EAACI position paper on occupational rhinitis

The present document is the result of a consensus reached by a panel of experts from European and non-European countries on Occupational Rhinitis (OR), a disease of emerging relevance which has received little attention in comparison to occupational asthma. The document covers the main items of OR including epidemiology, diagnosis, management, socio-economic impact, preventive strategies and medicolegal issues. An operational definition and classification of OR tailored on that of occupational asthma, as well as a diagnostic algorithm based on steps allowing for different levels of diagnostic evidence are proposed. The needs for future research are pointed out. Key messages are issued for each item

Malignant fibrous histiocytoma of bone associated with type-1 neurofibromatosis - A case report

Von Recklinghausen disease, or neurofibromatosis, is a congenital and familial disorder with an autosomal dominant pattern of inheritance. The disease primarily affects ectodermal tissues arising from the neural crest. It is divided into two basic forms: peripheral (type 1) and central (type 2), characterized by distinct skeletal and soft-tissue manifestations(1-6). Type-l neurofibromatosis usually manifests in early childhood and is more frequent than the type-2 form of the disease(7,8). Skeletal abnormalities and dysplasias, including erosive or pressure bone defects, pseudarthroses, and cranial defects, are diagnosed in approximately 80% of patients with type-1 neurofibromatosis. In addition, multiple nonossifying fibromas that predominantly affect the metaphyseal parts of the long tubular bones tend to develop in patients with this type of the disease(1). The most serious, and often fatal, complication of the disease is a malignant peripheral nerve sheath tumor. Most cases are located within the soft tissue of the proximal part of an extremity, the buttocks, or the shoulder girdle. Skeletal involvement usually occurs as a result of secondary invasion by a soft-tissue lesion; a primary malignant peripheral nerve sheath tumor in bone is extremely rare(9-12). These malignant tumors are highly aggressive, with a high propensity for distant metastases, especially to the lung, liver, and bones(11-13). We are aware of only one reported case of irradiation-induced malignant transformation of a neurofibromatous bone lesion of von Recklinghausen disease to malignant fibrous histiocytoma(14). We describe the case of a young patient with type-1 neurofibromatosis in whom a malignant fibrous histiocytoma of bone was diagnosed at the site of fibrous bone lesions without previous irradiation. The patient was informed that data concerning the case would be submitted for publication

Unusual presentation of osteoid osteoma of the scaphoid

The small carpal bones are infrequent sites for osteoid osteomas, and their clinical and imaging pictures may be quite confusing leading to suspect other etiologies. The authors present herein an unusual case of osteoid osteoma of the scaphoid superimposed on a wrist injury caused by a fall on the outstretched hand

Isolated dislocation of the scaphoid

Isolated dislocation of the carpal scaphoid is an extremely rare injury. The authors report herein a case of a 28-year-old man managed with open reduction and Kirschner wire fixation. The aim of this study is to comprehensively present this unusual injury along with its treatment and to attempt to merge the available experience in the literature in a suggested algorithm that will guide the surgeon confronted with this rare problem to treat it promptly and effectively

Acute Compartment Syndrome of the Forearm Following Autologous Blood Reinfusion: A Case Report

Compartment syndrome is a condition with multiple reported etiologies, and permanent disability may ensue if not treated in a timely fashion. We report the first case, to our knowledge, of acute forearm compartment syndrome caused by intravenous autologous blood reinfusion. The patient underwent forearm fasciotomy, and hematoma was encountered deep to the superficial volar fascia, presumably extravasated from the reinfusion catheter. With the rise in the number of knee and hip arthroplasties, surgeons need a heightened awareness of the possible complications and morbidity associated with a presumed increase in autologous blood reinfusion