We studied 39 patients with erythema-dyschromicum-perstans-like dermatitis seen at Changuinola Hospital in Panama. They were compared with 41 controls. The 2 groups were native field workers of the banana plantations exposed to many pesticides. In 34 patients, there was a positive patch test reaction to 2,4,5,6-1,3-tetrachloroisophthalonilnitrile (chlorothalonil, TCPN) 0.001% in acetone. In 39 cases, biopsies showed a lichenoid tissue reaction compatible with a chronic pigmented dermatitis or erythema-dyschromicum-perstans-like dermatitis. Chlorothalonil is possibly the cause of the pigmented dermatitis observed in the 39 banana farm workers studied. Until additional studies are carried out, we consider this a possible rather than definite cause-and-effect relationship.
Hepatitis C virus (HCV) infection is an important cause of mortality in human immune deficiency virus (HIV)-positive haemophiliacs. This study describes progression to AIDS, death from HCV end-stage liver disease (ESLD) and all-cause mortality over 20 years. All HIV-positive haemophiliacs in La Paz University Hospital were included in this cohort. HIV seroconversion was estimated using mathematical techniques for interval-censored data from 1979 to 1985. Poisson regression was used to estimate rates of AIDS, death from ESLD and all causes in different periods: before 1988, 1988-89, 1990-91, 1992-93, 1994-95, 1996-97 and 1998-2001 using competing risk models. Among 383 cohort members, global AIDS incidence was 9.7 per 100 person-years, peaking in 1992-93 and dropping by 87% in 1998-2001 compared with before 1988 [incidence rate ratio (IRR) 0.13; 95% CI: 0.03-0.53]. Overall mortality was 7.5 per 100 person-years, was highest from 1992 to 1997, and fell by 66% in 1998-2001 compared with before 1988 (IRR 0.34; 95% CI: 0.14-0.81). Eighteen (5%) persons died of ESLD which represented 19% of deaths before 1988, 4% during 1988-89, 1990-91 and 1992-93, 2% in 1994-95, 10% in 1996-97 and 33% in 1998-2001. Overall death rate from ESLD was 0.5 cases per 100 person-years with no statistically significant trend observed over time. Important reductions in HIV disease progression to AIDS and death have been observed from 1998 to 2001, and can be attributed to highly active antiretroviral therapy. Although no increase in the rate of HCV-related deaths can be demonstrated, HCV accounts for an increasing proportion of deaths in the recent years.
The period between isolation of HIV in the early 1980s and the development of effective viral inactivation procedures able to eradicate the virus from the blood supply was long and unfortunately many recipients of blood-derived products became infected; this translated into a devastating impact on their quality of life, quality of care as well as on their life expectancy. Some years later, hepatitis C virus infection was identified as another known blood-borne disease complicating the treatment of haemophilia. Nowadays, the potential threat of emerging new pathogens has stressed the need to provide effective but primarily safe products with regard to infectious agents, as well as to regularly update therapeutic guidelines for haemophilia. The aim of the present publication was to review some of the crucial aspects related to the choice of haemostatic concentrates for the treatment of haemophilia and other inherited bleeding disorders, to analyse the current situation in the United States, Canada and European Union countries and to report the most relevant aspects of the Spanish consensus opinion of haemophilia-treating doctors for the use of therapeutic products for haemophilia recently issued. Essentially, it suggests that a gradual switch to recombinant concentrates may be a beneficial decision for patients with haemophilia and for the National Health Service.
Los objetivos del estudio fueron medir la efectividad del consejo breve apoyado por material escrito y estudiar la progresión del tabaquismo. El estudió incluyó una encuesta autoadministrada y una coximetría, así como una reevaluación un año después. Se estudiaron 15 centros escolares, 8 del grupo intervención y 7 de control. Se administró consejo apoyado con un folleto frente al control en el que no se utilizaba el folleto. La asignación a los grupos no fue aleatoria.
Esta segunda edición de Inmunología de la piel, responde a la necesidad de poner a dispocisión de colegas, estudiantes, médicos, pediatras, dermatólogos, inmunólogos clínicos y alergólogos, entre otros, un contenido actualizado, analítico y de calidad. Con los avances que en la actualidad nos ofrecen la ciencia, el conocimiento y la tec-nología, los autores renovaron el contenido de los capítulos y, ahora, también se presentan otros temas como microbioma, cáncer e inmunomoduladores, todos estos, temas que ayudan a complementar y fortalecer la estructura del libro. Invitamos a nuestros lectores, desde su perspectiva de aprendizaje e interés académico, a emprender un nuevo viaje en la estructura y función inmunológica en la maravillosa profundidad de la piel.
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