Subject(s)
Acute Generalized Exanthematous Pustulosis/etiology , Antitussive Agents/adverse effects , Dermatitis, Allergic Contact/ethnology , Dextromethorphan/adverse effects , Acute Disease , Acute Generalized Exanthematous Pustulosis/diagnosis , Adult , Dermatitis, Allergic Contact/diagnosis , HumansSubject(s)
Dermatitis, Occupational/diagnosis , Hand Dermatoses/diagnosis , Larva Migrans/diagnosis , Albendazole/therapeutic use , Antiprotozoal Agents/therapeutic use , Dermatitis, Occupational/drug therapy , Dermatitis, Occupational/etiology , Hand Dermatoses/drug therapy , Hand Dermatoses/etiology , Humans , Larva Migrans/drug therapy , Larva Migrans/etiology , Middle AgedABSTRACT
BACKGROUND: Patients can be tested for IgE sensitivities with in vivo or in vitro testing, but patients' experiences of different allergy test modalities have not been studied. The objective of this study was to investigate adult patients' experiences, views and preferences for allergy testing, exploring skin prick testing and allergen-specific IgE testing. METHODS: A qualitative study of adults attending out-patients for investigation of a suspected allergy. A purposive, convenience sample identified participants and semi-structured interviews were conducted, face to face or by telephone. Interviews were recorded and transcribed verbatim. Thematic content analysis was used to explore patients' experiences. RESULTS: 23 patients were interviewed. The characteristics of skin prick tests particularly valued were the immediacy and visibility of results, which enabled testing and interpretation to be achieved within a single clinic appointment. In vitro testing offered patients simplicity and procedural speed, necessitating only a single puncture site, and was perceived to be a superior test as it was conducted in a laboratory. CONCLUSIONS: The patient preferred method of allergy testing was skin prick testing rather than in vitro allergen specific IgE testing. However, most patients were accepting of either testing modality because their desire to confirm or exclude an allergic trigger overrode any perceived disadvantages of the test method. TRIAL REGISTRATION: Not applicable as study descriptive and qualitative.
Subject(s)
Dermatitis, Allergic Contact , Dermatitis, Occupational , Dermatitis, Allergic Contact/diagnosis , Dermatitis, Allergic Contact/etiology , Dermatitis, Allergic Contact/physiopathology , Dermatitis, Allergic Contact/therapy , Dermatitis, Occupational/diagnosis , Dermatitis, Occupational/etiology , Dermatitis, Occupational/physiopathology , Dermatitis, Occupational/therapy , Diagnosis, Differential , Disease Management , Humans , Patch Tests/methodsABSTRACT
A 69-year-old gentleman with non-Hodgkin's lymphoma (stage I), with baseline fibrotic lung changes on CT, received six cycles of R-PMitCebo chemotherapy containing bleomycin. Three months later he presented to the Accident and Emergency Department with progressive dyspnoea, dry cough, pyrexia and generalised lethargy. Chest radiographs showed bilateral lower zone opacities. Clinically, all signs initially pointed to community-acquired penumonia, but he failed to respond to standard treatment for this. Repeat high-resolution CT (HRCT) subsequently showed widespread peripheral interstitial changes consistent with marked fibrotic lung changes. It became apparent that this was in fact bleomycin-induced pulmonary toxicity. The patient rapidly deteriorated and developed type I respiratory failure. Despite intensive steroid treatment, the patient progressively got worse and died in the Intensive Therapy Unit 10 days after admission. Death was directly attributed to pulmonary fibrosis secondary to bleomycin treatment.
ABSTRACT
OBJECTIVE: To determine the maternal morbidity and mortality associated with multiple repeat caesarean sections. DESIGN: Retrospective study. SETTING: Security Forces Hospital serving Ministry of Interior and Security Forces personnel in Riyadh, Kingdom of Saudi Arabia. POPULATION: Three hundred and eight case records undergoing between fifth and ninth caesarean section (mean 7) were studied and compared with a control group of 306 patients undergoing third or fourth caesarean section during the period January 1994-December 2002. MAIN OUTCOME MEASURE: Operative and post-operative complications and difficulties. RESULTS: Five or more caesarean sections were associated with a longer operating time as well as an increased rate of severe adhesions. Blood transfusion rate was similar in the two groups but a drop of pre-operative to post-operative haemoglobin was significantly higher in the study group compared with the controls. There was no significant difference in the Apgar score of the baby, neonatal admission rate, incidence of caesarean hysterectomy, uterine scar rupture, placenta praevia, placenta accreta, bladder injury, incidence of postpartum pyrexia, wound infection and urinary tract infection between the two groups. There was no maternal death in the study group but one mother died in the control group. CONCLUSION: The higher order (5-9) repeat caesarean sections carry no specific additional risk for the mother or the baby when compared with the lower order (3 or 4) repeat caesarean sections.
