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Vol. 35. Issue 5.
Pages 177-183 (September 2007)
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Vol. 35. Issue 5.
Pages 177-183 (September 2007)
DOI: 10.1157/13110312
Demographic, laboratory and clinical characterisation of adult portuguese asthmatic patients
Caracterızacıón demográfıca, analítıca y clínıca de pacıentes asmátıcos adultos portugueses
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O. Lourençoa, AM. Fonsecaa, L. Taborda-Baratab
a CICS, Centro de Investiga????o em Ci??ncias da Sa??de. University of Beira Interior. Covilh??. Portugal.
b CICS, Centro de Investiga????o em Ci??ncias da Sa??de. University of Beira Interior. Covilh??. Portugal. Cova da Beira Hospital. Covilh??. Portugal.
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Figure 1. --Relationship between severity of asthma and age in allergic asthmatic (Panel A) and non-allergic asthmatic (Panel B) patients. Patients were grouped into three age groups and severity was assessed according to GINA guidelines. Severity increased with age but was not statistically different between the two groups.
Figure 2. --Prevalence of exercise-induced and cough-variant asthma in allergic (dark columns) and non-allergic (light columns) asthmatic patients. Non-allergic asthmatics had a higher prevalence of cough-variant asthma compared to allergic asthmatics.
Table. I Lung function testing values in allergic and non-allergic asthmatics
Figure 3. --Main co-morbidities associated with bronchial asthma. Allergic (dark columns) asthmatic patients had a higher prevalence of rhinitis, whereas non-allergic (light columns) asthmatic patients had a higher prevalence of drug allergy and oesophageal reflux.
Figure 4. --Cutaneous reactivity to aeroallergens in allergic asthmatics. Allergen sensitisation was evaluated by skin prick test with a battery of the most common aeroallergens in the local flora, as well as mites, moulds and animal dander.
Table. II Sensitisation profile in the allergic asthmatic patients
Figure 5. --Degree of sensitisation to aeroallergens in allergic asthmatic patients. The degree of sensitisation, as analysed by specific IgE levels, was different between the major aeroallergens.
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Background: Asthma is a heterogeneous chronic inflammatory condition characterised by reversible airway obstruction and hyperresponsiveness associated with underlying bronchial inflammation and structural changes. It represents an increasing health problem and is a huge burden on the patients, their families and society. The aim of the study was to characterise the adult asthmatic population attending a Hospital Allergy Clinic between the years of 2003 and 2006. Methods: Clinical files from the Allergy Outpatient Clinic of Cova da Beira Hospital were sequentially studied. The total population analysed included 335 female and 130 male asthmatic patients. Bronchial asthma was characterised by clinical history, skin prick testing to aeroallergens, determination of total and specific IgE and lung function testing, and classified according to international guidelines. Results: Of the patients studied, 70 % had allergic asthma, and 30 % had non-allergic asthma. When compared to allergic asthma, non-allergic asthma was more frequently associated with older age, perennial symptoms and female gender. More allergic than non-allergic asthma patients also had rhinitis and the reverse was true regarding drug allergy and oesophageal reflux. Grass pollen and mites were the major sensitisers for allergic asthmatics. The sensitisation profile was significantly different between urban- and rural-based asthmatic patients regarding tree pollen, fungi and moulds. Conclusions: In this population, rhinitis was more frequently associated with allergic than with non-allergic asthma. The two types of asthma did not differ in clinical severity or changes in lung function. Sensitisation profiles were different between the urban and rural patients.
Keywords:
Allergens
Asthma
Human
Prevalence
Rural
Urban
Antecedentes: el asma es un estado inflamatorio crónico heterogéneo, caracterizado por la obstrucción reversible de las vías aéreas e hiperreactividad asociada con la subyacente inflamación bronquial y cambios estructurales. Representa un creciente problema de salud y es una gran carga para los pacientes, sus familias y la sociedad. El objetivo de este estudio ha sido caracterizar la población de asmáticos adultos atendidos en el Clínica de Alergia del Hospital entre los años 2003 y 2006. Métodos: se estudió la documentación de los pacientes asistidos en el Ambulatorio de la Clínica de Alergia del Hospital Cova da Beira. El total de población analizada comprende 335 mujeres y 130 hombres. El asma bronquial se diagnóstico por la historia clínica, las pruebas cutáneas con aeroalergenos, la determinación de IgE total y específica y la función pulmonar, clasificándolos de acuerdo con las guías internacionales. Resultados: de los pacientes estudiados, el 70% tenían asma alérgica, y el 30% asma no alérgica. Comparando ambos grupos, el asma no alérgica estuvo asociada con mayor frecuencia con los pacientes de mayor edad, el género femenino y los síntomas perennes. Más pacientes con asma alérgica que no alérgica, también tenían rinitis, y lo contrario se observó con la alergia a medicamentos o el reflujo gastroesofágico. El polen de gramíneas y los ácaros del polvo fueron los alergenos más frecuentes en los asmáticos alérgicos. El perfil de sensibilización a polen de árboles, hongos y ácaros, fue significativamente distinto en los pacientes de la ciudad y los del área rural. Conclusiones: en esta población, la rinitis fue más frecuentemente asociada con el asma alérgica. Los dos tipos de asma no difieren en cuanto a la graveada o los cambios en la función pulmonar. Los perfiles de sensibilización fueron diferentes en el área urbana y en la rural.

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