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Biomedical subjects

C K Naspitz

Publications and source records attributed to C K Naspitz.

At least 91 records · Page 5Linked to original sources
PubMedDate not supplied

Zinc deficient diet consequences for pregnancy and offsprings of Wistar rats.

Adult female Wistar rats (90 days old; weight 180 to 220 grams) were submitted to different zinc deficient diets (Zn; severe = 2.6 ppm; mild = 9.0 ppm and normal diet = 81.6 ppm), during 6 weeks. After this time they were coupled with normal male Wistar rats. No differences regarding fecundity and sterility were observed between the groups. During pregnancy, part of the animals from severe and mild Zn deficient groups received the same diet and the others received normal diet. The animals from the group receiving normal diet, were divided into other 3: the first received severe, the second mild Zn deficient diet and the third normal diet. During the study we observed that animals submitted to a Zn deficient diet (acute or chronic) had tendency to lower weight gain, lower weight of the offspring, lower serum levels of Zn in maternal and newborn (pool) blood. A significant reduction in the number of alive newborns was observed in the group of animals submitted to severe Zn deficiency. These data reinforces that Zn is a very important trace element overall during pregnancy.

Animals↗
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Metabolic and hematologic changes occurring after rapid intravenous infusion of gammaglobulin in patients with antibody deficiency syndromes.

OBJECTIVE: We wished to investigate whether increased IgG infusion rates are associated with metabolic and hematologic changes in pediatric patients with antibody deficiency syndromes. METHODS: We studied 7 patients (2-16 years old) with primary antibody deficiencies who had been on regular IgG replacement treatment, 350-600 mg/kg/dose every 3 weeks with a 3% IVIG preparation, for periods ranging from 6 months to 4 years. Initially, the IgG concentration of IVIG preparations was increased to 6, 9 and 12% in consecutive infusions at a constant IgG infusion rate of 4 mg/kg/min. Subsequently, the infusion rates were increased to 8, 12, and 16 mg/kg/min using the IVIG 12% preparation. RESULTS: Clinically, all patients tolerated increases in IVIG concentrations while the infusion rate was 4 mg/kg/min. However, 3 patients presented side effects when the infusion rate was increased to 8 and 16 mg/kg/min. CONCLUSION: We conclude that metabolic and hematologic sides effects occur with rapid infusion of IVIG even in patients who tolerate the increased infusion rate clinically. The advantages of using high infusion rates have to be re-evaluated.

Adolescent↗
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Protective effects of different doses of inhaled fenoterol on methacholine-induced bronchoconstriction in asthmatic children.

OBJECTIVE: To evaluate the protective effect of different doses of inhaled fenoterol (F) on bronchoconstriction induced by methacholine (M). DESIGN: Randomized double-blind study. SETTING: Referrence center. PARTICIPANTS: 9 children (aged from 7 to 15 years old), with mild or moderate asthma and allergic to D. pteronyssinus. INTERVENTION: On the first day, the M concentration necessary to induce a 20% fall in the forced expiratory volume in the first second (FEV1; PC20FEV1) was determined using closed circuit inhalation (De Vilbiss 646). On subsequent days, the children inhaled a dose of F (25 or 50 or 100 or 200 micrograms) through the same circuit and, after 15 minutes the FEV1 was measured, becoming the basal value. Bronchoprovocation was then initiated using the concentration prior to the PC20FEV1 of the first day and continuing until there was a 20% fall in the FEV1. This concentration was the "new" PC20FEV1. RESULTS: F in a dose of 25 micrograms protected 2 of the 9 children, in a dose of 50 mg protected 4 of the 9 and in doses of 100 and 200 micrograms protected all children. We did not observe any relationship between the magnitude of the bronchodilation and bronchoprotection induced by the inhalation of F. CONCLUSIONS: Our results suggest that a dose of 100 micrograms of F is capable of inducing bronchoprotection in children with mild/moderate asthma.

Administration, Inhalation↗
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[Non-specific bronchoprovocation with metacholine in children before and during sugar cane burning in Catanduva-SP]

OBJECTIVE: Evaluate the influence of sugar cane burning on BHR of asthmatic and "normal" control children by metacholine bronchoprovocation tests; and verify if interferes in pulmonary function tests.METHODS: Twenty-two asthmatic children (A) aged from 7 to 14 years old, and twelve "normal" control children (C), aged from 8 to 13 years, were submitted to non-specific bronchoprovocation test with methacholine before and during the sugar cane burning. The metacholine concentrations used were 0.025; 0.25; 1.0; 2.5; 10.0; 25.0 mg/ml, and the results were expressed in PC(20) FEV1 (concentration of metacholine that induces a fall of 20% or more in the forced expiratory volume in the first second).RESULTS: The PC(20) average for asthmatic children was significantly lower than the control group, before (A= 3.68; C= 25.62 mg/ml) and during the burning (A= 4.11; C= 25.25 mg/ml) (p < 0.05). However, there were no significant differences, when compared in each group PC(20) values before and during burning. The same was observed regarding FEV1, forced vital capacity (FVC) and forced expiratory flux between 25 and 75% of FVC (FEF (25-75%)).CONCLUSIONS: It was not possible to demonstrate that cane plantation burning influences the BHR, and pulmonary functions tests of the studied children.

Journal Article↗
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[Non specific bronchial hyperreactivity in infants].

OBJECTIVE: To evaluate the presence of bronchial hyperreactivity (BHR) in Wheezing Babies (WB) and Normal Control Infants (C) employing the methacholine (M) bronchoprovocation test (BPT). METHODS: Fifty-one WB and 20 C, all under two years old and assisted at the Department of Pediatrics of UNIFESP-EPM, were submitted to BPT with M, having pulmonary auscultation as monitoring parameter to evaluate PCW (provocative concentration of M causing wheezing). For all tests, M diluted in saline at increasing concentrations of: 0.025, 0.125, 0.25, 0.5, 1.0, 2.5, 5.0, and 10.0 mg/ml was delivered with O2 (5 l/min) by a face mask. It was inhaled through the mouth and nose during 2 minutes of quiet tidal breathing via nebulizer with 2 ml of solution. RESULTS: None collateral effects were observed, except for tachypnea and tachycardia. There was statistically significant differences between WB (2.3 mg/ml) PCW value and C (9.2 mg/ml) (p < 0.05). At the PCW value of 2.5 mg/ml, 41% of the WB had statistically positive response (p < 0.05). This was not observed in the group C, when a positive response only occurred at the concentration of 5 mg/ml (25%). At this concentration we observed a clear cut difference between WB and C (p< 0.05). According to the severity, the highest M concentration was observed within the group displaying mild symptoms. CONCLUSIONS: We conclude that BPT utilizing PCW may be a good option for detecting BHR in young children. It is well tolerated by children, easy and safe to perform. Follow-up studies may clarify the real mean of the PCW.

English Abstract↗
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[Risk factors and clinical evolution of asthma in children].

OBJECTIVE: The purpose of this study was to obtain data on the clinical evolution and risk factors related to asthma in children followed as outpatients in our Division of Allergy. METHODS: The asthmatic group consisted of 165 children (107 boys, 58 girls), between the ages of 3 and 14 years. All children were atopic and had a positive skin prick test to D. pteronyssinus. The control group consisted of 40 healthy children (20 boys, 20 girls), within the same age range, without personal history of asthma or other atopic disease and with negative skin prick test to D. pteronyssinus. The mothers were interviewed to obtain data on: a) clinical evolution, b) family history of asthma or any other atopic disease, c) description of the house environment. RESULTS: 1) in approximately half of the cases symptoms started on the first year of life. Mothers were not informed of the condition at the time; 2) upper respiratory tract infections and bronchiolitis were responsible for triggering the first wheezing episode in most cases and remain the main precipitating factors in the first year of the disease whilst allergens, irritants, sinusitis, physical exertion and emotional factors were the main precipitating factors between the ages of 5 and 13; 3) changes in climatic conditions precipitated acute attacks throughout the evolution of the disease and; 4) asthma was not the only allergic manifestation, allergic rhinitis being the most frequent associated condition; 5) family history of atopy (Relative Risk (RR) = 2.40; 95% confidence interval (CI95%) = 1.60-3.50); maternal history of asthma (RR = 2.23; CI95% = 1.10-4.63) and the presence of smokers in the house (RR = 2.30; CI95% = 1.20-4.31) were the main risk factors for the manifestation of asthma. CONCLUSIONS: a) there were no differences between boys and girls regarding the evolutionary aspects, b) asthma was underdiagnosed, c) family history of atopy, maternal history of asthma, and the presence of smokers in the house were risk factors for the manifestation of asthma.

English Abstract↗
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[Duration of bronchodilator effect of inhaled Salmeterol (dry powder x metered dose inhaler) in children with acute asthma attack].

Patients during a mild to moderate acute attack of asthma (FEV1: 50 - 80% of predicted) were treated with Salmeterol MDI - 50mcg or Rotadisk - 50mcg or Salbutamol (MDI -200mcg). The children were followed by Spirometry, measuring FEV1 (basal) and after treatment: at 30 minutes, 60 minutes and thereafter every 60 minutes until 780 minutes, if the patients maintained the FEV1 above 80% of the predicted value and/or an increment of 20% in the VEF1 basal value. The Salmeterol group showed a significant bronchodilation at 60 minutes which was maintained in half of the patients up to 9 hours. This was not observed in the Salbutamol group: the peak bronchodilatation was observed at 30 minutes and the bronchodilation effect was observed in half of the patients up to 6 hours. There were no significant differences between both presentations of Salmeterol. This drug allowed a prolonged bronchodilator effect and is, according to the several consensus on management of asthma, an adequate option in the treatment of moderate to severe asthma.

English Abstract↗
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[Lupic nephropathy in childhood: morphologic analysis of 18 cases].

Serum IgE concentration was determined in 17 newborn and 171 children with ages between 1 and 12 months. In the first group, blood was taken from the umbilical cord, and in the second, we used a periferic blood sample. The selection implied the exclusion of children with any suspicion of atopic disease, family history of atopy and recent viral infection. The serum IgE concentration was determined by enzyme linked immunoabsorbent assay (PRIST). The sex, race ( white and non white) and age were analyzed in the children studied. During a follow-up period (24 months) seven children (3,7%) developed atopic symptoms. The serum IgE concentration of the groups studied was higher than in other studies. The mean IgE in each group was as follows : newborns = 0.24 IU/ml; 1-3 months = 1.57 IU/ml; 4-6 months = 7.72 IU/ml; 7-9 months 12.07 IU/ml; 10-12 months = 12.14 IU/ml.

English Abstract↗
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[Intranasal azelastine in the treatment of perennial allergic rhinitis in children].

Twenty-five patients (5-15 years old) with perennial allergic rhinitis (PAR) for at least one year were treated with intranasal azelastine. The study was conducted in two separate occasions. In the first study, in a special prepared room, the patients underwent Active Anterior Rhinomanometry (AAR). Twenty minutes later, after 2 drops of saline installed in each nostril, the Total Nasal Resistance (TNR) and Total Nasal Conductance (TNC) were measured. This was followed by the intranasal application of azelastine (0.14 mg/nostril ) and the TNR and TNC were measured at 15,30,60,90 and 120 minutes. At the end of this period, a topical vasoconstrictor (fenoxazoline 0.05%) was instilled and TNR and TNC measured after 15 and 30 minutes. The patients were discharged with a prescription of intranasal azelastine, same dose, for 14 days, with diary cards. Clinical evaluation and clinical score were performed at days 3,7 and 14. There were no changes in TNR and TNC after the acute and prolonged (14 days) use of azelastine, which was observed after the use of fenoxazoline. Clinical scores (physician and patient), according to the diary card, were significant for itching and sneezing after 7 days of treatment. Intranasal azelastine is useful for the therapeutic management of PAR, mainly in those for whom nasal blockage is not important.

English Abstract↗
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[Atopic diseases in Brazilian children--etiologic multicentric study].

In order to determine the etiologic agents involved in atopic diseases in Brazilian children, we have performed this multicentric study in 8 areas in Brazil. We have done prick tests with inhalants and food antigens and analyzed skin tests results, considering positive the wheal mean diameter 3 mm. 22,2% of skin tests were negative and the majority were positive to inhalants: D.pteronyssinus(Dpt) (66.6%) and D. farinae(Df) (66.0%), house dust extract (29.0%), dogs epithelium (19.2%), cat's epithelium (8.8%), feather (5.5%), molds (4.2%), Penicillium sp (2.2%) and Lollium perene (0.6%). We have had 9,1% of food positive tests: cow milk (5.2%), peanut (3.5%), corn (3.2%), cocoa and soya (2.2%), eggs and wheat (1.9%). We have concluded that the domestic mites are the most important agents involved in the etiology of atopic diseases in Brazilian children, and the extracts involved, in line with the sensitization of each geographical area.

English Abstract↗
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[Effect of inhaled terbutaline sulphate (dry powder, Turbuhaler and nebulizer solution) in children with acute asthma].

Forty seven children (6-14 years), with an acute mild or moderate attack of asthma (clinical score 3 or FEV1 > 50% of the predicted), were treated with terbutaline sulphate, by inhalation route with a dry powder inhaler (Turbuhaler - 0,5 mg - group T; N=27, or by a nebulizer 1% solution-in saline-compressed air (6 l/min.) group S; N=20. The children were evaluated at 5, 15, 25 and 30 minutes after the initial treatment. In both groups a significant fall of the clinical score (starting at 15 minutes) (p < 0.05) and a significant improvement of the FEV(1), VC and FEF25-75% (starting at 5 minutes), were observed (p < 0.05). There were no significant changes in heart rates, respiratory rates and blood pressure (p > 0.05). At the end of the first treatment, the number of patients with a FEV(1) < 80% was similar in both groups (T = 13/27 and S = 10/20). The same treatment was repeated, and all the children showed a marked improvement, except for one boy of the group T was hospitalized. In conclusion, children with mild or moderate acute attacks of asthma can be treated up to a week with an inhalation of dry powder, resulting in adequate bronchodilatation without important side effects.

English Abstract↗
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International Study of Asthma and Allergies in Childhood (ISAAC) written questionnaire: validation of the asthma component among Brazilian children.

Written questionnaires have been widely used in epidemiological studies of asthma. However, when translated to another language, they must be validated. The International Study of Asthma and Allergies in Childhood (ISAAC) written questionnaire had been previously validated by a comprehensive study, but this had not been done in Brazil. Our objective was to validate the asthma component of the ISAAC self-applicable written questionnaire following its translation to Portuguese. A group of 10 pediatricians and 10 pediatric allergists graded the questions from 0 to 2, and established a maximum score for each question. The questionnaire was answered by parents or guardians of asthmatic children, aged 6 to 7 years old (n = 26) and of nonasthmatic control children of the same age (n = 26); and by asthmatic (n = 33) and nonasthmatic (n = 33) adolescents, aged 13 to 14 years. Half of these individuals responded to the same questionnaire after 2 to 4 weeks. This second response allowed the evaluation of the reproducibility of the ISAAC questionnaire. The maximum global score possible was 14, and cut-off levels of 5 and 6 were found for the groups of 6 to 7 and 13 to 14 year olds, respectively. There was significant agreement between the adolescents' responses to the questionnaire and those from their parents or guardians (74.3%); however, significant discordance was observed for individual questions including "wheezing with exercise." In both age periods the questionnaire was significantly reproducible (Kappa test) (6 to 7 year olds Kw = 1; 13 to 14 year olds Kw = 0.89). In conclusion, the asthma component of the ISAAC written questionnaire was proven to be reproducible, adequate and able to differentiate between asthmatics and controls. Adolescents answered the questionnaire appropriately, however the results suggest that adolescents' parents or guardians underestimate asthma symptoms which interfere little with the adolescent's daily activities.

Adolescent↗
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Common variable immunodeficiency: a clinical and laboratory evaluation of 15 cases.

The clinical and laboratory data for 15 patients with common variable immunodeficiency (CVI) (5 females and 10 males aged 3 years and 6 months to 40 years at first examination) were evaluated. The age of onset of infectious signs and symptoms ranged from 6 months to 35 years. Recurrent pulmonary infections predominated (86.6%), followed by chronic diarrhea (46.6%). Approximately 60% of the patients with pulmonary complaints presented chronic sequelae (bronchiectasis). Two developed a polymyositis-like picture. No neoplasms were observed. All patients presented immunoglobulin levels below 300 mg/dl and absence of antibody responses to poliovirus and to hemagglutinin. Two patients were negative when tested for autoimmunity. Cell immunity tested by the lymphoproliferative response in the presence of phytohemagglutinin was normal in 11 patients and depressed in 4. A decrease in the helper T population and inversion of the OKT4/8 ratio occurred in 13. Cimetidine treatment (1200 mg/day) applied to 5 patients for 4 weeks did not produce any clinical or laboratory improvement. Gamma globulin is the treatment of choice for these patients.

Adolescent↗
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Bronchial provocation with metacholine in young children: a simplified method.

Although pointed out as a characteristic of bronchial asthma, bronchial hyperreactivity (BH) has been documented in other clinical situations such as fibrocystic disease of pancreas and chronic obstructive pulmonary disease. BH is diagnosed in 90% of asthmatic patients and in almost all of those who are symptomatic. BH can be measured by specific bronchial provocation tests (BPT) (antigens and occupational sensitizing agents) and by exercise. Since their introduction, nonspecific BPT have been extensively used as a preliminary method for the evaluation of BH and also to diagnose bronchial asthma, to establish its severity, to determine the therapeutic efficacy of drugs, and for epidemiological studies.

Asthma↗
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[Rheumatic fever: atypical joint manifestations].

The diagnosis of rheumatic fever (RF) continues to be a difficult one in Pediatrics, mainly because of the polymorphism of its clinical presentation and the lack of specific laboratory test. Among the Jones' major criteria, arthritis is the most frequent and the least specific. Ninety three children with RF who presented 117 flares of the disease were studied in the Department of Pediatrics, Escola Paulista de Medicina, between Dec. 1989 and Dec. 1991. The presence of arthritis was defined as an inclusion criterion. The diagnosis was based on history, physical and laboratory examinations (Modified Jones' Criteria). The mean age was 10 years and the sex ratio was 1 male: 1.4 female. In 45% of the flares, arthritis was the only major criterion. In 44% there were arthritis and carditis, in 7% arthritis and chorea and in 4% arthritis, carditis and chorea. In 64% of the flares the pattern of articular involvement was migratory and in 36% addictive. Polyarthritis and oligoarthritis were observed respectively in 64% and 36%. Monoarthritis was reported in 3%. The definitive diagnosis of RF with atypical articular involvement only was possible in the presence of carditis or chorea. The authors conclude that physicians should be aware of the atypical involvement observed in some cases of RF, specially when arthritis is the only major criterion.

Adolescent↗
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Magnetic resonance imaging in a patient with X-linked agammaglobulinemia and chronic meningoencephalitis.

The case of a boy with congenital agammaglobulinemia is reported. In spite of regular immunoglobulin replacement therapy (fresh plasma transfusion from family donors--20 ml/kg/month), he developed chronic meningoencephalitis (ME). Besides characteristic clinical signs of ME, he also presented at cerebrospinal fluid analysis pleocytosis with lymphocyte predominance and class II cytomorphology, and delta and theta waves in the EEG. Computerized tomography showed dilatation of the ventricles and marked cortical fissures (sulci). Magnetic resonance imaging showed a disease affecting white and gray matter. After diagnosis of ME, replacement therapy with Sandoglobulin (700 mg/kg every 2 weeks) was started. His condition gradually worsened, and coma and death occurred after a follow-up of 18 months. The etiological agent could not be identified.

Agammaglobulinemia↗
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Serum penicillin concentrations after intramuscular administration of benzathine penicillin G in children with rheumatic fever and controls.

Serum and urine penicillin levels were determined in 11 children with rheumatic fever (RF) who were receiving benzathine penicillin G (BPG) prophylactically every 3 weeks and in 10 children without RF who received the drug for the treatment of other infections. The dose given was 600,000 units for children weighing less than 25 kg and 1,200,000 units for those with a weight above 25 kg. Blood and urine samples were collected from both groups before and on days 7, 14 and 21 after BPG administration. Our results showed that: minimum inhibitory concentrations (MICs) of BPG for group A beta-hemolytic streptococci were 0.02 IU/ml or 0.0125 microgram/ml; intramuscular BPG did not give adequate serum levels to block the growth of group A beta-hemolytic streptococci in approximately 24 and 62% of children included in the study on days 14 and 21 after its administration, respectively; BPG metabolism was similar in both groups and did not depend on the underlying disease; serum and urine levels did not vary according to sex and weight; and there was a small correlation between serum and urine levels.

Adolescent↗