Alejandra Macías-Weinmann

Atmospheric pollen count in Monterrey, Mexico.

There are few reports of pollen count and identification in Mexico; therefore, it is important to generate more information on the subject. This study was designed to describe the prevalence of pollen in the city of Monterrey, Mexico, during the year 2004. Atmospheric pollen was collected with a Hirst air sampler, with an airflow of 10 L/minute during 2004. Pollen was identified with light microscopy; the average monthly pollen count as well as total was calculated from January 2004 to January 2005. The months with the highest concentration of pollen were February and March (289 and 142 grains/m(3) per day, respectively), and July and November had the lowest concentration (20 and 11 grains/m(3) per day, respectively). Most of the pollen recollected corresponded to tree pollen (72%). Fraxinus spp had the highest concentration during the year (19 grains/m(3) per day; 27.5% of the total concentration of pollen). Tree pollen predominated from January through March; with Fraxinus spp, Morus spp, Celtis spp, Cupressus spp, and Pinus spp as the most important. Weed pollen predominated in May, June, and December and the most frequently identified, were Amaranthaceae/Chenopodiaceae, Ambrosia spp, and Parietaria spp. The highest concentration of grass pollen was reported during the months of May, June, September, October, and December with Gramineae/Poaceae predominating. Tree pollen was the most abundant during the year, with the ash tree having the highest concentration. Weed and grass pollen were perennial with peaks during the year.

Consenso mexicano para el diagnóstico y tratamiento de la dermatitis atópica en adolescentes y adultos

Busqueda sistematica de la literatura en PubMed y GREAT. Con apoyo metodologico y utilizando el metodo Delphi se desarrollo un consenso formal entre 16 expertos en dermatologia y alergologia, basandose en la evidencia actual y su aplicabilidad en el contexto mexicano. A parte de una comunicacion electronica intensa, se discutieron los puntos en desacuerdo en dos reuniones presenciales.BACKGROUND The diagnostic approaches and therapeutic strategies of atopic dermatitis (AD) are generally inconsistent among physicians and health institutions. OBJECTIVE To develop a consensus statement among experts to reduce the variations in practice regarding the diagnosis and treatment of patients ≥ 12 years with AD to improve their care. METHODS Systematic literature search in PubMed and GREAT. With methodological support and using the Delphi method, a formal consensus was developed among 16 experts in Dermatology and Allergology, based on the current evidence and its applicability in the Mexican context. Apart from intense electronic communication, several issues of disagreement were discussed in two face-to-face meetings. RESULTS The clinical experts reached consensus on 46 statements related to the definition, classification, diagnostic strategies and treatment of AD. For the diagnosis we suggest the Williams criteria and for severity scoring the SCORAD (by the doctor) and POEM (by the patient). In addition to general care and treatment education (workshops), we suggest four steps for treatment, depending on severity: 1. Topical treatment with anti-inflammatory agents (and systemic: antihistamines/antileukotrienes -low level evidence-) 2. Phototherapy, 3. Cyclosporin A and 4. Dupilumab, with the possibility of managing this biological earlier on if a fast effect is needed. In extrinsic AD we suggest evaluating the addition of allergen immunotherapy or an elimination diet, if there is an IgE-mediated respiratory or food allergy, respectively. CONCLUSION The panel of experts reached consensus on relevant aspects of AD with a focus on the transcultural adaptation of recent evidence.

465 Skeeter Syndrome, a Case Report and Literature Review

Background The worldwide prevalence of allergic reaction to mosquito bites is unknown. Some patients who suffer from local reactions have also systemic symptoms. Methods A 3 year old female who suffered from mosquitoes bites in her left lower extremity, had a large local reaction with erythema, edema, itching, pain and blisters of 5 × 6 cm. It was accompanied by fever of 38.5°C and emesis. She had a positive skin prick test for Aedes aegypti with diagnosis of Skeeter Syndrome. The patient was treated with antihistamine during 10 days and analgesics for 3 days. She was given antihistamine treatment for 10 days and analgesics for 3 days. Results Skeeter syndrome is defined as a large local reaction induced by mosquito bites associated with systemic symptoms (fever and vomiting) with specific IgE for mosquito identified by skin testing. The primary management of Skeeter syndrome is prevention of mosquito bites, the use of repellents and protective clothing. It is also important the symptomatic management control of pruritus with the use of antihistamines or if necessary topical steroids. Overall children with Skeeter syndrome remain healthy, except for the recurrence of large local reactions to mosquito Stings. Conclusions The early recognition of Skeeter syndrome is important to give the right management and to prevent unnecessary diagnostic tests and treatments that can increase the risk of adverse reactions and costs.

515 Prevalence of Latex Sensitization Between Medicine and Dentistry Students from Nuevo Leon University

Background Latex allergy has become an important health problem in the last 2 decades. Sensitization in general population is about 1%.1 Healthcare workers have a frequency of 2% to 25%.2 There is not information about this issue in Mexico. Our objective was to know and compare prevalence of latex sensitization in last grade medicine and dentistry students of the Nuevo Leon University. Methods This was an observational, prospective and comparative study. Last grade medicine and dentistry students were invited to participate. Spanish version of the Latex Allergy Questionnaire (ACAAI recommended) and skin tests for latex: prick test (SPT) (latex extract Allerstand 1:20 w/v), prick by prick (PBPT) (latex gloves) were performed in every patient. Positive control was histamine 10 mg/mL and glycerinated solution for negative control (allerstand) using duotip test disponsable. SPT and PBPT were read 15 min after application and positive result were interpreted as a wheal diameter of 3 mm more than negative control. Data were analyzed for demographics with Statistical Package for Social Sciences (SPSS v16.0), for comparison between groups of sensitized patients fisher exact test was performed. Results Study included 378 patients, 213 (56.3%) dentistry students and 165 (43.7%) medicine students. Male/female ratio was 1.2/1 for medicine and 0.36/1 for dentistry. Average age was 23 years in both groups. General sensitization to latex was 7.1% (27), per group medicine was 6% (10) and dentistry 7.9% (17). Almost to all commercial extract, only one patient in each group was positive to gloves PBPT. By questionnaire 10.9% medicine group and 17.3% of dentistry group report symptoms with latex, but only 14.8% of dentistry group was Skin test positive, no one in medicine group. Rhinitis or conjunctivitis symptoms were found in 48.1% of sensitized patients. Most frequent foods associated with symptoms were pineapple (2.6%), fig (2.1%), avocado (1.9%) and kiwifruit (1.6%). There was no statistical difference between both groups sensitization (P = 0.549). Conclusions Latex sensitization was more common in healthcare students than references in general population but symptoms referred to latex no always are demonstrated by IgE sensitization, so delayed mechanism must be take in to account to get a better diagnosis and treatment approach.