[Otologic determining factors on infra-red tympanic thermometry in children]. / Condicionantes otológicos en termometría timpánica con infrarrojos en niños.

OBJECTIVE: To evaluate the influence of different otoscopic findings on body thermometry in children using an infra-red tympanic thermometer. PATIENTS AND METHODS: Body temperature was measured on healthy right and left ear canals with Thermoscan systems. Moreover, it was determined on children with altered otoscopy, companng to normal contralateral ear. To assess its diagnostic fiability, accuracy ratios were calculated in different temperatures. RESULTS: Temperature measured bilaterally did not offer differences, and intra/interassay variation ratios were always less than 0.34%. Acute otitis externa increased tympanic thermometry a mean of 0.36 degrees C (p < 0.001), and cerumen and previously radical surgery decreased a mean of 0.62 and 0.53 degrees C, respectively (p < 0.001). CONCLUSIONS: The conditions mentioned before modify body thermometry if measured by infra-red tympanic thermometer. So, this system must be avoided in these circumstances. Otitis media, fluid in middle ear, tympanic perforation and ventilation tubes did not modify thermometric results.

Condicionantes otológicos en termometría timpánica con infrarrojos en niños / Otologic determining factors on infra-red tympanic thermometry in children

Objetivo: Evaluar la influencia de diferentes hallazgos otoscópicos sobre la termometría corporal en niños con un sensor timpánico de infrarrojos. Pacientes y métodos: Con sistemas Thermoscan se comparó la temperatura corporal en oídos derecho e izquierdo sanos, así como en niños con otoscopias alteradas, comparando su valor con el oído contralateral normal. Su fiabilidad se estudió midiendo los índices de precisión y exactitud a diversas temperaturas. Resultados: La temperatura sobre oídos sanos no demostró diferencias derecha/izquierda, y los coeficientes de variación intra/interensayo fueron siempre inferiores a 0,34 por ciento. La termometría timpánica se elevó en la otitis externa aguda una media de 0,36ºC (p<0,001), y se redujo en la cera y el antecedente de cirugía radical 0,62 y 0,53ºC, respectivamente (p<0,001). Conclusiones: Estas condiciones modifican la temperatura medida por termometría timpánica con infrarrojos, no debiéndose emplear este sistema. La otitis media, la perforación timpánica y el drenaje transtimpánico no modificaron la termometría (AU)

OBJECTIVE: To evaluate the influence of different otoscopic findings on body thermometry in children using an infra-red tympanic thermometer. PATIENTS AND METHODS: Body temperature was measured on healthy right and left ear canals with Thermoscan systems. Moreover, it was determined on children with altered otoscopy, companng to normal contralateral ear. To assess its diagnostic fiability, accuracy ratios were calculated in different temperatures. RESULTS: Temperature measured bilaterally did not offer differences, and intra/interassay variation ratios were always less than 0.34%. Acute otitis externa increased tympanic thermometry a mean of 0.36 degrees C (p < 0.001), and cerumen and previously radical surgery decreased a mean of 0.62 and 0.53 degrees C, respectively (p < 0.001). CONCLUSIONS: The conditions mentioned before modify body thermometry if measured by infra-red tympanic thermometer. So, this system must be avoided in these circumstances. Otitis media, fluid in middle ear, tympanic perforation and ventilation tubes did not modify thermometric results (AU)

[Non-interventional study on blood filterability changes in the clinical onset of sensorineural sudden deafness]. / Estudio no intervencionista de las alteraciones de la filtrabilidad sanguínea en el debut clínico de sorderas súbitas neurosensoriales.

An hemorheological study on whole blood filterability (WBF) was done in eleven patients bearing of sudden deafness, in a continuous way, even before clinical onset. This evaluation is making usually in animal models, but not in humans. Independently of clinical diagnosis of each patient (two cases of diabetes mellitus, one of ulcerative colitis, systemic lupus erythematosus, systemic hypertension, after blood transfusion, sepsis with disseminated intravascular coagulation, upper respiratory ways infection, after surgery, and two healthy individuals), all of them showed a decreased WBF when hearing loss appeared (from 19.97 +/- 1.15 microliters/sec to 16.87 +/- 1.21 microliters/sec). This value normalized at six or seven days from the onset in cases with some kind of hearing recovery (18.83 +/- 1.01 microliters/sec, n = 4), but did not in those with no improvement even at thirty days (17.39 +/- 0.77 microliters/sec, n = 7). There were differences in WBF values of patients with and without hearing recovery in determinations at seven and thirty days from onset. Decrease in WBF accompanies this hearing disorder and confirms the cochlear microcirculation susceptibility to the impairment of blood viscoelastic properties.

Estudio no intervencionista de las alteraciones de la filtrabilidad sanguínea en el debut clínico de sorderas súbitas neurosensoriales / Non interventionist study about blood filterability changes in clinical onset of sensorineural sudden deafness

En once pacientes que presentaron un cuadro de sordera súbita pudo efectuarse un estudio reológico de la filtrabilidad en sangre total (FST) de una forma seriada, incluso días antes del debut del trastorno. La evaluación de este hallazgo previo a la instauración de la hipoacusia es algo habitual en modelos experimentales, pero no en humanos. Independientemente del contexto clínico en que cada paciente se desenvolvía (2 casos de diabetes mellitus, uno de colitis ulcerosa, lupus eritematoso sistémico, hipertensión arterial, postrasfundido, sepsis con coagulación intravascular diseminada, infección de vías respiratorias altas, postquirúrgico, y dos individuos sanos) en todos se detectó un descenso en la FST al aparecer la sordera (de 19,97ñ1,15 a 16,87ñ1,21 µl/seg). Este valor tendió a normalizarse a los 6 ó 7 días del debut en los individuos en que existió algún tipo de recuperación auditiva (18,83ñ1,01 µl/seg, n=4), pero no lo hizo en los que no recuperaron ni siquiera a los 30 días (17,39ñ0,77 µl/seg, n=7). Existieron diferencias en la FST de los pacientes con y sin recuperación auditiva en las determinaciones a los siete y treinta días del debut. El descenso en esta prueba acompaña al trastorno auditivo y confirma la susceptibilidad de la microcirculación coclear al deterioro de las características viscoelásticas de la sangre (AU)

An hemorheological study on whole blood filterability (WBF) was done in eleven patients bearing of sudden deafness, in a continuous way, even before clinical onset. This evaluation is making usually in animal models, but not in humans. Independently of clinical diagnosis of each patient (two cases of diabetes mellitus, one of ulcerative colitis, systemic lupus erythematosus, systemic hypertension, after blood transfusion, sepsis with disseminated intravascular coagulation, upper respiratory ways infection, after surgery, and two healthy individuals), all of them showed a decreased WBF when hearing loss appeared (from 19.97 +/- 1.15 microliters/sec to 16.87 +/- 1.21 microliters/sec). This value normalized at six or seven days from the onset in cases with some kind of hearing recovery (18.83 +/- 1.01 microliters/sec, n = 4), but did not in those with no improvement even at thirty days (17.39 +/- 0.77 microliters/sec, n = 7). There were differences in WBF values of patients with and without hearing recovery in determinations at seven and thirty days from onset. Decrease in WBF accompanies this hearing disorder and confirms the cochlear microcirculation susceptibility to the impairment of blood viscoelastic properties (AU)

[Co-administration of histamine H1 antagonist and oral anticoagulants]. / Empleo simultáneo de antihistamínicos H1 y anticoagulantes orales.

Indications for oral anticoagulation and antihistamine H1 antagonists therapies are increasingly. So, it is easy to find individuals who need both treatments. The unknowledgement about possible interferences of antihistamines over acenocumarin often makes to avoid them at the same time. A review on a population receiving anticoagulation on a Therapeutic Center allowed us to verify disorders secondary to the association of antihistamines into their therapeutic scheme. Loratadine, ebastine and cetirizine show similar records of interaction into acenocumarin pharmacokinetics, probably due to a liver enzymatic induction on the anticoagulant drug, producing a decrease on INR values in which anticoagulation is measured. This could make necessary to increase temporally acenocumarin dose. During coadministration no thromboembolic event nor bleeding were registered.

Empleo simultáneo de antihistamínicos H1 y anticoagulantes orales / Coadministration of histamine H1 antagonist and oral anticoagulants

Las indicaciones terapéuticas de los anticoagulantes orales y los antihistaminícos H1 son cada vez mayores. Por ello no resulta infrecuente encontrar individuos que precisan ambos tratamientos. El desconocimiento de las potenciales interacciones medicamentosas de los antagonistas de la histamina sobre el acenocumarol hace que a menudo se evite su asociación. La revisión de una población atendida en un Control de Terapéutica Anticoagulante nos ha permitido objetivar los trastornos originados por la introducción de algún antihistamínico en su esquema terapéutico. Loratadina, ebastina y cetirizina presentaron índices similares de interacción en el perfil farmacocinético del acenocumarol, probablemente por inducción enzimática hepática inactivadora del anticoagulante, lo que originó una disminución en los valores de INR con los que se mide el nivel de hipocoagulabilidad. Ello puede hacer necesario elevar temporalmente las dosis de acenocumarol. Durante el tratamiento sincrónico no se registró ningún evento tromboembólico ni hemorrágico en los pacientes seguidos (AU)

Indications for oral anticoagulation and antihistamine H1 antagonists therapies are increasingly. So, it is easy to find individuals who need both treatments. The unknowledgment about possible interferences of antihistamines over acenocumarin often makes to avoid them at the same time. A review on a population receiving anticoagulation on a Therapeutic Center allowed us to verify disorders secondary to the association of antihistamines into their therapeutic scheme. Loratadine, ebastine and cetirizine show similar records of interaction into acenocumarin pharmacokinetics, probably due to a liver enzymatic induction on the anticoagulant drug, producing a decrease on INR values in which anticoagulation is measured. This could make necessary to increase temporally acenocumarin dose. During coadministration no thromboembolic event nor bleeding were registered (AU)