[Schizophrenia: subjective theories of illness. An explorative study. Part 2: Relatives]. / Schizophrenie: Subjektive Krankheitstheorien. Eine explorative Studie. Teil 2: Angehörige.

The growing acceptance of Zubin's vulnerability-stressor-modell in research and clinical practice stresses the importance of schizophrenic patients individual coping strategies. Coping strategies are influenced not only by individual cognitions concerning the actual illness but also by opinions of key-persons within the social network of the patient. Research on the acquisition of patients subjective view of the schizophrenic illness has to integrate both the individual psychological resources as well as the social context variables. The present paper reports about in depth open interviews with six patients and their key relatives. The results were derived from a structural analysis of the tape-recorded and transcribed interviews. Patients showed a broad variety of etiological explanations of their illness and expressed a need for more comprehensive information (part 1). Parents stated a more pessimistic prognosis of the course of illness than patients. Both patients and parents complained about the lack of mutual communication about the illness and its symptoms (part 2). Implications of these results concerning psychoeducational programs for patients and families as well are discussed.

[Schizophrenia: subjective illness theories--an explorative study. 1: Patients]. / Schizophrenie: Subjektive Krankheistheorien--Eine explorative Studie. Teil 1: Patienten.

The growing acceptance of Zubin's vulnerability-stressor-model in research and clinical practice stresses the importance of schizophrenic patients individual coping strategies. Coping strategies are influenced not only by individual cognitions concerning the actual illness but also by opinions of key-persons within the social network of the patient. Research on the acquisition of patients subjective view of the schizophrenic illness has to integrate both the individual psychological resources as well as the social context variables. The present paper reports about in depth open interviews with six patients and their key relatives. The results were derived from a structural analysis of the tape-recorded and transcribed interviews. Patients showed a broad variety of etiological explanations of their illness and expressed a need for more comprehensive information (part 1). Parents stated a more pessimistic prognosis of the course of illness than patients. Both patients and parents complained about the lack of mutual communication about the illness and its symptoms (part 2). Implications of these results concerning psychoeducational programs for patients and families as well are discussed.

Occupational allergic disease in cereal workers by stored grain pests.

It is well known that workers occupationally exposed to grain dust have a high prevalence of respiratory symptoms, but their pathogenesis remains obscure when sensitization to cereal flour cannot be demonstrated. Storage mites, tenebroids, and cockroaches are stored-grain pests found in grain and cereal products frequently in our area, where the cereal industry is the most important industry. An epidemiological analysis of sensitization of these stored-grain pests was performed on 4379 patients residing in an area of cereal industries. Fifty grain workers were selected for in vivo diagnostic tests with nine genera of mites, Tenebrio molitor and Blatta orientalis. Specific IgE antibodies to the extracts were demonstrated by prick tests and RAST. Association between respiratory symptoms and occupational exposure was confirmed by challenge tests (specific and methacholine). The prevalence of mite sensitization in the total sample studied (4379) was 18.96% (SEM 0.58, 95% CI 16.93-19.19). The prevalence of sensitization to storage mites among mite-sensitive patients was 11.88% (SEM 1.15, 95% CI 9.63-14.3). Among the 50 selected patients the most frequent sensitization was that to Dermatophagoides pteronyssinus (58%), followed by Dermatophagoides frinae (48%), Lepidoglyphus destructor and Tyrophagus putrescentiae (38%), Blomia kulagini (34%), and Acarus siro and Chortoglyphus arcuatus (24%). In addition, 22% of the patients presented negative prick tests and RAST for Dermatophagoides species with positive test to storage mites. Fifty percent of the 50 patients were sensitizated to Tenebrio molitor (SEM 0.7, CI 95% 36-64), and 36% to Blatta orientalis (SEM 0.67, CI 95% 23-49). The identification of mites, tenebroids, and cockroaches in dust samples yields useful data for the diagnosis of our patients.

Occupational allergy to mites in salty ham, chorizo and cheese.

We present three cases of occupational allergy caused by the manipulation of food: cheese, chorizo (typical Spanish salami) and salty ham. A IgE-mediated sensitization is demonstrated by skin tests, RAST and positive challenge tests to Acarus siro and Blomia kulagini of the cheese rind, Euroglyphus maynei of the "chorizo" and Tyrophagus putrescentiae of the salty ham.

Delayed-type hypersensitivity to subcutaneous enoxaparin.

BACKGROUND: Enoxaparin and other low-molecular-weight heparins are widely used to prevent and treat thromboembolic disorders. Cutaneous reactions secondary to enoxaparin injections include delayed hypersensitivity skin reactions described as erythematous, infiltrated plaques at injection sites. We studied three cases of erythematous infiltrated plaques after enoxaparin injection in order to establish the allergenic importance of this low-molecular-weight heparin. METHODS: Patch tests were performed with sodium heparin, calcium heparin, calcium enoxaparin, and calcium nadroparin. A subcutaneous test with calcium heparin and an intravenous challenge test with sodium heparin were done. A punch biopsy was obtained from an erythematous plaque in one patient. RESULTS: Patch tests were negative to calcium heparin in all patients, positive to enoxaparin and nadroparin in two patients, and positive to sodium heparin in one patient. In two patients, the subcutaneous challenge test was positive, the intravenous challenge test was negative, and the histopathologic appearance of the biopsy resembled a delayed-type hypersensitivity reaction. CONCLUSIONS: These cases provide evidence of type IV hypersensitivity and the possibility of crossed-allergenicity among unfractionated heparin and low-molecular-weight heparins. We show that the subcutaneous challenge test is the most reliable diagnostic measure.