Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 15.888
Filtrar
2.
Sichuan Da Xue Xue Bao Yi Xue Ban ; 52(5): 725-728, 2021 Sep.
Artigo em Chinês | MEDLINE | ID: mdl-34622583

RESUMO

Over the last decades, the overall prevalence of childhood asthma in China has been on the rise, and the level of diagnosis and treatment of asthma has also shown significant improvement. However, the overall control of childhood asthma in China has not yet reached the ideal level. The main causes are as follows: due to high social pressure and other factors, the accurate diagnosis of childhood asthma by clinicians is still insufficient; clinicians do not have sufficient understanding of environmental pollution and other controllable factors that may affect the rising prevalence of childhood asthma and poor asthma control; the standardization of clinical asthma treatment needs to be further improved. Clinicians should improve their understanding of childhood asthma, formulate therapeutic regimes based on the guidelines, and constantly improve the management of childhood asthma.


Assuntos
Asma , Asma/diagnóstico , Asma/epidemiologia , Asma/terapia , China/epidemiologia , Humanos , Prevalência
4.
Allergy Asthma Proc ; 42(5): 400-402, 2021 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-34474709

RESUMO

Background: On January 20, 2020, the first documented case of novel severe acute respiratory syndrome coronavirus 2 (coronavirus disease 2019 [COVID-19]) was reported in the United States. The U.S. Centers for Disease Control and Prevention continues to report more morbidity and mortality in adults than in children. Early in Pandemic, there was a concern that patients with asthma would be affected disproportionately from COVID-19, but this was not manifested. It is now recognized that angiotensin-converting enzyme 2 receptors that are used by the coronavirus for infection have low expression in children with atopy that may contribute to decreased infectivity in children who are atopic. There are several early reports of decreased emergency department (ED) visits for children with asthma. The authors previously reported a decrease in pediatric ED visits in the spring of 2020, which correlated with school closure. Objective: To determine if this trend of decreased ED visits for pediatric asthma was sustained throughout the first COVID-19 pandemic year. Methods: ED data from one inner city children's hospital were collected by using standard medical claims codes. Conclusion: We reported a sustained year of decreased ED visits for children with asthma in one pediatric ED in an inner-city hospital; this seemed to be secondary to school closure and decreased exposure to upper respiratory infections.


Assuntos
Asma , COVID-19/prevenção & controle , Progressão da Doença , Serviço Hospitalar de Emergência/tendências , Utilização de Instalações e Serviços/tendências , Doença Aguda , Adolescente , Asma/etiologia , Asma/fisiopatologia , Asma/terapia , Criança , Pré-Escolar , Exposição Ambiental/prevenção & controle , Exposição Ambiental/estatística & dados numéricos , Feminino , Humanos , Masculino , Michigan , Distanciamento Físico , Instituições Acadêmicas , Saúde da População Urbana
5.
J Med Internet Res ; 23(9): e26434, 2021 09 09.
Artigo em Inglês | MEDLINE | ID: mdl-34499039

RESUMO

BACKGROUND: Technology, including mobile apps, has the potential to support self-management of long-term conditions and can be tailored to enhance adoption. We developed an app to support asthma self-management among people with limited health literacy in a web-based workshop (to ensure physical distancing during the COVID-19 pandemic). OBJECTIVE: The aim of this study is to develop and test a prototype asthma self-management mobile app tailored to the needs of people with limited health literacy through a web-based workshop. METHODS: We recruited participants from a primary care center in Malaysia. We adapted a design sprint methodology to a web-based workshop in five stages over 1 week. Patients with asthma and limited health literacy provided insights into real-life self-management issues in stage 1, which informed mobile app development in stages 2-4. We recruited additional patients to test the prototype in stage 5 using a qualitative research design. Participants gave feedback through a concurrent thinking-aloud process moderated by a researcher. Each interview lasted approximately 1 hour. Screen recordings of app browsing activities were performed. Interviews were audio-recorded and analyzed using a thematic approach to identify utility and usability issues. RESULTS: The stakeholder discussion identified four themes: individual, family, friends, and society and system levels. Five patients tested the prototype. Participants described 4 ways in which the app influenced or supported self-management (utility): offering information, providing access to an asthma action plan, motivating control of asthma through support for medication adherence, and supporting behavior change through a reward system. Specific usability issues addressed navigation, comprehension, and layout. CONCLUSIONS: This study proved that it was possible to adapt the design sprint workshop to a web-based format with the added advantage that it allowed the development and the testing process to be done efficiently through various programs. The resultant app incorporated advice from stakeholders, including sources for information about asthma, medication and appointment reminders, accessible asthma action plans, and sources for social support. The app is now ready to move to feasibility testing.


Assuntos
Asma , COVID-19 , Letramento em Saúde , Autogestão , Asma/terapia , Humanos , Internet , Pandemias , SARS-CoV-2 , Design Centrado no Usuário
6.
Pediatr Clin North Am ; 68(5): 1119-1131, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34538303

RESUMO

The coronavirus disease 2019 (COVID-19) pandemic has caused severe economic and health impacts in the United States, and the impact is disproportionately more in socially disadvantages areas. The available data, albeit limited in children, suggest that the initial concerns of the potential of serious impact of COVID-19 illness in children with asthma are unproven so far. The reduction in asthma morbidities is due to improved adherence, COVID-19 control measures, school closures, and decreased exposure to allergens and viral infections in children. During the pandemic, asthma guidelines were updated to guide physicians in asthma care. In the face of unprecedented time, it is important to be vigilant, adhere to treatment guidelines, and implement preventive measures to eradicate the virus and improve outcomes in children with asthma.


Assuntos
Asma/enzimologia , Asma/terapia , COVID-19/epidemiologia , Educação de Pacientes como Assunto/métodos , Serviços de Saúde Escolar/organização & administração , COVID-19/terapia , Criança , Humanos , Adesão à Medicação , Instituições Acadêmicas/organização & administração , Telemedicina/estatística & dados numéricos , Estados Unidos
7.
MMWR Surveill Summ ; 70(5): 1-32, 2021 09 17.
Artigo em Inglês | MEDLINE | ID: mdl-34529643

RESUMO

PROBLEM: Asthma is a chronic disease of the airways that requires ongoing medical management. Socioeconomic and demographic factors as well as health care use might influence health patterns in urban and rural areas. Persons living in rural areas tend to have less access to health care and health resources and worse health outcomes. Characterizing asthma indicators (i.e., prevalence of current asthma, asthma attacks, emergency department and urgent care center [ED/UCC] visits, and asthma-associated deaths) and determining how asthma exacerbations and health care use vary across the United States by geographic area, including differences between urban and rural areas, and by sociodemographic factors can help identify subpopulations at risk for asthma-related complications. REPORTING PERIOD: 2006-2018. DESCRIPTION OF SYSTEM: The National Health Interview Survey (NHIS) is an annual cross-sectional household health survey among the civilian noninstitutionalized population in the United States. NHIS data were used to produce estimates for current asthma and among them, asthma attacks and ED/UCC visits. National Vital Statistics System (NVSS) data were used to estimate asthma deaths. Estimates of current asthma, asthma attacks, ED/UCC visits, and asthma mortality rates are described by demographic characteristics, poverty level (except for deaths), and geographic area for 2016-2018. Trends in asthma indicators by metropolitan statistical area (MSA) category for 2006-2018 were determined. Current asthma and asthma attack prevalence are provided by MSA category and state for 2016-2018. Detailed urban-rural classifications (six levels) were determined by merging 2013 National Center for Health Statistics (NCHS) urban-rural classification data with 2016-2018 NHIS data by county and state variables. All subregional estimates were accessed through the NCHS Research Data Center. RESULTS: Current asthma was higher among boys aged <18 years, women aged ≥18 years, non-Hispanic Black (Black) persons, non-Hispanic multiple-race (multiple-race) persons, and Puerto Rican persons. Asthma attacks were more prevalent among children, females, and multiple-race persons. ED/UCC visits were more prevalent among children, women aged ≥18 years, and all racial and ethnic groups (i.e., Black, non-Hispanic Asian, multiple race, and Hispanic, including Puerto Rican, Mexican, and other Hispanic) except American Indian and Alaska Native persons compared with non-Hispanic White (White) persons. Asthma deaths were higher among adults, females, and Black persons. All pertinent asthma outcomes were also more prevalent among persons with low family incomes. Current asthma prevalence was higher in the Northeast than in the South and the West, particularly in small MSA areas. The prevalence was also higher in small and medium metropolitan areas than in large central metropolitan areas. The prevalence of asthma attacks differed by MSA category in four states. The prevalence of ED/UCC visits was higher in the South than the Northeast and the Midwest and was also higher in large central metropolitan areas than in micropolitan and noncore areas. The asthma mortality rate was highest in non-MSAs, specifically noncore areas. The asthma mortality rate was also higher in the Northeast, Midwest, and West than in the South. Within large MSAs, asthma deaths were higher in the Northeast and Midwest than the South and West. INTERPRETATION: Despite some improvements in asthma outcomes over time, the findings from this report indicate that disparities in asthma indicators persist by demographic characteristics, poverty level, and geographic location. PUBLIC HEALTH ACTION: Disparities in asthma outcomes and health care use in rural and urban populations identified from NHIS and NVSS can aid public health programs in directing resources and interventions to improve asthma outcomes. These data also can be used to develop strategic goals and achieve CDC's Controlling Childhood Asthma and Reducing Emergencies (CCARE) initiative to reduce childhood asthma hospitalizations and ED visits and prevent 500,000 asthma-related hospitalizations and ED visits by 2024.


Assuntos
Asma/epidemiologia , Disparidades nos Níveis de Saúde , Vigilância da População , Adolescente , Adulto , Distribuição por Idade , Idoso , Instituições de Assistência Ambulatorial/estatística & dados numéricos , Asma/etnologia , Asma/terapia , Criança , Pré-Escolar , Estudos Transversais , Serviço Hospitalar de Emergência/estatística & dados numéricos , Grupos Étnicos/estatística & dados numéricos , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , População Rural/estatística & dados numéricos , Distribuição por Sexo , Estados Unidos/epidemiologia , População Urbana/estatística & dados numéricos , Adulto Jovem
8.
BMJ Open ; 11(8): e048137, 2021 08 05.
Artigo em Inglês | MEDLINE | ID: mdl-34353798

RESUMO

OBJECTIVE: This study will add to existing literature by examining the impact of smoke-free legislation in outdoor areas among children with asthma. We aimed to examine the effect of the 2015 Smoke-Free Ontario Act (SFOA) amendment, which prohibited smoking on patios, playgrounds and sports fields, on health services use (HSU) rates in children with asthma. METHODS: We conducted a population-based open cohort study using health administrative data from the province of Ontario, Canada. Each year, all Ontario residents aged 0-18 years with physician diagnosed asthma were included in the study. Annual rates of HSU (emergency department (ED) visits, hospitalisations and physician office visits) for asthma and asthma-related conditions (eg, bronchitis, allergic rhinitis, influenza and pneumonia) were calculated. Interrupted time-series analysis, accounting for seasonality, was used to estimate changes in HSU following the 2015 SFOA. RESULTS: The study population ranged from 618 957 individuals in 2010 to 498 812 in 2018. An estimated average increase in ED visits for asthma in infants aged 0-1 years of 0.42 per 100 individuals (95% CI: 0.09 to 0.75) and a 57% relative increase corresponding to the 2015 SFOA was observed. A significant decrease in ED visits for asthma-related conditions of 0.19 per 100 individuals (95% CI: -0.37 to -0.01) and a 22% relative decrease corresponding to the 2015 SFOA was observed. CONCLUSION: Based on the observed positive effect of restricting smoking on patios, playgrounds and sports fields on respiratory morbidity in children with asthma, other jurisdictions globally should consider implementing similar smoke-free policies.


Assuntos
Asma , Asma/epidemiologia , Asma/terapia , Criança , Estudos de Coortes , Serviço Hospitalar de Emergência , Hospitalização , Humanos , Lactente , Ontário/epidemiologia
9.
BMJ Open ; 11(8): e046294, 2021 08 18.
Artigo em Inglês | MEDLINE | ID: mdl-34408032

RESUMO

INTRODUCTION: Health systems in sub-Saharan African (SSA) countries are fragile and centralised. Consequently, majority of people have restricted access to healthcare services. Given the rise in the prevalence and burden of asthma in SSA, it is imperative to scrutinise the utilisation of healthcare services by people with asthma. We aim to understand, through this review, the extent of utilisation of healthcare services by asthma patients in SSA countries. METHODS AND ANALYSIS: Arksey and O'Malley's scoping review methodology framework will be used to guide the conduct of this scoping review. We will conduct a search of the literature on the electronic databases: Medline, (using PubMed interface), EMBASE, EBSCOHOST, Web of Science and Google Scholar, grey literature sources and the reference lists of key studies to identify studies appropriate for inclusion. Two reviewers will independently screen all abstracts and full-text studies for inclusion. Registration of the proposed scoping review on the PROSPERO has indicated that no similar work has been or is being done elsewhere. We will review studies published on the subject from January 2009 to May 2020 in SSA. ETHICS AND DISSEMINATION: The proposed scoping review will contribute towards the knowledge base on utilisation of healthcare services particularly for people with asthma. This will provide a better understanding of the extent of utilisation of healthcare services by asthma patients and ultimately contribute to improvement of quality of care for people suffering from asthma. The results from the review will enlighten and guide healthcare practitioners and researchers on developing appropriate and feasible interventions to increase the utilisation of healthcare services by asthma patients in resource-constrained settings in SSA countries. Results of this scoping review will be disseminated through a peer-reviewed publication, conference presentations and a 1-day stakeholder meeting. PROSPERO REGISTRATION NUMBER: CRD42020154127.


Assuntos
Asma , Atenção à Saúde , África ao Sul do Saara/epidemiologia , Asma/epidemiologia , Asma/terapia , Instalações de Saúde , Serviços de Saúde , Humanos , Literatura de Revisão como Assunto
11.
Arch. argent. pediatr ; 119(4): S123-S158, agosto 2021. tab, ilus
Artigo em Espanhol | LILACS, BINACIS | ID: biblio-1281031

RESUMO

En 1995 se publicó en Archivos Argentinos de Pediatría la primera "Guía de diagnóstico y tratamiento: asma bronquial en niños". En 2007 y 2016 se realizaron actualizaciones. Luego de 5 años se presentan los nuevos contenidos. Las modificaciones más relevantes, aunque no las únicas, se observan en las estrategias terapéuticas. En esta versión se estratifica el tratamiento en "niveles" (1 a 5). El paradigma de cambio en el tratamiento crónico del asma consiste en erradicar la prescripción de broncodilatadores (salbutamol) a demanda, por un lado, y por otro, aparece la opción de tratamiento combinado intermitente con corticoides inhalados y broncodilatadores acción prolongada (LABA) para las formas más leves (niveles 1 y 2), en niños de 12 años o mayores. Aún no se dispone de suficiente evidencia que avale estas opciones en menores de 12 años, por lo que se mantienen las normativas previas vigentes en este grupo. Para más detalles, sugerimos la lectura del documento completo


In 1995, the first Guideline on Diagnosis and Treatment for Childhood Asthma was published in Archivos Argentinos de Pediatría. Updates were made in 2007 and 2016. After 5 years, the new contents are presented. The most relevant modifications, although not the only ones, are observed in therapeutic strategies. In this version, treatment is stratified into "levels" (1 to 5). The current paradigm of change in chronic asthma treatment consists in eradicating the prescription of bronchodilators (salbutamol) on demand. Besides that, the option of intermittent treatment with inhaled corticosteroids plus long-acting bronchodilators (LABA) appears for milder forms (levels 1 and 2) in children > 12 years old. There is still not enough evidence to support these options in < 12 years old maintaining the previous recommendations in this group. For more details we suggest reading the full document.


Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Asma/diagnóstico , Asma/terapia , Asma/fisiopatologia , Asma/prevenção & controle , Asma/tratamento farmacológico , Asma/epidemiologia , Broncodilatadores/uso terapêutico , Anti-Inflamatórios/uso terapêutico
12.
J Fam Pract ; 70(6S): S19-S28, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34432620

RESUMO

KEY TAKEAWAYS: • The 2020 Focused Updates to the Asthma Management Guidelines: A Report from the National Asthma Education and Prevention Program Coordinating Committee Expert Panel Working Group provides updated recommendations for 6 topics related to the management of individuals with asthma. • The classification of asthma severity and asthma control, as well as the concept of utilizing a stepwise approach to pharmacologic treatment, were not updated from the Expert Panel Report 3, released in 2007. • However, important updates in preferred therapies for intermittent and persistent asthma at treatment steps 1 through 5 were suggested. • Recommendations regarding biologic therapy were not included in the 2020 update, as only evidence and US Food and Drug Administration approvals through October 2018 were considered. • The most recent 2021 Global Initiative for Asthma guidelines are not included in this review but can be used in a complementary manner to assist primary care clinicians to optimize decisions regarding the care of patients with asthma.


Assuntos
Asma/terapia , Atenção Primária à Saúde , Antiasmáticos/uso terapêutico , Termoplastia Brônquica , Tomada de Decisão Compartilhada , Expiração , Humanos , Imunoterapia , Adesão à Medicação , Óxido Nítrico/metabolismo , Medição de Risco , Índice de Gravidade de Doença
13.
Br J Hosp Med (Lond) ; 82(7): 1-7, 2021 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-34338015

RESUMO

People with severe and difficult to control asthma can be a complex and heterogenous group of patients often with multiple comorbidities. Living with this disease imposes a huge physical and psychological burden upon the patient which requires a comprehensive, systematic and patient-focused assessment, using a wide range of clinical expertise from within the multidisciplinary team. This article describes a severe asthma systematic and multidimensional day case assessment, and the positive benefits that the authors perceive it offers for patient care. These benefits include a confirmed diagnosis, consideration of alternative diagnosis, enhanced adherence, medication optimisation, access to and gatekeeping of high-cost specialist medications, improved patient self-management skills and signposting to appropriate therapies. As a consequence, they believe that this facilitates better patient outcomes through a reduction in corticosteroid exposure, exacerbations and hospitalisation. This severe asthma multidisciplinary team day case approach offers more than just physical benefits when compared with the traditional medical model. Patient feedback reports an excellent patient experience, feeling listened to, understood, empowered and hopeful for the future.


Assuntos
Asma , Asma/diagnóstico , Asma/terapia , Hospitalização , Humanos , Determinação de Necessidades de Cuidados de Saúde , Equipe de Assistência ao Paciente
15.
BMC Public Health ; 21(1): 1485, 2021 07 29.
Artigo em Inglês | MEDLINE | ID: mdl-34325679

RESUMO

BACKGROUND: Cockroach allergen is one of the most important asthma triggers for children. There is an extensive body of research on interventions to reduce exposure. However, adherence to these interventions is low. Insight into the knowledge, attitudes, and practices (KAP) associated with cockroach remediation is needed. We assessed KAP using the Health Beliefs Model (HBM) as a framework for predicting behavior. This study aimed to assess the socio-demographic and psycho-social characteristics associated with cockroach KAP and to quantify the relationship between KAP and number of cockroaches in the home. METHODS: To identify factors associated with cockroach KAP a cross-sectional study was conducted using a structured questionnaire administered to caregivers of children with asthma in New Orleans, Louisiana. Positive scores in each metric of the KAP signified better cockroach knowledge, increased concern about cockroaches' impact on health (attitudes), and participation in recommended cockroach remediation practices (practices). To evaluate cockroach KAP scores as a predictor of cockroach exposure in the home, a cohort study was conducted among a sub-sample of participants. RESULTS: Fifty-six caregivers participated in the study. Participants had positive scores on all subscales of KAP with knowledge having a lower score compared to attitudes and practices. Cockroach knowledge was inversely correlated with age at asthma diagnosis (ρ = - 0.36, p = 0.01). Caregivers identifying as black/African American had higher cockroach knowledge scores compared to other races (Median: 6.0 v 3.0; p = 0.05). Caregivers other than mothers had higher cockroach attitude scores (Median 6.5 v 4.0; p = 0.003) and total KAP scores (Median 18.0 v 14.0; p = 0.05). Twenty-six participants completed the cohort study. Cockroach exposure was not significantly associated with higher cockroach knowledge, cockroach practice, or total KAP score. For attitude scores, participants in the highest quartile had significantly lower exposure (ß: -1.96, 95% CI: - 3.50 - 0.42) compared to those in the lowest quartile (p = 0.01). CONCLUSIONS: Different socio-demographic and psycho-social factors were associated with the components of cockroach KAP. Greater concern about cockroaches (attitude) was significantly associated with reduced cockroach exposure. This highlights the importance of identifying the key elements of caregiver KAP to improve cockroach remediation among caregivers of children with asthma.


Assuntos
Asma , Baratas , Animais , Asma/terapia , Cuidadores , Criança , Estudos de Coortes , Estudos Transversais , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Louisiana
18.
JMIR Mhealth Uhealth ; 9(7): e24127, 2021 07 16.
Artigo em Inglês | MEDLINE | ID: mdl-34269684

RESUMO

BACKGROUND: Asthma affects 235 million people worldwide. Supported self-management, including an action plan agreed with clinicians, improves asthma outcomes. Internet-of-things (IoT) systems with artificial intelligence (AI) can provide customized support for a range of self-management functions, but trust is vital to encourage patients' adoption of such systems. Many models for understanding trust exist, some explicitly designed for eHealth, but no studies have used these models to explore trust in the context of using IoT systems to support asthma self-management. OBJECTIVE: In this study, we aim to use the McKnight model to explore the functionality, helpfulness, and reliability domains of patients' and clinicians' trust in IoT systems to deliver the 14 components of self-management support defined by the PRISMS (Practical Reviews in Self-Management Support) taxonomy. METHODS: We used think-aloud techniques in semistructured interviews to explore the views of patients and clinicians. Patients were recruited from research registers and social media and purposively sampled to include a range of ages, genders, action plan ownership, asthma duration, hospital admissions, and experience with mobile apps. Clinicians (primary, secondary, and community-based) were recruited from professional networks. Interviews were transcribed verbatim, and thematic analysis was used to explore perceptions of the functionality, helpfulness, and reliability of IoT features to support components of supported self-management. RESULTS: A total of 12 patients and 12 clinicians were interviewed. Regarding perceived functionality, most patients considered that an IoT system had functionality that could support a broad range of self-management tasks. They wanted a system to provide customized advice involving AI. With regard to perceived helpfulness, they considered that IoT systems could usefully provide integrated support for a number of recognized components of self-management support. In terms of perceived reliability, they believed they could rely on the system to log their asthma condition and provide preset action plan advice triggered by their logs. However, they were less confident that the system could operate continuously and without errors in providing advice. They were not confident that AI could generate new advice or reach diagnostic conclusions without the interpretation of their trusted clinicians. Clinicians wanted clinical evidence before trusting the system. CONCLUSIONS: IoT systems including AI were regarded as offering potentially helpful functionality in mediating the action plans developed with a trusted clinician, although our technologically adept participants were not yet ready to trust AI to generate novel advice. Research is needed to ensure that technological capability does not outstrip the trust of individuals using it.


Assuntos
Asma , Mídias Sociais , Inteligência Artificial , Asma/terapia , Feminino , Humanos , Masculino , Reprodutibilidade dos Testes , Confiança
20.
Tuberk Toraks ; 69(2): 253-260, 2021 Jun.
Artigo em Turco | MEDLINE | ID: mdl-34256517

RESUMO

Chronic rhinosinusitis with nasal polyps often accompanies severe asthma. Uncontrolled nasal polyp does not only impair the quality of life, but also makes it difficult to control the accompanying asthma. Eosinophilic chronic sinusitis dominated by type 2 inflammation is phenotypically manifested by nasal polyps. In recent years, approaches towards phenotype and endotype have developed in patients with chronic sinusitis as well as in asthma; biological treatments come into question in uncontrolled patients with appropriate endotype. Randomized controlled trials conducted on treatments that antagonize the Ig-E, IL-5, and IL-4a pathways in these patients are promising. The effectiveness of biological treatments, which we think will be more involved in clinical practice in the management of nasal polyp patients in the near future, will become clear with the increase in real life data in the literature.


Assuntos
Anti-Inflamatórios/uso terapêutico , Asma/terapia , Produtos Biológicos/uso terapêutico , Pólipos Nasais/terapia , Humanos , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...