Allergic contact dermatitis from acrylic nails in a flamenco guitarist.

Acrylates are molecules that are well known for their strong sensitizing properties. Historically, many beauticians and individuals using store-bought artificial nail products have developed allergic contact dermatitis from acrylates. More recently, the use of acrylic nails among flamenco guitarists to strengthen their nails has become very popular. A 40-year-old non-atopic male patient working as a flamenco guitarist developed dystrophy, onycholysis and paronychia involving the first four nails of his right hand. The lesions were confined to the fingers where acrylic materials were used in order to strengthen his nails to play the guitar. He noticed improvement whenever he stopped using these materials and intense itching and worsening when he began reusing them. Patch tests were performed and positive results obtained with 2-hydroxyethyl methacrylate (2-HEMA), 2-hydroxyethyl acrylate (2-HEA), ethyleneglycol-dimethacrylate (EGDMA) and 2-hydroxypropyl methacrylate (2-HPMA). The patient was diagnosed with occupational allergic contact dermatitis likely caused by acrylic nails. Artificial nails can contain many kinds of acrylic monomers but most cases of contact dermatitis are induced by 2-HEMA, 2-HPMA and EGDMA. This is the first reported case of occupational allergic contact dermatitis from acrylates in artificial nails in a professional flamenco guitar player. Since the practice of self-applying acrylic nail products is becoming very popular within flamenco musicians, we believe that dermatology and occupational medicine specialists should be made aware of the potentially increasing risk of sensitization from acrylates in this setting.

[Problems in the transmission of information during within-hospital medical consultations and referrals]. / Problemas en la transmisión de información durante el proceso de la interconsulta médica hospitalaria.

OBJECTIVE: Within-hospital medical consultations and referrals (MCR) have many problems, among them are those related to the oral and written transmission of information. Our aim is to analyze problems in the transmission of information related to MCR, and possible differences between medical (MS) and surgical (SS) services. MATERIAL AND METHODS: A prospective, observational study was conducted on the MCR requested to Internal Medicine Service over an 8 month period. The following variables were collected: age, sex, the requester, MCR type, type of admission, comorbidity, hospital stay and mortality, length of MCR, the number of physicians responsible for the patient requesting service during the MCR, MCR repeats, information on the request, available medical records, verbal contact, conflict between doctors, and medical information in the discharge summary. RESULTS: Of the total 215 MCR received, 66 (30.7%) were requested by MS, and 149 (69.3%) per SS. MCR duration was 3 days (standard deviation [SD] 4.8. The number of doctors responsible was 1.7 (SD 1.1), with, Repeats 43 (20%) and Urgent 14 (6.5%). Minimum information on the request, 6 (9.1%) MS and 21 (27.5%) SS. Low availability of medical record, 2 (3%) MS and 50 (33.6%) SS. No verbal contact, 33 (15.4%). Conflict between doctors 13 (6%). Information acceptably good in MCR urgent request 100% MS, and 80% SS. Two out of three MCR were without reference to the discharge report. CONCLUSIONS: There are significant losses in the transmission of information during the process of the MCR, which is higher in surgical than in medical departments.

Nocardiosis cutánea primaria en un paciente en tratamiento con certolizumab / Primary Cutaneous Nocardiosis in a Man Treated With Certolizumab

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Problemas en la transmisión de información durante el proceso de la interconsulta médica hospitalaria / Problems in the transmission of information during within-hospital medical consultations and referrals

Objetivo: La interconsulta médica (ICM) tiene múltiples problemas, entre ellos están los relacionados con la transmisión oral y escrita de información. Nuestro objetivo es analizar problemas en la transmisión de información relacionada con la ICM, y posibles diferencias entre los servicios del área médica (AM) y quirúrgica (AQ). Material y métodos: Estudio observacional prospectivo de las ICM recibidas por Medicina Interna durante 8 meses. Analizamos edad, sexo, servicio peticionario, tipo de ICM, tipo de ingreso, comorbilidad, estancia y mortalidad hospitalarias, duración de la ICM, número de médicos del servicio solicitante responsables del paciente durante la ICM, repetición de ICM, información en la solicitud, historia clínica disponible, contacto verbal, conflicto entre médicos e información en el informe de alta. Resultados: Se recibieron 215 ICM, 66 (30,7%) solicitadas por AM y 149 (69,3%) por AQ. Duración de la ICM 3 días (desviación estándar [DE] 4,8). Médicos responsables 1,7 (DE 1,1). Hubo 43 repeticiones (20%). Urgentes 14 (6,5%). En 6 ICM (9,1%) del AM la información en la solicitud fue mínima y en 21 (27,5%) del AQ. Historia clínica disponible mínima en 2 ICM (3%) del AM y en 50 (33,6%) del AQ. Sin contacto verbal en 33 ICM (15,4%). Conflicto entre médicos 13 (6%). Información aceptable-buena en la solicitud de ICM urgente 100% AM y 80% AQ. Dos de cada 3 ICM sin referencia en el informe de alta. Conclusiones: Durante el proceso de la ICM existen pérdidas significativas en la transmisión de información, mayores en los servicios quirúrgicos que en los médicos (AU)

Objective: Within-hospital medical consultations and referrals (MCR) have many problems, among them are those related to the oral and written transmission of information. Our aim is to analyze problems in the transmission of information related to MCR, and possible differences between medical (MS) and surgical (SS) services. Material and methods: A prospective, observational study was conducted on the MCR requested to Internal Medicine Service over an 8 month period. The following variables were collected: age, sex, the requester, MCR type, type of admission, comorbidity, hospital stay and mortality, length of MCR, the number of physicians responsible for the patient requesting service during the MCR, MCR repeats, information on the request, available medical records, verbal contact, conflict between doctors, and medical information in the discharge summary. Results: Of the total 215 MCR received, 66 (30.7%) were requested by MS, and 149 (69.3%) per SS. MCR duration was 3 days (standard deviation [SD] 4.8. The number of doctors responsible was1.7 (SD 1.1), with, Repeats 43 (20%) and Urgent 14 (6.5%). Minimum information on the request,6 (9.1%) MS and 21 (27.5%) SS. Low availability of medical record, 2 (3%) MS and 50 (33.6%) SS. No verbal contact, 33 (15.4%). Conflict between doctors 13 (6%). Information acceptably good in MCR urgent request 100% MS, and 80% SS. Two out of three MCR were without reference to the discharge report. Conclusions: There are significant losses in the transmission of information during the process of the MCR, which is higher in surgical than in medical departments (AU)

Nódulo umbilical congénito en paciente de un año / Congenital Umbilical Nodule in a 1-Year-Old Infant

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