Dermatitis de contacto alérgica por fragancias. Parte II / Allergic Contact Dermatitis to Fragrances: Part 2

La dermatitis de contacto alérgica por fragancias suele presentarse clínicamente como un eczema subagudo o crónico debido a la ubicuidad de este alérgeno en los productos de uso cotidiano y el contacto repetido. El paciente típico es una mujer de edad media con afectación de las manos y la cara, aunque la localización de las lesiones variará dependiendo del alérgeno y del producto causante. Dentro de la batería estándar del Grupo Español en Investigación de Dermatitis de Contacto y Alergia Cutánea (GEIDAC) están incluidos 4 marcadores de fragancias: el bálsamo del Perú, la mezcla de fragancias I, la mezcla de fragancias II y el lyral. En caso de que alguno de estos marcadores sea positivo está indicada la utilización de una serie de fragancias específicas para el diagnóstico. Esto, unido a la nueva legislación que obliga a la industria a notificar qué ingredientes y fragancias utiliza en sus productos, nos ayudará a la resolución de la dermatitis de pacientes alérgicos (AU)

Allergic contact dermatitis due to fragrances usually manifests as subacute or chronic dermatitis because fragrances are found in a wide range of products to which patients are repeatedly exposed. The typical patient is a middle-aged woman with dermatitis on her hands and face, although other sites may be affected depending on the allergen and the product in which it is found. The standard patch test series of the Spanish Contact Dermatitis and Skin Allergy Research Group (GEIDAC) contains 4 fragrance markers: balsam of Peru, fragrance mix I, fragrance mix II, and lyral. Testing with a specific fragrance series is recommended in patients with a positive result to any of these 4 markers. The use of a specific fragrance series and new legislation obliging manufacturers to specify the fragrances used in their products, will help to improve the management of allergic contact dermatitis due to fragrances (AU)

Allergic contact dermatitis to fragrances: part 2.

Allergic contact dermatitis due to fragrances usually manifests as subacute or chronic dermatitis because fragrances are found in a wide range of products to which patients are repeatedly exposed. The typical patient is a middle-aged woman with dermatitis on her hands and face, although other sites may be affected depending on the allergen and the product in which it is found. The standard patch test series of the Spanish Contact Dermatitis and Skin Allergy Research Group (GEIDAC) contains 4 fragrance markers: balsam of Peru, fragrance mix i, fragrance mix ii, and lyral. Testing with a specific fragrance series is recommended in patients with a positive result to any of these 4 markers. The use of a specific fragrance series and new legislation obliging manufacturers to specify the fragrances used in their products, will help to improve the management of allergic contact dermatitis due to fragrances.

Dermatitis de contacto alérgica por fragancias. Parte I / Allergic Contact Dermatitis to Fragrances. Part 1

Las fragancias son un grupo amplio de sustancias que representan la segunda causa más frecuente de dermatitis de contacto alérgica en nuestro medio. Son alérgenos ubicuos en nuestra sociedad a los cuales nos exponemos de manera continua y diaria. Actualmente, la batería estándar española tiene buenos marcadores para su detección, pero no ideales. En los últimos años han surgido nuevos marcadores que han sido incluidos en baterías de otros países y han demostrado ser rentables. El diagnóstico de esta entidad adquiere mayor importancia a partir de la entrada en vigor de la ley que obliga a la industria a especificar una lista de 26 ingredientes considerados fragancias en productos comerciales. El objetivo de este artículo es realizar una actualización en la dermatitis de contacto alérgica a fragancias. Revisamos las principales fuentes de exposición, las manifestaciones clínicas y proponemos un protocolo de diagnóstico y manejo terapéutico de estos pacientes (AU)

Fragrances are a large group of substances and the second most common cause of allergic contact dermatitis in Spain. These potential allergens are extremely common and the general population is subject to continuous exposure on a daily basis. While the fragrance markers included in the current Spanish standard patch test series are good, there is room for improvement. New markers that have emerged in recent years have proven to be of value in standard series used in other countries. Diagnosing fragrance allergy has taken on even greater importance since the European Union added 26 fragrances to its list of mandatory ingredients to be specified on product labels. The aim of this review is to provide an update on allergic contact dermatitis to fragrances. We examine the main sources of exposure and clinical manifestations of this condition and propose a diagnostic and treatment protocol (AU)

Allergic contact dermatitis to fragrances. Part 1.

Fragrances are a large group of substances and the second most common cause of allergic contact dermatitis in Spain. These potential allergens are extremely common and the general population is subject to continuous exposure on a daily basis. While the fragrance markers included in the current Spanish standard patch test series are good, there is room for improvement. New markers that have emerged in recent years have proven to be of value in standard series used in other countries. Diagnosing fragrance allergy has taken on even greater importance since the European Union added 26 fragrances to its list of mandatory ingredients to be specified on product labels. The aim of this review is to provide an update on allergic contact dermatitis to fragrances. We examine the main sources of exposure and clinical manifestations of this condition and propose a diagnostic and treatment protocol.

Allergic Contact Dermatitis to Fragrances. Part 1. / Dermatitis de contacto alérgica por fragancias. Parte I.

Fragrances are a large group of substances and the second most common cause of allergic contact dermatitis in Spain. These potential allergens are extremely common and the general population is subject to continuous exposure on a daily basis. While the fragrance markers included in the current Spanish standard patch test series are good, there is room for improvement. New markers that have emerged in recent years have proven to be of value in standard series used in other countries. Diagnosing fragrance allergy has taken on even greater importance since the European Union added 26 fragrances to its list of mandatory ingredients to be specified on product labels. The aim of this review is to provide an update on allergic contact dermatitis to fragrances. We examine the main sources of exposure and clinical manifestations of this condition and propose a diagnostic and treatment protocol.

Transcylindrical cholecystectomy: new technique for minimally invasive cholecystectomy.

Minilaparotomy cholecystectomy presents exposition difficulties, and laparoscopy requires expensive equipment and additional training. Laparotomy is more painful, causes trauma to the abdominal wall, and requires a longer convalescence; it is also less aesthetic. We present a new technique for minilaparotomy cholecystectomy, transcylindrical cholecystectomy (TC), based on the introduction of a 3.8- or 5.0-cm diameter cylinder (10.0 cm long). The cylinder serves the purpose of separating and isolating the hepatocystic triangle from the surrounding structures, thereby providing a stable surgical field and adequate vision of the hepatocystic triangle so the technique can be performed safely. Patients who have been diagnosed with symptomatic cholelithiasis, who are convalescent from biliary pancreatitis, or who have acute cholecystitis have been treated consecutively by TC. We have carried out the procedure on 116 occasions, 94 using the 3.8-cm cylinder and 28 with the 5.0-cm cylinder; both cylinders were used in 6 cases. The indications for using the 5.0-cm cylinder were mainly cholecystitis, pancreatitis, choledocholithiasis, and difficulty with the 3.8-cm cylinder. The result is a 4.5- or 7.0-cm incision. We had difficulty recognizing the anatomy in 11 dissections so we had to enlarge the incision. We have not had accidents related to placement of the cylinder, hemorrhage, or bile duct injuries. The median operating time was 43 minutes, and the mean postoperative stay was 1.8 days. Postoperative FVC and FEV, reductions were 21.7% and 27.4%, respectively. The technique has proved fast, safe, and practicable using conventional material. The cost of TC is $701 (US).

Headache in acute cerebrovascular disease: a prospective clinical study in 240 patients.

To evaluate the clinical features of headache in stroke, a prospective study was carried out in 240 consecutive patients with acute stroke who had intact expressive function. Headache occurred in 38%: 32% of 195 patients with ischemic stroke and 64.5% of 45 patients with hemorrhagic stroke (p < 0.0001). Headache patients were younger (mean age 62 +/- 15 vs 67 +/- 11.5 years) than non-headache patients (p < 0.01). A history of previous vascular or tension-type headache was found in 40.5% of the headache group, but in only 23.5% of the non-headache group (p < 0.01). In ischemic stroke, headache was observed in 41% of thrombotic infarcts, in 39% of cardioembolic infarcts, in 23% of lacunar infarcts and in 26% of TIA. Headache was significantly more common in thrombotic than lacunar infarcts (p < 0.05). In hemorrhagic stroke, headache was observed in all subarachnoid hemorrhages and in 58% of intraparenchymal hemorrhages. In ischemic stroke, the mean duration of the headache was 25 +/- 28 h and in hemorrhagic stroke 64.5 +/- 36.5 h (p < 0.00001). In ischemic stroke the headache was focal in 74% and mild or moderate in intensity in 74%. In hemorrhagic stroke, it was diffuse in 52% and the pain intensity was incapacitating in 70%. Headache was more common in vertebrobasilar stroke (59%), in comparison with carotid stroke (26%) or stroke of unclear vascular topography (33%) (p < 0.00001). Fifty-six and a half percent of patients with cortical stroke had headaches, as opposed to only 26.5% of patients with subcortical stroke (p < 0.005).(ABSTRACT TRUNCATED AT 250 WORDS)

[Headache in acute cerebrovascular ischemic disease: a prospective clinical study of 195 patients]. / Cefalea en la enfermedad cerebrovascular isquémica aguda: estudio clínico prospectivo de 195 pacientes.

BACKGROUND: Headache is a little known aspect in the study of acute ischemic cerebrovascular disease (AICVD). METHODS: To contribute to the knowledge of the clinical characteristics of headache in the different nosologic entities of AICVD a prospective study was performed in 195 patients consecutively studied by CT scan and/or cerebral MRI. RESULTS: There was headache in 32% of the total and in 41% of the thrombotic infarctions, 39% of the cardioembolisms, 26% of the transient ischemic attacks (TIA) and 23% of the lacunar infarcts. The mean duration was 25 +/- 28 hours. Headache was focal in 74% of the cases and of slight or moderate intensity in 74%. Headache was significantly more common in thrombotic infarctions than in lacunar ones (p < 0.05). It was more frequent when the topography is vertebrobasilar (57.5%), in comparison with carotid (21%) or undetermined (17.5%) (p < 0.0001). Headache was more common when topography was cortical (56.5%) in comparison with subcortical (26.5%) (p < 0.005). Eight per cent of the patients presented sentinel headache: 22% of the cardioembolic infarctions, 7% of the lacunars, 6.5% of the TIA and 5.5% of the thrombotic. CONCLUSIONS: Headache in acute ischemic cerebrovascular disease is not uncommon predominating in thrombotic infarctions and cardioembolisms of cortical topography and of vertebrobasilar vascular territory.