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Biomedical subjects

J L Estrada Rodríguez

Publications and source records attributed to J L Estrada Rodríguez.

11 recordsLinked to original sources
PubMed1991

Hypocomplementemic urticarial vasculitic syndrome, asthma and anaphylactic reaction with ampicillin.

A patient with hypocomplementemic urticarial vasculitic syndrome (HUV) is presented. This is an immunological pathology, limited to skin or multisystemic, that requires a differential diagnosis with erythematosus systemic lupus on the same occasions. The ever-present symptom is skin participation, such as urticaria-angioedema or fixed exanthema; biopsy shows necrotizing venulitis with polymorphonuclear infiltration and leukocytoclastic powder. Typical laboratory data are: diminished C3, C4 and C1q; C1 inhibition can be low or normal; the more characteristic finding is the presence of C1q associated immunocomplexes. Leukocytoclastic necrotizing vasculitis was found in the skin biopsy. During the course of illness (three years) the patient presented moderate cutaneous symptoms and asthma, without other systemic participation. During this period, antihistamines and, occasionally, corticoids were administered with improvement. Moreover, the patient presented urticaria related to ampicillin ingestion, and furthermore, the presence of anaphylaxis to beta-lactam was diagnosed in vivo and specific IgE was found in the laboratory study. This feature was previously observed by other authors; however, we cannot determine why the IgE-mediated allergy to beta-lactam and a complement pathology like HUV are related.

Adult↗
PubMed1991

Short-term treatment of asthma with budesonide versus placebo.

The effects of the topical steroid budesonide on bronchial hyperreactivity were evaluated in a patient group (A, n = 17) and a placebo-controlled patient group (B, n = 11). Group A was given budesonide 400 micrograms/12 h for 4 weeks and 200 micrograms/12 h for four more weeks. The drug proved efficient in controlling asthma clinically and improving the spirometric parameters: FVC (p < 0.05), FEF50 (p < 0.05) and FEV1 (p < 0.01). Bronchial hyperreactivity (PD20) decreased moderately in the treatment group (p < 0.1). On the contrary, basal spirometry and PD20 worsened in the control group. Some patients in group A showed peripheric eosinophilia (2/15) or in secretions (9/15), which persisted in one patient at end of treatment. Budesonide was effective in the clinical and spirometric control of asthma. We conclude that for a better assessment of the treatment of bronchial hyperreactivity with budesonide, the drug must be administered for a longer period of time. The differences between this study and previous ones is that the improvement in PD20 can be explained by the different characteristics of the patients selected for this study.

Administration, Topical↗
PubMedDate not supplied

Patient satisfaction and allergen immunotherapy.

Although health-related quality of life and patient satisfaction are shifting doctors' attention to the patient, the scant number of publications on quality of life questionnaires and allergen immunotherapy contrasts with the quickly growing number of those dealing with this topic and pharmacotherapy. We delivered an original, self-administered patient satisfaction questionnaire to 95 patients (age = 17.7 +/- 7.9 years) suffering from allergic rhinoconjunctivitis (45%) and/or asthma (55%), who had been receiving allergen immunotherapy for more than 1 year (22.2 +/- 10.5 months). The anonymous, voluntary questionnaire was filled in at home; although only 32% were returned, we found no significant differences relating to age, sex, asthma, allergen sensitization or allergen immunotherapy regimen between the source sample and those who replied. Patient expectations, which were scored on a scale of 1 to 10 points, were rather poor, in sharp contrast with patient perception score after treatment (5.4 +/- 1.8 vs. 8.0 +/- 2.0, p < 0.0001). Perception scores did not differ between patients receiving seasonal or perennial allergen immunotherapy, nor did they depend on the duration of treatment. In addition, patient age, sex, diagnosis or sensitization did not appear to influence perceptions. In conclusion, our data suggest that when a voluntary, anonymous questionnaire is used, patients express a poor opinion of allergen immunotherapy, in contrast with high satisfaction after treatment, provided that allergen immunotherapy lasts long enough.

Adolescent↗
PubMedDate not supplied

Asthma in children and ASA intolerance.

Intolerance to acetylsalicylic acid (ASA) in asthmatics has been widely studied in the adult population, and to a lesser extent in children. In the present study, we present 16 asthmatics between the ages of 2 and 14 suffering from asthma induced by ASA ingestion, and the clinical characteristics are compared with a population of asthmatic children with a negative challenge test. The following results were obtained: 1) in contrast to in adults, females are not predisposed to ASA intolerance in childhood, the male:female ratio being the usual 2:1 in infantile asthma; 2) ASA intolerance can appear at a very early age (in our series the youngest was 1 year old); 3) extrinsic asthmatics are the most commonly affected, and also children with exercise-induced asthma; 4) in extrinsic asthmatics with asthma attacks precipitated by ASA, sinusitis is more frequent than in extrinsic asthmatics with ASA tolerance; 5) polyposis is exceptional; 6) the presence of associated urticaria is frequent, and much greater than in adult ASA-intolerant asthmatics; and 7) the results of the challenge with NSAIDs are similar to those obtained in adult patients, which would indicate a common pathophysiological mechanism related to the capacity of these drugs to inhibit cyclooxygenase activity.

Adolescent↗
PubMedDate not supplied

Sensitization to Anisakis simplex: an unusual presentation.

It has recently been published patients suffering from urticaria or anaphylaxia induced by nematodes usually parasitizing fishs or cephalopode, in whom, Anisakis simplex (AK) sensitization prevalence was detected up to 37%. We tried out a prospective study to evaluate the presence of AK specific-IgE in an asthmatic population, comparing to other group of patients with urticaria. Complaints related to food ingestion were recorded in both, and dietetic measures were advised. Thirteen patients (13/66; 20%) showed AK specific IgE. Nine of them were asthmatics (p < 0.01), and only 4 suffered from urticaria. Four patients, three of them asthmatics, could link symptoms after fishs, cephalopode or, surprisingly, seafood intake, including epigastralgia, rhinorrhea, conjunctivitis, hives, and dyspnea. Atopia was not a consistent status, only five AK sensitized patients also did to common inhalants (all skin prick-test positive to house dust mites). Asthmatic AK-sensitized patients were older than non AK-sensitized asthmatics (46.23 vs 30.1; p < 0.05). The way of sensitization could be inhalative or through digestive mucosa parasitization by live larvae. Possibility that an AK allergen can play a role in adult asthma, should be considered specially in countries with high fish or seafood diet content.

Adolescent↗