Skin testing

The immunorestorative potential of inosiplex has been evaluated in several clinical conditions, including post-surgical trauma, cancer patients with concurrent viral infections, and cancer patients receiving radiotherapy or chemotherapy. For example, most (84%) of the surgery patients remained immunologicaHy depressed, but 56% of the inosiplex-treated surgery patients had complete restoration of normal skin test reactivity (probability level < 0.0005). The use of inosiplex as an adjuvant to chemotherapy or radiotherapy appears to be valuable in the prophylaxis against opportunistic infections. 

Safety is assessed by subjecting the antioxidant to a series of animal toxicity tests, eg, oral, inhalation, eye, and skin tests. Mutagenicity tests are also carried out to determine possible or potential carcinogenicity. Stabilizers are being granulated and Hquid products are receiving greater acceptance to minimize the inhalation of dust and to improve flow characteristics. 

Melamine ia a skin test on rabbits produced neither local irritation nor systemic toxicity. As a 10% solution ia methylceUulose, it caused no irritation ia the eyes of rabbits. Human subjects were given patch tests with melamine. No evidence of either primary irritation or sensitization was found. Such results suggest that melamine crystal may be handled ia ordinary iadustrial use without special hygienic precautions. 

MS 3 Skin tests m dermatitis and occupational chest disease... 

Infectious patients present a difficult challenge when trying to protect health care workers. These patients must be isolated from the health care workers as well as from the other patients in the hospital. Special isolation rooms are used for this purpose. These rooms are generally used for isolation of infectious tuberculosis (TB) patients, but could be used for patients with other airborne-transmitted diseases. In the United States, there were 22 812 new cases of tuberculosis in 1993, equal to 8.7 per 100 000 population. This represents a 2.8% increase since 1985, following a 6-7% annual decline from 1981-1984.Several studies have documented higher than expected tuberculin skin test (TST) conversion rates in hospital personnel.The National Institute for Occupational Safety and Health " reports that multiple-drug-resistant (MDR) strains of TB have been reported in 40 states and have caused outbreaks in at least 21 hospitals, with 18-35% of exposed workers having documented TST conversions. 

Those whose tuberculin skin test has become positive in the last 2 years... 

Those with positive skin tests whose radiographic findings indicate non progressive, healed, or quiescent (causing no symptoms) tubercular lesions... 

All patients younger than 35 years (primarily children to age 7) who have a positive skin test... 

Persons with acquired immunodefidency syndrome or those who are positive for the human immunodefidency virus and have a positive tuberculosis skin test or a negative tuberculosis skin test but a history of a prior significant reaction to purified protein derivative (a skin test for tuberculosis)... 

Impaired wound healing, thin fragile skin, petechiae, ecchymoses, erythema, increased sweating, suppression of skin test reactions, subcutaneous fat atrophy purpura, striae, hyperpig mentation, hirsutism, acneiform eruptions, urticaria, angioneurotic edema... 

SC Fatalities from immunotherapy and skin testing. J Allergy Clin Immunol 1987 79 666-677. 

Hymenoptera venom is a prominent trigger of systemic reactions. Severe and fatal reactions have been described in patients with mastocytosis [9, 30, 31]. In few cases with urticaria pigmentosa and Hymenoptera venom anaphylaxis, no sensitization could be detected by means of skin tests and determination of specific IgE antibodies [32]. However, larger series found evidence that these systemic reactions are normally IgE-mediated insect sting allergies [7,33]. 

If patients have experienced anaphylaxis, the identification of any possible elicitor is important to help avoid further episodes. With skin tests and specific IgE antibodies combined with history, a relevant allergy may be detected. Cellular tests monitoring basophil histamine release or basophil activation may be helpful in some patients who resist diagnosis by standard means [26,31]. 

The p-lactams (penicillins and their derivatives) are the drugs which most frequently cause IgE-mediated anaphylactic reactions. Diagnosis is based on skin tests. To date, the best vaUdated in vitro diagnostic methods are specific IgE and BAT. As for the determination of specific IgE using ImmimoCap (Phadia AB, Uppsala, Sweden), the sensitivity of the technique in the diagnosis of immediate reaction to (3-lactams with positive skin test ranges, according to the study, from 37 to 54% with a specificity of between 83 and 100% [23,24]. 

The usual diagnostic methods, both skin tests and specific IgE with whole Anisakis extract, have a good sensitivity but a low specificity to such a degree that in 22% of blood donors specific IgE to the parasite is detected [40] and at least 20% of patients with acute urticaria have positive skin prick tests with whole Anisakis extract [41 ]. As for BAT with whole Anisakis extract, Gonzalez-Munoz et al. [42] report a sensitivity of 96% with a specificity of 96%, which are clearly higher values than those from specific IgE. 

Within 1 year of the reaction, between 70 and 90% of patients have specific IgE positive to venoms while only between 10 and 20% of people with a negative history have positive test results. The predictive value of skin tests and the determination of specific IgE is not high in that between 55 and 76% of people with positive specific IgE... 

The sensitivity of these tests is very high in the first year after sting anaphylaxis more than 90% of patients have a positive result with both tests with an increasing interval from the last sting reaction the positivity rate decreases, more rapidly for specific IgE than for intracutaneous skin tests, but even 5 years after the reaction the majority of patients still have positive results [ 1, 24, 25]. The specificity of both skin tests and... 

The indication for venom immunotherapy is based on a history of systemic allergic reactions to Hymenoptera stings and positive diagnostic tests, skin tests and/or venom-specific serum IgE antibodies [45, 49]. In the presence of only mild systemic allergic reactions, limited to the skin, immunotherapy is not generally recommended in the USA not for children, in Europe not for children and adults, unless they are heavily exposed and had repeated such reactions. 

RCM are not able to form haptens Positive skin tests in patients but not in controls in optimal concentrations... 

Histopathology shows T-cell pathology and T-cell activation in acute reaction and in skin test... 

Numerous positive delayed skin tests in patients with contrast medium-induced non-immediate skin reactions have been reported when the patients were tested with the culprit contrast medium [summarized in 1]. In a large European multicenter study, 37% of patients with non-immediate reactions were positive in delayed IDEs and/or patch tests [13]. The majority of the patients also reacted to the culprit contrast medium and also to other, structurally similar RCM. Notably, in more than 30% of those skin test-positive patients a RCM had been administered for the first time. Thus, there is a lack of a sensitization phase. Again it may be hypothesized that these previously non-exposed patients may have already been sensitized. Different patterns of RCM cross-reactivity indicate that several chemical entities could be involved. No positive skin tests have been obtained with other contrast medium excipients, such as ethylenediaminetetraacetic acid (EDTA), and only rarely patients have been found to react to inorganic iodide. 

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