Nasal Provocation Test Useful in Diagnosing Latex Allergy

Latex allergies affects many workers(especially health workers), and has a significant impact on productivity and loss of work. There is no commercially available diagnostic method to confirm IgE-mediated latex hypersensitivity. Allergy specialist in the community have tried the latex glove test but has poor validity, and serum IgE titers to latex can be ordered but has poor sensitivity. A latex allergen skin prick test has been used for investigational purposes but is not commercially available. The nasal provocation test is interesting but requires further studies.

From Reuters Health Information

NEW YORK (Reuters Health) Jul 21 - The nasal provocation test is more sensitive than the glove test for diagnosing natural rubber latex allergy, according to a report in the June issue of Allergy.

However, a standard nasal provocation method has yet to be established, according to Dr. Mehmet Unsel and researchers from Ege University Medical Faculty, Izmir, Turkey.

The nasal provocation test was positive in 84.6% and negative in 15.4% of patients with positive skin prick test to natural rubber latex, the authors report, compared with 50% positive and 50% negative glove responses.

Nasal provocation test results were negative in patients with positive skin prick tests to other inhaler allergens and in a control group with no allergic diseases.

Using skin prick test positivity to natural rubber latex and a history of natural rubber latex-associated rhinitis as the gold standard for diagnosing natural rubber latex allergy, nasal provocation test had a sensitivity of 96%, specificity of 100%, negative predictive value of 98%, and positive predicative value of 100%, the investigators note.

In comparison, the glove use test had a sensitivity of 81%, specificity of 90%, negative predictive value of 75%, and positive predictive value of 93%.

"Nasal provocation test was successfully used for the first time in the diagnosis of natural rubber latex allergy," the authors conclude.

Allergy 2009;64:862-867.

Get Domains and WebHosting

WWW.LANDOMAIIUMS.COM

Allergy Control Products

A reader asked where one can obtain the dust mite pillow and mattress encasings. There are several vendors that sell their products in the internet. Most of my patients have obtained their allergy control supplies from these sites.

Allergy Control Products

National Allergy

These encasings have evolved over the past decades. In the past, recommendations were made to wrap one's mattress and pillow with plastic. Now, who can sleep with plastic wrapped on your bed and pillow? The newer encasings are tightly woven sheets that breathe just like regular fabric, and serve as an excellent barrier to getting exposed to the dust mite allergen(excretions).

As a disclaimer, I do not have any financial relationship with these companies and have nothing to gain financially from this posting. Just glad that I can help

Get Domains and WebHosting
www.LANDOMAINIUMS.COM

Dust Mite Allergen Avoidance

A lot of times after allergy skin testing, when a patient finds out one is allergic to dust mite allergen the usual reaction is eeek! And then the patient asks if these microscopic insects bite. So, here is the low down on the dust mite allergen.

When we are told that we are allergic to the dust mite allergen it means that we are allergic to the dust mite excretions. Dust mites feed on our skin flakes. They do not bite. We spend at least 8 hours a day in our beds. Thus, the highest concentration of human skin flakes are in our beds, and therefore, the highest concentration of dust mites and their excretions will be in our beds. That is why when we give environmental control recommendation for dust mites we focus on the premise of minimizing exposure to the dust mites and their excretions.

Avoidance measures that have been shown to be effective in dust mite allergen control.

• Pillow, mattress and box-spring allergen proof covers. These tightly woven dust mite encassements serve as a barrier method to prevent exposure to the allergen. Getting a new mattress is not a viable method since it will be repopulated with dust mites an a few months.
• Wash beddings frequently in hot water(130 degrees F) or use special detergents that remove allergens(eg. Allersearch allergen wash)
  
• Choose wood or tiled floors instead of carpeting
• Use vacuum cleaners with a HEPA filtration system or one with double-lining bags. Vacuum at least twice a week
• Use a dehumidifier in conjunction with your air-conditioner. Maintain humidity levels between 30-50% year round.

A link to the AAAAI is available on indoor allergen control. Ask your allergist for more information on dust mite control.

Get Domain and Web-hosting
WWW.LANDOMAINIUMS.COM

Australian Army Fined $200K over Teen's Peanut Allergy Death

We need to be constant advocates for those who suffer from food allergies. One death is too many. Read the article below taken from the Fairfax Digital Network

Army fined over teen's peanut allergy death
Fairfax Digital Network
By Selma Milovanovic
June 30, 2009

The Australian Army has been fined more than $200,000 over the death of a teenager from a peanut allergy at a cadets' school camp in May 2007.

Nathan Francis, 13, was a year nine student at Scotch College.

Regardless of his mother writing to the camp organisers that Nathan suffered from a severe peanut allergy he was given a lunch of beef satay on the first day of the camp and died shortly after.

In the Federal Court this morning, Justice Tony North ordered that the Commonwealth should pay $210,100 to the public purse.

The case came about when Comcare, a government workplace safety agency, sued the Commonwealth for a breach of the Occupational Health and Safety Act.

The Commonwealth, through the Chief of Army, was responsible for running the camp.

Justice North urged that the Victorian Coroner hold an inquest into Nathan's death to examine the role of Scotch College and its staff who manned the camp.

The school has promised to take steps to prevent the recurrence of another incident on the same camp in which six boys were lost in the forest for hours without radio contact.

Justice North adjourned that undertaking for one year.

The court heard WorkSafe Victoria had decided not to prosecute the school.

Justice North described the case as "every parent's worst nightmare" and commended Nathan's parents, Brian and Jessica, for their bravery during the proceedings.

Affordable Domains and Web-Hosting

www.LANDOMAINIUMS.COM

Your Dream starts with Your Domain^TM

Physical Activity, BMI and Asthma

After posting on the effect of weight or BMI on asthma yesterday, I noticed an article on the Annals of Allergy, Asthma and Immunology on the role of physical activity and weight on adults with asthma. These investigators in Toronto, Canada surveyed asthmatic and non-asthmatic adults on their health care utilization, their level of physical activity and BMI. See abstract for details.

The authors concluded that higher physical activity levels was associated with lower usage of health care in both asthmatics and controls. They also determined that for those with asthma, higher physical activity had a positive impact on lessening overnight hospital stays, while BOTH BMI and physical activity had a positive influence on out-patient physician visits.

I've seen overprotective parents not allowing their children to participate in physical activities due to a fear of an exacerbation. The key is to aggressive asthma control so one can perform physical activities to the fullest. Obviously eating right and keeping the weight down are helpful, too.

Affordable Domains and Web-Hosting

www.LANDOMAINIUMS.COM

Your Dream starts with Your Domain^TM

Does Weight have an Impact on Asthma?

There were 3 articles in the June issue of the Journal of Allergy and Clinical Immunology(JACI) that investigated the effect of weight or BMI on asthma. Interesting implications could be garnered from these published articles. Abstracts of these articles can be seen at JACI online

Key implications taken from these articles include.

• Currently being overweight in children is associated with dyspnea and bronchial hyperresponsiveness(BHR) at preschool and school age.
• Being overweight does not have a lasting effect on childhood dyspnea and BHR if the child develops a normal weight. See abstract on Scholtens' article.
  
• There is an association between central obesity and the presence and severity of asthma thus, measuring waist circumference should be considered, in addition to weight and height to better assess obesity and asthma risk. See abstract
  
• There is a modest association between an increased BMI and reduced therapeutic effect of inhaled corticosteroid containing regimens indicating that there might be a reduced response to ICS-containing medications. See abstract.

Thus cut back on those carbs and calories, get your kids active and yank them away from TV and video games.

Affordable Domains and Web-Hosting

www.LANDOMAINIUMS.COM

Your Dream starts with Your Domain^TM

Updated July Allergy Injections Schedule

Just a reminder. Due to vacations we will not be giving allergy shots on these days.

July 22, Wednesday CLOSED

July 29, Wednesday CLOSED

Call (859)371-3797 for any questions