[Frequency of food allergy in students of human medicine of a private university]. / Frecuencia de alergia alimentaria en estudiantes de medicina humana de una universidad privada.

OBJECTIVE: Determine the frequency of total food allergy, and to Peruvian products, in Human Medicine students. METHODS: A study design is observational, descriptive and retrospective was made. Human medicine students, aged 18-25 from a private Peruvian university were included in a type of snowball sampling via electronic messaging. The sample size was calculated using the OpenEpi v3.0 program and the prevalence formula. RESULTS: We registered 355 students, with a mean age of 20.87 years (SD ± 5.01). A frequency of food allergy was also found in 9.3% of the total participants in terms of native products and common in other countries, the highest percentage are seafood 2.24%, spices and condiments 2.24%, allergy to fruits 1.4%, milk 1.4%, red meat 0.84%. CONCLUSIONS: The frequencies of self-reported food allergy produced was 9.3% by native Peruvian products and commonly consumed nationwide.

OBJECTIVO: Determinar la frecuencia de alergia alimentaria en general, y de productos de consumo común oriundos del Perú, en estudiantes de medicina humana. MÉTODOS: Estudio observacional, descriptivo y retrospectivo, al que se incluyeron estudiantes de medicina humana de 18-25 años, de una universidad privada del Perú, seleccionados mediante muestreo tipo "bola de nieve" a través de mensajería electrónica. El tamaño de la muestra se calculó con el programa OpenEpi v3.0 y la fórmula de prevalencia. RESULTADOS: Se registraron 355 estudiantes, con edad media de 20.9 años (SD ± 5,01). La frecuencia de alergia alimentaria fue de 9.3% del total de la muestra; y la frecuencia de alergia a productos de consumo común (oriundos del país) reportó: mariscos 2.24%, especias y condimentos 2.24%, frutas 1.4%, leche 1.4% y carnes rojas 0.84%. CONCLUSIONES: Existe una frecuencia de 9.3% de alergia alimentaria autorreportada, producida por productos de consumo común (oriundos del Perú) a nivel nacional.

[Food allergy and its association with self-reported atopic dermatitis in young adults in Lima-Peru]. / Alergia alimentaria y su asociación con dermatitis atópica autorreportada en adultos jóvenes en Lima-Perú.

OBJECTIVE: To specify the association between atopic dermatitis and food allergies in students of Human Medicine in a private university in Lima-Peru. METHODS: An observational, analytical, cross-sectional study that included 355 students of human medicine between the ages of 18 and 25 years, of a private university in Lima-Peru, through a virtual survey. The data were analyzed using Fisher's technique, Student's T test, and Poisson regression. RESULTS: In a model that was adjusted by age and sex, having atopic dermatitis was associated with 5.53 times the probability of having food allergies (95 % confidence interval, 3.12-9.79). CONCLUSIONS: There was an association between the precedent of atopic dermatitis and reported food allergies in 28.95 % of the students of human medicine of a private university in Lima-Peru.

Objetivo: Precisar la asociación entre dermatitis atópica y alergia alimentaria en estudiantes de Medicina Humana de una universidad privada de Lima, Perú. Métodos: Estudio observacional, analítico, transversal, en el cual se incluyeron 355 estudiantes de medicina humana con edad entre 18 y 25 años, de una universidad privada de Lima, Perú, a través de una encuesta virtual. Los datos fueron analizados con la técnica de Fisher, t de Student y análisis de regresión de Poisson. Resultados: En un modelo ajustado por edad y sexo, tener dermatitis atópica se asoció con 5.53 veces la probabilidad de tener alergia alimentaria (intervalo de confianza de 95 %, 3.12-9.79). Conclusión: Existió asociación entre el antecedente de dermatitis atópica y haber reportado alergia alimentaria en 28.95 % de los estudiantes de medicina humana de una universidad privada de Lima, Perú.

Effect of silver nanoparticles upon the myocardial and coronary vascular function in isolated and perfused diabetic rat hearts.

Silver nanoparticles (AgNPs) are promising antibacterial nanomaterials for diagnostic and treatment of diabetes. However, toxicity and adverse cardiac responses induced by AgNPs related to nitric oxide (NO) and oxidative stress (OS) are described. Moreover, little is known about the diabetes influence upon AgNPs-toxicity. The aim of this work was to evaluate cardiovascular function in response to AgNPs through measuring perfusion pressure (PP) and left ventricle pressure (LVP), using perfused hearts from streptozotocin (STZ)-induced diabetic rats and identify the role of NO and OS. High concentrations but not the lower concentrations of AgNPs, promotes increases in PP and LVP, as well as increased OS. Additionally, diabetes alters the classic effects of phenylephrine (Phe) and acetylcholine (ACh). These data suggest that diabetes may intensify AgNPs-cardiotoxicity. Nevertheless, the precise mechanism of action is still under elucidation.

[Clinical-epidemiological profile of patients with suspicion of alimentary allergy in Mexico. Mexipreval Study]. / Perfil clínico-epidemiológico de pacientes con sospecha de alergia alimentaria en México. Estudio Mexipreval.

BACKGROUND: Adverse reaction to food has increased around the world in last years. Prevalence of food allergy raises between 2-4% in adults, and 6-8% in children. The clinical presentation is heterogeneous and varies from mild symptoms to anaphylactic reactions. Even the clinical history focused in the food is important; demonstration of allergen sensitization is mandatory. OBJECTIVE: To describe the profile of the patients with suspicion of food allergy and the regular clinical practice followed in Mexico. MATERIAL AND METHOD: An observational, descriptive, cross-sectional study was carried out from March 2013 to March 2014 using a convenience sample of allergic patients who were treated in the office, both private and public, of those physicians who seen food allergy patients. RESULTS: Clinical, epidemiological, diagnostic and therapeutic data were collected from 1,971 suspicious food allergic patients presenting for the first time in the departments of the researchers involved in the study. No difference was found in relation to gender. In relation to age, a bimodal distribution, with peaks at 2 and 35 years old, was found. A history of respiratory allergy was present in 75% of cases; 80% of patients had had any previous symptoms before seeking consultation and the most frequent clinical manifestations were cutaneous, 5% reported anaphylaxis. CONCLUSION: The foods involved in reactions change with age. The clinical presentation changes with the food, although the skin is the most frequently affected organ. Even if the suspicious were high, the confirmation with specific diagnostic tools is strongly recommended.

Antecedentes: las enfermedades alérgicas asociadas con alimentos se incrementan anualmente. Tienen una prevalencia de 2 a 4% en adultos y de 6 a 8% en niños. El cuadro clínico varía de síntomas leves hasta reacciones anafilácticas. El diagnóstico se basa en la historia clínica, pero debe demostrarse evidencia de sensibilización específica para el alergeno. Objetivo: conocer el perfil clínico-epidemiológico de los pacientes con sospecha de alergia alimentaria vistos en consultorios médicos (alergólogos y no alergólogos), así como la conducta diagnóstica y tratamiento habitual. Material y método: estudio observacional, transversal y descriptivo, efectuado en consultorios de médicos que atienden pacientes con alergia alimentaria en la República Mexicana durante un año natural de abril de 2013 a marzo de 2014, mediante un muestreo por conveniencia. Resultados: se realizaron 1,971 encuestas. No se encontró diferencia en relación con el género. En relación con la edad, se reportó una distribución bimodal, con picos a los 2 y 35 años de edad. Había antecedente de alergia respiratoria en 75% de los casos. El 80% de los pacientes tuvo algún síntoma antes de buscar atención y las manifestaciones clínicas más frecuentes afectaron la piel (57.1%). El 5% refirió haber padecido al menos un evento de anafilaxia. Conclusión: el tipo de alimento implicado cambia con la edad. La forma de manifestación clínica más frecuente fue la cutánea, pero varía con el tipo de alimento. Aun cuando la sospecha clínica sea alta, deben utilizarse métodos específicos que confirmen el diagnóstico.

In the (sub)tropics allergic rhinitis and its impact on asthma classification of allergic rhinitis is more useful than perennial-seasonal classification.

BACKGROUND: Two different allergic rhinitis (AR) symptom phenotype classifications exist. Treatment recommendations are based on intermittent-persistent (INT-PER) cataloging, but clinical trials still use the former seasonal AR-perennial AR (SAR-PAR) classification. This study was designed to describe how INT-PER, mild-moderate/severe and SAR-PAR of patients seen by allergists are distributed over the different climate zones in a (sub)tropical country and how these phenotypes relate to allergen sensitization patterns. METHODS: Six climate zones throughout Mexico were determined, based on National Geographic Institute (Instituto Nacional de Estadística y Geografía) data. Subsequent AR patients (2-68 years old) underwent a blinded, standardized skin-prick test and filled out a validated questionnaire phenotyping AR. RESULTS: Five hundred twenty-nine subjects participated in this study. In the tropical zone with 87% house-dust mite sensitization, INT (80.9%; p < 0.001) and PAR (91%; p = 0.04) were more frequent than in the subtropics. In the central high-pollen areas, there was less moderate/severe AR (65.5%; p < 0.005). Frequency of comorbid asthma showed a clear north-south gradient, from 25% in the dry north to 59% in the tropics (p < 0.005). No differences exist in AR cataloging among patients with different sensitization patterns, with two minor exceptions (more PER in tree sensitized and more PAR in mold positives; p < 0.05). CONCLUSION: In a (sub)tropical country the SAR-PAR classification seems of limited value and bears poor relation with the INT-PER classification. INT is more frequent in the tropical zone. Because PER has been shown to relate to AR severity, clinical trials should select patients based on INT-PER combined with the severity cataloging because these make for a better treatment guide than SAR-PAR.

Adverse effects of inhaled corticosteroids in funded and nonfunded studies.

BACKGROUND: Evidence regarding the safety profile of drugs may vary depending on study sponsorship. We aimed to evaluate differences between studies funded by the pharmaceutical manufacturer of the drug (PF) and those with no pharmaceutical funding (NoPF) regarding the finding and interpretation of adverse effects of inhaled corticosteroids. METHODS: We assessed the safety reporting of inhaled corticosteroids in 275 PF and 229 NoPF studies identified by a MEDLINE search using prespecified criteria. RESULTS: Overall, the finding of statistically significant differences for adverse effects was significantly less frequent in PF (34.5%) than in NoPF (65.1%) studies (prevalence ratio, 0.53; 95% confidence interval, 0.44-0.64). This association became nonsignificant (prevalence ratio, 0.94; 95% confidence interval, 0.77-1.15) after controlling for design features (such as dose or use of parallel groups) that tended to be associated with less frequent finding of adverse effects and were more common in PF studies. Among studies finding a statistically significant increase in adverse effects associated with the study drug, the authors of PF articles concluded that the drug was "safe" more frequently than the authors of NoPF studies (prevalence ratio, 3.68; 95% confidence interval, 2.14-6.33). CONCLUSIONS: The type of funding may have determinant effects on the design of studies and on the interpretation of findings: funding by the industry is associated with design features less likely to lead to finding statistically significant adverse effects and with a more favorable clinical interpretation of such findings. Disclosure of conflicts of interest should be strengthened for a more balanced opinion on the safety of drugs.

Síndrome antifosfolípido-cofactor: revisión / Antiphospholipid cofactor syndrome: a review

El síndrome antifosfolípido (SAF), caracterizado por un amplio espectro de manifestaciones clínicas y serológicas debidas a la presencia de anticuerpos antifosfolípido o su cofactores, constituye una entidad relativamente reciente y sobre la cual aún existen muchas interrogantes con respecto a su etiología, diagnóstico y tratamiento. En esta revisión se exponen los datos más recientes que se encuentran en la literatura acerca de las teorías de los mecanismos inmunopatogénicos y la traducción clínica de estos fenómenos relacionados con alteraciones de la cascada de la coagulación y otros sistemas, así como las nuevas perspectivas terapéuticas