Response to budesonide among atopic and non-atopic infants/preschoolers with recurrent wheezing.

BACKGROUND: The treatment in non-atopic young children with recurrent wheezing remains controversial. OBJECTIVE: The aim of the study was to compare the response of inhaled budesonide in atopic versus non-atopic infants/preschoolers with recurrent wheezing (more than three episodes in the last year or one episode per month in the last three months). METHODS: One hundred and seventy three infants/preschoolers (mean age 1.58+/-0.9 yrs) with recurrent wheezing without previous use of inhaled corticosteroids were enrolled and divided into two categories: atopics (eosinophils in peripheral blood > or =4%) and non-atopics (<4%). Both groups were treated with budesonide (200 mcg bid delivered by MDI and spacer) for three months. The primary outcome was the prevalence of wheezing exacerbation episodes at the end of the treatment. RESULTS: Thirty-seven out of 173 (21.4%) were atopics and they were significantly younger, more frequently with a father with asthma, maternal grandparents with asthma and rhinitis, paternal and maternal grandparents with eczema, and higher number of wheezing episodes in the last year than non-atopics. At the end of the study, among those with good compliance (>70% of the weekly doses), the proportion of wheezing episodes were similar among atopics and non-atopics (57.7% vs. 44.1%, p=0.25, respectively); the number of exacerbations requiring emergency department (ED) visits and hospital admission were also similar. CONCLUSION: Regular budesonide therapy may decrease the episodes of wheezing in infants/preschoolers with recurrent wheezing, independently of atopy.

Gemcitabine activity in cervical cancer cell lines.

PURPOSE: Gemcitabine (2',2'-difluorodeoxycytidine) is an antineoplastic agent with activity against a variety of solid tumors. To investigate its in vitro activity toward cervical cancer, we exposed six cervical cancer cell lines to gemcitabine. METHODS: Combinational cytotoxic studies using viability tests and clonogenicity assays. RESULTS: Gemcitabine was cytostatic and cytotoxic in some of the lines at peak plasma concentrations similar to those achieved in clinical trials. Gemcitabine was also found to effectively synergize with cisplatin and showed a radiosensitizing effect in these cells. The cytotoxicity observed in sensitive cell lines was due to apoptosis, as demonstrated by DNA fragmentation assays. CONCLUSIONS: We recommend performing additional in vitro experimentation so that these results can be confirmed to support clinical trials of gemcitabine in cervical cancer patients both as first-line therapy and with concomitant radiation.

Mean dose to lymphocytes during radiotherapy treatments.

Using a probabilistic model with parameters from four radiotherapy protocols used in Mexican hospitals for the treatment of cervical cancer, we have calculated the distribution of dose to cells in peripheral blood of patients. Values of the mean dose to the lymphocytes during and after a 60Co treatment are compared to estimates from an in vivo chromosome aberration study performed on five patients. Calculations indicate that the mean dose to the circulating blood is about 2% of the tumor dose, while the mean dose to recirculating lymphocytes may reach up to 7% of the tumor dose. Differences up to a factor of two in the dose to the blood are predicted for different protocols delivering equal tumor doses. The data suggest mean doses higher than the predictions of the model.