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This is the first synthetic report of (3S,4R)-dihydroxy-N-alkyl-l-homoprolines described so far. 2,4-O-Benzylidene-d-erythrose was obtained from d-glucose with an improved yield, and then transformed into the title (3S,4R)-dihydroxy-N-alkyl-l-homoprolines, in a two-step strategy, with excellent overall yields. Hydrogenolysis of the benzyl group led to the NH congener. The synthesis of final products from 1,4-lactone intermediates was studied by computational means either under acidic or basic conditions. The theoretical mechanism studies fully explain the experimental results: (a) an equilibrium between l-homoprolines and their bicyclic counterparts is established in acids; (b) the equilibrium suffers a complete displacement towards the l-homoproline side in a basic medium.
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Varicella zoster virus (VZV) primary infection usually causes varicella and its reactivation may lead to different clinical manifestations depending on the site of viral reactivation and its subsequent tissue spread. There is a growing recognition of the association between VZV reactivation and ensuing cerebrovascular accidents (CVA). The virus can spread to cerebral arteries, causing a wide clinical spectrum related to VZV vasculopathy. Herein we present an 80-year-old man with a previously undiagnosed immunosuppressive condition, admitted with disseminated herpes zoster, who subsequently developed an acute ischemic CVA and showed a substantial neurologic recovery under antiviral therapy.
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Dermatólogos , Herpes Zóster/diagnóstico , Infarto de la Arteria Cerebral Media/diagnóstico por imagen , Leucemia Linfocítica Crónica de Células B/diagnóstico , Rol del Médico , Anciano de 80 o más Años , Antivirales/uso terapéutico , Herpes Zóster/complicaciones , Herpes Zóster/tratamiento farmacológico , Herpes Zóster/inmunología , Herpesvirus Humano 3 , Humanos , Huésped Inmunocomprometido/inmunología , Infarto de la Arteria Cerebral Media/etiología , Infarto de la Arteria Cerebral Media/fisiopatología , Leucemia Linfocítica Crónica de Células B/complicaciones , Leucemia Linfocítica Crónica de Células B/inmunología , Masculino , Accidente Cerebrovascular , Tomografía Computarizada por Rayos X , Activación ViralRESUMEN
BACKGROUND: The increasing use of long-lasting nail aesthetic products has led to a growing number of cases of allergic contact dermatitis (ACD) caused by (meth)acrylates in recent years. OBJECTIVES: To provide information on ACD caused by (meth)acrylates related to nail cosmetic products. METHODS: We retrospectively reviewed files of patients with ACD caused by (meth)acrylates related to nail cosmetic products, who were patch tested between January 2011 and December 2015 in 13 departments of dermatology in Portugal. RESULTS: Two-hundred and thirty cases of ACD caused by (meth)acrylates (55 technicians, 56 consumers, and 119 with mixed exposure) had been documented, mostly as chronic hand eczema (93%). The most common sensitizers were: 2-hydroxyethyl methacrylate (HEMA), which was positive in 90% of the tested patients, 2-hydroxypropyl methacrylate (HPMA), which was positive in 64.1%, and ethyleneglycol dimethacrylate, which was positive in 54.5%. CONCLUSION: HEMA and HPMA were the most frequent positive allergens. HEMA, which identified 90% of cases, can be considered to be a good screening allergen. The high number of cases of ACD caused by (meth)acrylates in nail cosmetic products certainly warrants better preventive measures at the occupational level, and specific regulation in the field of consumer safety.
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Alérgenos/efectos adversos , Dermatitis Alérgica por Contacto/etiología , Dermatitis Profesional/etiología , Metacrilatos/efectos adversos , Humanos , Pruebas del Parche , Portugal , Estudios RetrospectivosAsunto(s)
Dermatitis Alérgica por Contacto/etiología , Dermatitis Profesional/etiología , Dermatosis Facial/etiología , Erupciones Liquenoides/etiología , Metalurgia , Estaño/efectos adversos , Adulto , Brazo , Dermatitis Alérgica por Contacto/diagnóstico , Dermatitis Profesional/diagnóstico , Dermatosis Facial/diagnóstico , Humanos , Erupciones Liquenoides/diagnóstico , Masculino , Pruebas del Parche , TóraxRESUMEN
Wildfires in the Mediterranean basin, especially in Portugal, have increased in extent and frequency over the last few years. One of the impacts of wildfires on humans and ecosystems is on the water quality of surface waters. Ashes and increased erosion rates might, for example, change oxygen levels and elevate the influx of sediments, nutrients, or other water quality-related components like metals and polycyclic aromatic hydrocarbons (PAHs), possibly affecting water supply. In this study, time series of eight water quality parameters: biological- and chemical oxygen demand (BOD and COD), electrical conductivity (EC), total phosphorous (TP), nitrate (NO3-), total suspended sediments (TSS), dissolved oxygen (DO), and pH, were assessed via changepoint analysis to identify events of post-fire water contamination in over 60 Portuguese reservoirs. Further, possible fire, watershed, reservoir, and climate-related drivers were linked with the occurrence of these contamination events through logistic regression using generalized additive models. All measured parameters exhibited post-fire changes, with some being more frequently affected than others. The concentrations of TP, NO3-, and TSS showed a noticeable increase following 9.6 %, 12.6 %, and 13.6 % of all wildfires, respectively. Most changes fell into the unusually large fire seasons of 2003-2005 and 2017. The most significant impacts could be seen in southern reservoirs after the fire seasons of 2003-2005. The burned area ratio of the watershed was identified as the main driver of post-fire water contamination, while reservoir and climate-related characteristics like water levels also played a significant role in some parameters. Increased levels of suspended sediments were identified as a potential threat to water supply, especially when large wildfires coincide with drought-induced low reservoir water levels. The identification of post-fire water contamination events and their drivers from large datasets can inform water managers about potential threats to water supply.
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Dermatitis Fotoalérgica/etiología , Dermatosis Facial/etiología , Fenofibrato/efectos adversos , Hipolipemiantes/efectos adversos , Pruebas del Parche/métodos , Rayos Ultravioleta/efectos adversos , Acrilatos/efectos adversos , Antiinflamatorios no Esteroideos/efectos adversos , Femenino , Humanos , Cetoprofeno/efectos adversos , Persona de Mediana Edad , Propanoles/efectos adversosRESUMEN
UNLABELLED: Study Type - Therapy (case series) Level of Evidence 4. What's known on the subject? and What does the study add? Until now, the transvaginal approach has been the only method of removing larger specimens from the abdominal cavity using natural orifice transluminal endoscopic surgery. There has been no means of extracting larger specimens in men and the means are restricted even in women, particularly in young women. The present study shows that the difficulty of large specimen retrieval can be overcome, irrespective of the diameter of the chosen port, through natural orifices using morcellation. OBJECTIVE: To show, in a porcine model, the feasibility of a complete transvesical natural orifice transluminal endoscopic surgery (NOTES) nephrectomy with kidney extraction after morcellation through the same port. MATERIALS AND METHODS: Transvesical nephrectomy and morcellation were performed in six pigs at Minho University, Braga, Portugal after institutional review board approval. The transvesical port and the cystotomy were created under the guidance of a ureteroscope, while the remaining steps were done under the guidance of an operating telescope. Dissection of the renal vessels and kidney was performed using dissection grasping forceps and a vessel sealing system (LigaSure(™) ; Covidien, Mansfield, MA, USA) and morcellation was done using a Piranha(™) morcellator (Richard Wolf, Knittlingen, Germany). RESULTS: There were no complications related to the creation of transvesical access. The image provided by the telescope was superior to that of the ureteroscope, especially underwater. Morcellation was quick and effective, with the support of a fixing needle through the abdominal wall, designed to fix the kidney, after laceration of a bowel loop occurred in the first experiment. It was found that technical improvements are needed to ensure safety of NOTES morcellation. CONCLUSIONS: Kidney morcellation after nephrectomy, using a natural orifice exclusively, is feasible. Despite technical limitations, this proof of concept study can be regarded as a potential step towards the application of NOTES in urology.
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Enfermedades Renales/cirugía , Riñón/cirugía , Cirugía Endoscópica por Orificios Naturales/métodos , Nefrectomía/métodos , Animales , Modelos Animales de Enfermedad , Estudios de Factibilidad , Femenino , PorcinosRESUMEN
BACKGROUND: Sulfites, preservatives and antioxidants used in the cosmetic, pharmaceutical and food industry are contact allergens whose relevance seems to be difficult to establish. OBJECTIVES: To perform a retrospective study on patients patch tested with a sulfite. Materials and methods. Between 1990 and 2010, 2763 patients were patch tested with sodium metabisulfite. The reactions were considered to be relevant if there was a clear relationship between the dermatitis and sulfite exposure. RESULTS: One hundred and twenty-four (4.5%) of 2763 patients patch tested positively to sodium metabisulfite. The most frequent localizations of the lesions were the face (40.3%) and the hands (24.2%). Six patients also reported systemic symptoms. Thirteen cases (10.5%) were occupational, 10 of them presenting with hand eczema. Sodium metabisulfite was the single allergen found in 76 cases (61.3%). The reactions were considered to be relevant in 80 cases (64.5%), of which 11 were occupational. CONCLUSIONS: Allergic contact dermatitis caused by sulfites is frequent and often relevant. One should be aware of possible relevant sources of exposure, particularly in occupational settings such as hairdressing and the food industry, and in pharmaceutical and cosmetic products. Patch testing with sodium metabisulfite, which seems to be the best indicator for sulfite contact allergy, is also useful in cases of immediate reactions to sulfite-containing products.
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Dermatitis Alérgica por Contacto/etiología , Exposición Profesional/efectos adversos , Sulfitos/efectos adversos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Antifúngicos/efectos adversos , Niño , Dermatosis Facial/inducido químicamente , Femenino , Conservantes de Alimentos/efectos adversos , Tinturas para el Cabello/efectos adversos , Dermatosis de la Mano/inducido químicamente , Humanos , Masculino , Persona de Mediana Edad , Pruebas del Parche , Conservadores Farmacéuticos/efectos adversos , Estudios Retrospectivos , Cuero Cabelludo , Torso , Adulto JovenRESUMEN
Essential oils (EOs) are complex mixtures of volatile compounds extracted from different parts of plants by different methods. There is a large diversity of these natural substances with varying properties that lead to their common use in several areas. The agrochemical, pharmaceutical, medical, food, and textile industry, as well as cosmetic and hygiene applications are some of the areas where EOs are widely included. To overcome the limitation of EOs being highly volatile and reactive, microencapsulation has become one of the preferred methods to retain and control these compounds. This review explores the techniques for extracting essential oils from aromatic plant matter. Microencapsulation strategies and the available technologies are also reviewed, along with an in-depth overview of the current research and application of microencapsulated EOs.
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Surface disinfection currently plays a decisive role in the epidemiological situation caused by the SARS-CoV-2 coronavirus. However, most disinfection products available on the market have a high evaporation rate and only an immediate action and not continuous, creating the need for a high frequency of disinfection. To overcome this limitation, in the present work, poly(methyl methacrylate) (PMMA) microcapsules were developed with an active agent (hydrogen peroxide) encapsulated, which has the ability to inactivate/neutralize the SARS-CoV-2 virus. PMMA-H2O2 microcapsules have a spherical shape and a smooth structure with low porosity and were successfully attached to nonwoven fabrics, as observed from scanning electron microscopy. The thermogravimetric analysis shows that PMMA-H2O2 microcapsules have high thermal stability and can increase the stability of H2O2. Nonfabric substrates functionalized with PMMA-H2O2 microcapsules were tested by a highly sensitive and specific reverse transcription-quantitative real-time polymerase chain reaction (RT-qPCR)-based method to evaluate antiviral activity through the degradation of SARS-CoV-2 deoxyribonucleic acids. The highest percentage of viral nucleic acid elimination was obtained when exposing the viral sample for 1 h to PMMA-H2O2 microcapsules, resulting in an elimination of >97% of the coronavirus. In addition, the microcapsules are stable over a period of three weeks and retain the ability to eliminate SARS-CoV-2. Hence, it is demonstrated that this microcapsule system is efficient for SARS-CoV-2 elimination and inherent surface disinfection.
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Dear Editor, Angiolymphoid hyperplasia with eosinophilia (ALHE) is a rare, locally proliferating disorder that affects predominantly the head and neck region (1,2). There seems to be a higher incidence in middle-aged Caucasian women (2,3). A 28-year-old female patient with no relevant personal or family medical history and only taking an oral contraceptive, presented to our department with multiple, well delimited, infracentimetric erythematous papules with a smooth surface on the left frontal, temporal, and preauricular regions (Figure 1). The lesions had appeared 7 months earlier, with progressive growth in number and dimensions since. The patient reported pruritus and denied previous trauma, topical application of any sort, insect bite at these locations, and any other accompanying symptoms. A thorough physical examination revealed no additional abnormalities. An excisional biopsy of one of the left temporal papules revealed a prominent lymphoid component, with a dense multinodular infiltrate in the superficial and deep dermis, with reactive germinative centers of considerable dimensions (Figure 2). Large and atypical lymphocytes were confined to the germinative centers, with reactive characteristics. Lymphocytes surrounding the germinative centers were predominantly small, accompanied by a significant number of scattered eosinophils. CD3 and CD20 immunohistochemical staining revealed B-cells predominantly in the nodular areas corresponding to the germinative centers, while T-cells displayed a diffuse peripheral distribution. There was severe neovascularization, with thick-walled vascular channels lined by enlarged plump endothelial cells with an "epithelioid" appearance. These findings supported the diagnosis of angiolymphoid hyperplasia with eosinophilia (ALHE). Laboratory workup did not show any abnormalities, including eosinophilia or elevation of immunoglobulin E levels. Due to pruritus and aesthetic concerns, surgical excision of the larger and most symptomatic papules was performed. The patient was assured of the benign nature of the disease and informed about the possible development of new lesions. Kept under clinical surveillance, the patient remained free of new lesions at 6-month follow-up. ALHE generally presents as solitary or multiple erythematous or hyperpigmented dome-shaped papulonodules. Lesions can be pruritic or painful and do not tend to resolve spontaneously (4). The pathogenesis of ALHE remains controversial, although some theories have been suggested. The most widely accepted hypothesis is that it is an angioproliferative process, accompanied by an inflammatory infiltrate, reactive to several stimuli (3). Some authors believe it is an allergic reaction, but no specific sole agent has been identified (5). Others claim ALHE may represent a T-cell lymphoproliferative disorder of benign or low-grade malignant nature (6). Some recent studies suggest that ALHE pathogenesis may be related to a vascular malformation secondary to a subcutaneous arteriovenous shunt (1-3). Histologically there are both vascular and inflammatory components, with an abnormal vascular proliferation and diffuse lymphocytic infiltrates with eosinophils. The vascular component is formed by capillaries clustered around arterial or venous vessels, dilated and atypical, with a protruded endothelium (3). The main differential diagnosis of ALHE is Kimura's disease, and there has been some discussion regarding the relationship between these two entities due to their clinical and histopathological similarities. However, most studies currently agree that they are distinct diseases. The differential diagnosis also includes angiosarcoma, particularly the epithelioid variant, epithelioid hemangioendothelioma, Kaposi sarcoma, pyogenic granuloma, and cutaneous metastasis (3). ALHE usually requires treatment as spontaneous regression, although reported in the literature, is rare (1,3). Many options have been suggested, with variable levels of success, but there is no definitive treatment for this condition (2). Surgical excision is the preferred choice, but recurrence may happen if the excision is incomplete (1). Mohs micrographic surgery with excision of abnormal vessels at the base of the lesion may be more effective in reducing recurrences (4). Other treatments reported include laser therapy (pulsed dye, CO2, copper vapor), systemic or intralesional corticosteroid injection, cryotherapy, imiquimod, tacrolimus, isotretinoin, radiotherapy, interferon alfa 2a, anti-interleukin-5 antibody, photodynamic therapy, and methotrexate (1). In the present case the diagnosis of ALHE was established through the conjunction of clinical and histological findings. Although a rare entity, its predominantly facial involvement in young adults and the absence of a satisfactory treatment can produce a significant impact that can include the quality of life of the patients.
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Hiperplasia Angiolinfoide con Eosinofilia/diagnóstico , Hiperplasia Angiolinfoide con Eosinofilia/terapia , Dermatosis Facial/diagnóstico , Dermatosis Facial/terapia , Adulto , Femenino , HumanosRESUMEN
Multinucleate cell angiohistiocytoma is a rare idiopathic benign fibrohistiocytic and vascular proliferation usually presenting as multiple asymptomatic papules, red to violaceous in colour, primarily located on the extremities of middle-aged females. This entity is probably underdiagnosed due to the lack of recognition by clinicians and pathologists. We describe a patient with a multinucleate cell angiohistiocytoma of the face, a less frequent localization, in order to increase awareness of this entity and elucidate its clinical, histopathological, and immunohistochemistry features.
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Neoplasias Faciales/patología , Histiocitoma Fibroso Benigno/patología , Neoplasias Cutáneas/patología , Biopsia , Mejilla/patología , Eritema/patología , Neoplasias Faciales/diagnóstico , Femenino , Histiocitoma Fibroso Benigno/diagnóstico , Humanos , Persona de Mediana Edad , Neoplasias Cutáneas/diagnósticoRESUMEN
INTRODUCTION: Birt-Hogg-Dubé syndrome (BHDS) is a rare autosomal dominant genodermatosis characterized by cutaneous fibrofolliculomas and/or trichodiscomas, lung cysts, spontaneous pneumothorax and renal tumors. However, its clinical expression is highly variable. This syndrome is caused by germline mutations in the folliculin gene (FLCN) on chromosome 17p11.2. MAIN OBSERVATIONS: Two men, 60 and 39-year-old, presented with a several year history of asymptomatic whitish papules scattered over the face and neck. Skin biopsies revealed fibrofolliculomas. The clinical diagnosis of BHDS was corroborated by identification of new heterozygotic mutations in FLCN gene, in exon 6 (C.573_574delinsT) and in exon 9 (c.1015C>T), respectively. Computed tomography scan of the thorax and abdomen showed pulmonary cysts with no suspicious kidneys lesions, and, in the case of the second patient, a mass in left adrenal gland. Laparoscopic left adrenalectomy was performed and histopathological examination was compatible with a malignant perivascular epithelioid cell tumor. CONCLUSIONS: The presence of multiple fibrofolliculomas should raise the suspicion of BHDS. Patients with this syndrome, regardless of the detected mutation, should be carefully monitored to ensure that potentially serious disease-related conditions can be detected early.
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This study is focused in mapping the structural fire risk in the vegetated area of Portugal using a deterministic approach based on the concept of fire risk currently accepted by the scientific community which consists in the combination of the fire hazard and the potential economic damage. The fire susceptibility map of Verde and Zêzere (2010) was adopted and updated by the use of a higher resolution digital terrain model, longer burnt area perimeter dataset (1975-2013) and the entire set of Corine land cover inventories. The susceptibility was mapped with five classes to be in accordance with the Portuguese law and the results confirms the good performance of this model not only in the favourability scores but also in the predictive values. Three different scenarios of (maximum, mean, and minimum annual) burnt area were consider to estimate the fire hazard which allow to estimate the likelihood of a pixel to burn (ranging between 0% and 20%) depending on the class to which it belongs and on the future burnt area scenario. The potential economic damage was estimated with the vulnerability scores and monetary values of species defined in the literature and by law. The obtained fire risk map identifies the areas more prone to be affected by fires in the future and provides an estimate of the economic damage of the fire which will be a valuable tool for forest and fire managers and to minimize the economic and environmental consequences of vegetation fires in Portugal.
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The present study focuses on the dependence of the space-time permutation scan statistics (STPSS) (1) on the input database's characteristics and (2) on the use of this methodology to assess changes on the fire regime due to different type of climate and fire management activities. Based on the very strong relationship between weather and the fire incidence in Portugal, the detected clusters will be interpreted in terms of the atmospheric conditions. Apart from being the country most affected by the fires in the European context, Portugal meets all the conditions required to carry out this study, namely: (i) two long and comprehensive official datasets, i.e. the Portuguese Rural Fire Database (PRFD) and the National Mapping Burnt Areas (NMBA), respectively based on ground and satellite measurements; (ii) the two types of climate (Csb in the north and Csa in the south) that characterizes the Mediterranean basin regions most affected by the fires also divide the mainland Portuguese area; and, (iii) the national plan for the defence of forest against fires was approved a decade ago and it is now reasonable to assess its impacts. Results confirmed (1) the influence of the dataset's characteristics on the detected clusters, (2) the existence of two different fire regimes in the country promoted by the different types of climate, (3) the positive impacts of the fire prevention policy decisions and (4) the ability of the STPSS to correctly identify clusters, regarding their number, location, and space-time size in spite of eventual space and/or time splits of the datasets. Finally, the role of the weather on days when clustered fires were active was confirmed for the classes of small, medium and large fires.
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Abstract: Multinucleate cell angiohistiocytoma is a rare idiopathic benign fibrohistiocytic and vascular proliferation usually presenting as multiple asymptomatic papules, red to violaceous in colour, primarily located on the extremities of middle-aged females. This entity is probably underdiagnosed due to the lack of recognition by clinicians and pathologists. We describe a patient with a multinucleate cell angiohistiocytoma of the face, a less frequent localization, in order to increase awareness of this entity and elucidate its clinical, histopathological, and immunohistochemistry features.
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Humanos , Femenino , Persona de Mediana Edad , Neoplasias Cutáneas/patología , Neoplasias Faciales/patología , Histiocitoma Fibroso Benigno/patología , Neoplasias Cutáneas/diagnóstico , Biopsia , Neoplasias Faciales/diagnóstico , Mejilla/patología , Histiocitoma Fibroso Benigno/diagnóstico , Eritema/patologíaRESUMEN
Spontaneous ileopsoas hematoma is a rare and potentially lethal complication of liver cirrhosis, with exceptional mention in medical literature. In this article we present a clinical case diagnosed in a patient with alcoholic liver cirrhosis.
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Hematoma/etiología , Cirrosis Hepática Alcohólica/complicaciones , Enfermedades Musculares/etiología , Músculos Psoas , Resultado Fatal , Humanos , Masculino , Persona de Mediana EdadRESUMEN
We report a case of a 26-year-old Caucasian male presented with 8-month history of asymptomatic erythematous papulonodular lesions symmetrically located on the face, trunk and limbs. Histopathologic examination revealed granulomas with histiocytes arranged in a palisading pattern around the foci of necrobiotic collagen with mucin deposition, and transepidermal and transfollicular elimination of degenerated collagen bundles. These histopathologic findings were compatible with perforating granuloma annulare. Three months later, the patient was admitted with the diagnosis of sepsis secondary to a gastroenteritis dyeing on the fourth day of presentation. Serologic tests for antibody to human immunodeficiency virus (HIV) performed at this time were positive establishing the diagnosis of acquired immunodeficiency syndrome (AIDS). Atypical variants of granuloma annulare including perforating types might be associated with AIDS. The course and presentation of granuloma annulare might be modified by disruption of both antigen presentation and effector cell mechanisms in the HIV-infected patient.