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J J Sienra-Monge

Publications and source records attributed to J J Sienra-Monge.

At least 19 recordsLinked to original sources
PubMed2006

GSTM1 and GSTP1 and respiratory health in asthmatic children exposed to ozone.

Acute exposure to ozone has been related to a wide spectrum of health effects in susceptible individuals. Genetic factors may influence interindividual variation in ozone response. The current authors investigated the relationships between common polymorphisms in two genes involved in response to oxidative stress, i.e. glutathione S-transferases M1 (GSTM1) and P1 (GSTP1), and both respiratory symptoms and lung function in response to ozone among childhood asthmatics. A total of 151 asthmatic children, who were participants in a randomised controlled trial of antioxidant vitamin supplementation in Mexico City, were studied. Children were genotyped using PCR methods and followed from October 1998-April 2000. Increases in reported breathing difficulty were associated with ozone exposure in children with GSTM1 null (8%, 95% confidence interval (CI) 1-15%, per 20-ppb increase in 1-h maximum daily average over 7 days) or GSTP1 Valine/Valine (Val/Val) genotypes (14%, 95% CI 5-25%). In children with both GSTM1 null and GSTP1 Val/Val genotypes, the increase in breathing difficulty associated with a 20-ppb increase in ozone exposure was even greater (21%, 95% CI 5-39%). GSTP1 genotypes were not significantly associated with ozone-related lung function changes. In conclusion, asthmatic children with glutathione S-transferase M1 null and glutathione S-transferase P1 Valine/Valine genotypes appear more susceptible to developing respiratory symptoms related to ozone exposure.

Air Pollution↗
PubMed2004

Antioxidant supplementation and nasal inflammatory responses among young asthmatics exposed to high levels of ozone.

The inflammatory response to ozone in atopic asthma suggests that soluble mediators of inflammation are released in response to oxidant stress. Antioxidants may alleviate additional oxidative stress associated with photochemical oxidant pollution. This study investigates the impact of antioxidant supplementation on the nasal inflammatory response to ozone exposure in atopic asthmatic children. We conducted a randomized trial using a double-blinded design. Children with asthma (n = 117), residents of Mexico City, were given randomly a daily supplement of vitamins (50 mg/day of vitamin E and 250 mg/day of vitamin C) or placebo. Nasal lavages were performed three times during the 4-month follow-up and analysed for content of interleukin-6 (IL-6), IL-8, uric acid and glutathione (GSx). IL-6 levels in the nasal lavage were increased significantly in the placebo group after ozone exposure while no increase was observed in the supplement group. The difference in response to ozone exposure between the two groups was significant (P = 0.02). Results were similar for IL-8, but with no significant difference between the groups (P = 0.12). GSx decreased significantly in both groups. Uric acid decreased slightly in the placebo group. Our data suggest that vitamin C and E supplementation above the minimum dietary requirement in asthmatic children with a low intake of vitamin E might provide some protection against the nasal acute inflammatory response to ozone.

Air Pollutants↗
PubMed2004

Genetic polymorphism of GSTM1 and antioxidant supplementation influence lung function in relation to ozone exposure in asthmatic children in Mexico City.

BACKGROUND: We recently reported that antioxidant supplementation with vitamins C and E mitigated ozone related decline in forced expiratory flow (FEF(25-75)) in 158 asthmatic children in an area with high ozone exposure in Mexico City. METHODS: A study was undertaken to determine whether deletion of glutathione S-transferase M1 (GSTM1 null genotype), a gene involved in response to oxidative stress, influences ozone related decline in FEF(25-75) and the benefit of antioxidant supplementation. RESULTS: GSTM1 null children receiving placebo had significant ozone related decrements in FEF(25-75) (percentage change per 50 ppb of ozone 2.9 (95% CI -5.2 to -0.6), p=0.01); GSTM1 positive children did not. Conversely, the effect of antioxidants was stronger in children with the GSTM1 null genotype. CONCLUSIONS: Asthmatic children with a genetic deficiency of GSTM1 may be more susceptible to the deleterious effects of ozone on the small airways and might derive greater benefit from antioxidant supplementation.

Antioxidants↗
PubMed2003

The relationship between asthma symptoms and anthropometric markers of overweight in a Hispanic population.

BACKGROUND: Previous studies have revealed the relationship between asthma and obesity, but the relationship with other markers of overweight and obesity has not yet been investigated. OBJECTIVE: To establish the relationship between asthma symptoms and simple anthropometric indexes (BMI, waist circumference (WC), and waist-to-hip ratio (WHR)) as markers of overweight in an adult Hispanic population. METHODS: The data were obtained from the PRIT (Prevalence of Cardiovascular Risks in General Hospital Workers) 2001 survey. The participants were workers at the Hospital General de México in Mexico City and included 135 men and 398 women aged 43.8 +/- 11.9 and 43.0 +/- 10.5, respectively. Odds ratios for asthma symptoms at different BMI, WC, and WHR cutoff points associated with excessive weight were calculated. The likelihood ratios for having asthma symptoms in participants with various cutoff values of BMI, WC, and WHR also were calculated. RESULTS: Asthma symptoms were not related to anthropometric markers of overweight or obesity in men, while they were associated in women with WC cutoff levels of 80 and 85 cm, and BMI of 25 and 27 kg/m2. No level of WHR was related to asthma symptoms in women. In women, the likelihood ratio for asthma symptoms increased proportionally from WC levels of 73.5 cm up to 86 cm, while this risk increased significantly from BMI levels of 22 up to 29 kg/m2. CONCLUSION: Overweight as assessed by BMI and WC (but not WHR) was related to asthma symptoms in women in the studied population.

Adult↗
PubMed2001

Effect of salmeterol and salmeterol plus beclomethasone on saliva flow and IgA in patients with moderate-persistent chronic asthma.

BACKGROUND: The use of short-acting beta2-agonists is associated with oral mucosa injuries that are probably provoked by decreased saliva flow and decreased concentrations of immunoglobulin (Ig)A in saliva. OBJECTIVES: To explore the effect of salmeterol, alone or combined with beclomethasone, on the health of oral mucosa, as well as its effect on saliva flow and IgA concentration in saliva. METHODS: Patients ranging in age from 6 to 15 years with moderate-persistent chronic asthma were enrolled. Patients received two 6-week treatments, one with salmeterol plus beclomethasone and the other with only salmeterol, with a 1-week washout period between treatments. Patients had oral cavity examinations and assessments of saliva flow, IgA in saliva, and total protein in saliva before the beginning and at the end of each treatment RESULTS: The results of the baseline oral examinations were normal in all patients. The postsalmetrol (PS) examinations detected 13 patients with gingivitis and the postbeclomethasone-salmeterol (PBS) examinations disclosed 10 patients with gingivitis and 1 with lower-lip ulceration. Baseline saliva flow was 16.25 +/- 7.04 mm/minute (confidence interval [CI] 95% 13.67; 18.89), PS was 13.53 +/- 5.93 mm/minute (CI 95% 11.33; 15.73), and PBS was 16.57 +/- 5.54 mm/minute (CI 95% 14.51; 18.62). No statistical differences between the different assessments were found. Mean saliva IgA at baseline was 4.99 +/- 1.96 mg/dL (CI 95% 4.26; 5.71), PS IgA was 6.53 +/- 3.02 mg/dL (CI 95% 5.41; 7.65), and PBS IgA was 4.82 +/- 1.98 mg/dL (CI 95% 4.08; 5.56). PS IgA was significantly higher than the other two determinations (P < 0.05 by Bonferroni and Tukey tests). Baseline saliva IgA-to-protein ratio was 0.72 +/- 0.24 (95% CI 0.64; 0.80), PS IgA:protein ratio was 1.02 +/- 0.38 (95% CI 0.88; 1.16), and PBS IgA:protein ratio was 0.72 +/- 0.25 (95% CI 0.62; 0.82). PS IgA:protein ratio was significantly higher than the other two determinations (P < 0.05 by Bonferroni and Tukey tests). CONCLUSIONS: In the present study it was demonstrated that salmeterol alone or in combination with beclomethasone induced injuries in the oral mucosa, but only salmeterol alone induced increases in the total and protein-adjusted IgA in saliva.

Administration, Inhalation↗
PubMed1999

Double-blind comparison of cetirizine and loratadine in children ages 2 to 6 years with perennial allergic rhinitis.

Antihistamines are the pharmacologic cornerstone of treatment for allergic rhinitis. The comparative effects of the newer, more specific H (1) -antagonists cetirizine and loratadine among younger patients are not well characterized. The efficacy and safety of cetirizine and loratadine were compared in a prospective, randomized, double-blind, longitudinal, parallel-group study of 80 children, 2 to 6 years of age, with perennial allergic rhinitis caused by house dust mites or plant pollens (verified by a radioallergosorbent or skin test). Patients received cetirizine or loratadine at 0.2 mg/kg once daily in the morning for 28 days. Histamine skin tests and eosinophil counts from nasal smears were performed at baseline and at the end of treatment. Individual rhinitis symptoms were assessed by the investigator at baseline and on day 28 and by parents at baseline and daily in symptom diaries. Global assessments were made by using a visual analog scale at baseline and at the end of treatment. Cetirizine produced significantly greater inhibition of the wheal response compared with loratadine (P <.0001). Eosinophil counts were improved to a comparable degree with both agents. Cetirizine and loratadine produced comparable improvements in symptoms and according to a global evaluation as assessed by the investigator at the end of treatment. Both agents produced substantial symptomatic relief according to patients' daily diary assessments; however, cetirizine was more effective than loratadine in relieving the symptoms of rhinorrhea, sneezing, nasal obstruction, and nasal pruritus (P <. 0001). Both treatments were well tolerated; two patients receiving cetirizine were dropped from the study because of adverse events. Cetirizine and loratadine provided effective, well-tolerated relief of the symptoms of perennial allergic rhinitis in small children. Cetirizine was more effective than loratadine in inhibiting the wheal response to histamine challenge and afforded greater reductions in most individual symptoms assessed daily by the parent.

Cetirizine↗
PubMed1999

Asthma and geographical altitude: an inverse relationship in Mexico.

Motivated by the great asthma-prevalence variation throughout the world, we analyzed the rate variation of medical services due to asthma in the 32 Mexican states at the Instituto Mexicano del Seguro Social (approximately 24 million insured subjects). In 1993, a total of 406,036 services were due to asthma, and state rates ranged from 53 to 476 x 10,000 insured subjects. A direct correlation (p < 0.05) was found for single-room house, ascariasis, and rubella rates, but the strongest (inverse) correlation was found for geographical altitude (r = -0.73, p < 10(-5)). Thus, in Mexico, geographical altitude affects the etiological factor(s) responsible for the development of asthma or for the triggering of asthma attacks.

Altitude↗
PubMed1995

Effects of urban air pollutants on emergency visits for childhood asthma in Mexico City.

The metropolitan area of Mexico City, Mexico, has serious air pollution problems. Although air contaminants may contribute to clinical asthma, there are at present no data on the relation between air pollution exposure and childhood asthma in Mexico City. The authors reviewed data on emergency visits from January to June 1990 at one major pediatric hospital in Mexico City. They used a Poisson regression model to study the relation between the number of daily emergency visits for asthma and air pollutant levels. The levels of ozone and sulfur dioxide-exposure were significantly associated with the number of emergency visits for asthma. After adjustment for potential confounding factors, the multivariate regression model predicted that an increase of 50 ppb in the 1-hour maximum ozone level would lead to a 43% increase in the number of emergency visits for asthma on the following day. Exposure to high ozone levels (> 110 ppb) for 2 consecutive days increased the number of asthma-related emergency visits by 68 percent. The results of this study suggest that ozone exposure is positively associated with the number of children's emergency visits for asthma in Mexico City.

Adolescent↗
PubMed1993

[Juvenile dermatomyositis: clinical, immunologic, and therapeutic characteristics].

Although dermatomyositis is a rare disease in infancy, it involves several systems and tissues throughout the body causing death or serious disabilities at the musculoesquelethal level. The increased incidence of vasculitis and other characteristics in children make their clinical presentation different from the adult, which could modify the diagnostic criteria, course disease and treatment of the child. We analyze the clinical experience at Hospital Infantil de Mexico Federico Gomez with 21 children studied during a period of ten years. All patients fulfilled the Bohan and Peters diagnostic criteria and 91% of them responded to treatment. At the present time 52% are in remission without treatment, 37.7% improved with treatment, 4.5% with little response to treatment and 4.7% have died because of infections.

Child↗
PubMed1993

[Asthma: bronchial inflammation and hyperreactivity].

There is not a clear definition of asthma, actually most of specialist consider to asthma how a reversible bronchial obstruction with an increased responsiveness (bronchial hyperreactivity, BHR), and inflammation. These inflammation can cause increase of the BHR and worseness the process. The new tendencies are to treat these BHR and control the two faces of asthma (early and late face). In the early or immediate face, bronchodilators are the most use full medicine meanwhile; the antiinflammatory drugs (sodium cromoglycate and inhaled steroids) are the best option for management of inflammation with reduction of BHR.

Asthma↗
PubMed1993

[Drug allergy].

Adverse reaction to drugs are classified as immunological and non-immunological. It is consider that one to five percent of the general population reactions to drugs. Allergic reactions are the most intense and dangerous, but they represent only five to ten per cent of all of them. Immunological adverse reactions may be induced by the drug or by their metabolites. There are risk factors to induced allergic reactions such as doses, administration time and way of administration. The four mechanism of damage from Gell and Coombs are discussed regarding to drugs, stressing the penicillin issue. Other common drugs reactions in the diary practice are cutaneous reactions with unknown immunological mechanism as it happens in febrile mucocutaneous syndrome and the phototoxic and photoallergic reactions. Pseudoallergic or "anaphylactoid" reactions have signs and symptoms like those of anaphylaxis, but the mechanism of damage is not immunological, as with local and general anesthetics and radiopaque media. Treatment for any adverse events is to stop the administration as soon as possible. The drug of choice is 1:1000 subcutaneous adrenaline besides colloid solutions, steroids and antihistaminics.

Anaphylaxis↗
PubMed1993

[Food allergy].

We are exposed to a large amount of potentially antigenic substances when we take aliments. Normally the mechanic, enzymatic and immunitary functions avoid the development of deleterious phenomena. Thus, when these mechanisms fail intolerance, idiosyncrasy or allergic reaction could be presented to the diet components. The adverse reactions to the aliments are present in one to three percent of the general population, while this occurs in the eight percent of the children under three years old. The clinical manifestations may comprise from abdominal pain pictures to anaphylactic shock. The symptomatology depends on age of the patient and the amount and kind of ingested food. The diagnosis must be establish on bases of careful anamnesis and physical examination. To confirm the diagnosis cutaneous test for immediate hypersensibility and the determination of specific IgE antibodies (RAST, ELISA) are used. The basic treatment consists in the withdrawal of the causative aliment and not on non-proper diets for the patient.

Child↗
PubMed1992

[Allergic conjunctivitis].

The eye reacts to foreign substances through a variety of specific and non-specific defense mechanisms. Constantly exposed to a great variety of microorganisms, the eye is capable of protecting itself without altering its own structure and function. Its resistance relies upon anatomic and physiological properties of its external components (eyelids, tears, conjunctiva and cornea). Most of the times, the conjunctiva becomes affected, resulting in a clinical picture of conjunctivitis where allergy predominates, expressed as allergic rhinoconjunctivitis, allergic conjunctivitis, vernal keratoconjunctivitis, giant papillary conjunctivitis and flictenular conjunctivitis. The physiopathology is considered to be of type I reaction (IgE mediated). Frequent complains often associated with other allergic diseases are: pruritus, tearing, photofobia and ocular redness. The diagnosis of allergic conjunctivitis in done by means of a throughout clinical history, conjunctival citology and evaluation of specific IgE with immediate skin tests. Treatment is symptomatic (antihistamines, antibiotics and/or topic steroids), but prevention (environmental control and sodium cromoglycate) and specific immunotherapy must be considered.

Conjunctivitis, Allergic↗
PubMed1991

[Management of status asthmaticus in children].

Acute bronchial asthmatic episodes represent one of the most common respiratory emergencies in medical practice. Its maximum expression "status asthmaticus", is an entity of low incidence in our medium, still it is a risk to the physical integrity of the patient. The management of an acute attack of asthma can be focused on doing away with the bronchial spasm and decreasing the inflammatory effects, as well as improve the movement of secretion and this way, maintain adequate alveolar ventilation. The full knowledge of the physiopathology behind the illness and medical treatment used to improve the patient's well-being, are necessary for the patient's full recuperation. The different components which comprise the integral management of an episode of status asthmaticus are analyzed in unison, emphasizing the data included in the clinical chart, medical management and other therapeutic measures employed.

Adolescent↗
PubMed1989

[Allergic rhinosinusitis].

Is a brief review of the allergic rhinosinusitis, the role of the immunology in the etiopathogenesis, remarking the importance of the good clinical study which is the corner stone of the diagnosis and which what others diseases make a differential diagnosis. We present also some of the ways to treat the rhinosinusitis including preventive drugs, hyposensitivity and symptomatic medications.

Child↗