Increasing Incidence of Pediatric Eosinophilic Esophagitis in the Southwest of Madrid, Spain.

OBJECTIVES: The incidence of eosinophilic esophagitis is unknown in our area. The aim of our study was to determine the incidence of eosinophilic esophagitis and its possible association with the most frequent absolute annual pollen counts. METHODS: A descriptive retrospective multicenter observational study was designed to calculate the incidence of eosinophilic esophagitis in children aged under 15 years in the southwest region of Madrid, Spain in 2002-2013 (data were provided by the Statistics Institute of Madrid). We collected data on age, sex, clinical presentation, and date of endoscopic diagnosis. Relative risk (RR) was estimated (Stata v.11) using negative binomial regression models to assess the association between incidence and pollen counts (provided by Subiza Clinic). RESULTS: The study population comprised 254 patients (192 male [75.6%], aged 0.5-14.99 years). The clinical presentation was esophageal impaction in 23.6%, dysphagia in 22%, gastroesophageal reflux-like symptoms in 44.9%, and other findings in 9.4%. The annual incidence from 2002 to 2013 per 100 000 children aged <15 years per year was, respectively, 0.81, 1.5, 0.37, 3.17, 3.07, 4.36, 6.87, 7.19, 8.38, 9.05, 9.14, and 9.68. The incidence of eosinophilic esophagitis increased by an average of 19% annually (RR, 1.19; 95%CI, 1.14-1.25; P<.001). In the overall analysis, the relationship between incidence and absolute annual and monthly counts during the pollen seasons of the respective pollen types was analyzed only for Platanus species, which had an RR >1 (1.17 and 1.06, respectively) (P<.05). CONCLUSION: The incidence of diagnosis of pediatric eosinophilic esophagitis increased by an average of 19% annually. No significant association was found between incidence and pollen counts, except for a weak association with Platanus species.

Increasing incidence of pediatric eosinophilic esophagitis in the Southwest of Madrid, Spain

Objectives: The incidence of eosinophilic esophagitis is unknown in our area. The aim of our study was to determine the incidence of eosinophilic esophagitis and its possible association with the most frequent absolute annual pollen counts. Methods: A descriptive retrospective multicenter observational study was designed to calculate the incidence of eosinophilic esophagitis in children aged under 15 years in the southwest region of Madrid, Spain in 2002-2013 (data were provided by the Statistics Institute of Madrid). We collected data on age, sex, clinical presentation, and date of endoscopic diagnosis. Relative risk (RR) was estimated (Stata v.11) using negative binomial regression models to assess the association between incidence and pollen counts (provided by Subiza Clinic). Results: The study population comprised 254 patients (192 male [75.6%], aged 0.5-14.99 years). The clinical presentation was esophageal impaction in 23.6%, dysphagia in 22%, gastroesophageal reflux-like symptoms in 44.9%, and other findings in 9.4%. The annual incidence from 2002 to 2013 per 100 000 children aged <15 years per year was, respectively, 0.81, 1.5, 0.37, 3.17, 3.07, 4.36, 6.87, 7.19, 8.38, 9.05, 9.14, and 9.68. The incidence of eosinophilic esophagitis increased by an average of 19% annually (RR, 1.19; 95%CI, 1.14-1.25; P<.001). In the overall analysis, the relationship between incidence and absolute annual and monthly counts during the pollen seasons of the respective pollen types was analyzed only for Platanus species, which had an RR >1 (1.17 and 1.06, respectively) (P<.05). Conclusion: The incidence of diagnosis of pediatric eosinophilic esophagitis increased by an average of 19% annually. No significant association was found between incidence and pollen counts, except for a weak association with Platanus species

Objetivo: La incidencia de esofagitis eosinofílica es desconocida en nuestra área. El objetivo de nuestro estudio es determinar la incidencia de diagnóstico de esofagitis eosinofílica y su posible asociación con los recuentos absolutos anuales de los pólenes más frecuentes. Métodos: Se diseñó un estudio descriptivo multicéntrico retrospectivo para el cálculo de la incidencia de esofagitis eosinofílica en niños menores de 15 años en el suroeste de la Comunidad de Madrid entre 2002-2013 (datos poblacionales obtenidos del Instituto de Estadística de la Comunidad de Madrid). Se recoge de cada paciente: edad, sexo, presentación clínica y fecha de diagnóstico endoscópico. Se estimó la asociación entre la incidencia y los recuentos polínicos (aportados por la Clínica Subiza) mediante cálculo del riesgo relativo usando modelos de regresión binomial negativa (Stata v.11).Resultados: Se incluyeron 254 pacientes, 75,6% varones (n=192), de edades comprendidas entre 0,5-14,99 años. La presentación clínica fue: impactación esofágica 23,6%, disfagia 22%, síntomas sugerentes de reflujo gastroesofágico 44,9% y otros 9,4%. Las incidencias anuales desde 2002 a 2013 (nº casos/100.000 niños menores de 15 años/año) fueron respectivamente: 0,81; 1,5; 0,37; 3,17; 3,07; 4,36; 6,87; 7,19; 8,38; 9,05; 9,14 y 9,68. La incidencia de esofagitis eosinofílica se incrementó en una media anual de 19% (RR 1,19, 95% IC: 1,14-1,25, p <0,001). En nuestro estudio únicamente existió asociación (RR>1) entre la incidencia y los recuentos polínicos absolutos de Platanus spp anuales y durante los meses de máxima polinización (1,17 and 1,06, respectivamente) (p <0,05).Conclusión: La incidencia de diagnóstico de esofagitis eosinofílica en la edad pediátrica se ha incrementado en una media anual de un 19%. No se encontró una asociación estadísticamente significativa entre la incidencia y los recuentos polínicos, excepto con el Platanus spp aunque ésta fue débil

[Allergenic pollens in Spain]. / Pólenes alergénicos en España.

Allergenic pollens that cause rhinoconjuctivitis and/or asthma are those from trees or plants that pollinate through the air (anemophilic pollination) and not through insects (entomophilic pollination). Although pollen grains would seem to be too large to easily reach the intrapulmonary airways, the relationship between pollen counts and the presence of asthmatic symptoms is only too evident. This is probably because the allergens inducing seasonal asthma are not only found within pollen grains but also outside the grains in particles of less than 10 mm that are freely found in the atmosphere. The most important pollens producing pollinosis in Spain are those from cypress trees from January-March, birch trees in April (macizo galaico), Platanus hispanica (March-April), grasses and olive trees from April-June, Parietaria from April-July and Chenopodium and/or Salsola from July-September. By geographical areas, the main cause of pollinosis are grasses in the center and north of the peninsula, olive trees in the south (Jaén, Sevilla, Granada, Córdoba) and Parietaria in the Mediterranean coast (Barcelona, Murcia, Valencia).

Pólenes alergénicos en España / Allergenic pollens in Spain

Los alergenos de los pólenes que desencadenan rinoconjuntivitis y/o asma, corresponden a los procedentes de los árboles y plantas que polinizan a través del aire (polinización anemófila) y no a través de los insectos (polinización entomófila). A pesar de que el tamaño de los granos de polen es aparentemente muy grande como para poder alcanzar con facilidad las vías aéreas intrapulmonares, la relación existente entre las concentraciones de pólenes y la presencia de síntomas de asma es mas que evidente. Esto es probablemente debido a que los alergenos inductores de asma estacional no sólo se encuentran dentro de los granos de polen, si no también fuera de los mismos en partículas inferiores a 10 m que se encuentran libres en la atmósfera. Los pólenes mas importantes productores de polinosis en España son los procedentes de los cipreses en enero-marzo, el abedul en abril (macizo galaico), Platanus hispanica (marzo-abril), las gramíneas y olivo en abril-junio, la Parietaria de abril-julio y el Chenopodium y/o Salsola de julio-septiembre. Por áreas geográficas la primera causa de polinosis son las gramíneas en el Centro y Norte de la península, el olivo en el Sur (Jaén, Sevilla, Granada, Córdoba) y la Parietaria en las regiones costeras mediterráneas (Barcelona, Murcia, Valencia) (AU)

Allergenic pollens that cause rhinoconjuctivitis and/or asthma are those from trees or plants that pollinate through the air (anemophilic pollination) and not through insects (entomophilic pollination). Although pollen grains would seem to be too large to easily reach the intrapulmonary airways, the relationship between pollen counts and the presence of asthmatic symptoms is only too evident. This is probably because the allergens inducing seasonal asthma are not only found within pollen grains but also outside the grains in particles of less than 10 m that are freely found in the atmosphere. The most important pollens producing pollinosis in Spain are those from cypress trees from JanuaryMarch, birch trees in April (macizo galaico), Platanus hispanica (March-April), grasses and olive trees from April-June, Parietaria from April-July and Chenopodium and/or Salsola from July-September. By geographical areas, the main cause of pollinosis are grasses in the center and north of the peninsula, olive trees in the south (Jaén, Sevilla, Granada, Córdoba) and Parietaria in the Mediterranean coast (Barcelona, Murcia, Valencia) (AU)

[Immunologic aspects of the macrophages in the milk of preterm mothers]. / Aspectos inmunológicos de los macrófagos de leche de madre pretérmino.

Number and function of milk macrophages from 25 healthy mothers delivering preterm (PHMMo) (mean gestational age 33 weeks) were compared with those obtained from 74 mothers with term delivery (THMMo). The average concentration of MMø in colostrum did not differ among both sources: 0.55 x 10(6)/ml (PHMMo) and 0.42 x 10(6)/ml (THMMo). The mean phagocytic index of PHMMo (3.35 yeasts/cell) and THMMo (3.40 yeasts/cell) was similar (p greater than 0.05); both cell types were significantly higher than control monocytes (CMo) (1.95 yeasts/cell) (p less than 0.001). The mean chemotactic function of PHMMo (11.58 cells/field) was significantly greater than THMMo (2.75 cells/field) (p less than 0.001). However, both milk cells showed lower chemotaxis than CMo (32.63 cells/field) (p less than 0.001).

[Immunological function of monocytes in pregnancy and the puerperium]. / Función inmunológica de los monocitos en embarazo y postparto.

Many immunological parameters are depressed during pregnancy. We have performed functional studies on monocytes from puerperal mothers and found a diminished phagocytic capacity. In contrast, chemotactic function of monocytes, but not of polymorphonuclear cells, from puerperal mothers and pregnant women, was enhanced. This could facilitate their migration to tissues and their presence in milk where they make up a large proportion of the cells and can play an important role in protecting newborns against infection.