[Asthma risk factors]. / Factores de riesgo para asma.

OBJECTIVE: To study the magnitude of risk factors known for asthma in 6-10 year-old children. MATERIAL AND METHODS: This is a case- and control-study with 6-10 year-old children; 58 were asthmatic and 117 were control, with a relation 2:1. Asthmatic patients were recruited from consult of immuno-allergies department and control patients, from familial medicine consult of Hospital de Especialidades 71, IMSS. Indirect (mother) and directed surveys were applied, they were of multiple option for exploring the most known in literature-risk factors. Statistical management was performed by odds ratio with confidence interval of 95%. RESULTS: The following variables were considered risk factors: ingestion of artificial colorants before having 1 year old (OR = 13.2), living in an urban area (OR = 7.74), maternal smoking during pregnancy (OR = 2.4), wool contact before having 1 year old (OR = 2.11), passive smoking exposure during pregnancy (OR = 1.486) and feeding with industrialized milk (OR = 1.2). CONCLUSIONS: Environmental risk factors are very important in our population, as well as early ablactation; however, ingestion before having 1 year old of allergens as egg, chocolate, orange and mango was not considered risk factor.

Neurocisticercosis / Neurocysticercosis

No disponible

Computed tomography scan versus ventilation-perfusion lung scan in the detection of pulmonary embolism.

This study compared the sensitivity and specificity of computed tomography (CT) scan and ventilation-perfusion (V-P) scan in detecting pulmonary embolism (PE) with pulmonary angiogram (AG) as the reference standard. Following a comprehensive search of the indexed medical literature, CT scan studies related to PE diagnosis were systematically evaluated to select those using AG as the reference standard and meeting specified methodologic criteria. Studies were further grouped by those reporting results for central PE findings only versus central and peripheral PE combined. A composite analysis of data derived from seven selected publications yielded sensitivity and specificity estimates for CT scan in detecting PE, which were statistically compared to the published results of a multi-center study reporting the sensitivity and specificity of the V-P scan with pulmonary AG as the reference standard. The calculated CT scan sensitivity was 77% for central PE only data and 81% for central and peripheral PE combined data, and the CT scan specificity was 91% and 98%, respectively. High-probability V-P scan sensitivity was 41% and specificity 97%; high- and intermediate-probability V-P scans combined yielded sensitivity 83% and specificity 52%. The sensitivity for PE detection was significantly greater for CT scan than for high-probability V-P scan; CT scan sensitivity was equivalent to V-P when high- and intermediate-probability scans were considered together. CT scan specificity for central and peripheral PE combined was equivalent to that of the high-probability V-P scan, but significantly greater than that of high- and intermediate-probability V-P scans considered together. Considering that only a small proportion of patients with suspected PE yield high-probability V-P scan results (which are usually indicative of PE), while as many as one-half of patients may yield intermediate-probability results (which are commonly not useful in PE diagnosis), our results suggest the CT scan may be an appropriate study for use by Emergency Physicians in the clinical evaluation of suspected PE.

Breakfast and performance.

Evidence suggests that the effect of fasting on performance is not uniform, but it is dependent on the basal nutritional status of the subject. Breakfast consumption has a short-term effect in improving selected learning skills, especially work memory. School breakfast programmes have a positive effect on the nutritional status of children, on school attendance and probably on dropout rates. The effect of breakfast consumption on school performance depends on the interaction between the programme, student characteristics (malnutrition) and school organisation. Unless the school setting guarantees a minimum quality standard, the benefits of breakfast consumption will not be evident in performance in complex areas like language or maths.

[Spirometric pulmonary age and its correlation with the chronological age of asthma patients]. / Edad pulmonar por espirometría y su correlación con la edad cronológica de pacientes con asma.

AIMS: Pulmonary age as a linear regression spirometric index, expresses pulmonary ventilatory function. OBJECTIVE: A pilot study was done to assess the differences of the values of the pulmonary age index and chronological age in patients with bronchial asthma and healthy volunteers. MATERIAL AND METHOD: We studies 111 subjects, 31 healthy and 80 with asthma. RESULTS: All of them underwent spirometry. Healthy individuals showed a mean chronological age of 35 years, and a pulmonary age of 26 years. Asthmatic patients showed a mean chronological age of 38 years, and a pulmonary age of 59 years. CONCLUSION: Both the time course and the severity of the disease increased pulmonary age.

[Frequency of association of rheumatoid factor in patients with breast cancer]. / Frecuencia de asociación del factor reumatoide en pacientes con cáncer de mama.

AIMS: It has been reported that some patients with cancer present auto-immune phenomenon mediated by auto-antibodies, suggesting a relationship between auto-immunity and cancer. Our interest was to determine the frequency of association of rheumatoid factor and breast cancer. MATERIAL AND METHOD: Fifty patients were studied, 3 on stage 111 and 19 on stage IV. Rheumatoid factor was measured in all of them. Auto-antibodies were measured by ELISA. The clinical files of all the patients were reviewed to determine the presence of metastases (osseous, pulmonary, CNS and hepatic) as well as the histological type of the cancer to correlate the expression of the rheumatoid factor with the patients' clinical status. RESULTS: Four (12.9%) out of the 31 patients on stage 111 had positive rheumatoid factor, while 9 (47.3%) out of 19 patients on stage IV had positive rheumatoid factor. The mean age of the patients on stage 111 with positive rheumatoid factor was 48 years, while the mean age of the patients on stage IV with positive rheumatoid factor was 53 years. Patients on stage 111 with positive rheumatoid factor only had local-regional metastases while patients on stage IV with positive rheumatoid factor had distant metastases. The predominant histological type was adenocarcinoma. CONCLUSION: In this study it is shown that breast cancer on the most advanced stages have higher expression of rheumatoid factor, and more clinical derangement with higher levels of rheumatoid factor expression. The proposal of auto-antibodies as predictors of the severity of the cancer requires further studies on several types of cancer.

[Effect of Staphylococcus aureus extract on the expression of L-selectin and LFA-1, in neutrophils from patients with allergic bronchial asthma]. / Efecto del extracto de Staphylococcus aureus en la expresión de L-selectina y LFA-1, en neutrófilos de pacientes con asma bronquial no alérgica.

OBJECTIVE: Messier L-selectin and LFA-1 in neutrophils from moderate and non atopic asthma patients, before and after stimuli with and without Sa (Staphylococcus aureus). MATERIALS AND METHOD: Design Trial; experimental. We studied neutrophils from 12 moderate and non atopic asthma patients and 12 healthy subjects before and after stimuli with and without Sa. MEASURES: The neutrophyls adhesion molecules, CD 62-L and CD 11 a was measured by citometric flow assays. RESULTS: The median of CD 62-L molecule expression increase with the stimuli in non atopic asthma patients from 2444 (CI 1966, CS 3627, RC 1661) to 6285.5 (CI 5243, CS 7203, RC 1960), and the median of CD 11 a molecule expression decrease with the stimuli in non atopic asthma patients from 9910.5 (CI 9765, CS 9961, RC 196) to 7670 (CI 7125, CS 8291, RC 1166). The median of CD 11 a molecule expression increase with the stimuli in healthy subjects from 593 (CI 361, CS 929, RC 568) to 1113 (CI 910, CS 1240, RC 330) and the median of CD 11 a molecule expression decrease with the stimuli in healthy subjects from 9850 (CI 9741, CS 9898, RC 157) to 9808.5 (CI 9693, CS 9890, RC 197) [CI. Inferior Cuartil, CS. Superior Cuartil, RC.-Cuartil Range].

[Frequent allergies in Mexico Valley in children]. / Alergenos frecuentes del Valle de México en niños.

The incidence of skin test positively for 48 allergens have been evaluated in children with bronchial asthma. We studied the 347 cards of clinical file the allergic children a course 32 months. The most frequent allergens is Dermatophagoides pteronyssinus, cat and the other 24 allergens were less 10%. This allergen appears to present in Mexico Valley, the incidence to this allergen might be considered must frequent in allergic children who do reducing skin test for diagnostic allergic diseases.

Fasting and cognition in well- and undernourished schoolchildren: a review of three experimental studies.

This paper reviews three experiments on the effects of an overnight and morning fast on attention and memory processes among 9-11-y-old children. Two of the experiments focused on middle-class, well-nourished boys and girls in the United States: the third involved boys from low-income families with and without nutritional risk in Huaraz, Peru. All experiments used the same crossover design and followed similar experimental procedures to control the subjects' intakes and motor activity during the study period. The children were admitted to a research center on two different evenings, approximately 7 d apart. After arrival the children ate dinner, played table games or watched television, and went to bed. They were awakened at 0730 and, by design, were either served breakfast (approximately 2301 kJ) or not. At 1100 they took psychologic tests that assessed recall from working memory and competence in discriminating visual stimuli. At 1200 the children were discharged. The consequences of the overnight and morning fast, particularly among the children who were nutritionally at risk, included slower stimulus discrimination, increased errors, and slower memory recall. We propose that these alterations result from a state of metabolic stress in which homeostatic mechanisms work to maintain circulating glucose concentrations.

When science and politics listen to each other: good prospects from a new school breakfast program in Peru.

This article provides an overview of a school breakfast program implemented in 1993 in the Peruvian Andes. The program, designed by the Instituto de Investigación Nutricional in Lima and supported by the government of Peru, constitutes a clear departure from previous school feeding programs, which were heavily politicized and poorly documented. From the program's inception, nutritionists, managers, and social scientists have collaborated to produce a sound nutritional design, efficient distribution mechanisms, and effective evaluation methods. During the program's first year, controlled evaluations conducted in several Andean regions documented improved dietary intake and a significant decline in the prevalence of anemia. An educational evaluation also found improved verbal skills, higher school attendance, and lower dropout rates among recipients of the school breakfast. The results have prompted the Peruvian government to continue supporting the program, thus setting a new standard for the effective management of social expenditure in the context of economic adjustment.

[Diagnostic use of enzymatic RAST skin tests and determination of eosinophils in nasal mucosa in allergic rhinitis]. / Utilidad diagnóstica de las pruebas cutáneas RAST enzimático y determinación de eosinófilos en moco nasal en la rinitis alérgica.

AIMS: Allergic rhinitis is the most frequent disease mediated by immunoglobulin E (IgE). Nasal challenge is the gold standard for the diagnosis of allergic rhinitis. Skin tests (ST) are the most used diagnostic method to detect the presence of specific IgE bind to skin mast cells. The exposition of the nasal mucous membrane to the allergen is followed by an increase of the local eosinophils; the count of eosinophils in nasal mucous (ENM) is a diagnostic test for allergic rhinitis. Enzymatic RAST or enzymatic allergo-sorbent test (ESA) measures the level of serum allergen-specific IgE. OBJECTIVE: To measure the sensitivity, specificity, and diagnostic precision of ST, EAST and ENM in allergic rhinitis. METHOD: We studied 241 individuals, 162 of them had allergic rhinitis, and 79 were healthy controls. They underwent nasal challenge and intradermic ST for Dermatophagoies spp (acarus). Fraxinus americana (Ash-tree), Amaranthus palmieri (quelite), Cynodon Dactylon (capriola) and Felis catus (cat), EAST for Dermatophagoides pteronyssinus (acarus), and ENIVI. Results of ST, EAST and ENIVI were compared with their corresponding nasal challenge, and the prevalence of allergic rhinitis for each allergen was calculated. The best cut point was assessed by means of receiver-operator curves (ROC), and sensitivity, specificity, positive predictive value, negative predictive value, inter-observer concordance coefficient, area under ROC (0), standard error of 0 (SEO), and 95% confidence interval of 0 of each test were calculated using the best cut point. RESULTS: ST and EAST had the best sensitivity and specificity. ENM had the lowest sensitivity and specificity. CONCLUSION: For the diagnosis of Dermatophagoides spp allergic rhinitis ST for Dermatophagoides spp and EAST for Dermatophagoides pteronyssinus have the same diagnostic precision. According to the indexes for diagnostic precision, and inter-observer concordance coefficient, ST and EAST are useful to diagnose allergic rhinitis induced by the evaluated allergens. ENIVI is a test that is not very useful for the diagnosis of allergic rhinitis.

[Superantigens in human disease]. / Superantígenos en la enfermedad humana.

Superantigens include viral and bacterial products, mainly of streptococci, staphylococci that stimulate T cells to proliferate nonspecifically through interaction with class II major histocompatibility complex products on antigen-presenting cells and then with variable regions on the beta chain of T cell receptor complex. Superantigens cause symptoms via release of immune cytokines. These proteins should be considered potential cause of illnesses such as rheumatic fever, arthritis. Kawasaki syndrome, atopic dermatitis, and guttate psoriasis because of their potent immune system-altering capacity.

beta-Carotene attenuates peroxide-induced vasoconstriction in the human placenta.

OBJECTIVE: Placental lipid peroxides and thromboxane are abnormally increased in preeclampsia. Peroxides stimulate thromboxane to increase placental vasoconstriction. Antioxidants, such as beta-carotene, control lipid peroxidation. Reduced levels of beta-carotene (0.25 mumol/L) have been found in preeclamptic women. We hypothesized that normal (0.5 mumol/L) or elevated (1.0 mumol/L) levels of beta-carotene would attenuate peroxide-induced vasoconstriction in the human placenta, whereas low levels would not. METHODS: Isolated human placental cotyledons (n = 8) were sequentially perfused with control Krebs-Ringer-bicarbonate buffer, 200 mumol/L t-butyl hydroperoxide, and then with progressively increasing concentrations of beta-carotene (0.25, 0.5, and 1 mumol/L) plus t-butyl hydroperoxide. Fetal perfusion pressure was monitored continuously, and maternal and fetal effluent samples were collected for each treatment. Samples were analyzed for lipid peroxides and for thromboxane and prostacyclin by their stable metabolites thromboxane B2 (TXB2) and 6-keto-prostaglandin (PG)F1 alpha. RESULTS: Compared with control, t-butyl hydroperoxide significantly increased perfusion pressure, vascular resistance, and the secretion rates of lipid peroxides, TXB2 and 6-keto-PGF1 alpha. Perfusion with normal (0.5 mumol/L) or increased (1 mumol/L) levels of beta-carotene significantly or completely inhibited t-butyl hydroperoxide-induced vasoconstriction and the increases in lipid peroxide and TXB2 secretion, but did not inhibit peroxide-induced increases in 6-keto-PGF1 alpha secretion. Reduced levels of beta-carotene (0.25 mumol/L) did not inhibit t-butyl hydroperoxide-induced vasoconstriction or the increases in lipid peroxide secretion. CONCLUSIONS: beta-carotene at levels found in normal pregnant women (0.5 mumol/L) or at levels achieved with beta-carotene supplementation (1 mumol/L) inhibited peroxide-induced vasoconstriction and lipid peroxide and thromboxane secretion. Levels of beta-carotene found in preeclamptic women (0.25 mumol/L) did not inhibit peroxide-induced vasoconstriction or lipid peroxide secretion.

[Premenstrual asthma: relation to hormones]. / Asma premenstrual: relación con hormonas.

Exacerbation of asthmatic symptoms just before or at the time of menstruation documented in some women with asthma has been called "premenstrual asthma" (PMA). The effect of sex hormones on airway function has not been well studied in spite of much evidence to suggest, therefore about relationships between the sex hormones and airway. The investigations of (PMA) have been based on studies of asthmatics already aware of a deterioration of asthma premenstrually. Little is known, therefore, about relationships between the menstrual cycle with asthma and (PMA) subjects. Although the mechanism of PMA remains unclear.

[Exposure to pollutants and allergens in the asthmatic child compared with the healthy child]. / Exposición a contaminantes y alergenos en el niño asmático en comparación con el niño sano.

To assess the frequency of exposure to allergens and indoor pollutants of school age asthmatic children at the time of their first visit to the specialist, we studied 14 cases with the diagnosis of asthma according to international criteria, and 21 healthy controls. The parents of the children filed a questionnaire asking about socio-economic level, family history of asthma, exposure to allergens or indoor pollutants, and clinical severity of the disease. Questionnaires with less than 80% of the responses were excluded from analysis. Asthmatic patients had higher frequency of exposure to tobacco smoke (42.8% vs 38%), moisture in the home walls (42.9% vs 19%), and to dust reservoirs (71.4% vs 52.4%). A high proportion of the asthmatic patients did not apply adequate environmental control measures. Education for the patients and their primary care physicians must be increased, to reduce the morbidity of the diseases.

Synthesis and pharmacology of alkanediguanidinium compounds that block the neuronal nicotinic acetylcholine receptor.

Taking as models the polyamine toxin fraction FTX from the funnel-web spider venom, and the guanidinium moiety of guanethidine, a series of azaalkane-1, omega-diguanidinium salts were obtained. Some of them blocked ion fluxes through the neuronal nicotinic receptors for acetylcholine (nAChR). The blockade was exerted at submicromolar concentrations, suggesting a highly selective interaction with the nAChR. In fact, the active compounds on the nAChR ion channel did not recognize the voltage-dependent Na+ or Ca2+ channels of bovine adrenal chromaffin cells. Therefore, these compounds may be useful tools to clarify the functions of nAChR receptors in the central and peripheral nervous systems.

[Nasal eosinophilia after specific provocation in patients with perennial allergic rhinitis]. / Eosinofilia nasal posterior al reto específico en pacientes con rinitis alérgica perenne.

We studied 35 patients with perennial allergic response to know the eosinophilia after the nasal challenge with specific antigen. Patients were selected randomly. In each patient, history and clinical examination, cutaneous tests, and eosinophil count in nasal mucous membrane were done 30 minutes and 8 hours after the challenge with Dermatophagoides antigen Results showed a significant increase of eosinophils after the challenge (P.006). Significant differences were not discussed between the eosinophil counts obtained 30 minutes and 8 hours after the challenge.

School breakfast and cognition among nutritionally at-risk children in the Peruvian Andes.

PIP: In 1993, in Peru, the Institute of Nutritional Research conducted two studies in Huaraz in the Andean region to evaluate the educational and nutritional impact of the government's School Breakfast Program. The school breakfast included a small cake and a glass of Amilac (similar in taste and color to milk), which provided 30% of each child's energy requirements, 60% of recommended dietary allowances for minerals and vitamins, and 100% of dietary iron needs. A case control study examined the effects of breakfast on cognition among 54 elementary schoolchildren 9-11 years old. It found that the school breakfast did not have a significant effect on the children's performance in the Number Discrimination, Peabody Picture Vocabulary Test, Raven Progressive Matrices, or Reaction Time tests. Children nutritionally at risk who received the placebo had significantly slower short-term memory scanning than their counterparts who received the breakfast. The no-risk placebo group exhibited more rapid discrimination between visual stimuli than the no-risk breakfast group. A field evaluation of the program in 10 rural schools, which were randomly assigned to a treatment or control condition, was conducted. In terms of energy, protein, and iron intake, the children in the case and control conditions were not significantly different. The children tended to be either very stunted or overweight. School attendance increased 0.58 points in the experimental group, while it decreased by 2.92 points in the control group (p 0.05). When both groups received the breakfast, attendance rates increased significantly in both groups (p 0.05). Vocabulary was sensitive to the effects of the breakfast. Specifically, the greater the child's weight, the higher his/her vocabulary test scores (p 0.05). These findings suggest that the brain is sensitive to decreases in the short-term availability of nutrients, and that an overnight and morning fast produces a physiological state accompanied by changes in brain function, especially working memory, particularly among nutritionally at-risk children.^ieng

[Immunology of the fetal-maternal relationship]. / Inmunología de la relación materno fetal.

For the last 40 years it has been considered that during pregnancy fetal antigens are expressed in a different manner in comparison with other grafts. Current data indicates that the acceptance of the fetus by the mother depends on the lack of expression of the polymorphic antigens and the production of hormones that act as immunological suppressors. During pregnancy there exists immunological recognition of the trophoblast antigens, but these antigens are not polymorphic and thus do not permit the identification of cytolytic T and natural killers cells. This structure also produces hormones that contribute to the diminished production and proliferation of T cells. It has been demonstrated that there exists an increase in the production by the trophoblast of complement inhibitors (DAF, CD46) and in the secretion of hormones such as progesterone, alpha-fetoprotein, steroids and prostanglandins. The identification of these immunological factors and mechanisms may be fundamental in the search for treatment regimens for such illnesses as cancer, infertility, spontaneous abortions, transplant rejection and graft versus host disease.

Efecto in vitro del cromoglicato disódico sobre la actividad fagocítica de los polimorfonucleares de pacientes asmáticos sanos / Disodium chromoglicate reduces in vitro phogcytic activity of the polymorphonuclear cells in asthmatic patients and healthy

El cromoglicato disódico (CGDS) interfiere con el trasporte de la membrana celular inhibiendo la liberación de mediadores y la activación de polimorfonucleares (PMN), al impedir el incremento del calcio libre intracelular. Para determinar si el CGDS disminuye la actividad fagocítica in vitro de PMN se incubaron PMN de personas sanas y asmáticos alérgicos con CGDS o con solución salina balanceada de Hank (SSBH) y se evaluó su actividad fagocítica con la técnica de quimioluminiscencia. Al comparar las muestras no se encontró diferencia significativa con la actividad fagocítica entre las incubadas con CGDS y las incubadas en SSBH sin CGDS; tampoco se halló diferencia en la actividad fagocítica entre los asmáticos y sanos y no hay diferencia en la capacidad fagocítica de PMN entre asmáticos y sanos