Asthma prevalence, but not allergic rhinitis nor atopic dermatitis, is associated to exposure to dogs in adolescents.

BACKGROUND: Exposure to pets can be a predisposing factor in the development of certain diseases, including allergic diseases. OBJECTIVE: We analyzed the role that exposure to indoor dogs and cats plays in the prevalence of allergic diseases. METHODS: We examined the cross-sectional data of 1056 women and 936 men aged 15 to 18 years; these individuals were selected through stratified and cluster random sampling. We asked all participants about their exposure to indoor dogs and cats during the year that preceded our study. The prevalence of allergic diseases was determined through core questions taken from The International Study of Asthma and Allergies in Childhood questionnaire. RESULTS: The prevalence was 12.7% (95% CI: 11.3%-14.2%) for asthma, 9.0% (95% CI: 7.8%-10.4%) for allergic rhinitis, and 5.2% (95% CI: 4.3%-6.2%) for atopic dermatitis. The multivariate analyses showed that exposure to indoor dogs, but not indoor cats, was associated with asthma prevalence (aOR 1.37; 95% CI: 1.03-1.83), as was male sex (aOR=1.42; 95% CI: 1.08-1.86), a personal history of allergic rhinitis (aOR=3.24; 95% CI: 2.25-4.66), and a maternal history of asthma (aOR=3.06; 95% CI: 1.89-4.98). The population attributable risk for exposure to indoor dogs was 18%. Notably, neither allergic rhinitis nor atopic dermatitis was found to be associated with dog or cat exposure (p> 0.05). CONCLUSION: Exposure to dogs in late adolescence is a factor associated with asthma, although its contribution to the development of asthma should be investigated in new studies.

[Prevalence of blood eosinophilia in adults with COPD according to the cut-off point]. / Prevalencia de eosinofilia en sangre en adultos con EPOC según el punto de corte.

OBJECTIVE: To determine the prevalence of blood eosinophilia in adults with chronic obstructive pulmonary disease (COPD) according to different cut-off points. METHODS: A cross-sectional study was carried out in patients with COPD. The frequency of blood eosinophilia was determined by absolute (cells/ µL) and relative (%) eosinophil count. Multivariate methods were used in order to identify the associated factors. RESULTS: 81 patients were included; the mean age was 71.9 ± 9.8 years; 46 (57%) of the patients were men. The prevalence of eosinophilia for the cut-off points of ≥ 100, ≥ 150, ≥ 200, ≥ 300, and ≥ 400 cells/µL was of 64.2%, 37.0%, 16.1%, and 9.9% respectively. Out of 81 patients, 34 (42%) had a relative eosinophil concentration of ≥ 2%; 21 (25.9%) ≥ 3%; 14 patients (17.3%) had ≥ 4%; and 10 patients (12.3%) had ≥ 5%. Eosinophilia of ≥ 100 cells/µL was associated with age of ≥ 80 years (OR = 6.04, p = 0.026), and with the exacerbation of COPD (OR = 9.40, p = 0.038); in contrast, eosinophilia of ≥ 2% was associated only with age of ≥ 80 years (OR = 3.73, p = 0.020). In addition, the eosinophil count of ≥ 100 and < 300 cells/µL was associated with the exacerbation of COPD (OR = 11.00, p = 0.026). CONCLUSIONS: Our results suggest that the frequency of eosinophilia in the context of COPD shows substantial variations according to the used definition.

Objetivo: Establecer la prevalencia de eosinofilia en sangre en adultos con enfermedad pulmonar obstructiva crónica (EPOC) según varios puntos de corte. Métodos: Se realizó un estudio transversal en pacientes con EPOC. La frecuencia de eosinofilia en sangre se determinó a partir de la concentración absoluta (células/µL) y relativa (%) de eosinófilos. Fueron realizados modelos multivariados para identificar factores asociados. Resultados: En 81 pacientes incluidos, la edad promedio fue de 71.9 ± 9.8 años; de los cuales, 46 (57 %) fueron hombres. La prevalencia de eosinofilia para los puntos de corte ≥ 100, ≥ 150, ≥ 200, ≥ 300 y ≥ 400 células/µL fue de 64.2, 43.2, 37.0, 16.1 y 9.9 %, respectivamente. De 81 pacientes, 34 (42 %) tuvieron una concentración ≥ 2 %; 21 (25.9 %) ≥ 3 %; 14 (17.3 %) ≥ 4 %; y 10 (12.3 %) ≥ 5 %. La eosinofilia ≥ 100 células/µL se asoció con la edad ≥ 80 años (RM = 6.04, p = 0.026) y con la exacerbación de la EPOC (RM = 9.40, p = 0.038); en cambio, la eosinofilia ≥ 2 %, lo hizo con solamente la edad ≥ 80 años (RM = 3.73, p = 0.020). Complementariamente, la concentración de eosinófilos ≥ 100 y < 300 células/µL se asoció con la exacerbación de la EPOC (RM = 11.00, p = 0.026). Conclusiones: Nuestros resultados sugieren que la frecuencia de eosinofilia en EPOC muestra variaciones sustanciales según la definición adoptada.

[The prevalence of oral allergy syndrome: regarding a new classification]. / Prevalencia del síndrome de alergia oral: a propósito de una nueva clasificación.

BACKGROUND: Recently, the oral allergy syndrome (OAS) has been classified according to the foods that induce it: phenotype I, when it is caused only by plant-derived foods; phenotype II, when it is caused by foods of both animal and plant origin. OBJECTIVE: To determine the prevalence of OAS in late teenagers according to the new classification. METHODS: A cross-sectional study in which data from 1,992 teenagers, aged 15-18 year-old, was analyzed; the information was obtained through a structured questionnaire, where questions were asked about oral symptoms according to the type of food that had been ingested. RESULTS: The overall prevalence of OAS was of 1.7% (95% CI = 1.2-2.4); for phenotype I, it was of 0.85% and, for phenotype II, it was of 0.85%. According to the phenotype, there was no difference by sex and personal history of atopic disease; instead, the onset time of the symptoms did show an association with the phenotype (p = 0.048). The frequency of skin and mucosal symptoms and respiratory ailments differed between the groups. Regarding gastrointestinal symptoms, diarrhea was markedly more frequent in phenotype II (p = 0.044). CONCLUSION: Two phenotypes with OAS were clearly identified: the first one was associated exclusively to foods of plant origin, and the other was related to foods of both plant and animal origin.

Antecedentes: Recientemente, el síndrome de alergia oral (SAO) ha sido clasificado de acuerdo con los alimentos que lo inducen: fenotipo I, relacionado con alimentos derivados de plantas; fenotipo II, provocado por alimentos de origen vegetal y animal. Objetivo: Determinar la prevalencia del síndrome de alergia oral en adolescentes tardíos según la nueva clasificación. Métodos: Estudio transversal en el que se analizaron los datos de 1992 adolescentes de 15 a 18 años; la información se obtuvo a través de un cuestionario estructurado, en el que se interrogó acerca de síntomas orales según el tipo de alimento consumido. Resultados: La prevalencia global de síndrome de alergia oral fue de 1.7 % (IC 95 % = 1.2-2.4): fenotipo I, 0.85 % y fenotipo II, 0.85 %. Según el fenotipo no hubo diferencia por sexo e historia personal de enfermedad atópica; el tiempo de inicio de los síntomas sí mostró asociación (p = 0.048). La frecuencia de los síntomas respiratorios, en piel y mucosas no difirieron entre los grupos; respecto a los síntomas gastrointestinales, la diarrea fue notoriamente más frecuente en el fenotipo II (p = 0.044). Conclusión: Se identificaron claramente los dos fenotipos del síndrome de alergia oral: uno asociado con alimentos de origen vegetal y otro a alimentos tanto de origen vegetal como animal.

Peanut allergy among Mexican adults with allergic respiratory diseases: prevalence and clinical manifestations.

BACKGROUND: Peanut allergy among adults with respiratory diseases has seldom been studied within Mexico. OBJECTIVE: To establish the prevalence of peanut allergy among adults that have been diagnosed with either asthma or allergic rhinitis; we will also be describing the symptoms that are associated with peanut allergy. METHODS: We carried out a cross-sectional study through which we analyzed the corresponding data of 257 patients with allergic respiratory diseases, asthma or allergic rhinitis, all participants were 16 years of age or older, and were recruited in a consecutive manner. Peanut allergy was established by testing positive to a peanut skin-prick test; we also conducted a standard interview with each patient. RESULTS: From our sample of 257 patients, 18 tested positive to peanut sensitization, (7.0%; 95% CI = 3.9% to 10.1%); among these 18 participants, 7 were considered to be allergic to peanuts (2.7%; 95% IC: 0.7% to 4.7%). Predominant symptoms were oral, primarily affecting the pharynx and the palate, followed by swelling of the lips. When it came to respiratory discomfort, sneezing and rhinorrhea stood out, and lastly there were cutaneous symptoms. We did not detect any systemic reactions to the peanut. CONCLUSION: In our study, peanut allergy among adults with allergic respiratory diseases is not an uncommon occurrence.

Antecedentes: La alergia al cacahuate en adultos con enfermedades respiratorias alérgicas pocas veces ha sido estudiada en México. Objetivo: Establecer la prevalencia de alergia al cacahuate en un grupo de adultos con asma o rinitis alérgica; también se describen los síntomas asociados con la alergia al cacahuate. Métodos: Se realizó estudio transversal en el que analizaron los datos correspondientes a 257 pacientes con enfermedades respiratorias alérgicas, asma o rinitis alérgica, con edad igual o mayor a 16 años; los pacientes fueron reclutados consecutivamente. La alergia al cacahuate se determinó por una prueba cutánea positiva al cacahuate y a través de una entrevista estandarizada. Se estimaron intervalos de confianza (IC) a 95 % para proporciones. Resultados: De los pacientes incluidos, 18 estuvieron sensibilizados al cacahuate (7.0 %, IC 95 % = 4.4-10.9), siete de ellos fueron considerados alérgicos al cacahuate, para una prevalencia de 2.7% (IC 95%: 1.2% - 5.6%). En los pacientes con alergia al cacahuate, los síntomas predominantes fueron los orales, principalmente el prurito en la faringe y en el paladar, seguidos de edema de los labios; entre las molestias respiratorias sobresalieron los estornudos y la rinorrea y, al final, los síntomas cutáneos. No se documentaron reacciones sistémicas al cacahuate. Conclusión: En nuestro estudio, la alergia al cacahuate en adultos con enfermedades respiratorias alérgicas no fue infrecuente.

[Trends in asthma prevalence and its symptoms in Mexican late adolescents over a 7-year period]. / Tendencia de la prevalencia de asma y sus síntomas en los adolescentes tardíos mexicanos en un periodo de siete años.

BACKGROUND: Late adolescents with asthma are rarely studied, since generally they are not included in children or adult groups; in addition, studies assessing asthma trends are scarce in Mexico, and their results might differ from findings in developed countries. OBJECTIVE: To determine the trends in asthma prevalence and its symptoms in late adolescents over a period of 7 years. METHODS: The prevalence of asthma and its symptoms were compared in two cross-sectional population-based cohorts, one from 2009 and the other from 2016. RESULTS: The presence of wheezing sometime in life and during the previous year was significantly increased between 2009 and 2016 (12.8 % versus 20.1 % and 7.3 % versus 10.3 %, p < 0.001 and 0.002, respectively). The prevalence of asthma went from 7.8 % in 2009 to 12.7 % in 2016 (p < 0.0001). In addition, the prevalence of allergic rhinitis (4.5 % versus 9.0 %) and atopic dermatitis (3.8 % versus 5.2 %) also showed marked increases (p < 0.0001 and 0.051, respectively). CONCLUSIONS: The prevalence of asthma and some of its symptoms in late adolescents substantially increased in a 7-year period.

Antecedentes: Los adolescentes tardíos con asma pocas veces son investigados, dado que generalmente no se incluyen en los grupos de niños ni adultos, además, en México, los estudios que evalúan la tendencia del asma son escasos y sus resultados pudieran diferir de los hallazgos en los países desarrollados Objetivo: Determinar la tendencia de la prevalencia del asma y sus síntomas en adolescentes tardíos en un periodo de siete años. Métodos: Se compararon las prevalencias de asma y sus síntomas de dos cortes transversales con base poblacional, uno en 2009 y otro en 2016. Resultados: La presencia de sibilancias alguna vez en la vida y durante el año previo se incrementó significativamente entre 2009 y 2016 (12.8 % versus 20.1 % y 7.3 % versus 10.3 %; p < 0.0001 y 0.002, respectivamente). La prevalencia del asma pasó de 7.8 % en 2009 a 12.7 % en 2016 (p < 0.0001). Adicionalmente, las prevalencias de rinitis alérgica (4.5 % versus 9.0 %) y dermatitis atópica (3.8 % versus 5.2 %) también sufrieron incrementos notorios (p < 0.0001 y 0.051 respectivamente). Conclusión: La prevalencia de asma y algunos de sus síntomas en adolescentes tardíos se incrementaron sustancialmente en los siete años previos.

[Prevalence of sensitization and allergy to kiwi fruit (Actinidia deliciosa) in adults with allergic diseases]. / Prevalencia de sensibilización y alergia al kiwi (Actinidia deliciosa) en adultos con enfermedades alérgicas.

BACKGROUND: The kiwi fruit (Actinidia deliciosa) is a food that has been recognized for its allergenic capability for more than 30 years. In general, kiwi allergy is characterized by local discomfort, but systemic reactions such as rash, angioedema, rhinitis, conjunctivitis or anaphylaxis can be triggered. OBJECTIVE: To determine the prevalence of sensitization and allergy to kiwi in adults with allergic diseases. METHODS: By means of a cross-sectional, retrolective study, data corresponding to 370 patients aged ≥16 years were analyzed. RESULTS: 226 patients had positive skin reaction against aeroallergens. The prevalence of food sensitization was 84/226 (37.2%; 95 % CI = 31.1 to 43.6). Overall, the prevalence of sensitization to kiwi fruit was 15/226 (6.6%; 95% CI = 3.9 to 10.7), and of kiwi allergy, 2/15 (13.3%; 95% CI = 2.5 to 39.1); one patient had symptoms consistent with oral allergy syndrome, and another, gastrointestinal and cutaneous manifestations. CONCLUSION: The prevalence of sensitization to kiwi fruit is not a rare event; in contrast, symptoms related to its consumption are uncommon.

Antecedentes: El kiwi (Actinidia deliciosa) es un alimento reconocido por su capacidad alergénica desde hace más de 30 años. Por lo general, la alergia al kiwi se caracteriza por molestias locales, pero pueden desencadenarse reacciones sistémicas como urticaria, angioedema, rinitis, conjuntivitis o anafilaxia. Objetivo: Determinar la prevalencia de sensibilización y alergia al kiwi en adultos con enfermedades alérgicas. Métodos: Mediante un estudio transversal se analizaron los datos correspondientes a 370 pacientes ≥ 16 años de edad. Resultados: Tuvieron reacción cutánea positiva contra aeroalérgenos 226/370 pacientes. La prevalencia de sensibilización a alimentos fue 84/226 (37.2 %; IC 95 % = 31.1 a 43.6 %). En general, la prevalencia de sensibilización al kiwi fue de 15/226 (6.6 %; IC 95 % = 3.9 a 10.7 %) y de alergia al kiwi de 2/226 (0.9 %; IC 95 % = 0.03% a 3.4 %), un paciente tuvo síntomas compatibles con síndrome de la alergia oral y otro, manifestaciones gastrointestinales y cutáneas. Conclusión: La prevalencia de sensibilización al kiwi no es un evento raro; en contraste, los síntomas relacionados con el consumo del fruto son poco frecuentes.

[High prevalence of food sensitization among adults with allergic diseases who live in the Guadalajara metropolitan area]. / Alta prevalencia de sensibilización a alimentos en adultos con enfermedades alérgicas residentes en la zona metropolitana de Guadalajara.

BACKGROUND: The prevalence of food sensitization in adults shows differences owing to geographic, regional and cultural circumstances. OBJECTIVE: To identify the prevalence and factors associated with food sensitization in adults with allergic diseases. METHODS: Cross-sectional study, where medical records of adult patients with any allergic disease and who tested positive to airborne allergens on at least one skin test were reviewed. Age, sex, underlying allergic disease and skin test result were recorded. Statistical analyses included food sensitization prevalence with the corresponding 95 % confidence intervals (CI), as well as a multivariate analysis to determine associated factors. RESULTS: We included 258 patients with a mean of 36 years of age; 75 % were of the female sex. The most common underlying condition was allergic rhinitis (59 %). The prevalence of food sensitization was 37 % (95 % CI, 31.5-43.3) and it did not vary significantly according to sex or allergic disease in question. The most sensitizing food was soybeans (44.8 %), and associated factors were sensitization to cat dander (OR = 1.8; 95 % CI, 1.03-3.2) and 5 or more positive skin tests (OR = 4.3, 95 % CI 2.3-8.1). CONCLUSION: The prevalence of food sensitization in people with allergic disease was 40 %. Further studies are required to determine its prevalence in the general population.

Antecedentes: La prevalencia de sensibilización a alimentos en adultos presenta diferencias debido a las condiciones geográficas, regionales y culturales. Objetivo: Identificar la prevalencia y los factores asociados a la sensibilización a alimentos en adultos con alguna enfermedad alérgica. Métodos: Estudio transversal en el que se revisaron los expedientes clínicos de adultos con alguna enfermedad alérgica que presentaron al menos una prueba cutánea positiva a aeroalérgenos. Se registró edad, sexo, enfermedad alérgica de base y resultado de la prueba cutánea. El análisis es-tadístico incluyó prevalencia de sensibilización a alimentos e intervalos de confianza (IC) de 95 %, así como análisis multivariado para determinar los factores asociados. Resultados: Se incluyeron 258 pacientes con edad media de 36 años; 75 % fue del sexo femenino. La enfermedad de base más frecuente fue la rinitis alérgica (59 %). La prevalencia de sensibilización a alimentos fue de 37 % (IC 95 %, 31.5-43.3) y no varió significativamente según sexo o enfermedad alérgica. El alimento más sensibilizante fue la soya (44.8 %) y los factores asociados, la sensibil-ización al epitelio de gato (OR = 1.8; IC 95 %, 1.03-3.2) y 5 o más pruebas cutáneas positivas (OR = 4.3; IC95 %, 2.3-8.1). Conclusiones: La prevalencia de sensibilización a alimentos en personas con enfermedad alérgica fue de 40 %; para determinarla en la población general se requieren estudios adicionales.