Revista alergia Mexico最新文献

An increasing number of studies are analyzing the relationship between serum vitamin D levels and the development of sensitization and allergic diseases in genetically predisposed individuals, as well as the impact of vitamin D supplementation. This article reviews the literature on this subject. Clinical trials, meta-analyses and systematic reviews consulted in PubMed, EMBASE, Scopus, Ovid, Wiley Online Library, Springer, Cochrane and manual resources were included, with the keywords: vitamin D, 25 hydroxyvitamin D, cholecalciferol, asthma, rhinitis, allergy, 25-OH-D, 1,25 hydroxyvitamin D, supplementation. The results show a positive linear trend, however, differ. We should keep in mind that in the studies there is heterogeneity of population groups and associated factors, which may modify such studies. It is necessary to increase research to clarify this relationship and to have successful interventions from the patient's approach to the strengthening of pharmacological and immunological treatment of allergic patients with these diseases.

Latex allergy is a major problem worldwide due to both the severity of the symptomatology it produces and the risk groups that are exposed to it. Complete avoidance is difficult, if not impossible, due to its ubiquity. Natural rubber latex (NRL) is a natural polymer that is released by the Hevea brasiliensis (Hev b) tree, which functions as a protective sealant. It is currently used for the manufacture of health-care products such as tube caps, pistons, masks, and cannulas. The purpose of this review is to highlight the epidemiological, clinical, and diagnostic aspects of NRL allergy, and to conduct a review of the literature on its management through a bibliographic search of articles in databases such as PubMed, Cochrane, UpToDate, and Google Scholar, up to September 2021. About 121 articles were reviewed, of which 76 were used as a reference. We concluded that latex allergy is an entity for which its treatment, even nowadays, is avoidance, despite having a worldwide prevalence of 4.3 % and representing a surgical complication in about 20 % of surgeries with an anaphylactic reaction and a mortality rate that can reach 9 %. The only treatment that could modify the evolution of this disease is immunotherapy, but there are no standardized extracts yet and it has not been possible to determine the safest and most effective way to apply it.

This allergy is a hypersensitivity reaction that is triggered by contact with latex. Symptoms vary depending on factors such as route, frequency, and exposure dose, as well as individual susceptibility. The clinical manifestations can be localized at the site of contact with latex or generalized. Exposure can occur directly as a result of contact with the skin and mucous membranes, that is by touching or being touched by objects with latex, or by inhaling (breathing) particles from objects with latex. Contact can also be indirect; for example, by ingesting food that has been handled by a worker wearing latex gloves or by having contact with a person who has been blowing up balloons. The diagnosis of latex allergy is made based on the patient's medical history and on what has been reported in the interrogation, and it is complemented with in vivo studies (such as skin tests and provocation tests) or in vitro studies (determination of specific IgE). The fundamental pillar in the treatment of latex allergy is the education of the patient to achieve the avoidance of products made with this material or the contact and intake of food that has had contact with latex. In view of the foregoing, latex allergy has a great medical and social relevance due to all the safety measures that the patient must take.

The COVID-19 pandemic has collapsed the health systems of many countries in the world and comorbidities in adults have exponentially increased their mortality; in matters of asthma, it has not been possible to establish a defining relationship in mortality. The clinical manifestations of asthmatic patients with SARS COV 2 are presented in a wide range; from asymptomatic to those who experience acute respiratory failure. The most sensitive method for the diagnosis of SARS-CoV-2 infection is RT-PCR. Antigen and serologic tests are quicker than RT-PCR, but they are less sensitive. Radiologic studies and the computed tomography of the chest assist in the diagnosis and follow-up of SARS-CoV-2 infection. The use of spirometry for diagnosis and follow-up is restricted due to the elevated risk of contagion. It has been shown that eosinophilia and TH2 inflammation, due to their antiviral immune effect, are protective factors against severe SARS-CoV-2/COVID-19. Patients with mild asthma express less angiotensin converting enzyme receptors (ACE2), and those with neutrophilic asthma express it in greater proportion, which suggests more severe presentations of COVID-19. The conventional asthma treatment modulates the SARS-CoV-2/COVID-19 immune response, which is why patients with controlled asthma have non-severe manifestations of COVID 19, however, the mechanisms are not clear.

Pollen-food syndrome (PFS) is characterized by allergic sensitization to proteins of pollens of grasses, weeds, and trees, which produce a type I hypersensitivity reaction that is associated with the intake of plant-derived foods that are usually in raw form. The most frequently-associated protein families are: profilins, PR-10, and ns LTP; however, others such as thaumatins, isoflavones, reductases, and B1,2 glucanases have been documented. The prototype syndrome is birch-fruit-vegetables, and of these, the most common is birch-apple due to the fact that more than 70 % of patients who are sensitized to birch present symptoms associated with the intake of plant-derived foods. The symptoms are restricted to the oral cavity; however, some patients may present systemic symptoms, including anaphylaxis, so it is important to identify the type of protein that is involved since the type of reaction that the patient may present depends on that. In spite of everything, it is considered an entity that may be under diagnosed due to its complex diagnosis and treatment, since the procedure, in most cases, is an elimination diet, because treatment with immunotherapy is not yet available. The purpose of this review is to describe the pathophysiology, as well as the most common pollen-food syndromes.

Even though the SARS-CoV-2 pandemic represents a historical challenge, science has had an exponential development, and the current vaccination campaigns are proof of this. Unfortunately, along came misinformation and myths regarding their production and their adverse effects. For this reason, we have considered of utter importance to review anaphylaxis, one of the most feared vaccine adverse events.Anaphylaxis can be defined as a life-threatening acute and systemic allergic reaction, with a wide clinical spectrum, which can be explained by many immunological mechanisms, and whose diagnostic complexity demands the fulfillment of strict criteria. Though infrequent, any vaccine has the potential to trigger anaphylaxis. In the United States, for the new SARS-CoV-2 vaccines, rates from 1:200 000 (Pfizer-BioNTech) to 1:360 000 doses (Moderna) have been estimated. Vaccine adverse events can be mediated by hypersensitivity reactions, either allergic or not. Unlike a typical drug allergy, rarely is the active ingredient responsible for the reaction. Therefore, excipients must be considered during the approach to this problem. Vaccine associated anaphylaxis has to be referred to an allergist so as to guarantee the maximum benefit for the patient and improve the vaccines' security profile.

Difficult-to-treat asthma refers to asthma that is not controlled despite high or medium doses of inhaled steroids or in which high doses of treatment are required to maintain an adequate control of the symptoms and to reduce the risk of exacerbations. An inadequate technique to use the inhaler, poor adherence to treatment, smoking, comorbidities, or an incorrect diagnosis should be considered. In severe asthma, despite adherence to treatment with optimized maximum doses and the management of factors that could contribute, multiple medications in maximum doses are required to have an adequate therapeutic control or this is not achieved. The approach to these patients involves a meticulous process due to the multiple factors that can influence poor asthma control and that can lead to a misclassification of the disease when, in reality, the patient can be presenting different comorbidities whose treatment could decrease the severity of asthma symptoms and modify the prognosis. The objective of this document is to make the approach to patients with difficult-to-treat asthma and severe asthma known, as well as the most frequent comorbidities. A search was made in PubMed with the purpose of identifying the main pathologies that may be present in patients and, based on what is described in the literature, to propose a diagnostic approach. 100 studies were comprised in this review, including clinical guidelines such as GINA, GEMA, and ERS/ATS.

Objective: To determine the prevalence and risk factors associated with tobacco use during the period of confinement in light of the COVID-19 pandemic.

Methods: Through an analytical and cross-sectional study, the data of 2, 372 participants were analyzed. The information was collected through a self-administered questionnaire that was built with the Google Forms tool, which was distributed and applied via email and WhatsApp; the private messaging platform. The relationship between the independent variables and the outcome was determined by multivariate logistic regression analysis.

Results: Out of the total population, 69.3 % were women, the median age was 20.11±2.01 years, the prevalence of asthma was 12.2 %, and the active tobacco use was 13.3 %. There was a higher number of patients with asthma who smoked (14.2 vs. 13.2 %) than of those who didn't have asthma. The multivariate logistic regression analysis showed that factors like considering that COVID-19 does not exist and not being confined were related to tobacco use in patients with asthma during the implementation of the contingency plan that the COVID-19 pandemic represents.

Conclusions: During confinement to home for COVID-19, the prevalence of tobacco use is higher in patients with asthma than in individuals without this ailment; the factors that favor the aforementioned are present in the family environment.

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.