Response to budesonide among atopic and non-atopic infants/preschoolers with recurrent wheezing

Background The treatment in non-atopic young children with recurrent wheezing remains controversial. Objective The aim of the study was to compare the response of inhaled budesonide in atopic versus non-atopic infants/preschoolers with recurrent wheezing (more than three episodes in the last year or one episode per month in the last three months). Methods One hundred and seventy three infants/preschoolers (mean age 1.58¡À0.9 yrs) with recurrent wheezing without previous use of inhaled corticosteroids were enrolled and divided into two categories: atopics (eosinophils in peripheral blood ¡Ý4%) and non-atopics (<4%). Both groups were treated with budesonide (200mcg bid delivered by MDI and spacer) for three months. The primary outcome was the prevalence of wheezing exacerbation episodes at the end of the treatment. Results Thirty-seven out of 173 (21.4%) were atopics and they were significantly younger, more frequently with a father with asthma, maternal grandparents with asthma and rhinitis, paternal and maternal grandparents with eczema, and higher number of wheezing episodes in the last year than non-atopics. At the end of the study, among those with good compliance (>70% of the weekly doses), the proportion of wheezing episodes were similar among atopics and non-atopics (57.7% vs. 44.1%, p=0.25, respectively); the number of exacerbations requiring emergency department (ED) visits and hospital admission were also similar. Conclusion Regular budesonide therapy may decrease the episodes of wheezing in infants/preschoolers with recurrent wheezing, independently of atopy

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Response to budesonide among atopic and non-atopic infants/preschoolers with recurrent wheezing.

BACKGROUND: The treatment in non-atopic young children with recurrent wheezing remains controversial. OBJECTIVE: The aim of the study was to compare the response of inhaled budesonide in atopic versus non-atopic infants/preschoolers with recurrent wheezing (more than three episodes in the last year or one episode per month in the last three months). METHODS: One hundred and seventy three infants/preschoolers (mean age 1.58+/-0.9 yrs) with recurrent wheezing without previous use of inhaled corticosteroids were enrolled and divided into two categories: atopics (eosinophils in peripheral blood > or =4%) and non-atopics (<4%). Both groups were treated with budesonide (200 mcg bid delivered by MDI and spacer) for three months. The primary outcome was the prevalence of wheezing exacerbation episodes at the end of the treatment. RESULTS: Thirty-seven out of 173 (21.4%) were atopics and they were significantly younger, more frequently with a father with asthma, maternal grandparents with asthma and rhinitis, paternal and maternal grandparents with eczema, and higher number of wheezing episodes in the last year than non-atopics. At the end of the study, among those with good compliance (>70% of the weekly doses), the proportion of wheezing episodes were similar among atopics and non-atopics (57.7% vs. 44.1%, p=0.25, respectively); the number of exacerbations requiring emergency department (ED) visits and hospital admission were also similar. CONCLUSION: Regular budesonide therapy may decrease the episodes of wheezing in infants/preschoolers with recurrent wheezing, independently of atopy.

Tenorrafia del tendón de aquiles: revisión de experiencia con técnica abierta / Achilles tendon tenorraphy: revision of an specific open technique

The surgical treatment of ruptured Achilles Tendon presents the advantage of less rerupture but increased complication rate due to surgery itself. This retrospective case revision include 25 surgical repair of Achilles Tendon with an open technique with a simple suture, from November 2002 to May 2006. Phone interview to 19 patients and clinical evaluation to 9 patients is presented. No surgical wound complications or rerupture of the tendon is present in this series. Functional recovery to normal daily living activities in 96 percent and return to previous sports activities in 64 percent are comparable to results in national and international literature.

El manejo quirúrgico de la rotura del tendón de Aquiles presenta dentro de sus ventajas un menor índice de rerotura y una rehabilitación más temprana. Por otro lado, se le atribuye un mayor índice de complicaciones propias de la cirugía. En este trabajo se revisaron los registros clínicos de 25 pacientes operados con técnica abierta y sutura mínima del tendón de Aquiles, entre noviembre del 2002 y mayo 2006. Se realizó una evaluación telefónica a 19 pacientes y posteriormente a 9 de ellos se les realizó un control clínico. El objetivo de este trabajo fue evaluar los resultados funcionales, presencia de complicaciones, función clínica, retorno laboral, retorno deportivo, indicación de rehabilitación y satisfacción global del paciente. En los resultados destaca la ausencia de complicaciones de la herida operatoria, el rápido retorno laboral, la recuperación funcional para actividades de la vida diaria y la satisfacción global presente en el 95 por ciento de los pacientes evaluados.