Occurrence and seasonality of Campylobacter spp. in Portuguese dairy farms.

The growing idea that natural products are better for consumption is creating behaviors that can lead to food safety problems and an increase of healthcare costs. One of the trending products is raw milk, which in some countries is sold by vending machines outside dairy farms. Campylobacteriosis is the most common gastrointestinal infection in humans in the European Union since 2005. Several outbreaks have been associated with the consumption of raw milk contaminated with Campylobacter spp. In the present study, the occurrence and seasonality of Campylobacter spp. in raw cow's milk were determined. Other samples from the dairy farm environment were also analyzed to understand the possible routes of contamination. The study was conducted from November 2020 to September 2021 in randomly selected dairy farms located in northern Portugal. One liter of milk was collected from bulk cooling tanks transported to the laboratory and analyzed within 24 h. Campylobacter spp. detection and identification were performed using real-time PCR methodology and confirmation followed ISO standards. From 100 dairy farms evaluated, the occurrence of Campylobacter spp. was estimated at 4.0 % in raw cow's milk samples. In the samples from the environment of the farms, only contaminated fecal samples were found, corresponding to an occurrence of 4.2 %. Positivity was observed in summer months. The results of this study indicate the potential risk of campylobacteriosis after the consumption of raw milk. Consumers who seek raw milk for health reasons should be aware of the risk, especially if they belong to vulnerable groups. Moreover, it raises the question of how climate change will impact food safety, suggesting that routine surveillance for zoonotic pathogens should be implemented in dairy farms.

Evaluation of Antimicrobial Resistance of Different Phylogroups of Escherichia coli Isolates from Feces of Breeding and Laying Hens.

Animal and food sources are seen as a potential transmission pathway of multi-drug resistance (MDR) micro-organisms to humans. Escherichia. coli is frequently used as an indicator of fecal contamination in the food industry and known as a reservoir of antimicrobial resistance genes (ARGs). Microbial contamination as a major outcome for the poultry and egg industry and is a serious public health problem. In the present study we performed the quantification of ß-glucoronidase positive E. coli in 60 fecal samples of breeding and laying hens collected in Portugal in 2019. Phylogenetic and pathotypic characterization, antimicrobial susceptibility, and detection of resistant extended-spectrum ß-lactamase (ESBL) genes were assessed. The phylogenetic and pathogenic characterization and detection of ESBL genes were assessed by real-time PCR and antimicrobial susceptibility was evaluated using the disk diffusion method. Overall, E. coli quantification was 6.03 log CFU/g in breeding hens and 6.02 log CFU/g in laying hens. The most frequent phylogroups were B1. None of the isolates was classified as diarrheagenic E. coli (DEC). In total, 57% of the isolates showed MDR and 3.8% were positive for ESBL. Our study highlights that consumers may be exposed to MDR E. coli, presenting a major hazard to food safety and a risk to public health.

Development and validation of the Frontal Fibrosing Alopecia Severity Score.

BACKGROUND: Frontal fibrosing alopecia (FFA) is a scarring alopecia characterized by recession of the frontotemporal hairline and loss of the eyebrows. OBJECTIVE: To design and validate a scoring system to assess the severity of FFA. METHODS: The Frontal Fibrosing Alopecia Severity Score (FFASS) was developed; criterion validity was assessed by the Investigator's Global Assessment, and construct validity was evaluated by the convergence of other measures of severity (the Patient's Global Assessment], the rest of the clinical features, the Lichen Planopilaris Activity Index, and quality of life measures (Dermatology Life Quality Index and Hospital Anxiety Depression Scale). Intraobserver and interobserver reliability were determined. RESULTS: In total, 103 female patients were included. The FFASS showed significant correlation to the Patient's Global Assessment, occipital involvement, and the Lichen Planopilaris Activity Index. Intraobserver reliability was completed for 31 subjects and showed good correlation (intraclass correlation coefficient, 0.86; 95% confidence interval, 0.7-0.95; P < .001). Interobserver reliability showed excellent correlation (intraclass correlation coefficient, 0.97; 95% confidence interval, 0.95-0.99; P < .001). LIMITATIONS: The study was performed at a single institution, and only female patients were assessed. CONCLUSIONS: The FFASS is a statistically validated scale and a reliable measure of FFA severity, and it can be used in clinical practice and future research studies as an assessment tool.

Protein contact dermatitis--case report.

Protein contact dermatitis is a skin condition not well known and underdiagnosed by dermatologists, resulting from an IgE-mediated allergic reaction. Clinically it presents as a chronic hand and/or forearms eczema of occupational origin, especially in professionals who work as food handlers. Epicutaneous tests are negative, and to diagnose this condition it is necessary to perform immediate-type allergy tests. The most sensitive and practical is the prick-by-prick test with food that the patient refers to cause intense itching after immediate skin contact. Treatment is symptomatic, and it is mandatory to avoid the responsible allergen, wearing plastic gloves and even sometimes leaving the workplace for symptom resolution.

Protein contact dermatitis - case report / Dermatite de contacto proteinica - relato de caso

Protein contact dermatitis is a skin condition not well known and underdiagnosed by dermatologists, resulting from an IgE-mediated allergic reaction. Clinically it presents as a chronic hand and/or forearms eczema of occupational origin, especially in professionals who work as food handlers. Epicutaneous tests are negative, and to diagnose this condition it is necessary to perform immediate-type allergy tests. The most sensitive and practical is the prick-by-prick test with food that the patient refers to cause intense itching after immediate skin contact. Treatment is symptomatic, and it is mandatory to avoid the responsible allergen, wearing plastic gloves and even sometimes leaving the workplace for symptom resolution.

A dermatite de contacto proteínica é uma condição pouco conhecida e infra-diagnosticada pelos dermatologistas, resultante de uma resposta alérgica de tipo imediato, mediada por IgE. Clinicamente apresenta-se como um eczema crónico em mãos e/ou antebraços de origem ocupacional, sobretudo em profissionais que trabalham manipulando alimentos. As provas epicutâneas são negativas e para realizar o diagnóstico desta condição há que realizar testes alérgicos de tipo imediato, sendo o mais sensível e rápido, o prick-by-prick test com os alimentos que o paciente refere causar-lhe prurido intenso e imediato ao seu contacto. O tratamento é sintomático, sendo necessário evitar o alérgeno responsável, utilizar luvas de plástico e em ocasiões abandonar o posto de trabalho para a sua resolução.

Undesirable effects after treatment with dermal fillers.

BACKGROUND: Soft tissue augmentation is one of the most frequent techniques in cosmetic dermatology. Nowadays, there are a high number of available materials. Nonanimal hyaluronic acid (HA) is one of most useful fillers for lip augmentation and for treating nasolabial folds, marionette lines, and the dynamic wrinkles of the upper face. OBJECTIVE: To evaluate the type and management of undesirable effects of nonanimal reticulated or stabilized HA observed in our cosmetic unit in the past 3 years. MATERIALS AND METHODS: The consecutive patients using HA attending to our clinic in the past 3 years were divided into 3 categories, according to the time of presentation of the adverse reactions: immediate, early, and late-onset complications. All patients were treated. RESULTS: Twenty-three patients presented to our clinic complaining of complications after soft tissue augmentation with HA. Ten patients presented immediate-onset complications, 8 showed early-onset complications, and 5 cases complaint of late-onset complications. Treatment of the first group consisted of hyaluronidase injection, massage, and topical antibiotics. Early- and late-onset complications were treated with intralesional triamcinolone acetonide. All patients improved, with the exception of a woman with recurrent granulomas. CONCLUSION: Generally, undesirable effects of HA (immediate, early, or late onset) are not frequent, and when present, they improve if treated properly. Physicians need to be aware of these possible adverse events in order to establish proper treatment and prevent scarring or other sequelae.

Las pruebas epicutáneas de contacto en medicina laboral / Patch testing in occupational medicine

Dentro de la Medicina Laboral las dermatosis ocupacionales suponen entre el 30-60% del total de enfermedades profesionales y, dentro de ellas el 80-90% son dermatitis de contacto. Este alto número no se ve reflejado en datos oficiales debido a que en muchas ocasiones, al ser condiciones de rápida resolución o de escasa repercusión sistémica, no son declaradas. En relación a las dermatitis de contacto, la forma más frecuente en el entorno laboral es la forma alérgica y la que preferentemente se declara, al ser un proceso que en muchas ocasiones constituye motivo de incapacidad. Para el abordaje diagnóstico y correspondiente asociación con el entorno de trabajo es imprescindible realizar una historia clínica laboral completa junto con la descripción de las lesiones, y la utilización de métodos diagnósticos distintos a los de otros procesos no cutáneos, como son las pruebas de parche (patch test) o pruebas epicutáneas. Constituyen un método simple, accesible y seguro para llegar al diagnóstico de las dermatitis alérgicas de contacto. Incluyen una batería estándar, propia de un país donde se trabaja, ampliada de baterías específicas en relación con el perfil, las tareas y los productos manipulados por el trabajador. La prevención en el trabajo es el único tratamiento etiológico para la sustitución y control de los riesgos laborales relacionados con las dermatosis profesionales (AU)

In occupational medicine, occupational dermatoses account for 30 to 60% of the total amount of occupational diseases and, within 80 to 90% of them correspond to contact dermatitis. This high number is not reflected in official data because in most cases, as conditions of rapid resolution or low systemic impact, they are not declared. Regarding contact dermatitis, the most common type in the workplace is the allergic type, which preferably is declared, because often results in disability. For the correct diagnosis and association with the work environment is essential to make a full history of the patient’ occupational background, correct description of the skin lesions, and the use of diagnostic methods other than those of non-cutaneous processes, such as patch testing. They provide a simple, accessible and safe method for the diagnosis of allergic contact dermatitis. They include a standard national baseline series, proper of the country where the patient works, and additional extended series, specific to the occupation performed by the worker. Prevention at work is the only etiological treatment for replacement and control of occupational hazards associated with occupational skin diseases (AU)

Afectación ungueal de origen ocupacional / Nail involvement of occupational origin

Desde el siglo V a.C. Hipócrates ya describía las afectaciones ungueales, las cuales luego se relacionaban con enfermedades sistémicas o adquiridas. Los médicos de medicina del trabajo se deben preparar para detectar las afectaciones por factores externos. Sin embargo son pocos los casos publicados sobre patología ungueal de origen ocupacional. Nuestra revisión consiste en brindar conocimientos básicos sobre esta asignatura. Desde su definición, función y la descripción de su anatomía. La patología ungueal la clasificaremos según: a) anomalías de: la forma, de la adhesión, de la coloración, superficie, infección; b) según el mecanismo de acción que se producen o c) según el tipo de ocupación. Al adquirir estos conocimientos podremos establecer posteriores pautas de prevención eficaces (AU)

From the V century B.C. Hippocrates described the damages in the nails, which then were related to systemic diseases or acquired. As physicians we must prepare work to detect the effects caused by external factors. However, few published cases of occupational origin nail pathology. Our review is to provide basic knowledge on this subject. From its definition, function and description of the anatomy. The nail pathology classify as: a) anomalies: the way of accession, coloration, surface, infection, b) according to the mechanism of action that occur oc) by type of occupation. By acquiring this knowledge we can establish effective prevention guidelines later (AU)

N-acetylcysteine in the Treatment of Trichotillomania.

Trichotillomania is as medical condition caused by the patient himself by pulling out of is own hair, resulting in a perceptible hair loss pattern that frequently is associated with other psychiatric processes. Generally has a chronic course in most patients, and a challenging therapeutical management. There are several available options for is treatment, but the clinical response is not satisfactory in many patients. Recently, N-acetylcisteine, a glutamate modulator, has shown efficacy in the treatment of trichotillomania and other compulsive behaviors, and is considered a new alternative in the management of this condition. We describe two patients with trichotillomania successfully treated with N-acetylcysteine. Nevertheless, further studies need to be conducted to establish the appropriate treatment regimen and to evaluate it long-term efficacy in improving this chronic condition.