Correspondencia:Dr. C. Álvarez-Aguilar. Unidad de Investigación en Epidemiología Clínica. Hospital General Regional No. 1 IMSS. Delegación Michoacán.Avda. Madero Poniente, 1200. 58000 Morelia. Michoacán. México
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Morelia. Michoacán. México" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Laboratorio de Investigación en Diabetes Mellitus tipo 2. Centro de Investigación Biomédica de Michoacán. México" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Unidad de Investigación en Enfermedades Nefrológicas.Hospital de Especialidades Centro Médico" "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Nacional Siglo XXI. IMSS. México, D.F. México" "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "**" "correspondencia" => "Correspondencia:Dr. C. Álvarez-Aguilar. Unidad de Investigación en Epidemiología Clínica. Hospital General Regional No. 1 IMSS. Delegación Michoacán.Avda. Madero Poniente, 1200. 58000 Morelia. Michoacán. México" ] ] ] 1 => array:2 [ "autoresLista" => "Jesús Ramírez-Enríquez" "autores" => array:1 [ 0 => array:2 [ "nombre" => "Jesús" "apellidos" => "Ramírez-Enríquez" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Hyperleptinemia as a risk factor in obesity-related hypertension" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2003-12-03" "fechaAceptado" => "2004-06-23" "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec222462" "palabras" => array:4 [ 0 => "Asma" 1 => "Mortalidad por asma" 2 => "Asma de riesgo vital" 3 => "Alternaria alternata" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec222461" "palabras" => array:4 [ 0 => "Asthma" 1 => "Asthma-associated mortality" 2 => "Vital risk asthma" 3 => "Alternaria alternata" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">FUNDAMENTO Y OBJETIVO</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Algunas observaciones otorgan un papel relevante al hongo Alternaria alternata como desencadenante de crisis de asma de riesgo vital (ARV). El objetivo de este trabajo fue determinar si las crisis de ARV de los pacientes sensibilizados a Alternaria cursan con un perfil clínico diferencial.</p> <span class="elsevierStyleSectionTitle">Pacientes y método</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Estudio descriptivo y multicéntrico (33 hospitales españoles) de 194 pacientes incluidos de forma prospectiva por padecer una crisis de ARV. Se recogieron las características y el curso clínico de la crisis, y cuando alcanzaron la estabilidad clínica se les practicaron una espirometría, pruebas cutáneas de alergia y determinación de IgE a Alternaria. Se estableció la sensibilización a Alternaria cuando la prueba cutánea o bien la IgE específica resultaron positivas.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">En 20 de los pacientes (10%) se pudo constatar sensibilización a Alternaria. En comparación con el grupo de pacientes no sensibilizados, los sensibilizados a Alternaria resultaron ser significativamente más jóvenes, con una media (DE) de edad de 35 (15) frente a 50 (21) años (p < 0,001); su ingreso hospitalario fue más corto –6,5 (5,5) frente a 9 (7) días (p = 0,039)–; se constató una mayor proporción de muertes o secuelas neurológicas graves –el 15 frente al 3% (p = 0,026)–; presentaron un mayor porcentaje de casos con sensibilización a otros alérgenos –el 68 frente al 22% (p = 0,003)– y una menor broncodilatación tras la inhalación de salbutamol –el 6 frente al 10% (p = 0,013)–.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Las características clínicas constatadas en las crisis de ARV de los pacientes sensibilizados a Alternaria parecen distinguirlos como fenotipo particular. Una conducta de evitación específica podría comportar efectos beneficiosos al prevenir crisis de ARV en los pacientes sensibilizados.</p>" ] "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Background and objective</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Some studies have pointed to Alternaria alternata as a trigger of fatal and near-fatal asthma (NFA) crises. The objective of this study was to determine the clinical characteristics of fatal and NFA crisis in patients sensitized to Alternaria.</p> <span class="elsevierStyleSectionTitle">Patients and method</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">One hundred ninety four patients with fatal or NFA attacks were enrolled in a multicenter (33 Spanish hospitals), prospective study. We gathered the characteristics and clinical course of the crises. We performed the following tests: spirometry, prick-test to common allergens, and specific IgE to Alternaria when patients were in stable condition. The sensitization test to Alternaria was performed when the prick-test and/or specific IgE levels were positive.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Twenty (10%) patients were sensitized to Alternaria. When compared to non-sensitized patients, Alternaria sensitized patients were significantly younger, 35 (15) vs 50 (21) years old (p < 0.001); their hospital admission length was shorter, 6.5 (5.5) against 9 (7) days (p = 0.039); they had a higher number of deaths or severe neurological sequelae, 15 vs 3% (p = 0.026); they had a higher sensitization frequency to the remaining allergens, 68 against 22% (p = 0.003); and they exhibited a fewer broncodilation response upon inhaled salbutamol, 6 vs 10% (p = 0.013).</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">The clinical characteristics of Alternaria sensitised, fatal-and NFA-patients, seem to identify a particular phenotype. Specific avoidance strategies could be useful to prevent fatal and NFA attacks.</p>" ] ] "NotaPie" => array:1 [ 0 => array:1 [ "nota" => "<p class="elsevierStyleNotepara">Este trabajo fue financiado por la Coordinación de Investigación en Salud del Instituto Mexicano delSeguro Social</p>" ] ] "bibliografia" => array:2 [ "titulo" => "REFERENCIAS BIBLIOGRáFICAS" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:35 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." 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2019 Agosto | 0 | 2 | 2 |
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2018 Octubre | 0 | 11 | 11 |
2018 Marzo | 1 | 1 | 2 |
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2017 Agosto | 68 | 7 | 75 |
2017 Julio | 55 | 8 | 63 |
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2017 Mayo | 112 | 10 | 122 |
2017 Abril | 81 | 14 | 95 |
2017 Marzo | 75 | 26 | 101 |
2017 Febrero | 55 | 5 | 60 |
2017 Enero | 45 | 4 | 49 |
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2016 Noviembre | 126 | 10 | 136 |
2016 Octubre | 175 | 15 | 190 |
2016 Septiembre | 192 | 23 | 215 |
2016 Agosto | 64 | 11 | 75 |
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2016 Abril | 76 | 19 | 95 |
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2015 Octubre | 79 | 25 | 104 |
2015 Septiembre | 66 | 16 | 82 |
2015 Agosto | 80 | 10 | 90 |
2015 Julio | 78 | 6 | 84 |
2015 Junio | 55 | 6 | 61 |
2015 Mayo | 73 | 10 | 83 |
2015 Abril | 94 | 22 | 116 |
2015 Marzo | 75 | 12 | 87 |
2015 Febrero | 34 | 6 | 40 |
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2014 Diciembre | 81 | 6 | 87 |
2014 Noviembre | 67 | 0 | 67 |
2014 Octubre | 50 | 3 | 53 |
2014 Septiembre | 57 | 4 | 61 |
2014 Agosto | 40 | 2 | 42 |
2014 Julio | 40 | 4 | 44 |
2014 Junio | 37 | 1 | 38 |
2014 Mayo | 35 | 1 | 36 |
2014 Abril | 18 | 3 | 21 |
2014 Marzo | 28 | 1 | 29 |
2014 Febrero | 38 | 5 | 43 |
2014 Enero | 27 | 2 | 29 |
2013 Diciembre | 30 | 3 | 33 |
2013 Noviembre | 32 | 1 | 33 |
2013 Octubre | 42 | 2 | 44 |
2013 Septiembre | 18 | 1 | 19 |
2013 Agosto | 42 | 2 | 44 |
2013 Julio | 25 | 2 | 27 |
2013 Mayo | 1 | 0 | 1 |
2004 Diciembre | 1344 | 0 | 1344 |