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

CIBERER : Spanish national network for research on rare diseases: A highly productive collaborative initiative

Altres ajuts: Instituto de Salud Carlos III (ISCIII); Ministerio de Ciencia e Innovación.CIBER (Center for Biomedical Network Research; Centro de Investigación Biomédica En Red) is a public national consortium created in 2006 under the umbrella of the Spanish National Institute of Health Carlos III (ISCIII). This innovative research structure comprises 11 different specific areas dedicated to the main public health priorities in the National Health System. CIBERER, the thematic area of CIBER focused on rare diseases (RDs) currently consists of 75 research groups belonging to universities, research centers, and hospitals of the entire country. CIBERER's mission is to be a center prioritizing and favoring collaboration and cooperation between biomedical and clinical research groups, with special emphasis on the aspects of genetic, molecular, biochemical, and cellular research of RDs. This research is the basis for providing new tools for the diagnosis and therapy of low-prevalence diseases, in line with the International Rare Diseases Research Consortium (IRDiRC) objectives, thus favoring translational research between the scientific environment of the laboratory and the clinical setting of health centers. In this article, we intend to review CIBERER's 15-year journey and summarize the main results obtained in terms of internationalization, scientific production, contributions toward the discovery of new therapies and novel genes associated to diseases, cooperation with patients' associations and many other topics related to RD research

Caracterización y selección de nuevos genotipos imberbes de cebada forrajera para el norte y centro de méxico

Dry matter yield and its fractions (stems, leaves and spikes), leaf/stem ratio, plant height and phenological stage of 36 awnless barley F7 lines, plus two commercial controls (triticale cv Eronga 83 and barley cv Cerro prieto), were evaluated in three environments (Torreón, Coahuila, Navidad, Nuevo León, and Celaya, Guanajuato) in central and northern Mexico. Experimental design was a randomly complete block design with three replicates. Data generated by locations and cycles (i.e. environments) were analyzed as a randomly block combined over environments. The genotype averages were used in a principal components analysis and a cluster analysis. The genotype x environment interaction had no effect on dry matter yield, and was different (PSe condujo una investigación en localidades de Torreón, Coah. (otoño-invierno, ciclos 02-03 y 03-04), Navidad, N.L. (02-03) y Celaya, Gto. (02-03) para evaluar el rendimiento de materia seca y sus fracciones (hojas, tallos y espigas), relación hoja tallo, altura de planta y etapa fenológica, de 36 líneas F7 de cebada forrajera imberbe, y los testigos comerciales triticale cv. Eronga 83 y cebada cv. Cerro prieto. Se utilizó un diseño de bloques completos al azar con tres repeticiones. La información generada a través de ciclos y localidades (ambientes) se analizó como bloques al azar combinado sobre ambientes. Con los promedios de los genotipos se realizaron análisis de componentes principales y de conglomerados. Los resultados indicaron ausencia de interacción genotipo ambiente para el rendimiento de materia seca y diferencias (

Agrupamiento de germoplasma de triticale forrajero por rendimiento, ahijamiento y gustosidad

Ye CWE, Díaz SH, Lozano RAJ, Zamora VVM, Ayala OMJ. Téc Pecu Méx 2001,39(1):15-30. Two experiments were conducted in the autumn-winter season of 96-97. Both experiments included 90 genotypes within four replicates, experimental plots were of 6.8 m2. In Exp 1, dry matter yields (t ha- 1)were evaluated in three cuts, and in the Exp 2, tillering capacity and palatabilty were determinated under grazing. The dry matter yield analysis of variance showed differences (PYe CWE, Díaz SH, Lozano RAJ, Zamora VVM, Ayala OMJ. Téc Pecu Méx 2001,39(1):15-30. Se condujeron dos experimentos en el ciclo otoño-invierno 96-97, evaluándose 90 genotipos con cuatro repeticiones en unidades experimentales de 6.8 m2. En el Exp 1 se evaluó el rendimiento de materia seca (t ha-1) en tres cortes y en el Exp 2 se evaluaron el ahijamiento y la gustosidad bajo pastoreo directo. El análisis de varianza para rendimiento resultó con efecto de la interacción cortes genotipos (

Rendimiento de biomasa y grano en variedades de triticale en el valle de Mexicali

The Mexicali valley is an important region in the production of meat and milk of bovine origin with acceptance in other countries, mainly the United States of America, Japan and Korea. For this reason, quality forage is required to feed cattle such as triticale, used invarious areas of Mexico;however, in the Mexicali valley, there is no information on agronomic behavior. The objective of this study was to evaluate the dry biomass and grain yield of 10 varieties of triticale in the 2014-2015 and 2015-2016 A-Wcycles, inthe Mexicali valley. The experimental design was randomized complete blocks with three replications. 10 varieties of triticale of different growth types were evaluated, 4 spring, 2 facultative, 4 winter and oats. In the first evaluation cycle, the highesttotal biomass production corresponded to the variety AN105 and AN125 with 10.7 and 10.5 t ha-1, in grain yield the varieties AN105, AN38, AN125, AN31B, ABT and Eronga produced from 7.3 to 5.4 t ha-1. For the second cycle, the superior varieties in total biomass were AN31B, ABT, AN38, AN34, AN31P and Eronga with 6to 4.9 t ha-1and in grain yield AN38, AN123, Eronga and AN125 from 4.1 to 3.1 t ha-1. In conclusion, the winter varieties AN31B and AN34 showed potential for the production of total biomass, the facultativevariety AN38 and the spring varieties AN125 and Eronga, showed superiority in grain yield in the two evaluation cyclesEl valle de Mexicali es una región importante en la producción de carne y leche de origen bovino con aceptación en otros países principalmente Estados Unidos de América, Japón y Corea. Por tal motivo, se requiere forraje de calidad para la alimentación del ganado como el triticale, utilizado en diversas zonas de México; sin embargo, en el valle de Mexicali no se tiene información del comportamiento agronómico. El objetivo de este estudio fue evaluar el rendimiento de biomasa seca y grano de 10 variedades de triticale en los ciclos O-I 2014-2015 y 2015-2016, en el Valle de Mexicali. El diseño experimental fue bloques completos al azar con tres repeticiones. Se evaluaron 10 variedades de triticale de diferentes tipos de crecimiento, 4 primaverales, 2 facultativos, 4 invernales y avena. En el primer ciclo de evaluación, la mayor producción de biomasa total correspondió a la variedad AN105 y AN125 con 10.7 y 10.5 t ha-1, en rendimiento de grano las variedades AN105, AN38, AN125, AN31B, ABT y Eronga produjeron de 7.3 a 5.4 t ha-1. Para el segundo ciclo, las variedades superiores en biomasa total fueron AN31B, ABT, AN38, AN34, AN31P y Eronga con 6 a 4.9 t ha-1 y en rendimiento de grano AN38, AN123, Eronga y AN125 de 4.1 a 3.1 t ha-1. En conclusión, las variedades invernales AN31B y AN34 mostraron potencial para la producción de biomasa total, la variedad facultativa AN38 y las variedades primaverales AN125 y Eronga, presentaron superioridad en rendimiento de grano en los dos ciclos de evaluació

Clasificación de triticales forrajeros por rendimiento de materia seca y calidad nutritiva en dos localidades de Coahuila

A study was carried out during the 1996/97 fall/winter cycle io arder to assess dry matter yield of 86 triticale lines and varieties across three clippings, compared to commercial controls: oats cv Coker 234, rye grass cv Alamo and Beetbuilder and barley at Matamoros and Zaragoza, Coahuila. An alfa-lattice design with tour replications was used. Based on dry matter mean yield, the best eight lines were selected for nutritional value anaIysis togetber with commercial controls, AN-31 and AN-34 Tridcale, oats cv Coker 234 and ryegrass cv Alamo. Nutritional value parameters, plus dry matter yields and phenological stages were analyzed by means of the Cluster Analysis and the Principal Component Analysis techniques. Results showed that the two identified triticale types outyielded ryegrass, which had the highest nutritional value. Facultative type triticales equaled oats' nutritional value and yield. On the other hand, intermediate-winter triticales yielded almost the same and showed simOar nutritional values in the first and second clippings. In cooc1usion, triticales constitute an excellent alternative for high quality winter forage production when compared to ryegrass and may replace oats in tbose Breas having frost problems. The existence of triticale types different from those previously reported is confirmed.Se condujo una investigación en el ciclo otoño-invierno 96--97 para evaluar el rendimiento de materia seca de 86 líneas y variedades de triticale a través de tres cortes, en comparación con los testigos comerciales avena Coker 234, baUicos cv. Alamo y Beefbuilder, y cebada, en las localidades de Matamoros y Zaragoza, Coahuila. Se utilizó un diseílo alfa-látice con cuatro repeticiones. Con base en el rendimiento promedio de materia seca y su proporción con respecto al triticale testigo AN-31 se seleccionaron las mejores ocho líneas para determinar su calidad nutritiva, asi como a los testigos: triticale AN-34, baUico Alamo y avena Coker 234. Las variables rendimiento de materia seca, etapa fenológica y de calidad nutritiva se analizaron mediante la técnica de análisis de conglomerados y componentes principales. Los resultados indicaron que los dos tipos identificados de triticale mostraron mayor producción que el ballico, quJen presentó los valores más altos de calidad nutritiva. El grupo de triticales de tipo facultativo Igualó en producción y calidad a la avena, por su parte los triticales de tipo intermedio-invernal mantuvieron casi constante su producción y calidad al pasar de un primer corte al segundo. Se concluye que los triticales son una excelente alternativa para la producción de forraje de alta calidad en la época invernal, al compararlos con el ballico, y pudieran también sustituir a la avena, sobre todo en regiones con alta frecuencia de heladas, confirmando la existencia de tipos de triticale diferentes a los tradicionalmente reportados

Producción de forraje y calidad nutritiva en mezclas de triticale (x triticosecale wittmack ) y ballico anual (lolium multiflorum l.) en Navidad, N.L.

The production and nutritional quality of two interspecific forage mixtures (ryegrass-triticale) and their monoculture in three different harvests were evaluated. Six total seeding rates and three mixture proportions were used (25:75, 50:50 and 75:25) in an alpha lattice design with 30 treatments and three replicates. In the facultative ryegrass-triticale mixture (BTF) the 3 mixture proportions surpassed the monocultures (P173 and 15 % over ryegrass and triticale respectively). In the intermediate ryegrass-triticale mixture (BTI), proportion 25:75 was the one that showed the greatest amount of dry matter production (P210 and 5 %) over ryegrass and triticale respectively). The 50:50 and 75:25 proportions surpassed only the ryegrass monoculture. The nutritional quality of the three mixture proportions, in both mixtures, was similar to the monocultures. The BTF mixture presented greater quality attributes while BTI gave more dry matter and greater amount of fiber. Ryegrass had higher contents of Ca and Mg, and triticale had greater P content. In both mixtures we registered a greater productive response in lower seeding rates. Harvests imposed a strong detrimental effect on forage production and quality. The use of mixtures of facultative or intermediate triticale with annual ryegrass at low and medium seeding rates can maximize forage production and quality under irrigation conditions in the north and central parts of Mexico during winter.En Navidad, N.L., México, se evaluó la producción y calidad nutritiva de dos mezclas forrajeras interespecíficas (ballico-triticale) y sus monocultivos en tres cortes. Se utilizaron seis densidades totales y tres proporciones en las mezclas, (25:75, 50:50 y 75:25), en un diseño alfa-látice con 30 tratamientos y tres repeticiones. En la mezcla ballico - triticale facultativo (BTF), las tres proporciones en mezcla superaron a los monocultivos (P173 y 15 % sobre ballico y triticale, respectivamente). En la mezcla ballico - triticale intermedio (BTI), la proporción 25:75 mostró mayor producción de forraje seco (P210 y 5 % sobre ballico y triticale, respectivamente), la 50:50 y 75:25 superaron sólo al ballico. La calidad nutritiva de las tres proporciones en mezcla fue similar a la de sus monocultivos en ambas mezclas. La mezcla BTF presentó mayores atributos de calidad, mientras que la BTI rindió más forraje seco con mayor porcentaje de fibra. El ballico registró mayores contenidos de Ca y Mg, y el triticale registró mayor contenido de P. En ambas mezclas se registró una mayor respuesta productiva a bajas densidades. Los cortes ejercieron un fuerte efecto detrimental sobre la producción y la calidad del forraje. La utilización de mezclas de triticales facultativos o intermedios con ballico anual a densidades bajas y medias, puede maximizar la producción y la calidad de forraje bajo condiciones de riego en el norte y centro de México durante la época invernal

Formación curricular en diseño para todas las personas en pedagogía = Training curriculum in design for all in pedagogy

227 p.La universidad ejerce un papel fundamental en la configuración de la sociedad en la que vivimos. Entre sus compromisos se encuentra la obligación de establecer las bases para la construcción de un entorno más diverso, accesible e inclusivo, en el que tengan cabida todas las personas, independientemente de su condición física, procedencia o entorno social, entre otras opciones. En el contexto de construir un entorno más inclusivo, se inició nuestra colaboración con el proyecto “Formación Curricular en Diseño para Todas las Personas”, una iniciativa surgida a partir de la presentación del Libro Blanco del Diseño para Todos en la Universidad (2006), elaborado por la Coordinadora del Diseño para Todas las Personas, con la colaboración de la Fundación ONCE y el Instituto de Mayores y Servicios Sociales (IMSERSO), y que supuso el punto de partida para la introducción de los conceptos básicos del Diseño para Todos (D4ALL) y la Accesibilidad Universal en los currículos formativos de los estudios universitario

Mexican Asthma Guidelines: GUIMA 2017

Background: The need for a national guideline, with a broad basis among specialists and primary care physicians was felt in Mexico, to try unifying asthma management. As several high-quality asthma guidelines exist worldwide, it was decided to select the best three for transculturation. Methods: Following the internationally recommended methodology for guideline transculturation, ADAPTE, a literature search for asthma guidelines, published 1-1-2007 through 31-12-2015 was conducted. AGREE-II evaluations yielded 3/40 most suitable for transculturation. Their compound evidence was fused with local reality, patient preference, cost and safety considerations to draft the guideline document. Subsequently, this was adjusted by physicians from 12 national medical societies in several rounds of a Delphi process and 3 face-to-face meetings to reach the final version. Results: Evidence was fused from British Thoracic Society Asthma Guideline 2014, Global Initiative on Asthma 2015, and Guía Española del Manejo del Asma 2015 (2016 updates included). After 3 Delphi-rounds we developed an evidence-based document taking into account patient characteristics, including age, treatment costs and safety and best locally available medication. Conclusion: In cooperation pulmonologists, allergists, ENT physicians, paediatricians and GPs were able to develop an evidence-based document for the prevention, diagnosis and treatment of asthma and its exacerbations in Mexico