[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).

[Reactive airway dysfunction syndrome. Clinical case]. / Síndrome de disfunción reactiva de las vías respiratorias. Caso clínico.

The reactive airway dysfunction syndrome (RADS) is a type of occupational asthma without any period of latency and induced by irritants of low molecular weight. It is a clinical illness diagnosed with scarce information of prevalence in our medical service, that is why it receives a deficient treatment with more morbidity. A clinical case of a 60 year old patient is reported with a sudden, intense and long exposure to clorhidric acid and the consequent development of RADS. We performed a complete study of her signs and symptoms as well as some diagnostic tests, such as respiratory function tests and a positive test to the clorhidric acid. Once the diagnosis was confirmed, the patient was treated with high doses of corticosteroids and bronchodilators of long action for a period of three months. She had complete remission of symptoms, with normal respiratory tests and return to her every day work activities. It is important to consider that this illness in patients with respiratory symptoms and exposed to irritants should receive an appropriate treatment, which makes a better prognosis of it.

[Hereditary Osler angioedema (report of case)]. / Angioedema heredofamiliar de Osler (informe de un caso).

A case of Osler's hereditary angioedema, that show a halimark of aedema of facing, neck, hands and foots, respiratory difficulty, to feel sick, to vomit, diarrhoea and abdominal pain, from the seven years old.

[Combined cefotaxime and amikacin for immunomodulation in the treatment of actinomycetoma resistant to conventional treatment]. / Cefotaxima más amikacina asociadas a inmunomodulación en el tratamiento de actinomicetoma resistente a tratamiento convencional.

Actinomycetoma is a chronic disease that affects subcutaneous tissue. We present a case of a patient with abdominal actinomycetoma caused by Nocardia brasiliensis resistant to different treatments over several years, who also presented phagocyte immunodeficiency. He received two cycles (23 day cycles) of cefotaxime, 1 g every 8-h, and amikacin, 500 mg every 12 hours. Immunomodulation was carried out with levamisole 300 mg per week, during 4 weeks and bacterial antigen (at a concentration of 600,000,000 bacteria per mL), twice for a week during 20 months. The importance of susceptibility testing and immunological function investigation in this type of patients is discussed.

[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).