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Patients seeking dental treatment may have known or unknown underlying allergies. The manifestation of these immunological reactions may range from mild rashes to life threatening conditions such as laryngeal edema. A good understanding of the various drugs and dental materials which can cause these allergies are necessary to taking adequate precautions to prevent any untoward incidences. Apart from patients, allergic reactions to certain dental materials and substances can be also be seen in the dental health care providers. Clinical relevance: This article describes the various hypersensitivity reactions and highlight the dental considerations in managing these hypersensitivity reactions that can been seen during dental practice. [ABSTRACT FROM AUTHOR]

While it is difficult to imagine that before the late 1800s, surgeons in the theatre environment operated on patients without gloves, gloves are now a clinical necessity. Their use has risen exponentially over the last 30 years, along with concerns over staff and patient allergy and sensitivity to the natural rubber latex proteins used in their manufacture. Having used latex gloves for the better part of 35 years, the author recently evaluated a latex-free alternative. In this article, which presents a rationale for the introduction of a latex-free glove policy across NHS departments and trusts, particularly in theatre settings, the author presents his experience, together with cases from four other surgeons, as well as evidence from the literature regarding potential clinical outcomes, quality of life and cost-effectiveness associated with latex-free gloves. [ABSTRACT FROM AUTHOR]

An estimated 85% of individuals with spina bifida (SB) survive into adulthood, warranting SB-specific transition to adult healthcare guidelines to address the diverse and complex medical, adaptive, and social needs particular to this condition. Latex allergy constitutes one important health concern for this population that requires ongoing and life-long evidence-based management. This article discusses management of latex allergy according to the SB Latex Allergy Healthcare Guidelines from the 2018 Spina Bifida Association's Fourth Edition of the Guidelines for the Care of People with Spina Bifida, reviews current care models in which such latex allergy guidelines can be implemented, and explores further relevant research topics in SB care relative to latex allergy. [ABSTRACT FROM AUTHOR]

Sterile protective gloves are used to reduce the risk of infection for patients and clinicians in all healthcare settings. This is particularly important in operating theatres, where surgical site infection is a common and serious complication for perioperative patients. These gloves have traditionally been made from natural rubber latex and dusted with cornstarch powder. However, frequent use of latex gloves can lead to a hypersensitivity or allergy to latex. A latex allergy causes discomfort and inconvenience, and it may reduce productivity, impose significant financial burdens and even be life threatening. There has not been sufficient evidence to ban the clinical use of latex; however, in cases of suspected latex allergy, guidelines recommend the use of either latex-free gloves or powder-free, low-protein latex gloves. The use of these alternative gloves has typically been limited to cases of allergy, because they have previously been associated with reduced dexterity and durability compared with latex gloves. This article presents four case studies, in which health professionals in a perioperative setting compare the advantages and disadvantages of using traditional latex surgical gloves with those of latex-free gloves manufactured by Cardinal Health. The findings of these case studies suggest that these latex-free gloves are equal to latex gloves in terms of establishing asepsis and providing comfort and dexterity to the wearer, without presenting the risk of developing latex sensitivity and/or allergy. [ABSTRACT FROM AUTHOR]

Occupational latex allergy is a common yet frequently neglected issue among healthcare workers. This study aims to highlight the issue of failure to diagnose work-relatedness, which leads to a series of cascading failure and suboptimal management of occupational latex allergy. This is the case whereby a nurse from a tertiary hospital in whom occupational latex allergy were identified, is being suboptimally managed medically and occupationally for many years. A series of cascading failure beginning from failure to recognise the work-relatedness nature of the condition, inevitably leading to failure of notification as occupational disease, hence failure to conduct appropriate investigation and intervention at the workplace, and ultimately failure to build a healthy workplace culture has been identified as important determinants leading to suboptimal management of occupational latex allergy. This report highlights the shortcomings among the patient, the treating physician, as well as the workplace manager with resultant series of cascading failure leading to failure of recognition and suboptimal management of occupational latex allergy. [ABSTRACT FROM AUTHOR]

Background: Urethral stricture is an abnormal narrowing or loss of distensibility of any segment of the urethra surrounded by corpus spongiosum. In the last two decades, there has been a change in the pattern of aetiology of urethral stricture in urban centres in Nigeria with a shift away from post-infective strictures to the emergence of traumatic and iatrogenic causes. Objective: This study aims to present our observation of the occurrence of long-segment urethral strictures in patients after urethral catheter placement for various indications. Methodology: This is a descriptive, cross sectional report of patients who presented to and were managed at the Urology Unit of a tertiary hospital in North-Western Nigeria. Relevant information were retrieved from patients' case notes and the data was entered into a proforma and analysed using the SPSS 20 software. Results: The mean age of the patients was 45.4 ± 19.4 years, with a range of 11-80 years. Indications for urethral catheterization were acute urine retention 11 (43.8%), intra-operative urine output monitoring 9 (28.1%), following road traffic accident 10(31.2%), unconsciousness secondary to meningitis 1 (3.1%) and after urologic surgery 1 (3.1%). Urethral catheterization was carried out in peripheral hospitals in 19 (56.3%) patients; and from the hospitals operating room in 10 (31.2%), accident and emergency room 2 (6.3%) and trauma centre 1 (3.1%). Strictures were panurethral in 22 (68.75%), in the bulbar urethra in 6 (18.75%) and in the penile urethra 4 (12.5%). The length of strictures ranged from 1 cm to 20 cm. Treatments offered included substitution urethroplasty using oral mucosa grafts (OMG) urethroplasty 30 (93.8%), fasciocutaneous penile flap 1 (3.1%) and direct visual internal urethrotomy (DVIU)1 (3.1%). Satisfactory voiding was recorded in 28 (87.5%), voiding was unsatisfactory in 2 (6.3%), while one patient had stricture recurrence and another one is awaiting second stage repair. Conclusion: Urethral catheterization is an emerging cause of panurethral strictures in our practice and may occur even after relief of acute urine retention but more worrisome following short-term catheterization during surgery. There is need for evaluation of the quality of silicone-coated latex urethral catheters currently available. [ABSTRACT FROM AUTHOR]

Since more than 50 million people in the United States have allergies, knowledge of the management of allergic reactions in the dental office is extremely important. Appropriate care may range from a simple referral to a primary care physician to lifesaving measures implemented during acute anaphylactic reactions. The authors present a basic review of the pathophysiology of allergic reactions and provide information detailing the diagnosis and management of allergic reactions that may be encountered in the dental office. Utilizing this information, the dental practitioner and ancillary staff will have a thorough understanding of allergic reactions and be prepared to successfully identify and treat these reactions. [ABSTRACT FROM AUTHOR]

Notwithstanding the efforts made in the last decades to mitigate the consequences of natural rubber latex allergy, this disease continues to be a major health problem, especially in developing countries. The categories of patients with greater and frequent exposure to latex (such as health care professionals and, in the pediatric field, subjects who undergo repeated surgery, e.g., those suffering from spina bifida and urogenital malformations) have an increased risk of developing sensitization and allergy to latex. Herein we provide an overview of the current knowledge and practical recommendations with a focus on epidemiology, diagnostics, and management (including both prevention and therapy) in order to guide a correct recognition and containment of this potentially fatal condition.

Objective: The purpose of this study was to evaluate the frequency of the use of gloves and to assess the prevalence of glove-related symptoms in a sample of Italian dentists with a high occupational exposure to latex gloves. Method and materials: A 31-question instrument was mailed to all dentists (n = 550) practicing in the town of Bologna during 1994 to determine the type of procedures for which gloves were worn by dentists and the prevalence of self-reported glove-related symptoms. Results: Of the dentists who replied to the items (n = 160), 94% reported that they usually wear nonsterile latex examination gloves; and 46% reported that they wear surgical gloves, even if not exclusively. About 98% reported changing gloves after contact with each patient, and 14% reported using disinfectants to treat examination gloves. Of the 106 respondents claiming to use examination gloves for surgical activities, 79 (74%) reported wearing them for extractions. Sterile surgical gloves were reported to be mostly worn for implant placement (47%) and periodontal surgery (42%). There were 46 (29%) responses indicating glove-related problems; of those subjects, 14 (30%) reported having other allergies. Conclusion: The use of gloves is common in the sample of Italian dentists, and the choice between nonsterile examination gloves and sterile surgical gloves seems to be more appropriately. (Quintessence Int 1999;30:633-636) [ABSTRACT FROM AUTHOR]

>bold<>italic/italic<>/bold< In pollen-allergic patients, cross-reacting allergens including cross-reactive carbohydrate determinants (CCDs) and profilins may result in positive natural rubber latex (NRL)-specific IgE (sIgE) antibody tests but the relationship between this sensitization and clinical NRL type 1 allergy is poorly described. >bold<>italic/italic<>/bold< The aims of this study were to determine the frequency and clinical relevance of NRL sIgE in grass pollen-sensitized individuals and to investigate which NRL allergen components these individuals were sensitized to. >bold<>italic/italic<>/bold< A total of 383 grass-sensitized patients answered questions about NRL allergy symptoms and their stored sera from previous investigations were analyzed for NRL sIgE. Patients with NRL sIgE (>italic/italic< = 32) underwent further investigations comprising medical history, skin prick test with NRL and inhalational allergens, and an additional blood sample. The additional blood samples were analyzed for total IgE and sIgE against NRL, timothy grass, birch, rHev b 1, 3, 5, 6.01, 6.02, 8, 9, 11, rPhl p 12, and MUXF3, which was used as a marker of CCD sensitization. >bold<>italic/italic<>/bold< Overall, 9.4% of all grass pollen-sensitized individuals showed IgE sensitization to NRL but only 1.6% had a confirmed type I NRL allergy. CCD and Hev b 8 explained the clinically irrelevant NRL IgE sensitization in 65% of the cases. We found a highly significant correlation between NRL profilin (Hev b 8) sensitization and grass profilin (Phl p 12) sensitization (>italic/italic< < 0.0001). >bold<>italic/italic<>/bold< Data from this study support the hypothesis that in patients with grass pollen sensitization, Hev b 8 mono-sensitization has little or no clinical relevance and is caused by cross sensitization from grass profilin (Phl p 12). [ABSTRACT FROM AUTHOR]

Objectives: Specific challenge tests (SICs) are considered reference tests for allergic occupational diseases diagnosis. However, in numerous cases, SICs cannot be carried out in the diagnosis of allergy to latex due to the risk of generalized reactions. The aim of the study was to evaluate the usefulness of sIgE determination to recombinant latex allergens in diagnostics of occupational respiratory allergy. Materials and Methods: The study group comprised 44 healthcare workers (HCW) suspected of suffering from occupational respiratory allergy to latex (they underwent a physical examination, skin‐prick tests (SPTs) to common and latex allergens, spirometry and SIC) and 17 controls not occupationally exposed to latex, with a positive sIgE against latex. Each serum was tested for allergen‐specific IgE to aeroallergens, latex, eight recombinant latex allergens and CCD‐markers. Results: Specific IgE against Hev b5, 6.01, and 6.02 were significantly more frequently detected in HCWs and their mean serum levels were higher compared with the control group. In 26 HCWs with occupational asthma (OA), sensitization to Hev b5, Hev b6.01, Hev b6.02 was significantly more frequent than in 18 HCWs with work‐exacerbated asthma (WEA); they had positive results SPT to latex significantly more frequently in comparison with subjects with WEA. Conclusions: Test for recombinant latex allergens is much more accurate in recognition of latex allergy than test for latex extract, which seems to produce false‐positive results in patients with pollen allergy. The measurements of sIgE against recombinant latex allergens Hev b 6.01, 6.02, 5, and 8 are useful in differentiating OA from WEA. [ABSTRACT FROM AUTHOR]

The study aimed to develop preventive measures for occupational allergy to latex in health care workers and to elucidate diagnostic specifics of latex sensitization by clinical and immunological parameters. One thousand three hundred forty-six health professionals whose work involves contact with latex-containing products underwent a screening questionnaire survey. One hundred twenty health professionals had an immunoassay done involving the estimation of total and latex-specific IgE. Thirty-six health care workers had a prick skin test done with a standard kit of allergens (home dust mites, epidermal, and pollen allergens). Latex allergy in health care workers is most often characterized by the development of skin manifestations and allergic rhinitis. Latex allergy in health professionals was found to be most common in individuals with the history of allergies, confirmed by increased total IgE values, which should be taken into consideration in occupational fitness assessments on a preliminary medical examination. [ABSTRACT FROM AUTHOR]

Penicillin allergy, local anesthetic hypersensitivity, latex allergy, contact hypersensitivity, and anaphylaxis are among the allergic reactions encountered in dental practice. This article reviews the literature pertaining to these important areas of overlap between dentistry and allergy/immunology. The epidemiology, diagnosis, and management of penicillin allergy as it relates to dentistry are reviewed. The relevant literature regarding local anesthetic and latex hypersensitivity is discussed. In addition, the presentation, evaluation, and management of contact hypersensitivity, including that to metals, are addressed. Recognition and appropriate treatment of anaphylaxis also are reviewed. This article will help dentists understand potential areas of comanagement with allergists/immunologists to optimize patient care. [ABSTRACT FROM AUTHOR]

Copyright of Revue Francaise d'Allergologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The Pennsylvania Patient Safety Reporting System is a confidential, statewide Internet reporting system to which all Pennsylvania hospitals, outpatient-surgery facilities, birthing centers, and abortion facilities must file information on incidents and serious events. Safety Monitor is a column from Pennsylvania's Patient Safety Authority, the authority that informs nurses on issues that can affect patient safety and presents strategies they can easily integrate into practice. For more information on the authority, visit www.patientsafety.pa.gov. For the original article discussed in this column or for other articles on patient safety, click on "Advisories and Events" and then "Pennsylvania Patient Safety Advisory" in the top navigation menu. [ABSTRACT FROM AUTHOR]

Background: Natural rubber latex (NRL) allergy is commonly diagnosed according to medical history, skin allergy tests, and serological analyses. However, skin tests are increasingly being abandoned because of (i) their time-consuming nature, (ii) latex preparations for skin tests being not commercially available, and (iii) the use of in-house prepared test solutions is becoming ever more difficult due to increasing regulatory hurdles. In this light, we have evaluated differences in the profiles of current and former patients with suspected latex allergy. Methods: Sera of skin test-positive patients from a historic cohort (1995–2001, n = 149 patients) and currently (2014–2015, n = 48 patients) were simultaneously analyzed for specific IgE to latex by ImmunoCAP. If the serological screening was positive (≥0.35 kU/L), component-resolved diagnostics including profilins and cross-reactive carbohydrate determinants (CCDs) were performed. Results: In contrast to 88% (131/149) of the skin test-positive patients from the 1990s, only 51.1% (24/47) of the current cohort were found positive for specific IgE to latex. While 48.3% (72/149) of the patients had a convincing positive history in the 1990s, current skin test-positive patients rarely reported a relevant medical history (8.5%, 4/47). Specific IgE levels to latex were significantly higher in former patients with suspected latex allergy (p < 0.001) than in former sensitized individuals without allergy. However, this significant difference was lost in current allergic and sensitized patients with positive skin tests. Conclusion: Sensitization profiles in patients with latex allergy have changed significantly over the last 2 decades. Discrimination between NRL sensitization and clinical allergy remains a diagnostic challenge. Our data highlight the need for a combination of all 3 criteria, i.e., patient history, skin test, and analysis of specific IgE, for a correct diagnosis of latex allergy. [ABSTRACT FROM AUTHOR]

Copyright of Dental Press Journal of Orthodontics is the property of Dental Press International and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: The pigeon tick Argas reflexus is a temporary parasite of pigeons. It bites during night hours and lies briefly on its prey, as long as it takes the blood meal. When pigeons are not accessible, ticks look for other hosts, invading nearby flats and biting humans. Case presentation: We present the case of a woman aged 46 years who experienced severe anaphylaxis during the night which required emergency medical treatment, tracheal intubation and hospitalization in intensive care unit. Kounis syndrome was documented by transient ST depression and elevation of troponin. The allergological work up ruled out hypersensitivity to drugs, latex and foods containing alpha-gal, which is a cause of anaphylaxis. Basal serum tryptase was in normal range (8.63 ng/ml). When questioned about the presence of ticks, the patient brought into view various specimens of ticks that were recognized by an entomologist as Argas reflexus. Conclusions: An in vitro diagnosis of allergy to Argas reflexus is currently not feasible because, though the major allergen Arg r 1 has been isolated, allergen extracts are not commercially available. Therefore, the diagnosis of anaphylaxis from Argas reflexus, when other causes of anaphylaxis are excluded, must rely only on history and clinical findings, as well as on the presence of pigeons and/or pigeon ticks in the immediate domestic environment. [ABSTRACT FROM AUTHOR]

Background: It has been suggested that latex-specific IgE analysis may lead to false-positive results, especially in patients with pollen allergy. In the present study, the reasons underlying clinically irrelevant latex-specific IgE positivity were investigated. Methods: Thirty patients with latex allergy (group 1), 89 patients sensitised to aeroallergens (group 2a), and 98 healthy individuals without allergy (group 2b) were enrolled. Participants from all 3 groups were subjected to skin prick tests with aeroallergens including latex, latex-specific IgE analysis (ImmunoCAP), and nasal provocation test with latex. All cases demonstrating positive latex-specific IgE also underwent specific IgE tests (ImmunoCAP) with latex profilin, birch pollen profilin, peach lipid transfer protein, and pineapple bromelain as cross-reactive carbohydrate determinants. Results: Comparison of the atopic and healthy control groups showed that the rate of positive latex-specific IgE was significantly higher in group 2a. Latex profilin-, birch pollen profilin-, and bromelain-specific IgE were remarkably higher in group 2a. Conclusion: False positivity to latex-specific IgE in ImmunoCAP analysis may be observed in approximately 19% of patients with pollen allergy. Profilins and bromelain are the main contributors to clinically irrelevant positive latex-specific IgE. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Traditional Medical Complementary Therapies is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: The only etiological and decisive therapy, able to influence the natural history of latex allergy is the specific desensitization. Aim: To verify the clinical efficacy and immunological changes determined by latex sublingual immunotherapy in allergic patients who underwent this treatment for at least 3 years. Material and methods: We enrolled 76 patients (16 males and 60 females, mean age 34 years old) with evidence of a natural rubber latex allergy. To assess the effectiveness of the immunotherapy we performed a latex skin prick test, specific IgE and IgG4 and challenge tests before and after at least 3 years of desensitization. Results: We observed a reduction in the mean diameter of the wheal area at the skin prick test and a decrease in latex specific IgE while no significant changes of latex IgG4 values were found. Moreover a reduction of symptoms and scores at the provocation tests were remarked. Conclusions: Although the primary prevention (which still remains the gold standard treatment for patients suffering from the latex allergy) sublingual immunotherapy can be offered with efficacy in addition to symptomatic treatment to selected patients. [ABSTRACT FROM AUTHOR]

Background: The prevalence of latex allergy ranges from 0.8 to 6.5% and is the second cause of perioperative anaphylaxis. The main risk factors are being a health worker or latex producer, hours of latex gloves or products usage, exposure to other hand irritants, history of atopy, neural tube closure defects or numerous surgeries at early age. Objective: To determine the frequency of latex sensitization in resident physicians of the Hospital General de México surgical area. Methods: Prospective, cross-sectional, descriptive study where skin prick tests were applied to residents of the surgical area of the Hospital General de México, which depends on the Ministry of Health and is located in Mexico City. Results: Ninety-two subjects were included and had skin tests practiced, with 11 surgical specialties participating. Latex sensitization in this population was 11.9%, whereas the presence of latex allergy was 10.8%. Conclusions: A high frequency of latex sensitization and allergy was demonstrated in Hospital General de Mexico surgery residents, which indicates the need for policies and procedures to be developed for health workers with latex allergy, as well as continuous training of employees on latex allergy. [ABSTRACT FROM AUTHOR]

Myelomeningocele (MMC) is a congenital malformation that occurs in the embryonic period, characterized by failure in closure of the caudal portion of the neural tube during central nervous system formation. Alterations and complications can be associated with this condition, such as hydrocephalus, neurogenic bladder, orthopedic problems, and motor and cognitive impairment. This patients with MMC also have predisposition to develop latex allergy and high caries risk and activity due to deficient oral hygiene, fermentable carbon hydrate-rich diet and prolonged use of sugar-containing oral medications. This paper reports the oral findings and dental treatment in a 15-year-old female patient diagnosed with MMC and describes the strategies used to improve dental treatment conditions and reduce the impact of associated risks to her health. The measures and precautions adopted in this case could be useful to reduce the barriers for patients with the same condition to access oral health care: regular visits to the dentist, initiating as early as possible; frequent reinforcement of oral homecare instructions and diet counseling; minor adaptions to the dental chair and dental office to improve ease of access due to patients' mobility problems; prevention of latex-related allergic reactions; reduction of gag reflex during dental procedures. [ABSTRACT FROM AUTHOR]

Background: Prevalence of latex allergy in medical students is not known. Objective: To determine the prevalence of self-reported latex allergy and associated factors in medical students. Methods: Cross-sectional, analytical study of students with or without self-reported latex allergy. By means of a structured questionnaire, past personal and family history of allergic disease, time and frequency of exposure to latex gloves and symptoms after exposure to products or foods associated with latex allergy were inquired. Logistic regression models were carried out. Results: Out of 854 subjects, 431 (50.5%) were females. Median age was 21 years. Overall prevalence of latex allergy was 4.3% (95% CI = 3.1 to 5.9). Associated risk factors were age (OR = 1.37; 95% CI = 1.05 to 1.79), personal history of atopic dermatitis (OR = 7.32; 95% CI = 3.14 to 17.08), use of gloves ≥ 15/week (OR = 2.59; 95% CI = 1.17 to 5.76), use of latex products (OR = 5.76; 95% CI = 2.15 to 15.49) and fruit allergy (OR = 3.24; 95% CI = 1.27 to 8.27). Conclusion: Four out of a hundred students reported latex allergy. Age, personal history of atopic dermatitis, higher frequency of exposure to latex gloves and history of fruit allergy were risk factors for self-report latex allergy. [ABSTRACT FROM AUTHOR]