Beneficiamento do sorgo em polidora de arroz para obtenção de farinhas de diferentes frações.

10º SLACA

Exercise-induced bronchospasm in children

Neste trabalho, são revisados conceitos atuais sobre definição, fisiopatologia, diagnóstico clínico e funcional pulmonar e tratamento do broncoespasmo induzido pelo exercício em crianças. O broncoespasmo induzido pelo exercício é o estreitamento da via aérea desencadeado por atividade física em pessoas com reatividade brônquica aumentada. Caracteriza-se por vários graus de obstrução ao fluxo aéreo, ocorrendo minutos após a finalização do exercício. Pode seguir-se também uma resposta tardia, especialmente em crianças. Atinge 15% da população geral, mais freqüentemente asmáticos. A apresentação clínica é variável. O diagnóstico é confirmado por uma queda no pico de fluxo expiratório (PFE) ou no volume expiratório final no primeiro segundo (VEF1) de 15% ou mais após o exercício, ou uma redução no fluxo expiratório forçado de 25 a 75% da capacidade vital (FEF25-75) de 20%. Várias teorias tentam explicar sua fisiopatologia. Os beta2-agonistas são, até o momento, as drogas mais usadas no tratamento e profilaxia do broncoespasmo induzido pelo exercício. Inibidores da degranulação dos mastócitos e antagonistas dos leucotrienos também são utilizados. O broncoespasmo induzido pelo exercício deve ser especialmente lembrado naqueles pacientes asmáticos com sintomas ao exercício. Embora muito já se conheça em termos de alternativas terapêuticas, esta é uma área ainda parcialmente explorada.We review the concept, pathophysiology, clinical diagnosis, pulmonary function tests, and treatment of exercise-induced bronchospasm in children. Exercise-induced bronchospasm is the acute narrowing of the airway that is triggered by vigorous physical activity in individuals with airway hyperreactivity. It is characterized by several degrees of obstruction occurring some minutes after the end of exercise. A late response may also occur, usually in children. Exercise-induced bronchospasm in children affects up to 15% of general population, and it is more prevalent in asthmatics. Diagnosis is suggested by typical history, and confirmed by specific tests. The clinical presentation is variable. Its diagnosis is confirmed by a recorded fall in the peak expiratory flow (PEF) or forced expiratory volume in 1 second (FEV1) of 15% or higher after exercise, or by a decrease in the forced expiratory flow at 25-75% (FEF25-75) of 20% in relation to baseline measurements. Many theories try to explain the pathophysiology of this condition. Beta-2 agonists are the most common drugs used in the treatment of exerciseinduced bronchospasm and in prophylaxis. Mast cell stabilizing agents and leukotriene antagonists can also be used. Exercise-induced bronchospasm should be remembered in asthmatic patients that present symptoms on exercising. Although there is a large amount of information available about therapeutic options, there is still much to be explored in this field of study

Geographic variation in the aetiology, epidemiology and microbiology of bronchiectasis

Bronchiectasis is a disease associated with chronic progressive and irreversible dilatation of the bronchi and is characterised by chronic infection and associated inflammation. The prevalence of bronchiectasis is age-related and there is some geographical variation in incidence, prevalence and clinical features. Most bronchiectasis is reported to be idiopathic however post-infectious aetiologies dominate across Asia especially secondary to tuberculosis. Most focus to date has been on the study of airway bacteria, both as colonisers and causes of exacerbations. Modern molecular technologies including next generation sequencing (NGS) have become invaluable tools to identify microorganisms directly from sputum and which are difficult to culture using traditional agar based methods. These have provided important insight into our understanding of emerging pathogens in the airways of people with bronchiectasis and the geographical differences that occur. The contribution of the lung microbiome, its ethnic variation, and subsequent roles in disease progression and response to therapy across geographic regions warrant further investigation. This review summarises the known geographical differences in the aetiology, epidemiology and microbiology of bronchiectasis. Further, we highlight the opportunities offered by emerging molecular technologies such as -omics to further dissect out important ethnic differences in the prognosis and management of bronchiectasis.NMRC (Natl Medical Research Council, S’pore)MOH (Min. of Health, S’pore)Published versio