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A case of sensitivity to chromates
Selected Abstracts Asthma UNDER TIIK J)IKF.CTIOX or
HAMUFJ. M . T'ETXHKRG, M.D.,
Observations Upon Cardiac Dyspnea, 193(5.
iluddox, K.;
('HICAOO
If. J. Australia 1: 122,
The author thinks that tliere ;u<> two main moehanisius in cardiac a.sthma. At one extreme is the type with advaiu-ed failure of the left ventricle with distended and rigid lungs, where the balance is i-eadily disturbed in the direction of an attack by relatively innocent stimuli. The latter comes froru the cerebrum through the vagus or 7-esults from a small but sudden addition to the pulmonary load, for example, from slipping into the horizontal position during sleep. At the other extreme are patients with a minor grade of failure but whose irritable nervous system allows of sudden coronary spasm, together with a spontaneous extra load on the left ventricle from general vasoconstriction. The author remarks on the presence of hyperten,sion during the attack of cardiac asthma, differing in this wise from bronchial asthnia. Broncholiths and Stone Astluna. Kadiology 25: 7T7, 19;!.i.
Pendergrass,
K. P., and Lorimier, A. A.:
The authors discuss the formation of broncholiths and their clinical significance. They say that calcific lesions in the lungs may be explained on any of the following pos.sibilities: (1) secondary calcification after degeneration or necrosis due to infection; (2) calcification of aspirated foreign bodies; (3) precipitation of the osseous inorganic elements, due to excessive concentration of them in the blood, and (4) metastases of bone-forming cells. The bronchial ' ' s t o n e s " are liable to produce infection, cough, heiuoptysis, and wheezing and dyspnea. The authors warn of the probability of such i)atliologic conditions in cases of unex))laiiie
Clerf, L. H.:
Ann.
The value of bronchoscopy in asthnia and related clinical conditions is emphasized. The author believes t h a t bronchoscopy should be given a trial in the treatment of cases of bronchial asthma t h a t do not respond to the usual methods. He obtains the best results in patients with tracheobronchitis, excessive secretions, or lironchial obstruction. Vaccines obtained from broncho scopically renunvd secretions have been found of value in bacterial asthma. A Case of Sensitivity to Chromates.
(,'ard, W. I.;
Lancet 2: 1348, 1935.
A twenty-eight-year-old v\oman working in a chromium-plating factory developed asthma after five months' exposure. The asthma cleared while in the hospital. The injecti(m of 4 lug. potassium dichi-oinat<' pro\'oked an attack of astlinui. Later
ABSTRACTS
533
the same dose of potassiuiii I'liroiuate hud a similar effect. There were im positive skin reactions to the usual allergens. Upon returning to work the symptoms re appeared. Since she has obtained other employment, there have lieen no further attacks. Prognosis in Bronchial Asthma.
Witts, L. .].:
I>ancet 1; 273, lO.'iti.
The author considers tlfe danger of death in the acute attack of asthma or following a paroxysm less rare t h a n is usually described. With respect to therapeutic results he says t h a t 20 per cent are completely relieved, about 60 per cent are more or less improved, and about 15 or 20 per cent are resistant to treatment. I'avorable features in prognosis are: the ability of the patient to cooperate completely with the physician; infrequency of attacks; early age of th<; p a t i e n t ; brief duration of the disease; and a seasonal incidence and sensitization to a single allergen. Unfavorable factors are the presence of complications, such as bronchitis, sinus disease, or ernphysema, and long duration of the disease. In patients under forty years with mild or occasional asthma the mortality is probably not more than 2.) per cent above the standard figures. I n patients over fort\' years with frequent and severe paroxysms the mortality is two or three times the standard value.
Dermatology I'NDKR TIIK DllihX'I'lUN- Of J l A l t l O X B . SllLZBKKGKK, M . I ) . , N E W Y O K K
Dermatitis From Dyed Hair, Furs and Fabrics. 230, 1935.
Ingram, John T.:
CrtV
Lancet 2;
The author reports t h a t the localization of dermatitides due to dyes sometimes leads to identification of the causative agent. ,Skin tests always should be employed: hair and fur dyes principally para- or metaphenylendiamiu and their products. Experiments convinced the author t h a t eczemas duo to these chemicals are caused by idiosyncrasies, not sensitizations. (This is ([uestioned by the reviewer.) Material dyes most exceptionally cause dermatitides. Symptoms are edema, particularly about the eyes, and discoloration of the skin; the former usually [)oiiits to hair and fur dyes, the l a t t e r to material dyes dissolved in sweat. Psychic and general disturbances may also be (encountered. Five case lystories serve as examples. In conclusion, the author remarks that most dyes ordinarily employed are quite harmless; t h a t there are no more skin diseases in dyeing establishments than in other industrial p l a n t s ; and that the usual .skin di.seases encountered in the dyeing industry are due to personal predisposition of the individual [predisposition to sensitization—M. B. R.]. The law should take cognizance of these facts. Anti-allergic Therapy. 1: 440, 470, 1935.
(Antiallergische Therapie.)
Trbach, Krich:
^led. Klin.
There are live possiljle methods of combating allergies—prophylaxis b_\' elimination of the allergic factor or l)\' keeping it a t a distance, deallergizatioii, specific, metaspecific desensitization, and aiitipathergic therapy, which means a nonspecific lowering of allergic reactivity. The author discusses in detail the procedures belonging to each group. It is also important for the physician to treat the allergic patient psychotherapeutically. The importance of this factor must not be underestimateil.
HAMUFJ. M . T'ETXHKRG, M.D.,
Observations Upon Cardiac Dyspnea, 193(5.
iluddox, K.;
('HICAOO
If. J. Australia 1: 122,
The author thinks that tliere ;u<> two main moehanisius in cardiac a.sthma. At one extreme is the type with advaiu-ed failure of the left ventricle with distended and rigid lungs, where the balance is i-eadily disturbed in the direction of an attack by relatively innocent stimuli. The latter comes froru the cerebrum through the vagus or 7-esults from a small but sudden addition to the pulmonary load, for example, from slipping into the horizontal position during sleep. At the other extreme are patients with a minor grade of failure but whose irritable nervous system allows of sudden coronary spasm, together with a spontaneous extra load on the left ventricle from general vasoconstriction. The author remarks on the presence of hyperten,sion during the attack of cardiac asthma, differing in this wise from bronchial asthnia. Broncholiths and Stone Astluna. Kadiology 25: 7T7, 19;!.i.
Pendergrass,
K. P., and Lorimier, A. A.:
The authors discuss the formation of broncholiths and their clinical significance. They say that calcific lesions in the lungs may be explained on any of the following pos.sibilities: (1) secondary calcification after degeneration or necrosis due to infection; (2) calcification of aspirated foreign bodies; (3) precipitation of the osseous inorganic elements, due to excessive concentration of them in the blood, and (4) metastases of bone-forming cells. The bronchial ' ' s t o n e s " are liable to produce infection, cough, heiuoptysis, and wheezing and dyspnea. The authors warn of the probability of such i)atliologic conditions in cases of unex))laiiie
Clerf, L. H.:
Ann.
The value of bronchoscopy in asthnia and related clinical conditions is emphasized. The author believes t h a t bronchoscopy should be given a trial in the treatment of cases of bronchial asthma t h a t do not respond to the usual methods. He obtains the best results in patients with tracheobronchitis, excessive secretions, or lironchial obstruction. Vaccines obtained from broncho scopically renunvd secretions have been found of value in bacterial asthma. A Case of Sensitivity to Chromates.
(,'ard, W. I.;
Lancet 2: 1348, 1935.
A twenty-eight-year-old v\oman working in a chromium-plating factory developed asthma after five months' exposure. The asthma cleared while in the hospital. The injecti(m of 4 lug. potassium dichi-oinat<' pro\'oked an attack of astlinui. Later
ABSTRACTS
533
the same dose of potassiuiii I'liroiuate hud a similar effect. There were im positive skin reactions to the usual allergens. Upon returning to work the symptoms re appeared. Since she has obtained other employment, there have lieen no further attacks. Prognosis in Bronchial Asthma.
Witts, L. .].:
I>ancet 1; 273, lO.'iti.
The author considers tlfe danger of death in the acute attack of asthma or following a paroxysm less rare t h a n is usually described. With respect to therapeutic results he says t h a t 20 per cent are completely relieved, about 60 per cent are more or less improved, and about 15 or 20 per cent are resistant to treatment. I'avorable features in prognosis are: the ability of the patient to cooperate completely with the physician; infrequency of attacks; early age of th<; p a t i e n t ; brief duration of the disease; and a seasonal incidence and sensitization to a single allergen. Unfavorable factors are the presence of complications, such as bronchitis, sinus disease, or ernphysema, and long duration of the disease. In patients under forty years with mild or occasional asthma the mortality is probably not more than 2.) per cent above the standard figures. I n patients over fort\' years with frequent and severe paroxysms the mortality is two or three times the standard value.
Dermatology I'NDKR TIIK DllihX'I'lUN- Of J l A l t l O X B . SllLZBKKGKK, M . I ) . , N E W Y O K K
Dermatitis From Dyed Hair, Furs and Fabrics. 230, 1935.
Ingram, John T.:
CrtV
Lancet 2;
The author reports t h a t the localization of dermatitides due to dyes sometimes leads to identification of the causative agent. ,Skin tests always should be employed: hair and fur dyes principally para- or metaphenylendiamiu and their products. Experiments convinced the author t h a t eczemas duo to these chemicals are caused by idiosyncrasies, not sensitizations. (This is ([uestioned by the reviewer.) Material dyes most exceptionally cause dermatitides. Symptoms are edema, particularly about the eyes, and discoloration of the skin; the former usually [)oiiits to hair and fur dyes, the l a t t e r to material dyes dissolved in sweat. Psychic and general disturbances may also be (encountered. Five case lystories serve as examples. In conclusion, the author remarks that most dyes ordinarily employed are quite harmless; t h a t there are no more skin diseases in dyeing establishments than in other industrial p l a n t s ; and that the usual .skin di.seases encountered in the dyeing industry are due to personal predisposition of the individual [predisposition to sensitization—M. B. R.]. The law should take cognizance of these facts. Anti-allergic Therapy. 1: 440, 470, 1935.
(Antiallergische Therapie.)
Trbach, Krich:
^led. Klin.
There are live possiljle methods of combating allergies—prophylaxis b_\' elimination of the allergic factor or l)\' keeping it a t a distance, deallergizatioii, specific, metaspecific desensitization, and aiitipathergic therapy, which means a nonspecific lowering of allergic reactivity. The author discusses in detail the procedures belonging to each group. It is also important for the physician to treat the allergic patient psychotherapeutically. The importance of this factor must not be underestimateil.