Pere Sanz-Gallen

Occupational contact allergy to omeprazole and fluoxetine

Occupational exposure to active pharmaceutical ingredients can cause adverse health effects, particularly in personnel working with potent compounds such as steroids or those with the capacity to cause cumulative damage, such as antineoplastic drugs and antibiotics (1). Although omeprazole and other proton pump inhibitors are potentially sensitizing, occupationally acquired cases are rare (2, 3). In the case of fluoxetine,

Picadura por coral de fuego: un riesgo asociado al turismo en aguas tropicales

2 pages, 1 figure.-- Este articulo se complementa con una replica publicada en Med Clin (Barc) 124(6): 238-239 (2005) https://dx.doi.org/10.1157/13071770

Occupational contact dermatitis caused by hydroxychloroquine sulfate

Occupational exposure to active pharmaceutical ingredients can have adverse health effects. Occupational contact dermatitis caused by 4aminoquinolines (amodiaquine, chloroquine, and hydroxychloroquine) is rare; 1 case caused by chloroquine sulfate 2 and another caused by hydroxychloroquine have been described. We report a case of occupational contact dermatitis caused by hydroxychloroquine sulfate in a worker in the pharmaceutical industry.

Occupational contact allergy to omeprazole and ranitidine

Omeprazole is a proton pump inhibition and ranitidine is an H2 histamine receptor antagonist widely used in the treatment of gastroesophageal reflex disease, peptic ulcer disease, Zollinger-Ellison syndrome and as a protector of the gastric mucosae. We report a case of occupational contact allergy to omeprazole and ranitidine. A 48-year-old man, with no pre-existing history of atopy or lifestyle factors. He neither had any medical history of consumption of drugs such as ranitidine and omeprazole. He worked for 19 months in the pharmaceutical company that manufactured ranitidine base. He presented rash in the face and eczema on the dorsum of the hands with itching. The study by prick tests with ranitidine gave negative response. Patch testing with ranitidine base and ranitidine hydrochloride gave positive response. A month later, when the patient was asymptomatic he returned to the pharmaceutical company, being switched from this previous job to the reactor manufacturing omeprazole. A few days after that, he presented erythematous eruptions involving face and neck with itching. Prick tests, path tests and in vitro laboratories studies with omeprazole gave positives. In this case the patient presented hypersensitivity type I at omeprazole and hypersensitivity type IV at omeprazole and ranitidine. Our aportation indicates the importance of careful analysis of the occupational exposure histories of patients with the suspected type I or type IV hypersensitivity to allergens, to determine whether work exposure is the cause. Med Pr 2017;68(3):433-435.

Maculopatía crónica bilateral en un soldador

espanolSe aporta un caso de maculopatia bilateral cronica, en un soldador que trabajaba en un pequeno taller mecanico. Consulta a un Servicio de Oftalmologia porque desde hacia varios meses presentaba una importante perdida de vision. El diagnostico se realiza principalmente a traves de la retinografia, las imagenes de autofluorescencia y de la tomografia de coherencia optica. Se comentan los principales casos descritos en la literatura medica. Tambien se describen las principales medidas preventivas que se deberian aplicar para evitar la aparicion de casos como este. EnglishA case of chronic bilateral maculopathy is provided in a welder working in a small workshop. Consult a Department of Ophthalmology because for several months has vision loss. The diagnosis is mainly done through retinography, images of autofluorescence and optical coherence tomography. Principal cases described in the literature are discussed. Preventive measures should be implemented to prevent the incidence of cases like this are also described.

Brugada Syndrome: Detection and Control Depending on Occupational Risks

Introduction Brugada syndrome is characterized by episodes of syncope or sudden death in patient with a normal heart but with an electrocardiographic pattern of ST segment elevation in precordial leads V1 to V3 and morphology resembling right bundle branch block. Syncope and sudden death are due to polymorphic ventricular tachycardia. These electrocardiographic signs may be discovered by chance during a routine occupational check-up of an asymptomatic patient. Case report A 37-year-old man with no history of syncope or fainting attended an occupational medicine service for a routine checkup. ECG showed an electrocardiographic pattern suggestive of Brugada syndrome type 2. The patient was referred to a reference centre for cardiac arrhythmias, where a flecainide test confirmed the diagnosis. Electrophysiological study showed a low profile of arrhythmic risk, and the patient was advised to avoid consumption of some medicaments and drugs of abuse that have been associated with sudden death in patients with Brugada syndrome. The patient remains asymptomatic 6 months after the diagnosis. Conclusions Occupational physicians making routine check-ups may diagnose Brugada syndrome and help prevent sudden death. It is important to know the occupational risks of a worker diagnosed Brugada syndrome to prevent or minimize the occurrence of ventricular arrhythmias.

Detección de un síndrome de Brugada en un reconocimiento médico laboral Detection of a Brugada syndrome in a occupational medical examination

Brugada syndrome is a genetic, non-structural heart disease caused by a primary alteration of the myocardial ion channels and it is associated with increased risk of sudden death. There are three electrocardiographic patterns diagnostic or suggestive of Brugada syndrome which can be identified in routine medical examinations. If the diagnosis is confirmed, implantation of an automatic defibrillator may be life-saving. We report an asymptomatic case of Brugada syndrome diagnosed during an occupational health check and review the steps to be followed after diagnosis of this syndrome. Med Segur Trab (Internet) 2011; 57 (224) 265-269