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Biomedical subjects

M L Palma-Carlos

Publications and source records attributed to M L Palma-Carlos.

At least 19 recordsLinked to original sources

Monoid sublingual immunotherapy.

Sublingual monoid immunotherapy with monomeric allergoids has been largely used in Europe in the last few years. An open trial of allergoid in tablets has been done in rhinitic patients allergic to house dust mites, grass pollens and Parietaria with clear improvement in clinics and drug consumption scores. In a second phase a double blind placebo controlled trial of grass pollens allergoids have been done in hay fever patients with significant decrease on the scores of rhinorrea, sneezing and conjunctivitis nasal steroid consumption and clinical score after serial nasal challenges. Monomeric allergoids are an efficace and safe immunotherapy in allergic rhinitis.

Administration, Sublingual↗

Trichophyton allergy: review of 89 cases.

A serie of 89 cases (55 men 34 women) of Tricophyton allergy is presented. All the patients had a clinical history and in 86 out of 89 lesions of dermatophytosis urticaria/angioedema was present in 57, eczema in 8, rhinitis in 12, conjunctivitis in 1 and asthma in 12. Skin prick tests to Tricophyton were positive in 53 (59,6%) of the patients and intradermal test in all. Specific IgE was found in 45 (69,3%) out of 70 patients. Antifungal treatment was effective at mean term in 18 cases. Specific immunotherapy was evaluated in 54 with good or very good results in 41 (83,3%). Tricophyton dermatophytosis must be looked for in all the cases of urticaria/angioedema and most cases of respiratory allergy without clear allergy to inhalants.

Antifungal Agents↗

Skin tests in NSAIDS hypersensitivity.

Prick tests are more specific but less sensitive than ID which can give false positive results. 3 NSAIDS groups can be considered: Aspirin, diclofenac and metamizol with a higher percentage of positivity. For others NSAIDS including the newer coxibs positivity around 50%. Nimesulid and acetaminophen with a lower of positivity. Skin tests can be used in NSAIDS hypersensitivity to confirm clinical history but also to choose, case by case, a drug less prone to give hypersentivity reactions.

Anti-Inflammatory Agents, Non-Steroidal↗

Prevalence of drug allergy in an out-patient population.

The prevalence of drug allergy in an out-patient population has been studied, 448 cases were diagnosed mainly to NSAIDS and beta-lactams and local anesthetics, sulfa drugs, quinolones and others. Clinical history and skin tests are sufficient to diagnose most cases of drug allergy.

Anesthetics, Local↗

Solar urticaria and porphyrias.

The importance of disturbances of porphyrin metabolism in solar urticaria is discussed. 15 cases of porphyrias with sun sensitivity are presented comprising 5 cases of erythropoietic protoporhyria, 8 cases of coproporphyria hereditaria and 2 cases of porphyria variegata, 9 out of these 10 patients presented neuroabdominal symptoms and in 4 cases contraceptive pills have triggered the disease. Due to the risk of severe forms of disease sometimes drugs induced porphyrias must be considered in all cases of solar urticaria and a correct laboratory study done in the suspected cases.

Abdominal Pain↗

Chronic urticaria and thyroid auto-immunity.

Purpose was to evaluate thyroid auto-immunity and thyroid function in chronic urticaria (CU). Evaluation of antibodies Ab to thyroglobulin (TG) thyroid peroxidase (TPO) and of TSH, FT3, FT4, and of intra-dermal self test with patients own serum in 56 patients presenting chronic idiopathic urticaria and in a matched control group of 56 subjects without CU. Ab to TG positive in 13 (22.2%) to TPO in 15 (26.8%). Overall thyroid antibodies 28.5%. Thyroid function normal in 52 patients, TSH increased in 2, FT3 decreased in 1, TG and TPO Abs and thyroid function results always normal in control group. Self test positive in 4 out of 56 patients. Therapy with thyroid extract was effective in 2 out of 5 cases. CU is associated with thyroid autoimmunity in most cases. Thyroid Ab and function must be evaluated in all the cases of chronic urticaria.

Adult↗

Allergy to sunflower seeds.

A case of oral syndrome after eating sunflower seeds is reported. Sensitization has been probably through inhalant route when using these seeds to feed birds. Skin prick tests with a fresh macerate of sunflower seeds has been clearly positive (greater than histamine control) but commercial extracts have given borderline positivity and specific IgE to sunflower was strongly positive.

Administration, Inhalation↗

Soluble intercellular adhesion molecule 1 in the peritoneal fluid of patients with endometriosis correlates with the extension of peritoneal implants.

OBJECTIVE: To investigate the correlation of the concentrations of soluble intercellular adhesion molecule 1 (sICAM-1) in the peritoneal fluid (PF) with the extent of peritoneal endometriotic lesions and with the presence of red lesions (RLs). STUDY DESIGN: Sixty-seven patients with endometriosis and 19 controls with normal pelvis had PF samples collected during laparoscopy. RESULTS: The concentrations of sICAM-1 in the PF of patients and controls were not different. Patients with peritoneal implant scores 4 or more had higher concentrations of sICAM-1 in the PF than those with implant scores less than 4 (P=0.018) and controls (P=0.031). No significant difference was found in sICAM-1 levels in patients with and without RLs. No correlation was detected between sICAM-1 and interleukin 1beta (IL-1beta) in either patients or controls. CONCLUSIONS: The increased concentrations of sICAM-1 in the PF of patients with greater implant scores may indicate an active shedding of the molecule from the endometriotic peritoneal tissue. No significant association was found with the presence of RLs. The levels of IL-1beta in the PF were not a relevant factor influencing the concentrations of sICAM-1.

Adult↗

Peritoneal fluid concentrations of interleukin-8 in patients with endometriosis depend on the severity of the disorder and are higher in the luteal phase.

BACKGROUND: Previous evaluations of the relationship between the concentrations of interleukin-8 (IL-8) in the peritoneal fluid and endometriosis led to non-consistent results. Our purpose was to investigate the correlation of the concentrations of IL-8 in the peritoneal fluid with the stage of endometriosis, the presence of red lesions and the phase of the menstrual cycle. METHODS: Ninety-two patients with infertility (n = 87) or undergoing sterilization (n = 5) had peritoneal fluid samples collected at laparoscopy. IL-8 determinations were performed using an enzyme-linked immunosorbent assay. RESULTS: The concentrations of IL-8 in the peritoneal fluid of the 68 women with endometriosis were not significantly different from those of the 24 controls. Patients with moderate/severe stages had IL-8 significantly higher than controls (P = 0.008) and marginally higher than patients with minimal/mild endometriosis (P = 0.053). Concentrations of IL-8 were significantly higher in patients than in controls in the luteal phase. Red lesions were associated with significantly increased levels of peritoneal fluid IL-8 only in the luteal phase. CONCLUSIONS: Our findings reinforce the importance of IL-8 in the pathogenesis of endometriosis.

Adult↗

Correlation between clinical classification, PEF and FEV1: guidelines and reality.

The currently proposed guidelines and consensus for asthma include Peak expiratory flow (PEF) and forced expiratory volume in the first second (FEV1) as two criteria to classify asthma severity. The report between these functional data and clinical classification degrees has been evaluated in 153 asthmatic patients. Concordance between functional evaluation and clinical degree has been found only for moderate persistent asthma but not for intermittent or mild persistent asthma. These results suggest that the correlation between clinical evaluation and lung function proposed in the guidelines must be reevaluated.

Adult↗

Lung function in asthma: relation to clinics, challenge tests and immunotherapy.

BACKGROUND: In the last few years the consensus on asthma, guidelines and GINA have introduced a classification based on clinical criteria, PFR or FEV1 values and reversibility. However the relation of clinical classification with the functional data is not well defined. PURPOSE: To correlate the clinical evaluation of asthma with the most usual parameters of larger and smaller airways bronchial obstruction, PFR and FEV1.n MATERIAL AND METHODS: 153 patients have been studied by spirometry on absence of bronchodilator or anti inflammatory therapy in the last few days. Clinically, they were classified following the 2002 revised strategy for asthma management (NIH), 66 as mild intermitent, 61 mild persistent and 26 moderate persistent asthmas. RESULTS: In mild intermitent asthma PFR was decreased in 53 patients (80.3%) and FEV1 in 51 (77.2%). In mild persistent PFR and FEV1 were decreased in 59 (96.7%). In medium persistent asthma PFR was decreased in 25 (96.0%) and FEV1 in 24 (92%). The values of PFR and FEV1 were statistically different in intermitent and persistent asthma. For PFR square chi X2 = 8.91, p < 0.01 and for FEV1 X2 = 9.0 p < 0.01. In contrast there were no statistically differences between mild and moderate persistent asthmas. For PFR X2 = 0.02 p < 0.8 and for FEV1 X2 = 0.039, p < 0.9 (tables 1, 2, 3, 4). DISCUSSION: The occurrence of 77.2% and 80.3% of decreased FEV1 and PFR values in non dyspnea as reported by the patients. There were also no functional differences between patients in the different groups of persistent asthma. Clinical and functional data must be correlated, case by case in order to establish a correct classification of asthmatic patients and improve therapy and the relation between lung function and clinic reevaluate.

Adolescent↗

Correlation between clinical classification, PEF and FEV1: guidelines and reality.

The currently proposed guidelines and consensus for asthma include Peak expiratory flow (PEF) and forced expiratory volume in the first second (FEV1) as two criteria to classify asthma severity. The report between these functional data and clinical classification degrees has been evaluated in 153 asthmatic patients. Concordance between functional evaluation and clinical degree has been found only for moderate persistent asthma but not for intermittent or mild persistent asthma. These results suggest that the correlation between clinical evaluation and lung function proposed in the guidelines must be reevaluated.

Adult↗

Candida and allergy.

The role of Candida species in allergic diseases is briefly reviewed pointing out the more common forms of cutaneous and respiratory allergy where Candida can be implied, the current laboratory diagnostic methods and the possible effectiveness of Candida immunotherapy in selected patients.

Antibodies, Fungal↗

Effect of allergen immunotherapy on soluble adhesion molecules.

UNLABELLED: The level of soluble adhesion molecules in the serum reflects the degree of systemic inflammation but the dynamics of these molecules in the pathogenesis of allergic diseases and their evolution during treatment, remains to be established. OBJECTIVE: To determine the evolution of the levels of soluble forms of serum intercellular adhesion molecule-1 (sICAM-1) and vascular cell adhesion molecule-1 (sVCAM-1) during immunotherapy to Dermatophagoides pteronyssinus in patients with allergic rhinitis and/or asthma. POPULATION: We included in this study 23 patients with perennial allergic rhinitis and/or asthma to Dermatophogoides pteronyssinus. 17 patients (6 males, 11 females, 13-48 years; mean: 27.2 years) were treated for one year with specific immunotherapy using standardized slow-release D. pteronyssinus extract (Lofarma, Milan, Italy). The other 6 patients (control group; 2 males, 4 females, 20-37 years; mean: 26.5 years) received only symptomatic treatment. METHODS: Serum sICAM-1 and sVCAM-1 were measured by ELISA method (R&D system). Blood samples were collected from each immunotherapy-treated patient at two timings: before immunotherapy (T0) and after one year of immunotherapy (T1). The two blood samples from each control patient (T0 and T1) were also collected one year apart. RESULTS: Before Immunotherapy (T0), the mean serum level of sICAM-1 was 336.0 ng/ml. After one year of immunotherapy (T1) it decreased to 325.2 ng/ml but this difference was not statistically significant. Mean serum level of sVCAM-1 was 655.5 ng/ml before immunotherapy (T0), decreasing significantly (p < 0.05) to 568.2 ng/ml (T1). In the control group both sICAM-1 and sVCAM-1 had no significant changes (sICAM-1: 363.1 ng/ml (T0) and 374.7 ng/ml (T1); sVCAM-1: 611.5 ng/ml (T0) and 649.8 ng/ml (T1). CONCLUSIONS: These results suggest that specific immunotherapy with D. pteronyssinus induces a decrease in serum sVCAM-1 but not in sICAM-1 levels. The decreased expression of sVCAM-1 after immunotherapy is probably related to a decrease in the inflammatory reactions.

Adolescent↗

Chronic mucocutaneous candidiasis revisited.

A study of 26 female patients with recurrent candidial infections have been studied. Delayed hypersensitivity to Candida antigens was observed only in 17 of the patients. 12 patients had also chronic urticaria. A defect in NK cells was found in 18 out of 23 cases (78%). Treatment with Candida vaccines had obtained good clinical results in 11 of the first 13 patients treated.

Adolescent↗

Antihistamines and serum adhesion molecule levels.

BACKGROUND: Some antihistamines are capable of inducing decreased expression of adhesion molecules in nasal and conjunctival tissues of allergic rhinoconjunctivitis patients. This study aimed to determine if one month of therapy with loratadine 10 mg once daily would also induce any decrease in serum levels of soluble ICAM-1 (sICAM-1) or VCAM-1 (sVCAM-1). MATERIAL AND METHODS: 40 monosensitized House Dust Mite (HDM) mild-to-moderate allergic rhinitis patients were included in the study. During the study, twenty patients randomly received 10 mg loratadine daily, the other twenty did not take any antihistamine. All patients were treated with nasal budesonide daily and sodium cromoglycate nasal spray when needed. Serum soluble ICAM-1 and VCAM-1 levels were determined by immunoenzimatic assay before and in the end of the study period. RESULTS: After one month of loratadine sVCAM-1 levels had a significant decrease (from 724.8 to 625 ng/ml) while sICAM-1 levels had a slight but not significant increase. Control patients did not have significant variations in sVCAM-1 or sICAM-1 serum levels. During regular antihistamine therapy patients improved their clinical scores. CONCLUSIONS: Loratadine 10 mg daily during one month induced a decrease in sVCAM-1 but not in sICAM-1 levels in HDM allergic rhinitis patients.

Animals↗

Allergic rhinitis and asthma: more similarities than differences.

Clinical epidemiological and pathophysiological studies suggest a strong functional and immunological relationship between the nose and the bronchi. Nasal stimulation, can induce bronchoconstriction by a proposed rhinobronchial reflex and inflammatory mediators originating from the nose could be inhaled and trigger bronchial inflammation. Bronchial provocation in sensitised subjects results in nasal inflammation through systemic circulation. There is an increased prevalence of asthma in patients with rhinitis relatively to patients without nasal complaints and allergic rhinitis patients have an increased risk to develop asthma. Nasal and bronchial co-morbidity is high, 75% of asthmatics have rhinitis and 20% to 40% of rhinitic patient suffer from asthma. In the World Health Initiative on Allergic Rhinitis and its effect on Asthma (ARIA) it is quoted that asthma and rhinitis are common co-morbidities suggesting the concept of one airway one disease. The term allergy rhinobronchitis has been proposed to link the association between asthma and rhinitis. The treatment of rhinitis and sinusitis is important for management of asthma. Treatment of chronic rhinitis not only reduces nasal inflammation obstruction and discharge but also can reduce lower airway hyperesponsiveness and symptoms of asthma. Treating nasal inflammation is a key point in asthma control. These data strength the functional and allergologial link between nose and bronchi. Nasal inflammation induced by nasal challenge in patients with rhinitis has the ability to also induce bronchial changes in some asthmatic patients.

Anti-Allergic Agents↗

Effect of specific immunotherapy versus loratadine on serum adhesion molecules.

OBJECTIVE: To evaluate comparatively the effect on serum ICAM-1 and VCAM-1 values of specific immunotherapy versus loratadine in the treatment of allergic rhinitis. POPULATION: 65 patients with mild to moderate House Dust Mite allergic rhinitis. METHODS: Patients were divided into three groups, according to patients' preference: a control group with patients receiving only rescue therapy (antihistamines and/or nasal cromoglycate when needed); an antihistamine group with patients receiving daily loratadine 10 mg (and nasal cromoglycate as rescue therapy); an immunotherapy group with patients receiving subcutaneous house dust mite specific immunotherapy (and antihistamines or nasal cromoglycate when needed). In all groups we measured soluble ICAM-1 and VCAM-1 serum levels before the start of the study period and at the end of the study period. The duration of the study was one year for the control group and for the immunotherapy group. In patients taking daily antihistamines we measured serum adhesion molecules one month after the beginning of the therapy. We used Student's T test for statistical analysis. RESULTS: Patients in the control group didn't have significant variations in serum ICAM-1 (p = 0.239) or VCAM-1 (p = 0.38) levels. Patients receiving loratadine showed significant decreases in serum VCAM-1 levels (p = 0.0012) but not in serum ICAM-1 levels (p = 0.224). Patients receiving immunotherapy also showed a similar pattern, with significant decreases in serum VCAM-1 levels (p = 0.012) but not in serum ICAM-1 levels (p = 0.254). CONCLUSIONS: Specific house dust mite immunotherapy and regular daily loratadine therapy are able to lower significantly serum levels of soluble VCAM-1. However, this effect, which can be interpreted as an anti-inflammatory action, is not applied to soluble ICAM-1 levels, which raises the possibility of a differential action of these therapies on the mechanisms of allergic inflammation. Patients on rescue medication alone did not show any significant differences in these parameters.

Adolescent↗