[Algoritmo de tratamiento de la dermatitis atópica en Perú. Consenso de expertos].

Objective: Atopic dermatitis is a chronic, systemic, relapsing disease with dermatological manifestations, which imposes a high burden on patients, families and the health care system and has a high psychological, social, and economic impact and on the quality of life of patients. It mainly affects the pediatric population and, to a lesser extent, the adult population. The clinical presentation varies according to the age and evolution of the disease, and currently there are multiple pharmacological and non-pharmacological therapies available for the symptomatic management of patients. Methods: To present an algorithm for the management of atopic dermatitis, proposed as a series of recommendations on the management, diagnosis, education, and follow-up of these patients. Results: A consensus was reached using the nominal group technique. The methodology was developed in 7 phases, including: posing the research questions, literature search, an initial proposal of recommendations, elaboration of the final recommendations and the management algorithm with three voting cycles, consensus was established with 80% favorability. Conclusions: The result of the consensus process is a management algorithm for patients with mild, moderate/severe atopic dermatitis derived from expert recommendations. The algorithm establishes diagnostic and treatment criteria and provides updated recommendations, including all therapeutic alternatives available in Peru for the management of patients with mild, moderate, and severe atopic dermatitis.

Objetivo: La dermatitis atópica es una enfermedad crónica, sistémica, reincidente, con manifestaciones dermatológicas, que impone una alta carga a los pacientes, las familias y los sistemas de salud, y tiene repercusión psicológica, social y económica, y en la calidad de vida de los pacientes. Afecta principalmente a la población pediátrica y con menor frecuencia a la adulta. Las manifestaciones clínicas varían según la edad y evolución de la enfermedad, y en la actualidad se dispone de múltiples opciones farmacológicas y no farmacológicas para el tratamiento de los pacientes. Métodos: Presentar un algoritmo de tratamiento de la dermatitis atópica, propuesto con una serie de recomendaciones acerca del diagnóstico, tratamiento y seguimiento de los pacientes. Resultados: Se llevó a cabo un consenso de expertos, utilizando la técnica del grupo nominal. La metodología se desarrolló en 7 fases que incluyeron: planteamiento de las preguntas de investigación, búsqueda de la bibliografía, propuesta inicial de las recomendaciones, elaboración de las recomendaciones finales y del algoritmo de tratamiento con tres ciclos de votación. Se estableció el consenso con un 80% de favorabilidad. Conclusiones: El resultado del consenso fue un algoritmo de tratamiento de pacientes con dermatitis atópica leve, moderada-grave, derivado de las recomendaciones de expertos. En el algoritmo se establecen criterios diagnósticos y de tratamiento, y se aportan recomendaciones actualizadas que incluyen las alternativas disponibles en Perú.

Information and communication technology use in asthmatic patients: a cross-sectional study in Latin America.

Rapid diffusion, low cost and broad availability of information and communication technologies (ICTs) make them an attractive platform for managing care, communication and interventions in asthma. There is little information in Latin America about usage frequency of ICTs in asthmatic patients. The analysis undertaken consisted of an observational, cross-sectional study that aimed to identify the frequency and type of ICTs most often used by asthmatics. The Spanish version of the Michigan questionnaire was employed in five Latin American countries. Age and educational level was categorised. Logistic regression was performed among these groups concerning the frequency of ICT usage and the level of interest shown in seeking and receiving information about asthma. In total, 673 asthma patients were surveyed. The mean age was 43.44 years. Over two-thirds of the participants were female (68.4%). The most used ICT was the short message service (SMS) (69.9%). SMS and E-mail are useful tools for communicating (i.e. receiving and seeking information) with all asthma patients, irrespective of their age. WhatsApp (61.5%) and Facebook (32.0%) were rated as being the most interesting channels of communication for receiving information. Regression analysis showed that younger asthmatics and asthmatics with higher educational levels were most likely to use almost all forms of ICTs. ICTs are generally an attractive platform for managing care, communication and interventions to improve asthma care. SMS and E-mail were found to be the preferred ICT forms among users. However, social media forms such as WhatsApp and Facebook may also be appropriate for certain types of patient.

[Reference intervals for peripheral blood lymphocyte subsets in healthy adults in Lima, Peru]. / Intervalos de referencia de subpoblaciones linfocitarias de sangre periférica en adultos sanos de Lima, Perú

In order to establish the reference intervals (RIs) of peripheral blood lymphocyte subsets (PBL) in healthy adults in Lima (Peru), a cross-sectional study was conducted among blood donors taken in between 2011 and 2012. Based on the criteria obtained from the guidelines of the Clinical and Laboratory Standards Institute (CLSI C28-A3), 318 samples were processed, 61.9% (197/318) coming from male donors. For PBL count, a flow cytometer with a simple platform was used. The RIs are established for each PBL in adults based on sex with their respective reference limits and 90% confidence intervals. Differences were found in CD3+ percentage counts (p=0.001) and in CD3-CD56+ absolute (p=0.003) and percentage counts (p?0.001). The RIs found are different to those described in studies conducted in other countries due to the characteristics of the population and the study model.

Intervalos de referencia de subpoblaciones linfocitarias de sangre periférica en adultos sanos de Lima, Perú / Reference intervals for peripheral blood lymphocyte subsets in healthy adults in Lima, Peru

Con el objetivo de establecer los Intervalos de Referencia (InR) de las subpoblaciones linfocitarias (SPL) de sangre periférica en adultos sanos de Lima (Perú), se realizó un estudio transversal en donantes de sangre captados entre el 2011-2012. Siguiendo criterios basados en las directrices del Clinical and Laboratory Standards Institute (CLSI C28-A3), se procesaron 318 muestras, el 61,9% (197/318) de ellas procedentes de donantes de sexo masculino. Para el recuento de las SPL se empleó un citómetro de flujo de plataforma simple. Se establecieron los InR de cada SPL en personas adultas según sexo con sus respectivos límites de referencia y sus intervalos de confianza al 90%. Se encontraron diferencias en los recuentos porcentuales de CD3+ (p<0,01); y en los recuentos absolutos (p<0,01) y porcentuales (p=0,01) de CD3-CD56+. Los InR hallados son diferentes a los descritos en estudios realizados en otros países. Dichas diferencias se deben a las características de la población y al modelo de estudio.

In order to establish the reference intervals (RIs) of peripheral blood lymphocyte subsets (PBL) in healthy adults in Lima (Peru), a cross-sectional study was conducted among blood donors taken in between 2011 and 2012. Based on the criteria obtained from the guidelines of the Clinical and Laboratory Standards Institute (CLSI C28-A3), 318 samples were processed, 61.9% (197/318) coming from male donors. For PBL count, a flow cytometer with a simple platform was used. The RIs are established for each PBL in adults based on sex with their respective reference limits and 90% confidence intervals. Differences were found in CD3+ percentage counts (p=0.001) and in CD3-CD56+ absolute (p=0.003) and percentage counts (p?0.001). The RIs found are different to those described in studies conducted in other countries due to the characteristics of the population and the study model.