Biomedical subjects

J C Cerdá

Publications and source records attributed to J C Cerdá.

3 recordsLinked to original sources

PubMed1999

Vocal cord dysfunction in a child.

Vocal cord dysfunction (VCD) involves paradoxical adduction of the vocal cord during the respiratory cycle. This usually occurs during inspiration, but can also be seen in expiration. Vocal cord appositioning produces airflow obstruction sufficient to cause wheezing, shortness of breath, chest tightness, and coughing. These symptoms often imitate the respiratory alterations of asthma, thus leading to inappropriate treatment; intubation or tracheotomy may prove necessary. An 11-year-old girl was admitted with intractable dyspnea. She had been diagnosed with atopic asthma, although she failed to respond to an increase in antiasthma medication, including high-dose oral steroids. Flow-volume loops were abnormal, with evidence of variable extrathoracic airway obstruction, manifested as a flat inspiratory loop. No structural abnormalities were seen with either computed tomography (CT) or magnetic resonance imaging (MRI). Fibroscopy revealed paradoxical adduction of the vocal cords during the respiratory cycle, no obstructive disorder being observed. After the diagnosis of VCD, the clinical manifestations resolved with psychiatric treatment. Adduction was not demonstrable at repeat fibroscopy after treatment. VCD may simulate bronchial asthma; it may also be associated with that disorder, thus masking the diagnosis. It should be suspected in patients with recurrent wheezing who fail to respond to usual asthma treatment. An early diagnosis avoids unnecessary aggressive management. Treatment should consist of respiratory and phonatory exercises; psychotherapy may be useful.

Asthma↗

PubMedDate not supplied

Prevalence of dermographism in children.

The prevalence of dermographism in our pediatric population was studied in 238 children of both sexes (128 boys and 110 girls) aged 2-14 years, randomly selected from a health care center. Skin reaction was evaluated after 5 min pressure (3,200 g/cm2) applied with a dermatographometer on a 5-cm length of dorsal skin. The reaction was considered positive when a wheal of more than 2 mm was observed. The prevalence of dermographism was found to be 24%, with a significant female predominance (33%) over males (16%). Forty-one percent of the children with dermographism reported exanthema in response to friction and pressure, which was compatible with symptomatic dermographism, compared with only 5% of those who yielded negative reactions. In order to assess the prevalence of dermographism in the atopic population, 100 patients in the 4-14 age range with respiratory disease (perennial allergic rhinitis and/or bronchial asthma) involving sensitization to aeroallergens (house dust mites and/or Alternaria) were studied. A positive response to the application of pressure (3,200 g/cm2) was observed in 47% of cases, this figure being significantly higher than in the general pediatric population.

Adolescent↗

PubMedDate not supplied

Lepidoglyphus destructor acarus in the urban house environment.

To assess the presence of Lepidoglyphus destructor in the household environment of sensitized children living in an urban environment, samples of house dust were collected at the homes where two groups of patients were living, as well as in two bakeries in the city of Valencia, which were taken as a reference. Patients were divided into two groups. Group A included atopic children suffering from rhinitis and/or asthma, who were sensitized to L. destructor, as proven by prick test and specific IgE (CAP). Group B included children with the same features as those included in Group A, who were sensitized to Dermatophagoides pteronyssinus, with prick and CAP tests showing no significant sensitization to L. destructor. The samples of dust were analyzed, and the amounts of Der p I, Der f I, Der II and Lep d I per gram of dust were assessed through a solid-phase ELISA with monoclonal antibodies. In Group A, all patients but two showed a sensitization to D. pteronyssinus by prick test and serum IgE. At the homes of the patients from both groups, significant levels of Dermatophagoides were found. In Group A, only three houses showed levels of L. destructor which were comparable to those found in bakeries. Lep d I was not found in the houses of Group B patients. This means that a sensitization to L. destructor, as assessed with full extracts, is not always an indicator of its presence at the patient's house environment; it may rather refer to cross-reactivity to Dermatophagoides. Thus, availability of the main antigen Lep d I seems necessary to increase the specificity of the allergologic study.

Adolescent↗