RESUMEN
OBJECTIVE: Annual recommendations on influenza vaccine use in different countries are developed by influenza-specific working groups within their Immunization Advisory Committees. Adults aged 65 years and over are included in the groups for which vaccination against influenza is particularly recommended due to the morbidity associated. A variety of influenza vaccines are available, some of which boosted immunity, are licensed for use only in this specific age group, where the immune response to traditional influenza vaccines may be suboptimal. We analyze the main annual recommendations on the use of the influenza vaccine issued by advisory committees on immunization for the population over 65 years of age. METHODS: The latest influenza vaccination guidelines have been selected and the recommendations for people over 65 years of age published by the main vaccination advisory committees have been reviewed. RESULTS: The UK Advisory Committee (JCVI) recommends the use of Quadruvalent Inactivated Influenza Vaccine with Adjuvant (aQIV) or High Dose Quadrivalent Inactivated Influenza Vaccine (QIV-HD). The US committee (ACIP) does not express a preference for any type of vaccine. The Australian committee (ATAGI) preferably recommends adjuvanted influenza vaccine. The advisory committees of Canada and Germany (NACI, STIKO) and the European Center for Disease Control (Ecdc) recommend using any of the age-appropriate flu vaccines available, although they bet on the The UK Advisory Committee (JCVI) recommends the use of Quadruvalent Inactivated Influenza Vaccine with Adjuvant (aQIV) or High Dose Quadrivalent Inactivated Influenza Vaccine (QIV-HD). The US committee (ACIP) does not express a preference for any type of vaccine. The Australian committee (ATAGI) preferably recommends adjuvanted influenza vaccine. The advisory committees of Canada and Germany (NACI, STIKO) and the European Center for Disease Control (Ecdc) recommend using any of the age-appropriate flu vaccines available, although they bet on the use of inactivated quadrivalent flu vaccine high dose at the individual level for those over 65 years.use of inactivated quadrivalent flu vaccine high dose at the individual level for those over 65 years. CONCLUSIONS: It is necessary further studies and improvement in their quality that analyze the different vaccines available and their comparability, although the use of reinforced immunity vaccines is generally recommended in the population over 65 years of age.
Asunto(s)
Vacunas contra la Influenza , Gripe Humana , Adulto , Comités Consultivos , Anciano , Australia , Humanos , Esquemas de Inmunización , Gripe Humana/prevención & control , Estaciones del Año , VacunaciónAsunto(s)
Endocarditis/epidemiología , Costos de la Atención en Salud/estadística & datos numéricos , Adulto , Distribución por Edad , Anciano , Endocarditis/economía , Endocarditis Bacteriana/economía , Endocarditis Bacteriana/epidemiología , Femenino , Humanos , Incidencia , Tiempo de Internación/estadística & datos numéricos , Tiempo de Internación/tendencias , Masculino , Persona de Mediana Edad , Mortalidad/tendencias , Distribución por Sexo , España/epidemiologíaRESUMEN
Background: The National Dietary Survey on the Child and Adolescent Population in Spain (ENALIA) provides data to assess the usual micronutrient intake among Spanish infants, children, and adolescents. Methods: Cross-sectional survey (November 2012-July 2014) of a representative sample of Spanish children and adolescents (six months-17 years) (n = 1862). Dietary information was collected using two non-consecutive one-day food diaries (six months-10 years old) or two 24 h dietary recalls (11 years and older) separated by at least 14 days. Estimates were calculated using the Iowa State University method and PC-SIDE software (version 1.0, department of statistics, center for agricultural and rural development, Ames, IA, USA) to account for within- and between-person variation. Results: Usual intake of vitamin D was insufficient in practically all individuals. Vitamin E, folate, and calcium were insufficient, especially from nine years of age, and magnesium and iodine from 14 years of age. The percentage of subjects with insufficient intakes was higher among females. Sodium intake was excessive in a considerable percentage of the population, especially in males, and it increased with age. Finally, over half of children under four years of age had zinc usual intakes that exceeded the Tolerable Upper Level. Conclusion: Vitamin and mineral intake in Spain should be improved, especially in late childhood and adolescence. Nutritional intervention and educational strategies are needed to promote healthy eating habits and correct micronutrient inadequacies in Spanish children and adolescents.
Asunto(s)
Dieta , Micronutrientes/sangre , Micronutrientes/deficiencia , Evaluación Nutricional , Necesidades Nutricionales , Adolescente , Antropometría , Calcio de la Dieta/administración & dosificación , Calcio de la Dieta/sangre , Niño , Preescolar , Estudios Transversales , Registros de Dieta , Ácido Fólico/administración & dosificación , Ácido Fólico/sangre , Humanos , Lactante , Masculino , Micronutrientes/administración & dosificación , Factores Socioeconómicos , Sodio/orina , España , Vitamina D/administración & dosificación , Vitamina D/sangre , Vitamina E/administración & dosificación , Vitamina E/sangre , Población BlancaRESUMEN
No disponible
Asunto(s)
Anciano , Femenino , Humanos , Masculino , Gripe Humana/complicaciones , Gripe Humana/diagnóstico , Gripe Humana/epidemiología , Gripe Humana/mortalidad , Gripe Humana/transmisión , Gripe Humana/prevención & control , Vacunas contra la Influenza/uso terapéutico , Vacunas contra la Influenza/inmunología , Monitoreo Epidemiológico/tendencias , Resultado del Tratamiento , Hospitalización , Vacunas de Productos Inactivados , Vacunas de Productos Inactivados/uso terapéutico , Grupos de Riesgo , Estudios Epidemiológicos , España/epidemiologíaRESUMEN
No disponible
Asunto(s)
Adulto , Femenino , Humanos , Masculino , Contención de Riesgos Biológicos/prevención & control , Vacunas contra la Influenza/uso terapéutico , Vacuna contra el Sarampión-Parotiditis-Rubéola/uso terapéutico , Vacunas contra la Hepatitis A/uso terapéutico , Vacunas contra Hepatitis B/uso terapéutico , Vacunas contra la Tuberculosis/uso terapéutico , Vacunas Neumococicas/uso terapéutico , Vacunas contra Poliovirus/uso terapéutico , Vacunas Meningococicas/uso terapéutico , Monitoreo Epidemiológico/tendencias , Vacunas Tifoides-Paratifoides/uso terapéutico , Enfermedades Transmisibles/epidemiología , Enfermedades Profesionales/epidemiología , Exposición Profesional , Riesgos Laborales , Vacunación , Salud Laboral , Empleos en Salud , Grupos de Riesgo , España/epidemiologíaRESUMEN
No disponible
Asunto(s)
Adolescente , Adulto , Femenino , Humanos , Masculino , Programas de Inmunización/tendencias , Vacuna contra Difteria, Tétanos y Tos Ferina/uso terapéutico , Vacunas Neumococicas/uso terapéutico , Vacunas Meningococicas/uso terapéutico , Vacunas contra Hepatitis Viral/uso terapéutico , Vacuna contra la Varicela/uso terapéutico , Vacuna contra el Herpes Zóster/uso terapéutico , Vacuna contra el Sarampión-Parotiditis-Rubéola/uso terapéutico , Vacunas contra Papillomavirus/uso terapéutico , Monitoreo Epidemiológico/tendencias , Vacunación , Vacunas contra la Influenza/uso terapéutico , Grupos de Riesgo , Huésped Inmunocomprometido , España/epidemiologíaRESUMEN
Background: The diagnosis of anaphylactic reactions due to opiates during anaesthesia can be difficult, since in most cases various drugs may have been administered. Detection of specific IgE to poppy seed might be a marker for sensitisation to opiates in allergic people and heroin-abusers. This study assessed the clinical value of morphine, pholcodine and poppy seed skin-prick and IgE determination in people suffering hypersensitivity reactions during anaesthesia or analgesia and drug-abusers with allergic symptoms. Methods: We selected heroin abusers and patients who suffered severe reactions during anaesthesia and analgesia from a database of 23,873 patients. The diagnostic yield (sensitivity, specificity and predictive value) of prick and IgE tests in determining opiate allergy was analysed. Results: Overall, 149 patients and 200 controls, mean age 32.9±14.7 years, were included. All patients with positive prick to opiates showed positive prick and IgE to poppy seeds, but not to morphine or pholcodine IgE. Among drug-abusers, 13/42 patients (31%) presented opium hypersensitivity confirmed by challenge tests. Among non-drug abusers, sensitisation to opiates was higher in people allergic to tobacco (25%), P<0.001. Prick tests and IgE against poppy seed had a good sensitivity (95.6% and 82.6%, respectively) and specificity (98.5% and 100%, respectively) in the diagnosis of opiate allergy. Conclusions: Opiates may be significant allergens. Drug-abusers and people sensitised to tobacco are at risk. Both the prick and specific IgE tests efficiently detected sensitisation to opiates. The highest levels were related to more-severe clinical profiles(AU)
Asunto(s)
Humanos , Masculino , Femenino , Adulto , Trastornos Relacionados con Sustancias/complicaciones , Trastornos Relacionados con Sustancias/diagnóstico , Trastornos Relacionados con Sustancias/inmunología , Morfina/uso terapéutico , Inmunoglobulina E/efectos adversos , Inmunoglobulina E , Inmunoglobulina E/toxicidad , Receptores de IgE/administración & dosificación , Receptores de IgE/metabolismo , Hipersensibilidad/complicaciones , Trastornos Relacionados con Sustancias/tratamiento farmacológico , Trastornos Relacionados con Sustancias/fisiopatología , Hipersensibilidad Inmediata/complicacionesRESUMEN
BACKGROUND: The diagnosis of anaphylactic reactions due to opiates during anaesthesia can be difficult, since in most cases various drugs may have been administered. Detection of specific IgE to poppy seed might be a marker for sensitisation to opiates in allergic people and heroin-abusers. This study assessed the clinical value of morphine, pholcodine and poppy seed skin-prick and IgE determination in people suffering hypersensitivity reactions during anaesthesia or analgesia and drug-abusers with allergic symptoms. METHODS: We selected heroin abusers and patients who suffered severe reactions during anaesthesia and analgesia from a database of 23,873 patients. The diagnostic yield (sensitivity, specificity and predictive value) of prick and IgE tests in determining opiate allergy was analysed. RESULTS: Overall, 149 patients and 200 controls, mean age 32.9 ± 14.7 years, were included. All patients with positive prick to opiates showed positive prick and IgE to poppy seeds, but not to morphine or pholcodine IgE. Among drug-abusers, 13/42 patients (31%) presented opium hypersensitivity confirmed by challenge tests. Among non-drug abusers, sensitisation to opiates was higher in people allergic to tobacco (25%), P<.001. Prick tests and IgE against poppy seed had a good sensitivity (95.6% and 82.6%, respectively) and specificity (98.5% and 100%, respectively) in the diagnosis of opiate allergy. CONCLUSIONS: Opiates may be significant allergens. Drug-abusers and people sensitised to tobacco are at risk. Both the prick and specific IgE tests efficiently detected sensitisation to opiates. The highest levels were related to more-severe clinical profiles.
Asunto(s)
Anafilaxia/diagnóstico , Codeína/análogos & derivados , Hipersensibilidad a las Drogas/diagnóstico , Inmunoglobulina E/sangre , Morfina , Morfolinas , Papaver/inmunología , Trastornos Relacionados con Sustancias/complicaciones , Trastornos Relacionados con Sustancias/inmunología , Adolescente , Adulto , Anciano , Anafilaxia/complicaciones , Estudios de Casos y Controles , Niño , Codeína/efectos adversos , Codeína/inmunología , Hipersensibilidad a las Drogas/complicaciones , Femenino , Humanos , Masculino , Persona de Mediana Edad , Morfina/efectos adversos , Morfina/inmunología , Morfolinas/efectos adversos , Morfolinas/inmunología , Opio/administración & dosificación , Papaver/efectos adversos , Valor Predictivo de las Pruebas , Semillas , Sensibilidad y Especificidad , Pruebas Cutáneas , Nicotiana/inmunología , Adulto JovenRESUMEN
Objetivo: Describir la tendencia y la estacionalidad de las infecciones por el virus respiratorio sincitial (VRS) en el Área de Salud de Valladolid Este durante el periodo 1993-2010.Pacientes y métodos: Se incluyeron en el estudio las muestras analizadas entre enero de 1993 y diciembre de 2010 por el Servicio de Microbiología e Inmunología del Hospital Clínico Universitario de Valladolid. Las muestras se clasificaron en función de la edad del paciente y el método de diagnóstico. El análisis virológico se llevó a cabo mediante técnicas de diagnóstico rápido, cultivo celular o microarrays. Se calcularon las tasas anuales referidas al área cubierta por el hospital para identificar la tendencia desde 1993 hasta 2010. Los meses epidémicos se establecieron mediante el índice epidémico, y la periodicidad mediante el método cosinor. Resultados: De 4.103 muestras analizadas de pacientes con síntomas respiratorios, en 1.644 (40,1%) se confirmó la presencia de VRS. Casi el 90% de los casos confirmados se dieron en pacientes menores de 2 años, y el 59,5% en menores de 1 año. Las tasas fluctuaron cada 2-4 años, alcanzando valores máximos en 2002 y 2003, con 41,5 y 44,9 casos por 100.000 habitantes-año, respectivamente. Aunque se produjeron casos durante todo el año, los periodos epidémicos se dieron entre septiembre y marzo, detectándose la mayor incidencia en enero y la menor en julio. Conclusiones: Los datos epidemiológicos (prevalencia del virus en muestras respiratorias y distribución por edad) fueron similares a los descritos en otros estudios. Los periodos epidémicos se describieron entre septiembre y marzo, alcanzado el máximo de incidencia en enero y el mínimo en julio. A pesar de ello, a lo largo de los 18 años estudiados sólo en 5 años no hubo circulación de VRS durante 2-3 meses, y en 8 más el VRS estuvo ausente durante un mes. No hay ningún dato que permita anticipar la ausencia de circulación del virus, aspecto importante para la profilaxis de esta infección (AU)
Purpose: The aim of the study is to describe the trend and seasonality of respiratory syncytial virus (RSV) infections in the East Valladolid Health Administrative-Division during the period1993-2010.Patients and Methods: Samples processed in the area of Eastern Valladolid by the Department of Microbiology and Immunology at the Hospital Clínico Universitario of Valladolid between January 1993 and December 2010 were included in the analysis. Cases were classified by age and diagnostic method. Virological diagnosis of the cases was carried out through rapid assay methods, shell-vial cell culture assay or microarray techniques. Annual rates were calculated to identify the trend of the infection from 1993 to 2010. The epidemic index was used to establish epidemic months and cosinor method to evaluate periodicity. Results: From 4,103 samples processed, collected from patients with respiratory symptoms, 1,644 (40.1%) were confirmed to be RSV possitive. Almost 90% of the confirmed cases appeared in patients under 2 years old, 59.5% in younger than1 year old children. The infection trend seems to fluctuate every 2-4 years with higher rate in 2002 and 2003, accounting for 41.5 and 44.9 cases detected per 100,000 inhabitants-year, respectively. Although cases were detected throughout all the year, epidemic periods were detected from September to March with highest values in January and lowest values in July. Conclusions: Epidemiological data (VRS prevalence in respiratory samples and distribution of cases by age) was similar to those obtained in previous studies. Epidemic periods were described from September to March with the highest numbers of cases in January and lowest values in July. In spite of this, along the eighteen years studied there were eight years without RSV detection in one month and only five years without detection in 2-3 months. There is no data that allows to predict the lack of circulation for RSV, being an important factor for the prophylaxis of the infection (AU)
Asunto(s)
Humanos , Masculino , Femenino , Virus Sincitiales Respiratorios/aislamiento & purificación , /complicaciones , /microbiología , /epidemiología , Bronquiolitis/epidemiología , Técnica del Anticuerpo Fluorescente Directa , Monitoreo Epidemiológico/tendencias , Infecciones del Sistema Respiratorio/patología , España/epidemiología , /fisiopatología , Cromatografía de Afinidad/métodos , Cromatografía de Afinidad , Reacción en Cadena de la PolimerasaRESUMEN
Background: Cannabis is the illicit drug most widely used by young people in high-income countries. Allergy symptoms have only occasionally been reported as one of the adverse health effects of cannabis use. Objectives: To study IgE-mediated response to cannabis in drug users, atopic patients, and healthy controls. Methods: Asthmatic patients sensitised to pollen, and all patients sensitised to tobacco, tomato and latex, considered as cross-reacting allergens, were selected from a data base of 21,582 patients. Drug users attending a drug-rehabilitation clinic were also included. Controls were 200 non-atopic blood donors. Specific IgE determination, prick tests and specific challenge with cannabis extracts were performed in patients and controls. Results: Overall, 340 patients, mean age 26.9±10.7 years, were included. Males (61.4%) were the most sensitised to cannabis (p<0.001). All cannabis-sensitised patients were alcohol users. Eighteen (72%) of the patients allergic to tomato were sensitised to cannabis, but a positive specific challenge to cannabis was highest in patients sensitised to tobacco (13/21, 61.9%), (p<0.001). Pollen allergy was not a risk factor for cannabis sensitisation. Prick tests and IgE for cannabis had a good sensitivity (92 and 88.1%, respectively) and specificity (87.1 and 96%) for cannabis sensitisation. Conclusions: Cannabis may be an important allergen in young people. Patients previously sensitised to tobacco or tomato are at risk. Cannabis prick tests and IgE were useful in detecting sensitisation (AU)
Asunto(s)
Humanos , Masculino , Femenino , Adulto , Hipersensibilidad/inmunología , Cannabis/inmunología , Asma/complicaciones , Asma/diagnóstico , Asma/inmunología , Hipersensibilidad Inmediata/diagnóstico , Hipersensibilidad Inmediata/inmunología , Inmunoglobulina E , Inmunoglobulina E/inmunología , Espirometría/métodos , Abuso de Marihuana/inmunología , Drogas Ilícitas/inmunología , Drogas Ilícitas/aislamiento & purificaciónRESUMEN
BACKGROUND: Cannabis is the illicit drug most widely used by young people in high-income countries. Allergy symptoms have only occasionally been reported as one of the adverse health effects of cannabis use. OBJECTIVES: To study IgE-mediated response to cannabis in drug users, atopic patients, and healthy controls. METHODS: Asthmatic patients sensitised to pollen, and all patients sensitised to tobacco, tomato and latex, considered as cross-reacting allergens, were selected from a data base of 21,582 patients. Drug users attending a drug-rehabilitation clinic were also included. Controls were 200 non-atopic blood donors. Specific IgE determination, prick tests and specific challenge with cannabis extracts were performed in patients and controls. RESULTS: Overall, 340 patients, mean age 26.9±10.7 years, were included. Males (61.4%) were the most sensitised to cannabis (p<0.001). All cannabis-sensitised patients were alcohol users. Eighteen (72%) of the patients allergic to tomato were sensitised to cannabis, but a positive specific challenge to cannabis was highest in patients sensitised to tobacco (13/21, 61.9%), (p<0.001). Pollen allergy was not a risk factor for cannabis sensitisation. Prick tests and IgE for cannabis had a good sensitivity (92 and 88.1%, respectively) and specificity (87.1 and 96%) for cannabis sensitisation. CONCLUSIONS: Cannabis may be an important allergen in young people. Patients previously sensitised to tobacco or tomato are at risk. Cannabis prick tests and IgE were useful in detecting sensitisation.
Asunto(s)
Alérgenos/inmunología , Antígenos de Plantas/inmunología , Asma/inmunología , Cannabis , Grupos de Población , Adolescente , Adulto , Alérgenos/efectos adversos , Asma/diagnóstico , Asma/epidemiología , Cannabis/inmunología , Reacciones Cruzadas , Femenino , Humanos , Drogas Ilícitas/inmunología , Inmunoglobulina E/inmunología , Solanum lycopersicum/inmunología , Masculino , Polen/efectos adversos , Riesgo , Sensibilidad y Especificidad , Pruebas Cutáneas , España , Nicotiana/inmunologíaRESUMEN
Prior to marketing of pandemic influenza vaccines, the only safety data were those from clinical trials. The objective of this study was to compare information coming from spontaneous reporting with that systematically collected in a formal observation study; this also permits to further evaluate safety of pandemic influenza vaccines in the targeted patients' population. Out of a sample of 507 vaccinated subjects, 103 (20.3%) developed some complication. In the same period 83 reports corresponding to all vaccinated people of Castilla y León (n=131,462) were collected. Severe cases were 1 (1%) and 7 (8.4%), respectively, with the two procedures. The spontaneous reporting rate was 322-fold lower than that identified through the follow-up study; when considered the severe cases, it was 37-fold lower. Under certain circumstances reporting might be performing better than usual due to strengthening of the surveillance system. Adverse events observed for the pandemic H1N1 vaccines lie within the expected safety profile for common events with influenza vaccines. An overall benefit-risk assessment of these vaccines should be done.
Asunto(s)
Subtipo H1N1 del Virus de la Influenza A/inmunología , Vacunas contra la Influenza/efectos adversos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Recolección de Datos/métodos , Femenino , Humanos , Vacunas contra la Influenza/administración & dosificación , Gripe Humana/prevención & control , Masculino , Persona de Mediana Edad , España , Adulto JovenRESUMEN
BACKGROUND: Allergen cross-reactivity between tobacco and other species of Solanaceae family (tomato, potato, aubergine and egg plant) have been reported. We have recently studied IgE response to tobacco in asthmatic patients sensitised to Lolium perenne (Perennial rye grass pollen) and have found that 30% of the tobacco responsive patients also have latex sensitisation. OBJECTIVE: The aim of our study was to investigate the possibility of cross-reactivity between tobacco and latex in asthmatic patients with IgE response to latex. METHODS: A study was performed on tobacco and latex exposure in 15 patients who suffered from asthma and latex sensitisation and who were randomly chosen from our database of latex-sensitive patients. To identify tobacco and latex as possible allergens that might cause clinical specific responses, all these patients were tested with prick-tests, specific IgE to tobacco, latex and related allergens, bronchial challenge, and patch tests with tobacco, latex and nicotine. Immunological response was evaluated with immunoblotting, immunoblotting-inhibition and EAST-inhibition tests. RESULTS: Positive prick and bronchial challenge with specific IgE>0.35 kU/L to tobacco was demonstrated in 11 asthmatics who were also sensitised to rye grass. Tobacco IgE level was related with sensitisation to latex (p<0.002), but not to other vegetables belonging to the Solanaceae family. EAST-inhibition and immunoblotting-inhibition showed the existence of cross-reactivity between tobacco and latex. CONCLUSIONS: Cross-reactivity exists between latex and tobacco allergens. Smoker patients with IgE response to tobacco may be a risk population for latex sensitisation.
Asunto(s)
Alérgenos/metabolismo , Reacciones Cruzadas/inmunología , Hipersensibilidad/inmunología , Adolescente , Adulto , Alérgenos/inmunología , Pruebas de Provocación Bronquial , Femenino , Humanos , Hipersensibilidad/sangre , Hipersensibilidad/diagnóstico , Hipersensibilidad/epidemiología , Inmunización , Inmunoglobulina E/sangre , Látex/inmunología , Masculino , Factores de Riesgo , Pruebas Cutáneas , Nicotiana/inmunologíaRESUMEN
No disponible
Asunto(s)
Humanos , Enfermedades Profesionales/prevención & control , Vacunación/métodos , Contención de Riesgos Biológicos/prevención & control , Grupos de Riesgo , Protección Personal/métodos , Factores de RiesgoRESUMEN
No disponible
Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto Joven , Esquemas de Inmunización , 51352 , Control de Enfermedades Transmisibles/métodos , Pautas de la Práctica en Medicina , Salud del Adolescente , Salud del AdultoRESUMEN
Diagnosis in patients sensitised to multiple pollens is difficult due to the relationship between pollen and food allergens. Misdiagnosis is often a cause for unsuccessful specific immunotherapy. Wheat is a potent allergen source and is one of the causes of baker's asthma, food and pollen allergy. Recently, we have performed a study on pollen sensitisation in our area, where cereal crops are very important. The clinical data from 19718 patients reviewed showed that grass pollen was the main source of clinical symptoms (6369 patients, 32.30% of asthmatics). However, wheat and cereal crop pollen showed very low prevalence. On the other hand, patients with wheat flour allergy after ingestion and/or with baker's asthma were not sensitised to wheat pollen, despite it containing some common allergens. In the same way, all our asthmatic bakers (135 patients) tolerated the ingestion of bread. Here we try to explain the reason for these surprising observations.
Asunto(s)
Asma/inmunología , Ingestión de Alimentos/inmunología , Harina , Polen/inmunología , Triticum/inmunología , Hipersensibilidad al Trigo/inmunología , Alérgenos/inmunología , Asma/diagnóstico , Humanos , Rinitis Alérgica Estacional/inmunología , Hipersensibilidad al Trigo/diagnósticoRESUMEN
AIM: Cardiopulmonary bypass is associated with a complex systemic inflammatory response and the extent of their increase has been correlated with the development of postoperative complications. Recent studies suggest that treatment with statins is associated with a significant and marked decrease in inflammation-associated variables such as cytokines. Therefore, we investigated the effects of preoperative simvastatin treatment on systemic inflammatory response and perioperative morbidity after cardiopulmonary bypass. METHODS: A prospective, randomized study, was designed. Forty-four subjects undergoing elective coronary artery bypass grafting who fulfilled the inclusion criteria were randomized to treatment with simvastatin (20 mg/day, group A, N. 22) or control (group B, N. 22) before surgery. Plasma levels of interleukins (IL-6, IL-8, TNF-alpha), and systemic inflammatory response score (SIRS) were measured during the surgical intervention and over the following 48 postoperative hours. Cytokine levels were measured by enzyme-linked assays from plasma samples obtained at specific time points pre- and post-operation. RESULTS: In both groups the serum levels of the proinflammatory cytokines (IL-6, IL-8, TNF-alpha), and leukocytes, and the SIRS score increased significantly over the baseline, though no significant differences were observed between the two groups. The preoperative and postoperative course did not differ between both groups. CONCLUSIONS: In patients undergoing coronary artery bypass grafting with cardiopulmonary bypass, the administration of simvastatin doses not produce any changes in the inflammatory response as measured by the levels of IL-6, IL-8, TNF-alpha and SIRS score, nor does it reduce the complications after cardiac surgery.
Asunto(s)
Puente Cardiopulmonar/efectos adversos , Puente de Arteria Coronaria/efectos adversos , Inhibidores de Hidroximetilglutaril-CoA Reductasas/uso terapéutico , Simvastatina/uso terapéutico , Síndrome de Respuesta Inflamatoria Sistémica/prevención & control , Anciano , Biomarcadores/sangre , Ensayo de Inmunoadsorción Enzimática , Femenino , Humanos , Mediadores de Inflamación/sangre , Interleucina-6/sangre , Interleucina-8/sangre , Recuento de Leucocitos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Índice de Severidad de la Enfermedad , Síndrome de Respuesta Inflamatoria Sistémica/etiología , Síndrome de Respuesta Inflamatoria Sistémica/inmunología , Factores de Tiempo , Resultado del Tratamiento , Factor de Necrosis Tumoral alfa/sangreRESUMEN
Diagnosis in patients sensitised to multiple pollens is difficult due to the relationship between pollen and food allergens. Misdiagnosis is often a cause for unsuccessful specific immunotherapy. Wheat is a potent allergen source and is one of the causes of baker's asthma, food and pollen allergy. Recently, we have performed a study on pollen sensitisation in our area, where cereal crops are very important. The clinical data from 19718 patients reviewed showed that grass pollen was the main source of clinical symptoms (6369 patients, 32.30% of asthmatics). However, wheat and cereal crop pollen showed very low prevalence. On the other hand, patients with wheat flour allergy after ingestion and/or with baker's asthma were not sensitised to wheat pollen, despite it containing some common allergens. In the same way, all our asthmatic bakers (135 patients) tolerated the ingestion of bread. Here we try to explain the reason for these surprising observations(AU)