Analysis of the inhalant allergen spectrum in 4 488 children with allergic rhinitis in Tianjin / 中华实用儿科临床杂志

Objective:To investigate the types and characteristics of inhalant allergens in children with allergic rhinitis (AR) in Tianjin, and to provide foundation for the prevention and treatment of AR in children.Methods:The data of 4 488 patients with AR at the Pediatric Asthma and Allergy Clinic of the Second Hospital of Tianjin Medical University from March 2016 to February 2022 were collected and analyzed retrospectively in this study.The distribution features of inhalant allergens in AR children were explored.The relationship between the positive results of inhalant allergens and the gender, age and other comorbid allergic diseases was discussed.Serum allergen-specific immunoglobulin E (sIgE) was determined using the UniCAP100 system(fluorescent enzyme-linked immunoassay). Enumeration data were expressed as the number of cases and percentage (%), and data were compared between groups by χ2 test. Results:(1)In the serum of 4 488 AR patients, 3 116 cases were positive for inhalant allergens, with a positive rate of 69.43%.There were 28.47%(887/3 116) AR patients positive for 1 allergen, 25.22%(786/3 116) positive for 2 allergens, 19.67%(613/3 116) positive for 3 allergens, and 26.64%(830/3 116) positive for 4 or more allergens.The most common inhalant allergens were moulds (45.72%, 2 052/4 488), followed by dermatophagoides farinae (34.71%, 1 558/4 488), mugwort (33.95%, 313/922), dermatophagoides pteronyssinus (31.13%, 1 397/4 488), and ragweed (30.97%, 227/733). (2)The positive rates of inhalant allergens in preschool, school age and adolescent groups were 56.15%(1 132/2 016), 79.26%(1 624/2 049) and 85.11%(360/423), respectively ( χ2=309.72, P<0.001). The most common inhalant allergen in the preschool and school age groups was moulds (40.23%, 50.85%). In the adolescent group, dermatophagoides farina (56.74%) was the predominant inhalant allergen, followed by dermatophagoides pteronyssinus (53.66%) and moulds (47.04%). There were significant differences in the types of positive inhalant allergens among the 3 groups ( χ2=466.99, P<0.001). Children in the preschool group were mostly positive for single allergens, while those in the school age and adolescent groups were positive for 4 or more inhalant allergens.(3)The positive rate of inhalant allergens in boys reached 73.28%(2 139/2 919), significantly higher than that in girls (62.40%, 979/1 569) ( χ2=58.28, P<0.001). The top 3 common inhalant allergens in boys and girls were moulds, dermatophagoides farinae, and dermatophagoides pteronyssinus.There were significant differences in the types of positive inhalant allergens between boys and girls ( χ2=75.02, P<0.001). About 20.78% of the girls were positive for single allergens, and 20.45% of the boys were positive for 4 or more allergens.(4)The AR group complicated with asthma and atopic dermatitis had the highest positive rate (79.21%)of inhalant allergens, followed by AR patients with asthma (73.67%), AR patients with atopic dermatitis (61.05%) and AR patients (57.05%) successively.There were significant differences between the groups ( χ2=178.57, P<0.001). Conclusions:The main inhalant allergens in AR children in Tianjin are moulds, dermatophagoides farinae, mugwort, dermatophagoides pteronyssinus, and ragweed.The distribution characteristics of inhalant allergens vary with the age, gender and combined allergic diseases.Allergens should be detected for AR children as soon as possible, so as to prevent AR in advance, reduce drug use, and provide evidence for specific allergen immunotherapy.

Correlation between house dust mites’ sensitization and allergic diseases - A retrospective study of Saudi Arabia

Background: Globally, inhalant allergen sensitization (IAS) in allergic diseases (ADs) is commonly associated with indoor allergens, mainly house dust mites (HDMs). Objective: The objective of this study was to determine the association between HDM sensitization (HDM-SN) and ADs. Materials and Methods: A retrospective study was conducted which included all patients with allergies, >15 years of age, and seen over a 1-year period at the Allergy Center, Lalune clinics, Jeddah, Saudi Arabia. Results of serum specific immunoglobulin E (sIgE) to 30 common inhalant allergens (INHs) were collected by medical students. Severity of sensitization was classified as 1–6 (1–2 being mild, 3–4 being moderate, and 5–6 being severe). Medical records of patients with HDM-SN were reviewed to determine any clinical diagnosis of ADs and other associated IAS. Results: A total of 55 adults with HDM-SN, 34 males (62%) and 21 females (38%), with an age range of 15>56 years were studied. ADs associated with HDM-SN were allergic rhinitis (AR) (27%), asthma (22%), allergic conjunctivitis (AC) (18%), atopic dermatitis (ATD) (16%), allergic sinusitis (9%), and chronic urticaria (8%). The average severity class of HDM-SN in our sample was moderate (Dermatophagoides pteronyssinus [2.3] and Dermatophagoides farinae [2.2]). Other IAS found to be associated with HDM-SN were cockroaches (13.86%), Alternaria (12.4%), cats (12.4%), Bermuda (11.67%), and mesquite (10.21%). Conclusion: Average HDM-SN severity class was moderate in the studied group of patients (early to middle adult ages). HDM-SN is always associated with other IAS (INH-SNs) which explains the importance of obtaining an all-INH panel in patients with HDM-SN. IAS which most frequently had an association with HDM-SN was cockroaches, Alternaria, and cats with two outdoor allergens Bermuda, and mesquite, following closely. HDM-SN is usually associated with multiple ADs mainly involving INHs including AR, asthma, and AC, and less commonly ATD, sinusitis, and chronic urticaria.

Comparison of continuous intravenous infusion of tramadol and tramadol-lidocaine-ketamine in the sevoflurane requirement in dogs / Comparação da infusão continua intravenosa de tramadol e de tramadol-lidocaína-cetamina no requerimento de sevofluorano em cães

The objective of this study was to compare the influence of continuous intravenous infusion of tramadol alone, or tramadol combined with lidocaine and ketamine, on minimum alveolar concentration of sevoflurane (MACsevo) of dogs undergoing an ovariohysterectomy (OHE). We used 28 healthy dogs of various breeds and age, randomly divided into two groups according to the infusion given: TRA (tramadol alone) or TLK (tramadol, lidocaine and ketamine). The patients were premedicated with acepromazine and midazolam, and then anesthesia was induced with propofol and maintained with sevoflurane. Fifteen minutes after induction, the patients received their loading dose of treatment. Then, the continuous infusion was then set to 1.3mg/kg/hour of tramadol with or without 3mg/kg/hour of lidocaine and 0.6mg/kg/hour of ketamine, diluted in a 500mL bag of saline solution at an infusion rate of 10mL/kg/hour. The Dixon method was chosen to determine the MACsevo and a skin incision was used as a noxious stimulus. An unpaired Student's t-test was used to identify statistically significant differences between the treatments. These differences were considered significant when p<0.05. The MACsevo of the TRA group was 1.22±0.15 vol% and the MACsevo of the TLK group was 0.85±0.22 vol%. We conclude that TLK infusion decreased the MACsevo by 30.22% compared to tramadol alone, demonstrating that the combination of drugs was effective in reducing MACsevo in dogs.(AU)

O objetivo deste estudo foi comparar a influência da infusão contínua intravenosa do tramadol isolado e associado com lidocaína e cetamina, na concentração alveolar mínima de sevofluorano (CAMsevo) em cadelas submetidas à ovariosalpingohisterectomia. Foram utilizados 28 animais saudáveis de várias raças e idades, divididos aleatoriamente em dois grupos de acordo com a infusão adminstrada: TRA (tramadol) ou TLK (tramadol, lidocaína e cetamina). A medicação pré-anestésica foi realizada com acepromazina e midazolam, em seguida, a anestesia foi induzida com propofol e mantida com sevofluorano. Quinze minutos após a indução, os pacientes receberam um bolus do tratamento, com a infusão continua iniciada logo em seguida, sendo 1,3mg/kg/hora de tramadol, associado ou não a 3mg/kg/hora de lidocaína e 0,6mg/kg/hora de cetamina, diluidos em uma bolsa de solução salina de 500mL a uma taxa de infusão taxa de 10ml/kg/hora. O método de Dixon foi escolhido para determinar a MACsevo e a incisão na pele foi utilizada como o estímulo nocivo. O teste t de Student não pareado foi utilizado para identificar diferenças estatisticamente significativas entre os tratamentos. Estas diferenças foram consideradas significativas quando p<0,05. A CAMsevo do grupo TRA foi de 1,22±0,15vol% e a CAMsevo do grupo TLK foi de 0,85±0,22vol%. Conclui-se que a infusão de TLK diminuiu a CAMsevo em 30,22% em relação ao tramadol isolado, o que demonstra que a combinação de agentes analgésicos foi eficaz na redução do requerimento de sevofluorano em cães.(AU)

No Laughing Matter: ‘Laughing Gas’ Addiction In Singapore

Recreational use of nitrous oxide (N2O) or ‘laughing gas’ inhalation is a common phenomenon in countries like UK and US where it is associated with music festivals and parties. However, as far as we know, recreational N2Ouse in Singapore has hitherto not been reported in the press or scientific journals. We report the first case of N2O use and addiction in a young Singaporean male who was introduced to it by a friend from a Western country where its use is prevalent. Methods: A 20-year-old Singaporean male with an existing psychiatric diagnosis of Major Depression presented with a 3-year history of solitary regular N2O inhalation that escalated from infrequent low dose use to the daily highdose use which he was unable to control. He exhibited symptoms of dependence, which included preoccupation, tolerance, withdrawal, craving and difficulty in cutting down. No major adverse medical complications were noted. Results: The patient was assessed to have Nitrous Oxide Dependence and was given regular individual counselling sessions with a trained addictions counsellor to motivate him to cut down his use in the short-term and to stop completely in the longer term. Conclusion: This case highlights not only the first reported case of N2Ouse and dependence in Singapore but also the first case seen in a Singapore national addictions treatment facility. Doctors, families, schools, and the community in general need to be aware of, and be prepared for, this practice that has come to Singapore and the region. While extant literature suggests that dependence is uncommon, we report the first case that clearly demonstrated psychological dependence. ASEAN Journal of Psychiatry, Vol. 18 (1): January – June 2017: XX XX

Death Related to Nitrous Oxide Abuse: Two Cases Report / 대한법의학회지

Nitrous oxide is medically used as an anesthetic gas and as an additive in whipped cream production. Few cases of death from nitrous oxide intoxication have been reported in Korea. However, fatalities due to inhalation of pure nitrous oxide in an amount enough to cause death have been recently increasing. We report two cases of death related to nitrous oxide abuse with a review of literature focusing on the fact that nitrous oxide abuse can be considered as a possible cause of death if appliances with nitrous oxide contents were found during the investigation, and the autopsy and toxicological findings cannot be attributed to nitrous oxide intoxication.

Las aportaciones de 40 años de investigación epidemiológica en México sobre consumo de solventes inhalables / Contributions from 40 years of epidemiological research on inhalant use in México

RESUMEN: Antecedentes: El estudio del consumo de solventes inhalables en México se inició en la década de 1970 y a pesar de que por periodos ha disminuido el interés en el mismo, éste no ha desaparecido y debido a que el consumo prevalece entre la población joven, es relevante actualizar el estado del arte en la materia. Objetivo: Identificar el estado del conocimiento sobre los solventes inhalables, las consecuencias, las alternativas de prevención y su tratamiento en las cuatro últimas décadas en México. Método: Se realizó una búsqueda bibliográfica entre agosto y septiembre de 2014, de los artículos publicados entre 1970 y 2014 sobre el consumo de solventes inhalables en México. Se integraron publicaciones incluidas en el archivo histórico de la Dirección de Investigaciones Epidemiológicas y Psicosociales, en la revista SALUD MENTAL, Medline, Elsevier y Scielo México. Resultados: Se identificaron 1083 artículos, 83 cumplieron con todos los criterios para ser incluidos en el análisis. Estos trabajos se realizaron en diferentes poblaciones: grupos marginales, integrantes de bandas juveniles, niños en situación de calle, adultos y menores recluidos en centros de detención, sexoservidoras, personas que acuden a solicitar tratamiento, estudiantes y población general. Discusión y conclusión: Se identificaron diferentes aspectos relevantes de la población consumidora de solventes inhalables en nuestro país, así como acciones pendientes en materia de investigación, con lo que se pueden desarrollar programas de prevención y tratamiento que atiendan las necesidades específicas de estos grupos, ya que son pocos los programas existentes y algunos no han tenido seguimiento o evaluación.

ABSTRACT: Background: The study about the misuse of inhalant solvents started in Mexico during the 1970, although the interest in this subject decreased during some periods, its consumption continued among the young population, thus, it is relevant to update the state of the art on this matter. Objective: Identify the state of knowledge on inhalant abuse, its consequences, prevention and the treatment alternatives in Mexico in the last four decades. Method: We performed a bibliographical inquiry between August and September 2014 on the papers published between 1970 and 2014 about inhalant solvents consumption in Mexico. It integrated the publications included in the historical archive of the Epidemiological and Psycho-social Research Direction, Mental Health Journal, Medline, Elsevier and Scielo México. Results: After revision, 83 out of 1083 papers fulfilled all the criteria that we considered for inclusion in the analysis. This body of work has been performed on different population segments: marginalized groups, juvenile gang members, children in street situation, adults and minors secluded in detention centers, sex workers, people seeking treatment, students, and the general population. Discussion and conclusion: The several relevant aspects of the consumer population of inhalant solvents in Mexico were identified. Detection of this ample profile of individuals at risk could serve as the basis for the development of prevention and treatment programs to attend to the specific needs of these groups, since the programs currently in progress are scarce and some of them have not had follow up assessments or have not been evaluated at all.

El consumo de solventes inhalables en la festividad de San Judas Tadeo / Solvent inhalants use in the San Judas Tadeo feast

INTRODUCCIÓN: A San Judas Tadeo se le considera en México el patrón de las causas difíciles y desesperadas. Entre las creencias populares, se piensa que los "niños en situación de calle" se acogen a él para que les proteja y ayude a dejar de consumir drogas. OBJETIVO: Conocer el espacio social del uso de solventes inhalables en el marco del culto a San Judas Tadeo, a partir las prácticas y experiencias vividas con los niños en situación de calle de la zona del Centro Histórico de la Ciudad de México. MÉTODO: Se aplicó la metodología conocida como "Lugares de Reunión" propuesta por Hughes y adaptada por Ortiz, en un periodo de trabajo que abarcó del año 2011 a inicios del 2014. Se utilizó la observación no participante y la participante, así como la entrevista no estructurada a informantes no calificados, a calificados y a clave. RESULTADOS: Se documentaron 22 celebraciones del día de San Judas incluyendo dos fiestas anuales. Se entrevistaron a más de 300 usuarios de solventes inhalables y los resultados mostraron, entre otras cosas, que la edad promedio es de 25 años, que se desempeñan en subocupaciones informales y a la mendicidad en la vía pública. Todos consumen activo, pero con diferencias en la intensidad, con periodos alternantes de consumos altos y bajos y consideran que es prácticamente imposible dejar de consumirlo. DISCUSIÓN Y CONCLUSIÓN: El vínculo entre el consumo de inhalables y el culto a San Judas Tadeo en los niños en situación de calle, es ficticio.

INTRODUCTION: San Judas Tadeo is the patron saint of the difficult and desperate causes. Among popular beliefs, it is supposed that street kids pray to him and that he helps them quit the use of drugs. OBJECTIVE: Understanding the phenomenon of the misuse of solvents in the context of the san Judas Tadeo festivity among street children living in the Historical Center zone of Mexico City. METHOD: The "Meeting places" methodology developed by Hughes and adapted by Ortiz was applied from 2011 to 2014. Non-participant and participant observations, as well as unstructured and structured interviews to key informants were conducted. RESULTS: Twenty-two festivities of san Judas Tadeo were documented, and more than 300 solvent users were interviewed. The average age was 25 years. They were unemployed and begged for money. All of them were activo users which they administered with monas. They usually did it in binge patterns: use - non use, high - low use. DISCUSSION AND CONCLUSION: The link between the consumption of inhalants and the cult of St. Jude in children living in the streets is fictitious.

Pulse pressure variation and stroke volume variation under different inhaled concentrations of isoflurane, sevoflurane and desflurane in pigs undergoing hemorrhage

OBJECTIVES: Inhalant anesthesia induces dose-dependent cardiovascular depression, but whether fluid responsiveness is differentially influenced by the inhalant agent and plasma volemia remains unknown. The aim of this study was to compare the effects of isoflurane, sevoflurane and desflurane on pulse pressure variation and stroke volume variation in pigs undergoing hemorrhage. METHODS: Twenty-five pigs were randomly anesthetized with isoflurane, sevoflurane or desflurane. Hemodynamic and echocardiographic data were registered sequentially at minimum alveolar concentrations of 1.00 (M1), 1.25 (M2), and 1.00 (M3). Then, following withdrawal of 30% of the estimated blood volume, these data were registered at a minimum alveolar concentrations of 1.00 (M4) and 1.25 (M5). RESULTS: The minimum alveolar concentration increase from 1.00 to 1.25 (M2) decreased the cardiac index and increased the central venous pressure, but only modest changes in mean arterial pressure, pulse pressure variation and stroke volume variation were observed in all groups from M1 to M2. A significant decrease in mean arterial pressure was only observed with desflurane. Following blood loss (M4), pulse pressure variation, stroke volume variation and central venous pressure increased (p <0.001) and mean arterial pressure decreased in all groups. Under hypovolemia, the cardiac index decreased with the increase of anesthesia depth in a similar manner in all groups. CONCLUSION: The effects of desflurane, sevoflurane and isoflurane on pulse pressure variation and stroke volume variation were not different during normovolemia or hypovolemia.

Inhalant Dependence: Is There A Role Of Achieving Abstinent Through Supported Employment? A Case Report

Objective: This case report highlights the success of community services and supported employment program that may be of help to a woman with chronic inhalant use to achieve a complete abstinence. Methods: We report the case of a 45 year old lady who chronically abused glue, presented after 10 years with substance induced psychosis and comorbid mood disorder. Results: Abstinent from inhalant dependence was achieved after series of home treatment services and supported employment program. Conclusion: Provision of acute community service and incorporating this patient in supported employment program contribute to her successful journey in achieving abstinence from inhalant dependence.

Profile of inhalant users seeking treatment at a de-addiction centre in north India.

Background & objectives: Inhalants are substances whose chemical vapors are inhaled to produce euphoric, disinhibiting, and exciting effects. Data on inhalant abuse in India are relatively scarce. We report the demographic and clinical profile of inhalant users among the treatment seekers at a Drug De-addiction and Treatment Centre in north India. Methods: The records of treatment seekers at the Drug De-addiction and Treatment Centre, over 10 years (2002-2011) were scanned to identify 92 cases reporting inhalant use. Of these 92 cases, the complete record files were available for 87 (94.6%) cases. These case files were reviewed and the relevant data were collected and analyzed. Results: Over the study period of 10 years, the number of cases with inhalant abuse per year rose steadily to peak at 20 cases (4.08% of new cases) in 2006 and then stabilized at 1-3 per cent of new cases annually. Of the 87 cases studied, all were males with a mean age of 18.9±4.12 yr, mean education of 9.8±3.42 yr and mean family income of ` 7676±7343.15 (median: ` 5000). Majority of subjects were unmarried (89.7%), urban resident (79.3%), and from a nuclear family (78.2%). About half of the subjects were students (50.6%). The most common inhalant used was typewriter correction fluid (73.6%) followed by typewriter diluent fluid (19.5%) and glue (6.9%). The most common reason for initiation was curiosity. The mean age of onset of inhalant use was 16.3±4.22 yr. Most subjects fulfilled the criteria for inhalant dependence (85.1%). Psychiatric co-morbidity and the family history of substance dependence were present in 26.4 and 32.9 per cent subjects, respectively. Majority of the subjects reported drug related problems, occupation and finance being the worst affected. Interpretations & conclusions: oOur results showed that the inhalant users were mostly urban youth belonging to middle socio-economic class families. The principal sources of inhalant abuse were the commonly available substances like typewriter correction fluids and majority of the subjects initiated it out of curiosity. Nearly three-fourth of the subjects used some other substance of abuse in addition, tobacco being the most common. In view of associated drug related problems, there is a need for strategies to prevent this emerging health care problem.

Inhalant abuse- A rising public health problem.

These days inhalant abuse is common in both rural and urban settings. Laymen and professionals alike are negligent of this abuse. It is widely seen in children and can sometimes follow into adulthood too. Children try it out initially due to their anxiousness but later on get addicted to it. Parents are more worried about their children being exposed to drugs like cocaine and marijuana. But the fact is that children are more addicted to the inhalants that are commonly found in household things. Even a single episode of inhalant abuse can result in serious health problems. It can seriously impair the vital organs like heart, brain and kidneys. Repeated abuse is seen due to the elated feel that they experience after its use that resembles alcohol consumption. It produces initial excitation, drowsiness, disinhibiting, wooziness and agitation. In order to prolong the period of intoxication, they abuse repeatedly which in severe cases can even lead to death. Other causes of death can be due to suffocation, seizures, and coma or due to choking. Detoxification programs along with proper support and care from the family and friends will help the abusers to bring back the lost colour in their life. A systemic review of various electronic bibliographic by utilizing suitable search terms were used to obtain the data.

Sensitization rates to inhalant allergens in children and adolescents of Incheon and Asan area and the relationship between polysensitization and prevalence of allergic diseases

PURPOSE: Sensitization to allergens is considered as major mechanism of allergy and related to the development of allergic diseases. The objective of this study was to evaluate overall sensitization rates of inhalant allergens and the relationship between polysensitization and prevalence of allergic diseases in children and adolescents. METHODS: A cross-sectional pilot study of 122 elementary school students, 114 middle school students, and 115 high school students from Incheon and Asan was conducted by using the International Study of Asthma and Allergies in Childhood (ISSAC) questionnaire. The skin prick tests were performed with 14 common inhalant allergens on 339 students. RESULTS: The inhalant allergen that has a significantly different sensitization rate according to age was Dermatophagoides farinae. And the inhalant allergen that has significantly different sensitization rate according to region was Japanese hop. In addition, girls have higher sensitization rate to any mold allergens than boys. In case of having sensitization more than two allergens, the risks of diagnosis of asthma and allergic rhinitis on questionnaire were increased. Asthma is related to sensitization of dog or cat and allergic rhinitis is related to sensitization of house dust mites. However, atopic dermatitis is not related to sensitization of any inhalant allergens. CONCLUSION: The sensitization rates of inhalant allergens may differ among age, gender, and region in children and adolescents of Incheon and Asan area. The polysensitized children and adolescents with inhalant allergens showed higher prevalences of allergic diseases such as asthma and allergic rhinitis on questionnaire than monosensitized group.

Assessment of Total/Specific IgE Levels Against 7 Inhalant Allergens in Children Aged 3 to 6 Years in Seoul, Korea

PURPOSE: Childhood allergies are a serious problem, as they may lead to lifetime chronic disease. Determination of total and specific IgE levels is known to be a diagnostic tool for allergic sensitization; however, IgE levels are affected by various factors, such as age, sex, ethnicity, and geographic area. Thus, we evaluated the distribution of total and specific serum IgE levels against seven inhalant allergens in preschool children and examined their association with allergic diseases in Seoul, Korea. METHODS: Total/specific serum IgE determination and skin prick tests for seven common allergens were performed on 509 children aged 3 to 6 years from 16 child care centers in Seoul, Korea. Demographic characteristics were surveyed from parents using a modified International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. A diagnosis of atopic dermatitis was made by physicians. RESULTS: The geometric mean of total IgE was 80.48+/-3.80 kU/L in preschool children. IgE levels were higher in boys (boys, 102.34+/-3.52 kU/L; girls, 62.37+/-3.93 kU/L; P<0.001) and atopic subjects (atopic, 158.00+/-3.35 kU/L; non-atopic, 52.75+/-3.44 kU/L; P<0.001). An increased prevalence of atopy was associated with a high monthly household income (P=0.004) and higher maternal education level (above university-level education; P=0.009), as well as increased total IgE levels (P=0.036). Physician-diagnosed atopic dermatitis was associated with sensitization to inhalant allergens. CONCLUSIONS: Total IgE levels were very high as compared with those in previous reports from other countries. The most common sensitized allergen was Dermatophagoides farinae, and the positive response rate peaked at age 3 years and was maintained thereafter, particularly in boys. Specific IgE levels for seven inhalant allergens varied with age in preschool children. Although further investigations are needed with a broad range of ages and various allergens, the distribution of the total and specific serum IgE levels in preschool children might help to serve as a reference value to diagnose atopy.

Síndrome de Townes-Brocks, depresión y adicción a inhalantes: a propósito de un caso / Townes-Brocks syndrome (TBS), major depression and inhalant addiction: a case report

El síndrome de Townes-Brocks (TBS) es un trastorno autosómico dominante con múltiples malformaciones y de expresión variable. Presentamos el caso de una mujer de 22 años de edad con malformaciones en el oído externo, ano imperforado, riñones en herradura, desviación cubital del pulgar, sindactilia en los dedos de ambos pies, estrabismo, útero bicorne y retardo mental; quien desarrolló distimia, depresión mayor y adicción a inhalantes.

Townes-Brocks syndrome (TBS) is an autosomal dominant disorder with multiple malformations and variable expression. We present a case of a 22-year-old woman with external ear malformations, imperforate anus, renal fusion, ulnar deviation of the thumbs, syndactyly in toes, strabismus, uterus bicornis and mental retardation who developed dysthymia, major depression and inhalant addiction.

Minimum alveolar concentrations and hemodynamic effects of two different preparations of sevoflurane in pigs

BACKGROUND: Original sevoflurane (Sevo A) is made with water, while a generic sevoflurane (Sevocris) is produced with propylene glycol as a stabilizing additive. We investigated whether the original and generic sevoflurane preparations differed in terms of their minimum alveolar concentration (MAC) values and hemodynamic effects. METHODS: Sixteen pigs weighing 31.6±1.8 kg were randomly assigned to the Sevo A or Sevocris groups. After anesthesia induction via mask with the appropriate sevoflurane preparation (6 percent in 100 percent oxygen), the MAC was determined for each animal. Hemodynamic and oxygenation parameters were measured at 0.5 MAC, 1 MAC and 1.5 MAC. Histopathological analyses of lung parenchyma were performed. RESULTS: The MAC in the Sevo A group was 4.4±0.5 percent, and the MAC in the Sevocris group was 4.1±0.7 percent. Hemodynamic and metabolic parameters presented significant differences in a dose-dependent pattern as expected, but they did not differ between groups. Cardiac indices and arterial pressures decreased in both groups when the sevoflurane concentration increased from 0.5 to 1 and 1.5 MAC. The oxygen delivery index (DO2I) decreased significantly at 1.5 MAC. CONCLUSION: Propylene glycol as an additive for sevoflurane seems to be as safe as a water additive, at least in terms of hemodynamic and pulmonary effects.

Identification of Dioscorea Batatas (Sanyak) Allergen as an Inhalant and Oral Allergen

Dioscorea batatas is widely used in Asia as a herbal medicine or food product with potential health benefits. There have been several reports of occupational asthma caused by inhalation of D. batatas dust. However, there has been no report of systemic allergic reactions after oral administration of D. batatas. Two patients with D. batatas allergy were enrolled. One had experienced severe urticaria and angioedema after indigestion, and the other had been exposed to D. batatas dust and was diagnosed as having occupational asthma. Both patients had high serum-specific IgE and IgG4 antibodies to D. batatas. And IgE immunoblot demonstrated that both sera bound to a 27-kDa protein with an IgE-binding motif, which was revealed by 2-D-electrophoresis to have the sequence Asn-Val-Glu-Asp-Glu-Phe-Ser-X-Ile- Glu-Gly-Asn-Pro-X-X-Pro-Glu-Asn-X-Gly (pI 6.40, 6.04). In conclusion, discorin from D. batatas (DB3S) was identified as the major allergen of D. batatas in patients sensitized via an oral or inhalant route.

Analysis of allergen sieving detection results and clinical significance in children with asthma / 中国医师进修杂志

Objective To explore the clinical use of sieving detection about inhalant allergens and fx5E in the CAP anaphylactogen detection system among the pathogen diagnosis of childhood asthma. Methods Two hundred and fifty cases of childhood asthma all received the sieving detection about allergen inhalant allergens and fx5E in the CAP anaphylactogen detection system which was produced by Sweden Pharmacia Company. The test's results were compared between age, sex, season, hypersensitive history and family hypersensitive history. Results Total positive ratio of CAP allergen was 82.80%, positive ratio of inhalant allergens was 79.20%, positive ratio of fx5E was 32.40%. The positive rate of inhalant allergens increased with age, the positive rate of fx5E decreased with age. The test's results were no significant difference between sex and the family hypersensitive history. The test's results were significant difference between the patient's hypersensitive histories. Conclusions Inhalant allergens are the most important allergen among childhood asthma. Sieving detection about allergen in the CAP anaphylactogen detection system is an important vitro test among childhood asthma.

Correlation of inhalant MAST on chronically coughing children / 소아과

PURPOSE: Recently, incidences of chronic cough with allergic disease have been increased. The identification of specific allergens for chronically coughing children is significant for diagnosis, proper treatment and prevention. The aim of this study was to identify significant contributors for sensitization in chronically coughing children. METHODS: A total of 106 children, aged 1-6 years, visiting for chronic cough(>3 weeks), were tested for inhalant multiple allergosorbent assay(MAST), eosinophil count and total IgE. Parents completed a questionnaire on past history of atopy(infantile eczema) and bronchiolitis, family history of allergy, breastfeeding, smoking, pets and floor coverings at home. RESULTS: Significant contributors for sensitization were:age(4-6 years), infantile eczema, positive family history of allergy and smoking by family. CONCLUSION: We were able to identify significant contributors for sensitization in chronically coughing children.

Simultaneously Content Determination of Camphor and Mentholum in Steam Inhalant by GC / 中国药房

OBJECTIVE:To establish a GC method for simultaneously content determination of camphor and mentholum in steam inhalant.METHODS:The glass packed column coated with10%PEG-20mol/L was used,the column temperature was set at120℃,the injection site temperature was160℃,the detector temperature was250℃,the carrier gas was nitrogen of high purity,the flow rate was50ml/min.RESULTS:The detected concentrations of camphor and mentholum showed a good linear correlation in the ranges of0.016～0.176mg/ml(r=0.9998)and0.04～0.44mg/ml(r=0.9999)respectively,the average recoveries were100.27%(RSD=0.79%)and100.18%(RSD=1.11%)respectively.CONCLUSION:The present method is convenient,accurate and sensitive,good resolution which can be used in simultaneously quantitative determination of camphor and mentholum in steam inhalant.

A study of total eosinophil count, total IgE concentration and sensitization of house dust mite allergens as atopic parameters in recurrent wheezing infants / 천식및알레르기

BACKGROUND: Recurrent wheezing is probably related to airway hyperresponsiveness. Many young infants wheeze during viral lower respiratory tract infections, but the pathogenesis of these episodes and their relation to the development of asthma or other allergic disease later in life are not well understood. Whether environmental allergen exposure affects the inception of asthma remains to be determined. OBJECTIVE: We performed this study to determine whether recurrent wheezing in infancy is related to atopy and if so, when infantile asthmatics become sensitized to house dust mite allergens. METHODS: In a cross-sectional study, we investigated the factors related to recurrent wheezing before the age of three. A total of 119 infants were selected for this study and they were divided into two groups : 88 infants who experienced wheezing episodes more than three times before the age of two as infantile asthmatics, and 31 infants who had never experienced wheezing before visiting our hospital between January 1998 and July 1999. For these subjects, we performed assessments including measurement of peripheral total eosinophil counts, serum total IgE levels, specific IgE levels (Dermatophagoides pteronyssinus, Dermatophagoides farinae and food allergens) and questionnaires were completed by the children's parents. RESULTS: The group who experienced recurrent wheezing showed significantly higher total eosinophil counts, serum concentrations of total IgE, D.p- and D.f-specific IgE than controls (p<0.05). There were no significant differences in the history of respiratory disease, familial history of allergic disease and environmental factors(domestic animals, bed cloth, carpet, smoking etc) between the group with recurrent wheezing and controls. The group who experienced recurrent wheezing showed significantly higher total eosinophil counts among those over 12 months old, and serum concentration of total IgE among those under 12 months old than controls(p<0.05). The concentration of D.p-specific IgE, but not D.f-specific IgE, in the recurrent wheezing group was higher than controls who were aged over 24 months(p<0.05). CONCLUSION: The infants with recurrent wheezing are strongly related to a predisposition to atopy. Eosinophilia is one of the important markers of recurrent wheezing. The period of sen- sitization of inhalant allergens like a D.p occurs as early as 24 months old. These findings suggest that early recognition of atopy and environmental controls are important to manage re- current wheezing in infants.