Clinical characteristics and comorbidities of elderly asthmatics who attend allergy clinics

Background: To date, few studies have focused on the clinical and allergic characteristics of asthma in the elderly, defined as asthma in people aged 60 or over. Thus, we propose to identify and study the clinical and allergic characteristics and comorbidities of patients with asthma among the elderly.Methods: A retrospective, observational, descriptive study was developed in five clinics and hospitals in Argentina. Allergy Physicians analyzed their patients? medical records in 2014 and included those adults over the age of 60, who had been diagnosed with asthma according to the GINA guidelines. Clinical and allergic characteristics were analyzed.Results: A total of 152 patients diagnosed with asthma, of whom 73% were women and 11% ex-smokers, were included in this study, with a mean age of 66 years. Only 10.5% of the participants had onset asthma past the age of 60. Regarding asthma severity, 74.3% were diagnosed with moderate persistent asthma, and 7.2% with severe persistent asthma. Eighty-four percent of the patients were treated with an inhaled corticosteroid (ICS) along with a long-acting β 2-adrenergic agent (LABA). More than half of the patients had two or more comorbidities simultaneously. Allergic comorbidities were the most frequent comorbidities, followed by arterial hypertension. Among allergic comorbidities, most patients presented allergies at the nasal level. There were no significant differences between the subpopulations of patients with late-onset asthma (LOA) and asthma with onset before the age of 60, i.e. early onset asthma (EOA) in most of their clinical characteristics. However, it was observed that EOA accounted for a higher percentage of patients with nasal allergies as compared to LOA (71% vs 46%, p < 0.05).It is worth mentioning that almost half of the patients with LOA had allergies at the nasal level.Conclusion: These results may provide a better understanding of the clinical characteristics of asthma in the elderly in Argentina, thus, enabling the development of future therapeutic strategies and a better quality of life for our elderly asthma patients.Fil: Yáñez, Anahí. Investigaciones En Alergia y Enfermedades Respiratoria; ArgentinaFil: Soria, Marcela. Gobierno de la Ciudad Autónoma de Buenos Aires. Hospital General de Niños "Ricardo Gutiérrez". Departamento de Medicina; ArgentinaFil: de Barayazarra, Norma Susana. Gobierno de la Provincia de Cordoba. Nuevo Hospital San Roque.; ArgentinaFil: Recuero, Nancy. Gobierno de la Provincia de Cordoba. Nuevo Hospital San Roque.; ArgentinaFil: Rovira, Francisco. No especifíca;Fil: Jares, Edgardo. No especifíca;Fil: Stok, Ana María. Instituto de Investigaciones En Patologías Respiratorias; ArgentinaFil: Nemirovsky, Sergio Ivan. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales; ArgentinaFil: Bueno, Carlos Alberto. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales; Argentin

Hypersensitivity Drug Reactions (HDR) In Latin America : Similarities and Differences Between Children and Adults

HDR are frequent motives for consultation in Allergology services. Possible etiologic factors and clinical presentation differences between Latin American children and adults have not been described yet.Facultad de Ciencias Médica

Drug-induced anaphylaxis, elicitors, risk factors, and management in Latin America

Nonsteroidal anti-inflammatory drugs were the most frequent triggers of drug-induced anaphylaxis in Latín America, whereas antibiotics elicited faster onset and more scvere reactions. An improvement was observed in epinephrinc use and adherence to guidelines in the emergency department treatment of anaphylaxis in Latín America compared with our last report.Facultad de Ciencias Médica

Multinational experience with hypersensitivity drug reactions in Latin America

Background: Epidemiologic drug allergy data from Latin America are scarce, and there are no studies on specific procedures focusing on this topic in Latin America.Objective: To assess the clinical characteristics and management of hypersensitivity drug reactions in different Latin American countries.Methods: An European Network of Drug Allergy questionnaire survey was implemented in 22 allergy units in 11 Latin American countries to report on consecutive patients who presented with a suspected hypersensitivity drug reaction. Each unit used its own protocols to investigate patients.Results: Included were 868 hypersensitivity drug reactions in 862 patients (71% of adults and elderly patients were women and 51% of children were girls, P < .0001). Children presented with less severe reactions than adults and elderly patients (P < .0001). Urticaria and angioedema accounted for the most frequent clinical presentations (71%), whereas anaphylaxis was present in 27.3% of cases. There were no deaths reported. Nonsteroidal anti-inflammatory drugs (52.3%), beta-lactam antibiotics (13.8%), and other antibiotics (10.1%) were the drugs used most frequently. Skin prick tests (16.7%) and provocation tests (34.2%) were the study procedures most commonly used. A large proportion of patients were treated in the emergency department (62%) with antihistamines (68%) and/or corticosteroids (53%). Only 22.8% of patients presenting with anaphylaxis received epinephrine.Conclusion: Nonsteroidal anti-inflammatory drugs and antibiotics were the drugs used in at least 75% of patients. More than half the reactions were treated in the emergency department, whereas epinephrine was administered in fewer than 25% of patients with anaphylaxis. Dissemination of guidelines for anaphylaxis among primary and emergency department physicians should be encouraged. (C) 2014 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.Libra Fdn, RA-1428 Buenos Aires, DF, ArgentinaClin El Avila, Caracas, VenezuelaUniv Antiquia, Medellin, ColombiaUniv Santo Amaro, São Paulo, BrazilUniversidade Federal de São Paulo, São Paulo, BrazilUniv Hosp, Monterrey, MexicoHosp San Bernardo, Salta, ArgentinaNuevo Hosp San Roque, Cordoba, ArgentinaUniv Cincinnati, Cincinnati, OH USAFdn Valle Lili, Cali, ColombiaConsultorios San Juan, San Juan, ArgentinaHosp Mocel, Mexico City, DF, MexicoUniv Nacl La Plata, La Plata, Buenos Aires, ArgentinaHosp Kennedy, Respiralab, Guayaquil, EcuadorUniversidade Federal de São Paulo, São Paulo, BrazilWeb of Scienc