[Prophylaxis in hereditary angioedema with normal C1 inhibitor]. / Profilaxis con inhibidor de C1 normal en angioedema hereditario.

INTRODUCTION: Hereditary angioedema is an infrequent genetic disorder; which mainly manifests with cutaneous and mucosal swelling. Minor trauma may trigger potentially life-threatening events. In type I and II hereditary angioedema, plasma-derived C1-inhibitor concentrate can be used as short-term prophylaxis. For hereditary angioedema, prophylaxis is not yet standardized, but normal C1 inhibitor could be beneficial. CASE REPORT: A 69-year-old woman, with a genetic diagnosis of hereditary angioedema with normal C1 inhibitor, who needed multiple dental extractions. The surgical procedure was performed under general anesthesia, using 1000 U of plasma-derived C1-inhibitor concentrate as prophylaxis an hour before. The patient was admitted in the ICU for postsurgical care and the outcome was good. CONCLUSION: We highlight the possibility of successfully using plasma-derived C1-inhibitor concentrate as prophylaxis in patients with hereditary angioedema with normal C1 inhibitor.

Introducción: El angioedema hereditario es una enfermedad genética poco frecuente, que se manifiesta principalmente con edema cutáneo o mucoso. Pequeños traumas pueden producir eventos potencialmente fatales. En angioedema hereditario tipos I y II se puede llevar a cabo profilaxis a corto plazo con concentrado plasmático de inhibidor de C1. La profilaxis aún no está estandarizada, pero el concentrado de inhibidor de C1 normal podría ser beneficioso. Reporte de caso: Mujer de 69 años, con diagnóstico genético de angioedema hereditario con inhibidor de C1 normal, quien necesitaba exodoncias dentarias múltiples. El procedimiento quirúrgico se realizó bajo anestesia general, utilizando como profilaxis 1000 U de concentrado de inhibidor de C1 derivado del plasma una hora antes. Cursó el posoperatorio en terapia intensiva con buena evolución. Conclusión: Resaltamos la posibilidad de utilizar con éxito el concentrado de inhibidor de C1 derivado del plasma como profilaxis en pacientes con angioedema hereditario con inhibidor de C1 normal.

[The epidemiology of asthma in adults. An insight]. / Epidemiología del asma en adultos. Una visión introspectiva.

BACKGROUND: Asthma is a chronic disease with a great impact on public health and on the patients' quality of life. In Latin America, there are scarce epidemiological studies. OBJECTIVE: To describe the prevalence of asthma and the clinical-demographic characteristics in an adult population from a private health system in the City of Buenos Aires. METHODS: A cross-sectional study of adults who were enrolled in the medical program of a private health system in Buenos Aires between January 1st, 2017, and January 1st, 2018. All the patients that were included in the study had been diagnosed with asthma. RESULTS: The prevalence of asthma in the adult patients of a prepaid health system in the City of Buenos Aires was of 6 % (n = 66, IC 95 % = 5-7), and the prevalence of severe asthma among the same group was of 5 % (n = 3, IC 95 % = 1-13). Most patients had intermittent and mild asthma. CONCLUSION: This study provides new data about the epidemiology of asthma in the region.

Antecedentes: El asma es una enfermedad crónica de gran impacto en la salud pública y en la calidad de vida de los pacientes. En Latinoamérica existen escasos estudios epidemiológicos Objetivo: Describir la prevalencia del asma y las características clínico-demográficas en una población adulta de un sistema de salud privado de la ciudad de Buenos Aires. Métodos: Estudio de corte transversal de adultos afiliados al programa médico de un sistema de salud privado de Buenos Aires, entre el 1 de enero de 2017 y 1 de enero de 2018, con diagnóstico médico de asma. Resultados: La prevalencia de asma en pacientes adultos de un sistema de salud prepago en la ciudad de Buenos Aires fue de 6 % (n = 66, IC 95 % = 5-7) y de asma grave de 5 % (n = 3 IC 95 % = 1-13) La mayoría de los pacientes presentaron asma intermitente y leve. Conclusión: El estudio aporta nuevos datos sobre la epidemiología del asma en la región.

Direct Medical Costs of Chronic Urticaria in a Private Health Organization of Buenos Aires, Argentina.

BACKGROUND: Scarce studies address the issue of resource consumption and direct health care costs of patients diagnosed with adult-onset chronic urticaria (CU). OBJECTIVES: To estimate medical resource consumption and direct health care costs of affected patients in a private health maintenance organization in Buenos Aires, Argentina. METHODS: Patients diagnosed with adult-onset CU (International Classification of Diseases, Ninth Revision, Clinical Modification code 708.1, 708.8, or 708.9) and who were members of the Italian Hospital Medical Care Program were included in the study. All data on hospitalizations, drug prescription, outpatient episodes, consultations, and investigations/tests in the 12 months before inclusion in the study were considered for the estimation of medical resource consumption and direct health care costs. Third-quarter 2014 costs were obtained from the Italian Hospital Medical Care Program and converted into US dollars (using the November 2014 exchange rate). RESULTS: A total of 232 patients were included in the study. The mean age at diagnosis was 54.2 ± 20.0 years, and the mean disease duration was 5.4 ± 2.6 years (range, 2-22 years). Of the total number of patients, 75% had allergists as their usual source of care, 23% had dermatologists, 18% had internists, and 3% had rheumatologists. Only 7.8% of the patients had an emergency room admission to manage CU symptoms. To manage the disease, 57.8% of patients used antihistamines and 11.6% used oral corticosteroids. The most relevant source of cost was the medical treatment received, followed by physician visits. The average yearly direct cost per patient was US $1015 ± $752 (95% confidence interval 803-2003). CONCLUSIONS: This is the first Argentine study that evaluated the costs of CU considering the direct medical costs of the disease. The study provides information on resource utilization and the disease-related economic burden, which is valuable to better understand CU in the local setting. Future research that takes into consideration the direct and indirect costs of the disease will expand knowledge and improve management of the disease.