Differences in Linear Epitopes of Ara h 9 Recognition in Peanut Allergic and Tolerant, Peach Allergic Patients.

Background: Peanut-allergic patients from the Mediterranean region are predominantly sensitized to the lipid transfer protein (LTP) Ara h 9, and the peach LTP Pru p 3 seems to be the primary sensitizer. However, LTP sensitization in peanut allergy is not a predictive marker for clinically relevant symptoms. Objective: We aimed to identify sequential epitopes of IgE and IgG4 from Pru p 3 and Ara h 9 in peach-allergic patients sensitized to peanuts. We also sought to determine the differences in IgE and IgG4 binding between patients who had developed peanut allergy and those tolerating peanuts. Methods: A total of 46 peach-allergic patients sensitized to peanuts were selected. A total of 35 patients were allergic to peanuts (peanut-allergic group) and 11 were tolerant to peanuts (peanut-tolerant group). We measured sIgE and sIgG4 in peanut, peach, and their recombinant allergen (Ara h 1, Ara h 2, Ara h 3, Ara h 8, and Ara h 9) with fluorescence enzyme immunoassay. We examined the IgE and IgG4 binding to sequential epitopes using a peptide microarray corresponding to linear sequences of the LTPs Ara h 9 and Pru p 3 with a library of overlapping peptides with a length of 20 amino acids (aa) and an offset of 3 aa. Results: The frequency and the intensity of IgE recognition of Ara h 9 and Pru p 3 peptides were higher in the peanut-tolerant group than in the peanut-allergic group. We found four Ara h 9 peptides (p4, p14, p21, and p25) and four Pru p 3 peptides (p1, p3, p21, and p24) with a significantly elevated IgE recognition in peanut-tolerant patients. Only one peptide of Ara h 9 (p4) recognized by IgG4 was significantly elevated in the peanut-tolerant group. The IgG4/IgE ratio of Ara h 9 peptide 4 was significantly higher in peanut-tolerant patients than in peanut-allergic patients, while no significant differences were observed in the IgG4/IgE ratio of this peptide in Pru p 3. Conclusion: Although we found significant differences in IgE and IgG4 recognition of Ara h 9 and Pru p 3 between peanut-tolerant and peanut-allergic patients (all of whom were allergic to peach), polyclonal IgE peptide recognition of both LTPs was observed in peach-allergic patients tolerating peanuts. However, the IgG4 blocking antibodies against Ara h 9 peptide 4 could provide an explanation for the absence of clinical reactivity in peanut-tolerant peach-allergic patients. Further studies are needed to validate the usefulness of IgG4 antibodies against Ara h 9 peptide 4 for peanut allergy diagnosis.

Hybrid model based on Genetic Algorithms and SVM applied to variable selection within fruit juice classification.

Given the background of the use of Neural Networks in problems of apple juice classification, this paper aim at implementing a newly developed method in the field of machine learning: the Support Vector Machines (SVM). Therefore, a hybrid model that combines genetic algorithms and support vector machines is suggested in such a way that, when using SVM as a fitness function of the Genetic Algorithm (GA), the most representative variables for a specific classification problem can be selected.

[Health problems and factors determining the number of on-demand visits of over-users of a health centre]. / Problemas de salud y factores determinantes del número de visitas a demanda en pacientes hiperutilizadores de un centro de salud.

OBJECTIVES: To describe the social and demographic characteristics and health problems of over-users of a health centre and to determine the number of attendances requested on demand at the general medical clinic. DESIGN: Retrospective and descriptive. Multivariate analysis: multiple linear regression. SETTING: Urban health centre. PATIENTS: Patients who requested a consultation at the health centre on at least nine occasions in 1999 (N = 7852). Random sample of 386 patients (alpha 0.05, 95% accuracy). MEASUREMENTS AND MAIN RESULTS: Dependent variable: number of on-demand consultations requested in 1999. INDEPENDENT VARIABLES: age, family size, area of residence, active or pensioner, inclusion in programmes, health problems (CIAP-2), number of drugs on repeat prescription (Anatomical Classification), short-term time off work. 57% of over-users were women (CI, 52.9-62.7%); mean age 55 (SD 18.5); family size 2.7 members (SD 1.457); 58.8% pensioners. Mean number of appointments 15 (SD 6.7). Mean habitual consumption of 1.58 medicines (SD 2.46). Inclusion in programmes: 37.7% hypertension, 16% diabetes, 17% dyslipaemia, 16% nursing clinic. Most prevalent pathologies: cardio-circulatory (43.8%), endocrino-metabolic (32%), traumatology (26.7%) and mental health (21%). The regression model included the variables of age, number of medicines and having had short-term time off. CONCLUSIONS: Over-users of our health centre are middle-aged women with chronic physical health problems and with mental health problems. The number of attendances is related to age and administrative requirements: medication and sick notes.

[Use of serological markers of hepatitis B and C viruses in a health center]. / Utilización de marcadores serológicos del virus de la hepatitis B y C en un centro de salud.

OBJECTIVE: To find the use of serological markers for the Hepatitis B (HBV) and Hepatitis C (HCV) viruses by doctors at an urban Health Centre, assessing the number of requests and their diagnostic effectiveness. DESIGN: Prospective and retrospective study of observation. SETTING: Primary Care. Urban Health Centre. PATIENTS: All those for whom requests for HBV and HCV serological markers were made between 1.1.92 and 30.3.93. MEASUREMENTS AND MAIN RESULTS: A total of 131 requests for HBV markers and 82 for HVC ones were made during the study period (1% of the total analyses performed). 30.5% of the HBV markers and 12.2% of the HCV ones were positive. 36% of the requests for HBV markers were for preventive as against 64% for diagnostic reasons. The diagnostic effectiveness (percentage of positives among the requests made for diagnostic reasons) was 35.7% for HBV and 13% for HCV serology. The manner of contagion could not be determined from the information collected in the clinical notes for 56% of the patients with positive serology. The performance of a Hepatic Biopsy was recorded for 10% of the patients with positive HBV or HCV serology, with diagnoses of 4 cases of active chronic Hepatitis and one of late cutaneous Porphyria. CONCLUSIONS: The availability of an accessible and correct request form for HBV and HCV markers could assist greater diagnostic accuracy and referral to specialists if required.

[The temporary work incapacities of professional administrative workers and nurses]. / Incapacidades laborales transitorias de los colectivos profesionales administrativos y de enfermería.

We show the results of a retrospective study designed to assess the features of transient job disability (TJD) episodes of workers from two groups (clerks and nurses) from an urban health basic zone with 24,536 inhabitants, out of which 6,009 were active workers registered in social security databases. Population pyramid and job distribution in active workers were obtained from a random sample including 5% of the active population, out of which 17% were clerks and 5.54% nurses. There were 1098 TJD episodes in 1990; 32.4% of them involved clerks and 8.3% nurses. The mean length of episodes was 28.2 days in nurses and 27.8 days among clerks, compared to 32.4 days in the active population. These differences remained (p < 0.001) even after excluding TJD episodes of pregnant women, in whose case the mean length of episodes involving male or female workers was the same. The percentage of TJD episodes was higher among female nurses and clerks, than among the whole female population. Influenza was responsible for 20.5% of TJD in clerks against 14.3% among nurses and 14.8% in the whole active population. We conclude that, in the groups studied, the rate of job absenteeism was higher than in the whole population, and higher in female than in males. However, in the whole population, there were no differences in TJD rates between males and females. We discuss that several factors other than illness may explain the differences among groups.

[Influence of sex, age, and profession on transient work disability at a health center]. / Influencia del sexo, la edad y la profesión en las incapacidades laborales transitorias en un centro de salud.

OBJECTIVE: To analyse whether the variables of gender, age and type of job of those in full-time work affect short-term unfitness for work (SUW) in a study undertaken within our health area. DESIGN: A prospective and retrospective study of all the SUW. SETTING: Primary Care. An urban Health Centre. PARTICIPANTS: Those people with full-time jobs registered at the Centre. MAIN MEASUREMENTS AND RESULTS: The entire 1098 certificates of SUW issued in 1990 were processed. The population pyramid and job distribution among those in full-time work was obtained by a random sample of 5% of the active population. When time off for maternity (TOM) was excluded, women accounted for 44.8% of SUW and men 55.2%. There were no significant differences with the percentages these figures represent for the active population as a whole. The number of SUW per 100 people in work was 15.9 for men and 21.5 and 17.4 for women (including and excluding TOM, respectively). The average length of SUW, excluding maternity, was 27.06 days for men and 26.8 for women. On the question of age, those under 19 and over 40 contributed least to the SUW percentage. Additionally, those under 19 and over 60 were the proportions of the population least prone to SUW. On the question of type of job, we found a higher contribution to absenteeism than expected within Groups 3 and 4 and less in Groups 0/1, 5 and 7/8/9. The longest average length of time for SUW was in Group X (84.2 days/SUW). CONCLUSIONS: Excluding TOM, gender does not appear to be a variable that affects SUW. Age group and type of job are variables affecting SUW. It will be necessary to undertake research into whether there are additional social or labour factors which might explain.