Latex Fruit Syndrome as a Case of a Lower GI Bleed.

Latex-fruit syndrome is characterized by hypersensitivity reactions to certain plant-derived foods in individuals allergic to natural rubber latex (NRL), affecting approximately 30-50% of NRL-allergic patients. This condition arises due to the cross-reactivity of IgE antibodies. Over time, this syndrome has been associated with an increased number of plant sources, including avocado, banana, chestnut, kiwi, peach, tomato, potato, and bell pepper. We present a case of an art student who developed latex-fruit syndrome following prolonged exposure to NRL art supplies.

Revisiting Latex-Fruit Syndrome after 30 Years of Research: A Comprehensive Literature Review and Description of Two Cases.

Thirty years have passed since the concept of latex-fruit syndrome (LFS) was first introduced. Since then, this phenomenon, characterized by cross-reactivity between natural latex rubber allergens and certain fruit allergens, has been extensively studied. This literature review sought to determine the prevalence of LFS in latex-allergic patients, identify the most common cross-reactions with fruit allergens in individuals with LFS, and understand the clinical manifestations of this syndrome. An extensive literature search was carried out using PubMed and Scopus databases, while applying the Preferred Reporting Items for Systematic Reviews and Meta-Analysis methodology. The analysis of original studies revealed a wide variation in LFS prevalence (4-88%) influenced by diverse diagnostic tools, different geographical regions, and the size of study populations. Our findings indicate that the most prevalent allergenic fruits in patients with LFS are banana, avocado, kiwifruit, and papaya. After evaluating the symptoms of the fruit hypersensitivity of patients with LFS, the clinical manifestation of hypersensitivity constituted 73% of systemic allergy symptoms and only 27% of reported symptoms described the localized allergy. Furthermore, the clinical picture of latex-fruit syndrome is illustrated through two cases, one typical and one with an unusual presentation. Their clinical features were assessed and contrasted utilizing different anaphylaxis severity grading criteria. To properly manage LFS, it is essential to establish standardized diagnostic criteria and severity grading systems, as these are crucial for accurate diagnosis and effective treatment.

Reduced protein levels in latex gloves may play an alternative approach to lowering latex sensitization risks among health workers; a cross-sectional analytical study.

BACKGROUND: Latex gloves are essential for protecting healthcare workers from biological hazards but pose a risk of latex allergy, particularly due to powdered, protein, and allergen content. Recent advancements in latex glove manufacturing have led to reduced levels of extractable proteins, a known factor triggering allergenic reaction. This study aimed to compare latex sensitization between nursing staff using low-protein and high-protein latex gloves at a tertiary university hospital in Thailand. METHODS: A cross-sectional analytical study categorized participants into two groups based on glove exposure: the low extractable protein group (only exposed to non-powdered latex gloves with extractable protein levels below 50 µg/g) and the high extractable protein group (exposed to powdered latex gloves with levels above 50 µg/g). The sample size comprised 163 individuals in the low protein group and 318 in the high protein group (1:2). Latex allergy symptoms and sensitization were assessed using a self-administered questionnaire and latex-specific IgE measurement (ImmunoCAP), respectively. Data analysis involved descriptive and inferential statistics, including odds ratios and 95%CI. RESULTS: Demographic data was mostly similar in both exposure groups except for age. No significant differences in latex sensitization between the low and high protein groups were found via latex-specific IgE measurement (crude OR 1.90, 95%CI: 0.5, 7.18), potentially attributed to lower extractable protein levels in powdered latex gloves compared to previous studies. In contrast, the low protein group exhibited significantly fewer current latex allergy symptoms in both bivariate (crude OR 0.24, 95%CI: 0.06, 0.74) and multiple variable analysis (adjusted OR 0.18, 95%CI: 0.04, 0.86). Moreover, there was a significant reduction in latex allergy symptoms among the low protein group, decreasing from 9.8% who reported experiencing symptoms (when powdered latex gloves were used) to 1.2% who still reported current symptoms (OR 0.11, 95%CI: 0.02, 0.44). CONCLUSIONS: This study underscores the importance of using non-powdered and low-protein latex gloves to reduce latex allergy symptoms while emphasizing the need for further investigation into the relationship between extractable protein levels in addition to the attempt of the major allergen removal and latex sensitization amid evolving glove manufacturing practices.

Guidelines in Practice: A Safe Environment of Care.

Creating a safe environment for performing surgical procedures is essential to achieve successful patient outcomes and protect the perioperative personnel who are providing care. Numerous factors challenge the provision of a safe environment of care and create a complex setting for perioperative nurses to manage. The updated AORN "Guideline for a safe environment of care" provides perioperative nurses with recommendations for establishing a safe environment for both patients and personnel. This article provides an overview of the guideline and discusses recommendations for implementing fire safety protocols, using warming cabinets, and creating a latex-safe environment. It also includes a scenario describing the care of a patient with an unidentified latex allergy who is undergoing a laparoscopic sleeve gastrectomy and hiatal hernia repair. Perioperative nurses should review the guideline in its entirety and implement recommendations as applicable in operative and other procedural settings.

Assessment of Knowledge, Attitude, and Practice of Pharmacovigilance and Materiovigilance among Oral Health Practitioners in India.

Aim: This electronic survey was carried out to assess the knowledge, attitude, and practices among the oral health practitioners. Methods: A questionnaire survey was conducted among undergraduates, graduated practitioners, and specialist practitioners. A Google Form that included a specified instruction format, informed consent with a clear description of the purpose of the study, and questions in different categories were sent through Whatsapp and email. Descriptive statistics were used to analyze responses. The association of knowledge and attitude with respect to oral health professionals was analyzed with the Chi-square test. Results: The questionnaire was completed by 570 participants. Thirty percent of participants encountered ADR related to the drugs available in the market and 33.2% of participants encountered adverse reaction related to materials used in practice. ADR should be reported as soon as it is detected, according to this study about 12.1% of participants reported the ADRs, and this reporting is primarily for patient safety. Almost 66.8% of participants perceived that dental products can cause ADR owing to a lack of information about ADR and reporting procedures, or due to fear of legal concerns. Only about 9.5% of the participants had previously attended an ADR workshop. Conclusion: Oral health practitioners have a general understanding of ADR; however, there is substantial evidence of underreporting and a lack of reporting system information. Organizing an orientation program and raising awareness about ADR reporting could help improve spontaneous reporting and better patient care.

Integrated approaches to prevent exposure risks related to latex-derived products.

Natural rubber latex is a widely used industrial raw material to produce many consumer and commercial products. Chronic exposures to latex allergenic proteins residual in the finished products can promote hypersensitive immune responses, which affects millions of workers and the general public worldwide. Research has shown the average prevalence of latex allergy worldwide remains approximately 10% among healthcare workers, 7% among susceptible patients, and 4% among general population. Although most effective in preventing latex allergy, completely avoiding contact to latex-derived products is extremely challenging, given the fact that millions of products possibly contain latex, but few are regulated and properly labeled. Due to the difficulty to assure a product completely absent of latex allergens, the United States Food and Drug Administration has recommended to stop using labels like "latex-free" or "does not contain latex." Here we evaluate published data, industrial standards and regulations, identify possible countermeasures, and propose an integrated strategy, including some more practicable approaches (e.g., education/training, product labeling, the use of proper personal protective equipment, occupational selection, and searchable product database) and novel medical treatments (e.g., immunotherapy) to help decreasing latex allergy prevalence.

Latex anaphylaxis in healthcare worker and the occupational health management perspective: A case report.

Latex allergy is a critical occupational health problem in healthcare settings. Exposure to latex can lead to severe allergic reactions, including anaphylaxis. However, in epidemiological studies, occupational anaphylaxis due to natural rubber latex is relatively rare. For this reason, allergic reactions from latex exposure in the workplace may not be well aware and, therefore, lead to delayed appropriate management. We reported a female physician who sought occupational health program counseling for her latex allergic reaction following occupational exposure and her two episodes of latex anaphylaxis during medical-surgical procedures. An occupational health management program (e.g. glove replacement and a bracelet with latex allergy labeling) was established. After the intervention, she rarely experienced any allergic symptoms. Given these points, anaphylaxis can be triggered by occupational exposure to latex; thus, occupational health management is key to preventing and managing latex allergies in the workplace.

Latex Allergy in Children.

Notwithstanding the efforts made in the last decades to mitigate the consequences of natural rubber latex allergy, this disease continues to be a major health problem, especially in developing countries. The categories of patients with greater and frequent exposure to latex (such as health care professionals and, in the pediatric field, subjects who undergo repeated surgery, e.g., those suffering from spina bifida and urogenital malformations) have an increased risk of developing sensitization and allergy to latex. Herein we provide an overview of the current knowledge and practical recommendations with a focus on epidemiology, diagnostics, and management (including both prevention and therapy) in order to guide a correct recognition and containment of this potentially fatal condition.

IgE Sensitization Profile in Patients with Netherton Syndrome.

BACKGROUND: Scant data are currently available on the allergen-specific immunoglobulin (Ig)E sensitization profile in primary immunodeficiencies with hyper IgE. Netherton syndrome (NS, OMIM 266500) is an extremely rare form of congenital ichthyosis characterized by congenital scaly erythroderma, hair abnormalities, and deregulated IgE reactivity associated with severe atopic manifestations. OBJECTIVE: The aim of this study was to evaluate the feasibility and reliability of a multiplex proteomic approach in the detection of specific IgE in NS. METHODS: Specific IgE was evaluated in 10 individuals with an established molecular diagnosis of NS using an allergenic molecules microarray (immuno-solid-phase allergen chip). RESULTS: Polireactivity to airway allergens, mainly house dust mites and olive tree pollen, and food allergens were observed in NS. Eighty per cent of patients were responsive to LTP or profilins. A clinical history suggestive of severe egg, milk, and fish allergy was confirmed by reactivity to the thermostable molecules Gal d 1, Bod 8, and parvalbumin Gad c 1, respectively. Latex reactivity was associated with Hev b 5 and 6 reactivity. Two distinct clusters of reactivity were observed after hierarchical analysis. Extremely high IgE levels (> 10,000 kU/L) do not affect the results obtained with microarrays. CONCLUSION: IgE multiplex evaluation allows (i) to profile IgE polyreactivity pictures, in the presence of LTP and profilin sensitization, (ii) to verify the clinical history of food allergy to milk, egg, and seafood, (iii) to confirm the allergic events associated with latex exposure, and (iv) to disclose the presence of preclinical sensitizations in patients affected by primary immunodeficiencies with hyper IgE, such as the NS.

Latex Anaphylaxis Caused by Occupational Exposure to Balloons.

Latex allergies often develop by sensitization to latex allergens by repeated exposure. Because in recent years latex has been ubiquitous in medical equipment, health workers have a higher prevalence of latex allergies than the general population, and care must be taken to ensure workers' safety. We report a case of a female health care worker in her 20s who experienced a severe, biphasic anaphylactic reaction within minutes after being exposed to rubber balloons at a latex-free children's hospital. After being stabilized with epinephrine, dexamethasone, and fluid resuscitation, over a six-hour period, she was discharged home. En route home, her symptoms recurred, and she was admitted to the ICU for observation for impending respiratory failure. She was hospitalized for about 48 hours before being discharged home. She presented to the occupational medicine clinic a few days later for further management. No acute care was required and she was discharged. This case is consistent with occupational latex-induced anaphylaxis. Health personnel should be educated about the importance of compliance with latex allergy mitigation procedures, as well as the severe nature of hypersensitivity reactions that may occur in sensitized persons. It may be beneficial to address the social pressures that can contribute to noncompliance, as balloons are a common gift for children and may be viewed as an acceptable way to cheer up a sick child, tempting some staff to turn a blind eye to policy. The reasons for the policy, and for strict adherence, should be communicated clearly.

Comprehensive Review on Banana Fruit Allergy: Pathogenesis, Diagnosis, Management, and Potential Modification of Allergens through Food Processing.

The pulp of the banana fruit is rich in bioactive compounds like dietary fibers, low glycemic carbohydrates, natural sugars, vitamins, minerals and antioxidants. These beneficial compounds are responsible for the proper functioning of immune system and enhance prevention against various deadly diseases like cancer, diabetes and heart diseases. Despite having, positive effects, the fruit are recognized as an important source for causing allergy to 0.6% of people in general population and up to 67 and 46% for people with asthma or atopic dermatitis. Fruit allergy is one of the most common food allergies witnessed worldwide. Banana fruit allergy results from the abnormal immune response to the banana proteins soon after its consumption. Symptoms range from oral allergy syndrome (OAS) to the life-threatening anaphylaxis. IgE reactivity of banana is associated with different proteins of which six proteins have been identified as major allergens, viz., Mus a1 (Profilin-actin binding protein), Mus a 2 (Class 1 chitinase), Mus a 3 (Nonspecific lipid transfer protein), Mus a 4 (Thaumatin like protein), Mus a 5 (Beta 1,3 glucanase) and Mus a 6 (Ascorbate peroxidase). This review focuses on pathogenesis, clinical features, diagnosis, and different food processing methods to mitigate the allergenicity of banana fruit.

Clinical and quality of life assessment in patients with latex allergy during COVID-19 pandemic: Possible protective role of continuous latex immunotherapy.

Introduction: During COVID-19 pandemic, the massive use of Personal Protective Equipment could provoke severe adverse reactions in latex allergy patients and could negatively affect their quality of life. Methods: Trough a survey the study aimed: (a) to evaluate the incidence of allergic reactions in patients with latex allergy during the SARS-CoV-2 pandemic; (b) to evaluate the protective role of continuous latex sublingual immunotherapy (SLIT) during this period; and (c) to evaluate quality of life of natural rubber latex allergy (NRLA) patients during the pandemic. Results: 67 patients (9 males and 58 females, mean age of 45.9 ± 11.4 years) suffering from latex allergy were included in the present study. We recorded among our patients 13 cases (34.2%) of urticarial/angioedema (U/A), 9 cases (23.6%) of respiratory symptoms (dyspnoea, shortness of breath and wheezing) and 7 cases (18.4%) of anaphylaxis. In patients who underwent continuous SLIT, we observed less cases of U/A (p < 0.001), respiratory symptoms (p < 0.001), anaphylaxis (p = 0.003), hospitalizations (p = 0.014) and a lower therapy administration. We compared the results of SF-36 questionnaire in patients who underwent continuous and not-continuous SLIT with a significance differences score between these two groups. Conclusions: Our study is the first that investigated the clinical and quality of life effects of COVID-19 pandemic in NRLA patients.

Reacción anafilactoide a látex tras colocación de malla transvaginal para corrección de cistocele / Anaphylactoid latex reaction after transvaginal mesh placement for cystocele correction

La incidencia de alergia al látex en la población general es del 1-2%, siendo las reacciones más frecuentemente descritas de hipersensibilidad inmediata o tipo i y tardía o tipo iv, aunque también han sido descritas reacciones de hipersensibilidad no mediadas por IgE.Presentamos el caso de una mujer de 71 años con factores de riesgo cardiovascular (HTA y DLP) e intervenida previamente de colecistectomía y cistocele que ingresa de forma programada para intervención de recidiva de cistocele grado iv tras 4 años de la primera intervención.En el postoperatorio inmediato presenta fracaso renal agudo, por lo que se retira la malla a las 24h, persistiendo deterioro progresivo del estado general con dificultad respiratoria, disminución del nivel de conciencia y empeoramiento de la función renal. Tras una exploración exhaustiva se visualiza eritema en región vulvar e inguinal, por lo que se sospecha reacción anafiláctica a sonda de látex, que se recambia por una sonda de silicona, iniciándose tratamiento con metilprednisolona intravenosa y se consulta con el servicio de Alergología, que establece finalmente el diagnóstico.La paciente requirió ingreso en la unidad de cuidados intensivos durante 10 días por insuficiencia renal aguda e insuficiencia respiratoria aguda asociadas a íleo paralítico y coagulopatía.La anafilaxia es una reacción sistémica aguda que resulta en la liberación brusca de mediadores de los mastocitos y basófilos, mediada o no por IgE. Se admite que es una reacción de hipersensibilidad sistémica grave, de inicio repentino y potencialmente mortal. Clínicamente se asocia a la aparición de manifestaciones cutáneas relacionadas con alteraciones cardiovasculares, respiratorias o gastrointestinales.

Allergy to latex in the general population is 1-2%, the most frequent reactions described being immediate or type i and late or type iv hypersensitivity, although non-IgE-mediated hypersensitivity reactions have also been described.We present the case of a 71-year-old woman with cardiovascular risk factors (HTN and PLD) and previously operated on for cholecystectomy and cystocele who was admitted on a scheduled basis for intervention for grade iv cystocele recurrence, 4 years after the first intervention.In the immediate postoperative period, she presented acute renal failure, for which the mesh was removed after 24h, her general condition progressively deteriorated with respiratory distress, decreased level of consciousness, and worsening of renal function. After an exhaustive examination, erythema was visualized in the vulvar and inguinal region, hence the suspicion of an anaphylactic reaction to a latex catheter, which was replaced by a silicone catheter. Treatment was started with intravenous methylprednisolone, and the Allergology service was consulted who finally established the diagnosis.The patient required admission to the intensive care unit for 10 days due to acute renal failure and acute respiratory failure, associated with paralytic ileus and coagulopathy.Anaphylaxis is an acute systemic reaction that results in the abrupt release of mediators from mast cells and basophils, mediated or not by IgE. It is recognized to be a severe, sudden onset, and life-threatening systemic hypersensitivity reaction. Clinically, it is associated with the appearance of skin manifestations related to cardiovascular, respiratory, or gastrointestinal disorders.

Management of internal and external root resorption in primary teeth of a 3-year-old with myelomeningocele: A case report.

BACKGROUND: Myelomeningocele (MMC) is a severe manifestation of spina bifida. Children with MMC have motor disability, hydrocephalus, skeletal abnormalities, and mental retardation. These individuals are more susceptible to caries due to poor oral hygiene, carbohydrate-rich diet, prolonged use of sugar-containing medications and limited motor abilities. Latex allergy is an important factor to be considered during the dental rehabilitation of such patients. CASE REPORT: A 3-year-old girl visited the dental clinic with the chief complaint of multiple carious teeth and H/o neural tube defect (NTD) which had been operated on at the age of 6 weeks. On dental examination, multiple dental abscesses and severe early childhood caries were noted. Radiographic evaluation revealed internal root resorption of tooth "K" and external root resorption of tooth "T." The two teeth were treated with ledermix paste followed by obturation with Vitapex® (Diadent Group International Inc., Burnaby, BC, Canada) along with triple antibiotic paste and placement of stainless steel crown (SSC). A latex-free environment was maintained during the entire treatment to prevent allergic reaction. A follow up after 42 months indicated clinical and radiographical success. CONCLUSION: The paper reports succesfull management of internal and external root resorption as well as latex allergy in a dental operatory. The dental perspective while dealing with patients having NTD is limited. Explaining the particulars of the treatment plan will aid in management of such cases .

[Latex allergy: a review on the most important aspects]. / Alergia al látex: una revisión sobre los aspectos más importantes.

This allergy is a hypersensitivity reaction that is triggered by contact with latex. Symptoms vary depending on factors such as route, frequency, and exposure dose, as well as individual susceptibility. The clinical manifestations can be localized at the site of contact with latex or generalized. Exposure can occur directly as a result of contact with the skin and mucous membranes, that is by touching or being touched by objects with latex, or by inhaling (breathing) particles from objects with latex. Contact can also be indirect; for example, by ingesting food that has been handled by a worker wearing latex gloves or by having contact with a person who has been blowing up balloons. The diagnosis of latex allergy is made based on the patient's medical history and on what has been reported in the interrogation, and it is complemented with in vivo studies (such as skin tests and provocation tests) or in vitro studies (determination of specific IgE). The fundamental pillar in the treatment of latex allergy is the education of the patient to achieve the avoidance of products made with this material or the contact and intake of food that has had contact with latex. In view of the foregoing, latex allergy has a great medical and social relevance due to all the safety measures that the patient must take.

La alergia es una reacción de hipersensibilidad desencadenada tras el contacto con el látex. Los síntomas varían dependiendo de factores como la ruta, frecuencia y dosis de exposición, además de la susceptibilidad individual. Las manifestaciones clínicas pueden darse de forma localizada, en el sitio de contacto con el látex, o generalizadas. La exposición puede ocurrir de forma directa como resultado del contacto con la piel y mucosas, por tocar o ser tocado por objetos con látex, o al inhalar partículas provenientes de objetos con látex. El contacto también puede ser indirecto, al ingerir alimentos que fueron manipulados por un trabajador con guantes de látex, al tener contacto con una persona que ha estado inflando globos, por ejemplo. El diagnóstico de alergia al látex se realiza basado en la historia clínica del paciente, lo reportado en el interrogatorio y se complementa con estudios in vivo (como las pruebas cutáneas y las pruebas de provocación) o estudios in vitro (determinación de IgE específica). El pilar fundamental en el tratamiento de la alergia al látex es la educación del paciente para lograr la evitación de productos elaborados con este producto o el contacto e ingesta de alimentos que tuvieron contacto con el látex. Por lo anterior, la alergia al látex tiene una gran relevancia médica y social por todas las medidas de seguridad que debe llevar el paciente.

Characteristics of hand eczema in final-year apprentice nurses during the COVID-19 pandemic.

BACKGROUND: Apprentice nurses are considered at high risk to developing occupational skin diseases. OBJECTIVES: This study assessed the frequency and origin of hand eczema, and work-related risk factors in apprentice nurses. METHODS: The study involved 240 final-year apprentice nurses (females 75%, median age 19 years) from vocational schools in Zagreb, Croatia. The study was performed in 2020/2021 and included a questionnaire and clinical examination by means of the Osnabrück Hand Eczema Severity Index (OHSI). Skin prick test (SPT) with natural rubber latex (NRL) allergen, and patch test with the basic series of allergens, and disinfectants, were performed in 42 apprentice nurses with hand eczema that lasted more than 3 months. RESULTS: Clinically observed and self-reported hand eczema were found in 49% and 46% of apprentice nurses, respectively. Those with observed changes were older and reported more days per month spent on practical work than those with healthy skin (P = .001). Median OHSI was 4 (interquartile range 2-6). There were no positive SPTs to latex, and 11 (26%) apprentice nurses had positive patch test reactions to one or more tested allergens, mostly nickel. CONCLUSIONS: Hand eczema was common in final-year apprentice nurses during the COVID-19 pandemic. It was mostly of irritative origin, associated with the duration of practical training, confirming cumulative effect of hazards on skin barrier.

Latex allergy guidelines for people with spina bifida.

An estimated 85% of individuals with spina bifida (SB) survive into adulthood, warranting SB-specific transition to adult healthcare guidelines to address the diverse and complex medical, adaptive, and social needs particular to this condition. Latex allergy constitutes one important health concern for this population that requires ongoing and life-long evidence-based management. This article discusses management of latex allergy according to the SB Latex Allergy Healthcare Guidelines from the 2018 Spina Bifida Association's Fourth Edition of the Guidelines for the Care of People with Spina Bifida, reviews current care models in which such latex allergy guidelines can be implemented, and explores further relevant research topics in SB care relative to latex allergy.

Prevalencia de sensibilidad y alergia al látex en médicos de un programa de residencia de un hospital pediátrico de Buenos Aires / Prevalence of latex sensitivity and allergy among physicians of a residency program in a children ́s hospital of Buenos Aires

Introducción. Publicaciones internacionales estiman una prevalencia de sensibilización al látex (SL) en el personal de salud del 7 % al 17 %, y se desconocen los valores en la Argentina.Objetivos. Estimar la prevalencia de sensibilización y alergia al látex en médicos residentes de un hospital pediátrico mediante la prueba epicutánea de lectura inmediata y evaluar factores de riesgo asociados en dicha población.Población y métodos. Estudio de corte transversal. Se incluyeron los residentes, jefes e instructores de Pediatría, Ortopedia, Cirugía y Terapia Intensiva entre junio y octubre de 2017. En todos, se realizó un cuestionario (que evaluó enfermedades atópicas y otros factores de riesgo) y la prueba epicutánea de lectura inmediata. En un subgrupo (residentes de 1ero, 4to año, especialidades quirúrgicas y terapia) se dosó inmunoglobulina E total y específica para látex.Resultados. Se incluyeron 113 participantes. La prevalencia de SL fue del 7,96 % (intervalo de confianza del 95 %: 3,70-14,58); 4 participantes resultaron alérgicos al látex. El antecedente de síntomas relacionados con el látex se asoció significativamente con prueba epicutánea de lectura inmediata + (p = 0,0196; odds ratio 6,13; intervalo de confianza del 95 %: 1,44-26,04). No hubo asociación entre SL y año de residencia.Conclusiones. La prevalencia de SL hallada fue del 7,9 %. Se evidenció una relación significativa entre el antecedente de SRL y un resultado de prueba epicutánea de lectura inmediata positiva

Introduction. International publications estimate a 7 %-17 % latex sensitization (LS) prevalence among health care workers, but values in Argentina are unknown.Objectives. To estimate the prevalence of latex sensitization and allergy among residents of a children's hospital using the immediate-reading prick test and to assess associated risk factors in this population.Population and methods. Cross-sectional study. Residents, trainers, and Chief residents of the Departments of Pediatrics, Orthopedics, Surgery and Intensive Care were included between June and October 2017. All of them were administered a questionnaire (assessing atopic diseases and other risk factors) and underwent the immediate-reading prick test. Total and latex-specific immunoglobulin E levels were determined in a subgroup of individuals (first- and fourth-year residents, surgical specialties, and intensive care).Results. A total of 113 participants were included. LS prevalence was 7.96 % (95 % confidence interval: 3.70-14.58); 4 participants were allergic to latex. A history of latex-related symptoms (LRS) was significantly associated with a positive result in the immediate-reading prick test (p = 0.0196; odds ratio: 6.13; 95 % confidence interval: 1.44-26.04). There was no association between LS and the year of the residency program.Conclusions. The observed LS prevalence was 7.9 %. There was a significant relation between a history of LRS and a positive result in the immediate-reading prick tes

Tailored Sublingual Immunotherapy in a Monosensitized Child with Natural Rubber Latex Allergy.

Adverse reactions to natural rubber latex (NRL) represent a group of clinical manifestations that include non-allergic reactions and immediate-type or delayed-type allergic reactions. NRL sublingual immunotherapy (SLIT) has been demonstrated to be an effective and safe practice for latex clinical manifestations with good patient tolerance. A pediatric case of NRL allergy managed with an effective tailored SLIT is described. This case is compelling because the girl, who did not have an atopic background, suffered from NRL allergy with high reactivity and unique monosensitization. To the best of our knowledge, this is the first case with this characteristic described to date. Moreover, the SLIT follow-up time reported was unusually long, extending from childhood to adulthood. The case described highlights several problems of real-life management, and it demonstrates how the pediatric allergist plays a key role in the management of all these issues in order to succeed in guiding the patient through the immunotherapy process with a personalized approach, in line with the precision medicine principles. However, further long-term clinical studies are needed to better define the natural history of NRL allergy and find new potential biomarkers of response to NRL immunotherapy.

Prevalence of latex sensitivity and allergy among physicians of a residency program in a children´s hospital of Buenos Aires. / Prevalencia de sensibilidad y alergia al látex en médicos de un programa de residencia de un hospital pediátrico de Buenos Aires.

Introduction: International publications estimate a 7 %-17 % latex sensitization (LS) prevalence among health care workers, but values in Argentina are unknown. Objectives: To estimate the prevalence of latex sensitization and allergy among residents of a children's hospital using the immediate-reading prick test and to assess associated risk factors in this population. Population and methods: Cross-sectional study. Residents, trainers, and Chief residents of the Departments of Pediatrics, Orthopedics, Surgery and Intensive Care were included between June and October 2017. All of them were administered a questionnaire (assessing atopic diseases and other risk factors) and underwent the immediatereading prick test. Total and latex-specific immunoglobulin E levels were determined in a subgroup of individuals (first- and fourth-year residents, surgical specialties, and intensive care). Results: A total of 113 participants were included. LS prevalence was 7.96 % (95 % confidence interval: 3.70-14.58); 4 participants were allergic to latex. A history of latex-related symptoms (LRS) was significantly associated with a positive result in the immediate-reading prick test (p = 0.0196; odds ratio: 6.13; 95 % confidence interval: 1.44-26.04). There was no association between LS and the year of the residency program. Conclusions: The observed LS prevalence was 7.9 %. There was a significant relation between a history of LRS and a positive result in the immediate-reading prick test.

Introducción. Publicaciones internacionales estiman una prevalencia de sensibilización al látex (SL) en el personal de salud del 7 % al 17 %, y se desconocen los valores en la Argentina. Objetivos. Estimar la prevalencia de sensibilización y alergia al látex en médicos residentes de un hospital pediátrico mediante la prueba epicutánea de lectura inmediata y evaluar factores de riesgo asociados en dicha población. Población y métodos. Estudio de corte transversal. Se incluyeron los residentes, jefes e instructores de Pediatría, Ortopedia, Cirugía y Terapia Intensiva entre junio y octubre de 2017. En todos, se realizó un cuestionario (que evaluó enfermedades atópicas y otros factores de riesgo) y la prueba epicutánea de lectura inmediata. En un subgrupo (residentes de 1ero, 4to año, especialidades quirúrgicas y terapia) se dosó inmunoglobulina E total y específica para látex. Resultados. Se incluyeron 113 participantes. La prevalencia de SL fue del 7,96 % (intervalo de confianza del 95 %: 3,70-14,58); 4 participantes resultaron alérgicos al látex. El antecedente de síntomas relacionados con el látex se asoció significativamente con prueba epicutánea de lectura inmediata + (p = 0,0196; odds ratio 6,13; intervalo de confianza del 95 %: 1,44-26,04). No hubo asociación entre SL y año de residencia. Conclusiones. La prevalencia de SL hallada fue del 7,9 %. Se evidenció una relación significativa entre el antecedente de SRL y un resultado de prueba epicutánea de lectura inmediata positiva.