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Many patients experience reactions during penicillin treatment. The diagnosis may be difficult and is mainly based on short-term tests. The European Network for Drug Allergy (ENDA) guidelines proposed for diagnosing penicillin allergy do not include long-term challenge. In this study a total of 405 patients were evaluated. The ENDA guidelines were extended, to include a 7-day oral treatment (p.0.7) with penicillin for all patients who were negative in the ENDA programme. Among the 405 patients; 85 had an immediate reaction to penicillin, and a further 13 reacted during p.o.7. Among the 307 patients with a negative outcome, 88 had a case history of reaction to other ß-lactam antibiotics and were subsequently tested with the culprit drug. Thirteen patients had a positive outcome: 3 on single-dose challenge and 10 during p.o.7. The extended penicillin diagnostic work-up was positive in 111 patients, 30.0% showed immediate reactions and 5.7% reacted during p.o.7. Approximately 20% of all patients with positive outcome during penicillin challenge are detected by adding p.o.7 with penicillin to the original ENDA guidelines. [ABSTRACT FROM AUTHOR]

Up to 10% of hospitalised patients are registered as penicillin allergic. However, 80-90% will tolerate penicillin after evaluation. New Danish guidelines suggest criteria for evaluation of patients based on risk stratification according to the severity of the index reaction. The allergy label can be removed immediately, if allergy can be ruled out using the criteria presented in this review, but all other patients should be referred for evaluation in a specialist allergy department. Specific IgE measurement should only be done in adult patients with an immediate reaction (onset less-than 2 h after intake of a tablet) or urticaria.

Introduction: The objective of this study is to estimate the incidence of major salivary gland tumors in a geographically well-defined area (the County of Funen, Denmark) and to analyse the demographic data and distribution of histological types., Materials and Methods: Patients with salivary gland tumors were identified through a search on pathology and diagnosis codes in the period 1984-2003, which initially resulted in a group of 951 patients. Of these a total of 682 patients (72%) fulfilled the criteria for inclusion., Results: The incidence of major salivary gland tumors for the County of Funen is calculated to 7.3 per 100,000 residents per year. The material consisted of 372 females (55%) and 310 males (45%), with a median age of 56 years. Pleomorphic adenoma (55%) was the most common type, followed by adenolymphoma (29%). 90% of the tumors were found in the parotid gland - 93% benign and 7% malignant. 10% were located in the submandibular gland - 73% benign and 27% malignant. Only one neoplasm was located in the sublingual gland and it was malignant (100%). The older group harboured significantly more malignant neoplasms (12%) than the younger group (7%). The occurrence of pleomorphic adenomas among females (66%) was higher than among males (43%), on the other hand more adenolymphomas were found in males (43%) than in females (17%)., Conclusion: The incidence of major salivary gland tumors in the County of Funen is calculated to 7.3 per 100,000 inhabitants per year which is equivalent to 383 new cases in Denmark per year.