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1.
ARS med. (Santiago, En línea) ; 47(4): 69-80, dic. 26, 2022.
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1451723

RESUMO

Introducción: la fibromialgia (FM) es una enfermedad crónica caracterizada por dolor musculoesquelético y un espectro de síntomas somáticos. Se asocia a un alto costo y compromiso en la calidad de vida de los pacientes, razón por la que es necesaria una política pública en atención primaria de salud (APS) en Chile, que contribuya con el diagnóstico temprano, tratamiento y seguimiento. Métodos: revisión bibliográfica narrativa centrada en las características de la FM, tratamiento y políticas públicas vigentes (Chile, España y Uru-guay), utilizando PubMed, Cochrane, Epistemonikos, Google Scholar y GreyLit. La búsqueda se realizó desde el 3 de septiembre al 11 de diciembre de 2020. Resultados: la prevalencia global de la FM alcanza el 2,7%, con una proporción mujeres y hombres de 3:1. Se estima una prevalencia entre 1 a 2% y un alto impacto en la calidad de vida y un alto costo asociado a discapacidad. Uruguay y España han implementado políticas públicas para FM, con enfoque principal en atención de salud integral y plan de reinserción laboral. En Chile, no existe la incorporación de la FM en ningún programa de salud que garantice el acceso y tratamiento. Conclusión: la FM es una enfermedad polisintomática, que impacta en la calidad de vida de los pacientes. Dada su prevalencia a nivel nacional, retraso en el diagnóstico e inicio de un tratamiento, se ve justificada una política pública. En el presente artículo se propone la creación de Unidades de Fibromialgia en APS, cuyas características consideren aspectos de interdisciplinaridad y territorialidad que permitan un acceso rápido a diagnóstico, tratamiento, seguimiento, derivación oportuna a especialistas y educación a los pacientes y profesionales.


Introduction: Fibromyalgia (FM) is a chronic musculoskeletal disease related to a somatic symptoms spectrum. It is associated with high economic costs and the deterioration of patients' quality of life. That explains why a public policy in the primary healthcare system (PHS) is necessary for Chile to contribute to early diagnosis, treatment, and follow-up. Methods: Narrative bibliographic review, focused on the FM clinical characteristics, their treatment, and current public policies about FM in Chile, Spain, and Uruguay. We utilized PubMed, Cochrane, Epistemonikos, Google Scholar, and Greylist as search engines from September 3rd to December 11th, 2020. Results: The FM global prevalence is 2.7%, with a proportion female: male 3:1, and in Chile is between 1.1% to 3.9%, with a high impact on the quality of life and high cost related to disability. Uruguay and Spain have implemented public policies about FM, especially in diagnosis and treat-ment. In Chile, there are not any health programs that guarantee access and early treatment to FM. Conclusion: FM is a polysymptomatic disease, which impacts to quality of life of patients. Given its prevalence in Chile, and the delay in diagnosis and treatment, a public policy is justified. This article proposes the creation of Fibromyalgia Units in PHC whose characteristics consider aspects of interdisciplinary and territorial that allow access and opportune treatment to FM, follow-up, timely referral to specialists, and pain education to patients.

2.
Expert Opin Pharmacother ; 21(18): 2293-2303, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32808830

RESUMO

INTRODUCTION: Human respiratory syncytial virus (hRSV) is the primary viral cause of respiratory diseases, leading to bronchiolitis and pneumonia in vulnerable populations. The only current treatment against this virus is palliative, and no efficient and specific vaccine against this pathogen is available. AREAS COVERED: The authors describe the disease symptoms caused by hRSV, the economic and social impact of this infection worldwide, and how this infection can be modulated using pharmacological treatments, preventing and limiting its dissemination. The authors discuss the use of antibodies as prophylactic tools -such as palivizumab- and the use of nonspecific drugs to decrease the symptoms associated with the infection -such as bronchodilators, corticoids, and antivirals. They also discuss current vaccine candidates, new prophylactic treatments, and new antivirals options, which are currently being tested. EXPERT OPINION: Today, many researchers are focused on developing different strategies to modulate the symptoms induced by hRSV. However, to achieve this, understanding how current treatments are working and their shortcomings needs to be further elucidated.


Assuntos
Corticosteroides/uso terapêutico , Antivirais/uso terapêutico , Broncodilatadores/uso terapêutico , Infecções por Vírus Respiratório Sincicial/tratamento farmacológico , Vacinas contra Vírus Sincicial Respiratório , Vírus Sincicial Respiratório Humano/efeitos dos fármacos , Corticosteroides/administração & dosagem , Corticosteroides/efeitos adversos , Anticorpos Monoclonais Humanizados/administração & dosagem , Anticorpos Monoclonais Humanizados/efeitos adversos , Anticorpos Monoclonais Humanizados/uso terapêutico , Antivirais/administração & dosagem , Antivirais/efeitos adversos , Broncodilatadores/administração & dosagem , Broncodilatadores/efeitos adversos , Humanos , Palivizumab/administração & dosagem , Palivizumab/efeitos adversos , Palivizumab/uso terapêutico , Infecções por Vírus Respiratório Sincicial/imunologia , Infecções por Vírus Respiratório Sincicial/prevenção & controle , Infecções por Vírus Respiratório Sincicial/virologia , Vírus Sincicial Respiratório Humano/imunologia , Proteínas Virais/antagonistas & inibidores , Proteínas Virais/imunologia
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