ABSTRACT
Abstract: Background: Metals are common agents of allergic contact dermatitis, occupational or not, with decreasing incidence over the last years in some countries that have regulated the amount of nickel in objects. Objectives: To analyze and compare with previous studies the profile of metal sensitization between 2003-2015. Methods: Patients who underwent patch testing between 2003-2015 were evaluated retrospectively regarding the sensitization rates to metals, the associations between them, the relationship with profession and epidemiology. Results: Of the 1,386 patients tested, 438 (32%) had positive test to some metal, similar results to the 404/1,208 (33%) of the previous study (1995-2002) performed at the same service (p=0.32). The frequency of nickel (77%), cobalt (32%) and chromium (29%) changed slightly (p=0.20). Most cases of sensitization to chromium were related to the occupation (64%), in contrast to nickel and cobalt (p<0.0001). There was a predominance of females among those sensitized to metal in both studies (p=0.63) and the age group of 20-49 years old (p=0.11); the number of fair-skinned individuals increased (p<0.001), as well as the lesions in the cephalic segment (50.5%; p<0.0001) and hands (45%; p<0.0001), which are not the most frequent location anymore. The number of cleaners decreased (39% vs. 59%; p<0.0001), which still lead in front of bricklayers/painters, which increased (14% vs. 9%; p=0.013). The frequency of wet work reduced (65% vs. 81%; p<0.0001). Study limitations: The study included a single population group; only patients with positive tests to metals were considered - the others were not evaluated for the possibility of false negatives. Conclusion: The sensitization to metals, occupational or not, has been significant over the last 21 years, with few epidemiological changes.
Subject(s)
Humans , Male , Female , Child , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Allergens/adverse effects , Chromium/adverse effects , Immunization/methods , Cobalt/administration & dosage , Dermatitis, Allergic Contact/etiology , Nickel/adverse effects , Time Factors , Patch Tests , Retrospective Studies , Cobalt/adverse effects , Dermatitis, Occupational/etiologyABSTRACT
Objective: to evaluate patients treated with primary bladder adenocarcinoma at our institution. Methods: A review of 30 patients diagnosed with bladder adenocarcinoma at a single institution from 1994 of 2005 was undertaken. Cases of primary bladder adenocarcinoma were retrospectively evaluated. Results: Out of 490 patients with bladder carcinoma, 30 had bladder adenocarcinoma: 22 metastatic tumors, eight (1.6%) primary adenocarcinoma. Of these, three (0.6%) were primary non-urachal and five (1.0%) were urachal adenocarcinoma. All patients were men with mean age of 55.8 years (range 37-83). Dysuria and hematuria were the main symptoms reported. Of the total, four patients had cancer-related mortality. Conclusion: Primary bladder adenocarcinoma is a rare neoplasm, observed in 1.6% patients with bladder malignancies. Late diagnosis limits therapeutic possibilities. Partial cystectomy seems to have unsatisfactory results and radical cystectomy, although remains as the gold standard, have no proven efficacy. New methods of adjuvant treatment must be studied to improve treatment outcomes, as high mortality is observed despite treatment.
Objetivo: avaliar pacientes com adenocarcinoma primário da bexiga tratados em uma instituição. Métodos: foi realizada uma revisão em 30 pacientes diagnosticados com adenocarcinoma da bexiga, em uma única instituição, no período de 1994 a 2005. Os casos de adenocarcinoma primário da bexiga foram avaliados retrospectivamente. Resultados: dos 490 pacientes tratados com carcinoma da bexiga, 30 tinham adenocarcinoma da bexiga: 22 eram tumores metastáticos, oito (1,6%) tinham adenocarcinoma primário. Destes, três (0,6%) eram não-úraco primários e cinco (1,0%) do úraco. Todos os pacientes eram homens com média de idade de 55,8 anos (entre 37-83). Disúria e hematúria foram os sintomas predominantes. Do total, quatro pacientes tiveram mortalidade relacionada ao câncer. Conclusões: adenocarcinoma da bexiga é um tumor raro, observado em 1,6% dos pacientes com neoplasias da bexiga. O diagnóstico tardio limita as possibilidades terapêuticas. A cistectomia parcial parece ter resultados pouco satisfatórios e a cistectomia radical, embora permaneça o padrão ouro, não provou eficácia. Novos métodos de tratamentos adjuvantes devem ser estudados para melhorar os resultados terapêuticos, pois alta mortalidade é observada mesmo após o tratamento.