Heterogeneity of sensitization profiles and clinical phenotypes among patients with seasonal allergic rhinitis in Southern European countries-The @IT.2020 multicenter study.

BACKGROUND: Pollen allergy poses a significant health and economic burden in Europe. Disease patterns are relatively homogeneous within Central and Northern European countries. However, no study broadly assessed the features of seasonal allergic rhinitis (SAR) across different Southern European countries with a standardized approach. OBJECTIVE: To describe sensitization profiles and clinical phenotypes of pollen allergic patients in nine Southern European cities with a uniform methodological approach. METHODS: Within the @IT.2020 multicenter observational study, pediatric and adult patients suffering from SAR were recruited in nine urban study centers located in seven countries. Clinical questionnaires, skin prick tests (SPT) and specific IgE (sIgE) tests with a customized multiplex assay (Euroimmun Labordiagnostika, Lübeck, Germany) were performed. RESULTS: Three hundred forty-eight children (mean age 13.1 years, SD: 2.4 years) and 467 adults (mean age 35.7 years SD: 10.0 years) with a predominantly moderate to severe, persistent phenotype of SAR were recruited. Grass pollen major allergenic molecules (Phl p 1 and/or Phl p 5) ranged among the top three sensitizers in all study centers. Sensitization profiles were very heterogeneous, considering that patients in Rome were highly poly-sensitized (sIgE to 3.8 major allergenic molecules per patient), while mono-sensitization was prominent and heterogeneous in other cities, such as Marseille (sIgE to Cup a 1: n = 55/80, 68.8%) and Messina (sIgE to Par j 2: n = 47/82, 57.3%). Co-sensitization to perennial allergens, as well as allergic comorbidities also broadly varied between study centers. CONCLUSIONS: In Southern European countries, pollen allergy is heterogeneous in terms of sensitization profiles and clinical manifestations. Despite the complexity, a unique molecular, multiplex, and customized in-vitro IgE test detected relevant sensitization in all study centers. Nevertheless, this geographical diversity in pollen allergic patients imposes localized clinical guidelines and study protocols for clinical trials of SAR in this climatically complex region.

[Influence of posture in musicians. A literature review]. / Influencia de la postura en el músico. Una revisión bibliográfica.

Playing-related musculoskeletal disorders represent a commitment to the health and competence of musicians. This review aimed to analyse how musician's posture influences instrumental practice and the appearance of musculoskeletal disorders related to musical performance. To do this, a literature search was carried out in the Medline, CINAHL and Web of Science, and Pubmed databases, obtaining 14 valid articles after application of the inclusion and exclusion criteria. Several authors analysed posture during instrumental practice, posture and interpretive quality, and the appearance of musculoskeletal disorders related to musical performance and postural quality, based on distinct variables such as the instrument and interpretive anxiety. Posture seems to be one of the most important risk factors, influencing both musculoskeletal and interpretive levels. Physiotherapy could be effective for prevention and treatment.

Assessment of male urinary incontinence postprostatectomy through the Consultation on Incontinence Questionnaire-Short Form.

OBJECTIVE: The objective of this study is to assess the correlation between the urinary incontinence results of the ICIQ-SF, and those obtained in the 1-hour and 24-hour pad tests, in a sample of men that underwent prostatectomy. MATERIAL AND METHODS: A prospective observational study was carried out in patients from the Integrated Management Area of Vigo (EOXI de Vigo) who underwent prostatectomy and suffered from urinary incontinence in the post-surgery period. Loss of urine was assessed by means of the 1-hour and 24-hour pad tests and the ICIQ-SF. A comparative analysis of the questionnaire findings was performed for both urinary incontinence tests. RESULTS: A correlation is observed between the ICIQ-SF and the amount of urine loss in the 1-hour and the 24-hour pad tests. However, the severity of urine loss established by instruments is less consistent. The 24-hour pad test is the one that obtained better correlation with the ICIQ-SF. CONCLUSIONS: The ICIQ-SF should be validated in a male population after prostatectomy in order to reinterpret the severity values observed in the different instruments studied. LEVEL OF EVIDENCE: 4.

[Circumstances that may decrease the reliability of instruments to assess male urinary incontinence]. / Circunstancias que pueden disminuir la fiabilidad de los instrumentos para valorar la incontinencia urinaria masculina.

OBJECTIVE: To identify situations that may alter the results of the 1-hour and 24-hour Pad test and the short-form International Consultation in Incontinence Questionnaire (SF-ICIQ). PARTICIPANTS: Five physiotherapists, who conducted the interviews and treatment of 81 patients undergoing radical prostatectomy. METHOD: A qualitative descriptive phenomenological study was carried out, using a focus group technique with five people (4 women and 1 man) responsible for the treatment and assessment of patients with urinary incontinence after prostatectomy. Recordings were transcribed and the Atlas.ti7 programme was used to carry out the coding of the variables. RESULTS: Important factors were identified in the use of measuring instruments for the diagnosis and assessment of urinary incontinence in all the tools used. CONCLUSIONS: Some situations can modify the objectivity of the various tests for the assessment of urinary incontinence. Some of the factors identified were lower fluid intake, less activity, use of manual clamp or urinals to avoid leakage, as well as the interference of certain drugs.

Correlation between the 1-hour and 24-hour pad test in the assessment of male patients with post-prostatectomy urinary incontinence.

INTRODUCTION: This study is aimed at studying the correlation between the 1-hour and 24-hour pad tests for urinary incontinence following prostatectomy; the second objective is to check whether the severity level established by both tests is adequate for male urinary incontinence. MATERIAL AND METHODS: The study population includes patients who had undergone prostatectomy at a single center between February 2015 and December 2016, using 159 measurements consisting of 24-hour and 1-hour pad tests, belonging 45 patients. Both tests have been performed according to the protocol standardized by the International Continence Society. Once all the data have been obtained, the levels marked by each of the pads have been established, and the statistical analysis has started. RESULTS: The relationship between the amounts recorded in grams by the two test is highly significant (P=0.000), however, when comparing the incontinence levels established by each test (mild, moderate and severe), discrepancies have been found. The median of the severe cases in the 24-hour pad test was 389.5 grams, and in the 1-hour pad test was 92 grams. So, patient's loss values are well above the cut-off point defined for severe urinary incontinence in both 24-hour (50 grams) and 1-hour pad test (75 grams). CONCLUSIONS: There is a diagnostic discrepancy between the 24-hour pad test and the 1-hour pad test in terms of defined urinary incontinence severity levels. In our opinion, these levels should be redefined for male urinary incontinence since the amount of urine loss is well above the threshold established for severe incontinence. LEVEL OF EVIDENCE: 4.

Airborne olive pollen counts are not representative of exposure to the major olive allergen Ole e 1.

Pollen is routinely monitored, but it is unknown whether pollen counts represent allergen exposure. We therefore simultaneously determined olive pollen and Ole e 1 in ambient air in Córdoba, Spain, and Évora, Portugal, using Hirst-type traps for pollen and high-volume cascade impactors for allergen. Pollen from different days released 12-fold different amounts of Ole e 1 per pollen (both locations P < 0.001). Average allergen release from pollen (pollen potency) was much higher in Córdoba (3.9 pg Ole e 1/pollen) than in Évora (0.8 pg Ole e 1/pollen, P = 0.004). Indeed, yearly olive pollen counts in Córdoba were 2.4 times higher than in Évora, but Ole e 1 concentrations were 7.6 times higher. When modeling the origin of the pollen, >40% of Ole e 1 exposure in Évora was explained by high-potency pollen originating from the south of Spain. Thus, olive pollen can vary substantially in allergen release, even though they are morphologically identical.

[Survival of patients with myasthenia gravis after thymectomy. Analysis of 100 cases]. / Supervivencia en pacientes con miastenia gravis después de la timectomía. Análisis de 100 casos.

In order to evaluate the survival of patients with myasthenia gravis (MG) after thymectomy (T), 100 patients with MG in which T had been performed between 1967 and 1995 were studied. Patients were divided into different groups for their analysis: patients with thymoma (TI), 22 cases; and patients without thymoma (NTI), 78 cases. In addition those patients belonging to the latter group were further separated according to the date of their surgery into two other subgroups: patients operated before 1980 (A80), 43 cases; and after 1980 (D80), 35 cases; trying to evaluate the prognostic implications of the therapeutical advances achieved over the last 15 years. The population studied was composed mainly of women (78%) but with a slight predominance of men in TI. The mean age was 29.47 years (range 10-70) for the entire population, with a tendency toward older ages in TI (mean 46 years, range 23-70). The mean follow-up period was 4.3 years (range 0.08-23.2) without significant differences between TI and NTI. The results showed that the overall mortality rate was 16/100 (16%) [Fig. 1], with nine of those deaths corresponding to TI (9/22, 40.91%) and only the remaining seven to NTI (7/78, 8.97%). These differences in mortality rate between TI and NTI were statistically significant in all the specific times of follow-up analyzed up to 10 years after surgery (p < 0.05) [Fig. 2]. Notoriously, all deaths in NTI occurred in the A80 subgroup giving a p value < 0.001 when compared with D80 [Fig. 3]. In terms of morbidity, 55/100 (55%) reached complete clinical remission (CCR) defined by the complete absence of symptoms related to MG: 8/22 (36.36%) in TI and 47/78 (60.25%) in NTI [Fig. 4]. Most interestingly the differences were statistically significant (p < 0.01) when the rates of CCR in A80 and D80 were compared for all the times assessed [Fig. 5-6-7-8]. It can be concluded that the best results in survival in MG after T are obtained in patients without thymoma and also that the benefits of the rational use of modern therapeutic modalities, including surgery and immunosuppression with drugs, can offer those patients high possibilities of leading completely normal lives.