A rela??o entre a asma n?o at?pica e a exposi??o ? infec??es nos primeiros anos de vida em escolares de uma comunidade pobre do sul do Brasil

Made available in DSpace on 2015-04-14T13:33:14Z (GMT). No. of bitstreams: 1 394372.pdf: 3378131 bytes, checksum: 54051b51d1734e1e091af2c4a6fd435b (MD5) Previous issue date: 2007-08-10Objetivo: Asma e comum nos centros urbanos da Am?rica Latina, mas a asma at?pica pode n?o ser o fen?tipo entre essas crian?as. As infec??es por helmintos s?o altamente prevalentes nas popula??es pobres. Nossa hip?tese ? que essas crian?as apresentam uma asma al?rgica atenuada, enquanto que outros fatores estariam relacionados com a express?o de sibil?ncia n?o at?pica/fen?tipos de asma. M?todos: Um total de 1.982 crian?as do sul do Brasil, com uma idade media de 10.1 ? 0.76 anos, completaram um question?rio sobre asma, e 1.011 foram avaliados para parasitose intestinal e atopia usando testes cut?neos. Resultados: Sibil?ncia nos ?ltimos 12 meses foi reportada por 25.6% e 9.3% demonstrou asma recorrente; 13% tinham testes cut?neos positivos e 19.1% eram positivos para algum tipo de helmintos. A maioria das crian?as com sibil?ncia ou asma apresentava teste cut?neo negativo; entretanto a sibil?ncia severa era mais prevalente entre a minoria at?pica. A infec??o por helmintos estava inversamente associada com testes cut?neos positivos. Bronquiolite X 2 anos de vida foi o maior fator de risco independente para asma n?o atopica aos 10 anos de vida; outros fatores de risco s?o: alta carga de infec??o de Ascaris, historia familiar de asma e testes cut?neos positivos. Conclus?es: A maioria da asma ou sibil?ncia era do fen?tipo n?o at?pico, sugerindo que alguns helmintos poderiam atenuar o efeito da express?o at?pica da doen?a, enquanto que a bronquiolite viral predisp?e mais especificamente a sintomas recorrentes das vias a?reas

A workshop on asthma management programs and centers in Brazil: reviewing and explaining concepts

Objective: To report the results of a workshop regarding asthma management programs and centers (AMPCs) in Brazil, so that they can be used as a tool for the improvement and advancement of current and future AMPCs. Methods: The workshop consisted of five presentations and the corresponding group discussions. The working groups discussed the following themes: implementation of asthma management strategies; human resources needed for AMPCs; financial resources needed for AMPCs; and operational maintenance of AMPCs. Results: The workshop involved 39 participants, from all regions of the country, representing associations of asthma patients (n = 3), universities (n = 7), and AMPCs (n = 29). We found a direct relationship between a lack of planning and the failure of AMPCs. Based on the experiences reported during the workshop, the common assumptions about AMPCs in Brazil were the importance of raising awareness of managers; greater community participation; interdependence between primary care and specialized care; awareness of regionalization; and use of medications available in the public health system. Conclusions: Brazil already has a core of experience in the area of asthma management programs. The implementation of strategies for the management of chronic respiratory disease and their incorporation into health care system protocols would seem to be a natural progression. However, there is minimal experience in this area. Joint efforts by individuals with expertise in AMPCs could promote the implementation of asthma management strategies, thus speeding the creation of treatment networks, which might have a multiplier effect, precluding the need for isolated centers to start from zero