Importance of education in pediatric bronchial asthma: pilot experience Introduction: Even though asthmatic children in Chile have a guaranteed access to treatment, an important number of them have a severe adverse evolution, requiring hospitalization. Education in bronchial asthma is fundamental in the management of these patients, just as pharmacological therapy, as yet most Health Centers in our country do not hold educational activities. Patients and Methods: A pilot prospective study was carried out to evaluate the usefulness of bronchial asthma education, in a group of 12 patients hospitalized for asthma crisis in Clínica Santa María, Santiago de Chile. Patients were randomized in 2 groups, 7 patients receiving formal educational activities and 5 patients receiving the standard information given by their physician. Patients were followed 2, 6 and 12 months after discharge. Results: All studied patients exhibited an improvement in asthma control measured by Asthma Control Test-ACT-, as well as an improvement in quality of life, measured by a questionnaire (PaQLQ). Nonetheless, patients that received the educational activities did attend the Emergency Room less frequently and required less systemic corticosteroid treatments during the study than the patients that did not undergo formal education on asthma. Conclusions: This pilot study suggests that asthma education is a useful tool for patients, in order to achieve a better control of the disease.

Studies on the etiology of lower respiratory infectionsAs a contribution to knowledge about the etiology of lower respiratory tract infections (LRI) in infants, 235 patients aged one year or less admitted to a children's hospital at northern metropolitan area of Santiago, Chile along years 1987 throughout 1989 with radiologically confirmed diagnosis were studied. Infants were eligible only if their symptoms lasted for not more than five days and their hospital stay was less than two days. Controls consisted on 74 healthy infants. A search for presumtive etiology was done by means of usual bacteriological procedures {pharyngeal swabs and blood cultures), plus latex test for type b Haemophitus influanzae (Hib) and Streptococcus pneumoniae (SP* in concentrated urine specimens; indirect inmunofluorescence (IF) for specific Chlamydia tracbomatis

Chlamydia trachomatosis pneumoniaFive infants with Chlamydia trachomatis associated pneumonia are analized. They were diagnosed out of 80 infants admitted to the hospital with pneumonia whose etiology was studied for virus, bacteria and Chlamydia trachomatis. Serum IgM antibodies to Chlamydia tr. were measured by indirect immunofluorescence (IIP), wich is considered to be specific in high titers (1 > 32). The five cases represented 10.4% of infants studied younger than six months. One child was born by cesarean section suggesting the posibility of other non oculogenital still undefined mechanism of transmission. Clinical symptoms and laboratory findings were characteristics of those described in Chlamydia tr. pneumonia. Chlamydia trachomatis must be considered an etiologic agent in infantile pneumonia specially in the first six months of life. The high specificity and sensitivity of the IFF makes this serologic test the best non-invasive method for diagnosis of Chlamydia tr. pneumonia currently available.

Fecal alpha-1-antitrypsin in infants. Reference values and in acute diarrhoeal diseaseAlpha-l-antitrypsin (a-l-AT) was determined in faeces by agorose radial inmunodiffusion plates in order to establish reference values in random faecal samples, and to determine the magnitude of intestinal protein loss in acute diarrhoea and its eventual association with the aetiology and clinical progress of the disturbance. Fifty three patients 1 to 11 months of age were studied. Fifteen infants admitted with acute respiratory disease, were investigated when fully recovered, just before discharge: reference values found were (mg/g dry weight): 4.80 to 50.80 (x ± 2 SD n _i)-Thirty eight cases with acute diarrhoea were studied within 24 hours after admission: increased faecal a-l-AT loss was detected in 47.3% of these patients, with 3 cases showing loses greater than 100 mg/g. Severe malnutrition was not observed. Faecal. a-l-AT loss was neither related to nutritional status nor to the aetiology of diarrhoea. However, increased loss was associated to watery stools, prolonged hcapitalization and probably to protracted diarrhoea (p -0.05).