Botanical Briefs: Handling the Heat From Capsicum Peppers.

Capsicum peppers-including chili peppers, paprika, and red peppers-are native to the Americas but used worldwide in spicy dishes. Capsaicin, the active ingredient of Capsicum peppers, is used topically to treat musculoskeletal pain, neuropathy, and other conditions. Capsaicin binds the transient receptor potential vanilloid 1 (TRPV1), releasing substance P and desensitizing nerves with long-term use. Capsicum peppers and capsaicin products (eg, medications, cosmetics, pepper sprays) can provoke an irritant contact dermatitis, causing erythema and cutaneous burning. Capsaicin-induced dermatitis can be relieved by washing the area with soap, detergents, or oily compounds. Ice water or high-potency topical steroids also can help. Capsaicin is available in creams, lotions, and patches. Synthetic TRPV1-agonist injectables based on capsaicin are in clinical trials for use in localized pain. Capsaicin is a neuropeptide-active compound found in Capsicum peppers with many promising applications; however, dermatologists should be aware of possible skin reactions to these plants and medications derived from them.

Characteristics of pepper spray-related injuries reported to the National Electronic Injury Surveillance System during 2000-2020.

INTRODUCTION: Exposure to pepper spray may result in adverse dermal, ocular, and inhalation effects. Furthermore, pepper spray, including the more potent bear spray, was used by both law enforcement and protesters in 2020 in the protests related to racial justice and COVID-19 pandemic restrictions. The objective of this study was to characterize pepper spray-related injuries treated at United States (US) emergency departments (EDs). METHODS: Data were obtained from the National Electronic Injury Surveillance System, a database of consumer product-related injuries collected from approximately 100 US hospital EDs. Pepper spray-related injuries reported during 2000-2020 were identified by reviewing all records that included the letter groups "pep" or "bear" in the Narrative field and "spray" in the Narrative field or Product code 1619 in the Product_1, Product_2, or Product_3 fields. RESULTS: A total of 1112 pepper spray-related injuries were identified, resulting in a national estimate of 34,582 pepper spray-related injuries, of which 43.4% were reported during 2014-2020. Of the estimated exposures, the age distribution was 14.5% 0-5 years, 18.5% 6-12 years, 18.2% 13-19 years, 19.6% 20-29 years, 11.8% 30-39 years, 9.1% 40-49 years, and 8.3% 50 years or older; 55.9% of the patients were male. The exposure route was 52.0% ocular, 25.7% dermal, 13.6% inhalation, 2.9% ingestion/oral, and 14.1% unknown. CONCLUSIONS: Patients with pepper spray-related injuries tended to be older children and young adults, and the majority of patients were male. The route of exposure of most of the injuries was ocular.

Capsaicin intake and oral carcinogenesis: A systematic review / Ingesta de capsaicina y carcinogénesis oral: una revisión sistemática

Background: Chili is the most heavily and frequently consumed spice, either as a flavouring or colouring agent,and it is also a major source of pro-vitamin A, vitamin E and C. The main capsaicinoid found in chili peppers iscapsaicin. It has been demonstrated that capsaicin acts as a cancer-suppressing agent through its antioxidant andanti-inflammatory effects, by blocking several signal transduction pathways. Oral squamous cell carcinoma isone of the most prevalent cancer worldwide. It is noteworthy that in countries where populations of diverse ethnicgroups co-exist, differences have been observed in terms of incidence of oral cancer. The variances in their dietcould explain, at least in part, these differences. The objective of this systematic review is to explore if there isevidence of a possible relationship between capsaicin intake and the incidence of oral squamous cell carcinoma,and discuss such association.Material and Methods: A bibliographical search was made in PubMed, Scopus and Web of Science databases, andfinally 7 experimental studies were included; OHAT risk of bias tool was used to assess their quality.Results: All the studies confirm that capsaicin is a chemopreventive agent that prevents the development of oralcancer, through inhibition of malignant cell proliferation and increase of apoptosis.Conclusions: More human studies are needed in order to clarify the real link between consumption of chili (cap-saicin) and the prevalence of oral cancer.(AU)

Reactivity of astrocytes in hippocampal CA1 area in rats after administration of habanero peppers.

INTRODUCTION: Astrocytes react to microenvironmental changes. Their reactivity is manifested by an increase in glial fibrillary acidic protein (GFAP) and S100b protein levels, hypertrophy and hyperplasia. The aim of the study was to analyse immunoreactive GFAP (GFAP-IR) and S100b (S100b-IR) astrocytes of hippocampal CA1 area in adult rats intragastrically (i.g.) treated with habanero peppers. MATERIAL AND METHODS: Brains from 10 control rats (group C) and 10 rats receiving oil suspension of habanero fruits for 7 days (group I-7) or 28 days (group II-28) were used. Antibodies against GFAP and S100b were used for immunohistochemistry. Morphology and distribution of astrocytes was evaluated under light microscope and their density was quantitatively analysed. RESULTS: In the CA1 hippocampal area of group II-28 rats, GFAP-IR cells with numerous, branched processes were observed. S100b-IR astrocytes had delicate, single processes in comparison with cells without processes observed in groups I-7 and C. In groups I-7 and II-28, GFAP-IR astrocytes' density significantly increased in SR - stratum radiatum of hippocampal CA1 area. In group I-7, a density of cells with the expression of S100b was significantly increased in SO - stratum oriens layer. In group II-28, the density of S100b-IR astrocytes was decreased. CONCLUSIONS: Habanero peppers administrated to rats, especially for a longer time, caused reactive changes in the astrocytes in hippocampal CA1 area, and thus these glial cells may protect neurons against excitotoxic damage.

Acute Effects of Red Chili, a Natural Capsaicin Receptor Agonist, on Gastric Accommodation and Upper Gastrointestinal Symptoms in Healthy Volunteers and Gastroesophageal Reflux Disease Patients.

The effects of chili on gastric accommodation (GA) in gastroesophageal reflux disease (GERD) patients have not been explored. METHODS: In total, 15 healthy volunteers (HV) and 15 pH-positive non-erosive GERD (NERD) patients underwent single-photon emission computed tomography after ingesting 2 g of chili or placebo in capsules in a randomized double-blind crossover fashion with a one-week washout period. GA was the maximal postprandial gastric volume (GV) after 250 mL of Ensure® minus the fasting GV. Upper gastrointestinal symptoms were evaluated by using a visual analog scale. RESULTS: NERD patients but not HV had significantly greater GA after chili compared to a placebo (451 ± 89 vs. 375 ± 81 mL, p < 0.05). After chili, the postprandial GVs at 10, 20, and 30 min in NERD patients were significantly greater than HV (10 min, 600 ± 73 vs. 526 ± 70 mL; 20 min, 576 ± 81 vs. 492 ± 78 mL; 30 min, 532 ± 81 vs. 466 ± 86 mL, all p < 0.05). In NERD, chili was associated with significantly less satiety, more severe abdominal burning (p < 0.05), and a trend of more severe heartburn (p = 0.06) compared to the placebo. In HV, postprandial symptoms after chili and placebo ingestion were similar (p > 0.05). CONCLUSIONS: Chili enhanced GA in NERD patients but not in HV. This suggests that the modulation of GA in NERD is abnormal and likely involves transient receptor potential vanilloid 1 (TRPV1) sensitive pathways.

High Chili Intake and Cognitive Function among 4582 Adults: An Open Cohort Study over 15 Years.

We aimed to examine the association between chili intake and cognitive function in Chinese adults. This is a longitudinal study of 4852 adults (age 63.4 ± 7.7) attending the China Health and Nutrition Survey during 1991 and 2006. Cognitive function was assessed in 1997, 2000, 2004 and 2006. In total, 3302 completed cognitive screening tests in at least two surveys. Chili intake was assessed by a 3-day food record during home visits in each survey between 1991 and 2006. Multivariable mixed linear regression and logistic regression were used. Chili intake was inversely related to cognitive function. In fully adjusted models, including sociodemographic and lifestyle factors, compared with non-consumers, those whose cumulative average chili intake above 50 g/day had the regression coefficients (and 95% CI) for global cognitive function of -1.13 (-1.71-0.54). Compared with non-consumers, those with chili consumption above 50 g/day had the odds ratio (and 95% CI) of 2.12(1.63-2.77), 1.56(1.23-1.97) for self-reported poor memory and self-reported memory decline, respectively. The positive association between chili intake and cognitive decline was stronger among those with low BMI than those with high BMI. The longitudinal data indicate that higher chili intake is positively associated with cognitive decline in Chinese adults in both genders.

The consumption of chili peppers and the risk of colorectal cancer: a matched case-control study.

BACKGROUND: Chili peppers have properties that plausibly could either increase or decrease a person's risk of developing colorectal cancer, but their consumption in relation to disease risk has not been well studied. We sought to explore the association between chili peppers intake and the risk of colorectal cancer. METHODS: Eight hundred subjects (400 cases with colorectal cancer and 400 controls) were enrolled in this study. Cases were primarily colorectal cancer patients diagnosed by histopathology at the Department of Intestinal Surgery, Sichuan Cancer Hospital from July 2010 to May 2012. Controls were people receiving routine medical examinations from the Zhonghe Community Health Service Center during the same period of time. An in-person interview was used to collect demographic characteristics, lifestyle, and dietary habits of the subjects in reference to the 10 years prior to disease diagnosis. Conditional logistic regression was conducted to examine the possible association between the risk of colorectal cancer and chili peppers consumption. RESULTS: Compared with persons who consumed chili peppers ≤ 2 times per week, those who consumed chili peppers 3-7 times per week (OR = 1.2, 95% CI 0.75-2.0, P = 0.413) and > 7 times per week (OR = 1.4, 95% CI 0.84-2.2, P = 0.205) were not at an increased risk of colorectal cancer. CONCLUSIONS: The results suggest that the consumption of chili peppers does not increase or decrease the risk of colorectal cancer. This question warrants being re-addressed in a study in which there is prospective ascertainment of dietary characteristics.

Risk factors associated with gastric cancer in Mexico: education, breakfast and chili

Background and aim: the aim of the study was to use a validated questionnaire to identify factors associated with the development of gastric cancer (GC) in the Mexican population. Methods: the study included cases and controls that were paired by sex and ± 10 years of age at diagnosis. In relation to cases, 46 patients with a confirmed histopathological diagnosis of adenocarcinoma-type GC, as reported in the hospital records, were selected, and 46 blood bank donors from the same hospital were included as controls. The previously validated Questionnaire to Find Factors Associated with Gastric Cancer (QUFA-GC(c)) was used to collect data. Odds ratio (OR) and 95% confidence interval (IC) were estimated via univariate analysis (paired OR). Multivariate analysis was performed by logistic regression. A decision tree was constructed using the J48 algorithm. Results: an association was found by univariate analysis between GC risk and a lack of formal education, having smoked for ≥ 10 years, eating rapidly, consuming very hot food and drinks, a non-suitable breakfast within two hours of waking, pickled food and capsaicin. In contrast, a protective association against GC was found with taking recreational exercise and consuming fresh fruit and vegetables. No association was found between the development of GC and having an income that reflected poverty, using a refrigerator, perception of the omission of breakfast and time period of alcoholism. In the final multivariate analysis model, having no formal education (OR = 17.47, 95% CI = 5.17-76.69), consuming a non-suitable breakfast within two hours of waking (OR = 8.99, 95% CI = 2.85-35.50) and the consumption of capsaicin ˃ 29.9 mg capsaicin per day (OR = 3.77, 95% CI = 1.21-13.11) were factors associated with GC. Conclusions: an association was found by multivariate analysis between the presence of GC and education, type of breakfast and the consumption of capsaicin. These variables are susceptible to intervention and can be identified via the QUFA-GC(c)

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Bell pepper allergy: different sensitization profiles

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Inibição do sistema quorum sensing AI-1 por Capsicum frutescens e Capsicum annuum em bactérias Gram-negativas / Inhibition of AI-1 quorum-sensing system by Capsicum frutescens and Capsicum annuum in Gram-negative bacteria

A inibição do quorum sensing (QS) altera a comunicação bacteriana, reduzindo a expressão de fatores de virulência e a formação de biofilmes, o que pode conferir menor pressão seletiva em comparação aos antibióticos tradicionais. As frutas e hortaliças constituem uma fonte rica em compostos com propriedades potenciais de inibição do QS. Entretanto, há pouca referência sobre o potencial de pimentas do gênero Capsicum e de seus compostos isolados como inibidores do QS. Esse trabalho teve como objetivo avaliar o efeito de extratos orgânicos obtidos das variedades de pimenta-malagueta e pimentão vermelho sobre o sistema QS dependente do sinalizador AI-1 (acil homoserina lactona - AHL) em bactérias Gram-negativas. Os extratos foram obtidos por extração em fase sólida e separados em uma fração metanólica e outra amônica; sendo os compostos característicos identificados e quantificados por cromatografia líquida de alta eficiência (CLAE). A atividade antimicrobiana dos extratos foi avaliada pela determinação da concentração inibitória mínima (MIC) e pela curva de crescimento de Chromobacterium violaceum ATCC 12472, Serratia liquefaciens MG1 e Pseudomonas aeruginosa PAO1. O efeito anti-QS dos extratos foi avaliado pelos testes de difusão em ágar e quantificação da produção de violaceína em meio líquido por C. violaceum e sobre a formação de biofilme, avaliado pelo ensaio de cristal violeta e microscopia confocal, em S. liquefaciens e P. aeruginosa nas temperaturas 30 ºC e 37 ºC. Os resultados obtidos pela CLAE indicaram que o extrato metanólico de pimenta-malagueta (EMPM) continha capsaicinoides como a capsaicina e dihidrocapsaicina, luteolina e outros compostos não identificados; já o extrato amônico desta não continha os compostos capsaicinoides. Ambos os extratos de pimentão vermelho continham luteolina e compostos não identificados, mas não apresentaram capsaicinoides. Como o EMPM era representativo dos demais extratos, por conter tanto capsaicinóides quanto luteolina, o foco deste trabalho foi avaliar os efeitos do EMPM sobre fenótipos microbianos nas concentrações 5; 2,5; 1,25 e 0,625 mg/ml, além de utilizar a capsaicina como controle comparativo em concentrações equivalentes às do extrato (25, 50 e 100 µg/ml). Os resultados da atividade antimicrobiana mostraram inibição parcial do crescimento das bactérias nas concentrações sub-MIC (MIC >5 mg/ml) de 5 e 2,5 mg/ml de EMPM. A capsaicina também inibiu parcialmente o crescimento das bactérias a 100 µg/ml, com exceção de S. liquefaciens a 37 ºC, cujo crescimento foi induzido em 50 e 25 µg/ml. A produção de violaceína foi reduzida pelo EMPM a 1,25 e 0,625 mg/ml, sem afetar o crescimento de C. violaceum. Ensaios com C. violaceum CV026, estirpe biosensora capaz de produzir o pigmento na presença de AI-1 exógeno, sugerem que o possível mecanismo de atuação do extrato sobre o sistema QS em C. violaceum 12472 é sobre a síntese do sinalizador, já que não foi observada inibição da produção de violaceína em CV026 pelo extrato. Contrariamente, a capsaicina incrementou a produção do pigmento na estirpe 12472, mas ensaios com a estirpe CV026 indicaram que a capsaicina não atua como sinalizador do QS, uma vez que esta não induziu a produção de violaceína nesta estirpe. Já a formação de biofilme foi incrementada na presença do EMPM, sendo consideravelmente maior em P. aeruginosa a 30 ºC. Igualmente, observou-se indução da formação de biofilme por capsaicina em S. liquefaciens (37 ºC) e P. aeruginosa (30 ºC). Porém, a capsaicina não teve efeito sobre a formação de biofilme de S. liquefaciens quando cultivada a 30 ºC, nem P. aeruginosa a 37 ºC. Os resultados revelam que a produção de violaceína em C. violaceum ATCC 12472 é inibida pelo EMPM, mas não pela capsaicina. Já, o EMPM e a capsaicina, de forma geral, não inibem a formação de biofilme de S. liquefaciens MG1 nem P. aeruginosa PAO1. Outros estudos são necessários para elucidar os mecanismos pelos quais o EMPM e a capsaicina agem sobre os fenótipos avaliados neste trabalho

Quorum sensing inhibition alters bacterial communication by reducing virulence factors expression and biofilm formation, exerting less selective pressure compared to antibiotics. Fruits and vegetables are rich sources of compounds with potential QS-inhibition properties. However, there are few references about the potential of peppers belonging to the genus Capsicum and its isolated compounds as QS inhibitors. This study aimed to assess the effect of organic extracts obtained from Capsicum varieties, pimenta-malagueta (red chili) and pimentão vermelho (red bell pepper), on the AI-1 dependent QS system. The extracts were obtained by solid phase extraction and split into a methanolic and an ammonic fraction. Characteristic compounds were identified and quantified by high performance liquid chromatography (HPLC). The antimicrobial activity of the extracts was assessed by determining the minimal inhibitory concentration (MIC) and the growth curve of Chromobacterium violaceum ATCC 12472, Serratia liquefaciens MG1 and Pseudomonas aeruginosa PAO1. The anti-QS effect of the extracts was evaluated by the agar diffusion assay and the quantification of violacein production was assessed in liquid medium by C. violaceum, as well as in the biofilm formation test determined by the crystal violet assay and confocal microscopy with S. liquefaciens and P. aeruginosa at 30 ºC and 37 ºC. HPLC results showed that the methanolic extract of pimenta-malagueta (EMPM) contained capsaicinoids such as capsaicin and dihidrocapsaicin, luteolin and other unidentified compounds in lower concentrations; while its ammonic extract did not have capsaicinoids. Both pimentão vermelho extracts contained luteolin and other unidentified compounds in low concentrations, but they did not contain capsaicinoids. As EMPM was representative among the extracts because it contained capsaicinoids and luteolin, the focus of this work was to assess the effect of EMPM over microbial phenotypes at concentrations of 5, 2.5, 1.25 and 0.625 mg/ml, using capsaicin as a comparative control at equivalent concentrations to those in EMPM (25, 50 and 100 µg/ml). Antimicrobial activity assays showed a partial inhibition growth of bacteria at sub-MIC concentrations (MIC >5 mg/ml) of EMPM at 5 and 2.5 mg/ml. Similarly, capsaicin partially inhibited bacterial growth at 100 µg/ml, except for S. liquefaciens at 37 ºC in which growth was induced at 50 and 25 µg/ml. Violacein production was reduced by EMPM at 1,25 and 0,625 mg/ml without affecting C. violaceum growth. Assays with C. violaceum CV026, a biosensor strain that produces violacein in the presence of exogenous AI-1, suggest that EMPM reduced violacein production in C. violaceum 12472 by interfering with the AI-1 synthesis. In contrast, capsaicin incremented violacein synthesis in strain 12472, but experiments with strain CV026 revealed that capsaicin does not function as an analog of AI-1. Biofilm formation was increased in EMPM presence, being remarkably superior in P. aeruginosa cultivated at 30 ºC, as opposed to cultivation at 37 ºC. Similarly, capsaicin induced biofilm formation in S. liquefaciens (37 ºC) and P. aeruginosa (30 ºC). However, capsaicin did not affect biofilm formation on S. liquefaciens cultured at 30 ºC, neither on P. aeruginosa at 37 ºC. These results show that violacein production in C. violaceum ATCC 12472 is inhibited by EMPM, but not by capsaicin. In general, EMPM and capsaicin did not inhibit biofilm formation in S. liquefaciens MG1 neither in P. aeruginosa PAO1. More studies are necessary to elucidate the mechanisms by which EMPM and capsaicin affect the studied phenotypes in this work

Oral submucous fibrosis: an etiological dilemma.

OBJECTIVE: Oral Submucous Fibrosis (OSF), is a well-recognized, oral potentially malignant disorder predominantly affecting the South- Asian countries. OSF causes unique generalized fibrosis of the submucosal oral soft tissues, resulting in marked rigidity of the oral mucosa leading to progressive inability to open the mouth, rigidity of lips and difficulty in protruding the tongue. In this review we have discussed the multifactorial etiology of this potentially malignant disorder, including Chillies, Nutritional Deficiencies, Inducible nitric oxide synthsis (iNOS), genetic and immunological predisposition; and most importantly the role of areca nut and the effect of copper content in it.

Esophageal Rupture After Ghost Pepper Ingestion.

BACKGROUND: The ghost pepper, or "bhut jolokia," is one of the hottest chili peppers in the world. Ghost peppers have a measured "heat" of > 1,000,000 Scoville heat units (SHU), more than twice the strength of a habanero pepper. To our knowledge, no significant adverse effects of ghost pepper ingestion have been reported. CASE REPORT: A 47-year-old man presented to the Emergency Department (ED) with severe abdominal and chest pain subsequent to violent retching and vomiting after eating ghost peppers as part of a contest. A subsequent chest x-ray study showed evidence of a left-sided pleural effusion and patchy infiltrates. A computed tomography scan of the abdomen and pelvis showed pneumomediastinum with air around the distal esophagus, suggestive of a spontaneous esophageal perforation and a left-sided pneumothorax. The patient was intubated and taken immediately to the operating room, where he was noted to have a 2.5-cm tear in the distal esophagus, with a mediastinal fluid collection including food debris, as well as a left-sided pneumothorax. The patient was extubated on hospital day 14, and was discharged home with a gastric tube in place on hospital day 23. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Spontaneous esophageal rupture, Boerhaave syndrome, is a rare condition encountered by emergency physicians, with a high mortality rate. This case serves as an important reminder of a potentially life- threatening surgical emergency initially interpreted as discomfort after a large spicy meal.

The VHOT (Vindaloo Hastens Outpouring of Troponins) Study.

BACKGROUND: Multiple cardiac and non-cardiac processes may cause an elevated highly sensitive troponin (hsTn). We postulated that the consumption of a seriously hot vindaloo could cause an increase in hsTn levels in seemingly healthy volunteers. OBJECTIVE: To determine whether eating a very hot curry can cause elevated hsTn. METHODS: This was a prospective observational cohort study. Participants had blood drawn for hsTn pre-ingestion and at 2 and 4 h post-ingestion of, first, a rather mild butter chicken and, 2 weeks later, a seriously hot lamb vindaloo. We assessed pre-curry tolerance and perception of curry hotness for both curries using the VHOT scale. RESULTS: Although no participant had a troponin above the reference range at any point in time, we found dramatic relative increases in troponin in many of our participants. In the vindaloo phase, 8/22 (36%) had a relative change >20%, whereas 5/22 (23%) had a relative change >50% at 4 h. However, these changes were not significantly different to those in the butter chicken phase. Based on biological variability alone, 15/22 (68%) had a relative change of >20%, and 11/22 (50%) had a relative change of >50% between the two sessions (pre-ingestion). CONCLUSIONS: Eating a seriously hot vindaloo does not appear to be a risk factor for troponitis, and people may consume vindaloo safely with the knowledge that this is unlikely to result in significant damage to their myocardium. However, clinicians should be aware of the biological variability of hsTn and exercise caution when interpreting apparent changes within the normal range.

Lack of an Apparent Association between Mycotoxin Concentrations in Red Chili Peppers and Incidence of Gallbladder Cancer in India : an Ecological Study.

Our recent studies conducted in South America have shown that mycotoxin contamination of red chili peppers (RCPs) may be associated with an increased risk of gallbladder cancer (GBC). Whether this relationship exists in India, a country with a high incidence of GBC and high consumption of RCPs, is unclear. We therefore measured concentrations of aflatoxins (AFs) and ochratoxin A (OTA) in RCPs from areas of low, medium, and high incidence of GBC in India, and compared these concentrations with GBC incidence in each area. Twentyone RCP samples were collected from nine cities (eight from a lowincidence area, five from a mediumincidence area, and eight from a highincidence area). Concentrations of AFs and OTA were measured using highperformance liquid chromatography. No significant differences in mean concentrations of AFs and OTA were found in the three areas. AFB1 levels in the lowincidence area (10.81 ?g/kg) and highincidence area (12.00 ?g/kg) were more than 2.2 and 2.4 times higher compared with the maximum permitted level of AFB1 in spices (5.0 ?g/kg) set by the Commission of the European Communities, or that (4.4 ?g/kg) obtained in our previous study in Chile. Our results show that the mean concentrations of mycotoxins in RCPs are similar among the three areas in India with different incidences of GBC. Further studies with human subjects are needed to evaluate any association between AFB1 and GBC.

Fatal chilli bite.

A healthy 2-year-old girl bit a green chilli accidentally following which she had many bouts of vomiting. She became unconscious and was immediately admitted to hospital. In spite of all medical intervention, she died after one day. The autopsy confirmed that the death was caused by respiratory failure due to acute respiratory distress syndrome following aspiration of gastric contents into tracheobronchial tree. Aspiration of gastric contents resulting in acute respiratory distress syndrome and death is not uncommon; however, death following the accidental bite of a chilli is rarely reported in medical-legal literature.

[Injuries from pepper spray used for self defense: analysis of 15 cases managed in an emergency chemical decontamination area]. / Agresiones realizadas con espráis de defensa personal atendidas en el área de descontaminación química de urgencias. A propósito de 15 casos.

EN: We analyzed epidemiologic and clinical characteristics, treatment received, and clinical course in cases of pepper spray injury treated in the chemical decontamination area of an emergency department over a 5-year period. A total of 15 patients with a mean (SD) age of 25 (8.3) years were included. Thirteen were men and 53% were foreign-born. All uses of pepper spray occurred during muggings that to place mainly in the early hours of the morning (66.7% between 4:30 and 6:30 AM). Two or more attackers were injured in 60% of the events. Seventy-three percent of the attacks took place on the street and the median delay in reaching the emergency department was 30 minutes. The face and eyes were usually injured, and symptoms included itching, irritation, burning, and pain. On arrival, the patients were treated immediately (mean delay, 3 minutes) with hypertonic saline, an amphoteric surfactant, and a chelating agent in 80% of the cases, in which improvement was substantial as mean pain scale scores changed from 7.2 on admission to 3 on discharge (P=.009). Patients spent an average of 40 minutes in the treatment area. Eleven patients required further care from an ophthalmologist and topical medication for symptoms. Outcomes were good and there were no complications in any of the cases. We conclude that pepper sprays are being used as an aid to self defense in muggings in our community. Decontamination measures have priority as they alleviate symptoms and prevent long-lasting effects.

ES: Evalúan las características epidemiológicas, clínicas, terapéuticas y evolutivas, de las asistencias realizadas en el área de descontaminación química (ADQ) del servicio de urgencias, a consecuencia de un ataque con espráis de defensa personal durante un período de 5 años. Se han incluido 15 pacientes con una edad media de 25 años. Trece fueron hombres y el 53% eran personas no nacidas en España. En todos los casos la agresión con el espray se produjo en el curso de una pelea o con ánimo de robo, sobre todo de madrugada (66,7% de los casos entre las 4:30 y las 6:30 h). En el 60% de las atenciones hubo dos o más personas afectadas de forma simultánea. El ataque se produjo en la vía pública en el 73% de las ocasiones y tardaron una mediana de 30 min en llegar a urgencias. Cara y ojos fueron las zonas más afectadas y los síntomas referidos con mayor frecuencia fueron el picor, irritación, quemazón o dolor. El tratamiento aplicado en el hospital fue inmediato (media de demora: 3 min) y se empleó una solución hipertónica, anfótera y quelante en el 80% de los casos, con notable mejoría sintomática, pasando en la escala visual analógica (EVA) del dolor de una puntuación media de 7,2 al ingreso a 3 a la salida (p = 0,009). El tiempo medio de permanencia en el ADQ fue de 40 min. Once de los casos precisaron además asistencia oftalmológica y tratamiento tópico sintomático. La evolución fue favorable y sin secuelas en todos los casos. Concluimos que el uso de espráis de defensa personal con ánimo de robo o agresión es una realidad en nuestro medio. Las medidas de descontaminación son prioritarias y contribuyen a aliviar los síntomas y evitar secuelas.

Paprika rhinoconjunctivitis case reveals new occupational Capsicum allergens.

No allergens related to paprika or cayenne respiratory allergy have been identified thus far. We describe a previously healthy 28-year woman who developed work-related rhinoconjunctivitis after four years of kebab-restaurant work. The allergy was studied using skin prick tests, serum specific IgE and nasal provocation tests. Specific IgE protein reactions were studied by Western blot analysis. Paprika, cayenne and curry allergens were identified from the strongest immunoblot bands using tandem mass spectrometry. A positive skin prick test, high specific IgE and positive nasal provocation test confirmed occupational rhinoconjunctivitis from Capsicum spices. Defensin J1 and Vicilin were identified as major paprika and cayenne allergens in this case. Vicilin was detected also from the curry ingredients. Two new occupational respiratory allergens from the Capsicum species were identified. These differ from previously reported bell pepper allergens. We emphasize that substantial spice handling at work poses an allergy risk.