By P. Rhobar. Averett College.
Carbamates are rubber accelerators that are common sensitizers and are closely related to thiurams generic zebeta 5 mg on-line. Currently cheap 5 mg zebeta visa, carbamates are the most common accelerators used in latex and nitrile medical gloves zebeta 10mg visa. Black rubber paraphenylenediamine is an antioxidant used in the manufacture of black rubber. This is fortunately a relatively uncommon sensitizer because avoidance of this ubiquitous substance is difficult. Thioureas and naphthyl compounds are rubber accelerators that are less common causes of allergy. Clothing-related Dermatitis Most clothing fibers are nonsensitizers or rare sensitizers ( 39). The disperse dyes, such as azo and anthraquinone dyes, which are used on synthetic fabrics, are most problematic. Fabrics containing cotton or rayon usually contain formaldehyde resins and a small amount of free formaldehyde. Allergy to free formaldehyde has become less common in recent years because manufacturers have reduced levels of free formaldehyde in fabrics. However, it is possible to have contact allergy to the formaldehyde resins used in these fabrics. Because allergy to clothing is not usually identified using a standard patch test, testing requires specialized nonstandard allergens. Spandex (except some from Europe which contains mercaptobenzothiazole) and Lycra are good substitutes. Plastic-related Dermatitis Plastics that can sensitize include epoxies (before full hardening occurs), paratertiary butyphenol formaldehyde resin (commonly used in leather adhesives), and acrylate and methacrylate monomers (40,41). Acrylic monomers, used in about 95% of dentures in the United States, are a common cause of contact allergy in dentists. Acrylic sculptured nails, nail products, and acrylic prostheses also can cause sensitization. Plants Allergic contact dermatitis to plants is most commonly due to the oleoresin fraction, especially the essential oil fraction. In contrast, type I reactions to plants are most commonly due to pollen and other plant proteins. Rhus Rhus dermatitis (poison ivy, oak, and sumac) is the most common form of allergic contact dermatitis seen in both children and adults in the United States ( 42,43). Ragweed Ragweed dermatitis generally affects older individuals and rarely occurs in children ( 44). Men are affected 20 times more often than women, primarily those who are dairy farmers. Although a sesquiterpene lactone mix is available for patch testing and will be positive in many cases of compositae allergy, it will miss some cases because sesquiterpene lactones may not be cross-reactive. Alstromeria Alstromeria (Peruvian lilly) is a common cause of allergy in florists and is due to tuliposide-A (a butyrolactone) ( 45). Photoreactions Phototoxic reactions are due to nonimmunologic mechanisms, usually occur on first exposure, and tend to resemble sunburn ( 46). Berloque dermatitis on the neck is caused by perfumes containing oil of bergamot (bergapten or 5-methoxy-psoralens). The most common cause in the past was halogenated salcylanides in soaps and cleansers; however, these are no longer used in the United States or Europe. Hexachlorophene, a halogenated phenol, also can cause photoallergy and can cross-react with these compounds. Phenothiazines are used in insecticides and can cause topical photoallergy and phototoxic reactions. This does not occur by the oral route, with the exception of chlorpromazine, which can cause phototoxic reactions. Most topical sulfonamides are not photosensitizers, but sulfanilamide can cause both photoallergic and phototoxic reactions. Potent materials that may sensitize on the first application include plant oleoresins, paraphenylenediamine, and methylsalicylate. Patch testing and especially repeated patch testing should not be performed unnecessarily. This is especially important when testing with a contactant not included in the standard patch test materials. To be significant, a substance must elicit a reaction at a concentration that will not cause reactivity in a suitable number of normal controls. Patch testing should never be performed in the presence of an acute or widespread contact dermatitis. False-positive reactions may be obtained because of increased reactivity of the skin. In addition, a positive patch test reaction with the offending agent may cause a flare-up of the dermatitis. The patient should be carefully instructed at the time of patch test application to remove any patch that is causing severe irritation. As mentioned earlier, an anaphylactoid reaction can occur when testing for contact urticaria. An interesting but poorly understood complication is the occasional occurrence of the nephrotic syndrome and glomerulonephritis in severe generalized contact dermatitis caused by poison ivy or poison oak (49).
The roots of the greater splanchnic nerves arose from as high as 4th thoracic ganglion and as low as 10th thoracic ganglion: even variable origins in each side of the same specimen were observed discount 5 mg zebeta with visa. In the majority of cases cheap zebeta 5 mg without a prescription, the segmental origin of the greater spanchnic nerve was found to come th th from the 6 to 9 thoracic ganglia (78% on the right side and 84% on the left side) buy discount zebeta 5mg. In most of the cases, the parasympathetic nerves were seen to arise from a single anterior vagus and, a single posterior vagus (73. However, in 8 cases, two anterior vagal trunks and one posterior vagal trunk were seen (17. The histological examination of the distribution and the mode of termination of the gastric nerves were determined in the stomachs of 15 human adults, 3 human fetuses, 8 albino rat, and 4 specimens from operative biopsy tissue by using various neurohistological and histochemical techniques. Nerve plexuses and ganglia were observed in the submucosa, muscular, and serosa layers of the stomach. Free as well as encapsulated endings were observed in the wall of the stomach of human and albino-rats. The type of nerve endings were free and free but organized endings such as loop-like endings. Pharmacological experiments were done in the stomachs of 2 albino-rats to prove the sympathetic and parasympathetic activities. Sympatho- mimetic agents were seen to evoke inhibitory responses where parasym-pathomimetic agents were found to evoke excitatory responses. Neurohistological and histochemical studies were done on the specimens from fifteen human adults, three human fetuses, eight albino-rats, and four specimens from human operative biopsy tissue. All parts of the stomach were supplied by the gastric branches of the coeliac plexus formed by both th th vagi and greater splanchnic nerves mainly from 6 to 9 thoracic ganglia. Neurohisto- chemically nerve plexuses and ganglia were observed in the submucosa, muscular, and serosa layers of the stomach. Intraepithelial free nerve endings, free but organized nerve endings such as loop-like endings and encapsulated endings such as Meissner s corpuscle and small bulbous corpuscles were 190 Bibliography of Research Findings on Gastrointestinal Diseases in Myanmar seen. Histochemicaly, acetylcholinesterase - positive ganglia, varicose nerve fibres and formaldehyde fluorescent nerve plexus were observed. Pharmacological experiments with sympathomimetic agents, sympatholytic agents, parasympathomimetic agents, and parasym- patholytic agents were done in the stomachs of two albino-rats to prove the sympathetic and parasympathetic activities. The review also outlines the rational approach to promotion of growth of Myanmar children. Studies conducted in Myanmar have shown that rice malabsorption is common in children, and may occur in up to two thirds of the population. It is possible that Helicobacter pylori infection frequently acquired during childhhod in developing countries has an impact on small bowel function. The precise mechanism is unknown but it has been proposed that it relates to the impact of infection on acid secretion, resulting in hypochlorhydria which may open the gate to enteric infections, small bowel bacterial overgrowth, and associated carbohydrate malabsorption. Elucidation of these mechanisms would allow a rational approach to promotion of growth of Myanmar children. An increase in the number of siblings was also found to be a high risk factor for H. Density of living, drinking water source, and type of latrine were not significantly associated with H. The findings indicated that intrafamilial transmission could play an important role in the high prevalence of H. Before implementation of clinical use of such a serological test requires validations for local use. Again growing popularity of "test- and-treat" policy requires evaluation of usefulness of such serological test-performance among under and over forty-five years age groups. The objectives were: a) to compare the gastric acid secretion together with urine acid output between malnourished and well-nourished children, b) to determine the relationship between the gastric acid secretion and urine acid out put. The study was carried out during June to December 2000 at the Yangon Children Hospital. Gastric acid secretion and urine acid output level before and after coffee stimulation in 40 malnourished and 20 well-nourished children. It was found that there was significantly decreased volume of stimulated gastric acid secretion within first hour (17. However, there was no significant quantitative relationship between gastric acid secretion and urine acid output in both malnourished and well-nourished children. Malnourished children were unable to respond appropriate to a stimulus for gastric acid production, poor response was markedly observed in children with kwashiorkor and lesser extent in marasmic-kwashiorkor children. All these patients underwent semi-urgent haemorrhoidectomy (Standard Ligation and Excision). During hospital stay, early post-operative complication were elected and compared with other series. On each visit of the follow-up, late post- operative complications was explored and the results were also compared and discussed with the other series. Study was done regarding the incidence, clinical presentation, pathological staging and type of operation and postoperative complication. The youngest one was 23 years old man (medical student) the oldest one was 75 years old man. However, the peak age incidence as well as average age incidence was one decade earlier than the counterparts in the Western countries, but similar to that of Egyptians and South African Bantu.
Chronic sulfasalazine therapy in the treatment of delayed pressure urticaria and angioedema buy zebeta 5 mg free shipping. Sulfasalazine in the treatment of corticosteroid-dependent chronic idiopathic urticaria zebeta 10 mg with visa. The American Academy of Allergy and Immunology and the National Institutes of Health have defined food reactions in an attempt to standardize the nomenclature used in scientific literature (1) zebeta 5mg sale. An adverse food reaction is defined as any untoward reaction to food or food additive ingestion. According to one prospective survey, at least one in four atopic adults report an adverse reaction to food they have ingested or handled ( 2). Similarly, 28% of mothers in one study perceived their children to have had at least one adverse reaction to food ( 3). A study of an unselected population of over 1,700 Danish children reported that 6. Recently, the prevalence of peanut and tree nut allergy in the United States, as determined by a nationwide telephone survey, was estimated to be approximately 1. Food allergy prevalence in the general population, as reported by Buckley, is estimated to be 0. Prevalence, however, appears to be much higher in children with moderate-severe, refractory atopic dermatitis. One study reported that one third of the 63 such patients recruited had immunoglobulin E (IgE)-mediated food allergy ( 7). Studies like those mentioned above have not been systematically conducted in adults, but some surveys suggest the prevalence of food allergy in adults to be 1% to 2%. They are notable for their immediate onset most within 1 hour but frequently within minutes. As with other IgE-mediated reactions they can have a late-phase response 4 to 6 hours later. Protracted anaphylaxis, relatively resistant to epinephrine, has been noted and also has been described with venom anaphylaxis (9). Recent studies have reported foods to be the number one cause of anaphylaxis ( 10,11). Historically, the incidence of fatal and near-fatal food-induced anaphylaxis has been difficult to ascertain, primarily due to a lack of coding in the International Classification of Disease. The four factors that appeared to contribute to a fatal outcome were a concomitant diagnosis of asthma, a delay in the administration of epinephrine, previous allergic reactions to the responsible food, and not recognizing food allergen in the meal. Its function is to digest food into forms more easily absorbed and available for energy and cell growth. In this process it must provide a defensive barrier against any pathogens entering by this route and simultaneously tolerate the many foreign proteins in foods to which it is exposed. Nonimmunologic or mechanical barriers include gastric acid secretions and proteolytic enzymes. These digest proteins into molecules that are less antigenic, either by reducing the size (14) or by altering the structure ( 4,14), as described below in the section on tolerance. Other physical barriers include peristalsis, mucus production, and mucus secretion. The gut epithelium itself provides a barrier against significant macromolecular absorption (15). Physical factors that increase the rate of absorption are alcohol ingestion and decreased gastric acid secretion. Increased acid production and food ingestion both decrease the rate of absorption ( 16). Dimeric secretory IgA accounts for most of the increase in IgA production and serves to bind proteins, forming complexes and thereby decreasing the rate of absorption ( 21). For the macromolecules that do get absorbed as intact antigens approximately 2% ( 19) there is the development of oral tolerance. Tolerance is an immunologic unresponsiveness to a specific antigen, in this case food proteins ( 23). Both the local and systemic immune system appear to play a significant role in the development of oral tolerance ( 22), although the exact mechanisms are not well understood. The processing of antigens by the gut into a nonallergenic or tolerogenic form is important ( 24). This has been reported in studies of mice fed ovalbumin, which is immunogenic when administered parenterally. Within 1 hour after ingestion, a form similar in molecular weight to native ovalbumin was recovered from the serum. This tolerogenic form of ovalbumin induced suppression of cell-mediated responses but not antibody responses to native ovalbumin in recipient mice ( 24). This intestinally processed ovalbumin is distinct from systemic antigen processing ( 24). Mice that were first irradiated were unable to process the ovalbumin into a tolerogenic form. Food hypersensitivity is the result of a loss of or lack of tolerance, the cause of which is likely multifactorial. Until recently some of this immaturity was thought to lead to increased absorption of macromolecules from the gut of infants, but studies now indicate that this is not likely ( 30,31).