Primary sensitivity to sulphonamide and secondary sensitization to aromatic amines.
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Biomedical subjects
Publications and source records attributed to P Rebandel.
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Dermatitis from 2-chloromethyl-4-phenyl-6-chloroquinazoline-3-oxide, an intermediate product in the preparation of chlorodiazepoxide, is described in 29 workers at a pharmaceutical plant. All were patch test positive to quinazoline oxide (1%) and six to 0.05%. In most patients, the face was earlier and more severely involved than the hands. Some were sensitized even if they did not have much contact with it, doing such work as washing the clothing of other workers, or working at a distance of 100 m from the production line building.
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Of 57 nurses suffering from dermatitis and having occupational contact with antibiotics 37 per cent exhibited positive tests with these drugs. Analogous figures for pharmaceutical industry workers were 34 subjects and 41 per cent and for veterinary surgeons 31 subjects and 29 per cent. A case of an ophthalmist sensitive to dethreomycin under occupational conditions was also recorded. Furthermore, six nurses exhibited inhalant allergy to penicillin manifested clinically by an anaphylactic shock or urticaria or, in two cases, by contact urticaria: one also due to penicillin and the other due to streptomycin.
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Of 182 subjects affected by occupational eczema only in 15% the eczema was found to be developed in the first three months. In 21.8% the diagnosis of occupational eczema was delayed by over 5 years. The methodological and social outcome of the delayed diagnosis was analysed.
Dermatoses characteristic for several branches of industry: metal, electrotechnical, photochemical and pharmaceutical and for laminators and galvanizers are discussed. The periods are given after which skin changes appear, their primary localisation and the allergens specific for the particular occupations. In photo-chemical industry workers, beside dermatitis. lichen planus was also noted.
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Three hundred sixty five children and hundred thirty nine adults with atopic dermatitis were divided into three groups. Group A included patients with negative family history of allergy; group B--allergy history in one parent or his family; group C--allergy in both parents or their families. It was found that total IgE level was higher in patients of group C in comparison with group A. Similarly, bronchial asthma and/or rhinitis coexisted more frequently, incidence of urticaria was higher and its onset earlier in patients of group C. The results noted in patients of group B occupied middle position between those in group A and group C. Results related to the incidence of RAST positive reactions and multiple sensitivity were similar but the differences were lower. Radioimmunologic assays were performed only in part of the tested patients.
The study involved 117 adults and 535 children with atopic dermatitis. Immunoglobulins E against D. pteronyssinus--main allergen of the home dust--were assayed with RAST technique in children and FAST technique in adult patients. It was found that the blood serum IgE levels increase with patients' age and is the highest in patients with coexisting allergic respiratory diseases (difference statistically significant). RAST precision was compared with that of "prick" skin tests in the detection of allergy to home dust mites. Desensitization of 15 patients with home mite allergen produced satisfactory effects.
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