Aortic homograft for aortic valve replacement in patient with Alpha-Gal allergy

Allergy to Galactose-Alpha-1,3-Galactose is an allergy to mammalian proteins, that are present on the surface of standard bioprosthestic valves, and could result in catastrophic allergic reaction or may cause early deterioration of the bioprostheses. Aortic homograft is an acceptable alternative to standard prosthetic valves (biological and mechanical) to avoid a potential allergic manifestation and the need of definitive oral anticoagulation. We report the implantation of an aortic homograft in a patient with an aortic stenosis who present a documented Alpha-Gal allergy.

Post-orgasmic Illness Syndrome: A Closer Look

Background: Post-orgasmic illness syndrome (POIS) is a rare condition in which someone experiences flu-like symptoms, such as feverish, myalgia, fatigue, irritabilty and/or allergic manifestation after having an orgasm. POIS can occur either after intercourse or masturbation, starting seconds to hours after having an orgasm, and can be lasted to 2 - 7 days. The prevalence and incidence of POIS itself are not certainly known. Reviews: Waldinger and colleagues were the first to report cases of POIS and later in establishing the diagnosis, they proposed 5 preliminary diagnostic criteria, also known as Waldinger's Preliminary Diagnostic Criteria (WPDC). Symptoms can vary from somatic to psychological complaints. The mechanism underlying this disease are not clear. Immune modulated mechanism is one of the hypothesis that is widely believed to be the cause of this syndrome apart from opioid withdrawal and disordered cytokine or neuroendocrine responses. POIS treatment is also not standardized. Treatments includeintra lymphatic hyposensitization of autologous semen, non-steroid anti-inflamation drugs (NSAIDs), steroids such as Prednisone, antihistamines, benzodiazepines, hormones (hCG and Testosterone), alpha-blockers, and other adjuvant medications. Summary: This syndrome still needs more research to understand its mechanisms to obtainclearer treatment. Besides that, the clinician's awareness is needed to recognize this syndrome so that it is not misdiagnosed.

Comparative Incidence of Allergy in the Presence or Absence of Cancer

Depression of the immune system may be related to cancer development. Allergic manifestations are due to enhanced immunological activity. Several authors have found lower rates of malignancy in atopic individuals. To elucidate the relationship between cancer and allergy, the prevalence of allergic manifestations was surveyed in 400 healthy Controls and 400 patients with cancer. The number of allergies was significantly higher ( P < 0.001) in the control group than in patients with cancer. Women were more atopic than men in both groups ( P < 0.001) but skin colour did not affect the prevalence of allergies. The type of cancer was not related to any specific allergic manifestation. The results suggest that allergies occur less frequently in men than in women and less frequently in patients with cancer than in healthy controls but these relationships are complex and depend on other factors that need further investigation.

Surgical Catgut: The Myth of Allergy

During the period 1950 to 1985, 137 patients stated to the author that they were allergic to catgut sutures. The allegations were based on a previous episode at various sites on the body where wound healing had been complicated. A review of the problem did not indicate any history of symptoms of allergy. The author used catgut in the completion of his surgery on each of these patients. None of them showed any allergic manifestation and all healed perfectly per primum. Recent molecular studies of the collagen proteins demonstrate that it is highly improbable for the material to cause antigenicity.