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1.
Arch. argent. pediatr ; 116(2): 105-111, abr. 2018. ilus, tab
Artigo em Inglês, Espanhol | LILACS, BINACIS | ID: biblio-887455

RESUMO

Introducción. El asma grave representa 5-7% del total de asmáticos. La OMS propuso un protocolo de seguimiento para categorizarlos como asma grave resistente al tratamiento (AGRT) o asma grave de difícil control (AGDC). Objetivo. Analizar las características clínicas, funcionales y terapéuticas de pacientes con AGRT o AGDC. Métodos. Estudio transversal, observacional y analítico para evaluar el diagnóstico, grado de control (clínico y funcional), comorbilidades, adherencia al tratamiento, técnica inhalatoria y factores ambientales en pacientes con asma grave. Resultados. Se incluyeron 69 pacientes: AGRT (n= 33) y AGDC (n= 36). El 100% del grupo con AGRT fue hospitalizado previamente por asma vs. 87,8% del grupo con AGDC (p= 0,03). El 63% del grupo AGRT requirió cuidados intensivos (UCI)), 82%, asistencia ventilatoria y uno fue traqueostomizado. En el AGDC, 54% requirió internación en la UCI , y 33%, asistencia ventilatoria (p= 0,03). La espirometría basal fue normal en el AGDC; se observó incapacidad ventilatoria obstructiva leve en el AGRT (p= 0,009). En el AGDC, hubo menor cumplimiento del tratamiento (p= 0,01). Se requirieron dosis mayores de corticoides inhalados en AGRT (p= 0,0001). Omalizumab fue indicado en AGRT (p= 0,0001). A los 6 meses de seguimiento, más del 75% de los niños en ambos grupos presentó asma controlada. Conclusiones. Se observó significativa falta de adherencia al tratamiento en el grupo AGDC. Se redujeron las dosis de tratamiento en este grupo. Se logró controlar la enfermedad en un alto porcentaje de niños con AGRT y AGDC.


Introduction. Severe asthma accounts for 5-7% of all asthma cases. The World Health Organization proposed a follow-up protocol to classify cases into severe, treatment-resistant asthma (STRA) or severe, difficult-to-control asthma (SDCA). Objective. To analyze the clinical, functional, and therapeutic characteristics of patients with STRA or SDCA. Methods. Cross-sectional, observational, and analytical study to assess the diagnosis, the extent of control (clinical and functional), comorbidities, treatment adherence, inhalation technique, and environmental factors in patients with severe asthma. Results. A total of 69 patients were included: STRA (n= 33) and SDCA (n= 36). In the group with STRA, 100% of patients had been previously hospitalized due to asthma compared to 87.8% in the group with SDCA (p= 0.03). In the group with STRA, 63% required admission to the intensive care unit (ICU); 82%, ventilatory support; and 1 patient, tracheostomy. In the group with SDCA, 54% required admission to the ICU; and 33%, ventilatory support (p= 0.03). The baseline spirometry was normal in the SDCA group; a mild obstructive ventilatory defect was observed in the STRA group (p= 0.009). In the SDCA group, treatment adherence was lower (p= 0.01). Higher inhaled corticosteroid doses were required in the STRA group (p= 0.0001). Omalizumab was indicated in the case of STRA (p= 0.0001). After 6 months of follow-up, more than 75% of children in both groups achieved asthma control. Conclusions. A significant lack of treatment adherence was observed in the SDCA group. In this group, treatment doses were reduced. Asthma was controlled in a high percentage of children with STRA and SDCA.


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Asma/diagnóstico , Asma/etiologia , Asma/terapia , Índice de Gravidade de Doença , Asma/complicações , Protocolos Clínicos , Estudos Transversais , Seguimentos , Cooperação do Paciente , Resultado do Tratamento , Terapia Combinada , Hospitalização
2.
Arch Argent Pediatr ; 116(2): 105-111, 2018 Apr 01.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-29557596

RESUMO

INTRODUCTION: Severe asthma accounts for 5-7% of all asthma cases. The World Health Organization proposed a follow-up protocol to classify cases into severe, treatment-resistant asthma (STRA) or severe, difficult-to-control asthma (SDCA). OBJECTIVE: To analyze the clinical, functional, and therapeutic characteristics of patients with STRA or SDCA. METHODS: Cross-sectional, observational, and analytical study to assess the diagnosis, the extent of control (clinical and functional), comorbidities, treatment adherence, inhalation technique, and environmental factors in patients with severe asthma. RESULTS: A total of 69 patients were included: STRA (n= 33) and SDCA (n= 36). In the group with STRA, 100% of patients had been previously hospitalized due to asthma compared to 87.8% in the group with SDCA (p= 0.03). In the group with STRA, 63% required admission to the intensive care unit (ICU); 82%, ventilatory support; and 1 patient, tracheostomy. In the group with SDCA, 54% required admission to the ICU; and 33%, ventilatory support (p= 0.03).The baseline spirometry was normal in the SDCA group; a mild obstructive ventilatory defect was observed in the STRA group (p= 0.009).In the SDCA group, treatment adherence was lower (p= 0.01). Higher inhaled corticosteroid doses were required in the STRA group (p= 0.0001). Omalizumab was indicated in the case of STRA (p= 0.0001). After 6 months of follow-up, more than 75% of children in both groups achieved asthma control. CONCLUSIONS: A significant lack of treatment adherence was observed in the SDCA group. In this group, treatment doses were reduced. Asthma was controlled in a high percentage of children with STRA and SDCA.


Assuntos
Asma/diagnóstico , Asma/terapia , Índice de Gravidade de Doença , Adolescente , Asma/complicações , Asma/etiologia , Criança , Protocolos Clínicos , Terapia Combinada , Estudos Transversais , Feminino , Seguimentos , Hospitalização , Humanos , Masculino , Cooperação do Paciente , Resultado do Tratamento
3.
Arch Argent Pediatr ; 110(5): 382-7, 2012 Oct.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-23070179

RESUMO

INTRODUCTION: Asthma is a major economic burden to families and public healthcare since it leads to a large number of emergency room (ER) visits and hospital admissions. Whereas healthcare programs for children with asthma have proved to be very effective to improve the course of the disease, there is less information about programs for children with severe asthma. OBJECTIVE: To comparatively analyze the impact of the Healthcare Program for Children with Severe Asthma (Programa de Atención de Niños con Asma Grave, PANAG). METHODS: This was a longitudinal, pre- and postintervention study. Two approaches were used to compare the frequency of asthma exacerbations and hospital admissions due to severe asthma in a group of patients: regular follow-up in a public hospital (pre-intervention period, 18 months) and follow-up while participating in PANAG (post-intervention period, 18 months). During the Program, patients received preventive treatment free of charge; educational activities were also organized. RESULTS: Twenty children were included, 16 (80%) out of the 20 were females, and the mean age was 13.3 years (SD 3.8). During the pre-intervention period 59 asthma attacks were recorded; after PANAG was implemented, they decreased to 26. This accounts for a significant reduction of 55% of asthma attacks (p= 0.0002). During the period previous to PANAG implementation, there were 4 asthma-related hospital admissions. In the period after the program implementation, there was only one hospital admission. CONCLUSIONS: The Healthcare Program for Patients with Severe Asthma is an effective strategy to manage this disease. This healthcare program is affordable to be used in a public hospital.


Assuntos
Asma/terapia , Pré-Escolar , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Masculino , Avaliação de Programas e Projetos de Saúde , Estudos Prospectivos , Estudos Retrospectivos , Índice de Gravidade de Doença
4.
Arch. argent. pediatr ; 110(5): 382-387, oct. 2012. graf, tab
Artigo em Espanhol | BINACIS | ID: bin-129359

RESUMO

Introducción. El asma tiene un alto impacto en la salud pública pues causa un gran número de consultas a los servicios de emergencias y de internaciones. Si bien los programas de atención de niños con asma han demostrado ser muy eficaces para mejorar la evolución de la enfermedad, existe menos información sobre programas para niños con asma grave. Objetivo. Evaluar en forma comparativa el impacto del Programa de Atención de Niños con Asma Grave (PANAG). Métodos. Estudio longitudinal, pre-posintervención. Se comparó el número de exacerbaciones y de internaciones por asma grave en un grupo de pacientes bajo dos estrategias: seguimiento regular en un hospital público (período preintervención, 18 meses) y seguimiento bajo el PANAG (período posintervención, 18 meses). Durante el PANAG los pacientes recibieron en forma gratuita la medicación preventiva y se organizaron actividades educativas. Resultados. Se incluyeron 20 niños, 16 mujeres (80%) con un promedio de edad de 13,3 años (DE 3,8). Durante el período pre-intervención se observaron 59 crisis asmáticas y luego de la implementación del PANAG hubo 26. Esto representa una reducción significativa del 55% en el número de crisis asmáticas (p= 0,0002). Durante el período previo al PANAG se observaron 4 internaciones por asma. En el período posterior solo hubo una hospitalización. Conclusiones. El programa de atención de pacientes con asma grave es una estrategia eficaz para el control de esta patología. Es un modelo de atención factible en un hospital público.(AU)


Introduction. Asthma is a major economic burden to families and public healthcare since it leads to a large number of emergency room (ER) visits and hospital admissions. Whereas healthcare programs for children with asthma have proved to be very effective to improve the course of the disease, there is less information about programs for children with severe asthma. Objective. To comparatively analyze the impact of the Healthcare Program for Children with Severe Asthma (Programa de Atención de Niños con Asma Grave, PANAG). Methods. This was a longitudinal, pre- and postintervention study. Two approaches were used to compare the frequency of asthma exacerbations and hospital admissions due to severe asthma in a group of patients: regular follow-up in a public hospital (pre-intervention period, 18 months) and follow-up while participating in PANAG (post-intervention period, 18 months). During the Program, patients received preventive treatment free of charge; educational activities were also organized. Results. Twenty children were included, 16 (80%) out of the 20 were females, and the mean age was 13.3 years (SD 3.8). During the pre-intervention period 59 asthma attacks were recorded; after PANAG was implemented, they decreased to 26. This accounts for a significant reduction of 55% of asthma attacks (p= 0.0002). During the period previous to PANAG implementation, there were 4 asthma-related hospital admissions. In the period after the program implementation, there was only one hospital admission. Conclusions. The Healthcare Program for Patients with Severe Asthma is an effective strategy to manage this disease. This healthcare program is affordable to be used in a public hospital.(AU)


Assuntos
Pré-Escolar , Feminino , Humanos , Masculino , Asma/terapia , Hospitalização/estatística & dados numéricos , Avaliação de Programas e Projetos de Saúde , Estudos Prospectivos , Estudos Retrospectivos , Índice de Gravidade de Doença
5.
Arch. argent. pediatr ; 110(5): 382-387, oct. 2012. graf, tab
Artigo em Espanhol | LILACS | ID: lil-657476

RESUMO

Introducción. El asma tiene un alto impacto en la salud pública pues causa un gran número de consultas a los servicios de emergencias y de internaciones. Si bien los programas de atención de niños con asma han demostrado ser muy eficaces para mejorar la evolución de la enfermedad, existe menos información sobre programas para niños con asma grave. Objetivo. Evaluar en forma comparativa el impacto del Programa de Atención de Niños con Asma Grave (PANAG). Métodos. Estudio longitudinal, pre-posintervención. Se comparó el número de exacerbaciones y de internaciones por asma grave en un grupo de pacientes bajo dos estrategias: seguimiento regular en un hospital público (período preintervención, 18 meses) y seguimiento bajo el PANAG (período posintervención, 18 meses). Durante el PANAG los pacientes recibieron en forma gratuita la medicación preventiva y se organizaron actividades educativas. Resultados. Se incluyeron 20 niños, 16 mujeres (80%) con un promedio de edad de 13,3 años (DE 3,8). Durante el período pre-intervención se observaron 59 crisis asmáticas y luego de la implementación del PANAG hubo 26. Esto representa una reducción significativa del 55% en el número de crisis asmáticas (p= 0,0002). Durante el período previo al PANAG se observaron 4 internaciones por asma. En el período posterior solo hubo una hospitalización. Conclusiones. El programa de atención de pacientes con asma grave es una estrategia eficaz para el control de esta patología. Es un modelo de atención factible en un hospital público.


Introduction. Asthma is a major economic burden to families and public healthcare since it leads to a large number of emergency room (ER) visits and hospital admissions. Whereas healthcare programs for children with asthma have proved to be very effective to improve the course of the disease, there is less information about programs for children with severe asthma. Objective. To comparatively analyze the impact of the Healthcare Program for Children with Severe Asthma (Programa de Atención de Niños con Asma Grave, PANAG). Methods. This was a longitudinal, pre- and postintervention study. Two approaches were used to compare the frequency of asthma exacerbations and hospital admissions due to severe asthma in a group of patients: regular follow-up in a public hospital (pre-intervention period, 18 months) and follow-up while participating in PANAG (post-intervention period, 18 months). During the Program, patients received preventive treatment free of charge; educational activities were also organized. Results. Twenty children were included, 16 (80%) out of the 20 were females, and the mean age was 13.3 years (SD 3.8). During the pre-intervention period 59 asthma attacks were recorded; after PANAG was implemented, they decreased to 26. This accounts for a significant reduction of 55% of asthma attacks (p= 0.0002). During the period previous to PANAG implementation, there were 4 asthma-related hospital admissions. In the period after the program implementation, there was only one hospital admission. Conclusions. The Healthcare Program for Patients with Severe Asthma is an effective strategy to manage this disease. This healthcare program is affordable to be used in a public hospital.


Assuntos
Pré-Escolar , Feminino , Humanos , Masculino , Asma/terapia , Hospitalização/estatística & dados numéricos , Avaliação de Programas e Projetos de Saúde , Estudos Prospectivos , Estudos Retrospectivos , Índice de Gravidade de Doença
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