Biomedical subjects

John P Dice

Publications and source records attributed to John P Dice.

3 recordsLinked to original sources

PubMed2006

Delay of chemotherapy to prevent progressive vaccinia.

OBJECTIVE: The goal was to discuss the potential risk of progressive vaccinia in the setting of smallpox vaccination with immunosuppression and to present strategies to avoid progressive vaccinia. METHODS: A case report and literature review are presented. RESULTS: A 21-year-old, male, military member received smallpox vaccination and was coincidentally diagnosed as having osteosarcoma approximately 2 weeks later. His recent vaccination was recognized, and chemotherapy was subsequently delayed until separation of the scab at the vaccination site. The patient received neoadjuvant chemotherapy and fared well, without any evidence of progressive vaccinia or other smallpox vaccine complications. CONCLUSIONS: Smallpox vaccine should be withheld from immunocompromised patients because of the risk of progressive vaccinia. Conversely, immunosuppressive therapies should be delayed for recently vaccinated patients. There are no controlled trials in this area, but withholding immunosuppressive therapy until separation of the scab is a rational approach. This patient was exposed to chemotherapy after scab separation and did not develop progressive vaccinia.

Adult↗

PubMed2004

Physical urticaria.

Physical urticarias are a unique subgroup of chronic urticaria in which patients develop urticaria secondary to environmental stimuli. Common triggers include exercise, temperature changes, cold, heat, pressure, sunlight, vibration, and water. Systemic symptoms have occurred during severe episodes. Physical urticarias are responsible for approximately 20% to 30% of all cases of chronic urticaria. A basic knowledge of these unusual disorders is important for all healthcare providers. This article covers the following types of physical urticarias: dermatographism, cholinergic urticaria, local heat urticaria, exercise-induced anaphylaxis, vibratory angioedema, solar urticaria, and aquagenic urticaria.

Chronic Disease↗

PubMed2003

Use of immunotherapy in the management of presumed anaphylaxis to the deer fly.

BACKGROUND: Anaphylactic reactions to biting insects are generally thought to be rare events. Diagnostic and therapeutic standards for these events are not well documented in the literature. OBJECTIVE: We describe a case report of a patient with multiple suspected immunoglobulin (Ig)E-mediated anaphylactic reactions to biting insects, specifically deer flies (Chrysops sp.), as well as a successful response to immunotherapy. METHODS: Prick and intradermal testing with deer fly whole-body extract and measurement of specific IgE were performed to help determine the extent of the patient's hypersensitivity. Immunotherapy was subsequently administered with whole-body deer fly extract. RESULTS: Skin testing was unable to differentiate between the patient and normal controls. In vitro testing was positive in the study patient but only at a low level. After initiating immunotherapy, the patient had repeated exposures to deer fly bites but failed to develop symptoms consistent with his previous anaphylactic episodes. Followup testing on the patient revealed no significant change in the level of skin reactivity or specific IgE. CONCLUSIONS: Anaphylaxis consistent with an IgE-mediated mechanism to Chrysops sp. is a real phenomenon and is amenable to immunotherapy for the prevention of life-threatening sequela after exposure. Skin testing using whole-body extract appears to be unreliable. In vitro testing was better able to discern a true sensitivity, although the difference between patient and controls was small.

Allergens↗