Characterization of the sensitization profile of bee venom allergic patients ­ Association with the severity of reaction? / Caracterização do perfil de sensibilização molecular de doentes alérgicos à picada de abelha - Associação com a gravidade da reação?

Introduction: Bee venom (BV) allergy, a common cause of anaphylaxis in adults, is often associated with severe reactions. The use of component-resolved diagnostics (CRD) increases diagnostic accuracy. Objectives: To characterize the sensitization profile of BV allergic patients and a possible correlation with the severity of reaction. Materials and methods: We selected patients with a clinical history of BV allergy, positive skin tests, and specific IgE (sIgE) for BV. The allergenic profile was analyzed by both CRD and Western blot using a well-defined and properly characterized BV extract. Results: Forty-four patients were included, 30 (68.2%) were men. Mean age was 48.9 (SD 17.9) years. Eleven (25%) had large local reactions (LLRs) and 33 (75%) had systemic sting reactions (SSRs). One patient with negative sIgE for BV had positive sIgE for Api m 1, Api m 5, and Api m 10. The sensitization frequency for BV, Api m 1, Api m 2, Api m 3, Api m 5, and Api m 10 was 97.7%, 75%, 47.7%, 20.5%, 40.9%, and 61.4%, respectively. Five patients (11.4%) were sensitized to all BV components. CRD association showed that 5 patients (11.4%) were sensitized only to Api m 1, 8 (18.2%) to Api m 1/Api m 3/Api m 10, and 16 (36.6%) to Api m 1/ Api m 10. Twenty-eight patients (84.8%) with SSRs were sensitized to Api m 1, and concomitant sensitization to Api m 1/Api m 10 was detected in 20 (60.6%). There was a significant difference in Api m 1 between patients with LLRs and SSRs (p = 0.0104). Similar profiles were identified by Western blot analysis, with relevance for the detection of Api m 6 in 28 (64%) and Api m 4 in 16 (36%) patients. Conclusion: The analysis of the sensitization profile using CRD and the association of several of these components can increase diagnostic accuracy in BV allergy. Our data showed that concomitant sensitization to Api m 1 and Api m 10, detected by both CRD and electrophoretic profile, may be associated with SSRs. We emphasize the identification of sensitization to Api m 6 in > 50% of patients, which may be considered a major allergen, and to Api m 4, which may be related to reactions during BV immunotherapy.

Introdução: A alergia ao veneno de abelha (VA) é uma causa frequente de anafilaxia em adultos e está muitas vezes associada a reações graves. O diagnóstico por componentes moleculares (CRD) contribui para uma melhor caracterização desta alergia. Objetivos: Caracterização do perfil de sensibilização molecular de doentes alérgicos ao veneno de abelha e possível correlação com a gravidade da reação. Material e métodos: Selecionaram-se doentes com história de alergia a VA, testes cutâneos e IgE específica (sIgE) positivos para VA. Avaliou-se o perfil alergênico por CRD e por Western Blot, utilizando extrato de VA bem caracterizado. Resultados: 44 doentes, 30 (68,2%) sexo masculino. Média de idades 48,9 ± 17,9 anos, 11 (25%) com reacções locais exuberantes e 33 (75%) com reações sistêmicas à picada (SSR). Um doente tinha sIgE negativa para VA, mas Api m 1, Api m 5 e Api m 10 positivas. A frequência de sensibilização para VA, Api m 1, Api m 2, Api m 3, Api m 5 e Api m 10 foi 97,7%; 75%; 47,7%; 20,5%; 40,9% e 61,4%, respectivamente. Cinco (11,4%) doentes estavam sensibilizados a todos os componentes. Por associação de CRD, detectaram-se 5 (11,4%) doentes sensibilizados apenas a Api m 1, 8 (18,2%) a Api m 1/Api m 3/Api m 10, e 16 (36,6%) a Api m 1/Api m 10. Vinte e oito (84,8%) doentes com SSR tinham Api m 1 positiva e 20 (60,6%) tinham Api m 1/Api m 10 simultaneamente positivas. Observou-se uma diferença estatisticamente significativa para a Api m 1 entre doentes com reações locais exuberantes e sistêmicas (p = 0,0104). Os perfis detectados por Western Blot foram semelhantes, de referir, à detecção de Api m 6 em 28 (64%) e Api m 4 em 16 (36%) dos doentes. Conclusão: A análise do perfil de sensibilização através de CRD e a sua associação aumentam a precisão do diagnóstico de alergia a VA. Sensibilização simultânea a Api m 1 e Api m 10 identificados tanto por CRD como por perfil eletroforético, pode estar associada à ocorrência de SSR. Destaca-se a sensibilização a Api m 6 em > 50% dos doentes, podendo ser considerado um alergênio major, e a Api m 4, possivelmente associado a reações durante a imunoterapia com VA.

Hipertensión arterial y diabetes mellitus tipo 2: impacto educativo en la calidad de vida de los pacientes / Blood hypertension and diabetes mellitus type 2: educational impact on the quality of life of patients

Evaluar el impacto educativo en pacientes con Diabetes Mellitus tipo 2 (DMT2) e Hipertensión arterial (HTA), y su efecto en la calidad de vida. Métodos: Se realizó un estudio intervención en comunidad, en pacientes con diagnóstico de DMT2 e HTA, en la consulta de Medicina Interna. Resultados: Participaron 314 pacientes, distribuidos en un grupo estudio (n = 160) y grupo control (n = 154). Sin diferencias en edad (p = 0,491) y sexo (p = 0,747). En la calidad de vida de pacientes DM entre pre y post charla, en cada grupo, sin diferencias entre grupos en pre-charla (p = 0,869), pero sí en post-charla (p = 0,001), siendo calidad de vida más alta en el grupo estudio (98,2%) que en grupo control (76,9%). Al evaluar los cambios entre pre y post charla, se observó que pre charla en el grupo estudio tuvo 86% de alta calidad de vida, posterior aumentó a 98,2%, cambio estadístico (p = 0,008), en grupo control en cambio, la calidad de vida pre charla fue 87% pasó a 76,9% posterior a ésta, aun así, fue un cambio significativo (p = 0,025) La calidad de vida en HTA, sin diferencias en pre y post charla. La comparación entre pre charla y post charla, en el grupo estudio, no tuvo cambios (p = 0,157) como igualmente en el grupo control (p = 0,317). Conclusiones: Se demostró el impacto positivo de un plan educativo en calidad de vida de los pacientes con diabetes, mas no en pacientes hipertensos(AU)

To evaluate the educational impact in patients with Type 2 Diabetes Mellitus (T2DM) and arterial hypertension (AHT), and its effect on quality of life. Methods: A community intervention study was carried out in patients diagnosed with T2DM and HBP in the Internal Medicine department. Results: 314 patients participated, distributed in a study group (n = 160) and control group (n = 154). No differences in age (p = 0.491) and sex (p = 0.747). In the quality of life of DM patients between pre and post talk, in each group, without differences between groups in pre-talk (p = 0.869), but in post-talk (p = 0.001), with higher quality of life in the study group (98.2%) than in the control group (76.9%). When evaluating the changes between pre and post talk, it was observed that pre-talk in the study group had 86% of high quality of life, later it increased to 98.2%, statistical change (p = 0.008), in control group instead, Pre-chat quality of life was 87%, after 76.9%, it was still a significant change (p = 0.025) Quality of life in HTA, without differences in pre and post talk. The comparison between pre-talk and post-talk, in the study group, did not change (p = 0.157) as well as in the control group (p = 0.317). Conclusions: The positive impact of an educational plan on the quality of life of diabetic patients was demonstrated, but not in hypertensive patients(AU)

Estado de salud de primeros molares permanentes en adolescentes. Secundaria Básica Luis Pérez Lozano. Cienfuegos / First permanent molars´ health status in adolescents. Secondary School Luis Pérez Lozano. Cienfuegos

Introducción: el conocimiento del estado de salud bucal de la población escolar resulta una premisa indispensable para el desarrollo de una correcta planificación, organización y control de la atención estomatológica. Objetivo: determinar el estado de salud de los primeros molares permanentes en estudiantes de la Secundaria Básica “Luis Pérez Lozano”, del Área 7, Cienfuegos, de enero a diciembre de 2015. Materiales y Métodos: estudio observacional-descriptivo en un universo constituido por 197 niños de 7mo grado. El muestreo fue bietápico, combinando aleatorio, estratificado, proporcional y simple. Los datos se obtuvieron a través del examen bucal. Se tuvieron en cuenta las variables edad, sexo, estado de salud, y ubicación de los molares afectados. Resultados: el mayor porcentaje de primeros molares permanentes cariados correspondió al primer molar mandibular derecho e izquierdo para 11,9 % en el sexo masculino y el sexo femenino con primer molar permanente izquierdo para 11,6 %. Las obturaciones de los primeros molares mandibulares izquierdo predominó con un 16,6 % en el masculino y el mandibular derecho con un 13,9 % en las féminas. El mayor número de molares permanentes perdidos resultó en los inferiores, mandibular izquierdo en las niñas para 9,3 % y el molar mandibular derecho en los varones (7,1 %). Ambos sexos igualmente afectados con diferencia porcentual del 1%. El índice de Cluné obtuvo que los molares sanos para el sexo masculino representan 52,3 % y 53,4 % del femenino. Conclusiones: El estado de salud de los primeros molares permanentes en general se clasifica de regular pues existe un número considerable de afectados (AU).

Introduction: the knowledge of the school population´s oral health is a necessary premise for carrying out a correct planning, organization and control of the dental care. Objective: to determine the health status of the first permanent molars in students of the secondary school “Luis Pérez Lozano” of the health area 7, Cienfuegos, from January to December 2015. Materials and methods: an observational, descriptive study applied in a universe of 197 seventh-grade children. The sampling was two-staging, combining the randomized, stratified, proportional and simple sampling. The sample was obtained through the oral examination. The variables taken into account were age, sex, health status, and location of the affected molars. Results: the higher percentage of carious permanent first molars corresponded to the right and left mandibular first molar for 11,9 % in male sex and to the first left permanent molar in female sex with 11,6 %. The fillings of the first left mandibular molars predominated with 16,6 % in the male sex, and the right mandibular one in women with 13,9 %. The highest number of lost permanent molars was found among the lower ones, the left mandibular in girls (9,3 %) and the right mandibular in boys (7,1 %). Both sexes were equally affected, with a 1 % percent difference. The Clune’s index showed that healthy molars are 52,3 % for the male sex and 53,4 % for the female sex. Conclusions: in general, the first permanent molars´ health status is classified as regular because there is a substantial number of carious ones (AU).