Gentowa

The skin tests are necessary supplements of all basic allergist examinations. The allergic hypersensitiveness proof was discovered by Charlie Blackley already in 1865. The technique

was later on improved by Grant Lewis, Pepyes and others, who introduced the prick test (stinger) usage. Nowadays the standardized method introduced by the European allergist and clinical immunology academy.

The skin test in based on the fact, that sensitive allergic patient has specific antibodies against the allergens not only in the particular organ, in which the clinical symptoms are active, but also in the cell membrane – mastocyte which are in the skin. While testing, the suspect allergen is injected into the patients´ skin near the forearm. The allergen choice is made according to the patients´ data on the clinical symptoms period. The standard group of allergens, which includes the following, is used:

● trees pollen

● grass pollen

● rye

● worm wood

● ambrosia

● mould

● feather

● mites

● positive control (histamine)

● negative control (usually a solution with dissolved allergens)

According to the seasonality, others allergens are added. If the patient is in the contact with the animals, the animal allergens (dog, cat, etc) are tested, as well. Before the testing the patient should cease the anti allergic treatment (the antihistamines for at least one week), but others, as well. For example many preparations used by the psychiatrists relieve even the skin reaction at the skin tests.

When possible, the patient should be tested even off pollen season. It is not appropriate to test somebody during or right after the infection since it can cover the reaction, as well. For checking the skin test realisation correctness beside the allergens, the positive and the negative control is injected. As the positive control histamine is used – a chemical, which is released during the allergic reaction in general, i.e. test with this chemical can be positive even in the case of the health people. If this reaction after the testing is negative, the test is not valid, since some of the processes or the medications relieved all reactions.

The negative checking is, on the contrary, is injected in order to exclude the reaction, which is only mechanical – the injury or the injection itself, or the allergic reaction to the solution, eventually to the conservative chemical in the allergen solution. The skin tests allergens are made commercially. Their content and dilution are standardised.

The pollen catcher is placed on the roof of the building. (The building should besituated representative enough for its surroundings, from which the information is given, thusnot near a factory or a chimney).The pollen catcher (pollen toils) - is a barrel with a vacuum cleaner, which draws in the airfrom the room and directs its flow with the help of the jet onto the adhesive tape.

All caught elements, which the air consists of, get caught on the adhesive tape. The tape isfixed on the inside of the barrel, which turns around slowly (360 degrees in seven days).The tape is removed from the barrel after a week, and is finally cut into seven piecesthat stand for particular days of the week. The pollen, which is caught on the rape, is colouredand finally evaluated under the microscope. Of course, these evaluations can be done only bythe experts, who can recognise and define the particular type of pollen drain according to itscolour, form and size.In addition to the type of pollen, the measurement of the pollen in the air has beenevaluated, as well.

The results are converted into 1 cubic metre. It is important, since thepatients react clinically to certain amount of the pollen in the air. The plants and flowers differin the aggressiveness from each other. To start the symptoms of the allergic reaction, 50pollen grains in 1 cubic metre are usually sufficient. While in season, the pollen count isseveral times higher.The pollen station sends the information to the centre (Štrbské Pleso in SR), whichprocesses the information and sends them to the central office in Vienna. At the same time,once in a week, it distributes the information to several doctors and public mass media.

The pollen calendar

The central office in Vienna under Dr. Siegfried Jäger processes the data fromEuropean pollen stations on the basis of the information gained. It enables to publish thepollen calendar periodically. It is a document - a map, which covers the pollen in the air indifferent European countries according to the months of the year.The calendar is important for all sufferers. The up–to-date month by month situationof the area where we are living at can be found here.We can find here the pollen situation in other countries, as well, which plays a significant rolefor everyone who is planning to travel abroad.The summary of the pollens in our country is shown in the following picture. Thevacation guideline for the allergic people can be found in the chapter Allergy on the road.

● Instead of feather pillows and duvets, it is required to use those plastic ones withplastic covers, as well, which do not cause allergic reaction

● Frequent changing and washing of clothes is necessary. Animal allergens often settlein there and can cause irritations even outside the place, where the animal is

.● It is necessary to wipe the floor and the furniture with a damp cloth. For vacuumcleaning only the vacuum cleaner with HEPA (high efficiency particulate arresting)filter is suitable.

The one being allergic should not come into the contact with vacuumcleaning. If he/she has to clean with the vacuum cleaner, he should use the maskprotecting himself from the dust. The air disposal plant is appropriate; it is able tofilter almost all flying dust, though it does not remove all allergens.We have to be aware of the important fact that: although all these activities reduce theamountof allergens in the family surroundings, they can not be substituted for the removal of theanimal. Even the removal itself without a special cleaning of the house means that you willlive in the environment surrounded by clinical important amount of allergens.All mentioned allergens can be, of course, found in dust. The dust by itself is formed by smallgrains of inorganic material - silica, together with other inorganic and organic matters andmentioned organic matters.

The home dust of particular households or working places varies according to the way a houseor working place is furnished.Therefore the diagnosis is made with individual allergens. The term “allergic to dust” does notindicate our actual reactions, therefore has been ceased to be used.The life of allergic people is getting worse even by other harmful substances, which donot start the actual allergic process, but get worse its development.

Pollen information service

The most frequent factor, which causes and starts the allergic reaction, is pollen. Thepollen count in the air directly influences the clinical symptoms, whereas there is a directrelationship between the amounts of pollen in the air and the seriousness of the symptoms. The seasons, when the flowers are in bloom and hence the pollen count is higher, can bepredicted approximately according to the usual duration of blooming time of the particularflower, which is stated in all botanic guidelines.However, the pollen calendars do not always correspond to the real time a flower is in bloom.The real bloom period can differ from the assumption even in several weeks. Moreover thelevel of the air pollen is noticeably influenced by meteorological conditions (rain, wind, coldheat,etc).

The up-to-date information about the situation i.e. what is the amount of pollen grainsand what kind of pollen grains are in the air, are necessary for the doctor and the patient, aswell.Within the information as a part of diagnosis the important anamnestic information –worsening or bettering of the patient’s health within a particular period, follows.Even more important is this information for the planning and conduction of the medicaltreatment.

While the air contains “our” particular allergen in the sufficient amount, the clinicalsymptoms arise.This can be prevented by taking the medicine on time. Its advantage lies in the fact, that in“our” season we can adjust our daily schedule (less walks, travelling to clinically betterenvironment and so on).The pollen count started to be examined already in 1873 by the English doctorBlackeley.

He suffered the allergy himself, and hence was interested in the possibleconnection between the amount of pollen in the air and the clinical seriousness of the allergy.He placed in different levels small glasses covered by glue, which caught the pollen.The need of exact information let to the gradual establishment of pollen stations,which measure the amount of pollen and other substances in the air. In 1930s first stationswere founded in Canada and USA.