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Biomedical subjects

W Aberer

Publications and source records attributed to W Aberer.

At least 91 records · Page 5Linked to original sources
PubMed1995

In vitro allergy testing needs better standardization--test results from different laboratories lack comparability mostly due to missing effective standards.

Correct determination of specific IgE is important for the diagnosis of allergic diseases. Different detection systems are supposed to yield similar results of this standardized parameter. In order to investigate this assumption, 40 sera from allergic patients were sent in eight mailings to 23 laboratories over a 2-year period. Three IgE determinations in each serum had to be performed according to laboratory-specific methods. Whereas 'wrong' results were rare with any of the methods and the overall results to a large degree comparable, sensitivity and specificity seemed to vary considerably between antigens, methods, companies and laboratories. According to our observations, better standardization of test reagents and test methods by the suppliers is essential in order to harmonize the test results and to avoid wrong conclusions. At present, the diversity of techniques that are used for IgE determination leads to quite divergent results, and the allergist has to know that. And finally, the legislator is urged to better control these diagnostic tools, because wrong results may lead to life-threatening situations.

Evaluation Studies as Topic↗
PubMed1995

Efficacy of cetirizine in cholinergic urticaria.

In order to examine the efficacy of cetirizine in cholinergic urticaria, we studied 24 patients in a double-blind crossover design during 3-week treatment periods, with either 10 or 20 mg/d cetirizine or placebo. The placebo period was always placed in between the two verum treatments to allow for a washout of the drug. Evaluation of the patients' daily symptom scores based on itching, erythema and whealing showed a highly significant improvement (p < 0.01). The percentage of days with mild or no symptoms was also increased significantly with the drug (p < 0.05). Except for whealing (p < 0.05), no significant differences between the two dosages of cetirizine could be determined. Since antihistamines have previously been shown to be frequently unsatisfactory in the treatment of cholinergic urticaria, the present data are encouraging regarding the control of symptoms in this condition.

Adult↗
PubMed1995

[Patch testing with the "Austrian standard series"--epidemiologic test values and results].

Patch testing for contact allergies is routinely performed by applying a "standard series" of the most frequently occurring contact allergens. Internationally "established" standard series have to be adapted to country- and population-specific factors (i.e., distribution of gender and age, occupational behavior, environmental factors etc.). In 1992 and 1993 altogether 11,690 patients were patch tested in 14 Austrian test centers with the "Austrian standard patch test series" as recommended by the working group "Contact Allergy" of the Austrian Society of Dermatology. Altogether data on 11,544 patients were complete and are analyzed in this study. 71.5% of the test population were female with an average age of 39 years, whereas the male patients had an average age of 40 years. 38.1% of the patients were younger than 30 years, 47.8% were in the group ranging from 31 to 60 years and 14% of the tested patients were older than 60 years. Cutaneous sensitization was found in 51% of the people tested with the "Austrian standard series". This proportion varied between 40.8 and 61.4% from center to center (with more than 100 tested persons). 15 (60%) of the 25 test substances in 1992 and 17 (68%) in 1993 surpassed the limit of a sensitization frequency of 1%. The "hit list" of substances did not differ qualitatively from those of other international studies, with only one remarkable, well described "Austrian-specific" exception, namely the mercury-containing thiomersal (second place).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1994

Reproducibility of patch tests. A multicenter study of synchronous left-versus right-sided patch tests by the German Contact Dermatitis Research Group.

BACKGROUND: The efficiency and reproducibility of patch tests remain controversial. OBJECTIVE: Our purpose was to determine the efficiency and reproducibility of patch tests and to identify factors influencing these features. METHODS: We double-tested 1285 patients concomitantly with 10 standard allergens by manually filled test chambers. Additional information was obtained from all patients with a standardized protocol. RESULTS: Patch test efficiency was good (> or = 0.94) with all 10 allergens. In contrast, nonreproducibility of patch tests was strongly allergen dependent, ranging from 0.2 for nickel sulfate to 0.6 for formaldehyde. The likelihood of nonreproducible allergic reactions increased when more than four positive reactions were seen at the same time, and with another positive reaction located in close proximity to an allergic reaction. Sex and age of patients, atopy, dermatitis at distant sites, sleeping habits, and the time of allergen exposure (24 or 48 hours) did not affect the rate of nonreproducible results. CONCLUSION: To increase patch test reproducibility, specific preparations of patch test allergens need to be improved. Furthermore, amplification effects by synchronous neighboring positive reactions should be excluded.

Allergens↗
PubMed1993

Palladium in dental alloys--the dermatologists' responsibility to warn?

Palladium is increasingly used in industry, but also in fine jewelry and in dentistry. Thus, palladium-silver alloys comprise a substantial part of the noble metal ceramic alloy sales in Western countries. The increased use of this metal seems, however, to be paralleled by a rise in the number of reports of palladium allergy. Recently a European study reported a sensitization rate of 2.8%. In Austria, where palladium has started to displace amalgam in dental fillings because of concerns about mercury toxicity, and gold due to price factors, we have found a sensitization rate of 8.3% in unselected eczema patients. Despite the current lack of clear clinical relevance of this finding, these numbers should motivate us to question this substance as "the alloy of the future".

Burning Mouth Syndrome↗
PubMed1993

[Benzalkonium chloride--a relevant contact allergen or irritant? Results of a multicenter study of the German Contact Allergy Group].

At eight dermatological clinics, a total of 2146 patients were tested between May 1990 and December 1991 to determine the significance of the preservative benzalkonium chloride in inducing allergic contact dermatitis and to evaluate recommendations for patch testing. In 225 cases an allergic reaction was proven, with 258 irritant reactions in addition. Only 12 cases were clinically relevant. Therefore, benzalkonium chloride is considered a weak allergen. A doubtful (erythema) or an incipient positive (with occasional papules) reaction may be regarded as an irritant reaction. In isolated cases a "repeated open application test" (ROAT) should be applied to determine clinical relevance. Our recommendation for patch testing is 0.1% benzalkonium chloride in vaseline, and also in water for special cases.

Benzalkonium Compounds↗
PubMed1993

[Epidemiology and diagnosis of allergic diseases].

Epidemiological studies indicate a world-wide and significant increase in atopic diseases over the past decades, which has adopted alarming dimensions within the industrialized world. However, allergic asthma and pollinosis, in particular, are on the increase in Third world countries, in parallel to the industrialization and westernization of their life-style. Since both antigen exposure and the presence of additional realization factors are required for the manifestation of atopic diseases, this increase in prevalence is not surprising. In addition to increased indoor and outdoor pollution, changes in the way of living--causing increased allergen exposure--certainly play an important role as cofactor in the increased incidence of allergies. Accurate diagnostic procedures permit a better understanding of the realization factors for allergic diseases in epidemiological studies and identification of the causative agent in the individual so that effective therapeutic and prophylactic steps can be taken. Despite improved in vivo and in vitro test methods, the case history is still of paramount importance in reaching a diagnosis; the potential hazards of skin and provocation testing, as well as the high costs and limitations of in vitro methods prohibit "blind allergy screening".

Adolescent↗
PubMed1992

Drug eruptions from mesna. After cyclophosphamide treatment of patients with systemic lupus erythematosus and dermatomyositis.

BACKGROUND: Mesna is used to abolish urotoxicity of cyclophosphamide and related compounds in immunosuppressive and antineoplastic treatment schedules. Adverse reactions to this drug have been reported only rarely. OBSERVATIONS: Drug eruptions to mesna have developed in seven of 15 patients with autoimmune disorders treated with monthly pulses of intravenous cyclophosphamide. Two different types of drug eruptions were observed: five patients had development of a macular and partly papular or urticarial rash and angioedema and two patients had a generalized fixed drug eruption, primarily and predominantly at the sites of previous skin lesions of their underlying condition. The results of prick, patch, and intradermal tests were similar in both types of rash; however, the two patients with fixed drug eruption had developed a generalized eruption upon prick testing with mesna. CONCLUSIONS: Two distinct eruptions to mesna have been induced in these patients during cyclophosphamide/corticosteroid therapy; these eruptions are not thought to share a common pathogenic mechanism. The results of skin and challenge tests do not support the hypothesis that a type 1 or a type 4 immune reaction may be responsible for these eruptions. The unusually high incidence (about 50%) of these reactions and their clinical presentation make it important to distinguish them from an exacerbation of the preexistent autoimmune disorder.

Adult↗
PubMed1992

[Quality control in the allergy laboratory--4 years "Allergy Ring Trial" in Austria].

In 1988 the Austrian Society for Allergology and Immunology initiated an external quality control program for the in vitro allergy diagnosis. In 12 mailings, 62 sera from allergic patients were sent to selected laboratories in order to determine total and antigen specific IgE according to the laboratory-specific methods. The values for total IgE varied considerably (73.9% were within +/- 1 SD, 94.3% within +/- 2 SD and 99.1% within +/- 2 SD, but only 0.9% beyond that). Sources of error were mainly attributable to inappropriate equipment and low quality reagents, but also bad test performance, with respect to personnel and the routines. In contrast, antigen specific IgE against pollen, mites, moulds, insect venoms, animal danders, drugs, parasites, environmental and food antigens revealed quite homogeneous results. Out of 1492 data, only 46 (3.1%) had to be declared as "wrong", and the variability of the RAST-classes was low. Whereas the quality of the reagents from all the different suppliers was not absolutely reliable at the beginning of the study, it improved considerably with time, as consequence of our complaints. The comparability of the methods for detecting total-IgE were non-satisfactory, whereas those for antigen specific IgE were generally good. The variety of methods employed (radio- and enzyme immunologic, fluoro- and nephelometric methods, etc.) should entail appropriate consequences, especially critical comparisons within one and the same laboratory; in addition, international standardization of the "normal" values should replace company-standards, and quality control programs for each test system before it is marketed should be mandatory. Our results confirm, that external control should be obligatory for any laboratory.(ABSTRACT TRUNCATED AT 250 WORDS)

Allergens↗
PubMed1991

Clinical characteristics of patients with repeated systemic reactions during specific immunotherapy with hymenoptera venoms. A retrospective study.

In general, specific immunotherapy with hymenoptera venoms can be considered as safe, but occasionally there are patients who cannot reach the maintenance dose due to repeated systemic reactions (RSR) or who suffer from RSR during maintenance therapy. In a multicenter retrospective study comprising seven departments in Germany, Austria and Switzerland 23 patients with RSR were reported from approximately 3000 patients treated with hymenoptera venoms (bee and wasp venom to approximately equivalent frequency). From these, 22 were allergic to bee venom and only one to vespid venom. In general the clinical symptoms of RSR were milder than the initial reaction. But 4/23 (18%) exhibited cardiovascular reactions up to full shock. Neither anamnestic details, reactivity in skin tests or in vitro tests revealed a special pattern of patients with RSR. In some patients, however, an extremely high reactivity in the skin test was found and may indicate the possibility of further RSR.

Adolescent↗
PubMed1991

Vaccination despite thimerosal sensitivity.

Thimerosal sensitivity is extremely common in Austria, being surpassed as a contact allergen only by nickel. This high incidence is still rising and is probably due to the frequent vaccinations which are performed in Austria. Most of the patch-test-positive patients had recently been immunized with thimerosal-containing vaccines, and no other obvious sources of exposure to thimerosal could be found. On retrospective questioning, 48 out of 50 patients had had no problems with their recent immunization; the 2 who reported massive local reactions had received their injections, against the recommendation of the manufacturer, subcutaneously. In a prospective study, 12 thimerosal-sensitized persons received their follow-up immunization at our department, and no side effects occurred. This enables us to conclude that sensitization had occurred through vaccines, but that those amounts of thimerosal delivered i.m. are not sufficient to elicit clinical symptoms. Patch-test positivity to thimerosal thus represents no contra-indication to i.m. immunization with thimerosal-containing vaccines.

Adolescent↗