[Procedure to demonstrate bronchospasm induced by exercise].
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Altitude↗
Biomedical subjects
B E del Río Navarro
Publications and source records attributed to B E del Río Navarro.
[Determination of immediate hypersensitivity to pollen in allergic patients in the Federal District].
AIMS: The immediate hypersensibility immediate mediated by IgE represents the damage mechanism type 1 according to the original classification of Gell & Coombs. MATERIAL AND METHOD: Observational study, descriptive, transverse in the one which were checked the files of 1250 patient of the Allergy Service of the Hospital Infantil de Mexico Federico Gomez with diagnostic of rhinitis allergic; asthma; asthma and rhinitis allergic. RESULTS: 1250 patient studied 468 were of the feminine sex (37.44%) and 782 (62.58%) of the masculine with a mean age in either case of 7.9 +/- 3.5 SD. With respect to result of cutaneous test 154 (12.32%) were negative and 1096 (87.68%) were positive to one or more antigens. CONCLUSIONS: The obtained results indicate the importance of accomplishing greater number of studies that relate not only the percentages of positive in the determination of immediate hypersensitive, but also to the frequency of pollens in the means to the one which is unfolded the patient, together with the stages of pollination throughout the Mexican Republic, in pediatric population as well as in adult, to effect cutaneous tests selects according to the zone and to stablish a specific treatment and adapted for each patient.
Asthma↗
[Degree and duration of bronchodilatation with an agonist beta 2 administered alone versus an agonist beta 2 administered with ipratropium bromide in children with acute asthma].
BACKGROUND: The asthma is the chronic illness of the most frequent respiratory tract of the pediatric age. MATERIAL AND METHOD: Prospective study, longitudinal, double blind, at random with 40 patient (split into two groups) with asthmatic crisis with ages of 8 to 15 years. To all was them accomplished tests of effected pulmonary function of basal way and subsequent to the inhalation of the medication. The medication were administered in two inhalations by three steps and with intervals of 10 minutes between each dose. It was considered that the treatment was effective if the improvement of the pulmonary function tests (VEF1) were presenting an increase of the 15% of their initial value. RESULTS: For each one of the tests accomplished in the different times were found meaningful increases in VEF1 (p < 0.05) in both groups compared with the basal and stayed meaningful until eight hours after the administration of both therapeutic plans. CONCLUSION: The bronchodilator effect of the salbutamol alone and in combination with bromide of ipratropio is similar in intensity and in action time demonstrated by the VEF1.
Acute Disease↗
[Procedure for bronchodynamic tests with inhaled allergens].
The asthma is one of the most frequent chronic illnesses in the children. It is characterized by hyperreactivity from the air roads to inspecific stimuli (metacholin and histamin) and specific (allergens). The broncodynamics tests determines the broncolability asthmatic boy's and they help to settle down the I diagnose functional. They should be carried out with antigenic extracts of high quality, lyophilized watery and standardized; you can use an open or closed circuit and a dosimeter, the initial dose of the allergen it is lower than with the one that the positive cutaneous reactivity was obtained, carrying out successive increments until the VEF-1 descend 15% or more. The patient's security is fundamental, they should be carried out for specialized personnel.
Administration, Inhalation↗
[Effect of heating on FEV-1 in children with asthma challenged with exercise].
AIMS: The exercise-induced bronchoespasm, also called asthma for exercise, it corresponds to a frequent clinical entity that commonly accompanies the asthmatic patient. Their frequency is of around the 80 to 90% for the patients with asthma; it is presented among 40 to 50% of the children with allergic rhinitis, in the athletes 14% and in the population's 12% in general. OBJECTIVE: To determine the effectiveness of a heating routine like preventive agent of the exercise-induced bronchoespasm. METHOD: 30 patients were included of between 10 and 16 years of age, asthmatic and with exercise-induced bronchoespasm by diagnosed by means of challenge test to the exercise. All the patients carried out an exercise routine with duration of 20 minutes during which movements of elasticity, calisthenics and light activity were made directed to the exercise to develop, taking as objective parameter 60% of the frequency heart submax. Did all the patients carry out challenge at once, again to the exercise, in which a band numberless was used, with speeds that were increased progressively from 1 to 8 km/h and with inclination of 0? 10 0. The spirometrics registrations was made before the challenge and at the 2, 5, 10, 15, 20, 25, 30 and 60 minutes after the same one. RESULTS: The average of the patient's age was of 12.8 +/- 2 years with size of 157 +/- 10 cm. CONCLUSION: The heating in children with broncoespasmo induced by exercise acts as a protective agent against the decrement of the VEF-1. Although the heating can be a good control method in the asthmatic patient, it is necessary to keep in mind that not all the patients have a benefit of this protection. This can only be used in patient with programmed physical activity, since in the preschoolers it is not possible to implant a heating routine for the characteristics characteristic of their activity.
Adolescent↗
[Immediate reaction to latex: comparison between skin test and IgE determination with ELISA].
BACKGROUND: Development of latex hypersensitivity type 1 response mediated by IgE depends on exposition intensitivity and genetic predisposition. Clinical manifestations are urticaria, rhinoconjunctivitis, asthma and anaphylaxis. OBJECTIVE: The aim of the study was to determine the frequency of latex immediate skin reactivity on allergy patients from 1-15 yr old from Hospital Infantil de México. METHODS: A clinical, prospective trial was performed between november 1998 and april 1999. During the study we documented 629 patients with allergy. Of them 30 had positive skin prick test (SPT) to latex according to Aas classification and 30 with negative SPT were randomly chosen as control group. Both groups were similar with respect to diagnosis, age, and sex characteristics. RESULTS: 629 children's with SPT, 30 had positive skin princk test (4.76%), 15 men and 15 women, with an average age of 8.9 years. For groups 1-5 years of age. The group age 6-10 years 6.21% and that of age 11-15 8.9%. Atopia antecedent 73.3%. For rhinitis and asthma diagnostic 63%, rhinitis 13%, asthma 20%, conjunctivitis 20%, atopic dermatitis and anaphylaxis 3.3%, urticaria 6.6%. Surgery antecedent 30%. 100% used a sucking, 93% used a latex toy the relationship of symptoms with the use of latex was 6.6%. Statistica1 ana1ysis was performed using: Nonparametric correlations the Kendall's tau-b: 0.329 and Spearman's rho 0.348 correlation is significant. CONCLUSION: It does exist a correlation between SPT and test for latex-especific IgE antibodies, the older the patient, the higher frequency of latex reaction, history of atopy is the mayor risk factor.
Adolescent↗
[Desensitization to human recombinant DNA insulin in an adolescent with insulin-dependent diabetes mellitus].
BACKGROUND: Adverse reactions to drugs have increased in the last years, about 15% of all side effects are thought to be immune mediated according to the Coombs and Gell classification they can be type I (immediate) hypersensitivity, type II (cytotoxic) type III (immune complex mediated) or type IV (delay). Allergy to insulin is defined as an immunological response type I, and type II or III to exogenous insulin solutions occurring the 0.1% and 0.2% of the patients. PATIENTS: A 13 year old female with a 4-year history of insulin-dependent diabetes mellitus who presented hypersensitivity against recombinant DNA (rDNA) insulin manifested with urticaria and itching. We used a premedication therapy without good response and impossibility to use alternative therapy for her metabolic control, so she needed desensitization with insulin. METHODS: Skin prick testing with rapid insulin preparations 1:10 W/V dilution were positive. IgE antibodies to insulin weren't presented. IgE serum values were normal. We began the desensitization with a rapid 1:1000 UI insulin solution by intradermal route, than by subcutaneous route until reaching the accumulated doses necessary per day. During the process it appeared a papular rash and itching which were treated with an intravenous antihistaminic without troubles. RESULTS: The patient tolerated the desensitization procedure very well. For the past 14 months she has been treated uneventfully by subcutaneous administration of rDNA insulin. DISCUSSION: The desensitization against drugs is not a frequently process it only has to be used when it is impossible to substitute the treatment. Our patient showed probably hypersensitivity type 1 to insulin. However, we have to take into account the cytotoxic reaction caused by IgG or IgM antibodies or by immune complex. The desensitization finally was tolerated, 14 months after our patient accepts correctly her daily dose of human recombinant insulin.
Adolescent↗
[Skin reactivity in allergic conjunctivitis].
Allergic conjunctivitis is a very common disease in our country. We intend to determine the most frequent ocular involvement and the specific sensitivity to common aeroallergens. A longitudinal prospective study was performed on 20 patients from the allergy/immunology and ophthalmology outpatient service, Hospital Infantil de Mexico Federico Gomez, from May to July 1990. All of them had allergic conjunctivitis and were evaluated for ocular involvement and reactivity to common aeroallergens by skin prick test.
Adolescent↗
[Skin tests for different species of acari in asthmatic children from Mexico City].
House dust mites, Dermatophagoides pteronyssinus (Dp) and Dermatophagoides farinae (Df) are the predominant cause of allergic asthma in our population. To detect the presence of sensitivity to other mites besides Dp and Df in 100 children that live in Mexico City, skin tests were performed in their arms with Multi-test devices and glycerinated extracts. There were 34 female and 66 male, aged 4 to 14 years (x = 9.1y), with history of mild and moderate asthma, 2 months to 12 years of evolution. Dp was positive in 96, Df in 80, Euroglyphus maynei in 41, Chortoglyphus in 22, Blomia tropicalis in 17, Trophagus putrescentiae in 12, Glycphagus in 12, Acarus siro in 7, Lepidoglyphus destructor in 7 and Gophieria in 7. Hypersensitivity to all of th species was common. Even we know about the cross-reactivity between them, there are species-specific allergens that could make some of them important in diagnosis and treatment.
Adolescent↗
[Potentially fatal anaphylaxis. Report of 3 cases].
Near fatal anaphylactic reactions to food are rarely reported, we identified three such cases in the Allergy Clinic at Children's Hospital Federico Gómez in México. All had known food allergies, they received familiar training for identification and recognition of anaphylactic reaction and how to administer adrenaline rapidly. Our results are similar to those found in the literature.
Anaphylaxis↗
[Level of knowledge of the technique for using metered-dose inhalers among pediatricians].
A longitudinal open prospective study involving 100 pediatricians from 4 different health institutions was performed. After a written description of inhaler technique was provided and a special questionnaire, physicians were asked to demonstrate the technique using a placebo MDI. Correct use was considered if 10 points were obtained. Thirty pediatricians used MDI in children less than 5 years. The correct written description was observed in 55% (55/100) but 32.7% (18/55) failed to use it properly. Although 45% (45/100) made an incorrect description 25% (25/45) demonstrated a describe previous reports which describe that more than half the physicians ignore the correct steps of inhaler technique. Moreover this lack of information appears to be one of the most important factors which affect self-management of acute and chronic symptoms of asthma in which have contributed to the increased morbidity/mortality of the disease since 1980.
Health Knowledge, Attitudes, Practice↗
[Anaphylaxis and urticaria caused by exercise. Review of the literature and report of 2 cases].
Urticaria is a common pathology, yet, urticaria induced by physical agents represent 17% of urticaria cases, they are more frequent in adolescents and young adults. Exercise may induce anaphylaxis, urticaria, asthma and rhinitis. This first two pathologies are not so usual. The incidence of cholinergic urticaria (CU) is five to seven percent. this incidence of anaphylaxis induces by exercise has not been described. It is very difficult to clinically distinguish CU and EIA, establish criteria are described in the paper. There are two clinical forms of CU; local and systemic. The ideal diagnostic methods was the ID methacholine test. Antihistaminics are the treatment of choice, together with tolerance induction by progressive exercise. Two typical cases of CU are presented as they occurred at the Allergy and Clinical Immunology Service of Hospital Infantil de Mexico, Federico Gomez.
Adolescent↗
[Comparison of 2 skin test methods for the diagnosis of allergic diseases].
Diagnosis of allergic diseases is realized by clinical history and cutaneous tests to determine the causative allergen. As several cutaneous test exist we consider necessary evaluate sensibility and specificity of epicutaneous (EP) and intradermic (ID) test. All open, prospective transversal study was carried out. The study included 45 patients suffering asthma, allergic rhinitis or both. The patients underwent both kind of test, with 10 allergens: Dermatophagoides pteronyssinus, Fraxinus, Ligustrum, Quereus, Schinus, Phleum, Amaranthus, Ambrosia, Artemisa. Alternaria and Hormodendrum. The mean age was 12 years. No difference was found comparing positive results for tree, grass, weed and molds allergens using both test. Instead for Dermatophagoides pt EP had 92.5% of sensibility and 100% of specificity, mean while ID has 100% of sensibility and 96.6% of specificity. We conclude that ID test have greater sensibility and EP have greater specificity, we recommend use EP for first instance.
Adolescent↗
[Cutaneous reactivity to foods among patients with allergic rhinoconjunctivitis].
Ocular allergy could be induced by food allergy or inhaled allergens. However there are few pediatric studies about it. Our objective was to know the frequency in children who have food allergy as cause of their ocular allergy. We perform a prospective and descriptive study in 50 patients within 6 to 16 years of age during June 1996 to January 1997. Skin prick tests to food allergens and inhalants, serum IgE levels by ELISA (enzyme immunoassay), nasal and conjunctival cytology were done. Not paired student T-test, Mann-Whitney U, and Kruskall-Wallis test were used for statistical analysis. We found mean of age 9.1 years +/- 2.5. Prick tests were positives to foods in 20%, 50% to inhalants and 30% to both. Food allergens seen more frequently were shellfish, tomato, rice, peanut and inhaled allergen Dermatophagoides pteronissinus. Serum IgE was elevated and ocular cytology was positive in food hypersensitivity group with significance difference (p = 0.023). In conclusion, we found a high frequency (50%) of food hypersensitivity in patients with allergic rhinoconjunctivitis.
Adolescent↗
[Comparison of 4 skin prick tests to detect immediate hypersensitivity].
AIMS: To diagnostic allergic diseases it's necessary an adequate history, and in vivo or in vitro test, to determine specific IgE. The skin prick test are the best for this, because are more sensitive, economic and quick to do. However there are variability in results with the different instruments to do it (the Morrow-Brown (MB), needle, Prick lancet (L)t Multi-Test (MT), and the Doutip-Test). To consider this instruments how adequate diagnostic proceedings, we should evaluate some characteristics. Because it, our objective was to evaluate precision, sensitivity, specificity and patient preference by each one. METHOD: Prospective study in 20 patients with asthma or allergic rhinitis who comes to the allergy service of Hospital Infantil de México Federico Gómez. We analyzed skin prick test with DT, MB, MT and L on the back surface with histamine in five times and glicerosaline in one. We measured wheel and flare diameters 15 minutes after applications. We consider positive results if medium diameter of wheel was 3 mm or flare 10 mm. Precision was measured by coefficient of variation of wheel with histamine with each instrument. Patient preference was considered in relation to low grade of discomfort with each one. Precision was compared by two- vias varianza analysis. No parametric Friedman test was used to compared patient preference. RESULTS: We studied 20 patients, 40% was females and 60% males. The ages were 10 to 16 years old Promedio wheal histamine diameter was to MB = 5.1 +/- 1.1, L = 6.1 +/- 0.8, DT = 6.7 +/- 0.9, MT = 6.3 +/- 1.5; promedio flare diameter with histamine was to MB: 15.9 +/- 4.2, L: 19.0 +/- 4.8, DT = 21.9 +/- 4.8, MT = 18 +/- 6.9. Sensibility of DT was 100%, L = 99%, MT = 97% and MB 95%. The specificity of MB was 90%, L = 70%, MT = 41.6% and DT 30%. DT coefficient of variation was 15.6%, L: 17.3%, MT = 24.4% and MB 24.6%. CONCLUSIONS: In our study more sensitive device was DT, more specific was MB and more precise was DT. Patients preferred the lancet, because they had less discomfort when used it.
Adolescent↗