Seropositivity and history of hospitalisation for dengue in relation to anthropometric indices among Colombian children and adults.

The role of anthropometric status on dengue is uncertain. We investigated the relations between anthropometric characteristics (height, body mass index and waist circumference (WC)) and two dengue outcomes, seropositivity and hospitalisation, in a cross-sectional study of 2038 children (aged 2-15 years) and 408 adults (aged 18-72 years) from Bucaramanga, Colombia. Anthropometric variables were standardised by age and sex in children. Seropositivity was determined through immunoglobulin G antibodies; past hospitalisation for dengue was self-reported. We modelled the prevalence of each outcome by levels of anthropometric exposures using generalised estimating equations with restricted cubic splines. In children, dengue seropositivity was 60.8%; 9.9% of seropositive children reported prior hospitalisation for dengue. WC was positively associated with seropositivity in girls (90th vs. 10th percentile adjusted prevalence ratio (APR) = 1.19; 95% confidence interval (CI) 1.03-1.36). Among adults, dengue seropositivity was 95.1%; 8.1% of seropositive adults reported past hospitalisation. Height was inversely associated with seropositivity (APR = 0.90; 95% CI 0.83-0.99) and with hospitalisation history (APR = 0.19; 95% CI 0.04-0.79). WC was inversely associated with seropositivity (APR = 0.89; 95% CI 0.81-0.98). We conclude that anthropometry correlates with a history of dengue, but could not determine causation. Prospective studies are warranted to enhance causal inference on these questions.

Analysis of Intrahospital Mortality in Patients With Lung Transplant Due to Diffuse Parenchymal Lung Disease.

BACKGROUND: Patients with diffuse parenchymal lung disease (DPLD) have the poorest survival rates both before and after lung transplantation (LT). Early mortality among LT patients as a result of DLPD is estimated at 10% to 20%. The aim of the study was to assess intrahospital mortality after LT procedures for DLPD and to identify factors in the recipient, donor, intra- and postoperative periods that might improve early outcomes. METHODS: A retrospective, observational, cohort, single-hospital study was conducted. Data from 67 patients with LT patients owing to DPLD were recorded between October 2008 to June 2017 in Madrid, Spain. RESULTS: Out of 67 LT recipients with DPLD, 51 had idiopathic pulmonary fibrosis (IPF)/usual interstitial pneumonia (UIP), 6 nonspecific interstitial pneumonia (NSIP), and 10 other DPLD. Intrahospital mortality took place in 13.4% of patients, with a median survival time of 34 days (interquartile range [IQR], 27.50-66). In the preoperative period, there were no differences in the recipients' demographic and hemodynamic characteristics, respiratory function, or time spent in the waiting list, except higher doses of systemic steroids in nonsurvivors (prednisone 15 vs 10 mg, P = .046). No differences were reported in the donors' characteristics (age, mechanical ventilation hours, PaO2/FiO2). In the intraoperative and postoperative periods, we found differences statistically significant in longer cold ischemia time and development of primary graft dysfunction (PGD) grade 3 in the nonsurvivor group. CONCLUSIONS: The mortality rate in our series was 13.4%, and the main risk factors for intrahospital mortality were longer cold ischemia time and greater incidence of PGD grade 3.

Influence of Pulmonary Hypertension on Intrahospital Mortality in Lung Transplantation for Interstitial Lung Disease.

BACKGROUND: Pulmonary hypertension (PH) is a comorbidity associated with interstitial lung disease (ILD). The purpose of this study was to evaluate the influence of PH on intrahospital mortality in lung transplantation (LT) for ILD. METHODS: We conducted a retrospective cohort study of 66 patients who underwent LT for ILD at the 12 de Octubre University Hospital (Madrid, Spain) from October 2008 to June 2014. PH was defined as mean pulmonary arterial pressure (mPAP) ≥25 mmHg on right-sided heart catheterization and intrahospital mortality as any death taken place after the transplantation of patients not being discharged. RESULTS: We retrospectively analyzed data of 66 patients; they were stratified by the presence or absence of PH before LT. Twenty-seven patients (41%) had PH. The PH group had a lower diffusing capacity of carbon monoxide (DLCO), carbon monoxide transfer coefficient (KCO), and 6-minute walk distance test (6MWT) and a higher total lung capacity (TLC), modified medical research council dyspnea scale (mMRC), and lung allocation score (LAS) than the non-PH group. Patients with PH more often underwent double lung transplantation (DLT; 59%) than single lung transplantation (SLT). Intrahospital mortality was 13% (9/66). No significant differences were observed in Kaplan-Meier survival curves for the PH and non-PH groups with a median survival time of 46 days versus 33 days (IQR 26-74; log-rank P = .056); however, the postoperative length of stay in the hospital was greater in the PH group. CONCLUSIONS: In our cohort, pulmonary hypertension was not related to early mortality in lung transplantation recipients for interstitial lung diseases.

Bronchial asthma, sensitisation and exposure to Der p1 and Der f1 in an Andean Ecuadorian school

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Utilidad de un cuestionario para rastreo del estres postraumatico en una poblacion colombiana / Use fulness of a screening questionnaire for post traumatic stress in a columbian population

Introducción. Las escalas para el diagnóstico del trastorno de estrés postraumático (TEPT) deben ser consistentes con los criterios del DSMIV y validarse para cada cultura. Objetivos. Validar una lista de síntomas (checklist) para el diagnóstico de TEPT en la población de un municipio colombiano semidestruido por un ataque de la guerrilla. Pacientes y métodos. Se seleccionó una muestra aleatoria, representativa y estratificada de 202 habitantes, mayores de 15 años, del municipio de San Joaquín (Santander, Colombia), dos años después de un ataque de la guerrilla. A los participantes se les hizo una entrevista clínica estructurada (SCID- I), basada en los criterios diagnósticos del DSM-IV para TEPT. 76 personas (37,6 por ciento) reunieron los criterios para TEPT y 126 (62,4 por ciento) se consideraron sin TEPT. A los dos grupos se les aplicó una lista de 24 síntomas de TEPT, calificados en una escala de 1 a 4. Resultados. La lista de síntomas tuvo una consistencia interna excelente (coeficiente alfa de Cronbach, 0,97). El grupo de TEPT obtuvo una puntuación de 70,4 ñ 22,9 y el grupo sin TEPT puntuó 37,2 ñ 13,7 (p< 0,0001). Un análisis discriminante mostró una capacidad de clasificación correcta del 88,6 por ciento (p<0,0001). La sensibilidad varió entre el 76,3 por ciento para un punto de corte de 51, hasta 81,6 por ciento para un corte en 45 puntos. La especificidad estuvo entre 71,4 por ciento para un corte en 45 y de 84,4 por ciento para un corte en 51. Conclusión. La lista de síntomas para TEPT tiene una excelente consistencia interna, una buena capacidad discriminante y buenos niveles de sensibilidad y especificidad

[Usefulness of a screening questionnaire for post traumatic stress in a Colombian population]. / Utilidad de un cuestionario para rastreo del estrés postraumático en una población colombiana.

INTRODUCTION: Rating scales for post traumatic stress disorder (PTSD) should be consistents with DSM IV criteria, and should be validate for each culture. OBJECTIVE: To validate a PTSD checklist in a Colombian little town population, which was semi destructed by a guerrilla attack. PATIENTS AND METHODS: A stratified, representative and randomized sample of 202 adult participants, aged over 15 year old, was selected from San Joaquin (Santander Colombia) two year after an guerrilla attack. A structured interview (SCID I), based on DSM IV criteria, was developed with each member of the sample. 76 participants (37.6%) met criteria for PTSD, and 126 (62.4%) were classified as non PTSD. A rating checklist with 24 symptoms of PTSD was applied by self report. Each item of the scale was scored 1 to 4. RESULTS: PTSD checklist had a reliability Cronbach s alpha coefficient of 0.97. PTSD group scored 70.4 22.9, and non PTSD 37.2 13.7 (p< 0.0001) on the PTSD checklist. A discriminant analysis found that the scale had a correctly classification capability of 88.6% (p< 0.0001). Sensibility was found between 76.3% for a cut off point of 51 and 81.6% for cut off point of 45. Specificity changed between 71.4% for a cut off point of 45 and 84.4% for a cut off point of 51. CONCLUSION: Checklist for PTSD had a high reliability, good discriminant capability, and good sensibility and specificity.

Utilidad de un cuestionario para rastreo del estrés postraumático en una población colombiana / Usefulness of a screening questionnaire for post traumatic stress in a colombian population

Introducción. Las escalas para el diagnóstico del trastorno de estrés postraumático (TEPT) deben ser consistentes con los criterios del DSM IV y validarse para cada cultura. Objetivos. Validar una lista de síntomas (checklist) para el diagnóstico de TEPT en la población de un municipio colombiano semidestruido por un ataque de la guerrilla. Pacientes y métodos. Se seleccionó una muestra aleatoria, representativa y estratificada de 202 habitantes, mayores de 15 años, del municipio de San Joaquín (Santander, Colombia), dos años después de un ataque de la guerrilla. A los participantes se les hizo una entrevista clínica estructurada (SCIDI), basada en los criterios diagnósticos del DSM-IV para TEPT. 76 personas (37,6 por ciento) reunieron los criterios para TEPT y 126 (62,4 por ciento) se consideraron sin TEPT. A los dos grupos se les aplicó una lista de 24 síntomas de TEPT, calificados en una escala de 1 a 4. Resultados. La lista de síntomas tuvo una consistencia interna excelente (coeficiente alfa de Cronbach, 0,97). El grupo de TEPT obtuvo una puntuación de 70,4 ñ 22,9 y el grupo sin TEPT puntuó 37,2 ñ 13,7 (p< 0,0001). Un análisis discriminante mostró una capacidad de clasificación correcta del 88,6 por ciento (p< 0,0001). La sensibilidad varió entre el 76,3 por ciento para un punto de corte de 51, hasta 81,6 por ciento para un corte en 45 puntos. La especificidad estuvo entre 71,4 por ciento para un corte en 45 y de 84,4 por ciento para un corte en 51. Conclusión. La lista de síntomas para TEPT tiene una excelente consistencia interna, una buena capacidad discriminante y buenos niveles de sensibilidad y especificidad (AU)

Dust mites but not grass pollen are important sensitizers in asthmatic children in the Ecuadorian Andes.

Grass pollen is an important cause of asthma and rhinoconjunctivitis in Europe and the United States. In the high Andes however, the role this pollen plays in respiratory allergies is unknown. In this study, we tested the prevalence of grass pollen sensitization in comparison to other aeroallergens on 433 asthmatic children living in Quito, Ecuador (the Andes mountain range, 2,800 m above sea level). The skin prick test technique was used. We found that the least sensitizing allergens of all were grass pollen (12.2%) and molds (7.4%) with p < 0.0001. A clear predominance of sensitization to the house dust mite Dermatophagoides pteronyssinus (77.8%) and Dermatophagoides farinae (76.9%), in comparison to the other aeroallergens tested, in terms of sensitization (p = 0.00000) and papule size (p < 0.0002), was observed. The most highly sensitized group consisted of asthmatics between 5 and 15 years of age (D. pteronyssinus 90.7%, D. farinae 87.5%, dog hair 37.4%, cat hair 43%, grass pollen 15.9% and molds 9.9%). In the total study group, males were only more sensitive than females to D. pteronyssinus (82.1% vs. 71.6%, p = 0.0009). We concluded that in the group of asthmatic children studied, grass pollen showed a low capacity of sensitization, even though it is widely found all over our city. The most sensitizing allergens were D. pteronyssinus and D. farinae, followed by cat and dog hair.

Asthma and its relation with Dermatophagoides pteronyssinus and Dermatophagoides farinae in Andean altitudes (Quito, Ecuador).

Previous investigations in alpine altitudes suggest a very low etiopathogenic relation between house-dust mites and bronchial asthma in these geographical zones. Our purpose was to analyze the relationship between asthma and sensitization to the house-dust mites D. pteronyssinus and D. farinae in Andean altitudes. We studied 587 asthmatic patients, residents in Quito, Ecuador, (2800 m above sea level), ranging in age from 8 months to 84 years. The patients were divided into five age groups. We investigated the prevalence of house-dust mite sensitization by skin prick tests in each group. Fifty asymptomatic students with ages between 6 to 20 years old were studied as a control group. Three hundred and thirty asthmatic patients (56.2%) were sensitized to house-dust mites while only 15 (30%) of the 50 asymptomatic students were sensitized (p < 0.01). The percentage of asthmatics sensitized followed an age-dependent curve that began with the children under 6 years old (45.1%), reached its maximum between 12 and 19 years old (79.0%) and decreased to 25.8% in asthmatics older than 40 years. The differences among these groups were statistically significant (p < 0.01). Also, we observed a significant prevalence in sensitization (p < 0.01) in males versus females. The mean size of the skin reaction obtained with D. pteronyssinus and D. farinae was larger (p < 0.001) in the 12-19 year olds than in the group of asthmatics over 40 years old. It was also greater in the asthmatics with chronic rhinitis than in the group of asthmatics without nasal symptoms (p < 0.01). We suggest that the house-dust mites D. pteronyssinus and D. farinae are an important source of allergens in the pathogenesis of bronchial asthma in patients who live in the high Andes.