Real life study of the use of omalizumab for pediatric patients with multiple food allergies

Background Multiple food allergies (MFAs) affect 30% of the child population with food allergy. The current treatment is the exclusion diet, which frequently affects the quality of life for these patients. The objective of the study was to describe the effect of omalizumab treatment in children diagnosed with MFAs who experienced frequent anaphylactic reactions and the impact on their quality of life. Material and methods A descriptive observational study. Patients with severe food restrictions and high-risk due to multiple episodes of anaphylaxis were included. The allergy was confirmed by compatible clinical, skin tests, positive specific IgE and oral food challenges (OFCs). Omalizumab treatment was initiated and the impact on the life quality of patients and their families was assessed using the validated Food Allergy Quality of Life Questionnaire-Parent Form. Results Five patients with an average age at diagnosis of 3.58 years (range between 1.5–7.9 years), were diagnosed with MFAs. All patients presented with anaphylaxis. All patients were treated with omalizumab between 2013 and 2019. Omalizumab treatment was initiated at a mean age of 6.05 years (range between 4.5–8.25 years). All patients have undergone OFC to reintroduce food successfully. 2 patients had their dose of omalizumab reduced by half, and 1 patient has had the time interval extended between administrations due to the maintenance of food tolerance. No immediate local or systemic adverse reactions were documented. Two patients have commenced omalizumab administration at home without incident. Conclusions Children with MFAs who are treated with omalizumab do not show reactions in response to most of the foods to which they previously had anaphylaxis. Consequently, these patients were able to significantly expand the variety of their diet, improving the life quality and avoid anaphylaxis following the inadvertent intake of these foods (AU)

Real life study of the use of omalizumab for pediatric patients with multiple food allergies.

BACKGROUND: Multiple food allergies (MFAs) affect 30% of the child population with food allergy. The current treatment is the exclusion diet, which frequently affects the quality of life for these patients. The objective of the study was to describe the effect of omalizumab treatment in children diagnosed with MFAs who experienced frequent anaphylactic reactions and the impact on their quality of life. MATERIAL AND METHODS: A descriptive observational study. Patients with severe food restrictions and high-risk due to multiple episodes of anaphylaxis were included. The allergy was confirmed by compatible clinical, skin tests, positive specific IgE and oral food challenges (OFCs). Omalizumab treatment was initiated and the impact on the life quality of patients and their families was assessed using the validated Food Allergy Quality of Life Questionnaire-Parent Form. RESULTS: Five patients with an average age at diagnosis of 3.58 years (range between 1.5-7.9 years), were diagnosed with MFAs. All patients presented with anaphylaxis. All patients were treated with omalizumab between 2013 and 2019. Omalizumab treatment was initiated at a mean age of 6.05 years (range between 4.5-8.25 years). All patients have undergone OFC to reintroduce food successfully. 2 patients had their dose of omalizumab reduced by half, and 1 patient has had the time interval extended between administrations due to the maintenance of food tolerance. No immediate local or systemic adverse reactions were documented. Two patients have commenced omalizumab administration at home without incident. CONCLUSIONS: Children with MFAs who are treated with omalizumab do not show reactions in response to most of the foods to which they previously had anaphylaxis. Consequently, these patients were able to significantly expand the variety of their diet, improving the life quality and avoid anaphylaxis following the inadvertent intake of these foods.

Agresiones sufridas por las personas que trabajan en atención primaria de la Comunidad de Madrid, 2011-2012 / Aggressions towards primary health care workers in MAdrid, Spain, 2011-2012

Fundamentos: Las agresiones de usuarios a los profesionales de Atención Primaria se han incrementado en los últimos años. No existen estudios previos en atención primaria que abarquen toda una Comunidad Autónoma y todas las categorías profesionales. El objetivo del estudio fue caracterizar la violencia en atención primaria de la Comunidad de Madrid. Métodos: Estudio descriptivo multicéntrico de las notificaciones de agresiones sufridas por los profesionales de Atención Primaria de la Comunidad de Madrid. Las variables del estudio incluyeron características sociodemográficas de las personas agresoras y de las agredidas, el tipo de agresión, sus causas y consecuencias. Se calcularon la mediana, el rango intercuartílico y las frecuencias. Se realizó un análisis de regresión logística calculando las OR y sus IC95%. Resultados: En el periodo de estudio se notificaron 1.157 agresiones, el 53,07% las notificaron médicos. En el 4,7% de los casos hubo agresión física. El principal motivo fue la disconformidad con la atención recibida (36,1%). El personal no sanitario mostró menos riesgo de ser agredido físicamente que el personal sanitario (OR: 0,38; IC95%: 0,17-0,86). La agresión fue cometida por un hombre en el 56,8% de los casos y del grupo de edad entre 31-40 años en el 26,8%. La persona agredida fue mujer en el 84% de los casos, con una edad comprendida entre 45-60 años. El 10% de los profesionales notificaron las agresiones y el 5,9% la denunció. Conclusiones: El riesgo de sufrir agresión es mayor en el personal sanitario, especialmente médicos. Tanto en el perfil de las personas agresoras como de las agredidas se detectaron diferencias significativas por sexo y edad (AU)

Background: The number of aggressions towards health care professionals has risen over the past few years. There are no previous studies in primary care covering an entire region and to all professional categories. The aim of this study was to characterize aggressions in Primary Care in the Community of Madrid. Methods: Multicenter cross-sectional study. Analysis of a Registration System that reports any type of aggression suffered by Primary Care workers, in the Community of Madrid. The study variables included sociodemographic characteristics of the aggressor and the victim, the type of aggression (verbal or physical abuse), its causes and consequences. We described median, intercuartilic range and frequencies. Logistic regression was performed calculating odds ratio and their 95% confidence intervals. Results: 1,157 assaults were reported, 53.07% suffered by doctors. Physical assault occurred in 4.7% of the cases. The main reason was dissatisfaction with the care (36.1%). The non-medical staff showed less risk of being physically assaulted (OR: 0.38; CI95%: 0.17-0.86). The perpetrator profile is male (56.8%), aged between 31-40 (26.8%) years. Health care victim profile was female (84%), aged between 45-60 years. 10% of professionals reported some form of aggression, 5,9% of aggression were submitted to court. Conclusions. The risk of assault is higher in health personnel, particularly physicians. There are significant differences by gender and age, both in the profile of the aggressor and the victim (AU)

Resultados de un programa de cirugía mayor ambulatoria en ginecología / Results of an ambulatory surgery program in gynecology

Objetivo: Evaluar los resultados de un programa de cirugía mayor ambulatoria (CMA) en ginecología. Material y métodos: Estudio retrospectivo del período 2002-2006. Las intervenciones incluidas fueron histeroscopias quirúrgicas y esterilizaciones tubáricas laparoscópicas. Se han analizado diversos indicadores de calidad (índice de sustitución, suspensión, ingresos, reingresos) y las complicaciones sistémicas y quirúrgicas que surgieron dentro de la primera semana tras la cirugía. Resultados: Mil doscientos catorce pacientes fueron intervenidos por el Servicio de Ginecología en el período indicado, con un índice de sustitución global del 90%. El índice de ingresos tras la cirugía fue 1,15%. Diez pacientes presentaron complicaciones graves, lo que representa un riesgo proporcional de 1:121. En 35 pacientes aparecieron complicaciones de menor gravedad que requirieron su ingreso hospitalario. Las complicaciones ginecológicas graves ocurrieron en 2 casos. Conclusiones: A pesar del cumplimiento de los requisitos óptimos, existe un porcentaje pequeño de complicaciones postoperatorias de gravedad variable (AU)

Objective: To evaluate the outcomes of an ambulatory surgery program in gynecological diseases. Material and methods: We performed a retrospective study of patients who underwent surgical hysteroscopy or laparoscopic tubal sterilization from January 2002 to December 2006. Several quality indicators (substitution, cancellation, admission and readmission rates) and the systemic and surgical complications appearing in the first week after surgery were analyzed. Results: During the study period, 1,214 patients underwent surgery in the gynecology service, with a global substitution rate of 90%. The admission rate after surgery was 1.15%. Severe complications occurred in 10 patients, representing a proportional risk of 1:121. Less severe complications requiring hospital admission occurred in 35 patients. Severe gynecological complications occurred in 2 patients. Conclusions: Despite compliance with optimal requirements, there was a low rate of postoperative complications of variable severity (AU)