-
[show abstract]
[hide abstract]
ABSTRACT: Die Zusammenführung sämtlicher Patientendaten in ein umfassendes Klinikinformationssystem (KIS) bietet ein erhebliches Potenzial
zur Rationalisierung und Beschleunigung der administrativen Arbeitsabläufe, die aktuell immer mehr zeitliche Ressourcen der
patientenbezogenen Primärprozesse binden. Wichtig für ein solches Datenmanagement ist, dass sowohl die persönlichen Daten
(Patientenstammdaten) wie Name, Adresse und Geburtsdatum des Patienten und nach Möglichkeit weitere behandelnde Kollegen erfasst
sind, als auch sämtliche medizinischen Daten des Patienten eingespeist und untereinander kompatibel aufbereitet werden. Dafür
muss das KIS bei aller Komplexität eine ausreichende Benutzerfreundlichkeit zeigen, um Anwender aus den unterschiedlichen
Bereichen einer Klinik zu befähigen, sein Potenzial zu nutzen. In der vorliegenden Untersuchung wird die konkrete Zeitersparnis
bei der Erstellung von Arztbriefen mithilfe des KIS (Soarian®) gegenüber der Arztbrieferstellung mit einem konventionellen,
isolierten Textverarbeitungsprogramm (Word®) analysiert, und bestehende Potenziale und Limitierungen werden aufgezeigt. Bei
der objektiven Zeiterfassung zeigte sich eine Reduzierung der Bearbeitungsdauer pro Seite für die Schreibkräfte, allerdings
keine Zeitersparnis für den diktierenden Arzt. In der subjektiven Wahrnehmung aller beteiligten Berufsgruppen wurde ein vermehrter
Zeitaufwand durch die Bearbeitung im KIS angenommen, bedingt durch rigide Editier- und Navigationsfunktionen. Zur Steigerung
der Akzeptanz bei den Anwendern besteht diesbezüglich Verbesserungspotenzial.
The insertion of all patient details in one clinical information system (CIS) provides an enormous potential to rationalize
and accelerate the administrative procedures in primary patient care. A successful data management system has to record not
only the entire spectrum of the patient’s medical data, but also the patient’s personal data like name, address, date of birth,
as well as names and addresses of other involved physicians. In addition, all aspects of the database gathered from varying
sources must be compatible. The program has to be user-friendly enough that many different workers with varying backgrounds
can effectively employ it. We investigated the effective saving of time in preparing a patient’s discharge report based on
conventional dictation using the clinical information system (Soarian®) compared to a conventional, isolated word-processing
program (Word®). Existing potentials and limitations concerning the use of the CIS are presented. The objective analysis of
measured processing times demonstrated a reduction for the typist, but no benefit for the physician dictating the discharge
report. In the subjective perception of all users, the processing time appeared to have increased due to awkward editing and
navigation functions. Improvements are required to increase the acceptance of the program by the users.
Der Hautarzt 04/2012; 60(10):821-825. · 0.58 Impact Factor
-
A Schnuch, V Mahler,
P Elsner,
S M John,
M Reusch,
H Merk,
H Ott,
A Bufe,
B Przybilla,
J Kleine-Tebbe,
T Werfel,
D Nowak
Der Hautarzt 03/2012; 63(3):250-1. · 0.58 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: In occupational fields with exposure to grease, oil, metal particles, coal, black lead or soot, cleansing formulations containing abrasive bodies (e.g. refined walnut shell, corn, wood, plastic or pumice) are used. These may constitute an irritant per se. As an alternative, hydrogenated castor oil (also known as castor wax) beads have been developed as dirt-binding particles. A polar surface contributes to their mechanical cleaning effects in removal of oily grime.
Standardized examination of the in vivo effects upon the skin barrier of castor wax beads in comparison with abrasive bodies and pure detergent.
Three cleansing preparations - (i) detergent, (ii) detergent containing castor wax beads, (iii) detergent containing walnut shell powder - were each repetitively applied in vivo (four times daily for 3 weeks), mimicking workplace conditions, in 30 healthy volunteers (15 with and 15 without an atopic skin diathesis) and compared vs. (iv) no treatment. The treatment effects upon the skin barrier were monitored by repeated measurements of functional parameters [transepidermal water loss (TEWL), redness] and surface topography.
After a 3-week treatment, a significant global treatment effect (P < 0.0001) was found in the atopic group concerning TEWL as indicator for barrier function. A significantly higher TEWL and increasing erythema in the area treated with detergent containing walnut shell powder reflected its irritant effect compared with castor wax beads dispensed in the identical detergent. Cleaning properties of the two formulas were comparably superior to detergent alone.
Castor wax beads constitute a novel nonirritating alternative for abrasive cleaning of recalcitrant oily skin contamination appropriate for individuals with an atopic skin diathesis in a three-step programme of occupational skin protection. As the skin barrier may additionally be influenced by the composition of dirt and use of skin protection and skin care measures under real workplace conditions, this component may now be used and examined further in different occupations.
British Journal of Dermatology 11/2009; 162(4):812-8. · 3.67 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The insertion of all patient details in one clinical information system (CIS) provides an enormous potential to rationalize and accelerate the administrative procedures in primary patient care. A successful data management system has to record not only the entire spectrum of the patient's medical data, but also the patient's personal data like name, address, date of birth, as well as names and addresses of other involved physicians. In addition, all aspects of the database gathered from varying sources must be compatible. The program has to be user-friendly enough that many different workers with varying backgrounds can effectively employ it. We investigated the effective saving of time in preparing a patient's discharge report based on conventional dictation using the clinical information system (Soarian) compared to a conventional, isolated word-processing program (Word). Existing potentials and limitations concerning the use of the CIS are presented. The objective analysis of measured processing times demonstrated a reduction for the typist, but no benefit for the physician dictating the discharge report. In the subjective perception of all users, the processing time appeared to have increased due to awkward editing and navigation functions. Improvements are required to increase the acceptance of the program by the users.
Der Hautarzt 07/2009; 60(10):821-5. · 0.58 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Drug-eluting stents become increasingly popular for the treatment of coronary artery disease. Consequently, side effects including hypersensitivity reactions have to be anticipated.
Here we report on a patient with an anaphylactic reaction 2 weeks after implantation of a polymer-based paclitaxel-eluting stent (Taxus, Boston Scientific). The patient presented with disseminated wheals, pruritus, bronchial asthma and acute synovitis. The reaction was successfully treated with initial intravenous injection followed by oral antihistamine treatment for 1 month until all stent-bound paclitaxel was assumed to be eluted. Thereafter no further anaphylactic reaction occurred.
This sequence of events points towards a causal relation of the stent implantation and hypersensitivity reaction with a central role of paclitaxel. The increasing use of this type of stent should therefore be carefully monitored for such adverse reactions.
Dermatology 12/2008; 218(1):52-5. · 2.05 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Periorbital dermatitis is common and frequently recalcitrant to treatment. Due to the exposed and visible location, patients often suffer severely from periorbital dermatitis.
To determine the frequency and causes of periorbital dermatitis including contact sensitizers.
We investigated two cohorts of patients (Erlangen and IVDK without Erlangen) between 1999 and 2004.
The differences between the two cohorts with periorbital dermatitis [Department of Dermatology at University Hospital Erlangen (n = 88) and the German Information Network of Departments of Dermatology (IVDK) collective (n = 2035)] were determined by the MOAHLFA (male, occupational dermatosis, atopic eczema, hand dermatitis, leg dermatitis, facial dermatitis, age > or = 40 years) index. Statistically significant factors for periocular eczema are female sex, atopic skin diathesis and age > or = 40 years. In both cohorts allergic contact dermatitis was the main cause of periorbital eczema (Erlangen 44.3%, IVDK 31.6%), followed by periorbital atopic dermatitis (Erlangen 25%, IVDK 14.1%), airborne dermatitis (Erlangen 10.2%, IVDK 1.9%), irritant contact dermatitis (Erlangen 9.1%, IVDK 7.6%), periorbital rosacea (Erlangen 4.5%, IVDK 2.2%), allergic conjunctivitis (Erlangen 2.3%, IVDK included in 'others') and psoriasis (Erlangen 2.3%, IVDK included in 'others'). The most relevant allergens/allergen sources inducing periorbital eczema were consumers' products (facial cream, eye shadow and ophthalmic therapeutics) (31%), fragrance mix (19%), balsam of Peru (10%), thiomersal (10%) and neomycin sulphate (8%); 12.5% of patients with allergic periocular dermatitis could be exclusively elucidated by testing patients' own products.
Our data demonstrate the multiplicity of causes for periorbital eczematous disease manifestation, which requires patch testing of standard trays as well as consumers' products to elucidate the relevant contact sensitization.
British Journal of Dermatology 09/2008; 159(4):858-63. · 3.67 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Economic factors dominate more and more the healthcare systems; modern technologies advance every day and offer opportunities for savings.
In a pilot study, digital speech recognition based on Dragon NaturallySpeaking, Version 7 was compared with common dictation in dermatology.
The conventional method took 24.1 minutes per page and reports could be sent out after 16.8 days; in sharp contrast, the reports dictated by digital speech recognition took 15.8 minutes per page and were sent out after 3.2 days.
Digital Speech recognition in dermatology has advantages compared to ordinary dictation, if the dictating person is trained with the software and it is implemented in a digital patient documentation system.
Der Hautarzt 03/2008; 59(2):131-4. · 0.58 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: HintergrundBei zunehmendem Kostendruck in der Medizin im Rahmen von sog. Gesundheitsreformen bestehen mögliche Einsparungspotenziale
durch Einsatz fortschreitender Technologien.
Materialien und MethodenIn einer Pilotstudie wurde ein digitales Spracherkennungssystem, basierend auf Dragon NaturallySpeaking®, Version7, in der
Dermatologie mit dem konventionellen Diktat verglichen.
ErgebnisseWährend mit der konventionellen Methode pro Seite durchschnittlich 24,1min Zeit aufgewendet und die Briefe nach durchschnittlich
16,8Tagen versendet wurden, war der Zeitaufwand mit der digitalen Spracherkennung durchschnittlich 15,8min, und die Briefe
wurden nach durchschnittlich 3,2Tagen verschickt.
SchlussfolgerungDigitale Spracherkennung hat in der Dermatologie dann Vorteile gegenüber der konventionellen Methode des Diktats, wenn der
Diktierende gut eingearbeitet ist und eine Einbindung in ein Dokumentenmanagementsystem besteht.
BackgroundEconomic factors dominate more and more the healthcare systems; modern technologies advance every day and offer opportunities
for savings.
Material and methodsIn a pilot study, digital speech recognition based on Dragon NaturallySpeaking®, Version 7 was compared with common dictation
in dermatology.
ResultsThe conventional method took 24.1 minutes per page and reports could be sent out after 16.8 days; in sharp contrast, the reports
dictated by digital speech recognition took 15.8 minutes per page and were sent out after 3.2 days.
ConclusionDigital Speech recognition in dermatology has advantages compared to ordinary dictation, if the dictating person is trained
with the software and it is implemented in a digital patient documentation system.
Der Hautarzt 01/2008; 59(2):131-134. · 0.58 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Epidemiological data on the prevalence and risk factors of latex sensitization have suggested a significant association between latex sensitization and the presence of one or more positive skin prick test responses to aeroallergens, food allergens and to one or more insect venoms. Xylose and core 3-fucose are typical complex glycans in plants and are foreign to mammals. Plant N-glycans and insect N-glycans may cross-react in humans.
The aim of our study was to investigate whether there are cross-reactive IgE-binding structures in natural rubber latex (NRL) and hymenoptera venoms and to examine their nature.
Hundred and twenty-five consecutive patients with insect venom allergy were screened for coincidental latex-specific IgE. IgE-binding components in the venoms from Apis mellifera and/or vespula species and in NRL extracts were characterized by IgE-immunoblotting to the natural allergen sources and determination of specific IgE to recombinant allergens. Cross-reactive components were investigated by inhibition experiments. The involvement of carbohydrates in the constitution of cross-reactive IgE-epitopes was further examined by specific IgE-binding to cross-reactive carbohydrate determinants (CCD) in bromelain and horseradish peroxidase as well as by periodate treatment.
NRL glove extracts inhibited patients' serum IgE-binding to venom allergens. Vice versa, the IgE-binding to latex glove extracts could be inhibited by pre-incubation with the insect venoms. Specific IgE-binding to recombinant latex allergens was absent, whereas the cross-reactive IgE-epitopes were sensitive to periodate treatment and specific IgE to CCD (MMXF and MUXF type) could be detected.
Insect venoms and NRL share IgE-binding CCD that may be responsible for positive serological test results to NRL in patients with insect venom allergy. This copositivity occurs frequently (13.6%) among venom-allergic individuals and did not elicit clinical symptoms upon contact to latex in the patients examined. In contrast, true cosensitization to insect venoms and NRL allergens can occur and may not be missed.
Clinical & Experimental Allergy 12/2006; 36(11):1446-56. · 5.03 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The treatment of inflammatory skin diseases is at present often empirical as causal therapeutic approaches, based on an incomplete knowledge of the immune pathogenesis, are mostly unavailable. The currently applied treatments can in fact lead to remission of the disease; however, under certain circumstances undesirable side-effects must be expected. On the basis of experience gained in cytokine modulation therapy of chronic inflammatory diseases such as rheumatoid arthritis and psoriasis, the application of TNF-alpha inhibitors represents a novel, more specific, and effective therapeutic option for distinct chronic inflammatory diseases.
The current status of the therapeutic effect of TNF-alpha blockers is discussed based on our own observations and a review of the current literature. Also discussed are potential undesirable side-effects and possible contraindications of this therapy.
Based on recent findings, the use of TNF-alpha blockers seems to be promising in the treatment of therapy-resistant inflammatory dermatoses. At present, guidelines for indications and contraindications of anti-TNF-alpha treatment of inflammatory skin disorders are rare. Such guidelines are necessary to improve the efficacy of anticytokine treatment and the reduction of side-effects.
Journal of the European Academy of Dermatology and Venereology 12/2006; 20(10):1171-87. · 2.98 Impact Factor
-
W Uter,
J Hegewald,
W Aberer,
F Ayala,
A J Bircher,
J Brasch,
P-J Coenraads,
M-L A Schuttelaar,
P Elsner,
M Fartasch, [......],
J D Johansen,
T Menné,
R Jolanki,
B Krêcisz,
M Kiec-Swierczynska,
F Larese,
D Orton,
A Peserico,
T Rantanen,
A Schnuch
[show abstract]
[hide abstract]
ABSTRACT: Since January 2001, the European Surveillance System on Contact Allergies (ESSCA), supported by European Union funding (contract QLK4-CT-2001-00343), has started to collect patch-test data. This comprises a standardized clinical history and the patch-test results using the European standard series, from 17 centres in 9 European countries listed above. In 2002 and 2003, 10 511 patients' test results have been pooled and analysed. The anamnestic data partly reflect the subspecialties of some centres. The most common allergen was nickel sulfate (17.3%); however, large international variations were observed. The prevalence of contact allergy to Myroxylon pereirae resin (balsam of Peru) (5.8%) is coming close to the frequency found with the fragrance mix (6.4%). Regarding contact allergy to chromium compounds, different frequencies were noted in the 2 centres focused on occupational dermatitis (2.3% in the FIOH versus 7.4% in the Nofer Institute). These most likely reflect the beneficial effect of addition of ferrous sulfate in one, but not the other country. As differences may partly be due to different patch-test reading, standardization may need to be refined further. By providing post-marketing surveillance in the field of contact allergy, ESSCA will meet its objective of increased consumer safety across Europe.
Contact Dermatitis 10/2005; 53(3):136-45. · 3.51 Impact Factor
-
D P Bruynzeel,
T L Diepgen,
K E Andersen,
F M Brandão,
M Bruze,
P J Frosch,
A Goossens,
A Lahti, V Mahler,
H I Maibach,
T Menné,
J D Wilkinson
[show abstract]
[hide abstract]
ABSTRACT: A 5-year retrospective study of the frequency of sensitization to the 25 allergens of the European standard series (ESS) was conducted in 10 centres in 8 European countries. Included were the results of 26 210 patients. The range in sensitivities differed moderately between the centres. Combining results of different centres and drawing conclusions on incidences can be done only with great care. The information on the ranking of the allergens and their sensitization incidence in the clinics are useful for decisions on the future composition of the standard series. The ESS is still a valid screening tool, and no substances should be deleted.
Contact Dermatitis 10/2005; 53(3):146-9. · 3.51 Impact Factor
-
A Schnuch,
D Kelterer,
A Bauer,
Ch Schuster,
W Aberer, V Mahler,
K Katzer,
J Rakoski,
U Jappe,
A Krautheim,
A Bircher,
P Koch,
M Worm,
H Löffler,
U Hillen,
P J Frosch,
W Uter
[show abstract]
[hide abstract]
ABSTRACT: Contact allergy to methyldibromo glutaronitrile (MDBGN), often combined with phenoxyethanol (PE) (e.g., Euxyl K 400), increased throughout the 1990s in Europe. Consequently, in 2003, the European Commission banned its use in leave-on products, where its use concentration was considered too high and the non-sensitizing use concentration as yet unknown. The 2 objectives of the study are (a) to find a maximum non-eliciting concentration in a leave-on product in MDBGN/PE-sensitized patients, which could possibly also be considered safe regarding induction and (b) to find the best patch test concentration for MDBGN. We, therefore, performed a use-related test (ROAT) in patients sensitized to MDBGN/PE (n = 39) with 3 concentrations of MDBGN/PE (50, 100 and 250 p.p.m. MDBGN, respectively). A subset of these patients (n = 24) was later patch-tested with various concentrations (0.1, 0.2, 0.3 and 0.5% MDBGN, respectively). 15 patients (38%, 95% confidence interval (CI) = 23-55%) had a negative and 24 (62%; 95% CI = 45-77%) a positive overall repeated open application test (ROAT) result. 13 reacted to the lowest (50 p.p.m.), 8 to the middle (100 p.p.m.) and 3 to the highest concentration (250 p.p.m.) only. In those 13 reacting to the lowest ROAT concentration, dermatitis developed within a few days (1-7). The strength of the initial and the confirmatory patch test result, respectively, and the outcome of the ROAT were positively associated. Of the 24 patients with a use and confirmatory patch test, 15 reacted to 0.1% MDBGN, 16 to 0.2%, 17 to 0.3% and 22 to 0.5%. With the patch test concentration of 0.5%, the number of ROAT-negative patients but patch-test-positive patients increases considerably, particularly due to + reactions. A maximum sensitivity of 94% (95% CI = 70-100%) is reached with a patch test concentration of 0.2%, and is not further improved by increasing the concentration. However, the specificity decreases dramatically from 88 (95% CI = 47-100%) with 0.2% to a mere 12.5% (95% CI = 0-53%) with 0.5%. It can be concluded (a) that for MDBGN 0.2% is very likely the best patch test concentration and (b) that 50 p.p.m. in a leave-on product can elicit contact dermatitis in sensitized persons. We were, therefore, unable to find a safe, still microbicidal, concentration for leave-on products. By contrast, with other contact allergens, dose-response use tests may be able to identify a non-eliciting concentration, which could give valuable clues to a non-inducing (i.e., safe) concentration in products.
Contact Dermatitis 05/2005; 52(4):197-206. · 3.51 Impact Factor
-
V Mahler
[show abstract]
[hide abstract]
ABSTRACT: Six questions regarding varicella-zoster virus-related skin diseases are addressed. The Cochran Library, MEDLINE, Clinical Evidence and several guideline providers were searched for evidence. The level of evidence in papers was appraised according to the Oxford Centre for Evidence-based Medicine Levels of Evidence. The current evidence for antiviral therapy of chickenpox in immunocompetent children, adults and pregnancy, recommendation of varicella vaccination, effect of time of initiation of antiviral therapy in acute zoster as well as route of treatment with regard to onset of post-zoster neuralgia are covered.
Der Hautarzt 04/2005; 56(3):241-50. · 0.58 Impact Factor
-
T L Diepgen,
H Dickel,
D Becker,
J Geier, V Mahler,
A Schmidt,
H-J Schwanitz,
C Skudlik,
E Wagner,
W Wehrmann,
E Weisshaar,
T Werfel,
O Blome
[show abstract]
[hide abstract]
ABSTRACT: Evidence-based guidelines about the distribution of type IV allergens of the European standard series in different professions and its occupational relevance are missing. Based on published data, epidemiological investigations, work related knowledge about industrial processes, and allergen specific properties, recommendations are given about the clinical impact in the working environment for the following allergens: acrylates/methacrylates, epoxy resins, dichromate, cobalt, nickel, formaldehyde, (chlor-)methylisothiazolone, p-phenylendiamine, colophony, thiurame, mercaptobenzothiazole, dithiocarbamate, n-isopropyl-n'-phenyl-p-phenylendiamine, fragrance mix, composite mix, and neomycinsulfate. These recommendations might improve the clearance rate and allergological evaluation of the occupational relevance of different delayed type sensitizations or allergens.
Der Hautarzt 04/2005; 56(3):207-23. · 0.58 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: A 37-year-old woman twice developed a life-threatening anaphylactic reaction after eating galettes, a special French pancake from Brittany. She had tolerated ordinary pancakes and crepes for many years. The allergological work-up revealed a Type I allergic reaction to buckwheat contained in the galettes. A prick test to buckwheat was positive and specific IgE antibodies to buckwheat were found in her serum. In contrast to wheat, buckwheat is not a cereal but a gluten-free knot-grass, initially from Asia. Whenever a patient suffers from allergic reactions due to pastries, a buckwheat allergy should be considered.
Der Hautarzt 03/2005; 56(2):160-3. · 0.58 Impact Factor
-
T. L. Diepgen,
H. Dickel,
D. Becker,
J. Geier, V. Mahler,
A. Schmidt,
H.-J. Schwanitz †,
C. Skudlik,
E. Wagner,
W. Wehrmann,
E. Weisshaar,
T. Werfel,
O. Blome
[show abstract]
[hide abstract]
ABSTRACT: Bisher fehlen evidenzbasierte Empfehlungen zur Beurteilung der beruflichen Exposition von Typ-IV-Allergene der Standardreihe. Aufgrund publizierter Literatur, epidemiologischer Untersuchungen, arbeitstechnischer Kenntnisse und spezifischer Allergeneigenschaften werden fr folgende Typ-IV-Allergene diesbezgliche Empfehlungen vorgestellt: Acrylate/Methacrylate, Epoxidharzsysteme, Dichromat, Kobaltsalze, Nickel, Formaldehyd, (Chlor-)Methylisothiazolone, p-Phenylendiamin, Kolophonium, Thiurame, Mercaptobenzothiazole, Dithiocarbamate, N-Isopropyl-N-phenyl-p-phenylendia-min, Duftstoffe, Kompositen, Neomycinsulfat. Dadurch wird die Aufklrung und allergologische Beurteilung der Auswirkung von Typ-IV-Sensibilisierungen im Berufsleben entscheidend verbessert.Evidence-based guidelines about the distribution of type IV allergens of the European standard series in different professions and its occupational relevance are missing. Based on published data, epidemiological investigations, work related knowledge about industrial processes, and allergen specific properties, recommendations are given about the clinical impact in the working environment for the following allergens: Acrylates/Methacrylates, Epoxy resins, Dichromate, Cobalt, Nickel, Formaldehyde, (Chlor-)Methylisothiazolone, p-Phenylendiamine, Colophony, Thiurame, Mercaptobenzothiazole, Dithiocarbamate, N-Isopropyl-N-phenyl-p-phenylendiamine, Fragrance Mix, Composite Mix, and Neomycinsulfate. These recommendations might improve the clearance rate and allergological evaluation of the occupational relevance of different delayed type sensitizations or allergens.
Der Hautarzt 02/2005; 56(3):207-223. · 0.58 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Wir berichten von einer 37-jhrigen Patientin, bei der es zweimal jeweils nach Genuss von Galettes zu anaphylaktischen Reaktionen kam. Crpes isst die Patientin seit Jahren ohne Probleme. Als Ursache der allergischen Reaktion konnten wir im Pricktest und mittels CAP-FEIA eine TypI-Allergie auf das enthaltene Buchweizenmehl nachweisen. Buchweizen ist im Gegensatz zu Weizen kein Getreide, sondern ein glutenfreies Knterichgewchs, das ursprnglich aus Mittelasien kommt. Bei allergischen Reaktionen nach Genuss von Teigwaren oder Gebck, insbesondere bei glutenfreier Kost, sollte daher eine TypI-Allergie auf Buchweizenmehl mitbedacht werden.A 37-year-old woman twice developed a life-threatening anaphylactic reaction after eating galettes, a special French pancake from Brittany. She had tolerated ordinary pancakes and crpes for many years. The allergological work-up revealed a TypeI allergic reaction to buckwheat contained in the galettes. A prick test to buckwheat was positive and specific IgE antibodies to buckwheat were found in her serum. In contrast to wheat, buckwheat is not a cereal but a gluten-free knot-grass, initially from Asia. Whenever a patient suffers from allergic reactions due to pastries, a buckwheat allergy should be considered.
Der Hautarzt 01/2005; 56(2):160-163. · 0.58 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: In Germany the most frequent initial report of occupational disease is due to occupational skin diseases ("Berufskrankheitenanzeige nach Nr. 5101 der Berufskrankheitenverordnung") defined as "severe or recurrent skin diseases that force the discontinuation of any activity that causes or that could be causing the development, the worsening, or the recurrence of the skin disease". The majority of these occupational skin diseases consists of irritant and allergic contact dermatitis. In contrast, work place- related Type I allergy (contact urticaria syndrome) is less frequent, but carries the risk of systemic reactions. The clinical manifestations and pattern of exposure to Type I allergens in the work place are described.
Der Hautarzt 02/2004; 55(1):34-41. · 0.58 Impact Factor
-
V Mahler,
S Vrtala,
O Kuss,
T L Diepgen,
R Suck,
O Cromwell,
H Fiebig,
A Hartl,
J Thalhamer,
G Schuler,
D Kraft,
R Valenta
[show abstract]
[hide abstract]
ABSTRACT: We have recently engineered recombinant derivatives of the major birch pollen allergen Bet v 1 (rBet v 1 fragments and trimer) with strongly reduced allergenic activity.
The aim of this study was the in vivo characterization of potential allergy vaccines based on Al(OH)3-adsorbed genetically modified rBet v 1 derivatives in mice.
BALB/c mice were immunized either with courses of nine injections of increasing doses of Al(OH)3-adsorbed rBet v 1 wild-type, rBet v 1 fragments, rBet v 1 trimer or Al(OH)3 alone in weekly intervals or with three high-dose injections applied in intervals of 3 weeks. Humoral immune responses to rBet v 1 wild-type and homologous plant allergens were measured by ELISA and Western blotting, and the ability of mouse antibodies to inhibit the binding of allergic patients IgE to Bet v 1 was studied by ELISA competition experiments.
In both schemes, hypoallergenic rBet v 1 derivatives induced low IgE but high IgG1 responses against rBet v 1 wild-type. The IgG1 antibodies induced by genetically modified rBet v 1 derivatives cross-reacted with natural Bet v 1 and its homologues from alder (Aln g 1) as well as hazel (Cor a 1) and strongly inhibited the binding of birch pollen allergic patients' IgE to Bet v 1 wild-type.
Genetically modified hypoallergenic rBet v 1 derivatives induce blocking antibodies in vivo. Their safety and efficacy for the treatment of birch pollen and associated plant allergies can now be evaluated in clinical immunotherapy studies.
Clinical & Experimental Allergy 02/2004; 34(1):115-22. · 5.03 Impact Factor
