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The book covers recent developments in research and practice of allergy and immunology. Special emphasis has been given to epidemiology and the relation of genetic and environmental factors in allergic diseases. Occupational aspects and the pathophysiology are additionally covered and an overview of the current pharmacotherapy and immunotherapy is provided.
This book, commissioned by the World Health Organization (WHO) and
written by international experts, provides consensus views on the
most important issues related to allergic hypersensitivities. The
text details predictive testing, diagnosis, epidemiological
monitoring of intervention measures, sources of sensitizing agents,
and mechanisms of action.
Allergy is one of the major health problems of most modern societies. Allergic diseases have increased in prevalence during the last decades; the reasons for this increase are unknown, there are only hypothetical concepts for explanation. The series New Trends in Allergy now covers five volumes origin- ing from special international symposia, started in 1980 and held every 5 years, which highlight specific areas of progress in allergy research and practice. The idea behind the 5-year interval between these s- posia is that real new developments do not occur very often and c- tainly not every year. The contents of this book focus on specific areas where progress in allergy research has shown fascinating developments, such as: - Elucidation of the complex genetic basis of atopy - The influence of environmental pollutants as well as natural biolo- cal environmental factors on allergy - Gene-environment interactions in the development of allergy - Psycho-neuro-immunological aspects of allergic sensitisation and disease - The nature and function of dendritic cells in skin and mucous m- branes - Interactions between lymphocytes and effector cells, such as mast cells, eosinophils and neutrophils - Allergen carriers, allergen release and bioavailability, allergen str- ture - Atopic eczema - Asthma and rhinoconjunctivitis - Food allergy and anaphylaxis - Pharmacotherapy - Unspecific (e. g.
The international symposium "New Trends in Allergy," held in Munich from July 13 to 15, 1990, brought together for the third time since 1980 some of the most experienced researchers working in the field of allergy. This volume comprises the papers presented at this meeting. All over the world, and not merely in the industrialized countries, allergy is becoming a cause of evermore serious diseases. In recent years, research in the field of allergy has provided numerous impor tant and fascinating results extending our knowledge considerably. Despite the new insights into basic mechanisms of allergic reactions, improved diagnostic methods, and new therapeutic approaches, how ever, many questions remain to be answered, including: Are allergies really increasing in frequency? If so, what are the reasons? Especially, does environmental pollution playa role? Which factors influence IgE synthesis? Can the IgE immune response be switched off? Does the nervous system interact with allergic reactions? If so, what are the mechanisms? Are new approaches in allergy prophylaxis and allergy therapy effi cient? What measures have proven useful and deserve to be employed in daily practice? In this volume, these questions and other current topics are dealt with. As each issue is covered by authors competent in the respective fields, the result is an extensive and critical review of the state of the art. Going through these papers, one comes to the conviction that allergy research is a multifacetted, explosively expanding, most stimulating field of work."
Anergic reactions and anergic diseases are found in many fields of medicine. As wen as affecting the skin, allergic diseases occur in internal organs such as the lungs and the kidneys and in the vascular and nervous systems. Interdisciplinary understanding and cooperation thus seem necessary to get a better insight into allergic reactions in the different fields of medicine in order that we may give our patients the best diagnostic and therapeutic care. Allergic diseases are on the increase. Studies from Sweden show that 15% of the population there are atopic, and some people speculate that in Germany about 10%-15% of all adults suffer from one of the many different allergic conditions. We in our clinic also have the impression that the incidence of atopic reactions has increased in recent years. The figure of 15% would mean something like 200 000 people in Munich alone We all know that a wide variety of environmental factors can induce allergic reactions in the skin, the respiratory system, or internal organs. The most important anergens in our environment are pollen, molds, animal dander, housedust mite, food or food additives, various insects, industrial compounds and drugs. The direct costs of hospital and community medical care, other services, and drugs to help patients with asthma, hay fever, and skin allergies have in creased considerably in the last 10 years. The figures should make it clear to everybody that we are dealing with a health and environmental problem of great practical importance."
There is no doubt among experts that the prevalence of allergic diseases has increased in many industrialized countries in recent years. The rea sons for this increase are unknown; only suppositions exist. Many people focus on environmental influences. However, the assumption that air pollution alone is responsible for this increase seems to be too simple: many other influences, including the genetic predisposition of individual patients, allergen exposure, and possibly socioeconomic factors, also have to be taken into consideration. Although our understanding of the complex mechanisms of allergic diseases has considerably improved thanks to the progress made in ex perimental immunology and allergology, we still have a long way to go before this scientific knowledge is translated into new therapeutic mo dalities. For this reason, the scientific community welcomed the gathering of scientists from very different disciplines and different parts of the world at an international symposium, "New Trends in Allergy IV" together with "Environmental Allergy and Allergotoxicology III" in Hamburg in 1995. This volume contains the invited papers, covering a wide range from basic science to practical clinical diagnosis and therapy. A further unique feature of this event was the concomitant first official workshop of the Environmental Pollution and Allergy Committee of the International Association of Allergy and Clinical Immunology (IAACI), at which the state of scientific knowledge in this field was defined and formulated."
Allergy is one of the major health problems of most modern societies. Although allergic diseases are well-known for almost two hundred years, their prevalence has increased dramatically over the last decades. Allergic reactions manifest in various organs, most commonly in the skin and mucous membranes, the frontier surfaces where the contact between the individual and the environment takes place. In a very concise and practical way this book covers all aspects of allergic reactions from pathophysiology to diagnosis, therapy and prevention with a strong focus on relevant aspects for the everyday work of the practising dermatologist and allergist in the hospital or office. This book reflects the rich personal experience of a German allergist with international training and reputation, who is active in immunology and allergy research and practice for almost 30 years. In this book, not only IgE-mediated allergic reactions are covered but all other kinds of allergies such as atopic eczema, contact dermatitis, drug eruptions, anaphylaxis and food allergies are equally represented as well as psychosomatic aspects and problems of environmental intolerances.
Der Grundgedanke dieses Buches ist der pragmatische Umgang mit Komplikationen, also wertfreies Aufzeigen des Abweichens vom "idealen" Verlauf in der Dermatologie. Die dermatologische Diagnostik und Therapie umfassen eine Vielzahl verschiedener Verfahren, die von konservativen bis zu invasiven Techniken reichen. Eine Zusammenfassung klinisch relevanter Komplikationen, getrennt nach verschiedenen diagnostischen Schwierigkeiten, ist in dieser Form neu. Eindrucksvolle Beispiele sind die Abnahmetechniken von Schuppenmaterial bei mykologischen Untersuchungen oder von Hautbiopsien zur histologischen Diagnostik. Viele Fallbeispiele und eindrucksvolle Illustrationen bieten dem Leser wertvolle Hilfestellung fur die tagliche Praxis sowie im Umgang mit Abweichungen von der Norm. Das Buch richtet sich sowohl an Facharzte der Dermatologie und Kollegen in der Facharztausbildung wie auch an Vertreter anderer Fachgruppen (wie z.B. Allgemeinmediziner), die mit dermatologischen Untersuchungsverfahren konfrontiert sind."
Der vorliegende Band dient den in Klinik und Praxis tatigen Dermatologen und dermatologisch interessierten AErzten zur kontinuierlichen Fortbildung und als verlassliche Informationsquelle. Die Schwerpunkte dieses Bandes liegen auf den Fortschritten im Bereich der klinischen und operativen Dermatologie, des atopischen Ekzems, der UEberlappungsdermatosen, der Erkrankungen des Fettgewebes, AIDS, der angewandten Allergologie, der Mikrobiologie, der Andrologie, der padiatrischen Dermatologie, der Entwicklungen in der Therapie und der Berichte aus der Forschung fur die Therapie.
Die Zunahme pathophysiologischer Erkenntnisse im Bereich der Der- matologie hat auch zu einer wesentlichen Erweiterung therapeutischer Ansatze gefiihrt. Waren friiher therapeutische Bemiihungen besonders bei entziindlichen Dermatosen hauptsachlich durch Anwendung auBerlicher TherapiemaBnahmen gekennzeichnet, so verfUgt der Dermatologe heute iiber hochdifferente, systemische Therapeutika wie Antibiotika, Gluko- kortikoide, Immunsuppressiva, Retinoide oder Zytostatika u. a., mit denen es gelingt, viele Hauterkrankungen wesentlich zu bessern oder zur Abheilung zu bringen. Die groBe Vielfalt sehr wirksamer innerlicher und auBerlicher Thera- peutika mit entsprechenden Nebenwirkungen erfordert vonjedem Haut- arzt entsprechende pharmakologische Kenntnisse zur Durchfiihrung notwendiger Kontrolluntersuchungen verschiedenster allgemeiner kli- nisch-chemischer Parameter, urn die jeweilige Therapie zu iiberwachen und Nebenwirkungen friihzeitig zu erkennen. In dem vorliegenden Buch wird ein Uberblick iiber das Arsenal an Wirkstoffen geboten, die heutzutage in der dermatologischen Therapie eingesetzt werden konnen. 1m Rahmen der auBerlichen Behandlung wird auch der indifferenten Dermatotherapie mit Grundlagen (Salbe, Creme, Paste, Lotio) besondere Aufmerksamkeit geschenkt. Dies scheint be- sonders wichtig in einer Zeit, in der man meint, den Dermatologen durch Richtlinien die Behandlung mit sogenannten wirkstofffreien Externa beschneiden zu miissen. Selbstverstandlich findet sich auch eine ein- gehende Besprechung der Wirkstoffe, die zur Behandlung bei Hauter- krankungen ihren Einsatz finden. Mit eingeschlossen sind Antiallergika sowie auch Pharmakotherapie in der Phlebologie und Proktologie sowie Andrologie. Breiter Raurn -und das ist wichtig -wird auch der innerlichen und auBerlichen Anwendung von Glukokortikosteroiden einschlieBlich der moglichen Nebenwirkungen an der Haut gewahrt. Neuere und noch in der Diskussion befindliche Therapieverfahren werden erwahnt, aber vor allen Dingen bewahrte herausgestellt.
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