[MIA 2021, Comprehensive Asthma Management. Guidelines for Mexico]. / MIA 2021, Manejo Integral del Asma. Lineamientos para México.

BACKGROUND: Asthma continues to be one of the most frequent chronic respiratory diseases in our country. New methods for diagnosis and treatment have been described; accordingly, the international guidelines were renewed. OBJECTIVE: To create a national platform for the development of updated guidelines, solidly based on evidence: Comprehensive Asthma Management (Spanish acronym: MIA). METHODS: MIA uses the ADAPTE method. The MIA development group consists of experts in pulmonology-allergology-methodology and representatives of 13 institutions and societies of specialties that manage asthma. The international reference guidelines (selected with AGREE-II): GINA 2020, GEMA 5.0, BTS/SIGN 2019 and ATS/ERS consensus document 2014-2019 on severe asthma. MIA covers suspected asthma, diagnosis, treatment, and special groups. Key clinical questions were formulated on treatment steps 1-3, biomarkers and severe asthma. RESULTS: Based on evidence, safety, cost and local reality, the core group developed responses. Through a Delphi process the broad MIA development group suggested adjustments until consensus was reached. CONCLUSION: A document was generated with multiple figures and algorithms, solidly based on evidence about asthma management, adjusted for Mexico with a broad base among different societies that participated in its development. It does not include guidelines for acute asthma.

Antecedentes: El asma sigue siendo una patología respiratoria crónica frecuente en México. Se han descrito nuevos métodos para el diagnóstico y tratamiento conforme se renuevan las guías internacionales. Objetivo: Crear la plataforma nacional Manejo Integral del Asma (MIA), para el desarrollo de lineamientos actualizados con base en evidencia. Métodos: Se utilizó el método ADAPTE. El grupo de desarrollo de MIA estuvo integrado por expertos en neumología, alergología y metodología y representantes de 13 instituciones y sociedades de especialidades que manejan asma. Las guías internacionales de referencia (seleccionadas con AGREE-II) fueron GINA 2020, GEMA 5.0, BTS/SIGN 2019 y consenso ATS/ERS 2014-2019. En MIA se aborda sospecha de asma, diagnóstico, tratamiento y grupos especiales. Se formularon preguntas clínicas clave sobre tratamiento en los pasos 1 a 3, biomarcadores y asma grave. Resultados: Con base en evidencia, seguridad, costo y realidad local, el grupo nuclear desarrolló respuestas. Mediante proceso Delphi, el grupo amplio de desarrollo sugirió ajustes hasta que se logró el consenso. Conclusión: El documento generado contiene múltiples figuras y algoritmos, está sólidamente basado en evidencia acerca del manejo del asma y fue ajustado para México con participación de diferentes sociedades para su desarrollo; no se incluyeron lineamientos para la crisis asmática.

Frecuencia de reacciones adversas de la vacuna antigripal en personal sanitario de un hospital universitario en España / Frequency of adverse reactions after influenza vaccination in health care personnel of a university hospital in Spain

Introducción Entre los argumentos del trabajador sanitario para no vacunarse de gripe está el temor a reacciones adversas (RA). El objetivo fue estudiar la frecuencia y las características de tales reacciones. Métodos Estudio de cohortes que incluyó a los 2.587 trabajadores vacunados en las temporadas (..) (AU)

Introduction One of the reported arguments to health-care personnel receiving influenza vaccination is fear of Adverse Reactions (AR). The objective of this study was to investigate the frequency and characteristics of AR associated with the influenza (..) (AU)

Frecuencia de reacciones adversas de la vacuna antigripal en personal sanitario de un hospital universitario en España / Frequency of adverse reactions after influenza vaccination in health care personnel of a university hospital in Spain

Introducción Entre los argumentos del trabajador sanitario para no vacunarse de gripe está el temor a reacciones adversas (RA). El objetivo fue estudiar la frecuencia y las características de tales reacciones. Métodos Estudio de cohortes que incluyó a los 2.587 trabajadores vacunados en las temporadas 2006–2007, 2007–2008 y 2008–2009. Para detectar RA se contactó con el trabajador una semana después de la vacunación. Esultados Se evaluaron 1.893 trabajadores (73,2%). El 30,3% sufrió alguna RA. Ninguna reacción fue grave. Conclusiones El temor a la gravedad de las RA no parece justificable como motivo de rechazo a la vacuna antigripal (AU)

Introduction One of the reported arguments to health-care personnel receiving influenza vaccination is fear of Adverse Reactions (AR). The objective of this study was to investigate the frequency and characteristics of AR associated with the influenza vaccine. Methods Cohort study; 2587 health-care workers vaccinated against influenza during the seasons 2006–2007, 2007–2008 and 2008–2009 were included. They were asked about any AR seven days after the vaccination. Results A total of 1893 health-care workers were evaluated (73.2%). An AR was reported by 30.3%. There were no serious AR reported. Conclusion The fear of the severity of AR does not seem to be justifiable as a reason for refusing the flu vaccine (AU)

[Frequency of adverse reactions after influenza vaccination in health care personnel of a university hospital in Spain]. / Frecuencia de reacciones adversas de la vacuna antigripal en personal sanitario de un hospital universitario en España.

INTRODUCTION: One of the reported arguments to health-care personnel receiving influenza vaccination is fear of Adverse Reactions (AR). The objective of this study was to investigate the frequency and characteristics of AR associated with the influenza vaccine. METHODS: Cohort study; 2587 health-care workers vaccinated against influenza during the seasons 2006-2007, 2007-2008 and 2008-2009 were included. They were asked about any AR seven days after the vaccination. RESULTS: A total of 1893 health-care workers were evaluated (73.2%). An AR was reported by 30.3%. There were no serious AR reported. CONCLUSION: The fear of the severity of AR does not seem to be justifiable as a reason for refusing the flu vaccine.