Air pollution and seasonal asthma during the pollen season. A cohort study in Puertollano and Ciudad Real (Spain).

BACKGROUND: Many studies have demonstrated a positive association between air pollutants and emergency visits for asthma. However, few studies have included pollen when analysing this relationship in mild-moderate asthmatic patients. OBJECTIVE: To determine the importance of the pollutants such as ozone (O(3)), particles (PM(10)), nitrogen dioxide (NO(2)) and sulphur dioxide (SO(2)) in the clinical course of mild-moderate pollen-allergic asthmatic patients from two Spanish towns in La Mancha: Puertollano (high pollution levels) and Ciudad Real (low pollution levels). METHODS: We used a Poisson regression model to study a cohort of 137 patients from Puertollano and Ciudad Real during two pollen seasons (2000-2001) and analysed the relationship between air pollutant and pollen levels and daily symptoms, the medication used and peak-flow measurements. RESULTS: The number of asthma symptoms and the mean values of the PM(10), SO(2) and NO(2) levels were higher in Puertollano than in Ciudad Real. In Puertollano, the risk of asthma increased by 6% with a 3-day lag for PM(10), by 8% with a 3-day lag for O(3), by 4% with a 1-day lag for SO(2) and by 15% with a 3-day lag for O(3) when its values exceeded the health threshold (P < 0.05). CONCLUSIONS: The air pollution levels in Puertollano were associated with an increased risk of asthma symptoms in pollen-allergic asthmatic patients com pared with a similar group from Ciudad Real.

Contact dermatitis due to povidone-iodine: allergic or irritant?

A contact dermatitis due to to povidone-iodine (PI) which seemed to be a strong irritant reaction is described. Nevertheless, patch-test results suggested an allergic reaction that is cell mediated.

[Plasma exchange in dermatology: apropos of a case of dermatomyositis]. / Recambio plasmático en dermatología: a propósito de un caso de dermatomiositis.

We present a 45 years old male with dermatomyositis refractory to eight months of standard treatment who responded to plasma exchange. The efficacy of the procedure is estimated from clinical follow-up (increase in strength) and serum creatine-kinase activity (decrease from 3,380 to 44 u/ml.) after five sessions of plasma exchange. The therapeutic indications for PE are reviewed in dermatological diseases with emphasis on cases where the response to steroids or cytotoxic drugs is inadequate.

Slow infusion of vincristine in the treatment of refractory thrombocytopenic purpura.

Eight patients with idiopathic thrombocytopenic purpura (ITP), who were refractory to glucocorticoid therapy, were given slow infusions of vincristine (VCR) over a 4- to 6-hour period at weekly intervals for 4 weeks. Three patients showed a return to normal platelet counts maintained for 3 months or longer. A transient recovery was observed in 1 patient and a partial response was observed in 3 patients. All patients tolerated therapy well, without side effects. In conclusion, therapy with slow infusion of VCR can be effective in refractory ITP.