bluuebunny/crossref_metadata_2025_split huggingface dataset:
Flow‐assisted diagnostic management of anaphylaxis from rocuronium bromide
Authors: Ebo D. G. , Bridts C. H. , Hagendorens M. M. , Mertens C. H. , De Clerck L. S. , Stevens W. J. 
Published: July 2006

Background:  Diagnosis of anaphylaxis from neuromuscular blocking agents (NMBA) is not always straightforward.Objectives:  To assess flow cytometric analysis of activated basophils (BAT) as a diagnostic instrument in anaphylaxis from rocuronium. To investigate whether the technique might help to identify cross‐reactive and safe alternative compounds.Methods:  For validation of the BAT, 14 patients with perioperative anaphylaxis demonstrating a positive skin test (ST) for rocuronium and eight individuals that tolerated rocuronium and a negative ST for this drug were enrolled.To confirm specificity of the BAT, five patients that tolerated atracurium or cisatracurium with a negative ST for rocuronium were tested.Basophil activation with rocuronium, vecuronium, atracurium, cisatracurium and suxamethonium was analysed flow cytometrically by labelling with anti‐CD123/anti‐HLADR/anti‐CD63.Results:  Sensitivity of BAT for rocuronium was 91.7% and specificity 100%. However, in two patients the BAT was lost as a diagnostic tool, as their cells were nonresponsive to positive control stimulation and allergen.Seven from the 12 responsive patients also demonstrated a clear basophilic activation for vecuronium. Moreover, according to ST and/or BAT cross‐reactivity between rocuronium and vecuronium was suspected in 10/14 patients.Except one patient, all patients had negative BAT and ST investigations for atracurium and cisatracurium. Currently, five patients tolerated administration of cisatracurium.All control individuals demonstrated negative ST and BAT for all tested NMBA.Conclusions:  The BAT constitutes a reliable instrument to diagnose anaphylaxis from rocuronium. The technique also allows quick and simultaneous testing of different potential cross‐reactive NMBA and to tailor a safe alternative.
Higher pH level, corresponding to that on the skin of patients with atopic eczema, stimulates the release of Malassezia sympodialis allergens
Authors: Selander C. , Zargari A. , Möllby R. , Rasool O. , Scheynius A. 
Published: July 2006

Background:  The opportunistic yeast Malassezia is a trigger factor in atopic eczema (AE). Around 30–80% of patients with AE have an IgE and/or T‐cell reactivity to the yeast. Several IgE‐binding components have been identified in Malassezia extracts and 11 allergens have been cloned and sequenced. The pH of the skin surface in patients with AE is higher than that of normal healthy skin. We here investigate whether different pH conditions mimicking those of AE skin and healthy skin can influence the production and release of Malassezia allergens.Methods:  Malassezia sympodialis (ATCC strain 42132) was cultured in Dixon broth at pH 6.1 to 5.0 for 1–15 days. Culture supernatants were analysed for the presence of IgE‐binding components by immunoblotting. The M. sympodialis cells were analysed for allergen expression and production with immunocytochemistry and quantitative polymerase chain reaction.Results:  We found that M. sympodialis cells produce, express and release allergens to a greater extent when cultured at the higher pH. This was particularly true of a 67‐kDa major allergen designated Mala s 12.Conclusions:  The data suggest that the skin barrier in AE patients provides an environment that can enhance the release of allergens from M. sympodialis, which can contribute to the inflammation.
Fish consumption during the first year of life and development of allergic diseases during childhood
Authors: Kull I. , Bergström A. , Lilja G. , Pershagen G. , Wickman M. 
Published: July 2006

Background:  Fish consumption during infancy has been regarded as a risk factor for allergic disease but later evidence suggests a protective role. However, methodological limitations in the studies make conclusions uncertain. The aim of this study was to assess the association between fish consumption during the first year of life and development of allergic diseases by age 4.Methods:  A prospective birth cohort of 4089 new‐born infants was followed for 4 years using parental questionnaires at ages 2 months, 1, 2 and 4 years to collect information on exposure and health effects. The response rate at 4 years was 90%. A clinical investigation was performed at age 4 years, which included blood sampling for analysis of specific IgE to common food and airborne allergens.Results:  Parental allergic disease and onset of eczema or wheeze during the first year of life delayed introduction of fish in the child's diet. After exclusion of such children to avoid disease‐related modification of exposure, regular fish consumption during the first year of life was associated with a reduced risk for allergic disease by age 4, ORadj 0.76 (95% CI 0.61–0.94) and sensitization, ORadj 0.76 (0.58–1.0). The reduced risk appeared most pronounced for multiple disease, ORadj 0.56 (0.35–0.89). IgE‐sensitization to fish was only present among 18 of the 2614 children.Conclusion:  Regular fish consumption before age 1 appears to be associated with a reduced risk of allergic disease and sensitization to food and inhalant allergens during the first 4 years of life.
Patients with drug reactions – is it worth testing?
Authors: Wöhrl S. , Vigl K. , Stingl G. 
Published: July 2006

Background: Unevaluated drug reactions that lead to the prescription of expensive alternative medication is the reason why the European Academy of Allergy and Clinical Immunology guidelines recommend verification. We evaluated whether a structured test procedure in patients with drug reactions is worth the potential risk.Methods: We retrospectively analysed the charts of a cohort of 291 (220 females/71 males) consecutive patients from January 2003 to June 2004, who presented at the department's allergy outpatient clinic with histories of drug reactions. Twenty‐three patients reported more than one independent episode resulting in 325 cases. All patients underwent the following procedure: (1) detailed history; (2) skin test and/orβ‐lactam‐specific IgE and; (3) if inconclusive, each patient was offered provocation testing – if needed with alternative medication.Results: We evaluated reactions to 130 antibiotics, 90 to nonsteroidal anti‐inflammatory drugs, 36 to local anaesthetics and 69 to other drugs. An association between drug intake and reaction was confirmed in 100 and excluded in 157 cases. Fourteen of 104 drug provocation tests (DPT), among these four reactions to placebo, yielded positive results but were managed without difficulty. In 68 cases, the procedure remained inconclusive. Additionally, we recommended 197 safe alternative regimens to 85 patients. Overall, our test procedure resulted in clear‐cut recommendations to 82.1% (239/291) of the patients.Conclusions: A standardized work‐up including DPTs in patients with drug reactions leads to clear‐cut advice concerning future tolerability or avoidance of certain drugs including recommendations for alternative medication in the vast majority of patients at the cost of only a low risk of mild side effects.
The association between non‐melanoma skin cancer and a young dimorphic Alu element within the major histocompatibility complex class I genomic region
Authors: Dunn D. S. , Inoko H. , Kulski J. K. 
Published: July 2006

AbstractA non‐melanoma skin cancer (NMSC) susceptibility locus within the major histocompatibility complex (MHC) class I region was previously identified telomeric of the HLA‐C gene using high‐density microsatellite markers. Here, we have extended the previous microsatellite study by using the same DNA samples obtained from 154 NMSC patients and 213 normal controls from the town of Busselton in Western Australia and examined the relationship between five polymorphic Alu insertions (POALINs) within the MHC class I region and their association with NMSC. The genotype distribution of the AluyTF insertion that is located within the NMSC susceptibility region telomeric of the HLA‐C gene was significantly increased according to the Fisher's exact test in the NMSC patients, and it was not in Hardy–Weinberg equilibrium in the control group. There was no difference between the cancer patients and controls for the genotypes of the AluyMICB locus within intron 1 of the MICB gene and the other three POALINs (AluyHJ, AluyHG and AluyHF) that are located within the genomic region of the HLA‐A, ‐G and ‐F gene cluster. The test for significant linkage disequilibrium for 10 pairs of POALIN loci and estimations of two locus POALIN haplotype frequencies also revealed AluyTF differences between the cases and controls. In conclusion, the MHC class I POALIN, AluyTF, that is located within the NMSC susceptibility locus and near the HLA‐C gene was strongly associated with NMSC. This finding, using five different polymorphic Alu insertion markers, supports the previous microsatellite association study that one or more genes located in close proximity to the AluyTF insertion has a potential role in NMSC.
High‐resolution molecular characterization of the HLA class I and class II in the Tarahumara Amerindian population
Authors: García‐Ortiz J. E. , Sandoval‐Ramírez L. , Rangel‐Villalobos H. , Maldonado‐Torres H. , Cox S. , García‐Sepúlveda C. A. , Figuera L. E. , Marsh S. G. E. , Little A. M. , Madrigal J. A. , Moscoso J. , Arnaiz‐Villena A. , Argüello J. R. 
Published: July 2006

AbstractWe describe for the first time the high‐resolution profiling of HLA‐A, ‐B, ‐C, ‐DRB1, ‐DQB1 and ‐DPB1 in a culturally and geographically distinct Mexican ethnic group, the Tarahumaras. The alleles most frequently found by reference strand‐mediated conformational analysis in this population were for class I: HLA‐A*240201, *020101/09, *0206, *310102, *680102; HLA‐B*4002, *1501, *510201, *3501/02/03, *4005, *4801; HLA‐Cw*0304, *0801, *0102, *040101; and for class II: HLA‐DRB1*080201, *1402, *040701; HLA‐DQB1*0402, *0301, *0302/07; HLA‐DPB1*0402, *0401, *020102. In addition, a novel allele, HLA‐A*0257, was found. Based on comparison of presently known HLA‐DRB1 and ‐DQB1 allele frequencies in Amerindian groups and worldwide populations, the Tarahumaras are unexpectedly more related to the geographically and linguistically distant Aymara and Terena Amerindian groups than they are to neighbouring tribes.
Inhibition of Porphyromonas gingivalis proteinases (gingipains) by chlorhexidine: synergistic effect of Zn(II)
Authors: Cronan C. A. , Potempa J. , Travis J. , Mayo J. A. 
Published: July 2006

Background/aims:  Gingipains, proteolytic enzymes produced by the periodontal pathogen Porphyromonas gingivalis, are regarded as virulence factors in the pathogenesis of periodontitis. Inhibition of gingipain activity therefore may have therapeutic potential, and it has been suggested that chlorhexidine may inhibit the activities of these enzymes. The purposes of the present study were to examine systematically the inhibitory effects of chlorhexidine on three purified gingipains and to determine the effect of Zn(II) on chlorhexidine inhibition.Methods:  The activities of lys‐gingipain (Kgp) and two forms of arg‐gingipain (RgpB and HRgpA) were measured in the presence of varying concentrations of chlorhexidine and with chlorhexidine supplemented with Zn(II). Inhibition constants (Ki's) were determined for chlorhexidine alone and in the presence of Zn(II). Fractional inhibitory constant indices were calculated to assess the synergy of the chlorhexidine–Zn(II) inhibition.Results:  RgpB, HRgpA, and Kgp were all inhibited by chlorhexidine with Ki's in the micromolar range. For RgpB and HRgpA, the inhibitory effects of chlorhexidine were enhanced 3–30‐fold by Zn(II). The chlorhexidine–Zn(II) interaction was synergistic for inhibition of HRgpA and RgpB. For Kgp, the effect of Zn(II) on chlorhexidine inhibition was antagonistic.Conclusions:  Chlorhexidine is an effective inhibitor of gingipains, and the inhibition of R‐gingipains is enhanced by Zn(II). A mixture of chlorhexidine and Zn(II) may be useful as an adjunct in the treatment of periodontitis and in the post‐treatment maintenance of periodontitis patients.
Induction ofPorphyromonas gingivalisGroEL signaling via binding to Toll‐like receptors 2 and 4
Authors: Argueta J. G. M. , Shiota S. , Yamaguchi N. , Masuhiro Y. , Hanazawa S. 
Published: July 2006

Background/aims: Heat shock protein 60 (HSP60) has been recognized as an important molecule in infectious and autoimmune diseases. AlthoughPorphyromonas gingivalisGroEL, a homologue of HSP60, is a potent stimulator of inflammatory cytokines, its receptor and signaling mechanisms are not yet understood in detail. In this study, we investigated whether the Toll‐like receptor (TLR) family plays a functional role as aP. gingivalisGroEL receptor.Methods: Human macrophage‐like THP‐1 cells were used and the nuclear factor‐κB (NF‐κB) activity of cells stimulated with a recombinantP. gingivalisGroEL was measured with a luciferase assay. Flow cytometry analysis was used to determine the binding to THP‐1 cells of fluorescein isothiocyanate (FITC)‐labeled GroEL. In addition, anti‐human TLR (anti‐hTLR)2 and anti‐hTLR4 monoclonal antibodies were used to assess the functional role of TLR2 and TLR4 as the receptors for GroEL.Results: We observed by luciferase assay that the purified recombinant GroEL was able to stimulate NF‐κB transcriptional activity in THP‐1 cells. Flow cytometry analysis showed that the FITC‐labeled GroEL bound to THP‐1 cells in a dose‐dependent fashion. Our binding competition analysis with FITC‐labeled and unlabeled GroEL showed that it bound to the cells as a specific mode of action. On the other hand, GroEL‐stimulated NF‐κB transcriptional activity was significantly inhibited by anti‐hTLR2 and anti‐hTLR4 antibodies and was inhibited more strongly by a combination of both antibodies.Conclusion: Our present study demonstrates thatP. gingivalisGroEL induces its intracellular signaling cascade in THP‐1 cells via TLR2 or TLR4 and via a combination of both receptors.
Propofol acts at the sigma‐1 receptor and inhibits pentazocine‐induced c‐Fos expression in the mouse posterior cingulate and retrosplenial cortices
Authors: Yamada M. , Nakao S. , Sakamoto S. , Takamori Y. , Tamura Y. , Mochizuki‐Oda N. , Kataoka Y. , Yamada H. , Shingu K. 
Published: July 2006

Background: The sigma‐1 receptor is functionally linked with psychotomimetic effects of various drugs. A sigma‐1 receptor agonist enhances bradykinin‐induced intracellular Ca2+concentration ([Ca2+]i) increase and induces c‐Fos expression in a part of the brain. The aim of this study was to investigate the effects of several intravenous anaesthetics on the sigma‐1 receptor.Methods: First, using Wistar rat brains, (+)[3H]SKF‐10,047, a selective sigma‐1 receptor agonist was displaced by propofol, dexmedetomidine, droperidol, and thiopental. Second, Fura‐2 loaded NG‐108 cells were incubated with (+)pentazocine, a selective sigma‐1 receptor agonist, and propofol and then its fluorescence was observed after stimulation with bradykinin. Third, male ICR mice received Intrafat® or propofol intraperitoneally (i.p.), followed by pentazocine i.p. Brain slices were prepared and Fos‐like immunoreactivity was detected using an immunohistochemical method.Results: Propofol, droperidol, and dexmedetomidine displaced (+)[3H]SKF‐10,047 binding in a concentration‐dependent manner with Ki50s of 10.2 ± 0.6, 0.17 ± 0.03, 5.73 ± 1.2 μM, respectively. Thiopental sodium was practically ineffective. Propofol produced a statistically significant reduction in the maximal binding capacity (Bmax) but did not affect the dissociation constant (Kd). (+)Pentazocine significantly enhanced bradykinin‐induced [Ca2+]i increases, but propofol did not affect it. Pentazocine induced marked Fos‐LI positive cells in the posterior cingulate and retrosplenial cortices (PC/RS), which was significantly reduced by propofol.Conclusions: These results suggest that propofol may be a sigma‐1 receptor antagonist, and that various effects of propofol on the brain may be mediated, at least partly, by the sigma‐1 receptor.
The effect of gabapentin on post‐operative pain following tonsillectomy in adults
Authors: Mikkelsen S. , Hilsted K. L. , Andersen P. J. , Hjortsø N.‐C. , Enggaard T. P. , Jørgensen D. G. , Hansen M. , Henriksen J. , Dahl J. B. 
Published: July 2006

Background:  The aim of the present study was to investigate whether a combination of rofecoxib and gabapentin could improve pain relief and reduce opioid requirements, compared with rofecoxib alone, during the first 5 days after tonsillectomy.Methods:  In a randomized, double‐blind, placebo‐controlled study, 49 patients received gabapentin 1200 mg pre‐operatively, followed by gabapentin 2 × 600 mg on the day of operation and gabapentin 3 × 600 mg for the next 5 days, or placebo. Both groups were given rofecoxib 50 mg daily. In the post‐operative care unit, intravenous morphine was administered in doses of 2.5 mg on request. From 4 h to 5 days post‐operatively, ketobemidone was offered as escape drug. Pain at rest and during swallowing, and side‐effects, were assessed using a four‐point verbal rating scale.Results:  As a result of the global withdrawal of rofecoxib, the study had to be terminated prematurely. This report comprises the results from 22 patients in the gabapentin group and 27 patients in the placebo group. Gabapentin reduced ketobemidone requirements during the first 24 h post‐operatively [4.5 mg (standard deviation, 3.0 mg) in the placebo group vs. 2.0 mg (standard deviation, 2.0 mg) in the gabapentin group; P < 0.003]. Gabapentin induced more dizziness (P < 0.002), gait disturbance (P < 0.02) and vomiting (P < 0.05) during days 0–5 than placebo. No other statistically significant differences were observed.Conclusion:  Gabapentin reduced opioid requirements in the first 24 h after tonsillectomy. The benefits of the reduced opioid intake may be overshadowed by the drawbacks of side‐effects.
Association of μ‐opioid receptor gene polymorphism (A118G) with variations in morphine consumption for analgesia after total knee arthroplasty
Authors: Chou W.‐Y. , Yang L.‐C. , Lu H.‐F. , Ko J.‐Y. , Wang C.‐H. , Lin S.‐H. , Lee T.‐H. , Concejero A. , Hsu C.‐J. 
Published: July 2006

Background:  Morphine consumption after a given surgical procedure can vary considerably. Studies show that single nucleotide polymorphism involving the nucleotide position 118 at exon 1 of the μ‐opioid receptor gene (OPRM1) may play a role in mediating the effects of opioids. This study was performed to correlate the A118G polymorphism at OPRM1 with morphine consumption in patients undergoing total knee arthroplasty.Methods:  Post‐operative pain was relieved by patient‐controlled analgesia (PCA). The analgesic effect was evaluated using a visual analogue scale. Side‐effects, such as sedation, nausea and vomiting, and pruritus, were recorded systematically. The genotypes were determined by sequencing polymerase chain reaction‐amplified DNA. The differences in demographics and consumed morphine from the PCA device between the different genotypes were tested using one‐way analysis of variance. The prevalence of side‐effects from morphine and sex distribution were compared using the Kruskal–Wallis test.Results:  One hundred and forty‐seven patients were included in the study. Twenty‐seven patients who required rescue analgesia were excluded; these patients did not differ demographically or genetically from the 120 who completed the study. Of the latter, 74 were A118 homozygous (AA), 33 were heterozygous (AG) and 13 were G118 homozygous (GG). Group GG consumed significantly more morphine (40.4 ± 22.0 mg) than group AA (25.3 ± 15.5 mg) and group AG (25.6 ± 11.7 mg) during the first 48 h post‐operatively. The groups did not differ with respect to reported pain, age, sex, weight and adverse effects.Conclusions:  G118 homozygotes have a poorer response to morphine for post‐operative pain control than A118 homozygotes or heterozygotes. The genotype may thus influence the post‐operative response to pain and cause differences in the amounts of analgesic consumed by patients after total knee arthroplasty.
Effect site concentrations of propofol producing hypnosis in children and adults: comparison using the bispectral index
Authors: Muñoz H. R. , Cortínez L. I. , Ibacache M. E. , León P. J. 
Published: July 2006

Background:  No study has determined the concentration of propofol producing a degree of hypnosis compatible with anaesthesia in children. As a result, concentrations determined in adults are recommended for children. As this can result in an inadequate depth of anaesthesia, we determined the predicted effect site concentration (Ce) of propofol necessary to obtain a bispectral index (BIS) of 50 in 50% (ECe50) of children and adults.Methods:  Twenty adults (aged 33–44 years) and 20 children (aged 3–11 years) undergoing surgery under general anaesthesia were studied. All were monitored with a BIS monitor, and a target controlled infusion of propofol aiming for a constant Ce value was started. After 10 min, patients were evaluated using a sedation scale, and the last 5 min was used to determine the mean BIS for this Ce value. The Ce value of propofol was defined using the up‐and‐down method of Dixon and Massey. The first patient in each group received Ce= 6 μg/ml; thereafter, it was modified in 0.5 μg/ml decrements/increments with positive or negative responses, respectively. A positive response was BIS < 50 and a negative response was BIS ≥ 50. The ECe50 value was compared using unpaired Student’s t‐test. The prediction probability (PK) was used to study the association between BIS and the sedation score.Results:  The mean ECe50 (95% confidence interval) values were 3.75 μg/ml (2.97–4.75 μg/ml) in adults and 3.65 μg/ml (3.36–3.96 μg/ml) in children (not significant). All patients with BIS < 50 were unarousable with tactile stimulation. The PK value was 0.99 in both groups.Conclusions:  The predicted Ce value of propofol resulting in BIS = 50 was similar in adults and children aged 3–11 years. The predicted Ce value of propofol producing hypnosis in adults also seems to be useful in this paediatric population.