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The prevalence of asthma, rhinitis, and atopic eczema in Brazil was variable; higher prevalence values, especially of asthma and eczema, were observed in regions located closer to the Equator.

Objective: To determine the prevalence of symptoms of asthma, rhinitis, and atopic eczema in adolescents (AD; 13-14 years) living in seven Brazilian cities, by applying the standardized written questionnaire (WQ) of the International Study of Asthma and Allergies in Childhood (ISAAC), and to evaluate the time trend nine years after the last assessment of ISAAC phase 3 (ISP3). Methods: The ISAAC-WQ was answered by 20,099 AD from the Northern, Northeastern, Southeastern, and Southern Brazilian regions. Values obtained were compared to those observed in ISP3 using nonparametric (chi-squared or Fisher) tests, and the ratio of annual increment/decrement was established for each of the centers, according to the symptom assessed. DOI se refere ao artigo: http://dx.doi.org/10.1016/j.jped.2014.05.002 ଝ Como citar este artigo: Solé D, Rosário Filho NA, Sarinho ES, Camelo-Nunes IC, Barreto BA, Medeiros ML, et al. Prevalence of asthma and allergic diseases in adolescents: nine-year follow-up study (2003-2012). J Pediatr (Rio J). 2015;91:30---5.

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istration of patients, the management of adverse events and the cost of medication. A 3.5% discount rate was used for the case of all outcomes. Monte Carlo simulation was employed to construct the 95% uncertainty intervals (UI) and to compute cost-effectiveness acceptability curve. RESULTS: The mean total QALYs estimate in the Len/Dex arm was 2.95 (95%UI: 2.75-3.14) and 2.20 (95%UI: 1.99-2.40) in the case of bortezomib, an incremental gain of 0.75 (95%UI: 0.47-1.02) QALYs. The mean total therapy cost was estimated at €76,782 (95%UI: 75,689-€77,927) and 46.380€ (95%UI: 45,719€-47,000€) for Len/Dex and Bortezomib, respectively. For both comparators, total therapy cost is mainly attributed to medication. The cost per life year gained was estimated at €35,081 (95%UI: €19,357-€73,180) and the cost per QALY gained at €42,012 (95%UI: 29,445-64,217). The probability for Len/Dex to be a cost-effective therapy option at a threshold three times the per capital income (€60,000 per QALY), was higher than 95%. Results remained constant under several one-way sensitivity analyses. CONCLUSIONS: Therefore therapy with combination of Len/Dex appears to be a cost-effective choice compared with Bortezomib alone for multiple myeloma patients in Greece.

Background:Sandoz etanercept (SDZ ETN) is a biosimilar of etanercept (ETN). COMPACT is an ongoing, non-interventional study, evaluating the effectiveness, safety, and quality of life with SDZ ETN treatment in patients (pts) with rheumatoid arthritis (RA), axial-spondyloarthritis (axSpA) or psoriatic arthritis (PsA) in real-world conditions.Objectives:We have reported an interim analysis, with the effectiveness and safety data focusing on pts who were in clinical remission or low disease activity under treatment with reference ETN or biosimilar ETN other than SDZ ETN (initial ETN; iETN) and switched to SDZ ETN.Methods:Pts aged ≥18 years for whom treatment with SDZ ETN were initiated are being enrolled. Pts were categorized under four treatment groups based on prior treatment status: Group A,pts on clinical remission or low disease activity under treatment with iETN and switched to SDZ ETN; Group B, pts who received targeted therapies and switched to SDZ ETN; Group C, biologic naïve considered uncontrolled with conventional therapy; Group D, DMARD naïve with recent diagnosis of RA considered suitable for treatment initiation with a biologic and started on treatment with SDZ ETN. Effectiveness assessments included Disease Activity Score 28-joint count Erythrocyte Sedimentation Rate (DAS28-ESR) or Ankylosing Spondylitis Disease Activity Score (ASDAS) until Week 24 after enrollment (baseline; BL) in the study. Functional disability was measured by the Health Assessment Questionnaire Disability Index (HAQ-DI). The effectiveness and safety results are reported for the pts who switched from iETN (Group A).Results:Of the 1437 pts recruited (analysis cut-off date: 16 Oct, 2020), 567 pts were switched from iETN, 163 were switched from other targeted therapies, 697 were biologic-naïve, and 10 were RA DMARD-naïve. Among pts who switched from iETN, 51.5% had RA, followed by axSpA (28.0%) and PsA (20.5%). Comorbidities were more frequent in pts with RA (70.2%) followed by PsA (58.6%) and axSpA (49.7%); musculoskeletal and connective tissue disorders were reported in 31.8% and 15.7% of pts with RA and axSpA, respectively. At BL, whilst receiving iETN, the mean (SD) DAS28-ESR scores were 2.5 (1.1) and 2.1 (1.1) in pts with RA and PsA, respectively (figure 1). The mean change from BL in DAS28-ESR score at Week 24 after switch to SDZ ETN was -0.1 (1.1) and 0 (1.0) in pts with RA and PsA, respectively. In pts with axSpA, the mean (SD) ASDAS score was 1.5 (0.7) at BL; mean change from BL in ASDAS score at Week 24 was 0.1 (0.5). At BL, the mean (SD) HAQ-DI scores were 0.8 (0.7), 0.5 (0.7) and 0.5 (0.6) in pts with RA, PsA and axSpA, respectively. Overall, the proportion of patients with at least one adverse event (AE) was 37.3%, 33.6% and 25.8% in pts with RA, PsA and axSpA, respectively. Serious AEs were reported in 6.5%, 1.7% and 3.1% of pts with RA, PsA, and axSpA, respectively. Injections site reactions were reported in 2.7%, 0.9% and 1.3% of pts with RA, PsA and axSpA, respectively.Figure 1.Disease activity in patients who switched from iETN to SDZ ETNConclusion:The interim analysis results shows that switch from iETN to SDZ ETN does not impact the effectiveness of ETN in pts with RA, axSpA or PsA, without any new safety signals.Disclosure of Interests:Marc Schmalzing Speakers bureau: Novartis, AbbVie, Chugai/Roche, Janssen-Cilag, Lilly, Consultant of: AstraZeneca, Chugai/Roche, Hexal/Sandoz, Gilead, AbbVie, Janssen-Cilag, Boehringer/Ingelheim, Grant/research support from: Travel grants: Chugai/Roche, Boehringer/Ingelheim, Celgene, Medac, Ayman Askari: None declared, Tom Sheeran Speakers bureau: Pfizer, UCB, Roche, Consultant of: Novartis, Pfizer, Grant/research support from: Novartis, UCB, Roche, David Walsh: None declared, Javier de Toro Santos: None declared, JULIO CESAR VAZQUEZ PEREZ-COLEMAN Speakers bureau: Sandoz, Abbvie, Sanofi, Fresenius, Charlotte Both Employee of: Sandoz employee Global Medical Affairs, Fabricio Furlan Employee of: Sandoz employee Global Medical Affairs, Sohaib HACHAICHI Employee of: Sandoz employee Global Medical Affairs, Herbert Kellner: None declared

Ora-pro-nobis (Pereskia aculeata Mill) is an unconventional food plant (UFP) rich in proteins, vitamins, fibers, and antioxidants. In this study, ora-pro-nobis leaves were investigated as a proof‑of‑concept by near-infrared (NIR) spectroscopy concerning the storage time (from collection to 12 days), packaging system: styrofoam-based packaging covered with stretchable polychloride vinyl (PVC) film, and vacuum packaging (nylon/poly), temperature (at room temperature of 20 ºC, and in the refrigerator at 4 ºC), and sanitization condition (washed and without washing). Principal component analysis (PCA) was applied to augmented matrices, showing that unwashed leaves stored in the refrigerator with styrofoam-based packaging covered with PVC film were better preserved over time. Furthermore, it has been suggested that NIR absorptions are related to proteins, carbohydrates, lipids, vitamins, antioxidants, and water from ora-pro-nobis leaves and their physiological reactions over time. By combining NIR spectroscopy and chemometrics, a complete understanding of the shelf life of ora-pro-nobis leaves was achieved.

A participação dos alimentos em reações imunológicas é fato constatado e de representatividade crescente nos consultórios brasileiros. Novas manifestações clínicas surpreendem profissionais experientes no assunto; diferentes fenótipos da doença, retardo na aquisição de tolerância oral e a identificação de um número cada vez maior de alérgenos são continuamente descritos.Simultaneamente, encontra-se robusta dificuldade em se estabelecer com precisão o diagnóstico das alergias a alimentos. A mimetização de sintomas comuns em uma vasta gama de reações adversas a alimentos implica em restrição dietética desnecessária e estigmatizante. Os exames laboratoriais isolados apresentam baixo poder de acurácia, e o teste de provocação oral, único método capaz de discernir a presença ou ausência de alergia, ainda é pouco utilizado na prática clínica geral Seguindo a tendência mundial de que alergias alimentares representam uma "nova era" entre as doenças alérgicas 1 , as iniciativas para identificação do perfil de pacientes brasileiros alérgicos a alimentos vêm aumentando sobremaneira. Os diferentes hábitos, alimentação, clima, fatores genéticos e condições socioeconômicas refletem em respostas imunológicas, etiologia, história natural e manejo particulares, não necessariamente comparáveis à população de outras regiões geográficas.Recente estudo multicêntrico brasileiro observou aumento na sensibilização a alimentos como leite, amendoim e milho nos últimos 12 anos 2 . Se por um lado a sensibilização é um indicativo de maior probabilidade de reações clínicas, por outro não define a prevalência de alergias alimentares.Senna et al. 3 demonstraram, por meio de testes de provocação oral duplo-cego e controlados por placebo, um dado inédito entre os estudos brasileiros de prevalência de alergia alimentar. Duzentas e trinta e quatro crianças com suspeita de alergia a algum alimento foram submetidas ao teste durante um período de 8 anos, e apenas 12,8% apresentaram resultados positivos. A primeira análise deste resultado aponta para a supervalorização de sintomas e sua relação com alergia.A grande maioria dos pacientes com resultados positivos (86,6%) apresentava leite e/ou ovo como fatores causais, o que corrobora com os estudos de sensibilização nacional de alimentos (PROAL II 2 ). Pacientes com dermatite atópica demonstraram maior chance de reação com alimentos, enquanto a presença isolada de asma não se mostrou parâmetro suficiente para restrições dietéticas.Outro achado bastante relevante do estudo foi a dissociação entre resultados positivos dos testes laboratoriais (IgE específica) e a positividade do padrão ouro (teste de provocação oral). Apenas 13,5% dos pacientes com IgE específica positiva apresentaram sintomas durante o teste oral. Paralelamente, a ausência de IgE para as proteínas alimentares testadas mostrou especificidade próxima a 100% entre os pacientes sem alergia alimentar.