Etiology of chronic urticaria: the Ecuadorian experience

Background: The purpose of this study was to identify chronic urticaria (CU) etiologies and treatment modalities in Ecuador. We propose that the sample distribution fits the expected one, and that there is an association between the etiology and its treatment. Methods: We performed a retrospective study involving 112 patients diagnosed with CU using a Checklist for a complete chronic urticaria medical history. Demographic and clinical variables were collected. The etiology of CU was classified using the EAACI/GA2LEN/EDF/WAO guideline. Descriptive analyses were performed for demographical and clinical variables. Chi square tests were applied to analyze the fit of distribution and the independence of variables. P values less than 0.05 were considered significant. Results: Among all the patients, 76.8% were diagnosed with chronic spontaneous urticaria (CSU), of which 22.3% had a known etiology or possible exacerbating condition. Food allergy was identified as the most common accompanying condition in patients with CSU (10.7%) (p < 0.01).. On the other hand, 23.2% inducible urticarias (CIndU) were indentified; dermographism was the most common (10.7%) (p < 0.01). Regarding treatment regimens, sg-H1-antihistamines alone represented the highest proportion (44.6%). The combination of any H1-antihistamine plus other drug was a close second (42.0%) (p < 0.01). Almost 48% of CSUs of unknown etiology were treated with any antihistamine plus another drug. In patients with known etiology, sg-antihistamines alone (44.0%) was the most common management. In addition, 53.8% of CIndUs were treated with sg-antihistamines alone. Though, these associations were not statistically significant. Conclusion: CSU is the most frequent subtype of CU. Modern non-sedating antihistamines in licensed doses are the drug of choice. Nevertheless, a great proportion of patients require the addition of another type of medication

Spanish validation of the revised depression attitude questionnaire (R-daq)

Purpose: The aim of the study was to develop and validate a Spanish version of the Revised Depression Attitude Questionnaire (R-DAQ). Methods: The R-DAQ was used as a baseline for the study. It was translated and tested to ensure the instrument was appropriate for the target population. 537 Ecuadorian healthcare professionals completed the revised Spanish version of the R-DAQ (SR-DAQ). Statistical and exploratory factor analyses were performed to examine construct validity, internal consistency, readability and floor and ceiling effects. Results: Three factors were obtained: “Professional confidence in depression care”; “Therapeutic optimism about depression”; and “Generalist perspective about depression occurrence, recognition, and management”. The internal consistency of the SR-DAQ was determined by means of Cronbach’s α coefficient, with values ranging between 0.61–0.8. The correlations with the English version reflected adequate validity. The model explained 39% of the variance. Subsequent analysis with a sample restricted to those who had received training in depression produced a model that explained 42% of the variance. Conclusion: The SR-DAQ meets the psychometric requirements for measuring depression attitude in a Spanish-speaking population and shows adequate internal consistency and validity

Contact dermatitis due to personal protective equipment use and hygiene practices during the COVID-19 pandemic: A systematic review of case reports

Background: Prolonged use of personal protective equipment (PPE) may lead to contact dermatitis during the coronavirus disease 19 (COVID-19) pandemic. This paper aims to identify the causative factors of contact dermatitis from PPE and hygiene practices.Methods: The search was conducted adhering to PRISMA 2020 guidelines. A Delphi process was employed to ensure that the aims of this study were met. PubMed and Web of Science databases were systematically searched through September 12, 2021, using search terms: Contact dermatitis, case report, covid-19. The findings were tabulated as author/year, gender, age, presentation, cause, dermatological diagnosis, testing modality, provided treatment, symptom resolution (time in days), prognosis, and follow-up.Results: The mean age of all individuals was 29.75 years, with 75% females. All cases presented with erythema, with 62.5% reporting pruritus and 37.5% reporting burning facial symptoms. Surgical masks and hand-hygiene products (37.5%) were the most commonly reported causative agent with 25% due to KN95/FFP type 2 use. Allergic contact dermatitis (50%) and irritant contact dermatitis (25%) were common diagnoses. Treatments included creams, emollients, and desloratadine, with restriction of irritant-causing factors. The prognosis was generally good among the cases, with 62.5% presenting complete resolution within a week and 12.5% showing moderate improvement at the fourth month after discontinuing use.Conclusion: This study finds pertinent links between PPE use and contact dermatitis during the COVID-19 pandemic. While many cases are bound to go underreported in literature, well-designed, large-scale studies in the future may help promote these associations in a more comprehensive manner

Percepción del apoyo social en pacientes con cáncer y su influencia en la depresión

Introduction: Different factors influence the appearance of depression in the oncological population, not all of them are modifiable. However, interaction with social networks can be an element that avoids or dampens depression instead of being a generator or maintainer of this disorder. Objective: To study the relationship between "perceived social support" and "depression" in adult patients with cancer. Material and Method: This is a transversal, quantitative, descriptive, correlational study; with a non-probabilistic sample of 112 patients, 22 men and 85 women, from a cancer hospital. The Beck Depression Inventory (BDI) short version and the MOS-SSS (Social Support Survey) questionnaire were used. Results: Social support was found to be associated with depression [p = 0.007 <α = 0.05], in an inverse manner. The most perceived types of support, according to their functionality, are "emotional support", followed by "instrumental support", the first understood as manifestations of affectivity, andthe second as social aid, material and provision of services by the environment. Depression is moderate in 14% of cases, mild in 24% and severe with 4.7%. The same ones that experience different degrees of sadness, despair and unhappiness, isolation, indecision, feelings of guilt, fatigue, among others. Conclusions: Cancer patients studied who perceive poor social support have depression. The majority of people investigated consider that they have adequate support, some of them present depression because there are multiple factors that are related to depressiIntroducción: Diferentes factores influyen en la aparición de depresión en la población oncológica, no todos ellos son modificables. No obstante,la interacción con las redes sociales puede ser un elemento que evite o amortigüe la depresión en lugar de ser un generador o mantenedorde este trastorno. Objetivo: Evaluar la relación entre “apoyo social percibido” y “depresión” en pacientes adultos con cáncer. Material y Método: Este es un estudio transversal, cuantitativo, de tipo descriptivo, correlacional; con una muestra no probabilística de 112 pacientes, 22 hombres y85 mujeres, de un hospital oncológico. Se utilizaron el inventario de depresión de Beck (BDI) versión breve y elcuestionario MOS-SSS (Social Support Survey). Resultados: Se encontró que el apoyo social se asocia con la depresión [p = 0,007 < α = 0.05], de forma inversa. Los tipos de apoyo más percibidos, conforme a su funcionalidad, son el “apoyo afectivo”, seguido del “apoyo instrumental”, el primero comprendido como manifestaciones de afectividad, y el segundo como ayudas sociales, material y prestación de servicios por parte del entorno. La depresión es moderada en un 14% de los casos, leve en el 24% y grave conun 4,7%. Los mismos que experimentan diversos grados de tristeza, desesperanza e infelicidad, aislamiento, indecisión, sentimientos de culpa, cansancio, entre otros. Conclusiones: Los pacientes de cáncer estudiados que perciben el apoyo social escaso presentan depresión. La mayor parte de personas investigadas considera que tienen un apoyo adecuado, algunas presentan depresión pues son múltiples los factores que se relacionan con la depres

Percepción del apoyo social en pacientes con cáncer y su influencia en la depresión

Introduction: Different factors influence the appearance of depression in the oncological population, not all of them are modifiable. However, interaction with social networks can be an element that avoids or dampens depression instead of being a generator or maintainer of this disorder. Objective: To study the relationship between "perceived social support" and "depression" in adult patients with cancer. Material and Method: This is a transversal, quantitative, descriptive, correlational study; with a non-probabilistic sample of 112 patients, 22 men and 85 women, from a cancer hospital. The Beck Depression Inventory (BDI) short version and the MOS-SSS (Social Support Survey) questionnaire were used. Results: Social support was found to be associated with depression [p = 0.007 <? = 0.05], in an inverse manner. The most perceived types of support, according to their functionality, are "emotional support", followed by "instrumental support", the first understood as manifestations of affectivity, andthe second as social aid, material and provision of services by the environment. Depression is moderate in 14% of cases, mild in 24% and severe with 4.7%. The same ones that experience different degrees of sadness, despair and unhappiness, isolation, indecision, feelings of guilt, fatigue, among others. Conclusions: Cancer patients studied who perceive poor social support have depression. The majority of people investigated consider that they have adequate support, some of them present depression because there are multiple factors that are related to depressiIntroducción: Diferentes factores influyen en la aparición de depresión en la población oncológica, no todos ellos son modificables. No obstante,la interacción con las redes sociales puede ser un elemento que evite o amortigüe la depresión en lugar de ser un generador o mantenedorde este trastorno. Objetivo: Evaluar la relación entre “apoyo social percibido” y “depresión” en pacientes adultos con cáncer. Material y Método: Este es un estudio transversal, cuantitativo, de tipo descriptivo, correlacional; con una muestra no probabilística de 112 pacientes, 22 hombres y85 mujeres, de un hospital oncológico. Se utilizaron el inventario de depresión de Beck (BDI) versión breve y elcuestionario MOS-SSS (Social Support Survey). Resultados: Se encontró que el apoyo social se asocia con la depresión [p = 0,007 < ? = 0.05], de forma inversa. Los tipos de apoyo más percibidos, conforme a su funcionalidad, son el “apoyo afectivo”, seguido del “apoyo instrumental”, el primero comprendido como manifestaciones de afectividad, y el segundo como ayudas sociales, material y prestación de servicios por parte del entorno. La depresión es moderada en un 14% de los casos, leve en el 24% y grave conun 4,7%. Los mismos que experimentan diversos grados de tristeza, desesperanza e infelicidad, aislamiento, indecisión, sentimientos de culpa, cansancio, entre otros. Conclusiones: Los pacientes de cáncer estudiados que perciben el apoyo social escaso presentan depresión. La mayor parte de personas investigadas considera que tienen un apoyo adecuado, algunas presentan depresión pues son múltiples los factores que se relacionan con la depres

Variances in BCG protection against COVID-19 mortality: A global assessment

The BCG vaccine is known to impart nonspecific immunological benefits alongside conferring protection to tuberculosis in endemic regions. It is also known to protect against bladder cancer and other respiratory tract infections. During the coronavirus disease 2019 (COVID-19) pandemic, the BCG vaccine has gained attention due to its role in conferring protective immunity. We demonstrate the potential immunological protective mechanisms that play a role against COVID-19. We conduct a global assessment of the countries that have the highest and lowest mortality rates determined by an a priori methodology. Lastly, we discuss the potential limitations of incorporating BCG vaccines as potential strategies against COVID-19 and provide recommendations regarding their use in ongoing and future epidemics

Latin American anaphylaxis registry

Background: Recent data about clinical features, triggers and management of anaphylaxis in Latin America is lacking. Objective: To provide updated and extended data on anaphylaxis in this region. Method: An online questionnaire was used, with 67 allergy units involved from 12 Latin-American countries and Spain. Among data recorded, demographic information, clinical features, severity, triggering agents, and treatment were received. Results: Eight hundred and seventeen anaphylactic reactions were recorded. No difference in severity, regardless of pre-existing allergy or asthma history was found. Drug induced anaphylaxis (DIA) was most frequent (40.6%), followed by food induced anaphylaxis (FIA) (32.9%) and venom induced anaphylaxis (VIA) (12%). FIA and VIA were more common in children-adolescents. Non-steroidal anti-inflammatory drugs (NSAIDs) and beta-lactam antibiotics (BLA) were the most frequent drugs involved. Milk (61.1% of FIA) and egg (15.4% of FIA) in children, and shellfish (25.5% of FIA), fresh fruits (14.2% of FIA), and fish (11.3% of FIA) in adults were the most common FIA triggers. Fire ants were the most frequent insect triggers, and they induced more severe reactions than triggers of FIA and DIA (p < 0.0001). Epinephrine was used in 43.8% of anaphylaxis episodes. After Emergency Department treatment, epinephrine was prescribed to 13% of patients. Conclusions: Drugs (NSAIDs and BLA), foods (milk and egg in children and shellfish, fruits and fish in adults) and fire ants were the most common inducers of anaphylaxis. Epinephrine was used in less than half of the episodes emphasizing the urgent need to improve dissemination and implementation of anaphylaxis guidelines.Revisión por pare

CRUSE®-An innovative mobile application for patient monitoring and management in chronic spontaneous urticaria

Background: Chronic spontaneous urticaria (CSU) is unpredictable and can severely impair patients' quality of life. Patients with CSU need a convenient, user-friendly platform to complete patient-reported outcome measures (PROMs) on their mobile devices. CRUSE ®, the Chronic Urticaria Self Evaluation app, aims to address this unmet need. Methods: CRUSE ® was developed by an international steering committee of urticaria specialists. Priorities for the app based on recent findings in CSU were defined to allow patients to track and record their symptoms and medication use over time and send photographs. The CRUSE ® app collects patient data such as age, sex, disease onset, triggers, medication, and CSU characteristics that can be sent securely to physicians, providing real-time insights. Additionally, CRUSE ® contains PROMs to assess disease activity and control, which are individualised to patient profiles and clinical manifestations. Results: CRUSE ® was launched in Germany in March 2022 and is now available for free in 17 countries. It is adapted to the local language and displays a country-specific list of available urticaria medications. English and Ukrainian versions are available worldwide. From July 2022 to June 2023, 25,710 observations were documented by 2540 users; 72.7% were females, with a mean age of 39.6 years. At baseline, 93.7% and 51.3% of users had wheals and angioedema, respectively. Second-generation antihistamines were used in 74.0% of days. Conclusions: The initial data from CRUSE ® show the wide use and utility of effectively tracking patients' disease activity and control, paving the way for personalised CSU management.</p

CRUSE®-An innovative mobile application for patient monitoring and management in chronic spontaneous urticaria

Background: Chronic spontaneous urticaria (CSU) is unpredictable and can severely impair patients' quality of life. Patients with CSU need a convenient, user-friendly platform to complete patient-reported outcome measures (PROMs) on their mobile devices. CRUSE ®, the Chronic Urticaria Self Evaluation app, aims to address this unmet need. Methods: CRUSE ® was developed by an international steering committee of urticaria specialists. Priorities for the app based on recent findings in CSU were defined to allow patients to track and record their symptoms and medication use over time and send photographs. The CRUSE ® app collects patient data such as age, sex, disease onset, triggers, medication, and CSU characteristics that can be sent securely to physicians, providing real-time insights. Additionally, CRUSE ® contains PROMs to assess disease activity and control, which are individualised to patient profiles and clinical manifestations. Results: CRUSE ® was launched in Germany in March 2022 and is now available for free in 17 countries. It is adapted to the local language and displays a country-specific list of available urticaria medications. English and Ukrainian versions are available worldwide. From July 2022 to June 2023, 25,710 observations were documented by 2540 users; 72.7% were females, with a mean age of 39.6 years. At baseline, 93.7% and 51.3% of users had wheals and angioedema, respectively. Second-generation antihistamines were used in 74.0% of days. Conclusions: The initial data from CRUSE ® show the wide use and utility of effectively tracking patients' disease activity and control, paving the way for personalised CSU management.</p