Health Articles

Pollen is the first thing that comes to our mind when we speak of allergies. Another major type is pet allergies. It is not often that we discuss chemical allergies as so common. Nevertheless, these conditions are vastly becoming common as the technology improves in every field.

Think of an allergy to a chemical such as formaldehyde, or even towards an acrylic. These were never considered so common before the advent of technology in various fields.

Most of the people with the sensitivity to dust or pollen undergo medical treatment. There are people with pet allergies who totally get rid of pets to avoid allergy-related problems. But think of the problems that you have to encounter if you are sensitive to a chemical substance that is present in many things that you use daily. How would you treat such kind of sensitivity? Common examples would be dyes, nail paint, detergents and so on, which contain a chemical called Formaldehyde.

The sensitivity that happens as a result of this simple ‘touch’ is called Contact Dermatitis. The name implies that this occurs when you touch something with a chemical that you are sensitive to. A common example is chemical like acrylic. Almost everything that we use daily contains acrylic. Most of the wall paints contain acrylic. There are trophies that are made of acrylic. Even dental products such as crowns use acrylic as a component. It is also found in certain types of tapes and glues.

In case of such contact dermatitis, your hands may need steroids to get alright. It is not that other parts of the body will catch this allergy. Even after your hands are alright, your feet might start cracking as a reaction to the acrylic that is used in the floor mats and carpets. You may have to shed quite a big amount to completely get rid of this condition and also the surrounding that create such a medical condition. You may have to relocate to a totally new surrounding and redo the entire house keeping in mind the cause of the said condition.

Even then, you should stay away from the pace until the work is absolutely over. Or else, you may end up with an asthma attack while the painting or carpeting is going on. Once your allergy is proven, then chances are that you will get the same problem wherever you go. While people with sensitivities to dust and dander only have to stay away from such surroundings, imagine people with chemical allergies! How can someone possibly keep away from all substances that contain acrylic everyday?

Some people with chemical allergies will have to adopt the go-green phenomenon and turn the house completely green. This will include using hard wood floors and furniture. Laminated flooring has acrylic in it. Some people actually end up staying in a rented space until the renovation is complete, or else the sensitivity may reappear. It is alarming that these types of chemical sensitivity are only increasing with technology.

There are quite a number of allergy types that can cause us serious ailments. If you are the type of a person who gets an instant allergic reaction from let’s say eating or drinking something, even being stung by a wasp or a bee, then you must consult a physician and be tested for an allergy. To those individuals that are sensitive or prone to having an allergy, then they must be careful and be constantly aware of what they are eating or what they are about to eat and drink. A person can be allergic to particular type of foods, plants and even animals. The following are some of the most common allergens: Bee or Wasp Stings; Shell fish allergies; Yeast; Peanut allergies and a whole lot more.
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An accidental contact with one of said allergens can actually cause someone some serious medical condition. We may or may not be aware that we had ingested or we have been exposed to one of the said lethal allergens. Truth be told, allergies can come when we least expect it. The swelling of one’s throat is considered as the most severe symptom that we can associate with it. This can actually make one’s breathing hard and can actually cause someone their life if no treated or corrected immediately. This is called as anaphylactic shock and this requires immediate medical treatment. Above mentioned allergens are the most serious types and are the ones that can actually lead one to suffer from an anaphylactic shock. An individual who is known to have a serious allergy from said allergens are advised to always carry with them an epi pen for emergencies like an allergy attack.
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One of the other symptoms can include difficulty in breathing; this can also start an asthma attack. Itchy rashes or hives are also some of the most common reactions that an allergic person can experience. Some are also known to experience minor swelling in the face. The good thing is, said milder allergy symptoms can be easily treated with an antihistamine medicine like Benadryl.

Millions of people suffer from pain during a sinus infection but that does not make it any easier to cope with. There are many causes of this type of pain as well as remedies for it. Finding them is an important step in getting relief.

Understanding Sinus Infection Pain

Sinus infection pain involves feelings of pressure and congestion along the sinus cavities. Depending on where the problem lies, the pain could be felt in the cheeks, nose, eyes, or the head. With a severe infection more than one area can be affected. Many people also experience pain in their ears and their teeth due to the pressure that has built up in their sinus cavities.

Too many people simply assume that they have a cough and even the flu when they develop this type of pain. They assume it will get better and it may with the help of some over the counter products. Most people do not realize they have a serious problem though unless the pain lasts for a very long time or it continues to come back again and again.

What Causes Pain

The pain from sinus infection is the result of inflammation after bacteria or a virus has developed in the sinus pathways. Bacteria commonly passes through them, but when it sticks around is when a problem develops. The sinus passageways are blocked too which makes it hard to breathe properly.

This type of pain can last for a few days or several weeks do do not just allow it to run its course. You will be suffering needlessly and in the mean time your entire body is going to be run down. You need to fight the causes of the sinus infection pain so that you are on the road to recovery. If you have a history of chronic problems with your sinuses then it is time to seek medical assistance.

Finding the source of the pain

Finding the source of the pain is not always easy, so try to provide your doctor with as much information as you can. For example it may be determined that you have a bad back tooth and that has lead to problems in one of your sinus regions. You may be suffering from terrible headaches and not realize that it could be your sinuses. You may think it is stress or that you need to get new glasses.

Individuals that already have other health problems often do not realize that they have a sinus issue either. For example those with breathing concerns, asthma, a weak immune system, and even diabetes may lump all of their symptoms together. This is why you need to get proper information as well as regular medical checkups.

While allergies can definitely cause sinus infection pain, there is much more going on than just allergies. Too often though people end up suffering needlessly because the allergy medicine they are taking does not have any ingredients to effectively fight the symptoms of a sinus problem.

Pain Relief during a sinus infection

The goal you and your doctor will have in common is getting you relief from sinus pain. However, when you simply rely upon over the counter products you may just be fighting the symptoms and not the underlying problem. Your doctor can help you to take care of both of these issues. That way you will be less likely to suffer from more pain in the future.

Paying close attention to your lifestyle is important as well. If you have bad habits including poor diet and smoking you are more likely to suffer from this type of pain. Listen to what your doctor tells you and take your medication as required. Do not skip doses and do not take too much of it either.

If you suffer from pain during sinus infection, it is time to take action. Learn all you can about the causes of it and the types of it. Then you can start out with some common home remedies or over the counter products for relief. If those do not help then you should schedule an appointment with your doctor. Inform them about how long you have had sinus infection pain, the patterns of it, how long it lasts, and where you experience the pain.

From this information along with a full exam and assessment they can help you get some relief. It can take some time to find the answers so do not put it off. The longer the sinus problems continue the more damage that will be done to your body. In extreme cases surgery may be needed in order for you to get relief from sinus infection pain.

In general, for metal to cause a problem it needs to be in a moist environment. It is moisture that corrodes the metal which then gets released into the body. Where do these moist environments and metal come together?
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Your skin is one moist place that can cause a problem. Sweat is basically salt water and is very corrosive. Have you ever seen a car that spent many years by the beach? Your skin is causing the same corrosive reaction with every piece of metal it comes in contact with. Jewelry, belt buckles, zippers, buttons, utensils; the list is endless. Once the sweat breaks down the metal it is absorbed by the skin and your body may mount an allergic response. Part of that response is for the body to create killer attack cells called Macrophages. The macrophage will destroy everything that it comes in contact with, including the skin itself. This allergic response, and the resulting skin damage it causes, is the exact same response as poison ivy!

However, another very moist place is inside our bodies. Metal gets there through the use of artificial joints, pace makers, pins, screws and orthodontics. The inner human body is very moist and can quickly cause problems. The macrophages that are created can attack internal tissue causing destruction of organs from which serious infection can result. There are many documented cases of artificial joints having to be removed due to the patient suffering a severe allergic reaction to the cobalt or titanium, a metal that is often touted as “hypo-allergenic”. Orthodontic devices have had to be removed when patients suffered severe reactions to the nickel that was used in their braces.

Another point of entry is food. Did you know that foods can contain metal naturally? Sometime in your life you were probably told to eat your spinach because it was high in iron. One metal of particular concern is nickel and it can be found naturally in the foods we eat. Foods like green beans are high in nickel. What does eating a high nickel diet do to someone that has nickel allergy? Studies are starting to suggest that it causes system wide issues with the most common complaint being chronic skin conditions. For highly allergic people doctors might suggest a nickel free diet.

Not only does metal occur in foods naturally, humans also introduce metals into foods in the strangest ways. Did you know that toothpaste is white because it is mixed with titanium dioxide, a powdered form of the metal titanium? Titanium dioxide is also used to make bright food coloring. Did you know the little white “M” on M&M candies is printed using titanium dioxide paint? Cookware could also cause problems for nickel allergy sufferers. If an acidic food, such as tomato sauce, is cooked in a pot that contains nickel it is thought that the nickel can leech out into the food itself.

Many allergic reactions are over harmless substances because the body is not very good at telling the difference. This also applies to metals that your body comes in contact with. Nickel allergy is common and becoming more of a problem everyday, however, nickel is just one form of metal and metal is just one substance of many that can cause an allergic reaction. When you discover what you are allergic to you can focus on finding alternatives. Unfortunately, for nickel allergy sufferers this means learning to live a nickel free life.
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The in vitro serum tests employ specific antisera, and the allergen antibody reactions are amplified as a radioimmunoassay (RAST), fluorescent immunoassay (FAST), or an enzyme-linked immunosorbent assay (ELISA). Each of these techniques is comparable when performed properly. In vitro tests are acceptable substitutes for skin tests in the following circumstances:
1) The patient has abnormal skin, such as dermatographism or extensive dermatitis,
2) The patient cannot or did not discontinue antihistamines or other interfering medications,
3) The patient is very allergic by history, and anaphylaxis is a possible risk, and
4) The patient is noncompliant regarding skin testing. The results of either skin tests or in vitro assays depend very much on the quality of the allergen and the competence with which the
test is performed.
A typical radioimmunoassay:

Although the quality of allergens is improving, there is need for more and better standardization. Both skin testing and in vitro assays have been criticized for lack of good quality control. Skin testing should not be an occasional test for the inexperienced and obviously never should be delegated to an inadequately trained or unsupervised assistant. Board certified allergy and immunology specialists are best qualified to correlate patient histories with tests results. Quality control also has been a major problem for in vitro serum IgE antibody tests.
Compulsory participation in quality control programs, such as that offered by the College of American Pathologists and mandated by the Clinical Laboratory Improvement Act, eventually will lead to better quality and standardization of in vitro serum IgE tests.

Positive tests for allergen-specific IgE do not diagnose allergy; they only indicate the presence of IgE molecules that have a particular immunologic specificity. Whether the specific IgE antibodies are responsible for clinically apparent disease must be determined by a well-trained physician. The ultimate standard for the diagnosis of allergic disease remains the combination of: a positive history, the presence of specific IgE antibodies, and demonstration that the symptoms are the result of IgE-mediated inflammation.
To avoid false-negative skin tests, short-acting antihistamines should be withheld for 36 to 48 hours and long-acting antihistamines (ie, astemizole) for 4 to 6 weeks before skin tests are performed because antihistamines suppress skin testing results. The specifics of skin testing are outlined in standard allergy textbooks. Skin tests with the appropriate allergens are mandatory in all patients prior to initiation of immunotherapy with allergy extracts, and the intensity of the local wheal and flare skin reactions is a guide for determining the initial dose of allergen.
Skin testing by the multiple serial dilution (end-point titration method) is not recommended by this author because multiple skin tests increase the cost of evaluating the patient and the postulated more quantitative results have not been validated. Sublingual challenge with allergen is not a useful diagnostic test for inhalant allergy, and so-called neutralization of allergy via sublingual drops of allergen has not been substantiated. In vitro cytotoxic leukocyte test has not been documented as a useful laboratory test in controlled studies and is not recommended.

Laboratory confirmation of the presence of IgE antibodies to specific allergens such as dust mites, pollens, or animals is very helpful in establishing a specific allergic diagnosis, especially if the history of exposure to a specific allergen is not clear-cut. It may be necessary to test for specific allergens to convince the family and patient of an allergic diagnosis and to reinforce the importance of environmental control.
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Although skin testing might be performed in any child at any age, children less than 1 year of age may not mount a positive reaction. Often, the child who has seasonal respiratory allergy will not manifest a positive test until after two seasons of exposure. Clinicians should use allergens for skin testing selectively and employ only common allergens of potential clinical importance. The most useful allergens for which to test in the child who has perennial inhalant allergy are house dust mites (Dermatophygoides), animal danders, and fungi (molds) (Table 2). Allergens important in the diagnosis of seasonal allergic rhinitis are weeds, grasses, and tree pollens. These allergens vary not only by season of year but by geographic distribution. Therefore, allergens used for skin testing must be individualized and should be selected on the basis of prevalence in the local area and the home and school environment.

IgE antibody can be tested via two methods: in vivo skin testing and in vitro serum testing (Table 3). Their advantages and disadvantages are outlined in Table 4. For most patients, skin tests that are performed properly offer the best available method for detecting the presence of allergen-specific IgE. The prick, also called the puncture or epicutaneous skin test, is preferred; scratch testing has been abandoned as too traumatic. If prick tests are negative and allergy is highly suspect, then intradermal testing, which is more sensitive, may be employed. Skin tests are both 10% to 20% more sensitive and less expensive on a per test basis than are in vitro serum tests.

DIAGNOSTIC TESTS
Many pediatricians believe in the need for a screening test for allergy. Blood eosinophilia and total serum IgE levels have been proposed as screening tests, but they have relatively low sensitivity and should be used selectively (Table 3). The nasal secretions or sputum of patients who have a respiratory allergy contain increased numbers of eosinophils, which forms the basis of a useful nonspecific test, although not one that will identify any specific allergen etiology. Eosinophilia may not be present in patients who have not been exposed to allergens recently or who have a superimposed upper respiratory tract infection. Both systemic and inhaled steroids can reduce eosinophilia
in secretions significantly; antihistamines have no direct effect on eosinophils.
Why do people get Allergies
The usefulness of nasal eosinophilia as a diagnostic test depends in large part on the technique used to obtain the specimens to prepare the slides for examination. Patients should expel nasal secretions onto wax paper or parafilm; secretions then are spread on a microscope slide, stained, and eosinophils counted under a microscope. It is difficult to quantify nasal eosinophilia accurately, although a finding of more than 3% eosinophils on stained smear of expelled nasal or bronchial secretions is considered increased. Because cotton or nylon nasal swabs trap secretions, they are not recommended for collecting secretions, except in the young child who will not or cannot expel secretions by blowing the nose. Peripheral blood eosinophilia is observed in allergic asthma but less commonly in allergic rhinitis. Blood eosinophilia is more frequent in atopic dermatitis and other conditions, such as parasite infection.

Total serum IgE is elevated in about 60% of patients who have allergic asthma but only in 30% of those who have allergic rhinitis.
Unfortunately, commercial laboratories have promoted tests of total serum IgE excessively, but its usefulness in screening for allergy is limited to positive tests only because more than 60% of patients who have nasal allergy will have normal levels of total serum IgE.

Microscopic inhaled airborne allergens are responsible for most respiratory allergy (Table 2). In temperate climates, seasonal allergic rhinitis is induced by tree pollens in the early spring, grass pollens in the late spring and early summer, and ragweed in the late summer and early fall. Because of geographic differences in the US, clinicians must become familiar with the pollination patterns in their individual regions.
Hay fever is an inappropriate term for allergic rhinitis because these patients neither are allergic to hay nor have fever. Flowering vegetation, such as roses and fruit blossoms, rarely cause allergy because these pollens are too heavy to become airborne; their germination is facilitated by bees and other insects. Fungi (mold) spores may be important outdoor aeroallergens in humid climates throughout the year, but their numbers decrease once there is significant frost in temperate climates. Fungi can be important indoor perennial allergens in damp environments. In perennial allergic rhinitis, house dust, animals, and molds all may be significant indoor inhalant allergens. The principal allergens in house dust are the cuticles and feces of the microscopic house dust mite Dermatophagoides.
Animal allergens, such as epidermal danders, salivary proteins, urinary proteins, feces, and feathers, especially from pets such as cats, dogs, and birds are important because about 50% of households in the US have indoor animal pets. Food allergens are of lesser importance in the etiology of allergic rhinitis but cannot be ignored, especially in young children. Patients can be sensitive to one or multiple allergens. Certain individuals react to miniscule amounts of inhaled allergens, while others tolerate a large allergen dose before developing symptoms.
In addition to allergens, viral infections, aerosolized cosmetics, cigarette smoke, industrial fumes, and changes in temperature, humidity, and barometric pressure contribute to exacerbation of both upper and lower respiratory tract symptoms in the allergic child.
Psychologic and social stresses also can enhance symptoms. The importance of these additional contributory factors varies greatly from patient to patient but should not be ignored when evaluating any individual.
Symptoms of nasal allergy consist of frequent sneezing, nasal pruritus, watery rhinorrhea, and often, nasal obstruction. Patients also may complain of red, itchy eyes as well as itchy throat and ears. If there is nasal obstruction, the patient will be a mouth breather and snoring can be a bedtime symptom; smell and taste also may be lost. Increased symptoms frequently are noted with increased exposure to the responsible allergen, such as after cutting grass or sleeping on a feather pillow.
When an allergic reaction develops, clear nasal secretions will be evident, and the nasal mucous membranes will become edematous without much erythema. The mucosa appear boggy and blue-gray. With continued exposure to the allergen, the turbinates will appear swollen and can obstruct the nasal airway. Conjunctival edema, itch, tearing, and hyperemia are frequent findings in patients who have associated allergic conjunctivitis. Patients who have allergic rhinitis, particularly children who have significant nasal obstruction and venous congestion, also may demonstrate edema and darkening of the tissues beneath the eyes. These so-called “shiners” are not pathognomonic for allergic rhinitis because they also can be seen in patients who have chronic rhinitis and/or sinusitis. Thick, purulent secretions indicate the presence of infection, including the possibility of sinusitis.

Allergic illnesses have a significant impact that allergic diseases have on children’s health and quality of life. Allergic diseases, including asthma, are among the major causes of chronic illnesses in the United States, affecting approximately 50 million patients or as many as one in five children. The economic impact is enormous; asthma alone is estimated to cost more than 6.2 billion dollars of health care expenditures annually. Of all the chronic illnesses, allergic respiratory problems, including allergic asthma, is the most common cause of school absenteeism. Even though allergic disease usually is not fatal, death can result as a consequence of allergic anaphylaxis related to medication, food, or insect venom allergy or from a complication of asthma. Therefore, the pediatrician must be capable of diagnosing allergic disease so as to institute appropriate management. This review will emphasize those clinical diagnostic features ascertained by history and physical examination as well as the appropriate laboratory studies useful in the diagnosis of respiratory (inhalant) and gastrointestinal (food) allergy.
General Features of Allergic Diseases
Allergic diseases are immunoglobulin E (IgE)-mediated immunologic illnesses that can affect any of the body’s major organ systems either individually or collectively. Typically, children are not born having allergies because maternal IgE normally does not cross the placenta.
In rare instances, neonates and young infants who apparently were sensitized in utero have been born with specific IgE to foods and had allergic reactions to those foods. Development of an allergy requires a familial predisposition and repeat exposure to an allergen (antigen) that provokes specific IgE antibody.
Epidemiologic surveys indicate that the familial trait for allergy is inherited as autosomal recessive. Whereas the frequency of positive allergy skin tests is similar in boys and girls, asthma is twice as common in males as in females prior to adolescence, but it appears equal in prevalence thereafter. A specific immune response gene has been identified for IgE antibody synthesis in rodents, but it has not yet been demonstrated conclusively in humans. With the recent advances in molecular genetics, it is anticipated that the genetic basis of allergy will be understood better in the near future.
Allergens sensitize by several potential routes and are categorized as inhalants, ingestants, injectants, and contactants (Table 1).
It is important for the physician to define the route by which any specific allergen provokes clinical allergy in individual patients. Of the inhalant IgE-mediated allergies, allergic rhinitis is by far the most common, affecting approximately 15% of all children.
Asthma, of which 80% has an allergic inhalant basis, occurs in more than 5% of children. Gastrointestinal (ingestant) allergy typically is associated with food allergy; however, ingestants also may provoke urticaria and atopic dermatitis and less often may trigger respiratory symptoms. Anaphylaxis is a systemic generalized allergic response consisting of hypotension, urticaria, and angioedema as well as upper and lower airway obstruction; it can be caused by severe allergic reactions to foods (ingestant), insect venom stings (injectant), or medications (ingestant, injectant, or contactant).
Although incriminated anecdotally as the cause for hyperactivity, poor school performance, learning disabilities, or abnormal child behavior, there are no definitive, appropriately controlled studies that document an IgE allergic etiology for these predominantly psychosocial or educational problems. The possibility that overgrowth of a yeast such as Candida is important in the pathogenesis of allergy never has been substantiated. The concept of such a candidal syndrome in the context of abnormal child behavior has no validity, and antifungal therapy in the absence of overt clinical candidal infection should be discouraged.