Clinical management, expectations, and satisfaction of patients with moderate to severe allergic rhinoconjunctivitis treated with SQ-standardized grass-allergen tablet under routine clinical practice conditions in Spain.

BACKGROUND: Sublingual immunotherapy has been proven as a well-tolerated and effective treatment for allergic rhinitis. Within this type of treatment, GRAZAX® is the most documented product in terms of safety and efficacy. The objective of this study was to identify the patients' expectations and level of treatment satisfaction, as well as the clinical management of patients with moderate/severe allergic rhinoconjunctivitis treated with GRAZAX®. METHODS: This was a non-interventional, observational, multi-centre, open-label study involving a total of 131 adult patients aged 18-66 years with confirmed diagnosis of grass-allergy and initiated treatment with GRAZAX® between June 2010 and April 2011. RESULTS: In the pollen season after starting treatment, 56.6% of patients stated that their symptoms were much less/less intense, 86% needed less symptomatic medication for control of their symptoms, and 74.4% manifested to have improved (quite/a lot) as regards their allergic disease since treatment was initiated as compared with previous grass pollen season. The patient satisfaction with GRAZAX® was measured using a visual analogue scale (VAS) between 0 (minimum satisfaction) and 100 (maximum satisfaction) comprising five different items: effectiveness, tolerability, cost, convenience and overall satisfaction. The results obtained for each item were [mean (SD)]: 74.7 (18.1), 70.3 (36.1), 39.3 (25.8), 86.2 (12.6), 78.4 (15.8) respectively. The patient's level of satisfaction is highly influenced, especially in terms of assessment of effectiveness, tolerability and convenience, by the information provided by the specialist. CONCLUSIONS: In summary, it can be concluded that improved communication leads to increased patient knowledge, greater patient compliance, and increased patient satisfaction.

[Usefulness of Holter in the diagnosis of apnea-hypopnea syndrome in cardiac patients]. / Utilidad diagnóstica del Holter en el síndrome de apneas-hipopneas durante el sueño en pacientes con cardiopatía.

BACKGROUND AND OBJECTIVE: Several studies have described the changes observed in the response of the autonomous nervous system in patients with obstructive sleep apnea syndrome (OSAS). From the point of view of cardiology outpatients, we tried to relate the presence of the disease with the behavior of a Holter algorithm, the very low frequency increment (VLFI), in a direct relationship to sympathetic regulation during sleep. In addition, we studied the characteristics of our population group with regard to OSAS. PATIENTS AND METHOD: Over a period of 2 years we included 147 patients, checking them all out with a 24-h Holter and a polygraphic recording of sleep. We separated out 3 subgroups of patients: slight OSAS, moderate-severe OSAS and patients with no OSAS. We correlated the variable VLFI and other clinical characteristics in the 3 subgroups. RESULTS: 74% of the patients were diagnosed with OSAS, notably in association with the presence of cardiopathy at more advanced stages of the disease. Moreover, a significant relationship was obtained between moderate to severe OSAS and an increase of VLFI in men but not in women and in less severe stages of the syndrome. CONCLUSIONS: In our study the variable VLFI of the Holter represented a very useful contribution when studying patients with a suspected ambulatory SAHS. Furthermore, this practice could help in the screening of this illness.

Utilidad diagnóstica del Holter en el síndrome de apneas-hipopneas durante el sueño en pacientes con cardiopatía / Usefulness of Holter in the diagnosis of apnea-hipopnea syndrome in cardiac patients

Fundamento y objetivo: Diversos autores han descrito los cambios observados en la respuesta del sistema nervioso autónomo en pacientes con síndrome de apneas-hipopneas durante el sueño (SAHS). Desde la perspectiva de la cardiología ambulatoria intentamos relacionar la presencia de la enfermedad con el comportamiento de un algoritmo del Holter, el VLFI (very low frequency increment), que guarda una relación directa con la regulación simpática durante el sueño. Asimismo, estudiamos las características de nuestro grupo de pacientes en relación con el SAHS. pacientes y método: Durante un período de 2 años incluimos en el estudio a 147 pacientes, a quienes se realizaron un Holter de 24 h y un registro poligráfico del sueño. Los clasificamos en 3 subgrupos: SAHS ligero, SAHS moderado-grave y sin SAHS. Correlacionamos estadísticamente la variable VLFI y otras características clínicas en los 3 subgrupos. Resultados: Se diagnosticó de SAHS al 74% de los pacientes y destacó su asociación a la presencia de cardiopatía en grados más avanzados de la enfermedad. Asimismo, la relación entre SAHS moderado-grave y el aumento del índice VLFI fue significativa en varones, pero no en mujeres ni en grados leves del síndrome. Conclusiones: En nuestro estudio la variable VLFI del Holter constituyó una aportación útil en el estudio de pacientes con sospecha ambulatoria de SAHS. Su utilización sistemática podría ser de ayuda en el escrutinio de la enfermedad

Background and objective: Several studies have described the changes observed in the response of the autonomous nervous system in patients with obstructive sleep apnea syndrome (OSAS). From the point of view of cardiology outpatients, we tried to relate the presence of the disease with the behavior of a Holter algorithm, the very low frequency increment (VLFI), in a direct relationship to sympathetic regulation during sleep. In addition, we studied the characteristics of our population group with regard to OSAS. Patients and method: Over a period of 2 years we included 147 patients, checking them all out with a 24-h Holter and a polygraphic recording of sleep. We separated out 3 subgroups of patients: slight OSAS, moderate-severe OSAS and patients with no OSAS. We correlated the variable VLFI and other clinical characteristics in the 3 subgroups. Results: 74% of the patients were diagnosed with OSAS, notably in association with the presence of cardiopathy at more advanced stages of the disease. Moreover, a significant relationship was obtained between moderate to severe OSAS and an increase of VLFI in men but not in women and in less severe stages of the syndrome. Conclusions: In our study the variable VLFI of the Holter represented a very useful contribution when studying patients with a suspected ambulatory SAHS. Furthermore, this practice could help in the screening of this illness