Sensitization to rodents (mouse/rat) in urban atopic populations without occupational exposure living in Campania district (Southern Italy): a multicenter study.

BACKGROUND: Up to now very few data on allergic sensitization to rodent allergens in Western Europe and Italy are available, and there are no information at district level.The aim of this report was to investigate clinical significance and characteristics of allergic sensitization to mouse/rat (M/Rt) allergens in atopic subjects living in Campania district (Southern Italy). METHODS: Allergists from the whole Campania district were required to report the results of skin prick tests of at least 100 consecutive subjects. In 1,477 consecutive outpatients, we selected all subjects with an immediate skin reaction to M/Rt dander. Clinical history including a careful evaluation of the modality of exposure and the results of skin-prick tests (SPTs) were recorded. RESULTS: Fifty seven patients were sensitized to M/Rt dander (5.78%). Two patients were mono-sensitized. Fourteen patients reported indoor conditions suggesting presence of rodents allergens at home. All patients exhibited low-moderate degree of SPT positivity to M/Rt. High frequency of concomitant allergic sensitization to dust mites was found. CONCLUSIONS: Our results suggest that the role of allergic sensitization to rodents is not negligible in atopic subjects without occupational exposure living in Campania district area; these values are higher in comparison to those previously found in Naples area. Highly atopic individuals should be tested by SPTs/evaluation of serum specific IgE to rodents in the case they should begin an occupational exposure to M/Rt or keep these animals as pets.

Avoiding hypothermia, an intervention to prevent morbidity and mortality from pneumonia in young children.

Observations and experiments in animals and human beings grant plausibility to the hypothesis that hypothermia is a risk factor for pneumonia. Exposure of body to cold stress causes alterations in the systemic and local defenses against respiratory infections, favoring the infection by inhalation of pathogens normally present in the oropharynx. Neonates and young infants with hypothermia have an increased risk of death; however, there is no strong demonstration that hypothermia leads to pneumonia in these children. Studies that properly addressed the problem of confounding variables have shown an association between cold weather and pneumonia incidence. Probably the strongest evidence that supports the plausibility of the hypothesis is provided by the controlled comparison between patients with traumatic brain injury treated with hypothermia and those treated under normal body temperature. The association between exposure to cold and pneumonia is strong enough to warrant further research focused in young children in developing countries.

The VISYT trial: Venom Immunotherapy Safety and Tolerability with purified vs nonpurified extracts.

BACKGROUND: Venom immunotherapy (VIT) is a highly effective treatment but can induce systemic adverse effects. OBJECTIVE: To evaluate the safety and tolerability of VIT with purified and nonpurified extracts for treating yellow jacket and honeybee allergy. METHODS: Ninety-four patients (mean age, 46 years) with a history of insect venom allergy were randomly allocated to undergo purified extract VIT (group A [44 patients]) or nonpurified extract VIT (group B [50 patients]). Fifty-six patients were allergic to yellow jacket venom (group A: 25; group B: 31) and 38 to honeybee (19 per group). The induction phase was performed using a 2- or 7-day ultrarush scheme. The maintenance phase lasted 11 weeks. Local and systemic reactions were recorded after each injection. RESULTS: A total of 1,401 VIT injections were performed. Six systemic reactions were observed in 4 patients (honeybee-allergic patients only) (4% of patients; 0.4% of injections): 1 patient in group A (2%) and in 3 in group B (6%) (P = .57). Local extensive reactions were recorded after 5 injections in 4 patients (9%) in group A (2 yellow jacket- and 2 honeybee-allergic patients) and after 17 injections in 12 patients (24%) in group B (8 yellow jacket- and 4 honeybee-allergic patients) (P = .02). Total reactions (systemic and large local) numbered 6 in group A (0.9% of injections; 11% of patients) and 20 in group B (2.7% of injections; 30% of patients) (P = .001). CONCLUSION: In patients with honeybee or yellow jacket venom allergy, VIT with purified extracts has a significantly lower propensity toward severe local reactions compared with VIT with nonpurified extracts.

Programa de uso eficiente de energia em um hospital de grande porte / Efficient use program of energy in a very great hospital

Hospital de grande porte, normalmente, possuí, além da extensa área física, grande probabilidade de exercer atendimentos a pacientes, tanto em nível ambulatorial, como procedimentos médicos de baixa, média e alta complexidade. Dessa forma, exige-se que o sistema elétrico dessa instituição forneça suporte seguro e eficiente, que seja compatível com os equipamentos biomédicos instalados. Normalmente esses equipamentos são eletrônicos e/ou micro processados, exigindo-se, portanto, além da Qualidade da Energia (Power Quality) de alimentação, maior eficiência do sistema como um todo, para que os resultados e análises dos procedimentos médicos não sejam adulterados ou sofram qualquer distorção importante. Todo o complexo hospitalar, composto de máquinas, compressores, transformadores, geradores de emergência e sua instalação em geral, deve ser monitorado e funcionar sempre de forma satisfatória. Outro fator importante é o custo devido ao consumo de energia elétrica, que tem representividade significativa no orçamento da instituição, sendo, portanto, importante a criação de programas de eficientização e racionalização do uso da energia. Neste trabalho, são feitas considerações básicas para se implementar um Programa de Eficiência Energética, com apresentação de pontos importantes que devem ser observados em um sistema elétrico típico.