Allergic Complications Research Articles

MP52-04 A NOVEL USE OF METHYLENE BLUE IN ANTERIOR URETHROPLASTY

You have accessJournal of UrologyTrauma/Reconstruction/Diversion: Urethral Reconstruction (including Stricture, Diverticulum) II1 Apr 2016MP52-04 A NOVEL USE OF METHYLENE BLUE IN ANTERIOR URETHROPLASTY Sanjay kulkarni, Pankaj Joshi, Sandesh Surana, Atef Homuda, and Jyotsna Kulkarni Sanjay kulkarniSanjay kulkarni More articles by this author , Pankaj JoshiPankaj Joshi More articles by this author , Sandesh SuranaSandesh Surana More articles by this author , Atef HomudaAtef Homuda More articles by this author , and Jyotsna KulkarniJyotsna Kulkarni More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.480AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The use of methylene blue (MB) to highlight anatomic structures in Urology is a well-established practice. A narrow urethral plate can be difficult to properly locate intraoperatively, particularly in Panurethral strictures. Our objective is to assess the value of intraurethral injection of MB during urethroplasty. METHODS 5 cc of MB (10mg/ml) is diluted in 10 cc of normal saline. The MB is gently injected retrograde into the urethra. A penile clamp is applied for 5 minutes to increase the contact time of the MB with the urethra. The urethroplasty commenced and the urethra was opened. The impact of the MB on the anatomy of the urethra was by subjective assessment of a single surgeon (S.B.K.). RESULTS 492 consecutive cases were prospectively evaluated from 2010-2014. Precise staining of the narrow lumen was successfully observed in 464 (94%). In these 464 cases, the diseased urethral strictured portion of the urethra was stained blue with MB. The grossly normal appearing urothelium remained pink and did not take up significant MB stain. Both stained and unstained mucosa was sent for histopathology examination in representative 20 patients. Blue stained urethra showed evidence of stricture in all patients. Unstained samples showed normal urethra. In 28 (6%) cases minimal or no staining was observed. Extravasation in to the spongiosa was seen in 8 (2%) cases. In 22 (4%) cases there was dense staining distal to the narrow lumen. There were no known allergic complications. CONCLUSIONS Normal urothelium does not absorb urine or water, and dilute MB flows over normal epithelium without staining. MB readily stains diseased and strictured urothelium. Intraurethral injection of MB is a useful tool in urethroplasty. It helps in delineation of stricture and identifying lumen. It guides us to the exact area of urethra to be augmented which has been corroborated with histopathology. It is a simple, non-costly and non-invasive tool. In our high volume tertiary referral unit, it is now standard to inject methylene blue in urethra immediately prior to urethroplasty. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e690 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Sanjay kulkarni More articles by this author Pankaj Joshi More articles by this author Sandesh Surana More articles by this author Atef Homuda More articles by this author Jyotsna Kulkarni More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Methylen blue dye related breast skin necrosis requiring mastectomy: Case report

Sentinel lymph node (SLN) biopsy is accepted as the gold standard procedure for assessing the status of the axillary lymph node in clinically node-negative breast cancer. The intraoperative blue dye injection is commonly performed to localize the SLN. Systemic allergic complications related to blue dye injection have been well documented, but local adverse effects requiring surgical excision are extremely rare. We report an infrequent case of skin and subcutaneous tissue necrosis following subdermal injection of methylen blue (MB) dye. A 48-year-old female, diagnosed with infiltrating ductal carcinoma, was treated by her initial surgeon with lumpectomy and SLN biopsy. For identification of the SLN, periareolar subdermal injection of 4 ml of 1% MB dye was performed. The patient was seen 10 days following discharge when it was noticed that the periareolar injection sites in the left breast had become necrotic. Since the necrosis invaded the majority of breast, mastectomy had to be performed. Histopathologic examination revealed necrosis of the skin and subcutaneous tissue of the left breast. Although the use of MB dye for SLN biopsy in breast cancer has few systemic reactions, its use has been associated with a number of undesired local complications. Deep parenchymal injections are recommended in order to avoid blue dye-associated skin lesions.

Angioneuroticus oedema előfordulása ischaemiás stroke miatt rt-PA-val kezelt betegekben

Data of our 254 patients who were treated with rt-PA between 1st of Jan, 2011 and 31st of Dec, 2014 were processed. We focused on angioneurotic oedema as allergic complication of thrombolysis which caused life threatening respiratory obstruction in two cases. We describe these two patients' history. Out of 254 patients six (2.3%) suffered angioneurotic edema caused respiratory obstruction in two (0.90%) cases. This occurrence is approximately 1.3-5.1% in literature. Five, out of six patients who suffered from angioneurotic oedema, had been treated with ACE inhibitors or ARB before. The role of ACE inhibitors is known in metabolism of bradykinin cascade. Plasmin which present during thrombolysis, precipitates biochemical mechanisms of this potential life threatening complication. Therefore rt-PA alone can be the cause of angioedema, but it can be more frequent together with ACE inhibitors therapy.

The Demographics and Rates of Tattoo Complications, Regret, and Unsafe Tattooing Practices: A Cross-Sectional Study.

Tattoos have become increasingly common in the United States; however, there are limited data on the rates of tattoo complications and tattoo regret. To determine the rates of infectious and allergic complications after tattooing, rates of tattoo regret, the perception of dermatologists among people with tattoos, and the demographics of people with tattoos. An 18-question cross-sectional survey was fielded in New Orleans in January 2015. Participants had to be at least 18 years old, have at least 1 tattoo, and reside within the United States. In total, 501 participants from 38 American states were enrolled. Of all participants, 3.2% had a history of an infected tattoo, 3.8% had a history of a painful tattoo, and 21.2% had a history of a pruritic tattoo; 16.2% of participants regret a current tattoo and 21.2% are interested in having 1 or more tattoos removed; 21.2% received a tattoo while intoxicated and 17.6% had a tattoo placed somewhere other than at a tattoo parlor; and 78.9% believe dermatologists are knowledgeable about the infectious and allergic complications of tattoos. Given the rates of pruritic tattoos and tattoo regret, there is an opportunity, and trust among people with tattoos, for dermatologists to manage these complications.

Traitement des sécheresses oculaires sévères secondaires à la maladie du greffon contre l’hôte chronique par lentilles sclérales perméables à l’oxygène

Graft-versus-host disease is a major complication of allogeneic hematopoietic stem cell transplantation. Severe keratoconjunctivitis sicca is common in patients with chronic GVH disease. The goal of this study was to evaluate the safety and efficacy of a gas-permeable scleral lens in the management of severe dry eye disease associated with chronic GVH. This is a retrospective study from June 2009 to November 2013. Patients fitted with scleral lenses for severe keratoconjunctivitis sicca associated with chronic GVH were included. The main outcomes measured were best-corrected visual acuity and quality of life (OSDI and NEI-VFQ25) composite scores before and six months after scleral lens fitting. Sixteen patients were included. The mean age was 52 years (19-69 years). Mean follow-up was 20 months (3-48 months). All patients reported improvement of their ocular symptoms. Best corrected visual acuity improved from 0.21 ± 0.26 to 0.1 ± 0.14 logMAR (P = 0.002), OSDI score improved from 92.1 ± 11.3 to 23.5 ± 11.2 (P = 0.002) and NEI-VFQ25 improved from 41.3 ± 7 to 83.1 ± 15.9 (P = 0.003), 6 months after scleral lens fitting. No serious adverse events, infectious, hypoxemic or allergic complications attributable to the scleral lens occurred. Gas-permeable scleral lens use appears to be safe and effective in patients with severe dry eye related to chronic GVH.

An injection molding device, improving the existing injection system for acrylic denture fabrication

Introduction: The advantages of injection molding system (IMS) are precise adaptation of acrylic to master cast, continuous compensation of acrylic shrinkage, low porosity and better physical properties of dentures. Traumatic, toxic and allergic complications are reduced. The existing IMS produces only one denture at a time. Using standard capsules leads to waste of material. Removable partial acrylic dentures (RPAD) with wire clasps haven`t been fabricated yet. Materials and methods: The objective is to construct a device for serial injection fabrication of acrylic dentures optimizing both working time and cost of restoration. The device should: provide a precise adaptation of material to master cast reduce residual monomer fabricate a lot of dentures for a short time fabricate RPAD with wire clasps optimize the amount of material A prototype of the device is designed and constructed. Results: The new device is based on the existing IMS. The following improvements are applied: The serial fabrication is achieved by dividing the injection and polymerization process by including a specially designed cap which is fixed on the flask after acrylic injection. It provides continuous pressure during the polymerization process. This allows fabrication of large number of dentures at the same time, injected by a single pneumatic cylinder. RPAD with wire clasps are fabricated by fixing the clasps with cold-cured acrylics and mechanical retention in the master mast. Capsules for multiple fabrication are used. Conclusion: A serial injection of large number of dentures as well as separate processing of each of them is possible at a time. The waste of material is reduced. Fabrication of RPAD with wire clasps is achieved.

Антигистаминные препараты в лечении простудных заболеваний у детей

The article is devoted to the relevant problem of pediatrics - treatment of acute respiratory infections in children. It examines the feasibility of a comprehensive treatment of colds in children with mandatory use of non-sedating antihistamines that increase the effectiveness of conventional treatment and prevent the development of allergic complications.

Профилактика и лечение пеленочного дерматита в условиях неонатологического стационара

The article is devoted to the relevant problem of pediatrics - treatment of acute respiratory infections in children. It examines the feasibility of a comprehensive treatment of colds in children with mandatory use of non-sedating antihistamines that increase the effectiveness of conventional treatment and prevent the development of allergic complications.

PATIENTS WITH SUSPECTED METAL IMPLANT ALLERGY: POTENTIAL CLINICAL PICTURES AND ALLERGOLOGICAL DIAGNOSTIC APPROACH (REVIEW)

The focus of this review are allergic complications following insertion of metallic orthopedic implants. Such potential allergic reactions encompass eczema, impaired wound and fracture healing, infection-mimicking reactions, effusions, pain and loosening. Nickel, cobalt and chromium seem to be the predominant eliciting allergens. Allergy might be considered prior to planned orthopaedic surgery or in patients with complications following arthroplasty We recommend, that differential diagnoses - in particular infection -should always be excluded in cooperation with surgery collegues. The clinical work up of a patient suspected of suffering from metal implant allergy should include a combined evaluation of medical history, clinical findings, patch testing and histology In vitro testing, namely the lymphocyte transformation test (LTT), can indicate metal sensitization, but needs careful interpretation.

Abstract 18056: High Dose Beta Blocker Use Does Not Increase the Frequency of Allergic Contrast Reaction in Coronary CT Angiogram Examinations: Results From the Advanced Cardiovascular Imaging Consortium

Background: A higher incidence of contrast reactions have been reported in atopic patients with the use of high dose beta blockers. High dose beta blockers are often used for heart rate control during coronary CT angiography (CTA) examinations. We sought to identify allergic complications in a large, multicenter, CTA registry. Methods: Patients undergoing coronary CTA at 53 Michigan institutions from January 2009 to March 2013 and participating in the ACIC were retrospectively analyzed. Patients were separated into two categories, those with and those without history of contrast allergy. Exposure to beta blockers was noted, and allergic reactions during or after CTA examinations were noted. Allergic reactions were defined as rash/hives, respiratory complications, anaphylaxis, generalized itching, wheezing, and face swelling immediately after completion of CT coronary angiogram. Results: Overall, 60 out of 26,725 patients included in the analysis had allergic complications (0.2%). Of the patients without a history of atopy that received high dose beta blocker, 42 out of 20206 (0.2%) patients had allergic complications when compared to 9/4725 (0.2%) of patients without high dose beta blockers (p= 0.81). Of the patients with a history of allergy in the past, 8/876 (0.9%) had allergic complications as compared with 52 out of 24,931 (0.2%) of patients without a history of allergy (p=0.002). Among allergic patients who received beta blockers, there were 7 out of 779 patients (0.9%) that had allergic complications when compared to 1 out of 97 patients (1.0%) who did not receive beta blockers (p=1.00). Conclusions: The overall incidence of allergic complications in patients undergoing coronary CT angiography is very low. The incidence of allergic reactions is higher in patients with a prior history of contrast allergy. There was no impact of high dose beta blockers on the incidence of contrast allergy in atopic patients.

Current Situation and Education Strategy About Bronchial Asthma With Other Allergic Complications in University Freshmen

Current Situation and Education Strategy About Bronchial Asthma With Other Allergic Complications in University Freshmen

Common Complications in Beta-Thalassemia Patients.

Even the life span has prolonged for the last 40 years, increase in frequently seen complications with increasing age negatively affect the life quality of thalassemia patients. In our study, complications encountered in 67 s-thalassemia patients who were followedup at our hospital between 1 January 2004 and 31 May 2009 were retrospectively analyzed. Fifty-six patients were followed up with diagnosis of thalassemia major and 11 with thalassemia intermedia. Totally, 56.7% of patients were male and 43.3% were female. Ages varied between 2-20 years with the mean age of 10.3±4.8 years. Mean ferritin level was 2212±1370 ng/mL (41-6263 ng/mL) for 4.5 years. Complications were increased with increasing age. Complication rates were significantly higher among thalassemia major patients compared to thalassemia intermedia patients. There was no statistically significant relationship between complications and mean ferritin levels. The most common complications were endocrine complications (38.8%). Cardiac complications developed in 22.4% of the patients; gastroenterological complications in 19.4%; allergic complications in 9%; infectious complications in 1.5%; and thrombosis was detected in 1.5%. The endocrine complications were osteoporosis, growth retardation, developmental delay, short stature, hypothyroidism, delayed puberty, hypogonadism, and diabetes mellitus. The cardiac complications were left ventricular wall hypertrophy, diastolic dysfunction, systolic dysfunction, heart failure, pericardial effusion, dilated cardiomyopathy, left ventricular dilatation, left atrial dilatation, and fatal arrhythmias. Mortality occurred in one (1.5%) out of 67 s-thalassemia patient due to dilated cardiomyopathy and fatal arrhythmia.

Vitiligo and Allergic Complications from Orthopaedic Joint Implants: The Role of Benzoyl Peroxide

Orthopaedic joint implants and osteosynthetic materials are progressively being employed more often. Complications mainly include physical-mechanical problems and infections. Uncommonly, allergic reactions to an alloy metal or a bone cement component have been implicated. Less attention has been paid to the components of bone cement, such as acrylate, catalysers (e.g. peroxide), additive polymers or stabilisers. An important bone cement component is benzoylperoxide (BPO), an initiator of the process enhancement of the bone cement. Vitiligo is an acquired, progressive depigmenting disorder that can induce autoimmune diseases. The occurrence of vitiligo in combination with an infection or allergy is not well described, and this manuscript highlights the possibility of an occurrence of a vitiligo whenever the immunesystem is activated and T-cell activation is observed. The aim of this article was to analyze the diagnosis and management of vitiligo and allergic complications from orthopaedic joint implants due to benzoyl-peroxide and relevant patents.

4:18 PM Abstract No. 58 - Percutaneous treatment of lumbar and cervical intervertebral disc herniations with radiopaque gelified ethanol (RGE): clinical and morphostructural changes in our experience

Purpose To demonstrate the safety and efficacy of injection of RGE in the percutaneuos treatment of lumbar and cervical disc herniations. Furthermore, intervertebral disc morfostructural changes has been evaluated by three dimensional compute tomography (3D-CT). Materials and Methods Between September 2010 and April 2012, 47 symptomatic patients (21 females, 26 males, age range at treatment: 33-75 years) have been treated for 54 lumbar intervertebral disc herniations in L2-L3 (n: 3), L4-L5 (n: 25), and L5-S1 (n: 26) levels, and 7 cervical intervertebral discs in C4-C5 (n: 2), C5-C6 (n: 3), C6-C7 (n: 1), and C7-D1 (n: 1) levels by percutaneous intradiscal injection of RGE (DISOGEL by Gelscom SAS Caen France). All treatments were performed under fluoroscopic guidance with biplanar 3D rotational angiographic system using 18 G needle for lumbar and 21 G for cervical. All patients received local anesthesia and a “short term” antibiotic therapy. In 14 patients, the treatment was performed in 2 levels in the same session. In 5 cases large extruded and migrated herniations have been treated. All patients underwent clinical evaluation, including VAS scale before treatment, soon after treatment, 3 and 6 months later. Low dose three-dimensional computed tomography (3D-CT) was obtained after treatment and 3 months later. Results All the procedures have been well tolerated. There were no allergic complications. 34 patients (85%) with lumbar disc herniations and 4 of 5 patients with cervical herniations obtained improvement in symptoms. In these patients, VAS scale showed a significant score reduction (p Conclusion These results show the efficacy and innocuity RGE. RGE does not produce any intervertebral disc morphostructural change.

Rare allergic complication in a patient with progressive Parkinson's disease (PD) and deep brain stimulation in the subthalamic nucleus

Rare allergic complication in a patient with progressive Parkinson's disease (PD) and deep brain stimulation in the subthalamic nucleus

Serum Levels of the CC Chemokines CCL2, CCL5, and CCL11 in Food Allergic Children with Different Clinical Manifestations

Food allergies (FA) are frequent in 8% of children under 3years old and approximately 2% of adults. Chemokine are involved in various allergies such as FA. The present study was aimed to determine CCL2, CCL5, and CCL11 levels in FA. The study population of this cross-sectional study contained 63 patients suffering from FA and 100 healthy controls. Concentrations of CCL2, CCL5, CCL11, and IgE were measured by enzyme-linked immunosorbent assay (ELISA). Eosinophils were counted using Casy Ι cell counter + analyzer system model SCAREF system GmbH. Differences were considered significant at P < 0.05. Current results showed that FA patients had significantly elevated numbers of circulating periphery eosinophils than the disease-free controls. Serum IgE levels in FA patients were also higher than controls. We also showed that serum levels of CCL2 and CCL11 were significantly enhanced in FA patients compared to control but CCL5 was not detectable. Results of present study revealed that both CCL2 and CCL11 were more elevated in FA children suffering from anaphylaxis and urticaria than bronchial asthma and atopic dermatitis. These results also indicated that more increased levels of CCL2 and CCL11 were observed following consumption of cow's milk and pistachio nuts. Overall, findings of the present study proposed that serum levels of CCL2 and CCL11 are elevated in FA and these may be considered as useful parameters in diagnosis of disorder. It is also possible to design treatments on the basis of blocking of chemokines expression by application of antibodies against them to overcome allergic complications in patients suffering from FA.

GSTT1 gene abnormality in minimal change nephrotic syndrome with elevated serum immunoglobulin E

Imbalance between T-helper 1 (Th1) and 2 (Th2) lymphocytes and effects of reactive oxygen species (ROS) upon glomerular capillary walls have been implicated in minimal change nephrotic syndrome (MCNS). By polymerase chain reaction and comparative genomic hybridization, we evaluated mutations of the GSTT1 gene (GSTT1), a member of the glutathione S-transferase (GST) supergene family associated with both protection of cells from ROS and control of allergic reactions and serum immunoglobulin (Ig) E. Among 15 children with MCNS, IgE elevation (over 2,000 IU/l) and GSTT1 deletion was found in 2 who showed severe allergic symptoms. Serum ROS concentrations in these 2 patients were significantly higher than in healthy controls or other MCNS patients. In addition, a Th2 shift caused by increased serum interleukin (IL)- 4 was observed. These results suggest presence of a GSTT1 abnormality in some children with MCNS having marked serum IgE elevations and various allergic complications. Defective ROS degradation and Th1/Th2 imbalance caused by GSTT1 abnormality could initiate proteinuria leading to MCNS.

Deep sedation in pediatric imaging: efficacy and safety of intravenous chlorpromazine

The quality of MRI and CT depends largely on immobility of the patient during the procedure, which is often difficult to achieve without sedation in children below the age of 6 years. To assess the efficacy and safety of intravenous chlorpromazine sedation for repeated imaging in young children treated for cancer. From July 2003 to January 2007, information on children younger than 6 years of age having MRI or CT was prospectively collected. Forty-five minutes before the scan, a 10-min infusion of chlorpromazine 0.5 mg/kg was administered and managed by non-anesthetic staff. Patient monitoring included continuous measurement of pulse, respiration, oxygen saturation and arterial blood pressure. Procedure-related parameters and adverse events were documented. Sedation was considered successful when the procedure was completed and at least 95% of images were usable. One-hundred-one procedures (82 MRI, 19 CT) were evaluated in 62 children, 3-74 months old. Adequate sedation was achieved in 96% of cases, with mean induction time, 22 min; mean duration of sleep, 72 min, and mean duration of procedure, 33 min. Mean time spent in the radiology unit was 104 min. Ninety-six percent of imaging procedures were successfully completed. No cardiac, respiratory, neurological or allergic complication occurred. Intravenous chlorpromazine is safe and effective for procedural sedation in young children with cancer undergoing MRI and CT.

Allergic complications from orthopaedic joint implants: the role of delayed hypersensitivity to benzoyl peroxide in bone cement

Allergic complications from orthopaedic joint implants: the role of delayed hypersensitivity to benzoyl peroxide in bone cement

Allergic complications from orthopaedic joint implants: the role of delayed hypersensitivity to benzoyl peroxide in bone cement

Orthopaedic implants and osteosynthesis materials are increasingly being used. Complications include mainly physical-mechanical problems and infections. Uncommonly, an allergic reaction towards an alloy metal or a bone cement component has been implicated. Potential bone cement allergens include acrylates, benzoyl peroxide, N,N-dimethyl-p-toluidine, and gentamicin. Typical symptoms are pain, swelling, inflammatory skin reactions, implant loosening, and fistula formation. To report on 5 patients with complications from a knee or a shoulder joint implant in whom a relevant sensitization to benzoyl peroxide was shown. Patch tests were performed with the European baseline series, an extended metal series, and a bone cement series. Patch tests with benzoyl peroxide were performed twice in all patients. A bone cement-free replacement was chosen in sensitized patients. In 4 patients sensitized to benzoyl peroxide, a bone cement-free replacement resulted in a considerable decrease or disappearance of pain and swelling, and complete clearing of cutaneous symptoms. Components of bone cement, such as benzoyl peroxide, may rarely cause allergic complications. However, because of the irritant potential of these substances, careful performance, reading and interpretation of the patch tests is required.