Skin Prick Research Articles

The Relationship of Dietary Pattern and Physical Activity on Cholesterol Level in Young Adults

High blood cholesterol levels are a serious problem because they are one of the risk factors for degenerative diseases such as cardiovascular. Research data shows that in Ambon City, 32.49% of the population has the habit of consuming fatty/cholesterol/fried foods ≥1 time per day. The purpose of this study was to determine the relationship between dietary habit and physical activity with blood cholesterol levels. The type of research used was quantitative, sampling technique used was convenience sampling for 30 people. The independent variables in this study were dietary intake (amount, frequency, and type) measured using a semi-quantitative FFQ and physical activity measured using the IPAQ questionnaire and dependent variable was cholesterol level. The limiting variable was blood cholesterol levels taken through skin pricks. The results showed no relationship between diet and physical activity and blood cholesterol levels.

Stability of severe asthma phenotypes

Introduction. Severe asthma (SA) is a heterogeneous disease with several phenotypes. There are lack of data about its stability.Aim. To assess stability of SA phenotypes in adult patients during 5 years follow-up.Materials and methods. Prospective study included 117 adult outpatients with allergic SA, 51 severe asthmatics with aspirin-induced disease, 59 patient with persistent airflow limitation (PAL) and 35 patients with SA and concomitant COPD, 65 steroid-dependent severe asthmatics and 89 patients with SA and frequent (≥2 per year) exacerbations. Spirometry and bronchodilator reversibility testing were carried out; fractional exhaled nitric oxide (FeNO) was measured; hypersensitivity to common inhalant allergens (skin prick and blood specific IgE testing) and peripheral blood eosinophil counts were estimated. Asthma control and asthma-related quality of life were assessed by using ACQ-5 and SGRQ questionnaire.Results. During 5-year prospective study stability of aspirin-induced SA and SA with COPD was 100%. Allergic phenotype was stable in 81% of SA cases and in patients with changed atopic status we revealed worsening of symptoms and accelerated lung function decline. Stability of SA phenotype with PAL without COPD was 86% and steroid-dependent SA was stable in 55% of cases. After 5 years of treatment frequent exacerbations remained in 28% of severe asthmatics.Conclusion. The most stable phenotypes of SA were aspirin-induced and asthma with concomitant COPD. Less stable were allergic SA, steroid-dependent SA and phenotype with persistent airflow limitation. The least stable was SA phenotype with frequent exacerbations.

Severe asthma phenotypes and endotypes

Introduction. Severe asthma is a heterogeneous disease with several phenotypes and endotypes. However, little is known about frequency of severe asthma phenotypes and endotypes in Russia.Aim. To assess frequency of severe asthma phenotypes and endotypes compared with mild/moderate asthma.Materials and methods. Cross-sectional single center study included 643 adult outpatients with mild/moderate asthma and 314 patients with severe asthma (SA) aged 18–90 years. Spirometry and bronchodilator reversibility testing were carried out. Fractional exhaled nitric oxide (FeNO) was measured by a chemiluminescent analyzer (logan 4100, UK). Hypersensitivity to common inhalant allergen was assessed by skin prick and blood specific IgE level. Peripheral blood eosinophil counts were measured by automatic analyzer. Asthma control and asthma-related quality of life were assessed by using ACQ-5 and SGRQ.Results. Allergic phenotype was more frequent in patients with mild/moderate asthma than in those with SA, but aspirin-induced asthma, steroid-dependent asthma, asthma with persistent airflow limitation and concomitant COPD, asthma with late onset and obesity were more frequent in SA. The majority of patients with SA had several phenotypes (mean 3 phenotypes) and at least one marker of T2-high endotype.Conclusion. The most frequent phenotypes of SA were allergic, with persistent airflow limitation, with concomitant obesity and COPD. Occurrence of asthma phenotypes differed between patients with SA and mild/moderate asthma. The majority of SA patients have T2-endotype.

Risk factors determining the development of food allergy intolerance at the first age in infants with atopic dermatitis

Objective: Very few studies have examined the risk factors for developing tolerance to food allergy in infants with atopic dermatitis (AD). To understand the risk factors for developing tolerance to food allergy in the first year in infants with atopic dermatitis and food allergy coexistence.Methods: Ninety-three infants were included in this retrospective study. Food allergy was detected using food-specific IgE, skin prick, and oral food challenge tests. The severity of the disease was evaluated using Scoring Atopic Dermatitis (SCORAD). Demographic parameters were recorded from medical records.Results: The rate of patients who tolerated food allergy in the first year was 61 (65.6%). The median age to tolerate food allergy was 12 (6-18 months). According to the SCORAD, 8 (8.6%) patients had mild, 50 (53.8%) had moderate AD, and 35 (37.6%) had severe AD. The median SCORAD value was 45.2 (35.2-54.6). There was no difference between the groups who tolerated food allergy and those who could not at the first age of life in terms of age, gender, gestational week, maternal age, and familial atopy history (p>0.05 for all). Egg allergy [p=0.035; OR:6.623 (CI:0.996-44.043)], parental atopy [p=0.024. OR:2.450 (CI:0.699-23.056], and AD severity [p=0.030. OR:1.240 (CI:1.001-22.105)] emerged as statistically significant variables at potential risk factors for food allergy intolerance in the first year.Conclusion: Egg allergy, parental atopy, and severity of atopic dermatitis emerged as potential risk factors for intolerance to food allergy in the first year of life in infants with atopic dermatitis and food allergy coexistence.

Immediate Hypersensitivity to Chlorhexidine: Experience from an Allergy Center in China.

Chlorhexidine generally has a good safety profile. However, allergic reactions are reported with increasing frequency. In China, it is rarely reported, and its characteristics are unknown. The purpose of this study was to summarize the experience of a Chinese allergy center with chlorhexidine allergy. The authors retrospectively reviewed all patients who underwent chlorhexidine allergy testing in the Allergy Center of West China Hospital, Sichuan University (Chengdu, China), in the period February 2018 to May 2022 (n = 43 patients) and included the patients diagnosed with chlorhexidine allergy for analysis. Ten patients who were diagnosed by skin prick and serum-specific immunoglobulin E tests were included. They experienced a total of 30 allergic reactions to chlorhexidine (mean ± SD, 3.0 ± 1.3). Five patients experienced six allergic reactions (6 of 30, 20%) during general or local anesthesia, and they may have been exposed to chlorhexidine via different routes. Only one allergic reaction (1 of 30, 3%) was recorded with exposure via a mouthwash. The other 23 allergic reactions (23 of 30, 77%) were caused via a skin disinfectant; the route of exposure was IV cannulation in 22 allergic reactions (22 of 23, 96%) and broken skin in one allergic reaction (1 of 23, 4%). The symptoms included a quick onset and great severity. Two patients (2 of 10, 20%) had been accidentally re-exposed to chlorhexidine after diagnosis. This study conducted in China showed that the majority of reactions to chlorhexidine were attributed to skin disinfectants, and IV cannulation was the most common exposure route; in general, however, chlorhexidine allergy was easily overlooked. The potential allergenicity of chlorhexidine used for skin preparation before IV cannulation or should be considered in patients who develop allergic reactions perioperatively.

Establishment of a duration criterion for acute exacerbations of chronic rhinosinusitis through qualitative analysis of patient experiences.

Establishment of a duration criterion for acute exacerbations of chronic rhinosinusitis through qualitative analysis of patient experiences.

Characteristics of Induced-Sputum Inflammatory Phenotypes in Adults with Asthma: Predictors of Bronchial Eosinophilia.

The objectives of this study were, for patients attending a specialist asthma clinic at a tertiary care hospital, to determine, from sputum induction (SI), proportions of bronchial inflammatory phenotypes, demographic, clinical and functional characteristics of each phenotype, and the most accessible non-invasive inflammatory marker that best discriminates between phenotypes. Included were 96 patients with asthma, attending a specialist asthma clinic at a tertiary care hospital, who underwent testing as follows: SI, spirometry, fractional exhaled nitric oxide (FeNO), blood eosinophilia, total immunoglobulin E (IgE), and a skin prick test. SI phenotypes were 46.9% eosinophilic, 33.3% paucigranulocytic, 15.6% neutrophilic, and 4.2% mixed. No significantly different clinical or functional characteristics were observed between the phenotypes. A positive correlation was observed between SI eosinophilia and both emergency visits in the last 12 months (p = 0.041; r = 0.214) and FeNO values (p = 0.000; r = 0.368). Blood eosinophilia correlated with SI eosinophilia (p = 0.001; r = 0.362) and was the best predictor of bronchial eosinophilia, followed by FeNO, and total blood IgE (area under the receiver operating characteristic curve (AUC-ROC) 72%, 65%, and 53%, respectively), although precision was only fair. In consultations for severe asthma, the most frequent phenotype was eosinophilic. Peripheral blood eosinophilia is a reliable marker for discriminating between different bronchial inflammatory phenotypes, is useful in enabling doctors to select a suitable biologic treatment and so prevent asthma exacerbation, and is a better predictor of bronchial eosinophilia than FeNO and IgE values.

COVID-19 VACCINE REACTIONS AND SUSPECTED POLYETHYLENE GLYCOL ALLERGY: A PEDIATRIC CASE SERIES

<h3>Introduction</h3> Studies have demonstrated tolerance in high risk patients receiving Covid-19 m-RNA vaccines containing polyethylene glycol (PEG) with rare reactions.There is limited pediatric data regarding safety in receiving PEG containing Covid-19 vaccines with a history of prior hypersensitivity reactions to PEG containing chemotherapy (PEG-CTX). <h3>Methods</h3> Retrospective chart review from referred Pediatric Oncology patients with a history of prior reactions to PEG-CTX (01/2020-04/2022). Selective skin testing was completed using PEG molecular weigh 3350 and m-RNA Covid-19 vaccines with controls. <h3>Results</h3> Four pediatric patients (≤18 years old) had evidence suggestive of an immediate, hypersensitive reaction to PEG-CTX following treatment for acute lymphoblastic leukemia (ALL). All 4 patients experienced prior reactions to chemotherapy (L-Asparaginase). Symptoms included: hypotension, flushing, urticaria, angioedema, emesis and tachycardia. Due to prior reactions, these high-risk patients were not administered PEG containing Covid-19 vaccines due to safety concerns. Non-PEG containing Covid-19 vaccines were not approved for use in pediatric patients. Allergy skin testing (skin prick and intradermal) was completed in all four patients. One of 4 patients tested positive to both PEG and PEG containing Covid-19 vaccine. The 3 negative patients were administered PEG containing Covid-19 vaccine with monitoring for one hour without symptoms. <h3>Conclusion</h3> Pediatric patients in our study with prior reactions to PEG-CTX tolerated PEG containing Covid-19 vaccines. Further studies are needed in assessing PEG allergy in high-risk patients with a past history of reactions to PEG-CTX.

TYPES OF IgE MEDIATED FOOD ALLERGY BASED ON SKIN PRICK TEST FOLLOWED BY FOOD PROVOCATION TEST IN EAST JAVA REGION-INDONESIA

Food allergy is medical condition when the immune system mistakenly perceives a particular foods ingredients as dangerous. The differences in the incidence and types of food allergens in different regions attract researchers to examine the foods that often cause allergies in Indonesia because it will help patients and clinicians to determine the types of food to be eliminated to reduce the impact of symptoms on patients. This study was conducted to know the most common types of food cause IgE-mediated food allergy based on skin prick followed by food provocation test. Our research was a descriptive retrospective study. Ages 0 to 18 were represented among the 143 samples that satisfied the inclusion criteria. The boy dominated the research subjects. The dominant age of the research subjects is 5-10 years. A total of 21 (14.7%) study subjects had parents and siblings with a history of atopy. This study showed that common food allergies were following eggs (25.2%), chocolate (20.3%), cows milk (18.2%), chicken (17.5%), shrimp (14.7%), fish (12.6%), and fruit (10.5%). The result concludes that the most common food cause IgE-mediated food allergy in children in sequence: eggs, chocolate, cows milk, chicken, shrimp, fish, and fruit.

Alpha-amylase as the culprit in an occupational mealworm allergy case

BackgroundOccupational allergy has been described in employees working in contact with mealworms in pet stores, live fish bait or infested stored grains and recently, in mealworm farming for animal feed and human consumption. Mealworm allergens linked to occupational allergy are troponin C, cockroach-like allergen, tropomyosin, arginine kinase, early-staged encapsulation inducing- and larval cuticle proteins.ObjectiveWe report a case of occupational mealworm allergy and studied the culprit component.MethodsDiagnosis was done by skin prick, specific IgE, basophil activation and lung function testing. Allergen purification was performed by anion-exchange chromatography and immunoblotting with patient IgE. Allergens were identified by in-gel trypsin digest and tandem mass spectrometry. Allergenicity and specificity further confirmed by IgE inhibition and passive basophil activation experiments.ResultsWe describe a new case of occupational mealworm allergy in a laboratory worker, with sensitization to different developmental stages and derivates of the mealworm. In basophil activation tests, the majority of patient's basophils (69%–91%) degranulated upon stimulation with the lowest concentration of mealworm extracts (0.16 µg/ml). Despite strong sensitization to mites, the patient did not show cross-reactivity to other insects. We were able to identify alpha-amylase as the main allergen and through inhibition experiments, we demonstrated that low amounts (0.1 µg/ml) of this allergen could strongly inhibit mealworm specific IgE by 79.1%. Moreover, passive BAT experiments demonstrated the IgE-alpha-amylase interaction to be functional, inducing up to 25.5% degranulation in healthy donor basophils.ConclusionAlpha-amylase can be identified as the responsible allergen in this specific case of occupational mealworm allergy.

Anaphylaxis after COVID-19 vaccination: A registry-based study

Anaphylaxis after COVID-19 vaccination: A registry-based study

Allergy to Local Anesthetics is a Rarity: Review of Diagnostics and Strategies for Clinical Management.

Local anesthetics (LA) are commonly used in procedures and in topical agents for pain management. With the increasing use of LA drugs, the management of LA reactions is more frequently encountered in the office and in operating rooms. True allergic reactions involving IgE-mediated reactions and anaphylaxis are rare; they have only been identified in case reports and account for less than 1% of adverse LA reactions. Most reactions are non-allergic or are a result of hypersensitivity to other culprits such as preservatives, excipients, or other exposures. LA reactions that are misclassified as true allergies can lead to unnecessary avoidance of LA drugs or delays in surgical procedures that require their use. A detailed history of prior LA reactions is the first and most crucial step for understanding the nature of the reaction. Reactions that are suspicious for an immediate hypersensitivity reaction can be evaluated with skin prick and intradermal testing with subsequent graded challenge. Reactions that are suspicious for a delayed hypersensitivity reaction can be evaluated with patch testing.

Localized and Generalized Skin Adverse Drug Reactions to Nadroparin Calcium Injection in 6 Cases of Pregnant Women

Background Despite the increasing number of skin adverse drug reactions caused by nadroparin calcium have been reported, mostly, little is known regarding of their details of clinical characteristics, especially for generalized skin adverse drug reactions. We sought to evaluate localized and generalized characteristics of the skin adverse drug reaction to nadroparin calcium injection in pregnant women. Methods A retrospective study was conducted on 6 pregnant women, who experienced localized and generalized skin adverse drug reactions during long-term nadroparin calcium injection. The patients' clinical and imaging information were retrieved from medical records. The skin prick test, patch test, and intradermal test were performed after they stopped lactation. Causality assessment of suspected adverse drug reactions was performed on these cases. Results The average total dose of nadroparin calcium injection in the 6 cases was 64.17 ± 22.66. Localized skin adverse drug reaction, manifested as erythema at the injection point, appeared after 47.5 ± 17.4 days of subcutaneous injection of nadroparin calcium. Generalized urticaria-like lesions, progressing from the injection site on the abdomen, appeared in 5.17 ± 3.60 days after the first appearance of localized reaction, while laboratory test results revealed essential peripheral blood eosinophilia. All rashes in the 6 cases subsided in 2–5 weeks after drug withdrawal. After delivery, 5 of 6 cases received complete skin tests to evaluate drug hypersensitivity. Results presented positive in the intradermal test within 7 days. Both the skin prick test and skin patch test were negative. Localized skin reactions and generalized urticaria-like adverse drug reactions were considered as definitely and probably caused by nadroparin calcium injection, respectively. Conclusion Subcutaneous injection of nadroparin calcium in pregnant women appears to be at risk of localized and generalized urticaria-like adverse drug reaction. It is important to follow up the pregnant woman during nadroparin calcium injection for evaluating adverse drug reactions. Timely detection of symptoms is pivotal in early diagnosis and treatment of adverse drug reactions.

Drug Allergies

Adverse drug reactions (ADRs) are an important public health problem. An ADR is defined by the World Health Organization as an unintended, noxious response to a drug that occurs at a dose usually tolerated by normal subjects. The classification of ADRs by Rawlins and Thompson divides ADRs into two major subtypes: (1) type A reactions, which are dose dependent and predictable, and (2) type B reactions, which are uncommon and unpredictable. The majority of ADRs are type A reactions, which include four subtypes: overdosage or toxicity, side effects, secondary effects, and interactions. Type B reactions constitute approximately 10 to 15% of all ADRs and include four subtypes: drug intolerance, idiosyncratic reactions, pseudoallergic reactions, and drug hypersensitivity reactions. This chapter reviews the epidemiology of ADRs, risk factors for drug hypersensitivity reactions, the classification of drug reactions, diagnostic tests, reactions to specific drugs, and management of the patient with drug allergy. Figures illustrate drugs as haptens and prohaptens, the Gell and Coombs system, the four basic immunologic mechanisms for drug reactions, the chemical structure of different β-lactam antibiotics, penicillin skin testing, sulfonamide metabolism and haptenation, nonsteroidal antiinflammatory drug effects, and patient management. Tables outline the classification of ADRs, drugs frequently implicated in allergic drug reactions, and reagents and concentrations recommended for prick and intradermal skin testing. This review contains 8 figures, 7 tables, and 60 references. Key Words: Adverse drug reactions, drug hypersensitivity reactions, overdosage, toxicity, Type A reactions, Type B reactions, human leukocyte antigen, pruritus, angioedema, urticarial, bronchospasm, laryngeal edema, rhinoconjunctivitis

Drug Allergies

Adverse drug reactions (ADRs) are an important public health problem. An ADR is defined by the World Health Organization as an unintended, noxious response to a drug that occurs at a dose usually tolerated by normal subjects. The classification of ADRs by Rawlins and Thompson divides ADRs into two major subtypes: (1) type A reactions, which are dose dependent and predictable, and (2) type B reactions, which are uncommon and unpredictable. The majority of ADRs are type A reactions, which include four subtypes: overdosage or toxicity, side effects, secondary effects, and interactions. Type B reactions constitute approximately 10 to 15% of all ADRs and include four subtypes: drug intolerance, idiosyncratic reactions, pseudoallergic reactions, and drug hypersensitivity reactions. This chapter reviews the epidemiology of ADRs, risk factors for drug hypersensitivity reactions, the classification of drug reactions, diagnostic tests, reactions to specific drugs, and management of the patient with drug allergy. Figures illustrate drugs as haptens and prohaptens, the Gell and Coombs system, the four basic immunologic mechanisms for drug reactions, the chemical structure of different β-lactam antibiotics, penicillin skin testing, sulfonamide metabolism and haptenation, nonsteroidal antiinflammatory drug effects, and patient management. Tables outline the classification of ADRs, drugs frequently implicated in allergic drug reactions, and reagents and concentrations recommended for prick and intradermal skin testing. This chapter contains 8 highly rendered figures, 3 tables, 83 references, 5 MCQs, and 1 teaching slide set.

Drug Allergies

Adverse drug reactions (ADRs) are an important public health problem. An ADR is defined by the World Health Organization as an unintended, noxious response to a drug that occurs at a dose usually tolerated by normal subjects. The classification of ADRs by Rawlins and Thompson divides ADRs into two major subtypes: (1) type A reactions, which are dose dependent and predictable, and (2) type B reactions, which are uncommon and unpredictable. The majority of ADRs are type A reactions, which include four subtypes: overdosage or toxicity, side effects, secondary effects, and interactions. Type B reactions constitute approximately 10 to 15% of all ADRs and include four subtypes: drug intolerance, idiosyncratic reactions, pseudoallergic reactions, and drug hypersensitivity reactions. This chapter reviews the epidemiology of ADRs, risk factors for drug hypersensitivity reactions, the classification of drug reactions, diagnostic tests, reactions to specific drugs, and management of the patient with drug allergy. Figures illustrate drugs as haptens and prohaptens, the Gell and Coombs system, the four basic immunologic mechanisms for drug reactions, the chemical structure of different β-lactam antibiotics, penicillin skin testing, sulfonamide metabolism and haptenation, nonsteroidal antiinflammatory drug effects, and patient management. Tables outline the classification of ADRs, drugs frequently implicated in allergic drug reactions, and reagents and concentrations recommended for prick and intradermal skin testing. This review contains 8 figures, 7 tables, and 60 references. Key Words: Adverse drug reactions, drug hypersensitivity reactions, overdosage, toxicity, Type A reactions, Type B reactions, human leukocyte antigen, pruritus, angioedema, urticarial, bronchospasm, laryngeal edema, rhinoconjunctivitis

Allergenic characterization of Bomb m 4, a 30-kDa Bombyx mori lipoprotein 6 from silkworm pupa.

Silkworm pupa (SWP) food anaphylaxis has been described frequently in Asian countries. However, false-positive reactions by skin pricks and serum IgE (sIgE) tests to the extract complicate diagnosis, requiring identification of clinically relevant major allergens. In this study, we characterized a novel SWP allergen, Bomb m 4, a 30-kDa lipoprotein, and evaluated its diagnostic sensitivity. Bomb m 4 was identified by a proteomic analysis. This recombinant (r)Bomb m 4 was overexpressed in Escherichia coli, and the IgE reactivity by ELISA was compared with other reported allergenic proteins: Bomb m 1 (arginine kinase), 27-kDa glycoprotein, Bomb m 3 (tropomyosin) using the serum samples from 17 SWP allergic patients and 11 asymptomatic sensitized subjects. rBomb m 4-specific IgE was recognized by all 17 SWP allergic patients. The 27-kDa glycoprotein and Bomb m 1sIgE were found in 35.3% and 0%, respectively, in the SWP allergic patients. ELISA sIgE reactivity increased significantly, when 4M urea was added in serum samples. However, only 16% inhibition of sIgE reactivity to the whole SWP extract was exhibited by rBomb m 4, whereas more than 93% of self-inhibition of rBomb m 4sIgE was obtained, possibly due to the low abundance of Bomb m 4 in the extract. Three linear epitopes (81-95, 191-205 and 224-238 residues) of rBomb m 4 were identified. These epitopes are shown to be released by pepsin digestion. Receiver operator characteristic (ROC) analysis showed the highest diagnostic value of Bomb m 4 followed by Bomb m 1, 27-kDa glycoprotein and Bomb m 3. Bomb m 4 is the major allergen of SWP allergic patients. It has cryptic epitopes which are exposed to IgE antibodies with digestive enzymes. This recombinant Bomb m 4 allergen permits exact diagnosis of SWP allergy.

Successful desensitization with chemotherapeutic drugs: a tertiary care center experience.

Introduction.Hypersensitivity reactions to chemotherapeutic drugs are increasing all over the world, and desensitization to them has become the standard treatment approach. This study aimed to evaluate the characteristics of chemotherapeutic drug hypersensitivity reactions and the outcome of desensitization procedures. Methods. Between January 2017 and 2019, patients who have been desensitized to chemotherapeutic drugs were included retrospectively. Data were obtained from the medical records of the patients. Results. A total of 35 patients were evaluated; of whom 24 (68.5%) were female and 11 were male (31.5%). The mean age was 54.54 ± 13.39 (min-max: 41-69) years. Colorectal cancer was the most common malignancy (n:14, 40%). Desensitization was performed with oxaliplatin in 17 (48.5%), carboplatin in nine (25.7%), paclitaxel in four (11.4%), cisplatin in two (5.7%), irinotecan in two (5.7%), rituximab in two (5.7%), and docetaxel in one (2.8%) patients. Thirty four (97.1%) were successfully desensitized without any reactions. Anaphylaxis occurred during desensitization with rituximab and the procedure could not be completed. The reactions occurred during the first administration of the chemotherapeutic agent in five (14.2%) patients. Skin tests were performed on 26 (74.2%) patients. Skin prick and intradermal tests were positive in 7 (26.9%) and 12 (46.1%) patients, respectively. Conclusions. Desensitization is an effective and safe treatment approach for chemotherapeutic drug hypersensitivity and can be performed safely by observing general precautions to anaphylaxis.

Vaccinating with a COVID-19 Vaccine: Experience of the Tertiary Allergology Center

Background: Allergic reactions after messenger RNA (mRNA)-based COVID-19 vaccines have been reported but detailed descriptions and further actions are not well characterized. Objective: To describe the symptoms of possible allergic reactions after the mRNA COVID-19 vaccine and outcomes of further vaccination. Methods: We descriptively analyzed data of adult (≥18 years of age) patients, who were sent for vaccination to our outpatient center for the Diagnostics and Treatment of Allergic and Immune diseases. All patients were vaccinated with the Pfizer–BioNTech Comirnaty® vaccine.Results: From January 2021 to July 2021 twenty-two patients were vaccinated in our center. Six patients experienced a reaction after the first Comirnaty® dose in different vaccination centers. The majority of them complained of various types of rashes after the first dose, one case was consistent with anaphylaxis. The latter patient was tested with the skin prick using Pfizer–BioNTech Comirnaty® vaccine and the test was negative. Other sixteen patients were vaccinated in our center from the first dose because of past allergic reactions to other medication or due to concomitant mast cell disorder. All patients were vaccinated without any immediate adverse reactions.Conclusions: None of our patients experienced repeated cutaneous reactions after the second dose. Patients with previous anaphylaxis or mastocytosis also were safely vaccinated.

Evaluation of low-volume plasma sampling for the analysis of meropenem in clinical samples.

Reducing the volume of blood sampled from neonatal or paediatric patients is important to facilitate research in a group that is under-represented in clinical studies. Not all patients have a cannula available for blood sampling, meaning there are real advantages in obtaining a blood microsample by skin prick. In this study, the results obtained from both capillary microsamples (CMS) and a microfluidic (MF)-CMS by skin prick are compared to conventional plasma sampled from an arterial catheter in a clinical bridging study. Six critically ill patients receiving meropenem were included with the incurred sample reanalysis test meeting the acceptance criteria for both CMS (n = 24 samples) and MF-CMS (n = 20 samples). Bland-Altman plots comparing MF-CMS to conventional arterial blood sampling revealed a difference of - 12.7 ± 22.1% (mean ± standard deviation (SD), and comparing CMS to conventional arterial blood sampling a difference of - 3.4 ± 17.0%. At - 12.7%, the bias between MF-CMS and conventional sampling is greater than the bias found with CMS, although within the limit of acceptability for analytical accuracy (that being ± 15%). Samples collected by skin prick and using CMS produced meropenem concentrations that were comparable to those obtained from conventional arterial catheter sampling. CMS samples were found to be stable when stored in the capillary tube for 24h at 5°C or for 4h at room temperature.