ABSTRACT
INTRODUCTION AND AIMS: The prevalence of cow's milk protein allergy in the first year of life varies from 1.8 to 7.5%. The Cow's Milk-related Symptom Score (CoMiSS) was published in 2014 and facilitates the diagnosis of cow's milk protein allergy. It is not meant to replace the clinical diagnosis, but rather to guide the treating team in the diagnostic process and reduce unnecessary diets. The aim was to translate the CoMiSS from English to Spanish and culturally adapt and validate the resulting Spanish version. MATERIALS AND METHODS: An adaptation and validation study on the CoMiSS questionnaire was carried out in two phases: First, the CoMiSS was translated from English to Spanish, after which interrater reliability of the translated score was assessed. Second, interrater reliability tests were carried out on 32 pediatric patients under 7 years of age that were treated for the first time at the Food Allergy Clinic of the Hospital Italiano de Buenos Aires, were suspected of having cow's milk protein allergy, and had not received any treatment, within the time frame of May 2018 and May 2019. RESULTS: Thirty-two patients were evaluated, 14 of whom were females (45%), and the median patient age was 3 months (IQR 2-4). The median result of the first measurement of the scale was 7.0 (IQR 4.5-9.0) and the median of the second measurement was 5.0 (IQR 4.0-8.0). The final intraclass correlation coefficient was 0.80 (95% CI 0.63-0.9). CONCLUSION: The Spanish translation of the CoMiSS was comparable to the original English version, with excellent interrater reliability. This simple and little-known tool has the benefit of being a noninvasive, rapid, reliable, and easy-to-use strategy.
Subject(s)
Milk Hypersensitivity , Milk , Animals , Female , Cattle , Humans , Male , Milk Hypersensitivity/diagnosis , Milk Hypersensitivity/therapy , Reproducibility of Results , PrevalenceABSTRACT
Antecedentes. A pesar de la frecuencia de la urticaria aguda (UA), no existen estudios epidemiológicos sobre su prevalencia y distribución en Argentina. Objetivo. Determinar la prevalencia y otras características epidemiológicas de la UA en los miembros de una organización privada de salud de Buenos Aires, la mayor área poblada de Argentina. Marco de referencia: Hospital Italiano (HIBA) de la Ciudad de Buenos Aires, Argentina. Diseño: Cohorte retrospectivo. Población. Pacientes con diagnóstico de UA miembros del HIBA, y con al menos 12 meses de seguimiento. Métodos. Se analizaron todos los registros médicos para calcular las tasas de prevalencia de UA por 100.000 habitantes con intervalo de confianza del 95% (IC95%) para el período comprendido entre el 1 de enero de 2013 y el 31 de diciembre de 2014. La tasa de prevalencia se calculó para toda la población y luego se discrimino para pacientes adultos y pediátricos (menores de 18 años en el momento del diagnóstico). Resultados. Se analizaron 158.926 miembros de la prepaga. Se identificó un total de 2100 casos de UA en el período analizado (1151 en pediatría, 949 en adultos), con una tasa de prevalencia de 1,32% (IC95%: 1,11-1,55%). La prevalencia de UA en la población adulta fue de 0,83% (IC95%: 0,64-0,97%), mientras que en la población pediátrica fue del 2,5% (IC95%: 1,9-2,8%). Conclusiones: este es el primer estudio que describe la prevalencia de UA en una población cerrada de Argentina y de la región.(AU)
Background. In spite of the frequency of acute urticaria (AU), there are no epidemiological studies on its prevalence and distribution in Argentina. Objetive. Was to estimate the prevalence and other epidemiological characteristics of AU in the members of a health maintenance organization of Buenos Aires, the largest populated area in Argentina. Setting: Italian Hospital, Buenos Aires, Argentina. Design. Retrospective cohort. Population. All patients with diagnosis of AU who are members of the IHMCP, and with at least 12 months of follow up were included in the study. Methods. All medical records were analyzed to calculate the prevalence rates for AU per 100,000 population with 95% CI for the period of January 1, 2013 and December 31, 2014. Prevalence rate was calculated for the entire population and then discriminated for adults and pediatric members (less than 18 years old at diagnosis). Results. 158,926 members were analyzed. A total of 2100 cases of AU were identified on prevalence period (1151 in pediatrics, 949 in adults), yielding a prevalence rate of 1.32% (CI 95% 1.11-1.55%). The prevalence of AU in adult population observed was 0.83 % (95% CI 0.64-0.97%), while in pediatrics it was 2.5 % (95% CI 1.9-2.8%). Conclusions. This is the first study to describe the prevalence of AU in a closed population of Argentina and the region(AU)
Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Aged , Urticaria/epidemiology , Health Maintenance Organizations , Argentina , Allergens , AngioedemaABSTRACT
Introducción. la alergia a la leche de vaca (aplv) es un problema sanitario global. Su diagnóstico adecuado y su seguimiento son esenciales ya que la leche de vaca es un alimento importante en la dieta de muchos lactantes. los desafíos orales doble ciego controlados por placebo (ddcpc) son la herramienta ideal para el diagnóstico y seguimiento de las alergias alimentarias. este estudio describe las características evolutivas de pacientes con aplv y las posibles variables que la pudieran modificar. material y métodos. Se estudiaron pacientes con diagnóstico de aplv previo con desafíos abiertos. Se catalogaron las reacciones de acuerdo a la normativa dracma. positivas fueron las pruebas en las que se presentaron alteraciones clínicas o variaciones hemodinámicas. negativas fueron aquellas en las que el paciente toleró la leche. Se consideraron edades de inicio y de realización del ddcpc, sexo y patología de aplv. resultados. Se estudiaron 106 pacientes (50 masculinos, 56 femeninos), promedio edad de inicio de síntomas 5,31 m (rango: 1-48 meses) y al procedimiento 23,14 m (5 meses - 5 años), y 13 pruebas positivas. un conjunto se refirió al mecanismo fisiopatológico y se dividió en ige mediadas (n=55) con 8 pruebas positivas y mixtas/celulares (n=51) con 5 pruebas positivas. otro conjunto fueron no gastrointestinales (n=61) con 7 pruebas positivas y gastrointestinales (n=45) con 6 pruebas positivas. todos los grupos fueron similares en cuanto a las variables demográficas. el sexo masculino y el diagnóstico de anafilaxia fueron factores de riesgo para no resolver su aplv (p=0,0125 y p=0,002 respectivamente). conclusiones. el momento de resolución de la aplv es independiente del mecanismo fisiopatológico subyacente o la edad de inicio de los síntomas. en general resuelven el problema de manera espontánea hacia los dos años de vida en más de un 87% de los casos. el sexo masculino (en ige mediadas) y el antecedente de anafilaxia podrían ser factores de riesgo para tener menos probabilidades de resolver la APLV. (AU)
Introduction: cow´s milk allergy (cma) is a global health issue. a proper diagnosis and follow up become essential. double blind placebo controlled challenges (dbpcc) is the gold standard for this purpose. this paper describes clinical evolution and characteristics of cma, as well as variables that may modify the affection course. methods & material: a group of patients, with a previous diagnosis of cma by open challenges, has been studied and its results cataloged according to dracma guidelines. tests with hemodynamic changes or clinical symptoms were considered as positives, while those with no clinical reaction were considered as negatives. variables involved were: age of symptoms starting, age of dbpcc performing, gender and cma clinical manifestations. results: 106 patients has been studied (50 male, 56 female), with a median age of 5,31 mo (range 5 48 mo) at the starting symptoms, and a median age of 23,14 mo (range 5 mo 5 y) at the performing of dbpcc. 13 tests were negative. as regards to the different immune mechanisms, 55 were ige dependent (8 negative), and 51 were mediated by mixed/cellular (5 negative). patients were divided into two groups: with gastrointestinal symptoms (n=45) and with no gastrointestinal symptoms (n=61). they showed 6 and 7 negative results, respectively. all groups were similar. male gender, and anaphylaxis diagnosis turned out to be risk factors not to resolve cma (p=0,0125 and p=0,002 respectively). conclusions: cma resolution is independent of the immune mechanisms involved or the age of its symptoms starting. cma is solved spontaneously towards the age of two in 87% of the cases. male gender, and anaphylaxis may become risk factors not to resolve cma.(AU)
