Dermatophagoides pteronyssinus: Changes in sensitisation in the past 11 years and comparison with other centres in Mexico

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Maloča Vuljanko, M. Turkalj, B. Nogalo, S. Bulat Lokas, D. Plavec" "autores" => array:5 [ 0 => array:2 [ "nombre" => "I." "apellidos" => "Maloča Vuljanko" ] 1 => array:2 [ "nombre" => "M." "apellidos" => "Turkalj" ] 2 => array:2 [ "nombre" => "B." "apellidos" => "Nogalo" ] 3 => array:2 [ "nombre" => "S." "apellidos" => "Bulat Lokas" ] 4 => array:2 [ "nombre" => "D." 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"apellidos" => "Fernández-Soto" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 2 => array:4 [ "nombre" => "B.E." "apellidos" => "Del Rio-Navarro" "email" => array:1 [ 0 => "blancadelrionavarro@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 3 => array:3 [ "nombre" => "O.J." "apellidos" => "Saucedo-Ramírez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 4 => array:3 [ "nombre" => "J.J.L." "apellidos" => "Sienra-Monge" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Alergia e Inmunología Clínica Pediátrica, Hospital Infantil de México Federico Gómez, México, DF, Mexico" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Subdirección de Pediatria Ambulatoria, Hospital Infantil de México Federico Gómez, México, DF, Mexico" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1318 "Ancho" => 2264 "Tamanyo" => 185235 ] ] "descripcion" => array:1 [ "en" => "Analysis of positive skin tests to Dermatophagoides in children under and over 6 years of age in different years. Note: For this analysis we only included patients with at least one positive SPT." ] ] ] "textoCompleto" => "IntroductionThe house dust mite is a ubiquitous air allergen in human habitat and is considered to be one of the most important causes of sensitisation to indoor allergens.<a class="elsevierStyleCrossRefs" href="#bib0185">1,2</a> It is an eight-legged arthropod of the arachnid group, belonging to the order Acari and comprises a large number of species grouped under several suborders, families and genera.The term “house dust mites” has been used traditionally for members of the family Pyroglyphidae that live permanently and almost exclusively in house dust where the main representatives (80–90%) are Dermatophagoides pteronyssinus (Der p.), Dermatophagoides farinae (Der f.), and Euroglyhpus maynei; whereas others such as Blomia tropicalis and Lipidoglyphus destructor, despite being considered as warehouse mites, are species commonly found in homes located in tropical and subtropical climates.<a class="elsevierStyleCrossRef" href="#bib0195">3</a>It has been demonstrated that exposure to dust mites is a fundamental factor for sensitisation and development of atopic pathology.<a class="elsevierStyleCrossRef" href="#bib0200">4</a> The prevalence of exposure and sensitisation varies greatly according to the region studied, which greatly depends on geographic and environmental factors of the mentioned regions, i.e., in Spain a sensitisation for Dermatophagoides is reported in children <6 years old of 11.8%, in Germany of 11.9% and The Netherlands of 13.6%,<a class="elsevierStyleCrossRef" href="#bib0205">5</a> with an overall average prevalence in Europe of 21.7% (4.8–36.8%) for Der p.<a class="elsevierStyleCrossRef" href="#bib0210">6</a>; whereas in Korea the frequency of sensitisation is from 36.8 to 40.9%.<a class="elsevierStyleCrossRef" href="#bib0215">7</a> In Latin America the frequency depends on the study location and ranges from 60.7% to Der p. in Colombia to 91.2% in Brazil.<a class="elsevierStyleCrossRef" href="#bib0220">8</a>According to world statistics, an estimated 1–2% of the world's population could be allergic to this allergen, i.e., equivalent to 65–130 million persons.<a class="elsevierStyleCrossRef" href="#bib0185">1</a> In México, various studies have been published on the frequency of sensitisation to house dust mites (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>).<elsevierMultimedia ident="tbl0005"></elsevierMultimedia>It is well known that there are differences in the percentage of positivity reported depending on the region where the test is applied, climate, and geography, as well as the technique used, the allergen extracted, and its strength. Most studies reported in Mexico on the sensitisation to mites are cross-sectional studies with the exception of the study by Meza-Velázquez et al. where a review of 2000 records of children with asthma or allergic rhinitis over a 10-year period was included.Mexico is located in the American Continent, in the northern hemisphere; comprising 1.9 million square kilometres of land area, with a climate from warm to cold, however, temperatures range from 10°C to 26°C in 93% of the territory<a class="elsevierStyleCrossRef" href="#bib0255">15</a> (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>).<elsevierMultimedia ident="tbl0010"></elsevierMultimedia>The prevalence of allergic diseases is increasing, but we do not know if, in terms of desensitisation, the same occurs as well, mainly to indoor allergens such as the house dust mites. The objective of this study was to determine the annual frequency and analyse changes in the sensitisation to Der p. in children treated in our hospital and compare these frequencies with different reports from Mexico.Patients and methodsA retrospective study was conducted in the Allergy and Clinical Immunology Department of the hospital, which included the data collection of skin test results to Der p. carried out by physicians and laboratory technicians from January 2004 to April 2015. We recruited all patients aged 2–18 years old who presented for evaluation of any type of allergic condition and those who required a skin prick test (SPT) according to ongoing guides. After the clinical history and review by a certified allergist and immunologist, subjects who met the criteria had the skin test performed to inhalants (previous consent and assent signed), among which this indoor allergen was included. Patients came principally from Mexico City, Estado de México, and surrounding areas. Demographic information for all patients was reviewed as well as the referring diagnoses. This study was approved by the Ethics, Research and Biosafety Committees from HIMFG (protocol number HIM/2015/045) following the rules of the institution.Skin tests were done during the entire time of the study with IPI Assac® extracts which have been standardised in the same way since 1999 and commercialised as UBE/ml (equivalent biologic unit). We used the same protocol for skin prick test SPT suggested by the Global Allergy and Asthma European Network, The European Academy of Allergy and Clinical Immunology and The American Academy of Allergy, Asthma and Immunology (AAAAI).<a class="elsevierStyleCrossRefs" href="#bib0260">16,17</a> Allergen extracts were stored at +2 to +8°C when not in use. Before the SPT, we recorded medications taken by the patient in the previous week to avoid false positives. Tests were applied on the upper back or in the volar aspect of the forearm, at least 2–3cm apart from the wrist and the antecubital fosase; histamine (10mg/ml) and saline solutions were used as positive and negative controls, respectively, in each patient. We previously marked the skin area with a pen, tests were placed 2cm apart from each other. A drop of each test solution was placed on the skin in identical order for all subjects tested and immediately pricked with a single-head metal lancet, without causing bleeding. Results were recorded after 15min. The largest and perpendicular diameter of the wheal was measured and the following value calculated: largest+perpendicular diameter/2. A wheal ≥3mm was considered to be a positive reaction with respect to the negative control. Each panel was comprised of a total of 27 environmental allergens, which included six moulds, four extracts from animal skin, 14 pollens including seven weeds, three grasses, and four trees, as well as cockroach and mite extract (only Dermatophagoides pteronyssinus – Der p. was used) (<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>).<elsevierMultimedia ident="tbl0015"></elsevierMultimedia>For the purposes of our goals, descriptive statistics were carried out to obtain a frequency and 95% CI of immediate hypersensitivity tests to Der p. analysed by intra- and intergroup χ2 with reported frequencies as in other studies in the country. We also analysed the differences that occurred in each during the 11 years studied.ResultsA total of 8794 patients were included with ages between 2 and 18 years old with a mean of 7.9 years (±3.7); 41.6% of the patients (95% CI 40–42) were from Mexico City, 51.6% Estado de México (95% CI 50–52) and 6.7% came from the remaining areas of Mexico (95% CI 6–7). The most frequent diagnosis was rhinitis (69.5%). <a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a> shows the distribution of the patients according to diagnosis where we can observe the overlap of these diseases as expected in atopic patients.<elsevierMultimedia ident="tbl0020"></elsevierMultimedia>Within 8794 tests, 14% (95% CI 13–14.8) were negative to the entire panel and of the remaining 7565 tests, 49.3% (95% CI 48–50) were positive for Der p., of which 2.7% (95% CI 2–3) were monosensitised (Der p.). The year with the highest percentage of sensitisation was 2006. Analysis of the results of positive skin tests for each year is shown in <a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>.<elsevierMultimedia ident="fig0005"></elsevierMultimedia>Of the tests conducted during the study, 34% (95% CI 33–35) were performed in children <6 years old, of whom 39% (95% CI 37–41) were positive for Dermatophagoides pteronyssinus. When the group of children >6 years old was studied, we found that the overall percentage of sensitisation was 54% (95% CI 52–55). Comparison between these groups was statistically significant (p=0.000). In all the years studied, we found a higher proportion of positive tests in children >6 years old (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>).<elsevierMultimedia ident="fig0010"></elsevierMultimedia>Stratifying the group, it was found that the ages with the highest percentage of sensitisation were 14–16 years old. From 6 to 18 years old, 50% of the children were sensitised to Dermatophagoides (<a class="elsevierStyleCrossRef" href="#tbl0025">Table 5</a>). When compared by age and by years we found a general decrease in the sensitisation percentage in all ages (<a class="elsevierStyleCrossRef" href="#tbl0030">Table 6</a>). In the rest of Mexico, the highest percentages were reported in Merida with 75% (95% CI 68–80%) followed by Monterrey and Irapuato. In the study by Larennas<a class="elsevierStyleCrossRef" href="#bib0240">12</a> a lower reactivity was reported in Queretaro (28%) (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>).<elsevierMultimedia ident="tbl0025"></elsevierMultimedia><elsevierMultimedia ident="tbl0030"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia>DiscussionIndoor allergens represent one of the most important factors in causing allergic diseases as well as in arousing symptoms. From these, house dust mites have been considered as the most important factor associated with rhinitis and asthma.Sensitisation to house dust mites is common and relatively constant; however, there are two important factors that have an influence on this sensitisation: the first corresponds to the geographic variation of the region studied and includes: weather, vegetation, altitude, etc.; the second corresponds to the characteristics inherent to the population: socioeconomic status, activity, exposure, etc. With this, we can understand why a different prevalence of sensitisation is reported in different populations, even in the same country and in the same city. An example of this is the prevalence reported in Europe and Asia—up to 75.5% in Israel,<a class="elsevierStyleCrossRef" href="#bib0280">20</a> 52.8% in Korea<a class="elsevierStyleCrossRef" href="#bib0285">21</a> and 19.2% in the UK.<a class="elsevierStyleCrossRef" href="#bib0290">22</a> In Latin America, a sensitisation—in decreasing order—of 82.1% in Argentina,<a class="elsevierStyleCrossRef" href="#bib0295">23</a> 76.9–81.5% in Cuba,<a class="elsevierStyleCrossRef" href="#bib0300">24</a> 80% in Chile<a class="elsevierStyleCrossRef" href="#bib0305">25</a> and 69.9% in Ecuador.<a class="elsevierStyleCrossRef" href="#bib0310">26</a> Another important point to understand when the sensitisation to house dust mites is studied, is the change in climate and air quality that has occurred the past years and it impacts not only on morbidity, but also on mortality of patients with allergic diseases.<a class="elsevierStyleCrossRef" href="#bib0315">27</a> Different authors have attempted to show the effect that this climate change has had on the sensitisation of patients with allergic diseases by examining differences between population groups.We reviewed the results of skin tests; therefore, our study provides valuable information about the variations in the frequency of sensitisation throughout this period. The study found a higher frequency of sensitisation to Dermatophagoides pteronyssinus in patients 6–16 years old compared with younger and older ages, the decision of selecting a cut-off of six years of age was made based on Moral et al.,<a class="elsevierStyleCrossRef" href="#bib0320">28</a> who report an increase of mites sensitisations after six years old, our results are similar to this author who found a progressive increase in sensitisation which ranged from 16% at 0–2 years to 87% at 6–14 years.<a class="elsevierStyleCrossRef" href="#bib0320">28</a> Subsequently, this trend inverts itself with a gradual decrease in the reactivity according to age, with lower values demonstrated close to 70 years of age.<a class="elsevierStyleCrossRef" href="#bib0290">22</a> However, there are reports about the cut-off age in which this change in the pattern of sensitisations takes place. Dottorini<a class="elsevierStyleCrossRef" href="#bib0325">29</a> and Pallasaho<a class="elsevierStyleCrossRef" href="#bib0330">30</a> found, in a cohort of patients 14–64 years of age, that the decrease occurred after the fifth decade of life, whereas other authors showed a decrease at 30 years of age.<a class="elsevierStyleCrossRef" href="#bib0335">31</a> Those investigators, who studied populations that included children as well as adults, found cut-off values even lower at ∼14 years old,<a class="elsevierStyleCrossRef" href="#bib0340">32</a> similar to our results.Another important point is that we found a decrease in general sensitisation to mites in the group >10 years old, both in the analysis group and the group stratified by ages. Warm<a class="elsevierStyleCrossRef" href="#bib0345">33</a> and Francis<a class="elsevierStyleCrossRef" href="#bib0350">34</a> obtained similar information in comparisons carried out from 1999 to 2009 and from 1986 to 2001, respectively; however, these results are not reproduced in all series such as the Copenhagen Allergy Study,<a class="elsevierStyleCrossRef" href="#bib0355">35</a> which found an increase from 12.2 to 14.1% in the frequency of positive tests to this indoor allergen between 1990 and 1998 in subjects 15–41 years old and in the study by Ronmark<a class="elsevierStyleCrossRef" href="#bib0360">36</a> who also reported an increase in sensitisation from 0.5 to 1.4% from 1996 to 2006. These differences can point to diverse factors such as the ages of the group included and type of allergens used, because in some series the extract varied from one year to another. In this regard, the fact of having used the same extracts with a relatively similar population represents a strength of our study.We found a decrease in sensitisation prevalence in the group of 16–18 years old from 2004 to 2014 as in all patients, but we saw this trend exacerbated in this group, perhaps as we said, it is a trend manifested in all groups we recognised this specifically group has less participants.When compared with similar studies in the rest of the country, we see variations in sensitisation according to the location where the tests were performed, type of extract used and the study population. Locations in Mexico with the greatest sensitisation were (in descending order) Merida, Irapuato, Monterrey and Queretaro. In our case the percentage of positivity corresponds to an intermediate value compared to the rest of Mexico. This is explained by the diversity of the population we have in our institution. We only review the frequency of Dermatophagoides pteronyssinus sensitisation, and perhaps this is a study limitation; according to Fernández-Duro et al., who evaluated the mite species found in Mexican homes of different regions, Dermatophagoides pteronyssinus is the predominant mite and was found in 100% of the samples.Finally, we found that the frequency of sensitisation to Dermatophagoides pteronyssinus increases with age until adolescence. In the past 11 years there has been a general tendency to a decrease in sensitisation to this indoor allergen in our population.Ethical disclosuresConfidentiality of dataThe authors declare that they have followed the protocols of their work centre on the publication of patient data and that all the patients included in the study have received sufficient information and have given their informed consent in writing to participate in that study.Right to privacy and informed consentThe authors have obtained the informed consent of the patients and/or subjects mentioned in the article. The author for correspondence is in possession of this document.Protection of human subjects and animals in researchThe authors declare that no experiments were performed on humans or animals for this investigation.FundingNo external funding sources were used for carrying out this study.Conflict of interestThe authors declare no conflict of interest." 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It has been shown that exposure to them is a fundamental factor in sensitisation and development of atopic disease. The objective of the study was to analyse changes in sensitisation to Dermatophagoides pteronyssinus (Der p.) in children treated in a tertiary level care hospital in Mexico City for a period of 11 years and compare with other studies carried out in Mexico. MethodsA retrospective study was performed at the Hospital Infantil de México Federico Gómez (HIMFG). Information was gathered from skin tests for Der p. performed in the Allergy Laboratory from January 2004 to April 2015. Patients 2–18 years old who presented for examination of some type of allergic condition and who had immediate hypersensitivity tests to Der p. were included in the study. Results were compared with prior reports from other institutions. Descriptive analysis and χ2 statistics were used. ResultsA total of 8794 patients were included in the study; 49.3% of the tests (95% CI 48–50) were positive for Der p. The percentage of monosensitised to mites was 2.7% for Der p. (95% CI 2–3). A significant difference was found between the results of older patients and those <6 years old. The frequency of sensitisation had a tendency to decrease during the 11 years analysed in all age groups. Conclusions and clinical relevanceThe frequency of sensitisation to Der p. increased with age until reaching adolescence. In the last 11 years a decrease in sensitisation to this air allergen was observed." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Background" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions and clinical relevance" ] ] ] ] "multimedia" => array:9 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1267 "Ancho" => 2534 "Tamanyo" => 195595 ] ] "descripcion" => array:1 [ "en" => "Percentage of skin test positivity to Dermatophagoides pteronyssinus by year (n=7565). 2004 n=718, 2005 n=870, 2006 n=641, 2007 n=653, 2008 n=379, 2009 n=319, 2010 n=759, 2011 n=769, 2012 n=646, 2013 n=788, 2014 n=801, 2015 n=222. Note: For this analysis we only included patients with at least one positive SPT." ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1318 "Ancho" => 2264 "Tamanyo" => 185235 ] ] "descripcion" => array:1 [ "en" => "Analysis of positive skin tests to Dermatophagoides in children under and over 6 years of age in different years. Note: For this analysis we only included patients with at least one positive SPT." ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1356 "Ancho" => 2742 "Tamanyo" => 191060 ] ] "descripcion" => array:1 [ "en" => "Comparison of the sensitisation to Dermatophagoides p. in different centre in Mexico. *Bedolla et al. (2010). n=752 patients with rhinitis 16–78 years old.<a class="elsevierStyleCrossRef" href="#bib0270">18</a> **Cavazos-Galvan et al. (2008) n=58 patients 27–31 years old.<a class="elsevierStyleCrossRef" href="#bib0230">10</a> ***Baeza M. 2005 n=176 patients with rhinitis and/or asthma 2–5 years old.<a class="elsevierStyleCrossRef" href="#bib0275">19</a> ****Larenas-Linneman et al., 2011 n=4169 2–65 years." ] ] 3 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Authors \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Year \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">n \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Included locations \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">% Sensitisation \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Meza-Velázquez et al. <a class="elsevierStyleCrossRef" href="#bib0225">[9]</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1999 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2000 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Mexico City \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">89% Der p. and Der f. \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Cavazos et al. <a class="elsevierStyleCrossRef" href="#bib0230">[10]</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2008 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">58 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Monterrey, Irapuato, Tampico \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Monterrey Der f. 88%, Der p. 83% Irapuato Der p. 70% and Der f. 60% Tampico Der p. 1 55% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Martínez et al. <a class="elsevierStyleCrossRef" href="#bib0235">[11]</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2010 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">334 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Mexico City \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">56.6% to 1–4 mites (Der p., Der f., Blo t, Der s) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Larennas-Linnemann et al. <a class="elsevierStyleCrossRef" href="#bib0240">[12]</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2011 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4169 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Multicenter \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Der p. 46–70% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Ramírez-Heredia et al. <a class="elsevierStyleCrossRef" href="#bib0245">[13]</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2013 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">150 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Mexico City \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Der p. 82.1%, Der f. 71.5% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Lopez-Rocha et al. <a class="elsevierStyleCrossRef" href="#bib0250">[14]</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2014 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">672 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Mexico City \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Der p. and Der f. 72.2% \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1302717.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Prevalence of house dust mite sensitisation in Mexico." ] ] 4 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at2" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "Source: Instituto Nacional de Estadística y Geografía México. Available on: <a class="elsevierStyleInterRef" id="intr0005" href="http://www.cuentame.inegi.org.mx/">http://www.cuentame.inegi.org.mx</a>." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Region \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Weather \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Average annual temperature \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Annual rainfall \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Mexico City \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Temperate, sub-humid \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">16°C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">600mm \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Mexico State \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Temperate, sub-humid \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">14.7°C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">900mm \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Guadalajara, Jalisco \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Temperate, sub-humid \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">20.5°C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">850mm \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Monterrey, Nuevo León \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Semidry and dry \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">20°C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">650mm \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Irapuato, Guanajuato \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Warm, sub-humid \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">18°C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">650mm \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Tampico, Tamaulipas \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Warm, humid \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">23.5°C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">780mm \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Mérida, Yucatán \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Warm, humid \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">26°C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1100mm \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Querétaro \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Temperate, sub-humid \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">18°C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">570mm \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1302722.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Climatic characteristics of some regions of Mexico." ] ] 5 => array:8 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at3" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "Note: For the purposes of this review we only show the Dermatophagoides pteronyssinus results." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Moulds and fungi \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Alternaria alternata \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Aspergillus fumigatus \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Candida albicans \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Cladosporium herbarum \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Mucor mucedo \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Penicillium notatum \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Epidermal \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Horse \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Cat hair \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Dog \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Chicken feathers \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Indoor \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Blatella germanica \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Dermatophagoides pteronyssinus \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Periplaneta americana \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Pollens \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Ambrosia trifida \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Artemisa vulgaris \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Chenopodium album \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Cynodon dactylon \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Fraxinus excelsior \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Helianthus annus \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Ligustrum vulgare \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Lolium perenne \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Phleum pratense \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Plantago lanceolata \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Quercus robur \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Rumex spp \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Salsola kali \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Schinus molle \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1302718.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Panel of 27 airborne allergens tested." ] ] 6 => array:8 [ "identificador" => "tbl0020" "etiqueta" => "Table 4" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at4" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "Note: The diagnoses were made by a paediatric allergist according to ongoing guides:Global Initiative for Asthma (GINA).Allergic Rhinitis and its Impact on Asthma (ARIA).Disease management of atopic dermatitis: Practice Parameter.No differences found in patients’ gender." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Diagnosis \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">% of patients (number of patients) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">95% CI \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Asthma \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">42.9% (3773) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">40–45 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Rhinitis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">69.7% (6130) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">67–71 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Atopic dermatitis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">41% (3605) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">38–42 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1302721.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Distribution of patients according to reported diagnosis (n=8794)." ] ] 7 => array:8 [ "identificador" => "tbl0025" "etiqueta" => "Table 5" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at5" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "Note: For this analysis we only included patients with at least one positive SPT." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Age group (years) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">2004–2015 (%) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">95% CI \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">2–4 (n=1050) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">34.50 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">31–37 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">4–6 (n=1565) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">43.40 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">40–45 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">6–8 (n=1391) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">51.70 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">49–55 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">8–10 (n=1210) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">53.70 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">50–56 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">10–12 (n=1043) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">55.40 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">52–58 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">12–14 (n=718) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">56.50 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">52–60 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">14–16 (n=437) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">59.30 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">54–63 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">16–18 (n=151) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">52.30 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">44–60 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1302720.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Percentage of sensitisation to Dermatophagoides pteronyssinus separated according to age in the study population (n=7565)." ] ] 8 => array:8 [ "identificador" => "tbl0030" "etiqueta" => "Table 6" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at6" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "Note: For this analysis we only included patients with at least one positive SPT." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Age group (years) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">2004 (%) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">2014 (%) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">2–4 (n=1050) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">44 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">29.70 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.03 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">4–6 (n=1565) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">52.90 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">40.37 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.03 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">6–8 (n=1391) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">65.22 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">40.50 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.00 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">8–10 (n=1210) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">73.15 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">44.19 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.00 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">10–12 (n=1043) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">65.85 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">52.34 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.07 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">12–14 (n=718) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">76.06 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">50 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.00 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">14–16 (n=437) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">76.36 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">59.26 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.06 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">16–18 (n=151) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">70 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">25 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.04 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1302719.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Comparison of the percentage of sensitisation to mites separated by age in 2004 vs. 2014 (n=7565)." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:36 [ 0 => array:3 [ "identificador" => "bib0185" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Dust mites" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "M.J. Colloff" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:4 [ "edicion" => "1st ed." "fecha" => "2009" "editorial" => "CSIRO Publishing" "editorialLocalizacion" => "The Netherlands" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0190" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Respiratory allergy caused by house dust mites: what do we really know?" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M.A. Calderón" 1 => "A. Linneberg" 2 => "J. Kleine-Tebbe" 3 => "F. De Blay" 4 => "D. Hernandez Fernandez de Rojas" 5 => "J.C. 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"vista" => "all" ] ] ] "idiomaDefecto" => "en" "url" => "/03010546/0000004500000001/v1_201612300037/S0301054616301513/v1_201612300037/en/main.assets" "Apartado" => array:4 [ "identificador" => "5554" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Original articles" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/03010546/0000004500000001/v1_201612300037/S0301054616301513/v1_201612300037/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0301054616301513?idApp=UINPBA00004N"]

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Original Article

E.M. Navarrete-Rodrígueza, J.R. Fernández-Sotoa, B.E. Del Rio-Navarroa,

Corresponding author

blancadelrionavarro@gmail.com

Corresponding author.

, O.J. Saucedo-Ramíreza, J.J.L. Sienra-Mongeb

a Servicio de Alergia e Inmunología Clínica Pediátrica, Hospital Infantil de México Federico Gómez, México, DF, Mexico

b Subdirección de Pediatria Ambulatoria, Hospital Infantil de México Federico Gómez, México, DF, Mexico

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are <span class="elsevierStyleItalic">Dermatophagoides pteronyssinus</span> &#40;<span class="elsevierStyleItalic">Der p</span>&#46;&#41;&#44; <span class="elsevierStyleItalic">Dermatophagoides farinae</span> &#40;<span class="elsevierStyleItalic">Der f</span>&#46;&#41;&#44; and <span class="elsevierStyleItalic">Euroglyhpus maynei</span>&#59; whereas others such as <span class="elsevierStyleItalic">Blomia tropicalis</span> and <span class="elsevierStyleItalic">Lipidoglyphus destructor</span>&#44; despite being considered as warehouse mites&#44; are species commonly found in homes located in tropical and subtropical climates&#46;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">3</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">It has been demonstrated that exposure to dust mites is a fundamental factor for sensitisation and development of atopic pathology&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">4</span></a> The prevalence of exposure and sensitisation varies greatly according to the region studied&#44; which greatly depends on geographic and environmental factors of the mentioned regions&#44; i&#46;e&#46;&#44; in Spain a sensitisation for <span class="elsevierStyleItalic">Dermatophagoides</span> is reported in children &#60;6 years old of 11&#46;8&#37;&#44; in Germany of 11&#46;9&#37; and The Netherlands of 13&#46;6&#37;&#44;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">5</span></a> with an overall average prevalence in Europe of 21&#46;7&#37; &#40;4&#46;8&#8211;36&#46;8&#37;&#41; for <span class="elsevierStyleItalic">Der p&#46;</span><a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">6</span></a>&#59; whereas in Korea the frequency of sensitisation is from 36&#46;8 to 40&#46;9&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">7</span></a> In Latin America the frequency depends on the study location and ranges from 60&#46;7&#37; to <span class="elsevierStyleItalic">Der p&#46;</span> in Colombia to 91&#46;2&#37; in Brazil&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">8</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">According to world statistics&#44; an estimated 1&#8211;2&#37; of the world&#39;s population could be allergic to this allergen&#44; i&#46;e&#46;&#44; equivalent to 65&#8211;130 million persons&#46;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">1</span></a> In M&#233;xico&#44; various studies have been published on the frequency of sensitisation to house dust mites &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">It is well known that there are differences in the percentage of positivity reported depending on the region where the test is applied&#44; climate&#44; and geography&#44; as well as the technique used&#44; the allergen extracted&#44; and its strength&#46; Most studies reported in Mexico on the sensitisation to mites are cross-sectional studies with the exception of the study by Meza-Vel&#225;zquez et al&#46; where a review of 2000 records of children with asthma or allergic rhinitis over a 10-year period was included&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Mexico is located in the American Continent&#44; in the northern hemisphere&#59; comprising 1&#46;9 million square kilometres of land area&#44; with a climate from warm to cold&#44; however&#44; temperatures range from 10<span class="elsevierStyleHsp" style=""></span>&#176;C to 26<span class="elsevierStyleHsp" style=""></span>&#176;C in 93&#37; of the territory<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">15</span></a> &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0035" class="elsevierStylePara elsevierViewall">The prevalence of allergic diseases is increasing&#44; but we do not know if&#44; in terms of desensitisation&#44; the same occurs as well&#44; mainly to indoor allergens such as the house dust mites&#46; The objective of this study was to determine the annual frequency and analyse changes in the sensitisation to <span class="elsevierStyleItalic">Der p&#46;</span> in children treated in our hospital and compare these frequencies with different reports from Mexico&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Patients and methods</span><p id="par0040" class="elsevierStylePara elsevierViewall">A retrospective study was conducted in the Allergy and Clinical Immunology Department of the hospital&#44; which included the data collection of skin test results to <span class="elsevierStyleItalic">Der p&#46;</span> carried out by physicians and laboratory technicians from January 2004 to April 2015&#46; We recruited all patients aged 2&#8211;18 years old who presented for evaluation of any type of allergic condition and those who required a skin prick test &#40;SPT&#41; according to ongoing guides&#46; After the clinical history and review by a certified allergist and immunologist&#44; subjects who met the criteria had the skin test performed to inhalants &#40;previous consent and assent signed&#41;&#44; among which this indoor allergen was included&#46; Patients came principally from Mexico City&#44; Estado de M&#233;xico&#44; and surrounding areas&#46; Demographic information for all patients was reviewed as well as the referring diagnoses&#46; This study was approved by the Ethics&#44; Research and Biosafety Committees from HIMFG &#40;protocol number HIM&#47;2015&#47;045&#41; following the rules of the institution&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Skin tests were done during the entire time of the study with IPI Assac<span class="elsevierStyleSup">&#174;</span> extracts which have been standardised in the same way since 1999 and commercialised as UBE&#47;ml &#40;equivalent biologic unit&#41;&#46; We used the same protocol for skin prick test SPT suggested by the Global Allergy and Asthma European Network&#44; The European Academy of Allergy and Clinical Immunology and The American Academy of Allergy&#44; Asthma and Immunology &#40;AAAAI&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0260"><span class="elsevierStyleSup">16&#44;17</span></a> Allergen extracts were stored at &#43;2 to &#43;8<span class="elsevierStyleHsp" style=""></span>&#176;C when not in use&#46; Before the SPT&#44; we recorded medications taken by the patient in the previous week to avoid false positives&#46; Tests were applied on the upper back or in the volar aspect of the forearm&#44; at least 2&#8211;3<span class="elsevierStyleHsp" style=""></span>cm apart from the wrist and the antecubital fosase&#59; histamine &#40;10<span class="elsevierStyleHsp" style=""></span>mg&#47;ml&#41; and saline solutions were used as positive and negative controls&#44; respectively&#44; in each patient&#46; We previously marked the skin area with a pen&#44; tests were placed 2<span class="elsevierStyleHsp" style=""></span>cm apart from each other&#46; A drop of each test solution was placed on the skin in identical order for all subjects tested and immediately pricked with a single-head metal lancet&#44; without causing bleeding&#46; Results were recorded after 15<span class="elsevierStyleHsp" style=""></span>min&#46; The largest and perpendicular diameter of the wheal was measured and the following value calculated&#58; largest<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>perpendicular diameter&#47;2&#46; A wheal &#8805;3<span class="elsevierStyleHsp" style=""></span>mm was considered to be a positive reaction with respect to the negative control&#46; Each panel was comprised of a total of 27 environmental allergens&#44; which included six moulds&#44; four extracts from animal skin&#44; 14 pollens including seven weeds&#44; three grasses&#44; and four trees&#44; as well as cockroach and mite extract &#40;only <span class="elsevierStyleItalic">Dermatophagoides pteronyssinus</span> &#8211; <span class="elsevierStyleItalic">Der p&#46;</span> was used&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0050" class="elsevierStylePara elsevierViewall">For the purposes of our goals&#44; descriptive statistics were carried out to obtain a frequency and 95&#37; CI of immediate hypersensitivity tests to <span class="elsevierStyleItalic">Der p&#46;</span> analysed by intra- and intergroup <span class="elsevierStyleItalic">&#967;</span><span class="elsevierStyleSup">2</span> with reported frequencies as in other studies in the country&#46; We also analysed the differences that occurred in each during the 11 years studied&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Results</span><p id="par0055" class="elsevierStylePara elsevierViewall">A total of 8794 patients were included with ages between 2 and 18 years old with a mean of 7&#46;9 years &#40;&#177;3&#46;7&#41;&#59; 41&#46;6&#37; of the patients &#40;95&#37; CI 40&#8211;42&#41; were from Mexico City&#44; 51&#46;6&#37; Estado de M&#233;xico &#40;95&#37; CI 50&#8211;52&#41; and 6&#46;7&#37; came from the remaining areas of Mexico &#40;95&#37; CI 6&#8211;7&#41;&#46; The most frequent diagnosis was rhinitis &#40;69&#46;5&#37;&#41;&#46; <a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a> shows the distribution of the patients according to diagnosis where we can observe the overlap of these diseases as expected in atopic patients&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><p id="par0060" class="elsevierStylePara elsevierViewall">Within 8794 tests&#44; 14&#37; &#40;95&#37; CI 13&#8211;14&#46;8&#41; were negative to the entire panel and of the remaining 7565 tests&#44; 49&#46;3&#37; &#40;95&#37; CI 48&#8211;50&#41; were positive for <span class="elsevierStyleItalic">Der p&#46;</span>&#44; of which 2&#46;7&#37; &#40;95&#37; CI 2&#8211;3&#41; were monosensitised &#40;<span class="elsevierStyleItalic">Der p</span>&#46;&#41;&#46; The year with the highest percentage of sensitisation was 2006&#46; Analysis of the results of positive skin tests for each year is shown in <a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall">Of the tests conducted during the study&#44; 34&#37; &#40;95&#37; CI 33&#8211;35&#41; were performed in children &#60;6 years old&#44; of whom 39&#37; &#40;95&#37; CI 37&#8211;41&#41; were positive for <span class="elsevierStyleItalic">Dermatophagoides pteronyssinus</span>&#46; When the group of children &#62;6 years old was studied&#44; we found that the overall percentage of sensitisation was 54&#37; &#40;95&#37; CI 52&#8211;55&#41;&#46; Comparison between these groups was statistically significant &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;000&#41;&#46; In all the years studied&#44; we found a higher proportion of positive tests in children &#62;6 years old &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0070" class="elsevierStylePara elsevierViewall">Stratifying the group&#44; it was found that the ages with the highest percentage of sensitisation were 14&#8211;16 years old&#46; From 6 to 18 years old&#44; 50&#37; of the children were sensitised to <span class="elsevierStyleItalic">Dermatophagoides</span> &#40;<a class="elsevierStyleCrossRef" href="#tbl0025">Table 5</a>&#41;&#46; When compared by age and by years we found a general decrease in the sensitisation percentage in all ages &#40;<a class="elsevierStyleCrossRef" href="#tbl0030">Table 6</a>&#41;&#46; In the rest of Mexico&#44; the highest percentages were reported in Merida with 75&#37; &#40;95&#37; CI 68&#8211;80&#37;&#41; followed by Monterrey and Irapuato&#46; In the study by Larennas<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">12</span></a> a lower reactivity was reported in Queretaro &#40;28&#37;&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0025"></elsevierMultimedia><elsevierMultimedia ident="tbl0030"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Discussion</span><p id="par0075" class="elsevierStylePara elsevierViewall">Indoor allergens represent one of the most important factors in causing allergic diseases as well as in arousing symptoms&#46; From these&#44; house dust mites have been considered as the most important factor associated with rhinitis and asthma&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Sensitisation to house dust mites is common and relatively constant&#59; however&#44; there are two important factors that have an influence on this sensitisation&#58; the first corresponds to the geographic variation of the region studied and includes&#58; weather&#44; vegetation&#44; altitude&#44; etc&#46;&#59; the second corresponds to the characteristics inherent to the population&#58; socioeconomic status&#44; activity&#44; exposure&#44; etc&#46; With this&#44; we can understand why a different prevalence of sensitisation is reported in different populations&#44; even in the same country and in the same city&#46; An example of this is the prevalence reported in Europe and Asia&#8212;up to 75&#46;5&#37; in Israel&#44;<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">20</span></a> 52&#46;8&#37; in Korea<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">21</span></a> and 19&#46;2&#37; in the UK&#46;<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">22</span></a> In Latin America&#44; a sensitisation&#8212;in decreasing order&#8212;of 82&#46;1&#37; in Argentina&#44;<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">23</span></a> 76&#46;9&#8211;81&#46;5&#37; in Cuba&#44;<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">24</span></a> 80&#37; in Chile<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">25</span></a> and 69&#46;9&#37; in Ecuador&#46;<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">26</span></a> Another important point to understand when the sensitisation to house dust mites is studied&#44; is the change in climate and air quality that has occurred the past years and it impacts not only on morbidity&#44; but also on mortality of patients with allergic diseases&#46;<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">27</span></a> Different authors have attempted to show the effect that this climate change has had on the sensitisation of patients with allergic diseases by examining differences between population groups&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">We reviewed the results of skin tests&#59; therefore&#44; our study provides valuable information about the variations in the frequency of sensitisation throughout this period&#46; The study found a higher frequency of sensitisation to <span class="elsevierStyleItalic">Dermatophagoides pteronyssinus</span> in patients 6&#8211;16 years old compared with younger and older ages&#44; the decision of selecting a cut-off of six years of age was made based on Moral et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">28</span></a> who report an increase of mites sensitisations after six years old&#44; our results are similar to this author who found a progressive increase in sensitisation which ranged from 16&#37; at 0&#8211;2 years to 87&#37; at 6&#8211;14 years&#46;<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">28</span></a> Subsequently&#44; this trend inverts itself with a gradual decrease in the reactivity according to age&#44; with lower values demonstrated close to 70 years of age&#46;<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">22</span></a> However&#44; there are reports about the cut-off age in which this change in the pattern of sensitisations takes place&#46; Dottorini<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">29</span></a> and Pallasaho<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">30</span></a> found&#44; in a cohort of patients 14&#8211;64 years of age&#44; that the decrease occurred after the fifth decade of life&#44; whereas other authors showed a decrease at 30 years of age&#46;<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">31</span></a> Those investigators&#44; who studied populations that included children as well as adults&#44; found cut-off values even lower at &#8764;14 years old&#44;<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">32</span></a> similar to our results&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Another important point is that we found a decrease in general sensitisation to mites in the group &#62;10 years old&#44; both in the analysis group and the group stratified by ages&#46; Warm<a class="elsevierStyleCrossRef" href="#bib0345"><span class="elsevierStyleSup">33</span></a> and Francis<a class="elsevierStyleCrossRef" href="#bib0350"><span class="elsevierStyleSup">34</span></a> obtained similar information in comparisons carried out from 1999 to 2009 and from 1986 to 2001&#44; respectively&#59; however&#44; these results are not reproduced in all series such as the Copenhagen Allergy Study&#44;<a class="elsevierStyleCrossRef" href="#bib0355"><span class="elsevierStyleSup">35</span></a> which found an increase from 12&#46;2 to 14&#46;1&#37; in the frequency of positive tests to this indoor allergen between 1990 and 1998 in subjects 15&#8211;41 years old and in the study by Ronmark<a class="elsevierStyleCrossRef" href="#bib0360"><span class="elsevierStyleSup">36</span></a> who also reported an increase in sensitisation from 0&#46;5 to 1&#46;4&#37; from 1996 to 2006&#46; These differences can point to diverse factors such as the ages of the group included and type of allergens used&#44; because in some series the extract varied from one year to another&#46; In this regard&#44; the fact of having used the same extracts with a relatively similar population represents a strength of our study&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">We found a decrease in sensitisation prevalence in the group of 16&#8211;18 years old from 2004 to 2014 as in all patients&#44; but we saw this trend exacerbated in this group&#44; perhaps as we said&#44; it is a trend manifested in all groups we recognised this specifically group has less participants&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">When compared with similar studies in the rest of the country&#44; we see variations in sensitisation according to the location where the tests were performed&#44; type of extract used and the study population&#46; Locations in Mexico with the greatest sensitisation were &#40;in descending order&#41; Merida&#44; Irapuato&#44; Monterrey and Queretaro&#46; In our case the percentage of positivity corresponds to an intermediate value compared to the rest of Mexico&#46; This is explained by the diversity of the population we have in our institution&#46; We only review the frequency of <span class="elsevierStyleItalic">Dermatophagoides pteronyssinus</span> sensitisation&#44; and perhaps this is a study limitation&#59; according to Fern&#225;ndez-Duro et al&#46;&#44; who evaluated the mite species found in Mexican homes of different regions&#44; <span class="elsevierStyleItalic">Dermatophagoides pteronyssinus</span> is the predominant mite and was found in 100&#37; of the samples&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Finally&#44; we found that the frequency of sensitisation to <span class="elsevierStyleItalic">Dermatophagoides pteronyssinus</span> increases with age until adolescence&#46; In the past 11 years there has been a general tendency to a decrease in sensitisation to this indoor allergen in our population&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Ethical disclosures</span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Confidentiality of data</span><p id="par0110" class="elsevierStylePara elsevierViewall">The authors declare that they have followed the protocols of their work centre on the publication of patient data and that all the patients included in the study have received sufficient information and have given their informed consent in writing to participate in that study&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Right to privacy and informed consent</span><p id="par0115" class="elsevierStylePara elsevierViewall">The authors have obtained the informed consent of the patients and&#47;or subjects mentioned in the article&#46; The author for correspondence is in possession of this document&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Protection of human subjects and animals in research</span><p id="par0120" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this investigation&#46;</p></span></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Funding</span><p id="par0125" class="elsevierStylePara elsevierViewall">No external funding sources were used for carrying out this study&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Conflict of interest</span><p id="par0130" class="elsevierStylePara elsevierViewall">The authors declare no conflict of interest&#46;</p></span></span>"
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      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Background</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">House dust mites are a ubiquitous air allergen in the human habitat&#46; It has been shown that exposure to them is a fundamental factor in sensitisation and development of atopic disease&#46; The objective of the study was to analyse changes in sensitisation to <span class="elsevierStyleItalic">Dermatophagoides pteronyssinus</span> &#40;<span class="elsevierStyleItalic">Der p&#46;</span>&#41; in children treated in a tertiary level care hospital in Mexico City for a period of 11 years and compare with other studies carried out in Mexico&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A retrospective study was performed at the Hospital Infantil de M&#233;xico Federico G&#243;mez &#40;HIMFG&#41;&#46; Information was gathered from skin tests for <span class="elsevierStyleItalic">Der p&#46;</span> performed in the Allergy Laboratory from January 2004 to April 2015&#46; Patients 2&#8211;18 years old who presented for examination of some type of allergic condition and who had immediate hypersensitivity tests to <span class="elsevierStyleItalic">Der p&#46;</span> were included in the study&#46; Results were compared with prior reports from other institutions&#46; Descriptive analysis and <span class="elsevierStyleItalic">&#967;</span><span class="elsevierStyleSup">2</span> statistics were used&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">A total of 8794 patients were included in the study&#59; 49&#46;3&#37; of the tests &#40;95&#37; CI 48&#8211;50&#41; were positive for <span class="elsevierStyleItalic">Der p&#46;</span> The percentage of monosensitised to mites was 2&#46;7&#37; for <span class="elsevierStyleItalic">Der p</span>&#46; &#40;95&#37; CI 2&#8211;3&#41;&#46; A significant difference was found between the results of older patients and those &#60;6 years old&#46; The frequency of sensitisation had a tendency to decrease during the 11 years analysed in all age groups&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions and clinical relevance</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">The frequency of sensitisation to <span class="elsevierStyleItalic">Der p</span>&#46; increased with age until reaching adolescence&#46; In the last 11 years a decrease in sensitisation to this air allergen was observed&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Background"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Methods"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Results"
          ]
          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Conclusions and clinical relevance"
          ]
        ]
      ]
    ]
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      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
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        "mostrarDisplay" => false
        "figura" => array:1 [
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        "descripcion" => array:1 [
          "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Percentage of skin test positivity to <span class="elsevierStyleItalic">Dermatophagoides pteronyssinus</span> by year &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>7565&#41;&#46; 2004 <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>718&#44; 2005 <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>870&#44; 2006 <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>641&#44; 2007 <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>653&#44; 2008 <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>379&#44; 2009 <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>319&#44; 2010 <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>759&#44; 2011 <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>769&#44; 2012 <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>646&#44; 2013 <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>788&#44; 2014 <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>801&#44; 2015 <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>222&#46; <span class="elsevierStyleItalic">Note</span>&#58; For this analysis we only included patients with at least one positive SPT&#46;</p>"
        ]
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        "identificador" => "fig0010"
        "etiqueta" => "Figure 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
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          "en" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Analysis of positive skin tests to <span class="elsevierStyleItalic">Dermatophagoides</span> in children under and over 6 years of age in different years&#46; <span class="elsevierStyleItalic">Note</span>&#58; For this analysis we only included patients with at least one positive SPT&#46;</p>"
        ]
      ]
      2 => array:7 [
        "identificador" => "fig0015"
        "etiqueta" => "Figure 3"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr3.jpeg"
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          "en" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Comparison of the sensitisation to <span class="elsevierStyleItalic">Dermatophagoides p</span>&#46; in different centre in Mexico&#46; &#42;Bedolla et al&#46; &#40;2010&#41;&#46; <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>752 patients with rhinitis 16&#8211;78 years old&#46;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">18</span></a> &#42;&#42;Cavazos-Galvan et al&#46; &#40;2008&#41; <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>58 patients 27&#8211;31 years old&#46;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">10</span></a> &#42;&#42;&#42;Baeza M&#46; 2005 <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>176 patients with rhinitis and&#47;or asthma 2&#8211;5 years old&#46;<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">19</span></a> &#42;&#42;&#42;&#42;Larenas-Linneman et al&#46;&#44; 2011 <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>4169 2&#8211;65 years&#46;</p>"
        ]
      ]
      3 => array:8 [
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        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
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        "detalles" => array:1 [
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            "detalle" => "Table "
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        "tabla" => array:1 [
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              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Authors&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Year&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">n</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Included locations&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">&#37; Sensitisation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Meza-Vel&#225;zquez et al&#46; <a class="elsevierStyleCrossRef" href="#bib0225">&#91;9&#93;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1999&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Mexico City&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">89&#37; <span class="elsevierStyleItalic">Der p&#46;</span> and <span class="elsevierStyleItalic">Der f&#46;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Cavazos et al&#46; <a class="elsevierStyleCrossRef" href="#bib0230">&#91;10&#93;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2008&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">58&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Monterrey&#44; Irapuato&#44; Tampico&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Monterrey <span class="elsevierStyleItalic">Der f&#46;</span> 88&#37;&#44; <span class="elsevierStyleItalic">Der p&#46;</span> 83&#37;<br>Irapuato <span class="elsevierStyleItalic">Der p&#46;</span> 70&#37; and <span class="elsevierStyleItalic">Der f&#46;</span> 60&#37;<br>Tampico <span class="elsevierStyleItalic">Der p&#46; 1 55&#37;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Mart&#237;nez et al&#46; <a class="elsevierStyleCrossRef" href="#bib0235">&#91;11&#93;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2010&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">334&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Mexico City&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">56&#46;6&#37; to 1&#8211;4 mites &#40;<span class="elsevierStyleItalic">Der p&#46;</span>&#44; <span class="elsevierStyleItalic">Der f&#46;</span>&#44; <span class="elsevierStyleItalic">Blo t</span>&#44; <span class="elsevierStyleItalic">Der s</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Larennas-Linnemann et al&#46; <a class="elsevierStyleCrossRef" href="#bib0240">&#91;12&#93;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2011&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4169&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Multicenter&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Der p&#46;</span> 46&#8211;70&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Ram&#237;rez-Heredia et al&#46; <a class="elsevierStyleCrossRef" href="#bib0245">&#91;13&#93;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2013&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">150&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Mexico City&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Der p&#46;</span> 82&#46;1&#37;&#44; <span class="elsevierStyleItalic">Der f&#46;</span> 71&#46;5&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Lopez-Rocha et al&#46; <a class="elsevierStyleCrossRef" href="#bib0250">&#91;14&#93;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2014&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">672&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Mexico City&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Der p&#46; and Der f&#46; 72&#46;2&#37;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
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        "descripcion" => array:1 [
          "en" => "<p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Prevalence of house dust mite sensitisation in Mexico&#46;</p>"
        ]
      ]
      4 => array:8 [
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        "etiqueta" => "Table 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
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            "identificador" => "at2"
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          "leyenda" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">Source</span>&#58; Instituto Nacional de Estad&#237;stica y Geograf&#237;a M&#233;xico&#46; Available on&#58; <a class="elsevierStyleInterRef" id="intr0005" href="http://www.cuentame.inegi.org.mx/">http&#58;&#47;&#47;www&#46;cuentame&#46;inegi&#46;org&#46;mx</a>&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Region&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Weather&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Average annual temperature&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Annual rainfall&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Mexico City&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Temperate&#44; sub-humid&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16<span class="elsevierStyleHsp" style=""></span>&#176;C&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">600<span class="elsevierStyleHsp" style=""></span>mm&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Mexico State&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Temperate&#44; sub-humid&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14&#46;7<span class="elsevierStyleHsp" style=""></span>&#176;C&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">900<span class="elsevierStyleHsp" style=""></span>mm&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Guadalajara&#44; Jalisco&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Temperate&#44; sub-humid&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">20&#46;5<span class="elsevierStyleHsp" style=""></span>&#176;C&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">850<span class="elsevierStyleHsp" style=""></span>mm&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Monterrey&#44; Nuevo Le&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Semidry and dry&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">20<span class="elsevierStyleHsp" style=""></span>&#176;C&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">650<span class="elsevierStyleHsp" style=""></span>mm&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Irapuato&#44; Guanajuato&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Warm&#44; sub-humid&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">18<span class="elsevierStyleHsp" style=""></span>&#176;C&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">650<span class="elsevierStyleHsp" style=""></span>mm&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Tampico&#44; Tamaulipas&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Warm&#44; humid&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">23&#46;5<span class="elsevierStyleHsp" style=""></span>&#176;C&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">780<span class="elsevierStyleHsp" style=""></span>mm&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">M&#233;rida&#44; Yucat&#225;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Warm&#44; humid&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">26<span class="elsevierStyleHsp" style=""></span>&#176;C&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1100<span class="elsevierStyleHsp" style=""></span>mm&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Quer&#233;taro&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Temperate&#44; sub-humid&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">18<span class="elsevierStyleHsp" style=""></span>&#176;C&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">570<span class="elsevierStyleHsp" style=""></span>mm&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab1302722.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Climatic characteristics of some regions of Mexico&#46;</p>"
        ]
      ]
      5 => array:8 [
        "identificador" => "tbl0015"
        "etiqueta" => "Table 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at3"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">Note</span>&#58; For the purposes of this review we only show the <span class="elsevierStyleItalic">Dermatophagoides pteronyssinus</span> results&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Moulds and fungi</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Alternaria alternata</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Aspergillus fumigatus</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Candida albicans</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Cladosporium herbarum</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Mucor mucedo</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Penicillium notatum</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Epidermal</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Horse&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Cat hair&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Dog&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Chicken feathers&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Indoor</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Blatella germanica</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Dermatophagoides pteronyssinus</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Periplaneta americana</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Pollens</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Ambrosia trifida</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Artemisa vulgaris</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Chenopodium album</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Cynodon dactylon</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Fraxinus excelsior</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Helianthus annus</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Ligustrum vulgare</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Lolium perenne</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Phleum pratense</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Plantago lanceolata</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Quercus robur</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Rumex</span> spp&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Salsola kali</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Schinus molle</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab1302718.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Panel of 27 airborne allergens tested&#46;</p>"
        ]
      ]
      6 => array:8 [
        "identificador" => "tbl0020"
        "etiqueta" => "Table 4"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at4"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">Note</span>&#58; The diagnoses were made by a paediatric allergist according to ongoing guides&#58;</p><p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Global Initiative for Asthma &#40;GINA&#41;&#46;</p><p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Allergic Rhinitis and its Impact on Asthma &#40;ARIA&#41;&#46;</p><p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">Disease management of atopic dermatitis&#58; Practice Parameter&#46;</p><p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">No differences found in patients&#8217; gender&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Diagnosis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">&#37; of patients &#40;number of patients&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">95&#37; CI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Asthma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">42&#46;9&#37; &#40;3773&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">40&#8211;45&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Rhinitis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">69&#46;7&#37; &#40;6130&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">67&#8211;71&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Atopic dermatitis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">41&#37; &#40;3605&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">38&#8211;42&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab1302721.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Distribution of patients according to reported diagnosis &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>8794&#41;&#46;</p>"
        ]
      ]
      7 => array:8 [
        "identificador" => "tbl0025"
        "etiqueta" => "Table 5"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at5"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0100" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">Note</span>&#58; For this analysis we only included patients with at least one positive SPT&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Age group &#40;years&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">2004&#8211;2015 &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">95&#37; CI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">2&#8211;4 &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1050&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">34&#46;50&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">31&#8211;37&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">4&#8211;6 &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1565&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">43&#46;40&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">40&#8211;45&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">6&#8211;8 &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1391&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">51&#46;70&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">49&#8211;55&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">8&#8211;10 &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1210&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">53&#46;70&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">50&#8211;56&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">10&#8211;12 &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1043&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">55&#46;40&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">52&#8211;58&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">12&#8211;14 &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>718&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">56&#46;50&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">52&#8211;60&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">14&#8211;16 &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>437&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">59&#46;30&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">16&#8211;18 &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>151&#41;&nbsp;\t\t\t\t\t\t\n
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          "en" => "<p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">Percentage of sensitisation to <span class="elsevierStyleItalic">Dermatophagoides pteronyssinus</span> separated according to age in the study population &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>7565&#41;&#46;</p>"
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          "en" => "<p id="spar0105" class="elsevierStyleSimplePara elsevierViewall">Comparison of the percentage of sensitisation to mites separated by age in 2004 vs&#46; 2014 &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>7565&#41;&#46;</p>"
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      "titulo" => "References"
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        0 => array:2 [
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                  "contribucion" => array:1 [
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                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
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                            0 => "L&#46; Carazo"
                            1 => "R&#46; Fern&#225;ndez"
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                      "titulo" => "Early-life house dust mite allergens&#44; childhood mite sensitization&#44; and respiratory outcomes"
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                        0 => array:2 [
                          "etal" => true
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                            0 => "L&#46; Casas"
                            1 => "J&#46; Sunyer"
                            2 => "C&#46; Tischer"
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                    0 => array:2 [
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                            0 => "P&#46;J&#46; Bousquet"
                            1 => "S&#46; Chinn"
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                0 => array:2 [
                  "contribucion" => array:1 [
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                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "H&#46;J&#46; Park"
                            1 => "J&#46;H&#46; Lee"
                            2 => "K&#46;H&#46; Park"
                            3 => "H&#46;W&#46; Ann"
                            4 => "M&#46;N&#46; Jin"
                            5 => "S&#46;Y&#46; Choi"
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                      ]
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                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.4168/aair.2014.6.3.222"
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                        "fecha" => "2014"
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                      "titulo" => "Cutaneous sensitivity to six mite species in asthmatic patients from five Latin American countries"
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                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "E&#46; Fern&#225;ndez-Caldas"
                            1 => "C&#46;E&#46; Baena-Cagnani"
                            2 => "M&#46; L&#243;pez"
                            3 => "C&#46; Pati&#241;o"
                            4 => "H&#46;E&#46; Neffen"
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                      "titulo" => "Cambios en la sensibilidad a al&#233;rgenos intradomiciliarios y extradomiciliarios en la ciudad de M&#233;xico&#58; Estudio de 2&#44;000 ni&#241;os a lo largo de 10 a&#241;os"
                      "autores" => array:1 [
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                          "etal" => false
                          "autores" => array:5 [
                            0 => "M&#46;R&#46; Meza-Vel&#225;zquez"
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Article information

ISSN: 03010546
Original language: English

DOI:10.1016/j.aller.2016.09.002

The statistics are updated each day

Year/Month	Html	Pdf	Total

2024 November	4	0	4
2024 October	60	13	73
2024 September	69	10	79
2024 August	58	15	73
2024 July	72	6	78
2024 June	77	4	81
2024 May	99	7	106
2024 April	96	9	105
2024 March	89	4	93
2024 February	64	7	71
2024 January	65	2	67
2023 December	75	9	84
2023 November	100	9	109
2023 October	144	15	159
2023 September	89	5	94
2023 August	138	8	146
2023 July	153	4	157
2023 June	218	6	224
2023 May	277	5	282
2023 April	262	0	262
2023 March	255	6	261
2023 February	148	2	150
2023 January	135	5	140
2022 December	106	8	114
2022 November	130	13	143
2022 October	80	14	94
2022 September	99	18	117
2022 August	138	23	161
2022 July	89	12	101
2022 June	104	7	111
2022 May	85	8	93
2022 April	98	6	104
2022 March	91	12	103
2022 February	107	6	113
2022 January	165	16	181
2021 December	94	15	109
2021 November	99	8	107
2021 October	207	11	218
2021 September	133	10	143
2021 August	156	10	166
2021 July	129	6	135
2021 June	79	16	95
2021 May	134	12	146
2021 April	210	18	228
2021 March	85	11	96
2021 February	29	14	43
2021 January	15	11	26
2020 December	3	0	3
2020 October	1	0	1
2020 July	0	1	1
2018 February	5	0	5
2018 January	15	3	18
2017 December	3	0	3
2017 November	1	0	1
2017 January	2	0	2
2016 December	0	2	2

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Allergologia et Immunopathologia is no longer published on Elsevier since the 2021 year.Transferred to Codon Publications

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Allergologia et Immunopathologia is no longer published on Elsevier since the 2021 year.Transferred to Codon Publications

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