[Asthma risk factors]. / Factores de riesgo para asma.

OBJECTIVE: To study the magnitude of risk factors known for asthma in 6-10 year-old children. MATERIAL AND METHODS: This is a case- and control-study with 6-10 year-old children; 58 were asthmatic and 117 were control, with a relation 2:1. Asthmatic patients were recruited from consult of immuno-allergies department and control patients, from familial medicine consult of Hospital de Especialidades 71, IMSS. Indirect (mother) and directed surveys were applied, they were of multiple option for exploring the most known in literature-risk factors. Statistical management was performed by odds ratio with confidence interval of 95%. RESULTS: The following variables were considered risk factors: ingestion of artificial colorants before having 1 year old (OR = 13.2), living in an urban area (OR = 7.74), maternal smoking during pregnancy (OR = 2.4), wool contact before having 1 year old (OR = 2.11), passive smoking exposure during pregnancy (OR = 1.486) and feeding with industrialized milk (OR = 1.2). CONCLUSIONS: Environmental risk factors are very important in our population, as well as early ablactation; however, ingestion before having 1 year old of allergens as egg, chocolate, orange and mango was not considered risk factor.

Breakfast and performance.

Evidence suggests that the effect of fasting on performance is not uniform, but it is dependent on the basal nutritional status of the subject. Breakfast consumption has a short-term effect in improving selected learning skills, especially work memory. School breakfast programmes have a positive effect on the nutritional status of children, on school attendance and probably on dropout rates. The effect of breakfast consumption on school performance depends on the interaction between the programme, student characteristics (malnutrition) and school organisation. Unless the school setting guarantees a minimum quality standard, the benefits of breakfast consumption will not be evident in performance in complex areas like language or maths.

[Spirometric pulmonary age and its correlation with the chronological age of asthma patients]. / Edad pulmonar por espirometría y su correlación con la edad cronológica de pacientes con asma.

AIMS: Pulmonary age as a linear regression spirometric index, expresses pulmonary ventilatory function. OBJECTIVE: A pilot study was done to assess the differences of the values of the pulmonary age index and chronological age in patients with bronchial asthma and healthy volunteers. MATERIAL AND METHOD: We studies 111 subjects, 31 healthy and 80 with asthma. RESULTS: All of them underwent spirometry. Healthy individuals showed a mean chronological age of 35 years, and a pulmonary age of 26 years. Asthmatic patients showed a mean chronological age of 38 years, and a pulmonary age of 59 years. CONCLUSION: Both the time course and the severity of the disease increased pulmonary age.

[Frequency of association of rheumatoid factor in patients with breast cancer]. / Frecuencia de asociación del factor reumatoide en pacientes con cáncer de mama.

AIMS: It has been reported that some patients with cancer present auto-immune phenomenon mediated by auto-antibodies, suggesting a relationship between auto-immunity and cancer. Our interest was to determine the frequency of association of rheumatoid factor and breast cancer. MATERIAL AND METHOD: Fifty patients were studied, 3 on stage 111 and 19 on stage IV. Rheumatoid factor was measured in all of them. Auto-antibodies were measured by ELISA. The clinical files of all the patients were reviewed to determine the presence of metastases (osseous, pulmonary, CNS and hepatic) as well as the histological type of the cancer to correlate the expression of the rheumatoid factor with the patients' clinical status. RESULTS: Four (12.9%) out of the 31 patients on stage 111 had positive rheumatoid factor, while 9 (47.3%) out of 19 patients on stage IV had positive rheumatoid factor. The mean age of the patients on stage 111 with positive rheumatoid factor was 48 years, while the mean age of the patients on stage IV with positive rheumatoid factor was 53 years. Patients on stage 111 with positive rheumatoid factor only had local-regional metastases while patients on stage IV with positive rheumatoid factor had distant metastases. The predominant histological type was adenocarcinoma. CONCLUSION: In this study it is shown that breast cancer on the most advanced stages have higher expression of rheumatoid factor, and more clinical derangement with higher levels of rheumatoid factor expression. The proposal of auto-antibodies as predictors of the severity of the cancer requires further studies on several types of cancer.

[Effect of Staphylococcus aureus extract on the expression of L-selectin and LFA-1, in neutrophils from patients with allergic bronchial asthma]. / Efecto del extracto de Staphylococcus aureus en la expresión de L-selectina y LFA-1, en neutrófilos de pacientes con asma bronquial no alérgica.

OBJECTIVE: Messier L-selectin and LFA-1 in neutrophils from moderate and non atopic asthma patients, before and after stimuli with and without Sa (Staphylococcus aureus). MATERIALS AND METHOD: Design Trial; experimental. We studied neutrophils from 12 moderate and non atopic asthma patients and 12 healthy subjects before and after stimuli with and without Sa. MEASURES: The neutrophyls adhesion molecules, CD 62-L and CD 11 a was measured by citometric flow assays. RESULTS: The median of CD 62-L molecule expression increase with the stimuli in non atopic asthma patients from 2444 (CI 1966, CS 3627, RC 1661) to 6285.5 (CI 5243, CS 7203, RC 1960), and the median of CD 11 a molecule expression decrease with the stimuli in non atopic asthma patients from 9910.5 (CI 9765, CS 9961, RC 196) to 7670 (CI 7125, CS 8291, RC 1166). The median of CD 11 a molecule expression increase with the stimuli in healthy subjects from 593 (CI 361, CS 929, RC 568) to 1113 (CI 910, CS 1240, RC 330) and the median of CD 11 a molecule expression decrease with the stimuli in healthy subjects from 9850 (CI 9741, CS 9898, RC 157) to 9808.5 (CI 9693, CS 9890, RC 197) [CI. Inferior Cuartil, CS. Superior Cuartil, RC.-Cuartil Range].

[Frequent allergies in Mexico Valley in children]. / Alergenos frecuentes del Valle de México en niños.

The incidence of skin test positively for 48 allergens have been evaluated in children with bronchial asthma. We studied the 347 cards of clinical file the allergic children a course 32 months. The most frequent allergens is Dermatophagoides pteronyssinus, cat and the other 24 allergens were less 10%. This allergen appears to present in Mexico Valley, the incidence to this allergen might be considered must frequent in allergic children who do reducing skin test for diagnostic allergic diseases.

When science and politics listen to each other: good prospects from a new school breakfast program in Peru.

This article provides an overview of a school breakfast program implemented in 1993 in the Peruvian Andes. The program, designed by the Instituto de Investigación Nutricional in Lima and supported by the government of Peru, constitutes a clear departure from previous school feeding programs, which were heavily politicized and poorly documented. From the program's inception, nutritionists, managers, and social scientists have collaborated to produce a sound nutritional design, efficient distribution mechanisms, and effective evaluation methods. During the program's first year, controlled evaluations conducted in several Andean regions documented improved dietary intake and a significant decline in the prevalence of anemia. An educational evaluation also found improved verbal skills, higher school attendance, and lower dropout rates among recipients of the school breakfast. The results have prompted the Peruvian government to continue supporting the program, thus setting a new standard for the effective management of social expenditure in the context of economic adjustment.

[Diagnostic use of enzymatic RAST skin tests and determination of eosinophils in nasal mucosa in allergic rhinitis]. / Utilidad diagnóstica de las pruebas cutáneas RAST enzimático y determinación de eosinófilos en moco nasal en la rinitis alérgica.

AIMS: Allergic rhinitis is the most frequent disease mediated by immunoglobulin E (IgE). Nasal challenge is the gold standard for the diagnosis of allergic rhinitis. Skin tests (ST) are the most used diagnostic method to detect the presence of specific IgE bind to skin mast cells. The exposition of the nasal mucous membrane to the allergen is followed by an increase of the local eosinophils; the count of eosinophils in nasal mucous (ENM) is a diagnostic test for allergic rhinitis. Enzymatic RAST or enzymatic allergo-sorbent test (ESA) measures the level of serum allergen-specific IgE. OBJECTIVE: To measure the sensitivity, specificity, and diagnostic precision of ST, EAST and ENM in allergic rhinitis. METHOD: We studied 241 individuals, 162 of them had allergic rhinitis, and 79 were healthy controls. They underwent nasal challenge and intradermic ST for Dermatophagoies spp (acarus). Fraxinus americana (Ash-tree), Amaranthus palmieri (quelite), Cynodon Dactylon (capriola) and Felis catus (cat), EAST for Dermatophagoides pteronyssinus (acarus), and ENIVI. Results of ST, EAST and ENIVI were compared with their corresponding nasal challenge, and the prevalence of allergic rhinitis for each allergen was calculated. The best cut point was assessed by means of receiver-operator curves (ROC), and sensitivity, specificity, positive predictive value, negative predictive value, inter-observer concordance coefficient, area under ROC (0), standard error of 0 (SEO), and 95% confidence interval of 0 of each test were calculated using the best cut point. RESULTS: ST and EAST had the best sensitivity and specificity. ENM had the lowest sensitivity and specificity. CONCLUSION: For the diagnosis of Dermatophagoides spp allergic rhinitis ST for Dermatophagoides spp and EAST for Dermatophagoides pteronyssinus have the same diagnostic precision. According to the indexes for diagnostic precision, and inter-observer concordance coefficient, ST and EAST are useful to diagnose allergic rhinitis induced by the evaluated allergens. ENIVI is a test that is not very useful for the diagnosis of allergic rhinitis.

[Superantigens in human disease]. / Superantígenos en la enfermedad humana.

Superantigens include viral and bacterial products, mainly of streptococci, staphylococci that stimulate T cells to proliferate nonspecifically through interaction with class II major histocompatibility complex products on antigen-presenting cells and then with variable regions on the beta chain of T cell receptor complex. Superantigens cause symptoms via release of immune cytokines. These proteins should be considered potential cause of illnesses such as rheumatic fever, arthritis. Kawasaki syndrome, atopic dermatitis, and guttate psoriasis because of their potent immune system-altering capacity.

[Premenstrual asthma: relation to hormones]. / Asma premenstrual: relación con hormonas.

Exacerbation of asthmatic symptoms just before or at the time of menstruation documented in some women with asthma has been called "premenstrual asthma" (PMA). The effect of sex hormones on airway function has not been well studied in spite of much evidence to suggest, therefore about relationships between the sex hormones and airway. The investigations of (PMA) have been based on studies of asthmatics already aware of a deterioration of asthma premenstrually. Little is known, therefore, about relationships between the menstrual cycle with asthma and (PMA) subjects. Although the mechanism of PMA remains unclear.

[Exposure to pollutants and allergens in the asthmatic child compared with the healthy child]. / Exposición a contaminantes y alergenos en el niño asmático en comparación con el niño sano.

To assess the frequency of exposure to allergens and indoor pollutants of school age asthmatic children at the time of their first visit to the specialist, we studied 14 cases with the diagnosis of asthma according to international criteria, and 21 healthy controls. The parents of the children filed a questionnaire asking about socio-economic level, family history of asthma, exposure to allergens or indoor pollutants, and clinical severity of the disease. Questionnaires with less than 80% of the responses were excluded from analysis. Asthmatic patients had higher frequency of exposure to tobacco smoke (42.8% vs 38%), moisture in the home walls (42.9% vs 19%), and to dust reservoirs (71.4% vs 52.4%). A high proportion of the asthmatic patients did not apply adequate environmental control measures. Education for the patients and their primary care physicians must be increased, to reduce the morbidity of the diseases.

[Nasal eosinophilia after specific provocation in patients with perennial allergic rhinitis]. / Eosinofilia nasal posterior al reto específico en pacientes con rinitis alérgica perenne.

We studied 35 patients with perennial allergic response to know the eosinophilia after the nasal challenge with specific antigen. Patients were selected randomly. In each patient, history and clinical examination, cutaneous tests, and eosinophil count in nasal mucous membrane were done 30 minutes and 8 hours after the challenge with Dermatophagoides antigen Results showed a significant increase of eosinophils after the challenge (P.006). Significant differences were not discussed between the eosinophil counts obtained 30 minutes and 8 hours after the challenge.

School breakfast and cognition among nutritionally at-risk children in the Peruvian Andes.

PIP: In 1993, in Peru, the Institute of Nutritional Research conducted two studies in Huaraz in the Andean region to evaluate the educational and nutritional impact of the government's School Breakfast Program. The school breakfast included a small cake and a glass of Amilac (similar in taste and color to milk), which provided 30% of each child's energy requirements, 60% of recommended dietary allowances for minerals and vitamins, and 100% of dietary iron needs. A case control study examined the effects of breakfast on cognition among 54 elementary schoolchildren 9-11 years old. It found that the school breakfast did not have a significant effect on the children's performance in the Number Discrimination, Peabody Picture Vocabulary Test, Raven Progressive Matrices, or Reaction Time tests. Children nutritionally at risk who received the placebo had significantly slower short-term memory scanning than their counterparts who received the breakfast. The no-risk placebo group exhibited more rapid discrimination between visual stimuli than the no-risk breakfast group. A field evaluation of the program in 10 rural schools, which were randomly assigned to a treatment or control condition, was conducted. In terms of energy, protein, and iron intake, the children in the case and control conditions were not significantly different. The children tended to be either very stunted or overweight. School attendance increased 0.58 points in the experimental group, while it decreased by 2.92 points in the control group (p 0.05). When both groups received the breakfast, attendance rates increased significantly in both groups (p 0.05). Vocabulary was sensitive to the effects of the breakfast. Specifically, the greater the child's weight, the higher his/her vocabulary test scores (p 0.05). These findings suggest that the brain is sensitive to decreases in the short-term availability of nutrients, and that an overnight and morning fast produces a physiological state accompanied by changes in brain function, especially working memory, particularly among nutritionally at-risk children.^ieng

[Immunology of the fetal-maternal relationship]. / Inmunología de la relación materno fetal.

For the last 40 years it has been considered that during pregnancy fetal antigens are expressed in a different manner in comparison with other grafts. Current data indicates that the acceptance of the fetus by the mother depends on the lack of expression of the polymorphic antigens and the production of hormones that act as immunological suppressors. During pregnancy there exists immunological recognition of the trophoblast antigens, but these antigens are not polymorphic and thus do not permit the identification of cytolytic T and natural killers cells. This structure also produces hormones that contribute to the diminished production and proliferation of T cells. It has been demonstrated that there exists an increase in the production by the trophoblast of complement inhibitors (DAF, CD46) and in the secretion of hormones such as progesterone, alpha-fetoprotein, steroids and prostanglandins. The identification of these immunological factors and mechanisms may be fundamental in the search for treatment regimens for such illnesses as cancer, infertility, spontaneous abortions, transplant rejection and graft versus host disease.

Efecto in vitro del cromoglicato disódico sobre la actividad fagocítica de los polimorfonucleares de pacientes asmáticos sanos / Disodium chromoglicate reduces in vitro phogcytic activity of the polymorphonuclear cells in asthmatic patients and healthy

El cromoglicato disódico (CGDS) interfiere con el trasporte de la membrana celular inhibiendo la liberación de mediadores y la activación de polimorfonucleares (PMN), al impedir el incremento del calcio libre intracelular. Para determinar si el CGDS disminuye la actividad fagocítica in vitro de PMN se incubaron PMN de personas sanas y asmáticos alérgicos con CGDS o con solución salina balanceada de Hank (SSBH) y se evaluó su actividad fagocítica con la técnica de quimioluminiscencia. Al comparar las muestras no se encontró diferencia significativa con la actividad fagocítica entre las incubadas con CGDS y las incubadas en SSBH sin CGDS; tampoco se halló diferencia en la actividad fagocítica entre los asmáticos y sanos y no hay diferencia en la capacidad fagocítica de PMN entre asmáticos y sanos

[In vitro effect of disodium cromoglycate on phagocytic activity of polymorphonuclear cells of healthy asthmatic patients]. / Efecto in vitro del cromoglicato disódico sobre la actividad fagocítica de los polimorfonucleares de pacientes asmáticos sanos.

Disodium chromoglicate interferes cellular membrane transport, inhibits mediators release and activation of polymorfonuclear cells (PMN) by blocking intracellular free calcium increment. In order to assess if DC reduces in vitro phagocytic activity of PMN, these cells obtained from allergic asthmatic patients and healthy subjects were incubated with DC or Hanks solution (HS). Their phagocytic activity was measured with chemoluminiscence technique. There were not significant differences in phagocytic activity between the cells incubated with DC and those incubated with HS, nor between cells from asthmatic patients and healthy subjects. We conclude that DC has not in vitro effect on phagocytic activity of PMN from healthy and asthmatic subjects. There are no difference in PMN phagocytic capacity between healthy and asthmatic subjects.

[Epidemiologic aspects of bronchial asthma in the Mexican Republic]. / Los aspectos epidemiológicos del asma bronquial en la República Mexicana.

This work was done to determine the mortality and morbidity rates secondary to asthma in Mexico, for age, gender, state of the country and time. Data were obtained from the Instituto Nacional de Estadística. Geografía e Informática. We calculated morbidity and mortality rates adjusting for age, by a direct method. In the results, there was a reduction in mortality rate in both genders, from 1960 to 1987. Age groups up to 4 years and older than 50 were the mainly affected. From 1960 to the present time, the state with highest mortality is Tlaxcala. The states with highest hospitalization rates were Morelos, Baja California Sur, Nuevo León, Durango and Tamaulipas. In conclusion, mortality rates secondary to asthma in Mexico show a decreasing trend, with a considerable rise in morbidity, especially in the adolescent group.

[Ethical principles of medical research using human subjects]. / Los principios éticos de la investigación médica en seres humanos.

Medical research involving human beings has contributed to the advancement of knowledge about prevention, diagnosis, and treatment of the diseases. All researchers, independently of their working country, must always have in mind the international ethical principles as a guide in the solution for the ethical problems that they may face during the practice of research activities on human beings. Among the ethical principles more widely accepted in the western culture, three are of upstanding importance for clinical research in human subjects: a) the principle of respect for persons, based upon the conception of the individual as an autonomous being, capable of shaping and directing his own life; b) the principle of beneficence, that refers to the ethical obligation to maximize benefits and to minimize harms and wrongs; and c) the principle of justice, that refers to the ethical imperative to treat each person in accordance with what is morally right and proper. The application of these theoretical principles to the real life problems is not easy, especially in cases in which the research group belong to a developed country, and the group of participating subjects, to an underdeveloped one. It is worthy to ask if the three mentioned ethical principles are universally acknowledged, and whether in the Latin American and Caribbean region, these principles are recognized as the gold rules for the solution of the ethical problems of medical research involving human subjects.

[In vitro effect of bacterial extracts of S. aureus in chemokinesis and chemotaxis of polymorphonuclear cells]. / Efecto in vitro del extracto bacteriano de S. aureus en la quimiocinesis y quimiotaxis de células polimorfonucleares.

The purpose of the study was to determine if the extract of Staphylococcus aureus in vitro can modify chemokinesis and induce chemotaxis of polimorphonuclear (PMN) cells of peripheral blood in healthy donors. Chemocinesis and chemotaxis of PMN of peripheral blood in 30 healthy donors of either sex from 18 to 40 years old was measured. A 5 mL sample of peripheral blood was drawn. PMN were separated by Boyum's method and challenged with of Staphylococcus aureus extract and C5a as chemotactic factors, and Hank's solution chemokinesis. Chemokinesis was 54.6 +/- 8.8 microns, chemotactic response to C5a was 89 +/- 12.5 microns and with bacterial extract the response was 103 +/- 20.1 microns (p). In conclusion, complete extract of Staphylococcus aureus stimulates in vitro chemotaxis of PMN from healthy donors, and this stimulation is similar to known chemotactic factors as C5a.

[In vitro effect of tuftsin (L-prolyl-L-arginine) on the oxidative capacity of polymorphonuclear lymphocytes in small-for-gestational-age newborn infants]. / Efecto in vitro de la tuftsina (L-prolil-L-arginina) en la capacidad oxidativa de los polimorfonucleares en niños recién nacidos pequeños para su edad gestacional.

Tuftsin has the function of activating cellular macrophages and polymorphonuclears (PMNs). This tetrapeptide is transported by the CH2 domain of the heavy chain between residues 289 and 292 of the gammaglobulin (IgG) molecule. The objective of this work is to determine the effect of synthetic tuftsin in its oxidative capacity of PMN cells of newborns of low birth weight for their gestational age having already been demonstrated that the phagocytic activity of these cells of macrophages and PMNs is diminished compared with the cells of newborns of normal birth weight according to gestational age. Results showed a stimulatory effect of the PMNs oxidative capacity with synthetic tuftsin by the increase of the nitrotetrazolium blue reduction, demonstrating that the low oxidative capacity of the cells of newborns of low birth weigh for gestational age does not correlate with an intrinsic cellular defect.