Background: Since raw egg may cause digestive toxic infections, we assessed whether pasteurized raw egg white is as reliable as fresh raw egg white in the diagnosis of egg allergy. Methods: Thirty-two egg-allergic children were challenged with both pasteurized and fresh raw egg white. Open challenges were carried out with increasing doses of pasteurized raw egg white and fresh raw egg white administered every 60 min. Results: Eleven children (34.4%) had positive challenges with pasteurized raw egg white. Twenty-one children (65.62%) who tolerated pasteurized raw egg white also had a negative challenge with fresh raw egg white. If the challenge with pasteurized raw egg white resulted positive, the study was stopped. The protein profile and IgE-binding capacity of both pasteurized and fresh egg white were almost identical as observed by SDS-PAGE and IgE immunoblotting. In the IgE immunoblotting-inhibition and ImmunoCAP-inhibition assays, both extracts behaved in a similar way. Conclusions: We did not find any relevant allergenic differences between fresh and pasteurized egg white. This study supports the use of pasteurized egg white in the diagnosis of allergy to fresh raw egg proteins.

Background:Anisakis simplex is a fish parasite responsible for gastrointestinal and allergic symptoms in humans. The Ani s 11-like protein has been proposed as an Anisakis allergen because its primary structure is similar to that of Ani s 11. The aims of this work were to analyse the frequency of detection of the Ani s 11-like protein and assess its diagnostic value. Methods: rAni s 11-like protein, rAni s 5 and rAni s 4 were expressed in Escherichia coli and rAni s 1 was produced in Pichia pastoris. Recombinant allergen detection patterns in 37 Anisakis-sensitised patients were determined. The stability to pepsin digestion and heat treatment of rAni s 11-like protein was also analysed by IgE immunoblotting. Results: Ani s 11-like protein is a major allergen detected by 78% of Anisakis-allergic patients, and 13.5% of patients detect only the rAni s 11-like allergen. This allergen is heat stable because it retains its capability of binding IgE after boiling for 30 min and it is resistant to pepsin digestion for 120 min. Conclusions: These data indicate that the Ani s 11-like protein is a pepsin- and heat-resistant major allergen (Ani s 11.0201) of Anisakis spp. and a valuable tool for Anisakis allergy component-resolved diagnosis.

The "complement system" is one of the efector pathways of the immune system against microorganisms and tumor cells. The complement system can be activated through three major pathways: classical, lectin, and alternative. The sequential activation through the generation of complex enzymes from inactive zymogens produces a cascade in which a capable enzyme generates a large number of active downstream molecules.C1 inhibitor (C1-INH) is a serine protease inhibitor (serpin) that regulates the following closely interrelated proteolytic pathways: complement system, coagulation system, contact system, and ibrinolysis system. The absence or malfunction of C1-INH results in the presence of atacks of angioedema (AE) due to uncontrolled activation of the contact system, with the generation of bradykinin (BK), a vasoactive peptide released from high-molecular-weight kininogen (HMWK). Some drugs that inhibit the catabolism of BK have been implicated in the development of AE. These include angiotensin-converting enzyme inhibitors (ACEIs), dipeptidyl peptidase IV (DPP-IV) inhibitors, aminopeptidase P (APP) inhibitors, and neutral endopeptidase (NEP) inhibitors.We describe in this chapter the biochemistry pathways implicated in the pathophysiology of bradykininergic angioedema (BK-AE) and the role of the complement system in the prototype of BK-AE, in hereditary angioedema with C1-INH deiciency (C1-INH-HAE), and also in acquired angioedema with C1-INH deiciency (C1-INH-AAE).

Introduction: Diabetic foot is the infection, ulceration or destruction of the deep tissues of the foot in patients with diabetes mellitus. This pathology occurs when there are high levels of glucose in the blood, as well as other factors such as high blood pressure and hypercholesterolemia. These factors cause damage to the vessels and nerves, producing medium and long-term complications. This is a health problem that affects diabetic patients throughout their lives. Objective: To know the different techniques and strategies that allow to carry out an appropriate management of the diabetic foot. Methodology: A narrative review was carried out between November 2021 and July 2022 in the different databases of Pubmed (Medline), Scielo, Scopus and Web of Science (WOS), with a search string that combined the keywords derived from thesauri, namely Descriptors of Health Sciences (DeCS) and Medical Subject Headings (MeSH), combined with the Boolean operators “AND”, “NOT” and “NOT”. Results: After applying the article selection criteria and evaluating the quality of the methodology, a total of 22 articles were obtained. The results affirm the existence of promising therapies for the treatment of diabetic foot ulcers such as negative-pressure therapy and hyperbaric oxygen therapy. It is highlighted that the use of therapeutic footwear and health education are deficient aspects that must be reinforced. Conclusion: After comparing the different articles, it was possible to determine that negative-pressure therapy and hyperbaric oxygen therapy should be promoted as they are suitable for the treatment of diabetic foot ulcers. In addition, therapeutic footwear is a baseline in the diabetic foot approach. On the other hand, it is necessary to reinforce interdisciplinary work in this area and health education for patients suffering from this disease.

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Thirty-eight children completed the study. At T1 all had rhinitis and 34 also had asthma. At T3, 30 patients had improved, six experienced no changes and two worsened. Improvement was associated to FEV1/FVC and VAS improvement; to a reduction in D. pteronyssinus skin prick test; to a progressive increase in serum levels of D. pteronyssinus IgE, and D. pteronyssinus, Der p1 and Der p2 IgG4. IL-10 levels showed an early increase at T2f (the end of initial build-up immunotherapy phase), and then a reduction at T3 (the end of a year of immunotherapy). Improvement associated to an early increase in IL-10 and was correlated with VAS and specific IgG4 evolution.

Background: To determine the relationship between physiological fatigue and the quality of cardiopulmonary resuscitation (CPR) in trained resuscitators in hostile thermal environments (extreme cold and heat) simulating the different conditions found in an out-of-hospital cardiorespiratory arrest. Methods: Prospective observational study involving 60 students of the health sciences with training in resuscitation, who simulated CPR on a mannequin for 10 min in different thermal environments: thermo-neutral environment (21 °C and 60% humidity), heat environment (41 °C and 98% humidity) and cold environment (−35 °C and 80% humidity). Physiological parameters (heart rate and lactic acid) and CPR quality were monitored. Results: We detected a significant increase in the number of compressions per minute in the “heat environment” group after three minutes and in the mean rate after one minute. We observed a negative correlation between the total number of compressions and mean rate with respect to mean depth. The fraction of compressions (proportion of time in which chest compressions are carried out) was significant over time and the mean rate was higher in the “heat environment”. Physiological parameters revealed no differences in heart rate depending on the resuscitation scenario; however, there was a greater and faster increase in lactate in the “heat environment” (significant at minute 3). The total proportion of participants reaching metabolic fatigue was also higher in the “heat environment”. Conclusions: A warm climate modifies metabolic parameters, reducing the quality of the CPR maneuver.

Introduction: Complex wounds require advanced techniques for their management and care. Wound care costs are high, so healthcare professionals need to be aware of available therapies. Negative pressure therapy is a technology for which more and more data on its effectiveness in complex wounds are being collected. Objective: The objectives of this review were to analyze if the application of negative pressure therapy in complex wounds is effective; to compare the effectiveness of negative pressure therapy with other conventional treatments, as well as its combination with other therapies; and to evaluate the quality of life of patients undergoing negative pressure therapy and collect their main characteristics. Methodology: A bibliographic review focused on articles published between November 2015 and June 2022 was carried out. The following databases were consulted: PubMed (Medline), Google Scholar, Web of Science (WOS), Scielo and Scopus. Results: The most used pressures in the studies coincide at −125 mmHg and in the range of −125 mmHg to −150 mmHg. In the pediatric population, pressure levels vary by age group. A pressure of −75 to −125 mmHg is recommended for children over 12 years of age, and −50 to −75 mmHg is recommended for children under 2 years of age. Conclusions: Negative pressure therapy stands out for its rapid rate of granulation, the prevention and effective treatment of infections, the variety and malleability of dressings, its various applications and the possibility of using it with other therapies to accelerate wound closure.