Recaídas del trastorno de espectro de la neuromielitis óptica e influencia estacional en una cohorte de un país ecuatorial / Neuromyelitis optica spectrum disorders relapses and seasonal influence in an equatorial country cohort

Introducción La evidencia sobre la distribución estacional de las recaídas del trastorno del espectro de la neuromielitis óptica (NMOSD), especialmente en países tropicales, es limitada y diversa. Objetivo Evaluar la influencia de las variaciones estacionales en las recaídas del NMOSD en un país localizado sobre la línea ecuatorial. Pacientes y métodos Se llevó a cabo un estudio ecológico, con información retrospectiva de una cohorte de pacientes con NMOSD atendida entre enero de 2003 y diciembre de 2020 en Medellín, Colombia. Se recolectaron datos demográficos y clínicos de los pacientes, así como información sobre variables estacionales y climáticas. Se calculó la frecuencia de recaídas por estación, mes y año, y se realizó una regresión binomial negativa para evaluar la asociación entre el número de recaídas, y las variables estacionales y climáticas. Resultados Se incluyó a 113 pacientes, de los cuales el 89,38% eran mujeres, con una edad media en el momento del diagnóstico de NMOSD de 44,97 (±13,98) años y una mediana de tres recaídas (rango intercuartílico: 1-2). Se registraron 237 recaídas, la mayoría en pacientes seropositivos para anticuerpos antiacuaporina 4 (87,76%) y con mielitis longitudinal extensa como la presentación clínica más común (53,59%). Las recaídas se presentaron con mayor frecuencia durante la segunda temporada lluviosa (28,69%; n = 68), y en los meses de noviembre y diciembre. Sin embargo, en la regresión binomial negativa no se observó una asociación significativa entre el número de recaídas y las variables climáticas y estacionales, los meses y los años. Conclusión Las variables climáticas y los patrones estacionales no muestran una asociación significativa con cambios en el número de recaídas del NMOSD en pacientes residentes en un país localizado sobre la línea ecuatorial. (AU)

INTRODUCTION Information about seasonal distribution of Neuromyelitis optica spectrum disorders (NMOSD) attacks, particularly in tropical countries, has rarely been described and the reported data are diverse. OBJECTIVE. To evaluate influence of seasonal variation in NMOSD relapses in an equatorial country. PATIENTS AND METHODS Exploratory observational, retrospective ecological study in a cohort of patients with NMOSD followed from January 2008 to December 2019. Data of demographic, clinical information, characteristics of relapses and seasonal temporal variation were recorded. Also, the annual, monthly and intra-annual seasonal variation of relapses was quantified. A negative binomial regression was used to estimate the associations between the number of relapses and climatic and temporal variables. RESULTS One hundred thirteen patients were included, most of them were female (89.38%), with a mean age at NMOSD diagnosis was 44.97 (±13.98) and the median of relapses per patient were 2 relapses (IQR 1-3). The patients presented 237 relapses, most of these in AQP4 seropositive patients (87.76%) and longitudinal extensive myelitis was the most frequent type of relapse (53.59%). According to the temporal variation, relapses were more common in the second rainy season (28.69%) during November and December. However, there weren’t significant differences in the number of relapses between seasons and climatic variables in the multivariable model. CONCLUSION. The number of NMOSD relapses in this equatorial country cohort did not exhibit any significant associations with climatic variations, including changes in rainy or dry seasons. (AU)

Revisión sistemática sobre la influencia de la edad, el género y las variaciones estacionales en el absceso periamigdalino / Systematic review on the influence of age, gender and seasonal variations on peritonsillar abscess

Introducción y objetivo: El absceso periamigdalino (AP) es la complicación más frecuente de la amigdalitis aguda. Dadas las discrepancias observadas en la literatura, presentamos una revisión sistemática de la bibliografía, para analizar la prevalencia del AP en nuestro ámbito, en relación con tres factores epidemiológicos: la edad, el sexo y la climatología. Método: Se realizó una búsqueda bibliográfica sobre la influencia de la edad, el género y la estacionalidad en el AP. Las bases utilizadas fueron PubMed, Cochrane y Medline, sin restricción de tiempo, siguiendo la metodología PRISMA. El registro se llevó a cabo por tres revisores independientes, durante el mes de octubre de 2022. Resultados: Se obtuvieron, tras excluir duplicados, 289 artículos, de los que tras el cribado que se detalla en la metodología, seleccionamos 23, como parte de la revisión sistemática. Discusión: En la mayoría de los trabajos incluidos, se objetiva un predominio del AP en los hombres, con una ratio hombres/mujeres, variable de 1,16 a 3. Se desconocen las causas de esta diferencia de género. La edad media de aparición del AP varía, según el estudio, de los 22 a los 39 años. Aunque con resultados dispares, el AP no parece tener un predominio estacional, sin que podamos descartar una cierta influencia climática. Conclusiones: El AP es la complicación más frecuente de la amigdalitis aguda. En el adulto, predomina en hombres. La media de edad oscila entre los 22 y 39 años. No parece mostrar preferencia climática. (AU)

Introduction and objective: Peritonsillar abscess (PA) is the most frequent complication of acute tonsillitis. Given the discrepancies observed in the literature, we present a systematic review to analyse the prevalence of PA in our setting in relation to three epidemiological factors: age, gender, and climatology. Methods: A literature search was carried out on the influence of age, gender, and seasonality on PA. The databases used were PubMed, Cochrane, and Medline, without time restriction, following the PRISMA methodology. The registry was carried out by three independent reviewers during the month of October 2022. Results: After excluding duplicates, 289 articles were obtained, of which, after the screening detailed in the methodology, we selected 23 as part of the systematic review. Discussion: In most of the included papers, a predominance of PA in men is observed, with a male/female ratio varying from 1.16 to 3. The mean age of onset of PA varies, depending on the study, from 22 to 39 years. Although with disparate results, AP does not seem to have a seasonal predominance, without being able to rule out a certain climatic influence. Conclusions: AP is the most frequent complication of acute tonsillitis. In adults, it predominates in men. The mean age ranges between 22 and 39 years. It does not seem to show climatic preference. (AU)

Estudio retrospectivo de la incidencia de los abscesos periamigdalinos y parafaríngeos en el periodo 2000-2021 / Retrospective study of the incidence of peritonsillar and parapharyngeal abscesses in the period 2000-2021

Introducción y objetivo: Las infecciones faringo-amigdalares y sus complicaciones son muy frecuentes y con características epidemiológicas variables, de unos países a otros. El objetivo de este trabajo ha consistido en determinar la incidencia, edad, género y estacionalidad, de los pacientes ingresados con amigdalitis (A), absceso periamigdalino (AP) y parafaríngeo (APF), en un hospital de tercer nivel, en Valladolid (España). Método: Estudio retrospectivo de 1339 pacientes ingresados en HCUV entre los años 2000 y 2021 por infecciones faringocervicales (A, AP y APF). Resultados: La media de edad de los pacientes ingresados con A es de 27,8 años, con AP de 35,5 y con APF de 47 años, siendo esta diferencia estadísticamente significativa (p<0,001). La amigdalitis predomina en mujeres (ratio: 1,26), y en hombres el AP (ratio: 1,44) y el APF (ratio: 2,4). No hemos encontrado relación significativa de estos procesos ni con los meses del año ni con las estaciones climáticas. Discusión: Las diferencias de género, edad media y estacionalidad entre la A y el AP generan controversia para poder entender el origen del AP y la posible influencia de los factores de riesgo. Hay pocos estudios epidemiológicos publicados sobre el APF, cuya incidencia parece que está aumentando, por causas desconocidas. Conclusiones: La A destaca en la infancia, el AP en adultos jóvenes y el APF en más mayores. Salvo la A y el AP en adolescentes, que predominan en mujeres, el resto de los abscesos faringocervicales son más frecuentes en hombres. En la población estudiada el clima no parece un factor etiopatogénico importante. (AU)

Introduction and objective: Pharyngotonsillar infections and their complications are very frequent, and their epidemiological characteristics vary from one country to another. The aim of this study was to determine the incidence, age, gender and seasonality of patients admitted with tonsillitis (T), peritonsillar abscess (PT) and parapharyngeal abscess (PPA) in a tertiary hospital in Valladolid (Spain). Method: Retrospective study of 1339 patients admitted to HCUV between 2000 and 2021 for pharyngo-cervical infections (A, PA and PPA). Results: The mean age of patients admitted with A was 27.8 years, 35.5 years with PA and 47 years with PPA, this difference being statistically significant (p<0.001). Tonsillitis predominates in women (ratio: 1.26), and in men PA (ratio: 1.44) and PPA (ratio: 2.4). We found no significant relationship between the frecuency of these processes and the months of the year or climatic seasons. Discussion: The differences in gender, mean age and seasonality between A and PA generate controversy in order to understand the origin of PA and the possible influence of risk factors. There are few epidemiological studies published on PPA, whose incidence seems to be increasing, for unknown causes. Conclusions: A tends out in childhood, PA in young adults and PPA in older patients. Except for A and PPA in adolescents, which predominate in women, the rest of the pharyngo-cervical abscesses are more frequent in men. In the population studied, climate does not seem to be an important etiopathogenic factor. (AU)

Testicular Torsion in Jiaodong Peninsula: A 14-Year Multicenter Retrospective Study

Background: To investigate the correlation between temperature and testicular torsion in Jiaodong Peninsula which has temperate continental monsoon climate and is represented by Yantai and its surrounding areas. Methods: A retrospective analysis was conducted by reviewing clinical data of 292 patients who were admitted and surgically confirmed to have testicular torsion in the Yantai Yuhuangding hospital medical complex between January 1, 2009, and August 31, 2022. Male patients who underwent circumcision (foreskin) were allocated to the control group. Temperature data were obtained from the China Meteorological Data Service Center. Chi-squared test or Fisher’s exact test and one-way analysis of variance were employed to compare patient characteristics and climatic variables among the different groups. Pearson’s correlation analysis was used to analyze the association between monthly average ambient temperature and monthly cumulative number of cases. Moreover, a logistic regression model was utilized to identify the independent factors of testicular torsion. Results: The mean age of patients with testicular torsion was 16.8 years. The number of cases was the highest in autumn. The temperature was the highest in summer and the lowest in winter (p < 0.01). Furthermore, the temperature difference (TD) in autumn was the highest in the four seasons groups (p < 0.01). The patients were divided into the high TD and low TD groups according to the mean TD (7.62 ◦C) on the admission day. The high TD group had a higher number of patients than the low TD group, and the temperature was lower in the former group than in the latter group (p < 0.01). A roughly negative correlation was observed between ambient temperature and the number of cases (Pearson’s r = −0.228, 95% confidence interval (CI): −0.366 to −0.079, p = 0.003) (AU)

Time trends and endoscopic management of foreign body ingestion in the upper GI tract: a retrospective analysis of 1152 cases in China

Objectives: foreign body ingestions are encountered in the clinical practice and sometimes require endoscopic management. However, time trends and epidemiology of these cases have not been fully clarified. Whether seasons and festivals have an effect on the occurrence has been poorly described. Method: from 2009 to 2020, 1,152 consecutive foreign body ingestion cases were enrolled in our endoscopic center. Case records were reviewed for demographic data, foreign body type and location, outpatient or hospitalization, adverse events and dates. Annual time trends and seasonal variation were analyzed as well as the influence of Chinese legal festivals on the incidence. The impact of SARS-CoV-2 pandemic on the potential delay for clinical consultation of these cases was preliminarily explored. Clinical features of these cases were demonstrated. Results: the overall success rate was 99.7 % and the adverse events rate was 2.4 %. There was an uptrend in the annual frequency of food foreign body ingestion endoscopic extraction from 0.65 in 2009 to 8.86 in 2020 per 1,000 esophagogastroduodenoscopy patients (r = 0.902, p < 0.001). Furthermore, the frequency of endoscopic extraction significantly increased in winter (p < 0.001) and during Chinese New Year celebratory season (p = 0.003). The duration of hospitalization may be longer in the pandemic period (p = 0.0049). Conclusion: considering the uptrend of the annual frequency of food related foreign body endoscopic extraction, the publicity about the danger of foreign body ingestion should be enhanced. Arrangement of endoscopic physicians and assistants during the high-incidence season should be emphasized. (AU)

Relación entre factores meteorológicos y número y gravedad de crisis asmáticas atendidas en urgencias / Association between meteorological factors and frequency and severity of asthma exacerbations attended in the pediatric emergency room

Introducción: la influencia del clima en las exacerbaciones asmáticas ha sido demostrada, pero los estudios que analizan la relación de los diferentes factores meteorológicos con la crisis asmática en Pediatría son limitados. El objetivo de este estudio es analizar la relación entre varios factores meteorológicos y las crisis asmáticas en una población pediátrica de un hospital de tercer nivel situado en una región con clima oceánico. Material y métodos: estudio descriptivo retrospectivo de los pacientes de 1 a 16 años atendidos en urgencias por crisis asmática, durante un periodo de cinco años. Se recogió la edad, el sexo y la necesidad de ingreso hospitalario. Las variables meteorológicas (velocidad del viento, precipitaciones, radiación solar, temperatura, humedad relativa y presión barométrica) se obtuvieron del Centro de Investigación del Medio Ambiente (CIMA). Se analizó mediante regresión logística la relación de las variables meteorológicas con el número de visitas a urgencias y el porcentaje de ingresos por crisis asmática. Resultados: se identificaron 8534 visitas a urgencias por crisis asmática, con un pico de incidencia en septiembre. Se obtuvo una relación inversa estadísticamente significativa de la radiación solar y las precipitaciones con el número de visitas a urgencias y el porcentaje de ingresos. Conclusiones: este estudio, realizado en una región de clima oceánico, confirma el patrón estacional ya descrito previamente para las exacerbaciones asmáticas. Se evidencia asociación inversa estadísticamente significativa entre las precipitaciones y la radiación solar con el número de visitas a urgencias y el porcentaje de ingresos por crisis asmáticas (AU)

Object: the influence of climate on asthma exacerbations has already been demonstrated but the studies that analyze the association between different meteorological factors and acute asthma exacerbation in pediatric patients are limited. The aim of the present study is determining association between some meteorological conditions and asthma exacerbations in children in a third level referral Academic Hospital located in an oceanic-climate area.Methods: we conducted a descriptive and retrospective study in 1 to 16 years old patients presenting with an asthma attack in the emergency department, during a 5-year period. Data about age, sex and the need for hospital admission were collected. Meteorological data (wind speed, rain, sunlight, temperature, humidity and barometric pressure) were obtained from the Environmental Research Center. The number of emergency department visits and percentage of hospital admissions were correlated to meteorological factors using logistic regression analysis.Results: a total of 8534 asthma exacerbations were attended in the emergency department with a peak incidence in September. It was found that sunlight and rain were significantly and inversely correlated with emergency department visits and percentage of hospital admissions.Conclusions: this study, conducted in an oceanic-climate area, confirms the previously described seasonal pattern for asthma exacerbations. We probe a statistically significant and inverse correlation between rain and sunlight and the number of emergency department visits for asthma and percentage of hospital admissions due to asthma attack. (AU)

COVID-19 en Pediatría: descripción clínica y microbiológica de los pacientes ingresados en un hospital terciario / COVID-19 in pediatrics: clinical and microbiological description of patients admitted to a tertiary hospital

Introducción: desde el inicio de la pandemia por el virus SARS-CoV-2 una de las grandes cuestiones que se ha formulado es qué papel desempeñan los niños en el control y manejo de la pandemia y cómo esta les ha afectado. Hay mucha bibliografía acerca de los síntomas y complicaciones que puede presentar esta población, pero poca de cómo ha sido el curso clínico de la infección en los niños ingresados en hospitales de tercer nivel y su impacto asistencial. Material y métodos: se han analizado descriptivamente las historias clínicas de los niños ingresados en el Hospital General Doctor Balmis de Alicante (España) desde enero de 2020 hasta julio de 2022. Se han analizado paralelamente los datos microbiológicos del SARS-CoV-2, variantes y linajes, desde agosto de 2021 hasta agosto de 2022. Resultados: se analizaron un total de 114 niños ingresados con diagnóstico de infección por SARS-CoV-2, de los cuales la mayoría tenían menos de 12 meses y eran de procedencia española. Los ingresos se distribuyeron de forma cronológica siguiendo un modelo de “olas”, siendo el motivo más frecuente la constatación del virus SARS-CoV-2 en las pruebas realizadas. El tratamiento que más frecuentemente recibieron durante el ingreso fueron los antibióticos orales. La mayor parte de los niños no tenían comorbilidades y no desarrollaron complicaciones. La variante mayoritaria fue ómicron y el linaje el BA.1. Discusión: los lactantes parecen ser más vulnerables a la infección por SARS-CoV-2 y las manifestaciones clínicas en este grupo de edad conllevan mayor probabilidad de ingreso. El desarrollo de complicaciones, necesidad de oxigenoterapia, ventilación mecánica e ingreso en UCI es mínimo en población pediátrica. El manejo de la infección difiere sustancialmente con el de los adultos, lo que se corresponde con tratamientos menos agresivos (AU)

Introduction: since the beginning of the SARS-CoV-2 pandemic, one of the main questions that has been asked is what role children play in the control and management of the pandemic and how it has affected them. There is much literature on the symptoms and complications that this population may have, but little on the clinical course of the infection in children admitted to tertiary hospitals and its impact on health care.Material and methods: the clinical histories of children admitted to the Hospital General Doctor Balmis (Alicante, Spain) from January 2020 to July 2022 were analyzed descriptively. At the same time, microbiological data on SARS-CoV-2, variants and lineages were analyzed from August 2021 to August 2022.Results: a total of 114 children admitted were analyzed, most of whom were younger than 12 months and from Spain. Admissions were distributed chronologically following a 'wave' pattern, the most frequent reason being the finding of SARS-CoV-2 virus in the tests performed. The most common treatment received during admission was oral antibiotics. Most of the children had no comorbidities and did not develop complications.Discussion: infants seem to be more vulnerable to SARS-CoV-2 infection, and clinical manifestations in this age group are more likely to lead to admission. The development of complications, need for oxygen therapy, mechanical ventilation and admission to the ICU is minimal in the pediatric population. The management of infection differs substantially from that of adults, which corresponds to less aggressive treatment. (AU)

Relación entre la estación del año y la gravedad de los síntomas en pacientes con fibromialgia / Relationship between season of the year and severity of symptoms in patients with fibromyalgia

Antecedentes y objetivo: Es frecuente que los pacientes con fibromialgia refieran que ciertas estaciones del año agravan sus síntomas. Como objetivo primario se determinó la asociación entre síntomas claves de la fibromialgia y estación del año. Como objetivo secundario se determinó la existencia de diferencias en función de los niveles de ansiedad o depresión.Material y métodoMuestra de conveniencia formada por 471 participantes con fibromialgia evaluados antes de iniciar un tratamiento multidisciplinar. Se recogieron datos demográficos y meteorológicos y se evaluaron, mediante instrumentos estandarizados, la intensidad del dolor, la funcionalidad, la fatiga, la rigidez, la calidad del sueño, así como la ansiedad y la depresión.ResultadosLos diferentes grupos estacionales fueron homogéneos en edad, género, nivel educativo, estado marital y situación laboral. No se encontraron diferencias significativas en intensidad del dolor (F=1,334; p=0,265), funcionalidad (F=0,402; p=0,669), fatiga (F=0,714; p=0,490), rigidez (F=0,299; p=0,741), ansiedad (F=0,376; p=0,687), depresión (F=0,608; p=0,545), distrés psicológico (F=0,261; p=0,770), duración del sueño (F=1,507; p=0,223) o el índice de problemas de sueño (F=0,343; p=0,710).ConclusionesNo se han encontrado diferencias en la intensidad de los síntomas de la fibromialgia ni en los porcentajes de gravedad entre las distintas estaciones del año. La ansiedad ha sido más prevalente que la depresión, posiblemente debido a las propias características de la muestra, con mayoría de pacientes con perfil disfuncional. (AU)

Background and objective: Fibromyalgia patients often report that certain seasons aggravate their symptoms. The main objective was to determinate the association between key symptoms of fibromyalgia and the season of the year. A secondary objective was to determinate the existence of differences based on levels of anxiety or depression.Material and methodConvenience sample made up of 471 participants with fibromyalgia evaluated before starting multidisciplinary treatment. Demographic and meteorological data were collected. Clinical data were assessed with standardized instruments of pain intensity, functionality, fatigue, stiffness, sleep quality, anxiety and depression.ResultsThe different groups of participants were homogeneous for age, gender, educational level, marital status and employment situation. No significant differences were found in pain intensity (F=1.334; P=.265), functionality (F=.402; P=.669), fatigue (F=.714; P=.490), stiffness (F=.299; P=.741), anxiety (F=.376; P=.687), depression (F=.608; P=.545), psychological distress (F=.261; P=.770), sleep quantity (F=1.507; P=.223) or sleep disturbances (F=.343; P=.710).ConclusionsNo differences were found in the intensity of fibromyalgia symptoms, nor in the percentages of severity among the different seasons of the year. Anxiety was more prevalent than depression, possibly due to the characteristics of the sample itself, with the majority of patients with a dysfunctional profile. (AU)

Hospitalizaciones por y con enfermedad pulmonar obstructiva crónica en Galicia: 20 años de evolución / Hospitalizations due to and with chronic obstructive pulmonary disease in Galicia: 20 years of evolution

Objetivo Analizar la evolución de las hospitalizaciones relacionadas con enfermedad pulmonar obstructiva crónica (EPOC) en Galicia en el período 1996-2018, tanto como causa principal del ingreso (POR EPOC) como si se codificaba en cualquier posición diagnóstica (CON EPOC), estudiando la influencia de la edad, el sexo, la estacionalidad u otras causas principales del ingreso. Metodología Se realizó un análisis del conjunto mínimo básico de datos (CMBD) de Galicia sobre el primer ingreso por EPOC entre 1996 y 2018. Se calcularon tasas brutas, específicas y estandarizadas tanto globales como por sexo y por grupos de edad. Resultados En el período 1996-2018 se produjeron en Galicia 310.883 primeros ingresos CON EPOC, de los que el 29,6% fueron POR EPOC. Las tasas de ingresos tanto CON EPOC como POR EPOC aumentaron, fundamentalmente en varones. Existe una clara estacionalidad de los ingresos, especialmente relevante POR EPOC. La razón de masculinidad media es aproximadamente 4 en ambos escenarios, si bien es inferior en los grupos etarios extremos, sin cambios a lo largo del tiempo. La edad media al ingreso ha aumentado tres años en este período en los varones; en las mujeres no hubo variaciones. Las causas principales del ingreso cuando no es POR EPOC son insuficiencia cardíaca y neumonía. Conclusión La evaluación combinada de los registros de ingresos hospitalarios CON y POR EPOC aporta información complementaria para un mejor conocimiento de las tendencias de esta enfermedad y establecer hipótesis que expliquen los resultados descritos, aportando información para una mejor planificación sanitaria (AU)

Objective This work aims to analyze the evolution of COPD-related hospitalizations in Galicia from 1996 to 2018 both as main cause of admission (DUE TO COPD) or when coded in any diagnostic order (WITH COPD), assessing the influence of age, sex, seasonality, and other main causes of the hospitalization. Methods An analysis was conducted of administrative healthcare database (CMBD) data on index COPD-related hospitalizations in Galicia from 1996 to 2018. Crude, specific, and standardized rates were calculated for the entire sample and according to age and sex groups. Results In the period from 1996 to 2018, there were 310,883 index admissions WITH COPD in Galicia, of which 29.6% were DUE TO COPD. Both WITH COPD and DUE TO COPD admission rates increased, mainly in men. There was a clear seasonality that was especially relevant in the DUE TO COPD group. The mean male-to-female ratio was approximately 4:1 in both groups, although it was lower in the extreme age groups, with no change over time. The mean age at admission increased three years in men during this period; there were no changes among women. The main causes of admission in those not hospitalized DUE TO COPD were heart failure and pneumonia. Conclusion The combined evaluation of records of hospital admissions WITH COPD and DUE TO COPD offers additional information for a better understanding of the trends of this disease and allows for establishing hypotheses that explain the results described, providing information for better healthcare planning (AU)

Variables influyentes en los niveles de 25(OH)D total y libre en población sana / Influencing variables on total and free 25(OH)D levels in healthy population

Introducción La vitamina D ejerce un papel fundamental en la homeostasis del calcio y el metabolismo óseo. Procede, mayoritariamente, de la síntesis cutánea, por acción de la luz solar. Así, variaciones en la exposición a esta radiación modifican sus niveles séricos. Estudiamos dos analitos diferentes de vitamina D en población sana española, y la influencia de la estacionalidad, el clima y la latitud en sus estatus. Métodos Estudio descriptivo, transversal. Se incluyeron 206 donantes de sangre de Burgos y Valencia de 18-60 años durante marzo-abril y octubre-noviembre de 2018. Se analizaron las concentraciones séricas de 25-hidroxicolecalciferol (25(OH)D) total y libre. Resultados Las concentraciones medias de 25(OH)D total y libre tras el verano en Burgos fueron: 24,31 ± 5,25 ng/mL y 5,01 ± 1,25 pg/mL; y en Valencia: 25,99 ± 6,87 ng/mL y 8,97 ± 2,82 pg/mL. Tras el invierno, los resultados en Burgos fueron: 17,66 ± 5,04 ng/mL y 4,08 ± 0,66 pg/mL, y en Valencia: 21,38 ± 3,77 ng/mL y 7,23 ± 2,44 pg/mL. Los cambios estacionales resultaron estadísticamente significativos para los dos componentes estudiados, tanto de manera global como en ambas poblaciones por separado. Las diferencias poblacionales en los niveles de 25(OH)D total y libre resultaron estadísticamente significativas, excepto en 25(OH)D total tras el verano (24,07 ng/mL vs. 26,03 ng/mL; p = 0,408). La latitud también demostró ser un factor influyente en las concentraciones de ambos analitos, en verano e invierno. Conclusiones Nuestro estudio refleja niveles de vitamina D más bajos de lo esperable tratándose de población sana española. Se demuestra la influencia de la estacionalidad, el clima y la latitud en los niveles de 25(OH)D total y 25(OH)D libre (AU)

Introduction Vitamin D plays a fundamental role in calcium homeostasis and bone metabolism. It mainly comes from cutaneous synthesis through the action of sunlight. Therefore, variations in exposure to this radiation modify serum levels. We studied two different analytes of vitamin D in the healthy Spanish population and the influence of seasonality, climate, and latitude on its levels. Methods This work is a cross-sectional, descriptive study. A total of 206 blood donors from Burgos and Valencia between 18-60 years of age were recruited during March-April and October-November 2018. Total and free serum 25-hydroxycholecalciferol (25(OH)D) were analyzed. Results After summer, total and free serum 25(OH)D medium levels were 24.31 ± 5.25 ng/mL and 5.01 ± 1.25 pg/mL in Burgos and 25.99 ± 6.87 ng/mL and 8.97 ± 2.82 pg/mL in Valencia. After winter, they were 17.66 ± 5.04 ng/mL and 4.08 ± 0.66 ng/mL in Burgos and 21.38 ± 3.77 ng/mL and 7.23 ± 2.44 ng/mL in Valencia. The seasonal changes were statistically significant for both components studied both in the sample as a whole and in the separate populations. The differences found between the two populations in total and free 25(OH)D levels were statistically significant except for total 25(OH)D after summer (24.07 ng/mL vs. 26.03 ng/mL; p = 0.408). Latitude was also shown to be a factor that influences concentrations of both analytes in summer and winter. Conclusions Our study shows lower vitamin D levels than expected for a healthy Spanish population. Seasonality, climate, and latitude were demonstrated to influence total and free 25(OH)D levels (AU)

La importancia de la estimulación a través de los colores / The importance of stimulation through colors

Este documento pretende hacer reflexionar sobre la importancia de los colores, tanto en el ámbito laboral como en el personal. Trata de plantear la policromía como una herramienta de estimulación, un ejemplo de diversidad y un camino para alcanzar el bienestar. (AU)

This document pretends to reflect on the importance of colors, both in professional field and in the personal. It tries to pose polychromy like a stimulation tool, an example of diversity and a way to wellness. (AU)

¿Dónde se esconde el virus respiratorio sincitial? / Where does Respiratory Syncytial Virus Hide?

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[Translated article] Where does Respiratory Syncytial Virus Hide? / ¿Dónde se esconde el virus respiratorio sincitial?

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Three-year pollen and fungi calendar in a Mediterranean region of the Northeast Greece

Pollen calendars have been proved clinically important in allergic disease management, as differences in airborne allergens exist not only between different countries but also between regions of the same country as well. This study aims to provide new data regarding the atmospheric pollen and fungi content of a Mediterranean region (Western Thrace/North-East Greece) and discuss seasonal trends, differences in pollen grains and fungi spores’ circulation over the years, and correlations with climate parameters.A 7-day continuously running volumetric trap was used to collect circulating pollen grains and fungi spores. Pollen taxa and fungi were characterized by standard protocols and counted as grains /m3 and average total grains and spores. The primary allergenic pollen season was discovered, and their 10-day averages were measured over time. Correlations with temperature, rain, and humidity were assessed by single linear regression analysis.Results Pollen grains from nine pollen families were identified, including five arboreal, two nonarboreal taxa, and spores from two fungi species. The three most prevalent taxa were Oleaceae, Poaceae, Pinaceae, and Cladosporium in the fungi. Peak pollen concentrations were detected during April and May, with daily averages exceeding 170 grains/m3. Poaceae presented the longest pollen season of 342 days and Oleaceae the shortest, extending to only 110 days, during the 3years. Cladosporium was the fungus with the highest spore concentration (180,129.9 spores) compared with Alternaria (28,026.1 spores). Correlations with meteorological parameters showed variable associations among different taxa, with rainfall and relative humidity being the most significant determinants.Conclusion In this study, the pollenic and fungal spectrum of a Mediterranean region and information that can be proved clinically significant for the appropriate diagnostic and therapeutic approach of allergic patients was presented

Persistence of airborne tree pollen from the Cupressaceae family during the last decade in the city of Bahia Blanca

Airborne pollen is a major contributor to allergic respiratory diseases. However, the literature on patterns and seasonality of specific pollen types mainly comes from northern hemisphere and developed regions, limiting our ability to extrapolate these findings to other geographical locations. With this research letter, our aim is to contribute to the current knowledge of aerobiology by analyzing the decade-long patterns of airborne tree pollen in the city of Bahia Blanca, Argentina. In general, we found late winter to early spring as the period with the highest Cupressaceae pollen counts. In 2020, the average pollen count during July through September was 78.81 (SD 79.70), the highest recorded during the last 10 years. These months had varying pollen concentrations from moderate (15–89 grains/m3 of air) to high (90–1499 grains/m3 of air). Regardless of such variation, August had consistently been the month with the highest peak concentrations from 2010 to 2020 (61.2, SD 57.3), followed by September (27.1, SD 20.3). We did not find any month with very high (˃1500 grains/m3 of air) peak concentration. Further studies need to be done to expand our knowledge on aerobiology to characterize specific pollen sub-types and determine the exact allergenic potential of airborne pollen in different regions (AU)

Eosinophilic Esophagitis due to Aeroallergens: A Systematic Review and Update

Eosinophilic esophagitis is a chronic antigen-mediated esophageal disease characterized clinically by symptoms related to esophageal dysfunction and histologically by TH2 inflammation (at least 15 eosinophils/high power field) when other secondary systemic and local causes of esophageal eosinophilia are excluded. Although this disease was initially ascribed to a delayed reaction to food allergens, emerging evidence suggests that aeroallergens may also play a role in pathogenesis and disease course. Some studies support seasonal variations in the diagnosis of eosinophilic esophagitis and disease exacerbations owing to the increase in aeroallergens to which patients are sensitized. It is also known that this disease can be caused by extensive, identifiable exposure to aeroallergens and after treatment with specific immunotherapy based on food or aeroallergens. It was recently postulated that treatment of allergic rhinoconjunctivitis can improve the symptoms of eosinophilic esophagitis, although data are limited to case reports and small series. Currently, biomarkers and biologic therapies are not helpful for diagnosis or inducing clinical and histological remission of the disease. Nevertheless, there are high hopes for dupilumab. This review aims to give visibility to the involvement of aeroallergens in the triggering and exacerbation of eosinophilic esophagitis, since many of them, in addition to being airborne and inhalant, can also be ingested as food. Clearly, we must try to identify the cause of the disease to ensure remission. (AU)

Características de los debuts diabéticos en los niños ingresados en un hospital terciario durante diez años / Characteristics of diabetic debuts in children admitted to a tertiary hospital for ten years

Introducción. La diabetes mellitus tipo 1 constituye unade las patologías crónicas más frecuentes en la infancia. Suincidencia está sufriendo un incremento en los últimos años.Objetivo. Describir y analizar las características epidemiológicas, clínicas, analíticas y terapéuticas en el momentodel debut de la enfermedad, comparándolas entre gruposde edad de los pacientes que debutan con DM1 en nuestraprovincia.Pacientes y métodos. Estudio observacional retrospectivo mediante revisión de historias clínicas de pacientesmenores de 14 años con debut de diabetes tipo 1 entre 2007y 2017 en un hospital de tercer nivel. La muestra se dividiópor edades en tres grupos (0-4 años, 5-9 años,10-14 años).Resultados. Se recogieron 64 pacientes con edad mediade 8,15 años (DE 3,41), el 48,4% entre 5-9 años. No se hallarondiferencias de sexo ni patrón estacional, aunque los pacientesde menor edad debutaron más frecuentemente en invierno.No se observó aumento en la incidencia con el tiempo nidiferencias en los síntomas entre grupos. Debutaron concetoacidosis diabética el 36%, fundamentalmente leves.Encontramos un porcentaje menor de anticuerpos IAA yantiGAD de lo esperado y mayor frecuencia de antecedentesfamiliares positivos. Se observó correlación lineal positivaentre las cifras de bicarbonato y cuerpos cetónicos en sangrey las necesidades de insulina por kg de peso (p 0,025 y p0,05, respectivamente). Los niños de menor edad presentanniveles de HbA1c más bajos al inicio de la enfermedad.Conclusiones. En nuestro medio no se está produciendoun aumento en el número de casos de esta enfermedad, aunque los mismos se concentran a menor edad de la esperada (AU)

Introduction. Type 1 diabetes mellitus is one of the mostfrequent chronic pathologies in childhood. Its incidence hasincreased in the last years.Objective. To analyze the epidemiological, clinical,analytical and therapeutic characteristics at the time of thedisease’s onset, and to compare them between age groupsof those patients with Diabetes mellitus type 1 in our region.Patients and methods. Retrospective observational studyby reviewing the medical records of patients under 14 yearsof age with onset of type 1 diabetes between 2007 and 2017in a tertiary-level hospital. The sample was divided by ageinto three groups (0-4 years, 5-9 years,10-14 years).Results. 64 patients were studied, the mean age was8.15 years (SD 3.41), 48.4% of them between 5-9 years. Nodifferences in sex or seasonal pattern were found, althoughyounger children became ill more frequently in winter. There was no increase in incidence over time ordifferencesin symptoms between groups. 36% debuted with diabeticketoacidosis, mainly mild. We found a lower percentage ofIAA and antiGAD antibodies than expected and a higherfrequency of positive family history. A positive linear correlation was observed between the levels of bicarbonateand ketone bodies in blood and the insulin needs per kg ofweight (p 0.025 and p 0.05 respectively). Younger childrenhave lower HbA1c levels at the beginning of the disease.Conclusions. In our centre there is not an increase in thenumber of cases of this disease, although we found morecases at a younger age than expected. (AU)