RESUMO
Background: This research aims to investigate the influence of environmental factors on the treatment efficacy of ocular lubricants in patients from urban areas with dry eye disease (DED). Methods: A phase IV clinical trial, which included 173 patients from major cities in Mexico, was randomly assigned to use ocular lubricants four times a day for 30 days. Ocular Surface Disease Index (OSDI), noninvasive tear film break-up time (NIBUT), ocular staining, and conjunctival hyperemia (CH) among other factors like weather, and air pollution as covariates were analysed. Results: After 30 days, OSDI score decreased by 14.8 points (p<0.001), and NIBUT increased by 2.9 seconds (p< 0.001), with longer values observed in patients recruited in autumn and winter (additional 1.8 seconds, p< 0.05) compared to those recruited in spring. Patients living in cities with cooler weather and high humidity, but low air quality had higher OSDI and conjunctival stain scores of up to 4.4 and 0.3 points, respectively, as compared to those living in cities with similar pollution and humidity levels but with higher temperatures (p-values= 0.019 and 0.050). Patients with moderate CH had an increase of up to 0.8 points in their corneal stain score (p< 0.010). We also found that ozone levels were related to the predicted changes in OSDI and NIBUT. Conclusion: This study demonstrated the impact of environmental factors on the signs and symptoms of DED and suggests that patients residing in cities with inadequately controlled air pollution can benefit from using ocular lubricants to alleviate their symptoms. Trial Registration: Trial is registered at clinicaltrials.gov (NCT04702776).
RESUMO
BACKGROUND: The oral allergy syndrome (OAS) is a common cause of food allergy in adults. OBJECTIVE: Our objectives were to determine its frequency and to describe its clinical characteristics among Mexican subjects with nasal pollinosis. METHODS: The diagnosis of OAS was made using the clinical history and fresh food prick-by-prick tests. The sample to estimate the frequency consisted of 100 consecutive subjects with nasal pollinosis. The clinical features of OAS were described in thirty patients of this sample. RESULTS: The frequency of OAS among the subjects was 13%, the average age was 29.9 years and 26 subjects were women. The most common symptoms were oropharyngeal pruritus, followed by lip edema, starting mainly within the first minute after food ingestion. The median for the serum IgE levels was 160 UI/ml, while the mean for total eosinophils was 278. We observed that predominant sensitizing aeroallergens were trees, among them, oaks. A total of 23 different OAS-related foods was detected: peach (23 cases), apple (18 cases), pear (8 cases) and almond (7 cases). The OAS evolution time correlated significantly with the evolution time of allergic rhinitis (rho=0.49 P=0.006) and the duration of OAS symptoms (rho=0.37 P=0.05), whereas these last two variables showed an interdependent correlation (rho=0.52 P=0.003). CONCLUSIONS: The patients with nasal pollinosis have a considerable proportion of OAS. In subjects sensitized to pollen of oaks and/or alders, OAS should be suspected.