Compromising between European and US allergen immunotherapy schools: Discussions from GUIMIT, the Mexican immunotherapy guidelines.

Background: Allergen immunotherapy (AIT) has a longstanding history and still remains the only disease-changing treatment for allergic rhinitis and asthma. Over the years 2 different schools have developed their strategies: the United States (US) and the European. Allergen extracts available in these regions are adapted to local practice.

[GUIMIT 2019, Mexican Guideline on Immunotherapy. Guideline on the diagnosis of IgE-mediated allergic disease and immunotherapy following the ADAPTE approach].

Background: In Mexico, allergen immunotherapy (AIT) and immunotherapy with hymenoptera venom (VIT) is traditionally practiced combining aspects of the European and American school. In addition, both types of extracts (European and American) are commercially available in Mexico. Moreover, for an adequate AIT/VIT a timely diagnosis is crucial.

Pediatric asthma treatment: What to do when international guideline recommendations do not agree.

Background: There was a need for a solid asthma guideline in Mexico to update and unify asthma management. Because high-quality asthma guidelines exist worldwide, in which the latest evidence on asthma management is summarized, the ADAPTE approach allows for the development of a national asthma guideline based on evidence from already existing guidelines, adapted to national needs.

Objective: To fuse evidence from the best asthma guidelines and adapt it to local needs with the ADAPTE approach.

[Prevalence of allergic rhinitis and its symptoms in the school children population of Cuernavaca, Morelos, Mexico].

Background: Studies on allergic rhinitis prevalence have found significant variations in their results, even in closely-living populations.

Objective: To determine and compare the prevalence of allergic rhinitis and its symptoms in schoolchildren from Cuernavaca, Morelos, Mexico.

Methods: Cross-sectional, descriptive study on the prevalence of allergic rhinitis diagnosis and symptoms, where the "Diagnostic questionnaire for epidemiological studies" was used between June and December 2015 in pre-school and primary and secondary school population, after authorization was granted by parents and school authorities.

[Mexican Asthma Guidelines: GUIMA 2017].

Background: The need for a national guideline, with a broad basis among specialists and primary care physicians was felt in Mexico, to try unifying asthma management. As several high-quality asthma guidelines exist worldwide, it was decided to select the best three for transculturation.

Methods: Following the internationally recommended methodology for guideline transculturation, ADAPTE, a literature search for asthma guidelines, published 1-1-2007 through 31-12-2015 was conducted.

[Prevalence of asthma and its symptoms in schoolchildren from Cuernavaca, Morelos, Mexico].

Background: Asthma is a chronic disease that has increased over the past 2 decades.

Objective: To determine the prevalence of asthma and its symptoms in the city of Cuernavaca, Morelos, Mexico.

Methods: A descriptive study of prevalence in public schools of the city of Cuernavaca, Morelos, at the preschool, elementary, and high school levels using the "Asthma diagnosis for epidemiological studies questionnaire.

[Prevalence of asthma and determination of symptoms as risk indicators].

Background: Asthma is a chronic inflammatory airway disease whose prevalence has increased, especially in developed countries; the results of studies of asthma prevalence vary in different populations and even within the same country; in Mexico we observed fluctuations in prevalence of asthma from 7% to 33%.

Objective: To determine the prevalence of asthma and severity of symptoms as risk indicators in school population in cities in various states of Mexico.

Material And Method: A descriptive study of detection of asthma prevalence and analytical-comparative observational study of determination of symptoms of asthma.

[Prevalence of rhinitis allergic in populations of several states of Mexico].

Background: Allergic rhinitis is an inflammatory disorder of the nasal mucosa, characterized by symptoms of itching, rhinorrhea, nasal congestion and sneezing induced by an IgE-mediated response. In Mexico we have reports of prevalence, with fluctuations of 5.5% to 47.

[Antihistamines for the treatment of urticaria in Mexico].

There are four types of histamine receptors. Allergic symptoms, especially those in rhinoconjunctivitis and urticaria, are mainly caused by activation of histamine receptor 1 (H1). Consequently, oral H1-antihistamines form and integral part of the treatment of these diseases.

How an online survey on the treatment of allergic rhinitis and its impact on asthma (ARIA) detected specialty-specific knowledge-gaps.

Background: To enhance the dissemination of the ARIA document (Allergic rhinitis (AR) and its impact on asthma) in Mexico, a Working Group composed of 35 specialists of 8 professional medical societies developed a transculturized ARIA México 2014 guideline. The ARIA guidelines use the GRADE system, which builds recommendations and suggestions around clinical questions (CQ).

Methods: As part of the dissemination strategy and to detect the physicians' view and knowledge-gaps concerning the treatment of AR an online survey was sent out to members of participating societies containing the CQ of ARIA México.

[Mexican guidelines on the diagnosis and treatment of urticaria].

Background: Urticaria is a disease that a fifth of the population shallsuffer once in a lifetime. Recent clinical guidelines have proposed some fundamental changes in the diagnosis and treatment of urticaria, making the development of a national, multidisciplinary guideline, with wide acceptability among different professional groups -both specialists and primary health care workers-, necessary in Mexico.

Material And Method: Internationally recognized tools for guidelinedevelopment were used.

[Validation of a diagnostic questionnaire of allergic rhinitis in children and adults for epidemiological studies].

Background: Allergic rhinitis is the most frequent allergic disease, characterized by nasal symptoms consisting of rhinorrhea, nasal block-age and sneezing triggered by and IgE mediated reaction to allergens.

Objective: To validate a questionnaire for the clinical diagnosis of allergic rhinitis.

Material And Method: A test of a test in which a questionnaire for the clinical diagnosis of allergic rhinitis was developed and validated it in 300 subjects (150 children, 150 adults, of both genders, 2-70 years), in allergy specialized centers, between November 2012 and February 2014.

In the (sub)tropics allergic rhinitis and its impact on asthma classification of allergic rhinitis is more useful than perennial-seasonal classification.

Background: Two different allergic rhinitis (AR) symptom phenotype classifications exist. Treatment recommendations are based on intermittent-persistent (INT-PER) cataloging, but clinical trials still use the former seasonal AR-perennial AR (SAR-PAR) classification. This study was designed to describe how INT-PER, mild-moderate/severe and SAR-PAR of patients seen by allergists are distributed over the different climate zones in a (sub)tropical country and how these phenotypes relate to allergen sensitization patterns.

Allergen sensitization linked to climate and age, not to intermittent-persistent rhinitis in a cross-sectional cohort study in the (sub)tropics.

Background: Allergen exposure leads to allergen sensitization in susceptible individuals and this might influence allergic rhinitis (AR) phenotype expression. We investigated whether sensitization patterns vary in a country with subtropical and tropical regions and if sensitization patterns relate to AR phenotypes or age.

Methods: In a national, cross-sectional study AR patients (2-70 y) seen by allergists underwent blinded skin prick testing with a panel of 18 allergens and completed a validated questionnaire on AR phenotypes.

[ARIA Mexico 2014. Adaptation of the Clinical Practice Guide ARIA 2010 for Mexico. Methodology ADAPTE].

Background: The global prevalence of allergic rhinitis is high. International Study of Asthma and Allergies in Childhood (ISAAC) Phase III reports a total estimated prevalence of 4.6% in Mexico.