[Clinical and spirometric correlation with home allergens and with pollutants]. / Correlación clínica y espirométrica con alergenos intradomiciliarios y con contaminantes.

INTRODUCTION: Environmental contamination causes an increase in respiratory symptoms, especially in patients with asthma. The severity of allergic asthma in children is associated with the presence of intradomicilliary aeroallergens and intramural contaminants. OBJECTIVE: Correlation to clinical abnormalities, spyrometryand skin test with the intradomiciliary pollution. MATERIALS AND METHODS: Children who participated ranged in age from 6 to 15 years, attended public schools, and were classified as healthy and asthmatic. A questionnaire was applied to them, as well as a clinical history, spirometry, skin tests, and an environmental study at home. RESULTS: Fifty-seven children were studied, of 10 years of age (+/- 3). Group 1 (23 healthy children): Positive skin tests, dust 66.6%, cockroaches 66.6%, mites 33.3%, cat 33.3%, dog 4.3%. Principal clinical symptoms were cough 91.3%, wheezing 78.3%, respiratory difficulty 39.1% with a morning predominance of 78.3%. Spirometry showed an obstructive pattern in 30.5%. Group 2 (34 asthmatic children): Positive skin tests, mites 52.1%, dust 47.8%, cockroach 21.7%, cat 21.7%, dog 4.3%, passive exposure to tobacco smoke 79.5%. Principal clinical symptoms were cough 91.3%, respiratory 82.3%, wheezing 79.4%, predominantly at night 70.5%. Spirometry showed obstructive pattern in 67.7%. CONCLUSIONS: Children with asthma present great contact and sensitivity for intradomicilliary allergens such as mites in household dust, proteins from cat, dog, and cockroach feces, in addition to greater frequency of passive smoking. It is important to point out that these factors can be modifiable at low cost, thus presenting the conditions for a better quality of life for the patient and diminishing costs of medical attention.

[Criteria for the diagnosis and treatment of chronic rhino-sinusitis in family medicine, otorhinolaryngology, and allergy services]. / Criterios de diagnóstico y tratamiento de la rinosinusitis crónica en servicios de medicina familiar, de otorrinolaringología y de alergia.

BACKGROUND: Rhinosinusitis is an inflammatory response affecting mucosa membrane of nasal cavity of one or more paranasal sinus. Its prevalence is of 14 and 5-13% in adults and children, respectively. Rhinosinusitis causes high rate of scholar and labor absenteeism. OBJECTIVE: To know diagnostic and treatment criteria of rhinosinusitis in units of familial medicine, otolaryngology and allergy. MATERIAL AND METHODS: A series of 25 patients randomly obtained from familial medicine units 21 and 28 of the IMSS, was studied. Diagnosis was assessed according to 1998 Consensus and computed tomography was considered the gold standard. It was performed to all patients and evaluated by a study-blind radiologist. RESULTS: Diagnosis of rhinosinusitis was done by familial medicine unit in 68%, otolaryngology service in 40% and allergy service in 64%. Clinical criteria most used were nasal congestion and anterior and posterior nasal discharge. The more requested examination was computed tomography (38.7%) and in 30% of cases, medical treatment was not prescribed. CONCLUSIONS: Familial physicians, otolaryngologists and allergists use, with low frequency, international criteria for diagnosis and treatment of chronic rhinosinusitis. Otolaryngologists perform other differential diagnosis.

[The use of the International Guidelines for the Diagnosis and Treatment of Asthma (GINA) in clinical practice among family physicians]. / El uso de las Guías internacionales de Diagnóstico y Tratamiento del Asma (GINA) en la práctica clínica de los médicos familiares.

OBJECTIVE: To evaluate the degree of knowledge of family physicians related to the International Guidelines for the Diagnosis and Treatment (GINA) of Asthmatic Patients. MATERIAL AND METHOD: We invited the family physicians from some clinics of Mexico City. A questionnaire was applied to 50 doctors who accepted to participate in the study; they had a 46 year-old age average and a proportion 1:1 between genders. The analysis was carried out with the test r of Pearson. RESULTS: The correlation between general knowledge of asthma and knowledge of GINA was r = 0.022; between the general knowledge of asthma and the specialty of family medicine was r = -0.117; and that among the knowledge on International Guides of Asthma and the specialty of family medicine was r = 0.33. CONCLUSIONS: A scarce knowledge exists on the guides proposed by GINA.