Allergologia et immunopathologia
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Allergen specific immunotherapy has been shown to be effective in rigorous double-blind placebo-controlled clinical trials in both children and adults A recent WHO position paper stated that immunotherapy is an effective treatment for patients with allergic rhinitis/conjunctivitis, allergic asthma and allergic reactions from stinging insects and is thought to be more effective in children than in adults. When speaking about children there are several questions that are important regarding the natural course of the disease. One of the most important is whether immunotherapy can prevent asthma, either by preventing sensitisation to allergens related to the development of asthma or by preventing the inflammation in the lungs caused by allergen exposure. ⋯ In a retrospective study of children treated with immunotherapy during childhood for at least three years, that were re-evaluated in early adulthood, the control patients who were treated with medication and no immunotherapy suffered almost 3.5 times more symptoms than the active group treated with immunotherapy. The current findings suggest that immunotherapy should be considered earlier in the course of allergic disease to prevent progression or to prevent the development of new sensitisation. Further studies with long term follow up particularly in children could address this possibility.
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Allergol Immunopathol (Madr) · Jan 2000
Review[Allergic reactions and pseudoallergies in surgical interventions with general anesthesia].
The Spanish Societies of Allergology and Anesthesiology have established a protocol for action for the performance of allergy tests for anesthesia. The protocol was published by the General Directorate of INSALUD, along with an informed consent form for general and loco-regional anesthesia, on 30 June 1994. Despite this, demands for care and requests for allergologic and anesthetic studies have increased. ⋯ Prevention should begin with the selection of less potent drugs, such as histamine releasing agents. Slow administration of drugs, as opposed to bolus administration, has been demonstrated to be more effective. The use of combined H1 and H2 antihistamines as a preanesthetic medication can significantly reduce tachycardia/bradycardia, hypotension, skin response, and even gastric pH changes induced by histamine release.
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Allergol Immunopathol (Madr) · Mar 1999
Review[Round Table: Severe asthma in pediatrics: treatment of acute crises].
Morbidity and mortality derived from asthma continue to be a main public health problem in many countries, in spite of the advances in the knowledge on the disease and its treatment. There are several risk factors for asthma attack which have to be considered in the management of patients in order to prevent exacerbations and mortality. Smooth bronchial muscle constriction and inflammation with oedema of the bronchial wall are the facts that cause airway flow and resistance disturbances, with hyperinflation, leading to a bigger respiratory work. ⋯ There are data on lung function in 36 of them, FEV1 is normal (> 85% of predicted, between 86 and 127) in 26 (78%) and < 85% (65 to 84%) of predicted in 8 (22%) FEV1 rises more than 15% (16 to 23%) in four patients after the inhalation of a ss2 agonist. Inhaled anesthetic agents and heliox have been used in some pediatric cases. After a severe asthma attack the strategy of management should be reviewed, as well as the possible risk factors.
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Allergol Immunopathol (Madr) · May 1998
Review[Epidemiology and chronology of allergic diseases and their risk factors].
An increase in allergic diseases in Western societies has been observed in all epidemiological studies. Various risk factors have been invoked to explain this increase, but the results are still inconclusive. We examined the type of patients who visited a hospital pediatric allergology unit in terms of the type of pathology presented, environmental factors, and time from the onset of symptoms until referral for allergy study. ⋯ Therefore, we think that it would be advisable if epidemiological studies would attempt to follow a model, which would facilitate the comparison of studies. Our aim was to evaluate the type of patients who required allergy studies in relation to the pathologies that they present and the different diagnostic methods to determine the presence of false allergies or non-allergies, the delay until study, most frequent pathologies, and environment. We report the data obtained from a sample of 200 children who visited our department for the first time in the period of a natural year.
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Allergic diseases, particularly asthma and asthma equivalents, are among the most frequent disorders seen in the pediatric clinic. Approximately 25% of children from developed countries have presented wheezing in recent years, and half of these children later experience major asthma attacks. Likewise, 25% of children between 8 and 11 years have at some time used beta agonists and at least 10% of them use preventive asthma medication. ⋯ The environmental factors most closely involved in the occurrence of asthma are: diet (early exposure to sensitizing foods); domestic, outside, and occupational seroallergens; pollution (particularly smoking and urban and industrial pollution); and infections, particularly viral infections. In the present study, the methods used for the early identification of children at risk are evaluated, as well as the role of the primary care pediatrician in the early detection of allergic children and the interventions that they carry out. Finally, an analysis is made of the preventive measures that should be taken in children at risk of allergic disease, particularly: 1) increasing awareness of health, 2) reduction of exposure to smoking. 3) reduction of urban and industrial pollution, 4) delayed introduction of certain foods, reduction in the level of domestic allergens, 6) control of infections, and 7) pharmacological measures designed to prevent the occurrence of asthma in children.