Introduction: Admissions for asthma are life threatening events that impair patients’ quality of ... more Introduction: Admissions for asthma are life threatening events that impair patients’ quality of life. The aim of this work is to characterize the population of patients admitted to a specialized respiratory hospital. Methods: Cross sectional prospective observational study of all admissions in ≥18 years old subjects along 1 year (Jan/12-Jan13) in a specialized respiratory hospital employing a single especially devised clinical record. Results: 164 consecutive admissions were studied in 147 patients. 157(95.4%) in a general ward and 7(4.2%) in ICU, 6 (85.7%) requiring mechanical ventilation (no deaths) 97(66%) pts were female. Mean age was 43±15.2 yrs. 12(8.2%) pts were admitted twice, 4(2.7%) 3 times and 1(0.7%) 4 times. 119(81%) had night awakenings in the last month;112(76.2%) had an emergency room visit in the last year; 94(64%) had been admitted once in their life and 30(20.4%) in the last year. 25.8% fulfilled ATS criteria for difficult to control asthma and 22.4% had experien...
During the last two years many works have dealt with the anti-anaphylactic properties of HC 20-51... more During the last two years many works have dealt with the anti-anaphylactic properties of HC 20-511, which chemically belongs to the cycloheptathiophene group of drugs. The excellent results obtained by different authors using this drug in various allergies, decided us to study its protective use in patients affected by rhinitis and/or extrinsec bronchial asthma, especially in connection with pollinoisis. We selected a group of patients of both sexes over 12 years of age, including those who had already received immunotherapy treatment. Diagnosis was determined by means of a clear clinical history, skin tests, and exposure tests to specific antigens, using the Gronemeyer and Fuchs method. The drug was administered orally (1 mg./twice a day) for 3 months. Exposition tests were carried out before beginning treatment and at 30 and 90 days, and measurement of vital capacity, FEV1, Maximal flow and Pneumometry were carried out. A check on the clinical state of the patient, as well as on h...
This clinical entity described for the first time by Osler in 1888 presented a great therapeutic ... more This clinical entity described for the first time by Osler in 1888 presented a great therapeutic problem during many decades because of its severity. Landerman and later on Donaldson and Evans established the pathogenic mechanisms of this disease finding a deficiency in the inhibitor of the first activated component of complement, an alpha 2 aminoglycoprotein, to be the mechanism responsible of the same. More concretely, alterations in the plasmin, kinin and kallikrein systems are those that will lead to a change in vascular permeability with resultant tissue alterations. Four cases of hereditary angioneurotic edema are studied in female patients aged between 15 and 50 years and with family history consistent with angioneurotic familiar edema in which there were six cases of death due to edema of the glottis. Once the diagnosis had been made the patients were subjected to treatment with EACA at doses of 2.5 gm every 6 hours. The determinations of complement were similar in the four ...
A study of the circadian rhythm of cAMP is carried out in ten patients suffering from mixed bronc... more A study of the circadian rhythm of cAMP is carried out in ten patients suffering from mixed bronchial asthma, with a marked bacterial component and with sensitizations due to pneumo-allergens (house dust and Dermatophagoides). Cyclic AMP levels were determined before and after treatment with Ketotifen (HC-20511). At the same time, cAMP levels were determined in a control group of 10 healthy subjects in order to realize a comparative study with the asthmatic group. Blood was drawn beginning at 5 AM. at four hour intervals for 24 hours. During this period, medication was withdrawn from these patients, although in some cases antibiotics and mucolytics were administered later; these same patients were treated with Ketotifen in a dose of 1 mg every 12 hours for 5 days. In the blood samples, cAMP levels were determined through a method based on Gilman's technique (comparative protein binding) using the Cyclic AMP Assay Kit (The Radiochemical Center, England). Among the results obtaine...
In chronic recurrent urticaria of months' or years' duration, it is difficult to identify... more In chronic recurrent urticaria of months' or years' duration, it is difficult to identify the causative factor. From an immunological point of view, various authors have attempted to demonstrate alterations in levels of immunoglobulins and complement fractions. We do not know of any previous studies of cellular immunity in this disorder. Fifty-one patients with chronic urticaria were studied, 22 females and 29 males, with ages ranging from 8 to 70 years. The patients were considered to be affected by recurrent or chronic urticaria with no clear allergic etiology. In all subjects a determination was made of serum levels of immunoglobulins G, A, M and E and of the complement fractions: C1 inhibitor, C1q, C3, C4 and C5. In addition, a study of cellular immunity was carried out on these patients. The results of tests of humoral immunity in the group of chronic urticarial patients studied showed only an increase of IgM in 41.7%. No significant changes were noted among the complem...
Resumen Introducción: El objetivo de este estudio consistió en un análisis de la base de datos de... more Resumen Introducción: El objetivo de este estudio consistió en un análisis de la base de datos del proyecto EAGLE (características de los pacientes hospitalizados por asma) limitado a la Argentina y el Uruguay. Pacientes y métodos: Para evaluar los cambios ...
The Allergic Rhinitis and its Impact on Asthma (ARIA) initiative commenced during a World Health ... more The Allergic Rhinitis and its Impact on Asthma (ARIA) initiative commenced during a World Health Organization workshop in 1999. The initial goals were (1) to propose a new allergic rhinitis classification, (2) to promote the concept of multi-morbidity in asthma and rhinitis and (3) to develop guidelines with all stakeholders that could be used globally for all countries and populations. ARIA-disseminated and implemented in over 70 countries globally-is now focusing on the implementation of emerging technologies for individualized and predictive medicine. MASK [MACVIA (Contre les Maladies Chroniques pour un Vieillissement Actif)-ARIA Sentinel NetworK] uses mobile technology to develop care pathways for the management of rhinitis and asthma by a multi-disciplinary group and by patients themselves. An app (Android and iOS) is available in 20 countries and 15 languages. It uses a visual analogue scale to assess symptom control and work productivity as well as a clinical decision support...
Localización: Archivos de bronconeumología: Organo oficial de la Sociedad Española de Neumología ... more Localización: Archivos de bronconeumología: Organo oficial de la Sociedad Española de Neumología y Cirugía Torácica SEPAR y la Asociación Latinoamericana de Tórax (ALAT), ISSN 0300-2896, Vol. 46, Nº. 8, 2010, pág. 451
La mayoría de los pacientes con rinitis alérgica no recibe el manejo idóneo, sino que se automedi... more La mayoría de los pacientes con rinitis alérgica no recibe el manejo idóneo, sino que se automedica. MASK (Mobile Airways Sentinel Network) forma parte integral de un proyecto apoyado por la Unión Europea contra las enfermedades crónicas y enfocado al envejecimiento activo y saludable. Constituye la tercera fase de ARIA (Allergic Rhinitis and its Impact on Asthma), en la cual mediante una aplicación móvil en un dispositivo inteligente se intenta guiar al paciente en el control de su multimorbilidad, rinitis o conjuntivitis alérgicas o asma. La aplicación Diario de Alergia por MACVIA-ARIA es gratuita y está disponible para Android e iOS. Al descargarla al celular del paciente, a este se le piden datos de su perfil, patologías alérgicas y medicación; posteriormente, mediante una escala visual analógica se le invita a determinar el grado de afectación en nariz, ojos y bronquios y su influencia sobre su productividad laboral/escolar. Con los datos del Diario de Alergia se observa que ex...
El impacto sanitario y económico de las enfermedades alérgicas está aumentando rápidamente y se n... more El impacto sanitario y económico de las enfermedades alérgicas está aumentando rápidamente y se necesitan cambios en las estrategias para su manejo. Su influencia reduce al menos en un tercio la capacidad de desempeño laboral y escolar. Los ICP (Vías Integradas de Atención) de las enfermedades de las vías respiratorias son planes de atención estructurados y multidisciplinarios, que promueven las recomendaciones de las guías en protocolos locales y su aplicación a la práctica clínica. En este documento se presenta un resumen ejecutivo para Argentina, México y España. Se desarrollan las guías ARIA de próxima generación para el tratamiento farmacológico de la rinitis alérgica (RA) utilizando las pautas basadas en GRADE para RA, probadas con evidencia de la vida real proporcionada por tecnología móvil basada en escalas visuales analógicas. Se concluye que en el tratamiento de la RA, los antihistamínicos anti-H1 son menos efectivos que los corticoides intranasales (CINS), que en la rinit...
Introduction: Admissions for asthma are life threatening events that impair patients’ quality of ... more Introduction: Admissions for asthma are life threatening events that impair patients’ quality of life. The aim of this work is to characterize the population of patients admitted to a specialized respiratory hospital. Methods: Cross sectional prospective observational study of all admissions in ≥18 years old subjects along 1 year (Jan/12-Jan13) in a specialized respiratory hospital employing a single especially devised clinical record. Results: 164 consecutive admissions were studied in 147 patients. 157(95.4%) in a general ward and 7(4.2%) in ICU, 6 (85.7%) requiring mechanical ventilation (no deaths) 97(66%) pts were female. Mean age was 43±15.2 yrs. 12(8.2%) pts were admitted twice, 4(2.7%) 3 times and 1(0.7%) 4 times. 119(81%) had night awakenings in the last month;112(76.2%) had an emergency room visit in the last year; 94(64%) had been admitted once in their life and 30(20.4%) in the last year. 25.8% fulfilled ATS criteria for difficult to control asthma and 22.4% had experien...
During the last two years many works have dealt with the anti-anaphylactic properties of HC 20-51... more During the last two years many works have dealt with the anti-anaphylactic properties of HC 20-511, which chemically belongs to the cycloheptathiophene group of drugs. The excellent results obtained by different authors using this drug in various allergies, decided us to study its protective use in patients affected by rhinitis and/or extrinsec bronchial asthma, especially in connection with pollinoisis. We selected a group of patients of both sexes over 12 years of age, including those who had already received immunotherapy treatment. Diagnosis was determined by means of a clear clinical history, skin tests, and exposure tests to specific antigens, using the Gronemeyer and Fuchs method. The drug was administered orally (1 mg./twice a day) for 3 months. Exposition tests were carried out before beginning treatment and at 30 and 90 days, and measurement of vital capacity, FEV1, Maximal flow and Pneumometry were carried out. A check on the clinical state of the patient, as well as on h...
This clinical entity described for the first time by Osler in 1888 presented a great therapeutic ... more This clinical entity described for the first time by Osler in 1888 presented a great therapeutic problem during many decades because of its severity. Landerman and later on Donaldson and Evans established the pathogenic mechanisms of this disease finding a deficiency in the inhibitor of the first activated component of complement, an alpha 2 aminoglycoprotein, to be the mechanism responsible of the same. More concretely, alterations in the plasmin, kinin and kallikrein systems are those that will lead to a change in vascular permeability with resultant tissue alterations. Four cases of hereditary angioneurotic edema are studied in female patients aged between 15 and 50 years and with family history consistent with angioneurotic familiar edema in which there were six cases of death due to edema of the glottis. Once the diagnosis had been made the patients were subjected to treatment with EACA at doses of 2.5 gm every 6 hours. The determinations of complement were similar in the four ...
A study of the circadian rhythm of cAMP is carried out in ten patients suffering from mixed bronc... more A study of the circadian rhythm of cAMP is carried out in ten patients suffering from mixed bronchial asthma, with a marked bacterial component and with sensitizations due to pneumo-allergens (house dust and Dermatophagoides). Cyclic AMP levels were determined before and after treatment with Ketotifen (HC-20511). At the same time, cAMP levels were determined in a control group of 10 healthy subjects in order to realize a comparative study with the asthmatic group. Blood was drawn beginning at 5 AM. at four hour intervals for 24 hours. During this period, medication was withdrawn from these patients, although in some cases antibiotics and mucolytics were administered later; these same patients were treated with Ketotifen in a dose of 1 mg every 12 hours for 5 days. In the blood samples, cAMP levels were determined through a method based on Gilman's technique (comparative protein binding) using the Cyclic AMP Assay Kit (The Radiochemical Center, England). Among the results obtaine...
In chronic recurrent urticaria of months' or years' duration, it is difficult to identify... more In chronic recurrent urticaria of months' or years' duration, it is difficult to identify the causative factor. From an immunological point of view, various authors have attempted to demonstrate alterations in levels of immunoglobulins and complement fractions. We do not know of any previous studies of cellular immunity in this disorder. Fifty-one patients with chronic urticaria were studied, 22 females and 29 males, with ages ranging from 8 to 70 years. The patients were considered to be affected by recurrent or chronic urticaria with no clear allergic etiology. In all subjects a determination was made of serum levels of immunoglobulins G, A, M and E and of the complement fractions: C1 inhibitor, C1q, C3, C4 and C5. In addition, a study of cellular immunity was carried out on these patients. The results of tests of humoral immunity in the group of chronic urticarial patients studied showed only an increase of IgM in 41.7%. No significant changes were noted among the complem...
Resumen Introducción: El objetivo de este estudio consistió en un análisis de la base de datos de... more Resumen Introducción: El objetivo de este estudio consistió en un análisis de la base de datos del proyecto EAGLE (características de los pacientes hospitalizados por asma) limitado a la Argentina y el Uruguay. Pacientes y métodos: Para evaluar los cambios ...
The Allergic Rhinitis and its Impact on Asthma (ARIA) initiative commenced during a World Health ... more The Allergic Rhinitis and its Impact on Asthma (ARIA) initiative commenced during a World Health Organization workshop in 1999. The initial goals were (1) to propose a new allergic rhinitis classification, (2) to promote the concept of multi-morbidity in asthma and rhinitis and (3) to develop guidelines with all stakeholders that could be used globally for all countries and populations. ARIA-disseminated and implemented in over 70 countries globally-is now focusing on the implementation of emerging technologies for individualized and predictive medicine. MASK [MACVIA (Contre les Maladies Chroniques pour un Vieillissement Actif)-ARIA Sentinel NetworK] uses mobile technology to develop care pathways for the management of rhinitis and asthma by a multi-disciplinary group and by patients themselves. An app (Android and iOS) is available in 20 countries and 15 languages. It uses a visual analogue scale to assess symptom control and work productivity as well as a clinical decision support...
Localización: Archivos de bronconeumología: Organo oficial de la Sociedad Española de Neumología ... more Localización: Archivos de bronconeumología: Organo oficial de la Sociedad Española de Neumología y Cirugía Torácica SEPAR y la Asociación Latinoamericana de Tórax (ALAT), ISSN 0300-2896, Vol. 46, Nº. 8, 2010, pág. 451
La mayoría de los pacientes con rinitis alérgica no recibe el manejo idóneo, sino que se automedi... more La mayoría de los pacientes con rinitis alérgica no recibe el manejo idóneo, sino que se automedica. MASK (Mobile Airways Sentinel Network) forma parte integral de un proyecto apoyado por la Unión Europea contra las enfermedades crónicas y enfocado al envejecimiento activo y saludable. Constituye la tercera fase de ARIA (Allergic Rhinitis and its Impact on Asthma), en la cual mediante una aplicación móvil en un dispositivo inteligente se intenta guiar al paciente en el control de su multimorbilidad, rinitis o conjuntivitis alérgicas o asma. La aplicación Diario de Alergia por MACVIA-ARIA es gratuita y está disponible para Android e iOS. Al descargarla al celular del paciente, a este se le piden datos de su perfil, patologías alérgicas y medicación; posteriormente, mediante una escala visual analógica se le invita a determinar el grado de afectación en nariz, ojos y bronquios y su influencia sobre su productividad laboral/escolar. Con los datos del Diario de Alergia se observa que ex...
El impacto sanitario y económico de las enfermedades alérgicas está aumentando rápidamente y se n... more El impacto sanitario y económico de las enfermedades alérgicas está aumentando rápidamente y se necesitan cambios en las estrategias para su manejo. Su influencia reduce al menos en un tercio la capacidad de desempeño laboral y escolar. Los ICP (Vías Integradas de Atención) de las enfermedades de las vías respiratorias son planes de atención estructurados y multidisciplinarios, que promueven las recomendaciones de las guías en protocolos locales y su aplicación a la práctica clínica. En este documento se presenta un resumen ejecutivo para Argentina, México y España. Se desarrollan las guías ARIA de próxima generación para el tratamiento farmacológico de la rinitis alérgica (RA) utilizando las pautas basadas en GRADE para RA, probadas con evidencia de la vida real proporcionada por tecnología móvil basada en escalas visuales analógicas. Se concluye que en el tratamiento de la RA, los antihistamínicos anti-H1 son menos efectivos que los corticoides intranasales (CINS), que en la rinit...
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