Revista alergia Mexico (Tecamachalco, Puebla, Mexico : 1993)
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Studies of association among parental atopy, tobacco exposure (passive or active) and adult asthma have provided conflicting results. ⋯ Results support hypothesis that family atopy, active smoke, allergic rhinitis and pollution favor the persistence of asthma symptoms and increase the risk of asthma in adults.
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We report an anaphylactic shock case secondary to propofol and fentanyl exposition, demonstrated by skin tests. A male patient, 19 years old, was admitted in the operating room for resection of residual juvenile nasal angyofibroma. ⋯ By the second minute the blood pressure dropped to 40/20 mmHg, tachycardia got 135, facial edema and generalized wheals occurred and the plestimography and oxymetry record were absent. Once resolved the event and the patient recovered, skin tests were performed with positive results to propofol and fentanyl, so that they were excluded in the next surgical intervention that concluded without incidents and with success.
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Chronic urticaria may be continuous or recurrent according to its form of appearance. Within the diseases associated to chronic urticaria there are mycosis, parasitism and bacterial infections where Helicobacter pylori stands out. This has been related to the allergic diseases promoting a Th2 response. ⋯ The high frequency of infection caused by Helicobacter pylori in the patient with chronic urticaria suggests a possible role in its etiopathogeny, extending the therapeutic possibilities.
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Morbidity and mortality by bronchial asthma continues to be a serious public health problem all over the world. Bronchial asthma is considered the most common chronic disease among children and asthmatic crises are the most frequent cause for visits to the emergency room. Among adults, bronchial asthma has also a high rate of morbidity and repercussions in productivity as well as in the costs of the health systems that assist them. On the other hand, despite the development of the International Guidelines for the DIAGNOSIS and Treatment of Bronchial Asthma (IGDTBA), supported by the best scientific medical researches based on evidence, which recommend the prompt and regular use of inhaled corticosteroids in the treatment of the persistent clinical forms of bronchial asthma to reduce their morbidity and mortality, this has not yet been modified. ⋯ The persistent morbidity from bronchial asthma in our study is due to: a) Most of physicians who care for asthmatic patients in emergency or outpatient services are not familiar with the International Guidelines for the DIAGNOSIS and Treatment of Bronchial Asthma (IGDTAB) and those who state that they do know about them have no interest in using them with their patients. b) Inhaled corticosteroids, recommended as the first line of anti-inflammatory medications for regular treatment of bronchial asthma, are not used by the majority of physicians. c) Asthmatic patients who follow regular treatment with inhaled corticosteroids account for lesser than 50%. d) There is no communication or cooperation among the different levels of medical attention for asthmatic patients (emergency medical service, outpatient service and specialists in asthma) for their education and treatment under the same parameters (IGDTBA), which partially explains the persistent morbidity and visit to emergency department.
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Review Case Reports
[Asthma or laryngeal amyloidosis? A report of a case and literature review].
The laryngeal amyloidosis is an uncommon disease accounting for 1% of all benign lesions of larynx. The commonest symptom is the dysphonia, sometimes accompanied by stridor, laryngeal globus sensation, dysphagia and, in rare occasions, cough, dyspnea and hemoptysis, specially when the tracheobronchial tree is also affected. This paper describes the case of a 30-year-old female patient, whose main symptoms were progressive dysphonia and dyspnea, admitted at allergy service to rule out asthma. ⋯ Biopsies of ventricular band, vocal cord and arytenoid stained with positive Congo red for amyloid tissue, established the laryngeal amyloidosis diagnosis. The complementary studies to rule out amyloid tissue in the remaining tracheobronchial tree were negative. Dyspnea had characteristics of laryngeal origin, caused by a pulmonary ventilation disorder provoked by the difficult arrival of air to alveoli, which caused the decreased partial pressure of oxygen and CO2.