[Premedication for the prevention of adverse reactions to ionic iodized contrast media. Comparative study]. / Premedicación preventiva de reacciones adversas a contrastes yodados iónicos. Estudio comparativo.

A study comparing two pretreatment protocols to prevent adverse reactions to iodinated radiocontrast media (IRCM) was performed in 45 adults patients. They followed inclusion and exclusion criteria. Pretreatment protocol A was within 12 hours before using the IRCM and pretreatment protocol B was for 72 hours before. A corticosteroid and two H2 receptor antagonists were given on both protocols. We managed these protocols by an aleatory way, so 22 patients received protocol A and 23 patients received protocol B. Excellent results were found in 63.6% and good results were found in 36.4% for protocol A. Excellent results were found in 78.2% and good results were found in 21.8% for protocol B. However, no statistically differences were detected for both protocols (p = 0.451).

[Giardia lamblia extract (giardine): its immunologic mechanism]. / Extracto de Giardia lamblia (giardina): su mecanismo inmunológico.

Giardia lamblia is a protozoa that invades the high portions of human small bowel, as well the gall bladder and biliary passages. The absorption from the gut of extrinsic particles which have all properties occurs at full scale in the small bowel. Infections by this protozoa may lead to different clinical symptoms: departing free-symptom, urticarial manifestations of variable intensity and malabsorption syndromes, as well. In Cuba, Giardia lamblia parasitism constitutes a health problem because of its high incidence and prevalence. Investigators have showed allergic dermatological disorders and others, in patients with giardiasis, that may obey from two mechanisms: first, the parasite or its metabolic products might be antigenic for the host; second, the parasite may act as a hapten, that in successive sensitizations might lead to such manifestations, producing specific antibodies which have been found in patients' sera with giardiasis. We recently have elaborated an allergenic extract from Giardia lamblia (we called it giardine ), for demonstrating cutaneous sensitization to such protozoa. In other way, Prausnitz and Küstner, in 1921, showed that a dermal allergic reaction could be passively transferred by means of sensitized patient's serum to a non-sensitized subject. More recently, in 1967, Ishizaka and Ishizaka and Johansson and Benich, in separate studies, showed that skin sensitizing antibodies belonged to a different kind of immunoglobulin, IgE, and it could be measured in serum from sensitized patients. So, a study of sensitization to Giardia lamblia has been performed. Twenty-two patients have been studied suffering from giardiasis with at least 3 month evolution of this disease.(ABSTRACT TRUNCATED AT 250 WORDS)

[Asthma and pregnancy: some immunologic aspects]. / Asma y embarazo: algunos aspectos inmunológicos.

We studied two groups of pregnant women: 30 asthmatic and 20 non- asthmatic ones (as control), within a eleven-month period. We filled clinical data with inclusion and exclusion criteria for our investigation. We performed tests for determination of E, G, A and M immunoglobulins; and spontaneous rosettes tests and lymphocytic CD4+ and CD8+ subpopulations, as well. We found high IgE levels in the asthmatic pregnant women, in each pregnancy quarter. In relation to IgG and IgA we found a diminishing tendency from the beginning to the end of pregnancy, with statistical meaning, in beth groups of women. We didn't get significant variations for IgM, spontaneous rosettes and lymphocytic CD4+ and CD8+ subpopulations levels, in any of the two pregnant groups, in any of three pregnancy quarters, in our investigation.

[Anemophilous fungi: viability and allergenicity]. / Hongos anemófilos: viabilidad y alergenicidad.

Three strains of anemophilous fungi (Alternaria, Rhizopus and Monilia) from different genera were studied. We found that the liquid Sabouraud and culture media used in this study lost nutrients after seven days of strain growth, without affecting their viability. This was proven when the fungi were reseeded at 15 and 60 days. Extracts from supposedly sensible patients were developed using intradermoreaction skin tests, finding no significant differences among the results obtained from these tests. We recommended further studies with more prolonged growth periods (90, 120, 180 or more days) to see whether this incides on the viability and allergenicity of the anemophilous fungi.

Chronic urticaria: humoral and clinical diagnosis of its morphological variables.

Thirty adult patients with a diagnosis of chronic urticaria were attended as outpatients at the Allergology Service, Clinical Surgical Hospital "Hnos. Ameijeiras". An accurate clinical history was made, humoral parameters such as erythrosedimentation, total eosinophil count, serum levels of immunoglobulins and complement fractions were measured, and a skin biopsy was done. Most of the patients with urticarial vasculitis showed almost permanent papulous reactions with fever and arthralgias. Duodenal smear was positive for Giardia lamblia in a high percentage of patients with urticarial vasculitis. Paraffin-embedded skin biopsy was very useful for measuring morphological variables, and it is recommended that this technique be used in recent reactions (< 24 h evolution).

Giardia lamblia allergenic extract as diagnosis procedures for determining sensitization to this protozoa.

We studied 200 patients assisting at the Allergy Department and the Gastroenterology Department in "Hermanos Ameijeiras" Clinical-Surgical Hospital. They were clinically and immunologically tested for giardiasis through duodenal fortis or gall bladder drainage and total IgE serum levels. All patients underwent intradermal and skin prick tests with Giardine allergenic extract. These skin tests showed high sensitivity and increased specificity. Thus, our procedure in diagnosis is accurate, accessible and economical.

[Melkersson Rosenthal syndrome. Presentation of a case]. / Síndrome de Melkersson Rosenthal. Presentación de un caso.

This a case report of a 24 year old black woman who referred to her physician recurrent episodes of inferior lip enlargement for a period of two years. Remission periods were incomplete, unrelated to any apparent cause and plicate tongue. No improvement was seen with medication, including the use of steroids. Complementary exams were negative except the biopsy which reported granulomatous cheilitis. We conclude that the Melkersson Rosenthal Syndrome must be considered when confronted with a patient who suffers from lip enlargement and pleated tongue, with or without neurological alterations as for example, facial paralysis.

Atopic dermatitis: serum immunoglobulins and T-lymphocyte subpopulations.

A group of patients with atopic dermatitis who attended the Allergy Outpatient Service of the Hermanos Ameijeiras Clinical Surgical Hospital from May, 1987 to May, 1988 were studied. The patients were assigned to 2 groups; the first one composed of 38 patients and the second one composed of 12 non-allergic, supposedly healthy subjects. Different tests were carried out for the quantification of total serum immunoglobulins (A, G, M, E) by means of the radial immunodiffusion method and the ELISA ultramicromethod. They were also submitted to quantification of lymphocyte subpopulations by means of the indirect immunofluorescence test with monoclonal antibodies, using Cuban antiserum prepared at the National Institute of Oncology and Radiobiology. In our study IgG and IgA values were within normal limits in patients, contrary to the statistically significant increase in IgM and IgE values. The relative values of total T-lymphocytes (anti-T3) and of the suppressor lymphocyte subpopulations decreased.

Atopic dermatitis. Findings of skin biopsies.

Twenty-eight adult patients with a clinical diagnosis of atopic dermatitis (according to the criteria of Hanifin and Lobitz) were studied at the Allergy Outpatient Service, the Dermatology Service and the Pathological Anatomy Service of the Hermanos Ameijeiras Clinical Surgical Hospital, from January to September 1986. The patients were submitted to a quantification of total serum IgE by means of the ELISA enzymatic ultramicromethod, developed at the Radioimmunoassay National Center, and skin biopsies were carried out by means of the paraffin and direct immunofluorescence methods. The most frequent histopathological findings were acanthosis, espongiosis, parakeratosis and exocitosis, as a chronic inflammatory infiltrate, mainly composed of lymphocytes, mast cells and eosinophils. In the skin direct immunofluorescence method we found depots of IgE in all the patients, having no relation in intensity to total serum IgE values.

[Determination of serum immunoglobulins in asthmatic patients]. / Determinación de inmunoglobulinas séricas en pacientes asmáticos.

One hundred eighty one asthmatic patients were evaluated at the Allergy Consultation in Hermanos Ameijeiras Clinical Surgical Hospital. A case history was made for each of the patients, where the family background and personal history of allergy was collected; possible precipitating factors (such as inhalable, food, infectious, irritant, as well as climate factors) and physical and respiratory examinations. Serum immunoglobulin tests (by means of the ultramicroanalitic system (SUMA) and the rest of Igs: IgA, IgG, IgM by means of Mancini's simple radial immunodifusion method were made. Total eosinophil count was made to all of the patients in the study as well as serial studies of the faces. An increase in the IgE and IgM figures was found in asthmatic patients related to individual controls, and in relation to the normal figures for the adult population in our country. IgA and IgG determinations were normal both in the asthmatic and control groups, related to the standard figures.

Some aspects of the allergy to cow's milk. Morphological alterations of the jejunal mucosa.

Forty-four patients were studied at the Allergology and Pediatric Outpatient Services of the "Centro Habana" Pediatric Hospital. Allergy to cow's milk was demonstrated in these children by means of a detailed medical history, suppression diet and reexposition, lactose tolerance test, intradermal skin tests with casein extracts and the remaining proteins of cow's milk; finally, a careful study of the jejunal mucosas by means of biopsy was carried out, according to Townley and Barnes' method with a Crosby capsule. The skin reactivity was evident in children with allergy to cow's milk with tested extracts, mainly casein; in the control group this result was scarce or nil. Likewise, it was verified that there are morphological changes in the jejunal mucosa of children with allergy to cow's milk; these changes consist of partial atrophy of the villi, increase in the cell-infiltrate of the lamina propria and patchy areas. Our results are compared with the studies carried out by other authors and were statistically assessed.

Immunology of atopic dermatitis.

Thirty-two adult patients with atopic dermatitis were studied at the Allergology Service of the "Hnos. Ameijeiras" Clinical Surgical Hospital. The diagnosis was established following the criteria of Hanifin and Lobitz. A detailed medical history was written for the patients; the study of some immunological parameters, such as the serum immunoglobulin quantification, delayed skin tests with a battery of antigens, and the spontaneous rosette-test, was also carried out. Almost all the patients showed serum IgE values above 150 UI, by means of the ELISA test modified by C.E.N.I.C. The mean values of the spontaneous rosette-test were low; this was more noticeable during the exacerbation period of the lesions. Candida sp, Mantoux and Streptokinase-Streptodornase antigens showed negative results in a high proportion of patients with atopic dermatitis, in relation with the control group. In atopic dermatitis, there are humoral disorders of immunity; this was demonstrated in our group by increased values of IgE and cellular disorders due to skin anergy, and to a low percentage of rosette forming cells; this does not allow to state that these phenomena have an active participation in the etiopathogenesis of this entity.

[Central serous choroiditis. Possible allergic etiopathogenesis] Preliminary report]. / Coroiditis central serosa. Posible etiopatogenia alérgica. Comunicación preliminar.

We performed a study of all patients with Central Serous Choroiditis that were attended in Ophthalmology consultation, both on ambulatory and emergency services, as well as in Allergy-Ophthalmology inter-consultations at the Provincial Educational Hospital "Saturnino Lora" in Santiago de Cuba, from January 1982 until July 1984. These patients were divided in two groups: A and B; the former was treated with suppression and challenge diets, and with antihistaminic drugs: the latter with conventional therapeutic agents. We established several criteria for the evaluation of results as: Good, Fair and Bad. We followed a similar procedure in evaluating the inflammatory state of the eye fundus as Discreet, Moderate and Severe. With the first evaluation of treatment at 15 days, we observed greater improvement in patients from group A than with patients from group B.

Atopic dermatitis and delayed hypersensitivity.

Studies of patients with atopic dermatitis show both clinical and laboratory evidence of a depression of cellular immunity. In order to study one aspect of this disease in vivo we studied 40 patients with atopic dermatitis of both sexes, aged 2-30 years and 40 supposedly healthy subjects with similar characteristics in regard to age and sex who served as the control group. Both groups were subjected to tests of delayed hypersensitivity with Candidin, Trycophytin and Tuberculin. Candidin response was negative in 72.5% and 85% at 48 and 72 hours respectively. Trycophytin response was negative in 77.5% and 87.5% of the readings at the same time intervals, and Tuberculin response was negative in 85.5% of the patients with atopic dermatitis studied. The results are shown to be statistically significant. It is concluded that, cellular immunity should be evaluated in patients with atopic dermatitis.

Alergia a los anestesicos locales:estudio en 45 pacientes. / Allergy to local anesthetics: study of 45 patients

Se estudiaron 45 pacientes supuestamente alergicos a los anestesicos locales, con historia clinica, pruebas alergicas cutaneas y transferencia pasiva. Asi como tambien se hizo un control a 48 personas para revisar las distintas manifestaciones inmunoalergicos que estos anestesicos producen. Se confirma el escaso valor de las testificaciones cutaneas en estos pacientes, asi como se hacen recomendaciones

[Prostaglandin E2 obtained by semisynthetic procedures from Gorgonia plexaura homomalla cubesis. Study of its bronchodilator effect]. / Prostaglandina E-2, obtenida por procedimientos semisintéticos de la gorgonia plexaura homomalla cubesis. Estudio de su efecto broncodilatador.

The bronchodilator effects of PGE-2, isolated by semisynthetic procedures from the plexaura homomalla of the insular platform of the Cuban archipelago, was studied. Fifty bronchial asthma patients were evaluated by spirometry, before and after inhalation of an aerosol of PGE-2, in alcohol solution. The patients were divided into 4 groups, each group being tested spirometically at different moments before and after aerosol administration. The results obtained within each group were compared. Systemic blood pressure (T.A.) and heart rate (F.C.C.) were recorded simultaneously in order to detect any secondary effects on the cardiovascular system. In parallel with this study, asthmatic patients were divided into 2 control group with whom the same study was done using a different aerosol composition. In one group, a placebo of ethyl alcohol was administered, in the same proportion as the PGE-2 would have been. In the other, the aerosol contained isoproterenol and ethyl alcohol. These tests were planned to determine the significance of the initiating effect of the alcohol. The significance of the difference in the results obtained was determined statistically in all cases. Finally, the PGE-2 aerosol was used by asthmatics during acute crises, with similar methodology. Results indicated that the product tested has initiating effects on the respiratory tract mucosa, lacks a significant bronchodilating capacity and has no secondary effects on the cardiovascular system.

[Parasitism and allergy]. / Parasitismo y alergia.

Relationship betwen parasitism and allergic diseases are briefly commented. The parasites which most frequently are involved in allergic conditions in our environment are pointed out. Some cases are reported and conclusions from the material reviewed are made.