[Current prevalence of asthma in schoolchildren in San Sebastián (Spain)]. / Prevalencia actual de asma en escolares en San Sebastián.

OBJECTIVE: To determine the current prevalence of asthma in children aged 6-12 years old in San Sebastian (Guipuzcoa, Spain). PATIENTS AND METHODS: An observational, cross sectional study was performed in 6-12-year-old children in schools. The International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire was employed. Bronchial hyperresponsiveness was investigated using the free running test, with peak expiratory flow (PEF) measured with a peak flow meter as the main measurement. The ISAAC questionnaire (n = 919) was distributed to 460 boys (50.1%) and 459 girls (49.9%) with a mean age of 8 years (SD 1.87). The response rate to the questionnaire was 93 % (n = 855). Participation in the free running test was 90.8% (n = 835). A total of 89.88% of the children (n = 826) completed both tests. RESULTS: The questionnaire of symptoms and signs compatible with asthma revealed a current prevalence of asthma of 25.56% (n = 216) and a cumulative prevalence of 25.44% (n = 85). Nocturnal asthma was found in 29.37% (n = 47) and severe asthma in 9.27% (n = 14). Bronchial hyperresponsiveness was found in 23% of the participants. An epidemiological diagnosis of asthma (asthma-related symptoms plus bronchial hyperresponsiveness) was made in 6.54%. CONCLUSIONS: The current prevalence of asthma in 6-12-year-old schoolchildren in San Sebastian, determined through symptoms and signs compatible with asthma in the previous year and a positive free running test, is similar to that reported in other national studies.

Prevalencia actual de asma en escolares en San Sebastián / Current prevalence of asthma in schoolchildren in San Sebastián (Spain)

Objetivo: Determinar la prevalencia actual de asma en escolares de 6 a 12 años en San Sebastián (España). Pacientes y métodos: Estudio observacional y transversal en centros escolares en niños de 6 a 12 años, mediante cuestionario de síntomas relacionados con asma (International Study of Asthma and Allergies in Childhood, ISAAC) y estudio de la hiperreactividad bronquial (HRB) (carrera al aire libre con esfuerzo máximo), utilizando como medida principal el flujo espiratorio máximo (FEM) medido con mini-wright. Se distribuyó el cuestionario ISAAC (n = 919) a 460 niños (50,1 %) y 459 niñas (49,9 %), con una media de edad de 8 años (desviación estándar [DE]: 1,87). La tasa de respuesta al cuestionario ISAAC fue del 93 % (n = 855). La participación en el test de carrera al aire libre fue del 90,8 % (n = 835). Completaron ambas pruebas el 89,88 % (n = 826). Resultados: Cuestionario de signos y síntomas compatibles con asma: prevalencia actual del asma, 25,56 % (n = 216); prevalencia acumulada, 25,44 % (n = 85); asma nocturna, 29,37 % (n = 47), y asma grave, 9,27 % (n = 14). Se ha objetivado HRB en el 23 % de los participantes. El diagnóstico epidemiológico del asma (síntomas relacionados con asma más HRB) ha sido del 6,54 %. Conclusiones: La prevalencia actual del asma en San Sebastián en escolares de 6-12 años, determinada mediante signos y síntomas compatibles con asma durante el último año y test de carrera libre positivo, es similar a otros estudios nacionales

Objective: To determine the current prevalence of asthma in children aged 6-12 years old in San Sebastian (Guipuzcoa, Spain). Patients and methods: An observational, cross sectional study was performed in 6-12-year-old children in schools. The International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire was employed. Bronchial hyperresponsiveness was investigated using the free running test, with peak expiratory flow (PEF) measured with a peak flow meter as the main measurement. The ISAAC questionnaire (n = 919) was distributed to 460 boys (50.1 %) and 459 girls (49.9 %) with a mean age of 8 years (SD 1.87). The response rate to the questionnaire was 93 % (n = 855). Participation in the free running test was 90.8 % (n = 835). A total of 89.88 % of the children (n = 826) completed both tests. Results: The questionnaire of symptoms and signs compatible with asthma revealed a current prevalence of asthma of 25.56 % (n = 216) and a cumulative prevalence of 25.44 % (n = 85). Nocturnal asthma was found in 29.37 % (n = 47) and severe asthma in 9.27 % (n = 14). Bronchial hyperresponsiveness was found in 23 % of the participants. An epidemiological diagnosis of asthma (asthma-related symptoms plus bronchial hyperresponsiveness) was made in 6.54 %. Conclusions: The current prevalence of asthma in 6-12-year-old schoolchildren in San Sebastian, determined through symptoms and signs compatible with asthma in the previous year and a positive free running test, is similar to that reported in other national studies

Use of antioxidants to treat pain in chronic pancreatitis.

OBJECTIVE: The purpose of this report is to analyze the results of a 1-year clinical study of antioxidant therapy in the treatment of pain and recurrent inflammatory episodes in patients with chronic and acute recurrent pancreatitis, using a prospective, descriptive, pre-post, open design. The intensity of pain at the beginning and end of treatment was assessed with a visual analogue scale, and these results along with the number of hospital admissions for pancreatic disease were analyzed. METHODS: We studied patients with acute recurrent or chronic pancreatitis who had suffered from pain or acute inflammatory episodes the year before the beginning of treatment with a complex containing L-methionine, beta-carotene, vitamin C, vitamin E and organic selenium. RESULTS: Of 10 patients with chronic pancreatitis who completed treatment, the intensity of pain was reduced considerably in 9 (61.5 +/- 21.5 mm vs. 19.6 +/- 26.1 mm, p = 0.03), and pain was completely absent in 3 of these patients. Twelve patients who completed treatment had fewer hospital admissions during the year with antioxidant treatment than they had had during the previous year (1.5 +/- 1.62 vs. 0.25 +/- 0.45 admissions, p = 0.03). CONCLUSIONS: Antioxidant treatment had a positive effect in patients who suffered from pancreatic inflammatory pain, and its effectiveness should be tested before more aggressive and costlier treatments are considered.

Utilización de antioxidantes en el tratamiento del dolor de la pancreatitis crónica / use of antioxidants to treat pain in chronic pancreatitis

OBJETIVO Y MÉTODO: el propósito de este trabajo ha sido analizar los resultados clínicos obtenidos a lo largo de 1 año, con una terapéutica antioxidante, en el tratamiento del dolor y de los episodios recurrentes inflamatorios en la pancreatitis crónica y aguda recurrente, mediante el diseño de un estudio prospectivo, descriptivo, pre-post y abierto. Se valoró la intensidad del dolor al inicio y final del año de tratamiento mediante una escala analógica visual y el número de ingresos hospitalarios por motivos pancreáticos. PACIENTES: enfermos con pancreatitis crónica y aguda recurrente que habían tenido dolor o episodios inflamatorios agudos el año inmediatamente anterior al inicio del tratamiento con un complejo que contiene L-metionina, betacaroteno, vitamina C, vitamina E y selenio orgánico. RESULTADOS: 10 pacientes con pancreatitis crónica que realizaron correctamente el tratamiento, nueve obtuvieron una disminución significativa en la intensidad del dolor (61,5 ñ 21,5 mm, vs 19,6 ñ 26,1 mm; p = 0,03) (en tres desapareció por completo). Doce pacientes que realizaron correctamente el tratamiento tuvieron un número de ingresos significativamente menor el año que fueron tratados con antioxidantes al compararlos con los que tuvieron al año inmediatamente anterior (1,5 ñ 1,62 vs 0,25 ñ 0,45 ingresos; p = 0,03). CONCLUSIONES: el tratamiento antioxidante influye favorablemente en un número no despreciable de pacientes con dolor de origen inflamatorio pancreático y debe probarse su utilidad antes de decidirse por otros tratamientos más agresivos y costosos (AU)

[Domiciliary intravenous antibiotic therapy]. / Antibioterapia intravenosa domiciliaria.

BACKGROUND: To assess the efficiency and safety of intravenous antibiotic therapy (IAT) when performed through the traditional simple infusion system by gravity in the home setting. PATIENTS AND METHODS: The clinical records of patients undergoing intravenous antibiotic therapy through the traditional gravitational infusion system in the home care unit over a five year period were reviewed retrospectively. RESULTS: 120 patients were treated (44 F/76 M), with a mean age of 48 years (44-52). 67% of the total had chronic diseases. Infections were most commonly found in bones and joints (38%), followed by the skin and soft tissues. A wide variety of antibiotics was used, 61% as monotherapy. 76% of them were given intermittently. 161 intravenous catheters were used, 53% of which were central catheters with peripheral insertion, 27% inserted centrally and 20% peripheral catheters. The overall incidence of phlebitis was 18% without associated bacteremia. 91% of our patients evolved well, 6% had to become in-patients, none of them due to problems with the infusion system or by their own petition. The intravenous treatment lasted a mean of 17 days at home and 25 days at both home and hospital, which represents a decrease of 2,040 hospital stays. CONCLUSIONS: The traditional gravitational system of infusion is an effective and safe method for intravenous antibiotic administration at home. For these therapies to be successful, suitable patients must be selected and continuous attention is required. This treatment at home satisfies the patient and permits hospital stays to be reduced, thus improving the use of hospital resources.

Glycine effects on glutamate-receptor elicited acetylcholinesterase release from slices and synaptosomes of the spinal ventral horn.

To study the mechanisms by which glutamate-elicited acetylcholinesterase release (GEAR) might play a part in the pathogenesis of excitotoxically triggered motor neurone disease, and to investigate the interaction of GEAR with spinal glycinergic mechanisms, we measured acetylcholinesterase (AChE) and cholinergic markers, after stimulating ventral horn slices and synaptosomes from the mouse spinal cord, with both glutamate- and glycine-receptor agonists. Glutamate (GLU), kainate and AMPA, as well as glycine (GLY) evoked dose-related, calcium-dependent liberation of soluble forms of AChE from both slices and synaptosomes. GLY-evoked AChE release showed remarkable age-related postnatal changes. In the immature slice of the ventral horn. GLY potentiated the GEAR response in the presence of strychnine, suggesting N-methyl-D-aspartate (NMDA) receptor involvement, and was also able to evoke a strychnine-sensitive AChE release in the absence of exogenous GLU. After the 28th postnatal day, nearly all the AChE secreted was released either after the activation of non-NMDA glutamate receptors or by strychnine-sensitive GLY-evoked AChE release mechanisms. Both GEAR and GLY-evoked AChE release might impair the negative feedback loop which modulates the overactivation of motor neurones, and cause prolonged extracellular rises of soluble AChE. These effects might augment the vulnerability of motor neurones to excitotoxic stress, promote fiber outgrowth, and eventually accelerate the metabolic exhaustion of lower motor neurones. It is possible that the mechanisms described are operative at the spinal cord of ALS/MND patients.

A specificity for cellular fibronectin in its effect on cultured chondroblasts.

Chick cellular fibronectin has previously been shown to alter the phenotypic properties of cultured chick-embryo vertebral chondroblasts. Over the course of several days, adhesion and spreading on plastic substrata in the presence of serum was stimulated, the morphology of the cells was changed, the synthesis of cartilage-specific type-IV proteoglycan was inhibited, and the synthesis of type-I collagen and fibronectin was induced or stimulated. In the present study, chick plasma fibronectin was isolated and observed to mimic the effect of cellular fibronectin on cell adhesion and spreading. Both kinetic and dose-response relationships were similar between the two isoproteins. In contrast, chick plasma fibronectin, at up to tenfold higher concentrations by weight, did not alter cell morphology or synthesis of type-IV proteoglycan. Control experiments showed that plasma fibronectin could not neutralize cellular fibronectin and that plasma fibronectin did not simply conceal an effect on type-IV proteoglycan production by shifting the balance released into the culture medium. The results suggest that the effect of cellular fibronectin on the differentiated properties of chondroblasts relies on some unique feature not possessed by plasma fibronectin, and thus is not solely dependent on its own ability to stimulate adhesion and spreading.