[Latex allergy]. / Lateksallergi.

During the last 10-15 years allergic reaction to Natural rubber latex (NLR) has become an increasing occupational problem among health-care workers. The allergy is caused by allergenic proteins in the NRL. The diagnosis is achieved through a relevant history, skin prick tests with aquous NRL glove extracts and blood tests. History and prick tests are most important. The most frequent cross-reaction is to banana. Careful instruction on prevention is a must.

Casual sex, extramarital sex, condom use and alcohol intake among heterosexual patients attending an STD clinic in Norway.

A study excluding homosexuals was performed to study casual sex, extramarital sex, the use of a condom with a casual sexual partner and the combination of alcohol intake and casual sex among patients attending a clinic for sexually transmitted diseases (STDs). Heterosexual patients (467) received a questionnaire, and 458 were included. Men reported more (94%) casual sexual partners than did women (76%). According to a multiple logistic regression analysis a condom was used significantly less frequently in "old" respondents, those having a permanent sexual partner, those having low education, those infected with STDs (earlier STDs), those who had had more than 4 sexual partners over the last year, and those combining alcohol intake and casual sex. Intravenous drug users/prostitutes used a condom more often than did men with paid sex and "other heterosexuals". To have an effect on STD patients, innovative forms of health education may be necessary, and greater emphasis should be placed on more informal means of information, including interactive health education and communication strategies to promote positive attitudes regarding condom use.

PIP: This study examined casual sex, extramarital sex, the use of a condom with a casual sexual partner, and the combination of alcohol intake and casual sex among heterosexual patients attending a sexually transmitted disease (STD) clinic. 467 patients received a questionnaire, and 458 were included in the study. Men reported casual sex more frequently than did women (94% and 76%, respectively). According to a multiple logistic regression analysis a condom was used significantly less frequently in "old" respondents, those having a permanent sexual partner, those having low education, those infected with STDs (earlier STDs), those who had had more than 4 sexual partners over the last year, and those combining alcohol intake and casual sex. Intravenous drug users/prostitutes used a condom more often than did men with paid sex and "other heterosexuals". To have an effect on STD patients, innovative forms of health education may be necessary, and greater emphasis should be placed on more informal means of information, including interactive health education and communication strategies to promote positive attitudes regarding condom use.

Knowledge of HIV infection and the fear of mixing socially with HIV-infected and AIDS-sick patients among STD patients in Bergen, Norway.

This is a study of data from 599 STD (sexually transmitted disease) clinic patients in Bergen, Norway who visited the clinic in April-June 1989. We studied the patients' knowledge of modes of HIV transmission and their degree of ignorance of how HIV is not transmitted. Particular interest was focused on how misconceptions influenced the respondents' perception of HIV/AIDS sick persons and the importance of confidence in AIDS information from the health authorities. The objective of the study was to compare the data from this investigation of STD patients with data from similar studies in the general public conducted in Norway between 1986 and 1991. HIV-infected blood (98.3%; 589/599) and unprotected vaginal intercourse (91%; 545/599) were frequently suggested as a mode of HIV transmission, while 22.4% (134/599) did not recognize anal sex as an unsafe sexual practice. There was no statistically significant difference in their knowledge of modes of HIV transmission between the following patient subgroups: homosexuals/bisexuals, intravenous drug users (IVDUs)/prostitutes, sex customers and respondents classified as 'other heterosexuals'. Regarding ways in which HIV is not transmitted, ignorance was first and foremost related to whether the HIV virus could be passed on by oral kissing (wrong: 38.5%). Knowledge of how HIV is not transmitted was positively correlated with education (p < 0.05) and confidence in the HIV/AIDS information from health authorities (p < 0.05), and negatively correlated with age (p < 0.05). Respondents knowing how HIV is not transmitted considered social contact with HIV/AIDS sick persons to be harmless (p < 0.001). The present information campaigns on HIV/AIDS have been less effective than expected. In the future we must find new ways of informing the public by identifying the essential components that are missing from the information campaigns we have today.

The effect of H1 receptor antagonists on peripheral blood mononuclear cells, adenoid cells and primary cell lines.

This study describes the in vitro effect of three H1 receptor antagonists (dexchlorpheniramine, terfenadine and loratadine) on human peripheral blood mononuclear cells (PBMC, n = 30) from allergic patients and healthy individuals. The three H1 receptor antagonists significantly inhibited antigen/mitogen-induced PBMC proliferation in a concentration-dependent manner. Allergen-specific T-cell responses in allergic individuals were similarly inhibited. The effect of the three drugs was also tested in cultures of mononuclear cells derived from adenoid tissue. The growth kinetics were investigated using spontaneously proliferating cell lines to examine whether the inhibition was caused by general toxicity. Three cell lines, HCT 8 (an ileocaecal adenocarcinoma) RPMI 8866 (B-cell line) and 166 A2 (T hybridoma) were tested. Loratadine (< 0.03 microM) and dexchlorpheniramine (< 0.62 microM) altered the kinetics of HCT 8 and RPMI 8866, respectively. When testing RPMI 8866 and 166 A2, the growth-inhibitory effect of terfenadine and loratadine could be neutralized by addition of cell culture filtrate from RPMI 8866 or 166 A2. These culture filtrates are rich in soluble low-affinity IgE receptor (sCD23) and IgE-binding factor (IgEBF), respectively. Our findings show that the antihistamines investigated display some non-convential in vitro anti-allergic properties possibly not related to their interaction with the H1 receptor. In addition, our results suggest: a) The H1 receptor antagonists used differ in their pattern of cell inhibition; b) The inhibitory effect is completely reversible at low drug concentrations.

Casual sexual experience abroad in patients attending an STD clinic and at high risk for HIV infection.

OBJECTIVE: To study possible "import" routes of HIV infection to Norway (by obtaining information on casual sexual contacts abroad from patients attending an STD clinic), and to assess their behavioural risk factors (such as alcohol intake, use of condom) for HIV infection. DESIGN AND SETTING: Patients visiting the clinic for sexually transmitted diseases (STD), April-June 1989, received a questionnaire. SUBJECTS: 606 consecutive persons of whom 599 agreed (98.8%) to participate. We grouped the patients in four categories. 1: Sex with a prostitute during the last 5 years, 2: Homosexuals/bisexuals, 3: prostitutes/intravenous drug abusers (IVDUs) and 4: Other heterosexuals. RESULTS: 245 patients (41%) reported having a casual sex partner abroad (M: 182, F: 63), mainly in Europe, particularly in Spain, Denmark and Greece. Outside Europe such contacts were most frequently reported from USA, Brazil and Thailand. Among men who had had sex with a prostitute, 93.5% reported such sex abroad (homosexuals/bisexuals: 63.6%, prostitutes/IVDUs: 66.7%, "other heterosexuals: 32.1%). Homosexual/bisexual men with casual partner(s) abroad used a condom more frequently than did others. CONCLUSION: 245 of 599 persons reported casual sex abroad during 1985-1989, and the different "risk groups" reported countries where most HIV infected persons belonged to their own "risk group". We have reason to believe that alcohol intake increased the likelihood of casual sexual activity and decreased the use of condom. Norwegian travellers need more information on the risks of casual sex abroad, the use of condoms and the combination of alcohol intake and casual sex.

HIV-seropositive rate and HIV test activity among STD clinic attendees in Bergen, Norway.

We wanted to determine the HIV seropositive rate and to study the connection between previous HIV testing, acceptance of HIV testing and sexual behaviour among STD clinic patients in Bergen, Norway. Patients attending the STD clinic in 1986-93 requesting HIV testing were registered, and all patients visiting the clinic in April-June 1989 received a questionnaire and were asked if they wanted to be HIV tested. The overall HIV seropositive rate was 0.4% (14/3805); in homo-/bisexual men: 2.9% (8/278); IVDUs: 0.4% (1/236) and in heterosexual non-IVDUs: 0.2% (5/3291). Among the 599 individuals offered anonymous HIV testing, 42.2% were HIV tested and 69.2% did not object to HIV-testing. IVDUs/prostitutes (p < 0.001), customers of prostitutes (p < 0.001), homo-/bisexuals (p < 0.01), and patients receiving blood transfusion (p < 0.005) had all been HIV tested more frequently than 'other heterosexuals'. Respondents reporting casual sex, casual sex abroad, infection with STDs, and a greater number of partners were more frequently HIV tested and also accepted HIV testing more frequently than respondents without such behaviour, indicating that there is some rationale behind the decision to be tested.

[Diaper dermatitis. Classification, occurrence, causes, prevention and treatment]. / Bleiedermatitt. Klassifikasjon, forekomst, årsaker, forebygging og behandling.

Diaper dermatitis is a multifactorial dermatological disorder characterized by inflammation in the diaper area. About half of all babies and old people in need of care experience light dermatitis, while 20% have moderate and 5% severe dermatitis. Friction from the diaper, occlusion, irritation from faeces, ammonia, detergents, candida albicans, proteolytic and lipolytic enzymes and moisture deposited on the epidermis cause damage at the stratum corneum layer of the epidermis. Diaper dermatitis is caused by a combination of mostly irritant effects. Compounds that infiltrate the skin can aggravate the reaction to the damaged epidermis. The barrier function of epidermis must be restored in order to prevent and treat diaper dermatitis.

[Local sunscreening agents--why, when, how and where?]. / Lokale solbeskyttelsesmidler--hvorfor, når, hvordan og hvor?

Sunscreens are used primarily to protect against sunburn. The cosmetic benefits of sunscreens have been widely accepted with the recent indictment of photoaging as a major cause of wrinkles. It is not so well known that sunscreens also protect against the development of carcinomatous processes in the skin. It is important to protect against UV-A as well as against UV-B because UV-A has an additional effect and can also itself initiate cancer. We advocate use of sunscreens with a high sun protection factor. It is of utmost importance to protect children against the deleterious effects of the sun to prevent development of skin cancer later in life. The article includes an overview of the most common active sunfilter compounds. Allergy to these compounds does occur but is rare. Certain textiles provide good but varying protection against the sun.

[Porphyria variegata--the first case in Norway]. / Porphyria variegata--for første gang i Norge.

In Norway, the most common porphyrias are acute intermittent porphyria and porphyria cutanea tarda. We describe the first case of porphyria variegata in this country. The patient showed symptoms of the skin and had no abdominal discomfort. Her family was also evaluated and two other persons were found with suspected latent porphyria variegata. We discuss the main symptoms of this type of porphyria and the possibilities of treatment. We emphasize that examination of porphyrins in the feces of patients with porphyria variegata is essential for the diagnosis.

Retinoids and systemic chemotherapy in cases of advanced mycosis fungoides. A report from the Scandinavian Mycosis Fungoides Group.

In cases of advance mycosis fungoides, the systemic chemotherapy combination of bleomycin, cyclophosphamide and prednisolone was given to 8 cases, and the same 3-drug combination with the addition of oral retinoids given to 12 cases. All cases were in a progressive phase of the disease. Remission was obtained in 5/8 cases treated with the combination and in 7/12 cases treated with the combination plus retinoids. The remissions were complete in half of the cases, but relapse occurred within 3 to 6 months in all but 2 cases. The two treatment patient groups were not fully comparable but the conclusion is that the addition of retinoids to systemic chemotherapy combination regimens is of some advantage. There still exists, however, need of more adequate treatment modalities in advanced mycosis fungoides.

Skin lesions in sadomasochism.

This paper presents the case of a 35-year-old man who consulted the department of venereology because of healing problems with some wounds caused by burning his skin perianally with cigarettes as part of a sexual satisfaction ritual. Knowledge of such lesions may be useful to physicians and social workers. Sadomasochism and 'offers' in the intimate-massage clinics in Copenhagen are surveyed.

Liver biopsies from patients with psoriasis related to photochemotherapy (PUVA): findings before and after 1 year of therapy in twelve patients. A blind study and review of literature on hepatotoxicity of PUVA.

In each of twelve patients with psoriasis, a liver biopsy was taken before and after 1 year of photochemotherapy (psoralen and long-wave ultraviolet light; PUVA). The mean dose of psoralen was 3,204 mg (range, 1360-5300) at the time of the latter liver biopsy, whereas the mean number of treatments was seventy-nine (range, 34-126 treatments). Analysis by the sign test showed no statistically significant differences in any of the light microscopic variables comparing pre- and posttherapy liver biopsies. No changes were found that appeared to be specific for PUVA therapy. Psoralen, in the doses given as part of PUVA therapy for 1 year in a limited number of patients, seems to have little hepatotoxicity. The literature on the possible hepatotoxicity after treatment with psoralen followed by ultraviolet A irradiation is reviewed. Patients receiving PUVA therapy should have only limited alcohol intake. From this reading, psoralens as part of PUVA therapy appear to have little or no hepatotoxicity.

Changes in liver histology during methotrexate therapy of psoriasis correlated to the concentration of methotrexate and folate in erythrocytes.

To investigate, whether an assessment of the folate and methotrexate concentrations in erythrocytes could be used to indicate incipient histological liver changes, these 2 parameters were related to liver histology in series of liver biopsies (means 4.3 biopsies) from 31 long-term methotrexate-treated psoriasis patients. Logistic regression analysis showed that the probability of changes in liver histology during methotrexate therapy increased significantly with increasing erythrocyte methotrexate concentrations and with decreasing erythrocyte folate concentration. The application of these variables as a decisive criterion when to institute liver biopsy surveillance needs further studies, but can probably help reduce the number of liver biopsies to be taken during long-term methotrexate therapy considerably.