No abstract

Blue dyes such as Patent Blue V (PBV) have been used in medical procedures for decades, and in the United Kingdom they are routinely utilised in sentinel lymph node biopsy (SLNB) for staging the axilla in early breast cancer. However, it has long been recognised that such dyes are associated with anaphylaxis. It has recently been estimated in a prospective study that allergy to PBV occurs with a frequency of 0.9%. Since repeated SLNB (and therefore further exposure to PBV) is increasingly being advocated for the small proportion of patients who develop a local (in-breast) recurrence, and because anaphylaxis can be life-threatening, it is important that those individuals that are allergic to PBV are recognised on their first medical exposure. The measurement of serum mast-cell tryptase (MCT) and skin prick test (SPT) are used in the investigation of suspected anaphylaxis because positive results are supportive of type-1 mediated hypersensitivity. Here we report the clinical features, MCT results and SPT results that pertain to a series of four patients referred to our drug allergy clinic with suspected anaphylaxis following SLNB. We recommend that all patients that show clinical evidence of allergy following exposure to PBV are referred to a specialist drug allergy service for further evaluation to investigate the cause.

289the commercial sexual revolution ultimately emerged as an imperative for thoseincluding both liberal and conservative politicians, city officials, business interests and legions of citizens -who wished to 'save' and 'revitalise' Hollywood, one of the city's most venerable, and profitable, districts. That imperative produced a larger battle over the terms on which sexual pleasure, straight or gay, could be made visible and the degree to which that visibility should be afforded protection by public measures. A new generation of urban liberals faced a decidedly difficult challenge: to respond to their constituents' increasingly libertarian views of sex and sexuality while not appearing to endorse civic disorder and economic decline. They had to defend both privacy rights and property rights. 3 Since the 1920s, American values had been moving, albeit haltingly and with recurrent opposition, in the direction of what historians John D'Emilio and Estelle Freedman have called 'sexual liberalism'. Sexual liberalism detached sex from procreation, affirmed heterosexual pleasure as a 'value in itself' and defined 'sexual satisfaction as a critical component of personal happiness and successful marriage'. Like other liberalisms, the sexual version made individual liberty its governing trope. Defining sexual pleasure as a value in itself, however, raised concerns that sex could be unbuckled from larger moral frameworks. Many Americans believed that the distance between sexual liberalism and total sexual licence was a short one and that slippage from one to the other led to several unhappy results: market relations and commerce, rather than morality, determining sexual values; a broad increase in crime, especially violent acts of rape and forms of sexual deviance, which for most ordinary people included homosexuality; and the corruption and exploitation of children. Over the course of the twentieth century this unease periodically erupted into episodes of public alarm and even moral panic about the threats of sexual liberalism. 4 These unhappy results and the public alarm over their possibility were intimately connected to fears of unsettled gender relations and the erosion of patriarchal visions of heterosexuality. Moral reformers worried about the 'hard' masculinity that pornography was said to promote. Men (or boys), detached from the 'soft', feminine influences of family and home, turned to sadism, violence and deviancy, a road that could lead away from women altogether, toward homosexuality. Inside the heterosexual family, male sexuality could be restrained and properly directed. Outside those bounds, as in pornographic fantasies and/or homosexuality, lay a treacherous slide toward sexual excess and violent crime. Gay-focused sexual panics could function to obscure or excuse heterosexual sexual excess, but they were also linked to broader discourses of deviancy and immorality. For many who claimed the mantle of moral traditionalist, topless (heterosexual) bars, 'adult' bookstores, porn theatres, gay bars and gay cruisin...

No abstract