RESUMO
International guidelines have been edited to standardize asthma management. These guidelines are often difficult to translate to clinical practice because of gaps in the knowledge of clinical practitioners but also because of compliance issues, particularly in children and adolescents. A new approach named SIT (for Single Inhaler Therapy) or SMART (for Symbicort Maintenance and Reliever Therapy) has demonstrated its safety and efficacy in numerous studies of adults with asthma summarized in two Cochrane reviews. We present here three clinical cases from our clinic where this approach was applied to children and adolescents with a clear clinical and functional response for two of them. We suggest that the SIT regimen can be used in some children and adolescents with asthma and has the potential to reduce compliance issues. Moreover asthma phenotypes have been described and it is possible that only some of these phenotypes respond to this regimen. However to confirm the efficacy and safety of the SIT regimen in children and adolescents more studies are needed.
La prise en charge de l'asthme se base sur des schémas résumés dans des recommandations internationales. En pratique, la mise en place de ces recommandations se heurte à de nombreux problèmes dont la méconnaissance du milieu médical, mais aussi l'observance, en particulier chez l'enfant et l'adolescent. Une nouvelle approche, appelée SIT (pour Single Inhaler Therapy) ou SMART (pour Symbicort Maintenance And Reliever Therapy) a démontré son efficacité chez l'adulte sur base de plusieurs études, résumées dans deux revues Cochrane. Nous présentons trois cas cliniques où ce traitement a été appliqué à des enfants et adolescents avec une efficacité certaine dans deux cas et une mauvaise réponse dans l'autre. Nous suggérons que ce schéma pourrait être efficace chez l'enfant et l'adolescent, notamment vu les problèmes de compliance dans cette tranche d'âge. En outre, il est possible que certains phénotypes d'asthme soient plus à même de répondre à ce schéma. Afin de confirmer l'efficacité et la sécurité de ce type de schéma dans cette tranche d'âge, des études complémentaires sont cependant indispensables.
Assuntos
Antiasmáticos/administração & dosagem , Asma/tratamento farmacológico , Budesonida/administração & dosagem , Fumarato de Formoterol/administração & dosagem , Administração por Inalação , Adolescente , Criança , Quimioterapia Combinada , Emergências , Feminino , Humanos , Quimioterapia de Manutenção , MasculinoRESUMO
Few data are available in the literature on the dermatological consequences and treatment of Neotrombicula autumnalis infestation in dogs and cats. In this study, 15 dogs naturally infested with Neotrombicula were affected with moderate to severe pruritic dermatitis. The dermatitis resolved with successful treatment of the parasitic infestation. In 14 dogs, treatment using a topical permethrin-pyriproxyfen combination (pump-spray or 'line-on') was effective within one to three weeks. Two applications were necessary in four dogs. Careful follow-up was conducted in all cases. Statistical analysis was performed to assess the impact of treatment on the parasite population and clinical signs over the three-week study period.
