Evaluation of the prevalence of asthma and chronic obstructive pulmonary disease among opium users, and cigarette smokers and comparison with normal population in Kharameh: a cross-sectional study.

BACKGROUND: Recent studies have suggested that opium use may increase mortality from pulmonary diseases. However, there are limited comprehensive studies regarding the prevalence of Asthma and Chronic Obstructive Pulmonary Disease (COPD) among tobacco and opium users has been published. We aimed to determine the prevalence of respiratory disease among tobacco and opium users. METHODS: This cross-sectional study of tobacco and opium users and matched controls was conducted in the Kharameh Cohort, Fars, Iran. The prevalence of COPD and asthma, along with the participants demographical and spirometry data were examined. RESULTS: The average age of participants was 57 ± 8 years. Never smokers had a significant higher BMI (26.6 vs. 24.8), FEV1 (91% vs. 82%) and FVC (96% vs. 88%) values compared to participants with a positive smoking status. There was a statistical difference in the prevalence of COPD, asthma, and asthma COPD overlap (ACO) based on the participants smoking status, with the highest prevalence among opium and cigarette smokers, followed by opium users alone. Based on multivariate analysis, higher age, lower BMI, lower education than under diploma, cigarette smoking and opium use were significantly correlated with higher COPD prevalence; while lower age, cigarette smoking and opium use were significantly correlated with higher asthma prevalence. Illiterate participants had a significantly higher prevalence of COPD (23.6%), asthma (22%), and ACO (7.9%) among the educational groups. Regarding the prevalence of asthma, the higher socio-economic group had the lowest prevalence. CONCLUSIONS: Opium and tobacco users had a significantly higher prevalence of respiratory diseases, along with lower lung function tests based on spirometry evaluation.

A survey of the training and working arrangements of general practitioners providing asthma and chronic obstructive pulmonary disease care in a rural area of Maharashtra State.

Background: Chronic respiratory diseases (CRD), especially asthma and chronic obstructive pulmonary disease (COPD), are common public health problems resulting in a substantial burden of disease for individuals. There is a need to understand the perceptions and practices of primary care physicians ("general practitioners [GPs]") who provide most of the health care in rural India. We surveyed all private and public practitioners listed as practising in a rural area of Western India with the aim of identifying GPs (GPs: graduates, registered and allowed to practice in India) to understand their training, working arrangements, and asthma/COPD workload. Methodology: We administered a short questionnaire at educational meetings or via e-mail to all private and public practitioners listed as providing community-based services in the Junnar block, Pune district, Maharashtra. The survey asked about qualifications, experience, and working arrangements, and about current asthma and COPD workload. A descriptive analysis was performed. Results: We approached 474 practitioners (434 from private sector and 40 from public sector). Eighty-eight were no longer practising in the study area. The response rate was 330/354 (93.2%) of private and 28/32 (87.5%) of public sector practitioners. We excluded 135 nonrespiratory hospital specialists and 23 private practitioners whose highest qualification was a diploma. Our final sample of 200 GPs (70% males) was 177 from private sector and 23 from public sector. The private GPs had more experience in clinical practice in comparison to public GPs (18.6 vs. 12.8 years). Eighty-four percent of GPs from the private sector only had Ayurveda, Yoga, Naturopathy, Unani, Siddha, and Homoeopathy (AYUSH) qualifications, though >90% provided "modern medicine" services. In the public sector, 43.5% GPs only had AYUSH qualifications, though all provided "modern medicine" services. A minority (9% of private GPs and 16% of public GPs) provided both services. Nearly two-thirds (62%) of private GPs had inpatient facilities compared to only 9% of public sector GPs. In both sectors, more GPs stated that they managed people with asthma than treated COPD (Private: 97% vs. 75%; Public 87% vs. 57%). Conclusion: Many GPs practising "modern medicine" only had qualifications in Ayurveda/Homeopathy and fewer GPs are involved in the management of COPD as compared to asthma. These are important factors that form the context for initiatives seeking to improve the quality of community-based care for people with CRD in Maharashtra state in India.

Asthmatic patient's preferences regarding frequency of physician consultation.

BACKGROUND & OBJECTIVE: To identify patient's factors from their clinical picture and demographics, and recognize their association and influence on frequency of physician visit. METHOD: Study was conducted in Karachi from January - December 2019. Primary data was collected from 255 asthmatic patients that visited different hospitals, homeopathic and herbal clinics. Questionnaire included patient's demographic details, treatment choice for asthma and satisfaction level with different treatments. Collected data was analyzed by SPSS 20. RESULT: Among 255 asthmatic patients, 101 visited 5 - 7 times to physician from the past year, 48 visited 8-10 times and 27 went to physician more than 10 times in past 12 months. While 30 patients did not visit the physician even once and only 20 patients visited 1-2 times in the last year. From clinical factors, association of severity (p = 0.0001), limitation (p = 0.0001) and side effects (p = 0.003) with physician visit were found to be statistically significant. In addition, among demographics, age (p = 0.004), education (p = 0.0001), income (p = 0.0001) and having pets (p = 0.007) were found to be significant factors associated with physician visit for asthma in the past year. CONCLUSION: Most of the asthmatic patients covered in the study visited the physician more than five times during the last year and chose allopathic treatment for asthma. Age, education, severity and side effects of asthma treatment were some of the significant factors associated with physician visit. Patients with frequent follow up visits to the physician were satisfied with their treatment.

Evaluation of the efficacy of isopathic immunotherapy in the treatment of allergic asthma in BALB/C mice.

Introduction: Homeopathy is a therapeutic method based on the fundamental principle of "like cures like." Homeopathic remedies are extremely dilute but involve vigorous shaking at each dilution. Isopathy is one approach of homeopathy, in which the causative agents or products of a disease are used to treat the same disease. Allergen immunotherapy is the only potential disease-modifying treatment for allergic patients. Subcutaneous immunotherapy is more effective than sublingual immunotherapy. However, subcutaneous immunotherapy is ineffective at a low dose, whereas at high doses it can result in an unacceptably high frequency of systemic reactions. In the current study, we evaluated the efficacy of isopathic immunotherapy with highly diluted ovalbumin (HD OVA) in the treatment of OVA-induced allergic asthma in BALB/c mice.Methods: BALB/c mice were sensitized with OVA and alum. Two weeks later, the mice received HD OVA on days 21, 22, 32 and 41 (8 h after the last challenge) of the treatment. The mice were challenged with OVA (5%) aerosols on days 35, 38 and 41 for 20 minutes using an ultrasonic nebulizer and sacrificed the next day.Results: Isopathic immunotherapy significantly reduced lung tissue inflammation, the number of eosinophils in bronchoalveolar fluid, allergen-specific IgE and interleukin-4 production. It also insignificantly increased the production of transforming growth factor-beta and proliferation of regulatory T cells against the allergen.Conclusion: Isopathic immunotherapy may be a good candidate treatment for allergic asthma.

Homeopathic therapy in pediatric atopic diseases: short- and long-term results.

AIM: To study the outcomes of atopic diseases in children treated with homeopathy at the Homeopathic Clinic of Lucca (Italy) and related long-term results after approximately an 8-year period. MATERIALS AND METHODS: Our data derive from an observational longitudinal study carried out on 857 pediatric patients who consecutive visited from 1998 to 2014. Children with atopic diseases were 325 (37.9%), 126 (39%) suffered from atopic dermatitis, 72 (22%) from allergic rhinitis, and 127 (39%) from asthma. Moreover, a long-term study was conducted on a subset of 107/165 patients, consecutively visited from 1998 to 2006, and with ≥5 years follow-up. The study also investigated the evolution of overall symptoms in those patients with a complex atopic symptomatology. RESULTS: 75.8% of atopic children had moderate or major improvement (67.1% with asthma as the primary disease; 84.2% rhinitis; 84.2% dermatitis). At re-evaluation after 5-10 years, complete remission of atopic symptoms was obtained in 70.1% of the children: 84.2% in dermatitis; 48.1% in allergic rhinitis; 71.4% in asthma. Children with two or three atopic diseases at the first visit were completely cured in 40% of cases. CONCLUSION: The results seem to confirm that homeopathic medicine produces positive therapeutic response in atopic children.

Persons with allergy symptoms use alternative medicine more often.

INTRODUCTION: The aim of the study is to indicate the relation between the use of alternative medicine and the occurrence of allergic diseases in the Polish population of adults in the age of 20-44 years. Moreover the additional aim of the study is to define the relation between the sex, age and place of living and the use of alternative medicine. MATERIAL AND METHODS: The data from the project Epidemiology of Allergic Diseases in Poland (ECAP) has been used for analysis. This project was a continuation of the European Community Respiratory Health Survey II. The questions on alternative medicine were asked to the group of 4671 respondents in the age of 20-44 years. Additionally outpatient tests were performed in order to confirm the diagnosis of allergic diseases. RESULTS: The total of 22.2% of respondents that participated in the study have ever used alternative medicine (n = 4621). A statistically significant relation between the use of alternative medicine and declaration of allergic diseases and asthma symptoms has been demonstrated (p < 0.001). No statistically significant relation between the use of alternative medicine by persons diagnosed by a doctor with any form of asthma or seasonal allergic rhinitis (p > 0.05) has been demonstrated. CONCLUSIONS: The occurrence of allergic diseases and asthma influences the frequency of alternative medicine use. However the frequency of alternative medicine use does not depend on allergic disease or asthma being confirmed by a doctor.

A Review on Comparison of Allopathic Medicines to other Drug Therapies in the Management of Asthma.

Asthma, is a chronic disease of the airways and is characterized by exacerbations of bronchospasm and noticeable airway inflammation. Current asthma therapy has emerged from naturally occurring compounds through rational pharmaceutical advancements, and it is very beneficial. In this review, we have discussed the different drug therapies i.e., Ayurvedic, Homeopathic, Unani, and Allopathic affecting asthma treatment. Allopathic medicines are used as a controller medication for regular maintenance of asthma i.e., long-acting ß-agonists, inhaled corticosteroids, anti-leukotriene medicines, and novel biologic agents. Pharmacological research is more important in generating effective, long-lasting, and safe asthma treatments, but it has been difficult to produce new classes of anti-asthmatic therapies. A combination inhaler that contains a long-acting ß2-agonist and a corticosteroid is currently the "gold standard" for treating asthma. Allopathic treatments for asthma have been proven effective in reducing the probability of asthma attacks and for improving symptoms along with lung functions as compared to other therapies. The level of asthma management and the possible risk of future worsening are used to determine the treatment's strategies. This review article describes the comparison of allopathic therapy of asthma with homeopathy, ayurvedic and Unani system and gives justification supported by a number of case studies for being allopathic, a better therapy when compared with others.

Trends in the Use of Complementary and Alternative Therapies among US Adults with Current Asthma.

Complementary and Alternative Medicines/Therapies (CAM) are commonly used by US asthma adults, yet little is known about recent trends in their use. Our aim was to report trends in CAM use among US adults with current asthma. We conducted a serial cross-sectional study using nationally representative data from the BRFSS Asthma Call-Back Survey (ACBS) collected between 2008 and 2019 (sample size per cycle, 8222 to 14,227). The exposure was calendar time, as represented by ACBS cycle, while the main outcomes were use of at least one CAM and eleven alternative therapies. We analyzed CAM use overall and by population subgroups based on age, gender, race/ethnicity, income, and daytime and night-time asthma symptoms. Our findings show that there was an increase in the use of at least one CAM from 41.3% in 2008 to 47.9% in 2019 (p-trend < 0.001) and an upward trend in the use of herbs, aromatherapy, yoga, breathing exercises, homeopathy, and naturopathy (p-trend < 0.05). However, the use of vitamins, acupuncture, acupressure, reflexology, and other CAM therapies remained stable (p-trend > 0.05). These trends varied according to population characteristics (age, sex, race, income) and asthma symptoms. In conclusion, our study suggests that CAM use among US adults with current asthma is either increasing or stable, and further studies are needed to explore the factors influencing these trends.

The treatment of asthma using the Chinese Materia Medica.

ETHNOPHARMACOLOGICAL RELEVANCE: Asthma is a costly global health problem that negatively influences the quality of life of patients. The Chinese Materia Medica (CMM) contains remedies that have been used for the treatment of asthma for millennia. This article strives to systematically summarize the current research progress so that more comprehensive examinations of various databases related to CMM anti-asthma drugs, can be performed, so as to sequentially provide effective basic data for development and application of anti-asthma drugs based on the CMM. MATERIALS AND METHODS: The research data published over the past 20 years for asthma treatment based on traditional CMM remedies were retrieved and collected from libraries and online databases (PubMed, ScienceDirect, Elsevier, Spring Link, Web of Science, PubChem Compound, Wan Fang, CNKI, Baidu, and Google Scholar). Information was also added from classic CMM, literature, conference papers on classic herbal formulae, and dissertations (PhD or Masters) based on traditional Chinese medicine. RESULTS: This review systematically summarizes the experimental studies on the treatment of asthma with CMM, covering the effective chemical components, typical asthma models, important mechanisms and traditional anti-asthma CMM formulae. The therapy value of the CMM for anti-asthma is clarified, and the original data and theoretical research foundation are provided for the development of new anti-asthmatic data and research for the CMM. CONCLUSIONS: Substantial progress against asthma has been made through relevant experimental research based on the CMM. These advances improved the theoretical basis of anti-asthma drugs for CMM and provided a theoretical basis for the application of a asthma treatment that is unique. By compiling these data, it is expected that the CMM will now contain a clearer mechanism of action and a greater amount of practical data that can be used for future anti-asthma drug research.

Evaluating the effect on asthma quality of life of added reflexology or homeopathy to conventional asthma management - an investigator-blinded, randomised, controlled parallel group study.

BACKGROUND: Asthma is a common chronic disease worldwide without any known cure. Despite remarkable improvement in asthma treatment, better education and guideline implementation strategies, there is growing interest in using complementary and alternative medicine, like reflexology and homeopathy. However, evidence supporting the effectiveness of homeopathy and reflexology in asthma treatment is not available. OBJECTIVE: The aim of this study was to evaluate the effect of reflexology and homeopathy as adjunctive therapies in asthma. METHODS: In a single centre, randomised, investigator blinded, controlled study 86 asthma patients were enrolled. They were assigned to one of three study groups (conventional treatment alone or conventional treatment with addition of either homeopathy or reflexology). All patients received their asthma treatment during the study and were followed as usual by their general practitioner. The study assignment group of individual patients were blinded to the investigators, who made the clinical evaluation of asthma control. The primary outcome was the change in the asthma quality of life questionnaire (AQLQ) scores after 26 weeks. Secondary outcomes included asthma control questionnaire, EuroQol, forced expiratory volume in 1 sec, morning and evening peak expiratory flow, asthma symptoms, rescue medication use, and total medication score. RESULTS: Minor improvements in the AQLQ score were observed in all three groups. However, no statistically significant changes in AQLQ scores were seen within or between groups. Likewise, secondary outcomes did not differ between groups. CONCLUSIONS: In this study, the addition of homeopathy or reflexology to conventional treatment did not result in improved quality of life in asthma.

The impact of reflexology and homeopathy added to conventional asthma treatment on markers of airway inflammation - a randomised study.

Background: Asthma is a common chronic airway disease associated with hyperresponsiveness and airway inflammation. Anti-inflammatory medication especially inhaled corticosteroids are important for control of airway inflammation, decrease of airway hyperresponsiveness and lung function variability, reduce asthma symptoms, and improve lung function as well as quality of life. Most studies investigating the influence of complementary and alternative medicine (CAM) in asthma measure clinical effectiveness, but only few evaluate the impact on markers of airway inflammation. Objective: The aim of this study was to investigate the effect of reflexology and homeopathy added to conventional treatment on different markers of airway inflammation in asthma. Methods: Eighty-four patients with asthma were randomized to receive conventional treatment alone or conventional treatment with addition of homeopathy or reflexology in a single center, investigator blinded, controlled, one-year trial. During the study period, patients regularly consulted their general practitioner for evaluation and asthma treatment. At randomization, and after 6 and 12 months, methacholine challenge test and measurement of exhaled nitric oxide were performed. Blood samples were collected for eosinophil count and measurement of serum eosinophil cationic protein. Results: No significant differences between groups for any of the inflammatory markers were demonstrated. Methacholine responsiveness improved in all three groups but improvements were not statistically significant within and between groups. Conclusions: This randomized controlled study of reflexology and homeopathy failed to show significant improvement on selected markers of inflammation and airway hyperresponsiveness in asthma.

A Systematic Review of Controlled Trials of Homeopathy in Bronchial Asthma.

Homeopathy is a controversial form of complementary therapy, but is widely practised to treat asthma. The aim of this systematic review is to evaluate the controlled trials of homeopathy in bronchial asthma. Relevant trials published between Jan 1, 1981, and Dec 31, 2016, were considered. Substantive research articles, conference proceedings, and master and doctoral theses were eligible. Methodology was assessed by Jadad's scoring, internal validity by the Coch-rane tool, model validity by Mathie's criteria, and quality of individualization by Saha's criteria. Sixteen trials were eligible. The majority were positive, especially those testing complex formulations. Methodological quality was diverse; 8 trials had "high" risk of bias. Model validity and individualization quality were compromised. Due to both qualitative and quantitative inadequacies, proofs supporting individualized homeopathy remained inconclusive. The trials were positive (evidence level A), but inconsistent, and suffered from methodological heterogeneity, "high" to "uncertain" risk of bias, incomplete study reporting, inadequacy of independent replications, and small sample sizes.

Complementary and Alternative Treatment for Allergic Conditions.

This article explains the proposed pathophysiology, evidence of efficacy, and adverse effects of several complementary and alternative medicine modalities, for the treatment of allergic conditions, such as traditional Chinese medicine formula, herbal treatments, acupuncture, and homeopathy.

Tratamento homeopatico na asma bronquica: relato de caso / Homeopathic treatment in bronchial asthma: case report

A Asma Brônquica é uma patologia de elevada prevalência e mortalidade, definida como uma doença inflamatória cronica das vias aéreas, caracterizada pela presença de broncoespasmo, inflamação da mucosa brônquica e hipersecreção brônquica decorrentes de hiper-reatividade pulmonar a diversos fatores. Clinicamente manifesta-se por episódios recorrentes de sibilância, dispneia e aperto no peito e tosse, ocorrendo mais pelo período noturno e manha. O tratamento é dividido em duas fases: tratamento do episódio agudo e tratamento de manutenção. Foi realizado um relato de caso no qual após uma anamnese detalhada na busca da individualização da paciente e da repertoriarão dos sintomas foi prescrito o medicamento homeopático Pulsatilla, associado ao tratamento convencional da asma. Observou-se uma melhora significativa do quadro clínico da paciente. Este relato de caso ressalta como a Homeopatia como proposta terapêutica coadjuvante pode contribuir para a diminuição das crises asmáticas recorrentes, assim como diminuir ou a retirada mais precoce das medicações de controle com melhora na qualidade de vida dos pacientes portadores de asma.

Bronchial Asthma is a pathology of high prevalence and mortality, defined as a chronic inflammatory disease of the airways, characterized by the presence of bronchospasm, inflammation of the bronchial mucosa and bronchial hypersecretion resulting from pulmonary hyperreactivity to various factors. Clinically it is manifested by recurrent episodes of wheezing, dyspnea and chest tightness and coughing, occurring more at night and in the morning. Treatment is divided into two phases: treatment of the acute episode and maintenance treatment. A case report was carried out in which, after a detailed anamnesis in the search for the individualization of the patient and the repertoire of the symptoms, the homeopathic medicine Pulsatilla was prescribed, associated with the conventional treatment of asthma. There was a significant improvement in the patient's clinical status. This case report highlights how Homeopathy as an adjuvant therapeutic proposal can contribute to the reduction of recurrent asthmatic crises, as well as the reduction or earlier withdrawal of control medications with an improvement in the quality of life of patients with asthma.

Tratamiento homeopático en adultos con asma bronquial / Homeopathic treatment of adults with asthma

Se realizó un estudio prospectivo, longitudinal, cuasiexperimental en el consultorio médico de la familia (CMF) 19 del Consejo Popular 10 de Octubre, municipio Ranchuelo, Villa Clara, Cuba, de febrero 2013 a febrero 2014, para determinar el efecto de la terapia homeopática en el tratamiento del asma bronquial en adultos durante un año. Se utilizó una formulación homeopática compuesta por Kalium nitricum 200 cH y Arsenicum album 200 cH. Se realizaron análisis estadísticos con pruebas no paramétricas. Al finalizar la intervención del número de crisis disminuyó en los pacientes que adhirieron al tratamiento de forma constante. Al comenzar el año de tratamiento, la totalidad de los pacientes se distribuían entre los 4 grupos de clasificación según la evolución temporal. Luego de aplicar el tratamiento, los pacientes adheridos al mismo disminuyeron en la clasificación de la enfermedad. Se recomienda promover la prescripción de los medicamentos homeopáticos junto al tratamiento convencional en el asma. (AU)

We performed a prospective, longitudinal and quasi experimental study at family outpatient clinic 19, October 10th Popular Council, Ranchuelo, Villa Clara, Cuba, from February 2013 through February 2014. The aim of the present study was to establish the effect of homeopathic medication for treatment of asthma among adults along 1 year. Patients received a combination of Kalium nitricum 200cH and Arsenicum album 200cH. Statistical analysis involved non-parametric tests. At the end of follow-up the number of asthma attacks decreased among the patients who took the medication continuously. At baseline, patients were distributed across all 4 severity groups; the degree of severity decreased among all the participants who adhered to treatment. Use of homeopathy as adjuvant to conventional treatment should be promoted. (AU)

Tratamiento del asma bronquial en niños según la medicina Bioenergética y Natural / Treatment of bronchial asthma in children using bioenergetic and natural medicine

Introducción: el asma bronquial es «la inflamación crónica de la vía aérea en la que desempeñan un papel destacado algunas células y mediadores. Es la enfermedad crónica en niños más frecuente a nivel mundial. Los tratamientos ofrecidos por la medicina alopática, si bien ofrecen control de síntomas con buenos resultados, no son efectivos en la totalidad de los pacientes. Las diferentes técnicas de la medicina Bioenergética y Natural son alternativas valiosas para el tratamiento del asma, ya que ofrecen la posibilidad de erradicar los síntomas de forma definitiva. Objetivo: diseñar una base teórico-metodológica para el desarrollo de la medicina bioenergética y natural como elemento que contribuya a elevar la calidad de la atención médica pediátrica. Material y método: se realizaron búsquedas en bases de datos bibliográficas computarizadas de estudios publicados en revistas indexadas como: Medline, Bireme, Lilacs, Índice Médico Español, Cochrane Library, Alternative Medicine Electronic Database, Acubase, BioMed Central. Se buscaron estudios, con los siguientes términos: asthma, acupuncture, therapy acupuncture gender, phisical therapy acupuncture, pediatric patients, pediatric asthma, children, homeopatic adolescent, acupressure. Resultados: se ofrecen opciones terapéuticas a la luz de la medicina Bioenergética y Natural aplicables a la edad pediátrica, útiles en el manejo del asma bronquial en niños en consultas ambulatorias u hospitalizados a la vez, teniendo en cuenta y aprovechando los conocimientos y los avances científicos de la alopatía. Conclusiones: esta revisión es una guía para los médicos que atienden niños, tanto en atención primaria como secundaria. La aplicación de estas terapias redundará en su salud, contribuirá además al tratamiento más efectivo del asma bronquial, es necesario elevar la calidad de las investigaciones es este campo para contribuir a la validación de la eficacia de sus terapéuticas.

Introduction: bronchial asthma is the chronic inflammation of the airway tract where some cells and mediators play an outstanding role. It is the most frequent chronic disease in children all over the world. The treatments offered by allopathic medicine can control the symptoms with good results, but these are not effective for the totally of patients. The different techniques of the bioenergetics and natural medicine are valuable alternatives to treat the asthma, offering the possibility to eradicate the symptoms permanently. Objective: to design a theoretical-methodological basis for the development of the bioenergetics and natural medicine as an element that contributes to the improvement of pediatric medical care. Material and method: computerized bibliographic databases of studies published in indexed journals were searched in: Medline, Bireme, Lilacs, Spanish Medical Index, Cochrane Library, Alternative Medicine, Electronic Database, Acubase, Central BioMed; along with studies comprising the following terms: asthma, acupuncture, therapy acupuncture gender, physical therapy acupuncture, pediatric patients, pediatric asthma, children, homeopathy, adolescent and acupressure. Results: therapeutic options were offered from the bioenergetics and natural medicine applicable to pediatric ages, which are useful in the management of bronchial asthma in children from ambulatory and hospitalized ways at the same time, supported on knowledge and scientific advantages of the allopathic medicine. Conclusions: this bibliographic review is a guideline for both primary and secondary health care pediatric physicians. The application of these therapies will result in health, contributing as well to the most effective management of bronchial asthma, it is essential to increase the quality of researches in this field to contribute to the validation of a therapeutic effectiveness.

Asociación del índice predictivo de asma y presencia de la enfermedad en niños de la comuna de Valdivia / Association of the asthma predictive index and presence of the disease in children in Valdivia, Chile

There are predictive indexes to identify asthmatic patients from the rest of the recurrent wheezing phenotypes. The aim of this work was to evaluate the association between the positive Asthma Predictive Index (API) and the presence of asthma between the age of six and seven years old, in children from Valdivia, Chile. Methods: API was applied to 101 asthmatic children (cases) and 100 non-asthmatic children (controls). Data were analyzed using STATA v. 11 (2009). Fisher Exact Test was used to determine the relationship between variables. Results: 72.3% of asthmatic patients and 3% of non- asthmatic patients had a positive index. Significant differences (p < 0.001) were shown in all the variables included in the API. In our group of patients, the probability for a child to develop asthma was at least 24 times higher if he/she had a positive API (OR = 84.3 CI95% 24.1-436.5). Conclusion: API is a good tool to predict asthma and allows to take right decisions in recurrent wheezing children younger than 36 months old.

Es un desafío identificar pacientes asmáticos entre sibilantes recurrentes, por eso existen índices predictivos. El objetivo de este estudio es evaluar la asociación entre índice predictivo de asma (IPA) positivo, y presencia de asma entre los seis y siete años de edad, en niños de la comuna de Valdivia. Material y Método: Se aplicó el índice IPA a 101 casos (niños asmáticos) y 100 controles (niños sin asma). Se utilizó STATA v.11 (2009), y Test exacto de Fisher para determinar relación entre variables. Resultados: 72,3% de los pacientes asmáticos y 3% de los no asmáticos tuvieron un índice IPA positivo. Se demostraron diferencias significativas (p < 0,001) en todas las variables que componen los criterios del IPA. En nuestros pacientes, la probabilidad de desarrollar asma fue al menos 24 veces mayor si tenían índice IPA positivo (OR 84,3 IC95% 24,1-436,5). Conclusión: El índice IPA es una buena herramienta para predecir asma, y permite tomar decisiones acertadas en pacientes sibilantes menores de tres años.

Asma bronquial y Medicinas complementarias-alternativas / Bronchial Asthma and Complementary-Alternative Medicines

La frecuencia y patrones de uso de Medicinas Complementarias-Alternativas (MCA) entre pacientes con asma bronquial es desconocida en nuestro país. El objetivo de este trabajo fue evaluar el uso de MCA entre pacientes con asma y comparar sus características con quienes no usaban esos recursos. Materiales y métodos: Entre 30-6-2005 y 30-6-2012, 635 pacientes mayores de 16 años con diagnóstico de asma fueron evaluados mediante entrevistas cara a cara con su médico en tres centros de las ciudades de Buenos Aires y General Rodríguez. La encuesta tuvo el carácter de anónima y voluntaria e incluyó variables demográficas, el tiempo de evolución de la enfermedad, la obstrucción al flujo aéreo medido por espirometria, parámetros de severidad y niveles control del asma. Se interrogó sobre el uso de al menos una vez por el lapso de un mes de alguna MCA, el tiempo de uso, la utilización simultánea o no de medicina alopática (MA), el tipo de MCA elegida y el resultado obtenido. Resultados: No se registraron rechazos a participar en el estudio; 246/635 (38.7%) de los pacientes usaron MCA con un valor de mediana de 12 meses (rango 0-359); entre ellos, un 39% habían abandonado la MA y un 15% todavía recurrían a alguna MCA. En el grupo con MCA había pacientes de mayor edad, mayor presencia de mujeres, tiempos de evolución más prolongados, niveles más altos de severidad y menor frecuencia de asma controlada, frente al grupo sin uso de MCA. Los resultados principales fueron mejoría o sin cambios (46% cada uno). Las MCA más frecuentemente elegidas fueron hierbas, homeopatía, acupuntura y yoga, encontrándose diferencias significativas según características demográficas, el uso simultáneo de MA y el reporte de resultados. Conclusiones: El uso de MCA entre nuestros pacientes con asma se asemeja a otras experiencias internacionales. Sin embargo, se requieren nuevas encuestas multicéntricas para alcanzar un estudio más profundo sobre los patrones regionales y nacionales de uso de MCA.

The frequency and patterns of Complementary-Alternative Medicines (CAM) use among asthmatic patients are unknown in our country. The objective of this work was to evaluate the CAM use in asthmatic patients and to compare their characteristics with those of asthmatic patients who are not CAM users. Materials and methods: Between 30 June 2005 and 30 June 2012, 635 patients with a diagnosis of asthma older than 15 years were evaluated through face-to-face interviews carried out by their own physicians in three clinics of Buenos Aires and General Rodriguez cities. The interviews were anonymous and free, and included the registry of variables such as demographic characteristics, evolution time from onset, airway obstruction by spirometry, levels of severity and control measures. Patients were asked if they had used any CAM at least once by a minimum period of a month, time of the intervention, simultaneous or not use of allopathic medicine (AM), type of CAM chosen and self-reported results. Results: All patients agreed to co-operate, and 246/635 (38.7%) referred having used CAM for a median period of 12 months (range 0-359); while using the alternative treatment, 39% of them had abandoned the AM and 15% were still using any kind of CAM. In comparison with non users, alternative users tended to be older and females, and to have longer time from the onset of symptoms, higher levels of severity and lower periods of controlled asthma. The main reported results were improvement and no change (46% each). The mainly CAM chosen were herbs, homeopathy, acupuncture and yoga. Significant differences were found according to demographic characteristics, simultaneous use of AM and self-reported results. Conclusions: Use of CAM among our asthmatic patients appears to be similar to that reported in other international experiences. However, new multicenter surveys are needed to reach a deeper insight into both regional and national patterns of use.

Homeopatia como uma alternativa para o tratamento da asma / Homeopathy as an alternative for asthma treatment

Introdução: a asma é uma doença inflamatória crônica caracterizada por uma obstrução reversível e uma hiper-reatividade das vias aérea inferiores [1]. É responsável por modificações no estilo de vida, e, considerando sua alta frequência, se tornou um problema importante no orçamento dos serviços de saúde pelo mundo. Aspectos como a falta de resultados definitivos e a presença de efeitos adversos, observados para o tratamento convencional, bem como a busca por melhor qualidade de vida têm aumentado o interesse dos pacientes por terapias alternativas e complementares, sendo a homeopatia uma das mais citadas [2]. Em 2001, a asma estava entre os 10 diagnósticos mais tratados pelos homeopatas nos Estados Unidos [3]. Objetivos: neste trabalho, uma pesquisa qualitativa foi realizada, objetivando avaliar a real contribuição que homeopatia pode representar para os pacientes com asma e o papel do farmacêutico neste tratamento. Metodologia: as bases de dados Medline, Sciencedirect e BIREME foram usadas para encontrar artigos científicos, aplicando as expressões ?asma?, ?homeopatia? e ?terapias alternativas e complementares. Resultados: pelo menos seis trabalhos demonstram aplicações de sucesso da homeopatia no tratamento de adultos ou crianças com asma. Os principais benefícios citados são a diminuição da frequência e da gravidade das crises, além de alguns casos de cura. Conclusões: Os dados ainda são escassos em relação ao tratamento homeopático da asma. Os poucos trabalhos encontrados mostraram que esse tipo de terapia é muito adequada, principalmente pelo componente emocional, mas também por ser livre de efeitos adversos, muito comuns no tratamento convencional (por exemplo, corticoides). Para assegurar que um tratamento correto está sendo feito, o farmacêutico deve estar presente e ativo na identificação e documentação dos pacientes, dando-lhes orientações corretas sobre o uso e o armazenamento dos medicamentos homeopáticos, além de estimular um relacionamento próximo e de confiança com o homeopata. Da mesma forma, a preparação dos medicamentos deve estar de acordo com as guias oficiais a fim de garantir a sua qualidade.(AU)

Background: Asthma is a chronic inflammatory disease characterized by a reversible obstruction and hyperactivity of inferior aerial treat [1]. It is responsible for lifestyle modification and, considering its high frequency, it became an important issue in the budget of health services around the world. Aspects like the lack of definitive results and presence of adverse effects, observed for traditional therapy, as well as the search for better quality of life have increased patients? interest for complementary and alternative medicines (CAM), being homeopathy one of the most cited [2]. In 2001, asthma was between the 10 diagnostics most treated by homeopaths in USA [3]. Aims: In this work, a qualitative research was made focusing the evaluation of the real contribution that homeopathy can represent for asthma patients and the role of pharmacist in this therapy. Methodology: databases such as Medline, Sciencedirect and Bireme were used to find scientific articles, applying the expressions ?asthma?, ?homeopathy? and ?complementary and alternative medicine?. Results: At least six works demonstrate successful applications of homeopathic treatment in children or adults with asthma. The main benefits cited are the decrease of frequency and gravity of the crises, besides of some cure cases. Conclusions: Data available are still scanty about asthma homeopathic treatment. The few works found showed this kind of therapy is very adequate, mainly because of the emotional component of the disease, but also because it represents to be away from the adverse effects commonly related to the traditional therapy (e. g. corticoids). To ensure a correct therapy is being made, the pharmacist must be present and active in the patients? identification and documentation, giving them right orientations about the use and storage of homeopathic medicines, besides of stimulating a close and confidence relationship with the homeopath. Also, the manufacturing of remedies must be according to the official guidelines in order to guarantee their quality.(AU)

Revisión narrativa del manejo de pacientes con síntomas de asma con tratamiento basado en homeopatía 2015 / Narrative review of the management of patients with asthma symptoms with treatment based on homeopathy 2015

El asma es una de las enfermedades respiratorias crónicas más frecuentes a nivel mundial, ocupando uno de los primeros lugares de morbilidad en Colombia. debido a que la medicina tradicional no ofrece sino una mejoría parcial o temporal, la comunidad ha buscado otras alternativas terapéuticas, dándose un gran apertura a las terapias alternativas, incluyendo a la homeopatía, que a través de los años ha demostrado resultados muy favorables en el manejo de ésta. En este trabajo se realizó una revisión documental sobre el manejo del asma con homeopatía, en los últimos 10 años, con el fin de proporcionar evidencia confiable para una buena toma de decisiones en salud y profundizar en el conocimiento de éste tema. Se tomaron los síntomas del Asma referidos en los libros de Medicina Interna (Harrison, Cecil y Farreras-Rozman); se convirtieron a lenguaje repertorial homeopático, y se realizó el ejercicio repertorial, encontrándose que los principales medicamentos son: Arsenicum album, Phosphurus, Sulphur, Antimonium tartaricum, Lachesis, Psorinum, Medorrhinum, Nux vómica, Dulcamara, Ignatia, Sambucus nigra, Belladona, Lobelia inflata, Ipecacuana, Grindelia, Cuprum metallicum, Aconitum napellus, Apis mellifica, Kali carbonicum, Nitricum acidum; de los cuales profundizaremos en los más usados. En los diferentes artículos encontramos los medicamentos más usados, los cuales los ponemos en una tabla con sus respectivas indicaciones de acuerdo a la sintomatología