Nonelective cesarean section is associated with the prevalence of asthma among Mexican children who attended childcare centers.

Background: The cesarean section (CS) mode of delivery can influence the prevalence of bronchial asthma (BA), allergic rhinitis (AR), or atopic dermatitis (AD) by promoting modifications in the infantile microbiome. Objective: To analyze the prevalence of asthma in children who were born through CS and attended childcare centers. Methods: The data were obtained through an online survey that was answered anonymously by one of the parents; the survey inquired about the route of delivery of the child and the prevalence of BA, AR, and AD. Results: A total of 525 children were included. The frequency of births by vaginal, elective CS, or nonelective CS was 34.1%, 37.9%, and 28.0%, respectively, and the prevalence of BA, AR, and AD was 4.8%, 19.8%, and 12.4%, respectively. Multivariate analyses identified nonelective CS as a factor associated with the prevalence of BA (odds ratio: 3.51, P = 0.026). Conclusion: Our study shows that being born through nonelective CS can increase the probability of BA in children who attended daycare centers.

[Geographical variation of asthma prevalence among Mexican children during the COVID-19 pandemic]. / Variación geográfica en la prevalencia de asma en niños mexicanos durante la pandemia de la COVID-19.

OBJECTIVE: The purpose of this study was to analyze the geographic variation in the prevalence of asthma in children, according to their place of residence in Mexico. METHODS: A cross-sectional analysis of the epidemiological surveillance system dataset for respiratory diseases in Mexico carried on. From 27 February to 5 November 2020, a total of 1,048,576 subjects were screened for SARS-CoV2 infection, of which 35,899 were children under 18 years of age. The strength of the association was estimated by odds ratio (OR). RESULTS: Of 1,048,576 patients who attended for SARS-CoV2 infection detection, 35,899 corresponded to pediatric patients who met the study criteria. The estimated national prevalence of asthma was 3.9% (95% CI: 3.7-4.1%). The nationwide prevalence of asthma was 3.9% (95% CI: 3.7% - 4.1%); the minimum was 2.8% (Southeast region) and the maximum 6.8% (Southeast region). Compared to the South-West Region that presented the minimum prevalence at the national level, the Northwest (OR = 2.41) and Southeast (OR = 1.33) regions showed the highest risk of asthma in pediatric population. CONCLUSIONS: The prevalence of asthma in children differed markedly among the different regions of Mexico; two regions, Northwest and Southeast, stood out. This study puts into context the role of the environment on the prevalence of asthma in children.

OBJECTIVO: Estimar la prevalencia de asma en pacientes pediátricos, según su lugar de residencia en la República Mexicana, durante la pandemia por SARS-CoV-2. MÉTODOS: Estudio transversal, llevado a cabo a partir de la revisión de datos del Sistema de Vigilancia Epidemiológica para Enfermedades Respiratorias en México, analizados del 27 febrero al 5 de noviembre de 2020. Criterios de inclusión: pacientes que acudieron a la detección de infección por SARS-CoV2, menores de 18 años. La fuerza de asociación se estimó con la razón de momios. RESULTADOS: De 1,048,576 pacientes que acudieron a la detección de infección de SARS-CoV2, 35,899 correspondieron a pacientes pediátricos que cumplieron con los criterios del estudio. La prevalencia nacional de asma estimada fue de 3.9% (IC95%: 3.7-4.1%); la prevalencia mínima se observó en la región Suroeste (2.8%) y la máxima en el Sureste (6.8%); comparada con la región Suroeste, que registró la prevalencia mínima a nivel nacional, y la Noroeste (RM = 2.41) y Sureste (RM = 1.33) mostraron el mayor riesgo de asma en la población pediátrica. CONCLUSIONES: La prevalencia de asma en niños mexicanos difirió notoriamente en los diferentes estados de la República Mexicana; sobresalieron las regiones Noroeste y Sureste. Este estudio pone de manifiesto el papel del medio ambiente en la prevalencia del asma en pacientes pediátricos mexicanos.

[Prevalence of cow´s milk allergy and lactose intolerance among Mexican late adolescents]. / Prevalencia de alergia a la leche de vaca e intolerancia a la lactosa en adolescentes tardíos mexicanos.

OBJECTIVE: To determine the prevalence of cow´s milk allergy and lactose intolerance in a sample of late adolescents. METHODS: Through a population-based study, data corresponding to students with aged 15 to 18 years were analyzed. RESULTS: A total of 1992 adolescents was analized. The prevalence of cow´s milk allergy was 1.4% (95% CI: 0.2% to 0.8%) and the prevalence of lactose intolerance was 0.5% (95% CI: 0.2% to 0.8%). Adolescents with cow´s milk allergy had fewer gastrointestinal symptoms (p = 0.036), but more skin (p < 0.001) and respiratory (p = 0.028) ailments than adolescents with lactose intolerance. CONCLUSIONS: The manifestations associated with cow's milk consumption in late adolescents seem to correspond mainly to cow´s milk allergy than to lactose intolerance.

OBJECTIVO: Determinar la prevalencia de alergia a la proteína de la leche de vaca e intolerancia a la lactosa en una muestra de adolescentes tardíos. MÉTODOS: Estudio transversal con base poblacional, en el que se analizaron los datos de pacientes adolescentes de 15 a 18 años. RESULTADOS: Se registraron 1992 estudiantes. La prevalencia de alergia a la proteína de la leche de vaca fue de 1.4% (IC95%: 0.9% a 2.0%) y de intolerancia a la lactosa de 0.5% (IC95%: 0.2% a 0.8%). Los adolescentes con alergia a la proteína de la leche de vaca tuvieron menos síntomas gastrointestinales (p = 0.036), pero más molestias cutáneas (p < 0.001) y respiratorias (p = 0.028) que los adolescentes con intolerancia a la lactosa. CONCLUSIONES: Las manifestaciones asociadas con el consumo de leche de vaca en adolescentes tardíos corresponden, principalmente, a la alergia de la proteína de la leche de vaca que a la intolerancia a la lactosa.

Oral Allergy Syndrome Associated with Jicama.

Background: The occurrence of oral symptoms after food consumption defines oral allergy syndrome (OAS). Thus, our objective was to report the association of oral allergy syndrome triggered by jicama. Methods: In this study, we report 10 cases of OAS associated with jicama eating. Results: Of the total cases, 6 were women; the mean age of the group was 28.3 ± 11.4 years. All patients suffered from allergic rhinitis and 3 of them also had asthma. On average, patients experienced the onset of symptoms 5 minutes after eating jicama. As expected, the patients had oral ailments, mainly itching in the pharynx, palate, and lips; furthermore, 4 out of 10 also had skin symptoms. The skin test by the prick-prick technique with fresh jicama had a mean diameter of 8.1 ± 5.4 mm. Conclusion: In closing, jicama should be considered as a cause of OAS, especially in regions where it is cultivated and eaten in large quantities.

[Obesity in adulthood is associated with the severity of asthma, but not with asthma control]. / La obesidad en adultos está asociada con la gravedad del asma, pero no con el control del asma.

BACKGROUND: The impact of obesity on the severity of asthma continues to be a cause of controversy. OBJECTIVE: To compare the severity of asthma and asthma control in obese patients with non-obese patients. METHODS: A cross-sectional study which included 188 patients with asthma, of ≥ 18 years of age, who were selected consecutively. The patients were categorized and compared based on the presence or absence of obesity. In order to establish an association between variables, logistic regression analyses were performed. RESULTS: In total, 111/188 of the patients had obesity; these patients were older than those without obesity (35.9 ± 15.3 years vs. 44.4 ± 13.8 years, p <0.001). No significant difference was observed in the groups regarding sex, total IgE serum concentration, peripheral blood eosinophil count, personal history of atopic diseases, frequency of allergic sensitization, hospitalization for asthma, and asthma control. Overall, obesity was significantly associated with moderate-severe asthma (OR = 1.82, p = 0.047), but not with asthma control (p = 0.094). CONCLUSIONS: Our results suggest that patients with asthma and obesity are older and that their pulmonary function is worse, which is reflected in a greater level of severity of asthma.

Antecedentes: El impacto de la obesidad sobre la gravedad del asma contiúa siendo motivo de controversia. Objetivo: Comparar la gravedad y el control del asma entre pacientes con obesidad y sin obesidad. Métodos: Estudio transversal que incluyó a 188 pacientes con asma, con edad ≥ 18 años, seleccionados consecutivamente. Los pacientes fueron categorizados y comparados de acuerdo con la presencia de obesidad o no. Para establecer asociación entre variables se realizó análisis de regresión logística. Resultados: En total, 111 pacientes tenían obesidad; su edad fue mayor que la de los pacientes sin obesidad (35.9 ± 15.3 años versus 44.4 ± 13.8 años, p < 0.001). No se observó diferencia significativa entre los grupos respecto a sexo, concentración sérica total de IgE, número de eosinófilos en sangre periférica, historia personal de enfermedad atópica, frecuencia de sensibilización alérgica, hospitalización por asma y control del asma. En general, la obesidad se asoció significativamente con el asma moderada o grave (RM = 1.82, p = 0.047), pero no lo hizo con el control del asma (p = 0.094). Conclusiones: Nuestros resultados sugieren que los pacientes con asma y obesidad tienen mayor edad y peor función pulmonar, la cual se reflejada en mayor gravedad del asma.

Low prevalence of asthma in Mexican children and adults with a positive rtRT-PCR test for SARS-CoV-2: a cross-sectional study during the 2020 pandemic.

BACKGROUND: It has recently been argued that asthma does not increase the risk of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. If so, the prevalence of asthma in subjects diagnosed with COVID-19 should be lower than in the general population. OBJECTIVE: To determine the prevalence of asthma in Mexican children and adults with SARS-CoV-2 infection. METHODS: A public database of the Epidemiological Surveillance System for Viral Respiratory Disease in Mexico was analyzed. Those who underwent the real-time reverse transcriptase-polymerase chain reaction-SARS-CoV-2 (rtRT-PCR-SARS-CoV-2) test from February 27 to June 21, 2020, were included. In addition to the prevalence of asthma, some factors associated with it were investigated. RESULTS: Data from 417,366 subjects were analyzed. Asthma prevalence in children, adults, and global were 3.7%, 3.3%, and 3.3%, respectively. Although the asthma prevalence was lower in SARS-CoV-2 positive over negative patients, significant differences were only found in adults (2.8% vs. 3.7% respectively; odds ratio (OR) = 0.74; 95% confidence interval (CI): 0.71-0.77); but not in children (3.5% vs. 3.8%, respectively; OR = 0.91; 95%CI: 0.76-1.10). Multivariate analysis showed in younger than 18 years that girls and immunosuppression were factors associated with a decrease in the odds to develop asthma. In adults, asthma was positively associated with females, obesity, smoking, immunosuppression, chronic obstructive pulmonary disease, arterial hypertension, and cardiovascular disease. CONCLUSION: The prevalence of asthma in child and adult were lower than those previously reported. Our study seems to support the hypothesis that asthma patients have a lower risk of SARS-CoV-2 infection. Further studies are required to demonstrate the consistency of our findings.

[Cold urticaria with risk of anaphylaxis treated with omalizumab. A case report]. / Urticaria por frío y riesgo de anafilaxia tratada con omalizumab. a propósito de un caso.

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.

Antecedentes: Omalizumab, un anticuerpo monoclonal anti-IgE, recientemente es utilizado como una opción en el tratamiento de la urticaria inducible. Caso clínico: Describimos el caso de una mujer de 46 años referida al Servicio de Alergia e Inmunología del Hospital Civil de Guadalajara Dr. Juan I. Menchaca, por historia de urticaria, picazón en el cuerpo, cambios en el color de la piel tras la exposición al agua y opresión en el pecho posterior el consumo de bebidas frías; en consecuencia, ella limitaba sus actividades al aire libre y de higiene personal. Se realizaron pruebas de desafío con calor, toalla húmeda, caminata en banda sinfín y dermografismo, las cuales fueron negativas; la prueba del cubo de hielo fue positiva. Para establecer la velocidad de la formación de la roncha establecimos intervalos de exposición al frío durante uno, tres, cinco y 10 minutos; se obtuvo un resultado positivo desde el tercer minuto. Debido a la mala respuesta al tratamiento farmacológicos y a las medidas para evitar el frío, así como por la mala calidad de vida, el alto riesgo de anafilaxis y el advenimiento de la temporada de invierno, se administraron 150 mg/mes de omalizumab durante la temporada de invierno. Después de la primera dosis no se notificaron episodios de urticaria en zonas expuestas al frío; la prueba del cubo de hielo antes de la segunda dosis y en los meses siguientes fue negativa y la paciente pudo ingerir bebidas y alimentos fríos. No se produjeron reacciones adversas atribuibles al uso de omalizumab. Tres años después de la primera dosis, la paciente permanecía asintomática. Conclusión: El caso descrito constituye uno de los primeros de urticaria inducida por el frío con riesgo de anafilaxia con respuesta positiva a omalizumab, lo que se reflejó en el control de los síntomas y la mejoría en la calidad de vida.

[The prevalence of oral allergy syndrome: regarding a new classification]. / Prevalencia del síndrome de alergia oral: a propósito de una nueva clasificación.

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.

Antecedentes: Recientemente, el síndrome de alergia oral (SAO) ha sido clasificado de acuerdo con los alimentos que lo inducen: fenotipo I, relacionado con alimentos derivados de plantas; fenotipo II, provocado por alimentos de origen vegetal y animal. Objetivo: Determinar la prevalencia del síndrome de alergia oral en adolescentes tardíos según la nueva clasificación. Métodos: Estudio transversal en el que se analizaron los datos de 1992 adolescentes de 15 a 18 años; la información se obtuvo a través de un cuestionario estructurado, en el que se interrogó acerca de síntomas orales según el tipo de alimento consumido. Resultados: La prevalencia global de síndrome de alergia oral fue de 1.7 % (IC 95 % = 1.2-2.4): fenotipo I, 0.85 % y fenotipo II, 0.85 %. Según el fenotipo no hubo diferencia por sexo e historia personal de enfermedad atópica; el tiempo de inicio de los síntomas sí mostró asociación (p = 0.048). La frecuencia de los síntomas respiratorios, en piel y mucosas no difirieron entre los grupos; respecto a los síntomas gastrointestinales, la diarrea fue notoriamente más frecuente en el fenotipo II (p = 0.044). Conclusión: Se identificaron claramente los dos fenotipos del síndrome de alergia oral: uno asociado con alimentos de origen vegetal y otro a alimentos tanto de origen vegetal como animal.

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

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.

[The prevalence of allergic rhinitis and atopic dermatitis in late adolescents differs according to their gender]. / La prevalencia de rinitis alérgica y dermatitis atópica en adolescentes tardíos difiere de acuerdo con el sexo.

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.

Antecedentes: En México son escasos los estudios encaminados a establecer la prevalencia de la rinitis alérgica y la dermatitis atópica en adolescentes tardíos. Objetivo: Determinar la prevalencia de rinitis alérgica y dermatitis atópica en adolescentes tardíos y compararla conforme el sexo. Métodos: Estudio transversal de 1992 adolescentes de 15 a 18 años, reclutados mediante muestreo probabilístico por conglomerados, estratificado y aleatorizado. Las prevalencias de rinitis alérgica y dermatitis atópica se identificaron con el cuestionario propuesto en The Internacional Study of Asthma and Allergies in Childhood. Resultados: Se incluyeron 1056 mujeres (53 %) y 936 hombres (47 %). La prevalencia de rinitis alérgica fue de 9.0 % (IC 95 % = 7.8-10.4); la frecuencia fue mayor en las mujeres (6.7 % versus 11.1 %, p = 0.001). Los síntomas de rinitis más conjuntivitis predominaron en las mujeres (16.0 % versus 23.1 %, p < 0.0001). La prevalencia de dermatitis atópica fue de 5.2 % (IC 95 % = 4.3-6.2); fue más frecuente en las mujeres (7.7 % versus 2.4 %, p < 0.0001). Los principales factores asociados con rinitis alérgica y dermatitis atópica fueron sexo femenino y atopia familiar (p < 0.001). Conclusiones: Se registró diferencia significativa en la prevalencia de rinitis alérgica y dermatitis atópica conforme el sexo en los adolescentes tardíos; las mujeres fueron las más afectadas. La atopia familiar fue otro factor asociado.

[Allergy to food in adults with allergic respiratory diseases: prevalence and clinical manifestations]. / Alergia a alimentos en adultos con enfermedades respiratorias alérgicas: prevalencia y manifestaciones clínicas.

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.

Antecedentes: La alergia a alimentos se considera un problema típico de la población pediátrica, sin embargo, los adultos se ven afectados cada vez con mayor frecuencia. Objetivo: Determinar la prevalencia de alergia a los alimentos en pacientes con rinitis alérgica y asma, así como los alimentos y los síntomas más relacionados con este problema. Métodos: Mediante un estudio transversal se analizaron los datos de 257 adultos con asma o rinitis alérgica. La información relacionada con la alergia a los alimentos se obtuvo por entrevista estandarizada. Se calcularon intervalos de confianza (IC) a 95 % para proporciones. Resultados: La prevalencia de alergia a alimentos fue de 17.5 % (IC 95 % = 13.3-22.6). Soya, camarón, almendra, aguacate y cacahuate fueron los alimentos que principalmente provocaron molestias; 35.6 % de los pacientes fue alérgico a un alimento, 17.8 % a dos y 17.8 % a tres. Las manifestaciones más frecuentes fueron las orales (62.2 %), prurito en faringe, lengua y paladar; las respiratorias (26.7 %), disnea y estornudos; y las cutáneas (26.7 %), comezón y ronchas. Conclusiones: La alergia a alimentos en adultos con asma o rinitis alérgica es un problema frecuente. Los síntomas orales son la principal molestia en este tipo de pacientes y principalmente son provocados por la soya.

[Prevalence of sensitization and allergy to kiwi fruit (Actinidia deliciosa) in adults with allergic diseases]. / Prevalencia de sensibilización y alergia al kiwi (Actinidia deliciosa) en adultos con enfermedades alérgicas.

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.

Antecedentes: El kiwi (Actinidia deliciosa) es un alimento reconocido por su capacidad alergénica desde hace más de 30 años. Por lo general, la alergia al kiwi se caracteriza por molestias locales, pero pueden desencadenarse reacciones sistémicas como urticaria, angioedema, rinitis, conjuntivitis o anafilaxia. Objetivo: Determinar la prevalencia de sensibilización y alergia al kiwi en adultos con enfermedades alérgicas. Métodos: Mediante un estudio transversal se analizaron los datos correspondientes a 370 pacientes ≥ 16 años de edad. Resultados: Tuvieron reacción cutánea positiva contra aeroalérgenos 226/370 pacientes. La prevalencia de sensibilización a alimentos fue 84/226 (37.2 %; IC 95 % = 31.1 a 43.6 %). En general, la prevalencia de sensibilización al kiwi fue de 15/226 (6.6 %; IC 95 % = 3.9 a 10.7 %) y de alergia al kiwi de 2/226 (0.9 %; IC 95 % = 0.03% a 3.4 %), un paciente tuvo síntomas compatibles con síndrome de la alergia oral y otro, manifestaciones gastrointestinales y cutáneas. Conclusión: La prevalencia de sensibilización al kiwi no es un evento raro; en contraste, los síntomas relacionados con el consumo del fruto son poco frecuentes.

[Trends in asthma prevalence and its symptoms in Mexican late adolescents over a 7-year period]. / Tendencia de la prevalencia de asma y sus síntomas en los adolescentes tardíos mexicanos en un periodo de siete años.

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.

Antecedentes: Los adolescentes tardíos con asma pocas veces son investigados, dado que generalmente no se incluyen en los grupos de niños ni adultos, además, en México, los estudios que evalúan la tendencia del asma son escasos y sus resultados pudieran diferir de los hallazgos en los países desarrollados Objetivo: Determinar la tendencia de la prevalencia del asma y sus síntomas en adolescentes tardíos en un periodo de siete años. Métodos: Se compararon las prevalencias de asma y sus síntomas de dos cortes transversales con base poblacional, uno en 2009 y otro en 2016. Resultados: La presencia de sibilancias alguna vez en la vida y durante el año previo se incrementó significativamente entre 2009 y 2016 (12.8 % versus 20.1 % y 7.3 % versus 10.3 %; p < 0.0001 y 0.002, respectivamente). La prevalencia del asma pasó de 7.8 % en 2009 a 12.7 % en 2016 (p < 0.0001). Adicionalmente, las prevalencias de rinitis alérgica (4.5 % versus 9.0 %) y dermatitis atópica (3.8 % versus 5.2 %) también sufrieron incrementos notorios (p < 0.0001 y 0.051 respectivamente). Conclusión: La prevalencia de asma y algunos de sus síntomas en adolescentes tardíos se incrementaron sustancialmente en los siete años previos.

[Self-reported prevalence of latex allergy and associated factors in healthcare workers]. / Prevalencia de autorreporte de alergia al látex y factores asociados en trabajadores de la salud.

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.

Antecedentes: pocas veces ha sido estudiada la prevalencia de alergia al látex en personal de la salud en México. Objetivo: determinar la prevalencia de autorreporte de alergia al látex y los factores asociados en trabajadores de la salud. Métodos: estudio trasversal de 1292 trabajadores de la salud de un hospital de segundo nivel, a quienes se les aplicó un cuestionario estructurado para identificar alergia al látex, historia personal y familiar de atopia, exposición a guantes de látex y antecedente de cirugías. La búsqueda de asociaciones entre variables se realizó mediante regresión logística. Se calcularon razones de momios (RM) e intervalo de confianza a 95 % (IC 95 %) Resultados: la relación mujer:hombre fue de 2.4:1. Edad media de 38.4 ± 11.6 años. La prevalencia de alergia al látex fue de 9.7 %, IC 95 %, 8.1-11.3 %. No hubo diferencia estadística por área laboral (p = 0.508). Los factores asociados con la alergia al látex fueron sexo femenino (RM = 1.68; IC 95 %, 1.03-2.73), historia personal de atopia (RM = 4.82; IC 95 %, 3.19-7.26), historia familiar de dermatitis atópica (RM = 4.33; IC 95 %, 1.20-4.41) e historia de alergia a frutos (RM = 2.30; IC 95 %, 2.62-7.14). Conclusiones: hasta 10 % los trabajadores de la salud podría presentar alergia al látex; los principales factores asociados fueron sexo femenino, atopia personal o familiar y alergia a frutos.

[Spontaneous pneumomediastinum and subcutaneous emphysema associated with bronchospasm in a woman with no history of asthma]. / Neumomediastino espontáneo y enfisema subcutáneo asociado con broncoespasmo en una mujer sin antecedente de asma.

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.

Antecedentes: Los desencadenantes del neumomediastino espontáneo de mayor relevancia son tos, vómito, problemas de alimentación, actividad física y el uso de drogas inhaladas. La asociación de neumomediastino espontáneo con broncoespasmo no relacionado con asma es un suceso inusitado. Caso clínico: Mujer de 21 años de edad sin antecedentes personales ni familiares de asma, rinitis alérgica o atopia, quien durante la etapa del puerperio tardío presentó súbitamente fiebre de 39 °C, disnea, tos paroxística y opresión torácica, así como sibilancias y enfisema subcutáneo en el cuello; no presentó síntomas nasales previos. La radiografía de tórax evidenció aire libre en mediastino y cara lateral izquierda del cuello. La posible causa del cuadro se atribuyó al broncoespasmo relacionado con infección de las vías respiratorias. El tratamiento consistió en la administración de broncodilatadores, esteroides sistémicos, antibióticos y oxígeno suplementario. La sintomatología remitió después de 48 horas. Conclusión: En el caso clínico descrito, al parecer el factor precipitante del neumomediastino espontáneo fue la tos paroxística asociada con el broncoespasmo, de tal forma que sugerimos se sospeche en los pacientes aun cuando no existan antecedentes de asma.

Prevalence of Peanut, Tree Nut, Sesame, and Seafood Allergy in Mexican Adults.

OBJECTIVE: To identify the prevalence of perceived and probable allergic reactions to peanuts, tree nuts, sesame seed, or seafood and its association with the personal history of allergic disease. METHODS: A cross-sectional study was performed in four cities of the metropolitan area of Guadalajara, located in western Mexico. Through sampling by gender and age, 1,126 subjects were included. Using a structured questionnaire, we investigated: (i) history of atopic disease, (ii) perception of allergic reaction after food intake, and (iii) probable allergic reaction to peanuts, tree nuts, sesame, or seafood. Prevalence and 95% confidence intervals were calculated. A multivariate analysis of factors associated to perceived and probable allergic reactions to food was performed by logistic regression. RESULTS: Men were 49.8%; mean age was 28.1 years; personal history of atopic disease included: allergic rhinitis (6.9%), asthma (6.8%), and atopic dermatitis (3.8%). Prevalence of perceived and probable food allergy was, respectively: pecan 0.4 and 0.3%; peanut 0.6 and 0.6%; sesame 0.1 and 0.1%; shellfish 4.2 and 4.0% (mainly shrimp); mollusk 0.8 and 0.7%; fish 1.4 and 1.2%. Asthma was significantly associated with perceived and probable allergy to pecans, peanuts, fish, or seafood. Atopic dermatitis was associated with perceived and probable allergic reaction to sea snail, seafood, shellfish, or mollusks. Finally, allergic rhinitis was associated with allergy to shrimp and crustaceans. CONCLUSIONS: This study shows that the prevalence of peanut, tree nut, sesame seed, and seafood allergy in this Mexican population is similar to that reported in developed countries.

[Frequency of sensitization to pollens of the subclass Rosidae in patients with respiratory allergy]. / Frecuencia de sensibilización a pólenes de la subclase Rosidae en pacientes con alergia respiratoria.

BACKGROUND: Studies related to the patterns of sensitization to rare species of aeroallergens are uncommon. OBJECTIVE: To determine the frequency of sensitization to pollens clinically relevant in Allergology, corresponding to subclass Rosidae in patients with respiratory allergy. PATIENTS AND METHOD: A cross-sectional study was done with patients included in a group with allergic rhinitis or asthma, respectively. We studied the clinical history, physical examination and reactivity to a panel of allergens, including the species Prosopis, Schinus, Acacia and Eucalyptus. Frequency of sensitization and confidence intervals at 95% (95%CI) were calculated. RESULTS: A total of 104 allergic rhinitis patients and 99 patients with asthma diagnosis were included. In both groups, the mean age corresponded to fourth decade of life. Women had greater frequency. In patients with allergic rhinitis, frequencies of sensitization were: mesquite tree 26.2% (95%CI: 17.7% to 34.6%), American pepper tree 11.5% (95%CI: 5.4% to 17.6%), eucalypt tree 6.7% (95%CI: 1.9% to 11.5%) and acacia tree 3% (95%CI: 0.3% to 6.3%). In subjects with asthma the results were as follows: mesquite tree 13.1% (95%CI: 6.5% to 19.7%), American pepper tree 7.1% (95%CI: 2% to 12.2%), eucalypt tree 4% (95%CI: 0.1% to 7.9%) and acacia tree 3% (95%CI: 0.4% to 6.4%). Both groups had a high frequency of sensitization to ash tree and oak tree followed by eucalypt, pine and acacia tree. CONCLUSIONS: Studied capacity of sensitization to tree pollens for this population is low, except for mesquite tree.

Antecedentes: los estudios relacionados con los patrones de sensibilización a especies de aeroalergenos poco comunes son infrecuentes. Objetivo: determinar la frecuencia de sensibilización a pólenes de relevancia alergológica provenientes de la subclase Rosidae en pacientes con alergia respiratoria. Pacientes y método: estudio descriptivo y transversal en el que se incluyeron pacientes de manera consecutiva a un grupo con rinitis alérgica y a otro con asma. Se estudiaron mediante historia clínica, exploración física y reactividad cutánea a un panel de alergenos, que incluyó a las especies Prosopis, Schinus, Acacia y Eucalyptus. Se determinaron las frecuencias de sensibilización y sus intervalos de confianza a 95% (IC 95%) respectivos. Resultados: se estudiaron 104 pacientes con rinitis alérgica y 99 con asma; en ambos grupos la media de edad se ubicó en la cuarta década de la vida y hubo predomino de mujeres. En los pacientes con rinitis alérgica se observó la siguiente frecuencia de sensibilización: mezquite 26.2% (IC 95%: 17.7 a 34.6%), pirul 11.5% (IC 95%: 5.4 a 17.6%), eucalipto 6.7% (IC 95%: 1.9 a 11.5%) y acacia 3% (IC 95%: 0.3 a 6.3%). En los sujetos con asma la conducta fue la siguiente: mezquite 13.1% (IC 95%: 6.5 a 19.7%), pirul 7.1% (IC 95%: 2 a 12.2%), eucalipto 4 (IC 95%: 0.1 a 7.9%) y acacia 3% (IC 95%: 0.4 a 6.4%). Los dos grupos manifestaron un predominio de sensibilización por los fresnos y encinos; al final se encontraron eucalipto, pino y acacia. Conclusión: la capacidad de sensibilización de los árboles analizados, con excepción del mezquite, es menor.

Food hypersensitivity in mexican adults at 18 to 50 years of age: a questionnaire survey.

PURPOSE: There is limited epidemiological evidence of food hypersensitivity (FH) in the adult population. We aimed to determine the prevalence of FH in Mexican adults, their clinical features and to establish common food involved in its appearance. METHODS: We designed a cross-sectional study using a fixed quota sampling; 1,126 subjects answered a structured survey to gather information related to FH. RESULTS: The prevalence of FH in adults was 16.7% (95% CI, 14.5% to 18.8%), without statistical significant differences related to gender (women, 17.5% and men, 15.9%) or residential location. The most common clinical manifestations in adults with FH were oral allergy syndrome (70 of 1,126) and urticaria (55 of 1,126). According to category, fruits and vegetables were the most frequent foods to trigger FH (6.12%) and were individually related to shrimp (4.0%), and cow milk (1.5%). Adults under age 25 had a higher frequency of FH (OR, 1.39; 95% CI, 1.01 to 1.91, P <0.001). Personal history of any atopic disease was significantly associated with FH (P <0.0001). CONCLUSIONS: The prevalence of FH is relatively high in Mexican adults, and FH is significantly associated with atopic diseases.