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Patch testing in children, adults, and the elderly: influence of age and sex on sensitization patterns.

Patch testing was done on 2776 consecutive patients (76.5% female) with a locally revised standard series of 34 contact allergens and the results analyzed for age- and gender-specific differences. At least one positive epicutaneous test reaction occurred in 48.9% of patients. Nickel (20.9%), ethylmercuric chloride (13.2%), thimerosal (11.8%), fragrance mix (9.3%), metallic mercury (8.9%), palladium (5.8%), balsam of Peru (3.8%), copper (3.7%), cobalt (3.3%), and chromium (2.3%) were the 10 most important sensitizers. The following tested allergens with sensitization rates of more than 1% were not part of the usual standard series: ethylmercuric chloride, metallic mercury, copper, propolis (1.3%), propylene glycol (1.0%). Reactions to nickel, cobalt, and palladium, but not to chromium, were significantly more abundant in females (p < 0.002, chi-squared test). The overall sensitization rate was highest in children less than 10 years old (62%) and decreased steadily, to be lowest among patients more than 70 years old (34.9%). The rate of positive reactions to nickel and thimerosal decreased with age, while fragrance mix and metallic mercury stayed at the same level through all age groups.

Adolescent↗

[Phlebotomine sandflies from Madagascar (Diptera: Psychodidae). IV--Description of Sergentomyia (Rondanomyia) goodmani n. sp. Reinstatement of the subgenus Rondanomyia Theodor].

This work is the fourth related to species recently described from Madagascar. The authors describe Sergentomyia goodmani on females and males. The female has tubular spermathecae with internal spines. It has an aspect, in Canada balsam, of transversally striped spermatheca, without being completely segmented. The spermathecal ducts share a proximal common part. The pharynx is narrow. The cibarial armature is comb-like. Based on these characters, the authors consider that S. goodmani belongs to the subgenus Rondanomyia. They reinstate this subgenus and consider Neophlebotomus sensu Lewis, 1977 as invalid. Considering Grassomyia as a genus, this is the first record of Sergentomyia in Madagascar.

Animals↗

Delayed readings of a standard screening patch test tray: frequency of "lost," "found," and "persistent" reactions.

BACKGROUND: Several studies have shown that patch test results vary depending on the time at which the patch test sites are evaluated. OBJECTIVE: This study aims to determine the frequency of "lost," "found," and "persistent" reactions to a standard screening tray by comparing initial and delayed readings of the same patch tests. METHODS: We performed a retrospective review of patch test reactions for 587 patients tested with the standard screening tray at The Cleveland Clinic Foundation (Cleveland, OH) between January 1, 1988, and December 31, 1991, for which an initial day-3 and delayed day-4 to day-8 readings were available. RESULTS: For the 587 patients, we identified 81 found (15%), 342 persistent (62%), and 127 lost (23%) reactions, for a total of 550 reactions (100%). The three most common found reactions were to neomycin sulfate (n = 19; 53%), p-phenylenediamine (n = 10; 29%), and thiomersal (n = 10; 18%). The three most common persistent reactions were to thiomersal (n = 41; 73%), nickel sulfate (n = 33; 73%), and quaternium 15 (n = 32; 74%). The three most common lost reactions were to balsam of Peru (n = 14; 39%), benzoyl peroxide (n = 12; 63%), and nickel sulfate (n = 9; 20%). CONCLUSION: Two patch test readings are necessary, followed by a final interpretation.

Dermatitis, Allergic Contact↗

Allergic contact dermatitis to latanoprost.

An 85-year-old male with glaucoma presented with a 1-1/2 year history of tearing; red eyes; and pruritic, edematous, eczematous eyelids. Treatment for presumed ocular rosacea and seborrhea was unhelpful. Patch testing to our standard 64 antigens yielded a positive reaction to Balsam of Peru. Notably, benzalkonium chloride, thimerosal, and other preservatives elicited negative reactions. Repeat open application testing elicited positive results to Xalatan (latanoprost) 0.005% ophthalmic solution (Pharmacia & Upjohn, Kalamazoo, MI). A second session of patch tests to 10 personal products, in addition to Xalatan 0.005% solution and the Xalatan vehicle (provided by the manufacturer), elicited a strong positive reaction only to the full preparation of Xalatan 0.005% solution. This report describes the first known case of ACD to latanoprost, a new prostaglandin analog that is widely prescribed for treatment of glaucoma.

Aged↗

Concomitant positive reactions to allergens in a patch testing standard series from 1988-1997.

BACKGROUND: Patch testing is a useful diagnostic technique in patients with suspected allergic contact dermatitis (ACD). Concomitant reactions may reflect associations between tested allergens. OBJECTIVE: This study was performed to identify positive correlations between reactions to test substances in a standard screening series. The results of patch testing in patients seen from 1988 to 1997 are described. METHODS: Data were collected from chart review for patients who underwent patch testing to the full standard screening series at the Massachusetts General Hospital Contact Dermatitis Clinic. The Fisher exact test was used to evaluate associations between allergens. RESULTS: A total of 927 patients were patch tested to 22 allergens included in a screening tray. The mean age was 43.9 years, and 68.6% were women. Two or more positive reactions occurred in 36.5% of patients. Reactions to 13 pairs of allergens were found to be significantly correlated: balsam of Peru/fragrance mix, carba mix/thiuram mix, carba mix/paraben mix, cobalt chloride/potassium dichromate, cobalt chloride/nickel sulfate, ethylenediamine/neomycin sulfate, formaldehyde/imidazolidinyl urea, formaldehyde/paraben mix, formaldehyde/quaternium-15, imidazolidinyl urea/quaternium-15, neomycin sulfate/potassium dichromate, paraben mix/quaternium-15, and potassium dichromate/thimerosal. CONCLUSION: Concomitant reactions to 13 pairs of allergens in a standard series occurred at a rate greater than would be predicted by chance. Such associations may reflect cross-sensitization or cosensitization.

Adult↗

Allergic contact dermatitis to benzyl alcohol in a hearing aid impression material.

A patient with allergic contact dermatitis caused by benzyl alcohol in a hearing aid impression material and in topical medications is described. In addition, the patient had topical and probably systemic corticosteroid allergy. Benzyl alcohol allergy is reviewed. allergic contact dermatitis is the most commonly reported allergic reaction to benzyl alcohol. There is also 1 report of contact urticaria. Balsam of Peru patch tests are frequently positive. Reported allergic reactions to injected benzyl alcohol include generalized urticarial reactions, 1 generalized maculopapular reaction and 1 delayed localized reaction.

Aged↗

Genetic variation of the bud and leaf phenology of seventeen poplar clones in a short rotation coppice culture.

Leaf phenology of 17 poplar ( Populus spp.) clones, encompassing spring phenology, length of growth period and end-of-year phenology, was examined over several years of different rotations. The 17 poplar clones differed in their latitude of origin (45 degrees 30'N to 51 degrees N) and were studied on a short rotation experimental field plantation, situated in Boom (province of Antwerpen, Belgium; 51 degrees 05'N, 04 degrees 22'E). A similar, clear pattern of bud burst was observed during the different years of study for all clones. Clones Columbia River, Fritzi Pauley, Trichobel (Populus trichocarpa) and Balsam Spire (Populus trichocarpa x Populus balsamifera) from 45 degrees 30'N to 49 degrees N reached bud burst (expressed as day of the year or degree day sums) almost every year earlier than clones Wolterson (Populus nigra), Gaver, Gibecq and Primo (Populus deltoides x Populus nigra) (50 degrees N to 51 degrees N). This observation could not be generalised to end-of-season phenology, for which a yearly returning pattern for all clones was lacking. Late bud burst and early leaf fall of some clones (Beaupré, Boelare, IBW1, IBW2, IBW3) was brought about by increasing rust incidence during the years of observation. For these clones, the variability in leaf phenology was reflected in high coefficients of variation among years. The patterns of genetic variation in leaf phenology have implications for short rotation intensive culture forestry and management of natural populations. Moreover, the variation in phenology reported here is relevant with regard to the genetic mapping of poplar.

Genetic Variation↗

[Allergies in adults].

Only few epidemiological studies have assessed allergic diseases in adults. In a follow-up study of the MONICA survey S3 (1994/95), which was performed 1997-1999, a total of 1,537 persons were interviewed and tested by skin prick and patch test. Furthermore data of the MONICA survey (RAST, cholesterol, food diaries) could be used. Within survey S4 (1999/2001) a total of 4,261 subjects were interviewed concerning their personal history of atopic diseases and the corresponding history of their partners. In survey S3 the prevalence of allergic sensitisation was 20.5 % for persons without formal graduation from school and 48.1 % for those with a university degree. 20.8 % reported a hypersensitivity to food and about one quarter exhibited a positive reaction in skin prick test. Atopic eczema and hay fever increased over quartiles of HDL cholesterol. Similar, allergic sensitisation (RAST) increased over quartiles of uptake of unsaturated fatty acids in men. 40 % of those who were patch tested exhibited a positive reaction, with perfume mix, nickel, thimerosal and balsam of Peru being the most prominent allergens. Inhabitants of the City of Augsburg were sensitised more often (34.0 % overall, 23.9 % pollen) than inhabitants of villages with (29.4 %, 17.0 %). Full time farmers were sensitised less frequently (22.0 %, 8.4 %). In survey S4 the lifetime prevalence of atopic diseases diagnosed by doctors was 5.1 % for atopic eczema, 6.1 % for asthma and 13.7 % for hay fever. Subjects who lived together with a partner who suffered from hay fever were affected in 19.6 % whereas 13.1 % had hay fever when the partner was not affected. Future studies will offer an unique opportunity to analyse the incidence and remission of manifestations of atopy in adults.

Adult↗

Comparative study of Finn Chambers and T.R.U.E. test methodologies in detecting the relevant allergens inducing contact dermatitis.

T.R.U.E. Test is a ready-to-use patch test system, which contains 23 allergens and is the only Food and Drug Administration-approved source of allergens currently commercially available in the United States. Previously, allergens dispersed in either petrolatum or water and designed to be applied utilizing Finn Chambers were also commercially available in the United States. During a 5-year study at the University of Kansas Medical Center, 167 patients were patch tested using both Finn Chamber and T.R.U.E. Test methodologies. Discordant positive reactions were examined for clinical relevance. The Finn Chamber methodology was superior in detecting clinically relevant allergies to fragrance mix, balsam of Peru, and thiuram mix. T.R.U.E. Test performed somewhat better than the Finn Chamber in detecting relevant allergic reactions to nickel, neomycin, and methylchloroisothiazolinone/methylisothiazolinone. Neither T.R.U.E. Test nor Finn Chamber methodologies performed optimally in detecting relevant allergies to formaldehyde and carbamates. Practitioners limited to only the T.R.U.E. Test methodology need to be aware that relevant reactions to fragrances, rubber accelerators/pesticides (carbamates and thiurams), and formaldehyde may be missed with this system.

Allergens↗

The effect of race and ethnicity on patch test results.

BACKGROUND: Allergic contact dermatitis is a condition that may be affected by differences in genetic and environmental factors. Race and ethnicity are possible examples of the former. OBJECTIVE: The objective of this study was to examine the differences in patch test results between white and black individuals tested by the members of the North American Contact Dermatitis Group from July 1, 1992, to June 30, 1998. METHODS: Patients evaluated in our patch test clinics were exposed to a standardized patch testing technique involving a standard series of 41 allergens in total. The standard series we used varied over the 6 years of the study in 2-year cycles. The series was the same at all centers during each of these 2-year cycles: 1992-94, 1994-96, and 1996-98. Over a 6-year period, our group tested 9624 patients. Of those individuals, 8610 (89.5%) were white and 1014 (10.5%) were black. RESULTS: Allergic contact dermatitis and irritant contact dermatitis were the final diagnoses assigned by the investigators to individuals of the 2 races: 49% and 16%, respectively, for the white patients and 46% and 15%, respectively, for the black patients. In at least one of the three 2-year periods, testing in white patients revealed higher rates of sensitization to formaldehyde, glutaraldehyde, and a number of the formaldehyde-releasing preservatives, as well as lanolin, epoxy resin, thioureas, and balsam of Peru. Black patients exhibited higher rates of sensitization to para-phenylenediamine, cobalt chloride, thioureas, and p-tert-butylphenol formaldehyde resin in at least one of the 2-year periods. CONCLUSION: In this test population, we found no differences in the overall response rate to allergens. There were some differences between white and black patients in their response to specific allergens. These differences, although possibly related to genetic factors based on race, are more likely related to differences in allergen exposure determined by ethnicity.

Allergens↗

Oxidized citrus oil (R-limonene): a frequent skin sensitizer in Europe.

BACKGROUND: Peel oil from citrus fruits consists of R-(+)-limonene, which is one of the most commonly used fragrance materials in technical products and in fine fragrances. This substance forms allergenic oxidation products during handling and storage. OBJECTIVE: We wanted to study the frequency of allergic reactions to oxidized R-(+)-limonene in patients with dermatitis and find a suitable test preparation. METHOD: Patch testing with oxidized R-(+)-limonene was performed on 2273 patients at 4 dermatology clinics in Europe. RESULTS: Of the consecutive patients tested, 3.8% to 3.9% had positive reactions in two of the clinics; 6.5% had positive reactions in the third clinic; and 0.3% had positive reactions in the fourth clinic. A total of 63 patients showed positive reactions. In total, 57% of the patients did not react to fragrance mix or balsam of Peru. We recommend testing with 3% oxidized R-(+)-limonene in patients referred for patch testing. CONCLUSION: The high frequency of oxidized limonene allergy provides clinical evidence for the European classification of R-(+)-limonene that contains oxidation products as skin sensitizers.

Cosmetics↗

Does nutrition-related stress carry over to spruce budworm, Choristoneura fumiferana (Lepidoptera: Tortricidae) progeny?

Three different patterns of feeding of sixth-instar spruce budworm, Choristoneura fumiferana Clemens were simulated in the laboratory. Larvae were fed artificial diets whose nitrogen and total soluble sugar contents varied according to levels similar to those found in three types of balsam fir, Abies balsamea (L.) Miller foliage (current-year foliage from middle and lower crown sections and one-year-old foliage). The biological performance of offspring was studied according to the nutrition of their parents. Although food quality had no impact on pupal weight of female parents and individual mean egg weight, progeny fitness was influenced by parental nutrition. Old foliage simulated diet, poor in nitrogen, clearly affected the early larval development of progeny, especially the percent of egg hatch and first-instar survival. Lower crown current-year foliage simulated diet, with low total soluble sugar content, reduced the first-instar survival of the progeny. However, the selective pressure exerted by low food qualities on the parental generation and on the early stages of their progenies resulted in C. fumiferana populations having higher tolerance to starvation and higher survival after the diapause period. These results highlighted the potentially direct and indirect effects of C. fumiferana parental nutrition on the next generation. The patterns of feeding of parental generations would appear to affect the quality and size of subsequent populations through several selections on the different life-history stages of both generations.

Animals↗

Potential sources of sugar for the phlebotomine sandfly Lutzomyia youngi (Diptera: Psychodidae) in a Colombian coffee plantation.

Sugar-deprived Lutzomyia youngi were exposed to each of the five most numerous plant species in a Colombian coffee plantation for 24 h and then tested for the presence of fructose by the cold anthrone assay. Many flies exposed to coffee (Coffea arabica) (up to 55% in an individual test) and guamo (Inga edulis) (up to 28.0%) gave positive results. Although some flies also took sugar from red-flowered balsam (Impatiens balsamina) and bamboo (Bambusa angustifolia), none of the insects exposed to plantain (Musa paradisiaca) gave a positive result unless the plants were infested with aphids (Pentalonia sp.). Although sandflies were successfully marked in the laboratory by exposing them to coffee and guamo plants whose roots had been treated with RbCl at 5000 p.p.m., RbCl was not detected by atomic emission spectrometry in wild specimens caught in the vicinity of RbCl-labelled coffee and guamo.

Animals↗

The cucurbit images (1515-1518) of the Villa Farnesina, Rome.

BACKGROUND: The gorgeous frescoes organized by the master Renaissance painter Raphael Sanzio (1483-1520) and illustrating the heavenly adventures of Cupid and Psyche were painted between 1515 and 1518 to decorate the Roman villa (now known as the Villa Farnesina) of the wealthy Sienese banker Agostino Chigi (1466-1520). Surrounding these paintings are festoons of fruits, vegetables and flowers painted by Giovanni Martini da Udine (1487-1564), which include over 170 species of plants. A deconstruction and collation of the cucurbit images in the festoons makes it possible to evaluate the genetic diversity of cucurbits in Renaissance Italy 500 years ago. FINDINGS: The festoons contain six species of Old World cucurbits, Citrullus lanatus (watermelon), Cucumis melo (melon), Cucumis sativus (cucumber), Ecballium elaterium (squirting cucumber), Lagenaria siceraria (bottle gourd) and Momordica balsamina (balsam apple), and two or three species of New World cucurbits, Cucurbita maxima, C. pepo and, perhaps, C. moschata (pumpkin, squash, gourd). The images of C. maxima are the first illustrations of this species in Europe.

Botany↗

Virulence of a nucleopolyhedrovirus to Neodiprion abietis (Hymenoptera: Diprionidae).

Different larval stages of balsam fir sawfly, Neodiprion abietis (Harris) (Hymenoptera: Diprionidae), were challenged by different concentrations of a nucleopolyhedrovirus in the laboratory to determine larval susceptibility to the virus and to test treatment effects of the virus on the sawfly survivors. The results indicated that younger larvae were more susceptible to the virus than older instars. The speed of larval death depended on the larval age and the virus concentration. Generally, the virus killed second or third instars in approximately 5 d and fourth or fifth instars in 10-12 d at concentrations of 10(7) polyhedral inclusion bodies (PIB) /ml. The virus had profound treatment effects on sawfly survivors. Feeding activity of the survivors was reduced by > 40% compared with that of the control group, pupal weight by approximately 25%, and adult emergence by > 30%. There was also a higher percentage of male adults in the virus-treated groups than in the control.

Animals↗

Influence of larval stage and virus inoculum on virus yield in insect host Neodiprion abietis (Hymenoptera: Diprionidae).

Virus yield produced by dead larvae of balsam fir sawfly, Neodiprion abietis (Harris) (Hymenoptera: Diprionidae), that had been infected at four different larval stages (second, third, fourth, or fifth instar) with two virus concentrations (10(5) polyhedral inclusion bodies (PIB) /ml or 10(7) PIB/ml), were analyzed and compared to determine the effects of instar and amount of virus inoculum on virus production. The results indicate that both larval stage and inoculation dosage significantly affect virus yield. On average, each dead larva produced 1.36-12.21 x 10(7) PIB, depending upon larval age and virus concentration of inoculation. Although each dead larva produced more PIB when it was inoculated in the fourth or fifth stage, inoculation of these larvae did not result in the highest virus yield because of low larval mortality. In terms of net virus return, third instars would maximize virus yield when they are inoculated with a virus concentration that can cause 95-100% larval mortality.

Animals↗

Interaction between indole-3-acetic acid and ethylene in the control of tracheid production in detached shoots of Abies balsamea.

We investigated the interaction between indole-3-acetic acid (IAA) and ethylene in the regulation of the seasonal periodicity of tracheid production in 1-year-old balsam fir (Abies balsamea (L.) Mill.) cuttings collected at different times during the dormant period. The cuttings were left with their buds intact or were debudded and treated either apically with IAA or 2-chloroethylphosphonic acid (Ethrel) in lanolin, laterally with IAA or Ethrel in lanolin, or basally with Ethrel, Co(2+) or Ag(+) in deionized water. The treated cuttings were then cultured for up to 5 weeks under controlled environment conditions favorable for cambial growth. No change in ethylene evolution was detected during the rest-quiescence transition, when IAA-induced tracheid production increased. The induction of cambial reactivation by IAA was associated with a rise in ethylene evolution, but there was no consistent relationship among IAA concentration, tracheid number and ethylene emission. Neither Ethrel, Co(2+) nor Ag(+) affected tracheid production when applied basally, except for 10 and 100 micro M Ethrel and 100 micro M Co(2+), which were inhibitory. In contrast, ethylene evolution was promoted by Ethrel and inhibited by Co(2+), whereas Ag(+) had no effect. Similarly, applying Ethrel apically or laterally increased ethylene evolution, but did not promote tracheid production except in the treatment in which 1 mg Ethrel g(-1) lanolin was applied laterally to cuttings treated apically with 0.1 mg IAA g(-1) lanolin, and in the treatment in which 10 mg Ethrel g(-1) lanolin was applied laterally to budded cuttings. We conclude that (1) ethylene evolution is not specifically associated with IAA-induced tracheid production, (2) ethylene does not mimic the promoting effect of IAA on tracheid production, and (3) ethylene can promote tracheid production, but only when its application results in a localized unphysiologically high concentration in the cambial region, which, in turn, induces an accumulation of IAA.

Journal Article↗

Laterally applied Ethrel causes local increases in radial growth and indole-3-acetic acid concentration in Abies balsamea shoots.

The terminal (1-year-old) shoot of quiescent, two-year-old balsam fir (Abies balsamea (L.) Mill.) seedlings was ringed with lanolin containing 0, 1 or 10 mg g(-1) Ethrel, an ethylene-generating compound, and cultured for 6 weeks under environmental conditions favorable for growth. Bud break and the elongation of the current-year terminal shoot were monitored, and the subjacent previous-year terminal shoot that had been treated with Ethrel was harvested to measure stem radial growth by microscopy, shoot ethylene evolution by gas chromatography, and cambial region indole-3-acetic acid (IAA) concentration by combined gas chromatography-mass spectrometry. Compared with the lanolin controls, Ethrel at 1 and 10 mg g(-1) did not affect bud break or longitudinal growth, but stimulated tracheid production and bark increment up to about 2-fold at the application site, though not above or below it. In addition, the 1 and 10 mg g(-1) Ethrel treatments increased the cambial region IAA concentration about 3-fold and the evolution of ethylene at least 40-fold at the application site, compared with unwounded portions of both treated and control shoots. The 10 mg g(-1) Ethrel treatment also stimulated ethylene evolution about 10-fold, both above and below the application site. However, this stimulation was not associated with an elevation in cambial region IAA concentration. Similarly, the lanolin control treatment increased ethylene evolution at the application site about 10-fold, without affecting the cambial region IAA concentration. Our results suggest that the localized stimulation of radial growth in woody shoots ringed with Ethrel is mediated by an increase in IAA concentration, which in turn is induced by a threshold, abnormally high concentration of Ethrel-derived ethylene.

Journal Article↗