Prolonged breastfeeding and delayed introduction of whole cow's milk into the diet are factors associated with egg sensitization: a matched case-control study

BACKGROUND: Both breastfeeding and the moment at which introduction to solid food occurs have been associated with food allergy. OBJECTIVE: To evaluate whether prolonged breastfeeding and the delayed introduction of whole cow's milk into an infant's diet are factors that can be associated with egg sensitization. METHODS: This was a hospital-based case-control study, matched by age and sex: each study group comprised 97 atopic children. Additionally, logistic regression was used to identify the factors associated with egg protein sensitization. RESULTS: The most common type of allergic disease among both groups was allergic rhinitis. After adjusting for possible confounding variables, a delayed introduction to whole cow's milk decreased the odds of egg protein sensitization; OR = 0.16 (95% CI: 0.07-0.36, p < 0.0001). Notably, breastfeeding during the first six months of life, regardless of whether it was the only milk an infant drank, increased the risk for sensitization to chicken eggs; OR = 5.54 (95% CI: 2.41-12.7, p < 0.0001). CONCLUSION: Prolonged breastfeeding, regardless of whether it was the only milk an infant drank, greatly increased the risk of egg sensitization. Interestingly, a delayed introduction to whole cow's milk was associated with a reduced possibility of becoming sensitized to eggs. Further studies are required to elucidate these findings

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Prevalence of oral allergy syndrome in children with allergic diseases

INTRODUCTION: The oral allergy syndrome (OAS) is a particular type of food allergy rarely explored in the paediatric population that is already considered an adult problem. OBJECTIVE: Identify the prevalence of OAS, symptoms and pollen species associated with its presence in children affected by allergic diseases. METHODS: A cross-sectional study was conducted. Consecutive sampling included children from 6 to 14 years who needed allergy treatment for the first time. A structured questionnaire was carried out to collect demographic and clinical data and history of OAS. Besides sensitisation to various allergens, the skin prick-by-prick test was performed to corroborate sensitisation to food related to OAS. Prevalence of OAS and its association with pollens was established following the covariate adjusted logistic regression. RESULTS: 267 subjects were included. Overall prevalence of OAS was 8.9% (95%CI 6.1-13.1%). Prevalence of OAS for allergic rhinitis and asthma were 8.8% and 9.1%, respectively. In patients sensitised to pollen, the prevalence ranged from 9.6% to 12.2% depending on the type of pollen. 62.5% of children with OAS were sensitive to pineapple. After adjusting for gender and family history of atopic disease, trees from the Quercus species showed an association with OAS (OR=2.7, 95%CI 1.2-6.2). CONCLUSIONS: OAS is not uncommon in our environment. Pineapple, a typical fruit from the region, was the main food related. Quercus sp., but not birch nor olive, was the pollen associated with this syndrome

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Prevalence and factors associated to peanut allergy in Mexican school children

BACKGROUND: In our country, the prevalence and the factors associated to peanut allergy are unknown, a health problem that has been emerging worldwide. OBJECTIVE: To establish the prevalence and the factors that are associated to peanut allergy amongst school children. METHODS: This is a population-based cross-sectional study. We included 756 children aged 6-7 years. The children's parents were questioned about their peanut intake habits. A structured questionnaire was applied, it included questions regarding peanut intake; family and personal history of asthma; rhinitis; and atopic dermatitis. Allergic reactions to peanuts were registered as: probable, convincing and systematic. The statistical analyses included logistical regression models to look for associated factors. RESULTS: Males were 356/756 (47.1%). Peanut allergy prevalence: probable reaction: 14/756 (1.8%), convincing reaction: 8/756 (1.1%) and systemic reaction: 3/756 (0.4%). Through multivariate analysis, the presence of symptoms of allergic rhinitis (OR = 4.2 95% CI 1.3-13.2) and atopic dermatitis (OR = 5.2; 95% CI 1.4-19.5) during the previous year, showed significant association to probable peanut reaction. The former year, the presence of atopic dermatitis was the only variable that was substantially associated to a convincing reaction (OR = 7.5; 95% CI 1.4-38.4) and to a systematic reaction (OR = 45.1; 95% CI 4.0-510.0), respectively. CONCLUSIONS: The reported prevalence of peanut allergy was consistent with that found in previous studies; symptoms of allergic rhinitis and atopic dermatitis were identified as associated factors to peanut allergy

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Estado de salud bucal en pacientes discapacitados del área de salud de Espartaco, municipio Palmira / Oral Health Status of disabled patients. Health Area of Spartacus, Palmira Municipality

Fundamento: las personas discapacitadas presentan condiciones que limitan sus posibilidades para desarrollar la vida cotidiana y por consiguiente requieren de una atención de salud integral; sin embargo se considera que a nivel mundial la mayoría de esta población no recibe atención bucodental acorde a sus requerimientos.Objetivo: determinar el estado de salud bucal en pacientes discapacitados.Métodos: estudio de serie de casos realizado de junio a septiembre de 2015, sobre 88 discapacitados que cumplieron con los criterios de inclusión. Se analizó: edad, sexo, nivel de escolaridad, ocupación, clasificación epidemiológica en cuanto a salud bucal, problemas de salud bucal, enfermedades crónicas, factores de riesgo, tratamientos realizados en atención primaria y secundaria. Resultados: predominó el sexo masculino sobre el femenino y el grupo de edades de 35 a 59 años; prevalecieron los técnicos medios y los de nivel preuniversitario; el 38, 6 % poseía empleo. Fueron más numerosas las discapacidades mentales. El 72, 2 % padecía de hipertensión arterial. La clasificación epidemiológica del estado de salud bucal mostró que 54, 5 % estaban enfermos; 19, 3 % sanos con riesgo y 26,1 % deficientes discapacitados. Dentro de los factores de riesgo sobresalieron los antecedentes de caries y cepillado incorrecto. En atención primaria predominaron las restauraciones (47,7 % ) y en la atención secundaria la ortodoncia (13,6 %). Conclusiones: la salud bucal en el grupo estudiado fue deficiente, lo que pudiera estar dado porque tanto pacientes como familiares dan más importancia a la condición física como discapacitado que a la salud bucal.

Foundation: Disbale people present conditions which limit their abilties to develop an everyday life and therefore require comprehensive health care; however it is considered that worldwide most of this population does not receive oral care according to their requirements. Objective: To determine status of Oral Health in disabled patients. Methods: A study of case series carried out from june to September 2015, about 88 disabled patients who achieved inclusion criteria. It was analyzed age, sex, scholarship, occupation, epidemiological classification regarding Oral Health, problems of Oral health, chronic diseases, risk factors, recieved treatments in primary and secundary health systems.Results: Male sex prevailed over the female one and age group from 35 to 59 years old; They prevailed technicians and senior high school level;; 38% had an employment. Mental disabilities were more frequent. 72.2% suffered from arterial hypertension. Epidemiological classification of Oral Health State showed that 54.5% were sick.; 19.3% were healthy and 26.1% defficent disabled. Among the risk factors, antecedents of caries and incorrect brushing stood out. In Primary Care restaurations prevailed (47.7%) and in Secondary Health care Orthodontics( 13.6%).Conclusion: There was a deficient oral health in the studied group, which could be given because both patients and relatives give more importance to the physical condition as disabled than to oral health.

Characterising the enzymatic profile of crude tentacle extracts from the South Atlantic jellyfish Olindias sambaquiensis (Cnidaria: Hydrozoa)

Jellyfish venoms are of medical and biotechnological importance, with toxins displaying antimicrobial, analgesic and anti-tumor activities. Although proteolytic enzymes have also been described, detailed characterisation of these proteins is scant in Olindias spp. High throughput mass spectrometry profiling of cnidarian venoms has become increasingly popular since the first description of the proteomic profile of putative toxins isolated from nematocysts of the hydrozoan jellyfish Olindias sambaquiensis describing the presence of orthologous enzymes as presented in venoms of advanced species as snakes. Rigorous bioinformatics analyses can aid functional annotation, but biochemical assays are prerequisite to unambiguously assign toxic function to a peptide or protein. Here we present results that experimentally confirm previously predicted proteomic analysis that crude venom extracts from tentacles of O. sambaquiensis are composed of polypeptides with metalloproteinase, serine proteinase and phospholipases A(2) activities. Surprisingly, levels of serine proteinase and phospholipase A(2) activities were comparable to those observed in venoms of Bothrops snakes which were used as positive controls in this study. Hence, these data offer new opportunities to explore serine proteinase and phospholipase A2 activities in the clinical sequelae following O. sambaquiensis envenomation, with future possible biopharmaceutical applications. (C) 2016 Elsevier Ltd. All rights reserved.

Genes de virulencia y bacteriocinas en cepas de Enterococcus faecalis aisladas desde diferentes muestras clínicas en la Región del Maule, Chile / Virulence genes and bacteriocins in Enterococcus faecalis strains isolated from different clinical samples in Maule Region, Chile

The presence of virulence genes (VG) and bacteriocins from different clinical samples was studied in Enterococcus faecalis isolated from urinary tract infections (UTI), bacteremia and endodontitis and was correlated with haemolysin and gelatinase activity. We evaluated the presence of VG by PCR in 150 strains of E. faecalis including cylA, aggA, efaA, eep, gelE, esp, as-48, bac31, entL50A/B, entA, entP, entB, enlA andentl071. Haemolysin and gelatinase activity was studied. gelE and cylA genes expressed hemolysin and gelatinase, respectively. This activity was observed in some strains of bacteremia, UTI and endodontitis. The highest number of VG was detected in bacteremic strains, being aggA and entA genes the most frequent. efaA, esp, entA, entL50A/B were associated with their clinical origin (p < 0.05). The most common genetic profile was aggA-eep-enlA-entL50A/B. E. faecalis from UTI, bacteremia and endodontitis presented different gene combinations. Some of the genes studied were related to their clinical origin. The results obtained in this study are similar to those reported in other countries.

Desde diferentes muestras clínicas se determinó la presencia de genes codificantes de factores de virulencia (FV) y bacteriocinas en Enterococcus faecalis aislados desde infecciones del tracto urinario (ITU), bacteriemias y endodontitis, correlacionándose con la actividad hemolisina y gelatinasa. En 150 cepas de E. faecalis fue evaluada mediante RPC la presencia de cylA, aggA, efaA, eep, gelE, esp, as-48, bac31, entL50A/B, entA, entP, entB, enlA, y ent1071 determinándose actividad hemolisina y gelatinasa. Los genes cylA y gelE expresaron hemolisina y gelatinasa, respectivamente. Esta actividad fue observada en algunas de las cepas causantes de bacteriemia, ITU y endodontitis. El mayor número de genes estudiados se detectó en cepas bacteriémicas. Los genes aggA y entA, fueron los más frecuentes. Los genes efaA, esp, entL50/AB y entA se asociaron a su origen clínico (p < 0,05). El perfil genético más recurrente fue aggA-eep-enlA-entL50A/B. Enterococcusfaecalis de ITU, bacteriemias y endodontitis presentaron distintas combinaciones génicas. AAlgunos de los genes estudiados se relacionaron con su origen clínico. Los resultados obtenidos son similares a los reportados en otros países.

Evaluación económica de un dispositivo para preparación de mezclas intravenosas en farmacia hospitalaria / Financial assessment of device for the preparation of intravenous mixtures in hospital pharmacy

Objetivo: Evaluar económicamente un dispositivo de preparación de mezclas intravenosas (DPMIV) -Sistema Grifill®- para preparar gammaglobulina i.v., salbutamol, ondansetrón/dexametasona, solución rehidratante de cisplatino y mesna. Material y métodos: Se valoran los recursos más relevantes empleados para la elaboración o reenvasado de cada una de las mezclas intravenosas anteriores (tanto para el DPMIV como para el sistema alternativo de práctica habitual), los costes unitarios (obtenidos de los seis hospitales participantes de ámbito español), y se obtiene una aproximación al coste real por sistema usado. Se hace un análisis de sensibilidad considerando las variables más influyentes. Los resultados se calculan para un mes de trabajo con el sistema. Resultados: En gammaglobulina i.v., mesna, salbutamol, ondansetrón/dexametasona y poliónica, el DPMIV presentó beneficios económicos, mientras que en la preparación de rehidratante de cisplatino no. Conclusiones: Es necesario hacer un estudio individualizado en cada centro para llegar a conseguir información económica fiable sobre la rentabilidad del sistema en el Servicio de Farmacia hospitalaria. El DPMIV podría permitir un ahorro económico importante en aquellos centros o servicios hospitalarios que utilicen productos farmacéuticos de alto coste, susceptibles de ser dosificados de forma personalizada, por ejemplo gammaglobulina i.v. u otros hemoderivados, anticuerpos monoclonales, y/o antibióticos; o mezclas intravenosas que requieran productos farmacéuticos habitualmente obtenidos por compra directa a los fabricantes y que pueden ser preparadas a partir de materias primas de bajo coste (por ejemplo salbutamol o solución poliónica), cuya manipulación requiera un alto nivel de calidad (por ejemplo esterilidad y precisión). (AU)

Impacto de un dispositivo de preparación de mezclas intravenosas en farmacia hospitalaria. Percepción de calidad asistencial y satisfacción del usuario / Impact of a intravenous mixture preparation device in hospital Pharmacy Departments. Perceived healthcare quality and user satisfaction

Objetivo: Evaluar de forma integral un dispositivo de preparación de mezclas intravenosas (DPMIV), desde el punto de vista de la percepción de mejora de la calidad asistencial del centro (cambios en el funcionamiento, organización del Servicio de Farmacia hospitalaria, satisfacción del personal de enfermería, y satisfacción del usuario).Material y métodos: El proyecto descrito es un estudio de evaluación de tecnologías sanitarias (análisis dirigido a estimar el valor y contribución relativas de una determinada tecnología sanitaria a la mejora de la salud individual y colectiva), observacional, multicéntrico y de ámbito nacional. La recogida de datos del trabajo de campo se realizó en 6 centros hospitalarios de España. Resultados: Las encuestas de evaluación completadas por las farmacias hospitalarias informaron en tres de los cuatro centros que utilizaron el DPMIV la contribución al ahorro de tiempo, la mejora de la calidad de los preparados y la seguridad proporcionada por el sistema, desde la perspectiva de enfermería el DPMIV fue considerado mayoritariamente como satisfactorio, mientras que desde la perspectiva del paciente, la mayoría (81 por ciento) manifestó estar más satisfechos con la atención recibida desde la introducción del DPMIV en la administración de su medicación. Conclusiones: El DPMIV mostró unas características satisfactorias y valoradas positivamente tanto por los Servicios de Farmacia hospitalaria evaluados, como por el Servicio de Enfermería y los pacientes (AU)

Environmental and genetic factors affecting mutability to aminoglycoside antibiotics among Escherichia coli K12 strains

Environmental and genetic factors affecting the in vitro spontaneous mutation frequencies to aminoglycoside resistance in Escherichia coli K12 were investigated. Spontaneous mutation frequencies to kanamycin resistance were at least 100 fold higher on modified Luria agar (L2) plates, when compared to results obtained in experiments carried out with Nutrient agar (NA) plates. In contrast to rifampincin, the increased mutability to kanamycin resistance could not be attributed to a mutator phenotype expressed by DNA repair defective strains. Kanamycin mutant selection windows and mutant preventive concentrations on L2 plates were at least fourfold higher than on NA plates, further demonstrating the role of growth medium composition on the mutability to aminoglycosides. Mutability to kanamycin resistance was increased following addition of sorbitol, suggesting that osmolarity is involved on the spontaneous mutability of E. coli K12 strains to aminoglycosides. The spontaneous mutation rates to kanamycin resistance on both L2 and NA plates were strictly associated with the selective antibiotic concentrations. Moreover, mutants selected at different antibiotic concentrations expressed heterogeneous resistance levels to kanamycin and most of them expressing multiple resistance to all tested aminoglycoside antibiotics (gentamicin, neomycin, amykacin and tobramycin). These results will contribute to a better understanding of the complex nature of aminoglycoside resistance and the emergence of spontaneous resistant mutants among E. coli K12 strains

Brote de gastroenteritis de origen alimentario provocado por Clostridium Perfringens / Outbreak of gastroenteritis foodborne provoker for Clostridium Perfringens

Un brote de origen alimentario por Clostridium perfringens tipo A se presentó en ocasión de un "lunch" en que sirvieron empanadas de carne fritas, canapés y masas dulces. De las 41 personas encuestadas, 23 (56 por ciento) desarrollaron un síndrome típico de gastroenteritis. Las empanadas de carne fritas mostraron la mayor diferencia entre las dos tasas de ataque (46 por ciento); alta para el grupo de comensales que las consumió (17 por ciento). La prueba de Chi2 (p<0.05) mostró una franca asociación con el consumo de empanadas. El recuento de C. perfringens en el picadillo de carne, de una empanada del mismo lote, pero sin freír, fue 2.6 x 10 UFC/g. El factor determinante del brote fue el enfriamiento inadecuado del picadillo de carne (punto crítico de control) que favoreció la germinación de las esporas de C. perfringens y la propagación posterior de las células vegetativas. Otros factores adicionales fueron: a) el uso de una olla en lugar de una sartén para la preparación del picadillo de carne, situación que mantuvo condiciones anaeróbicas durante el escaso período de enfriamiento (1 hora), b) la colocación en la heladera del picadillo de carne presuntamente tibio, c) la fritura de las empanadas (2 a 3 min.) que resultó insuficiente para reducir el número de células vegetativas contenidas en el picadillo d) la colocación en paquetes de las empanadas, inmediatamente después de haber sido fritas, que volvió a generar un enfriamiento inadecuado que se mantuvo durante 4 horas, hasta el consumo de las empanadas. Las recomendaciones son: a) cocer el picadillo de carne en recipientes poco profundos, b) enfriar el picadillo rápidamente a temperatura del ambiente, c) refrigerarlo a temperaturas menores de 4§C sin tapas y en capas no superiores a 10 cm, d) consumir los alimentos inmediatamente después de cocidos o conservarlos a temperaturas mayores de 65§C o recalentar a temperaturas internas mínimas de 75§C antes del consumo.

Prevalencia de trastornos mentales y factores de riesgo en una población de práctica médica general. / [Prevalence of mental disorders and risk factors in a population of a general medical practice]

The present paper reports the most relevant results from an epidemiologic survey that was carried out in a hospitals general practice service in Mexico. The survey comprises several issues such-as: the validity and standardization of the General Health Questionnaire (GHQ), a screening instrument, designed for the early detection of mental disorders, which is validated against the clinical criteria expressed through the Standardized Psychiatric Interview (SPI), the prevalence of psychiatric disorders which includes type of syndromes and affected subgroups, the relation between the ratings of the SPI and the scales of the GHQ (somatic symptoms, sleep disturbances, social disfunction and severe depression) with demographic variables. From the population attending the service during a period of 5 weeks, a total of 619 patients, to whom the GHQ was administered, were randomly selected. From this sample 364 patients were separately interviewed by means of the SPI. No significant differences were found between the sample and the population regarding age, sex, and educational level. The prevalence of mental disorders obtained for the mixed population was of 34

, being of 26

for men and of 36

for women. The only risk factor found for both populations was the low educational level of the head of the family. In the multiple regression analysis, significant differences were found among some groups in spite of the low predictive power of the studied variables.

El medico general en la deteccion de trastornos emocionales / The general practitioner in the detection of emotional disorders

Se comparo la eficacia del medico general con la del Cuestionario General de Salud de Goldberg en el descubrimiento de trastornos emocionales en la poblacion que asiste a la consulta externa de un hospital general. De la frecuencia total (33.3%) de trastornos emocionales estimada para esta poblacion, el medico general descubrio unicamente 15.9%, lo cual permitio identificar la tendencia del mismo hacia la sobreestimacion de los sujetos sin trastornos. El Cuestionario General de Salud mostro mayor eficacia al descubrir 25.6% de los pacientes con trastornos emocionales. Los resultados favorecen la utilizacion de instrumento como el cuestionario como medida de apoyo para el medico en el descubrimiento de trastornos mentales