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Lopez-Matas M.A.,Laboratorios LETI SL | Ferrer A.,Allergy Unit | Huertas A.J.,Complejo Hospitalario Universitario Of Cartagena | Pagan J.A.,Allergy Service | And 3 more authors.
International Archives of Allergy and Immunology | Year: 2013

Background: Although allergy to Cannabis sativa was first reported over 40 years ago, the allergenicity has scarcely been studied. The objectives of this study were to investigate the frequency of sensitization to this plant, to analyze the clinical characteristics and allergenic profile of sensitized individuals and to identify the allergens involved. Methods: Five hundred and forty-five individuals in Spain attending allergy clinics with respiratory or cutaneous symptoms underwent a skin-prick test (SPT) with C. sativa leaf extract. The extract was characterized by SDS-PAGE and 2-dimensional electrophoresis. Specific IgE to C. sativa was measured in positive SPT individuals. The clinical and allergenic profiles of sensitized individuals were investigated and the most-recognized allergens sequenced and characterized by liquid chromatography-mass spectrometry/mass spectrometry. Results: Of this preselected population, 44 individuals had positive SPT to C. sativa (prevalence 8.1%). Prevalence was higher in individuals who were C. sativa smokers (14.6%). Two individuals reported mild symptoms with C. sativa. Twenty-one individuals from 32 available sera (65.6%) had positive specific IgE to C. sativa. Twelve sera recognized at least 6 different bands in a molecular-weight range of between 10 and 60 kDa. Six of them recognized a 10-kDa band, identified as a lipid transfer protein (LTP) and 8 recognized a 38-kDa band, identified as a thaumatin-like protein. Conclusions: There is a high prevalence of sensitization to C. sativa leaves. The clinical symptoms directly attributed to C. sativa were uncommon and mild. The sensitization profile observed suggests that C. sativa sensitization may be mediated by two mechanisms, i.e. cross-reactivity, mainly with LTP and thaumatin-like protein, and exposure-related 'de novo' sensitization. Copyright © 2013 S. Karger AG, Basel. Source


Trujillo-Santos J.,Complejo Hospitalario Universitario Of Cartagena | Lozano F.,Complejo Asistencial de Salamanca | Lorente M.A.,Hospital de la Agencia Valenciana de Salud Vega Baja | Adarraga D.,Hospital de Montilla | And 6 more authors.
The American journal of medicine | Year: 2015

BACKGROUND: No prior studies have identified which patients with deep vein thrombosis in the lower limbs are at a low risk for adverse events within the first week of therapy.METHODS: We used data from the Registro Informatizado de la Enfermedad TromboEmbólica (RIETE) to identify patients at low risk for the composite outcome of pulmonary embolism, major bleeding, or death within the first week. We built a prognostic score and compared it with the decision to treat patients at home.RESULTS: As of December 2013, 15,280 outpatients with deep vein thrombosis had been enrolled. Overall, 5164 patients (34%) were treated at home. Of these, 12 (0.23%) had pulmonary embolism, 8 (0.15%) bled, and 4 (0.08%) died. On multivariable analysis, chronic heart failure, recent immobility, recent bleeding, cancer, renal insufficiency, and abnormal platelet count independently predicted the risk for the composite outcome. Among 11,430 patients (75%) considered to be at low risk, 15 (0.13%) suffered pulmonary embolism, 22 (0.19%) bled, and 8 (0.07%) died. The C-statistic was 0.61 (95% confidence interval [CI], 0.57-0.65) for the decision to treat patients at home and 0.76 (95% CI, 0.72-0.79) for the score (P = .003). Net reclassification improvement was 41% (P < .001). Integrated discrimination improvement was 0.034 for the score and 0.015 for the clinical decision (P < .001).CONCLUSIONS: Using 6 easily available variables, we identified outpatients with deep vein thrombosis at low risk for adverse events within the first week. These data may help to safely treat more patients at home. This score, however, should be validated. Copyright © 2015 Elsevier Inc. All rights reserved. Source


Carnes J.,Laboratorios LETI SL | De Larramendi C.H.,Allergy Section | Ferrer A.,Allergy Unit | Huertas A.J.,Complejo Hospitalario Universitario Of Cartagena | And 5 more authors.
Food Chemistry | Year: 2013

Goji berries (GB) have been introduced in Western diet. Preliminary reports have demonstrated its allergenic capacity. The objectives of the study were to investigate the frequency of sensitisation and the allergens involved. 566 individuals, with respiratory or cutaneous symptoms were skin-prick tested with GB extract. Thirty three were positive (5.8%). 94% were sensitised to other allergens. Specific IgE to GB, peach, tomato and nut-mix was measured. Thirteen individuals from 24 available sera (54.2%) had positive specific IgE. 92.3% of GB positive patients were positive to peach. Seven individuals recognised 8 bands and six recognised a 7 kDa band. This band was identified as a LTP by MS/MS. Cross-reactivity was demonstrated with tomato, tobacco, nutmix, Artemisia pollen and purified Lyc e 3 and Pru p 3. GB are a new allergenic source with high prevalence of sensitisation. LTP seems to be the major allergen involved in sensitisation and cross-reactivity. © 2012 Elsevier Ltd. All rights reserved. Source


Maestre A.,Hospital Vinalopo Salud | Trujillo-Santos J.,Complejo Hospitalario Universitario Of Cartagena | Visona A.,Vascular Medicine | Lobo J.L.,Hospital de Txagorritxu | And 4 more authors.
Thrombosis Research | Year: 2014

Background The prognostic value of D-dimer testing in patients with acute pulmonary embolism (PE) has not been thoroughly studied. Methods We used the RIETE Registry data to assess the 90-day prognostic value of increased IL Test D-dimer® levels at baseline in patients with PE, according to the presence or absence of cancer. Results As of May 2013, 3,283 patients with acute PE underwent D-dimer testing using IL Test D-dimer®. Among 2,588 patients without cancer, those with D-dimer levels in the highest quartile had a higher rate of fatal PE (2.6% vs. 0.9%; p = 0.002), fatal bleeding (1.1% vs. 0.3%; p = 0.017) and all-cause death (9.1% vs. 4.4%; p < 0.001) at 90 days compared with those with levels in the lowest quartiles. Among 695 patients with cancer, those with levels in the highest quartile had a similar rate of fatal PE or fatal bleeding but higher mortality (35% vs. 24%; p < 0.01). On multivariate analysis, non-cancer patients with D-dimer levels in the highest quartile had an increased risk for fatal PE (odds ratio [OR]: 3.3; 95% CI: 1.6-6.6), fatal bleeding (OR: 4.3; 95% CI: 1.4-13.7) and all-cause death (OR: 2.1; 95% CI: 1.4-3.1) compared with patients with levels in the lowest quartiles. Conclusions Non-cancer patients with acute PE and IL Test D-dimer® levels in the highest quartile had an independently higher risk for fatal PE, fatal bleeding and all-cause death at 90 days than those with levels in the lowest quartiles. In patients with cancer, D-dimer levels failed to predict fatal PE or fatal bleeding. © 2014 Elsevier Ltd. Source


Lopez-Matas M.A.,Laboratorios LETI SL | Huertas A.J.,Complejo Hospitalario Universitario Of Cartagena | Ferrer A.,Allergy Unit | Moya R.,Laboratorios LETI SL | And 3 more authors.
Journal of Investigational Allergology and Clinical Immunology | Year: 2015

Background: Tomato allergies have been extensively studied but component-resolved in vivo diagnosis with purified allergens has yet to be performed. Objectives: To evaluate the prevalence of sensitization to Sola l 3 in a Mediterranean population, and to compare the resulting sensitization profile with that of individuals sensitized to tomato, peach, and/or purified lipid transfer protein (LTP). Methods: Sola l 3 was purified, characterized, and used to prepare skin prick tests (SPTs). Two groups of patients were selected. Group 1 consisted of patients with at least 1 positive SPT to tomato, peach, or LTP mixture (marker extracts) who were subsequently tested with Sola l 3 (n=280). Group 2 (prevalence study) consisted of patients who underwent simultaneous SPT with the 3 marker extracts and Sola l 3 (n=658). Patients from either group who were positive to any of the 4 extracts were studied in detail (study group, n=123). ELISA and immunoblot assays were performed in individuals with a positive SPT to Sola l 3 to detect the presence of specific IgE antibodies to this allergen. Results: Prevalence of sensitization to Sola l 3 was 3.2% overall and 54.7% in tomato-positive patients. Most tomato-sensitized patients were asymptomatic. Symptoms were more common in Sola l 3–positive individuals. Sensitization to peach and the LTP mixture did not discriminate between Sola l 3–positive and Sola l 3–negative patients. Conclusions: This study confirms that LTP, not only from peach but also from other fruit and vegetables, including tomato, is an important allergen in the Mediterranean area. Sensitization to Sola l 3 is associated with more symptoms in tomato-sensitized patients. © 2015 Esmon Publicidad. Source

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