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 5,307 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Phadiatop, a new test for detecting hypersensitivity to airborne allergens, was used in 83 children aged 9 months to 6 years with recurrent respiratory manifestations, i.e. recurrent expiratory obstruction and/or recurrent respiratory infections. A good correlation was found between this test and both the prick tests (95%) and the specific IgE assays (91% for RASTS of classes greater than or equal to 1, and 95% for RASTS of classes greater than or equal to 2). However, the correlation was less strong with the total IgE level (68%). The overall correlation with the specialist's prediction based on history and physical evaluation was excellent (94%). In this study, Phadiatop was found to have a 90% sensitivity and a 98% specificity. Furthermore, this test costs 40% less than the often used strategy combining skin tests and determinations of total and specific IgE levels. In the age group studied, Phadiatop is most useful above the age of two, since in younger patients true respiratory allergies are fairly infrequent in recurrent ENT and lower respiratory tract infections, whereas infections are far more common.
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PMID:[Detection of respiratory allergies using the Phadiatop test in children 1 to 6 years of age]. 220 47

Occupational diseases of the skin have been detected in 19.6% of 352 workers engaged in molybdenum production. These diseases are characterized by a relatively low incidence on the dermatitis transformation into eczema and a considerable length of this process, by weak skin reactions to molybdenum tests (with 20% aqueous solution of ammonium paramolybdate), by the predominance of skin itching in the clinical picture, by a secondary pyococcic infection, and by frequent combination of eczema with allergic involvement of the ENT organs. Experimental and clinical immunologic studies have revealed that mostly humoral immune mechanisms with a relatively weak involvement of the T-lymphocytes contribute to the pathogenesis of the dermatoses due to molybdenum exposure; this fact is responsible for poor clinical manifestation of the delayed type hypersensitivity reactions and at the same time a manifest IgE-dependent pattern of allergic reactions. A clear-cut correlation between the frequency of the dermatoses and molybdenum level in environmental dust was detected, as were a considerable molybdenum contamination of the skin and the fact that hot and humid microclimate are conducive to the development of dermatoses. Basing on the results of these studies, the authors have developed recommendations on the diagnosis and prevention of molybdenum-induced dermatoses.
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PMID:[Clinico-immunologic characteristics and prevention of occupational allergic dermatoses due to molybdenum exposure]. 253 14

The high incidence of bacterial super-infection in atopic individuals has long been known, especially in asthma and atopic dermatitis. In recurrent ENT infections in children, increased IgE levels are found in half the cases; this increase results from two main mechanisms: a predisposition to allergy (often with positive RASTs), and certain viral infections: respiratory syncytial virus, para-influenzae, and measles, that trigger production of partly non-specific serum IgEs. In the latter situation, the increased IgE levels are both a cause and a consequence of recurrent infections. More recently, in some forms of atopic dermatitis (infant and Buckley syndrome), attention has been drawn to the severity of viral superinfections (herpes, chickenpox, vaccine), which is directly correlated with the IgE levels. The mechanism of such infections is unclear: the local increase in IgE levels is responsible for degranulation of mastocytes which in turn results in edema, fissures of mucosae and congestion; an effect on the lymphocytic response is possible, with inhibition of the production of certain lymphokines, especially interleukins.
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PMID:[The role of IgE in recurrent ORL infections in children]. 332 14

Exposure to oil mist used in metal work sometimes gives symptoms from skin and airways. This study was performed to evaluate histological and functional respiratory tract disorders. Six male lathe workers aged 31-64 years exposed to oil mist for 4-29 years were examined and compared with matched controls. The investigation included case history, ENT examination, nasal mucociliary function, routine blood tests, IgE, RAST, X-ray of sinus and lungs and biopsy of the nasal mucosa. The mucociliary test showed no difference between the groups. However, all 6 exposed workers had pathological histology findings in the nasal mucosa including lack of cilia, basal cell hyperplasia, goblet cell hyperplasia, squamous metaplasia and subepithelial hyalinization. The biopsies from the controls were mainly normal. The remainder of the investigations revealed no pathology. The study shows that exposure to oil mist--even below the permitted threshold limit--may cause airway symptoms and histological signs comparable to a premature ageing.
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PMID:Upper airway problems in industrial workers exposed to oil mist. 721 37

Allergic disorders have been found to be among the most common and costly health problems afflicting our nation. Many of the symptoms presenting daily in an ENT office practice can be triggered by an atopic or IgE mediated mechanism, or by a non-atopic or non-immune mechanism. The ability to differentiate between these two mechanisms has been enhanced by an in vitro serologic test for total IgE known as Prist test. A 10-month study demonstrated the value of this test in determining a treatment plan that was both acceptable to the patient and resulted in a high success rate. The need for including allergic disorders in the future training of the otolaryngologist is presented.
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PMID:Management of allergy-like symptoms in otolaryngology. 738 14

The hyper-IgE syndrome (HIS) is a complex immunologic disease, caused by an unknown basic defect. We report on two cases showing complications, which have not been described so far. Case 1: A 15-year-old boy suffering from HIS developed a liver tumour with severe eosinophilic infiltration and degranulation. The transformation process of the liver histologically resembled focal nodular hyperplasia. Therapy with cyclosporine A did not lead to clinical benefit. Now, a therapeutic attempt with interferon gamma is made. Case 2: In a 17-year-old female HIS patient, multiple papillomas and ulcers of the mucous membrane, caused by infection with human papilloma virus, emerged in the ENT region. Under treatment with interferon alpha, papillomatosis could be restrained. As therapy of the hyper-IgE syndrome only symptomatic treatment has been recommended so far. Future therapies should strive for systemic immunomodulation by application of cytokines or soluble cytokine receptors like interferons or sIL-4R.
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PMID:[Hyper-IgE syndrome--two case reports of unusual complications]. 792 82

The conditions of an allergological evaluation was determined in Switzerland, based on a questionnaire (1535 physicians and 648 pharmacists, of whom 33% answered). Besides dermatologists and allergists, ENT specialists are most frequently confronted with allergological problems. Serological determination of IgE are performed more frequently than skin tests, specifically by specialists for internal medicine and paediatrics. Pharmacists are quite often asked for remedies and tend to use alternative medical approaches more frequently than physicians. The data show that the specialty of allergology is changing and that, along with the high frequency of allergological patients, many non-allergologists participate in their treatment. The allergist of the future will deal more with complicated cases and be on the front line for establishing new diagnostic tools and therapies.
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PMID:[Allergology general practice in Switzerland: present and future]. 814 16

Chronic Rhinosinusitis (CRS) is a group of multifactorial diseases characterised by inflammation of the mucosa of the nose and paranasal sinuses with a history of at least 12 weeks of persistent symptoms and signs despite maximal medical therapy. IgE-mediated hypersensitivity and asthma are the two most important associated factors. Diagnosis of CRS is based upon the medical history and either an endoscopy or CT scan. Initial medical treatment usually consists of the avoidance of all the contributory factors and then nasal douching and nasal steroids. If medical treatment fails, endoscopic sinus surgery is considered. The authors review the most important factors associated with CRS, the diagnostic work-up and different treatment options. They also present a rationale for treatment.
B-ENT 2005
PMID:Management of chronic rhinosinusitis without polyps in adults. 1636 68

Nasal provocative test (NPT) can be defined as a method for recreating upper respiratory tract response to natural allergens or irritants. It can be used in solving nasal patophisiology problems: establishing whether and how the patient's nose is sensitive to antigens or irritants; quantitative evaluation of sensitivity; establishing factors influencing sensitivity. This method is employed to confirm clinical diagnosis in cases where difficulties arise in interpretation of diagnostic tests. The study based on nasal provocative tests establish an allergy to pollen in cases of pollinosis, and select appropriate components for the desensitising vaccine. Sample group included 53 patients, 29 were females and 24 were males, aged 15-42 years, selected from 1,021 patients diagnosed between 1999-2002 in the Allergology Department of the ENT Department of the MMI. The sample patients were diagnosed based on additional tests with allergic inflammation of the nasal mucosa caused by allergy to pollen of such plants as birch, grass, rye, mugwort and plantain. Research methods included: subjective physical examination, prick tests, total and specific IgE levels in serum, nasal provocative tests and rhinomanometric examination. Allergen solution was administered onto the mucosa with a calibrated atomiser. NPT solutions containing pollen of birch, grass, rye, mugwort and plantain were used. Provocative test was considered positive if, following allergen provocation, rhinomanometric examination revealed an increase in respiratory resistance by at least 40 % in comparison with the control test. On the basis of the study, 2 conclusions were drawn: 1) Nasal provocative test is an essential element in diagnostics of allergic nasal obstruction. 2) Rhinomanometry, as an objective method of examining nasal patency, is crucial for evaluating the nasal provocative test.
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PMID:Nasal provocative test in patients allergic to pollen. 1645 69

Hypereosinophilia in the blood and tissues is one of the main characteristics of the pathophysiology of allergic disease. CD4+ T cells polarized to a Th2 phenotype mediate inflammatory disorders; cytokines produced by Th2, including IL-4, IL-5, and IL-13, drive the cardinal features of the disease. Recent human experiments indicate that eosinophils may control the bronchial remodeling that occurs in asthma. Eosinophils are a rich source of fibrogenic factors, particularly TGF-ss. Atopy is defined by abnormal IgE production in response to an allergen (an antigen that is then designated an allergen). Allergy combines pre-existent sensitization (atopy) with various symptoms - cutaneous, ENT, respiratory, or digestive. Atopy is diagnosed primarily by cutaneous skin-prick tests and the new multi-allergen blood test. A diagnosis of allergy requires the presence of symptoms and justifies workups for asthma, rhinitis, food allergies, or atopic dermatitis.
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PMID:[Allergy-related hypereosinophilia]. 1646 78


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