Deprecated: Assigning the return value of new by reference is deprecated in /www/htdocs/w00a10d9/html/includes/classes/adodb/adodb.inc.php on line 893

Deprecated: Assigning the return value of new by reference is deprecated in /www/htdocs/w00a10d9/html/includes/classes/adodb/adodb.inc.php on line 1918

Deprecated: Assigning the return value of new by reference is deprecated in /www/htdocs/w00a10d9/html/includes/classes/adodb/adodb.inc.php on line 1990

Deprecated: mysql_connect(): The mysql extension is deprecated and will be removed in the future: use mysqli or PDO instead in /www/htdocs/w00a10d9/html/includes/classes/adodb/drivers/adodb-mysql.inc.php on line 360

Deprecated: Function split() is deprecated in /www/htdocs/w00a10d9/html/includes/pnLang.php on line 62

Strict Standards: Declaration of pnRender::clear_cache() should be compatible with Smarty::clear_cache($tpl_file = NULL, $cache_id = NULL, $compile_id = NULL, $exp_time = NULL) in /www/htdocs/w00a10d9/html/includes/pnRender.class.php on line 45

Strict Standards: Declaration of pnRender::is_cached() should be compatible with Smarty::is_cached($tpl_file, $cache_id = NULL, $compile_id = NULL) in /www/htdocs/w00a10d9/html/includes/pnRender.class.php on line 45

Strict Standards: Declaration of pnRender::fetch() should be compatible with Smarty::fetch($resource_name, $cache_id = NULL, $compile_id = NULL, $display = false) in /www/htdocs/w00a10d9/html/includes/pnRender.class.php on line 45

Deprecated: Function eregi() is deprecated in /www/htdocs/w00a10d9/html/includes/pnAntiCracker.php on line 41

Deprecated: Function eregi() is deprecated in /www/htdocs/w00a10d9/html/includes/pnAntiCracker.php on line 42

Deprecated: Function eregi() is deprecated in /www/htdocs/w00a10d9/html/includes/pnAntiCracker.php on line 43

Deprecated: Function eregi() is deprecated in /www/htdocs/w00a10d9/html/includes/pnAntiCracker.php on line 44

Deprecated: Function eregi() is deprecated in /www/htdocs/w00a10d9/html/includes/pnAntiCracker.php on line 45

Deprecated: Function eregi() is deprecated in /www/htdocs/w00a10d9/html/includes/pnAntiCracker.php on line 46

Deprecated: Function eregi() is deprecated in /www/htdocs/w00a10d9/html/includes/pnAntiCracker.php on line 47

Deprecated: Function eregi() is deprecated in /www/htdocs/w00a10d9/html/includes/pnAntiCracker.php on line 48

Deprecated: Function eregi() is deprecated in /www/htdocs/w00a10d9/html/includes/pnAntiCracker.php on line 49

Deprecated: Function eregi() is deprecated in /www/htdocs/w00a10d9/html/includes/pnAntiCracker.php on line 50

Deprecated: Function eregi() is deprecated in /www/htdocs/w00a10d9/html/includes/pnAntiCracker.php on line 51

Deprecated: Function eregi() is deprecated in /www/htdocs/w00a10d9/html/includes/pnAntiCracker.php on line 52

Deprecated: Function eregi() is deprecated in /www/htdocs/w00a10d9/html/includes/pnAntiCracker.php on line 53

Deprecated: Function eregi() is deprecated in /www/htdocs/w00a10d9/html/includes/pnAntiCracker.php on line 54

Deprecated: Function eregi() is deprecated in /www/htdocs/w00a10d9/html/includes/pnAntiCracker.php on line 41

Deprecated: Function eregi() is deprecated in /www/htdocs/w00a10d9/html/includes/pnAntiCracker.php on line 42

Deprecated: Function eregi() is deprecated in /www/htdocs/w00a10d9/html/includes/pnAntiCracker.php on line 43

Deprecated: Function eregi() is deprecated in /www/htdocs/w00a10d9/html/includes/pnAntiCracker.php on line 44

Deprecated: Function eregi() is deprecated in /www/htdocs/w00a10d9/html/includes/pnAntiCracker.php on line 45

Deprecated: Function eregi() is deprecated in /www/htdocs/w00a10d9/html/includes/pnAntiCracker.php on line 46

Deprecated: Function eregi() is deprecated in /www/htdocs/w00a10d9/html/includes/pnAntiCracker.php on line 47

Deprecated: Function eregi() is deprecated in /www/htdocs/w00a10d9/html/includes/pnAntiCracker.php on line 48

Deprecated: Function eregi() is deprecated in /www/htdocs/w00a10d9/html/includes/pnAntiCracker.php on line 49

Deprecated: Function eregi() is deprecated in /www/htdocs/w00a10d9/html/includes/pnAntiCracker.php on line 50

Deprecated: Function eregi() is deprecated in /www/htdocs/w00a10d9/html/includes/pnAntiCracker.php on line 51

Deprecated: Function eregi() is deprecated in /www/htdocs/w00a10d9/html/includes/pnAntiCracker.php on line 52

Deprecated: Function eregi() is deprecated in /www/htdocs/w00a10d9/html/includes/pnAntiCracker.php on line 53

Deprecated: Function eregi() is deprecated in /www/htdocs/w00a10d9/html/includes/pnAntiCracker.php on line 54

Deprecated: Function eregi() is deprecated in /www/htdocs/w00a10d9/html/includes/pnAntiCracker.php on line 41

Deprecated: Function eregi() is deprecated in /www/htdocs/w00a10d9/html/includes/pnAntiCracker.php on line 42

Deprecated: Function eregi() is deprecated in /www/htdocs/w00a10d9/html/includes/pnAntiCracker.php on line 43

Deprecated: Function eregi() is deprecated in /www/htdocs/w00a10d9/html/includes/pnAntiCracker.php on line 44

Deprecated: Function eregi() is deprecated in /www/htdocs/w00a10d9/html/includes/pnAntiCracker.php on line 45

Deprecated: Function eregi() is deprecated in /www/htdocs/w00a10d9/html/includes/pnAntiCracker.php on line 46

Deprecated: Function eregi() is deprecated in /www/htdocs/w00a10d9/html/includes/pnAntiCracker.php on line 47

Deprecated: Function eregi() is deprecated in /www/htdocs/w00a10d9/html/includes/pnAntiCracker.php on line 48

Deprecated: Function eregi() is deprecated in /www/htdocs/w00a10d9/html/includes/pnAntiCracker.php on line 49

Deprecated: Function eregi() is deprecated in /www/htdocs/w00a10d9/html/includes/pnAntiCracker.php on line 50

Deprecated: Function eregi() is deprecated in /www/htdocs/w00a10d9/html/includes/pnAntiCracker.php on line 51

Deprecated: Function eregi() is deprecated in /www/htdocs/w00a10d9/html/includes/pnAntiCracker.php on line 52

Deprecated: Function eregi() is deprecated in /www/htdocs/w00a10d9/html/includes/pnAntiCracker.php on line 53

Deprecated: Function eregi() is deprecated in /www/htdocs/w00a10d9/html/includes/pnAntiCracker.php on line 54

Deprecated: Function eregi() is deprecated in /www/htdocs/w00a10d9/html/includes/pnAntiCracker.php on line 41

Deprecated: Function eregi() is deprecated in /www/htdocs/w00a10d9/html/includes/pnAntiCracker.php on line 42

Deprecated: Function eregi() is deprecated in /www/htdocs/w00a10d9/html/includes/pnAntiCracker.php on line 43

Deprecated: Function eregi() is deprecated in /www/htdocs/w00a10d9/html/includes/pnAntiCracker.php on line 44

Deprecated: Function eregi() is deprecated in /www/htdocs/w00a10d9/html/includes/pnAntiCracker.php on line 45

Deprecated: Function eregi() is deprecated in /www/htdocs/w00a10d9/html/includes/pnAntiCracker.php on line 46

Deprecated: Function eregi() is deprecated in /www/htdocs/w00a10d9/html/includes/pnAntiCracker.php on line 47

Deprecated: Function eregi() is deprecated in /www/htdocs/w00a10d9/html/includes/pnAntiCracker.php on line 48

Deprecated: Function eregi() is deprecated in /www/htdocs/w00a10d9/html/includes/pnAntiCracker.php on line 49

Deprecated: Function eregi() is deprecated in /www/htdocs/w00a10d9/html/includes/pnAntiCracker.php on line 50

Deprecated: Function eregi() is deprecated in /www/htdocs/w00a10d9/html/includes/pnAntiCracker.php on line 51

Deprecated: Function eregi() is deprecated in /www/htdocs/w00a10d9/html/includes/pnAntiCracker.php on line 52

Deprecated: Function eregi() is deprecated in /www/htdocs/w00a10d9/html/includes/pnAntiCracker.php on line 53

Deprecated: Function eregi() is deprecated in /www/htdocs/w00a10d9/html/includes/pnAntiCracker.php on line 54

Deprecated: Function eregi() is deprecated in /www/htdocs/w00a10d9/html/includes/pnAntiCracker.php on line 41

Deprecated: Function eregi() is deprecated in /www/htdocs/w00a10d9/html/includes/pnAntiCracker.php on line 42

Deprecated: Function eregi() is deprecated in /www/htdocs/w00a10d9/html/includes/pnAntiCracker.php on line 43

Deprecated: Function eregi() is deprecated in /www/htdocs/w00a10d9/html/includes/pnAntiCracker.php on line 44

Deprecated: Function eregi() is deprecated in /www/htdocs/w00a10d9/html/includes/pnAntiCracker.php on line 45

Deprecated: Function eregi() is deprecated in /www/htdocs/w00a10d9/html/includes/pnAntiCracker.php on line 46

Deprecated: Function eregi() is deprecated in /www/htdocs/w00a10d9/html/includes/pnAntiCracker.php on line 47

Deprecated: Function eregi() is deprecated in /www/htdocs/w00a10d9/html/includes/pnAntiCracker.php on line 48

Deprecated: Function eregi() is deprecated in /www/htdocs/w00a10d9/html/includes/pnAntiCracker.php on line 49

Deprecated: Function eregi() is deprecated in /www/htdocs/w00a10d9/html/includes/pnAntiCracker.php on line 50

Deprecated: Function eregi() is deprecated in /www/htdocs/w00a10d9/html/includes/pnAntiCracker.php on line 51

Deprecated: Function eregi() is deprecated in /www/htdocs/w00a10d9/html/includes/pnAntiCracker.php on line 52

Deprecated: Function eregi() is deprecated in /www/htdocs/w00a10d9/html/includes/pnAntiCracker.php on line 53

Deprecated: Function eregi() is deprecated in /www/htdocs/w00a10d9/html/includes/pnAntiCracker.php on line 54

Deprecated: Assigning the return value of new by reference is deprecated in /www/htdocs/w00a10d9/html/includes/classes/safehtml/safehtml.php on line 607

Deprecated: Assigning the return value of new by reference is deprecated in /www/htdocs/w00a10d9/html/includes/classes/safehtml/HTMLSax3.php on line 161

Deprecated: Assigning the return value of new by reference is deprecated in /www/htdocs/w00a10d9/html/includes/classes/safehtml/HTMLSax3.php on line 163

Deprecated: Assigning the return value of new by reference is deprecated in /www/htdocs/w00a10d9/html/includes/classes/safehtml/HTMLSax3.php on line 164

Deprecated: Assigning the return value of new by reference is deprecated in /www/htdocs/w00a10d9/html/includes/classes/safehtml/HTMLSax3.php on line 165

Deprecated: Assigning the return value of new by reference is deprecated in /www/htdocs/w00a10d9/html/includes/classes/safehtml/HTMLSax3.php on line 167

Deprecated: Assigning the return value of new by reference is deprecated in /www/htdocs/w00a10d9/html/includes/classes/safehtml/HTMLSax3.php on line 168

Deprecated: Assigning the return value of new by reference is deprecated in /www/htdocs/w00a10d9/html/includes/classes/safehtml/HTMLSax3.php on line 169

Deprecated: Assigning the return value of new by reference is deprecated in /www/htdocs/w00a10d9/html/includes/classes/safehtml/HTMLSax3.php on line 244

Deprecated: Assigning the return value of new by reference is deprecated in /www/htdocs/w00a10d9/html/includes/classes/safehtml/HTMLSax3.php on line 251

Deprecated: Assigning the return value of new by reference is deprecated in /www/htdocs/w00a10d9/html/includes/classes/safehtml/HTMLSax3.php on line 260

Deprecated: Assigning the return value of new by reference is deprecated in /www/htdocs/w00a10d9/html/includes/classes/safehtml/HTMLSax3.php on line 267

Deprecated: Assigning the return value of new by reference is deprecated in /www/htdocs/w00a10d9/html/includes/classes/safehtml/HTMLSax3.php on line 274

Deprecated: Assigning the return value of new by reference is deprecated in /www/htdocs/w00a10d9/html/includes/classes/safehtml/HTMLSax3.php on line 281

Deprecated: Assigning the return value of new by reference is deprecated in /www/htdocs/w00a10d9/html/includes/classes/safehtml/HTMLSax3.php on line 289

Deprecated: Assigning the return value of new by reference is deprecated in /www/htdocs/w00a10d9/html/includes/classes/safehtml/HTMLSax3.php on line 486

Deprecated: Assigning the return value of new by reference is deprecated in /www/htdocs/w00a10d9/html/includes/classes/safehtml/HTMLSax3.php on line 488

Deprecated: Assigning the return value of new by reference is deprecated in /www/htdocs/w00a10d9/html/includes/classes/safehtml/HTMLSax3.php on line 490

Deprecated: Function ereg() is deprecated in /www/htdocs/w00a10d9/html/includes/legacy/counter.php on line 51

Deprecated: Function ereg() is deprecated in /www/htdocs/w00a10d9/html/includes/legacy/counter.php on line 51

Deprecated: Function ereg() is deprecated in /www/htdocs/w00a10d9/html/includes/legacy/counter.php on line 51

Deprecated: Function ereg() is deprecated in /www/htdocs/w00a10d9/html/includes/legacy/counter.php on line 51

Deprecated: Function ereg() is deprecated in /www/htdocs/w00a10d9/html/includes/legacy/counter.php on line 51

Deprecated: Function ereg() is deprecated in /www/htdocs/w00a10d9/html/includes/legacy/counter.php on line 53

Deprecated: Function ereg() is deprecated in /www/htdocs/w00a10d9/html/includes/legacy/counter.php on line 54

Deprecated: Function ereg() is deprecated in /www/htdocs/w00a10d9/html/includes/legacy/counter.php on line 55

Deprecated: Function ereg() is deprecated in /www/htdocs/w00a10d9/html/includes/legacy/counter.php on line 56

Deprecated: Function ereg() is deprecated in /www/htdocs/w00a10d9/html/includes/legacy/counter.php on line 57

Deprecated: Function eregi() is deprecated in /www/htdocs/w00a10d9/html/includes/legacy/counter.php on line 58

Deprecated: Function ereg() is deprecated in /www/htdocs/w00a10d9/html/includes/legacy/counter.php on line 63

Deprecated: Function ereg() is deprecated in /www/htdocs/w00a10d9/html/includes/legacy/counter.php on line 64

Deprecated: Function ereg() is deprecated in /www/htdocs/w00a10d9/html/includes/legacy/counter.php on line 64

Deprecated: Function ereg() is deprecated in /www/htdocs/w00a10d9/html/includes/legacy/counter.php on line 65

Deprecated: Function ereg() is deprecated in /www/htdocs/w00a10d9/html/includes/legacy/counter.php on line 66

Deprecated: Function ereg() is deprecated in /www/htdocs/w00a10d9/html/includes/legacy/counter.php on line 67

Deprecated: Function ereg() is deprecated in /www/htdocs/w00a10d9/html/includes/legacy/counter.php on line 68

Deprecated: Function ereg() is deprecated in /www/htdocs/w00a10d9/html/includes/legacy/counter.php on line 69

Deprecated: Function ereg() is deprecated in /www/htdocs/w00a10d9/html/includes/legacy/counter.php on line 70

Deprecated: Function ereg() is deprecated in /www/htdocs/w00a10d9/html/includes/legacy/counter.php on line 71

Deprecated: Assigning the return value of new by reference is deprecated in /www/htdocs/w00a10d9/html/modules/Xanthia/pnuserapi.php on line 70

Deprecated: Assigning the return value of new by reference is deprecated in /www/htdocs/w00a10d9/html/modules/Xanthia/pnuserapi.php on line 119

Strict Standards: Declaration of pnCEHTML::URL() should be compatible with pnHTML::URL($url = '', $text = '') in /www/htdocs/w00a10d9/html/modules/ContentExpress/pneditor/pnCEHTML.php on line 238

Deprecated: Function ereg() is deprecated in /www/htdocs/w00a10d9/html/modules/ContentExpress/pneditor/pnCEHTML.php on line 16

Deprecated: Function ereg() is deprecated in /www/htdocs/w00a10d9/html/modules/ContentExpress/pneditor/pnCEHTML.php on line 18

Deprecated: Function ereg() is deprecated in /www/htdocs/w00a10d9/html/modules/ContentExpress/pneditor/pnCEHTML.php on line 20

Deprecated: Function eregi() is deprecated in /www/htdocs/w00a10d9/html/modules/ContentExpress/pneditor/pnCEHTML.php on line 22

Deprecated: Function ereg() is deprecated in /www/htdocs/w00a10d9/html/modules/ContentExpress/pneditor/pnCEHTML.php on line 45

Deprecated: Function ereg() is deprecated in /www/htdocs/w00a10d9/html/modules/ContentExpress/pneditor/pnCEHTML.php on line 47

Deprecated: Function ereg() is deprecated in /www/htdocs/w00a10d9/html/modules/ContentExpress/pneditor/pnCEHTML.php on line 48

Deprecated: Function ereg() is deprecated in /www/htdocs/w00a10d9/html/modules/ContentExpress/pneditor/pnCEHTML.php on line 50

Deprecated: Function ereg() is deprecated in /www/htdocs/w00a10d9/html/modules/ContentExpress/pneditor/pnCEHTML.php on line 52

Deprecated: Function ereg() is deprecated in /www/htdocs/w00a10d9/html/modules/ContentExpress/pneditor/pnCEHTML.php on line 54

Deprecated: Function ereg() is deprecated in /www/htdocs/w00a10d9/html/modules/ContentExpress/pneditor/pnCEHTML.php on line 56

Deprecated: Function ereg() is deprecated in /www/htdocs/w00a10d9/html/modules/ContentExpress/pneditor/pnCEHTML.php on line 58

Deprecated: Function ereg() is deprecated in /www/htdocs/w00a10d9/html/modules/ContentExpress/pneditor/pnCEHTML.php on line 60

Deprecated: Function ereg() is deprecated in /www/htdocs/w00a10d9/html/modules/ContentExpress/pneditor/pnCEHTML.php on line 62

Deprecated: Function ereg() is deprecated in /www/htdocs/w00a10d9/html/modules/ContentExpress/pneditor/pnCEHTML.php on line 16

Deprecated: Function ereg() is deprecated in /www/htdocs/w00a10d9/html/modules/ContentExpress/pneditor/pnCEHTML.php on line 18

Deprecated: Function ereg() is deprecated in /www/htdocs/w00a10d9/html/modules/ContentExpress/pneditor/pnCEHTML.php on line 20

Deprecated: Function eregi() is deprecated in /www/htdocs/w00a10d9/html/modules/ContentExpress/pneditor/pnCEHTML.php on line 22

Deprecated: Function ereg() is deprecated in /www/htdocs/w00a10d9/html/modules/ContentExpress/pneditor/pnCEHTML.php on line 45

Deprecated: Function ereg() is deprecated in /www/htdocs/w00a10d9/html/modules/ContentExpress/pneditor/pnCEHTML.php on line 47

Deprecated: Function ereg() is deprecated in /www/htdocs/w00a10d9/html/modules/ContentExpress/pneditor/pnCEHTML.php on line 48

Deprecated: Function ereg() is deprecated in /www/htdocs/w00a10d9/html/modules/ContentExpress/pneditor/pnCEHTML.php on line 50

Deprecated: Function ereg() is deprecated in /www/htdocs/w00a10d9/html/modules/ContentExpress/pneditor/pnCEHTML.php on line 52

Deprecated: Function ereg() is deprecated in /www/htdocs/w00a10d9/html/modules/ContentExpress/pneditor/pnCEHTML.php on line 54

Deprecated: Function ereg() is deprecated in /www/htdocs/w00a10d9/html/modules/ContentExpress/pneditor/pnCEHTML.php on line 56

Deprecated: Function ereg() is deprecated in /www/htdocs/w00a10d9/html/modules/ContentExpress/pneditor/pnCEHTML.php on line 58

Deprecated: Function ereg() is deprecated in /www/htdocs/w00a10d9/html/modules/ContentExpress/pneditor/pnCEHTML.php on line 60

Deprecated: Function ereg() is deprecated in /www/htdocs/w00a10d9/html/modules/ContentExpress/pneditor/pnCEHTML.php on line 62

Deprecated: preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /www/htdocs/w00a10d9/html/includes/pnAPI.php on line 589

Deprecated: Function eregi() is deprecated in /www/htdocs/w00a10d9/html/header.php on line 30
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Strict Standards: Non-static method ADOConnection::UnixTimeStamp() should not be called statically, assuming $this from incompatible context in /www/htdocs/w00a10d9/html/includes/classes/adodb/adodb.inc.php on line 3007

Strict Standards: Non-static method ADOConnection::UnixTimeStamp() should not be called statically, assuming $this from incompatible context in /www/htdocs/w00a10d9/html/includes/classes/adodb/adodb.inc.php on line 3007

Strict Standards: Non-static method ADOConnection::UnixTimeStamp() should not be called statically, assuming $this from incompatible context in /www/htdocs/w00a10d9/html/includes/classes/adodb/adodb.inc.php on line 3007

Strict Standards: Non-static method ADOConnection::UnixTimeStamp() should not be called statically, assuming $this from incompatible context in /www/htdocs/w00a10d9/html/includes/classes/adodb/adodb.inc.php on line 3007

Strict Standards: Non-static method ADOConnection::UnixTimeStamp() should not be called statically, assuming $this from incompatible context in /www/htdocs/w00a10d9/html/includes/classes/adodb/adodb.inc.php on line 3007

Strict Standards: Non-static method ADOConnection::UnixTimeStamp() should not be called statically, assuming $this from incompatible context in /www/htdocs/w00a10d9/html/includes/classes/adodb/adodb.inc.php on line 3007

Strict Standards: Non-static method ADOConnection::UnixTimeStamp() should not be called statically, assuming $this from incompatible context in /www/htdocs/w00a10d9/html/includes/classes/adodb/adodb.inc.php on line 3007

Deprecated: Function ereg() is deprecated in /www/htdocs/w00a10d9/html/modules/ContentExpress/pneditor/pnCEHTML.php on line 16

Deprecated: Function ereg() is deprecated in /www/htdocs/w00a10d9/html/modules/ContentExpress/pneditor/pnCEHTML.php on line 18

Deprecated: Function ereg() is deprecated in /www/htdocs/w00a10d9/html/modules/ContentExpress/pneditor/pnCEHTML.php on line 20

Deprecated: Function eregi() is deprecated in /www/htdocs/w00a10d9/html/modules/ContentExpress/pneditor/pnCEHTML.php on line 22

Deprecated: Function ereg() is deprecated in /www/htdocs/w00a10d9/html/modules/ContentExpress/pneditor/pnCEHTML.php on line 45

Deprecated: Function ereg() is deprecated in /www/htdocs/w00a10d9/html/modules/ContentExpress/pneditor/pnCEHTML.php on line 47

Deprecated: Function ereg() is deprecated in /www/htdocs/w00a10d9/html/modules/ContentExpress/pneditor/pnCEHTML.php on line 48

Deprecated: Function ereg() is deprecated in /www/htdocs/w00a10d9/html/modules/ContentExpress/pneditor/pnCEHTML.php on line 50

Deprecated: Function ereg() is deprecated in /www/htdocs/w00a10d9/html/modules/ContentExpress/pneditor/pnCEHTML.php on line 52

Deprecated: Function ereg() is deprecated in /www/htdocs/w00a10d9/html/modules/ContentExpress/pneditor/pnCEHTML.php on line 54

Deprecated: Function ereg() is deprecated in /www/htdocs/w00a10d9/html/modules/ContentExpress/pneditor/pnCEHTML.php on line 56

Deprecated: Function ereg() is deprecated in /www/htdocs/w00a10d9/html/modules/ContentExpress/pneditor/pnCEHTML.php on line 58

Deprecated: Function ereg() is deprecated in /www/htdocs/w00a10d9/html/modules/ContentExpress/pneditor/pnCEHTML.php on line 60

Deprecated: Function ereg() is deprecated in /www/htdocs/w00a10d9/html/modules/ContentExpress/pneditor/pnCEHTML.php on line 62

Deprecated: preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /www/htdocs/w00a10d9/html/includes/pnAPI.php on line 589

Deprecated: preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /www/htdocs/w00a10d9/html/includes/pnAPI.php on line 589

Deprecated: preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /www/htdocs/w00a10d9/html/includes/pnAPI.php on line 589

Deprecated: preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /www/htdocs/w00a10d9/html/includes/pnAPI.php on line 589

Deprecated: preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /www/htdocs/w00a10d9/html/includes/pnAPI.php on line 589

Deprecated: preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /www/htdocs/w00a10d9/html/includes/pnAPI.php on line 589

Deprecated: preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /www/htdocs/w00a10d9/html/includes/pnAPI.php on line 589

Deprecated: preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /www/htdocs/w00a10d9/html/includes/pnAPI.php on line 589

Deprecated: preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /www/htdocs/w00a10d9/html/includes/pnAPI.php on line 589

Deprecated: preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /www/htdocs/w00a10d9/html/includes/pnAPI.php on line 589

Deprecated: preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /www/htdocs/w00a10d9/html/includes/pnAPI.php on line 589

Deprecated: preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /www/htdocs/w00a10d9/html/includes/pnAPI.php on line 589

Deprecated: preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /www/htdocs/w00a10d9/html/includes/pnAPI.php on line 589

Deprecated: preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /www/htdocs/w00a10d9/html/includes/pnAPI.php on line 589

Deprecated: preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /www/htdocs/w00a10d9/html/includes/pnAPI.php on line 589

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Allergien: Diagnostische Verfahren

Positionspapier der Österreichischen Gesellschaft für Allergologie und Immunologie

Das Ziel der allergologischen Diagnostik ist die Sicherung einer auf Grund der Anamnese erhobenen Verdachtsdiagnose. Im Zuge der Diskussion um Sparmassnahmen trägt jeder Arzt selber Verantwortung, unnötige Kosten (Stichwort: "Laborscreening") zu vermeiden. Nicht alles, was angeboten wird, ist tatsächlich für jede Abklärung erforderlich. Diagnostische Verfahren sollen dabei sequentiell im Sinne einer Stufendiagnostik eingesetzt werden. Das Notwendige vom Machbaren zu unterscheiden ist die Kunst. Nicht eingegangen wird auf komplementärmedizinische Verfahren.


1. In vivo Diagnostik

1.1. Hauttests zum Nachweis von Typ I Allergien
- Pricktest (Prick zu Prick test)
- Intrakutantest (auch in verschiedenen Verdünnungen als Titrationstest)
- Reibetest (unempfindlich, aber hohe Spezifität wenn positiv)

Zur Abklärung einer anamnestisch vermuteten Allergie wurden Provokationstests an den Schockorganen der allergischen Entzündung entwickelt. Sie können prinzipiell an Auge, Nase, Bronchien, Gastrointestinaltrakt und Haut durchgeführt werden. Dabei besitzen in vivo Testungen an der Haut die größte Bedeutung. In der Routinediagnostik sind sie praktisch die wichtigsten Testverfahren: sie sind rasch durchführbar, sehr gut standardisiert, relativ billig, eine umfangreiche Testung ist möglich. Sie sind - mit Ausnahme des Intrakutantests-delegierbar an Pflegepersonal und geschulte Praxisangestellte. Ihre Sensitivität und Spezifität hängen doch auch vom jeweiligen Allergen ab. Ablesung nach 20 min, bei manchen Indikationen auch nach 12-24 Stunden sinnvoll, wegen Spätreaktionen ("late phase reaction"). Der " Standard" Pricktest umfasst Frühblüher (Erle, Hasel, Birke, Esche) Gräserpollen (es ist nicht notwendig alle verschiedenen Sorten einzeln zu testen, da Gräser 98% kreuzreagieren), Unkräuter (Beifuß, Ragweed), verschiedene Tierhaarallergene (Katze, Hund, Pferd, Nager), Staubmilben und die wichtigsten Schimmelpilzallergene. Je nach Fragestellung bieten alle Hersteller eine umfangreiche Palette weiterer Allergene an. Eine praktisch relevante Variante des Pricktests stellt der Prick-zu-Prick Test dar: eindrücken der Lanzette in eine frische Frucht dann Prickttestung der Haut des Patienten, z.B. bei pollenassoziierter Nahrungsmittelallergie (Allergieauslöser sind chemisch labil), oder wenn einfach keine Testsubstanz zur Verfügung steht.

1.2. Hauttests zum Nachweis von Typ IV Reaktionen (Kontaktallergie):
Ablesung nach 48 und 72 h
Epikutantestung (Patch test, Pflastertest)
- Standardepikutantest und verschiedene Reihen
- Testung mit vom Patienten mitgebrachten relevanten Eigensubstanzen ( z.B. Berufssubstanzen, Körperpflegeprodukte ect.)
- Epikutantest bei Arzneimittelexanthemen (z.B. makulopapulöse Exantheme nach Einnahme von Aminopenicillinen), weiteres fixe Arzneimittelexantheme.
- Photopatchtest (belichteter Epikutantest)
- Atopie-Patchtest (bei Verdahct auf Allergen sensitives atopisches Ekzem)


1.3. Andere Provokationstestungen
Provokationstestsungen ermöglichen eine klinisch aktuelle Allergie festzustellen, wenn Anamnese, Hauttests und in vitro Diagnostik keine klare Aussage ergeben.

- Konjunktivaler Provokationstest
- Nasaler Provokationstest (aktive anteriore Rhinomanometrie)
- Bronchialer Provokationstest
- Oraler Provokationstest (Nahrungsmittel, Medikamente)

2. In vitro Diagnostik
Abgeleitet vom Radioallergosorbentassay (RAST) finden heute Enzym- und Fluoreszenz immunoassays Verwendung, die Analytik ist teil- oder vollautomatisiert, sie sind in der Durchführung standardisiert. die Reagenzien, daher auch die Diagnostik sind teuer, was nicht genügend beachtet wird. (Verwendung als Screeningtests oder gar bei "Gesundenuntersuchungen"!) . Sie sind auch nicht delegierbar (z.B. über Anamnesebögen an Labors, die dann die passenden Allergene aussuchen). Die Allergenpalette der Anbieter aus der Industrie umfasst mehrere hundert Allergene und- mixes. Als Leitallergene für die tägliche Arbeit braucht man aber deutlich weniger. Ihre Sensitivität und Spezifität reicht von ca 35%( Nahrungsmittel) bis> 95%Pollenallergene.Das ist neben der unterschiedlichen Qualität der verfügbaren Allergene u.a. dadurch erklärbar, dass eine lokale IgE Produktion am jeweiligen Schockorgan sich nicht immer durch zirkulierende spezifische IgE Antikörper manifestieren muss.

2.1. Bestimmung des Gesamt IgE

Gesamt IgE im Serum: Erwachsene: normal bis 100 KU/l

Die Normwerte für IgE sind altersabhängig, und zeigen in der Normalbevölkerung eine breite Streuung. Die Bedeutung des Gesamt IgE in der Allergiediagnostik wird kontrovers beurteilt. Der gesamt IgE Wert ist in der Routinediagnostik vor allem zur ersten Orientierung zwischen atopischen und nicht atopischen Erkrankungen hilfreich: bei Atopikern finden sich daher meist erhöhte Werte, ein normaler Wert schließt aber eine allergische Erkrankung nicht aus. Erhöhte Werte für gesamt IgE finden sich auch bei verschiedenen, nicht allergischen Erkrankungen (spätere Stadien der HIV Infektion, Lymphome, Wiskott Aldrich Syndrom, allergische bronchopulmonale Aspergillose, Parasitosen) sowie bei Rauchern.

2.2. Allergenspezifische IgE Antikörper

Bewertung in 6 Klassen gebräuchlich.
Die Höhe Allergenspezifischer IgE- Antikörper wird mitbeeinflusst von der Höhe des Gesamt -gE, korreliert aber nicht immer mit der Schwere der allergischen Erkrankung. Die wichtigsten Allergengruppen sind die Pollenallergene, Milbenallergene, Tierhaarallergene, Schimmelpilzallergene, Insektengifte, Nahrungsmittel und Medikamente. Während für Pollen, Insektengifte, und Milben positive IgE- Antikörper eine gute Aussage liefern, ist für Schimmelpilzallergene, v.a. aber für Nahrungsmittelallergene die Korrelation zwischen einem positiven IgE- Antikörperbefund und der klinischen Beobachtung nicht so gut. Der wesentliche Wert der Bestimmung spezifischer IgE- Antikörper liegt darin, dass sie unabhängig von der Einnahme von antiallergischen Medikamenten und dem Hautzustand (z.B. bei schwerer atopischer Dermatitis) einen Befund ermöglichen und auch bei sehr hoher Sensibilisierung den Patienten nicht gefährden. Die Indikation primär und als erste diagnostische Maßnahme spezifische IgE-Antikörper im Labor zu bestimmen sind der Verdacht gefährliche Typ I Allergien wie Latexallergie, anaphylaktische Reaktionen auf Nahrungsmittel, Insektengifte oder Penicilline, oder wenn eine Hauttestung wegen Ekzemen im Testbereich. Manchmal ist es auch bei Säuglingen oder Kleinkindern nicht möglich eine Hauttestung durchzuführen.


2.3 Präzipitierende Antikörper

Präzipitierende Antikörper (spezifische IgG, IgA, IgM) sollten bei Verdacht auf Allergien vom Typ III mit Immunkomplexbildung (Farmerlunge Vogelhalterlunger etc.) bestimmt werden. Sie sind ein Teil der Diagnostik- als Verlaufsparameter zur Erfassung der Krankheitsaktivität eignet sich die Bestimmung der BSG (Anstieg bei 86% der Untersuchten innerhalb 24 Stunden nach Allergenexposition begleitet von Leukozytose) als einfachere Methode. Die Bestimmung erfolgt mittels Doppeldiffusion (Ouchterlonymethode). Fluoreszenzimmunoassays sind zwar empfindlicher, es fehlen aber noch gute Referenzwerte für einzelne Antigene. Die Methode findet daher nur beschränkt Eingang in die Routinediagnostik.

2.4. Messung von Mediatoren der Entzündungszellen

Eosinophilic cationic protein (ECP):

Der eosinophile Granulozyt steht als Mediator und Effektorzelle im Mittelpunkt der Spätphase (Chronifizierung) der allergischen Entzündung. Von Eosinophilen sezernierte Produkte - u.a. das ECP - ermöglichen eine Einschätzung der Schwere der allergischer Entzündung. Insbesondere bei allergischem Asthma bronchiale, chron. Rhinosinusitis, oder eosinophiler Gastroenteritis hat sich das ECP - vor allem als Verlaufsmarker - bewährt.

Tryptase


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