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1.
Arch. argent. pediatr ; 122(2): e202310165, abr. 2024. tab
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1537598

ABSTRACT

En la pandemia por COVID-19 se exploraron estrategias de atención para garantizar el seguimiento de niños con asma grave. Estudio prospectivo, observacional, comparativo. Se incluyeron pacientes del programa de asma grave de un hospital pediátrico de tercer nivel (n 74). Se evaluó el grado de control, exacerbaciones y hospitalizaciones durante un período presencial (PP), marzo 2019-2020, y uno virtual (PV), abril 2020-2021. En el PP, se incluyeron 74 pacientes vs. 68 (92 %) del PV. En el PP, el 68 % (46) de los pacientes presentaron exacerbaciones vs. el 46 % (31) de los pacientes en el PV (p 0,003). En el PP, se registraron 135 exacerbaciones totales vs. 79 en el PV (p 0,001); hubo una reducción del 41 %. En el PP, el 47 % (32) de los pacientes tuvieron exacerbaciones graves vs. el 32 % (22) de los pacientes en el PV (p 0,048). Hubo 91 exacerbaciones graves en el PP vs. 49 en el PV (p 0,029), reducción del 46 %. No hubo diferencias en las hospitalizaciones (PP 10, PV 6; p 0,9). La telemedicina fue efectiva para el seguimiento de pacientes con asma grave


During the COVID-19 pandemic, health care strategies were explored to ensure the follow-up of children with severe asthma. This was a prospective, observational, and comparative study. Patients in the severe asthma program of a tertiary care children's hospital were included (n: 74). The extent of control, exacerbations, and hospitalizations during an in-person period (IPP) (March 2019­2020) and an online period (OP) (April 2020­2021) was assessed. A total of 74 patients were enrolled in the IPP compared to 68 (92%) in the OP. During the IPP, 68% (46) of patients had exacerbations versus 46% (31) during the OP (p = 0.003). During the IPP, 135 total exacerbations were recorded compared to 79 during the OP (p = 0.001); this accounted for a 41% reduction. During the IPP, 47% (32) of patients had severe exacerbations versus 32% (22) during the OP (p = 0.048). A total of 91 severe exacerbations were recorded during the IPP compared to 49 during the OP (p = 0.029); the reduction was 46%. No differences were observed in terms of hospitalization (IPP: 10, OP: 6; p = 0,9). Telemedicine was effective for the follow-up of patients with severe asthma.


Subject(s)
Humans , Child , Adolescent , Asthma/diagnosis , Asthma/therapy , Asthma/epidemiology , COVID-19 , Prospective Studies , Follow-Up Studies , Pandemics , Hospitalization
2.
Respirar (Ciudad Autón. B. Aires) ; 16(1): 85-92, Marzo 2024.
Article in Spanish | LILACS, UNISALUD, BINACIS | ID: biblio-1551285

ABSTRACT

El sarcoma folicular de células dendríticas (SFCD) es una neoplasia maligna rara derivada de las células dendríticas foliculares. Ha sido clasificado, dadas sus características inmunohistoquímicas, como parte del grupo de los sarcomas, donde representa un porcentaje menor al 1%. Actualmente, existen menos de 1.000 reportes en la literatura a nivel mundial, lo cual plantea una dificultad no sólo diagnóstica, siendo confundido frecuentemente con neoplasias de tipo linfoide; sino también terapéutica al no existir un claro consenso sobre su manejo definitivo. Esta revisión de caso clínico describe el primer caso reportado de SFCD en Costa Rica.


Follicular dendritic cell sarcoma (SFCD) is a rare malignant neoplasm derived from follicular dendritic cells, which has been classified, given its immunohistochemical characteristics, as part of the group of sarcomas, where it represents less than 1%. Currently, there are less than 1000 reports in the literature worldwide, which generates a difficulty not only in diagnosis, being frequently confused with lymphoid type neoplasms; but also, as therapeutic as there is no clear consensus on its definitive management. This clinical case review describes the first reported case of SFCD in Costa Rica.


Subject(s)
Humans , Female , Adult , Asthma/diagnosis , Cough/diagnosis , Dendritic Cell Sarcoma, Follicular/diagnosis , Mediastinal Neoplasms/diagnosis , Obesity/diagnosis , Biopsy , Case Reports , Diagnostic Imaging , Immunohistochemistry , Thoracotomy , Costa Rica
3.
Respirar (Ciudad Autón. B. Aires) ; 16(1): 79-83, Marzo 2024.
Article in Spanish | LILACS, UNISALUD, BINACIS | ID: biblio-1551228

ABSTRACT

Se presenta el caso de un niño de 3 años con diagnóstico de asma, rinitis alérgica, características craneofaciales dismórficas e infecciones respiratorias altas y bajas recurrentes, manejado como asma desde un inicio. Como parte del estudio de comorbilidades, se decide realizar una prueba del sudor que sale en rango intermedio y más tarde se encuentra una mutación, donde se obtiene un resultado positivo para una copia que se asocia a fibrosis quística. Se revisará el caso, así como el diagnóstico, clínica y tratamiento del síndrome metabólico relacionado con el regulador de conductancia transmembrana de fibrosis quística (CRMS).


We present the case of a 3-year-old boy with a diagnosis of asthma, allergic rhinitis, dysmorphic craniofacial characteristics and recurrent upper and lower respiratory infections, managed as asthma from the beginning. As part of the study of comorbidi-ties, it was decided to carry out a sweat test that came out in the intermediate range and later one mutation was found, where a positive result was obtained for a copy that is associated with cystic fibrosis. The case will be reviewed, as well as the diagnosis, symptoms and treatment of the metabolic syndrome related to the cystic fibrosis trans-membrane conductance regulator (CRMS).


Subject(s)
Humans , Male , Child, Preschool , Asthma/diagnosis , Respiratory Sounds/diagnosis , Cough/diagnosis , Cystic Fibrosis/diagnosis , Metabolic Syndrome/diagnosis , Rhinitis, Allergic/diagnosis , Respiratory Tract Infections , Radiography, Thoracic , Comorbidity , Neonatal Screening , Cystic Fibrosis Transmembrane Conductance Regulator/genetics
4.
Article in English | LILACS | ID: biblio-1529391

ABSTRACT

Abstract Objectives: to estimate the role of maternal overweight and obesity before pregnancy as predictors of childhood asthma in a population of Peruvian children under five years. Methods: we carried out a retrospective cohort study of children aged five years or less and their mothers from the Regional Hospital of Ayacucho and the María Auxiliadora Hospital in Lima, Peru. We included children who were born between 2013 and 2014 and follow them up until 2018 and 2019, respectively. The diagnosis of overweight and obesity of the mother before pregnancy and asthma in the child were registered in their clinical histories. Crude (cRR) and adjusted relative risks (aRR) and 95% confidence intervals (CI95%) were obtained using a generalized lineal model of the Poisson family with link log and robust variances. Results: we evaluated 431 medical records and found that 20.9% of the children had asthma, 26.7% of the mothers were overweight, and 20.2% were obese before pregnancy. In the adjusted regression model, overweight (aRR=2.94; CI95%= 1.54-5.60) and maternal obesity (aRR=5.10; CI95%= 2.73-9.51) were predictors of an increased risk of childhood asthma. Conclusions: maternal overweight and maternal obesity increased the risk of her children developing asthma threeand five-fold, respectively.


Resumen Objetivos: estimar el papel del sobrepeso y la obesidad materna antes del embarazo como predictores de asma infantil en una población de niños peruanos menores de cinco años. Métodos: realizamos un estudio de cohorte retrospectivo de niños de cinco años o menos y sus madres del Hospital Regional de Ayacucho y del Hospital María Auxiliadora de Lima, Perú. Se incluyeron niños nacidos entre 2013 y 2014 y se les dio seguimiento hasta 2018 y 2019, respectivamente. El diagnóstico de sobrepeso y obesidad de la madre antes del embarazo y asma en el niño fueron registrados en sus historias clínicas. Los riesgos relativos crudos (cRR) y ajustados (RRa) y los intervalos de confianza del 95% (IC95%) se obtuvieron mediante un modelo lineal generalizado de la familia de Poisson con log de enlace y varianzas robustas. Resultados: se evaluaron 431 historias clínicas y se encontró que el 20,9% de los niños tenían asma, el 26,7% de las madres tenían sobrepeso y el 20,2% eran obesas antes del embarazo. En el modelo de regresión ajustada, el sobrepeso (aRR=2,94; IC95%= 1,54-5,60) y obesidad materna (RRa=5,10; IC95%= 2,73-9,51) fueron predictores de un mayor riesgo de asma infantil. Conclusiones: el sobrepeso materno y la obesidad materna aumentaron tres y cinco veces el riesgo de que sus hijos desarrollaran asma, respectivamente.


Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Infant , Child, Preschool , Asthma , Risk Factors , Overweight , Obesity, Maternal , Peru , Cohort Studies
5.
Rev. Bras. Saúde Mater. Infant. (Online) ; 24: e20230223, 2024. tab, graf
Article in English | LILACS | ID: biblio-1535104

ABSTRACT

Resumo Objectives: to describe the scientific production of qualitative studies in childhood asthma. Methods: bibliometric analysis. Articles were from Web of Science, Scopus, Cochrane, and PubMed (1996-2018), using the search terms asthma, children, qualitative research, qualitative study, qualitative analysis, ethnographic, phenomenology and narrative. Results: 258 articles were retrieved from 143 journals, representing 1.2% of scientific articles on childhood asthma. The growth rate was high. Authorship included 969 authors (85.3% occasional) from 279 institutions. 94.2% were co-authored and 3.5% were international collaborations. The greatest number of articles were from the United States (45.3%), United Kingdom (17.4%) and Canada (7.4%). The categories with the highest number of articles were Nursing & Public, Environmental & Occupational Health (18.2%), Respiratory System (10.1%) and Allergy (7.7%). 99.7% of the articles were in English. Conclusion: these results show a lack of consolidation of the literature based on qualitative studies on childhood asthma with a high percentage of occasional authors and limited international collaboration, indicating a need to strengthen this approach.


Resumen Objetivos: describir la producción científica de los estudios cualitativos sobre el asma infantil. Métodos: análisis bibliométrico. Los artículos procedían de Web of Science, Scopus, Cochrane y PubMed (1996-2018), utilizando los términos de búsqueda asthma, children, qualitative research, qualitative study, qualitative analysis, ethnographic, phenomenology y narrative. Resultados: se recuperaron 258 artículos de 143 revistas, lo que representa el 1,2% de los artículos científicos sobre asma infantil. La tasa de crecimiento fue elevada. La autoría incluyó 969 autores (85,3% ocasionales) de 279 instituciones. El 94,2% fueron coautores y el 3,5% colaboraciones internacionales. El mayor número de artículos procedió de Estados Unidos (45,3%), Reino Unido (17,4%) y Canadá (7,4%). Las categorías con mayor número de artículos fueron Enfermería y Salud Pública, Ambiental y Ocupacional (18,2%), Aparato Respiratorio (10,1%) y Alergia (7,7%). El 99,7% de los artículos estaban en inglés. Conclusión: estos resultados muestran una falta de consolidación de la literatura basada en estudios cualitativos sobre el asma infantil, con un alto porcentaje de autores ocasionales y una limitada colaboración internacional, lo que indica la necesidad de reforzar este enfoque.


Subject(s)
Humans , Male , Female , Child , Asthma , Bibliometrics , Qualitative Research , Scientific Publication Indicators
6.
Vet. zootec ; 31: 1-20, 2024. ilus, tab
Article in Portuguese | LILACS, VETINDEX | ID: biblio-1552920

ABSTRACT

As doenças respiratórias são consideradas doenças graves e potencialmente deletérias. Dentre elas, a asma e a bronquite crônica caracterizam-se como disfunções respiratórias que ameaçam constantemente o bem-estar dos gatos. Os pacientes apresentam mudanças na estrutura respiratória, reversíveis ou não, devido ao extenso quadro inflamatório, que obstrui o fluxo de ar, permite o acúmulo de muco e reduz o lúmen das vias aéreas. Os gatos acometidos apresentam tosses, respiração ruidosa, dispneia, e, em muitos casos, assumem posição ortopneica. O diagnóstico pode ser obtido através de exames de rotina, uso de radiografias torácicas, coleta e análise de fluidos broncoalveolares, e testes alergênicos. O manejo terapêutico baseia-se, combinado ou não, no uso de drogas como broncodilatadores, antiinflamatórios esteroidais, mucolíticos, antibióticos, agentes inalatórios e mudanças ambientais com objetivo de redução da exposição aos possíveis agentes alergênicos responsáveis pela incitação do quadro respiratório.


Respiratory diseases are considered serious and potentially harmful diseases. Among them, asthma and chronic bronchitis are characterized as respiratory disorders that constantly threaten the well-being of cats. The patients present changes in the respiratory structure, reversible or not, due to the extensive inflammatory condition, which obstructs the air flow, allows the accumulation of mucus and reduces the lumen of the airways. Affected cats have coughs, wheezing, dyspnoea, and in many cases assume an orthopneic position. The diagnosis can be obtained through routine exams, use of chest x-rays, collection and analysis of bronchoalveolar fluids, and allergen testing. Therapeutic management is based, combined or not, on the use of drugs such as bronchodilators, steroidal anti-inflammatory, mucolytics, antibiotics, inhalational agents and environmental changes in order to reduce exposure to possible allergenic agents responsible for the incitation of the respiratory condition.


Las enfermedades respiratorias son consideradas enfermedades graves y potencialmente dañinas. Entre ellos, el asma y la bronquitis crónica se caracterizan por ser trastornos respiratorios que amenazan constantemente el bienestar de los gatos. Los pacientes presentan cambios en la estructura respiratoria, reversibles o no debido al cuadro inflamatorio extenso, que obstruye el flujo de aire, permite la acumulación de moco y reduce la luz de las vías respiratorias. Los gatos afectados presentan tos, respiración ruidosa, disnea y, en muchos casos, adoptan una posición ortopneica. El diagnóstico se puede obtener mediante exámenes de rutina, uso de radiografías de tórax, recolección y análisis de líquidos broncoalveolares, y pruebas de alérgenos. El manejo terapéutico se basa, combinado o no, en el uso de fármacos como broncodilatadores, antiinflamatorios esteroides, mucolíticos, antibióticos, agentes inhalatorios y cambios ambientales con el objetivo de reducir la exposición a posibles agentes alergénicos responsables de incitar la afección respiratoria.


Subject(s)
Animals , Cats , Asthma/pathology , Bronchitis/pathology , Bronchodilator Agents/therapeutic use , Airway Obstruction/veterinary , Anti-Inflammatory Agents/therapeutic use
7.
Respirar (Ciudad Autón. B. Aires) ; 15(4): 235-252, Diciembre 2023.
Article in Spanish | LILACS, UNISALUD, BINACIS | ID: biblio-1518682

ABSTRACT

Introducción: El asma es una patología respiratoria caracterizada por inflamación cró-nica y reversible de las vías aéreas. Esta se asocia con factores de riesgo modificables y no modificables que influyen sobre su control y exacerbaciones. En países como Puer-to Rico y Cuba, la prevalencia del asma es significativamente mayor a la global (22,8%, 23% y 6,6%, respectivamente).


Introduction: Asthma is a respiratory pathology characterized by chronic and reversible airway inflammation. It is associated with modifiable and non-modifiable risk factors that influence its control and exacerbations. In countries such as Puerto Rico (22.8 %) and Cuba (23 %), the prevalence of asthma is significantly higher than the global prevalence (6.6 %).


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Asthma/prevention & control , Therapeutics , Comorbidity , Risk Factors , Dominican Republic , Absenteeism , Symptom Flare Up
8.
Femina ; 51(8): 480-485, 20230830. ilus
Article in Portuguese | LILACS | ID: biblio-1512457

ABSTRACT

Objetivo: Analisar o uso dos contraceptivos hormonais em mulheres com asma e a escolha desses métodos contraceptivos para essa população, com avaliação de eventuais repercussões sobre novos episódios de asma e sibilos. Métodos: Foram selecionados estudos longitudinais, ensaios clínicos, revisões sistemáticas e metanálises. As plataformas consultadas foram PubMed, Embase, Cochrane e SciELO, com a utilização dos descritores: "contracepção", "contracepção hormonal", "sistema intrauterino liberador de levonorgestrel" e "asma". Resultados: Dois grandes estudos demonstraram que o uso de contraceptivos hormonais esteve associado à redução do risco de novos episódios de asma. Uma revisão sistemática concluiu que os resultados para o uso de contraceptivos hormonais para mulheres com asma foram mistos, com aumento ou redução dos seguintes riscos: novo episódio de asma e aumento da frequência das crises e dos sibilos. O uso da contracepção hormonal em pacientes obesas portadoras de asma é controverso. Conclusão: Os resultados para o uso de contraceptivos hormonais em mulheres com asma são inconsistentes, com relatos de aumento ou de redução do risco de novos episódios. O uso do método contraceptivo deve ser discutido individualmente, levando-se em consideração outros fatores de risco associados e o desejo da mulher. A paciente deverá ser orientada se houver piora dos sintomas clínicos de asma na vigência do uso de qualquer método contraceptivo hormonal.


Objective: To analyze the use of hormonal contraceptives in women with asthma and the choice of this contraceptive method for this population, evaluating possible repercussions on new episodes of asthma and wheezing. Methods: Longitudinal studies, clinical trials, systematic reviews and meta-analyses were selected. Platforms consulted: PubMed, Embase, Cochrane, SciELO, using the descriptors: "contraception", "hormonal contraception", "levonorgestrel-releasing intrauterine system" and "asthma". Results: Two large studies demonstrated that the use of hormonal contraceptives was associated with a reduced risk of new episodes of asthma. A systematic review concluded that the results for the use of hormonal contraceptives for women with asthma were mixed, with increased or decrease in the following risks: new asthma episodes, increased frequency and wheezing. The use of hormonal contraception in obese patients with asthma is controversial. Conclusion: The results for the use of hormonal contraceptives in women with asthma are inconsistent, with reports of increased or reduced risk of new episodes. The use of the contraceptive method should be discussed individually, taking into account other associated risk factors and the woman's desire. The patient will be advised if there is a worsening of the clinical symptoms of asthma while using any hormonal contraceptive method.


Subject(s)
Humans , Female , Adolescent , Adult , Asthma/complications , Contraceptive Agents, Hormonal/adverse effects , Contraceptive Agents, Hormonal/therapeutic use , Progesterone/adverse effects , Signs and Symptoms, Respiratory , Chest Pain/diagnosis , Menarche , Respiratory Sounds/diagnosis , Cross-Sectional Studies , Cohort Studies , Longitudinal Studies , Cough/diagnosis , Dyspnea/diagnosis , Estrogens , Systematic Review , Lung/physiopathology
9.
Arch. argent. pediatr ; 121(3): e202202639, jun. 2023. tab
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1435895

ABSTRACT

La dermatitis atópica (DA) es una enfermedad inflamatoria de la piel de alta prevalencia en pediatría, de acuerdo a estudios internacionales. Existe escasa información sobre las características epidemiológicas en la población pediátrica Argentina. El objetivo fue describir la prevalencia y características clínicas de la DA en una población de niños argentinos atendidos en el servicio de pediatría de un hospital general. Estudio observacional, de corte transversal. Se incluyeron 500 pacientes al azar, media de edad de 10 años (DE 5), el 50 % (250) de sexo femenino, de los cuales 24 presentaron DA. La prevalencia global fue del 5 % (IC95 % 3-7) y 3/24 fueron formas graves. La comorbilidad atópica más frecuente fue asma. La DA es una enfermedad con una prevalencia en nuestra población similar a la de otros países. Nuestro estudio aporta nuevos datos acerca de las características epidemiológicas de la dermatitis atópica en nuestra región


Atopic dermatitis (AD) is an inflammatory skin disease highly prevalent in pediatrics as per international studies. There is scarce information on the epidemiological characteristics of AD in the Argentine pediatric population. The objective of this study was to describe the prevalence and clinical characteristics of AD in a population of Argentine children seen at the Department of Pediatrics of a general hospital. Observational, cross-sectional study. Five hundred patients were randomly included; their mean age was 10 years (SD: 5); 50% (250) were female. A total of 24 had AD. The overall prevalence was 5% (95% confidence interval: 3­7) and 3/24 were severe forms. The most frequent atopic comorbidity was asthma. The prevalence of AD in our population is similar to that of other countries. Our study provides new data on the epidemiological characteristics of AD in our region.


Subject(s)
Humans , Child , Asthma/epidemiology , Dermatitis, Atopic/epidemiology , Prevalence , Cross-Sectional Studies , Hospitals, General
10.
Respirar (Ciudad Autón. B. Aires) ; 15(2): 81-87, jun2023.
Article in Spanish | LILACS | ID: biblio-1437510

ABSTRACT

Introducción: la evidencia de vida real muestra deficiencias en alcanzar los objetivos de control del asma, con elevado consumo de agonistas beta-2 de acción corta (SA-BA) y sobreuso de corticoides sistémicos (CS). Métodos: estudio observacional, des-criptivo, aplicando la herramienta ReferID con 4 preguntas para identificar pacientes con asma no controlada y/o en riesgo de crisis severas: en los últimos 12 meses [1] ¿Re-cibió ≥2 ciclos de CS y/o los usó como mantenimiento?; [2] ¿Tuvo ≥2 visitas a emergen-cias por asma?; [3] ¿Estuvo intubado o en Unidad de Cuidados Intensivos (UCI) por as-ma?; [4] ¿Cuántos inhaladores de SABA ha utilizado? Una respuesta afirmativa a las preguntas 1, 2 o 3, o usar ≥3 envases de SABA, sugieren riesgo de ataque grave, nece-sidad de CS y/o riesgo vital. En estos pacientes se recomienda evaluación por especia-listas. Resultados: participaron 441 pacientes de 7 instituciones del Área Metropolita-na de Buenos Aires. Al 60,1% (intervalo de confianza del 95% [IC95]:55,5%-64,7%) se le recomendó evaluación por especialista. El 33,8% (IC95:29,39%-38,21%) recibió ≥2 ciclos de CS y/o los usaba como mantenimiento. El 36,1% (IC95:31,62%-40,58%) asis-tió ≥2 veces a emergencias. El 41,5% (IC95:30,06%-38,94%) usó ≥3 envases de SABA. El 8,8% (IC95:6,16%-11,44%) tenía historia de intubación o UCI. El 37,2% se atendió en instituciones públicas, con indicadores de gravedad significativamente mayores que en las privadas. Conclusiones: ReferID es una herramienta simple que ayuda a identificar a pacientes en riesgo de crisis severa y/o que pudieran tener diagnóstico de asma gra-ve; y que se beneficiarían de una evaluación por un especialista. AU


Introduction: real-life evidence shows deficiencies in achieving asthma control goals, with high use of short-acting beta-2 agonists (SABA) and overuse of systemic cortico-steroids (SC). Methods: observational, descriptive study, applying the ReferID tool with 4 questions to identify patients with uncontrolled asthma and/or at risk of severe crisis: in the last 12 months [1] Have you received ≥2 cycles of CS and/or used them as main-tenance therapy?; [2] Have you had ≥2 emergency visits for asthma?; [3] Have you ever been intubated or admitted to the Intensive Care Unit (ICU) for asthma?; [4] How many SABA inhalers have you used? An affirmative answer to questions 1, 2 or 3, or using ≥3 canisters of SABA, suggests risk of severe attack, need for CS and/or life-threatening risk. In these patients, evaluation by specialists is recommended. Results: 441 patients from 7 institutions in the Metropolitan Area of Buenos Aires were enrolled. An evalu-ation by specialists was recommended for 60.1% (95% confidence interval [95%CI]: 55.5%-64.7%); 33.8% (95%CI:29.39%-38.21%) received ≥2 cycles of CS and/or used them as maintenance; 36.1% (95%CI:31.62%-40.58%) attended ≥2 times to the emer-gency department; 41.5% (95%CI:30.06%-38.94%) used ≥3 containers of SABA; 8.8% (95%CI:6.16%-11.44%) had a history of intubation or ICU admission; 37.2% were as-sisted in public institutions, with significantly higher severity indicators than in private ones. Conclusions: Refer ID is a simple, useful tool to quickly identify asthma patients who are at risk of severe exacerbations and/or may have a diagnosis of severe asthma and would benefit from evaluation by a specialist. AU


Subject(s)
Humans , Primary Health Care , Asthma/diagnosis , Surveys and Questionnaires , Argentina , Referral and Consultation , Patient Outcome Assessment
12.
Arch. argent. pediatr ; 121(2): e202202894, abr. 2023. tab
Article in Spanish | LILACS, BINACIS | ID: biblio-1425155

ABSTRACT

La rinitis alérgica (RA) es una de las enfermedades crónicas más frecuentes de la infancia. Sin embargo, permanece subdiagnosticada y subtratada. Su prevalencia ha aumentado en los últimos años y varía del 2 % al 25 %. Los síntomas de la RA incluyen estornudos, prurito, rinorrea y congestión nasal. Un correcto diagnóstico y tratamiento de la RA y sus comorbilidades, tales como rinosinusitis con o sin poliposis nasal, conjuntivitis, otitis media, asma bronquial e infecciones del tracto respiratorio, son importantes para reducir el impacto negativo en la afectación de la calidad de vida del paciente y sus familiares, y los gastos sanitarios que ocasiona. La inmunoterapia alérgeno específica, en pacientes correctamente seleccionados, previene nuevas sensibilizaciones y reduce la hiperreactividad bronquial asociada a la RA. Considerando todos estos factores, el Comité Nacional de Alergia de la Sociedad Argentina de Pediatría propone recomendaciones basadas en la evidencia actual.


Allergic rhinitis (AR) is one of the most common chronic diseases in children. However, it remains underdiagnosed and undertreated. Its prevalence has increased in recent years and varies from 2 to 25 %. Symptoms include sneezing, itching, runny nose, and nasal congestion. A correct diagnosis and treatment of AR and its comorbidities such as rhinosinusitis with or without nasal polyposis, conjunctivitis, otitis media, bronchial asthma and respiratory tract infections, are important to reduce the negative impact on the quality of life of the patient and their relatives, and in medical costs. Specific allergen immunotherapy, in correctly selected patients, prevents new sensitizations and reduces bronchial hyperreactivity associated with AR. Taking into account all these reasons, the National Allergy Committee of the Sociedad Argentina de Pediatría proposes current evidence based recommendations


Subject(s)
Humans , Child , Pediatrics , Asthma/complications , Rhinitis/complications , Rhinitis, Allergic, Perennial/diagnosis , Rhinitis, Allergic, Perennial/therapy , Rhinitis, Allergic, Perennial/epidemiology , Rhinitis, Allergic/diagnosis , Rhinitis, Allergic/therapy , Rhinitis, Allergic/epidemiology , Quality of Life
13.
Rev. cient. cienc. salud ; 5(1): 1-9, 26-01-2023.
Article in Spanish | LILACS, BDNPAR | ID: biblio-1437663

ABSTRACT

Introducción:Escasos reportes sobre asma existen en la literatura nacional. El objetivo delestudio es describir ciertas características clínicas, las comorbilidades y el riesgo para apnea obstructiva del sueño (AOS) en este colectivo. Material y métodos:Mediante un estudio observacional tipo caso-control, se incluyeron pacientes portadores de asma de ambos sexos y un grupo control pareado por sexo y edad. Se consignaron datos demográficos, características de la enfermedad, datos relativos al control del asma y espirometría, comorbilidades y riesgo de apnea de sueño medido por el cuestionario STOP-BANG durante una entrevista estructurada. Resultados: Se incluyeron 132 individuos en el grupo caso y 132 en el grupo control. Entre los asmáticos, se consignaron 38,63% de formas no controladas y 9% severas. También se constató mayor frecuencia dehipertensión arterial, obesidad, rinitis alérgicay trastornos de la memoria. Riesgo mayor para AOS, aunque no significativo, se consignó en el grupo de casos. En el subgrupo de asmáticos con obesidad o en adultos mayores, la diferencia fue estadísticamente significativa-Discusión:Aundisponiendo de medicamentos preventivos,la tasa de control de los asmáticos en esta muestra es llamativa y merece estudios sistemáticos. Es extremadamente importante tener en cuenta algunas comorbilidades para el manejo de este grupo de pacientes,incluyendo la estratificación de riesgo para AOS.Palabras clave:asma; comorbilidad; apnea obstructiva del sueño


Introduction.Few reports on asthma exist in the national literature. The objective of our study is to describe certain clinical characteristics, comorbidities, and risk for obstructive sleep apnea (OSA) in this group. Material and methods.Through an observational case-control study, patients with asthma of both sexes and a control group matched by sex and age were included. Demographic data, disease characteristics, data related to asthma control and spirometry, comorbidities, and risk of sleep apnea measured by the STOP-BANG questionnaire were recorded during a structured interview. Results.132 individuals were included in the case group and 132 in the control group. Among the asthmatics, 38.63% of uncontrolled forms and 9% were severe. There was also a higher frequency of arterial hypertension, obesity, allergic rhinitis and memory disorders. Higher risk for OSA, although not significant, was recorded in the case group. In the subgroup of asthmatics with obesity or in older adults, the difference was relevant to the statistical analysis. Discussion.Even with preventive medications available, the control rate of asthmatics in this sample is striking and deserves systematic studies. It is extremely important to take into account some comorbidities for the management ofthis group of patients, including risk stratification for OSA.Key Words:asthma; comorbidity;obstructive sleep apnea


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Asthma , Comorbidity , Sleep Apnea, Obstructive
14.
San Salvador; MINSAL; ene. 06, 2023. 117 p. ilus, graf.
Non-conventional in Spanish | BISSAL, LILACS | ID: biblio-1412600

ABSTRACT

Las enfermedades respiratorias crónicas golpean los sistemas de salud por los altos costos que se derivan por la atención de pacientes en los diferentes estadios de estas enfermedades, en particular aquellas etapas en las que las personas se encuentran con múltiples afecciones provocadas o sumadas por el desarrollo de las enfermedades respiratorias crónicas. Con el fin de mejorar la atención de los pacientes con enfermedades respiratorias crónicas priorizadas; y brindar al personal de salud una herramienta técnico-científica para estandarizar la identificación, diagnóstico y tratamiento de las personas mayores de 12 años, la Unidad de Prevención y Control de la Tuberculosis y Enfermedades Respiratorias, ha elaborado el presente documento, el cual será de mucha utilidad en los diferentes niveles de atención, para brindar una atención de calidad a los pacientes con enfermedades respiratorias crónicas. En su contenido se integran instrucciones para la atención del asma y la Enfermedad Pulmonar Obstructiva Crónica (EPOC), con un abordaje clínico terapéutico más actualizado, para que puedan darse las atenciones en los establecimientos del Sistema Nacional Integrado de Salud (SNIS), así como las actividades educativas que permitan incidir en la prevención de estas enfermedades


Chronic respiratory diseases hit health systems due to the high costs derived from the care of patients in the different stages of these diseases, particularly those stages in which people have multiple conditions caused or added by the development of chronic respiratory diseases. In order to improve the care of patients with prioritized chronic respiratory diseases; and provide health personnel with a technical-scientific tool to standardize the identification, diagnosis and treatment of people over 12 years of age, the Unit for the Prevention and Control of Tuberculosis and Respiratory Diseases has prepared this document, which will be of very useful at different levels of care, to provide quality care to patients with chronic respiratory diseases. Its content includes instructions for the care of asthma and Chronic Obstructive Pulmonary Disease (COPD), with a more up-to-date clinical-therapeutic approach, so that care can be given in the establishments of the National Integrated Health System (SNIS), as well as educational activities that make it possible to influence the prevention of these diseases


Subject(s)
Respiratory Tract Diseases , Asthma , Pulmonary Disease, Chronic Obstructive , Health Systems , El Salvador
15.
Rev. Esc. Enferm. USP ; 57: e20220329, 2023. tab, graf
Article in English, Portuguese | LILACS, BDENF | ID: biblio-1440978

ABSTRACT

ABSTRACT Objective: To analyze the knowledge of Primary Education teachers regarding asthma and learn about their experiences with the exacerbation of symptoms at school. Method: Sequential explanatory mixed study. In the quantitative stage, the Newcastle Asthma Knowledge Questionnaire and the characterization instrument were applied. Data analyzed by descriptive and inferential statistics. The production of qualitative data occurred from written statements analyzed using the deductive content analysis method. Results: Two hundred and seven teachers, mostly women (92%) and working in public schools (82%). As for knowledge, 132 (63.8%) had unsatisfactory performance. The questions with the lowest rates of correct answers were about medications used regularly and during the attacks. Teachers with higher scores had less time in the occupation (p = 0.017) and had been diagnosed with asthma (p = 0.006). In the qualitative stage, 35 teachers participated and the statements corroborated the quantitative findings, especially in relation to the knowledge gap and feeling of greater safety among asthmatic teachers. Conclusion: Teachers showed insufficient knowledge and reported fear and unpreparedness in the face of the situation.


RESUMEN Objetivo: Analizar el conocimiento de docentes de Educación Básica sobre el asma y conocer sus experiencias con la agudización de los síntomas en la escuela. Método: Estudio mixto del tipo explicativo secuencial. En la etapa cuantitativa, el Newcastle Asthma Knowledge Questionnaire y el instrumento de caracterización fueron aplicados. Datos fueron analizados por estadística descriptiva e inferencial. La producción de datos cualitativos se basó en declaraciones escritas analizadas utilizando el método de análisis de contenido deductivo. Resultados: Doscientos siete docentes, en su mayoría mujeres el 92%) y trabajando en escuelas públicas (el 82%). En cuanto al conocimiento, 132 (el 63,8%) tuvieron desempeño insatisfactorio. Las preguntas con las tasas más bajas de respuestas correctas fueron sobre medicamentos utilizados regularmente y durante la crisis. Los docentes con puntajes más altos tenían menos tiempo de trabajo (p = 0,017) y habían sido diagnosticados con asma (p = 0,006). En la etapa cualitativa participaron 35 docentes y las declaraciones corroboraron los hallazgos cuantitativos, especialmente en relación a la brecha de conocimiento y sensación de mayor seguridad entre los docentes asmáticos. Conclusión: Los docentes tenían conocimientos insuficientes y relataron temor y falta de preparación ante la situación.


RESUMO Objetivo: Analisar o conhecimento de professores da Educação Básica com relação à asma e conhecer suas vivências diante da exacerbação dos sintomas na escola. Método: Estudo misto do tipo explanatório sequencial. Na etapa quantitativa, foi aplicado remotamente o Newcastle Asthma Knowledge Questionnaire e o instrumento de caracterização. Dados analisados por estatística descritiva e inferencial. A produção dos dados qualitativos ocorreu a partir de depoimentos escritos analisados pelo método de análise de conteúdo dedutivo. Resultados: Duzentos e sete professores, maioria do sexo feminino (92%) e atuante em escolas públicas (82%). Quanto ao conhecimento, 132 (63,8%) apresentaram desempenho insatisfatório. As questões com menores índices de acerto eram sobre medicamentos utilizados regularmente e na crise. Os professores com maiores pontuações tinham menor tempo de atuação (p = 0,017) e possuíam diagnóstico de asma (p = 0,006). Na etapa qualitativa, participaram 35 professores e os depoimentos corroboraram os achados quantitativos, sobretudo com relação à lacuna de conhecimento e sentimento de maior segurança entre os professores asmáticos. Conclusão: Os professores apresentaram conhecimento insuficiente e relataram medo e despreparo frente à situação.


Subject(s)
Child Health , Nursing , Asthma , Educational Personnel
16.
Braz. J. Pharm. Sci. (Online) ; 59: e21115, 2023. tab
Article in English | LILACS | ID: biblio-1429953

ABSTRACT

Abstract For asthma treatment in children, caregivers need good knowledge and attitudes regarding the disease and its treatment. This study aimed to determine the impact of cultural factors, the level of health education provided to patients and their families, as well as the impact of stigmatization on the treatment awareness of children with asthma in southern Jordan. A validated questionnaire was used to collect data from a sample of ninety-seven caregivers selected from three hospitals in southern Jordan. Open ended questions were answered after demonstrating the inhaler technique in and evaluated according to the instructions of the National Asthma Education and Prevention Program (NAEPP, 2013). The result revealed moderate knowledge of asthma with a mean score of (22.36/32), as well as moderate knowledge of asthma treatment (24.26/40). A high mean was found for the impact of cultural and environmental factors (22.93/28), whereas low impact was found for stigma with a mean value of (4.73/12). Therefore, to improve future asthma management, additional efforts are required to educate caregivers and improve their asthma awareness and rectify any falsehoods regarding asthma medications by health care providers.


Subject(s)
Humans , Male , Female , Asthma/drug therapy , Child , Health Education/classification , Cultural Factors , Jordan/ethnology , Awareness/ethics , Pharmaceutical Preparations/administration & dosage , Christianity , Caregivers/ethics , Hospitals/standards
17.
Acta Medica Philippina ; : 32-38, 2023.
Article in English | WPRIM | ID: wpr-1003631

ABSTRACT

Background and Objectives@#Oral candidiasis (OC) is a well-known local side effect of inhaled corticosteroid (ICS) therapy in patients with asthma and chronic obstructive pulmonary disease (COPD). This study aimed to determine the prevalence of OC and its association with ICS-related factors in out-patient asthma and COPD patients of the Departments of Pulmonology and Pediatric Pulmonology of the Philippine General Hospital (PGH).@*Methods@#This is a cross-sectional study conducted from October 2019 to January 2020. Data was collected through a two-part questionnaire accomplished by doctors and patients with asthma or COPD. Results. A total of 67 patients were included in the study. Oral candidiasis was observed in 4 (5.97%) ICS users, and the prevalence was 1.65% to 14.59% (95% CI, SE: 0.028946).@*Conclusion@#This study determined the prevalence of oral candidiasis in asthma and COPD patients and its association with ICS-related factors, including the dosage, medication, device, and duration of therapy. The prevalence of OC in ICS users in PGH cannot be interpreted as high or low due to the small number of respondents, but is consistent with OC prevalence found in related literature. Increased prevalence was observed in adult females with asthma under low dose ICS therapy with Fluticasone/Salmeterol DPI for more than a year. There was no statistically significant correlation among OC prevalence, age, sex, and components of ICS-therapy including dosage, medication, device, frequency, and duration of therapy. A large-scale study is recommended for more accurate assessment of OC prevalence in the population and to determine statistically significant associations among the factors. It is also recommended to quantifiably measure patient compliance, inhalation technique and instruction, and its association to OC prevalence. Findings may be used to strengthen patient education, preventive measures, and disease management to facilitate improved compliance and effective treatment outcomes.


Subject(s)
Candidiasis, Oral , Adrenal Cortex Hormones , Asthma , Pulmonary Disease, Chronic Obstructive
18.
Acta Medica Philippina ; : 12-24, 2023.
Article in English | WPRIM | ID: wpr-998835

ABSTRACT

Objectives@#As asthma is a chronic inflammatory disease of the airways, anti-inflammatory treatment should be positioned at the forefront of guideline-directed asthma care. However, patients tend to rely on short-acting β2-agonists (SABAs) for rapid-onset symptom relief. The impact of SABA overuse and associated clinical outcomes have been investigated extensively in Europe and North America. Limited data are available from countries in Asia, Africa, Latin America, and the Middle East. The SABA use IN Asthma (SABINA) III program, a large multicountry, observational study, was undertaken to describe the global extent of SABA use and its potential contribution to suboptimal disease control. As part of the SABINA III study, we aimed to characterize SABA prescription collection and asthma-related clinical outcomes among patients in the Philippines.@*Methods@#This nationwide, observational, cross-sectional, SABINA III study included patients (aged ≥12 years) with a documented asthma diagnosis recruited between May 2019 and January 2020 from 10 sites in the Philippines. Demographics, disease characteristics and prescribed asthma treatments, including SABA and inhaled corticosteroids (ICS) in the 12 months preceding study start, were recorded during a single visit, and transcribed onto an electronic case report form (eCRF). Patients were classified by investigator-defined asthma severity, guided by the 2017 Global Initiative for Asthma (GINA) report and practice type, either primary or pulmonary medicine specialist care.@*Results@#Of 245 patients analyzed, 63.3% were classified as having moderate-to-severe asthma (GINA steps 3−5), and most patients (63.3%) were enrolled by pulmonary medicine specialists. Overall, 33.1% (n=81) of patients had experienced ≥1 severe exacerbation in the previous 12 months and 18.4% (n=45) of patients had uncontrolled asthma. With respect to asthma treatments, a total of 6.5% (n=16), 40.4% (n=99), and 2.4% (n=6) of patients were prescribed SABA monotherapy, SABA in addition to maintenance therapy, and ICS, respectively, in the 12 months prior to their study visit. Most patients (n=156 [63.7%]) received prescriptions of fixed-dose combina-tions of ICS and long-acting β2-agonists. SABA over-prescription, defined as ≥3 SABA canister prescriptions per year, was observed in 10.6% (n=21) of patients. Additionally, 25.6% (n=23) of patients classified as having mild asthma were prescribed either nebulized SABA (n=17) or oral SABA (n=6). Nearly one-third of patients (n=75 [30.6%]) had purchased over-the-counter (OTC) SABA, and 46.9% (n=115) were prescribed antibiotics.@*Conclusions@#In this SABINA III Philippines study cohort, more than 10% of patients were over-prescribed SABA canisters. Additionally, prescriptions for oral or nebulized SABA, the purchase of non-prescription (OTC) SABA, and the high percentage of prescriptions for antibiotics warrant country-wide improvements in asthma care and management.


Subject(s)
Asthma , Bronchodilator Agents , Philippines , Prescriptions
19.
Chinese Medical Journal ; (24): 1949-1958, 2023.
Article in English | WPRIM | ID: wpr-980980

ABSTRACT

BACKGROUND@#Previous research demonstrated that a homozygous mutation of g.136372044G>A (S12N) in caspase recruitment domain family member 9 ( CARD9 ) is critical for producing Aspergillus fumigatus -induced ( Af -induced) T helper 2 (T H 2)-mediated responses in allergic bronchopulmonary aspergillosis (ABPA). However, it remains unclear whether the CARD9S12N mutation, especially the heterozygous occurrence, predisposes the host to ABPA.@*METHODS@#A total of 61 ABPA patients and 264 controls (including 156 healthy controls and 108 asthma patients) were recruited for sequencing the CARD9 locus to clarify whether patients with this heterozygous single-nucleotide polymorphisms are predisposed to the development of ABPA. A series of in vivo and in vitro experiments, such as quantitative real-time polymerase chain reaction, flow cytometry, and RNA isolation and quantification, were used to illuminate the involved mechanism of the disease.@*RESULTS@#The presence of the p.S12N mutation was associated with a significant risk of ABPA in ABPA patients when compared with healthy controls and asthma patients, regardless of Aspergillus sensitivity. Relative to healthy controls without relevant allergies, the mutation of p.S12N was associated with a significant risk of ABPA (OR: 2.69 and 4.17 for GA and AA genotypes, P = 0.003 and 0.029, respectively). Compared with patients with asthma, ABPA patients had a significantly higher heterozygous mutation (GA genotype), indicating that p.S12N might be a significant ABPA-susceptibility locus ( aspergillus sensitized asthma: OR: 3.02, P = 0.009; aspergillus unsensitized asthma: OR: 2.94, P = 0.005). The mutant allele was preferentially expressed in ABPA patients with heterozygous CARD9S12N , which contributes to its functional alterations to facilitate Af -induced T H 2-mediated ABPA development. In terms of mechanism, Card9 wild-type ( Card9WT ) expression levels decreased significantly due to Af -induced decay of its messenger RNA compared to the heterozygous Card9S12N . In addition, ABPA patients with heterozygous CARD9S12N had increased Af -induced interleukin-5 production.@*CONCLUSION@#Our study provides the genetic evidence showing that the heterozygous mutation of CARD9S12N , followed by allele expression imbalance of CARD9S12N , facilitates the development of ABPA.


Subject(s)
Humans , Aspergillosis, Allergic Bronchopulmonary/complications , Aspergillus fumigatus/genetics , Asthma/genetics , Aspergillus , Mutation/genetics , CARD Signaling Adaptor Proteins/genetics
20.
Chinese Medical Journal ; (24): 1923-1928, 2023.
Article in English | WPRIM | ID: wpr-980979

ABSTRACT

The burden of chronic airway diseases, including chronic obstructive pulmonary disease (COPD), continues to increase, especially in low- and middle-income countries. Post-tuberculosis lung disease (PTLD) is characterized by chronic lung changes after the "cure" of pulmonary tuberculosis (TB), which may be associated with the pathogenesis of COPD. However, data on its prevalence, clinical manifestations, computed tomography features, patterns of lung function impairment, and influencing factors are limited. The pathogenic mechanisms underlying PTLD remain to be elucidated. This review summarizes the recent advances in PTLD and TB-associated COPD. Research is urgently needed both for the prevention and management of PTLD.


Subject(s)
Humans , Pulmonary Disease, Chronic Obstructive , Tuberculosis, Pulmonary/complications , Asthma , Tomography, X-Ray Computed/methods , Lung
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