RESUMO
This an updated guidelines for the diagnosis and management of asthma, developed by the Saudi Initiative for Asthma (SINA) group, a subsidiary of the Saudi Thoracic Society. The main objective of SINA is to have updated guidelines, which are simple to understand and easy to use by non-asthma specialists, including primary care and general practice physicians. This new version includes updates of acute and chronic asthma management, with more emphasis on the use of Asthma Control Test in the management of asthma, and a new section on "difficult-to-treat asthma." Further, the section on asthma in children was re-written to cover different aspects in this age group. The SINA panel is a group of Saudi experts with well-respected academic backgrounds and experience in the field of asthma. The guidelines are formatted based on the available evidence, local literature, and the current situation in Saudi Arabia. There was an emphasis on patient-doctor partnership in the management that also includes a self-management plan. The approach adopted by the SINA group is mainly based on disease control as it is the ultimate goal of treatment.
RESUMO
Respiratory syncytial virus RSV, a nonsegmented, single stranded ribonucleic acid virus, infects one-half of all infants within the first year of life. Respiratory syncytial virus possesses pathogenetic qualities that may be attributed to the interplay of viral and host-specific factors including virus strains of different virulence, size of the inoculum, family history of asthma or airway hyper-reactivity and immunologic anomalies of the host. Inflammatory cell recruitment and activation occur in response to RSV infection of epithelial cells. Epithelial cells initiate the inflammatory response to RSV by elaborating a wide variety of cytokines and chemokines that trigger further inflammatory responses. Treatment of RSV in infants with bronchiolitis is complicated due to the multifactorial nature of this infection. Treatment of RSV bronchiolitis rests primarily on supportive care with oxygen and fluid management. Other therapies commonly used include bronchodilators, corticosteroids and ribavirin, where considered appropriate. Although oxygen administration and judicious fluid replacement are the only interventions proved to be of reliable benefit to infants with bronchiolitis, newer studies support a role for adjunctive therapies aimed at relieving airway obstruction, especially when administered very early in the course of the illness or given to infants with more severe disease.
