Glucocorticoides inhalados y sibilancias posbronquiolitis / Inhaled corticosteroids and wheezing post-bronchiolitis

OBJETIVO: Determinar si el tratamiento con glucocorticoides inhalados durante 3 meses, después de una bronquiolitis leve, disminuye la incidencia y/o la gravedad de los episodios de sibilancias durante los siguientes 12 meses. DISEÑO: Estudio de intervención, multicéntrico, controlado, en grupos paralelos, con asignación aleatoria por bloques. ÁMBITO DE ESTUDIO: Centros de atención primaria de Lezo, Beraun, Andoain e Irún (Gipuzkoa). SUJETOS DEL ESTUDIO: Niños menores de 12 meses (n = 94) diagnosticados de bronquiolitis leve. INSTRUMENTALIZACIÓN: Se establecieron dos grupos de sujetos: grupo 1 (n = 47), tratados con beclometasona inhalada (250 mg/12 h) con cámara espaciadora Babyhaler(r), 8 días después del diagnóstico de bronquiolitis durante 3 meses; grupo 2 (n = 47), sin tratamiento. Se han comparado el número y gravedad de los episodios de sibilancias durante el período de intervención (3 meses) y durante el período de seguimiento (12 meses), mediante las pruebas de la t de Student y la ?2. RESULTADOS: Se han estudiado 89 niños (grupo 1, n = 42; grupo 2, n = 47). El 67 por ciento presentaron episodios de sibilancias durante el período del estudio (15 meses). No hubo diferencias significativas entre ambos grupos en los dos períodos estudiados. CONCLUSIÓN: El tratamiento con beclometasona durante 3 meses no modifica los episodios de sibilancias durante el tratamiento ni en los 12 meses siguientes (AU)

[Inhaled corticosteroids and wheezing post-bronchiolitis]. / Glucocorticoides inhalados y sibilancias posbronquiolitis.

OBJECTIVE: To determine whether inhaled corticosteroid therapy given for 3 months after mild bronchiolitis decreases the incidence and/or severity of wheezing in the following 12 months. DESIGN: Multicentric, single-blind, controlled, randomised intervention study. SETTING: Primary Health Care Centers in Lezo, Beraun, Andoain and Irún (Gipuzkoa, Spain). PATIENTS: Infants less than 12 months old (n = 94) diagnosed with mild bronchiolitis. INTERVENTION: We established two groups of patients: group 1 (n = 47) was treated with inhaled beclomethasone (250 pg/12 hours) using a valved holding chamber (Babyhaler); the treatment started eight days after diagnosis of bronchiolitis and lasted 3 months. Group 2 (n = 47) received no treatment. We compared the number of wheezing episodes and their severity during the intervention period (3 months) and the follow-up period (12 months) with the Students t-test and the Chi-squared test. RESULTS: We studied 89 infants (group 1, n = 42; group 2, n = 47), 67% of whom wheezed during the study period (15 months). There were no significant differences between the treatment and the control group in the study periods. CONCLUSIONS: Inhaled beclomethasone given for 3 months does not significantly modify the occurrence of wheezing episodes during the treatment period or during the following 12 months.

[Evaluation of the effectiveness of a physical exercise program in weight reduction]. / Evaluación de la efectividad de un programa de ejercicio físico en la disminución del peso graso.

OBJECTIVE: To evaluate the effectiveness of a programme of individualised physical exercise in reducing fat weight. DESIGN: A randomised preventive trial. SETTING: Health Centre. PATIENTS: Obese people of both sexes, between 32 and 67 years old and with a fat percentage of 20-45% (men)/25-50% (women), were selected at random from among chronic patients at the Centre, with the exclusion of patients with heart diseases and of others with pathologies which made the programme's completion difficult. Two samples, comparable in gender, age and fat percentage (n1=49, n2=47), were obtained. INTERVENTIONS: THE study lasted 6 months, with 3 evaluations. The Intervention Group (G1) was advised to walk: the frequency, length and intensity of the exercise was calculated individually with a computer programme. Measurements and main results. Weight, height and 4 cutaneous folds were measured in each evaluation, where the Index of corporal mass (ICM), fat percentage and fat weight (FW) were calculated. The programme's acceptance was assessed according to compliance and subjective improvement. In the last evaluation, the GI achieved a 2.9% average decrease in the ICM, with no appreciable changes in the CG (p < 0.001). The FW in the GI decreased by 18%, whereas in the GC it increased by 12% (p < 0.001). Sixteen patients of the GI (32.7%) succeeded in reducing their FW by more than 20%, as against one individual (2.1%) of the GC (p < 0.0001). In the GI, 93.9% noted improvement in their physical, and 75.5% in their mental, well-being. 67.3% stated that they exercised more than three days a week. CONCLUSIONS: An individually tailored and complete prescription of exercise facilitates and improves compliance, achieving greater decrease in fat weight.