RESUMO
In the past, asthma was considered mainly as a childhood disease. However, asthma is an important cause of morbidity and mortality in the elderly nowadays. In addition, the burden of asthma is more significant in the elderly than in their younger counterparts, particularly with regard to mortality, hospitalization, medical costs or health-related quality of life. Nevertheless, asthma in the elderly is still been underdiagnosed and undertreated. Therefore, it is an imperative task to recognize our current challenges and to set future directions. This project aims to review the current literature and identify unmet needs in the fields of research and practice for asthma in the elderly. This will enable us to find new research directions, propose new therapeutic strategies, and ultimately improve outcomes for elderly people with asthma. There are data to suggest that asthma in older adults is phenotypically different from young patients, with potential impact on the diagnosis, assessment and management in this population. The diagnosis of AIE in older populations relies on the same clinical findings and diagnostic tests used in younger populations, but the interpretation of the clinical data is more difficult. The challenge today is to encourage new research in AIE but to use the existing knowledge we have to make the diagnosis of AIE, educate the patient, develop a therapeutic approach to control the disease, and ultimately provide a better quality of life to our elderly patients.
RESUMO
Para determinar se o tratamento com Dosauxison (dexametasona-isonicotina aerossol) ou cetotifeno inibe reaçöes asmáticas e o aumento da hiperreatividade das vias aéreas induzidos pelo diisocianato de tolueno (TDI), estudamos seis pessoas sensibilizadas que apresentavam reaçöes asmáticas duais ou retardadas à inalaçäo de TDI. Três delas eram atópicas e três näo. Foram administrados por sete dias, antes da provocaçäo com TDI (0,010-0,015 ppm por 10-30 min) e em semanas bem distanciadas uma da outra, Dosauxison (quatro puffs 2 vezes/dia, i. e., 0,5 mg 2 vezes/dia, os últimos quatro puffs 30 minutos antes da inalaçäo de TDI), ou cetotifeno (1 mg 2 vezes/dia, oral), ou placebo, de acordo com uma estrutura estatística de simples cego e placebo no controle. Quando as pessoas foram tratadas com cetotifeno ou placebo, o VEF1 diminuiu marcadamente e a hiperreatividade aumentou após exposiçäo ao TDI. Pelo contrário, quando receberam Dosauxison, a queda do VEF, após o TDI foi significativamente menor. Esses resultados sugerem que o Dosauxison aerossol é altamente efetivo na asma provocada pelo TDI