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Biomedical subjects

J Dolovich

Publications and source records attributed to J Dolovich.

At least 181 records · Page 10Linked to original sources
PubMed1983

Isotopic and enzymatic IgE assays in non-allergic subjects.

In order to establish normal values in an adult population for serum IgE concentration, sera were obtained from 446 ambulatory Canadian caucasian subjects with negative allergy histories. A standard isotopic procedure, the Phadebas paper radioimmunosorbent test (PRIST), was compared with the new enzymatic counterpart, the Phadezyme PRIST. By the isotopic method, serum IgE concentrations in women and men were comparable from one age group to another with no age-related trend in the seven age groups examined (15-20, 21-30, 31-40, 41-50, 51-60, 61-70, above 70). The median and 95th percentile units (U)/ml respectively were 17.5 and 145 for 224 women and 25.5 and 275 for 222 men. Mean values +/- 1 SD for women were 43 +/- 102 and for men, 58 +/- 137. Levels were significantly higher in men as a group. Sera with IgE concentrations above 100 U and a sampling of additional sera were tested for specific IgE antibodies to 13 common allergens by the radioallergosorbent test (RAST). After exclusion of RAST-positive sera, the mean U/ml values +/- 1 SD were 22 +/- 29 for 204 women and 37 +/- 54 for 196 men. Geometric mean U/ml values for these sera were 14.6 for women and 22.3 for men and the median and 95th percentile U/ml respectively for the women were 15 and 66, for the men, 24 and 135. These 95th percentile values are considered the upper limits of normal in this population. The RAST identification of antibodies to allergens to which sensitization was demonstrated provided a potential explanation for serum IgE concentrations above 100 U/ml in less than 30% of the sera in this population with negative allergy histories. The isotopic method and the counterpart enzymatic method (Phadezyme PRIST) were highly comparable; the correlation coefficient (r) for all the sera was +0.93 (P less than 0.001). IgE levels were significantly higher in male smokers than non-smokers by both methods but these differences were not significant in women.

Female↗
PubMed1983

Does non-immunologic mast cell mediator release/activation elicit a late cutaneous response?

Early wheal responses to intracutaneous codeine injection have virtually no tendency to proceed to late cutaneous responses in normal subjects and patients with chronic urticaria. This finding is taken to indicate that the transient burst of mast cell mediator release/activation in a quantity sufficient to elicit a sizable early response may not, by itself, fulfill conditions required to lead to late cutaneous allergic responses. In patients with angioedema and a recent requirement for steroid therapy early wheals followed by small late cutaneous responses were elicited by codeine and histamine. This effect by histamine, not observed in normals, indicates a unique host susceptibility to prolonged responses in these individuals. The inhibition of these small late responses by ingested prednisone may be representative of the mechanism of therapeutic efficacy of the drug in these cases.

Angioedema↗
PubMed1983

Association of chronic urticaria and angioedema with thyroid autoimmunity.

Seventeen patients, constituting 12.1% of 140 consecutively seen cases of chronic urticaria, demonstrated thyroid autoimmunity with thyroid microsomal antibodies (TMAs) in serum titers greater than or equal to 1:1,600. Eight of these 17 patients had goiter or thyroid dysfunction. In a control group of 477 consecutively seen patients, only 27 (5.6%) had similar TMA titers. Routine and special immunologic test results in this group of 17 patients did not differ from those found in other patients with chronic urticaria and angioedema (CUA), and the only notable clinical feature was that all 17 had angioedema. The age and sex distribution and thyroid features of these 17 patients were similar to those described in autoimmune thyroiditis. Patients (especially women) with CUA should be tested for the presence of TMAs. In this subgroup, CUA may have an autoimmune basis.

Adolescent↗
PubMed1982

Salbutamol: comparison of bronchodilating effect of inhaled powder and aerosol in asthmatic subjects.

In the treatment of asthma salbutamol can be administered as an aerosol with a metered-dose inhaler or as a powder with a breath-actuated device (Rotahaler). The two forms of the drug were compared in a double-blind placebo-controlled study involving 10 asthmatic adults who were known to respond to salbutamol. The bronchodilating effect of the aerosol and the powder at doses of 200 micrograms and of the powder at doses of 200 and 400 micrograms was compared, bronchodilation being measured in terms of forced expiratory volume and vital capacity. The response was far greater to salbutamol than to placebo, but there was no significant difference between the two forms of the drug or between the lower and higher doses of powder. No side effects were observed.

Adult↗
PubMed1982

Control of asthma.

Developments of the past decade have greatly improved the likelihood that patients can control their asthma. Inhaled medications are basic to a regimen that may include bronchodilators only, or bronchodilators along with cromoglycate and steroid to the extent required to achieve and maintain control. The regimen is modified for the individual and designed to control symptoms while avoiding an overdose of any one agent and overuse of inhaled bronchodilators (a sign of their lessening effectiveness). The regimen outlined emphasizes controlling asthma day to day and providing effective intervention early to prevent attacks from becoming severe.

Adolescent↗
PubMed1982

Occupational asthma caused by nickel sulfate.

A 28-yr-old man developed asthma shortly after being exposed to nickel sulfate (NiSO4) in a metal-plating factory. Recordings of peak expiratory flow rates at work and for an off-work period showed increased variations at work, with best values on weekends. Allergy prick skin tests elicited an immediate reaction with NiSO4 at a concentration of 10 mg/ml. Experimental inhalation challenges with NiSO4 at the same concentration of 10 mg/ml for 60 sec produced a bronchial obstruction typical of an early asthmatic response. A control asthmatic subject with a similar level of sensitivity to histamine failed to react after the same inhalation of NiSO4, which suggests a specific rather than irritant mechanism for the reaction. the patient had evidence of IgE antibody to a NiSO4-human serum albumin antigen. His serum selectively bound 63 Ni, and the test was selectively blocked by nonlabeled nickel sulfate. These results, evaluated together, suggest the development of occupational asthma caused by allergy to NiSO4 in this patient.

Adult↗
PubMed1982

Occupational asthma caused by cedar urea formaldehyde particle board.

Two carpenters developed asthma and rhinitis related to occupational exposure to a cedar urea formaldehyde (CUF) particle board. One patient developed nasal and chest symptoms and an equivocal early asthmatic response after CUF sawdust exposure, but not after spruce or western red cedar sawdust exposure; possible late asthmatic response may have been inhibited by beclomethasone treatment. The other patient developed marked nasal and chest symptoms and a dual asthmatic response after CUF exposure, but not after spruce or cedar exposure. Both patients developed increased bronchial responsiveness to inhaled histamine, which persisted for at least six days in the first patient, and which was associated with increased asthmatic symptoms of days' to weeks' duration in both. A previously unexposed asthmatic patient, with more markedly hyperreactive bronchi, developed no symptoms, no change on spirometric testing, and no change in histamine response after CUF exposure. Specific IgE antibodies directed against formaldehyde-human serum albumin conjugate could not be demonstrated using the radioallergosorbent test. This investigation documents the occurrence of occupational asthma caused by urea formaldehyde used as a bonding agent in particle boards. Absence of a response in a previously unexposed, more severe asthmatic patient suggests specific sensitization to some component of the urea formaldehyde resin complex had developed.

Asthma↗
PubMed1981

Effects of oxatomide compared with chlorpheniramine in allergic rhinoconjunctivitis.

Oxatomide is an H1 receptor antagonist, which also inhibits antigen-induced mediator release from sensitized mast cells and basophils. The effects of ingested oxatomide (30 mg/capsule) were compared with those of chlorpheniramine (5 mg/capsule) in a double-blind non-crossover study in two groups of twenty-five subjects with ragweed pollen-induced hay fever during the pollen season. Oxatomide or chlorpheniramine was started when symptoms became troublesome and was used in a dose of two to four capsules daily according to severity. Other medications were added, in a standardized way, if hay fever symptoms were not controlled by the test capsules. Forty-one subjects completed the study; nineteen received oxatomide and twenty-two chlorpheniramine. Mean symptom scores, number of test capsules and number of doses of additional medication were not significantly different between the two groups. Drowsiness was reported by subjects in both groups but was worse in the chlorpheniramine group (P less than 0.05). We conclude that, in the studied doses, oxatomide is as effective for the treatment of allergic rhinoconjunctivitis as chlorpheniramine and produces less drowsiness.

Adolescent↗
PubMed1981

Inhibition of allergen-induced asthma by three forms of sodium cromoglycate.

The effect of three forms of sodium cromoglycate (SCG), 20 mg, on allergen-induced early asthmatic responses was examined in ten stable asthmatics. Dose response allergen inhalation tests were performed on five occasions at intervals of from 1 to 2 weeks to determine the provocation concentration producing a 20% reduction (PC20 allergen) in FEV1. Placebo was given before the first and the last tests to determine the reproducibility of responses to allergen over the study period; reduced responsiveness was observed in eight of the ten subjects. Major changes in levels of specific serum antibodies of the IgE and IgG classes did not serve to explain the changes in bronchial responses although there was a trend which suggested IgG-related desensitization. The observed changes in bronchial responses and antibody levels illustrate the requirement for tests of reproducibility of responses by the use of placebo controls at the beginning and end of a series of allergen inhalation challenges. SCG as (i) a micronized powder with lactose, (ii) micropellets without lactose, or (iii) an aerosol, were inhaled double-blind, in random order, 5 min before the additional three allergen inhalation tests. PC20 allergen was reduced following SCG in seven subjects; the differences were statistically significant for the group. There was no observed difference in efficacy between the different forms of SCG. In this study, the efficacy of SCG could not be related to age, atopic status, the initial level of allergen-specific IgE antibody, baseline FEV1, level of bronchial responsiveness to inhaled histamine or an effect of SCG on responsiveness to histamine.

Adolescent↗
PubMed1981

Cutaneous responses to tests with influenza vaccines.

Responses to the intracutaneous infection of influenza vaccines were examined at 24 and 48 hours. Whole virus and subunit virus vaccines of comparable potency induced local reactions of comparable magnitude. Cutaneous reactions to the influenza vaccines were present in almost all adults but absent in young children. Reactions were greatly reduced by ingested prednisone. Responses to a subunit commercial trivalent influenza vaccine were compared with responses to tuberculin in tuberculin-sensitive subjects. In each subject the tuberculin reaction had greater duration than the influenza reaction. In separate tuberculin-sensitive individuals the flu vaccine and tuberculin reactions were biopsied at 24 hours. There was mild to moderate cellularity in the responses to both reactants. The cellular infiltration was mainly mononuclear cells except in one case in whom both agents elicited an infiltrate in which neutrophils and eosinophils predominated. The microscopic findings in reactions to tuberculin and influenza vaccine were comparable. Immunofluorescence studies revealed the deposition of complement (C3) in most reactions and of immunoglobulin (particularly IgM) in some reactions of both types. The findings support the view that local reactions to influenza vaccines are acquired and probably immunologic; the difference in duration from tuberculin reactions points to a different pathogenesis which is not yet entirely characterized.

Adult↗
PubMed1980

Anaphylaxis due to thiopental sodium anesthesia.

Anaphylaxis due to an anesthetic is one type of cardiovascular emergency that can occur during general anesthesia. Anaphylactic reactions to muscle relaxants have been documented. Barbiturates, used as sedatives, are well known to produce cutaneous reactions, but anaphylaxis after their ingestion seems to be rare. Generalized allergic reactions to thiopental sodium during anesthesia are mentioned in the product monograph for Penthothal sodium, and rare case reports of anaphylactic reactions to infused thiopental have appeared, generally in the anesthesiology literature. Documentation of the immunologic responses to thiopental sodium has been limited to the demonstration of an allergic reaction to thiopental by skin testing in some cases. This report describes a woman who, after having tolerated thiopental sodium and other general anesthetics, became sensitive to this agent and had a severe acute reaction at the time of induction of general anesthesia.

Adult↗