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Biomedical subjects

D Solé

Publications and source records attributed to D Solé.

At least 73 records · Page 4Linked to original sources
PubMedDate not supplied

[Duration of bronchodilator effect of inhaled Salmeterol (dry powder x metered dose inhaler) in children with acute asthma attack].

Patients during a mild to moderate acute attack of asthma (FEV1: 50 - 80% of predicted) were treated with Salmeterol MDI - 50mcg or Rotadisk - 50mcg or Salbutamol (MDI -200mcg). The children were followed by Spirometry, measuring FEV1 (basal) and after treatment: at 30 minutes, 60 minutes and thereafter every 60 minutes until 780 minutes, if the patients maintained the FEV1 above 80% of the predicted value and/or an increment of 20% in the VEF1 basal value. The Salmeterol group showed a significant bronchodilation at 60 minutes which was maintained in half of the patients up to 9 hours. This was not observed in the Salbutamol group: the peak bronchodilatation was observed at 30 minutes and the bronchodilation effect was observed in half of the patients up to 6 hours. There were no significant differences between both presentations of Salmeterol. This drug allowed a prolonged bronchodilator effect and is, according to the several consensus on management of asthma, an adequate option in the treatment of moderate to severe asthma.

English Abstract↗
PubMedDate not supplied

[Lupic nephropathy in childhood: morphologic analysis of 18 cases].

Serum IgE concentration was determined in 17 newborn and 171 children with ages between 1 and 12 months. In the first group, blood was taken from the umbilical cord, and in the second, we used a periferic blood sample. The selection implied the exclusion of children with any suspicion of atopic disease, family history of atopy and recent viral infection. The serum IgE concentration was determined by enzyme linked immunoabsorbent assay (PRIST). The sex, race ( white and non white) and age were analyzed in the children studied. During a follow-up period (24 months) seven children (3,7%) developed atopic symptoms. The serum IgE concentration of the groups studied was higher than in other studies. The mean IgE in each group was as follows : newborns = 0.24 IU/ml; 1-3 months = 1.57 IU/ml; 4-6 months = 7.72 IU/ml; 7-9 months 12.07 IU/ml; 10-12 months = 12.14 IU/ml.

English Abstract↗
PubMedDate not supplied

[Intranasal azelastine in the treatment of perennial allergic rhinitis in children].

Twenty-five patients (5-15 years old) with perennial allergic rhinitis (PAR) for at least one year were treated with intranasal azelastine. The study was conducted in two separate occasions. In the first study, in a special prepared room, the patients underwent Active Anterior Rhinomanometry (AAR). Twenty minutes later, after 2 drops of saline installed in each nostril, the Total Nasal Resistance (TNR) and Total Nasal Conductance (TNC) were measured. This was followed by the intranasal application of azelastine (0.14 mg/nostril ) and the TNR and TNC were measured at 15,30,60,90 and 120 minutes. At the end of this period, a topical vasoconstrictor (fenoxazoline 0.05%) was instilled and TNR and TNC measured after 15 and 30 minutes. The patients were discharged with a prescription of intranasal azelastine, same dose, for 14 days, with diary cards. Clinical evaluation and clinical score were performed at days 3,7 and 14. There were no changes in TNR and TNC after the acute and prolonged (14 days) use of azelastine, which was observed after the use of fenoxazoline. Clinical scores (physician and patient), according to the diary card, were significant for itching and sneezing after 7 days of treatment. Intranasal azelastine is useful for the therapeutic management of PAR, mainly in those for whom nasal blockage is not important.

English Abstract↗
PubMedDate not supplied

[Atopic diseases in Brazilian children--etiologic multicentric study].

In order to determine the etiologic agents involved in atopic diseases in Brazilian children, we have performed this multicentric study in 8 areas in Brazil. We have done prick tests with inhalants and food antigens and analyzed skin tests results, considering positive the wheal mean diameter 3 mm. 22,2% of skin tests were negative and the majority were positive to inhalants: D.pteronyssinus(Dpt) (66.6%) and D. farinae(Df) (66.0%), house dust extract (29.0%), dogs epithelium (19.2%), cat's epithelium (8.8%), feather (5.5%), molds (4.2%), Penicillium sp (2.2%) and Lollium perene (0.6%). We have had 9,1% of food positive tests: cow milk (5.2%), peanut (3.5%), corn (3.2%), cocoa and soya (2.2%), eggs and wheat (1.9%). We have concluded that the domestic mites are the most important agents involved in the etiology of atopic diseases in Brazilian children, and the extracts involved, in line with the sensitization of each geographical area.

English Abstract↗
PubMedDate not supplied

[Effect of inhaled terbutaline sulphate (dry powder, Turbuhaler and nebulizer solution) in children with acute asthma].

Forty seven children (6-14 years), with an acute mild or moderate attack of asthma (clinical score 3 or FEV1 > 50% of the predicted), were treated with terbutaline sulphate, by inhalation route with a dry powder inhaler (Turbuhaler - 0,5 mg - group T; N=27, or by a nebulizer 1% solution-in saline-compressed air (6 l/min.) group S; N=20. The children were evaluated at 5, 15, 25 and 30 minutes after the initial treatment. In both groups a significant fall of the clinical score (starting at 15 minutes) (p < 0.05) and a significant improvement of the FEV(1), VC and FEF25-75% (starting at 5 minutes), were observed (p < 0.05). There were no significant changes in heart rates, respiratory rates and blood pressure (p > 0.05). At the end of the first treatment, the number of patients with a FEV(1) < 80% was similar in both groups (T = 13/27 and S = 10/20). The same treatment was repeated, and all the children showed a marked improvement, except for one boy of the group T was hospitalized. In conclusion, children with mild or moderate acute attacks of asthma can be treated up to a week with an inhalation of dry powder, resulting in adequate bronchodilatation without important side effects.

English Abstract↗
PubMedDate not supplied

International Study of Asthma and Allergies in Childhood (ISAAC) written questionnaire: validation of the asthma component among Brazilian children.

Written questionnaires have been widely used in epidemiological studies of asthma. However, when translated to another language, they must be validated. The International Study of Asthma and Allergies in Childhood (ISAAC) written questionnaire had been previously validated by a comprehensive study, but this had not been done in Brazil. Our objective was to validate the asthma component of the ISAAC self-applicable written questionnaire following its translation to Portuguese. A group of 10 pediatricians and 10 pediatric allergists graded the questions from 0 to 2, and established a maximum score for each question. The questionnaire was answered by parents or guardians of asthmatic children, aged 6 to 7 years old (n = 26) and of nonasthmatic control children of the same age (n = 26); and by asthmatic (n = 33) and nonasthmatic (n = 33) adolescents, aged 13 to 14 years. Half of these individuals responded to the same questionnaire after 2 to 4 weeks. This second response allowed the evaluation of the reproducibility of the ISAAC questionnaire. The maximum global score possible was 14, and cut-off levels of 5 and 6 were found for the groups of 6 to 7 and 13 to 14 year olds, respectively. There was significant agreement between the adolescents' responses to the questionnaire and those from their parents or guardians (74.3%); however, significant discordance was observed for individual questions including "wheezing with exercise." In both age periods the questionnaire was significantly reproducible (Kappa test) (6 to 7 year olds Kw = 1; 13 to 14 year olds Kw = 0.89). In conclusion, the asthma component of the ISAAC written questionnaire was proven to be reproducible, adequate and able to differentiate between asthmatics and controls. Adolescents answered the questionnaire appropriately, however the results suggest that adolescents' parents or guardians underestimate asthma symptoms which interfere little with the adolescent's daily activities.

Adolescent↗
PubMedDate not supplied

Serum levels of immunoglobulins in children with recurrent otitis media.

Seventy-seven children with recurrent otitis media took part in the study at the Department of Otorhinolaryngology and Pediatrics of the University of São Paulo from February 1992 to March 1995. They were administered serum immunoglobulins and the relationship between recurrent otitis media and immunodeficiency was evaluated. No total IgG and IgM values were detected below the normal level; however, seven children with low levels of subclasses of IgG were detected and a below normal IgA value was detected in a child.

Acute Disease↗
PubMedDate not supplied

Anaphylactic reaction in experimental malnutrition.

We evaluated the effects of malnutrition on the allergic response in male EPM-1 Wistar rats. The animals underwent two dietary regimens from the 21st to the 60th day of life as follows: control animals were fed a normoproteic diet (18% casein) and malnourished animals a hypoproteic diet (4.5% casein). On day 60, some of the animals were sacrificed for determination of total serum protein and albumin levels. In addition, within each subgroup of the remaining animals, some underwent intraperitoneal immunization with ovalbumin in aluminum hydroxide. Thus, four groups of animal were obtained: immunized controls (n = 11); immunized malnourished animals (n = 11); unimmunized controls (n = 7) and unimmunized malnourished rats (n = 8). Fourteen days after sensitization with ovalbumin, the animals were challenged with intravenous ovalbumin in order to induce an anaphylactic reaction, which was evaluated by vascular permeability increase as assessed by the Evans blue dye extravasation method. Extravasation of Evans blue was quantitated in dried gastrointestinal tissues obtained from rats sacrificed 10 min after induction of the anaphylactic reaction. Passive cutaneous anaphylaxis (PCA) reactions were also evaluated in the controls and malnourished rats. The adequacy of our model was confirmed by the reduction in weight gain, in food intake, and in total protein and albumin serum levels in malnourished rats as compared to controls at 60 days of life. The anaphylactic reaction induced significant increase in vascular permeability particularly among control animals. PCR results showed significantly lower titers in malnourished animals when their sera were injected into the skin of control animals. In contrast, PCA reactions using sera from immunized control rats to inject into the skin of malnourished rats showed an equally intense reaction as that observed in control animals. Our results suggest that malnourished animals have a normal capacity of releasing inflammatory mediators, and show a normal vascular response after anaphylaxis. The diminished vascular response seen in the gastrointestinal tract in malnourished animals, as compared to controls, may be due to the production of lower levels of IgE antibodies caused by malnutrition.

Anaphylaxis↗
PubMedDate not supplied

Common variable immunodeficiency: a clinical and laboratory evaluation of 15 cases.

The clinical and laboratory data for 15 patients with common variable immunodeficiency (CVI) (5 females and 10 males aged 3 years and 6 months to 40 years at first examination) were evaluated. The age of onset of infectious signs and symptoms ranged from 6 months to 35 years. Recurrent pulmonary infections predominated (86.6%), followed by chronic diarrhea (46.6%). Approximately 60% of the patients with pulmonary complaints presented chronic sequelae (bronchiectasis). Two developed a polymyositis-like picture. No neoplasms were observed. All patients presented immunoglobulin levels below 300 mg/dl and absence of antibody responses to poliovirus and to hemagglutinin. Two patients were negative when tested for autoimmunity. Cell immunity tested by the lymphoproliferative response in the presence of phytohemagglutinin was normal in 11 patients and depressed in 4. A decrease in the helper T population and inversion of the OKT4/8 ratio occurred in 13. Cimetidine treatment (1200 mg/day) applied to 5 patients for 4 weeks did not produce any clinical or laboratory improvement. Gamma globulin is the treatment of choice for these patients.

Adolescent↗
PubMedDate not supplied

Bronchial provocation with metacholine in young children: a simplified method.

Although pointed out as a characteristic of bronchial asthma, bronchial hyperreactivity (BH) has been documented in other clinical situations such as fibrocystic disease of pancreas and chronic obstructive pulmonary disease. BH is diagnosed in 90% of asthmatic patients and in almost all of those who are symptomatic. BH can be measured by specific bronchial provocation tests (BPT) (antigens and occupational sensitizing agents) and by exercise. Since their introduction, nonspecific BPT have been extensively used as a preliminary method for the evaluation of BH and also to diagnose bronchial asthma, to establish its severity, to determine the therapeutic efficacy of drugs, and for epidemiological studies.

Asthma↗
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Magnetic resonance imaging in a patient with X-linked agammaglobulinemia and chronic meningoencephalitis.

The case of a boy with congenital agammaglobulinemia is reported. In spite of regular immunoglobulin replacement therapy (fresh plasma transfusion from family donors--20 ml/kg/month), he developed chronic meningoencephalitis (ME). Besides characteristic clinical signs of ME, he also presented at cerebrospinal fluid analysis pleocytosis with lymphocyte predominance and class II cytomorphology, and delta and theta waves in the EEG. Computerized tomography showed dilatation of the ventricles and marked cortical fissures (sulci). Magnetic resonance imaging showed a disease affecting white and gray matter. After diagnosis of ME, replacement therapy with Sandoglobulin (700 mg/kg every 2 weeks) was started. His condition gradually worsened, and coma and death occurred after a follow-up of 18 months. The etiological agent could not be identified.

Agammaglobulinemia↗
PubMedDate not supplied

Hereditary angioedema type II--a study of two families.

Hereditary angioedema (HA) is caused by a quantitative or qualitative deficiency of C1 esterase inhibitor (C1 INH). We present a study of nine patients with HA belonging to two different families. The symptoms started before 10 years of age in most cases (78%). Facial edema (lips, eyes) and of the extremities (feet, hands) were the most frequent complaints. Three patients presented edema of the glottis and one of them underwent a tracheostomy twice. Laboratory tests, outside the acute crisis, revealed low levels of C4 in all patients. The serum levels of C1 INH were normal in seven patients; however, functional activity was not observed in any of them. After the use of a modified androgen (danazol), control of symptoms was observed in all patients, although functional activity was re-established in only five patients.

Adolescent↗
PubMedDate not supplied

Reduction in the oral doses of theophylline in asthmatic children during concomitant treatment with ketotifen.

Sixteen children with moderate or severe bronchial asthma underwent a double-blind study receiving either ketotifen (K) or placebo (P) in order to verify the sparing effect of K on theophylline. The study lasted 18 weeks. Slow release theophylline was administered to all patients at a dose of 300 mg every 12 hours for the first six weeks of the study ("washout"). From the seventh week on, eight patients received K (1 mg, 2x/day) and the others P. The theophylline dose was maintained and reduced every 4 weeks to 200 mg and 100 mg. The initial clinical characteristics were identical in both groups. The serum levels of theophylline decreased below the ideal range (less than 10 mcg/ml) in groups K and P with a 100 mg dose of theophylline. However, in group K patients, fewer reported worsening of symptoms (number of days with cough and/or wheeze, altered daytime or nighttime peak expiratory flow rate and consumption of beta agonist) when compared to group P. Increased PC20 of methacholine only occurred in group K patients.

Administration, Oral↗
PubMedDate not supplied

Ataxia-telangiectasia: a clinical and laboratory review study of 14 cases.

Fourteen patients with ataxia-telangiectasia and 10 relatives were studied. Besides neurological examination, laboratorial investigations as to their immunological condition were carried out. In this study, our attention was attracted to the most frequent and relevant laboratorial data being decreased serum and salivary levels of IgA, decreased rate of blastic transformation of lymphocytes and increased serum levels of alpha-fetoprotein (AFP). On the other hand, no patient showed increased levels of carcinoembryonic antigen (CEA). Our population reported a consanguinity rate of 28.5%.

Ataxia Telangiectasia↗
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[Familial Bloom's syndrome associated with neuroblastoma].

Bloom's syndrome (BS) is an autosomal recessive disease characterized by short stature, sensitivity to sunlight, and telangiectasic malar erythema. It is associated to chromosomal breakage, to primary combined immunodeficiency, and to a high incidence of neoplasias. The authors report the case of two siblings with BS and associated immunodeficiency. Both patients were male and 5 (A) and 4 (B) years old at the time of diagnosis. Chronic diarrhea, recurrent otitis media, purulent rhinitis, conjunctivitis and pyodermatitis were reported by patient A. Patient B was admitted with diagnosis of bilateral neuroblastoma and had the tumor resected. Later on, he presented with oral moniliasis, herpetic stomatitis, and skin abscesses. This patient did not have recurrent infections. Immunological evaluation showed normal serum levels of CH50, C3, and C4 for both patients. Serum IgG, IgA, IgM, and salivary IgA levels were: 455 mg/dl, 15mg/dl, 20mg/dl, 0.6mg/dl for A, and 400mg/dl, 15mg/dl, 20mg/dl, and 0.2mg/dl for B, respectively. Serum antipolio antibodies (1, 2, and 3) were normal, and low levels of isohemagglutinins were observed in both patients. T cells subset determination showed: patient A--OKT3 = 66%, OKT4 = 33%, OKT8 = 32%, and 4/8 ratio = 1.0; patient B--OKT3 = 70%, OKT4 = 32%, OKT8 = 34%, and 4/8 ratio = 1.0. In vitro cellular immune response to PHA was depressed only in patient B. Patients karyotype showed chromosomal breaks with sister chromatid exchanges. Neither patient had abnormal alphafetoprotein and carcinoembryonic antigen serum levels. The rarity of such associations justifies the presentation of the cases.

Bloom Syndrome↗
PubMedDate not supplied

[Anaphylactic shock].

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Anaphylaxis↗