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Biomedical subjects

J M Negro Alvarez

Publications and source records attributed to J M Negro Alvarez.

15 recordsLinked to original sources
PubMedDate not supplied

Omalizumab. A review of the new treatment of allergic asthma and seasonal allergic rhinitis.

The causal role of immunoglobulin E (IgE) in triggering the cascade of biochemical events leading to allergic disease is well established. Treatments that selectively inhibit IgE activity are a logical approach in managing the allergic response. Omalizumab is a recombinant humanised monoclonal antibody which specifically binds to the Cε3 domain of immunoglobulin (Ig) E, the site of high-affinity IgE receptor binding. The clinical benefit and steroid-sparing effect of treatment with the anti-immunoglobulin-E (IgE) antibody, Omalizumab, was assessed in patients with moderate-to-severe allergic asthma and seasonal allergic rhinitis. Intravenous and subcutaneous administration of anti-IgE mAb reduces circulating levels of IgE in atopic patients to low levels commonly seen in non-atopic individuals. Anti-IgE therapy offers protection against allergen-induced bronchoconstriction, reduces the need for short acting inhaled beta 2-agonist and corticosteroids among asthmatic patients and reduces severity of symptoms of allergic rhinitis. Adverse events were infrequent in clinical trials of omalizumab, and not significantly different from placebo. The most frequent drug-related event was mild to moderate urticaria. They do not induce anaphylaxis and the occurrence of antibodies against anti-IgE mAb is sporadic. The results of cited studies suggest that humanized anti-IgE monoclonal antibodies may have important immunotherapeutic benefit for treatment of allergic disorders.

Anti-Allergic Agents↗
PubMedDate not supplied

Pressurised metered-dose inhalers (MDIs) versus dry powder inhalers devices (DPIs) to rapid-acting inhaled b2-agonists for asthma in children.

OBJECTIVE: To compare the clinical effectiveness of pressurized metered-dose inhalers (MDIs) with that of dry powder inhalers (DPIs) in delivering short-acting b2-agonists in children with asthma. METHODS: Searches were performed in Medline (1997-March 2002), the Cochrane Library Database and the Embase reference lists of review articles and clinical trials. In addition, the international headquarters of b2-agonist manufacturers were contacted. We performed a review of randomized controlled trials. RESULTS: Ten randomized controlled trials were included. No differences in clinical effectiveness were found between MDIs and PDIs. Two studies reported that fewer adverse events occurred when the Turbuhaler was used. Two long-term studies in children found that children preferred the MDI to the Rotohaler. CONCLUSIONS: 1) In stable asthma, short-acting b2 bronchodilators in standard MDIs are as effective as dry powder inhalers. 2) Pooling of results was limited by the small number of studies and therefore no overall conclusions could be drawn. 3) From the limited data available, we found little or no evidence for an additional clinical benefit of DPI devices over standard MDIs in children with asthma.

Adrenergic beta-Agonists↗
PubMedDate not supplied

Determination of eosinophil rate after nasal provocation test in allergic rhinitis diagnosis.

After nasal provocation test in patients with allergic rhinitis, using the allergen they were sensitized to, we have observed: 1) an increase in the percentage of nasal eosinophils after 2, 3, 24 and 48 hours; 2) sneezes, mainly in the first 30 minutes; 3) nasal obstruction in the first three hours; 4) absence of rhinorrhea, but not in all the patients; and 5) no predominance of nasal, auricular and/or palatine pruritus at any time. When patients without rhinitis, or with allergic rhinitis were stimulated using a pneumoallergen they were not sensitized to, no significative increase in the nasal eosinophils percentage was found. No symptoms were observed either. So, we can conclude that nasal secretion samples, for eosinophilia percentage determination, should be taken from 2 to 48 hours after nasal provocation, and that the most frequent symptoms, which are probably related to cellular changes, are nasal obstruction and sneezes.

Adolescent↗
PubMedDate not supplied

[Adverse reactions to food preservatives].

We relate our experiences about the number of exacerbations that certain food preservatives such as sorbic acid, benzoic acid, sodium benzoate, metabisulfite and sodium nitrate can provoke in 62 patients affected with ASA-triad in steroid dependent intrinsic asthma with nasal polyps and acute bronchospasm caused by aspirin ingestion, and in 80 patients with chronic urticaria (C.U.) as well as the first assays of the possible usefulness of the HRT (Histamine release test automatized using whole blood) for the etiologic diagnosis process. In the cases of ASA-triad, and after the ingestion of aspirin (alternating with lactose in identical capsule), we consider the result as positive when the reduction of FEV1 is superior to 20% from its baseline value. Regarding the cases of C.U., the symptoms always exacerbate twice as much with the same substance within 24 hours of its administration. We have performed the HRT on 59 patients (14 with ASA-triad, 11 with steroid dependent intrinsic asthma; 20 with C.U. were negative to oral intake of analgesics/additives and 14 with C.U. showed positive results). Successive dilutions were incubated for 30 minutes using: pyrazolones, acetylsalicylate of lysine, sodium salicylate, sodium benzoate and 4-hydroxybenzoic acid which did not produce liberation of histamine in 100 controlled individuals. All the determinations were done in duplicate, considering positive those superior to 20% of the difference between total and basal histamine. We have not observed any significant descent of the FEV1 with benzoate and salicylate in our group of 62 patients with ASA-triad, nor any manifestations presented with sodium metabisulfite, sodium nitrate and sorbic acid.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

Characterization of human peripheral blood lymphocyte cells on the basis of surface properties.

Human lymphocytes are divided into two populations, thymus-dependent or T-cells, required for cell-mediated immunity, and B-cells which are thymus independent and responsible for antibody-mediated immunity. Conventional light microscopy cannot differentiate between T and B lymphocytes, but the introduction and studies of lymphocyte membrane markers have shown a lymphocyte heterogeneity. In the present paper, various methods for characterization of human peripheral blood lymphocyte cells; based on surface properties, have been studied. Because of the membrane markers of receptors on human lymphocytes, the immune function of the subpopulations may be described. Functional studies may be performed on cell suspensions in which subpopulations are eliminated or concentrated by means of their respective membrane markers. The surface of various lymphocyte subpopulations are characterized by the presence of receptors for immune molecules, immunoglobulin, complement, hormones active in immune processes, prostaglandins and histamine. The presence of these receptors may allow for the participation of the lymphocyte in the various stages of immune processes.

Animals↗
PubMedDate not supplied

[Incidence of adverse reactions to additives. Our experience over 10 years].

No published information exists about the incidence of food additives reactions in the general population. Most studies have been made in patients with urticaria and bronchial asthma. The majority of them lack an adequate design and, therefore, the reported results should be interpreted with extreme caution. In this article, we expose our ten years experience in this field. We have added up 1941 oral provocation tests, with an ample battery of additives, administering the tested substances directly or in aqueous or acid solution (1110 in patients with urticaria, mainly chronic urticaria, and 831 in asthmatic subjects, with or without aspirin intolerance). From these exhaustive data, we get the following conclusions: 1) in contrast with other-investigators, and using similar or even higher provocation doses, we get a very low incidence of adverse reactions. 2) We are sceptical that food additives play any role in chronic urticaria or in other cutaneous processes (only 0.63% provocation tests resulted in an urticarial exacerbation, and none of them was repeated after re-provocation). 3) In asthmatic patients, similar results were obtained, except with sulfites in acid solution challenge test (10% asthmatic exacerbations), possibly as a sign of nonspecific bronchial hyperreactivity. 4) The prescription of food additives free restrictive diets does not seem to be justified. The should be followed only by those patients with clear evidence of additives reactions. 5) In most cases, with punctual exceptions, the study of food additives reactions, in clinical allergy, implies a waste of time.

Adult↗
PubMedDate not supplied

[Techniques for determining case mix and their application to Allergology. 1].

The use of adequate technics, in the Allergology case-mix evaluation, is a necessity in the present, and an aim to the future. Doing so, we shall be able to guarantee the quality of medical assistance. This article's objective is to introduce the reader, with a clear language, in the diverse procedures employed, in the actuality, to evaluate the diverse Health Services productive processes. We point out their advantages and disadvantages, and make a final proposal about the use of some of them in Allergology. Firstly, we analyze and describe the International Disease Classification (IDC-9-CM), the Diagnosis Related Groups (DRGs), the AS-SCORE, the Patients Severity Illness, the Staging Disease, the APACHE, and the Patients Management Categories. In the second part, we review the Generic Algorithms, the RUGs and the Ambulatory Visits Groups (AVGs). Finally, we propose some methods to improve activities in our specialty, to increase our knowledge, and to educate our colleagues under training in the basic concepts they need, to carry out their activities. In this way, we'll be able to guarantee a good assistance for the allergic patients, and to present objective data to the society, about the efficacy and efficiency with which public funds are used.

Allergy and Immunology↗
PubMedDate not supplied

[Techniques for determining case mix and their application to Allergology. 2].

In this second part, we review the Generic Algorithms, the RUGs and the Ambulatory Visits Groups, remarking their possible application in our specialty. In an Allergology Service, most resources are spent on outpatients attendance. This fact allows us to propose that a production unit of that Service (GFH) could develop its activities, in its health area, ambulatorily. Its objectives and responsibilities, together with its human and material resources, could be clearly defined. An allergy outpatients clinic basic technological requirements are scarce, its costs being mainly determined by those of the staff. This makes possible the application of algorithms, to obtain the AVGs in Allergology, and to calculate the "cost by process", with the use of an indirect cost imputation system. The systematic use of evaluation technics in our specialty case-mix is a necessity in the present, because it permits: 1) a correct planning, fixing and ordering the objectives; 2) a better user of resources; 3) an adequate request of budgets, according to production; 4) obtaining a clinical and epidemiological data base; 5) billing the services; 6) information to the customer (patient) about the expenses his attention has generated.

Algorithms↗
PubMedDate not supplied

Platelet-activating factor antagonists.

Platelet-activating factor (PAF), identified as 1-O-alkyl-2-acetyl-sn-glyceryl-3-phosphorylcholine, exhibits potent proinflammatory properties. PAF is produced by numerous cell types, including endothelial cells, neutrophils, monocytes, macrophages, basophils, eosinophils and mastocytes. Since the discovery and identification of the chemical structure of PAF, a large variety of specific PAF-receptor antagonists, both natural and synthetic compounds, have been described. Intensive research has been conducted and development programs set up by more 25 pharmaceutical companies world-wide, studying the therapeutic interest of more than 50 PAF-receptors antagonists in various pathophysiological conditions. Medline (1966-1996), Embase (Excerpta Medica; 1974-1996), and other biomedical and drug directory databases were searched to identify English-language articles (basic science, clinical trial research, and review articles) and abstracts of conference proceedings on PAF receptor antagonists and related terms. The most important PAF receptor antagonists are reviewed with their effectiveness in various experimental tests. Fundamentally, PAF antagonists may be divided in two groups: natural and synthetic compounds. Natural (Ginkgolides, Kadsurenone, Chantancin, Phomactin, Swietemohonin A, Prehispalone, THC-7-oic acid, Aglafoline, FR 900452, PCA 4248 and SCH 37370), and synthetic antagonists (CV-3988, CV-6209, SRI 63-072, SRI 63-441, UR-10324, UR-11353, E-5880, CL 184005, 6-Mono and Bis-aryl phosphate antagonists, TCV-309, Ro-74719, WEB 2086, Y 24180, BN 50726, BN 50727, BN 50730, BN 50739, Ro 24-4736, Ro 24-0238, RP 55778, RP 59227, RP 66681, YM 264, YM 461, SM 10661, SR 27417, UK 74505, BB 182, BB 823, BB 654, SDZ 64-412, SDZ 65-123, L 652731, L 659898, L 668750, L 671284, L680573, L 680574, CIS 19, ABT-299 and Pinusolide) have a great variability in their chemical structure that might have importance in their different pharmacological profile. The great majority of these drugs are under development, and only a few have undergone clinical trials.

Humans↗
PubMedDate not supplied

The role of rhinovirus in allergic airway inflammation.

Epidemiological data demonstrate that viral infections are the most important trigger for acute asthma symptoms in children, and this association persists in many adults with asthma. Studies on volunteers experimentally infected with rhinoviruses (RV) suggest that atopy alone does not predispose to unusually severe symptoms. In contrast, experimental models combining viral infection and allergen exposure have identified potential links between virus-induced and allergen-induced inflammation. While in vitro studies suggest that cytokines may be an important part of this association, their role must be verified by sampling lower airway fluids and tissues in vivo after experimental and/or natural rhinovirus infections. Although it has long been recognized that the common cold is a potent trigger for symptoms of asthma, the mechanisms underlying the association between upper respiratory infection and increased lower airway obstruction remain obscure. The use of experimental infection of volunteers with or without respiratory allergies has enabled direct comparisons of common cold symptoms in these two groups. Furthermore, techniques such as bronchoalveolar lavage and segmental antigen challenge have been used to directly sample lower airway fluids and tissues during acute viral infection.

Bronchitis↗