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Koca F, Levent F, Demir ÖF, Kat N, Tenekecioglu E. Does the Use of Ethyl Chloride Spray Facilitate Radial Angiography? Angiology 2024; 75:22-28. [PMID: 37594307 DOI: 10.1177/00033197231196036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/19/2023]
Abstract
Ethyl chloride (EC) spray is a vapocoolant which is used in interventional procedures as a topical local anesthetic. The aim of the present study was to investigate whether or not EC spray can facilitate radial coronary angiography. The study was conducted on a study group EC of 106 (age: 58.1 ± 12.4) patients and a control group (placebo) of 104 (age: 59.1 ± 10.8) patients. Visual analogue scale scores (VAS), radial cannulation failure (RCF), the rates of clinical and anatomical radial artery spasm (RAS), pain lasting >2 day and >1 week, and radial artery occlusion (RAO) at first week and first month were evaluated in both groups. VAS scores, the rates of RCF, clinical and anatomical RAS and pain lasting >1 week were found significantly lower in the study group than the control group (p < .001, p = .024, p=.009, p = .028 and p = .042, respectively). But the rates of RAO were similar in both groups. Topical spray including EC, which has low-cost and rapid efficacy, may be preferred in transradial coronary angiography as it reduces the risk of RCF and RAS, and increases patient comfort with its analgesic effect, without significant side-effects.
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Affiliation(s)
- Fatih Koca
- Department of Cardiology, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Fatih Levent
- Department of Cardiology, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Ömer Furkan Demir
- Department of Cardiology, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Nurcan Kat
- Department of Radiology, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Erhan Tenekecioglu
- Department of Cardiology, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
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Banga AT, Westgarth-Taylor C, Grieve A. The epidemiology of paediatric burn injuries in Johannesburg, South Africa. J Pediatr Surg 2023; 58:287-292. [PMID: 36473740 DOI: 10.1016/j.jpedsurg.2022.10.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 10/11/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Children remain the most common victim of burns in Sub-Saharan Africa. This study describes the epidemiology of paediatric burn injury among patients admitted to Chris Hani Baragwanath Academic Hospital. METHODS Hospital based cross-sectional, prospective study. RESULTS 509 patients were admitted to the unit over a 12-month period, with 482 patients included for baseline analysis. 50% of admitted patients were between 15 and 47 months with a median age of 25 months. 58% of participants were male. The predominant mechanism of injury was scalding (84%), in the winter season (32%). The most common site of burn was upper limb (75%). 63% of all admissions received first aid. Among those who received first aid, a described first aid method was provided in 74% of the cases. 226 out of 482 participants (47%) provided sociodemographic information. Access to basic amenities was high, with most admissions coming from households with access to electricity (91%). 90% of caregivers held at least a high school leaving certificate. Migrant caregivers made 19% of the caregivers, which was four times the proportion of foreign nationals counted in the national census. Most admissions (79%) were referrals from other centres as opposed to walk-ins. Severe burns were associated with thermal mechanism of injury, multiple burn sites, and receiving first aid prior to admission. CONCLUSION Children under two years of age and children of minority groups are at greatest risk for burn injury and should therefore be targeted for injury prevention strategies and education on appropriate first aid. LEVEL OF EVIDENCE According to the Journal of pediatric Surgery, this research corresponds to Level II evidence as a prospective study with less than 80% follow-up.
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Affiliation(s)
- Agatha T Banga
- Department of Paediatric Surgery & Child Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa.
| | | | - Andrew Grieve
- Nelson Mandela Children's Hospital, Johannesburg, South Africa
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Abstract
PURPOSE OF REVIEW Photograph-based social media use among children and adolescents has skyrocketed over the past decade, raising concerns about the implications for self-confidence and behavior in this population. Social media 'challenges' encourage participants to complete potentially dangerous tasks while sharing their completion of the tasks on social media. Many of these challenges affect the skin and lead to recognizable findings on physical examination. This review discusses the history of prominent social media challenges and their effects on the skin. Attention is also given to the effects of social media trends on self-confidence and body image in children and adolescents. RECENT FINDINGS Over the past several years, there have been several notable social media trends that can harm the skin. These include the Kylie Jenner lip challenge, salt and ice challenge, deodorant challenge, eraser challenge, fire challenge, and hot water challenge. Participation in these challenges can cause morbidity in children and adolescent that should be recognized by clinicians. SUMMARY Social media has become an important platform for communication and self-expression among children and adolescents. Pediatricians should remain aware of social trends in this age group and look out for cutaneous findings that may signal dangerous behavior on social media.
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Affiliation(s)
- Trevor K Young
- The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, New York, USA
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4
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Kudo K, Masuda A, Mizobe T, Kihara J, Onoyama S, Furuno K, Furue M. Bullous artificial dermatitis due to aerosol sprays masquerading as fixed drug eruption. J Dermatol 2018; 46:e222-e224. [PMID: 30565292 DOI: 10.1111/1346-8138.14729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Kyoko Kudo
- Department of Dermatology, Fukuoka Children's Hospital, Fukuoka, Japan
| | - Akiko Masuda
- Department of Dermatology, Fukuoka Children's Hospital, Fukuoka, Japan
| | - Taro Mizobe
- Department of Child Psychiatry, Fukuoka Children's Hospital, Fukuoka, Japan
| | - Junko Kihara
- Department of Child Psychiatry, Fukuoka Children's Hospital, Fukuoka, Japan
| | - Sagano Onoyama
- Department of General Pediatrics and Interdisciplinary Medicine, Fukuoka Children's Hospital, Fukuoka, Japan
| | - Kenji Furuno
- Department of General Pediatrics and Interdisciplinary Medicine, Fukuoka Children's Hospital, Fukuoka, Japan
| | - Masutaka Furue
- Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Chu V, Begaj A, Patel L. Burns challenges – A social media dictated phenomena in the younger generation. BURNS OPEN 2018. [DOI: 10.1016/j.burnso.2017.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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6
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Le jeu du déodorant, challenge diagnostique en dermatologie pédiatrique. Ann Dermatol Venereol 2017; 144:384-386. [DOI: 10.1016/j.annder.2017.01.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Revised: 08/04/2016] [Accepted: 01/12/2017] [Indexed: 11/22/2022]
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7
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Use and Effectiveness of Ethyl Chloride for Hand Injections. J Hand Surg Am 2017; 42:175-181.e1. [PMID: 28259274 DOI: 10.1016/j.jhsa.2016.12.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Revised: 12/29/2016] [Accepted: 12/31/2016] [Indexed: 02/02/2023]
Abstract
PURPOSE Limited literature supports using ethyl chloride topical spray as an anesthetic for hand injections whereas documented risks include frostbite, skin irritation, and inhalation toxicity. We hypothesize that ethyl chloride spray imparts no benefit to patients' perception of pain or anxiety for routine hand injections. METHODS We first surveyed all members of the American Society for Surgery of the Hand to discern the prevalence of ethyl chloride use during routine injections. We then performed a prospective, randomized, study at 2 institutions evaluating the efficacy of ethyl chloride spray compared with "routine injection" (no topical spray) in patients indicated for a hand injection. All patients completed a pre- and postinjection 11-point questionnaire that inquired about various components of pain and anxiety. RESULTS A total of 2,083 (73% response rate) American Society for Surgery of the Hand members responded to the survey and revealed that 59% of hand surgeons always or often use ethyl chloride, and 24% never use it. There were no differences for region or practice setting, but experienced surgeons were less likely to routinely use ethyl chloride (35%) compared with younger surgeons (66%). Among 151 patients participating in the clinical study (75 with ethyl chloride), there were no differences for any outcome measure assessed. Injection pain in the spray and no-spray groups, pain after 1 minute, and overall anxiety were equivalent. Subgroup analysis demonstrated no effect of sex, anticipated anxiety, or pain threshold. CONCLUSIONS Ethyl chloride is widely used among hand surgeons but imparts no benefit for routine hand injections in the clinical setting. The potential risks and costs of ethyl chloride use may outweigh its benefits. TYPE OF STUDY/LEVEL OF EVIDENCE Therapeutic II.
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8
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Kim H, Bo-Abbas Y, Guenther LC. Cold-Induced Skin Disorders. J Cutan Med Surg 2016. [DOI: 10.1177/120347549600100211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Humans are commonly exposed to extremes in temperature. Fortunately, our skin behaves as an anatomic and physiologic barrier during these periods. Exposure to cold temperatures may result in a variety of symptoms and disorders. Objective: Our current understanding of the pathophysiology, clinical presentation, and therapies of cold-induced skin disorders are reviewed. Methods: Studies, reviews, and book chapters that contained information on cold-induced skin disorders were reviewed. Conclusion: Cold-induced skin disorders are a heterogeneous group of disorders that cause great morbidity, particularly in cold climates. These entities can be classified as physiologic or pathologic responses to freezing or nonfreezing cold exposure.
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Affiliation(s)
- H.L. Kim
- Division of Dermatology, University of Western Ontario, London, Ontario
| | - Y. Bo-Abbas
- Division of Dermatology, University of Western Ontario, London, Ontario
| | - Lyn C. Guenther
- Division of Dermatology, University of Western Ontario, London, Ontario
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Nizamoglu M, Tan A, El-Muttardi N. Bubble bath burns: an unusual case. Case Reports Plast Surg Hand Surg 2016; 3:48-9. [PMID: 27583271 PMCID: PMC4996054 DOI: 10.1080/23320885.2016.1196453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Accepted: 05/28/2016] [Indexed: 11/23/2022]
Abstract
We present an unusual case of flash burn injury in an adolescent following accidental combination of foaming bath bubbles and tea light candle flame. There has not been any reported similar case described before. This serves as a learning point for public prevention and clinicians managing burn injuries.
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Affiliation(s)
- Metin Nizamoglu
- St Andrew’s Centre for Plastics and Burns, Chelmsford, United Kingdom
| | - Alethea Tan
- St Andrew’s Centre for Plastics and Burns, Chelmsford, United Kingdom
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El Balkhi S, Coutaz-Fluck C, Moreau F, Paraf F, Gaulier JM. Is it worth carrying out determination of N-butane in postmortem samples? A case report and a comprehensive review of the literature. Int J Legal Med 2015; 130:1223-9. [PMID: 26364197 DOI: 10.1007/s00414-015-1260-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Accepted: 09/02/2015] [Indexed: 10/23/2022]
Abstract
The aim of this article is to illustrate the importance of N-butane determination in postmortem samples through a case report and to propose actions and precautions to be taken into consideration when butane is suspected to be involved in cases of death. The case concerns a 15-year-old boy found dead after sniffing a cigarette lighter refill. Toxicological investigation revealed the presence of butane in the heart and femoral blood (1280 and 1170 μg/L, respectively), in the gastric contents (326 μg/L), and in the liver (1010 μg/kg) and lung tissues (210 μg/kg). Propane was present only in the blood samples at concentrations tenfolds lower.Butane can be involved in three kinds of fatalities: deliberate inhalations including volatile substance abuse (VSA), involuntary exposure, and homicides. A fatal outcome of butane inhalation can be caused by asphyxia and/or cardiac arrhythmia. In the context where butane exposure is evidenced by non-toxicological investigations, the usefulness of the determination of butane in postmortem samples is often questionable. However, it is admitted that butane-related deaths are generally underreported. Several difficulties including sample handling and storage, substantial variation in tissue concentrations, and lack of a lethal threshold make the interpretation of butane results challenging. In our opinion, systematic toxicological methods should be developed in order to analyze butane, at least when it concerns a typical VSA victim, even when butane is not actually suspected to be the cause of death.
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Affiliation(s)
- Souleiman El Balkhi
- Department of Pharmacology and Toxicology, Centre Hospitalier Universitaire de Limoges, 87042, Limoges Cedex, France.
| | - Caroline Coutaz-Fluck
- Department of Forensic medicine, Centre Hospitalier Universitaire de Limoges, Limoges, France
| | - Fanny Moreau
- Department of Forensic medicine, Centre Hospitalier Universitaire de Limoges, Limoges, France
| | - François Paraf
- Department of Forensic medicine, Centre Hospitalier Universitaire de Limoges, Limoges, France
| | - Jean-Michel Gaulier
- Department of Pharmacology and Toxicology, Centre Hospitalier Universitaire de Limoges, 87042, Limoges Cedex, France.,Unit of Toxicology, University Hospital of Lille, Lille, France
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Effects of Ethyl Chloride Spray on Pain and Parameters of Needle Electromyography in the Upper Extremity. Am J Phys Med Rehabil 2014; 93:869-75. [DOI: 10.1097/phm.0000000000000106] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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12
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Affiliation(s)
| | - J Costello
- A & E Department, Royal Free London, London, UK
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13
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Im YG, Park HJ, Chae HY, Kim BG, Lim HS, Park JI, Kim JH. Comparison of changes in facial skin temperature caused by ethyl chloride spraying, ice block rubbing and cold gel packing in healthy subjects. J Oral Rehabil 2012; 39:931-40. [DOI: 10.1111/joor.12007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/11/2012] [Indexed: 11/30/2022]
Affiliation(s)
- Y.-G. Im
- Department of Oral Medicine; Chonnam National University Dental Hospital; Gwangju Korea
| | - H.-J. Park
- Department of Oral and Maxillofacial Surgery, School of Dentistry; Chonnam National University; Gwangju
| | | | - B.-G. Kim
- Department of Oral Medicine, School of Dentistry; Chonnam National University; Gwangju Korea
| | - H.-S. Lim
- Department of Dental Education, School of Dentistry; Chonnam National University; Gwangju Korea
| | - J.-I. Park
- Department of Dental Hygiene; Gwangju Health College; Gwangju Korea
| | - J.-H. Kim
- Department of Oral Medicine, School of Dentistry; Chonnam National University; Gwangju Korea
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Möhrenschlager M, May U, Stirner KH, Ring J, Lauener R. Thermische Schädigung nach unsachgemäßer Sprühdeoverwendung. Monatsschr Kinderheilkd 2010. [DOI: 10.1007/s00112-010-2298-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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15
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May U, Stirner KH, Lauener R, Ring J, Möhrenschlager M. Deodorant spray: a newly identified cause of cold burn. Pediatrics 2010; 126:e716-8. [PMID: 20679305 DOI: 10.1542/peds.2009-2936] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Two patients encountered a first-degree cold burn after use of a deodorant spray. The spray-nozzle to skin-surface distance was approximately 5 cm, and the spraying lasted approximately 15 seconds. Under laboratory conditions, the deodorant in use was able to induce a decline in temperature of >60 degrees C. These 2 cases highlight a little-known potential for skin damage by deodorant sprays if used improperly.
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Affiliation(s)
- Ulrich May
- Department of Dermatology and Allergology, Allergieklinik, Hochgebirgsklinik/Christine Kühne-Center for Allergy Research and Education, Herman-Burchard-Strasse 1, CH-7265 Davos, Switzerland
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16
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Stefanutti G, Yee J, Sparnon AL. Cryogenic burns from intentional use of aerosol spray in children: An emerging phenomenon. Burns 2010; 36:e65-7. [DOI: 10.1016/j.burns.2009.08.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2009] [Accepted: 08/21/2009] [Indexed: 11/29/2022]
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Abstract
Cold injury by liquid petroleum gas is produced by evaporation that causes damage by cold to vital structures. We present two cases of exposure to pressurised liquid petroleum gas during an industrial accident.
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Affiliation(s)
- Safvet Ors
- Department of Plastic and Reconstructive Surgery, Gunes Hospital, Kayseri/Turkey.
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18
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Soyuncu S, Yigit O, Eken C. Frostbite Injury Related to Chlorethane Application. Wilderness Environ Med 2009; 20:103-4. [DOI: 10.1580/08-weme-le-211.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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19
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Yoon WY, Chung SP, Lee HS, Park YS. Analgesic pretreatment for antibiotic skin test: vapocoolant spray vs ice cube. Am J Emerg Med 2008; 26:59-61. [DOI: 10.1016/j.ajem.2007.06.022] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2007] [Revised: 06/16/2007] [Accepted: 06/16/2007] [Indexed: 10/22/2022] Open
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20
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Waibel KH, Katial RK. Effect of topical vapocoolant spray on skin test wheal, flare, and pain responses. Ann Allergy Asthma Immunol 2005; 95:149-53. [PMID: 16136764 DOI: 10.1016/s1081-1206(10)61204-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Skin puncture and intradermal tests are commonly used to evaluate allergic rhinitis. Ethyl chloride, a topical vapocoolant spray, provides skin analgesia before venipuncture, but it has not been studied with allergy skin testing. OBJECTIVE To determine the effects of ethyl chloride vs placebo on skin puncture testing (SPT) and intradermal allergy testing. METHODS We enrolled 20 healthy adults with a history of positive aeroallergen skin test results in a randomized, double-masked, placebo-controlled study. Ethyl chloride and placebo sprays were randomly placed on the upper back. Paired SPT was performed with saline, histamine, and standardized aeroallergens, including Bermuda grass, Kentucky blue grass, timothy grass, cat, Dermatophagoides pteronyssinus, and Dermatophagoides farinae. Serial dilutional end-point intradermal tests were then performed using 1 standardized aeroallergen. Wheal and flare areas were outlined, scanned, and digitally measured. Participants used a 10-cm visual analog scale to record pain during skin testing. RESULTS Eighteen individuals completed the study. Compared with placebo, ethyl chloride had no significant effect on histamine wheal (P = .53), histamine flare (P = .39), aeroallergen wheal (P = .10), or aeroallergen flare (P = .71) area for SPT. Serial dilutional end-point intradermal testing was similar after ethyl chloride and placebo application (P = .75). Mean pain scores for SPT were improved with ethyl chloride compared with paired placebo skin tests, although pain scores did not reach significance for SPT (P = .21) or intradermal testing (P = .87). CONCLUSIONS Ethyl chloride does not significantly reduce histamine and aeroallergen wheal and flare areas during SPT and intradermal allergy skin testing. Ethyl chloride, vs placebo, reduced pain in some individuals during skin testing, although this did not attain statistical significance.
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Affiliation(s)
- Kirk H Waibel
- Allergy and Immunology Service, Department of Medicine, Dwight D. Eisenhower Army Medical Center, Fort Gordon, Georgia, 30905-5650, USA.
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Camp DF, Ateaque A, Dickson WA. Cryogenic burns from aerosol sprays: a report of two cases and review of the literature. ACTA ACUST UNITED AC 2003; 56:815-7. [PMID: 14615259 DOI: 10.1016/j.bjps.2003.08.009] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Cryogenic burns are uncommon. We present two patients who presented to a Regional Burns Unit on consecutive days with almost identical burn injuries caused by exposure to a unique source of sub-zero temperature, the spray from an aerosol deodorant. The clinical features and management of the cases are outlined, and we discuss the mechanism of a cryogenic burn.
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Affiliation(s)
- David F Camp
- Welsh Centre for Burns and Plastic Surgery, Morriston Hospital, Swansea SA6 6NL, UK.
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22
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Albright JT, Lebovitz BL, Lipson R, Luft J. Upper aerodigestive tract frostbite complicating volatile substance abuse. Int J Pediatr Otorhinolaryngol 1999; 49:63-7. [PMID: 10428406 DOI: 10.1016/s0165-5876(99)00009-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Volatile substance abuse has become increasingly popular among today's youth. It has reportedly been used by up to 13% of teenage populations. Physicians need to be aware of the potential complications which may arise from this form of substance abuse. We describe the case of a young male who presented with massive edema affecting his lips, oral cavity, oropharynx and trachea. It was later discovered that his injury was secondary to thermal trauma related to the abuse of a fluorinated hydrocarbon propellant. This presentation may easily be confused with allergic or angioneurotic edema. Denial by the patient can lead to a further delay in diagnosis. This case is especially notable since frostbite injury involving the upper aerodigestive tract is extremely rare. We discuss the differential diagnosis and the management principals required in the care of this patient. We also present a pertinent review of the literature related to both volatile substance abuse and its complications involving the airway.
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Affiliation(s)
- J T Albright
- Department of Otolaryngology, Head and Neck Surgery, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA
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Abstract
We report a case in which quick freeze injury occurred to both hands by helium vapour at extremely low temperatures. At the time of injury the victim was wearing protective gloves which were removed quickly after the accident. This prompt removal of gloves reduced the depth and severity of the injury. Initially he was treated by rapid thawing by immersing the hands in luke warm water (37 degrees C) and administering heparin by drip to prevent microvascular thrombosis. Delayed skin grafting was performed with good functional recovery. The circumstances accompanying this injury and preventive measures are discussed.
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Affiliation(s)
- P Kumar
- Department of Burns and Plastic Surgery, Katurba Medical College, Karnataka, India
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Affiliation(s)
- C M VanGelder
- Department of Surgery, Lahey Hitchcock Clinic, Burlington, Massachusetts, USA
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Kriechbaumer N, Hemmer W, Focke M, Götz M, Jarisch R. Sensitization to ethyl chloride in a handball player. Contact Dermatitis 1998; 38:227-8. [PMID: 9565308 DOI: 10.1111/j.1600-0536.1998.tb05724.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- N Kriechbaumer
- Dermatologic and Pediatric Allergy Clinic, Vienna, Austria
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26
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Porfiris E, Georgiou P, Popa CV, Harkiolakis G, Sgouras N. “Dry ice” CO2 induced frostbites. EUROPEAN JOURNAL OF PLASTIC SURGERY 1997. [DOI: 10.1007/bf01366528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Bircher AJ, Hampl K, Hirsbrunner P, Buechner SA, Schneider M. Allergic contact dermatitis from ethyl chloride and sensitization to dichlorodifluoromethane (CFC 12). Contact Dermatitis 1994; 31:41-4. [PMID: 7924293 DOI: 10.1111/j.1600-0536.1994.tb01904.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Despite the widespread use of ethyl chloride as a local anesthetic and chlorofluorocarbons as propellants in medical and cosmetic aerosols, contact allergy to these 2 gases is rare. In a 30-year-old woman, an unusual itchy dermatitis appeared at all skin sites where a medical aerosol containing ethyl chloride had been briefly applied. Subsequent re-exposure to the spray and patch tests revealed contact sensitization to ethyl chloride and dichlorodifluoromethane (CFC 12). Histologic and immunohistochemical examinations of the test reaction were consistent with a T-cell-mediated allergic reaction. The low incidence of contact allergy to ethyl chloride and chlorofluorocarbons may be due to the rapid evaporation of these volatile gases, thus preventing intense and prolonged contact with the skin and consequently contact sensitization. A modified patch test procedure using perforated plastic chambers to allow gas evaporation is necessary to test volatile agents.
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Affiliation(s)
- A J Bircher
- Department of Dermatology, University Hospital, Basel, Switzerland
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