Repositório Institucional - Unifesp :: Navegando por Palavras-chave "asma"

Navegando por Palavras-chave "asma"

Agora exibindo 1 - 13 de 13

Acesso aberto (Open Access)
Asthma in children and adolescents in Brazil: contribution of the International Study of Asthma and Allergies in Childhood (ISAAC)
(Sociedade de Pediatria de São Paulo, 2014-03-01) Solé, Dirceu [UNIFESP]; Camelo-Nunes, Ines Cristina; Wandalsen, Gustavo Falbo [UNIFESP]; Mallozi, Marcia Carvalho [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
Objective:To assess asthma among Brazilian pediatric population applying the International Study of Asthma and Allergies in Childhood (ISAAC), an internationally standardized and validated protocol.Data sources:ISAAC was conceived to maximize the value of epidemiologic studies on asthma and allergic diseases, establishing a standardized method (self-applicable written questionnaire and/or video questionnaire) capable to facilitate the international collaboration. Designed to be carried out in three successive and dependent phases, the ISAAC gathered a casuistic hitherto unimaginable in the world and in Brazil. This review included data gathered from ISAAC official Brazilian centers and others who used this method.Data synthesis:At the end of the first phase, it has been documented that the prevalence of asthma among Brazilian schoolchildren was the eighth among all centers participating all over the world. Few centers participated in the second phase and investigated possible etiological factors, especially those suggested by the first phase, and brought forth many conjectures. The third phase, repeated seven years later, assessed the evolutionary trend of asthma and allergic diseases prevalence in centers that participated simultaneously in phases I and III and in other centers not involved in phase I.Conclusions:In Brazil, the ISAAC study showed that asthma is a disease of high prevalence and impact in children and adolescents and should be seen as a Public Health problem. Important regional variations, not well understood yet, and several risk factors were found, which makes us wonder: is there only one or many asthmas in Brazil?
Somente Metadadados
Avaliação de risco futuro em uma coorte de asmáticos regularmente tratados: análise de cluster
(Universidade Federal de São Paulo (UNIFESP), 2013-04-24) Dracoulakis, Samir da Silva [UNIFESP]; Fernandes, Ana Luisa Godoy Fernandes [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
BACKGROUND: Asthma is a heterogeneous disorder consisted of several phenotypes. The characterization of phenotypes related to future risks might improve our understanding of the asthma pathophysiology, which leads to the reduction of long-term complications. OBJECTIVES: to describe the phenotype related to the occurrence of future risks. METHODS: We conducted a cluster analysis to describe the phenotype associated with future risks in a prospective cohort study of moderate and severe asthma outpatients. We recorded clinical characteristics (age, sex, atopy, BMI, asthma onset and duration of asthma, frequency of exacerbations, control level during routine visits and adverse effects), functional parameters (spirometry before and after bronchodilator), nasal lavage and sputum induced cytology at the beginning of the cohort and for at least a four-year-follow up period. RESULTS: Of the 70 patients, 55 were reassessed in the cohort. The cluster analysis identified two distinct clusters: stable not eosinophilic and unstable eosinophilic. The latter were predominantly male (p <0.001), younger (p <0.001), earlier onset of asthma (p = 0.046), and increased eosinophils cell count in both induced sputum (p <0.001) and nasal lavage (p <0.001). The unstable eosinophilic cluster showed greater clinical instability (p <0.001), more moderate and severe exacerbations per year (p = 0.012 and p = 0.036, respectively), and a shorter time to first severe exacerbation (p = 0.035). There was neither difference in accelerated decline in lung function nor inhaled corticosteroids side effects. CONCLUSIONS: The airway eosinophilia was a feature for unstable eosinophilic phenotype pointing to a higher occurrence of future risk in asthma.
Acesso aberto (Open Access)
Broncoprovocação com solução salina hipertônica em crianças asmáticas
(Sociedade de Pediatria de São Paulo, 2012-09-01) Costa, Cínthia Maria Xavier [UNIFESP]; Lanza, Fernanda de Cordoba [UNIFESP]; Solé, Dirceu [UNIFESP]; Centro Universitário de Ensino Superior de Maceió; Universidade Nove de Julho; Universidade Federal de São Paulo (UNIFESP)
OBJECTIVE: To verify if the bronchoprovocation test with 4.5% hypertonic saline solution allows to detect the gradient of response in asthmatic children and adolescents, according to asthma severity. METHODS: 75 asthmatic patients aged six to 18 years-old were evaluated in this cross-sectional study. They were classified according to asthma severity in: intermittent or mild persistent (IM) and moderate or severe persistent (MS). They were also classified according to sensitization to inhaled allergens in atopics: positive skin prick test to Dermatophagoides pteronyssinus, D. farinae and Blomia tropicalis; or non- atopic with negative skin prick tests. All patients underwent a bronchoprovocation test with 4.5% hypertonic saline solution. The result of the bronchoprovocation test was considerd positive if at least a reduction of 20% in the forced expiratory volume in one second (FEV1) was noted. RESULTS: 60 individuals were atopic. The bronchoprovocation test was positive more frequently in the MS group than in the IM one (93 versus 65%). Less time was needed for a 20% fall of FEV1 in the MG compared to the IL group [90 (30 - 330) versus 210 (30 - 690) seconds; p<0.05]. The percentage of FEV1 fall was higher in the MG group than in the IL one [26,4% (14 - 63) versus 20% (0 - 60); p<0.05]. CONCLUSIONS: The 4.5% hypertonic saline solution bronchoprovocation test is safe and easy to perform. It detects a gradient of response in asthmatic children and adolescents regarding asthma severity. Higher frequency of positive tests, shorter time for FEV1 fall, and higher percentage of FEV1 fall were observed in moderate and severe asthmatic patients.
Acesso aberto (Open Access)
Corticosteróides inalados no tratamento da alergia respiratória: segurança versus eficácia
(Sociedade Brasileira de Pediatria, 2006-11-01) Rizzo, Maria Cândida V. [UNIFESP]; Solé, Dirceu [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
OBJECTIVE: Review the molecular mechanisms of action, efficacy, and potential side effects associated with inhaled corticosteroids (ICS) in children with persistent asthma. SOURCES: Articles in English from MEDLINE. The following terms were used: corticosteroids, inhaled corticosteroids, asthma, children, beclomethasone, fluticasone, budesonide, ciclesonide, growth, adrenal insufficiency, bone mineral density, and oral candidiasis. Treatment guidelines, review articles, controlled trials, meta-analyses, and systematic reviews evaluating the efficacy and the adverse events of treatment with ICS were selected. SUMMARY OF THE FINDINGS: In vivo and in vitro studies show that the available ICS have different pharmacokinetic and pharmacodynamic properties that result in different action potentials. ICS also differ as to the systemic and local side effects. The bioavailability of these products is essential in order to determine the incidence of side effects. In general, ICS are capable of controlling asthma, reducing the number of exacerbations, medical consultations, hospitalizations, and the need of oral corticosteroid (applications) bursts. Improvement can also be seen in pulmonary function, especially in patients with recent onset asthma. The most documented adverse effect is transitory decrease of growth rate. CONCLUSIONS: ICS are the main anti-inflammatory agent used to treat persistent asthma. When administered in low doses, they seem to be safe and effective. Patient monitoring allows for early detection of possible side effects associated with ICS.
Acesso aberto (Open Access)
Educação permanente com agentes comunitários de saúde: uma proposta de cuidado com crianças asmáticas
(Fundação Oswaldo Cruz, Escola Politécnica de Saúde Joaquim Venâncio, 2012-06-01) Coriolano, Maria Wanderleya de Lavor; Lima, Marinus de Moraes; Queiroga, Bianca Arruda Manchester de; Ruiz-Moreno, Lidia [UNIFESP]; Lima, Luciane Soares de; Universidade Federal de Pernambuco Departamento de Enfermagem; Universidade Federal do Ceará; Universidade Federal de Pernambuco Departamento de Fonoaudiologia; Universidade Federal de São Paulo (UNIFESP)
The use of active methods in the health worker training process is a guideline that is recommended under the National Continuing Education in Health Policy (PNEPS) for National Health System (SUS) employees. In this study, the authors created an educational intervention for community health agents (CHA) regarding care aimed at children/families with asthma. The aim is to describe an educational action involving community health workers about asthmarelated knowledge, adopting the National Policy on Continuing Education in Health in the context of primary care. This was a 'quantiqualitative' study, with pretest and posttest assessments filled in by the community health workers them-selves, in addition to active approaches in three experiential focus groups, which had their activities recorded and transcribed for later data analysis using the content analysis methodology in accordance with the thematic mode proposed by Bardin. The CHA's knowledge about the myths related to asthma increased after the educational activity. The following themes emerged from the focus groups: Health education for the prevention of respiratory diseases; Meaning attributed to asthma; Firecrackers: demystifying concepts; Trigger factors for asthma; Adapting preventive care; Assessing the knowledge built. The use of active methodologies favored the development of skills among the CHAs, arousing motivation in the educational approach with children/families with asthma.
Somente Metadadados
Estudo sobre a participação dos linfócitos t invariantes “natural killer” na inflamação alérgica pulmonar
(Universidade Federal de São Paulo (UNIFESP), 2015-06-30) Andrade, David Anibal Garrido [UNIFESP]; Keller, Alexandre de Castro Keller [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
Objectives:1. Study the influence of iNKT cells on the frequency and suppressoractivity of regulatory T lymphocytes(Treg) during the development of allergic asthma. 2. Study the influence of regulatory T lymphocytes on iNKT cells activation and the impact on allergic asthma development. 3. Study the role of iNKT cells in the immunologic response to Blomia tropicalis mite and the influence on allergic asthma severity. Methods/Results: For the induction of allergic asthma, mice were sensitized with ovalbumin (OVA) adsorbed ontoalumin um hydroxide and challenge with OVA intranasal lly. To study the influence of iNKT cells on regulatory T lymphocytes, we used C57BL/6 WT or J?18-/- Knock In Foxp3 gfp mice strains. Our data show that the presence of iNKT cells during asthma development does Not influence the frequency of Treg lymphocytes, indicating that iNKT cells do not these lymphocytes. In line with this idea, the reconstitution of CCR4-/- animals with T reg lymphocytes from WT ou J?18-/- allergic mice show ed that iNKT cells do not hamper the suppressor activity of these lymphocytes. T o determine the activity of Bt antigens on the iNKT cells and its influence on allergic asthma, the C57BL/6J or BALB/c mice from WT or J?18-/- strains were sensitized with OVA and challenge with OVA or OVA + Bt. To study the acute phase of the allergic response, animals were euthanized 24h after the last challenge. To study the effect of Bt antigens on the memory responses to OVA challenge, these experimental groups were re-challenged with OVA, one week apart. Our data show that Bt antigens lead to an iNKT-independent acute neutrophilic inflammation. In contrast, the data concerning the re-challenge wit OVA, demonstrate that the exposition to Bt antigens affected the antigen-dependent inflammatoryresponse. The exposition to the Bt extract changed the classic OVA-dependent eosinophilic inflammation toward a neutrophilic response. This phenomenon seems to be iNKT dependent because the OVA-dependent airway neutrophilia was impaired in the J?18-/- animals, in comparison to WT mice. Moreover, the exposure to Bt resulted in a granulomatous inflammation, with a strong presence of giant cells. Conclusions: Our results strength the idea that iNKT cells play an important Role in the allergic asthma pathology, probably due the direct contr ibution to the Th2 polarization. In this context, Blomia tropicalis mite antigens exertan adjuvant activity on iNKT cells,which affect the antigen - specific response and disease pathology. Allergic animals exposed to Bt antigens presented with an important airway neutrophilia in association with the development of allergic granulomatosis, associating Bt and iNKT with asthma severity.
Somente Metadadados
Fatores associados ao desenvolvimento de asma e doenças alérgicas e sensibilização a aeroalérgenos em adolescentes da Região Centro-Sul de São Paulo/SP
(Universidade Federal de São Paulo (UNIFESP), 2015-03-07) Furlan, Fernanda Patini [UNIFESP]; Sole, Dirceu Sole [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
Objective: To determine the prevalence of asthma and rhinoconjunctivitis, identify factors associated with its manifestation and sensitization in teenagers center south region of São Paulo Second Protocol of the International Study of Asthma and Allergies in Childhood (ISAAC). Methods: Were randomly selected 600 adolescents (13-14 years) between 2459 adequately answered the questionnaire ISAAC. Affirmative and negative answer to the question "have you had wheezing in the last 12 months," defined active asthma (AA) and non-asthmatics (NA), respectively. Affirmative answer to the question "was sneezing, runny nose or nasal obstruction, watery or itchy eyes?" set rhinoconjunctivitis. AA and NA answered supplementary questionnaire ISAAC, underwent skin test allergens and compared as the factors associated with the manifestation of asthma and rhinoconjunctivitis, including sensitization (at least one positive test). Multivariate analysis results were expressed as odds ratios (OR) and 95% confidence intervals (95% CI). Results: Among the total number of adolescents, 21.1% and 29.6% had AA and rhinoconjunctivitis, respectively. Already, of 24.7% (139/562) of AA who continued in the study 55.4% had rhinoconjunctivitis. Associated to the AA manifestation: allergic sensitization (OR = 2.55, 95 %%: 1.53 to 4.24), rhinoconjunctivitis (OR = 1.97, 95% CI: 1.2 to 3.26) and smoking mother (OR = 1.87, 95% CI: 1.04 to 3.36); and rhinoconjunctivitis: have AA (OR = 2.06, 95% CI: 1.25 to 3.38) and attending day care (OR = 1.67, 95% CI: 1.07 to 2.60). The sensitization to airborne allergens rate was 47.7%, and D.pteronyssinus B.tropiclais being the most frequent. Conclusion: Asthma and rhinoconjunctivitis are highly prevalent among adolescents living in the south-central region of São Paulo. Rhinoconjunctivitis, sensitization and tobacco household exposure are crucial in the manifestation of asthma.
Acesso aberto (Open Access)
Função pulmonar em pacientes asmáticos com Síndrome da Apneia Obstrutiva do Sono: um estudo observacional transversal
(Universidade Federal de São Paulo (UNIFESP), 2016-12-21) Fransolin, Carolina [UNIFESP]; Carvalho, Luciane Bizari Coin de [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
Context. Asthma and Obstructive Sleep Apnea Syndrome are diseases which compromise respiratory function and interfere in lung mechanics as well as the quality of sleep. OSAS is a major factor in asthma exacerbations, it is necessary to investigate the relationship between asthma and OSA through examinations which assess and promote effective responses to questions. Objective. To evaluate and compare the pulmonary functional impairment through the variables Peak Expiratory Flow (PEF), Forced Expiratory Volume in the first second (FEV1), and Forced Vital Capacity (FVC). To evaluate and compare the daytime sleepiness in a sample of patients with asthma attack with OSAS and without OSAS in the emergency room and after 7 days of treatment. Methods. Sixty patients in asthma attacks moderate or severe, we included 24 patients who sought the emergency and emergency service of the São Paulo Hospital of the Escola Paulista de Medicina of the Federal University of São Paulo. Initially, PEF values less than 50% of the product according to age, height and sex were indispensable for the insertion of the patients in the research. Subsequently, all patients underwent pulmonary function tests in the initial 30 minutes in the emergency room after 4 hours and on return after 7 days. Sleepiness scales (Stanford Sleepiness Scale - SSS and Epworth Sleepiness Scale - ESS) were filled at the initial care and at 7-day follow-up. The polysomnography to diagnose the presence of OSAS was performed after 15 days of treatment. Results. The values of PEF, FEV1 and FVC of asthmatic patients with OSAS were lower when compared to asthmatic patients without OSAS at the initial evaluation (emergency room) and after seven days of follow-up (p <0.05). Patients with OSAS did not improve drowsiness after 7 days, but after the same period, patients without OSAS presented improvement in sleepiness, as measured by the Stanford scale. Asthmatic patients with OSAS were older than asthmatic patients without OSAS Conclusion. Asthmatic patients with OSA have greater impairment of lung function than asthmatic patients without OSA. Patients with OSA did not improvement in sleepiness after 7 days of treatment. Patients with OSA is older than patients without OSA.
Acesso aberto (Open Access)
Giardia lamblia e alergia respiratória: estudo em uma amostra de crianças de área urbana com frequência elevada da protozoose
(Sociedade Brasileira de Pediatria, 2012-06-01) Souza, Valdênia M. O.; Sales, Iana R. F.; Peixoto, Décio Medeiros [UNIFESP]; Costa, Vláudia M. Assis; Rizzo, José A.; Silva, Almerinda R.; Camilo, Roberta Faria [UNIFESP]; Pierotti, Felipe Faria; Solé, Dirceu [UNIFESP]; Sarinho, Emanuel S. C.; Universidade Federal de Pernambuco Laboratório de Imunopatologia Keizo Asami; UFPE Laboratório de Imunopatologia Keizo Asami; UFPE Hospital das Cínicas Imunologia; UFPE Hospital das Clínicas Imunologia; UFPE Hospital das Clínicas; Universidade Federal de São Paulo (UNIFESP); UFPE; UFPE Programa de Pós-graduação em Ciências da Saúde
OBJECTIVES: There is a high incidence of intestinal parasite infection in urban areas in the Northeast of Brazil. Giardia lamblia infections have been associated with increased prevalence of cutaneous allergies and gastrointestinal disorders. However, little is known about the relationship between giardiasis and allergic diseases of the airways. The present study aimed to investigate the possible association between respiratory allergic diseases and infections by G. lamblia in children from urban areas. METHODS: This study recruited 110 patients of both sexes aged 5-15 years. Patients were administered a questionnaire evaluating clinical symptoms and were given skin tests, parasite tests and serum tests. RESULTS: A high incidence of G. lamblia was observed (45%, 50/110). Infections by this protozoan were not associated with increased risk of respiratory allergy (p = 0.075), high total IgE levels (p = 0.701), positive specific IgE tests (p = 0.250), or positive skin tests for a range of environmental allergens (p = 0.239). CONCLUSION: This study demonstrated that symptoms of asthma, skin allergy and serum markers were not associated with G. lamblia infections in this sample of children from urban areas.
Acesso aberto (Open Access)
Prevalência de sibilância recorrente em lactentes
(Sociedade Brasileira de Pediatria, 2007-08-01) Chong Neto, Herberto José; Rosario Filho, Nelson Augusto; Solé, Dirceu [UNIFESP]; Mallol, Javier; Universidade Federal do Paraná Hospital de Clínicas; Universidade Federal de São Paulo (UNIFESP); Universidade de Santiago do Chile
OBJECTIVE: To identify the prevalence of recurrent wheezing in infants in the city of Curitiba, PR, Brazil. METHODS: A cross-sectional study carried out by means of administering questionnaires to the parents of infants aged 12 to 15 months attending health centers for immunization during the period between August 2005 and December 2006. This is a standardized and validated instrument consisting of questions on demographic characteristics, wheezing, respiratory infections and risk factors. At the time of the study the City Health Department had 107 health centers, 35 of which were selected by lots and distributed homogeneously across the municipal territory. RESULTS: A total of 1,364 infants (45.4%) had episodes of wheezing during their first 12 months of life, with onset at 5.5±3.1 months (mean ± standard deviation), and 678 (22.6%) had had three or more episodes. In 84.6% of the wheezing children treatment was with β2-agonists, with inhaled corticosteroids in 18.5%, oral corticosteroids in 24.3% and leukotriene receptor antagonists were used with 5.4%. The wheezing children exhibited nocturnal symptoms, intense difficulty breathing and visits to emergency services in the proportions of 58.9, 46.2 and 57.6%, respectively; 12.7% were admitted to hospital for asthma and 10.9% had had a medical diagnosis of asthma. Nocturnal symptoms, visits to emergency, severity of symptoms, hospital admissions for asthma and medical diagnoses of asthma were all more common among those who had suffered three or more crises (p < 0.001). CONCLUSIONS: There is an elevated prevalence of wheezing among the infants of Curitiba, with early onset and elevated morbidity. It is possible that these infants represent a large contingent of asthmatics.
Acesso aberto (Open Access)
Prevalência de sintomas de asma, rinite e eczema atópico entre crianças e adolescentes brasileiros identificados pelo International Study of Asthma and Allergies (ISAAC): fase 3
(Sociedade Brasileira de Pediatria, 2006-10-01) Solé, Dirceu [UNIFESP]; Wandalsen, Gustavo Falbo [UNIFESP]; Camelo-Nunes, Inês Cristina [UNIFESP]; Naspitz, Charles Kirov [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
OBJECTIVE: To determine the prevalence of symptoms of asthma, rhinitis, and atopic eczema among schoolchildren aged 6 to 7 years and adolescents aged 13 to 14 years in 20 Brazilian cities by using the standardized ISAAC written questionnaire, and to assess the association of this prevalence with latitude, altitude and average annual temperature of collaborating centers. METHODS: Schoolchildren and adolescents from five Brazilian regions participated in the study, totaling 23,422 ISAAC questionnaires answered by schoolchildren's parents and 58,144 questionnaires answered by adolescents. The values for latitude, altitude and average annual temperature were obtained from the Brazilian Institute of Geography and Statistics. RESULTS: The mean prevalence rates among schoolchildren and adolescents were respectively 24.3 and 19.0% for active asthma; 12.6 and 14.6% for rhinoconjunctivitis; and 8.2 and 5.0% for atopic eczema. A significant negative association was observed between latitude and physician-diagnosed asthma among schoolchildren, severe asthma, physician-diagnosed asthma, eczema and atopic eczema among adolescents. No association with altitude was found. CONCLUSIONS: The prevalence of asthma, rhinitis and atopic eczema in Brazil varies considerably. Higher prevalence rates, especially of asthma and eczema, were found at centers located closer to the equator.
Acesso aberto (Open Access)
Razão entre diâmetros torácicos para detecção de hiperinsuflação estática em crianças pela biofotogrametria
(Sociedade Brasileira de Pediatria, 2008-10-01) Ricieri, Denise da V.; Rosario Filho, Nelson Augusto; Costa, Jecilene R. [UNIFESP]; Universidade Federal do Paraná Departamento de Pediatria; UFPR Departamento de Pediatria Programa de Pós-Graduação em Saúde da Criança e do Adolescente; Universidade Federal de São Paulo (UNIFESP)
OBJECTIVES: To develop a photogrammetric method capable of identifying increases in anteroposterior chest diameters suggestive of pulmonary hyperinflation, and to test it with both asthmatic and asthma-free children. METHODS: Two distinct study designs were used to achieve these two objectives. The first was a descriptive analysis of diameters measured at the height of the axilla and of the xiphoid on digital images of 56 children aged 8 to 12 years photographed in the orthostatic position. The second was a case-control study of (a) 19 asthmatic children in treatment for at least 12 months; and (b) 37 children free from asthma with no prior history of complaints of respiratory/allergic disease. Diameters were measured on images of the front and left side views using CorelDRAW®, and the ratio between the front and side diameters was calculated for the axillary and xiphoid measurements, providing the diameter ratios. Diameter ratios close to or greater than 1 represent geometry tending towards a cylindrical shape, typical of hyperinflation on radiographs. RESULTS: Analysis with the t test for independent samples revealed a mean diameter ratio at the sternum that was significantly greater in the group of asthmatic children (p < 0.01) than the mean for the whole sample and also than the mean for the children without asthma. CONCLUSIONS: Despite the existence of disagreement on the best instruments, methods and times for identifying hyperinflation, results indicate that a system using diameter ratios obtained by photogrammetry is a promising tool for the identification of a kinesiopathological manifestation that is known to determine air entrapment in asthma patients. Research that combines clinical data with longitudinal intrapatient follow-up will be necessary to establish the strength of the evidence found in this study.
Acesso aberto (Open Access)
Remodelamento brônquico na asma
(Sociedade Brasileira de Pneumologia e Tisiologia, 2000-04-01) Mauad, Thais; Souza, Sandrini Lopes de [UNIFESP]; Saldiva, Paulo Hilário Nascimento; Dolhnikoff, Marisa; Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP)
The relationship between structure and function in asthma has been extensively studied. All the compartments of the airway have been shown to have some structural alterations contributing to functional defects. The structural alterations are thought to be a consequence of the chronic inflammation present in asthmatic airways, leading ultimately to remodeling. The decline of the ventilatory function over time in some asthmatic patients may be a consequence of airway remodeling. In this review, the authors describe the phenomena leading to airway remodeling and discuss the role of inflammatory mediators involved in this process. The structural alterations of the asthmatic airways are presented and the possible correlated functional defects are discussed.

Navegando por Palavras-chave "asma"

Resultados por página

Opções de Ordenação