Prevalencia de respiración oral y su efecto en el desempeño escolar en niños con alergia respiratoria

Antecedentes: El asma y la rinitis alérgica (RA) se han relacionado con alteraciones craneofaciales debido a la alta frecuencia de respiración oral en ambas patologías. Pacientes y métodos: Se realizó un estudio observacional y prospectivo de enero a diciembre del 2007 en pacientes de 6 a 15 años vistos por primera vez con alergia respiratoria. Después del examen físico completo, se realizó un cuestionario para determinar somnolencia diurna, ronquido y desempeño académico. Resultados: Se incluyeron 107 pacientes, 42 hombres y 65 mujeres. 80.4% tenían rinitis alérgica y 19.6% rinitis alérgica y asma. Los eventos de ronquido se clasificaron como leve (1-2 veces/semana) el 10.3%, moderado (3-5 veces /semana) 16.8% y como roncadores habituales (> 6 veces / semana) el 9.3%. El resto no roncaba (63.6%). La somnolencia diurna fue investigada por la facilidad de los niños de quedarse dormidos cuando viajaban en coche (23.4%), en la escuela (2.8%), al hacer tarea (4.7%) o mientras veían televisión (6.5%). Los pacientes con 3 o más alteraciones físicas fueron clasificados como respiradores orales, correspondiendo a un 29% (n=31). En el área académica el 92% de los niños con calificaciones reprobatorias pertenecieron al grupo de los respiradores orales. Las calificaciones buenas en conducta fueron más frecuentes en los respiradores nasales que en los orales (80% vs 20%,) (p < 0.001). Conclusión: La prevalencia de respiradores orales en pacientes de primera vez con diagnóstico de rinitis alérgica con o sin asma fue del 29%. El desempeño escolar (académico y de conducta) es menor en pacientes respiradores orales. Abstract: Introduction: Allergic rhinitis and asthma have been associated with craniofacial abnormalities due to the high frequency of oral breathing in both pathologies. Methods and materials: We conducted an observational prospective study from January to December 2007. Patients seen for the fist time, diagnosed with respiratory allergies between 6 and 15 years of age were included. After a complete history and physical examination, after that they answered a questionnaire inquiring about snoring characteristics, day-time sleepiness, and academic performance. Results: One hundred and seven patients were included, 42 males (39.3%) and 65 females (60.7%). Allergic rhinitis was the most prevalent diagnosis in 80.4% (86) of the cases, followed by allergic rhinitis and asthma in 18.6%. The snoring events were classified as mild (1–2 times/week) which represented 10.3%, moderate (3–5 times/week), which were 16.8 %, and habitual snorers (>6 times/week), which were 9.3 %, and 68 (63.6%) did not snore. Daytime somnolence was classified in groups as follows: ease of falling asleep while traveling by car (23.4% of all patients), at school (2.8%), while doing homework (4.7%) or watching TV (6.5%). Patients were classified as oral breathers if they had 3 or more physical findings, corresponding to a 29% (n=31). In the academic area, 92% of the children with failing grades belonged to the oral breathers. Good behavior grades were better in the nasal breathers group when compared with oral breathers (80% vs. 20%) (p < 0.001). Conclusion: The prevalence of oral breathing in first time patients with an allergic rhinitis diagnosis, with or without asthma, was 29%. Poor school performance (academic and behavioral) is worse in oral breathers

Prevalencia de respiración oral y su efecto en el desempeño escolar en niños con alergia respiratoria

El asma y la rinitis alérgica (RA) se han relacionado con alteraciones craneofaciales debido a la alta frecuencia de respi- ración oral en ambas patologías

La huerta como modelo terapéutico complementario en salud mental hospital “La Estrella”.

The positive effects generated in natural spaces such as institutional gardens on the mental health of psychiatric patients who, due to their mental disorders, must be treated with drugs, are not only relevant to improve their well-being but also exert importance in the creation of interest skills as part of the construction of a life plan, the expression of emotions through discharge therapy to manage anxiety, aggression, stress, frustration and abstinence, in addition to the reduction of environmental impacts generated by urbanization and the overexploitation of resources. natural resources of our generations. For this reason, based on its benefits, this work is presented as a reflective and interpretive perspective on the understanding of the benefits of complementary intervention in the nature-mental health binomial and its application in clinical practice at Hospital la Estrella located in the town of Ciudad Bolívar and where 21 patients are hospitalized, who are assigned roles according to their initial assessment and daily evaluation, carried out by health professionals and through horticultural practice, have presented positive results such as improvement in concentration, establishment of routines, empowerment of values such as responsibility, self-care and care for others, fundamental skills for a process of social and labor inclusion.El presente documento muestra los efectos positivos generados por la conexión del binomio naturaleza - salud mental a través de espacios verdes en los que pacientes de psiquiatría no sólo demuestren mejoría en su bienestar al expresar sus emociones por medio de la terapia de descarga para el manejo de la ansiedad, agresividad, estrés, frustración y abstinencia, sino también desarrollen habilidades de interés como parte de la construcción de un plan de vida. Además de la disminución de los impactos ambientales generados por la urbanización y la sobre-explotación de los recursos naturales de nuestras generaciones. Objetivo: Presentar de manera reflexiva los beneficios rehabilitadores percibidos en la salud mental de 21 pacientes que participan en la construcción y mantenimiento de la huerta institucional ubicada en la Unidad de Salud Mental la Estrella, localidad de Ciudad Bolívar. Metodología: La selección de los pacientes que participan en la intervención terapéutica a través de la huerta institucional, se hace desde terapia ocupacional, medicina general y psiquiatría, quienes son los que indican cuales son los pacientes aptos para dicha actividad y asignan roles de acuerdo a su valoración inicial y diaria. Resultados: Han sido positivos como mejoría en la concentración, establecimiento de rutinas, potencialización de valores como la responsabilidad, el autocuidado y el cuidado por el otro, habilidades fundamentales para un proceso de inclusión social, laboral y mejoramiento de la calidad de vida. Conclusiones: Esta conexión con la naturaleza permite tener una alternativa terapéutica en el abordaje de las enfermedades mentales que están presentes en la sociedad actual en la zona sur del distrito capital

Compromising between European and US allergen immunotherapy schools: Discussions from GUIMIT, the Mexican immunotherapy guidelines

Background: Allergen immunotherapy (AIT) has a longstanding history and still remains the only disease-changing treatment for allergic rhinitis and asthma. Over the years 2 different schools have developed their strategies: the United States (US) and the European. Allergen extracts available in these regions are adapted to local practice. In other parts of the world, extracts from both regions and local ones are commercialized, as in Mexico. Here, local experts developed a national AIT guideline (GUIMIT 2019) searching for compromises between both schools. Methods: Using ADAPTE methodology for transculturizing guidelines and AGREE-II for evaluating guideline quality, GUIMIT selected 3 high-quality Main Reference Guidelines (MRGs): the European Academy of Allergy, Asthma and Immunology (EAACI) guideines, the S2k guideline of various German-speaking medical societies (2014), and the US Practice Parameters on Allergen Immunotherapy 2011. We formulated clinical questions and based responses on the fused evidence available in the MRGs, combined with local possibilities, patient's preference, and costs. We came across several issues on which the MRGs disagreed. These are presented here along with arguments of GUIMIT members to resolve them. GUIMIT (for a complete English version, see Supplementary data) concluded the following: Results: Related to the diagnosis of IgE-mediated respiratory allergy, apart from skin prick testing complementary tests (challenges, in vitro testing and molecular such as species-specific allergens) might be useful in selected cases to inform AIT composition. AIT is indicated in allergic rhinitis and suggested in allergic asthma (once controlled) and IgE-mediated atopic dermatitis. Concerning the correct subcutaneous AIT dose for compounding vials according to the US school: dosing tables and formula are given; up to 4 non-related allergens can be mixed, refraining from mixing high with low protease extracts. When using European extracts: the manufacturer's indications should be followed; in multi-allergic patients 2 simultaneous injections can be given (100% consensus); mixing is discouraged. In Mexico only allergoid tablets are available; based on doses used in all sublingual immunotherapy (SLIT) publications referenced in MRGs, GUIMIT suggests a probable effective dose related to subcutaneous immunotherapy (SCIT) might be: 50–200% of the monthly SCIT dose given daily, maximum mixing 4 allergens. Also, a table with practical suggestions on non-evidence-existing issues, developed with a simplified Delphi method, is added. Finally, dissemination and implementation of guidelines is briefly discussed, explaining how we used online tools for this in Mexico. Conclusions: Countries where European and American AIT extracts are available should adjust AIT according to which school is followed

Corrigendum to ‘a horizon scan exercise for aquatic invasive alien species in Iberian inland waters’

info:eu-repo/semantics/publishedVersio

Black list and Alert list of the Aquatic Invasive Alien Species in the Iberian Peninsula: an action of the LIFE INVASAQUA

Resumen del trabajo presentado en VI Congreso Nacional sobre Especies Exóticas Invasoras y I Congreso Ibérico sobre EEI (EEI 2022) celebrado en Navarra del 20 al 23 de abril de 2022.One of the objectives of LIFE INVASQUA project is to develop tools that will be more efficient the Early Warning and Rapid Response (EWRR) framework for Invasive Alien Species in the Iberian Peninsula. Horizon scanning for high-risk IAS is basic in implementing measures to reduce new invasions, developing Alert lists, and to focus effort in the species already established, for instance making a Black list. We developed a trans national horizon scanning exercise focused on inland waters of Spain and Portugal in order to provide a prioritized lists (Black list and Alert list) of aquatic IAS that may pose a threat to aquatic ecosystems and socio economic sectors in the future. We followed a step approach of existing information about IAS (Plants, Freshwater Invertebrates, Estuarine Invertebrates and Vertebrates; 127 established taxa in Black list; 90 non established taxa in Alert list) combining with an expert scoring of prioritized taxa. IAS established in the Iberian aquatic system consistently highlighted as the worst included vertebrates (e.g. Cyprinus carpio, Gambusia holbrooki, Silurus glanis), freshwater and estuarine invertebrates (e.g. Procambarus clarkii, Dreissena polymorpha, Pacifastacus leniusculus, Ficopomatus enigmaticus, Callinectes sapidus, Corbicula fluminea) and plants (e.g. Eichhornia crassipes, Azolla filiculoides, Ludwigia grandiflora). Amongst taxa not yet established (Alert list), expert pointed to Perna viridis, Hydroides dirampha, Dreissena bugensis, Procambarus fallax f. virginallis, Perccottus glenii with higher risk of invasion, ecological and socioeconomic impacts. Over 20.6% of the taxa in the preliminary black list received no votes (no prioritization) by experts, 17.8% in the innitial alert list. Our horizon scanning approach is inclusive of all-taxa, prioritizes both established and emerging biological threats across trans-national scales, and considers not only the ecological impact, but also potential direct economic consequences as well as the manageability of invasive species.This work received funds from the LIFE Programme (LIFE17 GIE/ES/000515)

Feasibility and short-term outcomes in liver-first approach: a Spanish snapshot study (the RENACI project)

Producción CientíficaSimple Summary: Current evidence does not provide enough information for selecting a tailored approach pathway in patients with colorectal cancer and synchronous liver metastases. There are no randomized clinical trials or prospective series comparing the classical approach with the liver-first approach. In addition, information on the proportion of patients who actually complete the therapeutic regimen is limited. The RENACI Project was a prospective National Registry performed on patients with colorectal cancer and synchronous liver metastases undergoing the liver-first approach. This study aimed to present the data of feasibility and short-term outcomes of the Spanish National Registry of Liver First Approach (the RENACI Project).(1) Background: The liver-first approach may be indicated for colorectal cancer patients with synchronous liver metastases to whom preoperative chemotherapy opens a potential window in which liver resection may be undertaken. This study aims to present the data of feasibility and short-term outcomes in the liver-first approach. (2) Methods: A prospective observational study was performed in Spanish hospitals that had a medium/high-volume of HPB surgeries from 1 June 2019 to 31 August 2020. (3) Results: In total, 40 hospitals participated, including a total of 2288 hepatectomies, 1350 for colorectal liver metastases, 150 of them (11.1%) using the liver-first approach, 63 (42.0%) in hospitals performing <50 hepatectomies/year. The proportion of patients as ASA III was significantly higher in centers performing ≥50 hepatectomies/year (difference: 18.9%; p = 0.0213). In 81.1% of the cases, the primary tumor was in the rectum or sigmoid colon. In total, 40% of the patients underwent major hepatectomies. The surgical approach was open surgery in 87 (58.0%) patients. Resection margins were R0 in 78.5% of the patients. In total, 40 (26.7%) patients had complications after the liver resection and 36 (27.3%) had complications after the primary resection. One-hundred and thirty-two (89.3%) patients completed the therapeutic regime. (4) Conclusions: There were no differences in the surgical outcomes between the centers performing <50 and ≥50 hepatectomies/year. Further analysis evaluating factors associated with clinical outcomes and determining the best candidates for this approach will be subsequently conducted.Asociación Española de Cirujanos - (grant Research Projects 2020

Guía Mexicana de Práctica Clínica de Inmunoterapia 2011

Existen varias guías internacionales para la práctica clínica de in- munoterapia, que aplican solo parcialmente en México. La primera guía mexicana de inmunoterapia data de 1998

European scenarios for future biological invasions

1. Invasive alien species are one of the major threats to global biodiversity, ecosystem integrity, nature's contributions to people and human health. While scenarios about potential future developments have been available for other global change drivers for quite some time, we largely lack an understanding of how biological invasions might unfold in the future across spatial scales. 2. Based on previous work on global invasion scenarios, we developed a workflow to downscale global scenarios to a regional and policy-relevant context. We applied this workflow at the European scale to create four European scenarios of biological invasions until 2050 that consider different environmental, socio-economic and socio-cultural trajectories, namely the European Alien Species Narratives (Eur-ASNs). 3. We compared the Eur-ASNs with their previously published global counterparts (Global-ASNs), assessing changes in 26 scenario variables. This assessment showed a high consistency between global and European scenarios in the logic and assumptions of the scenario variables. However, several discrepancies in scenario variable trends were detected that could be attributed to scale differences. This suggests that the workflow is able to capture scale-dependent differences across scenarios. 4. We also compared the Global- and Eur-ASNs with the widely used Global and European Shared Socioeconomic Pathways (SSPs), a set of scenarios developed in the context of climate change to capture different future socio-economic trends. Our comparison showed considerable divergences in the scenario space occupied by the different scenarios, with overall larger differences between the ASNs and SSPs than across scales (global vs. European) within the scenario initiatives. 5. Given the differences between the ASNs and SSPs, it seems that the SSPs do not adequately capture the scenario space relevant to understanding the complex future of biological invasions. This underlines the importance of developing independent but complementary scenarios focussed on biological invasions. The downscaling workflow we implemented and presented here provides a tool to develop such scenarios across different regions and contexts. This is a major step towards an improved understanding of all major drivers of global change, including biological invasions

European scenarios for future biological invasions

Invasive alien species are one of the major threats to global biodiversity, ecosystem integrity, nature's contributions to people and human health. While scenarios about potential future developments have been available for other global change drivers for quite some time, we largely lack an understanding of how biological invasions might unfold in the future across spatial scales. Based on previous work on global invasion scenarios, we developed a workflow to downscale global scenarios to a regional and policy-relevant context. We applied this workflow at the European scale to create four European scenarios of biological invasions until 2050 that consider different environmental, socio-economic and socio-cultural trajectories, namely the European Alien Species Narratives (Eur-ASNs). We compared the Eur-ASNs with their previously published global counterparts (Global-ASNs), assessing changes in 26 scenario variables. This assessment showed a high consistency between global and European scenarios in the logic and assumptions of the scenario variables. However, several discrepancies in scenario variable trends were detected that could be attributed to scale differences. This suggests that the workflow is able to capture scale-dependent differences across scenarios. We also compared the Global- and Eur-ASNs with the widely used Global and European Shared Socioeconomic Pathways (SSPs), a set of scenarios developed in the context of climate change to capture different future socio-economic trends. Our comparison showed considerable divergences in the scenario space occupied by the different scenarios, with overall larger differences between the ASNs and SSPs than across scales (global vs. European) within the scenario initiatives. Given the differences between the ASNs and SSPs, it seems that the SSPs do not adequately capture the scenario space relevant to understanding the complex future of biological invasions. This underlines the importance of developing independent but complementary scenarios focussed on biological invasions. The downscaling workflow we implemented and presented here provides a tool to develop such scenarios across different regions and contexts. This is a major step towards an improved understanding of all major drivers of global change, including biological invasions. Read the free Plain Language Summary for this article on the Journal blog