Sinergia en la analgesia tratada con ibuprofeno y codeína / Drug synergism in analgesia treated with ibuprofen and codeine

Una de las principales características de una buena combinación farmacológica es la sinergia. Existe en el mercado, desde hace relativamente poco tiempo, una nueva combinación analgésica de ibuprofeno, un antiinflamatorio no esteroideo (AINE) muy usado en la práctica médica diaria por su buen cociente de eficacia y seguridad, y codeína, un opiáceo menor muy utilizado como segundo escalón analgésico en combinación. Hemos realizado una revisión en MEDLINE de los principales estudios publicados en la literatura médica en cuanto a eficacia y seguridad de ambos principios activos por separado, para finalizar con una aproximación tanto de la experiencia clínica mostrada en estudios con combinaciones analgésicas en general, como en las hipótesis de un posible sinergismo entre AINE y opiáceos (AU)

One of the principal characteristics of a good pharmacological combination is drug synergism. A new analgesic combination of ibuprofen, a non-steroidal anti-inflammatory drug, used frequently in clinical practice due to good quotient of efficacy and safety, and codeine, a minor opiate used very much as second analgesic step in combination, has recently come on the market. We have conducted a review in MEDLINE of the principal studies published in the medical literature as regards the efficacy and safety of both drugs separately and finally, a review of the clinical experience showed in studies with analgesic combinations in general and on the hypothesis of a possible drug synergism between NSAIDs and Opiates (AU)

[Drug synergism in analgesia treated with ibuprofen and codeine]. / Sinergia en la analgesia tratada con ibuprofeno y codeína.

One of the principal characteristics of a good pharmacological combination is drug synergism. A new analgesic combination of ibuprofen, a non-steroidal anti-inflammatory drug, used frequently in clinical practice due to good quotient of efficacy and safety, and codeine, a minor opiate used very much as second analgesic step in combination, has recently come on the market. We have conducted a review in MEDLINE of the principal studies published in the medical literature as regards the efficacy and safety of both drugs separately and finally, a review of the clinical experience showed in studies with analgesic combinations in general and on the hypothesis of a possible drug synergism between NSAIDs and Opiates.

[Prevalence of hiatal hernia and chronic esophagitis in adult asthmatic patients]. / Prevalencia de hernia hiatal y esofagitis crónica en pacientes asmáticos adultos.

BACKGROUND: The association among asthma, hiatus hernia, oesophagitis and gastro-oesophageal reflux has been reported as etiologic factor that alters the clinical evolution of the asthma. MATERIAL AND METHODS: Prospective, longitudinal and comparative study was developed. 90 patients were incoming with persistent light and moderate asthma, of allergic etiology. By the 6 months of immune-allergic treatment the clinical answer was valued being classified in two groups: Group A: 40 patients with intermittent light asthma and group B: 50 patients with persistent severe moderate asthma. In both groups they were submitted to an endoscopy for the diagnosis of esophageal pathology, with biopsies in the 3 esophageal thirds. They registered symptoms of gastro-oesophageal reflux. RESULTS: 72 women and 28 men, age average 35.9 years. There was hiatus hernia in 33 patients, 12 of the group A and 21 of the B. Upper oesophagitis in 21 patients, 8 of the group A and 13 of the B. Symptoms of gastro-oesophageal reflux in 71 patients, 29 of the group A and 42 of the B. The association among hiatus hernia, oesophagitis and gastro-oesophageal reflux was observed in 12 patients, 2 of the group A and 10 of the B (p < 0.05). CONCLUSIONS: The association of symptoms among gastro-oesophageal reflux, hiatus hernia and upper oesophagitis, is bigger in the patients with bad answer to the anti-asthmatic treatment; they are justified to endoscopy study and biopsies of the upper oesophagus (in the group of patients with bad response and symptoms of gastro-oesophageal reflux) when 24 hours pH-monitoring is not available.

[Effect of immunotherapy with allergens in asthmatic children with integral treatment]. / Efecto de la inmunoterapia con alergenos en niños asmáticos con tratamiento integral.

OBJECTIVE: To analyze the effect of the immunotherapy with allergens (ITA) in asthmatic pediatric patients with integral treatment. MATERIAL AND METHODS: We included children with allergic rhinitis and asthma to treatment in the Clinic of Asthma and Allergy. We made a monthly evaluation of symptoms and annual of laboratory tests. RESULTS: The results are described in averages, G1 followed by G2. They were 16 (12 M/4 F) and 17 (11 M/F) patients with ages of 6.1 +/- 2.8 and 6.2 +/- 2 years. They presented 1.2 +/- 0.5 and 1.3 +/- 0.5 crisis per month and also 4.9 +/- 3.4 and 4.8 +/- 3 hospitalizations per year. In all the treatment began with CGIDS in spray and in 8 and 7 BDP was also used. The use of b-agonists at home was bigger in G1: 3 +/- 2.1 vs 0.6 +/- 0.7 (p = 0.0004). Acute treatment in more occasions was granted in G1: 21 vs 2 (p < 0.0001). It was bigger the number of applications of CGIDS in G1: 30.1 +/- 5.3 vs 15.4 +/- 2.7 (p < 0.0001) and of immunotherapy with allergens 8.1 +/- 9.6 vs 5.1 +/- 6.4 (p = 0.1). CONCLUSIONS: The asthmatic pediatric patients on integral treatment present a bigger and quicker improvement of their rhinitic and asthmatic symptoms when they are also treated with specific IT, even from the beginning of the treatment, they also improve their general immunity and they present reduction of allergic markers. They also use less medications, they present less acute exacerbation's and less hospitalizations.

[Leukocyte adhesion deficiency syndrome: case report]. / Síndrome de adhesión leucocitaria deficiente: informe de un caso.

INTRODUCTION: Leukocyte adhesion deficiency syndrome (LAD) is an altered phagocytic disorder characterised by the deficiency of one or several integrins which are included within the adhesion molecules group and cell surface receptors superfamily. OBJECTIVE: To describe the clinical features of a rare primary immunodeficiency case. CLINICAL CASE: A nineteen days-old male newborn was referred to the pediatrics infectology service because a 15 days clinical course characterised by delayed cord detachment; fever and skin lesions in several arcas that evolved to, cellulitis and dermal necrosis: Then he was admitted with the diagnosis of septicemia secondary to omphalitis. There were a partial response to antimicrobial treatment. Thereafter he had recurrent respiratory and gastrointestinal fungal and bacterial infections. Then he suffered psychomotor impairment and severe malnutrition. The patient died because septicemia at 5 months-old. WBC counts showed persistent leukocytosis between 42,000 and 133,000 cells/mm3, mostly neutrophils (64%-88%). We also found defective neutrophil quimiotaxis. By flow cytometer it was detected CDII/18 adhesins deficiency. Otherwise immunological, bone marrow biopsy and viral tests were, normal. CONCLUSIONS: Although its prevalence is rare, leukocyte adhesion defects must be considered in those patients with delayed cord detachment, recurrent severe infections and both persistent and elevated neutrophilia and with other primary and secondary immunodeficiencies previously discarded.

[Comparison of extracts of cockroaches, house dust and Dermatophagoides with intradermal tests in allergy patients]. / Comparación entre extractos de cucaracha, polvo casero y Dermatophagoides con pruebas intradérmicas en pacientes alérgicos.

In the order to know both the sensitivity and positivity between the allergenic extracts of cockroach (C), house dust (HDJ, and Dermatophagoides pteronyssinus (Dpt) we made a transversal study in 783 allergic patients who underwent intradermal skin tests with the antigens of C, HD and Dpt. Allergic asthma and rhinitis were the more frequent diagnosis. There was no significative difference between the sensitivity to C and HD (p = 0.1),-women were more sensitive to C than to HD (p < 0.05). We found a greater sensitivity to Dpt than C and HD (p < 001). There were more positive patients to C than to HD (p = 0.01) and although we observed more positive patients to Dpt than to C (p = 0.01) this difference was not significative for women (p = 0.05). We can conclude than cockroach, as an allergic source, has similar importance that house dust mite, and it is inadequate its substitution with house dust extracts in skin tests screening.

[Occupational disease at an allergy service]. / Enfermedad ocupacional en un servicio de alergia.

26 nurses were included in a prospective study mean age of 37.2 years old. 14 of them participated either in the application or preparation of allergenic extracts (vaccines) for several months (range 3-60). The other 12 were taken as control subjects. In both groups, we obtained atopic background, clinical evaluation, seric IgE, nasal smears, skin test with glicerinated antigens, positive and negative control. The study concluded allergy sensibilization occurs in those nurses working at the allergy service mainly in those whom referred genetic background for atopy.