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At least 19 recordsLinked to original sources
PubMed1991

Skin prick testing using allergen-coated lancets: a comparison between a multiple lancet device and a single lancet applied with varying pressures.

Allergen-coated lancets have been developed to simplify skin prick testing. The effect of variation in application pressure on the response to prick tests was assessed in 20 atopic subjects, and the results compared to the response obtained with a newly devised multiple lancet device (MLD), capable of holding up to eight lancets and of providing a standardized application pressure. A positive weal (greater than or equal to 7 mm2) using light pressure occurred in 2/20 subjects, compared with 14/20 after moderate pressure. The largest weals were obtained using hard pressure and with the MLD (all 20 subjects obtained positive weals) and there was no significant difference in weal size between the two. There was evidence of a late reaction in 4/17 subjects with the MLD and with hard pressure applied to a single lancet, but in only one with moderate and in none with light pressure. Thus both the early and late skin responses are dependent on the pressure applied. The newly designed MLD allows skin prick tests to be performed using a standard pressure. It is also convenient for multiple allergen testing of uncooperative children.

Adult↗
PubMed1993

The batch-to-batch variation of the potency of dog- and cat-allergen-coated lancets. Evaluation by skin prick testing.

In clinical work I formed the impression that the potency of Phazet lancets, for cat and dog allergens, was lower than earlier and too low to diagnose all clinically sensitive children with cat and dog allergy. Therefore, I decided to investigate the potency of newly produced and several years old Phazet lancets coated with dog and cat allergens. Twenty-six adults with case histories of cat and/or dog allergy and skin reactive to extracts of either dog dander or cat epithelium were skin prick tested in duplicate with one old batch and one newly produced batch of Phazet dog and/or cat lancets as well as the in-house reference of cat and/or dog allergen, 100,000 BU/ml. The potency of Phazet lancets in relation to the standard was evaluated by the median slope of the allergen dose-response relationship. The potency of the old dog lancets (mean 48,900 BU/ml) was higher (NS) than that of the newly produced lancets (mean 28,000 BU/ml), and the potency of both types of lancets was significantly less (P < 0.001) than that of the dog allergen in-house standard. On the other hand, the potency of newly produced (123,000 BU/ml), but not old (108,000), cat-allergen-coated Phazet lancets was higher than that of the cat allergen in-house reference extract (P = 0.048). There was a marked variation in potency between patients. Most of this variation was due to factors varying between patients, not between lancets, indicating that the composition of the allergen on the lancets was partly different from that of the standard.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

[Comparative study of 3 types of lancets for performing prick tests].

Skin Prick Test is considered the cutaneous test of choice in rutinary clinical practice as well as in research. In the last 15 years a large number of lancets for puncture test have been developed looking for a higher level of standardisation and reproducibility. We have compared three lancets, two of them, NeoAbelló (NA) and Dome/Hollister Stier (DHS), used in puncture test and a third one, Blood Lancet (BL), in the modified prick test. Twenty-two patients sensitised to Phleum pratense were tested with the three lancets at three extract concentrations and histamine 10 mg/mL in duplicate. We compared their wheal sizes by means of parallel line assay, their reproducibility, frequency of bleeding wheals, the disturbance for the patient and the correlation between specific IgE and skin response. Wheal size was similar for puncture tests (DHS and NA lancets) and significatively lower than BL, being necessary to increase 1.9 times the extract concentration when using DHS and NA lancets to achieve the same wheal size than when using BL lancets (p < 0.01). Reproducibility with histamine was similar with the three lancets while with the extract was somehow better with puncture tests but without statistical significance. Bleeding was significantly more frequent with BL although this did not influence the results. Less pain was obtained with BL. Finally, correlation with specific IgE was slightly significant for NA and very similar for the other two. With these results in mind we think that any of the three lancets is valid for the diagnostic of the allergic patient. Nevertheless, puncture tests are probably the most suitable at a research level.

Adolescent↗
PubMed1999

Capillary blood sampling: relation between lancet diameter, lancing pain and blood volume.

The relation between pain of capillary blood sampling and lancet diameter was studied in 52 healthy subjects. The tips of six fingers were pricked with a Softclix(R) II lancing device using lancets with identical facet geometry but needle diameters of 0.3, 0.4 and 0.8 mm. Two penetration depths (0.9 and 1.2 mm) were applied. Pain intensity and blood volume were recorded.At a puncture depth of 0.9 mm, pain did not differ between the three lancets. Pain increased with penetration depth, and at 1.2 mm the thicker lancets were somewhat more painful than the thinner ones. Blood volumes increased with lancet diameter and penetration depth. If the pain for punctures providing just enough blood for a glucose test (>/=10 µl) was compared, there was no difference between the lancets.It can be concluded that lancet diameter is of minor importance for the patient. Copyright 1999 European Federation of Chapters of the International Association for the Study of Pain.

Journal Article↗
PubMed1983

Comparison of a new lancet and a hypodermic needle for skin prick testing.

Skin prick tests with a standard allergen panel were carried out in duplicate (one on each arm) on all patients referred to an allergy out-patient clinic. A new lancet with 1-mm point length and a disposable hypodermic needle were used. Patients were randomized to lancet-needle, lancet-lancet, or needle-needle, and the skin prick tests were done by experienced or inexperienced nurses. The mean of the biggest and smallest diameters was used as a measure of the size of the wheal. Skin reactions from a total of 142 patients were included. For both lancet and needle a significant difference was noted when comparing experienced versus inexperienced investigators' reproducibility expressed as coefficient of variation. There was no significant difference in reproducibility when comparing lancet and needle results, and no significant difference in wheal size when comparing with histamine references. Surprisingly, the reactions on left arms were generally larger than those on right arms.

Allergens↗
PubMed2001

An automatic incision device for obtaining blood samples from the heels of preterm infants causes less damage than a conventional manual lancet.

OBJECTIVES: To evaluate in a randomised blind study the effect on puncture site lesions of two different incision devices used to obtain blood samples from preterm infants by repeated heel sticks. SETTING: The neonatal intensive care unit at the Hospital for Children and Adolescents and Laboratory, Helsinki University Central Hospital. PATIENTS: A total of 100 preterm infants (birth weight below 2500 g) not previously subjected to heel stick sampling. INTERVENTIONS: The infants were randomly allocated to blood sampling from the heel with either a conventional manual lancet or an automatic incision device. The same type of lancet was used for any given baby throughout the study (2-21 days). MAIN OUTCOME MEASURES: The damage caused by sampling was evaluated using four criteria: bruising of the heel, inflammation of the heel, bruising of either the ankle or the leg, and skin healing at the puncture site. The evaluation was based on photographs presenting typical categories of each outcome. RESULTS: To obtain a sufficient volume of blood, on average 2.6 times more punctures were needed when the conventional manual lancet was used than when the automatic incision device was used. Heels punctured with the lancet had more bruising (100% v 84%) and more signs of inflammation (79% v 53%), and there was more bruising of the ankle or leg (92% v 53%) than when the automatic incision device was used. Skin healed equally rapidly in the two groups. CONCLUSION: The use of an automatic incision device for collecting repeated skin puncture samples from preterm infants is less traumatic than the use of a conventional manual lancet.

Blood Specimen Collection↗
PubMed1979

A new lancet for skin prick testing.

A new lancet with a point length of 1.0 mm suitable for skin prick testing is described. The weal reactions appearing after the use of histamine chloride 1 mg/ml and an extract of Phleum pratense in a 1 HEP concentration (1 histamine equivalent prick) prove suitable as regards size and reproducibility compared with the reactions produced by a more conventional prick test method. The new lancet simplifies the prick test procedure and does not require as much experience as do needles and longer lancets.

Adult↗
PubMed1992

A study of experimental lancets for blood collection to avoid bone infection of infants.

We describe a study made at two pediatric centers to test experimental lancets for blood collection by skin puncture of infants' heels or fingers. Our primary goal is to decrease the hazard of osseous injury while collecting adequate blood, by using three lancet widths at a constant length of 1.0 mm. The three widths used were 1.0, 1.25, and 1.5 mm. When success at skin puncture was defined rigidly on the basis of the blood volume obtained, the data show that success was related neither to the lancets' dimensions as tested nor to the age of the child, but rather to the phlebotomist's skill and experience, which improved with time.

Blood Specimen Collection↗
PubMed1970

Comparative studies of smallpox vaccination by the bifurcated needle and rotary lancet techniques.

Comparisons were made in groups of schoolchildren in New Delhi of the rotary lancet and bifurcated needle techniques for primary vaccination and revaccination against smallpox. Vaccines of 3 different titres were employed in the tests. The results indicate that the bifurcated needle technique is superior to the rotary lancet technique for both primary vaccination and revaccination, the percentage of major reactions in revaccinations in which the bifurcated needle technique was used being significantly higher, irrespective of the vaccine dilution. However, the proportion of major reactions decreased gradually in both techniques with the greater dilution of the vaccine.It was shown that when a fully potent vaccine is used there is no advantage in making 2 insertions by the bifurcated needle technique but that when the rotary lancet technique is employed and when the vaccine is not fully potent there is a significant improvement in the successful take rate when 2 insertions are given. In areas where storage facilities for vaccines in the field are not ideal and the full potency of vaccines is doubtful, the use of the bifurcated needle technique with 2 insertions seems to be the method of choice.

Child↗
PubMed1999

Disclosure of researcher contributions: a study of original research articles in The Lancet.

BACKGROUND: Authorship disputes and abuses have increased in recent years. In response to a proposal that researcher contributions be specified for readers, The Lancet began disclosing such contributions at the end of original articles. OBJECTIVE: To analyze the descriptions researchers use for their contributions and to determine how the order of names on the byline corresponds to these contributions, whether persons listed on the byline fulfill a lenient version of the criteria for authorship specified by the International Committee of Medical Journal Editors (the Vancouver Group), and whether the contributions of persons listed as contributors overlap with the contributions of those who are acknowledged. DESIGN: Descriptive study. MEASUREMENTS: A taxonomy of researchers' contributions was developed and applied to researchers' self-reported contributions to original research articles published in The Lancet from July to December 1997. RESULTS: Contributors lists occupied little page space (mean, 2.5 cm of column length). Placement on the byline did not indicate the specific category of task performed, although the first-contributor position corresponded to a significantly greater number of contributions (mean numbers of contributions: first-contributor position, 3.23; second-contributor position, 2.51; third-contributor position, 2.20; and fourth-contributor position, 2.51) (P < 0.01). Forty-four percent of contributors on the byline did not fulfill a lenient version of the Vancouver Group's criteria for authorship. Sixty percent of the most common categories of activities described on contributors lists overlapped with those on acknowledgements lists. CONCLUSIONS: Publication of lists that specify contributions to research articles is feasible and seems to impart important information. The criteria for authorship outlined by the Vancouver Group do not seem to be congruent with the self-identified contributions of researchers.

Authorship↗
PubMed1998

Evaluating the BMJ guidelines for economic submissions: prospective audit of economic submissions to BMJ and The Lancet.

CONTEXT: Editorial management of articles on health economics may benefit from guidelines for peer review and revision. OBJECTIVE: To assess whether publication (in August 1996) of the BMJ guidelines on peer review of economics submissions made any difference to editorial and peer review processes, quality of submitted manuscripts, and quality of published manuscripts. DESIGN AND SETTING: Before-after study conducted in the editorial offices of BMJ and The Lancet of the effect of the BMJ guidelines on review and revision of economics submissions, defined as those making explicit comments about resource allocation and/or costs of interventions. MAIN OUTCOME MEASURES: Editorial fate and changes in the quality of submissions. RESULTS: A total of 2982 manuscripts were submitted to the 2 journals during the before periods, 105 (3.5%) of which were economics submissions. Of these, 27 (24.3%) were full economics evaluations, and 78 (75.7%) were other economics submissions. Overall acceptance rate was 11.6% (12/105). During the after period 2077 manuscripts were submitted to the 2 journals, 87 (4.2%) of which were economics submissions. Eighteen (20.7%) were full economics evaluations, and 69 (79.3%) were other economics submissions. Overall acceptance rate was 6.9% (6/87). Although a number of manuscripts could not be traced to determine whether they were economics submissions, there appeared to be little difference between the 2 journals in numbers or editorial fate of the manuscripts. There was no change in the quality of submitted manuscripts, but BMJ editors found the guidelines and checklists useful and sent fewer economics submissions for external peer review in the after phase. CONCLUSIONS: Publication of the guidelines helped the BMJ editors improve the efficiency of the editorial process but had no impact on the quality of economics evaluations submitted or published.

Economics↗
PubMed1992

The Lancet's statistical review process: areas for improvement by authors.

The Lancet now incorporates statistical review of submitted papers which remain candidates for publication after conventional review. We summarise here criticisms noted by the statistical reviewers for 191 such papers received between November, 1990, and June, 1991. Only 54% of papers were deemed acceptable or acceptable after revision; the others were either recommended for rejection (14%) or for more substantial revision and re-review (32%). Descriptions of methods and of results were found inadequate in about half of the papers; about one-quarter of papers had inadequate abstracts and conclusions. Major errors of inference were made in 48 papers and went hand in hand with major criticisms of analysis or design in those papers. The natural focus of statistical review is whether conclusions drawn are justified by study design and statistical analysis. In this, there is room for improvement by authors.

Bias↗
PubMed1998

175 years at The Lancet. The editors.

The founder of The Lancet, Thomas Wakley, is well known as a powerful figure whose outspoken and radical views dominated the journal over many decades. His influence went beyond his own term as editor, as the journal was handed first to one son, then the other, and finally to his grandson. The Wakley dynasty ran the journal for 85 years but the 20th century demanded new approaches, and a series of remarkable men took charge of the journal and steered it through the fast-changing world of medicine and journalism. Continuity was maintained by the practice of appointing, In most cases, from within the existing staff of the journal. The story of the editors is the story of the journal itself. These were men of their time--no women so far--who stamped their own ideas on the journal, but who did so within the framework of reliable and radical reporting which the Wakleys established. There have been only 12 editors during the journal's 175-year existence, and their biographies provide a rare insight into the interface between personal qualities and professional achievements during this period.

England↗
PubMed1998

Out of step with the Lancet homeopathy meta-analysis: more objections than objectivity?

The meta-analysis of homeopathy trials that appeared in the Lancet in 1997 seemed to endorse the experience of practitioners and patients that homeopathic medicines have specific clinically relevant effects. However, results from later unsuccessful trials, and negative inferences from a review of trials for a condition excluded from the meta-analysis--delayed onset muscle soreness (DOMS)--have since been presented to suggest that the meta-analysis may well have overestimated the positive effects of homeopathy, and that the "placebo question is still not resolved." This article reviews the evidence underlying this challenge to the meta-analysis and homeopathy, and demonstrates that it would be valid if it were based on: a comprehensive literature search; appropriate classification of primary studies; clear discrimination between clinical effectiveness and placebo questions; sound and transparent review methods; and a reliable and unconfounded clinical treatment model for testing the ultramolecular hypothesis. It is suggested that different models are needed to answer different questions.

Bias↗
PubMed1988

Allergy screening including a comparison of prick test results with allergen-coated lancets (Phazet) and liquid extracts.

During an allergy screening of families with a history of allergy in one or more subjects, skin prick tests (SPT) were performed in duplicate in 314 adults. The tests were performed with a new type of lancet with a 0.9 mm long point, loaded either with allergen (Phazet) or used together with standardized extracts (10,000 and 100,000 BU/ml). Wheals obtained with both methods were compared, and related to total IgE concentrations and history. A wheal area of 3 and 7 mm2 was used as cut-off limit. Results with Phazet were close to those with Pharmalgen 100,000 BU/ml. With both methods precision was good for allergens, but less for Phazet histamine than for the corresponding wet test. SPT results obtained with Phazet and 100,000 BU/ml correlated better with history than the results with 10,000 BU/ml. Using a wheal size of 7 mm2 as cut-off limit the efficiency for five tested allergens was 91%. "False positive" tests, possibly indicating an unobserved or latent type of allergy, were found more often with higher serum IgE concentrations. The safety of SPT was confirmed and Phazet was well accepted by nurses and tested subjects.

Adult↗
PubMed1989

Allergen-coated lancets (Phazet) for skin prick testing in children.

With a new allergen-coated lancet (Phazet), skin prick tests can be made directly on the skin without separate use of liquid extract (the Phazet dry method), and reactions are recorded as for the ordinary method with liquid allergen extract (Pharmalgen) (the Pharmalgen wet method). 100 children were tested in parallel with the two methods. As a double control each Phazet was used twice (Phazet 1 and 2) in each child, who was tested with nine standard allergens. Good agreement was found between the results obtained with the two methods and also between Phazet 1 and Phazet 2. No general reactions were shown in relation to the numerous skin prick tests with allergen extract of a strength up to 100,000 BU/ml. 66% of the children preferred the Phazet while 22% had no preference.

Adolescent↗