Fixed drug eruption to cetirizine with positive lesional patch tests to the three piperazine derivatives

BACKGROUND: The H1-antihistamine cetirizine, a piperazine derivative widely used in daily practice, is rarely the cause of cutaneous drug reaction. Nevertheless, four cases of fixed drug eruption (FDE) as a result of this drug have been described recently. We present the case of a 45-year-old woman with a multilocalized FDE following oral intake of cetirizine for allergic rhinitis. METHODS: Patch testing with hydroxyzine 1% and 10% in petrolatum (Chemotechnique), and with powdered Zyrtec (cetirizine) and Xyzal (levocetirizine) pills, prepared at 20% in water and at 20% in petrolatum, was performed in both residual lesions and healthy skin. RESULTS: Positive results (++) to these drugs (24 h occlusion and readings at days 2 and 3) were obtained in residual lesions only. These results allowed us to confirm the drug responsible for this FDE and to study cross-reactions between antihistamines of the same chemical family. CONCLUSIONS: To the best of our knowledge, this is the first report of FDE to cetirizine with positive patch testing to hydroxyzine, cetirizine, and levocetirizine. This case highlights the importance of patch testing in the study of cutaneous drug reactions, namely FDE

Gastric leiomyoma and hyperplastic polyposis coli in a patient with multiple cutaneous and uterine leiomyomatosis

BACKGROUND: Cutaneous leiomyomatosis has been associated with multiple uterine myomas and, more recently, with germline heterozygous mutations of the FH gene and certain types of renal cancer. Despite the growing amount of knowledge concerning this genodermatosis, its clinical spectrum remains incompletely characterized. OBJECTIVE: We report the observation of a patient with multiple cutaneous and uterine leiomyomatosis (MCUL) with unusual gastrointestinal manifestations. METHODS AND RESULTS: A gastric leiomyoma was diagnosed on a 38-year-old female MCUL patient on endoscopy performed because of mild dyspepsia. Furthermore, routine colonoscopy disclosed hyperplastic polyposis. Genetic testing revealed a previously not reported mutation of the FH gene. CONCLUSION: Gastrointestinal lesions such as the present ones are frequently asymptomatic and probably underdiagnosed. As the phenotypical spectrum associated with mutations of the FH gene keeps expanding, clinicians should keep in mind that, besides renal cancer, other unexpected tumors could also arise in this setting

Exploratory experiment on fertilization of five tropical legumes on a soil from a "cerrado" area

Êste trabalho teve por objetivo verificar quais as deficiências de nutrientes que limitam o desenvolvimento de cinco leguminosas em um solo sob vegetação de cerrado. Assim, realizou-se um estudo em casa de vegetação, utilizando-se um Latosol Vermelho (fase cerrado) e testando-se as seguintes leguminosas: Glycine javanica L. (var. comum), Glycine javanica L. (var. tinaroo), Phaseolus atropurpureus D.C. (siratro), Pueraria javanica Benth. (kudzu tropical) e Centrosema pubescens Benth. Os resultados obtidos nos permitem tirar as seguintes conclusões: a) as leguminosas reagiram diferentemente em relação às deficiências apresentadas pelo solo em estudo; b) o solo apresentou acentuada deficiência de fósforo, que se refletiu na diminuição do pêso de nódulos, produção de N e produção de massa sêca de tôdas as leguminosas; c) a omissão de K ou S não teve efeito prejudicial sobre a produção de massa sêca ou fixação de N; d) verificou-se uma pronunciada deficiência de microelementos, sendo que a soja perene var. tinaroo foi a mais sensível e o siratro pràticamente não foi afetado;  e) a falta da calagem afetou seriamente todas as leguminosas, reduzindo sua produção de massa seca e a fixação de N; entretanto, contribuiu para aumentar a produção de nódulos ineficientes, principalmente nas espécies kudzu e centrosema; f) a aplicação de nitrogênio mineral reduziu o pêso de nódulos, mas elevou a produção de N da parte aérea; o N total fixado nas cinco leguminosas variou de 53 a 84% em relação à produção de N das plantas que receberam N mineral.A greenhouse experiment was carried out to investigate nutrient deficiencies which restrict the development of the legumes: Glycine javanica L. (var. comum), Glycine javanica (var. tinaroo), Phaseolus atropurpureus D.C. (siratro), Pueraria javanica Benth. (kudzu tropical) and Centrosema pubescens Benth., on a red-latosol "fase cerrado". The results obtained led to the following conclusions: a) Individual legume response was different in relation to the deficiencies presented by the "cerrado" soil; b) The large phosphorus deficiency presented by this soil caused a decrease in nodule weight and in nitrogen and dry matter yields of all legumes; c) Ommission of both potassium and sulfur failed to cause any negative effect on dry matter yield or nitrogen fixation; d) The accentuated micro-element deficiency which seriously affected the tinaroo variety of Glycine javanica, had almost no effect on the siratro variety; e) All legumes were seriously affected by omission of liming, which caused a decrease in both dry matter yield and nitrogen fixation, and increased production of ineffective nodules, especially in kudzu and Centrosema; f) Application of nitrogen fertilizer decreased nodule weight, but increased total nitrogen in the plant. Total nitrogen fixed in the five legumes ranged from 53 to 83% of the nitrogen assimilated by the plants receiving mineral nitrogen

Release of IL-1β via IL-1β-Converting Enzyme in a Skin Dendritic Cell Line Exposed to 2,4-Dinitrofluorobenzene

We used a mouse fetal skin dendritic cell line (FSDC) to study the effect of the strong allergen 2,4-dinitrofluorobenzene (DNFB) on interleukin (IL)-1β release and IL-1β receptor immunoreactivity. Stimulation with DNFB (30 minutes) increased IL-1β release without changing the mRNA levels of the protein. Furthermore, DNFB increased transiently the interleukin-1β-converting enzyme (ICE) activity, as measured with its fluorogenic substrate Z-Tyr-Val-Ala-Asp-AFC. The ICE inhibitor Z-YVAD-FMK prevented the release of IL-1β evoked by DNFB. Incubation of the cells with DNFB (30 minutes) strongly increased IL-1β receptor immunoreactivity. The rapid effect of DNFB on the release of mature IL-1β, without inducing an increase of IL-1β mRNA in FSDC, suggests a posttranslational modification of pro-IL-1β by ICE activity

DR(E)SS TO ABACAVIR CONFIRMED BY PATCH TESTS

A reacção de hipersensibilidade (HS) ao abacavir é uma doença sistémica, potencialmente fatal, que ocorre em 2-9% dos doentes expostos. Inicia-se nas primeiras 6 semanas de tratamento e assemelha-se clinicamente ao DRESS, no entanto, sem eosinofilia. A relação desta reacção com o HLA-B*5701 foi definitivamente comprovada quando os casos imputáveis ao abacavir foram confirmados com um teste epicutâneo (TE) positivo. O HLA-B*5701 foi considerado um indicador excelente de HS ao abacavir, com um valor preditivo positivo da ordem dos 55%, pelo que actualmente se recomenda a sua pesquisa antes de iniciar qualquer esquema de tratamento com este fármaco. Relata-se um caso de HS ao abacavir, relembrando a sua semelhança clínica com o DRESS e realçando as suas diferenças, bem como a importância da fenotipagem HLA antes de iniciar o tratamento e a utilidade dos TE, tanto na confirmação da etiologia da reacção imunológica como no estudo dos mecanismos efectores.Abacavir hypersensitivity is a potentially fatal systemic adverse reaction that occurs in 2-9% of exposed patients. Symptoms appear during the first 6 weeks of therapy and are similar to DRESS although usually there is no eosinophilia. Studies have confirmed a positive relation with HLA-B*5701, particularly when only cases confirmed by a positive epicutaneous patch test were considered. This HLA allele is now considered an excellent predictor of abacavir hypersensitivity reaction (55% positive predictive value) and it is mandatory to perform a genetic screening before initiating any HIV treatment with abacavir. We report a case of abacavir hypersensitivity reaction, reminding its clinical resemblance with DRESS and pointing out the differences between these two entities, as well as highlighting the importance of HLA phenotyping before beginning treatment with abacavir and the utility of the patch test in confirming this immunologic reaction and studying its effector mechanisms

Insights into the expectations of mobility students: the impact of Erasmus in their future professional careers

[EN] At the celebration of its 30th anniversary, Erasmus is recognised as the most successful exchange program ever implemented. The prospects of attaining a common European consciousness challenged the program's ability to blend together knowledge, attitudes and skills in a winning combination. It is no longer sufficient to communicate and integrate: mobility should actively foster skills to support students's professional career at national and international levels. Although literature on mobility is vast and interesting, studies on the impact of the mobility experience in the students' future employability profile rarely provide first-hand data on their expectations in this regard. This exploratory research comprises a qualitative focus group approach with Erasmus students during their exchange period in a Portuguese university and collected some insightful data on how students consider their mobility in terms of new learning outcomes, the professional value of the experience and the development of new skills. Results indicate that students seem to be quite aware of the positive implications of mobility in their professional careers and of the set of skills developed during that period. Overall, this article contributes to demonstrating the importance of assessing skills development during Erasmus mobility experiences. Managerial implications and suggestions for future research are provided.This work is financially supported by National Funds through FCT – Fundação para a Ciência e a Tecnologia, I.P., under the project UID/CED/00194/2013.Simões, D.; Pinheiro, MM.; Santos, C.; Filipe, S.; Barbosa, B.; Dias, GP. (2017). Insights into the expectations of mobility students: the impact of Erasmus in their future professional careers. En Proceedings of the 3rd International Conference on Higher Education Advances. Editorial Universitat Politècnica de València. 696-704. https://doi.org/10.4995/HEAD17.2017.536069670