Idiopathic musculoskeletal pain, musculoskeletal pain syndromes, and use of electronic devices in adolescents with asthma

Objetivo: Avaliar o uso de mídias digitais em adolescentes com asma, comparando-os com uma população de adolescentes sem doenças crônicas; avaliar a associação entre dor musculoesquelética e uso da mídia digital em adolescentes com asma comparando-a com adolescentes sem doenças crônicas; avaliar a associação entre os asmáticos com queixa saúde (QVRS) e controle da asma. Métodos: Estudo transversal com 150 adolescentes asmáticos (10 a 18 anos) de um hospital público da cidade de São Paulo comparados com 300 adolescentes sem doenças crônicas (11 a 17 anos) provenientes de uma escola pública da cidade de São Paulo, que responderam um questionário individual e autoaplicável, com perguntas sobre o uso de dispositivos eletrônicos; dados demográficos; prática de atividade física e sintomas dolorosos do sistema musculoesquelético. Aplicado o questionário ACT/ c- ACT (Asthma control test/ Children Asthma control test) para classificação do controle da asma e o PedsQLTM 4.0 (Pediatric Quality of Life) para avaliação dos aspectos da QVRS no grupo asmático. Após a aplicação dos questionários, foi realizado exame físico específico do aparelho musculoesquelético nos adolescentes asmáticos e do grupo controle que apresentavam queixas álgicas nos últimos três meses, visando à avaliação das seguintes síndromes musculoesqueléticas: fibromialgia juvenil, síndrome de hipermobilidade articular benigna, síndrome miofascial, tendinite, bursite, epicondilite e síndrome de dor regional complexa. Resultados: Dor musculoesquelética foi significativamente menor em adolescentes com asma comparados aos controles (42% vs. 61%, p = 0,0002), bem como síndromes de dor musculoesquelética (2,7% vs. 15,7%, p = 0,0006). A frequência de dor nas mãos e punhos foi significativamente reduzida no grupo asma (12,6% vs. 31,1%, p = 0,004), da mesma forma que o uso de telefone celular (80% vs. 93%, p 20, uso simultâneo de pelo menos dois dispositivos eletrônicos, uso de telefone celular nos fins de semana e nos dias de semana como variáveis independentes, mostrou que o sexo feminino (OR 2,06; IC 95%, 1,929- 6,316, p = 0,0009) e ACT > 20 (OR 0,194; IC 95%, 0,039-0,967, p = 0,045) foram associados com asma e dor musculoesquelética (Nagelkerke R2 = 0,206). As análises das médias dos itens do questionário PedsQLTM 4.0 foram significativamente menores nos domínios saúde e sentimentos em asmáticos com dor versus asmáticos que não relataram dor (p 20, simultaneous use of at least two electronic devices, cell phone use, weekends and weekdays of cell phone use as independent variables, showed that female sex (OR, 2.06; 95%CI, 1.929- 6.316, p=0.0009) and ACT > 20 (OR, 0.194; 95%CI, 0.039-0.967, p=0.045) were associated with asthma and musculoskeletal pain (Nagelkerke R2= 0.206). The analysis of the means of the items in the PedsQLTM 4.0 questionnaire were significantly lower in the domains health and feelings in asthmatics with pain versus asthmatics who did not report pain (p < 0.0001 and p < 0.0006, respectively). Conclusions: Musculoskeletal pain and musculoskeletal pain syndromes were lower in adolescents with asthma compared to healthy controls. Female sex was associated with musculoskeletal pain in asthmatic adolescents, whereas patients with asthma and well controlled disease reported lower musculoskeletal pain. Adolescents with asthma and who reported pain had a worse rate in assessing quality of life in questions about health and feeling

A concept for integrated care pathways for atopic dermatitis-A GA 2 LEN ADCARE initiative

The integrated care pathways for atopic dermatitis (AD-ICPs) aim to bridge the gap between existing AD treatment evidence-based guidelines and expert opinion based on daily practice by offering a structured multidisciplinary plan for patient management of AD. ICPs have the potential to enhance guideline recommendations by combining interventions and aspects from different guidelines, integrating quality assurance, and describing co-ordination of care. Most importantly, patients can enter the ICPs at any level depending on AD severity, resources available in their country, and economic factors such as differences in insurance reimbursement systems. The GA 2 LEN ADCARE network and partners as well as all stakeholders, abbreviated as the AD-ICPs working group, were involved in the discussion and preparation of the AD ICPs during a series of subgroup workshops and meetings in years 2020 and 2021, after which the document was circulated within all GAL 2 EN ADCARE centres. The AD-ICPs outline the diagnostic procedures, possible co-morbidities, different available treatment options including differential approaches for the pediatric population, and the role of the pharmacists and other stakeholders, as well as remaining unmet needs in the management of AD. The AD-ICPs provide a multidisciplinary plan for improved diagnosis, treatment, and patient feedback in AD management, as well as addressing critical unmet needs, including improved access to care, training specialists, implementation of educational programs, assessment on the impact of climate change, and fostering a personalised treatment approach. By focusing on these key areas, the initiative aims to pave the way for a brighter future in the management of AD

A concept for integrated care pathways for atopic dermatitis—A GA2LEN ADCARE initiative

Abstract Introduction The integrated care pathways for atopic dermatitis (AD‐ICPs) aim to bridge the gap between existing AD treatment evidence‐based guidelines and expert opinion based on daily practice by offering a structured multidisciplinary plan for patient management of AD. ICPs have the potential to enhance guideline recommendations by combining interventions and aspects from different guidelines, integrating quality assurance, and describing co‐ordination of care. Most importantly, patients can enter the ICPs at any level depending on AD severity, resources available in their country, and economic factors such as differences in insurance reimbursement systems. Methods The GA2LEN ADCARE network and partners as well as all stakeholders, abbreviated as the AD‐ICPs working group, were involved in the discussion and preparation of the AD ICPs during a series of subgroup workshops and meetings in years 2020 and 2021, after which the document was circulated within all GAL2EN ADCARE centres. Results The AD‐ICPs outline the diagnostic procedures, possible co‐morbidities, different available treatment options including differential approaches for the pediatric population, and the role of the pharmacists and other stakeholders, as well as remaining unmet needs in the management of AD. Conclusion The AD‐ICPs provide a multidisciplinary plan for improved diagnosis, treatment, and patient feedback in AD management, as well as addressing critical unmet needs, including improved access to care, training specialists, implementation of educational programs, assessment on the impact of climate change, and fostering a personalised treatment approach. By focusing on these key areas, the initiative aims to pave the way for a brighter future in the management of AD