ABSTRACT
BACKGROUND: Specific immunotherapy (SIT) and treatment with anti-immunoglobulin (Ig)E antibody are complementary approaches to treat allergic rhinoconjunctivitis, which may be used for single or combined treatment. OBJECTIVE: A randomized, double-blind, placebo-controlled trial was conducted to compare the efficacy of single and combined treatment with SIT and anti-IgE (Omalizumab) in reducing symptom severity and rescue medication use. METHODS: A total of 221 subjects with birch and grass pollen allergic rhinoconjunctivitis aged 6-17 years were analysed during the grass pollen season. Group A (SITbirch + placebo) served as a reference group obtaining no effective treatment for grass pollen allergy. Group B received anti-IgE monotherapy during grass pollen season, group C SIT grass pollen monotherapy, and group D the combined treatment of SIT and Omalizumab. RESULTS: Preseasonal treatment with grass pollen SIT alone compared with SIT with the nonrelated allergen did not reduce symptoms or rescue medication use. Anti-IgE monotherapy significantly diminished rescue medication use and number of symptomatic days. The combined treatment with SIT and anti-IgE showed superior efficacy on symptom severity compared with anti-IgE alone. CONCLUSIONS: Co-seasonal Omalizumab therapy showed considerable effects in children with seasonal allergic rhinitis. The combination of SIT plus Omalizumab was clinically superior to each treatment alone during the first year of observation.
Subject(s)
Antibodies, Monoclonal/therapeutic use , Desensitization, Immunologic , Poaceae/immunology , Pollen/immunology , Rhinitis, Allergic, Seasonal/therapy , Adolescent , Antibodies, Anti-Idiotypic , Antibodies, Monoclonal, Humanized , Child , Double-Blind Method , Humans , Omalizumab , Prospective StudiesABSTRACT
Los epónimos hacen parte fundamental del lenguaje y la cultura histórica de los ortopedistas y es interesante conocer algunas de las personas cuyo trabajo dio origen o popularizó los epónimos más frecuentes utilizados en ortopedia y traumatología.
Subject(s)
EponymsSubject(s)
Airway Obstruction/etiology , Bronchial Neoplasms/secondary , Bronchial Neoplasms/surgery , Carcinoma, Mucoepidermoid/secondary , Kidney Neoplasms/pathology , Pneumonia/diagnosis , Wilms Tumor/secondary , Airway Obstruction/diagnosis , Biopsy, Needle , Bronchial Neoplasms/pathology , Bronchoscopy , Carcinoma, Mucoepidermoid/pathology , Carcinoma, Mucoepidermoid/surgery , Child , Diagnosis, Differential , Follow-Up Studies , Humans , Kidney Neoplasms/therapy , Male , Pneumonectomy/methods , Pneumonia/etiology , Tomography, X-Ray Computed , Treatment Outcome , Wilms Tumor/diagnosis , Wilms Tumor/therapyABSTRACT
Paciente de 47 años de edad, que consultó al departamento de urgencias del Hospital Universitario del Valle el 30 de marzo de 1995, después de sufrir una caída sobre la mano derecha por una diferencia de nivel en el suelo. al ingreso presentaba limitación dolorosa de la flexión y extensión del codo y bloqueo de la prono-supinación, con aumento del perímetro de la muñeca y prominencia distal de la ulna (cúbito). Al examinar las radiografias iniciales encontramos una luxación radio-ulnar proximal a expensas de la cabeza radial y una luxación radio-ulnar distal con acortamiento del radio y prominencia de la ulna (cúbito) distal hacia el dorso. No se visualizó fractura en los huesos del antebrazo.
Subject(s)
Forearm Injuries , Joint Dislocations , Radio , ColombiaABSTRACT
BACKGROUND: The induction of TH2 immune responses is critically dependent on initial IL-4. Although crucial, the source of this early IL-4 has not been identified. One candidate is a CD1 restricted NK1.1+ T cell subpopulation which is known to produce such early IL-4. OBJECTIVES AND METHODS: The necessity of NK1.1+ T cells for the expression of an IgE-dependent phenotype was investigated in a NK1.1+ T cell deficient mouse model. The allergic phenotype was defined as immediate cutaneous hypersensitivity. It was induced by immunization of mice with ovalbumin. Mouse strains used were C57BL/6 mice and C57BL/6 mice homozygous for a targeted mutation of the beta2 microglobulin gene with consecutive loss of CD1 expression, which leads to a drastic reduction of NK1.1+ T cells. Manifestation of an allergic sensitization was assessed by intradermal allergen challenge after i.v. injection of Evans blue solution. The blue stained weal formations were quantified with the Bonitur method. In addition, the Th2 response was confirmed by the measurement of cytokines and serum immunoglobulins. The capability to produce early IL-4 was tested through the assessment of IL-4 mRNA shortly after a single challenge. RESULTS: Wild type and mutated mice did not differ in any of the immunological parameters measured. CONCLUSION: A single exposure to antigen with or without adjuvant induces early IL-4 production in C57BL/6 beta2m-/- mice. This early IL-4 is therefore independent of the presence of NK1.1+ T cells and functional MHC class I molecules and leads to IgE production and immediate cutaneous hypersensitivity.
Subject(s)
Dermatitis, Atopic/immunology , Immunoglobulin E/immunology , Killer Cells, Natural/immunology , Animals , Cell Degranulation , DNA Primers/chemistry , Dermatitis, Atopic/chemically induced , Enzyme-Linked Immunosorbent Assay , Immunophenotyping , Interleukin-4/biosynthesis , Interleukin-4/genetics , Intradermal Tests , Mast Cells/immunology , Mice , Mice, Inbred C57BL , Mice, Mutant Strains , Ovalbumin , RNA, Messenger/metabolism , Th2 Cells/immunology , beta 2-Microglobulin/physiology , p-Methoxy-N-methylphenethylamineSubject(s)
Abdominal Muscles , Abscess/classification , Abscess/diagnosis , Abscess/etiology , Myositis/therapyABSTRACT
La mayoria de los pacientes politraumatizados estan en su mejor momento de salud a su ingreso al hospital, y si son bien resucitados y estabilizados, pueden tolerar bien la fijacion interna de las fracturas mayores inestables en las primeras 24 horas. Esta nueva actitud quirurgica reduce la incidencia del sindrome de insuficiencia respiratoria aguda del adulto y de la falla multisistemica, y por tanto la mortalidad de estos pacientes, facilitando su movilizacion, cuidados de enfermeria y rehabilitacion en forma precoz
Subject(s)
Humans , Male , Female , Fractures, Bone , Multiple Trauma , Colombia , Fractures, Bone/complications , Fractures, Bone/surgery , Multiple Trauma , Multiple Trauma/complications , Multiple Trauma/mortality , Multiple Trauma/prevention & control , Multiple Trauma/surgery , Multiple Trauma/therapy , Nursing CareABSTRACT
Se presenta la transferencia del extensor propio del indice al abductor corto del pulgar como la mejor eleccion dentro del armamentario de oponentoplastias disponibles para el cirujano de mano: tecnicamente facil, no reuiere crer poleas ni injertos tendinosos, corto periodo de inmovilizacion, al actuar como ferula interna obvia la necesidad de ferulas externas, reeducacion facil y rapida, no crea deformidades, no requiere anestesia general, procedimiento ambulatorio, no disminuye la funcion de la mano por efecto de la transferencia.
Subject(s)
Child, Preschool , Child , Adolescent , Adult , Middle Aged , Humans , Male , Female , Median Nerve/injuries , Median Nerve/surgery , Peripheral Nervous System Diseases/complications , Peripheral Nervous System Diseases/surgery , Hand/surgery , Surgical Procedures, Operative , ThumbABSTRACT
Aunque los injertos de piel son un procedimiento tan frecuente en la practica medica, los medicos tienen poca exposicion al metodo y sus detalles, debido a que los textos clasicos ingoran la tecnica de los injertos. Por este motivo al revisar el tema, se hace enfasis en los tipos de injertos, sus indicaciones y se recomienda el uso del dermatoma simplificado, ideal en el medio colombiano por su bajo costo, y su manejo sencillo al alcance de todo medico, pues se puede emplear en cualquier medio, hospital, consultorio o puesto de salud tanto en pacientes hospitalizados como ambulatorios. Este sistema permite utilizar al maximo las indicaciones de los injertos de piel y acrecentar el arsenal terapeutico del medico
