RESUMEN
OBJECTIVE: To compare the efficacy and safety of levocabastine nasal spray asid cetirizine oral for the treatment of perennial allergic rhinitis in children. MATERIAL AND METHODS: In this randomized, prospective experimental, open clinical trial. We studied 30 children with ages between 6 and 16 years with perennial allergic rhinitis. Group 1, 17 subjects (7 female, 10 male) received cetirizine once daily, 5 mg children weientig less dian 30 k asid 10 mg in children weighing more trw' 30 k during 15 days. Group 2, 13 subjects (7 male, 6 female) received levocabastine 2 puffs BID on each nostril during tbe same time. A nasal symptoms score, nasal peal: flow vid eosinophils in a nasal smear were performed before and after treatment. RESULTS: There were no statistical differences in age, weight, height and arid duration of symptoms. Both groups showed improvement of symptoms via nasal peak flow with no differences between them (intergroup); nasal eosinophils remained unchanged. We for third statistical differences pre vid postreatment in each group (intragroup): Group 1, nasal congestion p = 0.002, ocular itch p = 0.01, sneezing p = 0.007, nasal secretion p = 0.01, nasal itch O = 0.009, total points O = 0.0005. Group 2, nasal congestion O = 0.02, ocular itch p = 0.05, sneezing p = 0.01, nasal secretion p = 0.01, nasal itch p = 0.04, total points p = 0.005. Significant differences were found in nasal peal' flow in Group 1 (p = 0.01) but no differences in eosinophils between file two groups. Side effects: 3 subjects in Group 1 (drowsiness, 1 appetite increase said 1 rhinorrea with epistaxis) vide 1 in Group 2 sensation of facial edema. CONCLUSION: Bofil drugs are effective the clinical relief of symptoms of perennial allergic rhinitis in children vied levocabastine has less side effects.
Asunto(s)
Antialérgicos/uso terapéutico , Cetirizina/uso terapéutico , Antagonistas de los Receptores Histamínicos H1/uso terapéutico , Piperidinas/uso terapéutico , Rinitis/tratamiento farmacológico , Adolescente , Cetirizina/efectos adversos , Niño , Eosinofilia/tratamiento farmacológico , Eosinofilia/inmunología , Femenino , Antagonistas de los Receptores Histamínicos H1/efectos adversos , Humanos , Masculino , Piperidinas/efectos adversos , Estudios Prospectivos , Rinitis/inmunologíaRESUMEN
OBJECTIVE: During the last decades the impact of pollution in big cities on the upper respiratory tract of children has become an issue of interest. The purpose of the present study was to determine if exposure of healthy children to different concentrations of atmospheric pollution alters morphologically the nasal respiratory epithelium. MATERIAL AND METHODS: In this randomised, prospective, open clinical trial we included 71 healthy children matched for age and sex and divided them into 3 groups: Group I, 31 children from Mexico City. Group II, 21 children from Tula, Hidalgo a moderate polluted area, and Group III, 19 children from Contepec, Michoacán, a rural non-polluted area. We took a nasal biopsy from the lower turbinate and performed nasal cytology in all children. The samples were examined twice by a pathologist with a double-blind technique. Ozone measurements were taken during 1992. RESULTS: Nasal symptoms (nasal obstruction, pruritus and dryness) were present in 96.8%, 71.4% and 52.6% of patients in groups I, II and III respectively (p = 0.001). We also found bilateral hypertrophy turbinates in 100% of children in group I versus 81% and 73% in groups II and III (p = 0.009). Citologic examination disclosed no significant differences among the study groups, although p values were 0.06 respecting inflammation and abnormal goblet cells when we compared group I versus group II and III. Respecting histological examination we found significant differences when comparing group I versus II and III in squamous metaplasia (p = 0.02) and pseudoepitheliomatous hyperplasia (p = 0.003), with not significant differences among keratinization (p = 0.06) and dysplasia (p = 0.06). CONCLUSIONS: The results of this study indicate that exposure to a polluted atmosphere is followed by severe changes in the histology and cytology of the nasal mucosa in healthy children, with these changes being more frequent and severe in the more polluted areas. These findings implicate that we must put more attention on the long term effects of atmospheric pollution in order to establish stronger control measures.
Asunto(s)
Contaminación del Aire/efectos adversos , Mucosa Nasal/patología , Obstrucción Nasal/patología , Rinitis/patología , Adolescente , Contaminantes Atmosféricos/efectos adversos , Biopsia , Niño , Método Doble Ciego , Femenino , Humanos , Hipertrofia , Masculino , Metaplasia , México , Ozono/efectos adversos , Estudios Prospectivos , Población Rural , Cornetes Nasales/patología , Población UrbanaRESUMEN
Asthmatic crisis is one of the most frequent urgencies in children. One of the most difficult decision for a physician is to determine what patient requires only ambulatory treatment and what patient needs hospital treatment. Many investigators have developed predictive scores, but to date conclusions are confusing. The purpose of the present study was to compare the value of arterial oxygen saturation versus peak expiratory flow rate measurements as predictors of the outcome of the asthmatic crisis in children. We performed a prospective, longitudinal, observational, comparative study in 50 children (30 males, 20 female), with ages between 6 and 18 years old, with the presence of a moderate asthmatic crisis. We measured arterial oxygen saturation and peak expiratory flow rate at the moment of their arrival to urgencies and at 30 minutes, 2, 4 and 24 hours after the administration of nebulized albuterol (100 mcg/k/dose). We found significant differences on baseline arterial oxygen saturation and the registrations taken at 2, 4, and 24 hours posttreatment (0.01), and we could only find significant differences between baseline peak expiratory flow rate and the registrations taken at 24 hours pretreatment. In conclusion arterial oxygen saturation is a better predictor than peak expiratory flow rate in the evolution of the asthmatic crisis in children.
Asunto(s)
Oxígeno/sangre , Ápice del Flujo Espiratorio , Estado Asmático/fisiopatología , Adolescente , Albuterol/farmacología , Albuterol/uso terapéutico , Antiasmáticos/farmacología , Antiasmáticos/uso terapéutico , Niño , Estudios de Cohortes , Femenino , Humanos , Masculino , Presión Parcial , Ápice del Flujo Espiratorio/efectos de los fármacos , Valor Predictivo de las Pruebas , Estudios Prospectivos , Estado Asmático/sangre , Estado Asmático/tratamiento farmacológico , Estado Asmático/epidemiologíaRESUMEN
During the last years it has been discovered that inflammation is the main substrate in asthma psychopathology. Treatment with steroids, inhaled or systemic is the first step in the antiinflammatory course during acute or chronic stages, and the early introduction is recommended to avoid prolongation of the attack. Actually, the disponibility of inhaled steroids, change the way we face with this illness, due their great local potency, their minimal side effects and the availability of metered dose devices.
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Asma/tratamiento farmacológico , Esteroides/uso terapéutico , Niño , Humanos , Esteroides/farmacologíaRESUMEN
Allergen skin testing is one of the preferred in vivo methods for assessing the presence of specific IgE antibodies against an allergen. This article review the clinical applications, techniques, reagents, evaluation, and safety of skin testing to help the allergologist to its better clinical use.
Asunto(s)
Hipersensibilidad/diagnóstico , Pruebas Cutáneas , Alérgenos , Humanos , Hipersensibilidad/inmunología , Inmunoglobulina E/inmunología , Indicadores y Reactivos , Pruebas Cutáneas/efectos adversos , Pruebas Cutáneas/clasificación , Pruebas Cutáneas/métodosRESUMEN
Although we still do not fully understand many aspects of eosinophil function, they are certainly active participants in important physiological and pathophysiological events. Eosinophils kill many species of helmints and other parasites and probably play a role in defence against infection; they also probably play a role in inflammatory responses in the lung, skin and heart. The following discussion will review finding that support such conclusions.
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Eosinófilos/fisiología , Animales , Adhesión Celular , División Celular , Quimiotaxis , Eosinófilos/citología , Humanos , Hipersensibilidad/inmunologíaRESUMEN
Methotrexate represents a new therapeutic modality in patients with corticoresistant asthma. Its mechanism of action is the competitive inhibition of the folate reducing enzyme, converting folic acid in tetrahydrofolate during the S phase of the cell cycle. It is 50% fixed to albumin and excreted by glomerular filtration and proximal tubule secretion.
Asunto(s)
Asma/tratamiento farmacológico , Metotrexato/uso terapéutico , Corticoesteroides , Resistencia a Medicamentos , HumanosRESUMEN
Present practices concerning childhood feeding are dynamic. During the first four to six months of life breast feeding proportionates all the necessary nourishment. If breast feeding is not possible, we can give milk formulas by baby bottle; during the first four months with "starting" formulas, and later with "follow up" formulas. The American Academy of Pediatrics does not recommend to give whole cow's milk during the first year of life. Since the physiological and neurological development approach, we can begin the introduction of solid foods between four and six months old, in a systemic form and offering foods with a nutritional content, texture, coloration and taste varied and appropriated for the baby's age, to achieve the primary objective in childhood feeding, that consists in provide enough calories and nourishment to promote the optimal growth and development.