INFLUENCIA DEL TIPO DE ALIMENTACIÓN EN EL DESARROLLO DE LA ALERGIA A LA LECHE DE VACA. FACTORES INVOLUCRADOS EN EL PROCESO POR EL CUAL SE ADQUIERE LA ENFERMEDAD / Infl uence of the type of feeding in the development of cow's milk allergy. Factors involved in the process by which the disease is acquired

Antecedentes. Los resultados de las investigaciones sobre la historia natural de la alergia a la leche de vaca (ALV) no han provisto aún, de un cuadro claro y consistente que ayude en la práctica al médico tratante. Objetivo. Identifi car los factores involucrados en el desarrollo de la enfermedad en lactantes pequeños, con el fi n de determinar perfi les específi cos e índices predictivos. Lugar de realización: Río Cuarto, Córdoba, Argentina. Diseño. Análisis observacional y retrospectivo. Población. 91 niños con diagnóstico de ALV y 91 controles, de ambos sexos, menores de 6 años. Método. Análisis de factores seleccionados de las historias clínicas, su relación individual con el diagnóstico (prueba X2, Odds Ratios, diferencias de medias) y su incidencia conjunta en la probabilidad de ser ALV para determinar perfi les (análisis de correspondencias múltiple y regresión logística). Elaboración de 3 índices predictivos basados en: odds ratios individuales, los correspondientes a la regresión logística y la identifi cación de criterios mayores y menores, con su respectiva evaluación de efectividad diagnóstica (sensibilidad, especifi cidad, valores predictivos y curva ROC). Resultados. Se encontró que la edad de inicio de los síntomas, el tipo de alimentación recibida hasta el 3er mes de vida, la exposición al humo de cigarrillo, los antecedentes alérgicos maternos y el tipo de manifestaciones clínicas con que comienza la ALV son factores que con mayor probabilidad inciden en su desarrollo. Conclusión. La utilidad de estos perfi les e índices predictivos radica en una temprana identifi cación de pacientes con riesgo de padecer ALV(AU)

Background: The results of the research on the natural history of allergy to cow's milk allergy (CMA) still have not provided a clear picture and consistent that in practice helps the attending physician. Objective: to identify the factors involved in the development of the disease in young infants, in order to determine specifi c profi les and predictive clinical indexes. Setting: Río Cuarto, Córdoba, Argentina. Design: observacional and retrospective analysis. Population: 91 children with a diagnosis of CMA and 91 controls, of both sexes, under the age of 6 years. Methods: analysis of selected factors of the clinical histories, their relationship with the individual diagnosis (test X2, Odds Ratios, differences in average) and their combined impact on the probability of being CMA to determine profi les (multiple correspondence analysis and logistic regression). Elaboration of 3 predictive indices based on: individual Odds Ratios, corresponding to the logistic regression and the identifi cation of greater and smaller criteria, with its respective evaluation of effectiveness diagnoses (predictive sensitivity, specifi city, values and ROC curve). Results: we found that the age of onset of symptoms, the type of feeding received until the 3rd month of life, exposure to cigarette smoke, the maternal allergy history and the type of clinical manifestations with that begins the CMA, are factors that most likely have an impact on its development. Conclusion: the utility of these profi les and predictive clinics indexes lies in an early identifi cation of patients at risk of CMA.(AU)

A mutation in mitochondrial 12S rRNA, A827G, in Argentinean family with hearing loss after aminoglycoside treatment.

Mutations in mitochondrial DNA (mtDNA) have been found to be associated with sensorineural hearing loss. We report the clinical, genetic, and molecular characterization of one Argentinean family with aminoglycoside-induced impairment in two of their members. Clinical evaluation revealed the variable phenotype of hearing impairment including audiometric configuration in these subjects. Mutational analysis of the mtDNA in these pedigrees showed the presence of homoplasmic 12S rRNA A827G mutation, which has been associated with hearing impairment. The A827G mutation is located at the A-site of the mitochondrial 12S rRNA gene which is highly conserved in mammals. It is possible that the alteration of the tertiary or quaternary structure of this rRNA by the A827G mutation may lead to mitochondrial dysfunction, thereby playing a role in the pathogenesis of hearing loss and aminoglycoside hypersensitivity. However, incomplete penetrance of hearing impairment indicates that the A827G mutation itself is not sufficient to produce clinical phenotype.