[Montelukast: new therapeutic option in patients with nasal polyps associated to respiratory allergic disease]. / Montelukast: nueva opción terapéutica en pacientes con poliposis nasal asociada a enfermedad alérgica respiratoria.

BACKGROUND: The physiopathogenic mechanism of nasal polyposis is unknown. Chemical mediators found in nasal polyposis are: histamine, serotonin, leukotrienes (LTC4, LTD4, LTE4, LTB4), norepinephrine and possibly prostaglandin D2. Leukotrienes that mediate bronchoconstriction as well as chemical mediators of inflammation are observed in the nasal disease associated to polyposis. HYPOTHESIS: Antileukotrienes might play a significant role in controlling polyposis and symptoms due to sinonasal disease. They represent an alternative to conventional treatments with oral steroids as well as to operations in the long-term control. OBJECTIVE: This study is a one year investigation that evaluates the important role of leukotriene receptor antagonists on nasal polyposis, with or without association to any allergic disease. Likewise, it compares its use with the conventional therapy used in the above mentioned disease. PATIENTS AND METHODS: We included 30 patients, 12 men (40%) and 18 women (60%), with ages between 16-45 years old. The mean age was of 20.7 years. Systematic assessments were made at the beginning of the study, as well as in the third, sixth, ninth, and twelfth month. Objective assessments, computed axial tomography of paranasal sinuses, allergological tests, nasal and bronchial symptoms evaluation, and interleukines, eosinophils, and immunoglobulin determinations were made. RESULTS: There was an improvement of nasal symptoms in the patients of group 1 (montelukast plus beclomethasone). They included the respiratory ones (p < 0.05), the nasal washing cells (p < 0.05), and the peak flow (p < 0.05) at the third, sixth, and twelfth months, respectively. There was no significant difference with the improvement obtained in the patients of group 3 (surgery-montelukast-beclomethasone) (p < 0.05). There was no significant change in group 2 regarding the baseline in the studied variables (p > 0.05).

[Comparative study on diagnostic probes: spirometry vs plethysmography in asymptomatic adult asthmatics]. / Estudio comparativo de dos pruebas diagnósticas: espirometría vs pletismografía en adultos asmáticos asintomáticos.

MATERIAL AND METHOD: The study to aim to do the comparison the sensibility between spirometry and pletismography in 20 asthmatic adult free of acute symptoms in basals conditions and to use subsequent of salbutamol spray. RESULTS: Were found to equal value for vital capacity (CV) with p = 0.02 for the both methods. For the total capacity pulmonary (CPT) with p = 0.05, p = 0.02 and increment in residual volume (VA) with p = 0.001 in the pletismography in both conditions (basal and post-salbutamol). The specific conductance (CE) to show p = < 0.001. The flows velocities (VF50, VF25-75) and (VF75, VF75-85) to show similar obstructions for aerial track smaller and smallest with p = < 0.20. CONCLUSION: Than both methods to have the same specificity, but no sensibility. The pletismography apparently to be more sensitive to diagnostic obstruction in airway tract of caliber medium.

[Radiological findings in patients with perennial allergic rhinitis]. / Hallazgos radiológicos en pacientes con rinitis alérgica perenne.

BACKGROUND: Rhinitis is clinically defined by obstruction, sneezing, pruritus and rhinorrhea. MATERIAL AND METHOD: There were studied 69 consecutive patients, from clinical immunology and allergy service of Hospital de Especialidades del Centro Medico Nacional Siglo XXI. RESULTS: 53 of them were women and 16 were men, all of them with ages between 15 and 55 years. They all had perennial allergic rhinitis, 50.7% of them had atopy, 47.8%, asthma as an added disease, 27.5%, nasal polyposis and 44.9%, sinusitis, in maxillary sinus 59.9%, in ethmoid 36.2% in 7.2% frontal. With septal deviation 33.3%, in 7.2% septal deviation with spur, obstruction of the osteomeatal complex in 4.3%, turbinate hypertrophy in 53.5%, polyps in 27.5% and bullous conchae in 7.2%. The diagnosis was performed by axial computerized tomography of paranasal sinuses. The chi square determined the association between structural alterations and the presence of sinusitis, with p = 0.001, with close relation between allergic rhinitis and sinusitis. CONCLUSIONS: Diagnosis and appropriate treatment proved to be very important in handling this disease.

[Interferon alpha 2b in pain caused by herpes zoster. Preliminary report]. / Interferón alpha 2b en el dolor por herpes zoster. Informe preliminar.

We studied forty patients with Zoster Herpes, twenty two of them, with this acute disease, eighteen with postherpetic neuralgia, to those that were considered chronic. The evaluation of the effect of INF alpha 2b, in the secondary pain of Zoster Herpes acute disease, in the patients with chronic severe secondary neuralgia they shared; the evolution with the treatment for half for visual pain analog scale in both groups the patients with acute pain, entered for visual pain analog scale between 10 and two points, with medium of 8.2 SD 2.1. They did not find any significance difference with this values p < 0.6. Most of the patients with acute pain was of 6 a 0 points with the medium a 0.27 y SD: 1,2 in the chronics went from. 6 to 0 points with a medium of 1.27 (SD:2.4), with a significative difference for t Student for comparation the initial scale in final in both groups of (p < 0.0001). The comparation of the best days, the disease bettered in acute quicker than the chronics with significance difference: (p < 0.001).

[Combined treatment in recurrent laryngeal papillomatosis with CO2 laser microlaryngoscopic resection and interferon alpha 2b]. / Tratamiento combinado en papilomatosis laríngea recidivante con resección microlaringoscópica láser CO2 e lfn alpha 2b.

Laryngeal papillomatosis of viral origin and bad prognosis is characterized by multiple recurrence that induced obstruction of air pathways. Surgical remove with laser CO2 is the elected treatment and the its combination with interferon (INF) has improved the prognosis of this recurrent viral disease. Here is a presents a preliminary study based upon such therapeutic scheme. Twelve patients diagnosed with laryngeal papillomatosis; 6 women and 6 men from 32 to 72 years of age were included into two therapeutic schemes: Group B, Combined: One woman and 5 men to whom the surgical procedure was followed by a initial local dose of 3 x 10(6) IU of INF alpha 2b (Intron A) and subsequently 10 X 10(6) (of the same INF were administered intramuscular every days during 15 months the statistical analysis (Fisher test) between patients of the both groups of treatment showed a significant (p < 0.0001) clinical improvement of the patients who received the combined treatment (B). In this group of patients was found incidence of the collateral effects such as: headache, fever arthralgias, depression and anorexia.

[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.

[Chronic mucocutaneous candidiasis. A case report]. / Candidiasis mucocutánea crónica. Reporte de un caso.

We present a case of chronic mucocutaneous candidiasis of the chronic diffuse kind. It began at eight months of age with lesions in plaque in the totality of the oral and nasal mucosa with affection of the nails. He received different treatment during ten years, without improvements. The diagnosis was established by clinical features en laboratory exams as follows: Skin test to Candida antigen and PPD antigen, direct smears, immunoglobulins and leucocyte random migration test. He received treatment with ketoconazole at an initial dose of 100 mg daily, and it was increased to 200 mg each day for a two years period, and then 100 mg every other day for an other year. Simultaneously, a Candida antigen stimulus treatment was used. We stress about the possibility of an immune enhancing role for ketoconazole as well as about that the correction of secondary immunodeficiency due to the chronic antigen stimulus.