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Biomedical subjects

A Sánchez Palacios

Publications and source records attributed to A Sánchez Palacios.

At least 19 recordsLinked to original sources
PubMed1991

Skin cross-reactivity between Dermatophagoides pteronyssinus and storage mites in atopic children.

In our environment, some children with allergic respiratory pathology do not have as favorable an evolution as expected after three years of immunotherapy with D. pteronyssinus extracts. We believe this is due to the existence of other mites whose antigenic determinants are not present in D. pteronyssinus. The purpose of the present study was to evaluate skin cross-reactivity between Dermatophagoides and storage mites in children with bronchial asthma. Fifty patients were chosen, with a mean age of 7.78 +/- 2.98 years and a range of 3-14 years. There were 38 boys (76%) and 12 girls (24%) with rhinitis and bronchial asthma. All patients had skin tests and prick tests with the following extracts performed on them: house dust (HD), Dermatophagoides farinae (DFA), Dermatophagoides pteronyssinus (DPT), Acarus siro (AS), Glycyphagus domesticus (GD), Lepidoglyphus destructor (LD), Tyrophagus putrescentiae (TP), with negative and positive controls. The areas of the papulae were evaluated in crosses, according to the size of the histamine and using computerized papulometry, using the Kurta series one graphic tablet with one resolution of 200 points per inch. The data were processed with the "Image-pro" analysis image program. The following conclusions were obtained from our study: 1) No case of skin sensitization to storage mites was found in any of our 50 patients, without house dust and/or Dermatophagoides mites also being present. 2) The greatest skin response with regard to histamine was found for DFA (52%), DPT (44%), HD (22%), GD (10%), AS (4%) and GF (2%).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1980

[Correlative urinary excretion of sodium-uric acid in hyperuricemia (author's transl)].

Since uricosuria is an essential compensative factor in hyperuricemia, multiple factors exist which can influence on the uric acid excretion in the tubules. Normally, 90% of the uric acid filtered by the glomerulus is reabsorbed, and its active tubular secretion forms the greater part of the uric acid present in the urine. One of the factors observed as leading to urinary excretion of uric acid, is saline overload, although this effect cannot always be achieved. This study is an attempt to assess the importance of hyperuricemia as a determinant of the action of sodium upon the urinary excretion of uric acid. The series were grouped according to the plasma and urinary values of uric acid. In cases studied, the percentage of sodium was similar independent of the excretion percentages obtained for uric acid. Nevertheless, in the groups with increased plasma levels of uric acid, a direct and significant correlation was found between the excretion percentage of sodium and that of uric acid. These data cannot be obtained in groups with normal plasma levels of uric acid. Since saline overload does not always lead to hyperuricosuria, other factors must condition the secondary effect. The obtained results suggest that hyperuricemia can be one of those factors, offering a great amount of uric acid to the renal tubule, a condition in which the sodium may act as a dragging factor which may not be possible with a lesser degree of uric acid.

Adult↗
PubMed1979

[Diseases associated with chronic bronchopathies and plasma alpha-1-antitrypsin deficiency (author's transl)].

Two groups of patients were selected according to their plasma levels of alpha-1-antitrypsin deficiency from among 58 patients with a chronic bronchopathy. Group I had normal plasma levels of alpha-1-antytrypsin; group II had plasma values lower than normal. The pathologic conditions associated with chronic bronchopathies were studied in both groups and so were the gasometric characteristics of the same. Chronic bronchopathies in subjects belonging to group II showed a clear tendency to present normal levels of pCO2 and hydrogen ions possibly related to a greater bronchial impairment in these patients. Independently of the genetic characteristics of plasma alpha-1-antitrypsin deficiency, its general levels are the real indication of its possible etiopathogenic action. Patients with recurrent plasma alpha-1-antitrypsin deficiency, its general levels are the real indication of its possible etiopathogenic action. Patients with recurrent plasma alpha-1-antitrypsin deficiency are more susceptible to bacterial infections, liver cirrhosis, diabetes, and allergic states. All this would be related to the protective effect of this protein fraction, and its reduction according to the most recognized theories would decrease the resistance of hepatic and pancreatic cells.

Bronchial Diseases↗
PubMedDate not supplied

[Sublingual immunotherapy with cat epithelial extract. Personal experience].

Because cats are a common pet in many houses and tourist complexes in the Canary Islands, sensitization to cat epithelium is a frequent problem. A total of 19.2% of patients with intrinsic asthma are sensitized to cat epithelium. In the Canary Islands, the percentage of sensitization among patients with a household cat is 18.1%, which higher is higher than in the rest of Spain (11.9). Many patients with extrinsic asthma sensitized to house dust mites undergo conventional subcutaneous immunotherapy but evolution is unsatisfactory due to sensitization to cat epithelium (whether a cat is present or not). The aim of this study was to evaluate the clinical effectiveness of sublingual immunotherapy with extract of cat epithelium in monosensitized patients with perennial allergic rhinitis and/or bronchial asthma. Forty patients monosensitized to cat epithelium were selected. Of these, 20 were administered sublingual immunotherapy and another 20 received placebo. The following evaluation was carried out in both groups: in vivo and in vitro: symptom score, skin tests, nasal challenge with cat epithelium, specific IgE determination, specific IgG4 and eosinophilic cationic protein. After 1 year of treatment the cumulative dose was 3.6 micrograms of Fe ld I, equivalent to 10 ng/drop. Duration of treatment was 365 days. Our conclusions, based on our patients in the Canary Islands, were the following: 1. Sublingual Fel d I therapy is effective after 1 year of treatment. 2. There were no modifications in IgE, eosinophilic cationic protein or skin tests. 3. An increase in IgG4 occurred which was related to clinical improvement. 4. In general, tolerance was good, except in one patient who presented urticaria and sublingual pruritus. 5. In polysensitized patients, sublingual immunotherapy to cat epithelium is complementary to immunotherapy to dermatophagoides.

Administration, Sublingual↗
PubMedDate not supplied

[Latex allergy. Diagnosis and therapeutic aspects].

In the last two decades of the 20th century, latex allergy has reached epidemic proportions. Epidemiological studies demonstrate that 3-25 % of health personnel is allergic to latex. The main risk groups are health workers, machine operators in latex factories, and children with spina bifida and urogenital anomalies. From the allergenic point of view, latex contains 240 peptides but approximately 50 are able to react to IgE. Latex elongation factor Hevdl is the relevant allergen in patients with spina bifida. Prohevein (hev B6) behaves as a major allergen, since it reacts to IgE in most of the sera of patients with latex allergy. The nature of latex is complex; it is an allergenic mixture that depends on chemical, immunological and epidemiological variables. Latex proteins show strong cross reactivity with several proteins from fruit and vegetable grains such as avocado, potato, banana, tomato, chestnut, and kiwi. In vivo studies have shown that class I chitinase from avocado and chestnut behave as major allergens in allergic patients with latex-fruit syndrome. The clinical manifestations related to the use of latex products depend on the type of exposure, the amount of the allergen, and individual variability. The most useful diagnostic method is the skin prick test. Several perioperative guidelines are recommended in patients sensitized to latex as well as various alternatives to rubber gloves. An increasing number of studies describe the efficacy of etiological treatment (immunotherapy), using different guidelines and routes of administration. These preliminary data encourage the hope that in the near future immunomodulatory therapy will be available to mitigate against the latex allergy epidemic.

Adult↗
PubMedDate not supplied

Modification of mediators of immune reaction after general anaesthesia.

UNLABELLED: The adverse reactions that may occur during a surgical intervention are of concern to anesthesiologists and allergists due to the civil responsibility they entail and the increased demand for healthcare in allergology units. The aim of the present study was to determine the prevalence of adverse reactions in our setting (Island of Lanzarote) and modifications to immune response mediators using three types of representative myorelaxants (succinylcholine, cisatracurium and vecuronium) in order to predict and prevent adverse reactions. MATERIAL AND METHODS: We performed a prospective, cross sectional, observational study in a population of 201 patients scheduled to undergo surgery in the Surgery Department of the Lanzarote General Hospital from October 1998. Three groups were retrospectively selected: vecuronium (73 patients), cisatracurium (80 patients), and succinylcholine (48 patients). Blood was extracted from all patients before and after the intervention and the following in vitro variables were evaluated: histaminemia, eosinophil cationic protein, tryptase, IgE to latex, CD4/CD8 fractions, total lymphocytes, total IgE, C3 and C4, and also the histaminuria. CONCLUSIONS: The mean age of the patients was 41 years with a predominance of women. Sixty percent had not previously undergone surgery. The mean operating time was 2 hours. Digestive surgery accounted for the greatest number of interventions (38.8 %) and most of the patients had no personal history of atopy (91.5 %). The greatest number of perioperative reactions was produced by cisatracurium (38.8 %), followed by succinylcholine (27.4 %) and vecuronium (20 %). The reactions observed were immediate type 1 and 2 reactions. All reactions were reversible without sequelae. Histaminuria levels were significantly decreased in the cisatracurium group. Histaminemia and eosinophil cationic protein showed no significant changes in any of the three groups. Tryptase concentrations in blood did not increase in the postoperative period in any of the three groups. On the contrary, concentrations were significantly lower than basal values. In the vecuronium and succinylcholine groups, CD4/CD8 fractions decreased in the postoperative period. Total lymphocytes decreased in all three groups. Total IgE tended to decrease in the cisatracurium and succinylcholine groups. IgE to latex was negative in the three groups. Specific IgE to succinylcholine was unmodified. C3 complement fraction was unmodified in all three groups and C4 fraction was reduced in the vecuronium group. In our setting and in our patients, the three myorelaxants produced immunosuppression of immune response mediators. The present study confirms that tests for allergy to myorelaxants are not indicated in the preoperative period.

Adolescent↗
PubMedDate not supplied

[Allergic reactions and pseudoallergies in surgical interventions with general anesthesia].

The Spanish Societies of Allergology and Anesthesiology have established a protocol for action for the performance of allergy tests for anesthesia. The protocol was published by the General Directorate of INSALUD, along with an informed consent form for general and loco-regional anesthesia, on 30 June 1994. Despite this, demands for care and requests for allergologic and anesthetic studies have increased. This review examines the diagnostic, preventive, and therapeutic criteria for adverse reactions during general anesthesia according to the most relevant international literature. Pseudoallergic reactions are one of the most frequent and important adverse reactions that occur during general anesthesia. These reactions are caused by the release of histamine and, probably, other mediators. The histamine-releasing effect depends on the dose of the medication. The most potent medications are morphine and almost all muscular relaxants, in the following proportions (succinylcholine: 43%; vecuronium: 37%; pancuronium: 13%; alcuronium: 76%; atracurion: 6.8%; galamine: 56%). Somewhat less than 50% of all severe intraoperative allergic reactions are really anaphylactoid reactions. The mediators involved in anaphylactic/anaphylactoid responses are: IgE in type I hypersensitivity mechanisms, IgA, immunocomplexes, complement activated by an alternative pathway, tryptase, and histamine. Numerous and varied agents are involved. Table III lists general intravenous anesthetics; table IV shows muscular relaxants. According to national studies, intraoperative latex sensitization occurs in 1% to 5% of health-care personnel and 40% of children with spina bifida. More than 6% of blood donors have IgE against latex. Cross-reactions between latex and fruit proteins, such as banana and kiwi, have been reported. As many as 50% of patients with latex allergy have such cross-reactions, according to some authors. Diagnostic methods include skin tests, challenge, histamine release test, RIA, human basophil optical degranulation test, and ImmunoCAP. Skin tests are the technique most often used in Allergology Units in Spain. Risk factors are debated. Although the female sex is accepted as predominant, atopy is controversial. The only known negative factor is the insertion of an endotracheal tube in asthmatic patients. Prevention should begin with the selection of less potent drugs, such as histamine releasing agents. Slow administration of drugs, as opposed to bolus administration, has been demonstrated to be more effective. The use of combined H1 and H2 antihistamines as a preanesthetic medication can significantly reduce tachycardia/bradycardia, hypotension, skin response, and even gastric pH changes induced by histamine release.

Anaphylaxis↗
PubMedDate not supplied

[An integrated approach to the psychological features of the asthmatic child].

The work starts from the interrelation that occurs in asthmatic children between physical and psychical aspects. We carry out the experiment on an instructional programme as an efficient method of intervention that on one hand improves the levels of personal, social school and family adaptation and that on the other hand helps to modify the wrong attitudes about the illness, presuming that, in some way, it will be a relief in the physical aspect of the illness. The sample chosen by randomization and stratification from the Allergy Service of the Insular Hospital of Gran Canaria was tested using an experimental and control-placebo with retest design. The children were between nine and eleven years old. The results for the adaptative aspects of the subjects were similar to the ones that Doctors Hernández and Hernández from La Laguna University (Canarias) got through similar studies, though the outcomes were not as successful as we hoped in cognitive/affective and social restriction. About the modification of the more internal aspects of asthmatic problems the programme was successful though we didn't modify some attitudes. We had the improvements that we hoped in some physical aspects as secondary effects but it seems that the programme can have more influence among them.

Adaptation, Psychological↗
PubMedDate not supplied

[Epidemiological study of asthmatic crises in a maternal-child emergency service].

In our region, allergic respiratory diseases affects over 55% of the child up to 5 years. This could be attributed to some peculiarities of our region, such as consanguinity, climate and predominant sensitisation to dermatophagoides mite. We made an epidemiologic study on the bronchospasm urgent cases attended in the Urgency Unit of our Maternal-Child Hospital in Las Palmas. We took 935 patients with a mean age of 32.36 months with acute attacks of bronchospasm, and found no significant difference between patients from the Northern and Southern zones of the island. Bronchospasm cases were more frequently observed in Autumn and Winter. We discuss here about the possible causing agents involved and want to draw attention to the need of education for our patients' parents for them to learn antiasthmatic medication and how to use it, before going to the Urgency Unit of any Hospital.

Acute Disease↗
PubMedDate not supplied

A new method of administration of topical nasal extracts. Immunoaerosol therapy.

Topical nasal immunotherapy (TNI) is a therapeutic option in residual rhinitis. Adverse reactions are common with pollen extracts and often are related to the phenol and thimerosal conservatives. This study sought to determine the clinical effectiveness of two methods of administration of TNI. Twenty-eight patients with allergic perennial rhinitis treated for 2 years with parenteral semidepot immunotherapy were divided into two groups of 14 patients: group A receiving conventional aerosol nebulization (TNE), and group B, which received TNAI using a type F aerosol electrocompressor. Clinical response and tolerance to TNI were evaluated using scores for signs and symptoms. The conclusions were: Both group A and group B exhibited statistically significant differences between baseline and post-immunotherapy parameters (p < 0.001). There were no statistically significant differences in the degree of improvement achieved in the two groups. The main advantages of TNAI were better tolerance of the D. pteronyssinus extracts, perhaps due to the elimination of conservatives, and the guarantee of correct administration of the dose and control of minimum reactions. For these reasons it is a viable therapeutic option in allergic perennial rhinitis previously treated for two years with parenteral semidepot immunotherapy.

Administration, Intranasal↗
PubMedDate not supplied

[Immunologic clinical evaluation of a biological response modifier, AM3, in the treatment of childhood infectious respiratory pathology].

To assess the immunoclinical effectiveness of a biological response immunomodulator, we used AM3 (glycophosphopeptide ), a glucomannan polysaccharide extracted from the cell wall of a strain of Candida utilis, in 20 children with asthmatic bronchitis. They received 2 envelopes (1 g) daily for 4 months. The results were compared with a control group of 20 untreated children with the same pathology. The following clinical and immunological parameters were assessed in all of them: cough, dyspnea, expectoration, frequency and intensity of the bronchospasm, time of administration of the symptomatic medication, and the delayed cutaneous cells response by means of the intradermal reaction of 5 antigens (Trichophyton, Candida albicans, tuberculin, E. coli and bacterial antigens). In the treated group, the immunoferon (AM3) reduced the symptoms, the intensity and frequency of the bronchospasm, and the symptomatic medication (table I, II and III). In basal conditions, the 40 children presented a state of 75% anergy; after 4 months of treatment, the treated group experienced a 45% decrease in their anergic situation, variation which was statistically significant when compared with the control group. In our 20 treated patients, AM3 behaved like and immunostimulant, improving the clinical situation and progress in patients with infectious respiratory disorders. We consider that the immunoferon constitutes a coadjuvant therapy to bacterial immunotherapy.

Anti-Bacterial Agents↗
PubMedDate not supplied

Immunoregulation with methisoprinol in Sjögren's syndrome.

In this work, we studied the therapeutic clinical efficacy and the immunoregulating effect of methisoprinol in 4 cases of primary SS and one case of secondary SS. After 12 weeks of treatment, no significant clinical improvement was detected in the glandular histology, in Schirmer's test and sialography. On the other hand, we have observed the following alterations: immunological changes characterized by an increase in the total population of T-lymphocytes (OKT3), a normalization and thereby a diminution in IgM, an increase in T-helper subpopulation (OKT4) in four cases and in T-suppressor subpopulation in one case. A noticeable fact was the best immunological response of the patient showing a negative histology, a functional alteration of the parotid and a short evolution of the syndrome. These findings support the hypothesis that methisoprinol can be an efficient coadjuvant in the treatment of primary Sjögren's syndrome in early stages when there is only functional alteration but no glandular atrophy.

Adult↗
PubMedDate not supplied

Comparative clinical-immunological study of oral and subcutaneous immunotherapy in children with extrinsic bronchial asthma.

There is discrepancy of criteria regarding the clinical immunological efficacy of allergenic extracts, administered by oral way, for the control of allergic symptoms of the respiratory airways. The predominant mono-sensitization to D. pteronyssinus and the early development of allergic respiratory symptoms in our medium motivated us to evaluate the clinical-immunological efficacy of oral immunotherapy in children with bronchial asthma. Twenty-eight patients affected with extrinsic bronchial asthma to D. pteronyssinus were included in our study; their average age was 27.93 months (range between 18-42 months) and the SD (standard deviation), 5.46. For the reception of oral and subcutaneous vaccines, made-up of 100% D. pteronyssinus, the patients were divided into two groups of 14 children each. The clinical immunological evaluation was realized in basal conditions, 6 and 12 months after the initiation of both vaccines. IgE and seric IgG4 against D. pteronyssinus was quantified through RAST. The results obtained were as follows: 1. Subcutaneous immunotherapy (SI) was seen to be more effective than oral immunotherapy (OI), throughout the 12 months of the study. 2. In both vaccines, the IgE against D. pteronyssinus did not undergo any statistically significant changes (p less than 0.766 and p less than 0.246). 3. IgG4 against D. pteronyssinus increased more with subcutaneous than with oral therapy. There were statistically significant differences for both kinds of therapy at 6 and 12 months, the difference between basal and 12 months being p less than 0.001 and p less than 0.020, for subcutaneous and oral therapy respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Oral↗
PubMedDate not supplied

Reliability diagnosis of FAST in allergic rhinitis. Correlation with RAST, nasal provocation and prick test.

Not much data is available on the reliability diagnosis of IgE FAST, in comparison with other "in vitro" and "in vivo" techniques. The motive of this study was to evaluate FAST sensitivity in patients with rhinitic allergies, comparing it with RAST and the prick test. Thirty-four patients, monosensitized in 11 cases for pollen, in 16 for mites and in 7 for moulds were studied. Ten patients with negative nasal provocation were used for the control group. In a total of 133 sera, there was class concordance between FAST and prick test in 59.39% of the cases, with a r = +0.41 and p less than 0.001 correlation coefficient. Corcordance of FAST and RAST for a total of 135 sera was 65.18%. Concordance in those who had nasal positive provocation was 87.65% for FAST, 75.04% for RAST and 92.85% for prick. From our experience with FAST, in patients with allergic rhinitis for the pneumoallergens evaluated, we conclude that this test constitutes an alternative "in vitro" diagnosis in the cases indicated. We found that its advantages were its low cost in the way of human and economical resources, its greater reliability in comparison with RAST, its simple administration and it being harmiess.

Allergens↗
PubMedDate not supplied

Eosinophilic gastroenteritis: a description of a new case with serous affectation.

We discuss a case of a 51 year old female who presented periodic episodes of abdominal pain, nausea and vomitus consisting of food elements and in addition in the last crisis presented ascites and increased abdominal circumference. The laboratory studies performed included the remarkable increase in eosinophils found in peripheral blood and ascitic fluid with the rest of the laboratory findings within the normal limits (biochemical, proteinogram, Igs, urine and stool examination, and negative food provocation test). Radiography demonstrated swelling of the gastric wall at antral level and the small intestinal wall. A gastric sample was taken via endoscopy which established the diagnosis of EG. EG is a disease of still disputable etiopathogenesis. Some think it is mediated by type I hypersensitivity mechanism and others (like our case) mediated by immunologic mechanism different from atopy which on occasions form part of a systemic feature. Regarding the role of eosinophil, it seems to be important as latest studies have found a relation between the degree of cell degranulation and the degree of histologic lesion. From the distinct form of EG (muscular, mucosa, serosa), EG with involvement of the serosa layer is the less frequent. It is usually associated to some other layer (generally muscular) and presenting ascites. Some authors denominate mixed-type EG to these forms whereby important involvement of more than one layer of the digestive tract is demonstrated.

Eosinophilia↗
PubMedDate not supplied

Immunotherapy with standard bacterial and bacterial ribosomal antigens in childhood bronchial asthma.

UNLABELLED: In this study we compared the therapeutic effectiveness of a lyophilized bacterial vaccine (LBV) with that of a vaccine prepared from bacterial ribosomal antigens (ARB) in 150 children with bacterial bronchial asthma. The immunological response of the patients was assessed clinically at 6 months, 1 year and 3 years, by determining the intensity and frequency of the bronchospasm. The serum immunoglobulin levels, the only immunologic parametres studied, were determined at basal conditions and following immunotherapy. CLINICAL RESULTS: after 360 days we detected a better clinical response in those patients who received the ribosomal vaccine (ARB), whereas after 3 years there was no difference in the clinical response between this group of patients and the group who received the bacterial vaccine (LBV). Immunological results: we were not able to show a statistically significant increase in immunoglobulin levels during the three years of immunotherapy with the two vaccines. However, those patients who possessed a deficit in IgG displayed a statistically significant increase in IgG levels after 360 days (t = 3.58, p less than 0.01), and an even greater increase after 1080 days (t = 7.86, p less than 0.001), of treatment with the standard bacterial vaccine. The ribosomal vaccine produced a significant increase in IgG levels (t = 9.59, p less than 0.001) after 1080 days also in patients with a deficit in IgG. In patients with a previous deficit in IgA we did not observe an increase in serum IgA levels during immunotherapy with the bacterial vaccine, but with the ribosomal vaccine these patients displayed significantly higher levels of IgA (t = 13.09, p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Antibodies, Bacterial↗
PubMedDate not supplied

[Apropos of a case of chronic eosinophilic pneumonia associated with iridocyclitis and bronchial asthma].

In this study, we report the case of a 48 year-old female patient showing a clinical picture after a month's evolution consisting of cough, moderate effort dyspnoea, asthenia, anorexia and loss of weight. One year before, she had been diagnosed with bronchial asthma and she had been treated for two years with policarpine collyrium for a glaucoma simplex. The exploration only showed the existence of iris synechias in the right eye and conjunctival hyperaemia on the same side, together with basal crepitant rales on auscultation. Once we had proved the existence of a peripheral eosinophilia superior to three thousand elements per mm3 and of peripheral pulmonary infiltrates with radiographic negative for pulmonary edema, the picture was included in the so-called P.I.E. syndrome whose various etiologies were discarded subsequently. Following a pharmacological survey, a study of parasites in faeces and cutaneous tests as well as provocative tests, the specific causes of P.I.E. were discarded. According to the transbronchial biopsy and the biopsies of skin, nerve and muscle, it was unlikely that the diagnosis would be granulomatosis and/or angiitis. No evidence was found of any of the affections in which P.I.E. is regarded as a minor component. In view of the above, we thought the correct diagnosis was chronic eosinophilic pneumonia, since all the characteristics defining this picture according to Carrington were fulfilled. The treatment was started with corticoids and a clear improvement of all clinical symptoms was observed, including the ocular findings and the disappearance of radiographic pulmonary infiltrates.(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenal Cortex Hormones↗