Childhood asthma outcomes during the COVID-19 pandemic: Findings from the PeARL multi-national cohort.

BACKGROUND: The interplay between COVID-19 pandemic and asthma in children is still unclear. We evaluated the impact of COVID-19 pandemic on childhood asthma outcomes. METHODS: The PeARL multinational cohort included 1,054 children with asthma and 505 non-asthmatic children aged between 4-18 years from 25 pediatric departments, from 15 countries globally. We compared the frequency of acute respiratory and febrile presentations during the first wave of the COVID-19 pandemic between groups and with data available from the previous year. In children with asthma, we also compared current and historical disease control. RESULTS: During the pandemic, children with asthma experienced fewer upper respiratory tract infections, episodes of pyrexia, emergency visits, hospital admissions, asthma attacks and hospitalizations due to asthma, in comparison to the preceding year. Sixty-six percent of asthmatic children had improved asthma control while in 33% the improvement exceeded the minimal clinically important difference. Pre-bronchodilatation FEV1 and peak expiratory flow rate were improved during the pandemic. When compared to non-asthmatic controls, children with asthma were not at increased risk of LRTIs, episodes of pyrexia, emergency visits or hospitalizations during the pandemic. However, an increased risk of URTIs emerged. CONCLUSION: Childhood asthma outcomes, including control, were improved during the first wave of the COVID-19 pandemic, probably because of reduced exposure to asthma triggers and increased treatment adherence. The decreased frequency of acute episodes does not support the notion that childhood asthma may be a risk factor for COVID-19. Furthermore, the potential for improving childhood asthma outcomes through environmental control becomes apparent

Is diet partly responsible for differences in COVID-19 death rates between and within countries?

Correction: Volume: 10 Issue: 1 Article Number: 44 DOI: 10.1186/s13601-020-00351-w Published: OCT 26 2020Reported COVID-19 deaths in Germany are relatively low as compared to many European countries. Among the several explanations proposed, an early and large testing of the population was put forward. Most current debates on COVID-19 focus on the differences among countries, but little attention has been given to regional differences and diet. The low-death rate European countries (e.g. Austria, Baltic States, Czech Republic, Finland, Norway, Poland, Slovakia) have used different quarantine and/or confinement times and methods and none have performed as many early tests as Germany. Among other factors that may be significant are the dietary habits. It seems that some foods largely used in these countries may reduce angiotensin-converting enzyme activity or are anti-oxidants. Among the many possible areas of research, it might be important to understand diet and angiotensin-converting enzyme-2 (ACE2) levels in populations with different COVID-19 death rates since dietary interventions may be of great benefit.Peer reviewe

Childhood asthma outcomes during the COVID-19 pandemic: Findings from the PeARL multinational cohort

Background The interplay between COVID-19 pandemic and asthma in children is still unclear. We evaluated the impact of COVID-19 pandemic on childhood asthma outcomes.Methods The PeARL multinational cohort included 1,054 children with asthma and 505 non-asthmatic children aged between 4 and 18 years from 25 pediatric departments, from 15 countries globally. We compared the frequency of acute respiratory and febrile presentations during the first wave of the COVID-19 pandemic between groups and with data available from the previous year. In children with asthma, we also compared current and historical disease control.Results During the pandemic, children with asthma experienced fewer upper respiratory tract infections, episodes of pyrexia, emergency visits, hospital admissions, asthma attacks, and hospitalizations due to asthma, in comparison with the preceding year. Sixty-six percent of asthmatic children had improved asthma control while in 33% the improvement exceeded the minimal clinically important difference. Pre-bronchodilatation FEV1 and peak expiratory flow rate were improved during the pandemic. When compared to non-asthmatic controls, children with asthma were not at increased risk of LRTIs, episodes of pyrexia, emergency visits, or hospitalizations during the pandemic. However, an increased risk of URTIs emerged.Conclusion Childhood asthma outcomes, including control, were improved during the first wave of the COVID-19 pandemic, probably because of reduced exposure to asthma triggers and increased treatment adherence. The decreased frequency of acute episodes does not support the notion that childhood asthma may be a risk factor for COVID-19. Furthermore, the potential for improving childhood asthma outcomes through environmental control becomes apparent.</p

Fertilización nitrogenada después de la poda del cafeto robusta en Cambisoles

El objetivo de este trabajo fue evaluar la influencia de la fertilización mineral nitrogenada, después de la poda del cafeto robusta, sobre la productividad del cultivo y algunos indicadores químicos (pH, materia orgánica) y microbiológicos (respiración biológica y nitrificación) de dos Cambisoles en Tercer Frente, Santiago de Cuba y La Alcarraza, Holguín, durante los años 2003-2007. Se estudió la respuesta a dosis crecientes de nitrógeno (0 hasta 400 kg ha-1), en presencia de un fondo fijo de P (50 kg ha-1) y K (160 kg ha-1), en un diseño experimental de bloques al azar, con cuatro réplicas. Para productividades entre 0,50 y 0,84 Mg ha-1 de café, son suficientes 75 kg ha-1 de N. Aplicaciones de 100 kg ha-1 de N permitieron productividades de 1,22 a 1,25 Mg ha-1de café. Con dosis de 153 kg ha-1 de N, se logran producciones de 1,80 Mg ha-1 de café, mientras que para productividades superiores a 2 Mg ha-1 se necesita aplicar 200 kg ha-1 en ambos suelos. Se encontró un incremento importante en las productividades del cafeto por cada quilogramo de N aplicado, que osciló entre 2,13 y 7,80. Las dosis propuestas por sitio no afectaron la actividad microbiana y la materia orgánica de los suelos. Se encontró disminución del pH del suelo respecto a su estado inicial

Aeroallergen immunotherapy associated with reduced risk of severe COVID-19 in 1095 allergic patients

Introduction: Allergen immunotherapy (AIT) brings along changes in the immune system, restoring dendritic cell function, reducing T2 inflammation and augmenting the regulatory cell activation. Coronavirus disease (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections, interferes with the immune system causing immune suppression during the first phase and over-activation in more advanced disease. We decided to explore the interaction of both in a real-world observational trial. Methods: We registered COVID-19 outcomes in patients with allergic disorders in Latin America, treated with and without AIT. The registry was conducted during the first 1.3 years of the pandemic, with most of the data collected before COVID-19 vaccination was concluded in most countries. Data collection was anonymous via a web-based instrument. Ten countries participated. Results: 630/1095 (57.6%) of the included patients received AIT. Compared to patients without AIT, those treated with AIT had a reduced risk ratio (RR) for COVID-19 lower respiratory symptoms (RR 0.78, 95% CI: 0.6703–0.9024; p = 0.001662) and need for oxygen therapy (RR 0.65, 95% CI: 0.4217–0.9992; p = 0.048). In adherent patients on maintenance sublingual immunotherapy/subcutaneous immunotherapy (SLIT/SCIT) the RR reduction was larger [RR = 0.6136 (95% CI 0.4623–0.8143; p < 0.001) and RR: 0.3495 (95% CI 0.1822–0.6701; p < 0.005), respectively]. SLIT was slightly more effective (NS). We excluded age, comorbidities, level of health care attendance, and type of allergic disorder as confounders, although asthma was related to a higher frequency of severe disease. When analyzing patients with allergic asthma (n = 503) the RR reduction favoring AIT was more pronounced with 30% for lower respiratory symptoms or worse (RR 0.6914, 95% CI 0.5264 to 0.9081, p = 0.0087) and 51% for need of oxygen therapy or worse (RR 0.4868, 95% CI 0.2829–0.8376, p = 0.0082). Among severe allergic patients treated with biologics (n = 24) only 2/24 needed oxygen therapy. There were no critical cases among them. Conclusion: In our registry AIT was associated with reduced COVID-19 severity

MASK (Mobile Airways Sentinel Network), una app móvil con la solución integral de ARIA en países de habla hispana

Aunque existen guías clínicas de alta calidad sobre rinitis alérgica, numerosos pacientes reciben tratamiento deficiente, en parte debido al alto grado de automedicación. 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; en ella, los pacientes indican diariamente cuánto les molestan los síntomas a través de cinco pantallas con una escala visual análoga; recientemente se agregaron dos pantallas más (afectación del sueño). La aplicación también permite descargar los datos del “Diario de alergias” en la computadora del médico en el momento de la consulta a través de un código QR. En este artículo reseñamos el primer año de experiencia en España, México y Argentina, que utilizan la versión española.Fil: Larenas Linnemann, Désirée. Fundación Clínica Médica Sur; ArgentinaFil: Mullol, Joaquim. Universitat de Barcelona; EspañaFil: Ivancevich, Juan Carlos. Clínica Santa Isabel; ArgentinaFil: Anto, Josep M. Universitat Pompeu Fabra; EspañaFil: Cardona, Victoria. Hospital Vall d’Hebron; EspañaFil: Dedeu, Toni. European Regional and Local Health Association; BélgicaFil: Rodríguez González, Mónica. Hospital Español; MéxicoFil: Huerta Villalobos, Yunuen Rocío. Instituto Mexicano del Seguro Social; MéxicoFil: Neffen, Hugo. Center of Allergy; ArgentinaFil: Fuentes Pérez, José Miguel. Instituto Mexicano del Seguro Social; MéxicoFil: Rodríguez Zagal, Endira. Instituto Mexicano del Seguro Social; MéxicoFil: Valero, Antonio. Universidad de Barcelona; EspañaFil: Zernotti, Mario Emilio. Universidad Católica de Córdoba. Facultad de Ciencias de la Salud; ArgentinaFil: Bartra, Joan. Hospital Clínic; EspañaFil: Alobid, Isam. Hospital de La Fe; EspañaFil: Castillo Vizuete, José Antonio. Hospital Universitari Quirón; EspañaFil: Dordal, Teresa. Hospital Municipal Badalona; EspañaFil: Hijano, Rafael. Hospital del Mar; EspañaFil: Picado, César. European Federation of Allergy and Respiratory; España Diseases PatientsFil: Sastre, Joaquín. Fundación Jiménez Díaz; EspañaFil: Blua, Ariel Eduardo. Hospital Privado Universitario de Córdoba; ArgentinaFil: Jares, Edgardo. Sociedad Latinoamericana de Alergia; ArgentinaFil: Lavrut, Alberto Jorge. Hospital General de Niños Pedro de Elizalde; ArgentinaFil: Máspero, Jorge. Fundación Centro de Investigación de Enfermedades Alérgicas y Respiratorias; ArgentinaFil: Bedolla Barajas, Martín. Centro Médico Zambrano Hellion; MéxicoFil: Burguete Cabañas, María Teresa. Hospital Ángeles de Puebla; MéxicoFil: García Cobas, Cecilia Yvonne. Hospital Star Médica Aguascalientes; ArgentinaFil: García Cruz, María de la Luz Hortensia. Hospital Ángeles de Puebla; MéxicoFil: Hernández Velázquez, Luiana. 8Universidad Autónoma de Baja California Campus Ensenada; MéxicoFil: Luna Pech, Jorge A. Universidad de Guadalajara; MéxicoFil: Matta, Juan José. Instituto Mexicano del Seguro Social; MéxicoFil: Mogica Martínez, María Dolores. Instituto Mexicano del Seguro Social; MéxicoFil: Rivero Yeverino, Daniela. Universidad Autónoma de Puebla; ArgentinaFil: Ruiz, Lucy Tania. Instituto Mexicano del Seguro Social; MéxicoFil: Del Río Navarro, Blanca E. Hospital Infantil de México; MéxicoFil: Gómez Vera, Javier. Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado; MéxicoFil: Macías Weinmann, Alejandra. Universidad Autónoma de Nuevo León; MéxicoFil: Murray, Ruth. MedScript Ltd; IrlandaFil: Onorato, Gabrielle. MACVIA-France; FranciaFil: Laune, Daniel. Kyomed; FranciaFil: Bedbrook, Anna. MACVIA-France; FranciaFil: Bousquet, Jean. Université Versailles St-Quentin-en-Yvelines; Franci

Executive Summary of ARIA 2019: Integrated care pathways for allergic rhinitis in Argentina, Spain and Mexico

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 rinitis grave los CINS representan la primera línea de tratamiento, y que la combinación intranasal de CINS + anti-H1 es más eficaz que la monoterapia. Sin embargo, según el estudio MASK observacional en vida real, los pacientes tienen pobre adherencia al tratamiento y frecuentemente se automedican de acuerdo con sus necesidades.The health and economic impact of allergic diseases are increasing rapidly, and changes in management strategies are required. Its influence reduces the capacity of work and school performance by at least a third. The ICPs of the airways (integrated care pathways for respiratory diseases) are structured multidisciplinary healthcare plans, promoting the recommendations of the guidelines in local protocols and their application to clinical practice. This document presents an executive summary for Argentina, Mexico, and Spain. Next-generation ARIA guidelines are being developed for the pharmacological treatment of allergic rhinitis (AR), using the GRADE-based guidelines for AR, tested with real-life evidence provided by mobile technology with visual analogue scales. It is concluded that in the AR treatment, H1-antihistamines are less effective than intranasal corticosteroids (INCS), in severe AR the INCS represent the first line of treatment, and intranasal combination INCS + anti-H1 is more effective than monotherapy. However, according to the MASK real-life observational study, patients have poor adherence to treatment and often self-medicate, according to their needs

Childhood asthma outcomes during the COVID-19 pandemic: findings from the PeARL multinational cohort

Background: The interplay between COVID-19 pandemic and asthma in children is still unclear. We evaluated the impact of COVID-19 pandemic on childhood asthma outcomes. Methods: The PeARL multinational cohort included 1,054 children with asthma and 505 non-asthmatic children aged between 4 and 18 years from 25 pediatric departments, from 15 countries globally. We compared the frequency of acute respiratory and febrile presentations during the first wave of the COVID-19 pandemic between groups and with data available from the previous year. In children with asthma, we also compared current and historical disease control. Results: During the pandemic, children with asthma experienced fewer upper respiratory tract infections, episodes of pyrexia, emergency visits, hospital admissions, asthma attacks, and hospitalizations due to asthma, in comparison with the preceding year. Sixty-six percent of asthmatic children had improved asthma control while in 33% the improvement exceeded the minimal clinically important difference. Pre-bronchodilatation FEV1 and peak expiratory flow rate were improved during the pandemic. When compared to non-asthmatic controls, children with asthma were not at increased risk of LRTIs, episodes of pyrexia, emergency visits, or hospitalizations during the pandemic. However, an increased risk of URTIs emerged. Conclusion: Childhood asthma outcomes, including control, were improved during the first wave of the COVID-19 pandemic, probably because of reduced exposure to asthma triggers and increased treatment adherence. The decreased frequency of acute episodes does not support the notion that childhood asthma may be a risk factor for COVID-19. Furthermore, the potential for improving childhood asthma outcomes through environmental control becomes apparent.</p

Memorias del I Congreso Internacional de Bioingeniería y Sistemas Inteligentes de Rehabilitación - CIBSIR 2017

El I Congreso Internacional de Bioingeniería y Sistemas Inteligentes de Rehabilitación, se celebró en Quito, capital del Ecuador. Su organización estuvo a cargo de profesores e investigadores de la Escuela Politécnica Nacional (EPN), Universidad Politécnica Salesiana (UPS), Universitat Politécnica de Valencia (UPV), Universidad Técnica del Norte (UTN), Escuela Superior Politécnica del Chimborazo (ESPOCH), Universidad de las Fuerzas Armadas (ESPE), Universidad Central del Ecuador (UCE), Escuela Superior Politécnica del Litoral (ESPOL), Universidad San Francisco de Quito (USFQ), Universidad de Las Américas (UDLA) y Universidad Mariana de Colombia. Todas ellas universidades que han trabajado de manera rigurosa para la creación de un programa académico que sirva de marco para la investigación y el intercambio de conocimientos y experiencias, así como para el desarrollo de oportunidades de colaboración para promover la difusión de tecnologías relacionadas con estos campos. Este congreso fue dirigido tanto a académicos como a profesionales y estudiantes interesados en compartir conocimientos y experiencias en las áreas de Bioingeniería y Sistemas Inteligentes de Rehabilitación. En la actualidad, el creciente avance tecnológico dedicado a los campos de la Bioingeniería y Sistemas de Rehabilitación, hace necesaria la disponibilidad de un espacio de difusión para las investigaciones que se han desarrollado en instituciones de educación superior e investigación dedicadas a estos trabajos