[Frequency of exercise-induced asthma in a group of children and adolescents with mild asthma attending a summer camp]. / Frecuencia de asma inducida por ejercicio en un grupo de niños y adolescentes con asma leve que acudieron a un campamento de verano.

BACKGROUND: Exercise-induced asthma is a transitory bronchospasm, which occurs after 6 to 8 minutes of continuous exercise. Diagnosis is done by a suggestive clinical history and by 15 to 20% post-challenge fall in FEV1. It happens in about 6 to 13% of general population, 90% of asthmatic individuals and 40% of individuals with allergic rhinitis. OBJECTIVE: To know the frequency of asthma induced by exercise in a group of asthmatic children and teenagers who went to a summer camp. MATERIAL AND METHODS: A cross-sectional, descriptive and observational study, which included 33 patients suffering from intermittent mild asthma, was based on espirometric measurements made before and after 8 minutes of continuous exercise (running). None of them had previous diagnosis of exercise-induced asthma. FEV1 greater than or equal to 15% was considered exercise-induced asthma. The test was performed at a room temperature of 73F and humidity of 40%. All patients were asymptomatic before the study and were given short-acting inhaled beta2-agonists as rescue medication, which was not administered during the 12 previous hours to the test. Data analysis was made by means of descriptive statistic. RESULTS: Thirty-three children aged 8-16 years with diagnosis of asthma were studied, with an average age of 12.5 years; 42.4% were female and 57.5% male. Of the 33 patients, 6 had (18.2%) a 15% fall in FEV1 after exercise; 50% of these patients showed exercise-induced mild asthma, 33% moderate and 17% severe. At the end of the test, in six patients (100%) FEV1 increased by 15%, five minutes after the administration of a beta2-agonist. CONCLUSIONS: Exercise-induced asthma is frequent among asthmatic pediatric patients, occurring in 18.8% of this study. Likelihood of having exercise-induced asthma must be deliberately investigated in all asthmatic patients, in order to establish an opportune diagnosis of this condition and provide recommendations of preventing therapy.

[Clinical characteristics of atopic dermatitis in a group of patients attending to the Regional Center of Allergy and Clinical Immunology of Monterrey, Mexico]. / Características clínicas de la dermatitis atópica en un grupo de pacientes que acude al Centro Regional de Alergia e Inmunología Clínica de Monterrey, México.

BACKGROUND: Atopic dermatitis is a chronic inflamatory disease of the skin which mainly affects children. It is characterized by itch and cutaneous hyperactivity with typical lesions that depend on the affected age group and the disease stage. It is frequently associated to rhinitis and asthma. OBJECTIVE: To identify the clinical characteristics of atopic dermatitis in patients treated at the Regional Center of Allergy and Clinical Immunology of Monterrey, NL, Mexico. MATERIAL AND METHODS: A retrospective and descriptive study was done by the review of clinical files of patients with atopic dermatitis diagnosis from January 1997 to May 2002. The statistical analysis was done by central tendency measures. RESULTS: We reviewed 119 clinical files, 53 (44.5%) were male and 66 (55.5%) female. The most frequent clinical manifestations were pruritus and eczematous lesions, both in 117 patients (98.3%). Fifty-five percent of the patients initiated symptoms before 6 years of age. Eighty eight patients (74%) had family and/or personal history of atopia. Other associated manifestations were allergic rhinitis in 38 patients (31.9%), asthma and rhinitis in 25 patients (21%) and only asthma in 2 patients (1.7%). In 44 patients, food skin tests were done with a positive result in 25 patients, the most frequent was to egg (68%) and in 64 patients these were positive to aeroallergens being the most frequent Dermatophagoides p teronyssinus (85.1%). CONCLUSIONS: The pruritus and eczematous lesions were the most constant manifestations in this group of patients where family and/ or personal history of atopia was frequent.

[Use of alternative medicine in the treatment of allergic diseases]. / Uso de medicina alternativa en el tratamiento de enfermedades alérgicas.

BACKGROUND: The alternative medicine and the complementary medicine are forms of treatment very spread and frequently demanded by patients with allergic diseases. According to recent studies, homeopathy, acupuncture and herbal medicine are the most commonly used types of alternative medicine. OBJECTIVE: To know the frequency in the use of different types of alternative medicine for the treatment of allergic diseases in patients attended at the Centro Regional de Alergia e Immunologia Clínica of the Hospital Universitario de Monterrey, Nuevo León. MATERIAL AND METHODS: A transversal, descriptive and observational study was done by the use of questionnaires applied to patients and/or patients' relatives attended in this Center. This survey included questions to focus the investigation in the use of a Iternative medicine for the treatment of any allergic disease. The data analysis was done by descriptive statistics. RESULTS: Four hundred one questionnaires were applied. The average age of the patients was of 14 years (range from 1 to 73 years). Fourty-seven percent (189 patients) were female and 58.2% (212 patients) were male. The diagnoses included: allergic rhinitis in 215 patients (53.6), asthma in 97 (24.2%), rhinitis and asthma in 73 (18.2) and atopic dermatitis in 16 (4%). Out of the patients 34.4% (138) had used at least one type of alternative medicine for the treatment of their allergic disease. Homeopathy was the most commonly used type of alternative medicine (78.2%), followed by the natural medicine (31.5%). CONCLUSIONS: Alternative medicine for the treatment of allergic diseases is frequent in patients who attend to this center. Homeopathy and the natural medicine are the most used.

[Limitation of the development of physical activity in asthmatic children and adolescents]. / Limitación del desarrollo de actividades físicas en niños y adolescentes asmáticos.

BACKGROUND: Asthma can, direct or indirect cause physical limitations in asthmatic patients affecting their quality of life. OBJECTIVE: To identify factors that influence and limit the physical activities in asthmatic children and teenagers. MATERIAL AND METHODS: This was a descriptive and observational study in 83 asthmatic children and teenagers, between 6 to 18 years old, who attended a summer camp for asthmatic patients. They answered a questionnaire about the kind of physical activities that they regularly, in order to identify factors that limit their physical activities. In the camp, some of them had to stop exercising because of an asthma crisis. For the statistical analysis, we used central and percentage tendency. RESULTS: Sixty patients (72.3%) regularly practiced some kind of sport being the most frequent soccer (36.7%), swimming (20.1%), athletics (8.4%) and basketball (8.4%). Of the 23 children and teenagers that did not regularly practice any sport, 19 of them were between 5 to 10 years old. In the first group, 28 (46.7%) said that they had to stop exercising when suffered an asthma crisis. In the camp, eight children (9.7%) had to stop their physical activities because an asthma crisis. Only 47 children (56.6%) knew the kind of physical activity in which they could participate and the correct way to perform it; as a result of an educational process. CONCLUSION: In our community, the development of asthma crisis and the lack of adequate physical education are facts that limit exercise practicing in asthmatic children and teenagers.

[Knowledge of flowmetry among asthmatic children and adolescents]. / Conocimiento de la flujometría en niños y adolescentes asmáticos.

BACKGROUND: The correct control of asthmatic children and teenagers substantially improves their quality of life. The use of the peak flowmeter permits to monitor the pulmonary function and to control this disease. OBJECTIVE: To gather information about the use of the peak flowmeter in asthmatic children and teenagers. MATERIAL AND METHODS: It was a descriptive and observational study done in 81 asthmatic children and teenagers who attended a summer camp. They answered a questionnaire in order to know their knowledge about the peak flowmeter's use. RESULTS: The age of the studied group ranked from five to 18 years (54.3% between five to 10 years). Out of the 81 children and teenagers, 64 knew about the peak flow. In spite of the knowledge, only 38 (46.9%) had used it in at least one occasion and 20 (24.7%) in an ambulatory manner (16 used it when they feel bad, and four, every day). Only nine of these 20 children knew the correct way to use it, to interpret the results and what the normal peak flow was. All of these children and teenagers were under medical control. Allergists were attending 66.7%. Independently of the specialty of their doctors, the average of the children that didn't use the peak flowmeter in their control of asthma was always over than 50%. CONCLUSIONS: In spite that all these children and teenagers were on medical care, the knowledge of the peak flowmeter usage was not enough to take advantage.

[Bronchial foreign body as a differential diagnosis for asthma. Report of a case and review of the literature]. / Cuerpo extraño bronquial como diagnóstico diferencial de asma. Reporte de un caso y revisión de la literatura.

The aspiration of foreign bodies into the airway is a common problem in childhood, mainly in children younger than 10-years old. Foreign bodies located in the tracheobronchial tree can cause episodic cough, dyspnea and wheezing, and generate a misdiagnosed of asthma if physicians do not consider the possibility of a bronchial foreign body as a differential diagnosis of this disease. In these cases, chest X-ray films are very important because those can show the most of foreign bodies or indirect radiographic signs of a bronchial foreign body. Nowadays, bronchoscopy is the method of choice for removal foreign bodies from the tracheobronchial tree. If there are not complications, most of patients may recover and become non-symptomatic in a short-term after the foreign body extraction. We show the case of a nine years old boy who suffered the aspiration of a tack, which stayed in a bronchi during several years, and was misdiagnosed as asthmatic.

[Psychological profile of the pediatric asthma patient]. / Perfil psicológico del paciente pediátrico con asma.

BACKGROUND: When a child develops asthma symptoms, several changes in his/her behavior, in his/her family and in his/her social environment begin. OBJECTIVE: To identify the most frequent personality traits and psychological disturbances in asthmatic children and adolescents. MATERIAL AND METHODS: A transversal, observational and descriptive study was performed on 85 asthmatic children and adolescents ages from 5 to 18 years old that attended a questionnaire, and a graphic test on 77 of those children, which consisted on drawing two pictures. Such pictures were analyzed by a psychotherapist to determine the personality traits and the psychological disturbance present in these individuals. RESULTS: All the children answered positively at least one of the questions which detect data related to depression in the questionnaire, being the more frequent: easy anger (40%), insomnia (29%), sadness (15%), auto-aggression or suicide ideas (11%) and loss of appetite (6%). According to graphic test interpretation, 39% of children showed a depression disturbance, 29% adaptation disturbance with depression symptoms, and 12% an adaptation disturbance. In addition, we found that 2 children were victim of abuse and negligence into their families. CONCLUSION: The 100% of the evaluated asthmatic children and adolescents, showed data related to depression presence.

[Errors in the technique of using measured-dose inhalers in asthmatic children and adolescents]. / Errores en la técnica de uso de inhaladores de dosis medida en niños y adolescentes asmáticos.

BACKGROUND: The MDI's are widely used in the treatment of asthma and are relatively easy to use. The response to this medicament is influenced by several facts that include the physical characteristics of the container and the technique used by the patient. OBJECTIVE: To identify the mistakes made by asthmatic children and teenagers in the use of the MDI's. MATERIAL AND METHODS: This paper was a descriptive and observational study in 57 asthmatic patients who were between 5 to 17 years. For the evaluation of the inhalation technique we used a placebo without a spacer. There are 5 steps for the correct use of the inhaled medications: 1) opening, 2) agitation, 3) coordination between inhalation and the shoot of the MDI's, 4) a deep breath and holding it for at lest 6 seconds. RESULTS: 20 of the 57 patients (35%) followed all the steps correctly. The most frequent mistake was to take the deep breath, which was perform only by 20 (35%) out of the children. The second mistake we found in this study was the up holding inspiration at least for 6 seconds, which was done properly only by 31 patients (54%). CONCLUSIONS: The implantation of inhaled therapy programs directed and performed by specialists is recommended.

Lucha concertada contra la poliomielitis / The fight against poliomyelitis

Como um dos 11 cidadäos que se destacaram por sua contribuiçäo à saúde no continente americano, o autor resgata sua trajetória no campo da Saúde Pública e as iniciativas de prevençäo e controle da poliomielite na América, desenvolvidas pela Organizaçäo Mundial da Saúde e Organizaçäo Panamericana da Saúde.(MAM)

Prevalencia de rinosinusitis. Estadística enero-diciembre 1993 / rhinosinusitis prevalence. estatistic january-december 1993

La rinosinusitis es un diagnóstico muy común en la práctica del alergólogo; en este estudio retrospectivo tangencial de un año de duración (1993) encontramos que esta enfermedad ocurre en 42 por ciento del total de las consultas realizadas en nuestro servicio. No exite diferencias por sexo; por edad, la prevalencia fue mayor en menores de 15 años (57 por ciento). La causa alérgica representa 57 por ciento, la infecciosa 25 por ciento y la mixta 18 por ciento. El dermatofagoides fue el antigeno más frecuentemente encontrado en las pruebas cutáneas

Rinosinusitis crónica, síntomas predominantes en menores de 14 años que acudieron al centro regional para la prevención y el tratamiento de las enfermedades alérgicas / Chronic rhinosinusitis in population younger 14 years main symptoms

La rinosinusitis crónica afecta al 5 por ciento de la población que sufre infecciones de las vías respiratorias. El objetivo del presente estudio es conocer los sintomas predominantes en la población menor de 14 años con diagnóstico de rinosinusitis crónica, conocer su distribución etaria, por sexo y tiempo de evolución. Se incluyeron 100 pacientes con este diagnóstico a quienes se les realizaron: historia clínica, examen físico, citología nasal, pruebas cutáneas y serie de senos paranasales. Los sintomas predominantes fueron: tos, halitosis, descarga retronasal purulenta, fiebre, cefalea, odinofagia, dolor facial, y edema periorbitario, de predominio en el sexo masculino y con un tiempo promedio de evolución de 1-2 años

Estudio de hipersensibilidad a aeroalergenos frecuentes en la región centro de Coahuila / Study hipersensitivity frecuently a aeroalergens in Coahuila

Revisión restrospectiva de 247 expedientes clínicos de pacientes que acudieron a una consulta particular de alergia e inmunología durante los años 1990 a 1993 en la ciudad de Monclova, Coahuila, por cursar con padecimientos alérgicos. La revisión se efectuó para determinar la frecuencia de sensibilización a aeroalergenos y alimentos en la región centro de Coahuila mediante pruebas cutáneas de alergia (intradérmicas y punción) y MAST Immuno Systems (Multiple Allergy System Test). Los pacientes más sensibles a los aeroalergenos lo fueron al polvo(13.5 por ciento) y pólenes: (Salsola(7.1 por ciento), Amaranthus(5.4 por ciento), Capriola (4.9 por ciento), Nogal(4.8 por ciento), Ambrosía(4.8 por ciento), Lolium (4.8 por ciento), otros pólenes (32.4 por ciento). Los hongos: Candida (3.2 por ciento), alternaria(2.7 por ciento), fusarium(2.1 por ciento), otros hongos (8.7 por ciento). Los alimentos sensibilizantes más frecuentes fueron: trigo(21.3 por ciento), queso(10.0 por ciento), carne de cerdo(8.8 por ciento), yema de huevo(7.5 por ciento)

Estudio de hipersensibilidad a alergenos frecuentes en la región centro de Coahuila / Hipersensivity study to frequent allergens in the central region of Coahuil

Revisión retrospectiva de 247 expedientes clínicos de pacientes que acudieron a la consulta particular de alergia e inmunología de 1990 a 1993 en la ciudad de monclova, Coah., por cursar con padecimientos alérgicos y realizada para determinar la frecuencia de sensibilización a aeroalergenos y alimentos en la región centro de Coahuila mediante pruebas de alergia cutáneas (intradérmicas y punción) y MAST Immuno Systens (Multiple Allergy System Test). Los pacientes fueron más sensibles dentro de los aeroalergenos al polvo (13.5 por ciento) y póneses: salsola (7.1 por ciento), Amaranthus (5.4 por ciento), capriola (4.9 por ciento), nogal (4.8 por ciento), ambrosía (4.8 por ciento), Lolium (4.8 por ciento), otros pólenes (32.4 por ciento). Los hongos: Candida (3.2 por ciento), alternaria (2.7 por ciento) rhizopus (3.6 por ciento), penicillium (2.1 por ciento), fusarium (2.1 por ciento), otros hongos (8.7 por ciento). Los alimentos sensibilizantes más frecuentes fueron: trigo (21.3 por ciento), queso (10.0 por ciento), mariscos (10.0 por ciento), carne de cerdo (8.8 por ciento), yema de huevo (7.5 por ciento)

Mortalidad por asma en el estado de Nuevo León, México / Asthma mprtality in the state of Nuevo Leon, Mexico

La definición de asma ha cambiado radicalmente en los últimos años y se ha dado mayor importancia al componente inflamatorio que puede llegar a ser irreversible. No es aún clara la causa del incremento de la morbilidad y mortalidad del asma observada en países desarrollados a pesar del aumento en el número y eficacia de los recursos terapéuticos. Falta mucho por hacer en cuanto a las estadísticas de prevalencia y mortalidad de los países en desarrollo. En América Latina, la prevalencia del asma, en 1983 se reportó 3.5 por ciento en siete países estudiados. Nosotros revisamos los certificados de defunción del estado de Nuevo León, México, en el decenio de 1980, y comparamos el total de defuncioes con las atribuidas a asma, según el código de diagnóstico 493 de la Clasificación Internacional de Enfermedades. Revisamos también los registros de ingresos a un hospital general (Universitario de Monterrey NL, México), así como también los dictámenes de autopsias realizadas en el mismo periodo. La tasa de mortalidad general, y la tasa de mortalidad por padecimientos respiratorios (asma, enfisiema, bronquitis crónica y otras) permaneció sin cambio (5.5 x 100.000 habitantes), a pesar de haberse incrementado la población en 100 por ciento. La prevalencia del asma ha aumentado de 1.2 por ciento en 1979 a 2.5 por ciento en 1989 (aproximadamente 75,000 casos). De 1,114 autopsias en el decenio mencionado, en ninguna, la causa pudo atribuirse al asma. Es inaplazable que en otros estados del país se realicen estudios paralelos al nuestro para obtener cifras confiables de prevalencia y mortalidad por asma. Con estom podremos comprender la distribución y consecuencias de esta enfermedad

Epidemiología de las enfermedades alérgicas en el área metropolitana de Monterrey / Epidemiology of allergic diseases in the metropolitan area of Monterrey

Se efectuo un estudio con el proposito de confirmar si la prevalencia de las enfermedades alergicas se ha modificado en los ultimos 10 a;os en poblacion abierta. Para ello se estudiaron 243 familias seleccionadas al azar en el area metropolitana de la ciudad de monterrey, mediante un cuestionario de 12 preguntas. Del total de familias estudiadas se encontrar5on 95 con alguna enfermedad alergica, 11.2% de las 1207 personas entrevistadas.

Distribución espacial de la hemoglobina en los hematies de pacientes asmáticos / Spatial distribution of hemoglobins in the hematies of patients with asthma

El objetivo de este estudio fue demostrar si los hematíes de los asmáticos presentan alteraciones morfológicas. Los resultados demostraron que en los pacientes asmáticos la hemoglobina pierde su distribución anular para dar lugar a una formación homogénea que borra la cavidad eritrocino, dándole el aspecto de un flan. Estas alteraciones no se observaron en el grupo control