Nasal allergen challenge (NAC): Practical aspects and applications from an EU/US perspective-a Work Group Report of the AAAAI Rhinitis, Rhinosinusitis and Ocular Allergy Committee.

Nasal allergen challenge (NAC) is applied in a variety of settings (research centers, specialty clinics, and hospitals) as a useful diagnostic and research tool. NAC is indicated for diagnosis of seasonal and perennial allergic rhinitis, local allergic rhinitis, and occupational rhinitis; to design the composition of allergen immunotherapy in patients who are polysensitized; and to investigate the physio-pathological mechanisms of nasal diseases. NAC is currently a safe and reproducible technique, although it is time- and resource-consuming. NAC can be performed by a variety of methods, but the lack of a uniform technique for performing and recording the outcomes represents a challenge for those considering NAC as a clinical tool in the office. The availability of standardized allergens for NAC is also different in each country. The objective of this workgroup report is to review the current information about NAC, focusing on the practical aspects and application for diagnosis of difficult rhinitis phenotypes (eg, local allergic rhinitis, occupational rhinitis), taking into account the particular context of practice in the United States and the European Union.

Maternal temperature variation during parturition.

OBJECTIVE: To characterize temperatures for normal full-term parturients. METHODS: A retrospective chart review of 189 consecutive singleton deliveries during 1996 was conducted. All available maternal sublingual temperatures were collected from the time of admission to the time of discharge from the delivery area. To evaluate the effect of prophylactic antibiotics in labor, maximum labor temperatures of patients who did not receive (group 1) and who received (group 2) antibiotics were compared. Using simple linear regression, temperature slopes were calculated for patients who had at least two temperature observations during labor. RESULTS: A total of 147 (77.7%) patients met inclusion criteria. No statistical difference was found between the maximum temperatures of patients who received and did not receive prophylactic antibiotics for labor or recovery. The mean maximum temperature in labor was 37.0 +/- 0.42C. The average of each patient's mean temperature was 36.8 +/- 0.33C, and 95% of the observations were between 36.2C and 37.5C. The mean temperature slope of the 100 patients who had more than one labor temperature observation was 0.01 +/- 0.12C per hour. CONCLUSION: In the normal full-term parturient, labor alone does not significantly increase normal body temperature.