Generalized eczema induced by nadroparin.

The case of a 39-year-old female with generalized eczema following sodium nadroparin administration was referred to us. Positive patch-tests for several low molecular weight heparins (LMWH), but negative for unfractionated heparins (UFH) and tinzaparin were obtained. Furthermore, intradermal tests gave positive results to sodium and calcium heparin, while only subcutaneous challenge showed tinzaparin sensitivity. In summary, in heparin type IV hypersensitivity diagnosis, the intradermal test seems to be an eligible tool, rather than patch-test.

Hepatitis por danazol en paciente con déficit funcional de C1 inhibidor / Hepatitis induced by danazol in a patient with functional deficit of C1-inhibitor

No disponible

Programas informáticos para la organización de bibliografía médica / Computer programs for the organization of medical bibliography

La búsqueda bibliográfica es una parte importante del trabajo del médico hoy en día. Por otra parte, la difusión del ordenador personal, el abaratamiento del módem y el acceso gratuito a bases de datos médicas (pe.la popular Medline) han hecho posible las búsquedas en tiempo real (online) tanto en el lugar de trabajo como en el propio hogar.Estas bases de datos son en nuestros días uno de los recursos más interesantes que ofrece la WWW al médico que investiga y publica o simplemente quiere estar al día. No obstante, el manejo de la información obtenida de esta manera frecuentemente conlleva muchas horas y esfuerzo. Para facilitar al médico esta tarea existen en el mercado diferentes aplicaciones de software de organización bibliográfica. En este artículo ofrecemos al médico prácticos consejos de organización bibliográfica 'bajada' desde Internet, y una valoración crítica del software de organización bibliográfica actualmente disponible en el mercado internacional (AU)

Patient satisfaction and allergen immunotherapy.

Although health-related quality of life and patient satisfaction are shifting doctors' attention to the patient, the scant number of publications on quality of life questionnaires and allergen immunotherapy contrasts with the quickly growing number of those dealing with this topic and pharmacotherapy. We delivered an original, self-administered patient satisfaction questionnaire to 95 patients (age = 17.7 +/- 7.9 years) suffering from allergic rhinoconjunctivitis (45%) and/or asthma (55%), who had been receiving allergen immunotherapy for more than 1 year (22.2 +/- 10.5 months). The anonymous, voluntary questionnaire was filled in at home; although only 32% were returned, we found no significant differences relating to age, sex, asthma, allergen sensitization or allergen immunotherapy regimen between the source sample and those who replied. Patient expectations, which were scored on a scale of 1 to 10 points, were rather poor, in sharp contrast with patient perception score after treatment (5.4 +/- 1.8 vs. 8.0 +/- 2.0, p < 0.0001). Perception scores did not differ between patients receiving seasonal or perennial allergen immunotherapy, nor did they depend on the duration of treatment. In addition, patient age, sex, diagnosis or sensitization did not appear to influence perceptions. In conclusion, our data suggest that when a voluntary, anonymous questionnaire is used, patients express a poor opinion of allergen immunotherapy, in contrast with high satisfaction after treatment, provided that allergen immunotherapy lasts long enough.

Sensitization to Anisakis simplex: an unusual presentation.

It has recently been published patients suffering from urticaria or anaphylaxia induced by nematodes usually parasitizing fishs or cephalopode, in whom, Anisakis simplex (AK) sensitization prevalence was detected up to 37%. We tried out a prospective study to evaluate the presence of AK specific-IgE in an asthmatic population, comparing to other group of patients with urticaria. Complaints related to food ingestion were recorded in both, and dietetic measures were advised. Thirteen patients (13/66; 20%) showed AK specific IgE. Nine of them were asthmatics (p < 0.01), and only 4 suffered from urticaria. Four patients, three of them asthmatics, could link symptoms after fishs, cephalopode or, surprisingly, seafood intake, including epigastralgia, rhinorrhea, conjunctivitis, hives, and dyspnea. Atopia was not a consistent status, only five AK sensitized patients also did to common inhalants (all skin prick-test positive to house dust mites). Asthmatic AK-sensitized patients were older than non AK-sensitized asthmatics (46.23 vs 30.1; p < 0.05). The way of sensitization could be inhalative or through digestive mucosa parasitization by live larvae. Possibility that an AK allergen can play a role in adult asthma, should be considered specially in countries with high fish or seafood diet content.

[Occupational asthma due to exotic wood: Nesorgordonia papaverifera (danta or kotibe)]. / Asthme professionnel à un bois exotique: Nesorgordonia papaverifera (danta ou kotibe).

The authors report the first description of occupational asthma induced by sensitisation to danta or kotibe wood in an atopic, smoking, cabinet maker presenting with non-specific bronchial hyper-reactivity. The asthma used to appear several hours after finishing work and was exclusively on those days when he was handling danta wood. After exclusion of the offending allergen for several weeks a delayed asthmatic reaction was seen seven hours after a provocation test with the incriminated wood dust. The bronchial reaction was accompanied by cutaneous symptoms also. An immediate positive cutaneous reaction to the wood dust extract was seen and the cutaneous sensitivity could be passively transferred. These results, as well as the efficacy of treatment with disodium cromoglycate, suggest that an IgE mechanism is involved in the pathogenesis of this occupational asthma.

Long-term modification on histamine-induced bronchoconstriction by disodium cromoglycate and ketotifen versus placebo.

In order to compare long-term changes induced on a wide spectrum of bronchial hyperreactivity (BH) by the antiallergic drugs disodium cromoglycate (DSCG) and ketotifen, 56 asthmatic patients (age range 15-55 years) were studied. Patients were allocated to three groups with similar age and BH level. During 2 months, 15 individuals inhaled 20 mg DSCG four times a day, 14 took ketotifen 1 mg twice a day orally and 14 one placebo (lactose) capsule twice a day. After preliminary results, an additional group of 13 patients took clemastine 1 mg orally twice a day for 1 week. Only the ketotifen and clemastine groups differed significantly from the placebo group on shifting log dose-response curves of inhaled histamine. In addition, no significant difference was seen between the ketotifen and clemastine groups. These results suggest that changes induced by ketotifen were mainly related to its powerful antihistamine action; similarly, nonspecific BH is not wholly dependent on mediator release.