Immune System and Allergic Diseases and Nursing Care 2023-2024 Lecture Notes PDF

MEDICAL NURSING II ASST. PROF. DR. UFUK KAYA 2023-2024 SPRING TERM  IMMUNE SYSTEM AND ALLERGIC DISEASES AND NURSING CARE Assist. Prof. Dr. Ufuk KAYA CYPRUS HEALTH AND SOCIAL SCIENCES UNIVERSITY FACULTY OF HEALTH SCIECNES, DEPARTMENT OF NURSING 2022...

MEDICAL NURSING II ASST. PROF. DR. UFUK KAYA 2023-2024 SPRING TERM  IMMUNE SYSTEM AND ALLERGIC DISEASES AND NURSING CARE Assist. Prof. Dr. Ufuk KAYA CYPRUS HEALTH AND SOCIAL SCIENCES UNIVERSITY FACULTY OF HEALTH SCIECNES, DEPARTMENT OF NURSING 2022 2  DEFINITIONS RELATED TO THE SUBJECT ALLERGEN: substance that causes allergies ATOPIC BODY: hypersensitive body HYPERSENSITIVITY SHOCK ORGAN/TARGET ORGAN: the organ where the sensitive cell is located AUTOIMMUNE: the immune response of the organism against its own protein 3 DEFINITIONS RELATED TO THE SUBJECT ALLERGIC ANSWER: sensitivity to substances that would not normally be harmful to the organism MAST CELL/BASOPHIL CELL: susceptible cell. Connective tissue (support tissue) cells containing heparin and histamine granules Anaphylaxis: a sudden, immediate reaction that occurs as a result of the combination of antigen and antibody 4 ALLERGY AND HYPERSENSITIVITY 5  What is allergy? Allergy is the body's overreaction to any foreign substance. The immune system of people with allergies, an overreaction to the foreign substance we call 'allergen', causes a number of symptoms in the patient. Allergy is a personal situation. Substances to which allergic people are sensitive may differ from each other. For some, pollen can be an allergen, while for others, strawberries can be allergens. 6  ALLERGY Some people have a tendency to allergies. It is passed down genetically. Determined by large amounts of IgE antibodies 7 What are the most common allergens? Allergens can vary from person to person. The most common allergens: house dust mites, pollen, mold fungi, food allergens, animal allergens, drug allergens etc... 8 If the allergen is in the air, it causes symptoms in the eyes, nose, lungs (watering in the eyes, runny nose, cough, shortness of breath, etc.). If swallowed, it will cause allergic reactions in the mouth, stomach and intestines (constipation, gas, bloating, diarrhea, etc.). Sometimes the allergic response reaches dimensions that affect the entire system, and as a result, chemicals released from mast cells can cause low blood pressure, shock, loss of consciousness and death. This condition is called anaphylactic shock.. 9  How are allergic diseases diagnosed? Patient's story It is important that the patient's symptoms after exposure to the allergen are completely normal between attacks. Apart from that, skin tests can help the diagnosis. There are many allergens and they may not be detected by skin testing alone. Allergic patients may have high IgE levels in the blood. In addition, there are diagnostic methods that vary according to the type of disease. 10  Treatment in allergic diseases The most effective prevention in allergic patients is to stay away from allergens. Often this is not possible. But some precautions can be taken inside the house to minimize it. For example; not to have pets, not to use items that may contain dust (carpet flooring, wool pillow), not to smoke in the house, to stay away from irritating smells such as perfume, bleach, etc. 11 There are some precautions that the patient can take. - Not to be in dusty and smoky environments, if necessary, wearing a mask - Adjusting the temperature and humidity - Being indoors as much as possible and keeping the doors and windows closed during the high pollen seasons. - As much as possible, leather, vinyl and plastic items should be used instead of carpets, rugs and blankets. 12 *Allergen house dust should be cleaned from the environment, bedroom, house dust etc. *There should be very few items in the patient's room and dust should be removed frequently with a wet cloth. *When the patient is in the room, cleaning should not be 13  There are some precautions that the patient can take. Plants and pets should not be kept in the house. - Using specially prepared bedding and linens, if not available, washing all linens and linens regularly with hot water - Pay attention that the vacuum cleaner does not give dust outside - Avoid furry toys - In which environment and situations the patient feels that his/her complaints start or increase, he/she should take his/her own precautions accordingly. 14  Treatment in allergic diseases Antihistamines: prevent the effects of histamine. Some antihistamines can cause drowsiness and drowsiness and therefore may not be suitable for use during the day. Corticosteroids: Corticosteroids act by suppressing the immune system. Although it is a very effective drug, especially in emergency situations, it can have many side effects in long-term use. Some side effects of corticosteroids, which are important when used systemically, increase susceptibility to infection due to suppression of the immune system. It raises blood sugar. This can be a problem, especially in patients with diabetes and asthma. It gains weight. May cause stomach complaints, ulcers. 15  Treatment in allergic diseases Other: Mast cell stabilizers used in asthma and some drugs that expand the bronchi are among the frequently used ones. Vaccine treatment: It is effective in allergy patients, but in a limited group of patients, with this method, which is based on the application of the allergen with repeated small doses and reducing the sensitivity to the allergen. 16  ALLERGIC rhinitis Any inflammation of the mucous membrane lining the inside of the nose is called rhinitis. If this inflammation is caused by allergic factors, it is called allergic rhinitis. 17  Symptoms of allergic rhinitis - Sneezing at certain periods or continuously, - Itching in the nose, - Runny nose, - Nasal congestion, - Postnasal discharge, -Tickle in the throat, - Eyes tearing, redness and itching, - Ear fullness, rustling, itching, - Head and ear pain, - Smell disorder, - Taste disturbance, - Voice disorder, etc. 18  Treatment 1-Allergen protection (elimination) 2- Drug Treatment 3 - Immunotherapy (Vaccination Treatment) 19 As drug therapy, the most commonly used antihistamines. These drugs are aimed at reducing histamine, which plays a role in allergic reactions. are corticosteroids (cortisone). There are also nasal sprays called decongestants and drugs called cromolyn that prevent allergic reactions. 20 ASTHMA 21 It gives different symptoms according to the affected places. While the eyes and nose are affected in allergic rhinitis, the lungs in asthma and the skin in eczema are affected. Symptoms of allergic asthma: - Dry cough, - Wheezing - Chest tightness, - Shortness of breath: Narrowing of the bronchi, and severe shortness of breath- winging- can occur due to the narrowing of the bronchi and the mucus plug produced blocking the airway. Triggers that cause a crisis: The most common triggers of allergic asthma are upper respiratory tract infections such as colds and flu, Polluted air, Pollen, Exercise, Some nutrients and additives, Air change, etc. 22  etiology Extrinsic Asthma: It is a type of asthma caused by IgE reaginic antibodies. It is common between the ages of 2-50. Allergens in this type of asthma; pollen, fungal spores, house dust, animal hair and skin debris. Intrinsic Asthma: It is accepted that bacterial allergens play a role in this type of asthma. It is more common before the age of 2 and after the age of 50. Asthma caused by aspirin: It manifests itself with runny nose, nausea, vomiting, wheezing, dyspnea up to cyanosis within 20 minutes to 2 hours after taking aspirin. Exercise-induced asthma: a certain amount of strenuous exercise can cause bronchospasm in asthmatics. Fatigue, wheezing and dyspnea when tired are noted in the stories of this type of asthma. 23  Signs and Symptoms When the individual is exposed to intrinsic or extrinsic agents to which they are hypersensitive, bronchial constriction occurs. The cause of the symptoms seen in the patient is bronchial constriction and edema. Later, edema develops in the bronchial mucosa and the bronchial passage narrows. The patient has difficulty in expiration, wheezing and dyspnea. Patients cannot exhale as much air as they breathe in with inspiration, and the residual volume gradually increases. Therefore, as the disease progresses, the lung expands, the elastic tissue of the thorax is stretched, the chest expands, and in some cases, a barrel chest occurs. 24  Signs and Symptoms Alveoli and ventilation-perfusion ratio are disturbed and therefore acid-base balance is disturbed. At the onset of asthma attacks, as a result of the resistance of the airways and the increase in residual volume, CO2 accumulates in the body and O2 decreases. Hyperventilation happens. therefore, respiratory alkalosis develops first. Respiratory acidosis may develop if the airways are blocked. Eosinophils may be seen in the sputum. Patients with bronchial asthma produce thick and sticky sputum during moderate seizures. In this sputum, there are small gelatin-like substances, 5 mm-2 cm long, white and yellow in color, in the form of twisted strands called crushman spirals. These are typical for asthma bronchial. 25  Treatment 1- Protection from allergens 2- Drug Treatment 3 - Immunotherapy (Vaccination Treatment) 26  Treatment and Nursing Care Hyposensitization (immunotherapy); It reduces the patient's sensitivity to allergens. Elimination; To prevent the patient's contact with the allergens that cause the disease. It prevents the patient's contact with known or possible allergen. symptomatic treatment; if symptoms of the disease have occurred, to control them with drug therapy. Epinephrine, aminophylline, ephedrine, antihistamine or corticosteroids are given to relieve the patient and provide bronchodilation. 27  Status Asthmaticus: In advanced bronchial asthma, asthma attacks continue uninterrupted and for a long time. Breathing is audible and the patient has wheezing. The patient is extremely agitated, tired and very anxious. The patient often sits in a sitting position, leaning slightly forward. It consumes energy to breathe, and it is inactive for activities such as eating and drinking. Patient (uses subclavicular, intercostal, and subcostal accessory respiratory muscles to breathe). Inspiration is fast and expiration time is long. 28 Status asthmaticus treatment and nursing care The purpose of the treatment; to resolve bronchospasm, to ensure the patency of the airways by treating edema and mucus, to correct and maintain the fluid-electrolyte, acid- base balance, and to treat complications. Oxygen is given. Fluid and electrolytes are given intravenously. For bronchospasm, aminophylline, epinephrine, ephedrine are administered. The patient's pulse and blood pressure arterial should be closely monitored. In addition, corticosteroids are given to control the asthmatic seizure. 29 Status asthmaticus treatment and nursing care In status asthmaticus seizures, sedatives are not given to the patient because they suppress the respiratory center and cough reflex. Morphine, on the other hand, is definitely not given because it both suppresses the respiratory center and causes vasoconstriction. The patient is in fear and his anxiety is very high. For this reason, the patient and family members are tried to be relieved by providing the necessary psychological support. The environment is kept calm, clean and humid. Patient visitors are restricted. 30  ANAPHYLAXIS It is a picture that develops suddenly in a short time to be expressed in minutes and requires urgent intervention. 31 ANAPHYLAXIS Substances causing systemic anaphylactic reaction: Parenteral drug, vaccine and serum applications, proteins (hormones, enzymes, some nutrients) 32  SYMPTOMS Local symptoms such as redness, urticaria, itching and angioneurotic edema within a few minutes of exposure to the allergen, Cardiovascular, respiratory, gastrointestinal, skin and mucous membrane symptoms appear within 30 minutes. 33  TREATMENT It's an emergency. Contact with antigen is eliminated epinephrine for vasoconstriction Antihistamine to eliminate capillary permeability developed by the effect of histamine. Corticosteroids with anti-inflammatory action for urticaria and angioneurotic edema Aminophylline given for bronchospasm 34  WHAT IS HIV? HIV virus, named with the initials of the words Human Immunodeficieny Virus, is a virus that weakens the immune system of the individual by settling in the immune system. The number of CD4 + lymphocytes, the main target of the virus, gradually decreases. 35  WHAT IS AIDS? AIDS is a contagious viral disease. Its microbe is the HIV virus. HIV affects and destroys the body's immune system, which provides the body's ability to resist germs. In addition to the effect of HIV, various microbes also cause diseases in the body whose resistance is decreased. 36  HOW IS AIDS TRANSMITTED? It is transmitted through unprotected sexual intercourse. 80-85% of all transmissions occur in this way. HIV is also found in men's semen and women's vaginal secretions. By entering the body through damaged tissues and cracks during sexual intercourse; It can be transmitted from man to woman, woman to man, man to man or woman to woman. It can be transmitted by the contact of bleeding in the genitals or menstrual blood of men and women with HIV to the penis, vagina and mouth. 37  HOW IS AIDS TRANSMITTED? It is transmitted by blood 10-15% of all transmissions occur in this way. HIV is found in the blood of AIDS patients and their carriers. Transmission through blood with HIV occurs in several ways: It is transmitted by uncontrolled blood transfusion. Used and not disinfected; Infection can occur with all sharp and piercing tools such as injectors, needles, surgical instruments, dental instruments, tattoo instruments, acupuncture needles, razors, scissors. Contamination can occur with needles, injectors and spoons in which the drug is dissolved, shared by intravenous drug users. There is also the possibility of transmission through organ, tissue and sperm transplantation with HIV. It is transmitted from mother to baby. 38  transmitted by blood HIV can be transmitted from a sick or surrogate mother to her baby during pregnancy, childbirth or breastfeeding. The rate of transmission of HIV to the child born to an HIV-positive woman is around 30%. With the treatment of the pregnant mother, this rate drops to 7%. Although the rate of transmission through milk is not high, breastfeeding is not recommended for HIV-positive mothers. 39 What are the situations in which HIV is not transmitted? HIV is not transmitted by being in the same room, studying at the same school, or breathing the same air in daily life. HIV does not pass through intact skin. Saliva, tears, sweat, sneezing, cough, urine, stool; Handshake, skin touching, caressing, hugging, cheek and hand kissing; Food, drinks, forks, spoons, glasses, plates, telephones; Toilet, shower, faucet, swimming pool, sea, sauna, Turkish bath; Mosquito and other insect bites, living with cats, dogs and other animals do not transmit HIV. 40 AIDS test Since HIV enters the body, special antibodies are formed in the body to fight it. Detection of these antibodies in the blood by ELISA method is called Anti-HIV test. A period of 3 months (window period) is needed for anti-HIV antibodies to reach a level that can be measured by the ELISA method. Therefore, the test should be done 3 months after infection. A positive anti-HIV test indicates the presence of HIV virus in the blood. However, there is a possibility that the anti-HIV test will be false positive. For this reason, in order for the person to be able to say that he or she is HIV positive (seropositive), a confirmation test called the Westernblood test must also be performed and the result must be positive. 41 41  CLINICAL SYMPTOMS Respiratory System Diseases The most common lung disease encountered during the course of HIV infection is pneumonia (pneumonia) due to fungus. It is a table with fever, night sweats, weight loss, increased cough and shortness of breath. The incidence of tuberculosis in HIV-infected patients is higher than in non-HIV-infected patients. Some drugs used in the treatment of tuberculosis have interactions with drugs used for the treatment of HIV infection. Care should be taken in this regard. 42  CLINICAL SYMPTOMS Oral Cavity (Intraoral) Findings During the course of HIV infection, many lesions may occur in the oral cavity. The most common is a fungal infection, also known as thrush. The most common cause is Candida type fungi. It causes difficulty in swallowing and impaired taste. Gastrointestinal system involvement A) Esophagus (Eesophagus) diseases: The most common complaint in AIDS patients is difficulty in swallowing. Often the cause is a fungal infection of the esophagus (esophageal candidiasis). B) Stomach and small intestine disorders: Nausea, vomiting and abdominal pain are the most common complaints. C) Enterocolitis: Diarrhea occurs in more than half of AIDS patients at any time during the course of the disease and is one of the major causes of death. 43 43 Cardiac involvement The most common cardiovascular problem detected during the course of HIV infection is fluid collection in the pericardium (pericardial effusion). Hematological (blood and bone marrow) diseases Anemia (anemia) is the most common blood disease in AIDS patients. It can be seen due to the disease itself or due to blood loss from the gastrointestinal tract. Nervous system findings HIV is a virus that can cause different clinical pictures in the nervous system. 44 Opportunistic infections Toxoplasmosis: It is an infection caused by a parasite called Toxoplasma gondii. Patients have complaints of fever, headache, and weakness in the arms and legs, just as in paralysis. Brain tomography is used for diagnosis. Cryptococcosis: Meningitis caused by the fungus Cryptococcus neoformans, is the third most common central nervous system disease in AIDS patients after toxoplasmosis and lymphoma. Cytomegalovirus infection: Cytomegalovirus (CMV) infection is very common in patients with AIDS. It can infect the retina and cause blindness and various neurological diseases. C) AIDS-Dementia Complex (AIDS-Dementia Table) It is a picture that goes with thinking, motor and behavioral disorders. It is usually one of the late-stage complications of HIV infection. 45 Cancers A) Kaposi's Sarcoma (KS) is the most common cancer in HIV-infected patients. A virus defined as "Human Herpes Virus 8" (HHV8) has a role in its pathogenesis. Purple, red colored cancer tissue can be seen on the face, arms and legs. B) Lymphoma The second most common cancer associated with HIV is lymphoma, a type of cancer that originates from lymph cells. fever, weight loss, and enlarged lymph nodes. C ) Anal (breech) cancer is common in HIV- infected patients. 46  TREATMENT IN HIV INFECTION There is no treatment that eliminates the virus in HIV infection, but there are drugs that control the replication of the virus. The general name of these drugs is "Antiretroviral drugs", and the treatment with these drugs is antiretroviral therapy. 47  protect yourself from AIDS Condoms must be used as a protective method in any sexual intercourse with people who are not sure whether they have HIV or not. It is necessary to make sure that blood products have passed the necessary tests. While shaving at the barber, it should be ensured that a new razor is used for ourselves. Care should be taken that the manicure and pedicure tools in the hairdressers are disinfected. 48 48 protect yourself from AIDS The most RELIABLE way to avoid this sexually transmitted disease is not to have unprotected sex and to prefer monogamy. The protective cover (hood, condom, condom) should be used correctly and in every sexual intercourse. The control of blood and blood products, tissue and organ transplants is carried out by health institutions. Apart from this, piercing and cutting tools (injector, needle, etc.) should not be shared. HIV-positive women should be advised not to become pregnant. If she is pregnant, the risks should be explained, if she insists on giving birth to the baby, drug treatment should be started and the risk should be tried to be minimized. 49 49  protect yourself from AIDS Safe Blood donors are needed to obtain safe blood Due to the 6-12 week Window period of the disease, people who act in such a way should not donate blood and apply to the nearest AIDS Hotline, since there is a small amount of blood contamination as a result of risky behavior by the person/persons. 50 50  FOOD ALLERGY They are systemic allergic reactions caused by foods in sensitive individuals. 51  What is food allergy? It occurs when the body thinks one of the components of a food, often a protein, is harmful and creates a defense system (antibody) to fight it. 52  etiology Any substance that is eaten as food can be an allergen. In order for the food to cause an allergic reaction, the atopic nature of the person who takes the food, as well as the frequent eating and cooking-preparation methods, also play a role. eg. Cooking food for a long time reduces its allergic properties. On the other hand, its preparation by frying method causes the emergence of some new allergens. Allergic reactions caused by food occur 12 hours after ingestion of the food. 53 Among the foods that cause food allergies: breast milk, cow's milk, eggs, meats, fish, wheat, corn, rice, rye, barley, some grains such as oats, citrus fruits, bananas, melons, strawberries, some fruits such as apples, peas, beans Some vegetables such as tomatoes, potatoes, spinach, ready-made foods containing artificial food dyes, nuts such as hazelnuts, peanuts, soudjouk, pastrami, salami, sausage can be counted. 54  SYMPTOMS OF A FOOD ALLERGY Allergies affect almost every part of the body: Skin: Itching, burning, redness, fever, chills, tingling, sweating, red spots, pimples. Eye: Blurring, pain, watering, strabismus, discomfort from lights, itching, falling, redness and swelling. Cardiovascular: Palpitations in the heart, increased pulse rate, fever, chills, bruising in the hands, fainting and pain in the vertebrae. Digestive system: Dryness in the mouth, increased salivation, bitterness in the tongue, toothache, heartburn, indigestion, nausea, vomiting, abdominal pain, diarrhea. Nervous system: Headache, migraine, constant sleepiness, drowsiness, slowness, stagnation, malaise, crying spells, tension, hyperactivity, nervousness, concentration disorder, laughing, stuttering, forgetfulness. Respiratory system: Shortness of breath, wheezing, cough, bronchial mucus formation, nasal congestion, sneezing, nasal itching, sore throat, dry cough, ringing in the ears, pain, moderate deafness, dizziness and imbalance. Urogenital system: Frequent and painful urination, inability to control urination, itching. Movement system: Fatigue, muscle weakness, joint and muscle aches, tension, chest and back pain. 55 Diagnosis: History is very important in diagnosis. In addition, an elimination diet is applied to the patient. The peculiarity of this diet is that it is a diet system made by cutting out all nutrients and starting with the least antigenic foods and adding a new nutrient each time. 56 Treatment and Nursing care Elimination: It is the removal of allergenic foods from the diet. Symptomatic drug therapy: It is applied according to the symptoms that occur in the shock organ affected by food allergy. Immunotherapy (vaccine treatment): this method has been abandoned recently. 57 GASTROINTESTINAL ALLERGY The shock organ is the gastrointestinal tract. 58  etiology Foods are the most common cause of Gastrointestinal Allergy. Especially eggs, cow's milk, wheat, fish, tomatoes, nuts and chocolate often cause GIA. Oral or injection drug administration causes GIA, especially in adults. Hormones (esp. Insulin), penicillin, aspirin, barbiturates, iodine compounds, sulfanamides, tetracyclines and vitamins often cause GIA. In addition to all these, infection, hormonal changes, emotional factors, extreme fatigue, sudden weather changes, foods that are too hot or cold, too spicy, raw or too immature, too oily or too pulpy can also cause GIA. 59  Signd and Symptoms The most typical symptoms of GIA are recurrent abdominal pain, insomnia and restlessness. In the mouth and pharynx; dermatitis, edema, aphthae, bad breath and bad taste in the mouth, Difficulty in swallowing, pain in the esophagus, Epigastric pain and feeling of heaviness, Nausea, vomiting, cardiospasm and pyloric spasm, In the intestines; diarrhea, constipation, colic, In the rectal and anal region; dermatitis, pyruritus, bleeding are common signs and symptoms. 60  Diagnosis A family history of allergy and recurrent signs and symptoms are helpful in diagnosis. In addition, the presence of eosinophils in the blood, stool and GI mucus, 61  Treatment and Nursing care Prevention and elimination include drug therapy and hyposensitization. Protection and elimination begins in infancy and even during the mother's pregnancy. During pregnancy, the mother should not eat foods that she knows cause allergies. After birth, the baby should receive breast milk as much as possible. Additional foods should be introduced to the baby one by one and allergy-causing foods should not be given. Barbiturates or antispasmodic drugs can be given against abdominal pains. Antihistamines are not used in TIA because they are not effective. Antihistamines can only be used because of their sedative effects. 62  Urticaria (Hives) Urticaria is a common skin lesion. Urticaria is a common skin lesion. It is not a disease on its own, but a clinical picture that occurs due to many reasons. Urticaria; They are itchy and edematous (swelling) plaques of various shapes, ranging in size from a few millimeters to a few centimeters, surrounded by redness on the skin surface. 63 64  The form with mucosal edema of the lips or internal organs or involving the deep parts of the skin is called ANGIOEDEMA. 65 URTICARIA If the attacks of urticaria include a period of less than 6 weeks, it is called ACUTE URTICARY, and if the lesions persist in attacks for more than 6 weeks, it is called CHRONIC URTICARE. Urticaria can be seen in all age groups, but acute urticaria is generally observed in children and young adults, and chronic urticaria is more common in adults and especially in middle-aged female patients. Urticaria plaques can occur in any part of the body, but angioedema is usually seen on the face, tongue, hands and feet, and genitals. 66 URTICARIA In particular, it should not be overlooked that aspirin, vitamins, and anti-flu drugs, which are frequently used in daily life, can also cause urticaria. Urticaria can also be seen in parasitic diseases. 67  URTICARIA The emotional state of the person affects the course of the disease in urticaria and angioedema. Elimination of the patient's problems or daily stresses increases the success of chronic urticaria treatment. It has been shown that autoimmunity (that is, the reaction of the immune system against its own tissues and cells) plays a role in a significant part of chronic urticaria. 68 ATOPIC DERMATITIS (ECZEMA) 69 70 ATOPIC DERMATITIS (ECZEMA) They are chronic, recurrent, pink-colored, itchy rashes with a rough surface. Active lesions may be widespread throughout the body or limited to one area. They can become infected as a result of excessive scratching. Skin thickening, streaking, peeling and darkening of color may occur during periods when the lesions recur or do not heal continuously. 71  How Is It Treated? 1. Protective Measures: The skin of these patients is extremely dry. Dry skin causes exacerbation of symptoms. Therefore, it is extremely important to constantly moisturize the skin. In addition, these people should not use normal soap. It is recommended to use cream soaps. Since sweating increases the complaints, it is recommended to be careful especially in hot weather. If any allergen (such as cow's milk, egg, house dust mite) causing symptoms is detected in the examinations, precautions should be taken to avoid this allergen. 72  How Is It Treated? 2. Drug Treatment: 1. Anti-itching agents (antihistamines) The most important complaint of these patients is itching. In order to eliminate these complaints, it is necessary to use the recommended drug during periods of exacerbation of the complaints. 2.Local Corticosteroids (ointment, cream) It is applied as a thin layer on the lesion during active periods of skin lesions, taking into account the duration of use. 73 A new type of allergy, which has become increasingly common in recent years and has begun to be seen in more people, is latex allergy. 74 latex allergy In order for latex allergy to occur, the person who is prone to allergy must be in contact with latex for a certain period of time (average 3-5 years). During these contacts, antibodies of the IgE class are formed against latex. After the amount of these antibodies reaches a certain level, allergic symptoms develop when contact with a latex- containing substance (inflating balloons, wearing gloves…). 75  latex allergy It is an allergy that gives symptoms in the form of redness, itching, watering and crusting on the skin surface that products containing latex come into contact with. Such allergies are not caused by latex proteins, but by substances such as mercaptobenzothiazole, thiuram and carbamate, which are used during the processing of natural latex (for example, the production of rubber gloves). Since the integrity of the skin is impaired due to contact eczema, real latex allergy may occur in these patients over time as latex proteins are absorbed through the skin cracks. 76 latex allergy Latex allergy symptoms Until recently, it was thought that latex only caused irritations such as redness, swelling and itching where it came into contact with the skin. However, today we know that latex can cause many allergic diseases, from allergic rhinitis to asthma. The most dangerous of these is anaphylactic shock, which can lead to death. 77  WHO IS AT RISK? People with atopic (allergic) structure People who have had repetitive surgery (such as congenital urinary tract anomaly, shunt surgeries) Those who use urinary catheters due to urinary incontinence (cerebral palsy, paralyzed patients) People working in latex production Doctors, dentists, nurses and caregivers 78  latex allergy Attention; Those who are allergic to latex should avoid contact with this substance. - Those with anaphylactic type allergy to latex should carry a necklace or tag indicating this, and should have automatic adrenaline injectors with them. Those who are allergic to latex should use products that do not contain latex while being examined or operated. 79 Immune Deficiency Diseases congenital post-secondary; immunosuppressive therapy, hodgkin lymphoma, HIV, malnutrition 80 AUTOIMMUNE DISEASES Immune mechanisms; recognizes the body differently from bacteria, viruses. This phenomenon is defined as tolerance to the body's own tissues. Tolerance: It is thought to develop during the preprocessing of T lymphocytes in the thymus and B lymphocytes in the CI. Sometimes immune tolerance is reduced. The incidence is higher with increasing age. 81 autoimmune diseases Rheumatic fever: joint immune response against heart valve tissue Glomerulonephritis: develops an immune response against the basement membrane of the glomeruli Myasthenia gravis: against acetylcholine receptors Lupus erythematosus: It creates a response to many body tissues at the same time. 82 THANK YOU! 83