Allergic sensitization profiles among the foreign-born population in the north of Madrid.

Summary: Background. We assessed differences in allergic sensitization and clinical characteristics in a foreign-born population. Methods. Prospective, observational, descriptive study of patients aged > 12 years who were seen at the Department of Allergy, La Paz Hospital (Madrid, Spain), between January 2017 and December 2018. Patients were classified by geographical origin and ethnicity. Results. We included 150 patients (110 female) with a mean age of 38.38 years. Mean time to onset of respiratory symptoms after immigration was 8.47 years. Significant differences were observed between ethnic groups (p = 0.007). The most frequent sensitization was to grass pollen (75.2%), which was more common in South American patients (p = 0.005). We found that 59% of patients were sensitized to Cupressus and Olea pollen (higher in Asian patients, p = 0.032 and p = 0.049). Conclusions. Allergic sensitization in the foreign-born population was similar to that of the autochthonous population although differences between the groups were identified.

Asthma Exacerbations in the Pediatric Emergency Department at a Tertiary Hospital: Association With Environmental Factors.

INTRODUCTION: Children with asthma experience recurrent respiratory symptoms and exacerbations due to multiple environmental factors. The aim of this study was to describe the prevalence and triggers of asthma exacerbations and their management in a cohort of pediatric patients attended in an emergency department (ED). METHODS: We performed an observational, retrospective, single-center study in the pediatric ED of Hospital Universitario La Paz, Madrid, Spain in 2015. Children with asthma exacerbations attending the ED were included after a thorough search using our institutional computer database. Pollen and atmospheric mold spore counts and pollution data were collected for that period from official websites. Multiple logistic regression was used to assess the association between daily pollution (NO2, PM10, ozone, pollen, and molds) and admissions to the ED because of asthma. RESULTS: During 2015, a total of 50 619 patients were attended in the ED of our hospital. Of these, 2609 (5%) were diagnosed with asthma exacerbation/bronchospasm. The patient had to be admitted to hospital in 21.7% of cases. The main triggers of asthma exacerbations were respiratory infection in 1841 cases (70.6%). A significant correlation was found between grass pollen counts and ED admissions (P<.0001). A positive correlation was also found between ED admissions and NO2 0.58 (95%CI, 0.02-0.87) and PM10 0.75 (95%CI, 0.31-0.93) (P<.05). CONCLUSION: Environmental factors such as grass pollen counts and pollution (NO2 and PM10) are associated with a higher frequency of admission to the ED.

Anaphylaxis in Adolescent/Adult Patients Treated in the Emergency Department: Differences Between Initial Impressions and the Definitive Diagnosis.

OBJECTIVES: To contrast the initial suspected etiology of anaphylaxis with the postworkup diagnosis in patients attended at the emergency department (ED) of a tertiary-level hospital in Spain and to investigate the incidence, causes, and management of anaphylaxis. METHODS: We performed an observational study of patients aged more than 15 years who came to the ED with anaphylaxis between 2009 and 2010. All clinical records from the ED were reviewed. We recorded data on clinical management, the etiology proposed by the attending emergency physician, and the cause reported by the patient. The findings were compared with the diagnosis reached after the allergy workup. RESULTS: The incidence of anaphylaxis was 0.08%. The most common manifestation was skin-mucosal symptoms (98.3%). Anaphylaxis was diagnosed in the ED in only 44% of the cases, regardless of severity. Only 39.7% received epinephrine, which was administered more frequently when the ED physician diagnosed anaphylaxis, regardless of severity. A total of 60 patients were subsequently seen at the allergy department. The final etiology differed from the initial suspicion in the ED in 45% of cases. The frequency of anaphylaxis of uncertain origin decreased from 33.3% to 13.3%. After the allergy workup, drugs (41.7%) were considered the main cause of anaphylaxis, followed by food (25%). CONCLUSIONS: The incidence of anaphylaxis (0.08%) was double that estimated in the ED. Anaphylaxis is underdiagnosed. A correct diagnosis conditions the administration of epinephrine, regardless of the severity of symptoms. The real etiology of anaphylaxis should only be proposed after an allergy workup, which is recommended in all cases, as the real cause can differ considerably from the initial impression in the ED.

[Being a nurse today]. / Ser enfermera hoy.

This article was presented as a conference in Soria as part of the celebration of International Nursing Day 2000. The topic of this conference was the contribution Florence Nightingale made to the definition of the real essence of the nursing profession, and its evolution over the course of the century. The author included a discussion of these topics: What do nurses want? What do business managers want? What does society want and need? Finally, the author concluded that nursing is a lively profession which has tremendous desires to improve itself.

[Oto-cranio-facial syndromes with asymmetrical involvement of the face]. / Síndromes otocraneofaciales con afectación asimétrica de la cara.

Four cases otocraniumfacial syndromes with asymmetrical affectation of the face are presented. Clinic, radiologic and genetic studies are made. Authors comment the difference between Goldenhar's syndrome and hemifacial microsomia. Finally the etiopathogenic thesis, differential diagnostics and treatment are commented.

[Hypochondroplasia: an effected family presentation (author's transl)]. / Hipocondroplasia. Presentación de una familia con varios miembros afectados

A family suffering from hypochondroplasia in which father, mother and offspring are affected and in whose family tree various probably affected members are found on both sides, according to a pattern of autosomic dominant heritage is presented. The difficulty of diagnosis is discussed, not only in the first years of life but also later on, and in mild or moderate forms, which may in part explain the few cases reported in the literature.

[Familial blepharophimosis (author's transl)]. / Blefarofimosis familiar

A typical case of familial blepharophimosis is reported. The genealogical tree is reviewed up to the third generation, finding a total of seven affected individuals, 40% of the studied patients. A nervous pattern in the E.N.G. of the facial nerve was found and its possible implication in the genesis of the facial features is discussed. In the genetic study, there was a normal cariotype, and in the genealogical tree a dominant autosomic transmission, without any evident difference in the transmission related to the primitively involved sex was observed.

[Early appearing neurofibromatosis (author's transl)]. / Neurofibromatosis de aparición precoz. Nuestra casuística

Six cases of neurofibromatosis in children under seven years of age with other members of the family affected are reported. Mental retardation was observed in five patients, and one had convulsive crises. Growth and bone maturation retardation, without HGH deficiency after glucagon stimulation were observed.