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Dopamine in the Immune and Hematopoietic Systems
Published in Nira Ben-Jonathan, Dopamine, 2020
Diagnosis of the specific allergy is based on a person’s medical history, added by further skin and blood tests. The prick test pierces the skin surface while depositing a tiny amount of the allergen. The test is done on the back or the inside of the arms with several allergens tested at once. If positive, redness and swelling appear at the site of the prick. The intradermal test injects the allergen with a very fine needle under the first few skin layers. This type of skin test may be used when the result of a prick test is not clear. Although the skin test is very sensitive, on some occasion, blood may be tested for the presence of antibodies against suspected specific allergens.
In vivo testing
Published in Richard F. Lockey, Dennis K. Ledford, Allergens and Allergen Immunotherapy, 2020
Intracutaneous or intradermal skin testing is performed using a small-gauge needle. Its advantages over epicutaneous testing are increased sensitivity and better reproducibility, especially if performed as recommended by the Committee on Standardization of the American College of Allergy, Asthma and Immunology [7,13]. A 0.1cc glass syringe with a 30-gauge needle with a metal plunger was used. It was held almost flat at 10° to the skin surface, bevel up. As soon as the opening of the needle disappeared into the skin, 0.02 mL of extract was injected and the needle then withdrawn. Ideally, this should result in approximately a 3 mm skin bleb. It is doubtful today that these recommendations are followed precisely by practitioners who perform such tests. In general, a disposable 1.0cc tuberculin-type plastic syringe is used with a half-inch 27-gauge needle. Comparative testing in the same individual shows that to obtain the same size wheal and flare as occurs with intracutaneous testing, a prick test using a 1000-fold greater concentration is necessary [23]. In comparison to the prick skin test, the older technique of the scratch test, which introduced a greater amount of allergen extract into the epidermis, required 30- to 500-fold greater concentration of allergen to achieve a similar size wheal and flare to the intracutaneous skin test [6].
Test Methods for Allergic Contact Dermatitis in Animals
Published in Francis N. Marzulli, Howard I. Maibach, Dermatotoxicology Methods: The Laboratory Worker’s Vade Mecum, 2019
The skin test sites are examined approximately 22 and 46 hr after removal of the patch, and the elicited skin reactions are estimated according to a standard scoring system. The sensitivity of the SIAT can be improved by increasing the number of intradermal exposures during the induction phase (DIAT and/or TIAT, i.e., double and/or triple induction injection), and/or by rechallenging (booster effect). Even if less sensitive than the GPMT of Magnusson and Kligman, the SIAT is easy to perform, more flexible, and not as time-consuming. Other merits and deficiencies are discussed by Goodwin et al. (1983); Goodwin and Johnson (1985); Basketter and Allenby (1991). SIAT is not suitable for testing nonsoluble or suspensible chemicals and “end use” products.
Safety considerations of current drug treatment strategies for nosocomial pneumonia
Published in Expert Opinion on Drug Safety, 2021
Adrian Ceccato, Pierluigi Di Giannatale, Stefano Nogas, Antoni Torres
Given that 90% of patients reporting an allergy are de-labeled after investigation, it is necessary to conduct exhaustive evaluations in these patients. Risk can be stratified based on the previous reaction, as follows: low risk can include those who developed gastrointestinal symptoms, headache, or rashes other than urticaria; medium risk can include those who developed urticaria or other pruritic rashes; and high risk for those with a history of anaphylaxis, a positive skin test, or allergy to multiple beta-lactams [25,26]. Recently a score was developed and validated that includes previously reported allergy, fewer than 5 years since reaction, anaphylaxis, angioedema or severe cutaneous reaction, or treatment needed. The score had a high negative predictive value and could be used for fast identification of low risk patients. Patients with low risk can be safely assessed with an amoxicillin challenge. In contrast to the other beta-lactams, hypersensitivity reactions to carbapenems are uncommon [30].
Reduced longitudinal cardiac strain in asthma patients
Published in Journal of Asthma, 2019
I. Tuleta, N. Eckstein, F. Aurich, G. Nickenig, C. Schaefer, D. Skowasch, R. Schueler
The prevalence of allergic asthma is increasing worldwide (1). In contrast to chronic obstructive pulmonary disease (COPD) which frequently coexists with cardiovascular diseases (2), little is known about the interaction between asthma and cardiovascular disorders. An increased risk of coronary heart disease was demonstrated in adult-onset asthmatics (3). However, the results concerning this issue are inconsistent, as other studies showed either that the above mentioned association was sex-dependent and only found in women (4) or there was no such association, irrespective of sex or other factors (5). In systolic heart failure airflow obstruction was frequent due to acute or chronic congestion and distinctly underdiagnosed (6). Inversely, the diagnosis of asthma was related to an increased hazard of heart failure (7). In contrast, in other work, individuals with asthma did not have an enhanced likelihood for heart failure compared to the control group (3). Furthermore, there are no conclusive reports on the impact of allergy on the cardiovascular disease. Comorbid allergy was not a modifying factor in asthma-associated increased cardiovascular disease risk (7). On the contrary, allergy detected in the skin test was linked to an enhanced cardiovascular mortality (8).
Swept-source optical coherence tomography analysis in asthmatic children under inhaled corticosteroid therapy
Published in Cutaneous and Ocular Toxicology, 2019
Murat Gunay, Mahmut Dogru, Gokhan Celik, Betul Onal Gunay
Skin prick tests with common aeroallergens [Dermatophagoides pteronyssinus, Dermatophagoides farinea, Alternaria alternaria, cockroaches (Blatella germanica)], cat dander and dog dander, mixture of grass pollens (Lollium perenne, Dactylis glomerata, Phleum pratense, Anthoxanthum odaratum, Poa pratensis, Festuca eliator, Agrostis vulgaris, Holcus lanatus, Cynodon dactylon, Avena sativa, Avena fatua, Lotus Corniculatus), a mixture of grain pollens (oats, wheat, barley, corn), a mixture of tree pollens (Acer pseudoplanatus, Aesculus hippocastanum, Robinia pseudoacacia, Tilia platyphyllos, Platanus vulgaris), and weed-mix pollens (Medicago sativa, Trifolium pratense, Brassica nigra, Urtica dioica, Rumex acetosa; Stallergenes SA, Antony, France) were performed using lancet. Skin prick tests were applied on the anterior surface of the forearm. Histamine (10 mg/ml) and physiological saline were used as positive and negative references, respectively. Skin reactions were evaluated 20 min after the application of the skin test, and indurations of ≥3 mm were considered as indicative of a positive reaction.