Update on skin allergy.

Skin diseases with an allergic background such as atopic dermatitis, allergic contact dermatitis, and urticaria are very common. Moreover, diseases arising from a dysfunction of immune cells and/or their products often manifest with skin symptoms. This review aims to summarize recently published articles in order to highlight novel research findings, clinical trial results, and current guidelines on disease management. In recent years, an immense progress has been made in understanding the link between skin barrier dysfunction and allergic sensitization initiating the atopic march. In consequence, new strategies for treatment and prevention have been developed. Novel pathogenic insights, for example, into urticaria, angioedema, mastocytosis, led to the development of new therapeutic approaches and their implementation in daily patient care. By understanding distinct pathomechanisms, for example, the role of IL-1, novel entities such as autoinflammatory diseases have been described. Considerable effort has been made to improve and harmonize patient management as documented in several guidelines and position papers.

Acute generalised exanthematous pustulosis induced by the herbal remedy Ginkgo biloba

Acute generalised exanthematous pustulosis (AGEP) is a clinical reaction pattern that is induced, in over 90% of cases, by systemic drugs (most frequently antibacterial drugs). This is the first reported case of AGEP caused by the herbal remedy Ginkgo biloba.

Alergias a alimentos ou a derivados usados como excipientes em medicamentos

Aditivos químicos têm como principal objetivo melhorar os produtos industrializados, como fármacos, conferindo-lhes cor, aroma, textura, conservação, entre outros. Os aditivos utilizados na indústria farmacêutica são denominados excipientes, completando a massa ou o volume especificado no medicamento. São considerados substâncias inativas, uma vez que não apresentam propriedades curativas ou preventivas de doenças ou dos seus sintomas. No âmbito deste trabalho, foi realizado uma revisão bibliográfica sobre os excipientes naturais e sintéticos mais usados na indústria farmacêutica, agrupando-os mediante a sua função específica. Assim, foi feita uma breve descrição sobre alguns dos excipientes mais utilizados nas formulações farmacêuticas, nomeadamente os antioxidantes, os corantes, os edulcorantes e os conservantes, que visam garantir a conservação do produto em condições viáveis. Uma vez que os excipientes são considerados substâncias inativas, são vistos como inofensivos para a saúde. No entanto, é cada vez mais evidente que os excipientes não são sempre inertes e podem apresentar riscos para o desenvolvimento de reações alérgicas, podendo promover alterações mais prejudiciais. As reações alérgicas associadas aos excipientes são consideradas raras, visto que são incorporadas baixas concentrações destes em formulações farmacêuticas, tendo surgido, no entanto, diversos casos associados aos diferentes excipientes anteriormente referidos. Dependendo do excipiente e da sensibilidade do indivíduo, as alergias podem originar dermatites de contacto, prurido, urticária, edema, reações anafiláticas, entre outros. É importante salientar que o excesso de aditivos pode originar problemas de saúde, normalmente em indivíduos suscetíveis e na população pediátrica, sendo necessário aplicar cuidados adicionais que promovam uma maior vigilância e orientação no uso de medicamentos.

Estudo da prevalência e da gravidade da dermatite de contacto em 'frango do campo'

O sector avícola enfrenta atualmente dois desafios muito estimulantes. O primeiro decorre do aumento, que se prevê continuar a crescer, nos níveis de procura de carne de aves no mercado interno e internacional; o segundo decorre do facto da criação avícola ter adotado métodos de produção mais intensivos (kg peso vivo/m2/ano) e em maior escala, i.e. com maior concentração animal na mesma exploração. Este carácter vincadamente “industrial” tem merecido uma natural atenção das sociedades e das autoridades pecuárias no sentido desta economia de escala passar a ter num conjunto de instrumentos legais e técnicos o devido contrapeso para a salvaguarda das aves enquanto ser vivo. O presente trabalho tem como ponto de partida a Directiva 2007/43/CE do Conselho de 28 de Junho, relativa ao estabelecimento de regras mínimas para a proteção de frangos de carne. Em virtude de não existir ainda informação suficiente sobre a forma como a qualidade do maneio animal pode ser monitorizada, ao nível do abate, por médicos veterinários e auxiliares oficiais, em frangos de criação especial segundo os modelos definidos no Regulamento (CE) n.º 543/2008, urge realizar estudos neste domínio. O principal objetivo da realização do presente trabalho de campo foi o estudo da ocorrência das dermatites de contacto plantar (pododermatites) e da bolsa sinovial préesternal em frangos produzidos em sistemas de produção considerados “protetores” do bem-estar animal, designadamente os seguintes: i) ar livre; e, ii) extensivo de interior. O estudo foi efetuado num centro de abate de frangos do campo, em Oliveira de Frades, entre Maio de 20012 e Março de 2013. Os animais abatidos foram criados em explorações com contratos de integração situadas no Distrito de Viseu. Os dados foram recolhidos em 39 bandos diferentes da espécie Gallus domesticus, dos quais 1021 carcaças foram avaliadas após evisceração, o que correspondeu ao exame de uma a cada quinze aves da linha de abate. Para a avaliação da pododermatite foi utilizado o método adaptado pela DGAV, enquanto para a avaliação da bursite esternal foi efetuada tendo em conta o modelo aplicado em perus por Berk em 2002. Apesar do modelo estatístico desenvolvido para a análise dos resultados obtidos no presente trabalho exigir um maior número de observações, foi possível identificar com grande precisão alguns fatores de risco que devem ser realçados pela sua relevância no contexto dos sistemas produtivos escrutinados ou no mecanismo fisiopatológico da dermatite de contacto, nomeadamente os seguintes: (i) a idade das aves que, apesar de não ter sido identificada uma relação directa com os scores de pododermatite e bursite, verificou-se que a idade elevada que os animais tipicamente atingem nos sistemas de produção extensivos está associada a uma taxa superior de rejeições pela inspecção sanitária; (ii) o peso pré-abate que, independentemente da inconsistência defendida por diversos autores em relação à influência do peso vivo do frango industrial sobre a dermatite de contacto, nos animais produzidos em regime extensivo, esta variável pode desempenhar um fator chave para a ocorrência desta lesão. De facto, há que realçar que o peso destes animais tem uma importância fulcral na modelação da biomecânica da ave, incluindo na pressão exercida sobre a superfície plantar; (iii) o tipo de sistema de abeberamento, tendo ficado demonstrado que a selecção do tipo de bebedouro tem uma importância peculiar sobre a ocorrência de pododermatite em “frango de campo”, algo que está provavelmente relacionado com a influência exercida sobre o teor de humidade da cama. Globalmente, as frequências de pododermatite e bursite apuradas neste trabalho devem ser consideradas inquietantes. Esta preocupação eleva-se quando se toma consciência que as aves provieram de regimes considerados “amigáveis” e “sustentáveis”, pelo que urge monitorizar adequadamente aqueles sistemas produtivos, melhorar as suas condições e reanalisar os benefícios ao nível do bem-estar animal.

Caracterización de las condiciones de salud y de trabajo y su relación con lesiones cutáneas en los orfebres artesanales de Mompox Bolivar-Colombia 2015

INTRODUCCIÓN Las alteraciones de la salud relacionadas con el trabajo (enfermedades y accidentes), pueden prevenirse desde las actividades bien enfocadas del Sistema de Gestión de Seguridad y Salud en el Trabajo (SGSST), realizando la identificación y control de los agentes causales en el ambiente de trabajo y la vigilancia de la salud de la población trabajadora. El proyecto desarrollado va dirigido a un grupo específico de artesanos orfebres en la ciudad de Mompox, Bolivar, en la que esta labor artesanal se centra en el arte de la filigrana, transmitido generacionalmente desde antaño En esta ciudad los artesanos orfebres, aunque corresponden a un sector informal de la economía, se encuentran agremiados principalmente en tres asociaciones ubicadas en la cabecera municipal. En el desempeño de sus labores, estos profesionales del arte de la filigrana manipulan agentes químicos como el ácido nítrico, el ácido sulfúrico, la plata y el mercurio, los cuales se utilizan en las diferentes etapas del proceso que incluye técnicas propias de esta labor. Teniendo en cuenta que la información disponible en la literatura científica describe principalmente los efectos de agentes químicos en otros oficios diferentes a la población orfebre y conociendo que la exposición a estas sustancias químicas puede generar variados efectos en el organismo, el interés de este proyecto se centra específicamente en las alteraciones cutáneas posiblemente relacionadas con las condiciones de trabajo de esta población del sector informal. MATERIALES Y METODOS La presente investigación es un estudio de corte trasversal, el cual realizó una selección por conveniencia de 114 trabajadores de orfebres Momposinos con el fin de identificar la relación de las condiciones de trabajo con la presencia de alteraciones cutáneas de los trabajadores que laboran en la orfebrería artesanal en la ciudad de Mompox, departamento de Bolívar, en el año 2015, de tal manera que dejando a consideración la descripción de los hallazgos encontrados, se posibiliten futuras y precisas investigaciones e intervenciones en este colectivo de trabajadores. Los instrumentos empleados para la recolección de la información y para el cumplimento de los objetivos fueron la encuesta Nacional de Condiciones de Trabajo del Instituto Nacional de Seguridad e Higiene en el trabajo de España (INSHT) que permite recolectar información sobre la caracterización de la población a nivel sociodemográfico y ocupacional, y para la determinación de patologías dermatológicas relacionadas con el trabajo se utilizó el Cuestionario NOSQ-2002 Nórdico- Enfermedades Cutáneas de origen Laboral, en su versión validada en español. Se describieron las variables categóricas con porcentajes y las continuas (cuantitativas) con medidas de tendencia central y dispersión La asociación entre los hallazgos de exposición ocupacional y los síntomas y signos en piel, fue estimada mediante riesgos relativos. RESULTADOS El 75,4% del total de la población correspondió al género masculino y el 67,5% reportó realizar sus labores como trabajadores independientes. Respecto a la identificación de condiciones de salud, la percepción por parte de los orfebres fue positiva, reportando muy buena salud en el 34% de los mismos. El 8% de la población manifestó alteraciones dermatológicas tipo eczema en los últimos seis meses y el 11% las presentó principalmente en manos. Respecto de la iniciación del eczema, el 97% de los trabajadores reportó que se iniciaba al contacto con sustancias químicas y el 98,7% manifestó que se encontraban realizando la labor de orfebrería cuando inició el eczema. La lesión prevalente fue mancha roja sin edema (8%), seguida de ronchas o manchas y ampollas pequeñas (3%) y de piel seca con escamas (2%). CONCLUSIONES Los resultados de la presente investigación mostraron la prevalencia de alteraciones cutáneas principalmente en las manos, tipo eczema (manchas rojas) o prurito (picor). Se recomienda la disminución de los tiempos de exposición, adecuación de jornadas y tiempos de descanso, sistemas de protección personal adecuados y la implementación de un programa de educación y participación para el control integral del riesgo.

Alteraciones cutáneas de miembros superiores por exposición a agroquímicos en cultivos de arroz, departamento de La Guajira 2016

Introducción: la vida, salud y trabajo del agricultor tienen sus propias particularidades, estilos y actividades, su calidad de vida puede afectarse por exponerse a sustancias químicas, convirtiéndola en una labor muy riesgosa. Objetivo: establecer la prevalencia de las alteraciones cutáneas de miembros superiores por exposición a agroquímicos en cultivos de arroz. Material y método: estudio de corte transversal, población de 100 trabajadores, ubicadas en zona rural de Fonseca La Guajira, durante el año 2016. Se analizaron variables sociodemográficas, laborales y clínicas relacionadas. Para el análisis estadístico se aplicaron las pruebas de Shapiro-Wilk, Ji-Cuadrado de Pearson, medidas de asociación con OR y sus respectivos intervalos de confianza del 95%, análisis multivariado con una Regresión Logística Incondicional, nivel de significancia del 5% (p<0.05) para pruebas estadísticas. Resultados: el 98,9% fueron hombres, las edades oscilaron entre los 18 y 83 años (media de 43,7 años). El 40,91% reporto fumigar y el, 15,15% abona. Reportaron tener rinitis alérgica el 21,2%, alergia ocular 25,3%, asma 16,41%, eczemas en las manos 19,15% y ronchas o habones 17,95%; el 40,31% uso herbicidas, 8,77% fungicidas, 35,09% insecticidas, 14,04% fertilizante y 1,75% coadyuvante. La dependencia es prácticamente nula entre la aparición de eczemas y categoría toxica (p=0,021); R de Pearson (R=0,121; p=0,247) con correlación positiva; no existe una relación entre el número de personas con alergias dérmicas y la toxicidad (X2= 2,271; p=0,518), el R de Pearson (R=-0,152; p=0,150). Conclusión: la exposición a agroquímicos sin las condiciones mínimas de seguridad y salud en el trabajo, se relaciona con la aparición de alteraciones cutáneas.

Interaction between staining and degradation of a composite resin in contact with colored foods

Composite resins might be susceptible to degradation and staining when in contact with some foods and drinks. This study evaluated color alteration and changes in microhardness of a microhybrid composite after immersion in different colored foods and determined whether there was a correlation between these two variables. Eighty composite disks were randomly divided into 8 experimental groups (n = 10): kept dry; deionized water; orange juice; passion fruit juice; grape juice; ketchup; mustard and soy sauce. The disks were individually immersed in their respective test substance at 37 ºC, for a period of 28 days. Superficial analysis of the disk specimens was performed by taking microhardness measurements (Vickers, 50 g load for 45 seconds) and color alterations were determined with a spectrophotometer (CINTRA 10- using a CIEL*a*b* system, 400-700 nm wavelength, illuminant d65 and standard observer of 2º) at the following times: baseline (before immersion), 1, 7, 14, 21 and 28 days. Results were analyzed by ANOVA and Tukey's test (p < 0.05). Both variables were also submitted to Pearson's correlation test (p < 0.05). The passion fruit group underwent the greatest microhardness change, while the mustard group suffered the greatest color alteration. Significant positive correlation was found between the two variables for the groups deionized water, grape juice, soy sauce and ketchup. Not all color alteration could be associated with surface degradation.

Dependence of the crossover exponent with the diffusion rate in the generalized contact process model

We study how the crossover exponent, phi, between the directed percolation (DP) and compact directed percolation (CDP) behaves as a function of the diffusion rate in a model that generalizes the contact process. Our conclusions are based in results pointed by perturbative series expansions and numerical simulations, and are consistent with a value phi = 2 for finite diffusion rates and phi = 1 in the limit of infinite diffusion rate.

Contact endoscopy for identifying the parathyroid glands during thyroidectomy

Aim of this study was to analyse contact endoscopy as an auxiliary method for identifying parathyroid glands during thyroid surgery and to identify other variables that may interfere with this correlation. overall, 125 patients underwent thyroid surgery between January 2004 and February 2006. The variables analysed were: the total duration of surgery; time taken to locate and identify parathyroid glands; improvement in identifying these; numbers of parathyroid glands located by the surgeon and confirmed by contact endoscopy; histopathological diagnosis; presence of thyroiditis; thyroid weight; number of parathyroid glands left in thyroid specimens; and number of parathyroid gland autotransplantations. A total of 331 parathyroid glands were observed by the surgeon. however, 282 glands were identified by contact endoscopy. nine parathyroid glands (7.2%) were observed together with thyroid specimens (Kappa = 0.534). The longer the total duration of surgery (p = 0.03) and time taken to locate and identify (p = 0.00) the parathyroid glands by contact endoscopy, the lower the observed agreement. The second year of performing contact endoscopy led to better agreement between the results (p = 0.02). in conclusion, contact endoscopy is an efficient auxiliary method for identifying parathyroid glands during thyroid surgery. During the period studied, association between total duration of surgery and time taken to locate and identify parathyroid glands was statistically significant.

Relatedness and HLA-DRB1 typing may discriminate the magnitude of the genetic susceptibility to tuberculosis using a household contact model

Background Tuberculosis clusters in families may be due to increased household exposure, shared genetic factors, or both. Household contact studies are useful to control exposure because socioeconomic and environmental conditions are similar to all subjects, allowing the evaluation of the contribution of relatedness to disease development. Methods In this study, the familial aggregation of tuberculosis using relatedness and a specific inherited marker (HLA-DRB1) was evaluated. Fifty families, which had at least two cases of tuberculosis diagnosed within the past 5 years, were selected from a cohort of tuberculosis carried out in Recife, Brazil. The first case diagnosed was considered to be a primary case. The secondary attack rate of tuberculosis in household contacts was estimated according to the degree of relatedness. The relative risk of having tuberculosis based on the degree of relatedness household and the population attributable fraction to relatedness were also estimated. HLA-DRB1 typing and attributable etiologic/preventive fractions were calculated among sick and healthy household contacts. Results Compared to unrelated contacts, the relative risk for tuberculosis adjusted for age was 1.38 (95% CI 0.86 to 2.21). Relatedness contributed 23% to the development of tuberculosis at the population levels. The HLA-DRB1*04 allele group (OR = 2.44; p =0.0324; etiologic fraction =0.15) was overrepresented and the DRB1*15 allele group (OR=0.48; p=0.0488; protective fraction=0.19) was underrepresented among household contacts exhibiting tuberculosis. The presence of DRB1 shared alleles between primary cases and their contacts was a risk factor for tuberculosis (p=0.0281). Conclusion This household contact model together with the utilisation of two genetic variables permitted the evaluation of genetic factors contributing towards tuberculosis development.

Women`s feelings about early contact with their infants on the labour ward

Objectives: to identify women`s feelings after early contact with their newborn infants in the delivery room, and to identify how health professionals involved in mother and infant care behave in the intrapartum setting. Design: a qualitative approach using semi-structured interviews and observation. Content analysis was used to derive the three themes that emerged from the interviews. Setting and participants: 23 postpartum women and their caregivers in a public maternity hospital in Ribeirao Preto, Brazil. Findings: three thematic categories emerged from the interviews: heightened fear, severe pain and intense conflict. The professionals` actions revealed that they have theoretical and practical abilities for humanisation of care, but their actions are fragmented. Final considerations: women can feel lonely, fearful and conflicted in the delivery room, and they also experience pain. Giving birth is a major event in a woman`s life, so it is important to facilitate a positive experience. Health professionals were found to display interventionist and impersonal attitudes; these influenced the potential choices of women at their first contact with their infant. Implications for practice: the focus of health care needs to extend beyond the institution. This means fewer normative actions performed by health professionals, enabling women to enjoy their early contact with their newborn infants. (C) 2010 Elsevier Ltd. All rights reserved.

The effects of skin-to-skin contact during acute pain in preterm newborns

Background and purpose: Several promising non-pharmacological interventions have been developed to reduce acute pain in preterm infants including skin-to-skin contact between a mother and her infant. However, variability in physiological outcomes of existing studies on skin-to-skin makes it difficult to determine treatment effects of this naturalistic approach for the preterm infant. The aim of this study was to test the efficacy of mother and infant skin-to-skin contact during heel prick in premature infants. Method: Fifty nine stable preterm infants (born at least 30 weeks gestational age) who were undergoing routine heel lance were randomly assigned to either 15 min of skin-to-skin contact before, during and following heel prick (n = 31, treatment group), or to regular care (n = 28, control group). Throughout the heel lance procedure, all infants were assessed for change in facial action (NFCS), behavioral state, crying, and heart rate. Results: Statistically significant differences were noted between the treatment and control groups during the puncture, heel squeeze and the post phases of heel prick. Infants who received skin-to-skin contact were more likely to show lower NFCS scores throughout the procedure. Both groups of infants cried and showed increased heart rate during puncture and heel squeeze although changes in these measures were less for the treated infants. Conclusions: Skin-to-skin contact promoted reduction in behavioral measures and less physiological increase during procedure. It is recommended that skin-to-skin contact be used as a non-pharmacologic intervention to relieve acute pain in stable premature infants born 30 weeks gestational age or older. (C) 2007 European Federation of Chapters of the International Association for the Study of Pain. Published by Elsevier Ltd. All rights reserved.

Non-linear boundary element formulation applied to contact analysis using tangent operator

This work presents a non-linear boundary element formulation applied to analysis of contact problems. The boundary element method (BEM) is known as a robust and accurate numerical technique to handle this type of problem, because the contact among the solids occurs along their boundaries. The proposed non-linear formulation is based on the use of singular or hyper-singular integral equations by BEM, for multi-region contact. When the contact occurs between crack surfaces, the formulation adopted is the dual version of BEM, in which singular and hyper-singular integral equations are defined along the opposite sides of the contact boundaries. The structural non-linear behaviour on the contact is considered using Coulomb`s friction law. The non-linear formulation is based on the tangent operator in which one uses the derivate of the set of algebraic equations to construct the corrections for the non-linear process. This implicit formulation has shown accurate as the classical approach, however, it is faster to compute the solution. Examples of simple and multi-region contact problems are shown to illustrate the applicability of the proposed scheme. (C) 2011 Elsevier Ltd. All rights reserved.

Characterization of micro-bubble size distribution and flow configuration in DAF contact zone by a non-intrusive image analysis system and tracer tests

This paper aims to investigate the influence of some dissolved air flotation (DAF) process variables (specifically: the hydraulic detention time in the contact zone and the supplied dissolved air concentration) and the pH values, as pretreatment chemical variables, on the micro-bubble size distribution (BSD) in a DAF contact zone. This work was carried out in a pilot plant where bubbles were measured by an appropriate non-intrusive image acquisition system. The results show that the obtained diameter ranges were in agreement with values reported in the literature (10-100mm), quite independently of the investigated conditions. The linear average diameter varied from 20 to 30mm, or equivalently, the Sauter (d(3,2)) diameter varied from 40 to 50mm. In all investigated conditions, D(50) was between 75% and 95%. The BSD might present different profile (with a bimodal curve trend), however, when analyzing the volumetric frequency distribution (in some cases with the appearance of peaks in diameters ranging from 90-100mm). Regarding volumetric frequency analysis, all the investigated parameters can modify the BSD in DAF contact zone after the release point, thus potentially causing changes in DAF kinetics. This finding prompts further research in order to verify the effect of these BSD changes on solid particle removal efficiency by DAF.

Backside contact effect on the morphological and optical features of porous silicon photonic crystals

The present work reports on the effect of the type of backside contact used in the electrochemical process and their relation with the structural features and optical responses of the one-dimensional photonic crystal (PC) anodized in simple and double electrochemical cell. The PC, obtained in the single cell, showed to have thicker layers than of the PC obtained in double electrochemical cell. Additionally, the PC obtained in double cell showed highest reflectance in the band gap region than of the PCs obtained in single cell. These results suggest that the interface roughness between adjacent layers in the PC devices obtained in double electrochemical cell is minimized. (C) 2008 Elsevier Ltd. All rights reserved.