay fever ( allergic rhinitis ) and asthma symptoms that are not well controlled with medicine Hives and angioedema Food allergies Skin rashes ( dermatitis ), in which the skin ...

  18. The association of asthma, nasal allergies, and positive skin prick tests with obesity, leptin, and adiponectin.

    Science.gov (United States)

    Newson, R B; Jones, M; Forsberg, B; Janson, C; Bossios, A; Dahlen, S-E; Toskala, E M; Al-Kalemji, A; Kowalski, M L; Rymarczyk, B; Salagean, E M; van Drunen, C M; Bachert, C; Wehrend, T; Krämer, U; Mota-Pinto, A; Burney, P; Leynaert, B; Jarvis, D

    2014-02-01

    Cross-sectional and longitudinal reports show that obese adults have more asthma than non-obese adults. A proposed mechanism is via effects of adipokines (leptin and adiponectin) on the immune system. We wished to measure the associations of asthma and other atopic diseases with serum adipokine levels and to find whether the associations with asthma were strong enough to rule out the possibility that they are secondary to the association of fatness measures with asthma. The Global Asthma and Allergy Network of Excellence (GA(2) LEN) clinical follow-up survey is a clinical survey, embedded in a larger multi-centre cross-sectional postal survey, involving, with a case/control design, enrichment of the sample with subjects with asthma and chronic rhinosinusitis (CRS). We recorded serum leptin or adiponectin in 845 men and 1110 women in 15 centres and also anthropometric measures of fatness including body mass index and waist/hip ratio, current asthma, and specific skin prick and IgE sensitisation. We used inverse sampling-probability-weighted rank and regression statistics to measure population associations of disease outcomes with adipokines in males and females, adjusting for confounders (area, age, smoking history, and number of elder siblings) and also mutually adjusting associations with adipokines and fatness measures. One thousand nine hundred and fifty-five subjects aged 16-77 years had information on leptin or adiponectin levels. Leptin and leptin/adiponectin ratio were positively associated with the level of asthma, especially in females (Somers' D of leptin by asthma score, 0.20; 95% CI, 0.08-0.30; P = 0.00079). These associations were attenuated after adjusting for confounders and became non-significant after additionally adjusting for fatness measures and multiple comparisons. Asthma levels are positively associated with serum leptin. However, we cannot rule out the possibility that this association is secondary to associations of both with fatness

  19. The effect of allergic rhinitis with positive skin prick test on choroidal thickness.

    Science.gov (United States)

    Yenigun, Alper; Elbay, Ahmet; Dogan, Remzi; Ozturan, Orhan; Ozdemir, Mehmet Hakan

    2017-06-01

    Allergic rhinitis is an inflammatory disease that develops through immunoglobulin E in the rhino-ocular mucosa due to allergy. The main symptoms are runny nose, nasal congestion, sneezing and itchy nose. This study was designed to investigate the effect of allergic rhinitis on choroidal thickness. This study was planned as a case-control study. This study performed in a tertiary referral center. The study included 61 patients with allergic rhinitis and 35 healthy subjects. Patients in both groups underwent skin prick test. In allergic rhinitis patients and healthy persons; subfoveal, temporal and nasal choroidal thickness measurement was performed. The choroidal thicknesses were measured without pupil dilation using the Spectralis Optical Coherence Tomography. In the subfoveal and temporal region, choroidal tissue was followed up significantly thicker in allergic rhinitis patients statistically compared to healthy persons (p = 0.031, p = 0.049). However, no significant difference was followed up between the nasal choroidal thickness measurements statistically (p = 0.54). Runny nose (67.2%), sneeze (65.5%), stuffiness (62.2%), itching of the nose (40.9%), and nasal discharge (21.3%) complaints were observed significantly higher in the group having allergic rhinitis. The effect of allergic rhinitis on choroidal thickness were assessed and compared with the control group. Our study revealed that there was significant association between increased choroidal thickness and allergic rhinitis. Allergic sensitivity may play an important role in increased choroidal thickness.

  20. Skin test concentrations for systemically administered drugs -- an ENDA/EAACI Drug Allergy Interest Group position paper

    NARCIS (Netherlands)

    Brockow, K.; Garvey, L. H.; Aberer, W.; Atanaskovic-Markovic, M.; Barbaud, A.; Bilo, M. B.; Bircher, A.; Blanca, M.; Bonadonna, B.; Campi, P.; Castro, E.; Cernadas, J. R.; Chiriac, A. M.; Demoly, P.; Grosber, M.; Gooi, J.; Lombardo, C.; Mertes, P. M.; Mosbech, H.; Nasser, S.; Pagani, M.; Ring, J.; Romano, A.; Scherer, K.; Schnyder, B.; Testi, S.; Torres, M.; Trautmann, A.; Terreehorst, I.

    2013-01-01

    Skin tests are of paramount importance for the evaluation of drug hypersensitivity reactions. Drug skin tests are often not carried out because of lack of concise information on specific test concentrations. The diagnosis of drug allergy is often based on history alone, which is an unreliable

  1. Validity of a self-reported history of a positive tuberculin skin test. A prospective study of drug users.

    Science.gov (United States)

    Kunins, Hillary V; Howard, Andrea A; Klein, Robert S; Arnsten, Julia H; Litwin, Alain H; Schoenbaum, Ellie E; Gourevitch, Marc N

    2004-10-01

    To define the prevalence of and factors associated with having a negative purified protein derivative (PPD) among persons who self-report a prior positive PPD and to define the safety of repeat testing in such persons. Observational cohort study. Methadone maintenance program with onsite primary care. Current or former drug users enrolled in methadone maintenance treatment. Structured interview, tuberculin skin testing regardless of self-reported PPD status, and anergy testing. Nearly one third (31%) of participants who self-reported a prior positive PPD had a negative measured PPD, despite receipt of a "booster" PPD. A single participant (0.5%) blistered in response to the PPD without lasting ill effect. Participants with PPD results discordant from their history were more likely to be HIV-seropositive and nonreactive to the anergy panel. The discordance rate among HIV-infected participants was 43%, and was largely attributable to immune dysfunction. Among HIV-seronegative participants, the discordance rate was 27%. Recent crack-cocaine use was independently associated with discordance in the absence of HIV infection. We confirmed that planting a PPD in patients who self-report a positive PPD history confers minimal risk. Substantial rates of discordance exist between self-reported history of a positive PPD and measured PPD status. Further research is needed to define the optimal management of PPD-negative patients who self-report a prior positive PPD and who have not received prior treatment for latent tuberculosis.

  2. Skin test concentrations for systemically administered drugs -- an ENDA/EAACI Drug Allergy Interest Group position paper

    DEFF Research Database (Denmark)

    Brockow, K; Garvey, L H; Aberer, W

    2013-01-01

    Skin tests are of paramount importance for the evaluation of drug hypersensitivity reactions. Drug skin tests are often not carried out because of lack of concise information on specific test concentrations. The diagnosis of drug allergy is often based on history alone, which is an unreliable...... search on skin test drug concentration in MEDLINE and EMBASE, reviewed and evaluated the literature in five languages using the GRADE system for quality of evidence and strength of recommendation. Where the literature is poor, we have taken into consideration the collective experience of the group...... to recommend appropriate drug concentration. There is urgent need for multicentre studies designed to establish and validate drug skin test concentration using standard protocols. For most drugs, sensitivity of skin testing is higher in immediate hypersensitivity compared to nonimmediate hypersensitivity....

  3. School based screening for tuberculosis infection in Norway: comparison of positive tuberculin skin test with interferon-gamma release assay

    Directory of Open Access Journals (Sweden)

    Harstad Ingunn

    2008-10-01

    Full Text Available Abstract Background In Norway, screening for tuberculosis infection by tuberculin skin test (TST has been offered for several decades to all children in 9th grade of school, prior to BCG-vaccination. The incidence of tuberculosis in Norway is low and infection with M. tuberculosis is considered rare. QuantiFERON®TB Gold (QFT is a new and specific blood test for tuberculosis infection. So far, there have been few reports of QFT used in screening of predominantly unexposed, healthy, TST-positive children, including first and second generation immigrants. In order to evaluate the current TST screening and BCG-vaccination programme we aimed to (1 measure the prevalence of QFT positivity among TST positive children identified in the school based screening, and (2 measure the association between demographic and clinical risk factors for tuberculosis infection and QFT positivity. Methods This cross-sectional multi-centre study was conducted during the school year 2005–6 and the TST positive children were recruited from seven public hospitals covering rural and urban areas in Norway. Participation included a QFT test and a questionnaire regarding demographic and clinical risk factors for latent infection. All positive QFT results were confirmed by re-analysis of the same plasma sample. If the confirmatory test was negative the result was reported as non-conclusive and the participant was offered a new test. Results Among 511 TST positive children only 9% (44 had a confirmed positive QFT result. QFT positivity was associated with larger TST induration, origin outside Western countries and known exposure to tuberculosis. Most children (79% had TST reactions in the range of 6–14 mm; 5% of these were QFT positive. Discrepant results between the tests were common even for TST reactions above 15 mm, as only 22 % had a positive QFT. Conclusion The results support the assumption that factors other than tuberculosis infection are widely contributing to

  4. Skin test concentrations for systemically administered drugs -- an ENDA/EAACI Drug Allergy Interest Group position paper.

    Science.gov (United States)

    Brockow, K; Garvey, L H; Aberer, W; Atanaskovic-Markovic, M; Barbaud, A; Bilo, M B; Bircher, A; Blanca, M; Bonadonna, B; Campi, P; Castro, E; Cernadas, J R; Chiriac, A M; Demoly, P; Grosber, M; Gooi, J; Lombardo, C; Mertes, P M; Mosbech, H; Nasser, S; Pagani, M; Ring, J; Romano, A; Scherer, K; Schnyder, B; Testi, S; Torres, M; Trautmann, A; Terreehorst, I

    2013-06-01

    Skin tests are of paramount importance for the evaluation of drug hypersensitivity reactions. Drug skin tests are often not carried out because of lack of concise information on specific test concentrations. The diagnosis of drug allergy is often based on history alone, which is an unreliable indicator of true hypersensitivity.To promote and standardize reproducible skin testing with safe and nonirritant drug concentrations in the clinical practice, the European Network and European Academy of Allergy and Clinical Immunology (EAACI) Interest Group on Drug Allergy has performed a literature search on skin test drug concentration in MEDLINE and EMBASE, reviewed and evaluated the literature in five languages using the GRADE system for quality of evidence and strength of recommendation. Where the literature is poor, we have taken into consideration the collective experience of the group.We recommend drug concentration for skin testing aiming to achieve a specificity of at least 95%. It has been possible to recommend specific drug concentration for betalactam antibiotics, perioperative drugs, heparins, platinum salts and radiocontrast media. For many other drugs, there is insufficient evidence to recommend appropriate drug concentration. There is urgent need for multicentre studies designed to establish and validate drug skin test concentration using standard protocols. For most drugs, sensitivity of skin testing is higher in immediate hypersensitivity compared to nonimmediate hypersensitivity. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  5. The association of asthma, nasal allergies, and positive skin prick tests with obesity, leptin, and adiponectin

    DEFF Research Database (Denmark)

    Newson, R. B.; Jones, M.; Forsberg, B.

    2014-01-01

    BackgroundCross-sectional and longitudinal reports show that obese adults have more asthma than non-obese adults. A proposed mechanism is via effects of adipokines (leptin and adiponectin) on the immune system. ObjectiveWe wished to measure the associations of asthma and other atopic diseases...... with serum adipokine levels and to find whether the associations with asthma were strong enough to rule out the possibility that they are secondary to the association of fatness measures with asthma. MethodsThe Global Asthma and Allergy Network of Excellence (GA(2)LEN) clinical follow-up survey is a clinical...... measures of fatness including body mass index and waist/hip ratio, current asthma, and specific skin prick and IgE sensitisation. We used inverse sampling-probability-weighted rank and regression statistics to measure population associations of disease outcomes with adipokines in males and females...

  6. Positivity of autologous serum skin test in patients with alopecia areata and vitiligo and in healthy individuals

    Directory of Open Access Journals (Sweden)

    Münevver Güven

    2015-09-01

    Full Text Available Background and Design: Autologous serum skin test (ASST, the best in-vivo test displaying in vitro basophil histamin releasing activity, is used in the diagnosis of chronic autoimmune urticaria. Besides, it is cheap and is easy to perform. It has been found that in ASST-positive chronic urticaria patients, autoimmune thyroid disease especially and other autoimmune diseases were more common and the level of autoimmune markers were higher compared to others. Autoimmunity is accused in the pathogenesis of alopecia areata and vitiligo. In this study, we assessed ASST results in healthy controls and those with autoimmune diseases, and aimed to explore the effects of thyroid autoantibodies and other factors in ASST positivity. Materials and Methods: ASST was administered to 51 patients with alopecia areata, 53 patients with vitiligo and 51 healthy controls, and thyroid function tests and thyroid autoantibodies (anti-Tg, anti-TPO were assessed. Results: ASST was positive in 64.7% of patients with in alopecia areata, 64.2% of those with vitiligo and in 45.1% of controls. There was no statistically significant difference between the groups in terms of ASST positivity. We observed that ASST positivity had no relationship with age, anti-Tg, anti-TPO and the presence of one or both autoantibody positivity. It was seen that the frequency of ASST positivity was higher in females than in men in all groups, but it was statistically significant in alopecia areata group only. Among the all study groups, the frequency of ASST positivity was statistically significantly higher in females than in men. Conclusion: The high rates of ASST positivity in individuals with alopecia areata and vitiligo as well as in healthy control, indicate that ASST positivity does not solely exist in chronic urticaria patients. With logical regression analysis, it was shown that, having alopecia areata and being female significantly increase the risk of having ASST positivity. Therefore

  7. Allergy Skin Tests

    Science.gov (United States)

    ... medications: Know your options Allergy skin tests About Advertisement Mayo Clinic does not endorse companies or products. ... a Job Site Map About This Site Twitter Facebook Google YouTube Pinterest Mayo Clinic is a not- ...

  8. Mantoux Tuberculin Skin Test

    Centers for Disease Control (CDC) Podcasts

    2006-11-22

    Learn how to evaluate people for latent TB infection with the Mantoux tuberculin skin test. This podcast includes sections on administering and reading the Mantoux tuberculin skin test, the standard method for detecting latent TB infection since the 1930s.  Created: 11/22/2006 by National Center for HIV, STD and TB Prevention (NCHHSTP).   Date Released: 12/12/2006.

  9. Freqüência de positividade em teste cutâneo para aeroalérgenos Frequency of positive skin tests for airborne allergic agents

    Directory of Open Access Journals (Sweden)

    Ricardo Godinho

    2003-12-01

    frequency of positive skin tests for specific airborne allergic agents, we assessed medical records of 398 patients with nasal symptoms suggestive of allergy or other otolaryngologic complaints which required skin testing to aid in the diagnosis. RESULTS: The most frequently found allergic agents were house dust (74,9%, dermatophagoides farinae (58,4% and mold (36,5%, followed by dog hair (32,7%, grass (22,4%, cat hair (16,9%, feathers (16,4% and wool (15,6%. Only 3,5% were positive for lovebird feathers and 1,5% for flowers. 39 patients (9,8% had negative skin tests, 10 (2,5% had reactions to the solution extract and 8 (2% did not react to histamine. We did not have complications in performing the test. CONCLUSION: House dust was the most frequently found allergic agent. Skin tests must be performed based on the clinical history, and their results may guide us towards the correct diagnosis and treatment of nose diseases.

  10. False-positive skin prick test responses to commercially available dog dander extracts caused by contamination with house dust mite (Dermatophagoides pteronyssinus) allergens

    NARCIS (Netherlands)

    van der Veen, M. J.; Mulder, M.; Witteman, A. M.; van Ree, R.; Aalberse, R. C.; Jansen, H. M.; van der Zee, J. S.

    1996-01-01

    BACKGROUND: In an outpatient population, a high frequency of positive skin prick test responses to dog dander was found in the absence of detectable IgE to dog dander in the RAST. The majority of these patients were sensitized to house dust mites (Dermatophagoides pteronyssinus) and had no obvious

  11. Performance of QuantiFERON-TB Gold test compared to tuberculin skin test in detecting latent tuberculosis infection in HIV- positive individuals in Iran

    Directory of Open Access Journals (Sweden)

    Mardani Masoud

    2010-01-01

    Full Text Available Background: There is limited data about the performance of QuantiFERON-TB Gold (QFT-G test in detecting latent tuberculosis infection (LTBI in our region. We intended to determine the performance of QFT-G compared to conventional tuberculin skin test (TST in detecting LTBI in HIV-positive individuals in Iran. Methods: This study was conducted in a HIV clinic in Tehran, Iran in April 2007. A total of 50 consecutive HIV-positive patients, not currently affected with active tuberculosis (TB, were recruited; 43 (86% were male. The mean age was 38 ± 7.2 years (21-53. All had history of Bacillus Calmette Guerin (BCG vaccination. A TST with purified protein derivative (PPD and whole-blood interferon-gamma release assay (IGRA in reaction to ESAT-6 and CFP-10 antigens was performed and measured by enzyme-linked immuno-sorbent assay (ELISA. The agreement between TST and QFT-G results were analyzed using Kappa test. Results: A total of 36 (72% patients had negative and 14 (28% revealed positive TST. For QFT-G, 20 (40% tested positive, 19 (38% tested negative, and the results in 11 cases (22% were indeterminate. A total of 14 (28% patients had a CD4 count of < 200. Of the 14, TST + group, 12 had QFT-G +, only one case TST+/QFT-G-, and QFT-G was indeterminate in one TST positive case. Of the 36 patients with negative TST tests, 8 (22% had positive GFT-G and 10 (28% yielded indeterminate results. There was no association between a positive TST and receiving highly active anti-retroviral therapy (HAART or absolute CD4 counts. Similarly, the association between QFT-G results and receiving HAART or CD4 counts was not significant (P = 0.06. Although TST results were not significantly different in patients with CD4 < 200 vs. CD4> 200 (P = 0.295, association between QFT-G results and CD4 cutoff of 200 reached statistical significance (P = 0.027. Agreement Kappa coefficient between TST and QFT-G was 0.54 (Kappa = 0.54, 95% CI = 38.4-69.6, P < 0.001. Conclusion

  12. PPD skin test

    Science.gov (United States)

    ... Tell your provider if you have received the BCG vaccine and if so, when you received it. (This ... outside the United States who have had a vaccine called BCG may have a false-positive test result.

  13. Prevalences of positive skin test responses to 10 common allergens in the US population: results from the third National Health and Nutrition Examination Survey.

    Science.gov (United States)

    Arbes, Samuel J; Gergen, Peter J; Elliott, Leslie; Zeldin, Darryl C

    2005-08-01

    Allergy skin tests were administered in the second and third National Health and Nutrition Examination Surveys (NHANES II and III) conducted in the United States from 1976 through 1980 and 1988 through 1994, respectively. This study estimated positive skin test response rates in NHANES III and identified predictors of one or more positive test responses. Comparisons with NHANES II were also made. In NHANES III, 10 allergens and 2 controls were tested in all subjects aged 6 to 19 years and a random half-sample of subjects aged 20 to 59 years. A wheal-based definition of a positive test response was used. In NHANES III, 54.3% of the population had positive test responses to 1 or more allergens. Prevalences were 27.5% for dust mite, 26.9% for perennial rye, 26.2% for short ragweed, 26.1% for German cockroach, 18.1% for Bermuda grass, 17.0% for cat, 15.2% for Russian thistle, 13.2% for white oak, 12.9% for Alternaria alternata, and 8.6% for peanut. Among those with positive test responses, the median number of positive responses was 3.0. Adjusted odds of a positive test response were higher for the following variables: age of 20 to 29 years, male sex, minority race, western region, old homes, and lower serum cotinine levels. For the 6 allergens common to NHANES II and III, prevalences were 2.1 to 5.5 times higher in NHANES III. The majority of the US population represented in NHANES III was sensitized to 1 or more allergens. Whether the higher prevalences observed in NHANES III reflect true changes in prevalence or methodological differences between the surveys cannot be determined with certainty.

  14. Standardisation of defined approaches for skin sensitisation testing to support regulatory use and international adoption: position of the International Cooperation on Alternative Test Methods.

    Science.gov (United States)

    Casati, S; Aschberger, K; Barroso, J; Casey, W; Delgado, I; Kim, T S; Kleinstreuer, N; Kojima, H; Lee, J K; Lowit, A; Park, H K; Régimbald-Krnel, M J; Strickland, J; Whelan, M; Yang, Y; Zuang, Valérie

    2018-02-01

    Skin sensitisation is the regulatory endpoint that has been at the centre of concerted efforts to replace animal testing in recent years, as demonstrated by the Organisation for Economic Co-operation and Development (OECD) adoption of five non-animal methods addressing mechanisms under the first three key events of the skin sensitisation adverse outcome pathway. Nevertheless, the currently adopted methods, when used in isolation, are not sufficient to fulfil regulatory requirements on the skin sensitisation potential and potency of chemicals comparable to that provided by the regulatory animal tests. For this reason, a number of defined approaches integrating data from these methods with other relevant information have been proposed and documented by the OECD. With the aim to further enhance regulatory consideration and adoption of defined approaches, the European Union Reference Laboratory for Alternatives to Animal testing in collaboration with the International Cooperation on Alternative Test Methods hosted, on 4-5 October 2016, a workshop on the international regulatory applicability and acceptance of alternative non-animal approaches, i.e., defined approaches, to skin sensitisation assessment of chemicals used in a variety of sectors. The workshop convened representatives from more than 20 regulatory authorities from the European Union, United States, Canada, Japan, South Korea, Brazil and China. There was a general consensus among the workshop participants that to maximise global regulatory acceptance of data generated with defined approaches, international harmonisation and standardisation are needed. Potential assessment criteria were defined for a systematic evaluation of existing defined approaches that would facilitate their translation into international standards, e.g., into a performance-based Test Guideline. Informed by the discussions at the workshop, the ICATM members propose practical ways to further promote the regulatory use and facilitate

  15. A chromosome 5q31.1 locus associates with tuberculin skin test reactivity in HIV-positive individuals from tuberculosis hyper-endemic regions in east Africa.

    Science.gov (United States)

    Sobota, Rafal S; Stein, Catherine M; Kodaman, Nuri; Maro, Isaac; Wieland-Alter, Wendy; Igo, Robert P; Magohe, Albert; Malone, LaShaunda L; Chervenak, Keith; Hall, Noemi B; Matee, Mecky; Mayanja-Kizza, Harriet; Joloba, Moses; Moore, Jason H; Scott, William K; Lahey, Timothy; Boom, W Henry; von Reyn, C Fordham; Williams, Scott M; Sirugo, Giorgio

    2017-06-01

    One in three people has been infected with Mycobacterium tuberculosis (MTB), and the risk for MTB infection in HIV-infected individuals is even higher. We hypothesized that HIV-positive individuals living in tuberculosis-endemic regions who do not get infected by Mycobacterium tuberculosis are genetically resistant. Using an "experiment of nature" design that proved successful in our previous work, we performed a genome-wide association study of tuberculin skin test positivity using 469 HIV-positive patients from prospective study cohorts of tuberculosis from Tanzania and Uganda to identify genetic loci associated with MTB infection in the context of HIV-infection. Among these individuals, 244 tested were tuberculin skin test (TST) positive either at enrollment or during the >8 year follow up, while 225 were not. We identified a genome-wide significant association between a dominant model of rs877356 and binary TST status in the combined cohort (Odds ratio = 0.2671, p = 1.22x10-8). Association was replicated with similar significance when examining TST induration as a continuous trait. The variant lies in the 5q31.1 region, 57kb downstream from IL9. Two-locus analyses of association of variants near rs877356 showed a haplotype comprised of rs877356 and an IL9 missense variant, rs2069885, had the most significant association (p = 1.59x10-12). We also replicated previously linked loci on chromosomes 2, 5, and 11. IL9 is a cytokine produced by mast cells and TH2 cells during inflammatory responses, providing a possible link between airway inflammation and protection from MTB infection. Our results indicate that studying uninfected, HIV-positive participants with extensive exposure increases the power to detect associations in complex infectious disease.

  16. Insect sting allergy with negative venom skin test responses.

    Science.gov (United States)

    Golden, D B; Kagey-Sobotka, A; Norman, P S; Hamilton, R G; Lichtenstein, L M

    2001-05-01

    In our 1976 controlled venom immuno rapy trial, 33% of 182 patients with a history of systemic reactions to insect stings were excluded because of negative venom skin test responses. There have been reports of patients with negative skin test responses who have had severe reactions to subsequent stings. Our aim is to increase awareness about the patient with a negative skin test response and insect sting allergy and to determine the frequency and significance of negative skin test responses in patients with a history of systemic reactions to insect stings. We prospectively examined the prevalence of negative venom skin test responses in patients with a history of systemic reactions to stings. In patients who gave informed consent, we analyzed the outcome of retesting and sting challenge. Of 307 patients with positive histories screened for our sting challenge study, 208 (68%) had positive venom skin test responses (up to 1 microg/mL concentration), and 99 (32%) had negative venom skin test responses. In 36 (36%) of the 99 patients with negative skin test responses, the venom RAST result was a low positive (1-3 ng/mL), or repeat venom skin test responses were positive; another 7 (7%) patients had high venom-specific IgE antibody levels (4-243 ng/mL). Notably, 56 (57%) of 99 patients with positive histories and negative skin test responses had negative RAST results. In patients with positive skin test responses, sting challenges were performed in 141 of 196 patients, with 30 systemic reactions. Sting challenges were performed on 37 of 43 patients with negative skin test responses and positive venom-specific IgE and in 14 of 56 patients with negative skin test responses and negative RAST results. There were 11 patients with negative skin test responses who had systemic reactions to the challenge sting: 2 had negative RAST results, and 9 had positive RAST results at 1 ng/mL. The frequency of systemic reaction was 21% in patients with positive skin test responses and 22

  17. Flu Vaccine Skin Patch Tested

    Science.gov (United States)

    ... Past Issues Subscribe September 2017 Print this issue Flu Vaccine Skin Patch Tested En español Send us ... Each year, millions of people nationwide catch the flu. The best way to protect yourself is to ...

  18. Clinical and investigative assessment of patients with positive versus negative autologous serum skin test: A study of 80 south Indian patients

    Directory of Open Access Journals (Sweden)

    D S Krupashankar

    2012-01-01

    Full Text Available Background: Chronic urticaria (CU is defined as urticaria persisting daily as or almost daily for more than 6 weeks and affecting 0.1% of the population. Mast cell degranulation and histamine release is of central importance in the pathogenesis of CU. About 40-50% of the patients with chronic idiopathic urticaria demonstrate an immediate wheal and flare response to intra-dermal injected autologous serum. This led to the concept of autoimmune urticaria. Aims: To determine the occurrence, clinical features, associated clinical conditions, comorbidities of autoimmune urticaria and to compare this with chronic spontaneous urticaria. This study aimed to find the frequency of autologous serum skin test (ASST positive patients among patients with CU and to identify the clinical and laboratory parameters associated with positive ASST. Materials and Methods: Prospective correlation study was done on 80 chronic urticaria patients, more than 6 weeks duration, attending outpatient department of dermatology during a period of November 2007 to January 2010. Patients were subjected to ASST, complete blood count, urine routine examination, liver function tests, renal function tests, thyroid function tests, H. pylori antibody tests, C3 and C4 complement level estimation, antinuclear antibody, and urine analysis. Results: ASST was positive in 58.75% and negative in 41.25% of the patients, respectively. Out of 33 patients with history of angioedema, 9 (27.3% patients were in ASST negative group and 24 were in positive group, this was statistically significant. Both groups showed no statistically significant difference for epidemiological details. Conclusion: ASST is considered a screening test for an autoimmune urticaria, which decreases the rate of diagnosis of "idiopathic" form of chronic urticaria. Patients with an autoimmune urticaria have more severe urticaria, more prolonged duration, more frequent attacks, and angioedema. Identification of autoimmune

  19. Azathioprine in autologous serum skin test positive chronic urticaria: A case-control study in a tertiary care hospital of eastern India

    Directory of Open Access Journals (Sweden)

    Dulal Chandra Bhanja

    2015-01-01

    Full Text Available Context: Urticaria, also referred to as hives or wheals is a common and distinctive reaction pattern characterized by spontaneous eruption of wheals. About 30-50% of patients categorized as idiopathic urticaria have autoimmune urticaria, needing immunosuppressive agents. Immunosuppressive agents are either too costly or have serious side effects. Azathioprine seems to address both these issues, being less costly. Aims: The aim was to evaluate the role of azathioprine in autologous serum skin test (ASST positive chronic urticaria (CU. Settings and Design: A single-blind randomized control trial of ASST positive patients of CU. Materials and Methods: Patients with positive ASST were allotted into two treatment groups, named group A and group B. Patients in group A were administered azathioprine (50 mg/day for a period of 8 weeks and followed up till 36 weeks, while patients in group B were given placebo pills. All patients were directed to take levocetirizine (5 mg on as and when basis, in addition. Urticaria was assessed by total severity score. Statistical Analysis Used: MedCalc statistical software (v 12.5 for Windows to calculate P values in independent samples by t-test, Mann-Whitney test, Friedmann test, and ANOVA. Results: Administration of azathioprine in group A resulted in a significant diminution of the intensity of the disease as well as in the requirement of rescue antihistamine (positive primary and secondary outcome. Conclusion: Azathioprine not only had immunomodulatory properties during the treatment period, but also had lasting therapeutic effect as well. There were some gastrointestinal side effects in the initial stages but no incidence of hematological or biochemical disturbances.

  20. Relation between BCG vaccine scar and an interferon-gamma release assay in immigrant children with "positive" tuberculin skin test (≥10 mm).

    Science.gov (United States)

    Gudjónsdóttir, Margret Johansson; Kötz, Karsten; Nielsen, Ruth Stangebye; Wilmar, Philip; Olausson, Sofia; Wallmyr, Daniel; Trollfors, Birger

    2016-10-06

    Immigrants from countries with high incidence of tuberculosis (TB) are usually offered screening when they arrive to low incidence countries. The tuberculin skin test (TST) is often used. The interferon gamma release assays (IGRAs) are more specific and not affected by BCG vaccination. The aims of this study were 1. To see if there if there is a correlation between a positive IGRA (QFT) and presence of a BCG scar in children with TST ≥10 mm, 2. To compare the TST diameter with QFT result, 3. To see if chest X-ray can be omitted in QFT negative children despite TST ≥10 mm. 762 healthy children/adolescents (median age 14 years) arriving to Gothenburg and surroundings with TST ≥10 mm were tested with QFT. A total of 163/492 (33 %) children with BCG scar had positive QFT, whereas 205/270 (76 %) without BCG scar had positive QFT (p BCG scar. Among the QFT positive children 25/368 had chest X-ray changes compared to 2/393 among the QFT negative children (p BCG vaccination had an effect on the TST diameter so an IGRA is recommended to diagnose latent TB. Using only TST for screening of latent TB would lead to overdiagnosis. The TST diameter was larger in QFT positive than in QFT negative children but could not predict QFT in the individual patient. Chest X ray contributes little to the diagnosis of TB in QFT negative children but can not be omitted because of late seroconversion of QFT in some patients. Not applicable.

  1. Metal allergy to everolimus-eluting cobalt chromium stents confirmed by positive skin testing as a cause of recurrent multivessel in-stent restenosis.

    Science.gov (United States)

    Nakajima, Yoshifumi; Itoh, Tomonori; Morino, Yoshihiro

    2016-03-01

    A 54-year-old woman treated with cobalt-chromium everolimus eluting stents (CoCr-EES) for her left distal circumflex and diagonal branch lesions suffered from repeated in-stent restenosis in both lesions. Neointimal proliferation occurred rapidly and almost simultaneously in the two lesions. The cause was established to be metal allergy, as determined by patch tests which were strongly positive for bare metal stents and weakly positive for CoCr-EES. Following the third successive angioplasty, we initiated treatment with prednisolone (30 mg daily) and the anti-allergic and anti-proliferative drug tranilast (300 mg daily). An elective angiogram performed 3 months later showed no evidence of in-stent restenosis in any of the stented lesions. Furthermore, the patient has remained angina-free for 15 months. The unique features of this case include: (1) near-simultaneous repeated multivessel in-stent restenosis in a patient with skin test-documented metal allergy to cobalt-chromium stents; (2) adjunctive systemic medical therapy with prednisolone and tranilast appeared to terminate the malignant restenotic cycle. © 2015 Wiley Periodicals, Inc.

  2. Autologous serum skin test in children

    Directory of Open Access Journals (Sweden)

    Godse Kiran

    2008-01-01

    Full Text Available Chronic urticaria in children occurs less often than adults. Out of 17 children (age group 6-16 years, [Table 2], six children (2 boys and 4 girls, 35% showed a positive result in form of wheal and flare more than 1.5 mm than saline control.Autologous serum skin test is cheap, is easy to perform, and, if performed as appropriate, it has good sensitivity and even better specificity at detecting autoantibodies in children.

  3. Variables affecting interpretation of skin prick test results

    OpenAIRE

    Suhan Günasti Topal; Bilge Fettahlıoğlu Karaman; Varol L Aksungur

    2017-01-01

    Background: Both performer- and device-dependent variabilities have been reported in sizes of wheal responses to skin prick tests. Objective: We aimed to evaluate whether or not variabilities in sizes of wheal responses influence the final interpretation of skin prick tests; in other words, the decision on whether or not there is an allergy to a given antigen. Methods: Skin prick tests with positive and negative controls and extracts of Dermatophagoides farinae and Dermatophagoides pter...

  4. The proportions of people living with HIV in low and middle-income countries who test tuberculin skin test positive using either a 5 mm or a 10 mm cut-off: a systematic review.

    Science.gov (United States)

    Kerkhoff, Andrew D; Gupta, Ankur; Samandari, Taraz; Lawn, Stephen D

    2013-07-08

    A positive tuberculin skin test (TST) is often defined by skin induration of ≥10 mm in people who are HIV-seronegative. However, to increase sensitivity for detection of Mycobacterium tuberculosis infection in the context of impaired immune function, a revised cut-off of ≥5 mm is used for people living with HIV infection. The incremental proportion of patients who are included by this revised definition and the association between this proportion and CD4+ cell count are unknown. The literature was systematically reviewed to determine the proportion of people living with HIV (PLWH) without evidence of active tuberculosis in low and middle-income countries who tested TST-positive using cut-offs of ≥5 mm and ≥10 mm of induration. The difference in the proportion testing TST-positive using the two cut-off sizes was calculated for all eligible studies and was stratified by geographical region and CD4+ cell count. A total of 32 studies identified meeting criteria were identified, providing data on 10,971 PLWH from sub-Saharan Africa, Asia and the Americas. The median proportion of PLWH testing TST-positive using a cut-off of ≥5 mm was 26.8% (IQR, 19.8-46.1%; range, 2.5-81.0%). Using a cut-off of ≥10 mm, the median proportion of PLWH testing TST-positive was 19.6% (IQR, 13.7-36.8%; range 0-52.1%). The median difference in the proportion of PLWH testing TST-positive using the two cut-offs was 6.0% (IQR, 3.4-10.1%; range, 0-37.6%). Among those with CD4+ cell counts of cut-off that were between 5.0 and 9.9 mm in diameter was similar (12.5%, 12.9% and 10.5%, respectively). There is a small incremental yield in the proportion of PLWH who test TST-positive when using an induration cut-off size of ≥5 mm compared to ≥10 mm. This proportion was similar across the range of CD4+ cell strata, supporting the current standardization of this cut-off at all levels of immunodeficiency.

  5. The skin prick test – European standards

    Science.gov (United States)

    2013-01-01

    Skin prick testing is an essential test procedure to confirm sensitization in IgE-mediated allergic disease in subjects with rhinoconjunctivitis, asthma, urticaria, anapylaxis, atopic eczema and food and drug allergy. This manuscript reviews the available evidence including Medline and Embase searches, abstracts of international allergy meetings and position papers from the world allergy literature. The recommended method of prick testing includes the appropriate use of specific allergen extracts, positive and negative controls, interpretation of the tests after 15 – 20 minutes of application, with a positive result defined as a wheal ≥3 mm diameter. A standard prick test panel for Europe for inhalants is proposed and includes hazel (Corylus avellana), alder (Alnus incana), birch (Betula alba), plane (Platanus vulgaris), cypress (Cupressus sempervirens), grass mix (Poa pratensis, Dactilis glomerata, Lolium perenne, Phleum pratense, Festuca pratensis, Helictotrichon pretense), Olive (Olea europaea), mugwort (Artemisia vulgaris), ragweed (Ambrosia artemisiifolia), Alternaria alternata (tenuis), Cladosporium herbarum, Aspergillus fumigatus, Parietaria, cat, dog, Dermatophagoides pteronyssinus, Dermatophagoides farinae, and cockroach (Blatella germanica). Standardization of the skin test procedures and standard panels for different geographic locations are encouraged worldwide to permit better comparisons for diagnostic, clinical and research purposes. PMID:23369181

  6. The skin prick test – European standards

    Directory of Open Access Journals (Sweden)

    Heinzerling Lucie

    2013-02-01

    Full Text Available Abstract Skin prick testing is an essential test procedure to confirm sensitization in IgE-mediated allergic disease in subjects with rhinoconjunctivitis, asthma, urticaria, anapylaxis, atopic eczema and food and drug allergy. This manuscript reviews the available evidence including Medline and Embase searches, abstracts of international allergy meetings and position papers from the world allergy literature. The recommended method of prick testing includes the appropriate use of specific allergen extracts, positive and negative controls, interpretation of the tests after 15 – 20 minutes of application, with a positive result defined as a wheal ≥3 mm diameter. A standard prick test panel for Europe for inhalants is proposed and includes hazel (Corylus avellana, alder (Alnus incana, birch (Betula alba, plane (Platanus vulgaris, cypress (Cupressus sempervirens, grass mix (Poa pratensis, Dactilis glomerata, Lolium perenne, Phleum pratense, Festuca pratensis, Helictotrichon pretense, Olive (Olea europaea, mugwort (Artemisia vulgaris, ragweed (Ambrosia artemisiifolia, Alternaria alternata (tenuis, Cladosporium herbarum, Aspergillus fumigatus, Parietaria, cat, dog, Dermatophagoides pteronyssinus, Dermatophagoides farinae, and cockroach (Blatella germanica. Standardization of the skin test procedures and standard panels for different geographic locations are encouraged worldwide to permit better comparisons for diagnostic, clinical and research purposes.

  7. Autologous Serum Skin Test versus Autologous Plasma Skin Test in Patients with Chronic Spontaneous Urticaria

    Directory of Open Access Journals (Sweden)

    Aysegul Alpay

    2013-01-01

    Full Text Available Previous studies indicate that 25–45% of chronic urticaria patients have an autoimmune etiology. Autologous serum skin test (ASST and autologous plasma skin test (APST are simple tests for diagnosing chronic autoimmune urticaria (CAU. However, there are still some questions about the specificity of these tests. This study consisted of 50 patients with chronic spontaneous urticaria (CSU and 50 sex- and age-matched healthy individuals aged 18 years, and older. A total of 31 (62% patients and 5 (10% control patients had positive ASST; 21 (42% patients and 3 (6% control patients had positive APST. Statistically significant differences were noted in ASST and APST positivity between the patient and control groups (ASST P<0.001; APST P<0.001. Thirteen (26% patients and 5 (10% control patients had antithyroglobulin antibodies or antithyroid peroxidase antibody positivity. No statistically significant differences were noted in thyroid autoantibodies between the patient and control groups (anti-TG P=0.317; anti-TPO P=0.269. We consider that the ASST and APST can both be used as in vivo tests for the assessment of autoimmunity in the etiology of CSU and that thyroid autoantibodies should be checked even when thyroid function tests reveal normal results in patients with CSU.

  8. Evaluation of a skin test for chicken pox.

    Science.gov (United States)

    Florman, A L; Umland, E T; Ballou, D; Cushing, A H; McLaren, L C; Gribble, T J; Duncan, M H

    1985-08-01

    Results with a VZV skin test as a marker of past infection were compared with histories of chicken pox and specific antibody detected by ELISA in 100 individuals--25 of whom were pediatric patients with malignant diseases. A negative or uncertain history was not reliable, neither were the skin test results among the oncology patients. However, among the normal individuals, the skin test when compared with the ELISA had a sensitivity of 85%, a specificity of 100%, and a positive predictive value of 100%.

  9. Skin testing versus radioallergosorbent testing for indoor allergens.

    Science.gov (United States)

    Chinoy, Birjis; Yee, Edgar; Bahna, Sami L

    2005-04-15

    BACKGROUND: Skin testing (ST) is the most common screening method for allergy evaluation. Measurement of serum specific IgE is also commonly used, but less so by allergists than by other practitioners. The sensitivity and specificity of these testing methods may vary by type of causative allergen and type of allergic manifestation. We compared ST reactivity with serum specific IgE antibodies to common indoor allergens in patients with respiratory allergies. METHODS: 118 patients (3 mo-58 yr, mean 12 yr) with allergic rhinitis and/or bronchial asthma had percutaneous skin testing (PST) supplemented by intradermal testing (ID) with those allergens suspected by history but showed negative PST. The sera were tested blindly for specific IgE antibodies by the radioallergosorbent test (Phadebas RAST). The allergens were D. farinae (118), cockroach (60), cat epithelium (90), and dog epidermal (90). Test results were scored 0-4; ST >/= 2 + and RAST >/= 1 + were considered positive. RESULTS: The two tests were in agreement (i.e., either both positive or both negative) in 52.2% (dog epidermal) to 62.2% (cat epithelium). When RAST was positive, ST was positive in 80% (dog epidermal) to 100% (cockroach mix). When ST was positive, RAST was positive in 16.3% (dog epidermal) to 50.0% (D. farinae). When RAST was negative, ST was positive in 48.5% (cat epithelium) to 69.6% (D. farinae). When ST was negative, RAST was positive in 0% (cockroach) to 5.6% (cat epithelium). The scores of ST and RAST showed weak to moderate correlation (r = 0.24 to 0.54). Regardless of history of symptoms on exposure, ST was superior to RAST in detecting sensitization to cat epithelium and dog epidermal. CONCLUSION: For all four indoor allergens tested, ST was more sensitive than RAST. When both tests were positive, their scores showed poor correlation. Sensitizations to cat epithelium and dog epidermal are common, even in subjects who claimed no direct exposure.

  10. Skin testing versus radioallergosorbent testing for indoor allergens

    Directory of Open Access Journals (Sweden)

    Bahna Sami L

    2005-04-01

    Full Text Available Abstract Background Skin testing (ST is the most common screening method for allergy evaluation. Measurement of serum specific IgE is also commonly used, but less so by allergists than by other practitioners. The sensitivity and specificity of these testing methods may vary by type of causative allergen and type of allergic manifestation. We compared ST reactivity with serum specific IgE antibodies to common indoor allergens in patients with respiratory allergies. Methods 118 patients (3 mo-58 yr, mean 12 yr with allergic rhinitis and/or bronchial asthma had percutaneous skin testing (PST supplemented by intradermal testing (ID with those allergens suspected by history but showed negative PST. The sera were tested blindly for specific IgE antibodies by the radioallergosorbent test (Phadebas RAST. The allergens were D. farinae (118, cockroach (60, cat epithelium (90, and dog epidermal (90. Test results were scored 0–4; ST ≥ 2 + and RAST ≥ 1 + were considered positive. Results The two tests were in agreement (i.e., either both positive or both negative in 52.2% (dog epidermal to 62.2% (cat epithelium. When RAST was positive, ST was positive in 80% (dog epidermal to 100% (cockroach mix. When ST was positive, RAST was positive in 16.3% (dog epidermal to 50.0% (D. farinae. When RAST was negative, ST was positive in 48.5% (cat epithelium to 69.6% (D. farinae. When ST was negative, RAST was positive in 0% (cockroach to 5.6% (cat epithelium. The scores of ST and RAST showed weak to moderate correlation (r = 0.24 to 0.54. Regardless of history of symptoms on exposure, ST was superior to RAST in detecting sensitization to cat epithelium and dog epidermal. Conclusion For all four indoor allergens tested, ST was more sensitive than RAST. When both tests were positive, their scores showed poor correlation. Sensitizations to cat epithelium and dog epidermal are common, even in subjects who claimed no direct exposure.

  11. Implementation of a penicillin allergy skin test

    Directory of Open Access Journals (Sweden)

    Aparecida Tiemi Nagao-Dias

    2009-09-01

    Full Text Available The penicillin allergy skin testing is the only accurate and reliable test for penicillin hypersensitivity mediated by IgE. It is useful for identifying patients with doubtful history of allergy. Positive test for major and minor determinants presents a positive predictive value of 50% and negative predictive value of 99%. In Brazil, the Ministry of Health suggests a protocol for in house made reagents, since they are not commercially available. As the referred protocol does not mention some important details about the test procedures, we propose in the present work to implement them, critically evaluating each step in order to allow the protocol establishment at any health service, with quality and safety.O teste cutâneo para alergia imediata a penicilina é o único teste validado internacionalmente, sendo que sua grande utilidade reside na avaliação de pacientes com história positiva de alergia a penicilina. O teste positivo para determinantes principais e secundários da penicilina apresenta um valor preditivo positivo de 50% e valor preditivo negativo de 99%. Em nosso meio, o Ministério de Saúde disponibiliza um protocolo para o preparo dos reagentes, uma vez que os mesmos não estão disponíveis comercialmente. Como o referido protocolo não apresenta maiores detalhes sobre o cuidado relativo às etapas de preparo das soluções, bem como faltam algumas considerações no que tange a realização do teste, propusemo-nos no presente trabalho operacionalizar o teste, avaliando de forma crítica e minuciosa cada etapa, de forma que outros profissionais possam reproduzi-lo de maneira mais segura e eficaz.

  12. Mantoux skin test reactivity among household contacts of hiv ...

    African Journals Online (AJOL)

    Objective: To compare the prevalence of Tuberculosis (TB) infection as demonstrated by a positive Mantoux skin test (MST) among household contacts of sputum smear positive (SSP) HIV infected and un-infected TB patients. Methods: A cross-sectional study of household contacts of patients with TB (index cases) attending ...

  13. Autologous serum skin test in chronic idiopathic urticaria

    Directory of Open Access Journals (Sweden)

    Godse Kiran

    2004-09-01

    Full Text Available BACKGROUND AND AIMS: Chronic urticaria has a spectrum of clinical presentations and causes. About 25%-45% of patients have histamine releasing autoantibodies in their blood. The term autoimmune urticaria is increasingly being accepted for this subgroup of patients. The term autoimmune urticaria is used to reflect advances in knowledge about functional autoantibodies that activate mast cells and basophils through cross linking high affinity IgE receptors to secrete histamine. This study was started to find out incidence of autoimmune urticaria in Indian patients. METHODS: The autologous serum skin test was done in 45 patients with chronic urticaria of more than six weeks duration. Physical urticaria patients were not included in the study. RESULTS: Twelve patients had positive autologous serum skin test suggestive of autoimmune urticaria. CONCLUSIONS: Positive autologous serum skin test was seen in 26.67% of patients which is less than reports from Western literature. This is a useful screening test for autoimmune urticaria.

  14. The skin prick test - European standards

    NARCIS (Netherlands)

    Heinzerling, Lucie; Mari, Adriano; Bergmann, Karl-Christian; Bresciani, Megon; Burbach, Guido; Darsow, Ulf; Durham, Stephen; Fokkens, Wytske; Gjomarkaj, Mark; Haahtela, Tari; Bom, Ana Todo; Wöhrl, Stefan; Maibach, Howard; Lockey, Richard

    2013-01-01

    Skin prick testing is an essential test procedure to confirm sensitization in IgE-mediated allergic disease in subjects with rhinoconjunctivitis, asthma, urticaria, anapylaxis, atopic eczema and food and drug allergy. This manuscript reviews the available evidence including Medline and Embase

  15. Is a positive intracutaneous test induced by penicillin mediated by histamine?

    DEFF Research Database (Denmark)

    Tannert, Line K; Falkencrone, Sidsel; Mortz, Charlotte G

    2017-01-01

    Background: Diagnostic workup of penicillin allergy comprises skin testing with penicillins, and patients are deemed allergic if skin test is positive. However, the literature suggests that skin test-positive patients may be challenge-negative, indicating that the skin test may be falsely positive....... Objective: To investigate real-time histamine release from a positive intracutaneous test induced by penicillin in patients with positive and negative challenges to penicillin. Methods: Skin microdialysis was performed in 21 penicillin-allergic patients with positive skin test, 13 non-allergic volunteers...... serving as negative controls, and 7 grass pollen-allergic patients serving as positive controls. Histamine was measured by microdialysis after skin test with penicillin/grass/NaCl. Penicillin challenge was subsequently performed in 12 of the patients. Results: Only 10/21 patients (47.6%) were skin test...

  16. [Allergy diagnosis in patients with bronchial asthma (bronchial provocation test, skin test and RAST) (author's transl)].

    Science.gov (United States)

    Baur, X; Fruhmann, G; von Liebe, V

    1978-12-15

    87 patients with bronchial asthma underwent skin test, RAST and measurment of airway resistance before and after inhalation of control solution as well as at least 10 times after each of one to four bronchial provocations (making up a total of 171 tests) with extracts of house dust, house dust mite, animal dander, mould spores and pollen in increasing concentrations. An actual clinical significance of the skin test reactions was found in 60% of all cases and of the RAST results in 66% of all cases. The overall agreement between skin test results and RAST results was 61%. The correlations between the different tests depended on the degree of hypersensitivity, on the tested allergen and on whether the results of skin test and RAST, respectively, were positive or negative. There existed a good correlation between the results of all three test methods and case history only for pollen allergens and animal dander. Noticeably often negative RAST results with house dust and mould spores, as well as positive skin tests with house dust mite and mould spores could not be confirmed by the provocation test. Important indications for a bronchial provocation test in asthmatics are doubtful case history, doubtful skin test or RAST results with the problem-allergens house dust, house dust mite and mould spores; the bronchial provocation test is especially commendable when drastic or cumbersome therapeutic measures (immunotherapy, change of home, change of job) are to follow or if late asthmatic reactions are expected.

  17. Variables affecting interpretation of skin prick test results.

    Science.gov (United States)

    Topal, Suhan Günasti; Karaman, Bilge Fettahlıoğlu; Aksungur, Varol L

    2017-01-01

    Both performer- and device-dependent variabilities have been reported in sizes of wheal responses to skin prick tests. We aimed to evaluate whether or not variabilities in sizes of wheal responses influence the final interpretation of skin prick tests; in other words, the decision on whether or not there is an allergy to a given antigen. Skin prick tests with positive and negative controls and extracts of Dermatophagoides farinae and Dermatophagoides pteronyssinus were done for 69 patients by two different persons, using two different puncturing devices- disposable 22-gauge hypodermic needles and metal lancets. Among four different skin prick tests, the average coefficients of variation in sizes of wheal responses were near to or higher than 20% for all of them. On the other hand, in the final interpretation of results, kappa values indicated substantial or almost perfect agreements between these tests. However, the frequency of establishing allergy to the house dust mites widely ranged in these tests (20.8-35.8% for D. farinae and 20.8-28.3% for D. pteronyssinus). The conduction of the study in a single center and the comparisons of results of only two performers. We feel that variabilities in sizes of wheal responses of skin prick test can influence its categorical results.

  18. Pattern Of Skin Prick Allergy Test Results In Enugu | Mgbor ...

    African Journals Online (AJOL)

    The “Allergo Ganzer” Allergy test kit (Germany) was used for skin prick allergy test on each patient. Result The reactivities to test allergens were found to be in 44.4% patients positive to house dust mites I & II, 27.2% to house dust, 22% to grass, 16.6% to cereal and trees respectively and only 8.3% to mould. Conclusion

  19. Comparison of Multi-Test device skin testing and modified RAST results.

    Science.gov (United States)

    Levine, J L; Mabry, R L; Mabry, C S

    1998-06-01

    The initial purpose of this study was to determine the potential correlation between allergy test results obtained with the Multi-Test skin testing method and the radioallergosorbent test (RAST) blood test (used as a "standard"). Twenty patients with a history and physical examination findings suggestive of inhalant allergy underwent both a Multi-Test system screen (14 antigens plus histamine and glycerine controls) and RAST testing. The relationship between wheal size and Multi-Test system grade for each antigen and the corresponding RAST class was studied. The correlation between positive Multi-Test system and RAST results was poor, with an average agreement by antigen of 56.26% and overall agreement of 67.86%. However, the overall agreement between negative Multi-Test system results (RAST results (Test system result indicates that significant inhalant allergy is unlikely, whereas a positive Multi-Test system result necessitates follow-up with more definitive testing by additional skin testing or RAST.

  20. Variation of Mycobacterium tuberculosis antigen-specific IFN-γ and IL-17 responses in healthy tuberculin skin test (TST-positive human subjects.

    Directory of Open Access Journals (Sweden)

    Lin Fan

    Full Text Available OBJECTIVE: To determine the variation of IFN-γ and IL-17 responses to M. tuberculosis antigens in healthy TST+ humans. METHODS: We isolated peripheral blood mononuclear cells from 21 TST+ healthy adults, stimulated them with phytohemagglutinin (PHA, PPD, Ag85B, ESAT-6, and live M. bovis BCG, and assayed IFN-γ and IL-17 secretion by ELISA in supernatants after 24 or 72 hours of incubation respectively. RESULTS: As in other studies, we found a wide range of IFN-γ responses to M. tuberculosis antigens; the variation significantly exceeded that observed in the same donors to the polyclonal T cell stimulus, phytohemagglutinin (PHA. In addition, we assayed IL-17 secretion in response to the same stimuli, and found less subject-to-subject variation. Analysis of the ratio of IFN-γ to IL-17 secretion on a subject-to-subject basis also revealed a wide range, with the majority of results distributed in a narrow range, and a minority with extreme results all of which were greater than that in the majority of subjects. The data suggest that study of exceptional responses to M. tuberculosis antigens may reveal immunologic correlates with specific outcomes of M. tuberculosis infection. CONCLUSION: Variation of IFNγ and IFN-γ/IL-17 responses to mycobacterial antigens exceeds that of responses to the polyclonal stimulus, PHA, in TST positive healthy humans. This indicates a quantitative spectrum of human immune responses to infection with M. tuberculosis. Since the outcome of human infection with M. tuberculosis varies greatly, systematic study of multiple immune responses to multiple antigens is likely to reveal correlations between selected immune responses and the outcomes of infection.

  1. Penicillin skin testing is a safe and effective tool for evaluating penicillin allergy in the pediatric population.

    Science.gov (United States)

    Fox, Stephanie J; Park, Miguel A

    2014-01-01

    Penicillin skin testing has been validated in the evaluation of adult patients with penicillin allergy. However, the commercially available benzylpenicilloyl polylysine (Pre-Pen) is not indicated in the pediatric population. Moreover, the safety and validity of penicillin skin testing in the pediatric population has not been well studied. We describe the safety and validity of penicillin skin testing in the evaluation of children with a history of penicillin allergy. Children (penicillin allergy were evaluated with penicillin skin tests and were reviewed for basic demographics, penicillin skin test results, adverse drug reaction to penicillin after penicillin skin test, and adverse reaction to penicillin skin test. By using the χ(2) test, we compared the differences in the proportion of children and adults with a positive penicillin skin test. P value (penicillin skin testing; 703 of 778 patients had a negative penicillin skin test (90.4%), 66 had a positive test (8.5%), and 9 had an equivocal test (1.1%). Children were more likely to have a positive penicillin skin test (P penicillin skin test (52%) were challenged with penicillin, and 14 of 369 patients (3.8%) had an adverse drug reaction. No adverse reactions to penicillin skin testing were observed. Penicillin skin testing was safe and effective in the evaluation of children with a history of penicillin allergy. Copyright © 2014 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  2. Skin irritation testing of antimicrobial conjugated electrolytes.

    Science.gov (United States)

    Wilde, Kristin N; Nguyen, Phuong A H; Whitten, David G; Canavan, Heather E

    2017-04-20

    Each year, the United States spends about $20 billion to treat people who have been infected with antibiotic resistant bacteria. Even so, the development of new antibiotics has slowed considerably since the mid-20th century. As a result, researchers are looking into developing synthetic compounds and materials with antimicrobial activities such as those made by the Schanze and Whitten groups [ACS Appl. Mater. Interfaces 3, 2820 (2011)]. Previously, they have demonstrated that poly(phenylene ethynylene) (PPE) based electrolytes and oligomeric end-only phenylene ethynylene (EO-OPE) based electrolytes possess strong biocidal activity. However, before the PPE and OPE can be used with humans, skin irritation tests are required to ensure their safety. In this work, in vitro skin assays are used to predict in vivo irritation. Tissues were conditioned for 24 h, exposed to test substances for 1 h, and then tested for viability using colorimetric and cytokine assays. Concentrations up to 50 μg/ml were tested. Viability assays and cytokine (IL-1α) assays demonstrated that the two polymers, three symmetric oligomers, and three "end only" oligomers were nonirritants. In addition, electrospun mats consisting of several promising compounds, including poly(caprolactone), were evaluated. Therefore, all test substances are conservatively classified as nonirritants after a 1 h exposure time period.

  3. [Aeroallergens, skin tests and allergic diseases in 1091 patients].

    Science.gov (United States)

    Enríquez Palomec, O; Hernández Chávez, L; Sarrazola Sanjuan, D M; Segura Méndez, N H; Hernández Colín, D D; Martínez-Cairo, S

    1997-01-01

    To know the frequency of positively of several skin tests, data cards from patients, of the Allergy and Clinic Immunology Service of the Hospital de Especialidades del Centro Medico Nacional Siglo XXI (Mexico City), between January, 1989 and March, 1995, were reviewed. Aqueous extracts manufactures by our laboratory were applied, in a dilution of 1:1000 weight-volume. 1091 from 5,651 skin tests patients were positive. Asthma and rhinitis were diagnosed in 492, allergic rhinitis in 289, allergic asthma in 111, and other diagnosis in 199 cases. The most frequent inhalable aeroallergens were house dust and perennial Dermatophagoides p and f1 with predominance in the rainy season, followed by pollens from Fraxinus a. Quercus a and Capriola, with predominance in the rainy season. The most frequent fungi were Candida and Fusarium, with predominance in the dry season.

  4. Reactions to prick and intradermal skin tests.

    Science.gov (United States)

    Bagg, Andrew; Chacko, Thomas; Lockey, Richard

    2009-05-01

    Allergy skin testing is a common procedure for the diagnosis of atopic diseases with a small risk of systemic reactions. To determine the 12-month incidence of systemic reactions (SRs) to skin prick testing (SPT) and intradermal skin testing (ST) and the symptoms and response to immediate treatment with epinephrine intramuscularly. A prospective study was conducted to evaluate SRs from ST in 1,456 patients. A standard form was used to record symptoms, signs, and treatment. The SRs are defined as any sign or symptom other than a local reaction thought to be secondary to ST. No vasovagal reactions were included. Nurses, as instructed by attending physicians, administered epinephrine (0.2 mL of a 1:1,000 dilution) intramuscularly in the deltoid as soon as any remote signs or symptoms occurred. Fifty-two patients (3.6%) had SRs (6 SPT and 46 intradermal): 43 (83%) were female, and 17 (33%) had asthma. Systemic symptoms included (SPT/intradermal) pruritic eyes, nose, or pharynx (0%/46%); worsening cough (50%/26%); sensation of difficulty swallowing (0%/20%); worsening nasal congestion (17%/15%); rhinorrhea (17%/13%); chest tightness or shortness of breath (33%/11%); generalized pruritus (17%/11%); sneezing (33%/9%); wheeze (0%/4%); and urticaria (17%/2%). No severe asthma, shock, hypotension, unconsciousness, or biphasic reactions occurred. All 52 patients received epinephrine intramuscularly, 48 (92%) oral prednisone, 9 (17%) oral prednisone to take 6 to 8 hours after a reaction, 50 (96%) oral antihistamine, and 6 (12%) nebulized beta-agonist. Of patients who underwent ST, SRs occurred in 3.6% (0.4% for SPT and 3.2% for intradermal ST), all of whom readily responded to epinephrine intramuscularly in the deltoid. This immediate administration of epinephrine seems to prevent more serious and biphasic reactions.

  5. Comparison of the Skin Test and ImmunoCAP System in the Evaluation of Mold Allergy

    Directory of Open Access Journals (Sweden)

    Kai-Li Liang

    2006-01-01

    Conclusion: The positive rate of the skin test is higher than CAP when evaluating mold allergy. Clinicians should note that a discrepancy may exist between the results of in vitro and in vivo tests when evaluating mold allergy.

  6. Skin prick test reactivity to aeroallergens by filaggrin mutation status

    DEFF Research Database (Denmark)

    Hougaard, M G; Johansen, J D; Linneberg, A

    2014-01-01

    BACKGROUND: Studies have shown that filaggrin gene (FLG) mutations are positively associated with sensitization to aero allergens. We hypothesized that FLG mutations would also have an effect on the mean size of positive skin prick test (SPT) reactions as well as the number of positive reactions....... OBJECTIVE: To investigate the effect of FLG mutations on the mean size and the number of positive SPT reactions, as well as the association with positive specific IgE. METHODS: A random sample of 3335 adults from the general population in Denmark was genotyped for the R501X and 2282del4 mutations in the FLG....... SPT and specific IgE measurements to common aeroallergens were also performed. RESULTS: FLG mutations did not influence the mean size and number of positive SPT reactions. Also, no association was found between FLG mutations and specific IgE measurements. CONCLUSION: Our findings suggest that FLG...

  7. How to improve skin notation. Position paper from a workshop

    DEFF Research Database (Denmark)

    Sartorelli, Pietro; Ahlers, Heinz W; Alanko, Kristiina

    2007-01-01

    their ideas on several aspects of S such as the problems related to the absorption through the compromised skin, the different approaches to S and models that can be used as alternatives to S. Participants agreed to produce a position paper with the goal of exploring the actions needed to improve the S system...... towards international harmonization. They consider that further discussions are needed to obtain an international consensus, but at the same time they believe that by improving and harmonizing systems for setting S we can make an important contribution to improving health of people with potential dermal...

  8. EMLA cream for pain reduction in diagnostic allergy skin testing: effects on wheal and flare responses.

    Science.gov (United States)

    Sicherer, S H; Eggleston, P A

    1997-01-01

    The use of a topical anesthetic cream containing prilocaine and lidocaine (EMLA) has been considered to reduce the pain of diagnostic allergy skin testing, but the effects of the cream on interpretation of skin tests is unclear. To determine the effects of the cream for pain reduction using prick and ID skin tests and for possible alteration of wheal and flare responses to allergen, saline, and histamine. In a randomized, double-masked, placebo-controlled design, 20 adult volunteers with a history of positive allergen tests had EMLA and placebo cream placed according to the manufacturer's recommendations on the volar aspect of the arms. Paired skin tests were placed and subjects rated the tests on a pain scale from 0 to 5 and average wheal and flare diameters were determined. Mean pain scores (+/-SEM) were significantly reduced from 2.5 +/- 0.7 to 1.1 +/- 0.6 for prick tests (n = 20, P wheal sizes for allergen prick tests, allergen ID tests, and histamine ID tests were identical in comparing placebo to EMLA-treated skin. Flare responses were reduced on the actively treated skin, on average, as follows: allergen skin tests- 52% (P response, all on the EMLA treated skin. EMLA significantly reduced the pain associated with diagnostic allergy skin testing and with no effect on the size of the wheal response. It reduces the flare response, in some cases inhibiting it completely, which must be taken into consideration in interpreting results.

  9. Comparison of different diagnostic products for skin prick testing.

    Science.gov (United States)

    Pagani, M; Antico, A; Cilia, M; Calabrò, D; Poto, S; Pecora, S; Burastero, S E

    2009-02-01

    Different in vivo methods are used to quantify the amount of allergens in products for skin prick testing. It is unclear how this impacts on the correct diagnosis of allergies. We compared the allergenic potency of three commercial extracts for skin prick testing and evaluated batch-to-batch differences within each product. Patients with a mono-sensitization (specific IgE level > 0,70 KU/L, ImmunoCAP, Phadia) to Phleum pratense (N=21), Parietaria judaica (N=20) or Dermatophagoides pteronyssinus (N=28) were evaluated by standard skin prick testing and with the end-point dilution technique using commercial products from Stallergenes (A) (Antony, France), Lofarma Allergeni (B) (Milan, Italy) and ALK Abellò (C) (Hoersholm, Denmark). Results were expressed as mean areas of the wheal (cut-off for positive reactions: 7 mm2). With standard prick testing, the following differences in wheal areas were found: Phleum, C higher than B (p=0.0454); Parietaria, C higher than A (p=0.094); Dermatophagoides, C higher than A (p=0.021). With limiting dilution testing, the following differences in dilutions yielding positive skin prick tests were found: Phleum, C and B higher than A (p=0.0391 and 0.0039, respectively); Dermatophagoides, C higher than A and B (p=0.0010 and 0.0156, respectively). In the batch-to-batch comparison, mean differences between wheal areas of compared undiluted solutions did not significantly differ in any allergen tested, although in single cases large differences were observed. At the 1 to 64 dilution, agreement was significant only with Dermatophagoides from Manufacturer C (p= 0.262). At the 1 to 16 dilution, agreement was significant with Phleum from Manufacturer C (p=0.0116) and with Dermatophagoides from Manufacturer B and C (p=0.0239 and 0.0001, respectively). At the 1 to 4 dilution agreement was significant with Dermatophagoides from the three considered Manufacturers (p=0.0189, 0.0052 and 0.0077, respectively) and with Phleum from Manufacturer B and C

  10. Preoperative position splint versus skin traction in patients with hip fracture: An experimental study.

    Science.gov (United States)

    Tosun, Betul; Aslan, Ozlem; Tunay, Servet

    2018-02-01

    The aim of the study was to compare the effects of a preoperative position splint and skin traction on pain, comfort, complications, and satisfaction with the treatment and care for patients with hip fracture. This randomized trial was conducted with a total of 68 patients with hip fracture in a tertiary care hospital in Turkey. Preoperatively, a position splint was applied to the patients in the intervention group (n = 34) and skin traction was applied to patients (n = 34) in the control group. Outcomes studied were pain, comfort, satisfaction and complications. Mann-Whitney U Test showed a significant difference between the position splint group and skin traction group regarding pain severity after the application (p < .05). A significant difference was demonstrated between the two groups concerning comfort levels after the application (p < .05). The position splint group was significantly more satisfied with the treatment and care than the control group in the later period after the application (p < .05). The number of preoperative complications in the position splint group was significantly fewer than that of the skin traction group in the preoperative period (p < .05). Preoperative position splint application in patients with hip fracture relieved pain and complications and increased comfort and satisfaction with treatment and care. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. Anaphylaxis during skin testing with food allergens in children.

    Science.gov (United States)

    Pitsios, Constantinos; Dimitriou, Anastasia; Stefanaki, Efthalia C; Kontou-Fili, Kalliopi

    2010-05-01

    Skin testing is the diagnostic cornerstone for allergies and is considered extremely safe. It is usually performed with the prick and the prick-to-prick method. The aim of this study is to report the first two pediatric cases of systemic allergic reactions during skin prick tests (SPT) with commercial food allergens. Both patients had a history of fish allergy. A 5-year-old girl, with a history of atopic dermatitis and asthma, reported an episode of urticaria and angioedema due to ingestion of fish, which had occurred 2 years before consultation. Ten minutes after having completed SPT to fish extracts, which had resulted positive, she suffered from generalized pruritus, nausea, stomach pain, and loss of consciousness. A 9-year-old boy, with a history of asthma and two episodes of acute urticaria and angioedema upon eating fish during infancy, reported a recent episode of oropharyngeal pruritus after tasting salmon. He was evaluated for fish allergy with SPT but developed conjunctivitis and acute urticaria during the first 10 min of the test. Anaphylaxis appears to be a rare side effect of skin testing in pediatric patients. Children with a history of asthma and atopic dermatitis are more likely to react.

  12. Debates in allergy medicine: Molecular allergy diagnosis with ISAC will replace screenings by skin prick test in the future.

    Science.gov (United States)

    Jensen-Jarolim, E; Jensen, A N; Canonica, G W

    2017-01-01

    In today's clinical practice patients' skin is used as screening organ for diagnosing type 1 allergy. According to European guidelines skin prick testing with a panel of 18 allergen extracts is recommended, in the US between 10 to 50 allergens are used. The specificity and sensitivity of skin testing is individually highly variable depending on age, body mass, and skin barrier status. In atopic inflammation skin testing gives more false positive results. Smaller skin area and strain limits prick testing in small children. Although the risk for systemic reactions in skin prick testing is very small, emergency medications must be available. Considering the fact that IgE is the only reliable biomarker for type I allergy, upfront IgE screening with ISAC, followed by fewer skin tests to approve positive sensitizations, is proposed. It is time to arrive in the age of molecular allergy diagnosis in daily patient care.

  13. In vitro and human testing strategies for skin irritation.

    Science.gov (United States)

    Robinson, M K; Osborne, R; Perkins, M A

    2000-01-01

    Prior to the manufacture, transport, and marketing of chemicals or products, it is critical to assess their potential for skin toxicity (corrosion or irritation), thereby protecting the worker and consumer from adverse skin effects due to intended or accidental skin exposure. Traditionally, animal testing procedures have provided the data needed to assess the more severe forms of skin toxicity, and current regulations may require animal test data before permission can be obtained to manufacture, transport, or market chemicals or the products that contain them. In recent years, the use of animals to assess skin safety has been opposed by some as inhumane and unnecessary. The conflicting needs of the industrial toxicologist to (1) protect human safety, (2) comply with regulations, and (3) reduce animal testing have led to major efforts to develop alternative, yet predictive, test methods. A variety of in vitro skin corrosion test methods have been developed and several have successfully passed initial international validation. These have included skin or epidermal equivalent assays that have been shown to distinguish corrosive from noncorrosive chemicals. These skin/epidermal equivalent assays have also been modified and used to assess skin irritation potential relative to existing human exposure test data. The data show a good correlation between in vitro assay data and different types of human skin irritation data for both chemicals and consumer products. The effort to eliminate animal tests has also led to the development of a novel human patch test for assessment of acute skin irritation potential. A case study shows the benefits of in vitro and human skin irritation tests compared to the animal tests they seek to replace, and strategies now exist to adequately assess human skin irritation potential without the need to rely on animal test methods.

  14. Comparing chest Radiograph and Tuberculin Skin Tests in Children

    Directory of Open Access Journals (Sweden)

    Ghafari Firoozeh

    2009-10-01

    Full Text Available World Health organization (WHO has reported that out of more than 10,000 of 250,000 tuberculosis afflicted children die annually. Pulmonary tuberculosis is a research priority in our country, and diagnos-ing this disease especially in children who are known as the major transmitter of the disease is rather difficult. As a result, it was decided to conduct an overall assessment on this age group in order to determine the importance of the findings of chest radiography and skin test in diagnosing the disease. The present descriptive study was carried out based on the findings of a health plan in Fasa , a Iranian town, during 1995 and 1996, on 2 groups: first-grade students of Fasa elementary schools. Among 2263 students, 102 (4.5% cases had a positive skin test. According to the radiographic findings, tuberculosis was reported in seven (6.9% of them. The diagnosis of tuberculosis is more difficult in children; this is because taking sputum samples for laboratory examination is rather difficult especially in children lower than 10 years. In this group, diagnosis is made based on the symptoms like cough, weight loss, history of contact with a TB patient and other diagnostic procedures including chest radiographies and skin test.

  15. Skin test reactivity to dog-derived antigens.

    Science.gov (United States)

    Lutsky, I; Fink, J N; Arkins, J A; Hoffman, R; Morouse, M

    1980-05-01

    Skin test reactivity to canine antigens was studied by testing atopic patients and veterinarians using a commercially prepared mixed-dog epithelial antigen and breed-specific antigens including dander extracts, serum and urine, obtained from thirty-one different pure-bred dogs. Increased skin test reactivity was noted using breed-specific antigens as compared to the mixed-dog commercial screening extract. Variation in skin test responsivity related to specific breed antigens was also noted. The results suggest that skin tests using canine urine and serum antigens, in addition to the conventional dander antigens, may be useful in the diagnosis of hypersensitivity to dogs.

  16. Penicillin skin testing in the evaluation and management of penicillin allergy.

    Science.gov (United States)

    Fox, Stephanie; Park, Miguel A

    2011-01-01

    to review the role of penicillin skin testing in the evaluation and management of penicillin allergy mediated by IgE. PubMed and OVID search of English-language articles regarding penicillin allergy, penicillin allergy testing, and management of penicillin allergy. articles pertinent to the subject matter were selected and reviewed. the major determinant (benzylpenicillin polylysine) detects the greatest number of penicillin allergic patients during skin testing, and the minor determinants of penicillin increase the sensitivity of penicillin skin testing. Penicillin skin testing to the major and minor determinants was found to have a negative predictive value of 97% to 99%. The incidence of systemic adverse reaction to penicillin skin testing is less than 1%. a detailed history of the prior reaction to penicillin is an integral part of the evaluation, but it is not accurate in predicting a positive penicillin skin test result. A patient with a negative penicillin skin test result to the major and minor determinants is at a low risk of an immediate-type hypersensitivity reaction to penicillin. Patients with a positive skin test result should undergo desensitization to penicillin or an alternative antibiotic should be considered.

  17. GA(2)LEN skin test study II: clinical relevance of inhalant allergen sensitizations in Europe

    DEFF Research Database (Denmark)

    Burbach, G J; Heinzerling, L M; Edenharter, G

    2009-01-01

    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 (GA(2)LEN) study with data on clinical relevance was ...

  18. Skin testing and oral penicillin challenge in patients with a history of remote penicillin allergy.

    Science.gov (United States)

    Goldberg, Arnon; Confino-Cohen, Ronit

    2008-01-01

    Penicillin administration is usually contraindicated in penicillin-allergic patients with positive skin test results. To examine whether penicillin oral challenge for patients with a history of remote non-life-threatening allergic reaction to penicillin can be well tolerated irrespective of skin test results. In a prospective open-label trial, 8,702 individuals were screened between November 1998 and January 2000. Of 687 patients with a non-life-threatening allergic reaction to penicillin, occurring longer than 3 years earlier, 169 were enrolled. Regardless of the response to penicillin skin testing, patients received the usual 1-day dosage of penicillin and amoxicillin, on 2 separate occasions. Two to 6 years later, a follow-up was conducted to assess the outcomes of further penicillin administration. A total of 272 combined skin tests and oral challenges were performed on 169 patients. Among 137 challenges with a positive skin test result and 135 patients with a negative skin test result, 9 (6.6%) and 5 (3.7%) (P = .29), respectively, developed a mild rash to oral challenge. At follow-up, 2 to 6 years afterward, 3 of 55 patients (5.5%) who were given a full treatment course of penicillin developed a mild skin eruption. Positive penicillin skin test results for patients with a remote history of non-life-threatening allergic reaction to penicillin were not associated with a greater prevalence of adverse reactions to oral challenge with penicillin than negative results. Because skin testing is considered the gold standard and the safest method for predicting tolerance to penicillin administration, oral penicillin challenge may be used as a diagnostic method only in these specific patients when skin testing is not feasible.

  19. Skin testing only with penicillin G in children with a history of penicillin allergy.

    Science.gov (United States)

    Picard, Matthieu; Paradis, Louis; Bégin, Philippe; Paradis, Jean; Des Roches, Anne

    2014-07-01

    The absence of commercially available penicilloyl-polylysine (PPL) for most of the last decade severely hampered the practice of penicillin allergy evaluation because skin testing without PPL is reported to have a poor negative predictive value (NPV). To determine the safety and NPV of skin testing without PPL using only penicillin G followed by a 3-dose graded challenge to the incriminated penicillin in children with a history of penicillin allergy. Patients evaluated for a history of penicillin allergy at the CHU Sainte-Justine Allergy Clinic between December 2006 and December 2009 were skin tested only with penicillin G and underwent a 3-dose graded challenge to the culprit penicillin if the skin test result was negative. Among 563 patients skin tested to penicillin G, 185 (33%) had a positive skin test result. These patients had a shorter interval between the initial reaction and skin testing compared with patients with a negative skin test result (P = .03). A total of 375 of 378 patients (99%) with a negative skin test result were challenged and 18 (4.8%) reacted, translating into a NPV of 95.2% (95% confidence interval [CI], 92.5%-97.1%). Three of 17 patients with a history of anaphylaxis and a negative skin test result reacted to challenge (NPV, 82.4%; 95% CI, 59.0-93.8%). All challenge reactions were mild and resolved promptly with treatment. Among children with a history of penicillin allergy, skin testing only with penicillin G followed by a 3-dose graded challenge to the incriminated penicillin is safe and yields a good NPV. This approach could be useful when PPL is unavailable. Copyright © 2014 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  20. Measurement and interpretation of skin prick test results

    NARCIS (Netherlands)

    J.P.M. van der Valk; R. Gerth van Wijk (Roy); E.J. Hoorn (Ewout); L. Groenendijk (Laurens); I.M. Groenendijk (Ilse M.); N.W. de Jong (Nicolette)

    2016-01-01

    textabstractBackground: There are several methods to read skin prick test results in type-I allergy testing. A commonly used method is to characterize the wheal size by its 'average diameter'. A more accurate method is to scan the area of the wheal to calculate the actual size. In both methods, skin

  1. [The relationship between the skin allergy test and house dust mites].

    Science.gov (United States)

    Atambay, Metin; Aycan, Ozlem M; Yoloğlu, Saim; Karaman, Ulkü; Daldal, Nilgün

    2006-01-01

    Since 1960 it has been known that house dust mites are related to allergy and that they cause pulmonary tract diseases. There are various house dust mites and among these Dermatophagoides pteronyssinus (Trouessart, 1897) and Dermatophagoides farinae (Hughes, 1961) are best known with regard to their medical importance and morphological characteristics. Skin tests are used to determine the role of mites in allergic diseases. The tests are performed by using D. pteronyssinus and D. farinae antigens. In order to study, the concordance between the skin test results and the presence of house dust mites, dust samples from the houses of 49 patients diagnosed with allergic diseases who underwent skin tests were taken to investigate the presence of mites in dust. House dust mites were determined in 23 (46.3%) of the houses. Mites were found in the houses of 15 (50.0%) of 30 patients with positive skin test results and 8 (42.0%) of 19 patients with negative skin test results. There was no significant difference between the skin test positivity and negativity in the presence of house dust mites (P>0,005). In conclusion, we thought that it was necessary to evaluate the presence of mites in the houses of people who have allergic symptoms even if they had negative skin test results.

  2. Anaphylaxis to muscle relaxants: rational for skin tests.

    Science.gov (United States)

    Moneret-Vautrin, D A; Kanny, G

    2002-09-01

    IgE-dependent allergy to muscle relaxants (MR) has an estimated prevalence of 1 out of 6500 General Anesthesias (GA). 62% of anaphylaxis during surgery are due to MR anaphylaxis. All the molecules are divalent, carrying two NH4+ epitopes (quaternary ammonium ions), either structurally or after rapid in vivo protonization (vecuronium). The excellent overall performance of skin test makes them the golden standard for the diagnosis of anaphylactoid reactions. Techniques include intradermal tests and prick-tests. The current localizations are the forearm and the back. Positivity criteria are 3 mm for prick-tests. For IDTs, the criterium is the doubling of the size of the injection papula, when 0.02 to 0.04 ml is injected: 8 mm. The recommended concentrations are not falsely negative. Commercial concentrations can be tested by prick tests, except for mivacurium and atracurium tested of 1:10 dilution. A scale of concentrations is advised for IDT starting with 1:10,000, up to a normally non reactive concentration that is: 100 micrograms/ml (succinylcholine), 200 micrograms/ml (gallamine), 10 micrograms/ml (atracurium), 2 micrograms/ml (mivacurium), 200 micrograms/ml (pancuronium), 400 micrograms/ml (vecuronium), 1,000 micrograms/ml (rocuronium), 200 micrograms/ml (cis atracurium). The specificity and sensitivity of the skin tests to MRs are greater than 95%. The reproducibility over years is 88%. The overall concordance of PT and IDR is 97%. Both types of tests can be used for the diagnosis. IDT have to be carried out for the search of the cross sensitization. 84% of patients do have cross sensitization to MRs but only 16% react to all MRs. The further use of MRs selected by negative IDTs has been proved to be safe.

  3. Utility of minor determinants for skin testing in inpatient penicillin allergy evaluation.

    Science.gov (United States)

    Geng, Bob; Eastman, Jacqueline J; Mori, Karen; Braskett, Melinda; Riedl, Marc A

    2017-09-01

    Most patients with a history of penicillin allergy can tolerate penicillin. Skin testing can identify tolerant patients, but not all known allergenic determinants are commercially available. Protocols exist that use only available reagents, but the sensitivity and safety of these protocols, particularly for hospitalized patients, are controversial. To determine the number of hospitalized patients referred for penicillin skin testing who showed unique positivity to the minor determinants penicilloate and penilloate. A retrospective chart review was conducted of all inpatients who underwent penicillin skin testing at 1 institution. Patients were referred by their treating physician. All patients underwent skin prick testing to benzylpenicilloyl polylysine (major determinant), penicillin G, penicilloate, penilloate (minor determinants), amoxicillin, and positive and negative controls. If the result was negative, then intradermal testing was done with the same penicillin determinants and the negative control. A 4-mm wheal with flare was considered a positive reaction. Inpatient penicillin skin testing was done in 528 subjects. Any positive test reaction was found in 107 subjects (20%). Three subjects (3%) reacted to penilloate only, 25 (23%) reacted to penicilloate only, 2 (2%) reacted to penicillin G only, and 8 (8%) reacted to amoxicillin only. Sixty-eight subjects (64%) reacted to a compound other than the major determinant. This study found a high rate of exclusively positive skin test reactions to the minor determinants penicilloate and penilloate. Because patients with positive test reactions are at increased risk of reaction to drug challenge, these data support the use of these reagents for penicillin skin testing in hospitalized patients. Copyright © 2017 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  4. Assessment of autologous serum skin test in chronic idiopathic urticaria

    Directory of Open Access Journals (Sweden)

    Mohammad Kazem Nooh pisheh

    2009-09-01

    Full Text Available Background: In the vast majority of patients with chronic urticaria , the etiology is unknown. It has been noted that in one third of such patients it has an autoimmune base. Autologous serum skin test (ASST is currently the best in vivo test for the detection of such patients. Our aim was to identify the prevalence of positive ASST among patients with chronic idiopathic urticaria (CIU and to compare features of ASST + and ASST – groups. Methods: this study was done on 79 patients with CIU. Samples of 0.05ml of autologous serum and normal saline were separately injected intradermaly into the volar aspect of right and left forearm respectively. ASST Was deemed to be positive if a serum induced weal had a diameter bigger than a sailin induced response by < 1.5 mm was seen at 30min. Also we compare the clinical and laboratory parameters of ASST+ and ASST - groups.Results: Out of 79 patients with CIU, 39 patients (39% had positive ASST and it was found that the frequency of attacks was higher in these patients (P=0.04. Conclusion: Significant percent of patients with CIU showed positive response to ASST which is most likely an autoimmune source for them. ASST can be used as a simple and cost - effective test for the detection of these patients, which has proven to be a therapeutic challenge to the treating physician.

  5. Immediate hypersensitivity to iodinated contrast media: diagnostic accuracy of skin tests and intravenous provocation test with low dose.

    Science.gov (United States)

    Sesé, L; Gaouar, H; Autegarden, J-E; Alari, A; Amsler, E; Vial-Dupuy, A; Pecquet, C; Francès, C; Soria, A

    2016-03-01

    The diagnosis of HSR to iodinated contrast media (ICM) is challenging based on clinical history and skin tests. This study evaluates the negative predictive value (NPV) of skin tests and intravenous provocation test (IPT) with low-dose ICM in patients with suspected immediate hypersensitivity reaction (HSR) to ICM. Thirty-seven patients with suspected immediate hypersensitivity reaction to ICM were included retrospectively. Skin tests and a single-blind placebo-controlled intravenous provocation test (IPT) with low-dose iodinated contrast media (ICM) were performed. Skin tests with ICM were positive in five cases (one skin prick test and five intradermal test). Thirty-six patients were challenged successfully by IPT, and only one patient had a positive challenge result, with a grade I reaction by the Ring and Messmer classification. Ten of 23 patients followed up by telephone were re-exposed to a negative tested ICM during radiologic examination; two experienced a grade I immediate reaction. For immediate hypersensitivity reaction to ICM, the NPV for skin tests and IPT with low dose was 80% (95% CI 44-97%). © 2016 John Wiley & Sons Ltd.

  6. Human skin equivalent as an alternative to animal testing

    OpenAIRE

    Mertsching, Heike; Weimer, Michaela; Kersen, Silke; Brunner, Herwig

    2008-01-01

    The 3-D skin equivalent can be viewed as physiologically comparable to the natural skin and therefore is a suitable alternative for animal testing. This highly differentiated in vitro human skin equivalent is used to assess the efficacy and mode of action of novel agents. This model is generated from primary human keratinocytes on a collagen substrate containing human dermal fibroblasts. It is grown at the air-liquid interface which allows full epidermal stratification and epidermal-dermal in...

  7. Evaluation of skin test reactivity to environmental allergens in healthy cats and cats with atopic dermatitis.

    Science.gov (United States)

    Schleifer, Sebastian G; Willemse, Ton

    2003-06-01

    To evaluate skin test reactivity to environmental allergens in healthy cats and in cats with atopic dermatitis (AD). 10 healthy cats and 10 cats with AD. 10 allergens in serial dilutions were injected ID on the lateral aspect of the thorax of sedated cats. Histamine (0.01% solution) and buffer solutions were used as positive and negative controls, respectively. Immediately after the last injection, 10% fluorescein solution was administered IV. Skin test results were evaluated with ultraviolet light after 15 to 30 minutes and at 4 and 6 hours by 2 independent observers. In the control group, skin tests were repeated after 6 weeks. Skin test reactivity and the nature of the immunoglobulin involved were investigated by use of the Prausnitz-Küstner test with untreated and heat-treated cat sera. Intertest and interobserver agreement were high when measurement of the diameter of the fluorescent wheal was used to evaluate skin test responses, compared with assessment of its intensity. In both groups of cats, immediate skin test reactivity was observed as an IgE-mediated reaction, as an IgG-mediated reaction, and as a result of nonspecific mast cell degranulation. There was no correlation between allergen concentration and the type of reaction observed. Skin test reactivity in cats should be evaluated after IV administration of 10% fluorescein solution by means of a Prausnitz-Küstner test to differentiate among IgE-mediated, IgG-mediated, and nonspecific reactions.

  8. Functional testing of topical skin formulations using an optimised ex vivo skin organ culture model

    OpenAIRE

    Sidgwick, G. P.; McGeorge, D.; Bayat, A.

    2016-01-01

    A number of equivalent-skin models are available for investigation of the ex vivo effect of topical application of drugs and cosmaceuticals onto skin, however many have their drawbacks. With the March 2013 ban on animal models for cosmetic testing of products or ingredients for sale in the EU, their utility for testing toxicity and effect on skin becomes more relevant. The aim of this study was to demonstrate proof of principle that altered expression of key gene and protein markers could be ...

  9. Feasibility, Benefits, and Limitations of a Penicillin Allergy Skin Testing Service.

    Science.gov (United States)

    Narayanan, Prasanna P; Jeffres, Meghan N

    2017-06-01

    To critically examine the feasibility, benefits, and limitations of an inpatient penicillin skin testing service and how pharmacists can be utilized. A PubMed search was performed from July 2016 through September 2016 using the following search terms: penicillin skin testing, penicillin allergy, β-lactam allergy. Additional references were identified from a review of literature citations. All English-language studies assessing the use of penicillin skin testing as well as management and clinical outcomes of patients with a β-lactam allergy were evaluated. The prevalence of people self-identifying as penicillin allergic ranges from 10% to 20% in the United States. Being improperly labeled as penicillin allergic is associated with higher health care costs, worse clinical outcomes, and an increased prevalence of multidrug-resistant infections. Penicillin skin testing can be a tool used to clarify penicillin allergies and has been demonstrated to be a successful addition to antimicrobial stewardship programs in multiple health care settings. Prior to implementing a penicillin skin testing service, institutions will need to perform a feasibility analysis of who will supply labor and accept the financial burden as well as identify if the positive benefits of a penicillin skin testing service overcome the limitations of this diagnostic test. We conclude that institutions with high percentages of patients receiving non-β-lactams because of penicillin allergy labels would likely benefit the most from a penicillin skin testing service.

  10. Effect of topical vapocoolant spray on skin test wheal, flare, and pain responses.

    Science.gov (United States)

    Waibel, Kirk H; Katial, Rohit K

    2005-08-01

    Skin puncture and intradermal tests are commonly used to evaluate allergic rhinitis. Ethyl chloride, a topical vapocoolant spray, provides skin analgesia before venipuncture, but it has not been studied with allergy skin testing. To determine the effects of ethyl chloride vs placebo on skin puncture testing (SPT) and intradermal allergy testing. We enrolled 20 healthy adults with a history of positive aeroallergen skin test results in a randomized, double-masked, placebo-controlled study. Ethyl chloride and placebo sprays were randomly placed on the upper back. Paired SPT was performed with saline, histamine, and standardized aeroallergens, including Bermuda grass, Kentucky blue grass, timothy grass, cat, Dermatophagoides pteronyssinus, and Dermatophagoides farinae. Serial dilutional end-point intradermal tests were then performed using 1 standardized aeroallergen. Wheal and flare areas were outlined, scanned, and digitally measured. Participants used a 10-cm visual analog scale to record pain during skin testing. Eighteen individuals completed the study. Compared with placebo, ethyl chloride had no significant effect on histamine wheal (P = .53), histamine flare (P = .39), aeroallergen wheal (P = .10), or aeroallergen flare (P = .71) area for SPT. Serial dilutional end-point intradermal testing was similar after ethyl chloride and placebo application (P = .75). Mean pain scores for SPT were improved with ethyl chloride compared with paired placebo skin tests, although pain scores did not reach significance for SPT (P = .21) or intradermal testing (P = .87). Ethyl chloride does not significantly reduce histamine and aeroallergen wheal and flare areas during SPT and intradermal allergy skin testing. Ethyl chloride, vs placebo, reduced pain in some individuals during skin testing, although this did not attain statistical significance.

  11. Relationships between skin test, specific IgE and levels of cytokines in patients with penicillin allergy.

    Science.gov (United States)

    Qiao, H-L; Liu, J-H; Yang, J; Dong, Z-M

    2005-08-01

    The aim of this study was to investigate the relationships between skin test, specific immunoglobulin (Ig) E and cytokines in penicillin allergy. We collected the sera of 259 patients with historical positive skin test to penicillins, with immediate positive skin test and with a negative skin test results. The positive rate of specific IgE antibodies in 259 patients was 62.2% (161) by using radioallergosorbent test (RAST). Of the eight kinds of antigenic determinants, the positive rates of specific IgE to major and minor determinants were 43.63% (113) and 52.51% (136), respectively (p test, when the degrees of skin test were +, 2+, 3+ and 4+, the positive rates of specific IgE were 45.7, 57.1, 85.2 and 100%, respectively. The levels of interleukin (IL)-4, IL-13 and interferon (IFN)-gamma in the sera of patients with positive skin test were significantly increased with the degree of positive skin test (p RAST offers the better test for the detection of penicillin-specific IgE antibodies. IL-4, IL-13 and IFN-gamma play important roles in penicillin allergy.

  12. Skin prick test results to artesunate in children sensitized to Artemisia vulgaris L.

    Science.gov (United States)

    Mori, F; Pantano, S; Rossi, M E; Montagnani, C; Chiappini, E; Novembre, E; Galli, L; de Martino, M

    2015-09-01

    Artemisia vulgaris L and Artemisia annua L (Chinese: qinghao) are similar plants of the Asterbaceae family. Artesunate, a semi-synthetic derivate of artemisin which is the active principle extract of the plant qinghao, has antimalarial properties. Some cases of severe allergic reactions to artesunate have been described. The purpose of this study was to evaluate the association between positive skin tests to Artemisia vulgaris L allergen and a preparation of injectable artesunate. A total of 531 children were skin prick tested with inhalants (including Artemisia vulgaris L), foods, and artesunate. Among the 59 patients positive to Artemisia vulgaris L only one child was also positive to artesunate. No child was positive to artesunate in those negative to Artemisia vulgaris L. We conclude that Artemisia vulgaris L sensitization is not associated with sensitization to artesunate; consequently, skin test to artesunate should not be carried out before using the drug considering the rare allergic reactions. © The Author(s) 2015.

  13. The potential utility of iodinated contrast media (ICM) skin testing in patients with ICM hypersensitivity.

    Science.gov (United States)

    Ahn, Young-Hwan; Koh, Young-Il; Kim, Joo-Hee; Ban, Ga-Young; Lee, Yeon-Kyung; Hong, Ga-Na; Jin, U-Ram; Choi, Byung-Joo; Shin, Yoo-Seob; Park, Hae-Sim; Ye, Young-Min

    2015-03-01

    Both immediate and delayed hypersensitivity reactions to iodinated contrast media (ICM) are relatively common. However, there are few data to determine the clinical utility of immunologic evaluation of ICM. To evaluate the utility of ICM skin testing in patients with ICM hypersensitivity, 23 patients (17 immediate and 6 delayed reactions) were enrolled from 3 university hospitals in Korea. With 6 commonly used ICM including iopromide, iohexol, ioversol, iomeprol, iopamidol and iodixanol, skin prick (SPT), intradermal (IDT) and patch tests were performed. Of 10 patients with anaphylaxis, 3 (30.0%) and 6 (60.0%) were positive respectively on SPTs and IDTs with the culprit ICM. Three of 6 patients with urticaria showed positive IDTs. In total, 11 (64.7%) had positive on either SPT or IDT. Three of 6 patients with delayed rashes had positive response to patch test and/or delayed IDT. Among 5 patients (3 anaphylaxis, 1 urticaria and 1 delayed rash) taken subsequent radiological examinations, 3 patients administered safe alternatives according to the results of skin testing had no adverse reaction. However, anaphylaxis developed in the other 2 patients administered the culprit ICM again. With 64.7% (11/17) and 50% (3/6) of the sensitivities of corresponding allergic skin tests with culprit ICM for immediate and delayed hypersensitivity reactions, the present study suggests that skin tests is useful for the diagnosis of ICM hypersensitivity and for selecting safe ICM and preventing a recurrence of anaphylaxis caused by the same ICM.

  14. [Assessment of hypersensitivity to honey-bee venom in beekeepers by skin tests].

    Science.gov (United States)

    Becerril-Ángeles, Martín; Núñez-Velázquez, Marco; Marín-Martínez, Javier

    2013-01-01

    Beekeepers are exposed to frequent honey-bee stings, and have the risk to develop hypersensitivity to bee venom, but long-term exposure can induce immune tolerance in them. Up to 30% of beekeepers show positive skin tests with honey-bee venom. The prevalence of systemic reactions to bee stings in beekeepers is from 14% to 42%. To know the prevalence of hypersensitivity to honeybee venom in Mexican beekeepers and non-beekeepers by the use of skin tests. A group of 139 beekeepers and a group of 60 non-beekeeper volunteers had a history and physical related to age, sex, family and personal atopic history and time of exposure to bee stings. Both groups received intradermal skin tests with honey-bee venom, 0.1 mcg/mL and 1 mcg/mL, and histamine sulphate 0.1 mg/mL and Evans solution as controls. The skin tests results of both groups were compared by chi-squared test. Of the group of beekeepers, 116 were men (83%) and 23 women, average age was 39.3 years, had atopic family history 28% and personal atopy 13%, average time of exposure to bee stings was 10.9 years, skin tests with honey-bee venom were positive in 16.5% and 11% at 1 mcg/mL and 0.1 mcg/mL, respectively. In the non-beekeepers group venom skin tests were positive in 13.3% and 6.7% at 1 mcg/mL and 0.1 mcg/mL. We did not find significant differences between the two venom concentrations tested in both groups, neither in the number of positive skin tests between the two groups. We found hypersensivity to honey-bee venom slightly higher in the beekeepers than in the group apparently not exposed. Both honey-bee venom concentrations used did not show difference in the results of the skin tests. The similarity of skin tests positivity between both groups could be explained by immune tolerance due to continued exposure of beekeepers.

  15. Bacterial cellulose skin masks-Properties and sensory tests.

    Science.gov (United States)

    Pacheco, Guilherme; de Mello, Carolina Véspoli; Chiari-Andréo, Bruna Galdorfini; Isaac, Vera Lucia Borges; Ribeiro, Sidney José Lima; Pecoraro, Édison; Trovatti, Eliane

    2017-09-29

    Bacterial cellulose (BC) is a versatile material produced by microorganisms in the form of a membranous hydrogel, totally biocompatible, and endowed with high mechanical strength. Its high water-holding capacity based on its highly porous nanofibrillar structure allows BC to incorporate and to release substances very fast, thus being suitable for the preparation of skincare masks. The preparation and characterization of cosmetic masks based on BC membranes and active cosmetics. The masks were prepared by the simple incorporation of the cosmetic actives into BC membranes, used as a swelling matrix. The masks were characterized by Fourier transform infrared (FTIR), scanning electron microscopy (SEM), sensory tests, and skin moisture tests on volunteers. The results of sensory tests revealed the good performance of BC, being considered effective by the panel of volunteers, specially for adhesion to the skin (7.7 at the score scale), and improvement of the skin moisture (the hydration effect increased 76% in 75% of the volunteers that used vegetable extract mask formulation [VEM]), or a decrease in skin hydration (80% of the volunteers showed 32.6% decrease on skin hydration using propolis extract formulation [PEM] treatment), indicating the BC nanofiber membranes can be used to skincare applications. The results demonstrate the BC can be used as an alternative support for cosmetic actives for skin treatment. © 2017 Wiley Periodicals, Inc.

  16. Estimating Skin Cancer Risk: Evaluating Mobile Computer-Adaptive Testing.

    Science.gov (United States)

    Djaja, Ngadiman; Janda, Monika; Olsen, Catherine M; Whiteman, David C; Chien, Tsair-Wei

    2016-01-22

    Response burden is a major detriment to questionnaire completion rates. Computer adaptive testing may offer advantages over non-adaptive testing, including reduction of numbers of items required for precise measurement. Our aim was to compare the efficiency of non-adaptive (NAT) and computer adaptive testing (CAT) facilitated by Partial Credit Model (PCM)-derived calibration to estimate skin cancer risk. We used a random sample from a population-based Australian cohort study of skin cancer risk (N=43,794). All 30 items of the skin cancer risk scale were calibrated with the Rasch PCM. A total of 1000 cases generated following a normal distribution (mean [SD] 0 [1]) were simulated using three Rasch models with three fixed-item (dichotomous, rating scale, and partial credit) scenarios, respectively. We calculated the comparative efficiency and precision of CAT and NAT (shortening of questionnaire length and the count difference number ratio less than 5% using independent t tests). We found that use of CAT led to smaller person standard error of the estimated measure than NAT, with substantially higher efficiency but no loss of precision, reducing response burden by 48%, 66%, and 66% for dichotomous, Rating Scale Model, and PCM models, respectively. CAT-based administrations of the skin cancer risk scale could substantially reduce participant burden without compromising measurement precision. A mobile computer adaptive test was developed to help people efficiently assess their skin cancer risk.

  17. Comparison of the skin test and ImmunoCAP system in the evaluation of mold allergy.

    Science.gov (United States)

    Liang, Kai-Li; Su, Mao-Chang; Jiang, Rong-San

    2006-01-01

    Mold is ubiquitous in our environment and is a common allergen in allergic diseases. The skin test and the Pharmacia ImmunoCAP system (CAP) for assay-specific immunoglobulin E (IgE) antibodies are both widely used. The goal of this study was to compare the performance of the skin test and CAP in the evaluation of mold allergy. Patients with allergic rhinitis were enrolled at our outpatient department. The diagnosis of allergic rhinitis was based on typical symptoms for more than 2 years. All patients were tested by both intradermal skin test and serum assay for specific IgE antibodies. The skin test included house dust, cotton, ragweed, and 5 fungal antigens (Candida, Alternaria, Aspergillus, Cladosporium, and Penicillium). The serum-specific IgE antibodies were quantified using the radioimmunoassay version of CAP. Seventy-five patients (44 males and 31 females) with allergic rhinitis were enrolled in this study. Their ages ranged from 12 to 76 years old, with a mean of 31.9 years. The positive rates of skin test and CAP were 56.0% versus 9.3% for Candida, 22.7% versus 1.3% for Alternaria, 16% versus 9.3% for Aspergillus, 14.7% versus 1.3% for Cladosporium, and 32% versus 8% for Penicillium. There were statistically significant differences between the positive rates for Candida, Alternaria, Cladosporium, and Penicillium when analyzed by the McNemar test. The positive rate of the skin test is higher than CAP when evaluating mold allergy. Clinicians should note that a discrepancy may exist between the results of in vitro and in vivo tests when evaluating mold allergy.

  18. Natural history of skin prick test reactivity

    DEFF Research Database (Denmark)

    Schou Nielsen, Jesper; Meteran, Howraman; Ulrik, Charlotte Suppli

    2017-01-01

    aeroallergens (ie, birch, grass, mugwort, horse, dog, cat, house dust mite [Dermatophagoides pteronyssinus and Dermatophagoides farinae] and 2 molds [Alternaria iridis and Cladosporium herbarum]). RESULTS: The prevalence of allergy to any tested allergen peaked at the ages of 13 to 23 years. Rates...

  19. Evaluation of autologous serum skin test and skin prick test reactivity to house dust mite in patients with chronic spontaneous urticaria.

    Directory of Open Access Journals (Sweden)

    Zhiqiang Song

    Full Text Available BACKGROUND: Chronic spontaneous urticaria (CSU is a common skin disorder with etiology that is not well understood. METHODS: In this study, we evaluated the prevalence of autologous serum skin test (ASST and skin prick testing (SPT to house dust mite (HDM in 862 CSU cases in China. Clinical features, courses and treatment responses were also recorded. RESULTS: The prevalence of positive ASST was 46.3%, and patients aged 30-39 years had the highest positive rate (52.1%. Positive SPT to HDM was seen in 153 patients (17.7% with the highest positive rate (34.2% in patients aged 20 or less. Patients with positive ASST had higher urticaria activity scores (UAS (4.18±0.65 vs. 3.67±0.53 but lower positive rates of HDM (24.6% vs. 37.6%, as compared with those with negative ASST (odds ratio (OR 1.84, 95% CI 1.38-2.47. Patients could be categorized into four groups based on the results of ASST and SPT to HDM and patients with positive ASST and positive SPT to HDM had the highest disease activity scores, experienced higher frequencies of angioedema, diseases duration, and required higher dosage of loratadine every month, compared with other subgroups (P<0.0001. CONCLUSIONS: Patients with CSU showed varied responses of positive ASST and varied sensitivity to HDM, Patients with positive ASST and/or positive SPT had more disease activity compared with patients with negative ASST and/or negative SPT. Further classification can be made based on the result of SPT and ASST.

  20. Testing Expected Shortfall Models for Derivative Positions

    NARCIS (Netherlands)

    Kerkhof, F.L.J.; Melenberg, B.; Schumacher, J.M.

    2003-01-01

    In this paper we test several risk management models for computing expected shortfall for one-period hedge errors of hedged derivatives positions.Contrary to value-at-risk, expected shortfall cannot be tested using the standard binomial test, since we need information of the distribution in the

  1. Non-animal testing strategies for assessment of the skin corrosion and skin irritation potential of ingredients and finished products.

    Science.gov (United States)

    Robinson, M K; Cohen, C; de Fraissinette, A de Brugerolle; Ponec, M; Whittle, E; Fentem, J H

    2002-05-01

    The dermatotoxicologist today is faced with a dilemma. Protection of workers and consumers from skin toxicities (irritation and allergy) associated with exposure to products, and the ingredients they contain, requires toxicological skin testing prior to manufacture, transport, or marketing. Testing for skin corrosion or irritation has traditionally been conducted in animals, particularly in rabbits via the long established Draize test method. However, this procedure, among others, has been subject to criticism, both for its limited predictive capacity for human toxicity, as well as for its use of animals. In fact, legislation is pending in the European Union which would ban the sale of cosmetic products, the ingredients of which have been tested in animals. These considerations, and advancements in both in vitro skin biology and clinical testing, have helped drive an intensive effort among skin scientists to develop alternative test methods based either on in vitro test systems (e.g. using rat, pig or human skin ex vivo, or reconstructed human skin models) or ethical clinical approaches (human volunteer studies). Tools are now in place today to enable a thorough skin corrosion and irritation assessment of new ingredients and products without the need to test in animals. Herein, we describe general testing strategies and new test methods for the assessment of skin corrosion and irritation. The methods described, and utilized within industry today, provide a framework for the practicing toxicologist to support new product development initiatives through the use of reliable skin safety testing and risk assessment tools and strategies.

  2. Erythema exsudativum multiforme after a Leishmania skin test

    NARCIS (Netherlands)

    Wind, Bas S.; Guimarães, Luiz H.; Machado, Paulo R. L.

    2014-01-01

    A 45-year-old otherwise healthy male from an endemic region for Leishmania braziliensis infection in Bahia, Brazil, presented with three erosive hemorrhagic infiltrated plaques on the left shin accompanied with lymphadenopathy in the groin since one month. A Leishmania skin test performed on the

  3. Skin Prick Tests and Dose Response Relationship between ...

    African Journals Online (AJOL)

    Zagazig Journal of Occupational Health and Safety ... Objectives: the objectives of this study were to: a) study the association between chronic exposure to flour among bakers and the prevalence of work related respiratory and allergic symptoms, b) assess allergic reaction to flour dust using Skin Prick Test (SPT), c) evaluate ...

  4. Where to prick the apple for skin testing?

    NARCIS (Netherlands)

    Vlieg-Boerstra, B. J.; van de Weg, W. E.; van der Heide, S.; Dubois, A. E. J.

    Mal d 1 is not equally distributed over the apple. We aimed to examine the influence of the location of pricking in the apple on prick-to-prick skin prick test (PTP) results. PTPs were performed in autumn 2007 and spring 2008, before the birch pollen season, in 32 Dutch adults with symptoms of oral

  5. A statewide assessment of tuberculin skin testing of preschool children enrolled in medicaid managed care.

    Science.gov (United States)

    Vivier, Patrick M; O'haire, Christen; Alario, Anthony J; Simon, Peter; Leddy, Tricia; Peter, Georges

    2006-03-01

    This study examined tuberculosis screening among preschool children enrolled in a statewide Medicaid managed care program. A random sample of 2,000 was selected from 19 to 35 month old children who were continuously enrolled in Rhode Island's Medicaid managed care program for 1 year. Sociodemographic data were obtained from computerized administrative databases. Medical record audits were performed to obtain the dates and results of tuberculosis tests. Data from the medical record audits were available for 1,988 of the study children. For 1,215 of the study children (1,215/1,988 = 61%) a tuberculin skin test had been performed, but a reading was only documented for 736 children (60% of children who received a tuberculin skin test) and only one child tested positive (0.1%). A majority of preschool children in this population in which the prevalence of risk factors for tuberculosis is likely to be relatively high did have a tuberculosis test performed. However, in many cases the tuberculin skin test was either not read or the results not documented. The low rate of positivity is consistent with current AAP guidelines for selective tuberculin skin testing.

  6. Changes in skin test reactivity among adults with atopic disease: a 3-year prospective study

    DEFF Research Database (Denmark)

    Aslund, N.; Thomsen, S.F.; Molgaard, E.

    2008-01-01

    Background: Our knowledge about longtudinal predictors of atopy is limited. Objectives: To describe changes in skin test reactivity during a 3-year period in a sample of adolescents and adults with atopic disease and to identify factors of importance for these changes. Methods: From a sample of 1......, 186 candidates, ranging in age from 14 to 44 years, who in a screening questionnaire reported symptoms suggestive of respiratory allergic disease, 344 individuals with a positive skin prick test (SPT) result concomitantly with asthma and/or rhinitis were clinically studied on 2 occasions, 3 years...

  7. Simplification of intradermal skin testing in Hymenoptera venom allergic children.

    Science.gov (United States)

    Cichocka-Jarosz, Ewa; Stobiecki, Marcin; Brzyski, Piotr; Rogatko, Iwona; Nittner-Marszalska, Marita; Sztefko, Krystyna; Czarnobilska, Ewa; Lis, Grzegorz; Nowak-Węgrzyn, Anna

    2017-03-01

    The direct comparison between children and adults with Hymenoptera venom anaphylaxis (HVA) has never been extensively reported. Severe HVA with IgE-documented mechanism is the recommendation for venom immunotherapy, regardless of age. To determine the differences in the basic diagnostic profile between children and adults with severe HVA and its practical implications. We reviewed the medical records of 91 children and 121 adults. Bee venom allergy was exposure dependent, regardless of age (P venom allergic group, specific IgE levels were significantly higher in children (29.5 kUA/L; interquartile range, 11.30-66.30 kUA/L) compared with adults (5.10 kUA/L; interquartile range, 2.03-8.30 kUA/L) (P venom were higher in bee venom allergic children compared with the wasp venom allergic children (P venom. At concentrations lower than 0.1 μg/mL, 16% of wasp venom allergic children and 39% of bee venom allergic children had positive intradermal test results. The median tryptase level was significantly higher in adults than in children for the entire study group (P = .002), as well as in bee (P = .002) and wasp venom allergic groups (P = .049). The basic diagnostic profile in severe HVA reactors is age dependent. Lower skin test reactivity to culprit venom in children may have practical application in starting the intradermal test procedure with higher venom concentrations. Copyright © 2016 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  8. Functional testing of topical skin formulations using an optimised ex vivo skin organ culture model.

    Science.gov (United States)

    Sidgwick, G P; McGeorge, D; Bayat, A

    2016-07-01

    A number of equivalent-skin models are available for investigation of the ex vivo effect of topical application of drugs and cosmaceuticals onto skin, however many have their drawbacks. With the March 2013 ban on animal models for cosmetic testing of products or ingredients for sale in the EU, their utility for testing toxicity and effect on skin becomes more relevant. The aim of this study was to demonstrate proof of principle that altered expression of key gene and protein markers could be quantified in an optimised whole tissue biopsy culture model. Topical formulations containing green tea catechins (GTC) were investigated in a skin biopsy culture model (n = 11). Punch biopsies were harvested at 3, 7 and 10 days, and analysed using qRT-PCR, histology and HPLC to determine gene and protein expression, and transdermal delivery of compounds of interest. Reduced gene expression of α-SMA, fibronectin, mast cell tryptase, mast cell chymase, TGF-β1, CTGF and PAI-1 was observed after 7 and 10 days compared with treated controls (p animal models in this context, prior to study in a clinical trial environment.

  9. Is a positive history of non-anaesthetic drug allergy a predictive factor for positive allergy tests to anaesthetics?

    Science.gov (United States)

    Hagau, Natalia; Gherman-Ionica, Nadia; Hagau, Denisa; Tranca, Sebastian; Sfichi, Manuela; Longrois, Dan

    2012-03-01

    International recommendations stipulate not performing screening skin tests to a drug in the absence of a clinical history consistent with that specific drug allergy. Nevertheless, two publications showed that a positive history of non-anaesthetic drug allergy was the only predictive factor for a positive skin test when screening for allergy to anaesthetic drugs was done. We selected from a surgical population 40 volunteers with a prior history of allergy to non-anaesthetic drugs in order to analyse the prevalence of positive allergy tests to anaesthetics. The selected adult patients were tested for 11 anaesthetic drugs using in vivo tests: skin prick (SPT) and intradermal (IDT) tests and in vitro tests: the basophil activation test (BAT) and detection of drug-specific immunoglobulin E (IgE). The prevalence for the positive SPT and IDT was 1.6% and 5.8% respectively. The result of flow cytometry agreed with the SPT in five out of seven positive SPT (71%). IgEs confirmed two positive SPT with corresponding positive BAT. Ten per cent of the patients had a positive prick test to neuromuscular blocking agents (NMBA). For midazolam none of the SPT was positive, but 11 patients had positive IDT nonconfirmed by BAT. The prevalence of positive in vivo and in vitro allergy tests to NMBAs is higher in our study population. This could be an argument for pre-operative SPT to NMBAs for the surgical population with reported non-anaesthetic drug allergies. A larger prospective study is needed to validate changes in clinical practice. © 2011 The Authors. British Journal of Clinical Pharmacology © 2011 The British Pharmacological Society.

  10. On Standardized Testing: An ACEI Position Paper

    Science.gov (United States)

    Solley, Bobbie A.

    2007-01-01

    Following the whirlwind standards movement of the 1980s, the beginning of the 1990s ushered in an overwhelming interest in and use of testing to document students' progress. In 1991, the Association for Childhood Education International (ACEI) issued its second position paper calling for a moratorium on standardized testing in the early years of…

  11. Non-animal test methods for predicting skin sensitization potentials.

    Science.gov (United States)

    Mehling, Annette; Eriksson, Tove; Eltze, Tobias; Kolle, Susanne; Ramirez, Tzutzuy; Teubner, Wera; van Ravenzwaay, Bennard; Landsiedel, Robert

    2012-08-01

    Contact allergies are complex diseases, and it is estimated that 15-20 % of the general population suffers from contact allergy, with increasing prevalence. Evaluation of the sensitization potential of a substance is usually carried out in animal models. Nowadays, there is much interest in reducing and ultimately replacing current animal tests. Furthermore, as of 2013, the EU has posed a ban on animal testing of cosmetic ingredients that includes skin sensitization. Therefore, predictive and robust in vitro tests are urgently needed. In order to establish alternatives to animal testing, the in vitro tests must mimic the very complex interactions between the sensitizing chemical and the different parts of the immune system. This review article summarizes recent efforts to develop in vitro tests for predicting skin sensitizers. Cell-based assays, in chemico methods and, to a lesser extent, in silico methods are presented together with a discussion of their current status. With considerable progress having been achieved during the last years, the rationale today is that data from different non-animal test methods will have to be combined in order to obtain reliable hazard and potency information on potential skin sensitizers.

  12. GA(2)LEN skin test study I: GA(2)LEN harmonization of skin prick testing: novel sensitization patterns for inhalant allergens in Europe

    DEFF Research Database (Denmark)

    Heinzerling, L M; Burbach, G J; Edenharter, G

    2009-01-01

    BACKGROUND: Skin prick testing is the standard for diagnosing IgE-mediated allergies. However, different allergen extracts and different testing procedures have been applied by European allergy centres. Thus, it has been difficult to compare results from different centres or studies across Europe....... It was, therefore, crucial to standardize and harmonize procedures in allergy diagnosis and treatment within Europe. AIMS: The Global Asthma and Allergy European Network (GA(2)LEN), with partners and collaborating centres across Europe, was in a unique position to take on this task. The current study...... is the first approach to implement a standardized procedure for skin prick testing in allergies against inhalant allergens with a standardized pan-European allergen panel. METHODS: The study population consisted of patients who were referred to one of the 17 participating centres in 14 European countries (n...

  13. Allergy skin test responses during experimental infection with respiratory syncytial virus.

    Science.gov (United States)

    Skoner, David P; Gentile, Deborah A; Angelini, Betty; Doyle, William J

    2006-06-01

    Allergy skin testing is one of the most frequently performed physician office procedures. Many factors can affect the results of those tests, including the well-defined suppressive effect of systemic antihistamines. False-positive allergen skin test results are known to occur; however, contributing factors are not well understood. To determine whether a viral upper respiratory tract infection affects allergy skin test responsiveness. We performed skin tests with histamine and a panel of geographically relevant inhalant allergens on 16 adults before and 3, 6, and 21 days after experimental exposure to respiratory syncytial virus (RSV), a virus that causes signs and symptoms of a cold. The RSV exposure, with and without documented infection, caused increased wheal and flare areas to histamine and allergen and de novo positive allergen test responses in individuals with no measurable responses at baseline. These were noted as late as 21 days after RSV exposure and may be consistent with mediation by up-regulated neurogenic inflammation during RSV infection. These results may have implications for explaining the cause of such well-known complications of RSV infection as otitis media, bronchiolitis, and asthmatic exacerbation.

  14. [Three cases of perioperative anaphylaxis identified by using skin-prick tests].

    Science.gov (United States)

    Inoue, Kazuyoshi; Kawanishi, Hiroyuki; Nakamura, Hitoshi; Yatsu, Yuichi; Takebe, Sawako; Nagai, Akihiro; Matsuda, Rikiya; Hirasaki, Akihito

    2014-11-01

    We encountered three cases of perioperative anaphylaxis identified by using skin-prick tests. [Case 1] A 43-year-old woman was scheduled to undergo elective laparoscopic subtotal gastrectomy under general anesthesia for gastric tumor. However, the procedure was cancelled because of anaphylaxis that was noted at the beginning of the surgery. We performed a skin-prick test and observed a positive reaction with ro- curonium. [Case 2] A 79-year-old man underwent laparoscopic colon resection under general anesthesia for colon cancer. Anaphylaxis was noted at the end of surgery. We performed a skin-prick test and observed a positive reaction with sugammadex. [Case 3] A 44-year-old woman underwent myomectomy under general anesthesia for a uterine fibroid. Anaphylaxis was noted approximately 10 minutes after the beginning of surgery. We performed a skin-prick test and noted a positive reaction with latex. It is difficult to identify the reason for anaphylaxis during surgery under general anesthesia because various agents may be responsible for the anaphylactic reaction. Anaphylaxis during surgery is a rare but life-threatening event and it is important to identify the causative agent for anaphylaxis.

  15. Multi-centre comparison of ABBOTT MATRIX Aero to Pharmacia Standard RAST, Modified RAST and skin puncture tests.

    Science.gov (United States)

    Ownby, D R; Adkinson, N F; Hamilton, R G; Homburger, H A; Zeitz, H J; Kowalski, D; Lindberg, R E; Frank, P M; Hrusovsky, I

    1994-08-01

    ABBOTT MATRIX Aero is an enzyme immunoassay which measures specific IgE antibodies to 14 individually calibrated airborne allergens using a single serum specimen. In this study, ABBOTT MATRIX performance was evaluated in comparison to the results of skin puncture test and the Standard and Modified RAST procedures. The ABBOTT MATRIX demonstrated overall sensitivity of 89% vs. Standard RAST and Modified RAST, with specificity greater than 92% vs. both methods. ABBOTT MATRIX sensitivity vs. skin test (71%) exceeded that of the Standard and Modified RAST procedures (62% and 67% respectively). Positive results reported by ABBOTT MATRIX but not RAST were corroborated by skin test results for 3 of 5 allergens evaluated. All in vitro systems demonstrated specificity of approximately 90% vs. skin test. The ABBOTT MATRIX system provided results which compared favorably with the results of skin test and RAST, but required less hands-on time to obtain quantitative specific IgE measurements to multiple allergens.

  16. Human skin-color sexual dimorphism: a test of the sexual selection hypothesis.

    Science.gov (United States)

    Madrigal, Lorena; Kelly, William

    2007-03-01

    Applied to skin color, the sexual selection hypothesis proposes that male preference for light-skinned females explains the presence of light skin in areas of low solar radiation. According to this proposal, in areas of high solar radiation, natural selection for dark skin overrides the universal preference of males for light females. But in areas in which natural selection ceases to act, sexual selection becomes more important, and causes human populations to become light-skinned, and females to be lighter than males. The sexual selection hypothesis proposes that human sexual dimorphism of skin color should be positively correlated with distance from the equator. We tested the prediction that sexual dimorphism should increase with increasing latitude, using adult-only data sets derived from measurements with standard reflectance spectrophotometric devices. Our analysis failed to support the prediction of a positive correlation between increasing distance from the equator and increased sexual dimorphism. We found no evidence in support of the sexual selection hypothesis. (c) 2006 Wiley-Liss, Inc.

  17. The association between allergy skin testing, atopic respiratory conditions, and stroke mortality in middle-aged and elderly adults.

    Science.gov (United States)

    Matheson, Eric M; Mainous, Arch G; Carnemolla, Mark A

    2009-01-01

    A history of atopic respiratory conditions has been linked to an increased risk of stroke. What remains unclear is whether positive allergy skin testing is associated with an increased risk of stroke. The primary goal of this study was to determine whether positive allergy skin testing is associated with an increased risk of fatal stroke. A secondary goal is to determine whether having both positive allergy skin testing and an atopic respiratory condition is associated with a particularly high risk of stroke death. An analysis was performed of the National Health and Nutrition Examination Survey II Mortality Cohort. Controlling for age, gender, race, alcohol use, smoking status, diabetes, hypertension, and body mass index, patients with positive allergy skin testing had a hazard ratio for stroke mortality of 1.56 (95% CI, 1.01-2.40) versus those without positive allergy testing. Patients with both positive allergy testing and an atopic respiratory condition had a hazard ratio for stroke mortality of 2.31 (95% CI, 1.13-4.73). Individuals with both positive allergy skin testing and an atopic respiratory condition have more than a 2-fold increased risk of fatal stroke. This novel risk factor has substantial implications for a large segment of the population not previously considered at risk.

  18. Mold testing by RAST and skin test methods in patients with allergic fungal sinusitis.

    Science.gov (United States)

    Mabry, R L; Marple, B F; Mabry, C S

    1999-09-01

    RAST tests have traditionally been considered less sensitive than skin tests during investigation of atopy involving molds. This has been attributed to technical problems such as difficulty in binding the mold antigen to the carrier substrate. Ten patients with proven allergic fungal sinusitis were evaluated for sensitivity to 11 important molds by both RAST and dilutional intradermal testing. A predictable correlation between RAST and skin test scores was observed in many, but not all, cases. Most often this disparity was in the form of greater sensitivity indicated by skin testing than by RAST, sometimes differing by as many as 3 classes. The lack of concordance was not confined to testing for the fungi cultured from the sinuses, nor was it more or less pronounced in the case of dematiaceous fungi. The most likely causes for the disparity noted in this series are subtle differences in antigens used in skin test material and for RAST standards. Skin tests allow for evaluation of delayed and late-phase reactions, a measurement not possible by specific IgE testing with RAST. Delayed skin test reactions were not noted in this series of patients. An additional important finding was the sensitivity of patients with allergic fungal sinusitis to virtually every fungal antigen to which they were tested.

  19. Hypersensitivity reactions to penicillins: studies in a group of patients with negative benzylpenicillin G skin test.

    Science.gov (United States)

    Qiao, H-L; Li, Z; Yang, J; Tian, X; Gao, N; Jia, L-J

    2009-06-01

    Although skin tests are usually employed to evaluate current penicillin allergy status, a negative result does not exclude hypersensitivity. There is a need for accurate in vitro tests to exclude hypersensitivity. A radioallergosorbent test (RAST) is a potentially good supplementary approach, but there is little information on the suitability of this method to diagnose penicillin hypersensitivity in subjects with a negative skin test to benzylpenicillin. A total of 133 patients with a negative skin test to benzylpenicillin G (PG) and all of whom developed allergic reactions to PG were studied. RAST was used to detect eight kinds of specific IgE antibodies to penicillins in serum, which included four kinds of major and minor antigenic determinants to four penicillin drugs. The combination sites for the specific IgE antibodies were studied by RAST inhibition test. The rate of positive reactions for the specific IgE antibodies was 59.40% (79/133). Of the eight kinds of antigenic determinants, the positive rates for specific IgE against the major and minor determinants were 39.10% (52) and 42.86% (57) respectively. Of the four drugs, positive cases only to PG were 10 (7.5%), were significantly fewer than the cross-reacting positive cases (36) to PG (P RAST inhibition studies all drugs exhibited good inhibitory potencies, and in some instances the side-chain of the penicillins could induce specific responses with a variable degree of cross-reactivity among the different penicillins. Radioallergosorbent test is a good complementary test in persons who are skin-test negative with PG, and the sensitivity of RAST increases with increasing specificity of IgE antibodies to be detected. 6-APA and the groups, making part of the different side-chains on penicillins, all contributed to the cross-reactivity.

  20. Prevalence of skin test reactivity in patients with convincing, vague, and unacceptable histories of penicillin allergy.

    Science.gov (United States)

    Stember, Rishon H

    2005-01-01

    Penicillin (PCN) allergy has been vastly overdiagnosed, and too many people are incorrectly labeled as allergic to PCN, which affects their health by preventing the use of beta-lactam antibiotics. This investigation explores whether taking a careful history can eliminate the need for some to carry the PCN allergy label. A retrospective study of a focused history and PCN skin testing was done in a consecutive sample of a suburban allergy population of 319 patients who had a positive history of PCN allergy. The patients were divided into three groups based on PCN history: convincing, vague, and unacceptable. The convincing group had patients with impressive histories of PCN allergy likely to be immunoglobulin E-mediated. The vague group had unimpressive but plausible histories of PCN allergy. The unacceptable group were those patients with the PCN-allergic label who were either never exposed to PCN or the PCN reaction was too far-fetched to be believable. Out of 319 patients with a positive PCN allergy history, 135 (42.3%) patients were classified as convincing, 150 (47%) patients were classified as vague, and 34 (10.7%) patients were classified as unacceptable. Positive PCN skin tests were found in 19 of 135 (14.1%) patients in the convincing group, in 10 of 150 (6.7%) patients in the vague group, and 0 of 34 (0%) patients in the unacceptable group. The finding that 6.7% of patients with a vague PCN allergy history had positive skin tests suggests that skin testing is necessary in this group. The PCN-allergic label in the unacceptable group had been unchallenged by 33 primary care physicians and 9 allergists. This study suggests that physician acceptance of unwarranted PCN-allergic labels is not uncommon, and that such labels can be removed without skin testing.

  1. Validation of artificial skin equivalents as in vitro testing systems

    Science.gov (United States)

    Schmitt, Robert; Marx, Ulrich; Walles, Heike; Schober, Lena

    2011-03-01

    With the increasing complexity of the chemical composition of pharmaceuticals, cosmetics and everyday substances, the awareness of potential health issues and long term damages for humanoid organs is shifting into focus. Artificial in vitro testing systems play an important role in providing reliable test conditions and replacing precarious animal testing. Especially artificial skin equivalents ASEs are used for a broad spectrum of studies like penetration, irritation and corrosion of substances. One major challenge in tissue engineering is the qualification of each individual ASE as in vitro testing system. Due to biological fluctuations, the stratum corneum hornified layer of some ASEs may not fully develop or other defects might occur. For monitoring these effects we developed an fully automated Optical Coherence Tomography device. Here, we present different methods to characterize and evaluate the quality of the ASEs based on image and data processing of OCT B-scans. By analysing the surface structure, defects, like cuts or tears, are detectable. A further indicator for the quality of the ASE is the morphology of the tissue. This allows to determine if the skin model has reached the final growth state. We found, that OCT is a well suited technology for automatically characterizing artificial skin equivalents and validating the application as testing system.

  2. Sensitivity Comparison of the Skin Prick Test and Serum and Fecal Radio Allergosorbent Test (RAST in Diagnosis of Food Allergy in Children

    Directory of Open Access Journals (Sweden)

    Hamid Reza Kianifar

    2016-05-01

    Full Text Available Background: Diagnosis of food allergy is difficult in children. Food allergies are diagnosed using several methods that include medical histories, clinical examinations, skin prick and serum-specific immunoglobulin E (IgE tests, radio-allergosorbent test (RAST, food challenge, and supervised elimination diets. In this study we evaluated allergies to cow's milk, egg, peanut, and fish in children with suspected food allergies with skin prick tests and serum and feces RAST. Methods: Forty-one children with clinical symptoms of food allergies were enrolled in the study. Skin prick tests and serum and fecal RAST were performed and compared with challenge tests. Results: The most common sites of food allergy symptoms were gastrointestinal (82.9% and skin (48.8%. 100% of the patients responded to the challenge tests with cow’s milk, egg, peanut, and fish. 65% of the patients tested positive with the skin prick test, 12.1% tested positive with serum RAST, and 29.2% tested positive with fecal RAST. Conclusions: The skin prick test was more sensitive than serum or fecal RAST, and fecal RAST was more than twice as sensitive as serum RAST.

  3. Sensitivity Comparison of the Skin Prick Test and Serum and Fecal Radio Allergosorbent Test (RAST) in Diagnosis of Food Allergy in Children.

    Science.gov (United States)

    Kianifar, Hamid Reza; Pourreza, Alireza; Jabbari Azad, Farahzad; Yousefzadeh, Hadis; Masomi, Fatemeh

    2016-04-01

    Diagnosis of food allergy is difficult in children. Food allergies are diagnosed using several methods that include medical histories, clinical examinations, skin prick and serum-specific immunoglobulin E (IgE) tests, radio-allergosorbent test (RAST), food challenge, and supervised elimination diets. In this study we evaluated allergies to cow's milk, egg, peanut, and fish in children with suspected food allergies with skin prick tests and serum and feces RAST. Forty-one children with clinical symptoms of food allergies were enrolled in the study. Skin prick tests and serum and fecal RAST were performed and compared with challenge tests. The most common sites of food allergy symptoms were gastrointestinal (82.9%) and skin (48.8%). 100% of the patients responded to the challenge tests with cow's milk, egg, peanut, and fish. 65% of the patients tested positive with the skin prick test, 12.1% tested positive with serum RAST, and 29.2% tested positive with fecal RAST. The skin prick test was more sensitive than serum or fecal RAST, and fecal RAST was more than twice as sensitive as serum RAST.

  4. Skin sensitivity to rocuronium and vecuronium: a randomized controlled prick-testing study in healthy volunteers.

    Science.gov (United States)

    Dhonneur, Gilles; Combes, Xavier; Chassard, Didier; Merle, Jean Claude

    2004-04-01

    Prick tests are frequently used for the authentication of neuromuscular blocking drugs (NMBDs) as causative drugs for anaphylactic reactions during anesthesia. Unfortunately, the actual threshold concentration for skin testing remains debatable for most NMBDs. We studied the flare and wheal responses to prick tests with rocuronium and vecuronium. Thirty healthy, nonatopic, anesthesia-naive male and female volunteers (14 men and 16 women) from 18 to 40 yr of age were assigned randomly to receive a total of 10 prick tests-4 ascending dilutions (1:1000, 1:100, 1:10, and 1) of rocuronium and vecuronium and 2 controls-on both forearms. An assessor blinded to the assignment monitored systemic and skin responses to NMBDs and measured wheal and flare surfaces immediately after and 15 min after prick tests. None of the volunteers experienced any immediate systemic or cutaneous responses to rocuronium or vecuronium. Although a dilution of 1:1000 of both NMBDs failed to promote any skin response at 15 min, 50% and 40% of the subjects had a positive skin reaction to undiluted rocuronium and vecuronium, respectively. We demonstrated a sex effect related to smaller threshold concentration-induced cutaneous reactions in female volunteers to both muscle relaxants. Our observation questions the reliability of prick testing with undiluted solutions of rocuronium and vecuronium for the diagnosis of allergy. Building concentration-skin response curves to prick tests with rocuronium and vecuronium in healthy, nonatopic, anesthesia-naive male and female volunteers demonstrated that the nonreactive concentration for both muscle relaxants is the 1:1000 dilution of the stock solutions. Our observation calls into question the past practice of prick-testing skin for sensitivity to neuromuscular blocking drugs by using undiluted solutions.

  5. The lancet weight determines wheal diameter in response to skin prick testing with histamine

    OpenAIRE

    Andersen, Hjalte H.; Anna Charlotte Lundgaard; Petersen, Anne S.; Hauberg, Lise E.; Neha Sharma; Hansen, Sofie D.; Jesper Elberling; Lars Arendt-Nielsen

    2016-01-01

    Background Skin prick test (SPT) is a common test for diagnosing immunoglobulin E-mediated allergies. In clinical routine, technicalities, human errors or patient-related biases, occasionally results in suboptimal diagnosis of sensitization. Objective Although not previously assessed qualitatively, lancet weight is hypothesized to be important when performing SPT to minimize the frequency of false positives, false negatives, and unwanted discomfort. Methods Accurate weight-controlled SPT was ...

  6. Human skin safety test of green tea cell extracts in condition of allergic contact dermatitis.

    Science.gov (United States)

    Kim, Hyun Kyu; Choi, Sun Young; Chang, Hui Kyoung; Baek, Seok Yun; Chung, Jin Oh; Rha, Chan Su; Kim, Beom Joon; Kim, Myeung Nam

    2012-06-01

    Various kinds of positive effects of green tea extracts had been studied for long time which included anti-inflammation, anti-aging, and cardiometabolic effects. Although topical steroid and non-steroidal calcineurin inhibitors may control clinical symptoms of allergic contact dermatitis, some of patients also present allergic reaction to these topical agents. Therefore, we have tried green tea extracts for managing this skin disorder with expectation of anti-inflammatory effect without potential side effects including skin irritation and toxic responses. The toxicity test of green tea extract also did not show any sign of irritation in the skin throughout the test period. Moderate severity of allergic contact dermatitis presented satisfactory clinical outcome at second week follow-up which was final visit of outpatient. This result mean that green tea extract has a positive effect for managing allergic contact dermatitis but its potency and efficacy seem to be so not strong enough to control moderate severity allergy skin lesion. In this pilot study, we were able to conclude that green tea cell extracts might be applied for potential anti-inflammatory soaking without skin toxicity.

  7. Increased Sensitization to Mold Allergens Measured by Intradermal Skin Testing following Hurricanes.

    Science.gov (United States)

    Saporta, Diego; Hurst, David

    2017-01-01

    Objective . To report on changes in sensitivity to mold allergens determined by changes in intradermal skin testing reactivity, after exposure to two severe hurricanes. Methods . A random, retrospective allergy charts review divided into 2 groups of 100 patients each: Group A, patients tested between 2003 and 2010 prior to hurricanes, and Group B, patients tested in 2014 and 2015 following hurricanes. Reactivity to eighteen molds was determined by intradermal skin testing. Test results, age, and respiratory symptoms were recorded. Chi-square test determined reactivity/sensitivity differences between groups. Results . Posthurricane patients had 34.6 times more positive results ( p hurricanes ( p hurricanes ( p hurricanes. This supports climatologists' hypothesis that environmental changes resulting from hurricanes can be a health risk as reflected in increased allergic sensitivities and symptoms and has significant implications for physicians treating patients from affected areas.

  8. A pilot study of penicillin skin testing in patients with a history of penicillin allergy admitted to a medical ICU.

    Science.gov (United States)

    Arroliga, M E; Wagner, W; Bobek, M B; Hoffman-Hogg, L; Gordon, S M; Arroliga, A C

    2000-10-01

    Penicillin skin testing is an accurate method to determine whether a person with a history of penicillin allergy is at risk of having an immediate reaction to penicillin. A patient with a negative reaction to a skin test may be able to use a penicillin compound safely, which could reduce the use of broad-spectrum antibiotics in this patient population. We prospectively studied all patients with histories of penicillin allergy who were admitted to a medical ICU during a 3-month period and who received antibiotics. Skin testing was performed with benzylpenicilloyl polylysine and penicillin G. We determined the incidence of true allergy, the percentage of patients in whom antibiotic coverage was modified, and the safety of the test. Two hundred fifty-seven patients were admitted to the medical ICU of The Cleveland Clinic Foundation during the study period. Twenty-four patients (9%), labeled as penicillin allergic and receiving antibiotics, were enrolled. Three patients (13%, 3 of 21) gave histories of type I reaction to penicillin and were not skin tested. Twenty patients (95%, 20 of 21) had negative skin test reactions to penicillin and positive skin test reactions to histamine control. One patient (4%, 1 of 21) with negative skin test reactions to both penicillin and histamine control had a test dose challenge with piperacillin that was well tolerated. There were no adverse events. Antibiotic coverage was changed in 10 patients (48%) as a result of skin testing. Most patients with histories of allergy to penicillin have negative reactions to skin tests and may receive penicillin safely. Penicillin skin testing can be utilized as a safe and effective strategy to reduce the use of broad-spectrum antibiotics.

  9. Skin Tests for Evaluation of Cell Mediated Immunity in Leprosy

    Directory of Open Access Journals (Sweden)

    P S Mallya

    1989-01-01

    Full Text Available Cell-mesate,d immune (CMI response to lepromin and dinitrochloro benzene (DNCB was evaluatt-d in 60 freshly detected leprosy cases. It was observed that 70%, ( 28 of 40 of the pa across tie leprosy spectrum except LL cases revealed delayed hypersensitivity to DNCB as -against 42.5% (1-7 of 40 to lepromin. DNCB test was found superior to lepromin test to measure CMI because of its simplicity and easy interpretation of skin reactivity. It detected CMI in 40% of BL cases who were lepromin negative. Grading of skin reactivity showed a program decrease in delayed hypersensitivity across the spectrum of leprosy from TT to LL. It can be concluded that there is no gross impairment of non-specific CMI in leprosy patients other than LL cases and this non-specific CMI depression correlates well with Ridley-Jopling clinical scale of leprosy.

  10. Optical Blade Position Tracking System Test

    Energy Technology Data Exchange (ETDEWEB)

    Fingersh, L. J.

    2006-01-01

    The Optical Blade Position Tracking System Test measures the blade deflection along the span of the blade using simple off-the-shelf infrared security cameras along with blade-mounted retro-reflective tape and video image processing hardware and software to obtain these measurements.

  11. Anaphylaxis to Spirulina confirmed by skin prick test with ingredients of Spirulina tablets.

    Science.gov (United States)

    Le, Thuy-My; Knulst, André C; Röckmann, Heike

    2014-12-01

    Spirulina (Arthrospira platensis), blue-green microalgae, has high content in proteins, γ-linoleic acid and vitamins and therefore gained popularity as food supplement. According to the Food and Agriculture Organization of the United Nations Spirulina is also an interesting alternative and sustainable protein source with the growing world population. We present a case of a 17-year-old male, who developed anaphylaxis the first time he ingested a Spirulina tablet. Skin prick test with diluted Spirulina tablet was positive. Further skin prick testing with separated ingredients (Spirulina platensis algae, silicon dioxide, inulin and magnesium stearate) was only positive for Spirulina platensis algae and negative in controls, confirming the allergy was caused by Spirulina and not by one of the additives. This case report shows that diagnosis of Spirulina allergy can safely be made by skin prick test with dilutions of the A. platensis or even more simple by skin prick test with the diluted tablet. Since Spirulina has gained popularity as food and nutritional supplement, it is important to realize the potential risk of this dietary supplement. Before Spirulina is produced and consumed on a wider scale, allergenicity risk assessment should be performed, including investigation of potential crossreactivity with well-known inhalant allergens and foods.

  12. Diagnostic performance of the "MESACUP anti-Skin profile TEST".

    Science.gov (United States)

    Horváth, Orsolya N; Varga, Rita; Kaneda, Makoto; Schmidt, Enno; Ruzicka, Thomas; Sárdy, Miklós

    2016-01-01

    The "MESACUP anti-Skin profile TEST" is a new, commercially available ELISA kit to detect circulating IgG autoantibodies against desmoglein 1, desmoglein 3, BP180, BP230, and type VII collagen, both simultaneously and more rapidly than previous assays. The aim of this study was to evaluate the diagnostic accuracy of this kit for the diagnosis of pemphigus foliaceus, pemphigus vulgaris, bullous pemphigoid and epidermolysis bullosa acquisita. Dual-centre retrospective study in which 138 patients with autoimmune blistering diseases were compared to 40 controls Using the MESACUP anti-Skin profile TEST, both sensitivities and specificities for desmoglein 1, desmoglein 3, BP180, BP230, and type VII collagen autoantibodies were similar to those obtained using previous, specific ELISA systems and 88% of the results were concordant without any significant difference. The MESACUP anti-Skin profile TEST had a similar performance to previously produced ELISA systems. The novel kit can be used for rapid diagnosis of most common autoimmune blistering diseases and is especially suitable for identifying overlapping disorders.

  13. Concordant or discordant results by the tuberculin skin test and the quantiFERON-TB test in children reflect immune biomarker profiles

    DEFF Research Database (Denmark)

    Dhanasekaran, S; Jenum, S; Stavrum, R

    2014-01-01

    The tuberculin skin test (TST) and QuantiFERON-TB-Gold-In-tube (QFTGIT) are adjunctive tests used in the diagnosis of pediatric tuberculosis (TB). Neither test can rule out TB; however, a positive test usually triggers preventive treatment in TB contacts aged

  14. Herbal supplements and skin testing: the lack of effect of commonly used herbal supplements on histamine skin prick testing.

    Science.gov (United States)

    More, D R; Napoli, D C; Hagan, L L

    2003-06-01

    The use of herbal supplements is common, yet little is known about their pharmacologic properties. The purpose of this study was to assess the effects of 23 commonly used herbal supplements on histamine skin prick testing (SPT). Fifteen healthy volunteers participated in a double-blind, placebo-controlled, single-dose, crossover study. Wheal and flare responses to SPT with histamine phosphate (1 mg/ml) were measured before and 4 h after administration of each of the 23 popular herbal supplements, fexofenadine (60 mg) and placebo. Wheal and flare areas were recorded with tracings performed 10 min after the prick test and measured with a PC-digitizer using stereometric software. Fexofenadine significantly suppressed the wheal (P wheal and flare areas compared with placebo (P > 0.10). When taken in single-doses, the popular herbal supplements tested did not significantly affect the histamine skin response. Therefore, it seems unnecessary for clinicians to ask patients to discontinue these herbal supplements prior to allergy skin testing.

  15. Comparison of skin prick allergy test in urban and rural children

    Directory of Open Access Journals (Sweden)

    Fakhri Widyanto

    2011-04-01

    Full Text Available Background Children who grow up in rural areas have a lower incidence of atopy and other allergic manifestations than children in urban areas. Several recent studies have suggested that agricultural exposure may protect children from developing asthma and atopy, but these findings are inconsistent. Objective To examine an association between living in rural or urban areas and skin prick allergy test results in children and to detennine associated risk factors for atopy. Methods We conducted a cross-sectional study in Karo district (rural and Medan (urban in October-December 2009. We enrolled primary school children who had a history of atopy in their families. Skin prick testing was done on the volar side of the forearm and included eight aero-allergens: house dust mites, house dust, cotton, chicken feathers, cat dander, cockroaches, mould, and pollen. We analyzed the folloMng risk factors for association Mth atopy: tobacco smoke, pets, livestock exposure, and having older sibling(s. Results We recruited 49 children from the Karo district and 52 children from the city of Medan. There were significant associations between living in an urban area and positive skin prick test results for house dust mites and house dust compared to living in a rural area (P=0.04, 95% CI: 1.11 to 5.91; P=0.04, 95% CI: 1.13 to 12.45, respectively. The reverse was true for cockroach allergens (P=0.02, 95% CI: 0.16 to 0.81. Tobacco smoke and livestock exposure were associated Mth negative skin prick test results in rural children (P=O.03, 95% CI: 0.03 to 0.81 and P=0.002, 95% CI: 0.02 to 0.42, respectively. Multivariate analysis revealed that lack of livestock exposure was the major risk factor associated Mth any positive skin prick test results in rural children (P=0.004; 95% CI ; 0.02 to 0.49. Conclusion There were differing associations between living in rural and urban areas to various skin prick test results in children. Lack of livestock exposure was the risk

  16. Apparatus for testing skin samples or the like

    Science.gov (United States)

    Holland, J.M.

    1982-08-31

    An apparatus for testing the permeability of living skin samples has a flat base with a plurality of sample-holding cavities formed in its upper surface, the samples being placed in counterbores in the cavities with the epidermis uppermost. O-rings of Teflon washers are respectively placed on the samples and a flat cover is connected to the base to press the rings against the upper surfaces of the samples. Media to maintain tissue viability and recovery of metabolites is introduced into the lower portion of the sample-holding cavities through passages in the base. Test materials are introduced through holes in the cover plate after assembly of the chamber.

  17. Laser Wire and Beam Position Monitor tests

    CERN Document Server

    Boogert, S T; Lyapin, A; Nevay, L; Snuverink, J

    2013-01-01

    This subtask involved two main activities; Firstly the development and subsequent usage of high resolution beam position monitors (BPM) for the International Linear Collider (ILC) and Compact Linear Collider projects (CLIC); and secondly the development of a laser-wire (LW) transverse beam size measurement systems. This report describes the technical progress achieved at a large-scale test ILC compatible BPM system installed at the Accelerator Test Facility 2 (ATF2). The ATF2 is an energy-scaled demonstration system for the final focus systems required to deliver the particle beams to collision at the ILC and CLIC. The ATF2 cavity beam position monitor system is one of the largest of its kind and rivals systems used at free electron lasers. The ATF2 cavity beam position system has achieved a position resolutionof 250 nm (with signal attuenation) and 27 nm (without attenuation). The BPM system has been used routinely for lattice diagnostics, beam based alignment and wakefield measurements. Extensive experience...

  18. Interactions of skin thickness and physicochemical properties of test compounds in percutaneous penetration studies

    NARCIS (Netherlands)

    Wilkinson, S.C.; Maas, W.J.M.; Nielsen, J.B.; Greaves, L.C.; Sandt, J.J.M. van de; Williams, F.M.

    2006-01-01

    Objectives: To determine the effect of skin thickness on the percutaneous penetration and distribution of test compounds with varying physicochemical properties using in vitro systems. Studies were carried out in accordance with OECD guidelines on skin absorption tests. Methods: Percutaneous

  19. Course of Skin Symptoms and Quality of Life in Children Referred for Patch Testing

    DEFF Research Database (Denmark)

    Simonsen, Anne B; Sommerlund, Mette; Deleuran, Mette

    2015-01-01

    for patch testing, a retrospective questionnaire was sent to children and adolescents referred for patch testing during a 9-year period. Persistent eczema at follow-up was strongly associated to atopic dermatitis, but was not explained by gender, age, contact allergy or time span from patch testing...... to follow-up. Among patients without atopic dermatitis, 23.5% reported to suffer from chronic eczema. Persistent eczema increased the risk of severe impairment of life quality. Our findings indicate a significant risk of childhood eczema becoming chronic and affecting life quality considerably. Patch......Children are patch tested in the same manner as adults, but little has been done to establish whether positive or negative findings influence the course of skin symptoms. To uncover the course of skin symptoms and the impact of persistent eczema on life quality in paediatric patients referred...

  20. Skin Test for Paragonimiasis among Schoolchildren and Villagers in Namback District, Luangprabang Province, Lao PDR

    Science.gov (United States)

    Song, Hyun-Ouk; Rim, Han-Jong; Youthanavanh, Vonghachack; Daluny, Bouakhasith; Sengdara, Vongsouvan; Virasack, Banouvong; Bounlay, Phommasak

    2008-01-01

    As a part of a broader effort to determine the status of Paragonimus species infection in Lao PDR, an epidemiological survey was conducted on villagers and schoolchildren in Namback District between 2003 and 2005. Among 308 villagers and 633 primary and secondary schoolchildren, 156 villagers and 92 children evidenced a positive reaction on a Paragonimus skin test. Only 4 schoolchildren out of 128 skin test-positive cases had Paragonimus sp. eggs in their sputum, all of which was collected on 1 day. Several types of crabs, which were identified as the second intermediate host of the Paragonimus species, were collected from markets and streams in a paragonimiasis endemic area for the inspection of metacercariae. Among the examined crabs, only "rock crabs" (Indochinamon ou) harbored Paragonimus sp. metacercariae, and it is speculated that the life cycle of Paragonimus sp. was maintained via rock crabs in Namback District, Lao PDR. PMID:18830059

  1. Lack of correlation between Helicobacter pylori infection and autologous serum skin test in chronic idiopathic urticaria.

    Science.gov (United States)

    Başkan, Emel Bülbül; Türker, Tugba; Gülten, Macit; Tunali, Sükran

    2005-12-01

    There are controversial reports about the direct role of Helicobacterpylori infection in chronic idiopathic urticaria. The indirect role of H. pylori infection in the induction of pathogenetic antibodies is not fully elucidated either. This study aims to reveal the association of H. pylori infection with autologous serum skin test positivity in chronic idiopathic urticaria (CIU) patients. A total of 47 patients (35 women, 12 men, age range 17-65 years) diagnosed as CIU were included in the study. Autologous serum skin test was performed on all patients. The patients were examined with a commercially available ELISA test for H. pylori-specific antibodies. Gastroscopy with mucosal biopsy and rapid urease tests were proposed to verify the presence of H. pylori infection. Helicobacter pylori infection was detected in 33 of the 47 patients (70%). No significant relation was found between the autologous serum skin test positivity and the serological and histopathological presence of H. pylori infection. The results of our study suggest that chronic H. pylori infection does not appear to have a role in the induction of autoantibodies in CIU.

  2. [Canine visceral leishmaniasis diagnosis by immunohistochemistry and PCR in skin tissues in association with IFAT and ELISA-test].

    Science.gov (United States)

    de Queiroz, Nina M G P; de Assis, Juliana; Oliveira, Trícia M F S; Machado, Rosângela Z; Nunes, Cáris M; Starke-Buzetti, Wilma A

    2010-01-01

    The purpose of the present study was to evaluate the immunohistochemistry (IMHC) and PCR (Polymerase Chain Reaction) tests for Canine Visceral Leishmaniasis (CVL) diagnosis and compare the results with serological tests such as the indirect fluorescence antibody test (IFAT), ELISA and a parasitological test (microscopic direct examination of the parasite stained with haematoxylin and eosin--HE). For this study, samples of healthy or lesion skin tissues were obtained from 34 CVL naturally infected dogs classified in three groups: asymptomatic, oligosymptomatic and polisymptomatic. Not only lesion (56.5%) but also healthy skins (31.8%) were positives by IMHC and confirmed by PCR in 97.8% of skin samples. In asymptomatic group, 87.5% dogs were negatives by serological tests, but positives by IMHC in 50% and by PCR in 100%. In oligosymptomatic group, 100%, 85.7% and 28.6% of dogs were positives, respectively by PCR, serological and IMHC tests. In addition, 91.7% of polisymptomatic dogs were serum positive and had intact parasites in the skin. In general, PCR showed higher positivity (100%). The efficiency of each test varied with the evolution of the disease. IMHC may be used to confirm the results of the serology and PCR in inconclusive cases after HE and IMHC. The association of techniques proposed in this study may increase the positivity and contributed to the control of this canine disease.

  3. Penicillin allergy: value of including amoxicillin as a determinant in penicillin skin testing.

    Science.gov (United States)

    Lin, Erina; Saxon, Andrew; Riedl, Marc

    2010-01-01

    Allergy to penicillins remains an important issue. Penicillin skin testing (PST) with major and minor determinants has been shown to be a highly valuable tool for identifying IgE-mediated penicillin allergy. The value of additional testing with side-chain-specific moieties from semisynthetic penicillins such as amoxicillin is not well-established in spite of the widespread use of these medications. A retrospective review of all consecutive inpatient PST results from 1995 to 2007 comprising 1,068 patients was performed in our institution on individuals with a self-reported history of beta-lactam allergy to assess the importance of including the amoxicillin determinant in a previously validated PST panel. Descriptive statistics were performed. The PST panel included penicilloyl-polylysine, penicillin G, penicilloate, penilloate and amoxicillin. Of 1,068 patients, 243 (23%) had a positive skin test reaction on the PST panel. Testing with amoxicillin was positive in 30.9% of patients, the majority of whom (81%) were also positive to 1 or more standard penicillin reagents. Fourteen of the 243 positive patients (5.8%) had a positive skin test reaction only to amoxicillin. Additionally, the use of penicilloate and penilloate minor determinants in combination with penicillin G identified a greater percentage of penicillin-allergic individuals compared to using only penicillin G (22.6 vs. 6.6%), demonstrating their importance in the PST panel. These data indicate that the inclusion of the amoxicillin determinant appears to identify a small but important group of allergic individuals who may otherwise test negative on a PST panel. Copyright 2010 S. Karger AG, Basel.

  4. Autologous serum and plasma skin tests in chronic spontaneous urticaria: A reappraisal

    Directory of Open Access Journals (Sweden)

    Muthu Sendhil Kumaran

    2017-01-01

    Full Text Available Aim: The objective of this study was to assess autologous serum skin test (ASST vs autologous plasma skin test (APST response in chronic spontaneous urticaria (CSU patients and study the significance of intensity of positive responses in relation to clinicoepidemiological parameters. Materials and Methods: One hundred CSU patients and 100 age and sex-matched controls were recruited. The demographic and clinical features were recorded in all patients and routine investigations were performed. ASST and APST tests were performed as per the standard guidelines. Results: The mean duration of illness was 4.85 ± 5.07 years, 90% patients were APST (+, 68% ASST (+, and 22 patients were only APST (+. Positive predictive value (PPV of ASST and APST was 90.7% and 95.7%, respectively. A significant inverse association was seen between thyroid status and serum IgE levels with APST and ASST positivity. Conclusion: APST appears to have better PPV and high intensity of positive response on autologous tests, and correlates with ANA positivity and angioedema.

  5. Purified protein derivative skin test reactions are associated with clinical outcomes of patients with nonmuscle invasive bladder cancer treated with induction bacillus Calmette-Guérin therapy.

    Science.gov (United States)

    Niwa, Naoya; Kikuchi, Eiji; Matsumoto, Kazuhiro; Kosaka, Takeo; Mizuno, Ryuichi; Oya, Mototsugu

    2017-10-30

    To investigate the relationship between purified protein derivative (PPD) skin test reactions before bacillus Calmette-Guérin (BCG) therapy and the clinical outcomes of BCG-naïve nonmuscle invasive bladder cancer patients treated with adjuvant BCG therapy. A total of 288 nonmuscle invasive bladder cancer patients subjected to the PPD skin test before BCG therapy were included. PPD skin test reactions were categorized into 3 groups: positive, slightly positive, and negative. The presence of an induration was positive. If an induration was absent, erythema of 10mm or more and less than 10mm corresponded to slightly positive and negative, respectively. A total of 66 (22.9%), 149 (51.7%), and 73 (25.3%) patients exhibited a positive, slightly positive, and negative to PPD skin test, respectively. The 5-year recurrence-free survival rate of patients with positive PPD skin test reactions was 89.4 ± 4.1%, which was significantly higher than those of patients with slightly positive (65.5 ± 4.2%, P = 0.001) and negative reactions (56.4 ± 6.6%, P<0.001). A multivariate Cox regression analysis revealed that a positive PPD skin test reaction was independently associated with tumor recurrence (hazard ratio of 0.233, P<0.001), but not with stage progression. The incidence of fever persisting for more than 2 days or fever of ≥38°C was significantly higher in patients with a positive PPD skin test reaction (18.2%) than in patients with slightly positive (8.7%) and negative PPD skin test reactions (4.1%). The PPD skin test reactions before BCG therapy may predict clinical outcomes following BCG therapy and help clinicians counsel patients exhibiting strong therapeutic effects with BCG therapy and potentially major BCG-related side effects. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Pain perception and performance of three devices for single-site allergen skin testing.

    Science.gov (United States)

    Nelson, Harold S; Lopez, Phillip; Curran-Everett, Douglas

    2014-01-01

    Skin testing remains the preferred method for most allergists for establishing the presence of allergen sensitization. This study examined the performance of a new single-site skin test device that incorporates initial pressure to reduce the sensation of pain. Comparators were a conventional skin testing system and a smallpox needle. Twenty subjects were tested on the back, four sites with histamine and four sites with saline with each of the three skin testing devices. The single-site skin test device was applied with downward pressure, the conventional skin testing system, and smallpox needle (SPN) by pricking at a 45°angle. Outcomes were size and reproducibility of the skin test reactions and discomfort, as graded by the subject. The whealing responses to histamine were larger with the conventional skin testing system than with the single-site skin test device and both produced larger wheals than the SPN. The conventional skin testing system also produced greater intrasubject variability. Only the conventional skin testing system produced wheals of >3 mm with saline. There was no significant difference in perception of pain, which was low with all three devices. All three devices were well tolerated, without a significant difference in perception of discomfort. Testing with histamine revealed differences in wheal size and reproducibility among the three devices and testing with saline revealed differing likelihood of inducing a significantly sized wheal.

  7. Positive patch test reactions to oxidized limonene

    DEFF Research Database (Denmark)

    Bråred Christensson, Johanna; Andersen, Klaus E; Bruze, Magnus

    2014-01-01

    BACKGROUND: R-Limonene is a common fragrance terpene found in domestic and industrial products. R-Limonene autoxidizes on air exposure, and the oxidation products can cause contact allergy. In a recent multicentre study, 5.2% (range 2.3-12.1%) of 2900 patients showed a positive patch test reaction...... to oxidized R-limonene. OBJECTIVE: To study the exposure to limonene among consecutive dermatitis patients reacting to oxidized R-limonene in an international setting, and to assess the relevance of the exposure for the patients' dermatitis. METHODS: Oxidized R-limonene 3.0% (containing limonene...... hydroperoxides at 0.33%) in petrolatum was tested in 2900 consecutive dermatitis patients in Australia, Denmark, the United Kingdom, Singapore, Spain, and Sweden. A questionnaire assessing exposure to limonene-containing products was completed. RESULTS: Overall, exposure to products containing limonene was found...

  8. Interpreting skin prick tests in the evaluation of food allergy in children.

    Science.gov (United States)

    Eigenmann, P A; Sampson, H A

    1998-11-01

    Skin prick tests (SPTs) are utilized routinely in the evaluation of food allergy and several authors have discussed their utility. Efforts to standardize SPT reagents and procedures have been made, but the accuracies of different recording techniques have not been clearly defined. The aim of this study was to compare different SPT recording methods with the outcome of oral food challenge and determine whether they offer any advantage over the criteria proposed by Bock and May (1). Children suspected of IgE-mediated symptoms to any of five common food allergens (egg, milk, peanut, soy and wheat) were skin tested by the prick technique utilizing commercial extracts. The wheal reactions were recorded by two different methods: first by measuring the largest diameter of the wheal and the diameter orthogonal to it (mean wheal diameter), and second by recording the surface area of the wheal with a hand-held scanner. Wheal sizes above the 95% confidence interval of tolerant individuals were considered positive. The results of double-blind, placebo-controlled food challenges were considered the "gold standard" for diagnosis. Cut-off values were compared for positive responses in our study population (mean diameter/surface area of wheal): 4 mm/16 mm2 for egg, 5 mm/29 mm2 for milk, 6 mm/40 mm2 for peanut, 3 mm/9 mm2 for soy, and 3 mm/7 mm2 for wheat. Significant differences in wheal sizes were seen between individuals who were allergic or tolerant to egg (P Skin prick tests are a useful procedure for evaluating clinical reactivity to egg, milk, peanut and wheat, but not to soy. While the size of the SPT wheals may be interpreted utilizing mean diameter or surface area cut-offs, the predictive values of these measurement methods were no better than the commonly utilized grading method where a positive skin test was recorded as a mean wheal diameter 3 mm greater than the negative control.

  9. Skin Test Reactivity to Indoor Allergens Correlates with Asthma Severity in Jeddah, Saudi Arabia

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    Koshak Emad A

    2006-03-01

    Full Text Available Abstract Background There is increased emphasis on the role of indoor allergens in asthma. Objective To examine the spectrum of skin test reactivity (sensitization to indoor allergens and its correlation with asthma severity in Jeddah, Saudi Arabia. Methods Asthmatic patients referred to the allergy clinic at King Abdulaziz University Hospital (KAUH in Jeddah were studied. Measures of clinical severity were adopted from national and international asthma guidelines. The degree of sensitization was assessed by the wheal size (positive ≥ 3 mm from standard skin-prick tests for the following common indoor inhalant allergens: house dust mites (Dermatophagoides pteronyssinus [Dp] and Dermatophagoides farinae [Df], cat, and cockroach. Results Skin test results from 113 of 151 (74.8% asthmatic patients were positive for one or more allergens. The patients' ages ranged between 9 and 63 years (mean, 30 ± 13 years, and females constituted 65.5%. The predominant asthma severity level was moderate persistent (55.8%, followed by mild persistent (33.6%. The prevalences of sensitization to indoor allergens were as follows: Dp, 87% (3-25 mm [mean, 7 mm]; Df, 84% (3-20 mm [mean, 7 mm]; cat, 44% (3-15 mm [mean, 6 mm]; and cockroach, 33% (3-12 mm [mean, 4 mm]. Higher asthma severity levels were significantly correlated with the number of allergens with positive sensitization (R = 0.3, p Dp [degrees of freedom {df} = 16, p Df [df = 17, p df = 10, p df = 8, p Conclusions Immunoglobulin E-mediated skin test reactivity to indoor allergens, particularly to house dust mites, was common in asthmatic patients from Jeddah at KAUH. Increased sensitization was associated with higher levels of asthma severity, which is compatible with the literature. This emphasizes the importance of identifying sensitization to relevant indoor allergens in the clinical evaluation of asthmatic persons.

  10. Mold and Alternaria skin test reactivity and asthma in children in Connecticut.

    Science.gov (United States)

    Lyons, Todd W; Wakefield, Dorothy B; Cloutier, Michelle M

    2011-04-01

    Sensitivity to mold has been associated with asthma incidence, persistence, and severity. To examine the relationship between skin test reactivity (STR) to molds and specifically to Alternaria and asthma severity in a group of ethnically diverse children in Connecticut. Demographics and STR to 14 local allergens, including Alternaria, Penicillium, and mold mix, were obtained for 914 Puerto Rican, African American, and non-Hispanic white children. A total of 126 children (14%) had a positive skin test result to mold, and 58 (6%) demonstrated STR to Alternaria. Compared with non-Hispanic white children, there was no difference in the likelihood of being sensitized to Alternaria for Puerto Rican and African American children (odds ratio [OR], 0.7; 95% confidence interval [CI], 0.3-1.5; and OR, 0.9; 95% CI, 0.4-2.2; respectively). In an adjusted analysis, Alternaria STR was associated with severe, persistent asthma (OR, 3.4; 95% CI, 1.2-8.6) but did not predict increasing asthma severity. STR to cat (OR, 2.5; 95% CI, 1.3-4.9) and dog (OR, 2.9; 95% CI, 1.3-6.0) was also associated with severe persistent asthma. Alternaria STR was associated with severe persistent asthma independent of the total number of positive skin test results. Mold and Alternaria STR were uncommon among children in Connecticut. Alternaria STR was not associated with increasing asthma severity but was associated with severe, persistent asthma independent of the total number of positive skin test results. There was no association between ethnicity and Alternaria STR. Copyright © 2011 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  11. Generalized reactions during skin testing with clindamycin in drug hypersensitivity: a report of 3 cases and review of the literature.

    Science.gov (United States)

    Papakonstantinou, Eleni; Müller, Sabine; Röhrbein, Jan H; Wieczorek, Dorothea; Kapp, Alexander; Jakob, Thilo; Wedi, Bettina

    2018-01-22

    The diagnostic approach to drug hypersensitivity includes a detailed medical history, clinical examination, and skin testing and/or oral challenge with a culprit or alternative drug, depending on the type of reaction and the suspected drugs. Although skin testing is considered to be rather safe, cutaneous and systemic, including fatal, reactions have been described. To report 3 cases with generalized delayed reactions after skin testing with clindamycin, and to review the existing literature. Thorough clinical examination, blood tests and prick, intradermal and patch tests were performed in 3 patients. All patients experienced generalized maculopapular exanthema after intradermal and patch testing with clindamycin and amoxicillin in the first patient, and clindamycin alone in the second and third patients. None of the patients showed immediate reactions to skin tests, while positive intradermal reactions after 24 h to amoxicillin and clindamycin were observed in the first patient, and positive intradermal reactions after 24 h to clindamycin were observed in the second and third patients. Skin testing with clindamycin in the diagnosis of drug hypersensitivity carries some risk of adverse reactions. A stepwise and individual diagnostic work-up, considering potential risk factors, and testing in a specialized centre with emergency equipment available is highly recommended. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  12. Comparison of mantoux and tine tuberculin skin tests in BCG-vaccinated children investigated for tuberculosis.

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    Wenli Pan

    Full Text Available BACKGROUND: Tuberculin skin tests (TSTs are long-established screening methods for tuberculosis (TB. We aimed to compare agreement between the intradermal Mantoux and multipuncture percutaneous Tine methods and to quantify risk factors for a positive test result. METHODOLOGY/PRINCIPAL FINDINGS: 1512 South African children younger than 5 years of age who were investigated for tuberculosis (TB during a Bacille Calmette Guerin (BCG trial were included in this analysis. Children underwent both Mantoux and Tine tests. A positive test was defined as Mantoux >or=15 mm or Tine >or= Grade 3 for the binary comparison. Agreement was evaluated using kappa (binary and weighted kappa (hierarchical. Multivariate regression models identified independent risk factors for TST positivity. The Mantoux test was positive in 430 children (28.4% and the Tine test in 496 children (32.8%, p<0.0001, with observed binary agreement 87.3% (kappa 0.70 and hierarchical agreement 85.0% (weighted kappa 0.66. Among 173 children culture-positive for Mycobacterium tuberculosis, Mantoux was positive in 49.1% and Tine in 54.9%, p<0.0001 (kappa 0.70. Evidence of digit preference was noted for Mantoux readings at 5 mm threshold intervals. After adjustment for confounders, a positive culture, suggestive chest radiograph, and proximity of TB contact were risk factors for a positive test using both TST methods. There were no independent associations between ethnicity, gender, age, or over-crowding, and TST result. CONCLUSIONS/SIGNIFICANCE: The Tine test demonstrated a higher positive test rate than the Mantoux, with substantial agreement between TST methods among young BCG-vaccinated children. TB disease and exposure factors, but not demographic variables, were independent risk factors for a positive result using either test method. These findings suggest that the Tine might be a useful screening tool for childhood TB in resource-limited countries.

  13. Distribution of Skin Prick Test Results in Rhinitis Allergic Patients at Dr. Hasan Sadikin General Hospital Bandung

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    Gama Antares

    2017-03-01

    Full Text Available Background: Allergic Rhinitis (AR is an inflammation condition in nasal mucous because of type 1 hypersensitivity. Skin prick test is one of the diagnostic tests to diagnose AR. Purpose of this study was to know the distribution of skin prick test in AR patients. Methods: This study used retrospective descriptive method as cross sectional design. This study was performed from 1 August to 31 October 2014. This study used medical record as secondary data at Department of Otorhinolaryngology–Head and Neck Surgery of Dr. Hasan Sadikin General Hospital. There were 175 cases which fulfilled the inclusion criteria of the study. The data were then analyzed using computer program. Results: Forty seven cases were positive for house dust (26.8%, 127 cases were positive for dust mite (72.5%, 85 cases were positive for rice pollen (48.5%, 62 cases were positive for maize pollen (35.5%, 56 cases were positive for mixed fungi (32%, 100 cases were positive for cockroach (57.1%, 63 cases were positive for horse dander (36%, 50 cases were positive for cat dander (28.5%, 93 cases were positive for dog dander (53.1%, and 38 cases were positive for chicken feather (21.9%. Conclusions: The most aeroallergen making positive result in skin prick test is dust mite.

  14. Increased Sensitization to Mold Allergens Measured by Intradermal Skin Testing following Hurricanes

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    Diego Saporta

    2017-01-01

    Full Text Available Objective. To report on changes in sensitivity to mold allergens determined by changes in intradermal skin testing reactivity, after exposure to two severe hurricanes. Methods. A random, retrospective allergy charts review divided into 2 groups of 100 patients each: Group A, patients tested between 2003 and 2010 prior to hurricanes, and Group B, patients tested in 2014 and 2015 following hurricanes. Reactivity to eighteen molds was determined by intradermal skin testing. Test results, age, and respiratory symptoms were recorded. Chi-square test determined reactivity/sensitivity differences between groups. Results. Posthurricane patients had 34.6 times more positive results (p<0.0001 at weaker dilutions, all tested molds were found to be more reactive, and 95% had at least one positive test versus only 62% before the hurricanes (p<0.0001; average mold reactivity was 55% versus 16% while 17% of patients reacted to the entire panel versus none before the hurricanes (p<0.0001. The posthurricane population was younger (p<0.001 and included more patients with asthma or lower respiratory symptoms (p<0.05. Conclusion. Reactivity and sensitization to mold allergens increased compared to patients before the hurricanes. This supports climatologists’ hypothesis that environmental changes resulting from hurricanes can be a health risk as reflected in increased allergic sensitivities and symptoms and has significant implications for physicians treating patients from affected areas.

  15. State of the art in non-animal approaches for skin sensitization testing: from individual test methods towards testing strategies.

    Science.gov (United States)

    Ezendam, Janine; Braakhuis, Hedwig M; Vandebriel, Rob J

    2016-12-01

    The hazard assessment of skin sensitizers relies mainly on animal testing, but much progress is made in the development, validation and regulatory acceptance and implementation of non-animal predictive approaches. In this review, we provide an update on the available computational tools and animal-free test methods for the prediction of skin sensitization hazard. These individual test methods address mostly one mechanistic step of the process of skin sensitization induction. The adverse outcome pathway (AOP) for skin sensitization describes the key events (KEs) that lead to skin sensitization. In our review, we have clustered the available test methods according to the KE they inform: the molecular initiating event (MIE/KE1)-protein binding, KE2-keratinocyte activation, KE3-dendritic cell activation and KE4-T cell activation and proliferation. In recent years, most progress has been made in the development and validation of in vitro assays that address KE2 and KE3. No standardized in vitro assays for T cell activation are available; thus, KE4 cannot be measured in vitro. Three non-animal test methods, addressing either the MIE, KE2 or KE3, are accepted as OECD test guidelines, and this has accelerated the development of integrated or defined approaches for testing and assessment (e.g. testing strategies). The majority of these approaches are mechanism-based, since they combine results from multiple test methods and/or computational tools that address different KEs of the AOP to estimate skin sensitization potential and sometimes potency. Other approaches are based on statistical tools. Until now, eleven different testing strategies have been published, the majority using the same individual information sources. Our review shows that some of the defined approaches to testing and assessment are able to accurately predict skin sensitization hazard, sometimes even more accurate than the currently used animal test. A few defined approaches are developed to provide an

  16. NIACIN SKIN FLUSH TEST: A RESEARCH TOOL FOR STUDYING SCHIZOPHRENIA

    OpenAIRE

    Nadalin, Sergej; Buretić-Tomljanović, Alena; Rubeša, Gordana; Tomljanović, Draško; Gudelj, Lea

    2010-01-01

    Background: A body of biochemical evidence suggests that abnormal phospholipid metabolism may play a role in the etiology of schizophrenia, and possibly, other psychiatric and neurological diseases. Niacin, a B-complex vitamin, induces prostaglandin synthesis, vasodilatation, and skin flushing when applied as a solution on the skin or taken orally. In schizophrenia, diminished or absent skin response to niacin represents a robust finding. Results: Attenuated niacin skin-flush respons...

  17. Evaluation of methods for the estimation of threshold concentrations by the skin prick test.

    Science.gov (United States)

    Dreborg, Sten; Holgersson, Margareta

    2015-01-01

    The allergen dose-response curve is flat; thus, small changes in wheal size reflect large differences in skin sensitivity. The sensitivity as measured by provocation tests is given by the threshold concentration that causes symptoms and/or objective signs. The threshold concentrations differ by several magnitudes between the most and the least sensitive individuals clinically allergic to the same allergen. Variation in technique can be minimized by relating allergen responses to that to histamine. The aim here is to present and validate simple methods for estimation of the skin sensitivity given as the concentration inducing a wheal of the same size as that with the positive reference, 10 mg/ml of histamine HCl, in the same patient. Data from previously reported trials on the biological equilibration of allergen extracts were used to document a method to calculate the concentration of allergen required to induce a wheal of the same size as that with 10 mg/ml of histamine dihydrochloride in the same patient, and to validate the methods using the parallel line bioassay as the gold standard. The validated methods correlated well with the results obtained using the gold standard method and provide results of skin prick testing based on threshold concentrations of allergen. The validated methods reduce the error of differences in testing techniques and make it possible to report skin sensitivity at threshold concentrations. A simple method to be used in clinical practice and a method suitable to describe changes in skin reactivity over time or during treatment are proposed. © 2015 S. Karger AG, Basel.

  18. 78 FR 68076 - Request for Information on Alternative Skin Sensitization Test Methods and Testing Strategies and...

    Science.gov (United States)

    2013-11-13

    ... pain and distress) animal use. NICEATM provides scientific and operational support for ICCVAM and... require the use of animals. Specific ICCVAM or NICEATM activities include the following: ICCVAM... international efforts to replace the use of animals in skin sensitization testing for hazard and potency...

  19. History of penicillin allergy and referral for skin testing: evaluation of a pediatric penicillin allergy testing program.

    Science.gov (United States)

    Langley, Joanne M; Halperin, Scott A; Bortolussi, Robert

    2002-10-01

    Penicillin allergy, commonly reported in children, leads to use of more expensive, broad-spectrum drugs. The results and effectiveness of a skin testing program for immediate hypersensitivity to penicillin in children were studied. Children seen at the IWK Health Centre in Halifax between 1986 and 2000 with a history of suspected penicillin allergy were referred by their family physician or pediatrician. Two-stage skin testing (scratch, intradermal) of benzylpenicilloyl-polylysin and penicillin G sodium, with histamine and saline as positive and negative controls, was carried out. If the test results were negative, an oral challenge was conducted and the child observed for 60 minutes. If no adverse reaction was noted, a letter was sent to the referring physician and to Health Records at the IWK Health Centre, indicating that warning labels should be removed from the chart. Of 72 children tested, 32% described their past cutaneous eruption as hives and 68% had other rashes; 96% of rashes were generalized. The mean age at the time of the suspected penicillin allergy was 4.4 years; it was 7.4 years at the time of testing. There was no positive response to the scratch testing, but 4% of children had a positive response to intradermal testing. No adverse responses to oral challenge were observed. Letters confirming negative status were not received in 4% (3 of 69) cases, resulting in ongoing avoidance of penicillins and falsely labelling of the child as penicillin allergic. In this referral setting, true penicillin allergy was uncommon, suggesting that many children are incorrectly labelled as penicillin-allergic. Communication of test results to family and care providers and health records administration must be effective if testing is to affect prescribing behaviour.

  20. Tuberculin skin testing in intravenous drug users: differences between HIV-seropositive and HIV-seronegative subjects.

    Science.gov (United States)

    Portu, José J; Aldamiz-Etxebarria, Mikel; Agud, José M; Arévalo, José M; Almaraz, María J; Ayensa, Cándido

    2002-04-01

    The prevalence of tuberculin skin test reactions among intravenous drug abusers and differences in tuberculin skin test positivity between HIV-seropositive and HIV-seronegative subjects were evaluated in a cross-sectional study of 1131 subjects. They were recruited from a therapeutic community, from those who attended the centre for the treatment of drug addiction and from those who visited for any reason an acute tertiary-care hospital in Vitoria-Gasteiz, Basque Country (Spain). All subjects underwent skin testing with purified protein derivative (PPD) tuberculin and testing for HIV antibodies. CD4(+) T-lymphocyte count was determined in HIV-seropositive individuals. Positive PPD tests were recorded in 35% of drug users who were HIV-seropositive and in 65% in those who were HIV-seronegative. In the HIV-infected group, there was a significant association between results of the tuberculin test and CD4(+) T-lymphocyte count. When the CD4(+) T-lymphocyte count was > or = 500 cells/mm(3), percentages of positive PPD tests were similar in HIV-seropositives and HIV-seronegatives (47% versus 65%) but when the CD4(+) count was < 500 cells/mm(3), positive PPD tests occurred in only 21% of HIV-seropositives. The PPD test showed a decreased sensitivity for detecting tuberculosis infection in HIV-infected intravenous drug users with CD4(+) T-lymphocyte counts fewer than 500 cells/mm(3).

  1. Aero-allergens in canine atopic dermatitis in southeastern Australia based on 1000 intradermal skin tests.

    Science.gov (United States)

    Mueller, R S; Bettenay, S V; Tideman, L

    2000-06-01

    To determine the most relevant aero-allergens involved in canine atopic dermatitis in southeastern Australia and provide information about these aero-allergens to the general practitioner. Dogs presented to the Animal Skin & Allergy Clinic with history and clinical signs of atopic dermatitis were injected intradermally with 38 different allergens and negative and positive control. Intradermal skin tests in 1000 dogs were retrospectively evaluated. One third of all patients reacted to the house dust mite Dermatophagoides farinae. Allergens reacting in more than 15% of the patients were wheat (Triticum aestivum), sweet vernal (Anthoxanthum odoratum), English couch (Agropyron repens), yellow dock (Rumex crispus), Mexican tea (Chenopodium ambrosioides), plantain (Plantago lanceolata), melaleuca (Melaleuca quinquenervia) and peppercorn (Schimus spp). House dust mites are the most common allergens in canine atopic dermatitis in southeastern Australia and D farinae is involved most frequently. However, a number of grass, weed and tree pollens also are involved regularly.

  2. Long-term repeatability of the skin prick test is high when supported by history or allergen-sensitivity tests

    DEFF Research Database (Denmark)

    Bødtger, Uffe; Jacobsen, C R; Poulsen, L K

    2003-01-01

    BACKGROUND: Long-term reproducibility of the skin-prick test (SPT) has been questioned. The aim of the study was to investigate the clinical relevance of SPT changes. METHODS: SPT to 10 common inhalation allergens was performed annually from 1999 to 2001 in 25 nonsensitized and 21 sensitized subj....... CONCLUSION: SPT changes are clinically relevant. Further studies using other allergens are needed. Long-term repeatability of SPT is high in the presence of a supportive history.......BACKGROUND: Long-term reproducibility of the skin-prick test (SPT) has been questioned. The aim of the study was to investigate the clinical relevance of SPT changes. METHODS: SPT to 10 common inhalation allergens was performed annually from 1999 to 2001 in 25 nonsensitized and 21 sensitized...... subjects. An SPT was positive when > or =3 mm, and repeatable if either persistently positive or negative. Clinical sensitivity to birch pollen was used as model for inhalation allergy, and was investigated at inclusion and at study termination by challenge tests, intradermal test, titrated SPT and Ig...

  3. Tuberculin Skin Tests versus Interferon-Gamma Release Assays in Tuberculosis Screening among Immigrant Visa Applicants

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    Stella O. Chuke

    2014-01-01

    Full Text Available Objective. Use of tuberculin skin tests (TSTs and interferon gamma release assays (IGRAs as part of tuberculosis (TB screening among immigrants from high TB-burden countries has not been fully evaluated. Methods. Prevalence of Mycobacterium tuberculosis infection (MTBI based on TST, or the QuantiFERON-TB Gold test (QFT-G, was determined among immigrant applicants in Vietnam bound for the United States (US; factors associated with test results and discordance were assessed; predictive values of TST and QFT-G for identifying chest radiographs (CXRs consistent with TB were calculated. Results. Of 1,246 immigrant visa applicants studied, 57.9% were TST positive, 28.3% were QFT-G positive, and test agreement was 59.4%. Increasing age was associated with positive TST results, positive QFT-G results, TST-positive but QFT-G-negative discordance, and abnormal CXRs consistent with TB. Positive predictive values of TST and QFT-G for an abnormal CXR were 25.9% and 25.6%, respectively. Conclusion. The estimated prevalence of MTBI among US-bound visa applicants in Vietnam based on TST was twice that based on QFT-G, and 14 times higher than a TST-based estimate of MTBI prevalence reported for the general US population in 2000. QFT-G was not better than TST at predicting abnormal CXRs consistent with TB.

  4. Anaphylaxis due to patent blue dye during lymphography, with negative skin prick test.

    Science.gov (United States)

    Crivellaro, Mariangiola; Senna, Gianenrico; Dama, Annarita; Bonadonna, Patrizia; Passalacqua, Giovanni

    2003-01-01

    We report here a case of anaphylaxis due to patent blue dye, which was administered to an adult female during a lymphographic intraoperative procedure. The patient was not atopic, and other possible causes of anaphylaxis (anesthetics, latex) had been carefully excluded through routine tests. The skin-prick test and patch test carried out with patent blue (PB) dye were negative, but the intradermal test with 100 microliters of the dye showed a remarkable positivity. There was no available commercial, specific IgE assay for PB dye, but the negativity of prick tests would exclude the involvement of an IgE-mediated mechanism. We want to highlight the possible danger derived from a dye that is considered inert, and that is now increasingly being used in surgical procedures.

  5. Comparison of skin test reactivity to histamine on back and forearm in young children.

    Science.gov (United States)

    Yuenyongviwat, Araya; Koonrangsesomboon, Duangrachanee; Sangsupawanich, Pasuree

    2012-12-01

    Skin responses to standardized positive and negative controls are important in the interpretation of a skin prick tests (SPT). However, this information in young children is lacking. We aimed to determine skin reactivity and compare the skin responses to these controls on the upper back and forearm in young children. SPTs for histamine hydrochloride 1 mg/ml (positive control) and 50% glycerol-saline (negative control) were performed on the upper back and forearm of children aged 6-25 months who came to the well-child clinic at Songklanagarind Hospital. SPTs to common allergens (cow's milk, soybean, egg white and house dust mite) were also evaluated. A total of 133 children with a mean age of 12.4 months were enrolled in the study. Seventy-five children (56.4%) were male. The results from the upper back and the forearm of the histamine-induced mean wheal diameter + standard deviation (SD) were 4.74+1.37 mm and 3.86+1.82mm (p responses to histamine on the upper back and the forearm were 18.47 +/- 4.28 mm and 16.37 +/- 5.50 mm (p wheal (0.57+1.17 vs. 0.34+0.89 mm, p = 0.007) and flare (4.57 +/- 3.04 mm vs. 3.34 +/- 1.91 mm, p wheal and flare responses to standardized positive and negative controls in young children. The upper back is more reactive than the forearm and is the preferred SPT site in young-aged children.

  6. Skin signs in Ehlers-Danlos syndrome: clinical tests and para-clinical methods

    DEFF Research Database (Denmark)

    Remvig, Lars; Duhn, Ph; Ullman, S

    2010-01-01

    extensibility. The present study aimed to assess skin signs by means of clinical and para-clinical methods. Methods: A total of 31 EDS patients and 28 healthy controls were examined blinded and in random order. Inter-examiner analysis of clinical tests for skin extensibility, consistency, scarring, and bruising...... was performed, followed by analyses of extensibility with the suction cup (SC), consistency with a soft tissue stiffness meter (STSM), and thickness with ultrasonography (US). Semi-quantitative assessment of skin extensibility in healthy controls was incorporated in the tests. Results: The clinical analyses...... with classical-type EDS and controls with respect to skin extensibility by SC (4.91 vs. 12.52 kPa/mm) and skin consistency by STSM (0.59 vs. 0.76 N). We found no difference in skin thickness. Conclusion: The reproducibility of the clinical skin tests was substantial to good, apart from the consistency...

  7. SA-I Mechanoreceptor Position in Fingertip Skin May Impact Sensitivity to Edge Stimuli

    Directory of Open Access Journals (Sweden)

    Gregory J. Gerling

    2010-01-01

    Full Text Available Background: The skin plays a role in conditioning mechanical indentation into distributions of stress/strain that mechanoreceptors convert into neural signals. Solid mechanics methods have modelled the skin to predict the in vivo neural response from mechanoreceptors. Despite their promise, current models cannot explain the role that anatomical positioning and receptor organ morphology play in producing differences in neural response. This work hypothesises that the skin's intermediate ridges may help explain, in part, the sensitivity of slowly adapting type I (SA-I mechanoreceptors to edge stimuli. Method: Two finite-element models of the fingertip were built, validated and used to analyse the functionality of the intermediate ridges. One of the two-dimensional, cross-sectional models included intermediate ridges, while the other did not. The analysis sought to determine if intermediate ridges (1 increase the magnitude of strain energy density (SED near the SA-I location and (2 help differentiate one 2.0-mm indenter from two 0.5-mm wide indenters with a 1.0-mm gap. Results: Higher concentrations of SED were found near the tips of the intermediate ridges, the anatomical location that coincides with the SA-I receptors. This first result suggested that the location of the SA-Is in the stiffer epidermal tissue helps magnify their response to edge stimuli. The second result was that both models were equally capable of predicting the spatial structure within the in vivo neural responses, and therefore the addition of intermediate ridges did not help in differentiating the indenters. Conclusion: The finding, a 15%–35% increase in response when the sampling point lies within the stiffer tissue at the same depth, seeks to inform the positioning of force sensors in robotic skin substrates.

  8. [Frequency of Food-Sensitization by Prick-to-Prick Skin Tests and Atopy Patch Tests in Children with Allergic Diseases].

    Science.gov (United States)

    Maya-Epelstein, Jonathan; Rosas-Vargas, Miguel Ngel; Del-Rio-Navarro, Blanca

    2012-01-01

    Food allergy is a health problem that has increased its prevalence in the last decade, and plays a role in the multiple symptoms of allergic diseases like asthma, atopic dermatitis and allergic rhinitis. It has become the new epidemic with significant implications. To describe the frequency of sensitization to food antigens by skin tests, prick-to-prick and atopy patch tests, in a group of allergic children in a pediatric hospital. We retrospectively reviewed the results of skin tests with foods, prick-to-prick and atopy patch tests, in the clinical records of 170 and 140 children respectively, with a diagnosis of asthma, allergic rhinitis, atopic dermatitis, food allergy or eosinophilic gastroenteropathies, and analyzed the results with measures of central tendency and chi2 test. Immediate hypersensitivity tests with fresh foods (prick-to-prick) were positive in 135 cases. Cowís milk was positive in 28.8%, followed by egg white with 20.1% and banana in 19.4%. In the group of 1 to 5 years, cowís milk was positive in 26.9% (p chocolate with 50.5%. In the group with atopic dermatitis soybean was positive in 55.6% (p <0.05). In the group of 1 to 5 years, soybean was positive in 52.1% (p <0.05). In children with various allergic diseases, with prick-to-prick skin tests, cowís milk was the food allergen with more frequent positive results. When we used atopy patch tests, soybean was the food with more positive results. We observe sensitization to different foods, according to the mechanism of injury, type I or IV, which is dependent on the type of skin tests used.

  9. Ranitidine-induced anaphylaxis: clinical features, cross-reactivity, and skin testing.

    Science.gov (United States)

    Park, K H; Pai, J; Song, D-G; Sim, D W; Park, H J; Lee, J-H; Jeong, K Y; Pan, C-H; Shin, I; Park, J-W

    2016-04-01

    Histamine H2 receptor antagonists are commonly prescribed medications and are known to be well tolerated. However, 99 cases of ranitidine-induced anaphylaxis occurred in Korea from 2007 to 2014. The purpose of this study was to determine the incidence, clinical features, and diagnostic methods for ranitidine-induced anaphylaxis. Ranitidine-related pharmacovigilance data from 2007 to 2014 were reviewed. Adverse drug reactions with causal relationships were selected, and clinical manifestations, outcomes, and drug-related information were assessed. For further investigation, 8 years of pharmacovigilance data were collected at a single centre. Twenty-three patients participated in in vivo and in vitro studies. Skin tests, oral provocation tests, and laboratory tests were performed, including tests using other kinds of histamine H2 receptor antagonists. Over 7 years, 584 patients suffered adverse reactions to ranitidine. The most common manifestation was cutaneous symptoms. Among them, 99 patients (17.0%) experienced anaphylaxis. In a single-centre study, skin prick tests were positive in 91.7% of ranitidine-induced anaphylaxis patients (11/12); the optimal concentration was 20 mg/mL. Detection of ranitidine-specific immunoglobulin E failed. Cimetidine and proton pump inhibitors showed no cross-reactivity with ranitidine based on the skin prick test, oral provocation test, or clinical determination. Surprisingly, 82.6% of patients reintroduced ranitidine and re-experienced the same adverse reactions because ranitidine was not considered the culprit drug. Although ranitidine is known as a safe drug, it can also cause diverse adverse reactions, including anaphylaxis. This study demonstrates the need to pay attention to adverse reactions to ranitidine and consider ranitidine as a cause of anaphylaxis. © 2016 John Wiley & Sons Ltd.

  10. Activation of blood coagulation in plasma from chronic urticaria patients with negative autologous plasma skin test.

    Science.gov (United States)

    Asero, R; Cugno, M; Tedeschi, A

    2011-02-01

    Skin reactivity to the intradermal injection of autologous serum (autologous serum skin test - ASST) and/or plasma (autologous plasma skin test - APST) is thought to identify chronic urticaria (CU) patients with an autoimmune/autoreactive disease. Immune-mediated inflammation and coagulation are strictly linked, and coagulation activation has been described in CU patients as shown by the elevation of plasma prothrombin fragment F1+2 and, in severe cases, of d-dimer as well. The aim of this study was to evaluate whether the coagulation cascade is activated in APST-negative CU patients as it has been described in CU patients with an autoreactive disease. A total of 43 adults with CU (M/F 15/28; mean age 43.5 years; 16 APST-negative patients and 27 APST-positive) and 30 healthy subjects were studied. Prothrombin fragment F1+2, d-dimer and C-reactive protein (CRP) plasma levels were measured by ELISA. Prothrombin fragment F1+2 and d-dimer were elevated in seven of 16 APST-negative CU patients. The activation of the coagulation cascade was associated with disease severity. Men were more prevalent in idiopathic than in autoreactive CU patients (M/F: 10/6 vs. 5/22; Pcoagulation cascade is activated although with a lower intensity than in patients with autoreactive disease. © 2010 The Authors. Journal of the European Academy of Dermatology and Venereology © 2010 European Academy of Dermatology and Venereology.

  11. Mold-specific IgE antibodies in relation to exposure and skin test data in schoolchildren

    OpenAIRE

    Taskinen, Taina; Laitinen, Sirpa; Hyvärinen, Anne; Meklin, Teija; Husman, Tuula; Nevalainen, Aino; Korppi,Matti

    2001-01-01

    Background: The purpose of the present study was to compare mold specific IgE results with skin test and exposure data, as well as in relation to asthma and other allergic manifestations. Methods: We performed skin prick tests (SPT) to 13 molds in 341 children from six schools and studied the microbial status of all school buildings. Subsequently, mold specific IgE was measured by enzyme immunoassay (EIA) to 10 molds in 31 of those children with a positive (≥3 mm) or weak SPT reaction (1–2...

  12. Duration of postoperative immunosuppression assessed by repeated delayed type hypersensitivity skin tests

    DEFF Research Database (Denmark)

    Hammer, J H; Nielsen, Hans Jørgen; Moesgaard, F

    1992-01-01

    The duration of postoperative impairment in cell-mediated immunity was assessed by repeated skin testing with seven delayed type common antigens in 15 patients undergoing major elective abdominal surgery compared to a similar testing regimen in 10 healthy volunteers. All were skin tested four times......, with 72-hour intervals, and in the surgical patients the first test was applied 2 days before surgery, followed by tests on postoperative days 1, 4 and 7. The tests were read after 48 h. Postoperatively, the skin test area decreased on day 3 (p less than 0.01) and recurred to preoperative levels on day 9...

  13. Effect of nutritional status on Tuberculin skin testing.

    Science.gov (United States)

    Piñeiro, Roi; Cilleruelo, María José; García-Hortelano, Milagros; García-Ascaso, Marta; Medina-Claros, Antonio; Mellado, María José

    2013-04-01

    To evaluate Tuberculin skin test (TST) results in a population of immigrants and internationally adopted children from several geographical areas; to analyze whether nutritional status can modify TST results. This cross-sectional observational study included adopted children and immigrants evaluated in the authors' unit between January 2003 and December 2008. Children diagnosed with tuberculosis, or vaccinated with live attenuated virus 2 mo earlier, HIV-infected, chronically ill or under treatment with immunosuppressive agents were excluded. TST was considered as dependent variable. Independent variables were gender, age, geographical origin, BCG scar, nutritional status, immune status and intestinal parasitism. One thousand seventy four children were included; 69.6 % were girls. There was a BCG scar in 79 % of children. Mantoux = 0 mm was found in 84.4 %, Nutrition (McLaren's classification) was normal (≥90 %) in 26.7 % of the subjects, with mild malnutrition (80-89 %) in 36 %, moderate (70-79 %) in 23.2 % and severe (≤69 %) in 14.1 %. There was no difference in TST results among different nutritional status children. The nutritional status, measured by McLaren's classification, does not changes the results of TST. McLaren's classification only grades protein-caloric malnutrition, so in authors' experience this type of malnutrition does not interfere with TST results. Implementing other nutritional parameters could help to determine whether nutritional status should be taken into account when interpreting TST results.

  14. Intraoperative anaphylaxis to sugammadex and a protocol for intradermal skin testing.

    Science.gov (United States)

    Sadleir, P H M; Russell, T; Clarke, R C; Maycock, E; Platt, P R

    2014-01-01

    Sugammadex is a selective binding agent for aminosteroid neuromuscular blockers whose use is increasing in anaesthetic practice. We present three cases of severe anaphylaxis coincident with sugammadex administration. Subsequent intradermal testing confirmed sugammadex as the triggering agent, with all patients having positive skin responses to a 1:100 dilution of the standard 100 mg/ml solution and two out of three having a positive response to a 1:1000 dilution. As all patients were administered sugammadex to reverse neuromuscular blockade with rocuronium, we considered that sugammadex-rocuronium complexes were a potential unique allergen. In the two patients who were additionally tested with a rocuronium-sugammadex (3.6:1 molecular ratio) mixture, the wheal-and-flare response was significantly attenuated.

  15. Histoplasmosis diffusion in Somalia: study of skin-test and serological survey.

    Science.gov (United States)

    Nuti, M; Tarabini, G C; Adorisio, E; Zardi, O

    1979-01-01

    Histoplasmin skin-test was applied to 1014 patients in two different parts of Somalia: in Mogadishu, an arid area, and in Jilib, a southern village on the banks of the Juba river. Among these patients only three gave areas of induration greater than 5 mm in diameter; all reactors were from Jilib. Results of a serological survey (latex-agglutination test) of histoplasmosis antibodies among 203 Somalian patients from three villages in river valleys are compared with the results of 171 inhabitants of the town of Mogadishu. Indirect agglutination antibody titers greater than or equal to 20 were found in 21.6% of the Mogadishu population as compared to 52.2% found in the river villages. In 96.2% of our cases in which the two tests were contemporarily used, the skin-test was completely negative despite high titres of positivity in the serological test. The results indicate the existence of founts of histoplasmosis infection in Somalia, particularly in humid areas bordering the rivers rather than in the surrounding arid semi-desert area characteristic of most of the country.

  16. Kangaroo supported diagonal flexion positioning: New insights into skin-to-skin contact for communication between mothers and very preterm infants.

    Science.gov (United States)

    Buil, A; Carchon, I; Apter, G; Laborne, F X; Granier, M; Devouche, E

    2016-09-01

    Skin-to-skin contact shows benefits in the relationship developed between a mother and her premature infant. In the skin-to-skin session, face-to-face exchanges are impossible in vertical infant positioning. We therefore undertook an observational, prospective, single-center study using kangaroo "supported diagonal flexion" (SDF) positioning. The first aim was to evaluate the safety of kangaroo SDF positioning compared to the usual vertical positioning. The second aim was to evaluate SDF positioning on early communication between the mother and her infant and to improve their well-being. Fifteen mothers and their very premature infants (birth 26kangaroo positioning modes, either the current vertical positioning (n=7) or SDF positioning (n=8). Physiological variables and critical events were recorded before, during, and after ten successive skin-to-skin contact sessions. The first and last sessions were videotaped to allow later behavioral measurements. Mothers' risk for depression and feelings about the way they experienced communication with their infant were assessed through questionnaires. In terms of the infant's physiology, no negative effects were associated with SDF positioning in comparison with the usual vertical positioning. SDF positioning led to fewer disorganized gestures, negative vocalizations, and drowsiness, in favor of more deep sleep. SDF led to more mother-infant eye-to-eye contact as well as maternal vocalizations, smiles, and caressing, although these differences did not reach significance. The score for the risk of postnatal depression decreased significantly between the first and the last session in the SDF group, whereas it did not change in the vertical positioning group. These results support the idea that the kangaroo SDF positioning technique is physiologically safe, has obvious immediate benefits on mothers' infant-directed communicative behaviors, and respects the baby's naturally flexed and asymmetrical tonic neck posture. It is an

  17. The relationship between RAST and skin test results in patients with asthma or rhinitis: a quantitative study with purified major allergens.

    Science.gov (United States)

    Witteman, A M; Stapel, S O; Perdok, G J; Sjamsoedin, D H; Jansen, H M; Aalberse, R C; van der Zee, J S

    1996-01-01

    Study of the relationship between skin test results and IgE antibody levels is seriously hampered by the use of conventional allergen extracts because the precise amount of relevant allergen for each patient is unknown. This study was designed to investigate skin reactivity with purified major allergens and to assess the relation with serum levels of IgE antibodies and to determine which additional factors contribute to the skin test result. We used five purified major allergens (Der p 1, Der p 2, Fel d 1, Lol p 1, and Lol p 5) in skin tests, RASTs, and histamine release tests in 43 multisensitized patients with asthma or rhinitis. The differences in biologic activity of the five major allergens at a given level of specific IgE are within one order of magnitude. A significant residual variation remains in the correlation between skin test results and levels of IgE antibodies, which cannot be explained by imprecision of both tests (Pearson log skin test vs log specific IgE: r = 0.46-0.92). With similar levels of specific IgE, the amount of allergen that is required for a positive skin test result may differ by as much as a factor of 100 between patients. The amount of total IgE in serum contributes significantly to the skin test result. High values of total IgE are accompanied by a lower skin reactivity for allergen. Within individuals, allergens that cause skin test results that deviate from the prediction based on IgE antibody level often show a similar deviation in the histamine release test. This indicates that the type of IgE response (i.e., affinity or epitope recognition pattern) contributes significantly to the skin test result. Skin reactivity for histamine does not significantly influence the skin reactions expressed as allergen threshold. However, increased skin reactions with higher allergen dosages depend on histamine reactivity. The major allergens tested show similar biologic activities. In addition to IgE antibody level, total serum IgE and type of

  18. Diagnostic evaluation of a large group of patients with immediate allergy to penicillins: the role of skin testing.

    Science.gov (United States)

    Torres, M J; Romano, A; Mayorga, C; Moya, M C; Guzman, A E; Reche, M; Juarez, C; Blanca, M

    2001-09-01

    Penicillin is no longer the most commonly prescribed beta-lactam, and the pattern of reactions has changed. We studied the diagnostic value of skin testing in penicillin-allergic subjects from a population where benzylpenicillin is not now the most frequently used beta-lactam. Patients with a history of immediate allergic reactions to penicillins were studied with: skin tests with major and minor determinants of benzylpenicillin (BPO/MDM), amoxicillin, and ampicillin; in vitro determination of specific IgE; and controlled administration for those with a positive history but negative skin and in vitro tests. A reaction was considered immediate when symptoms appeared within a maximum of 1 h after drug intake. After testing, 290 patients (71% having anaphylaxis and 29% having urticaria) proved to be allergic. Amoxicillin was involved in 64.8% and benzylpenicillin in 2.8% of the patients. Skin test positivity to at least one determinant appeared in 70% of cases, amoxicillin being the most frequent. The overall sensitivity decreased markedly when only BPO and MDM were considered. In 13.1% of patients, the diagnosis was established by in vitro test and in 16.9% by controlled administration. Of the 290 patients, 42.1% were positive to determinants generated from benzylpenicillin and 57.9% were selective responders. Sensitivity of skin tests to BPO was lower than reported, being partly replaced by minor determinants, mostly amoxicillin. The incorporation of additional reagents and the development of new tests are required, and these will probably change as the patterns of consumption vary.

  19. Telavancin versus standard therapy for treatment of complicated skin and skin structure infections caused by gram-positive bacteria: FAST 2 study.

    Science.gov (United States)

    Stryjewski, Martin E; Chu, Vivian H; O'Riordan, William D; Warren, Brian L; Dunbar, Lala M; Young, David M; Vallée, Marc; Fowler, Vance G; Morganroth, Joel; Barriere, Steven L; Kitt, Michael M; Corey, G Ralph

    2006-03-01

    Telavancin is a bactericidal lipoglycopeptide with a multifunctional mechanism of action. We conducted a randomized, double blind, active-control phase II trial. Patients > or = 18 years of age with complicated skin and skin structure infections caused by suspected or confirmed gram-positive organisms were randomized to receive either telavancin at 10 mg/kg intravenously every 24 h (q24h) or standard therapy (antistaphylococcal penicillin at 2 g q6h or vancomycin at 1 g q12h). A total of 195 patients were randomized and received at least one dose of study medication. Clinical success rates were similar in all analysis populations at test of cure. In microbiologically evaluable patients with Staphylococcus aureus at baseline (n = 91), 96% of the telavancin group and 90% of the standard-therapy group were cured. Among patients with methicillin-resistant S. aureus (MRSA) at baseline (n = 45), clinical cure rates were also 96% for telavancin and 90% for standard therapy. Microbiologic eradication in patients with S. aureus infection was better with telavancin compared to standard therapy (92% versus 78%, P = 0.07) and significantly better in patients with MRSA (92% versus 68%; P = 0.04). Therapy was discontinued for an adverse event (AE) in 6% and 3% of the patients receiving telavancin and standard therapy, respectively. Except for two cases of rash in the telavancin group, these AEs were similar in type and severity in the two groups. The overall incidences and severities of AEs and laboratory abnormalities were similar between the two groups. These data support the ongoing studies assessing the efficacy and safety of telavancin in the treatment of serious gram-positive infections, particularly involving MRSA.

  20. Pregnancy-associated plasma protein A is positively correlated to first trimester skin microvascular reactivity.

    Science.gov (United States)

    Iacobaeus, C; Kahan, T; Jörneskog, G; Bremme, K; Andolf, E; Thorsell, M

    2017-04-11

    To investigate if there is a correlation between levels of circulating maternal pregnancy-associated plasma protein A (PAPP-A) and first trimester maternal vascular function. A cross-sectional study of 53 healthy non-smoking, pregnant, nulliparous women in Stockholm, Sweden. PAPP-A and vascular function were assessed during gestational week 11-14. Forearm skin microcirculation was investigated by laser Doppler perfusion imaging during iontophoresis of acetylcholine (ACh) and sodium nitroprusside (SNP) to assess endothelium dependent and endothelium independent microvascular vasodilatation, respectively. Vascular endothelial dependent and independent vasodilatation in the brachial artery was evaluated by post-ischemic hyperaemia induced flow mediated vasodilatation (FMD) and by sublingual glyceryl trinatrate (GTN), respectively. PAPP-A related to skin microvascular endothelial function index, i.e. peak Ach/peak SNP (β for PAPP-A 1.008 (0.34 - 1.68), r 2  = 0.17, P = 0.004). PAPP-A also related inversely to FMD (β for PAPP-A = -0.052 (-0.094 - -0.011), r 2  = 0.14, P = 0.014) but did not to FMD/GTN. The results were retained in multivariate analyses including known confounding factors. First trimester endothelium dependent skin microvascular reactivity was positively related to PAPP-A-levels. If confirmed, these novel findings suggest that first trimester skin microvascular reactivity could be a useful early marker for placental function. This article is protected by copyright. All rights reserved.

  1. Long-term repeatability of the skin prick test is high when supported by history or allergen-sensitivity tests

    DEFF Research Database (Denmark)

    Bodtger, U; Jacobsen, C R; Poulsen, Lars K.

    2003-01-01

    Long-term reproducibility of the skin-prick test (SPT) has been questioned. The aim of the study was to investigate the clinical relevance of SPT changes.......Long-term reproducibility of the skin-prick test (SPT) has been questioned. The aim of the study was to investigate the clinical relevance of SPT changes....

  2. Factors influencing and modifying the decision to pursue genetic testing for skin cancer risk.

    Science.gov (United States)

    Fogel, Alexander L; Jaju, Prajakta D; Li, Shufeng; Halpern-Felsher, Bonnie; Tang, Jean Y; Sarin, Kavita Y

    2017-05-01

    Across cancers, the decision to pursue genetic testing is influenced more by subjective than objective factors. However, skin cancer, which is more prevalent, visual, and multifactorial than many other malignancies, may offer different motivations for pursuing such testing. The primary objective was to determine factors influencing the decision to receive genetic testing for skin cancer risk. A secondary objective was to assess the impact of priming with health questions on the decision to receive testing. We distributed anonymous online surveys through ResearchMatch.org to assess participant health, demographics, motivations, and interest in pursuing genetic testing for skin cancer risk. Two surveys with identical questions but different question ordering were used to assess the secondary objective. We received 3783 responses (64% response rate), and 85.8% desired testing. Subjective factors, including curiosity, perceptions of skin cancer, and anxiety, were the most statistically significant determinants of the decision to pursue testing (P skin cancer (odds ratio 0.5, P = .01). Age and family history of skin cancer did not influence this decision. Participants increasingly chose testing if first queried about health behaviors (P skin cancer is primarily determined by subjective factors, such as anxiety and curiosity. Health factors, including skin cancer history, also influenced decision-making. Priming with consideration of objective health factors can increase the desire to pursue testing. Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  3. Compatibility of Clinical Manifestation with Skin Prick Test Result and Food Provocation Test in Food Cross Reaction

    OpenAIRE

    Lubis, Azwin; Barlianto, Wisnu; Endaryanto, Anang; Harsono, Ariyanto

    2017-01-01

    Background: Subjective diagnostic test of food allergy is hugely biased, resulting in irrational diet avoidance. Additional objective tools by skin prick test following food provocation test resulting more accurate cause and prevalence on population. Purpose: To evaluate the compatibility of clinical symptoms with skin prick test and provocation test for imunoglobulin E (IgE) mediated food allergy in Dr. Soetomo Hospital Surabaya. Methods: Cross sectional observational analytic study. Patient...

  4. A Comparison of Two-Step Tuberculin Skin Test between Health-Care Workers and Nonhospital Employees

    Directory of Open Access Journals (Sweden)

    Iraj Nikokar

    2010-09-01

    Full Text Available Background: The tuberculin test is widely used to identify tuberculosisinfection. Some individuals infected with Mycobacteriumtuberculosis may have an initial negative skin test reactionto tuberculin. The two step purified protein derivative skin testcan decrease misinterpretation of tuberculin test .This study wasaimed at comparing the two- step tuberculin skin test and boosterphenomenon in health care workers and non hospital employees.Methods: One hundred and eighty five health service employeesfrom Razi University Hospital and 181 non hospitalemployees were subjected to an initial tuberculin skin test.Those who were negative on the first test underwent a secondone 2 weeks later. The reactions to the tests were measured 72hours later. Tests with an induration of ≥ 10 mm was consideredpositive. Moreover, second tests with an induration of atleast 6 mm increase relative to the relevant first tests wereconsidered positive.Results: Compared to non hospital employees (n=79, 43.6%, asignificantly higher number of health care workers (n=113,61.1% were positive on the first tuberculin test. 18.5 % of healthcare workers and 31.5% of non hospital employees demonstrateda boosted reaction after the second tuberculin test. The occurrenceof boosted reaction was significantly associated with ageboth groups. There was no association between the presence ofBCG scars and the occurrence of boosted reaction.Conclusion: the present study shows that the prevalence of TBwas higher among health care worker than non hospital employees.Moreover, it demonstrated that non hospital employeeshad a higher age-associated booster reaction to the second tuberculinskin test than health care workers. Therefore, to avoidmissing false negative cases, it would be necessary to do a secondtuberculin test for subjects with a negative reaction to theinitial test, especially in subjects older than 40 years.

  5. Clinical condition and comorbidity as determinants for blood culture positivity in patients with skin and soft-tissue infections

    NARCIS (Netherlands)

    van Daalen, F. V.; Kallen, M. C.; van den Bosch, C. M. A.; Hulscher, M. E. J. L.; Geerlings, S. E.; Prins, J. M.

    2017-01-01

    The utility of performing blood cultures in patients with a suspected skin infection is debated. We investigated the association between blood culture positivity rates and patients' clinical condition, including acute disease severity and comorbidity. We performed a retrospective study, including

  6. Duration of postoperative immunosuppression assessed by repeated delayed type hypersensitivity skin tests

    DEFF Research Database (Denmark)

    Hammer, J H; Nielsen, Hans Jørgen; Moesgaard, F

    1992-01-01

    The duration of postoperative impairment in cell-mediated immunity was assessed by repeated skin testing with seven delayed type common antigens in 15 patients undergoing major elective abdominal surgery compared to a similar testing regimen in 10 healthy volunteers. All were skin tested four tim....... In contrast, the skin test area in the volunteers increased from test to test (p less than 0.001) during the study, confirming a previous finding of a vaccination effect. These results suggest that the postoperative immunosuppression is maintained for about 6-9 days....

  7. Diagnosis of penicillin allergy revisited: the value of case history, skin testing, specific IgE and prolonged challenge.

    Science.gov (United States)

    Hjortlund, J; Mortz, C G; Skov, P S; Bindslev-Jensen, C

    2013-08-01

    Skin testing in duplicate, correlation between case history of immediate and nonimmediate reactions and challenge outcome and prolonged oral treatment with penicillin in the diagnostic evaluation of allergic reactions to β-lactam antibiotics, mimicking real-life situations, have only been addressed in few studies. A total of 342 patients suspected of having β-lactam allergy were investigated according to the European Network for Drug Allergy (ENDA) guidelines and patients found to be negative in the ENDA program were supplemented with a 7-day oral treatment with penicillin. Skin testing with penicillins was performed in duplicate. Patients with case histories of reactions to other β-lactams were also subsequently challenged with the culprit drug. Nineteen patients were IgE-sensitized to penicillin. Then, intracutaneous tests (ICTs) were performed, in which 35 patients tested positive for allergy, 21 with delayed and 14 with immediate reactions. Only three patients tested positive for the major (PPL) and/or minor (MDM) penicillin determinants, all being positive for penicillin G in ICT. The remaining 291 patients were challenged with penicillin: 10 tested positive in single-dose challenge and 23 tested positive in the 7-day challenge. A total of 17 of 78 patients with a negative penicillin challenge tested positive during challenges with other β-lactams. We found no correlation between case histories of immediate and nonimmediate reactions and reaction time during challenge. The data suggest that case history is often insufficient to discriminate between immediate reactors and nonimmediate reactors. A 7-day challenge with the culprit β-lactam may yield more positive reactions than the accepted one- or 2-day challenge. Interpretation of skin testing should be made with caution. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  8. Epstein–Barr Virus-Positive T/NK-Cell Lymphoproliferative Disorders Manifested as Gastrointestinal Perforations and Skin Lesions

    Science.gov (United States)

    Xiao, Hai-Juan; Li, Ji; Song, Hong-Mei; Li, Zheng-Hong; Dong, Mei; Zhou, Xiao-Ge

    2016-01-01

    Abstract Systemic Epstein–Barr virus (EBV)-positive T-cell lymphoproliferative disorders (LPDs) of childhood is a highly aggressive EBV-positive T/natural killer (NK)-cell LPD, which emerges in the background of chronic active EBV infection (CAEBV) or shortly after primary acute EBV infection. The clinical presentations of CAEBV are varied; patients with atypical manifestations are easily misdiagnosed. We described a 14-year-old boy suffering from digestive disorders and intermittent fever for 1 year and 9 months, whose conditions worsened and skin lesions occurred 2 months before hospitalization. He was diagnosed as inflammatory bowel diseases (IBD) and treated accordingly. His other clinical features, hepatosplenomegaly, lymphadenopathy, anemia, hypoalbuminemia, and elevated inflammatory marks, were found in hospitalization. The boy suffered from repeatedly spontaneous intestinal perforations shortly after hospitalization and died of intestinal hemorrhea. The pathological results of intestine and skin both showed EBV-positive T/NK-cell LPD (lymphoma stage). There are rare studies reporting gastrointestinal perforations in EBV-positive T/NK-cell LPD, let alone repeatedly spontaneous perforations. Based on the clinical features and pathological results of this patient, the disease progressed from CAEBV (T-cell type) to systemic EBV-positive T-cell LPD of childhood (lymphoma). Not all the patients with CAEBV could have unusual patterns of anti-EBV antibodies. However, the presence of high EBV loads (EBV-encoded early small ribonucleic acid (RNA) (EBER) in affected tissues and/or EBV deoxyribonucleic acid (DNA) in peripheral blood) is essential for diagnosing CAEBV. Maybe because of his less common clinical features for CAEBV and negative anti-EBV antibodies, the boy was not diagnosed correctly. We should have emphasized the test for EBER or EBV-DNA. Meanwhile, for the IBD patients whose manifestations were not typical, and whose conditions were not improved by

  9. Causes of false-positive HIV rapid diagnostic test results

    OpenAIRE

    Klarkowski, Derryck; O?Brien, Daniel P.; Shanks, Leslie; Singh, Kasha P.

    2014-01-01

    HIV rapid diagnostic tests have enabled widespread implementation of HIV programs in resource-limited settings. If the tests used in the diagnostic algorithm are susceptible to the same cause for false positivity, a false-positive diagnosis may result in devastating consequences. In resource-limited settings, the lack of routine confirmatory testing, compounded by incorrect interpretation of weak positive test lines and use of tie-breaker algorithms, can leave a false-positive diagnosis undet...

  10. Complementary and Alternative Medicine Usage in Skin Diseases and the Positive and Negative Impacts on Patients

    Directory of Open Access Journals (Sweden)

    Gülşen Tükenmez Demirci

    2012-12-01

    Full Text Available Objective: Our purpose was to compare the sosciodemographical differences between Complementary and Alternative medicine (CAM users and non users with skin diseases and to investigate the positive and negative impacts of CAM among patients. Methods: The patients with dermatological conditions attending the dermatology outpatient clinic were enrolled to the study randomly. The sociodemographical properties, diagnosis of the skin diseases, duration of the disease, CAM usage and duration of usage and the positive and negative impacts of the treatments were recorded. Results: A total of 522 (302 female, 220 male, median age 34.8±16.7 patients were enrolled in the study. Eighty-eight patients (16.8% were found to have used a CAM method. The mean age of CAM users (28.2±14.3 were statistically lower than non users (36.0±16.9 (p=0.000 <0.05. The disease duration of CAM users (4.3±5.5 year was statistically longer than non-users (2.8±5.2 year. The CAM methods were mostly preferred in acne vulgaris disease (31.8%, and the mostly used CAM method was herbal therapies (59.1%. We found that 16 (18.2% out of 88 CAM users had side effects from CAM treatment while nine patients (10.3% improved. Conclusion: Complementary and alternative medicine usage is not frequent among skin diseases. The patients with longer disease duration are more prone to use CAM. The side effects rarely occur due to CAM use and we ascertain that very rarely do patients benefit from CAM methods.

  11. Effect of evaporative coolers on skin test reactivity to dust mites and molds in a desert environment.

    Science.gov (United States)

    Prasad, Chaithra; Hogan, Mary Beth; Peele, Kathleen; Wilson, Nevin W

    2009-01-01

    Dust mites and molds are usually not found in arid environments and have a lower prevalence in desert areas. Evaporative (swamp) coolers increase indoor humidity significantly. The purpose of this study is to determine whether evaporative coolers affect the skin test rate to dust mites and molds in patients. Patients with asthma or allergic rhinitis who were undergoing skin testing for molds, indoor allergens, grasses, weeds, and trees were asked about presence of central, window, and evaporative cooler air conditioning in their home. All were tested using the prick technique with controls. One hundred ninety patients between 1 and 42 years (mean, 5.4 years) were evaluated. Fifty-nine (31%) had an evaporative cooler in their home. Twenty-five (42%) of those with evaporative coolers had a positive skin test to at least one mold compared with 26 (19%) without coolers (chi-square, 10.5; p = 0.001). Twenty (34%) of those with evaporative coolers had a positive skin test to dust mites compared with 23 (17.5%) without coolers (chi-square, 6.2; p = 0.013). Children molds or mites. This appears to be because of humidity caused by these devices. Patients with asthma in homes with evaporative coolers should be counseled about the risk for mold and dust-mite allergy. Humidity monitoring, cooler maintenance, and filter changes should be discussed.

  12. Results of a tuberculin skin testing survey in Albania.

    Science.gov (United States)

    Hafizi, Hasan; Aliko, Anila; Sharra, Elda; Fico, Albana; Migliori, Giovanni Battista; Castiglia, Paolo; Sotgiu, Giovanni

    2014-03-13

    Tuberculosis affected about 8.5 million patients in 2011. Numerous efforts are needed to reduce the pool of individuals with latent TB infection (LTBI). The aim of the study was to describe a tuberculin skin testing (TST) survey carried out in Albania to estimate the LTBI burden; furthermore, knowledge of TB was evaluated through an ad hoc questionnaire. A TST survey was performed in three geographical districts of Albania: Tirana-Kamez, Vlora, and Dibra. Cluster sampling was carried out of young Albanian students. In addition, the same students were given a questionnaire to assess their knowledge, attitudes, and any misconceptions about TB. The mean (standard deviation) age of the individuals, according to their educational level, was the following: grade five, 11.03 (0.18) years; grade six, 12.02 (0.17) years; and grade seven, 13.02 (0.16) years. The TST induration size was read in 4,648 students. About 5.0% showed a reaction >5 mm, with a significant variability in the districts selected (12.1% in the district of Dibra). An induration diameter >15 mm was found mainly in those areas with high TB incidence (i.e., Tirana-Kamez and Dibra). About 13% of the students had no knowledge of TB. LTBI prevalent cases are estimated to be low in Albania, although there are areas where the TB management should be improved to reduce the probability of Mycobacterium tuberculosis transmission. The level of knowledge about TB disease is inadequate and new public health strategies should be implemented, focusing on educational TV programs.

  13. Skin Testing in the Evaluation and Management of Carboplatin-Related Hypersensitivity Reactions.

    Science.gov (United States)

    Lax, Timothy; Long, Aidan; Banerji, Aleena

    2015-01-01

    Carboplatin-induced hypersensitivity reactions (HSRs) are a frequent occurrence in patients being retreated for malignancy. The most common and severe reactions are thought to be IgE mediated. Currently, skin testing is the only method used clinically to identify individuals sensitized to carboplatin. Despite almost 20 years of clinical use, a standardized approach to skin testing and its use in the management of carboplatin HSRs has not been well established. We review the utility of carboplatin skin testing and discuss factors that influence the interpretation of skin testing results. A risk stratification strategy using skin testing and desensitization to manage patients with carboplatin HSRs is proposed. Copyright © 2015 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  14. A skin test survey of valley fever in Tijuana, Mexico.

    Science.gov (United States)

    Fredrich, B E

    1989-01-01

    Results of a study of the prevalence of valley fever among 1128 residents of Tijuana, Baja California are presented. Children from primary and middle schools (n = 497) and adults from technical institutes and maquiladoras (assembly plants) were tested for reaction to both spherulin and coccidioidin during 1985-1986, and they completed a questionnaire containing 23 variables on their socio-environment. Place of residence was mapped. The population sampled is largely middle class. Discriminant analysis indicates the distribution of positive cases is not clustered, nor can it be correlated with geomorphic factors such as mesa tops, canyons, or valley bottoms.

  15. Modified M20 Beam Position Monitor Testing

    Science.gov (United States)

    Koros, Jessica; Musson, John

    2017-09-01

    Beam position monitors (BPMs) are used to measure lateral beam position. Two pairs of modified wire BPMs are being evaluated for installation into the injector at Jefferson Lab (JLab). The BPMs were coated with a Non-Evaporable Getter (NEG) to aid in pumping at the electron gun, as an ultra-high vacuum is required to protect the gun and to avoid scattering the beam. Beam in the injector has a large diameter, allowing extraction of second moments to give information about beam profile and emittance. The purpose of this project is to determine the effects of NEG coating on the BPMs and to calculate second moments from beam models on the Goubau Line (G-Line). Using the G-Line, scans of the BPMs were taken before and after NEG coating. Each scan produced an electrical field map, which characterizes properties of the BPM, including scale factors and coupling. Second moments were calculated using superposition of previous scan data, and verification of this method was attempted using several beam models. Results show the BPMs responded well to NEG and that measurement of second moments is possible. Once the BPMs are installed, they will enhance gun vacuum and enable monitoring of shape and trajectory of the beam as it exits the electron gun to ensure quality beam for experiments. This work is made possible through support from NSF award 1659177 to Old Dominion University.

  16. The lancet weight determines wheal diameter in response to skin prick testing with histamine

    DEFF Research Database (Denmark)

    Andersen, Hjalte Holm; Lundgaard, Anna Charlotte; Sohrt Petersen, Anne

    2016-01-01

    BACKGROUND: Skin prick test (SPT) is a common test for diagnosing immunoglobulin E-mediated allergies. In clinical routine, technicalities, human errors or patient-related biases, occasionally results in suboptimal diagnosis of sensitization. OBJECTIVE: Although not previously assessed...

  17. Interactions of skin thickness and physicochemical properties of test compounds in percutaneous penetration studies

    DEFF Research Database (Denmark)

    Wilkinson, Simon C.; Maas, Wilfred J. M.; Nielsen, Jesper Bo

    2006-01-01

    Abstract   Objectives: To determine the effect of skin thickness on the percutaneous penetration and distribution of test compounds with varying physicochemical properties using in vitro systems. Studies were carried out in accordance with OECD guidelines on skin absorption tests. Methods......: Percutaneous penetration of caffeine (log P -0.01), testosterone (log P 3.32), propoxur (log P 1.52) (finite dose in ethanol to water vehicle ratio) and butoxyethanol (log P 0.83) (undiluted finite dose or as an infinite dose 50% [v/v] aqueous solution) through skin of varying thicknesses under occluded......: The maximum flux of caffeine was increased with decreasing skin thickness, although these differences were found to be non-significant. The presence of caffeine in the skin membrane was not altered by skin thickness. Maximum flux and cumulative dose absorbed of testosterone and butoxyethanol (in both finite...

  18. Impact of source position on high-dose-rate skin surface applicator dosimetry.

    Science.gov (United States)

    Jeong, Jeho; Barker, Christopher A; Zaider, Marco; Cohen, Gil'ad N

    2016-01-01

    Skin surface dosimetric discrepancies between measured and treatment planning system predicted values were traced to source position sag inside the applicator and to source transit time. We quantified their dosimetric impact and propose corrections for clinical use. We measured the dose profiles from the Varian Leipzig-style high-dose-rate (HDR) skin applicator, using EBT3 film, photon diode, and optically stimulated luminescence dosimeter for three different GammaMedplus HDR afterloaders. The measured dose profiles at several depths were compared with BrachyVision Acuros calculated profiles. To assess the impact of the source sag, two different applicator orientations were considered. The dose contribution during source transit was assessed by comparing diode measurements using an HDR timer and an electrometer timer. Depth doses measured using the three dosimeters were in good agreement, but were consistently higher than the Acuros dose calculations. Measurements with the applicator face up were significantly (exceeding 10%) lower than those in the face down position, due to source sag inside the applicator. Based on the inverse square law, the effective source sag was evaluated to be about 0.5 mm from the planned position. The additional dose during source transit was evaluated to be about 2.8% for 30 seconds of treatment with a 40700 U (10 Ci) source. With a very short source-to-surface distance, the small source sag inside the applicator has a significant dosimetric impact. This effect is unaccounted for in the vendor's treatment planning template and should be considered before the clinical use of the applicator. Further investigation of other applicators with large source lumen diameter may be warranted. Copyright © 2016 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  19. Novel simple templates for reproducible positioning of skin applicators in brachytherapy.

    Science.gov (United States)

    Villalba, Silvia Rodríguez; Perez-Calatayud, Maria Jose; Bautista, Juan Antonio; Carmona, Vicente; Celada, Francisco; Tormo, Alejandro; García-Martinez, Teresa; Richart, José; Ortega, Manuel Santos; Silla, Magda; Ballester, Facundo; Perez-Calatayud, Jose

    2016-08-01

    Esteya and Valencia surface applicators are designed to treat skin tumors using brachytherapy. In clinical practice, in order to avoid errors that may affect the treatment outcome, there are two issues that need to be carefully addressed. First, the selected applicator for the treatment should provide adequate margin for the target, and second, the applicator has to be precisely positioned before each treatment fraction. In this work, we describe the development and use of a new acrylic templates named Template La Fe-ITIC. They have been designed specifically to help the clinical user in the selection of the correct applicator, and to assist the medical staff in reproducing the positioning of the applicator. These templates are freely available upon request. Templates that were developed by University and Polytechnic Hospital La Fe (La Fe) and Hospital Clínica Benidorm (ITIC) in cooperation with Elekta, consist of a thin sheet made of transparent acrylic. For each applicator, a crosshair and two different circles are drawn on these templates: the inner one corresponds to the useful beam, while the outer one represents the external perimeter of the applicator. The outer circle contains slits that facilitate to draw a circle on the skin of the patient for exact positioning of the applicator. In addition, there are two perpendicular rulers to define the adequate margin. For each applicator size, a specific template was developed. The templates have been used successfully in our institutions for more than 50 patients' brachytherapy treatments. They are currently being used for Esteya and Valencia applicators. The template La Fe-ITIC is simple and practical. It improves both the set-up time and reproducibility. It helps to establish the adequate margins, an essential point in the clinical outcome.

  20. Novel simple templates for reproducible positioning of skin applicators in brachytherapy

    Directory of Open Access Journals (Sweden)

    Silvia Rodríguez Villalba

    2016-08-01

    Full Text Available Purpose : Esteya and Valencia surface applicators are designed to treat skin tumors using brachytherapy. In clinical practice, in order to avoid errors that may affect the treatment outcome, there are two issues that need to be carefully addressed. First, the selected applicator for the treatment should provide adequate margin for the target, and second, the applicator has to be precisely positioned before each treatment fraction. In this work, we describe the development and use of a new acrylic templates named Template La Fe-ITIC. They have been designed specifically to help the clinical user in the selection of the correct applicator, and to assist the medical staff in reproducing the positioning of the applicator. These templates are freely available upon request. Material and methods: Templates that were developed by University and Polytechnic Hospital La Fe (La Fe and Hospital Clínica Benidorm (ITIC in cooperation with Elekta, consist of a thin sheet made of transparent acrylic. For each applicator, a crosshair and two different circles are drawn on these templates: the inner one corresponds to the useful beam, while the outer one represents the external perimeter of the applicator. The outer circle contains slits that facilitate to draw a circle on the skin of the patient for exact positioning of the applicator. In addition, there are two perpendicular rulers to define the adequate margin. For each applicator size, a specific template was developed. Results: The templates have been used successfully in our institutions for more than 50 patients’ brachytherapy treatments. They are currently being used for Esteya and Valencia applicators. Conclusions : The template La Fe-ITIC is simple and practical. It improves both the set-up time and reproducibility. It helps to establish the adequate margins, an essential point in the clinical outcome.

  1. Skin Prick Test Reactivity to Common Aero and Food Allergens among Children with Allergy

    Directory of Open Access Journals (Sweden)

    Safoora Hosseini

    2014-01-01

    Full Text Available Background: The prevalence of allergic diseases has risen in the last decades. The objective of this study was to determine the common allergens in children via the skin prick test. Methods: This cross-sectional study recruited 313 allergic children (4 months to 18 years old referred to the Asthma and Allergy Clinic of Children’s Medical Center in Tehran. A questionnaire containing demographic data and patient history was completed. The Skin Prick Test (SPT was selected according to the patients’ history of food and/or aeroallergen sensitivity. Results: Patients (62.4% male, 37.6% female with symptoms of asthma (n=141, 57.1%, allergic rhinitis (n=50, 20.4%, atopic dermatitis (n=29, 11.7%, and urticaria (n=20, 8.1% were studied. Positive skin prick test to at least one allergen was 58.1%. The most prevalent allergens were tree mix (26%, Alternaria alternata (26%, weed mix (23.6%, Dermatophagoides farinae (22.9%, Dermatophagoides pteronyssinus (22.9%, milk (21.7%, eggs (20%, and wheat flour (18.3%. Also, common allergens in the patients with different symptoms of allergic disorders were as follows: asthma (tree mix, weed mix, and Dermatophagoides farinae; allergic rhinitis (Dermatophagoides farinae, tree mix, and Dermatophagoides pteronyssinus; and atopic dermatitis (Alternaria alternata, Dermatophagoides pteronyssinus, and cockroaches. Conclusion: Identifying allergens in each area is necessary and has an important role in the diagnosis and management of allergic disorders and possibility of performing immunotherapy. In this study, the most common aeroallergens were tree mix, Alternaria alternata, and weed mix and also the most common food allergens were milk, eggs, and wheat. Considering these data, appropriate preventive strategies can decrease the cost and morbidity of therapeutic actions.

  2. Predictive performance for human skin sensitizing potential of the human cell line activation test (h-CLAT).

    Science.gov (United States)

    Nukada, Yuko; Ashikaga, Takao; Sakaguchi, Hitoshi; Sono, Sakiko; Mugita, Nanae; Hirota, Morihiko; Miyazawa, Masaaki; Ito, Yuichi; Sasa, Hitoshi; Nishiyama, Naohiro

    2011-12-01

    Recent changes in regulatory restrictions and social opposition to animal toxicology experiments have driven the need for reliable in vitro tests for predicting the skin sensitizing potentials of a wide variety of industrial chemicals. Previously, we developed the human cell line activation test (h-CLAT) as a cell-based assay to predict the skin sensitizing potential of chemicals, and showed the correspondence between the h-CLAT and the murine local lymph node assay results. This study was conducted to investigate the predictive performance of the h-CLAT for human skin sensitizing potential. We selected a total of 66 test chemicals with known human sensitizing potential, and tested all chemicals with the h-CLAT. We then evaluated the performance of the h-CLAT in predicting human sensitizing potential. Forty-five of 51 tested sensitizers were positive in the h-CLAT, indicating relatively high sensitivity. Also, 10 of 15 non-sensitizers were correctly detected as negative. The overall agreement between human data and h-CLAT outcome was 83%. Furthermore, the h-CLAT could accurately predict the human sensitizing potential of 23 tested chemicals that were amines, heterocyclic compounds, or sulfur compounds. Our data indicate the utility of the h-CLAT for predicting the human skin sensitizing potential of a variety of chemicals. © 2011 John Wiley & Sons A/S.

  3. Prediction of atopy by skin prick tests in patients with asthma and/or persistent rhinitis.

    Science.gov (United States)

    Karakaya, G; Ozturk, A B; Kalyoncu, A F

    2012-01-01

    Patient history gives important clues about the likelihood of atopy. However, the accuracy of assessment of atopy based on detailed allergy history is low. The objective of this survey was to determine the successful prediction rate of atopy by a questionnaire and the effect of various factors on the successful prediction. A standard questionnaire including detailed allergy history was filled in by two experienced allergists for 169 patients having bronchial asthma and/or persistent rhinitis symptoms. Skin prick test (SPT) results were predicted based on the clinical data obtained by a questionnaire. Final diagnosis was made after SPT. Sensitivity and specificity analysis of SPT results prediction was investigated using two different cut-off values (3mm and 5mm) for positive tests, and factors associated with successful atopy prediction were analysed. SPT was predicted to be positive in 42.6% and was positive in 36.1%. Depending on SPT results with the cut-off value 3mm, prediction sensitivity was 77%, specificity was 65.3%, positive predictive value was 65%, and negative predictive value was 86%. Successful positive atopy prediction was associated with age; true negative prediction was also associated with age and high education. With the threshold of 5mm for a positive test, sensitivity, specificity, positive and negative predicted values were 91%, 61%, 14% and 99%, respectively. It seems that the success rate of detailed history is high for negative prediction. However, detailed history alone does not seem to be efficient for atopy prediction. Copyright © 2010 SEICAP. Published by Elsevier Espana. All rights reserved.

  4. Effect of test position on pelvic floor muscle assessment.

    Science.gov (United States)

    Frawley, Helena C; Galea, Mary P; Phillips, Bev A; Sherburn, Margaret; Bø, Kari

    2006-06-01

    The aims of this study were to analyse the effect of different body positions on pelvic floor muscle (PFM) assessment using digital muscle testing, manometry and transabdominal ultrasound. In addition, subject acceptance of each testing position was recorded. Subjects were 20 women's health physiotherapists. The testing protocol included the best of three maximum voluntary contractions tested in each of four positions (crook lying, supine, sitting and standing). Significant differences in muscle strength and subject acceptance between positions were found with each tool, most often between lying and upright positions. Digital muscle testing and vaginal squeeze-pressure scores were highest in the lying position, and vaginal resting pressure and transabdominal ultrasound scores were highest in the standing position. Subjects preferred the lying positions for internal examinations. The clinical significance of these differences and the reasons for these variations require further investigation.

  5. GA(2)LEN skin test study I: GA(2)LEN harmonization of skin prick testing: novel sensitization patterns for inhalant allergens in Europe

    NARCIS (Netherlands)

    Heinzerling, L. M.; Burbach, G. J.; Edenharter, G.; Bachert, C.; Bindslev-Jensen, C.; Bonini, S.; Bousquet, J.; Bousquet-Rouanet, L.; Bousquet, P. J.; Bresciani, M.; Bruno, A.; Burney, P.; Canonica, G. W.; Darsow, U.; Demoly, P.; Durham, S.; Fokkens, W. J.; Giavi, S.; Gjomarkaj, M.; Gramiccioni, C.; Haahtela, T.; Kowalski, M. L.; Magyar, P.; Muraközi, G.; Orosz, M.; Papadopoulos, N. G.; Röhnelt, C.; Stingl, G.; Todo-Bom, A.; von Mutius, E.; Wiesner, A.; Wöhrl, S.; Zuberbier, T.

    2009-01-01

    BACKGROUND: Skin prick testing is the standard for diagnosing IgE-mediated allergies. However, different allergen extracts and different testing procedures have been applied by European allergy centres. Thus, it has been difficult to compare results from different centres or studies across Europe.

  6. Skin prick testing to food allergens in breast-fed young infants with moderate to severe atopic dermatitis.

    Science.gov (United States)

    Rennick, Gordon J; Moore, Elizabeth; Orchard, David C

    2006-02-01

    SUMMARY The role of food allergy in atopic dermatitis is controversial. This study presents results of skin prick tests to 31 different food allergens in a selected population of predominantly breast-fed young infants who had moderate to severe generalized atopic dermatitis. Of the 59 infants (22 female, mean age 26.5 weeks) tested, 54 infants (91.5%) had positive responses to one or more foods, 53 infants (90%) were positive to one or more of the five common food allergens (egg white, cow's milk, peanuts, wheat or soy) and 80% were positive to egg white, which was by far the most common positive test. A total of 37 infants had strongly positive responses to one or more foods, with 33 of these 37 having strongly positive responses to egg white. The significance of these responses is discussed. It is concluded that positive skin prick tests to foods, particularly to egg white, are very common in this selected population of breast-fed infants with moderate to severe atopic dermatitis.

  7. Prospective, multicenter clinical trial to validate new products for skin tests in the diagnosis of allergy to penicillin.

    Science.gov (United States)

    Fernández, J; Torres, M J; Campos, J; Arribas-Poves, F; Blanca, M

    2013-01-01

    Allergy to penicillin is the most commonly reported type of drug hypersensitivity. Diagnosis is currently confirmed using skin tests with benzylpenicillin reagents, ie, penicilloyl-polylysine (PPL) as the major determinant of benzylpenicillin and benzylpenicillin, benzylpenicilloate and benzylpenilloate as a minor determinant mixture (MDM). To synthesize and assess the diagnostic capacity of 2 new benzylpenicillin reagents in patients with immediate hypersensitivity reactions to B-lactams: benzylpenicilloyl octa-L-lysine (BP-OL) as the major determinant and benzylpenilloate (penilloate) as the minor determinant. Prospective multicenter clinical trial performed in 18 Spanish centers. Efficacy was assessed by detection of positive skin test results in an allergic population and negative skin test results in a nonallergic, drug-exposed population. Sensitivity, specificity, and negative and positive predictive values were determined. The study sample comprised 94 allergic patients: 31 (35.23%) presented anaphylaxis, 4 (4.55%) anaphylactic shock, 51 (58.04%) urticaria, and 2 (2.27%) no specific condition. The culprit 8-lactams were amoxicillin in 63 cases (71.60%), benzypencillin in 14 cases (15.89%), cephalosporins in 2 cases (2.27%), other drugs in 3 cases (3.42%), and unidentified agents in 6 cases (6.82%). The results of testing with BP-OL were positive in 46 cases (52.3%); the results of testing with penilloate were positive in 33 cases (37.5%). When both reagents were taken into consideration, sensitivity reached 61.36% and specificity 100%. Skin testing with penilloate was significantly more often negative when the interval between the reaction and the study was longer. The sensitivity of BP-OL and penilloate was 61%. Considering that amoxicillin was the culprit drug in 71% of reactions, these results indicate that most patients were allergic to the whole group of penicillins. These data support the use of benzylpenicillin determinants in the diagnosis of allergy

  8. Enkephalin-like immunoreactivity in human skin is found selectively in a fraction of CD68-positive dermal cells

    DEFF Research Database (Denmark)

    Nissen, J B; Lund, Marianne; Stengaard-Pedersen, K

    1997-01-01

    psoriasis, sections of skin from psoriatic patients were immunohistochemically stained with antisera against methionine and leucine enkephalin, CD68 (KP1, PG-M1), calprotectin (M747), M130 (Ber-MAC3), CD1a and CD3. Enkephalin-like activity was detected selectively in dermal CD68-positive macrophages....../monocytes. The activity showed no association with the activation markers M747 and Ber-MAC3. There was a statistically significant increase in enkephalin-positive cells in involved psoriatic skin compared with uninvolved and normal skin. These results were confirmed by radioimmunoassay which showed elevated levels...... the threshold for biological activity, they may play a role in the regulation of the inflammatory processes seen in this skin disease....

  9. Skin signs in Ehlers-Danlos syndrome: clinical tests and para-clinical methods

    DEFF Research Database (Denmark)

    Remvig, L; Duhn, Ph; Ullman, S

    2010-01-01

    The criteria for Ehlers-Danlos syndrome (EDS) and the hypermobility syndrome (HMS) should be reliable. Examination for general joint hypermobility has high reliability but there is only sparse information on the reliability of skin tests, and no information on the level of normal skin extensibility...

  10. Topical botanically derived products: use, skin reactions, and usefulness of patch tests. A multicentre Italian study.

    Science.gov (United States)

    Corazza, Monica; Borghi, Alessandro; Gallo, Rosella; Schena, Donatella; Pigatto, Paolo; Lauriola, Maria Michela; Guarneri, Fabrizio; Stingeni, Luca; Vincenzi, Colombina; Foti, Caterina; Virgili, Annarosa

    2014-02-01

    The evidence on the safety of topical preparations containing botanical extracts is limited. To assess (i) the use of botanically derived compounds in a large population, (ii) the incidence of cutaneous side-effects, and (iii) the diagnostic usefulness of patch testing. A questionnaire was used in 2661 patients to assess both the prevalence and type of topical botanical preparations used, and the occurrence of adverse skin reactions. Patients declaring adverse reactions were patch tested with (i) the Italian (SIDAPA) baseline series, (ii) an additional botanical series, and (iii) the patients' own products. Of the patients, 1274 (48%) reported the use of topical botanical products; 139 patients (11%) commented on adverse cutaneous reactions; 75 (54%) showed positive reactions with the Italian baseline series. Among the 122 patients tested with the botanical series, 19 (16%) showed positive reactions, in many cases with concomitant relevant positivity to at least one allergen of the Italian series connected with cosmetics. The commonest botanically derived allergens were propolis, Compositae extracts, and Melaleuca alternifolia (tea tree) oil. Contact allergy is a possible adverse effect of natural products. Baseline series supplemented with the commonest botanical allergens may be adequate for detecting most of the cases of contact allergy to natural topical products. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  11. Skin Prick Test Reactivity to Aeroallergens among Egyptian Patients with Isolated Allergic Conjunctival Disease.

    Science.gov (United States)

    Abo-Ali, Fawzeia H; Farres, Mohamed N; Shahin, Rasha Y; Eissa, Abeer M; Ahmed, Abutaleb; Abdel-Monsef, Ahmed; Arafa, Naglaa A

    2015-06-01

    Allergic conjunctival disease (ACD) is a type of ocular allergy, which includes seasonal allergic conjunctivitis (SAC), perennial allergic conjunctivitis (PAC), and vernal keratoconjunctivitis (VKC). Little is known about the pattern of sensitization or prevalent aeroallergens among patients with isolated ACD in Egypt We aimed to evaluate the prevalence of skin prick test positivity to common aeroallergens among Egyptian patients with isolated allergic conjunctival disease. The study included 75 patients with isolated ACD recruited from a tertiary Egyptian outpatient clinic. Skin prick test (SPT) was performed for all patients with common aeroallergens. Total serum immunoglobulin E (IgE) was measured by ELISA. A positive SPT reaction was present among 32 patients (42.7%). The most prevalent aeroallergens among all patients were mites and pollens (12% respectively), followed by grass (8%) and hay dust (6.7%). Eight patients (10.7%) had SAC, 19 patients (25.3%) had PAC, and 48 patients (64%) had VKC. Prevalence of SPT positivity to indoor allergens was significantly more common among PAC (52.6%) than among SAC (25%) and VKC (16.7%), P= 0.011. Outdoor allergen sensitization did not differ significantly between the 3 subgroups, P= 0.614. Elevated IgE levels were observed among 62.5%, 73.7% and 66.7% of patients with SAC, PAC and VKC, respectively, with no statistically significant difference between them, P= 0.806. In conclusion aeroallergen sensitization is common among Egyptian patients with isolated ACD. Accordingly, SPT should be included in the diagnostic workup of these patients. Copyright© by the Egyptian Association of Immunologists.

  12. Documented tuberculin skin testing among infliximab users following a multi-modal risk communication interventions.

    Science.gov (United States)

    Shatin, Deborah; Rawson, Nigel S B; Curtis, Jeffrey R; Braun, M Miles; Martin, Carolyn K; Moreland, Larry W; Becker, Angela F; Patkar, Nivedita M; Allison, Jeroan J; Saag, Kenneth G

    2006-01-01

    Following its licensure, tuberculosis (TB) was reported as a potential adverse effect of infliximab. Subsequently, the product circular was changed to recommend tuberculin skin testing before patients received infliximab, which was reinforced by several risk communication efforts. The aim of this study was to evaluate patterns and predictors of documented tuberculin skin testing in patients before and after manufacturer, federal, and academic risk communications. Patients administered infliximab were identified from 11 health plans located throughout the United States, and claims data were examined to determine whether the patients had received a tuberculin skin test. Patients were divided into three cohorts depending on the timing of their first infliximab treatment in relation to the risk communication efforts. The overall tuberculin skin testing rate doubled from 15.4% in the first cohort to 30.9% in the last cohort, while the rate of pre-infliximab treatment testing increased from 0 to 27.7% (Chi-squared test for trend, p testing rates were significantly higher in women, those with a diagnosis of rheumatoid or psoriatic arthritis, and those with a rheumatologist as prescriber. After multivariable analysis, only rheumatologist remained significantly associated with tuberculin skin testing. Although the tuberculin skin testing rate was relatively low overall, tuberculin skin testing doubled over 30 months of ongoing risk communication efforts and under ascertainment likely occurred. We also found variation in the tuberculin skin testing rate associated with physician specialty. This study demonstrates a significant change in patient care following risk communication efforts. (c) 2005 John Wiley & Sons, Ltd.

  13. Risk assessment of immediate systemic reactions from skin tests with β-lactam antibiotics.

    Science.gov (United States)

    Antico, A; Pagani, M; Compalati, E; Vescovi, P P; Passalacqua, G

    2011-01-01

    Some clinical studies have demonstrated that skin tests for β-lactam antibiotics may cause more adverse reactions than skin tests for common allergens. To assess the risk of systemic reactions from penicillin skin testing, based on a pre-test categorization of patients, in order to establish an appropriate strategy for preempting and dealing with cases. A case series of 175 patients with a suspected allergy to penicillin was reviewed, and patients were classified as having a low or high probability of allergic sensitization to penicillin, according to their clinical history. For every group, the rate and the increase in the relative risk (RRI) of systemic reactions by skin testing were calculated. The results were compared to those reported in the available literature. In our case series of 175 patients, 52 were classified as having a high probability of being allergic to penicillin, according to their clinical history. Five systemic reactions to skin testing were observed, and these were exclusively in this group (9.61%, RRI = 479). In agreement with the literature, patients with a high likelihood of penicillin allergy showed an increase of up to 10% in the occurrence of systemic reactions at skin testing; in patients who had had severe allergic reactions, this figure was up to 20%. The RRI of systemic reactions by skin testing is proportional to the pre-test probability of a true immediate hypersensitivity reaction to β-lactam antibiotics. In the present case series, only patients with high pre-test probability were at risk, and this group should therefore be skin tested and monitored in a hospitalization regimen, where resuscitation staff and access to an emergency room are immediately available. Copyright © 2011 S. Karger AG, Basel.

  14. Assessment of skin sensitization under REACH: A case report on vehicle choice in the LLNA and its crucial role preventing false positive results.

    Science.gov (United States)

    Watzek, Nico; Berger, Franz; Kolle, Susanne Noreen; Kaufmann, Tanja; Becker, Matthias; van Ravenzwaay, Bennard

    2017-04-01

    In the EU, chemicals with a production or import volume in quantities of one metric ton per year or more have to be tested for skin sensitizing properties under the REACH regulation. The murine Local Lymph Node Assay (LLNA) and its modifications are widely used to fulfil the data requirement, as it is currently considered the first-choice method for in vivo testing to cover this endpoint. This manuscript describes a case study highlighting the importance of understanding the chemistry of the test material during testing for 'skin sensitization' of MCDA (mixture of 2,4- and 2,6-diamino-methylcyclohexane) with particular focus on the vehicle used. While the BrdU-ELISA modification of the LLNA using acetone/olive oil (AOO) as vehicle revealed expectable positive results. However, the concentration control analysis unexpectedly revealed an instability of MCDA in the vehicle AOO. Further studies on the reactivity showed MCDA to rapidly react with AOO under formation of various imine structures, which might have caused the positive LLNA result. The repetition of the LLNA using propylene glycol (PG) as vehicle did not confirm the positive results of the LLNA using AOO. Finally, a classification of MCDA as skin sensitizer according to the Globally Harmonized System (GHS) was not justified. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Design, Fabrication, and Testing of Active Skin Antenna with 3D Printing Array Framework

    Directory of Open Access Journals (Sweden)

    Jinzhu Zhou

    2017-01-01

    Full Text Available An active skin antenna with structural load-bearing and electromagnetic functions is usually installed in the structural surface of mobile vehicles such as aircrafts, warships, and high-speed train. This paper presents the design, fabrication, and testing of a novel active skin antenna which consists of an encapsulation shell, antenna skin, and RF and beam control circuits. The antenna skin which consists of the facesheet, honeycomb, array framework, and microstrip antenna elements was designed by using Bayesian optimization, in order to improve the design efficiency. An active skin antenna prototype with 32 microstrip antenna elements was fabricated by using a hybrid manufacturing method. In this method, 3D printing technology was applied to fabricate the array framework, and the different layers were bonded to form the final antenna skin by using traditional composite process. Some experimental testing was conducted, and the testing results validate the feasibility the proposed antenna skin structure. The proposed design and fabrication technique is suitable for the development of conformal load-bearing antenna or smart skin antenna installed in the structural surface of aircraft, warships, and armored vehicles.

  16. Reactivation of tuberculosis during immunosuppressive treatment in a patient with a positive QuantiFERON-RD1 test

    DEFF Research Database (Denmark)

    Ravn, Pernille; Munk, Martin E; Andersen, Ase Bengaard

    2004-01-01

    A patient with polymyositis developed tuberculosis during immunosuppressive treatment. Tuberculin Skin Test and chest X-ray failed to demonstrate latent tuberculosis, whereas a blood sample that was tested with a modified QuantiFERON-TB-assay, using the recombinant ESAT-6 and CFP-10, was positive...

  17. A dataset on 145 chemicals tested in alternative assays for skin sensitization undergoing prevalidation.

    Science.gov (United States)

    Natsch, Andreas; Ryan, Cindy A; Foertsch, Leslie; Emter, Roger; Jaworska, Joanna; Gerberick, Frank; Kern, Petra

    2013-11-01

    Skin sensitization is a key endpoint for cosmetic ingredients, with a forthcoming ban for animal testing in Europe. Four alternative tests have so far been submitted to ECVAM prevalidation: (i) MUSST and (ii) h-Clat assess surface markers on dendritic cell lines, (iii) the direct peptide reactivity assay (DPRA) measures reactivity with model peptides and (iv) the KeratinoSens(TM) assay which is based on detection of Nrf2-induced luciferase. It is anticipated that only an integrated testing strategy (ITS) based on a battery of tests might give a full replacement providing also a sensitization potency assessment, but this concept should be tested with a data-driven analysis. Here we report a database on 145 chemicals reporting the quantitative endpoints measured in a U937- test, the DPRA and KeratinoSens(TM) . It can serve to develop data-driven ITS approaches as we show in a parallel paper and provides a view as to the current ability to predict with in vitro tests as we are entering 2013. It may also serve as reference database when benchmarking new molecules with in vitro based read-across and find use as a reference database when evaluating new tests. The tests and combinations thereof were evaluated for predictivity, and overall a similar predictivity was found as before on three-fold smaller datasets. Analysis of the dose-response parameters of the individual tests indicates a correlation to sensitization potency. Detailed analysis of chemicals false-negative and false-positive in two tests helped to define limitations in the tests but also in the database derived from animal studies. Copyright © 2013 John Wiley & Sons, Ltd.

  18. The Return of Delayed-Type Hypersensitivity Skin Testing for Coccidioidomycosis.

    Science.gov (United States)

    Wack, Elizabeth E; Ampel, Neil M; Sunenshine, Rebecca H; Galgiani, John N

    2015-09-01

    A skin test that detects dermal hypersensitivity in persons with past infection with Coccidioides species is again available for clinical use. Nearly all of the clinical studies with similar materials were published prior to the 1990s, and as a result, many practicing physicians will be unfamiliar with how skin testing for coccidioidomycosis might be useful in patient management or as a research tool. We review clinical and epidemiological studies with past skin test antigens, the composition of past and current skin test preparations with particular attention to differences in the preservatives, and how the current preparation could be used today. Published by Oxford University Press on behalf of the Infectious Diseases Society of America 2015. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  19. Reevaluating leishmanin skin test as a marker for immunity against cutaneous leishmaniasis.

    Science.gov (United States)

    Momeni Boroujeni, Amir; Aminjavaheri, Malih; Moshtaghian, Bahador; Momeni, Arash; Momeni, Ali Z

    2013-07-01

    The leishmanin skin test (LST) has been used for clinical diagnosis of leishmaniasis and epidemiological studies of the disease. Thus far, evidence has suggested that LST conversion indicates a degree of protection against leishmaniasis. In this study, we have put this assumption to test. A total of 273 participants with positive LST living in a hyperendemic area for leishmaniasis were followed for three years for any occurrence of cutaneous leishmaniasis. Twenty-two of the 273 participants contracted leishmaniasis during the 3-year follow-up. These new cases included participants who had a previous history of active disease, those who had a history of leishmanization, or those who were suspected of having a history of subclinical infection. In this study, the incidence of leishmaniasis in individuals with positive LST was close to the general incidence of the disease in the same hyperendemic area. These results suggest that although LST conversion may be a marker for partial immunity towards leishmaniasis, it may not, however, indicate complete protection against the disease, and consequently there is a need for revision of current vaccine development approaches which are based on rendering vaccinated individuals LST positive. © 2013 The International Society of Dermatology.

  20. 75 FR 47592 - Final Test Guideline; Product Performance of Skin-applied Insect Repellents of Insect and Other...

    Science.gov (United States)

    2010-08-06

    ... AGENCY Final Test Guideline; Product Performance of Skin-applied Insect Repellents of Insect and Other... Product Performance of Skin-applied Insect Repellents of Insect and Other Arthropods Test Guidelines... ``Product Performance of Skin-applied Insect Repellents of Insects and Other Arthropods'' (OPPTS Test...

  1. How Stress and Anxiety Can Alter Immediate and Late Phase Skin Test Responses in Allergic Rhinitis

    OpenAIRE

    Kiecolt-Glaser, Janice K.; Heffner, Kathi L.; Glaser, Ronald; Malarkey, William B.; Porter, Kyle; Atkinson, Cathie; Laskowski, Bryon; Lemeshow, Stanley; Marshall, Gailen D.

    2009-01-01

    Allergic rhinitis (AR) is the fifth most common chronic disease, and the association between allergic disorders and anxiety is well-documented. To investigate how anxiety and stressors modulate skin prick test (SPT) responses and associated inflammatory responses, 28 men and women with AR were selected by clinical history and skin test responses. The participants were admitted twice to a hospital research unit for 4 hours in a crossover trial. Changes in SPT wheals were assessed before and af...

  2. A guide to performing skin-prick testing in practice: tips and tricks of ...

    African Journals Online (AJOL)

    2013-04-16

    Apr 16, 2013 ... from 95-100%.3,4,6,7. Skin-prick tests are used to confirm a diagnosis of both .... A severe reaction to nuts, horse hair, latex or a food allergen ... Others: Relevant food allergens, e.g. cow's milk and egg, especially in young children. Table II: Drugs that may interfere with skin-prick testing. Drug. Withhold prior ...

  3. Age, sex and the association between skin test responses and IgE titres with asthma.

    Science.gov (United States)

    Mohammad, Hasan Raza; Belgrave, Danielle; Kopec Harding, Kamilla; Murray, Clare S; Simpson, Angela; Custovic, Adnan

    2016-05-01

    Skin prick tests (SPTs) and allergen-specific serum IgE (sIgE) measurements are the main diagnostic tools for confirming atopic sensitization. Results are usually reported as 'positive' or 'negative', using the same arbitrary cut-offs (SPT>3 mm, sIgE>0.35 kUA /l) across different ages and sexes. We investigated the influence of age and sex on the interpretation of allergy test in the context of childhood asthma. In a population-based birth cohort (n = 1051), we ascertained the information on asthma/wheeze (validated questionnaires) and performed SPTs and sIgE measurement to inhalant allergens (dust mite, cat, dog) at follow-ups between ages three and 11 years. We investigated the association between quantitative sensitization (sum of SPT mean wheal diameters [MWD] and sIgE titres to the three allergens) and current wheeze and asthma across ages and sexes. We observed a significant association between the SPT MWD and sIgE titres and wheeze/asthma at most ages and for both sexes. However, the strength of this association was age- and sex-dependent. For SPTs, the strength of the association between MWD and asthma increased with increasing age; we observed the opposite pattern for sIgE titre. For any given SPT MWD/sIgE titre, boys were significantly more likely to express clinical symptoms, particularly in early life; this difference between males and females diminished with age and was no longer significant by age 11 years. Age and sex should be taken into account when interpreting the results of skin tests and sIgE measurement, and age- and sex-specific normative data are needed for these allergy tests. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  4. [Practice patterns in Mexican allergologists about skin tests with allergens during 2005-2006].

    Science.gov (United States)

    Larenas Linnemann, Désirée; Fogelbach, Guillermo Arturo Guidos; Cruz, Alfredo Arias

    2008-01-01

    Immunotherapy has been practiced since over a hundred years. The exact composition of the immunotherapy concentrate, with which the patient is treated, depends partly on the results of the skin prick tests applied to the allergic patient. As such, the effectiveness of the immunotherapy depends heavily on the quality of the skin prick test. The detailed recommendations for the realization of the skin prick tests have evolved and changed over the years, leading to multiple variations in its application in Mexico. We tried to get a picture of the daily practice patterns of the members of CMICA and CoMPedIA concerning the application of skin prick tests. Aquestionnaire was sent in various occasions to all members of the Colegio Mexicano de Inmunologia Clinica y Alergia (CMICA) and of the Colegio Mexicano de Pediatras, Especialistas en Inmunologia y Alergia (CoMPedIA). The results are presented descriptively and by calculation of the frequency/percentages of intervals of replies, in the case of numerical responses. A response rate of 61 (17%) was obtained of the College members, showing consistency in some replies but a wide variation in others, for example in the time certain medication has to be suspended before the execution of the skin prick test. Comparing the replies obtained with recent recommendations in international publications, some discrepancy can be detected. In some aspects of the survey there is coincidence of the skin test practices among the participants; however, in other items there is an important variation.

  5. Equine Culicoides hypersensitivity: evaluation of a skin test and of humoral response.

    Science.gov (United States)

    Ferroglio, E; Pregel, P; Accossato, A; Taricco, I; Bollo, E; Rossi, L; Trisciuoglio, A

    2006-02-01

    Intradermal tests were carried out on 18 horses with clinical signs of Culicoides hypersensitivity (CHS) and 23 horses without clinical signs of CHS, and sera from these horses were analysed by SDS-PAGE and Western blotting (W-B). Intradermal injections of 0.1 ml of 25 microg/microl sterile Culicoides extract, 0.1 ml of 1:10,000 histamine (positive control) and 0.1 ml of physiological saline (negative control) were made in the dermis of the middle region of the neck. Analysis of reactions indicated that a 1 cm wheal and a skinfold thickness >10% at 24 h represented a valid cut-off between horses with and without CHS. In these conditions the test, even in winter when clinical signs were absent, had 100% sensitivity and specificity. The W-B was performed after running Culicoides extract on a 12% polyacrylamide gel. The test revealed the presence of several bands with molecular weight ranging from 6 to 200 kDa. In particular, a band of 65 kDa was predominantly found in hypersensitive horses by using an anti-IgE antibody while in normal horses the same band was mainly detected by using an anti-IgG antibody. Our results demonstrated that the skin test is a valid diagnostic test, with high sensitivity and specificity and that the band of about 65 kDa probably corresponds to the allergen involved in the pathogenesis of CHS.

  6. Immediate-type hypersensitivity reactions to proton pump inhibitors: usefulness of skin tests in the diagnosis and assessment of cross-reactivity.

    Science.gov (United States)

    Kepil Özdemir, S; Yılmaz, I; Aydin, Ö; Büyüköztürk, S; Gelincik, A; Demirtürk, M; Erdoğdu, D; Cömert, S; Erdoğan, T; Karakaya, G; Kalyoncu, A F; Oner Erkekol, F; Dursun, A B; Misirligil, Z; Bavbek, S

    2013-08-01

    Data are limited about the value of skin tests in the diagnosis of proton pump inhibitor (PPI)-induced hypersensitivity reactions and the cross-reactivity between PPIs. We aimed to assess the role of skin testing in the diagnosis of PPI-related immediate hypersensitivity reactions and the cross-reactivity patterns among PPIs. The study was designed in a prospective, national, multicentre nature. Sixty-five patients with a suggestive history of a PPI-induced immediate hypersensitivity reaction and 30 control subjects were included. Standardized skin prick and intradermal tests were carried out with a panel of PPIs. Single-blind, placebo-controlled oral provocation tests (OPTs) with the PPIs other than the culprit PPI that displayed negative results in skin tests (n = 61) and diagnostic OPTs with the suspected PPI (n = 12) were performed. The suspected PPIs were lansoprazole (n = 52), esomeprazole (n = 11), pantoprazole (n = 9), rabeprazole (n = 2), and omeprazole (n = 1). The sensitivity, specificity, and negative and positive predictive values of the skin tests with PPIs were 58.8%, 100%, 70.8%, and 100%, respectively. Fifteen of the 31 patients with a hypersensitivity reaction to lansoprazole had a positive OPT or skin test result with at least one of the alternative PPIs (8/52 pantoprazole, 6/52 omeprazole, 5/52 esomeprazole, 3/52 rabeprazole). Considering the high specificity, skin testing seems to be a useful method for the diagnosis of immediate-type hypersensitivity reactions to PPIs and for the evaluation of cross-reactivity among PPIs. However, OPT should be performed in case of negativity on skin tests. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  7. Correlation between symptoms of the irritable bowel syndrome and the response to the food extract skin prick test

    Directory of Open Access Journals (Sweden)

    R.L.S. Soares

    2004-05-01

    Full Text Available The relationship between the irritable bowel syndrome (IBS and food intolerance is not clear. We studied the cutaneous response to food antigens in 43 volunteers who were students and employees of the Faculty of Medicine of Universidade Federal Fluminense. Subjects were divided into 3 groups after evaluation for Roma II criteria for functional disease of the gastrointestinal tract: group I, 14 volunteers with IBS; group II, 15 volunteers with functional dyspepsia; group III, 14 volunteers without habitual gastrointestinal symptoms. The subjects were submitted to the skin prick test with 9 food antigen extracts, for a total of 387 skin tests (9 per volunteer. Of the 126 tests applied to group I, 24 (19.4% were positive (a 3-mm wider papule than the negative control and of the 135 tests applied to group II, 3 (2.3% were positive. Of the 126 tests applied to group III, 6 (4% were positive. The number of positive responses obtained in group I (IBS differed significantly from the other 2 groups (P < 0.01. None of the volunteers with IBS reported intolerance to any isolated food. The higher reactivity to food antigens in group I compared to groups II and III suggests that intestinal permeability may be increased in patients with IBS.

  8. The effect of montelukast on wheal reactions in skin prick tests: a double-blind-placebo-controlled randomized trial.

    Science.gov (United States)

    Bulan, Keziban; Aydogan, Metin; Siraneci, Rengin; Aydogmus, Cigdem Yilmaz

    2013-10-01

    It is well-known that number of drugs may interfere with wheal reactions in skin prick test. However, the effect of long-term use of montelukast, a cystenil leukotriene receptor antagonist, on skin prick test hasn't been full elucidated. The aim of present study was to demonstrate the effect of montelukast on skin prick tests (SPT). This is a single-center, randomized, double-blinded, placebo-controlled study including two treatment periods with a wash-out interval. The subjects received montelukast (5 mg per day), fexofenadine HCl (60 mg per day) and placebo (lactose) with a double-blinded manner during 7- and 21-days treatment periods with a 14 days wash-out period. Dermatophagoides farinae (D. farinae) was used as the skin test material, while histamine as positive control and normal saline as negative control. Overall, 7 skin prick tests were performed at following time points: before treatment periods, on the last days of both treatment periods, 24 h after completion of treatment periods, and on the last day of 14-days interval. Sixty house dust mite (HDM) allergic children (23 girls and 37 boys) with allergic rhinitis and/or asthma completed the study. Mean age was 8.3 ± 2.0 years. In the fexofenadine group, a significant suppression was observed in post-treatment values when compared to baseline values in SPT with D. farinae (p = 0.019). In the montelukast group, no significant suppression was observed in SPT with D. farinae at all time points when compared to baseline. Our results showed that montelukast had no effect on measurements of SPT. Thus, we concluded that there is no need to discontinue the treatment in order to perform SPT in patients receiving montelukast, even in those on montelukast treatment for at least 21 days. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  9. Causes of false-positive HIV rapid diagnostic test results.

    Science.gov (United States)

    Klarkowski, Derryck; O'Brien, Daniel P; Shanks, Leslie; Singh, Kasha P

    2014-01-01

    HIV rapid diagnostic tests have enabled widespread implementation of HIV programs in resource-limited settings. If the tests used in the diagnostic algorithm are susceptible to the same cause for false positivity, a false-positive diagnosis may result in devastating consequences. In resource-limited settings, the lack of routine confirmatory testing, compounded by incorrect interpretation of weak positive test lines and use of tie-breaker algorithms, can leave a false-positive diagnosis undetected. We propose that heightened CD5+ and early B-lymphocyte response polyclonal cross-reactivity are a major cause of HIV false positivity in certain settings; thus, test performance may vary significantly in different geographical areas and populations. There is an urgent need for policy makers to recognize that HIV rapid diagnostic tests are screening tests and mandate confirmatory testing before reporting an HIV-positive result. In addition, weak positive results should not be recognized as valid except in the screening of blood donors.

  10. Suitability of skin integrity tests for dermal absorption studies in vitro.

    Science.gov (United States)

    Guth, Katharina; Schäfer-Korting, Monika; Fabian, Eric; Landsiedel, Robert; van Ravenzwaay, Ben

    2015-02-01

    Skin absorption testing in vitro is a regulatory accepted alternative method (OECD Guideline 428). Different tests can be applied to evaluate the integrity of the skin samples. Here, we compared the pre- or post-run integrity tests (transepidermal electrical resistance, TEER; transepidermal water loss, TEWL; absorption of the reference compounds water, TWF, or methylene blue, BLUE) and additionally focused on co-absorption of a (3)H-labeled internal reference standard (ISTD) as integrity parameter. The results were correlated to absorption profiles of various test compounds. Limit values of 2kΩ, 10 gm(-2)h(-1) and 4.5∗10(-3)cmh(-1) for the standard methods TEER, TEWL and TWF, respectively, allowed distinguishing between impaired and intact human skin samples in general. Single skin samples did, however, not, poorly and even inversely correlate with the test-compound absorption. In contrast, results with ISTD (e.g. (3)H-testosterone) were highly correlated to the absorption of (14)C-labeled test compounds. Importantly, ISTD did not influence analytics or absorption of test compounds. Therefore, ISTD, especially when adjusted to the physico-chemical properties of test compounds, is a promising concept to assess the integrity of skin samples during the whole course of absorption experiments. However, a historical control dataset is yet necessary for a potential routine application. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  11. Seeking health information on the web: positive hypothesis testing.

    Science.gov (United States)

    Kayhan, Varol Onur

    2013-04-01

    The goal of this study is to investigate positive hypothesis testing among consumers of health information when they search the Web. After demonstrating the extent of positive hypothesis testing using Experiment 1, we conduct Experiment 2 to test the effectiveness of two debiasing techniques. A total of 60 undergraduate students searched a tightly controlled online database developed by the authors to test the validity of a hypothesis. The database had four abstracts that confirmed the hypothesis and three abstracts that disconfirmed it. Findings of Experiment 1 showed that majority of participants (85%) exhibited positive hypothesis testing. In Experiment 2, we found that the recommendation technique was not effective in reducing positive hypothesis testing since none of the participants assigned to this server could retrieve disconfirming evidence. Experiment 2 also showed that the incorporation technique successfully reduced positive hypothesis testing since 75% of the participants could retrieve disconfirming evidence. Positive hypothesis testing on the Web is an understudied topic. More studies are needed to validate the effectiveness of the debiasing techniques discussed in this study and develop new techniques. Search engine developers should consider developing new options for users so that both confirming and disconfirming evidence can be presented in search results as users test hypotheses using search engines. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  12. Seborrheic inclusion cyst of the skin positive for cytoplasmic inclusion bodies and HPV antigen.

    Science.gov (United States)

    Terada, Tadashi

    2012-01-01

    Seborrheic inclusion cyst (SIC) is a very rare variant of epidermal cyst of the skin. SIC shows seborrheic keratosis (SK)-like lesion in epidermal cyst. SIC is extremely rare; only 6 case reports have been published in the English literature. However, no immunohistochemical study of SIC has been reported. A 41-year-old Japanese man noticed a subcutaneous tumor in the neck. Physical examination showed slightly mobile tumor in the subcutaneous tissue, and total excision was performed. Grossly, the tumor (1 x 1 x 0.8 cm) was cyst containing atheromatous keratin. Microscopically, the lesion is a cyst containing keratins. About one half of the cyst showed features of epidermal cyst consisting of mature squamous epithelium with granular layers. The other one half showed SK-like epidermal proliferation. The SK-like area showed basaloid cell proliferation with pseudohorn cysts. No significant atypia was noted. Many eosinophilic cytoplasmic inclusion bodies were noted in the SK-like area. Immunohistochemically, the SK-like area was positive for pancytokeratin AE1/3, pancytokeratin CAM5.2, p63, and Ki-67 (labeling=8%) and HPV, but negative for p53. The pathological diagnosis was SIC.

  13. Construction of Tests in the Cognitive and Psychomotor Domains for Skin and Scuba Diving.

    Science.gov (United States)

    McCarthy, Jean

    The fundamental purposes of this study were to develop mastery tests in the cognitive and psychomotor domains for skin and scuba diving and to establish validity and reliability for the tests. A table of specifications was developed for each domain, and a pilot study refined the initial test batteries into their final form. In the main study,…

  14. Accounting for False Positive HIV Tests: Is Visceral Leishmaniasis Responsible?

    Directory of Open Access Journals (Sweden)

    Leslie Shanks

    Full Text Available Co-infection with HIV and visceral leishmaniasis is an important consideration in treatment of either disease in endemic areas. Diagnosis of HIV in resource-limited settings relies on rapid diagnostic tests used together in an algorithm. A limitation of the HIV diagnostic algorithm is that it is vulnerable to falsely positive reactions due to cross reactivity. It has been postulated that visceral leishmaniasis (VL infection can increase this risk of false positive HIV results. This cross sectional study compared the risk of false positive HIV results in VL patients with non-VL individuals.Participants were recruited from 2 sites in Ethiopia. The Ethiopian algorithm of a tiebreaker using 3 rapid diagnostic tests (RDTs was used to test for HIV. The gold standard test was the Western Blot, with indeterminate results resolved by PCR testing. Every RDT screen positive individual was included for testing with the gold standard along with 10% of all negatives. The final analysis included 89 VL and 405 non-VL patients. HIV prevalence was found to be 12.8% (47/ 367 in the VL group compared to 7.9% (200/2526 in the non-VL group. The RDT algorithm in the VL group yielded 47 positives, 4 false positives, and 38 negatives. The same algorithm for those without VL had 200 positives, 14 false positives, and 191 negatives. Specificity and positive predictive value for the group with VL was less than the non-VL group; however, the difference was not found to be significant (p = 0.52 and p = 0.76, respectively.The test algorithm yielded a high number of HIV false positive results. However, we were unable to demonstrate a significant difference between groups with and without VL disease. This suggests that the presence of endemic visceral leishmaniasis alone cannot account for the high number of false positive HIV results in our study.

  15. Accounting for False Positive HIV Tests: Is Visceral Leishmaniasis Responsible?

    Science.gov (United States)

    Shanks, Leslie; Ritmeijer, Koert; Piriou, Erwan; Siddiqui, M Ruby; Kliescikova, Jarmila; Pearce, Neil; Ariti, Cono; Muluneh, Libsework; Masiga, Johnson; Abebe, Almaz

    2015-01-01

    Co-infection with HIV and visceral leishmaniasis is an important consideration in treatment of either disease in endemic areas. Diagnosis of HIV in resource-limited settings relies on rapid diagnostic tests used together in an algorithm. A limitation of the HIV diagnostic algorithm is that it is vulnerable to falsely positive reactions due to cross reactivity. It has been postulated that visceral leishmaniasis (VL) infection can increase this risk of false positive HIV results. This cross sectional study compared the risk of false positive HIV results in VL patients with non-VL individuals. Participants were recruited from 2 sites in Ethiopia. The Ethiopian algorithm of a tiebreaker using 3 rapid diagnostic tests (RDTs) was used to test for HIV. The gold standard test was the Western Blot, with indeterminate results resolved by PCR testing. Every RDT screen positive individual was included for testing with the gold standard along with 10% of all negatives. The final analysis included 89 VL and 405 non-VL patients. HIV prevalence was found to be 12.8% (47/ 367) in the VL group compared to 7.9% (200/2526) in the non-VL group. The RDT algorithm in the VL group yielded 47 positives, 4 false positives, and 38 negatives. The same algorithm for those without VL had 200 positives, 14 false positives, and 191 negatives. Specificity and positive predictive value for the group with VL was less than the non-VL group; however, the difference was not found to be significant (p = 0.52 and p = 0.76, respectively). The test algorithm yielded a high number of HIV false positive results. However, we were unable to demonstrate a significant difference between groups with and without VL disease. This suggests that the presence of endemic visceral leishmaniasis alone cannot account for the high number of false positive HIV results in our study.

  16. Integrating non-animal test information into an adaptive testing strategy - skin sensitization proof of concept case.

    Science.gov (United States)

    Jaworska, Joanna; Harol, Artsiom; Kern, Petra S; Gerberick, G Frank

    2011-01-01

    There is an urgent need to develop data integration and testing strategy frameworks allowing interpretation of results from animal alternative test batteries. To this end, we developed a Bayesian Network Integrated Testing Strategy (BN ITS) with the goal to estimate skin sensitization hazard as a test case of previously developed concepts (Jaworska et al., 2010). The BN ITS combines in silico, in chemico, and in vitro data related to skin penetration, peptide reactivity, and dendritic cell activation, and guides testing strategy by Value of Information (VoI). The approach offers novel insights into testing strategies: there is no one best testing strategy, but the optimal sequence of tests depends on information at hand, and is chemical-specific. Thus, a single generic set of tests as a replacement strategy is unlikely to be most effective. BN ITS offers the possibility of evaluating the impact of generating additional data on the target information uncertainty reduction before testing is commenced.

  17. Methodologic aspects of the quantification of skin prick test responses: the EGEA study.

    Science.gov (United States)

    Maccario, Jean; Oryszczyn, Marie-Pierre; Charpin, Denis; Kauffmann, Francine

    2003-04-01

    The expression of responses of allergy skin prick tests is not standardized. Usual definitions of atopy are not quantitative. We sought to perform a biometric analysis of responses to various allergens to propose synthetic, quantitative indices independent of the heterogeneity of responses to various allergens. Adults (N = 1286) from the Epidemiological Study on the Genetics and Environment of Asthma, Bronchial Hyperresponsiveness, and Atopy (EGEA) were included in the analysis. The first step, conducted for 678 subjects with at least 1 wheal >0, was to perform a standardization of wheal diameters to obtain comparable figures for 10 allergens through use of the means of the squares of wheal size as a scaling factor. The second step was a factor analysis of the standardized responses conducted not only for all subjects but also separately for asthmatic case and nonasthmatic control subjects. Finally, the strength of the link between various dichotomous and quantitative scores was assessed with multiRAST, total IgE, and asthma. Analyzed quantitative scores were based on the number of positive responses and on the nonstandardized and standardized sizes of the wheals. The standardization was efficient. Among asthmatic subjects but not other subjects, factor analysis evidenced a pattern with 3 factors, corresponding to outdoor, indoor, and mold allergens. The link study showed that all scores performed very similarly. The number of positive tests is a quantitative score with valid biometric properties. It should be used more widely in clinical settings and in epidemiology to assess the severity of atopy.

  18. The Lancet Weight Determines Wheal Diameter in Response to Skin Prick Testing with Histamine.

    Science.gov (United States)

    Andersen, Hjalte H; Lundgaard, Anna Charlotte; Petersen, Anne S; Hauberg, Lise E; Sharma, Neha; Hansen, Sofie D; Elberling, Jesper; Arendt-Nielsen, Lars

    2016-01-01

    Skin prick test (SPT) is a common test for diagnosing immunoglobulin E-mediated allergies. In clinical routine, technicalities, human errors or patient-related biases, occasionally results in suboptimal diagnosis of sensitization. Although not previously assessed qualitatively, lancet weight is hypothesized to be important when performing SPT to minimize the frequency of false positives, false negatives, and unwanted discomfort. Accurate weight-controlled SPT was performed on the volar forearms and backs of 20 healthy subjects. Four predetermined lancet weights were applied (25 g, 85 g, 135 g and 265 g) using two positive control histamine solutions (1 mg/mL and 10 mg/mL) and one negative control (saline). A total of 400 SPTs were conducted. The outcome parameters were: wheal size, neurogenic inflammation (measured by superficial blood perfusion), frequency of bleeding, and the lancet provoked pain response. The mean wheal diameter increased significantly as higher weights were applied to the SPT lancet, e.g. from 3.2 ± 0.28 mm at 25 g to 5.4 ± 1.7 mm at 265 g (presponse increased significantly. At 265 g saline evoked two wheal responses (/160 pricks) below 3 mm. The applied weight of the lancet during the SPT-procedure is an important factor. Higher lancet weights precipitate significantly larger wheal reactions with potential diagnostic implications. This warrants additional research of the optimal lancet weight in relation to SPT-guidelines to improve the specificity and sensitivity of the procedure.

  19. Social problems of indeterminate and false positive HIV test results ...

    African Journals Online (AJOL)

    Increased availability of Human Immunodeficiency Virus (HIV) screening test and more public enlightenment have resulted in more people coming forward to access counseling and testing at the HIV counseling and testing centers in Nigeria. Some of the clients however obtained indeterminate and false positive results ...

  20. Development of a standardized testing procedure for assessing the irritation potential of occupational skin cleansers.

    Science.gov (United States)

    Elsner, Peter; Seyfarth, Florian; Antonov, Dimitar; John, Swen Malte; Diepgen, Thomas; Schliemann, Sibylle

    2014-03-01

    Frequent skin cleaning fulfils the definition of occupational 'wet work'. Standardized methods are required to assess the irritation potential of workplace cleansers. To develop a standardized procedure for testing the irritation potential of occupational skin cleansers. In this single-blind, single-centre trial in 25 healthy volunteers, the irritation potential of five generic reference cleansers was tested by three-times-daily washing with an automated skin cleaning device for 4 days, and quantification of cumulative skin barrier damage was performed by visual scoring, chromametry, transepidermal water loss TEWL, and corneometry. For two cleansers, reproducibility of the irritancy assessment was assessed. Furthermore, the irritation induced by four commercial workplace skin cleansers was studied. Whereas no significant changes were observed for any of the tested cleansers by either visual scoring or chromametry, significant increases in TEWL and significant decreases in stratum corneum hydration were found for all cleansers. Cleansers differed significantly in their irritation potential. On retesting of two cleansers, the first results were confirmed. Among the four commercial cleansers, one that was claimed to be mild was found to be disproportionally irritant. The presented model for testing cleansing preparations allows a highly controlled, practically relevant and reproducible irritancy assessment of occupational skin cleansers. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  1. Thermographic assessment of skin prick tests in comparison with the routine evaluation methods

    Directory of Open Access Journals (Sweden)

    Tomasz Rok

    2016-06-01

    Full Text Available Introduction :Theskin prick test is still the first and basic procedure in the diagnosis of allergic diseases. The possibility of using a sensitive thermographic method supported by the mathematical model for the assessment of skin test results will be highlighted in the studies. Aim :To compare the proposed approach with routine planimetric and thermographic methods. Material and methods: A mathematical model of allergic reaction was developedSimplifying assumptions of the IgE-mediated skin reaction is the essence of the model. Investigations were performed in a group of 40 patients. Results: Using the spatio-temporal evolution of temperature distributions, the ratios of the histamine released from mast cells to the control histamine were determined. The obtained values very well correlate with the standard evaluation of skin prick tests (correlation coefficient = 0.98. Conclusions : The proposed method of skin test evaluation presents several advantages. The continuous acquisition of data provides the monitoring of time course of the allergic response. The transport of mediator and its concentration were distinctly discriminated, which may be diagnostically useful, especially for abnormal cases. The high sensitivity of the method enables studying patients regardless of age and skin sensitivity.

  2. Factors associated with negative histamine control for penicillin allergy skin testing in the inpatient setting.

    Science.gov (United States)

    Geng, Bob; Thakor, Ami; Clayton, Elisabeth; Finkas, Lindsay; Riedl, Marc A

    2015-07-01

    Identification of factors adversely affecting the utility of allergy skin testing is important in optimizing patient care. Inpatient penicillin skin test data from 1997 through 2007 demonstrate that up to 20% of attempted penicillin skin tests are indeterminate owing to a negative histamine test response, despite exclusion of H1 antagonists. Critical illness, vasopressors, steroid use, and psychotropic medications have been postulated to influence outcomes, but large studies are lacking. To identify factors associated with a negative histamine test response for the inpatient setting. Fifty-two cases were identified with a negative histamine response after penicillin skin testing in the absence of antihistamine therapy for 72 hours before testing. One hundred twenty-five controls with a normal histamine response were randomly selected from same population. Independent variables assessed included stay in the intensive care unit (ICU), skin color, diabetes, age, use of vasopressors, H2 blocker, steroids, other immunosuppressive drugs, thyroid replacement, proton pump inhibitors, diuretics, 5 categories of psychotropic medications, and amiodarone. Mean age was 68 years for cases vs 60 years for controls (P = .002). Bivariate analysis showed ICU stay was more frequent in cases than in controls (73.1% vs 33.6%, P Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  3. Risk factors for positive tuberculin tests in children

    Directory of Open Access Journals (Sweden)

    Purnomo Sidhi

    2011-12-01

    Full Text Available Background Tuberculosis (TB is a chronic infectious disease and a public health problem. The World Health Organization (WHO declared TB to be a global emergency because of currently increasing rates of disease and drug resistance. Two million people die annually because of TB. Children are one of the highest groups at risk for TB infection. An effort to define risk factors is needed for effective intervention. Objective To identify risk factors for positive tuberculin tests in children. Methods This case control study was done in elementary school children aged 8–12 years in areas served by three community health centers in Semarang. Twenty-nine subjects were Mantoux positive and 29 others served as controls. Consecutive sampling was used for all negative Mantoux test results. Pulmonary TB was diagnosed using the TB scoring system, including the Mantoux test. Statistical bivariate and multivariate analyses were performed. Results History of household TB contact as a risk factor for positive tuberculin test in children resulted in an OROR of 3.76 (95% CI 1.059 to 13.342, P=0.040. History of illness at the time of testing resulted in an OR of 10.23 (95% CI 1.138 to 91.930, P=0.038. The probability of positive tuberculin testing was 90.7% if both these variables were positive. Conclusion History of household TB contact and the history of illness at the time of testing were risk factors for positive tuberculin tests in children.

  4. Surfactant-induced dermatitis: comparison of corneosurfametry with predictive testing on human and reconstructed skin.

    Science.gov (United States)

    Piérard, G E; Goffin, V; Hermanns-Lê, T; Arrese, J E; Piérard-Franchimont, C

    1995-09-01

    Surfactants elicit alterations in the stratum corneum. Predictive tests that avoid animal experimentation are needed. This study compares three methods of rating and predicting shampoo-induced irritation. Corneosurfametry entails collection of stratum corneum followed by brief contact with diluted surfactants and measurement of variations in staining of samples. Corneosurfametry appears to correlate well with in vivo testing in volunteers with sensitive skin. However, corneosurfametry presents less interindividual variability than in vivo testing and allows better discrimination among mild products. Morphologic information about surfactant-induced loosening of corneocytes may be increased by testing surfactants on human skin equivalent. Results are similar to those provided by specimens used for corneosurfametry. The corneosurfametric prediction of surfactant irritancy correlates with in vivo testing and with in vitro evaluation on human skin equivalent.

  5. Dermatoscopy versus Tzanck smear test: a comparison of the value of two tests in the diagnosis of pigmented skin lesions.

    Science.gov (United States)

    Durdu, Murat; Baba, Mete; Seçkin, Deniz

    2011-11-01

    Dermatoscopy is the most commonly used noninvasive tool for the diagnosis of pigmented skin lesions, but few studies have investigated the value of cytology in the identification of those lesions. We compared the accuracy of dermatoscopy with that of the Tzanck smear test in the diagnosis of pigmented skin lesions, and in differentiating melanocytic from nonmelanocytic lesions. Two dermatologists used either dermatoscopy or the Tzanck smear test to evaluate pigmented skin lesions, and the diagnostic accuracy of those methods was determined. Two hundred pigmented skin lesions (110 melanocytic and 90 nonmelanocytic) were evaluated. Cytology was superior to dermatoscopy in differentiating melanocytic pigmented lesions from nonmelanocytic pigmented lesions, but the overall diagnostic accuracy of those methods was the same (90.5%) for all lesions. The diagnostic accuracy of the Tzanck smear test was higher than that of dermatoscopy for both melanocytic and nonmelanocytic malignant pigmented lesions; however, those differences were not significant. Pigmented skin lesions were not evaluated by a dermatologist who used a combination of dermatoscopy and the Tzanck smear test. No conclusion was made about the reliability of those two methods or whether the experience of the dermatologist affected the results. Immunohistochemical staining of the cytologic samples was not performed. The diagnostic accuracy of the Tzanck smear test in assessing pigmented skin lesions is similar to that of dermatoscopy. The Tzanck smear test may be a useful diagnostic adjunct to dermatoscopy for determining the melanocytic or nonmelanocytic origin of certain pigmented skin lesions. Copyright © 2010 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

  6. Effect of testing position on dynamic visual acuity.

    Science.gov (United States)

    Danenbaum, Elizabeth; Chilingaryan, Gevorg; Fung, Joyce

    2008-12-01

    To investigate the effect of altering testing position on dynamic visual acuity (DVA) in vestibulopathic adults. Quasiexperimental research. Outpatient vestibular program. Twelve vestibulopathic adults with impaired DVA in the sitting position. DVA scores were collected during (1) sitting, (2) standing comfortably, and (3) semitandem standing as subjects viewed a vision (E) chart 3.48 m in front of them. DVA was obtained as the head was passively moved by the evaluator at a frequency of 1.5 Hz in both horizontal and vertical directions. A further subgroup of subjects (n=5) was retested after performing the "viewing x1" gaze stability home exercise four times daily (1 minute duration in the horizontal direction while sitting) for 2 months. Noncomputerized DVA score. The DVA score remained constant independent of testing position as the Friedman test did not reveal any significant differences in the DVA scores in the horizontal or vertical direction. Subjects who improved after performing the viewing x1 exercise in the horizontal direction in the sitting position tended to have the same improvement in DVA in all three positions. The results of this study show that DVA score is independent of testing position. This is clinically important since it shows that the results of DVA testing in one position are valid for other positions and that subjects can be trained to improve their DVA in a sitting posture while having carry-over effects to other, more challenging postures.

  7. Use of the complement fixation and brucellin skin tests to identify cattle vaccinated with Brucella abortus strain RB51.

    Science.gov (United States)

    De Massis, F; Giovannini, A; Di Emidio, B; Ronchi, G F; Tittarelli, M; Di Giannatale, E; Di Ventura, M; Nannini, D; Caporale, V

    2005-01-01

    In the European Union, RB51 vaccine can be used only under strictly controlled conditions for the immunisation of cattle at risk of infection with Brucella abortus. A test is therefore necessary to distinguish vaccinated from unvaccinated animals. The complement fixation test with RB51 antigen (RB51-CFT), dot-blot and gamma-interferon used to identify vaccinated animals have been described, but sensitivity of the tests has been poor and positivity transient after calfhood vaccination. To avail of a rapid and accurate diagnostic tool, the authors produced, controlled and evaluated an experimental brucellin prepared from strain RB51 (RB51 brucellin). The potency of this brucellin was evaluated in guinea-pigs sensitised with RB51 and compared with a commercially available brucellin. Both allergens produced similar biological activity in guinea-pigs. The RB51 brucellin skin test was performed in 10 cattle 414 days after calfhood vaccination with RB51 when they were negative to the RB51-CFT. The skin test revealed 60% sensitivity (with a confidence interval of 95%, CI 30.8%-83.3%) and 100% specificity (CI 60.7%-100%). These findings limit the use of the skin test only for screening to detect RB51 vaccinated herds, not individual animals. Nevertheless, following intradermal inoculation of RB51 brucellin, a transient antibody increase to the RB51-CFT was observed, from day 9 to day 20 post inoculation with RB51 brucellin. This transient antibody increase, when evaluated in parallel with the RB51 brucellin skin test results, enables detection of individual vaccinated animals (sensitivity 100%; CI 76.2%-100%).

  8. Oral food challenge: safety, adherence to guidelines and predictive value of skin prick testing.

    Science.gov (United States)

    Calvani, Mauro; Berti, Irene; Fiocchi, Alessandro; Galli, Elena; Giorgio, Valentina; Martelli, Alberto; Miceli Sopo, Stefano; Panetta, Valentina

    2012-12-01

    The diagnostic gold standard of food allergy is the oral food challenge (OFC). Data on severe reactions and drug use during OFC are scarce. Our aims were (i) to investigate the prevalence and spectrum of reactions' severity during OFC and to assess drug use and epinephrine use in anaphylaxis due to OFC; (ii) to investigate the predictive value of the skin prick test wheal size for the outcome of OFCs. A retrospective charts review of children undergoing OFC at three Allergy Centres between January 2007 and December 2008 was performed. A total of 544 OFCs were analysed. Most frequently involved foods were egg, milk and wheat. 254/526 (48.3%) were positive. 167 (65.7%) were defined mild reactions, 81 (31.9%) multiorgan reactions and 6 (2.4%) anaphylaxis. No patients had cardiovascular symptoms. Data on treatments were available in 98.8% OFCs. In half of them antihistamines were used vs. 10% cases in which steroids were preferred. Six children (2.4%) were treated with Epinephrine inhalation, 5 (2%) with beta-2 inhalation, 8 (3.1%) with steroid inhalation. One child was treated with IM Epinephrine + IV fluids. Skin prick tests predictive cut-off were 9 mm for albumen, 7 for yolk, 13 for fresh albumen, 10 for α-lactalbumin, seven for casein, eight for β-lactoglobulin, 20 for cow's milk and 10 for fresh cow's milk. OFCs performed in controlled settings by expert Allergists are safe. Consideration needs to be given as to whether the Anaphylaxis' Guideline need to be modified when applied in treating patients undergoing OFC. © 2012 John Wiley & Sons A/S.

  9. Relevance of cat and dog sensitization by skin prick testing in childhood eczema and asthma.

    Science.gov (United States)

    Hon, Kam Lun E Lun; Tsang, Kathy Yin Ching; Leung, Ting Fan

    2017-06-14

    Household animal dander has been implicated as aeroallergen in childhood atopic diseases. Many parents seek healthcare advice if household pet keeping may be detrimental in atopic eczema (AE) and atopies. We investigated if skin sensitization by cat/dog dander was associated with disease severity and quality of life in children with AE. Demographics, skin prick test (SPT) results, disease severity (Nottingham eczema severity score NESS), Children Dermatology Life Quality Index (CDLQI), blood IgE and eosinophil counts of a cohort of AE patients were reviewed. 325 AE patients followed at a pediatric dermatology clinic were evaluated. Personal history of asthma was lowest (20%) in the dog-dander-positive-group but highest (61%) in both-cat-and-dog-dander-positive group (p=0.007). Unlike dust mite or food sensitization, the incidence of cat or dog sensitization was low. Binomial logistic regression ascertained that cat-dander sensitization was associated with increasing age (adjusted odds ratio [aOR], 1.056; 95% Confidence Interval [CI], 1.006 to 1.109; p=0.029), dust-mite sensitization (aOR, 4.625; 95% CI, 1.444 to 14.815; p=0.010), food-allergen sensitization (aOR, 2.330; 95% CI, 1.259 to 4.310; p=0.007) and keeping-cat-ever (aOR, 7.325; 95% CI, 1.193 to 44.971; p=0.032); whereas dog-dander sensitization was associated with dust-mite sensitization (aOR, 9.091; 95% CI, 1.148 to 71.980; p=0.037), food-allergen sensitization (aOR, 3.568; 95% CI, 1.341 to 9.492; p=0.011) and keeping-dog-ever (aOR, 6.809; 95% CI, 2.179 to 21.281; p=0.001). However, neither cat nor dog sensitization were associated with asthma, allergic rhinitis, parental or sibling atopic status, disease severity or quality of life. Physicians should advise parents that there is no direct correlation between AE severity, quality of life, asthma or allergic rhinitis with skin sensitization to cats or dogs. Sensitized patients especially those with concomitant asthma and severe symptoms may consider non

  10. Practical guide to skin prick tests in allergy to aeroallergens

    DEFF Research Database (Denmark)

    Bousquet, J; Heinzerling, L; Bachert, C

    2012-01-01

    in the management of allergic diseases. It is not a long or detailed scientific review of the topic. However, the recommendations in this pocket guide were compiled following an in-depth review of existing guidelines and publications, including the 1993 European Academy of Allergy and Clinical Immunology position...

  11. A retrospective comparison of false negative skin test rates in penicillin allergy, using pencilloyl-poly-lysine and minor determinants or Penicillin G, followed by open challenge.

    Science.gov (United States)

    Rosenfield, Lana; Kalicinsky, Chrystyna; Warrington, Richard

    2015-01-01

    A history of penicillin allergy in patients is common, but only 10-15 % are truly allergic. While the gold standard for diagnosing penicillin allergy is challenge, it is not recommended that this be done without first carrying out diagnostic skin testing. This is carried out with the major determinant benzylpenicilloyl (PPL) and the minor determinant mixture (MDM), consisting of penilloate, penicilloate and Penicillin G. However, since availability of the MDM is limited, Penicillin G alone has been used. A retrospective chart review was carried out on patients tested for penicillin allergy in the Clinical Immunology and Allergy Clinic at the Health Sciences Centre, Winnipeg, Canada between 2005 and 2013. A total of 521 patients charts were reviewed, of whom 240 had skin testing, ImmunoCap(®) for IgE to Penicillin G and V and had oral challenges with penicillin, amoxicillin or cloxacillin. 17/240 (7.5 %) were skin test positive, 8 to PPL, 4 to MDM and 5 to Penicillin G. One was also positive on ImmunoCap(®) testing. Three patients had negative skin tests but weakly positive ImmunoCap(®). 222 patients with negative skin tests and serological tests were challenged. Of these, 12 patients reacted to challenge. Three of the challenges were equivocal. Of the nine patients with definite positive challenges, three were tested with Penicillin G and six with MDM. Therefore the false negative rates for testing were 2.3 % with PPL and Penicillin G and 6.97 % for PPL and MDM. The difference was not significant (p = 0.0856). In this group of patients with a history of penicillin allergy tested with the major determinant of benzyl penicillin and either MDM or Penicillin G, there was no difference in the rate of false negative testing, based on oral penicillin challenges. Therefore, Penicillin G can be safely used as an alternative to MDM in diagnosing penicillin allergy.

  12. False-positive Human Papillomavirus DNA tests in cervical screening

    DEFF Research Database (Denmark)

    Rebolj, Matejka; Pribac, Igor; Lynge, Elsebeth

    2011-01-01

    Based on data from randomised controlled trials (RCT) on primary cervical screening, it has been reported that the problem of more frequent false-positive tests in Human Papillomavirus (HPV) DNA screening compared to cytology could be overcome. However, these reports predominantly operated with a...... with a narrow definition of a (false-)positive test. The aim of this paper was to illustrate how the narrow definition affected the measured adverse effects of HPV DNA screening compared with cytology screening....

  13. Evaluation of a multiple food specific IgE antibody test compared to parental perception, allergy skin tests and RAST.

    Science.gov (United States)

    Adler, B R; Assadullahi, T; Warner, J A; Warner, J O

    1991-11-01

    This study was set up to evaluate the food panel of a multiple specific IgE antibody assay in 67 atopic asthmatic children by comparing it to the conventional radioallergosorbent test (RAST) and skin-prick tests (SPT) and then comparing the results of these investigations with the parents' perceptions of food related problems. Fifteen food specific IgE antibodies were measured using the multiple chemiluminescence assay (MAST-CLA). IgE antibodies to five of these food allergens were also measured by conventional RAST and SPTs were performed in 43 using 11 standardized food extracts matched to the multiple allergosorbent chemiluminescent assay (MAST-CLA) profile. SPT and MAST-CLA results showed good agreement with one another, range 68.8-96.7% (average 87%), with significant correlation for most allergens tested. MAST-CLA was discrepant with RAST and/or SPTs in 58/210 (27.6%). A questionnaire was sent to the parents to determine their perception of food related symptoms. Sixty-two (92%) questionnaire replies were received, of which 56% reported symptoms with food. The most frequent symptom perceived to be due to food intolerance was behavioural disturbance. The commonest foods implicated were additives (39%), egg (27%), milk (26%), chocolate (23%) and orange (15%). History, SPT, MAST-CLA and RAST were compared for five allergens in 42 patients (210 values). In 14/210 (6.7%), all the tests were negative despite reported symptoms. Conversely in 49/210 (23.3%) at least one test was positive without symptoms. This study did not support a benefit of multipole testing instead of individually selected RASTs or SPTs.(ABSTRACT TRUNCATED AT 250 WORDS)

  14. GALEN skin test study III: Minimum battery of test inhalent allergens needed in epidemiological studies in patients

    NARCIS (Netherlands)

    Bousquet, P.-J.; Burbach, G.; Heinzerling, L. M.; Edenharter, G.; Bachert, C.; Bindslev-Jensen, C.; Bonini, S.; Bousquet-Rouanet, L.; Demoly, P.; Bresciani, M.; Bruno, A.; Gjomarkaj, M.; Canonica, G. W.; Darsow, U.; Durham, S.; Fokkens, W. J.; Giavi, S.; Gramiccioni, C.; Papadopoulos, N. G.; Haahtela, T.; Kowalski, M. L.; Magyar, P.; Muraközi, G.; Orosz, M.; Röhnelt, C.; Stingl, G.; Todo-Bom, A.; von Mutius, E.; Wiesner, A.; Wöhrl, S.; Bousquet, J.; Zuberbier, T.

    2009-01-01

    Background: The number of allergens to be tested in order to identify sensitized patients is important in order to have the most cost-effective approach in epidemiological studies. Objective: To define the minimal number and the type of skin prick test (SPT) allergens required to identify a patient

  15. Skin test reactivity among Danish children measured 15 years apart

    DEFF Research Database (Denmark)

    Thomsen, SF; Ulrik, Charlotte Suppli; Porsbjerg, C

    2006-01-01

    to most allergens tested, statistically significant; however, only for mugwort and Alternaria iridis. Among subjects, who were sensitized to only one allergen, we found significantly fewer individuals with reactions to D. pteronyssinus and mugwort. CONCLUSIONS: The prevalence of atopic sensitization...

  16. Differential skin test reactivity to pollens in pollen food allergy syndrome versus allergic rhinitis.

    Science.gov (United States)

    Ta, Von; Scott, David R; Chin, William K; Wineinger, Nathan E; Kelso, John M; White, Andrew A

    2015-01-01

    Pollen food allergy syndrome (PFAS), also called oral allergy syndrome, is a form of food allergy in which uncooked foods cause allergic symptoms generally limited to the oral mucosa. It occurs in a subset of patients with pollen allergy, although not all patients have prominent rhinitis symptoms. PFAS is related to antigenic similarity between the pollen and food allergen. The size of skin test reactions in a group of subjects with pollen sensitivity with PFAS was compared with a group of subjects who were pollen sensitive and without PFAS. Self-reported rhinitis symptoms between the two groups were compared to identify if symptom severity differed. Twenty subjects with PFAS and 20 subjects with seasonal allergic rhinitis without PFAS were enrolled in the study. All the subjects underwent standard skin-prick testing to a panel of common allergens, including select fresh fruits and vegetables. The subjects completed a Mini Rhinoconjunctivitis Quality of Life Questionnaire as part of their clinical evaluation. The subjects with PFAS and those without PFAS were compared statistically. The subjects with PFAS had significantly larger-sized skin-prick test results specific to pollens (p allergic rhinitis and PFAS reported milder nasal symptoms in relation to pollen skin test result size when compared with allergic rhinitis controls without PFAS. Our study outlined basic differences between two seemingly similar patient groups with a particularly striking discordance between skin test result sizes and rhinitis symptoms. This discordance should be explored further to increase mechanistic understanding of allergen cross-reactivity in PFAS.

  17. Potential for false positive HIV test results with the serial rapid HIV testing algorithm

    Directory of Open Access Journals (Sweden)

    Baveewo Steven

    2012-03-01

    Full Text Available Abstract Background Rapid HIV tests provide same-day results and are widely used in HIV testing programs in areas with limited personnel and laboratory infrastructure. The Uganda Ministry of Health currently recommends the serial rapid testing algorithm with Determine, STAT-PAK, and Uni-Gold for diagnosis of HIV infection. Using this algorithm, individuals who test positive on Determine, negative to STAT-PAK and positive to Uni-Gold are reported as HIV positive. We conducted further testing on this subgroup of samples using qualitative DNA PCR to assess the potential for false positive tests in this situation. Results Of the 3388 individuals who were tested, 984 were HIV positive on two consecutive tests, and 29 were considered positive by a tiebreaker (positive on Determine, negative on STAT-PAK, and positive on Uni-Gold. However, when the 29 samples were further tested using qualitative DNA PCR, 14 (48.2% were HIV negative. Conclusion Although this study was not primarily designed to assess the validity of rapid HIV tests and thus only a subset of the samples were retested, the findings show a potential for false positive HIV results in the subset of individuals who test positive when a tiebreaker test is used in serial testing. These findings highlight a need for confirmatory testing for this category of individuals.

  18. Potential for false positive HIV test results with the serial rapid HIV testing algorithm.

    Science.gov (United States)

    Baveewo, Steven; Kamya, Moses R; Mayanja-Kizza, Harriet; Fatch, Robin; Bangsberg, David R; Coates, Thomas; Hahn, Judith A; Wanyenze, Rhoda K

    2012-03-19

    Rapid HIV tests provide same-day results and are widely used in HIV testing programs in areas with limited personnel and laboratory infrastructure. The Uganda Ministry of Health currently recommends the serial rapid testing algorithm with Determine, STAT-PAK, and Uni-Gold for diagnosis of HIV infection. Using this algorithm, individuals who test positive on Determine, negative to STAT-PAK and positive to Uni-Gold are reported as HIV positive. We conducted further testing on this subgroup of samples using qualitative DNA PCR to assess the potential for false positive tests in this situation. Of the 3388 individuals who were tested, 984 were HIV positive on two consecutive tests, and 29 were considered positive by a tiebreaker (positive on Determine, negative on STAT-PAK, and positive on Uni-Gold). However, when the 29 samples were further tested using qualitative DNA PCR, 14 (48.2%) were HIV negative. Although this study was not primarily designed to assess the validity of rapid HIV tests and thus only a subset of the samples were retested, the findings show a potential for false positive HIV results in the subset of individuals who test positive when a tiebreaker test is used in serial testing. These findings highlight a need for confirmatory testing for this category of individuals.

  19. Interpretation of tuberculin skin-test results in the diagnosis of ...

    African Journals Online (AJOL)

    Introduction: The tuberculin skin test is one of the most valuable tests for demonstrating tuberculous infection in both symptomatic and asymptomatic children. However, its application is often undermined by difficulties in interpretation of results arising from its low sensitivity and specificity. Objectives: This review aimed to ...

  20. Reliability of candida skin test in the evaluation of T-cell function in ...

    African Journals Online (AJOL)

    Background: Both standardized and non-standardized candida skin tests are used in clinical practice for functional in-vivo assessment of cellular immunity with variable results and are considered not reliable under the age of 1 year. We sought to investigate the reliability of using manually prepared candida intradermal test ...

  1. A 3D-psoriatic skin model for dermatological testing: The impact of culture conditions

    Directory of Open Access Journals (Sweden)

    Alexandra Duque-Fernandez

    2016-12-01

    psoriatic skin substitutes.•Potential and veratility of a 3d-reconstructed model to perform dermatological testing.

  2. In vitro skin absorption tests of three types of parabens using a Franz diffusion cell.

    Science.gov (United States)

    Seo, Ji-Eun; Kim, Sungkyoon; Kim, Bae-Hwan

    2017-05-01

    The objective of this study was to evaluate the permeation of paraben derivatives - methylparaben (MP), propylparaben (PP), and butylparaben (BP) - in hairless mouse full skin and human cadaver epidermis using a Franz diffusion cell method, which is proposed as a reliable alternative method to an skin absorption test. Parabens, esterified hydroxybenzoic acid compounds, are widely used as preservatives in food, cosmetics, and pharmaceutical products. The skin permeation rate showed dose dependency, and the hairless mouse full skin showed a higher flux value than human cadaver epidermis. Among the permeability coefficient (Kp) values of three parabens, MP showed a higher Kp value than PP or BP. Hence, according to the definitions of Marzulli et al., parabens would be classified as "moderate" penetrants.

  3. False-positive urine pregnancy tests clinicians as detectives ...

    African Journals Online (AJOL)

    Reliably diagnosing pregnancy in women presenting with nonspecific abdominal pain can be lifesaving. If diagnostic tests are unreliable, however, valuable time and resources can be wasted pursuing unnecessary and potentially harmful interventions. After four false positive-urine pregnancy tests in one week, we began ...

  4. Predictive value of the tuberculin skin test among newly arriving immigrants.

    Directory of Open Access Journals (Sweden)

    Christiaan Mulder

    Full Text Available RATIONALE: Screening and treating newly arriving immigrants for latent tuberculosis infection (LTBI in low-incidence countries could be promising to reduce the tuberculosis incidence among this population. The effectiveness of screening with the tuberculin skin test (TST is unknown. OBJECTIVES: To estimate the risk of progression to tuberculosis within two years after entry, stratified by TST result at entry. METHODS: In a case-base design, we determined the prevalence of TST positives (10 mm and 15 mm among a representative cohort of immunocompetent immigrants (n = 643 aged ≥18 years who arrived between April 2009 and March 2011 in The Netherlands (base cohort. Immigrants who progressed to tuberculosis within two years after arrival in 2005, 2006 or 2007 were extracted from the Netherlands Tuberculosis Register (case source cohort. The prevalence of TST positives from the base cohort was projected on the case source cohort to estimate the risk of progression to active tuberculosis by using bayesian analyses to adjust for the sensitivity of the TST and Poisson regression analyses to take into account the random error of the number of extracted cases. RESULTS: The prevalence of TST positives was 42% and 23% for a cut-off value of 10 mm and 15 mm, respectively. The overall risk of progression to tuberculosis if TST positive was 238 per 100,000 population (95% CI 151-343 and 295 per 100,000 population (95% CI 161-473 for a cut-off value of ≥10 mm and ≥15 mm, respectively. The corresponding risk for TST negatives was 19 (95% CI 0-59 and 58 (95% CI 25-103. CONCLUSION: The TST has the discriminatory ability to differentiate between individuals at low and high risk of disease.

  5. False positive HIV test in low prevalence region: Pakistan.

    Science.gov (United States)

    Ikram, Nadeem; Ahmad, Sajid

    2012-01-01

    The prevalence of HIV in Pakistan is less than 0.1%, but is feared to be spreading among the general population rapidly. Screening tests for HIV is based on antibody detection. There seems to be little knowledge regarding the interpretation of HIV results among the population. Most often the patients are being issued a positive HIV report based on single screening test when in fact it should be confirmed before issuing a positive HIV result. There is a lot of stigma associated with the disease in Pakistan, on the other hand the test is done mostly without counselling services hence causing physical and mental trauma to the patients.

  6. Screening for tuberculosis infection among newly arrived asylum seekers: Comparison of QuantiFERON®TB Gold with tuberculin skin test

    Directory of Open Access Journals (Sweden)

    Harstad Ingunn

    2008-05-01

    Full Text Available Abstract Background QuantiFERON®TB Gold (QFT is a promising blood test for tuberculosis infection but with few data so far from immigrant screening. The aim of this study was to compare results of QFT and tuberculin skin test (TST among newly arrived asylum seekers in Norway and to assess the role of QFT in routine diagnostic screening for latent tuberculosis infection. Methods The 1000 asylum seekers (age ≥ 18 years enrolled in the study were voluntarily recruited from 2813 consecutive asylum seekers arriving at the national reception centre from September 2005 to June 2006. Participation included a QFT test and a questionnaire in addition to the mandatory TST and chest X-ray. Results Among 912 asylum seekers with valid test results, 29% (264 had a positive QFT test whereas 50% (460 tested positive with TST (indurations ≥ 6 mm, indicating a high proportion of latent infection within this group. Among the TST positive participants 50% were QFT negative, whereas 7% of the TST negative participants were QFT positive. There was a significant association between increase in size of TST result and the likelihood of being QFT positive. Agreement between the tests was 71–79% depending on the chosen TST cut-off and it was higher for non-vaccinated individuals. Conclusion By using QFT in routine screening, further follow-up could be avoided in 43% of the asylum seekers who would have been referred if based only on a positive TST (≥ 6 mm. The proportion of individuals referred will be the same whether QFT replaces TST or is used as a supplement to confirm a positive TST, but the number tested will vary greatly. All three screening approaches would identify the same proportion (88–89% of asylum seekers with a positive QFT and/or a TST ≥ 15 mm, but different groups will be missed.

  7. A study of skin sensitivity to various allergens by skin prick test in patients of nasobronchial allergy

    Directory of Open Access Journals (Sweden)

    Prasad R

    2009-01-01

    Full Text Available Objective: To study skin sensitivity to various allergens in patients of nasobronchial allergy. Materials and Methods: 2880 skin prick tests with 60 allergens were performed in 48 patients of nasobronchial allergy. Results: Most common offending allergens were insects (21.2%, followed by dusts (12.0%, pollens (7.8%, animal dander (3.1%, and fungi (1.3%. The common insect antigen were locust female (33.3% followed by locust male (25%, grasshopper (20.8%, cricket (16.7%, cockroach female (16.7% and cockroach male (14.6%. Common dust allergens were house dust, wheat dust, cotton mill and paper dust. Among pollens, Amaranthus spinosus, Argemone mexicana, Adhatoda vasica, Ailanthus and Cannabis were found to be common allergens. In animal danders common offending allergens were cow dander and dog dander. Among fungi Aspergillus fumigatus, Aspergillus flavus, Alternaria teneis and Fusarium sodani were common allergens. Patients of bronchial asthma had associated allergic rhinitis in 80% cases. Conclusion: Common allergens in patients of nasobronchial allergy were identified. The data may prove useful in of allergen avoidance and immunotherapy in these patients.

  8. Skin prick test and basophil reactivity to cetuximab in patients with IgE to alpha-gal and allergy to red meat.

    Science.gov (United States)

    Michel, S; Scherer, K; Heijnen, I A F M; Bircher, A J

    2014-03-01

    Severe hypersensitivity reactions to red meat with delay of several hours in patients with IgE to alpha-gal (galactose-alpha-1,3-galactose) have been reported. The diagnosis of meat allergy is difficult, because of the limited sensitivity of skin prick tests and specific IgE tests to meat extracts. These circumstances have been explained by the delayed expression of alpha-gal due to digestive processes. Because of the low sensitivity of skin prick tests to meat, we studied the possibility to perform skin prick tests with cetuximab, which carries the alpha-gal epitope. Skin prick and intradermal tests with cetuximab were clearly positive in 2 of 2 patients. As a further diagnostic step, we performed basophil activation tests with cetuximab. Skin prick tests and basophil activation test using cetuximab may be a more sensitive alternative in patients with an assumed allergy to meat. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  9. Lack of Correlation between Severity of Clinical Symptoms, Skin Test Reactivity, and Radioallergosorbent Test Results in Venom-Allergic Patients.

    Science.gov (United States)

    Warrington, Rj

    2006-06-15

    To retrospectively examine the relation between skin test reactivity, venom-specific immunoglobulin E (IgE) antibody levels, and severity of clinical reaction in patients with insect venom allergy. Thirty-six patients (including 15 females) who presented with a history of allergic reactions to insect stings were assessed. The mean age at the time of the reactions was 33.4 +/- 15.1 years (range, 4-76 years), and patients were evaluated 43.6 +/- 90 months (range, 1-300 months) after the reactions. Clinical reactions were scored according to severity, from 1 (cutaneous manifestations only) to 3 (anaphylaxis with shock). These scores were compared to scores for skin test reactivity (0 to 5, indicating the log increase in sensitivity from 1 mug/mL to 0.0001 mug/mL) and radioallergosorbent test (RAST) levels (0 to 4, indicating venom-specific IgE levels, from undetectable to >17.5 kilounits of antigen per litre [kUA/L]). No correlation was found between skin test reactivity (Spearman's coefficient = 0.15, p = .377) or RAST level (Spearman's coefficient = 0.32, p = .061) and the severity of reaction. Skin test and RAST scores both differed significantly from clinical severity (p test reactivity and RAST score (p = .042). There was no correlation between skin test reactivity and time since reaction (Spearman's coefficient = 0.18, p = .294) nor between RAST and time since reaction (r = 0.1353, p = .438). Elimination of patients tested more than 12 months after their reaction still produced no correlation between skin test reactivity (p = .681) or RAST score (p = .183) and the severity of the clinical reaction. In venom-allergic patients (in contrast to reported findings in cases of inhalant IgE-mediated allergy), there appears to be no significant correlation between the degree of skin test reactivity or levels of venom-specific IgE (determined by RAST) and the severity of the clinical reaction.

  10. Skin prick test: the only predictive tool of anaphylaxis? A case report.

    Science.gov (United States)

    Giannetti, A; Meglio, P; Ricci, G

    2014-01-01

    Currently, in the literature there is a lack of definite predictive values parameters to identify patients with the risk to develop anaphylaxis. The controlled oral food challenge remains the gold standard for food allergy diagnosis. We report a case of a girl allergic to cow's milk with low levels of specific IgE and large skin prick test wheal sizes for cow's milk. In some cases the high diameter of skin prick test wheal may be more reliable than specific IgE levels in predicting an anaphylactic reaction.

  11. Comparison of the Skin Test and ImmunoCAP System in the Evaluation of Mold Allergy

    OpenAIRE

    Liang, Kai-Li; Su, Mao-Chang; Jiang, Rong-San

    2006-01-01

    Mold is ubiquitous in our environment and is a common allergen in allergic diseases. The skin test and the Pharmacia ImmunoCAP system (CAP) for assay-specific immunoglobulin E (IgE) antibodies are both widely used. The goal of this study was to compare the performance of the skin test and CAP in the evaluation of mold allergy. Methods: Patients with allergic rhinitis were enrolled at our outpatient department. The diagnosis of allergic rhinitis was based on typical symptoms for more than 2...

  12. Pulse testing in the presence of wellbore storage and skin effects

    Energy Technology Data Exchange (ETDEWEB)

    Ogbe, D.O.; Brigham, W.E.

    1984-08-01

    A pulse test is conducted by creating a series of short-time pressure transients in an active (pulsing) well and recording the observed pressure response at an observation (responding) well. Using the pressure response and flow rate data, the transmissivity and storativity of the tested formation can be determined. Like any other pressure transient data, the pulse-test response is significantly influenced by wellbore storage and skin effects. The purpose of this research is to examine the influence of wellbore storage and skin effects on interference testing in general and on pulse-testing in particular, and to present the type curves and procedures for designing and analyzing pulse-test data when wellbore storage and skin effects are active at either the responding well or the pulsing well. A mathematical model for interference testing was developed by solving the diffusivity equation for radial flow of a single-phase, slightly compressible fluid in an infinitely large, homogeneous reservoir. When wellbore storage and skin effects are present in a pulse test, the observed response amplitude is attenuated and the time lag is inflated. Consequently, neglecting wellbore storage and skin effects in a pulse test causes the calculated storativity to be over-estimated and the transmissivity to be under-estimated. The error can be as high as 30%. New correlations and procedures are developed for correcting the pulse response amplitude and time lag for wellbore storage effects. Using these correlations, it is possible to correct the wellbore storage-dominated response amplitude and time lag to within 3% of their expected values without wellbore storage, and in turn to calculate the corresponding transmissivity and storativity. Worked examples are presented to illustrate how to use the new correction techniques. 45 references.

  13. Medical clowns ease anxiety and pain perceived by children undergoing allergy prick skin tests.

    Science.gov (United States)

    Goldberg, A; Stauber, T; Peleg, O; Hanuka, P; Eshayek, L; Confino-Cohen, R

    2014-10-01

    Intervention of medical clowns (MC) during various medical procedures performed in children has been used to relieve anxiety and pain. Their role in allergy skin testing has never been evaluated. To evaluate whether MC can diminish pain and anxiety perceived by children undergoing allergy skin prick tests (SPT). In a prospective, randomized, controlled, and blinded study, children undergoing SPT were or were not accompanied by MC. All parents and children ≥8 years completed the State-Trait Anxiety Inventory (STAI) before and after SPT. Videotapes recorded during the procedure were scored for anxiety (m-YPAS) for all children and for pain (FLACC) for children 2-7 years old by a psychologist who was unaware of the MC's presence. After SPT, children ≥8 years completed a visual analog score (VAS) for pain. Ninety-one children (mean age 8.2 years, M/F = 54/37) were recruited of whom 45 were accompanied by clowns. A significant reduction in state-STAI was found in the clowns group, in both parents and children, when compared with the regular group (26.9 ± 6.6 and 32.3 ± 10.0; P = 0.004, and 27.1 ± 4.2 and 34.3 ± 7.6; P = 0.002, respectively). Both m-YPAS and FLACC were reduced in the clowns group compared with the regular one. In the clowns group, m-YPAS positively correlated with both VAS and FLACC (P = 0.000 and 0.002, respectively). m-YPAS was positively correlated with FLACC in the regular group (P = 0.000). Medical clowns significantly decrease the level of anxiety perceived by both children undergoing allergy SPT and their parents, as well as the pain perceived by young children. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  14. Porcine ear skin as a biological substrate for in vitro testing of sunscreen performance.

    Science.gov (United States)

    Sohn, Myriam; Korn, Verena; Imanidis, Georgios

    2015-01-01

    The purpose of the study was to examine the use of skin from porcine ears as a biological substrate for in vitro testing of sunscreens in order to overcome the shortcomings of the presently used polymethylmethacrylate (PMMA) plates that generally fail to yield a satisfactory correlation between sun protection factors (SPF) in vitro and in vivo. Trypsin-separated stratum corneum and heat-separated epidermis provided UV-transparent substrates that were laid on quartz or on PMMA plates. These were used to determine surface roughness by chromatic confocal imaging and to measure SPF in vitro of 2 sunscreens by diffuse transmission spectroscopy. The recovered skin layers showed a lower roughness than full-thickness skin but yielded SPF in vitro values that more accurately reflected the SPF determined in vivo by a validated procedure than PMMA plates, although the latter had in part roughness values identical to those of intact skin. Combination of skin tissue with a high roughness PMMA plate also provided accurate SPF in vitro. Besides roughness, the improved affinity of the sunscreen to the skin substrate compared to PMMA plates may explain the better in vitro prediction of SPF achieved with the use of a biological substrate. © 2014 S. Karger AG, Basel.

  15. Lack of Correlation between Severity of Clinical Symptoms, Skin Test Reactivity, and Radioallergosorbent Test Results in Venom-Allergic Patients

    Directory of Open Access Journals (Sweden)

    Warrington RJ

    2006-06-01

    Full Text Available Abstract Purpose To retrospectively examine the relation between skin test reactivity, venom-specific immunoglobulin E (IgE antibody levels, and severity of clinical reaction in patients with insect venom allergy. Method Thirty-six patients (including 15 females who presented with a history of allergic reactions to insect stings were assessed. The mean age at the time of the reactions was 33.4 ± 15.1 years (range, 4-76 years, and patients were evaluated 43.6 ± 90 months (range, 1-300 months after the reactions. Clinical reactions were scored according to severity, from 1 (cutaneous manifestations only to 3 (anaphylaxis with shock. These scores were compared to scores for skin test reactivity (0 to 5, indicating the log increase in sensitivity from 1 μg/mL to 0.0001 μg/mL and radioallergosorbent test (RAST levels (0 to 4, indicating venom-specific IgE levels, from undetectable to >17.5 kilounits of antigen per litre [kUA/L]. Results No correlation was found between skin test reactivity (Spearman's coefficient = 0.15, p = .377 or RAST level (Spearman's coefficient = 0.32, p = .061 and the severity of reaction. Skin test and RAST scores both differed significantly from clinical severity (p p = .042. There was no correlation between skin test reactivity and time since reaction (Spearman's coefficient = 0.18, p = .294 nor between RAST and time since reaction (r = 0.1353, p = .438. Elimination of patients tested more than 12 months after their reaction still produced no correlation between skin test reactivity (p = .681 or RAST score (p = .183 and the severity of the clinical reaction. Conclusion In venom-allergic patients (in contrast to reported findings in cases of inhalant IgE-mediated allergy, there appears to be no significant correlation between the degree of skin test reactivity or levels of venom-specific IgE (determined by RAST and the severity of the clinical reaction.

  16. Advanced Development of Leishmania Topical Skin Test Antigen

    Science.gov (United States)

    2012-09-28

    Microbiological Assay Test for the Presence of Non Agar Cultivable Mycoplasma using Vero Cell Culture Assay Assays Performed on Leishmania tropica...2 2.2 CHARACTERIZATION OF CELL BANKS………………………………………………………………3 2.3 FORMULATION STUDIES……………………………………………………………..………………3 2.4 MANUFACTURE OF...Candida albicans (Candin®) for use in the detection of cell -mediated immunity. For this reason, Allermed was recognized by the U.S. Army as uniquely

  17. Aluminum sulfate significantly reduces the skin test response to common allergens in sensitized patients

    Directory of Open Access Journals (Sweden)

    Grier Thomas J

    2006-02-01

    Full Text Available Abstract Background Avoidance of allergens is still recommended as the first and best way to prevent allergic illnesses and their comorbid diseases. Despite a variety of attempts there has been very limited success in the area of environmental control of allergic disease. Our objective was to identify a non-invasive, non-pharmacological method to reduce indoor allergen loads in atopic persons' homes and public environments. We employed a novel in vivo approach to examine the possibility of using aluminum sulfate to control environmental allergens. Methods Fifty skin test reactive patients were simultaneously skin tested with conventional test materials and the actions of the protein/glycoprotein modifier, aluminum sulfate. Common allergens, dog, cat, dust mite, Alternaria, and cockroach were used in the study. Results Skin test reactivity was significantly reduced by the modifier aluminum sulfate. Our studies demonstrate that the effects of histamine were not affected by the presence of aluminum sulfate. In fact, skin test reactivity was reduced independent of whether aluminum sulfate was present in the allergen test material or removed prior to testing, indicating that the allergens had in some way been inactivated. Conclusion Aluminum sulfate was found to reduce the in vivo allergic reaction cascade induced by skin testing with common allergens. The exact mechanism is not clear but appears to involve the alteration of IgE-binding epitopes on the allergen. Our results indicate that it may be possible to diminish the allergenicity of an environment by application of the active agent aluminum sulfate, thus producing environmental control without complete removal of the allergen.

  18. Results of aircraft positioning tests in postprocessing using the GNSS

    Directory of Open Access Journals (Sweden)

    Henryk JAFERNIK

    2017-06-01

    Full Text Available In this paper, the results of an aircraft’s positioning in aviation during two flight tests are presented. The aircraft’s position was established using GPS data with a sample rate of 1 s in both experiments. The raw GPS data were collected by a Topcon Hiper Pro receiver, which was installed in the pilot’s cabin of a Cessna aircraft. The aircraft’s coordinates in the BLh geodetic frame were determined using the single point positioning (SPP method in gLAB software. The mathematical algorithm for the aircraft’s coordinates are also described in the article. The typical standard deviations for the aircraft’s coordinates were less than 10 m in test I and less than 30 m in test II.

  19. A tiered approach to the use of alternatives to animal testing for the safety assessment of cosmetics: skin irritation.

    Science.gov (United States)

    Macfarlane, Martin; Jones, Penny; Goebel, Carsten; Dufour, Eric; Rowland, Joanna; Araki, Daisuke; Costabel-Farkas, Margit; Hewitt, Nicola J; Hibatallah, Jalila; Kirst, Annette; McNamee, Pauline; Schellauf, Florian; Scheel, Julia

    2009-07-01

    Evaluation of the skin irritancy and corrosivity potential of an ingredient is a necessity in the safety assessment of cosmetic ingredients. To date, there are two formally validated alternatives to the rabbit Draize test for skin corrosivity in place, namely the rat skin transcutaneous electrical resistance (TER) assay and the Human Skin Model Test using EpiSkin, EpiDerm and SkinEthic reconstructed human epidermal equivalents. For skin irritation, EpiSkin, EpiDerm and SkinEthic are validated as stand-alone test replacements for the rabbit Draize test. Data from these tests are rarely considered in isolation and are evaluated in combination with other factors to establish the overall irritating or corrosive potential of an ingredient. In light of the deadlines established in the Cosmetics Directive for cessation of animal testing for cosmetic ingredients, a COLIPA scientific meeting was held in Brussels on 30th January, 2008 to review the use of alternative approaches and to set up a decision tree approach for their integration into tiered testing strategies for hazard and safety assessment of cosmetic ingredients and their use in products. In conclusion, the safety assessments for skin irritation/corrosion of new chemicals for use in cosmetics can be confidently accomplished using exclusively alternative methods.

  20. Prevailence of Patch Test Positivity with Some Bases

    Directory of Open Access Journals (Sweden)

    J S Pasricha

    1987-01-01

    Full Text Available To evaluate the suitability of some chemicals to act as bases for antigens for patch tests, patch tests were performed with these agents in patients having contact dermatitis. Propylene glycol′used as such produced positive reactions in 25 (50% patients of which 12 were 2 + or more, polyethylene glycol 200 produced positive reactions in 9 (18% cases of which 4 cases were 2 + or more, a mixture of liquid paraffin and hard paraffin gave rise to positive reactions in 10 (10% cases 3 of these being 2 +, a mixture of liquid paraffin and bees wax was positive in 14 (14,Yo cases 3 of these being 2 +, yellow petrolatum was positive in 4 (8% cases, one of which was 2 +, white petrolatum was positive in S (6% cases all of these being + reactions only, and glycerol gave rise to a I + reaction in only one (2% caw. In tropical countries, water should be as base for as many antigens as possible for others, a control test with the b must be included.

  1. Onset and duration of action of topical antihistamine: a study of histamine skin test response.

    Science.gov (United States)

    Danarti, Retno; Waskito, Fajar; Indrastuti, Niken

    2008-08-01

    Most patients who require skin prick testing cannot deal with their pruritus without taking antihistamines (AH). Orally administered AH has a quick onset of action, but it will suppress skin test responses (STR) from several days to weeks. In this study, we aimed to determine the onset and duration of action of single topical AH application by observing histamine-STR suppression over time. A two-step, randomized, intraindividual parallel-comparative, double-blind, placebo-controlled trial was conducted on the volar side of the forearm. Step 1 was aimed to determine the onset, while step 2 determined the duration of action. The topical AH tested was a single application of 5% doxepin hydrochloride cream, while 10 mg/ml histamine dihydrochloride was used to test the skin responses. Our 10 subjects' mean age was 35.8 +/- 3.179 years. Histamine wheal response was suppressed starting on minute 90 and the wheal width were back to >/= 7 mm(2 )on minute 270. Significant histamine reactivity difference between genders (P = 0.201) and atopic status (P = 1.000), which could be a source of bias in histamine STR, was not found among our subjects. Single application of topical AH has an onset of action in 90 min and duration of action skin prick testing after a few hours, without influencing the patient's STR.

  2. Risk-stratification protocol for carboplatin and oxaliplatin hypersensitivity: repeat skin testing to identify drug allergy.

    Science.gov (United States)

    Wang, Alberta L; Patil, Sarita U; Long, Aidan A; Banerji, Aleena

    2015-11-01

    Hypersensitivity reactions (HSRs) to platinum-based chemotherapies are increasingly being recognized. The authors developed a novel risk-stratification protocol that was used successfully in a small number of patients with carboplatin-induced HSRs. To describe the utility of this protocol in a large number of patients with carboplatin- or oxaliplatin-induced HSRs. A 5-year retrospective review of patients referred to Massachusetts General Hospital with carboplatin- or oxaliplatin-induced HSR was performed. Patients were managed using a risk-stratification protocol using 3 repeat skin tests (STs) with intervening desensitizations. If the repeat ST result remained negative 3 times, patients received subsequent infusions without desensitization. From 2008 to 2012, 142 patients (92 treated with carboplatin, 50 treated with oxaliplatin) completed 574 desensitizations. Most patients were women (84.5%, mean ± SD 58.1 ± 9.3 years). Patients with carboplatin-induced HSRs were classified as having positive (n = 32, 34.8%), negative (n = 38, 41.3%), or converted (n = 22, 23.9%) ST reactions when the initial negative ST reaction converted to positive at repeat ST. Of those with oxaliplatin-induced HSRs, 22 (44%) had positive, 25 (50%) had negative, and 3 (6%) had converted ST reactions. Of the patients with negative ST reactions, 17 with carboplatin-induced HSRs and 16 with oxaliplatin-induced HSRs safely completed 59 and 95 outpatient infusions, respectively, without desensitizations. For carboplatin and oxaliplatin, ST conversion was associated with an interval of at least 6 months from the HSR to the initial ST (carboplatin, P = .002; oxaliplatin, P = .045). This risk-stratification protocol for presumed carboplatin- and oxaliplatin-induced HSRs safely identifies false-negative ST reactions and nonallergic patients who can receive infusions without desensitizations. This leads to fewer unnecessary desensitizations and improved patient care. Copyright © 2015 American

  3. House dust bioactivities predict skin prick test reactivity for children with high risk of allergy.

    Science.gov (United States)

    Kim, Haejin; Tse, Kevin; Levin, Linda; Bernstein, David; Reponen, Tiina; LeMasters, Grace; Lummus, Zana; Horner, Anthony A

    2012-06-01

    Although evidence suggests that ambient exposures to endotoxin and other immunostimulants during early life influence allergic risk, efforts to understand this host-environment relationship have been hampered by a paucity of relevant assays. These investigations determined whether parameters of house dust extract (HDE) bioactivity were predictive of allergen skin prick test (SPT) reactivity for infants at high risk of allergy participating in the Cincinnati Childhood Allergy and Air Pollution Study (CCAAPS). We conducted a nested case-control study, selecting 99 CCAAPS children who had positive SPT results to at least 1 aeroallergen at age 3 years and 101 subjects with negative SPT results. HDEs were prepared from dust samples collected from the subjects' homes at age 1 year. Murine splenocytes and bone marrow-derived dendritic cells were incubated with HDEs, and supernatant cytokine concentrations were determined by means of ELISA. Alternatively, bone marrow-derived dendritic cells were preincubated with HDEs, and then LPS-induced IL-6 responses were assessed. HDE endotoxin levels were determined by using the limulus amebocyte lysate assay. HDEs derived from the homes of children with positive (cases) and negative (control subjects) SPT results had similar bioactivities. However, when cases were considered in isolation, HDEs with higher levels of bioactivity were significantly associated with children who had lower numbers of positive SPT results. Analogous statistical analyses did not identify any association between HDE endotoxin levels and the aeroallergen sensitization profiles of children included in this study. HDE immunostimulatory activities predicted the aeroallergen sensitization status of CCAAPS subjects better than HDE endotoxin levels. These results provide the first published evidence that HDE bioassays have clinical relevance in predicting atopic risk. Copyright © 2012 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All

  4. The Lancet Weight Determines Wheal Diameter in Response to Skin Prick Testing with Histamine.

    Directory of Open Access Journals (Sweden)

    Hjalte H Andersen

    Full Text Available Skin prick test (SPT is a common test for diagnosing immunoglobulin E-mediated allergies. In clinical routine, technicalities, human errors or patient-related biases, occasionally results in suboptimal diagnosis of sensitization.Although not previously assessed qualitatively, lancet weight is hypothesized to be important when performing SPT to minimize the frequency of false positives, false negatives, and unwanted discomfort.Accurate weight-controlled SPT was performed on the volar forearms and backs of 20 healthy subjects. Four predetermined lancet weights were applied (25 g, 85 g, 135 g and 265 g using two positive control histamine solutions (1 mg/mL and 10 mg/mL and one negative control (saline. A total of 400 SPTs were conducted. The outcome parameters were: wheal size, neurogenic inflammation (measured by superficial blood perfusion, frequency of bleeding, and the lancet provoked pain response.The mean wheal diameter increased significantly as higher weights were applied to the SPT lancet, e.g. from 3.2 ± 0.28 mm at 25 g to 5.4 ± 1.7 mm at 265 g (p<0.01. Similarly, the frequency of bleeding, the provoked pain, and the neurogenic inflammatory response increased significantly. At 265 g saline evoked two wheal responses (/160 pricks below 3 mm.The applied weight of the lancet during the SPT-procedure is an important factor. Higher lancet weights precipitate significantly larger wheal reactions with potential diagnostic implications. This warrants additional research of the optimal lancet weight in relation to SPT-guidelines to improve the specificity and sensitivity of the procedure.

  5. Instrumented Impact Testing: Influence of Machine Variables and Specimen Position

    Energy Technology Data Exchange (ETDEWEB)

    Lucon, E.; McCowan, C. N.; Santoyo, R. A.

    2008-09-15

    An investigation has been conducted on the influence of impact machine variables and specimen positioning on characteristic forces and absorbed energies from instrumented Charpy tests. Brittle and ductile fracture behavior has been investigated by testing NIST reference samples of low, high and super-high energy levels. Test machine variables included tightness of foundation, anvil and striker bolts, and the position of the center of percussion with respect to the center of strike. For specimen positioning, we tested samples which had been moved away or sideways with respect to the anvils. In order to assess the influence of the various factors, we compared mean values in the reference (unaltered) and altered conditions; for machine variables, t-test analyses were also performed in order to evaluate the statistical significance of the observed differences. Our results indicate that the only circumstance which resulted in variations larger than 5 percent for both brittle and ductile specimens is when the sample is not in contact with the anvils. These findings should be taken into account in future revisions of instrumented Charpy test standards.

  6. In Vitro susceptibility of Gram-positive cocci isolated from skin and respiratory tract to azithromycin and twelve other antimicrobial agents

    Directory of Open Access Journals (Sweden)

    Caio M. F. Mendes

    Full Text Available This study was conducted to evaluate the activity of azithromycin in comparison to 12 other antibacterial agents against recent isolates obtained consecutively from patients with respiratory tract or skin infections, from January to July, 2000. A total of 717 Gram-positive cocci were analyzed in this study and the following species were studied: Staphylococcus aureus (n=576, beta-hemolytic streptococci ( n=115, and Streptococcus pneumoniae (n=26. Susceptibility testing was carried out by the disk diffusion method and interpreted according to NCCLS breakpoints. The activity of azithromycin was compared to erythromycin, clindamycin, chloramphenicol, ciprofloxacin, ofloxacin, oxacillin, penicillin, ceftriaxone, tetracycline, trimethoprim/sulfamethoxazole, teicoplanin, and vancomycin. Of the 26 S. pneumoniae isolates recovered from the respiratory tract, 5 (19.2% were intermediate resistant to penicillin. All of these strains were susceptible to chloramphenicol, ofloxacin, and vancomycin, and 24 (92% were also susceptible to azithromycin, clindamycin, and erythromycin. Among the 67 beta-hemolytic streptococci strains isolated from the respiratory tract, 66 (99% were susceptible to azithromycin, erythromycin, clindamycin, and ofloxacin. All 48 beta-hemolytic streptococci strains isolated from skin were susceptible to azithromycin and clindamycin, 47 (98% were susceptible to erythromycin, and 46 (96% were susceptible to ofloxacin. Of the 576 strains of S. aureus, 253 (43.9% were isolated from the respiratory tract and 323 (56.1% from skin. Among S. aureus isolates from the respiratory tract and skin, 46 (18% and 78 (24%, respectively were resistant to oxacillin. Isolates from the respiratory tract and skin showed the same percentage of resistance (36% to azithromycin. These in vitro results suggest that azithromycin can be a therapeutic option for treatment of infections caused by these bacteria since the newer macrolides have several distinct

  7. Skin-test reactions in chronic allergic rhinitis in Benin | Ogisi ...

    African Journals Online (AJOL)

    Background: Skin testing is an established mode of investigation of atopic allergic conditions, to determine the allergen or allergens responsible for clinical symptoms as well as the degree of reactivity in individual cases. However over the years little has been reported on the pattern of reactions in the common condition of ...

  8. Pyrazinamide-induced anaphylaxis: diagnosed by skin test and successful desensitization.

    Science.gov (United States)

    Bavbek, Sevim; Yılmaz, Insu; Aydın, Ömür; Ozdemir, Seçil Kepil

    2012-01-01

    Pyrazinamide (PZA), an antituberculosis drug, may cause hypersensitivity reactions. Here, we report a case of anaphylaxis secondary to a PZA administration for tuberculosis pleuritis. To the best of our knowledge, this is the first reported case of strongly possible IgE-mediated, PZA-induced anaphylaxis proved by skin prick test and oral provocation/desensitization. Copyright © 2011 S. Karger AG, Basel.

  9. Skin prick test: the only predictive tool of anaphylaxis? A case report

    National Research Council Canada - National Science Library

    Giannetti, A; Meglio, P; Ricci, G

    2014-01-01

    .... The controlled oral food challenge remains the gold standard for food allergy diagnosis. We report a case of a girl allergic to cow's milk with low levels of specific IgE and large skin prick test wheal sizes for cow's milk...

  10. A survey on leishmaniasis and the leishmanin .skin test profile

    African Journals Online (AJOL)

    A survey on leishmaniasis and the leishmanin .skin test profile in Lower Awash Valley, northeast Ethiopia. Ahmed Ali 1, Teshome' Gebre-Michael 2, Genene Mengistu 3, Fekade Baleha 2. Abstract. Background: The prevalence of both visceral and cutaneous leishmaniasis in various parts of Ethiopia is evident.

  11. Allergen skin prick test should be adjusted by the histamine reactivity.

    Science.gov (United States)

    Dreborg, Sten

    2015-01-01

    Skin prick test results are mostly reported as mean wheal diameter obtained with one concentration of allergen. Differences in technique between personnel causes variation in wheal size. The research question was whether the influence of differences in skin prick test technique among assistants and centers can be reduced by relating the allergen wheal response to that of histamine. Two methods for estimating skin reactivity, the method of Nordic Guidelines using histamine as a reference and the method of Brighton et al. [Clin Allergy 1979;9:591-596] not using histamine as a reference, were applied to data from two biological standardization trials, using the same batch of freeze-dried timothy pollen preparation. The concentration defining the Nordic biological unit, defined as a concentration of allergen eliciting a wheal of the same size as that of histamine dihydrochloride 10 mg/ml, did not differ between the centers. When not using histamine as a reference, applying the method of Brighton et al., there was a 15-fold difference in the estimate of the biological activity between the trials that was eliminated by adjusting the allergen response to that of the histamine reference. To reduce the influence of differences in test technique among assistants and centers responses to allergen-induced skin prick tests should be compared to that of histamine. © 2015 S. Karger AG, Basel.

  12. Development and characterisation of an in vitro photomicronucleus test using ex vivo human skin tissue

    NARCIS (Netherlands)

    Reus, A.A.; Meeuwen, R.N.C. van; Vogel, N. de; Maas, W.J.M.; Krul, C.A.M.

    2011-01-01

    Photosafety testing is of concern for the evaluation of personal care products and pharmaceuticals. Current regulatory guidance state that photosafety should be evaluated for compounds that absorb radiation between 290 and 700 nm with relevant exposure in the skin or eyes. However, oversensitivity

  13. A guide to performing skin-prick testing in practice: tips and tricks of ...

    African Journals Online (AJOL)

    In practice, it is critical to identify the offending allergen in atopic individuals. This will not only influence therapeutic interventions, but may also have a significant impact on the individual's quality of life. The most common clinical test for allergy detection is the introduction of an allergen directly into the skin in the form of a ...

  14. Outpatient penicillin use after negative skin testing and drug challenge in a pediatric population.

    Science.gov (United States)

    Picard, Matthieu; Paradis, Louis; Nguyen, Mélanie; Bégin, Philippe; Paradis, Jean; Des Roches, Anne

    2012-01-01

    The practice of elective penicillin skin testing could be compromised by the fact that patients, their parents, or their physicians remain reluctant to reuse penicillin-class antibiotics (PCAs) despite a negative evaluation by an allergist. This study addresses reuse of PCAs in a pediatric population after negative penicillin skin testing and drug challenge and factors associated with its reluctance. All children evaluated for a history of penicillin allergy at the CHU Sainte-Justine Allergy Clinic between January 1998 and June 2000 with negative skin testing and drug challenge were included in the study. A telephone survey was conducted between May and October 2002 to assess the perception of the initial reaction by the parents, subsequent use of antibiotics, and antibiotic-related adverse reactions. Among the 200 children selected, parents of 170 (85%) children completed the survey. Since the allergist evaluation, 130 (76%) children had received antibiotics. PCA was used in 59 (45%) children. Parents of 24 (18%) children refused PCAs because they still feared an adverse reaction. They were more likely to have been very frightened by their child's allergic reaction than other parents whose children had used PCAs (p = 0.008). Although elective penicillin skin testing is useful and safe in the pediatric population, a significant proportion of parents still refuse PCAs even though they are needed. Identification of parents that were very frightened by their children's allergic reactions and additional reassurance could improve this situation.

  15. Predictive value of the tuberculin skin test among newly arriving immigrants

    NARCIS (Netherlands)

    Mulder, Christiaan; Mulleners, Brigit; Borgdorff, Martien W.; van Leth, Frank

    2013-01-01

    Screening and treating newly arriving immigrants for latent tuberculosis infection (LTBI) in low-incidence countries could be promising to reduce the tuberculosis incidence among this population. The effectiveness of screening with the tuberculin skin test (TST) is unknown. To estimate the risk of

  16. United States Air Force Health Care Provider Practices: Skin Testing for Mycobacterium Tuberculosis

    Science.gov (United States)

    1997-04-03

    Infection Control Manager Nurse Manager, Family Practice Clinic Infection Control Assistant Manager Clinical Nurse, Obstetrical Ward Clinical...172 Air Force health care providers at a mid- level medical treatment facility including: medical doctors (MD), doctors of osteopathy (DO...of osteopathy , physician assistants, nurse practitioners and independent duty medical technicians. Knowledge of tuberculosis skin testing: shall be

  17. Proficiency testing of skin prick testers as part of a quality assurance system

    DEFF Research Database (Denmark)

    Malling, Hans-Jørgen; Allesen-Holm, Pernille; Karved, Lisbeth Sys

    2016-01-01

    BACKGROUND: Skin prick test is an important diagnostic procedure in clinical allergy but documentation of the quality is often missing. METHODS: We describe a proficiency system to evaluate staff members in relation to the international recommended reproducibility in terms of coefficient...

  18. Use of recombinant CFP-10 protein for a skin test specific for ...

    African Journals Online (AJOL)

    Jane

    2010-10-18

    Oct 18, 2010 ... TB diagnosis was evaluated by skin testing in guinea pigs sensitized with M. tuberculosis, M. bovis, and. M. bovis BCG. Our results show that the ... being used widely for immunization against MTB infection. (Huebner et al., 1993; Harboe, ..... Amicosante M, Girardi E (2005). Selected RD1 peptides for active.

  19. Herbalife hepatotoxicity: Evaluation of cases with positive reexposure tests.

    Science.gov (United States)

    Teschke, Rolf; Frenzel, Christian; Schulze, Johannes; Schwarzenboeck, Alexander; Eickhoff, Axel

    2013-07-27

    To analyze the validity of applied test criteria and causality assessment methods in assumed Herbalife hepatotoxicity with positive reexposure tests. We searched the Medline database for suspected cases of Herbalife hepatotoxicity and retrieved 53 cases including eight cases with a positive unintentional reexposure and a high causality level for Herbalife. First, analysis of these eight cases focused on the data quality of the positive reexposure cases, requiring a baseline value of alanine aminotransferase (ALT) Herbalife in these eight cases were probable (n = 1), unlikely (n = 4), and excluded (n = 3). Confounding variables included low data quality, alternative diagnoses, poor exclusion of important other causes, and comedication by drugs and herbs in 6/8 cases. More specifically, problems were evident in some cases regarding temporal association, daily doses, exact start and end dates of product use, actual data of laboratory parameters such as ALT, and exact dechallenge characteristics. Shortcomings included scattered exclusion of hepatitis A-C, cytomegalovirus and Epstein Barr virus infection with only globally presented or lacking parameters. Hepatitis E virus infection was considered in one single patient and found positive, infections by herpes simplex virus and varicella zoster virus were excluded in none. Only one case fulfilled positive reexposure test criteria in initially assumed Herbalife hepatotoxicity, with lower CIOMS based causality gradings for the other cases than hitherto proposed.

  20. Skin test reactivity of allergic subjects to basidiomycetes' crude extracts in a tropical environment.

    Science.gov (United States)

    Rivera-Mariani, Félix E; Nazario-Jiménez, Sylvette; López-Malpica, Fernando; Bolaños-Rosero, Benjamín

    2011-11-01

    Fungal allergies can be detected by the skin prick test with extracts of the organisms, but not all fungi, including the basidiomycetes, are being examined. We determined the level of sensitization to basidiomycetes in allergic subjects and compared their reactivity to commercial extracts commonly used to detect allergies. Crude spore extracts of the basidiomycetes Ganoderma applanatum, Chlorophyllum molybdites, and Pleurotus ostreatus, which are known to release numerous spores, were examined along with commercial extracts on 33 subjects with asthma, allergic or non-allergic rhinitis. Overall, affected subjects showed the highest reactivity to mites (36%), followed by Ganoderma applanatum (30%), grass (27%) Chlorophyllum molybdites (12%) and Pleurotus ostreatus (12%). Allergic rhinitis patients were most reactive to mites (58%), grass (42%), Ganoderma applanatum (25%), Penicillium spp. (25%), and cat (17%). Those with asthma primarily responded to mites (44%), Ganoderma applanatum (44%), grass (33%), and Pleurotus ostreatus (22%). IgE levels correlated with positive basidiomycetes extracts. This finding, coupled with higher reactivity to basidiospores as compared to mitospores, and the similar sensitivities of patients to G. applanatum and mites, suggest that basidiomycetes are important allergen sources in the tropics.

  1. Cytokine profile in Montenegro skin test of patients with localized cutaneous and mucocutaneous leishmaniasis.

    Science.gov (United States)

    Nogueira, Marcia Ferraz; Goto, Hiro; Sotto, Mírian Nacagami; Cucé, Luiz Carlos

    2008-01-01

    American tegumentary leishmaniasis presents as two major clinical forms: localized cutaneous leishmaniasis (LCL) and mucocutaneous leishmaniasis (MCL). The immune response in leishmaniasis is efficiently evaluated by the response to Leishmania antigen through the Montenegro skin test (MST). Both LCL and MCL present positive response to MST, indicating that the patients present cell-mediated immunity against the parasite - Leishmania. In spite of the presence of immunity in MCL, this is not sufficient to stop disease progression and prevent resistance to treatment. In this study we demonstrated interleukin (IL) 2, 4, 5 and interferon (IFN) gamma expression in biopsies of MST of ten patients with American tegumentary leishmaniasis. The obtained results were compared between LCL (n = 5) and MCL (n = 5) patients. The MST of MCL patients displayed a higher expression of IL-2, IL-4 and IL-5, in comparison to LCL. There was no significant difference in IFN-gamma expression between groups. The obtained results suggest the role of IL-4 and IL-5 in the maintenance of the immunopathogenic mechanism of the destructive lesions that characterize MCL.

  2. Tuberculin skin test conversion among HIV patients on antiretroviral therapy in Uganda.

    Science.gov (United States)

    Kirenga, B J; Worodria, W; Massinga-Loembe, M; Nalwoga, T; Manabe, Y C; Kestens, L; Colebunders, R; Mayanja-Kizza, H

    2013-03-01

    A human immunodeficiency virus (HIV) clinic in a setting of high tuberculosis (TB) and HIV prevalence. To study the incidence of and factors associated with tuberculin skin test (TST) conversion in HIV patients on antiretroviral therapy (ART). Prospective cohort study of TST-negative, ART-naïve HIV patients (CD4 cell count conversion were calculated, and logistic regression analyses were performed. Of the 142 patients, 105 (75.5%) were females. The mean age was 35.9 years (standard deviation 8.1) and the median CD4 cell count was 119 cells/l (interquartile range 42168). The incidence of TST conversion was 30.2/100 person years (95%CI 19.546.8). Conversion was not associated with clinical, CD4 cell count or chest radiography findings. A high incidence of TST conversion was observed, supporting the World Health Organization recommendation to provide isoniazid preventive therapy (IPT) to all HIV patients in high TB prevalence settings. If case-control programmes choose to provide IPT only to TST-positive patients, repeat TST should be considered following initiation of ART.

  3. Prevalence of Mantoux test positivity among apparently healthy ...

    African Journals Online (AJOL)

    Prevalence of Mantoux test positivity among apparently healthy children in Maiduguri, Nigeria. MG Mustapha, AM Garba, AI Rabasa, MS Gimba. Abstract. Background. The impact of tuberculosis (TB) is highest in the developing countries of Asia and Africa, especially among children, in whom the diagnosis is challenging.

  4. Effect of Limb Position at the Time of Skin Marker Application on Sagittal Plane Kinematics of the Dog.

    Science.gov (United States)

    Kim, Sun-Young; Torres, Bryan T; Sandberg, Gabriella S; Budsberg, Steven C

    2017-11-01

    Objectives To evaluate the effect of limb position during initial skin marker application on sagittal plane kinematics of the hindlimb. Methods Six healthy dogs (20-30 kg) were evaluated. An established two-dimensional kinematic model of the pelvic limb was utilized to describe sagittal plane motion. Kinematic markers were applied separately for each dog while standing in three different positions: (1) the limb extended cranially, (2) a normal standing limb position and (3) the limb extended caudally. Following marker application at each of the three positions, dynamic gait was recorded at a walk (velocity, 0.9-1.2 m/s; acceleration, 0.5m/s2). Five valid trials were used for comparison. Complete waveform analysis was performed with generalized indicator function analysis (GIFA). Maximum and minimum joint angles and joint range of motion were compared with a one-way repeated measures ANOVA with significance at p < 0.05. Results Significant differences were found between stifle waveforms. No differences were found between the hip or tarsus waveforms. Minimum and maximum joint angles were significantly different for the hip and stifle but not for the tarsus. No differences were found between ranges of motion for any joint evaluated. Clinical Significance Limb position at the time of skin marker application affects gait data and is an important consideration for kinematic analysis of the hindlimb in dogs. Schattauer GmbH Stuttgart.

  5. Lightning testing of a linear optical position transducer

    Science.gov (United States)

    Lundberg, Jon

    1994-10-01

    An advantage to using a Fly-By-Light system with fiberoptic transducers and interconnects is immunity to disrupts and/or failure due to lightning strikes. The most vulnerable area of any flight control system on a helicopter is the swashplate region, where linear optical position transducers (LOPTs) would measure mean rotor actuator ram position. On the RAH-66 Comanche helicopter, LOPTs would be mounted inside the cylinders of these rams, providing protection from a direct lightning attachment to the ram. Lightning survivability testing was conducted at the Boeing Developmental Center's Lightning Facility the week of December 14 - 18, 1992. A time-division multiplexed LOPT was tested in a protected, aircraft-similar installation as well as unprotected. Transducer data during the strikes were compared to the results of similar tests performed on a linear variable differential transformer.

  6. A prospective observational study of the effect of penicillin skin testing on antibiotic use in the intensive care unit.

    Science.gov (United States)

    Arroliga, Mercedes E; Radojicic, Christine; Gordon, Steven M; Popovich, Marc J; Bashour, C Allen; Melton, Alton L; Arroliga, Alejandro C

    2003-05-01

    Patients with penicillin allergy admitted to the intensive care unit (ICU) frequently receive non-beta-lactam antimicrobials for the treatment of infection. The use of these antimicrobials, more commonly vancomycin and fluoroquinolones, is associated with the emergence of multidrug-resistant infections. The penicillin skin test (PST) can help detect patients at risk of developing an immediate allergic reaction to penicillin and those patients with a negative PST may be able to use a penicillin antibiotic safely. We determined the incidence of true penicillin allergy, the percentage of patients changed to a beta-lactam antimicrobial when the test was negative, the safety of the test, and the safety of administration of beta-lactam antimicrobials in patients with a negative test. Skin testing was performed using standard methodology. One hundred patients admitted to 4 ICUs were prospectively studied; 58 of them were male. The mean age was 63 years. Ninety-six patients had the PST: one was positive (1.04%), 10 (10.4%) were nondiagnostic, and 85 (88.5%) were negative. Of the 38 patients who received antimicrobials for therapeutic reasons, 31(81.5%) had the antibiotic changed to a beta-lactam antimicrobial after a negative reading versus 7 patients of the 57 (12%) who had received a prophylactic antimicrobial (P penicillin allergic and admitted to the ICU.

  7. Perlecan expression influences the keratin 15-positive cell population fate in the epidermis of aging skin.

    Science.gov (United States)

    Dos Santos, Morgan; Michopoulou, Anna; André-Frei, Valérie; Boulesteix, Sophie; Guicher, Christine; Dayan, Guila; Whitelock, John; Damour, Odile; Rousselle, Patricia

    2016-04-01

    The epidermis is continuously renewed by stem cell proliferation and differentiation. Basal keratinocytes append the dermal-epidermal junction, a cell surface-associated, extracellular matrix that provides structural support and influences their behaviour. It consists of laminins, type IV collagen, nidogens, and perlecan, which are necessary for tissue organization and structural integrity. Perlecan is a heparan sulfate proteoglycan known to be involved in keratinocyte survival and differentiation. Aging affects the dermal epidermal junction resulting in decreased contact with keratinocytes, thus impacting epidermal renewal and homeostasis. We found that perlecan expression decreased during chronological skin aging. Our in vitro studies revealed reduced perlecan transcript levels in aged keratinocytes. The production of in vitro skin models revealed that aged keratinocytes formed a thin and poorly organized epidermis. Supplementing these models with purified perlecan reversed the phenomenon allowing restoration of a well-differentiated multi-layered epithelium. Perlecan down-regulation in cultured keratinocytes caused depletion of the cell population that expressed keratin 15. This phenomenon depended on the perlecan heparan sulphate moieties, which suggested the involvement of a growth factor. Finally, we found defects in keratin 15 expression in the epidermis of aging skin. This study highlighted a new role for perlecan in maintaining the self-renewal capacity of basal keratinocytes.

  8. The adverse outcome pathway for skin sensitisation: Moving closer to replacing animal testing.

    Science.gov (United States)

    Schultz, Terry W; Dimitrova, Gergana; Dimitrov, Sabcho; Mekenyan, Ovanes G

    2016-10-01

    This article outlines the work of the Organisation for Economic Co-operation and Development (OECD) that led to being jointly awarded the 2015 Lush Black Box Prize. The award-winning work centred on the development of 'The Adverse Outcome Pathway for Skin Sensitisation Initiated by Covalent Binding to Proteins'. This Adverse Outcome Pathway (AOP) has provided the mechanistic basis for the integration of skin sensitisation-related information. Recent developments in integrated approaches to testing and assessment, based on the AOP, are summarised. The impact of the AOP on regulatory policy and on the Three Rs are discussed. An overview of the next generation of the skin sensitisation AOP module in the OECD QSAR Toolbox, based on more-recent work at the Laboratory of Mathematical Chemistry, is also presented. 2016 FRAME.

  9. How stress and anxiety can alter immediate and late phase skin test responses in allergic rhinitis.

    Science.gov (United States)

    Kiecolt-Glaser, Janice K; Heffner, Kathi L; Glaser, Ronald; Malarkey, William B; Porter, Kyle; Atkinson, Cathie; Laskowski, Bryon; Lemeshow, Stanley; Marshall, Gailen D

    2009-06-01

    Allergic rhinitis (AR) is the fifth most common chronic disease, and the association between allergic disorders and anxiety is well-documented. To investigate how anxiety and stressors modulate skin prick test (SPT) responses and associated inflammatory responses, 28 men and women with AR were selected by clinical history and skin test responses. The participants were admitted twice to a hospital research unit for 4h in a crossover trial. Changes in SPT wheals were assessed before and after a standardized laboratory speech stressor, as well as again the following morning; skin responses assessed twice during a lab session without a stressor and again the following morning served as the contrast condition. Anxiety heightened the magnitude of allergen-induced wheals following the stressor. As anxiety increased, SPT wheal diameters increased after the stressor, compared to a slight decrease following the control task. Anxiety also substantially enhanced the effects of stress on late phase responses: even skin tests performed the day after the stressor reflected the continuing impact of the speech stressor among the more anxious participants. Greater anxiety was associated with more IL-6 production by Con A-stimulated leukocytes following the stressor compared to the control visit. The data suggest that stress and anxiety can enhance and prolong AR symptoms.

  10. Mechanical testing of CFRP materials for application as skins of sandwich composites

    Directory of Open Access Journals (Sweden)

    Adriana STEFAN

    2017-09-01

    Full Text Available Sandwich structures are ultralight materials that are part of a special class and consist of two face skins, that are thin, light and stiff. These materials are of great interest for aeronautical and aerospace applications and they represent one of the important research directions in this field. As skins, a large variety of materials can be used, i.e. aluminium, titanium or polymeric laminates. For the evaluation of sandwich composites based on metallic foam core, a larger study is being currently conducted, one of the objectives within this study being the evaluation of the sandwich system components (CFRP skins developed by two different methods: manual lay-up/room temperature curing and prepreg processing; as well as evaluation of core materials. This paper contains technical work that presents the preliminary results regarding the evaluation of CFRP skins based on CARP/T193 carbon fiber fabric and low viscosity L20 epoxy resin (Diglycidyl Ether of Bisphenol A developed by manual lay-up/room temperature curing. The obtained materials were tested at different mechanical loads and the failure mode was analyzed with the aim to evaluate their performances as possible skins of the sandwich structure with metallic foam core.

  11. Serum sex hormone levels and their relationship with autologous serum skin test in chronic urticaria patients

    Directory of Open Access Journals (Sweden)

    Yeşim Yayla Güngör

    2015-12-01

    Full Text Available Background and Design: Although the etiology of chronic urticaria is not clear, autoimmune and inflammatory activities are suspected. We aimed to determine the relationship of serum sex hormone levels with disease severity and autologous serum skin test (ASST positivity in chronic urticaria patients on the basis of the fact that sex hormones have a regulatory role on the functions of inflammatory cells. Materials and Methods: Fifty female chronic urticaria patients and 25 age-matched healthy females were included. In the patient group, severity of illness was determined and ASST was performed. Serum prolactin, dehydroepiandrosterone sulphate (DHEA-S, follicle stimulating hormone (FSH, luteinizing hormone (LH, estradiol, progesterone and total testosterone levels in both groups were recorded. Results: There was no significant difference in the severity of illness between ASST (- and ASST (+ patients. DHEA-S levels in ASST (- and ASST (+ groups were compared, and significantly lower levels were detected in the patient group. There was no significant correlation between ASST positivity and DHEA-S levels. There was no significant difference in other hormone levels between control and patient groups. It was also found that there was no significant difference in LH/FSH levels between patient and control groups. Conclusion: In chronic urticaria patients, DHEA-S and total androgens, progesterone levels which have anti-inflammatory effects are expected to be lower, and estrogen and prolactin levels which have proinflamatory effects are expected to be higher. The reason that there was no significant difference between patient and control groups in levels other than DHEA-S may be due to the fact that these hormone levels are not directly related with autoreactivity and/or chronic urticaria.

  12. Oral Challenge without Skin Testing Safely Excludes Clinically Significant Delayed-Onset Penicillin Hypersensitivity.

    Science.gov (United States)

    Confino-Cohen, Ronit; Rosman, Yossi; Meir-Shafrir, Keren; Stauber, Tali; Lachover-Roth, Idit; Hershko, Alon; Goldberg, Arnon

    Penicillins are the drug family most commonly associated with hypersensitivity reactions. Current guidelines recommend negative skin tests (ST) before re-administering penicillins to patients with previous nonimmediate reactions (NIR). The objective of this study was to examine whether ST are necessary before re-administering penicillin to patients with NIR. Patients with NIR to penicillins starting longer than 1 hour after last dose administration or starting any time after the first treatment day or patients with vague recollection of their reaction underwent penicillin ST. Disregarding ST results, patients were challenged with the relevant penicillins. One-tenth of the therapeutic dose followed by the full dose was administered at 1-hour interval and patients continued taking the full dose for 5 days. A total of 710 patients with alleged BL allergy were evaluated. Patients with a history of immediate reaction (52, 7.3%) or cephalosporin allergy (16, 2.2%) were excluded. Of the remaining 642 patients, 62.3% had negative ST, 5.3% positive ST, and 32.4% equivocal ST. A total of 617 (96.1%) patients were challenged. Immediate reaction was observed in 9 patients (1.5%): 1-positive ST, 7-negative ST, and 1-equivocal ST (P = .7). Late reaction to the first-day challenge occurred in 24 patients (4%). An at-home challenge was continued by 491 patients. Complete 5-day and partial challenges were well tolerated by 417 (85%) and 44 patients (8.9%), respectively, disregarding ST results. Thirty patients (6.1%) developed mild reactions to the home challenge regardless of their ST results. A 5-day oral challenge without preceding ST is safe and sufficient to exclude penicillin allergy after NIR developing during penicillin treatment. Copyright © 2017 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  13. Human Skin Safety Test of Green Tea Cell Extracts in Condition of Allergic Contact Dermatitis

    OpenAIRE

    Kim, Hyun Kyu; Choi, Sun Young; Chang, Hui Kyoung; Baek, Seok Yun; Chung, Jin Oh; Rha, Chan Su; Kim, Beom Joon; Kim, Myeung Nam

    2012-01-01

    Various kinds of positive effects of green tea extracts had been studied for long time which included anti-inflammation, anti-aging, and cardiometabolic effects. Although topical steroid and non-steroidal calcineurin inhibitors may control clinical symptoms of allergic contact dermatitis, some of patients also present allergic reaction to these topical agents. Therefore, we have tried green tea extracts for managing this skin disorder with expectation of anti-inflammatory effect without poten...

  14. False-positive results with amylase testing of citrus fruits.

    Science.gov (United States)

    Ricci, Ugo; Carboni, Ilaria; Torricelli, Francesca

    2014-09-01

    In a case of robbery in which the criminals passed through the garden adorned with calamondin trees (Citrus madurensis), the investigators found in the grass six calamondin fruits, some undamaged, while others apparently bitten. The fruits were collected and sent to the laboratory for DNA analysis to verify the presence of saliva and robbers' DNA profile. A specific immunochromatographic strip test for saliva confirmed the presence of human salivary α-amylase, but similar positive results were also observed for intact calamondin and other citrus fruits. Further analysis with a specific automated amylase test confirmed the absence of amylase activity. DNA quantification and typing using a specific forensic kit revealed no human DNA presence in any fruits. This case report demonstrates for the first time the occurrence of false positives when human saliva is sought on citrus fruits. © 2014 American Academy of Forensic Sciences.

  15. Socioeconomic disparities in diagnostic testing after positive aneuploidy screening.

    Science.gov (United States)

    Wong, Amy E; Dungan, Jeffrey; Feinglass, Joseph; Grobman, William A

    2015-02-01

    The objective of this study was to investigate the association between type of health insurance (Medicaid vs. private) and uptake of diagnostic testing for fetal aneuploidy after a positive screening test result. We performed a retrospective cohort study of pregnant women who underwent aneuploidy screening in the first and/or second trimesters of pregnancy and received positive results. The characteristics of and outcomes for women with Medicaid were compared with those of women with private insurance in both univariable and multivariable analyses. In this study, 75 women with Medicaid and 75 with private insurance were analyzed. Those with Medicaid were younger (33.8 vs. 36.9 years, p aneuploidy screen (35 vs. 57%, p screening for aneuploidy. These results emphasize the potential importance of improved counseling for low-income women. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  16. Risks of Skin Cancer Screening

    Science.gov (United States)

    ... of Skin Cancer Skin Cancer Screening Research Skin Cancer Screening (PDQ®)–Patient Version What is screening? Go to ... all skin colors can get skin cancer. Skin Cancer Screening Key Points Tests are used to screen for ...

  17. Diagnosis and immunotherapy of mould allergy. III. Diagnosis of Cladosporium allergy by means of symptom score, bronchial provocation test, skin prick test, RAST, CRIE and histamine release.

    Science.gov (United States)

    Malling, H J; Dreborg, S; Weeke, B

    1986-01-01

    Thirty-three adult asthmatic patients suspected of mould allergy were investigated by in vivo and in vitro tests in order to establish a specific diagnosis of asthma caused by the mould species Cladosporium. The patients were evaluated by daily symptom scores in the peak Cladosporium season, bronchial provocation test (BPT), skin prick test (SPT), RAST, histamine release from basophil granulocytes (HIST), and crossed radioimmunoelectrophoresis (CRIE), and the results were scored as negative (score 0), equivocal (score 1) or positive (score 2). Based on daily symptom scores and the result of BPT the patients were classified as being manifest allergic (asthma) to Cladosporium (positive allergy), inconclusive or negative. Positive allergy was defined as asthma symptoms oscillating with the spore concentration and a BPT score 2 (positive at allergen concentration less than 10,000 BU). Negative allergy was defined as no asthma symptoms and a negative BPT (score 0) and inconclusive in the case of symptoms and BPT sum of score 1-3. According to the classification a final diagnosis (positive or negative) could be established in 85% of the patients. "False positive" tests were found: for BPT in 27%, SPT 18%, RAST 0%, HIST 18%, and CRIE 0%. The corresponding figures for "false negative" were: BPT 0%, SPT 0%, RAST 27%, HIST 18%, and CRIE 23%. The relative risk of being allergic in spite of a negative test result was 0% for BPT and SPT, and 25-30% with RAST, HIST, and CRIE. In the case of positive test the risk was 90-100%. Excluding BPT, SPT was found to be the optimal single test to predict/rule out clinical allergy. A stepwise combination of positive SPT and positive RAST was found exclusively in patients clinically evaluated as positive, and does not call for an additional BPT. Using a potent allergenic extract a negative SPT excluded clinically important allergy. The primary conclusion of the study, however, is that the final diagnosis of Cladosporium asthma could not be

  18. First-in-man open clinical trial of a combined rdESAT-6 and rCFP-10 tuberculosis specific skin test reagent.

    Directory of Open Access Journals (Sweden)

    Winnie Bergstedt

    2010-06-01

    Full Text Available Tuberculin is still the only available skin test reagent for the diagnosis of mycobacterial infection. The product has a remarkable sensitivity, but poor specificity. Previous studies, including two human phase I clinical trials, have indicated that rdESAT-6 has a potential as an improved skin test reagent. Animal studies have shown that the sensitivity may be increased by inclusion of the genetically related CFP-10 antigen in the preparation without loosing specificity.In this study a Lactococcus fermented, recombinant skin test reagent consisting of a 1ratio1 wt/wt of rdESAT-6 and CFP-10 was manufactured according to GMP standards and tested for the first time in 42 healthy adult volunteers. The two doses of 0.01 microg or 0.1 microg were injected intradermally by the Mantoux technique with 6 or 12 weeks interval. No serious adverse events and only mild adverse reactions were reported. The reagent elicited a positive skin test reaction after the first injection in one participant, who most likely was latently infected with M. tuberculosis as indicated by an appreciable IFN gamma response just below the Quantiferon(R cut-off level at the screening visit. None of the remaining participants in the four groups had any skin test reactions and sensitisation by the reagent could therefore be excluded.The investigational skin test reagent rdESAT-6 and CFP-10 appeared safe and non-sensitising in this first-in-man clinical trial in human volunteers and can now be tested in larger clinical trials involving individuals with latent M. tuberculosis infection or active TB disease.ClinicalTrials.gov NCT00793702.

  19. Skin sensitisation--moving forward with non-animal testing strategies for regulatory purposes in the EU.

    Science.gov (United States)

    Basketter, David; Alépée, Nathalie; Casati, Silvia; Crozier, Jonathan; Eigler, Dorothea; Griem, Peter; Hubesch, Bruno; de Knecht, Joop; Landsiedel, Robert; Louekari, Kimmo; Manou, Irene; Maxwell, Gavin; Mehling, Annette; Netzeva, Tatiana; Petry, Thomas; Rossi, Laura H

    2013-12-01

    In a previous EPAA-Cefic LRI workshop in 2011, issues surrounding the use and interpretation of results from the local lymph node assay were addressed. At the beginning of 2013 a second joint workshop focused greater attention on the opportunities to make use of non-animal test data, not least since a number of in vitro assays have progressed to an advanced position in terms of their formal validation. It is already recognised that information produced from non-animal assays can be used in regulatory decision-making, notably in terms of classifying a substance as a skin sensitiser. The evolution into a full replacement for hazard identification, where the decision is not to classify, requires the generation of confidence in the in vitro alternative, e.g. via formal validation, the existence of peer reviewed publications and the knowledge that the assay(s) are founded on key elements of the Adverse Outcome Pathway for skin sensitisation. It is foreseen that the validated in vitro assays and relevant QSAR models can be organised into formal testing strategies to be applied for regulatory purposes by the industry. To facilitate progress, the European Partnership for Alternative Approaches to animal testing (EPAA) provided the platform for cross-industry and regulatory dialogue, enabling an essential and open debate on the acceptability of an in vitro based integrated strategy. Based on these considerations, a follow up activity was agreed upon to explore an example of an Integrated Testing Strategy for skin sensitisation hazard identification purposes in the context of REACH submissions. Copyright © 2013 Elsevier Inc. All rights reserved.

  20. Definition of Sensitive Skin: An Expert Position Paper from the Special Interest Group on Sensitive Skin of the International Forum for the Study of Itch.

    Science.gov (United States)

    Misery, Laurent; Ständer, Sonja; Szepietowski, Jacek C; Reich, Adam; Wallengren, Joanna; Evers, Andrea W M; Takamori, Kenji; Brenaut, Emilie; Le Gall-Ianotto, Christelle; Fluhr, Joachim; Berardesca, Enzo; Weisshaar, Elke

    2017-01-04

    Sensitive skin is a frequent complaint in the general population, in patients, and among subjects suffering from itch. The International Forum for the Study of Itch (IFSI) decided to initiate a special interest group (SIG) on sensitive skin. Using the Delphi method, sensitive skin was defined as "A syndrome defined by the occurrence of unpleasant sensations (stinging, burning, pain, pruritus, and tingling sensations) in response to stimuli that normally should not provoke such sensations. These unpleasant sensations cannot be explained by lesions attributable to any skin disease. The skin can appear normal or be accompanied by erythema. Sensitive skin can affect all body locations, especially the face". This paper summarizes the background, unresolved aspects of sensitive skin and the process of developing this definition.

  1. Assuring consumer safety without animal testing: a feasibility case study for skin sensitisation.

    Science.gov (United States)

    Maxwell, Gavin; Aleksic, Maja; Aptula, Aynur; Carmichael, Paul; Fentem, Julia; Gilmour, Nicola; Mackay, Cameron; Pease, Camilla; Pendlington, Ruth; Reynolds, Fiona; Scott, Daniel; Warner, Guy; Westmoreland, Carl

    2008-11-01

    Allergic Contact Dermatitis (ACD; chemical-induced skin sensitisation) represents a key consumer safety endpoint for the cosmetics industry. At present, animal tests (predominantly the mouse Local Lymph Node Assay) are used to generate skin sensitisation hazard data for use in consumer safety risk assessments. An animal testing ban on chemicals to be used in cosmetics will come into effect in the European Union (EU) from March 2009. This animal testing ban is also linked to an EU marketing ban on products containing any ingredients that have been subsequently tested in animals, from March 2009 or March 2013, depending on the toxicological endpoint of concern. Consequently, the testing of cosmetic ingredients in animals for their potential to induce skin sensitisation will be subject to an EU marketing ban, from March 2013 onwards. Our conceptual framework and strategy to deliver a non-animal approach to consumer safety risk assessment can be summarised as an evaluation of new technologies (e.g. 'omics', informatics), leading to the development of new non-animal (in silico and in vitro) predictive models for the generation and interpretation of new forms of hazard characterisation data, followed by the development of new risk assessment approaches to integrate these new forms of data and information in the context of human exposure. Following the principles of the conceptual framework, we have been investigating existing and developing new technologies, models and approaches, in order to explore the feasibility of delivering consumer safety risk assessment decisions in the absence of new animal data. We present here our progress in implementing this conceptual framework, with the skin sensitisation endpoint used as a case study. 2008 FRAME.

  2. Organizational Benchmarks for Test Utilization Performance: An Example Based on Positivity Rates for Genetic Tests.

    Science.gov (United States)

    Rudolf, Joseph; Jackson, Brian R; Wilson, Andrew R; Smock, Kristi J; Schmidt, Robert L

    2017-04-01

    Health care organizations are under increasing pressure to deliver value by improving test utilization management. Many factors, including organizational factors, could affect utilization performance. Past research has focused on the impact of specific interventions in single organizations. The impact of organizational factors is unknown. The objective of this study is to determine whether testing patterns are subject to organizational effects, ie, are utilization patterns for individual tests correlated within organizations. Comparative analysis of ordering patterns (positivity rates for three genetic tests) across 659 organizations. Hierarchical regression was used to assess the impact of organizational factors after controlling for test-level factors (mutation prevalence) and hospital bed size. Test positivity rates were correlated within organizations. Organizations have a statistically significant impact on the positivity rate of three genetic tests.

  3. Purification of bufadienolides from the skin of Bufo bufo gargarizans Cantor with positively charged C18 column.

    Science.gov (United States)

    Li, Xiaolong; Guo, Zhimou; Wang, Chaoran; Shen, Aijin; Liu, Yanfang; Zhang, Xiuli; Zhao, Weijie; Liang, Xinmiao

    2014-04-01

    As a kind of promising anticancer compounds, the preparation of bufadienolides is a hot study spot. However, due to the complexity of biological sample, the purification of bufadienolides from a crude sample (toad skin) is a tough work. In this paper, we reported a new way based on positively charged C18 material (XCharge C18) to quickly separate and purify bufadienolides from toad skin. By this method, the different ionic feature of the amino acid conjugated bufadienolides (AACBs) and the free form bufadienolides (AAUBs) was firstly utilized to obtain distinct separation selectivity on the XCharge C18 column. Additionally, the peak tailing problem of AACBs on conventional C18 was resolved and better resolutions were achieved on the XCharge C18, thus, two kinds of bufadienolides on one column were successfully purified respectively. Taking F13 as an example, the method was validated by liquid chromatography-mass spectrometry (LC-MS), and then 4 AACBs as well as 4 AAUBs were simultaneously purified by preparative XCharge C18. In addition, the application of this method in other fractions was also validated. The results suggested that the developed method is a practical and promising tool for efficient separation and purification of bufadienolides from toad skin. Copyright © 2014 Elsevier B.V. All rights reserved.

  4. In Vitro Activities of Tedizolid and Linezolid against Gram-Positive Cocci Associated with Acute Bacterial Skin and Skin Structure Infections and Pneumonia.

    Science.gov (United States)

    Chen, Ko-Hung; Huang, Yu-Tsung; Liao, Chun-Hsing; Sheng, Wang-Hui; Hsueh, Po-Ren

    2015-10-01

    Tedizolid is a novel, expanded-spectrum oxazolidinone with potent activity against a wide range of Gram-positive pathogens. A total of 425 isolates of Gram-positive bacteria were obtained consecutively from patients with acute bacterial skin and skin structure infections (ABSSSIs) or pneumonia. These isolates included methicillin-susceptible Staphylococcus aureus (MSSA) (n = 100), methicillin-resistant Staphylococcus aureus (MRSA) (n = 100), Streptococcus pyogenes (n = 50), Streptococcus agalactiae (n = 50), Streptococcus anginosus group (n = 75), Enterococcus faecalis (n = 50), and vancomycin-resistant enterococci (VRE) (Enterococcus faecium) (n = 50). The MICs of tedizolid and linezolid were determined by the agar dilution method. Tedizolid exhibited better in vitro activities than linezolid against MSSA (MIC90s, 0.5 versus 2 μg/ml), MRSA (MIC90s, 0.5 versus 2 μg/ml), S. pyogenes (MIC90s, 0.5 versus 2 μg/ml), S. agalactiae (MIC90s, 0.5 versus 2 μg/ml), Streptococcus anginosus group (MIC90s, 0.5 versus 2 μg/ml), E. faecalis (MIC90s, 0.5 versus 2 μg/ml), and VRE (MIC90s, 0.5 versus 2 μg/ml). The tedizolid MICs against E. faecalis (n = 3) and VRE (n = 2) intermediate to linezolid (MICs, 4 μg/ml) were 1 μg/ml and 0.5 μg/ml, respectively. The tedizolid MIC90s against S. anginosus, S. constellatus, and S. intermedius were 0.5, 1, and 0.5 μg/ml, respectively, and the rates of susceptibility based on the U.S. FDA MIC interpretive breakpoints to the isolates were 16%, 28%, and 72%, respectively. Tedizolid exhibited 2- to 4-fold better in vitro activities than linezolid against a variety of Gram-positive cocci associated with ABSSSIs and pneumonia. The lower susceptibilities of tedizolid against isolates of S. anginosus and S. constellatus than against those of S. intermedius in Taiwan were noted. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

  5. Anaphylaxis due to Brazil nut skin testing in a walnut-allergic subject.

    Science.gov (United States)

    Senna, G; Bonadonna, P; Crivellaro, M; Schiappoli, M; Passalacqua, G

    2005-01-01

    The diagnosis and management of nut allergy can be difficult because of the possible severity of the clinical manifestations and the cross reactivity between different species. We report a case of anaphylaxis due to skin testing in a young adult with clinically ascertained walnut allergy. After an episode of anaphylaxis due to walnut ingestion, a routine diagnostic workup was carried out, involving skin prick test with commercial extracts, prick by prick with fresh food and CAP-RAST assay for different nuts. Immediately after pricking with fresh Brazil nut, a severe episode of anaphylaxis occurred, that required epinephrine and intravenous steroids. The subject had never eaten Brazil nut before. Therefore we hypothesize a cross reactivity effect, since this phenomenon is well known for tree nuts. Our case suggests that in vivo diagnosis, especially if fresh nuts are used, should be performed only if adequate equipment to treat anaphylaxis is available.

  6. Evaluation of the tuberculin skin test and the interferon-gamma release assay for TB screening in French healthcare workers.

    Science.gov (United States)

    Tripodi, Dominique; Brunet-Courtois, Benedicte; Nael, Virginie; Audrain, Marie; Chailleux, Edmond; Germaud, Patrick; Naudin, Frederique; Muller, Jean-Yves; Bourrut-Lacouture, Martine; Durand-Perdriel, Marie-Henriette; Gordeeff, Claire; Guillaumin, Guyonne; Houdebine, Marietherese; Raffi, Francois; Boutoille, David; Biron, Charlotte; Potel, Gilles; Roedlich, Claude; Geraut, Christian; Schablon, Anja; Nienhaus, Albert

    2009-11-30

    Using French cut-offs for the Tuberculin Skin Test (TST), results of the TST were compared with the results of an Interferon-gamma Release Assay (IGRA) in Healthcare Workers (HCW) after contact to AFB-positive TB patients. Between May 2006 and May 2007, a total of 148 HCWs of the University Hospital in Nantes, France were tested simultaneously with IGRA und TST. A TST was considered to indicate recent latent TB infection (LTBI) if an increase of >10 mm or if TST >/= 15 mm for those with no previous TST result was observed. For those with a positive TST, chest X-ray was performed and preventive chemotherapy was offered. All HCWs were BCG-vaccinated. The IGRA was positive in 18.9% and TST >/= 10 mm was observed in 65.5%. A recent LTBI was believed to be highly probable in 30.4% following TST. Agreement between IGRA and TST was low (kappa 0.041). In 10 (16.7%) out of 60 HCWs who needed chest X-ray following TST the IGRA was positive. In 9 (20%) out of 45 HCWs to whom preventive chemotherapy was offered following TST the IGRA was positive. Of those considered TST-negative following the French guidelines, 20.5% were IGRA-positive. In a two-step strategy - positive TST verified by IGRA - 18 out of 28 (64.3%) IGRA-positive HCWs would not have been detected using French guidelines for TST interpretation. The introduction of IGRA in contact tracings of BCG-vaccinated HCWs reduces X-rays and preventive chemotherapies. Increasing the cut-off for a positive TST does not seem to be helpful to overcome the effect of BCG vaccination on TST.

  7. Evaluation of the tuberculin skin test and the interferon-γ release assay for TB screening in French healthcare workers

    Directory of Open Access Journals (Sweden)

    Raffi Francois

    2009-11-01

    Full Text Available Abstract Introduction Using French cut-offs for the Tuberculin Skin Test (TST, results of the TST were compared with the results of an Interferon-γ Release Assay (IGRA in Healthcare Workers (HCW after contact to AFB-positive TB patients. Methods Between May 2006 and May 2007, a total of 148 HCWs of the University Hospital in Nantes, France were tested simultaneously with IGRA und TST. A TST was considered to indicate recent latent TB infection (LTBI if an increase of >10 mm or if TST ≥ 15 mm for those with no previous TST result was observed. For those with a positive TST, chest X-ray was performed and preventive chemotherapy was offered. Results All HCWs were BCG-vaccinated. The IGRA was positive in 18.9% and TST ≥ 10 mm was observed in 65.5%. A recent LTBI was believed to be highly probable in 30.4% following TST. Agreement between IGRA and TST was low (kappa 0.041. In 10 (16.7% out of 60 HCWs who needed chest X-ray following TST the IGRA was positive. In 9 (20% out of 45 HCWs to whom preventive chemotherapy was offered following TST the IGRA was positive. Of those considered TST-negative following the French guidelines, 20.5% were IGRA-positive. In a two-step strategy - positive TST verified by IGRA - 18 out of 28 (64.3% IGRA-positive HCWs would not have been detected using French guidelines for TST interpretation. Conclusion The introduction of IGRA in contact tracings of BCG-vaccinated HCWs reduces X-rays and preventive chemotherapies. Increasing the cut-off for a positive TST does not seem to be helpful to overcome the effect of BCG vaccination on TST.

  8. Pollen food allergy syndrome in Turkey: Clinical characteristics and evaluation of its association with skin test reactivity to pollens.

    Science.gov (United States)

    Özdemir, Seςil Kepil; Özgüςlü, Selcan

    2017-09-17

    There is limited data regarding pollen food allergy syndrome (PFAS) in Turkey. To investigate the clinical characteristics and possible risk factors of PFAS in Turkey, and to evaluate if there was an association between skin test reactivity to pollens and presence of PFAS. A total of 254 consecutive adult patients with pollen sensitivity were prospectively recruited. Patients were interviewed with a questionnaire including a list of pollen-associated foods. Patients were classified as having PFAS if they reported clear allergic symptoms compatible with PFAS. All participants underwent skin prick tests (SPT) to a panel of common aeroallergens, prick-to-prick tests with culprit fresh foods were performed in patients who gave consent. Self-reported PFAS was observed in 49 patients (19.3%). The most common culprit foods were kiwi, peach, tomato, melon and watermelon. Multiple logistic regression analysis showed that potential risk factors for PFAS were having asthma (OR=2.392, P=0.044) and tree pollen sensitization (OR=2.904, P=0.004). There were no significant differences in the SPT wheal sizes to individual pollen extracts between patients with and without PFAS with a positive SPT result for that pollen extract (P> 0.05). PFAS is frequent in pollen sensitized adults in Turkey. The most commonly implicated foods are kiwi, peach,tomato, melon and watermelon, in our geographical region. SPT wheal sizes to pollen extracts seems to be similar in patients with and without PFAS.

  9. Skin testing and drug challenge outcomes in antibiotic-allergic patients with immediate-type hypersensitivity.

    Science.gov (United States)

    Mawhirt, Stephanie L; Fonacier, Luz S; Calixte, Rose; Davis-Lorton, Mark; Aquino, Marcella R

    2017-01-01

    The evaluation of antibiotic immediate-type hypersensitivity is intricate because of nonstandardized skin testing and challenge method variability. To determine the safety outcomes and risk factors for antibiotic challenge reactions in patients reporting a history of antibiotic immediate-type hypersensitivity. A 5-year retrospective review of patients evaluated for immediate-type antibiotic allergy was conducted. Data analyzed included patient demographics, index reaction details, and outcomes of skin testing and challenges, classified as single-step or multistep. Antibiotic hypersensitivity history was identified in 211 patients: 78% to penicillins, 10% to fluoroquinolones, 7.6% to cephalosporins, and 3.8% to carbapenems. In total, 179 patients completed the challenges (median age 67 years, range 50-76 years, 56% women), and compared with nonchallenged patients, they reported nonanaphylactic (P antibiotic allergies (P = .005). No correlation was detected between the reported index and observed challenge reaction severities (κ = -0.05, 95% confidence interval -0.34 to 0.24). Anaphylactic rates were similar during single-step and multistep challenges (3.6% vs 3.3%). In the present population, younger women with multiple reported antibiotic allergies were at greatest risk for challenge reactions. Negative skin testing results did not exclude reactions, and index severity was not predictive of challenge outcome. The multistep and full-dose methods demonstrated a comparable reaction risk for anaphylaxis. Copyright © 2016 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  10. Test equality between two binary screening tests with a confirmatory procedure restricted on screen positives.

    Science.gov (United States)

    Lui, Kung-Jong; Chang, Kuang-Chao

    2015-01-01

    In studies of screening accuracy, we may commonly encounter the data in which a confirmatory procedure is administered to only those subjects with screen positives for ethical concerns. We focus our discussion on simultaneously testing equality of sensitivity and specificity between two binary screening tests when only subjects with screen positives receive the confirmatory procedure. We develop four asymptotic test procedures and one exact test procedure. We derive sample size calculation formula for a desired power of detecting a difference at a given nominal [Formula: see text]-level. We employ Monte Carlo simulation to evaluate the performance of these test procedures and the accuracy of the sample size calculation formula developed here in a variety of situations. Finally, we use the data obtained from a study of the prostate-specific-antigen test and digital rectal examination test on 949 Black men to illustrate the practical use of these test procedures and the sample size calculation formula.

  11. Epstein-Barr Virus-Positive T/NK-Cell Lymphoproliferative Disorders Manifested as Gastrointestinal Perforations and Skin Lesions: A Case Report.

    Science.gov (United States)

    Xiao, Hai-Juan; Li, Ji; Song, Hong-Mei; Li, Zheng-Hong; Dong, Mei; Zhou, Xiao-Ge

    2016-02-01

    Systemic Epstein-Barr virus (EBV)-positive T-cell lymphoproliferative disorders (LPDs) of childhood is a highly aggressive EBV-positive T/natural killer (NK)-cell LPD, which emerges in the background of chronic active EBV infection (CAEBV) or shortly after primary acute EBV infection. The clinical presentations of CAEBV are varied; patients with atypical manifestations are easily misdiagnosed. We described a 14-year-old boy suffering from digestive disorders and intermittent fever for 1 year and 9 months, whose conditions worsened and skin lesions occurred 2 months before hospitalization. He was diagnosed as inflammatory bowel diseases (IBD) and treated accordingly. His other clinical features, hepatosplenomegaly, lymphadenopathy, anemia, hypoalbuminemia, and elevated inflammatory marks, were found in hospitalization. The boy suffered from repeatedly spontaneous intestinal perforations shortly after hospitalization and died of intestinal hemorrhea. The pathological results of intestine and skin both showed EBV-positive T/NK-cell LPD (lymphoma stage).There are rare studies reporting gastrointestinal perforations in EBV-positive T/NK-cell LPD, let alone repeatedly spontaneous perforations. Based on the clinical features and pathological results of this patient, the disease progressed from CAEBV (T-cell type) to systemic EBV-positive T-cell LPD of childhood (lymphoma). Not all the patients with CAEBV could have unusual patterns of anti-EBV antibodies. However, the presence of high EBV loads (EBV-encoded early small ribonucleic acid (RNA) (EBER) in affected tissues and/or EBV deoxyribonucleic acid (DNA) in peripheral blood) is essential for diagnosing CAEBV. Maybe because of his less common clinical features for CAEBV and negative anti-EBV antibodies, the boy was not diagnosed correctly. We should have emphasized the test for EBER or EBV-DNA. Meanwhile, for the IBD patients whose manifestations were not typical, and whose conditions were not improved by suitable

  12. Correlation of serum antithyroid microsomal antibody and autologous serum skin test in patients with chronic idiopathic urticaria

    Directory of Open Access Journals (Sweden)

    Snehal Balvant Lunge

    2015-01-01

    Full Text Available Background: About 25-45% of patients of chronic urticaria (CU have been stated to have histamine releasing autoantibodies in their blood. The term autoimmune urticaria is increasingly being accepted for this subgroup of patients. Review of the literature suggests high autologous serum skin test (ASST positivity and presence of antithyroid microsomal antibodies in patients with autoimmune urticaria. Aims: To study prevalence of ASST positivity and antithyroid microsomal antibodies in chronic "idiopathic" urticaria and to study the correlation between the two parameters. Methods: All patients of chronic idiopathic urticaria satisfying inclusion/exclusion criteria were enrolled in the study after written informed consent. Patients of CU secondary to infections and infestations, physical urticaria including dermatographism, mastocytosis, urticarial vasculitis and those on treatment with immunosuppressive drugs for urticaria were excluded from the study. In all of these patients, complete blood count; ASST, serum T3/T4/thyroid stimulating hormone levels, antithyroid microsomal antibody (AMA levels were done. Statistical analysis was done by Chi-square test, Fisher exact test and Kappa statistics. Results: Study included 24 males and 26 females with mean age of 39.54 years. Majority of patients belonged to 20-40 years of age. Females showed more ASST positivity. A total of 12 out of 50 (24% patients showed positive ASST. A total of four out of 12 (33.33% had positive ASST and raised AMA levels. Conclusion: Only 25% of patients of chronic idiopathic urticaria had positive ASST. ASST and AMA levels were positively correlated in our study. Further studies are required to authenticate this association.

  13. Correlation of serum antithyroid microsomal antibody and autologous serum skin test in patients with chronic idiopathic urticaria

    Science.gov (United States)

    Lunge, Snehal Balvant; Borkar, Milind; Pande, Sushil

    2015-01-01

    Background: About 25–45% of patients of chronic urticaria (CU) have been stated to have histamine releasing autoantibodies in their blood. The term autoimmune urticaria is increasingly being accepted for this subgroup of patients. Review of the literature suggests high autologous serum skin test (ASST) positivity and presence of antithyroid microsomal antibodies in patients with autoimmune urticaria. Aims: To study prevalence of ASST positivity and antithyroid microsomal antibodies in chronic “idiopathic” urticaria and to study the correlation between the two parameters. Methods: All patients of chronic idiopathic urticaria satisfying inclusion/exclusion criteria were enrolled in the study after written informed consent. Patients of CU secondary to infections and infestations, physical urticaria including dermatographism, mastocytosis, urticarial vasculitis and those on treatment with immunosuppressive drugs for urticaria were excluded from the study. In all of these patients, complete blood count; ASST, serum T3/T4/thyroid stimulating hormone levels, antithyroid microsomal antibody (AMA) levels were done. Statistical analysis was done by Chi-square test, Fisher exact test and Kappa statistics. Results: Study included 24 males and 26 females with mean age of 39.54 years. Majority of patients belonged to 20–40 years of age. Females showed more ASST positivity. A total of 12 out of 50 (24%) patients showed positive ASST. A total of four out of 12 (33.33%) had positive ASST and raised AMA levels. Conclusion: Only 25% of patients of chronic idiopathic urticaria had positive ASST. ASST and AMA levels were positively correlated in our study. Further studies are required to authenticate this association. PMID:26225328

  14. GPS (Global Positioning System) Data Link for Test and Training

    Science.gov (United States)

    1982-09-01

    exercisej. Virst, because GPS -ill be world-wide, the range need I not be tied to a specific piece of real estate ; variety in training is thus; muc...terminal as well. The data bus thus provides a menas for solving two prcblems associated with the use of operational aircraft in tests and instrýA... real -time or near real -time player positions would p..obably be required; this, in turn, would "probably require a GPS set at the range receiving station

  15. Skin prick test reactivity to lupin in comparison to peanut, pea, and soybean in atopic and non-atopic German subjects: A preliminary cross-sectional study.

    Science.gov (United States)

    Bähr, Melanie; Fechner, Anita; Kaatz, Martin; Jahreis, Gerhard

    2014-08-01

    The increasing use of lupin in food processing poses a problem of potential (cross-)allergic reactions. To evaluate the prevalence of sensitization to lupin in comparison to that of other legumes skin prick tests were performed with lupin, pea, peanut, and soybean in atopic (n = 81) and non-atopic (n = 102) German adults. Of these 183 subjects, 20 subjects had to be excluded due to invalid skin prick tests (reaction to histamine 2 mm). Thus, skin prick tests of 163 subjects were included in final analyses. Of 163 subjects, 18 had a positive reaction to at least one legume tested. Overall skin prick test reactivity was different among non-atopic and atopic subjects (P = 0.005). Altogether, six subjects (4%) were sensitized to lupin, 12 (7%) to pea, 5 (3%) to peanut, and 8 (5%) to soybean. Two (2%) of the 92 non-atopic subjects and 4 (6%) of the 71 atopic subjects had a positive skin prick test to lupin. Of the 6 subjects sensitized to lupin, 3 (50%) were also sensitized to pea, 3 (50%) to peanut, and 5 (83%) to soybean. In conclusion, the prevalence rates of lupin sensitization were comparable to or even lower than those of pea, peanut, and soybean. To date, lupin allergy is suspected to be relatively uncommon in the overall German population since lupin sensitization occurred in only 2% of non-atopic subjects. However, there is a clear risk of a lupin allergy in predisposed subjects, since the frequency of lupin sensitization was 6% in atopic subjects. In particular, subjects with existing sensitization or allergy to other legumes are at higher risk for a sensitization or allergy to lupin due to cross-reactivity.

  16. Autologous serum skin test as an indicator of chronic autoimmune urticaria in a tertiary care hospital in South India

    Directory of Open Access Journals (Sweden)

    Adaikalampillai Ganapathy Vikramkumar

    2014-01-01

    Full Text Available Background: Autologous serum skin test (ASST is a simple in-vivo clinical test for the detection of basophil histamine releasing activity and to diagnose chronic autoimmune urticaria (CAU among chronic spontaneous urticaria (CSU patients. Diagnosing these patients is also important as they may need high doses of antihistamines and systemic corticosteroids during acute exacerbations. Aims and Objectives: The aim of this study is to study the prevalence of CAU among cases of CSU by using ASST. Materials and Methods: This was a cross-sectional study done among 48 patients presenting with CSU. Detailed history, physical examination and routine investigations were recorded for all patients. ASST was done on all the 48 patients. Results: Of the 48 patients included in the study, 20 patients (41.6% were ASST positive, while the remaining 28 (58% were ASST negative. The median duration of disease in both ASST positive and negative patients was 1 year. ASST positivity was higher (66.6% among patients with a history of round shaped weals, though not statistically significant. ASST positivity was seen in 5 (71.4% out of seven patients with systemic involvement, which was again not statistically significant. Conclusion: Our study did not show any significant difference between patients with and without antibodies regarding mean age and sex distribution, clinical morphology of individual weals, duration, severity, systemic symptoms, angioedema, atopy, and association with other autoimmune conditions.

  17. Reactivation of tuberculosis during immunosuppressive treatment in a patient with a positive QuantiFERON-RD1 test

    DEFF Research Database (Denmark)

    Ravn, Pernille; Munk, Martin E; Andersen, Ase Bengaard

    2004-01-01

    A patient with polymyositis developed tuberculosis during immunosuppressive treatment. Tuberculin Skin Test and chest X-ray failed to demonstrate latent tuberculosis, whereas a blood sample that was tested with a modified QuantiFERON-TB-assay, using the recombinant ESAT-6 and CFP-10, was positive...... indicating that this patient was latently infected before immunosuppressive therapy. This case indicates the risk of progressing from latent to active tuberculosis given that the subject is RD1 responsive, and we believe that preventive anti-tuberculous treatment could have prevented this case...... of tuberculosis. We suggest that RD1 based tests are evaluated further in immunocompromised patients....

  18. Rubbing test responses of the skin to man-made mineral fibres of different diameters.

    Science.gov (United States)

    Stam-Westerveld, E B; Coenraads, P J; van der Valk, P G; de Jong, M C; Fidler, V

    1994-07-01

    The irritant potency of 5 types of insulation wools (2 types of rockwool and 3 types of glasswool) were studied on the basis of their differences in diameter by a standardized rubbing test. Assessment was done by laser Doppler flowmetry (LDF) and erythema scores. Insulation wools show a wide distribution of the diameter around the mean. Of the rockwool material, 30% consisted of small grains, called "shot". The control test site did not change over time; thus, the rubbing procedure itself does not seem to contribute to the skin reactions. All fibre types proved to be irritant to the skin. The irritant reactions did not correspond with the mean diameter, although the fibre type with the smallest diameter was the least irritant and the fibre type with the largest diameter the strongest. The presence of "shot" had a significant effect on the LDF responses. "Shot" and the distribution around the mean diameter may play a role in eliciting the skin irritation by insulation wools.

  19. Comparison between Siriraj mite allergen vaccine and standardized commercial mite vaccine by skin prick testing in normal Thai adults.

    Science.gov (United States)

    Visitsunthorn, Nualanong; Pacharn, Punchama; Jirapongsananuruk, Orathai; Weeravejsukit, Sirirat; Sripramong, Chaweewan; Sookrung, Nitat; Bunnag, Chaweewan

    2010-03-01

    House dust mite is a major cause of allergic asthma and rhinitis in Thai population. Skin prick test (SPT) is a useful tool for the diagnosis of the IgE-mediated reactions. The imported commercial mite vaccine for SPT is available but it is relatively expensive. Aim of this study is to compare Siriraj Mite Allergen Vaccine (SMAV) with standardized commercial mite allergen vaccine by skin prick testing in normal Thai adults. A double blind, self-controlled study between the SMAV and standardized commercial mite allergen vaccine was performed by SPT in 17 normal Thai adult males and non-pregnant or non-lactating females aged 18-60 years. The study showed that 35.29 % of non atopic adults had positive SPT reaction to Dp and Df of both SMAV and standardized commercial mite allergen vaccine. Mean wheal and flare diameters from SPT of Dp and Df of SMAV showed strong correlation with standardized commercial mite allergen vaccine (r= 0.768 and 0.897 in Dp and Df respectively, p standardized commercial mite allergen vaccine. No systemic or large local reaction was found in any of the study cases.

  20. Clinical features of allergic rhinitis and skin prick test analysis based on the ARIA classification: a preliminary study in Malaysia.

    Science.gov (United States)

    Asha'ari, Zamzil Amin; Yusof, Suhaimi; Ismail, Rushdan; Che Hussin, Che Maraina

    2010-08-01

    Allergic rhinitis (AR) is a prevalent disease worldwide but is still underdiagnosed in many parts of Asia. We studied the clinical profiles of AR patients in our community based on the new ARIA classification and investigated the aetiological allergens using a skin prick test. In 2008, 142 newly diagnosed patients with AR were seen and underwent skin prick testing with 90 patients completing the study. Intermittent mild and moderate/severe AR were evident in 10% and 21.1% of the patients, while persistent mild and moderate/severe were seen in 20% and 48.9%, respectively. Rhinitis and asthma co-morbidity occurred in 28.8% with asthma incidence significantly higher in persistent AR (P = 0.002). There was no significant association between AR severity, city living and asthma co-morbidity. Nasal itchiness and sneezing were the main presenting complaints and were more common in intermittent AR (P Sleep disturbance was associated with moderate-severe AR (P <0.05). Polypoidal mucosa was associated with asthma co-morbidity (P <0.05). Monosensitivity reaction occurred in 12.2% of patients and was associated with fungi sensitivity (P <0.05). Majority of patients were oligosensitive (52.8%) and polysensitive (34.4%) and were significantly associated with moderate-severe persistent AR (P <0.01). The highest positive skin prick reaction and the largest average wheal diameter were for the house dust mites and cat allergen (P <0.05). Our results reflected the AR profiles in our country, which was comparable with typical profiles of the neighbouring country and other Mediterranean countries with a similar temperate climate.

  1. Anomalous cutaneous absorption of allergens as cause of skin prick testing adverse reactions in adult patients. Clinical and experimental evidence.

    Science.gov (United States)

    Antico, A; Arisi, M; Lima, G

    2015-07-01

    Paediatric age, active eczema and high number of allergens tested in poly-sensitized patients have been pinpointed as possible risk factors of systemic reactions by skin prick testing. As far as atopic eczema concerns, the higher penetration of the allergens into the skin because of the scraping or micro-injuries is an intuitive rationalization. Purpose of the present study is to provide documentary evidence that adverse reactions elicited by anomalous absorption of allergens can occur also in adult patients with apparently normal skin. Report of some exemplifying clinical and experimental observations. Measuring the inoculum volume into impaired skin and its variability in relation to the variation of the chemical-physical characteristic of the solutions used for the tests by means of a method of direct assay based on the use of a gamma-camera. Localized impairments of the skin permeability can cause a significant increase in inoculum volume by prick-test. Critical amounts of allergens can be introduced into the skin because of the possibility of direct absorption, also without pricking, of allergy diagnostic solutions. The greater water content of the solutions used for prick-testing can significantly increase the inoculum volume. This study adds clinical and experimental evidences that localized impairments of permeability can occur in adult patients with apparently normal skin. Special precautions should be taken when a change of the drops' normal shape and cohesion is seen, because allergy prick-testing in such areas is potentially associated with increased risk of large local or systemic reactions.

  2. Characterizing the Vertical Distribution of Hydraulic Conductivity Using the Multilevel Slug Test Subject to Skin Effects: Comparison of the Uniform-head and Uniform-flux Wellbore Conditions

    Science.gov (United States)

    wei-Chiang, C.; Chen, C. S.

    2016-12-01

    The multilevel slug test (MLST) is an in-well technique in characterizing the vertical distribution of hydraulic conductivity K(z) in granular or fractured formations. In modeling MLST, the well screen is either simulated as a uniform-flux (UF) or a uniform head (UH) condition. This study investigates the impact of the skin effect, positive or negative, on the UH and UF models. The positive skin effect, as associated with a reduced hydraulic conductivity surrounding the well due to drilling mud invasion, is taken into account by making use of a skin factor, Sk.The negative skin effect, as associated with an increased hydraulic conductivity due to overdeveloping of the well, is modeled by using an effective well radius, re, which is greater than or equal to the well radius, rw. The UF and UH models are compared using different values of Sk and re for a variety of the partial penetration ratio of screen length to aquifer thickness, φ, the vertical anisotropy ratio of hydraulic conductivity, κ, and the aspect ratio of rw to the screen length, α. It is found that (1) the two models yield results of negligible difference when the well fully penetrates the aquifer (i.e., φ=1) regardless of the values of α,κ, Sk or re, (2) the two models yield essentially the same results for negative skin for all α and κ, (3) the difference between the two models decreases as Sk gets larger, regardless of the values of α, φ, or κ, yet it becomes negligible for Sk is greater than unity, and (4) when the skin effect is absent, the maximum difference between the two models is within 3-5%. As a result, it is suggested the UF model be used since it is mathematically easier to solve than the UH model, with or without skin effects.

  3. Assessment of a protein cocktail-based skin test for bovine tuberculosis in a double-blind field test in cattle.

    Science.gov (United States)

    Xin, Ting; Jia, Hong; Ding, Jiabo; Li, Pingjun; Yang, Hongjun; Hou, Shaohua; Yuan, Weifeng; Guo, Xiaoyu; Wang, Haichun; Liang, Qianqian; Li, Ming; Wang, Bin; Zhu, Hongfei

    2013-04-01

    Bovine tuberculosis (bTB) is a worldwide zoonosis caused mainly by Mycobacterium bovis. The traditional diagnostic method used often is the tuberculin skin test, which uses bovine purified protein derivatives (PPD-B). However, it is difficult to maintain uniformity of PPD-B from batch to batch, and it shares common antigens with nonpathogenic environmental mycobacteria. To overcome these problems, M. bovis-specific antigens that showed good T cell stimulation, such as CFP-10, ESAT-6, Rv3615c, etc., have been used in the skin test, but there have been no large-scale clinical studies on these antigens. In this study, two combinations (CFP-10/ESAT-6/TB10.4 protein cocktail and CFP-10/ESAT-6/Rv3872/MPT63 protein cocktail) were developed and used as stimuli in the skin test. Cattle were double-blind tested to assess the efficiency of the protein cocktail-based skin tests. The results showed that the CFP-10/ESAT-6/TB10.4 protein cocktail-based skin test can differentiate TB-infected cattle from Mycobacterium avium-infected ones and that it shows a high degree of agreement with the traditional tuberculin skin test (κ = 0.8536) and gamma interferon (IFN-γ) release assay (κ = 0.8154). Compared to the tuberculin skin test, the relative sensitivity and relative specificity of the CFP-10/ESAT-6/TB10.4-based skin test were 87% and 97%, respectively., The relative sensitivity and relative specificity of the CFP-10/ESAT-6/TB10.4-based skin test were 93% and 92%, respectively, on comparison with the IFN-γ release assay. The correlation between the increases in skin thickness observed after the inoculation of stimuli was high (PPD-B versus CFP-10/ESAT-6/TB10.4, Spearman r of 0.8435). The correlation between the optical density at 450 nm (OD450) obtained after blood stimulation with PPD-B and the increase in skin thickness observed after inoculation of the CFP-10/ESAT-6/TB10.4 protein cocktail was high (Spearman r = 0.7335). Therefore, the CFP-10/ESAT-6/TB10.4-based skin test

  4. The detection of sensitivity of proprioception by a new clinical test: the dual joint position test.

    Science.gov (United States)

    Beckmann, Yesim Yetimalar; Çiftçi, Yeliz; Ertekin, Cumhur

    2013-07-01

    To date, very few studies have paid attention to the joint sense (proprioception) of toes other than the big toe. We evaluated the sensitivity of joint position sense at the joint of the great toe in comparison to other digits, and with that determined by the dual digit stimulation test, in a sample of healthy normal controls and patients with clinical diagnosis of the lemniscal system dysfunction. Seventy-two patients with lemniscal system dysfunction (55 clinically definitive multiple sclerosis, 17 vasculitis) and 110 healthy volunteers participated in the study. All subjects underwent the joint position sense test of all digits of upper and lower extremities. The position sense resulting from the combined operation of the joints of the second and the fourth digits (simultaneous two digits position sense) was also measured and subsequently compared with the results of the great toe position sense. Upper extremities: no difference was found in recognition of the position sense in the single digits of the upper extremities between patients and healthy volunteers. There was a significant difference in the dual joint position test of the right upper extremity between patients and the case group (pproprioception of the great toe neither in the right and nor in the left side between patients and normal subjects. However, the joint position sense of other single digits was deteriorated in the patients, a difference that was significant compared to normal controls (pproprioception of simultaneous dual digits is diminished in patients when compared to a single digit position sense. Moreover, the great toe proprioception is less sensitive than other digits. Taken together, these observations lend evidence for a new clinical method which we named as dual joint position test. We suggest this novel method offers clinical utility to demonstrate lemniscal system dysfunction. Copyright © 2012 Elsevier B.V. All rights reserved.

  5. Safety of the two-step tuberculin skin test in Indian health care workers.

    Science.gov (United States)

    Christopher, Devasahayam J; Shankar, Deepa; Datey, Ashima; Zwerling, Alice; Pai, Madhukar

    2014-12-01

    Health care workers (HCW) in low and middle income countries are at high risk of nosocomial tuberculosis infection. Periodic screening of health workers for both TB disease and infection can play a critical role in TB infection control. Occupational health programs that implement serial tuberculin skin testing (TST) are advised to use a two-step baseline TST. This helps to ensure that boosting of waned immune response is not mistaken as new TB infection (i.e. conversion). However, there are no data on safety of the two-step TST in the Indian context where HCWs are repeatedly exposed. Nursing students were recruited from 2007 to 2009 at the Christian Medical College and Hospital, Vellore, India. Consenting nursing students were screened with a baseline two-step TST at the time of recruitment. From 2007 to 2008 adverse events were recorded when reported during the TST reading (Cohort A). Nurses recruited in the final study year (2009) answered an investigator administered questionnaire assessing all likely side-effects Cohort B). This information was extracted from the case report forms and analysed. Between 2007 and 09, 800 trainees consented to participate in the annual TB screening study and 779 did not have a past history of TB or recall a positive TST and were selected to administer TST. Of these, 755 returned for reading the result and had complete data and were included for the final analysis - 623 subjects in (cohort A) and 132 in (cohort B). These were included for the final analysis. In cohort A only 1.3% reported adverse events. In cohort B, as per the investigator administered questionnaire; 25% reported minor side effects. Itching and local pain were the most common side effects encountered. There were no major adverse events reported. In particular, the adverse events were similar in the second step of the test and not more severe. Screening of HCWs with two-step TST for LTBI is simple and safe, and hence suitable for wide scale implementation in high

  6. Testing GNSS ionosphere models based on the position domain

    Science.gov (United States)

    Orus-Perez, Raul; Rovira, Adria

    2017-04-01

    As is well know, the ionosphere is one of the main contributors to the navigation error of single-frequency users. Currently, there are many models available for correcting the ionosphere delay. Thus, the different GNSS provide its own ionosphere corrections in the Signal-in-Space as for instance, NeQuick G for Galileo or Klobuchar for GPS. Other sources for ionosphere corrections are the Satellite Based Augmentation Systems (i.e. EGNOS or WAAS), Global Ionospheric Maps (i.e. provided by IGS), regional maps and even climatological models, like NeQuick or IRI. With this large variety of models, there have been a lot of efforts to define a suitable strategy to test the accuracy of the different models. Usually, this testing has been done by computing a "reference ionosphere", using all kind of GNSS techniques, using ionosonde data or using altimeter data. These techniques are not bias free and they may raise questions on which is the absolute accuracy they achieve. In order to complement these tests, a new methodology has been developed to test ionosphere models for GNSS. This methodology is based on the position domain, modeling the observables on each frequency with geodetic accuracy, and then to combine the obtained least square solutions to determine the ionosphere error. The results of the testing for different GIMs from IGS and different Signal-in-Space models (GPS, Galileo, and EGNOS) will be presented for 2 years of the last Solar Maximum with more than 40 receivers worldwide. The weaknesses and strengths of the new methodology will also be shown to get a comprehensive idea of its capabilities.

  7. Course of Skin Symptoms and Quality of Life in Children Referred for Patch Testing - A Long-term Follow-up Study

    DEFF Research Database (Denmark)

    Simonsen, Anne B; Sommerlund, Mette; Deleuran, Mette

    2014-01-01

    Children are patch tested in the same manner as adults, but little has been done to establish whether positive or negative findings influence the course of skin symptoms. To uncover the course of skin symptoms and the impact of persistent eczema on life quality in paediatric patients referred...... for patch testing, a retrospective questionnaire was sent to children and adolescents referred for patch testing during a 9-year period. Persistent eczema at follow-up was strongly associated to atopic dermatitis, but was not explained by gender, age, contact allergy or time span from patch testing...... to follow-up. Among patients without atopic dermatitis, 23.5% reported to suffer from chronic eczema. Persistent eczema increased the risk of severe impairment of life quality. Our findings indicate a significant risk of childhood eczema becoming chronic and affecting life quality considerably. Patch...

  8. [Diagnostic use of enzymatic RAST skin tests and determination of eosinophils in nasal mucosa in allergic rhinitis].

    Science.gov (United States)

    Gómez Castillo, C A; Martínez Cairo Cueto, S

    1998-01-01

    Allergic rhinitis is the most frequent disease mediated by immunoglobulin E (IgE). Nasal challenge is the gold standard for the diagnosis of allergic rhinitis. Skin tests (ST) are the most used diagnostic method to detect the presence of specific IgE bind to skin mast cells. The exposition of the nasal mucous membrane to the allergen is followed by an increase of the local eosinophils; the count of eosinophils in nasal mucous (ENM) is a diagnostic test for allergic rhinitis. Enzymatic RAST or enzymatic allergo-sorbent test (ESA) measures the level of serum allergen-specific IgE. To measure the sensitivity, specificity, and diagnostic precision of ST, EAST and ENM in allergic rhinitis. We studied 241 individuals, 162 of them had allergic rhinitis, and 79 were healthy controls. They underwent nasal challenge and intradermic ST for Dermatophagoies spp (acarus). Fraxinus americana (Ash-tree), Amaranthus palmieri (quelite), Cynodon Dactylon (capriola) and Felis catus (cat), EAST for Dermatophagoides pteronyssinus (acarus), and ENIVI. Results of ST, EAST and ENIVI were compared with their corresponding nasal challenge, and the prevalence of allergic rhinitis for each allergen was calculated. The best cut point was assessed by means of receiver-operator curves (ROC), and sensitivity, specificity, positive predictive value, negative predictive value, inter-observer concordance coefficient, area under ROC (0), standard error of 0 (SEO), and 95% confidence interval of 0 of each test were calculated using the best cut point. ST and EAST had the best sensitivity and specificity. ENM had the lowest sensitivity and specificity. For the diagnosis of Dermatophagoides spp allergic rhinitis ST for Dermatophagoides spp and EAST for Dermatophagoides pteronyssinus have the same diagnostic precision. According to the indexes for diagnostic precision, and inter-observer concordance coefficient, ST and EAST are useful to diagnose allergic rhinitis induced by the evaluated allergens. ENIVI

  9. Her-2 Positive Gastric Cancer Presented with Thrombocytopenia and Skin Involvement: A Case Report

    Directory of Open Access Journals (Sweden)

    Deniz Arslan

    2014-01-01

    Full Text Available Gastric cancer is the 5th most frequent cancer around the world and the 3rd most frequent reason of deaths due to cancer. Every year, about 1 million new cases are taking place, with varying geographical distribution. Gastric cancer is often metastatic to liver, lungs, and bones in hematogenous way, to peripheral lymph nodes in lymphogenous way, and to peripheral tissues in adjacency way, yet bone marrow (BM and cutaneous metastasis are quite seldom. Pancytopenia is a more frequent finding identified in BM metastasis of solid organ cancers, and isolated thrombocytopenia is less often. The human epidermal growth factor 2 (HER-2 is positive in gastric cancer at a rate of 7–34%. Here, we have presented our HER-2 positive gastric cancer incident which presented with BM and cutaneous metastasis, and has no 18F-fluoro-2-deoxi-D-glucose (FDG involvement except bone metastases.

  10. Stability Testing of a Wide Bone-Anchored Device after Surgery without Skin Thinning

    Directory of Open Access Journals (Sweden)

    Malou Hultcrantz

    2015-01-01

    Full Text Available Objective. To longitudinally follow the osseointegration using Resonance Frequency Analysis (RFA for different lengths of abutment on a new wide bone-anchored implant, introduced with the non-skin thinning surgical technique. Study Design. A single-center, prospective 1 year study following adults with bone-anchored hearing implants. Materials and Methods. Implantation was performed and followed for a minimum of 1 year. All patients were operated on according to the tissue preserving technique. A 4.5 mm wide fixture (Oticon Medical with varying abutments (9 to 12 mm was used and RFA was tested 1 week, 7 weeks, 6 months, and 12 months later. Implant Stability Quotient (ISQ, was measured from 1 to 100. Stability was compared to a group of patients (N=7 implanted with another brand (Cochlear BI400 of 4.5 mm fixtures. Results. All 10 adults concluded the study. None of the participants lost their implant during the test period indicating a good anchoring of abutments to the wide fixture tested. Stability testing was shown to vary depending on abutment length and time after surgery and with higher values for shorter abutments and increasing values over the first period of time. One patient changed the abutment from 12 to 9 mm and another from a 9 to a 12 during the year. No severe skin problems, numbness around the implant, or cosmetic problems arose. Conclusion. After 1 year of follow-up, combination of a wide fixture implant and the non-skin thinning surgical technique indicates a safe procedure with good stability and no abutment losses.

  11. Risk of Allergic Reactions to Recurrent Intravenous Penicillin Administration in Penicillin Skin Test Negative Patients.

    Science.gov (United States)

    Dorman, Steve M; Seth, Sharon; Khan, David A

    Patients with a history of penicillin allergy who are found to be skin test negative to penicillin are able to tolerate repeated oral doses of penicillin with low rates of resensitization. However, the resensitization rate after repeated doses of intravenous penicillin is less clear. We sought to evaluate the risk of allergic reactions to repeated doses of intravenous penicillin in patients who previously reported penicillin allergy and were found to be penicillin skin test and oral challenge negative. A retrospective review was conducted between 2010 and 2016 of adult patients who were treated at our academically affiliated hospitals. Patients included in the review had negative penicillin allergy testing and were treated with 2 or more courses of intravenous penicillins. Charts were evaluated to identify any adverse drug reactions. Thirty-two patients met our inclusion criteria. The index penicillin-associated reactions ranged from rash to hypotension and were, for the most part, remote as 75% had reported reactions more than 10 years previously. More than 50% of patients received 3 or more courses of intravenous penicillins. The most frequently repeated intravenous penicillin overall was piperacillin/tazobactam. Thirty-two patients received a total of 111 courses of intravenous penicillins and none developed an immediate hypersensitivity reaction. In patients who report penicillin allergy and have negative penicillin allergy testing, repeated administration of intravenous penicillin antibiotics appears to be safe. Larger prospective studies should be performed to confirm these observations. Copyright © 2017 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  12. Sensitivity Comparison of the Skin Prick Test and Serum and Fecal Radio Allergosorbent Test (RAST) in Diagnosis of Food Allergy in Children

    OpenAIRE

    Kianifar, Hamid Reza; Pourreza, Alireza; Jabbari Azad, Farahzad; Yousefzadeh, Hadis; Masomi, Fatemeh

    2016-01-01

    Background: Diagnosis of food allergy is difficult in children. Food allergies are diagnosed using several methods that include medical histories, clinical examinations, skin prick and serum-specific immunoglobulin E (IgE) tests, radio-allergosorbent test (RAST), food challenge, and supervised elimination diets. In this study we evaluated allergies to cow's milk, egg, peanut, and fish in children with suspected food allergies with skin prick tests and serum and feces RAST. Methods: Forty-o...

  13. Compositional analysis and physicochemical and mechanical testing of tanned rabbit skins

    Directory of Open Access Journals (Sweden)

    M.L. R. Sousa

    2016-09-01

    Full Text Available Chemical composition and physicochemical and mechanical parameters of New Zealand White rabbit tanned skin were evaluated. Skin samples from 70-d-old males, in natura and semi-finished, were collected for evaluation. The in natura treatment comprise skins without any processing, while semi-finished treatment comprise skins after soaking, fleshing, liming, de-liming, purging, degreasing, pickling, tanning, neutralising, re-tanning and dyeing, followed by oiling, drying, stretching and softening. After tanning, samples from the dorsal and flank regions were removed for tensile and physicochemical testing in the longitudinal and transverse directions. A split plot design was used with plot treatments (leather regions: R1=dorsal and R2=flank and subplots directions (S1=longitudinal and S2=transversal, using 10 examples per treatment. At the end of processing, the leather analysis revealed low moisture (31.76%, protein (46.48% and fat content (24.95%, and a high ash content (8.58%. Leather presented a pH of 4.9 and contained 2.0% chromium oxide, 25.5% extractable substances in dichloromethane, and these characteristics were coupled with a higher tensile strength (10.84 N/mm2 in the dorsal region. However, samples in the same region proved to have higher elasticity (64.57% in the longitudinal direction, although there was no difference in the progressive tearing analysis (21.07-23.50 N/mm. Overall, our analyses suggest that, in this case, the tanned leather product does not have sufficient resistance for application in clothing production.

  14. Tuberculin skin test and ELISPOT/T. SPOT.TB in children and adolescents with juvenile idiopathic arthritis

    National Research Council Canada - National Science Library

    Sztajnbok, Flavio; Boechat, Neio L F; Ribeiro, Samantha B; Oliveira, Sheila K F; Sztajnbok, Denise C N; Sant'Anna, Clemax C

    2014-01-01

    There are controversies regarding the accuracy of the tuberculin skin test (TST) and methods based on the production of interferon gamma by sensitized T cells for the diagnosis of latent tuberculosis infection (LTBI...

  15. Prediction of new-onset asthma and nasal allergy by skin prick test and RAST in a cohort of adults.

    Science.gov (United States)

    Gallmeier, Kerstin; Becker, Eva; Kirsten, Anne; Wölke, Gabriele; Manuwald, Olaf; Meyer, Heike; Magnussen, Helgo; Nowak, Dennis; Heinrich, Joachim

    2014-01-01

    Limited information exists regarding the incidence and predictors of asthma and nasal allergy in adulthood. We determined the incidence rate of asthma and nasal allergy in adults and assessed the predictive value of skin prick tests (SPTs) and radioallergosorbent tests (RASTs) for these two outcomes. Two German centres involved in the European Community Respiratory Health Survey conducted a follow-up assessment in 2012 of the baseline participants (1185 adults aged 21-47 years assessed in 1990). The predictive value of SPTs and RASTs on new-onset asthma and nasal allergy was assessed by Cox regression and by calculating the positive or negative predictive value. During the 20 years between baseline and follow-up, 3.1 and 4.4 per 1000 person-years of new-onset asthma and nasal allergy cases were recorded, respectively. The hazard ratios for SPTs of any specific and of all aeroallergens combined were slightly higher than those of RASTs for asthma and nasal allergy. The negative predictive values of both the SPT and RAST were very high and similar (0.94-0.96), whereas the postive predictive values were low (0.09-0.20). Positive SPT results showed a better association with new onset asthma and nasal allergy than positive RAST either to any specific aeroallergens or to all combined.

  16. Approach/avoidance motivation, message framing and skin cancer prevention: a test of the congruency hypothesis.

    Science.gov (United States)

    Hevey, David; Dolan, Michelle

    2014-08-01

    The congruency hypothesis posits that approach-orientated individuals are persuaded to engage in prevention behaviours by positively framed messages; conversely, negatively framed messages are more persuasive in encouraging those who are avoidance-orientated. A 2 (frame: loss vs gain) × 2 (motivation: avoidance vs approach) design examined the effects of skin cancer information on sun-protective intentions and free sunscreen sample requests among 533 young adults. Gain-framed messages had the strongest effect on sun-protective intentions for approach-oriented individuals, whereas loss-framed messages had the strongest effect on avoidance-oriented individuals. Message framing effects on precautionary sun behaviour intentions were moderated by motivational differences. © The Author(s) 2013.

  17. Comparison of the Performance of Skin Prick, ImmunoCAP, and ISAC Tests in the Diagnosis of Patients with Allergy.

    Science.gov (United States)

    Griffiths, Rebecca L M; El-Shanawany, Tariq; Jolles, Stephen R A; Selwood, Clive; Heaps, Adrian G; Carne, Emily M; Williams, Paul E

    2017-01-01

    Allergy is diagnosed from typical symptoms, and tests are performed to incriminate the suspected precipitant. Skin prick tests (SPTs) are commonly performed, inexpensive, and give immediate results. Laboratory tests (ImmunoCAP) for serum allergen-specific IgE antibodies are usually performed more selectively. The immuno-solid phase allergen chip (ISAC) enables testing for specific IgE against multiple allergen components in a multiplex assay. We retrospectively analysed clinic letters, case notes, and laboratory results of 118 patients attending the National Adult Allergy Service at the University Hospital of Wales who presented diagnostic difficulty, to evaluate which testing strategy (SPT, ImmunoCAP, or ISAC) was the most appropriate to use to confirm the diagnosis in these complex patients, evaluated in a "real-life" clinical service setting. In patients with nut allergy, the detection rates of SPTs (56%) and ISAC (65%) were lower than those of ImmunoCAP (71%). ISAC had a higher detection rate (88%) than ImmunoCAP (69%) or SPT (33%) in the diagnosis of oral allergy syndrome. ImmunoCAP test results identified all 9 patients with anaphylaxis due to wheat allergy (100%), whereas ISAC was positive in only 6 of these 9 (67%). In this difficult diagnostic group, the ImmunoCAP test should be the preferred single test for possible allergy to nuts, wheat, other specific foods, and anaphylaxis of any cause. In these conditions, SPT and ISAC tests give comparable results. The most useful single test for oral allergy syndrome is ISAC, and SPT should be the preferred test for latex allergy. © 2017 S. Karger AG, Basel.

  18. The sensitization potential of sunscreen after ablative fractional skin resurfacing using modified human repeated insult patch test.

    Science.gov (United States)

    Boonchai, Waranya; Sathaworawong, Angkana; Wongpraparut, Chanisada; Wanitphakdeedecha, Rungsima

    2015-10-01

    Ablative fractional skin resurfacing has become popular and proven to be useful in treating scars, photoaging and wrinkles. Although post-inflammatory hyperpigmentation (PIH) is the most common complication especially in dark-skinned patients like Asian. Several modalities have been used to overcome the PIH. To determine the sensitization potential of sunscreen applied immediately after ablative fractional skin resurfacing. Sixty volunteers were recruited. Of these 30 subjects were from previous ablative fractional skin resurfacing study who applied broad-spectrum sunscreen containing anti-inflammatory agent starting on the first day after resurfacing and another 30 non-resurfacing subjects had applied the same sunscreen on the intact skin. All subjects were patch/photopatch tested for sensitization study by using modified human repeated insult patch test (HRIPT). There were significantly higher sensitization rate of UV-filter, octocrylene and the sunscreen in resurfacing group than in non-resurfacing group. Early application of sunscreen after ablative fractional skin resurfacing has increased the incidence of sensitization potential of sunscreen. The sunscreen is recommended to start using from D3 after fractional ablative skin resurfacing to ensure the complete recovery of skin barrier and minimize the risk of sensitization.

  19. Beam position determination for the Test Storage Ring

    Energy Technology Data Exchange (ETDEWEB)

    Baumann, Peter

    1987-01-01

    The Test Storage Ring (TSR) for heavy ions, currently under design and construction at the Max Planck Institute for Nuclear Physics in Heidelberg, requires an extensive beam diagnostics system in order to enable it to operate without friction. This thesis concerns the beam position determination sub-system of this diagnostics system which is intended to determine the beam center of gravity of a bunched beam inside the cross section of the beam tube in a non-destructive manner. An electrostatic pickup is used to sense the location of the beam; the mode of operation of this device will be explained in detail. The signals go to a preamplifier from where they are then sent via a multiplex system to the measuring unit. This point also represents the interface to the computer system that controls the TSR. The prototype developed here was tested with the aid of a particle beam, as well as with other measurement methods. Resolutions of better than 1 mm about the center have been measured. In order to achieve or even improve such resolutions later in actual operation, it is possible to determine the properties of the preamplifiers with the aid of calibration signals and to take these into account in the course of the signal evaluation in the computer. The differences between the individual electrodes of a given pickup must also be compensated. These procedures and their associated electronic circuits are also described in this paper.

  20. Predictive value of the cow?s milk skin prick test in infantile colic

    OpenAIRE

    Moravej, Hossein; Imanieh, Mohammad H.; Kashef, Sara; Handjani, Farhad; Eghterdari, Fardin

    2010-01-01

    BACKGROUND AND OBJECTIVES: Infantile colic is a common problem among young infants. Cow?s milk allergy has been suggested as one of the causes. We aimed to investigate the value of the cow?s milk skin test for the diagnosis of cow?s milk allergy in exclusively breast-fed infants with infantile colic. METHODS: Exclusively breast-fed infants with infantile colic were enrolled in this study. On the first visit, the average hours of crying of the infant in a 24-h period were recorded and the cow?...

  1. Proposal of abolition of the skin sensitivity test before equine rabies immune globulin application

    Directory of Open Access Journals (Sweden)

    CUPO Palmira

    2001-01-01

    Full Text Available An epizootic outbreak of rabies occurred in 1995 in Ribeirão Preto, SP, with 58 cases of animal rabies (54 dogs, 3 cats and 1 bat confirmed by the Pasteur Institute of São Paulo, and one human death. The need to provide care to a large number of people for the application of equine rabies immune globulin (ERIG prevented the execution of the skin sensitivity test (SST and often also the execution of desensitization, procedures routinely used up to that time at the Emergency Unit of the University Hospital of the Faculty of Medicine of Ribeirão Preto, University of São Paulo (EU-UHFMRP-USP, a reference hospital for the application of heterologous sera. In view of our positive experience of several years with the abolition of SST and of the use of premedication before the application of antivenom sera, we used a similar schedule for ERIG application. Of the 1489 victims of animal bites, 1054 (71% received ERIG; no patient was submitted to SST and all received intravenously anti-histamines (anti-H1 + anti-H2 and corticosteroids before the procedure. The patients were kept under observation for 60 to 180 minutes and no adverse reaction was observed. On the basis of these results, since December 1995 ERIG application has been decentralized in Ribeirão Preto and has become the responsibility of the Emergency Unit of the University Hospital and the Central Basic Health Unit, where the same routine is used. Since then, 4216 patients have received ERIG (1818 at the Basic Health Unit and 2398 at the EU-UHFMRP, with no problems. The ideal would be the routine use of human rabies immune globulin (HRIG in public health programs, but this is problematic, because of their high cost. However, while this does not occur, the use of SST is no longer justified at the time of application of ERIG, in view of the clinical evidence of low predictive value and low sensitivity of SST involving the application of heterologous sera. It is very important to point out

  2. Testing Human Skin and Respiratory Sensitizers—What Is Good Enough?

    Directory of Open Access Journals (Sweden)

    Anki Malmborg

    2017-01-01

    Full Text Available Alternative methods for accurate in vitro assessment of skin and respiratory sensitizers are urgently needed. Sensitization is a complex biological process that cannot be evaluated accurately using single events or biomarkers, since the information content is too restricted in these measurements. On the contrary, if the tremendous information content harbored in DNA/mRNA could be mined, most complex biological processes could be elucidated. Genomic technologies available today, including transcriptional profiling and next generation sequencing, have the power to decipher sensitization, when used in the right context. Thus, a genomic test platform has been developed, denoted the Genomic Allergen Rapid Detection (GARD assay. Due to the high informational content of the GARD test, accurate predictions of both the skin and respiratory sensitizing capacity of chemicals, have been demonstrated. Based on a matured dendritic cell line, acting as a human-like reporter system, information about potency has also been acquired. Consequently, multiparametric diagnostic technologies are disruptive test principles that can change the way in which the next generation of alternative methods are designed.

  3. P16INK4a Positive Cells in Human Skin Are Indicative of Local Elastic Fiber Morphology, Facial Wrinkling, and Perceived Age

    DEFF Research Database (Denmark)

    Waaijer, Mariëtte E C; Gunn, David A; Adams, Peter D

    2016-01-01

    Senescent cells are more prevalent in aged human skin compared to young, but evidence that senescent cells are linked to other biomarkers of aging is scarce. We counted cells positive for the tumor suppressor and senescence associated protein p16INK4a in sun-protected upper-inner arm skin biopsies......INK4a positive cells were significantly associated with age-associated elastic fiber morphologic characteristics, such as longer and a greater number of elastic fibers. The p16INK4a positive epidermal cells (identified as primarily melanocytes) were also significantly associated with more facial...... wrinkles and a higher perceived age. Participants in the lowest tertile of epidermal p16INK4a counts looked 3 years younger than those in the highest tertile, independently of chronological age and elastic fiber morphology. In conclusion, p16INK4a positive cell numbers in sun-protected human arm skin...

  4. Reactivation of tuberculosis during immunosuppressive treatment in a patient with a positive QuantiFERON-RD1 test

    DEFF Research Database (Denmark)

    Ravn, Pernille; Munk, Martin E; Andersen, Ase Bengaard

    2004-01-01

    A patient with polymyositis developed tuberculosis during immunosuppressive treatment. Tuberculin Skin Test and chest X-ray failed to demonstrate latent tuberculosis, whereas a blood sample that was tested with a modified QuantiFERON-TB-assay, using the recombinant ESAT-6 and CFP-10, was positive...... indicating that this patient was latently infected before immunosuppressive therapy. This case indicates the risk of progressing from latent to active tuberculosis given that the subject is RD1 responsive, and we believe that preventive anti-tuberculous treatment could have prevented this case...

  5. Validitas Hasil Pemeriksaan Skin Prick Test terhadap Imunoglobulin E RAST Tungau Debu Rumah dan Debu Rumah pada Dermatitis Atopik

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    Yeyen Yovita Mulyana

    2012-09-01

    Full Text Available In extrinsic type atopic dermatitis (AD there is an increased of specific immunoglobulin (IgE towards house dust mites (HDM and house dust (HD, resulting in positive skin prick test (SPT. The method of this study was cross sectional, analytic-observational, to find validity of SPT toward HDM and HD IgE radioallergosorbent (RAST in AD patients. The study was held from August to November 2011 in Department of Dermatovenereology Dr. Hasan Sadikin Hospital Bandung. Spearman’s rank correlation coefficient was used for statistical analysis. The results showed positive SPT to HDM in AD patients were statistically significant higher than non-AD. Positive SPT to HD in AD patients were higher than non-AD but statistically non significant. Value of HDM SPT positivity and IgE RAST in AD was directly proportional, but not with HD. There was a higher positivity of HMD SPT in AD patients (15/16 than in non-AD (5/16. Positivity value of HDM SPT was proportional to the HDM IgE RAST in AD patients with Spearman’s Rank correlation coefficient 0.541 (p=0.031. The results of HDM SPT toward HDM IgE RAST in AD patients showed higher validity sensitivity, specificity, and accuracy, 100%, 25% and 81% respectively, while HD SPT toward HD IgE RAST with sensitivity, specificity, and accuracy 43%, 78% and 63% respectively. In conclusions, HDM TDR examination could be used as a marker for AD diagnosis, due to positive HDM TDR examination result could give a meaning of increased specific IgE with RAST IgE examination.

  6. Palmitoleic acid isomer (C16:1delta6) in human skin sebum is effective against gram-positive bacteria.

    Science.gov (United States)

    Wille, J J; Kydonieus, A

    2003-01-01

    The percent lipid composition of pooled human sebum analyzed by thin-layer chromatography was: ceramides (13%), fatty acid (47%), cholesterol (7%), cholesterol esters (2%), squalene (11%), triglycerides (3%), and wax esters (17%). Total sebum lipids (2- 4 mg/ml), sonicated into bacterial culture medium, caused 4- to 5-fold log reduction in growth of gram-positive bacteria, Staphylococcus aureus, Streptococcus salivarius and the anaerobe Fusobacterium nucleatum, but was ineffective against most gram-negative bacteria. Fractionation of the sebum lipids showed that both saturated and unsaturated fatty acids contained the bulk of the antimicrobial activity. Lauric acid (C12:0) was the most active saturated fatty acid. The unsaturated fatty acid, palmitoleic acid (C16:1delta6, cPA) was both the most predominant monoene and the most active antimicrobial fatty acid. Purified cPA (>99%) yielded typical minimal inhibitory concentration (MIC) values of 10-20 microg/ml against gram-positive bacteria. Organically synthesized cPA isomer gave MIC values comparable to the natural material. Both natural and synthetic cPA were found to be the most active sebum lipid fraction in blocking the adherence of a pathogenic strain of Candida albicans to porcine stratum corneum. Ethanol in combination with cPA exerts a synergistic bactericidal activity against gram-negative pathogenic bacteria, including Pseudomonas aeruginosa, Propionibacterium acnes, Escherichia coli, and several methacillin-resistant strains of S. aureus. Palmitoleic acid may be useful in topical formulations for treatment of secondary gram-positive bacterial infections, as a gram-positive bacteria antimicrobial in wound dressings, and as a natural gram-positive antimicrobial preservative in skin and hair care products. Copyright 2003 S. Karger AG, Basel

  7. The results of skin prick testing in patients with allergic rhinitis: a comparison between a multiple lancet device and a single lancet.

    Science.gov (United States)

    Ateş, Aşkin; Kinikli, Gülay; Turgay, Murat; Aydoğan, Nergis; Duman, Murat

    2004-01-01

    Skin prick testing (SPT) is widely used in the assessment of allergic disorders. Different SPT techniques are widely used. The aim of this study was to compare the response to SPT using a multiple lancet device (MLD) with the results of a single lancet (SL). Fifty patients with allergic rhinitis were included in this study. Initially, SPT was performed by a SL technique. After one week SPT was repeated using the MLD on all patients. The patients were tested with a panel containing 19 specific allergens including grass pollen, tree pollen, house dust mites, weed pollen allergen extracts, histamine and a negative control. The skin responses were recorded after 15 minutes for each device by measuring the diameter of the wheal and the erythema. The skin wheal responses for grass pollen, tree pollen, weed pollen and house dust mite allergen extracts obtained using the SL were generally significantly larger than those using the MLD. The comparison between the MLD and the SL methods revealed that SPT was positive with SL and negative with MLD in 176 tests (15.3%), and on the contrary SPT was positive with MLD and negative with SL in only 13 tests (1%). In conclusion, we claim that SPT using SL shows a higher degree of sensitivity and reproducibility.

  8. An evaluation of the diagnostic value of different skin tests with egg in clinically egg-allergic children having atopic dermatitis

    DEFF Research Database (Denmark)

    Hansen, Tine K; Høst, Arne; Bindslev-Jensen, Carsten

    2004-01-01

    in diagnosing egg allergy. Ten clinically egg-allergic children with atopic dermatitis (AD; age 10 months to 8.4 yr, mean 3.4 yr) and 10 egg-tolerant children with and 10 without AD (age 2.4-11 yr, mean 5.5 yr) participated. In SAFT several false-negative reactions were seen, whereas all clinically egg......Skin testing is a common diagnostic procedure in food allergy, but the final diagnosis of food allergy is based on the clinical response to food challenge. We studied the value of the skin prick-prick test (SPT), skin application food test (SAFT) and atopy patch test (APT) with fresh egg extract......-allergic children were positive in SPT and 40-60% in APT. In APT and in SPT false-positive reactions to egg were observed. In this study comprising a small number of patients including control subjects, neither SAFT nor APT with fresh whole egg extract were able to increase the diagnostic accuracy in detecting egg...

  9. Direct antiglobulin test positivity in multi-transfused thalassemics

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    Ashish Jain

    2016-01-01

    Full Text Available Introduction: Red cell allo- and auto-immunization is a well recognized problem in multi-transfused thalassemic patients. We conducted this study on 301 multi-transfused thalassemic patients under the Thalassemia Transfusion Programme of Advanced Pediatric Centre of PGIMER. Aims and Objectives: The study was designed to determine the frequency of alloimmunization and autoimmunization in multi-transfused thalassemic patients and to establish the specificity of alloantibody to red cell antigens, if alloimmunization is detected. Materials and Methods: The antibody screening was performed by the conventional tube technique using commercially available three cell screening panel (Diamed Switzerland by saline, low ionic strength solution (LISS and albumin indirect antiglobulin test (IAT. Samples with alloantibodies were then tested with red cell identification panel to determine the alloantibody specificity. Autoantibody screening was performed by direct antiglobulin test (DAT during pre-transfusion testing. Results: Of the 301 patients, 52 (17.28% were found to have antibodies (-allo and –autoantibodies. A total of 11 red cell alloantibodies were detected in 10 patients and the specificities were anti-Kell in 6(54.5%, anti-D in 2(18.2%, anti-c in 1(9.1% and a combination of anti-E (9.1% and anti-Jkb in 1 (9.1% patients. DAT was positive in 48 (15.9% patients. The frequency of autoantibody was significantly higher in alloimmunized group as compared to non-alloimmunized group (60% V/s 14.4%. Also, the pre-transfusion hemoglobin was significantly lower in the immunized group (8.5 gm/dl V/s 9.0 gm/dl; p=0.03 than the non-immunized group. Conclusion: Based on these observations, we suggest antigen typing of all thalassemia major patients for ABO, Rh and Kell antigens before initiating transfusion therapy. Also, screening for allo- and auto-antibodies at regular intervals should be done prior to each transfusion.

  10. SU-E-T-459: Impact of Source Position and Traveling Time On HDR Skin Surface Applicator Dosimetry

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, J; Barker, C; Zaider, M; Cohen, G [Memorial Sloan Kettering Cancer Center, New York, NY (United States)

    2015-06-15

    Purpose: Observed dosimetric discrepancy between measured and treatment planning system (TPS) predicted values, during applicator commissioning, were traced to source position uncertainty in the applicator. We quantify the dosimetric impact of this geometric uncertainty, and of the source traveling time inside the applicator, and propose corrections for clinical use. Methods: We measured the dose profiles from the Varian Leipzig-style (horizontal) HDR skin applicator, using EBT3 film, photon diode, and optically stimulated luminescence dosimeter (OSLD) and three different GammaMed HDR afterloders. The dose profiles and depth dose of each aperture were measured at several depths (up to about 10 mm, depending on the dosimeter). The measured dose profiles were compared with Acuros calculated profiles in BrachyVision TPS. For the impact of the source position, EBT3 film measurements were performed with applicator, facing-down and facing-up orientations. The dose with and without source traveling was measured with diode detector using HDR timer and electrometer timer, respectively. Results: Depth doses measured using the three dosimeters were in good agreement, but were consistently higher than the Acuros dose calculations. Measurements with the applicator facing-up were significantly lower than those in the facing-down position with maximum difference of about 18% at the surface, due to source sag inside the applicator. Based on the inverse-square law, the effective source sag was evaluated to be about 0.5 mm from the planned position. The additional dose from the source traveling was about 2.8% for 30 seconds with 10 Ci source, decreasing with increased dwelling time and decreased source activity. Conclusion: Due to the short source-to-surface distance of the applicator, the small source sag inside the applicator has significant dosimetric impact, which should be considered before the clinical use of the applicator. Investigation of the effect for other applicators

  11. QuantiFERON-TB Gold and Tuberculin Skin Test for the Diagnosis of Latent Tuberculosis Infection in Children

    Directory of Open Access Journals (Sweden)

    Hossein Masoumi Asl

    2015-09-01

    Full Text Available Background: Appropriate diagnosis and treatment of latent tuberculosis infection (LTBI play the most important role in the control of tuberculosis. This study aimed to determine the prevalence of LTBI among healthy tuberculosis unexposed children vaccinated with BCG using the tuberculin skin test (TST and QuantiFERON TB Gold In-Tube (QFT-GIT and comparing the agreement between the two tests. Methods: A cross-sectional study was carried out between October 2009 and March 2010 in 24 schools and 11 daycare centers. A total of 967 children were divided into 15 age groups, with a minimum of 64 children per group. Results: The prevalence rates of LTBI with TST were 3.8%, and 2.2% with QFT-GIT. One case was positive in TST and QFT-GIT, 20 cases were QFT-GIT positive, but TST negative and 36 cases were TST positive, but QFT-GIT negative, and finally, 910 cases were negative in both. There was poor agreement between TST and QFT-GIT (1.8%, 95%, CI: 0%-5.3%, k=0.007. The specificity of QFT-GIT in the BCG vaccinated, children aged 1-15 years old, was 97.8% (97.8%, 95% CI: 96.8%-98.8%. After three months, 2/17 (11.8% of those initially QFT-GIT negative converted, and 10/15 (66% of those initially QFT-GIT positive reverted. Conclusion: It seems that TST and QFT-GIT are not appropriate tests for the diagnosis of LTBI among healthy tuberculosis unexposed BCG vaccinated children. There was a low reproducibility rate of QFT-GIT. The cause of the the poor agreement requires further studies.

  12. 'False-positive' and 'false-negative' test results in clinical urine drug testing.

    Science.gov (United States)

    Reisfield, Gary M; Goldberger, Bruce A; Bertholf, Roger L

    2009-08-01

    The terms 'false-positive' and 'false-negative' are widely used in discussions of urine drug test (UDT) results. These terms are inadequate because they are used in different ways by physicians and laboratory professionals and they are too narrow to encompass the larger universe of potentially misleading, inappropriate and unexpected drug test results. This larger universe, while not solely comprised of technically 'true' or 'false' positive or negative test results, presents comparable interpretive challenges with corresponding clinical implications. In this review, we propose the terms 'potentially inappropriate' positive or negative test results in reference to UDT results that are ambiguous or unexpected and subject to misinterpretation. Causes of potentially inappropriate positive UDT results include in vivo metabolic conversions of a drug, exposure to nonillicit sources of a drug and laboratory error. Causes of potentially inappropriate negative UDT results include limited assay specificity, absence of drug in the urine, presence of drug in the urine, but below established assay cutoff, specimen manipulation and laboratory error. Clinical UDT interpretation is a complicated task requiring knowledge of recent prescription, over-the-counter and herbal drug administration, drug metabolism and analytical sensitivities and specificities.

  13. A Simple Data Analysis Method for a Pumping Test with Skin and Wellbore Storage Effects

    Directory of Open Access Journals (Sweden)

    Chia-Shyun Chen Chuan-Gui Lan

    2009-01-01

    Full Text Available In a pumping test conducted in a con fined aquifer in northern Taiwan, drawdown in the observation well was subject to wellbore storage of its own and the combined effect of wellbore storage and skin of the nearby pumping well. For such a complicated pumping test condition, the appropriate well hydraulics solutions are complicated in mathematics and involve five unknown a priori parameters; namely, the aquifer transmissivity, the aquifer storage coefficient, the skin factor of the pumping well, and the wellbore storage co efficients of the pumping and observation wells. The conventional trial-and-er ror procedure for a simul taneous determination of these five parameters is not easy to apply. Here, a simple data analysis method is de veloped, which takes advantage of the late-time characteristics of drawdown data and the late-time asymptotic behavior of the appropriate wellhy draulics solutions. As a re sult, some currently available graphic techniques are proven us ful for the determination of these parameters. Validity of this approach is verified by the excellent agree ment between the calculated drawdown using the appropriate well hydraulics solutions with the parameter estimates obtained from the field drawdown data.

  14. Association Between Aeroallergens and Allergic Diseases Based on Skin Prick Test in Bushehr Province

    Directory of Open Access Journals (Sweden)

    Ali Moradi

    2017-01-01

    Full Text Available Background: The prevalence of allergic diseases is growing in the world and Iran. Allergens play an important role in creating these diseases. Since inhalation allergens are an important part of these allergens the aim of this study was to assess the prevalence of aeroallergens and their association with allergic diseases based on skin prick test (SPT. Material and Methods: In this study, the frequency of these allergens were examined by using 22 aeroallergens and based on Skin Prick Test in 1100 patients with allergic diseases who referred to Shohadaye- Khalije- Fars university hospital. Results: The reaction severity of SPT and the severity of disease associated with inhaled allergens with Russian thistle (21.1%, P꞊0.001, Chenopodium album pollen (14%, P꞊0.001 and Dermatophagoid Pteronyssinus (9%, P꞊0.001 respectively. Also, in these patients, the frequency of inhalation allergens were House Dust Mite (HDM (69%, feather (60.8%, Russian this tle (59.9% pollen and Alternaria mold (59.6% respectively. Conclusion: This study indicated that outdoors inhaled allergens  such as Russian thistle and Chenopodium album pollen have the most allergenicity in patients with allergic and asthma in Bushehr province, Meanwhile, the prevalence of indoor aeroallergens such as HDM, feather and mold were high in these patients.

  15. Bayesian integrated testing strategy to assess skin sensitization potency: from theory to practice.

    Science.gov (United States)

    Jaworska, Joanna; Dancik, Yuri; Kern, Petra; Gerberick, Frank; Natsch, Andreas

    2013-11-01

    Frameworks to predict in vivo effects by integration of in vitro, in silico and in chemico information using mechanistic insight are needed to meet the challenges of 21(st) century toxicology. Expert-based approaches that qualitatively integrate multifaceted data are practiced under the term 'weight of evidence', whereas quantitative approaches remain rare. To address this gap we previously developed a methodology to design an Integrated Testing Strategy (ITS) in the form of a Bayesian Network (BN). This study follows up on our proof of concept work and presents an updated ITS to assess skin sensitization potency expressed as local lymph node assay (LLNA) potency classes. Modifications to the ITS structure were introduced to include better mechanistic information. The parameters of the updated ITS were calculated from an extended data set of 124 chemicals. A detailed validation analysis and a case study were carried out to demonstrate the utility of the ITS for practical application. The improved BN ITS predicted correctly 95% and 86% of chemicals in a test set (n = 21) for hazard and LLNA potency classes, respectively. The practical value of using the BN ITS is far more than a prediction framework when all data are available. The BN ITS can develop a hypothesis using subsets of data as small as one data point and can be queried on the value of adding additional tests before testing is commenced. The ITS represents key steps of the skin sensitization process and a mechanistically interpretable testing strategy can be developed. These features are illustrated in the manuscript via practical examples. Copyright © 2013 John Wiley & Sons, Ltd.

  16. False-Positive Head-Impulse Test in Cerebellar Ataxia

    Science.gov (United States)

    Kremmyda, Olympia; Kirchner, Hanni; Glasauer, Stefan; Brandt, Thomas; Jahn, Klaus; Strupp, Michael

    2012-01-01

    The objective of this study was to compare the findings of the bedside head-impulse test (HIT), passive head rotation gain, and caloric irrigation in patients with cerebellar ataxia (CA). In 16 patients with CA and bilaterally pathological bedside HIT, vestibuloocular reflex (VOR) gains were measured during HIT and passive head rotation by scleral search coil technique. Eight of the patients had pathologically reduced caloric responsiveness, while the other eight had normal caloric responses. Those with normal calorics showed a slightly reduced HIT gain (mean ± SD: 0.73 ± 0.15). In those with pathological calorics, gains 80 and 100 ms after the HIT as well as the passive rotation VOR gains were significantly lower. The corrective saccade after head turn occurred earlier in patients with pathological calorics (111 ± 62 ms after onset of the HIT) than in those with normal calorics (191 ± 17 ms, p = 0.0064). We identified two groups of patients with CA: those with an isolated moderate HIT deficit only, probably due to floccular dysfunction, and those with combined HIT, passive rotation, and caloric deficit, probably due to a peripheral vestibular deficit. From a clinical point of view, these results show that the bedside HIT alone can be false-positive for establishing a diagnosis of a bilateral peripheral vestibular deficit in patients with CA. PMID:23162531

  17. The value of counting BCG scars for interpretation of tuberculin skin tests in a tuberculosis hyperendemic shanty-town, Peru

    Science.gov (United States)

    Saito, M.; Bautista, C. T.; Gilman, R. H.; Bowering, A.; Levy, M. Z.; Evans, C. A.

    2010-01-01

    SUMMARY SETTING The tuberculin skin test (TST) is widely used as a diagnostic or screening test for Mycobacterium tuberculosis infection and disease. A peri-urban shanty-town in the desert hills of south Lima, Peru, highly endemic for tuberculosis, and where bacille Calmette-Guérin (BCG) vaccine had been given in multiple doses until 1995. OBJECTIVE To analyze the effect of multiple BCG vaccines on TST in a community-based setting. DESIGN Point-prevalence survey of TST reactions of 572 people aged 6–26 years from 255 households. TST reactions were compared to the observed number of BCG scars and other potential risk factors (age, living with a TST-positive person, and contact with active tuberculosis). RESULT People with two or more scars had significantly larger reactions, even after adjusting for potential risk factors. The adjusted population attributable fraction of being TST-positive and having two or more BCG scars was 26%. CONCLUSION There is no demonstrated benefit of repeat BCG vaccination. We therefore recommend that physicians take into consideration the number of BCG scars when interpreting the TST and that programs give no more than one BCG vaccination. PMID:15260275

  18. [Empirical therapeutic approach to infection by resistant gram positive (acute bacterial skin and skin structure infections and health care pneumonia). Value of risk factors].

    Science.gov (United States)

    González-DelCastillo, J; Núñez-Orantos, M J; Candel, F J; Martín-Sánchez, F J

    2016-09-01

    Antibiotic treatment inadequacy is common in these sites of infection and may have implications for the patient's prognosis. In acute bacterial skin and skin structure infections, the document states that for the establishment of an adequate treatment it must be assessed the severity, the patient comorbidity and the risk factors for multidrug-resistant microorganism. The concept of health care-associated pneumonia is discussed and leads to errors in the etiologic diagnosis and therefore in the selection of antibiotic treatment. This paper discusses how to perform this approach to the possible etiology to guide empirical treatment.

  19. CD4+CD8β+ double-positive T cells in skin-draining lymph nodes respond to inflammatory signals from the skin

    DEFF Research Database (Denmark)

    Overgaard, Nana Haahr; Cruz, Jazmina L.; Bridge, Jennifer A.

    2017-01-01

    CD4+CD8+ double-positive (DP), mature, peripheral T cells are readily detectable in a variety of species and tissues. Despite a common association with autoimmune and malignant skin disorders, however, little is understood about their role or function. Herein, we show that DP T cells are readily...

  20. Testing a family intervention hypothesis: the contribution of mother-infant skin-to-skin contact (kangaroo care) to family interaction, proximity, and touch.

    Science.gov (United States)

    Feldman, Ruth; Weller, Aron; Sirota, Lea; Eidelman, Arthur I

    2003-03-01

    The provision of maternal-infant body contact during a period of maternal separation was examined for its effects on parent-infant and triadic interactions. Participants were 146 three-month-old preterm infants and their parents, half of whom received skin-to-skin contact, or kangaroo care (KC), in the neonatal nursery. Global relational style and micro-patterns of proximity and touch were coded. Following KC, mothers and fathers were more sensitive and less intrusive, infants showed less negative affect, and family style was more cohesive. Among KC families, maternal and paternal affectionate touch of infant and spouse was more frequent, spouses remained in closer proximity, and infant proximity position was conducive to mutual gaze and touch during triadic play. The role of touch as a constituent of the co-regulatory parent-infant and triadic systems and the effects of maternal contact on mothering, co-parenting, and family processes are discussed.

  1. Catch-up validation study of an in vitro skin irritation test method based on an open source reconstructed epidermis (phase I).

    Science.gov (United States)

    Mewes, K R; Fischer, A; Zöller, N N; Laubach, V; Bernd, A; Jacobs, A; van Rompay, A; Liebsch, M; Pirow, R; Petersohn, D

    2016-10-01

    We have developed a new in vitro skin irritation test based on an open source reconstructed epidermis (OS-REp) with openly accessible protocols for tissue production and test performance. Due to structural, mechanistic and procedural similarity, a blinded catch-up validation study for skin irritation according to OECD Performance Standards (PS) was conducted in three laboratories to promote regulatory acceptance, with OS-REp models produced at a single production site only. While overall sensitivity and predictive capacity met the PS requirements, overall specificity was only 57%. A thorough analysis of the test results led to the assumption that some of the false-positive classifications could have been evoked by volatile skin-irritating chemicals tested in the same culture plate as the non-irritants falsely predicted as irritants. With GC/MS and biological approaches the cross-contamination effect was confirmed and the experimental set-up adapted accordingly. Retesting of the affected chemicals with the improved experimental set-up and otherwise identical protocol resulted in correct classifications as non-irritants. Taking these re-test results into account, 93% overall sensitivity, 70% specificity and 82% accuracy was achieved, which is in accordance with the OECD PS. A sufficient reliability of the method was indicated by a within-laboratory-reproducibility of 85-95% and a between-laboratory-reproducibility of 90%. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  2. Full can test: Mechanisms of a positive test in patients with shoulder pain.

    Science.gov (United States)

    Timmons, Mark K; Yesilyaprak, Sevgi S; Ericksen, Jeff; Michener, Lori A

    2017-02-01

    The full can test is theorized to produce compressive loads on the supraspinatus tendon within the subacromial space. Characterizing the width of the subacromial outlet, scapular orientation, and shoulder pain during the full can test will improve the mechanistic understanding of the positive full can test. Cross-sectional repeated measures design. Participants with subacromial pain syndrome (n=30) were compared to a matched control group (n=30) during 2 conditions: passive support, and the full can test. The full can test was performed with the arm elevated to 90° in the scapular plane. In both conditions, measurements were taken of acromiohumeral distance with ultrasonography, scapular position using electromagnetic tracking, shoulder strength using a dynamometer, and shoulder pain with the 11-point rating scale. During the full can test, both groups had a decreased acromial humeral distance, scapular upward rotation, posterior tilt, external rotation and clavicular protraction as compared to passive support (ppain group as compared to the control group reported greater shoulder pain (ppain and reduced strength in those with subacromial pain syndrome can be explained additionally by an increase in scapular anterior tilt. These mechanistic changes may lead to tendon compression, but this cannot be verified as direct tendon compression was not measured. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. Prevalence of Latent Tuberculosis Infection in Low-Risk Children Using Tuberculin Skin Test: A Study in Shiraz

    Directory of Open Access Journals (Sweden)

    A Alborzi

    2012-10-01

    Full Text Available Background: Tuberculin skin test (TST is a readily available test for the diagnosis of latent tuberculosis infection (LTBI. This study was designed to evaluate LTBI in low-risk children aged 1-15 years.Methods: This cross-sectional study was performed in Shiraz, Iran, over six months during 2009. Totally, 1289 boys and girls were selected by stratified multistage random sampling from four municipality areas before allocating them to 15 groups. Inclusion criteria included age 1-15 years, documented history of BCG vaccination at birth, Iranian nationality and a healthy state of being. Children with acute febrile diseases, immunosuppression, on medication and immigrants were excluded. We considered a TST ≥ 10 mm of induration as positive.Results: The prevalence of LTBI in 1-15 years old children was 4.5%. The percentage was 3.5% in 1-5 year old, 4.1% in 6-10 year old and 5.7% in 11-15 year old children. The highest rate of infection was 9.8% in 15 year olds and the lowest was 2.2% in 3-year old children. Gender had no effect on LTBI rate. There is no significant difference of LTBI prevalence between four municipality areas.Conclusion: The prevalence of LTBI in this study was lower in comparison with other studies performed in Iran. Positive predictive value of TST decreases in low endemic areas for tuberculosis, especially in low-risk groups; therefore, most positive results are false-positive created by nonspecific reactions and infection with environmental mycobacteria. Hence, there is a need for new diagnostic tools that are easy and cost-effective.

  4. Beyond skin testing: state of the art and new horizons in food allergy diagnostic testing.

    Science.gov (United States)

    Caubet, Jean-Christoph; Sampson, Hugh A

    2012-02-01

    Food allergy affects approximately 1% to 10.8% of the general population, and its prevalence seems to be increasing. An accurate diagnosis is particularly important because a misdiagnosis could lead to life-threatening reactions or to unnecessary restrictive diets. However, allergy tests currently used in clinical practice have limited accuracy, and an oral food challenge, considered as the gold standard, is often required to confirm or exclude a food allergy. This article reviews several promising novel approaches for the diagnosis of food allergy, such as new molecular diagnostic technologies and functional assays, along with their potential clinical applications. Copyright © 2012 Elsevier Inc. All rights reserved.

  5. Serologic Evaluation of Patients from Missouri with Erythema Migrans-Like Skin Lesions with the C6 Lyme Test

    OpenAIRE

    Philipp, Mario T.; Masters, Edwin; Wormser, Gary P.; Hogrefe, Wayne; Martin, Dale

    2006-01-01

    Southern tick-associated rash illness (STARI), also known as Masters disease, affects people predominantly in the Southeast and South Central United States. These patients exhibit skin lesions that resemble erythema migrans (EM), the characteristic skin lesion in early Lyme disease. The etiology of STARI remains unknown, and no serologic test is available to aid in its diagnosis. The C6 Lyme enzyme-linked immunosorbent assay was used to evaluate coded serum specimens from patients with STARI ...

  6. EAACI Position Paper for practical patch testing in Allergic Contact Dermatitis in children

    DEFF Research Database (Denmark)

    de Waard-van der Spek, Flora B; Darsow, Ulf; Mortz, Charlotte G

    2015-01-01

    Allergic Contact Dermatitis (ACD) in children appears to be on the increase, and contact sensitization may already begin in infancy. The diagnosis of contact dermatitis requires a careful evaluation of a patient's clinical history, physical examination and skin testing. Patch testing is the gold ...

  7. The power of extraverts: testing positive and negative mood regulation

    Directory of Open Access Journals (Sweden)

    Gonzalo Hervas

    Full Text Available Extraversion is a personality trait which has been systematically related to positive affect and well-being. One of the mechanisms that may account for these positive outcomes is the ability to regulate the responses to positive, as well as negative, moods. Prior research has found that extraverts' higher positive mood maintenance could explain their higher levels of positive affect. However, research exploring differences between extraverts and introverts in negative mood regulation has yielded mixed results. The aim of the current study was explore the role of different facets of mood regulation displayed by extraverts, ambiverts, and introverts. After been exposed to a sad vs. happy mood induction, participants underwent a mood regulation task. Extraverts and ambiverts exhibited higher positive mood regulation than introverts, but similar mood repair. Thus, this research highlights the importance of positive mood regulation in the psychological functioning of extraverts, and opens new conceptualizations for developing interventions for introverts to improve their positive mood regulation and, hence, overall positive affect and well-being.

  8. Development Of A Pig Skin Model To Test Nanocomposite Materials For Antibacterial Properties

    Directory of Open Access Journals (Sweden)

    Katrina Rushford

    2017-12-01

    Full Text Available INTRODUCTION Polyhedral oligomeric silsesquioxane is making advancements towards medical application as an effective material for drug delivery. POSS is a unique molecule because of its structure. It is a class of organosilicon- three-dimensional compounds with cage frameworks and different degrees of symmetry. OBJECTIVE Our objective was to introduce a biomedical application for POSS in area of drug delivery. For large open wounds it should have a capability to reduce bleeding and as well as provide the release of an antibiotics to reach minimal inhibitory concentrations at the site for infection coverage. If the treatment is successful POSS can be applied in the field as a protective dressing that is capable of enhancing clot formation prevent infection and ultimately enhance tissue repair. METHODS Two formulations of POSS were prepared and tested in vitro to release inhibitory concentration of Clindamycin. Clindamycin release was determined spectrophotometrically and the MIC was determined using a bacterial pig skin wound model were determined. RESULTS Minimal inhibitory concentration of Clindamycin was detected from both POSS formulation for up to 96 hours. In the pig skin wound model the POSS formulation without kaolin reduced the bacterial load more efficiently than POSS containing kaolin and was comparable to a triple antibiotic cream coverage. CONCLUSION Nanocomposites of POSS can be formulated to limit bacterial growth and further reduction of bacterial load can be accomplished by attaching an antibiotic to the functional groups of the caged nanostructure of POSS.

  9. House dust mite-related allergic diseases: role of skin prick test, atopy patch test, and RAST in the diagnosis of different manifestations of allergy.

    Science.gov (United States)

    Fuiano, Nicola; Fusilli, Saverio; Incorvaia, Cristoforo

    2010-07-01

    The atopy patch test (APT) was recently defined as an important tool in diagnosis of atopic dermatitis (AD) and also of rhinitis and asthma caused by hypersensitivity to the house dust mites. We evaluated 465 children (279 males and 186 females) aged 0.4-17.6 years (mean 6.6 +/- 3.8 years), by dividing them into four groups: group A, current AD (40 patients); group B, current AD with respiratory symptoms (156 patients); group C, past AD with respiratory symptoms (203 patients); and the control group, respiratory symptoms with no history of AD (66 patients). The APT was significantly more frequently positive in groups with current AD (groups A and B) or past AD (group C) than in the control group, while skin prick test (SPT) and radioallergosorbent test (RAST) were significantly more frequently positive in the control group. With multivariate analysis, for APT, significant differences were found in the comparison between group A vs group B (odds ratio (OR) 1.55) and between group A vs group C (OR 1.81). The mean age was significantly lower in group A than in groups B, C, and the control group and with less significance in groups C vs D. Children sensitized to mites with current or past AD, with or without respiratory symptoms, have a different response to diagnostic tests, which is characterized by a highly significantly more frequent positive APT in comparison with subjects who have respiratory symptoms but a negative history for AD, who show the common response to SPT and RAST.

  10. The impact of penicillin skin testing on clinical practice and antimicrobial stewardship.

    Science.gov (United States)

    Rimawi, Ramzy H; Cook, Paul P; Gooch, Michael; Kabchi, Badih; Ashraf, Muhammad S; Rimawi, Bassam H; Gebregziabher, Mulugeta; Siraj, Dawd S

    2013-06-01

    Penicillin skin testing (PST) is a simple and reliable way of diagnosing penicillin allergy. After being off the market for 4 years, penicilloyl-polylysine was reintroduced in 2009 as PRE-PEN. We describe the negative predictive value (NPV) of PST and the impact on antibiotic selection in a sample of hospitalized patients with a reported history of penicillin allergy. We introduced a quality improvement process at our 861-bed tertiary care hospital that used PST to guide antibiotic usage in patients with a history consistent with an immunoglobulin E (IgE)-mediated reaction to penicillin. Subjects with a negative PST were then transitioned to a β-lactam agent for the remainder of their therapy. NPV of skin testing was established at 24-hour follow-up. We are reporting the result of 146 patients tested between March 2012 and July 2012. A total of 146 patients with a history of penicillin allergy and negative PST were treated with β-lactam antibiotics. Of these, only 1 subject experienced an allergic reaction to the PST. The remaining 145 patients tolerated a full course of β-lactam therapy without an allergic response, giving the PST a 100% NPV. We estimated that PST-guided antibiotic alteration for these patients resulted in an estimated annual savings of $82,000. Patients with a history of penicillin allergy who have a negative PST result are at a low risk of developing an immediate-type hypersensitivity reaction to β-lactam antibiotics. The increased use of PST may help improve antibiotic stewardship in the hospital setting. Copyright © 2013 Society of Hospital Medicine.

  11. Using IFN-gamma release assay to confirm tuberculin skin test improves the screening of latent tuberculosis infection in Italian healthcare workers.

    Science.gov (United States)

    Olivieri, Raffaela; Scarnera, Sara; Ciabattini, Annalisa; De Vuono, Giulia; Manzi, Pietro; Pozzi, Gianni; Battista, Giuseppe; Medaglini, Donata

    2016-01-01

    Healthcare workers (HCWs) represent a tuberculosis (TB) risk group for a wide range of tasks in healthcare, even in countries with low TB incidence, like Italy. Latent Tuberculosis Infection (LTBI) screening programs are an important tool for TB prevention in these setting. A retrospective study under a LTBI screening program among HCWs at the Siena University Hospital (Italy), was conducted between September 2011 and July 2015. Tuberculin Skin Test (TST) was used as a first level examination; all TST-positive cases were tested with QuantiFERON-TB Gold In-Tube (QFT-GIT) test, together with a group of TST-negative subjects. Among the 2136 HCWs screened, 144 (6.7 %) were TST-positive and therefore tested with QFT-GIT, confirming a positive result in 36 cases (25 %). Agreement between two tests was poor (k = 0.092; 95 %, Confidence Interval [CI]- 0.048-0.136, p = 0.002). Among TST-positive cases, discordant results occurred more frequently in BCG vaccinated than unvaccinated HCWs (86.3 %, p < 0.001). The probability of a QFT-GIT-positive result increased according to the TST diameter (p = 0.001). No putative risk factor was associated with LTBI occurrence. The use of QFT-GIT test as a second step in TST-positive cases offers an appropriate tool for LTBI detection, especially among BCG-vaccinated HCWs.

  12. Psychological Testing of Black People; A Position Paper.

    Science.gov (United States)

    Dent, Harold E.; Williams, Robert L.

    The psychological testing of blacks and other minorities inflicts dehumanization upon them by subjecting them to culturally-biased examinations. These tests are defended on "scientific" grounds, although it is evident that they are simply a form of institutionalized racism. Standardized tests of intelligence reflect a middle-class white bias that…

  13. Disagreement between skin prick test and specific IgE in young children

    DEFF Research Database (Denmark)

    Schoos, Ann-Marie Malby; Chawes, BLK; Følsgaard, N V

    2015-01-01

    BACKGROUND: Skin prick test (SPT) and measurement of serum-specific IgE (sIgE) level are important tools for the clinician to diagnose allergic sensitization. However, little is known about the agreement between the two methods in young children. METHODS: SPT and sIgE levels were assessed...... points was analyzed using kappa statistics. RESULTS: The prevalence of inhalant allergen sensitization increased during childhood diagnosed by both sIgE levels (0.6% to 4.2% to 18.1% to 24.8%, P P ... sensitization increased during childhood when diagnosed from sIgE (7.8% to 12.1% to 15.0% to 18.9%, P P = 0.05). Overall, the agreement between SPT and sIgE levels was poor to moderate (all κ-coefficients ≤ 0.60) and decreased from...

  14. Skin prick test results of atopic asthmatic subjects in a chest disease clinic in Sanliurfa

    Directory of Open Access Journals (Sweden)

    İbrahim Koç

    2015-06-01

    Full Text Available Objective: Skin prick test (SPT is used widely to determine the allergens in atopic patients. In this study, we aimed to determine the spectrum of aeroallergen sensitivity of atopic asthmatic subjects in Şanlıurfa district. Methods: We evaluated clinical, demographic findings and SPT results of 95 male and 162 female in a total 257 patients who had asthma and allergic symptoms. Results: Most common allergens causing a sensitivity reaction detected in our clinic were as follows; cockroach (56.8%, wheat pollen (53.3%, corn pollen (47.4%, grass pollen (36.5%, poplar tree pollen (26%, house dust mite (19.4%, pepper (16.7% and cat dander (15.1%. Conclusion: High levels of sensitivity to wheat and corn pollens and relatively low sensitivity levels of cat dander results meet our expectations in the area of agricultural land and where pet ownership is not common.

  15. The incidence and features of systemic reactions to skin prick tests.

    Science.gov (United States)

    Sellaturay, Priya; Nasser, Shuaib; Ewan, Pamela

    2015-09-01

    Skin prick testing (SPT) has been regarded as a safe procedure with few systemic reactions. To evaluate the rate of systemic reactions and their associations after SPT in the largest population to date. In this study reactions were recorded prospectively in a specialist UK allergy clinic for 6 years (2007-2013). An estimated 31,000 patients underwent SPT. Twenty-four patients (age range 7 months to 56 years, mean 23.5 years, 17 female patients, 12 with asthma) had systemic reactions. The rate of systemic reactions to SPT was 0.077%. The likely allergens causing the reaction were foods (18; peanut, 7; walnut, 1; Brazil nut, 2; pistachio, 1; lupin, 1; cow's milk, 2; shrimp, 1; spinach, 1; legume, 1; soy, 1), aeroallergens (4; rabbit, 1; rat, 1; ragwort, 1; grass pollen, 1), wasp venom (1), and Tazocin (1). The causative SPT wheal was larger than 8 mm in 75%. The reaction to Tazocin was severe, with anaphylaxis occurring minutes after SPT. Reactions were treated immediately in the clinic and did not require further medical care. In this largest single-center study, the rate of systemic reactions after SPT was 77 per 100,000 patients. It is the first study to identify foods as a common and important cause (75%), with nuts posing the highest risk. This study reports the first systemic reaction to venom SPT and the first anaphylactic reaction after drug SPT. There was an association with a history of severe reactions and large skin test reaction. There are risks, albeit small, when undertaking SPT. Copyright © 2015 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  16. Constructing Human Skin Equivalents on Porcine Acellular Peritoneum Extracellular Matrix for In Vitro Irritation Testing.

    Science.gov (United States)

    Tsai, Pei-Chin; Zhang, Zheng; Florek, Charles; Michniak-Kohn, Bozena B

    2016-01-01

    The irritancy of topical products has to be investigated to ensure the safety and compliance. Although several reconstructed human epidermal models have been adopted by the Organization for Economic Cooperation and Development (OECD) to replace in vivo animal irritation testing, these models are based on a single cell type and lack dermal components, which may be insufficient to reflect all of the components of irritation. In our study, we investigated the use of acellular porcine peritoneum extracellular matrix as a substrate to construct full-thickness human skin equivalents (HSEs) for use as irritation screening tool. The acellular peritoneum matrix (APM) exhibited excellent skin cell attachment (>80%) and proliferation for human dermal fibroblasts (HDF) and immortalized human keratinocytes (HaCaT). APM-HSEs based on coculture of HDF and HaCaT were prepared. Increased HDF seeding density up to 5 × 10(4)/cm(2) resulted in APM-HSEs with a thicker and more organized epidermis. The epidermis of APM-HSEs expressed keratin 15, a keratinocyte proliferation marker, and involucrin, a differentiation marker, respectively. To assess the use of APM-HSEs for irritation testing, six proficiency chemicals, including three nonirritants (phosphate-buffered saline, polyethylene glycol 400, and isopropanol) and three irritants (1-bromohexane, heptanol, and sodium dodecyl sulfate) were applied. The APM-HSEs were able to discriminate nonirritants from irritants based on the viability. Levels of cytokines (interleukin [IL]-1α, IL-1ra, IL-6, IL-8, and granulocyte macrophage colony-stimulating factor [GM-CSF]) in these treatment groups further assisted the irritancy ranking. In conclusion, we have developed partially differentiated full-thickness APM-HSEs based on acellular porcine peritoneum matrix, and these APM-HSEs demonstrated utility as an in vitro irritation screening tool.

  17. The evaluation of a positive direct antiglobulin test (autocontrol) in pretransfusion testing revisited.

    Science.gov (United States)

    Judd, W J; Barnes, B A; Steiner, E A; Oberman, H A; Averill, D B; Butch, S H

    1986-01-01

    Direct antiglobulin tests (DATs) using anti-IgG were performed on 65,049 blood samples from prospective transfusion recipients; 3570 tests (5.49%) were positive. Using criteria published previously (primarily excluding patients not transfused within the preceding 14 days), 778 samples from other than neonatal patients were selected for further evaluation. Eluates that did not react were obtained on 518 (66.6%) of these samples. Warm-reactive autoantibodies were apparent in 192 eluates, while 16 contained drug-related antibodies, anti-A or anti-B from prior transfusion with ABO mismatched blood components, or anti-D passively acquired from immune serum globulin. Fifty-two eluates contained alloantibodies; however, in only six of these cases did the corresponding serum lack unexpected alloantibodies, as determined by routine pretransfusion studies. Three additional weakly reactive clinically significant alloantibodies were detected solely through additional serum tests performed on DAT-positive samples. On the basis of these findings, the DAT had a low predictive value when used to detect the early manifestations of an immune response to recently transfused red cells. Elimination of the autocontrol from routine pretransfusion testing, therefore, carries minimal risk to patients yet will undoubtedly contribute to the containment of health care costs. Moreover, the risk is lower than that associated with the elimination of the antiglobulin crossmatch.

  18. Racial differences in the association of CD14 polymorphisms with serum total IgE levels and allergen skin test reactivity

    Directory of Open Access Journals (Sweden)

    Wang ZY

    2013-06-01

    Full Text Available ZongYao Wang,1 John S Sundy,1 Catherine M Foss,1 Huiman X Barnhart,2 Scott M Palmer,1 Sallie D Allgood,3 Evan Trudeau,1 Katie M Alexander,3 Marc C Levesque31Division of Pulmonary, Allergy and Critical Care Medicine, 2Duke Clinical Research Institute, 3Division of Rheumatology and Immunology, Duke University Medical Center, Durham, NC, USABackground: The CD14 C-159T single nucleotide polymorphism (SNP has been investigated widely as a candidate genetic locus in patients with allergic disease. There are conflicting results for the association of the CD14 C-159T SNP with total serum immunoglobulin E (IgE levels and atopy. There are limited data regarding the association of the CD14 C-159T SNP in subjects of African ancestry. The aim of the study was to determine whether the C-159T SNP and other CD14 SNPs (C1188G, C1341T were associated with total serum IgE levels and with allergy skin test results in nonatopic and atopic subjects; as well as in Caucasian and African American subjects.Methods: A total of 291 participants, 18–40 years old, were screened to determine whether they were atopic and/or asthmatic. Analyses were performed to determine the association between CD14 C-159T, C1188G, or C1341T genotypes with serum IgE levels and with the number of positive skin tests among Caucasian or African American subjects.Results: We found no significant association of serum total IgE level with CD14 C-159T, C1188G, or C1341T genotypes within nonatopic or atopic subjects. Subjects with CD14-159 T alleles had significantly more positive allergen skin tests than subjects without CD14-159 T alleles (P = 0.0388. There was a significant association between the CD14 1188 G allele, but not the CD14 1341 T allele, with the number of positive skin-test results in Caucasians, but not in African Americans.Conclusion: These results support a possible association between CD14 polymorphisms and atopy. CD14-159 T or CD14 1188 G alleles were associated with atopic

  19. The Tritiated Water Skin Barrier Integrity Test: Considerations for Acceptance Criteria with and Without (14)C-Octanol.

    Science.gov (United States)

    Lehman, Paul A; Beatch, Kacie; Raney, Sam G; Franz, Thomas J

    2017-01-01

    A study was designed to assess barrier integrity simultaneously using separate compounds (probes) for polar and non-polar pathways through the skin, (3)H2O and (14)C-octanol, respectively; and to determine whether the two probe approach could better define barrier integrity. A 5-min dose of water containing (3)H2O and (14)C -octanol was applied to ex vivo human skin mounted in Franz diffusion cells. The receptor solution was sampled at 30 min, analyzed for (3)H and (14)C content, and the correlation between water and octanol absorption was determined by statistical tests suitable for non-normally distributed data. This study was conducted on skin from 37 donors with from 3 to 30 replicate skin sections per donor (a total of 426 sections). The correlation between (3)H2O and (14)C-octanol absorption was low (Pearson correlation coefficient = 0.3485). The (3)H2O absorption cutoff used in this study to select for a normal skin barrier rejected some sections in which (14)C-octanol absorption was within normal limits and accepted others in which (14)C-octanol absorption was abnormally high. The converse was true for (3)H2O absorption when the (14)C-octanol-based cutoff was used. The results of the (3)H2O test or of similar tests that primarily assess the permeability of polar pathways through the skin may not necessarily provide information relevant to the absorption of highly lipophilic compounds. Octanol, or another molecule that more closely matches the physicochemical attributes of the test compound, may characterize properties of the skin barrier that are more relevant to compounds of low water solubility.

  20. Influence of skin incision position on physiological and biochemical changes in tissue after primary total knee replacement - a prospective randomised controlled trial.

    Science.gov (United States)

    Donaldson, David Q; Torkington, Matthew; Anthony, Iain C; Wheelwright, Eugene F; Blyth, Mark Jg; Jones, Bryn G

    2015-04-16

    Influence of skin incision position on physiological and biochemical changes in tissue after primary total knee replacement. A prospective randomised controlled trial. The blood supply to the skin covering the anterior knee has been shown to arise predominantly from blood vessels on the medial side of the knee. Skin incisions for primary Total Knee Replacement (TKR) positioned medially therefore risk creating a large lateral skin flap that may be poorly perfused. Poorly perfused skin is likely to result in hypoxia at the wound edges and consequently may lead to delayed wound healing and complications. We have carried out a randomised controlled trial (n = 20) to compare blood flow on both the medial and lateral sides of two commonly used skin incisions in TKR (midline and paramedian). We have also assessed interstitial biochemistry (glucose, pyruvate and lactate levels) in the presumed at risk lateral skin flap of both incision types. In both incision types tissue hyper-perfusion occurs post-operatively and is maintained for at least 3 days. We found no significant difference between blood flow between the two incision types on the medial side of the incision at either day 1 (p = 0.885) or day 3 post-op (p = 0.269), or, on the lateral side of the incision (p = 0.885 at day 1, p = 0.532 at day 3). Glucose levels are maintained post-operatively in the at risk lateral flap with only minimal changes. Lactate levels rise post-operatively and remain elevated for at least 24 hours. However, the levels did not reach levels suggestive of critical ischaemia in either incision group and no significant difference was observed between incision types. We conclude that the use of a paramedian incision results in only minimal biochemical changes, which are unlikely to alter wound healing. ISRCTN06592799 .

  1. Cow’s milk allergy: Evaluating tolerance through skin-prick test

    Directory of Open Access Journals (Sweden)

    Flavia Valença de Oliveira Neves

    Full Text Available Summary Objective: To evaluate the wheal diameter in allergy skin-prick tests (SPT with cow’s milk extract (CM comparing tolerant and persistent patients. Method: A retrospective cohort study involving database analysis of children with diagnosis of cow’s milk protein allergy (CMPA mediated by immunoglobulin E in a specialized outpatient clinic that regularly performed SPT between January 2000 and July 2015. Patients were allocated into two groups: tolerant or persistent. Comparisons were made at diagnosis and over time between tolerant and persistent patients using Fisher’s, Mann-Whitney or Wilcoxon tests and significance level at 5%. Results: After applying inclusion and exclusion criteria, the sample includes 44 patients (29 tolerant and 15 who persisted with CMPA. In the tolerant group, the medians of SPT were: 6 mm at diagnosis and 2 mm at the development of tolerance; a significant difference (p<0.0001 was found. In the persistent group, the median SPT at diagnosis was 7 mm, while in the last SPT it was 5 mm, with no statistical difference (p=0.173. The comparison of medians in the last SPT between groups was significant (p=0.001, with a reduction greater than 50% in SPT in the tolerant group. Conclusion: Serial SPTs were useful for diagnosis, and a decrease higher than 50% in diameter can indicate the moment to perform oral food challenge (OFC tests, helping to detect tolerance in CMPA.

  2. Association Between Allergic Diseases and Food Allergens Based on Skin Prick Test in Bushehr Province

    Directory of Open Access Journals (Sweden)

    Saman Keshvari

    2017-04-01

    Full Text Available Background: The Frequency of allergic diseases is growing in recent years. Identification of frequency of food allergens in different areas play an important role in diagnosis and treatment of these diseases. The aim of this study was to determine frequency and association of common food allergens in patients with allergic diseases based on Skin Prick Test in Bushehr province. Material and Methods: In this descriptive cross-sectional study, 1100 patients were enrolled with allergic diseases which had a sensitivity to at least one allergen.  This test was carried out with 21 common food allergens extract. Results: In all patients, association between the severity of the reaction prick allergy test and severity of allergic diseases with shrimp, cow's Milk and peanuts were (P= 0.01, (P= 0.02 and (P=0.04 respectively. In this study, the frequency of allergic rhinitis, asthma, chronic and acute urticaris and atopic eczema were 54.2%, 23%, 12.4%, 4.1% and 12%, respectively. While the the most common food allergens were peanuts (46.6%, egg yolk (43.1% and shrimp (42% respectively. Conclusion: This study indicated that food allergens such as shrimp, cow's Milk and peanuts have a greater role in severity of allergic diseases and this food allergens showed the highest frequency in patients.

  3. Relevance of positive patch-test reactions to fragrance mix.

    NARCIS (Netherlands)

    Devos, S.A.; Constandt, L.; Tupker, R.A.; Noz, K.C.; Lucker, G.P.H.; Bruynzeel, D.P.; Schuttelaar, M.L.; Kruyswijk, M.R.; Zuuren, E.J. van; Vink, J.; Coenraads, P.J.; Kiemeney, L.A.L.M.; Valk, P.G.M. van der

    2008-01-01

    BACKGROUND: Fragrances are an important cause of allergic contact dermatitis. We presume that the traditional fragrance mix (FM) detects 70 to 80% of fragrance-allergic patients. FM has an irritant potential. Weak positive reactions may have a greater chance of being irrelevant than strong

  4. Relevance of positive patch-test reactions to fragrance mix

    NARCIS (Netherlands)

    Devos, S.A.; Constandt, L.; Tupker, R.A.; Noz, K.C.; Lucker, G.P.H.; Bruynzeel, D.P.; Schuttelaar, M.L.A.; Kruyswijk, M.R.J.; van Zuuren, E.J.; Vink, J.; Coenraads, P.J.; Kiemeney, L.A.L.M.; van der Valk, P.G.M.

    2008-01-01

    BACKGROUND: Fragrances are an important cause of allergic contact dermatitis. We presume that the traditional fragrance mix (FM) detects 70 to 80% of fragrance-allergic patients. FM has an irritant potential. Weak positive reactions may have a greater chance of being irrelevant than strong

  5. A Hybrid Positioning Method Based on Hypothesis Testing

    DEFF Research Database (Denmark)

    Amiot, Nicolas; Pedersen, Troels; Laaraiedh, Mohamed

    2012-01-01

    We consider positioning in the scenario where only two reliable range estimates, and few less reliable power observations are available. Such situations are difficult to handle with numerical maximum likelihood methods which require a very accurate initialization to avoid being stuck into local m...

  6. Prevalence of Mantoux test positivity among apparently healthy ...

    African Journals Online (AJOL)

    pen' technique of Sokal,10 which helps to make measurements more accurate. Reading of the reaction was done in a good light, and an induration of 10 mm and above was considered positive. The Mantoux reactions of the subjects were stratified into (modified from Egbagbe et al.11): (i) negative, induration. 0 - 4 mm; (ii) ...

  7. Evaluation of liver function tests of HIV positive patients on ...

    African Journals Online (AJOL)

    Liver enzymes-alanine and aspartate aminotransferases and alkaline phosphatase (AST, ALT and ALP), bilirubin and serum proteins were determined using standard laboratory methods and these parameters were used to evaluate the liver function of human immunodeficiency virus (HIV)- positive patients receiving ...

  8. Research Protocol - An Evaluation of False Positive HIV Results due to Testing Errors

    OpenAIRE

    Maparo, Tatenda; Mungofa, Stanley; Bara, Hilda T.; Chirisa, Florence

    2014-01-01

    An unacceptably high frequency of false positive HIV test results has been reported in various settings. Given the severity and implications of an HIV+ diagnosis, a false positive result is likely to be psychologically traumatic and may result in inappropriate and potentially harmful treatment. The current HIV testing algorithm being used in Zimbabwe does not include repeat testing for HIV positive results, and it is not currently known whether testing errors are leading to false positive dia...

  9. Use of a Penicillin Allergy Screening Algorithm and Penicillin Skin Testing for Transitioning Hospitalized Patients to First-Line Antibiotic Therapy.

    Science.gov (United States)

    Ramsey, Allison; Staicu, Mary L

    2017-12-11

    Penicillin allergy is the most commonly reported antibiotic allergy. Avoidance of β-lactam antibiotics in hospitalized patients leads to the use of second-line therapies. The utility of a penicillin allergy history algorithm (PAHA) and subsequent penicillin skin testing (PST) in transitioning hospitalized patients from second- to first-line antibiotic therapy is described. Through an electronic medical record report, pharmacists identified adult inpatients with penicillin allergy receiving moxifloxacin, intravenous vancomycin, aztreonam, daptomycin, or linezolid, in which a β-lactam antibiotic was preferred. The PAHA was administered to identify patients for PST. Skin-test negative patients were transitioned to first-line β-lactam antibiotic therapy. Fifty patients consented to the study. Historical reactions included hives (16 patients, 32%), angioedema (15, 30%), anaphylaxis (6, 12%), unknown (6, 12%), rash (6, 12%), and dyspnea (1, 2%). Pre-PST antibiotic regimens included vancomycin (82%), aztreonam (22%), moxifloxacin (6%), daptomycin (4%), and/or linezolid (2%). Forty-seven patients (94%) were skin-test negative and were subsequently transitioned to a β-lactam antibiotic. Two patients were skin-test positive and one was histamine nonreactive. No patients experienced an immediate adverse reaction when challenged with a penicillin-based antibiotic. A total of 982 days of second-line antibiotic therapy and at least 23 hospital days to administer the antibiotic were avoided. The use of the PAHA and subsequent PST is a safe, effective multidisciplinary intervention that facilitates the transition to β-lactam antibiotics. Our approach is unique in that it prioritizes patients based on the use of second-line antibiotics, and then applies an algorithm to determine eligibility for PST. Copyright © 2017 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  10. Is asthma caused by atopy (positive skin prick tests)? Epidemiologic evidence suggests a negative answer.

    Science.gov (United States)

    Ronchetti, Roberto; Jesenak, Milos; Ronchetti, Francesco; Rennerova, Zuzana

    2010-06-01

    In this paper we shortly discuss epidemiological data on the relationship between asthma and atopy according to recent personal and literature epidemiological publications. The coexistence in several subjects of asthma (and of other "atopic" diseases) and IgE hyperproduction generated the dogma that these two biological conditions are mainly genetic in origin and are linked by a strong casual relationship. In the last decades atopy increased at 5-10 % annual rate and at present atopy prevalence, although variable in different countries, reaches somewhere the prevalence of more than 60 %. Similarly, asthma prevalence increased in the last decades, especially so in western and English speaking countries, reaching in certain countries prevalence values higher than 40 %. For these reasons, although certainly dependent on a genetic predisposition, atopy and asthma can nowadays be considered to be largely determined by environmental factors. Moreover, the analysis of epidemiological data derived from studies conducted worldwide, showed that the prevalence of the two conditions were clearly not correlated so that in certain countries with a 50-60% prevalence of atopy asthma prevalence is lower than 2-6 %, while in other countries asthma prevalence is double than atopy prevalence. Further, in countries with high atopy, the prevalence this conditions is high both in asthmatics and in normal subjects and in the places where asthma prevalence reaches high levels this condition is high both in atopic and non atopic people. In conclusion, epidemiological data show that environmental factors affecting asthma prevalence are different from those affecting atopy prevalence and that subjects bearing one of the two conditions don't show any preferential tendency to develop the other one. From aetiological and pathogenetic point of view asthma and atopy appear to be independent conditions We therefore believe that the association between asthma and atopy demonstrated in almost all the "population studies" (atopy prevalence has always been found 20-30 % higher in asthmatics than in non asthmatic subjects) doesn't prove the existence of a "causal" relationship between the two conditions: this could be a kind of association without causative meaning as is the association between blond hair and blue eyes which in no way can be considered a prove that one of the two conditions is the cause of the other.

  11. The navicular position test - a reliable measure of the navicular bone position during rest and loading

    DEFF Research Database (Denmark)

    Spörndly-Nees, Søren; Dåsberg, Brian; Nielsen, Rasmus Oestergaard

    2011-01-01

    Lower limb injuries are a large problem in athletes. However, there is a paucity of knowledge on the relationship between alignment of the medial longitudinal arch (MLA) of the foot and development of such injuries. A reliable and valid test to quantify foot type is needed to be able to investigate...... the relationship between arch type and injury likelihood. Feiss Line is a valid clinical measure of the MLA. However, no study has investigated the reliability of the test....

  12. Triple positive antiphospholipid antibody profile in outpatients with tests for lupus anticoagulants.

    Science.gov (United States)

    Froom, Paul; Saffuri-Elias, Enas; Rozenberg, Orit; Barak, Mira

    2015-01-01

    A triple positive antiphospholipid (aPL) antibody profile [two positive serum IgG aPL antibodies along with one positive functional plasma lupus anticoagulant (LAC) test result] is associated with an increased risk for thrombosis, whereas patients with single positive test results may have little to no increased risk. The frequency of triple positivity in outpatients with various combinations of LAC test results is unclear. We extracted from our database all LAC test results [dilute Russell viper venom times (dRVVT) and silica clotting times (SCT)] that had concomitant serum IgG aPL testing [both serum anti β2-glycoprotein I (anti-β2GPI) and anti-cardiolipin (aCL) antibodies]. There were 3195 patients without a prolonged prothrombin time. Double antibody positivity was found in 1% (31/2955) of those with normal functional LAC test results, in 16.0% (31/81) of those with a positive dRVVT, in 12.7% (10/79) of those with a positive SCT, and in 56.3% (45/80) of those with both tests positive (pLAC test result. We conclude that 28% of patients with elevated LAC tests have a triple positive aPL antibody profile and patients with two positive LAC tests have a higher prevalence of a triple positive profile than do those with one positive LAC test result.

  13. Risk of breast cancer after false-positive test results in screening mammography

    DEFF Research Database (Denmark)

    von Euler-Chelpin, My Catarina; Risør, Louise Madeleine; Thorsted, Brian Larsen

    2012-01-01

    Screening for disease in healthy people inevitably leads to some false-positive tests in disease-free individuals. Normally, women with false-positive screening tests for breast cancer are referred back to routine screening. However, the long-term outcome for women with false-positive tests...

  14. Multiple IgE-mediated sensitizations to enzymes after occupational exposure: evaluation by skin prick test, RAST, and immunoblot.

    Science.gov (United States)

    Zentner, A; Jeep, S; Wahl, R; Kunkel, G; Kleine-Tebbe, J

    1997-09-01

    We investigated 10 sensitized and 10 nonsensitized workers from a pharmaceutic factory who had been exposed to powdered trypsin, chymotrypsin, bromelain, papain, amylase, and lipase. Ten nonallergic subjects served as a control group. Titrated skin prick tests (SPT), RAST, and immunoblot studies were performed with all six enzymes. SPT reactivity revealed multiple sensitizations to proteolytic enzymes, i.e., papain (specifically sensitized/total number of sensitizations: 9/10), trypsin (8/10), chymotrypsin (8/10), and bromelain (7/10) and appeared to be more frequent and more pronounced than sensitizations to amylase (3/10) or lipase (3/10). The low molecular weight of proteolytic enzymes (20-30 kDa) and their biologic activity might facilitate mucosal penetration more easily and thus-compared to amylase and lipase-permit an immune response and induction of allergic hypersensitivity. Immunoblot studies demonstrated IgG-binding bands in both SPT-positive and -negative workers, indicating exposure to the enzymes, but not in 10 unexposed control subjects. IgE-binding bands of the enzymes were detected only in workers with a positive SPT reaction and/or a positive RAST result. IgG bands were more frequent and the IgG/IgE ratio was increased in workers without allergic complaints compared to symptomatic workers. This might indicate that high levels of specific IgG antibodies to enzymes are associated with an immune response lacking allergic manifestations in spite of IgE-mediated sensitizations to the enzymes. Atopic subjects were at greater risk of developing IgE-mediated sensitization (7/10) and allergic symptoms to enzymes (5/7). However, even without risk of atopy, IgE-mediated hypersensitivity occurred in a few subjects (3/13) exposed to enzymes by inhalation for prolonged periods of time.

  15. HUBUNGAN AUTOLOGOUS SERUM SKIN TEST/ASST DENGAN KEPARAHAN KLINIS URTIKARIA KRONIK IDIOPATIK DI RSUP Dr. MOH HOESIN PALEMBANG

    Directory of Open Access Journals (Sweden)

    Suryadi Tjekyan

    2008-06-01

    Full Text Available Severity of Chronic Idiopathic Urticaria In RSUP Dr. Moh. Hoesin Palembang. There were differences in clinical finding among authors about autologous serum skin test/ASST result in chronic idiopathic urtikaria/CIU. Tanus et al (1996 reported there was no significant differences in clinical features of CIU, whereas Sabroe et al (1999 found significant differences in duration and itch of CIU patients. The prevalence of urticaria in General Hospital Dr. Moh. Hoesin Palembang showed increased tendency but there was no data about CIU and the severity of clinical features. The objectives of this study were to find out the significant correlation between ASST and severity of clinical features of CIU, and compared the difference of clinical features of CIU with and without positive ASST. This study was an observational analytic study, with cross sectional design. Fifty four subjects included in this study after following selection. Ethical approval was obtained from Bioethics and Humanities Unit, Faculty of Medicine Sriwijaya University and Dr. Moh. Hoesin Hospital Palembang. The clinical feature of 54 patients with CIU were evaluated. The data of physical examination and the anamnesis about clinical scores collected and analyzed using SPSS software and Spierman correlation was used to analyze the correlation between clinical severity of CIU and ASST result. Student’s t-test was used to analyze the differences in clinical severity of CIU with and without positive ASST. There was significant correlation between the severity clinical feature of CIU and ASST result (p=0,00 ; R=0,598. Patients with positif ASST results (46,3% had more duration of illness (0,00, higher pruritus score (0,00, and angiodema score (0,024. The CIU patients with severity clinical score of 27 (cut-off point, 11 times more likely to develop autoimmune urticaria than the patients with cut-off below 27 (p=0,00.

  16. Safety and Efficacy Assessment of Two New Leprosy Skin Test Antigens: Randomized Double Blind Clinical Study

    Science.gov (United States)

    Rivoire, Becky L.; Groathouse, Nathan A.; TerLouw, Stephen; Neupane, Kapil Dev; Ranjit, Chaman; Sapkota, Bishwa Raj; Khadge, Saraswoti; Kunwar, Chatra B.; Macdonald, Murdo; Hawksworth, Rachel; Thapa, Min B.; Hagge, Deanna A.; Tibbals, Melinda; Smith, Carol; Dube, Tina; She, Dewei; Wolff, Mark; Zhou, Eric; Makhene, Mamodikoe; Mason, Robin; Sizemore, Christine; Brennan, Patrick J.

    2014-01-01

    Background New tools are required for the diagnosis of pre-symptomatic leprosy towards further reduction of disease burden and its associated reactions. To address this need, two new skin test antigens were developed to assess safety and efficacy in human trials. Methods A Phase I safety trial was first conducted in a non-endemic region for leprosy (U.S.A.). Healthy non-exposed subjects (n = 10) received three titrated doses (2.5 µg, 1.0 µg and 0.1 µg) of MLSA-LAM (n = 5) or MLCwA (n = 5) and control antigens [Rees MLSA (1.0 µg) and saline]. A randomized double blind Phase II safety and efficacy trial followed in an endemic region for leprosy (Nepal), but involved only the 1.0 µg (high dose) and 0.1 µg (low dose) of each antigen; Tuberculin PPD served as a control antigen. This Phase II safety and efficacy trial consisted of three Stages: Stage A and B studies were an expansion of Phase I involving 10 and 90 subjects respectively, and Stage C was then conducted in two parts (high dose and low dose), each enrolling 80 participants: 20 borderline lepromatous/lepromatous (BL/LL) leprosy patients, 20 borderline tuberculoid/tuberculoid (BT/TT) leprosy patients, 20 household contacts of leprosy patients (HC), and 20 tuberculosis (TB) patients. The primary outcome measure for the skin test was delayed type hypersensitivity induration. Findings In the small Phase I safety trial, reactions were primarily against the 2.5 µg dose of both antigens and Rees control antigen, which were then excluded from subsequent studies. In the Phase II, Stage A/B ramped-up safety study, 26% of subjects (13 of 50) showed induration against the high dose of each antigen, and 4% (2 of 50) reacted to the low dose of MLSA-LAM. Phase II, Stage C safety and initial efficacy trial showed that both antigens at the low dose exhibited low sensitivity at 20% and 25% in BT/TT leprosy patients, but high specificity at 100% and 95% compared to TB patients. The high dose of both antigens

  17. Safety and efficacy assessment of two new leprosy skin test antigens: randomized double blind clinical study.

    Directory of Open Access Journals (Sweden)

    Becky L Rivoire

    Full Text Available New tools are required for the diagnosis of pre-symptomatic leprosy towards further reduction of disease burden and its associated reactions. To address this need, two new skin test antigens were developed to assess safety and efficacy in human trials.A Phase I safety trial was first conducted in a non-endemic region for leprosy (U.S.A.. Healthy non-exposed subjects (n = 10 received three titrated doses (2.5 µg, 1.0 µg and 0.1 µg of MLSA-LAM (n = 5 or MLCwA (n = 5 and control antigens [Rees MLSA (1.0 µg and saline]. A randomized double blind Phase II safety and efficacy trial followed in an endemic region for leprosy (Nepal, but involved only the 1.0 µg (high dose and 0.1 µg (low dose of each antigen; Tuberculin PPD served as a control antigen. This Phase II safety and efficacy trial consisted of three Stages: Stage A and B studies were an expansion of Phase I involving 10 and 90 subjects respectively, and Stage C was then conducted in two parts (high dose and low dose, each enrolling 80 participants: 20 borderline lepromatous/lepromatous (BL/LL leprosy patients, 20 borderline tuberculoid/tuberculoid (BT/TT leprosy patients, 20 household contacts of leprosy patients (HC, and 20 tuberculosis (TB patients. The primary outcome measure for the skin test was delayed type hypersensitivity induration.In the small Phase I safety trial, reactions were primarily against the 2.5 µg dose of both antigens and Rees control antigen, which were then excluded from subsequent studies. In the Phase II, Stage A/B ramped-up safety study, 26% of subjects (13 of 50 showed induration against the high dose of each antigen, and 4% (2 of 50 reacted to the low dose of MLSA-LAM. Phase II, Stage C safety and initial efficacy trial showed that both antigens at the low dose exhibited low sensitivity at 20% and 25% in BT/TT leprosy patients, but high specificity at 100% and 95% compared to TB patients. The high dose of both antigens showed lower specificity (70% and 60

  18. Safety and efficacy assessment of two new leprosy skin test antigens: randomized double blind clinical study.

    Science.gov (United States)

    Rivoire, Becky L; Groathouse, Nathan A; TerLouw, Stephen; Neupane, Kapil Dev; Ranjit, Chaman; Sapkota, Bishwa Raj; Khadge, Saraswoti; Kunwar, Chhatra B; Kunwar, Chatra B; Macdonald, Murdo; Hawksworth, Rachel; Thapa, Min B; Hagge, Deanna A; Tibbals, Melinda; Smith, Carol; Dube, Tina; She, Dewei; Wolff, Mark; Zhou, Eric; Makhene, Mamodikoe; Mason, Robin; Sizemore, Christine; Brennan, Patrick J

    2014-01-01

    New tools are required for the diagnosis of pre-symptomatic leprosy towards further reduction of disease burden and its associated reactions. To address this need, two new skin test antigens were developed to assess safety and efficacy in human trials. A Phase I safety trial was first conducted in a non-endemic region for leprosy (U.S.A.). Healthy non-exposed subjects (n = 10) received three titrated doses (2.5 µg, 1.0 µg and 0.1 µg) of MLSA-LAM (n = 5) or MLCwA (n = 5) and control antigens [Rees MLSA (1.0 µg) and saline]. A randomized double blind Phase II safety and efficacy trial followed in an endemic region for leprosy (Nepal), but involved only the 1.0 µg (high dose) and 0.1 µg (low dose) of each antigen; Tuberculin PPD served as a control antigen. This Phase II safety and efficacy trial consisted of three Stages: Stage A and B studies were an expansion of Phase I involving 10 and 90 subjects respectively, and Stage C was then conducted in two parts (high dose and low dose), each enrolling 80 participants: 20 borderline lepromatous/lepromatous (BL/LL) leprosy patients, 20 borderline tuberculoid/tuberculoid (BT/TT) leprosy patients, 20 household contacts of leprosy patients (HC), and 20 tuberculosis (TB) patients. The primary outcome measure for the skin test was delayed type hypersensitivity induration. In the small Phase I safety trial, reactions were primarily against the 2.5 µg dose of both antigens and Rees control antigen, which were then excluded from subsequent studies. In the Phase II, Stage A/B ramped-up safety study, 26% of subjects (13 of 50) showed induration against the high dose of each antigen, and 4% (2 of 50) reacted to the low dose of MLSA-LAM. Phase II, Stage C safety and initial efficacy trial showed that both antigens at the low dose exhibited low sensitivity at 20% and 25% in BT/TT leprosy patients, but high specificity at 100% and 95% compared to TB patients. The high dose of both antigens showed lower specificity (70% and 60

  19. Evaluation of a Novel Rapid Test System for the Detection of Allergic Sensitization to Timothy Grass Pollen against Established Laboratory Methods and Skin Prick Test

    Directory of Open Access Journals (Sweden)

    R. Lucassen

    2010-01-01

    Full Text Available Type I hypersensitivity is driven by allergen specific immunoglobulin E (sIgE and thus sIgE represents a marker for modern allergy diagnosis. Recently, a rapid assay for the detection of sIgE, termed as (Allergy Lateral Flow Assay ALFA, has been developed. The objective of our study is the evaluation of a scanner-based system for the semiquantitative interpretation of ALFA results. Agreement to Skin Prick Test (SPT, Allergopharma, ALLERG-O-LIQ System (Dr. Fooke, and ImmunoCAP (Phadia was investigated using 50 sera tested for specific IgE to timothy grass pollen (g6. 35/50 sera were positive by SPT, ALLERG-O-LIQ, and ImmunoCAP. Excellent agreement was observed between ALFA results and SPT, ImmunoCAP, and ALLERG-O-LIQ. Area under the curve (AUC values were found at 1.0, and 100% sensitivity and specificity was found versus all other methods. Visual- and scanner-based interpretation of the ALFA results revealed excellent agreement.

  20. The navicular position test - a reliable measure of the navicular bone position during rest and loading

    DEFF Research Database (Denmark)

    Spörndly-Nees, Søren; Dåsberg, Brian; Nielsen, Rasmus Oestergaard

    2011-01-01

    Lower limb injuries are a large problem in athletes. However, there is a paucity of knowledge on the relationship between alignment of the medial longitudinal arch (MLA) of the foot and development of such injuries. A reliable and valid test to quantify foot type is needed to be able to investiga...

  1. The navicular position test - a reliable measure of the navicular bone position during rest and loading

    DEFF Research Database (Denmark)

    Spörndly-Nees, Søren; Dåsberg, Brian; Nielsen, Rasmus Oestergaard

    2011-01-01

    Background: Lower limb injuries are a large problem in athletes. However, there is a paucity of knowledge on the relationship between alignment of the medial longitudinal arch (MLA) of the foot and development of such injuries. A reliable and valid test to quantify foot type is needed to be able ...

  2. Correlation between skin temperature and heart rate during exercise and recovery, and the influence of body position in these variables in untrained women

    Science.gov (United States)

    Neves, Eduardo Borba; Cunha, Raphael Martins; Rosa, Claudio; Antunes, Natacha Sousa; Felisberto, Ivo Miguel Vieira; Vilaça-Alves, José; Reis, Victor Machado

    2016-03-01

    It was known that the thermal response varies according to some variables. Until now, there are no studies that have investigated the relationship of skin temperature and heart rate during and after the workout, either the thermal behavior during postural changes. Objective: the aim of this study was to evaluate the behavior of skin temperature and heart rate, during exercise and up to an hour of recovery (with postural change), performed in two different intensities sessions (70% and 85% of 10 repetitions maximum) and observe the correlation between them. Method: This was a short longitudinal study, carried out with women aged from 18 to 30 years. A sample of 31 untrained women, aged 18 and 30 was used. The volunteers were randomized into two groups: Biceps Group (BG), with 15 women, and Quadriceps Group (QG) with 16 women. Results: During and after completion of the exercise session, there was a significant reduction in skin temperature on the active muscles in both groups (BG and QG), with similar thermal responses for the two intensities studied (70% and 85%) to the minute 15 (which marks the end of the recovery in the standing position). From minute 15 to minute 20-60, the skin temperature increases abruptly and significantly, returning to levels close to those observed before exercise. Conclusion: There were no statistical differences in thermal response to exercises in 70% or 85% of 10RM. There is a negative correlation between heart rate and skin temperature when untrained women perform anaerobic exercise. It was observed that after a change of posture (from a standing position to a sitting posture) skin temperature increased abruptly and significantly.

  3. Novel volatiles of skin-borne bacteria inhibit the growth of Gram-positive bacteria and affect quorum-sensing controlled phenotypes of Gram-negative bacteria.

    Science.gov (United States)

    Lemfack, Marie Chantal; Ravella, Srinivasa Rao; Lorenz, Nicola; Kai, Marco; Jung, Kirsten; Schulz, Stefan; Piechulla, Birgit

    2016-12-01

    The skin microbiota is import for body protection. Here we present the first comprehensive analysis of the volatile organic compound (VOC) profiles of typical skin-resident corynebacterial and staphylococcal species. The VOC profile of Staphylococcus schleiferi DSMZ 4807 was of particular interest as it is dominated by two compounds, 3-(phenylamino)butan-2-one and 3-(phenylimino)butan-2-one (schleiferon A and B, respectively). Neither of these has previously been reported from natural sources. Schleiferon A and B inhibited the growth of various Gram-positive species and affected two quorum-sensing-dependent phenotypes - prodigiosin accumulation and bioluminescence - of Gram-negative bacteria. Both compounds were found to inhibit the expression of prodigiosin biosynthetic genes and stimulate the expression of prodigiosin regulatory genes pigP and pigS. This study demonstrates that the volatile schleiferons A and B emitted by the skin bacterium S. schleiferi modulate differentially and specifically its interactions with members of diverse bacterial communities. A network of VOC-mediated interspecies interactions and communications must be considered in the establishment of the (skin) microbiome and both compounds are interesting candidates for further investigations to better understand how VOCs emitted by skin bacteria influence and modulate the local microbiota and determine whether they are relevant to antibiotic and anti-virulence therapies. Copyright © 2016 Elsevier GmbH. All rights reserved.

  4. Mold-specific IgE antibodies in relation to exposure and skin test data in schoolchildren

    Directory of Open Access Journals (Sweden)

    Taina Taskinen

    2001-01-01

    Conclusions: Mold allergy, as assessed by IgE measurements or skin tests, is rare in children. School- aged asthmatic boys having exposed to indoor air dampness seem to form a susceptible group for mold allergy, being at risk for worsening of their asthma.

  5. Standard skin prick testing and sensitization to inhalant allergens across Europe--a survey from the GALEN network

    NARCIS (Netherlands)

    Heinzerling, L.; Frew, A. J.; Bindslev-Jensen, C.; Bonini, S.; Bousquet, J.; Bresciani, M.; Carlsen, K.-H.; van Cauwenberge, P.; Darsow, U.; Fokkens, W. J.; Haahtela, T.; van Hoecke, H.; Jessberger, B.; Kowalski, M. L.; Kopp, T.; Lahoz, C. N.; Lodrup Carlsen, K. C.; Papadopoulos, N. G.; Ring, J.; Schmid-Grendelmeier, P.; Vignola, A. M.; Wöhrl, S.; Zuberbier, T.

    2005-01-01

    Skin prick testing (SPT) is the standard method for diagnosing allergic sensitization but is to some extent performed differently in clinical centres across Europe. There would be advantages in harmonizing the standard panels of allergens used in different European countries, both for clinical

  6. EVALUATION OF DIAGNOSTIC ACCURACY OF THE COMPARATIVE TUBERCULIN SKIN TEST IN REHABILITANT BORNEAN ORANGUTANS (PONGO PYGMAEUS).

    Science.gov (United States)

    Dench, Rosalie; Sulistyo, Fransiska; Fahroni, Agus; Philippa, Joost

    2015-12-01

    The tuberculin skin test (TST) has been the mainstay of tuberculosis (TB) testing in primates for decades, but its interpretation in orangutans (Pongo spp.) is challenging, because many animals react strongly, without evidence of infection with Mycobacterium tuberculosis complex. One explanation is cross-reactivity with environmental nontuberculous mycobacteria (NTM). The use of a comparative TST (CTST), comparing reactivity to avian (representing NTM) and bovine (representing tuberculous mycobacteria) tuberculins aids in distinguishing cross-reactivity due to sensitization by NTM from shared antigens. The specificity of the TST can be increased with the use of CTST. We considered three interpretations of the TST in rehabilitant Bornean orangutans ( Pongo pygmaeus ) using avian purified protein derivative (APPD; 25,000 IU/ml) and two concentrations of bovine purified protein derivative (BPPD; 100,000 and 32,500 IU/ml). The tests were evaluated for their ability to identify accurately seven orangutans previously diagnosed with and treated for TB from a group of presumed negative individuals (n = 288 and n = 161 for the two respective BPPD concentrations). BPPD at 32,500 IU/ml had poor diagnostic capacity, whereas BPPD at 100,000 IU/ml performed better. The BPPD-only interpretation had moderate sensitivity (57%) and poor specificity (40%) and accuracy (41%). The comparative interpretation at 72 hr had similar sensitivity (57%) but improved specificity (95%) and accuracy (94%). However, best results were obtained by a comparative interpretation incorporating the 48- and 72-hr scores, which had good sensitivity (86%), specificity (95%) and accuracy (95%). These data reinforce recommendations that a CTST be used in orangutans and support the use of APPD at 25,000 IU/ml and BPPD at 100,000 IU/ml. The highest score at each site from the 48- and 72-hr checks should be considered the result for that tuberculin. If the bovine result is greater than the avian result, the

  7. Evaluation of commercial skin prick test solutions for selected occupational allergens.

    Science.gov (United States)

    van Kampen, V; de Blay, F; Folletti, I; Kobierski, P; Moscato, G; Olivieri, M; Quirce, S; Sastre, J; Walusiak-Skorupa, J; Kotschy-Lang, N; Müsken, H; Mahler, V; Schliemann, S; Ochmann, U; Sültz, J; Worm, M; Sander, I; Zahradnik, E; Brüning, T; Merget, R; Raulf-Heimsoth, M

    2013-01-01

    Skin prick testing (SPT) is an important step in the diagnosis of IgE-mediated occupational allergic diseases. The outcome of SPT is related to the quality of allergen extracts. Thus, the aim of the study was to assess different commercially available SPT solutions for selected occupational allergens. SPT was performed in 116 bakers, 47 farmers and 33 subjects exposed to natural rubber latex (NRL), all with work-related allergic symptoms. The SPT solutions from different manufacturers (n = 3-5) for wheat flour, rye flour, soy, cow hair/dander, storage mites (Tyrophagus putrescentiae, Lepidoglyphus destructor, Acarus siro) and NRL were analysed with respect to their protein and antigen contents. SPT was carried out in 16 allergy centres in six European countries using standardized procedures. Specific IgE values were used as the gold standard to calculate the sensitivity and specificity of SPT solutions. The optimal cut-point for each SPT solution was determined by Youden Index. Protein and antigen contents and patterns of the SPT solutions varied remarkably depending on the manufacturer. While SPT solutions for wheat flour and soy reached overall low sensitivities, sensitivities of other tested SPT solutions depended on the manufacturer. As a rule, solutions with higher protein and antigen content showed higher sensitivities and test efficiencies. There is a wide variability of SPT solutions for occupational allergens, and the sensitivity of several solutions is low. Thus, improvement and standardization of SPT solutions for occupational allergens is essential. © 2013 John Wiley & Sons A/S. Published by Blackwell Publishing Ltd.

  8. Constrictive pericarditis causing a positive TI-201 SPECT stress test for myocardial ischemia

    Energy Technology Data Exchange (ETDEWEB)

    Matthews, R.J.; Lightfoote, J.; Grusd, R.S. (Diagnostic Imaging of Southern California Medical Group, Sherman Oaks (USA))

    1990-08-01

    A case of constritive pericarditis was demonstrated by a positive thallium SPECT stress test for myocardial ischemia. After pericardiectomy, the repeat thallium stress test was normal. The disappearance of the criteria for a positive test suggests that constrictive pericarditis can cause myocardial ischemia, which can be demonstrated by thallium SPECT stress testing.

  9. Clinical relevance is associated with allergen-specific wheal size in skin prick testing

    DEFF Research Database (Denmark)

    Haahtela, T.; Burbach, G. J.; Bachert, C.

    2014-01-01

    by providing quantitative decision points. MethodsThe GA(2)LEN SPT study with 3068 valid data sets was used to investigate the relationship between SPT results and patient-reported clinical relevance for each of the 18 inhalant allergens as well as SPT wheal size and physician-diagnosed allergy (rhinitis......, asthma, atopic dermatitis, food allergy). The effects of age, gender, and geographical area on SPT results were assessed. For each allergen, the wheal size in mm with an 80% positive predictive value (PPV) for being clinically relevant was calculated. ResultsDepending on the allergen, from 40% (blatella......) to 87-89% (grass, mites) of the positive SPT reactions (wheal size3mm) were associated with patient-reported clinical symptoms when exposed to the respective allergen. The risk of allergic symptoms increased significantly with larger wheal sizes for 17 of the 18 allergens tested. Children with positive...

  10. Testing Bernese Precise Point Positioning Over a Five Year Period

    Science.gov (United States)

    Dodson, A. H.; Teferle, F. N.; Orliac, E. J.; Bingley, R. M.; Kierulf, H. P.

    2005-12-01

    In this presentation we investigate the use of the precise point positioning (PPP) technique within the Bernese GPS software version 5.0. Although this method has normally been associated with the GIPSY OASIS software developed at the Jet Propulsion Laboratory (JPL), the Bernese GPS software is also able to carry out undifferenced analysis of GPS measurements. In previous studies, the PPP capability in Bernese has, however, only been used for evaluations of IGS rapid and final products over days or weeks. To the knowledge of the authors, no results using, e.g. several years of CGPS data, have been published. In recent years, the PPP technique has gained in popularity, partly responsible for this are the continuous improvements in the satellite orbits and clocks, and the related Earth rotation parameters produced and made available by the IGS community. The Bernese PPP processing strategy presented is still in development, but is in principle similar to the strategy applied when using GIPSY OASIS II, in terms of computing a set of transformation parameters from a global network of stations that are then applied during post-processing. We discuss results obtained for the global IGb00 network and a dense network over Europe using both IGS final and rapid products. A comparison with PPP coordinate time series from GIPSY OASIS II is also included.

  11. Skin prick test reactivity in allergic rhinitis patients to airborne pollens.

    Science.gov (United States)

    Erkara, Ismuhan Potoglu; Cingi, Cemal; Ayranci, Unal; Gurbuz, Kezban Melek; Pehlivan, Sevil; Tokur, Suleyman

    2009-04-01

    The aim was to investigate the impact of atmospheric pollen in determining allergic rhinitis. It was conducted with 130 patients with allergic rhinitis in three different sites in Eskisehir, Turkey, in 2000-2001, using a gravimetric method with a Durham sampler. Skin prick test results, the symptoms of patients and their findings all confirmed the presence of allergic reactions to pollen allergens in the patients observed. During the period, a total of 47,082 pollen grains/cm(2) belonging to 45 taxa were recorded. Of the total pollen grains, 81.0% were arboreal and 18% non-arboreal. The majority of the investigated pollen grains were from Pinaceae, Salix spp., Chenopodiaceae/Amaranthaceae, Cupressaceae and Poaceae. Pollen concentrations reached the highest level in May (54.36%). The pollen allergens provoking severe sensitization were grasscereal mixtures (58.5%), followed by arboreals (33.8%). All patients (100.0%) were sensitive to grass. This study emphasizes the significance of determining the types and concentrations of pollen with a view to comparing changes in highly concentrated allergens.

  12. Risk of redocumenting penicillin allergy in a cohort of patients with negative penicillin skin tests.

    Science.gov (United States)

    Rimawi, Ramzy H; Shah, Kaushal B; Cook, Paul P

    2013-11-01

    Even though electronic documentation of allergies is critical to patient safety, inaccuracies in documentation can potentiate serious problems. Prior studies have not evaluated factors associated with redocumenting penicillin allergy in the medical record despite a proven tolerance with a penicillin skin test (PST). Assess the prevalence of reinstating inaccurate allergy information and associated factors thereof. We conducted a retrospective observational study from August 1, 2012 to July 31, 2013 of patients who previously had a negative PST. We reviewed records from the hospital, long-term care facilities (LTCF), and primary doctors' offices. Vidant Health, a system of 10 hospitals in North Carolina. Patients with proven penicillin tolerance rehospitalized within a year period from the PST. We gauged hospital reappearances, penicillin allergy redocumentation, residence, antimicrobial use, and presence of dementia or altered mentation. Of the 150 patients with negative PST, 55 (37%) revisited a Vidant system hospital within a 1-year period, of whom 21 were LTCF residents. Twenty (36%) of the 55 patients had penicillin allergy redocumented without apparent reason. Factors associated with penicillin allergy redocumentation included age >65 years (P = 0.011), LTCF residence (P = 0.0001), acutely altered mentation (P Penicillin allergy was still listed in all 21 (100%) of the LTCF records. At our hospital system, penicillin allergies are often redocumented into the medical record despite proven tolerance. The benefits of PST may be limited by inadequately removing the allergy from different electronic/paper hospital, LTCF, primary physician, and community pharmacy records. © 2013 Society of Hospital Medicine.

  13. The Clinical Test of Nano gold Cosmetic for Recovering Skin Damage Due to Chemicals: Special Case

    Science.gov (United States)

    Taufikurohmah, T.; Wardana, A. P.; Tjahjani, S.; Sanjaya, I. G. M.; Baktir, A.; Syahrani, A.

    2018-01-01

    Manufacturing of Nano gold cosmetics was done at PT. Gizi Indonesia. Clinical trials to cosmetics data supported that cosmetics are able to treat skin health which has been reported partially. For special cases, the recovery process of facial skin damage should also receive attention including cases of facial skin damage caused by chemicals such as phenol, HCl, aqua regia or other harsh chemicals. The problem determined whether the Nano gold is able to recover skin damage due to the harsh chemicals. This clinical trial data on the forms of early skin damage caused by phenol was delivered in the forms of facial photos patients. The recovery progress of facial skin condition was obtained every week for two months. The data included the forms of widespread wounds during the recovery process. This statement supported by anova statistical analysis of the widespread wound changing every week for 8 times. The conclusion is skin damage due to Phenol impregnation can be recovered with the use of Nano gold cosmetics for 8 weeks. This results support the manufacturing of Nano gold cosmetics for the needs of society. It also suggest that Nano gold material can be used for medicine manufacturing in the future.

  14. Inhibitory effects of oral prednisolone and fexofenadine on skin responses by prick tests with histamine and compound 48/80.

    Science.gov (United States)

    Inoue, Tomoko; Katoh, Norito; Kishimoto, Saburo; Matsunaga, Kayoko

    2002-12-01

    The prick test is a useful skin test for diagnosing immediate hypersensitivity response. Sometimes it is necessary to perform prick tests on patients who have already received antihistamines or corticosteroids. It is, however, occasionally uncertain whether the results of prick tests are reliable. In this study, the inhibitory effects of prednisolone (10 mg/day) and fexofenadine (120 mg/day) on the response to prick tests induced with histamine and compound 48/80 were examined. During a 7-day-continual drug administration, prick tests were performed 8 h after drug administration. The inhibitory effects of fexofenadine on both the histamine- and compound 48/80-induced skin responses were exhibited on the 1st day and persisted from 24 to 36 h after the final administration. The histamine-induced wheal responses were not inhibited by prednisolone, while the compound 48/80-induced flare and wheal responses were significantly inhibited on the 5th day of drug administration. These responses returned to the baseline level 24 h after the last drug administration. Thus, the results of skin tests performed during administration of antihistamines and corticosteroids should be carefully interpreted.

  15. Gram stain of skin lesion

    Science.gov (United States)

    Skin lesion gram stain ... skin sore. This procedure is called a skin lesion biopsy . Before the biopsy, your provider will numb ... means bacteria have been found in the skin lesion. Further tests are needed to confirm the results. ...

  16. Tuberculin skin test result and risk of death among persons with active TB.

    Directory of Open Access Journals (Sweden)

    Sara C Auld

    Full Text Available BACKGROUND: Although the tuberculin skin test (TST is frequently used to aid in the diagnosis of tuberculosis (TB disease and to identify persons with latent TB infection, it is an imperfect test and approximately 10-25% of persons with microbiologically confirmed TB disease have a negative TST. Previous studies have suggested that persons with a negative TST are more likely to present with severe TB disease and have an increased rate of TB-related death. METHODS: We analyzed culture-confirmed TB cases captured in US TB surveillance data from 1993 to 2008 and performed multivariate logistic regression analysis to determine the association between TST result and death. RESULTS: Of 284,866 cases of TB reported in the US, 58,180 persons were eligible for inclusion in the analysis and 3,270 of those persons died after initiating TB treatment. Persons with a negative TST accounted for only 14% of the eligible cases but accounted for 42% of the deaths. Persons with a TST≥15 mm had 67% lower odds of death than persons with a negative TST (adjusted odds ratio 0.33, 95% confidence interval 0.30-0.36. CONCLUSIONS: A negative TST is associated with an increased risk of death among persons with culture-confirmed TB disease, even after adjustment for HIV status, site of TB disease, sputum smear AFB status, drug susceptibility, age, sex, and origin of birth. In addition to indicating risk of developing disease, the TST may also be a marker for increased risk of death.

  17. Serum fractions associated with positive and false positive reactions in the ELA test for trichinellosis in swine. [Accuracy of packinghouse tests for Trichinella in pork

    Energy Technology Data Exchange (ETDEWEB)

    Clinard, E.H.

    1976-01-01

    A considerable number of packinghouse swine sera give false positive results in the enzyme-labeled antibody (ELA) test for Trichinosis. Efforts to understand the nature of this problem directed toward isolation and identification of a serum factor responsible for the false positive reactions are discussed.

  18. Aircraft Skin Penetrator and Agent Applicator. Volume 2. Test and Evaluation.

    Science.gov (United States)

    1984-11-01

    which will penetrate aircraft skin and serve as a discharge outlet to dispense fire - extinguishing agent. AMETEK, Inc./ORED designed a tool to meet...grease Degrease with 1,1,1-Trichloro- ethane, steem clean and blow dry. 3. Odor Rinse with solution of baking soda (sodium bicarbonate) then rinse with...development and construction of an aircraft skin penetrator device to provide rapid penetration and allow placement of a suitable fire suppressing agent onto

  19. Recent tests at Langley with a University of Tennessee Space Institute (UTSI) skin friction balance

    Science.gov (United States)

    Lawing, Pierce L.; Vakili, A. D.; Wu, J. M.

    1987-01-01

    The experience at LaRC with the University of Tennessee Space Institute skin friction balances is summarized. The Karman-Schoenherr flat plate skin friction formulation is included for comparison. It is concluded that the balance is capable of operation in environments as diverse as cryogenic, transonic, high-shear rate of the 0.3 meter Transonic Cryogenic Tunnel, and high-temperature supersonic environment of the Unitary Plan Wind Tunnel. Proposed new research is outlined.

  20. De-labelling self-reported penicillin allergy within the emergency department through the use of skin tests and oral drug provocation testing.

    Science.gov (United States)

    Marwood, Joseph; Aguirrebarrena, Gonzalo; Kerr, Stephen; Welch, Susan A; Rimmer, Janet

    2017-10-01

    Self-reported penicillin allergy is common among patients attending the ED, but is a poor predictor of true immunoglobulin E-mediated hypersensitivity to penicillin. We hypothesise that with a combination of skin testing and drug provocation testing, selected patients can be safely de-labelled of their allergy. This prospective study enrolled a sample of patients presenting to an urban academic ED between 2011 and 2016 with a self-reported allergy to penicillin. Standardised skin prick and intradermal testing with amoxicillin and both major and minor determinants of penicillin was performed in the department. If negative, testing was followed by a graded oral challenge of amoxicillin over 9 days. The primary end point was the allergy status of participants at the end of the study. A total of 100 patients (mean age 42; standard deviation 14 years; 54% women) completed the testing. Of these, 81% (95% confidence interval 71.9-88.2) showed no hypersensitivity to penicillin and were labelled non-allergic. The majority (16/19) of allergies were confirmed by skin testing, with three suspected allergies detected by the oral challenge. Women were more likely than men to have a true penicillin allergy, with odds ratio of 4.0 (95% confidence interval 1.23-13.2). There were no serious adverse events. Selected patients in the ED who self-report an allergy to penicillin can be safely tested there for penicillin allergy, using skin tests and oral drug provocation testing. This testing allows a significant de-labelling of penicillin allergy, with the majority of these patients able to tolerate penicillin without incident. © 2017 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  1. Skin testing with raw egg does not predict tolerance to baked egg in egg-allergic children.

    Science.gov (United States)

    Turner, P J; Kumar, K; Fox, A T

    2014-11-01

    Most children with egg allergy tolerate egg in baked foods, such as cake, but tolerance cannot be predicted with conventional allergy testing. We hypothesized that the skin prick test (SPT) wheal to unprocessed raw egg might predict tolerance of baked egg at formal oral food challenge (OFC). We conducted a retrospective chart review to assess the utility of SPT wheal to egg extract (EE), raw egg (RE), and the ratio of EE:RE in predicting outcome of baked-egg OFC in children presenting to our tertiary referral centers with a physician diagnosis of egg allergy and following complete egg avoidance in their diet, between 2009 and 2013. OFC were performed following a standardized protocol using baked egg in cake, to a total dose equivalent to 3g egg protein. Data were analyzed from 186 completed challenges: OFC was positive in 64 (34%) children and negative in 122 (66%). Six children experienced anaphylaxis at OFC. Children tolerant to baked egg were more likely to have a lower SPT to egg extract/raw egg and EE:RE (median 0.56) than their allergic counterparts (0.70, p raw egg and EE:ER equal to 0.71, 0.63 and 0.60, respectively. EE:RE was not helpful in predicting outcome of baked-egg OFC. Indeed, SPT to egg extract was slightly better at predicting outcome than either SPT to raw egg or EE:RE. Unfortunately, tolerance to baked egg can only be predicted from previous history or through controlled exposure. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  2. Role of skin prick test in allergic disorders: A prospective study in Kashmiri population in light of review

    Directory of Open Access Journals (Sweden)

    Roohi Rasool

    2013-01-01

    Full Text Available Background: Skin prick test (SPT is the most effective diagnostic test to detect IgE mediated type I allergic reactions like allergic rhinitis, atopic asthma, acute urticaria, food allergy etc. SPTs are done to know allergic sensitivity and applied for devising immunotherapy as the therapeutic modality. Materials and Methods: This prospective study was conducted in the department of Immunology and Molecular medicine at SKIMS. A total of 400 patients suffering from allergic rhinitis, asthma and urticaria were recruited in this study. SPT was performed with panel of allergens including house dust mite, pollens, fungi, dusts, cockroach, sheep wool and dog epithelia. Allergen immunotherapy was given to allergic rhinitis and asthmatic patients as therapeutic modality. Results: In our study, age of patients ranged from 6 to 65 years. Majority of patients were in the age group of 20-30 years (72% with Male to female ratio of 1:1.5. Of the 400 patients, 248 (62% had urticaria, 108 (27% patients had allergic rhinitis and 44 (11% patients had asthma. SPT reaction was positive in 38 (86.4% with allergic asthma, 74 (68.5% patients with allergic rhinitis and 4 (1.6% patient with urticaria, respectively. Allergen immunotherapy was effective in 58% patients with allergic rhinitis and 42% allergic asthma. Conclusion: Identifiable aeroallergen could be detected in 86.4% allergic asthma and 68.5% allergic rhinitis patients by SPT alone. Pollens were the most prevalent causative allergen. There was significant relief in the severity of symptoms, medication intake with the help of allergen immunotherapy.

  3. First-in-man open clinical trial of a combined rdESAT-6 and rCFP-10 tuberculosis specific skin test reagent

    DEFF Research Database (Denmark)

    Bergstedt, Winnie; Tingskov, Pernille N; Thierry-Carstensen, Birgit

    2010-01-01

    Tuberculin is still the only available skin test reagent for the diagnosis of mycobacterial infection. The product has a remarkable sensitivity, but poor specificity. Previous studies, including two human phase I clinical trials, have indicated that rdESAT-6 has a potential as an improved skin test...

  4. Skin test results but not serology reflect immediate type respiratory sensitivity: a study performed with recombinant allergen molecules.

    Science.gov (United States)

    Niederberger, V; Stübner, P; Spitzauer, S; Kraft, D; Valenta, R; Ehrenberger, K; Horak, F

    2001-10-01

    The diagnosis of type I allergy, an IgE-antibody-mediated hypersensitivity disease affecting more than 25% of the population, is based on the measurement of allergen-specific serum IgE levels and provocation testing. Whether the determination of allergen- specific serum IgE levels can replace in vivo provocation testing for allergy diagnosis is a controversial issue. We used purified recombinant timothy grass and birch pollen allergens to compare by skin prick and nasal provocation testing as well as by serology in vivo sensitivity with antibody-binding capacity in 24 pollen allergic patients and eight control individuals. Results from biologic tests were correlated with each other and with allergen-specific IgE and IgG1-4 levels. IgE-reactive allergens induced immediate skin and nasal reactions, but the intensity of the allergic tissue reactions was not correlated with either the levels of allergen-specific IgE or the levels of allergen-specific IgG antibodies. Less frequently detected allergens with low IgE-binding capacity were able to induce strong allergic reactions comparable to those caused by major allergens with high IgE-binding capacity. In contrast, skin test and nasal provocation results were significantly correlated (r = 0.63, p components for specific immunotherapy.

  5. Engineering and science positioning tests in Flanders: powerful predictors for study success?

    OpenAIRE

    Vanderoost, Jef; Van Soom, Carolien; Langie, Greet; Van den Bossche, Johan; Callens, Riet; Vandewalle, Joos; De Laet, Tinne

    2015-01-01

    A new battery of positioning tests for Science and Engineering was broadly implemented in Flanders in the summer of 2013. The goal of the non-mandatory and non-binding positioning test is to allow future students, with a clear choice for engineering or science, to position themselves with respect to the required prior knowledge and skills and to stimulate students to participate in a remediation program if necessary. For each engineering or science bachelor under study, a specific position...

  6. Predicting the risk of a false-positive test for women following a mammography screening programme

    DEFF Research Database (Denmark)

    Njor, Sisse Helle; Olsen, Anne Helene; Schwartz, Walter

    2007-01-01

    screening to women aged 50-69 years in Copenhagen and Fyn, Denmark. METHODS: We defined the outcome from a screen as being either a false-positive test or not a false-positive test. We then tested whether the outcomes from subsequent screens were independent, and afterwards estimated the risk over 10......OBJECTIVES: The objectives of this study was to provide a simple estimate of the cumulative risk of a false-positive test for women participating in mammography screening. To test the method, we used data from two well-established, organized mammography screening programmes offering biennial...... screens of a false-positive test, i.e. the risk of getting at least one false-positive test for a woman participating in all 10 screens typically offered in Europe. RESULTS: The outcomes of subsequent screens were found to be independent. After completion of screening rounds 3-5, the risk of a false...

  7. A 3D-psoriatic skin model for dermatological testing: The impact of culture conditions.

    Science.gov (United States)

    Duque-Fernandez, Alexandra; Gauthier, Lydia; Simard, Mélissa; Jean, Jessica; Gendreau, Isabelle; Morin, Alexandre; Soucy, Jacques; Auger, Michèle; Pouliot, Roxane

    2016-12-01

    Inadequate representation of the human tissue environment during a preclinical screen can result in inaccurate predictions of compound effects. Consequently, pharmaceutical investigators are searching for preclinical models that closely resemble original tissue for predicting clinical outcomes. The current research aims to compare the impact of using serum-free medium instead of complete culture medium during the last step of psoriatic skin substitute reconstruction. Skin substitutes were produced according to the self-assembly approach. Serum-free conditions have no negative impact on the reconstruction of healthy or psoriatic skin substitutes presented in this study regarding their macroscopic or histological appearances. ATR-FTIR results showed no significant differences in the CH2 bands between psoriatic substitutes cultured with or without serum, thus suggesting that serum deprivation did not have a negative impact on the lipid organization of their stratum corneum. Serum deprivation could even lead to a better organization of healthy skin substitute lipids. Percutaneous analyses demonstrated that psoriatic substitutes cultured in serum-free conditions showed a higher permeability to hydrocortisone compared to controls, while no significant differences in benzoic acid and caffeine penetration profiles were observed. Results obtained with this 3D-psoriatic skin substitute demonstrate the potential and versatility of the model. It could offer good prediction of drug related toxicities at preclinical stages performed in order to avoid unexpected and costly findings in the clinic. Together, these findings offer a new approach for one of the most important challenges of the 21st century, namely, prediction of drug toxicity.

  8. Increased risk of breast cancer in women with false-positive test

    DEFF Research Database (Denmark)

    von Euler-Chelpin, My; Kuchiki, Megumi; Vejborg, Ilse

    2014-01-01

    INTRODUCTION: Studies have shown that women with a false-positive result from mammography screening have an excess risk for breast cancer compared with women who only have negative results. We aimed to assess the excess risk of cancer after a false-positive result excluding cases...... of misclassification, i.e. women who were actually false-negatives instead of false-positives. METHOD: We used data from the Copenhagen Mammography Screening Programme, Denmark. The study population was the 295 women, out of 4743 recalled women from a total of 58,003 participants, with a false-positive test during...... the women with misclassified tests had been excluded, there was an excess risk of breast cancer of 27% (RR=1.27, 95% confidence interval (CI), 1.11-1.46) among the women with a false-positive test compared to women with only negative tests. Women with a false-positive test determined at assessment had...

  9. False-positive and indeterminate human immunodeficiency virus test results in pregnant women

    National Research Council Canada - National Science Library

    Doran, T I; Parra, E

    2000-01-01

    .... These recommendations have resulted in an increased number of low-risk women being tested and a significant rise in the percentage of false-positive results from HIV antibody screening tests and ambiguous (indeterminate...

  10. Non-animal assessment of skin sensitization hazard: Is an integrated testing strategy needed, and if so what should be integrated?

    Science.gov (United States)

    Roberts, David W; Patlewicz, Grace

    2018-01-01

    There is an expectation that to meet regulatory requirements, and avoid or minimize animal testing, integrated approaches to testing and assessment will be needed that rely on assays representing key events (KEs) in the skin sensitization adverse outcome pathway. Three non-animal assays have been formally validated and regulatory adopted: the direct peptide reactivity assay (DPRA), the KeratinoSens™ assay and the human cell line activation test (h-CLAT). There have been many efforts to develop integrated approaches to testing and assessment with the "two out of three" approach attracting much attention. Here a set of 271 chemicals with mouse, human and non-animal sensitization test data was evaluated to compare the predictive performances of the three individual non-animal assays, their binary combinations and the "two out of three" approach in predicting skin sensitization potential. The most predictive approach was to use both the DPRA and h-CLAT as follows: (1) perform DPRA - if positive, classify as sensitizing, and (2) if negative, perform h-CLAT - a positive outcome denotes a sensitizer, a negative, a non-sensitizer. With this approach, 85% (local lymph node assay) and 93% (human) of non-sensitizer predictions were correct, whereas the "two out of three" approach had 69% (local lymph node assay) and 79% (human) of non-sensitizer predictions correct. The findings are consistent with the argument, supported by published quantitative mechanistic models that only the first KE needs to be modeled. All three assays model this KE to an extent. The value of using more than one assay depends on how the different assays compensate for each other's technical limitations. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

  11. Assessing the Prevalence of Latent Tuberculosis among Health Care Providers in Zagazig City, Egypt Using Tuberculin Skin Test and QuantiFERON-TB Gold In-Tube Test.

    Science.gov (United States)

    El-Sokkary, Rehab H; Abu-Taleb, Ashwak M; El-Seifi, Omnia S; Zidan, Haidy E; Mortada, Eman M; El-Hossary, Dalia; Farag, Salama E

    2015-12-01

    Early detection of latent tuberculosis infection (LTBI) will prevent development of active TB among health care providers. The aim of the study was to assess the prevalence of LTBI among health care providers and compare the QuantiFERON-TB Gold In-Tube Test (QFT-GIT) and Tuberculin skin test in efforts to detect LTBI and to investigate possible associated risk factors of infection. A cross sectional study was carried out during the period of 6 months in the Chest Hospital in Zagazig city and the Nephrology Unit at Zagazig University Hospitals in 132 randomly selected health care providers who were examined for LTBI by QFT-GIT and Tuberculin skin test and for the associated risk factors as well. The prevalence of LTBI identified by QFT-GIT and by Tuberculin skin test was 28.8% and 59.1%, respectively. Poor agreement was observed between the two tests (kappa=0.10). Working more than 10 years, being nurse, diabetic and smoker were risk factors significantly associated with LTBI (p<0.05). QFT-GIT is considered a useful tool in detecting LTBI cases, especially in a country where BCG vaccination is a national policy (as in Egypt). Duration of work, profession, diabetes and smoking are the risk factors for LTBI. Active surveillance and infection control measures are recommended to reduce the risk of LTBI. Copyright© by the National Institute of Public Health, Prague 2015.

  12. The use of different concentrations of leishmanial antigen in skin testing to evaluate delayed hypersensitivity in american cutaneous leishmaniasis

    Directory of Open Access Journals (Sweden)

    César A. Cuba Cuba

    1985-12-01

    Full Text Available Three concentrations of Leishmania mexicana amazonensis sonicated whole promastigote antigen (30, 9.6 and 3 ug N in 0.1 ml wereprepared and 0.1 ml of each inoculated intradermally intopatients who live in one endemic leishmaniasis region in Brazil. Patients were divided into groups with active cutaneous leishmaniasis (ACL, healed cutaneous leishmaniasis (HCL, mucosal leishmaniasis (ML, and Controls (C. Skin reactions were recorded by measuring induration 48 hours after inoculation. Skin tests using 9.6 ugN/0.1 mlyielded the best diagnostic resultssince 97% of 30 patients with active lesions (cutaneous or mucosal and 83% with HCL showed reactions of 5 mm orgreater as compared with 4% Controls. Tests using 30ug N/O. 1 ml causedan unacceptable levei of skin reactions with necrosis (10% of ACL patients tested and 17% of HCL, respectively. Tests using 3 ug N/O. 1 ml were less sensitive since only 87% of patients with active lesions and 68% with HCL had reactions of 5mm orgreater. The 3 ug N/O. 1 ml dose was utilized to ask the questions whether skin delayed hypersensitivity decreased with time after the initial lesion and whether mucosal involvement is associated with enhaced hypersensitivity to leishmanial antigen. Decreased delayed hypersensitivity was noted only in those patients who had an initial lesion more than 30 years ago. The mean induration of the reaction in 10 patients with ML was 11.3 mm ± 7.15, in 41 patients with HCL, 9.27 mm ± 6.78 and in 20patients with ACL 10. 7 mm ± 6.10 mm. The percent of patients with 5 mm orgreater induration was ML 80%, HCL 71%, ACL 90%. Thus, we could not confirm an association between enhanced delayed hypersensitivity and mucosal involvement in leishmaniasis.

  13. Melan-a-positive "pseudomelanocytic nests": a pitfall in the histopathologic and immunohistochemical diagnosis of pigmented lesions on sun-damaged skin.

    Science.gov (United States)

    Beltraminelli, Helmut; Shabrawi-Caelen, Laila El; Kerl, Helmut; Cerroni, Lorenzo

    2009-05-01

    We encountered recently 3 cases with a histopathologic diagnosis of melanoma in situ on sun-damaged skin (male = 2, female = 1; median age: 59 years; range: 52-60 years). The diagnosis was based mainly on the finding of actinic elastosis in the dermis and increased number of melanocytes in the epidermis and was confirmed by strong positivity for Melan-A in single cells and in small nests ("pseudomelanocytic nests"), located at the dermoepidermal junction. Indeed, examination of slides stained with hematoxylin and eosin revealed the presence of marked hyperpigmentation and small nests of partially pigmented cells at the dermoepidermal junction, positive for Melan-A. The histologic and especially the immunohistochemical features were indistinguishable from those of melanoma in situ on chronic sun-damaged skin. In addition, a variably dense lichenoid inflammation was present. Clinicopathologic correlation, however, showed, in all patients, the presence of a lichenoid dermatitis (phototoxic reaction, 1 case; lichen planus pigmentosus, 1 case; and pigmented lichenoid keratosis, 1 case). Our cases clearly show the histopathologic pitfalls represented by lichenoid reactions on chronic sun-damaged skin. Immunohistochemical investigations, especially if performed with Melan-A alone, may lead to confusing and potentially disastrous results. The unexpected staining pattern of Melan-A in cases like ours raises concern about the utility of this antibody in the setting of a lichenoid tissue reaction on chronic sun-damaged skin. It should be underlined that pigmented lesions represent a paradigmatic example of how immunohistochemical results should be interpreted carefully and always in conjunction with histologic and clinical features.

  14. The risk of systemic reactions to skin prick-tests using food allergens: CICBAA data and literature review.

    Science.gov (United States)

    Codreanu, F; Moneret-Vautrin, D A; Morisset, M; Guénard, L; Rancé, F; Kanny, G; Lemerdy, Ph

    2006-02-01

    Prick-tests to foods are usually carried out as the first step in the diagnosis of food allergy. Severe anaphylaxis accounts for 4.9 % of allergies in children and occurs more frequently in adults, raising the possibility of systemic reactions to prick-tests in highly sensitized people. Several studies published in the literature have used commercial extracts. As for airborne allergens, concentrations causing a skin reaction of 15 mm do not present a risk of systemic reactions. Prick-tests to native foods--prick-in-prick tests--have been less extensively studied. The CICBAA1 data, from 1,138 food allergic patients of all ages, cover 34,905 prick-in-prick tests to foods. The wheal of these prick-tests has been regulary registered. The risk of systemic reactions can be evaluated at 0.008 %. There were no severe reactions and anti-histamine and corticosteroid therapy were sufficient. These results are similar to those of the large study in 2000 carried out by Devenney in neonates (0.005%). A review of the literature reveals only a few severe reactions in adults. The authors draw attention to the necessary precautions: temporary contra-indication for skin prick-tests in children and adults with grade 3 or 4 asthma, with particular attention to such foods as all kinds of nuts, fish, etc.

  15. Skin Prick Test Results of Canakkale Onsekizmart University Faculty of Medicine Dermatology Department

    Directory of Open Access Journals (Sweden)

    Selda Isik

    2016-02-01

    Full Text Available Aim: In this study we aimed to evaluate the prick test results of the patients with chronic urticaria, allergic rhinitis, sinusitis conjunctivitis, pharyngitis, allergic asthma and atopic dermatitis who attended to dermatology department of Canakkale Onsekiz Mart University Faculty of Medicine. Material and Method: The prick test results of 583 patients with chronic urticaria, allergic rhinitis, sinusitis, conjunctivitis, pharyngitis, allergic asthma, atopic dermatitis were assessed retrospectively for this study. 50 standard allergens including pollens, grass, weed, fungal allergens, latex, cat fur, dog hair, house dust mites and foods were performed to the patients. Results: The ages of the patients were between 3 and 70 (mean age was 30.6±17.5. At least one positive prick test result to any allergen were obtained in 359 patients (61.6%. The most common allergens were; house dust mites (50.5%, weed(28.8%, polen grains(29%, tomato (13.7%, coffee (13.1%, chicken meat (13.0% and chocolate (12.7%, respectively. Discussion: We think that our study will help to contribute to the allergen map of our country.

  16. The Limitations of Standardized Science Tests as Benchmarks for Artificial Intelligence Research: Position Paper

    OpenAIRE

    Davis, Ernest

    2014-01-01

    In this position paper, I argue that standardized tests for elementary science such as SAT or Regents tests are not very good benchmarks for measuring the progress of artificial intelligence systems in understanding basic science. The primary problem is that these tests are designed to test aspects of knowledge and ability that are challenging for people; the aspects that are challenging for AI systems are very different. In particular, standardized tests do not test knowledge that is obvious...

  17. For Men: A Positive Zika Virus Test, What Does It Mean for Me?

    Science.gov (United States)

    CDC’s Response to Zika FOR MEN: A POSITIVE ZIKA VIRUS TEST What does it mean for me? You’ve just learned from your ... or healthcare provider that you have a positive Zika test result, which means that you have Zika ...

  18. Sensitization to cereals and peanut evidenced by skin prick test and specific IgE in food-tolerant, grass pollen allergic patients

    Directory of Open Access Journals (Sweden)

    Martens Maria

    2011-12-01

    Full Text Available Abstract Background The botanical relation between grass and cereal grains may be relevant when diagnosing food allergy to cereals. The aim was to investigate the diagnostic specificity of skin prick test (SPT and specific immunoglobulin E (sIgE tests to cereals and peanut in grass pollen allergic subjects without history of, and clinically reactions to foods botanically related to grass. Methods 70 subjects (41 females; mean age 32 years and 20 healthy controls (13 females; mean age 24 years were tested by open food challenge (OFC with cereals and peanut. SPT and sIgE both with Immulite® (Siemens and ImmunoCAP® (Phadia to grass and birch pollen, cereals, peanut and bromelain were performed. Results Of the 65 OFC-negative subjects 29-46% (SPT, depending on cut-off, 20% (Immulite and 38% (ImmunoCAP had positive results to one or more of the foods tested. Controls were negative in all tests. Cross-reactive carbohydrate determinants (CCD as evidenced by reaction to bromelain could explain only a minority of the measured IgE-sensitizations. Conclusion Grass pollen allergic patients with documented food tolerance to cereals and peanut may express significant sensitization. False-positive cereal or peanut allergy diagnoses may be a quantitatively important problem both in routine clinical work and epidemiological studies.

  19. False-positive oral fluid rapid HIV tests--New York City, 2005-2008.

    Science.gov (United States)

    2008-06-20

    The New York City Department of Health and Mental Hygiene (NYC DOHMH) operates 10 sexually transmitted disease (STD) walk-in clinics offering various free services, including confidential or anonymous testing for human immunodeficiency virus (HIV). In January 2004, the STD clinics introduced on-site rapid HIV testing of finger-stick whole-blood specimens using the OraQuick(R) brand test (OraSure Technologies, Bethlehem, Pennsylvania). In March 2005, the clinics replaced finger-stick whole-blood testing with oral fluid testing with the OraQuick Advance Rapid HIV-1/2 Antibody Test. The clinics use Western blot confirmatory tests on serum to confirm all whole-blood or oral fluid reactive (i.e., preliminary positive) rapid tests. In late 2005, an unexpected increase in the number of false-positive oral fluid tests occurred, but the increase subsided after several months. In December 2005, while the cluster of false-positive oral fluid test results was being investigated, the NYC DOHMH Bureau of STD Control suspended oral fluid testing in the clinics for 3 weeks and replaced it with finger-stick whole-blood rapid testing, which produced no false-positive test results. On December 21, 2005, NYC DOHMH resumed oral fluid rapid testing but also introduced the use of immediate follow-up finger-stick whole-blood testing, using a second OraQuick test, after any reactive oral fluid test result. In late 2007, another larger increase in the incidence of false-positive oral fluid rapid test results was observed. The cause for the episodic increases in false-positive oral fluid tests has not yet been determined. NYC DOHMH has again suspended the use of oral fluid testing in STD clinics, and finger-stick whole-blood testing is the only rapid HIV test being used in this setting. These findings underscore the importance of confirming all reactive HIV tests, both from oral fluid and whole-blood specimens. In addition, the results suggest that the NYC DOHMH strategy of following up

  20. Uptake of noninvasive prenatal testing (NIPT) in women following positive aneuploidy screening.

    Science.gov (United States)

    Chetty, Shilpa; Garabedian, Matthew J; Norton, Mary E

    2013-06-01

    The aim of this study was to investigate how the introduction of noninvasive prenatal testing (NIPT) impacted women's testing choices following a positive prenatal screening (PNS) result. Beginning in March 2012, women referred to our Prenatal Diagnosis Center following a positive PNS result were offered NIPT or invasive prenatal diagnosis. Rates of invasive testing and declining follow-up were compared with testing decisions the prior year. Differences were compared using t-test and chi-square. Multivariable logistic regression was performed to identify predictors of test choice. Between March 2012 and February 2013, 398 screen positive women were seen: 156 (39.2%) underwent invasive testing, 157 (39.4%) had NIPT and 84 (21.1%) declined further testing. In the prior year, 638 screen positive patients were seen: 301 (47.2%) had invasive testing and 337 (52.8%) declined. The rate of invasive testing declined significantly (p = 0.012). Moreover, fewer women declined follow-up testing after introduction of NIPT, 21.2% versus 52.8%, p ≤ 0.001. Race/ethnicity and timing of results (first versus second trimester) were predictors of testing choices; payer and maternal age were not. The introduction of NIPT resulted in a significant decrease in invasive diagnostic testing. Additionally, fewer women declined further testing when NIPT was available. © 2013 John Wiley & Sons, Ltd.

  1. The relationship between RAST and skin test results in patients with asthma or rhinitis: a quantitative study with purified major allergens

    NARCIS (Netherlands)

    Witteman, A. M.; Stapel, S. O.; Perdok, G. J.; Sjamsoedin, D. H.; Jansen, H. M.; Aalberse, R. C.; van der Zee, J. S.

    1996-01-01

    Study of the relationship between skin test results and IgE antibody levels is seriously hampered by the use of conventional allergen extracts because the precise amount of relevant allergen for each patient is unknown. This study was designed to investigate skin reactivity with purified major

  2. Non-invasive methods to establish the diagnosis of terra firma-forme dermatosis: The SMART (Skin Modified by Alcohol Rubbing Test) evaluation and dermoscopy.

    Science.gov (United States)

    Greywal, Tanya; Cohen, Philip R

    2016-06-15

    Terra firma-forme dermatosis may mimic a variety of hyper pigmented dermatoses.  The diagnosis can be characterized using dermoscopy and confirmed with the SMART (Skin Modified by Alcohol Rubbing Test) evaluation.  When terra firma-forme dermatosis (Duncan's dirty dermatosis) is clinically suspected, clearance of the dermatosis follows rubbing the affected skin with 70% isopropyl alcohol.

  3. Skin Irritation to Glass Wool or Continuous Glass Filaments as Observed by a Patch Test among Human Japanese Volunteers

    Science.gov (United States)

    TSUNODA, Masashi; KIDO, Takamasa; MOGI, Sachiyo; SUGIURA, Yumiko; MIYAJIMA, Eriko; KUDO, Yuichiro; KUMAZAWA, Tatenao; AIZAWA, Yoshiharu

    2014-01-01

    Glass wool and continuous glass filaments have been used in industry. We examined the irritability of those among Japanese. A patch test was performed on 43 volunteers for the followings: glass wool for non-residential use with and without a urea-modified phenolic resin binder, that for residential use with and without the binder, and continuous glass filaments with diameters of 4, 7, 9, and 13 µm. Materials were applied to an upper arm of each volunteer for 24 h. The skin was observed at 1 and 24 h after the removal. At 1 h after removal, slight erythema was observed on the skin of a woman after the exposure to glass wool for residential use without the binder. Erythema was observed on the skin of another woman at 1 h after a 24-h exposure to glass wool for non-residential use without the binder. There were no reactions at 24 h after the removal. The low reactions in the patch test suggested that the irritability caused by glass wool, irrespective of a resin component, could be induced mechanically, and that the irritability caused by continuous glass filaments with resin could be slight and either mechanical or chemical. PMID:25070402

  4. Two cases of pollen-food allergy syndrome to soy milk diagnosed by skin prick test, specific serum immunoglobulin E and microarray analysis.

    Science.gov (United States)

    Yagami, Akiko; Inaba, Yasuko; Kuno, Yuki; Suzuki, Kayoko; Tanaka, Akira; Sjolander, Sigrid; Saito, Hirohisa; Matsunaga, Kayoko

    2009-01-01

    Oral allergy syndrome to soy milk is classified as a phenotype of pollen-food allergy syndrome (PFAS). As causative antigens, Gly m 4 (Bet v 1 homolog, 17 kD) and oleosin (23 kD), have been reported. In this study, we report two cases of PFAS to soy milk. Both cases showed positive reactions to soy milk in skin prick tests (SPT) and to Gly m 4 in specific serum immunoglobulin (Ig)E antibody. When we measured specific serum IgE antibody of soy-related proteins using a new laboratory testing method, microarray analysis, both cases showed a positive reaction for Bet v 1. One case was weakly positive for a soybean protein, beta-conglycinin. Other results for reactivity to soy, peanut, cross-reactive carbohydrate determinants and profilin were negative. Based on these results, we diagnosed the two cases as PFAS to Gly m 4. We also performed protein microarray analysis and found it useful as a screening test for immediate allergy, such as PFAS.

  5. [Prevalence of infection with Mycobacterium tuberculosis and associated factors in community health workers in Brazil based on the tuberculin skin