Prevalence of the eosinophilic phenotype among severe asthma patients in Brazil: the BRAEOS study.

OBJECTIVE: To assess the prevalence of the eosinophilic and allergic phenotypes of severe asthma in Brazil, as well as to investigate the clinical characteristics of severe asthma patients in the country. METHODS: This was a cross-sectional study of adult patients diagnosed with severe asthma and managed at specialized centers in Brazil. The study was conducted in 2019. RESULTS: A total of 385 patients were included in the study. Of those, 154 had a blood eosinophil count > 300 cells/mm3 and 231 had a blood eosinophil count of ≤ 300 cells/mm3. The median age was 54.0 years, and most of the patients were female, with a BMI of 29.0 kg/m2 and a history of allergy (81.6%). The prevalence of patients with a blood eosinophil count > 300 cells/mm3 was 40.0% (95% CI: 35.1-44.9), and that of those with a blood eosinophil count > 300 cells/mm3 and a history of allergy was 31.9% (95% CI: 27.3-36.6). Age and BMI showed positive associations with a blood eosinophil count > 300 cells/mm3 (OR = 0.97, p < 0.0001; and OR = 0.96, p = 0.0233, respectively), whereas the time elapsed since the onset of asthma symptoms showed an increased association with a blood eosinophil count > 300 cells/mm3 (OR = 1.02, p = 0.0011). CONCLUSIONS: This study allowed us to characterize the population of severe asthma patients in Brazil, showing the prevalence of the eosinophilic phenotype (in 40% of the sample). Our results reveal the relevance of the eosinophilic phenotype of severe asthma at a national level, contributing to increased effectiveness in managing the disease and implementing public health strategies.

Prevalence of the eosinophilic phenotype among severe asthma patients in Brazil: the BRAEOS study / Prevalência do fenótipo eosinofílico em pacientes com asma grave no Brasil: o estudo BRAEOS

ABSTRACT Objective: To assess the prevalence of the eosinophilic and allergic phenotypes of severe asthma in Brazil, as well as to investigate the clinical characteristics of severe asthma patients in the country. Methods: This was a cross-sectional study of adult patients diagnosed with severe asthma and managed at specialized centers in Brazil. The study was conducted in 2019. Results: A total of 385 patients were included in the study. Of those, 154 had a blood eosinophil count > 300 cells/mm3 and 231 had a blood eosinophil count of ≤ 300 cells/mm3. The median age was 54.0 years, and most of the patients were female, with a BMI of 29.0 kg/m2 and a history of allergy (81.6%). The prevalence of patients with a blood eosinophil count > 300 cells/mm3 was 40.0% (95% CI: 35.1-44.9), and that of those with a blood eosinophil count > 300 cells/mm3 and a history of allergy was 31.9% (95% CI: 27.3-36.6). Age and BMI showed positive associations with a blood eosinophil count > 300 cells/mm3 (OR = 0.97, p < 0.0001; and OR = 0.96, p = 0.0233, respectively), whereas the time elapsed since the onset of asthma symptoms showed an increased association with a blood eosinophil count > 300 cells/mm3 (OR = 1.02, p = 0.0011). Conclusions: This study allowed us to characterize the population of severe asthma patients in Brazil, showing the prevalence of the eosinophilic phenotype (in 40% of the sample). Our results reveal the relevance of the eosinophilic phenotype of severe asthma at a national level, contributing to increased effectiveness in managing the disease and implementing public health strategies.

RESUMO Objetivo: Avaliar a prevalência dos fenótipos eosinofílico e alérgico da asma grave no Brasil e investigar as características clínicas dos pacientes com asma grave no país. Métodos: Estudo transversal com pacientes adultos com diagnóstico de asma grave atendidos em centros especializados no Brasil. O estudo foi realizado em 2019. Resultados: Foram incluídos no estudo 385 pacientes. Destes, 154 apresentavam contagem de eosinófilos no sangue > 300 células/mm3 e 231 apresentavam contagem de eosinófilos no sangue ≤ 300 células/mm3. A mediana da idade foi de 54,0 anos, e a maioria dos pacientes era do sexo feminino, com IMC de 29,0 kg/m2 e história de alergia (81,6%). A prevalência de pacientes com contagem de eosinófilos no sangue > 300 células/mm3 foi de 40,0% (IC95%: 35,1-44,9), e a daqueles com contagem de eosinófilos no sangue > 300 células/mm3 e história de alergia foi de 31,9% (IC95%: 27,3-36,6). A idade e o IMC apresentaram associações positivas com contagem de eosinófilos no sangue > 300 células/mm3 (OR = 0,97, p < 0,0001 e OR = 0,96, p = 0,0233, respectivamente), ao passo que o tempo decorrido desde o início dos sintomas de asma apresentou associação aumentada com contagem de eosinófilos no sangue > 300 células/mm3 (OR = 1,02, p = 0,0011). Conclusões: Este estudo possibilitou a caracterização da população de pacientes com asma grave no Brasil, mostrando a prevalência do fenótipo eosinofílico (em 40% da amostra). Nossos resultados revelam a relevância do fenótipo eosinofílico da asma grave em nível nacional, contribuindo para aumentar a eficácia no manejo da doença e na implantação de estratégias de saúde pública.

Respira project: Humanistic and economic burden of asthma in Brazil.

OBJECTIVE: To determine the association of asthma on health-related quality of life (QoL), productivity, and use of healthcare resources among adults in Brazil. METHODS: Data were analyzed from the 2015 Brazil National Health and Wellness Survey, a cross-sectional survey with 12,000 adult respondents. Asthma and control groups were compared with respect to health-related QoL, asthma control, work productivity, and adherence. Generalized linear models were developed to compare asthma-related associations controlling for potential confounding factors. RESULTS: Among respondents, 4.1% (n = 494) reported an asthma diagnosis; those without asthma symptoms were used as the control group (n = 11,487). Regarding asthma control, 51.2% of patients had uncontrolled asthma, 36.4% partially controlled asthma, and 12.3% were fully controlled. Short-acting ß2 agonists were the most commonly used class of drugs (38.5%). Approximately 32.4% of asthma patients were considered fully adherent to their treatment. In multivariable analyses, asthma patients presented lower health-related QoL and had more frequent visits with medical healthcare providers (6.1 versus 4.2) emergency room visits (1.0 versus 0.5), and more hospitalizations (0.4 versus 0.2), than control respondents six months prior to the study (p < 0.05). Rates of absenteeism and presenteeism varied between 11.5% and 7.4% (p < 0.05) and 30.4% and 20.9% (p < 0.001) between asthma patients and controls, respectively. CONCLUSIONS: Asthma had a negative association on health-related QoL, work productivity, and use of healthcare resources. Excessive use of short-acting ß2 agonists and poor treatment adherence reflect poor asthma control and suggest the need to implement new strategies for asthma treatment in Brazil.

Precisão, sensibilidade e confiança na percepção háptica de peso na presença ou ausência de movimento e visão / Precision, sensitivity and confidence in haptic perception of weight in the presence or absence of movement and vision / Precisión, sensibilidad y confiabilidad en la percepción háptica de peso en la presencia o ausencia de movimiento y visión

Esta pesquisa investigou a influência do movimento muscular e da visão na precisão, sensibilidade e nível de confiança na percepção háptica de peso. Os participantes compararam pesos colocados sobre as palmas das mãos e, conforme a condição experimental, podiam movimentar ou não os braços, bem como visualizar ou não suas mãos e os estímulos. Os resultados mostraram que a precisão e a sensibilidade foram influenciadas pelo movimento e, em menor grau, pela visão. Em geral, o movimento leva à maior precisão e mais sensibilidade, e a contribuição da visão ocorreu nas condições sem movimento. O nível de confiança não foi influenciado pelo movimento, mas foi influenciado pela visão, sobretudo nas condições sem movimento. O nível de confiança foi congruente à precisão dos julgamentos somente na ausência de visão, sugerindo um conhecimento implícito da precisão.(AU)

In this research we investigated the influence of muscle movement and vision in precision, sensitivity and level of confidence in the haptic perception of weight. The participants compared objects' weight placed on the palms of their hands and, according to the experimental condition, they could or could not make arm movements and make visual contact with the stimuli. The results showed that precision and sensitivity were mainly affected by movement and, to a less extent, by vision. In general, movements produced better precision and sensitivity, and vision contributed only in the conditions without movement. The confidence level was influenced by vision, especially in conditions without movement. Confidence was consistent with precision in conditions without vision, suggesting an implicit knowledge about precision.(AU)

Este estudio investigó la influencia de los movimientos musculares y visión en la precisión, la sensibilidad y el nivel de confiabilidad en la percepción háptica de peso. Los participantes compararon los pesos colocados en las palmas de las manos y, de acuerdo a la condición experimental, se podían o no mover sus brazos y visualizar o no los estímulos. Los resultados mostraron que la precisión y la sensibilidad han sido influenciados por el movimiento y, en menor medida, por la visión. En general, el movimiento conduce a una mayor precisión y sensibilidad, y la contribución de la visión ocurrió en las condiciones sin movimientos. El nivel de confiabilidad fue afectado por la visión, especialmente en condiciones sin movimientos. El nivel de confianza era congruente con la precisión de los juicios únicamente en ausencia de la visión, lo que sugiere un conocimiento implícito de la precisión.(AU)

Precisão, sensibilidade e confiança na percepção háptica de peso na presença ou ausência de movimento e visão / Precision, sensitivity and confidence in haptic perception of weight in the presence or absence of movement and vision / Precisión, sensibilidad y confiabilidad en la percepción háptica de peso en la presencia o ausencia de movimiento y visión

Esta pesquisa investigou a influência do movimento muscular e da visão na precisão, sensibilidade e nível de confiança na percepção háptica de peso. Os participantes compararam pesos colocados sobre as palmas das mãos e, conforme a condição experimental, podiam movimentar ou não os braços, bem como visualizar ou não suas mãos e os estímulos. Os resultados mostraram que a precisão e a sensibilidade foram influenciadas pelo movimento e, em menor grau, pela visão. Em geral, o movimento leva à maior precisão e mais sensibilidade, e a contribuição da visão ocorreu nas condições sem movimento. O nível de confiança não foi influenciado pelo movimento, mas foi influenciado pela visão, sobretudo nas condições sem movimento. O nível de confiança foi congruente à precisão dos julgamentos somente na ausência de visão, sugerindo um conhecimento implícito da precisão...

In this research we investigated the influence of muscle movement and vision in precision, sensitivity and level of confidence in the haptic perception of weight. The participants compared objects' weight placed on the palms of their hands and, according to the experimental condition, they could or could not make arm movements and make visual contact with the stimuli. The results showed that precision and sensitivity were mainly affected by movement and, to a less extent, by vision. In general, movements produced better precision and sensitivity, and vision contributed only in the conditions without movement. The confidence level was influenced by vision, especially in conditions without movement. Confidence was consistent with precision in conditions without vision, suggesting an implicit knowledge about precision...

Este estudio investigó la influencia de los movimientos musculares y visión en la precisión, la sensibilidad y el nivel de confiabilidad en la percepción háptica de peso. Los participantes compararon los pesos colocados en las palmas de las manos y, de acuerdo a la condición experimental, se podían o no mover sus brazos y visualizar o no los estímulos. Los resultados mostraron que la precisión y la sensibilidad han sido influenciados por el movimiento y, en menor medida, por la visión. En general, el movimiento conduce a una mayor precisión y sensibilidad, y la contribución de la visión ocurrió en las condiciones sin movimientos. El nivel de confiabilidad fue afectado por la visión, especialmente en condiciones sin movimientos. El nivel de confianza era congruente con la precisión de los juicios únicamente en ausencia de la visión, lo que sugiere un conocimiento implícito de la precisión...

Hamartoma fibroso infantil: lesão volumosa com envolvimento de plexo braquil / Children's fibrous hamartoma: extensive injury involving brachial plexus

OBJETIVO: Apresentar um caso de hamartoma fibroso da infância em lactente ressecado tardiamente e se apresentando como lesão extensa, com envolvimento de elementos vasculares e neurais do plexo braquial. MÉTODOS: Estudo de caso clínico e revisão de literatura pertinente. RESULTADOS: Criança do sexo masculino, com massa tumoral axilar direita, irregular surgida aos 2 meses de idade e relacionada à administração da vacina BCG, sendo tratada com agentes anti-tuberculosos, sem resposta. Mediante biópsia a lesão foi diagnosticada como hamartoma fibroso infantil, e, após sofrer período de crescimento rápido, foi submetida à exérese cirúrgica completa. CONCLUSÃO: O hamartoma fibroso juvenil é um tumor benigno raro, tipicamente se apresentando no primeiro ano de vida em meninos, com localização mais comum no oco axilar. O diagnóstico diferencial se faz com tumores de partes moles em geral e, em casos de apresentação na axila direita, com adenopatias axilares causadas por reação à BCG. O tratamento é exerese completa da lesão e o prognóstico é favorável.

OBJECTIVE: To present a case of fibrous hamartoma in a late-dried infant presenting as an extensive injury, involving vascular and neural elements of brachial plexus. METHODS: Clinical case study and pertinent literature review. RESULTS: Male child, with right axillary irregular tumoral mass, of which onset occurred at 2 months of age and related to BCG vaccine application, being treated with anti-tuberculosis agents, not responding to therapy. Upon biopsy, the injury was diagnosed as childrenÆs fibrous hamartoma, and, after a fast growing period, was submitted to total surgical exeresis. CONCLUSION: The juvenile fibrous hamartoma is a rare benign tumor, typically occurring within the first year of life in boys, most commonly located at axillary gap. The differential diagnosis is performed with soft parts tumors in general, and, in right axillary location cases, with axillary adenopathies caused by responses to BCG vaccine. Treatment approach is total exeresis of the injury and the prognosis is favorable.