1194 research outputs found
Sort by
Occupational allergic contact dermatitis to mercaptobenzotiazol
No full textIntrodução: A dermatite de contacto alérgica ao mercaptobenzotiazol e seus derivados tem sido reconhecida
de forma crescente nos países industrializados devido ao seu uso alargado na polimerização da borracha
sintética. Os autores descrevem dois casos clínicos com relevante exposição profissional. Caso 1: Homem de 46 anos, trabalhador na construção civil, com uma dermatite de oito meses de evolução, pruriginosa, localizada apenas nos
punhos, refratária a corticóide tópico de alta potência e anti-histamínico oral. Ao exame objetivo apresentava placas eritemato-violáceas infiltradas e pápulas eritematosas escoriadas em ambos os punhos. Os testes Prick e RAST ao latex foram negativos. Foram efetuados testes epicutâneos com a bateria padrão do Grupo Português de Estudo de Dermatite de Contacto, bateria de borrachas, bateria de colas e fragmentos da própria luva tendo-se verificado positividade ao mercaptobenzotiazol (++), mistura de mercapto (++) e à faixa elástica presente no punho das luvas,
às 72h e aos 7 dias. Caso 2: Homem de 61 anos, carpinteiro, com placas eritematosas infiltradas, pruriginosas, na região geniana e extensão para região cervical posterior, com cerca de 12 meses de evolução. Foram realizados testes epicutâneos com a bateria padrão do Grupo Português de Estudo de Dermatite de Contacto, bateria de borrachas e colas, bateria de cosméticos e fragmentos da própria máscara de proteção. Verificou-se positividade para mercaptobenzotiazol
(+ +), mistura mercapto (+ +) e elástico de máscara (+ +) na leitura das 72 horas e aos 7 dias. Discussão:
Apesar de serem alergénios bem conhecidos, o mercaptobenzotiazol e seus derivados podem estar presentes noutras fontes de exposição à borracha como o tecido elástico no vestuário. Uma vez o trabalhador sensibilizado, pode ser causa de incapacidade quer para a profissão quer para as atividades de vida diária.info:eu-repo/semantics/publishedVersio
Mauriac syndrome still exists
Get PDFBACKGROUND/OBJECTIVE:
Mauriac syndrome (MS) is a rare complication of type 1 diabetes mellitus (DM1). It is related to low insulin concentrations and is less common since longer-acting insulins became available. It is characterized by hepatomegaly, growth and puberty delay, and the presence of elevated transaminases and serum lipids. The aim of this study was to describe the patients from a pediatric diabetic population that fulfill the criteria of MS.
MATERIALS AND METHODS:
A retrospective analysis of the pediatric diabetic population with diagnostic criteria of MS currently followed at Hospital de Braga, was performed.
RESULTS:
From a population of 91 patients with DM1 18 years, 6 patients with the criteria for MS were identified: 5 girls, and 1 boy. The age at presentation was 13-17 years, with a minimum interval between DM1 diagnosis and MS criteria of 4 years. All the patients were prescribed intensive insulin therapy (median daily insulin dose: 0.88U/kg). All had a previous history of poor glycemic control before the diagnosis of MS with glycated hemoglobin (HbA1c) between 8.8 and 12.9%. Increase of hepatic enzymes was present in all the patients; 4 of them had associated hepatomegaly. All the girls presented puberty delay and cushingoid features. None of the patients presented short stature and 5 of them presented mixed dyslipidemia.
CONCLUSIONS:
Although MS is an ancient entity described in DM1, it still exists, particularly in adolescent females. Being aware of MS is of extreme importance since most of the clinical features are reversible with better glycemic control
Rapidly lethal dermatomyositis associated with cutaneous lymphangitis carcinomatosa
Get PDFA 70-year-old woman with a recent diagnosis of dermatomyositis (DM) presented to the dermatology department for study of a probably paraneoplastic syndrome. On examination, we observed discrete, indurated, reddish, painful plaques and nodules on her abdomen and both thighs. A cutaneous biopsy from an abdominal nodule, performed as part of the paraneoplastic workup, was suggestive of cutaneous lymphangitis carcinomatosa, secondary to unknown malignancy. An extensive investigation to locate the site of the primary tumour revealed no specific findings. A course of palliative chemotherapy with cisplatin and 5-fluorouracil was then given, but the patient's condition deteriorated and 6 months after her initial observation the patient died. We describe this case because, to our knowledge, the association between DM and cutaneous lymphangitis carcinomatosa has not been described yet in the literature and to highlight that, DM can be a rapidly lethal disease
Convalescence after tonsillectomy: comparative study between traditional dissection and with harmonic scalpel (Ultracision)
Get PDFIntrodução: Na população pediátrica a amigdalectomia é
um dos procedimentos cirúrgicos mais frequentes. O facto
de existirem diversas técnicas cirúrgicas e de poderem
estar associadas a diferente morbilidade, continua a gerar
discussão acerca de qual escolher. Nesse sentido, o objectivo
deste trabalho é comparar a morbilidade pós-operatória de
2 técnicas de amigdalectomia: dissecção clássica e dissecção
com bisturi harmónico.
Material e métodos: Estudo retrospectivo. Foram
alternadamente seleccionados doentes submetidos a
amigdalectomia por dissecção clássica e com bisturi
harmónico, no Serviço de Otorrinolaringologia do Hospital de
Braga, Portugal, entre Julho e Dezembro de 2011, num total
de 40 doentes em cada grupo. Dados relativos à duração do
internamento, complicações no pós-operatório imediato,
data de introdução da dieta habitual e recurso ao serviço de
urgência até ao 15º dia pós-operatório foram recolhidos e
comparados.
Resultados: 80 crianças, entre os 3 e os 14 anos, idade
média de 6 anos, 56% do sexo feminino. Foram submetidas
a adenoamigdalectomia 73 crianças e a amigdalectomia
7 crianças. Não se verificaram complicações durante o internamento e todos os doentes tiveram alta no dia
seguinte ao da cirurgia. Um número significativamente
maior de doentes submetidos a amigdalectomia com bisturi
harmónico (12/40 vs 1/40) recorreu ao serviço de urgência
nos dias seguintes à cirurgia, por odinofagia ou hemorragia
(p <0.05). O número de dias após cirurgia, em média, em que
foi introduzida dieta habitual, foi também significativamente
maior no grupo submetido a amigdalectomia com bisturi
harmónico (7 dias vs 4 dias) (p <0.05).
Conclusões: O uso do bisturi harmónico na amigdalectomia
mostrou neste estudo estar associado a maior morbilidade
pós-operatória, verificando-se maior recurso ao serviço de
urgência e maior demora na introdução de dieta habitual.
Estes factores devem ser tidos em conta na indicação da
técnica cirúrgica de amigdalectomia, principalmente na
população pediátrica
Role of central obesity in risk stratification after an acute coronary event: Does central obesity add prognostic value to the Global Registry of Acute Coronary Events (GRACE) risk score in patients with acute coronary syndrome?
Get PDFBACKGROUND:
Accurate risk stratification is an important step in the initial management of acute coronary syndrome (ACS), and current guidelines recommend the use of risk scores, such as the Global Registry of Acute Coronary Events risk score (GRACE RS). Recent studies have suggested that abdominal obesity is associated with cardiovascular events in patients with ACS. However, little is known about the additional value of abdominal obesity beyond risk scores. The aim of our study was thus to assess whether waist circumference, a surrogate of abdominal adiposity, adds prognostic information to the GRACE RS.
METHODS:
This was a retrospective cohort study of ACS patients admitted consecutively to a cardiac care unit between June 2009 and July 2010. The composite of all-cause mortality or myocardial reinfarction within six months of index hospitalization was used as the endpoint for the analysis.
RESULTS:
A total of 285 patients were studied, 96.1% admitted for myocardial infarction (with or without ST elevation) and 3.9% for unstable angina. At the end of the follow-up period, 10 patients had died and the composite endpoint had been reached in 27 patients (9.5%). More than 70% of the study population were obese or overweight, and abdominal obesity was present in 44.6%. The GRACE RS showed poor predictive accuracy (area under the curve 0.60), and most of the GRACE variables did not reach statistical significance in multivariate analysis. The addition of waist circumference to the GRACE RS did not improve its discriminatory performance.
CONCLUSION:
Abdominal obesity does not add prognostic information to the GRACE RS to predict six-month mortality or myocardial reinfarctio
Strychnine Intoxication: A Case Report
Get PDFStrychnine acts as an inhibitor of post-synaptic neuronal inhibition and intoxication leads to distinct clinical manifestations which may culminate in death. Since its commercialization is prohibited in most countries, cases of strychnine intoxication are now rare. We present a case of an elderly patient who voluntarily ingested a white powder thought to be strychnine. He developed myoclonus, startle response, and episodes of generalized muscle contractions accompanied by respiratory arrest in one occasion. Diazepam, valproic acid and supportive treatments were able to control manifestations, however the patient died after 2 days. Our aim is to alert clinicians that, despite its rarity, strychnine intoxication may still be seen in emergency departments, and clinical outcome can be influenced by rapid recognition and timely institution of adequate treatment
