Immunologic responses to the major allergen of Olea europaea in local and systemic allergic rhinitis subjects.

OBJECTIVE: To evaluate the in vivo and in vitro responses to nOle e 1 in allergic rhinitis (AR) and local allergic rhinitis (LAR) patients sensitized to olive tree pollen (OL) confirmed by nasal allergen provocation test (NAPT). METHODS: Twelve subjects with AR, 12 with LAR and 12 subjects as control group (CG) were selected. Skin testing and NAPT with nOle e 1 were performed. Eosinophilic cationic protein (ECP) and tryptase were measured in nasal lavages before and after NAPT. Serum IgE to OL allergens was measured by ELISA. Basophil activation tests (BAT) with OL and nOle e 1 and dendritic cell maturation/proliferation studies were carried out. RESULTS: All AR (12/12) and 10/12 (83%) of LAR had a +NAPT to nOle e 1. ECP levels in nasal lavages were significantly increased after NAPT in both AR and LAR compared with CG at 15 min (P < 0.05). Serum IgE was positive only in AR. All AR had +BAT responses to OL and 10/12 to nOle e 1 (83%); 8/12 LAR (66.6%) had a +BAT to OL and 4/12 (33%) to nOle e 1, with only one subject of the CG with a +BAT to both OL and nOle e 1 (8%). Dendritic cell proliferation to nOle e 1 was increased in AR compared to LAR and CG (P = 0.019 and P = 0.001, respectively). CONCLUSION: Both AR and LAR had a similar in vivo response to nOle e 1 with release of inflammatory mediators. Specific basophil activation with OL and nOle e 1 was observed in LAR confirming previous data obtained with dust mites.

Patterns of skin prick test positivity in allergic patients: usefulness of a nationwide SPT chart review.

BACKGROUND: A previous survey on allergens used by Mexican allergists in their skin prick test (SPT) panel showed wide variation. Humidity varies in different zones of Mexico. This might lead to differences in natural exposure and allergic sensitisation throughout the country. We aim to describe the SPT sensitivity patterns in the different climatic zones in Mexico and to show the usefulness of a structured SPT chart-review including multiple clinics in obtaining these allergen sensitisation patterns. METHODS: A retrospective, structured chart-review of SPT results was undertaken in allergy clinics throughout Mexico. Ratios of SPT positivity were calculated for individual allergens, per climatic zone and nation-wide. Per allergen group the most important allergens were identified. Statistically significant differences between zones and the nation-wide data were tested with Pearson's Chi-squares test. RESULTS: 4169 skin test charts were recollected. The most important allergens causing sensitisation were very similar in different zones, despite climate variation. The allergen with highest ratio of SPT positivity was Dermatophagoides pteronyssinus (51%), with trees (Ash-27%, Alder-22%, Oak19%), and Bermuda grass (26%) as second and third. In the hot zones (humid and dry) Aspergillus was statistically significant more frequently than in more temperate zones. Cockroaches thrive in big cities and humid zones and Mesquite and Poplar in dry zones. Weeds are less important. CONCLUSION: Mexico has its own SPT sensitisation pattern, which is different from America and Europe. A structured chart-review of SPT results is able to show this and might be a tool for allergists in other countries.

Incidence, patterns of care and prognostic factors for outcome of gastroenteropancreatic neuroendocrine tumors (GEP-NETs): results from the National Cancer Registry of Spain (RGETNE).

BACKGROUND: Neuroendocrine tumors (NETs) are an unusual family of neoplasms with a wide and complex spectrum of clinical behavior. Here, we present the first report of a National Cancer Registry of gastroenteropancreatic neuroendocrine tumors from a Southern European country. PATIENTS AND METHODS: Data was provided online at www.retegep.net by participating centers and assessed for internal consistency by external independent reviewers. RESULTS: The study cohort comprised 907 tumors. The most common tumor types were carcinoids (55%), pancreatic nonfunctional tumors (20%), metastatic NETs of unknown primary (9%), insulinomas (8%) and gastrinomas (4%). Forty-four percent presented with distant disease at diagnosis, most often those from small intestine (65%), colon (48%), rectum (40%) and pancreas (38%), being most unusual in appendix primaries (1.3%). Stage at diagnosis varied significantly according to sex, localization of primary tumor, tumor type and grade. Overall 5-year survival was 75.4% (95% confidence interval 71.3% to 79.5%) and was significantly greater in women, younger patients and patients with hormonal syndrome and early stage or lower grade tumors. Prognosis also differed according to tumor type and primary tumor site. However, stage and Ki-67 index were the only independent predictors for survival. CONCLUSION: This national database reveals relevant information regarding epidemiology, current clinical practices and prognosis of NETs in Spain, providing valuable insights that may contribute to understand regional disparities in the incidence, patterns of care and survival of this heterogeneous disease across different continents and countries.

Role of effector cells (CCR7(-)CD27(-)) and effector-memory cells (CCR7(-)CD27(+)) in drug-induced maculopapular exanthema.

Maculopapular exanthema (MPE) induced by drugs is a T-cell mediated reaction and effector cells may play an important role in its development. We assessed the effector and cutaneous homing phenotype in peripheral blood cells from allergic patients after drug stimulation. This study included 10 patients and 10 controls. The effector phenotype (CCR7(-)CD27(+/-)), chemokine receptors (CCR4 and CCR10), and activation (CD25(low)) and regulatory markers (CD25(high)) were measured by flow cytometry in both peripheral blood mononuclear cells (PBMCs) and CD4-T-lymphocytes. Proliferation was determined by 5-(-6)-carboxyfluorescein diacetate succinimidyl ester (CFSE) assay and the migratory capacity by a chemotaxis assay using CCL17 and CCL27. Compared to controls, CCR7(-)CD27(-) cells were increased in patients without (p=0.003) and with drug stimulation (p less than 0.001) and had significantly higher proliferation (p=0.010). CCR10 expression was increased in patients after drug stimulation in total and memory CD27(+) T-cells. Lymphocyte migration with CCL27 was higher in patients with drug stimulation (p=0.048), with a decrease in CCR7(-)CD27(-) (p less than 0.0001) and an increase in CCR7(-)CD27(+) (p=0.017). In patients, CD4-T-lymphocytes were significantly activated after drug stimulation (p less than 0.001). In conclusion, we show that effector memory CD4(+) T-cells (CCR7(-)CD27(+)) respond specifically to the drug responsible for MPE and confirm previous data about the involvement of CCR10 in cell trafficking to the skin.

Breastfeeding's protection against illness-induced anorexia is mediated partially by docosahexaenoic acid.

OBJECTIVE: To test whether breastfeeding's protection against anorectic responses to infection is mediated by n-3 fatty acids' attenuation of interleukin (IL)-1beta and tumor necrosis factor (TNF)alpha. DESIGN: Experimental and observational studies. SETTING: A hospital-based study was conducted. SUBJECTS: Five groups of infants were followed; three in the experimental and two in the observational study. METHODS: Breast-fed- (BF-1), DHA-supplemented formula- (SFF-1), and non-DHA-supplemented formula-fed (FF-1) infants were studied before and after immunization against diphtheria, tetanus, pertussis and haemophilus influenzae type b. Pre- and post-immunization energy intakes (EI) and serum IL-1beta and TNFalpha were measured. The two other groups, breast-fed (BF-2) and formula-fed (FF-2) infants with pneumonia were followed throughout hospitalization. EI, IL-1beta and TNFalpha were measured at admission and discharge. Baseline erythrocyte fatty acid contents were determined. RESULTS: Both cytokines increased following immunization in all feeding groups. Post-immunization reductions in EI of SFF-1 infants (-11.8+/-5%, CI(95)=-23.3, 1.4%, P=0.07) were intermediate to those observed in BF-1 (-5.2+/-4.2%, CI(95)=-15.2, 5.9%, P=0.27) and FF-1 infants (-18+/-4.4%, CI(95)=-29%, -5.4%, P=0.02). In the observational study, TNFalpha (17.2+/-8.3 vs 3.4+/-3.0 ng/l, P=0.001) and decreases in EI (-31+/-43 vs -15+/-31%, CI(95)=-34%, 0.001%, P=0.056) were greater in FF-2 than in BF-2 infants at admission. Breastfeeding duration was associated positively with docosahexaenoic acid (DHA) erythrocyte contents, and negatively with admission TNFalpha. Decreases in EIs were associated with IL-1beta and TNFalpha concentrations. CONCLUSION: Reductions in EI following immunologic or infectious stimuli were associated with increases in IL-1beta and TNFalpha. Those reductions were attenuated by breastfeeding, and mediated in part by tissue DHA.

T cell assessment in allergic drug reactions during the acute phase according to the time of occurrence.

Allergic drug reactions can be classified as immediate, accelerated or delayed. This classification usually correlates with the mechanism involved: immediate reactions are IgE mediated and delayed reactions are T cell dependent. We analyzed lymphocyte involvement in patients with these reactions by determining cell subpopulations, activation state and skin homing receptor expression (CLA) in blood and skin. Patients with immediate, accelerated and delayed reactions were evaluated during the acute phase and after resolution. Controls taking drugs were included. Phenotypic immunofluorescence analysis was done by flow cytometry in peripheral blood, and by immunohistochemistry in skin for delayed reactions. Forty-six patients were included, 17 with immediate reactions, 10 accelerated and 19 delayed. At the acute phase CLA was significantly increased in delayed reactions and HLA-DR in all three types of reaction. In the severest delayed reactions, Steven-Johnson/Lyell syndromes, the CD4 subsets were increased in peripheral blood and skin compared to maculopapular exanthemas and urticaria and HLA-DR when compared with urticaria. In maculopapular exanthemas CLA was significantly increased in peripheral blood and skin compared to urticaria and the severe reactions. We found that T-cells are implicated, besides delayed reactions, in immediate and accelerated reactions. In delayed reactions there is a parallelism between results found in skin and peripheral blood with a higher participation of CD4+ cells the more severe the reaction.

[13C]linoleic acid oxidation and transfer into milk in stunted lactating women with contrasting body mass indexes.

BACKGROUND: The fat concentration of human milk is associated with maternal adiposity, but there is no clear understanding of the mechanisms controlling milk fat concentration. OBJECTIVE: We evaluated the effect of postpartum body mass index (BMI; in kg/m(2)) on the metabolic distribution of an oral dose of [13C]linoleic acid in lactating women. DESIGN: Ten lactating women stratified by BMI (either <22.5 or >23.5) at 5 mo postpartum received orally 2.5 mg [13C]linoleic acid/kg body wt. Exhaled air, milk, and plasma samples were collected in relation to tracer administration. Linoleic acid was determined by gas chromatography. Dietary intake, serum, milk composition, [13C]linoleic acid enrichment in milk and plasma, and exhaled 13CO2 (by isotope ratio mass spectrometry) were assessed. RESULTS: Women with a higher BMI exhaled more 13CO2 than did women with a lower BMI (22.8 +/- 9.4% compared with 8.6 +/- 3.5% of dose, P < 0.03). Cumulated 72-h transfer of [13C]linoleic acid to milk was not significantly different between groups (14.8 +/- 6.5% compared with 17.7 +/- 6.7% of dose). Within the first 9 h after dose administration, 51.6 +/- 4.9% of the total isotope transfer into milk had passed in women with a higher BMI, but only 24.0 +/- 15.3% had passed in those with a lower BMI (P = 0.02). CONCLUSIONS: Women with a lower BMI, who were reputed as having less body fat, oxidized and secreted into milk less dietary linoleic acid within 12 h after tracer administration than did women with a higher BMI. In both groups, a large proportion of [13C]linoleic was retained in the maternal compartment, most likely fat tissue, in a slow turnover pool, and released slowly in later hours.

Contribution of dietary and newly formed arachidonic acid to human milk lipids in women eating a low-fat diet.

BACKGROUND: Polyunsaturated fatty acids in milk are derived from direct intestinal absorption, endogenous synthesis, or maternal body stores. Arachidonic acid (AA) intake is frequently low in undernourished women, but milk secretion of this fatty acid is similar to that in well-nourished women. OBJECTIVE: The objective was to evaluate the contribution of dietary and endogenously synthesized AA to its total secretion in the milk of women eating a low-fat diet. DESIGN: Ten lactating women who habitually ate a low-fat diet (17% of energy) received 2.5 mg [(13)C]linoleic acid (LA)/kg body wt orally 5 mo postpartum. LA and AA concentrations and (13)C enrichment were measured in milk samples collected before and after the tracer application. Total lipid, LA, and AA contents were determined in diet composites. Fatty acids were assessed by gas chromatography and (13)C enrichment by isotope ratio mass spectrometry. RESULTS: The cumulative 72-h recovery of [(13)C]LA in milk was 16.3 +/- 6.4% of the dose; only 0.01% of the label was found as [(13)C]AA. The calculated transfer of dietary LA and AA into milk was 32.8 +/- 18.0% and 11.8 +/- 6.6%, respectively. AA originating from conversion of dietary LA contributed only 1.1% to the total milk AA secreted. CONCLUSIONS: Little milk AA originates from conversion of LA; 70% of LA and 90% of AA secreted in milk were not derived from direct intestinal absorption. Our results suggest that maternal body stores are the major source of milk LA and AA in these women.

2-Amino-3-substituted-6-[(E)-1-phenyl-2-(N-methylcarbamoyl)vinyl]imid azo[1,2-a]pyridines as a novel class of inhibitors of human rhinovirus: stereospecific synthesis and antiviral activity.

A series of 2-amino-3-substituted-6-[(E)-1-phenyl-2-(N-methylcarbamoyl)vinyl]+ ++imid azo[1,2-a]pyridines 1a-i, structurally related to Enviroxime and its analogous benzimidazoles, was designed and prepared for testing as antirhinovirus agents. The imidazo ring in this class of compounds was constructed starting from the aminopyridine after tosylation and subsequent treatment with the appropriate acetamides. The key steps in the synthesis include the development and use of a new Horner-Emmons reagent for the direct incorporation of methyl vinylcarboxamide. The reaction was stereospecific in the substrates 5a-f leading exclusively to the desired E-isomer and avoiding the use of reverse-phase preparative HPLC for the separation of both possible isomers before antiviral activity evaluation. The isopropylsulfonyl group, known as the best substituent at the 1-position in the benzimidazole SAR in terms of activity, was introduced in this new series of imidazo[1,2-a]pyridines via halogen-metal exchange and subsequent treatment with isopropyl isopropanethiolsulfonate. Compounds 1a-i were evaluated in plaque reduction assay and in a cytopathic effect assay. Compounds 1b-d,h exhibited a strong antirhinovirus activity, and no apparent cellular toxicity was visible. The substitution at the 3-position was required for activity. Surprisingly the isopropylsulfonyl in this family of compounds did not enhance the activity as in the case of benzimidazoles. Instead, compound 1i was 4 times less active than its phenyl and sulfide partners. The chemistry as well as the biological evaluation are discussed.

Benzopyranopyridine derivatives. 1. Aminoalkyl derivatives of the azaxanthenes as bronchodilating agents.

The preparation of the four isomeric azaxanthones 3 and a number of their aromatic ring substituted derivatives is described. These ketones were converted into the title compounds which were examined for their biological properties. The most interesting compound in this series, the 1-methyl-4-piperidylidene derivative of 1-azaxanthene, shows the profile of an orally effective potent bronchodilating agent as well as a moderate antihistamine. Biological properties of this compound were compared to a number of antihistamines as well as known bronchodilating agents. Structure-activity relationships are also discussed.

Inhibition of sympathetic hypertensive responses in the guinea-pig by prejunctional histamine H3-receptors.

1. The effect of (R)-alpha-methylhistamine, a selective H3-histamine receptor agonist, was examined on the neurogenic hypertension and tachycardia that is induced by stimulation of areas in the medulla oblongata of guinea-pigs. Electrical medullary stimulation (32 Hz, 3-5 s trains, 0.5-1.0 ms square pulse, 25-400 microA) produced intensity-dependent increases in blood pressure and a more variable tachycardia. 2. (R)-alpha-methylhistamine inhibited the hypertension and tachycardia due to submaximal CNS stimulation. The inhibition of hypertension by (R)-alpha-methylhistamine was dose-dependent (10-300 micrograms kg-1, i.v.) and was not seen at high intensities of stimulation. 3. (R)-alpha-methylhistamine (300 micrograms kg-1, i.v.) did not attenuate the pressor response to adrenaline (1 and 3 micrograms kg-1, i.v.), indicating that the effect of (R)-alpha-methylhistamine was not mediated by a postjunctional action on smooth muscle. 4. The inhibition of CNS-induced hypertension by (R)-alpha-methylhistamine (300 micrograms kg-1, i.v.) was blocked by the H3 antagonists, thioperamide (ID50 = 0.39 mg kg-1, i.v.), impromidine (ID50 = 0.22 mg kg-1, i.v.) and burimamide (ID50 = 6 mg kg-1, i.v.). The rank order potency of these antagonists is consistent with activity at the H3B receptor subtype. Chlorpheniramine (30 micrograms kg-1, i.v.) and cimetidine (3 mg kg-1, i.v.) did not antagonize the inhibition of CNS-hypertension by (R)-alpha-methylhistamine. 5. These results suggest that (R)-alpha-methylhistamine inhibits sympathetic hypertensive responses in guinea-pigs by activation of prejunctional H3-receptors, possibly located on postganglionic nerve terminals. Furthermore, on the basis of the rank order potency to different H3-antagonists, it appears that the H3B-receptor subtype is involved with H3-receptor responses on vascular sympathetic nerves.

Evan's blue dye blocks capsaicin-induced cough and bronchospasm in the guinea pig.

The influence of Evan's blue dye on capsaicin-induced bronchoconstrictor and cough responses was investigated in the guinea pig. Evan's blue (30 mg kg-1 i.v.) pretreatment shifted the bronchoconstrictor dose-response to capsaicin (0.3-100 micrograms kg-1 i.v.) to the right by 10-fold, but had no effect on the bronchospasm elicited by neurokinin A (0.3-10 micrograms kg-1 i.v.). Evan's blue (0.3-30 mg kg-1 s.c.) also inhibited capsaicin-induced cough in a dose-dependent manner. Evan's blue blocked capsaicin responses by the intravenous, subcutaneous, or inhaled routes of administration. We conclude bronchoconstrictor responses and cough in vivo.

(R)-alpha-methylhistamine augments neural, cholinergic bronchospasm in guinea pigs by histamine H1 receptor activation.

In the airways, activation of histamine H3-receptors with (R)-alpha-methylhistamine inhibits neurally induced cholinergic contractions in vitro and peptidergic responses in vivo. The role of histamine H3-receptors on the cholinergic bronchoconstriction induced by electrical stimulation of the dorsal medulla in guinea pigs was assessed in this study. There was no evidence for an H3-receptor mediated inhibition of cholinergic bronchospasm in vivo. However, there was potentiation of central cholinergic bronchoconstriction by (R)-alpha-methylhistamine or histamine by a mechanism involving H1-receptors. I.v. (R)-alpha-methylhistamine (0.3-3 mg/kg) or histamine (0.001-0.01 mg/kg) produced a transient bronchospasm and potentiated the bronchoconstriction due to medullary stimulation. These effects of (R)-alpha-methylhistamine and histamine were blocked by the histamine H1-antagonist, chlorpheniramine (30 micrograms/kg i.v.) but not by H2- or H3-receptor antagonists. (R)-alpha-Methyl-histamine did not potentiate the bronchoconstriction due to i.v. methacholine. Other bronchoconstrictor agents such as methacholine and serotonin did not potentiate the CNS-induced bronchospasm.

Additions of enantiopure alpha-sulfinyl carbanions to (S)-N-sulfinimines: asymmetric synthesis of beta-amino sulfoxides and beta-alphamino alcohols

The addition of the lithium anions derived from (R)- and (S)-methyl and -ethyl p-tolyl sulfoxides to (S)-N-benzylidene-p-toluenesulfinamide provides an easy access route to enantiomerically pure beta-(N-sulfinyl)amino sulfoxides. Stereoselectivity can be achieved when the configurations at the sulfur atoms of the two reagents are opposite (matched pair), thus resulting in only one diastereoisomer, even for the case in which two new chiral centers are created. The N-sulfinyl group primarily controls the configuration of the carbon bonded to the nitrogen, whereas the configuration of the alpha-sulfinyl carbanion seems to be responsible for the level of asymmetric induction, as well as for the configuration of the new stereogenic C-SO carbon in the reactions with ethyl p-tolyl sulfoxides. An efficient method for transforming the obtained beta-(N-sulfinyl)amino sulfoxides into optically pure beta-amino alcohols, based on the stereoselective non-oxidative Pummerer reaction, is also reported.

Characterization of a fluorometric method for lipoprotein lipase.

A fluorometric assay for determining lipoprotein lipase (LPL) activity is described. Dibutyrilfluorescine (DBF) was used as substrate for the enzyme and the fluoresceine liberated by enzymatic hydrolysis of the substrate was measured. Extracts of acetone powder from adipose tissue as an enzyme source showed characteristics of lipoprotein lipase activity, i.e., inhibition by NaCl and optimum activity in alkaline pH. There was close agreement in LPL activity when the same sample was measured simultaneously using either dibutyrilfluorescine or tri[9,10(3)H]oleylglycerol as substrate. The extent of inhibition of lipoprotein lipase by NaCl was similar with both methods. The fluorometric method detected changes in LPL activity in heart and adipose tissue related to the nutritional status of the animal with the same specificity and sensitivity than did the radioactive method. The fluorometric method is as sensitive, less expensive and less time consuming than the radioactive method.

Influence of triflusal on platelet activation after coronary artery bypass graft.

The aim of the study was to investigate the effects of the antiplatelet agent triflusal on the changes in platelet function in patients who underwent a cardiopulmonary bypass for coronary arteries (CABG). In 20 surgical patients, blood was sampled before and at the conclusion of surgery, 48 h later (in the intensive care unit), and after 10 days of treatment with 600 mg/day triflusal (triflusal was administered from the first day after surgery). Adenosine diphosphate (ADP) and collagen-induced platelet aggregation in whole blood, granular release of beta-thromboglobulin and platelet release of thromboxane B2 were measured. Basal values were compared with results in a group of ten healthy volunteers. All platelet determinations of activation were higher in coronary patients than in healthy volunteers. Immediately after CABG, the platelet reactivity to ADP and collagen were significantly lower, and release of beta-thromboglobulin and thromboxane B2 were higher, than in the pre-CABG samples. During the patient's stay in the intensive care unit, all values tend to return to pre-CABG values. Triflusal inhibits both platelet beta-thromboglobulin (63% with respect to the post-CABG value) and thromboxane B2 (91% with respect to the post-CABG value) release. Platelet aggregation after 10 days of triflusal treatment tended to return to the pre-CABG values. In conclusion, Triflusal reduces platelet activation caused by the coronary artery bypass graft surgery.

HLA system. Phenotypic and gene frequencies in celiac and healthy subjects from the same geographical area.

OBJECTIVE: To compare the phenotypic and gene frequencies of the HLA system in celiac and healthy subjects the same geographical area. PATIENTS AND METHODS: HLA A, B, C, DR and DQ phenotypic and gene frequencies have been estimated in 38 celiac children and healthy subjects. The HLA typing has been done according to the microlymphocytotoxicity assay. The individual HLA antigen frequencies in each group have been compared by Chi-square test using Yates correction. For each specificity, the strength of association with celiac disease has been estimated by Odds Ratio and 95% confidence limit. RESULTS: The comparative study of both population show increased phenotypic and gene frequencies among celiac patients and significant differences compared with healthy subjects for B8, Cw7, DR3, DR7 and DQ2. On the contrary, Cw4 and DQ1 phenotypic and gene frequencies are significantly increased in the control population. CONCLUSIONS: Our findings support the role of HLA antigens as predisposing factors for celiac disease. The presence of Cw4 and DQ1 can be a protective factor against such disease.

Analgesia no farmacológica durante la realización del cribado metabólico. Aplicación en otros procedimientos dolorosos / Non-pharmacological analgesia during the heel lance procedure in newborns. Application in other painful procedures

INTRODUCCIÓN: uno de los primeros estímulos dolorosos al que es sometido un recién nacido sano es el cribado neonatal, mediante punción en el talón y extracción de muestra sanguínea. Tradicionalmente se ha tendido a menospreciar la sensibilidad al dolor neonatal y no se ha visto la necesidad de aplicar técnicas de analgesia para evitarlo. MATERIAL Y MÉTODOS: se diseñó un estudio experimental con una muestra de 106 recién nacidos en el Hospital San Pedro de Logroño (España) durante el año 2018. Se dividió la muestra en tres grupos en función de la analgesia recibida durante el procedimiento y se evaluó la respuesta al dolor mediante una escala validada. RESULTADOS: el dolor producido fue significativamente mayor en el grupo de no intervención frente a los grupos de suero glucosado o lactancia materna (p <0,001). Sin embargo, no se encontraron diferencias estadísticamente significativas entre ambos procedimientos analgésicos (p = 0,851). CONCLUSIONES: a la vista de los resultados, proponemos la implementación de estas intervenciones en otros procedimientos dolorosos. Los profesionales sanitarios han de tomar conciencia de la percepción del dolor en los procedimientos llevados a cabo tanto en el ámbito hospitalario como en Atención Primaria

INTRODUCTION: neonatal screening is one of the first painful stimuli in newborns. It consists in the extraction of a capillary blood sample by puncturing the heel. Neonatal pain is often underestimated and also the need to apply analgesia in these cases has not always been taken into account. PATIENTS AND METHODS: an experimental study was conducted on a sample of 106 newborns in the San Pedro Hospital in Logroño during 2018. Depending on the analgesia received during the heal lance, the population sample was divided into three groups. Pain response was evaluated using a validated scale. RESULTS: pain was significantly higher in the non-intervention group compared to the groups treated with glucose or breastfeeding (p <0.001). However, no statistically significant differences were found between both the analgesic procedures (p = 0.851). CONCLUSIONS: we propose the implementation of these interventions in other painful procedures. Health professionals must be aware of the perception of pain in the procedures carried out in Hospitals or Primary Care Centers