The Journal of allergy and clinical immunology
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J. Allergy Clin. Immunol. · Oct 2002
Epinephrine dispensing patterns for an out-of-hospital population: a novel approach to studying the epidemiology of anaphylaxis.
The underlying rate of occurrence of anaphylaxis from all potential triggers in the general population is unknown. ⋯ Epinephrine dispensing data provide a novel and practical approach for studying and monitoring the epidemiology of anaphylaxis in a community. Using this approach, we provide evidence that anaphylaxis from all triggers peaks in early childhood and then gradually declines into old age.
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J. Allergy Clin. Immunol. · Aug 2002
ReviewAnaphylactic reactions during surgical and medical procedures.
The most common agents that are responsible for intraoperative anaphylaxis are muscle relaxants. However, latex accounts for a significant number of these reactions, and the incidence of intraoperative anaphylaxis caused by latex is increasing. It is now probably the second most important cause of intraoperative anaphylaxis. ⋯ Therefore, the major emphasis has been on prevention. The key elements of prevention include an adequate history, testing for latex allergy in high-risk patients, preadmission measures, and the establishment of a "latex-free environment" while the individual is hospitalized. This is particularly important in the operating and recovery rooms.
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As a result of the increase in latex product manufacturing and use during the last 10 to 13 years, latex sensitivity has become an important health issue. Requests for evaluation and control of potential exposure to latex allergens have prompted questions about how to best sample surfaces and the air for the presence and concentration of latex allergens, a search for reasonable occupational exposure limits, and means and methods of control or remediation. ⋯ Suggestions for control and remediation are based on successful programs and projects resulting in elimination of latex and residual latex allergens in health care settings. Measurement of latex allergens on surfaces and in the air and comparison with suggested occupational exposure limits are viable means of risk analysis, and control and remediation can be successful, permitting sensitized individuals to return to the workplace.
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J. Allergy Clin. Immunol. · Jul 2002
Endotoxins prevent murine IgE production, T(H)2 immune responses, and development of airway eosinophilia but not airway hyperreactivity.
Contact with immunomodulatory factors, such as LPS, in early infancy is associated with decreased allergen sensitization. ⋯ These data indicate that local and systemic application of LPS modulates systemic and local T(H)1/T(H)2 immune responses in a distinct but similarly IL-12-dependent mode.
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J. Allergy Clin. Immunol. · Jul 2002
Clinical significance of bronchoalveolar eosinophils in childhood asthma.
To evaluate the relationship between clinical parameters and differential cell counts, bronchoalveolar lavage was performed in 79 asthmatic infants and children with unusual asthma. Multivariate analysis showed significant associations between (1) allergic asthma and the presence of alveolar eosinophils and (2) persistent and longer asthma and an increased number of alveolar neutrophils. Our results provide the first evidence that in asthmatic infants and children eosinophilic inflammation is related to allergic sensitization.