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Biomedical subjects

J Birnbaum

Publications and source records attributed to J Birnbaum.

At least 55 records · Page 3Linked to original sources
PubMed1994

Can mite-specific IgE be used as a surrogate for mite exposure?

Several epidemiologic studies suggest that in mite-sensitive patients symptoms are dependent upon mite-exposure level. However, in clinical practice, it si not easy to measure major mite allergens. In contrast, assay of specific IgE antibodies can be done routinely. Thus, we wanted to compare, in a group of 40 mite-sensitive patients, the levels of mite-specific IgE (measured by RAST grade 0-6) and the level of mite group I allergen in mattresses (measured in micrograms/g house dust). The correlation coefficient between both variables was highly significant (P = 0.001). Subjects with a RAST grade of 3 or more had a 77% probability of being exposed to high (i.e., > 10 micrograms/g dust) mite allergen level. In contrast, subjects with RAST grades 0, 1, or 2 had a 77% probability of not being exposed to such high levels. Thus, measurement of serum mite-specific IgE level could be used in routine prediction of mite exposure.

Allergens↗
PubMed1993

Quality of life of persons with onychomycosis.

Onychomycosis is a fungal infection of the nails which, although unsightly in appearance, is often considered to be a cosmetic problem. This research reports on the development and performance of a quality-of-life instrument to measure the impact of this disease on the patients' mental and general health, social functioning, pain, and self-confidence. In telephone interviews, 680 members of a health maintenance organization (299 with onychomycosis and 381 without) were asked a battery of items regarding quality of life (mental and social functioning, self-esteem, pain) and specific problems and symptoms related with one's nails. Persons with onychomycosis had significantly poorer ratings compared with the healthy persons with respect to general health (p = 0.02) and bodily pain p < 0.001). Persons with onychomycosis also had significantly (p < 0.05) poorer ratings for mental health, social functioning, health concern, physical appearance, and functional limitations associated with activities involving standing on one's feet or working with one's fingers. This study is the first to document the impact of onychomycosis on an individual's quality of life. Persons with onychomycosis may adapt to this condition, but they continue to experience embarrassment and discomfort that reduces their quality of life.

Adolescent↗
PubMed1993

Rapid Hymenoptera venom immunotherapy: comparative safety of three protocols.

We compared 284 sting-allergic patients treated with either a 4 day (group 1), 6 hr (group 2) or 210 min (group 3) rapid venom immunotherapy (RVIT) protocol using honey bee (HB) or yellow jacket (YJ) venom at cumulative doses of 527.6 micrograms, 226.6 micrograms and 101.1 micrograms respectively. The 4 day protocol involved four times as many injections as the 210 min protocol and twice as many as the 6 hr protocol. Desensitization was conducted in a hospital providing full emergency resuscitation facilities. In group 1, 1 x 100 micrograms boosters were given on days 7, 10, 15 and 45 and, in groups 2 and 3, 2 x 50 micrograms boosters were given on day 15 and 1 x 100 micrograms on day 45. The patients in the three groups were comparable with regard to clinical characteristics and immunological reactivity determined by skin tests. All patients had large local reactions. Systemic reactions (SR) occurred in 28.2% of patients in group 1, 28.6% in group 2 and 6.9% in group 3. The mean total cumulative venom dose (s.e.m.) for occurrence of SR was 123.75 (+/- 24.2) in group 1, 183.27 (+/- 28.5) in group 2, and 36.43 (+/- 9.3) in group 3. HB led to more systemic reactions than YJ venom. The rate of SR decreased when the cumulative venom dose was reduced during RVIT. The median dose was 137.6 micrograms in group 1, 226.6 micrograms in group 2, and 21.1 micrograms in group 3. No systemic reactions were observed after the booster injections. The results of this study suggest that short RVIT protocols with low cumulative doses carry a lesser risk of SR.

Adolescent↗
PubMed1993

Effect of dry cleaning on mite allergen levels in blankets.

Since one of the greatest reservoirs of allergens is the blanket, we assessed mite allergen levels in dust collected from five blankets by vacuuming before and after dry cleaning with perchlorethylene and compared the results with five control blankets. Assays with monoclonal antibodies showed that group I (Der p I and Der f I) mite allergen levels per g dust were 78% lower after dry cleaning. Group I allergen levels per m2 of dry-cleaned blankets were 98% lower. RAST inhibition showed that total allergen levels decreased 70% after dry cleaning. Mite allergens were not denatured by perchlorethylene. The effect of dry cleaning resulted from physical washing out of dust and allergens.

Allergens↗
PubMed1993

Patch test reactions to mite antigens: a GERDA multicentre study. Groupe d'Etudes et de Recherches en Dermato-Allergie.

We performed patch tests with Dermatophagoides pteronyssinus (Dp) antigens from 2 different sources in 355 non-randomly selected patients with atopic dermatitis (AD) and 398 subjects of a control group. The study demonstrated that contact sensitization to mites occurred in an appreciable % of AD cases (20.8%), using commonly available assay products. The differences recorded between the 2 materials tested were related to the concentration of P1 antigen. Non-atopic patients rarely showed positive reactions to Dp (0.75%), when strict criteria for readings were applied and if 2 readings were performed. Patients with positive patch tests did not necessarily show positive immediate skin tests. It would be useful to carry out tests systematically in atopic patients, even if it is not yet known what modern treatment would be best for the patient. Laboratories still do not provide standardized house dust mite preparations--measuring and codifying their biological activity--for use in patch tests. It is to be hoped that the extension of this type of test will lead to the production of better test materials, in syringes with homogeneous dispersion and concentration.

Administration, Inhalation↗
PubMed1992

Prevalence of allergy to hymenoptera stings in different samples of the general population.

To get figures of prevalence of systemic reactions (SRs) to hymenoptera sting in adults between the ages of 18 to 65 years, we performed three different surveys using the same questionnaire from 1984 to 1988. The first one was a door-to-door survey in Southeast France, which included 8271 adults and used a questionnaire. The second one, which included 2067 adults, was performed in a health care center and comprised the same questionnaire and venom skin tests in subjects reporting a history of SRs. The third survey was a national poll performed through a home-based national computer network. The percentage of SRs ranged from 0.66% in the second survey including skin tests to 3.3% in the poll survey. The higher prevalence figure in this latter survey may be related to a false-positive history. There was no urban-rural difference in prevalence of SR.

Adolescent↗
PubMed1991

An improved method for the detection of soluble interleukin 2 receptors in liver transplant recipients by flow cytometry.

A new flow cytometric method (FCM) for detection of soluble interleukin 2 receptor (sIL-2R) in serum was established. Using this method, results from one to forty samples can be obtained in less than 2 hr as compared with 5 hr in an ELISA. Comparing over 300 sera samples tested by both methods, we found the FCM to be as specific and sensitive as the ELISA, but even more reproducible. Regression analysis of ELISAt on FCMt showed there is a strong relationship between the two assays and they mimic each other over time. We studied the daily serum levels of sIL-2R by FCM in 18 liver allograft recipients: 7 were in the stable group, 6 in the rejection group, and 5 had both rejection and infection. Low or decreasing sIL-2R levels correlated with absence of rejection. In patients with rejection episodes, a typical elevation of sIL-2R was followed by a rapid decrease of sIL-2R after successful response to rejection therapy. Patients with multiple complications displayed elevated sIL-2R levels. In conclusion, because of its rapid turnover time and accuracy, the FCM has the potential to determine the appropriate timing of post-transplant liver biopsies.

Antibodies, Monoclonal↗
PubMed1991

Medication requirements and house dust mite exposure in mite-sensitive asthmatics.

To better understand the clinical consequences of exposure to house dust mites (HDM), we investigated the relationship between treatment requirements to control symptoms in mite-allergic asthmatic patients and HDM-allergenic levels in their mattresses. This study included 49 asthmatic subjects recruited from an outpatient clinic. The protocol consisted of a questionnaire about the number of asthma attacks and treatment requirements in the last 3 months. Patients provided a sample of house dust collected from their mattresses by a standardized vacuum cleaning procedure. Mean antigen P1 equivalent defined as the sum of major allergens Der pI and Der fI (Ag P1 Eq) level was 1.34 micrograms/g dust in patients who had no treatment, 5.4 micrograms/g dust in patients who took puffs of beta 2-agonists only when required and 17.8 micrograms/g dust in patients who required daily long-term treatment. Similar relationships were demonstrated between mean Ag P1 Eq levels and the number of asthma attacks. These data support the clinical role of allergenic exposure in HDM-allergic asthmatics.

Adolescent↗
PubMed1991

Altitude and allergy to house-dust mites. A paradigm of the influence of environmental exposure on allergic sensitization.

To further investigate the possibility of a cause and effect relationship between exposure to house-dust mite (HDM) allergens and respiratory disease associated with dust mite sensitivity, we compared schoolchildren living in the Alps, where exposure to HDM is low, with those living at sea level, where it is high. The study included 933 schoolchildren from the fourth and fifth grades. The protocol included the standardized 1978 American Thoracic Society (ATS) questionnaire for children, skin testing using common aero-allergens and controls, and antigenic measurements of dust samples from mattresses (Group I antigen). The prevalence of asthma with positive skin test to HDM and the overall prevalence of positive skin test to HDM were significantly lower in mountain schoolchildren. The mean geometric HDM antigenic level in mattresses was much lower in the Alps (0.36 micrograms/g dust) than at sea level (15.8 micrograms/g dust). In contrast, the prevalence of hay fever and positive skin test to grass pollens as well as the overall prevalence of positive skin tests to grass pollens were significantly higher in the Alps. These data illustrate a striking relationship between exposure to environmental allergens and atopic sensitization.

Altitude↗
PubMed1991

Extrinsic asthma and environmental allergens.

House dust mites allergens are one of the most common antigens able to induce a high degree of sensitization in a general population. Owing to the possibility of quantifying the amount of major mite allergens in the environment, epidemiological studies have led to propose threshold values above which there is an increased risk for the occurrence of mite sensitizing, for the development of asthma and for the occurrence of symptoms. All these studies and some others dealing with the number of mites in house dust support the hypothesis that exposure to house dust mites may have a major influence on developing allergic diseases.

Allergens↗
PubMed1990

[Alcohol-related admissions in a community hospital].

We reviewed 150 alcoholic patients (1.3% of all admissions) hospitalized in this department during 1983-1987 and compared them with a random sample of 450 other patients in the department during the same period. In the alcoholic group were more males, an increased prevalence of those of Yemenite and Indian origin, and a higher rate of unemployed. The clinical presentation was heterogenous. In 26% of the chronic alcoholics no abnormality related to alcoholic injury was detected. The other patients in that group suffered from a variety of clinical problems related to alcohol. In 41% the immediate cause of admission was related to chronic alcoholism, and in others (31%) we observed alcohol-related pathology in addition to the main cause of hospitalization. We wish to increase awareness of the medical problems of chronic alcoholics encountered in a community hospital in order to promote quicker diagnosis, avoid unnecessary diagnostic procedures, and lead to better medical care.

Alcoholism↗
PubMed1990

Immunotherapy in allergic respiratory diseases.

Much more work is needed to specify the correct indications for immunotherapy in respiratory allergic diseases. Immunotherapy with pollen and mite extracts has shown some clinical efficacy versus placebo in controlled studies in allergic rhinitis and/or asthma. However, controlled studies comparing the cost, the risk factors and the efficacy of immunotherapy versus treatment with antihistaminic drugs, bronchodilators and topical steroids are needed. Additional studies are needed to established the place of immunotherapy in animal danders and mould allergy. In any case, before initiating immunotherapy in respiratory allergy the following questions must be answered: is there sufficient evidence of a close relationship between symptoms and allergen exposure? is it possible to achieve efficient allergen avoidance? is simple drug treatment no sufficient? is there evidence in the literature of effectiveness of IT for this allergen? is the patient able to comply with a long and constraining treatment?

Allergens↗