Impacto del tratamiento alergológico integral en la calidad de vida de los pacientes con asma / Wholemeal allergologic treatment impact in the quality of life of patients with asthma

Introducción: Calidad de vida es la percepción del paciente de los efectos de suenfermedad y sus consecuencias terapéuticas. Con los cuestionarios validados yestandarizados se evalúa la calidad de vida de los pacientes con asma.Objetivo: Estimar el impacto del tratamiento alergológico integral en los pacientescon asma que acudieron a consulta al servicio de Alergia e InmunologíaClínica del Hospital Universitario de Puebla.Material y métodos: Se realizó un estudio prospectivo en pacientes con asmaalérgica de ambos sexos y mayores de 18 años, con inclusión de dos meses yseguimiento de 12 visitas. A cada paciente se le realizó la anamnesis, las pruebascutáneas, la espirometría y un cuestionario de calidad de vida y estimaciónde la gravedad al inicio y final del seguimiento. El tratamiento alergológico integralse basó en los criterios de GINA. El tamaño de la muestra se calculó deacuerdo a métodos estandarizados.Resultados: Se incluyeron 20 pacientes y todos terminaron el seguimiento. El85% era mujer y la edad media era de 41,8 años con una desviación estándarde 13,4. La gravedad más frecuente fue la moderada persistente en el 40% alinicio y al final del seguimiento y la intermitente en el 75%. Se observaron diferenciassignificativas entre el índice de calidad de vida al ingreso de los pacientesy durante el seguimiento a partir de la octava visita.Conclusión: El tratamiento alergológico integral modifica la calidad de vida yla gravedad de los pacientes con asma alérgica

Introduction: The quality of life is conceived as the perception of the patient of the functional effects of his/her illness and its therapeutics consequences. Development of validated and standardized questionnaires had may to evaluated the quality of life of patients with asthma. Objective: Determine the impact of integral alergologic treatment on quality of life of patients with allergic asthma visited in the external consultation of the service of Allergy and Clinical Immunology of the Hospital Universitario de Puebla. Material and methods: A prospective study was carried out in patients of both sexes, older than 18 years, whit allergic asthma, through a period of inclusion of two months with twelve visits of follow-up. History, skin test, spirometry and a standarized questionary were obtained in each patient, as well as estimation of severity degree of the illness at the beginning and at the end of the study. The integral allergic treatment was based on the Global Innitiative for Asthma judgments. The size of the sample was calculated according to standardized methods. Results: Twenty patients were included an all of them completed the follow-up. Eighty-five per cent of them were women. The average age was 41.8 years old with a SD of 13.4. The severity degree most frequent were the moderate persistent, with a 40% at inclusion and end of the follow- up, and the intermittent with a 75%. Significative differences between index of quality of life at the inclusion and during the follow-up were observed after 8th visit. Conclusion: The integral treatment modifies the quality of life and severity degree of the patients with allergic asthma

[Efficacy and safety of fexofenadine and cetirizine in the treatment of allergic rhinitis]. / Eficacia y seguridad de la fexofenadina y la cetirizina en el tratamiento de la rinitis alérgica.

BACKGROUND: Allergic rhinitis affects 20 million of people in United States and a higher figure all around the world. OBJECTIVE: To evaluate the efficacy and safety of fexofenadine compared with certirizine in the treatment of allergic rhinitis. MATERIAL AND METHOD: It was carried out a prospective, double blind, comparative, randomized and multicentric study in patients with allergic rhinitis, with ages between 12 and 65 years. In the first phase, placebo was administered during three days to all the patients; and then, they were randomly allocated to receive fexofenadine 120 mg or cetirizine 10 mg in one dose a day during 14 days. Laboratory and cabinet tests at the beginning and at the end were performed to value security, as well as a global evaluation of the researcher to estimate effectiveness. RESULTS: 176 patients were included, 63.6% were women, average age was 27 years (+/- 12), 47.7% received fexofenadine and 52.2%, cetirizine. There was not significant difference in parameters of effectiveness nor of security in the studied group. CONCLUSION: The results of the present study confirm the efficacy and safety of the antihistaminic fexofenadine in the treatment of allergic rhinitis.

[Correlation between Blatella germanica and Periplaneta americana in allergic patients]. / Correlación entre Blatella germanica y Periplaneta americana en pacientes alérgicos.

BACKGROUND: It has been identified shared allergens from whole body between Blatella germanica and Periplaneta americana. It has been reported high correlation between both cockroaches. OBJECTIVE: To estimate correlation between skin test for two major species of intradomiciliary cockroaches. METHODS: It was included patients with clinical diagnostic of allergy pathology whom attended to external consult of Allergy and Clinical Immunology Service of the Hospital Universitario de Puebla in a period of six months, prick skin tests with standardized antigens of Blatella germanica and Periplaneta americana were made. RESULTS: One hundred twenty patients were enrolled in the study, 54.2% were women and 45.8% were men, with a mean age of 15.7 years old. The correlation coefficient between Germany cockroach and American cockroach to erythema was 0.49 and to papule was 0.40. CONCLUSION: The outcomes showed a moderate correlation or a considerable relation between both cockroaches whether erythema or papule. Based on the results presented, we suggest to evaluate both antigens in order to improve diagnostic accuracy.

[Incidence of adverse reactions to immunotherapy in allergic patients at Puebla University Hospital]. / Incidencia de reacciones adversas a la inmunoterapia en pacientes alérgicos del Hospital Universitario de Puebla.

MATERIAL AND METHOD: In order to know adverse reaction incidence to, immunotherapy, it realized a longitudinal, prospective and descriptive study in patients of outward consultation of Allergy Immunology Clinic Service of Hospital Universitario de Puebla in a period of 10 months. It determined age, sex, diagnostic, reaction adverse kind and presentation time of them. Initial immunotherapy dose was 0.05 ml administered subcutaneously with treatment antigens 1:100 weight/volume without premedication. It included 170 patients with average age of 22.6 years (SID 15.4), 56.5% female sex and 43.5% male. RESULTS: Most frequent pathologics were asthma and rhinitis. Adverse reactions incidence at specific immunotherapy were 2.4%, all of them were of immediate and local kind. CONCLUSION: These results are influence by the concentration and dose of antigens utilized and may differ of another studies.

[Prevalence of latex hypersensitivity among medical personnel]. / Prevalencia de hipersensibilidad al látex en personal médico.

In order to determine the latex hypersensitivity prevalence in medical residents from Hospital Universitario de Puebla, it was carried out a transversal, observational and descriptive study including the medical staff of all specialties. The epicutancous test was effectuated with 1:20 latex antigen dilution. It was studied a total of 90 medical residents, 68.9% were males and 31.1% females. The mean age was 30.6 years (SD 3.8). The 50% were from clinical specialties and 50% else were from surgical. The global latex hypersensitivity prevalence was 8%. It will be convenient to carry out a follow up of studied cohort to establish if continual exposition, years later, will determine skin reactivity to latex in professional practice.

[Predictive value of IGE in the newborn infant]. / Valor predictivo de la IgE en el recién nacido.

To study the relationship of IgE titles to development of allergy disease in the nursing, it was quantified the levels of this immunoglobulin in blood of the umbilical cord in healthy term eutrofic infants born consecutively in a period of two months. A total of 74 infants were followed for six with monthly appointments. The mean of IgE was 0.08 IU/ml with standard deviation of 0.15. Only two infants developed allergy, this determined a negative predictive value for IgE of 94%. Our outputs agree with that of other authors with respect to high negative predictive value of the low or normal levels of IgE in blood of the umbilical cord and the development of allergy. We concluded that its determination should limit to infants with family antecedent of atopy in order to improve the capacity of prediction of this illness.

[Comparative assessment of astemizole-pseudoephedrine and loratadine-pseudoephedrine in children with allergic rhinitis]. / Evaluación comparativa del astemizol-pseudoefedrina y loratadina-pseudoefedrina en niños con rinitis alérgica.

The purpose of the study was to evaluate the effectiveness and safety of astemizole-pseudoephedrine solution compared to loratadine-pseudoephedrine syrup in the treatment of allergic rhinitis. Fifty children (34 boys and 16 girls) ages between 2 and 7 years were enrolled and randomly assigned to each group. Patients were evaluated before treatment and on the third and seventh days of therapy. Children treated with astemizole-pseudoephedrine had better results with an average effectiveness of 84% compared to 64% for children treated with loratadine-pseudoephedrine. Differences were significant for eye symptoms by medical evaluation and for blocked nose, sneezing and itchy nose according to the patients diary. Both treatment groups started action within 30 minutes after drug intake. 4 hours later, 38% of the patients in the astemizole-pseudoephedrine group and 16% in the loratadine-pseudoephedrine groups had experienced improvement. One patient in the former and three in the latter showed adverse effects.

[Reference values of T-lymphocyte subsets in umbilical cord blood]. / Valores de referencia de las subpoblaciones de linfocitos T en la sangre del cordón umbilical.

In order to determine reference values of T lymphocyte subpopulations in cord blood in the metropolitan area of Puebla city we randomly selected 80 from a total of 400 term, eutrofic and without pathology newborn. The percentage of CD3, CD4 and CD8 T lymphocyte subpopulations in cord blood were determined by flow cytometry. Reference values were gotten from the 25 and 75 percentile in parameters without gaussian distribution. Reference values are CD3 (45.5 to 91.3%), CD4 (26.2 to 69.4%), CD8 (16.2 to 24.1%) and NK (2.0 to 8.5%). The presented data represent valuable normal ranges of T lymphocyte subsets to compare with values observed in sick or in risk of developing immunoallergic pathology children.

[Rhino-bronchial syndrome: new diagnostic approach]. / Síndrome rino-bronquial: nuevo enfoque diagnóstico.

The studies in relation to rhino-bronchial syndrome are very few. That's true because of the diagnosis and treatment of the specimens is not made in a randomized way. And because of the many different etiology. In this paper two hundred and thirty files were studied within the diagnosis of RBS among patients consulting in the Pediatric Allergy Service in 1989. The results show that this process is multifactorial: allergic 72%, infections 23% and functional (gastric reflux) in 4%. There was improvement with specific treatment with immunotherapy and general measurements in 82%. Since fourth month of treatment.