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Introducción: Evaluar la seguridad y la eficacia de la inducción de tolerancia oral mediante pauta rush en pacientes con alergia a proteínas de leche de vaca persistente. Material y métodos: Estudio prospectivo realizado en 3 hospitales españoles. Se incluyó a niños mayores de 3 años con alergia IgE-mediada a proteínas de leche de vaca, a los que se administraron dosis crecientes de leche durante 5 días, desde 1 cc al 1% hasta 200 cc de leche pura en régimen de hospital de día. Las reacciones adversas a la administración de leche fueron registradas y se trataron atendiendo a la clasificación de Clark. Se realizó seguimiento clínico durante 2 años. Se determinaron los niveles de IgE específica basales y a los 6, 12 y 24 meses. Resultados: Se incluyó a 18 niños (13 varones) entre 3 y 14 años (media 5,96). De 271 dosis administradas, 55 presentaron algún tipo de reacción. Un 84% de las mismas fueron leves. Al finalizar el protocolo, el 100% presentaba algún grado de tolerancia (39% total). Tras 2 años, el 72% de los pacientes realizaba una dieta sin restricción de productos lácteos. Dos pacientes presentaron pérdida de la tolerancia alcanzada. Se observó un descenso significativo de los niveles de IgE específica a leche de vaca y α-lactoalbúmina a los 24 meses, y de caseína a los 6, 12 y 24 meses respecto de los niveles basales. Conclusiones: La desensibilización mediante pauta rush es una opción terapéutica eficaz y segura a medio plazo para pacientes con alergia persistente a proteínas de leche de vaca (AU)

Objective: The aim of this study was to evaluate the safety and efficacy of oral rush desensitization in children with cow milk allergy. Material and methods: Prospective study. We included IgE-mediated cow milk allergy children over 3 years in 3 Spanish hospitals. Increasing doses of cow milk for 5 days from 1 cc of 1% to 200cc of pure milk were administered. Clinical follow-up was conducted and we compared specific IgE levels at onset, 6, 12 and 24 months after desensitization. Results: We included 18 children (13 males) between 3 and 14 years (mean 5.96). A total of271 doses were administered; there were 55 adverse reactions (84% mild). At the end of the protocol, 100% showed some degree of tolerance (39% total). Full tolerance was achieved in 72%of patients after two years. Two children failed to achieve tolerance. There was a significant decrease in the levels of specific IgE to cow milk and alpha-lactalbumin at 24 months, and to casein at 6, 12 and 24 months, compared to baseline. Conclusions: Oral rush desensitization is a safe and effective therapeutic option for patients with persistent cow milk allergy to medium term (AU)

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OBJECTIVE: The aim of this study was to evaluate the safety and efficacy of oral rush desensitization in children with cow milk allergy. MATERIAL AND METHODS: Prospective study. We included IgE-mediated cow milk allergy children over 3 years in 3 Spanish hospitals. Increasing doses of cow milk for 5 days from 1 cc of 1% to 200 cc of pure milk were administered. Clinical follow-up was conducted and we compared specific IgE levels at onset, 6, 12 and 24 months after desensitization. RESULTS: We included 18 children (13 males) between 3 and 14 years (mean 5.96). A total of 271 doses were administered; there were 55 adverse reactions (84% mild). At the end of the protocol, 100% showed some degree of tolerance (39% total). Full tolerance was achieved in 72% of patients after two years. Two children failed to achieve tolerance. There was a significant decrease in the levels of specific IgE to cow milk and alpha-lactalbumin at 24 months, and to casein at 6, 12 and 24 months, compared to baseline. CONCLUSIONS: Oral rush desensitization is a safe and effective therapeutic option for patients with persistent cow milk allergy to medium term.

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La incidencia de meningitis neumocócica de forma globalha disminuido tras la introducción de la vacuna heptavalente.Sin embargo, los casos producidos por serotipos novacunales probablemente han aumentado.Objetivo: Estimar la prevalencia de meningitis neumocócicaen nuestra provincia y su evolución en los últimosaños.Material y métodos: Estudio prospectivo de las meningitisneumocócicas ingresadas en el Hospital Universitariode Salamanca en los años 2003 a 2008.Resultados: Se registraron 5 casos de meningitis, estimandouna prevalencia anual de 6/100.000 niños menoresde 5 años. Los serotipos aislados fueron el 7F en 3 ocasionesy el 19A en una. Comparando la prevalencia en los 3 primerosaños del estudio con el segundo trienio, ésta se incrementóen un 32%.Conclusiones: En la actualidad, las meningitis neumocócicasen nuestro medio están producidas por serotiposno vacunales, en especial el 7F y 19A. En los últimos añoshemos asistido a un aumento en la incidencia de las mismas (AU)

Pneumococcal meningitis, globally have decreased sinceheptavalent conjugate vaccine was introduced. However,cases due to nonvaccine serotypes have increased.Object: To know the prevalence of pneumococcal meningitisin our province and the evolution during last years.Methods: Prospective study of pneumococcal meningitisadmitted in the University Hospital of Salamanca during2003 to 2008.Results: Five cases of meningitis were recorded. Annualprevalence was estimated at 6 per 100.000 children < 5 years.Serotypes isolated were 7F in three patients and one 19A.Prevalence rate during first 3 years compared to last 3 yearsrised up to 32%.Conclusions: Nowdays, pneumococcal meningitis in ourprovince are due to nonvaccine serotypes, especially to 7F and19A. During last years incidence rates of these was increased (AU)

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