Past History Of Allergy Research Articles

COT-6 Body mass index and height in relation to brain tumor risk in a Japanese population

Purpose: Because the prognosis of the malignant brain tumor including glioblastoma is extremely worse than other cancer, it is important to clarify the preventive factors of the brain tumor in the prospective cohort study. In the Japanese epidemiologic study of the brain tumor, the report of the prospective cohort study has not been accomplished. Therefore, we have reported the study in recent years from a multipurpose cohort study (Japan Public Health Center-based Prospective Study: JPHC study) that the national cancer center was mainly conducted. This prospective study investigated the association between height and BMI (Body mass index) and brain tumor risk in an Asian population, whose distribution of anthropometric data differs from Westerners. Methods: A total of 106,324 subjects (50,438 men and 55,886 women) enrolled in JPHC Study, was followed from 1990. We divided participants into 5 categories based on the distribution of BMI as <18.5, 18.5- <23, 23- <25, 25- <27.5, and >-27.5 Kg/m2. We used the Cox proportional hazards regression model and estimated brain tumor incidence by gender and tumor subtype, with adjustment for potential confounding variables; age, sex, pack-years of cigarette smoking, alcohol intake, coffee intake, green tea intake, past history of allergy and past history of diabetes mellitus.Results: During an average follow-up of 18.1 years, 157 incident cases of brain tumor were newly identified, included glioma (n=60), meningioma (n =51), lymphoma(n=9), schwannoma(n=3), pituitary adenoma(n=2), and others(n=32). Higher BMI was significantly positively associated with the risk of brain tumor. This positive association of BMI was stronger in men and for meningioma in subgroup analyses. In contrast, height showed no clear association with brain tumor risk. Conclusion: Higher BMI was associated with an increased risk of brain tumor, in particular of meningioma, and among men.Full article has been published annals of epidemiology.

The Correlation of Peripheral Blood Eosinophils with Allergic Nasal Polyps

Aim: To observe the association of peripheral blood eosinophil percentage in patients with allergic nasal polyps. Design: Descriptive cross-sectional study Place and duration: Pathology Department of Bakhtawar Amin Medical &amp; Dental Hospital, Multan from September 2020 to August 2021. Methodology: Blood samples of all the cases operated for nasal polyps in Bakhtawar Amin Trust Institute are drawn before surgery to look for eosinophils. Family and past history of allergy is recorded. Histopathology of all the operated specimen of nasal polyps is done and sample for eosinophil count is collected again in cases that proved to be allergic nasal polyps on microscopic examination to look for any alteration in eosinophil percentage in blood on excision of polyps. Results: Twenty nine out of forty (72.5) percent of patients with allergic nasal polyps reveal increase in peripheral blood eosinophil percentage that returned to normal in 26(65%) patient on excision of nasal polyps. Conclusion: The study disclosed a notable link between allergic nasal polyps and peripheral blood eosinophil percentage and this association is further enhanced by the fact that the blood eosinophil count returned to normal on removal of nasal polyps. Keywords: Allergic nasal polyps, peripheral blood eosinophilia, eosinophil count, atopy

Impact of Inpatient Allergy Consultation on Drug Allergy Documentation and Management at an Adult Tertiary Care Center

Allergy documentation is frequently incomplete and/or inaccurate in the electronic health record. The aim of this study was to evaluate the impact of inpatient drug allergy consultation on documentation and management. After IRB approval, a retrospective chart review was performed on all drug allergy consults (N=90) between July 2018 – June 2019. Descriptive statistics including frequencies and percentages were calculated using Excel. The most common reason for consult was past history of allergy (N=40, 44%), most often to beta-lactams (N=45, 38%) and NSAIDs (N=19, 16%) reported as pruritus (N=31, 15%) and urticaria (N=29, 14%). Graded dose challenge was recommended most often (N=38, 42%) followed by desensitization (N=23, 26%), use of alternative therapy (N=16, 18%), delabeling by history alone (N=9, 10%), and inpatient skin prick testing (N=4, 4%). Inpatient evaluation recommendations were completed successfully in a majority of the sixty-five cases recommending inpatient evaluation (N=48, 74%). The recommended evaluation wasn’t performed in fifteen (21%) of the cases and was unsuccessful in two (3%). In the fifty-five cases warranting allergy history modification, the history was modified (N=51, 93%) most often by the pharmacist (N=18, 35%). Comments were more often made to the allergies (N=27, 53%) rather than removing them (N=24, 47%). After a majority of inpatient allergy consultations, the drug allergy documentation was modified based on the management outcome. There is still a need to clarify when an allergy should be removed versus be commented on to ensure that allergies are not inappropriately added back to the history.

Missed Registration of Disease Codes for Pediatric Anaphylaxis at the Emergency Department.

Background It is important to register anaphylaxis codes correctly to study the exact prevalence of anaphylaxis. The purpose of this study was to analyze the clinical characteristics and disease codes of inaccurately registered groups in pediatric anaphylaxis patients. Methods This study reviewed the medical records of all pediatric patients who presented to the university hospital emergency department over a 5-year period. Study subjects were divided into 2 groups: the accurate group, including those registered under anaphylaxis codes, and the inaccurate coding group, including those registered under other codes. Results From a total of 79,676 pediatric patients, 184 (0.23%) had anaphylaxis. Of these, 23 (12.5%) and 161 (87.5%) patients were classified to the accurate and inaccurate coding groups, respectively. Average age, time from symptom onset to emergency department presentation, past history of allergy, and penicillin and cephalosporin as causes of anaphylaxis differed between the 2 groups. Cardiovascular (39.1% vs. 5.6%, p=0.001) and respiratory symptoms (65.2% vs. 42.2%, p=0.038) manifested more frequently in the accurate group, while gastrointestinal symptoms (68.3% vs. 26.1%, p=0.001) were more frequently observed in the inaccurate coding group. Fluid administration (82.6% vs. 28.0%, p=0.001), steroid use (60.9% vs. 23.0%, p=0.001), and epinephrine use (65.2% vs. 13.0% p=0.001) were more common treatments for anaphylaxis in the emergency department in the accurate group. Anaphylaxis patients with cardiovascular symptoms, steroid use, and epinephrine use were more likely to be accurately registered with anaphylaxis disease codes. Conclusions In the case of pediatric anaphylaxis, more patients were registered inaccurately under other allergy-related codes and simple symptom codes, rather than under anaphylaxis codes. Therefore, future research on anaphylaxis should consider inaccurately registered anaphylactic patients, as shown in this study.

Accuracy for registration of disease codes in pediatric anaphylaxis

Purpose: The aim of this study was to survey the accuracy of registration as anaphylaxis codes and the clinical characteristics of ana- phylaxis registered correctly and incorrectly in pediatric anaphylaxis. Methods: This study was conducted retrospectively using the medical records of patients under 15 years who visited a training hos- pital Emergency Department (ED) for 5 years. The study subjects were divided into the correct group (registered as anaphylaxis codes correctly) and the incorrect group (registered as other anaphylaxis related codes). Results: Of the 133 patients, 14 belonged to the correct group and 119 to the incorrect group. The median age of the correct group was 9 years old and that of the incorrect group was 2 years old. Sex, transportation to the ED, elapsed time from exposure to ED ar- rival, past history of allergy, causes of anaphylaxis except drug, severity of symptom, mental status, and antihistamine use were not different between the 2 groups. Drugs as the cause of anaphylaxis and cardiovascular/neurologic symptoms were more common in the correct group. Gastrointestinal symptoms were more frequent in the incorrect group. Intravenous fluid, steroid, bronchodilator, and epinephrine were more commonly used as the treatment for anaphylaxis in the correct group. The pediatric patients treated with epinephrine tended to be registered anaphylaxis correctly. Conclusion: More patients were registered incorrectly as other anaphylaxis-related disease codes rather than correctly as the ana phylaxis disease codes in pediatric ana-phylaxis. Epinephrine use was the associated factor for being registered correctly as the ana -phylaxis disease codes in pediatric anaphylaxis. (Allergy Asthma Respir Dis 2017:5:159-164)

Anti-Toxocara antibodies detected in children attending elementary school in Vitoria, State of Espírito Santo, Brazil: prevalence and associated factors

The aim of this study was to evaluate the frequency of anti-Toxocara antibodies in serum from 7-year-old children attending elementary school in Vitória-ES, Brazil and to correlate these antibodies with socio-demographic factors, the presence of intestinal helminths, blood eosinophil numbers, past history of allergy or asthma, and clinical manifestations of helminth infections. The detection of anti-Toxocara antibodies was performed using an ELISA (Cellabs Pty Ltd)on serum from 391 children who had already been examined by fecal examination and blood cell counts. Data from clinical and physical examinations were obtained for all children. The prevalence of anti-Toxocara antibodies was 51.6%, with no gender differences. No significant differences were observed between positive serology and the presence or absence of intestinal worms (60.3 and 51.7%, respectively; p = 0.286). The only variables significantly related to positive serology were onycophagy and the use of unfiltered water. Although eosinophilia (blood eosinophil count higher than 600/mm³) was significantly related to the presence of a positive ELISA result, this significance disappeared when we considered only children without worms or without a past history of allergy or asthma. No clinical symptoms related to Toxocara infection were observed. There is a high prevalence of anti-Toxocara antibodies in children attending elementary schools in Vitória, which may be partially related to cross-reactivity with intestinal helminths or to a high frequency of infection with a small number of Toxocara eggs.

1253 Adverse Drug Reactions in Children Admitted to a Tertiary Care Center

Background and aims: Knowledge of adverse drug reactions (ADR) is scant in the pediatric population compared to adults. Our goul was to determine the incidence of ADR in hospitalized patients, identify the drugs involved, the most frequent clinical manifestations and their follow-up. Methods: Retrospective study of clinical records of patients hospitalized in a tertiary care hospital, in which an ADR was reported, over a 16 years period. Results: We identified 188 ADR, 0.46% of total admissions. The ADR was the reason for admission in 20,2%. The most common diagnoses were infectious diseases. Children had a mean age of 4.0±3.8 years, 57,4% were male and a past history of allergy or immunodeficiency was reported in 26.7%. The most frequent clinical manifestations were mucocutaneous (51.6%), followed by cardiovascular (14.4%) and gastrointestinal (12.2%). The drugs most often implicated were antibiotics (40.3%), especially vancomycin (19.7%) and amoxicillin-clavulanate (18.4%), followed by chemotherapeutic agents (8.0%), vaccines (6.9%) and steroids (5.9%). Intravenous administration was associated with 54,3% of ADR and the time from first drug administration to ADR was > 48 hours in 51.6%. The reactions were mild in 83.5%, but 3 cases required admission to ICU, with one fatality. Only 14 children (7.4%) were referred to a consultation for follow-up. Conclusions: Our data showed a low incidence of ADR compared to recent prospective studies, but the type of reactions and drugs involved were similar. It is necessary to alert health professionals to occurrence of ADR in order to implement their coding and reporting to the authorities.

A Correlation of Allergic Contact Dermatitis with Allergen Type and Patient Categorical Variables

Allergic contact dermatitis is a very treatable disease once it is diagnosed. In this study, statistical analysis was done on 105 patients with allergic contact dermatitis and the data were correlated with allergen type and patient categorical variables. Once allergens were identified, patients were advised to practice avoidance of the identified allergens. Significant differences in gender and past history of allergy were noted. Improvement after avoidance of identified allergens was also tracked, and a significant negative correlation was observed between number of allergens and improvement of patients’ conditions. Although not reaching a statistical level of significance, some interesting trends were found regarding age versus severity and age versus improvement, which should be explored in future studies. In addition, a larger study population would ensure the collection of more statistically significant data for future research.

The problems of multiple-chemical sensitivity patients in using medicinal drugs

Multiple-chemical sensitivity (MCS) patients are presumed to be compelled to lead inconvenient and difficult lives, because unpleasant and multiorgan symptoms are caused by very small amounts of various chemicals in the living environment. Therefore we conducted a questionnaire survey of MCS patients who are members of support groups to elucidate the problems of MCS patients in using medicinal drugs. In this report, we selected 205 persons who stated that they had been "diagnosed with MCS by a physician" or "a physician suspected a diagnosis of MCS" on the questionnaire as the reason they judged themselves to have MCS. The questionnaire results showed that about 60% of MCS patients have difficulty in using medicinal drugs and that the difficulties are more likely to occur in women, in people 40-59 years old, and in patients who developed MCS in reaction to pesticides or medicinal drugs. The prescribed drugs and OTC drugs noted as usable or unusable by patients in the questionnaire were analyzed from the viewpoint of their medicinal constituents. The results indicated that lidocaine is likely to be unusable by MCS patients. In addition, caffeine, aspirin, chlorphenylamine maleate, minocycline hydrochloride, levofloxacin, etc. were also likely to be unusable by MCS patients. Many patients who recorded drugs containing the above-mentioned remedies as unusable had a past history of allergy, suggesting that allergy is involved in the difficulties of MCS patients in using medicinal drugs.

Ultrasonographic findings of iodide mumps: a case report

Description of case(s): A 73-year-old man with advanced gastric cancer was referred for CT evaluation of staging. The patient had no past history of allergy and never received iodinated compounds. CT was performed after intravenous injection of 140 mL of low osmolality contrast agent: Ioxaglate (Hexabrix 320, Gerbet, France). Within 10 minutes after the CT scan, he complained of progressive swelling of the submandibular area. Physical examination revealed swelling of the bilateral submandibular gland with mild tenderness. Ultrasonography of the neck was performed with a 7–10 MHz linear array transducer. Ultrasonography showed diffuse swelling and internal low-echoic thick septa of bilateral submandibular glands. However, the parotid and thyroid glands were not swollen. About 1 hour after the CT scan, swelling of submandibular gland started to regress and return to normal the next day.

Acute idiopathic scrotal edema in children—Revisited

Background: Acute idiopathic scrotal edema (AISE), a self-limiting acute scrotal edema and erythema that resolves without sequela, was first reported by Qvist in 1956. Methods: Thirty eight patients with AISE seen in the authors' department over the last 10 years were reviewed, comprising 44 episodes, most occurring in children under 10 years of age. The average age at presentation was 6.2 years. No past history of allergy was elicited. Results: Unilateral involvement predominated (90.1%). None of the patients was found to have a primary source of scrotal, perineal, or perianal infection. Scrotal discomfort; scrotal, perineal, and inguinal swelling; and erythema were the most common findings. Laboratory and ancillary examination findings were normal, except for the occasional eosinophilia. Characteristic ultrasonographic findings, such as marked thickening of the scrotal wall, with heterogeneous and edematous appearance, increased peritesticular blood flow, mild reactive hydrocele, and enlarged inguinal lymph nodes were found. Treatment was conservative in 92.1% of the patients. Resolution of all episodes occurred within 1 to 4 days. Recurrent episodes were observed in 4 patients (10 episodes), which were clinically more severe than the original episode. Conclusion: Clinical experience, good judgment, and color Doppler ultrasound scan can reliably identify those children with an acute scrotum who require exploration and spare those with AISE, where surgery is not indicated. J Pediatr Surg 37:1200-1202. Copyright 2002, Elsevier Science (USA). All rights reserved.

Allergy as a risk factor for nursing care problems in the elderly cancer patient

The purpose of this secondary analysis was to determine (a) the nursing diagnoses in elderly patients with cancer and (b) whether elderly cancer patients with a current or past history of allergy were at risk for selected nursing problems. A retrospective clinical data base from 59 patients (32 male, 27 female) with a diagnosis of cancer and an age range of 55-85 years with a mean age of 65.6 years was examined. The most frequently occurring priority nursing diagnoses identified by Clinical Nurse Specialists (CNS) were Pain, Risk for Infection, and Impairment of Skin Integrity. When examining the comprehensive list of priority and nonpriority nursing diagnoses, identified for these patients with cancer, it was found that those with a history of allergy were significantly more likely to have a high risk for infection than those without a history of allergy. Two other diagnoses (knowledge deficit and potential fluid volume deficit) occurred in a significant number in the allergy group, but there was no occurrence of these two diagnoses in the nonallergy group. The limitations of assessing immunologic status as a part of regular nursing assessments were discussed. Recommendations were provided for future research in the area of immunology, aging, and nursing diagnoses.

Incidence and risk factors for latent sensitization to chymopapain: predictive skin-prick tests in 700 candidates for chemonucleolysis.

Seven hundred patients were investigated prospectively before undergoing chemonucleolysis. A past history of allergy and/or previous exposure to papain, either in food, beverages or drugs, was sought, and a skin-prick test with chymopapain was performed. Based on the results obtained, the subjects were classified into four groups: Group I--225 non-atopic non-papain-exposed subjects; Group II--285 non-atopic papain-exposed subjects; Group III--69 atopic non-papain-exposed subjects; and Group IV--121 atopic papain-exposed subjects. Latent sensitization to papain was observed in 0.4% of subjects in Group I, 3.16% in Group II, 5.8% in Group III and 7.4% in Group IV. The odds ratios were 13.8 for atopy and 7.3 for exposure to papain. Interaction between atopy and papain exposure did not result in a significantly greater risk. Neither sex nor age nor a history of a previous drug reaction were risk factors. Only one patient out of the 23 who were sensitive to papain had no risk factor. The 677 skin-test negative patients then underwent chemonucleolysis and none of them had an anaphylactic reaction. This was significantly less frequent: (P = 0.04) than the incidence in a random population (0.45%). Prick tests performed 6 weeks and 6 months after chemonucleolysis revealed newly acquired sensitization in 36% of the patients. Atopy was not a risk factor for this event.(ABSTRACT TRUNCATED AT 250 WORDS)

Studies on the hymenoptera: IV. Correlation of passive transfer in hymenoptera allergy with culprit insect and direct skin tests

Direct skin tests and passive transfer tests with the sera of 16 patients who had suffered a generalized reaction to the sting of a hymenopterous insect were found to be positive. In contrast, these tests in skin and sera of 12 patients who had suffered only a local reaction tended to be negative. Passively transferable antibodies correlated more nearly with the species of the culprit insect than did direct skin tests, and these antibodies seemed on occasion to result from former stings rather than from the most recent sting. No significant difference was found in family history and past history of allergy between the 2 groups.

Allergic reaction to pyrvinium pamoate.

PYRVINIUM pamoate (Povan) is a commonly used agent for the effective treatment of enterobiasis. Side reactions of nausea, vomiting, and abdominal pain have been reported in children and adults receiving large doses.¹These adverse reactions are presumably on the basis of local irritation. The following is a case report of a reaction to pyrvinium pamoate. <h3>Report of a Case</h3> The patient, a 5-year-old, white boy, had been in good health and was treated with a single dose of 100 mg pyrvinium pamoate suspension for enterobiasis. Eight hours after receiving the medication, he began to have fever, periorbital edema, arthralgia, and an intensely pruritic rash. An unknown quantity of "cortisone syrup and aspirin" was administered by the family physician without any apparent relief of symptoms. Forty hours after symptoms began, the patient was admitted to Fort Campbell Army Hospital. The patient had no past history of allergy, serious illness, recent

SENSITIVITY TO THIOURACIL

In view of the recent reports1on the treatment of hyperthyroidism with thiouracil, several cases were selected for this type of therapy. Nine cases have been treated to date and three have exhibited manifestations of drug sensitivity. Our purpose in this report is to point out the toxic effects observed in the treatment of relatively few patients. It is not our desire at this time to comment on the efficacy of the drug in the treatment of hyperthyroidism. Case 1.— A man aged 55 complained of nervousness, sweating, weight loss, protrusion of the eyeballs, palpitation and exertional dyspnea. There was no past history of allergy. On examination there were noted moderate exophthalmos, an enlarged thyroid gland, moist palms and a tremor of the outstretched hands. The heart was overactive, with a rate of 120. The blood pressure was 150/70 mm. of mercury. The basal metabolic rate on two occasions

SENSITIZATION REACTION TO SULFANILAMIDE

Many reports of eruptions of the skin have been described as having resulted from sulfanilamide. Dermatitis medicamentosa, a simple maculopapular rash, has appeared during the second week of treatment in about 6 per cent of cases.1It usually disappears in two or three days after treatment has been discontinued. Erythematous eruptions covering part or all of the body have been described2and there have been some cases of exfoliative dermatitis which cleared up only after several months.3Only one report of definite sensitization to the drug has come to my attention, in an unpublished personal communication; hence the following case report seems worthy of notice. REPORT OF CASE Mrs. R., aged 58, an American housewife with two children, gave a past history of allergy. In 1921, to relieve severe pruritus vulvae, a resection of the left ilio-hypogastric and ilio-inguinal nerves was done under 1 per cent procaine