Doxofylline as a steroid-sparing treatment in Mexican children with asthma.

OBJECTIVE: The aim of this pilot study was to assess the efficacy of doxofylline as an ICS-sparing agent in the treatment of Mexican children with asthma. METHODS: 10-week, open-label, crossover, pilot study, we examined the steroid-sparing effect of doxofylline in Mexican children with asthma. Patients aged 6-16 years treated with inhaled corticosteroids (ICS) for at least 8 wk before enrollment were divided randomly into two groups at the baseline visit. Group A (n = 31) received doxofylline (18 mg/kg/day) plus standard-dose budesonide (D + SDB) for the first 4-week period followed by doxofylline plus reduced-dose budesonide (D + RDB) for the second 4-week period. Group B (n = 30) received D + RDB followed by D + SDB. Clinical outcomes assessed included lung function (forced expiratory volume; in 1 s, FEV1), fractional exhaled nitric oxide (FeNO), asthma control, number of exacerbations and use of rescue medication (salbutamol). RESULTS: It was shown that combined use of doxofylline and ICS may allow children with asthma to reduce their daily dose of ICS while maintaining lung function and improving asthma control (p = 0.008). There were few asthma exacerbations and only one patient required treatment with systemic corticosteroids. Rescue medication use decreased significantly in patients receiving D + SDB during the first 4-week period. CONCLUSIONS: Our results suggest that doxofylline may be a steroid-sparing treatment in asthma, but longer-term, controlled studies are needed to confirm these observations.

Sick building syndrome: do outdoor pollutants and pollen affect it?

Introduction: Sick building syndrome (SBS) refers to non-specific complaints, including upper-respiratory irritative symptoms, headaches, fatigue, and rash, which are usually associated with a particular building by their temporal pattern of occurrence and clustering among inhabitants or colleagues. The aim of the study was to determine the association between the clinical manifestations of sick building syndrome with outdoor pollutants and airborne pollen. Methods: It was a descriptive and prospective observational study conducted from November 2021 to April 2022. It included subjects over 18 years old who completed an online survey on sick building syndrome (general symptoms, nasal, ocular, oropharyngeal, and skin symptoms) presented at home, housing information and personal history. The APS-330 from Pollen Sense ® was used to obtain data on pollen in the air and the local pollution monitoring system (SIMA) to obtain information regarding pollutants. For statistical analysis, SPSS version 16 was used. Results: A total of 402 surveys were included; 91% of the subjects reported having at least 1 symptom. Females presented more general symptoms (fatigue and headache) than males. Subjects with a personal history of atopy showed a higher prevalence of practically all symptoms. Airborne pollen exposure was positively associated with mucosal symptoms in eyes and nose. Outdoor fungi spore exposure was positively associated with oculo-nasal and cutaneous symptoms in the scalp. Conclusion: This study found significant associations with female gender and a history of atopy, which suggests a higher risk for these subjects. Despite the limitations of the study, we can conclude that there is an association between the clinical manifestations of sick building syndrome with indoor and outdoor pollution.

The association of air pollution in respiratory allergy: Its impact in an industrial city.

Background: Asthma and allergic diseases have increased in recent decades and are more common in industrialized countries. Industrial areas with a considerably high number of inhabitants and vehicles can favor the presence of serious air pollution and therefore the appearance and exacerbation of respiratory allergy symptoms. The objective of this study was to determine the relationship between exposure to environmental pollutants with exacerbation of respiratory allergy. Methods: A total of 240 subjects above 6 years old who lived in the metropolitan area of Monterrey, Nuevo León, Mexico, with diagnosis of allergic rhinitis and/or asthma, were included. The subject's address was registered in the database and the rhinitis control assessment test (RCAT) and the asthma control test (ACT) were applied. Environmental data were obtained from the Environmental Monitoring System (SIMA) of Nuevo León. Geolocation of industries and avenues in proximity of subject's addresses and SIMA stations were obtained through geographic information systems using ArcGis software. Results: The relation between pollutants and subjects' RCAT, ACT, and spirometry results in the 14 stations was established. PM10 and forced vital capacity (FVC) had an r = 0.074 with p = 0.005, PM10 and absolute FEV1/FVC ratio presented an r = -0.102 with a p = 0.000; The distance found to be associated with a worsening of respiratory symptoms was living 165 m from a main road or 241 m from an industrial establishment. Conclusions: Exposure to pollutants present in the environment are factors associated with increased symptoms in subjects with respiratory allergies.

[Epidemiology of food allergy]. / Epidemiología de la alergia alimentaria.

Food allergy is very common throughout the world and has become a major public health problem, with 220 million people suffering from it. Food allergy has been disproportionately observed in people from industrialized or Western countries and was previously considered to predominate in the pediatric versus adult population. However, the current exponential growth of the adult population and older adults, especially in Western countries, and environmental and lifestyle changes, have profoundly changed the epidemiology of food allergy, with a growing increase even at advanced ages. The foods that represent the greatest severity and clinical impact are peanuts, walnuts, fish, shellfish, eggs, cow's milk protein, wheat, soy and seeds. Although some types of food allergies (cow's milk and egg) may disappear, peanut and tree nut allergies may persist into adulthood. The control or cure of cow's milk protein allergy is gradual throughout childhood and adolescence. Despite the predominance of allergy to fish, shellfish, peanuts, and tree nuts in most reactions in adults, the most common form of IgE-mediated food allergy is oral allergy syndrome or pollen allergy syndrome. food.

La alergia alimentaria es muy común en todo el mundo y se ha convertido en un importante problema de salud pública, pues 220 millones de personas la padecen. La alergia alimentaria se ha observado de manera desproporcionada en personas de países industrializados u occidentales, y se considera previamente con predominio en la población pediátrica versus adultos. Sin embargo, el crecimiento exponencial actual de la población adulta y adultos mayores, especialmente en los países occidentales, y los cambios ambientales y de estilo de vida, han cambiado profundamente la epidemiología de la alergia alimentaria, con un aumento creciente incluso en edades avanzadas. Los alimentos que representan mayor gravedad y repercusión clínica son: cacahuate, nuez, pescado, mariscos, huevo, proteína de leche de vaca, trigo, soya y semillas. Aunque algunos tipos de alergia alimentaria (leche de vaca y huevo) pueden desaparecer, la alergia al cacahuete y la nuez de árbol pueden persistir hasta la edad adulta. El control o curación de la alergia a la proteína de leche de vaca es gradual a lo largo de la niñez y la adolescencia. A pesar del predominio de la alergia al pescado, mariscos, cacahuates y nueces de árbol en la mayoría de las reacciones en adultos, la forma más común de alergia alimentaria mediada por IgE en es el síndrome de alergia oral o síndrome de alergia al polen-alimento.

Rinosinusitis crónica, síntomas predominantes en menores de 14 años que acudieron al centro regional para la prevención y el tratamiento de las enfermedades alérgicas / Chronic rhinosinusitis in population younger 14 years main symptoms

La rinosinusitis crónica afecta al 5 por ciento de la población que sufre infecciones de las vías respiratorias. El objetivo del presente estudio es conocer los sintomas predominantes en la población menor de 14 años con diagnóstico de rinosinusitis crónica, conocer su distribución etaria, por sexo y tiempo de evolución. Se incluyeron 100 pacientes con este diagnóstico a quienes se les realizaron: historia clínica, examen físico, citología nasal, pruebas cutáneas y serie de senos paranasales. Los sintomas predominantes fueron: tos, halitosis, descarga retronasal purulenta, fiebre, cefalea, odinofagia, dolor facial, y edema periorbitario, de predominio en el sexo masculino y con un tiempo promedio de evolución de 1-2 años