***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The clinical implication s of sensitization to the fragrance material isoeugenol were studied in 19 subjects .  Patch testing with serial dilutions of isoeugenol and a repeated open application test ( ROAT ) were performed The minimum effect level under patch test conditions was below 0.01 % isoeugenol in 4/19 ( 20 % ) of the test subjects . The ROAT was performed with a test solution of 0.2 % isoeugenol in ethanol . which is the recommended maximum concentration used in perfumes , ethanol being applied as vehicle control . 4 weeks was the maximum exposure period . The upper arm was used as test site the 1st 14 days and the upper arm as well as the neck for the next 14 days , 12/19 ( 63 % ) of test subjects had a positive ROAT . 4 of the responders ( 33 % ) reacted beyond day 7 , but none alter day 14 . Use testing on the neck for 14 days did not add any further ROAT‐positive cases , compared with testing on the upper arm . The sensitivity found on patch testing may be a guidance for the outcome of use tests with the same compound . In this study , all subjects with a positive use test to isoeugenol ( 0.2 % ) in ethanol also demonstrated on patch testing a minimum effect level of 0.2 % or lower . Data from serial dilution patch and use IC‐N may contribute significant information to assessment of the relationship between patch test responses and clinical contact hypersensitivity , and thus the safety of allergens used in cosmetics OBJECTIVES To assess the effect of incentive size on response rates , data quality , and cost in a digestive health status mail survey of a community sample of health plan enrollees . DATA SOURCES / SETTING The study population was selected from a data base of enrollees in various health plans obligated to receive care at Park Nicollet Clinic-HealthSystem Minnesota , a large , multispecialty group in Minneapolis , Minnesota , and the nearby suburbs . STUDY DESIGN A total of 1,800 HealthSystem Minnesota enrollees were r and omly assigned to receive a survey with an incentive of $ 5 or $ 2 . The response rates for each incentive level were determined . Data quality , as indicated by item nonresponse and scale scores , was measured . Total cost and cost per completed survey were calculated . PRINCIPAL FINDINGS The response rate among enrollees receiving $ 5 ( 74.3 percent ) was significantly higher than among those receiving $ 2 ( 67.4 percent ) ; differences were more pronounced in the first wave of data collection . Data quality did not differ between the two incentive groups . The total cost per completed survey was higher in the $ 5 condition than in the $ 2 condition . CONCLUSIONS A $ 5 incentive result ed in a higher response rate among a community patient sample with one mailing than did a $ 2 incentive . However , the response rates in the $ 2 condition approached the level of the $ 5 incentive , and costs were significantly lower when the full follow-up protocol was completed . Response rates were marginally increased by follow-up phone calls . The incentive level did not influence data quality . The results suggest if a survey budget is limited and a timeline is not critical , a $ 2 incentive provides an affordable means of increasing participation The pattern of patch test reactivity to nickel sulfate and fragrance mix was studied with respect to patch test performance , reproducibility and clinical relevance in a population of unselected infants followed prospect ively from birth to 18 months of age . TRUE Test ™ patches with nickel sulfate in 3 concentrations , 200 , 66 and 22 µg/cm2 , and fragrance mix 430 µg/cm2 were used . A likely case of nickel sensitivity was defined as a reproducible positive reaction with at least homogeneous erythema and palpable infiltration occurring at least 2 × and present at both the 12 and 18 months follow‐up . 543 infants ( 268 girls and 275 boys ) were tested at least 1 × , 304 were tested at both 12 and 18 months . The prevalence of a reproducible positive reaction to nickel was 8.6 % ( 20 girls and 6 boys ) . A transient positive reaction was observed in 111 children . Clinical relevance of nickel sensitivity was found in only 1 child . No reproducible positive reaction to fragrance mix was found . The high proportion of transient patch test reactivity to nickel sulfate 200 µg/cm2 indicates that this st and ard concentration used for adults can not be applied to infants . The interpretation of a single positive nickel patch test in infants must be assessed with caution and it is probably of non‐specific or irritant nature BACKGROUND There is a big contradiction in the medical literature regarding the relationship between atopy and contact hypersensitivity . Some research ers believe that atopy would prevent , whereas others believe that it would promote , the development of contact allergy . Possible causes of this confusion range from different study population s to different definitions of atopy . OBJECTIVE To evaluate the relationship between atopy and contact hypersensitivity in a well-defined general population sample using objective ly measurable markers . METHODS I studied 135 r and omly selected students from 5 vocational schools : 73 women and 62 men aged 18 to 19 years . The following atopy markers were tested : positive skin prick test results , positive Phadiatop test results , and total IgE levels greater than 120 kU/L. Contact hypersensitivity was detected by using patch tests . Statistical analyses included the Fisher exact test , the Mann-Whitney U test , and calculation of odds ratios . RESULTS At least 1 positive skin prick test result was found in 23.7 % ( 95 % confidence interval [ CI ] , 16.5%-30.9 % ) of study participants , positive Phadiatop test results were found in 20.0 % ( 95 % CI , 13.3%-26.7 % ) , and total IgE levels greater than 120 kU/L were found in 23.7 % ( 95 % CI , 16.5%-30.9 % ) . Positive patch test reactions were found in 28.1 % ( 95 % CI , 20.6%-35.7 % ) of participants , most frequently to thimerosal ( 18.5 % ; 95 % CI , 12.0%-25.1 % ) and nickel ( 9.6 % ; 95 % CI , 4.6%-14.6 % ) . For persons with atopy markers , odds ratios for contact hypersensitivity ranged from 1.0 to 3.2 , the highest being for nickel hypersensitivity among those with total IgE levels greater than 120 kU/L. None of these relationships were statistically significant . CONCLUSION Atopy and contact hypersensitivity are independent phenomena Few studies have so far addressed the prevalence and risk factors for contact sensitization in the general adult population ; however , many such studies have been conducted in hospitals . We present the prevalence of contact sensitization in a general adult population and its relationship to potential risk factors like smoking , ear piercing and atopic diseases . 1236 adults ( 44.2 % men and 55.8 % women ) were r and omly selected from a cross‐section of the population in Sør‐Varanger municipality , Norway , and patch tested with TRUE Test ( Pharmacia , Hillerød , Denmark ) . Contact sensitivity to at least 1 out of 24 allergens was found in 35.4 % of the women and in 14.8 % of the men . The most common allergens were nickel ( 17.6 % ) , cobalt ( 2.8 % ) , thiomersal ( 1.9 % ) , fragrance mix ( 1.8 % ) and colophony ( 1.2 % ) . All other allergens were observed in 1.0 % or less . In women , ear piercing was an important risk factor for nickel sensitization . No such significant correlation was seen in men [ in women relative risk ( RR ) = 3.30 , 95 % confidence interval ( CI ) = 2.01–5.43 , and in men RR = 1.82 , 95 % CI = 0.66–5.00 ] , and contact sensitivity was associated with atopic dermatitis ( AD ) [ adjusted odds ratio ( OR ) = 1.58 , 95 % CI = 1.04–2.40 ] and smoking ( adjusted OR = 1.42 , 95 % CI = 1.01–1.99 ) in women but not in men . The prevalence of contact sensitivity was common in this general population , especially in women . Smoking and AD might be a risk factor for contact sensitization This is a report on a comparative study of the reactivity of TRUE test and Finn Chamber patch test techniques .  413 patients attending a contact dermatitis clinic in Singapore were simultaneously patch tested with panels 1 and 2 of the TRUE test st and ard series and with corresponding allergens ( Hermal . Hamburg ) using Finn Chambers . The left/right application of the TRUE test and Finn Chambers was r and omized . The concordance of positive patch test reactions to the 2 test techniques was studied The number of patient with positive ructions was 38 % and 42 % for TRUE Test and Finn Chamber techniques , respectively ( n.s . ) . The overall concordance of positive patch test reactions was 64 % , ( 209/328 ) 13 % ( 42/128 ) of positive reactions appeared on TRUE Test only and 24 % ( 77 % 328 ) on Finn Chamber only . When only relevant positive reactions were considered , the concordance fate was 67 % ; 11 6 % Of positive reactions appeared on TRUE Test only and 21 % on Finn Chamber only . Positive reactions to p‐phenylenediamine ( PPD ) and neomycin were more frequent with the Finn Chamber technique than with TRUE Test , i e. , false negative reactions to PPD and neomyein were more likely to occur with TRUE Test . It appeared that the TRUE Test and Finn Chamber techniques were comparable when used for patch testing However false negative and false positive patch test reactions can occur when using either technique In 1990 and 1998 15 - 41-year-old people were patch-tested  in 2 cross-sectional studies of r and om sample s of the population in the western part of Copenhagen County , Denmark . In 1990 , 290 subjects and in 1998 , 469 subjects were patch-tested . The participation rates were 69 % and 51 % , respectively . Contact sensitivity to one or more haptens was found in 15.9 % and 18.6 % in 1990 and 1998 , respectively . Nickel sensitivity is still the most common contact sensitivity . The risk of contact sensitivity to the cosmetic-related haptens included in the series ( formaldehyde was not included ) increased significantly from 2.4 % in 1990 to 5.8 % in 1998 ( odds ratio 2.44 , 95 % confidence interval 1.04 - 5.73 ) . The prevalence of contact sensitivity to cosmetic-related allergens has been doubled between 1990 and 1998 The aim of the present study was to investigate the relationship between patients ' own recognition of skin problems using consumer products and the results of patch testing with markers of fragrance sensitization . Eight hundred and eighty-four consecutive eczema patients , 18 - 69 years of age , filled in a question naire prior to patch testing with the European st and ard series . The question naire contained questions about skin symptoms from the use of scented and unscented products as well as skin reactions from contact with spices , flowers and citrus fruits that could indicate fragrance sensitivity . A highly significant association was found between reporting a history of visible skin symptoms from using scented products and a positive patch test to the fragrance mix , whereas no such relationship could be established to the Peru balsam in univariate or multivariate analysis . Our results suggest that the role of Peru balsam in detecting relevant fragrance contact allergy is limited , while most fragrance mix-positive patients are aware that the use of scented products may cause skin problems BACKGROUND Fragrances are the first or second most common cause of contact allergy in dermatitis patients . OBJECTIVE The aim of this study was to identify risk products for fragrance contact allergy . METHODS The design was a case-control study with a case group of 78 fragrance-mix-positive eczema patients and two control groups , one consisting of 1,279 subjects selected as a r and om sample of the general population and the other consisting of 806 fragrance-mix-negative eczema patients . The identification of risk products was based on the patients ' histories of rash to scented products . Analysis of the associations between first-time rash caused by different specified product categories and fragrance mix sensitivity was performed using logistic regression . RESULTS It was found that first-time rash caused by deodorant sprays and /or perfumes were related to fragrance contact allergy in a comparison with both control groups . The risk ( odds ratio ) of being diagnosed as fragrance allergic was 2.3 to 2.9 greater in cases of a history of first-time rash to deodorant sprays and 3.3 to 3.4 greater in cases of a history of rash to perfumes than if no such history were present . First-time rash to cleansing agents , deodorant sticks , or h and lotions was also statistically significant but only in comparison with one of the control groups . CONCLUSION Safety evaluation of fragrance material s used in perfumes and deodorant sprays should be performed with special attention 
    Output:
    
Based on the reliability of patch test data from the general population and exposure data obtained from patients with dermatitis , the prevalence and burden of fragrance sensitization in the general population is significant