Exaggerated test conditions were frequently used to investigate the cutaneous tolerance of detergent products in the past. As the sensitivity of newly designed biometric methods is steadily improving, the trend towards more realistic test conditions should be encouraged. A hand immersion test under laboratory-controlled usage conditions is presently described, fulfilling such principles. Panelists soaked their hands in 2 different hand dishwashing liquids, 2x daily for 10 min each (with successive in-solution/out-of-solution cycles) for 4 consecutive days. Products were at usual dilution for dishwashing liquids and were randomized between the dominant and non-dominant hands of panelists. Visual scoring of erythema and dryness developing on the whole hands (scoring scales including interdigital areas and joints) during the week did not allow discrimination between the 2 products. However the dominant hands were significantly more susceptible to alterations than the non-dominant hands, regardless of product attribution. In contrast, skin electrical measurements (Corneometer CM800 and Skicon 200) on the dorsum of the hands (muscle mass between thumb and index) and squamometry analysis of tape stripping (harvested from the same site) yielded significant differences between the 2 products. In conclusion, a hand immersion test under realistic conditions has been described, which discriminates between products when sensitive assessment methods are used to explore skin sites partially protected from daily-life skin aggressions.

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Tonsi llectomy is one of the most commonly performed procedures of the head and neck. It is performed for a wide variety of indications in both adults and children. It is common to send the material achieved in the surgery to routine histopathologic exam, as to analyze suspected material or for a medical-legal documentation. Objective: Analyze the utility and cost of routine histopathologic diagnosis for tonsillectomy. Methodology: retrospective study of the histopathologic result of all tonsillectomies between 1978 and 2004 in a university hospital and analyzed the files of the patients with cancer. Results: 2103 results of histopathologic exams were analyzed. Of these, only four cases presented any case of malignancy, being all of these non-Hodgkin lymphoma and already suspected before the surgery. Discussion: The world literature has encountered similar results and each time more the histopathologic analysis of all cases is questioned. The cost of the exam is high and your results, in the case of malignancy were already knew before the surgery. Conclusion: Histopathologic analysis of all tonsillectomies is not indicated. The risks factors established by Beaty should guide the solicitation of the exam, to try to low the costs with unnecessary exams.

Otitis media is one of the most common infectious diseases of infancy; a reduction in its incidence would have a significant economic and social impact. Vaccines may play a role in the prevention of otitis media. This report discusses vaccines against pneumococci and influenza viruses. We reviewed the literature for results of studies examining the role of these vaccines in the prevention of otitis media. The 23-valent polysaccharide anti-pneumococcal vaccine did not modify the incidence of otitis media in children aged 2 years less, the age group with the highest incidence of otitis. The heptavalent anti-pneumococcal vaccine did not significantly reduce the incidence of otitis media overall. This vaccine did, however, reduce the number of episodes of otitis media with effusion and the number of recurrences; it also altered the profile of causative microorganisms by increasing otitis caused by different microorganisms. We found the inactivated anti-influenza virus vaccine to be effective in reducing otitis media during peak incidence periods of influenza. As these new vaccines are currently available in Brazil, otolaryngologists must be aware of their potential role and impact in the reduction of otitis media, to counsel patients appropriately.

Disseminated histoplasmosis is a disease with a high case-fatality rate, especially in patients with the acquired immunodeficiency syndrome (AIDS). The disease can occur in various sites, such as the lungs, eyes, oral cavity, larynx, nervous system, gastrointestinal tract and, more rarely, the nasal sinus region. It is a cosmopolitan mycosis with a high prevalence in Brazil. Nasal manifestation of the disease is rare, with only three cases reported in the literature, but it is part of the differential diagnosis for other granulomatous diseases, such as Wegener's granulomatosis, tegumentary leishmaniasis and nasal lymphoma. The authors of this study present a literature review and report a case of nasal histoplasmosis in a patient with AIDS. No record of such an aggressive presentation has been reported previously in the literature.