Effect of Sodium Cromoglycate on Acetic Acid-induced Ulcerative Colitis in Mice / 대한소화기학회지

BACKGROUND/AIMS: Ulcerative colitis (UC) is a type of inflammatory bowel disease that mainly involves the colon. Thus far, glucocorticoids and amino-salicylate have been the main treatment.METHODS: To assess drugs with fewer side effects, this study evaluated the effects of sodium cromoglycate (SCG) on acetic acid-induced UC in rats. The treatment groups included SCG receivers (50 and 100 mg/kg, intra-orally) and sulfasalazine (SSZ) receivers (100 mg/kg, intra-orally). The colonic mucosal injury was assessed by clinical, macroscopic, and histopathological examinations.RESULTS: In the treatment groups with 50 and 100 mg/kg of SCG, the clinical activity score decreased to 2.67±0.18 and 1.73±0.21 (p<0.05), respectively, compared to the UC control group (3.21±0.31), and were higher than that of the group given the standard treatment of 100 mg/kg SSZ (1.10±0.09). The treatment groups with 50 and 100 mg/kg of SCG showed a lower clinical gross lesion score than the UC control group (2.91±0.28 and 2.10±0.43, vs. 4.49±0.61, p<0.05) and were higher than the standard group (0.95±0.18). Treatment with SCG (100 mg/kg) decreased the macroscopic scores significantly compared to the UC control group (p<0.05) on the 8th day.CONCLUSIONS: SCG (100mg/kg) decreased significantly the clinical activity score, gross lesion, and percentage-affected area compared to the UC controls on the 8th day.

Exercise-Induced bronchoconstriction and therapeutic modulation in Iraqi Girls Intermediate School Students

EIB (Exercise-Induced Bronchoconstriction) describes the narrowing that accurs in the airway follow a short period of exercise. EIB is found in 8-10% of normal children population as occult bronchospasm during or after physical activities. The mecanisms of EIB are related to rapid ventilation and mouth brathing which cause beat and water loss during breathing leading to bronchoconstriction. Peak Expiratory Flow Rate (PEFR) measured pre and post-exercise in students aged 12-16 years in girl intrmediate school. Any female shows PEFR values reduction 15% after 6 minutes continuous free running considered as asthmatic patient, this give an incidence rate of asthmatic patient of 9% in female students in this age. Treatment of EIB, Zafirlukast treatment gives (85.7%) protection rate. While salbutamol inhalation gives a protection rate 88%. Only 66.6% of girls with EIB give an improvement in PEFR values after sodium cromoglycate treatment. A regular measurement of PEFR in school students appears to be a good indicator of EIB, while inhalation of salbutaol 15 minutes before exercise give a good protection against EIB attacks at least for 4 hours (AU)

Inhibitory effects of 2,6-di-tert-butyl-4-hydroxymethylphenol on asthmatic responses to ovalbumin challenge in conscious guinea pigs

This study evaluated the anti-asthmatic activities of 2,6-di-tert-butyl-4-hydroxymethylphenol (DBHP) that is a potent phenolic antioxidant in edible vegetable oil. The effects of DBHP on bronchial asthma were evaluated by determining the specific airway resistance (sRaw) and tidal volume (TV) during the immediate asthmatic response (IAR) and the late-phase asthmatic response (LAR) in guinea pigs with aerosolized ovalbumin-induced asthma. Recruitment of leukocytes and the levels of biochemical inflammatory mediators were determined in the bronchoalveolar lavage fluids (BALFs), and histopathological surveys performed in lung tissues. DBHP significantly inhibited the increased sRaw and improved the decreased TV on IAR and LAR, and also inhibited recruitment of eosinophils and neutrophils into the lung, and release of biochemical inflammatory mediators such as histamine and phospholipase A₂ from these infiltrated leukocytes, and improved pathological changes. However, anti-asthmatic activities of DBHP at oral doses of 12.5 to 50 mg/kg was less than those of dexamethasone (5 mg/kg, p.o.) and cromoglycate (10 mg/kg, p.o.), but more potent or similar to that of salbutamol (5 mg/kg, p.o.). These results in the present study suggest that anti-asthmatic effects of DBHP in the guinea pigs model of OVA-induced asthmatic responses principally are mediated by inhibiting the recruitments of the leukocytes and the release of biochemical inflammatory mediators from these infiltrated leukocytes.

Tacrolimus eye drops as monotherapy for vernal keratoconjunctivitis: a randomized controlled trial / Colírio de Tacrolimus 0, 03% como único agente antialérgico para o tratamento de ceratoconjuntivite primaveril: ensaio clínico randomizado

ABSTRACT Purpose: To assess the efficacy of monotherapy using tacrolimus eye drops versus sodium cromoglycate for the treatment of vernal keratoconjunctivitis (VKC). Methods: Randomized double-masked controlled trial comparing the efficacy of tacrolimus 0.03% eye drops t.i.d. (Group 1) with sodium cromoglycate 4% eye drops t.i.d. (Group 2) for the symptomatic control of VKC at days 0, 15, 30, 45, and 90 of follow-up. Visual acuity, intraocular pressure, and other complications were evaluated to assess safety and side effects. Results: In total, 16 patients were included, with 8 enrolled in each group. Two patients from Group 2 were excluded from the analysis at days 45 and 90 because of corticosteroid use. Most patients were male (81.8%) and presented with limbal VKC (56.3%). There were statistically significant differences in favor of tacrolimus in the following severity scores: itching at day 90 (p=0.001); foreign body sensation at day 15 (p=0.042); photophobia at day 30 (p=0.041); keratitis at day 30 (p=0.048); and limbal activity at days 15 (p=0.011), 30 (p=0.007), and 45 (p=0.015). No relevant adverse effects were reported, except for a burning sensation with tacrolimus, though this did not compromise treatment compliance. Conclusion: Treatment with tacrolimus was superior to sodium cromoglycate when comparing severity scores for symptoms of itching, foreign body sensation, and photophobia, as well as for signs of limbal inflammatory activity and keratitis.

RESUMO Objetivo: Demonstrar a eficácia do colírio de tacrolimus 0,03% como único agente antialérgico versus o colírio de cromoglicato de sódio 4% no tratamento de ceratoconjuntivite primaveril (CCP). Métodos: Ensaio clínico randomizado duplo-mascarado comparando a eficácia do colírio de tacrolimus 0,03% 3 vezes ao dia, versus o colírio de cromoglicato 4% 3 vezes ao dia, no controle dos sintomas e sinais de pacientes com o diagnóstico de ceratoconjuntivite primaveril, durante o período de 3 meses, com avaliações nos dias 0, 15, 30, 45 e 90. Acuidade visual, pressão intraocular e outras possíveis complicações foram avaliadas para determinar segurança e efeitos adversos. Resultados: Dezesseis pacientes foram incluídos no estudo, sendo que oito fizeram uso de colírio de tacrolimus 0,03% (Grupo 1) e oito fizeram uso de colírio de cromoglicato de sódio 4% (Grupo 2). Dois pacientes do Grupo 2 foram excluídos da análise dos dias 45 e 90, devido à necessidade de utilização de corticosteroide tópico. A maioria dos pacientes era do sexo masculino (81,8%) e 56,3% apresentavam a doença em sua forma limbar. Houve diferença estatisticamente significativa entre os Grupos 1 e 2 em relação à graduação de severidade para os sintomas de prurido no dia 90 (p=0,001), sensação de corpo estranho no dia 15 (p=0,042), fotofobia no dia 30 (p=0,041) e para os sinais de atividade inflamatória limbar nos dias 15 (p=0,011), 30 (p=0,007) e 45 (p=0,015), e ceratite no dia 30 (p=0,048). Nenhum efeito adverso relevante foi notado, exceto queixa de queimação ocular quando da instilação de tacrolimus, o que não comprometeu à adesão ao tratamento. Conclusão: O colírio de tacrolimus 0,03% foi superior ao colírio de cromoglicato de sódio 4% comparando a graduação de severidade para os sintomas de prurido, sensação de corpo estranho e fotofobia, assim como para os sinais de atividade inflamatória limbar e ceratite, em determinados períodos de tempo durante o seguimento.

Sodium cromoglycate attenuates experimental endometriosis in rats by regulating mast cells / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To investigate the effect of sodium cromoglycate on experimental endometriosis in rats.</p><p><b>METHODS</b>Endometriosis model was established in 36 unpregnant female SD rats by transplanting autologous fragments of endometrium to the inner surface of the abdominal wall. The endometriotic lesions were measured by a second laparotomy 2 weeks after surgery. Then the rats were randomly divided into four groups (n=8 in each group) to receive intraperitoneal injection of different doses of sodium cromoglycate for 2 weeks: high-dose group (20 mg·kg⁻¹·d⁻¹); low-dose group (10 mg·kg⁻¹·d⁻¹); the negative control group and the blank control group. The animals were sacrificed and the size of the lesions were measured. The endometriosis model of SD rats was identified by HE staining and immunohistochemical staining of keratin and vimentin. The total number of mast cells and their degranulation were measured by Toluidine blue staining; the concentrations of TNF-α in serum were measured by enzyme linked immunosorbent assay; the concentrations of estradiol in serum were measured by enzyme immunoassay; the expression of tryptase and nerve growth factor (NGF) were measured by immunohistochemical staining.</p><p><b>RESULTS</b>The number of activated mast cells (MC) by Toluidine blue staining in high-dose group was significantly lower than that in negative control group (P<0.05), and its ratio of degranulation/total number of MC was significantly lower than that in negative control group or blank control group (P<0.05). The serum TNF-α levels and tryptase expression in tissues in high-dose group were significantly lower than those in negative control group or blank control group (P<0.05). However, no significant difference in the size of endometriotic lesions and expression of NGF was found among groups (P>0.05).</p><p><b>CONCLUSION</b>Sodium cromoglycate can stabilize mast cells from degranulation, which may relieve the clinical symptoms of endometriosis by reducing TNF-α and tryptase levels.</p>

Posicionamento da Academia Brasileira de Rinologia sobre terapias tópicas nasais / Brazilian Academy of Rhinology position paper on topical intranasal therapy

Opresente documento tem por objetivo esclarecer àqueles que tratam das doenças nasossinusais, tanto especialistas quanto generalistas, sobre as terapêuticas tópicas nasais. Por meio de uma revisão das evidências científicas, a Academia Brasileira de Rinologia vem proporcionar sua visão prática e atualizada sobre as medicações tópicas nasais mais utilizadas, excetuando-se as medicações que possuam antibióticos tópicos na sua formulação.

This documents aims at educating those who treat sinonasal diseases - both general practitioners and specialists - about topical nasal treatments. By means of scientific evidence reviews, the Brazilian Academy of Rhinology provides its practical and updated guidelines on the most utilized topical nasal medication, except for the drugs that have topical antibiotics in their formulas.

Human seminal plasma allergy: successful pregnancy after prophylactic anti-histamine treatment

Human seminal plasma allergy is a rare phenomenon. Its clinical manifestations are diverse, and range from mild local pruritus to fatal anaphylaxis. Treatment varies with severity of the reactions: abstinence, condom usage or immunotherapy (subcutaneous or intravaginal) with seminal fluid. Local allergic reactions can be managed by prophylactic use of antihistamines or local cromolyn cream. A 33-year-old female visited the Asthma and Allergy Clinic in Seoul National University Bundang Hospital for the recurrent generalized urticarial reactions after sexual intercourse. She had been suffering from asthma, allergic rhinoconjunctivitis and atopic dermatitis for 10 years. She gave birth to a baby 6 months ago and no problem before. However, recently she began to recognize unexpected generalized urticaria that occurred after the sexual intercourse with husband. She wanted to have the second baby but hesitated because of the recurrent symptoms after the intercourse. She showed positive response to skin prick test with her husband's seminal fluid. The IgE-binding components were 15, 22, 28, and 35 kDa. Considering her moderate cutaneous reactions, we decided to try prophylactic treatments with oral anti-histamine one hour before sexual intercourse. She did not experience urticarial reactions with intercourse while oral anti-histamine was administered in advance. Finally, treatment outcome was successful, and the couple successfully gave birth to their second baby. We suppose that prophylactic antihistamine may be also applied in seminal plasma allergy patients if systemic reactions are limited to mild to moderate generalized urticaria.

Irritable bowel syndrome

Irritable bowel syndrome (IBS) is traditionally defined as a functional disorder

Study of Cutaneous Neuropeptides-induced Mast Cell Activation / 대한해부학회지

Neuropeptides are widely distributed throughout skin, gastrointestinal tracts, and nervous and immune systems. Neuropeptides act to mediate the vasodilation and induce mast cell activation in humans and rats in vitro. However, the mechanism of the cutaneous neuropeptides-induced mast cell activation and the extent of the vascular permeability by cutaneous neuropeptides are not fully understood. This issue was investigated by the injecting six cutaneous neuropeptides-atrial natriuretic peptide, calcitonin gene-related peptide, neuropeptide Y, somatostatin, substance P and vasoactive intestinal peptide-into the skin of rats and by treatment of six cutaneous neuropeptides in rat peritoneal mast cell (RPMC) in vitro. All of the cutaneous neuropeptides increased the significant vascular permeability by the injection into the back skin of normal rats. All of the cutaneous neuropeptides also induced the mast cell degranulation and the histamine release from RPMCs, in a dose-dependent pattern, and increased the calcium uptake and decreased the level of cAMP of RPMCs in vitro. The effects of cutaneous neuropeptides on the vascular permeability and mast cell activation were inhibited by mast cell stabilization agent, disodium cromoglycate. These findings show that cutaneous neuropeptides can induce the mast cell activation by not only increasing the calcium uptake and decreasing the level of cAMP in RPMCs, but also the increment of vascular permeability in the skin of rats.

Mast cell stabilizers as a potential treatment for Irritable bowel syndrome: a randomized placebo-controlled clinical trial

Mast cells are believed to play a role in irritable bowel syndrome pathogenesis and symptom genesis due to their close neighborhood to gastrointestinal innervations. This study was designed to evaluate the efficacy of orally administered cromolyn for reduction of symptoms in patients with irritable bowel syndrome [IBS]. A randomized placebo-controlled double-blinded 6x6 weeks cross-over study was performed in a private gastrointestinal clinic. 10 patients were allocated to group A and 6 patients to group B. Patients in group A received 150 mg cromolyn divided in three equal doses for the first 6 weeks and placebo for the next 6 weeks but patients in group B received placebo for the first 6 weeks and cromolyn in the next 6 weeks. Weekly evaluation was performed and visual analogue scale was used to determine severity of symptoms. Sixteen patients completed the study. Mean age of the patients was 40.3 +/- 10.9 years old [range: 24-57]. Eight patients had D-IBS [Diarrhea dominant] and other 8 had CIBS [Constipation dominant]. Both cromolyn sodium and the placebo decreased the severity of bloating [Freidman test, p 0.001 and 0.006 respectively]. The severity of the main symptom [diarrhea or constipation] did not decrease in patients of group A and B who were treated with different sequences of the drug or placebo. The severity of pain decreased drastically after 6th week of treatment with cromolyn. Freidman test showed a significant difference between the pain levels of the former defined treatment spots [p 0.01, and 0.02 for patients in group A and B, respectively]. No adverse drug reactions were observed during the study. In conclusion, long term administration of cromolyn seems to be partially effective for treatment of abdominal pain in patients with IBS while main symptoms [diarrhea or constipation] might not decrease during this treatment

Role of sodium cromoglycate in brain protection and its effects on tumor necrosis factor-alpha and interleukin-1beta after global cerebral ischemia-reperfusion injury in gerbils / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the role of sodium cromoglycate in brain protection and its effects on brain tumor necrosis factor-alpha (TNF-alpha) and interleukin-1beta (IL-1beta) expressions after global cerebral ischemia-reperfusion (IR) injury in gerbils.</p><p><b>METHODS</b>Twenty-four healthy male gerbils were randomized into 3 equal groups, namely the sham-operated group with isolation of the bilateral carotid arteries but without occlusion, IR injury model group with bilateral carotid artery occlusion, and sodium cromoglycate treatment group with bilateral carotid artery occlusion and sodium cromoglycate administration at 25 mg/kg via the lingual vein as soon as the reperfusion start with another dose 1 h later. The animals were then sacrificed and the thalamus were removed, fixed in 10% formaldehyde and sliced for observation under light microscope with HE staining. The rest brain tissues were prepared into homogenate to determine the content of TNF-alpha and IL-1beta. The right hemispheres of the gerbils were measured for wet weight and dry weight to calculate the water content in the brain.</p><p><b>RESULTS</b>The water content in the brain of the gerbils in the model group was the highest among the groups, and that in sodium cromoglycate treatment group was significantly less than that of the model group (P<0.05). Microscopic examination showed the most severe brain tissue damage in the model group with also the highest TNF-alpha and IL-1beta levels in the brain. The brain TNF-alpha and IL-1beta levels in sodium cromoglycate group were significantly decreased as compared with those in the model group (P<0.05).</p><p><b>CONCLUSION</b>Sodium cromoglycate can alleviate brain IR injury possibly by lowering the TNF-alpha and IL-1beta levels in the brain tissues.</p>

Efficacy of ketotifen fumarate 0.025% eye drops in treatment of vernal keratoconjunctivitis

This prospective hospital-based study has been conducted to evaluate the efficacy of ketotifen fumarate 0.025% eye drops in controlling the signs and symptoms of vernal keratoconjunctivitis and to compare its effect with that of commonly used combination of eye drops for vernal keratoconjunctivitis both in mild and severe cases. A total of 20 patients [40 eyes] who came to the outpatient clinics at the ophthalmology department at King Hussein Medical Center were selected during the period between January 2004 and May 2004. They were diagnosed to have vernal keratoconjunctivitis with no other ocular or systemic pathologies that might affect the results. Two groups of medications were used; ketotifen for the right eye and naphazoline with antazoline and sodium cromoglycate for the left eye. Steroids were used for both eyes at the beginning to establish a primary control and added if needed later. The patients were followed up and given scores for their signs and symptoms on the first visit and on each follow up visits, which were distributed over a period of 6 weeks. Further division of the population into two subgroups of mild and moderate-severe groups as the behavior of the drugs differs in each group of the two. Generally, similar behavior of the disease was noticed in the two groups of medications, particularly in the mild cases where ketotifen alone could achieve a satisfactory final result as that of the combination of sodium cromoglycate and naphazoline with antazoline. The improvement was noticed in all signs and symptom studied [itching, watery discharge, redness photophobia, hyperemia, papillae and corneal signs of vernal keratoconjunctivitis]. In mild cases, there was no significant difference between the two groups of medications [p>0.05]. Steroids could be avoided in the mild cases. In the severer cases, ketotifen alone was not enough in controlling the signs and symptoms and steroids were needed at frequent intervals. In severe cases the improvement was significantly better in the group using ketotifen fumarate in the symptoms of watery discharge and redness, and in the hyperemia sign [p<0.05], while other symptoms and signs improved in both groups of medications without significant difference [p>0.05]. The use of ketotifen is of an advantage over the combination of naphazoline 0.025% with antazoline 0.5%, and sodium cromoglycate 4% as it is only one bottle with a lower frequency of instillation, thus the compliance would be better, although it almost has the same price as the other two combined. The use of ketotifen is convenient for patients with mild symptoms as a solo drug after few days of steroids. In the severe cases, ketotifen alone could not be used without frequent intervals of steroids, although a significant improvement in this group was noticed over the group of combined medications in watery discharge and redness symptoms and hyperemia sign

HPLC-MS/MS method for determination of sodium cromoglycate concentration in human plasma and its pharmacokinetics / 药学学报

The study established an HPLC-MS/MS method for determining the concentrations of sodium cromoglycate in human plasma and evaluated the pharmacokinetics of nasal drops and nasal spray. A C18 column was used to separate sodium cromoglycate in plasma with a mobile phase of a mixture of ammonium-methanol (involves 50% acetonitrile) (15:85) at a flow rate of 0.4 mL x min(-1). Electronic spray ionization (ESI) and multiple-reaction monitoring (MRM) were used for the determination of sodium cromoglycate in human plasma. The linear range of the standard curve of sodium cromoglycate was from 0.3 to 20 ng x mL(-1), and the minimum concentration of detection was 0.3 ng x mL(-1). The extraction recovery was more than 94.1%, intra-day and inter-day RSD were less than 14.3%. After a single dose of sodium cromoglycate, the main pharmacokinetic parameters of nasal spray and nasal drops were as follows, T(1/2)(1.82 +/- 0.54) h, (1.59 +/- 0.52) h; Tmax (0.47 +/- 0.12) h, (0.44 +/- 0.15) h; Cmax, (9.79 +/- 4.66) ng x mL(-1), (10.88 +/- 4.05) ng x mL(-1); AUC(0-5 h)(11.52 +/- 3.46) ng x mL(-1) x h x h, (12.63 +/- 4.23) ng x mL(-1) x h, Fr(93.6 +/- 13.8)%. The method is sensitive, rapid and accurate. It is suitable for therapeutic drug monitoring and human pharmacokinetic study of sodium cromoglycate.

Cromolyn sodium ameliorates rat left cardiac function during intestinal ischemia-reperfusion / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate cardiac function impairment and myocardial injury in rats with intestinal ischemia-reperfusion and the protective effect of cromolyn sodium.</p><p><b>METHODS</b>Thirty-two SD rats were randomized into 4 groups (n=8), namely the sham operation group, model group, 50 mg/kg cromolyn sodium group, and 25 mg/kg cromolyn sodium group. Intestinal damage was induced by clamping the superior mesenteric artery for 45 min followed by reperfusion for 60 min. Cromolyn Sodium was administrated intaperitoneally 15 min before reperfusion. The heart rate (HR), left ventricle pressure (LVSP), and the maximal/minimum rate of LVSP (+dp/dt(max), -dp/dt(max)) were sacrificed immediately before ischemia (baseline, T(0)), at 15 min (T(1)), 30 min (T(2)), 45 min (T(3)) of ischemia, and at 3 min (T(4)), 5 min (T(5)), 10 min (T(6)), 15 min (T(7)), 45 min (T(8)), 60 min (T(9)) of reperfusion. At the end of the experiment, the rats were executed and the hearts were immediately removed for observation of the pathological changes and determination of MDA contents and SOD activity.</p><p><b>RESULTS</b>Compared with the baseline T(0), the HR, +dp/dt(max), -dp/dt(max) and the LVSP were decreased significantly at T(8) and T(9) in the model group and the two cromolyn sodium groups (P<0.05). Compared with the sham operation group, these indices were also significantly decreased at T(8) and T(9) in the model group and the two cromolyn sodium groups, but the model group had significantly lower levels for these indices at T(8) and T(9) than the two cromolyn sodium groups (P<0.05). The score of myocardial injury in the model group and the two cromolyn sodium groups were significantly higher than that of group A, and 50 mg/kg cromolyn sodium group had lower score than the model group (P<0.05). The rats in the model group had significantly higher MDA levels than those in the sham operation group and the 50 mg/kg cromolyn sodium group. SOD activities in the model group and 25 mg/kg cromolyn sodium group was lower than that in the sham operation group (P<0.05), but 50 mg/kg cromolyn sodium group had significantly higher SOD activities than the model group (P<0.05).</p><p><b>CONCLUSION</b>Cromolyn sodium can protect the myocardium against intestal ischemia-reperfusion injury and improve the cardiac function.</p>

Dexmedetomidina para sedación durante intubación difícil con Fibrobroncoscopia / Dexmedetomidina for sedation during intubación difficult with Fibrobroncoscopia

Paciente de 48 años de sexo femenino, con diagnóstico de bocio gigante, valorada en consulta preanestésica que presenta una gran masa en cuello que ya había sido operada previamente y que se extendía al pulmón derecho. Al evaluar la vía aérea se encontró una desviación traqueal importante, con Mallampati III y se programó como intubación difícil con fibrobroncoscopia. El día de la cirugía, se decidió colocar un tubo doble lumen No. 37, previa anestesia tópica con lidocaina spray, 2 mg de midazolam y un bolo de Dexmedetomidina (DXM) 0,7 microgr/kg en 10 minutos, seguido por una infusión continua de 0,25-0,3 microgr/Kg. Se midió el nivel de sedacion mediante la escala de Ramsay, considerando adecuado un nivel 2 y 3 y se procedió a la intubación nasotraqueal con fibrobroncoscopia. Una vez confirmada se le colocó tiopental sódico 3 mg/kg más Rocuronio 0,5 mg/kg y Fentanyl 2 microgr/kg IV. Se continúo con DXM durante todo el procedimiento y se adicionó Isorane a 1 MAC. Se realizó cervicotomía y esternotomía para extraer la masa, se suspendió la DXM 15 minutos antes de finalizar el procedimiento y se extubó a la paciente despierta; hemodinámicamente estable, se llevó a UCI donde evolucionó satisfactoriamente y fue dada de alta a los 3 días...

Montelukast versus sodium cromoglycate in children with mild persistent asthma: effect on allergic inflammation and bronchial hyperresponsiveness

The effect of montelukast and cromolyn on allergic inflammation and bronchial hyperresponsiveness was compared in 40 children with mild persistent asthma. Twenty children received oral montelukast [Singulair] while twenty children received inhaled cromolyn [Intal-5 MDI] during the study period of 6 weeks. Asthmatic children were evaluated clinically and with pulmonary function tests [forced expiratory volume in one second [FEV[1]] and peak expiratory flow [PEFR], challenge tests [histamine and exercise] and measurement of inflammatory markers [blood eosinophil count, serum immunoglobulin E [IgE], eosinophil cationic protein [ECP], interleukin 4[IL4] and nitric-oxide products in sputum] both. before and after six weeks therapy with either montelukast or cromolyn. Twenty age and sex matched non atopic children served as controls. Asthmatic children, on admission, had significant decrease in mean FEV[1] and PEFR and increase in mean eosinophil count, serum levels of total serum IgE, ECP, IL4 and sputum nitric-oxide products as compared to controls. Both drugs produced significant and equal improvement in pulmonary functions [FEV[1] and PEFR], decrease in the degree of bronchial hyperresponsiveness to histamine and exercise and a significant decrease in blood eosinophil count, serum IgE, ECP and IL4 and sputum nitric-oxide products. However all these parameters were still significantly different as compared to mean control levels. Better asthma symptoms control was observed with montelukast than with cromolyn sodium and there was a greater significant adherence with montelukast than with cromolyn- sodium with both patients and parents preference for montelukast

[Efficacy of Beclomethasone and Cromolyn Sodium nasal spray in allergic rhinitis]

Allergic rhinitis is a common disease, and application of an appropriate remedy to melt away the disease signs is essential. Cromolyn Sodium nasal sprays and Beclomethasone are most commonly among the medications prescribed to treat allergic rhinitis. Regarding to differences in their prices and side effects, the present study tries to compare them in use. This is a clinical trial conducted in a private ENT clinic in Isfahan. The sample included 52 patients over age 10 referred to this clinic. The samples, diagnosed with allergic rhinitis entered the study and five clinical signs rhinorrhea, nose itching, eyes itching, sneeze and nose congestion were scored based on existence and severity. Then, patients were randomly treated by Beclomethasone or Cromolyn Sodium spray with every other on sequence. Patients were investigated again after one month and the signs regarding existence and severity were evaluated and recorded. Both medications were effective in controlling all the signs of the patients. Regarding similar effect of Beclomethasone spray and Cromolyn Sodium on controlling various signs in allergic rhinitis in all patients, application of Cromolyn with lower complications and price is recommended

Comparison of efficacy and safety of topical ketotifen [zaditen] and cromolyn sodium in vernal keratoconjunctivitis

The purpose of this study is to compare the efficacy of Ketotifen fumarate 0.025% [Zaditen] with Cromolyn sodium 4% eye drops in prevention of itching, tearing and redness in vernal keratoconjunctivitis [VKC]. This double masked randomized single center clinical trial conducted between April and August 2004 in Yazd. One hundred eligible patients with clinical diagnosis of moderate VKC were randomly assigned to Zaditen [Group A, n=50] and Cromolyn sodium [Group B, n=50] eye drops for a 4 week period. Itching, lacrimation, redness and photophobia were scored on a 4-point severity scale. At the follow up visits, the responder rate based on subjects assessment of global efficacy was significantly greater in Ketotifen group [71.5%] than in Cromolyn group [53%]. A clear response to treatment occurred in 94.4% of Zaditen patients and 81.2% of sodium Cromoglycate patients. The investigator's assessment of responder rates also showed that Ketotifen was superior to Cromolyn sodium [p=0.001]. Ketotifen produced a significantly better outcome than Cromolyn [p<0.05] for relief of signs and symptoms of VKC. Ketotifen fumarate treatment significantly reduced the total signs and symptoms score for each patient compared to day 0. Ketotifen had a faster onset of action and provided better symptom relief than Cromolyn: the rapid onset of action and symptom control, make Zaditen a valuable treatment for VKC

The Effects of Anti-Histamine and Mast Cell Stabilizer against Ischemia-Reperfusion Injury to TRAM Flap in Rat

PURPOSE: The purpose of this study was to evaluate the role of mast cell and histamine as typical product of mast cell in ischemia-reperfusion injury of muscle flap using H2 receptor blocker and mast cell stabilizer. METHODS: Thirty-five Sprague-Dawley rats weighing 250-300 gm were divided into four groups; Group I: Control group without ischemia, Group II: Normal saline injection group with ischemia, Group III: Cimetidine injection group with ischemia, Group IV: Sodium cromoglycate injection group with ischemia. Well established single pedicled transverse rectus abdominis musculocutaneous(TRAM) flap was designed in all rats and were rendered ischemia by clamping the artery for 150 minutes. All injections were applied intramuscular around gluteal area 30 minutes before reperfusion. The flap survival was evaluated at 7 days after operation. Neutrophil counts and mast cell counts were evaluated 24 hours after reperfusion. RESULTS: The difference of skin flap survival between control group and cimetidine injection group was not significant. In the normal saline injection group flap survival was markedly decreased compared to that of control group. The muscle flap survival was similar to the results of skin flap survival. The neutrophil counts were significantly decreased in control group and sodium cromoglycate injection group than normal saline injection group. The mast cell counts were significantly decreased in cimetidine injection group and control group than both normal saline injection and sodium cromoglycate injection groups. The protective effect of sodium cromoglycate was not seen in the skin flap, but the muscle flaps showed protective effects of sodium cromoglycate compared to normal saline injection group. CONCLUSION: It is suggests that commonly used antihistamine(H2 receptor blocker) has protective effect against ischemia-reperfusion injury to skin and muscle flaps by reducing neutrophil and mast cell. The mast cell stabilizer was not effective for skin flap but, possibly, for muscle flap.

Allergic rhinitis in children:diagnosis and treatment / 소아과

Allergic rhinitis is a common disease of childhood characterized by nasal, throat, and ocular itching, rhinorrhea, sneezing, nasal congestion. Those affected with allergic rhinitis often suffer from associated inflammatory conditions of the mucosa, such as allergic conjunctivitis, rhinosinusitis, asthma, otitis media with effusion, and other atopic conditions, such as eczema and food allergies. Allergic rhinitis must be diagnosed and treated properly to prevent complications and impaired quality of life. Despite a high prevalence, allergic rhinitis isoften undiagnosed and inadequately treated, especially in the pediatric population. The first step in treatment is environmental control when appropriate. It may be difficult to eliminate all offending allergens effectively to reduce symptoms, so medications are often required. Many different classes of medications are now available, and they have been shown to be effective and safe in a large number of well-designed, clinical trials. Antihistamines are effective in treating immediate symptoms of sneezing, pruritus, watery eyes, and rhinorrhea. Second generation antihistamines are the preferred antihistamines because of their superior side effect profile. Thus, decongestants are commonly used with oral antihistamines. Intranasal corticosteroids are the most effective therapy for allergic rhinitis. Leukotriene modifier may be as effective as antihistamines in treating allergic rhinitis symptoms. Cromolyn sodium is an option for mild disease when used prophylactically, and ipratropium bromide is effective when rhinorrhea is the predominant symptom. When avoidance measures and medications are not effective, specific immunotherapy is an effective alternative. Only immunotherapy results in sustained changes in the immune system. Because of improved understanding of the pathogenesis, new and better therapies may be forthcoming. The effective treatment of allergic rhinitis in children will reduce symptoms and will improve overall health and quality of life, making a happier, healthier child.