Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 4.625
Filter
1.
Rev. bras. med. esporte ; 28(3): 192-194, May-June 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1365704

ABSTRACT

ABSTRACT Introduction: Chronic obstructive pulmonary disease (COPD) is one of the most common diseases in the lungs. Objective: To evaluate the clinical effect of respiratory rehabilitation training combined with Traditional Chinese and western medicine on the clinical treatment of motor function in patients with COPD. Methods: 156 patients with chronic obstructive pulmonary disease admitted to a hospital from December 2013 to June 2015 were selected as study subjects and randomly divided into groups for treatment. Results: comparing blood gas exchange rates of patients in the four groups, the experimental group, trained using integrated Chinese and Western medicine, was significantly better than the control groups A, B and C, in aspects such as PaCO2, PaO2, SaO2, pH, etc., the difference was statistically significant (p < 0.05). The improvement of lung function in the experimental group was significantly better than in the other three groups, with statistical significance (p < 0.05). Conclusions: Applying Chinese and Western Medicine combined with comprehensive respiratory rehabilitation training has a significant clinical effect. It effectively improved patients' related clinical indicators and should be widely promoted. Level of evidence II; Therapeutic studies - investigation of treatment results.


RESUMO Introdução: A doença pulmonar obstrutiva crônica (DPOC) é uma das doenças pulmonares mais comuns. Objetivo: Avaliar os efeitos clínicos de treino para reabilitação respiratória somado ao uso de medicina ocidental e medicina tradicional chinesa combinadas, no tratamento da função motora de pacientes com DPOC. Métodos: 156 pacientes com DPOC, hospitalizados entre dezembro de 2013 e junho de 2015, foram selecionados como objetos de estudo e aleatoriamente divididos em grupos de tratamento. Resultados: Quanto aos níveis de troca gasosa dos pacientes nos quatro grupos, o grupo experimental, treinado por meio de práticas de medicina ocidental e de medicina tradicional chinesa combinadas teve uma performance significativamente melhor que a dos grupos A, B, e C, em aspectos tais como PaCO2, PaO2, SaO2, pH, etc., com significância estatística (p<0,05). A melhoria da função pulmonar no grupo experimental também foi significativamente maior que nos outros grupos, mais uma vez com significância estatística (p<0,05). Conclusões: A aplicação da medicina chinesa e da medicina ocidental combinadas, somadas a um treino de reabilitação respiratória abrangente, teve um efeito clínico significativo, efetivamente melhorando indicadores clínicos relevantes. Tal aplicação deveria ser largamente promovida. Nível de evidência II; Estudos terapêuticos - investigação de resultados de tratamento.


RESUMEN Introducción: La enfermedad pulmonar obstructiva crónica (EPOC) es una de las enfermedades pulmonares más comunes. Objetivo: Evaluar los efectos clínicos de entrenamiento para rehabilitación respiratoria sumado al uso de medicina occidental y medicina tradicional china combinadas en el tratamiento de la función motora de pacientes con EPOC. Métodos: 156 pacientes con EPOC, hospitalizados entre diciembre de 2013 y junio de 2015, fueron seleccionados como objetos de estudio y aleatoriamente divididos en grupos de tratamiento. Resultados: En cuanto a los niveles de intercambio gaseoso de los pacientes de los cuatro grupos, el grupo experimental, entrenado mediante prácticas combinadas de medicina occidental y medicina tradicional china, obtuvo un rendimiento significativamente mejor que los grupos A, B y C, en aspectos como PaCO2, PaO2, SaO2, pH, etc., con significancia estadística (p<0,05). La mejora de la función pulmonar en el grupo experimental también fue significativamente mayor que en los otros grupos, una vez más con significancia estadística (p<0,05). Conclusiones: La aplicación de la medicina china y de la medicina occidental combinadas, sumadas a un entrenamiento de rehabilitación respiratorio abarcativo, tuvo un efecto clínico significativo, efectivamente mejorando indicadores clínicos relevantes. Tal aplicación debería ser largamente promovida. Nivel de evidencia II; Estudios terapéuticos - investigación de resultados de tratamiento.

2.
Invest. educ. enferm ; 40(1): 37-52, 01/03/2022. ilus, tab
Article in English | LILACS, BDENF, COLNAL | ID: biblio-1367715

ABSTRACT

Objective. To investigate the effect of teach-back education on patient asthma control and family care pressure of patients with asthma. Methods. The present study is a clinical trial and the study population was patients referred to Shahid Faghihi and Shahid Motahhari clinics in Shiraz, Iran. 58 patients with asthma and their caregivers were randomly assigned to the intervention and control groups, for a total of 29 subjects in each group. In the intervention group: the teach-back method was delivered individually to the patient and his or her primary caregiver in three sessions of approximately 60 minutes at one-day intervals. each session included presentations, practical techniques and a booklet. In this study, patients and caregivers in the control group were not trained. Before the intervention, 4 and 8 weeks after the intervention, asthma control test and spirometry test were performed to evaluate asthma control; Also, before the intervention and 8 weeks after the intervention, Zarit test was performed to evaluate the care burden. Results. The findings of repeated measures tests showed that, compared to the control group, the intervention group obtained a greater increase in the vital capacity index (p=0.028) and in the disease control score (p=0.001), as well as a reduction in the burden of care on family members (p<0.001). Conclusion. The present study showed that teaching asthma related topics to the patient and her caregiver along with the follow-up and supervision of the nurse improves the asthma control of the patient and also reduces the caregiver pressure.


Objetivo. Investigar el efecto de la educación con el método teach-back sobre el control del asma y la carga del cuidado familiar de estos pacientes. Métodos. Ensayo clínico cuya población de estudio fueron los pacientes remitidos a las clínicas Shahid Faghihi y Shahid Motahhari en Shiraz, Irán. Se asignaron aleatoriamente 58 pacientes con asma y sus cuidadores a los grupos de intervención y control, con un total de 29 díadas en cada grupo. Las personas del grupo de intervención recibieron formación con el método teach-back que se impartió individualmente al paciente y a su cuidador principal en tres sesiones de aproximadamente 60 minutos en tres días consecutivos. Cada sesión incluía presentaciones, técnicas prácticas y un folleto. Los pacientes y cuidadores del grupo de control no recibieron formación. Antes de la intervención y a las 4 y 8 semanas después de la misma, se aplicaron las escalas de control del asma y la de Zarit para evaluación de la carga del cuidado y, además se practicó una espirometría. Resultados. Las pruebas de medidas repetidas entre los grupos de estudio mostraron que, comparando con el grupo control, el grupo de intervención obtuvo mayor aumento del índice de capacidad vital (p=0.028) y del puntaje de control de la enfermedad (p=0.001), además, se redujo la carga del cuidado en los familiares (p<0.001). Conclusión. El presente estudio mostró que con la enseñanza de temas relacionados con el asma al paciente y a su cuidador, junto con el seguimiento y la supervisión de la enfermera, se mejora el control del asma en el paciente y también se reduce la carga del cuidador.


Objetivo. Investigar o efeito da educação com o método teach-back sobre o controle da asma e a carga do cuidado familiar destes pacientes. Métodos. Ensaio clínico no qual a população de estudo foram os pacientes enviados às clínicas Shahid Faghihi e Shahid Motahhari em Shiraz, Irã. 58 pacientes com asma e seus cuidadores foram designados aleatoriamente aos grupos de intervenção e controle, com um total de 29 díade em cada grupo. As pessoas do grupo da intervenção receberam formação com o método teach-back que se transmitiu individualmente ao paciente e ao seu cuidador principal em três sessões de aproximadamente 60 minutos em três dias consecutivos. Cada sessão incluía apresentações, técnicas práticas e um folheto. Os pacientes e cuidadores do grupo de controle não receberam formação. Antes da intervenção e às 4 e 8 semanas depois dela, se aplicaram as escalas de controle da asma e a de Zarit para avaliação da carga do cuidado e, além disso se praticou uma espirometria. Resultados. As provas de medidas repetidas entre os grupos de estudo mostraram que, comparando com o grupo de controle, o grupo de intervenção obteve maior aumento do índice de capacidade vital (p=0.028) e da pontuação de controle da doença (p=0.001), ademais de que se reduziu a carga do cuidado nos familiares (p<0.001). Conclusão. O presente estudo mostrou que o ensino de temas relacionados com a asma ao paciente e ao seu cuidador, junto com o seguimento e a supervisão da enfermeira, se melhora o controle da asma no paciente e também se reduz a carga do cuidador.


Subject(s)
Humans , Asthma , Teach-Back Communication , Caregiver Burden , Education
3.
Int. arch. otorhinolaryngol. (Impr.) ; 26(1): 91-96, Jan.-Mar. 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1364918

ABSTRACT

Abstract Introduction Combination of chronic inflammation and an altered tissue remodeling process are involved in the development of Chronic Rhinosinusitis with Nasal Polyps (CRSwNP). Studies demonstrated that mesenchymal stem cells expressing the progenitor gene CD133 were involved in a significant reduction of the chronic inflammatory process in the polypoid tissue. Objective To evaluate the levels of CD133 (Prominin-1) in nasal polypoid tissue and its correlation with interleukin-8 (IL-8) and transforming growth factor β1 (TGF-β1). Methods A total of 74 subjects were divided in the following groups: control group (n = 35); chronic rhinosinusitis with nasal polyps nonpresenting comorbid asthma and aspirin intolerance (CRSwNPnonAI) group (n = 27); and chronic rhinosinusitis with nasal polyps presenting comorbid asthma and aspirin intolerance (CRSwNPAI) group (n = 12). Histologic analysis and also evaluation of the concentration of CD133, IL-8, and TGF-β1 by enzyme-linked immunosorbent assay (ELISA) kits were performed in nasal tissue obtained from nasal polypectomy or from middle turbinate tissue. Results Higher eosinophilic infiltration was found in both CRSwNP groups by histologic analysis. Lower levels of TGF-β1 and IL-8 were observed in both CRSwNP groups when compared with the control group, whereas the CD133 levels were significantly reduced only in the CRSwNPnonAI group compared with the control group. Conclusion It was demonstrated that the nasal mucosa presenting polyposis showed a significant reduction of CD133 levels, and also that this reduction was significantly correlated with the reduction of TGF-β1 levels, but not with IL-8 levels. Therefore, these findings may be involved in the altered inflammatory and remodeling processes observed in the nasal polyposis.

4.
Rev. colomb. anestesiol ; 50(1): e501, Jan.-Mar. 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1360953

ABSTRACT

Abstract Severe asthma affects more than 250 million people and represents high healthcare costs. Bronchial thermoplasty is a relatively new technique in interventional pulmonology for managing this condition. The procedure is done under general anesthesia and the patients are mostly ASA II and III; therefore, the anesthesia plan must be safe. The purpose of the article is to describe the anesthetic technique used (general anesthesia and laryngeal mask) and the immediate and early complications of the procedure. Four patients were included, each undergoing three sessions. The complications during and immediately after the procedure, as well as the early complications (up to seven days post-procedure) that could have required hospital management were discussed. In three of the sessions at least one acute bronchospasm event presented, but only one patient required hospital admission for more than 24 hours. Experience suggests that thermoplasty may be safely conducted under general anesthesia and laryngeal mask.


Resumen El asma grave afecta a más de 250 millones de personas y genera altos costos en el sistema de salud. La termoplastia bronquial es una técnica relativamente novedosa de la neumología intervencionista para el manejo de esta condición. Este procedimiento se realiza bajo anestesia general, y los pacientes son en su mayoría ASA II y III, por lo que el plan anestésico debe ser seguro. El objetivo del artículo es describir la técnica anestésica utilizada (anestesia general y máscara laríngea) y las complicaciones inmediatas y tempranas del procedimiento. Se incluyeron cuatro pacientes, cada uno de los cuales fue sometido a tres sesiones. Se describieron las complicaciones durante e inmediatamente después del procedimiento y las complicaciones tempranas (hasta siete días posprocedimiento), que hubieran requerido manejo hospitalario. En tres de las sesiones se presentó al menos un evento agudo de broncoespasmo y solo un paciente requirió hospitalización mayor a 24 horas. La experiencia sugiere que la termoplastia puede ser llevada a cabo de manera segura bajo anestesia general y mascara laríngea.

5.
Medicina (B.Aires) ; 82(1): 154-158, feb. 2022. graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1365142

ABSTRACT

Resumen La hiperplasia difusa idiopática de células neuroendocrinas es una entidad extremadamente infrecuente caracterizada por una proliferación generalizada de células neuroendocrinas, sin proceso primario que lo justifique, generalmente, aunque también están descriptas formas asintomáticas. Se describen los casos de dos mujeres y un hombre, edad promedio 63 años (rango 57-71) que consultaron por presentar nodulillos pulmonares bilaterales. Promedio de seguimiento: 1 año, 3 meses (rango 1 mes-3 años). Las dos mujeres presentaban tos, disnea progresiva y obstrucción al flujo aéreo en el estudio espirométrico, fueron tra tadas por asma y enfermedad pulmonar obstructiva crónica respectivamente con poco alivio de los síntomas. El tercer paciente, varón, consultó por hallazgo incidental en una tomografía de tórax, de nódulos pulmonares, con razonable sospecha de enfermedad metastásica de origen desconocido. En sendas biopsias se diagnosticaron: en el primer y tercer caso hiperplasia neuroendócrina difusa idiopática-tumorlets; y en el segundo caso tumor carcinoide típico e hiperplasia neuroendocrina difusa idiopática. En el primer caso los síntomas se controlaron con tratamiento broncodilatador máximo. La segunda paciente tuvo en el postoperatorio, insuficiencia respiratoria que requirió asistencia respiratoria mecánica y fibrilación auricular con alta respuesta ventricular, interpretados ambos signos como síndromes paraneoplásicos, que respondieron favorablemente a la administración empírica de octeotride. El tercer paciente se halla asintomático y en control. La hiperplasia difusa de células neuroendó crinas representa un desafío diagnóstico. La biopsia pulmonar en pacientes con nodulillos pulmonares múltiples, bilaterales e historia clínica de tos y disnea progresiva debe ser considerada para confirmar esta entidad.


Abstract Diffuse idiopathic hyperplasia of neuroendocrine cells is an extremely rare condition. It is a widespread proliferation of neuroendocrine cells, without primary process justifying it. Usually symptomatic in most cases, asymptomatic forms are also described. We describe three cases, 2 women and 1 man, average age 63 years (range 57-71) who presented with bilateral pulmonary nodules. Average follow-up: one year and three months (range 1 month-3 years). The two women had cough, progressive dyspnea and airflow obstruction in the spirometry, and were treated for asthma and chronic obstructive pulmonary disease, respectively, with little relief of symptoms. The remaining patient consulted for diagnosis of pulmonary nodules of unknown cause and a suspicion of metastatic disease. The biopsies diagnostic were: in the first and third case diffuse idiopathic hyperplasia of euroendocrine cells - tumorlets; and in the second case typical carcinoid tumor and diffuse idiopathic hyperplasia of neuroendo crine cells. The first patient controlled the symptoms with maximum bronchodilator therapy. The second patient presented immediate postoperative severe bronchospasm and respiratory failure which required ventilatory as sistance, atrial fibrillation with rapid ventricular response (both signs interpreted as paraneoplastic syndromes) which responded favorably to the empirical octeotride management. The third patient is asymptomatic and in control. The diffuse neuroendocrine cell hyperplasia represents a diagnostic challenge because of the rarity of this condition. Lung biopsy in patients with multiple, bilateral pulmonary nodules and clinical history of cough and progressive dyspnea should be considered to confirm this entity.

6.
Chinese Journal of School Health ; (12): 123-128, 2022.
Article in Chinese | WPRIM | ID: wpr-920518

ABSTRACT

Objective@#To explore trends in the asthma burden among Chinese children and adolescents 1-19 years old during 1990-2019.@*Methods@#Based on data from the 2019 Global Burden of Disease Study, joinpoint regression was used to analyze the dynamic changes in the gender and age specific asthma burden, and the asthma burden in China was compared with countries that have different socio demographic indices(SDI). In addition, trends in asthma burden attributed to different risk factors were also investigated.@*Results@#The asthma burden decreased slightly from 1990 to 1996 [annual percent change (APC)=-1.7%], then rapidly decreased from 1996 to 2005 (APC=-5.7%). The age standardized disability adjusted life years (DALYs) rate decreased from 158.55/100 000 to 88.59/100 000 in patients 1-19 years of age. From 2005 to 2017, the DALYs rate for asthma increased slowly, then rapidly. In 2017, the DALYs rate peaked at 176.18/100 000, then decreased to 126.79/100 000 in 2019. The burden of asthma in boys was higher than girls, and the DALYs rate for asthma in the group 5-9 years of age was higher than the remaining age groups. Furthermore, the age standardized DALYs rate for asthma among Chinese children and adolescents was relatively low among countries with a different SDI. In addition, the DALYs rate attributed to high body mass index increased in all age groups in China. Specifically, the average APC (AAPC) was 2.9% in group 1-4 years of age and the AAPC was 4.2% in the remaining age groups. The DALYs rate attributed to occupational asthmagens in the group 15-19 years of age decreased from 1990 to 2019 and the AAPC was -2.5%.@*Conclusion@#The asthma burden was relatively low among Chinese children and adolescents, and there were gender and age differences. The gender and age specific DALYs rate for asthma had a tendency to decrease, increase, then decrease. More attention should be paid to boys and the group 5-9 years of age, and strengthen the intervention of obesity and occupational asthmagens.

7.
Article in Chinese | WPRIM | ID: wpr-920370

ABSTRACT

Objective To explore the relationship between the outpatient visits for adult asthma and air pollution in a tertiary hospital in Hefei. Methods The number of outpatient visits for asthma in a tertiary hospital in Hefei from 2014 to 2020 was collected. The air pollutant data was obtained through the Hefei Air Monitoring Station, and the meteorological indicators of the same period were collected through the China Meteorological Network. The R statistical software was used to establish a generalized additive model to analyze the lag effect of air pollution on the number of outpatient visits for asthma. Results From 2014 to 2020, there were 7 220 asthma outpatients in the tertiary hospital in Hefei, including 3104 males and 4 116 females, 3 798 patients in warm season, and 3 422 patients in cold season. During the period, the average concentrations of SO2, NO2, CO, O3, PM10, and PM2.5 were 11.9μg/m3, 40.1μg/m3, 0.9 mg/m3, 87.3μg/m3, 81.3μg/m3, and 55.7μg/m3, respectively. The results of the single-pollutant model showed that every 10μg/m3 increase in SO2 concentration increased the risk of asthma by 0.74% (95%CI: 0.22%-1.29%), and the effect was the greatest on Lag2 day. NO2 increased the risk of asthma by 0.31% (95%CI: 0.13%-0.49%), with the greatest effect on Lag0 day. The analysis of the dual pollutant model found that whereas the effect of SO2 decreased after the incorporation of NO2, the effect increased after the incorporation of CO, O3, PM10, or PM2.5, respectively. The effect of NO2 on asthma decreased after the incorporation of SO2, whereas the effect on asthma increased after the inclusion of CO, PM10, or PM2.5. Stratified analysis of cold and warm seasons showed that the effect of NO2 on asthma was the greatest in lag0 in cold season. The effect of SO2 was higher in cold season than in warm season, and it was the highest in lag2. The gender stratification analysis showed that the effects of SO2 and NO2 on male asthma were higher than those on females. Conclusion From 2014 to 2020, the increase of SO2 and NO2 concentrations in Hefei is positively correlated with the risk of asthma in the outpatient department of a tertiary hospital. The effect has a certain lag. It is of great significance to formulate relevant preventive measures for the occurrence and attack of asthma.

8.
Article in English | WPRIM | ID: wpr-922580

ABSTRACT

OBJECTIVE@#To analyze the intellectual landscape and emerging research trends of Chinese medicine (CM) in the management of pediatric asthma through a scientometric study.@*METHODS@#Publications related to CM in the management of pediatric asthma were retrieved from the Web of Science Core Collection using relevant keywords. A scientometric study was performed using CiteSpace and VOSviewer.@*RESULTS@#A total of 1,673 original articles and reviews from 1991 to 2019 were included in the analysis. The amount of annual publications had a gradual increase with time. USA was the major contributor both in country and institution analyses. Based on the co-citation, the published journals were grouped into 4 clusters. Keyword analysis indicated that the main hotspots were: (1) comprehensive management; (2) risk factors, mechanism, and prevalence; (3) prevention and treatment; (4) inflammation; and (5) environmental research. Lastly, we predicted that three emerging trends were quality of life promotion, immune response, and combination therapy.@*CONCLUSIONS@#CM research in the management of pediatric asthma will maintain the current trend of steady growth. This scientometric analysis may help scientists to identify the areas of interests and future directions in the field.


Subject(s)
Asthma/drug therapy , Bibliometrics , Child , Humans , Medicine, Chinese Traditional , Publications , Quality of Life
9.
Braz. arch. biol. technol ; 65: e22200620, 2022. graf
Article in English | LILACS-Express | LILACS | ID: biblio-1364468

ABSTRACT

Abstract: Asthma is a chronic respiratory disease affecting 300 million people worldwide. It results in several structural changes in the airways, which are minimally accessible in clinical practice. Cell therapy using mesenchymal stromal cells (MSCs) is a promising strategy for treating asthma due to the paracrine activity of MSCs, which influences tissue regeneration and modulates the immune response. Studies using extracellular vesicles (EV) released by MSCs have demonstrated their regenerative properties in animal models. The aim of this study was to evaluate the potential of EVs isolated from human bone marrow MSCs (hBM-MSCs) to control lung tissue remodeling in ovalbumin-induced allergic asthma in Balb/c mice. We isolated hBM-MSCs from a single donor, expanded and characterized them, and then isolated EVs. Asthma was induced in 43 male Balb/c mice, divided into four groups: control, asthmatic (AS), asthmatic plus systemic EVs (EV-S), and asthmatic plus intratracheal EVs (EV-IT). Upon completion of asthma induction, animals were treated with EVs either locally (EV-IT) or intravenously (EV-S). Seven days after, we performed bronchoalveolar lavage (BAL) and the total nuclear cells were counted. The animals were euthanized, and the lungs were collected for histopathological analysis of the airways. The EV-S group showed improvement in only the total BAL cell count compared with the AS group, while the EV-IT group showed significant improvement in almost all evaluated criteria. Therefore, we demonstrate that the local application of EVs derived from hBM-MSCs may be a potential treatment in controlling asthma.

10.
Braz. oral res. (Online) ; 36: e039, 2022. tab, graf
Article in English | LILACS-Express | LILACS, BBO | ID: biblio-1364589

ABSTRACT

Abstract: Deleterious oral habits (DOH) have been described as a common finding in pediatric series. Studies have investigated their association with local and systemic health problems. In this study, the association between DOH and asthma was investigated. PubMed, Scopus, Lilacs, Web of Science, Google Scholar, and OpenThesis were accessed to identify observational studies that evaluated the association between DOH (thumb sucking, pacifier use, onychophagia or nail biting, bottle feeding) and asthma in children aged 2-17 years. Information on DOH was obtained from the verbal report of the children's parents. Asthma diagnosis was performed by a physician or using the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. We used a random-effects model to pool the results. The odds ratio (OR) was used as measure of association between DOH and asthma. The National Institutes of Health Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies was used to assess risk of bias. The GRADE approach was used to assess the quality of evidence. Five studies were included and data from 18,733 children aged 2 to 13 years were analyzed. We found an association between bottle feeding and asthma (OR = 1.25; 95%CI 1.13-1.38; p < 0.001) with moderate level of certainty. Despite the association between pacifier use and asthma (OR = 1.11; 95%CI 1.00-1.24; p = 0.05), the quality of evidence was low. Only one study provided data on nail biting and thumb-sucking, and the individual results showed no association between these habits and asthma. This meta-analysis found an association between bottle feeding, pacifier use, and asthma in children.

11.
Einstein (Säo Paulo) ; 20: eAO6412, 2022. tab
Article in English | LILACS-Express | LILACS | ID: biblio-1364799

ABSTRACT

ABSTRACT Objective To investigate whether different genotypes of p.Arg16Gly, p.Gln27Glu, p.Arg19Cys and p.Thr164Ile variants interfere in response to treatment in children and adolescents with moderate to severe acute asthma. Methods This sample comprised patients aged 2 to 17 years with a history of at least two wheezing episodes and current moderate to severe asthma exacerbation. All patients received multiple doses of albuterol and ipratropium bromide delivered via pressurized metered-dose inhaler with holding chamber and systemic corticosteroids. Hospital admission was defined as the primary outcome. Secondary outcomes were changes in forced expiratory volume in the first second after 1 hour of treatment, and for outpatients, length of stay in the emergency room. Variants were genotyped by sequencing. Results A total of 60 patients were evaluated. Hospital admission rates were significantly higher in carriers of the genotype AA relative to those with genotype AG or GG, within the p.Arg16Gly variant (p=0.03, test χ2, alpha=0.05). Secondary outcomes did not differ between genotypes. Conclusion Hospital admission rates were significantly higher among carriers of the genotype AA within the p.Arg16Gly variant. Trial registration: ClinicalTrials.gov: NCT01323010

12.
Braz. j. med. biol. res ; 55: e11149, 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1355921

ABSTRACT

More information is needed on asthma control and health-related quality of life (HRQoL) in smokers with severe asthma. The main study objective was to characterize the association of HRQoL and disease control with cigarette smoking in individuals with severe asthma. A secondary objective was to analyze subject characteristics according to asthma onset: asthma that developed before smoking initiation versus asthma that developed after smoking initiation. This cross-sectional study included subjects with severe asthma aged 18-65 years. HRQoL was assessed using the Asthma Quality of Life Questionnaire (AQLQ) and asthma control was assessed using the Asthma Control Test (ACT) and Global Initiative for Asthma (GINA) criteria. Of the 87 patients studied, 58 (66.7%) were classified as asthmatics who had never smoked and 29 (33.3%) as asthmatics with smoking exposure. The proportion of subjects with uncontrolled asthma was higher in the asthma and smoking group (GINA criteria: P=0.032 and ACT criteria: P=0.003. There were no between-group differences in overall AQLQ score (P=0.475) or AQLQ domain scores (P>0.05). Fifty-eight subjects (66.7%) were nonsmokers, 20 (23%) had asthma onset before smoking, and 9 (10.3%) had asthma onset after smoking. Asthma onset before smoking was associated with uncontrolled asthma (P=0.013). In subjects with severe asthma, smoking was associated with a higher rate of uncontrolled disease but not with HRQoL scores.

13.
Ciênc. Saúde Colet ; 27(2): 545-554, Fev. 2022. tab, graf
Article in English | LILACS | ID: biblio-1356068

ABSTRACT

Abstract The objective was to estimate association between prenatal and neonatal factors and asthma symptoms in children at six years of age. A cross-sectional study using secondary data from a cohort study with a sample of 578 children was carried out. Data were analyzed using three levels hierarchical Poisson Regression. Of the 578 children included in the study, 43.4% (95% CI 39.4; 47.4) had asthma symptoms. The variables with significantly higher prevalence of symptoms and asthma at six years of age were: male gender, with 5% higher prevalence (PR = 1.05 95% CI 1.01; 1.11) (p = 0.043); children of pregnant women presenting infectious diseases with 7% higher prevalence (PR = 1.07; 95% CI 1.02; 1.13) (p = 0.011); children who were not breastfed, with a 12% higher prevalence (PR = 1.12; 95% CI 1.02; 1.24) (p = 0.022) and children with respiratory problems in the first month of life, with a 14% higher prevalence (PR = 1.14; 95% CI 1.01; 1.29) (p = 0.033). It could be concluded that male gender, time-independent breastfeeding deprivation and respiratory problems in the first month of life were independently associated with asthma symptoms at six years of age. The occurrence of infectious diseases during pregnancy was the only factor with intrauterine physiology that was associated with the occurrence of asthma symptoms at six years of age.


Resumo O objetivo foi estimar a associação entre fatores pré-natais e neonatais e sintomas de asma em crianças aos seis anos de idade. Foi realizado um estudo epidemiológico transversal com dados secundários provenientes de estudo de coorte com amostragem de 578 crianças. Os dados foram analisados por meio de regressão de Poisson. Do total de 578 crianças incluídas no estudo, 43,4% (IC 95% 39,4; 47,4) apresentavam sintomas de asma. As variáveis com prevalências significativamente maiores de sintomas de asma aos seis anos de idade foram: sexo masculino, com prevalência 5% maior (RP = 1,05 IC 95% 1,01; 1,11) (p = 0,043); crianças de gestantes portadoras de doenças infecciosas, com prevalência 7% maior (RP = 1,07; IC 95% 1,02; 1,13) (p = 0,011); crianças que não foram amamentadas, com prevalência 12% maior (RP = 1,12; IC 95% 1,02; 1,24) (p = 0,022), e crianças com problemas respiratórios no primeiro mês de vida, com prevalência 14% maior (RP = 1,14; IC 95% 1,01; 1,29) (p = 0,033). Concluiu-se que sexo masculino, privação de amamentação, independentemente do tempo, e problemas respiratórios no primeiro mês de vida foram associados de forma independente aos sintomas de asma aos seis anos de idade. A ocorrência de doenças infecciosas durante a gravidez foi o único fator fisiológico intra-uterino associado à ocorrência de sintomas de asma aos seis anos de idade.


Subject(s)
Humans , Male , Female , Pregnancy , Infant, Newborn , Child , Asthma/epidemiology , Breast Feeding , Prevalence , Cross-Sectional Studies , Risk Factors , Cohort Studies
14.
Einstein (Säo Paulo) ; 20: eAO5609, 2022. tab
Article in English | LILACS-Express | LILACS | ID: biblio-1360398

ABSTRACT

ABSTRACT Objective To determine the maternal and early childhood factors associated with asthma and obesity in children aged 6 to 7 years. Methods A case-control study conducted with children aged 6 to 7 years. Applications with questions about asthma symptoms in the last 12 months, maternal and childhood data in the first 2 years of life, and anthropometric data were collected. Children who presented asthma symptoms were considered as cases and those without asthma symptoms were considered as controls, later divided into two subgroups that were eutrophic or overweight/obesity. Logistic regression was performed to estimate the association between asthma symptoms (adequate weight and overweight/obesity) and gestational and personal factors, calculating odds ratio and 95% confidence interval (95%CI). Values of p<0.05 were considered significant. Results Two hundred and one children were evaluated, 25.4% had asthma symptoms, 37.2% of them were overweight/obesity. Waist circumference, triceps skinfold, and body mass index were higher in the group with overweight/obesity asthma symptoms compared to no asthma symptoms (p<0.05). Factors significantly associated with asthma and overweight/obesity symptoms included: the maternal history of asthma (odds ratio of 3.73; 95%CI: 1.10-12.6) and hypertension during pregnancy (odds ratio of 3.29; 95%CI: 1.08-9.94). Conclusion Maternal history of asthma and hypertension during pregnancy increased the chances of children, at 6 and 7 years of age, having symptoms of asthma and obesity.

15.
Pediátr. Panamá ; 50(3): 37-47, 30 diciembre 2021.
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1352582

ABSTRACT

La aceptación de padecer una enfermedad crónica y aprender a convivir con ésta puede ser un proceso lento para el paciente y su familia. Los niños y los adolescentes con una enfermedad crónica se enfrentan a un desafío que requiere afrontar la responsabilidad y exigencias de la necesidad de un tratamiento diario a largo plazo que muchas veces requiere adaptar sus actividades y su vida para cumplir con el mismo. El objetivo del tratamiento en las enfermedades crónicas es minimizar los síntomas, alcanzar el control o modificar la evolución natural para lograr una calidad de vida adecuada. Adherencia significa la aceptación de un rol activo en el propio cuidado de la salud, pero que debe comprender la colaboración entre el paciente, su familia y el equipo de salud. Esta colaboración debe incluir confianza, términos como negociación, toma de decisiones en forma conjunta y comunicación para determinar el tratamiento adecuado de la enfermedad. La adherencia al tratamiento es un problema y constituye un reto y una preocupación para los médicos que tratan a pacientes con enfermedades crónicas porque la falta de adherencia genera empeoramiento de la enfermedad, aumento del número de hospitalizaciones, altos costos para el paciente, la familia y el sistema de salud.


Accepting to suffer from a chronic disease and learning to live with this disease can be a slow process for the patient and their family. Children and adolescents with a chronic disease face a challenge that requires facing the responsibility and demands of the need for long-term daily treatment that often requires adapting their activities and their lives to comply with it. The goal of treatment in chronic diseases is to minimize symptoms, achieve control, or modify the natural history to achieve an adequate quality of life. Adherence means the acceptance of an active role in one's own health care but that must include collaboration between the patient, his family and the health team. This collaboration should include trust, terms such as negotiation, joint decision-making, and communication to determine the appropriate treatment for the disease. Adherence to treatment is a problem and constitutes a challenge and concern for physicians who treat patients with chronic diseases because lack of adherence leads to a worsening of the disease, an increase in the number of hospitalizations, high costs for the patient, the family and the health system.

16.
Bol. latinoam. Caribe plantas med. aromát ; 20(6): 638-648, nov. 2021. tab
Article in Spanish | LILACS | ID: biblio-1369909

ABSTRACT

The prevalence, morbidity and costs of asthma care have increased worldwide. This study describes the effect and safety of an outpatient medical treatment with traditional medicine for asthma, through a retrospective case series with patients admitted to outpatient consultation from 1995 to 2015 in Cota, Colombia. Analyzing 26 cases with a clinical diagnosis of asthma, during the treatment 34.6% (9/26) did not present episodes of uncontrolled asthma and 61.5% (16/26) were classified as controlled asthma in their last consultation of control. 88.4% (23/26) of the patients reported no adverse reactions and the three reported were mild. The results allow to generate hypotheses about the effectiveness and safety of an outpatient treatment based on the incorporation of resources from traditional medicine. These observations could beexplored with experimental studies to determine their long-term effectiveness, safety and low cost.


La prevalencia, morbilidad y costos de atención del asma se ha incrementado en el mundo. Este estudio describe el efecto y la seguridad de un tratamiento médico ambulatorio con recursos de la medicina tradicional para el asma, mediante una serie de casos retrospectiva con pacientes admitidos a consulta externa de 1995 a 2015 en Cota, Colombia. Analizando 26 casos con diagnóstico clínico de asma, durante el tratamiento el 34,6% (9/26) no presentó episodios de asma no controlada y el 61,5% (16/26) fueron clasificados como asma controlada en su última consulta de control. El 88,4% (23/26) de los pacientes no reportó reacciones adversas y las tres reportadas fueron leves. Los resultados permiten generar hipótesis acerca de la efectividad y seguridad de un tratamiento ambulatorio basado en la incorporación de recursos de la medicina tradicional. Estas observaciones podrían ser exploradas con estudios experimentales, para determinar su efectividad, seguridad y bajo costo a largo plazo.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Young Adult , Plants, Medicinal , Asthma/drug therapy , Medicine, Traditional , Safety , Retrospective Studies , Treatment Outcome , Colombia , Ambulatory Care , Culturally Competent Care
17.
Medisan ; 25(5)2021. tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1346538

ABSTRACT

Introducción: Las sibilancias recurrentes en lactantes y preescolares son motivo frecuente de consulta en pediatría. Objetivo: Caracterizar a niños con sibilancia recurrente desde los puntos de vista clínico y epidemiológico. Métodos: Se realizó una investigación observacional, longitudinal y prospectiva de 140 niños con sibilancia recurrente, atendidos en el Servicio de Respiratorio del Hospital Infantil Docente Sur Dr. Antonio María Béguez César de Santiago de Cuba, desde de enero de 2016 hasta diciembre de 2018. Resultados: Predominaron el sexo masculino (57,1 %), los pacientes de procedencia urbana (62,1 %) y el área de salud 28 de septiembre como la de mayor incidencia (42,7 %). El promedio de edad fue de 1 año y 5 meses, aproximadamente. Los niños incluidos en el intervalo de 6 a 11 meses y 29 días fueron los más afectados (28,6 %). Entre los municipios, Guamá aportó el mayor número de casos (33,9 %). No existió asociación estadística entre el índice predictivo de asma y el sexo; sin embargo, resultó mayor entre los varones (19,3 %). Conclusiones: Las características clínicas y epidemiológicas de los pacientes con sibilancia recurrente de esta casuística no difieren del contexto epidemiológico mundial, siendo una entidad de observación frecuente en los servicios de pediatría.


Introduction: The recurrent wheezing in infants and preschool children are frequent reason of visit in pediatrics. Objective: To characterize children with recurrent wheezing from the clinical and epidemiologic points of view. Methods: An observational, longitudinal and prospective investigation of 140 children with recurrent wheezing, assisted in the Respiratory Service of Dr. Antonio María Béguez Cesar Southern Teaching Children Hospital was carried out in Santiago de Cuba, from January, 2016 to December, 2018. Results: There was a prevalence of the male sex (57.1 %), the patients of urban origin (62.1 %) and 28 de Septiembre health area as that of more incidence (42.7 %). The average age was of 1 year and 5 months, approximately. The children included in the interval from 6 to 11 months and 29 days were the most affected (28.6 %). Among the municipalities, Guamá contributed the higher number of cases (33.9 %). There was no statistical association between the prediction index of asthma and the sex; however, it was higher among males (19.3 %). Conclusions: The clinical and epidemiologic characteristics of the patients with recurrent wheezing of this case material don't differ from the world epidemiologic context, being an entity of frequent observation in the pediatrics services.


Subject(s)
Asthma/epidemiology , Child , Respiratory Sounds/diagnosis , Child, Preschool , Infant
18.
J. pediatr. (Rio J.) ; 97(5): 546-551, Sept.-Oct. 2021. tab, graf
Article in English | LILACS | ID: biblio-1340156

ABSTRACT

Abstract Objective: The aim of this study was to evaluate the association between possible functional interleukin-10 (IL-10) polymorphisms, IL-10 expression and regulatory T cells (Tregs) frequency, and/or asthma severity in a sample of children and adolescents. Methods: This is a nested case-control genetic association study. The study sample consisted of children and adolescents aged 8-14 from public schools. Four polymorphisms of the IL-10 gene (rs1518111, rs3024490, rs3024496, rs3024491) were genotyped in asthmatic subjects and controls using real-time PCR. Tregs cells and IL-10 were analyzed in peripheral blood mononuclear cells by flow cytometry. The severity of asthma was defined according to the Global Initiative for Asthma (GINA) guideline. Results: One hundred twenty-three asthmatic subjects and fifty-eight controls participated in the study. The single nucleotide polymorphism (SNP) rs3024491 (T allele) showed association with asthma severity, presenting a higher frequency in patients in the moderate asthma group. The T allele of variant rs3024491 also showed an association with reduced IL-10 levels (p = 0.01) and with increased Tregs frequency (p = 0.01). The other variants did not present consistent associations. Conclusions: Our results suggest that moderate asthma is associated with a higher frequency of the T allele in the SNP rs3024491. In addition, the variant rs3024491 (TT) was associated with a reduction in IL-10 production and an increased percentage of Tregs cells, suggesting possible mechanisms that influence asthma severity.


Subject(s)
Humans , Child , Adolescent , Asthma/genetics , Interleukin-10/genetics , Leukocytes, Mononuclear , Polymorphism, Single Nucleotide/genetics , Forkhead Transcription Factors , Interleukin-2 Receptor alpha Subunit
19.
Biomédica (Bogotá) ; 41(3): 481-492, jul.-set. 2021. tab, graf
Article in Spanish | LILACS | ID: biblio-1345398

ABSTRACT

Resumen Introducción. El asma es una enfermedad crónica y potencialmente grave. El 80 % de los casos es de origen alérgico, por lo cual la inmunoterapia específica con alérgenos es una alternativa terapéutica que modula el curso natural de la enfermedad. Objetivo. Evaluar el impacto de la inmunoterapia en pacientes pediátricos con asma atendidos en una institución de salud de Colombia. Materiales y métodos. Se hizo un estudio observacional descriptivo con componente analítico de corte transversal. Se incluyeron 62 pacientes con diagnóstico de asma alérgica sensibilizados a ácaros del polvo y en tratamiento, mínimo, con seis dosis de inmunoterapia contra ácaros. El efecto del tratamiento se evaluó mediante la escala de puntuación del ACT (Asthma Control Test), la escala de tratamiento de la GINA (Global Initiative for Asthma) y la espirometría. Resultados. La puntuación de la prueba ACT antes del inicio de la inmunoterapia, correspondía a 30 % de pacientes con asma no controlada, 28 % con buen control y 4 % con asma totalmente controlada. Entre los pacientes con asma no controlada, el 46,7 % logró un buen control y el 23,3 % alcanzó un control total. En cuanto a la percepción de los pacientes sobre la mejoría con la inmunoterapia, el 9,75 % percibió una mejoría menor del 50 %, el 45,2 %, una entre el 50 y el 90 %, en tanto que el 41,9 % refirió una igual o mayor del 90 %. No se encontraron cambios significativos en los valores del volumen espiratorio forzado en un segundo (VEF1) en las espirometrías. Conclusiones. Se observaron cambios significativos en los puntajes del ACT y en la percepción de mejoría de la enfermedad en la población tratada con inmunoterapia específica para ácaros, es decir, que esta tendría un efecto beneficioso en el curso natural de la enfermedad


Abstract Introduction: Asthma is a chronic and potentially serious disease and 80% of the cases have an allergic etiology. In this sense, allergen-specific immunotherapy is an alternative that modulates the natural course of the disease. Objective: To evaluate the impact of immunotherapy in pediatric asthma patients treated at a health institution in Colombia. Materials and methods: We conducted an observational descriptive study with an analytical cross-sectional component. Sixty-two patients diagnosed with allergic asthma sensitized to dust mites and treated with at least 6 doses of mite immunotherapy were included. We assessed the impact of immunotherapy using the Asthma Control Test (ACT), the Global Initiative for Asthma (GINA) treatment scale, and spirometry values. Results: The ACT score before the start reported 30% of patients with uncontrolled asthma, 28% with good control, and 4% with totally controlled asthma. Of the patients with uncontrolled asthma, 46.7% achieved good control and 23.3% total control. Regarding patients' perception of improvement with the immunotherapy, 9.75% perceived a response of less than 50%, 45.2% one between 50% -90%, and 41.9% reported response equal to or greater than 90%. No significant changes in FEV1 values were found in spirometry. Conclusions: Significant changes in the ACT scores and the perception of disease improvement were observed in the population evaluated with specific mite immunotherapy, i.e., it had a positive impact on the natural course of the disease.


Subject(s)
Asthma , Immunotherapy , Pediatrics , Spirometry , Rhinitis , Mites
20.
Arch. argent. pediatr ; 119(4): S123-S158, agosto 2021. tab, ilus
Article in Spanish | LILACS, BINACIS | ID: biblio-1281031

ABSTRACT

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.


Subject(s)
Humans , Child , Asthma/diagnosis , Asthma/therapy , Bronchodilator Agents/therapeutic use , Adrenal Cortex Hormones/therapeutic use , Anti-Inflammatory Agents/therapeutic use
SELECTION OF CITATIONS
SEARCH DETAIL