Longitudinal Validation of the Spanish Version of the Health-Related Quality of Life Questionnaire for Hymenoptera Venom Allergy (HRQLHA).

BACKGROUND AND OBJECTIVE: The Spanish version of the health-related quality of life questionnaire for allergy to hymenoptera venom (HRQLHA) has been shown to be reliable, internally consistent, and externally valid. The aim of this study was to complete the validation of the HRQLHA by analyzing its sensitivity to changes (longitudinal validity) using the sting challenge test (SCT) as the variable of change. PATIENTS AND METHODS: Patients over the age of 17 years with a systemic allergic reaction to Apis, Vespula, or Polistes venom were included during their first year of venom-specific immunotherapy. Patients were assigned to either a group that underwent the SCT or a control group that did not. All patients completed the HRQLHA at baseline and after a period of 2 to 4 months, during which time the SCT was performed in the active group, with no intervention in the control group. RESULTS: Fifty patients were included in the study: 25 in the SCT group and 25 in the control group. The patients in the SCT group showed a significant improvement in mean HRQLHA score (+0.35, P=.03) after the SCT, while those in the control group showed no significant changes in questionnaire scores. CONCLUSIONS: Our results demonstrate the sensitivity of the HRQLHA to changes and thus complete the longitudinal validation of the questionnaire. A well-tolerated SCT improves the quality of life of venom-allergic patients as it reduces anxiety associated with the fear of being stung.

Cross-Sectional Validation of a Quality of Life Questionnaire in Spanish for Patients Allergic to Hymenoptera Venom.

INTRODUCTION AND OBJECTIVES: The first quality of life questionnaire for Vespula-allergic patients (Vespid Allergy Quality of Life Questionnaire [VQLQ) was developed in 2002. Our objective was to perform the cross-sectional validation of the Spanish version of this questionnaire. PATIENTS AND METHODS: Using the original English-language version of the VQLQ as a starting point, the Spanish translation and cultural adaptation were performed and the first Spanish version was backtranslated into English and discussed with the authors of the original version. The result was the Spanish Health-related Quality of Life Questionnaire for Hymenoptera Venom-Allergic Patients (HRQLHA). Cross-sectional validation was carried out in a multicenter study using a test-retest design. Patients over the age of 14 diagnosed with systemic allergic reaction to venom from Apis, Vespula, or Polistes species were included. The test-retest reliability, external validity, and internal consistency of the questionnaire were measured. RESULTS: The sample comprised 116 patients. The mean HRQLHA score was 3.48. Test-retest reliability showed an intraclass correlation coefficient of 0.85. HRQLHA showed a positive correlation (0.5) with an external questionnaire, thus demonstrating its external validity. Analysis of the internal consistency of the HRQLHA yielded a Cronbach α of 0.95, which can be considered to be excellent. CONCLUSIONS: Statistical analysis revealed the high test-retest reliability, internal consistency, and external validity of the HRQLHA. The HRQLHA is the first validated questionnaire to include patients allergic to Polistes species, which is common in our area. Our findings show that the questionnaire is also valid for these patients.

Microabrasion: a treatment option for white spots.

The aim of the present study was to describe a clinical protocol for the treatment of white spots with the use of an abrasive material. A four-year-old patient presented with a white spot on tooth 51 and a white spot associated with a carious lesion in the cervical region of tooth 52. Treatment was planned with microabrasion and restoration of the upper right lateral incisor. Prophylaxis was first performed, followed by protection with a dental dam and the application of the abrasive material (silicon carbide and hydrochloric acid 6%). Five applications were needed to remove the spots. The restoration of the upper right lateral incisor was then performed with a resin composite. A good esthetic outcome was achieved and both the patient and her guardians were satisfied with the results. Microabrasion is a conservative treatment option that achieves satisfactory results with regard to tooth color.

Necrotizing sialometaplasia in an HIV positive cocaine user: a case report.

The aim of this paper was to present a case report of a male patient attending a Semiology and Stomatology Clinic with an erythematous ulcerated lesion on his palate. The patient reported that he was HIV positive as well as being addicted to cocaine. After a biopsy and a histopathological exam, he was diagnosed as having necrotizing sialometaplasia. The lesion diminished spontaneously in thirty days after the exam. Correct diagnosis as well as physical and complementary exams are paramount to avoid any incorrect therapy. As drug addiction and HIV infection have both been associated to necrotizing sialometaplasia, as in the present case, it is difficult to establish if the aetiological factor was drug usage or the HIV infection or even, the combination of these two factors. Although considering the influence of HIV infection on the oral health, we may assume that, at least, it favored the onset of this oral lesion.

Correlation between Alt a 1 levels and clinical symptoms in Alternaria alternata-monosensitized patients.

BACKGROUND: Alternaria alternata is a risk factor for developing asthma.Alt a 1, which has been described as the major allergen in A alternata, shows a good correlation with A alternata spores only when they have germinated. OBJECTIVES: The objective of this study was to determine the correlation between spore counts and clinical symptoms in patients with allergic asthma and/or rhinitis monosensitized to A alternata. METHODS: Two types of samplers were used to determine exposure: a Burkard spore trap to collect A alternata spores and a high-volume air sampler to collect airborne particles. A total of 366 air filters were collected. Alt a 1 levels were measured by monoclonal antibody-based enzyme-linked immunosorbent assay. Eighteen monosensitized patients were asked to record their daily symptoms throughout the year. RESULTS: A alternata spores were detected throughout the year, whereas Alt a 1 was detected only between March and December. Symptoms showed positive and significant correlations with spore counts (r=0.459, P<.001), and Alt a 1 levels (r=0.294, P<.001). The correlation between spores and Alt a 1 was low. The negative binomial model proved that an increase of 10 pg/m3 in Alt a 1 levels increased the number of symptoms at a 3-day lag by 5%. CONCLUSIONS: In patients who are allergic to A alternata, Alt a 1 levels can be considered an important marker for predicting the risk of respiratory symptoms.

Induction of oral tolerance to peanut: a successful home-based protocol.

In Spain, peanut allergy is increasingly prevalent. Successful protocols for the induction of oral tolerance (LOT) with several foods have been reported. We aimed to induce clinical tolerance to peanut in a child with severe peanut allergy (age 4 years, facial urticaria and lip angioedema upon licking a peanut; peanut skin prick test, 13 x 10 mm; specific immunoglobulin (Ig) E > 100 kUA/L). At age 6, the threshold oral challenge dose was 62.5 mg. Several peanut solutions were prepared and sequentially administered at the patient's home. Over 138 days, the dose was increased from 0.625 to 5500 mg. There were 43 mild-to-moderate reactions (28% of the doses administered). Pre-LOT and post-LOT peanut IgE and IgG4 values were 265 vs 487 kUA/L, and 6.11 vs 14.8 mg/L. This is the first report of successful LOT to peanut in Spain. This home-based regimen is safe under permanent and close medical supervision by an allergist.

Celecoxib, a highly selective COX-2 inhibitor, is safe in aspirin-induced asthma patients.

BACKGROUND: In 5-10% of adult patients with asthma, aspirin and most other nonsteroidal anti-inflammatory drugs (NSAIDs) precipitate acute asthmatic attacks. Therefore, choosing an alternative anti-inflammatory agent for patients who have suffered adverse reactions to a nonsteroidal anti-inflammatory agent is a common problem in clinical practice. The discoveries that cyclooxygenase COX-2 is an inducible form of COX involved in inflammation and COX-1 is the major isoform responsible for the production of prostaglandins have provided a reasonable basis for the development of specific COX-2 inhibitors as a new class of anti-inflammatory agents. OBJECTIVE: The purpose of this study is to demonstrate that celecoxib, a specific inhibitor of COX-2, does not cause asthmatic attacks in patients with aspirin and/or other nonsteroidal anti-inflammatory drug-induced asthma. METHODS: We studied 33 patients, all of whom suffered from asthma induced by at least two different NSAID drugs. They were challenged in a single-blind manner with different doses of celecoxib on three different days, until either the therapeutic dose of 200 mg or intolerance was reached. Each patient was rechallenged with 200 mg celecoxib seven days later if no evidence of intolerance was previously observed. RESULTS: Celecoxib 200 mg was proven to be well tolerated in all 30 three aspirin- and NSAID-induced asthma patients. CONCLUSION: Our study appears to demonstrate that celecoxib is a suitable NSAID in aspirin-induced and/or nonsteroidal anti-inflammatory drug-induced asthma patients.

Hypersensitivity to quail egg proteins: what about hen egg?

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Longitudinal validation of the spanish version of the health-related quality of life questionnaire for hymenoptera venom allergy (HRQLHA)

Background and Objective: The Spanish version of the health-related quality of life questionnaire for allergy to hymenoptera venom (HRQLHA) has been shown to be reliable, internally consistent, and externally valid. The aim of this study was to complete the validation of the HRQLHA by analyzing its sensitivity to changes (longitudinal validity) using the sting challenge test (SCT) as the variable of change. Patients and Methods: Patients over the age of 17 years with a systemic allergic reaction to Apis, Vespula, or Polistes venom were included during their first year of venom-specific immunotherapy. Patients were assigned to either a group that underwent the SCT or a control group that did not. All patients completed the HRQLHA at baseline and after a period of 2 to 4 months, during which time the SCT was performed in the active group, with no intervention in the control group. Results: Fifty patients were included in the study: 25 in the SCT group and 25 in the control group. The patients in the SCT group showed a significant improvement in mean HRQLHA score (+0.35, P=.03) after the SCT, while those in the control group showed no significant changes in questionnaire scores. Conclusions: Our results demonstrate the sensitivity of the HRQLHA to changes and thus complete the longitudinal validation of the questionnaire. A well-tolerated SCT improves the quality of life of venom-allergic patients as it reduces anxiety associated with the fear of being stung (AU)

Introducción y objetivo: El cuestionario de calidad de vida en español para alérgicos a veneno de himenópteros (HRQLHA) ha demostrado su fiabilidad, consistencia interna y validez externa. El objetivo de este estudio era completar la validación del HRQLHA mediante el análisis de su sensibilidad al cambio o validación longitudinal, considerando como variable de cambio la prueba de repicadura controlada intrahospitalaria (RIH). Pacientes y Métodos: Se incluyeron pacientes mayores de 17 años con reacción sistémica por alergia a veneno de Apis, Vespula o Polistes, en el primer año de tratamiento con inmunoterapia. Los pacientes se distribuyeron en un grupo sometido a RIH y un grupo control no sometido a esta prueba. Los pacientes cumplimentaron el HRQLHA basal y después de la repicadura o después de un periodo de 2-4 meses si pertenecían al grupo control. Resultados: Se incluyeron 50 pacientes en el estudio. 25 en el grupo de RIH y 25 en el grupo control. Los pacientes del grupo RIH presentaron una mejoría significativa en la puntuación del cuestionario HRQLHA después de la repicadura de + 0,35 (p=0,03), mientras que los pacientes del grupo control no mostraron cambios significativos en la puntuación del cuestionario. Conclusiones: Los resultados obtenidos demuestran la sensibilidad al cambio del HRQLHA y permiten completar la validación longitudinal del cuestionario. La prueba de repicadura controlada intrahospitalaria bien tolerada mejora la calidad de vida de los pacientes alérgicos a venenos ya que disminuye su ansiedad ante una nueva picadura (AU)

Cross-sectional validation of a quality of life questionnaire in spanish for patients allergic to hymenoptera venom

Introducción: En 2002 se desarrolló el primer cuestionario de calidad de vida para alérgicos a veneno de Vespula (VQLQ). El objetivo de este trabajo es desarrollar y validar una versión en español de este cuestionario. Métodos y Pacientes: Partiendo del VQLQ en inglés se realizó la traducción al español y adaptación cultural del cuestionario con una posterior retraducción consensuada con los autores de la versión original. Así se desarrolló el cuestionario de calidad de vida en español para pacientes alérgicos a veneno de himenópteros (HRQLHA). La validación transversal se realizó mediante un estudio multicéntrico, con diseño test-retest en el que se incluyeron pacientes mayores de 14 años con reacción sistémica por alergia a veneno de Apis, Vespula o Polistes . Se analizó la fiabilidad test-retest, la validez externa y la consistencia interna del cuestionario. Resultados: Se incluyeron 116 pacientes alérgicos a venenos de Apis, Vespula o Polistes . La puntuación media del HRQLHA fue 3.48. El estudio de fiabilidad test-retest mostró un coeficiente de correlación intraclase de 0.85. El HRQLHA mostró una correlación positiva (0.5) con el cuestionario de referencia externa, confirmando su validez. En el análisis de la consistencia interna se encontró una Alpha de Cronbach de 0.95 Conclusiones: El análisis estadístico muestra una elevada fiabilidad test-retest y consistencia interna del HRQLHA, además de su validez externa. En la validación del HRQLHA se han incluido por primera vez pacientes alérgicos a veneno de Polistes, muy prevalente en nuestra área, demostrando la utilidad del cuestionario también en estos pacientes (AU)

Introduction and Objectives: The first quality of life questionnaire for Vespula-allergic patients (Vespid Allergy Quality of Life Questionnaire [VQLQ]) was developed in 2002. Our objective was to perform the cross-sectional validation of the Spanish version of this questionnaire. Patients and Methods: Using the original English-language version of the VQLQ as a starting point, the Spanish translation and cultural adaptation were performed and the first Spanish version was backtranslated into English and discussed with the authors of the original version. The result was the Spanish Health-related Quality of Life Questionnaire for Hymenoptera Venom–Allergic Patients (HRQLHA). Cross-sectional validation was carried out in a multicenter study using a test-retest design. Patients over the age of 14 diagnosed with systemic allergic reaction to venom from Apis, Vespula, or Polistes species were included. The test-retest reliability, external validity, and internal consistency of the questionnaire were measured. Results: The sample comprised 116 patients. The mean HRQLHA score was 3.48. Test-retest reliability showed an intraclass correlation coefficient of 0.85. HRQLHA showed a positive correlation (0.5) with an external questionnaire, thus demonstrating its external validity. Analysis of the internal consistency of the HRQLHA yielded a Cronbach a of 0.95, which can be considered to be excellent. Conclusions: Statistical analysis revealed the high test-retest reliability, internal consistency, and external validity of the HRQLHA.The HRQLHA is the first validated questionnaire to include patients allergic to Polistes species, which is common in our area. Our findings show that the questionnaire is also valid for these patients (AU)

Lolium perenne pollen from a polluted city shows high allergenic potency and increased associated enterobacteriaceae counts

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