Résumé
Abstract Objective: The aim of this study was to identify which types of skin reactions are associated with slime toys and which of their ingredients are most frequently involved in cases of poisoning. Data source: Between January and July 2021, articles were selected using PubMed, SciELO, and LILACS databases. The following descriptors were used: (dermatitis OR rash OR eczema OR inflammation) AND slime. Inclusion criteria were articles available in full, in either Portuguese, English, or Spanish, published between January 2000 and July 31, 2021, and articles reporting cases of contact dermatitis or eczema potentially or directly attributed to slime toys. Articles not meeting these criteria and duplicate texts in the databases were excluded. Data synthesis: In total, 65 publications were identified, of which 16 were included in this review. This resulted in a total of 22 children (2 males, 20 females), aged between 4 and 13 years, who were reportedly intoxicated by slime toys, most of these being linked to homemade preparations. Studies reported the occurrence of contact or allergic dermatitis on hands, fingers, nails, forearms, and cheeks. The most allergenic and/or irritant ingredients included liquid detergent and soap. Additionally, patch tests identified positive reactions to methylisothiazolinone and methylchloroisothiazolinone, the preservatives used by chemical industries on preparation of glue, soap, detergents, etc. Conclusions: Although slime toys might be important for improving motor development and parental relationships, homemade slime toy recipes include several allergenic and irritant ingredients which might be exposed to vulnerable children and cause intoxications. Therefore, homemade slime toys preparations should be used cautiously and under the supervision of adults.
Resumo Objetivo: Identificar quais tipos de reações de pele e ingredientes do brinquedo slime estão frequentemente envolvidos em relatos de intoxicação. Fontes de dados: Entre janeiro e julho de 2021, ocorreu a seleção dos artigos, utilizando-se as bases de dados: United States National Library of Medicine (PubMed), Scientific Electronic Library Online (SciELO) e Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS). Foram utilizados os seguintes descritores: (dermatitis OR rash OR eczema OR inflammation) AND slime. Incluíram-se artigos disponíveis na íntegra, em português, inglês ou espanhol, publicados entre janeiro de 2000 e 31 julho de 2021, que relatassem casos de crianças e adolescentes que apresentaram reação cutânea após a manipulação do brinquedo slime. Foram excluídos artigos sem aderência ao tema e textos duplicados nas bases de dados. Síntese dos dados: Identificaram-se 65 publicações, sendo 16 utilizadas para a elaboração desta revisão. Isso resultou no total de 22 crianças (duas do sexo masculino, 20 do feminino), com idades entre quatro e 13 anos, que teriam sido intoxicadas por slime, a maioria dos casos ligado a preparações caseiras. Estudos relataram a ocorrência de dermatite de contato ou alérgica nas mãos, dedos, unhas, antebraços e bochechas. Os ingredientes mais alergênicos e/ou irritantes foram detergentes líquidos e sabão. Ademais, o patch test identificou reações positivas para metilisotiazolinona e metilcloroisotiazolinona, que são conservantes utilizados em produtos como cola, sabão, detergente, etc. Conclusões: Ainda que o brinquedo slime seja importante para o desenvolvimento motor e das relações parentais, receitas caseiras incluem vários ingredientes alergênicos e irritantes, que podem ser expostos a crianças vulneráveis e causar intoxicações. Sendo assim, as preparações do slime devem ser feitas com cautela e sob supervisão de adultos.
Résumé
Abstract Plant-derived products can assist in the healing process of dermal wounds. It has been demonstrated that Hancornia speciosa latex present angiogenic, osteogenic, anti-inflammatory, and antioxidant activities. Then, it could contribute to the wound healing process. However, natural products in contact with skin may cause dermatitis. The objective of this work was to evaluate the allergic and irritant potential of H. speciosa serum fraction latex using in vitro assays. The obtained results showed that the H. speciosa serum fraction latex has a slightly irritant potential and is not cytotoxic neither allergenic for human cells. Moreover, we identified a remarkable low amount of proteins in this material in comparison to Hevea brasiliensis latex. This result could explain the non-allergenic potential of H. speciosa serum fraction latex because proteins present in latex are the main responsible for allergy. This biomaterial could be used as a non-allergenic source for development of new medicines.
Resumo Produtos derivados de plantas podem auxiliar no processo de cicatrização de feridas cutâneas. Foi demonstrado que o látex de Hancornia speciosa apresenta atividades angiogênicas, osteogênicas, antiinflamatórias e antioxidantes. Então, este biomaterial pode contribuir para o processo de cicatrização de feridas. No entanto, produtos naturais em contato com a pele podem causar dermatites. O objetivo deste trabalho foi avaliar o potencial alérgico e irritante do látex da fração soro de H. speciosa por meio de ensaios in vitro. Os resultados obtidos mostraram que o látex da fração do soro de H. speciosa possui um potencial pouco irritante e não é citotóxico nem alergênico para células humanas. Além disso, foi identificado uma notável baixa quantidade de proteínas neste material em comparação ao látex de Hevea brasiliensis. Esse resultado poderia explicar o potencial não alergênico do látex da fração soro de H. speciosa, pois as proteínas presentes no látex são as principais responsáveis pela alergia. Este biomaterial pode ser utilizado como fonte não alergênica para desenvolvimento de novos medicamentos.
Sujets)
Humains , Apocynaceae , Hevea , Cicatrisation de plaie , Matériaux biocompatibles , Allergènes , LatexRésumé
Objective: To analyze the case characteristics of Chronic obstructive pulmonary disease caused by occupational irritant chemicals (OI-COPD). To provide basis for revising its diagnostic criteria. Methods: From June to December 2021, we investigated the information of OI-COPD patients confirmed by Shandong Institute of Occupational Health and Prevention of Occupational Diseases, Guangxi Zhuang Autonomous Region Institute of Occupational Disease Prevention and Control, Qingdao Central Hospital affiliated to Qingdao University and other diagnostic institutions in the past five years, a total of 41 cases. The basic information of OI-COPD cases, occupational risk factors exposure information, medical history, smoking history and clinical symptoms were analyzed retrospectively. The measurement data were tested for normal distribution, which was described by x±s, and compared between groups by t test; Those who do not conform to the normal distribution are described by the median [M (Q(1), Q(3)) ] and analyzed by nonparametric test; The counting data were expressed in frequency and rate (% ), and the comparison between groups was tested. Results: Of the 41 cases, 33 were male and 8 were female. The age of the patient diagnosed with OI-COPD was (49.5±10.3) years old, and the minimum age was 30 years old; Among them, 8 patients had a definite long-term smoking history (more than 5 years) ; The exposure duration of occupational risk factors was (18.6±10.3) years, of which 3 patients had exposure duration of less than 5 years; The occupational risk factors leading to OI-COPD include acids and acid-forming compounds, bases, aldehydes, nitrogen oxides, chlorine and its compounds, etc. The exposure level of occupational risk factors is related to the degree of COPD airflow restriction (χ(2)=6.17, P <0.05). 18 patients with diagnosis age <50 years old were diagnosed as early-onset COPD. The incidence of respiratory symptoms in the early diagnosis COPD group was lower than that in the non-early diagnosis COPD group, and the FEV1% pred was significantly higher than that in the non-early diagnosis COPD group. The difference was statistically significant (P<0.01 ) . Conclusion: The exposure level of occupational risk factors may be the risk factor affecting the degree of COPD airflow restriction. With the increase of the exposure level of COPD patients, the proportion of respiratory symptoms will also increase accordingly.
Sujets)
Humains , Mâle , Femelle , Adulte , Adulte d'âge moyen , Études rétrospectives , Chine/épidémiologie , Broncho-pneumopathie chronique obstructive/diagnostic , Poumon , Facteurs de risque , Maladies professionnelles/diagnostic , Exposition professionnelle/effets indésirablesRésumé
Plant-derived products can assist in the healing process of dermal wounds. It has been demonstrated that Hancornia speciosa latex present angiogenic, osteogenic, anti-inflammatory, and antioxidant activities. Then, it could contribute to the wound healing process. However, natural products in contact with skin may cause dermatitis. The objective of this work was to evaluate the allergic and irritant potential of H. speciosa serum fraction latex using in vitro assays. The obtained results showed that the H. speciosa serum fraction latex has a slightly irritant potential and is not cytotoxic neither allergenic for human cells. Moreover, we identified a remarkable low amount of proteins in this material in comparison to Hevea brasiliensis latex. This result could explain the non-allergenic potential of H. speciosa serum fraction latex because proteins present in latex are the main responsible for allergy. This biomaterial could be used as a non-allergenic source for development of new medicines.
Produtos derivados de plantas podem auxiliar no processo de cicatrização de feridas cutâneas. Foi demonstrado que o látex de Hancornia speciosa apresenta atividades angiogênicas, osteogênicas, antiinflamatórias e antioxidantes. Então, este biomaterial pode contribuir para o processo de cicatrização de feridas. No entanto, produtos naturais em contato com a pele podem causar dermatites. O objetivo deste trabalho foi avaliar o potencial alérgico e irritante do látex da fração soro de H. speciosa por meio de ensaios in vitro. Os resultados obtidos mostraram que o látex da fração do soro de H. speciosa possui um potencial pouco irritante e não é citotóxico nem alergênico para células humanas. Além disso, foi identificado uma notável baixa quantidade de proteínas neste material em comparação ao látex de Hevea brasiliensis. Esse resultado poderia explicar o potencial não alergênico do látex da fração soro de H. speciosa, pois as proteínas presentes no látex são as principais responsáveis pela alergia. Este biomaterial pode ser utilizado como fonte não alergênica para desenvolvimento de novos medicamentos.
Sujets)
Apocynaceae/composition chimique , Cicatrisation de plaie/effets des médicaments et des substances chimiques , Techniques in vitroRésumé
Abstract Plant-derived products can assist in the healing process of dermal wounds. It has been demonstrated that Hancornia speciosa latex present angiogenic, osteogenic, anti-inflammatory, and antioxidant activities. Then, it could contribute to the wound healing process. However, natural products in contact with skin may cause dermatitis. The objective of this work was to evaluate the allergic and irritant potential of H. speciosa serum fraction latex using in vitro assays. The obtained results showed that the H. speciosa serum fraction latex has a slightly irritant potential and is not cytotoxic neither allergenic for human cells. Moreover, we identified a remarkable low amount of proteins in this material in comparison to Hevea brasiliensis latex. This result could explain the non-allergenic potential of H. speciosa serum fraction latex because proteins present in latex are the main responsible for allergy. This biomaterial could be used as a non-allergenic source for development of new medicines.
Resumo Produtos derivados de plantas podem auxiliar no processo de cicatrização de feridas cutâneas. Foi demonstrado que o látex de Hancornia speciosa apresenta atividades angiogênicas, osteogênicas, antiinflamatórias e antioxidantes. Então, este biomaterial pode contribuir para o processo de cicatrização de feridas. No entanto, produtos naturais em contato com a pele podem causar dermatites. O objetivo deste trabalho foi avaliar o potencial alérgico e irritante do látex da fração soro de H. speciosa por meio de ensaios in vitro. Os resultados obtidos mostraram que o látex da fração do soro de H. speciosa possui um potencial pouco irritante e não é citotóxico nem alergênico para células humanas. Além disso, foi identificado uma notável baixa quantidade de proteínas neste material em comparação ao látex de Hevea brasiliensis. Esse resultado poderia explicar o potencial não alergênico do látex da fração soro de H. speciosa, pois as proteínas presentes no látex são as principais responsáveis pela alergia. Este biomaterial pode ser utilizado como fonte não alergênica para desenvolvimento de novos medicamentos.
Résumé
Occupational contact dermatitis (OCD) is an occupational inflammatory skin disease. According to its pathogenesis, it can be divided into irritant contact dermatitis and allergic contact dermatitis. This review introduced the high-risk occupations of OCD, its incidence, common irritants and allergens, and corresponding treatments. Agriculture workers, construction workers, production workers, hairdressers, and medical workers are high-risk occupations of OCD who should be paid attention to.
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Objective To investigate the effects of the multidisciplinary cooperative management intervention model on the self‐management efficacy of patients with ileostomy irritant dermatitis. Methods Among the patients with irritative dermatitis in the ileostomy section of the Anorectal Surgery and Ostomy Clinic of Hwamei Hospital, the Chinese Academy of Sciences, 72 patients, who visited the clinic from August 2016 to August 2018, met the inclusion criteria and were finally included in the study. According to the random number table method, 36 patients each were assigned to the control and observation groups respectively. There were no significant differences in age, sex and education between the two cohorts. The control groups were compared. The control group was treated with routine nursing methods. The observation group underwent multidisciplinary nursing intervention that was based on the routine measures of the control group. The Chinese version of the cancer self‐management efficacy was used as the questionnaire survey that was administered before and after treatment. The results were compared and analyzed between the patient groups. The independent sample t‐test was used to compare the results between the groups, and the paired sample t‐test was used for intra‐group comparisons. Results After intervention, the total scores of self‐management efficacy and positive attitude, self‐decompression and self‐decision scores were higher in the observation group than in the control group (t=4.192, 3.095, 4.123, 2.267, P<0.05). The scores of self‐administration efficacy and each dimension of the two groups were higher than those before intervention, and the difference was statistically significant (P<0.01). After the intervention, 3 patients (10.0%) in the observation group with recurrent dermatitis and 13 patients (43.3%) in the control group. The recurrence rate of the observation group was significantly lower than that of the control group (χ2= 8.357, P<0.05). Conclusion Multidisciplinary cooperative management can improve the self‐management efficacy of patients with irritating dermatitis and reduce the incidence of this condition.
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Cough is a physiological defense reflex for protecting the airways from aspiration and irritation. Thus, roles of environmental triggers are postulated in the pathogenesis of chronic cough. There are several lines of epidemiological evidence demonstrating the relationships between environmental irritant and pollutant exposure and chronic cough. However, positive findings from cross-sectional studies just reflect the protective nature of cough but may not properly address the true impact of environmental triggers. If harmful inhalation is repeated, cough may be seen as chronic but indeed is protective in nature. Therefore, long-term residual outcomes would be the key for understanding the effects of environmental triggers on chronic cough. The present review aims to summarize the associations between chronic cough and environmental pollutants or irritant exposure, with a focus on the long-term residual effects of (1) chronic persistent exposure and (2) acute high-intensity exposure on chronic cough, and also to examine (3) whether childhood irritant/pollutant exposure may increase the risk of chronic cough in adulthood.
Sujets)
Toux , Études transversales , Polluants environnementaux , Épidémiologie , Hypersensibilité , Inflammation , Inspiration , RéflexeRésumé
La dermatitis palpebral constituye un proceso inflamatorio frecuente, ya que la piel que recubre los párpados es especialmente susceptible a la acción de agentes irritantes y alergénicos. La piel de ésta región es cuatro veces más fina que en el resto de la cara, lo que facilita la aparición de edema en caso de inflamación. Otros factores que influyen son la función anormal de la barrera cutánea que puede promover el desarrollo de la sensibilización, y el fácil acceso de numerosos alergenos a dicha zona, los que pueden llegar por contacto directo con las manos, por vía aerotransportada y en menor medida por aproximación. Son múltiples las causas que pueden originar dermatitis palpebral, tanto puramente dermatológicas como sistémicas, siendo en algunas ocasiones multifactorial. De todas ellas la más frecuente es la dermatitis alérgica por contacto, y en menor medida la dermatitis atópica y dermatitis irritativa por contacto También pueden verse comprometidos con un estado inflamatorio crónico los bordes palpebrales, lo que se denomina blefaritis. Los pacientes pueden referir dolor, ardor, prurito y sensación de cuerpo extraño. En ocasiones, debido a la variedad de patologías que pueden producir dermatitis palpebral, el diagnóstico diferencial suele ser difícil de realizar. Es importante conocer el factor causal para poder realizar un tratamiento adecuado, ya que al ser un trastorno por lo general persistente, los pacientes a menudo se someten a terapias inadecuadas, sin obtener la curación del cuadro.
Palpebral dermatitis is a frequent inflammatory process, since the skin covering the eyelids is especially susceptible to the action of irritants and allergens. The skin of this region is four times thinner than in the rest of the face, which facilitates the appearance of edema in case of inflammation. Other factors that influence are the abnormal function of the cutaneous barrier that can promote the development of sensitization, and the easy access of numerous allergens to this area, which can come by direct contact with the hands, by airborne and to a lesser extent by approximation. There are many causes that can cause palpebral dermatitis, both purely dermatological and systemic, being sometimes multifactorial. Of all of them, the most frequent is allergic contact dermatitis, and to a lesser extent, atopic dermatitis and irritant contact dermatitis. The palpebral borders can also be compromised with a chronic inflammatory state, which is called blepharitis. Patients may report pain, burning, pruritus and foreign body sensation. Occasionally, due to the variety of pathologies that can produce palpebral dermatitis, the differential diagnosis is usually difficult to perform. It is important to know the causal factor to be able to perform an adequate treatment, since being a generally persistent disorder, patients often undergo inadequate therapies, without obtaining the cure of the pathology.
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Objective@#o explore the problems encountered in the application of GBZ/T 237-2011 edition of "Diagnosis of Chronic Obstructive Pulmonary Disease Caused by Occupational Stimulating Chemicals" , and to provide reference for the revision of the new standard.@*Methods@#Delphi expert survey method was used to consult experts on the reasonableness of six primary indicators (scope of application, diagnostic principles, diagnostic indicators, treatment principles, diagnostic grading, appendix A) and their corresponding secondary indicators in the Diagnosis of Chronic Obstructive Pulmonary Disease (COPD) caused by Occupational Stimulant Chemicals.@*Results@#The results of the first round of Delphi method showed that the reasonable mean of the diagnostic criteria about long-term occupational history, smoking history and clinical diagnostic criteria was less than 7, and the coefficient of variation was greater than 0.25, indicating that the experts disagreed with the scope of application of the original criteria; the average of smoking history and 3-year working age were 1.78 and 3.43 (less than 7) respectively, which indicated that the experts agreed that the two diagnostic indexes were not conducive to the practical work of occupational disease clinicians; among the diagnostic indicators, smoking history and smoking volume were taken into account in a comprehensive way, and the average values were 7.61 and 7.61 (greater than 7) , respectively. the coefficient of variation was less than 0.25, indicating that the experts had concentrated their opinions and agreed that such indicators could be considered into the diagnostic index system.@*Conclusion@#"Diagnosis of Chronic Obstructive Pulmonary Disease Caused by Occupational Stimulating Chemicals" should be improved by expanding the scope of occupational irritant gases. Smoking problems can be considered in combination with clinical practice, and occupational exposure history can be considered to reduce appropriately.
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PURPOSE: This study was done to develop an evidence-based nursing clinical practice guideline for Moisture associated skin damage (MASD) prevention and management for patients in Korea. METHODS: The guideline adaptation process was used and conducted according to the guideline adaptation manual developed by the Korean Hospital Nurses Association. It consists of three main phases and 9 modules including a total of 24 steps. RESULTS: The adapted MASD clinical practice guideline consisted of 4 sections, 8 domains and 28 recommendations. The number of recommendations in each section was: 7 on MASD assessment, 14 on MASD prevention and management, 4 on education, and 3 on organizational policy. Of the recommendations, 3.6% were marked as A grade, 28.6% as B grade, and 67.8% as C grade. CONCLUSION: This MASD clinical practice guideline is the first to be developed in Korea. The developed guideline will contribute to standardized and consistent MASD prevention and management. The guideline can be recommended for dissemination and utilization by nurses nationwide to improve the quality of MASD prevention and management. Regular revision is recommended.
Sujets)
Humains , Dermatite irritative , Éducation , Soins infirmiers factuels , Pratique factuelle , Intertrigo , Corée , Politique organisationnelle , Hygiène de la peau , PeauRésumé
Objective To investigate reflectance confocal microscopy (RCM) features of irritant cutaneous reactions to sodium lauryl sulphate (SLS) in healthy persons aged from 18 to 60 years,to analyze effects of age and gender on cutaneous reactions,and to estimate the value of RCM in objective evaluation of cutaneous reactions.Methods An occlusive patch test was performed on the back of 120 healthy testees with 0.1％ and 0.5％ SLS solution (0.1％ and 0.5％ SLS groups) and distilled water (negative control group) for 48 hours.At different time points after the patch removal,clinical evaluation and RCM were performed.Results RCM imaging in the 0.1％ and 0.5％ SLS groups showed parakeratosis,indistinct structure of the stratum corneum,spongiosis and infiltration of inflammatory cells in the epidermis,and telangiectasia in the papillary dermis.The incidence of RCM features reached the peak until 24 hours after the removal of 0.1％ and 0.5％ SLS patches,and the incidence of telangiectasia in the dermis was up to 66.7％ and 95.0％ in the 0.1％ and 0.5％ SLS groups respectively.At 24 hours after the removal of 0.5％ SLS patch,the incidence of spongiosis was significantly lower in the males than in the females (68.9％ [42/61] vs.84.7％ [50/59],x2 =4.24,P ＜ 0.05).However,the incidence of spongiosis was significantly higher in testees aged 18-40 years than in those aged 41-60 years at 24 hours after the removal of 0.1％ SLS patch (53.3％[32/60] vs.35.0％[21/60],x2 =4.09,P ＜ 0.05).For the other RCM features,there were no significant differences in their incidence between different genders or age groups after the removal of 0.1％ and 0.5％ SLS patches (all P ＞ 0.05).Clinical evaluation showed that after the removal of 0.1％ and 0.5％ SLS patches,no significant difference in the incidence of irritant cutaneous reactions was observed between the males and the females or between the testees aged 18-40 years and those aged 41-60 years (all P ＞ 0.05).There were good correlations between the clinical evaluation results and RCM features.At 24 hours after the removal of 0.1％ SLS patch,the correlation coefficient between spongiosis and clinical evaluation results was up to 0.77,so was that between telangiectasia in the dermis and clinical evaluation results (both P ＜ 0.001).However,at 0.5 hour after the removal of SLS patches,clinical evaluation showed that the positive reaction rates were 2.5％ (3/120) and 12.5％ (15/120) in the 0.1％ and 0.5％ SLS groups respectively.In the meantime,there were 17.5 ％ (21 / 120) and 51.7％ (62/120) of testees manifesting more than 2 RCM features in the 0.1％ and 0.5％ SLS groups respectively,which were more similar to the clinical evaluation results at 24 hours after the removal of SLS patches (34.2％ [41/120] and 85.0％ [102/120] in the 0.1％ and 0.5％ SLS groups respectively) compared with the clinical evaluation results at 0.5 hour after the removal of SLS patches.Conclusions Neither gender nor age affects irritant cutaneous reactions to 0.1％ and 0.5％ SLS.Compared with clinical evaluation,RCM can evaluate cutaneous reactions more objectively and accurately in the early stage of irritant reactions.
Résumé
Se efectuó un estudio descriptivo y transversal, de casos y controles no pareado, de 120 pacientes con asma persistente, atendidos en la consulta de Alergología del Policlínico de Especialidades, perteneciente al Hospital Provincial Docente Clinicoquirúrgico Saturnino Lora Torres de Santiago de Cuba, desde enero de 2014 hasta igual periodo de 2015, con vistas a describir las características clínicas y causas de esta enfermedad. Los pacientes fueron seleccionados mediante muestreo aleatorio simple y se distribuyeron en 2 grupos: uno de 60 integrantes con asma severa (de estudio) y el otro de igual cantidad con asma ligera (control). En la casuística predominaron los afectados con asma persistente moderada-severa del sexo femenino y el grupo etario de 40 años y más, mientras que los irritantes inespecíficos y las infecciones respiratorias resultaron ser los factores predisponentes de mayor ocurrencia. Sobresalieron la asociación con nasosinopatías y los cambios bruscos de temperatura
A descriptive and cross-sectional, cases and controls non paired study of 120 patients with persistent asthma was carried out. They were assisted in the Allergology Service of the Specialties Polyclinic, belonging to Saturnino Lora Torres Teaching Clinical Surgical Provincial Hospital in Santiago de Cuba, from January, 2014 to the same period in 2015, aimed at describing the clinical characteristics and causes of this disease. The patients were selected by means of simple random sampling and they were distributed into 2 groups: one of 60 members with severe asthma (study group) and the other with the same number with light asthma (control group). In the case material there was a prevalence of those affected with moderate-severe persistent asthma from the female sex and the 40 years age group and over, while the unspecific irritant and the respiratory infections were the predisposing factors that occurred with more frequency. The association with nasosinopathies and the abrupt changes of temperature were notable
Sujets)
Humains , Mâle , Femelle , Adulte , Asthme/étiologie , État de mal asthmatique/physiopathologie , Facteurs précipitants , Infections de l'appareil respiratoire , Signes et symptômes respiratoires , Soins secondaires , Épidémiologie Descriptive , Études transversalesRésumé
Resumen:La dermatosis profesional es aquella alteración dermatológica que se ve originada o empeorada por las condiciones de trabajo. Los estudios comparativos entre países se ven limitados por las diferencias existentes en la notificación de enfermedades profesionales, siendo muchas veces su incidencia subestimada a pesar de ser de gran impacto socioeconómico, pues éstas son una causa frecuente de incapacidad y/o discapacidad relacionada con el trabajo, pudiendo constituir un porcentaje importante de las indemnizaciones económicas en muchas naciones. Es difícil establecer la relación de causalidad entre las dermatosis y una profesión o actividad laboral específica sin disponer de parámetros objetivos, por lo que este artículo busca dar un amplio panorama de cómo abordar el problema médico legal de las dermatosis ocupacionales en las pericias diarias de un médico legista.
Abstract:The professional dermatosis is a dermatological alteration that is originated or worsened by conditions of work. The comparative studies among different countries are limited by the differences in the notification system of occupational diseases, in such a manner that is often underestimated even though they have a socioeconomic impact. In the case of the occupational dermatosis, in many countries they constitute an important percentage of the economic indemnifications, and also a frequent reason of disability related to the job itself. Being able to establish a relation of causality between the dermatosis and a profession or specific labor activity without having objective parameters is most of the time difficult, so that this article seeks to give a wide panorama of how to approach the medical legal problem of the occupational dermatosis in the daily expertise of a forensic doctor.
Sujets)
Humains , Dermatite irritative/diagnostic , Dermatite professionnelle/diagnostic , Médecine légaleRésumé
PURPOSE: Nonallergenic irritants can aggravate the symptoms of rhinitis. We investigated the clinical responses of children with allergic rhinitis (AR) and nonallergic rhinitis (NAR) to nonallergenic irritants, and identified factors associated with these responses. METHODS: Children with chronic rhinitis (n=208) were classified as having AR or NAR based on the presence of aeroallergen-specific IgE. Healthy controls (n=24) were recruited for comparison. The Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines were used to classify patients, and their irritant score (0-21 points) and current symptom score (5-35 points) were measured. Subjects with irritant scores ≥3 and <3 were classified as having irritant and nonirritant rhinitis, respectively. RESULTS: The mean age of enrolled subjects was 6.8 years (range: 1.8-16.0 years). The AR and NAR groups had similar irritant scores (P=0.394) and proportions of subjects with irritant scores ≥3 (P=0.105). Irritant score correlated positively with symptom score (P=0.005), and the proportion of subjects with irritant scores ≥3 was greater in children with moderate-severe rhinitis than in those with mild rhinitis (P=0.046). Multiple logistic regression analysis indicated that the presence of atopic eczema increased the risk for sensitivity to a nonallergenic irritant (aOR=2.928, 95% CI 1.567-5.473, P=0.001). CONCLUSIONS: Response to a nonallergenic irritant was useful for gauging the severity of rhinitis, but not for differentiating AR from NAR. AR and NAR patients with atopic eczema may increase nasal sensitivity to nonallergenic irritants.
Sujets)
Enfant , Humains , Asthme , Eczéma atopique , Immunoglobuline E , Irritants , Modèles logistiques , RhiniteRésumé
Contexto: Estudos epidemiológicos em Dermatite Ocupacional e uso de Equipamentos de Proteção Individual (EPIs) no Brasil são raros porque não há notificação obrigatória dessa doença. Estima-se que existam casos de subdiagnóstico, pois muitos trabalhadores não procuram o serviço de saúde temendo a perda do emprego e, além disso, o mau uso de EPIs decorrente de dermatite pode expor o trabalhador à fatores agressores presentes em sua atividade profissional. Objetivos: Verificar a relação entre a ocorrência da dermatite de contato irritativa e o uso dos EPIs, identificando fatores de risco e medidas adotadas. Métodos: Foram selecionados 100 trabalhadores, no período de julho a dezembro de 2013, que utilizam diariamente EPIs para suas atividades profissionais e que foram encaminhados ao ambulatório da empresa INMETRA. Todos foram convidados a preencher um questionário sobre lesões de pele e EPIs. Resultados: De acordo com os dados obtidos, nota-se que a incidência de dermatites é 27%, a doença atinge principalmente mulheres (p<0,001), acomete principalmente mãos (96,3%) e não se correlaciona ao compartilhamento de EPIs entre colegas, mas sim ao uso prolongado na jornada de trabalho (p<0,002) e uso por mais de 1 dia (p<0,044). Conclusões: Este estudo nos fez refletir sobre a importância da propagação do conhecimento sobre a dermatite de contato irritativa (DCI) junto aos trabalhadores, quanto a orientação correta sobre o diagnóstico e medidas a serem tomadas para o tratamento e ainda a avaliação de um EPI adequado para as pessoas acometidas pela doença.
Context: Epidemiological studies in Occupational Dermatitis and use of Personal Protective Equipment (PPE) in Brazil are rare because there is no mandatory reporting of this disease. There are some cases of underdiagnosis because many workers do not seek health services fearing to lose their jobs and, moreover, the misuse of PPE due to dermatitis may expose the employee to the aggressive factors present in their professional activity is estimated. Objectives: To investigate the relationship between the occurrence of irritant contact dermatitis and use of PPE, identifying all the risk factors and measures adopted. Methods: There were selected 100 workers in the period from July to December 2013 using PPE for their daily professional activities, that were referred to the outpatient clinic of the company INMETRA. All of them were asked to complete a questionnaire about skin lesions and PPE. Results: According to the data obtained, we noted that the incidence of dermatitis is 27%, mainly affects women (p<0.001), mainly affects the hands (96.3%) and does not correlate to the IPE sharing between colleagues, but the prolonged use of working hours (p<0.002) and the use for more than 1 day (p<0.044). Conclusions: This study made us reflect on the importance of spreading knowledge about the DCI with the workers, as the correct guidance on the diagnosis and measures to be taken for treatment and further evaluation of PPE suitable for people affected by disease.
Sujets)
Dispositifs de protection , Santé au travail , Dermatite irritative , Dermatite professionnelle , Eczéma de contact/prévention et contrôle , Facteurs de risqueRésumé
Objective To understand the prevalence and the nursing status of incontinence and incontinence-associated dermatitis (IAD),analyze the risk factors of the occurrence of IAD,and to provide effective measures for the prevention and management of IAD.Methods Using the questionnaire survey, 1 318 hospitalized patients in 2 grade three hospitals of Suzhou were investigated,and then the results were analyzed.Results The prevalence of incontinence was 10.70％(141/1 318),among the prevalence of urinary incontinence was 4.63％(61/1 318),fecal incontinence was 4.32％(57/1 318);with 24.11％(34/141) of incontinent patients having IAD;disposable pad and briefs were the most common containment devices,only 36.17％ (51/141) of the incontinent inpatients using skin protectant after perineal skin clean.Single factor analysis revealed that IAD was related with wards, types of incontinence, character of stools, frequency of feces, antibiotics, modes of nutrition support, Braden scores, level of albumin and prealbumin.Unconditional Logistic regression indicated that risk factors of IAD included the level of serum albumin (OR=0.769, P＜ 0.05), Braden scores(OR=0.335, P＜ 0.05) and frequency of feces(OR=11.076, P ＜ 0.05).Conclusions Incontinence and IAD are common in hospitalized patients,low serum albumin, low Braden scores and high frequency of feces are the risk factors of IAD.The clinical nurses have not paied enough attention on the prevention of IAD, lacked relevant knowledge and skin care regimen.