[Asthma risk factors]. / Factores de riesgo para asma.

OBJECTIVE: To study the magnitude of risk factors known for asthma in 6-10 year-old children. MATERIAL AND METHODS: This is a case- and control-study with 6-10 year-old children; 58 were asthmatic and 117 were control, with a relation 2:1. Asthmatic patients were recruited from consult of immuno-allergies department and control patients, from familial medicine consult of Hospital de Especialidades 71, IMSS. Indirect (mother) and directed surveys were applied, they were of multiple option for exploring the most known in literature-risk factors. Statistical management was performed by odds ratio with confidence interval of 95%. RESULTS: The following variables were considered risk factors: ingestion of artificial colorants before having 1 year old (OR = 13.2), living in an urban area (OR = 7.74), maternal smoking during pregnancy (OR = 2.4), wool contact before having 1 year old (OR = 2.11), passive smoking exposure during pregnancy (OR = 1.486) and feeding with industrialized milk (OR = 1.2). CONCLUSIONS: Environmental risk factors are very important in our population, as well as early ablactation; however, ingestion before having 1 year old of allergens as egg, chocolate, orange and mango was not considered risk factor.

[Spirometric pulmonary age and its correlation with the chronological age of asthma patients]. / Edad pulmonar por espirometría y su correlación con la edad cronológica de pacientes con asma.

AIMS: Pulmonary age as a linear regression spirometric index, expresses pulmonary ventilatory function. OBJECTIVE: A pilot study was done to assess the differences of the values of the pulmonary age index and chronological age in patients with bronchial asthma and healthy volunteers. MATERIAL AND METHOD: We studies 111 subjects, 31 healthy and 80 with asthma. RESULTS: All of them underwent spirometry. Healthy individuals showed a mean chronological age of 35 years, and a pulmonary age of 26 years. Asthmatic patients showed a mean chronological age of 38 years, and a pulmonary age of 59 years. CONCLUSION: Both the time course and the severity of the disease increased pulmonary age.

[Frequency of association of rheumatoid factor in patients with breast cancer]. / Frecuencia de asociación del factor reumatoide en pacientes con cáncer de mama.

AIMS: It has been reported that some patients with cancer present auto-immune phenomenon mediated by auto-antibodies, suggesting a relationship between auto-immunity and cancer. Our interest was to determine the frequency of association of rheumatoid factor and breast cancer. MATERIAL AND METHOD: Fifty patients were studied, 3 on stage 111 and 19 on stage IV. Rheumatoid factor was measured in all of them. Auto-antibodies were measured by ELISA. The clinical files of all the patients were reviewed to determine the presence of metastases (osseous, pulmonary, CNS and hepatic) as well as the histological type of the cancer to correlate the expression of the rheumatoid factor with the patients' clinical status. RESULTS: Four (12.9%) out of the 31 patients on stage 111 had positive rheumatoid factor, while 9 (47.3%) out of 19 patients on stage IV had positive rheumatoid factor. The mean age of the patients on stage 111 with positive rheumatoid factor was 48 years, while the mean age of the patients on stage IV with positive rheumatoid factor was 53 years. Patients on stage 111 with positive rheumatoid factor only had local-regional metastases while patients on stage IV with positive rheumatoid factor had distant metastases. The predominant histological type was adenocarcinoma. CONCLUSION: In this study it is shown that breast cancer on the most advanced stages have higher expression of rheumatoid factor, and more clinical derangement with higher levels of rheumatoid factor expression. The proposal of auto-antibodies as predictors of the severity of the cancer requires further studies on several types of cancer.

[Effect of Staphylococcus aureus extract on the expression of L-selectin and LFA-1, in neutrophils from patients with allergic bronchial asthma]. / Efecto del extracto de Staphylococcus aureus en la expresión de L-selectina y LFA-1, en neutrófilos de pacientes con asma bronquial no alérgica.

OBJECTIVE: Messier L-selectin and LFA-1 in neutrophils from moderate and non atopic asthma patients, before and after stimuli with and without Sa (Staphylococcus aureus). MATERIALS AND METHOD: Design Trial; experimental. We studied neutrophils from 12 moderate and non atopic asthma patients and 12 healthy subjects before and after stimuli with and without Sa. MEASURES: The neutrophyls adhesion molecules, CD 62-L and CD 11 a was measured by citometric flow assays. RESULTS: The median of CD 62-L molecule expression increase with the stimuli in non atopic asthma patients from 2444 (CI 1966, CS 3627, RC 1661) to 6285.5 (CI 5243, CS 7203, RC 1960), and the median of CD 11 a molecule expression decrease with the stimuli in non atopic asthma patients from 9910.5 (CI 9765, CS 9961, RC 196) to 7670 (CI 7125, CS 8291, RC 1166). The median of CD 11 a molecule expression increase with the stimuli in healthy subjects from 593 (CI 361, CS 929, RC 568) to 1113 (CI 910, CS 1240, RC 330) and the median of CD 11 a molecule expression decrease with the stimuli in healthy subjects from 9850 (CI 9741, CS 9898, RC 157) to 9808.5 (CI 9693, CS 9890, RC 197) [CI. Inferior Cuartil, CS. Superior Cuartil, RC.-Cuartil Range].

[Frequent allergies in Mexico Valley in children]. / Alergenos frecuentes del Valle de México en niños.

The incidence of skin test positively for 48 allergens have been evaluated in children with bronchial asthma. We studied the 347 cards of clinical file the allergic children a course 32 months. The most frequent allergens is Dermatophagoides pteronyssinus, cat and the other 24 allergens were less 10%. This allergen appears to present in Mexico Valley, the incidence to this allergen might be considered must frequent in allergic children who do reducing skin test for diagnostic allergic diseases.

[Diagnostic use of enzymatic RAST skin tests and determination of eosinophils in nasal mucosa in allergic rhinitis]. / Utilidad diagnóstica de las pruebas cutáneas RAST enzimático y determinación de eosinófilos en moco nasal en la rinitis alérgica.

AIMS: Allergic rhinitis is the most frequent disease mediated by immunoglobulin E (IgE). Nasal challenge is the gold standard for the diagnosis of allergic rhinitis. Skin tests (ST) are the most used diagnostic method to detect the presence of specific IgE bind to skin mast cells. The exposition of the nasal mucous membrane to the allergen is followed by an increase of the local eosinophils; the count of eosinophils in nasal mucous (ENM) is a diagnostic test for allergic rhinitis. Enzymatic RAST or enzymatic allergo-sorbent test (ESA) measures the level of serum allergen-specific IgE. OBJECTIVE: To measure the sensitivity, specificity, and diagnostic precision of ST, EAST and ENM in allergic rhinitis. METHOD: We studied 241 individuals, 162 of them had allergic rhinitis, and 79 were healthy controls. They underwent nasal challenge and intradermic ST for Dermatophagoies spp (acarus). Fraxinus americana (Ash-tree), Amaranthus palmieri (quelite), Cynodon Dactylon (capriola) and Felis catus (cat), EAST for Dermatophagoides pteronyssinus (acarus), and ENIVI. Results of ST, EAST and ENIVI were compared with their corresponding nasal challenge, and the prevalence of allergic rhinitis for each allergen was calculated. The best cut point was assessed by means of receiver-operator curves (ROC), and sensitivity, specificity, positive predictive value, negative predictive value, inter-observer concordance coefficient, area under ROC (0), standard error of 0 (SEO), and 95% confidence interval of 0 of each test were calculated using the best cut point. RESULTS: ST and EAST had the best sensitivity and specificity. ENM had the lowest sensitivity and specificity. CONCLUSION: For the diagnosis of Dermatophagoides spp allergic rhinitis ST for Dermatophagoides spp and EAST for Dermatophagoides pteronyssinus have the same diagnostic precision. According to the indexes for diagnostic precision, and inter-observer concordance coefficient, ST and EAST are useful to diagnose allergic rhinitis induced by the evaluated allergens. ENIVI is a test that is not very useful for the diagnosis of allergic rhinitis.

[Premenstrual asthma: relation to hormones]. / Asma premenstrual: relación con hormonas.

Exacerbation of asthmatic symptoms just before or at the time of menstruation documented in some women with asthma has been called "premenstrual asthma" (PMA). The effect of sex hormones on airway function has not been well studied in spite of much evidence to suggest, therefore about relationships between the sex hormones and airway. The investigations of (PMA) have been based on studies of asthmatics already aware of a deterioration of asthma premenstrually. Little is known, therefore, about relationships between the menstrual cycle with asthma and (PMA) subjects. Although the mechanism of PMA remains unclear.

[Exposure to pollutants and allergens in the asthmatic child compared with the healthy child]. / Exposición a contaminantes y alergenos en el niño asmático en comparación con el niño sano.

To assess the frequency of exposure to allergens and indoor pollutants of school age asthmatic children at the time of their first visit to the specialist, we studied 14 cases with the diagnosis of asthma according to international criteria, and 21 healthy controls. The parents of the children filed a questionnaire asking about socio-economic level, family history of asthma, exposure to allergens or indoor pollutants, and clinical severity of the disease. Questionnaires with less than 80% of the responses were excluded from analysis. Asthmatic patients had higher frequency of exposure to tobacco smoke (42.8% vs 38%), moisture in the home walls (42.9% vs 19%), and to dust reservoirs (71.4% vs 52.4%). A high proportion of the asthmatic patients did not apply adequate environmental control measures. Education for the patients and their primary care physicians must be increased, to reduce the morbidity of the diseases.

[Nasal eosinophilia after specific provocation in patients with perennial allergic rhinitis]. / Eosinofilia nasal posterior al reto específico en pacientes con rinitis alérgica perenne.

We studied 35 patients with perennial allergic response to know the eosinophilia after the nasal challenge with specific antigen. Patients were selected randomly. In each patient, history and clinical examination, cutaneous tests, and eosinophil count in nasal mucous membrane were done 30 minutes and 8 hours after the challenge with Dermatophagoides antigen Results showed a significant increase of eosinophils after the challenge (P.006). Significant differences were not discussed between the eosinophil counts obtained 30 minutes and 8 hours after the challenge.

Efecto in vitro del cromoglicato disódico sobre la actividad fagocítica de los polimorfonucleares de pacientes asmáticos sanos / Disodium chromoglicate reduces in vitro phogcytic activity of the polymorphonuclear cells in asthmatic patients and healthy

El cromoglicato disódico (CGDS) interfiere con el trasporte de la membrana celular inhibiendo la liberación de mediadores y la activación de polimorfonucleares (PMN), al impedir el incremento del calcio libre intracelular. Para determinar si el CGDS disminuye la actividad fagocítica in vitro de PMN se incubaron PMN de personas sanas y asmáticos alérgicos con CGDS o con solución salina balanceada de Hank (SSBH) y se evaluó su actividad fagocítica con la técnica de quimioluminiscencia. Al comparar las muestras no se encontró diferencia significativa con la actividad fagocítica entre las incubadas con CGDS y las incubadas en SSBH sin CGDS; tampoco se halló diferencia en la actividad fagocítica entre los asmáticos y sanos y no hay diferencia en la capacidad fagocítica de PMN entre asmáticos y sanos

[In vitro effect of disodium cromoglycate on phagocytic activity of polymorphonuclear cells of healthy asthmatic patients]. / Efecto in vitro del cromoglicato disódico sobre la actividad fagocítica de los polimorfonucleares de pacientes asmáticos sanos.

Disodium chromoglicate interferes cellular membrane transport, inhibits mediators release and activation of polymorfonuclear cells (PMN) by blocking intracellular free calcium increment. In order to assess if DC reduces in vitro phagocytic activity of PMN, these cells obtained from allergic asthmatic patients and healthy subjects were incubated with DC or Hanks solution (HS). Their phagocytic activity was measured with chemoluminiscence technique. There were not significant differences in phagocytic activity between the cells incubated with DC and those incubated with HS, nor between cells from asthmatic patients and healthy subjects. We conclude that DC has not in vitro effect on phagocytic activity of PMN from healthy and asthmatic subjects. There are no difference in PMN phagocytic capacity between healthy and asthmatic subjects.

[Epidemiologic aspects of bronchial asthma in the Mexican Republic]. / Los aspectos epidemiológicos del asma bronquial en la República Mexicana.

This work was done to determine the mortality and morbidity rates secondary to asthma in Mexico, for age, gender, state of the country and time. Data were obtained from the Instituto Nacional de Estadística. Geografía e Informática. We calculated morbidity and mortality rates adjusting for age, by a direct method. In the results, there was a reduction in mortality rate in both genders, from 1960 to 1987. Age groups up to 4 years and older than 50 were the mainly affected. From 1960 to the present time, the state with highest mortality is Tlaxcala. The states with highest hospitalization rates were Morelos, Baja California Sur, Nuevo León, Durango and Tamaulipas. In conclusion, mortality rates secondary to asthma in Mexico show a decreasing trend, with a considerable rise in morbidity, especially in the adolescent group.

[Ethical principles of medical research using human subjects]. / Los principios éticos de la investigación médica en seres humanos.

Medical research involving human beings has contributed to the advancement of knowledge about prevention, diagnosis, and treatment of the diseases. All researchers, independently of their working country, must always have in mind the international ethical principles as a guide in the solution for the ethical problems that they may face during the practice of research activities on human beings. Among the ethical principles more widely accepted in the western culture, three are of upstanding importance for clinical research in human subjects: a) the principle of respect for persons, based upon the conception of the individual as an autonomous being, capable of shaping and directing his own life; b) the principle of beneficence, that refers to the ethical obligation to maximize benefits and to minimize harms and wrongs; and c) the principle of justice, that refers to the ethical imperative to treat each person in accordance with what is morally right and proper. The application of these theoretical principles to the real life problems is not easy, especially in cases in which the research group belong to a developed country, and the group of participating subjects, to an underdeveloped one. It is worthy to ask if the three mentioned ethical principles are universally acknowledged, and whether in the Latin American and Caribbean region, these principles are recognized as the gold rules for the solution of the ethical problems of medical research involving human subjects.

[In vitro effect of bacterial extracts of S. aureus in chemokinesis and chemotaxis of polymorphonuclear cells]. / Efecto in vitro del extracto bacteriano de S. aureus en la quimiocinesis y quimiotaxis de células polimorfonucleares.

The purpose of the study was to determine if the extract of Staphylococcus aureus in vitro can modify chemokinesis and induce chemotaxis of polimorphonuclear (PMN) cells of peripheral blood in healthy donors. Chemocinesis and chemotaxis of PMN of peripheral blood in 30 healthy donors of either sex from 18 to 40 years old was measured. A 5 mL sample of peripheral blood was drawn. PMN were separated by Boyum's method and challenged with of Staphylococcus aureus extract and C5a as chemotactic factors, and Hank's solution chemokinesis. Chemokinesis was 54.6 +/- 8.8 microns, chemotactic response to C5a was 89 +/- 12.5 microns and with bacterial extract the response was 103 +/- 20.1 microns (p). In conclusion, complete extract of Staphylococcus aureus stimulates in vitro chemotaxis of PMN from healthy donors, and this stimulation is similar to known chemotactic factors as C5a.

[In vitro effect of tuftsin (L-prolyl-L-arginine) on the oxidative capacity of polymorphonuclear lymphocytes in small-for-gestational-age newborn infants]. / Efecto in vitro de la tuftsina (L-prolil-L-arginina) en la capacidad oxidativa de los polimorfonucleares en niños recién nacidos pequeños para su edad gestacional.

Tuftsin has the function of activating cellular macrophages and polymorphonuclears (PMNs). This tetrapeptide is transported by the CH2 domain of the heavy chain between residues 289 and 292 of the gammaglobulin (IgG) molecule. The objective of this work is to determine the effect of synthetic tuftsin in its oxidative capacity of PMN cells of newborns of low birth weight for their gestational age having already been demonstrated that the phagocytic activity of these cells of macrophages and PMNs is diminished compared with the cells of newborns of normal birth weight according to gestational age. Results showed a stimulatory effect of the PMNs oxidative capacity with synthetic tuftsin by the increase of the nitrotetrazolium blue reduction, demonstrating that the low oxidative capacity of the cells of newborns of low birth weigh for gestational age does not correlate with an intrinsic cellular defect.

[Detection of heterozygotes for ataxia telangiectasia using sensitivity to ionizing radiation]. / Detección de heterocigotos de ataxia telangiectasia por la sensibilidad a la radiación ionizante.

Recent research have demonstrated that homozygotic and heterozygotic patients with ataxia telangiectasia (AT) show chromosomal rupture. Taking in consideration this characteristic, a study was designed, inducing chromosomal breaks in granulocytes from patients with AT, and heterozygotic carriers of AT compared with a group of healthy individuals. The number of chromosomic ruptures induced by 14 doses of radiation at 125 KV and 125 mA, was measured in all of them. Results suggest significant differences in the number of chromosomal structural alterations induced by radiation in granulocytes from heterozygotic carriers of AT, similar to structural alterations in lymphocytes from patients with AT. It is demonstrated that these alterations occur preferentially in one group C chromosome, both in homozygotic and heterozygotic patients with AT.

[Asthma mortality trends in Mexico]. / Tendencia de la mortalidad por asma en México.

The objective of this cross-sectional study was to estimate mortality and morbidity from asthma in Mexico by federative entity (state) of residence, age, and sex during the period between 1960 and 1988. Statistics published by the National Institute of Statistics, Geography, and Information Science were reviewed, as were vital statistics and information from other sources. Data were selected on mortality, hospital admissions, and outpatient visits, as well as population by federative entity, age, and sex. Mortality and morbidity rates were adjusted for age using the direct method. From 1960 to 1987, mortality decreased for both sexes. The groups with the highest asthma mortality were those under 4 years of age and those over 50. From 1960 to the present, the state with the highest mortality was Tlaxcala. Hospitalizations increased from 10 to 140 per 100,000 population for the country as a whole. When both outpatient visits and hospitalizations were considered, the morbidity rates rose from 180 to 203.4 per 100,000 between 1960 and 1970. In 1970, hospital morbidity was higher among males than females. From 1960 up to the 1990s, the highest rates of hospitalization and outpatient visits were registered among those under 4 and those over 60. The states with the highest asthma hospitalization rates were Morelos, Baja California Sur, Nuevo León, Durango, and Tamaulipas. It is concluded that asthma mortality in Mexico is showing a downward trend, while morbidity is increasing considerably, especially among adolescents.

[Descriptive study of morbidity and mortality due to asthma at a Health Sector institution]. / Estudio descriptivo sobre la morbilidad y mortalidad debida a asma en una institución del Sector Salud.

The objective of this study was to determine the morbidity and mortality rate due to asthma from a Health Institution, which represents the majority of working population. Asthma data were obtained from the National Institute of Informatical, Geography and Statistics (INEGI), Mexican Health Secretary (SS) and Mexican Social Security Institute (IMSS). The underlying cause of death hospitalization or visit were obtained. Asthma was coded according to the International Classification of Disease (ninth revision). Asthma death rate was adjusted by age using direct method. In the IMSS, asthma death rate increased from 3.24/200,000 in 1980 to 12.76/100,000 in 1990. The asthma letality increased from 0.34 in 1980 to 1.23 in 1990. The average length of hospital stay was 3.96 days in 1990; there was noy significant differences by sex the most affected groups were children under 4 years of age and persons older than 65 years of age. In conclusion, from 1980 to 1990, the morbidity and mortality rate due to asthma in IMSS increased. It suggests that future health policy efforts should be focused to reduce the morbidity, mainly in high risk groups.

[Evaluation of eosinophils in nasal mucus from patients with perennial allergic rhinitis during nasal provocation tests]. / Evaluación de los eosinófilos en el moco nasal de pacientes con rinitis alérgica perenne durante la prueba de provocación nasal.

The purpose of this study was the evaluation of the behaviour of the eosinophils in the nasal mucous of patients with perennial allergic rhinitis in the moment of making a nasal initiation test 30 subjects were studied to which a nasal initiation test was applied with a 1:100 dilution of aqueous extracts, the samples were taken with a inferior nostril swab in basal form, in 30 minutes. Two and eight hours after the antigenic dare, the samples were tinged with the Wright technic, and the quantity of eosinophils and polymorphonuclear cells were determined. There were not adverse reaction during the procedure. The results showed eosinophils of 4.9% basal form, 13% at the 30 minutes, 19% at two hours and 28%, eight hours after the antigenic initiation, the percentage of polymorphonuclear cells was of 40.6%, 34.2%, 34.8% and 31.7% respectively. The obtained results are in accordance to the expectations in the different phases of the allergic response in rhinitis. We suggest for a correct evaluation of this nasal cytology test in patients with allergic rhinitis, the allergic response phase where the patient is, should be known.

[In vitro transfer of immunity against PPD with dialyzable extract of leukocytes from human colostrum]. / Transferencia in vitro de inmunidad a PPD con extracto dializable de leucocitos de calostro humano.

The aim of this study is to demonstrate the transference of PPD hypersensibility in an in vitro model, with dialysable colostral leukocyte extract (DCLE) of PPD+ and PPD-mothers, through measurements of leukocyte migration inhibition factor activity (LIF) from blood obtained of the umbilical cord of newborns from PPD+ mothers. The results show that DCLE PPD+ incubated with leukocytes of newborns from PPD- mothers had inhibition of leukocyte migration compared with migration of leukocytes incubated with DCLE PPD-. These results suggest that in this in vitro model, DCLE transfers hypersensibility to PPD.