RESUMO
BACKGROUND: Exercise-induced asthma is a transitory bronchospasm, which occurs after 6 to 8 minutes of continuous exercise. Diagnosis is done by a suggestive clinical history and by 15 to 20% post-challenge fall in FEV1. It happens in about 6 to 13% of general population, 90% of asthmatic individuals and 40% of individuals with allergic rhinitis. OBJECTIVE: To know the frequency of asthma induced by exercise in a group of asthmatic children and teenagers who went to a summer camp. MATERIAL AND METHODS: A cross-sectional, descriptive and observational study, which included 33 patients suffering from intermittent mild asthma, was based on espirometric measurements made before and after 8 minutes of continuous exercise (running). None of them had previous diagnosis of exercise-induced asthma. FEV1 greater than or equal to 15% was considered exercise-induced asthma. The test was performed at a room temperature of 73F and humidity of 40%. All patients were asymptomatic before the study and were given short-acting inhaled beta2-agonists as rescue medication, which was not administered during the 12 previous hours to the test. Data analysis was made by means of descriptive statistic. RESULTS: Thirty-three children aged 8-16 years with diagnosis of asthma were studied, with an average age of 12.5 years; 42.4% were female and 57.5% male. Of the 33 patients, 6 had (18.2%) a 15% fall in FEV1 after exercise; 50% of these patients showed exercise-induced mild asthma, 33% moderate and 17% severe. At the end of the test, in six patients (100%) FEV1 increased by 15%, five minutes after the administration of a beta2-agonist. CONCLUSIONS: Exercise-induced asthma is frequent among asthmatic pediatric patients, occurring in 18.8% of this study. Likelihood of having exercise-induced asthma must be deliberately investigated in all asthmatic patients, in order to establish an opportune diagnosis of this condition and provide recommendations of preventing therapy.
Assuntos
Asma Induzida por Exercício/epidemiologia , Acampamento , Adolescente , Agonistas de Receptores Adrenérgicos beta 2 , Agonistas Adrenérgicos beta/uso terapêutico , Antiasmáticos/uso terapêutico , Asma/tratamento farmacológico , Asma/epidemiologia , Asma Induzida por Exercício/diagnóstico , Asma Induzida por Exercício/tratamento farmacológico , Asma Induzida por Exercício/prevenção & controle , Criança , Estudos Transversais , Teste de Esforço , Feminino , Volume Expiratório Forçado , Humanos , Masculino , CorridaRESUMO
BACKGROUND: The Global Initiative for Asthma (GINA) is a collaborative effort to disseminate updated guidelines about the diagnosis and management of patients that suffer from asthma. Implementation of these guidelines by the primary care practitioners reduces the morbidity of these patients. OBJECTIVE: To evaluate the efficacy of a training course of asthma on the knowledge of the primary care physicians. PATIENTS AND METHODS: Sixty physicians were evaluated before and after a lecture-based educational intervention on asthma. The overall score and per-topic subscores were compared. Likewise, differences among physicians from distinct specialties were assessed. The correlation between perceived and actual usefulness was calculated. RESULTS: The mean score before the training course was of 65.76 (SD = 11.95) points, and after the course of 84.87 (SD = 9.27) points; p < 0.0001. The mean improvement percentage was of 34.48% for the overall score, 41.47% for general knowledge, 47.57% for diagnosis and 28.4% for treatment. Improvement had no relation with physician's specialty. The correlation between perceived and actual usefulness was of -0.005 (p > 0.05) for the absolute score change and 0.025 (p>0.05) for the percentage change. CONCLUSIONS: A short lecture-based training course of asthma increases the knowledge of bronchial asthma and GINA guidelines among primary health care physicians. Differences among physicians of distinct specialties were not significant.