Insect Venom Immunotherapy: Analysis of the Safety and Tolerance of 3 Buildup Protocols Frequently Used in Spain.

INTRODUCTION: Hymenoptera venom immunotherapy (VIT) is an effective treatment but not one devoid of risk, as both local and systemic adverse reactions may occur, especially in the initial phases. We compared the tolerance to 3 VIT buildup protocols and analyzed risk factors associated with adverse reactions during this phase. MATERIALS AND METHODS: We enrolled 165 patients divided into 3 groups based on the buildup protocol used (3, 4, and 9 weeks). The severity of systemic reactions was evaluated according to the World Allergy Organization model. Results were analyzed using exploratory descriptive statistics, and variables were compared using analysis of variance. RESULTS: Adverse reactions were recorded in 53 patients (32%) (43 local and 10 systemic). Local reactions were immediate in 27 patients (63%) and delayed in 16 (37%). The severity of the local reaction was slight/moderate in 15 patients and severe in 13. Systemic reactions were grade 1-2. No significant association was found between the treatment modality and the onset of local or systemic adverse reactions or the type of local reaction. We only found a statistically significant association between severity of the local reaction and female gender. As for the risk factors associated with systemic reactions during the buildup phase, we found no significant differences in values depending on the protocol used or the insect responsible. CONCLUSIONS: The buildup protocols compared proved to be safe and did not differ significantly from one another. In the population studied, patients undergoing the 9-week schedule presented no systemic reactions. Therefore, this protocol can be considered the safest approach.

Insect venom immunotherapy: analysis of the safety and tolerance of 3 buildup protocols frequently used in Spain

Introduction: Hymenoptera venom immunotherapy (VIT) is an effective treatment but not one devoid of risk, as both local and systemic adverse reactions may occur, especially in the initial phases. We compared the tolerance to 3 VIT buildup protocols and analyzed risk factors associated with adverse reactions during this phase. Materials and Methods: We enrolled 165 patients divided into 3 groups based on the buildup protocol used (3, 4, and 9 weeks). The severity of systemic reactions was evaluated according to the World Allergy Organization model. Results were analyzed using exploratory descriptive statistics, and variables were compared using analysis of variance. Results: Adverse reactions were recorded in 53 patients (32%) (43 local and 10 systemic). Local reactions were immediate in 27 patients (63%) and delayed in 16 (37%). The severity of the local reaction was slight/moderate in 15 patients and severe in 13. Systemic reactions were grade 1-2. No significant association was found between the treatment modality and the onset of local or systemic adverse reactions or the type of local reaction. We only found a statistically significant association between severity of the local reaction and female gender. As for the risk factors associated with systemic reactions during the buildup phase, we found no significant differences in values depending on the protocol used or the insect responsible. Conclusions: The buildup protocols compared proved to be safe and did not differ significantly from one another. In the population studied, patients undergoing the 9-week schedule presented no systemic reactions. Therefore, this protocol can be considered the safest approach (AU)

Introducción: La inmunoterapia con veneno de himenópteros (ITV) es un tratamiento eficaz, pero no está desprovisto de riesgo ya que pueden ocurrir reacciones adversas locales o sistémicas, especialmente en las etapas iniciales del tratamiento. Comparamos la tolerancia de tres protocolos de inicio de ITV y analizamos los factores de riesgo asociados con las reacciones adversas que se produjeron en esta fase. Métodos: Se incluyeron 165 pacientes divididos en tres grupos según el protocolo de iniciación utilizado (3, 4 o 9 semanas). Evaluamos la gravedad de las reacciones sistémicas de acuerdo con el modelo de la Organización Mundial de Alergia. Analizamos los resultados mediante estadística descriptiva exploratoria y comparamos variables mediante el análisis de la varianza. Resultados: Cincuenta y tres pacientes (32%) experimentaron algún tipo de reacción adversa; 43 eran locales y 10 sistémicas. Las reacciones locales fueron inmediatas en 27 pacientes (63%) y tardías en 16 (37%). La gravedad de la reacción local fue leve o moderada en 15 pacientes y grave en 13. Las reacciones sistémicas fueron de grado 1 o 2. No encontramos asociación significativa entre la modalidad de tratamiento y la aparición de reacciones adversas locales o sistémicas o el tipo de reacción local. Solo encontramos una asociación estadísticamente significativa de la gravedad de la reacción local con el sexo femenino. En cuanto a los factores de riesgo asociados con las reacciones sistémicas en la fase de inicio, no se encontraron diferencias significativas en estos valores en función del protocolo utilizado o el insecto responsable. Conclusiones: Los protocolos de inicio comparados demostraron ser seguros y no difirieron significativamente entre sí. En la población estudiada, el protocolo de 9-semanas no produjo reacciones sistémicas, por lo que se puede considerar el protocolo más seguro (AU)

Fiabilidad y validez de un cuestionario para evaluar la percepción de calidad de las familias atendidas en los Centros de Atención Temprana / Reliability and validity of a questionnaire to evaluate the perceived quality of the families seen in Early Intervention Centers

Objetivo: Validar un instrumento para medir la percepción de la calidad del servicio prestado en los Centros de Atención Infantil Temprana. Material y método: Estudio transversal y multicéntrico para la validación de un cuestionario autocumplimentado. Los participantes fueron los familiares de niños-as que reciben tratamiento de Atención Temprana en 14 Centros de Atención Temprana de la provincia de Málaga, autocumplimentando el cuestionario 670 personas (75,8% mujeres y 24,2% hombres) seleccionadas mediante muestreo por conveniencia con edades entre los 20 y 80 años. Se comprobó la validez de contenido mediante grupo de expertos. La consistencia interna fue evaluada mediante el coeficiente alfa de Cronbach. Para la validez de constructo, el análisis factorial exploratorio se realizó con un método de componentes principales, autovalores mayores a uno y rotación varimax, mientras que en el análisis factorial confirmatorio se emplearon diferentes índices de bondad de ajuste. Resultados: Los 48 ítems se agruparon en 6 dimensiones. La consistencia interna fue satisfactoria. El análisis factorial exploratorio identificó una estructura de 14 factores, explicando cada dimensión en torno al 50% de la varianza. El análisis factorial confirmatorio proporcionó adecuados valores para los índices de ajuste considerados, con resultados dentro de los límites establecidos. Conclusiones: El inventario de calidad en los Centros de Atención Infantil Temprana es un instrumento que reúne adecuadas propiedades psicométricas como para ser considerado una herramienta pragmática, útil y fiable para medir la calidad percibida por los usuarios atendidos en este tipo de centros

Objective: To validate a tool to measure the perception of the quality of service provided in Early Intervention Centers. Material and method: A cross-sectional and multicenter study was performed for the validation of a self-completed questionnaire. Participants were the family members of children who were receiving treatment at 14 Early Intervention Centers in the province of Malaga. A total of 670 persons (75.8% women and 24.2% men) filled out the questionnaire. They had been selected by sampling for convenience with ages ranging from 20 to 80 years. Content validity was verified by experts. Internal consistency was evaluated using Cronbach's alpha coefficient. The exploratory factor analysis of the main components with eigenvalues above 1, and Varimax rotation was performed for construct validity. Different goodness of fit indexes were used for the confirmatory factor analysis. Results: The 48 items were grouped into 6 dimensions. Internal consistency was satisfactory. Exploratory factor analysis identified 14 factors that accounted for approximately 50% of the variance. The confirmatory factor analysis provided appropriate values for the adjustment indexes considered, with results within established limits. Conclusions: The Quality Inventory of Early Intervention Centers is a tool whose psychometric results are sufficient to be considered as a pragmatic, useful and reliable tool for the measurement of the quality perceived by users of the Early Interventions Centers