Heterogeneity of pollen food allergy syndrome in seven Southern European countries: The @IT.2020 multicenter study.

BACKGROUND: Pollen food allergy syndrome (PFAS) is a frequently underdiagnosed disease due to diverse triggers, clinical presentations, and test results. This is especially relevant in geographic areas with a broad spectrum of pollen sensitization, such as Southern Europe. OBJECTIVES: To elucidate similarities and differences of PFAS in nine Southern European centers and identify associated characteristics and unique markers of PFAS. METHODS: As part of the @IT.2020 Multicenter Study, 815 patients with seasonal allergic rhinitis (SAR), aged 10-60 years, were recruited in seven countries. They completed questionnaires regarding SAR, comorbidities, family history, and PFAS, and underwent skin prick testing (SPT) and serum IgE testing. RESULTS: Of the 815 patients, 167 (20.5%) reported PFAS reactions. Most commonly, eliciting foods were kiwi (58, 34.7%), peach (43, 25.7%), and melon (26, 15.6%). Reported reactions were mostly local (216/319, 67.7%), occurring within 5 min of contact with elicitors (209/319, 65.5%). Associated characteristics included positive IgE to at least one panallergen (profilin, PR-10, or nsLTP) (p = 0.007), maternal PFAS (OR: 3.716, p = 0.026), and asthma (OR: 1.752, p = 0.073). Between centers, heterogeneity in prevalence (Marseille: 7.5% vs. Rome: 41.4%, p < 0.001) and of clinical characteristics was apparent. Cypress played a limited role, with only 1/22 SPT mono-sensitized patients reporting a food reaction (p < 0.073). CONCLUSIONS: PFAS is a frequent comorbidity in Southern European SAR patients. Significant heterogeneity of clinical characteristics in PFAS patients among the centers was observed and may be related to the different pollen sensitization patterns in each geographic area. IgE to panallergen(s), maternal PFAS, and asthma could be PFAS-associated characteristics.

"Whole" vs. "fragmented" approach to EAACI pollen season definitions: A multicenter study in six Southern European cities.

BACKGROUND: The adequate definition of pollen seasons is essential to facilitate a correct diagnosis, treatment choice, and outcome assessment in patients with seasonal allergic rhinitis. A position paper by the European Academy of Allergy and Clinical Immunology (EAACI) proposed season definitions for Northern and Middle Europe. OBJECTIVE: To test the pollen season definitions proposed by EAACI in six Mediterranean cities for seven pollen taxa. METHODS: As part of the @IT.2020 multi-center study, pollen counts for Poaceae, Oleaceae, Fagales, Cupressaceae, Urticaceae (Parietaria spp.), and Compositae (Ambrosia spp., Artemisia spp.) were collected from January 1 to December 31, 2018. Based on these data, pollen seasons were identified according to EAACI criteria. A unified monitoring period for patients in AIT trials was created and assessed for feasibility. RESULTS: The analysis revealed a great heterogeneity between the different locations in terms of pattern and length of the examined pollen seasons. Further, we found a fragmentation of pollen seasons in several segments (max. 8) separated by periods of low pollen counts (intercurrent periods). Potential monitoring periods included often many recording days with low pollen exposure (max. 341 days). CONCLUSION: The Mediterranean climate leads to challenging pollen exposure times. Monitoring periods for AIT trials based on existing definitions may include many intermittent days with low pollen concentrations. Therefore, it is necessary to find an adapted pollen season definition as individual solution for each pollen and geographical area.

Characterization of oat beta-glucan and coenzyme Q10-loaded beta-glucan powders generated by the pressurized gas-expanded liquid (PGX) technology.

The physicochemical properties of the oat beta-glucan powder (BG) and coenzyme Q10 (CoQ10)-loaded BG powder (L-BG) produced by the pressurized gas-expanded liquid (PGX) technology were studied. Helium ion microscope, differential scanning calorimeter, X-ray diffractometer, AutoSorb iQ and rheometer were used to determine the particle morphology, thermal properties, crystallinity, surface area and viscosity, respectively. Both BG (7.7µm) and L-BG (6.1µm) were produced as micrometer-scale particles, while CoQ10 nanoparticles (92nm) were adsorbed on the porous structure of L-BG. CoQ10 was successfully loaded onto BG using the PGX process via adsorptive precipitation mainly in its amorphous form. Viscosity of BG and L-BG solutions (0.15%, 0.2%, 0.3% w/v) displayed Newtonian behavior with increasing shear rate but decreased with temperature. Detailed characterization of the physicochemical properties of combination ingredients like L-BG will lead to the development of novel functional food and natural health product applications.

Improving Communication between Physicians and Their Patients through Mindfulness and Compassion-Based Strategies: A Narrative Review.

Communication between physicians and patients is a key pillar of psychosocial support for enhancing the healing process of patients and for increasing their well-being and quality of life. Physicians and other health professionals might benefit from interventions that increase their self-care, awareness, compassion, and other-focused concern, and reduce the chances of distress and burnout. There is substantial evidence for the contribution of different management strategies to achieve these aims. The goal of this article is to review the potential effect of mindfulness and compassion-based strategies for the improvement of physician-patient interactions. The acquisition of the necessary skills by physicians requires continuous education. Future research will be useful for identifying more evidence on the cost-effectiveness of this type of intervention.

Acceptability and Effectiveness of a Long-Term Educational Intervention to Reduce Physicians' Stress-Related Conditions.

INTRODUCTION: This study aimed to test the acceptability and effectiveness of a two-phase mindfulness-based stress reduction program (8-week initial treatment plus a 10-month maintenance phase) in alleviating work stress-related symptoms (i.e., burnout, heart rate [HR], and blood pressure [BP]) in a sample of 42 physicians. METHODS: A randomized controlled trial and a simple pre-post design were used, respectively, for each of the two phases of the study. Outcome measures included the Five Facets of Mindfulness Questionnaire and the Maslach Burnout Questionnaire. HR and BP measures were also obtained in the experimental group by means of a digital monitor. RESULTS: After the initial 8 weeks of treatment, significant improvements for the experimental group in mindfulness levels and reductions in emotional exhaustion, HR, and BP were obtained. Effect sizes (Cohen d) significantly increased over the 10-month maintenance period, especially for mindfulness and systolic BP. Acceptance was notably high (low attrition rate and high compliance with program activities). DISCUSSION: Outcomes are significant in terms of practical consequences for reducing and controlling risks of developing burnout and cardiovascular disease in this population and enhancing well-being in life.

Enhancing relaxation states and positive emotions in physicians through a mindfulness training program: A one-year study.

Previous research on mindfulness has focused mainly on stress-related negative symptoms and short-term effects. In contrast, the present article focuses on the impact of a mindfulness-based stress reduction (MBSR) program on improving well-being (i.e. relaxation states and related positive emotions) in a longitudinal study for a period of one year. A randomized controlled trial in a sample of 42 physicians was used. The intervention group participated in an 8-week MBSR program, with an additional 10-month maintenance period and completed measures of mindfulness and relaxation at pre-intervention, post-intervention and after 10 months. Heart rate measures were also obtained. Significant improvements in favor of the experimental group compared with the control group on the levels of mindfulness and relaxation (including positive emotional states, such as at ease/peace, renewal, energy, optimism, happiness, acceptance, and even transcendence) were obtained after eight weeks. Remarkably, change magnitudes (effect size) significantly increased at the end of the maintenance period after a year, especially for mindfulness and positive energy. Additionally, heart rate significantly decreased for the intervention group and maintained a year after the beginning of the treatment. Results are relevant in terms of practical consequences for improving health and well-being in this population and also in terms of cost-efficiency.

Functional textiles for atopic dermatitis: a systematic review and meta-analysis.

Atopic dermatitis (AD) is a relapsing inflammatory skin disease with a considerable social and economic burden. Functional textiles may have antimicrobial and antipruritic properties and have been used as complementary treatment in AD. We aimed to assess their effectiveness and safety in this setting. We carried out a systematic review of three large biomedical databases. GRADE approach was used to rate the levels of evidence and grade of recommendation. Meta-analyses of comparable studies were carried out. Thirteen studies (eight randomized controlled trials and five observational studies) met the eligibility criteria. Interventions were limited to silk (six studies), silver-coated cotton (five studies), borage oil, and ethylene vinyl alcohol (EVOH) fiber (one study each). Silver textiles were associated with improvement in SCORAD (2 of 4), fewer symptoms, a lower need for rescue medication (1 of 2), no difference in quality of life, decreased Staphyloccosus aureus colonization (2 of 3), and improvement of trans-epidermal water loss (1 of 2), with no safety concerns. Silk textile use was associated with improvement in SCORAD and symptoms (2 of 4), with no differences in quality of life or need for rescue medication. With borage oil use only skin erythema showed improvement, and with EVOH fiber, an improvement in eczema severity was reported. Recommendation for the use of functional textiles in AD treatment is weak, supported by low quality of evidence regarding effectiveness in AD symptoms and severity, with no evidence of hazardous consequences with their use. More studies with better methodology and longer follow-up are needed.

Efecto diferencial de una intervención breve basada en la conciencia plena (mindfulness) y valores en las dimensiones del dolor crónico en espondilitis y artritis / Differential effect of brief values and mindfulness-based intervention in chronic pain dimensions for spondylitis and arthritis

En el modelo multidimensional del dolor se destaca la influencia de los componentes emocionales y cognitivos en la experiencia subjetiva del mismo. Desde esta perspectiva, se hace imprescindible el tratamiento psicológico para facilitar su afrontamiento. El presente estudio examinó los efectos diferenciales de una intervención breve basada en conciencia plena y valores en las diversas dimensiones del dolor crónico asociado a las enfermedades reumáticas. Se evaluaron a 10 participantes mediante el "Cuestionario de dolor, de McGuill" y una escala de "Preocupación y autoeficacia". Los resultados mostraron la eficacia de la intervención para mejorar la dolencia de la enfermedad, disminuyendo en la evaluación pos-intervención específicamente el componente valorativo del dolor, la percepción de la intensidad actual del mismo y la preocupación respecto al dolor. Asimismo, en la evaluación del seguimiento a los 8 meses se encontró una educción en el número de puntos considerados dolorosos. Nuestro estudio, pese a sus limitaciones metodológicas, ofrece unos resultados prometedores que sugieren la utilidad de la intervención en conciencia plena y valores para el manejo del dolor crónico en las enfermedades reumáticas (AU)

The multidimensional model of pain emphasizes the influence of emotional and cognitive components in the subjective experience of pain. From this perspective, the successful management of pain seems to require psychological treatment. The present study examined the differential effects of a brief psychological intervention program based on mindfulness and values in the diverse dimensions of chronic pain associated with rheumatic disease. Ten participants were assessed with the McGuill's Pain Questionnaire and a Scale of Worry and Self-efficacy. The results indicate that the intervention program improved the management of pain at post-intervention assessment, showing specific reductions in the following dimensions: evaluative component of pain, perception of actual pain intensity and worry about illness and pain. In addition, a reduction in amount of painful points was found at 8-months follow-up. Despite its methodological limitations, our results suggest that a brief mindfulness and values-based intervention can be useful in the management of pain in patients with chronic rheumatic conditions

Dietary intake of α-linolenic acid and low ratio of n-6:n-3 PUFA are associated with decreased exhaled NO and improved asthma control.

As recently described, adherence to the Mediterranean diet is associated with improved asthma control. However, evidence of how specific nutrients such as fatty acids and antioxidants may affect this relationship remains largely unknown. We aimed to examine the association between dietary intake of fatty acids and antioxidants and asthma control. A cross-sectional study was developed in 174 asthmatics, mean age of 40 (SD 15) years. Dietary intake was obtained by a FFQ, and nutritional content was calculated using Food Processor Plus™ software (ESHA Research, Inc., Salem, OR, USA). Good asthma control was defined by the combination of forced expiratory volume during the first second, exhaled NO (eNO) and Asthma Control Questionnaire (ACQ) score (control: forced expiratory volume in the first second ≥80 %; eNO ≤35 ppb; ACQ <1·0, scale 0-6 score). Multiple linear and logistic regression models were performed to analyse the associations between nutrients and asthma outcomes, adjusting for confounders. A high n-6:n-3 PUFA ratio predicted high eNO, whereas high intakes of n-3 PUFA, a-linolenic acid (ALA) and SFA were associated with low eNO. Odds for controlled asthma improved along with an increased intake of n-3 PUFA (OR 0·14, 95% CI 0·04, 0·45; P for trend=0·001), SFA (OR 0·36, 95% CI 0·13, 0·97; P for trend=0·047) and ALA (OR 0·18, 95% CI 0·06, 0·58; P for trend=0·005). A high n-6:n-3 PUFA ratio increased the odds for uncontrolled asthma (OR 3·69, 95% CI 1·37, 9·94; P for trend=0·009), after adjusting for energy intake, sex, age, education and use of inhaled corticosteroids. Higher intakes of n-3 PUFA, ALA and SFA were associated with good asthma control, while the risk for uncontrolled asthma increased with a higher n-6:n-3 PUFA ratio. The present results introduce a protective effect of ALA in asthma control, independent of marine n-3 fatty acids, and provide a rationale to dietary intervention studies in asthma.

Eficacia de un programa de entrenamiento en conciencia plena (mindfulness) y valores humanos como herramienta de regulación emocional y prevención del estrés para profesores / Human values education and mindfulness meditation as a tool for emotional regulation and stress prevention for teachers: an efficiency study

El presente estudio pone a prueba la eficacia de un entrenamiento que aúna los valores humanos y las habilidades de conciencia plena (mindfulness) como herramientas de autorregulación emocional y prevención del estrés. Participaron cuarenta profesores que constituyeron un grupo de intervención (N= 25) y otro control (N= 15). Se utilizaron indicadores subjetivos, conductuales y psicofisiológicos (respiración y conductancia dérmica), apreciándose diferencias en los tres tipos de medida. El grupo de profesores entrenado mejoró los índices subjetivos de afecto negativo, ansiedad, depresión, preocupación, sensación de estrés percibido, comprensión emocional y dolores musculares en contraste con el grupo control. Asimismo, los resultados de la prueba psicofisiológica señalaron una tendencia a tener menor reactividad frente a situaciones desagradables asociada a una menor activación del sistema nervioso simpático. Además, en los indicadores conductuales se apreció un incremento en la calidad de su atención. En conclusión, el entrenamiento en habilidades de conciencia plena y valores humanos mostró eficacia como herramienta de autorregulación emocional y prevención del estrés propiciando una mejora en la calidad de vida de los profesionales de la educación (AU)

This study was aimed at testing the efficacy of a training program involving human values education and mindfulness skills as a tool for emotional self-regulation and stress prevention. Forty school teachers took part in this study. Participants were assigned to two different groups: experimental (N= 25) and control (N= 15). Subjective, behavioral and psychophysiological (respiration and skin conductance) measures were taken. The results revealed significant effects of the training program on the three types of measures. The experimental group showed significant improvements in the subjective measures of negative affect, anxiety, depression, worry, perceived stress, emotional comprenhension and muscular pain. Participants who received the training program also showed, in the psychophysiological test, less activation of the sympathetic nervous system associated with less reactivity to unpleasant and stressful situations. In addition, behavioral measures suggested an improvement in the quality of attention. It is concluded that training in human values and mindfulness skills is an effective tool for emotional self-regulation and stress prevention helping to improve the quality of life for teaching proffesionals

Treating chronic worry: Psychological and physiological effects of a training programme based on mindfulness.

The present study examines psychological and physiological indices of emotional regulation in non-clinical high worriers after a mindfulness-based training programme aimed at reducing worry. Thirty-six female university students with high Penn State Worry Questionnaire scores were split into two equal intervention groups: (a) mindfulness, and (b) progressive muscle relaxation plus self-instruction to postpone worrying to a specific time of the day. Assessment included clinical questionnaires, daily self-report of number/duration of worry episodes and indices of emotional meta-cognition. A set of somatic and autonomic measures was recorded (a) during resting, mindfulness/relaxation and worrying periods, and (b) during cued and non-cued affective modulation of defence reactions (cardiac defence and eye-blink startle). Both groups showed equal post-treatment improvement in the clinical and daily self-report measures. However, mindfulness participants reported better emotional meta-cognition (emotional comprehension) and showed improved indices of somatic and autonomic regulation (reduced breathing pattern and increased vagal reactivity during evocation of cardiac defense). These findings suggest that mindfulness reduces chronic worry by promoting emotional and physiological regulatory mechanisms contrary to those maintaining chronic worry.

Allergy in marathon runners and effect of Lactobacillus GG supplementation on allergic inflammatory markers.

OBJECTIVE: We studied the prevalence of asthma and allergy in non-elite marathon runners and investigated the effects of probiotic supplementation on allergic inflammatory markers. METHODS: Asthma and allergies were surveyed by questionnaire, and blood eosinophils, serum eosinophil cationic protein (ECP), total IgE, and Phadiatop were measured in 141 Finnish marathon runners who took part in the Helsinki City Marathon. They were also randomized to receive either Lactobacillus GG (LGG) or placebo during the 3 months of the pollen season prior to the marathon. RESULTS: Lifetime prevalence of physician-diagnosed asthma was 4.3% (six out of 139 athletes), of allergic rhinitis 17.3% (24/139), of food allergy 5.0% (7/139), and of atopic eczema 4.3% (6/139). Prevalence of atopy was 31% (35/112), and 21% (24/112) of the athletes were sensitized to birch pollen. Asthma or allergy medication was used by 20% (28/139) of the athletes. During pollen season, serum ECP increased significantly in all athletes, and total IgE and Phadiatop in atopics. The marathon induced a significant eosinopenia but had no effect on serum ECP or total IgE. No differences in changes were seen between groups receiving LGG or placebo. CONCLUSION: Non-elite marathon runners have asthma and allergies similar to Finnish general population. LGG supplementation did not prevent the increase of allergic markers during the pollen season, or the eosinopenia induced by the marathon.

Oxigenación hiperbárica en el tratamiento de fístulas gastrointestinales postoperatorias

Se trataron 30 pacientes, con Oxigenación Hiperbárica como tratamiento coadyuvante, que presentaban fístulas crónicas o agudas enterocutáneas, sin tendencia objetiva al cierre, en el Hospital Celestino Hernández Robau, de Junio de 1991 a Julio de 2004, de forma ambulatoria o ingresados. Los tratamientos se realizaron en cámaras monoplazas (OKM-T) con velocidad de compresión y descompresión de 0.1 0.2 Kg.f/cm2, programándose cursos de tratamiento de 10 sesiones a 2 ATA. Se evaluaron los resultados, según los criterios de la Comisión Nacional de Medicina Hiperbárica, considerando un resultado SATISFACTORIO, aquellos casos en los que se obtuvo el cierre total de la fístula. Del total de pacientes afectos, tratados con Oxigenación Hiperbárica como parte del tratamiento médico, se obtuvo un 83 por ciento de éxito, con un tiempo promedio menor a 10 días, lo que nos indica que este es un tratamiento que mejora significativamente el cierre de estas fístulas, que acorta el tiempo de resolución, que disminuye los días de estancia intrahospitalaria, reintervenciones quirúrgicas, tratamientos con múltiples antibióticos y el costo, que esto conlleva. (Total de palabras: 170)(AU)