25 research outputs found
Changes in Skin Test Aeroallergen Sensitization in Mexico Over the Past 14 Years and According to Climate
No full textDésirée Larenas-Linnemann,1 Blanca María Morfín-Maciel,2 Victor Gonzalez-Uribe,3 Claudia Ivonne Gallego-Corella,4 Germán Agustín Rico-Solís,5 Luiana Hernández-Velázquez,6 Daniel García-Imperial,7 Chrystopherson Gengyny Caballero-Lopez,8 Ondina Marlene Garibay-Vargas,9 José Luis Gálvez-Romero,10 Daniela García Fajardo,11 Joel Barroso-Santos,12 Herberth de Jesús Pérez-Áviles,13 Jorge Agustín Luna-Pech,14 Cecilia Yvonne García-Cobas,15 Kareli Guadalupe Coronado-Hernández,16 Margarita Ortega-Cisneros,17 Carlos Humberto González-Gutiérrez,18 Daniela Rivero-Yeverino,8 Elsy Maureen Navarrete-Rodríguez,19 Leticia Lezama-Vázquez,20 Karen Lilian Rivera-Alvarado,21 Georgina Guadalupe Ochoa-López,22 Sara Elizabeth Covarrubias-Ramírez,23 Claudia Patricia Reyes-Galindo,24 Beatriz Bayardo-Gutiérrez,25 María del Carmen Calderón-Ezquerro26 1Centro de Excelencia en Asma y Alergia Larenas, Hospital Médica Sur, Mexico City, DF, Mexico; 2Private practice, Mexico City, DF, Mexico; 3AlergiaMx, Mexico City, DF, Mexico; 4Centro de Alergia y Asma de Tijuana, Tijuana, BCN, Mexico; 5Hospital Regional Valentín Gómez Farías, Department of Allergy and Clinical Immunology, Colima, COL, Mexico; 6IMSS Hospital General de Zona Número 8, Ensenada, BCN, Mexico; 7Private Practice, Querétaro, QRO, Mexico; 8Hospital Universitario de Puebla, Benemérita Universidad Autónoma de Puebla, Puebla, PUE, Mexico; 9Private practice, Uruapan, MICH, Mexico; 10Jefatura de investigación, Hospital Regional ISSSTE, Puebla, PUE, Mexico; 11Private Practice, San Luis Potosí, SLP, Mexico; 12Private practice, Pachuca, HGO, Mexico; 13Private Practice, Mérida, YUC, Mexico; 14Departamento de Disciplinas Filosófico, Metodológico e Instrumentales, CUCS, Universidad de Guadalajara, JAL, Mexico; 15Alergia e Inmunología, HGR 46, Instituto Mexicano del Seguro Social, Guadalajara, JAL, Mexico; 16Centro Médico Nacional del Occidente Pediatrics, Guadalajara, JAL, Mexico; 17Centro Médico Nacional de Occidente UMAE Hospital de Especialidades, Department of clinical immunology and allergy, Guadalajara, JAL, Mexico; 18HGZ # 1 IMSS, Zacatecas, ZAC, Mexico; 19Hospital Infantil de México ‘Federico Gómez’, Mexico City, DF, Mexico; 20Private practice, Tuxtla-Gutiérrez, CHIS, Mexico; 21IMSS UMAE 14, Veracruz, VER, Mexico; 22Private practice, Ciudad Juárez, CHIH, Mexico; 23Plebitos, Especialidades Pediátricas, Mazatlán, SIN, Mexico; 24ISSSTE, Ciudad Victoria, TAMPS, Mexico; 25Centro Médico Nacional de Occidente UMAE Hospital de Especialidades, Departamento de Inmunología Clínica y Alergia, Hospital Regional ISSSTE, Puebla, PUE, Mexico; 26Instituto de Ciencias de la Atmósfera y Cambio Climático, Universidad Autónoma de México, Mexico City, DF, MexicoCorrespondence: Désirée Larenas-Linnemann, Centro de Excelencia en Asma y Alergia Larenas, Hospital Médica Sur, Torre 2 cons. 602, Puente de Piedra 150, Col. Toriello Guerra, Del. Tlalpan, Ciudad de México, 14050, Mexico, Tel +52-55-5171-2248 ; +5606-6222 Ext.4372 ; +52-55-8509-5950, Email [email protected]: Aeroallergen exposure has an intra- and extra-domiciliary component and varies according to climatological zones. Mexico is a large country with a great variety of climates. A previous study (2009) evaluated skin prick test results (SPT) in different regions. In this study, we compare previous sensitization patterns from 14y ago with current ones and compare them between different climatological zones.Methods: Mexican allergists were asked to share their last 100 SPT results in patients with respiratory allergy. Clinics were grouped in (semi)humid vs (semi)dry zones. Results were analyzed nationwide and compared to the 2009 results, calculating odds ratio (OR) and 95% confidence intervals (95% CIs), with p < 0.05 as cut-off. Similarly, we compared (semi)humid versus dry zones.Results: We collected 2915 SPT results from 28 clinics (19 cities). Dermatophagoides was the most frequently sensitizing allergen. There was a significant increase in SPT positivity from 2009 to 2023 in both in- and outdoor aeroallergens (OR 1.26– 2.65, 95% CI from 1.06– 1.50 to 1.99– 3.52). Comparing dry-humid zones, sensitization to pollen from Oleaceae, Fagaceae (p < 0.0001 all) and most weeds is more frequent in humid zones, as are Dermatophagoides and cockroach (both p < 0.0001). Eucalyptus, mesquite, and all grass pollen sensitizations predominate in dry zones (p < 0.05– 0.0001). There are no differences in sensitization to cat or dog between zones.Conclusion: We found a general increase in SPT sensitization over the past fourteen years, suggesting that this is probably not only due to climate change. The different sensitization profile throughout the country was mainly related to humidity. Repeating epidemiologic SPT studies over the years could help tracking changes in allergen sensitization over time.Keywords: allergy, diagnosis, skin prick testing, aeroallergen, climate change, pollen allergy, allergic rhinitis, allergic asthm
Allergen sensitization linked to climate and age, not to intermittent-persistent rhinitis in a cross-sectional cohort study in the (sub)tropics.
No full textBACKGROUND: Allergen exposure leads to allergen sensitization in susceptible individuals and this might influence allergic rhinitis (AR) phenotype expression. We investigated whether sensitization patterns vary in a country with subtropical and tropical regions and if sensitization patterns relate to AR phenotypes or age. METHODS: In a national, cross-sectional study AR patients (2-70 y) seen by allergists underwent blinded skin prick testing with a panel of 18 allergens and completed a validated questionnaire on AR phenotypes. RESULTS: 628 patients were recruited. The major sensitizing allergen was house dust mite (HDM) (56%), followed by Bermuda grass (26%), ash (24%), oak (23%) and mesquite (21%) pollen, cat (22%) and cockroach (21%). Patients living in the tropical region were almost exclusively sensitized to HDM (87%). In the central agricultural zones sensitization is primarily to grass and tree pollen. Nationwide, most study subjects had perennial (82.2%), intermittent (56.5%) and moderate-severe (84.7%) AR. Sensitization was not related to the intermittent-persistent AR classification or to AR severity; seasonal AR was associated with tree (p<0.05) and grass pollen sensitization (p<0.01). HDM sensitization was more frequent in children (0-11 y) and adolescents (12-17 y) (subtropical region: p<0.0005; tropical region p<0.05), but pollen sensitization becomes more important in the adult patients visiting allergists (Adults vs children+adolescents for tree pollen: p<0.0001, weeds: p<0.0005). CONCLUSIONS: In a country with (sub)tropical climate zones SPT sensitization patterns varied according to climatological zones; they were different from those found in Europe, HDM sensitization far outweighing pollen allergies and Bermuda grass and Ash pollen being the main grass and tree allergens, respectively. Pollen sensitization was related to SAR, but no relation between sensitization and intermittent-persistent AR or AR severity could be detected. Sensitization patterns vary with age (child HDM, adult pollen). Clinical implications of our findings are dual: only a few allergens -some region specific- cover the majority of sensitizations in (sub)tropical climate zones. This is of major importance for allergen manufacturers and immunotherapy planning. Secondly, patient selection in clinical trials should be based on the intermittent-persistent and severity classifications, rather than on the seasonal-perennial AR subtypes, especially when conducted in (sub)tropical countries
Development and validation of an electronic daily control score for asthma (e-DASTHMA): a real-world direct patient data study
No full textBackground Validated questionnaires are used to assess asthma control over the past 1-4 weeks from reporting. However, they do not adequately capture asthma control in patients with fluctuating symptoms. Using the Mobile Airways Sentinel Network for airway diseases (MASK-air) app, we developed and validated an electronic daily asthma control score (e-DASTHMA). Methods We used MASK-air data (freely available to users in 27 countries) to develop and assess different daily control scores for asthma. Data-driven control scores were developed based on asthma symptoms reported by a visual analogue scale (VAS) and self-reported asthma medication use. We included the daily monitoring data from all MASK-air users aged 16-90 years (or older than 13 years to 90 years in countries with a lower age of digital consent) who had used the app in at least 3 different calendar months and had reported at least 1 day of asthma medication use. For each score, we assessed construct validity, test-retest reliability, responsiveness, and accuracy. We used VASs on dyspnoea and work disturbance, EQ-5D-VAS, Control of Allergic Rhinitis and Asthma Test (CARAT), CARAT asthma, and Work Productivity and Activity Impairment: Allergy Specific (WPAI:AS) questionnaires as comparators. We performed an internal validation using MASK-air data from Jan 1 to Oct 12, 2022, and an external validation using a cohort of patients with physician-diagnosed asthma (the INSPIRERS cohort) who had had their diagnosis and control (Global Initiative for Asthma [GINA] classification) of asthma ascertained by a physician. Findings We studied 135 635 days of MASK-air data from 1662 users from May 21, 2015, to Dec 31, 2021. The scores were strongly correlated with VAS dyspnoea (Spearman correlation coefficient range 0.68-0.82) and moderately correlated with work comparators and quality-of-life-related comparators (for WPAI:AS work, we observed Spearman correlation coefficients of 0.59-0.68). They also displayed high test-retest reliability (intraclass correlation coefficients range 0.79-0.95) and moderate-to-high responsiveness (correlation coefficient range 0.69-0.79; effect size measures range 0.57-0.99 in the comparison with VAS dyspnoea). The best-performing score displayed a strong correlation with the effect of asthma on work and school activities in the INSPIRERS cohort (Spearman correlation coefficients 0.70; 95% CI 0.61-0.78) and good accuracy for the identification of patients with uncontrolled or partly controlled asthma according to GINA (area under the receiver operating curve 0.73; 95% CI 0.68-0.78). Interpretation e-DASTHMA is a good tool for the daily assessment of asthma control. This tool can be used as an endpoint in clinical trials as well as in clinical practice to assess fluctuations in asthma control and guide treatment optimisation. Funding None. Copyright (c) 2023 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license
Prueba de fracción exhalada de óxido nítrico para el diagnóstico del asma
No full text: figura ; 28 cm.La presente revisión tuvo como objetivo analizar la prueba de Fracción exhalada de óxido nítrico (FENO) como posibilidad para realizar el diagnóstico del asma. La revisión se realizó teniendo en cuenta los diferentes artículos reportados en bases de datos como Scopus, PubMed, Google académico. Los resultados indican que la prueba FENO es útil en el diagnóstico del asma y sirve además como predictora de la enfermedad. Sin embargo, se recomienda que en niños menores de 16 años la prueba pueda estar acompañada por otras técnicas diagnósticas. Se estima que la prevención temprana del asma puede reducir los costos clínicos producto de la gravedad de la enfermedad en Colombia.Consideraciones generales.-- Pregunta de investigación.-- Objetivo de investigación.-- Justificación.-- Marco referencial.-- Metodología.-- Resultados.-- Conclusiones.-- Recomendaciones.-- Bibliografía.PregradoTerapeuta RespiratorioTerapia Respiratori
Transfer of innovation on allergic rhinitis and asthma multimorbidity in the elderly (MACVIA-ARIA) - EIP on AHA Twinning Reference Site (GARD research demonstration project)
No full textAbstract
The overarching goals of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) are to enable European citizens to lead healthy, active and independent lives whilst ageing. The EIP on AHA includes 74 Reference Sites. The aim of this study was to transfer innovation from an app developed by the MACVIA-France EIP on AHA reference site (Allergy Diary) to other reference sites. The phenotypic characteristics of rhinitis and asthma multimorbidity in adults and the elderly will be compared using validated information and communication technology (ICT) tools (i.e. the Allergy Diary and CARAT: Control of Allergic Rhinitis and Asthma Test) in 22 Reference Sites or regions across Europe. This will improve the understanding, assessment of burden, diagnosis and management of rhinitis in the elderly by comparison with an adult population. Specific objectives will be: (i) to assess the percentage of adults and elderly who are able to use the Allergy Diary, (ii) to study the phenotypic characteristics and treatment over a 1-year period of rhinitis and asthma multimorbidity at baseline (cross-sectional study) and (iii) to follow-up using visual analogue scale (VAS). This part of the study may provide some insight into the differences between the elderly and adults in terms of response to treatment and practice. Finally (iv) work productivity will be examined in adults
Transfer of innovation on allergic rhinitis and asthma multimorbidity in the elderly (MACVIA-ARIA) - EIP on AHA Twinning Reference Site (GARD research demonstration project)
No full textThe overarching goals of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) are to enable European citizens to lead healthy, active and independent lives whilst ageing. The EIP on AHA includes 74 Reference Sites. The aim of this study was to transfer innovation from an app developed by the MACVIA-France EIP on AHA reference site (Allergy Diary) to other reference sites. The phenotypic characteristics of rhinitis and asthma multimorbidity in adults and the elderly will be compared using validated information and communication technology (ICT) tools (i.e. the Allergy Diary and CARAT: Control of Allergic Rhinitis and Asthma Test) in 22 Reference Sites or regions across Europe. This will improve the understanding, assessment of burden, diagnosis and management of rhinitis in the elderly by comparison with an adult population. Specific objectives will be: (i) to assess the percentage of adults and elderly who are able to use the Allergy Diary, (ii) to study the phenotypic characteristics and treatment over a 1-year period of rhinitis and asthma multimorbidity at baseline (cross-sectional study) and (iii) to follow-up using visual analogue scale (VAS). This part of the study may provide some insight into the differences between the elderly and adults in terms of response to treatment and practice. Finally (iv) work productivity will be examined in adults
Evidencia de Leptospira spp. en sangre de perros de una comunidad rural de Yucatán, México.
No full textObjective. To describe the frequency of infection with Leptospira spp. in dogs of a rural community in the state of Yucatán, Mexico. Materials and methods. Blood samples were collected in 120 dogs from Maxcanú, Yucatán. Besides, characteristics such as sex, age, and breed were registered, and owners were asked about the vaccine history. The samples were transported to the laboratory and through the polymerase chain reaction diagnostic test, were reported the amplification of two fragments of the 16S ribosomal gene belonging to Leptospira spp. Results. The infection frequency found was 1.7% (2/120; 95%CI= 0.2 - 5.9%). Both positive dogs were males, puppies, mongrels (mix of breeds), and no vaccination history. Conclusions. A low frequency of infection is described in the dogs of the study site. More epidemiological research is needed to know the Leptospira species involved in the infection and identify the risk of transmission to the inhabitants or other domestic animals of the study site.Objetivo. Describir la frecuencia de infección con Leptospira sp. en perros de una comunidad rural del estado de Yucatán, México. Materiales y métodos. Se recolectaron muestras sanguíneas en 120 perros de Maxcanú, Yucatán. Además, se registraron características como sexo, edad, raza y se preguntó a los dueños sobre el historial de vacunas. Las muestras se transportaron al laboratorio y mediante la prueba diagnóstica de reacción en cadena de la polimerasa (PCR), se identificó la amplificación de dos fragmentos del gen 16S ribosomal perteneciente a Leptospira sp. Resultados. La frecuencia de infección encontrada fue de 1.7% (2/120; IC95%= 0.2 – 5.9%). Ambos perros positivos fueron machos, cachorros, mestizos (mezcla de razas) y sin historial de vacunación. Conclusiones. Se describe una frecuencia baja de infección en perros del sitio de estudio. Es necesaria más investigación epidemiológica para conocer las especies de Leptospira involucradas en la infección e identificar el riesgo de transmisión a los habitantes u otros animales domésticos del sitio de estudio
Geolocation with respect to personal privacy for the Allergy Diary app - a MASK study
No full textBackgroundCollecting data on the localization of users is a key issue for the MASK (Mobile Airways Sentinel networK: the Allergy Diary) App. Data anonymization is a method of sanitization for privacy. The European Commission’s Article 29 Working Party stated that geolocation information is personal data.To assess geolocation using the MASK method and to compare two anonymization methods in the MASK database to find an optimal privacy method.MethodsGeolocation was studied for all people who used the Allergy Diary App from December 2015 to November 2017 and who reported medical outcomes. Two different anonymization methods have been evaluated: Noise addition (randomization) and k-anonymity (generalization).ResultsNinety-three thousand one hundred and sixteen days of VAS were collected from 8535 users and 54,500 (58.5%) were geolocalized, corresponding to 5428 users. Noise addition was found to be less accurate than k-anonymity using MASK data to protect the users’ life privacy.Discussionk-anonymity is an acceptable method for the anonymization of MASK data and results can be used for other databases
Guidance to 2018 good practice: ARIA digitally-enabled, integrated, person-centred care for rhinitis and asthma
No full textAims: Mobile Airways Sentinel NetworK (MASK) belongs to the Fondation Partenariale MACVIA-LR of Montpellier, France and aims to provide an active and healthy life to rhinitis sufferers and to those with asthma multimorbidity across the life cycle, whatever their gender or socio-economic status, in order to reduce health and social inequities incurred by the disease and to improve the digital transformation of health and care. The ultimate goal is to change the management strategy in chronic diseases. Methods: MASK implements ICT technologies for individualized and predictive medicine to develop novel care pathways by a multi-disciplinary group centred around the patients. Stakeholders: Include patients, health care professionals (pharmacists and physicians), authorities, patient's associations, private and public sectors. Results: MASK is deployed in 23 countries and 17 languages. 26,000 users have registered. EU grants (2018): MASK is participating in EU projects (POLLAR: impact of air POLLution in Asthma and Rhinitis, EIT Health, DigitalHealthEurope, Euriphi and Vigour). Lessons learnt: (i) Adherence to treatment is the major problem of allergic disease, (ii) Self-management strategies should be considerably expanded (behavioural), (iii) Change management is essential in allergic diseases, (iv) Education strategies should be reconsidered using a patient-centred approach and (v) Lessons learnt for allergic diseases can be expanded to chronic diseases
Influencia de los pesticidad en la desaparición de las abejas nativas sin aguijón (ANSA) y la importancia de su conservación
No full textLa Abeja Nativa Sin Aguijón (ANSA), es una especie relevante y diferente entre los polinizadores, son insectos considerados imprescindibles para el 75% de los cultivos agrícolas al mejorar su productividad en la gran mayoría de cultivos, los cuales representan para la abeja su fuente proteica y energéticas el “polen y néctar” de la planta, en su alimentación.
La escaza presencia de la especie en diferentes lugares de Sudamérica, se relaciona a posibles factores como sobreexposición a pesticidas; acción que atribuye tanto a impactos positivos como negativos en la productividad agrícola, debido a que el uso de pesticidas es usado para controlar patógenos externos que afectan el óptimo desarrollo de las plantas, proceso que resulta beneficioso hasta el punto en el que se hace uso indiscriminado de diferentes productos sobre las plantas, acción catalogada como dañina a la fauna que frecuenta y entra en contacto con estas plantas para extraer su alimento, causando toxicidad en diferentes niveles. En cuanto a la economía, genera pérdidas económicas al generar altos costos en la producción agrícola y una reducción en la calidad de los forrajes. El objetivo de esta revisión sistemática es revisar las evidencias experimentales sobre los efectos tóxicos causados por los diferentes compuestos químicos que conforman cada pesticida sobre la abeja nativa sin aguijón, con el fin de fortalecer la información entorno a la verdadera influencia del uso de pesticidas en campo, mediante búsquedas exhaustivas en bases de datos científicas, basándose en investigaciones publicadas previamente sobre informacion entorno a las mortalidades registradas de la abeja nativa sin aguijón y sus posibles causas. La metodología se realizó a través del modelo prisma, en donde se cribaron los estudios relacionados con el tema para su posterior análisis; es por ello que en base a diferentes tipos de estudios realizados por otras fuentes, permitió evidenciar la verdadera influencia de los principales grupos de pesticidas sobre la especie ANSA, con el fin de medir su sensibilidad a los tóxicos expuestos, a diferentes de otras especies que aunque también presentaban sensibilidad, resultaron más resistentes. Ahora bien, otro hallazgo encontrado en los estudios, fue el uso de compuestos químicos considerados seguros para el uso en el campo, cuando en realidad puede causar efectos neurológicos al suministrarse en grandes cantidades. En conclusión, se puede identificar como la especie ANSA, se encuentra amenazada constante, al exponerse a posibles intoxicaciones al momento de buscar su alimento, y en consecuencia, se presentan afectaciones en el desarrollo productivo de los cultivos, creando debates, estrategias que pueda sobre llevar la escasez de polinizadores, incrementando los costos de mano de obra en el cultivo.The Native Stingless Bee (ANSA) is a relevant and different species among pollinators, they are insects considered essential for 75% of agricultural crops by improving their productivity in the vast majority of crops, which represent their source for the bee. protein and energy the "pollen and nectar" of the plant, in its diet. The scarce presence of the species in different places in South America is related to possible factors such as overexposure to pesticides; action that attributes both positive and negative impacts on agricultural productivity, due to the fact that the use of pesticides is used to control external pathogens that affect the optimal development of plants, a process that is beneficial to the point where indiscriminate use is made of different products on plants, an action classified as harmful to the fauna that frequents and comes into contact with these plants to extract their food, causing toxicity at different levels. Regarding the economy, it generates economic losses by generating high costs in agricultural production and a reduction in the quality of forage. The objective of this systematic review is to review the experimental evidence on the toxic effects caused by the different chemical compounds that make up each pesticide on the native stingless bee, in order to strengthen the information regarding the true influence of the use of pesticides in the field. , through exhaustive searches in scientific databases, based on previously published research on information regarding recorded mortalities of the native stingless bee and its possible causes. The methodology was carried out through the prism model, where the studies related to the subject were screened for their subsequent analysis; That is why, based on different types of studies carried out by other sources, it allowed to demonstrate the true influence of the main groups of pesticides on the ANSA species, in order to measure its sensitivity to the toxic substances exposed, different from other species that although they also presented sensitivity, they were more resistant. However, another finding found in the studies was the use of chemical compounds considered safe for use in the field, when in fact it can cause neurological effects when supplied in large quantities. In conclusion, it can be identified as the ANSA species, it is constantly threatened, by exposing itself to possible poisoning when looking for its food, and consequently, there are effects on the productive development of crops, creating debates, strategies that can on lead to a shortage of pollinators, increasing labor costs in the crop.Lista de tablas. -- Lista de figuras. -- Resumen. -- 1. Introducción. -- 2. Planteamiento del problema. -- 2.1. Antecedentes del problema. -- 3. Justificación. -- 4. Objetivos. -- 4.1. Objetivo general. -- 4.2. Objetivo específico. -- 5. Marco conceptual. -- 5.1. Tipos de ANSA. -- 5.2. Pesticidas. -- 5.3. Exposición de las abejas a los tóxicos en la naturaleza. -- 6. Marco normativo. -- 6.1. Marco legal para Meliponicultores (Meliponini). -- 7. Estado del arte. -- 8. Metodología. -- 8.1. Búsqueda inicial. -- 8.2. Búsqueda sistemática. -- 8.2.1. Criterios de inclusión. -- 8.2.2. Criterios de exclusión. -- 8.3. Búsqueda manual. -- 9. Resultados. -- 10. Discusión. -- 11. Conclusiones. – [email protected]
