Serum Vitamin D Is Inversely Associated with Blood Eosinophil Count Among Adults with Allergic Asthma.

OBJECTIVE: To evaluate the role that serum vitamin D concentration plays in the number of eosinophils in peripheral blood in adults with allergic asthma. MATERIAL AND METHODS: A total of 142 patients were categorized based on different cutoff points for eosinophils: ≥200, ≥300, ≥400, and ≥500 cells/mL. The vitamin D concentration was stratified into <20 and ≥20 ng/mL. The association between vitamin D (independent variable) and eosinophils (dependent variable) was explored using multivariate analysis. RESULTS: The average number of eosinophils in the included patients was 418 cells/mL, and 33.8% of the included patients had vita- min D concentrations ≥20 ng/mL. Asthmatic patients with vitamin D< 20 ng/mL had a higher mean concentration of eosinophils than did asthmatic patients with vitamin D ≥20 ng/mL (464 ± 377.7 eosinophils/mL vs. 327.8 ± 247.2 eosinophils/mL, P = .025). We also observed that vitamin D was inversely correlated with eosinophil count (rho = 0.244, P = .003). In the multivariate analysis, vitamin D <20 ng/mL showed a significant inverse association with each cutoff value for eosinophilia (odds ratio >1). CONCLUSION: Vitamin D concentrations <20 ng/mL are associated with a significant increase in the number of eosinophils in blood. Studies that analyze the use of vitamin D supplements as complementary therapy for the treatment of asthma are needed.

Association Between Allergic Rhinitis and Asthma in Adults With Loss of Interest in Sex.

BACKGROUND: The alterations of sexual desire in allergy respiratory diseases have seldom been analyzed. This paper aims to evaluate the association of allergic rhinitis and asthma among adults with the loss of interest in sex. METHODS: Through a cross-sectional study, we compared three groups of subjects: one with patients with allergic rhinitis, another with allergic asthma, and a control group. The loss of interest in sex was assessed with the Beck Depression Inventory-II, which includes a scale that evaluates this characteristic. RESULTS: The prevalence of loss of interest in sex in patients with allergic asthma, allergic rhinitis, and controls was 48.8%, 39.5%, and 20.2%, respectively. In multivariate models, a positive association between a loss of interest in sex and allergic asthma (OR =2.4, p =0.005) and allergic rhinitis (OR =2.1, p =0.03) was found independently. In both models, other associated factors included being female (p <0.001) and living as a couple (p <0.001). In contrast, no significant association was found with age (≥40 years), smoking, alcohol consumption, physical activity, or excess weight. CONCLUSION: Loss of interest in sex is highly prevalent and is notoriously associated with allergic respiratory diseases; similarly, it is associated with living as a couple and being female.

Changes in the national prevalence of asthma and coronavirus disease 2019 fatality: A population-based cross-sectional study.

BACKGROUND: The coronavirus disease 2019 (COVID-19) mitigation and containment strategies implemented by each country can influence the prevalence of asthma and its fatality. OBJECTIVE: To analyze the trend of asthma prevalence and COVID-19 fatality in children and adults with asthma. METHODS: The prevalence of asthma and fatalities were compared among the peaks of 5 pandemic waves in Mexico. RESULTS: Among patients with COVID-19, the prevalence rates of asthma among children were as follows: wave I, 3.5%; wave II, 2.6%; wave III, 2.2%; wave IV, 2.4%; and wave V, 1.9% (P for trend < .001); the prevalence rates of asthma among adults were as follows: wave I, 2.5%; wave II, 1.8%; wave III, 1.5%; wave IV, 1.7%; and wave V, 1.6% (P for trend < .001). The rates of fatality because of COVID-19 among individuals with asthma were as follows: wave I, 8.9%; wave II, 7.7%; wave III, 5.0%; wave IV, 0.9%; and wave V, 0.2% (P for trend < .001). CONCLUSION: The prevalence rates of asthma and fatalities from COVID-19 suggest a gradual reduction throughout the pandemic in Mexico.

[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.

Is suicidal ideation associated with allergic asthma and allergic rhinitis?

OBJECTIVE: To investigate whether there is an association between suicidal ideation (SI) and allergic diseases in adults. METHODS: This was a comparative cross-sectional study involving individuals ranging from 20 to 50 years of age recruited from a university hospital in the city of Guadalajara, Mexico. We included patients with a confirmed diagnosis of allergic asthma, those with a confirmed diagnosis of allergic rhinitis, and healthy controls. All subjects completed the Beck Depression Inventory-II (BDI-II), which includes an item that evaluates the presence of suicidal thoughts or desires within the last two weeks, in order to identify SI. RESULTS: The sample comprised 115 patients with allergic asthma, 111 patients with allergic rhinitis, and 96 healthy controls. The number of individuals identified with SI in the three groups were, respectively, 17 (14.8%), 13 (11.7%), and 8 (8.3%). Regarding the presence of SI, no statistically significant association was found in the allergic asthma group (OR = 1.98; 95% CI: 0.78-4.64; p = 0.154) or in the allergic rhinitis group (OR = 1.46; 95% CI: 0.58-3.68; p = 0.424) when they were compared with the control group. However, the presence of depression was associated with SI in the three groups: allergic asthma (OR = 12.36; 95% CI: 2.67-57.15; p = 0.001); allergic rhinitis (OR = 6.20; 95% CI: 1.66-23.14; p = 0.006); and control (OR = 21.0; 95% CI: 3.75-117.36; p < 0,001). CONCLUSIONS: In comparison with the control group, no association was found between SI and the groups with allergic diseases. In contrast, there was association between SI and depression in the three groups.

Is suicidal ideation associated with allergic asthma and allergic rhinitis? / Ideação suicida apresenta associação com asma e rinite alérgicas?

ABSTRACT Objective: To investigate whether there is an association between suicidal ideation (SI) and allergic diseases in adults. Methods: This was a comparative cross-sectional study involving individuals ranging from 20 to 50 years of age recruited from a university hospital in the city of Guadalajara, Mexico. We included patients with a confirmed diagnosis of allergic asthma, those with a confirmed diagnosis of allergic rhinitis, and healthy controls. All subjects completed the Beck Depression Inventory-II (BDI-II), which includes an item that evaluates the presence of suicidal thoughts or desires within the last two weeks, in order to identify SI. Results: The sample comprised 115 patients with allergic asthma, 111 patients with allergic rhinitis, and 96 healthy controls. The number of individuals identified with SI in the three groups were, respectively, 17 (14.8%), 13 (11.7%), and 8 (8.3%). Regarding the presence of SI, no statistically significant association was found in the allergic asthma group (OR = 1.98; 95% CI: 0.78-4.64; p = 0.154) or in the allergic rhinitis group (OR = 1.46; 95% CI: 0.58-3.68; p = 0.424) when they were compared with the control group. However, the presence of depression was associated with SI in the three groups: allergic asthma (OR = 12.36; 95% CI: 2.67-57.15; p = 0.001); allergic rhinitis (OR = 6.20; 95% CI: 1.66-23.14; p = 0.006); and control (OR = 21.0; 95% CI: 3.75-117.36; p < 0,001). Conclusions: In comparison with the control group, no association was found between SI and the groups with allergic diseases. In contrast, there was association between SI and depression in the three groups.

RESUMO Objetivo: Investigar se existe associação entre ideação suicida (IS) e doenças alérgicas em adultos. Métodos: Estudo transversal comparativo envolvendo indivíduos com idade entre 20 e 50 anos recrutados em um hospital universitário da cidade de Guadalajara, México. Foram incluídos pacientes com diagnóstico confirmado de asma alérgica, aqueles com diagnóstico confirmado de rinite alérgica e controles saudáveis. Todos os sujeitos preencheram o Beck Depression Inventory-II (BDI-II), que inclui um item que avalia a presença de pensamentos ou desejos suicidas nas últimas duas semanas, a fim de identificar IS. Resultados: A amostra foi composta por 115 pacientes com asma alérgica, 111 pacientes com rinite alérgica e 96 controles saudáveis. O número de indivíduos identificados com IS nos três grupos foi de 17 (14,8%), 13 (11,7%) e 8 (8,3%), respectivamente. Quanto à presença de IS, não foi encontrada associação estatisticamente significativa no grupo asma alérgica (OR = 1,98; IC95%: 0,78-4,64; p = 0,154) ou no grupo rinite alérgica (OR = 1,46; IC95%: 0,58-3,68; p = 0,424) quando os mesmos foram comparados com o grupo controle. No entanto, a presença de depressão apresentou associação com IS nos três grupos: asma alérgica (OR = 12,36; IC95%: 2,67-57,15; p = 0,001); rinite alérgica (OR = 6,20; IC95%: 1,66-23,14; p = 0,006); e controle (OR = 21,0; IC95%: 3,75-117,36; p < 0,001). Conclusões: Em comparação com o grupo controle, não foi encontrada associação entre IS e os grupos com doenças alérgicas. Por outro lado, houve associação entre IS e depressão nos três grupos.

[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.

Rhinitis as an associated factor for anxiety and depression amongst adults / Rinite como fator associado para ansiedade e depressão entre adultos

Abstract Introduction: Anxiety and depression are frequent disorders of chronic diseases, yet there is no conclusive information to their association with rhinitis. Objective: The objective is to determine the frequency of anxiety and depression and its possible association to allergic rhinitis (AR) and non-allergic rhinitis (NAR). Methods: This is a cross-sectional study in which procured subjects with AR (n = 111), NAR (n = 34) and a control group (n = 96) from the university hospital. The presence of anxiety and depression was considered when it reached a score > 13 based on The Beck Anxiety Inventory Test and The Beck Depression Inventory II Test, respectively. The association between AR and NAR with anxiety and depression was adjusted with the Mantel-Haenszel Method and logistic regression. Results: The frequency for anxiety in AR, NAR and the control group was 45.9%, 52.9%, 10.4%, respectively (p < 0.001); depression frequency was 38.7%, 47.1%, 16.6% (p = 0.0003), respectively. Both AR and NAR were associated to anxiety and depression in women, but not to men. After adjusting the sex: AR was associated to anxiety (OR = 5.7, p < 0.001) and depression (OR = 2.5, p = 0.015), while NAR was also associated to anxiety (OR = 7.8, p < 0.001) and depression (OR = 3.3, p < 0.014). In multivariate analysis it was identified that AR, NAR and the individual's sex (women) were factors associated to anxiety and depression. Results showed that age was only associated to anxiety. Conclusion: AR and NAR are diseases associated to anxiety and depression, at least in women.

Resumo Introdução: Ansiedade e depressão são distúrbios frequentes em doenças crônicas, embora não haja informação conclusiva sobre sua associação com a rinite alérgica. Objetivo: Determinar a frequência de ansiedade e depressão e sua possível associação a rinite alérgica (RA) e rinite não alérgica (NRA). Método: Estudo transversal, no qual indivíduos com RA (n = 111), NRA (n = 34) e um grupo controle (n = 96) foram recrutados a partir do hospital universitário. A presença de ansiedade e depressão foi considerada quando atingiu uma pontuação > 13 no Teste do Inventário de Ansiedade de Beck e no Teste II do Inventário de Depressão de Beck, respectivamente. A associação entre a RA e RNA com ansiedade e depressão foi ajustada com o Método de Mantel-Haenszel e regressão logística. Resultados: A frequência de ansiedade na RA, RNA e grupo controle foi de 45,9%, 52,9%, 10,4%, respectivamente (p < 0,001); a frequência de depressão foi de 38,7%, 47,1%, 16,6% (p = 0,0003), respectivamente. Tanto a RA como a RNA foram associadas a ansiedade e depressão em mulheres, mas não para os homens. Depois de ajustar o sexo: RA foi associada à ansiedade (OR = 5,7, p < 0,001) e depressão (OR = 2,5, p = 0,015), enquanto a RNA foi associada a ansiedade (OR = 7,8, p < 0,001) e depressão (OR = 3,3, p < 0,014). Na análise multivariada identificou-se que a RA, RNA e o sexo do indivíduo (mulheres) foram fatores associados a ansiedade e depressão. Os resultados mostraram que a idade só foi associada à ansiedade. Conclusão: RA e RNA são doenças associadas a ansiedade e depressão, pelo menos em mulheres.

[Prevalence of vitamin D insufficiency and deficiency in Mexican adults with allergic asthma]. / Prevalencia de insuficiencia y deficiencia de vitamina D en adultos mexicanos con asma alérgica.

BACKGROUND: Hypovitaminosis D has been associated with various chronic diseases such as infections, autoimmune diseases, chronic obstructive pulmonary disease, cancer and asthma Objective: The objective at hand is to determine the prevalence of vitamin D (VD) insufficiency and deficiency in adults with allergic asthma. OBJECTIVE: Objective: The objective at hand is to determine the prevalence of vitamin D (VD) insufficiency and deficiency in adults with allergic asthma. METHODS: Through a cross-sectional study, we analyzed corresponding data amongst 135 patients. VD concentration was categorized as sufficient (≥ 30 ng/mL), insufficient (21-29 ng/mL), and deficient (≤ 20 ng/mL). The level of VD deficiency was measured through chemo-luminescence. We estimated the prevalence of VD alterations and their respective confidence intervals at 95 % (CI 95 %). RESULTS: Within the analyzed population, there were 99/135 women (73.3 %); the mean age was 34.5 ± 10.3 years. The mean concentration of VD was 17.9 ± 6.9 ng/mL and the median was 17 ng/mL. The prevalence of VD insufficiency and deficiency was 25.2 % (CI 95 %, 18.6-33.2 %) and 71.1 % (CI 95 %, 62.9-78.1 %), respectively; VD concentrations ≤ 10 ng/mL had 13.3 % (CI 95 %, 8.5-20.2 %) and ≥ 30 ng/mL at 3.7 % (CI 95 %: 1.4-8.6 %). When we contrasted the men to the women, the median concentration of VD did not differ significantly (16 ng/mL vs. 18 ng/mL, p = 0.71). CONCLUSION: In this study, patients with allergic asthma had distinctively reduced VD concentration levels; future research will determine if and how VD affects the severity of asthma.

Antecedentes: La hipovitaminosis D ha sido asociada con diversas enfermedades crónicas como infecciones, enfermedades autoinmunes, enfermedad pulmonar obstructiva crónica, cáncer y asma. Objetivo: Determinar la prevalencia de insuficiencia y deficiencia de vitamina (VD) en adultos con asma alérgica. Métodos: Estudio transversal en el que se analizaron los datos de 135 pacientes. La concentración de VD fue categorizada en suficiente (≥ 30 ng/mL), insuficiente (21-29 ng/mL) y deficiente (≤ 20 ng/mL). La concentración de VD se midió por quimioluminiscencia. Se estimaron las prevalencias de las alteraciones de la VD y sus respectivos intervalos de confianza a 95 % (IC 95 %). Resultados: En la población analizada, 99 fueron mujeres (73.3 %), con edad media de 34.5 ± 10.3 años. La concentración media de VD fue 17.9 ± 6.9 ng/mL (mediana de 17 ng/mL). La prevalencia de insuficiencia y deficiencia de VD fue de 25.2 % (IC 95 %, 18.6-33.2 %) y 71.1 % (IC 95 %, 62.9-78.1 %), respectivamente; las concentraciones de VD ≤ 10 ng/mL representaron 13.3 % (IC 95 %, 8.5-20.2 %) y ≥ 30 ng/mL, 3.7 % (IC 95 %, 1.4-8.6 %). Al contrastar hombres y mujeres, la concentración mediana de VD no difirió significativamente (16 ng/mL versus 18 ng/mL, p = 0.71). Conclusiones: En este estudio, los pacientes con asma alérgica tuvieron concentraciones de VD notoriamente disminuidas. Con futuras investigaciones se podrá evaluar el papel de la VD en la gravedad del asma.

[High prevalence of food sensitization among adults with allergic diseases who live in the Guadalajara metropolitan area]. / Alta prevalencia de sensibilización a alimentos en adultos con enfermedades alérgicas residentes en la zona metropolitana de Guadalajara.

BACKGROUND: The prevalence of food sensitization in adults shows differences owing to geographic, regional and cultural circumstances. OBJECTIVE: To identify the prevalence and factors associated with food sensitization in adults with allergic diseases. METHODS: Cross-sectional study, where medical records of adult patients with any allergic disease and who tested positive to airborne allergens on at least one skin test were reviewed. Age, sex, underlying allergic disease and skin test result were recorded. Statistical analyses included food sensitization prevalence with the corresponding 95 % confidence intervals (CI), as well as a multivariate analysis to determine associated factors. RESULTS: We included 258 patients with a mean of 36 years of age; 75 % were of the female sex. The most common underlying condition was allergic rhinitis (59 %). The prevalence of food sensitization was 37 % (95 % CI, 31.5-43.3) and it did not vary significantly according to sex or allergic disease in question. The most sensitizing food was soybeans (44.8 %), and associated factors were sensitization to cat dander (OR = 1.8; 95 % CI, 1.03-3.2) and 5 or more positive skin tests (OR = 4.3, 95 % CI 2.3-8.1). CONCLUSION: The prevalence of food sensitization in people with allergic disease was 40 %. Further studies are required to determine its prevalence in the general population.

Antecedentes: La prevalencia de sensibilización a alimentos en adultos presenta diferencias debido a las condiciones geográficas, regionales y culturales. Objetivo: Identificar la prevalencia y los factores asociados a la sensibilización a alimentos en adultos con alguna enfermedad alérgica. Métodos: Estudio transversal en el que se revisaron los expedientes clínicos de adultos con alguna enfermedad alérgica que presentaron al menos una prueba cutánea positiva a aeroalérgenos. Se registró edad, sexo, enfermedad alérgica de base y resultado de la prueba cutánea. El análisis es-tadístico incluyó prevalencia de sensibilización a alimentos e intervalos de confianza (IC) de 95 %, así como análisis multivariado para determinar los factores asociados. Resultados: Se incluyeron 258 pacientes con edad media de 36 años; 75 % fue del sexo femenino. La enfermedad de base más frecuente fue la rinitis alérgica (59 %). La prevalencia de sensibilización a alimentos fue de 37 % (IC 95 %, 31.5-43.3) y no varió significativamente según sexo o enfermedad alérgica. El alimento más sensibilizante fue la soya (44.8 %) y los factores asociados, la sensibil-ización al epitelio de gato (OR = 1.8; IC 95 %, 1.03-3.2) y 5 o más pruebas cutáneas positivas (OR = 4.3; IC95 %, 2.3-8.1). Conclusiones: La prevalencia de sensibilización a alimentos en personas con enfermedad alérgica fue de 40 %; para determinarla en la población general se requieren estudios adicionales.

Rhinitis as an associated factor for anxiety and depression amongst adults.

INTRODUCTION: Anxiety and depression are frequent disorders of chronic diseases, yet there is no conclusive information to their association with rhinitis. OBJECTIVE: The objective is to determine the frequency of anxiety and depression and its possible association to allergic rhinitis (AR) and non-allergic rhinitis (NAR). METHODS: This is a cross-sectional study in which procured subjects with AR (n=111), NAR (n=34) and a control group (n=96) from the university hospital. The presence of anxiety and depression was considered when it reached a score>13 based on The Beck Anxiety Inventory Test and The Beck Depression Inventory II Test, respectively. The association between AR and NAR with anxiety and depression was adjusted with the Mantel-Haenszel Method and logistic regression. RESULTS: The frequency for anxiety in AR, NAR and the control group was 45.9%, 52.9%, 10.4%, respectively (p<0.001); depression frequency was 38.7%, 47.1%, 16.6% (p=0.0003), respectively. Both AR and NAR were associated to anxiety and depression in women, but not to men. After adjusting the sex: AR was associated to anxiety (OR=5.7, p<0.001) and depression (OR=2.5, p=0.015), while NAR was also associated to anxiety (OR=7.8, p<0.001) and depression (OR=3.3, p<0.014). In multivariate analysis it was identified that AR, NAR and the individual's sex (women) were factors associated to anxiety and depression. Results showed that age was only associated to anxiety. CONCLUSION: AR and NAR are diseases associated to anxiety and depression, at least in women.

[Features of Guillain-Barre syndrome in adults: results of a university hospital]. / Características del síndrome de Guillain-Barré en adultos: resultados de un hospital universitario.

BACKGROUND: Guillain-Barré syndrome (GBS) has a cosmopolitan distribution. Its course is usually mild and tends to limit itself, but in severe cases it can cause death. The aim of this article is to describe the characteristics of a group of adults with GBS diagnosed and treated at a university hospital. METHODS: All cases of GBS that occurred between January 1, 2005 to December 31, 2009 were analyzed. The clinical records were reviewed through the implementation of a structured survey that included the following sections: patient identification, clinical data, history of infection, season of occurrence, rates of electrophysiological variants, and lethality. RESULTS: A total of 45 patients were included; the male to female ratio was 1.4: 1 and the mean age was 48.2 ± 16.0 years. The season with the highest number of cases was the summer. History of intestinal infection was present in 40 % of patients, and respiratory infection in 24.4%. The lethality associated with GBS was 11.1 % (95 % CI, 4.4-23.9), fatal cases occurred in patients older than the survivors (65.2 ± 15.0 versus 46.0 ± 14.9, p = 0.01). The most common variant was acute motor axonal neuropathy (64.4 %); there were four cases of Miller Fisher syndrome. CONCLUSIONS: The most common electromyographic variant of GBS was acute motor axonal neuropathy. The highest number of cases was observed during the summer season.

Introducción: el Síndrome de Guillain-Barré (SGB) tiene una distribución cosmopolita. Usualmente su curso es benigno y tiende a autolimitarse, pero en casos severos puede ocasionar la muerte. El objetivo de este artículo es describir las características de un grupo de adultos con SGB diagnosticados y tratados en un hospital universitario. Métodos: se analizaron todos los casos de SGB ocurridos del 1 de enero de 2005 al 31 de diciembre de 2009. Se revisaron los expedientes clínicos a través de la aplicación de una cédula estructurada que comprendió las siguientes secciones: identificación del paciente, datos clínicos, historia de infección, estación del año de ocurrencia, tipos de variantes electrofisiológicas y letalidad. Resultados: en total se incluyeron 45 pacientes; la relación hombre-mujer fue de 1.4:1 y la edad media del grupo fue 48.2 ± 16.0 años. La estación del año con mayor número de casos fue el verano. La historia de infección intestinal estuvo presente en 40 % de los pacientes, y la infección respiratoria en 24.4 %. La letalidad asociada con SGB fue de 11.1 % (IC: 95 %, 4.4-23.9), los casos fatales se presentaron en los pacientes con mayor edad que los que sobrevivieron (65.2 ± 15.0 frente a 46.0 ± 14.9, p = 0.01). La variante más frecuente fue la neuropatía axonal motora aguda (64.4 %); hubo cuatro casos de síndrome de Miller Fisher. Conclusiones: la variante electromiográfica más frecuente del SGB fue la neuropatía axonal motora aguda. Se observó mayor número de casos durante la estación de verano.

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.

Asthma in late adolescents of Western Mexico: prevalence and associated factors.

INTRODUCTION: Given the number of changes that occur during late adolescence, it is possible that the behavior of asthma may also be different. The aim of our paper is to determine the prevalence of asthma in a population of late adolescents and its possible association with obesity, tobacco smoke exposure and family history of allergic disease. METHODS AND SUBJECTS: In a cross-sectional, population-based analytical study design, we selected a stratified random sample of subjects aged 15 to 18. By modeling risk through logistic regression, we assessed the relationship between asthma and the following covariables: gender, obesity, excess weight, family history of allergic disease and tobacco smoke exposure. RESULTS: 1,600 subjects were included, and the following prevalences were identified: asthma 7.8%, obesity 9.6%, active smoking in the father 2 9.8%, active smoking in the mother 18.6% and active smoking habit in the study subjects 15.1%. In the final model, a significant association was found between asthma and the following variables: 1) asthma in the mother (adjusted OR [aOR]=2.95, 95% CI, 1.55 to 5.6); 2) history of allergic rhinitis (aOR=4.66, 95% CI, 2.63 to 8.25); and 3) male sex (aOR=1.48, 95% CI, 1.02 to 2.15). No association was seen with obesity or tobacco smoking of the parents. CONCLUSION: Our results suggest that maternal history of asthma, personal history of allergic rhinitis and male sex are related with asthma late adolescence, while smoking and being overweight are not.

[Spontaneus pneumomediastinum associated with exacerbation of asthma during the epidemic of influenza A H1N1: Inform of four cases]. / Neumomediastino espontáneo asociado a exacerbación del asma durante la epidemia de influenza A H1N1; informe de cuatro casos.

Spontaneus pneumomediastinum (SP) is an infrequent but usually benign pathology. Its main clinical manifestations are thoracic pain, dyspnea and subcutaneous emphysema. We describe the clinical findings of 4 SP patients, identified in the context of an A H1N1 influenza virus epidemic. All the patients were young and all of them required initial medical attention for asthma exacerbation. The most frequent symptoms and signs to detect SP were cervical pain and subcutaneous emphysema; chest radiography helped to confirm the diagnosis. Concomitant A H1N1 influenza virus infection was documented in two patients. The treatment was focused in the basic pathology; two patients were placed on oseltamivir, whereas the two others just had expectant management.