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Détails bibliographiques
Auteur principal:	Blanca María Morfín-Maciel
Format:	Artículo científico
Langue:	es
Publié:	Colegio Mexicano de Inmunología Clínica y Alergia, A.C. 2020
Sujets:	Medicina Adulto Triptasa Anafilaxia Sensibilización cutánea Alergia a la leche de vaca
Accès en ligne:	https://www.redalyc.org/articulo.oa?id=486763616008 https://www.redalyc.org/journal/4867/486763616008/ https://www.redalyc.org/journal/4867/486763616008/html/ https://www.redalyc.org/journal/4867/486763616008/486763616008.epub https://www.redalyc.org/journal/4867/486763616008/movil
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Anaﬁ laxia por contacto con leche en un adulto con alergia alimentaria. Reporte de caso Blanca María Morfín-Maciel Blanca María Castillo-Morfín Medicina Adulto Triptasa Anafilaxia Sensibilización cutánea Alergia a la leche de vaca Antecedentes: La alergia a proteínas de leche de vaca es la alergia alimentaria más frecuente y su prevalencia se ha incrementado en la última década. Aunque la mayoría de los pacientes presenta síntomas por ingestión, se ha descrito sensibilización cutánea y de mucosas. Caso clínico: Hombre de 31 años, chef de profesión, en quien se iniciaron síntomas orofaríngeos después de la ingesta de leche. No suprimió de su dieta otros productos lácteos que toleraba en ese momento, sin embargo, los cuadros alérgicos fueron progresando y se añadieron manifestaciones cutáneas; ﬁ nalmente presentó anaﬁ laxia por contacto con masa de pan que contenía mantequilla y leche. El paciente fue atendido en urgencias, donde se comprobó la elevación de la triptasa sérica. Las pruebas cutáneas y serológicas resultaron positivas para leche y sus derivados. Conclusión: La anaﬁ laxia por contacto con leche es infrecuente y solo se ha informado en niños. Consideramos que la manipulación repetida de alimentos pudiera favorecer la sensibilización cutánea en adultos con historia personal de atopia. 2020 otro 0002-5151 https://www.redalyc.org/articulo.oa?id=486763616008 https://www.redalyc.org/journal/4867/486763616008/ https://www.redalyc.org/journal/4867/486763616008/html/ https://www.redalyc.org/journal/4867/486763616008/486763616008.epub https://www.redalyc.org/journal/4867/486763616008/movil 10.29262/ram.v67i1.669 es http://www.redalyc.org/revista.oa?id=4867 Revista Alergia México application/pdf Colegio Mexicano de Inmunología Clínica y Alergia, A.C. Revista Alergia México (México) Num.1 Vol.67

if (filemtime($filename) + $maxlifetime < time()) { unlink($filename); $count++; } } return $count; } /** * A function that is called internally when session data is to be saved. * * @param string $sessId The current session ID * @param string $data The session data to write * * @return bool */ protected function saveSession($sessId, $data): bool { $sessFile = $this->path . '/sess_' . $sessId; if ($handle = fopen($sessFile, 'w')) { $return = false; // Lock the file for exclusive access to avoid issues with multiple // processes writing session simultaneously: if (flock($handle, LOCK_EX)) { $return = fwrite($handle, $data); // Make sure that there's no trailing data by truncating the file to // the correct length: ftruncate($handle, strlen($data)); fflush($handle); flock($handle, LOCK_UN); } fclose($handle); if ($return !== false) { return true; } } // If we got this far, something went wrong with the file output... // It is tempting to throw an exception here, but this code is called // outside of the context of exception handling, so all we can do is // echo a message.

// Anecdotal testing Today and Yesterday seems to indicate destroy() // is called by the garbage collector and everything is good. // Something to keep in mind though. return 0; } /** * Write function that is called when session data is to be saved. * * @param string $sessId The current session ID * @param string $data The session data to write * * @return bool */ public function write($sessId, $data): bool { if ($this->writesDisabled) { return true; } return $this->saveSession($sessId, $data); } /** * A function that is called internally when session data is to be saved. * * @param string $sessId The current session ID * @param string $data The session data to write * * @return bool */ abstract protected function saveSession($sessId, $data): bool; }

* * @return void */ public function writeClose() { // The assumption is that we're using PHP's ext/session. // session_write_close() will actually overwrite $_SESSION with an // empty array on completion -- which leads to a mismatch between what // is in the storage object and $_SESSION. To get around this, we // temporarily reset $_SESSION to an array, and then re-link it to // the storage object. // // Additionally, while you _can_ write to $_SESSION following a // session_write_close() operation, no changes made to it will be // flushed to the session handler. As such, we now mark the storage // object isImmutable. $storage = $this->getStorage(); if (! $storage->isImmutable()) { $_SESSION = $storage->toArray(true); session_write_close(); $storage->fromArray($_SESSION); $storage->markImmutable(); } } /** * Attempt to set the session name * * If the session has already been started, or if the name provided fails * validation, an exception will be raised. * * @param string $name * @return SessionManager * @throws Exception\InvalidArgumentException */ public function setName($name) { if ($this->sessionExists()) { throw new Exception\InvalidArgumentException( 'Cannot set session name after a session has already started'

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