Acneiform eruption from epidermal growth factor receptor inhibitors

One of the fundamental aims of oncological research is the search for molecules with greater efficacy against tumors and less toxicity than the usual chemotherapeutic agents. Epidermal growth factor receptor inhibitors are a new group of drugs which, because of their more specific effect against neoplastic cells, seem to meet these characteristics. Skin eruptions are one of the most frequent adverse effects associated with their use, secondary to the drug's direct inhibitory effect on homeostasis of the epidermis and of the pilosebaceous follicle. Several cases of cutaneous toxicity in patients treated with epidermal growth factor receptor inhibitors have recently been published. We present three cases of acneiform eruptions attributable to different drugs in this family (cetuximab, gefitinib and erlotinib).     

Epicutaneous test with inhalers in the study of atopic dermatitis

In some 80% of patients with atopic dermatitis, the presence of specific IgE is found when facing food or environmental allergens. It has also been demonstrated in a sub-group of patients with atopic dermatitis that the dermatitis lesions are exacerbated following the ingestion or inhalation of allergens, and that they improve with reduction of exposure to allergens. Although the prick method and the determination of specific IgE in serum are highly sensitive techniques, epicutaneous tests, applying the allergen directly to the skin, might be the ideal diagnostic method since they reproduce the characteristic inflammatory response of the disease on the affected organ itself, the skin. However, there is great variability in the results obtained through epicutaneous tests with aeroallergens, basically due to methodological differences, which are reviewed in this paper. Finally, we present the results of carrying out epicutaneous tests with inhalant allergens on our patients with atopic dermatitis and controls, where some 27% of positive patches were obtained, basically with acari, and in those patients with more severe dermatitis, without there being complete concordance with the prick technique. For this reason, the epicutaneous test appears to be a method of allergological diagnosis that might be useful and complementary to the routine techniques of the prick method and the determination of specific IgE in serum, but it is in need of suitable standardization.     

From rhinitis to asthma,one or two diseases?

Rhinitis and asthma commonly coexist in allergic patients. This observation might be attributable to their coexistence in time, but it is also possible that both diseases are the opposite poles of a single disease affecting the respiratory system, or even an anomalous systemic immune response to the allergen. Nose-lung interactions have been widely studied from epidemiological, physiopathological, aetiological and pharmacological aspects. In the present article we review this topic and its main clinical implications.     

Local immunotherapy

Specific immunotherapy, together with avoidance of the allergen and symptomatic treatment, forms part of the treatment of allergic pathology. The oldest, best known and most studied form is subcutaneous immunotherapy (SCIT), whose efficacy, both in the short and the long term, has been widely demonstrated in numerous studies. However, in spite of having been shown to be safe, it is not free of adverse effects and must be administered under the supervision of medical personnel. This has encouraged the search for new ways of administration of similar efficacy, with a good safety profile and good adherence on the patient's side. Sublingual immunotherapy (SLIT) is the most relevant of the different alternatives studied. In this alternative the antigen is administered in the form of drops under the tongue. There are different dosages of administration depending on the allergen involved. The optimum treatment dose has still to be determined, at present a wide range of dosages are found in comparison with subcutaneous immunotherapy. Its mechanism of action is little known although immunological changes have been observed in different studies. SLIT has shown a good safety profile with scarce secondary effects, normally of a local character. Similarly, different clinical tests have been carried out in which its efficacy has been shown in the treatment of respiratory allergy both in children and in adults. For this reason, although there are still unresolved data concerning this way of administering the immunotherapy, it has been proposed by the WHO as a valid alternative to SCIT.     

Factors linked to bacterial vaginosis in nonpregnant women

OBJECTIVES: The purposes of this study were to test the hypothesis that vaginal douching is linked to bacterial vaginosis in both symptomatic and asymptomatic women and to identify other demographic, reproductive, and lifestyle factors associated with bacterial vaginosis. METHODS: In this cross-sectional study involving 3 clinic sites, 496 nonpregnant women completed a self-administered questionnaire. Their vaginal smears were assessed and cross-validated for bacterial vaginosis. RESULTS: The prevalence of bacterial vaginosis across clinics ranged from 15% to 30%. In analyses restricted to site 1, adjusted odds ratios (ORs) for bacterial vaginosis remained significant for African American women with 13 or fewer years of education (OR = 5.5, 95% confidence interval [CI] = 2.1, 14.5), hormone use within the past 6 months (OR = 0.5, 95% CI = 0.2, 0.8), and vaginal douching within the past 2 months (OR = 2.9, 95% CI = 1.5, 5.6). CONCLUSIONS: Two lifestyle factors emerge as strongly associated with bacterial vaginosis: systemic contraceptives appear protective, whereas douching is linked to an increase in prevalence. The temporal relationship between douching and bacterial vaginosis needs further clarification.     

血清NO、IL-6及IL-8与急性高原病的关系研究

目的 :了解血清一氧化氮 (Nitricoxide ,NO)、白介素 - 6 (Interleuk - 6 ,IL - 6 )及白介素 - 8(Interleuk - 8,IL - 8)与急性高原病 (Acutehighaltitudediseaes ,AHAD)及NO与IL -6、IL - 8之间的关系。方法 :将 4 7例AHAD患者随机分为两组 ,一组为常规药物治疗组 (2 3例 ) ,另一组为NO治疗组 (2 4例 )。常规药物治疗组给予吸氧、氨茶碱、地塞米松、速尿等药物常规治疗 ,NO治疗组仅给予吸入由海拔 36 5 8m高度的空气平衡的 1 0 ppm的NO气体 ,每天2次 ,上午、下午各 1h ,并对两组AHAD患者治疗前后的血清NO(NO以其代谢终产物NO3-和NO2 - 表示 )、IL - 6及IL - 8含量进行观察比较。结果 :两组治疗后的血清IL - 6及IL - 8含量均显著低于治疗前 ,NO含量则均显著高于治疗前 (NO治疗组P <0 .0 0 1 ,常规药物治疗组P <0 .0 5～ 0 .0 1 )。且两组治疗后的血清NO、IL - 6及IL - 8含量亦具有显著性差异 (P <0 .0 5 )。结论 :血清NO、IL - 6及IL - 8与AHAD有着密切关系 ,NO能抑制AHAD患者IL -6及IL - 8的分泌 ,对患者的康复有着积极的作用     

Digital beam attenuator technique for compensated chest radiography

The feasibility of producing patient-specific beam attenuators for chest radiography has been investigated using an anthropomorphic phantom and a human volunteer. A low-dose test exposure is digitized, processed, and used to print a small cerium filter, which is placed in the x-ray beam near the collimator. The final radiograph is recorded on film. The technique results in relatively uniform film exposure, so that structures in all regions of the chest are simultaneously displayed with optimal film contrast. The equalized exposure improves image quality in the normally underpenetrated regions and reduces the role of cross-scatter from the lungs. The image is analogous to optical or computer-processed unsharp masking techniques, but the processing is accomplished in the x-ray beam and results in an improved exposure distribution, giving advantages that cannot be achieved with image processing techniques alone.     

Riesgo de adenomas colorrectales en pacientes con enfermedad celiaca: una revisión sistemática y metaanálisis

Introduction and aims

Whether celiac disease increases the risk of presenting with colorectal adenoma or not, has not been extensively evaluated. This question becomes relevant when considering early screening methods in patients with the disease. The aim of our article was to determine the risk of colorectal adenomas in celiac disease patients.