Prevalence of asthma, allergic rhinitis and pollinosis in a city of Brazil: A monitoring study.

BACKGROUND: Allergic respiratory diseases such as asthma and allergic rhinitis have increased considerably in the last decades. OBJECTIVE: The present study estimates prevalence trends of asthma, allergic rhinitis and pollinosis in the population of a city of Southern Brazil, without restriction of age, from 2011 to 2018, using the ISAAC standardized questionnaire. METHODS: Data was collected from March to June of 2011 and during the same months in 2018, in order to verify trends in the prevalence of these allergic conditions. The total sample consisted of 3132 individuals of both sexes living in the municipality of Santo Ângelo, in the state of Rio Grande do Sul, Brazil. RESULTS: No differences were observed in the prevalence of asthma diagnosis (15.1% in 2011 and 13.8% in 2018), however the prevalence of current wheeze was significantly reduced from 24.7% in 2011 to 21.2% in 2018 (p<0.05). Regarding allergic conditions in 2011 and in 2018, a significant reduction was observed (p<0.001) in reported current rhinitis (63.3% vs. 50.5%), rhinoconjunctivitis (48.9% vs. 38.8%), hay fever (52.0% vs. 43.3%), and pollinosis (29.0% vs 17.0%). Moreover, we observed an inverse relation between age and rhinoconjunctivitis and hay fever, and all symptoms were more frequent in females. Rhinoconjunctivitis and hay fever, as well as current rhinitis and pollinosis were highly prevalent among 30-39 years-old individuals, whereas current wheeze affected mainly the age group 10-19 years-old. CONCLUSION: While the prevalence of asthma remained similar after seven years, allergic rhinitis and pollinosis declined between 2011 and 2018.

[General anesthesia for magnetic resonance. Experience on 100 cases]. / Anestesia generale per la risonanza magnetica. Esperienza su 100 casi.

The diffusion of magnetic resonance imaging as a powerful non-invasive diagnostic procedure has led to an increasing request for general anaesthesia in patients who cannot lie still and/or who cannot guarantee adequate spontaneous breathing during the procedure. We report our own experience in 100 patients of this kind, in whom the need for general anaesthesia was due to neurological problems and/or tender age. Anaesthesia and monitoring devices were either devoted of ferromagnetic properties (allowing their location near the patient; as the ARM-S88 portable ventilator, which we used for adult patients) or connected to the patient with long connectors (allowing their location outside the resonance magnetic field; as the Draeger-Babylog pressometric ventilator, which we used in pediatric patients). On these bases administration of intravenous (86 patients) and inhalation (14 patients) anaesthesia during magnetic resonance proved safe in our experience.

Submaximal nerve stimulation with the Datex relaxograph NMT monitor in myasthenia gravis.

Recently submaximal train-of-four stimulation of motor nerves has been reported as a reliable technique for monitoring the neuromuscular function in patients awakening from anaesthesia, in order to prevent residual curarization. On the basis of the similarity between curarization and Myasthenia Gravis, we studied the neuromuscular impairment of four myasthenic patients by means of a commercially available monitor, which has been designed for routine application in the operating room. We demonstrate that the cardinal features of Myasthenia Gravis can be easily detected with this simple and painless method.

[Pre- and postoperative evaluation of plasma creatine kinase in 142 children subjected to "uncomplicated" anesthesia in muscle biopsy]. / Valutazione pre e postoperatoria della creatinkinasi plasmatica in 142 bambini sottoposti "senza complicazioni" ad anestesia per biopsia muscolare.

Pre- and postoperative serum CK activity is evaluated in 142 children submitted, "uneventfully", to diagnostic muscle biopsy under halothane (77 patients), ketamine (50 patients) or "local" (15 patients) anaesthesia. The purpose was to ascertain whether or not anaesthesia-induced-rhabdomyolysis (AR) was an asymptomatic (and unrecognized) complication of "uneventful" anaesthesia. The majority of patients with low preoperative CK values showed a slight increase of serum CK activity on the first postoperative day. On the contrary, a postoperative decrease was observed in the majority of patients with high preoperative values (namely in almost all ketamine patients and in 2/3 of halothane-patients). In no case postoperative increase reached a value suggesting the occurrence of AR even though a postoperative value of 16480 U/I was observed in a patient with Duchenne muscular dystrophy after halothane anaesthesia. Sudden interruption of motor activity induced by general anaesthesia seems to be the most important factor in reducing the release of CK from muscle. When preoperative release is low, any further postoperative reduction is not sufficient to balance the moderate increase of CK produced by the surgical procedure; the opposite should happen in patients presenting with high preoperative release. So far as anaesthetics are concerned, our data seem to suggest that ketamine has a higher "protective" role compared to halothane.

Increased activation effects of succinylcholine in neurological patients.

Succinylcholine, a depolarizing muscle relaxant with both activating and desensitizing effects, is used to facilitate endotracheal intubation. The activating effects were found to be above-normal on induction of anesthesia in 7 neurological patients: generalized muscle spasm in 1 myotonic patient, contractures or prolonged contractions in "anatomically" denervated muscles (1 patient), in "functionally" denervated muscles (1 patient) and in "centrally" denervated muscles (4 patients). One of these four presented hyperkalemia and cardiocirculatory collapse. It is important to differentiate these anomalous responses to succinylcholine from those occurring as early signs of rhabdomyolysis or malignant hyperthermia.