[Comparison of treatment of acute asthma attacks in children with salbutamol dispensed by the Volumatic dispenser or by a nebulizer]. / Comparación del tratamiento con salbutamol mediante Volumatic vs nebulizador en niños con ataque agudo de asma.

Eighteen children with acute asthma were administered equal doses of Salbutamol either through a nebulizer and face mask or a dose-metered inhaler, spacer (Volumatic) and tidal breathing mechanism. Consecutive doses at twenty minute intervals were administered until either no significant improvement in pulmonary function was observed or until a cumulative dose of 0.15 mg/Kg (maximum of 5 mgs) had been given. All subjects finally received a dose of 0.15 mg/Kg (maximum of 5 mgs) of nebulized Salbutamol at the end of the study. No difference in bronchodilation was obvious between the methods of treatment. No significant side-effect was observed in any patient. Treatment of acute asthma in children with Salbutamol via a pressurized inhaler, spacer and tidal breathing mechanism may be an efficacious, safe and readily available method, but further work is needed before it can be recommended for routine home management of asthma attacks.

[Significance of IgG serum levels in cystic fibrosis]. / Significado del nivel sérico de IgG en la fibrosis quística.

IgG serum levels were measured in 25 patients with cystic fibrosis aged 1 to 19 years and in 4 additional patients deceased over the last 4 years. Levels were correlated with a number of parameters. Twelve patients (group A) had raised IgG levels, and 17 (group B) normal or low levels. Age between groups did not differ. Patients in group A had lower Shwachman score (p less than 0.001), worse Chrispin and Norman radiologic score (p less than 0.05), lower weight (p less than 0.001) and height (p less than 0.05) and lower FVC (p less than 0.05), and FEV1 (p less than 0.01). Raised levels were associated with increased number of serum precipitins against Pseudomonas aeruginosa but not against Staphylococcus aureus. Raised IgG levels might be secondary to heavier bronchial infection, but there is growing evidence that immunologic response in cystic fibrosis may worsen the course of the disease.