[Epidemiological profile of allergic respiratory disease in Mexican children]. / Perfil epidemiológico de la enfermedad respiratoria alérgica en niños mexicanos.

OBJECTIVE: Report the prevalence and severity of the most common allergic diseases in children living in Monterrey, México. METHODS: Cross-sectional multi-center survey on the most common allergic diseases, completed by parents of 6-7-year-old children and by 13-14- year-old adolescents in the Monterrey metropolitan area, between January 2018 and December 2019. RESULTS: A total of 3,044 questionnaires were eligible for the analysis. Among children between 6-7 years old, 30.2% (n = 143/473) presented wheezing at any time in their life; with a higher prevalence in the male population. In the adolescent group, 26.4% reported having experienced wheezing at some point in their life, with a slight predominance in the female group (54.9%). CONCLUSIONS: Knowing the prevalence of allergic diseases in our population gives us tools to generate strategies that allow us to provide the best quality healthcare to our patients.

OBJETIVO: Reportar la prevalencia y gravedad de las enfermedades alérgicas más comunes en niños residentes en Monterrey, México. MÉTODOS: Encuesta multicéntrica transversal, acerca de las enfermedades alérgicas más comunes, completada por padres de niños de 6 aa 7 años y por adolescentes de 13 a 14 años del área metropolitana de Monterrey, entre enero de 2018 y diciembre de 2019. RESULTADOS: Un total de 3044 cuestionarios fueron elegibles para el análisis. Entre los niños de 6-7 años, 30.2% (n = 143/473) manifestaron sibilancias en algún momento de su vida; con mayor prevalencia en la población masculina. En el grupo de adolescentes el 26.4% refirió haber tenido sibilancias alguna vez en su vida, con un ligero predominio en el grupo femenino (54.9%). CONCLUSIONES: Conocer la prevalencia de las enfermedades alérgicas en la población brinda herramientas para generar estrategias para la mejor calidad asistencial en los pacientes.

Patient-important outcomes in clinical trials of atopic diseases and asthma in the last decade: A systematic review.

Background: Randomized Clinical Trials (RCTs) are important tools to establish the effects of a given intervention. Investigators should focus on outcomes that patients perceive: patient-important outcomes (PIOs), clinical endpoints that patients value directly and reflect how they feel, function, or survive. However, it is easier to consider surrogated outcomes to reduce costs and achieve better-looking results. The problem with these outcomes is that they indirectly measure PIOs, which might not correlate linearly or translate reliably into a positive PIO. Methods: We systematically searched MEDLINE for atopic disease RCTs rated among the top 10 allergic diseases and general internal medicine journals from the last 10 years. Two independent reviewers worked in duplicate and independently to collect data from all eligible articles. We gathered information regarding the type of study, title, author information, journal, intervention type, atopic disease, and primary and secondary outcomes. We assessed the outcomes investigators used in RCTs of atopic diseases and asthma. Results: This quantitative analysis included n = 135 randomized clinical trials. The most studied atopic disease during the period selected was asthma (n = 69), followed by allergic rhinitis (n = 51). When divided by atopic disease, primary outcomes in RCTs valuing allergic rhinitis had the most significant proportion of PIOs (76.7), asthma surrogated outcomes (38), and asthma/allergic rhinitis laboratory outcomes (42.9). PIOs in allergic rhinitis trials had the most significant proportion of PIOs favoring the intervention (81.4), asthma had the greatest proportion of surrogated outcomes (33.3), and asthma/allergic rhinitis laboratory outcomes (40). When divided by atopic disease, trials studying atopic dermatitis and urticaria had the same proportion of PIOs (64.7) as their secondary outcomes. Asthma had the highest (37.5) surrogate outcomes. Journals of general/internal medicine had a greater proportion of PIOs, and a post hoc analysis showed a significant difference in the proportion and secondary outcomes that favored the intervention between PIOs and laboratory outcomes. Conclusion: Approximately 7.5 out of 10 primary outcomes in RCTs published in general/internal medicine are PIOs compared to 5 out of 10 primary outcomes in atopic disease journals. Investigators should focus on selecting patient-important outcomes in their clinical trials to establish clinical guidelines with better-quality recommendations that impact patients' life and values. Registration: International Prospective Register of Systematic Reviews (PROSPERO, NIHR) ID: CRD42021259256.

Psychological impact of the COVID-19 pandemic on patients with allergic diseases.

BACKGROUND: On March 2020, World Health Organization (WHO) declared COVID-19 to be a pandemic disease. Interactions between allergy-related inflammatory and psychiatric disorders including depression, anxiety, and post-traumatic stress disorder (PTSD) have been documented. Therefore, those who have pre-existing allergic conditions may have an increased psychiatric reaction to the stresses of the COVID-19 pandemic. OBJECTIVE: Identify the psychological impact of COVID-19 in patients with allergic diseases and determine if these individuals have a greater risk of presenting with post-traumatic stress disorder (PTSD). METHODS: It is a cross-sectional, survey-based study designed to assess the degree of symptoms of depression and the risk of PTSD using the Patient Health Questionnaire (PHQ-9) and the Impact of Event Scale-Revised (IES-R), respectively, in allergic patients. RESULTS: A total of 4106 surveys were evaluated; 1656 (40.3%) were patients with allergic disease, and 2450 (59.7%) were non-allergic (control) individuals. Of those with allergies, 76.6% had respiratory allergic disease including asthma and allergic rhinitis. Individuals with allergic disease reported higher scores regarding symptoms of PTSD on the IES-R scale (p = 0.052, OR 1.24 CI 0.99-1.55) as well as a higher depression risk score in the PHQ-9 questionnaire (mean 6.82 vs. 5.28) p = 0.000 z = -8.76.The allergy group presented a higher score in the IES-R questionnaire (mean 25.42 vs. 20.59), being more susceptible to presenting PTSD (p = 0.000, z = -7.774).The individuals with allergic conditions were further divided into subgroups of those with respiratory allergies such as allergic rhinitis and asthma vs those with non-respiratory allergies such as drug and food allergy, urticaria and atopic dermatitis. This subgroup analysis compares respiratory versus non-respiratory allergic patients, with similar results on the IES-R (mean 25.87 vs 23.9) p = 0.0124, z = -1.539. There was no significant difference on intrusion (p = 0.061, z = -1.873) and avoidance (p = 0.767, z = -0.297), but in the hyperarousal subscale, patients with respiratory allergy had higher scores (mean 1.15 vs. 0.99) p = 0.013 z = -2.486. CONCLUSIONS: Psychological consequences such as depression and reported PTSD are present during the COVID-19 pandemic causing an impact particularly in individuals with allergic diseases. If we acknowledge the impact and how it is affecting our patients, we are able to implement interventions, follow up, and contribute to their overall well-being.