Comparison of allergen-induced late inflammatory reactions in the nose and in the skin in house dust mite-allergic patients with or without asthma.

Background: It remains to be established which factors contribute to the occurrence of asthma in allergic individuals. We hypothesized that differences in the late allergic inflammatory reaction to allergen between asthmatic and non-asthmatic house dust mite-allergic individuals might contribute to the difference in the clinical presentation of allergy.

Aim: To compare allergen-induced changes in parameters for cellular inflammation during the phase of the late allergic reaction in the skin and nose, in house dust mite-allergic individuals with or without asthma.

Differences in nonspecific bronchial responsiveness between patients with asthma and patients with rhinitis are not explained by type and degree of inhalant allergy.

Patients with allergic asthma have higher levels of nonspecific bronchial responsiveness than patients with allergic rhinitis. The aim of the study was to investigate whether this is caused by differences in the degree of allergy to inhalant allergens between asthmatics and rhinitics. Therefore, bronchial responsiveness to histamine was measured in 25 allergic patients with isolated upper airways symptoms.

Fel d 1-specific IgG antibodies induced by natural exposure have blocking activity in skin tests.

Cat-allergic patients frequently have IgG antibodies directed against Fel d 1. The aim of this study was to investigate whether these IgG antibodies influence the results of the skin test. Titrated skin tests were performed with Fel d 1 and IgE and IgG antibody levels were measured in 59 patients with cat allergy.

The relationship between RAST and skin test results in patients with asthma or rhinitis: a quantitative study with purified major allergens.

Background: Study of the relationship between skin test results and IgE antibody levels is seriously hampered by the use of conventional allergen extracts because the precise amount of relevant allergen for each patient is unknown.

Objective: This study was designed to investigate skin reactivity with purified major allergens and to assess the relation with serum levels of IgE antibodies and to determine which additional factors contribute to the skin test result.

Methods: We used five purified major allergens (Der p 1, Der p 2, Fel d 1, Lol p 1, and Lol p 5) in skin tests, RASTs, and histamine release tests in 43 multisensitized patients with asthma or rhinitis.

[HIV and dentistry. Part 10. Concluding remarks].

In a summarizing report of the series 'HIV and dentistry' the most important aspects of the dental treatment of HIV-seropositive patients are dealt with, supplemented with some additional comments.

[HIV and dentistry. Part 9. HIV infection and dental care].

Dental treatment of HIV-infected or AIDS patients can be safely performed in the dental office. In general, no special precautions are necessary. Only in case of severe illness a dental emergency may have to be referred to a dedicated clinic.

[HIV and dentistry. Part 8. Can a dentist refuse treatment to an HIV seropositive patient?].

An overview is presented of the ethical guidelines in different parts of the world on the subject of dental treatment of HIV-seropositive patients. Does a dentist ever have the right to decline treatment and will the answer to this question be influenced by the presence or absence of dental complaints? Based on several reports it is likely that some dentists refuse treatment of HIV-seropositive patients.

[HIV and dentistry. Part 7. The HIV positive dentist or student].

What should a dentist or dental student do when he happens to be HIV-seropositive? Should he or she disclose the disease to the patients or, in case of a student, to the university? Does he has to give up his practice or perhaps not even open one? Apparently, the legal regulations differ in various parts of the world. In the Netherlands dentists are advised to take their own responsibility in this matter.

[HIV and dentistry. Part 6. Mouth defects in HIV infections: guidelines for referral].

As for any oral lesion that cannot be properly diagnosed by the dentist, referral to the specialist is indicated for lesions that might be associated with or indicative of an underlying HIV infection. In most instances, there is no need to discuss the subject of HIV infection in the dental office. In the letter of referral the same information should be given as has been provided to the patient.

[HIV and dentistry. Part 5. Practice hygiene].

When complying a good standard hygiene protocol in the dental office the risk of cross-infection of whatever type of microorganism, including the hepatitis-B-virus and HIV, is almost eliminated.

[HIV and dentistry. Part 4. Oral deviations in HIV infections: present classification and diagnostic criteria].

In the present classification of oral lesions associated with HIV infection a distinction is made between presumptive and definitive diagnostic criteria. The former relate to the initial clinical appearance of the lesion and the latter are often the result of special investigations. Candidiasis, hairy leukoplakia, specific forms of periodontal disease, Kaposi's sarcoma and non-Hodgkin's lymphoma are strongly associated with HIV infection.

[HIV and dentistry. Part 3. HIV infection: pathogenesis, epidemiology, definitions and classification].

The acquired immunodeficiency syndrome (AIDS) is caused by a retrovirus, the human immunodeficiency virus (HIV), that selectively deteriorates cell-mediated immunity. Consequently fatal opportunistic infections and/or malignancies occur. In this paper the pathogenesis and the epidemiology of HIV infection are described.

[HIV and dentistry. Part 2. Needlestick injury].

The risk for dentists to acquire HIV infection at work is low but not neglectable. Needlestick injuries are among the most hazardous events in this respect. Prevention of these injuries will considerably reduce the risk of occupational HIV infection in dentistry.

[HIV and dentistry. Part 1: Disclosure of HIV-seropositivity to the dentist].

For a number of reasons it is recommended to disclose one's HIV-seropositivity to the dentist. This information will enable the dentist to take extra precautions during treatment. Furthermore, extra measures may be taken with regard to prevention or early treatment of dental and oral diseases, e.

[Dental treatment of HIV-infected and AIDS patients in the dental office in The Netherlands].

Every dentist should accept the responsibility of treating HIV-infected and AIDS' patients in his own office. By taking the appropriate hygienic measures, the risk of HIV-transmission in the dental office can be almost completely eliminated.