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Lymphocyte subset distribution in apparently normal and single intradermal test-positive water buffaloes analyzed by flow cytometry.

Monoclonal antibodies (mAbs) against bovine lymphocyte cell surface antigens namely, MHC Class I, MHC class II (DP, DQ and DR), CD3, CD4, CD8, gamma delta TCR, WC1N1 and WC1N2, were tested for their reactivity on apparently normal buffalo mononuclear cells prepared from spleen, lymph nodes and peripheral blood. All the mAbs cross-reacted with the buffalo mononuclear cells. The mean (+/-SD) CD4:CD8 cell ratio in the peripheral blood of apparently normal buffaloes was 1.08+/-0.049 while in the spleen and lymph nodes it was 0.90+/-0.080 and 1.81+/-0.430, respectively. The lymphocyte subsets in the buffaloes positive for tuberculosis by the single intra dermal (SID) test was found to be altered; the CD4 cells were reduced while the CD8 and gamma delta cells were increased. The mean CD4:CD8 ratio in the SID positive buffaloes was 0.36+/-0.010.

Animals↗

Herd-based monitoring for tuberculosis in extensive swedish deer herds by culling and meat inspection rather than by intradermal tuberculin testing.

The effect of random slaughter and meat inspection as a tool to detect or eradicate tuberculosis in large, extensive deer herds in Sweden was evaluated. A computer spreadsheet model based on the Reed-Frost method was developed. Numbers of new infections and of infected deer slaughtered as well as probability of detecting tuberculosis or slaughtering all infected deer in a herd, were simulated. The model predicted that, given a 20% annual slaughter and that disease was introduced with one infected deer, the infection would be detected or eliminated in most herds (90%) after 15 years.

Abattoirs↗

[Substances responsible for peranesthetic anaphylactic shock. A third French multicenter study (1992-94)].

Since 1989, the epidemiological survey of anaphylactoid reactions occurring during anaesthesia is obtained in France with repeated inquiries by the Perioperative Anaphylactic Reactions Study Group. The members of this group collect during the study period the cases of patients having suffered from an anaphylactoid reaction and tested in their allergo-anaesthetic outpatient clinic, their characteristics (age, gender), the results of the allergological tests (mechanism, agents responsible for the reactions). The two previous surveys published in the Annales françaises d'anesthesie et de réanimation in 1990 and 1993 included 1,240 and 1,585 patients respectively. The current survey concerned 1,750 patients tested in 27 diagnostic centres, from January 1992 to June 1994. The reactions occurred at all ages, predominantly between 10 and 50 years, the sex-ratio (F/M) was 2.4. Allergological tests carried out to diagnose an immune mechanism for the shock were cutaneous tests in all centres (prick-tests in 21 centres, intradermal tests in 27 centres) using the same dilutions for the tested agents and the same threshold for positivity. Specific IgE antibodies against muscle relaxants, thiopentone and propofol, were measured by radio immunoassays in 20 centres. The leucocyte histamine release test was used in 10 centres. The immune origin of the shock--IgE dependent anaphylaxis--was diagnosed in 1,000 patients (57.8%) and due to 1,030 agents muscle relaxants (59.2%), latex (19%), hypnotics (5.9%), benzodiazepines (2.1%), opioids (3.5%), plasma substitutes (5%), antibiotics (3.1%) and other drugs given during anaesthesia such as aprotinine and protamine (2.2%). Suxamethonium was responsible for 39.3% of muscle relaxant anaphylaxis, vecuronium for 36%, atracurium for 14.5%, pancuronium for 4.8%, gallamine for 3.1% and alcuronium for 2.3%. The latter has been withdrawn from the French market in 1993. These differences in the incidence of reactions are correlated with the clinical use of muscle relaxants in France for vecuronium and atracurium, however not for suxamethonium, responsible for 39% of the reactions but representing only 5% of the muscle relaxants sold in France. The comparison with the two previous surveys confirms that the mechanism of more than half of the anaphylactoid reactions occurring during anaesthesia is of immune origin, due to specific IgE antibodies. It is therefore essential to systematically carry out an allergologic assessment several weeks after the reaction, in order to discard for the subsequent anaesthetics the agent(s) responsible for anaphylaxis. If the muscle relaxants remain the first drugs involved in shock occurring at induction, there is a significant increase in latex shock, as demonstrated by the three epidemiological surveys (0.5%, 12.5% and now 19%). The incidence of other anaesthetic agents, antibiotics and plasma substitutes remains unchanged.

Adolescent↗

[Intradermal tuberculin test].

Mantoux test expresses a delayed hypersensitivity induced after either BCG vaccination or a BK contact. In France, a purified protein fraction is used. The quality of technique and lecture are essential. The lowest positivity limit is > 5 mm. Sensitivity and specificity are imperfect. For the interpretation of positivity, the most important factors are the age of vaccination (the younger the child is, the lower the reaction is) and the infection prevalence rate in the group considered (the lowest it is, the highest a criteria may be used for induration > 15 mm). The background is most important for interpretation. The main situations are a postvaccinal test, a diagnosis of infection (or illness) or the environment of a contagious adult. A lot of situations are less clear and require the knowing of a risk factor (risk people, contagion...). In spite of these limits, Mantoux test is the only valid technique, useful when considered with other points: collective (prevalence of the illness in some groups) or individual (contagion, clinical or radiological signs...).

Adult↗

Eyelid dermatitis: experience in 203 cases.

Allergic contact dermatitis has been considered the most common of the many dermatologic conditions found with eyelid dermatitis. This is a retrospective study of 203 patients who presented with persistent or recurrent eyelid dermatitis with or without dermatitis elsewhere. Almost all underwent patch testing and, when indicated, radioallergosorbent test, skin prick and intradermal tests, and in many cases, usage tests as part of the workup. Relevant allergic contact dermatitis was found in 151 of 203 patients (74.%): 46 (23.%) had protein contact dermatitis, but only 7% had protein contact dermatitis without concurrent allergic contact dermatitis. Less than 1% had irritant dermatitis alone. Twenty-three patients had atopic eczema, of whom 16 also had allergic contact dermatitis, protein contact dermatitis, or both. Other conditions included seborrheic dermatitis (n = 11), psoriasis (n = 7), dry eyes (n = 9), and dermatomyositis or overlapping connective tissue disease (n = 7). Important sources of contact sensitivity include cosmetics, metals, topical medications including corticosteroids, eye medications, dust mites, animal dander, and artificial nails; only 5 cases were caused by nail lacquer. Eyelid dermatitis is a multifaceted clinical problem, but in this group of patients, allergic contact dermatitis was a common cause, even among those with atopic eczema.

Cosmetics↗

Short interval intradermal skin testing in farmed red deer (Cervus elaphus) inoculated with Mycobacterium bovis.

Two groups of 26 red deer (Cervus elaphus) were tuberculin skin tested for 41 weeks at three and six week intervals respectively, except at 17 weeks when the internal was two and five weeks. Seventeen weeks after the start of the experiment 36 deer were inoculated intratracheally with Mycobacterium bovis, and the remaining 16 were run in-contact. At six weeks post inoculation, 35 of the 36 inoculated deer reacted to the skin test with a mean skin thickness difference (STD) of 6.3 mm. In inoculated deer further testing led to a suppression of skin sensitivity which was significantly greater in the three-weekly tested group. There was no statistical difference in skin thickness response between 1 and 2 mg/ml bovine purified protein derivative (PPD). Of 454 tests on noninoculated deer (noninfected), 107 produced reactions. These reactions were small and 96% had a STD of less than 2 mm.

Journal Article↗

Drug skin tests in cutaneous adverse drug reactions to pristinamycin: 29 cases with a study of cross-reactions between synergistins.

The present study was made to determine the value of drug skin tests in patients with cutaneous adverse drug reactions (CADRs) due to a synergistin (pristinamycin) and to determine the frequency of cross-reactions between synergistins. 29 patients were referred during the onset of the CADR due to pristinamycin: 18 with maculopapular rash, 9 erythrodermas, 1 angioedema and 1 Stevens-Johnson syndrome. They all had patch tests with pristinamycin and, in most cases, with other synergistins [virginiamycin and dalfopristin-quinupristin (DQ)], prick tests (10 cases) and intradermal tests (IDT) (5 cases). Skin tests with synergistins were positive in 27 cases, patch tests with pristinamycin in 20/29 cases (69%), prick tests with pristinamycin in 3/9 cases on immediate (1 case) or on delayed (2 cases) readings, and IDT with DQ in 4/5 cases. Cross-reactions between synergistins occurred in 9/22 with virginiamycin and in 7/8 cases with DQ. Skin tests with synergistins are useful in investigating CADR due to pristinamycin. Synergistins are composed of 2 chains (1 depsipeptide and 1 macrocyclic lactone) with many structural analogies between all synergistins. According to the chemical structures and our results, it seems advisable to avoid all synergistins in patients with CADR due to pristinamycin.

Adolescent↗

Incidence of immediate sensitivity to Aspergillus fumigatus in a North American asthmatic population.

Allergic bronchopulmonary aspergillosis might be less frequent in North America because the incidence of immediate sensitivity by asthmatics to A. fumigatus is less. In order to check this hypothesis, 200 asthmatics were skin tested with two extracts of A. fumigatus which had been shown to produce positive reactions in fifty patients who had allergic aspergillosis. Of the asthmatics, 21.5% reacted to the commercial extract by prick testing and 39% by intradermal testing. Using an extract kindly provided by Professor Pepys, 19.5% reacted to a concentration of 1 mg/ml and 31.5% to 10 mg/ml. By the prick method, 21.5% reacted to both extracts. Specific IgE was measured with one of the extracts and a good correlation (r = 0.48) was found with the size of the prick reaction. The increase in specific IgE was reflected in the increase of total IgE (r = 0.84). The authors conclude that the incidence of immediate sensitivity to A. fumigatus in asthmatic patients in North America is at least equal to that found in the U.K.

Airway Obstruction↗

Hydrocortisone sensitivity. An investigation into the nature of the allergen.

11 patients, positive to tixocortol pivalate on patch testing, were tested intradermally with a variety of hydrocortisone analogues. Substitution at the C21 position had no effect on the occurrence of positive reactions to hydrocortisone, whereas alteration of any of the carbon rings significantly reduced the number of positive reactions. We suggest that the C17 side chain is involved in protein binding and subsequent presentation of antigenic sites on the carbon rings.

Administration, Topical↗