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Toxic oil syndrome (TOS) was an epidemic which broke out in Spain in 1981, caused by the ingestion of rapeseed oil denatured with 2% aniline and sold illegally as edible oil. More than 20,000 people were affected and mortality rate was 8.4%. Genetic susceptibility appears to be involved in the pathology of this disease. Several reports have described association between the chronic stage of the disease and DR-DQ antigens (DR3, DR4, DR2 and DQ8). In the present work, we have reassessed the HLA class II antigens in a well-designed case-control study. Triplets of subjects (n=265) composed by chronic patients (n=117), non-affected family members (n=71) and non-related controls (n=77) were studied. Also, HLA class II antigens were analyzed in patients who had died from TOS (n=34) and in TOS control patients who died from other non-TOS related causes (n=13). Regarding surviving patients no significant association was found between HLA and disease. In contrast, an increase in phenotypic frequency of DR2 antigen, was found in patients who had died from TOS (73.5%) compared with the whole study group: TOS-affected alive patients (25.6%, corrected P<0.001), non-affected family members (28.5%, corrected P<0.001), non-related controls (23.9%, corrected P<0.001) and dead controls (38.4%, P=0.03). [ABSTRACT FROM AUTHOR]

Bronchial asthma, one of the most common illnesses in the Western world (10% of children and 3 to 5% of the adult population are affected), is increasing in prevalence and severity and is becoming a public health problem in the developing world.The therapeutic programme for subjects with asthma includes recommendations for modifying their environment as well as employing a drug regimen designed to alleviate symptoms, minimise exacerbations and improve quality of life. An international consensus report on the diagnosis and management of asthma was released in 1992. The recommendations contained in this report emphasised the regular use of anti-inflammatory drugs (preferably inhaled corticosteroids) as first-line therapy for anything more severe than occasional mild asthma and a shift in emphasis away from reliance on bronchodilators.In Spain, the cost of antiasthmatics for inhalation has increased: in 1998 they were the third most costly pharmacological subgroup for the National Health System (after lipid-lowering drugs and ACE inhibitors) representing more than 283.23 million Euros ($US248.95 million). To what extent this increase in cost resulted from an update to the recent guidelines remains unclear. Therefore, we have conducted a study to ascertain the pattern and trend of antiasthmatic drug use over an extended period of time (1989 to 1998), and to determine the possible influence that recent evidence about asthma treatment has had upon that use. [ABSTRACT FROM AUTHOR]

The monoclonal antibody nirsevimab was at least 70% effective in preventing hospitalisations in infants with lower respiratory tract infections (LRTI) positive for respiratory syncytial virus (RSV) in Spain (Oct 2023-Jan 2024), where a universal immunisation programme began late September (coverage range: 79-99%). High protection was confirmed by two methodological designs (screening and test-negative) in a multicentre active surveillance in nine hospitals in three regions. No protection against RSV-negative LRTI-hospitalisations was shown. These interim results could guide public-health decision-making.

Background: Studies on the role of eosinophils in coronavirus disease 2019 (COVID-19) are scarce, though available findings suggest a possible association with disease severity. Our study analyzes the relationship between eosinophils and COVID-19, with a focus on disease severity and patients with underlying chronic respiratory diseases., Methods: We performed a retrospective analysis of 3018 subjects attended at two public hospitals in Madrid (Spain) with PCR-confirmed SARS-CoV-2 infection from January 31 to April 17, 2020. Patients with eosinophil counts less than 0.02×10 9 /L were considered to have eosinopenia. Individuals with chronic respiratory diseases (n=384) were classified according to their particular underlying condition, i.e., asthma, chronic pulmonary obstructive disease, or obstructive sleep apnea., Results: Of the 3018 patients enrolled, 479 were excluded because of lack of information at the time of admission. Of 2539 subjects assessed, 1396 patients presented an eosinophil count performed on admission, revealing eosinopenia in 376 cases (26.93%). Eosinopenia on admission was associated with a higher risk of intensive care unit (ICU) or respiratory intensive care unit (RICU) admission (OR:2.21; 95%CI:1.42-3.45; p <0.001) but no increased risk of mortality ( p >0.05)., Conclusions: Eosinopenia on admission conferred a higher risk of severe disease (requiring ICU/RICU care), but was not associated with increased mortality. In patients with chronic respiratory diseases who develop COVID-19, age seems to be the main risk factor for progression to severe disease or death., Competing Interests: JS reports having served as a consultant to Thermofisher, MEDA, Novartis, Sanofi, Leti, Faes Farma, Mundipharma, and GSK; having been paid lecture fees by Novartis, GSK, Stallergenes, Leti, and Faes Farma; as well as having received grant support for research from Thermofisher, Sanofi, and ALK. VP reports having served as a consultant to Astra Zeneca and GSK and having been paid lecture fees by both. MR-N reports having received grant support for research from Astra Zeneca and GSK, having served as a consultant to Astra Zeneca and GSK, and having received payments for lectures by both. JAC has received payment for lecture by Astra Zeneca. MV-M has received payment for lecture from GSK. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Valverde-Monge, Cañas, Barroso, Betancor, Ortega-Martin, Gómez-López, Rodríguez-Nieto, Mahíllo-Fernández, Sastre and Del Pozo.)

Scope: Shrimp is a seafood consumed worldwide and the main cause of severe allergenic reactions to crustaceans. Seafood allergy has been related to mite sensitization, mainly mediated by tropomyosin, but other proteins could be involved. The aim of the study was to identify new shrimp allergens implicated in mite-seafood cross-reactivity (CR) in two different climate populations: dry and humid climates., Methods and Results: Shrimp and mite IgE-binding profiles of patients from continental dry and humid climates were analyzed by immunoblotting, and the most frequently recognized Solenocera melantho shrimp proteins were identified by MS as α-actinin, β-actin, fructose biphosphate aldolase, arginine kinase, sarcoplasmic calcium-binding protein, and ubiquitin. Using inhibition immunoblot assays, we demonstrate that tropomyosin and ubiquitin were responsible for mite-seafood CR from both climates; but also α-actinin and arginine kinase are implicated in dry- and humid-climate populations, respectively. Reciprocal inhibition assays demonstrated that mites are the primary sensitizer in humid-climate, as shrimp is in continental dry-climate population., Conclusion: Several new shrimp allergens have been identified and should be considered in the diagnosis and treatment of shrimp allergy and mite-seafood CR. Differences in mite-seafood CR were founded to be based on the climate., (© 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.)

Introduction: The Asthma Control Questionnaire™ (ACQ) was developed to assess asthma control. The objective of this study is to determine the cut-off points that best differentiate between several types of asthma control in three versions of the ACQ used in clinical practice., Materials and Methods: It appears 607 adult asthmatic patients (61% female) were recruited from 43 outpatient clinics in Spain. Once the patients were stratified by severity of asthma, they were then evaluated in an epidemiological study. To determine the optimum cut-off points, the area under the receiver operating characteristics (ROC) curve, as well as sensitivity, specificity, and positive and negative predictive values (PPV and NPV, respectively), was calculated for each version of the ACQ (ACQ-FEV₁ (forced expiratory volume in the first second), ACQ-PEF (peak expiratory flow), and ACQ-wLF (without lung function))., Results: The optimal cut-off for ACQ-FEV₁ was 1.14 (the sum of 8 points/7 items), for ACQ-PEF 1.28 (the sum of 9 points/7 items), and for ACQ-wLF 0.83 (the sum of 5 points/6 items), and the percentage of correctly classified patients was 76.5%, 77.3%, and 77.2%, respectively. A comparison of ROCs obtained from the three versions of the ACQ shows that ACQ-wLF had a significantly greater area under the curves (AUC) (p = .004) than ACQ-FEV₁. Patients were considered as having some control if their ACQ-FEV₁ score fell between 1.14 and 1.57, if ACQ-PEF values were between 1.28 and 1.57, or if ACQ-wLF scores ranged between 0.83 and 1.5., Conclusions: Our study, which was carried out in a manner which more closely reflects clinical practice, reveals differences in cut-offs used to define well-controlled asthma among three versions of the ACQ.

Background: Cupressaceae is a family of plants resistant to airborne contamination, and its pollen is the main cause of winter allergic respiratory diseases, especially in North America, Japan, and Mediterranean countries. Recently, a major allergen from Cupressus arizonica pollen grains, Cup a 3, was cloned and expressed., Objective: To study the effects of air pollution on the expression of Cup a 3, a thaumatinlike protein, in C. arizonica pollen grains using a combination of transmission electron microscopy and immunocytochemical techniques., Methods: Observations were made in mature and hydrated C. arizonica pollen grains from various regions in Spain with different degrees of air pollution. Specimens were fixed using freezing protocols, and ultrathin sections were incubated with anti-rCup a 3 rabbit polyclonal antibodies., Results: Labeling of Cup a 3 was detected in mature and hydrated C. arizonica pollen grains. It was more intense in pollen from polluted air regions, and abundant gold particles were observed as they were released through the pollen grain walls. Furthermore, gold particles remained abundant in the pollen cytoplasm. The labeling was noticeably lower in pollen grains from unpolluted air regions., Conclusions: Cup a 3 is present in the cytoplasm and walls of cypress pollen grains during the air dispersion and hydration stages. The abundance of Cup a 3 in pollen grains under polluted air conditions indicates that these cypresses intensify their activity as a defense from environmental pollution, thus strengthening their allergenicity.

Objective: During the past few years there have been changes in the availability of opioids in Spain, and new policies on palliative care have been implemented. The aim of this study was to describe the new pattern of opioid consumption in Spain and the associated economic impact., Methods: A search in the ECOM (Especialidades Consumo de Medicamentos) database of the Ministry of Health and Consumer Affairs for the 1992-2006 period was carried out. This database contains information on prescriptions of primary care medicines that are covered by the National Health System in Spain., Results: Since 1992, overall opioid consumption has increased 14-fold, from 0.3 DDD/1000 inhabitants per day to 4.4 DDD/1000 inhabitants per day. For the six drugs that require a special prescription form--morphine, methadone, oxycodone pethidine, tilidine and fentanyl--consumption increased from 0.1 DDD/1000 inhabitants per day in 1992 to 1.2 in 2006. During this same period, the total costs of these prescriptions increased by 36.8-fold, and the cost per day and per patient doubled., Conclusion: A huge increase in opioid consumption has occurred during the time period covered by this study, with fentanyl consumption accounting for most of that increase. Although oral morphine is the first-choice drug among strong opioids, fentanyl is currently the most consumed.

Background: Recent studies have revealed a rise in the use of anxiolytic and hypnotic drugs as well as the improper use thereof in Western countries. This study is aimed at ascertaining the pattern of use of anxiolytic and hypnotic drugs in Spain within the 1995-2002 period., Methods: The data related to the use of medications was taken from the Ministry of Health and Consumer Affairs' ECOM (Medicinal Products Consumption) database, which includes information on the use of medications delivered through the community pharmacies and reimbursed by the National Health System. The data are expressed in Defined Daily Doses per 1,000 inhabitants per day., Results: The use of anxiolytic and hypnotic drugs rose from 39.71 Defined Daily Doses per 1,000 inhabitants per day in 1995 to 62.02 in 2002. Throughout the period under study, benzodiazepines having a medium-range half-life (8-24 h.) were those most used, especially lorazepam, alprazolam and lormetazepam. The active ingredient having shown the greatest drop in use was flunitrazepam., Conclusions: Although the use of anxiolytic and hypnotic drugs has undergone a considerable rise in recent years in Spain, the pattern of use has shown no major changes.

Background: Over the past ten years, new drugs and new approaches to treatment have been implemented making it possible to assume changes in the use of antipsychotic drugs in our environment. This study is aimed at characterizing the pattern of use of antipsychotic drugs in Castile and Leon throughout the 1990-2001 period as well as ascertaining the bearing which the marketing of new antipsychotic drugs may have had on the pattern of consumption of these drugs., Methods: The drug consumption data was obtained from the Ministry of Health and Consumer Affairs' consumption database ECOM (Especialidades Consumo de Medicamentos). This database contains information on the consumption of medications dispensed charged to the Social Insurance system in community pharmacies nationwide. To estimate the consumption outside of the National Health System, data from the IMS (International Marketing Services) firm for the years 2000 and 2001 was used. The data was given in Defined Daily Doses/1000 inhabitants/day., Results: The use of antipsychotic drugs rose by 146% within the 1990-2001 period. Throughout the period studied, haloperidol was the antipsychotic drug most used in Spain and in Castile and Leon. The atypical antipsychotic drugs totaled 49% of the total consumption for 2001 and 90% of the costs, a strong trend being found toward an increase in the consumption of these atypical antipsychotic drugs in detriment to the typical antipsychotic drugs. It has been estimated that 14% of the antipsychotic drugs used in Castile and Leon were used outside of the National Health System.. Appreciable differences exist among the different provinces., Conclusions: The consumption of antipsychotic drugs in Castile and Leon grew by 146% throughout the twelve months studied. The marketing of new atypical antipsychotic drugs and the legal measures related to the deinstitutionalization of mental patients may have played a major role in this increase. The marketing of the new antipsychotic drugs has led to a change in their pattern of use and has give rise to an rise in the direct costs. The consumption of these medications not charged to the National Health System is minor, but not negligible.