Atopy can manifest in childhood as infantile eczema (atopic dermatitis), allergic rhinitis and asthma. In practice, it is critical to identify the offending allergen in atopic individuals. This will not only influence therapeutic interventions, but may also have a significant impact on the individual's quality of life. The most common clinical test for allergy detection is the introduction of an allergen directly into the skin in the form of a skin-prick test. Skin-prick testing is recommended in the diagnostic workup for allergies because it is reliable, safe, convenient, inexpensive, minimally invasive, and has the advantage of multiple allergen testing in one, 15-to 20-minute, test. Skin-prick testing can be performed from birth onwards. Although there is a small risk of developing anaphylaxis, the test remains safe to perform in a consultation room or at the patient's bedside. Worldwide, a skin-prick test remains the test of choice for allergy because of its convenience and cost-effectiveness. A globally accepted guideline for skin-prick testing is still lacking and would be beneficial to both patient and physician.Peer reviewed.
Corresponding author: R J Green (robin.green@up.ac.za) Background. Colonisation of the airway by Pseudomonas spp. in cystic fibrosis has been reported to be an important determinant of decline in pulmonary function. Objective. To assess pulmonary function decline and the presence of bacterial colonisation in patients with cystic fibrosis (CF) attending a CF clinic in a developing country. Methods. A retrospective audit of patients attending the CF clinic at Steve Biko Academic Hospital, Pretoria, South Africa, was performed. The data included spirometric indices and organisms routinely cultured from airway secretions (Pseudomonas aeruginosa (PA) and Staphylococcus aureus (SA)).Results. There were 29 study subjects. Analysis of variance for ranks (after determining that baseline pulmonary function, age, gender and period of follow-up were not contributing to pulmonary function decline) revealed a median decline in forced expiratory volume in 1 second, forced vital capacity and forced expiratory flow over 25 -75% expiration of 12%, 6% and 3%, respectively, for individuals colonised by PA. There was no pulmonary function decline in individuals not colonised by PA, or in individuals colonised by SA. Conclusion. Pulmonary function decline in this South African centre is significantly influenced by chronic pseudomonal infection. Other influences on this phenomenon should be explored.
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