Síndrome de alergia cruzada artemisa-mostaza : estudio clínico e inmunológico

Programa de doctorado: Avances en Medicina Interna. La fecha de publicación es la fecha de lectura

Prevalencia de Atopia y determinación de los alérgenos inhalantes más comunes entre los adolescentes de Octavo y Noveno de Básica en Cuenca-Ecuador, durante el año lectivo 2013-2014

Las atopias constituyen un problema de salud que puede afectar a adolescentes y adultos, llegando incluso a ser mortal en ciertos casos. La investigación en este tema es escasa en nuestro medio, es por ello que este estudio tiene como objetivo determinar la prevalencia de atopias y los alérgenos inhalantes más comunes entre los adolescentes de octavo y noveno de básica de las áreas urbana y rural del cantón Cuenca, mediante la aplicación de un “skin prick test”. Para ello fueron evaluados los estudiantes de octavo y noveno de básica de los colegios del cantón Cuenca, incuyendo una muestra aleatoria representativa de 991 alumnos. Los resultados demostraron que más de la mitad de los participantes fueron atópicos para al menos uno de los alérgenos probados, situación que refleja un problema de salud pública que debe ser considerado. La prevalencia de atopia no fue diferente de acuerdo al sexo de los participantes; de los 20 alérgenos probados, los alérgenos intra-domiciliarios y las gramíneas estuvieron entre los más prevalentes, los cinco más comunes fueron los ácaros D. pteronyssinus y blomia tropicalis, epitelio de cucaracha, mezcla de pólenes de gramíneas y ecynodon. No se encontró una diferencia significativa en la prevalencia global de atopia según la ubicación geográfica de los colegios. Sin embrago, el análisis por alérgeno reveló que la atopia al epitelio de cucaracha fue mayor entre los alumnos que asisten a colegios rurales y la atopia al salix fue mayor entre los adolescentes de los colegios urbanos

Sensibilización y alergia alimentaria mediada por Inmunoglobulina E específica y su afectación a la calidad de vida en un grupo de adolescentes de 13 a 15 años de edad en el Cantón Santa Isabel: Un estudio trasnversal.

Antecedentes: Este estudio reporta la prevalencia de SA, AA y su afectación en la calidad de vida en un grupo de adolescentes de Santa Isabel-Ecuador. Métodos: Un estudio de corte transversal se llevó a cabo en 462 adolescentes de los colegios de Santa Isabel entre Julio de 2014 y Febrero de 2016. La recolección de datos incluyó la aplicación de test cutáneos utilizando un total de 19 alérgenos alimentarios y un cuestionario de auto reporte de síntomas a todos los participantes. Los adolescentes con test cutáneo positivo a uno o varios alimentos y con síntomas tras la ingesta de los mismos se les aplicó un cuestionario de calidad de vida y se cuantificó la Inmunoglobulina E (IgE) sérica específica para corroborar el diagnóstico de AA. Resultados: La prevalencia de SA fue del 7,14% y de AA 4,33%. En ambos casos el camarón y el maní fueron los principales alérgenos. La cuantificación de IgE específica, corroboró la presencia de AA en 2.4% de los participantes. La presencia de AA no afecta la calidad de vida de adolescentes en promedio 0,05/6, DE±0,94 Conclusiones: Este estudio contribuye con la prevalencia de SA y AA cuya importancia radica en la metodología utilizada, lo que servirá de base teórica para estudios posteriores. La SA y AA son prevalentes en los adolescentes del cantón de Santa Isabel, siendo el maní y camarón los alérgenos de mayor importancia asociados a reacciones anafilácticas. A pesar de los riesgos, los adolescentes no refleja afectación en su calidad de vida.

Prevalencia de las deformidades óseas y estructurales en pacientes con pie diabético que acuden al área de consulta externa de traumatología del Hospital Regional Vicente Corral Moscoso, Cuenca-Ecuador 2015

Objetivo general: Establecer la prevalencia de las deformidades óseas y estructurales en pacientes con pie diabético que acudieron al área de consulta externa de Traumatología del Hospital Regional Vicente Corral Moscoso durante el período de tres meses. Metodología: Estudio descriptivo llevado a cabo en 100 pacientes con pie diabético que acudieron a la consulta externa de Traumatología durante tres meses. El método de investigación fue la observación directa; las técnicas comprendieron entrevista, evaluación mediante plantoscopía y valoración radiográfica, los instrumentos usados fueron los formularios, los datos tras su validación fueron ingresados en una base en el programa SPSS V15; mediante el cual se realizó el análisis usando tablas simples con porcentajes y frecuencias relativas. Resultados: La media de edad fue de 64,09 años con el 84% de la población de sexo femenino; el cuadro clínico se caracterizó por presencia de callosidades 62%; metatarsalgia 57%; talalgia 48% y dolor en bunion de 21%. Tomando en consideración los parámetros radiográficos se diagnosticó hallux valgus 71%; deformidades de los dedos en garra 56%; pie plano 34%; dedos en martillo 31%; juanetillo de sastre 30%; hallux rigidus 16% y pie cavo 13%. La valoración mediante el uso de plantoscopía reveló 39% de pacientes pie plano y el 17% pie cavo

Effect of firefighter boots and viscoelastic insoles on the impact force of the ground reaction force’s vertical component

The aims of the present study were to determine the effect of firefighter's boots on the vertical component of the ground reaction force (GRF) at heel strike, also known as heel strike transient and to analyze the effect of the viscoelastic insoles placed into the firefighter’s boots on this force during the gait. The magnitude of the impact force (FZI) from the vertical ground reaction force, the time to the production of this force (TZI) and the loading rate (GC) were registered. 39 firefighters without any pathology during 2 years before the study were recruited. Three different walking conditions were tested: 1) gait with firefighter's boots, 2) gait with firefighter's boots and viscoelastic insoles and 3) gait with sport shoes. The results showed a higher production and magnitude of the impact force during gait with firefighter's boots than during gait with sport shoes (13,1 vs. 2,6 % of occurrence of the impact force and 61,39 ± 35,18 %BW (body weight) vs. 49,38 ± 22,99 %BW, respectively). The gait with viscoelastic insoles placed into the firefighter's boots did not show significant differences in any of the parameters characterizing the impact force compared to the gait without insoles. The results of this study show a lower cushioning of the impact force during the gait with firefighter's boots in comparison to the gait with sport shoes and the inefficiency of the viscoelastic insoles placed inside the firefighter's boots to ameliorate the cushioning of the impact force at natural walking speed.

Estudo comparativo da injeção de água usando poços verticais e horizontais

Oil recovery using waterflooding has been until now the worldwide most applied method, specially for light oil recovery, its success is mainly because of the low costs involved and the facilities of the injection process. The Toe- To-Heel Waterflooding TTHWTM method uses a well pattern of vertical injector wells completed at the bottom of the reservoir and horizontal producer wells completed at the top of it. The main producing mechanism is gravitational segregation in short distance. This method has been studied since the early 90´s and it had been applied in Canada with positive results for light heavy oils, nevertheless it hasn´t been used in Brazil yet. In order to verify the applicability of the process in Brazil, a simulation study for light oil was performed using Brazilian northwest reservoirs characteristics. The simulations were fulfilled using the STARS module of the Computer Modelling Group Software, used to perform improved oil recovery studies. The results obtained in this research showed that the TTHWTM well pattern presented a light improvement in terms of recovery factor when compared to the conventional 5- Spot pattern, however, it showed lower results in the economic evaluation

Estudo do processo de combustão in-situ usando poços horizontais como produtores de óleo (Toe-to-Hell Air Injection)

The method "toe-to-heel air injection" (THAITM) is a process of enhanced oil recovery, which is the integration of in-situ combustion with technological advances in drilling horizontal wells. This method uses horizontal wells as producers of oil, keeping vertical injection wells to inject air. This process has not yet been applied in Brazil, making it necessary, evaluation of these new technologies applied to local realities, therefore, this study aimed to perform a parametric study of the combustion process with in-situ oil production in horizontal wells, using a semi synthetic reservoir, with characteristics of the Brazilian Northeast basin. The simulations were performed in a commercial software "STARS" (Steam, Thermal, and Advanced Processes Reservoir Simulator), from CMG (Computer Modelling Group). The following operating parameters were analyzed: air rate, configuration of producer wells and oxygen concentration. A sensitivity study on cumulative oil (Np) was performed with the technique of experimental design, with a mixed model of two and three levels (32x22), a total of 36 runs. Also, it was done a technical economic estimative for each model of fluid. The results showed that injection rate was the most influence parameter on oil recovery, for both studied models, well arrangement depends on fluid model, and oxygen concentration favors recovery oil. The process can be profitable depends on air rate

Cohort Profile: The Barwon Infant Study

The modern environment is associated with an increasing burden of non-communicable diseases (NCDs). Mounting evidence implicates environmental exposures, experienced early in life (including in utero), in the aetiology of many NCDs, though the cellular/molecular mechanism(s) underlying this elevated risk across the life course remain unclear. Epigenetic variation has emerged as a candidate mediator of such effects. The Barwon Infant Study (BIS) is a population-derived birth cohort study (n ¼ 1074 infants) with ante-natal recruitment, conducted in the south-east of Australia (Victoria). BIS has been designed to facilitate a detailed mechanistic investigation of development within an epidemiological framework. The broad objectives are to investigate the role of specific environmental factors, gut microbiota and epigenetic variation in early-life development, and subsequent immune, allergic, cardiovascular, respiratory and neurodevelopmental outcomes. Participants have been reviewed at birth and at 1, 6, 9 and 12 months, with 2-and 4-year reviews under way. Biological samples and measures include: maternal blood, faeces and urine during pregnancy; infant urine, faeces and blood at regular intervals during the first 4 years; lung function at 1 month and 4 years; cardiovascular assessment at 1 month and 4 years; skin-prick allergy testing and food challenge at 1 year; and neurodevelopmental assessment at 9 months, 2 and 4 years. Data access enquiries can be made at [www.barwoninfantstudy.org.au] or via [peter.vuillermin@deakin.edu.au].

The PREPARE pilot RCT of home-based progressive resistance exercises for venous leg ulcers

OBJECTIVE: To establish the feasibility of conducting a home-based progressive resistance exercise programme to improve calf muscle pump function in community-based patients with venous leg ulcers. METHOD: Participants were randomised to receive a 12-week progressive resistance exercise programme using heel raises in addition to compression. The control was usual care in addition to compression. Randomisation was stratified by ulcer duration and ulcer size. Air plethysmography was used to determine changes in calf muscle pump function from baseline. Changes in ulcer parameters were measured using the SilhouetteMobile device. RESULTS: Forty participants were randomised. There were significantly greater improvements in ejection fraction of the calf muscle in the exercise group compared with the control (usual care) group (mean difference 18.5%, 95% CI 0.03 to 36.6%, p<0.05). Other parameters improved in the exercise group but the mean differences were not significant. Adherence with prescribed exercises was 81% and there was no significant difference in the numbers reporting adverse events. There were also no significant differences in ulcer healing parameters (change in area, percentage change in area, number healed at 12 weeks, time to healing). CONCLUSION: A community-based randomised trial of progressive resistance exercise is feasible. The prescribed exercises appeared to increase ejection fraction, but the effect of exercise on ulcer healing requires further investigation.

VITALITY trial: protocol for a randomised controlled trial to establish the role of postnatal vitamin D supplementation in infant immune health

Introduction Postnatal vitamin D supplementation may be associated with a reduction in IgE-mediated food allergy, lower respiratory tract infections and improved bone health. Countries in the Northern hemisphere recommend universal infant vitamin D supplementation to optimise early vitamin D levels, despite the absence of large trials proving safety or efficacy for any disease outcome. With the aim of determining the clinical and cost-effectiveness of daily vitamin D supplementation in breastfed infants from age 6–8 weeks to 12 months of age, we have started a double-blind, randomised, placebo-controlled trial of daily 400 IU vitamin D supplementation during the first year of life, VITALITY. Methods nd analysis Infants (n=3012) who are fully breastfed and not receiving vitamin D supplementation will be recruited at the time of their first immunisation, from council-led immunisation clinics throughout metropolitan Melbourne, Australia. The primary outcome is challenge-proven food allergy at 12 months of age. Secondary outcomes are food sensitisation (positive skin prick test), number of lower respiratory infections (through hospital linkage), moderately-severe and persistent eczema (by history and examination) and vitamin D deficiency (serum vitamin D <50 nmol/L) at age 12 months. The trial is underway and the first 130 participants have been recruited.

User centric design, data analysis and performance of snowboard bindings

This study focuses on soft boot snowboard bindings by looking at how users interact with their binding and proposes a possible solution to overcome such issues. Snowboarding is a multibillion-dollar sport that has only reached mainstream in the last 30 years its levels of progression in technology have evolved in that time. However, snowboard bindings for the most part still consist of the same basic architecture in the last 20 years. This study was aimed at taking a user centric point of view and using additive manufacturing technologies to be able to generate a new snowboard binding that is completely adaptable to the user. The initial part of the study was a survey of 280 snowboarders focussing on preferences, style and habits. This survey was generated from over 15 nations with the vast majority of boarders on the snow for five to fifty days a year. Significant emphasis was placed on the relationship between boarder binding set-up and occurrence of pain and/or injury. From the detailed survey it was found that boarder's experienced pain in the front foot/toe area as a result from the toe strap being too tight. However boarders wanted tighter bindings to increase responsiveness. Survey data was compared to ankle and foot biomechanics to build a relationship to assess the problem of pain versus responsiveness. The design stage of the study was to develop a binding that overcame the over-tightening of the binding but still maintain equivalent or better responsiveness compared to traditional bindings. The resulting design integrated the snowboard boot much more into the design, by using the sole as a "semi-rigid" platform and locking it in laterally between the heel cup and the new toe strap arrangement. The new design developed using additive manufacturing techniques was tested via qualitative and quantitative measures in the snow and in the lab. It was found that using the new arrangement in a system resulted in no loss of performance or responsiveness to the user. Due to the design and manufacturing approach users have the ability to customise the design to their specific needs.

Mechanical ageing performance of minimalist and traditional footwear foams

The aim of this study was to obtain a fundamental understanding of how running shoe midsole foam thickness contributes to footwear degradation using the heel and forefoot regions of traditional (TS) and minimalist (MS) running shoes. We hypothesized that ethylene vinyl acetate (EVA) foam midsole material properties and footwear degradation performance under a biofidelic mechanical ageing protocol would differ as a function of shoe type and thickness. Attenuated totalreflectance Fourier transform infrared spectra indicated that the foam chemical compositions were similar and confirmed that all midsoles were composed of EVA copolymer. Differences in density and cell size were detected between shoes and thicknesses. MS foam was uniformly high density (rMS D 240 kg/m3), while TS foam consisted of two co-molded layers with forefoot density (rTS-FF D 250 kg/m3) greater than heel (rTS-H D 160 kg/m3). Relative density and cell size values were generally proportional and inversely proportional to density, respectively. Degradation from mechanical ageing was greatest in the first 2 km of ageing, with the full ageing (21 km) resulting in an average 54% loss of energy absorption. Regardless of shoe type or foam microstructure, thicker and softer heel foams absorbed 83% more energy but degraded ata 49% faster rate. The fact that the heel degraded more rapidly than forefoot caused the drop to decrease at an equivalent rate for both shoe types. Overall, thickness was a greater predictor of average performance than microstructure variables for the present footwear conditions. However, the apparent drawback of thicker foam was exemplified by heel samples, which underwent a 1.4 mm greater loss of thickness and lost 550 mJ more energy absorption than forefoot samples.

Balance ability in 7- and 10-year-old children:associations with prenatal lead and cadmium exposure and with blood lead levels in childhood in a prospective birth cohort study

OBJECTIVES: Most studies reporting evidence of adverse effects of lead and cadmium on the ability to balance have been conducted in high-exposure groups or have included adults. The effects of prenatal exposure have not been well studied, nor have the effects in children been directly studied. The aim of the study was to identify the associations of lead (in utero and in childhood) and cadmium (in utero) exposure with the ability to balance in children aged 7 and 10 years. DESIGN: Prospective birth cohort study. PARTICIPANTS: Maternal blood lead (n=4285) and cadmium (n=4286) levels were measured by inductively coupled plasma mass spectrometry in women enrolled in the Avon Longitudinal Study of Parents and Children (ALSPAC) during pregnancy. Child lead levels were measured in a subsample of 582 of ALSPAC children at age 30 months. MAIN OUTCOME MEASURES: Children completed a heel-to-toe walking test at 7 years. At 10 years, the children underwent clinical tests of static and dynamic balance. Statistical analysis using SPSS V.19 included logistic regression modelling, comparing categories of ≥ 5 vs <5 µg/dL for lead, and ≥ 1 vs <1 µg/L for cadmium. RESULTS: Balance at age 7 years was not associated with elevated in utero lead or cadmium exposure (adjusted OR for balance dysfunction: Pb 1.01 (95% CI 0.95 to 1.01), n=1732; Cd 0.95 (0.77 to 1.20), n=1734), or with elevated child blood lead level at age 30 months (adjusted OR 0.98 (0.92 to 1.05), n=354). Similarly, neither measures of static nor dynamic balance at age 10 years were associated with in utero lead or cadmium exposure, or child lead level. CONCLUSIONS: These findings do not provide any evidence of an association of prenatal exposure to lead or cadmium, or lead levels in childhood, on balance ability in children. Confirmation in other cohorts is needed.

Prenatal alcohol exposure and childhood balance ability:findings from a UK birth cohort study

OBJECTIVE: To investigate the association of prenatal alcohol exposure with balance in10-year-old children. DESIGN: Population-based prospective longitudinal study. SETTING: Former Avon region of UK (Southwest England). PARTICIPANTS: 6915 children from the Avon Longitudinal Study of Parents and Children who had a balance assessment at age 10 and had data on maternal alcohol consumption. OUTCOME MEASURES: 3 composite balance scores: dynamic balance (beam-walking), static balance eyes open, static balance eyes closed (heel-to-toe balance on a beam and standing on one leg, eyes open or closed). RESULTS: Most mothers (95.5%) consumed no-to-moderate amounts (3-7 glasses/week) of alcohol during pregnancy. Higher total-alcohol consumption was associated with maternal-social advantage, whereas binge drinking (≥4 units/day) and abstinence were associated with maternal social disadvantage. No evidence was found of an adverse effect of maternal-alcohol consumption on childhood balance. Higher maternal-alcohol use during pregnancy was generally associated with better offspring outcomes, with some specific effects appearing strong (static balance eyes open and moderate total alcohol exposure at 18 weeks, adjusted OR 1.23 (95% CI 1.01 to 1.49); static balance eyes closed and moderate total alcohol exposure at 18 weeks, adjusted OR 1.25 (95% CI 1.06 to 1.48). Similar results were found for both paternal and postnatal maternal alcohol exposure. A Mendelian-randomization approach was used to estimate the association between maternal genotype and offspring balance using the non-synonymous variant rs1229984*A (ADH1B) to proxy for lower maternal alcohol consumption; no strong associations were found between this genotype/proxy and offspring balance. CONCLUSIONS: No evidence was found to indicate that moderate maternal alcohol consumption in this population sample had an adverse effect on offspring balance at age 10. An apparent beneficial effect of higher total maternal alcohol consumption on offspring balance appeared likely to reflect residual confounding.

Balance ability of 7 and 10 year old children in the population:results from a large UK birth cohort study

OBJECTIVE: The literature contains many reports of balance function in children, but these are often on atypical samples taken from hospital-based clinics and may not be generalisable to the population as a whole. The purpose of the present study is to describe balance test results from a large UK-based birth cohort study. METHODS: Data from the Avon Longitudinal Study of Parents and Children (ALSPAC) were analysed. A total of 5402 children completed the heel-to-toe walking test at age 7 years. At age 10 years, 6915 children underwent clinical tests of balance including beam-walking, standing heel-to-toe on a beam and standing on one leg. A proportion of the children returned to the clinic for retesting within 3 months allowing test-retest agreement to be measured. RESULTS: Frequency distributions for each of the balance tests are given. Correlations between measures of dynamic balance at ages 7 and 10 years were weak. The static balance of 10 year old children was found to be poorer with eyes closed than with eyes open, and poorer in boys than in girls for all measures. Balance on one leg was poorer than heel-to-toe balance on a beam. A significant learning effect was found when first and second attempts of the tests were compared. Measures of static and dynamic balance appeared independent. Consistent with previous reports in the literature, test-retest reliability was found to be low. CONCLUSIONS: This study provides information about the balance ability of children aged 7 and 10 years and provides clinicians with reference data for balance tests commonly used in the paediatric clinic.