ABSTRACT
OBJECTIVES: The aims of this study were to determine the incidence of allergy to cow's milk protein in infants and the cost of treatment with hydrolyzed formulae in the Autonomous Community of Madrid. PATIENTS AND METHODS: Infants with suspected adverse reaction to cow's milk protein born between March 1, 2000 and February 28, 2001 within the catchment area covered by the pediatric services of Hospital La Paz were studied. The diagnostic algorithm of allergy to cow's milk protein of our department was used. The theoretical consumption of hydrolyzed formulae in the treatment of allergic infants was calculated and extrapolated to the Community of Madrid. RESULTS: There were 5367 live births in the above-mentioned catchment area. Adverse reaction to cow's milk protein was suspected in 185 infants. Allergy to cow's milk protein was confirmed in 101 (54 %). The incidence of allergy to cow's milk protein was 101/5356 (1.9 %). In the same period there were 57 078 live births in the Autonomous Community of Madrid. The number of infants that might be allergic in one year would be 1084. The cost of hydrolyzed formulae per infant and year would be 1,585.72 Euros. Thus, the cost of hydrolyzed formulae in the 1084 allergic infants would be 1,718,922.9 Euros; in the 923 in whom allergy was ruled out, the cost would be 1,463,621.8 Euros. CONCLUSIONS: The incidence of allergy to cow's milk protein in the first year of life is at least 1.9 %. The correct diagnosis allows us to rule out allergy to cow's milk protein in almost half of the cases, thus avoiding the use of unnecessary substitutive diets involving a high cost.
Subject(s)
Milk Hypersensitivity/epidemiology , Algorithms , Humans , Incidence , Infant , Infant Food/statistics & numerical data , Milk Hypersensitivity/immunologyABSTRACT
Objetivos: Cálculo de la incidencia de alergia a proteínas de leche de vaca (APLV) en el lactante y coste del tratamiento con hidrolizados de leche de vaca en la comunidad de Madrid. Pacientes y métodos Lactantes con sospecha de APLV nacidos entre el 1 de marzo de 2000 y el 28 de febrero de 2001 en el Hospital La Paz pertenecientes a las áreas que atiende el Hospital Infantil. Se les aplicó el algoritmo diagnóstico de APLV del servicio. Se realizó el cálculo teórico del consumo de hidrolizados utilizados en el tratamiento de los APLV y se extrapoló a la comunidad de Madrid. Resultados Nacidos vivos en el Hospital La Paz pertenecientes a las áreas citadas: 5.356 niños. Consultaron por sospecha fundada de APLV: 185 niños. Se diagnosticaron como alérgicos a PLV a 101 (54 per cent). La incidencia calculada de APLV fue de: 101/5.356: 1,9 per cent. Nacidos en la comunidad de Madrid en el mismo período: 57.078 niños. El número de posibles APLV en un año sería de 1.084. El cálculo aproximado de consumo de hidrolizados en el primer año de vida por niño, supone un coste de 1.585,72 3. El gasto de hidrolizados en los 1.084 alérgicos en la comunidad de Madrid sería de 1.718.922,9 3. El gasto de los 923 niños en los que se descartó alergia supondría 1.463.621,8 3.Conclusiones La incidencia de APLV en el primer año de vida en nuestro medio es de, al menos, 1,9 per cent. El diagnóstico correcto permite descartar APLV en casi la mitad de los casos, evitando someter al lactante a dietas innecesarias y que suponen un elevado coste (AU)
Subject(s)
Infant , Humans , Milk Hypersensitivity , Incidence , Algorithms , Infant FoodABSTRACT
BACKGROUND: The demonstration of specific IgE antibodies to egg supports the existence of allergy to this food, but a correct diagnosis can only be obtained after a challenge test. Several studies have assessed different cut-off points in the level of these antibodies as predictors of clinical reactivity. OBJECTIVE: Validation of the specific IgE antibodies measured by the CAP System Fluorescence enzyme immunoassay (FEIA) technique in the diagnosis of egg allergy in children under 2 years of age. METHODS: A prospective study of 81 children with suspected egg allergy was performed. Specific IgE antibodies was quantified for egg white, egg yolk, ovoalbumin and ovomucoid. The diagnostic challenge test was carried out following the previously established criteria. The validity of the specific IgE antibodies was analysed using children with a negative diagnostic challenge test as control group. RESULTS: The prevalence of egg allergy in the group studied was 79% and egg white was the allergen that showed the greatest diagnostic efficacy. The sensitivity and positive predictive value of the prick test and of the CAP to egg white were excellent and the specificity and the negative predictive value had lower values. A level of > or = 0.35 KU(A)/L for specific IgE antibodies to egg white predicted the existence of reaction in 94% of the cases. CONCLUSIONS: Quantification of the specific IgE antibodies to egg white is useful in the diagnosis of egg allergy. In children under 2 years of age with a background of immediate hypersensitivity after egg ingestion and presence of specific IgE antibodies to egg white of > or = 0.35 KU(A)/L, diagnostic challenge test is not necessary to establish the diagnosis of allergy to this food.
Subject(s)
Antibody Specificity/immunology , Egg Hypersensitivity/etiology , Egg White/adverse effects , Immunoglobulin E/immunology , Child Welfare , Child, Preschool , Egg Hypersensitivity/diagnosis , Female , Humans , Hypersensitivity, Immediate/diagnosis , Hypersensitivity, Immediate/etiology , Immunoglobulin E/blood , Infant , Infant Welfare , Male , Predictive Value of Tests , Prospective Studies , ROC Curve , Reproducibility of Results , Sensitivity and Specificity , Skin TestsABSTRACT
Fundamentos: no hay estudios que evalúen la utilidad del sildenafilo (Viagra®) en Atención Primaria.Objetivos: valorar la efectividad del sildenafilo en hombres con disfunción eréctil (DE) mediante un cuestionario y una pregunta de eficacia global, así como el grado de satisfacción de su pareja.Diseño: estudio de intervención antes-después no aleatorio.Emplazamiento: centro de salud urbano.Pacientes: varones * 18 años con DE * 6 me ses de evolución.Métodos: se recogieron variables sociode mográficas, las patologías asociadas, el grado de DE -mediante la administración pre y postratamiento del campo función eréctil del Índice Internacional de Función Eréctil (IIEF) más una pregunta de eficacia global postratamiento- y una pregunta pre y postratamiento del grado de satisfacción de la pareja. Se utilizó el test de Wilcoxon para valorar la mejoría en la puntuación del cuestionario.Resultados: 45 varones aceptaron inicialmente participar en el estudio con una edad media de 56,8 (IC 95 por ciento: 32,6-81) años, 11 con DE leve, 21 moderada y 13 grave. Doce sujetos rechazaron posteriormente realizar el tratamiento; 5 de ellos por miedo a secundarismos. Los 33 sujetos que lo completaron presentaron un IIEF inicial con valor medio de 12,73 puntos (IC 95 por ciento: 11,22-14,24) y el IIEF final de 24 (IC 95 por ciento: 21,47-26,53), siendo esta mejoría estadísticamente significativa (p<0,0001) y 28 mejoraron subjetivamente. Tres pacientes presentaron cefalea y dos rubefacción facial. De las 23 parejas (mujeres) que participaron, 20 refirieron aumento del grado de satisfacción.Conclusiones: el sildenafilo ha demostrado ser efectivo en la población de estudio en concordancia con otros trabajos a pesar de las limitaciones del diseño y del tamaño muestral (AU)
Subject(s)
Male , Humans , Erectile Dysfunction/drug therapy , Vasodilator Agents/therapeutic use , Piperazines , Clinical TrialSubject(s)
Cardiac Tamponade/diagnosis , Cardiac Tamponade/etiology , Precursor Cell Lymphoblastic Leukemia-Lymphoma/complications , Adult , Cardiac Tamponade/diagnostic imaging , Echocardiography , Electrocardiography , Female , Humans , Precursor Cell Lymphoblastic Leukemia-Lymphoma/diagnosis , Primary Health CareABSTRACT
Tonometric and tonographic techniques were evaluated in the normal pony and compared to other species. Applanation tonometry was utilised to calculate the ocular ridigity of the normal equine eye. The mean intraocular pressure for the pony eye was established as 23.5 mm Hg (sd +/- 4.5). Comparing the non-anaesthetised and anaesthetised pony eye (xylazine-ketamine and glycerol guaiacolate) no significant change in intraocular pressure occurred (P < 0.49). Mean aqueous outflow facility was 0.88 microliter/min/mm Hg (sd +/- 0.65) which is significantly higher (P < 0.01) than the canine and human species. The ocular rigidity values for the pony eye were higher which indicates that the eye is more rigid than either the canine or human eye.
