[Pulmonary gammagraphy study in asthmatic children with gastroesophageal reflux]. / Estudio de gammagrafía pulmonar en niños asmáticos con reflujo gastroesofágico.

BACKGROUND: The asthmatic children who do not respond favorably to the specifically anti-allergic treatment, and also begin their breathlessness crisis preferably at night, are suspicious of suffering gastric-esophagus reflux that stimulate bronchial spasm crisis by means of an aspiration mechanism, or more frequently, by means of a reflective mechanism through the vagal via. OBJECTIVES: To know probable physiopathologic mechanism of gastric-esophagus reflux that exacerbates asthmatic crisis. To know digestive symptoms associated to respiratory process. To evaluate clinic evolution of children after antireflux treatment. MATERIAL AND METHODS: There were chosen 50 moderate-severe persistent asthmatic patients with non favorable evolution and gastric-esophagus reflux. The diagnosis was settled by means of radiological study, with barium contrast in esophagus, stomach and duodenum, and esophagus-pulmonary gammagraphy with technetium 99 (99mTc). Besides, a searching of bronchial aspiration signs with the isotopic exploration was carried out. RESULTS: It was demonstrated that 38% of all cases had bronchial microaspirations and 30% did not have digestive symptoms associated to the respiratory process. Patients were subjected to an antireflux treatment and 78% of them considerably improved their asthmatic crisis after the treatment. CONCLUSIONS: 38% of the cases showed bronchial microaspirations in pulmonary gammagraphy. The more probable physiopathologic mechanism was vagal via, because 62% of the patients did not have bronchial aspiration signs. There were no digestive symptoms (silent reflux) in 30% of the children. Asthmatic crisis evolved favorably in 78% of the cases after antireflux treatment.

[Therapeutic effects of an antileukotriene in children with moderate-severe persistent asthma]. / Efectos terapéuticos de un antileucotrieno en niños con asma persistente moderada-grave.

BACKGROUND: Asthma is a chronic inflammatory disease of the airways, in which participate many cells and cellular elements. OBJECTIVE: To assess the utility of the zafirlukast, an antagonist of the receivers of the leukotrienes, in asthmatic children of our environment and to evaluate the grade of safety of the medication in the preventive treatment of the asthma. MATERIAL AND METHODS: We selected 50 moderate-severe asthmatic children, between 12 and 16 years (of both sexes) with non satisfactory evolution, in spite of the conventional preventive treatment for the asthma. Zafirlukast were given in dose of 20 mg every 12 hours, far from the foods, during 12 weeks. We carried out laboratory studies, before and after the treatment, evaluating the hematic (Hb and Hto), renal (creatinine) and hepatic (TGP) functions. They were continued in allergy consultation at the 4, 8, and 12 weeks of treatment, to know their clinical evolution, the apparition of adverse reactions and the use of other asthmatic medications in the period of the treatment. RESULTS: The 88% of the children improved clinically. The patients decreased the use of oral steroids and only 4 adverse reactions (8%) were reported, with total regression of the symptoms when suppressing the medication. The averages of the laboratory results, before and after the treatment, reflected values into the established normal limits, Hb: 12.4 (before) and 12.1 g/L (later), creatinine: 63.2 and 67.1 mMol/1 and TGP: 2.1 and 3.6 units. CONCLUSIONS: We observed in our study that the preventive treatment with Zafirlukast is useful and well tolerated, representing a new expectation for the asthma, in pediatric ages.

Niños con IgE elevada en sangre del Cordon Umbilical. Seguimiento de 1 a 6 años / Children with elevated IgE in umbilical cord blood. Follow-up from 1 to 6

Los valores elevados de IgE en suero del cordon umbilical se senalan como predictivos de desarrollo de alergias en etapas tempranas de la vida. La lactancia materna, dietas hipoalergicas y el control de los aeroalergenos son preventivos de la aparicion de estas afecciones. Como parte del Programa de Prevencion de Enfermedades Alergicas de Cuba y con el objetivo de conocer el valor predictivo de la IgE y el efecto de las medidas preventivas sobre los ninos en riesgo se siguieron 752 ninos durante 1 a 6 anos con IgE elevada al nacer y se les indico dichas medidas. La IgE al nacer y hasta los 3 anos fue mayor en los enfermos en forma significativa (p 0,0241). Enfermaron menos aquellos que lactaron y cumplieron las medidas orientadas (p 0,0028 y 0,0140) respectivamente. Se evidencio el valor predictivo de la IgE y los beneficios de las medidas profilacticas

Niños con IgE elevada en sangre del Cordón Umbilical. Seguimiento de 1 a 6 años / Children with elevated IgE in umbilical cord blood. Follow-up from 1 to 6

Los valores elevados de IgE en suero del cordón umbilical se señalan como predictivos de desarrollo de alergias en etapas tempranas de la vida. La lactancia materna, dietas hipoalérgicas y el control de los aeroalergenos son preventivos de la aparición de estas afecciones. Como parte del Programa de Prevención de Enfermedades Alérgicas de Cuba y con el objetivo de conocer el valor predictivo de la IgE y el efecto de las medidas preventivas sobre los niños en riesgo se siguieron 752 niños durante 1 a 6 años con IgE elevada al nacer y se les indicó dichas medidas. La IgE al nacer y hasta los 3 años fue mayor en los enfermos en forma significativa (p 0,0241). Enfermaron menos aquéllos que lactaron y cumplieron las medidas orientadas (p 0,0028 y 0,0140) respectivamente. Se evidenció el valor predictivo de la IgE y los beneficios de las medidas profilácticas(AU)