Tratamiento de las alopecias de patrón masculino y femenino. Eficacia clínica del aminexil y SP94 en dos series de 180 pacientes, hombres y mujeres / Treatment of alopecias of male and female patterns. Clinical efficacy of aminexil and SP94 in two surveys of 180 patients, men and women

El efecto del aminexil combinado con SP.94 fue evaluado como positivo en un grupo de pacientes de ambos sexos. Para poder confirmar estos positivos efectos se ha realizado un estudio en 180 pacientes de cada sexo en las Unidades de Tricología de dos Hospitales. Los pacientes se aplicaron sobre cuero cabelludo y cabellos húmedos 6 ml. de la loción todas las noches. A los pacientes se les realizó controles al comienzo del tratamiento y a los 45,90 y 180 días. Se efectuó en todos tipificación de la alopecia según las escalas de Ebling y Ludwig, y se les preguntó por su edad separándolos en grupos de menores de 17 años, entre 18 y 34 años, entre 35 y 49 años, y 50 o más años. También se interrogó por enfermedades y medicación concomitantes, presencia de dermatitis seborreica, cantidad de cabellos caídos en un lavado de 48 horas antes, deficiencias nutricionales o errores congénitos. A las mujeres con signos clínicos de síndrome SAHA se les realizó una analítica hormonal. La exploración del paciente en cada visita incluyó la realización de un tricograma con estudio del diámetro de los cabellos, signo de arrancamiento, sebometrías, corneometría, control iconográfico, graduación de la alopecia, y una valoración de la evolución de la dermatitis seborreica según una escala cuantitativa. En las visitas también se les pidió a los pacientes una valoración de la cosmeticidad y eficacia del producto, que de (..) (AU)

Effect of aminexil combined with SP94 was evaluated as positive in a group of patients of both genders. To confirm these positive effects a survey in 180patients of each gender has been performed in two Trichology Units of two Hospitals. Patients applied 6 ml. of the lotion in humid scalp all the nights. Controls to the start of treatment and at 45, 90, and 180 days was realized. Graduation of alopecia in accordance with the Ebling’s and Ludwig’s scales, and differentiation on four group of age (less than 17 year, between 18 and 34 years, between 35 and 49 years, and more than 50 year) was performed. All the patients were asked about their clinical background or treatments realized, seborrhoeic dermatitis, number of hairs shedding in a wash 48 hour before, nutritional deficiencies or congenital errors. Women with clinical signs of SAHA syndrome an hormonal analysis was performed Exploration of patients at each visit included trichogram and study of the hair diameter, pull sign, sebometry, corneometry, photographic control, graduation of alopecia, and a valoration of seborrhoeic dermatitis evolution in a quantitative scale. In each visit was also asked to patients for a evaluation about cosmeticity and efficacy of the lotion, by which of a subjecitive manner was divided in worst, similar, acceptable-better, and excellent, that was contrasted with the opinion of two physicians that had their evaluation based on the signs and photograph of each visit. Patient’s compliment was study with the Morisky-Green’s questionnaire. Patients that do not follow the protocol of application or that did not attend to some visit were substituted. Results permit to assure aminexil associated with SP.94 stop or delay loss of hair and favored its wide, although regroth of new hair lost in the evolutive process of androgenetic alopecia was not demonstrated, neither its actuation in seborrhorea and soborrhoeic dermatitis (AU)

Clinical and polygraphic evolution of sleep-related breathing disorders in adolescents.

It has been suggested that sleep-related breathing disorders (SRBD) involve a continuum that develops over the course of life. If modifiable factors could be identified, the progression of SRBD could perhaps be addressed early in life. Although some studies have looked at the evolution of SRBD in pre-pubertal children, very few studies obtained data in adolescents. Anthropometric, clinical and polygraphic variables were collected during a 4-yr follow-up study among 148 normal adolescents after initial cross-sectional analysis. From a total of 267 adolescents studied at baseline (mean+/-sd age 14.3+/-2.1 yrs), 148 (55.4%) were followed up for 4 yrs. During follow-up, there were no significant changes in snoring and polygraphic parameters. However, a tendency toward weight gain with centrally distributed fat was observed. Habitual snorers had a significantly higher body mass index and more centrally distributed fat than nonsnorers. Males had a higher snoring prevalence and a higher number of respiratory events than females. Snoring at baseline, male sex and poor academic performance were significant predictors of snoring at follow-up. Snoring tends to persist during adolescence and male sex acts as a risk factor. A relationship between snoring and academic performance was observed. These findings may have implications for long-term management of sleep-related breathing disorders.

Home respiratory polygraphy for diagnosis of sleep-disordered breathing in heart failure.

The present study assessed the usefulness of home cardiorespiratory polygraphy as an alternative to overnight polysomnography for the diagnosis of sleep-disordered breathing in heart failure. A total of 75 patients with chronic stable heart failure due to systolic dysfunction (left ventricular ejection fraction < or =45%) underwent polysomnography at the Virgen del Rocio Hospital and cardiorespiratory polygraphy at home. The two studies were performed in random order and within 30 days. The accuracy of polygraphical findings was determined by sensitivity and specificity obtained by area under the receiver operating characteristics (ROC) curves for apnoea-hypopnoea index (AHI) thresholds of > or =5, > or =10 and > or =15 in the polysomnography. The area under the ROC curve for AHI > or =5, > or =10 and > or =15 was 0.896, 0.907 and 0.862, respectively. The diagnostic accuracy of polygraphy compared with polysomnography ranged 78.6-84%, with sensitivities of 68.4-82.5%, and specificities of 88.6-97.8% for the different AHI thresholds. Altogether, 29 patients had an AHI > or =10 (central pattern 24, obstructive pattern 5). Sensitivity and specificity of home polygraphy for identifying the sleep-disordered breathing pattern was 100%. These data show that home cardiorespiratory polygraphy has a high sensitivity and specificity for the diagnosis of sleep-disordered breathing associated with heart failure.

[Respiratory morbidity after hospital discharge in premature infants born at < or = 32 weeks gestation with bronchopulmonary dysplasia]. / Morbilidad respiratoria tras el alta hositalaria en prematuros (< or = 32 semanas) con displasia broncopulmonar.

BACKGROUND: Bronchopulmonary dysplasia (BPD) is the most frequent cause of respiratory morbidity in the first 2 years of life among preterm infants who survive the first 28 days. OBJECTIVES: To evaluate respiratory morbidity in the first 2 years of life in a group of preterm infants born at (32 weeks' gestation with BPD (oxygen requirement at 36 weeks' postconceptional age) by comparing it with that in preterm infants born at (32 weeks without BPD and with a control group of full term infants without neonatal morbidity. To determine whether respiratory morbidity in children with BPD decreases after the age of 2 years. PATIENTS AND METHOD: Group I: preterm children with BPD (n = 29). Group II: preterm children without BPD (n = 29). Group III: children with appropriate gestational age and weight (n = 32). A cross-sectional, descriptive study of the three groups was performed over a 2-year period. In 17 children in group 1, the study was prolonged to the age of 4 years. We analyzed wheezing on at least two occasions, use of inhaled bronchodilators, use of inhaled glucocorticosteroids for more than 6 months, and hospitalization for respiratory illness. The chi-square test and Fischer's exact test were performed. RESULTS: At least one episode of wheezing occurred in 25 children (86.2%) in group I compared with 12 children (41.4%) in group II and 6 (18.8%) in group III. Nineteen children (65.5%) in group I and none in the remaining two groups received treatment with inhaled glucocorticosteroids for more than 6 months (p < 0.001). Inhaled bronchodilators were used by 25 children (86.2%) in group I compared with 12 (41.4%) in group II and 6 (18.8%) in the control group (p < 0.001). Twelve children (41.3%) in group I were hospitalized for respiratory illness compared with 8 (27.6%) in group II. There were no admissions among the control group. None of the children with BPD who received prophylaxis with palivizumab contracted respiratory syncytial virus infection. Seventeen children with BPD were evaluated until the age of 4 years. Episodes of wheezing decreased from 88.2% in the first year to 41 % between the third and fourth years (p < 0.001). Treatment with inhaled glucocorticosteroids for more than 6 months was given to 88.2% in the first year, 41.2 % between the first and second year and to 0 % after the second year (p < 0.001). Hospital admissions for respiratory illness decreased from 52.9% in the first year to 17.6% in the second year. None of the children were hospitalized after the age of 2 years (p < 0.001). CONCLUSIONS: During the first 2 years of life, children with BPD showed a greater number of admissions and episodes of wheezing and a greater need for medical treatment. Respiratory morbidity improved with age, 40% showed recurrent wheezing episodes at the age of 4 years.

Morbilidad respiratoria tras el alta hospitalaria en prematuros (32 semanas) con displasia broncopulmonar / Respiratory morbidity after hospital discharge in premature infants born at<= 32 weeks´ gestation with bronchopulmonary dysplasia

Antecedentes: La displasia broncopulmonar es la causa más frecuente de morbilidad respiratoria en los primeros 2 años en el niño pretérmino que sobrevive a los 28 días de vida. Objetivos: Valorar la morbilidad respiratoria durante los primeros 2 años de vida en un grupo de niños pretérmino (>=32 semanas) con displasia broncopulmonar (necesidad de oxígeno a las 36 semanas de edad posconcepcional), comparándola con la de niños pretérmino (<=32 semanas) sin displasia broncopulmonar y con un grupo control de nacidos a término sin enfermedad neonatal. Comprobar si la morbilidad respiratoria en los niños con displasia broncopulmonar disminuye a partir de los 2 años de edad. Pacientes y método: Grupo I: niños pretérmino con displasia broncopulmonar (n=29). Grupo II: niños pretérmino sin displasia broncopulmonar (n=29). Grupo III: niños de peso y edad gestacional adecuados (n=32). En los 3 grupos se realizó estudio longitudinal descriptivo durante 2 años, y en 17 niños del grupo I se realizó el mismo estudio hasta la edad de 4 años. Se analizaron las siguientes variables: sibilancias en al menos dos ocasiones, empleo de broncodilatadores inhalados, utilización de glucocorticoides inhalados durante más de 6 meses, ingresos hospitalarios por problemas respiratorios mediante test de chi cuadrado (X2) y test de Fischer. Resultados: Tuvieron algún episodio de sibilancias 25 niños del grupo I (86,2 por ciento) frente a 12 (41,4 por ciento) del grupo II y 6 (18,8 por ciento) del grupo III. Fueron tratados con glucocorticoides inhalados durante más de 6 meses, 19 niños del primer grupo (65,5 por ciento) y ninguno de los otros 2 grupos (p < 0,001). Utilizaron broncodilatadores inhalados 25 niños del grupo I (86,2 por ciento) frente a 12 (41,4 por ciento) del grupo II y 6 (18,8 por ciento) del grupo control (p < 0,001). Fueron hospitalizados por problemas respiratorios 12 niños del grupo I (41,3 por ciento) frente a 8 (27,6 por ciento) del grupo II, sin que ingresara ninguno del grupo control. De los niños con displasia broncopulmonar que recibieron profilaxis con palivizumab ninguno tuvo infección demostrada por virus respiratorio sincitial (VRS).Se evaluaron hasta los 4 años de edad 17 niños con displasia broncopulmonar. Los episodios de sibilancias disminuyeron del 88,2 por ciento en el primer año al 41 por ciento entre el tercer y cuarto años (p < 0,001). Recibieron tratamiento con glucocorticoides inhalados durante más de 6 meses el 88,2 por ciento en el primer año, el 41,2 por ciento entre el primer y segundo años y ninguno a partir del segundo año (p < 0,001).Los ingresos hospitalarios por problemas respiratorios descendieron del 52,9 por ciento en el primer año al 17,6 por ciento en el segundo, y ningún niño necesitó ingreso a partir de los 2 años (p < 0,001). Conclusiones: Durante los primeros 2 años, los niños con displasia broncopulmonar tienen mayor número de ingresos, más episodios de sibilancias y más necesidad de tratamiento médico; mejoran con la edad, aunque a los 4 años el 40 por ciento tienen episodios repetidos de sibilancias (AU)