Social wasps in Spain: the who and where.

OBJECTIVE: The objective of this study was to list the social vespids occurring in Spain, determine their presence in each region, and correlate the data with the vespids responsible for allergic reactions and their progression over time. METHODS: Insects distribution data were collected in two phases: from the southern half of Spain (2008-2012), and from the northern half of Spain (2016-2019). Data for the vespids were collected from the prescriptions of Hymenoptera venom immunotherapy (HVIT) at six Spanish hospitals in the years 2009 and 2019. RESULTS: Polistes dominula and Vespula germanica were the most widely distributed species. Vespa velutina was found to be present in a large part of northern Spain. During the 10 year period, the prescriptions of vespid VIT increased by 42.63%. The north of Spain saw a 3.61 fold greater predominance of prescriptions for Vespula (to some extent influenced by Vespa velutina allergy) whereas in central and southern Spain, there was a 3.97 fold greater predominance of prescriptions for Polistes. CONCLUSIONS: It is the first study that compares the vespid distribution maps with VIT prescription. A noteworthy finding is the wide presence of Polistes dominula and Vespula germanica in Spain and the appearance of Vespa velutina allergy in the northern part of the country. Data of HVIT prescriptions reflect inter-regional variability with the predominance of Vespula (due to Vespula and Vespa) in the north and that of Polistes in the center and south of Spain.

New developments in work-related asthma.

INTRODUCTION: Work-related asthma includes two subtypes: occupational asthma or asthma caused by specific agents (sensitizers or irritants) in the workplace, and work-exacerbated asthma or pre-existing asthma worsened by workplace exposures. Areas covered: This review provides an update on the definitions and the clinical features of the different work-related asthma subtypes as well as new insights into their etiology and the pathophysiological mechanisms involved. The diagnosis of work-related asthma should be made on objective basis using a constellation of clinical, physiologic and allergologic tests. Specific inhalation challenge with the suspected occupational agent(s) remains as the reference standard for diagnosis. A literature search was performed using the following terms: work-related asthma, occupational asthma, work-exacerbated asthma, irritant-induced asthma and etiological agents. Expert commentary: Studies focusing on the biological effects and mechanisms of environmental exposures in the development of sensitizer-induced or irritant-induced asthma in various workplace settings are of greatest interest. An integrative approach that combines clinical parameters with component-resolved diagnosis as well as inflammatory biomarkers appears to be very promising. Occupational allergy provides a good opportunity to understand the complex relationships between exposure to allergens in the workplace, interaction with genes and the co-exposures to other factors in the working environment.

[Occupational asthma caused by two different agents]. / Asma ocupacional por doble agente causal.

We describe a case of a worker with occupational asthma caused by two separate etiologic agents, resulting from mixed exposures in different work areas. Isocyanates and epoxy resins are established causes of occupational disease, and their role in this case was confirmed by immediate and delayed pulmonary function testing, together with a specific bronchial challenge. A thorough evaluation of exposure to harmful substances in the workplace is essential, together with continued clinical monitoring following cessation of exposure in order to verify clinical improvement.

Se describe el caso de una trabajadora con asma ocupacional en el que se detecta un doble agente etiológico condicionado por la exposición mixta en distintas áreas de trabajo. Los isocianatos y resinas epoxi se han descrito como responsables de enfermedad profesional y se ha confirmado su relevancia en las pruebas de función pulmonar tanto de manera inmediata como tardía y en la prueba de provocación bronquial específica. Se destaca la necesidad de evaluar exhaustivamente la exposición a sustancias en el ambiente laboral y comprobar la mejoría clínica tras el cese permanente de la exposición a los agentes implicados.

[Use of component-resolved diagnosis in the follow-up of children with plant food allergy]. / Utilidad del diagnóstico por componentes en el seguimiento de niños con alergia a alimentos vegetales.

Food allergy poses a major problem during childhood. Component-resolved diagnosis detects allergy to proteins isolated in food. This descriptive study analyzes the use of customized and standardized recommendations in a sample made up of 22 children aged 2 to 16 years old with plant food allergy and assesses sensitivity to four plant panallergens. According to component-resolved diagnosis results, therapy was personalized, guidelines on what foods or components to avoid were provided, and co-factors that may favor food allergic reactions were explained. No new reactions were referred by 20/22 cases. Oral allergy syndrome developed in 2/22 patients with allergy to profilin because they did not follow the recommendations. Component-resolved diagnosis was useful for the diagnosis and management of these children. Standardized recommendations, based on each patient's component-resolved diagnosis, prevented severe food allergic reactions.

Introducción. En la práctica clínica, hemos observado una concentración elevada de interleucina 6 (IL-6) en los casos de septicemia por gramnegativos. Objetivo. Investigar la relación entre las concentraciones de IL-6 y proteína C-reactiva (PCR) y la determinación temprana de la septicemia neonatal por gramnegativos o grampositivos. Población y métodos. Se compararon el recuento de leucocitos y las concentraciones de IL-6 y PCR entre los distintos grupos. Resultados. Los grupos de infección por gramnegativos, infección por grampositivos y micosis estaban formados por 73, 82 y 15 pacientes, respectivamente. Los valores de corte ideales de IL-6 entre el grupo de infección por gramnegativos y el de infección por grampositivos y el de micosis eran 202 pg/ml y 57 pg/ml, respectivamente. En el grupo de micosis se observaron concentraciones de PCR más altas que en los grupos de infección por gramnegativos e infección por grampositivos. Conclusiones. Hasta donde sabemos, este es el estudio de mayor envergadura notificado con el objetivo de determinar los valores de corte de IL-6 para diferenciar la etiología de la septicemia neonatal. Los microorganismos gramnegativos provocaron una producción de IL-6 diez veces mayor. La evaluación de IL-6 y PCR resulta útil para diagnosticar, y asimismo diferenciar, la etiología de la septicemia neonatal.