Original salbutamol versus similar salbutamol in children with asthma exacerbation: a randomized, controlled, double-blind study.

INTRODUCTION: There is clinical evidence suggesting that original salbutamol is more effective than a similar salbutamol product to revert symptoms in acute asthma exacerbation.. OBJECTIVE: To evaluate the bronchodilator response of both salbutamol medicinal products in children with asthma and to establish, based on the forced expiratory volume, if there is a difference between the group treated with the original salbutamol and the group treated with similar salbutamol. DESIGN: Prospective, randomized, controlled, double-blind study. MATERIAL AND METHODS: One hundred and twenty six children (63 boys, age 9.18 ± 2.83 years old) were included. They were administered a dose of 20 drops (5 mg) of the original salbutamol or similar salbutamol product in nebulizing solution diluted only once in 2 ml saline solution. Pre- and post-bronchodilator, intra- and inter-group forced expiratory volume was compared at baseline and at 30 minutes. The weight of salbutamol drops was determined by gravimetry, the concentration by chromatography and the number of drops by bottle. RESULTS: The bronchodilator response between the pre- and post-bronchodilator forced expiratory volume was 225 ml (95% CI: 164-286) and 224 ml (95% CI: 163-284) for original salbutamol and similar salbutamol, respectively (p < 0.001). The Delta difference was 1.3 ml (95% CI: -86+83) (p = 0.97). The mean, standard deviation and variation coefficient percentage of the weight of the drop was 364.75 mg (± 6.01, 1.65) and 543.88 mg (± 56.09, 10.31) (p < 0.001) for original salbutamol and similar salbutamol, respectively. CONCLUSION: There were no differences in the bronchodilator response measured by FEV1 between the original salbutamol and a similar salbutamol product.

Original salbutamol versus similar salbutamol in children with asthma exacerbation: A randomized, controlled, double-blind study / Salbutamol original contra salbutamol similar en niños con crisis de asma: Estudio aleatorizado, controlado y doble ciego

Introduction.There is clinical evidence suggesting that original salbutamol is more effective than a similar salbutamol product to revert symptoms in acute asthma exacerbation.. Objective. To evaluate the bronchodilator response of both salbutamol medicinal products in children with asthma and to establish, based on the forced expiratory volume, if there is a difference between the group treated with the original salbutamol and the group treated with similar salbutamol. Design. Prospective, randomized, controlled, double-blind study. Material and Methods. One hundred and twenty six children (63 boys, age 9.18 ± 2.83 years old) were included. They were administered a dose of 20 drops (5 mg) of the original salbutamol or similar salbutamol product in nebulizing solution diluted only once in 2 ml saline solution. Preand post-bronchodilator, intra- and inter-group forced expiratory volume was compared at baseline and at 30 minutes. The weight of salbutamol drops was determined by gravimetry, the concentration by chromatography and the number of drops by bottle. Results. The bronchodilator response between the pre- and post-bronchodilator forced expiratory volume was 225 ml (95% CI: 164-286) and 224 ml (95% CI: 163-284) for original salbutamol and similar salbutamol, respectively (p < 0.001). The Delta difference was 1.3 ml (95% CI: -86+83) (p = 0.97). The mean, standard deviation and variation coefficient percentage of the weight of the drop was 364.75 mg (± 6.01, 1.65) and 543.88 mg (± 56.09, 10.31) (p < 0.001) for original salbutamol and similar salbutamol, respectively. Conclusion. There were no differences in the bronchodilator response measured by FEV1 between the original salbutamol and a similar salbutamol product.

Introducción. Existe evidencia clínica que sugiere que el salbutamol original sería más eficaz que el salbutamol similar para revertir los síntomas en el episodio agudo de asma. Objetivo. Evaluar la respuesta broncodilatadora de ambas especialidades farmacéuticas de salbutamol en niños con asma y establecer, mediante el volumen espiratorio forzado, si difiere entre los grupos tratados con salbutamol original y similar. Diseño. Estudio prospectivo, aleatorizado, controlado, a doble ciego. Material y métodos. Se incluyeron 126 niños (63 varones, edad 9,18 ± 2,83 años), que recibieron una dosis de 20 gotas (5 mg) de salbutamol original o similar en solución para nebulizar diluida en 2 ml de solución fisiológica por única vez. Se comparó el volumen espiratorio forzado prebroncodilatador y posbroncodilatador, intragrupos e intergrupos, al inicio y a los 30 minutos. Se determinó el peso de las gotas de salbutamol por gravimetría, la concentración por cromatografía y el número de gotas por envase. Resultados. La respuesta broncodilatadora entre el volumen espiratorio forzado prebroncodilatador y posbroncodilatador fue de 225 ml (IC 95%: 164-286) y 224 ml (IC 95%: 163-284) para salbutamol original y similar, respectivamente (p <0,001). El delta de la diferencia fue de 1,3 ml (IC 95%: -86+83) (p= 0,97). La media, desvío estándar y porcentaje del coeficiente de variación del peso de las gotas fue de 364,75 mg (± 6,01, 1,65) y 543,88 mg (± 56,09, 10,31) (p <0,001) para salbutamol original y similar, respectivamente. Conclusión. No hubo diferencias en la respuesta broncodilatadora medida por el VEF1 entre salbutamol original y similar.

Original salbutamol versus similar salbutamol in children with asthma exacerbation: A randomized, controlled, double-blind study / Salbutamol original contra salbutamol similar en niños con crisis de asma: Estudio aleatorizado, controlado y doble ciego

Introduction.There is clinical evidence suggesting that original salbutamol is more effective than a similar salbutamol product to revert symptoms in acute asthma exacerbation.. Objective. To evaluate the bronchodilator response of both salbutamol medicinal products in children with asthma and to establish, based on the forced expiratory volume, if there is a difference between the group treated with the original salbutamol and the group treated with similar salbutamol. Design. Prospective, randomized, controlled, double-blind study. Material and Methods. One hundred and twenty six children (63 boys, age 9.18 ± 2.83 years old) were included. They were administered a dose of 20 drops (5 mg) of the original salbutamol or similar salbutamol product in nebulizing solution diluted only once in 2 ml saline solution. Preand post-bronchodilator, intra- and inter-group forced expiratory volume was compared at baseline and at 30 minutes. The weight of salbutamol drops was determined by gravimetry, the concentration by chromatography and the number of drops by bottle. Results. The bronchodilator response between the pre- and post-bronchodilator forced expiratory volume was 225 ml (95% CI: 164-286) and 224 ml (95% CI: 163-284) for original salbutamol and similar salbutamol, respectively (p < 0.001). The Delta difference was 1.3 ml (95% CI: -86+83) (p = 0.97). The mean, standard deviation and variation coefficient percentage of the weight of the drop was 364.75 mg (± 6.01, 1.65) and 543.88 mg (± 56.09, 10.31) (p < 0.001) for original salbutamol and similar salbutamol, respectively. Conclusion. There were no differences in the bronchodilator response measured by FEV1 between the original salbutamol and a similar salbutamol product.(AU)

Introducción. Existe evidencia clínica que sugiere que el salbutamol original sería más eficaz que el salbutamol similar para revertir los síntomas en el episodio agudo de asma. Objetivo. Evaluar la respuesta broncodilatadora de ambas especialidades farmacéuticas de salbutamol en niños con asma y establecer, mediante el volumen espiratorio forzado, si difiere entre los grupos tratados con salbutamol original y similar. Diseño. Estudio prospectivo, aleatorizado, controlado, a doble ciego. Material y métodos. Se incluyeron 126 niños (63 varones, edad 9,18 ± 2,83 años), que recibieron una dosis de 20 gotas (5 mg) de salbutamol original o similar en solución para nebulizar diluida en 2 ml de solución fisiológica por única vez. Se comparó el volumen espiratorio forzado prebroncodilatador y posbroncodilatador, intragrupos e intergrupos, al inicio y a los 30 minutos. Se determinó el peso de las gotas de salbutamol por gravimetría, la concentración por cromatografía y el número de gotas por envase. Resultados. La respuesta broncodilatadora entre el volumen espiratorio forzado prebroncodilatador y posbroncodilatador fue de 225 ml (IC 95%: 164-286) y 224 ml (IC 95%: 163-284) para salbutamol original y similar, respectivamente (p <0,001). El delta de la diferencia fue de 1,3 ml (IC 95%: -86+83) (p= 0,97). La media, desvío estándar y porcentaje del coeficiente de variación del peso de las gotas fue de 364,75 mg (± 6,01, 1,65) y 543,88 mg (± 56,09, 10,31) (p <0,001) para salbutamol original y similar, respectivamente. Conclusión. No hubo diferencias en la respuesta broncodilatadora medida por el VEF1 entre salbutamol original y similar.(AU)

Viruses and atypical bacteria associated with asthma exacerbations in hospitalized children.

UNLABELLED: OBJECTIVES AND WORKING HYPOTHESIS: To evaluate the prevalence of respiratory viruses Mycoplasma pneumoniae and Chlamydophila pneumoniae and gain insight into their seasonal circulation pattern in children with acute asthma exacerbations in a temperate southern hemisphere region. STUDY DESIGN: Patients hospitalized between 3 months and 16 years of age were included in a 1-year prospective, observational, cross-sectional study. Respiratory secretions were collected and the presence of different viruses and atypical bacteria analyzed by immunofluorescence and polymerase chain reaction. RESULTS: Two hundred nine patients (118 females) aged (mean +/- SD) 4.4 +/- 4 years were included. A potential causative agent was detected in 78% of the patients. The most frequently detected viruses were respiratory syncytial virus (HRSV) (n = 85; 40%) and rhinovirus (HRV) (n = 52; 24.5%); M. pneumoniae and C. pneumoniae were detected in 4.5% and 2% of the cases, respectively. Patients with HRSV (vs. HRV) were hospitalized for a longer time (6.7 vs. 5.2 days, P = 0.012), required more days of oxygen supply (5.1 vs. 3.4, P = 0.005), had a longer duration of the exacerbation before hospitalization (3.6 vs. 1.9 days, P = 0.001) and were younger (3.7 vs. 5.1 years, P = 0.012). Three peaks of admissions were observed. A first peak (early autumn) caused by HRV, a second peak (winter) caused mainly by HRSV and a third one (spring), caused by HRSV, an increase in HMPV together with a second outbreak of HRV. CONCLUSIONS: Children with an acute asthma exacerbation presented a high prevalence of respiratory viruses. Most hospitalizations corresponded to seasonal increases in prevalence of HRV and HRSV.

[New respiratory viruses in children 2 months to 3 years old with recurrent wheeze]. / Nuevos virus respiratorios en niños de 2 meses a 3 años con sibilancias recurrentes.

INTRODUCTION: Respiratory viruses are associated with respiratory exacerbations, more frequently Respiratory Syncytial Virus in infants and Rhinovirus in children. OBJECTIVE: To evaluate the prevalence and epidemiological features of newer and traditional respiratory viruses in infants and young children with recurrent wheeze. MATERIAL AND METHODS: Cross sectional, prospective and descriptive study. Patients with recurrent wheeze and risk factors for asthma, age 2 months to 3 years, hospitalized with bronchial obstruction were included. On admission a respiratory sample was obtained through a nasopharyngeal aspirate. Immunofluorescence was performed to detect Respiratory Syncytial Virus, Adenovirus, Parainfluenza 1, 2, 3 and Influenza A and B. Polymerase Chain Reaction was used to detect Rhinovirus, Enterovirus, Metapneumovirus, Bocavirus, Adenovirus and Coronavirus. RESULTS: 119 patients (61 female), age (x E DS) 1.5 E 0.9 years were included. Days on admission and on oxygen requirement were, respectively (x E DS): 6.3 E 2.9 y 4.4 E 2.7. One hundred and two (86%) positive cases were diagnosed. Fifty five percent of the viruses were detected by Immunofluorescence and 45% by Polymerase Chain Reaction. A single virus was present in 75% of the samples, 22% had a double co-infection and 3% a triple virus co-infection. Overall, the prevalence of detected respiratory viruses was: Respiratory Syncytial Virus 55 (43%); Rhinovirus 30 (23%); Metapneumovirus 13 (10%); Influenza A 8 (6%); Enterovirus 6 (5%); Bocavirus 6 (5%); Adenovirus 4 (3%); Coronavirus 3 (2%); Parainfluenza 1: 2 (1%); Influenza B, 1 (1%) and Parainfluenza 3: 1 (1%). CONCLUSIONS: Infants and young children with recurrent wheeze and risk factors for asthma hospitalized for bronchial obstruction present a high prevalence of respiratory viruses. Hospital admissions were more frequent during months of higher respiratory circulation.

Nuevos virus respiratorios en niños de 2 meses a 3 años con sibilancias recurrentes / New respiratory viruses in children 2 months to 3 years old with recurrent wheeze

Introducción. Los virus respiratorios son los agentes que con más frecuencia desencadenan sibilancias, especialmente, el virus sincicial respiratorio en los lactantes y los rinovirus en niños mayores.Objetivos. Conocer la prevalencia y la circulación estacional de los virus respiratorios nuevos y tradicionalesen lactantes y niños pequeños con sibilancias recurrentes.Material y métodos. Estudio de corte transversal, prospectivo y descriptivo. Se incluyeron pacientes de 2 meses a 3 años con sibilancias recurrentes yfactores de riesgo para desarrollar asma hospitalizados por obstrucción bronquial. Se obtuvo una muestra de secreciones respiratorias por aspiradonasofaríngeo y se utilizó la técnica de inmunofluorescencia para detectar Virus Sincicial Respiratorio, Adenovirus, Parainfluenza 1, 2 y 3 e Influenza A y B,y la Reacción en Cadena de la olimerasa para determinar Rinovirus, Enterovirus, Virus Sincicial Respiratorio, Bocavirus, Adenovirus y Coronavirus.Resultados. Se evaluaron 119 pacientes (61 femeninos), edad (x más menos DE) 1,5 más menos 0,9 años. Los días de internación y de requerimientos de oxígeno fueron(x más menos DE): 6,3 más menos 2,9 y 4,4 más menos 2,7 respectivamente. Se hallaron 102 (86 por ciento) casos positivos. El 55 por ciento de los virus se detectó por Inmunofluorescencia y el 45 por cientopor Reacción en Cadena de la polimerasa. El 75 por ciento delas muestras respiratorias presentó un solo agente viral, el 22 por ciento una coinfección doble y el 3 por ciento unacoinfección triple. Las prevalencias de los virus respiratorios detectados fueron: Virus Sincicial Respiratorio55 (43 por ciento); Rinovirus 30 (23 por ciento); Metapneumovirus13 (10 por ciento); Influenza A 8 (6 por ciento), Enterovirus 6 (5 por ciento); Bocavirus 6 (5 por ciento); Adenovirus 4 (3 por ciento); Coronavirus3 (2 por ciento); Parainfluenza 1: 2 (1 por ciento); Influenza B, 1(1 por ciento) y Parainfluenza 3: 1 (1 por ciento).

[Flexible bronchoscopy in a pediatric pulmonology service]. / Broncoscopia flexible en un servicio de neumonología infantil.

INTRODUCTION: Flexible bronchoscopy is a valuable diagnostic and therapeutic tool. The objective of the study is to describe the experience with flexible bronchoscopy in a Pulmonology Section of a Pediatric tertiary care hospital associated to the university. POPULATION AND METHODS: Studies performed between 01/2002 and 12/2005 were reviewed. Olympus(R) bronchoscopes (external diameters 2.8 and 4.8 mm) were used. Bronchoalveolar lavage was performed with 3 aliquots of 1 ml/kg of warmed sterile saline solution. RESULTS: One hundred and two fiberoptic bronchoscopies (49 males, 42 outpatients) and 77 bronchoalveolar lavage were performed. Patient's age ranged from 2 months to 18 years. Fifty one studies were done in an endoscopy suite, 47 in the operating room and 4 in the intensive care unit. Patient's diagnosis were: chronic lung disease (recurrent/ persistent pneumonia, bronchiectasis, primary ciliary dyskinesia) 65% (n: 66); immune deficiencies 18% (n: 18); cystic fibrosis 7% (n: 7), difficult airway 5% (n: 6) and noisy breathing 5% (n: 5). Ten patients developed mild complications (7 hypoxemia, 2 upper airway obstruction, 1 cardiac arrhythmia), and 1 patient a severe one (severe bronchial obstruction). Eighty five (65/77) bronchoalveolar lavage samples, 100% (12/12) bronchial brushing and 100% (6/6) endobronchial biopsies were representative. Procedures helped the decision-making process in 75% (76/102) of the patients studied. CONCLUSIONS: In this carefully selected population, flexible bronchoscopy and bronchoalveolar lavage were useful for their diagnosis and treatment.

Broncoscopia flexible en un servicio de neumonología infantil / Flexible bronchoscopy in a pediatric pulmonology service

La fibrobroncoscopia constituye una herramienta diagnóstico-terapéutica de gran valor.El objetivo del presente estudio es describir la experienciacon fibrobroncoscopia en un servicio deneumonología de un hospital de niños urbano asociadoa la Universidad.Material y métodos. Se revisaron todos los procedimientosde fibrobroncoscopia realizados entre01/2002 y 12/2005. Se utilizaron broncoscopiosOlympus® (diámetro externo 2,8 mm y 4,8 mm). El lavado broncoalveolar se realizó con 3 alícuotas de1 ml/kg de solución salina entibiada.Resultados. Se efectuaron 102 fibrobroncoscopias(49 varones, 42 pacientes ambulatorios), y en 77 casosse realizó lavado broncoalveolar. El intervalo deedad fue de 2 meses a 18 años. Cincuenta y unestudios se realizaron en la sala de procedimientosde la unidad, 47 en quirófano y 4 en la unidad decuidados intensivos. Los diagnósticos de los pacientesfueron: enfermedad pulmonar crónica (neumoníarecurrente/persistente, bronquiectasias, sospechade disquinesia ciliar) 65% (n: 66); huésped inmunocomprometido18% (n: 18); fibrosis quística 7% (n:7), intubación dificultosa 5% (n: 6) y respiraciónruidosa 5% (n: 5). Diez pacientes tuvieron complicacionesleves (7 hipoxemia, 2 obstrucción laríngea, 1arritmia cardíaca), y 1 paciente complicación grave(obstrucción bronquial graves). Ochenta y cinco porciento (65/77) de las muestras de lavado broncoalveolar,100% (12/12) de los cepillados bronquiales y100% (6/6) de las biopsias de mucosa fueron representativas.Los procedimientos fueron de utilidadclínica en 75% (76/102) de los pacientes estudiados.Conclusiones. En esta población cuidadosamenteseleccionada, los resultados de la fibrobroncoscopiay el lavado broncoalveolar fueron útiles para sudiagnóstico y tratamiento.

Introduction. Flexible bronchoscopy is a valuable diagnostic and therapeutic tool. The objective of the study is to describe the experience with flexible bronchoscopy in a Pulmonology Section of a Pediatric tertiary care hospital associated to the university. Population and methods. Studies performed between 01/2002 and 12/2005 were reviewed. Olympus® bronchoscopes (external diameters 2.8 and 4.8 mm) were used. Bronchoalveolar lavage was performed with 3 aliquots of 1 ml/kg of warmed sterile saline solution. Results. One hundred and two fiberoptic bronchoscopies (49 males, 42 outpatients) and 77 bronchoalveolar lavage were performed. Patient’s age ranged from 2 months to 18 years. Fifty one studies were done in an endoscopy suite, 47 in the operating room and 4 in the intensive care unit. Patient’s diagnosis were: chronic lung disease (recurrent/persistent pneumonia, bronchiectasis, primary ciliary dyskinesia) 65% (n: 66); immune deficiencies 18% (n: 18); cystic fibrosis 7% (n: 7), difficult airway 5% (n: 6) and noisy breathing 5% (n: 5). Ten patients developed mild complications (7 hypoxemia, 2 upper airway obstruction, 1 cardiac arrhythmia), and 1 patient a severe one (severe bronchial obstruction). Eighty five (65/77) bronchoalveolar lavage samples, 100% (12/12) bronchial brushing and 100% (6/6) endobronchial biopsies were representative. Procedures helped the decision-making process in 75% (76/102) of the patients studied. Conclusions. In this carefully selected population, flexible bronchoscopy and bronchoalveolar lavage were useful for their diagnosis and treatment.

Broncoscopia flexible en un servicio de neumonología infantil / Flexible bronchoscopy in a pediatric pulmonology service

La fibrobroncoscopia constituye una herramienta diagnóstico-terapéutica de gran valor.El objetivo del presente estudio es describir la experienciacon fibrobroncoscopia en un servicio deneumonología de un hospital de niños urbano asociadoa la Universidad.Material y métodos. Se revisaron todos los procedimientosde fibrobroncoscopia realizados entre01/2002 y 12/2005. Se utilizaron broncoscopiosOlympus« (diámetro externo 2,8 mm y 4,8 mm). El lavado broncoalveolar se realizó con 3 alícuotas de1 ml/kg de solución salina entibiada.Resultados. Se efectuaron 102 fibrobroncoscopias(49 varones, 42 pacientes ambulatorios), y en 77 casosse realizó lavado broncoalveolar. El intervalo deedad fue de 2 meses a 18 años. Cincuenta y unestudios se realizaron en la sala de procedimientosde la unidad, 47 en quirófano y 4 en la unidad decuidados intensivos. Los diagnósticos de los pacientesfueron: enfermedad pulmonar crónica (neumoníarecurrente/persistente, bronquiectasias, sospechade disquinesia ciliar) 65% (n: 66); huésped inmunocomprometido18% (n: 18); fibrosis quística 7% (n:7), intubación dificultosa 5% (n: 6) y respiraciónruidosa 5% (n: 5). Diez pacientes tuvieron complicacionesleves (7 hipoxemia, 2 obstrucción laríngea, 1arritmia cardíaca), y 1 paciente complicación grave(obstrucción bronquial graves). Ochenta y cinco porciento (65/77) de las muestras de lavado broncoalveolar,100% (12/12) de los cepillados bronquiales y100% (6/6) de las biopsias de mucosa fueron representativas.Los procedimientos fueron de utilidadclínica en 75% (76/102) de los pacientes estudiados.Conclusiones. En esta población cuidadosamenteseleccionada, los resultados de la fibrobroncoscopiay el lavado broncoalveolar fueron útiles para sudiagnóstico y tratamiento.(AU)

Introduction. Flexible bronchoscopy is a valuable diagnostic and therapeutic tool. The objective of the study is to describe the experience with flexible bronchoscopy in a Pulmonology Section of a Pediatric tertiary care hospital associated to the university. Population and methods. Studies performed between 01/2002 and 12/2005 were reviewed. Olympus« bronchoscopes (external diameters 2.8 and 4.8 mm) were used. Bronchoalveolar lavage was performed with 3 aliquots of 1 ml/kg of warmed sterile saline solution. Results. One hundred and two fiberoptic bronchoscopies (49 males, 42 outpatients) and 77 bronchoalveolar lavage were performed. Patientãs age ranged from 2 months to 18 years. Fifty one studies were done in an endoscopy suite, 47 in the operating room and 4 in the intensive care unit. Patientãs diagnosis were: chronic lung disease (recurrent/persistent pneumonia, bronchiectasis, primary ciliary dyskinesia) 65% (n: 66); immune deficiencies 18% (n: 18); cystic fibrosis 7% (n: 7), difficult airway 5% (n: 6) and noisy breathing 5% (n: 5). Ten patients developed mild complications (7 hypoxemia, 2 upper airway obstruction, 1 cardiac arrhythmia), and 1 patient a severe one (severe bronchial obstruction). Eighty five (65/77) bronchoalveolar lavage samples, 100% (12/12) bronchial brushing and 100% (6/6) endobronchial biopsies were representative. Procedures helped the decision-making process in 75% (76/102) of the patients studied. Conclusions. In this carefully selected population, flexible bronchoscopy and bronchoalveolar lavage were useful for their diagnosis and treatment.(AU)

Efecto del propionato de fluticasona sobre la función pulmonar en niños menores de 2 años, con sibilancias recurrentes y factores de riesgo para dessarrollar asma / Effects of inhaled fluticasone propionate in children less than 2 years old with recurrent wheezing and risk factors to develop asthma

Diversos estudios demostraton la utilidad clínica de los corticoides inhalados para tratar el asma en lactantes y niños pequeños. Sin embargo, hasta el momento, no se han publicado estudios que evalúen su efecto sobre la función pulmonar en este grupo etario.El objetivo del estudio fue evaluar la función pulmonar y la eficacia clínica del tratamiento con propionato de fluticasona (PF) durante 6 meses, en niños <2 años con sibilancias recurrentes y factores de riesgo para desarrollar asma.En un estudio aleatorizado, doble ciego, controlado con placebo, se etudiaron niños de 6 a 20 meses de edad, con 3 o más episodios previos de sibilancias, antecedentes de asma o atopia en familiares de primer grado y un score de desviación estándar del flujo máximo a nivel de la capacidad residual funcional (SDS V´maxFRC<) menor de -1. Se asignó a los pacientes en forma aleatorizada para recibir PF (125 µg)o placebo, dos veces por día, conun aerosol presurizado y espaciador, durante 6 meses. Se evaluó la funciónpulmonar al inicio y al final. Durante el estudio, los padres completaron diariamente una cartilla conlos síntomas respiratorios, el requerimiento de medicación de rescate y las consultas de emergencia.Se evaluaron 14 niños en el grupo PF (12,9 ± 4 meses) y 12 en el grupo placebo (14 ± 4 meses). La diferencia promedio del SDS V´max FRC fue 5,86 (IC: 2,94-8,78) y 0,82 (IC: -2,34-3,97) para los grupos PF y placefo, respectivamente (p = 0,02). El porcentaje de días sin síntomas fue 91,3 ± 7 y 83,9 ± 10 (p = 0,05), el número de exacerbaciones respiratorias fue 2,1 ± 1,7 y 4,1 ± 3 (p = 0,04) y el porcentaje de días de administración de salbutamol fue de 8,6 ± y 16,3 ± 9 (p = 0,025) con PF y placebo, respectivamente.El tratamiento con PF 125 µg, dos veces por día, durante 6 meses aumenta la función pulmonar y mejora la evolución clínica en lactantes y niños pequeños con sibilancias recurrentes y factores de riesgo de asma.

Efecto del propionato de fluticasona sobre la función pulmonar en niños menores de 2 años, con sibilancias recurrentes y factores de riesgo para dessarrollar asma / Effects of inhaled fluticasone propionate in children less than 2 years old with recurrent wheezing and risk factors to develop asthma

Diversos estudios demostraton la utilidad clínica de los corticoides inhalados para tratar el asma en lactantes y niños pequeños. Sin embargo, hasta el momento, no se han publicado estudios que evalúen su efecto sobre la función pulmonar en este grupo etario.El objetivo del estudio fue evaluar la función pulmonar y la eficacia clínica del tratamiento con propionato de fluticasona (PF) durante 6 meses, en niños <2 años con sibilancias recurrentes y factores de riesgo para desarrollar asma.En un estudio aleatorizado, doble ciego, controlado con placebo, se etudiaron niños de 6 a 20 meses de edad, con 3 o más episodios previos de sibilancias, antecedentes de asma o atopia en familiares de primer grado y un score de desviación estándar del flujo máximo a nivel de la capacidad residual funcional (SDS V´maxFRC<) menor de -1. Se asignó a los pacientes en forma aleatorizada para recibir PF (125 Ag)o placebo, dos veces por día, conun aerosol presurizado y espaciador, durante 6 meses. Se evaluó la funciónpulmonar al inicio y al final. Durante el estudio, los padres completaron diariamente una cartilla conlos síntomas respiratorios, el requerimiento de medicación de rescate y las consultas de emergencia.Se evaluaron 14 niños en el grupo PF (12,9 ± 4 meses) y 12 en el grupo placebo (14 ± 4 meses). La diferencia promedio del SDS V´max FRC fue 5,86 (IC: 2,94-8,78) y 0,82 (IC: -2,34-3,97) para los grupos PF y placefo, respectivamente (p = 0,02). El porcentaje de días sin síntomas fue 91,3 ± 7 y 83,9 ± 10 (p = 0,05), el número de exacerbaciones respiratorias fue 2,1 ± 1,7 y 4,1 ± 3 (p = 0,04) y el porcentaje de días de administración de salbutamol fue de 8,6 ± y 16,3 ± 9 (p = 0,025) con PF y placebo, respectivamente.El tratamiento con PF 125 Ag, dos veces por día, durante 6 meses aumenta la función pulmonar y mejora la evolución clínica en lactantes y niños pequeños con sibilancias recurrentes y factores de riesgo de asma. (AU)

Fluticasone improves pulmonary function in children under 2 years old with risk factors for asthma.

This study assessed the effects of treatment with fluticasone in children younger than 2 years old with recurrent wheezing and risk factors of developing asthma. This double-blind placebo-controlled study randomized children to receive fluticasone (125 mug; n = 14) or placebo (n = 12) twice daily for 6 months. Pulmonary function was assessed at the beginning and end, and parents filled out a daily diary recording respiratory symptoms, need for rescue medication, and emergency care. The SD score of maximum flow at functional residual capacity was -0.74 +/- 0.6 at the beginning and 0.44 +/- 1 at the end for the fluticasone group (p = 0.001), and -0.79 +/- 0.3 at the beginning and -0.78 +/- 1.4 at the end for the placebo group (p = 0.97). A statistically significant difference (p = 0.02) was observed between treatments. The percentage of symptom-free days was 91.3 +/- 7% for fluticasone and 83.9 +/- 10% for placebo (p = 0.05). The number of respiratory exacerbations was 2.1 +/- 1.7 and 4.1 +/- 3 (p = 0.04), and the percentage of days on albuterol was 8.6 +/- 6% and 16.3 +/- 9% (p = 0.028). Treatment with fluticasone twice daily for 6 months improves pulmonary function and clinical outcomes in children with asthma younger than 2 years.

Respiratory viruses seasonality in children under five years of age in Buenos Aires, Argentina: a five-year analysis.

OBJECTIVES: During the winter months there is a remarkable increase in paediatric hospitalisations due to viral acute lower respiratory infections (ALRI). We aimed to perform a five-year retrospective analysis (1998-2002) of ALRI viral aetiology in children under 5 years of age admitted to public hospitals in Buenos Aires city to evaluate its seasonality. MATERIALS AND METHODS: Nasopharyngeal aspirates (NPA) were analysed by indirect immunofluorescence to determine viral aetiology. A Spearman's rank correlation test between meteorological parameters and viral frequencies was performed. RESULTS: Viruses were identified in 6083 (32.8%) of 18,561 NPA tested. Among the former 4796 (78.8%) were RSV, 508 (8.3%) IA, 473 (7.8%) AV, 293 (4.8%) PIV and 13 (0.2%) IB. RSV and IA peaked during the coldest and dampest months, whereas PIV did so in early spring and AV lasted throughout the year. For RSV and IA an inverse correlation with mean monthly temperature (r = -0.9 and r = -0.87, respectively, p<0.0001) and solar UVB radiation (r = -0.92 and r = -0.80, respectively, p<0.0001) was detected, while it was positive when relative humidity was considered (r = 0.6, p<0.0001 and r = 0.47, p=0.0068, respectively). CONCLUSIONS: This study highlights the seasonal variation of ALRI and allows the implementation of adequate healthcare strategies and practice guidelines.

Effects of inhaled fluticasone propionate in children less than 2 years old with recurrent wheezing.

Our objective was to evaluate the efficacy and safety of two doses of fluticasone propionate (FP) in young children with recurrent wheezing and risk factors for asthma. Our study design was a randomized, double-blind, placebo-controlled comparison of inhaled FP 50 mcg twice daily (FP 100) and 125 mcg twice daily (FP 250), for 6 months. Outcome measures included number of wheezing episodes, days on albuterol, height standard deviation score (height SDS), osteocalcin (OC), bone alkaline phosphatase fraction (AKP), insulin-like growth factor-binding protein 3 (IGFBP-3), and serum levels of cortisol (SC). Our subjects were 30 patients, aged 7-24 months. Mean wheezing episodes were 6.0 +/- 1.9, 1.9 +/- 1.9, and 2.8 +/- 1.2; mean days of albuterol use were 24.3 +/- 1.3, 6.5 +/- 0.8, and 9.1 +/- 0.8, per patient for placebo, FP100, and FP250 groups, respectively. There was a significant reduction in clinical outcome in the two FP groups compared to placebo (P < 0.01). No significant correlations were found between FP dosage and height SDS, OC, AKP, IGFBP-3, and SC. In conclusion, in young children with asthmatic symptoms, FP at 50 and 125 mcg b.i.d. for 6 months significantly improved respiratory symptoms without causing significant side effects on growth and bone metabolism.