Variation of the group 5 grass pollen allergen content of airborne pollen in relation to geographic location and time in season.

BACKGROUND: Allergies to grass pollen are the number one cause of outdoor hay fever. The human immune system reacts with symptoms to allergen from pollen. OBJECTIVE: We investigated the natural variability in release of the major group 5 allergen from grass pollen across Europe. METHODS: Airborne pollen and allergens were simultaneously collected daily with a volumetric spore trap and a high-volume cascade impactor at 10 sites across Europe for 3 consecutive years. Group 5 allergen levels were determined with a Phl p 5-specific ELISA in 2 fractions of ambient air: particulate matter of greater than 10 µm in diameter and particulate matter greater than 2.5 µm and less than 10 µm in diameter. Mediator release by ambient air was determined in FcεRI-humanized basophils. The origin of pollen was modeled and condensed to pollen potency maps. RESULTS: On average, grass pollen released 2.3 pg of Phl p 5 per pollen. Allergen release per pollen (potency) varied substantially, ranging from less than 1 to 9 pg of Phl p 5 per pollen (5% to 95% percentile). The main variation was locally day to day. Average potency maps across Europe varied between years. Mediator release from basophilic granulocytes correlated better with allergen levels per cubic meter (r(2) = 0.80, P < .001) than with pollen grains per cubic meter (r(2) = 0.61, P < .001). In addition, pollen released different amounts of allergen in the non-pollen-bearing fraction of ambient air, depending on humidity. CONCLUSION: Across Europe, the same amount of pollen released substantially different amounts of group 5 grass pollen allergen. This variation in allergen release is in addition to variations in pollen counts. Molecular aerobiology (ie, determining allergen in ambient air) might be a valuable addition to pollen counting.

Identification of potential sources of airborne Olea pollen in the Southwest Iberian Peninsula.

This study aims to determine the potential origin of Olea pollen recorded in Badajoz in the Southwest of the Iberian Peninsula during 2009-2011. This was achieved using a combination of daily average and diurnal (hourly) airborne Olea pollen counts recorded at Badajoz (south-western Spain) and Évora (south-eastern Portugal), an inventory of olive groves in the studied area and air mass trajectory calculations computed using the HYSPLIT model. Examining olive pollen episodes at Badajoz that had distinctly different diurnal cycles in olive pollen in relation to the mean, allowed us to identify three different scenarios where olive pollen can be transported to the city from either distant or nearby sources during conditions with slow air mass movements. Back trajectory analysis showed that olive pollen can be transported to Badajoz from the West on prevailing winds, either directly or on slow moving air masses, and from high densities of olive groves situated to the Southeast (e.g. Andalucía). Regional scale transport of olive pollen can result in increased nighttime concentrations of this important aeroallergen. This could be particularly important in Mediterranean countries where people can be outdoors during this time due to climate and lifestyle. Such studies that examine sources and the atmospheric transport of pollen are valuable for allergy sufferers and health care professionals because the information can be incorporated into forecasts, the outputs of which are used for avoiding exposure to aeroallergens and planning medication. The results of studies of this nature can also be used for examining gene flow in this important agricultural crop.

Misdosing of Non-Vitamin K Antagonist Oral Anticoagulants in Primary Care.

PURPOSE: Prescription patterns of non-vitamin K antagonist oral anticoagulants (NOACs) are unknown among primary care physicians, where most patients with nonvalvular atrial fibrillation (NVAF) are diagnosed and followed up. The goal of this study was to evaluate overdosing and underdosing of NOACs in patients with NVAF followed up in primary care and determine their clinical predictors. METHODS: This multicenter cross-sectional study included all patients with NVAF followed up in 13 primary care units in the center region of Portugal. Patients receiving antithrombotic regimens other than NOACs and patients with missing data were excluded. FINDINGS: The study included 858 patients with NVAF on an NOAC regimen. Overall, 30.3% were prescribed an off-label dosage (25.4% with infratherapeutic dosing [ITD] and 4.9% with supratherapeutic dosing). Chronic kidney disease (odds ratio, 14.0; 95% CI, 5.4-36.5; P < 0.001) and female sex (odds ratio, 2.6; 95% CI, 1.2-5.7; P < 0.001) were independent predictors of supratherapeutic dosing. We also found a significant effect of chronic kidney disease on ITD (odds ratio, 0.22; 95% CI, 0.258-0.678; P < 0.001). IMPLICATIONS: In primary care, NOACs are frequently prescribed with unadjusted dosages, generally infratherapeutic. Attention should be paid to women and patients with chronic kidney disease.

Adult Acne: Prevalence and Portrayal in Primary Healthcare Patients, in the Greater Porto Area, Portugal.

INTRODUCTION: Though typically found in adolescents, acne frequently affects the adult population. In Portugal, no representative studies about acne prevalence in greater populational areas are known. This study had the following objectives: calculate acne prevalence in primary healthcare patients; its characteristics, including risk factors for onset and worsening; collect information concerning selfmedication and/or prescribed treatment. MATERIAL AND METHODS: Application of a questionnaire and physical examination into a convenience sample, composed by adults from20 - 60 years old that visited, in random days, five primary healthcare centers of the Greater Porto area. RESULTS: From the 1,055 evaluated adults, acne prevalence was estimated at 61.5%. Only 36.8% of acne suffering adults was awareof their condition. More than half of tobacco users (62.3%) had acne. Just 25% of acne sufferers sought treatment. The most affected areas were the malars, differing from the younger disease form. DISCUSSION: Acne prevalence was relatively higher than other studies. The results of this study have confirmed that acne seems to be related with increased calorie intake, tobacco smoking, whole milk and fat-reduced milk consumption, hirsutism, alopecia and seborrhea. CONCLUSION: In the primary healthcare set, more than half of adults were acne sufferers. These numbers show how important primary healthcare services can be in preventing and intervening when managing acne-related risk factors and psychosocial consequences.

Introdução: A acne, apesar de caraterística no adolescente, afeta frequentemente o adulto. Em Portugal, não são conhecidos estudos sobre a prevalência da acne no adulto, nomeadamente observada nos grandes centros populacionais. Os objetivos deste estudo foram estimar a prevalência da acne nos utentes dos serviços de cuidados de saúde primários, as suas características, incluindo fatores de risco para início e/ou agravamento, além de coletar informação relacionada com a automedicação e/ou tratamento prescrito. Material e Métodos: Aplicação de questionário e exame físico a amostra composta por adultos entre os 20 - 60 anos de idade que visitaram, em dias aleatórios, cinco centros de saúde da área do Grande Porto. Resultados: Dos 1 055 adultos avaliados, a prevalência estimada de acne foi de 61,5%. Apenas 36,8% dos portadores estavam cientes da sua condição e somente 25% afirmou ter procurado tratamento. Mais de metade dos fumadores (62,3%) apresentavam acne. A zona mais afetada foi a região malar, diferindo da forma adolescente da doença. Discussão: A prevalência encontrada de acne foi mais elevada do que em outros estudos. A acne aparentou estar relacionada com a ingestão calórica aumentada, tabagismo, consumo de leite gordo ou meio gordo, hirsutismo, alopécia e seborreia. Conclusão: No contexto dos cuidados de saúde primários, mais de metade dos adultos eram portadores de acne. Estes números demonstram o quão importante pode ser a prevenção e intervenção pelos profissionais dos cuidados de saúde primários, tanto para a redução de eventuais factores de risco como para a intervenção terapêutica e consequências psicossociais relacionadas com a acne. Palavras-chave: Acne Vulgaris/epidemiologia; Adulto; Cuidados de Saúde Primários; Portugal; Prevalência.