[Atopic dermatitis. Allergological characteristics and association with respiratory disease]. / Dermatitis atópica: características alergológicas y asociación a patología respiratoria.

BACKGROUND: Atopic dermatitis (AD) is a chronic inflammatory skin disease that frequently precedes the development of asthma or other respiratory allergies. The aim of this study was to review allergen sensitization, type of feeding in infancy, and development of asthma or rhinitis in a group of patients with AD. METHODOLOGY: One hundred children with AD were selected. All patients underwent skin prick and patch tests to foodstuffs and inhalant allergens, total and specific IgE determination, and oral challenge tests. RESULTS: The study included 57 boys and 43 girls. The mean age at consultation was 3.77 +/- 2.81 years and mean age at onset of of AD was 1.09 +/- 1.69 years. Twenty-eight percent of the children were exclusively sensitized to food allergens, 20% to inhalant allergens and 22% to both food and inhalant allergens. Mean serum IgE levels were higher in children sensitized to Dermatophagoides pteronyssinus (DPT) (346.86 +/- 430.43 U/ml) than in non-sensitized children (78.24 +/- 132.93 U/m) (p < 0.001). Total IgE levels were also higher in patients with respiratory symptoms (283.77 +/- 336.53 U/ml) than in children without respiratory disease (124.62 +/- 285.21 U/ml) (p = 0.021). Thirty-five percent of the children developed some kind of respiratory allergic disease (asthma and/or rhinitis) in a mean interval of 2.55 years after the onset of dermatitis. Of the children sensitized to inhalant allergens (DPT), 55.26 % developed respiratory symptoms compared with 22.58 % of the non-sensitized children (p < 0.001). The odds ratio of developing respiratory allergy if the patient showed sensitization to DPT was 4.235 (95 % CI 1.768-0.147, p = 0.002). CONCLUSIONS: Children with AD that develops in the first year of life, associated with high IgE levels and early sensitization, independently of the kind of feeding, develop respiratory allergic disease more frequently than children without these factors.

[Treatment of status asthmaticus. Experience of intravenous beta-adrenergic bronchodilator therapy in 71 cases]. / Tratamiento del estado asmático. Experiencia del tratamiento broncodilatador beta-adrenérgico EV sobre 71 casos.

A retrospective study of the patients admitted during the last 8 years with status asthmaticus is reported. We compare the requirement of mechanical ventilation with the beta-agonist therapy received and the type of asthma. About 71 patients admitted, 67% were IgE dependent asthmatic (EDA) children and 31% no-IgE dependent asthmatic (nEDA) ones. They needed intermittent positive pressure ventilation (IPPV) in 20 instances; no difference was found between both types of asthma. We studied the ventilatory parameters used. The 33% of EDA children was treated using a continuous IV infusion of hexoprenalina, requiring IPPV in 5 (31%) of them. The rest received a continuous IV of isoproterenol, and only the 16% required IPPV. We found isoproterenol to be more effective than hexoprenalina in the treatment of status asthmaticus. Similar results were obtained with the nEDA group. The Downes score was showed to be a good predictor-index scoring system in many cases.