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H Mosbech

Publications and source records attributed to H Mosbech.

80 records · Page 5Linked to original sources

Death caused by wasp and bee stings in Denmark 1960-1980.

During a 21-year period in Denmark a total of 26 deaths were caused by wasp or bee stings (according to the National Health Service). The deaths might be classified, with some overlapping, as caused by either anaphylactic/anaphylactoid shocks (between 65% and 80%), suffocation after stings in the airways (about 15%) or preexisting diseases, especially arteriosclerotic heart disease (approx. 20%). Characteristically, in most persons with shock reactions unconsciousness and death occurred very shortly after the sting (within 45 min), while the interval between sting and death was longer (30 min to a couple of hours) when death was caused by suffocation. In more than 21 of the 26 cases it seemed reasonable to assume that insect allergy might have contributed to the fatal outcome. Six of these cases had a previous history of abnormal reactions to insect venom, thus only a small group would have benefited from the prophylactic effect of hyposensitisation. There was no known previous history of reactions to insect stings in the other cases, but it is likely that more than six persons had had severe reactions to insect stings on other occasions. Presumably many deaths where insect stings have been involved--through not verified as causal--are classified as inexplicable or accidental, thus the real number of deaths caused by wasp or bee stings could be substantially greater. Consequently hyposensitisation after severe insect sting reactions of verified allergic genesis can still be advised.

Adolescent↗

Comparison of a new lancet and a hypodermic needle for skin prick testing.

Skin prick tests with a standard allergen panel were carried out in duplicate (one on each arm) on all patients referred to an allergy out-patient clinic. A new lancet with 1-mm point length and a disposable hypodermic needle were used. Patients were randomized to lancet-needle, lancet-lancet, or needle-needle, and the skin prick tests were done by experienced or inexperienced nurses. The mean of the biggest and smallest diameters was used as a measure of the size of the wheal. Skin reactions from a total of 142 patients were included. For both lancet and needle a significant difference was noted when comparing experienced versus inexperienced investigators' reproducibility expressed as coefficient of variation. There was no significant difference in reproducibility when comparing lancet and needle results, and no significant difference in wheal size when comparing with histamine references. Surprisingly, the reactions on left arms were generally larger than those on right arms.

Allergens↗

Comparison between specific IgE measured by RAST, two chemiluminescent assays and skin prick test.

Two hundred adult patients referred to a regional outpatient allergy clinic were skin prick tested and their specific IgE against ten inhalant allergens was measured by three different assays: the classical radioallergosorbent assay, Phadebas RAST (P-RAST), (Pharmacia AB, Uppsala, Sweden), the multi-allergosorbent chemiluminescent assay CLA (MAST), (Dome/Hollister-Stier, Miles Ltd., UK), and the immunocheminometric assay, MAGIC LITE SQ Specific IgE (ML), (ALK Laboratorierne, Hørsholm, Denmark). Skin prick test (SPT) was performed with extracts from the same companies. Marked differences between the assays were seen especially in the low range. Specific IgE was detected in 17% of the samples by P-RAST, in 66% by CLA, and in 17% by ML. Frequency distribution of P-RAST and ML measurements showed a peak at zero and a gradual decline towards larger values, whereas distribution for CLA was U-shaped with a peak at zero and another peak close to maximum reactions. Kendall's rank correlation coefficient being 0.80 for P-RAST vs. CLA. Correlation coefficient between measurements of specific IgE and SPT was high for CLA (0.65). Even in the low-level subgroup where IgE was detected by CLA only, a high correlation (0.60) between CLA and SPT was observed. In conclusion marked differences were observed between the three assays for specific IgE measurement. The CLA system seems to be more sensitive than the conventional P-RAST and ML, but further studies should reveal whether this extra sensitivity is clinically useful.

Adolescent↗

Skin prick testing with standardized extracts from 3 different manufacturers. A comparative randomized study.

The aim of this study was to compare skin reactivity to routine allergen prick test with panels of allergens, supplied by three different manufacturers. The allergens comprised ten aero-allergens commonly used for skin prick test in Northern Europe, and included pollen, dander, house dust mites, and moulds. Two hundred consecutive patients were tested. The methods for standardization of allergen extracts, declaration of allergenic potency, and recommended lancets differed. The equipment were Soluprick SQ (Allergologisk Laboratorium A/S, Denmark) (ALK), Alphatest (Dome/Hollister-Stier, U.K.) (DHS), and Phazet (Pharmacia, Sweden) (PHA). The coefficient of variation for the allergen coated PHA (same lancet was applied twice) was 0.31, and for ALK and DHS allergen extracts 0.13 and 0.18, respectively. The frequencies of patients with positive reactions to the various allergens were generally similar, although DHS appeared to elicit less positive reactions to Timothy, dog, and Dermatophagoides pteronnyssinus. For the individual physician, it may be important to know the allergenic activity of the different allergens in his routine panel compared to the activity in other similar panels.

Adolescent↗