Constance H. Katelaris

Spatial variability in the pollen count in Sydney, Australia: can one sampling site accurately reflect the pollen count for a region?

BACKGROUND There is increasing interest in the daily pollen count, with pollen-sensitive individuals using it to determine medication use and researchers relying on it for commencing clinical drug trials and assessing drug efficacy according to allergen exposure. Counts are often expressed qualitatively as low, medium, and high, and often only 1 pollen trap is used for an entire region. OBJECTIVES To examine the spatial variability in the pollen count in Sydney, Australia, and to compare discrepancies among low-, medium-, and high-count days at 3 sites separated by a maximum of 30 km. METHODS Three sites in western Sydney were sampled using Burkard traps. Data from the 3 sites were used to compare vegetation differences, possible effects of some meteorological parameters, and discrepancies among sites in low-, medium-, and high-count days. RESULTS Total pollen counts during the spring months were 14,382 grains/m3 at Homebush, 11,584 grains/m3 at Eastern Creek, and 9,269 grains/m3 at Nepean. The only significant correlation between differences in meteorological parameters and differences in pollen counts was the Homebush-Nepean differences in rainfall and pollen counts. Comparison between low- and high-count days among the 3 sites revealed a discordance rate of 8% to 17%. CONCLUSIONS For informing the public about pollen counts, the count from 1 trap is a reasonable estimation in a 30-km region; however, the discrepancies among 3 trap sites would have a significant impact on the performance of a clinical trial where enrollment was determined by a low or high count. Therefore, for clinical studies, data collection must be local and applicable to the study population.

Allergic Rhinoconjunctivitis in Elite Athletes Optimal Management for Quality of Life and Performance

Allergic rhinoconjunctivitis is a common condition with a peak incidence in the age range of the majority of elite athletes. The condition has been shown to have a significant impact on the quality of life of those affected and poses particular challenges when present in the elite athlete. When an athlete is looking for exceptional performance at events such as the Olympic Games, any factor which affects quality of life by interfering with sleep, decreasing the ability to concentrate, or reducing peak physical fitness, may have a significant impact on the ability to perform at one’s best.Optimal management begins with correct diagnosis and identification of triggering factors.There are a number of therapeutic options available to the treating physician. When formulating a management plan for the elite athlete, the physician must consider ‘doping’ rules and the possible effect of medication on athletic performance.Medication choices include the newer, non-sedating antihistamines, used either orally or topically, and the prophylactic use of intranasal corticosteroids. When allergic conjunctivitis is the principal problem, the newer, topical antihistamines are highly effective and have a rapid onset of action. Since avoidance strategies are rarely practical for the athlete, consideration should be given to strategies such as immunotherapy, where long-term benefit is possible.

Zoster sine herpete of the trigeminal nerve

Zoster sine herpete infection that involves the trigeminal nerve is rarely reported. The present case details a case of varicella zoster virus infection of the mandibular division of the left trigeminal nerve without evidence of a vesicular eruption. The diagnosis was established on clinical findings and was supported by the demonstration of an IgG antibody titer of > 1:640 during the acute phase of the disease.

Hereditary angioedema and pregnancy

Background:  Hereditary angioedema (HAE) is an autosomal dominant disease caused by a quantitative or functional defect in C1‐esterase inhibitor (C1‐INH). Patients with this deficiency present with episodes of angioedema which can be life‐threatening. Studies examining HAE and pregnancy are scarce with little known about the interrelationship between the two.

Oral complications in type 1B glycogen storage disease

A case of type 1b glycogen storage disease (GSD) in which neutropenia and neutrophil dysfunction were prominent features is described. Oral complications included rapidly progressive periodontal disease and recurrent mucosal ulceration.

A 7 year pollen profile of major Olympic Games venues in Sydney, Australia

The year 2000 Olympic and Paralympic Games heldin Sydney, Australia were unique in the historyof the Games because they were staged in theearly to mid spring. This led to the concernthat pollen-sensitive athletes may havesignificant problems with allergic symptomstriggered by pollen exposure and that this mayhave compromised their ability to attain theirbest performance. Unfortunately, there was nosystematic pollen count data available for thecity of Sydney up until this time so thepurpose of this study was to obtain a profileof the pattern and type of pollens in theregion so that Olympic team managers andmedical staff could be adequately advised andable to prepare allergic athletes for anyexposures encountered while training andcompeting.We performed pollen monitoring of three majorOlympic venues over the six years before theGames to provide a profile of the mostprevalent species appearing over the spring.The pollen counts obtained at the major siteswere extremely high over the periods oftraining and competition. Tree pollens appearedfrom late July, peaking in August andSeptember, whilst grass pollens appeared fromSeptember and peaked in mid October. Arelatively small number of pollen varietiescomprise the majority of the pollen count.

Latex Allergy in the Prehospital Setting

INTRODUCTION Latex allergy first was recognized early in the 20th Century, but was not a matter of concern until the last decade of that Century. The reported incidence of latex allergy in different occupations varies considerably. It has been documented in dental workers, operating theater staff, anesthetists, and laboratory technicians. However, little data specifically related to those involved in patient care in the emergency prehospital setting are available. METHODS A questionnaire was distributed to a sample of both volunteer and salaried first responders from St. John Ambulance Australia in South Australia and Western Australia, and the South Australian Ambulance Service. The first responders were surveyed to: (1) determine the incidence of latex allergy; (2) consider possible factors associated with its development; (3) compare characteristics of the surveyed groups; and (4) reinforce the development of an educational program. The study tool had predetermined statistical qualities. Data were collated and processed using standard statistical procedures. Surveys were collected anonymously. RESULTS Of the 2,716 forms distributed, 1,099 were returned, resulting in an overall response rate of 40.5%. Atopy was identified in 14.9% of participants, hand dermatitis in 9.4%, and latex allergy in 6.4%. In the group of full-time ambulance officers, there was a significantly higher incidence of hand dermatitis and latex allergy. There also was a significant relationship between latex allergies and both dermatitis and glove usage (as measured by frequency and duration). CONCLUSION In a group of first responders assessed by an anonymous, voluntary questionnaire, the subset of full-time, salaried ambulance officers was identified as having a higher incidence of hand dermatitis and latex allergy than their volunteer co-workers. These results require further assessment to substantiate the frequency of latex allergy and determine the predisposing factors. All personnel must learn about hand care. Non-powdered, natural rubber latex gloves should be supported for general use in this setting.