REPERCUSSIONS OF BARIATRIC SURGERY ON METABOLIC PARAMETERS: EXPERIENCE OF 15-YEAR FOLLOW-UP IN A HOSPITAL IN MACEIÓ, BRAZIL.

Objective: Obesity is a disease characterized by an excessive accumulation of body fat, which is harmful to health, and it has grown significantly in the past years in the majority of countries. The surgery should be recommended to those patients with obesity who did not succeed in conservative clinical therapy after a rigorous analysis by a multidisciplinary team. The aim of this study was to compare metabolic results, weight loss, and parameters associated with obesity in the preoperative and postoperative periods of patients treated with bariatric surgery.

Randomized study for assessment of hypolipidic diet in digestive symptoms immediately following laparoscopic cholecystectomy.

Objective: To validate the need for prescribing low-fat diet in the prevention or reduction of dyspeptic symptoms in the postoperative period in patients undergoing laparoscopic cholecystectomy.

Methods: We selected 40 patients, free of liver or pancreatic disease, biliary gallstones, gastritis, ulcer, diabetes and dyslipidemia, who were divided into two groups. We conducted dietary anamnesis, identification of dyspepsia before the onset of cholelithiasis and guidance on appropriate postoperatively feeding (normal or low-fat).

Elevations of local leukotriene C4 levels during viral upper respiratory tract infections.

Background: One potential mechanism by which respiratory viruses trigger illness and complications is via the local elaboration of inflammatory mediators.

Objective: To determine whether there is an increase in local leukotriene C4 (LTC4) levels during experimental infection with influenza A virus (FLU), rhinovirus (RV), or respiratory syncytial virus (RSV).

Methods: Healthy adults were intranasally inoculated with a safety-tested strain of FLU (n = 29), RV (n = 16), or RSV (n = 21).

Understanding asthma pathophysiology.

Asthma is best described as a chronic disease that involves inflammation of the pulmonary airways and bronchial hyperresponsiveness that results in the clinical expression of a lower airway obstruction that usually is reversible. Physiologically, bronchial hyperresponsiveness is documented by decreased bronchial airflow after bronchoprovocation with methacholine or histamine. Other triggers that provoke airway obstruction include cold air, exercise, viral upper respiratory infection, cigarette smoke, and respiratory allergens.

Pharmacokinetics and tolerability of a new intravenous immunoglobulin preparation, IGIV-C, 10% (Gamunex, 10%).

Background And Objectives: A new intravenous immunoglobulin (IGIV) process has been developed that integrates efficient inactivation of enveloped virus, using caprylate, with immunoglobulin G (IgG) purification and caprylate removal by column chromatography. Two clinical studies were conducted to compare the pharmacokinetics of the new product, IGIV-C, 10% (Gamunex, 10%), formulated with glycine, with the licensed solvent-detergent (SD)-treated intravenous immunoglobulin IGIV-SD, 10% (Gamimune N, 10%), formulated with glycine, and IGIV-C, 5%, formulated with 10% maltose.

Materials And Methods: Both studies were randomized, multicentre crossover trials of 18 and 20 (respectively) adult patients with primary humoral immune deficiency in which patients received one IGIV product for three consecutive periods (3-4 weeks) before crossing over to the other product.

Systemic steroid for chronic otitis media with effusion in children.

Objective: To determine the efficacy of a short course of an adrenocorticosteroid agent (prednisolone) given with amoxicillin as compared with that of amoxicillin alone for the treatment of chronic middle ear effusion (MEE). The efficacy of 2 weeks versus 4 weeks of amoxicillin with and without steroid was also assessed.

Methods: In a double-blind, randomized trial, children who were 1 to 9 years of age and had MEE of at least 2 months' duration were assigned to 1 of 4 treatment arms: 1) steroid + amoxicillin for 14 days, then amoxicillin for 14 more days; 2) steroid + amoxicillin for 14 days, then placebo for amoxicillin for 14 more days; 3) placebo (for steroid) + amoxicillin for 14 days, then amoxicillin for 14 more days; or 4) placebo (for steroid) + amoxicillin for 14 days, then placebo for amoxicillin for 14 more days.

Children's adherence to recommended asthma self-management.

Purpose: Adherence to peak expiratory flow rate monitoring by children with asthma was evaluated, and a behavioral strategy to enhance adherence to daily monitoring was tested.

Design And Methods: Forty-two 7- through 11-year-old children with persistent asthma were recruited into a 5-week randomized, controlled clinical trial. Adherence data were collected electronically by PeakLog and the self-report Asthma Diary.

Virus-provoked rhinitis in patients who have allergies.

The most common illnesses in humans are the respiratory tract infections caused by viruses. When limited to the upper respiratory region, these infections often are designated as "a common cold." Viruses commonly associated with these upper respiratory infections (URI) include rhinoviruses (RVs), respiratory syncytial virus, influenza virus, parainfluenza virus, corona virus, and adenoviruses.

Effect of experimental influenza A infection on systemic immune and inflammatory parameters in allergic and nonallergic adult subjects.

Background: The economic impact and medical complication rate of viral upper respiratory infections are well documented, but many of the physiologic, inflammatory, and immune responses to respiratory viruses have only recently been investigated. A previous study demonstrated differential systemic immune and inflammatory responses in allergic rhinitis (AR) and nonallergic rhinitis (NAR) subjects during experimental infection with rhinovirus-39.

Objective: The purpose of this study was to compare selected systemic immune and inflammatory responses to experimental influenza A virus (FLU) challenge in seronegative AR and NAR subjects.

Urinary histamine metabolite elevations during experimental influenza infection.

Background: Although histamine is hypothesized to mediate symptoms induced by viral upper respiratory infections, elevations of this mediator have not been observed in nasal lavage fluids recovered from patients with viral upper respiratory infections.

Objective: The purpose of this study was to use a novel method to determine whether histamine is released during experimental influenza A infection.

Methods: Healthy adults (n = 15) were cloistered and inoculated intranasally with influenza A virus, and monitored for infection and illness.

Long-term safety and efficacy of a chlorofluorocarbon-free beclomethasone dipropionate extrafine aerosol.

Background: Beclomethasone dipropionate (BDP) extrafine aerosol, a newly developed pressurized metered dose inhaler (pMDI) with a hydrofluoroalkane-134a (HFA) propellant (HFA-BDP; Qvar, 3M Pharmaceuticals, St. Paul, MN), has been shown to be effective in controlling asthma symptoms at approximately half the daily dose of chlorofluorocarbon (CFC)-BDP.

Objective: This study evaluated the long-term efficacy and safety of switching patients with asthma maintained on a stable dose of CFC-BDP pMDI to therapy with HFA-BDP pMDI at approximately half their previous daily dose of CFC-BDP.

Combination of inhaled corticosteroids plus other medications in the management of moderate to severe persistent asthma.

Severe persistent asthma accounts for a small percentage, probably less than 5% of all patients with asthma, but is responsible for the major portion of health care costs associated with the illness. According to the National Institutes of Health (National Asthma Education and Prevention Program) guidelines for the management of asthma, patients with severe asthma should be treated with high dosages of inhaled corticosteroids. These inhaled corticosteroids can be given in conjunction with a brief course of oral or parenteral systemic steroids, but it is best to decrease or eliminate systemic corticosteroid therapy whenever possible to prevent the side effects of long-term oral prednisone therapy.

Abnormal middle ear pressures during experimental influenza A virus infection--role of Eustachian tube function.

Introduction: Experimental infection of adults with influenza A virus, rhinovirus or RSV causes abnormal ME pressure in some, but not all subjects. The hypothesis tested in this study is that the response variability is caused by constitutional differences in the functioning of the Eustachian tube.

Methods: 18 adult subjects were experimentally infected with influenza A virus.

Diagnostic assessment of otitis media.

Accurate diagnosis of OM is important but often difficult. To enhance the likelihood of accurate diagnosis, pneumatic otoscopy is the preferred method of examination generally available to clinicians. Findings by pneumatic otoscopy should be coupled with the presence or absence of symptoms and signs to delineate a diagnosis of AOM or OME.

Therapeutic approaches to allergic rhinitis: treating the child.

Allergic rhinitis is currently the most common of all chronic diseases in children. However, children frequently lack the ability to verbalize their symptoms, with the result that the condition may go undiagnosed and untreated. Unfortunately, untreated allergic rhinitis not only detrimentally affects children's physical and psychosocial well-being, quality of life, and capacity to function and learn, but it is also associated with and may contribute to potentially serious sequelae, including asthma, sinusitis, and otitis media.

Rhinitis and asthma connection: management of coexisting upper airway allergic diseases and asthma.

Asthma is a chronic inflammatory disease of the lower airways. Epidemiologic surveys and clinical reports have documented that allergic rhinitis coexists with asthma in many patients. Provocative bronchial challenge with allergens responsible for allergic rhinitis in susceptible asthma patients can elicit asthma, and these responses have been linked to bronchial airway hyperreactivity.

Delayed separation of the umbilical cord and partial deficiency of sialyl lewis X antigen.

A 5-week-old male infant presented with failure of separation of the umbilical cord. He was evaluated for the presence of integrin and selectin ligand leukocyte adhesion molecules on his neutrophils and monocytes. Integrin molecules appeared to be normally expressed, but expression of sialyl Lewis X (sLe(x)) was decreased.

Diminished IL-10 production in subjects with allergy after infection with influenza A virus.

Background: Recent studies have documented a link between respiratory viral infections and the expression of asthma and other allergic disorders. Results from other studies have suggested that diminished production of IL-10, an anti-inflammatory cytokine, may contribute to the pathophysiologic features of these diseases.

Objective: The objective of this study was to determine whether diminished IL-10 production and TH2 cytokine skewing occur in allergic, as compared with nonallergic, subjects after experimental infection with the influenza A virus.

Body odor in dermatologic diagnosis.

Patients with an unpleasant body odor often consult dermatologists. A dermatologist needs to become familiar with the occurrence and significance of medically related odors. Although body odor may be essentially physiological, and problems with body mal-odor are paid little attention, they can cause many personal troubles and may induce a variety of psychosocial disturbances.

Intranasal budesonide aqueous pump spray (Rhinocort Aqua) for the treatment of seasonal allergic rhinitis. Rhinocort Aqua Study Group.

To determine the relative efficacy, compare the incidence of adverse events, and ascertain the systemic glucocorticoid effect of the nasal application of several doses of budesonide, 406 patients with seasonal ragweed-induced allergic rhinitis were randomized in a double-blind, parallel group design to receive intranasal budesonide aqueous pump spray (Rhinocort Aqua) 32 micrograms, 64 micrograms, 128 micrograms, 256 micrograms, or placebo once daily for 4 weeks. A total of 231 adults and 175 children participated in the study conducted at 14 centers in two geographic regions, the Midwest and the Northeast United States, during the 1994 ragweed season. Pollen counts were collected at each site by the Rotorod method.

Increased interleukin-6 levels in nasal lavage samples following experimental influenza A virus infection.

Interleukin-6 (IL-6) is a pleotropic cytokine implicated in the pathogenesis of local inflammation during viral upper respiratory infections. This study determined if experimental influenza A virus infection causes local IL-6 production. Seventeen healthy, adult subjects were intranasally inoculated, by course drops, with a safety-tested strain of influenza A/Kawasaki/86 (H1N1) virus.