Estado de nutrición de yodo y prevalencia de concentraciones anormales de TSH en la población escolar de 6-7 años de la comunidad autónoma del País Vasco / Iodine nutrition status and prevalence of abnormal TSH levels in schoolchildren aged 6-7 years in the autonomous community of the Basque Country

Introducción: Un estudio epidemiológico realizado entre 1988 y 1992 puso de manifiesto la existencia de deficiencia de yodo y bocio endémico en la población escolar de la comunidad autónoma del País Vasco. Objetivos: 1) Conocer el estado de nutrición de yodo de los escolares de 6-7 años de edad y 2) estimar la prevalencia de concentraciones anormales de TSH en sangre capilar. Población y métodos: Fueron estudiados 497 escolares seleccionados mediante muestreo aleatorizado. Para evaluar el estado de nutrición de yodo se utilizó la mediana de las concentraciones urinarias de yodo (mCUY). Para estimar la prevalencia de concentraciones anormales de TSH se utilizó el intervalo de referencia derivado de la población estudiada. Resultados: La mCUY (P25-P75) fue de 140 μg/L (82-217). Fue mayor en los que utilizaban sal yodada en sus domicilios que en los que no lo hacían (146 [85-222] frente a 126 μg/L [73-198]; p < 0,05). También fue mayor en los que consumían 2 o más raciones diarias de leche y yogur que en los que consumían menos de 2 raciones (146 [87-225] vs. 110 μg/L [66-160]; p < 0,0001). La prevalencia de concentraciones anormales de TSH fue del 2%. No hubo correlación entre las concentraciones de TSH en sangre capilar y las CUY (R = 0,082; p = 0,076). Discusión y conclusiones: Los escolares de 6-7 años de la comunidad autónoma del País Vasco tienen un estado de nutrición de yodo adecuado. La utilización de sal yodada en el domicilio y el consumo diario de leche y yogur se asociaron con las mayores CUY

Introduction: An epidemiological study conducted between 1988 and 1992 showed iodine deficiency and endemic goiter in the schoolchildren of the autonomous community of the Basque Country. Objectives: 1) To ascertain the iodine nutrition status of schoolchildren aged 6-7 years, and 2) to estimate the prevalence of abnormal TSH levels in capillary blood. Population and methods: The study was conducted on 497 schoolchildren selected by random sampling. Median urinary iodine concentration (mUIC) was used to assess iodine nutritional status, and the reference interval derived from the study population was used to estimate the prevalence of abnormal TSH levels. Results: The mUIC (P25-P75) was 140 (82-217) μg/L. A higher value was found in those who used iodized salt at home than in those who did not (146 [85-222] versus 126 μg/L [73-198], P<0.05). It was also higher in those who consumed 2 or more daily servings of milk and yogurt than in those taking less than 2 servings (146 [87-225] versus 110 μg/L [66-160], P<0.0001). Abnormal TSH levels were found in 2% of children. There was no correlation between TSH levels in capillary blood and urinary iodine concentrations (R=0.082; P=0.076). Discussion and conclusions: Schoolchildren aged 6-7 years of the autonomous community of the Basque Country have an adequate iodine nutrition status. Use of iodized salt at home and daily consumption of milk and yogurt were associated to the highest UICs

Is eosinophilic esophagitis an equivalent of pollen allergic asthma? Analysis of biopsies and therapy guided by component resolved diagnosis

Background: Eosinophilic esophagitis (EoE) is characterized by esophageal dysfunction and, histologically, by eosinophilic inflammation. There is not a clear etiologic treatment. Biopsies analysis using plant histology methods may show callose and pollen tubes in the esophageal mucosa. Component-resolved diagnosis (CRD) with microarrays could detect possible allergens involved and indicate an elimination diet and allergen immunotherapy (AIT). Methods: One hundred and twenty-nine patients with EoE were tested for environmental and food allergens. CRD, histological and botanical analysis were performed. Clinical scores and endoscopic biopsy were performed every six months for three years. Fifty healthy patients, 50 asthmatics due to pollen, and 53 celiac disease patients were included as comparison groups. CRD-directed AIT was administered in 91 EoE patients and elimination diet in 140 patients (87 EoE and all 53 CD patients). Results: CRD detected allergen hypersensitivity in 87.6% of patients with EoE. The predominant allergens were grass group 1 (55%), lipid transfer proteins (LTP) of peach and mugwort, hazelnuts and walnuts. Callose from pollen tubes was found in 65.6% of biopsies. After CRD-guided elimination diet and/or AIT, 101 (78.3%) EoE patients showed significant clinical improvement (p < 0.017) and 97 (75.2%) were discharged (negative biopsy, no symptoms, no medication) without relapse (AU)

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Evaluation of a new rapid diagnostic test for the detection of influenza and RSV / Evaluación de un nuevo test de diagnóstico rápido para la detección de influenza y VRS

INTRODUCTION: Influenza viruses and respiratory syncytial virus (RSV) can cause an acute respiratory disease that occurs seasonally in epidemic waves. This retrospective study was conducted to evaluate the Sofia®Influenza A + B and the Sofia® RSV fluorescence immunoassays (FIAs), two novel rapid detection tests (RDTs) for influenza A and B and RSV. METHODS: Two hundred and nine breath samples were selected from patients with respiratory symptoms determined to be positive/negative for influenza A, influenza B or RSV using one of the reference diagnostic techniques, cell culture and/or RT-PCR (Simplexa™Flu A/B & RSV). The Sofia Influenza A + B FIA was tested on 123 samples (63 from children and 60 from adults) and the Sofia RSV FIA was tested on 86 pediatric samples. Sensitivity and specificity values of both assays were calculated assuming the reference techniques as the gold standard. RESULTS: Sensitivity and specificity values for the Sofia Influenza A + B FIA were 73.1% and 97.8%, respectively. Sensitivity and specificity values for the Sofia RSV FIA were 87.5% and 86.7%, respectively. CONCLUSION: The sensitivity results obtained for the two assays were considerably higher than those reported for other RDTs. In conclusion, the Sofia Influenza A + B and the Sofia RSV FIAs are appropriate tools for the rapid diagnosis of these viruses

INTRODUCCIÓN: Los virus influenza A y B y el virus respiratorio sincitial (VRS) causan infecciones respiratorias agudas de forma estacional en olas epidémicas. Este estudio restrospectivo se llevó a cabo para evaluar dos nuevos tests de diagnóstico rápido para detectar los virus influenza A y B y VRS: Sofia® Influenza A + B y Sofia® RSV Fluorescence Immunoassays (FIAs). MÉTODOS: Se seleccionaron 209 muestras respiratorias procedentes de pacientes con síntomas respiratorios en las que se había establecido el diagnóstico de presencia o ausencia de influenza A, influenza B o VRS mediante las técnicas de referencia: cultivo celular o RT-PCR PCR (Simplexa™Flu A/B & RSV). Sofia Influenza A + B se realizó en 123 muestras (63 de niños y 60 de adultos) y Sofia RSV en 86 muestras pediátricas. Se calcularon los valores de sensibilidad y especificidad de ambos test tomando las técnicas de referencia como gold standard. RESULTADOS: Los valores de sensibilidad y especificidad de Sofia Influenza A + B fueron 73,1 y 97,8%. Los valores de sensibilidad y especificidad de Sofia RSV fueron 87,5 y 86,7%. CONCLUSIONES: Los valores de sensibilidad obtenidos para ambos tests son mayores que los descritos para otras técnicas de diagnóstico rápido. Por lo tanto, Sofia Influenza A + B FIA y Sofia RSV FIA son test adecuados para el diagnóstico rápido de influenza y VRS

Cord IgE and ECP levels of Malay neonates

Background: Cord IgE and ECP levels are major atopic markers implicated in early childhood allergy development. Most epidemiological studies to date have not utilised current technology to establish baseline cord IgE levels, further aggravated by lack of data in this region. This study also attempts to identify a relationship between cord IgE and ECP levels as a mean to improve sensitivity for early prediction of atopy. Methods: A total of 3183 cord blood IgE including 44 cord ECP samples of term neonates from Malay parentage were recruited. Total IgE and ECP levels were determined by ImmunoCAP and fluoroimmunoenzymatic, respectively. Results: Cord IgE geometric mean was 0.15 kU/L. Males had higher IgE geometric mean than females (0.17 vs. 0.13). IgE values between 17 pair of twins was not significant (p=0.169). Frequency of males (29.9%) in >0.9 kU/L IgE category was higher than females (26.1%). In the <0.35 kU/L category, females had a higher frequency (44.8%) than males (39.1%). Males had significantly (p=0.023) higher IgE level than females. November and February had the highest mean and median cord IgE level whereas October and December were the lowest, respectively. IgE level across months was not significant (p=0.234). Cord ECP mean was 5.21 g/L and median was 3.75 μg/L. There was no significant correlation (p=0.513; r=-0.101) between cord blood ECP and IgE levels. Conclusion: Cord blood IgE level of Malay male neonates was significantly higher than females. These results do not support cord ECP as plausible adjunct parameter to IgE for early atopic detection (AU)

Expresión de nefrina, podocina y alfa-actinina-4 en tejido renal de pacientes con proteinuria / No disponible

Introducción: Las alteraciones en el diafragma de filtración y/o citoesqueleto del podocito están relacionadas con proteinuria y síndrome nefrótico. En nuestra población, la glomerulopatía más frecuente, demostrada por biopsia, es la glomerulosclerosis focal y segmentaria. Nuestro objetivo fue buscar alteraciones en la expresión de algunas de las proteínas asociadas con el diafragma de filtración en pacientes con proteinuria en rango nefrótico. Métodos: Tejido renal de 40 pacientes con proteinuria en rango nefrótico, de 10 pacientes con proteinuria leve, de tres con hematuria aislada y 10 muestras de tejido renal normal (donantes cadáveres) se estudiaron, por inmuno fluorescencia indirecta, para expresión de nefrina, podocina y alfa-actinina4. Resultados: La expresión de estas proteínas fue lineal, homogénea, en las paredes capilares glomerulares del tejido renal normal y de pacientes con hematuria aislada. En proteinuria nefrótica y en algunos casos de proteinuria leve este aspecto normal estaba alterado y su expresión cambió de lineal a granular fina. En 22 casos (45%) de pacientes con proteinuria nefrótica y en 3 casos (30%) de pacientes con proteinuria subnefrótica hubo pérdida en la expresión de al menos una de estas proteínas (p = 0,49). Estas alteraciones se encontraron en las diferentes glomerulopatías que de forma más habitual causan síndrome nefrótico, aunque ninguna en particular fue significativamente más frecuente. Conclusiones: En la proteinuria nefrótica es muy frecuente la redistribución o la pérdida de proteínas asociadas al diafragma de filtración, lo que en muchos casos podría ser una consecuencia más que una causa de la proteinuria. Estas alteraciones pueden evidenciarse también en pacientes con proteinuria leve (AU)

Introduction: Slit diaphragm and/or podocyte¿s cytoskeleton alterations are related to proteinuria and nephrotic syndrome. In our population, focal and segmental glomerulosclerosis causing nephrotic syndrome is the more frequent biopsy demonstrated glomerulopathy. Our aim was search for alterations in some slit diaphragm-associated proteins in patients with nephrotic range proteinuria. Methods: Renal tissue from 40 patients with nephrotic range proteinuria, 10 patients with non-nephrotic proteinuria, 3 with isolated hematuria, and 10 samples of normal renal tissue (deceased donors) were studied, by indirect immunofluorescence, for expression of nephrin, podocin, and a-actinin-4. Results: Expression of these proteins was lineal, homogeneous, in the glomerular capillary walls in normal renal tissue and in patients with isolated hematuria. In nephrotic proteinuria this normal appearance was altered and immunostaining showed a fine granular appearance. In 18 cases (45%) of patients with nephrotic proteinuria and 3 cases (30%) of patients with non-nephrotic proteinuria there was loss of at least one of these proteins (p = 0.49). These alterations were found in the diverse glomerulopathies more frequently causing nephrotic syndrome. Conclusions: In nephrotic range proteinuria redistribution or loss of expression of slit diaphragm-associated proteins is very frequent. In many of our cases this fact could be more a consequence than a cause of proteinuria. These alterations can be also evidenced in patients with non-nephrotic proteinuria (AU)