RESUMEN
Cow's milk allergy (CMA) is an immune-based disease that has become an increasing problem. The diagnosis and management of CMA varies from one clinical setting to another and represents a challenge in pediatric practice. In addition, because nonallergic food reactions can be confused with CMA symptoms, there is an overdiagnosis of the disease. In response to these situations, pediatric specialties from recognized institutions throughout Latin America decided to develop a clinical guideline for diagnosis and management of cow's milk allergy. These guidelines include definitions, epidemiology, pathophysiology overview, clinical and evidencebased recommendations for the diagnosis and treatment of CMA. They also include prevention and prognosis sections and identify gaps in the current knowledge to be addressed through future research.
Asunto(s)
Hipersensibilidad a la Leche/diagnóstico , Proteínas de la Leche/efectos adversos , Guías de Práctica Clínica como Asunto , Medicina Basada en la Evidencia , Humanos , América Latina , Hipersensibilidad a la Leche/epidemiología , Hipersensibilidad a la Leche/terapia , Proteínas de la Leche/inmunología , PronósticoRESUMEN
ETHNOPHARMACOLOGICAL RELEVANCE: The decoction of dried fruits of Ternstroemia pringlei (Rose) Standl. (Theaceae), commonly known as "Flor de Tila", is used in the Mexican traditional medicine to diminish insomnia and fear. AIM OF THE STUDY: To examine the sedative effects of the dried fruits of Ternstroemia pringlei and investigate a possible synergistic pharmacodynamic interaction between the sedative effect of aqueous extract of this plant and six central nervous system (CNS) depressant drugs. MATERIALS AND METHODS: The sedative effect was performed using the exploratory cylinder test in ICR mice. The extracts and drugs were intraperitoneally administered 30 min before testing in different doses, with exception of ethanol and buspirone which were administered 5 and 20 min before testing, respectively. An isobolographic analysis was used to characterize the interaction between Ternstroemia pringlei extract and six CNS depressant drugs. RESULTS: The intraperitoneal administration of the hexane, dichloromethane, methanol and aqueous extracts of Ternstroemia pringlei showed a dose-dependent sedative effect. Ternstroemia pringlei aqueous extract combined with buspirone, diazepam, diphenhydramine, haloperidol or pentobarbital exerted a super-additive (synergistic) sedative interaction. Whereas the combination Ternstroemia pringlei extract plus ethanol resulted in a sub-additive (attenuate) sedative interaction. CONCLUSIONS: These findings are in agreement with the traditional use of Ternstroemia pringlei in the treatment of insomnia, however it is a plant that interacts in a complex form with CNS depressant drugs. It may represent an advertence on the use of this plant concomitantly with other neuroactive drugs.