A fetal scalp electrode as a simple aid in the search for a lost needle fragment during sacrospinous ligament fixation

A needle fragment was lost during a sacrospinous ligament fixation. This was recognized during the procedure, but could not be found at that moment. The patient complained of severe buttock pain postoperatively. The needle fragment was localized on CT scan of the pelvis. A fetal scalp electrode helped as a search device to localize the needle on X-ray during the secondary surgery. The patient was operated successfully and was free of pain after 6 weeks

A study on serum IgE and clinical symptomatology of atopy in patients suffering from the lysosomal storage disorder Fabry disease.

Background Lysosomal storage disorders may impair intracellular lysosomal processing of antigen with consequences for antibody production [e.g. immunoglobulin E (IgE)] and atopic disease status. Aims Serum concentration of total IgE as well as clinical symptoms of atopic disorders as an indirect consequence of lysosomal impairment of antigen processing were studied in male and female Fabry disease (FD) patients with and without replacement of the missing lysosomal enzyme, alpha-galactosidase A (alpha-Gal A). Methods Observational study in 31 adult FD patients with measurements of total serum IgE concentration. Questionnaire-derived data were obtained for atopic eczema (AE) skin lesions, allergic rhinoconjunctivitis (RCA) and allergic asthma (AA) at present or in the past. Results Among 12 FD males under enzyme replacement therapy (ERT), 2 showed total IgE concentrations above 100 kU/L. Clinical symptoms for AA were found in 2, RCA and AE in 1, respectively. Among 10 FD females under ERT, 4 showed total IgE concentrations above 100 kU/L. Clinical symptoms for AA were found in 4, RCA in 2 and AE in 2. Among 9 females without ERT, 2 showed total IgE concentrations above 100 kU/L. Clinical symptoms for AA were found in 2, RCA in 2 and AE in none. Conclusions FD patients may demonstrate an increased total serum IgE concentration and may show symptoms of atopic disorders (AA, RCA, AE) in a prevalence rate comparable to international experience for individuals without FD. There was no difference between patients with and without ERT. Lack of detection of AE in females without ERT is suggested to be caused by the small sample size. FD patients without any alpha-Gal A activity prior to initiation of ERT should be in the focus of future studies

Food allergy: An increasing problem for the elderly.

As populations become older all over the world, allergic reactions in elderly persons will be encountered more often in the future. Up to now, there has been much more literature on allergy prevalence in childhood than on allergy diseases in adults. As a challenge to epidemiology, allergic disorders in elderly persons may be masked by various symptoms corresponding with a general age-induced decline of physiological functions, including vitamin D deficiency and gastric pH increase. How much structural and functional changes (e.g. low calcitriol level) or effects caused by drugs (e.g. acid-suppression medications) in addition to immunological alterations encountered at old age are responsible for this development is a matter of debate. In the years ahead, the problem of allergy in adulthood and especially in the elderly will become more pronounced

A boy with a one-sided red rash.

We report on a boy with a sudden onset of unilateral skin lesions following tonsillar infection with fever 2 weeks before. The lesions consisted of erythematous macules with scaling affecting trunk, axillar, as well as inguinal region. CRP, blood differential, serum IgG and IgM antibodies (coxsackievirus, cytomegalovirus, parvovirus, herpes virus, varicella zoster virus, human herpesvirus-6/-7), and lesional swabs (bacteria, dermatophytes, yeasts) were uneventful

Picture quiz: Painless non-itching yellow-white spots on genital mucosa.

A 28 year old white man presented to the dermatology clinic because of raised, yellow-white coloured skin lesions on the glans of his penis that had been increasing in number over two years. Repeated attempts had been made to cure the affected areas with topical antimycotic drugs, antibiotics, and virostatic agents. Macroscopic inspection showed a penile mucosa covered by densely aggregated yellow-white, minute papules. Lesional swabs to look for colonisation with bacteria, fungi, or viruses were unremarkable

Early BCG and pertussis vaccination and atopic diseases in 5- to 7-year-old preschool children from Augsburg, Germany: Results from the MIRIAM study.

The role of immunization in the development of atopic disorders is still under debate. One reason might be, that because of high vaccination coverage in most countries only few and selected children are not immunized, leading to unstable and often biased effect estimates. In Germany, the situation was different between 1985 and 1991: bacillus Calmette-Guérin (BCG) and pertussis vaccination were not officially recommended leading to high numbers of non-vaccinated children in the 1990s. We report on a cross-sectional study with 1673 participants among 5- to 7-year-old preschool children conducted in 1996. We found no hint that BCG vaccination or whole-cell pertussis (WCP) vaccination may lead to higher prevalences of asthma, allergic rhinitis, eczema or allergic sensitization at preschool age. None of the associations was significantly positive. WCP vaccination may be protective against asthma OR 0.55 (95% CI: 0.31-0.98) and against symptoms of eczema in boys

Thermische Schädigung nach unsachgemäßer Sprühdeoverwendung.

Die Anwendung eines Sprühdeodorants aus wenigen Zentimetern Entfernung vermag eine Erfrierung am betroffenen Hautareal zu induzieren. Unter Laborbedingungen konnte bei Besprühung einer Temperaturmesssonde mit einem Deodorant aus 5 cm Entfernung ein Temperaturabfall von über 60°C innerhalb von weniger als 12 s nachgewiesen werden. Der vorgestellte Fallbericht einer jugendlichen Patientin weist auf eine mögliche, wenngleich wenig bekannte Schädigungsmöglichkeit des Hautorgans durch unsachgemäßen Gebrauch eines Sprühdeodorants hin. (Spraying of a deodorant within a distance of a few centimeters from the skin surface may cause a freeze burn in the affected area. Under laboratory conditions spraying of a thermometer (distance 5 cm) induced a decline in temperature of more than 60A degrees C within less than 12 s. This case report of a teenager underlines a possible, although little known way of causing cutaneous damage by improper use of a deodorant spray.