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Gram-negative bacteria build an asymmetric outer membrane (OM), with lipopolysaccharides (LPS) and phospholipids (PLs) occupying the outer and inner leaflets, respectively. This distinct lipid arrangement is widely conserved within the Bacteria domain and confers strong protection against physical and chemical insults. The OM is physically separated from the inner membrane and the cytoplasm, where most cellular resources are located; therefore, the cell faces unique challenges in the assembly and maintenance of this asymmetric bilayer. Here, we present a framework for how gram-negative bacteria initially establish and continuously maintain OM lipid asymmetry, discussing the state-of-the-art knowledge of specialized lipid transport machines that place LPS and PLs directly into their corresponding leaflets in the OM, prevent excess PL accumulation and mislocalization, and correct any lipid asymmetry defects. We critically assess current studies, or the lack thereof, and highlight important future directions for research on OM lipid transport, homeostasis, and asymmetry. [ABSTRACT FROM AUTHOR]

Copyright of Drama Therapy Review is the property of Intellect Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Latar belakang. Asma merupakan penyakit saluran napas akibat adanya peradangan kronis pada saluran napas yang sering terjadi pada anak-anak dengan prevalensi mencapai 20%. Steroid merupakan anti-inflamasi yang dinilai paling efektif dalam terapi penyakit peradangan kronis seperti asma. Akan tetapi, penelitian sebelumnya mengungkapkan bahwa steroid memiliki potensi menyebabkan penurunan kepadatan massa tulang atau osteoporosis. Tujuan. Penelitian ini bertujuan untuk menganalisis hubungan pemakaian steroid inhalasi dengan osteoporosis pada pasien asma anak. Metode. Studi observasional analitik ini menggunakan desain penelitian cross-sectional terhadap 13 pasien asma anak yang berobat di Rumah Sakit Umum Daerah Dr. Saiful Anwar, Malang, yang didapat melalui purposive sampling. Pasien asma anak yang memenuhi kriteria inklusi dalam rentang usia 5-18 tahun serta telah menjalani pengobatan steroid inhalasi minimal 3 bulan dilakukan pemeriksaan bone mass density (BMD) melalui alat dual energy x-ray absorptiometry (DXA) kemudian dicatat hasil z-score. Analisis data menggunakan metode korelasi Rank Spearman untuk variabel bebas, yaitu dosis steroid inhalasi dan durasi pemakaian steroid inhalasi dengan variabel terikat yaitu nilai z-score BMD. Hasil. penelitian ini didapatkan hubungan signifikan berkorelasi negatif kuat antara dosis steroid inhalasi kumulatif dengan nilai z-score BMD (p=0.000, r=-0.827) dan hubungan signifikan berkorelasi negatif sedang antara durasi pemakaian steroid inhalasi dengan nilai z-score BMD (p=0.043, r=-0.568). Kesimpulan. Penelitian ini menunjukkan bahwa pemakaian steroid inhalasi menyebabkan penurunan kepadatan massa tulang dan berisiko menyebabkan osteoporosis.

Introduction: Patients with sickle cell disease exhibit different patterns in pulmonary function tests. In particular, there is little evidence on the fractional exhaled nitric oxide (FeNO) test, and its value ranges and its interpretation in these patients have been under debate in recent years. Methods: We conduced a cross-sectional, observational and descriptive study between November 2021 and January 2023 including patients aged 6–18 years with sickle cell disease able to perform the FeNO test. We applied the GLI-2012 reference values and the ERS/ATS standards. We defined statistical significance as P < 0.05. Results: The sample included 43 patients with a median age of 12 years (IQR, 10−15). We did not find an association between significantly elevated FeNO (≥25 ppb) and the diagnosis of asthma (P = 0.37), an obstructive pattern in spirometry (P = 0.67), a positive bronchodilator test (P = 0.53), clinical bronchial hyperreactivity in the context of cold or flu-like symptoms (P = 0.48), cough with exercise (P = 0.42) or nocturnal cough (P = 1.0), but found an association with peripheral eosinophilia (P < 0.01). Conclusions: We found no association between FeNO values and the classic features of asthma (clinical or spirometric) in patients with sickle cell disease. Therefore, airway inflammation mechanisms are probably different in these patients. Resumen: Introducción: Los pacientes con enfermedad de células falciformes presentan diferentes patrones en el estudio de función pulmonar. En concreto, el FeNO ha sido poco estudiado y sus valores e interpretación en estos pacientes han sido objeto de debate en los últimos años. Material y métodos: Estudio observacional, descriptivo y de corte transversal realizado entre noviembre de 2021 y enero de 2023 que incluye a pacientes de 6 a 18 años con enfermedad de células falciforme capaces de realizar el examen de FeNO. Se utilizaron valores de referencia GLI-2012 y estándares de ERS/ATS. Significación p

Introduction: Asthma is a common chronic disease in the paediatric age group that requires close follow-up. Clinical practice guidelines offer evidence-based recommendations to achieve adequate control of the disease. Objective: To assess the management of childhood asthma in the primary care setting in the Community of Madrid, and the adherence of health care professionals to guideline recommendations. To analyse the association of asthma management with age, the socioeconomic level of the catchment population and the workload of primary care centres. Methods: retrospective longitudinal study in patients aged 6–14 years newly diagnosed with asthma in primary care centres of the Community of Madrid in 2021. We analysed sociodemographic and clinical variables and the compliance with recommendations at the time of diagnosis and over 1 year of follow-up. The source of data was the electronic health record database of the primary care system. Results: We found a proportion of compliance with the recommendations upon diagnosis of the disease of 5.84%, with differences associated to the socioeconomic level of the catchment population (P = .033), and the pressure of care (P = .006). The proportion of compliance with recommendations during follow-up was 12.73%, with differences based on age (P = .01), socioeconomic level (P = 0.006) and centre workloads (P = .002). Conclusions: Compliance with the recommendations of the main childhood asthma management guidelines in the primary care setting was low in the Community of Madrid. Strategies need to be implemented to improve the management of this disease and the adherence of professionals to the protocols developed for this purpose. Resumen: Introducción: El asma es una enfermedad crónica frecuente en la edad pediátrica y precisa un seguimiento estrecho. Para lograr un buen control de la enfermedad las Guías de Práctica Clínica ofrecen recomendaciones basadas en la evidencia científica. Objetivo: Valorar el manejo del asma que se realiza en Atención Primaria de la Comunidad de Madrid, y la adecuación a las recomendaciones de las guías por parte de los profesionales sanitarios. Analizar la relación del manejo con la edad, el nivel socioeconómico de la población y la presión asistencial de los centros de salud. Métodos: Estudio longitudinal retrospectivo en pacientes de 6 a 14 años con un nuevo diagnóstico de asma durante el año 2021 en los centros de salud de la Comunidad de Madrid. Se analizaron variables sociodemográficas, clínicas y el cumplimiento de las recomendaciones al diagnóstico y durante un año de seguimiento. La fuente de información fue la Historia Clínica Electrónica para Atención Primaria. Resultados: El cumplimiento de las recomendaciones al diagnóstico de la enfermedad fue del 5,84%, con diferencias según el nivel socioeconómico (p = 0,033) y la presión asistencial (p = 0,006). El cumplimiento de las recomendaciones durante el seguimiento fue del 12,73%, con diferencias según la edad (p = 0,01), nivel socioeconómico (p = 0,006) y la presión asistencial (p = 0,002). Conclusiones: El cumplimiento registrado de las recomendaciones sobre el manejo del asma en Atención Primaria de la Comunidad de Madrid es bajo. Es necesario fomentar estrategias para mejorar el manejo de esta enfermedad y, la adhesión de los profesionales a los programas diseñados para ello.

Dedifferentiated liposarcoma (DDLPS) is a non-lipogenic sarcoma, generally arising from well-differentiated liposarcoma (WDLPS), although it can develop de novo. DDLPS tumors rarely trans-differentiate into non-adipose mesenchymal tissues; however, the latter lack notable variety and mostly show striated muscle or osteogenic/chondrogenic differentiation. Here, we report a case of DDLPS that contained numerous atypical vessels. A man in his sixties presented with a large tumor in his right thigh, and the tumor was surgically resected. Microscopically, most of the tumor was WDLPS, but a minor portion showed DDLPS, consisting of high-grade spindle cells. Remarkably, the DDLPS contained vessels of various sizes with atypical cytoarchitecture, including vessels with seemingly muscular layers. Immunohistochemically, the atypical cells within the vascular wall expressed aSMA, consistent with smooth muscle cells or pericytes, whereas surrounding high-grade spindle cells only focally expressed it, and these aSMA-positive cells within the vessels exhibited MDM2 amplification by immuno-fluorescence in situ hybridization. Our results demonstrate that DDLPS can trans-differentiate into smooth muscle cells of various-sized accompanying vessels, which may support their survival and proliferation. [ABSTRACT FROM AUTHOR]

Objective: To describe the scientific production, through bibliometric analysis, about asthma in Latin America. Methods: Observational, descriptive, retrospective and cross-sectional study, with a quantitative bibliometric approach, to evaluate the scientific production of asthma in Latin America, using the Scopus and SciELO platforms to recover files published between 2003 and 2022. Results: A totoal of 3041 documents were obtained in Scopus and 592 in SciELO. In both repositories, the original articles (2379 and 478) and the reviews (379 and 43) were the most published documents. The largest producer was Brasil: n = 1538 in Scopus, and n = 406 in SciELO, and the journal with the highest number of publications was Jornal Brasileiro de Pneumologia with 169 articles in Scopus and 164 articles in SciELO. Conclusion: The bibliometric analysis shows the panorama of the last 20 years in research on asthma in Latin America, where scientific production has progressively increased, mainly in Brazil, Mexico and Chile. [ABSTRACT FROM AUTHOR]

Copyright of Medicina (Buenos Aires) is the property of Medicina (Buenos Aires) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista de la Facultad de Medicina Humana is the property of Instituto de Investigaciones en Ciencias Biomedicas de la Universidad Ricardo Palma and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Improper inhalation technique (IT) is associated with uncontrolled asthma. Continuous training improves IT. The objective was to evaluate IT of patients who had incorrectly demonstrated IT in a previous study (E1), carrying out a new cross-sectional study (E2) with patients who had incorrect IT in E1, carried out 30 months earlier, in the same place, where IT is oriented in every medical appointment. Questionnaire filled out with sociodemographic data, assessment of control using the Asthma Control Test, type of inhalation device (ID) in use, time of use and existence of medical instructions for use. IT was considered correct when all stages of use were carried out properly, according to the medication leaflets. 31 (72.1%) patients from E1 were included. Seventeen (54.8%) used dry powder inhalers (DPI) and 14 (45.2%) metered dose inhlaers (MDI). Fifteen (48.4%) had controlled asthma. All received guidance on how to use their IDs and 21 (67.7%) had been using them for at least 2 years. Twenty-one (67.7%) presented the IT incorrectly. Eight of 17 (47.1%) DPI users and 2 (14.3%) MDI users had the correct IT (p=0.049). IT training gradually improves its quality, but this process is slow. About two-thirds of the sample remained with the wrong IT, especially among AD users. [ABSTRACT FROM AUTHOR]

Asthma is a chronic inflammatory disorder of the airways that manifests as wheezing, shortness of breath, chest tightness, and coughing. Among the evaluation tools there is a new method, namely Impulse Oscillometry or IOS. It is a simple and non-invasive technique, based on the measurement of sound waves reflected by the resistance of the airways. The IOS machine produces and transmits small pulses of pressure along the tracheobronchial tree and records changes in pressure and flow to the mouth. A prospective study was conducted on 55 asthmatic patients assessed by IOS at time 0 and 3 months after initiation of inhaled corticosteroid (ICS) or ICS/LABA therapy, which demonstrated the value of IOS as a method of evaluation of the clinical response of the treatment implemented in the asthmatic patient. [ABSTRACT FROM AUTHOR]

This study aims to develop and validate a composite index, based on the integration of biomarkers, lung function parameters and clinical scores, for more accurate and informative risk stratification in patients with asthma. Through advanced multivariate analyses, the parameters most predictive of loss of control will be identified. An AI-based diagnostic algorithm will integrate these variables to construct the composite index, which will be prospectively validated in an independent cohort of patients. The objective is to evaluate the clinical applicability of the index, the impact on therapeutic management and outcomes of patients with asthma, to support clinicians in precision medicine for this complex disease. [ABSTRACT FROM AUTHOR]

Artificial intelligence algorithms are increasingly finding their way into the diagnosis, early treatment, prevention and monitoring of chronic respiratory diseases. Diagnosis of asthma often requires the use of various instrumental and laboratory investigations for better framing and phenotyping, including analysis of the fraction of exhaled nitric oxide (FeNO) for profiling eosinophilic inflammation and the forced oscillation technique (FOT), which plays a role not codified by guidelines. This project aims to develop a new predictive model for the early diagnosis of asthma by modelling data from the analysis of FeNO and FOT combined with clinical, laboratory and spirometric data using machine learning algorithms [ABSTRACT FROM AUTHOR]

Copyright of Biomédica: Revista del Instituto Nacional de Salud is the property of Instituto Nacional de Salud of Colombia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

INTRODUÇÃO: A síndrome de Hamman é uma condição que afeta 1 a cada 25.000 pessoas, entre 5 e 34 anos de idade, sendo a maioria do sexo masculino (70%) e do biotipo longilíneo. Suas repercussões clínicas podem comprometer a qualidade de vida do paciente, sendo necessários seu conhecimento e adoção de medidas de prevenção. OBJETIVO: Descrever relato de caso sobre síndrome de Hamman e sua correlação com a asma, assim como a importância da adesão terapêutica e do conhecimento entre os profissionais de saúde. RELATO DE CASO: Pré-escolar, masculino, branco, com IMC de 20,5 kg/m2, foi admitido no serviço com crise asmática há 5 dias, associada a dor torácica e piora da tosse há 1 dia, evoluindo com enfisema subcutâneo. Apresentava-se eupneico, afebril, sem esforço respiratório, com murmúrio vesicular reduzido e estertores subcrepitantes em base posterior esquerda de hemitórax direito, enfisema subcutâneo que, inicialmente, envolvia a circunferência torácica, e, posteriormente, expandiu para a região cervical anterior e supraclavicular, bilateralmente. Estava em uso irregular da medicação para a asma. A tomografia de tórax evidenciou extenso enfisema subcutâneo, pneumomediastino e pneumorraque. Pela suspeita de síndrome de Hamman, orientou-se conduta expectante e observação em leito de enfermaria. Paciente recebeu alta hospitalar após melhora clínica, e foi encaminhado para seguimento no ambulatório de pneumologia pediátrica do serviço. CONCLUSÃO: Disseminar o conhecimento sobre esta rara afecção entre profissionais de saúde poderá permitir o manejo adequado do paciente, assim como evitar recidivas e desfechos clínicos desfavoráveis.

Resumen: El asma bronquial una de las patologías crónicas más frecuentes en el embarazo, afectando entre el 6 al 10% de la población de mujeres en gestación según reportes internacionales. De este grupo de pacientes, aproximadamente un tercio presentará un deterioro importante de los síntomas, exponiendo a la madre y el feto a un alto riesgo de exacerbaciones y uso de corticoides sistémicos. El mal control de los síntomas del asma se debe en muchos casos a dosis subóptimas, e incluso suspensión de la terapia con corticosteroide inhalado, que constituye la base de la terapia antiinflamatoria y controladora en el asma. Está demostrado que el asma mal controlada en el embarazo aumenta el riesgo de complicaciones obstétricas. El manejo respiratorio de estas pacientes debe ser proactivo, basado en la educación y el uso informado de los tratamientos antiasmáticos, altamente efectivos y de fácil acceso para la mayoría de las pacientes. En este artículo se revisará la fisiopatología, el diagnóstico y manejo farmacológico del asma en el embarazo. Abstract: Bronchial asthma is considered one of the most common chronic pathologies in pregnancy, affecting between 6 to 10% of pregnant women according to international reports. In this group of patients, approximately one third will present a significant aggravation in asthma symptoms, exposing the mother and fetus to a high risk of exacerbations and use of systemic corticosteroids. Poor control of asthma symptoms is in many cases due to suspension or suboptimal therapy with inhaled corticosteroid, which constitutes the basis of anti-inflammatory and controller therapy in asthma. It has been shown that poorly controlled asthma during pregnancy increases the risk of obstetric complications. The respiratory management of these patients must be proactive, patient education based and with informed use of anti-asthmatic treatments, which are highly effective and, for most patients, easily accessible. This article will review the pathophysiology, diagnosis and pharmacological management of asthma in pregnancy.

Introducción. El asma es una enfermedad crónica que afecta a millones de personas en todo el mundo. La calidad del aire es uno de los factores clave que puede desencadenar los síntomas del asma. Objetivo. Analizar la calidad del aire y su relación con el asma en habitantes de grandes altitudes en La Paz (Bolivia). Materiales y métodos. Se desarrolló un estudio analítico, descriptivo y retrospectivo. Se recolectaron datos de pacientes con diagnóstico de asma en el Instituto Nacional del Tórax y en el Instituto Boliviano de Biología de Altura. Además, se monitoreó la calidad del aire y su material particulado en las estaciones de la “Red de monitoreo de la calidad del aire”. Resultados. El 56,9 % de los casos fueron mujeres del Instituto Nacional del Tórax y el 45,7 % del Instituto Boliviano de Biología de Altura. En ambas instituciones, la media de edad fue de 47 años y los pacientes presentaban sobrepeso u obesidad. Se registraron incrementos de material particulado fino (PM2,5) en otoño, invierno y primavera, en 2014, 2016-2019 y en las cuatro estaciones del 2015. El material particulado inhalable grueso (PM10) se incrementó en otoño e invierno del 2014 al 2020, dentro de los límites establecidos. Se observó una asociación positiva y significativa entre la concentración de material particulado PM2,5 y los parámetros espirométricos de capacidad vital forzada, flujo espiratorio máximo y el porcentaje de reversión. La relación de partículas PM10 y los parámetros espirométricos de capacidad vital forzada, volumen espiratorio máximo en el primer segundo y flujo espiratorio máximo, también fue estadísticamente significativa. Conclusión. Los casos de asma se presentaron en promedio a los 47 años y en personas con sobrepeso u obesidad. Se observó una asociación positiva entre el material particulado, PM2,5 y PM10, con los parámetros espirométricos, la cual fue más marcada con las partículas PM2,5.

Copyright of Revista Médica Clínica Las Condes is the property of Editorial Sanchez y Barcelo and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Ciência & Saúde Coletiva is the property of Associacao Brasileira de Pos-Graduacao em Saude Coletiva and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Argentinian Journal of Respiratory & Physical Therapy (AJRPT) is the property of Asociacion Civil Cientifica de Difusion y Promocion de la Kinesiologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: Report the prevalence and severity of the most common allergic diseases in children living in Monterrey, México. Methods: Cross-sectional multi-center survey on the most common allergic diseases, completed by parents of 6-7-year-old children and by 13-14- year-old adolescents in the Monterrey metropolitan area, between January 2018 and December 2019. Results: A total of 3,044 questionnaires were eligible for the analysis. Among children between 6-7 years old, 30.2% (n = 143/473) presented wheezing at any time in their life; with a higher prevalence in the male population. In the adolescent group, 26.4% reported having experienced wheezing at some point in their life, with a slight predominance in the female group (54.9%). Conclusions: Knowing the prevalence of allergic diseases in our population gives us tools to generate strategies that allow us to provide the best quality healthcare to our patients. [ABSTRACT FROM AUTHOR]

Copyright of Roca: Revista Científico-Educacional de la Provincia de Granma is the property of Universidad de Granma, Departamento Editorial and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Pediatría de Atención Primaria is the property of LUA Ediciones 3.0 S.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Summa, Animali da Compagnia is the property of Point Veterinaire Italie s.r.l. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Airways are covered by a thin layer of fluid known as airway lining fluid (ALF), which is made up of a complex mixture of proteins, peptides, lipids, electrolytes, and water. Exhaled breath condensate (EBC) represents an extremely valid biological matrix for the study of ALF. EBC is obtained by oral breathing through a mouthpiece equipped with a saliva trap and a one-way valve that diverts the flow of air through a tube into a cooling chamber. The exhaled air saturated with water vapor and the aerosolized ALF particles condense on the surface of the chamber so that the condensed liquid can be collected. EBC includes over 2,000 compounds and several biomarkers indicated for the evaluation of airway inflammation, screening and early diagnosis, evaluation of environmental and professional exposure, pharmacological monitoring, exercise physiology. [ABSTRACT FROM AUTHOR]

The Asian Summer Monsoon (ASM) exhibit different modes of variability in which the active and break phases is one of the most prominent intraseasonal scale variability of the ASM. The shift in convective centres to more polluted regions coupled with the associated circulation features during these phases results in a redistribution of trace species in the upper troposphere and lower stratosphere (UTLS) region. Apropos to this, this study presents a quantitative assessment of the variability in the spatial distribution of ozone, carbon monoxide (CO) and water vapour (H2O) in the UTLS during the active and break phase of ASM with respect to the seasonal mean background using fifteen years (2005–2019) of Aura-MLS observations in conjunction with reanalysis data sets, cloud-top brightness temperatures and trajectory analysis. These 15-years of data is used to make composite maps of tracer anomalies to investigate the varying influence of monsoon convection, transport and ASMA dynamics in the UTLS region during the active/break phase. This study shows that, while the distribution of trace species during both phases is determined by the combined role of convection and transport in the upper troposphere, changes in ASMA modes, transport and tropopause dynamics during the active/break phases controls the spatial pattern of both tropospheric and stratospheric species near the tropopause level. [ABSTRACT FROM AUTHOR]

Copyright of Revista ADM is the property of Asociacion Dental Mexicana and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objetivo: Comparar las reconsultas al servicio de urgencias (SU) por asma durante la semana posterior al alta y explorar los factores asociados antes y después de la implementación de un protocolo asistencial. Materiales y métodos: Se realizó un estudio de cohorte retrospectivo que incluyó las consultas por crisis asmática de adultos al SU de un hospital universitario en los períodos 2016-2018 (preprotocolo) y 2019-2020 (posprotocolo). Se utilizó un modelo de regresión logística multivariado y se reportaron odds ratios (OR) e intervalos de confianza al 95 % (IC95%). Se consideró significativo un valor p < 0,05. Resultados: Las reconsultas fueron 38 (31,40 %) para el período preprotocolo y 33 (26,61 %) para el período posprotocolo. En el modelo de regresión multivariable, no se encontraron diferencias en las reconsultas tempranas al comparar el período posprotocolo con el período preprotocolo (OR 0,68; IC95% 0,26-1,74; p=0,421). Los factores asociados a las reconsultas tempranas fueron la edad (OR: 1,02; IC95%:1,00-1,04; p=0,017), el sexo masculino (OR 0,21 IC95%: 0,08-0,59; p=0,003), y el haber tenido más de una consulta al SU en el último año (OR 6,19 IC95%: 2,48-15,46; p

Asthma, the most prevalent chronic disease in pediatric age, continues to pose challenges in its management and treatment. National and international guidelines emphasize the importance of therapeutic education (TE) to achieve disease control. TE involves imparting knowledge and skills to the patient and their family, enhancing medication adherence, rectifying errors in inhalation technique, and tailoring treatment based on individual patient characteristics.It is essential for TE to be progressive, gradual, and personalized, spanning all levels of care. Training healthcare professionals in TE is crucial, particularly for pediatricians, who must also be aware of the extensive variability of available meds and inhalers and their respective age-specific indications.Addressing this need, the REGAP Group extensively reviewed inhalers currently available in Spain for pediatric asthma treatment. The review encompassed different inhalation systems and inhaled drugs used for pediatric asthma treatment. This review will be updated annually, providing information on medications, devices, inhalation chambers, indications, and financiation. The REGAP Group hopes that these tables will be a valuable help for pediatricians in their daily clinical practice and serve as an effective TE tool. Resumen: El asma, la enfermedad crónica más prevalente en la edad pediátrica, continúa planteando desafíos en su manejo y tratamiento.1 Guías nacionales e internacionales destacan la importancia de la educación terapéutica (ET) para lograr el control de esta enfermedad.2,3 Esta educación implica la transmisión de conocimientos y habilidades al paciente y su familia, mejorando la adherencia a la medicación, corrigiendo errores en la técnica de inhalación y ajustando el tratamiento según las características individuales de cada paciente.4,5Es esencial que la ET sea progresiva, gradual e individualizada, y que esté presente en todos los niveles asistenciales. La formación en ET de profesionales sanitarios es crucial, especialmente para los pediatras, quienes además deben conocer la extensa variabilidad de medicamentos e inhaladores disponibles y sus indicaciones para cada edad.6Para abordar esta necesidad, el Grupo REGAP ha revisado exhaustivamente los inhaladores actualmente disponibles en España para el tratamiento del asma en la edad pediátrica. La revisión incluye una revisión de los distintos sistemas de inhalación y los distintos fármacos inhalados, utilizados para el tratamiento del asma en la edad pediátrica. Esta revisión se actualizará anualmente, incluyendo información sobre fármacos, dispositivos, cámaras de inhalación, indicaciones y financiación. El Grupo REGAP espera que estas tablas sean una valiosa ayuda para los pediatras en su práctica clínica diaria y constituyen una eficaz herramienta de ET.

“Wandering prevention: Pneumology on the road” born as a free pneumological screening project to “reach” the most disadvantaged population in our mountain area of Aosta Valley. It consists of the organization of 12 “Pneumological Days”, one for each of the reference villages of the 12 collateral Valleys, in which the population will be allowed to perform simple spirometry, thoracic ultrasound and assessment of oxygen saturation. The objective is the early diagnosis of asthma/ COPD and the referral of patients with spirometric or ultrasound anomalies to the Pneumology Center of Aosta. The project would, then, include home spirometric monitoring for patients selected based on severity and distance from the Hospital. [ABSTRACT FROM AUTHOR]

Patients with severe asthma often do not respond to inhalation therapy and have inadequate symptoms control that negatively affects their social and professional life. The development of new “biological” drugs has revolutionized the treatment of this subgroup of patients, providing better symptom control, reducing the number of exacerbations and allowing for greater disease control. However, improvement in clinical/functional parameters does not necessarily translate into an improvement in quality of life. This study aims to assess the impact of biological drugs on patient quality of life and patient reported outcomes by evaluating changes in the Asthma Quality of Life Questionnaire and SF-36 scores. [ABSTRACT FROM AUTHOR]

La exposición a alergenos inhalantes se asocia con sensibilización alergeno especifica, factor de riesgo para el desarrollo de asma bronquial, junto con factores genéticos y del medio ambiente. La exposición temprana en la vida a los ácaros aumenta el riesgo de sensibilización y desarrollo de asma en niños de alto riesgo. Lo mismo ocurriría con los niveles de alergeno de gato dentro de la casa y aumento del riesgo de sensibilización en el preescolar y escolar. Por otra parte, el contacto precoz con múltiples microorganismos contribuye a una inmunomodulación preventiva induciendo tolerancia a los alergenos. Se ha demostrado que el cambio climático aumenta la potencia de los pólenes alergénicos y la severidad de la exposición a hongos, lo cual podría explicar en parte el incremento de las enfermedades alérgicas en los últimos años. Existe mucha evidencia respecto a la exposición a alergenos en niños asmáticos sensibilizados y la exacerbación del asma. Es fundamental conocer a qué alergenos está sensibilizado el paciente para implementar medidas de evitación ambiental. En este artículo se resume una actualización sobre los mecanismos de sensibilización a alergenos inhalantes de niños asmáticos y su relación con el cambio climático y la severidad del asma. También se exponen las principales medidas de prevención, control ambiental y el papel de la inmunoterapia.

Introducción. Las enfermedades crónicas no transmisibles representan la principal causa de muerte en el mundo y su prevalencia va en aumento debido a la transición epidemiológica. A pesar de los avances en su manejo, las cifras de control son deficientes y esto se atribuye a múltiples factores, como el cumplimiento del tratamiento farmacológico, que es uno de los más representativos y menos estudiados en la población colombiana. Objetivo. Establecer la frecuencia de casos que cumplieron con el tratamiento farmacológico en pacientes colombianos con hipertensión arterial, enfermedad cerebrovascular, diabetes mellitus, asma, enfermedad pulmonar obstructiva crónica y dislipidemia, entre el 2005 y el 2022. Materiales y métodos. Se llevó a cabo una revisión sistemática de la literatura y un metaanálisis de los estudios identificados mediante las bases de datos Medline y LILACS para sintetizar cuantitativamente el porcentaje de cumplimiento del tratamiento. Resultados. Catorce estudios cumplieron los criterios de inclusión y se analizaron 5.658 pacientes. El cumplimiento del tratamiento fue del 59 %, con una heterogeneidad alta entre los estudios incluidos (IC95 % = 46-71 %; I2 = 98,8 %, p

Copyright of Anadolu Tarım Bilimleri Dergisi is the property of Ondokuz Mayis Universitesi, Ziraat Fakultesi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Anadolu (1300-0225) is the property of Anadolu Dergisi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: Determine the annual economic burden of the disease from an institutional perspective and based on GINA's recommended classification in a retrospective cohort of adults treated at Instituto Nacional de Enfermedades Respiratorias (INER) of Mexico City. Methods: A retrospective, longitudinal observational study comprised by data from 247 female asthma patients, annual direct costs were estimated including: visits, laboratory tests, pharmacological treatment and management of crisis or exacerbations, to determine the annual burden of the disease from an institutional perspective and according to Global Initiative for Asthma classification. Results: The average annual cost was $43,813.92, which increased in relation to the need of inhaled corticosteroids and long-acting beta agonists dosage increase. The average doctor's appointment cost was $2,004.57, $982.82 for crisis management and $2,645.95 for laboratory testing. Pharmacological treatment represented the main economic burden with an annual average cost of $38,180.58. Conclusions: The results highlight an economic burden of asthma estimated at an annual cost per patient of $43,813.92 MXN (SD=93,348.85) in the context of the third level of care in the Mexican public health system. The asthma severity and treatments such as biologics were the main factors that increased direct costs of care. [ABSTRACT FROM AUTHOR]

Objective: To revise the impact of telehealth on the quality of life, reduction in pulmonary exacerbations, number of days using antibiotics, adherence to treatment, pulmonary function, emergency visits, hospitalizations, and the nutritional status of individuals with asthma and cystic fibrosis. Data source: Four databases were used, MEDLINE, LILACS, Web of Science and Cochrane, as well as manual searches in English, Portuguese and Spanish. Randomized clinical trials, published between January 2010 and December 2020, with participants aged 0 to 20 years, were included. Data synthesis: Seventy-one records were identified after the removal of duplicates; however, twelve trials were eligible for synthesis. Included trials utilized: mobile phone applications (n=5), web platforms (n= 4), mobile telemedicine unit (n=1), software with an electronic record (n=1), remote spirometer (n=1), and active video games platform (n=1). Three trials used two tools, including telephone calls. Among the different types of interventions, improvement in adherence, quality of life, and physiologic variables were observed for mobile application interventions and game platforms compared to usual care. Visits to the emergency department, unscheduled medical appointments, and hospitalizations were not reduced. There was considerable heterogeneity among studies. Conclusions: The findings suggest that better control of symptoms, quality of life, and adherence to treatment can be attributed to the technological interventions used. Nevertheless, further research is needed to compare telehealth with face-to-face care and to indicate the most effective tools in the routine care of children with chronic lung diseases. [ABSTRACT FROM AUTHOR]

Copyright of COMU Journal of Agriculture Faculty / ÇOMÜ Ziraat Fakültesi Dergisi is the property of Canakkale Onsekiz Mart University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Erzincan University Journal of Science & Technology is the property of Erzincan Binali Yildirim Universitesi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Biomédica: Revista del Instituto Nacional de Salud is the property of Instituto Nacional de Salud of Colombia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The small airways (SA), i.e., branches of the tracheo-bronchial tree with a diameter of less than 2 millimetres, not only conduct airflow but also represent an important determinant of lung mechanics. Their involvement in broncho-obstructive diseases, such as asthma and COPD, correlates closely with worsening of the underlying disease. However, there is still no gold standard for functionally defining the presence of SA obstruction. The most widely used parameters in the clinical practice are based on the use of spirometry or the Impulse Oscillometry System, which provide non-concordant and complementary information on the function of SA. Further studies are required to define the standard criteria for SA obstruction. [ABSTRACT FROM AUTHOR]

The transition of adolescents with asthma is a complex pathway, which must meet the educational and psychosocial needs that characterize this delicate phase of life, to enable the adolescent to acquire the ability to self-manage the disease. Therefore, the transition process must consider the clinical characteristics of the adolescent with asthma to identify possible risk factors for the persistence of asthma and possible evolution into chronic obstructive pulmonary disease in adulthood, and also comorbidities and factors that may lead to failure to control symptoms, such as obesity, functional breathing disorders, psychiatric issues, vaping, smoking, and the social context. In fact, adolescence is characterized by the desire to become progressively independent from the family; while this can be a limitation in adherence to therapy and self-management of the disease, it can however be an opportunity for healthcare providers to support adolescents to develop the knowledge, skills, and confidence needed to manage the disease and cope with the changes typical of the age. Therefore, a multidisciplinary, person-centered approach would be desirable to address important psychological, cultural, and social aspects typical of this age. Recently published guidelines from the European Academy of Allergy and Clinical Immunology provide evidence-based recommendations to guide the transition process, which needs to be adapted in the Italian national and regional context. This review aims to discuss the peculiarities of the management of the asthmatic adolescent and the transition process in close collaboration with adult services, to share priorities and goals in terms of care. [ABSTRACT FROM AUTHOR]

Background: Exclusive mother's milk (ASI) is needed to meet optimal nutrition for babies during the first 6 months of life, only breast milk. There are various kinds of allergic diseases such as asthma, eczema, and allergic rhinitis which can arise if there are triggers. Until now there are still not many studies regarding the relationship of exclusive breastfeeding with the incidence of allergic diseases that have been examined using the ISAAC questionnaire. To strengthen previous research, research will be carried out which is expected to provide an overview of the prevalence of decreased incidence of allergies with risk factors for consuming exclusive breastfeeding at the age of 0-6 months in students aged 13-14 years at SMPN 3 Surakarta by filling out the ISAAC questionnaire. The purpose of this study was to determine whether exclusive breastfeeding can reduce the incidence of disease and determine the prevalence of allergic disease in SMPN 3 Surakarta. Method: This type of research uses quantitative research. Survey research with a cross sectional approach design. The location of the research to be carried out is students aged 13-14 years at SMPN 3 Surakarta in March 2023. The sampling technique in this study was total sampling. Obtained the optimal number of samples at least 71 respondents. All data were obtained using the ISAAC questionnaire and processed using chi-square data analysis using the SPSS ver 23 tool. Result: Based on the results of the chi-square test, this study showed that there was a significant relationship between exclusive breastfeeding consumption and a decrease in the incidence of allergic diseases. Conclusion: there is a relationship between exclusive breastfeeding with a decrease in the incidence of allergic diseases in SMPN 3 Surakarta students. [ABSTRACT FROM AUTHOR]

Introducción: la parasitosis zoonótica causada por Toxocara canis ha sido sugerida como posible agente etiológico del asma. Objetivo: evaluar la asociación entre la infección por Toxocara canis y el asma en niños del Hospital Nacional Cayetano Heredia (HNCH), Lima, Perú. Asimismo evaluar los factores asociados a la infección por T. canis en la población de estudio. Material y métodos: estudio caso-control, que incluyó a 75 niños asmáticos y 75 niños no asmáticos, de 2 a 13 años, atendidos en el HNCH en el año 2002. Se aplicó un cuestionario para evaluar los factores asociados a toxocariosis y a asma respectivamente. La seroprevalencia de T. canis fue determinada mediante la prueba ELISA IgG para T. canis. Resultados: la seroprevalencia de toxocariosis fue de 16%, no se encontró una asociación significativa entre la seropositividad para Toxocara canis y el asma. Sin embargo se observó una relación estadísticamente significativa entre una mayor frecuencia de crisis de sibilancia nocturna y una serología positiva para Toxocara canis. Los factores asociados a la toxocariosis fueron el contacto intenso con perros, particularmente con cachorros y una ausencia de grado de instrucción universitario de los padres. Los factores asociados al asma fueron: el poco contacto con perros y el grado de instrucción universitario de los padres. Conclusiones: no hubo asociación entre la presencia de serología positiva para T. canis y asma, pero sí con una mayor frecuencia de sibilancia nocturna. Son necesarios estudios posteriores que evalúen esta última observación.

Introdução: A asma é uma doença respiratória crônica que tem chamado a atenção pelo número de casos no Brasil e no mundo. Diferentes tecnologias para asma têm sido submetidos a Comissão Nacional de Incorporação de Tecnologias (Conitec) para incorporação no Sistema Único de Saúde do Brasil. Objetivo: Este artigo tem como objetivo analisar os relatórios de recomendação sobre tecnologias para tratamento de asma disponibilizados pela Conitec no período de fevereiro de 2012 a maio de 2021 para classificar os principais critérios de análise como ponto forte ou fraco para cada tecnologia. Métodos: Uma busca por relatórios de recomendação sobre tecnologias para tratamento de asma submetidos para incorporação no período descrito acima foi performada na base de dados da Conitec. A partir disso, uma estrutura de análise de decisão multicritério (MCDA) foi estabelecida para classificar cada critérios como ponto forte ou fraco. Resultados: Foram encontrados nove relatórios de recomendação sobre asma representando a submissão de dez tecnologias, formando um conjunto de alternativas: omalizumabe (três submissões: 2013; 2016; 2019), fluticasona (duas submissões: 2013; 2015); budesonida+formoterol (duas submissões: 2015; 2021), tiotrópio, ben- ralizumabe, mepolizumabe (2021). Além disso, o seguinte conjunto de critérios foi estabelecido: eficácia; segurança; avaliação econômica; e impacto orçamentário. Tiotrópio e benralizumabe obtiveram todos os critérios classificados como ponto forte. Fluticasona (2013) obteve todos os critérios classificados como ponto fraco. Conclusão: Foi possível classificar os quatro critérios como ponto forte ou fraco para cada tecnologia submetida à Conitec. A análise proposta pode ser facilmente aprimorada para apoiar o processo de tomada de decisão a partir de diferentes características.

Objetivo: Identificar y registrar las esporas de hongos más importantes captadas en nuestra estación de aerobiología, además reportar la prevalencia de sensibilización cutánea a estos alérgenos. Métodos: La identificación y los conteos de esporas de hongos se realizaron según la técnica estandarizada con un equipo colector Burkard Spore Trap For Seven Days, siguiendo las recomendaciones de la National Allergy Bureau (NAB), de la American Academy Allergy Asthma and Immunology (AAAAI). El equipo se instaló a 20 m de altura desde el nivel del suelo, en la azotea de la Clínica SANNA El Golf, distrito de San Isidro, (12°5'54"S 77°3'6"O), en la zona sur-oeste del área urbana de Lima. El periodo de captación se llevó a cabo entre septiembre de 2020 y octubre de 2021. Se realizaron estudios de pruebas cutáneas (skin prick-test), según recomendaciones de la Sociedad Española de Alergología e Inmunología Clínica (SEAIC), en 200 pacientes (entre 18 y 60 años), con sintomatología de rinoconjuntivitis y/o asma. Fueron evaluados en el servicio de Alergología de la Clínica SANNA El Golf. Se aplicaron extractos alergénicos de ácaros del polvo (Dermatophagoides pteronyssinus, Dermatophagoides farinae, Blomia tropicalis), epitelios de gato y perro, Periplaneta americana, mezclas de seis gramíneas, mezclas de malezas, hongos ambientales (Cladosporium herbarum, Alternaria alternata, Aspergillus fumigatus, Penicillium notatum, Nigrospora spp.), extractos del laboratorio INMUNOTEK-España. Además, testeamos otros alérgenos fúngicos de Fusarium spp, Stemphylium spp, Curvularia spp, una mezcla de Helmintosporum/Dreschlera spp. del laboratorio DIATER-Argentina. Resultados: Identificamos esporas de Alternaria alternata, Cladosporium spp., Nigrospora spp., Stemphylium spp., Fusarium spp., Curvularia spp., Dreschlera/Helmintosporum spp. Los pacientes mostraron sensibilización a Cladosporium herbarum (14%), Fusarium spp. (13,5%), Nigrospora spp. (8%), Alternaria Alternata (7%), Stemphylium (6%), Dreschlera/Helmintosporium spp. (5,5%), Curvularia spp. (3%) y Aspergillus fumigatus (2,5%). Conclusiones: Los habitantes de la zona sur-oeste de la ciudad urbana de Lima están expuestos a distintas esporas de hongos con potencial alergénico, identificándose mayor concentración durante los meses de verano y otoño. Se demuestra sensibilización cutánea en porcentajes variables a las esporas fúngicas identificadas en este muestreo aerobiológico. Los resultados de este estudio deberían ampliarse y ser comparados con data en los años siguientes, identificar fluctuaciones estacionales y anuales y extender los captadores a otras locaciones en Lima.

La crisis de asma en niños es un motivo frecuente de consulta en el Servicio de Urgencia. Se estima que 60% de los pacientes con asma presentan una o más crisis cada año. Un tercio de ellos consulta en urgencia y solo el 2% se hospitaliza (1). La gran mayoría de los pacientes responde al tratamiento de primera línea que incluye el uso de oxígeno, broncodilatadores y corticoides sistémicos. Solo un 20% de los casos es refractario a este manejo requiriendo de otras medidas terapéuticas, tales como Sulfato de magnesio, uso precoz de naricera de alto flujo y/o ventilación mecánica no invasiva. El manejo en la urgencia debe ser escalonado y considerar una línea de tiempo, de modo que en un plazo no superior a 2 horas el destino del paciente pueda estar definido (2). El objetivo de este artículo es responder las preguntas más frecuentes que surgen en relación con el manejo de la crisis de asma en el Servicio de Urgencia, de modo que sirvan de guía para lograr un óptimo tratamiento de esta condición.

Foundation: Asthma is a chronic inflammatory disease with a high prevalence in South America, which requires proper diagnosis, optimal management and prevention measures supported by constantly updated scientific evidence.Objective: to carry out a comparative analysis between the Global Initiative for Asthma and the South American guidelines for the diagnosis, management and prevention of asthma in pediatric patients.Methods: descriptive observational study that compares the 2023 Global Initiative for Asthma guideline with national guidelines from the South American countries Colombia, Argentina, Chile, Uruguay, Venezuela and Peru, in the following parameters: diagnostic recommendations, management recommendations and prevention strategies.Results: differences were found in prevention and education recommendations in the guides analyzed, while the Global Initiative for Asthma and some South American guides mention prevention measures, other guides do not mention them or have limited information in this regard. In auxiliary tests, all guidelines mention performing spirometry to evaluate lung function, but there are differences with the inclusion of other tests, such as the allergy test or the measurement of exhaled nitric oxide.Conclusions: Greater standardization and updating of South American guidelines is required to guarantee adequate and consistent management of asthma in the region.

Foundation: bronchial asthma is one of the most prevalent chronic diseases in childhood. The guidelines for diagnosis and treatment are governed by severity, level of control and quality of life, however, there is no evidence that demonstrates its statistical association.Objective: to measure the association degree between the severity of bronchial asthma, control level and quality of life in children.Methods: cross-sectional study, carried out from January to December 2022, in a sample of 189 patients with a bronchial asthma confirmed diagnosis. The analyzed variables were: age, sex, severity, level of control and quality of life. Statisticians, absolute frequency, percentage, arithmetic mean and standard deviation were calculated. The Chi-square test (pResults: the mean age was 9.17 years (SD ± 0.67). Males predominated, representing 53.54%. Intermittent asthma (39.15%), partial control level (59.79%) and high quality of life (50.26%) prevailed. When relating severity with level of control, the association statistician indicated X2=190.461 (VC= 0.662); in the case of severity and quality of life, X2=252.673 (VC=0.762); and between level of control and quality of life, X2=66.733 (VC=0.401).Conclusions: there was a strong association between severity of bronchial asthma-level of control and between severity of asthma-quality of life; as well as a moderate association between level of control-quality of life.