Study of the relationship between acetaminophen and asthma in Mexican children aged 6 to 7 years in 3 Mexican cities using ISAAC methodology.

OBJECTIVE: To establish the relationship between the use of acetaminophen and the frequency of asthma in Mexican children in 3 Mexican cities. METHODS: Ours was a multicenter, observational, descriptive, cross-sectional study. Patients from 6 to 7 years of age participating in Phase Three B of the ISAAC (International Study of Asthma and Allergies in Children) living in the north of Mexico City, Victoria City, and Merida were included. After adjusting for confounders, we calculated the odds ratios (OR) for the presence of wheezing ever, wheezing in the last 12 months, asthma ever, and the use of acetaminophen in the first year of life and during the last 12 months. RESULTS: The ORs for wheezing ever, wheezing in the last year, and asthma ever with respect to use of acetaminophen in the first year of life were not statistically significant (P > .05) in Mexico City, but they were significant in Victoria City (P < .05) and Merida (P < .05). The ORs (95% confidence intervals) for wheezing ever, wheezing in the last year, and asthma ever with respect to use of acetaminophen in the last year were 3.44 (2.96-4.0), 7.97 (5.89-10.78), and 6.10 (3.30-8.81) (P < .05) in Mexico City. Values forVictoria City were 1.36 (1.13-1.63), 3.80 (2.88-5.05), and 2.18(1.57-3.01) (P < .05). Those for Merida were 1.61 (1.40-1.85), 2.07 (1.73-2.48), and 1.53 (1.29-1.82) (P < .05). CONCLUSION: The use of acetaminophen is associated with the presence of wheezing and asthma in 3 different cities in Mexico.

Factors associated with allergic rhinitis in children from northern Mexico City.

BACKGROUND: The International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire allows users to find factors associated with allergic diseases, but thus far most of the studies on risk factors for allergic diseases have been devoted to asthma and not to rhinitis. OBJECTIVE: To determine the main factors associated with symptoms of allergic rhinitis and rhinoconjunctivitis in school children and adolescents in northern Mexico City. PATIENTS AND METHODS: A cross sectional, multicenter survey was conducted in northern Mexico City, in children aged 6-7 and 13-14 years. The survey instrument was the Phase Three B ISAAC questionnaire, which was validated and standardized in Spanish. RESULTS: There were 4106 6-7-year-olds and 6576 13-14-year-olds. The total prevalence of diagnosis of allergic rhinitis was 4.6%. The prevalence of cumulative and current symptoms of rhinitis was considered high (>29%), but the prevalence of the diagnosis of allergic rhinitis was considered low (ranging from 3.4% to 5.6%). The prevalence of symptoms of rhinitis with conjunctivitis had intermediate values (ranging from 20.3% to 30.2%). Cumulative symptoms of allergic rhinitis, current symptoms of allergic rhinitis, and rhinoconjunctivitis were related to symptoms of current or cumulative asthma, symptoms of current or cumulative atopic eczema, and current use of paracetamol (odds ratio > 1, P < .05). CONCLUSION: The present results support the concept of rhinitis and asthma as common chronic respiratory diseases, and this study also found a relation between paracetamol use and rhinitis in children.

A comparative study of bronchodilator reversibility with albuterol, between asthma symptomatic and asymptomatic children according to ISAAC questionnaire in Mexico City.

BACKGROUND: Asthma is an important childhood disease. Recent surveys of the International Study of Asthma and Allergies in Childhood (ISAAC) suggest that the prevalence of asthma is increasing but these surveys do not include any pulmonary tests to confirm the possible diagnosis of asthma. OBJECTIVE: To compare bronchodilator reversibility with the albuterol test in symptomatic and asymptomatic 6-7-year-old children with asthma participating in the ISAAC survey and living in Mexico City. PATIENTS AND METHODS: We performed an observational, descriptive, comparative, cross sectional study in children participating in phase 3b of the ISAAC study. According to the ISAAC questionnaire children were classified as asthma symptomatic or asymptomatic. Both groups had bronchodilator reversibility with the albuterol test, using the guidelines of the American Thoracic Society to confirm or rule out the diagnosis of asthma. RESULTS: The asymptomatic group had a baseline FEV1 of 1.70 +/- 0.34 l/sec (mean +/- SD) and an endpoint FEV1 of 1.76 +/- 0.42 l/sec; in the symptomatic group the respective values were 1.51 +/- 0.41 l/sec and 1.57 +/- 0.44 l/sec (p < 0.05). A positive reversibility test was found in 13/136 (9.6 %) children in the asymptomatic group and in 22/112 (19.6 %) children in the symptomatic group (p < 0.05). CONCLUSION: Because of its low sensitivity, bronchodilator reversibility cannot be considered a diagnostic tool to confirm diagnosis of asthma.

A comparative study of bronchodilator reversibility with albuterol, between asthma symptomatic and asymptomatic children according to ISAAC Questionnaire in Mexico City

Background: Asthma is an important childhood disease. Recent surveys of the International Study of Asthma and Allergies in Childhood (ISAAC) suggest that the prevalence of asthma is increasing but these surveys do not include any pulmonary tests to confirm the possible diagnosis of asthma. Objective: To compare bronchodilator reversibility with the albuterol test in symptomatic and asymptomatic 6-7-year-old children with asthma participating in the ISAAC survey and living in Mexico City. Patients and methods: We performed an observational, descriptive, comparative, cross sectional study in children participating in phase 3b of the ISAAC study. According to the ISAAC questionnaire children were classified as asthma symptomatic or asymptomatic. Both groups had bronchodilator reversibility with the albuterol test, using the guidelines of the American Thoracic Society to confirm or rule out the diagnosis of asthma. Results: The asymptomatic group had a baseline FEV1 of 1.70 ± 0.34 l/sec (mean ± SD) and an endpoint FEV1 of 1.76 ± 0.42 l/sec; in the symptomatic group the respective values were 1.51 ± 0.41 l/sec and 1.57 ± 0.44 l/sec (p < 0.05). A positive reversibility test was found in 13/136 (9.6 %) children in the asymptomatic group and in 22/112 (19.6 %) children in the symptomatic group (p < 0.05). Conclusion: Because of its low sensitivity, bronchodilator reversibility cannot be considered a diagnostic tool to confirm diagnosis of asthma (AU)

Introducción: El asma es una enfermedad infantil importante. Las encuestas recientes del Estudio Internacional sobre Asma y Alergias en la Infancia (ISAAC, por sus siglas en inglés) sugieren un aumento de la prevalencia del asma, si bien este instrumento de estudio no incluye ninguna prueba pulmonar para confirmar el posible diagnóstico de la enfermedad. Objetivo: Comparar la reversibilidad con tratamiento broncodilatador a base de albuterol entre niños asmáticos sintomáticos y asintomáticos según el estudio ISAAC, de edades comprendidas entre los 6 y 7 años y residentes en Ciudad de México. Pacientes y métodos: Se trató de un ensayo comparativo transversal, de carácter descriptivo y basa- do en la observación, realizado sobre niños que participaron en una encuesta de la fase 3b del ISAAC. Según el cuestionario del ISAAC, los niños se clasificaron como asmáticos sintomáticos o asintomáticos para asma. Ambos grupos fueron sometidos a la prueba de reversibilidad con tratamiento broncodilatador a base de albuterol, siguiendo las directrices de la Sociedad Torácica Americana, para confirmar o descartar el diagnóstico de asma. Resultados: El grupo asintomático presentó un FEV1 inicial de 1,70 ñ 0,34 l/seg (media ñ DE) y un FEV1 final de 1,76 ñ 0,42 l/seg; en el grupo sintomático, los valores respectivos fueron 1,51 ñ 0,41 l/seg y 1,57 ñ 0,44 l/seg (p < 0,05). En el grupo asintomático, 13 de 196 niños (el 9,6 por ciento) dieron positivo en la prueba de reversibilidad; en el grupo sintomático dieron positivo 22 de 112 niños (el 19,6 por ciento) (p < 0.05). Conclusión: La reversibilidad con tratamiento broncodilatador no puede considerarse una herramienta para confirmar el diagnóstico del asma debido a su bajo nivel de precisión (AU)

[Knowledge about infant asthma in medical students of Mérida, Yucatán, México]. / Conocimiento sobre asma infantil en estudiantes de medicina de Mérida, Yucatán, México.

146 undergraduate medical students at the Universidad Autónoma de Yucatán completed a questionnaire designed to measure knowledge about childhood asthma. Knowledge about asthma increased over each of the 7 years of the medical course, but the global qualification was lower their 60 points. The results suggest the necessity of implementation an educational program about childhood asthma.

[Development of a questionnaire to assess the knowledge on infantile++ asthma in medical students]. / Elaboración de un cuestionario para evaluar el conocimiento sobre el asma infantil en estudiantes de medicina.

Asthma is the most common chronic childhood illness. The increasing morbidity and mortality are striking contrast to major scientific advances in our understanding of asthma. It is now regarded as a chronic rather than a episodic illness and the major factors contributing to asthma morbidity and mortality are underdiagnosis and inappropriate treatment. The majority of children with asthma are cared for by nonspecialist physicians. Studies have shown that only small proportions of practitioners have an adequate understanding of the changing concepts of asthma management. We development an asthma knowledge questionnaire based on "Guidelines and the Practice Parameters for the Diagnosis and Management of Asthma" of The National Heart, Lung, and Blood Institute. The questionnaires include 25 questions on definition, physiopathology, diagnosis and treatment.

[Prevalence of asthma in schoolchildren in Merida, Yucatan]. / Prevalencia de asma en niños escolares de Mérida, Yucatán.

A survey was conducted in Merida, Yucatan, between February and June 1994 in order to determine the prevalence of asthma and the frequency of a family history of the disease in school-age children. A random sample was taken of 505 children of both sexes between the ages of 6 and 12 who were enrolled in elementary schools in the urban area of Merida. Every child's father or mother was surveyed and asked if the child had had recurrent episodes of loud, difficult breathing with wheezing chest sounds, if he or she had had bronchitis, asthmatiform bronchitis, or asthma, and if the mother, father, or any of the siblings had ever suffered from asthma. A total of 61 children with asthma (cumulative prevalence, 12%) was found. Among these children a history of maternal or paternal asthma was more frequent (25 and 18%, respectively) than in other children (10 and 6%, respectively), the difference being statistically significant (P < 0.002) in both cases. Results show the high prevalence of asthma in Merida and suggest that heredity plays a role in the development of the disease.

[Asthma: bronchial inflammation and hyperreactivity]. / Asma: inflamación e hiperreactividad bronquial.

There is not a clear definition of asthma, actually most of specialist consider to asthma how a reversible bronchial obstruction with an increased responsiveness (bronchial hyperreactivity, BHR), and inflammation. These inflammation can cause increase of the BHR and worseness the process. The new tendencies are to treat these BHR and control the two faces of asthma (early and late face). In the early or immediate face, bronchodilators are the most use full medicine meanwhile; the antiinflammatory drugs (sodium cromoglycate and inhaled steroids) are the best option for management of inflammation with reduction of BHR.

[Prevalence of asthma. Survey of a school population in Villahermosa, Tabasco, Mexico]. / Prevalencia del asma. Encuesta en una población escolar de Villahermosa, Tabasco, México.

In the state of Tabasco, Mexico, there apparently exists a great demand for medical care in children with asthma, yet the exact number of children with this illness is unknown. This motivated us to survey the parents of 5,625 school children with ages ranging from 6 to 12 years old (2,386 girls and 2,789 boys) living in the city of Villahermosa, Tabasco. The study included 11% of the school children in the vicinity. The survey showed that 22.3% of the population of school children refer chronic or repetitive respiratory symptoms; 8.7% referred a diagnosis of asthma; 6.8% bronchitis; 2.3% asthmatic form bronchitis; and 3.9% symptoms suggestive of repeated bronchial obstruction.

[Use of sodium cromoglycate in nebulizations for asthmatic children less than 7 years of age]. / Uso de cromoglicato de sodio por nebulizaciones en niños asmáticos menores de siete años.

One of the new ways to treat the inter crisis of asthma, is the use of Cromolyn (SCG) in spray or in Rothaller and it's necessary that the patient help's in the cooperation to use this medication. Now with SCG in solution to nebulizer is easy to use this medication in young children. We studied 18 boys and girls in 5 different cities of the mexican Republic, all the patient were younger than 7 years old and had asthma, they received 20 mg. of SCG in nebulizer 4 time daily up to 12 weeks. At the end of the study we found that the symptoms and the use of symptomatic medication were reduce in important way with statistic significance. We conclude the use SCG in nebulizer is safety and efficacy to treat patient with chronic asthma.

[Allergic rhinosinusitis]. / Rinosinusitis alérgica.

Is a brief review of the allergic rhinosinusitis, the role of the immunology in the etiopathogenesis, remarking the importance of the good clinical study which is the corner stone of the diagnosis and which what others diseases make a differential diagnosis. We present also some of the ways to treat the rhinosinusitis including preventive drugs, hyposensitivity and symptomatic medications.