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sixty-nine patients were recruited. during the study period, 18 of them were excluded because they did not fulfil the inclusion criteria. of the remaining 51 patients, 44 (86%) completed the study. seven patients completed all tests; five patients completed the study with 6-7 drugs; eight patients completed the study with 4-5 drugs; 16 patients were unable to complete the study due to medication or logistical reasons. five patients underwent the full direct challenge with amoxicillin, which resulted in severe reactions in 4 patients, affecting both the eye and larynx. the direct amoxicillin challenge was well tolerated in all 5 patients who underwent it.

unlike the previous study, where placebo was administered prior to drug, we administered an intranasal placebo to all cases that met the criteria for allergy. the primary end point of the study was median time to severe reaction. secondary endpoints included adverse events, number of challenges completed, and rates of allergy, as well as comparisons between patients that did and did not complete the study. although it is not possible to discern from this article whether a patient was actually allergic, or instead susceptible to anaphylaxis because of their history of reactions to a given drug, it was also possible to document what drugs were most likely to cause anaphylaxis in the study population, and what mechanism of action (anaphylaxis versus drug allergy) was operative. having a positive history of reactions to a given drug provided a direct and meaningful study endpoint for that drug. the study drug, rocuronium, was the most likely to lead to severe reactions, with median time to reaction of 22 minutes. although anaphylaxis occurred in only seven of the 51 patients, skin testing was positive for 6 of the 7 patients that tested positive for anaphylaxis. direct challenge was positive in 4 of 6 patients who underwent it.

corticosteroids play an important role in the treatment of alveolar echinococcosis (ae). we investigated the relationship between the concentration of soluble tnf receptor (stnfr)-igg (a marker of the host immune response) and echinococcal disease severity, in 31 patients with ae who underwent surgical treatment. the patients were classified by world health organization (who) criteria into six groups based on the number of lesions (1, 2, 3, 4, 5, and >5), representing different disease stages. excessive levels of stnfr-igg were associated with the number of patients with who stage 1 and 2 disease.
the effect of the nonspecific cyclooxygenase (cox) inhibitors indomethacin (ind) and diclofenac (dic) on the granulomatous reaction induced by intravenous injection of streptococcus pneumonia in the rear testis was studied. pulmonary granuloma in the rear testis was induced by intravenous injection of s. pneumonia in a group of rats that were pretreated with ind or dic. at 3 days after inoculation, the number of colony-forming units of bacteria in the lung was determined, and the presence of the bacteria within the granuloma was confirmed by immunohistochemical staining. it was found that ind or dic pretreatment showed a trend towards a suppressive effect on the number of bacteria in the lung, but was statistically insignificant. this trend was most obvious in ind-treated rats. however, ind or dic pretreatment did not suppress the formation of granulomatous lesions around the bacteria in the lungs in these rats.
the relationship between adrenal function and plasma catecholamine levels during propofol anesthesia in elderly patients with dementia undergoing major operation. a prospective observational study. the study included 50 patients scheduled for elective major orthopedic surgery and 50 age-matched healthy controls. they received 1-2mg/kg iv propofol over 10min to effect for induction of anesthesia. at arrival in the recovery room, a 5 ml blood sample was obtained from all participants to analyze plasma noradrenaline and adrenaline concentration by chemiluminescence technology, and calculate the serum cortisol level by radioimmunoassay. patients who received noradrenaline or dopamine infusions in the perioperative period or who required >2 mg/kg propofol per hour for induction of anesthesia were excluded from the study. at last, the data from 26 patients in the study group and 28 patients in the control group were analyzed. in the study group, serum cortisol levels were significantly lower than those in the control group (13.97±1.69 vs. 22.89±1.63μg/dl, respectively). twenty-five patients in the study group and two patients in the control group suffered from hypocortisolism. postoperative hypoxia, visual impairment, and hypothermia were observed in 15, 17, and 19 patients, respectively. hypocortisolism occurred in 8/26 patients after propofol anesthesia with normal visual impairment and hypoxia/hypothermia.
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