RESUMO
In this article a French working party critically review the international literature to revise the definition, pathophysiology, treatment and cost of exacerbations of adult asthma. The various guidelines do not always provide a consistent definition of exacerbations of asthma. An exacerbation can be defined as deterioration of clinical and/or functional parameters lasting more than 24 hours, without return to baseline, requiring a change of treatment. No single clinical or functional criterion can be used as an early marker of an exacerbation. Innate and acquired immune mechanisms, modified by contact with infectious, irritant or allergenic agents, participate in the pathogenesis of exacerbations, which are accompanied by bronchial inflammation. In 2010, mortality is related to progression of exacerbations, often occurring before the patient seeks medical attention. The objective of treatment is to control asthma and prevent exacerbations. However, many factors can trigger exacerbations and often cannot be controlled. The efficacy of inhaled corticosteroids has been demonstrated on reduction of the number of exacerbations and the number of asthma-related deaths. This treatment is cost-effective, especially in terms of reduction of exacerbations.
Assuntos
Estado Asmático/fisiopatologia , Corticosteroides/economia , Corticosteroides/uso terapêutico , Agonistas de Receptores Adrenérgicos beta 2/uso terapêutico , Adulto , Poluição do Ar/efeitos adversos , Antiasmáticos/economia , Antiasmáticos/uso terapêutico , Antibacterianos/uso terapêutico , Anticorpos Anti-Idiotípicos , Anticorpos Monoclonais/uso terapêutico , Anticorpos Monoclonais Humanizados , Bronquite/complicações , Bronquite/fisiopatologia , Broncodilatadores/uso terapêutico , Administração de Caso , Comorbidade , Análise Custo-Benefício , Humanos , Leucócitos/patologia , Antagonistas de Leucotrienos/uso terapêutico , Omalizumab , Oxigenoterapia , Infecções Respiratórias/complicações , Infecções Respiratórias/tratamento farmacológico , Infecções Respiratórias/microbiologia , Infecções Respiratórias/fisiopatologia , Infecções Respiratórias/virologia , Estado Asmático/complicações , Estado Asmático/tratamento farmacológico , Estado Asmático/economia , Estado Asmático/mortalidade , Estado Asmático/psicologia , Estado Asmático/terapiaAssuntos
Doença Pulmonar Obstrutiva Crônica , Educação Médica , Estudos Epidemiológicos , França/epidemiologia , Educação em Saúde , Acessibilidade aos Serviços de Saúde , Humanos , Participação do Paciente , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Doença Pulmonar Obstrutiva Crônica/prevenção & controle , Doença Pulmonar Obstrutiva Crônica/terapia , Qualidade da Assistência à Saúde , Projetos de Pesquisa , Fatores de Risco , Prevenção do Hábito de FumarRESUMO
INTRODUCTION: The manufacture of dental prostheses exposes the technician to inhalation of various potentially dangerous dusts (silica, hard metals, dental alloys and acrylic resins). BACKGROUND AND VIEWPOINT: Inhalation of dusts produced by the technician in the work place may lead to several respiratory disorders (pneumoconiosis, hypersensitivity pneumonitis, asthma, lung cancer). The continuous development of new materials leads to further manifestations of these disorders and justifies their notification, even in the absence of an accepted occupational disease. This step is taken inconsistently as many dental technicians are not salaried or insured. CONCLUSION: The seriousness of some of these disorders and the absence of effective treatment makes it important to develop effective methods of prevention for the protection of individuals and groups, and for early detection.