Background: In allergic rhinitis, a relevant outcome providing information on the effectiveness of interventions is needed. In MASK-air (Mobile Airways Sentinel Network), a visual analogue scale (VAS) for work is used as a relevant outcome. This study aimed to assess the performance of the work VAS work by comparing VAS work with other VAS measurements and symptom-medication scores obtained concurrently. Methods: All consecutive MASK-air users in 23 countries from 1 June 2016 to 31 October 2018 were included (14 189 users; 205 904 days). Geolocalized users selfassessed daily symptom control using the touchscreen functionality on their smart phone to click on VAS scores (ranging from 0 to 100) for overall symptoms (global), nose, eyes, asthma and work. Two symptom-medication scores were used: the modified EAACI CSMS score and the MASK control score for rhinitis. To assess data quality, the intra-individual response variability (IRV) index was calculated. Results: A strong correlation was observed between VAS work and other VAS. The highest levels for correlation with VAS work and variance explained in VAS work were found with VAS global, followed by VAS nose, eye and asthma. In comparison with VAS global, the mCSMS and MASK control score showed a lower correlation with VAS work. Results are unlikely to be explained by a low quality of data arising from repeated VAS measures. Conclusions: VAS work correlates with other outcomes (VAS global, nose, eye and asthma) but less well with a symptom-medication score. VAS work should be considered as a potentially useful AR outcome in intervention studies.
ResumoObjetivos: Rever conceitos, gravidade e planos de tratamento a longo prazo da asma na criança.Método: Identificar os agentes desencadeantes e/ou agravantes dos quadros agudos de asma e classificá-la para permitir-se o estabelecimento de um plano de tratamento a longo prazo.Resultado: Classificada como leve, moderada e grave, a asma terá planos distintos de manejo, ficando a abordagem com agentes antiinflamatórios reservada às formas moderada e grave.Conclusões: No tratamento do paciente asmático, a identificação e o controle dos agentes etiológicos e dos possíveis agravantes é parte fundamental. A via inalatória é a mais adequada para a administração de fármacos a pacientes asmáticos. As principais drogas habitualmente utilizadas no tratamento da asma são revistas e o emprego precoce de glicocorticosteróides inalados tem sido recomendado pela maioria dos autores.J. pediatr. (Rio J.). 1998; 74 (Supl.1): S48-S58: asma, alérge-nos, criança, tratamento, terapia inalatória, imunoterapia. AbstractObjectives: To review concepts, classification based on severity, and long term treatment for children with asthma.Methods: To identify precipitating factors of acute asthma attacks and classify the disease in order to establish long term treatment.Results: Different plans of management according to its classification: mild, moderate and severe asthma. Antiinflammatory therapy is reserved to moderate and severe asthma.Conclusions: The identification and control of the etiologic and precipitating factors are important tasks in the management of asthma. The inhalatory route is the most appropriate to treat patients suffering from asthma. The usual drugs indicated in asthma treatment are reviewed. Precocious treatment with inhaled glucocorticosteroids is recommended by several authors. J. pediatr. (Rio J. IntroduçãoA asma é definida pelo II Consenso Brasileiro no Manejo da Asma como uma doença crônica das vias aéreas caraterizada por a) obstrução ao fluxo aéreo reversível (embora não completamente em alguns pacientes) espontaneamente ou com tratamento; b) inflamação em que muitas células têm um papel importante, em particular mastócitos e eosinófilos; c) aumento da reatividade das vias aéreas a uma variedade de estímulos (hiper-responsividade brônquica = HRB); d) episódios recidivantes de sibilância, dispnéia, aperto no peito e tosse, particularmente à noite e pela manhã ao acordar 1 .A análise de fragmentos de mucosa brônquica obtidos por endoscopia, mesmo de indivíduos com asma leve e de início recente, ou por autópsia de indivíduos asmáticos falecidos durante episódio agudo, revela alterações características que variam de intensidade segundo a gravidade da asma. Estas alterações incluem: a) infiltração da mucosa e submucosa com células inflamatórias (especialmente eosinófilos e linfócitos T), b) descamação irregular do epitélio, c) espessamento da musculatura lisa da via aérea, d) fibrose subepitelial, e) hiperplasia de glândulas mucosas e de células caliciformes e f) tampões mucosos disseminados na asma fatal 2,3 .O p...
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