Identification of New Allergens in Macadamia Nut and Cross-Reactivity with Other Tree Nuts in a Spanish Cohort.

The consumption of macadamia nuts has increased due to their cardioprotective and antioxidant properties. However, this rise is consistent with an increase in the cases of macadamia nut allergy, leading to severe reactions. Although two Macadamia integrifolia allergens (Mac i 1 and Mac i 2) have been identified in Australian and Japanese patients, the allergenic sensitization patterns in Western European populations, particularly in Spain, remain unclear. For this purpose, seven patients with macadamia nut allergy were recruited in Spain. Macadamia nut protein extracts were prepared and, together with hazelnut and walnut extracts, were used in Western blot and inhibition assays. IgE-reactive proteins were identified using MALDI-TOF/TOF mass spectrometry (MS). Immunoblotting assays revealed various IgE-binding proteins in macadamia nut extracts. Mass spectrometry identified three new allergens: an oleosin, a pectin acetylesterase, and an aspartyl protease. Cross-reactivity studies showed that hazelnut extract but not walnut extract inhibited macadamia nut oleosin-specific IgE binding. This suggests that oleosin could be used as marker for macadamia-hazelnut cross-reactivity. The results show an allergenic profile in the Spanish cohort different from that previously detected in Australian and Japanese populations. The distinct sensitization profiles observed highlight the potential influence of dietary habits and environmental factors exposure on allergenicity.

Bases teóricas sobre la evaluación de la calidad del servicio en salud / Theoretical bases on health service quality assessment

Exponer las diferentes conceptualizaciones y los modelos de evaluación de la calidad de servicio en salud, respecto a sus características, fundamentos, y diferencias a través del análisis y síntesis de los aspectos más significativos encontrados en la literatura. Se realizó una revisión bibliográfica, bajo el sustento teórico de los siguientes métodos teóricos: Análisis, síntesis, histórico lógico y análisis documental de 19 artículos completos, accesibles en el idioma español e inglés, recolectados de bases de datos académicos como Google Académico, Research Gate, PubMed, Cochrane Library, Scielo Salud pública. Destacar que la búsqueda, recolección y análisis se realizó en los meses de mayo a julio. Tras la revisión bibliográfica pone en manifiesto la falta de consenso entre los expertos en el tema de calidad respecto a su conceptualización, misma que ha evolucionado conforme al contexto, social, tecnológico y científico. En definitiva, las bases teóricas para la evaluación de la calidad de atención en el servicio de salud, el primer modelo específico aplicado a salud fue el modelo de Abedis Donabedian, continuando las bases teóricas con el paradigma de la desconfirmación liderada por el modelo nórdico de Grönroos, el modelo de Parasumaran, Berry y Zeithaml respecto a la brecha que existe entre las expectativas y percepción; y el modelo de Cronin Taylor respecto a la valoración de las percepciones. Así mismo, se concluye, que el constructo de calidad está en evolución y su interpretación depende del observador y sus prioridades en base a la adaptación del instrumento respecto al contexto de aplicabilidad.

To expose the different conceptualizations and models of health service quality evaluation, regarding their characteristics, foundations, extension and differences through the analysis and synthesis of the most significant aspects found in the literature. A bibliographic review was carried out under the theoretical support of the following theoretical methods: analysis, synthesis, logical history and documentary analysis of 18 complete articles, accessible in Spanish and English, collected from academic databases such as Google Scholar, Research Gate, PubMed, Cochrane Library, Scielo Public Health, the search, collection and analysis was carried out from May to July. The bibliographic review reveals the lack of consensus among experts on the subject of quality with respect to its conceptualization, which has evolved according to the social, technological and scientific context. In short, the theoretical bases for the evaluation of the quality of care in the health service, the first specific model applied to health was the Abedis Donabedian model, continuing the theoretical bases with the paradigm of disconfirmation led by the Nordic model of Grönroos, the model of Parasumaran, Berry and Zeithaml regarding the gap that exists between expectations and perception; and the Cronin Taylor model regarding the assessment of perceptions. It is also concluded that the quality construct is evolving and its interpretation depends on the observer and his or her priorities based on the adaptation of the instrument to the context of applicability

Fertility and Pregnancy Outcomes in Women with Polycystic Ovary Syndrome Following Bariatric Surgery.

CONTEXT: Restoration of ovulation is quite common in women with polycystic ovary syndrome (PCOS) after surgically induced weight loss. Whether or not this results in an improvement of PCOS-associated infertility is uncertain. OBJECTIVE: To study fertility and gestational outcomes in women with PCOS after bariatric surgery. DESIGN: Unicenter cohort study. SETTING: Academic hospital. PATIENTS: Two hundred and sixteen premenopausal women were screened for PCOS before bariatric surgery. Women were followed-up after the intervention until mid-2019 regardless of having or not PCOS. INTERVENTIONS: All participants underwent bariatric surgery from 2005 to 2015. MAIN OUTCOME MEASURES: Pregnancy and live birth rates in the PCOS and control groups. RESULTS: In women seeking fertility, pregnancy rates were 95.2% in PCOS and 76.9% in controls (P = 0.096) and live birth rates were 81.0% and 69.2%, respectively (P = 0.403). The time to achieve the first pregnancy after surgery was 34 ±â€…28 months in women with PCOS and 32 ±â€…25 months in controls. Albeit the mean birth weight was lower (P = 0.040) in newborns from women with PCOS (2763 ±â€…618 g) compared with those from controls (3155 ±â€…586 g), the number of newborns with low birth weight was similar in both groups (3 in the PCOS group and 1 in the controls, P = 0.137). Maternal (17.6% in PCOS and 22.2% in controls, P = 0.843) and neonatal (23.5% in PCOS and 14.8% in controls, P = 0.466) complications were rare, showing no differences between groups. CONCLUSIONS: Pregnancy and fertility rates in very obese women with PCOS after bariatric surgery were high, with few maternal and neonatal complications.