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Abstract Background Latex gloves are essential for protecting healthcare workers from biological hazards but pose a risk of latex allergy, particularly due to powdered, protein, and allergen content. Recent advancements in latex glove manufacturing have led to reduced levels of extractable proteins, a known factor triggering allergenic reaction. This study aimed to compare latex sensitization between nursing staff using low-protein and high-protein latex gloves at a tertiary university hospital in Thailand. Methods A cross-sectional analytical study categorized participants into two groups based on glove exposure: the low extractable protein group (only exposed to non-powdered latex gloves with extractable protein levels below 50 µg/g) and the high extractable protein group (exposed to powdered latex gloves with levels above 50 µg/g). The sample size comprised 163 individuals in the low protein group and 318 in the high protein group (1:2). Latex allergy symptoms and sensitization were assessed using a self-administered questionnaire and latex-specific IgE measurement (ImmunoCAP), respectively. Data analysis involved descriptive and inferential statistics, including odds ratios and 95%CI. Results Demographic data was mostly similar in both exposure groups except for age. No significant differences in latex sensitization between the low and high protein groups were found via latex-specific IgE measurement (crude OR 1.90, 95%CI: 0.5, 7.18), potentially attributed to lower extractable protein levels in powdered latex gloves compared to previous studies. In contrast, the low protein group exhibited significantly fewer current latex allergy symptoms in both bivariate (crude OR 0.24, 95%CI: 0.06, 0.74) and multiple variable analysis (adjusted OR 0.18, 95%CI: 0.04, 0.86). Moreover, there was a significant reduction in latex allergy symptoms among the low protein group, decreasing from 9.8% who reported experiencing symptoms (when powdered latex gloves were used) to 1.2% who still reported current symptoms (OR 0.11, 95%CI: 0.02, 0.44). Conclusions This study underscores the importance of using non-powdered and low-protein latex gloves to reduce latex allergy symptoms while emphasizing the need for further investigation into the relationship between extractable protein levels in addition to the attempt of the major allergen removal and latex sensitization amid evolving glove manufacturing practices.

Thirty years have passed since the concept of latex-fruit syndrome (LFS) was first introduced. Since then, this phenomenon, characterized by cross-reactivity between natural latex rubber allergens and certain fruit allergens, has been extensively studied. This literature review sought to determine the prevalence of LFS in latex-allergic patients, identify the most common cross-reactions with fruit allergens in individuals with LFS, and understand the clinical manifestations of this syndrome. An extensive literature search was carried out using PubMed and Scopus databases, while applying the Preferred Reporting Items for Systematic Reviews and Meta-Analysis methodology. The analysis of original studies revealed a wide variation in LFS prevalence (4–88%) influenced by diverse diagnostic tools, different geographical regions, and the size of study populations. Our findings indicate that the most prevalent allergenic fruits in patients with LFS are banana, avocado, kiwifruit, and papaya. After evaluating the symptoms of the fruit hypersensitivity of patients with LFS, the clinical manifestation of hypersensitivity constituted 73% of systemic allergy symptoms and only 27% of reported symptoms described the localized allergy. Furthermore, the clinical picture of latex-fruit syndrome is illustrated through two cases, one typical and one with an unusual presentation. Their clinical features were assessed and contrasted utilizing different anaphylaxis severity grading criteria. To properly manage LFS, it is essential to establish standardized diagnostic criteria and severity grading systems, as these are crucial for accurate diagnosis and effective treatment. [ABSTRACT FROM AUTHOR]

BACKGROUND: The coronavirus 2019 (COVID-19) pandemic has led to a significant increase in the use of latex gloves among nurses. However, concerns about the rise in latex allergies and related complaints due to this increase remain uncertain. OBJECTİVE: This study aims to assess the rates of latex glove usage and allergy-related complaints among nurses working in hospitals during the COVID-19 pandemic. METHODS: Between May 15 and June 15, 2021, ethical approvals were obtained for a cross-sectional study involving 448 volunteer nurses. Descriptive statistics were used to represent categorical values as counts (n) and percentages (%), while continuous values were represented as mean±standard deviation. The normal distribution of the data was assessed using the Kolmogorov-Smirnov and Shapiro-Wilk tests. Comparative analyses were conducted using paired sample t-test, Pearson's chi-squared (x2) test, McNemar's chi-squared (x2) test, and Spearman correlation analysis. RESULTS: Before the pandemic, the average number of invasive procedures was 45.13±26.48, whereas during the pandemic, this rate increased to 50.23±29.14. The average glove usage duration went from 7.69±3.13 hours to 14.73±3.68 hours during the pandemic. Among nurses, the rate of allergic symptoms, which was previously at 31.5%, rose to 33.3% during the pandemic. CONCLUSİON: This study revealed a significant increase in daily invasive procedures and the use of latex gloves among nurses during the pandemic period. Simultaneously, the frequency of allergic symptoms also rose. These findings underscore the importance of awareness and preventive measures, particularly regarding latex allergies, in the healthcare field. [ABSTRACT FROM AUTHOR]

Background: Latex gloves are essential for protecting healthcare workers from biological hazards but pose a risk of latex allergy, particularly due to powdered, protein, and allergen content. Recent advancements in latex glove manufacturing have led to reduced levels of extractable proteins, a known factor triggering allergenic reaction. This study aimed to compare latex sensitization between nursing staff using low-protein and high-protein latex gloves at a tertiary university hospital in Thailand. Methods: A cross-sectional analytical study categorized participants into two groups based on glove exposure: the low extractable protein group (only exposed to non-powdered latex gloves with extractable protein levels below 50 µg/g) and the high extractable protein group (exposed to powdered latex gloves with levels above 50 µg/g). The sample size comprised 163 individuals in the low protein group and 318 in the high protein group (1:2). Latex allergy symptoms and sensitization were assessed using a self-administered questionnaire and latex-specific IgE measurement (ImmunoCAP), respectively. Data analysis involved descriptive and inferential statistics, including odds ratios and 95%CI. Results: Demographic data was mostly similar in both exposure groups except for age. No significant differences in latex sensitization between the low and high protein groups were found via latex-specific IgE measurement (crude OR 1.90, 95%CI: 0.5, 7.18), potentially attributed to lower extractable protein levels in powdered latex gloves compared to previous studies. In contrast, the low protein group exhibited significantly fewer current latex allergy symptoms in both bivariate (crude OR 0.24, 95%CI: 0.06, 0.74) and multiple variable analysis (adjusted OR 0.18, 95%CI: 0.04, 0.86). Moreover, there was a significant reduction in latex allergy symptoms among the low protein group, decreasing from 9.8% who reported experiencing symptoms (when powdered latex gloves were used) to 1.2% who still reported current symptoms (OR 0.11, 95%CI: 0.02, 0.44). Conclusions: This study underscores the importance of using non-powdered and low-protein latex gloves to reduce latex allergy symptoms while emphasizing the need for further investigation into the relationship between extractable protein levels in addition to the attempt of the major allergen removal and latex sensitization amid evolving glove manufacturing practices. [ABSTRACT FROM AUTHOR]

This retrospective study aimed to assess allergic sensitisation among adult patients tested at National Health Laboratory Service (NHLS) laboratories across nine provinces in South Africa. With a primary focus on identifying prevalent allergens, the investigation extends to comparative analyses with workers tested at the National Institute for Occupational Health (NIOH) and explores trends during a ten-year period from 2012. The overarching objective was to ascertain the potential value of leveraging routine public-health data for comprehensive occupational allergy (OA) surveillance, attempting to fill a critical gap in existing South African OA data. In examining allergic sensitisation, the study spanned NHLS laboratory tests conducted from January 2012 to December 2021, encompassing adult demographic ages from 18 to 65 years, which represent the typical working age of South Africans. The results for allergens recommended by the South African Allergic Rhinitis Working Group and other allergens of relevance in occupational settings were extracted and analysed, providing a robust foundation for a nuanced exploration of sensitisation patterns. Of the 31 913 NHLS laboratory records, 48.48% of adults tested positive for ImmunoCAP Phadiatop, indicative of atopy. In addition, the percentage sensitisation to common aeroallergens of 538 workers tested at the NIOH using the skin-prick test method was compared to those of patients tested at the NHLS. Furthermore, the study uncovered a spectrum of sensitisation patterns, with house-dust mites and grass pollens emerging as predominant allergens. Occupational allergens, including latex, alpha-amylase and chlorhexidine, manifested as noteworthy contributors to sensitisation, shedding light on potential workplace hazards. Provincial variations in sensitisation patterns underscore the nuanced nature of allergic responses across different regions. Dermatophagoides pteronyssinus dominated in five provinces, signifying geographical disparities in allergen prevalence. Intriguingly, comparison with NIOH data reveals significantly higher sensitisation rates in NHLS patients for specific allergens, which suggests potential variations in testing methodologies and patient selection between the two institutions. Drawing from these insights, the study concluded that routine NHLS data are of critical importance for trend analysis and preventive strategies. The high prevalence of sensitisation to common allergens underscores the imperative for targeted preventive measures. This study, bridging the gap in OA data, lays the groundwork for future research exploring the intricate associations between routine allergen sensitisation testing and OA surveillance. [ABSTRACT FROM AUTHOR]

Creating a safe environment for performing surgical procedures is essential to achieve successful patient outcomes and protect the perioperative personnel who are providing care. Numerous factors challenge the provision of a safe environment of care and create a complex setting for perioperative nurses to manage. The updated AORN “Guideline for a safe environment of care” provides perioperative nurses with recommendations for establishing a safe environment for both patients and personnel. This article provides an overview of the guideline and discusses recommendations for implementing fire safety protocols, using warming cabinets, and creating a latex-safe environment. It also includes a scenario describing the care of a patient with an unidentified latex allergy who is undergoing a laparoscopic sleeve gastrectomy and hiatal hernia repair. Perioperative nurses should review the guideline in its entirety and implement recommendations as applicable in operative and other procedural settings. [ABSTRACT FROM AUTHOR]

Latex allergy is a disease with increasing prevalence and importance and can be seen in the whole population, especially in healthcare workers and those working in rubber production. It can lead to clinical pictures ranging from allergic urticaria to dermatitis, rhinoconjunctivitis, asthma, and even anaphylaxis. Various methods are used for the diagnosis, including the skin prick and patch tests, latex-specific immunoglobulin E, and nasal provocation. Latex fruit syndromes may also occur due to cross-reactivity with latex. Preventive measures and patient education constitute the most important part of the treatment. Medication, latex immunotherapy, and the use of omalizumab are among the main treatment modalities. [ABSTRACT FROM AUTHOR]

Aim: This electronic survey was carried out to assess the knowledge, attitude, and practices among the oral health practitioners. Methods: A questionnaire survey was conducted among undergraduates, graduated practitioners, and specialist practitioners. A Google Form that included a specified instruction format, informed consent with a clear description of the purpose of the study, and questions in different categories were sent through Whatsapp and email. Descriptive statistics were used to analyze responses. The association of knowledge and attitude with respect to oral health professionals was analyzed with the Chi-square test. Results: The questionnaire was completed by 570 participants. Thirty percent of participants encountered ADR related to the drugs available in the market and 33.2% of participants encountered adverse reaction related to materials used in practice. ADR should be reported as soon as it is detected, according to this study about 12.1% of participants reported the ADRs, and this reporting is primarily for patient safety. Almost 66.8% of participants perceived that dental products can cause ADR owing to a lack of information about ADR and reporting procedures, or due to fear of legal concerns. Only about 9.5% of the participants had previously attended an ADR workshop. Conclusion: Oral health practitioners have a general understanding of ADR; however, there is substantial evidence of underreporting and a lack of reporting system information. Organizing an orientation program and raising awareness about ADR reporting could help improve spontaneous reporting and better patient care. [ABSTRACT FROM AUTHOR]

Aim: This electronic survey was carried out to assess the knowledge, attitude, and practices among the oral health practitioners. Methods: A questionnaire survey was conducted among undergraduates, graduated practitioners, and specialist practitioners. A Google Form that included a specified instruction format, informed consent with a clear description of the purpose of the study, and questions in different categories were sent through Whatsapp and email. Descriptive statistics were used to analyze responses. The association of knowledge and attitude with respect to oral health professionals was analyzed with the Chi-square test. Results: The questionnaire was completed by 570 participants. Thirty percent of participants encountered ADR related to the drugs available in the market and 33.2% of participants encountered adverse reaction related to materials used in practice. ADR should be reported as soon as it is detected, according to this study about 12.1% of participants reported the ADRs, and this reporting is primarily for patient safety. Almost 66.8% of participants perceived that dental products can cause ADR owing to a lack of information about ADR and reporting procedures, or due to fear of legal concerns. Only about 9.5% of the participants had previously attended an ADR workshop. Conclusion: Oral health practitioners have a general understanding of ADR; however, there is substantial evidence of underreporting and a lack of reporting system information. Organizing an orientation program and raising awareness about ADR reporting could help improve spontaneous reporting and better patient care.

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. [ABSTRACT FROM AUTHOR]

Natural rubber latex is a widely used industrial raw material to produce many consumer and commercial products. Chronic exposures to latex allergenic proteins residual in the finished products can promote hypersensitive immune responses, which affects millions of workers and the general public worldwide. Research has shown the average prevalence of latex allergy worldwide remains approximately 10% among healthcare workers, 7% among susceptible patients, and 4% among general population. Although most effective in preventing latex allergy, completely avoiding contact to latex-derived products is extremely challenging, given the fact that millions of products possibly contain latex, but few are regulated and properly labeled. Due to the difficulty to assure a product completely absent of latex allergens, the United States Food and Drug Administration has recommended to stop using labels like "latex-free" or "does not contain latex." Here we evaluate published data, industrial standards and regulations, identify possible countermeasures, and propose an integrated strategy, including some more practicable approaches (e.g., education/training, product labeling, the use of proper personal protective equipment, occupational selection, and searchable product database) and novel medical treatments (e.g., immunotherapy) to help decreasing latex allergy prevalence. [ABSTRACT FROM AUTHOR]

The authors described a 43-year-old male Thai practical nurse (PN) who developed anaphylaxis several times between 2013 and 2019, possibly caused by jackfruit (Artocarpus heterophyllus) and eggplant (Solanum melongena) ingestion. The occupational medicine physician suspected that the anaphylaxis might be due to a cross reaction of these plants to latex protein in medical gloves as this PN had a history of contact urticaria while using disposable latex gloves in December 2014. The symptoms disappeared after he used sterile latex powdered gloves with reusable. According to the history and the result of specific IgE against latex of 28.1 KUA/L and jackfruit of 1.61 KUA/L, although no skin prick test was performed, he was then diagnosed with latex-fruit syndrome. The use of nitrile gloves and latex products avoidance were advised. At the 1-year follow-up, he had no recurrent allergic symptoms or anaphylaxis. [ABSTRACT FROM AUTHOR]

This paper presents a case of urosepsis caused by Escherichia coli in an 11-year-old girl with a neurogenic bladder. The patient had not previously been supervised by a nephrologist or urologist. On admission, significantly elevated serum markers of inflammation (C-reactive protein 32.4 mg/dl, procalcitonin 64.2 ng/ml), kidney failure (creatinine 6.9 mg/dl, pH 7.22, HCO3 6.3 mmol/l), and increased serum urea (399 mg/dl) were detected. Antibiotic therapy with rehydration was started and improved renal function without dialysis. However, a 9-cm-long perirenal abscess site was diagnosed. It required surgical treatment, which was complicated by an anaphylactic reaction to latex. Colitis caused by Clostridium difficile was also diagnosed. Hospital treatment lasted 38 days. After 4 months the patient's glomerular filtration rate was 66 ml/min/1.73 m² and indicated stage 2 chronic kidney disease. Because early diagnosis of urinary tract infection is crucial for preventing complications in children with neurogenic bladder, they should undergo regular nephro-urological care. [ABSTRACT FROM AUTHOR]

In relevant studies on the lines of work that used latex as a raw material, an increased prevalence of respiratory complaints and occupational asthma was reported. The present study aimed to investigate the prevalence of latex sensitivity in a workplace that produced rubber-based vehicle seals. Objective: To present study aimed to investigate the prevalence of latex sensitivity in a workplace that produced rubber-based vehicle seals. Method: The serum latex-specific IgE levels, respiratory complaints, PFT, serum interleukin (IL)-4, IL-5, IL-8, IL-10, IL-13 levels of all male workers (n = 108) exposed to latex in the workplace, which produced rubber seals, were compared with the control group (n = 52). Results: The rates of latex-specific IgE >0.10 kU/L in the workers and control group were 12.3% and 4.1%, respectively (P = 0.147). There was no difference in IL-4, IL-5, IL-10, and IL-13 levels between latex-specific IgE-positive, and -negative participants. Conclusion: Latex sensitivity was higher in workers who used rubber as a raw material than in the control group but it was not statistically significant. [ABSTRACT FROM AUTHOR]

Background: Scant data are currently available on the allergen-specific immunoglobulin (Ig)E sensitization profile in primary immunodeficiencies with hyper IgE. Netherton syndrome (NS, OMIM 266500) is an extremely rare form of congenital ichthyosis characterized by congenital scaly erythroderma, hair abnormalities, and deregulated IgE reactivity associated with severe atopic manifestations. Objective: The aim of this study was to evaluate the feasibility and reliability of a multiplex proteomic approach in the detection of specific IgE in NS. Methods: Specific IgE was evaluated in 10 individuals with an established molecular diagnosis of NS using an allergenic molecules microarray (immuno-solid-phase allergen chip). Results: Polireactivity to airway allergens, mainly house dust mites and olive tree pollen, and food allergens were observed in NS. Eighty per cent of patients were responsive to LTP or profilins. A clinical history suggestive of severe egg, milk, and fish allergy was confirmed by reactivity to the thermostable molecules Gal d 1, Bod 8, and parvalbumin Gad c 1, respectively. Latex reactivity was associated with Hev b 5 and 6 reactivity. Two distinct clusters of reactivity were observed after hierarchical analysis. Extremely high IgE levels (> 10,000 kU/L) do not affect the results obtained with microarrays. Conclusion: IgE multiplex evaluation allows (i) to profile IgE polyreactivity pictures, in the presence of LTP and profilin sensitization, (ii) to verify the clinical history of food allergy to milk, egg, and seafood, (iii) to confirm the allergic events associated with latex exposure, and (iv) to disclose the presence of preclinical sensitizations in patients affected by primary immunodeficiencies with hyper IgE, such as the NS. [ABSTRACT FROM AUTHOR]

Background: Latex allergy is a common occupational problem among healthcare workers (HCWs). Although latex allergy prevalence has been researched in various countries, data in Egyptian hospitals is lacking. Objectives: To determine the frequency of latex allergy among the HCWs in a tertiary hospital in Egypt. Patients and Methods: One hundred and thirty healthcare workers at Ain Shams University Hospitals participated in the current cross-sectional study in the period from September 2020 to March 2021. All participants were evaluated for symptoms related to exposure of latex products, and skin prick test (SPT) for latex protein was done. Results: Twenty-six (20%) of HCWs had positive SPT to latex. The most common allergic manifestations reported were skin allergy (53.84%), followed by allergic rhinitis (23.07%), allergic conjunctivitis (11.53%), bronchial asthma (7.69%), and angioedema (3.84%). Conclusion: Latex allergy prevalence among HCWs was 20%. This rate is relatively higher than previous studies. [ABSTRACT FROM AUTHOR]

Background: Myelomeningocele (MMC) is a severe manifestation of spina bifida. Children with MMC have motor disability, hydrocephalus, skeletal abnormalities, and mental retardation. These individuals are more susceptible to caries due to poor oral hygiene, carbohydrate‐rich diet, prolonged use of sugar‐containing medications and limited motor abilities. Latex allergy is an important factor to be considered during the dental rehabilitation of such patients. Case Report: A 3‐year‐old girl visited the dental clinic with the chief complaint of multiple carious teeth and H/o neural tube defect (NTD) which had been operated on at the age of 6 weeks. On dental examination, multiple dental abscesses and severe early childhood caries were noted. Radiographic evaluation revealed internal root resorption of tooth "K" and external root resorption of tooth "T." The two teeth were treated with ledermix paste followed by obturation with Vitapex® (Diadent Group International Inc., Burnaby, BC, Canada) along with triple antibiotic paste and placement of stainless steel crown (SSC). A latex‐free environment was maintained during the entire treatment to prevent allergic reaction. A follow up after 42 months indicated clinical and radiographical success. Conclusion: The paper reports succesfull management of internal and external root resorption as well as latex allergy in a dental operatory. The dental perspective while dealing with patients having NTD is limited. Explaining the particulars of the treatment plan will aid in management of such cases. [ABSTRACT FROM AUTHOR]

Aim of our study is to analyse the sensitisation profile to molecular components of latex and of food allergens with the use of ALEX2 Allergy Xplorer test and to compare these results with the anamnestical data after latex exposure and with the anamnestical data after exposure to food allergens in atopic dermatitis patients., Methods: 100 patients were included in the study (49 men and 51 women with the average age 40.6 years). The specific IgE was examined with the use of ALEX2 Allergy Xplorer test. A detailed personal history of allergic reaction to latex and allergic reaction to food allergens was taken in all included patients., Results: The sensitisation to latex was recorded in 17 % of patients, majority of patients have positive results of specific IgE to Hev b 8 without clinical reaction to latex. In 7 % of patients with positive results of specific IgE to Hev b 1, Hev b 3, Hev b 5, Hev b 6.02 and Hev b 11 the contact urticaria or contact dermatitis were recorded. The latex fruit syndrome was recorded in 7 % of patients; in another 10 % of patients we recorded no clinical reaction to latex, but the positive results to molecular components of latex and the clinical symptoms after ingestion of different kinds of fruits., Conclusion: The significant relation between the results of specific IgE to molecular components Hev b 3, Hev b 5 and Hev b 6.02 and the clinical reaction to latex was confirmed; these components significantly imply clinical reactivity to latex., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

In response to increasing rates of self-reported latex allergies, changes have been made to prevent anaphylaxis in the operating room, including the use of latex-free gloves. However, the impact of these changes on the risk of prosthetic joint infection (PJI) after arthroplasty is unclear. This study evaluated whether documented latex allergy is an independent risk factor for PJI and aseptic revision surgery after total hip arthroplasty (THA) and total knee arthroplasty (TKA). A retrospective matched cohort study was conducted with an administrative claims database. A total of 17,501 patients who underwent TKA and had documented latex allergy were matched 1:4 with 70,004 control subjects, and 8221 patients who underwent THA and had documented latex allergy were matched 1:4 with 32,884 control subjects. Multivariable logistic regression showed that patients who had TKA and had a latex allergy showed significantly higher risk of PJI at both 90 days (odds ratio [OR], 1.26) and 1 year (OR, 1.22) and significantly higher risk of aseptic revision TKA at 1 year (OR, 1.21) after surgery compared with control subjects. Patients who had THA and had a latex allergy had significantly higher risk of PJI at 1 year (OR, 1.19) compared with control subjects. Rates of aseptic revision THA were higher in the latex allergy cohort but statistically comparable (P>.05). Latex allergy was associated with significantly increased risk of PJI and aseptic revision after TKA and significantly increased risk of PJI after THA. More work is needed to determine whether these risks can be mitigated or if latex allergy is an inherent, nonmodifiable risk factor requiring modification to typical arthroplasty pathways. [Orthopedics. 2022;45(4):244-250.]. [ABSTRACT FROM AUTHOR]

The pulp of the banana fruit is rich in bioactive compounds like dietary fibers, low glycemic carbohydrates, natural sugars, vitamins, minerals and antioxidants. These beneficial compounds are responsible for the proper functioning of immune system and enhance prevention against various deadly diseases like cancer, diabetes and heart diseases. Despite having, positive effects, the fruit are recognized as an important source for causing allergy to 0.6% of people in general population and up to 67 and 46% for people with asthma or atopic dermatitis. Fruit allergy is one of the most common food allergies witnessed worldwide. Banana fruit allergy results from the abnormal immune response to the banana proteins soon after its consumption. Symptoms range from oral allergy syndrome (OAS) to the life-threatening anaphylaxis. IgE reactivity of banana is associated with different proteins of which six proteins have been identified as major allergens, viz., Mus a1 (Profilin-actin binding protein), Mus a 2 (Class 1 chitinase), Mus a 3 (Nonspecific lipid transfer protein), Mus a 4 (Thaumatin like protein), Mus a 5 (Beta 1,3 glucanase) and Mus a 6 (Ascorbate peroxidase). This review focuses on pathogenesis, clinical features, diagnosis, and different food processing methods to mitigate the allergenicity of banana fruit. [ABSTRACT FROM AUTHOR]

A growing number of students with health conditions, many of which carry with them the potential for an emergency, increases the likelihood of adverse events occurring in the school setting. An adverse event can be either preventable or nonpreventable. This article reviews a preventable adverse event which took place in a second-grade classroom of a student with spina bifida. Children with spina bifida are at increased risk for the development of latex allergy and subsequent anaphylaxis. The seriousness of accumulated exposure to latex necessitated initiation of a quality improvement plan with the goal of decreasing the risk of future exposures and increasing the quality of collaboration among school staff in meeting student health needs. The article describes the adverse event and discusses the five factors that were addressed in the quality improvement plan: communication deficit, knowledge deficit, hierarchical culture, product labeling, and data collection. [ABSTRACT FROM AUTHOR]

Background: Apprentice nurses are considered at high risk to developing occupational skin diseases. Objectives: This study assessed the frequency and origin of hand eczema, and work‐related risk factors in apprentice nurses. Methods: The study involved 240 final‐year apprentice nurses (females 75%, median age 19 years) from vocational schools in Zagreb, Croatia. The study was performed in 2020/2021 and included a questionnaire and clinical examination by means of the Osnabrück Hand Eczema Severity Index (OHSI). Skin prick test (SPT) with natural rubber latex (NRL) allergen, and patch test with the basic series of allergens, and disinfectants, were performed in 42 apprentice nurses with hand eczema that lasted more than 3 months. Results: Clinically observed and self‐reported hand eczema were found in 49% and 46% of apprentice nurses, respectively. Those with observed changes were older and reported more days per month spent on practical work than those with healthy skin (P =.001). Median OHSI was 4 (interquartile range 2‐6). There were no positive SPTs to latex, and 11 (26%) apprentice nurses had positive patch test reactions to one or more tested allergens, mostly nickel. Conclusions: Hand eczema was common in final‐year apprentice nurses during the COVID‐19 pandemic. It was mostly of irritative origin, associated with the duration of practical training, confirming cumulative effect of hazards on skin barrier. [ABSTRACT FROM AUTHOR]

Background: Anaphylaxis is a rare but fatal condition with intraoperative diagnosis and treatment difficulties. Incidence of intraoperative anaphylaxis is 1/1500-5000. Triggering agents commonly include latex, neuromuscular blockers, intravenous anesthetics, antibiotics, and protamine. However, in approximately 16% of these cases, no etiology has been identified1. In the present case, we aimed to describe our approach and differential diagnostic management of intraoperative hemodynamic collapse in a patient with no known allergy. Case: A 60-year-old patient with contact dermatitis, no known allergy was scheduled for occipital mass operation. The patient was intubated and put in the prone position with a skull clamp. Acute sinus hemorrhage developed in the 40th minute of the operation during removal of occipital bone. The surgeons were able to stop bleeding, but the patient's blood pressure kept dropping. Noradrenaline was administered when there was no response to fluid resuscitation, however hypotension persisted. Arterial blood gas revealed hemoglobin 13mg/dL, PCO2 39mmHg. Following adequate fluid replacement, prednol and pheniramine maleate were administered. Considering a potential anaphylactic scenario, a blood sample was sent to the lab for analysis of serum tryptase and latex-specific IgE, and latex-containing substances were removed away. Hemodynamically stabilized patient was transferred to the ICU following surgery. The patient was admitted to ward on the 2nd postoperative day and the results showed positive latex-specific IgE. Conclusion: There are many causes of intraoperative hypotension in neuroanesthesia. Failure to achieve hemodynamic stabilization with bleeding control and adequate fluid-blood replacement, besides no clinical improvement despite normal ventilation and blood gas parameters led us away from surgical bleeding and air embolism diagnoses, and persistent hypotension suggested potential anaphylaxis. Latex allergy is one of the most common causes of anaphylaxis in the operating room3. Its confusion with contact dermatitis is documented in the literature. For this reason, latex allergy was considered in the patient and all agents were removed and treatment was. However, the development of anaphylaxis after bleeding at 40 minutes in the case presented here suggests that the hemostasis material containing oxidized regenerated cellulose used by the surgical team during bleeding control may also have triggered anaphylaxis. [ABSTRACT FROM AUTHOR]

This allergy is a hypersensitivity reaction that is triggered by contact with latex. Symptoms vary depending on factors such as route, frequency, and exposure dose, as well as individual susceptibility. The clinical manifestations can be localized at the site of contact with latex or generalized. Exposure can occur directly as a result of contact with the skin and mucous membranes, that is by touching or being touched by objects with latex, or by inhaling (breathing) particles from objects with latex. Contact can also be indirect; for example, by ingesting food that has been handled by a worker wearing latex gloves or by having contact with a person who has been blowing up balloons. The diagnosis of latex allergy is made based on the patient's medical history and on what has been reported in the interrogation, and it is complemented with in vivo studies (such as skin tests and provocation tests) or in vitro studies (determination of specific IgE). The fundamental pillar in the treatment of latex allergy is the education of the patient to achieve the avoidance of products made with this material or the contact and intake of food that has had contact with latex. In view of the foregoing, latex allergy has a great medical and social relevance due to all the safety measures that the patient must take. [ABSTRACT FROM AUTHOR]

Objectives: We conducted a multicenter study using the same questionnaire in 1999 and 2014 to investigate changes in the characteristics of patients with latex allergy. Methods: We mailed questionnaires on latex allergy to hospitals in Japan that were members of the Japanese Latex Allergy Society. Results: We compared the 25 responses received in 2014 and the 81 responses received in 1999. With regard to the age distribution, the number of patients with latex allergy in their 20s declined significantly from 1999 to 2014 (P=0.004). The largest proportion of latex allergy cases was observed among those aged

Latex-fruit syndrome is characterized by hypersensitivity reactions to certain plant-derived foods in individuals allergic to natural rubber latex (NRL), affecting approximately 30-50% of NRL-allergic patients. This condition arises due to the cross-reactivity of IgE antibodies. Over time, this syndrome has been associated with an increased number of plant sources, including avocado, banana, chestnut, kiwi, peach, tomato, potato, and bell pepper. We present a case of an art student who developed latex-fruit syndrome following prolonged exposure to NRL art supplies., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Zinabu et al.)

The article examines that latex allergies are a clear and present danger to many patients presented to healthcare systems, with several percentage of the general population worldwide having a documented allergy. Topics include considered the clinical presentation of these allergies can range from relatively mild, local cutaneous reactions to severe, generalized anaphylactoid reactions.

Objective: Adequate training and protective measures are some of the effective ways to preventi latex allergy. This study aimed to assess the level of knowledge about latex allergy, behavioral patterns and the incidence of latex allergy. Methods: Four hundred ten healthcare workers (HCWs) were invited to participate in a survey and answer a questionnaire on the level of knowledge and protective methods of latex allergy. A second supplemental questionnaire was applied to 53 HCWs who were diagnosed with latex allergy or had symptoms of latex exposure. Results: The study population consisted of 410 HCWs; 240 (61.9%) were female and had a median working duration of 5 (IQR: 0.13-38) years. 74 (18%) HCWs described symptoms after latex exposure with a median working time of 34.5 (IQR: 21-50) years. Despite the symptoms, skin test was not performed 41 (78.8%) of 74 patients. When the knowledge levels of protection methods from the latex allergen were compared, research assistants and nurses were found to be more than the technicians (p=0.047, p=0.016, respectively). When the anxiety level was compared between occupational groups, it was significantly higher in nurses and technicians compared to research assistants (p=0.012, p=0.001, respectively). Conclusion: The data indicated that HCWs are not adequately informed about latex allergy, and comparing the occupational groups, this fact was more remarkable among technicians. Continuing education of HCWs regarding latex allergy, appropriate diagnostic tests in the presence of symptoms, and taking effective protective measures are essential steps in the fight against latex allergy. [ABSTRACT FROM AUTHOR]

Aims: Latex sensitivity has been a concern for health-care workers in recent years. Due to the excessive exposure to latex products in the operating room, the personnel of this department are exposed to high sensitivity to these products. Therefore, the present study was conducted to investigate the prevalence of latex sensitivity among operating room personnel. Materials and Methods: This systematic review and meta-analysis conducted based on a Preferred Reporting Items for Systematic Reviews and Meta-Analysis checklist. The present study researchers explored four international databases, namely Medline/PubMed, ProQuest, Scopus, and Embase in February 2020. The selected keywords for international databases were classified into three categories (a) operating room personnel, (b) latex sensitivity, and (c) prevalence. The collected data were entered into the EndNote X8 software and analytical analysis was performed by STATA statistical software version 12. Results: Seventy-five articles were found by searching for databases. After several screening steps, 12 articles entered the final analysis. The results show that the prevalence of latex sensitivity in total is 14.76 (confidence interval 95%: 9.27–20.25). Meta-regression results showed that the relationship between the years of study and the prevalence of latex sensitivity is not statistically significant (P = 0.222). Conclusion: The results of the present study showed that sensitivity to latex is significantly prevalent among operating room staff. Due to the importance of sterility and sensitive working conditions in the operating room, as well as frequent contact with latex products, it is important to pay attention to the side effects caused by latex powder. [ABSTRACT FROM AUTHOR]

Abstract Background Natural rubber latex and chlorhexidine have previously been identified as causative substances in perioperative anaphylaxis. A pelvic examinations is generally considered noninvasive, however, this procedure is rarely associated with severe allergic reactions. We reported a rare case of dual latex and chlorhexidine allergies which caused anaphylaxis after pelvic examination in a woman with a history of latex-related fruits allergy. Case presentation A 54-year-old woman had severe anaphylaxis after a pelvic examination due to dual latex and chlorhexidine (CHX) allergies. The gynecologist used CHX for the vaginal preparation and wore latex-containing gloves with lubricating gel during the examination. In vivo and in vitro tests revealed CHX sensitization by a positive skin prick test to chlorhexidine at a very low concentration (0.002 mg/mL), and a positive basophil activation test to CHX. Latex allergy was confirmed by a positive specific IgE to latex and a positive glove-use test at 20 min. An analysis of specific IgE to latex component revealed positive results for Hev b 1, 5, 6.02, and 11. As she also had a past history of fruit allergy, prick-to-prick testing with latex-related fruits was performed. The results were positive for avocado, banana, jackfruit, kiwi, and longan. Conclusions Concomitant mucosal exposure of both natural rubber latex and CHX in highly sensitized patients during pelvic examinations can lead to severe anaphylaxis. Pre-procedural screening for an allergy to latex or CHX, or to any other allergen, should be performed in patients where there is suspicion of a specific allergy due to a previous allergic reaction. Increased awareness of these two allergens in all healthcare settings may improve patient safety.

The article presents a case report of a 52-year-old male due for kidney transplantation who had Kounis syndrome with a normal perfusion study with no stress-induced ischemia, and who later underwent transplantation without incidence when latex was avoided during the perioperative period.

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Objectives Occupational skin disease (OSD) arises from work-related activity. However, there is a paucity of literature on OSD in physicians. The aim of the this review was therefore to examine and summarize what types of symptomatic OSD physicians experience. Methods We conducted a systematic literature search on Cochrane Library, Embase, and Pubmed. Results Contact dermatitis from formaldehyde and glutaraldehyde were found in 11.5 and 13.5% of cases, respectively. In total 2.4–14.9% had latex allergy. The reported standardized incidence ratio of squamous cell carcinoma and melanoma was up to 2.15 [95% confidence interval (CI) 1.57–1.95] and 3.2 (95% CI 1.38–6.31). Transmission of human papilloma virus (HPV) particles during carbon dioxide laser wart ablation were found in 70% of samples collected from protective gloves and in 52% of samples from vapors. Conclusions The most frequently reported OSD in physicians is contact dermatitis from allergens in disinfectants and rubber gloves. There is also a risk of cutaneous reactions to latex. The incidence of skin cancer was higher in physicians than in the general population, and the reason for this remains unexplained and potentially biased. There are no reports of transmission of patient HPV to surgeons during wart ablation, possibly because of proper use of protective equipment. [ABSTRACT FROM AUTHOR]