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Biomedical subjects

D Solé

Publications and source records attributed to D Solé.

At least 55 records · Page 3Linked to original sources
PubMed1990

Evaluation of beta-adrenergic function in normal and asthmatic children.

Low levels of serum glucose have been observed in atopic individuals after a subcutaneous injection of epinephrine. This less than normal hyperglycemia could be evidence of partial beta-adrenergic blockade in atopy. We compared the basal values of glucose with those obtained after 30 and 60 minutes of a subcutaneous injection of epinephrine 1/1000 (0.006 ml/kg; maximum of 0.3 ml) in normal and atopic asthmatic children (mild, moderate, and severe). The glucose-oxidase method was used for the determination of glucose levels in peripheral blood. Glucose serum levels in normal children were significantly higher at 30 and 60 minutes compared with basal values. In patients with mild and moderate asthma, significantly higher values were observed only at 30 minutes. In severe asthmatics, the glucose levels at 30 minutes were not different from the basal values, but higher than those observed at 60 minutes. Comparison among the four groups showed significant differences between the nonatopic normal children and the severe asthmatic children at 30 and 60 minutes. The moderate asthmatic children showed significantly lower levels when compared with nonatopic normal children at 30 minutes.

Albuterol↗
PubMed1990

[Selective deficiency of IgA. Infrequent complications].

The association of selective IgA deficiency and/or autoimmune disease is not uncommon. This article includes two rare associations, recurrent parotiditis and Turner syndrome, in two patients with selective IgA deficiency, IgA; IgA deficiency; recurrent parotiditis; Turner's syndrome.

Child↗
PubMed1990

Abnormal maxillary sinus radiographs in children: do they represent bacterial infection?

Thirty-three children with chronic tonsillitis and/or adenoid enlargement and without previous diagnosis of sinusitis were studied regarding the bacterial flora of their maxillary sinuses. Puncture of maxillary sinus was performed at surgery (adenoidectomy and/or tonsillectomy) and aspirates were cultured. Streptococcus pneumoniae was isolated from 8 of 12 (66.7%) patients whose x-rays showed completely opacified maxillary sinus. Streptococcus viridans, Streptococcus faecalis, and Staphylococcus epidermidis were recovered from 6 (28.6%) of the 21 patients with normal maxillary sinus radiographs. Bacterial titers were greater than 10(4) colonies/mL in all but one of the positive cultures. No anaerobic bacteria were isolated. History of bronchial asthma, presence of nasal purulent secretion, elevated blood eosinophils, and elevated serum IgE were found more frequently in children with complete opacification of maxillary sinus. Serum levels of IgG2 were low in 29% of the children, but no correlation was found between low IgG2 levels and positive cultures from maxillary sinus aspirates. We concluded that children with complete radiologic opacification of maxillary sinus had bacterial infection in almost 70% of the cases with symptoms that did not prompt their physicians to consider the diagnosis of sinusitis.

Child↗
PubMed1989

Theophylline serum levels in children with bronchial asthma after administration of slow release theophylline as open or closed capsules.

Theophylline serum levels were studied after oral administration of slow release theophylline (Talofilina) in children with bronchial asthma. The children received the drug as closed capsules or as granules, obtained by opening the capsules, for 1 week in each form. The mean dose used was 8.6 mg/kg every 12 h. The theophylline blood levels at 4, 8 and 12 h after drug ingestion were significantly lower when granules from open capsules were used. Our recommended dose of Talofilina for Brazilian children is 16 mg/kg/day, if administered as closed capsules, every 12 h. On open capsule administration every 12 h, the total daily recommended dose is 20 mg/kg/day.

Asthma↗
PubMed1989

[Congenital agammaglobulinemia: study of 5 cases].

Five congenital agammaglobulinemic (CA) boys, started their recurrent bacterial infections between the ages of 3-18 months, presenting otitis (4), pneumonias (4), chronic diarrhea (4), meningitis (2), septicemia (2), septic arthritis (1) and urinary infection (1). The gamma globulin fraction was below 0.08 mg/dL in all patients. IgG, IgA, IgM and IgE levels were always below 50 mg/dL, 2 mg/dL, 35 mg/dL and 20 IU/mL, respectively. Secretory IgA was non-detectable in all patients. Total complement levels were normal (3) and the C3 fraction was elevated in 4 patients. The in vitro response of peripheral lymphocytes to PHA was normal in 4 patients, as well as the number of OKT3, OKT4 and OKT8 cells (2).

Agammaglobulinemia↗
PubMed1987

Treatment of acute attacks of bronchial asthma. A comparative study of epinephrine (subcutaneous) and fenoterol (inhalation).

Two treatment schedules for the initial treatment of acute asthma were evaluated in 150 children. The treatments were randomized so that 75 patients received the beta-2-agonist fenoterol nebulized by facial mask and 75 patients received epinephrine by subcutaneous injection. No significant differences in cardiovascular side effects occurred among the four groups at any time after the initial treatment. We conclude that inhaled fenoterol and subcutaneous epinephrine are equally effective. We recommend the use of inhaled fenoterol for the treatment of acute asthma to avoid the discomfort of injections.

Acute Disease↗
PubMedDate not supplied

Evaluation of quality of life in children and teenagers with allergic rhinitis: adaptation and validation of the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ).

BACKGROUND: in the last decades, the study on life quality has stimulated an increasing interest among health researchers. Instruments to evaluate the chronic disease impact on patients day-by-day, have been developed and published by researchers in many countries. The objective of this study was to adapt to the Portuguese Language (Brazilian culture), the RQLQ questionnaire (Rhinoconjunctivitis Quality of Life Questionnaire), destined for life quality evaluation in teenagers with allergic rhinitis. METHODS: in the beginning of the study, a list with 75 items, translated from the original article, was applied to 57 teenagers with perennial allergic rhinitis. The most frequent and troublesome items were selected to compose the modified questionnaire. The validation, reproducibility and responsiveness of the new instrument were evaluated through an interview with 52 patients before the beginning of the treatment, and of 2 and 4 weeks after the treatment. The obtained scores in these interviews were statistically analyzed to verify the questionnaire capacity to detect clinical improvement after the treatment. RESULTS: a significant difference was observed between the total score and those regarding domains, obtained at the first evaluation, compared to later evaluations. A positive correlation was also observed during the treatment, between the questionnaire score and the patient grades related to nasal symptom severity. CONCLUSIONS: the adapted questionnaire is reproducible, valid to be used in longitudinal studies and useful as an instrument of evaluation, but it should be submitted to other investigations to consolidate its properties.

Activities of Daily Living↗
PubMedDate not supplied

Specific and non-specific nasal provocation tests in children with perennial allergic rhinitis.

BACKGROUND: nasal provocation tests (NPT) have been extensively used in clinical practice to evaluate chronic rhinopathies, mainly allergic rhinitis (AR). METHODS: we submitted 10 perennial AR children (aged from six to 15 years) to histamine (H), Dermatophagoides pteronyssinus (Dp) and Blomia tropicalis (Bt) NPT. All children were sensitized (positive skin prick test, mean wheal > 3 mm) to both mites. Dp and Bt specific NPT were realized in two occasions, apart one week, always preceeded 24 hours by H challenge. Increased concentrations were applied to the nasal mucosa during each NPT: H (0,03 to 16 mg/ml), Dp (1/100,000 to 1 /2.5) and Bt (1/125,000 to 1/10). NPT were evaluated by clinical and rhinomanometric parameters (total score, TS), and by lung function tests. NPT was considered positive, when total nasal resistance (TNR) doubled in relation to basal value. RESULTS: H NPT was positive twice in 8/10 patients. Concordance between H concentration that induces a positive NPT measured by TNR or TS was observed. Regarding to specific NPT, 90 % of patients were positive to Dp and 60 % to Bt. There was no concordance between the allergen concentration that induces a positive SPT and a positive NPT, considering the different concentrations. There were no modification in lung function tests during both specific and non-specific provocation tests. CONCLUSIONS: NPT with H is an objective and reproducible method which allow evaluate nasal reactivity. Specific NPT have restricted indications, mainly when there where doubts about AR's etiology.

Adolescent↗
PubMedDate not supplied

Asthma and respiratory disease mortality rates in the state of Sao Paulo, Brazil: 1970-1996.

BACKGROUND: Asthma morbidity and mortality have been increasing. Data of asthma and respiratory mortality rates in Brazil are scarse. METHODS: We studied asthma and respiratory disease mortality rates in the state of So Paulo (capital and country side) from 1970 to 1996, as its relation with sales of drugs usually used in asthma treatment. RESULTS: Asthma mortality in the 5-34-year age group has doubled in the state of So Paulo (0.2 deaths/100,000 inhabitants in 1970 to 0.4 in 1996), mainly by its increase in the capital. The greatest increase was observed in the population of up to 15 years of age. The sales of inhaled anti-inflammatory drugs are proportionally very low and reflect a greater concern about the treatment of acute exacerbations. CONCLUSION: We believe that the institution of a public health supply to the whole population could provide better conditions for the control of those indexes.

Adolescent↗
PubMedDate not supplied

Prevalence of rhinitis and related-symptoms in schoolchildren from different cities in Brazil.

By using the standard written questionnaire (WQ), designed for the International Study of Asthma and Allergies in Childhood (ISAAC) we determined the prevalence of rhinitis and its related-symptoms, in Brazilian children and adolescents, living in different cities of the country. The WQ was answered by the parents of 11,403 children aged 6-7 years from five Brazilian cities: Porto Alegre (South, N = 2,846), São Paulo (Southeast, N = 3,005) Uberlândia (Southeast, N = 2,991), Itabira (Southeast, N = 1,151) and Recife (Northeast, N = 1,410). The WQ was also applied to 20,587 adolescents (13-14 years old) living in: Porto Alegre (South, N = 3,195), Curitiba (South, N = 3,004), São Paulo (Southeast, N = 3,008), Uberlândia (Southeast, N = 2,998), Itabira (Southeast, N = 2,134), Salvador (Northeast, N = 3,162) and Recife (Northeast, N = 3,086). The mean response rates were 75% and 95%, for the 6-7 year-old children and for the adolescents, respectively. The data was transcribed to a database (Epi-Info) and analyzed regarding the answers to questions of rhinitis module. The mean prevalence of rhinitis (affirmative response to question 2) was 26.6% and 34.2% in the groups of 6-7 and 13-14 year-old, respectively. Applying the criteria that evaluate the association between nasal and ocular symptoms (affirmative response to question 3) the mean prevalence of allergic rhinitis were 12.8% for the 6-7 year-old children and 18.0% for the adolescents. In conclusion, the prevalence of rhinitis and its related symptoms among children and adolescents living in different Brazilian cities was as high as the prevalence observed in other areas of the world.

Adolescent↗
PubMedDate not supplied

Childhood tuberculosis diagnosed and managed as asthma: case report.

The worldwide incidence of tuberculosis (TB) has been increasing. Although its diagnosis is well established in adults, in children it is difficult due to its particular aspects. We report a 3 years and 8 month-old infant who experienced chronic wheezing, classified as moderate-to-severe asthma, had recurrent pneumonia, and was not responsive to management with beta adrenergic agents. Chest X-rays (CXR) showed heterogeneous condensation in medium lobe and the chest computerized-tomography scan (CCT) a heterogeneous increase in pulmonary transparency, like condensation in the same lobe. After four months of treatment with anti tuberculosis agents, a significant improvement in symptoms, normal CXR, absence of pulmonary medium lobe condensation, and persistence fibro-atelectatic band in lingula were observed.

Adrenergic beta-Agonists↗
PubMedDate not supplied

Zinc deficient diet consequences for pregnancy and offsprings of Wistar rats.

Adult female Wistar rats (90 days old; weight 180 to 220 grams) were submitted to different zinc deficient diets (Zn; severe = 2.6 ppm; mild = 9.0 ppm and normal diet = 81.6 ppm), during 6 weeks. After this time they were coupled with normal male Wistar rats. No differences regarding fecundity and sterility were observed between the groups. During pregnancy, part of the animals from severe and mild Zn deficient groups received the same diet and the others received normal diet. The animals from the group receiving normal diet, were divided into other 3: the first received severe, the second mild Zn deficient diet and the third normal diet. During the study we observed that animals submitted to a Zn deficient diet (acute or chronic) had tendency to lower weight gain, lower weight of the offspring, lower serum levels of Zn in maternal and newborn (pool) blood. A significant reduction in the number of alive newborns was observed in the group of animals submitted to severe Zn deficiency. These data reinforces that Zn is a very important trace element overall during pregnancy.

Animals↗
PubMedDate not supplied

Metabolic and hematologic changes occurring after rapid intravenous infusion of gammaglobulin in patients with antibody deficiency syndromes.

OBJECTIVE: We wished to investigate whether increased IgG infusion rates are associated with metabolic and hematologic changes in pediatric patients with antibody deficiency syndromes. METHODS: We studied 7 patients (2-16 years old) with primary antibody deficiencies who had been on regular IgG replacement treatment, 350-600 mg/kg/dose every 3 weeks with a 3% IVIG preparation, for periods ranging from 6 months to 4 years. Initially, the IgG concentration of IVIG preparations was increased to 6, 9 and 12% in consecutive infusions at a constant IgG infusion rate of 4 mg/kg/min. Subsequently, the infusion rates were increased to 8, 12, and 16 mg/kg/min using the IVIG 12% preparation. RESULTS: Clinically, all patients tolerated increases in IVIG concentrations while the infusion rate was 4 mg/kg/min. However, 3 patients presented side effects when the infusion rate was increased to 8 and 16 mg/kg/min. CONCLUSION: We conclude that metabolic and hematologic sides effects occur with rapid infusion of IVIG even in patients who tolerate the increased infusion rate clinically. The advantages of using high infusion rates have to be re-evaluated.

Adolescent↗
PubMedDate not supplied

Protective effects of different doses of inhaled fenoterol on methacholine-induced bronchoconstriction in asthmatic children.

OBJECTIVE: To evaluate the protective effect of different doses of inhaled fenoterol (F) on bronchoconstriction induced by methacholine (M). DESIGN: Randomized double-blind study. SETTING: Referrence center. PARTICIPANTS: 9 children (aged from 7 to 15 years old), with mild or moderate asthma and allergic to D. pteronyssinus. INTERVENTION: On the first day, the M concentration necessary to induce a 20% fall in the forced expiratory volume in the first second (FEV1; PC20FEV1) was determined using closed circuit inhalation (De Vilbiss 646). On subsequent days, the children inhaled a dose of F (25 or 50 or 100 or 200 micrograms) through the same circuit and, after 15 minutes the FEV1 was measured, becoming the basal value. Bronchoprovocation was then initiated using the concentration prior to the PC20FEV1 of the first day and continuing until there was a 20% fall in the FEV1. This concentration was the "new" PC20FEV1. RESULTS: F in a dose of 25 micrograms protected 2 of the 9 children, in a dose of 50 mg protected 4 of the 9 and in doses of 100 and 200 micrograms protected all children. We did not observe any relationship between the magnitude of the bronchodilation and bronchoprotection induced by the inhalation of F. CONCLUSIONS: Our results suggest that a dose of 100 micrograms of F is capable of inducing bronchoprotection in children with mild/moderate asthma.

Administration, Inhalation↗
PubMedDate not supplied

[Non-specific bronchoprovocation with metacholine in children before and during sugar cane burning in Catanduva-SP]

OBJECTIVE: Evaluate the influence of sugar cane burning on BHR of asthmatic and "normal" control children by metacholine bronchoprovocation tests; and verify if interferes in pulmonary function tests.METHODS: Twenty-two asthmatic children (A) aged from 7 to 14 years old, and twelve "normal" control children (C), aged from 8 to 13 years, were submitted to non-specific bronchoprovocation test with methacholine before and during the sugar cane burning. The metacholine concentrations used were 0.025; 0.25; 1.0; 2.5; 10.0; 25.0 mg/ml, and the results were expressed in PC(20) FEV1 (concentration of metacholine that induces a fall of 20% or more in the forced expiratory volume in the first second).RESULTS: The PC(20) average for asthmatic children was significantly lower than the control group, before (A= 3.68; C= 25.62 mg/ml) and during the burning (A= 4.11; C= 25.25 mg/ml) (p < 0.05). However, there were no significant differences, when compared in each group PC(20) values before and during burning. The same was observed regarding FEV1, forced vital capacity (FVC) and forced expiratory flux between 25 and 75% of FVC (FEF (25-75%)).CONCLUSIONS: It was not possible to demonstrate that cane plantation burning influences the BHR, and pulmonary functions tests of the studied children.

Journal Article↗
PubMedDate not supplied

[Non specific bronchial hyperreactivity in infants].

OBJECTIVE: To evaluate the presence of bronchial hyperreactivity (BHR) in Wheezing Babies (WB) and Normal Control Infants (C) employing the methacholine (M) bronchoprovocation test (BPT). METHODS: Fifty-one WB and 20 C, all under two years old and assisted at the Department of Pediatrics of UNIFESP-EPM, were submitted to BPT with M, having pulmonary auscultation as monitoring parameter to evaluate PCW (provocative concentration of M causing wheezing). For all tests, M diluted in saline at increasing concentrations of: 0.025, 0.125, 0.25, 0.5, 1.0, 2.5, 5.0, and 10.0 mg/ml was delivered with O2 (5 l/min) by a face mask. It was inhaled through the mouth and nose during 2 minutes of quiet tidal breathing via nebulizer with 2 ml of solution. RESULTS: None collateral effects were observed, except for tachypnea and tachycardia. There was statistically significant differences between WB (2.3 mg/ml) PCW value and C (9.2 mg/ml) (p < 0.05). At the PCW value of 2.5 mg/ml, 41% of the WB had statistically positive response (p < 0.05). This was not observed in the group C, when a positive response only occurred at the concentration of 5 mg/ml (25%). At this concentration we observed a clear cut difference between WB and C (p< 0.05). According to the severity, the highest M concentration was observed within the group displaying mild symptoms. CONCLUSIONS: We conclude that BPT utilizing PCW may be a good option for detecting BHR in young children. It is well tolerated by children, easy and safe to perform. Follow-up studies may clarify the real mean of the PCW.

English Abstract↗
PubMedDate not supplied

[Risk factors and clinical evolution of asthma in children].

OBJECTIVE: The purpose of this study was to obtain data on the clinical evolution and risk factors related to asthma in children followed as outpatients in our Division of Allergy. METHODS: The asthmatic group consisted of 165 children (107 boys, 58 girls), between the ages of 3 and 14 years. All children were atopic and had a positive skin prick test to D. pteronyssinus. The control group consisted of 40 healthy children (20 boys, 20 girls), within the same age range, without personal history of asthma or other atopic disease and with negative skin prick test to D. pteronyssinus. The mothers were interviewed to obtain data on: a) clinical evolution, b) family history of asthma or any other atopic disease, c) description of the house environment. RESULTS: 1) in approximately half of the cases symptoms started on the first year of life. Mothers were not informed of the condition at the time; 2) upper respiratory tract infections and bronchiolitis were responsible for triggering the first wheezing episode in most cases and remain the main precipitating factors in the first year of the disease whilst allergens, irritants, sinusitis, physical exertion and emotional factors were the main precipitating factors between the ages of 5 and 13; 3) changes in climatic conditions precipitated acute attacks throughout the evolution of the disease and; 4) asthma was not the only allergic manifestation, allergic rhinitis being the most frequent associated condition; 5) family history of atopy (Relative Risk (RR) = 2.40; 95% confidence interval (CI95%) = 1.60-3.50); maternal history of asthma (RR = 2.23; CI95% = 1.10-4.63) and the presence of smokers in the house (RR = 2.30; CI95% = 1.20-4.31) were the main risk factors for the manifestation of asthma. CONCLUSIONS: a) there were no differences between boys and girls regarding the evolutionary aspects, b) asthma was underdiagnosed, c) family history of atopy, maternal history of asthma, and the presence of smokers in the house were risk factors for the manifestation of asthma.

English Abstract↗