Publications by authors named "Martin Bedolla-Barajas"

64 Publications

Prevalence of allergic diseases and their symptoms in schoolchildren according to the birth mode.

Bol Med Hosp Infant Mex 2021 Mar 2. Epub 2021 Mar 2.

Colegio Mexicano de Inmunología Clínica y Alergia, Puebla, Puebla. México.

Background: The relationship between birth by cesarean section (CS) and allergic diseases' prevalence continues to be controversial. We aimed to investigate if being born by CS is associated with the prevalence of allergic diseases and their symptoms in schoolchildren.

Methods: This study included children between 6 and 7 years of age, selected by population-based sampling. We investigated the presence of allergic diseases and their symptoms, family history of asthma, smoking in parents, breastfeeding, exposure to pets, the season of birth, number of siblings, consumption of unpasteurized cow's milk, and mode of birth.

Results: We included 1003 subjects (526 girls), of which 44.2% were born through CS. The prevalence of allergic diseases did not differ according to birth mode. Asthma in either parent, current smoking by the mother, breastfeeding, and unpasteurized cow's milk consumption were associated with wheezing at some time in life.

Conclusions: No association between CS birth mode and allergic diseases and their symptoms was found.
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http://dx.doi.org/10.24875/BMHIM.20000114DOI Listing
March 2021

[The prevalence of oral allergy syndrome: regarding a new classification].

Rev Alerg Mex 2020 Jul-Sep;67(3):214-223

Nuevo Hospital Civil de Guadalajara Dr. Juan I. Menchaca, Servicio de Alergia e Inmunología Clínica, Jalisco, México.

Background: Recently, the oral allergy syndrome (OAS) has been classified according to the foods that induce it: phenotype I, when it is caused only by plant-derived foods; phenotype II, when it is caused by foods of both animal and plant origin.

Objective: To determine the prevalence of OAS in late teenagers according to the new classification.

Methods: A cross-sectional study in which data from 1,992 teenagers, aged 15-18 year-old, was analyzed; the information was obtained through a structured questionnaire, where questions were asked about oral symptoms according to the type of food that had been ingested.

Results: The overall prevalence of OAS was of 1.7% (95% CI = 1.2-2.4); for phenotype I, it was of 0.85% and, for phenotype II, it was of 0.85%. According to the phenotype, there was no difference by sex and personal history of atopic disease; instead, the onset time of the symptoms did show an association with the phenotype (p = 0.048). The frequency of skin and mucosal symptoms and respiratory ailments differed between the groups. Regarding gastrointestinal symptoms, diarrhea was markedly more frequent in phenotype II (p = 0.044).

Conclusion: Two phenotypes with OAS were clearly identified: the first one was associated exclusively to foods of plant origin, and the other was related to foods of both plant and animal origin.
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http://dx.doi.org/10.29262/ram.v67i3.740DOI Listing
February 2021

[Cold urticaria with risk of anaphylaxis treated with omalizumab. A case report].

Rev Alerg Mex 2020 Oct-Dec;67(4):408-412

Hospital Civil de Guadalajara Dr. Juan I. Menchaca, Servicio de Alergia e Inmuno-logía Clínica, Jalisco, México.

Background: Omalizumab, which is a monoclonal anti-IgE antibody, has recently been used as an option in the treatment of inducible urticaria.

Case Report: We describe the case of a 46-year-old woman who was referred to the Department of Allergy and Immunology of "Hospital Civil de Guadalajara, Dr. Juan I. Menchaca" due to a history of hives, body itching, changes in the color of the skin after exposure to water, and chest tightness after the intake of cold beverages; therefore, she used to limit her outdoor activities and personal hygiene. We conducted challenge tests with heat, soaked towels, treadmill walks, and dermographism; which were negative. The ice cube test was positive. To establish the speed of wheal formation, we established intervals of exposure to cold of one, three, five, and ten minutes; a positive result was obtained from the third minute. Due to the poor response to the drug treatment and to measures to avoid the cold, as well as to the poor quality of life, the high risk of anaphylaxis, and the advent of winter season, omalizumab was administered at monthly doses of 150 mg during the winter season. After the first dose, there were no reports of episodes of hives in areas exposed to cold; the ice cube test was negative before the second dose and in the following months, and the patient was able to ingest cold beverages and cold food. There were no adverse reactions that could be attributable to the use of omalizumab. Three years after the first dose, the patient was still asymptomatic.

Conclusion: The described case is one of the first cases of cold urticaria with risk of anaphylaxis with a positive response to omalizumab, which was reflected in symptom control and the improvement in the quality of life.
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http://dx.doi.org/10.29262/ram.v67i4.744DOI Listing
February 2021

Beyond eosinophilia: inflammatory patterns in patients with asthma.

J Asthma 2020 Dec 7:1-16. Epub 2020 Dec 7.

Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico.

Recently, inflammatory cell ratios have gained importance as useful indicators in the categorization of asthma. We compared the concentration of white blood cells in peripheral blood, as well as their respective inflammatory cell ratios, between patients with asthma and a healthy control group. We performed cross-sectional analyses of the data obtained from 53 adult patients with asthma and 109 adult controls. In our study, we estimated and compared the following inflammatory cell ratios: Neutrophil-Lymphocyte Ratio (NLR), Eosinophil-Lymphocyte Ratio (ELR), Eosinophil-Neutrophil Ratio (ENR), Eosinophil-Monocyte Ratio (EMR), and Platelet-Lymphocyte Ratio (PLR). The magnitude of association was quantified with the odds ratio. In both groups, the average age was 33 years. In asthmatic patients, we obtained the following results: eosinophils ≥ 400 cells/µl, accounted for 37.7%; basophils ≥ 110 cells/µl, comprised 37.7%; and monocytes < 320 cells/µl, reached 11.3%. In the control group, the results were as follows: 4.6%, 9.2% and 0.9%, respectively. When compared to the control group, asthmatic patients had higher odds of eosinophils ≥ 400 cells/µl (OR = 12.61,  < 0.0001); higher odds of basophils ≥ 110 cells/µl (OR = 6.00,  < 0.0001); and increased odds of monocytes < 320 cells/µl (OR = 13.79,  = 0.017). NLR did not differ between our two groups; however, ELR, ENR, EMR and PLR were significantly higher in the asthma group. Overall, patients with asthma have a higher concentration of eosinophils and basophils, fewer monocytes in their blood, and higher ratios of increased chronic inflammation.
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http://dx.doi.org/10.1080/02770903.2020.1852413DOI Listing
December 2020

ARIA digital anamorphosis: Digital transformation of health and care in airway diseases from research to practice.

Authors:
Jean Bousquet Josep M Anto Claus Bachert Tari Haahtela Torsten Zuberbier Wienczyslawa Czarlewski Anna Bedbrook Sinthia Bosnic-Anticevich G Walter Canonica Victoria Cardona Elisio Costa Alvaro A Cruz Marina Erhola Wytske J Fokkens Joao A Fonseca Maddalena Illario Juan-Carlos Ivancevich Marek Jutel Ludger Klimek Piotr Kuna Violeta Kvedariene Ltt Le Désirée E Larenas-Linnemann Daniel Laune Olga M Lourenço Erik Melén Joaquim Mullol Marek Niedoszytko Mikaëla Odemyr Yoshitaka Okamoto Nikos G Papadopoulos Vincenzo Patella Oliver Pfaar Nhân Pham-Thi Christine Rolland Boleslaw Samolinski Aziz Sheikh Mikhail Sofiev Charlotte Suppli Ulrik Ana Todo-Bom Peter-Valentin Tomazic Sanna Toppila-Salmi Ioanna Tsiligianni Arunas Valiulis Erkka Valovirta Maria-Teresa Ventura Samantha Walker Sian Williams Arzu Yorgancioglu Ioana Agache Cezmi A Akdis Rute Almeida Ignacio J Ansotegui Isabella Annesi-Maesano Sylvie Arnavielhe Xavier Basagaña Eric D Bateman Annabelle Bédard Martin Bedolla-Barajas Sven Becker Kazi S Bennoor Samuel Benveniste Karl C Bergmann Michael Bewick Slawomir Bialek Nils E Billo Carsten Bindslev-Jensen Leif Bjermer Hubert Blain Matteo Bonini Philippe Bonniaud Isabelle Bosse Jacques Bouchard Louis-Philippe Boulet Rodolphe Bourret Koen Boussery Fluvio Braido Vitalis Briedis Andrew Briggs Christopher E Brightling Jan Brozek Guy Brusselle Luisa Brussino Roland Buhl Roland Buonaiuto Moises A Calderon Paulo Camargos Thierry Camuzat Luis Caraballo Ana-Maria Carriazo Warner Carr Christine Cartier Thomas Casale Lorenzo Cecchi Alfonso M Cepeda Sarabia Niels H Chavannes Ekaterine Chkhartishvili Derek K Chu Cemal Cingi Jaime Correia de Sousa David J Costa Anne-Lise Courbis Adnan Custovic Biljana Cvetkosvki Gennaro D'Amato Jane da Silva Carina Dantas Dejan Dokic Yves Dauvilliers Giulia De Feo Govert De Vries Philippe Devillier Stefania Di Capua Gerard Dray Ruta Dubakiene Stephen R Durham Mark Dykewicz Motohiro Ebisawa Mina Gaga Yehia El-Gamal Enrico Heffler Regina Emuzyte John Farrell Jean-Luc Fauquert Alessandro Fiocchi Antje Fink-Wagner Jean-François Fontaine José M Fuentes Perez Bilun Gemicioğlu Amiran Gamkrelidze Judith Garcia-Aymerich Philippe Gevaert René Maximiliano Gomez Sandra González Diaz Maia Gotua Nick A Guldemond Maria-Antonieta Guzmán Jawad Hajjam Yunuen R Huerta Villalobos Marc Humbert Guido Iaccarino Despo Ierodiakonou Tomohisa Iinuma Ewa Jassem Guy Joos Ki-Suck Jung Igor Kaidashev Omer Kalayci Przemyslaw Kardas Thomas Keil Musa Khaitov Nikolai Khaltaev Jorg Kleine-Tebbe Rostislav Kouznetsov Marek L Kowalski Vicky Kritikos Inger Kull Stefania La Grutta Lisa Leonardini Henrik Ljungberg Philip Lieberman Brian Lipworth Karin C Lodrup Carlsen Catarina Lopes-Pereira Claudia C Loureiro Renaud Louis Alpana Mair Bassam Mahboub Michaël Makris Joao Malva Patrick Manning Gailen D Marshall Mohamed R Masjedi Jorge F Maspero Pedro Carreiro-Martins Mika Makela Eve Mathieu-Dupas Marcus Maurer Esteban De Manuel Keenoy Elisabete Melo-Gomes Eli O Meltzer Enrica Menditto Jacques Mercier Yann Micheli Neven Miculinic Florin Mihaltan Branislava Milenkovic Dimitirios I Mitsias Giuliana Moda Maria-Dolores Mogica-Martinez Yousser Mohammad Steve Montefort Ricardo Monti Mario Morais-Almeida Ralph Mösges Lars Münter Antonella Muraro Ruth Murray Robert Naclerio Luigi Napoli Leyla Namazova-Baranova Hugo Neffen Kristoff Nekam Angelo Neou Björn Nordlund Ettore Novellino Dieudonné Nyembue Robyn O'Hehir Ken Ohta Kimi Okubo Gabrielle L Onorato Valentina Orlando Solange Ouedraogo Julia Palamarchuk Isabella Pali-Schöll Peter Panzner Hae-Sim Park Gianni Passalacqua Jean-Louis Pépin Ema Paulino Ruby Pawankar Jim Phillips Robert Picard Hilary Pinnock Davor Plavec Todor A Popov Fabienne Portejoie David Price Emmanuel P Prokopakis Fotis Psarros Benoit Pugin Francesca Puggioni Pablo Quinones-Delgado Filip Raciborski Rojin Rajabian-Söderlund Frederico S Regateiro Sietze Reitsma Daniela Rivero-Yeverino Graham Roberts Nicolas Roche Erendira Rodriguez-Zagal Christine Rolland Regina E Roller-Wirnsberger Nelson Rosario Antonino Romano Menachem Rottem Dermot Ryan Johanna Salimäki Mario M Sanchez-Borges Joaquin Sastre Glenis K Scadding Sophie Scheire Peter Schmid-Grendelmeier Holger J Schünemann Faradiba Sarquis Serpa Mohamed Shamji Juan-Carlos Sisul Mikhail Sofiev Dirceu Solé David Somekh Talant Sooronbaev Milan Sova François Spertini Otto Spranger Cristiana Stellato Rafael Stelmach Michel Thibaudon Teresa To Mondher Toumi Omar Usmani Antonio A Valero Rudolph Valenta Marylin Valentin-Rostan Marilyn Urrutia Pereira Rianne van der Kleij Michiel Van Eerd Olivier Vandenplas Tuula Vasankari Antonio Vaz Carneiro Giorgio Vezzani Frédéric Viart Giovanni Viegi Dana Wallace Martin Wagenmann De Yun Wang Susan Waserman Magnus Wickman Dennis M Williams Gary Wong Piotr Wroczynski Panayiotis K Yiallouros Osman M Yusuf Heather J Zar Stéphane Zeng Mario E Zernotti Luo Zhang Nan Shan Zhong Mihaela Zidarn

Allergy 2021 01 23;76(1):168-190. Epub 2020 Oct 23.

University Clinic of Respiratory and Allergic Diseases, Golnik, Slovenia.

Digital anamorphosis is used to define a distorted image of health and care that may be viewed correctly using digital tools and strategies. MASK digital anamorphosis represents the process used by MASK to develop the digital transformation of health and care in rhinitis. It strengthens the ARIA change management strategy in the prevention and management of airway disease. The MASK strategy is based on validated digital tools. Using the MASK digital tool and the CARAT online enhanced clinical framework, solutions for practical steps of digital enhancement of care are proposed.
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http://dx.doi.org/10.1111/all.14422DOI Listing
January 2021

Anxiety and depression in adult patients with asthma: the role of asthma control, obesity and allergic sensitization.

J Asthma 2020 May 2:1-9. Epub 2020 May 2.

Servicio de Alergia e Inmunología Clínica, Nuevo Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", Jalisco, México.

To determine the frequency of anxiety and depression in adult patients with asthma and to identify factors associated with them. This cross-sectional study included 164 consecutively recruited patients with asthma aged ≥ 18 years. Participants were clinically assessed and the mental state was analyzed through of the Beck Anxiety Inventory (BAI), the Beck Depression Inventory II (BDI-II); the Asthma Control Test (ACT) was measured, and allergic sensitization and respiratory function were also evaluated. Binary logistic regression models to identify the factors related to anxiety or depression were carried out. Complementary, 95% confidence intervals (CI) were estimated. Anxiety was present in 54.3% of patients (95% CI: 46.6%-61.7%) while depression was found in 50.6% (95% CI: 43.0%-58.2%). Depression increased the odds of anxiety in patients with asthma (OR: 26.00,  < 0.0001), whereas an ACT score ≥ 20 points and allergic asthma were associated with a lower odds than the reference group (OR: 0.29;  = 0.007 and OR: 0.29;  = 0.024, respectively). Depression was associated with anxiety and obesity (OR: 25.33,  < 0.0001 and OR: 3.66;  = 0.014, respectively). Overall, more than half of all asthmatic patients suffer from anxiety and depression. Well-controlled asthma and allergic sensitization decreased the likelihood of anxiety, while depression was associated with both obesity and anxiety.
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http://dx.doi.org/10.1080/02770903.2020.1759087DOI Listing
May 2020

[Executive Summary of ARIA 2019: Integrated care pathways for allergic rhinitis in Argentina, Spain and Mexico].

Rev Alerg Mex 2019 Oct-Dec;66(4):409-425

Universidad del Salvador, Facultad de Medicina, Buenos Aires, Argentina.

The health and economic impact of allergic diseases are increasing rapidly, and changes in management strategies are required. Its influence reduces the capacity of work and school performance by at least a third. The ICPs of the airways (integrated care pathways for respiratory diseases) are structured multidisciplinary healthcare plans, promoting the recommendations of the guidelines in local protocols and their application to clinical practice. This document presents an executive summary for Argentina, Mexico, and Spain. Next-generation ARIA guidelines are being developed for the pharmacological treatment of allergic rhinitis (AR), using the GRADE-based guidelines for AR, tested with real-life evidence provided by mobile technology with visual analogue scales. It is concluded that in the AR treatment, H1-antihistamines are less effective than intranasal corticosteroids (INCS), in severe AR the INCS represent the first line of treatment, and intranasal combination INCS + anti-H1 is more effective than monotherapy. However, according to the MASK real-life observational study, patients have poor adherence to treatment and often self-medicate, according to their needs.
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http://dx.doi.org/10.29262/ram.v66i4.643DOI Listing
September 2020

[Allergy to cow's milk protein, or lactose intolerance: a cross-sectional study in university students].

Rev Alerg Mex 2019 Oct-Dec;66(4):394-402

Universidad Autónoma del Estado de México, Centro de Investigación en Ciencias Médicas, Estado de México, México.

Background: Factors like ethnic origin and geographical area affect the frequency of cow's milk protein allergy (CMPA) and lactose intolerance (LI). Epidemiological information about the non-pediatric population is still missing.

Objective: To determine the prevalence of CMPA and LI in university students.

Methods: A cross-sectional study of 1200 students of 18 to 25-year-old. A structured questionnaire was applied in order to identify the clinical manifestations triggered by the intake of cow's milk (CM), and these were categorized as linked to CMPA or linked to LI.

Results: Thirty students met the criteria for CMPA (prevalence of 2.5 %; CI 95 % = 1.7-3.6 %) and 128 for LI (prevalence of 10.7 %, CI 95 % = : 9.0 % - 12.5 %). The frequency of personal history of food allergy and dust mite allergy was higher in students with CMPA than in students with LI. Oral pruritus, skin and respiratory discomforts were predominant in CMPA. Abdominal cramps and flatulence were predominant in LI.

Conclusions: IL is more frequent than CMPA; which frequency was one in every 10 students; and the frequency of CMPA was one in 400.
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http://dx.doi.org/10.29262/ram.v66i4.640DOI Listing
September 2020

Peanut allergy among Mexican adults with allergic respiratory diseases: prevalence and clinical manifestations.

Rev Alerg Mex 2019 Jul-Sep;66(3):314-321

Hospital Civil de Guadalajara Dr. Juan I. Menchaca, Servicio de Alergia e Inmunología Clínica, Guadalajara, Jalisco, México.

Background: Peanut allergy among adults with respiratory diseases has seldom been studied within Mexico.

Objective: To establish the prevalence of peanut allergy among adults that have been diagnosed with either asthma or allergic rhinitis; we will also be describing the symptoms that are associated with peanut allergy.

Methods: We carried out a cross-sectional study through which we analyzed the corresponding data of 257 patients with allergic respiratory diseases, asthma or allergic rhinitis, all participants were 16 years of age or older, and were recruited in a consecutive manner. Peanut allergy was established by testing positive to a peanut skin-prick test; we also conducted a standard interview with each patient.

Results: From our sample of 257 patients, 18 tested positive to peanut sensitization, (7.0%; 95% CI = 3.9% to 10.1%); among these 18 participants, 7 were considered to be allergic to peanuts (2.7%; 95% IC: 0.7% to 4.7%). Predominant symptoms were oral, primarily affecting the pharynx and the palate, followed by swelling of the lips. When it came to respiratory discomfort, sneezing and rhinorrhea stood out, and lastly there were cutaneous symptoms. We did not detect any systemic reactions to the peanut.

Conclusion: In our study, peanut allergy among adults with allergic respiratory diseases is not an uncommon occurrence.
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http://dx.doi.org/10.29262/ram.v66i3.619DOI Listing
April 2020

Allergic Rhinitis Is Associated With Loss of Energy and Concentration Difficulty: A Cross-sectional Study.

Am J Rhinol Allergy 2020 Jan 26;34(1):108-114. Epub 2019 Sep 26.

Servicio de Alergia e Inmunología Clínica, Hospital Militar Regional de Especialidades, Mérida, Mexico.

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http://dx.doi.org/10.1177/1945892419877554DOI Listing
January 2020

Next-generation ARIA care pathways for rhinitis and asthma: a model for multimorbid chronic diseases.

Authors:
J Jean Bousquet Holger J Schünemann Alkis Togias Marina Erhola Peter W Hellings Torsten Zuberbier Ioana Agache Ignacio J Ansotegui Josep M Anto Claus Bachert Sven Becker Martin Bedolla-Barajas Michael Bewick Sinthia Bosnic-Anticevich Isabelle Bosse Louis P Boulet Jean Marc Bourrez Guy Brusselle Niels Chavannes Elisio Costa Alvaro A Cruz Wienczyslawa Czarlewski Wytske J Fokkens Joao A Fonseca Mina Gaga Tari Haahtela Maddalena Illario Ludger Klimek Piotr Kuna Violeta Kvedariene L T T Le Desiree Larenas-Linnemann Daniel Laune Olga M Lourenço Enrica Menditto Joaquin Mullol Yashitaka Okamoto Nikos Papadopoulos Nhân Pham-Thi Robert Picard Hilary Pinnock Nicolas Roche Regina E Roller-Wirnsberger Christine Rolland Boleslaw Samolinski Aziz Sheikh Sanna Toppila-Salmi Ioanna Tsiligianni Arunas Valiulis Erkka Valovirta Tuula Vasankari Maria-Teresa Ventura Samantha Walker Sian Williams Cezmi A Akdis Isabella Annesi-Maesano Sylvie Arnavielhe Xavier Basagana Eric Bateman Anna Bedbrook K S Bennoor Samuel Benveniste Karl C Bergmann Slawomir Bialek Nils Billo Carsten Bindslev-Jensen Leif Bjermer Hubert Blain Mateo Bonini Philippe Bonniaud Jacques Bouchard Vitalis Briedis Christofer E Brightling Jan Brozek Roland Buhl Roland Buonaiuto Giorgo W Canonica Victoria Cardona Ana M Carriazo Warner Carr Christine Cartier Thomas Casale Lorenzo Cecchi Alfonso M Cepeda Sarabia Eka Chkhartishvili Derek K Chu Cemal Cingi Elaine Colgan Jaime Correia de Sousa Anne Lise Courbis Adnan Custovic Biljana Cvetkosvki Gennaro D'Amato Jane da Silva Carina Dantas Dejand Dokic Yves Dauvilliers Antoni Dedeu Giulia De Feo Philippe Devillier Stefania Di Capua Marc Dykewickz Ruta Dubakiene Motohiro Ebisawa Yaya El-Gamal Esben Eller Regina Emuzyte John Farrell Antjie Fink-Wagner Alessandro Fiocchi Jean F Fontaine Bilun Gemicioğlu Peter Schmid-Grendelmeir Amiran Gamkrelidze Judith Garcia-Aymerich Maximiliano Gomez Sandra González Diaz Maia Gotua Nick A Guldemond Maria-Antonieta Guzmán Jawad Hajjam John O'B Hourihane Marc Humbert Guido Iaccarino Despo Ierodiakonou Maddalena Illario Juan C Ivancevich Guy Joos Ki-Suck Jung Marek Jutel Igor Kaidashev Omer Kalayci Przemyslaw Kardas Thomas Keil Mussa Khaitov Nikolai Khaltaev Jorg Kleine-Tebbe Marek L Kowalski Vicky Kritikos Inger Kull Lisa Leonardini Philip Lieberman Brian Lipworth Karin C Lodrup Carlsen Claudia C Loureiro Renaud Louis Alpana Mair Gert Marien Bassam Mahboub Joao Malva Patrick Manning Esteban De Manuel Keenoy Gailen D Marshall Mohamed R Masjedi Jorge F Maspero Eve Mathieu-Dupas Poalo M Matricardi Eric Melén Elisabete Melo-Gomes Eli O Meltzer Enrica Menditto Jacques Mercier Neven Miculinic Florin Mihaltan Branislava Milenkovic Giuliana Moda Maria-Dolores Mogica-Martinez Yousser Mohammad Steve Montefort Ricardo Monti Mario Morais-Almeida Ralf Mösges Lars Münter Antonella Muraro Ruth Murray Robert Naclerio Luigi Napoli Leila Namazova-Baranova Hugo Neffen Kristoff Nekam Angelo Neou Enrico Novellino Dieudonné Nyembue Robin O'Hehir Ken Ohta Kimi Okubo Gabrielle Onorato Solange Ouedraogo Isabella Pali-Schöll Susanna Palkonen Peter Panzner Hae-Sim Park Jean-Louis Pépin Ana-Maria Pereira Oliver Pfaar Ema Paulino Jim Phillips Robert Picard Davor Plavec Ted A Popov Fabienne Portejoie David Price Emmanuel P Prokopakis Benoit Pugin Filip Raciborski Rojin Rajabian-Söderlund Sietze Reitsma Xavier Rodo Antonino Romano Nelson Rosario Menahenm Rottem Dermot Ryan Johanna Salimäki Mario M Sanchez-Borges Juan-Carlos Sisul Dirceu Solé David Somekh Talant Sooronbaev Milan Sova Otto Spranger Cristina Stellato Rafael Stelmach Charlotte Suppli Ulrik Michel Thibaudon Teresa To Ana Todo-Bom Peter V Tomazic Antonio A Valero Rudolph Valenta Marylin Valentin-Rostan Rianne van der Kleij Olivier Vandenplas Giorgio Vezzani Frédéric Viart Giovanni Viegi Dana Wallace Martin Wagenmann De Y Wang Susan Waserman Magnus Wickman Dennis M Williams Gary Wong Piotr Wroczynski Panayiotis K Yiallouros Arzu Yorgancioglu Osman M Yusuf Heahter J Zar Stéphane Zeng Mario Zernotti Luo Zhang Nan S Zhong Mihaela Zidarn

Clin Transl Allergy 2019 9;9:44. Epub 2019 Sep 9.

260University Clinic of Respiratory and Allergic Diseases, Golnik, Slovenia.

Background: In all societies, the burden and cost of allergic and chronic respiratory diseases are increasing rapidly. Most economies are struggling to deliver modern health care effectively. There is a need to support the transformation of the health care system into integrated care with organizational health literacy.

Main Body: As an example for chronic disease care, MASK (Mobile Airways Sentinel NetworK), a new project of the ARIA (Allergic Rhinitis and its Impact on Asthma) initiative, and POLLAR (Impact of Air POLLution on Asthma and Rhinitis, EIT Health), in collaboration with professional and patient organizations in the field of allergy and airway diseases, are proposing real-life ICPs centred around the patient with rhinitis, and using mHealth to monitor environmental exposure. Three aspects of care pathways are being developed: (i) Patient participation, health literacy and self-care through technology-assisted "patient activation", (ii) Implementation of care pathways by pharmacists and (iii) Next-generation guidelines assessing the recommendations of GRADE guidelines in rhinitis and asthma using real-world evidence (RWE) obtained through mobile technology. The EU and global political agendas are of great importance in supporting the digital transformation of health and care, and MASK has been recognized by DG Santé as a Good Practice in the field of digitally-enabled, integrated, person-centred care.

Conclusion: In 20 years, ARIA has considerably evolved from the first multimorbidity guideline in respiratory diseases to the digital transformation of health and care with a strong political involvement.
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http://dx.doi.org/10.1186/s13601-019-0279-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6734297PMC
September 2019

Asthma prevalence, but not allergic rhinitis nor atopic dermatitis, is associated to exposure to dogs in adolescents.

Allergol Immunopathol (Madr) 2020 Jan - Feb;48(1):34-41. Epub 2019 Aug 30.

Division de Pediatría, Nuevo Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", Salvador de Quevedo y Zubieta No. 750, Colonia La Perla, Guadalajara, Jalisco C. P. 44340, Mexico. Electronic address:

Background: Exposure to pets can be a predisposing factor in the development of certain diseases, including allergic diseases.

Objective: We analyzed the role that exposure to indoor dogs and cats plays in the prevalence of allergic diseases.

Methods: We examined the cross-sectional data of 1056 women and 936 men aged 15 to 18 years; these individuals were selected through stratified and cluster random sampling. We asked all participants about their exposure to indoor dogs and cats during the year that preceded our study. The prevalence of allergic diseases was determined through core questions taken from The International Study of Asthma and Allergies in Childhood questionnaire.

Results: The prevalence was 12.7% (95% CI: 11.3%-14.2%) for asthma, 9.0% (95% CI: 7.8%-10.4%) for allergic rhinitis, and 5.2% (95% CI: 4.3%-6.2%) for atopic dermatitis. The multivariate analyses showed that exposure to indoor dogs, but not indoor cats, was associated with asthma prevalence (aOR 1.37; 95% CI: 1.03-1.83), as was male sex (aOR=1.42; 95% CI: 1.08-1.86), a personal history of allergic rhinitis (aOR=3.24; 95% CI: 2.25-4.66), and a maternal history of asthma (aOR=3.06; 95% CI: 1.89-4.98). The population attributable risk for exposure to indoor dogs was 18%. Notably, neither allergic rhinitis nor atopic dermatitis was found to be associated with dog or cat exposure (p> 0.05).

Conclusion: Exposure to dogs in late adolescence is a factor associated with asthma, although its contribution to the development of asthma should be investigated in new studies.
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http://dx.doi.org/10.1016/j.aller.2019.04.008DOI Listing
September 2020

[MASK (Mobile Airways Sentinel Network), a mobile App with ARIA's comprehensive solution in Spanish-speaking countries].

Rev Alerg Mex 2019 Apr-Jun;66(2):263-268

Fundación Clínica Médica Sur, Centro de Excelencia en Asma y Alergia, Ciudad de México, México.

Although there are high quality clinical guidelines about allergic rhinitis, many patients receive deficient treatment, partly due to the high level of self-medication. MASK (Mobile Airways Sentinel Network) is an integral part of a project against chronic diseases which it is focused on active and healthy aging and is supported by the European Union. It forms the third phase of ARIA (Allergic Rhinitis and its Impact on Asthma) in which, through a mobile app on a smart device, the purpose is to guide patients in the control of their multimorbidity, allergic rhinitis or conjunctivitis, or asthma. The "Allergy Diary" app by MACVIA-ARIA is free and it is available for Android and iOS; on it, patients indicate how unpleasant the symptoms are on a daily basis through five screens with an analogous visual scale; two more screens were recently added (sleep affectation). With the app, it is also possible to download the information of the "Allergy Diary" on the physician's computer through a QR code at the moment of the medical consultation. In this article, we review the first year of experience in Spain, Mexico and Argentina, where the Spanish version is used.
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http://dx.doi.org/10.29262/ram.v66i2.628DOI Listing
January 2020

[The prevalence of allergic rhinitis and atopic dermatitis in late adolescents differs according to their gender].

Rev Alerg Mex 2019 Apr-Jun;66(2):147-153

Nuevo Hospital Civil de Guadalajara Dr. Juan I. Menchaca, Servicio de Alergia e Inmunología Clínica, Guadalajara, Jalisco, México.

Background: In Mexico, there are very few studies aimed at establishing the prevalence of allergic rhinitis (AR) and atopic dermatitis (AD) in late adolescents.

Objective: To determine the prevalence of allergic rhinitis and atopic dermatitis in late adolescents and compare it according to their gender.

Methods: A cross-sectional study that included 1992 15 to 18 year old adolescents who were recruited through a stratified and randomized probabilistic sample by clusters. The prevalence of AR (allergic rhinitis) and AD (atopic dermatitis) was identified with the questionnaire of "The International Study of Asthma and Allergies in Childhood".

Results: 1056 (53%) women and 936 (47%) men were included in the study. The prevalence of AR was 9.0% (95% CI = 7.8% - 10.4%); the frequency was higher in women (6.7% versus 11.1%, p = 0.001). The symptoms of rhinitis plus conjunctivitis predominated in women (16.0% versus 23.1%, p < 0.0001). The prevalence of AD was 5.2% (95% CI = 4.3% - 6.2%) and, once again, it was more frequent in women (7.7% versus 2.4%, p < 0.0001). The main factors associated with AR and AD were the female gender and a history of family atopic allergic diseases (p < 0.001).

Conclusions: There was a significant difference in the prevalence of AR and AD according to gender in late adolescents; women were most affected. In addition, a history of family atopic allergic diseases was another risk factor that was linked to both diseases.
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http://dx.doi.org/10.29262/ram.v66i2.521DOI Listing
January 2020

Enfermedad periodontal como factor de riesgo adicional asociado con nacimiento pretérmino en México: un estudio de casos y controles.

Gac Med Mex 2019 ;155(2):143-148

Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", Servicio de Alergia e Inmunología Clínica. Guadalajara, Jalisco, México.

Introduction: Substances related to microorganisms involved in periodontal disease can reach the maternal-fetal interface via the hematogenous route and stimulate uterine contractility.

Objective: To determine the association between periodontal disease and preterm birth.

Method: Case-control study in 343 preterm and 686 full-term pregnant women. Gestational age was calculated based on the date of the last menstrual period and confirmed with Capurro and Ballard methods. Periodontal disease was diagnosed according to the depth of the space between the tooth root and the gum. The association was measured with logistic regression.

Results: Maternal age of the cases was 23.8 ± 6.7 years, and 23.2 ± 6.7 in the controls. Periodontal disease was present in 66.8% of cases and 40.5% of controls. The factors associated with preterm birth were periodontal disease (Odds ratio [OR] = 2.26), history of preterm birth (OR = 4.96), unplanned pregnancy (OR = 2.15) poor prenatal control (OR = 2.53), urinary tract infection (OR = 2.22), preeclampsia (OR = 4.49), premature rupture of membranes (OR = 2.59) and caesarean section delivery (OR = 9.15).

Conclusion: Periodontal disease in pregnancy was an independent risk factor for preterm birth.
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http://dx.doi.org/10.24875/GMM.18004332DOI Listing
November 2019

[MASK (Mobile Airways Sentinel Network). ARIA's comprehensive solution for mobile app for the multimorbidity of allergic rhinitis and asthma].

Rev Alerg Mex 2019 Jan-Mar;66(1):140-146

Médica Sur, Centro de Excelencia en Asma y alergia, Ciudad de México, México.

The vast majority of patients with allergic rhinitis (AR) do not receive the proper management which is recommended by the guidelines, but they frequently self-medicate. MASK (Mobile Airways Sentinel Network) is an integral part of a project that is supported by the European Union against chronic diseases and focused on active and healthy aging. MASK represents the third phase of ARIA (Allergic Rhinitis and its Impact on Asthma), in which, by using a mobile application in a smart device, the objective is to guide the patient in the control of his/her multi-morbidity, AR and/or allergic conjunctivitis (AC) and/or asthma. The mobile app Allergy Diary by MACVIA-ARIA is free and it is available for both Android and iOS platforms. After it is downloaded to the patient's cell phone, it first requests some information about the patient's profile, allergic pathologies and medication; afterwards, through a visual analog scale, the patient is invited to determine the degree of affectation in the nose, eyes, and bronchi, and its influence on their productivity at work / school. After analyzing the data generated by filling the Allergy Diary, it became clear there is a new clinical entity: allergic rhinitis+ allergic conjunctivitis +asthma, with greater effect; in addition to a high level of self-medication: in general, the patient takes medication on days when symptoms are present. The app has already been deployed in 23 countries, including several Spanish-speaking countries.
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http://dx.doi.org/10.29262/ram.v66i1.578DOI Listing
December 2019

[Allergy to food in adults with allergic respiratory diseases: prevalence and clinical manifestations].

Rev Alerg Mex 2019 Jan-Mar;66(1):1-8

Hospital Civil de Guadalajara Dr. Juan I. Menchaca, Servicio de Alergia e Inmunología Clínica, Guadalajara, México.

Background: Food allergy is considered a typical problem in the pediatric population, however, cases occur in adults more frequently.

Objective: To determine the prevalence of food allergy in patients with allergic rhinitis and asthma; as well as the foods and symptoms most related to said problem.

Methods: Through a cross-sectional study, the information of 257 adults with asthma or allergic rhinitis was analyzed. The information related to food allergy was obtained through a standardized interview; the confidence intervals (CI) were calculated for 95% proportions.

Results: The prevalence of food allergy was 17.5% (95% CI = 13.3% to 22.6%). The main foods that caused symptoms were soy, shrimp, almonds, avocado and peanuts. The majority of patients who were allergic to a single food were 35.6%, two foods were 17.8% and three foods were 17.8%. The most frequent affections of food allergy were oral (62.2%): itching of the pharynx, tongue and palate; respiratory (26.7%), dyspnea and sneezing; and skin (26.7%), itching and hives.

Conclusions: Food allergy in adults with asthma or allergic rhinitis is a common problem. Oral symptoms are the main ailments in this type of patients and are mainly caused by soy.
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http://dx.doi.org/10.29262/ram.v66i1.400DOI Listing
December 2019

Epidural pneumorrhachis, a rare complication of asthma exacerbation.

J Asthma 2019 12 10;56(12):1356-1359. Epub 2019 Jan 10.

Servicio de Alergia e Inmunología Clínica, Hospital Civil de Guadalajara "Dr. Juan I. Menchaca" , Guadalajara , Jalisco , México.

: An association between pneumorrhachis and asthma exacerbation is uncommon. However, we present a clinical case involving a patient with exacerbated asthma, subcutaneous emphysema, spontaneous pneumomediastinum (SPM), and pneumorrhachis. : The patient was an 18-year-old male with asthma since childhood who only relied on salbutamol to control his asthma symptoms. : The patient suddenly experienced dyspnea, chest tightness, and paroxysmal coughing, which prompted him to visit the emergency department. Upon arrival, subcutaneous emphysema was detected on the face, neck, thorax, and left forearm. Chest X-ray showed air in the mediastinum, neck, left supraclavicular region, and chest, all of which were verified by a computed tomography scan that also revealed air in the epidural region. At the hospital, his treatment focused on preventing asthma exacerbation and managing associated symptoms. : When a patient has asthma exacerbation that is accompanied by SPM and extensive emphysema, the presence of epidural pneumorrhachis should not be overlooked.
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http://dx.doi.org/10.1080/02770903.2018.1539101DOI Listing
December 2019

[Prevalence of asthma, allergic rhinitis and atopic dermatitis in school children of the Mexican Bajío region].

Rev Alerg Mex 2018 Oct-Dec;65(4):372-378

Universidad Quetzalcóatl en Irapuato, Guanajuato, México.

Background: The prevalence of allergic diseases markedly varies according to the geographical region.

Objective: To determine the prevalence of asthma, allergic rhinitis and atopic dermatitis in children of six and seven years of age.

Methods: Cross-sectional study that included a sample of almost 15 thousand children in five cities of Mexico. To obtain the prevalence of allergic diseases and their symptoms, the parents of the children answered The International Study of Asthma and Allergies in Childhood questionnaire. 95% confidence intervals (CI) were estimated for proportions.

Results: Of the total sample, 7466 (52.5 %) were boys and 7463 (47.5%) girls. In general, the prevalence of asthma, exercise-induced asthma and current asthma was 6.1 % (95% CI = 5.7%-6.5%), 2.1 % (95% CI = 1.9%-2.3%) and 11.6 % (95% CI = 11.1% -12.1%), respectively. On the other hand, the prevalence of allergic rhinitis was 5.4 % (95% CI = 5.1%-5.8%), rhinitis with conjunctivitis, 19.2 % (95% CI = 18.6%-19.8%), and current rhinitis, 52.8% (95% CI = 52.0%-53.6%). The prevalence of atopic dermatitis and current dermatitis was 3.4 % (95% CI = 3.1%-3.7%) and 7.8% (95 % CI = 7.4%-8.2%), respectively.

Conclusions: Our results indicate that the prevalence of allergic diseases in school children is similar to that observed in previous studies in Mexico.
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http://dx.doi.org/10.29262/ram.v65i4.527DOI Listing
October 2019

[Trends in asthma prevalence and its symptoms in Mexican late adolescents over a 7-year period].

Rev Alerg Mex 2018 Oct-Dec;65(4):331-340

Universidad Veracruzana, Instituto de Salud Pública, Veracruz, México.

Background: Late adolescents with asthma are rarely studied, since generally they are not included in children or adult groups; in addition, studies assessing asthma trends are scarce in Mexico, and their results might differ from findings in developed countries.

Objective: To determine the trends in asthma prevalence and its symptoms in late adolescents over a period of 7 years.

Methods: The prevalence of asthma and its symptoms were compared in two cross-sectional population-based cohorts, one from 2009 and the other from 2016.

Results: The presence of wheezing sometime in life and during the previous year was significantly increased between 2009 and 2016 (12.8 % versus 20.1 % and 7.3 % versus 10.3 %, p < 0.001 and 0.002, respectively). The prevalence of asthma went from 7.8 % in 2009 to 12.7 % in 2016 (p < 0.0001). In addition, the prevalence of allergic rhinitis (4.5 % versus 9.0 %) and atopic dermatitis (3.8 % versus 5.2 %) also showed marked increases (p < 0.0001 and 0.051, respectively).

Conclusions: The prevalence of asthma and some of its symptoms in late adolescents substantially increased in a 7-year period.
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http://dx.doi.org/10.29262/ram.v65i4.392DOI Listing
October 2019

The characterization of asthma with blood eosinophilia in adults in Latin America.

J Asthma 2019 Nov 5;56(11):1138-1146. Epub 2018 Nov 5.

Unidad de Investigación, Hospital Médica Sur , Puente de Piedra 150, Colonia Toriello Guerra , Ciudad de México , CP. 14050 , México.

To identify and characterize asthma with blood eosinophilia in adults. : This cross-sectional study consisted of 164 asthma patients, aged 18 years or older. Multivariate analyses by logistic regression were performed to identify clinical characteristics and biomarkers associated with asthma with blood eosinophilia (defined as asthma and a peripheral blood eosinophil count ≥400 cells/mm). To evaluate the diagnostic accuracy of these biomarkers, the sensitivity, specificity and predictive values were calculated. Additionally, the area under the receiver operating characteristic (ROC) curve (AUC) was estimated for each biomarker. : Overall, 37.8% (95%CI: 30.7-45.4%) of asthma patients had blood eosinophilia. The following factors were associated with this characteristic: patient age <50 years (OR 3.25; 95% CI: 1.33-7.94), a serum level of IgE ≥300 UI/mL (OR 2.32; 95%CI: 1.14-4.75), and an Asthma Control Test (ACT) score <20 points (OR 3.10; 95%CI: 1.35-4.75); asthma with blood eosinophilia was also associated with a baseline FEV/FVC <70% (OR 2.68; 95%CI: 1.28-5.59). On the other hand, age <50 years and ACT score <20 showed the highest sensitivity (above 80% each). Serum IgE level ≥300 UI/mL had the highest specificity (almost 68%). Finally, those with an ACT score <20 had the highest AUC (68%). : In our study population, one-third of asthmatic adults had asthma with blood eosinophilia. Furthermore, the prevalence was greater in those ≤50 years of age; these patients experienced more severe, more poorly controlled asthma and had higher total serum IgE levels.
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http://dx.doi.org/10.1080/02770903.2018.1520863DOI Listing
November 2019

Self-reported prevalence of clinical features of allergy to nuts and seeds, and seafood in university students.

Asia Pac Allergy 2018 Apr 25;8(2):e19. Epub 2018 Apr 25.

Servicio de Alergia e Inmunología Clínica, Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", Jalisco 44340, México.

Background: In developing countries, there is a lack of epidemiological information related to food hypersensitivity, including nuts and seafood.

Objective: The aim was to determine the prevalence of allergic reactions and clinical manifestations associated with the consumption of nuts and seeds or seafood in university students.

Methods: We designed an observational cross-sectional study. A structured questionnaire was applied to Mexican university students to identify allergic reactions associated with the consumption of nuts and seeds, and seafood.

Results: A sample of 1,200 students was included; mean age of 19.7 ± 1.7 years. Prevalence of symptoms associated with the consumption of nuts and seeds, and seafood were 2.8% (33 of 1,200) and 3.5% (42 of 1,200) respectively. The main clinical manifestations were abdominal pain (63.6% in nuts and seeds), flushing (50% in seafood), and pharyngeal oppression (19% in seafood). Prevalence of perceived, probable and systemic allergy to nuts and seeds was 2.8% (95% confidence interval [CI], 2.5%-3.0%), 0.8% (95% CI, 0.3%-1.3%) and 0.2% (95% CI, 0%-0.4%) respectively. On the other hand, the prevalence (perceived, probable, and systemic) associated with seafood consumption was 3.5% (95% CI, 2.5%-4.5%), 1.8% (95% CI, 1.0%-2.5%), and 0.5% (95% CI, 0.1%-0.9%). Walnut and shrimp were the most frequently reported foods.

Conclusion: For every 100 Mexican university students, approximately 3 or 4 perceived to have allergy attributed to the consumption of some nuts and seeds or seafood, while 1 or 2 students would have a probable reaction to this same type of food. Walnut and shrimp would be causing the higher quantity of food allergic reactions.
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http://dx.doi.org/10.5415/apallergy.2018.8.e19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5931926PMC
April 2018

[Prevalence of sensitization and allergy to kiwi fruit (Actinidia deliciosa) in adults with allergic diseases].

Rev Alerg Mex 2018 Jan-Mar;65(1):19-24

Hospital Civil de Guadalajara Dr. Juan I. Menchaca, Servicio de Alergia e Inmunología Clínica, Guadalajara, Jalisco, México.

Background: The kiwi fruit (Actinidia deliciosa) is a food that has been recognized for its allergenic capability for more than 30 years. In general, kiwi allergy is characterized by local discomfort, but systemic reactions such as rash, angioedema, rhinitis, conjunctivitis or anaphylaxis can be triggered.

Objective: To determine the prevalence of sensitization and allergy to kiwi in adults with allergic diseases.

Methods: By means of a cross-sectional, retrolective study, data corresponding to 370 patients aged ≥16 years were analyzed.

Results: 226 patients had positive skin reaction against aeroallergens. The prevalence of food sensitization was 84/226 (37.2%; 95 % CI = 31.1 to 43.6). Overall, the prevalence of sensitization to kiwi fruit was 15/226 (6.6%; 95% CI = 3.9 to 10.7), and of kiwi allergy, 2/15 (13.3%; 95% CI = 2.5 to 39.1); one patient had symptoms consistent with oral allergy syndrome, and another, gastrointestinal and cutaneous manifestations.

Conclusion: The prevalence of sensitization to kiwi fruit is not a rare event; in contrast, symptoms related to its consumption are uncommon.
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http://dx.doi.org/10.29262/ram.v65i1.293DOI Listing
October 2019

[Latex allergy self-report in medical students: prevalence and associated factors].

Rev Alerg Mex 2018 Jan-Mar;65(1):10-18

Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", Servicio de Alergia e Inmunología Clínica, Guadalajara, Jalisco, México.

Background: Prevalence of latex allergy in medical students is not known.

Objective: To determine the prevalence of self-reported latex allergy and associated factors in medical students.

Methods: Cross-sectional, analytical study of students with or without self-reported latex allergy. By means of a structured questionnaire, past personal and family history of allergic disease, time and frequency of exposure to latex gloves and symptoms after exposure to products or foods associated with latex allergy were inquired. Logistic regression models were carried out.

Results: Out of 854 subjects, 431 (50.5%) were females. Median age was 21 years. Overall prevalence of latex allergy was 4.3% (95% CI = 3.1 to 5.9). Associated risk factors were age (OR = 1.37; 95% CI = 1.05 to 1.79), personal history of atopic dermatitis (OR = 7.32; 95% CI = 3.14 to 17.08), use of gloves ≥ 15/week (OR = 2.59; 95% CI = 1.17 to 5.76), use of latex products (OR = 5.76; 95% CI = 2.15 to 15.49) and fruit allergy (OR = 3.24; 95% CI = 1.27 t o8.27).

Conclusion: Four out of a hundred students reported latex allergy. Age, personal history of atopic dermatitis, higher frequency of exposure to latex gloves and history of fruit allergy were risk factors for self-report latex allergy.
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http://dx.doi.org/10.29262/ram.v65i1.290DOI Listing
October 2019

Pediatric asthma treatment: What to do when international guideline recommendations do not agree.

Authors:
Désirée E S Larenas Linnemann Margarita Fernández Vega Jorge Agustín Luna Pech Jimena Villaverde Rosas José Antonio Ortega Martell Blanca Estela Del Río Navarro María Del Carmen Cano Salas Jade Romero Lombard Erika Del Carmen López Estrada Monica Rodriguez-González José Luis Mayorga Butrón Jorge Salas Hernández Juan Carlos Vázquez García Ignacio Ortiz Aldana Mario Humberto Vargas Becerra Martín Bedolla Barajas Noel Rodríguez Pérez Ambrocio Aguilar Aranda Carlos Adrián Jiménez González Carlos García Bolaños Claudia Garrido Galindo David Alejandro Mendoza Hernández Enrique Mendoza López Gerardo López Pérez Guillermo Hideo Wakida Kuzonoki Héctor Hernán Ruiz Gutiérrez Héctor León Molina Héctor Martínez de la Lanza Héctor Stone Aguilar Javier Gómez Vera Jorge Olvera Salinas José Joel Oyoqui Flores José Luis Gálvez Romero José Santos Lozano Saenz Juan Ignacio Salgado Gama Marcos Alejandro Jiménez Chobillon Martha Angélica García Avilés Martha Patricia Guinto Balanzar Miguel Alejandro Medina Ávalos Robert Camargo Angeles Rogelio García Torrentera Saraí Toral Freyre Gabriel Montes Narvaez Héctor Solorio Gómez Juan Rosas Peña Sergio Jesús Romero Tapia Adela Reyes Herrera Francisco Cuevas Schacht Joaquín Esquer Flores José Antonio Sacre Hazouri Lorenzo Compean Martínez Pablo Julián Medina Sánchez Sergio Garza Salinas Carlos Baez Loyola Iraís Romero Alvarado José Luis Miguel Reyes Laura Elizabeth Huerta Espinosa Manuel Ángel Correa Flores Ricardo Castro Martínez

Ann Allergy Asthma Immunol 2018 07 15;121(1):7-13.e4. Epub 2018 Mar 15.

Private practice, San Luis Potosí, Mexico.

Background: There was a need for a solid asthma guideline in Mexico to update and unify asthma management. Because high-quality asthma guidelines exist worldwide, in which the latest evidence on asthma management is summarized, the ADAPTE approach allows for the development of a national asthma guideline based on evidence from already existing guidelines, adapted to national needs.

Objective: To fuse evidence from the best asthma guidelines and adapt it to local needs with the ADAPTE approach.

Methods: The Appraisal of Guidelines for Research and Evaluation (AGREE) II asthma guidelines were evaluated by a core group to select 3 primary guidelines. For each step of asthma management, clinical questions were formulated and replied according to (1) evidence in the primary guidelines, (2) safety, (3) Cost, and (4) patient preference. The Guidelines Development Group, composed of a broad range of experts from medical specialties, primary care physicians, and methodologists, adjusted the draft questions and replies in several rounds of a Delphi process and 3 face-to-face meetings, taking into account the reality of the situation in Mexico. We present the results of the pediatric asthma treatment part.

Results: Selected primary guidelines are from the British Thoracic Society and Scottish Intercollegiate Guidelines Network (BTS/SIGN), Global Initiative for Asthma (GINA), and Spanish Guidelines on the Management of Asthma (GEMA) 2015, with 2016 updates. Recommendations or suggestions were made for asthma treatment in Mexico. In this article, the detailed analysis of the evidence present in the BTS/SIGN, GINA, and GEMA sections on the (non) pharmacologic treatment of pediatric asthma, education, and devices are presented for 2 age groups: children 5 years or younger and children 6 to 11 years old with asthma.

Conclusion: For the pediatric treatment and patient education sections, applying the AGREE II and Delphi methods is useful to develop a scientifically sustained document, adjusted to the Mexican situation, as is the Mexican Guideline on Asthma.
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http://dx.doi.org/10.1016/j.anai.2018.03.008DOI Listing
July 2018

Pediatric asthma treatment: What to do when international guideline recommendations do not agree.

Authors:
Désirée E S Larenas Linnemann Margarita Fernández Vega Jorge Agustín Luna Pech Jimena Villaverde Rosas José Antonio Ortega Martell Blanca Estela Del Río Navarro María Del Carmen Cano Salas Jade Romero Lombard Erika Del Carmen López Estrada Monica Rodriguez-González José Luis Mayorga Butrón Jorge Salas Hernández Juan Carlos Vázquez García Ignacio Ortiz Aldana Mario Humberto Vargas Becerra Martín Bedolla Barajas Noel Rodríguez Pérez Ambrocio Aguilar Aranda Carlos Adrián Jiménez González Carlos García Bolaños Claudia Garrido Galindo David Alejandro Mendoza Hernández Enrique Mendoza López Gerardo López Pérez Guillermo Hideo Wakida Kuzonoki Héctor Hernán Ruiz Gutiérrez Héctor León Molina Héctor Martínez de la Lanza Héctor Stone Aguilar Javier Gómez Vera Jorge Olvera Salinas José Joel Oyoqui Flores José Luis Gálvez Romero José Santos Lozano Saenz Juan Ignacio Salgado Gama Marcos Alejandro Jiménez Chobillon Martha Angélica García Avilés Martha Patricia Guinto Balanzar Miguel Alejandro Medina Ávalos Robert Camargo Angeles Rogelio García Torrentera Saraí Toral Freyre Gabriel Montes Narvaez Héctor Solorio Gómez Juan Rosas Peña Sergio Jesús Romero Tapia Adela Reyes Herrera Francisco Cuevas Schacht Joaquín Esquer Flores José Antonio Sacre Hazouri Lorenzo Compean Martínez Pablo Julián Medina Sánchez Sergio Garza Salinas Carlos Baez Loyola Iraís Romero Alvarado José Luis Miguel Reyes Laura Elizabeth Huerta Espinosa Manuel Ángel Correa Flores Ricardo Castro Martínez

Ann Allergy Asthma Immunol 2018 07 15;121(1):7-13.e4. Epub 2018 Mar 15.

Private practice, San Luis Potosí, Mexico.

Background: There was a need for a solid asthma guideline in Mexico to update and unify asthma management. Because high-quality asthma guidelines exist worldwide, in which the latest evidence on asthma management is summarized, the ADAPTE approach allows for the development of a national asthma guideline based on evidence from already existing guidelines, adapted to national needs.

Objective: To fuse evidence from the best asthma guidelines and adapt it to local needs with the ADAPTE approach.

Methods: The Appraisal of Guidelines for Research and Evaluation (AGREE) II asthma guidelines were evaluated by a core group to select 3 primary guidelines. For each step of asthma management, clinical questions were formulated and replied according to (1) evidence in the primary guidelines, (2) safety, (3) Cost, and (4) patient preference. The Guidelines Development Group, composed of a broad range of experts from medical specialties, primary care physicians, and methodologists, adjusted the draft questions and replies in several rounds of a Delphi process and 3 face-to-face meetings, taking into account the reality of the situation in Mexico. We present the results of the pediatric asthma treatment part.

Results: Selected primary guidelines are from the British Thoracic Society and Scottish Intercollegiate Guidelines Network (BTS/SIGN), Global Initiative for Asthma (GINA), and Spanish Guidelines on the Management of Asthma (GEMA) 2015, with 2016 updates. Recommendations or suggestions were made for asthma treatment in Mexico. In this article, the detailed analysis of the evidence present in the BTS/SIGN, GINA, and GEMA sections on the (non) pharmacologic treatment of pediatric asthma, education, and devices are presented for 2 age groups: children 5 years or younger and children 6 to 11 years old with asthma.

Conclusion: For the pediatric treatment and patient education sections, applying the AGREE II and Delphi methods is useful to develop a scientifically sustained document, adjusted to the Mexican situation, as is the Mexican Guideline on Asthma.
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July 2018

[Self-reported prevalence of latex allergy and associated factors in healthcare workers].

Rev Alerg Mex 2017 Oct-Dec;64(4):430-438

Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", Servicio de Alergia e Inmunología Clínica, Guadalajara, Jalisco, México.

Background: In our country, the prevalence of latex allergy in health personnel has rarely been studied.

Objective: To determine the prevalence and associated factors to self-reported latex allergy in health care workers.

Methods: A cross-sectional study was conducted among 1,292 health care workers of a second level hospital. All workers were included and they were required to answer a structured questionnaire aimed at identifying latex allergy, atopic personal and family history, exposure to latex gloves and surgical background. Odds ratio (OR) and 95 % confidence interval (95 % CI) were estimated using regression logistic to investigate factors associated to latex allergy.

Results: The female to male ratio was 2.4:1. The men age 38.4 ± 11.6 years. The prevalence of latex allergy auto-reported was 9.7 %, with a confidence interval of 95 % (95 % CI) 8.1 %-11.3 %. There was no statistical difference by workplace (p = 0.508). Factors associated with latex allergy included female gender (OR = 1.68; 95 % CI: 1.03-2.73, p = 0.037), personal history of atopy (OR = 4.82; 95 % CI: 3.19-7.26, p < 0.0001), family history of atopic dermatitis (OR = 4.33, 95 % CI: 1.20-4.41) and history of allergy to fruits (OR = 4.33; 95 % CI: 2.62-7.14, p < 0.0001).

Conclusions: Up to 10 out to 100 health workers may have latex allergy. The main factors associated with latex allergy in this study were: being a female, personal or familiar atopy and allergy to fruits.
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http://dx.doi.org/10.29262/ram.v64i4.289DOI Listing
July 2019

[Spontaneous pneumomediastinum and subcutaneous emphysema associated with bronchospasm in a woman with no history of asthma].

Rev Alerg Mex 2017 Jul-Sep;64(3):386-389

Hospital Civil de Guadalajara Dr. Juan I. Menchaca, Servicio de Alergia e Inmunología Clínica, Guadalajara, Jalisco, México.

Background: Spontaneous pneumomediastinum most relevant triggering events are cough, vomiting, nutritional problems, physical activity and use of inhaled drugs. Association of spontaneous pneumomediastinum with non-asthma-related bronchospasm is an infrequent event.

Clinical Case: This is the case of a 21-year-old woman without personal or family history of asthma, allergic rhinitis or atopy who during late puerperium had 39 °C fever, paroxysmal cough and chest oppression of sudden onset, as well as wheezing and subcutaneous emphysema of the neck; she had no previous nasal symptoms. Chest X-ray revealed free air in the mediastinum and left lateral side of the neck. Possible cause of the condition was attributed to bronchospasm related to airway infection. Treatment was based on bronchodilators, systemic steroids and supplementary oxygen administration. The symptoms subsided after 48 hours.

Conclusions: In the clinical case herein presented, spontaneous pneumomediastinum precipitating factor appeared to be paroxysmal cough associated with bronchospasm and, hence, we suggest for this entity to be suspected in patients even if there is no previous history of asthma.
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http://dx.doi.org/10.29262/ram.v64i3.262DOI Listing
July 2019

Self-report prevalence and associated factors to drug hypersensitivity in Mexican young adults.

Asia Pac Allergy 2017 Jul 26;7(3):156-162. Epub 2017 Jul 26.

Centro de Investigación en Ciencias Médicas, Universidad Autónoma del Estado de México, Toluca, México.

Background: Drug hypersensitivity is defined as any unfavorable reaction that occurs after the administration of any drug. It may or may not be mediated by the involvement of the immune system. Epidemiological data related to drug hypersensitivity reactions in our country are scarce.

Objective: To determine the prevalence of drug hypersensitivity in a group of young adults, as well as to identify associated factors.

Methods: A structured questionnaire was applied to young people aged 18 to 25 years. The instrument was oriented to identify reactions of drug hypersensitivity, as well as the most prevalent drugs involved. In addition, a personal and family history of atopic diseases was included. Analysis for associations between variables was been done through logistic regression.

Results: The prevalence of drug hypersensitivity reactions was 12% (144 of 1,200). The antibiotics were the agents most related to hypersensitivity reactions (9.8%) followed by nonsteroidal anti-inflammatory drugs (1.6%). Factors associated with drug hypersensitivity were a personal history of asthma, odds ratio (OR) 3.15 (95% confidence interval [CI], 1.44-6.91), maternal and paternal history of drug hypersensitivity, OR 2.33 (95% CI, 1.21-4.48) and OR 3.11 (95% CI, 1.22-7.92), respectively.

Conclusion: The results of this research show that drug hypersensitivity in young adults is a highly prevalent event and it is associated with personal history of asthma and history of drug hypersensitivity in parents.
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http://dx.doi.org/10.5415/apallergy.2017.7.3.156DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5537080PMC
July 2017

Prevalence of respiratory viruses in wheezing children not older than 24 months of age.

Gac Med Mex 2017 May-Jun;153(3):329-334

Nuevo Hospital Civil de Guadalajara Dr. Juan I. Menchaca, Guadalajara, Jalisco, Mexico.

Introduction: Wheezing in children not older than 24 months of age is a frequent event, and viruses are usually the causative agents. The aim of the study was to estimate the prevalence of respiratory viruses in wheezing children who were not older than 24 months of age and who had no history of asthma.

Methods: Fifty-five Mexican children were included in an analytical cross-sectional study. Nasal secretions were obtained by using sterile rayon-tipped applicators to identify the virus by polymerase chain reaction or reverse transcription-polymerase chain reaction: adenovirus, bocavirus, human rhinovirus, influenza virus type A, human metapneumovirus, parainfluenza, rhinovirus, and respiratory syncytial virus. The prevalence of viral etiology was estimated by dividing the frequency of the identified virus by the number of participants. Ninety-five percent confidence intervals for proportions were calculated.

Results: Most of the patients were male (35/55, 63.6%). The average time of evolution of wheezing episode was 3 days. The third part of enrolled population were receiving antibiotics. Respiratory viruses were detected in 33 (60%; 95% CI: 46.8-71.9%) out of 55 cases, and viral coinfection was detected in five cases (9.1%; 95% CI: 3.5-19.9%). Human metapneumovirus was the most frequently identified virus (23.6%), followed by bocavirus (14.5%), respiratory syncytial virus and rhinovirus (12.7% each), and to a lesser extent influenza virus type A and parainfluenza. Rhinovirus was the predominant virus in outpatient children (28.6%). In the inpatient emergency room and inhalotherapy room, human metapneumovirus predominated (41.2 and 16.1%, respectively).

Conclusion: bocavirus and human metapneumovirus were the most frequently identified viruses in Mexican children who were < 2 years of age, suffered from wheezing, and had no history of asthma.
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February 2018