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Jiménez-Vázquez LN, Saucedo-Ramírez OJ, Del Río-Navarro B. [Absceso cerebral como manifestación inicial de Deficiencia especifica de anticuerpos]. Rev Alerg Mex 2023; 70:196. [PMID: 37933937 DOI: 10.29262/ram.v70i3.1291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2023] Open
Abstract
Background Specific antibody deficiency (SAD) is an inborn error of immunity, in patients older than 2 years, characterized by normal immunoglobulin levels and IgG subclasses, but with recurrent infections and decreased antibody responses to polysaccharide antigens. Case report A 10-year-old female, previously healthy, with no significant family history. She is known in this institution for symptoms of headache, vomiting and paresis. A CT scan of the skull was performed, where 4 brain abscesses, edema and displacement of the midline were observed, a right frontal trephine was performed and abscess drainage, antimicrobial management for infectology, blood cultures, Gram staining and cultures of negative drainage material. Assessed for allergy and immunology, for abscesses in deep focus, an approach was performed to rule out inborn error of immunity, immunoglobulins, isohemagglutinins, flow cytometry and response to normal protein antigens. Antibodies against post-vaccination polysaccharide antigens are requested, where a response to only 2 serotypes (18.1% response) is observed, with normal IgG subclasses, a diagnosis of specific antibody deficiency is integrated and management with immuno- globulin at replacement doses is started, as well as annual vaccination with 13 valent. Conclusion SAD has been considered a problem that can be resolved over time, especially in children, but in others it can evolve into more severe forms of humoral immunodeficiency. Decisions to treat with prophylactic antibiotics and/or gamma globulin are guided by clinical judgment, small studies, and recent consensus documents, which may evolve over time.
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Vasquez-Echeverri E, Navarrete-Rodriguez EM, Del Río-Navarro B. Antibiotic use in the first year of life as a risk factor for asthma symptoms. What is new in the association? World Allergy Organ J 2020. [DOI: 10.1016/j.waojou.2020.100360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Larenas-Linnemann D, Mullol J, Ivancevich JC, Antó JM, Cardona V, Dedeu T, Rodríguez-González M, Huerta Y, Neffen H, Fuentes-Pérez JM, Rodríguez-Zagal E, Valero A, Zernotti M, Bartra J, Alobid I, Castillo-Vizuete JA, Dordal T, Hijano R, Picado C, Sastre J, Blua AE, Jares E, Lavrut AJ, Máspero J, Bedolla-Barajas M, Burguete M, Costa MC, Domínguez-Silva M, Espinoza-Contreras JG, Gálvez-Romero JL, García-Cobas CY, García-Cruz MDLLH, Hernández-Velázquez L, Luna-Pech J, Matta JJ, Mogica-Martínez MD, Rivero-Yeverino D, Ruiz-Segura LT, Del Río-Navarro B, Gómez J, Macías-Weinmann A, Murray R, Onorato G, Laune D, Bedbrook A, Bousquet J. [MASK (Mobile Airways Sentinel Network). ARIA's comprehensive solution for mobile app for the multimorbidity of allergic rhinitis and asthma]. ACTA ACUST UNITED AC 2019; 66:140-146. [PMID: 31013416 DOI: 10.29262/ram.v66i1.578] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The vast majority of patients with allergic rhinitis (AR) do not receive the proper management which is recommended by the guidelines, but they frequently self-medicate. MASK (Mobile Airways Sentinel Network) is an integral part of a project that is supported by the European Union against chronic diseases and focused on active and healthy aging. MASK represents the third phase of ARIA (Allergic Rhinitis and its Impact on Asthma), in which, by using a mobile application in a smart device, the objective is to guide the patient in the control of his/her multi-morbidity, AR and/or allergic conjunctivitis (AC) and/or asthma. The mobile app Allergy Diary by MACVIA-ARIA is free and it is available for both Android and iOS platforms. After it is downloaded to the patient's cell phone, it first requests some information about the patient's profile, allergic pathologies and medication; afterwards, through a visual analog scale, the patient is invited to determine the degree of affectation in the nose, eyes, and bronchi, and its influence on their productivity at work / school. After analyzing the data generated by filling the Allergy Diary, it became clear there is a new clinical entity: allergic rhinitis+ allergic conjunctivitis +asthma, with greater effect; in addition to a high level of self-medication: in general, the patient takes medication on days when symptoms are present. The app has already been deployed in 23 countries, including several Spanish-speaking countries.
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Nieto-Zermeño J, Flores RO, Río-Navarro BD, Salgado-Arroyo B, Molina-Díaz JM. [Efectos sobre el perfil metabólico, el índice de masa corporal, la composición corporal y la comorbilidad en adolescentes con obesidad mórbida, que han fallado al manejo conservador para bajar de peso, operados de manga gástrica laparoscópica. Reporte del primer grupo de cirugía bariátrica pediátrica en México]. GAC MED MEX 2018; 154:S22-S29. [PMID: 30532105 DOI: 10.24875/gmm.18004573] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Introduction Obesity is a world pandemic; in Mexico 3 out of 10 adolescents suffer from it. Conservative management of morbid obesity is not effective and bariatric surgery is the only useful therapy. International pediatric bariatric surgery series are scarce and in Mexico there is limited experience. Method We analyze the metabolic repercussions, comorbidities and complications in our series of Mexican adolescents with morbid obesity who underwent a gastric sleeve between 2011 and 2015. Results 54 morbid obese adolescents were included, 10 fulfilled criteria for surgery. 5 were male, mean age 14.3 ± 1.4 years, weight 117.3 ± 15.2 kg, initial body mass index 43.71 ± 4.1, waist 130.3 ± 6.8 cm, 8 dyslipidemia, 6 metabolic syndrome, 5 liver steatosis, 4 hypertension, 3 type-2 diabetes. Complications: 2 atelectasis, 1 fistula, 1 pneumonia, 1 cholelithiasis; no patient developed nutritional deficits. Weight loss of 33% one-year after surgery and 23% at 2 years. Body fat decreased 22.4% and water content increased 36.1%. Excess weight loss was significant p = 0.001. Two-years after surgery severe steatosis and diabetes had subsided, lipid profile improved and only one patient remained hypertensive. Discussion Our results demonstrate that all serious comorbidities associated to morbid obesity were improved (diabetes, dyslipidemia and hypertension) and will confer a better prognosis for these children. Conclusions Gastric sleeve is useful in morbid obese adolescents. Longer follow-up is needed.
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Affiliation(s)
- Jaime Nieto-Zermeño
- Departamento de Cirugía Pediátrica. Hospital Infantil de México Federico Gómez, Ciudad de México, México
| | - Ricardo Ordorica Flores
- Departamento de Cirugía Pediátrica. Hospital Infantil de México Federico Gómez, Ciudad de México, México
| | - Blanca Del Río-Navarro
- Departamento de Inmunología y Alergia. Hospital Infantil de México Federico Gómez, Ciudad de México, México
| | - Betzabé Salgado-Arroyo
- Departamento de Nutrición. Hospital Infantil de México Federico Gómez, Ciudad de México, México
| | - Jorge Mario Molina-Díaz
- Departamento de Endocrinología. Hospital Infantil de México Federico Gómez, Ciudad de México, México
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Larenas-Linnemann D, Medina-Ávalos MA, Ortega-Martell JA, Beirana-Palencia AM, Rojo-Gutiérrez MI, Morales-Sánchez MA, Solorio-Gómez H, Alonzo-Romero Pareyón ML, Vargas-Correa JB, Baez-Loyola C, Blancas-Espinosa R, Esquer-Flores J, Gómez-Vera J, Guzmán-Perea MG, Macías-Weinmann A, Maldonado-García CA, Martínez-Villarreal JD, Matta-Campos JJ, Medina-Segura E, Del Río-Navarro B, Salgado-Gama JI, Stone-Aguilar H, Sienra-Monge JJL, González-Díaz SN, Mendoza-López E, Amaya-Guerra M, Lemini-López A, Blanco-Montero A, Chavarría-Jiménez MT, Guerrero-Michaus MG, Martínez-Pérez A, Ramírez-Segura RIM, Montes-Narváez G, Olvera-Salinas J, Rosas-Sumano AB. [Mexican guidelines on the diagnosis and treatment of urticaria]. Rev Alerg Mex 2014; 61 Suppl 2:S118-S193. [PMID: 25724222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023] Open
Abstract
BACKGROUND Urticaria is a disease that a fifth of the population shallsuffer once in a lifetime. Recent clinical guidelines have proposed some fundamental changes in the diagnosis and treatment of urticaria, making the development of a national, multidisciplinary guideline, with wide acceptability among different professional groups -both specialists and primary health care workers-, necessary in Mexico. MATERIAL AND METHOD Internationally recognized tools for guidelinedevelopment were used. An interdisciplinary group of clinical experts (some of them knowledgeable in methodology of guideline development) determined the objectives and scope of the Evidence Based Clinical Practice Guideline with SCOPE. It was decided to adapt and transculturize international guidelines on the diagnosis and treatment of urticaria. With AGREE-II three high-quality guidelines (Zuberbier 2014, Sánchez-Borges 2012, Powell 2007) were selected to function as basic guidelines (BG). A set of Clinical Questions was formulated that lead to recommendations/suggestions, based on these BG, taking into account the cultural and economic background of Mexico, according to GRADE recommendation development. RESULTS By a formal process of discussion and voting during several working-sessions, experts and first level healthcare physicians determined the wording of the final guideline, taking particularly care of developing a document, adjusted to the reality, values and preferences of the Mexican patients. The use of oral second generation, non-sedating antihistamines as first line treatment is emphasized. CONCLUSION This document is an Evidence Based Clinical Practice Guideline for the diagnosis and treatment of acute and chronic urticaria, based on three, high quality, international guidelines. It was developed by a multidisciplinary group. Tables and algorithms make the guideline user-friendly for both, first line health care physicians and specialists.
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Larenas-Linnemann D, Mayorga-Butrón JL, Sánchez-González A, Ramírez-García A, Medina-Ávalos M, Figueroa-Morales MA, Montaño-Velázquez BB, Montes-Narváez G, Romero-Tapia S, Stone-Aguilar H, Xochihua-Díaz L, Salas-Hernández J, Hernán-Ruiz H, Betancourt-Suárez MA, Cano-Salas MC, Curiel-Aceves L, Dibildox-Martínez J, Fernández-Vega M, García-Bolaños C, Iduñate-Palacios F, Jiménez-Chobillon MA, López-Lizárraga DN, Matta-Campos JJ, Olvera-Salinas J, Rivera-Gómez MA, Virgen-Ortega C, Sienra-Monge JJ, Del Río-Navarro B, Arias-Cruz A, Sacre-Hazouri A, Aguilar-Aranda A, Vásquez Del Mercado-Cordero R, Barnica RH, Velasco-Hidalgo L, Solís-Galicia C. [ARIA Mexico 2014. Adaptation of the Clinical Practice Guide ARIA 2010 for Mexico. Methodology ADAPTE]. Rev Alerg Mex 2014; 61 Suppl 1:S3-S116. [PMID: 24941973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Abstract
BACKGROUND The global prevalence of allergic rhinitis is high. International Study of Asthma and Allergies in Childhood (ISAAC) Phase III reports a total estimated prevalence of 4.6% in Mexico. There is evidence based on allergic rhinitis Clinical Practice Guidelines (CPG), but its promotion, acceptance and application is not optimal or adequate in Mexico. OBJECTIVE To generate a guideline for the treatment of allergic rhinitis and its impact on asthma by adaptating the 2010 ARIA Guideline to Mexican reality, through a transculturation process applying the ADAPTE methodology. PATIENTS AND METHOD Using the ADAPTE Methodology, the original 2010 ARIA CPG recommendations were evaluated by the guideline development group (GDG) into which multiple medical specialities managing patients with allergic rhinitis were incoorporated. The GDG valorated the quality of 2010 ARIA, checked and translated key clinical questions. Moreover, the GDG adjusted recommendations, patient preferences and included comments in the context of the Mexican reality (safety, costs and cultural issues). To accomplish this, we ran Delphi panels with as many rounds as necessary to reach agreement. One extra question, not included in the original 2010 ARIA, on the use of Nasal Lavages for AR was created sustained by a systematic literature review. RESULTS A total of 45 questions from the original 2010 ARIA were included and divided into six groups covering prevention, medical treatment, immunotherapy and alternative medicine to treat patients with allergic rhinitis with or without asthma. Most of the questions reached agreement in one or two rounds; one question required three rounds. CONCLUSIONS An easy-to-use, adaptated, up-to-date and applicable allergic rhinitis guideline for Mexico is now available.
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León-Mimila P, Villamil-Ramírez H, Villalobos-Comparán M, Villarreal-Molina T, Romero-Hidalgo S, López-Contreras B, Gutiérrez-Vidal R, Vega-Badillo J, Jacobo-Albavera L, Posadas-Romeros C, Canizalez-Román A, Río-Navarro BD, Campos-Pérez F, Acuña-Alonzo V, Aguilar-Salinas C, Canizales-Quinteros S. Contribution of common genetic variants to obesity and obesity-related traits in mexican children and adults. PLoS One 2013; 8:e70640. [PMID: 23950976 PMCID: PMC3738539 DOI: 10.1371/journal.pone.0070640] [Citation(s) in RCA: 82] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2013] [Accepted: 06/24/2013] [Indexed: 12/12/2022] Open
Abstract
Background Several studies have identified multiple obesity-associated loci mainly in European populations. However, their contribution to obesity in other ethnicities such as Mexicans is largely unknown. The aim of this study was to examine 26 obesity-associated single-nucleotide polymorphisms (SNP) in a sample of Mexican mestizos. Methods 9 SNPs in biological candidate genes showing replications (PPARG, ADRB3, ADRB2, LEPR, GNB3, UCP3, ADIPOQ, UCP2, and NR3C1), and 17 SNPs in or near genes associated with obesity in first, second and third wave GWAS (INSIG2, FTO, MC4R, TMEM18, FAIM2/BCDIN3, BDNF, SH2B1, GNPDA2, NEGR1, KCTD15, SEC16B/RASAL2, NPC1, SFRF10/ETV5, MAF, PRL, MTCH2, and PTER) were genotyped in 1,156 unrelated Mexican-Mestizos including 683 cases (441 obese class I/II and 242 obese class III) and 473 normal-weight controls. In a second stage we selected 12 of the SNPs showing nominal associations with obesity, to seek associations with quantitative obesity-related traits in 3 cohorts including 1,218 Mexican Mestizo children, 945 Mexican Mestizo adults, and 543 Indigenous Mexican adults. Results After adjusting for age, sex and admixture, significant associations with obesity were found for 6 genes in the case-control study (ADIPOQ, FTO, TMEM18, INSIG2, FAIM2/BCDIN3 and BDNF). In addition, SH2B1 was associated only with class I/II obesity and MC4R only with class III obesity. SNPs located at or near FAIM2/BCDIN3, TMEM18, INSIG2, GNPDA2 and SEC16B/RASAL2 were significantly associated with BMI and/or WC in the combined analysis of Mexican-mestizo children and adults, and FTO locus was significantly associated with increased BMI in Indigenous Mexican populations. Conclusions Our findings replicate the association of 8 obesity-related SNPs with obesity risk in Mexican adults, and confirm the role of some of these SNPs in BMI in Mexican adults and children.
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Affiliation(s)
- Paola León-Mimila
- Unidad de Genómica de Poblaciones Aplicada a la Salud, Facultad de Química, Universidad Nacional Autónoma de México (UNAM)-Instituto Nacional de Medicina Genómica (INMEGEN), Mexico City, Mexico
- Unidad de Biología Molecular y Medicina Genómica, Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubirán” (INCMNSZ), Mexico City, Mexico
| | - Hugo Villamil-Ramírez
- Unidad de Genómica de Poblaciones Aplicada a la Salud, Facultad de Química, Universidad Nacional Autónoma de México (UNAM)-Instituto Nacional de Medicina Genómica (INMEGEN), Mexico City, Mexico
- Unidad de Biología Molecular y Medicina Genómica, Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubirán” (INCMNSZ), Mexico City, Mexico
| | | | | | | | - Blanca López-Contreras
- Unidad de Genómica de Poblaciones Aplicada a la Salud, Facultad de Química, Universidad Nacional Autónoma de México (UNAM)-Instituto Nacional de Medicina Genómica (INMEGEN), Mexico City, Mexico
| | - Roxana Gutiérrez-Vidal
- Unidad de Genómica de Poblaciones Aplicada a la Salud, Facultad de Química, Universidad Nacional Autónoma de México (UNAM)-Instituto Nacional de Medicina Genómica (INMEGEN), Mexico City, Mexico
- Unidad de Biología Molecular y Medicina Genómica, Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubirán” (INCMNSZ), Mexico City, Mexico
| | - Joel Vega-Badillo
- Unidad de Genómica de Poblaciones Aplicada a la Salud, Facultad de Química, Universidad Nacional Autónoma de México (UNAM)-Instituto Nacional de Medicina Genómica (INMEGEN), Mexico City, Mexico
- Unidad de Biología Molecular y Medicina Genómica, Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubirán” (INCMNSZ), Mexico City, Mexico
| | | | - Carlos Posadas-Romeros
- Departmento de Endocrinología, Instituto Nacional de Cardiología Ignacio Chávez (INCICh), Mexico City, Mexico
| | | | - Blanca Del Río-Navarro
- Departamento de Alergia e Inmunología Clínica, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | | | | | | | - Samuel Canizales-Quinteros
- Unidad de Genómica de Poblaciones Aplicada a la Salud, Facultad de Química, Universidad Nacional Autónoma de México (UNAM)-Instituto Nacional de Medicina Genómica (INMEGEN), Mexico City, Mexico
- Unidad de Biología Molecular y Medicina Genómica, Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubirán” (INCMNSZ), Mexico City, Mexico
- * E-mail:
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Larenas-Linnemann D, Ortega-Martell JA, Del Río-Navarro B, Rodríguez-Pérez N, Arias-Cruz A, Estrada A, Becerril-Ángeles M, Pietropaolo-Cienfuegos DR, Ambriz-Moreno MDJ, Báez-Loyola C, Cossío-Ochoa E, González-Díaz SN, Hidalgo-Castro EM, Huerta-Hernández RE, Macías-Weinmann A, Oyoqui-Flores J, Stone-Aguilar H, Treviño-Salinas MB, Zárate-Hernández MDC. [Mexican clinical practice guidelines of immunotherapy 2011]. Rev Alerg Mex 2011; 58:3-75. [PMID: 21967873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Abstract
BACKGROUND Several international guidelines on immunotherapy exist, but they only apply partially in Mexico. The Mexican guideline of immunotherapy dates from 1998. OBJECTIVES To establish clinical recommendations and suggestions for Allergy residents and specialists for skin testing and allergen immunotherapy based on evidence and Mexican expert opinion, according to the GRADE system. METHODS The guidelines were developed following the methodology of a guideline for clinical practice starting with the formulation of clinical questions, in the context of Mexican environmental conditions and morbidity, with the participation of allergists from all regions of the country. External validation was obtained. Its development followed three steps: 1. formulation of 24 clinical questions. 2. Search for consensus on the answers among members of the Regional chapters of both Mexican Colleges of Allergists (CMICA and COMPEDIA) during regional meetings. 3. Literature search for articles related to the questions and grading of its quality according to GRADE. RESULTS Based on the regional consensus, 116 articles and the safety, patient acceptance/ comfort and cost clinical recommendations and suggestions were developed on basic aspects of skin testing, subcutaneous and sublingual immunotherapy (patient preparation, vial preparation and application schedules) and the treatment of eventual adverse reactions. CONCLUSIONS A clinical guideline was developed respecting particular methodology, validated by CMICA and COMPEDIA for its implementation among Mexican allergists. Several aspects deserve further study to improve scientific evidence. KEYWORDS Allergen immunotherapy, subcutaneous immunotherapy, sublingual immunotherapy, skin testing, allergy diagnosis, rhinitis, asthma, atopic dermatitis, house dust mite, pollens, anaphylaxis, adrenaline, Mexico.
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