Bibliometric analysis in paediatric dental journals listed in journal citation reports. Current trends

AIM

The aim of this study was to analyse articles published in paediatric dental journals included in Journal Citation Reports (JCR), to determine current trends in paediatric publishing.

METHODS

Articles included in paediatric dentistry journals in 2020 JCR were selected, published during the period 2008-2020. After applying inclusion criteria, author-based parameters (article title, first author's name, institution, sex and number of authors, number of affiliations, first/last author's origin and geographic origin), and article-based parameters (article type, main topic, research design) were registered for each article.

CONCLUSION

International Journal of Paediatric Dentistry, Journal of Clinical Pediatric Dentistry, European Journal of Paediatric Dentistry and Pediatric Dentistry were the four main journals in terms of production volume, USA being the most productive country. The most recurrent topic was dental surgery, and the most common design was observational studies. Study design, geographic origin of the articles, article type and main subject of the article might predict citation.

The Lights And The Shadows Of Controlled Sting Challenge With Hymenoptera

Hymenoptera venom immunotherapy (VIT) is a treatment which has been shown to be effective in the protection of individuals with systemic allergic reactions caused by Hymenoptera stings. The need for a tool which shows the degree of protection afforded by VIT and the lack of useful biomarkers, has converted the Sting Challenge Test (SCT) into the gold standard for this disorder although its use has both lights and shadows. SCT with Hymenoptera is a test consisting of causing a real sting in a patient diagnosed with an allergy to the venom of the stinging insect and who normally is undergoing treatment with specific immunotherapy. In Spain, SCT is included in the list of services offered by some hospitals and forms part of their habitual clinical practice. This review aims to analyze the strengths and weaknesses of this test and describe the standardized procedure and necessary resources, based on the experience of a group of Spanish experts and a review of the literature.

Cross-Sectional Validation of a Quality of Life Questionnaire in Spanish for Patients Allergic to Hymenoptera Venom

INTRODUCTION AND OBJECTIVES

The first quality of life questionnaire for Vespula-allergic patients (Vespid Allergy Quality of Life Questionnaire [VQLQ) was developed in 2002. Our objective was to perform the cross-sectional validation of the Spanish version of this questionnaire.

PATIENTS AND METHODS

Using the original English-language version of the VQLQ as a starting point, the Spanish translation and cultural adaptation were performed and the first Spanish version was backtranslated into English and discussed with the authors of the original version. The result was the Spanish Health-related Quality of Life Questionnaire for Hymenoptera Venom-Allergic Patients (HRQLHA). Cross-sectional validation was carried out in a multicenter study using a test-retest design. Patients over the age of 14 diagnosed with systemic allergic reaction to venom from Apis, Vespula, or Polistes species were included. The test-retest reliability, external validity, and internal consistency of the questionnaire were measured.

RESULTS

The sample comprised 116 patients. The mean HRQLHA score was 3.48. Test-retest reliability showed an intraclass correlation coefficient of 0.85. HRQLHA showed a positive correlation (0.5) with an external questionnaire, thus demonstrating its external validity. Analysis of the internal consistency of the HRQLHA yielded a Cronbach α of 0.95, which can be considered to be excellent.

CONCLUSIONS

Statistical analysis revealed the high test-retest reliability, internal consistency, and external validity of the HRQLHA. The HRQLHA is the first validated questionnaire to include patients allergic to Polistes species, which is common in our area. Our findings show that the questionnaire is also valid for these patients.

Longitudinal Validation of the Spanish Version of the Health-Related Quality of Life Questionnaire for Hymenoptera Venom Allergy (HRQLHA)

BACKGROUND AND OBJECTIVE

The Spanish version of the health-related quality of life questionnaire for allergy to hymenoptera venom (HRQLHA) has been shown to be reliable, internally consistent, and externally valid. The aim of this study was to complete the validation of the HRQLHA by analyzing its sensitivity to changes (longitudinal validity) using the sting challenge test (SCT) as the variable of change.

PATIENTS AND METHODS

Patients over the age of 17 years with a systemic allergic reaction to Apis, Vespula, or Polistes venom were included during their first year of venom-specific immunotherapy. Patients were assigned to either a group that underwent the SCT or a control group that did not. All patients completed the HRQLHA at baseline and after a period of 2 to 4 months, during which time the SCT was performed in the active group, with no intervention in the control group.

RESULTS

Fifty patients were included in the study: 25 in the SCT group and 25 in the control group. The patients in the SCT group showed a significant improvement in mean HRQLHA score (+0.35, P=.03) after the SCT, while those in the control group showed no significant changes in questionnaire scores.

CONCLUSIONS

Our results demonstrate the sensitivity of the HRQLHA to changes and thus complete the longitudinal validation of the questionnaire. A well-tolerated SCT improves the quality of life of venom-allergic patients as it reduces anxiety associated with the fear of being stung.

Component-resolved diagnosis of vespid venom-allergic individuals: phospholipases and antigen 5s are necessary to identify Vespula or Polistes sensitization

BACKGROUND

Cross-reactivity between hymenoptera species varies according to the different allergenic components of the venom. The true source of sensitization must therefore be established to ensure the efficacy of venom immunotherapy.

OBJECTIVE

In the Mediterranean region, Polistes dominulus and Vespula spp. are clinically relevant cohabitating wasps. A panel of major vespid venom allergens was used to investigate whether serum-specific IgE (sIgE) could be used to distinguish sensitization to either vespid.

METHODS

Fifty-nine individuals with allergic reactions to vespid stings and positive ImmunoCAP and/or intradermal tests to vespid venoms were studied. sIgE against recombinant and natural venom components from each wasp species was determined using the ADVIA Centaur(®) system.

RESULTS

sIgE against recombinant antigen 5s sensitization to be detected in 52% of the patients tested (13/25). The sensitivity increased to 80% (20/25), when using natural antigen 5s, and to 100% with the complete panel of purified natural components, because the sIgE was positive to either the antigen 5s (Pol d 5/Ves v 5) or to the phospholipases (Pol d 1/Ves v 1) of the two vespids, or to both components at the same time. In 69% of cases, it was possible to define the most probable sensitizing insect, and in the rest, possible double sensitization could not be excluded. Vespula hyaluronidase was shown to have no additional value as regards the specificity of the assay.

CONCLUSIONS

The major allergens of P. dominulus' and Vespula vulgaris' venom, namely phoshpholipases and antigen 5s, are required to discriminate the probable sensitizing species in vespid-allergic patients.

Epidemiologic observations on Hymenoptera allergy in Spain: the Alergológica-2005 study

BACKGROUND

To date there has been an absence of nation-wide epidemiologic studies on insect allergy in Spain.

OBJECTIVES

To measure the frequency and to determine the characteristics of Hymenoptera hypersensitivity in a Spanish population at a particular point in time and compare with the data obtained in a similar study carried out in 1992.

MATERIAL AND METHODS

An observational, prospective and cross-sectional study (Alergológica-2005) was carried out all over Spain.

RESULTS

The number of patients included in the study was 4991, of whom 77 (1.54%) were diagnosed with insect sting allergy. This represented an increase of 0.7% compared to Alergológica-1992. The honey bee was responsible for 45.5% of reactions, Vespula spp for 27.3% and Polistes spp for 23.4%. 64.9% of reactions were systemic. The group with Hymenoptera allergy had a predominance of males (69.1% vs. 42.7% in the general sample, P < .0001), older patients (median age 37,4 vs. 32,1, P < .013), and homes in rural zones (33% vs. 18.3%, P < .004). The median of days necessary to reach a diagnosis was lower (P < .0001). This population needed assistance in emergency units and hospitalisation more frequently. They had a low score on the mental component of the quality of life questionnaire.

CONCLUSIONS

There was an increase in cases diagnosed with insect allergy with regard to Alergológica-1992. The typical patient profile is of a man, living in a small village, working outdoors with significant exposure to insect stings and in contact with farm animals, without atopic diseases. Bees and wasps are equally responsible of the stings. The need of emergency assistance in those patients is higher and the waiting time to be attended by an allergist is shorter.

Regulation of murine Tap1 and Lmp2 genes in macrophages by interferon gamma is mediated by STAT1 and IRF-1

The genes of the transporter associated with antigen processing (Tap)-1, and the low molecular weight peptide (Lmp)-2, are crucial for class I major histocompatibility complex function and share a common bidirectional promoter. In murine bone marrow-derived macrophages, interferon gamma (IFN-gamma) induced Tap-1 and upregulated Lmp-2, which is constitutively expressed at low levels. The IFN-gamma-induction was independent of early gene synthesis. The mRNA induced by IFN-gamma was very stable. In macrophages from STAT1 knockout mice, IFN-gamma did not induce the expression of Tap-1 or Lmp-2. Several areas in the promoter can be controlled by IFN-gamma, such as proximal and distal GAS boxes in the direction of the Tap-1 gene, NFgammaB and IRF-1 boxes. By making deletions of the promoter, we found that only the proximal GAS and IRF-1 boxes are required for IFN-gamma induction of Tap-1 and Lmp-2. Experiments using nuclear extracts from macrophages treated for 30 min with IFN-gamma and gel shift analysis indicated that STAT1 binds to the GAS box. The nuclear extracts from macrophages treated for at least 2 h with IFN-gamma bound to the IRF-1 box. These results indicate that both STAT1 and IRF-1 are required for the IFN-gamma induction of Tap-1 and Lmp-2 genes.

IFN-gamma-dependent transcription of MHC class II IA is impaired in macrophages from aged mice

To determine the effect of aging on IFN-gamma-induced MHC class II antigen expression, we produced bone marrow-derived macrophages in vitro. In these conditions, we analyzed the effect of aging on the genomic expression of macrophages without the influence of other cell types that may be affected by aging. Although macrophages from young and aged mice showed an identical degree of differentiation, after incubation with IFN-gamma, the expression at the cell surface of the IA complex and the levels of IAbeta protein and mRNA were lower in aged macrophages. Moreover, the transcription of the IAbeta gene was impaired in aged macrophages. The amount of transcription factors that bound to the W and X, but not to the Y, boxes of the IAbeta promoter gene was lower in aged macrophages. Similar levels of CIITA mRNA were found after IFN-gamma treatment of both young and aged macrophages. This shows that neither the initial cascade that starts after the interaction of IFN-gamma with the receptor nor the second signals involved in the expression of CIITA are impaired in aged macrophages. These data indicate that aging is associated with low levels of MHC class II gene induction by IFN-gamma because of impaired transcription.

[Hereditary angioedema. Control and treatment in 7 cases]

Hereditary angioedema (HAE) is due to a deficit of the C1 inhibitor (C1 INH) of a dominant autosomic inheritance. Seven patients are presented from a family with HAE, four of whom with poor prognosis due to the frequency and site of the angioedema. Prophylaxis was obtained with long-term danazol since antifibrinolytic drugs are not efficient in the prevention of outbreaks of angioedema. In three cases a concentrate of C1 INH was administered and in another as short term prophylaxis prior to surgery. C1 INH was more efficient under these indications than fresh plasma or antifibrinolytic drugs.