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Background:The proposal and the initiative to conduct the Prevalence of Severe Asthma in Hospital Units in Spain (PAGE) study arises from the perspective of widespread implementation of electronic medical records and the limited data available on the prevalence of severe asthma in hospitals in our setting.Objectives: The primary objective is to determine the prevalence of severe asthma in the outpatient departments of allergy and pneumology services in Spain. Secondary objectives include describing the most prevalent characteristics and phenotypes of severe asthma, evaluating the selection criteria for receiving approved biological treatments for this disease, and estimating resource consumption. Furthermore, taking advantage of the incorporation of digital technology and new data collection sources, which allow the reuse of information stored in electronic medical records (Big Data), the use of one of these tools (Savana) has been integrated into the study. Methods:The PAGE study is designed as a multicenter, non-experimental, observational, cross-sectional study in a first phase, and prospective in a second phase, controlled, population-based, with a two-stage selection of subjects by random sampling. The research will be carried out in 40 hospitals, following a criterion of convenience, which assumes the geographical representativeness of Spain.Results: This manuscript describes the study design and protocol. Conclusions:Our study design is robust to avoid bias and to allow establishing the prevalence of patients with severe asthma in Spanish hospitals. It is the first to incorporate new tools that can help in routine clinical practice and research, such as big data analysis software, and to evaluate its reliability and efficiency. ResumenAntecedentes: La propuesta y la iniciativa de realizar el estudio Prevalencia del Asma Grave en las Unidades Hospitalarias de España (PAGE) surge desde la perspectiva de una implantación generalizada de la historia clínica electrónica y de los escasos datos disponibles sobre la prevalencia del asma grave en los hospitales de nuestro entorno.Objetivos: el objetivo principal es determinar la prevalencia de asma grave en las consultas externas de los servicios de alergia y neumología en España.Como objetivos secundarios, se incluyen describir las características y fenotipos más prevalentes del asma grave, evaluar los criterios de selección para recibir los tratamientos biológicos aprobados para esta enfermedad y estimar el consumo de recursos. Además, aprovechando la incorporación de la tecnología digital y las nuevas fuentes de recogida de datos, que permiten la reutilización de la información almacenada en las historias clínicas electrónicas (Big Data), se ha integrado en el estudio la utilización de una de estas herramientas (Savana). Métodos:El estudio PAGE está diseñado como un estudio multicéntrico, no experimental, observacional, transversal en una primera fase, y prospectivo en una segunda fase, controlado, basado en la población, con una selección de sujetos en dos etap...

Background: Acrylates are used in a wide variety of products such as solvents, adhesives, paints, printing ink, soft contact lenses, porcelain nails, and methacrylates (used by dentists and orthopedists). Currently there are various types of acrylic compounds: acrylates, cyanoacrylates (such as tissue adhesives and home glues), and methacrylates (prostheses and dental and orthopedic fillings). The sensitization mechanism is unknown, but the allergy is believed to be due to a non-IgE mediated phenomenon, since a late asthmatic response occurs. Various cases of acrylate-induced asthma have been reported, especially in dentists and persons using glues or paints containing this substance. Material and methods: We present the case of a 52-year-old man who had been working in graphic arts for the previous 7 years. For the previous 2 years he had experienced persistent cough with a sensation of drowning, dyspnea that increased with moderate exertion, and nasal obstruction despite continuous treatment. The symptoms first appeared after an episode of acute respiratory difficulty associated with weight loss, pulmonary infiltrates, and eosinophilia. Peak expiratory flow (PEF) was measured during work and sick leave, and specific bronchial challenge with acrylates was performed in a bronchial chamber. Results: The PEF improved on weekends and sick leave. The challenge test provoked a late astmatic response and the non-specifc bronchial hyperreactivity increased after the test. As well in the sputum samples there was a increase of eosinophil amount.