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      Control de asma bronquial en niños y adolescentes atendidos en establecimientos de salud de Chiclayo Translated title: Control of bronchial asthma in children and adolescents treated in health facilities in Chiclayo

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          Abstract

          RESUMEN Introducción: El asma es un problema frecuente en la niñez y adolescencia y es importante su adecuado control. Objetivos: Estimar el nivel de control de asma en niños y adolescentes atendidos en establecimientos de salud. Métodos: Estudio censal de tipo transversal descriptivo realizado en la ciudad de. Chiclayo, entre julio-diciembre 2013. Se incluyeron menores de edad de 5 a 18 años con diagnóstico de asma. Se identificaron a los pacientes en la base de datos de la red de salud Lambayeque y se les realizó una visita domiciliaria donde se les invitó al estudio y se aplicó el instrumento de evaluación. Resultados: Se identificaron 203 pacientes, se contactaron y reclutaron 107 individuos. Se incluyeron 89 (83,2 %) niños y 18 (16,8 %) adolescentes con una mediana de edad de 7 (p25= 5/p75= 9) años y 15 (p25= 15/p75= 17) años, respectivamente. Según el puntaje del instrumento de evaluación: 52 (48,6 %) estaban mal controlados; 46 (43,0 %) parcialmente controlados; y 9 (8,4 %), bien controlados. En el caso de los niños, la frecuencia de “no control” fue de 48,3 %, “parcialmente controlado” 43,8 % y “controlado” 7,9 %; y en los adolescentes fue de 50,0; 38,9 y 11,1 %, respectivamente. Se observó una relación significativa entre el nivel de control y el nivel educativo del cuidador en niños (p= 0,006) y adolescentes (p= 0,005). Conclusiones: Se demuestra una frecuencia elevada de control inadecuado de asma, lo cual contrasta con otras realidades similares donde hay una mayor frecuencia de control.

          Translated abstract

          ABSTRACT Introduction: Asthma is a common problem in childhood and adolescence and is important its adequate control. Objectives: To estimate the level of asthma control in children and adolescents treated in health facilities. Methods: Census data of descriptive cross-sectional type study conducted in the city of Chiclayo, from July to December, 2013. There were included children from 5 to 18 years diagnosed with asthma. Patients were identified in the database of Lambayeque health network and underwent a home visit where they were invited to the study and it was applied the assessment instrument. Results: 203 patients were identified, and there were contacted and recruited 107 individuals. 89 (83.2%) children and 18 (16.8%) adolescents were included with a mean age of 7 (p25= 5/p75= 9) and 15 (p25= 15/p75= 17) years, respectively. According to the score of the assessment instrument: 52 (48.6%) were poorly controlled; 46 (43.0%) partially controlled; and 9 (8.4%), well-controlled. In the case of children, the frequency of “no control" was of 48.3%, "partially controlled" was 43.8% and "controlled” was 7.9%; and in the adolescents, it was 50.0, 38.9 and 11.1%, respectively. It was observed a significant relationship between the level of control and the educational level of the caregiver in children (p= 0.006) and adolescents (p= 0.005). Conclusions: It is demonstrated the high frequency of inadequate control of asthma, which contrasts with other similar realities where there is a greater frequency of control.

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          The International Study of Asthma and Allergies in Childhood (ISAAC) Phase Three: a global synthesis.

          This ISAAC Phase Three synthesis provides summarised information on the main findings of the study, regional tables and figures related to the prevalence and severity of current symptoms of asthma, rhinoconjunctivitis and eczema in the main regions of the world. The large number of surveyed children (≈1,200,000), the large number of centres (233) and countries (98) that participated in ISAAC Phase Three makes this study the most comprehensive survey of these diseases ever undertaken. Globally, the prevalence for current asthma, rhinoconjunctivitis and eczema in the 13-14-year age group was 14.1%, 14.6% and 7.3%, respectively. In the 6-7-year age group the prevalence for current asthma, rhinoconjunctivitis and eczema was 11.7%, 8.5% and 7.9%, respectively. The study shows a wide variability in the prevalence and severity of asthma, rhinoconjunctivitis and eczema which occurs not just between regions and countries but between centres in the same country and centres in the same city. This study definitively establishes that the prevalence of those diseases can be very high in non-affluent centres with low socioeconomic conditions. The large variability also suggests a crucial role of local environment characteristics to determine the differences in prevalence between one place and another. Thus, ISAAC Phase Three has provided a large body of epidemiological information on asthma, rhinoconjunctivitis and eczema in childhood from contrasting environments which is expected to yield new clues about the aetiology of those conditions and reasons for their marked global variability. Copyright © 2012 SEICAP. Published by Elsevier Espana. All rights reserved.
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            Compliance, adherence, and concordance: implications for asthma treatment.

            Rob Horne (2006)
            Good-quality outcomes in asthma hinge not just on the availability of medications but also on their appropriate use by patients: optimal "self-management." In asthma, low rates of adherence to prophylactic (preventer) medication are associated with higher rates of hospitalization and death. Many patients choose not to take their medication because they perceive it to be unnecessary or because they are concerned about potential adverse effects. Approximately one third of asthma patients have strong concerns about adverse effects from inhaled corticosteroids (ICS). These concerns are not just related to the experience of local symptoms attributed to ICS side effects, but also include more abstract concerns about the future, arising from the belief that regular use of ICS will result in adverse long-term effects or dependence. We need more effective ways of eliciting and addressing patients' concerns about ICS. The development of ICS options with an improved safety profile remains a key objective. However, the ideal solution is not just pharmacologic. We also need more effective ways of communicating the relative benefits and risks to patients in order to facilitate informed adherence. Clinicians must be prepared to work in an ongoing partnership with patients to ensure that they are offered a clear rationale as to why ICS are necessary and to address their concerns about potential adverse effects. This approach, based on a detailed examination of patients' perspectives on asthma and its treatment, and an open, nonjudgmental manner on the part of the clinician, is consistent with the idea of concordance.
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              Difficult asthma: people's perspectives on taking corticosteroid therapy

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                Author and article information

                Journal
                ped
                Revista Cubana de Pediatría
                Rev Cubana Pediatr
                Editorial Ciencias Médicas (Ciudad de la Habana, , Cuba )
                0034-7531
                1561-3119
                June 2020
                : 92
                : 2
                : e834
                Affiliations
                [2] Lima Lima orgnameUniversidad Científica del Sur orgdiv1Facultad de Ciencias de la Salud Peru
                [1] Chiclayo Lambayeque orgnameUniversidad Católica Santo Toribio de Mogrovejo orgdiv1Facultad de Medicina Peru
                Article
                S0034-75312020000200007 S0034-7531(20)09200200007
                3080bc34-cfd0-467f-9bd9-3f19766054a6

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 26 January 2020
                : 23 February 2019
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 17, Pages: 0
                Product

                SciELO Cuba

                Categories
                ARTÍCULOS ORIGINALES

                niño,adolescente,asthma,prevention of diseases,child,adolescent,asma,prevención de enfermedades

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