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1.
JAAPA ; 33(6): 48-50, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-32452963

RESUMEN

Many patients with severe asthma continue to have high symptom burden despite maximization of conventional therapy. As the understanding of asthma pathophysiology has evolved, however, more personalized therapy options have become available. Asthma biologics are a new class of medications that target the specific pathways that underlie a patient's disease and can reduce the frequency of asthma exacerbations and improve patient quality of life. Clinicians should refer potential candidates to a specialist for further evaluation.


Asunto(s)
Anticuerpos Monoclonales/uso terapéutico , Asma/tratamiento farmacológico , Productos Biológicos/uso terapéutico , Guías de Práctica Clínica como Asunto , Asma/etiología , Humanos , Medicina de Precisión , Calidad de Vida , Derivación y Consulta , Índice de Severidad de la Enfermedad , Estado Asmático/prevención & control
2.
Artículo en Alemán | MEDLINE | ID: mdl-27359239

RESUMEN

In daily practice, acute and chronic pulmonary diseases are common issues presenting to the anesthetist. Respiratory physiology in general is affected by both general and regional anesthesia, which results in an increased number of perioperative complications in pulmonary risk patients. Therefore, anesthetic management of patients with bronchial asthma needs to address different clinical topics: the physical appearance of pulmonary disease, type and extent of surgical intervention as well as effects of therapeutic drugs, anesthetics and mechanical ventilation on respiratory function. The present work describes important precautions in preoperative scheduling of the asthmatic patient. In the operative course, airway manipulation and a number of anesthetics are able to trigger intraoperative bronchial spasm with possibly fatal outcome. It is essential to avoid these substances to prevent asthma attack. If asthmatic status occurs, appropriate procedures according to therapeutic standards have to be applied to the patient. Postoperatively, sufficient pain therapy avoids pulmonary complications and improves outcome.


Asunto(s)
Anestésicos Generales/administración & dosificación , Complicaciones Intraoperatorias/etiología , Complicaciones Intraoperatorias/prevención & control , Estado Asmático/etiología , Estado Asmático/prevención & control , Procedimientos Quirúrgicos Operativos/efectos adversos , Anestésicos Generales/efectos adversos , Humanos , Monitoreo Intraoperatorio/métodos
3.
Masui ; 63(4): 418-22, 2014 Apr.
Artículo en Japonés | MEDLINE | ID: mdl-24783608

RESUMEN

We experienced severe asthmatic crisis during general anesthesia in a 45-year-old man with IgG4-related disease, COPD and athma undergoing removal of submandibular gland. The ventilatiory failure was caused by the stimulation of the operation, sputum, and neostigmine. His serum IgG4 level was extremely high. IgG4 related disease is a recently emerging entity characterized by a diffuse or mass forming inflammatory reaction rich in IgG4-positive plasma cells associated with fibrosclerosis and obliterative phlebitis. It is associated with an elevated serum level of IgG4 and an allergic disease. We must be careful in perioperative management of the patients with IgG4-related disease because general anesthesia can induce asthmatic crisis.


Asunto(s)
Anestesia General , Inmunoglobulina G/sangre , Complicaciones Intraoperatorias/etiología , Atención Perioperativa , Estado Asmático/etiología , Asma/complicaciones , Hiperreactividad Bronquial/complicaciones , Humanos , Inflamación/complicaciones , Complicaciones Intraoperatorias/prevención & control , Masculino , Persona de Mediana Edad , Neostigmina/efectos adversos , Flebitis/complicaciones , Enfermedad Pulmonar Obstructiva Crónica/complicaciones , Fibrosis Retroperitoneal/complicaciones , Fibrosis Retroperitoneal/congénito , Estado Asmático/prevención & control , Glándula Submandibular/cirugía , Síndrome
4.
Arerugi ; 63(2): 187-203, 2014 Feb.
Artículo en Japonés | MEDLINE | ID: mdl-24714184

RESUMEN

BACKGROUND: We developed a tailored education program using a touch-screen computer for changing management behavior with asthmatic children and their caregivers. The purpose of this study was to examine the effect of the tailored education program. METHODS: Caregivers including children with asthma were recruited during visits to a national children's hospital and those whose month-long asthma condition on the JPAC (Japanese Pediatric Asthma Program) score was 14 and below were included. Caregivers were randomized to the tailored education (intervention group) or non-tailored education (control group). The intervention group underwent a patient education program using a touch-screen computer, and they received tailored messages generated by a computer program. A research nurse and clinical psychologist used a computer-based resource to tailor the education messages and provided counseling using motivational interviewing for the caregivers including children with asthma. The control group received only a booklet on asthma. RESULTS: Forty-seven subjects aged 1 to 6 years were enrolled. Forty-seven caregivers were randomized to the tailored education (n=22) or non-tailored education (n=25) group. The results of two-way ANOVA showed that interactions between groups were observed in the score of JPAC and asthma knowledge for preschool children whose asthma onset was within one year and a half. The main effects of time were observed in the total and subscale score of QOL (Quality of Life) and the total score of P-CASES (Parental Childhood Asthma's Self-efficacy Scale). CONCLUSION: These findings indicate the benefit of a tailored education program to control symptoms in such caregivers.


Asunto(s)
Asma/tratamiento farmacológico , Asma/psicología , Cuidadores/educación , Cuidadores/psicología , Educación en Salud/métodos , Desarrollo de Programa , Estado Asmático/prevención & control , Adulto , Ciencias de la Conducta , Niño , Preescolar , Femenino , Humanos , Lactante , Masculino , Calidad de Vida , Autoeficacia
5.
Int J Immunopathol Pharmacol ; 24(2): 517-8, 2011.
Artículo en Inglés | MEDLINE | ID: mdl-21658327

RESUMEN

The prevalence of sesame food allergy continues to increase worldwide. The diagnostic tools to confirm such allergy include skin prick tests, specific IgEs and food challenge. We report the case of a 7-year-old girl who presented recurrent episodes of wheezing and dyspnoea. After performing skin tests and evaluating specific IgEs we hypothesised an allergy to sesame. Our patient actually benefitted from avoiding any contact with sesame and sesame seeds. We confirmed our diagnosis through an inhalation food challenge. Further, by reviewing her personal history, we suspect inhalation was the mechanism in which the girl became sensitised to sesame.


Asunto(s)
Manipulación de Alimentos , Hipersensibilidad a los Alimentos/etiología , Sesamum/efectos adversos , Estado Asmático/etiología , Niño , Disnea/etiología , Femenino , Hipersensibilidad a los Alimentos/diagnóstico , Hipersensibilidad a los Alimentos/inmunología , Hipersensibilidad a los Alimentos/prevención & control , Humanos , Inmunoglobulina E/sangre , Exposición por Inhalación , Recurrencia , Ruidos Respiratorios/etiología , Pruebas Cutáneas , Estado Asmático/inmunología , Estado Asmático/prevención & control , Factores de Tiempo
6.
Clin Trials ; 8(3): 311-9, 2011 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-21730079

RESUMEN

BACKGROUND: Asthma exacerbations are seasonal with the greatest risk in elementary-age students occurring shortly after returning to school following summer break. Recent research suggests that this seasonality in children is primarily related to viral respiratory tract infections. Regular hand washing is the most effective method to prevent the spread of viral respiratory infections; unfortunately, achieving hand washing recommendations in schools is difficult. Therefore, we designed a study to evaluate the effect of hand sanitizer use in elementary schools on exacerbations among children with asthma. PURPOSE: To describe the process of redesigning the trial in response to changes in the safety profile of the hand sanitizer as well as changes in hand hygiene practice in the schools. METHODS: The original trial was a randomized, longitudinal, subject-blinded, placebo-controlled, community-based crossover trial. The primary aim was to evaluate the incremental effectiveness of hand sanitizer use in addition to usual hand hygiene practices to decrease asthma exacerbations in elementary-age children. Three events occurred that required major modifications to the original study protocol: (1) safety concerns arose regarding the hand sanitizer's active ingredient; (2) no substitute placebo hand sanitizer was available; and (3) community preferences changed regarding hand hygiene practices in the schools. RESULTS: The revised protocol is a randomized, longitudinal, community-based crossover trial. The primary aim is to evaluate the incremental effectiveness of a two-step hand hygiene process (hand hygiene education plus institutionally provided alcohol-based hand sanitizer) versus usual care to decrease asthma exacerbations. Enrollment was completed in May 2009 with 527 students from 30 schools. The intervention began in August 2009 and will continue through May 2011. Study results should be available at the end of 2011. LIMITATIONS: The changed design does not allow us to directly measure the effectiveness of hand sanitizer use as a supplement to traditional hand washing practices. CONCLUSIONS: The need to balance a rigorous study design with one that is acceptable to the community requires investigators to be actively involved with community collaborators and able to adapt study protocols to fit changing community practices.


Asunto(s)
Desinfección de las Manos/métodos , Proyectos de Investigación , Instituciones Académicas , Alabama , Niño , Estudios Cruzados , Humanos , Entrevistas como Asunto , Estudios Longitudinales , Infecciones del Sistema Respiratorio/prevención & control , Infecciones del Sistema Respiratorio/virología , Estado Asmático/prevención & control
7.
Health Promot Pract ; 12(6 Suppl 1): 52S-62S, 2011 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-22068360

RESUMEN

Care coordination programs have been used to address chronic illnesses, including childhood asthma, but primarily via practice-based models. An alternative approach employs community-based care coordinators who bridge gaps between families, health care providers, and support services. Merck Childhood Asthma Network, Inc. (MCAN) sites developed community-based care coordination approaches for childhood asthma. Using a community-based care coordination logic model, programs at each site are described along with program operational statistics. Four sites used three to four community health workers (CHWs) to provide care coordination, whereas one site used five school-based asthma nurses. This school-based site had the highest caseload (82.5 per year), but program duration was 3 months with 4 calls or visits. Other sites averaged fewer cases (35 to 61 per CHW per year), but families received more (7 to 17) calls or visits over a year. Retention was 43% to 93% at 6 months and 24% to 75% at 12 months. Pre-post cross-site data document changes in asthma management behaviors and outcomes. After program participation, 93% to 100% of caregivers had confidence in controlling their child's asthma, 85% to 92% had taken steps to reduce triggers, 69% to 100% had obtained an asthma action plan, and 46% to 100% of those with moderate to severe asthma reported appropriate use of controller medication. Emergency department visits for asthma decreased by 36% to 63%, and asthma-related hospitalizations declined by 26% to 78%. More than three fourths had fewer school absences. In conclusion, MCAN community-based care coordination programs improved management behaviors and decreased morbidity across all sites.


Asunto(s)
Personal Administrativo , Asma , Redes Comunitarias/organización & administración , Asma/tratamiento farmacológico , Niño , Promoción de la Salud , Humanos , Modelos Organizacionales , Puerto Rico , Estado Asmático/prevención & control , Estados Unidos , Población Urbana
8.
Nutrients ; 13(2)2021 Feb 03.
Artículo en Inglés | MEDLINE | ID: mdl-33546262

RESUMEN

African Americans have higher incidence of, and mortality from, many health-related problems than European Americans. They also have a 15 to 20-fold higher prevalence of severe vitamin D deficiency. Here we summarize evidence that: (i) this health disparity is partly due to insufficient vitamin D production, caused by melanin in the skin blocking the UVB solar radiation necessary for its synthesis; (ii) the vitamin D insufficiency is exacerbated at high latitudes because of the combination of dark skin color with lower UVB radiation levels; and (iii) the health of individuals with dark skin can be markedly improved by correcting deficiency and achieving an optimal vitamin D status, as could be obtained by supplementation and/or fortification. Moderate-to-strong evidence exists that high 25-hydroxyvitamin D levels and/or vitamin D supplementation reduces risk for many adverse health outcomes including all-cause mortality rate, adverse pregnancy and birth outcomes, cancer, diabetes mellitus, Alzheimer's disease and dementia, multiple sclerosis, acute respiratory tract infections, COVID-19, asthma exacerbations, rickets, and osteomalacia. We suggest that people with low vitamin D status, which would include most people with dark skin living at high latitudes, along with their health care provider, consider taking vitamin D3 supplements to raise serum 25-hydroxyvitamin D levels to 30 ng/mL (75 nmol/L) or possibly higher.


Asunto(s)
COVID-19/etiología , COVID-19/prevención & control , Colecalciferol/administración & dosificación , Suplementos Dietéticos , Disparidades en el Estado de Salud , Deficiencia de Vitamina D/etnología , Deficiencia de Vitamina D/epidemiología , Negro o Afroamericano , Enfermedad de Alzheimer/etiología , Enfermedad de Alzheimer/prevención & control , Antígenos de Neoplasias , Demencia/etiología , Demencia/prevención & control , Diabetes Mellitus/etiología , Diabetes Mellitus/prevención & control , Femenino , Humanos , Masculino , Prevalencia , Estado Asmático/etiología , Estado Asmático/prevención & control , Vitamina D/análogos & derivados , Vitamina D/sangre , Deficiencia de Vitamina D/complicaciones
9.
Bol Asoc Med P R ; 101(2): 17-20, 2009.
Artículo en Inglés | MEDLINE | ID: mdl-19954095

RESUMEN

Asthma morbidity and mortality have increased in the past two decades; Puerto Rican children have the highest prevalence of asthma in the United States. An asthma admission to PICU is a marker of asthma severity. This study describes the profile of the pediatric population admitted with status asthmaticus during a three year period to PICU at Hospital Episcopal San Lucas. An ambispective cohort chart review of 46 cases was performed; there was a mean average age of 6.2 years, male predominance (70%) and a strong family and personal history of asthma and allergies. 48% were classified as persistent asthmatics, only 19% of these received preventive mediation regimens. 72% of patients were covered under Puerto Rico's Health Care Reform and 28% had private insurance. Of the patients covered by Puerto Rico's Health Care Reform, classified as persistent asthmatics, 79% did not receive preventive treatment medication compared to 46% in private insurance. Background asthma management remains suboptimal in children needing hospitalization. Lack of preventive medication appears to be related to the type of health insurance.


Asunto(s)
Unidades de Cuidados Intensivos/estadística & datos numéricos , Estado Asmático/epidemiología , Antiasmáticos/uso terapéutico , Asma/tratamiento farmacológico , Niño , Preescolar , Estudios de Cohortes , Utilización de Medicamentos/estadística & datos numéricos , Femenino , Adhesión a Directriz/estadística & datos numéricos , Reforma de la Atención de Salud/estadística & datos numéricos , Humanos , Cobertura del Seguro/estadística & datos numéricos , Seguro de Salud/clasificación , Seguro de Salud/estadística & datos numéricos , Masculino , Puerto Rico/epidemiología , Estado Asmático/prevención & control
10.
Respir Care ; 64(11): 1325-1332, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31088987

RESUMEN

BACKGROUND: Asthma is a common reason for admissions to the pediatric intensive care unit (PICU). Since June 2014, our institution has used a pediatric asthma clinical pathway for all patients, including those in PICU. The pathway promotes respiratory therapist-driven bronchodilator weaning based on the Modified Pulmonary Index Score (MPIS). This pathway was associated with decreased hospital length of stay (LOS) for all pediatric asthma patients; however, the effect on PICU patients was unclear. We hypothesized that the implementation of a pediatric asthma pathway would reduce hospital LOS for asthmatic patients admitted to the PICU. METHODS: We retrospectively reviewed the medical records of all pediatric asthma subjects 2-17 y old admitted to our PICU before and after pathway initiation. Primary outcome was hospital LOS. Secondary outcomes were PICU LOS and time on continuous albuterol. Data were analyzed using the chi-square test for categorical data, the t test for normally distributed data, and the Mann-Whitney test for nonparametric data. RESULTS: A total of 203 eligible subjects (49 in the pre-pathway group, 154 in the post group) were enrolled. There were no differences between groups for age, weight, gender, home medications, cause of exacerbation, medical history, or route of admission. There were significant decreases in median (interquartile range) hospital LOS (4.4 [2.9-6.6] d vs 2.7 [1.6-4.0] d, P < .001), median PICU LOS (2.1 [1.3-4.0] d vs 1.6 [0.8-2.4] d, P = .003), and median time on continuous albuterol (39 [25-85] h vs 27 [13-42] h, P = .001). Significantly more subjects in the post-pathway group were placed on high-flow nasal cannula (32% vs 6%, P = .001) or noninvasive ventilation (10% vs 4%, P = .02). CONCLUSION: The implementation of an asthma pathway was associated with decreased hospital LOS, PICU LOS, and time on continuous albuterol. There was also an increase in the use of high-flow nasal cannula and noninvasive ventilation after the implementation of this clinical pathway.


Asunto(s)
Albuterol/uso terapéutico , Broncodilatadores/uso terapéutico , Vías Clínicas , Unidades de Cuidado Intensivo Pediátrico/estadística & datos numéricos , Tiempo de Internación/estadística & datos numéricos , Terapia Respiratoria/métodos , Adolescente , Asma/fisiopatología , Asma/terapia , Niño , Preescolar , Protocolos Clínicos , Vías Clínicas/organización & administración , Vías Clínicas/estadística & datos numéricos , Femenino , Humanos , Masculino , Readmisión del Paciente , Estado Asmático/diagnóstico , Estado Asmático/prevención & control , Factores de Tiempo , Estados Unidos/epidemiología
12.
Arerugi ; 57(2): 107-20, 2008 Feb.
Artículo en Japonés | MEDLINE | ID: mdl-18349585

RESUMEN

BACKGROUND: A cross-sectional survey, Asthma Insights and Reality in Japan (AIRJ) conducted in 2000 demonstrated that the level of asthma control and inhaled corticosteroid (ICS) use in Japanese asthmatics were low compared to the average in European countries. The purpose of the AIRJ survey in 2005 was to assess changes in the burden of asthma and asthma management in Japan since 2000 AIRJ survey. METHODS: We used identical methods to AIRJ 2000, including random-digit dialing to identify current asthmatics throughout Japan in 2005. A detailed telephone survey which included items on the burden of asthma and clinical management was conducted in 800 households (400 adults, 400 children) from the identified asthmatics. We compared AIRJ 2005 results with those of AIRJ 2000 separately for adults and children with statistical adjustment for differences in population characteristics between AIRJ 2000 and AIRJ 2005. RESULTS: Participants in 2005 reported significantly lower prevalence of symptoms, including a decrease in daytime symptoms in adults (52% to 46%, p=0.046) and a decrease in night-time awaking in children (40% to 33%, p=0.039). The number of patients who experienced one or more asthma episodes in the past year (ER visits, hospitalization, or unscheduled doctor visits) decreased significantly from 2000 in adults (41% to 31%, p<0.01) and children (62% to 49%, p<0.001). ICS use rate increased significantly in adults (12% to 18%, p=0.019) and had a tendency to increase in children (5% to 8%, p=0.059). CONCLUSIONS: There have been improvements in the burden of asthma patients and clinical disease management as well as more use of ICS in Japan since 2000. Nevertheless, in most patients, ICS use still remained low, and asthma management fell short of the goals of treatment outlined in the Japanese guidelines. There is a need to increase awareness of and compliance with the asthma guidelines and to popularize standardized therapy in Japan.


Asunto(s)
Asma/tratamiento farmacológico , Asma/epidemiología , Administración por Inhalación , Adolescente , Corticoesteroides/administración & dosificación , Adulto , Niño , Estudios Transversales , Utilización de Medicamentos/estadística & datos numéricos , Femenino , Humanos , Entrevistas como Asunto , Japón/epidemiología , Modelos Logísticos , Masculino , Persona de Mediana Edad , Prevalencia , Estado Asmático/prevención & control , Factores de Tiempo
13.
Nutr. hosp ; 40(4): 829-838, Juli-Agos. 2023. tab, ilus, graf
Artículo en Inglés | IBECS (España) | ID: ibc-224208

RESUMEN

Objective: to evaluate the role of probiotics in the treatment of asthma patients by meta-analysis.Methods: PubMed, Embase, The Cochrane Library, Web of Science, and other databases were searched by computer, and the relevant literature on the treatment of asthma by probiotics that met the inclusion criteria was screened by manual retrieval. Meta-analysis was performed using Revman 5.4 software and the combined effect was evaluated by odds ratio (OR) or mean difference (MD) and 95 % confidence interval (CI). Results: a total of ten references were included, all of which were randomized controlled studies, and a total of 1,101 people were investigated. Fractional exhaled nitric oxide (FeNO) (MD = -7.17, 95 % CI: -12.81, -1.54), asthma symptom severity (MD = -0.07, 95 % CI: -0.10, -0.04), Childhood Asthma Control Test (CACT) (MD = 2.26, 95 % CI: 1.14, 3.39), and the number of acute episodes of asthma (OR = 0.30, 95 % CI: 0.19, 0.47) in the probiotics group were better than those in the control group. There was no significant difference in forced expiratory volume in the first second (FEV1) (MD = 0.11, 95 % CI: -0.05, 0.26) and FEV1/FVC (%) (MD = 0.32, 95 % CI: -1.48, 2.12). Conclusion: the use of probiotics in patients with asthma can improve lung inflammation and asthma symptoms, reduce the number of asthma attacks, and have no effect on lung function.(AU)


Objetivo: evaluar el papel de los probióticos en el tratamiento de pacientes con asma mediante metaanálisis.Métodos: se realizaron búsquedas informáticas en PubMed, Embase, The Cochrane Library, Web of Science y otras bases de datos, y se examinó la literatura relevante sobre el tratamiento del asma con probióticos que cumplía con los criterios de inclusión mediante recuperación manual. El metaanálisis se realizó con el software Revman 5.4 y el efecto combinado se evaluó mediante la razón de probabilidades (OR) o diferencia media (MD) y el intervalo de confianza (IC) del 95 %. Resultados: se incluyó un total de diez referencias, todas ellas estudios controlados aleatorios, y se investigó un total de 1.101 personas. El óxido nítrico exhalado (FeNO) (MD = -7,17, IC 95 %: -12,81, -1,54), la gravedad de los síntomas del asma (MD = -0,07, IC 95 %: -0,10, -0,04), la Prueba de Control del Asma (CACT-ACT) (MD = 2,26, IC 95 %: 1,14, 3,39) y el número de episodios agudos de asma (OR = 0,30, IC 95 %: 0,19, 0,47) en el grupo de probióticos fueron mejores que en el grupo de control. No hubo diferencia significativa en volumen espiratorio forzado en el primer segundo (FEV1) (DM = 0,11, IC 95 %: -0,05, 0,26) y FEV1/FVC (%) (DM = 0,32, IC 95 %: -1,48, 2,12). Conclusión: el uso de probióticos en pacientes con asma puede mejorar la inflamación pulmonar y los síntomas del asma, reducir el número de ataques de asma y no tener efecto sobre la función pulmonar.(AU)


Asunto(s)
Humanos , Probióticos/administración & dosificación , Probióticos/uso terapéutico , Asma/dietoterapia , Asma/prevención & control , Neumonía/dietoterapia , Estado Asmático/dietoterapia , 52503 , Ciencias de la Nutrición , Estado Asmático/prevención & control
14.
Trials ; 19(1): 466, 2018 Aug 29.
Artículo en Inglés | MEDLINE | ID: mdl-30157917

RESUMEN

BACKGROUND: Despite effective treatments and long-standing management guidelines, there are approximately 1400 hospital admissions for asthma weekly in the United Kingdom (UK), many of which could be avoided. In our previous research, a secondary analysis of the intervention (ARRISA) suggested an improvement in the management of at-risk asthma patients in primary care. ARRISA involved identifying individuals at risk of adverse asthma events, flagging their electronic health records, training practice staff to develop and implement practice-wide processes of care when alerted by the flag, plus motivational reminders. We now seek to determine the effectiveness and cost-effectiveness of ARRISA in reducing asthma-related crisis events. METHODS: We are undertaking a pragmatic, two-arm, multicentre, cluster randomised controlled trial, plus health economic and process evaluation. We will randomise 270 primary care practices from throughout the UK covering over 10,000 registered patients with 'at-risk asthma' identified according to a validated algorithm. Staff in practices randomised to the intervention will complete two 45-min eLearning modules (an individually completed module giving background to ARRISA and a group-completed module to develop practice-wide pathways of care) plus a 30-min webinar with other practices. On completion of training at-risk patients' records will be coded so that a flag appears whenever their record is accessed. Practices will receive a phone call at 4 weeks and a reminder video at 6 weeks and 6 months. Control practices will continue to provide usual care. We will extract anonymised routine patient data from primary care records (with linkage to secondary care data) to determine the percentage of at-risk patients with an asthma-related crisis event (accident and emergency attendances, hospitalisations and deaths) after 12 months (primary outcome). We will also capture the time to crisis event, all-cause hospitalisations, asthma control and any changes in practice asthma management for at-risk and all patients with asthma. Cost-effectiveness analysis and mixed-methods process evaluations will also be conducted. DISCUSSION: This study is novel in terms of using a practice-wide intervention to target and engage with patients at risk from their asthma and is innovative in the use of routinely captured data with record linkage to obtain trial outcomes. TRIAL REGISTRATION: ISRCTN95472706 . Registered on 5 December 2014.


Asunto(s)
Antiasmáticos/uso terapéutico , Asma/tratamiento farmacológico , Sistemas de Apoyo a Decisiones Clínicas , Técnicas de Apoyo para la Decisión , Prestación Integrada de Atención de Salud/organización & administración , Capacitación en Servicio/métodos , Admisión del Paciente , Atención Primaria de Salud/organización & administración , Sistema de Registros , Estado Asmático/prevención & control , Antiasmáticos/economía , Asma/diagnóstico , Asma/economía , Asma/fisiopatología , Análisis Costo-Beneficio , Prestación Integrada de Atención de Salud/economía , Costos de los Medicamentos , Registros Electrónicos de Salud , Costos de Hospital , Humanos , Pulmón/efectos de los fármacos , Pulmón/fisiopatología , Estudios Multicéntricos como Asunto , Admisión del Paciente/economía , Ensayos Clínicos Pragmáticos como Asunto , Atención Primaria de Salud/economía , Ensayos Clínicos Controlados Aleatorios como Asunto , Medición de Riesgo , Factores de Riesgo , Estado Asmático/diagnóstico , Estado Asmático/economía , Estado Asmático/fisiopatología , Factores de Tiempo , Resultado del Tratamiento , Reino Unido , Grabación en Video
15.
Stud Health Technol Inform ; 126: 137-43, 2007.
Artículo en Inglés | MEDLINE | ID: mdl-17476056

RESUMEN

The primary goal of the Care for Asthma via Mobile Phone (CAMP) service is to provide an effective method by which Taiwan's asthma patients can easily monitor their asthma symptoms using a common mobile phone. With the CAMP service, the patient uses his own cellular phone to submit his daily peak expiratory flow rate (PEFR) and answer a simple questionnaire regarding to daily activities. The CAMP service participant then receives an asthma symptom assessment and care suggestion message immediately after imputing his information. This assessment, which is in accordance with the World Health Organization's (WHO) Global Initiative for Asthma (GINA) standard, includes weather conditions that might adversely affect the asthma patient (e.g. temperature, pollen count, etc.). This information is, in turn, used to advise the asthma patient how to avoid a severe asthmatic attack.


Asunto(s)
Consulta Remota/métodos , Estado Asmático/prevención & control , Telemedicina , Humanos , Autocuidado , Taiwán
16.
Sante Publique ; 18(2): 289-98, 2006 Jun.
Artículo en Francés | MEDLINE | ID: mdl-16886551

RESUMEN

A program of patient education was set up at the CHU of Nantes, for groups of children with asthma in 1997. The aim of this study is to realize a formative evaluation to corelate with some effects. This study was proposed to 99 families with asthmatic children. A written questionnaire, was administered to the parents and children, exploring their satisfaction with the programme, their general knowledge and know-how, biomedical parameters. The observation focused on skills and day-to-day life with the illness. The study was completed by 21 families. The majority of the children, aged 7 to 11 years old, had asthma that needed treatment. All of the parents and children were satisfied with their visit to "l'espace du souffle". They all declared having increased their general knowledge and know-how and biomedical parameters did better. They did, however, feel that they did not know enough about how to recognise precursory symptoms of an attack, about how to practise a sport or how to use "corticoids". They also could not control their personal fear during an attack. During the oral questionnaire a general feeling of stress and worry was clearly noticeable in the parents feeling, that did not appear in the written questionnaire. This patient education program appears to be beneficial. Furthermore, this evaluation highlights some subjects that pass unseen during current individual consultations.


Asunto(s)
Asma , Educación del Paciente como Asunto/normas , Antiasmáticos/administración & dosificación , Asma/fisiopatología , Asma/prevención & control , Asma/psicología , Actitud Frente a la Salud , Niño , Miedo/psicología , Francia , Conductas Relacionadas con la Salud , Conocimientos, Actitudes y Práctica en Salud , Hospitales de Enseñanza , Humanos , Padres/psicología , Satisfacción del Paciente , Evaluación de Programas y Proyectos de Salud , Autocuidado , Deportes/fisiología , Estado Asmático/prevención & control , Estado Asmático/psicología , Estrés Psicológico/psicología
19.
MULTIMED ; 24(5)2020. tab
Artículo en Español | CUMED | ID: cum-78221

RESUMEN

Se realizó un estudio prospectivo, con modelo cuasi experimental en los pacientes asmáticos pertenecientes del Policlínico 13 de Marzo, con el objetivo de evaluar la eficacia de la tintura de ajo al 20 por ciento en el tratamiento intercrisis del Asma Bronquial, en el período comprendido de enero de 2018 a mayo de 2019. El Universo estuvo representado por 88 pacientes asmáticos entre 20-59 años de edad dispensarizados en el consultorio 25. La muestra quedó constituida por 84 pacientes que cumplieron con los criterios de inclusión y de exclusión. Los pacientes fueron distribuidos de forma aleatoria, en dos grupos control y experimental, utilizando la tabla de números aleatorios computarizados, en una proporción pareada de 1:1. Se empleó la prueba de diferencia de proporciones para muestras independientes y se trabajó con un nivel de significación p=0,05. Con este proyecto se contribuyó al desarrollo de la medicina natural y tradicional en nuestro país. Se demostró la eficacia de la tintura de ajo en el 97.6 por ciento de los pacientes. Los hombres fueron los más afectados por las crisis y se reportaron 3 efectos adversos de forma leve(AU)


A prospective study was carried out, with a quasi-experimental model in asthmatic patients belonging to the 13 de Marzo Polyclinic, with the aim of evaluating the efficacy of the 20 percent garlic tincture in the inter-crisis treatment of Bronchial Asthma, in the period from January from 2018 to May 2019. El universo was represented by 88 asthmatic patients between 20-59 years of age dispensed in the office 25. The sample consisted of 84 patients who met the inclusion and exclusion criteria. The patients were randomized into two control and experimental groups, using the table of computerized random numbers, in a paired ratio of 1: 1. The difference of proportions test was used for independent samples and the level of significance was p = 0.05. This project contributed to the development of natural and traditional medicine in our country. The efficacy of garlic tincture was demonstrated in 97.6 percent of patients. Men were the most affected by the seizures and 3 mild adverse effects were reported(EU)


Asunto(s)
Humanos , Masculino , Ajo/efectos adversos , Estado Asmático/prevención & control , Eficacia , Medicina Tradicional , Estudios Prospectivos , Ensayos Clínicos Controlados no Aleatorios como Asunto
20.
Rev. cuba. pediatr ; 92(2): e834, abr.-jun. 2020. tab
Artículo en Español | LILACS, CUMED | ID: biblio-1126747

RESUMEN

Introducción: El asma es un problema frecuente en la niñez y adolescencia y es importante su adecuado control. Objetivos: Estimar el nivel de control de asma en niños y adolescentes atendidos en establecimientos de salud. Métodos: Estudio censal de tipo transversal descriptivo realizado en la ciudad de. Chiclayo, entre julio-diciembre 2013. Se incluyeron menores de edad de 5 a 18 años con diagnóstico de asma. Se identificaron a los pacientes en la base de datos de la red de salud Lambayeque y se les realizó una visita domiciliaria donde se les invitó al estudio y se aplicó el instrumento de evaluación. Resultados: Se identificaron 203 pacientes, se contactaron y reclutaron 107 individuos. Se incluyeron 89 (83,2 por ciento) niños y 18 (16,8 por ciento) adolescentes con una mediana de edad de 7 (p25= 5/p75= 9) años y 15 (p25= 15/p75= 17) años, respectivamente. Según el puntaje del instrumento de evaluación: 52 (48,6 por ciento) estaban mal controlados; 46 (43,0 por ciento) parcialmente controlados; y 9 (8,4 por ciento), bien controlados. En el caso de los niños, la frecuencia de no control fue de 48,3 por ciento, parcialmente controlado 43,8 por ciento y controlado 7,9 por ciento; y en los adolescentes fue de 50,0; 38,9 y 11,1 por ciento, respectivamente. Se observó una relación significativa entre el nivel de control y el nivel educativo del cuidador en niños (p= 0,006) y adolescentes (p= 0,005). Conclusiones: Se demuestra una frecuencia elevada de control inadecuado de asma, lo cual contrasta con otras realidades similares donde hay una mayor frecuencia de control(AU)


Introduction: Asthma is a common problem in childhood and adolescence and is important its adequate control. Objectives: To estimate the level of asthma control in children and adolescents treated in health facilities. Methods: Census data of descriptive cross-sectional type study conducted in the city of Chiclayo, from July to December, 2013. There were included children from 5 to 18 years diagnosed with asthma. Patients were identified in the database of Lambayeque health network and underwent a home visit where they were invited to the study and it was applied the assessment instrument. Results: 203 patients were identified, and there were contacted and recruited 107 individuals. 89 (83.2 percent) children and 18 (16.8 percent) adolescents were included with a mean age of 7 (p25= 5/p75= 9) and 15 (p25= 15/p75= 17) years, respectively. According to the score of the assessment instrument: 52 (48.6 percent) were poorly controlled; 46 (43.0 percent) partially controlled; and 9 (8.4 percent), well-controlled. In the case of children, the frequency of no control was of 48.3 percent, partially controlled was 43.8 percent and controlled was 7.9 percent; and in the adolescents, it was 50.0, 38.9 and 11.1 percent , respectively. It was observed a significant relationship between the level of control and the educational level of the caregiver in children (p= 0.006) and adolescents (p= 0.005). Conclusions: It is demonstrated the high frequency of inadequate control of asthma, which contrasts with other similar realities where there is a greater frequency of control(AU)


Asunto(s)
Humanos , Masculino , Asma/prevención & control , Estado Asmático/prevención & control
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