[Impact of the integral allergological treatment on quality of life of patients with allergic rhinitis at the University Hospital of Puebla]. / Impacto del tratamiento alergológico integral en la calidad de vida de los pacientes con rinitis alérgica del Hospital Universitario de Puebla.

BACKGROUND: In order to determine the impact of allergic rhinitis on the quality of life of the patients, standardized and validated questionnaires have been developed. The quality of life is the perception of the patient of the functional effects of his illness and its therapeutics consequences. OBJECTIVE: To determine the modification of index the quality of life on the patients with allergic rhinitis attended at the external consultation of the service of allergy and clinical immunology of the Hospital Universitario de Puebla when they were submitted to integral allergologic treatment. PATIENTS AND METHODS: It was carried out a longitudinal, prospective, experimental and prolective study in patients of both sexes, older than 18 years with diagnosis of allergic rhinitis, a validated and standardized questionnaire was applied to assess the quality of life index every 14 days during 6 months. It was measured severity degree at the beginning and the end of the study. It was assessed the sample size considering a reasonable size of the effect 1 and a variability of 0.8 for usual techniques. The severity degree was compared with RIDIT analysis and the mean with variance, a value of p smaller than 0.05 was considered significant. RESULTS: Sixteen patients were included, 75% were women. The average age was 34.2 years old. When the severity degrees were compared it was an average RIDIT of 0.014 with a "z" of -5.0 that implicated a value of p < 0.001. The comparison among the initial quality of life and the subsequently visits mean was significantly different since third visit. CONCLUSION: The integral allergologic treatment modifies the quality of life and the severity degree in the patients with allergic rhinitis.

[Prevalence of seropositividad to antibodies IgG and IgM against Helicobacter pylori in the medical residents of the University Hospital of Puebla]. / Prevalencia de seropositividad a anticuerpos IgG e IgM contra Helicobacter pylori en el personal médico residente del Hospital Universitario de Puebla.

BACKGROUND: Helicobacter pylori is a gram-negative, curved, microaerophilic, oxidase, catalase and urease positive bacillus. It lives in the gastric mucosa, and is the main etiological agent of peptic ulcer, and of atrophic and multifocal gastritis. It is associated with extraintestinal, vascular, autoimmune and cutaneous diseases. The infection by this bacteria causes a chronic inflammatory process related with the sensibilization of mast cells, which increases the incidence of allergic diseases. OBJECTIVE: To estimate the seropositivity prevalence of IgG and IgM antibodies against Helicobacter pylori in medical resident personnel. PATIENTS AND METHOD: A transversal, descriptive and observational study was carried out in medical residents of the Hospital Universitario de Puebla. Serum levels of IgG and IgM antibodies against Helicobacter pylori were determined by chemiluminescence. Data were analyzed applying descriptive statistics, such as: frequency, central tendency and dispersion measures. RESULTS: 57 residents were included, 54.4% were men. The mean age was 28.4 (SD 2.9). Seropositivity prevalence of IgG and IgM antibodies was 24.6 and 33.3%, respectively. Combined seropositivity prevalence of IgG and IgM was of 43.9%. CONCLUSION: Seropositivity prevalence of IgG and IgM antibodies against Helicobacter pylori in the medical resident personnel of the Hospital Universitario de Puebla was similar to the reported in the general population. This estimation might be considered a reference to other epidemiological and clinical studies such as those pretending to evaluate and demonstrate the relationship between infection by Helicobacter pylori and other entities, even allergies.

[Frequency of Helicobacter pylori infection in patients with chronic urticaria of Puebla University Hospital]. / Frecuencia de infección por Helicobacter pylori en pacientes con urticaria crónica del Hospital Universitario de Puebla.

BACKGROUND: Chronic urticaria may be continuous or recurrent according to its form of appearance. Within the diseases associated to chronic urticaria there are mycosis, parasitism and bacterial infections where Helicobacter pylori stands out. This has been related to the allergic diseases promoting a Th2 response. OBJECTIVE: To determine the frequency of infection caused by Helicobacter pylori in patients with chronic urticaria of the allergic and clinical immunology service of the Puebla University Hospital. PATIENTS AND METHODS: A descriptive, cross-sectional, prolective and observational study was made in adult patients, between 18 and 60 years old, with diagnosis of chronic urticaria. Inhalated and food skin prick test were made to all the patients. The infection by Helicobacter pylori was documented by serology, fecal antigen, endoscopy with fast test of urease and histological study. Descriptive statistics was implemented such as frequency, percentage, central tendency and dispersion measures. RESULTS: 30 patients were included; 83.3% were women. The average age was 37.8 years (SD 13.2). The most frequent type of chronic urticaria was the persistent one, representing 56.7%. The frequency of positivism of IgG antibodies against Helicobacter pylori represented the 60.0%, for IgM 33.3% and for fecal antigen 60.0%, the combined IgG, IgM, fecal antigen, fast test of ureasa and histological study was of 83%. CONCLUSION: The high frequency of infection caused by Helicobacter pylori in the patient with chronic urticaria suggests a possible role in its etiopathogeny, extending the therapeutic possibilities.

[Impact of integrated asthma treatment on the patients' quality of life]. / Impacto del tratamiento integral del asma sobre la calidad de vida de los pacientes.

BACKGROUND: Patient's perception about the effect of disease's manifestations on daily activities is called health-related quality of life, and it is used to evaluate the individual response to treatment. At present, there are some questionnaires designed to evaluate it. OBJECTIVE: To evaluate the effect of integral treatment dosage on quality of life in asthmatic adults. MATERIAL AND METHODS: A prospective, longitudinal and experimental study was made. We included male and female adult patients, with allergic asthma. A standardized questionnaire of quality of life was applied to all of them in every visit, for eight times. The integral treatment was based on Global Initiative for Asthma judgments. RESULTS: Ten patients were included, 70% of them were women. The media age was 37.4 +/- 15.73 years old. The asthma was diagnosed as intermittent in 10% cases, mild persistent in 20%, moderate persistent in 20% and severe persistent in 50% patients. The group of age most frequently affected was that of 20 to 30 years old. The media index of quality of life was 2.43 +/- 0.91 at the first visit and it was 5.73 +/- 1.11 at eighth visit. It was found a significant difference. CONCLUSION: Integral treatment improves quality of life in asthmatic adults.

[Impact of integral allergic treatment in the quality life of patients with allergic rhinitis]. / Impacto del tratamiento alergológico integral en la calidad de vida de pacientes con rinitis alérgica.

BACKGROUND: The quality of life is the perception of a patient about functional effects of his illness and therapy. Recently, appropriate instruments were devised to evaluate the health related with the quality of life, as the standardized and validated questionnaires for rhino-conjunctivitis. OBJECTIVE: To determine the impact of integral allergological treatment upon the quality of life of patients with allergic rhinitis that were attended as outpatients at the Service of Allergy and Clinical Immunology of Hospital Universitario de Puebla. MATERIAL AND METHODS: It was carried out a longitudinal, prospective, experimental and prolective study in patients of both sexes, older than 18 years old, with diagnosis of allergic rhinitis; life quality was evaluated by means of the application of a validated and standardized questionnaire every 15 days during 4 months. After being included in the study, patients received the integral allergological treatment conformed by educational measures, environmental control, pharmacotherapy and specific immunotherapy. We determined frequency for qualitative variables and average for quantitative variables. The averages were compared by means of variance analysis. The significance value was established down in 0.05. RESULTS: Thirteen patients were included, 61.5% of them were male. The average age was 33.2 (SD 17.0). There was a significative difference in quality of life index when patient was included in comparison with the indexes in subsequent visits. The most frequent allergic rhinitis was the moderate-severe persistent type, with a 76.9% rate. CONCLUSION: Integral allergological treatment improves quality of life of patients with allergic rhinitis.

Incidencia de reacciones adversas a la inmunoterapia en pacientes alérgicos del Hospital Universitario de Puebla / Adverse effects incidence associated with immunotherapy in patients allergic of Hospital Universitario de Puebla, Mexico

Antecedentes: la inmunoterapia específica ha evolucionado recientemente y se postula que las dosis altas son más efectivas, pero conllevan un incremento en las reacciones locales y sistémicas indeseables, que en su grado máximo producen anafilaxia. Material y método: estudio longitudinal, prospectivo y descriptivo en pacientes de la consulta externa del servicio de alergia e inmunología clínica del hospital Universitario de puebla efectuado en un periodo de 10 meses. Se determinó la edad, el sexo, el diagnóstico, el tipo de reacción adversa y el tiempo de presentación de la misma. La dosis inicial de inmunoterapia fue de 0.05 ml con antígenos de tratamiento (Laboratorios Aphi) a una dilución de 1:100 peso/volumen sin premedicaión a la misma. Se incluyeron 170 pacientes con edad promedio de 22.6 años (De 15.4), 56.5 por ciento del sexo femenino y 43.5 por ciento del masculino. Resultados: los padecimientos más frecuentes fueron asma y rinitis. La incidencia de reaciones adversas a la inmunoterapia específica fue de 2.4 por ciento, todas ellas de tipo inmediato y local. Conclusión: estos resultados están influidos por la concentración y dosis de los antígenos utilizados y pueden definir de otros estudios

Fenotipo del niño alérgico / phenotype of the allergic children

Objetivo: establecer la frecuencia de características fenotípicas en pacientes alérgicos, vistos en el Hospital Universitario de Puebla (HUP) por presentar signos y síntomas de enfermedades alérgicas respiratorias y comparar esta frecuencia con la encontrada en un grupo de pacientes pediátricos sin alergias. Método: Revisamos el expediente médico y realizamos la exploración física en 100 pacientes alérgicos vistos en el servicio de Alergia e Inmunología del HUP (casos) y en 100 pacientes pediátricos (controles). Resultados: En la muestra total de pacientes alérgicos el sexo masculino predominó sobre el sexo femenino con una relación de 60:40. Los síntomas y signos revisados fueron: conjuntivitis, blefaritis, prurito nasal, surco nasal, ojeras, mucosa pálida y lengua geográfica. No se encontró una diferencia estadisticamente significativa (con la prueba de X², p<0.05) entre los casos y los controles, ni en edad ni en estigmas alérgicas. Conclusión: Los síntomas y signos que se consideran característicamente de pacientes alérgicos también se encuentran con frecuencia en la población abierta

Inmunoterapia alergeno específica: causas de abandono durante el primer año de inicio, en el Hospital Universitario de Puebla / Allergen-specific immunotherapy: causes of abandon during the first year after inicialization at the Universitary Hospital of Puebla

Se estudiaron 36 pacientes con enfermedad alérgica, menores de 15 años de edad, que por primera vez les fue implementada inmunoterapia alergeno específica y que abandonaron permanentemente el procedimiento durante el transcurso del primer año. Se aplicó un cuestionario en el hogar de los pacientes para investigar las causas de abandono. Se evaluaron los resultados mediante análisis estadístico descriptivo. Se incluyó a un total de 36 pacientes. El fenómeno de abandono se dio más en el primer trimestre de implementada la inmunoterapia, 17 pacientes (44 por ciento). La causa más frecuente de deserción fue por mejoría clínica del cuadro alérgico en 13 pacientes (36 por ciento), siguiendo en orden descendente de frecuencia la dificultad para cudir a consulta, el incrmento de la sintomatología alérgica, dolor e incredulidad al procedimiento. Se concluye que es alta la frecuencia de abandono debido a mejoría del cuadro alérgico en los primeros meses de iniciado el procedimiento

Frecuencia de pruebas cutaneas positivas para enfermedades alérgicas en el Hospital Universitario de Puebla / Frequency of positivity skin test of allergic diseases in the Universitary Hospital of Puebla

Con la finalidad de conocer la frecuencia de positividad de las pruebas cutáneas (PC) por el método de Prick, y determinar, al mismo tiempo, los 10 antígenos inhalables y alimentarios con mayor positividad de las mismas, se revisaron 2,202 expedientes de pacientes a los cuales se les realizaron PC: De éstas, 1890 (86 por ciento) fueron antígenos inhalables y 312 (14 por ciento) a antígenos alimentarios. De las PC a inhalables, 1456 (77 por ciento) fueron positivas y 434 (23 por ciento) negativas; las PC con antígenos alimentarios tuvieron una posibilidad del 65 por ciento (202 PC) y 35 por ciento (110 PC) negativas. Los antígenos a inhalables más frecuentes fueron: Dermatophagoides pteronysinnus (61 por ciento), Ambrosia eliator (radweed) (21 por ciento), Amaranthus palmeri (quelite) (20 por ciento), Artemisa vulgaris (manzanilla) (19 por ciento); con repecto a los antígenos alimentarios, en orden de frecuencia, fueron: uva (38 por ciento), cacahuate (34 por ciento), clara de huevo (33 por ciento), piña (28 por ciento). Los resultados muestran que el Dermatophagoides pt. y la Ambrosia eliator, de los inhalables, y la uva y el cacahuate, de los alimentos, son los antígenos más frecuentes en la hipersensibilidad inmediata de nuestros pacientes, así mismo las PC son un método útil para complementar el diagnóstico de las enfermedades alérgicas