ABSTRACT
Objetivo: Realizar revisão da literatura sobre análises econômicas utilizadas para a asma, os custos diretos e indiretos, tendo em vista a sobrecarga econômica que essa doença acarreta para o sistema de saúde. Fonte de dados: Pesquisa de artigos originais, revisões e consensos, indexados nos bancos de dados Medline, Lilacs, Embase e Pubmed, publicados entre 1996-2012. Síntese dos dados: A asma é uma doença pulmonar inflamatória crônica que acomete pessoas de todas as idades, cujo descontrole leva a hospitalizações frequentes, visitas à emergência e aumento na morbidade, gerando grande impacto na vida social e econômica dos pacientes, com piora da qualidade de vida. A partir dos programas de controle da asma e rinite alérgica e da dispensação de medicamentos de alto custo, houve significativa queda das hospitalizações por asma no período de 2006 a 2010. Em 2012, implementou-se o Programa Saúde não tem Preço, ação integrante do Programa Farmácia Popular do Ministério da Saúde (MS), com fornecimento gratuito de brometo de ipratrópio, diproprionato de beclometasona e sulfato de salbutamol. Com este programa, houve crescimento significante de 443% no número de asmáticos beneficiados, aumentando de 48.495 para 263.227 pessoas. Os dados do MS apontaram que a asma ainda causa a morte de 2,5 mil pessoas por ano no Brasil. Em 2011 do total de 117,8 mil internações no Sistema Único de Saúde (SUS) em decorrência da asma, 77,1 mil acometeram crianças na faixa etária de 0 a 6 anos. A asma ainda representa um importante problema global de saúde pública com elevados custos diretos e indiretos, que oneram de forma expressiva os pacientes e os sistemas públicos de saúde. Conclusão: Os programas implementados proporcionaram melhora da saúde dos indivíduos, tornando-os mais aptos ao trabalho, aumentando a produtividade e reduzindo significativamente os custos para a sociedade
Objective: To review the literature on economic analyzes used for asthma, the direct and indirect costs and the economic burden that this disease poses to the health system.Source of data: Survey of original articles, reviews and consensus, indexed in Medline, Lilacs, Embase and PubMed, published between 1996-2012. Data Synthesis: Asthma is a chronic inflammatory lung disease that affects people of all ages, whose lack leads to frequent hospitalizations, emergency room visits and increased morbidity, generating great impact on social and economic life of patients with worsening quality of life. After the beginning of asthma and allergic rhinitis control programs with free delivery of expensive drugs expensive, there was a significant drop in hospitalizations for asthma in the period from 2006 to 2010. In 2012, 48,495 people had access to drugs for asthma, from the implementation of the Health Program, integral action of Popular Pharmacy Program of the Ministry of Health (MH), with free supply of ipratropium bromide, beclomethasone dipropionate and salbutamol sulphate, this number increased signifcantly from 48,495 to 263,227 people, representing growth of 443% adherence to the program. The MH data showed that asthma still kills 2500 people a year in Brazil, in 2011 the total of 117,800 hospitalizations in the Unified Health System (UHS) due to asthma were affected 77.1 thousand children aged 0-6 years. In addition, asthma is an important global public health problem with high direct and indirect costs, which affect expressively patients and public health systems. Conclusion: The programs implemented provided improves the health of individuals, making them more apt to work, increasing productivity and significantly reducing costs to society
Subject(s)
Humans , Hypersensitivity/classification , Hypersensitivity/diagnosis , Hypersensitivity/prevention & control , Rhinitis , National Health Programs , Review Literature as TopicABSTRACT
Las enfermedades alérgicas constituyen un grupo heterogéneo de enfermedades asociadas clásicamente a una reacción de hipersensibilidad tipo I, en cuya respuesta inmune, mediada principalmente por IgE, participan diversas clases de celulas como linfocitos, especialmente los CD4 polarizados a Th2, linfocitos B antígeno específicos, mastocitos, basófilos y finalmente citoquinas. Durante la última década se ha observado un incremento de la incidencia de las enfermedades alérgicas en los países occidentales, especialmente en niños. Este artículo resume y expone aspectos básicos para comprender la existencia de la alergia en la infancia. Así mismo, se expone la opinión de Comités de expertos internacionales en el área de alergia, quienes han propuesto una nueva nomenclatura para estas enfermedades, según la reacción de hipersensibilidad involucre o no un mecanismo inmune, y esté o no mediada por IgE.
Subject(s)
Humans , Child , Hypersensitivity/genetics , Hypersensitivity/immunology , Hypersensitivity, Immediate/genetics , Hypersensitivity, Immediate/immunology , Hypersensitivity/classification , Phenotype , Precipitating FactorsABSTRACT
Monosensitization differs both immunologically and clinically from polysensitization, and specific immunotherapy is more effective in patients sensitized only to a single pollen than in multiple-pollen sensitized patients. To further examine the differences between monosensitized and polysensitized allergies, allergic indices were examined in 68 monosensitized and 62 polysensitized patients with childhood asthma. Measurements included symptom scores, eosinophil counts, skin prick tests, serum total and specific IgE levels, and IL-10 levels, and were used to compare allergic indices between the two groups. Patients were followed for 18 months following immunotherapy to examine the effectiveness of the treatment. Symptom scores and total IgE levels were significantly higher in the polysensitized group than those in the monosensitized group (p<0.05). The levels of skin test response decreased significantly in both groups following immunotherapy. In the monosensitized group, symptom scores and specific IgE levels were significantly reduced after immunotherapy (p<0.05). In the polysensitized group, symptom scores were reduced after immunotherapy (p<0.05), but the degree of reduction was less than that of the monosensitized group (p<0.05). Moreover, in the polysensitized group, specific IgE levels after immunotherapy did not differ from that before immunotherapy. Serum IL-10 levels were not significantly increased after immunotherapy in either group. In conclusion, polysensitized patients tend to show higher allergic indices and immunotherapy might be less effective for these patients.
Subject(s)
Male , Humans , Female , Child , Skin Tests/methods , Sensitivity and Specificity , Reproducibility of Results , Hypersensitivity/classification , Health Status Indicators , Asthma/classificationABSTRACT
Monosensitization differs both immunologically and clinically from polysensitization, and specific immunotherapy is more effective in patients sensitized only to a single pollen than in multiple-pollen sensitized patients. To further examine the differences between monosensitized and polysensitized allergies, allergic indices were examined in 68 monosensitized and 62 polysensitized patients with childhood asthma. Measurements included symptom scores, eosinophil counts, skin prick tests, serum total and specific IgE levels, and IL-10 levels, and were used to compare allergic indices between the two groups. Patients were followed for 18 months following immunotherapy to examine the effectiveness of the treatment. Symptom scores and total IgE levels were significantly higher in the polysensitized group than those in the monosensitized group (p<0.05). The levels of skin test response decreased significantly in both groups following immunotherapy. In the monosensitized group, symptom scores and specific IgE levels were significantly reduced after immunotherapy (p<0.05). In the polysensitized group, symptom scores were reduced after immunotherapy (p<0.05), but the degree of reduction was less than that of the monosensitized group (p<0.05). Moreover, in the polysensitized group, specific IgE levels after immunotherapy did not differ from that before immunotherapy. Serum IL-10 levels were not significantly increased after immunotherapy in either group. In conclusion, polysensitized patients tend to show higher allergic indices and immunotherapy might be less effective for these patients.
Subject(s)
Male , Humans , Female , Child , Skin Tests/methods , Sensitivity and Specificity , Reproducibility of Results , Hypersensitivity/classification , Health Status Indicators , Asthma/classificationABSTRACT
A consequência do rápido desenvolvimento de novas drogas para tratamentos e diagnósticos de doenças humanas tem levado a aumento na incidência de reações adversas a estas drogas, podendo acarretar um aumento de morbidade e até mortalidade / As a consequence to the development of new drugs and a pharmaceutical agents for diagnosis of human diseases, the number of adverse reactions to the drugs has also increased, resulting incresead morbidity and mortalities..
Subject(s)
Medicamentous Disease in Homeopathy/epidemiology , Drug Hypersensitivity , Hypersensitivity/classification , Rebound EffectABSTRACT
Se analizaron las frecuencias alélicas del locus DYS19 provenientes de 5 poblaciones rurales venezolanas deascendencia africana (Panaquire; Sotillo; Curiepe; Birongo; Ganga), y se compararon con otras 3 de ascendencia canaria (San Antonio; San Diego; Hoyo de la Cumbre) y con otras reportadas a nivel mundial, utilizando técnicas multivariantes como el Análisis de Correspondencias Binarias (ACB) y la Clasificación Automática. Se pudieron definir 4 grupos de poblaciones asociados a alelos específicos y diferentes orígenes geográficos. Todas las poblaciones venezolanas se ubicaron en el grupo europeo, lo que indica un flujo génico europeo importante por vía masculina en ellas; no obstante, el uso del ACB y la Clasificación Automática permitió diferenciar en un subgrupo a las 5 poblaciones rurales de ascendencia africana. Los resultados obtenidos reflejan la utilidad de los métodos multivariantes utilizados para maximizar el poder discriminante de loci altamente informativos como el DYS19, cuando no se dispone de recursos para estudiar varios loci simultáneamente. Además ofrecieron la posibilidad de mejorar la calidad de la información genética que se poseía sobre las poblaciones venezolanas estudiadas.
The allelic frequencies of locus DYS19 from 5 rural African-derived Venezuelan populations (Panaquire; Sotillo; Curiepe; Birongo; Ganga) were analyzed, and compared with 3 Canarian-derived Venezuelan populations (San Antonio; San Diego; Hoyo de la Cumbre) and with others reported to worldwide, using multivariate method like Correspondences Analysis and Cluster Analysis. Four population clusters were found to be associated with specific alleles and different geographic origins. All the Venezuelan populations were localized in the European cluster, which indicates the existence in them of an important European gene flow through male. Nevertheless the use of both Correspondences Analysis and Cluster Analysis simultaneously, allowed to differentiate in a sub cluster with the 5 rural African-derived Venezuelan populations. The results show the usefulness of the multivariate statistical methods to maximize the discrimination power of highly informative loci like DYS19, when resources are not available to study many loci simultaneously. Furthermore its use improved the quality of the genetic information which already existed for some of the Venezuelan populations studied.
Subject(s)
Humans , Male , Female , Hypersensitivity/classification , Hypersensitivity/diagnosis , Indigenous Peoples , Multivariate Analysis , Rural Population , Genetics , Health StatisticsSubject(s)
Humans , Allergens/immunology , Allergy and Immunology , Anaphylaxis , Asthma , Asthma/classification , Asthma/diagnosis , Asthma/therapy , Conjunctivitis, Allergic/diagnosis , Conjunctivitis, Allergic/therapy , Dermatitis, Atopic , Desensitization, Immunologic , Eczema , Hypersensitivity/classification , Hypersensitivity/genetics , Immunotherapy , Rhinitis/diagnosis , Rhinitis/therapy , Urticaria/diagnosis , Urticaria/therapy , Air Pollution, Indoor , Drug Hypersensitivity , Environmental Pollution , Food Hypersensitivity , Pollen/adverse effectsABSTRACT
Los productos de látex son escenciales en la vida cotidiana y en la práctica médica. Su uso se ha ralacionado con un incremento en la frecuencia de reacciones alérgicas. La presentación clínica más común es la hipersensibilidad tardía de origen no inmunológico. Aunque menos frecuente, la hipersensibilidad inmediata puede ocasionar reacciones anafilácticas graves, inclusive letales. En pacientes con factores de riesgo, es necesaria la detección oportuna del problema. En el momento actual, la única medida contra la alergia al látex consiste en evitar por completo todo contacto con sus antígenos
Subject(s)
Allergens/classification , Health Personnel , Hypersensitivity/classification , Latex/adverse effects , Latex/therapeutic use , SRS-AABSTRACT
Para determinar algunas características epidemiológicas del asma en la costa caribe colombiana, se examinaron cuatro mil personas de Cartagena para establecer la prevalencia de esta enfermedad y los registros de defunciones ocurridas desde 1986 hasta 1990 en dos departamentos representativos del sector geográfico (Bolivar y Atlántico), con el fin de investigar la tendencia de la tasa de mortalidad por asma en ese período. Además, se investigó la importancia del asma entre otras enfermedades alérgicas haciendo un estudio poblacional con los pacientes que asistieron a un consultorio de alergias en Cartagena, en el cual se obtuvieron las frecuencias de las enfermedades alérgicas por la que consultaron. Los resultados mostraron una prevalencia de asma acumulativa y puntual de 8.8 por ciento y 12.2 por ciento respectivamente y una tasa de mostalidad en ascenso con valores que van desde 0.74 en 1986 hasta 1.62 en 1990. Setenta por ciento de la población general afectada por asma tenían menos de 15 años de edad y en la consulta de alergias se observó que el asma era la segunda enfermedad más frecuente después de la rinitis. Los datos de estos estudios sugieren que la frecuencia de asma es alta, la mortalidad por dicha enfermedad no es muy diferente a la encontrada en otros sitios y la distribución de las enfermedades alérgicas muestra un predominio de los procesos respiratorios.
Subject(s)
Humans , Asthma , Asthma/classification , Asthma/complications , Asthma/diagnosis , Asthma/drug therapy , Asthma/epidemiology , Asthma/ethnology , Asthma/etiology , Asthma/physiopathology , Asthma/therapy , Hypersensitivity/classification , Hypersensitivity/complications , Hypersensitivity/diagnosis , Hypersensitivity/drug therapy , Hypersensitivity/epidemiology , Hypersensitivity/ethnology , Hypersensitivity/etiology , Hypersensitivity/physiopathology , Hypersensitivity/therapyABSTRACT
Las enfermedades alérgicas son la patología crónica benigna más frecuente en los seres humanos. Por ello, constituye un reto clínico que debe afrontarse diariamente tanto en la consulta como en el trabajo hospitalario. La alergia es un dominio donde las conocimientos han evolucionado en forma prodigiosa, beneficiándose del desarrollo acelerado de la inmunología. En esta revisión se presenta en forma condensada pero atractiva y precisa, los conceptos actuales que permiten comprender e interesarse por el tema. Punto central de este escrito es la inflamación donde se define bajo las premisas actuales de la inmunología y la bioquímica,con especial énfasis en el papel que desempeñan el factor activador de plaquetas (PAF) y las principales enfermedades alérgicas, en las cuales la inflamación es sintomática y clínicamente muy importante.
Subject(s)
Hypersensitivity/classification , Inflammation , Inflammation/physiopathology , Asthma , Rhinitis , Interleukins , Dermatitis , EosinophilsABSTRACT
Se realizo un analisis descriptivo de las plantas consideradas capaces de producir reaccion alergica por los granos de polen. Se trabajo con 106 especimenes de 30 familias y 79 generos, solo 57 especies contribuyeron a la coleccion con preparaciones fijas de polen acetolizado. Asimismo, se realizaron descripciones morfologicas del grano de polen. Se revisaron historias clinicas, seleccionandose a los pacientes que dieron reaccion positiva a algun polosn (1 101 pacientes) y reaccion positiva a algun alimento. Esto se corroboro con pruebas de ingestion alimentaria de origen vegetal. Las gramineas, leguminosas rosaceas y solanaceas fueron el grupo mas importante de alimentos de origen vegetal que dieron reaccion positiva por ingestion alimentaria y 37.52% a reaccion cutanea.
Subject(s)
Plants , Food Hypersensitivity/diagnosis , Food Hypersensitivity/etiology , Food Hypersensitivity/immunology , Hypersensitivity/classification , Hypersensitivity/etiology , Hypersensitivity/physiopathology , Plants/analysis , Plants/classification , Pollen/analysis , Pollen/immunology , Pollen/ultrastructureABSTRACT
Se efectuo un estudio con el proposito de confirmar si la prevalencia de las enfermedades alergicas se ha modificado en los ultimos 10 a;os en poblacion abierta. Para ello se estudiaron 243 familias seleccionadas al azar en el area metropolitana de la ciudad de monterrey, mediante un cuestionario de 12 preguntas. Del total de familias estudiadas se encontrar5on 95 con alguna enfermedad alergica, 11.2% de las 1207 personas entrevistadas.
Subject(s)
Humans , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Male , Female , Cohort Studies , Hypersensitivity/classification , Hypersensitivity/epidemiology , Hypersensitivity/physiopathology , MexicoABSTRACT
Las reacciones graves de hipersensibilidad que se observan durante el primer uso de los materiales de hemodiálisis son relativamente infrecuentes. No obstante, cuando éstas se presentan pueden comprometer la vida del enfermo. El motivo de nuestra comunicación es describir el caso de un paciente con el denominado "síndrome del primer uso" y analizar los mecanismos fisiopatológicos involucrados en este tipo de reacciones