Prophylactic management of children at risk for recurrent upper respiratory infections: the Preventia I Study.

BACKGROUND: Given the morbidity and mortality of asthma and the recent dramatic increase in its prevalence, pharmacologic prophylaxis of this disease in children at risk would represent a major medical advance. OBJECTIVES: The Preventia I Study was designed to evaluate the efficacy and long-term safety of loratadine in reducing the number of respiratory infections in children at 24 months. A secondary objective was to investigate the benefit of loratadine treatment in preventing the onset of respiratory exacerbations. METHODS: Preventia I was a randomized placebo-controlled study involving 22 countries worldwide. The children were 12-30 months of age at enrollment and had experienced at least five episodes of ENT infections, and no more than two episodes of wheezing during the previous 12 months. Phase I was a 12-month double-blind period during which the children were treated with loratadine 5 mg/day (2.5 mg/day for children

[Chronic rhinosinusitis: predominant symptoms in children under 14 years of age who were seen at the Regional Center for the Prevention and Treatment of Allergic Diseases]. / 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 occurs to 5% of the population with upper respiratory infections. The objective of this study is to know the main symptoms in a pediatric population younger than 14 years with the diagnosis of chronic rhinosinusitis, to know age and sex distribution and evolution. We did a medical history, physical examination, nasal cytology, skin tests and sinus X rays in each of 100 patients. Results the main symptoms were: cough, halitosis, postnasal discharge, fever, headache, sore throat, facial sensitivity and periorbital edema. This findings predominated in males and the average evolution time was 1-2 years.

[Prevalence of rhinosinusitis. Statistics: January-December 1993]. / Prevalencia de rinosinusitis. Estadística enero-diciembre 1993.

UNLABELLED: The rhinosinusitis es becoming a more common diagnosis in the practice of the allergist, in this retrospective langencial study of one year (1993) we found this disease occurred in the 42% of the total consultation demanding our service. There was not difference by sex, and by age were more prevalent under 15 years (57%). ETIOLOGY: the allergic represented 57% of patients infectious in 25% and both in 18%. Mites were the most frequent antigen found positive buy skin test.

[Hypersensitivity to airborne allergens common in the central region of Coahuila]. / Estudio de hipersensibilidad a aeroalergenos frecuentes en la región centro de Coahuila.

A retrospective review of 247 clinical files of patient that have responded to the office allergy and immunology since 1990 to 1993 in Monclova, Coah., for allergy illness. This study was to determine the frequency of Aeroalergens and foods sensitization in Monclova, Coahuila, mediated Allergy Test Skin (intradermo reactions, and Prick) and MAST immuno Systems (Multiple Allergy System Test). The patients were highly sensitive to house dust (13.5%) others aeroalergen pollen grains, were; rusian thistle (7.1%), Pigweed (5.4%), Cynodon Dactylon (4.9%), Pecan (4.8%), Ragweed Mix (4.8%), Rye grass (4.8%) other polen (32.4%). The molds: Candida (3.2%), Alternaria (2.7%), Rhizopus (3.6%), Penicillium (2.1%), Fusarium (2.1%), other molds (8.7%). The foods more important were: Wheat (21.3%), Cheese (10.0%), Shellfish Mix (10.0%), Pork (8.8%), Egg Yolk (7.5%).

[Hypersensitivity to common allergens in the central region of Coahuila]. / Estudio de hipersensibilidad a alergenos frecuentes en la región centro de Coahuila.

A retrospective review of 247 clinical files of patient that have responded to the office Allergy and immunology since 1990 to 1993 in Monclova, Coah, for allergy illness. This study was to determine the frequency of Aeroalergens and foods sensitization in Monclova, Coahuila, mediated Allergy Test Skin (intradermo reactions, and Prick) and MAST immuno Systems (Multiple Allergy System Test). The patients were highly sensitive to house dust (13.5%) others aeroalergen pollen grains, were: rusian thistle (7.1%), Pigweed (5.4%), Cynodon Dactylon (4.9%), Pecan (4.8%), Radweed Mix (4.8%), Rye grass (4.8%) other pollen (32.4%). The molds: Candida (3.2%), Alternaria (2.7%), Rhizopus (3.6%), Penicillium (2.1%), Fusarium (2.1%), other molds (8.7%). The foods more important were: wheat (21.3%), Cheese (10.0%), Shelfish Mix (10.0%), Pork (8.8%), Egg Yolk (7.5%).

[Asthma mortality in the state of Nuevo León, México]. / Mortalidad por asma en el estado de Nuevo León, México.

Definition of asthma has radically changed in the last few years. It has been given great importance to the its inflammatory component that can become irreversible. It is not clear yet the cause of the increase in prevalence and mortality of asthma observed in developed countries despite an increase in the number and efficacy of the therapeutic resources. There is still much to do on studying of the statistics on prevalence and mortality rate of the undeveloped countries. In Latin America, asthma prevalence, in 1983 was reported in 3.5% in seven countries. We reviewed the death certificates in the state of Nuevo León, México, in the 1980's decade, and compared the total death rate with those attributed to asthma, according to the diagnostics criteria code 493 from the International Classification of Diseases. We also reviewed the clinical records of patients admitted to a general hospital (University Hospital of Monterrey, Nuevo Leon, Mexico) as well as the autopsy reports from the same time period. General mortality rate, as well as the mortality rate due to respiratory diseases (asthma, emphysema, chronic bronchitis and others) was unchanged (5.5 x 100,000 people), despite an increase of 100% in the size of the population. Asthma prevalence has increased from 1.2% in 1979 to 2.5% in 1989 (approximately 75,000 cases). From the 1,114 autopsies done in the University Hospital in the 1980's decade, none could be attributed to an asthma death. It is mandatory that other states in this country report parallel studies to ours, so we can have reliable data on prevalence and mortality rates of asthma. In doing so, we can learn the distribution and consequences of this disease.

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

A study was conducted in order to know whether the prevalence of allergic illnesses, in an open population, has changed in the last 10 years. For the study, 243 families from the Monterrey metropolitan area, were randomly selected, using a questionnaire. Of the total number of families studied, 95 were found to have some kind of allergic disease, 11.2% of 1207 people interviewed.

[Determination of the eosinophil count in nasal mucus. Comparison of 2 techniques]. / Determinación de la cuenta de eosinófilos en moco nasal. Comparación de dos técnicas.

We compared swab and scraping (Rhino-probe) technics in the nasal cytology obtention for eosinophils count in 36 patients with a range of 2-46 years old (mean age 18.6 years) with diagnosis of Allergic Rhinitis. The eosinophil count with swab technic was between 0-79 cells with average of 6.5 cells and in the scraping (Rhino-probe) was in a rate of 0-100 cells with a average of 13.4 cells. Of the 36 patients with Rhinitis seen at our clinic, 13 (36%) of positive with swab and 19 (53%) with scraping technics (Rhino-probe) with percent differential of 17%. The comparison between the eosinophils count with both technics was p less than 0.05 for scraping (Rhino-probe) technic.

Hiposensibilizacion. / Hyposensitization

La hiposensibilizacion, desensibilizacion e inmunoterapia son practicamente sinonimos. Noon y Freeman la inician desde el ano de 1911 en pacientes con rinitis y Cook en 1937 atribuye la mejoria clinica de los pacientes sujetos a inmunoterapia a la presencia de anticuerpos bloqueadores. En 1967 se inician las bases cientificas de la IgE por Ishizaka.Los trabajos de Norman en la decada de los 70 prueban definitivala decada de los 70, prueban definitivamente que la inmunoterapia no es un placebo y bien aplicado el metodo es una arma util para el "control" de los pacientes alergicos. Otro mecanismo de accion de la inmunoterapia, ademas de la formacion de anticuerpos bloqueadores es el equilibro sobre la produccion de la IgE estimulando a los linfocitos supresores que estan deficientes en los enfermos atopicos. En la actualidad se han tratado de modificar los antigenos para que pierdan su alergenicidad pero tratando de conservar su antigenicidad, de manera que se pueda acortar el tiempo de hiposensibilizacion, asi han aparecido los "alergoides". No olvidar nunca la terapeutica sintomatica, la rehabilitacion, el control ambiental que aunados a la inmunoterapia daran resultados optimos en el control de los pacientes alergicos