Biomedical subjects

Manuela Cuevas

Publications and source records attributed to Manuela Cuevas.

4 recordsLinked to original sources

PubMed2004

Allergic contact urticaria from natural rubber latex in healthcare and non-healthcare workers.

To compare the prevalence of natural rubber latex (NRL) sensitization and allergic contact urticaria from NRL in healthcare and non-healthcare workers, we studied all 1171 patients who attended our clinic during 2001 and 2002. Prick testing for NRL and patch testing with European standard series were performed in all patients and an additional rubber series in those who had contact with rubber. Specific immunoglobulin E (IgE) levels against NRL and tropical fruits were measured when prick testing was positive. Sensitization to NRL (positive prick test and specific IgE levels) was much more common in healthcare workers than that in non-healthcare workers, 16.7 versus 2.3%. Among the non-healthcare workers, sensitization to NRL was more common in food handlers (17.1%), construction workers (6.6%), painters (6.2%), hairdressers (5.1%) and cleaners (3.8%). The difference in the prevalence of specific IgE to tropical fruits was not significant. Allergic contact urticaria from NRL was also much more frequent in healthcare workers, 71.4 versus 28.6%. In conclusion, sensitization to NRL and allergic contact urticaria from NRL are more common in healthcare workers, but this is a growing problem in non-healthcare workers and should be investigated in all workers with a history of NRL intolerance or who have contact with NRL.

Dermatitis, Occupational↗

PubMed2003

Dermatitis artefacta?

A 35-year-old man presented with a 2-month history of intensely pruritic excoriated and crusted linear lesions on the dorsa of the left hand and left forearm (Fig 1). The patient had worked in construction for 2 years, and his job consisted mainly in covering the facades of buildings with cement. The patient was right-handed and used a black rubber glove as a protective measure only on his left hand (Fig 2). He reported that the lesions resolved partially during holidays and weekends and clearly flared in association with his work. There was no history of atopic dermatitis, drug use, or intolerance to metals, rubber, or fruits. On physical examination, linear excoriations with crusts were observed on the dorsa of the left hand, extending to the ventral and dorsal aspects of the forearm, involving the whole area that was in contact with the glove. Lichenified erythematous plaques and excoriations on the dorsal surface of the metacarpophalangeal joints and scaly lesions on the dorsal surfaces of the fingers were also present. On the palm, only discrete hyperkeratosis was seen. The right hand and forearm were free of lesions. He complained of intense pruritus when wearing the rubber glove and admitted to continuous scratching to relieve his discomfort, inducing the linear and excoriated lesions. Treatment with topical corticosteroids was initiated, with progressive resolution of the lesions.

Adult↗

PubMed2002

Glucoamylase: another fungal enzyme associated with baker's asthma.

BACKGROUND: Aspergillus-derived enzymes are widely used as dough additives in the baking industry. These enzymes may give rise to immunoglobulin (Ig)E-mediated sensitization and occupational asthma. Glucoamylase (or amyloglucosidase) is an important industrial enzyme obtained from Aspergillus niger and used to provide fermentable sugars for yeast to improve loaf volume and texture. OBJECTIVE: The aim of our study was to investigate the potential allergenic role of glucoamylase in baker's asthma. METHODS: We report four subjects with work-related allergic respiratory symptoms who were exposed to glucoamylase and other starch-cleaving enzymes used as baking additives. The causative role of glucoamylase in work-related asthma was investigated by immunologic tests and specific inhalation challenges (SIC). Glucoamylase allergenic components were characterized by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and immunoblotting. RESULTS: Skin prick tests to glucoamylase (10 mg/mL) gave a positive response in all patients. Further, a positive skin prick test to alpha-amylase was obtained in the four patients and to hemicellulase in two of them. SIC to glucoamylase elicited isolated early asthmatic responses in the three patients tested, and SIC to alpha-amylase elicited early asthmatic responses in two patients and a dual asthmatic response in another patient. Immunoblotting with glucoamylase showed several IgE-binding bands with molecular masses between 33 and 96 kD. IgE-inhibition assays showed scarce to moderate allergenic cross-reactivity between glucoamylase and alpha-amylase. CONCLUSIONS: These bakers had developed IgE-mediated occupational asthma to glucoamylase and alpha-amylase. Fungal glucoamylase is widely used as a baking additive and this enzyme may give rise to allergic respiratory reactions among exposed workers.

Adult↗

PubMed2002

Serologic IgE immune responses against Aspergillus fumigatus and Candida albicans in patients with cystic fibrosis.

OBJECTIVES: The objectives of this study were to determine the prevalence of Aspergillus fumigatus and Candida albicans in the sputa of patients with cystic fibrosis (CF), to assess serologic IgE responses of these patients to the presence of fungi in the sputum, to evaluate what effect this may have on clinical status, and to determine how the above-mentioned factors relate to allergic bronchopulmonary aspergillosis (ABPA). PATIENTS: Seventy-six CF patients (40 male and 36 female patients; age, 15.3 plus minus 8.7 years [mean plus minus SD]) were studied. MEASUREMENTS AND RESULTS: A total of 1,239 sputum samples from 66 patients were cultured for fungi. A fumigatus was grown in 256 sputum specimens (20.7%), and C albicans was grown in 588 sputum samples (47.5%). Forty patients (60.6%) had at least one positive culture finding for A fumigatus, and 58 patients (87.9%) had at least one positive culture finding for C albicans. Forty-nine patients (64.5%) were sensitized to A fumigatus, and 20 patients (26.7%) were sensitized to C albicans. No correlation was found between the finding of A fumigatus in sputum and IgE to A fumigatus. Only patients who had at least one positive culture finding for C albicans had IgE to C albicans develop. Lung function values and chest radiograph scores were not significantly lower in patients sensitized to either A fumigatus or C albicans as compared to nonsensitized patients. Of the 20 patients sensitized to C albicans, 10 patients had confirmed ABPA and 10 patients had some immunologic characteristics of ABPA. CONCLUSIONS: A high prevalence of colonization and sensitization to A fumigatus and C albicans in CF patients was observed. The sensitization to these fungi was not related to the clinical severity. IgE to C albicans may be an immunologic marker related to the development of ABPA in patients with CF.

Adolescent↗