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      Relación entre la severidad de las manifestaciones de asma bronquial y el cumplimiento del tratamiento intercrisis Translated title: Relation between the severity of bronchial asthma manifestations and the fulfilment of the inter-crisis treatment

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          Abstract

          INTRODUCCIÓN: En la última década han aumentado la morbilidad y la mortalidad por asma bronquial. Se estima que esta enfermedad la padecen actualmente 300 millones de personas en el mundo. En Cuba, el asma bronquial constituye también un importante problema de salud. OBJETIVO: Establecer la relación entre el cumplimiento del tratamiento en periodos intercrisis y la severidad de las manifestaciones clínicas de la enfermedad. MÉTODOS: Se estudiaron 119 pacientes con diagnóstico de asma bronquial pertenecientes al policlínico "Ana Betancourt". Para la recolección de datos se aplicaron cuestionarios de forma individual a los pacientes o a los familiares que están directamente al cuidado de estos. Los pacientes fueron agrupados según la Guía española para el manejo del asma de 2009. RESULTADOS: Se detectaron 23 pacientes asmáticos intermitentes, 42 persistentes leves, 36 persistentes moderados y 18 persistentes graves. El 95 % de los pacientes estudiados desencadenaba la crisis con inhalantes respiratorios. En el 79 % de los hogares se detectó la presencia de fumadores. Solo el 41 % de los pacientes cumplía el tratamiento correctamente en los periodos intercrisis. CONCLUSIONES: Existe una relación directa entre la severidad de las manifestaciones clínicas del asma bronquial y el no cumplimiento del tratamiento intercrisis, lo que puede condicionar la exacerbación de la enfermedad.

          Translated abstract

          INTRODUCTION: In past decade the morbidity and mortality from bronchial asthma have increased. This is a diseased suffered nowadays by 300 millions of persons in the world. In Cuba, the bronchial asthma is also an important health problem. OBJECTIVE: To establish the relation between the fulfilment of treatment in inter-crisis period and the severity of the clinical manifestations of this entity. METHODS: A total of 119 patients diagnosed with bronchial asthma from the "Ana Betancourt" Polyclinic were studied. In data collection authors applied individual questionnaires among patients and relatives this latter directly related to its care. Patients were grouped according to the Spanish Guide for asthma management (SGAM) of 2009. RESULTS: Twenty three intermittent asthmatic patients were detected, 42 were slight persistent, 36 were of persistent moderate type and 18 were severe persistent. The 95 % of study patient triggered the crisis using respiratory inhalants. In the 79 % of homes there was presence of smokers. Only the 41 % of patients fulfils the treatment appropriately during the inter-crisis periods. CONCLUSIONS: There is a direct relation between the severity of the clinical manifestations of bronchial asthma and the non-fulfillment of inter-crisis treatment leading to the disease exacerbation.

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          A new perspective on concepts of asthma severity and control.

          Concepts of asthma severity and control are important in the evaluation of patients and their response to treatment but the terminology is not standardised and the terms are often used interchangeably. This review, arising from the work of an American Thoracic Society/European Respiratory Society Task Force, identifies the need for separate concepts of control and severity, describes their evolution in asthma guidelines and provides a framework for understanding the relationship between current concepts of asthma phenotype, severity and control. "Asthma control" refers to the extent to which the manifestations of asthma have been reduced or removed by treatment. Its assessment should incorporate the dual components of current clinical control (e.g. symptoms, reliever use and lung function) and future risk (e.g. exacerbations and lung function decline). The most clinically useful concept of asthma severity is based on the intensity of treatment required to achieve good asthma control, i.e. severity is assessed during treatment. Severe asthma is defined as the requirement for (not necessarily just prescription or use of) high-intensity treatment. Asthma severity may be influenced by the underlying disease activity and by the patient's phenotype, both of which may be further described using pathological and physiological markers. These markers can also act as surrogate measures for future risk.
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            Decline in lung function in the Busselton Health Study: the effects of asthma and cigarette smoking.

            Asthma in adults may be associated with chronic airflow obstruction, possibly resulting from airway disease in early life and/or a greater rate of decline in lung function in adult life compared with those with asthma. Treatment and cigarette smoking may also influence the rate of decline of lung function. The aim of this analysis was to examine the level and rate of decline in lung function in relationship to asthma and cigarette smoking in adults. Subjects (n = 9,317) had participated as adults (> 18 years) in one or more of the cross-sectional Busselton Health Surveys between 1966 and 1981 or in the follow-up study of 1994/1995. The effects of sex, doctor-diagnosed asthma, smoking status, and anthropometric data on the level and rate of decline in FEV1 were examined in a linear mixed effects model. At the age of 19 years, FEV1 was reduced in subjects with asthma but was similar in smokers and nonsmokers. Males, taller subjects, smokers, and subjects with asthma had greater declines in FEV1 with age. Smoking and asthma had additive but not multiplicative effects on decline. Thus, asthma is associated with reduced lung function at the beginning of adult life as well as an increased rate of decline during adult life.
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              State of World Allergy Report 2008: Allergy and Chronic Respiratory Diseases

              This activity was supported by unrestricted educational grants from Stallergenes Allergen Vaccines Worldwide, Nestlé Nutrition Institute, and UCB. Stallergenes - http://www.stallergenes.com/nc/en.html http://www.nestlenutrition-institute.org/en http://www.ucb-group.com/ and http://www.todaysallergies.com A Message from Professor G. Walter Canonica President, World Allergy Organization June 2008 Genoa, ITALY Dear Colleagues: One of my first duties as President of the World Allergy Organization (WAO) is the pleasure of presenting the State of World Allergy Report 2008. This exciting new WAO initiative, launched at the World Allergy Congress in Bangkok in December 2007, will provide a biennial review of the explosion of allergies around the globe and will consider how the medical, social and economic issues surrounding allergic diseases should be addressed. This first report provides a snapshot of the prevailing situation in 2008 from the perspective of organizations, such as the WAO and the World Health Organization through the Global Alliance against Chronic Respiratory Diseases, which represent allergists and clinical immunologists -- the clinicians at the forefront of attempts to recognize, assess and address this global crisis. The focus of WAO's mandate for the next two years is Innovation in Continuity . WAO will continue to build on its existing programs to further support and develop new research, education and training initiatives in this specialty and to focus attention on the importance of the allergist as the key coordinator of allergy patient care. The State of World Allergy Report is a call to action for everyone with an interest in allergy to develop a partnership with WAO in a global effort to control and manage allergic diseases on behalf of the world's population. Yours sincerely, Professor G. Walter Canonica President, World Allergy Organization
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                Author and article information

                Journal
                mgi
                Revista Cubana de Medicina General Integral
                Rev Cubana Med Gen Integr
                ECIMED (Ciudad de La Habana, , Cuba )
                0864-2125
                1561-3038
                September 2011
                : 27
                : 3
                : 294-306
                Affiliations
                [01] La Habana orgnamePoliclínico Docente Ana Betancourt Cuba tdelavega@ 123456infomed.sld.cu
                Article
                S0864-21252011000300001 S0864-2125(11)02700301
                dd2b4ecd-fda8-415d-a281-87f8bcabe622

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 15 July 2011
                : 14 December 2010
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 20, Pages: 13
                Product

                SciELO Cuba

                Categories
                TRABAJOS ORIGINALES

                severity,inter-crisis treatment,Bronchial asthma,exacerbación,manifestaciones clínicas,clinical manifestations,exacerbation,Asma bronquial,tratamiento intercrisis,severidad

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