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1.
Sensors (Basel) ; 22(8)2022 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-35459037

RESUMO

The high impact of air quality on environmental and human health justifies the increasing research activity regarding its measurement, modelling, forecasting and anomaly detection. Raw data offered by sensors usually makes the mentioned time series disciplines difficult. This is why the application of techniques to improve time series processing is a challenge. In this work, Singular Spectral Analysis (SSA) is applied to air quality analysis from real recorded data as part of the Help Responder research project. Authors evaluate the benefits of working with SSA processed data instead of raw data for modelling and estimation of the resulting time series. However, what is more relevant is the proposal to detect indoor air quality anomalies based on the analysis of the time derivative SSA signal when the time derivative of the noisy original data is useless. A dual methodology, evaluating level and dynamics of the SSA signal variation, contributes to identifying risk situations derived from air quality degradation.


Assuntos
Poluentes Atmosféricos , Poluição do Ar em Ambientes Fechados , Poluição do Ar , Poluentes Atmosféricos/análise , Poluição do Ar/análise , Poluição do Ar em Ambientes Fechados/análise , Monitoramento Ambiental/métodos , Previsões , Humanos
2.
Int Endod J ; 54(3): 454-463, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33063865

RESUMO

AIM: To evaluate the current situation of undergraduate endodontic teaching in Spanish dental schools. METHODOLOGY: An online version, translated into Spanish, of a survey conducted in the UK (Int Endod J 52, 2019, 1077) was sent via email to the undergraduate endodontic programme leads in all 23 Spanish dental schools. RESULTS: The response rate was 96%. In 95% of dental schools, endodontics is taught in the fourth year. Students treat simple root canal treatment cases in 100% of schools and only in 40% treat moderate cases. In 65% of schools, students are supervised by full-time professors who are specialists in Endodontics, significantly more frequently in private dental schools (P = 0.002). Spanish dental schools use both rotary and reciprocating instrumentation systems during endodontic training, with consistency on methods of working length determination, use of silicate-based endodontic cements, irrigating solutions, inter-visit medicaments and canal filling techniques. No type of magnification is used in 90% of dental schools, and only 25% use ultrasonic instruments. Private dental schools have a significantly better staff: student ratio during clinical practice (P = 0.041), spend significantly more hours in clinical training (P = 0.04) and have significantly greater number of clinical areas specifically dedicated to Endodontics (P = 0.010). CONCLUSIONS: Undergraduate endodontic teaching in Spanish dental schools follows the key recommendations of the ESE Undergraduate Curriculum Guidelines (Int Endod J 46, 2013, 1105), being, in most respects, comparable to that carried out in the UK (Int Endod J 52, 2019, 1077). The use of magnification and ultrasonic instruments needs to be increased. Private schools reported better results than public schools in some of the variables that were analysed.


Assuntos
Endodontia , Educação em Odontologia , Humanos , Faculdades de Odontologia , Espanha , Estudantes , Inquéritos e Questionários
3.
Med Oral Patol Oral Cir Bucal ; 26(2): e208-e215, 2021 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-32851982

RESUMO

BACKGROUND: Previous studies have linked apical periodontitis (AP) to inflammatory bowel disease (IBD). The aim of this study was to compare the prevalence of AP and root canal treatment (RCT) in patients with ulcerative colitis (UC) and Crohn´s disease (CD). MATERIAL AND METHODS: A cross-sectional study, including 28 patients with Crohn´s disease and 26 with ulcerative colitis, was conducted. AP was diagnosed as radiolucent periapical lesions (RPLs), using the periapical index score (PAI). Student's t test, 2 test and multivariate logistic regression were used in the statistical analysis. RESULTS: Multivariate logistic regression run with age, gender, number of teeth, number of RFT, periodontal disease and the type of IBD as covariates, taking as dependent variable and outcome "periapical status" (0 = no tooth with RPL; 1 = at least one tooth with RPL), showed that both UC and CD patients had the prevalence apical periodontitis (OR = 1.03; C.I. 95% = 0.25 - 4.31; p = 0.97). The multivariate analysis, including all the above covariates, shows that both in UC and CD patients the prevalence of RCT was similar (OR = 0.76; C.I. 95% = 0.17 - 7.31; p = 0.73). Periapical status was significantly associated with endodontic status (OR = 42.72; C.I. 95% = 3.87 - 472.15; p = 0.002), regardless of IBD type. CONCLUSIONS: The results of the present study show similar frequency of AP and RFT in both UC and CD patients. The type of IBD does not appear to affect the prevalence of radiographically detectable periapical lesions or the prevalence of root canal treatment.


Assuntos
Colite Ulcerativa , Doença de Crohn , Periodontite Periapical , Colite Ulcerativa/complicações , Colite Ulcerativa/epidemiologia , Doença de Crohn/complicações , Doença de Crohn/epidemiologia , Estudos Transversais , Humanos , Periodontite Periapical/epidemiologia , Prevalência , Tratamento do Canal Radicular
4.
Exp Parasitol ; 209: 107825, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31877275

RESUMO

Ciliate ectoparasites are one of the most important groups of pathogens in fish culture, and the traditional treatments are sometimes harmful to the fish and the environment. Thus, the search for novel compounds that are effective at low concentrations and safe for fish are necessary to optimise treatments in aquaculture. The antiprotozoal capacity of silver nanoparticles (AgNPs) against the ciliate Tetrahymena has been documented; however, their toxicity may vary with the synthesis methodology and nanoparticle size. The objectives of this study were a) to evaluate the acute toxicity in vitro of two AgNPs (Argovit™ and UTSA) on Tetrahymena sp., a biological model for ciliated ectoparasites of fish and b) to test the safety of lethal and higher doses of UTSA AgNPs for ciliates on the fish C. estor. Light microscopy and scanning electron microscopy (SEM) were used to determine whether AgNPs affected the structure of the cell surface of Tetrahymena. The mortality, histopathological alterations and metagenomics of the fish were used to determine the major effects of UTSA AgNPs. In Tetrahymena, the median lethal concentration (LC50) for Argovit™ was 2501 ± 1717 ng/L at 15 min and 796 ± 510 ng/L at 60 min, while the LC50 for UTSA AgNPs was 4 ± 2 and 1 ± 0.6 ng/L at 15 min and 60 min, respectively. A concentration of 3300 ng/L Argovit™ and 10.6 ng/L UTSA AgNPs for 15 and 60 min, respectively, was 100% effective against Tetrahymena. After 60 min of exposure to 0.25 and 0.50 ng/L UTSA AgNPs, the number of cilia significantly reduced, there were small holes on the cell surface, and the cellular membrane was ruptured. In fish exposed to lethal (10.6 ng/L) and higher (31.8 and 95.4 ng/L) doses of UTSA, the AgNPs did not affect fish survival after 96 h, and there were no signs of histopathological damage or gut microbial changes. This study is the first report on microscopic and ultrastructural changes in Tetrahymena after exposure to significantly low concentrations of UTSA AgNPs with antiprotozoal efficacy without evidence of harmful effects on fish. These results provide the basis for further studies of both pet aquarium and commercial fish that may validate these findings at a larger experimental scale, taking into account AgNPs bioaccumulation, safety for human consumption and environmental impact.


Assuntos
Ectoparasitoses/veterinária , Doenças dos Peixes/tratamento farmacológico , Nanopartículas Metálicas/toxicidade , Prata/farmacologia , Tetrahymena/efeitos dos fármacos , Animais , Aquicultura , Ectoparasitoses/tratamento farmacológico , Ectoparasitoses/parasitologia , Doenças dos Peixes/parasitologia , Peixes , Água Doce , Microbioma Gastrointestinal , Humanos , Dose Letal Mediana , Metagenômica , Nanopartículas Metálicas/química , Microscopia Eletrônica de Varredura/veterinária , Prata/química , Prata/toxicidade , Tetrahymena/ultraestrutura
5.
Int Endod J ; 53(4): 447-454, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31691312

RESUMO

AIM: To investigate whether dental anxiety influences the intraoperative pain felt by patients during root canal treatment. METHODOLOGY: In a cross-sectional design, 180 patients (90 men and 90 women) were included. Pre-operative anxiety levels were assessed using the short-form Dental Anxiety Inventory (S-DAI). Pain during root canal treatment was evaluated using a 10-cm visual analogue scale (VAS) that ranked the level of pain between 'Absence of pain' and 'Unbearable pain'. The minimal sample size was determined using the software of the National Center for Advancing Translational Sciences (NIH, UK). Multivariate logistic regression analysis was used to identify relationships between variables. RESULTS: Mean pain level during root canal treatment was 2.2 ± 2.1. The mean anxiety S-DAI score was 27.2 ± 12.5. Fifty percent of men had mild anxiety levels, while in 70% of women anxiety was moderate or high (P = 0.017). Anxiety correlated positively with intraoperative pain (R = 0.406). Multivariate logistic regression analysis revealed that anxiety was significantly associated with intraoperative pain felt by patients (OR = 4.0; 95% C.I. = 1.7-9.3; P = 0.001). CONCLUSIONS: Anxious patients were more than twice as likely to feel moderate or intense intraoperative pain during root canal treatment. To know the patient´s degree of anxiety could help the dentist to decide whether to use anxiolytic premedication and/or supplemental local anaesthesia to assure better control of pain during root canal treatment.


Assuntos
Ansiedade ao Tratamento Odontológico , Cavidade Pulpar , Estudos Transversais , Feminino , Humanos , Masculino , Dor , Tratamento do Canal Radicular
6.
Med Oral Patol Oral Cir Bucal ; 25(5): e652-e659, 2020 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-32388515

RESUMO

BACKGROUND: Several studies published in the last two decades have found an association between the prevalence of apical periodontitis (AP) or root canal treatment (RCT) and cardiovascular diseases (CVDs). However, the demonstration of association does not prove by itself the existence of a cause-effect relationship. Two diseases can appear as statistically related without any of them directly affecting the values of the other, resulting in a non-causal relationship. The aim of this narrative review is to summarize the current state of knowledge regarding the association between AP and CVDs, analysing it according to the Hill's causality criteria. MATERIALS AND METHODS: Epidemiological studies carried out on the association between CVDs and AP or RCT published in English until 8 December 2019 were identified. Forty-four articles were selected and its results were analysed. RESULTS: Numerous cross-sectional epidemiological studies have found significant relationship between CVDs and AP. The odds ratio values range 1.6 - 5.4. However, other studies have not found significant association. Respect to RCT, some studies found correlation, but others found no association or even found that RCT is a protective factor against CVDs. CONCLUSIONS: The results are inconsistent and a causal relationship between CVDS and endodontic disease cannot be stablished. The risk factors common to both diseases can act as confounding factors, biasing the results. To reach definitive conclusions about the type of association (causal or non-causal) between both diseases, longitudinal epidemiological studies must be carried out to establish the temporal relationship and the dose-response gradient.


Assuntos
Doenças Cardiovasculares , Periodontite Periapical , Estudos Transversais , Humanos , Fatores de Risco , Tratamento do Canal Radicular
7.
Int Endod J ; 52(6): 790-802, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30667519

RESUMO

Endodontic Medicine has gained more attention and is becoming a more important issue in Endodontics. As an example, more than one hundred articles on this topic have been published in the last eight years. Several of these studies have found an association between endodontic variables, that is the prevalence of apical periodontitis, the prevalence of root canal treatment (RCT) and the outcome of RCT assessed as root filled teeth (RFT) with radiolucent periapical lesions (RPL) or non-retained RFT, and several systemic diseases, such as diabetes, cardiovascular disease, smoking habits, osteoporosis, inherited coagulopaties, biological medications, low birth weight or physical fitness. However, the demonstration of association does not prove by itself the existence of a cause-effect relationship. Two variables can be related statistically to each other without either variable directly affecting the values of the other thus resulting in a non-causal relationship. Causality is assumed when one variable is shown to contribute to the development of the other, and its removal is shown to reduce the frequency of disease. Therefore, once a significant statistical association has been found between two variables, it is necessary to exclude the presence of bias, which would imply that the association is artefactual, and to analyse if the causation criteria defined by Hill (Proceedings of the Royal Society of Medicine 1965; 58: 295-300) are fulfilled to establish a causal relationship. Only if they are satisfied, can it be concluded that the association is causal. The aim of this study was to analyse the difference between association and causation, applying the criteria of causality to the specific case of the association between endodontic disease and diabetes mellitus.


Assuntos
Diabetes Mellitus , Endodontia , Periodontite Periapical , Humanos , Obturação do Canal Radicular , Tratamento do Canal Radicular
8.
Int Endod J ; 52(3): 297-306, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30168851

RESUMO

Previous studies have found an association between the outcome of root canal treatment (RCT) and diabetic status. This systematic review and meta-analysis aimed to analyse the potential relationship between diabetes and the occurrence of extracted root filled teeth (RFT). The clinical PICO question was as follows: in adult patients with RFT, does the absence or presence of diabetes influence the prevalence of RFT extraction? The key words used in the systematic search were as follows: (Diabetes OR Diabetes Mellitus OR Hyperglycaemia OR Diabetic) AND (Endodontic OR Endodontics OR Endodontic Treatment OR Root Canal Treatment OR Root Canal Preparation OR Root Canal Therapy OR Root Filled Teeth OR Endodontically Treated Teeth) AND (Extraction OR Retention OR Survival OR Success OR Failure OR Outcome). The primary outcome variable was odds ratio (OR) for the frequency of extracted RFT in diabetics and healthy subjects. The method of DerSimonian-Laird with random effects was used to calculate the overall OR. Three hundred titles were identified, and three studies achieved the inclusion criteria. Data from 54 936 root canal treatments, 50 301 in nondiabetic control subjects and 4635 in diabetic patients, were analysed. The calculated overall odds ratio (OR = 2.44; 95% CI = 1.54-3.88; P = 0.0001) implies that diabetics had a significantly higher prevalence of extracted RFT than healthy nondiabetic subjects. The results of available studies indicate a significant relationship between DM and increased frequency of nonretained root filled teeth. Diabetes mellitus should be considered an important preoperative prognostic factor in root canal treatment.


Assuntos
Diabetes Mellitus , Periodontite Periapical/complicações , Periodontite Periapical/cirurgia , Tratamento do Canal Radicular , Extração Dentária , Dente não Vital , Adulto , Humanos , Fatores de Risco
9.
Clin Oral Investig ; 23(3): 1161-1170, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29967975

RESUMO

BACKGROUND AND OBJECTIVE: Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis have been frequently isolated in periodontitis patients in Morocco. Its persistence after the subgingival debridement of the biofilm has been correlated with worse clinical outcomes. The aim of this study was to evaluate the antimicrobial susceptibilities of A. actinomycetemcomitans and P. gingivalis, to amoxicillin, amoxicillin plus clavulanate, metronidazole, and azithromycin. In addition, microbiological profiles of patients harbouring A. actinomycetemcomitans, P. gingivalis, or both were compared. MATERIAL AND METHODS: In 45 consecutive periodontitis Moroccan patients, subgingival samples were taken and processed by culture. Twenty-four A. actinomycetemcomitans and 30 P. gingivalis colonies were isolated (54 strains) and susceptibility tests, using the epsilometric method, were run for amoxicillin, amoxicillin plus clavulanate, metronidazole, and azithromycin. Minimum inhibitory concentrations for 50 (MIC50) and 90% (MIC90) of the organisms were calculated. RESULTS: The prevalence of A. actinomycetemcomitans and P. gingivalis was 79.5 and 84.4%, respectively. A. actinomycetemcomitans showed susceptibility to amoxicillin, amoxicillin plus clavulanate, while 28% of the isolated strains were resistant to azithromycin and 61.7% towards metronidazole. No P. gingivalis resistance towards amoxicillin, amoxicillin plus clavulanate, metronidazole, and azithromycin was found. CONCLUSION: A. actinomycetemcomitans and P. gingivalis were frequently detected in Moroccan patients with periodontitis, while antimicrobial resistance was only detected for A. actinomycetemcomitans to metronidazole and azithromycin. CLINICAL RELEVANCE: A. actinomycetemcomitans resistance against some antimicrobials in periodontitis patients in Morocco can influence the selection of the therapeutic approaches.


Assuntos
Periodontite , Porphyromonas gingivalis , Aggregatibacter actinomycetemcomitans , Anti-Infecciosos , Humanos , Marrocos
10.
Sensors (Basel) ; 19(20)2019 Oct 17.
Artigo em Inglês | MEDLINE | ID: mdl-31627443

RESUMO

Physiological sensors can be used to detect changes in the emotional state of users with affective computing. This has lately been applied in the educational domain, aimed to better support learners during the learning process. For this purpose, we have developed the AICARP (Ambient Intelligence Context-aware Affective Recommender Platform) infrastructure, which detects changes in the emotional state of the user and provides personalized multisensorial support to help manage the emotional state by taking advantage of ambient intelligence features. We have developed a third version of this infrastructure, AICARP.V3, which addresses several problems detected in the data acquisition stage of the second version, (i.e., intrusion of the pulse sensor, poor resolution and low signal to noise ratio in the galvanic skin response sensor and slow response time of the temperature sensor) and extends the capabilities to integrate new actuators. This improved incorporates a new acquisition platform (shield) called PhyAS (Physiological Acquisition Shield), which reduces the number of control units to only one, and supports both gathering physiological signals with better precision and delivering multisensory feedback with more flexibility, by means of new actuators that can be added/discarded on top of just that single shield. The improvements in the quality of the acquired signals allow better recognition of the emotional states. Thereof, AICARP.V3 gives a more accurate personalized emotional support to the user, based on a rule-based approach that triggers multisensorial feedback, if necessary. This represents progress in solving an open problem: develop systems that perform as effectively as a human expert in a complex task such as the recognition of emotional states.


Assuntos
Técnicas Biossensoriais , Resposta Galvânica da Pele/fisiologia , Frequência Cardíaca/fisiologia , Monitorização Fisiológica , Conscientização , Emoções , Humanos , Aprendizagem/fisiologia , Temperatura , Interface Usuário-Computador
11.
Allergy ; 73(6): 1206-1222, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29318625

RESUMO

The prevalence of sensitization to dogs and cats varies by country, exposure time and predisposition to atopy. It is estimated that 26% of European adults coming to the clinic for suspected allergy to inhalant allergens are sensitized to cats and 27% to dogs. This document is intended to be a useful tool for clinicians involved in the management of people with dog or cat allergy. It was prepared from a consensus process based on the RAND/UCLA method. Following a literature review, it proposes various recommendations concerning the diagnosis and treatment of these patients, grounded in evidence and clinical experience. The diagnosis of dog and cat allergy is based on a medical history and physical examination that are consistent with each other and is confirmed with positive results on specific IgE skin tests. Sometimes, especially in polysensitized patients, molecular diagnosis is strongly recommended. Although the most advisable measure would be to avoid the animal, this is often impossible and associated with a major emotional impact. Furthermore, indirect exposure to allergens occurs in environments in which animals are not present. Immunotherapy is emerging as a potential solution to this problem, although further supporting studies are needed.


Assuntos
Alérgenos/imunologia , Hipersensibilidade/diagnóstico , Hipersensibilidade/imunologia , Animais de Estimação/imunologia , Algoritmos , Animais , Gatos , Terapia Combinada , Consenso , Suscetibilidade a Doenças , Cães , Hipersensibilidade/terapia , Imunização , Imunoglobulina E/imunologia , Prevalência , Qualidade de Vida , Testes Cutâneos
12.
Int Endod J ; 51(9): 981-988, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-29480932

RESUMO

Regenerative endodontic procedures (REPs) are biologically based procedures planned to replace damaged tissues, including dentinee and root structures, as well as cells of the pulp-dentine complex. Effective sterilization of the root canal is essential in REPs, and antibiotics have been widely used to disinfect root canals. The aim of this paper was to review the scientific literature on (i) Effectiveness of antibiotics used in REPs against bacteria implicated in endodontic disease; (ii) Scientific evidence supporting the use of topical antibiotics in REPs; (iii) Clinical implications of the use of antibiotics in REPs and the possible side effects; (iv) Effect of antibiotics on dental pulp stem cells; and (v) Ongoing research on the use of antibiotics in REPs. Antibiotics used in REPs are effective against bacteria implicated in endodontic infections. Triple antibiotic pastes with minocycline attain complete disinfection of immature teeth with necrotic pulps, without affecting SCAP. Experimental studies carried out in dogs support the use of antibiotics in REPs. Clinical studies report high success rates of RET using antibiotics as intracanal dressings. However, tooth discolouration is an important side effect of the use of TAP. An antibiotic paste containing only metronidazole and ciprofloxacin could be a good alternative to the use of TAP. The use of antibiotic-containing scaffolds or clindamycin-modified triple antibiotic (metronidazole, ciprofloxacin and clindamycin) polymer could be a biologically safe antimicrobial drug delivery system in REPs.


Assuntos
Antibacterianos/uso terapêutico , Endodontia Regenerativa/métodos , Administração Tópica , Antibacterianos/administração & dosagem , Humanos , Resultado do Tratamento
13.
Int Endod J ; 51(1): 118-127, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-28375572

RESUMO

AIM: To determine the knowledge of undergraduate Spanish dental students regarding the indications of systemic antibiotics in the management of endodontic infections. METHODOLOGY: The final year dental students from four Spanish dental schools were requested to answer a one-page questionnaire on the indications for systemic antibiotics in the treatment of endodontic infections. One hundred and seventy-five students were asked to participate in this research. Data were analysed using descriptive statistics and chi-square test. RESULTS: One hundred and four students (93.7%) completed satisfactorily the survey and were included in the study. The average duration of antibiotic therapy was 7.0 ± 2.0 days. All respondents chose amoxicillin as the first-choice antibiotic in patients with no medical allergies, alone (47%) or associated with clavulanic acid (53%). The first drug of choice for patients with an allergy to penicillin was clindamycin 300 mg (99%). For cases of irreversible pulpitis, up to 63% of students would prescribe antibiotics. For the scenario of a necrotic pulp, symptomatic apical periodontitis and no swelling, 44% would prescribe antibiotics. Almost 40% of students would prescribe antibiotics for necrotic pulps with asymptomatic apical periodontitis and a sinus tract. CONCLUSIONS: It is necessary for the Spanish schools of dentistry to improve students' knowledge about antibiotics and their indications in endodontics. Interactive education analysing real endodontic cases using problem-based learning would help students acquire better skills in prescribing antibiotics in pulp-periapical pathosis.


Assuntos
Antibacterianos/uso terapêutico , Competência Clínica , Estudantes de Odontologia , Necrose da Polpa Dentária/tratamento farmacológico , Humanos , Masculino , Periodontite Periapical/tratamento farmacológico , Pulpite/tratamento farmacológico , Espanha , Inquéritos e Questionários , Adulto Jovem
14.
Allergy ; 72(6): 959-966, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-27886391

RESUMO

BACKGROUND: Despite the socioeconomic importance of allergic rhinitis (AR), very few prospective studies have been performed under conditions of clinical practice and with a sufficiently long observation period outside the clinical trial scenario. We prospectively estimated the direct and indirect costs of AR in patients attending specialized clinics in Spain. METHODS: Patients were recruited at random from allergy outpatient clinics in 101 health centers throughout Spain over 12 months. We performed a multicenter, observational, prospective study under conditions of clinical practice. We analyzed direct costs from a funder perspective (healthcare costs) and from a societal perspective (healthcare and non-healthcare costs). Indirect costs (absenteeism and presenteeism [productivity lost in the workplace]) were also calculated. The cost of treating conjunctivitis was evaluated alongside that of AR. RESULTS: The total mean cost of AR per patient-year (n = 498) was €2326.70 (direct, €553.80; indirect, €1772.90). Direct costs were significantly higher in women (€600.34 vs €484.46, P = 0.02). Total costs for intermittent AR were significantly lower than for persistent AR (€1484.98 vs €2655.86, P < 0.001). Total indirect costs reached €1772.90 (presenteeism, €1682.71; absenteeism, €90.19). The direct costs of AR in patients with intermittent asthma (€507.35) were lower than in patients with mild-persistent asthma (€719.07) and moderate-persistent asthma (€798.71) (P = 0.006). CONCLUSIONS: The total cost of AR for society is considerable. Greater frequency of symptoms and more severe AR are associated with higher costs. Indirect costs are almost threefold direct costs, especially in presenteeism. A reduction in presenteeism would generate considerable savings for society.


Assuntos
Efeitos Psicossociais da Doença , Custos de Cuidados de Saúde , Rinite Alérgica/economia , Absenteísmo , Humanos , Presenteísmo/economia , Estudos Prospectivos , Espanha
15.
Allergol Immunopathol (Madr) ; 44(3): 263-75, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26316421

RESUMO

Food allergy and respiratory allergy are two frequently associated diseases and with an increasing prevalence. Several reports show the presence of respiratory symptoms in patients with food allergy, while certain foods may be related to the development or exacerbation of allergic rhinitis and asthma. The present update focuses on this relationship, revealing a pathogenic and clinical association between food and respiratory allergy. This association is even more intense when the food hypersensitivity is persistent or starts in the early years of life. Food allergy usually precedes respiratory allergy and may be a risk factor for allergic rhinitis and asthma, becoming a relevant clinical marker for severe atopic asthma. Furthermore, the presence of co-existing asthma may enhance life-threatening symptoms occurring during a food allergic reaction. Recommendations for dietary restrictions during pregnancy and breastfeeding to prevent the development of respiratory allergy are controversial and not supported by consistent scientific data. Current recommendations from medical societies propose exclusive breastfeeding during the first four months of life, with the introduction of solid food in the fourth to the seventh month period of life. A delayed introduction of solid food after this period may increase the risk of developing subsequent allergic conditions. Further studies are encouraged to avoid unjustified recommendations involving useless dietary restrictions.


Assuntos
Asma/epidemiologia , Aleitamento Materno , Dieta Saudável/métodos , Hipersensibilidade Alimentar/epidemiologia , Rinite Alérgica/epidemiologia , Asma/etiologia , Asma/prevenção & controle , Comorbidade , Feminino , Hipersensibilidade Alimentar/etiologia , Hipersensibilidade Alimentar/prevenção & controle , Humanos , Gravidez , Prevalência , Rinite Alérgica/etiologia , Rinite Alérgica/prevenção & controle , Fatores de Risco
16.
J Investig Allergol Clin Immunol ; 25(4): 276-82, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26310042

RESUMO

BACKGROUND: Nasal polyposis (NP) is a chronic inflammatory disease that constitutes a major health problem with significant comorbidities and a considerable associated socioeconomic burden. OBJECTIVE: To describe the clinical features and management of patients with NP attending Spanish allergy centers, the use of health care resources, and the degree of compliance with the diagnostic and therapeutic recommendations of the European Position Paper on Rhinosinusitis and Nasal Polyps (EPOS). METHODS: We performed a multicenter, observational, and cross-sectional epidemiologic study of 671 patients consulting for NP in 67 Spanish allergy departments. We used sociodemographic and clinical questionnaires to evaluate clinical characteristics, use of health care resources, diagnostic methods, and treatment administered. RESULTS: NP was closely associated with asthma (66%), allergic rhinitis (45.9%), and hypersensitivity to nonsteroidal anti-inflammatory drugs (NSAIDs) (26%). Atopy was present in the 50% of cases, with Dermatophagoides pteronyssinus as the most frequent sensitizing allergen. Eleven percent of NP patients visited the emergency department during the previous year, and more than 58% used primary care, allergy, or otorhinolaryngology services. The most frequently used diagnostic tests were skin prick tests (93.6%) and anterior rhinoscopy (79.4%). Intranasal corticosteroids were the drug class most frequently prescribed by allergists (74.6%). Specific immunotherapy was prescribed in 21% of patients. CONCLUSIONS: NP is a chronic inflammatory disease that generates considerable use of health care resources. The close association with atopy, asthma, and NSAID hypersensitivity highlights the usefulness of an allergy workup in all patients with NP. Analysis of the clinical management of NP by allergists in Spain revealed a high degree of compliance with EPOS diagnostic and therapeutic recommendations.


Assuntos
Recursos em Saúde , Pólipos Nasais/terapia , Adolescente , Adulto , Comorbidade , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
17.
J Investig Allergol Clin Immunol ; 25(6): 396-407, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26817136

RESUMO

Nasal hyperreactivity is the abnormal reaction of nasal tissue to a stimulus that is innocuous to most people. This response is caused by dysregulation of the autonomic nervous system at various levels of the nasal autonomic reflex arc. Various stimuli (methacholine, histamine, adenosine 5'-monophosphate, cold air, mannitol, rapsaicin, phentolamine, and distilled water) have been used in an attempt to find the test that most reliably differentiates between healthy individuals and patients and also between different types of rhinitis. Despite the small number of publications available, in the present review, we provide an update on current nonspecific nasal provocation techniques. The studies published to date are not comparable: the stimuli applied act through different mechanisms and are used to assess different pathways, and the methodologies differ in terms of selection of participants, concentrations used, and assessment of response (criteria for positivity). Given the limited use of nonspecific nasal provocation tests in routine clinical practice, we believe that more studies are warranted to address the research issues we present at the end of the present review, for example, the need to standardize the methodology for each test or even the clinical benefits of knowing whether or not a patient has nasal hyperreactivity.


Assuntos
Testes de Provocação Nasal/métodos , Rinite Alérgica/diagnóstico , Histamina/farmacologia , Humanos , Cloreto de Metacolina/farmacologia
18.
J Invertebr Pathol ; 131: 242-55, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26146227

RESUMO

The world population is growing quickly and there is a need to make sustainable protein available through an integrated approach that includes marine aquaculture. Seafood is already a highly traded commodity but the production from capture fisheries is rarely sustainable, which makes mollusc culture more important. However, an important constraint to its continued expansion is the potential for trade movements to disseminate pathogens that can cause disease problems and loss of production. Therefore, this review considers legislative and regulatory aspects of molluscan health management that have historically attempted to control the spread of mollusc pathogens. It is argued that the legislation has been slow to react to emerging diseases and the appearance of exotic pathogens in new areas. In addition, illegal trade movements are taken into account and possible future developments related to improvements in areas such as data collection and diagnostic techniques, as well as epidemiology, traceability and risk analysis, are outlined.


Assuntos
Aquicultura/legislação & jurisprudência , Aquicultura/normas , Moluscos , Frutos do Mar/normas , Animais , Aquicultura/métodos
19.
Plant Dis ; 99(5): 676-682, 2015 May.
Artigo em Inglês | MEDLINE | ID: mdl-30699672

RESUMO

Downy mildew, caused by Pseudoperonospora cubensis, is a severe foliar disease of many cucurbit crops worldwide. Forty-one cucurbit cultigens (commercial cultivars and plant introductions) from five genera (Cucumis, Citrullus, Cucurbita, Lagenaria, and Luffa) were assessed for susceptibility to P. cubensis in a research field exposed to natural inoculum in Michigan. Eight cultigens from a differential set for pathotype determination were included within the 41 cultigens to detect changes in dominant P. cubensis pathotypes present. No pathotype differences were found between 2010 and 2011. Cucumis melo cultigen MR-1 was less susceptible to Michigan P. cubensis populations than other C. melo cultigens. No symptoms or signs of infection were detected on cultigens of Cucurbita moschata and C. pepo. Disease onset was later in 2011 than 2010; greater than 90% disease severity in pickling cucumber 'Vlaspik' was observed in both years. This study confirmed that Cucumis is the most susceptible cucurbit genus, while Citrullus and Cucurbita cultigens were the least susceptible genera to populations of P. cubensis in Michigan. Area under the disease progress curve values indicated that disease progress was limited on all Citrullus cultigens compared with Cucumis cultigens, and pathogen sporulation was not detected under field conditions. Future studies should evaluate the ability of a reduced fungicide program to control downy mildew on less susceptible Cucumis melo 'Edisto 47', 'Primo', 'Athena', 'Strike', 'Ananas', 'Banana', and 'Tam-Dew'. Many of the melon cultivars evaluated were selected on the basis of reported resistance to downy mildew, yet they showed significant disease symptoms. It is important to evaluate candidate cultigens for resistance to local P. cubensis populations.

20.
J Helminthol ; 89(5): 593-600, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-25007240

RESUMO

The aim of this study was to assess the effect of infection with the nematode whipworm Trichuris muris on the course of chemically induced acute ulcerative colitis in CBA/J mice, a strain proven to be highly resistant to infection with T. muris. Each mouse was infected with 50 embryonated eggs of T. muris by oral gavage. Acute colitis was triggered by administering 4% dextran sulphate sodium (DSS) in the drinking water for nine consecutive days at different times after infection. Concurrent infection and DSS administration exacerbate the severity of the colitis while favouring the permanence of parasites in the intestine. The induction of ulcerative colitis from days 54 to 62 post-infection (p.i.), when all worms had been expelled, ameliorated the course of the inflammatory disease. When ulcerative colitis was triggered earlier on, from days 27 to 35 p.i., the beneficial effects on inflammatory events were clearly shown with signs of mucosal epithelization and regeneration as early as day 1 after DSS administration. Previous infections by T. muris therefore accelerate recovery from subsequently induced inflammatory bowel disease and such an effect assists the nematode to persist in the intestinal niche.


Assuntos
Colite Ulcerativa/patologia , Tricuríase/patologia , Trichuris/fisiologia , Animais , Colite Ulcerativa/induzido quimicamente , Colite Ulcerativa/parasitologia , Modelos Animais de Doenças , Feminino , Humanos , Intestinos/parasitologia , Camundongos , Camundongos Endogâmicos CBA , Tricuríase/parasitologia
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