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Resumen: Introducción: La enfermedad pulmonar obstructiva crónica (EPOC) es la tercera causa de muerte a nivel global y en Argentina tiene una prevalencia de 14,5%, pero se desconoce el manejo de los pacientes en la vida real. Los objetivos del trabajo fueron: a) conocer las opiniones de los neumólogos de Argentina que manejan pacientes con EPOC en la práctica diaria. b) Comparar nuestros hallazgos con los especialistas de España y c) considerar nuestros resultados para planificar futuras directrices en el manejo de la EPOC en nuestro país. Material y métodos: Participaron de un consenso Delphi 89 neumólogos de Argentina, expertos en EPOC, quienes respondieron una encuesta con cinco dominios: a) adhesión al tratamiento, b) control de la EPOC, c) rasgos tratables, d) dispositivos de inhalación y e) accesibilidad a los recursos terapéuticos. Resultados: Tras dos rondas, se alcanzó el consenso en 77,6% del total de las afirmaciones y discriminando por dominio los resultados fueron: adhesión al tratamiento: 5/9 (55,5%). Control de la EPOC: 10/14 (71,4%). Rasgos tratables: 6/6 (100%). Dispositivos de inhalación: 10/14 (71,4%) y accesibilidad al tratamiento: 6/6 (100%). En la mayoría de las afirmaciones los resultados fueron similares a los obtenidos por los neumólogos españoles. Conclusiones: Los neumólogos argentinos manejamos a los pacientes con EPOC de manera similar y con mínimas diferencias con nuestros colegas españoles. Se evidenció que, en la práctica diaria, existen factores que impactan negativamente en el acceso a los tratamientos indicados. Nuestro trabajo podría servir como punto de partida para mejorar esta situación. Abstract: Introduction: COPD is the third cause of death globally and in Argentina COPD has a prevalence of 14.5%, but the management of patients in real life is unknown. The objectives of this work were: a) To know the opinions of pulmonologists in Argentina who manage patients with COPD in different aspects of daily practice. b) Compare our findings with specialists from Spain and c) Consider our results to plan future directives in the management of COPD in our country. Material and methods: 89 pulmonologists from Argentina, experts in COPD, participated in a Delphi consensus, who responded to a survey with five domains. a) Adherence to treatment, b) Control of COPD, c) Treatable features, d) Inhalation devices and e) Accessibility to therapeutic resources. Results: After two rounds of questions, total consensus was achieved in 77.6% of the statements and discriminating by domain: Treatment adherence: 5/9 (55.5%). COPD control: 10/14 (71.4%). Treatable traits: 6/6 (100%). Inhalation devices: 10/14 (71.4%) and Accessibility to treatment: 6/6 (100%). In most of the affirmations, the results were similar to those obtained by Spanish pulmonologists. Conclusions: Pulmonologists from Argentina manage COPD patients in a similar way and with minimal differences with our Spanish colleagues. It became evident that, in daily practice, there are factors that negatively impact access to the indicated treatments. Our work could serve as a starting point to improve this situation.

Resumen: Introducción: El mepolizumab es un anticuerpo monoclonal que bloquea la interleuquina 5 circulante (IL5). El benralizumab se une a la subunidad alfa del receptor de la IL 5 induciendo la eliminación directa de eosinófilos y basófilos. El propósito fue evaluar su efectividad en nuestra práctica clínica habitual. Métodos: Estudio observacional retrospectivo de una cohorte de pacientes asmáticos graves eosinofílicos tratados con mepolizumab y benralizumab durante al menos 6 meses. El seguimiento se ha realizado en la unidad de asma. Resultados: Se analizaron 25 pacientes en tratamiento con mepolizumab y 13 con benralizumab alcanzando un tiempo de seguimiento de 12 meses en el 73,7% de los mismos (10 en el caso de benralizumab y 18 para mepolizumab). Tras el tratamiento biológico se observa una disminución del 71% en el número de ingresos (p = 0,0027) y del 66% (p = 0,0013) en las visitas a urgencias. Se contabilizaron 31 ciclos de corticoides vs. 15 tras el tratamiento biológico suponiendo un descenso de un 52% (p = 0,0069). El control del asma medido por cuestionario de control (ACT) fue de 10,8 puntos (SD: 4,73) vs. 20,3 puntos (SD: 4,77), (p = 0,001) y el % FEV1 fue del 70,6% (SD: 21.5) vs. 76,2% (SD: 27,2), (p = 0,0437). Conclusiones: Se confirma la efectividad de los fármacos anti-IL5 en vida real mostrando mejoras en exacerbaciones, control y función pulmonar. Abstract: Introduction: Mepolizumab is a monoclonal antibody that inhibits circulating interleukin 5 (IL-5). Benralizumab binds to the alpha subunit of the IL-5 receptor, inducing the direct elimination of eosinophils and basophils. The aim of this study was to evaluate their effectiveness in our routine clinical practice. Methods: A retrospective observational study of a cohort of patients with severe eosinophilic asthma treated with mepolizumab and benralizumab for at least 6 months, and followed up in the asthma unit. Results: We analyzed 25 patients who received mepolizumab and 13 who received benralizumab, 73.7% of whom were followed up for 12 months (10 months for benralizumab and 18 for mepolizumab). After biological treatment, there was a 71% reduction in the number of admissions (p = .0027) and a 66% reduction (p = .0013) in emergency visits. A reduction in corticosteroid use was recorded: 31 cycles of corticosteroids compared to 15 after biological treatment, representing a decrease of 52% (p = .0069). Asthma control measured by the Asthma Control Test was 10.8 (SD: 4.73) vs. 20.3 (SD: 4.77), (p = .001) and FEV1% was 70.6% (SD: 21.5) vs. 76.2% (SD: 27.2), (p = .0437). Conclusions: The effectiveness of anti-IL-5 drugs in real life was confirmed, with improvements in exacerbations, asthma control and lung function.

Introduction: COPD is the third cause of death globally and in Argentina COPD has a prevalence of 14.5%, but the management of patients in real life is unknown. The objectives of this work were: a) To know the opinions of pulmonologists in Argentina who manage patients with COPD in different aspects of daily practice. b) Compare our findings with specialists from Spain and c) Consider our results to plan future directives in the management of COPD in our country., Material and Methods: 89 pulmonologists from Argentina, experts in COPD, participated in a Delphi consensus, who responded to a survey with five domains. a) Adherence to treatment, b) Control of COPD, c) Treatable features, d) Inhalation devices and e) Accessibility to therapeutic resources., Results: After two rounds of questions, total consensus was achieved in 77.6% of the statements and discriminating by domain: Treatment adherence: 5/9 (55.5%). COPD control: 10/14 (71.4%). Treatable traits: 6/6 (100%). Inhalation devices: 10/14 (71.4%) and Accessibility to treatment: 6/6 (100%). In most of the affirmations, the results were similar to those obtained by Spanish pulmonologists., Conclusions: Pulmonologists from Argentina manage COPD patients in a similar way and with minimal differences with our Spanish colleagues. It became evident that, in daily practice, there are factors that negatively impact access to the indicated treatments. Our work could serve as a starting point to improve this situation., (© 2024 Sociedad Española de Neumología y Cirugía Torácica (SEPAR). Published by Elsevier España, S.L.U.)

This study aimed to develop and test common scenes of real life to study emotions in women. The methodology adopted herein combined qualitative and quantitative methods and involved three distinct study stages: (i) use of a descriptive question to identify daily situations that evoked negative emotions among women; (ii) construction of everyday life scenes; (iii) assessment of how effectively the constructed videos manipulated emotions. The visual analog scale (VAS), a descriptive question, and a focus group were used to discuss the negative emotion and neutral emotional condition evoked during the experiment. The videos developed, Routine Life Scenes and Dramas of Life Scenes fulfilled the objective of the study. The qualitative approach helped to understand how the videos mobilized the emotions. The participants recognized themselves in similar experiences, in contexts of life, and by the worry and fearfulness of the possibility of living the same experiences.

Introduction: Mepolizumab is a monoclonal antibody that inhibits circulating interleukin 5 (IL-5). Benralizumab binds to the alpha subunit of the IL-5 receptor, inducing the direct elimination of eosinophils and basophils. The aim of this study was to evaluate their effectiveness in our routine clinical practice., Methods: A retrospective observational study of a cohort of patients with severe eosinophilic asthma treated with mepolizumab and benralizumab for at least 6 months, and followed up in the asthma unit., Results: We analyzed 25 patients who received mepolizumab and 13 who received benralizumab, 73.7% of whom were followed up for 12 months (10 months for benralizumab and 18 for mepolizumab). After biological treatment, there was a 71% reduction in the number of admissions (p = .0027) and a 66% reduction (p = .0013) in emergency visits. A reduction in corticosteroid use was recorded: 31 cycles of corticosteroids compared to 15 after biological treatment, representing a decrease of 52% (p = .0069). Asthma control measured by the Asthma Control Test was 10.8 (SD: 4.73) vs. 20.3 (SD: 4.77), (p = .001) and FEV 1 % was 70.6% (SD: 21.5) vs. 76.2% (SD: 27.2), (p = .0437)., Conclusions: The effectiveness of anti-IL-5 drugs in real life was confirmed, with improvements in exacerbations, asthma control and lung function., (© 2021 Sociedad Española de Neumología y Cirugía Torácica (SEPAR). Published by Elsevier España, S.L.U.)

The health and economic impact of allergic diseases are increasing rapidly, and changes in management strategies are required. Its influence reduces the capacity of work and school performance by at least a third. The ICPs of the airways (integrated care pathways for respiratory diseases) are structured multidisciplinary healthcare plans, promoting the recommendations of the guidelines in local protocols and their application to clinical practice. This document presents an executive summary for Argentina, Mexico, and Spain. Next-generation ARIA guidelines are being developed for the pharmacological treatment of allergic rhinitis (AR), using the GRADE-based guidelines for AR, tested with real-life evidence provided by mobile technology with visual analogue scales. It is concluded that in the AR treatment, H1-antihistamines are less effective than intranasal corticosteroids (INCS), in severe AR the INCS represent the first line of treatment, and intranasal combination INCS + anti-H1 is more effective than monotherapy. However, according to the MASK real-life observational study, patients have poor adherence to treatment and often self-medicate, according to their needs.

Objective: To analyze the effect of sodium glucose cotransporter 2 (SGLT2) inhibitors in a group of insulin-dependent type 2 diabetes mellitus (T2D) patients., Patients and Methods: One hundred and five insulin treated T2D patients were enrolled. Primary endpoints were: fasting plasma glucose, HbA1c, weight, total insulin doses (TDI), total basal insulin (TDB) and total rapid insulin (TDR). Secondary variables were: total cholesterol, LDL cholesterol (cLDL), HDL cholesterol (cHDL), triglycerides and systolic (SBP) and diastolic (DBP) blood pressure. Safety and tolerance were evaluated through the appearance of severe hypoglycemia, ketoacidosis and infections., Results: After 4 months follow-up, a 0.7 (1.0)% HbA1c reduction was found, accompanied by a -2.8 (11.5) UI/day TDI decrease. Weight dropped for 73.7% of patients, with an average -2.0 (2.7) kg reduction. A global cHDL increase was noted after treatment, while no differences were observed for total cholesterol, triglycerides or cLDL. SBP dropped significantly, but no change in DBP was observed., Conclusion: The use of SGLT2 inhibitors in insulin treated T2D patients resulted in reduction of HbA1c, which was associated to weight loss, cHDL increase and SBP decrease., (Published by Elsevier España, S.L.U.)

Background: The efficacy of omalizumab in the treatment of chronic spontaneous urticaria has been demonstrated in phase iii clinical trials, but limited information is available regarding real-life effectiveness using the weekly Urticarial Activity Score (UAS7). The aim of the study was to assess clinical response (UAS7≤6) and complete response (UAS7=0) rates at weeks 12 and 24 in a real-life cohort and to identify possible predictors of response to omalizumab., Methods: Clinical records of consecutive patients with moderate-to-severe chronic spontaneous urticaria (UAS≥16) treated with omalizumab at a university-affiliated reference dermatology department in Barcelona, Spain, from February 2014 to September 2017 were retrospectively reviewed. UAS7 values and patients' evolution were assessed according to a predefined protocol. Statistical analysis of data was done using SPSS 18 statistical package (SPSS 18 Inc., Chicago, IL, USA) software., Results: Forty-eight patients were included in the study. All of them completed at least 24-weeks of treatment and follow-up. At week 12, clinical response rates (UAS7<6) were 70.8% and complete response rates (UAS7=0) were 47.9%. At week 24, clinical response rates were 64.6% and complete response rates were 52.1%., Patients: with long-term urticaria (≥18 months' duration) were less likely to achieve a clinical response at week 12 (odds ratio: 0.25; 95% confidence interval 0.06-0.96). Previous immunosuppressive treatment tended to be associated with a lower probability of complete response at week 12 (odds ratio: 0.27 95% confidence interval: 0.07-1.02). H1-antihistamine treatment was associated with lower probability of response at week 24 (odds ratio: 0.1 95% 95% confidence interval: 0.01-0.88) CONCLUSIONS: The effectiveness and safety of omalizumab in real life are similar to efficacy and safety in clinical trials. Duration of disease, previous immunosuppressive therapy and requirement for concomitant H1-antihistamine treatment may be helpful in predicting response to omalizumab treatment., (Copyright © 2018 AEDV. Publicado por Elsevier España, S.L.U. All rights reserved.)

Introduction: Pirfenidone was the first antifibrotic drug approved in Argentina for idiopathic pulmonary fibrosis (IPF). Outcomes in real life may differ from the results of clinical trials. The primary endpoint was to study the tolerance of pirfenidone in real life. Secondary endpoints were to analyze effectiveness and reasons for discontinuation., Materials and Methods: Retrospective observational study conducted in 4 specialized centers in Argentina. We analyzed the medical records of patients with IPF who received pirfenidone between June 2013 and September 2016. Adverse events (AE) and the variables that could influence these results were analyzed. Forced vital capacity (FVC%) parameters were also compared between the pre-pirfenidone and post-pirfenidone periods., Results: Fifty patients were included, 38 (76%) men, with mean age (SD) 67.8 (8.36) years. Mean (SD) exposure to pirfenidone was 645.68 (428.19) days, with a mean daily dose (SD) of 2,064.56mg (301.49). Nineteen AEs in 15 patients (30%) were reported: nausea (14%), asthenia (10%) and skin rash (8%). A total of 18 patients (36%) interrupted treatment, only 1 definitively. The most frequent reason for discontinuation was failure of suppliers to provide the drug (9 subjects; 18%). We compared the evolution of FVC% between the pre-pirfenidone and post-pirfenidone periods, and found a mean (SD) FVC% decline of 4.03% (7.63) pre-pirfenidone and 2.64% (7.1) post-pirfenidone (P=.534)., Conclusions: In our study, pirfenidone was well tolerated and associated with a reduction in FVC decline, although without reaching statistical significance., (Copyright © 2018 SEPAR. Publicado por Elsevier España, S.L.U. All rights reserved.)