Early focal electroencephalogram and neuroimaging findings predict epilepsy development after aneurysmal subarachnoid hemorrhage.

INTRODUCTION: Seizures are a common complication of subarachnoid hemorrhage (SAH) in both acute and late stages: 10-20 % acute symptomatic seizures, 12-25 % epilepsy rate at five years. Our aim was to identify early electroencephalogram (EEG) and computed tomography (CT) findings that could predict long-term epilepsy after SAH. MATERIAL AND METHODS: This is a multicenter, retrospective, longitudinal study of adult patients with aneurysmal SAH admitted to two tertiary care hospitals between January 2011 to December 2022. Routine 30-minute EEG recording was performed in all subjects during admission period. Exclusion criteria were the presence of prior structural brain lesions and/or known epilepsy. We documented the presence of SAH-related cortical involvement in brain CT and focal electrographic abnormalities (epileptiform and non-epileptiform). Post-SAH epilepsy was defined as the occurrence of remote unprovoked seizures ≥ 7 days from the bleeding. RESULTS: We included 278 patients with a median follow-up of 2.4 years. The mean age was 57 (+/-12) years, 188 (68 %) were female and 49 (17.6 %) developed epilepsy with a median latency of 174 days (IQR 49-479). Cortical brain lesions were present in 189 (68 %) and focal EEG abnormalities were detected in 158 patients (39 epileptiform discharges, 119 non-epileptiform abnormalities). The median delay to the first EEG recording was 6 days (IQR 2-12). Multiple Cox regression analysis showed higher risk of long-term epilepsy in those patients with CT cortical involvement (HR 2.6 [1.3-5.2], p 0.009), EEG focal non-epileptiform abnormalities (HR 3.7 [1.6-8.2], p 0.002) and epileptiform discharges (HR 6.7 [2.8-15.8], p < 0.001). Concomitant use of anesthetics and/or antiseizure medication during EEG recording had no influence over its predictive capacity. ROC-curve analysis of the model showed good predictive capability at 5 years (AUC 0.80, 95 %CI 0.74-0.87). CONCLUSIONS: Focal electrographic abnormalities (both epileptiform and non-epileptiform abnormalities) and cortical involvement in neuroimaging predict the development of long-term epilepsy. In-patient EEG and CT findings could allow an early risk stratification and facilitate a personalized follow-up and management of SAH patients.

Evaluation of multimodal intraoperative neurophysiologic monitoring during supratentorial aneurysm surgery: a comparative study.

The objective of this study is to determine the role of multimodal intraoperative neurophysiologic monitoring (IONM) in the overall outcome of intracranial aneurysms surgery, and the risk factors associated with ischemic complications. We grouped 268 ruptured and unruptured intracranial aneurysms surgically treated at our institution into 2 cohorts, based on the use of IONM (180; 67.16%) or non-use of IONM (88; 32.84%). The IONM technique used was multimodal: electroencephalogram (EEG), somatosensory evoked potentials (SSEPs), transcranial (TES), and direct cortical (DCS) stimulation motor evoked potentials (MEPs). There was a significant difference, with a reduction in perioperative strokes (p = 0.011) and better motor surgery-related outcome in the IONM group (p = 0.016). Independent risk factors identified for surgery ischemic complications were temporary clipping time ≥ 6'05″ (odds ratio [OR]: 3.03; 95% CI: 1.068-8.601; p = 0.037), aneurysm size ≥ 7.5 mm (OR: 2.65; 95% CI: 1.127-6.235; p = 0.026), and non-use of IONM (OR: 2.79; 95% CI: 1.171-6.636; p = 0.021). Conversely, aneurysm rupture was not detected as an independent risk factor (OR: 2.5; 95% CI: 0.55-4.55; p = 0.4). Longer temporary clipping time, larger aneurysm size, and the non-use of IONM could be considered as risk factors for ischemic complications during microsurgical clipping. A standardized designed protocol including multimodal IONM with DCS provides continuous information about blood supply and allows reduction of treatment-related morbidity. Multimodal IONM is a valuable technique in intracranial aneurysm surgery.

Integrated molecular signaling involving mitochondrial dysfunction and alteration of cell metabolism induced by tyrosine kinase inhibitors in cancer.

Cancer cells have unlimited replicative potential, insensitivity to growth-inhibitory signals, evasion of apoptosis, cellular stress, and sustained angiogenesis, invasiveness and metastatic potential. Cancer cells adequately adapt cell metabolism and integrate several intracellular and redox signaling to promote cell survival in an inflammatory and hypoxic microenvironment in order to maintain/expand tumor phenotype. The administration of tyrosine kinase inhibitor (TKI) constitutes the recommended therapeutic strategy in different malignancies at advanced stages. There are important interrelationships between cell stress, redox status, mitochondrial function, metabolism and cellular signaling pathways leading to cell survival/death. The induction of apoptosis and cell cycle arrest widely related to the antitumoral properties of TKIs result from tightly controlled events involving different cellular compartments and signaling pathways. The aim of the present review is to update the most relevant studies dealing with the impact of TKI treatment on cell function. The induction of endoplasmic reticulum (ER) stress and Ca2+ disturbances, leading to alteration of mitochondrial function, redox status and phosphatidylinositol 3-kinase (PI3K)-protein kinase B (Akt)-mammalian target of rapamycin (mTOR) and AMP-activated protein kinase (AMPK) signaling pathways that involve cell metabolism reprogramming in cancer cells will be covered. Emphasis will be given to studies that identify key components of the integrated molecular pattern including receptor tyrosine kinase (RTK) downstream signaling, cell death and mitochondria-related events that appear to be involved in the resistance of cancer cells to TKI treatments.

Desempeño de las funciones ejecutivas según estado cognitivo en adultos mayores / Performance of the executive functions according to cognitive state in elderly adults

Resumen Introducción: De acuerdo al envejecimiento que ha experimentado la población a causa de un aumento en la expectativa de vida y las repercusiones que ello ha conllevado a nivel cognitivo, se ha observado un aumento en el número de adultos mayores que presentan dificultades cognitivas. La presente investigación aborda el desempeño de las funciones ejecutivas según el estado cognitivo en adultos mayores de la ciudad de Puerto Montt. Método: Se realizó un estudio correlacional comparativo en una muestra de 34 adultos mayores entre 60 y 90 años de la ciudad de Puerto Montt. Se evaluó el nivel cognitivo de los participantes y el desempeño de las funciones ejecutivas, para luego estimar el nivel de correlación de ambas variables con la prueba de Pearson y se compararon los grupos con ANOVA. Resultados: El análisis de los datos da cuenta de una alta correlación entre el deterioro del estado cognitivo y el desempeño de las funciones ejecutivas igualmente disminuiría (valor de correlación = 0,636). Por otra parte, al comparar el grupo de adultos mayores sin deterioro cognitivo y el grupo con deterioro cognitivo leve, no se observaron diferencias significativas en ambos grupos (p > 0,05). Discusión: Los resultados indican que hay una correlación significativa entre el deterioro de las funciones ejecutivas y el deterioro cognitivo general, sin embargo, parece ser que el desempeño de las funciones ejecutivas permanece estable durante el estado cognitivo conservado como en el estado de deterioro cognitivo leve en el adulto mayor.

Introduction: According to the aging of the population due to an increase in life expectancy and the repercussions that this has led to a cognitive level, an increase in the number of older adults with cognitive difficulties has been observed. The present investigation approaches the performance of the executive functions according to the cognitive state in older adults of the city of Puerto Montt. Method: A comparative correlation study was carried out in a sample of 34 older adults between 60 and 90 years old from the city of Puerto Montt. The cognitive level of the participants and the performance of the executive functions were evaluated to then estimate the level of correlation of both variables with the Pearson test and the groups with ANOVA were compared. Results: The analysis of the data shows a high correlation between the deterioration of the cognitive state and the performance of the executive functions would also decrease (correlation value = 0.636). On the other hand, when comparing the group of older adults without cognitive impairment, and the group with mild cognitive impairment, no significant differences were observed in both groups (p > 0.05). Discussion: The results indicate that there is a significant correlation between the deterioration of the executive functions and the general cognitive deterioration, however it seems that the performance of the executive functions remains stable during the conserved cognitive state as in the state of mild cognitive deterioration in the adult higher.

Alergológica 2015: A National Survey on Allergic Diseases in the Spanish Pediatric Population.

BACKGROUND: Allergic diseases are highly prevalent in industrialized populations. In Spain, children suspected of having an allergic disease are usually referred by their primary care pediatrician to an allergy unit at a general hospital or a children's hospital. We report data from a subanalysis of the pediatric population in Alergológica 2015. METHODS: Data were collected from pediatric patients (age, ≤14 years) consulting an allergist for the first time in 2014 and the first quarter of 2015 in order to determine variations compared with data reported in Alergológica 2005. RESULTS: Alergológica 2015 included fewer pediatric patients than Alergológica 2005. The study population comprised 481 patients aged ≤14 years from more than 200 centers throughout Spain. Males accounted for 56.5%. Rhinoconjunctivitis was the main reason for consulting an allergist (53.8% vs 46.3% in 2005), followed by asthma (30.2% vs 34.6%), and food allergy (20.0% vs 14.5%). CONCLUSIONS: The findings of Alergológica 2015 show a notable increased frequency of allergic rhinitis, drug allergy, and food allergy. The frequency of other allergic conditions remained unchanged, except for asthma, whose frequency decreased, as in adult patients.

Alergológica 2015: A National Survey on Allergic Diseases in the Adult Spanish Population.

BACKGROUND AND OBJETIVE: The frequency of allergic diseases is increasing worldwide, particularly in industrialized countries. From a clinical, management, and public heath perspective, it is important to determine the reasons for consulting an allergist, the distribution by frequency of allergic diseases, and how health care is provided. Objective: Alergológica 2015 was carried out to obtain information on clinical practice in allergy departments in Spain, and compare it with the previous study editions. METHODS: The data cover the year 2014 and the first quarter of 2015. The target sample was 6000 patients seen at public and private centers throughout Spain. A total of 500 allergists were invited to participate. Data were collected on an electronic case report form. Data were compared with the Alergológica surveys for 1992 and 2005 to identify differences. RESULTS: The final study population comprised 2914 patients (mean age 33.6 [18.9] years, 58% women, 17% children), of whom 6.1% were foreign-born. The frequency distribution was as follows: rhinitis, 62%; asthma, 23.4%; drug allergy, 17.7%; urticaria/angioedema, 11.5%; food allergy, 10.4%; contact dermatitis, 4%; atopic dermatitis, 3%; insect venom allergy, 2%. A statistically significant increase was observed between data from 2005 and from 2015 with respect to the prevalence for allergic rhinitis, food allergy and drug hypersensitivity. An increase in the prevalence of a personal history of asthma, rhinitis, conjunctivitis, and eczema/atopic dermatitis were also observed. Besides, the number of relevant allergens in the same patient also increased. Most patients were referred from primary care, although a considerable percentage were referred by ENT specialists and dermatologists. CONCLUSIONS: Increasing trends were observed for allergic rhinitis, drug allergy, and food allergy, and a decreasing trend was observed for asthma. Findings for other diseases remained practically unchanged. Allergic patients are increasingly complex and present with a myriad of atopic manifestations.

Alergólogica 2015: a national survey on allergic diseases in the adult Spanish population

Background: The frequency of allergic diseases is increasing worldwide, particularly in industrialized countries. From a clinical, management, and public heath perspective, it is important to determine the reasons for consulting an allergist, the distribution by frequency of allergic diseases, and how health care is provided. Objective: Alergológica 2015 was carried out to obtain information on clinical practice in allergy departments in Spain, and compare it with the previous study editions. Methods: The data cover the year 2014 and the first quarter of 2015. The target sample was 6000 patients seen at public and private centers throughout Spain. A total of 500 allergists were invited to participate. Data were collected on an electronic case report form. Data were compared with the Alergológica surveys for 1992 and 2005 to identify differences. Results: The final study population comprised 2914 patients (mean age 33.6 [18.9] years, 58% women, 17% children), of whom 6.1% were foreign-born. The frequency distribution was as follows: rhinitis, 62%; asthma, 23.4%; drug allergy, 17.7%; urticaria/angioedema, 11.5%; food allergy, 10.4%; contact dermatitis, 4%; atopic dermatitis, 3%; insect venom allergy, 2%. A statistically significant increase was observed between data from 2005 and from 2015 with respect to the prevalence for allergic rhinitis, food allergy and drug hypersensitivity. An increase in the prevalence of a personal history of asthma, rhinitis, conjunctivitis, and eczema/atopic dermatitis were also observed. Besides, the number of relevant allergens in the same patient also increased. Most patients were referred from primary care, although a considerable percentage were referred by ENT specialists and dermatologists. Conclusions: Increasing trends were observed for allergic rhinitis, drug allergy, and food allergy, and a decreasing trend was observed for asthma. Findings for other diseases remained practically unchanged. Allergic patients are increasingly complex and present with a myriad of atopic manifestations

Antecedentes: La frecuencia de las enfermedades alérgicas está aumentando globalmente, particularmente en los países industrializados. Desde una perspectiva clínica, de gestión y de salud pública, es importante determinar los motivos de consulta al alergólogo, la distribución de la frecuencia de las enfermedades alérgicas y cómo se presta la atención sanitaria. Objetivo: Alergológica 2015 se realizó para obtener información de la práctica clínica en los servicios de alergia españoles y comparar sus resultados con los de las ediciones previas del estudio. Métodos: Los datos cubren el año 2014 y el primer trimestre de 2015. La muestra diana fue de 6.000 pacientes atendidos en los centros públicos y privados de toda España. Se invitó a participar a un total de 500 alergólogos. Los datos se recogieron en un formulario electrónico. Se compararon los datos con lo de los estudios de los años 1992 y 2005 para identificar diferencias. Resultados: La población final del estudio comprendió 2.914 pacientes (edad media 33,6 [18,9] años), 58% de mujeres, 17% niños) de los cuáles el 6,1% fueron extranjeros. La distribución por frecuencia fue: rinitis en el 62% de los sujetos; asma 23,4%; alergia a fármacos 17,7%; urticaria/angioedema 11,5%; alergia alimentaria 10,4%; dermatitis de contacto 4%; dermatitis atópica 3%; alergia al veneno de insectos 2%. Comparativamente con los resultados obtenidos en Alergológica 2005 se observó un aumento estadísticamente significativo con respecto a la prevalencia de rinitis alérgica, alergia a los alimentos e hipersensibilidad a los medicamentos. También se observó un aumento en la prevalencia de antecedentes personales de asma, rinitis, conjuntivitis y eccema / dermatitis atópica. Además, el número de alérgenos relevantes en el mismo paciente también aumentó La mayoría de los pacientes fueron remitidos desde atención primaria, si bien un porcentaje considerable lo hizo por el especialista ORL y dermatología. Conclusiones: Se observaron tendencias al alza para rinitis alérgica, alergia a fármacos y alergia a los alimentos y una tendencia a la baja para el asma. Los hallazgos para otras enfermedades alérgicas quedaron prácticamente iguales. Los pacientes alérgicos son cada vez más complejos y presentan una diversidad de manifestaciones atópicas

Alergólogica 2015: a national survey on allergic diseases in the Spanish pediatric population

Background: Allergic diseases are highly prevalent in industrialized populations. In Spain, children suspected of having an allergic disease are usually referred by their primary care pediatrician to an allergy unit at a general hospital or a children’s hospital. We report data from a subanalysis of the pediatric population in Alergológica 2015. Methods: Data were collected from pediatric patients (age, ≤14 years) consulting an allergist for the first time in 2014 and the first quarter of 2015 in order to determine variations compared with data reported in Alergólogica 2005. Results: Alergológica 2015 included fewer pediatric patients than Alergológica 2005. The study population comprised 481 patients aged ≤14 years from more than 200 centers throughout Spain. Males accounted for 56.5%. Rhinoconjunctivitis was the main reason for consulting an allergist (53.8% vs 46.3% in 2005), followed by asthma (30.2% vs 34.6%), and food allergy (20.0% vs 14.5%). Conclusions: The findings of Alergológica 2015 show a notable increased frequency of allergic rhinitis, drug allergy, and food allergy. The frequency of other allergic conditions remained unchanged, except for asthma, whose frequency decreased, as in adult patients

Antecedentes: Las enfermedades alérgicas son muy prevalentes en las poblaciones industrializadas. En España, los niños con sospecha de enfermedad alérgica son habitualmente derivados por su médico de atención primaria a una unidad de alergia de un hospital general o de un hospital infantil. Se notifican los datos del subanálisis de la población pediátrica de Alergológica 2015. Métodos: Se recogieron los datos de los pacientes pediátricos (edad ≤ 14 años) que acudieron al alergólogo por primera vez en 2014 y el primer trimestre de 2015 con el objetivo de determinar las variaciones con respecto a los datos de Alergológica 2005. Resultados: Alergológica 2015 incluyó menos pacientes pediátricos que Alergológica 2005. La población estudiada comprendía 481 pacientes de edad ≤14 años, de más de 200 centros españoles. Los varones representaron el 56,5%. La rinoconjuntivitis fue el principal motivo de consulta al alergólogo (53,8% frente a 46,3% en 2005), seguida del asma (30,2% frente a 34,6%) y la alergia alimentaria (20,0% frente a 14,5%). Conclusiones: Los hallazgos de Alergológica 2015 muestran un aumento notable de la frecuencia de la rinitis alérgica, la alergia a fármacos y la alergia alimentaria. La frecuencia de otras afecciones alérgicas permaneció inalterada, excepto para el asma, cuya frecuencia disminuyó, al igual que en los pacientes adultos

Anaphylaxis caused by green tea: a case repor

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Thermolability of soybean allergen gly m bd 30K: report of a case of anaphylaxis

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Oral immunotherapy for food allergy: A Spanish guideline. Egg and milk immunotherapy Spanish guide (ITEMS GUIDE). Part 2: Maintenance phase of cow milk (CM) and egg oral immunotherapy (OIT), special treatment dosing schedules. Models of dosing schedules of OIT with CM and EGG

Introduction: Cow's milk and egg are the most frequent causes of food allergy in the first years of life. Treatments such as oral immunotherapy (OIT) have been investigated as an alternative to avoidance diets. No clinical practice guides on the management of OIT with milk and egg are currently available. Objectives: To develop a clinical guide on OIT based on the available scientific evidence and the opinions of experts. Methods: A review was made of studies published in the period between 1984 and June 2016, Doctoral Theses published in Spain, and summaries of communications at congresses (SEAIC, SEICAP, EAACI, AAAAI), with evaluation of the opinion consensus established by a group of experts pertaining to the scientific societies SEICAP and SEAIC. Results: Recommendations have been established regarding the indications, requirements and practical aspects of the different phases of OIT, as well as special protocols for patients at high risk of suffering adverse reactions. Conclusions: A clinical practice guide is presented for the management of OIT with milk and egg, based on the opinion consensus of Spanish experts (AU)

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Oral immunotherapy for food allergy: A Spanish guideline. Immunotherapy egg and milk Spanish guide (items guide). Part I: Cow milk and egg oral immunotherapy: Introduction, methodology, rationale, current state, indications contraindications and oral immunotherapy build-up phase

Introduction: Cow's milk and egg are the most frequent causes of food allergy in the first years of life. Treatments such as oral immunotherapy (OIT) have been investigated as an alternative to avoidance diets. No clinical practice guides on the management of OIT with milk and egg are currently available. Objectives: To develop a clinical guide on OIT based on the available scientific evidence and the opinions of experts. Methods: A review was made of studies published in the period between 1984 and June 2016, Doctoral Theses published in Spain, and summaries of communications at congresses (SEAIC, SEICAP, EAACI, AAAAI), with evaluation of the opinion consensus established by a group of experts pertaining to the scientific societies SEICAP and SEAIC. Results: Recommendations have been established regarding the indications, requirements and practical aspects of the different phases of OIT, as well as special protocols for patients at high risk of suffering adverse reactions. Conclusions: A clinical practice guide is presented for the management of OIT with milk and egg, based on the opinion consensus of Spanish experts (AU)

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Oral Immunotherapy for Food Allergy: A Spanish Guideline. Immunotherapy Egg and Milk Spanish Guide (ITEMS Guide). Part I: Cow Milk and Egg Oral Immunotherapy: Introduction, Methodology, Rationale, Current State, Indications, Contraindications, and Oral Immunotherapy Build-up Phase.

BACKGROUND AND OBJECTIVE: Cow milk and egg are the most frequent causes of food allergy in the first years of life. Oral immunotherapy (OIT) has been investigated as an alternative to avoidance diets. No clinical practice guidelines on the management of OIT with milk and egg are currently available. Objectives: To develop clinical guidelines for OIT based on available scientific evidence and the opinions of experts. METHODS: A review was made of studies published between 1984 and June 2016, doctoral theses published in Spain, summaries of communications at scientific meetings (SEAIC, SEICAP, EAACI, and AAAAI), and the consensus of opinion established by a group of experts from the scientific societies SEICAP and SEAIC. RESULTS: Recommendations were established regarding the indications, requirements and practical aspects of the different phases of OIT, as well as special protocols for patients at high risk of adverse reactions. CONCLUSIONS: Clinical practice guidelines based on the consensus reached between Spanish experts are presented for the management of OIT with milk and egg.

Oral immunotherapy for food allergy: A Spanish guideline. Egg and milk immunotherapy Spanish guide (ITEMS GUIDE). Part 2: Maintenance phase of cow milk (CM) and egg oral immunotherapy (OIT), special treatment dosing schedules. Models of dosing schedules of OIT with CM and EGG.

INTRODUCTION: Cow's milk and egg are the most frequent causes of food allergy in the first years of life. Treatments such as oral immunotherapy (OIT) have been investigated as an alternative to avoidance diets. No clinical practice guides on the management of OIT with milk and egg are currently available. OBJECTIVES: To develop a clinical guide on OIT based on the available scientific evidence and the opinions of experts. METHODS: A review was made of studies published in the period between 1984 and June 2016, Doctoral Theses published in Spain, and summaries of communications at congresses (SEAIC, SEICAP, EAACI, AAAAI), with evaluation of the opinion consensus established by a group of experts pertaining to the scientific societies SEICAP and SEAIC. RESULTS: Recommendations have been established regarding the indications, requirements and practical aspects of the different phases of OIT, as well as special protocols for patients at high risk of suffering adverse reactions. CONCLUSIONS: A clinical practice guide is presented for the management of OIT with milk and egg, based on the opinion consensus of Spanish experts.

Oral immunotherapy for food allergy: A Spanish guideline. Immunotherapy egg and milk Spanish guide (items guide). Part I: Cow milk and egg oral immunotherapy: Introduction, methodology, rationale, current state, indications contraindications and oral immunotherapy build-up phase.

INTRODUCTION: Cow's milk and egg are the most frequent causes of food allergy in the first years of life. Treatments such as oral immunotherapy (OIT) have been investigated as an alternative to avoidance diets. No clinical practice guides on the management of OIT with milk and egg are currently available. OBJECTIVES: To develop a clinical guide on OIT based on the available scientific evidence and the opinions of experts. METHODS: A review was made of studies published in the period between 1984 and June 2016, Doctoral Theses published in Spain, and summaries of communications at congresses (SEAIC, SEICAP, EAACI, AAAAI), with evaluation of the opinion consensus established by a group of experts pertaining to the scientific societies SEICAP and SEAIC. RESULTS: Recommendations have been established regarding the indications, requirements and practical aspects of the different phases of OIT, as well as special protocols for patients at high risk of suffering adverse reactions. CONCLUSIONS: A clinical practice guide is presented for the management of OIT with milk and egg, based on the opinion consensus of Spanish experts.

Oral Immunotherapy for Food Allergy: A Spanish Guideline. Egg and Milk Immunotherapy Spanish Guide (ITEMS GUIDE). Part II: Maintenance Phase of Cow Milk (CM) and Egg Oral Immunotherapy (OIT), Special Treatment Dosing Schedules. Models of Dosing Schedules of OIT With CM and Egg.

BACKGROUND AND OBJECTIVE: Cow milk and egg are the most frequent causes of food allergy in the first years of life. Oral immunotherapy (OIT) has been investigated as an alternative to avoidance diets. No clinical practice guidelines on the management of OIT with milk and egg are currently available. Objectives: To develop clinical guidelines for OIT based on available scientific evidence and the opinions of experts. METHODS: A review was made of studies published between 1984 and June 2016, doctoral theses published in Spain, summaries of communications at scientific meetings (SEAIC, SEICAP, EAACI, and AAAAI), and the consensus of opinion established by a group of experts from the scientific societies SEICAP and SEAIC. RESULTS: Recommendations were established regarding the indications, requirements and practical aspects of the different phases of OIT, as well as special protocols for patients at high risk of adverse reactions. CONCLUSIONS: Clinical practice guidelines based on the consensus reached between Spanish experts are presented for the management of OIT with milk and egg.

Oral immunotherapy for food allergy: a Spanish Guideline. Egg and milk immunotherapy Spanish Guide (ITEMS GUIDE). Part II: Maintenance phase of cow milk (CM) and egg oral immunotherapy (OIT), special treatment dosig schedules. Models of dosing Schedules of OIT with CM and egg

Introduction: Cow milk and egg are the most frequent causes of food allergy in the first years of life. Oral immunotherapy (OIT) has been investigated as an alternative to avoidance diets. No clinical practice guidelines on the management of OIT with milk and egg are currently available. Objectives: To develop clinical guidelines for OIT based on available scientific evidence and the opinions of experts. Methods: A review was made of studies published between 1984 and June 2016, doctoral theses published in Spain, summaries of communications at scientific meetings (SEAIC, SEICAP, EAACI, and AAAAI), and the consensus of opinion established by a group of experts from the scientific societies SEICAP and SEAIC. Results: Recommendations were established regarding the indications, requirements and practical aspects of the different phases of OIT, as well as special protocols for patients at high risk of adverse reactions. Conclusions: Clinical practice guidelines based on the consensus reached between Spanish experts are presented for the management of OIT with milk and egg (AU)

Introducción: El huevo y la leche de vaca son la causa más frecuente de alergia alimentaria en los primeros años de vida. Como alternativa terapéutica a la dieta de eliminación se han investigado otras formas de tratamiento como la inmunoterapia oral (ITO). Actualmente no existen guías de práctica clínica para el manejo de la ITO con leche y huevo. Objetivos: Elaborar una guía clínica para el tratamiento con ITO basada en la evidencia científica disponible y en la opinión de expertos. Métodos: Revisión de estudios publicados desde el año 1984 hasta junio de 2016, tesis doctorales publicadas en España, resúmenes de comunicaciones en congresos (SEAIC, SEICAP, EAACI, AAAAI) y consenso de opinión de un grupo de expertos de las sociedades científicas SEICAP y SEAIC. Resultados: Se establecen recomendaciones acerca de la indicación, requerimientos, aspectos prácticos del tratamiento en las diferentes fases de la ITO, y pautas especiales para pacientes de alto riesgo de reacciones adversas. Conclusiones: Se presenta una guía con las directrices para el manejo en la práctica clínica de la ITO con leche y huevo que aúna la opinión consensuada de expertos españoles (AU)